Update on osteoporosis from the 2014 Santa Fe Bone symposium.

The 2014 Santa Fe Bone Symposium provided a setting for the presentation and discussion of the clinical relevance of recent advances in the fields of osteoporosis and metabolic bone disease. The format included oral presentations of abstracts by endocrinology fellows, plenary lectures, panel discussions and breakout sessions, with ample opportunities for informal discussions before and after scheduled events. Topics addressed in these proceedings included a review of the important scientific publications in the past year, fracture prevention in patients with dysmobility and immobility, fracture liaison services for secondary fracture prevention, management of pre-menopausal osteoporosis, the role of bone microarchitecture in determining bone strength, measurement of microarchitecture in clinical practice and methods to improve the quality of bone density testing. This is a report of the proceedings of the 2014 Santa Fe Bone Symposium.

LS 5039: A runaway microquasar ejected from the galactic plane

We have compiled optical and radio astrometric data of the microquasar LS 5039 and derived its proper motion. This, together with the distance and radial velocity of the system, allows us to state that this source is escaping from its own regional standard of rest, with a total systemic velocity of about 150 km/s and a component perpendicular to the galactic plane larger than 100 km/s. This is probably the result of an acceleration obtained during the supernova event that created the compact object in this binary system. We have computed the trajectory of LS 5039 in the past, and searched for OB associations and supernova remnants in its path. In particular, we have studied the possible association between LS 5039 and the supernova remnant G016.8-01.1, which, despite our efforts, remains dubious. We have also discovered and studied an HI cavity in the ISM, which could have been created by the stellar wind of LS 5039 or by the progenitor of the compact object in the system. Finally, in the symmetric supernova explosion scenario, we estimate that at least 17 solar masses were lost in order to produce the high eccentricity observed. Such a mass loss could also explain the observed runaway velocity of the microquasar.

The new final Clinical Skills examination in human medicine in Switzerland: Essential steps of exam development, implementation and evaluation, and central insights from the perspective of the national Working Group.

OBJECTIVE: Since 2011, the new national final examination in human medicine has been implemented in Switzerland, with a structured clinical-practical part in the OSCE format. From the perspective of the national Working Group, the current article describes the essential steps in the development, implementation and evaluation of the Federal Licensing Examination Clinical Skills (FLE CS) as well as the applied quality assurance measures. Finally, central insights gained from the last years are presented. METHODS: Based on the principles of action research, the FLE CS is in a constant state of further development. On the foundation of systematically documented experiences from previous years, in the Working Group, unresolved questions are discussed and resulting solution approaches are substantiated (planning), implemented in the examination (implementation) and subsequently evaluated (reflection). The presented results are the product of this iterative procedure. RESULTS: The FLE CS is created by experts from all faculties and subject areas in a multistage process. The examination is administered in German and French on a decentralised basis and consists of twelve interdisciplinary stations per candidate. As important quality assurance measures, the national Review Board (content validation) and the meetings of the standardised patient trainers (standardisation) have proven worthwhile. The statistical analyses show good measurement reliability and support the construct validity of the examination. Among the central insights of the past years, it has been established that the consistent implementation of the principles of action research contributes to the successful further development of the examination. CONCLUSION: The centrally coordinated, collaborative-iterative process, incorporating experts from all faculties, makes a fundamental contribution to the quality of the FLE CS. The processes and insights presented here can be useful for others planning a similar undertaking.

Effect of Cumulating Exposure to Abacavir on the Risk of Cardiovascular Disease Events in Patients From the Swiss HIV Cohort Study.

BACKGROUND: Patients with HIV exposed to the antiretroviral drug abacavir may have an increased risk of cardiovascular disease (CVD). There is concern that this association arises because of a channeling bias. Even if exposure is a risk, it is not clear how that risk changes as exposure cumulates. METHODS: We assess the effect of exposure to abacavir on the risk of CVD events in the Swiss HIV Cohort Study. We use a new marginal structural Cox model to estimate the effect of abacavir as a flexible function of past exposures while accounting for risk factors that potentially lie on a causal pathway between exposure to abacavir and CVD. RESULTS: A total of 11,856 patients were followed for a median of 6.6 years; 365 patients had a CVD event (4.6 events per 1000 patient-years). In a conventional Cox model, recent--but not cumulative--exposure to abacavir increased the risk of a CVD event. In the new marginal structural Cox model, continued exposure to abacavir during the past 4 years increased the risk of a CVD event (hazard ratio = 2.06; 95% confidence interval: 1.43 to 2.98). The estimated function for the effect of past exposures suggests that exposure during the past 6-36 months caused the greatest increase in risk. CONCLUSIONS: Abacavir increases the risk of a CVD event: the effect of exposure is not immediate, rather the risk increases as exposure cumulates over the past few years. This gradual increase in risk is not consistent with a rapidly acting mechanism, such as acute inflammation.

