Building healthy bones throughout life: an evidence-informed strategy to prevent osteoporosis in Australia

A white paper resulting from the outcomes of the Osteoporosis Australia Summit, 20 October 2011 Abstract Osteoporosis imposes a tremendous burden on Australia: 1.2 million Australians have osteoporosis and 6.3 million have osteopenia. In the 2007–08 financial year, 82 000 Australians suffered fragility fractures, of which > 17 000 were hip fractures. In the 2000–01 financial year, direct costs were estimated at $1.9 billion per year and an additional$5.6 billion on indirect costs. Osteoporosis was designated a National Health Priority Area in 2002; however, implementation of national plans has not yet matched the rhetoric in terms of urgency. Building healthy bones throughout life, the Osteoporosis Australia strategy to prevent osteoporosis throughout the life cycle, presents an evidence-informed set of recommendations for consumers, health care professionals and policymakers. The strategy was adopted by consensus at the Osteoporosis Australia Summit in Sydney, 20 October 2011. Primary objectives throughout the life cycle are: to maximise peak bone mass during childhood and adolescence to prevent premature bone loss and improve or maintain muscle mass, strength and functional capacity in healthy adults to prevent and treat osteoporosis in order to minimise the risk of suffering fragility fractures, and reduce falls risk, in older people. The recommendations focus on three affordable and important interventions — to ensure people have adequate calcium intake, vitamin D levels and appropriate physical activity throughout their lives. Recommendations relevant to all stages of life include: daily dietary calcium intakes should be consistent with Australian and New Zealand guidelines serum levels of vitamin D in the general population should be above 50nmol/L in winter or early spring for optimal bone health regular weight-bearing physical activity, muscle strengthening exercises and challenging balance/mobility activities should be conducted in a safe environment

A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures

Background Vertebroplasty has become a common treatment for painful osteoporotic vertebral fractures, but there is limited evidence to support its use. Methods We performed a multicenter, randomized, double-blind, placebo-controlled trial in which participants with one or two painful osteoporotic vertebral fractures that were of less than 12 months\u27 duration and unhealed, as confirmed by magnetic resonance imaging, were randomly assigned to undergo vertebroplasty or a sham procedure. Participants were stratified according to treatment center, sex, and duration of symptoms (&lt;6 weeks or 6 weeks). Outcomes were assessed at 1 week and at 1, 3, and 6 months. The primary outcome was overall pain (on a scale of 0 to 10, with 10 being the maximum imaginable pain) at 3 months. Results A total of 78 participants were enrolled, and 71 (35 of 38 in the vertebroplasty group and 36 of 40 in the placebo group) completed the 6-month follow-up (91%). Vertebroplasty did not result in a significant advantage in any measured outcome at any time point. There were significant reductions in overall pain in both study groups at each follow-up assessment. At 3 months, the mean (&plusmn;SD) reductions in the score for pain in the vertebroplasty and control groups were 2.6&plusmn;2.9 and 1.9&plusmn;3.3, respectively (adjusted between-group difference, 0.6; 95% confidence interval, &ndash;0.7 to 1.8). Similar improvements were seen in both groups with respect to pain at night and at rest, physical functioning, quality of life, and perceived improvement. Seven incident vertebral fractures (three in the vertebroplasty group and four in the placebo group) occurred during the 6-month follow-up period. Conclusions We found no beneficial effect of vertebroplasty as compared with a sham procedure in patients with painful osteoporotic vertebral fractures, at 1 week or at 1, 3, or 6 months after treatment. (Australian New Zealand Clinical Trials Registry number, ACTRN012605000079640.)<br /

Weighing the Giants II: Improved Calibration of Photometry from Stellar Colors and Accurate Photometric Redshifts

