samedi 24 juin 2017

In appropriate answer to decreased confidence in the vaccines

http://www.rtl.fr/actu/bien-etre/tous-les-discours-anti-vaccins-me-sont-insupportables-tonne-michel-cymes-7789036706

Aging physicians

https://www.wsj.com/articles/when-are-doctors-too-old-to-practice-1498311380

In Search of Lost Time

The days grow short. A cold wind stirs the fallen leaves, and some mornings the vineyards are daubed with frost. Yet all across France, life has begun anew: the 2007 harvest is in. And what a harvest it has been. At least 727 new novels, up from 683 for last autumn's literary rentrée. Hundreds of new music albums and dozens of new films. Blockbuster art exhibitions at all the big museums. Fresh programs of concerts, operas and plays in the elegant halls and salles that grace French cities. Autumn means many things in many countries, but in France it signals the dawn of a new cultural year.

And nobody takes culture more seriously than the French. They subsidize it generously; they cosset it with quotas and tax breaks. French media give it vast amounts of airtime and column inches. Even fashion magazines carry serious book reviews, and the Nov. 5 announcement of the Prix Goncourt — one of more than 900 French literary prizes — was front-page news across the country. (It went to Gilles Leroy's novel Alabama Song.) Every French town of any size has its annual opera or theater festival, nearly every church its weekend organ or chamber-music recital.

There is one problem. All of these mighty oaks being felled in France's cultural forest make barely a sound in the wider world. Once admired for the dominating excellence of its writers, artists and musicians, France today is a wilting power in the global cultural marketplace. That is an especially sensitive issue right now, as a forceful new President, Nicolas Sarkozy, sets out to restore French standing in the world. When it comes to culture, he will have his work cut out for him.

Only a handful of the season's new novels will find a publisher outside France. Fewer than a dozen make it to the U.S. in a typical year, while about 30% of all fiction sold in France is translated from English. That's about the same percentage as in Germany, but there the total number of English translations has nearly halved in the past decade, while it's still growing in France. Earlier generations of French writers — from Molière, Hugo, Balzac and Flaubert to Proust, Sartre, Camus and Malraux — did not lack for an audience abroad. Indeed, France claims a dozen Nobel literature laureates — more than any other country — though the last one, Gao Xingjian in 2000, writes in Chinese.

France's movie industry, the world's largest a century ago, has yet to recapture its New Wave eminence of the 1960s, when directors like François Truffaut and Jean-Luc Godard were rewriting cinematic rules. France still churns out about 200 films a year, more than any other country in Europe. But most French films are amiable, low-budget trifles for the domestic market. American films account for nearly half the tickets sold in French cinemas. Though homegrown films have been catching up in recent years, the only vaguely French film to win U.S. box-office glory this year was the animated Ratatouille — oops, that was made in the U.S. by Pixar.

The Paris art scene, birthplace of Impressionism, Surrealism and other major -isms, has been supplanted, at least in commercial terms, by New York City and London. Auction houses in France today account for only about 8% of all public sales of contemporary art, calculates Alain Quemin, a researcher at France's University of Marne-La-Vallée, compared with 50% in the U.S. and 30% in Britain. In an annual calculation by the German magazine Capital, the U.S. and Germany each have four of the world's 10 most widely exposed artists; France has none. An ArtPrice study of the 2006 contemporary-art market found that works by the leading European figure — Britain's Damien Hirst — sold for an average of $180,000. The top French artist on the list, Robert Combas, commanded $7,500 per work.

France does have composers and conductors of international repute, but no equivalents of such 20th century giants as Debussy, Satie, Ravel and Milhaud. In popular music, French chanteurs and chanteuses such as Charles Trenet, Charles Aznavour and Edith Piaf were once heard the world over. Today, Americans and Brits dominate the pop scene. Though the French music industry sold $1.7 billion worth of recordings and downloads last year, few performers are famous outside the country. Quick: name a French pop star who isn't Johnny Hallyday.

