Sun exposure behaviour, seasonal vitamin D deficiency, and relationship to bone health in adolescents

YesContext: Vitamin D is essential for bone health in adolescence, where there is rapid bone mineral content accrual. As cutaneous sun-exposure provides vitamin D, there is no recommended oral intake for UK adolescents. Objective: Assess seasonal vitamin D status and its contributors in white Caucasian adolescents, and examine bone health in those found deficient. Design: Prospective cohort study. Setting: Six schools in Greater Manchester, UK. Participants: 131 adolescents, 12–15 years. Intervention(s): Seasonal assessment of circulating 25-hydroxyvitamin D (25OHD), personal sunexposure and dietary vitamin D. Adolescents deficient (25OHD <10 ng/mL/25 nmol/L) in ≥one season underwent dual-energy X-ray absorptiometry (lumbar spine, femoral neck), with bone mineral apparent density (BMAD) correction for size, and peripheral quantitative computed tomography (distal radius) for volumetric (v)BMD. Main Outcome Measure: Serum 25OHD; BMD. Results: Mean 25OHD was highest in September: 24.1 (SD 6.9) ng/mL and lowest in January: 15.5 (5.9) ng/mL. Over the year, 16% were deficient in ≥one season and 79% insufficient (25OHD <20 ng/mL/50 nmol/L) including 28% in September. Dietary vitamin D was low year-round while personal sun-exposure was seasonal and predominantly across the school week. Holidays accounted for 17% variation in peak 25OHD (p<0.001). Nineteen adolescents underwent bone assessment, which showed low femoral neck BMAD versus matched reference data (p=0.0002), 3 with Z≤ -2.0 distal radius trabecular vBMD. Conclusions: Sun-exposure levels failed to provide adequate vitamin D, ~one-quarter adolescents insufficient even at summer-peak. Seasonal vitamin D deficiency was prevalent and those affected had low BMD. Recommendations on vitamin D acquisition are indicated in this age-group.The Bupa Foundation (Grant number TBF-M10-017)

Obstructive Sleep Apnea and Incidence of Postoperative Delirium after Elective Knee Replacement in the Nondemented Elderly

ABSTRACT Background: Postoperative delirium, a common complication in the elderly, can occur following any type of surgery and is associated with increased morbidity and mortality; it may also be associated with subsequent cognitive problems. Effective therapy for postoperative delirium remains elusive because the causative factors of delirium are likely multiple and varied. Methods: Patients 65 yr or older undergoing elective knee arthroplasty were prospectively evaluated for postoperative Diagnostic and Statistical Manual of Mental Disorders-IV delirium. Exclusion criteria included dementia, mini-mental state exam score less than 24, delirium, clinically significant central nervous system/neurologic disorder, current alcoholism, or any serious psychiatric disorder. Delirium was assessed on postoperative days 2 and 3 using standardized scales. Patients&apos; preexisting medical conditions were obtained from medical charts. The occurrence of obstructiv

Fractional Sunburn Threshold UVR Doses Generate Equivalent Vitamin D and DNA Damage in Skin Types I-VI but with Epidermal DNA Damage Gradient Correlated to Skin Darkness

Dermatology-oncolog

Late highstand patterns of shifting and stepping coastal barriers and wasgover-fans (late Messinian, Sorbas Basin, SE Spain).

The late Messinian Sorbas Member, up to 75 m thick, consists in its type area of a parasequence sel of three prograding coastal barriers (sequences I-III), associated With lagoon and washover sediments. Around the town of Sorbas these strata can be studied exceptionally well due 10 absence of burrowing by raised Messinian salinities and exposure along a network of up to 30 m deep canyons. Fifteen vertical sections were logged and careífully correlated. This permits to reconstruct and discuss pattems of relative sea-level movements between decímetres. up to 15 m within a parasequence. Excellent examples of non-tidal transgressive facies are characterized by lagoon and washover sedimenls instead of The usual combinatíon of washover and tidal deposits (channel and flood-tidal delta). Implications for the sandstone connectivity are given. The lower two sequences Are deposited in a relatively large tectonically enhanced wedge-shaped accommodation space. The show both fining-up, deepening sequences, followed by prograding coarsening-up shoaling sequences and can be compared to the c1assical parasequences of the Westem Interior Basin (USA). Progradation of sequence II was intemlpted by a major slide event (most likely triggered by an earthquake), which caused more than 400 m seaward slumping of a stretch of 1 km of coastal sands. The architecture of sequence III is more complex due to limited accommodation space characterístic for the late híghstand, so that this setting was very sensitive to sea-level fluctuations. This resulted in an intricate pattem of juxtaposed and superposed lagoonal muds, washover üms and swash zones. So-called "stranded" coastal barriers occur, which were lef behind after seaward Jump of the coastline over more than 1.5 km during forced regression. The pattem of reconstructed sea-level positions is weIl comparable to the sequential partem shown by the correlated equivalent, along the northem basin margin, which belong to the so-called Terminal Carbonate Complex. The problem of ranking the complex sequence III as one or more parasequences and it, consequences for cyclostratigraphy are shortly discussed. Two models of washover formation are given, respectively during more rapid and more slow sea-level rise. The intluence of synsedimentary folding on the location of barriers is discussed and also the source arca of extra and intraclasts supplied to barriers and washovers. After deposition of the Sorbas Member the sea withdrew from the Sorbas Basin, probably as a result of the majar downdrop in lhe Mediterranean at the maximum colation during the Salinity Crisis. It 15 suggested that the semi-enclosed selting of the basin resulted only in límited localized eros ion, in contrast to the deeper adjacent Vera Basin, which was more open to the Mediterranean