Emerging bacterial pathogens: the past and beyond.

Since the 1950s, medical communities have been facing with emerging and reemerging infectious diseases, and emerging pathogens are now considered to be a major microbiologic public health threat. In this review, we focus on bacterial emerging diseases and explore factors involved in their emergence as well as future challenges. We identified 26 major emerging and reemerging infectious diseases of bacterial origin; most of them originated either from an animal and are considered to be zoonoses or from water sources. Major contributing factors in the emergence of these bacterial infections are: (1) development of new diagnostic tools, such as improvements in culture methods, development of molecular techniques and implementation of mass spectrometry in microbiology; (2) increase in human exposure to bacterial pathogens as a result of sociodemographic and environmental changes; and (3) emergence of more virulent bacterial strains and opportunistic infections, especially affecting immunocompromised populations. A precise definition of their implications in human disease is challenging and requires the comprehensive integration of microbiological, clinical and epidemiologic aspects as well as the use of experimental models. It is now urgent to allocate financial resources to gather international data to provide a better understanding of the clinical relevance of these waterborne and zoonotic emerging diseases.

Unca Don and Unca Scrooge’s Guide to History. Representations of the Past in the Disney Comics of Don Rosa

This thesis studies the various forms and layers of representations of the past that can be found in the Disney comics of Don Rosa. To stay true to the legacy of renowned comic book artist Carl Barks, Rosa has stopped time in the duck universe to the 1950’s: the decade when Barks created his most noted stories. There is a special feel of historicalness in Rosa’s duck stories, as his characters recall events that occurred in both Rosa’s own stories as well as Barks’. Rosa has shed new light to the past of the characters by writing and illustrating the history of Scrooge McDuck, one of the most beloved Disney characters. Rosa is also adamant that the historical facts used in his stories are always correct and based on thorough research. The methodological tools used in the analysis of the comics come from the fields of comic book studies, film theory, and history culture. Film and comics are recognized by many scholars as very similar media, which share elements that make them comparable in many ways. This thesis utilizes studies on historical film, narrative and genre, which provide valuable insight and comparisons for analysis. The thesis consists of three main chapters, the first of which deconstructs the duck universe in the stories in order to understand how the historicalness in them is created,and which outside elements might affect them, including the genre of Disney comics, publishers, and the legacy of Barks. The next chapter focuses on The Life and Times of Scrooge McDuck series, i.e. the stories which are located in the past. Such stories feature similar representations of history as for example Westerns. They also compress and alter history to meet the restrictions of the medium of comics. The last part focuses on the adventure stories which draw inspiration from for example mythology, and take the characters to strange and mystical, but yet historical worlds. Such treasure-hunting stories show similarity to the action-adventure genre in film and for example their stereotypical representations of foreign cultures. Finally, the chapter addresses the problematic of historical fiction and its capability to write history.

A strategy for obtaining social benefits from the gene revolution

The strategy described in the present paper offers details about the possibility for Brazil to play a more substantial role in the gene revolution. If successfully applied, the powerful science-based technology currently available in Brazil can contribute to extend the benefits of the gene revolution to the poorest countries, very much like the Green Revolution did in the past, thereby reducing the hunger syndrome which claimed the lives of millions of people in some Asian countries, particularly Pakistan and India, decades ago. In his visit to Brazil in February 2004, Norman Borlaug had the opportunity to witness the success of Brazilian agriculture. At a Conference held at ESALQ - Superior School of Agriculture Luiz de Queiroz in Piracicaba, SP, Brazil, he stated that the 21st century revolution will come from Brazil in the area of agriculture. He also said that reducing hunger is essential for the world to achieve socioeconomic stability. A central question remains unanswered: who will fund this revolution? The FAO 2003-2004 Annual Report listed the barriers preventing the gene revolution from reaching the poorest countries: inadequate regulatory procedures - Intellectual Property Rights and Biosafety, poorly functioning seed delivering systems and weak domestic plant breeding capacity; all are discussed in this paper.