We present improved methods for using stars found in astronomical exposures to calibrate both star and galaxy colors as well as to adjust the instrument flat field. By developing a spectroscopic model for the SDSS stellar locus in color-color space, synthesizing an expected stellar locus, and simultaneously solving for all unknown zeropoints when fitting to the instrumental locus, we increase the calibration accuracy of stellar locus matching. We also use a new combined technique to estimate improved flat-field models for the Subaru SuprimeCam camera, forming `star flats' based on the magnitudes of stars observed in multiple positions or through comparison with available SDSS magnitudes. These techniques yield galaxy magnitudes with reliable color calibration (< 0.01 - 0.02 mag accuracy) that enable us to estimate photometric redshift probability distributions without spectroscopic training samples. We test the accuracy of our photometric redshifts using spectroscopic redshifts z_s for ~5000 galaxies in 27 cluster fields with at least five bands of photometry, as well as galaxies in the COSMOS field, finding sigma((z_p - z_s)/(1 + z_s)) ~ 0.03 for the most probable redshift z_p. We show that the full posterior probability distributions for the redshifts of galaxies with five-band photometry exhibit good agreement with redshifts estimated from thirty-band photometry in the COSMOS field. The growth of shear with increasing distance behind each galaxy cluster shows the expected redshift-distance relation for a flat Lambda-CDM cosmology. Photometric redshifts and calibrated colors are used in subsequent papers to measure the masses of 51 galaxy clusters from their weak gravitational shear. We make our Python code for stellar locus matching available at http://big-macs-calibrate.googlecode.com; the code requires only a catalog and filter functions.Comment: Accepted by MNRAS with only minor revisions. Code available: http://big-macs-calibrate.googlecode.com (v2 latex symbols removed from abstract

Effects of combined calcium and vitamin D supplementation on insulin secretion, insulin sensitivity and β-cell function in multi-ethnic vitamin D-deficient adults at risk for type 2 diabetes: a pilot randomized, placebo-controlled trial

ObjectivesTo examine whether combined vitamin D and calcium supplementation improves insulin sensitivity, insulin secretion, &beta;-cell function, inflammation and metabolic markers.Design6-month randomized, placebo-controlled trial.ParticipantsNinety-five adults with serum 25-hydroxyvitamin D [25(OH)D] &le;55 nmol/L at risk of type 2 diabetes (with prediabetes or an AUSDRISK score &ge;15) were randomized. Analyses included participants who completed the baseline and final visits (treatment n = 35; placebo n = 45).InterventionDaily calcium carbonate (1,200 mg) and cholecalciferol [2,000&ndash;6,000 IU to target 25(OH)D &gt;75 nmol/L] or matching placebos for 6 months.MeasurementsInsulin sensitivity (HOMA2%S, Matsuda index), insulin secretion (insulinogenic index, area under the curve (AUC) for C-peptide) and &beta;-cell function (Matsuda index x AUC for C-peptide) derived from a 75 g 2-h OGTT; anthropometry; blood pressure; lipid profile; hs-CRP; TNF-&alpha;; IL-6; adiponectin; total and undercarboxylated osteocalcin.ResultsParticipants were middle-aged adults (mean age 54 years; 69% Europid) at risk of type 2 diabetes (48% with prediabetes). Compliance was &gt;80% for calcium and vitamin D. Mean serum 25(OH)D concentration increased from 48 to 95 nmol/L in the treatment group (91% achieved &gt;75 nmol/L), but remained unchanged in controls. There were no significant changes in insulin sensitivity, insulin secretion and &beta;-cell function, or in inflammatory and metabolic markers between or within the groups, before or after adjustment for potential confounders including waist circumference and season of recruitment. In a post hoc analysis restricted to participants with prediabetes, a significant beneficial effect of vitamin D and calcium supplementation on insulin sensitivity (HOMA%S and Matsuda) was observed.ConclusionsDaily vitamin D and calcium supplementation for 6 months may not change OGTT-derived measures of insulin sensitivity, insulin secretion and &beta;-cell function in multi-ethnic adults with low vitamin D status at risk of type 2 diabetes. However, in participants with prediabetes, supplementation with vitamin D and calcium may improve insulin sensitivity.<br /

