Health technology assessment (HTA) is an interesting scientific field. The new digital opportunities allow people to participate in medical and medication trials in their homes or even in bed. Their health data and the administration of medication is also encouraged and sometimes supported through digital devices. The pharma and health industries have many devices ready to go. The differences to the traditional forms of medical trials, however, is an issue as we want to compare the results from both kinds of trials. Participants of trials, might prefer or struggle with these novel kinds of study designs. In any case the results will be impacted in several forms (Study Link). In the best of all worlds for the researcher the effects will cancel out each other, but is rather unlikely. Some participants will reach more positive effects with the use of digital tools, whereas others are challenged and might even abandon during the trial. Monitoring during the study (for example through digital inhalors) is another advantage of such distributed trials. Rather than taking adherence to a trial medication for granted, digital tools allow a more precise monitoring of subgroups as well. Data and effort invested in the trial is preserved through the easier access to person’s information, assuming continuous readiness to stay on in the trial.
Our own smartphones are still underexploited in terms of health monitoring and use in research designs. The possibilities to link data to other external data sources shall further advance the research potentials in many interesting ways. Data protection and data security become even more important with the ever smarter phones and connected devices.
Health data
2025 will be a crucial year for health data across the EU. Germany introduced the electronic patient card, which can store basic information to then access data in the health insurance cloud for medical doctors, hospitals and other related health services. Potentially this is a great step ahead as some tests do not have to be repeated if they had been completed recently before already.
In pseudomised form, research may draw samples from such databases to enhance our science based understanding of disease. The evaluation of public health interventions becomes easier and medium and long term efficiency of measures can be assessed in many instances.
The Belgian research using health data has met to discuss the potential and limitations to link health data to other data sources to allow more complete and more complex analyses of health and disease processes. Another extensive data source sits on our smartphone. Collection of steps walked, sleep patterns or heart beats give valuable insights into a person’s own contribution and care about personal health. Although data are frequently incomplete, researchers are used to estimate missing data on the basis of existing or comparable person’s data. The basis for improving health for all are quite promising, data handling and linking them will be a challenge to the competence of all stakeholders and everyone involved in better health. It will be stressful before it becomes a routine. 
String Quartets
There is a plural form of Quartet. Philip Glass has composed a piece for 3 string quartets. Thanks to the Kronos Quartet performing and celebrating in Brussels, modern compositions are continuously added to the repertoire written for and performed by string quartets. Contrary to received wisdom the tradition of string quartets is still alive and kicking. At Bozar (Brussels) the marathon performance of 27 quartets, not all at once, but spread over a day and several locations, afforded a great free-of-charge opportunity to wipe off the dust from the sometimes rather introverted form of string quartets. Despite the high share of young musicians who performed well at the occasion, the afternoon focused more on new compositions. Concerning the audience, however, there is still an older age bias in listeners, more the standard Bozar clientele so far.
The afternoon reminded me on listening CDs entitled: “I don’t like classic music, but this one I do”. Many people came for art exhibitions at Bozar, but then (re-)discovered on the sideline the atmosphere of chamber music at this occasion. Closing the age and social gap in classical music is quite a challenge. It is surely more like a marathon than just a few sprints here and there. The new format at Bozar in cooperation with the Kronos Fifty for the Future Marathon will sooner or later find extended audiences beyond the happy few this time. I would recommend listening to string quartet music more often until the “Transcranial direct current stimulation (tDCS)” will be the new hype. 
Sociolegal Circularity
At times legal systems feel like going round in circles. Legal procedures move from one stage to the next and they may get referred back to the previous instance to resolve a particular issue or restart the procedure. This has good reasons with the aim of “doing justice”. Sociolegal circularity, however, begins before the, right at the beginning and negotiation of legislation on which all legal systems are based in democracies, that is. Hence, the legal definition of waste, recycling as part of the circular economy and society is rather crucial.
Circularity is a complex sociolegal issue as the example of PFAS in plastics demonstrate. In economic theory the existence of externalities invites profit seeking of the kind like: “the sea in large part is owned by us all and there is no price attached to the (ab)use of it. Dumb PFAS into the sea, because the costs of cleaning up will be shared by all of us”. In order to limit the extent of this economic logic, we have to rely on sociolegal processes. The precise definition of property rights and liabilities beyond the PFAS issue have to be well-defined. It is an intergenerational topic as well, not only in view of deferred payments.
Parliaments have to be rather competent to look through all the complex issues of producing and recycling of materials to make sound provisions in law including future generations. Going round in circles in parliament is yet another element of necessary condition of circularity in a rather broad sense.
The air we breathe and the water we drink have become part of this “economic externality”, which is a very internal, inside of our body kind of sociolegal affair. Who is responsible for the bad air we breathe and the contaminated water we drink? Air and water have for a long time become marketable products. The more your local water is polluted, the more we are forced to buy water. The more the air in inner cities is filled with fine dust particles, the more medical doctors, hospitals and rehabilitation facilities we need to construct.
