Overweight children have a greater proportion of fat mass relative to muscle mass in the upper limbs than in the lower limbs : implications for bone strength at the distal forearm

Background: The influence of adiposity on upper-limb bone strength has rarely been studied in children, despite the high incidence of forearm fractures in this population.

Objective: The objective was to compare the influence of muscle and fat tissues on bone strength between the upper and lower limbs in prepubertal children.

Design: Bone mineral content, total bone cross-sectional area, cortical bone area (CoA), cortical thickness (CoTh) at the radius and tibia (4% and 66%, respectively), trabecular density (TrD), bone strength index (4% sites), cortical density (CoD), stress-strain index, and muscle and fat areas (66% sites) were measured by using peripheral quantitative computed tomography in 427 children (206 boys) aged 7–10 y.

Results: Overweight children (n = 93) had greater values for bone variables (0.3–1.3 SD; P < 0.0001) than did their normal-weight peers, except for CoD 66% and CoTh 4%. The between-group differences were 21–87% greater at the tibia than at the radius. After adjustment for muscle cross-sectional area, TrD 4%, bone mineral content, CoA, and CoTh 66% at the tibia remained greater in overweight children, whereas at the distal radius total bone cross-sectional area and CoTh were smaller in overweight children (P < 0.05). Overweight children had a greater fat-muscle ratio than did normal-weight children, particularly in the forearm (92 ± 28% compared with 57 ± 17%). Fat-muscle ratio correlated negatively with all bone variables, except for TrD and CoD, after adjustment for body weight (r = −0.17 to −0.54; P < 0.0001).

Conclusions: Overweight children had stronger bones than did their normal-weight peers, largely because of greater muscle size. However, the overweight children had a high proportion of fat relative to muscle in the forearm, which is associated with reduced bone strength.

Relative deprivation between neighbouring wards is predictive of coronary heart disease mortality after adjustment for absolute deprivation of wards

Background The aims of this study were to assess whether deprivation inequality at small area level in England is associated with coronary heart disease (CHD) mortality rates and to assess whether this provides evidence of an association between area-level and individual-level risk.

Methods Mortality rates for all wards in England were calculated using all CHD deaths between 2001 and 2006. Ward-level deprivation was measured using the Carstairs Index. Deprivation inequality within local authorities (LAs) was measured by the IQR of deprivation for wards within the LA. Relative deprivation for wards was measured as the modulus of the difference between deprivation for the ward and average deprivation for all neighbouring wards.

Results Deprivation inequality within LAs was positively associated with CHD mortality rates per 100 000 (eg, all men β; 95% CI=2.7; 1.1 to 4.3) after adjustment for absolute deprivation (p<0.001 for all models). Relative deprivation for wards was positively associated with CHD mortality rates per 100 000 (eg, all men 1.4; 0.7 to 2.1) after adjustment for absolute deprivation (p<0.001 for all models). Subgroup analyses showed that relative deprivation was independently associated with CHD mortality rates in both affluent and deprived wards.

Conclusions Rich wards surrounded by poor areas have higher CHD mortality rates than rich wards surrounded by rich areas, and poor wards surrounded by rich areas have worse CHD mortality rates than poor wards surrounded by poor areas. Local deprivation inequality has a similar adverse impact on both rich and poor areas, supporting the hypothesis that income inequality of an area has an impact on individual-level health outcomes.

Smartpumps: a negotiated relative advantage?

Significant improvements in smart healthcare are only possible if a multidisciplinary approach is taken to the design, implementation, and application of technology in their respective social context. Pregnant women living with type 1 diabetes (PWT1D) face a series of challenges including ongoing management of diet and physical activity, continued delivery and adjustment of insulin doses. These women often feel socially and geographically isolated, due to the rarity of their condition, the paucity of accurate personal healthcare information, and the demands of a high-risk pregnancy. ITenabled smartpumps which allow information to be shared between women with type 1 diabetes and their healthcare team, are one possible solution to this problem. This paper highlights the adoption and application of IT-enabled smartpumps by PWT1D. Using a Cross Community Information Systems (CCIS) approach we examine some of the benefits and drawbacks of smartpumps from the perspective of a range of stakeholders associated with the health and wellbeing of PWT1D and their unborn children. Ultimately we argue that with a considered approach to their adoption and use smartpumps provide an effective tool for ongoing support and collaboration within the healthcare team.

Estimating relative disulfide energies : an accurate ab initio potential energy surface

Disulfide torsional energy, a good predictor of disulfide redox potential in proteins, may be estimated by interpolation on a potential energy surface (PES) describing the twisting of diethyl disulfide through its three central dihedral angles. Here we update PES calculations at the M05-2X level of theory with the 6-31G(d) basis set. Although the surface shows no qualitative differences from an earlier MP2(full) PES, energy differences greater than 1 kJ mol^–1 were seen for conformations with χ₂ between –60° and 30°, or with χ₃ below 60° or above 130°. This is particularly significant for highly strained disulfides that are likely to be spontaneously reduced by mechanical means. In benchmarking against the high-level G3X method, M05-2X showed significantly reduced root mean squared deviation compared with MP2(full) (1.0 versus 2.0 kJ mol^–1 respectively). Results are incorporated into a web application that calculates relative torsional energies from disulfide dihedral angles (http://www.sbinf.org/applications/pes.html).

Life in the really slow lane : loggerhead sea turtles mature late relative to other reptiles

1. Age at maturity is hard to estimate for species that cannot be directly marked or observed throughout their lives and yet is a key demographic parameter that is needed to assess the conservation status of endangered species. 2. For loggerhead turtles (Caretta caretta) in the North Atlantic and North Pacific, juvenile growth rates (c. 10 cm year−1) were calculated by examining size increases during transoceanic journeys; durations of which were estimated from satellite-tracked Lagrangian surface drifter buoy trajectories. 3. Lagrangian-derived growth estimates were used in a weighted loglinear model of size-specific growth rates for loggerhead turtles and combined with newly available information on size at maturity to estimate an age at maturity of 45 years (older than past estimates). 4. By examining the age at maturity for 79 reptile species, we show that loggerhead turtles, along with other large-bodied Testudine (turtle and tortoise) species, take longer to reach maturity than other reptile species of comparable sizes. This finding heightens concern over the future sustainability of turtle populations. By maturing at an old age, sea turtles will be less resilient to anthropogenic mortality than previously suspected.