Loading...
whose most likely to?
Quiz by Francesca
Customize this quiz to suit your class
Instantly translate to 100+ languages
Tag the questions with any skills you have. Your dashboard will track each student's mastery of each skill.
Give this quiz to my class
To the Lakota, and other indigenous people on North America's Great Plains, the bison was an essential part of their culture ( expressed in the quote on the previous page). The bison provided meat for nutrition, a hide for clothing and shelter, bones for tools, and fat for soap. The bison was also central to their religious beliefs. So, when European settlers hunted the bison nearly to extinction, Lakota culture suffered. Culture is central to a society and the identity of its people, as well as its continued existence. Therefore, geographers study culture as a way to understand similarities and differences among societies across the world, and in some cases, to help preserve these societies. Analyzing Culture All of a group's learned behaviors, actions, beliefs, and objects are a part of culture. It is a visible force seen in a group's actions, possessions, and influence on the landscape. For example, in a large city you can see people working in offices, factories, and stores, and living in high-rise apartments or suburban homes. You might observe them attending movies, concerts, or sporting events. Culture is also an invisible force guiding people through shared belief systems, customs, and traditions. Culture is learned, in that it develops through experiences, and not merely transmitted through genetics. For example, many people in the United States have developed a strong sense of competitiveness in school and business, and believe that hard work is a key to success. These types of elements, visible and invisible, are cultural traits. A series of interrelated traits make up a cultural complex, such as the process of steps and acceptable behaviors related to greeting a person in different cultures. A single cultural artifact, such as an automobile, may represent many different values, beliefs, behaviors and traditions and be representative of a cultural complex. Since culture is learned there are many ways that one generation passes its culture to the next. Children and adults learn traits three ways: âą imitation, as when learning a language by repeating sounds or behaviors from a person or television âą informal instruction, as when a parent reminds a child to say "please" âą formal instruction, as when students learn history in school 132 HUMAN GEOGRAPHY: AP" EDITION CULTURAL COMPLEX OF THE AUTOMOBILE The automobile provides much more than just transportation, as it reflects many values that are central to American culture. Origins of Culture The area in which a unique culture or a specific trait develops is a culture hearth. Classical Greece was a culture hearth for democracy more than 2,000 years ago. New York City was a culture hearth for rap music in the 1970s. Geographers study how cultures develop in hearths and diffuse-or spread-to other places. Geographers also study taboos, behaviors heavily discouraged by a culture. For example, many cultures have taboos against eating certain foods, such as pork or insects. What is considered taboo changes over time. In the United States, marriages between Protestants and Catholics were once taboo, but they are not widely opposed now. Traditional, Folk, and Indigenous Cultures With the beginning of the Industrial Revolution in the late 18th century, modern transportation and communication connected people as never before and led to extensive cultural mixing, especially as cities have grown. The world prior to this time was very different; however, remnants of the past are still evident in our modern cultures. Traditional, folk, and indigenous cultures share some important characteristics and are often grouped together, but they do have some subtle differences. Traditional Culture Recently, the meanings of traditional, folk, and indigenous culture have begun to merge, causing geographers to debate when each should be used. Increasingly, the term traditional culture is used to encompass all three cultural designations. All three types share the function of passing down long-held beliefs, values, and practices and are generally resistant to rapid changes in their culture. Folk Culture The beliefs and practices of small, homogenous groups of people, often living in rural areas that are relatively isolated and slow to change, are known as folk cultures. Like all cultures, they demonstrate the diverse ways that people have adapted to a physical environment. For example, people around the world learned to make shelters out of available resources, whether 3.1: INTRODUCTION TO CULTURE 133 it was snow or mud bricks or wood. However, people used similar resources such as wood differently. In Scandinavia, people used trees to build cabins. In the American Midwest, people processed trees into boards, built a frame, and attached the boards to it. Many traits of folk culture continue today. Corn was first grown in Mexico around 10,000 years ago, and it is still grown there today. While many elements of folk culture exist side by side with modern culture, there are people whose societies have changed little, if at all, from long ago. These people practice traditional cultures, those which have not been affected by modern technology or influences. They often live in remote