Bolje od bilo kojeg doktora. Budistički pogledi na termalne izvore u Sikkumu na Himalaji

Himalayan peoples bathe in hot springs for medical and spiritual therapy. Included in local myths, hot springs are natural features that form a part of cultural memory and are social, cultural, religious, and medical venues. They also represent the tension between economic growth and environmental protection and, consequently, the competition between different parts of people’s identities. By analyzing religious, historical, and medical texts in combination with biographical accounts, a comprehensive picture of the cultural and religious significance of hot springs in the Himalayas is presented. The focus lies on Buddhist influenced societies within the Tibetan Cultural Area which are those parts in the Himalayas that have been influenced by Tibetan culture.Za narode Himalaja kupanje u termalnim izvorima oblik je medicinske i duhovne terapije. Osim što su sastavnica lokalnih mitova, termalni su izvori i prirodna obilježja koja čine dio kulturnog sjećanja te su društvena, kulturna, religijska i medicinska mjesta susreta. Također, reprezentiraju napetost između ekonomskog rasta i zaštite okoliša te, posljedično, natjecanja između različitih sastavnica identiteta ljudi. Analizom vjerskih, povijesnih i medicinskih tekstova u kombinaciji s biografskim prikazima, dana je opsežna slika kulturnog i vjerskog značaja termalnih izvora na Himalaji. Težište je na društvima pod utjecajem budizma unutar tibetanskog kulturnog područja, odnosno onih područja Himalaja koja su pod utjecajem tibetanske kulture

Destination Design: A heuristic case study approach to sustainability-oriented innovation

The landscape of research outputs in tourism planning is fragmented and multi-disciplinary. Design as a meta-discipline has the power to integrate sectoral thought and inject creativity, non-linear thought and transdisciplinarity into planning processes, particularly when tackling sustainability challenges. This paper defines Destination Design as a novel framework capable of evolving the concepts of spatial and participatory planning using the design thinking cognitive style to address sustainability paradoxes. The features of are explored through the unique case study of sustainability-oriented innovation in the Dolomites UNESCO World Heritage Site. Results show that design thinking can be invaluable for pioneering pro-sustainability initiatives. Further, creative forms of engagement might encourage the acceptance and support of local transformations, but are difficult to implement

Taming of supernatural entities and animal sacrifice. The synthesis of Tibetan Buddhism and local shamanistic traditions in Northern Sikkim (India)

Les sacrifices d’animaux font partie de l’ancienne tradition chamanique du Sikkim. Pour les Sikkimais, il n’est pas contradictoire d’être, à la fois, adepte du bouddhisme tibétain et de poursuivre des pratiques chamaniques locales telles que le sacrifice d’animaux ; c’est même le signe que ces traditions sont fortement interconnectées. Ces pratiques ont été cependant vigoureusement critiquées par les maîtres bouddhistes venant du Tibet. On assiste ainsi à une confrontation entre les théories du bouddhisme tibétain, notamment ne pas tuer, et les pratiques d’une culture vivante au sein de communautés locales dans l’Himalaya.Animal sacrifice is part of the old shamanic traditions in Sikkim. For the Sikkimese people, it is not contradictory to follow Tibetan Buddhism and practise local shamanic elements like animal sacrifice, but it is rather a sign that these traditions are strongly interconnected. But Buddhist masters who arrived from Tibet criticised certain practices such as animal sacrifice. These encounters marked a confrontation of theories of Tibetan Buddhism, for example not killing, with the practices of a lived culture within local communities in the Himalaya

Surgical Treatment of Neer Group VI Proximal Humeral Fractures: Retrospective Comparison of PHILOS® and Hemiarthroplasty

