Medical explanations have often been thought on the model of biological ones and are frequently defined as mechanistic explanations of a biological dysfunction. In this paper, I argue that topological explanations, which have been described in ecology or in cognitive sciences, can also be found in medicine and I discuss the relationships between mechanistic and topological explanations in medicine, through the example of network medicine and medical genetics. Network medicine is a recent discipline that (...) relies on the analysis of various disease networks in order to find organizing principles in disease explanation. My aim is to show how topological explanations in network medicine can help solving the conceptual issues that pure mechanistic explanations of the genetics of disease are currently facing, namely the crisis of the concept of genetic disease, the progressive geneticization of diseases and the dissolution of the distinction between monogenic and polygenic diseases. However, I will also argue that topological explanations should not be considered as independent and radically different from mechanistic explanations for at least two reasons. First, in network medicine, topological explanations depend on and use mechanistic information. Second, they leave out some missing gaps in disease explanation that require, in turn, the development of new mechanistic explanations. Finally, I will insist on the specific contribution of topological explanations in medicine: they push us to develop an explanation of disease in general, instead of focusing on single explanations of individual diseases. This last point may have major consequences for biomedical research. (shrink)

For at least the past several decades, medicine has been embroiled in a crisis concerning the nature of its professionalism. The fundamental questions that drive this ongoing crisis are primarily three. First, what is the nature of medical professionalism? Second, who are medical professionals? Third, what does medicine or these professionals profess or promise? In this paper, the professionalism crisis vis-à-vis these questions is examined and analyzed chiefly in terms of both Francis Peabody’s and Edmund Pellegrino’s writings. Based (...) on their writings, I introduce a conceptual framework for professionalism to address the crisis. In addition, I contend that to address the professionalism crisis adequately, medicine’s position within an evolving health care network must also be considered. To that end, I first discuss the genesis of the crisis in terms of the Flexner Report and especially Peabody’s response to it. Next, I explore how the crisis intensified during the twentieth century, particularly in terms of medicine’s ultimate scientification and eventual commercialization, and how Pellegrino reacted to this. I then propose a health care professionalism cycle and a care-competence cycle to provide a conceptual framework for addressing the crisis. I conclude that medicine’s position is no longer as the center of health care but rather as another node within a wider evolving health care network. And the resolution of medicine’s professionalism crisis depends on medicine’s positioning and defining itself in terms of the professionalism for each of the other professions within the health care network. (shrink)

BackgroundSocial networking sites (SNSs) have penetrated all aspects of health care professionals’ (HCPs’) professional and private lives. A new term, e-professionalism, has emerged, which describes the linking of traditional values with this new dynamic online environment for HCPs. The four aims of this study were: (1) to examine their SNS prevalence and usage habits, (2) to examine their perception of e-professionalism, (3) to develop an e-professionalism assessment compatibility index and (4) to investigate their tendencies and differences in values of the (...) e-professionalism assessment compatibility index (ePACI).MethodsA cross-sectional study was conducted among MDs and DMDs in Croatia via email using a questionnaire. The questionnaire was distributed to all MDs and DMDs who were members of their respective chambers. In addition to descriptive statistics, Chi-square or Fisher’s exact test when appropriate, t-test, ANOVA and Mann–Whitney U tests were used to determine differences between groups. A principal component analysis (PCA) with varimax rotation was used to investigate dimensionality. Results of the PCA were compared to the coding based on the Social Media e-Professionalism rubric in order to create the ePACI.ResultsOf the 1013 gathered responses, 753 were from valid SNS users and suitable for further analysis. Facebook (91.6%) and Instagram (63.1%) were the predominant SNSs used. Both groups have a good understanding of e-professionalism. The newly developed ePACI deviates slightly in the “conservative” direction in the cases of both, MDs (t506 = 19.033, p < 0.001) and DMDs (t245 = 12.991, p < 0.001). HCPs who are older (r = 0.308, p < 0.001), who have fewer SNS profiles (rs = −0.142, p < 0.001), and who access their profiles less frequently (r = −0.166, p < 0.001) have statistically significantly more conservative ePACI values.ConclusionsMDs and DMDs in Croatia are frequent SNS users, with Facebook and Instagram being the main SNSs used. Both groups have a good understanding of e-professionalism. The newly developed ePACI deviates slightly towards the conservative side regarding perception of the e-professionalism content for both groups. The development of the ePACI, and its subsequent usage in further research, will have a direct influence in its validation, gathering comparable data, and be able to direct efforts in oversight, regulation and education. (shrink)

Artificial neural networks (ANNs) are new mathematical techniques which can be used for modelling real neural networks, but also for data categorisation and inference tasks in any empirical science. This means that they have a twofold interest for the philosopher. First, ANN theory could help us to understand the nature of mental phenomena such as perceiving, thinking, remembering, inferring, knowing, wanting and acting. Second, because ANNs are such powerful instruments for data classification and inference, their use also leads us into (...) the problems of induction and probability. Ever since David Hume expressed his famous doubts about induction, the principles of scientific inference have been a central concern for philosophers. (shrink)