Criminal justice system in pondicherry - a comparative critical study of the past and the presen

The Union Territory of Pondicherry prior to its merger with the Indian Union was a French Colony. The erstwhile territory of Pondicherry along with its hamlets, namely, KARAIKKAL, MAHE and YANAM was administered by the French Regime. Before it was established by French in 1 6 74 A.D. it was part of Vijayanagara Empire. Prior to this, Pondicherry was a part of the Kingdom of Chola and Pallava Kings. During French Regime, the laws which were in force in France in relation to administration of civil and criminal justice were extended to the erstwhile Territory of Pondicherry. Thus while Pondicherry stood influenced by the Inquisitorial system since the beginning of the 18th century, the neighboring states forming part of the Indian Union since Independence came under the Influence of the British system, viz. accusatorial system. The territory of Pondicherry, for administrative reasons, came to be merged with the Indian Union in the early 60's. Following the merger, the Indian administration sought to extent its own laws from time to time replacing erstwhile French Laws, however, subject to certain savings. Thus the transitional period witnessed consequential changes in the administration of the territory, including the sphere of judicial system. Since I 963, the Union Territory of Pondicherry was brought under the spell of the Indian Legal System The people in Pondicherry ' thus have had the benefit of experiencing both the svstems. Their experiences will be of much help to those who undertake comparative studies in law. The plus and minus points of the respective systems help one to develop a detachment that helps independent evaluation of the svstents. The result of these studies could be relevant in revitalising our criminal systems.The present system is evaluated in the light of the past system. New dimensions are added by way' of an empirical study also.

The dark side of the Mediterranean : expression of fear from the inquisition to the present

Inside the stones of its most famous buildings, Évora keeps mysteries and secrets which constitute the most hidden side of its cultural identity. A World Heritage site, this town seems to preserve, in its medieval walls, a precious knowledge of the most universal and ancient human emotion: fear. Trying to transcend many of its past and future fears, some of its historical monuments in Gothic style were erected against the fear of death, the most terrible of all fears, which the famous inscription, in the Bones Chapel of the Church of São Francisco, insistently reminds us, through the most disturbing words: “Nós ossos que aqui estamos pelos vossos esperamos”. If the first inquisitors worked in central Europe (Germany, northern Italy, eastern France), later the centres of the Inquisition were established in the Mediterranean regions, especially southern France, Italy, Portugal, and Spain. Consequently, the roots of fear in Évora are common to other towns, where the Inquisition developed a culture of fear, through which we can penetrate into the dark side of the Mediterranean, where people were subjected to the same terrifying methods of persecution and torture. This common geographical and historical context was not ignored by one of the most famous masters of American gothic fiction, Edgar Allan Poe. Through the pages of The Pit and the Pendulum, readers get precise images of the fearful instruments of terror that were able to produce the legend that has made the first grand inquisitor, Tomas de Torquemada, a symbol of ultimate cruelty, bigotry, intolerance, and religious fanaticism, which unfortunately are still the source of our present fears in a time when religious beliefs can be used again as a motif of war and destruction. As Krishnamurti once suggested, only a fundamental realization of the root of all fear can free our minds.

Multiple phases of North African humidity recorded in lacustrine sediments from the Fazzan Basin, Libyan Sahara

The Fazzan Basin of south-west Libya is at present arid with less than 20 mm of rainfall per annum. However, regionally extensive limestones, lacustrine sands and coquina (fossiliferous carbonate rock) deposits show that the Fazzan Basin previously contained a large palaeolake, indicating that the climate in the past was more humid. Optically stimulated luminescence (OSL) dating techniques have been applied to key lacustrine deposits within the basin in an attempt to provide an internally consistent chronology for this humidity record. Results indicate that palaeolake sediments within the Fazzan Basin record a very long history of palacohydrological change, ranging from present day and conditions to humidity capable of sustaining a lake with an approximate area of 76,250 km(2). The existence of humid periods in mid oxygen isotope stage 5 and the early Holocene is confirmed. An older lacustrine event, tentatively correlated to oxygen isotope stage 11, is also recognized. In addition, evidence is presented for at least two humid phases beyond the age range over which the conventional OSL dating technique is applicable. This study demonstrates that OSL dating of palaeolake sediments within the Fazzan Basin offers the potential to provide a detailed record of North African humidity spanning several glacial-interglacial cycles. (c) 2006 Elsevier Ltd. All rights reserved.

