Update on the clinical use of trabecular bone score (TBS) in the management of osteoporosis: results of an expert group meeting organized by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO), and the International Osteoporosis Foundation (IOF) under the auspices of WHO Collaborating Center for Epidemiology of Musculoskeletal Health and Aging

Purpose: Trabecular bone score (TBS) is a grey-level textural measurement acquired from dual-energy X-ray absorptiometry lumbar spine images and is a validated index of bone microarchitecture. In 2015, a Working Group of the European Society on Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) published a review of the TBS literature, concluding that TBS predicts hip and major osteoporotic fracture, at least partly independent of bone mineral density (BMD) and clinical risk factors. It was also concluded that TBS is potentially amenable to change as a result of pharmacological therapy. Further evidence on the utility of TBS has since accumulated in both primary and secondary osteoporosis, and the introduction of FRAX and BMD T-score adjustment for TBS has accelerated adoption. This position paper therefore presents a review of the updated scientific literature and provides expert consensus statements and corresponding operational guidelines for the use of TBS. Methods: An Expert Working Group was convened by the ESCEO and a systematic review of the evidence undertaken, with defined search strategies for four key topics with respect to the potential use of TBS: (1) fracture prediction in men and women; (2) initiating and monitoring treatment in postmenopausal osteoporosis; (3) fracture prediction in secondary osteoporosis; and (4) treatment monitoring in secondary osteoporosis. Statements to guide the clinical use of TBS were derived from the review and graded by consensus using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach. Results: A total of 96 articles were reviewed and included data on the use of TBS for fracture prediction in men and women, from over 20 countries. The updated evidence shows that TBS enhances fracture risk prediction in both primary and secondary osteoporosis, and can, when taken with BMD and clinical risk factors, inform treatment initiation and the choice of antiosteoporosis treatment. Evidence also indicates that TBS provides useful adjunctive information in monitoring treatment with long-term denosumab and anabolic agents. All expert consensus statements were voted as strongly recommended. Conclusion: The addition of TBS assessment to FRAX and/or BMD enhances fracture risk prediction in primary and secondary osteoporosis, adding useful information for treatment decision-making and monitoring. The expert consensus statements provided in this paper can be used to guide the integration of TBS in clinical practice for the assessment and management of osteoporosis. An example of an operational approach is provided in the appendix. Summary: This position paper presents an up-to-date review of the evidence base, synthesised through expert consensus statements, which informs the implementation of Trabecular Bone Score in clinical practice

Update on the clinical use of trabecular bone score (TBS) in the management of osteoporosis: results of an expert group meeting organized by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO), and the International Osteoporosis Foundation (IOF) under the auspices of WHO Collaborating Center for Epidemiology of Musculoskeletal Health and Aging

Purpose Trabecular bone score (TBS) is a grey-level textural measurement acquired from dual-energy X-ray absorptiometry lumbar spine images and is a validated index of bone microarchitecture. In 2015, a Working Group of the European Society on Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) published a review of the TBS literature, concluding that TBS predicts hip and major osteoporotic fracture, at least partly independent of bone mineral density (BMD) and clinical risk factors. It was also concluded that TBS is potentially amenable to change as a result of pharmacological therapy. Further evidence on the utility of TBS has since accumulated in both primary and secondary osteoporosis, and the introduction of FRAX and BMD T-score adjustment for TBS has accelerated adoption. This position paper therefore presents a review of the updated scientific literature and provides expert consensus statements and corresponding operational guidelines for the use of TBS. Methods An Expert Working Group was convened by the ESCEO and a systematic review of the evidence undertaken, with defined search strategies for four key topics with respect to the potential use of TBS: (1) fracture prediction in men and women; (2) initiating and monitoring treatment in postmenopausal osteoporosis; (3) fracture prediction in secondary osteoporosis; and (4) treatment monitoring in secondary osteoporosis. Statements to guide the clinical use of TBS were derived from the review and graded by consensus using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach. Results A total of 96 articles were reviewed and included data on the use of TBS for fracture prediction in men and women, from over 20 countries. The updated evidence shows that TBS enhances fracture risk prediction in both primary and secondary osteoporosis, and can, when taken with BMD and clinical risk factors, inform treatment initiation and the choice of antiosteoporosis treatment. Evidence also indicates that TBS provides useful adjunctive information in monitoring treatment with long-term denosumab and anabolic agents. All expert consensus statements were voted as strongly recommended. Conclusion The addition of TBS assessment to FRAX and/or BMD enhances fracture risk prediction in primary and secondary osteoporosis, adding useful information for treatment decision-making and monitoring. The expert consensus statements provided in this paper can be used to guide the integration of TBS in clinical practice for the assessment and management of osteoporosis. An example of an operational approach is provided in the appendix. Summary This position paper presents an up-to-date review of the evidence base, synthesised through expert consensus statements, which informs the implementation of Trabecular Bone Score in clinical practice