The network approach to psychopathology posits that mental disorders can be conceptualized and studied as causal systems of mutually reinforcing symptoms. This approach, first posited in 2008, has grown substantially over the past decade and is now a full-fledged area of psychiatric research. In this article, we provide an overview and critical analysis of 363 articles produced in the first decade of this research program, with a focus on key theoretical, methodological, and empirical contributions. In addition, we turn our (...) attention to the next decade of the network approach and propose critical avenues for future research in each of these domains. We argue that this program of research will be best served by working toward two overarching aims: (a) the identification of robust empirical phenomena and (b) the development of formal theories that can explain those phenomena. We recommend specific steps forward within this broad framework and argue that these steps are necessary if the network approach is to develop into a progressive program of research capable of producing a cumulative body of knowledge about how specific mental disorders operate as causal systems. (shrink)

The integration of standardized biomedical terminologies into a single, unified knowledge representation system has formed a key area of applied informatics research in recent years. The Unified Medical Language System (UMLS) is the most advanced and most prominent effort in this direction, bringing together within its Metathesaurus a large number of distinct source-terminologies. The UMLS Semantic Network, which is designed to support the integration of these source-terminologies, has proved to be a highly successful combination of formal coherence and broad (...) scope. We argue here, however, that its organization manifests certain structural problems, and we describe revisions which we believe are needed if the network is to be maximally successful in realizing its goals of supporting terminology integration. (shrink)

Las redes sociales asociadas al conocimiento resultan de interés tanto a los estudios en Ciencia Tecnología y Sociedad, como al desenvolvimiento del pensamiento de la complejidad que se desarrolla en el país. Su análisis explica la naturaleza social de la producción científica y la existencia del capital social, cuyas características se vinculan con la satisfacción y resolución de las necesidades sociales dentro de la población cubana. Se muestra una red, conformada en torno a la Publicación Archivo Médico de Camagüey, durante (...) los años 2003, 2004 y dos bimestres del 2005 sobre el desenvolvimiento de las co autorías dentro de ella. Delineando en qué forma los investigadores se relacionaron entre sí, para valorar algunos de sus resultados. Se describen, los grupos esenciales de investigación y sus principales fortalezas. Constituye una herramienta de trabajo, al exponer los cambios que están ocurriendo en torno a la Universidad Médica Camagüeyana The social networks associated to human knowledge are useful to the studies in Science Technology and Society. Their analysis explains the social nature of the scientific production and the existence of social resources, which link the satisfaction and resolution of the social necessities inside the Cuban population. The characteristics of this networks conformed in Archivo Médico de Camagüey publication on the development of co authorship from 2003 to 2005 were presented in this article. The researchers were related to each other in this work to value in which way they function together and analyze some of their results. The essential groups of investigation and their main strengths were also described. It constitutes a work tool for further research works, to considering the changes that are happening about the scientific knowledge production in Camagüey University of Medicine. (shrink)

Precision medicine is emerging as a scientific bandwagon within the contemporary biomedical sciences in the United States. PM brings together concepts and tools from genomics and bioinformatics to develop better diagnostics and therapies based on individualized information. Developing countries like China and Brazil have also begun pursuing PM projects, motivated by a desire to claim genomic sovereignty over its population. In spite of commonalities, institutional arrangements produced by the history of genomics research in China and Brazil are ushering PM (...) along different trajectories. In the Chinese case, we identify a strong state-backed push for PM combined with a dynamic network of international academic and private actors along the lines of networked technonationalism that has made large-scale, speculative PM projects possible. The Brazilian case is characterized by an institutional void at the federal level in which PM is driven by domestic academic actors in universities in the regional level, resulting in smaller scale, needs-driven PM projects. Through these cases, this paper shows how a scientific bandwagon adapts to national histories and institutions. Through this peripheral translation of the scientific bandwagon, the global infrastructure of biomedical knowledge has the potential to be transformed. (shrink)

This study aims to describe social network and social participation and to assess associations with depressive symptoms in older persons with increased risk for dementia in Germany. We conducted a cross-sectional observational study in primary care patients (aged 60-77) as part of a multicenter cluster-randomized controlled trial (AgeWell.de). We present descriptive and multivariate analyses for social networks (Lubben Social Network Scale and subscales) and social participation (item list of social activities) and analyze associations of these variables with depressive (...) symptoms (Geriatric Depression Scale). Of 1030 included patients, 17.2% were at risk for social isolation (Lubben Social Network Scale < 12). Looking at the subscales, a reduced non-family network was found almost twice as often as a reduced family network. Patients with depressive symptoms had significantly smaller social networks than patients without depression (p < 0.001). They rather engaged in social activities of low involvement level or no weekly social activity at all (p < 0.001). The study shows associations of depressive symptoms with a decreased social network and less social participation in elderly participants. Sufficient non-family contacts and weekly social activities seem to play an important role in mental health and should be encouraged in elderly primary care patients. (shrink)

