Moderation in Proportional Systems: Coalitions Matter

This paper examines the role of the coalition formation process in a proportional system. It models its impact on the voters (who maximize their expected utilities) and the parties (who choose their platforms in a Nash game). In contrast with the intuitive idea that proportional systems represent “proportionally”, I show that a proportional system with minimal range coalitions leads to party convergence towards the median of the political spectrum. Indeed, a political party’s prospects of power are better when it is more likely to find ideological partners, i.e. when it is not ideologically isolated. In contrast, if coalitions are formed according to a minimum winning coalition rule a la Riker, any policy can be implemented in equilibrium

Comparing Electoral Systems: A Geometric Analysis

This paper constructs a game-theoretic model of elections in alternative electoral systems with three or four candidates. Each electoral system specifies how the platforms of the candidates and their scores give rise to an outcome. When geometrical analysis shows that two outcomes can compete against each other for victory, a pivot probability is associated to that pair. Each voter is rational and picks the candidate that maximizes her expected utility, which results from the balancing of her preferences and beliefs about the pivot-probabilities. Candidate positioning is endogenous and the result of a Nash game. The possible equilibria are computed for plurality and runoff majority systems

Countries, constituencies and parties: three essays in political economics and on the strategic aspects of voting

Doctorat en sciences sociales, politiques et économiquesinfo:eu-repo/semantics/nonPublishe

Complications cardiovasculaires aiguës et pratique du sport.

SCOPUS: re.jinfo:eu-repo/semantics/publishe

Contre-indications à la pratique du sport chez le cardiaque.

The cardiologist is faced with the problem of eliminating a subject with heart disease from a sports competition and of prescribing beneficial physical activity to patients with heart disease. The difficulty in the prescription (or contra-indication) is due to the need for an individual assessment of each case. Several general rules can be proposed for cases of heart disease with a high risk of mortality or with a poor haemodynamic status. In most cases, the beneficial or detrimental effect can not be predicted. In this review, the authors present various approaches, based on data from the literature, for different types of heart disease and for different sports. They conclude that each case requires a thorough investigation in order to reduce the number of victims of the sports stadium.SCOPUS: re.jinfo:eu-repo/semantics/publishe

Physiological cost of vocational activities after myocardial infarction

Oxygen consumption was measured during 30 min of work in 16 patients, after a myocardial infarction (anterior or posterior), and compared with 16 normal subjects, of the same age, involved in the same activities, in a steel factory. The V̇O2 at work of the patients was a little lower than in normals. The mean heart rate for 8 h was also a little lower in patients than in normals. The patients used a higher percentage of their residual capacity (V̇O2 max) as evaluated on a bicycle ergometer in the laboratory; the difference may be important between patients with a residual coronary insufficiency and controls. There are no important differences in the psychologial attitudes of the two groups; the patient seems to be more motivated. From this study, based on a limited number of patients who had returned to work and had no complaints in daily life, it appears that the patients were working more 'economically' that the normals, that they are able to use a higher percentage of their residual physiological capacity and that the psychological attitude is comparable in the two groups towards work. Return to previous work should never be excluded a priori in post-infarction patients with good clinical progress.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Minimally invasive versus open distal pancreatectomy for resectable pancreatic cancer (DIPLOMA): an international randomised non-inferiority trialResearch in context

Summary: Background: The oncological safety of minimally invasive surgery has been questioned for several abdominal cancers. Concerns also exist regarding the use of minimally invasive distal pancreatectomy (MIDP) in patients with resectable pancreatic cancer as randomised trials are lacking. Methods: In this international randomised non-inferiority trial, we recruited adults with resectable pancreatic cancer from 35 centres in 12 countries. Patients were randomly assigned to either MIDP (laparoscopic or robotic) or open distal pancreatectomy (ODP). Both patients and pathologists were blinded to the assigned approach. Primary endpoint was radical resection (R0, ≥1 mm free margin) in patients who had ultimately undergone resection. Analyses for the primary endpoint were by modified intention-to-treat, excluding patients with missing data on primary endpoint. The pre-defined non-inferiority margin of −7% was compared with the lower limit of the two-sided 90% confidence interval (CI) of absolute difference in the primary endpoint. This trial is registered with the ISRCTN registry (ISRCTN44897265). Findings: Between May 8, 2018 and May 7, 2021, 258 patients were randomly assigned to MIDP (131 patients) or ODP (127 patients). Modified intention-to-treat analysis included 114 patients in the MIDP group and 110 patients in the ODP group. An R0 resection occurred in 83 (73%) patients in the MIDP group and in 76 (69%) patients in the ODP group (difference 3.7%, 90% CI −6.2 to 13.6%; pnon-inferiority = 0.039). Median lymph node yield was comparable (22.0 [16.0–30.0] vs 23.0 [14.0–32.0] nodes, p = 0.86), as was the rate of intraperitoneal recurrence (41% vs 38%, p = 0.45). Median follow-up was 23.5 (interquartile range 17.0–30.0) months. Other postoperative outcomes were comparable, including median time to functional recovery (5 [95% CI 4.5–5.5] vs 5 [95% CI 4.7–5.3] days; p = 0.22) and overall survival (HR 0.99, 95% CI 0.67–1.46, p = 0.94). Serious adverse events were reported in 23 (18%) of 131 patients in the MIDP group vs 28 (22%) of 127 patients in the ODP group. Interpretation: This trial provides evidence on the non-inferiority of MIDP compared to ODP regarding radical resection rates in patients with resectable pancreatic cancer. The present findings support the applicability of minimally invasive surgery in patients with resectable left-sided pancreatic cancer. Funding: Medtronic Covidien AG, Johnson & Johnson Medical Limited, Dutch Gastroenterology Society