regions, such as some small tribes in the Amazon rainforest, and have scant knowledge of the outside world. As the lines continue blurring between cultural designations, the Amish of Pennsylvania are often referenced as both folk and traditional culture. Indigenous Culture When members of an ethnic group reside in their ancestral lands, and typically possess unique cultural traits, such as speaking their own exclusive language, they are considered an indigenous culture. Some indigenous peoples have been displaced from their native lands, but still practice their indigenous culture. Native Americans in the United States, such as the Navajo, have kept indigenous cultural practices. First Nations of Canada, such as the Inuit, have also retained their indigenous culture. Globalization and Popular Culture As a result of the Industrial Revolution, improvements in transportation and communication have shortened the time required for movement, trade, or other forms of interaction between two places. This development, known as space-time compression (see Topics 1.4 and 3.6), has accelerated culture change around the world. In 1817, a freight shipment from Cincinnati needed 52 days to reach New York City. By 1850, because of canals and railroads, it took half that long. And by 1852, it took only 7 days. Today, an airplane flight takes only a few hours, and digital information takes seconds or less. Similar change has occurred on the global scale. People travel freely across the world in a matter of hours, and communication has advanced to a point where people share information instantaneously across the globe. The increased global interaction has had a profound impact on cultures, from spreading English across the world to instant sharing of news, events and music. Globalization specifically refers to the increased integration of the world economy since the 1970s. The process of intensified interaction among peoples, governments, and companies of different countries around the globe has had profound impacts on culture. The culture of the United States is intertwined with globalization. Through the influence of its corporations, Hollywood movies, and government, the United States exerts widespread influence in other countries. But other countries also shape American culture. For example, in 2019, the National Basketball Association included players from 38 countries or territories. When cultural traits- such as clothing, music, movies, and types of 134 HUMAN GEOGRAPHY: AP. EDITION businesses-spread quickly over a large area and are adopted by various groups, they become part of popular culture. Elements of popular culture often begin in urban areas and diffuse quickly through globalization processes such as the media and Internet. These elements can quickly be adopted worldwide, making them part of global culture. People around the world follow European soccer, Indian Bollywood movies, and Japanese animation known as anime. With people in many nations wearing similar clothes, listening to similar music, and eating similar food, popular cultural traits often promote uniformity in beliefs, values, and the cultural landscape across many places The cultural landscape, also known as the built environment (see Topic 3.2), is the modification of the environment by a group and is a visible reflection of that group's cultural beliefs and values. Traditional Culture to Popular Culture Popular culture emphasizes trying what is new rather than preserving what is traditional. Many people, especially older generations or those who follow a folk culture, openly resist the adoption of popular cultural traits. They do this by preserving traditional languages, religions, values, and foods. While older generations often resist the adoption of popular culture, they seldom are successful in keeping their traditional cultures from changing, especially among the young people of their society. One clash between popular and traditional culture is occurring in Brazil. As the population expands to the interior of the rain forest, many indigenous cultures, like the Yanamamo tribe, have more contact with outside groups. Remaining isolated by the forest is becoming increasingly difficult as many young people from the indigenous cultures become exposed to popular culture and begin to integrate into the larger Brazilian society. As the young people leave their communities, they are more likely to accept popular culture at the expense of their indigenous cultural heritage, which threatens the very existence of their folk culture. Traditional culture typically exhibits horizontal diversity, meaning each traditional culture has its own customs and language that makes it distinct from other culture groups. Yet, people people within each group are usually homogeneous, or very similar to each other. By contrast, popular culture typically exhibits vertical diversity, meaning that modern urban societies are usually heterogeneous, or exhibiting differences, within the society and usually contain numerous multiethnic neighborhoods. However, on a global scale popular cultures are relatively similar with the same type of malls, shops, fast food, and clothing. Urban global culture centers are not identical, yet, global cities often do not have as much horizontal diversity across space as folk cultures. 