Un regard incontournable sur les conflits d’intérêts dans la pratique médicale

Compte-rendu / ReviewDans son livre : Conflicts of Interest and the Future of Medicine: The United States, France and Japan, Mark A. Rodwin aborde la question des conflits d’intérêts (CI) des médecins en comparant les systèmes de soins de santé de ces trois pays. Son analyse perspicace lui permet de proposer des pistes de solutions s’appliquant aux principales situations de CI rencontrées dans la pratique médicale.In his book: Conflicts of Interest and the Future of Medicine: The United States, France and Japan, Mark A. Rodwin discusses the conflicts of interest (COI) of physicians by comparing the healthcare systems of these three countries. His insightful analysis allows him to propose possible solutions applicable to major COI situations encountered in medical practice

BioéthiqueOnline : Moving to Peer-Review = BioéthiqueOnline : Passage à l’évaluation par les pairs

Éditoral / Editoria

Responsible Conduct of Research in Research-Creation: Moving into Uncharted Terrain

Responsible conduct of research (RCR) is ubiquitous, and present in most areas of research. One area that has received little attention is Research-Creation (RC): • an emergent eld at the interface of academic research and creative activities • in Quebec, Canada, RC is de ned as “research activities or approaches that foster the creation or interpretation/ performance of literary or artistic works of all types” Researcher-Creators – who are at the same time researchers and practising artists, musicians, or designers – may be faced with very di erent issues or challenges from colleagues in the rest of academia. • How do researcher-creators reconcile their dual obligations to creation and to research? • Are the usual research ethics guidelines (e.g., TCPS2, ICH relevant and how do they apply? • How do the creative/artistic dimensions of research a ect evaluations by grant committees and REBs? To better understand how RCR issues are articulated in the very heterogeneous RC community, we combine here results from a literature review and an international survey on RCR in RC.FRQ Action concerté

Effect of climate change on the spatial distribution of genomic variants involved in the resistance to East Coast Fever in Ugandan cattle

East Coast Fever (ECF) is a major livestock disease caused by Theileria parva Theiler, 1904, an emo-parasite protozoan transmitted by the tick Rhipicephalus appendiculatus Neumann, 1901. This disease provokes high mortality in cattle populations of East and Central Africa, especially in exotic breeds and crossbreds (Olwoch et al., 2008). Here, we use landscape genomics (Joost et al., 2007) to highlight genomic regions likely involved into tolerance/resistance mechanisms against ECF, and we introduce Spatial Areas of Genotype Probability (SPAG) to delimit territories where favourable allelic variants are predicted to be present. Between 2010 and 2012, the NEXTGEN project (nextgen.epfl.ch) carried out the geo-referencing and genotyping (54K SNPs) of 803 Ugandan cattle, among which 496 were tested for T. parva presence. Moreover, 532 additional R. appendiculatus occurrences were obtained from a published database (Cumming, 1998). Current and future values of 19 bioclimatic variables were also retrieved from the WorldClim database (www.worldclim.org/). In order to evaluate the selective pressure of the parasite, we used MAXENT (Phillips et al., 2006; Muscarella et al., 2014) and a mixed logistic regression (Bates et al., 2014) to model and map the ecological niches of both T. parva and R. appendiculatus. Then, we used a correlative approach (Stucki et al., 2014) to detect molecular markers positively associated with the resulting probabilities of presence and built the corresponding SPAG. Finally, we considered bioclimatic predictors representing two different climate change scenarios for 2070 - one moderate and one severe - to forecast the simultaneous shift of both SPAG and vector/pathogen niches. While suitable ecological conditions for T. parva are predicted to remain constant, the best environment for the vector is predicted around Lake Victoria. However, when considering future conditions, parasite occurrence is expected to decrease because of the contraction of suitable environments for the tick in both scenarios. Landscape genomics’ analyses revealed several markers significantly associated with a high probability of presence of the tick and of the parasite. Among them, we found the marker ARS-BFGL-NGS-113888, whose heterozygous genotype AG showed a positive association. Interestingly, this marker is located close to the gene IRAK-M, an essential component of the Toll-like receptors involved in the immune response against pathogens (Kobayashi et al., 2002). If the implication of this gene into resistance mechanisms against ECF is confirmed, the corresponding SPAG (Figure 1) represents either areas where the variant of interest shows a high probability to exist now, or areas where ecological characteristics are the most favorable to induce its presence under future climatic conditions. Beyond the results presented here, the combined use of SPAG and niche maps could help identifying critical geographical regions that do not present the favourable genetic variant in the present, but where a parasite is likely to expand its range in the future. This may represent a valuable tool to support the identification of current resistant populations and to direct future targeted crossbreeding schemes