In this paper, we describe the spiritual and kinship alliances between heads of an urban Santo Daime church from Rio de Janeiro and some leaders of the Yawanawá people from the Amazonian region. We suggest that these alliances involve exchanges and dialogical relationships that hold different meanings for the diverse social actors that take part in them. Further, we argue that equivocation and functional misunderstandings have an important role in these multidirectional dialogues. Based on this case study, we approach the (...) Yawanawá strategies for capturing otherness, and the insertion of the daimistas in the indigenous sociality networks. We focus especially on the Yawanawá mode of producing kin by capturing non-indigenous people and their participation in exchange networks that encompass multiple regimes of value. From the daimista point of view, we describe these relationships using the native category of “eclecticism.” We suggest that the daimistas attempt to translate the Yawanawá shamanic knowledge and the consumption of the “forest medicines,” experiencing the performance of “becoming indigenous.”. (shrink)

In this paper, we describe the spiritual and kinship alliances between heads of an urban Santo Daime church from Rio de Janeiro and some leaders of the Yawanawá people from the Amazonian region. We suggest that these alliances involve exchanges and dialogical relationships that hold different meanings for the diverse social actors that take part in them. Further, we argue that equivocation and functional misunderstandings have an important role in these multidirectional dialogues. Based on this case study, we approach the (...) Yawanawá strategies for capturing otherness, and the insertion of the daimistas in the indigenous sociality networks. We focus especially on the Yawanawá mode of producing kin by capturing non‐indigenous people and their participation in exchange networks that encompass multiple regimes of value. From the daimista point of view, we describe these relationships using the native category of “eclecticism.” We suggest that the daimistas attempt to translate the Yawanawá shamanic knowledge and the consumption of the “forest medicines,” experiencing the performance of “becoming indigenous.”. (shrink)

Farmers’ markets, often structured as non-profit or cooperative organizations, play a prominent role in emerging alternative food networks of western Canada. The contribution of these social economy organizations to network development may relate, in part, to the process of regional clustering. In this study we explore the nature and significance of farmers’ market clustering in the western Canadian provinces of British Columbia and Alberta, focusing on the possible connection between clustering and a “scaling up” of alternative food networks. Survey (...) and interview results from four regional clusters indicate that in addition to spatial agglomeration, dynamic processes of interaction and knowledge exchange are occurring and are shaped by vendor mobility as well as collaborative and competitive forces. Horizontal and vertical collaborations are resulting in innovative strategies to address challenges of scale, scope, infrastructure, and organizational capacity that are prevalent in alternative food networks. Government support for market clustering has been modest to date but, we argue, could play a more prominent role in facilitating cluster development as part of a broader collaborative strategy involving public, private, and social economy sectors in the scaling up of alternative food networks. (shrink)

In the past decades, reductionism has dominated both research directions and funding policies in clinical psychology and psychiatry. The intense search for the biological basis of mental disorders, however, has not resulted in conclusive reductionist explanations of psychopathology. Recently, network models have been proposed as an alternative framework for the analysis of mental disorders, in which mental disorders arise from the causal interplay between symptoms. In this target article, we show that this conceptualization can help explain why reductionist approaches (...) in psychiatry and clinical psychology are on the wrong track. First, symptom networks preclude the identification of a common cause of symptomatology with a neurobiological condition; in symptom networks, there is no such common cause. Second, symptom network relations depend on the content of mental states and, as such, feature intentionality. Third, the strength of network relations is highly likely to depend partially on cultural and historical contexts as well as external mechanisms in the environment. Taken together, these properties suggest that, if mental disorders are indeed networks of causally related symptoms, reductionist accounts cannot achieve the level of success associated with reductionist disease models in modern medicine. As an alternative strategy, we propose to interpret network structures in terms of D. C. Dennett's (1987) notion ofreal patterns, and suggest that, instead of being reducible to a biological basis, mental disorders feature biological and psychological factors that are deeply intertwined in feedback loops. This suggests that neither psychological nor biological levels can claim causal or explanatory priority, and that a holistic research strategy is necessary for progress in the study of mental disorders. (shrink)

This is an introduction to the topical collection Microbes, Networks, Knowledge: Disease Ecology in the twentieth Century, based on a workshop held at Queen Mary, University London on July 6–7 2016. More than twenty years ago, historian of science and medicine Andrew Mendelsohn asked, “Where did the modern, ecological understanding of epidemic disease come from?” Moving beyond Mendelsohn’s answer, this collection of new essays considers the global history of disease ecology in the past century and shows how epidemics and (...) pandemics have made “microbes complex”. (shrink)

In France between 1780 and 1815, doctors opened a broad correspondence with medical faculties and public officials about foetal anomalies . Institutional and legal reforms forced doctors to encounter monstrous births with greater frequency, and they responded by developing new ideas about heredity and embryology to explain malformations to public officials. Though doctors achieved consensus on pathogenesis, they struggled to apply these ideas in forensic cases, especially with doubtful sex. Medical networks simultaneously allowed doctors to explore obstetrical techniques, as licensing (...) regulations forced practitioners into emotional encounters with child anomalies. Doctors thus developed a new ethics for treating monstrosities, viewing them as pathological specimens, forensic objects, and obstetrical tragedies. (shrink)