For GDP calculations these are win-win-win situations, although they make us all worse off. Society and politics are in charge to define and redefine (yes, circles again) the legal basis with a lot of precision and scientific detail. Sociolegal circularity is key. You just have to turn it in the right direction.
(Image, Palais de Justice, Brussels view from Forest district).
Socioeconomic Circularity
Some sectors of the economy receive a lot of attention, for example sectors selling fancy cars. Other sectors, like the ones regrouped under the name of circular economy, receive much less attention and show up little in headlines. In fact, the circular economy is a great example of this. There are thousands of waste and rubbish collection, sorting and recycling centers, several hundreds of waste-to-energy plants, composting sites across the European Union. Of course, there is also a European Federation of the sector (FEAD). On the last FEAD conference in Brussels 2024 it became clear that Europe is finally waking up to the challenge of recycling costly raw materials.
The narrative concerning the sector needs to change further: what used to be subsumed as costly nuisance is in fact a potential profit center for companies and society at large. We do no longer want to import lots of raw materials from countries with dubious social and environmental records as part of our supply chains for raw materials. Time to act. This, however, is a rather complex socioeconomic challenge of circularity. The price mechanisms are not fully functional in most Member States, let alone across the EU. Additionally, the social practice to recycle varies greatly between countries. Distributional issues matter as well. It is rather obvious that dumping waste from one region/country in another one has huge implications (nuclear waste), but if one country values waste more than another one, due to innovative recycling techniques, the matter takes a marketable turn. Regulation should carefully distinguish categories of materials as we do for hazardous materials in production, consumption and for health and safety purposes of employees.
Metal, battery, cement, plastic and wood recycling pose challenges, but also opportunities to improve the European material import/export balance sheets. However, first in the circle of circularity is the use of materials. There we are clear that “less is better”. Less input of raw materials, most of which we import in the EU, reduces our dependence on other countries. This is the tricky social question of circularity. Mainstreaming of more conscious use and reuse of resources is a huge social issue, which we tend to relegate to a task for the education system. The awareness that supposed waste is also a valuable resource is spreading and the growth of the sector a business and employment opportunity for many. Circularity is the new sexy sector of the 21st century.
What have you recycled today? and myself? Well, scientific online publications. Now think of ChatGPT and the AI gold mines of 2024. There is lots of value in recycling.
(Image FEAD conference Brussels, 2024) 
Book Annotation
For most people book annotations are considered a nuisance. However, most pupils or students mark their so-called textbooks, which contain many images nowadays anyway. A good mindmap, summary of text, highlighting or critical comments may be part of their day-to-day working with a book. Some editors facilitate this using broad margins and more space between lines. Working through a text can take multiple forms and books have allowed over centuries different kinds of their usage.
There is yet another underexplored usage of books. On printed volumes annotations of previous readers may serve as a guide to a script of places, thoughts or material of particular importance. I have always found annotated copies of other readers interesting in their own right. Reading an annotated copy felt like reading another person’s mind, thought or learning process.
A modern view of books as a tool of communication might extend this perspective to study annotations of several readers on the same copy. Just like we comment today in word processing on texts from collaborators or students. Books are a means of communicating with other people or machines (AI) usually with the aim of spreading ideas, content, horror or pleasure.
Therefore, I am always happy to find annotated versions of a book, especially of prominent authors. It sometimes feels like reading a “partition”, a transcript of music which contains the comments or fingering of the reader or the performing musician. The BNF has a lot of such special copies in its archives, usually found in the donations of persons or prominent authors and their families to the archives. This can be put together to make an interesting exhibition of the process of thinking and writing and of special treasures – annotated books.
Image Bibliothèque nationale de France BNF, collection, “Annotations by Jean Racine on Homer “Ilias“.
Book Value
What is the value of a book? For the author of a book each book s/he has written or sweated the value of the accomplishment is pretty high. From the publisher’s perspective a book is an investment and sometimes a very risky one. The book store makes choices and takes the risk to devote time and effort to select the bestselling books or the best one suited to the local or passing audiences. Next in line are librarians who either stock everything published in a specific language or country (legal deposit) or select from the offer according to perceived interests of their subscribers. On the way to their audience many mistakes may occur. Books miss their targets or librarians go wild in their efforts to guard or discard books. In any case, many books do not find their audience. Some sit on shelves for years and will never be touched by anybody. Other ones pass from one hand to the other rapidly with long waiting lists.
Even if many conservationists don’t like it, it is the use of books that honors books and authors. Pocket books play a specific role in this link of readers and writer. Use rather than conservation, is the prime role of these lighter versions of books. They also have to endure heavy weather, scratches and folding of persons focused on content rather than precious form.
Last but not least in line comes the market for recycled books. Re-use of read or unread books has increased over years and some readers are happy to discover a discarded book from a previous owner (public or private). The value of a book lies in most cases in the eye of the reader. This then makes it an object of competitive marketing and continuous auctioneering.
(Image: pocket books at display of Popular heritage Lost and Found at the Royal library of Belgium 2024.