Background: Neer Group VI proximal humeral fractures often are related to persistent disability despite surgical treatment. We retrospectively compared the outcome after open reduction and internal fixation with the PHILOS® plate or primary hemiarthroplasty in patients with Neer Group VI fractures focusing on complications, shoulder function, health-related quality of life (SF-36), and potential risk factors for complications. Questions/purposes: The aim of this study was to compare the PHILOS® plate with primary hemiarthroplasty for treatment of specific Neer Group VI fractures. We asked whether (1) both procedures have comparable clinical and radiologic complication rates; (2) one procedure is superior in terms of revision rate; (3) objective and subjective shoulder function (Constant-Murley score) and health-related quality of life (SF-36) were comparable in both groups at final followup; and (4) there are clinical or radiologic predictors for complications in any group? Methods: Between 2002 and 2007, 44 consecutive patients (mean, 75.2years) with a Neer Group VI proximal humeral fracture were included. Twenty-two patients treated with a PHILOS® plate were compared with 22 patients treated by primary hemiarthroplasty. Both groups were similar in all criteria. At minimum followup of 12months (mean, 30months; range, 12-83months), radiographic control, Constant-Murley score, and SF-36 were performed. Results : Fourteen patients with complications (63.6%) were counted in the PHILOS® plate group, of which 10 (45.4%) needed revision surgery, mostly as a result of avascular necrosis and screw cut-outs. In the primary hemiarthroplasty group, only one patient needed revision surgery (4.5%). Smoking and steroid therapy were substantially associated with complications in the PHILOS® plate group. There were no differences between the two groups regarding Constant-Murley or SF-36 scores. Conclusions : Angular stable open reduction and internal fixation was associated with high complication and revision rates, especially in patients who smoked and those receiving steroid therapy. Primary hemiarthroplasty provides limited function, which had little influence on the quality of life in this elderly collective. There are predictive factors for complications after the treatment of Neer Group VI proximal humeral fractures with the PHILOS® plate. Primary hemiarthroplasty remains a good option, especially when treating elderly patients. Level of Evidence: Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidenc

Phytosociological analysis of alpine swards and heathlands (pioneer patches) on ridges and peaks in the Julian Alps (NW Slovenia)

We conducted a phytosociological analysis of more than 250 relevés in the Julian Alps and compared them with similar communities elsewhere in the Alps and in the Dinaric Alps to describe the following new syntaxa of alpine swards and heathlands from the alliance Caricion firmae (class Elyno-Seslerietea): Saxifrago squarrosae-Caricetum mucronatae, Saussureo pygmaeae-Caricetum rupestris, Seslerio sphaerocephalae-Dryadetum octopetalae, Homogyno discoloris-Vaccinietum gaultherioidis, Saxifrago paniculatae-Caricetum fuliginosae and Homogyno discoloris-Loiseleurietum caricetosum firmae, the new association Achilleo clavennae-Elynetum myosuroidis from the alliance Oxytropido-Elynion and two new syntaxa from the alliance Loiseleurio-Vaccinion (class Loiseleurio-Vaccinietea): Homogyno alpinae-Vaccinietum gaultherioidis and Empetro-Vaccinietum gaultherioidis rhododendretosum hirsuti. Many species that are rare, of conservation concern or protected in Slovenia occur in the newly described communities

Landscape metrics as functional traits in plants: perspectives from a glacier foreland

Spatial patterns of vegetation arise from an interplay of functional traits, environmental characteristics and chance. The retreat of glaciers offers exposed substrates which are colonised by plants forming distinct patchy patterns. The aim of this study was to unravel whether patch-level landscape metrics of plants can be treated as functional traits. We sampled 46 plots, each 1 m x 1 m, distributed along a restricted range of terrain age and topsoil texture on the foreland of the Nardis glacier, located in the South-Eastern Alps, Italy. Nine quantitative functional traits were selected for 16 of the plant species present, and seven landscape metrics were measured to describe the spatial arrangement of the plant species' patches on the study plots, at a resolution of 1 cm x 1 cm. We studied the relationships among plant communities, landscape metrics, terrain age and topsoil texture. RLQ-analysis was used to examine trait-spatial configuration relationships. To assess the effect of terrain age and topsoil texture variation on trait performance, we applied a partial-RLQ analysis approach. Finally, we used the fourth-corner statistic to quantify and test relationships between traits, landscape metrics and RLQ axes. Floristically-defined relevé clusters differed significantly with regard to several landscape metrics. Diversity in patch types and size increased and patch size decreased with increasing canopy height, leaf size and weight. Moreover, more compact patch shapes were correlated with an increased capacity for the conservation of nutrients in leaves. Neither plant species composition nor any of the landscape metrics were found to differ amongst the three classes of terrain age or topsoil texture. We conclude that patch-level landscape metrics of plants can be treated as species-specific functional traits. We recommend that existing databases of functional traits should incorporate these type of data

Black medicine: an observational study of doctors’ coffee purchasing patterns at work