Triassic sedimentation and postaccretionary crustal evolution along the Solonker suture zone in Inner Mongolia, China

Detrital zircon U-Pb dating of the Xingfuzhilu Formation in southern Inner Mongolia yields a maximum depositional age of around 220 Ma. The predominantly Permian and Triassic zircons are characterized by oscillatory zoning and euhedral shapes, with mostly positive zircon εHf(t) values (+2.0 to +16.4), indicating that they were derived from a proximal magmatic source. Early-Middle Paleozoic zircons have variable zircon εHf(t) values from −6.2 to +11.2 and are characterized by weak oscillatory zoning and subhedral-subrounded shapes, suggesting that the sources are a proximal magmatic arc, possibly mixed with components of the Ondor Sum magmatic arc and the magmatic arc at the northern margin of the North China Craton. The remnants of Precambrian blocks in the southeastern Central Asian Orogenic Belt (CAOB), and the North China Craton may also have been a minor source region for the Xingfuzhilu succession. These results, combined with regional data, indicate that a closing remnant ocean basin or narrow seaway possibly existed in the Middle Permian (Guadalupian) immediately prior to final collision of the CAOB and closure of the Paleo-Asian Ocean. Subsequent collision resulted in the crustal uplift and thickening along the Solonker suture zone, accompanied by possible slab break-off and lithospheric delamination during the Latest Permian to Middle Triassic. The resultant orogen in the Late Triassic underwent exhumation and denudation of rocks in response to the postorogenic collapse and regional extension. Vertical crustal growth in the Triassic is documented by detrital zircons from the Xingfuzhilu Formation and appears to have been widespread across entire eastern CAOB

« Much Ado about Nothing » ? Le cas de l’Espagne dans l’historiographie de la critique des hypotextes shakespeariens

International audienceThis article deals with the historiographical examination of the evolution of theoretical tools and textual analysis practices used in the study of Shakespearean hypotexts, traditionally called “sources”. The corpus is made up of a few examples of Spanish origin in the plays of William Shakespeare taken from the works of critics of Shakespearean sources (Henry Thomas, Geoffrey Bullough or Kenneth Muir…) This paper aims at establishing the shift from the notion of “source” to the notion of “hypotext” as widening possibilities and renewing analysis perspectives, the notion of “hypotext” enabling research to tackle this matter with new methodologies, such as, among others, transtextuality and adaptation theories.L’objet d’étude de cet article est l’évolution historiographique des outils théoriques et des pratiques d’analyse textuelle utilisés dans l’étude des hypotextes shakespeariens, traditionnellement appelés « sources ». Le corpus est constitué de quelques exemples d’origine espagnole dans le théâtre de William Shakespeare tirés des travaux des théoriciens des sources shakespeariennes (Henry Thomas, Geoffrey Bullough ou encore Kenneth Muir). L’objectif est de démontrer que l’élargissement des possibles et le renouveau des perspectives d’analyse résident dans le glissement de la notion de « source » vers la notion d’« hypotexte » qui permet d’aborder la question sous l’angle de nouvelles méthodologies comme, entre autres, la transtextualité ou la théorie de l’adaptation

Henry V and Holinshed's Chronicles or the Dramatisation of Chronicle Writing Materials

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Henry V and Holinshed's Chronicles or the Dramatisation of Chronicle Writing Materials

International audienc

L’acte de témoigner par la transtextualité ou la révélation de lanature textuelle : l’exemple de Coriolan de William Shakespeare

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Iberian sources of Elizabethan and Jacobean theatre : networks of influence, circulation of texts, dramaturgy and theatricality