3.1: INTRODUCTION TO CULTURE 135 COMPARING TRADITIONAL AND POPULAR CULTURE Trait Traditional Culture Popular or Global Culture Society âą Rural and isolated location âą Urban and connected location âą Homogeneous and âą Diverse and multiethnic indigenous population population âą Most people speak an âą Many people speak a global indigenous or ethnic local language such as English or language Arabic âą Horizontal diversity âą Vertical diversity Social âą Emphasis on community and âą Emphasis on individualism and Structure conformity making choices âą Families live close to each âą Dispersed families other âą Weakly defined gender roles âą Well-defined gender roles Diffusion âą Relatively slow and limited âą Relatively rapid and extensive âą Primarily through relocation âą Often hierarchical âą Oral traditions and stories âą Social media and mass media Buildings and âą Materials produced locally, âą Materials produced in distant Housing such as stone or grass factories, such as steel or glass âą Built by community or owner âą Built by a business âą Similar style for community âą Variety of architectural styles âą Different between cultures âą Similar between cities âą Traditional architecture âą Postmodern / contemporary architecture Food âą Locally produced âą Often imported âą Choices limited by tradition âą Wide range of choice âą Prepared by the family or âą Purchased in restaurants community Spatial Focus âą Local and regional âą National and global Artifacts, Mentifacts, and Sociofacts Whether a cultural attribute is considered traditional, folk, indigenous, or popular in nature, it is valuable to differentiate between elements of culture that can be seen and those that can not. There are artifacts that comprise the material culture, which consists of tangible things, or those that can be experienced by the senses. Art, clothing, food, music, sports, and housing types are all tangible elements of culture. Another element of the study of artifacts is understanding the techniques to use or build a specific artifact. Artifacts can be unique to a particular culture, or can be shared. For example, people of all cultures need to communicate through language, yet there are many groups that possess languages unique to their culture. The ability to read, write and understand the English language is an artifact of importance for much of popular global culture. 136 HUMAN GEOGRAPHY: AP" EDITION Mentifacts comprise a group's nonmaterial culture and consist ofintangible concepts, or those not having a physical presence. Beliefs, values, practices, and aesthetics (pleasing in appearance) determine what a cultural group views as acceptable and desirable. Mentifacts can also be unique or shared. People of many cultures possess an belief in one or many deities, and often the deities are unique to that culture. The belief in a god is a mentifact-the religious building or symbols are artifacts. Cultural groups also possess sociofacts, which are the ways people organize their society and relate to one another. Taken altogether, people tend to see the whole of their culture as greater than the sum of its individual parts. Sociofacts are embodied through families, governments, sports teams, religious organizations, education systems, and other social constructs. As with artifacts and mentifacts, sociofacts may also be unique or similar to other societies. Families are the foundations of most societies, yet what constitutes the structure of a family may vary widely between cultural groups. For example, Western cultures tend to view the nuclear family, consisting of the parents and their children as the basic family unit. By contrast, in many Western African cultures the norm is the extended family, consisting of several generations and other family members such as cousins living under one roof.Long Call Option Trading Strategy: Learn the Basics LONG CALL SUMMARY Purchasing a call option is a bullish strategy that gives the buyer the right, but not the obligation, to buy 100 shares of the underlying asset at a specified strike price on or before the expiration date. This strategy is typically employed when an investor believes that the price of the underlying asset will increase in the future. The value of a call option is influenced by several factors, including the underlying asset's price, the strike price, the time to expiration, and implied volatility. As the price of the underlying asset increases and approaches or breaches the long call's strike price, the option's value will appreciate. This is because the option holder has the right to buy the underlying asset at a lower price than the current market price, resulting in a potential profit. Out-of-the-money (OTM) calls have a strike price that is higher than the current market price of the underlying asset. These options are typically cheaper than in-the-money (ITM) calls, which have a strike price lower than the current market price. ITM calls have intrinsic value, which is the difference between the strike price and the current market price, and extrinsic value, which is the additional premium paid for the option's time value. Extrinsic value decays over time as the option approaches expiration, and this can cause the option to lose value, especially if the underlying asset does not move towards the strike price. LONG CALL OPTION Purchasing a call option grants you the privilege, but not the responsibility, to buy 100 shares of the underlying asset at the specified strike price on or before the expiration date. This option grants you the flexibility