As a standard, health has proven to be as fecund a source of philosophic interest as it is enigmatic. The metaphor of health peppers the history of Western philosophy from its inception, and brings with it a network of questions related to the highly problematic constructions of the relationships between body and mind with which this history is littered. In particular, the connection between medical and political discourses in archaic and classical Greece is well documented, and reveals the extent (...) to which the metaphor of health has proven operative in multiple realms of classical Greek thought. This intertwining of medical and political discourses is powerfully present in the dialogues of Plato as well, and in the Republic in particular. This dissertation addresses itself to the role of medicine within Plato's Republic, and takes as its overarching project the investigation of the role of doctors and medicine in this dialogue in order to indicate the manner in which medicine is used to make clearer the position of the philosopher within the city. The following pages attempt to show that, when faced in the Republic with the need to give an account of the philosopher within the city, Plato found the medical art indispensable to this enterprise. Thus medicine emerges as intimately connected to the paradoxical coincidence of philosophy and political power for which the Republic calls. (shrink)

Sir, The recent discussion by Elovici et al. on “Ethical Considerations when Employing Fake Identities in Online Social Networks for Research ” is very interesting . Elovici et al. raised an important question “Is it legitimate to use fake identities for studying OSNs or for collecting OSN data for research? ” In fact, “fake” is not a reality and this might be problematic. In medicine, “fake” is not acceptable. This is not the same as “placebo”, which is a standard (...) method for management of the disorder of the patients. Also, it is not the “blinding”, which is the standard clinical trial technique. As a worker in the field of medical journalism, “fake” might be classified as a “falsification”. According to the standard international medical journal, the “fake” data is totally not acceptable. However, focusing on the “fake identities”, if it is used in researching, it might deviate the research result. This has to be disclose .. (shrink)

In describing and explaining the sexes, medicine and science participated in the delineation of what was "feminine" and what was "masculine" in the Middle Ages. Hildegard of Bingen and Albertus Magnus, among others, writing about gynecology, the human constitution, fetal development, or the naturalistic dimensions of divine Creation, became increasingly interested in issues surrounding reproduction and sexuality. Did women as well as men produce procreative seed? How did the physiology of the sexes influence their healthy states and their susceptibility (...) to disease? Who derived more pleasure from sexual intercourse, men or women? The answers to such questions created a network of flexible concepts which did not endorse a single model of male-female relations, but did affect views on the health consequences of sexual abstinence for women and men and on the allocation of responsibility for infertility - problems with much social and religious significance in the Middle Ages. Sometimes at odds with, and sometimes in accord with other forces in medieval society, medicine and natural philosophy helped to construct a set of notions that divided significant portions of the world - from the behavior of animals to the operations of astrological signs - into "masculine" and "feminine." Even cases that seemed to exist outside the definitions of this duality, for example, hermaphrodite features or homosexual behavior, were brought under control by the application of gendered labels, such as "masculine women.". (shrink)

A large network of alchemical agents spread from the tiny, land-locked duchy of Saxe- Gotha-Altenburg outward across Europe. At its centre, Duke Friedrich I meticulously documented his interactions with many alchemical personalities during the 1670s and 1680s. The story of one such personality illustrates the changing meanings of distant alchemical knowledge both to the inner circle of courtly alchemists and to a larger alchemical republic. Born near Gotha, Johann Otto von Hellwig built his pan-European career on a youthful stay (...) on Java. To some, this indicated his access to exotic naturalia which might be imported to a centre of collection, such as Gotha. For others, Hellwig could access a wisdom hidden abroad since ancient Egypt, which should be disseminated among widely dispersed adepts. These viewpoints indicate different functions for distant knowledge, as well as differing desired trajectories for this knowledge. (shrink)

Metabolism is a set of chemical reactions, used by living organisms to process chemical compounds in order to take energy and eliminate toxic compounds, for example. Its processes are referred as metabolic pathways. Understanding metabolism is imperative to biology, toxicology and medicine, but the number and complexity of metabolic pathways makes this a difficult task. In our paper, we investigate the use of causal Bayesian networks to model the pathways of yeast saccharomyces cerevisiae metabolism: such a network can (...) be used to draw predictions about the levels of metabolites and enzymes in a particular specimen. We propose a two-stage methodology for causal networks, as follows. First construct a causal network from the network of metabolic pathways. The viability of this causal network depends on the validity of the causal Markov condition. If this condition fails, however, the principle of the common cause motivates the addition of a new causal arrow or a new `hidden' common cause to the network (stage 2 of the model formation process). Algorithms for adding arrows or hidden nodes have been developed separately in a number of papers, and in this paper we combine them, showing how the resulting procedure can be applied to the metabolic pathway problem. Our general approach was tested on neural cell morphology data and demonstrated noticeable improvements in both prediction and network accuracy. (shrink)