The Low Mass End of the Fundamental Relation for Gravitationally Lensed Star Forming Galaxies at 1<z<6

We present VLT/X-shooter spectra of 13 galaxies in the redshift range 1< z < 6, which are strongly lensed by massive galaxy clusters. Spectroscopic redshifts are measured for nine galaxies, while three sources have redshifts determined from continuum breaks in their spectra. The stellar masses of the galaxies span four orders of magnitude between 10^7 and 10^11 M_sun and have luminosities at 1500 A rest-frame between 0.004 and 9 L^* after correcting for the magnification. This allows us to probe a variety of galaxy types from young, low-mass starburst galaxies to massive evolved galaxies. The lensed galaxies with stellar masses less than 10^10 M_sun have a large scatter compared to the fundamental relation between stellar mass, star formation rates and oxygen abundances. We provide a modified fit to the fundamental relation for low-mass, low-metallicity galaxies with a weaker dependence of the metallicity on either the star formation rate or stellar mass compared to low-redshift, high-mass and high-metallicity SDSS galaxies.Comment: 21 pages, Accepted for publication in MNRA

Volkswirtschaftliche Bedeutung der biobasierten Wirtschaft in Deutschland

Das Thünen-Institut wurde vom Bundesministerium für Ernährung, Landwirtschaft und Verbraucherschutz (BMELV) gebeten, die volkswirtschaftliche Bedeutung der biobasierten Wirtschaft in Deutschland zu kalkulieren. Grundlage bildet die vom Bioökonomierat der Bundesregierung aufgestellte Definition der biobasierten Wirtschaft als alle wirtschaftlichen Sektoren und ihre dazugehörigen Dienstleistungen, die biologische Ressourcen produzieren, be- und verarbeiten oder in irgendeiner Form nutzen. Mithilfe verschiedener, hauptsächlich amtlicher Statistiken wurden die Wirtschaftssektoren und deren Anteile biobasierten Wirtschaftens für das Jahr 2007 in Deutschland ermittelt. Die Quantifizierung erfolgte über die Größen Anzahl der Unternehmen, Beschäftigte, Umsatz und Bruttowertschöpfung. Werden alle Aktivitäten von der Primärproduktion über die Verarbeitung und Vermarktung bis zu den Dienstleistungen berücksichtigt, so sind diesen Berechnungen zu Folge knapp 5 Millionen Beschäftige, was etwa 12,5 % aller Beschäftigten entspricht, dem Bereich zuzuordnen. Mit einer Bruttowertschöpfung von knapp 165 Mrd. Euro liegt der Anteil der biobasierten Wirtschaft bei etwa 7,6 % der Gesamtwirtschaft. Insgesamt wird deutlich, dass die Rohware Biomasse Grundlage für beträchtliche wirtschaftliche Aktivitäten ist. Im Arbeitsbericht wird an verschiedenen Stellen auf die Unschärfe der Zuordnung von Daten zur biobasierten Wirtschaft, aber auch auf das bisher nicht befriedigend gelöste Problem der trennscharfen Zuordnung von Aktivitäten zur biobasierten oder nicht-biobasierten Wirtschaft hingewiesen und eingegangen.This working paper has been compiled due to a request of the German Federal Ministry of Food, Agriculture and Consumer Protection (BMELV) to the Thünen-Institut for calculating the importance of bioeconomy within the national economy. It is based upon the definition of biobased economy by the German Bio-Economy Council (Bioökonomierat, an independent research council): The bioeconomy encompasses all those sectors and their related services which produce process or use biological resources in whatever form. For the determination of the different industries and their impact on bioeconomy we mainly work with various official statistics. We analysed the year 2007. The indicators we used were number of companies, employment, turnover and gross value added. Altogether, five million employees, representing 12.5 % of all employees and 165 billion Euros, representing 7.6 % of German gross national product have been calculated as the share of biobased economy in Germany. Challenges, still not finally solved are that neither the available data nor the economic activities themselves can be unambiguously assigned to bioeconomy or non-bioeconomy