Human total, basal and activity energy expenditures are independent of ambient environmental temperature

Lower ambient temperature (Ta) requires greater energy expenditure to sustain body temperature. However, effects of Ta on human energetics may be buffered by environmental modification and behavioral compensation. We used the IAEA DLW database for adults in the USA (n = 3213) to determine the effect of Ta (−10 to +30°C) on TEE, basal (BEE) and activity energy expenditure (AEE) and physical activity level (PAL). There were no significant relationships (p > 0.05) between maximum, minimum and average Ta and TEE, BEE, AEE and PAL. After adjustment for fat-free mass, fat mass and age, statistically significant (p < 0.01) relationships between TEE, BEE and Ta emerged in females but the effect sizes were not biologically meaningful. Temperatures inside buildings are regulated at 18–25°C independent of latitude. Hence, adults in the US modify their environments to keep TEE constant across a wide range of external ambient temperatures

Diagnosis and management of bone fragility in diabetes: an emerging challenge

Fragility fractures are increasingly recognized as a complication of both type 1 and type 2 diabetes, with fracture risk that increases with disease duration and poor glycemic control. Yet the identification and management of fracture risk in these patients remains challenging. This review explores the clinical characteristics of bone fragility in adults with diabetes and highlights recent studies that have evaluated bone mineral density (BMD), bone microstructure and material properties, biochemical markers, and fracture prediction algorithms (i.e., FRAX) in these patients. It further reviews the impact of diabetes drugs on bone as well as the efficacy of osteoporosis treatments in this population. We finally propose an algorithm for the identification and management of diabetic patients at increased fracture risk

The impact of future socio-economic and climate changes on agricultural land use and the wider environment in East Anglia and North West England using a metamodel system

This paper describes a procedure to use a model interactively to investigate future land use by studying a wide range of scenarios defining climate, technological and socio-economic changes. A full model run of several hours has been replaced by a metamodel version which takes a few seconds, and provides the user with an immediate visual output and with the ability to examine easily which factors have the greatest effect. The Regional Impact Simulator combines a model of agricultural land use choices linked with models of urban growth, flooding risk, water quality and consequences for wildlife to estimate plausible futures of agricultural land on a timescale of 20–50 years. The model examines the East Anglian and North West regions of the United Kingdom at a grid resolution of 5 × 5 km, and for each scenario estimates the most likely cropping and its profitability at each location, and classifies land use as arable, intensive or extensive grassland or abandoned. From a modelling viewpoint the metamodel approach enables iteration. It is thus possible to determine how product prices change so that production meets demand. The results of the study show that in East Anglia cropping remains quite stable over a wide range of scenarios, though grassland is eliminated in scenarios with the 2050s High climate scenario – almost certainly due to the low yield in the drier conditions. In the North West there is a very much greater range of outcomes, though all scenarios suggest a reduction in grassland with the greatest in the 2050s High climate scenario combined with the “Regional Stewardship” (environmental) socio-economic scenario. The effects of the predicted changes in land use on plant species showed suitability for species to vary greatly, particularly between the socio-economic scenarios, due to detrimental effects from increases in nitrogen fertilisation. A complete simulation with the Regional Impact Simulator takes around 15 seconds (computer-dependent), which users who responded felt was adequate or better than adequate. The main areas for future improvement, such as the speed of the system, user interaction and the accuracy and detail of the modelling, are c

A surrogate FRAX model for Pakistan

Summary: a surrogate FRAX® model for Pakistan has been constructed using age-specific hip fracture rates for Indians living in Singapore and age-specific mortality rates from Pakistan.Introduction: FRAX models are frequently requested for countries with little or no data on the incidence of hip fracture. In such circumstances, the International Society for Clinical Densitometry and International Osteoporosis Foundation have recommended the development of a surrogate FRAX model, based on country-specific mortality data but using fracture data from a country, usually within the region, where fracture rates are considered to be representative of the index country.Objective: this paper describes the development and characteristics of a surrogate FRAX model for Pakistan.Methods: the FRAX model used the ethnic-specific incidence of hip fracture in Indian men and women living in Singapore, combined with the death risk for Pakistan.Results: the surrogate model gave somewhat lower 10-year fracture probabilities for men and women at all ages compared to the model for Indians from Singapore, reflecting a higher mortality risk in Pakistan. There were very close correlations in fracture probabilities between the surrogate and authentic models (r ≥ 0.998) so that the use of the Pakistan model had little impact on the rank order of risk. It was estimated that 36,524 hip fractures arose in 2015 in individuals over the age of 50 years in Pakistan, with a predicted increase by 214% to 114,820 in 2050.Conclusion: the surrogate FRAX model for Pakistan provides an opportunity to determine fracture probability within the Pakistan population and help guide decisions about treatment