The ability of the Society of Jesus to engage in a broad and enduring tradition of scientific activity is here addressed in terms of its programmatic commitment to the consolidation and extension of the Catholic confession and its mastery of the administrative apparatus necessary to operate long-distance networks. The Society's early move into two major apostolates, one in education and the other in the overseas missions, brought Jesuits into regular contact with the educated elites of Europe and at the same (...) time placed the Society's missionaries in remote parts of the natural world. The modes of organization of travel and communication required by the Society's long-distance networks not only facilitated scientific communication and collaboration within the order, it also provided Jesuits with the resources they needed to engage successfully in 'ministries among the learned'. Evidence of a sustained attempt by Jesuit authors to assume the role of Kulturträger is found in the several genres of scientific publications that dominate the Society's scientific corpus. Thus the Society's early recognition of the "apostolic value" of scientific publications in recruiting friends and allies among Europe's intellectual elites, I argue, allowed a robust interest in natural knowledge to emerge as a legitimate part of the Jesuit vocation. (shrink)

Marian Hobson's work has made a seminal contribution to our understanding of the European Enlightenment, and of Diderot and Rousseau in particular. This book presents her most important articles in a single volume, translated into English for the first time. Hobson's distinctive approach is to take a given text or problématique and position it within its intellectual, historical and polemical context. From close analysis of the underlying conceptual structures of literary texts, she offers a unique insight into the vibrant networks (...) of people and ideas at work throughout Europe, and across disciplinary boundaries as diverse as literature and mathematics, medicine and music. In their translations of Hobson's essays, Kate Tunstall and Caroline Warman present the primary sources in both the original eighteenth-century French and modern English, making the detail of these debates accessible to everyone, from the specialist to the student, whatever their academic discipline or interest. (shrink)

A shortage or backlog of inventory can easily occur due to the backward forecasting method typically used, which will affect the normal flow of funds in pharmacies. This paper proposes a replenishment decision model with back propagation neural network multivariate regression analysis methods. With the regular pattern between sales and individual variables, supplemented with the safety stock empirical formula, an accurate replenishment quantity can be obtained. In the case analysis, this paper takes the sales situation of a pharmacy as (...) an example and tests the accuracy and stability of the model. The results show that the model has good prediction accuracy which can be introduced into the intelligent pharmacy system and used in the replenishment of the intelligent pharmacy to prevent overstocking or a shortage of stock, thus improving the financial situation, reducing the manpower burden of typical retail pharmacy, and helping residents buy medicines. (shrink)

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is universally acknowledged as the prominent reference textbook for the diagnosis and assessment of psychiatric diseases. However, since the publication of its first version in 1952, controversies have been raised concerning its reliability and validity and the need for other novel clinical tools has emerged. Currently the DSM is in its fourth edition and a new fifth edition is expected for release in 2013, in an intense intellectual debate and in a (...) call for new proposals. (shrink)

BackgroundBiobanks provide an important foundation for genomic and personalised medicine. In order to enhance their scientific power and scope, they are increasingly becoming part of national or international networks. Public trust is essential in fostering public engagement, encouraging donation to, and facilitating public funding for biobanks. Globalisation and networking of biobanking may challenge this trust.MethodsWe report the results of an Australian study examining public attitudes to the networking and globalisation of biobanks. The study used quantitative and qualitative methods in (...) conjunction with bioethical analysis in order to determine factors that may contribute to, and threaten, trust.ResultsOur results indicate a generally high level of trust in biobanks and in medical research more broadly. Key factors that can reduce perceived trustworthiness of biobanks are commercialisation and involvement in global networking.ConclusionsWe conclude that robust ethical oversight and governance standards can both promote trust in global biobanking and ensure that this trust is warranted. (shrink)

Chinese medicine (CM) is one ofseveral ancient systems of medical care basedupon a different worldview than the prevailingbiomedical model; it employs its own language,systems of logic, and criteria forunderstanding health and diagnosing illness.Medicinal herbs play a central role in the CMsystem of practice and knowledgeable CMpractitioners have extensive clinicalexperience using them. However, the establishedscientific and regulatory organizations thatrely upon biomedical understandings ofpathology do not accept the definitions formedicinal herb quality used by CMpractitioners. Furthermore, local medicinalherb growers within the upper (...) Midwest are in aposition to grow many herbs, but are unclearabout the demand for and desired qualities ofthe medicinal herbs they produce. Given thissituation, the Medicinal Herb Network wasfounded as a partnership effort of small-scalemedicinal herb growers and practitioners of CMto develop more appropriate standards ofmedicinal herb quality and to encourage locallygrown, high quality medicinal herbs consistentwith these standards. An overview of CM servesas grounding from which to articulate thedilemmas experienced by CM practitioners ofperceiving medicinal herb quality andintegrating knowledge across divergent medicalsystems. A Network initiative designed toovercome these dilemmas illustrates thepossibility of developing a lexicon of qualitydescriptors for medicinal herbs using Chinesemedical theory, while drawing from descriptivesensory analysis procedures currently practicedby a sub-group of food scientists. (shrink)