France's diminished cultural profile would be just another interesting national crotchet — like Italy's low birthrate, or Russia's fondness for vodka — if France weren't France. This is a country where promoting cultural influence has been national policy for centuries, where controversial philosophers and showy new museums are symbols of pride and patriotism. Moreover, France has led the charge for a "cultural exception" that would allow governments to keep out foreign entertainment products while subsidizing their own. French officials, who believe such protectionism is essential for saving cultural diversity from the Hollywood juggernaut, once condemned Steven Spielberg's 1993 Jurassic Park as a "threat to French identity." They succeeded in enshrining the "cultural exception" concept in a 2005 UNESCO agreement, and regularly fight for it in international trade negotiations.

Accentuate the positive
In addition, France has long assigned itself a "civilizing mission" to improve allies and colonies alike. In 2005, the government even ordered high schools in France to teach "the positive role" of French colonialism, i.e. uplifting the natives. (The decree was later rescinded.) Like a certain other nation whose founding principles sprang from the 18th century Enlightenment, France is not shy about its values. As Sarkozy recently observed: "In the United States and France, we think our ideas are destined to illuminate the world."

Sarkozy is eager to pursue that destiny. The new President has pledged to bolster not just France's economy, work ethic and diplomatic standing — he has also promised to "modernize and deepen the cultural activity of France." Details are sketchy, but the government has already proposed an end to admission charges at museums and, while cutting budgets elsewhere, hiked the Culture Ministry's by 3.2%, to $11 billion.

Whether such efforts will have much impact on foreign perception is another matter. In a September poll of 1,310 Americans for Le Figaro magazine, only 20% considered culture to be a domain in which France excels, far behind cuisine. Domestic expectations are low as well. Many French believe the country and its culture have been in decline since — pick a date: 1940 and the humiliating German occupation; 1954, the start of the divisive Algerian conflict; or 1968, the revolutionary year which conservatives like Sarkozy say brought France under the sway of a new, more casual generation that has undermined standards of education and deportment.

For French of all political colors, déclinisme has been a hot topic in recent years. Bookstores are full of jeremiads like France is Falling, The Great Waste, The War of the Two Frances and The Middle Class Adrift. Talk-show guests and opinion columnists decry France's fading fortunes, and even the French rugby team's failure at the World Cup — held in France this year — was chewed over as an index of national decay. But most of those laments involve the economy, and Sarkozy's ascension was due largely to his promise to attend to them.

Cultural decline is a more difficult failing to assess — and address. Traditionally a province of the right, it speaks to the nostalgia of some French for the more rigorous, hierarchical society of the 19th and early 20th centuries. Paradoxically, that starchy era inspired much of France's subsequent cultural vitality. "A lot of French artists were created in opposition to the education system," says Christophe Boïcos, a Paris art lecturer and gallery owner. "Romantics, Impressionists, Modernists — they were rebels against the academic standards of their day. But those standards were quite high and contributed to the impressive quality of the artists who rebelled against them."

The taint of talkiness
Quality, of course, is in the eye of the beholder — as is the very meaning of culture. The term originally referred to the growing of things, as in agriculture. Eventually it came to embrace the cultivation of art, music, poetry and other "high-culture" pursuits of a high-minded élite. In modern times, anthropologists and sociologists have broadened the term to embrace the "low-culture" enthusiasms of the masses, as well as caste systems, burial customs and other behavior.

The French like to have it all ways. Their government spends 1.5% of GDP supporting a wide array of cultural and recreational activities (vs. only 0.7% for Germany, 0.5% for the U.K. and 0.3% for the U.S.). The Culture Ministry, with its 11,200 employees, lavishes money on such "high-culture" mainstays as museums, opera houses and theater festivals. But the ministry also appointed a Minister for Rock 'n' Roll in the 1980s to help France compete against the Anglo-Saxons (unsuccessfully). Likewise, parliament in 2005 voted to designate foie gras as a protection-worthy part of the nation's cultural heritage.