to capitalize on potential price increases of the underlying asset. The value of a call option is positively correlated with the price of the underlying asset. As the price of the stock or ETF rises and approaches your strike price, the value of your call option increases. This is because the difference between the market price and the strike price widens, giving you a greater potential profit. This characteristic makes call options suitable for bullish strategies where investors anticipate price increases. Conversely, the value of a call option diminishes when the price of the underlying asset drops or remains constant. Time decay, which refers to the gradual loss of an option's value as its expiration date approaches, also contributes to the depreciation of call options. Over time, the intrinsic value of the option, which represents the difference between the strike price and the underlying asset's market price, decreases as the option nears expiration. Additionally, if the price of the underlying asset remains below the strike price, the option may expire worthless, resulting in a total loss of the premium paid. Understanding these dynamics is crucial when trading call options. It allows you to make informed decisions about when to enter and exit positions, taking into account factors such as the underlying asset's price movements, time decay, and market sentiment. Buying call options can provide an alternative strategy to gain long exposure to a stock's price movement without the need for purchasing shares directly. This approach, known as a long call position, offers the potential advantage of lower capital outlay compared to buying shares outright. However, it's crucial to understand the concept of time decay, which significantly impacts the value of long call options. Time decay refers to the gradual decrease in the value of an option as time passes. This phenomenon occurs due to two primary factors: theta and vega. Theta measures the rate at which an option's value decays over time, while vega measures the sensitivity of an option's price to changes in implied volatility. As the expiration date of the call option approaches, both theta and vega work together to erode the option's value. Consequently, to offset the impact of time decay, the underlying stock price must rise at a greater velocity towards the call option's strike price. This is because the intrinsic value of a call option, which represents the difference between the strike price and the underlying stock's current market price, increases as the stock price moves higher. Another important consideration when evaluating call options is the distinction between out-of-the-money (OTM) and in-the-money (ITM) calls. OTM calls have a strike price higher than the current market price of the underlying stock, while ITM calls have a strike price lower than the current market price. OTM calls are typically less expensive than ITM calls because their value is composed entirely of extrinsic value. Extrinsic value refers to the portion of an option's price that is not attributable to its intrinsic value. ITM calls, on the other hand, have both intrinsic and extrinsic value, resulting in a higher cost per contract. As time relentlessly marches forward, the value of call options undergoes a transformation. The extrinsic value, which represents the premium paid for the potential of future price movements, steadily diminishes as expiration approaches. This decay is universal, affecting all call options regardless of their initial strike price or distance from the underlying asset's current price. However, amidst this gradual erosion of extrinsic value, ITM (in-the-money) call options stand as an exception. These options retain their intrinsic value at expiration, which is the difference between the strike price and the underlying asset's price. This characteristic sets ITM call options apart from their OTM (out-of-the-money) counterparts, whose extrinsic value decays entirely to zero near or at expiration. The distinction between ITM and OTM call options underscores the significance of carefully considering both the time frame and strike price when making investment decisions. Traders seeking to maximize their potential gains through call options must be mindful of the impending decay of extrinsic value as expiration draws near. For long ITM call options, the ideal scenario is for the underlying asset to exhibit a significant upward movement. Such a price increase would enhance the intrinsic value of the option, making it worth more at expiration than the initial purchase price. This scenario holds true for OTM call options as well, as they require the underlying asset to move ITM at expiration to possess any value. Prior to expiration, both OTM and ITM call options have the potential to gain a combination of extrinsic and intrinsic value if the stock exhibits a rapid upward trajectory. This dynamic underscores the importance of monitoring market conditions and adjusting investment strategies accordingly. Understanding the Interplay of Time, Strike Price, and Option Value in Call Option Trading: In the realm of call option trading, comprehending the intricate interplay between time, strike price, and option value is paramount to success. These three factors collectively shape the dynamics of call option contracts, allowing traders to make informed decisions and capitalize on market opportunities. Time (Days to