Public goods, as well as commercial commodities, are affected by exclusive arrangements secured by intellectual property (IP) rights. These rights serve as an incentive to invest human and material capital in research and development. Particularly in the life sciences, IP rights regulate objects such as food and medicines that are key to securing human rights, especially the right to adequate food and the right to health. Consequently, IP serves private (economic) and public interests. Part of this charge claims that the (...) current IP regime is privatizing the very building blocks of research and development – that used to be part of the commons. The public domain, in contrast to the private domain, may be the locus of much more diverse forms of creativity that at the same time ensures a wider plurality of productive traditions. An IP regime must support a sense of public morality because it is dependent upon civil support. This inevitably prompts questions of what are “good” exclusive rights and what are “bad” exclusive rights, and how shall such IP rights be developed. We argue that the democratization of the current IP regimes is an important first step to respond to these issues. (shrink)

The concept of disease remains hotly contested. In light of problems with existing accounts, some theorists argue that the disease concept ought to be eliminated. We answer this skeptical challenge by reframing the discussion in terms of the role that the disease concept plays in the complex network of health-care institutions in which it is deployed. We argue that while prevailing accounts do not suffer from the particular defects that critics have identified, they do suffer from other deficits, and (...) this leads us to propose a new account that satisfies the desiderata for a concept of disease in human medicine. (shrink)

This article explores the activities of the Society of Apothecaries and its members following the foundation of a laboratory for manufacturing chemical medicines in 1672. In response to political pressures, the guild created an institutional framework for production which in time served its members both functionally and financially and established a physical site within which the endorsement of practical knowledge could take place. Demand from state and institutional customers for drugs produced under corporate oversight affirmed and supported the society's trading (...) role, with chemical and pharmaceutical knowledge utilized to fulfil collective and individual goals. The society benefited from the mercantile interests, political connections and practical expertise of its members, with contributions to its trading activities part of a much wider participation in London's medical, scientific and commercial milieu. Yet, as apothecaries became increasingly engaged in the practice of medicine rather than the preparation and sale of drugs, the society struggled to reconcile the changing priorities of those it represented, and tensions emerged between its corporate and commercial activities. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Introduction: Conflicting Interest in Medicine: Stories by Physicians on How Financing Affects Their WorkJames M. DuBois, Symposium EditorPhysicians frequently enter into special relationships that establish personal financial interests that could conflict with their patients’ best interests. Examples include receiving gifts from drug companies, sharing a patent on a medical device, or accepting funding from industry to conduct a drug study. In recent years, such “conflicts of interests” in (...) medicine have received growing attention from medical associations (Association of American Medical Colleges, 2008, 2010), policy bodies (Institute of Medicine, 2009), industry (Pharmaceutical Research and Manufacturers of America, 2008), journalists (Caputo, 2009; Nguyen, Ornstein, & Weber, 2010), and even Congress, which included in the 2010 Patient Protection Affordable Care Act a Physician Payment Sunshine provision requiring industry to report a wide variety of ties to physicians. All of these efforts appear motivated by a similar assumption: Gifts and financially beneficial relationships can unconsciously motivate physicians to prioritize their own or industry’s interests over patients’ interests when providing care, conducting medical research, or educating physicians (American Association of Medical Colleges, 2008; Dana & Loewenstein, 2003).The call for stories produced for this narrative symposium provided the following request:We are interested in hearing about positive and negative experiences associated with a variety of financial relationships. The stories should give readers a sense of what it is like to be a physician in the midst of complex relationships to industry, physician practices, and third–party payers—relationships that go beyond ordinary reimbursement for care or research expenses.Obtaining stories proved more challenging than anticipated for reasons related to our theme. Precisely because access to physicians is considered valuable, it is highly restricted. Listservs and blogs that serve physicians typically prohibit postings from anyone except physician members, and even they are sometimes not allowed to post messages freely. While at least one listserv circulated our call to members (at the request of a member), others rejected our request, and one blog offered to post our call as a 1–month ad for $20,000. This contrasts radically with the relatively easy access we have had to other groups, including mental health consumers and living organ donors, who have broad grass root communication systems, and bioethicists, who have several listservs and blogs that readily share news about relevant scholarly opportunities.The collection of stories obtained resulted from extensive personal networking and a small amount of arm twisting. The collection was not what we expected to obtain, but is in many ways even more interesting. One story (Hodges) explicitly addresses the impact that pharmaceutical representatives can have on prescribing patterns—the classic, voluntary, conflicted relationship, insofar as sales reps are [End Page 65] welcomed in facilities, often bearing free samples, free lunches, and glossy articles on their products, all in the hopes of influencing prescribing patterns. But most stories do not fit the typical mold found in discussions of conflicts of interest. Among those expressing concerns about the impact of financial factors on medical practice, one focuses on the insufficient management of bias within the Food and Drug Administration (Perlmutter); three focus on the bias that is introduced through our current fee–for–service reimbursement system (Mikulec, Nagaldine, and Zientek)—of these, two illustrate ways that third parties seek to manipulate physician practices to maximize profits; one notes how any kind of clinical trial—whether government or industry sponsored—may affect patient care decisions (Cruz); while two argue that worries over industry sponsorship of research are disproportionate (Bierut and Sofair), and two address widespread concerns about industry sponsorship of educational activities, with one illustrating how bias might be reduced (Seitz & Diao), and another illustrating the potential harms of prohibiting educational sponsorship (Peppin).To be clear, all of these narratives are responsive to our call for stories that “describe positive and negative experiences associated with a variety of financial relationships.” Yet they are not classic conflict of interest stories; rather, they represent the conflicting interests that concern physicians today—conflicts that are often intrinsic to our current healthcare and research systems rather than special relationships courted by physicians.While making no pretense of representativeness or comprehensiveness, these stories provide fertile ground for reflection, as seen in our... (shrink)