Objective: To evaluate doctors’ coffee consumption at work and differences between specialties.Design: Single centre retrospective cohort study.Setting: Large teaching hospital in Switzerland.Participants: 766 qualified doctors (425 men, 341 women) from all medical specialties (201 internal medicine, 76 general surgery, 67 anaesthetics, 54 radiology, 48 orthopaedics, 43 gynaecology, 36 neurology, 23 neurosurgery, 96 other specialties).Data source: Staff purchasing history from staff canteens’ electronic payment system linked to separate anonymised personal data from the human resource database.Main outcome measure: Numbers of coffees purchased per person per year.Results: 84% (644) of doctors purchased coffee at one of the hospital canteens. 70 772 coffees were consumed by doctors in 2014. There was a significant association between specialty and yearly coffee purchasing (F=12.45;

A Rare Periosteal Diaphyseal Lesion of the Ulna

Periosteal lesions of the ulna diaphysis are rare, include a wide spectrum of tumors, and may cause considerable diagnostic problems. Surgical treatment may vary widely, based on an accurate diagnosis. We present the case of a periosteal, extraskeletal low grade myxoid chondrosarcoma of the ulna diaphysis. The surgical therapy included an en-bloc resection with allograft reconstruction. The patient showed a favorable outcome. Careful preoperative evaluation and planning are imperative to obtain a satisfactory oncological and functional outcome, especially with uncommon tumor presentations at rare locations

Climate change affects vegetation differently on siliceous and calcareous summits of the European Alps

The alpine life zone is expected to undergo major changes with ongoing climate change. While an increase of plant species richness on mountain summits has generally been found, competitive displacement may result in the long term. Here, we explore how species richness and surface cover types (vascular plants, litter, bare ground, scree and rock) changed over time on different bedrocks on summits of the European Alps. We focus on how species richness and turnover (new and lost species) depended on the density of existing vegetation, namely vascular plant cover. We analyzed permanent plots (1 x 1 m) in each cardinal direction on 24 summits (24 x 4 x 4), with always four summits distributed along elevation gradients in each of six regions (three siliceous, three calcareous) across the European Alps. Mean summer temperatures derived from downscaled climate data increased synchronously over the past 30 years in all six regions. During the investigated 14 years, vascular plant cover decreased on siliceous bedrock, coupled with an increase in litter, and it marginally increased on higher calcareous summits. Species richness showed a unimodal relationship with vascular plant cover. Richness increased over time on siliceous bedrock but slightly decreased on calcareous bedrock due to losses in plots with high plant cover. Our analyses suggest contrasting and complex processes on siliceous versus calcareous summits in the European Alps. The unimodal richness-cover relationship and species losses at high plant cover suggest competition as a driver for vegetation change on alpine summits

Using automated vegetation cover estimation from close-range photogrammetric point clouds to compare vegetation location properties in mountain terrain

In this paper we present a low-cost approach to mapping vegetation cover by means of high-resolution close-range terrestrial photogrammetry. A total of 249 clusters of nine 1 m2 plots each, arranged in a 3 × 3 grid, were set up on 18 summits in Mediterranean mountain regions and in the Alps to capture images for photogrammetric processing and in-situ vegetation cover estimates. This was done with a hand-held pole-mounted digital single-lens reflex (DSLR) camera. Low-growing vegetation was automatically segmented using high-resolution point clouds. For classifying vegetation we used a two-step semi-supervised Random Forest approach. First, we applied an expert-based rule set using the Excess Green index (ExG) to predefine non-vegetation and vegetation points. Second, we applied a Random Forest classifier to further enhance the classification of vegetation points using selected topographic parameters (elevation, slope, aspect, roughness, potential solar irradiation) and additional vegetation indices (Excess Green Minus Excess Red (ExGR) and the vegetation index VEG). For ground cover estimation the photogrammetric point clouds were meshed using Screened Poisson Reconstruction. The relative influence of the topographic parameters on the vegetation cover was determined with linear mixed-effects models (LMMs). Analysis of the LMMs revealed a high impact of elevation, aspect, solar irradiation, and standard deviation of slope. The presented approach goes beyond vegetation cover values based on conventional orthoimages and in-situ vegetation cover estimates from field surveys in that it is able to differentiate complete 3D surface areas, including overhangs, and can distinguish between vegetation-covered and other surfaces in an automated manner. The results of the Random Forest classification confirmed it as suitable for vegetation classification, but the relative feature importance values indicate that the classifier did not leverage the potential of the included topographic parameters. In contrast, our application of LMMs utilized the topographic parameters and was able to reveal dependencies in the two biomes, such as elevation and aspect, which were able to explain between 87% and 92.5% of variance