Expiration): Time, measured in days until expiration, is a crucial element in call option trading. As expiration approaches, the value of a call option is directly influenced by the time premium. The closer an option gets to expiration, the less time value it holds. This time decay accelerates in the final days leading up to expiration. Therefore, traders must carefully consider the time factor when selecting their expiration dates. Strike Price: The strike price represents the predetermined price at which the underlying asset can be bought (in the case of a call option) or sold (in the case of a put option). When choosing a strike price, traders must assess the current market price of the underlying asset and make an educated guess about its future direction. ITM (In-the-Money) call options are those with a strike price below the current market price, while OTM (Out-of-the-Money) call options have a strike price above the current market price. Option Value: Option value refers to the premium paid by the buyer of an option contract to the seller. This premium comprises two components: intrinsic value and time value. Intrinsic value is the difference between the strike price and the underlying asset's current market price. Time value, as mentioned earlier, is the premium paid for the remaining time until expiration. Auto-Exercise and Expiration Scenarios: Auto-Exercise: Long call options that expire ITM by $0.01 or more will be automatically exercised. This means that the buyer of the call option has the right to purchase the underlying asset at the strike price. If the investor holds only a long call, this will result in 100 long shares per contract purchased at the call option's strike price. On the other hand, investors holding the corresponding short shares will cover or buy shares at the call option's strike price. Expiration Worthless: Any long call options that expire OTM will expire worthless. In this scenario, the investor loses the entire premium paid for the contract, resulting in a maximum loss. Understanding these concepts is instrumental in developing effective call option trading strategies. By carefully considering the interplay between time, strike price, and option value, traders can position themselves to make profitable trades and minimize potential losses. PROFIT & LOSS DIAGRAM OF A LONG OTM CALL A long OTM call option can be profitable if the current market value of the option exceeds the price paid to purchase it. This can occur in two main scenarios: Stock Price Surpasses Strike Price: If the underlying asset's price rises above the strike price of the call option by more than the premium paid for the option, the call option becomes profitable. This is because the intrinsic value of the call option (the difference between the strike price and the underlying asset's price) becomes positive, and the call option can be exercised to purchase the underlying asset at a price below the market price. OTM Call Moves Closer to Underlying Asset Price: Even if the underlying asset's price does not reach the strike price, a long OTM call can still be profitable if the option's price increases. This can happen when there is a quick rally in the underlying asset's price, causing the call option's price to increase as well, even if the strike price is not reached. This is because the time value of the call option increases as the expiration date approaches, and the call option becomes more likely to be in the money. However, it's important to note that long OTM call options can also result in losses if the underlying asset's price does not surpass the breakeven point. The breakeven point is the price at which the call option's intrinsic value becomes equal to the purchase price of the option. If the underlying asset's price remains below the breakeven point until expiration, the call option will expire worthless, and the investor will lose the entire amount paid for the option. The maximum profit potential of a long OTM call option indeed has no theoretical limit, as a stock's price can theoretically rise indefinitely. This means that if the underlying stock price increases significantly, the call option holder can potentially reap substantial profits by exercising the option and buying the stock at the predetermined strike price. On the downside, the maximum loss on a long call option is limited to the premium paid for the option. This premium represents the total amount invested in the option contract and acts as a protective barrier against further losses. If the stock price declines or stays below the strike price at expiration, the option will expire worthless, and the investor will lose the entire premium paid. The flattened red loss zone in the diagram illustrates this limited loss potential. This zone represents the range of stock prices below the strike price at expiration where the option holder will lose money. The loss amount decreases as the stock price approaches the strike price and becomes zero when the stock price equals the strike price. Beyond the strike price, the option holder starts to make a profit. It's important to note that while the maximum profit potential is theoretically unlimited, it is highly unlikely for a stock price to rise dramatically within the short timeframe of an OTM option's expiration period. Therefore, while the potential rewards can be significant, the probability of achieving them is relatively low. PROFIT & LOSS