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A fatal combined infection with canine distemper virus (CDV) and orthopoxvirus (OPXV) in Asian marmots (Marmota caudata) is reported in this article. A total of 7 Asian marmots from a small zoological garden in Switzerland were found dead in hibernation during a routine check in the winter of 2011. The marmots died in February 2011. No clinical signs of disease were observed at any time. The viruses were detected in all individuals for which the tissues were available (n = 3). Detection of the viruses was performed by reverse transcription polymerase chain reaction. The most consistent gross lesion was a neck and thorax edema. A necrotizing pharyngitis and a multifocal necrotizing pneumonia were observed histologically. Numerous large intracytoplasmic eosinophilic inclusions were seen in the epithelial cells of the pharynx, of the airways, and in the skin keratinocytes. Brain lesions were limited to mild multifocal gliosis. Phylogenetic analysis revealed that the marmot CDV strain was closely related to the clusters of CDVs detected in Switzerland in wild carnivores during a local outbreak in 2002 and the 2009-2010 nationwide epidemic, suggesting a spillover of this virus from wildlife. The OPXV was most closely related to a strain of cowpoxvirus, a poxvirus species considered endemic in Europe. This is the first reported instance of CDV infection in a rodent species and of a combined CDV and OPXV infection.

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CONTEXT: E-learning resources, such as virtual patients (VPs), can be more effective when they are integrated in the curriculum. To gain insights that can inform guidelines for the curricular integration of VPs, we explored students' perceptions of scenarios with integrated and non-integrated VPs aimed at promoting clinical reasoning skills. METHODS: During their paediatric clerkship, 116 fifth-year medical students were given at least ten VPs embedded in eight integrated scenarios and as non-integrated add-ons. The scenarios differed in the sequencing and alignment of VPs and related educational activities, tutor involvement, number of VPs, relevance to assessment and involvement of real patients. We sought students' perceptions on the VP scenarios in focus group interviews with eight groups of 4-7 randomly selected students (n = 39). The interviews were recorded, transcribed and analysed qualitatively. RESULTS: The analysis resulted in six themes reflecting students' perceptions of important features for effective curricular integration of VPs: (i) continuous and stable online access, (ii) increasing complexity, adapted to students' knowledge, (iii) VP-related workload offset by elimination of other activities, (iv) optimal sequencing (e.g.: lecture--1 to 2 VP(s)--tutor-led small group discussion--real patient) and (V) optimal alignment of VPs and educational activities, (vi) inclusion of VP topics in assessment. CONCLUSIONS: The themes appear to offer starting points for the development of a framework to guide the curricular integration of VPs. Their impact needs to be confirmed by studies using quantitative controlled designs.

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Joseph Furttenbach (1591 1667) wirkte als Architekt, Ingenieur, Baumeister, Sammler, Chronist und Tagebuchschreiber in der ersten Hälfte des 17. Jahrhunderts. Seine autobiographischen Aufzeichnungen sind bisher unveröffentlicht geblieben. Sie werfen faszinierende Schlaglichter auf das Leben eines protestantischen Vermittlers italienischer Barockkultur im Süden des Alten Reiches, auf die kulturellen und sozialen Aktivi täten eines Kunstkammerbesitzers sowie den Alltag eines Stadtbaumeisters und frommen Lutheraners in der Reichsstadt Ulm.

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Viele Menschen erleben das mittlere Alter als eine spannende, teils auch bedrängende Übergangszeit. Die Erfahrung des langsamen körperlichen Alterns, der Verlust von jugendlicher Schönheit und körperlicher Kraft zeigen an, dass die eigene Lebenszeit nicht unbegrenzt ist. Damit rückt die Frage ins Zentrum, wie die verbleibende Zeit am besten zu nutzen ist. Neuorientierungen in Partnerschaft und Beruf können die Folge sein. Die individuellen Werte können sich deutlich verschieben. Im Gegensatz zur Jugend und dem höheren Alter hat das mittlere Alter bisher in der Öffentlichkeit weniger Beachtung gefunden. Als erste umfassende Ausstellung zur Thematik bietet die Ausstellung «Halbzeit» eine vertiefte Auseinandersetzung mit der Phase des Übergangs von der Jugend zum Alter. Sie vereinigt künstlerische Positionen, Interviews mit Menschen im mittleren Alter und zahlreiche Sachexponate zu einem interaktiven Erlebnis- und Erfahrungsraum.