Life histories of music service histories, the past in inductees' present

This article discusses inductee music service teachers (to 25 years of age). It explores how their lives, as perceived, shape current identities in teaching and result in several career problems. Respondents were drawn from a comprehensive life history study of 28 Local Education Authority employees. Of this larger cohort, four were age 25 years and below, and the remaining 24 teachers made retrospective comments. Data were collected and analysed between October 2002 and March 2004. Principal findings suggest that schooling failed to address these educators' needs as musical learners; key childhood experiences were external of schools. This often resulted in an idealistic trajectory, in teenage years, towards an occupation as a performer. An occupation in music education was entirely disregarded. Consequently, inductees now consider training experiences an inappropriate platform for their professional lives. Managing group teaching and children's behaviour engenders considerable anxiety. Music service work is also deemed a transient state of affairs. There are implications for training, retention and professional development.

Climate and human influences on global biomass burning over the past two millennia

Large, well-documented wildfires have recently generated worldwide attention, and raised concerns about the impacts of humans and climate change on wildfire regimes. However, comparatively little is known about the patterns and driving forces of global fire activity before the twentieth century. Here we compile sedimentary charcoal records spanning six continents to document trends in both natural and anthropogenic biomass burning for the past two millennia. We find that global biomass burning declined from AD 1 to 1750, before rising sharply between 1750 and 1870. Global burning then declined abruptly after 1870. The early decline in biomass burning occurred in concert with a global cooling trend and despite a rise in the human population. We suggest the subsequent rise was linked to increasing human influences, such as population growth and land-use changes. Our compilation suggests that the final decline occurred despite increasing air temperatures and population. We attribute this reduction in the amount of biomass burned over the past 150 years to the global expansion of intensive grazing, agriculture and fire management.

Pleistocene water intrusions from the Mediterranean and Caspian Seas into the Black Sea

The hydrological balance of the Black Sea is governed by riverine input and by the exchange with the Mediterranean Sea. A speleothem record from a cave in northern Turkey that tracks the isotopic signature of Black Sea surface water suggests an open connection to the Mediterranean Sea in at least twelve periods in the past 670,000 years.

Britain and the Commonwealth: confronting the past - imagining the future

This is an extended version of Philip Murphy's inaugural lecture as director of the Institute of Commonwealth Studies, delivered on 23 February 2011. It traces the relationship of the UK with the wider Commonwealth over 40 years, paying particular attention to the rhetoric of governments and opposition parties from Wilson and Heath to Cameron. It examines the reasons for the Commonwealth being relegated to a peripheral role in British foreign policy, especially European preoccupations and the issues of Rhodesia and South Africa. It argues that the Commonwealth remains of considerable practical and enormous symbolic importance to the UK. The British government should engage with the Commonwealth more than it has done in the recent past and the Commonwealth should be both open to and critical of its imperial past.

Evidence for a climate signal in trends of global crop yield variability over the past 50 years

Low variability of crop production from year to year is desirable for many reasons, including reduced income risk and stability of supplies. Therefore, it is important to understand the nature of yield variability, whether it is changing through time, and how it varies between crops and regions. Previous studies have shown that national crop yield variability has changed in the past, with the direction and magnitude dependent on crop type and location. Whilst such studies acknowledge the importance of climate variability in determining yield variability, it has been assumed that its magnitude and its effect on crop production have not changed through time and, hence, that changes to yield variability have been due to non-climatic factors. We address this assumption by jointly examining yield and climate variability for three major crops (rice, wheat and maize) over the past 50 years. National yield time series and growing season temperature and precipitation were de-trended and related using multiple linear regression. Yield variability changed significantly in half of the crop–country combinations examined. For several crop–country combinations, changes in yield variability were related to changes in climate variability.