DIAGRAM OF A LONG ITM CALL ITM (In-the-Money) options have a unique characteristic where the price of their intrinsic value directly correlates with the underlying asset's price. This means that for every one point movement in the underlying asset's price, the ITM option's intrinsic value moves by the same amount. While purchasing an ITM option provides immediate intrinsic value, it does not guarantee profitability upon execution. Similar to buying an OTM (Out-of-the-Money) call option, the purchase price of an ITM call must increase for it to be profitable. This requires the stock price to move further above the call strike price. This relationship is visually represented in the diagram, where the red and green zones converge on the x-axis. The maximum potential loss on a long call option is limited to the debit paid for the option, which is represented by the flattened red area in the diagram. This means that the most an investor can lose on a long call is the premium paid for the option, regardless of how far the underlying asset's price moves below the strike price. Understanding the price dynamics and potential risks associated with ITM options is crucial for traders and investors. While ITM options offer immediate intrinsic value, careful analysis and consideration of market conditions are necessary to determine their potential profitability. EXAMPLE OF A LONG OTM CALL OPTION XYZ currently trading @ $45 Buy to Open +1 XYZ 50-strike call @ $4 debit Cost: $4 debit ($400 total, ($4 x 100 shares)) Time Decay Affect Works against the optionâs value Max Profit Theoretically unlimited Max Loss Debit paid per contract ($400) Breakeven Price (at expiration) Strike price + debit paid ($54) Account Type Required Cash, Margin, and IRA EXAMPLE OF A LONG ITM CALL OPTION XYZ currently trading @ $45 Buy to Open +1 XYZ 40-strike call @ $7 debit ($5 intrinsic value + $2 extrinsic value) Cost: $7 debit ($700 total) Time Decay Affect Works against the optionâs value Max Profit Theoretically unlimited Max Loss Debit paid per contract ($700) Breakeven Price (at expiration) Strike price + debit paid ($47) Account Type Required Cash, Margin, and IRA âOn this night, we share a roof protecting us from fleets of inequity. Our unification promises a better tomorrow. Those larger than myself, sitting on their marble thrones, sipping blood from cups composed of human skin and singing songs of so-called virtue, grow weaker each moment. Their caravans are revolting. There is hope yet. There is progress! Though tonight may mark a countdown, it is still a celebration. Look at all we have done, not just for Trials but for Palatium Infra as a whole. In four years, when Iâm no longer Sovereignty, the Spoiled Purity and his people will continue to strive. So drink! Smoke! Crush up those exotic plants and snort them! We will not falter, weaken, or wane. Our influence is expanding, and somebody new opens their eyes every day. Even the Silbys of Aculeus have reached alarming potentials despite their embittered minds. So long as you relish in tonight, dance, and pray to your âdeadâ Gods, our revolution shall rise beyond the bounds of class, and when Iâm only a commoner, we shall rise again beyond our brainwashed adversaries! Cheers, my people. Cheers!â Followers raised their cups. Some clinked theirs together. Others stood still and screamed breathlessly in agreement. I smiled with courtesy, then stepped off my platform. My voice still rang across the cellar. Speeches before were grander. Those displays were supposed to be emptying, and yet this one left me bloated, swollen tight. I watched as they popped the corks of their bottles and chanted in the name of Purity. Maybe the quality of my words wasnât what mattered to them anyway, so long as I screamed loud enough. Thereâs no merit in attacking your people, a voice corrected me. âThatâs right,â I said aloud. âKnox, my-my Sovereign!â squealed a nearby devotee, jittering as he stuffed his face with catered pastries. He was one Iâd never seen before or had failed to remember. âLook what Iâve found! Itâs wine, and not the shoddy Infran kind, either. Earth-made with good fruit! I donât know how anyone managed to get their hands on this. Maybe some space travel mischief.â He giggled and held up a small glass bottle. âHow neat.â âI want you to have it, Sir.â I nodded my head. âYes, of course. Thank you.â Backing off into the midst of rowdy disciples, I clutched the bottle. What a waste of grapes. It could have been jam instead. Earthly food had a superior taste, ripe with delicate intricacies and nostalgia, but Palatium Infra had mastered the art of alcohol. Why waste your time with a drunkenness so sad and sickening? The booze of trash. Not many more followers approached me. The barren peroration must have upset them. My hands itched to submerge into my suit pockets, and my legs stood suddenly numb, wobbling. Four more years until Iâm nothing. But tonight, you are nothing. âShut up,â I told myself. Tightly packed together in the corner of the dwelling sat the Sibyls. A mound of writhing fabric and tones of skin made up their unified silhouette. I snapped the strap of the nearest gown, balancing on my hands and knees, waving the bottle before them. In their almost rodent nature, narrow noses prodded my way. Their dresses wrinkled and fell to their ankles. Knees dropped, and eyes widened. Many grumbled at me like hungry she-beasts. Those newer ones with faded curtains for hair, sunken eyes, and dirtied nails looked, hid their face, then sobbed. I imagined them in a pack together, fighting wildly against the Spoiled Purity in their rat decorumâbiting down with square teeth laced with rabies. âIâve got you all something,â I said. âGo back off to your pedestal and yap some more. We donât want it.