Cette thèse se propose de réévaluer le statut des sources ibériques au sein d’un corpus de pièces anglaises jouées entre la fin du règne d’Élisabeth Ie et le début de l’ère jacobéenne, période marquée par de profonds changements socio-culturels. Elle se concentre non pas sur la tension bien connue et souvent étudiée entre hispanophilie et hispanophobie qui caractérise alors la représentation des relations anglo-ibériques, mais envisage ce rapport selon une perspective textuelle, culturelle et esthétique incluant les relais qui, à l’échelle européenne, permettaient à ces textes de circuler, tout en les modifiant. Ce travail porte donc sur les réseaux d’influence des textes ibériques de la culture de cour des XVe et XVIe siècles, et leur impact sur le théâtre anglais de la première modernité. Il aborde notamment le roman sentimental Tractado de amores de Arnalte y Lucenda de Diego de San Pedro, la poésie de cour de Juan Boscán et Garcilaso de la Vega avec le long poème Leandro et le sonnet XXIX « Pasando el mar Leandro el animoso », la romance pastorale Los siete libros de La Diana de Jorge de Montemayor et le récit picaresque publié anonymement, La vida de Lazarillo de Tormes, y de sus fortunas y adversidades. Ces œuvres sont mises en dialogue avec des textes didactiques et philosophiques tels que El libro aureo de Marco Aurelio d’Antonio de Guevara, Le Courtisan de Baldassare Castiglione traduit par Boscán et El Examen de Ingenios de Juan Huarte de San Juan, qui s’intéressent tous à la figure du courtisan et à la notion de « service ». Quant au corpus de textes dramatiques anglais privilégiés dans cette étude, il est principalement constitué de pièces de Shakespeare, en particulier de The Two Gentlemen of Verona, Love’s Labour’s Lost, The Merry Wives of Windsor, Twelfth Night et The Winter’s Tale. Ces œuvres sont mises en relation avec d’autres écrits contemporains : Hero and Leander de Christopher Marlowe, Blurt Master Constable de Thomas Dekker, ainsi que des textes de John Lyly et de Ben Jonson. En complétant et réorientant les études portant sur les intrigues et les personnages de la littérature dramatique anglaise, champ d’investigation traditionnel des Source Studies, cette thèse aborde ces éléments selon une approche qui prend en compte les perspectives sociétales et théâtrales inhérentes à la littérature issue de la société de cour ibérique : cette littérature innovante reflète, façonne et interroge tout particulièrement la théâtralité d’un milieu où les individus ne cessent de se mettre en scène. Tour à tour auteurs, dédicataires et personnages-clés de ces fictions dont ils sont très friands, les membres de la société de cour ibérique fournissent ainsi aux écrivains anglais de la première modernité un terrain de jeu propice à l’innovation et à l’expérimentation dramaturgiquesThis dissertation proposes to reassess the status of Iberian sources within a corpus of English plays staged between the last years of the reign of Elizabeth I and the beginning of the Jacobean era, a period marked by deep socio-cultural changes. It does not focus on the well-known and often studied tension between Hispanophilia and Hispanophobia which characterises the representation of Anglo-Iberian relations at the time, but considers this relationship from a textual, cultural and aesthetic perspective including the go-betweens that, at a European scale, enabled these texts to circulate while they were altering them. This work thus deals with the networks of influence of Iberian texts belonging to 15th-and-16th-century court culture and the impact they had on early modern English drama. In particular, it tackles the sentimental romance Tractado de amores de Arnalte y Lucenda by Diego de San Pedro, court poetry by Juan Boscán and Garcilaso de la Vega with the long poem Leandro and sonnet XXIX « Pasando el mar Leandro el animoso », the pastoral romance Los siete libros de La Diana by Jorge de Montemayor and the anonymously published picaresque tale La vida de Lazarillo de Tormes, y de sus fortunas y adversidades. These works are set in conversation with didactic and philosophical texts such as El libro aureo de Marco Aurelio by Antonio de Guevara, The Courtier by Baldassare Castiglione translated by Boscán and El Examen de Ingenios by Juan Huarte de San Juan: they all deal with the figure of the courtier and the notion of « service ». As to the corpus of English dramatic texts chosen for this study, it is mainly composed of plays by Shakespeare, notably The Two Gentlemen of Verona, Love’s Labour’s Lost, The Merry Wives of Windsor, Twelfth Night et The Winter’s Tale. These works are related to other contemporary writings: Hero and Leander by Christopher Marlowe, Blurt Master Constable by Thomas Dekker, along with texts by John Lyly and Ben Jonson. By supplementing and redirecting the studies addressing plots and characters in the English dramatic literature, the traditional field of investigation of Source Studies, this dissertation discusses these elements from a perspective which takes into account the societal and theatrical dimensions inherent to the literature born out of the Iberian court society : this innovative literature reflects, shapes and questions especially the theatricality of an environment where individuals never cease to stage themselves. Alternately authors, dedicatees and key-characters and figures of these fictions they enjoy thoroughly, the members of the Iberian court society thus provide early modern English writers with a playground conducive to dramaturgical innovation and experimentation

Henry V and Holinshed's Chronicles or the Dramatisation of Chronicle Writing Materials

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Henry V and Holinshed's Chronicles or the Dramatisation of Chronicle Writing Materials

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