Democracy in Korea
For all scholars of the theory of democracy the writings of Alexis de Tocqueville (1835) “De la démocratie en Amérique” are a major point of reference. The comparison of the democracy in America with the French king and both constitutions reveals comparative strengths and weaknesses of political systems. Korea after the 4th of December 2024 is yet another warning of what are the dangers to democratic systems. The attempted “coup d’état” by the president of Korea together with a former defense minister and several hundred soldiers has failed due to the speedy reaction of the elected members of parliament and an attentive and reactive public (Korea Times reports).
Tocqueville (p.130-131, French edition online) states, beyond the separation of powers (John Locke), the importance of the right to nominate key positions in a society also public opinion for the survival of democracy. Modern social media have increased the “reaction time” of public opinion and the “time to action” if need be. The combination of both elements of public opinion ensured that parliamentarians in Korea rushed to parliament and used their potentially last chance to vote against the imposed martial law, which started to seal off parliament already.
Several lessons for democratic systems derive from this. Separation of power remains key for democracy. The distribution of state functions on many shoulders under the control of parliament are essential. Legal mechanisms, in case of a spontaneous attack on the system, have to be able to react fast in order to avoid spreading fake news about legality/illegality of interventions. Public opinion, the people at large, should have their opinions distributed rapidly as well. This is necessary even beyond the traditional media of TV, radio and print. In Korea 2024 the attempted “coup d’état” tried also to block traditional media and prominent figures of the opposition with high power of influencing and reach on social media.
Tocqueville stated already that kings are threatened by revolution. Elected presidents have to fear public opinion. A lesson still valid beyond the US., France and Korea in the 21st century.
(Image: joint exhibition at “Traditional Korean Painting”, Korean Cultural Centre Brussels, 2024) 
Virtual author
« La Mort de l’auteur « . In a radical sense Roland Barthes was the first to proclaim the death of author as the sole master or mastermind of a text or speech. In fact there are many more on whose direct or indirect contributions a text is based on. However, biographical accounts of an author can only enlighten some (minor) aspects of the influences on the author and the final version of a text, (l’écriture), and the reader (lecteur). In « Le degre zero » the analysis of the different styles of Flaubert and Proust are extolled ( p. 131-139). Flaubert is characterized as the author with infinite corrections on the same texts and sources. It appears today as an endless loop of an algorithm where the stopping rule is not properly defined or implemented. Much in line with the « tabula gratulatoria » of Barthes (p. 279 of Fragments…, see image below) some AI systems return fake versions of a bibliography some readers will rely on.
In the 21st century l’écriture has become almost inexistant without the technical support of machines, but most of all artificial intelligence. The author is dead, long live the virtual author. The assistance of spelling, grammar and style editing from software programs has widened the spectrum of coauthoring. Editors take more influence through pushing marketing potentials of authors and their writings. Based on previous manuscripts and publications it is possible to produce hallucinations of an author whereby only the author might be able to identify the virtual authorship. At best AI generates first drafts, but similar to the linguist of Barthes, AI is likely to become another brother or sister of l’ecrivain (p. 139).
The thrust of Barthes is to highlight that there is more to a text than just the version at hand. In fact there are texts in a text or multiple versions or layers of a text. « L’enjeu de l’analyse structurale n’est pas la vérité du texte mais son pluriel » (1972, par ou commencer p.148). In conclusion, almost 50 years after the death of the author we currently witness the miraculous rebirth of the virtual author as the original deus ex machina which we always feared. Don’t worry it’s just another sibling of the original authors. 
Degré zéro
As all of us use GPS systems to navigate across the world or just in your city, “degré zéro” might nowadays be associated first of all with the prime meridian 0° longitude, which runs through Greenwich near London and around the globe.
In « Le degré zéro de l’écriture », Roland Barthes (1953) challenges the bourgeois kind of writing of literature. He introduced the pertinent distinction of the verticality of writing styles in the sense of social classes as well as the horizontal form of spoken language He further distinguished écriture as a person’s style which is embedded into the historical and social context of her/his time. As a radical change, Barthes proposed to use scriptor instead of writer as the latter expression is too much loaded with the historical package of the person. Barthes inserts the scriptor as écrivain into her/his time and insists on the intellectual and social context of writing or the author.
As the scriptor (p. 26) does not escape to become a writer « écrivain «, the degree zero de l’écriture postulates a homogeneous society, which obviously is an ill-conceived vision of reality. Language and texts, therefore, are not universal in kind, but bound to situations, which are defined in historical time and space (p. 67). Semiotics was a major field of his analyses of literature and language.
Whereas in a talk you might focus on the person you are talking to, in a written text the other person is « the many » readers, wherever they are and maybe at a much later time as well. There is a qualitative difference and yet modern “voice to text” transcription makes all spoken words immediately available as written document or “compte rendu”. (Source: Roland Barthes: De la parole à l’écriture. in Le grain de la voix, Entretien 1962-1980. p. 12).
Let’s watch our language as we follow the longitude or latitude around the globe and even small deviations from degree zero matter a lot. 