Quand les bactéries font la loi : regards éthiques, épistémiques, juridiques, politiques, sociales et techniques sur l’utilisation du microbiome humain à des fins judiciaires

L’utilisation du microbiome humain à des fins judiciaires comme objet d’étude implique divers enjeux allant d’une remise en question de notre conception traditionnelle de l’identité au respect de la vie privée, en passant par le type de consentement à recueillir lors du prélèvement d’un échantillon de microbiome. La particularité de cette étude nécessite le travail conjoint d’une équipe multidisciplinaire composée de spécialistes en éthique, criminalistique, droit, microbiologie, philosophie et science politique

Modeling the spatial distribution of Theileria parva (Theiler 1904), causative agent of East Coast Fever disease in cattle

Theileria parva is a protozoan emo-parasite affecting sub-Saharan Bos taurus and Bos indicus populations. It is the causative agent of East Coast Fever, a major cattle disease causing the death of ~1.1∙106 animals per year and an annual loss of ~168∙106 USD (Norval et. al., 1992). T. parva geographical occurrence is bound to the presence of susceptible bovine host populations, the main tick vector Rhipicephalus appendiculatus (Neumann 1901), as well as suitable ecological conditions for the survival of both the vector and the parasite. While tick habitat requirements have been extensively investigated (see e.g. Cumming, 2002), studies focusing solely on the environmental conditions determining the parasite occurrence are still lacking. The goal of the study is to define T. parva ecological fundamental niche, thus fostering our understanding of the environmental requirements needed to maintain the parasite-vector-host biological system

Combining landscape genomics and ecological modelling to investigate local adaptation of indigenous Ugandan cattle to East Coast fever

East Coast fever (ECF) is a fatal sickness affecting cattle populations of eastern, central, and southern Africa. The disease is transmitted by the tick Rhipicephalus appendiculatus, and caused by the protozoan Theileria parva parva, which invades host lymphocytes and promotes their clonal expansion. Importantly, indigenous cattle show tolerance to infection in ECF-endemically stable areas. Here, the putative genetic bases underlying ECF-tolerance were investigated using molecular data and epidemiological information from 823 indigenous cattle from Uganda. Vector distribution and host infection risk were estimated over the study area and subsequently tested as triggers of local adaptation by means of landscape genomics analysis. We identified 41 and seven candidate adaptive loci for tick resistance and infection tolerance, respectively. Among the genes associated with the candidate adaptive loci are PRKG1 and SLA2. PRKG1 was already described as associated with tick resistance in indigenous South African cattle, due to its role into inflammatory response. SLA2 is part of the regulatory pathways involved into lymphocytes' proliferation. Additionally, local ancestry analysis suggested the zebuine origin of the genomic region candidate for tick resistance

When innovation fails: An institutional perspective of the (non)adoption of boundary spanning IT innovation

We combine the concepts of legitimacy, institutional (mis)alignments, strategic responses and organizing visions to develop a conceptual framework to analyze the adoption of innovations that span organizational fields. We apply this framework to examine a telehealth innovation connecting a public sector hospital-based Eye Clinic with private sector optometry practices. We find that while compromise strategies were successful in encouraging adoption within each field, the innovation ultimately failed because the fields developed different organizing visions that could not be reconciled. The findings suggest that institutional misalignments within and between fields interact to amplify their overall effect on the adoption of hybrid innovations

Les conflits d’intérêts en médecine : un exemple vétérinaire

In health care, professionals may find themselves at risk of abusing their powers by neglecting the interests of their clients. In particular, a conflict of interest can arise when the practitioner focuses on a secondary interest, such as his own financial gain, at the expense of a primary interest or professional responsibility, such as the interest of the patient. This case study, inspired by a true story in veterinary medicine, illustrates the ethical problem by which high-tech interventions are used in practice, even if their use is not necessarily in the client’s best interest