Cultural subsidies in France are ubiquitous. Producers of just about any nonpornographic movie can get an advance from the government against box-office receipts (most loans are never fully repaid). Proceeds from an 11% tax on cinema tickets are plowed back into subsidies. Canal Plus, the country's leading pay-TV channel, must spend 20% of its revenues buying rights to French movies. By law, 40% of shows on TV and music on radio must be French. Separate quotas govern prime-time hours to ensure that French programming is not relegated to the middle of the night. The government provides special tax breaks for freelance workers in the performing arts. Painters and sculptors can get subsidized studio space. The state also runs a shadow program out of the Foreign Ministry that goes far beyond the cultural efforts of other major countries. France sends planeloads of artists, performers and their works abroad, and it subsidizes 148 cultural groups, 26 research centers and 176 archaeological digs overseas.

With all those advantages, why don't French cultural offerings fare better abroad? One problem is that many of them are in French, now merely the world's 12th most widely spoken language (Chinese is first, English second). Worse still, the major organs of cultural criticism and publicity — the global buzz machine — are increasingly based in the U.S. and Britain. "In the '40s and '50s, everybody knew France was the center of the art scene, and you had to come here to get noticed," says Quemin. "Now you have to go to New York."

Another problem may be the subsidies, which critics say ensure mediocrity. In his widely discussed 2006 book On Culture in America, former French cultural attaché Frédéric Martel marvels at how the U.S. can produce so much "high" culture of lofty quality with hardly any government support. He concludes that subsidy policies like France's discourage private participants — and money — from entering the cultural space. Martel observes: "If the Culture Ministry is nowhere to be found, cultural life is everywhere."

Other critics warn that protecting cultural industries narrows their appeal. With a domestic market sheltered by quotas and a language barrier, French producers can thrive without selling overseas. Only about 1 in 5 French films gets exported to the U.S., 1 in 3 to Germany. "If France were the only nation that could decide what is art and what is not, then French artists would do very well," says Quemin. "But we're not the only player, so our artists have to learn to look outside."

Certain aspects of national character may also play a role. Abstraction and theory have long been prized in France's intellectual life and emphasized in its schools. Nowhere is that tendency more apparent than in French fiction, which still suffers from the introspective 1950s nouveau roman (new novel) movement. Many of today's most critically revered French novelists write spare, elegant fiction that doesn't travel well. Others practice what the French call autofiction — thinly veiled memoirs that make no bones about being conceived in deep self-absorption. Christine Angot received the 2006 Prix de Flore for her latest work, Rendez-vous, an exhaustively introspective dissection of her love affairs. One of the few contemporary French writers widely published abroad, Michel Houellebecq, is known chiefly for misogyny, misanthropy and an obsession with sex. "In America, a writer wants to work hard and be successful," says François Busnel, editorial director of Lire, a popular magazine about books (only in France!). "French writers think they have to be intellectuals."

Conversely, foreign fiction — especially topical, realistic novels — sells well in France. Such story-driven Anglo-Saxon authors as William Boyd, John le Carré and Ian McEwan are over-represented on French best-seller lists, while Americans such as Paul Auster and Douglas Kennedy are considered adopted sons. "This is a place where literature is still taken seriously," says Kennedy, whose The Woman in the Fifth was a recent best seller in French translation. "But if you look at American fiction, it deals with the American condition, one way or another. French novelists produce interesting stuff, but what they are not doing is looking at France."

French cinema has also suffered from a nouveau roman complex. "The typical French film of the '80s and '90s had a bunch of people sitting at lunch and disagreeing with each other," quips Marc Levy, one of France's best-selling novelists. (His Et si c'Etait Vrai... , published in English as If Only It Were True, became the 2005 Hollywood film Just Like Heaven starring Reese Witherspoon and Mark Ruffalo.) "An hour and a half later, they are sitting at dinner, and some are agreeing while others are disagreeing." France today can make slick, highly commercial movies — Amélie, Brotherhood of the Wolf — but for many foreigners the taint of talkiness lingers.