Niels Kaj Jerne has proposed the “immune network theory” of interactions among anti‐idiotypic antibodies, able to interfere with humoral responses to certain antigens. After the occurrence of the primary generation of antibodies, against an antigenic epitope, idiotypes of these antibodies induce anti‐idiotypic antibodies that modulate the intensity of the first response, and so on. Adverse effects following SARS‐COV‐2 COVID‐19 vaccines are occasionally similar to the symptoms of COVID‐19 infection. Rare events linked to SARS‐CoV‐2 vaccines also resemble some rarely reported (...) COVID‐19 complications. Safety data from product information by European Medicines Agency suggest that spectra do overlap for four main vaccines. The proposition is that vaccine events and COVID‐19 complications are related to anti‐idiotypic antibodies whose spatial shape can lead to interactions with ACE2 molecules, in individuals with a prolonged Spike protein synthesis. The vaccines target cells by their affinity to the vaccine vector, or to engulf lipid nanoparticles. Anti‐idiotypic antibodies shaped similarly to the Spike protein possibly interact with ACE2 molecules and cause diverse signs and symptoms. (shrink)

This edited volume provides a biosemiotic analysis of the ecological relationship between food and medicine. Drawing on the origins of semiotics in medicine, this collection proposes innovative ways of considering aliments and treatments. Considering the ever-evolving character of our understanding of meaning-making in biology, and considering the keen popular interest in issues relating to food and medicines - fueled by an increasing body of interdisciplinary knowledge - the contributions here provide diverse insights and arguments into the larger ecology (...) of organisms’ engagement with and transformation through taking in matter. Bodies interpret molecules, enzymes, and alkaloids they intentionally and unintentionally come in contact with according to their pre-existing receptors. But their receptors are also changed by the experience. Once the body has identified a particular substance, it responds by initiating semiotic sequences and negotiations that fulfill vital functions for the organism at macro-, meso-, and micro-scales. -/- Human abilities to distill and extract the living world into highly refined foods and medicines, however, have created substances far more potent than their counterparts in our historical evolution. Many of these substances also lack certain accompanying proteins, enzymes, and alkaloids that otherwise aid digestion or protect against side-effects in active extracted chemicals. Human biology has yet to catch up with human inventions such as supernormal foods and medicines that may flood receptors, overwhelming the body’s normal satiation mechanisms. This volume discusses how biosemioticians can come to terms with these networks of meaning, providing a valuable and provocative compendium for semioticians, medical researchers and practitioners, sociologists, cultural theorists, bioethicists and scholars investigating the interdisciplinary questions stemming from food and medicine. (shrink)

This paper offers one explanation for the institutional basis of food insecurity in Australia, and argues that while alternative food networks and the food sovereignty movement perform a valuable function in building forms of social solidarity between urban consumers and rural producers, they currently make only a minor contribution to Australia’s food and nutrition security. The paper begins by identifying two key drivers of food security: household incomes (on the demand side) and nutrition-sensitive, ‘fair food’ agriculture (on the supply side). (...) We focus on this second driver and argue that healthy populations require an agricultural sector that delivers dietary diversity via a fair and sustainable food system. In order to understand why nutrition-sensitive, fair food agriculture is not flourishing in Australia we introduce the development economics theory of urban bias. According to this theory, governments support capital intensive rather than labour intensive agriculture in order to deliver cheap food alongside the transfer of public revenues gained from rural agriculture to urban infrastructure, where the majority of the voting public resides. We chart the unfolding of the Urban Bias across the twentieth century and its consolidation through neo-liberal orthodoxy, and argue that agricultural policies do little to sustain, let alone revitalize, rural and regional Australia. We conclude that by observing food system dynamics through a re-spatialized lens, Urban Bias Theory is valuable in highlighting rural–urban socio-economic and political economy tensions, particularly regarding food system sustainability. It also sheds light on the cultural economy tensions for alternative food networks as they move beyond niche markets to simultaneously support urban food security and sustainable rural livelihoods. (shrink)

After WWII, global concerns about the uses of nuclear energy and radiation sources in agriculture, medicine, and industry brought about calls for radiation protection. At the beginning of the 1960s radiation protection involved the identification and measurement of all sources of radiation to which a population was exposed, and the evaluation and assessment of populations in terms of the biological hazard their exposure posed. Mexico was not an exception to this international trend. This paper goes back to the origins (...) of the first studies on the effects of radiation and on radioprotective compounds in the Genetics and Radiobiology Program of the National Commission of Nuclear Energy founded in 1960, at a time when the effects of radiation on living beings and radiation protection demanded the attention of highly localized groups of scientists and the creation of international as well as national institutions, and its connection to dosimetry and radiation protection until the 1990s. This historical reconstruction examines the circulation of knowledge, scientists, and their material and cognitive resources, to show that radiobiology, with dosimetry and radiation protection as cases in point, not only were carried out with high international standards in parallel with international agencies, but also reflected local material needs, including the standardization of new experimental techniques. (shrink)

As local food activities expand and grow, an important question to answer is how various participants contribute to a local food system’s overall vitality and strength. This paper does so by focusing on the relationships between locally-oriented farm and retail actors and assessing what the configuration of these relationships tells us about the workings of the broader local food system. Such an analysis reveals two things. Empirically, it shows the important role food retailers play in the overall vibrancy of local (...) food exchanges: food retailers form crucial links holding the broader system together and significantly expanding consumer access to local foods. Further, different retailer types have distinct impacts on network configurations, each serving particular roles in the development and maintenance of local food systems. Methodologically, this paper shows the value of applying social network analysis techniques to the study of local food systems: such an approach yields insights that may not be as readily assessable from other strategies. In this paper, I overview common network analysis techniques and apply them to a case study of local food activities in New England, suggesting how such an approach might be applied to local food systems in other places. (shrink)

The Warburg Institute, founded in the 1920s in Hamburg by art and cultural historian Aby Warburg, is a pioneering institution that has greatly shaped the fields of art, myth, religion, medicine, philosophy, and intellectual history. When, in 1933, the institute was moved to London to escape the Nazis, its research and legacy were protected and further developed by a network of researchers dispersed throughout the UK, the US, and Canada. The first interdisciplinary study of the Warburg network (...) as an arena of intellectual transmission, transformation, and exchange, this volume reveals the dynamics, agencies, and actors at play in the development of the Warburg Institute's program and output, with a specific focus on the role of Raymond Klibansky in the institute's major ventures. Among these collective projects of the institute are the famous Saturn and Melancholy, which blends art history with philosophical and cultural history, and the Latin and Arabic Corpus Platonicum Medii Aevi series, which contributed to research on the continuity of Platonic thought. Consulting published and unpublished sources including correspondences, memories, and diaries of affiliated scholars, the essays explore the history of the Warburg Library as a vital cultural institution and the personal and intellectual relationships of the researchers devoted to it. From Hamburg to London to Montreal, Raymond Klibansky and the Warburg Library Network takes readers on a journey into more than forty years of intellectual life at one of the most prestigious cultural research institutes. Contributors include Philippe Despoix, Georges Leroux, Eric Méchoulan, Elisabeth Otto, Elizabeth Sears, Davide Stimilli, Jillian Tomm, Martin Treml, Jean-Philippe Uzel, Regina Weber, Claudia Wedepohl, and Graham Whitaker. (shrink)

We live in the Age of Big Data. In medicine, artificial intelligence and machine learning algorithms, fueled by big data, promise to change how physicians make diagnoses, determine prognoses, and develop new treatments. An exponential rise in articles on these topics is seen in the medical literature. Recent applications range from the use of deep learning neural networks to diagnose diabetic retinopathy and skin cancer from image databases, to the use of various machine learning algorithms for prognostication in cancer (...) and cardiovascular disease. Many factors are driving the adoption of AI in health care, from... (shrink)

Mobile ad hoc network is a network composed of mobile terminals without infrastructure. Due to its fast-networking ability, it is widely used in smart cities, car networking, military, agriculture, medicine, and other fields. Routing technology is a key technology in the field of MANET. The energy consumption is optimized through the technical network simulator NS-3, and the nodes in the MANET routing protocol can accurately simulate the problem, thereby optimizing the MAC layer of important research tools. (...) This article combines the advantages of the lithium-ion battery model. Compared with the KiBaM battery model, the effective charge in the KiBaM model simulates the output voltage well, which can reflect the battery capacity effect rate and the recovery effect of the lithium-ion-KiBaM battery model. The model can respond to the characteristics of the output voltage as the society gets lower and lower. In order to solve the problem that the analytic solution of differential equations cannot be obtained in the model, a numerical solution of the optimization algorithm is proposed based on the implicit Runge–Kutta method. The MAC layer energy consumption and routing protocol optimization algorithm proposed in this paper can be applied well in various fields. (shrink)

Biobanks are increasingly being linked together into global networks in order to maximise their capacity to identify causes of and treatments for disease. While there is great optimism about the potential of these biobank networks to contribute to personalised and data-driven medicine, there are also ethical concerns about, among other things, risks to personal privacy and exploitation of vulnerable populations. Concepts drawn from theories of globalisation can assist with the characterisation of the ethical implications of biobank networking across borders, (...) which can, in turn, inform more ethically sophisticated responses. Using the China Kadoorie Biobank as a case study, we show how distinguishing between the subnational, transnational, supranational and extranational spheres of operation and influence can help researchers, institutions and regulators to understand and manage the ethical issues raised by the globalisation of biobanking. (shrink)