The next act
How to make France a cultural giant again? One place to start is the education system, where a series of reforms over the years has crowded the arts out of the curriculum. "One learns to read at school, one doesn't learn to see," complains Pierre Rosenberg, a former director of the Louvre museum. To that end, Sarkozy has proposed an expansion of art-history courses for high schoolers. He has also promised measures to entice more of them to pursue the literature baccalaureate program. Once the most popular course of study, it is now far outstripped by the science and economics-sociology options. "We need literary people, pupils who can master speech and reason," says Education Minister Xavier Darcos. "They are always in demand."

Sarkozy sent a chill through the French intelligentsia last summer by calling for the "democratization" of culture. Many took this to mean that cultural policy should be based on market forces, not on professional judgments about quality. With more important adversaries to confront — notably the pampered civil-service unions — Sarkozy is unlikely to pick a fight over cultural subsidies, which remain vastly popular.

But the government may well try to foster private participation by tinkering with the tax system. "In the U.S. you can donate a painting to a museum and take a full deduction," says art expert Boïcos. "Here it's limited. Here the government makes the important decisions. But if the private sector got more involved and cultural institutions got more autonomy, France could undergo a major artistic revival." Sarkozy's appointment of Christine Albanel as Culture Minister looks like a vote for individual initiative: as director of Versailles, she has cultivated private donations and partnerships with businesses. The Louvre has gone one step further by effectively licensing its name to offshoots in Atlanta and Abu Dhabi.

A more difficult task will be to change French thinking. Though it is perilous to generalize about 60 million people, there is a strain in the national mind-set that distrusts commercial success. Opinion polls show that more young French aspire to government jobs than to careers in business. "Americans think that if artists are successful, they must be good," says Quemin. "We think that if they're successful, they're too commercial. Success is considered bad taste."

At the same time, other countries' thinking could use an update. Britain, Germany and the U.S. in particular are so focused on their own enormous cultural output that they tend to ignore France. Says Guy Walter, director of the Villa Gillet cultural center in Lyon: "When I point out a great new French novel to a New York publisher, I am told it's 'too Frenchy.' But Americans don't read French, so they don't really know."

What those foreigners are missing is that French culture is surprisingly lively. Its movies are getting more imaginative and accessible. Just look at the Taxi films of Luc Besson and Gérard Krawczyk, a rollicking series of Hong Kong-style action comedies; or at such intelligent yet crowd-pleasing works as Cédric Klapisch's L'Auberge Espagnole and Jacques Audiard's The Beat That My Heart Skipped, both hits on the foreign art-house circuit. French novelists are focusing increasingly on the here and now: one of the big books of this year's literary rentrée, Yasmina Reza's L'Aube le Soir ou la Nuit (Dawn Dusk or Night) is about Sarkozy's recent electoral campaign. Another standout, Olivier Adam's A l'Abri de Rien (In the Shelter of Nothing), concerns immigrants at the notorious Sangatte refugee camp. France's Japan-influenced bandes dessinées (comic-strip) artists have made their country a leader in one of literature's hottest genres: the graphic novel. Singers like Camille, Benjamin Biolay and Vincent Delerm have revived the chanson. Hip-hop artists like Senegal-born MC Solaar, Cyprus-born Diam's and Abd al Malik, a son of Congolese immigrants, have taken the verlan of the streets and turned it into a sharper, more poetic version of American rap.

Therein may lie France's return to global glory. The country's angry, ambitious minorities are committing culture all over the place. France has become a multiethnic bazaar of art, music and writing from the banlieues and disparate corners of the nonwhite world. African, Asian and Latin American music get more retail space in France than perhaps any other country. Movies from Afghanistan, Argentina, Hungary and other distant lands fill the cinemas. Authors of all nations are translated into French and, inevitably, will influence the next generation of French writers. Despite all its quotas and subsidies, France is a paradise for connoisseurs of foreign cultures. "France has always been a country where people could come from any country and immediately start painting or writing in French — or even not in French," says Marjane Satrapi, an Iranian whose movie based on her graphic novel Persepolis is France's 2008 Oscar entry in the Best Foreign Film category. "The richness of French culture is based on that quality."

And what keeps a nation great if not the infusion of new energy from the margins? Expand the definition of culture a bit, and you'll find three fields in which France excels by absorbing outside influences. First, France is arguably the world leader in fashion, thanks to the sharp antennae of its cosmopolitan designers. Second, French cuisine — built on the foundation of Italian and, increasingly, Asian traditions — remains the global standard. Third, French winemakers are using techniques developed abroad to retain their reputation for excellence in the face of competition from newer wine-growing regions. Tellingly, many French vines were long ago grafted onto disease-resistant rootstocks from, of all places, the U.S. "We have to take the risk of globalization," says Villa Gillet's Guy Walter. "We must welcome the outside world."

Jean-Paul Sartre, the giant of postwar French letters, wrote in 1946 to thank the U.S. for Hemingway, Faulkner and other writers who were then influencing French fiction — but whom Americans were starting to take for granted. "We shall give back to you these techniques which you have lent us," he promised. "We shall return them digested, intellectualized, less effective, and less brutal — consciously adapted to French taste. Because of this incessant exchange, which makes nations rediscover in other nations what they have invented first and then rejected, perhaps you will rediscover in these new [French] books the eternal youth of that 'old' Faulkner."

Thus will the world discover the eternal youth of France, a nation whose long quest for glory has honed a fine appreciation for the art of borrowing. And when the more conventional minds of the French cultural establishment — along with their self-occupied counterparts abroad — stop fretting about decline and start applauding the ferment on the fringes, France will reclaim its reputation as a cultural power, a land where every new season brings a harvest of genius.

By DON MORRISON/PARIS

mercredi 21 juin 2017

Hepatitis B vaccine and multiple sclerosis

https://curia.europa.eu/jcms/upload/docs/application/pdf/2017-06/cp170066fr.pdf

C'est un peu plus compliqué que cela puisqu'il y a un effet adjuvant de la stimulation immunitaire vaccinale sur la SEP préclinique.
Chez les patients qui sont en train de constituer l'inflammation chronique et l'auto immunité dans leur système nerveux central, la vaccination accélère l'arrivée de La SEP qui bien évidemment apparaît dans les statistiques. En revanche sur le moyen long terme il n'y aura pas d'augmentation du pourcentage de sclérose en plaques dans la population vaccinée par rapport à celle qui n'est pas vaccinée où a celle qui historiquement sert de référence.
La bien évidemment la causalité juridique prend le pas sur la causalité scientifique car elle ne relèvent pas de la même rationalité.
Expliquer cela à un patient avant de le vacciner c'est-à-dire obtenir un consentement éclairé, vraiment éclairé est un vrai défi.
"La cour de justice du Luxembourg serait-elle supérieure scientifiquement à Cochrane et aux différentes méta-analyses qui disent le contraire?"



Il ne s'agit pas de supériorité il s'agit du faite que le domaine du droit et le domaine de la science n'épousent pas la même rationalité. Et comme je l'explique juste au-dessus il y a quand même lien, le lien n'est pas causale sur le déclenchement des événements initiaux de l'auto-immunité mais il est causale sur l'accélération du processus auto-immuns et de l'inflammation.

Il faut sortir de la causalité 1,0. Tout dépend de quelle causalité on parle. Bien évidemment que l'initiation du processus auto-immuns précède la vaccination quand la sclérose en plaques se déclare dans les semaines ou les mois qui suivent. Néanmoins il est bien établi par le pic de prévalence que des sclérose en plaques qui se seraient déclarées plusieurs mois ou plusieurs années après vont se déclarer plus tôt . Le vaccin joue un rôle adjuvant dans le processus auto-immune est dans le processus inflammatoire. Les cours historique ne mettent pas en évidence d'augmentation de la gravité. En conclusion le modèle de compréhension actuel est que le vaccin accélère le processus auto-immun et inflammatoire, si le patient n'avait pas un tel processus avant rien ne se passe, s'il était en train de constituer une maladie auto-immune et en particulier du système nerveux comme la sclérose en plaques il y a une petite mais parfaitement mesurable augmentation de la prévalence post-vaccinale de cette maladie.

Barcelona supercomputer

http://blog.lenovo.com/en/blog/barcelona-supercomputing-center-mare-nostrum/
 
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