â A woman rose from the pile and spat. âYou donât even know what it is yet. It's Earth hooch, or more likely a near-flawless replica. I figured you girls would also like a chance to enjoy yourselves tonight.â âYour playmates have been harassing us since the moment you hung the banners and opened the cellar door.â The youngest, with a striking cyan mop upon her head, uncoiled from the mass. What was she now? 20, 21? We celebrated a birthday recently, I thought as she spun around me. âI remember something about a promise. Multiple promises, actually. Are you trying to bribe us into just shutting up and taking it? Because if another sticky, 40-year-old, Earth-born virgin gropes my shoulder, Iâm going to have an aneurysm!â the girl continued. âWhy not an Infran follower? Do you like it when they touch you?â I returned her accusing tone. âIâm sorry, sweet prophets, that you feel Iâve neglected my duties. Iâll keep a better eye out. Remember, you can always just holler if somebody is bothering you. And Anwen, friend, if Iâve ever tried to bribe you with anything, it was certainly the hair dye. I mean, look at you! Such handsomeness!â I exclaimed. The other Siblys began to encircle her, uttering compliments or even announcements of their envy. Anwen disappeared in a wink with flushed cheeks back into the mound. âIâll just leave this here.â Smiling, I set down the bottle. ** â141, 143. . .â I counted each step as I trekked the staircase. There was no doubt I lost track somewhere. The ledges kept spawning under my feet, infinitely multiplying until I wasnât moving at allâswallowing me up in a whirlpool of stone. My tie still hung around my neck, and my blazer remained tied around my hips as a skirt. Streaks of red dribbled off from the cavity in my chest. It was a gorgeous marking, sensual to my fingertips as I traced its edges. Purity, oh, Purity. Purity and his wings of burnt skin. Purity and his many faces. Purity the spoiled. Purity the mutilated. The Silbys did not bother waiting for me. On bare feet, they stormed up the stairs to their room. A trail of red, though in paint unlike mine, streamed after them. None looked remotely near me as they squeaked and gossiped intangibly. I saved them, those Infran broads, enlightened them. As much as they liked to deny it, spit at me, and bask in the thought of their victimhood, in this home, they stood empowered. Youâve done well, my thoughts affirmed, though in the manner of an insincere commentator rather than a hype man. Teeth grace in tile violin goes laundry paper when. It dissolved into an intruding drivel. I rubbed my head and sniveled. âDo you need help, Knox?â called a Silby. Fattened by my coddling, her shadow fell upon me from the doorway steps ahead. I attempted counting again. There mustâve been at least another hundred between me and her. âIâm hallucinating some,â I said, breathing deeply to suppress a burp as I struggled to recall her name. Two syllables. Typically Latin, though sometimes English. Drops of slobber leaked from my mouth. âIâm hallucinating some, Tybal. Do you like your name, Tybal? I would have named you something better. Ty-Tyballinia. No, weâd have to eliminate the âballâ aspect. It sounds too crude.â âOne foot in front of the other,â she said. So I walked. Mess greeted me at the doorway. Dirtied culinary obscured the dark wooden countertops, and the sink lay running. I approached the kitchen table, sat, and set my face down upon its cool wooden surface. Assaulting my nose was the smell of neglected flowers, like soil mixed with the kind of sweet cough medicine that would have left me gagging as a child. Open windows whispered songs of the twilight hour through the vessels of busy trolleys and shooting guns. My mouth strained to vomit, but there was nothing in my stomach to regurgitate except the petals of Stultoâs bloom, which came out effortlessly in little sputters. Teetering, I stood up and brushed disgorged plant parts off the tabletop. âLove,â I said as I slogged up yet another staircase. âAre you awake?â She said sheâd wait. Somebodyâs gotten her. No, she always misses movie night. That sleepyhead, I assured myself. There was a stirring amidst the manorâs cloak of dusk. Portraits of myself, my wife, and my daughter turned to face me as the hallway lights flickered, escaping their quartz frames to penetrate my ears with nonsense. The taxidermied heads of Infran creatures bared their teeth. I stopped to stare at my favorite, an adabactor with daunting spiked tusks poking out from its forehead. Its nose remained black and sharp, and its eyes wide with malice. âWhere is my Spes, Adaba-boy? Is she sleepy?â Thereâs someone in the house. The sounds of the stirring rose along with my blood pressure. Footsteps orbited around me, drawing near and far and then near again, little dancers in the dark. The carpet immersed me in its mass of purples and blues, leaving my skin stained indigo and my vision abstracted. I toiled to reach the master bedroom across the aisle as it stretched out to me with bright lights and celestial howling, like a dove struggling in a pool of oil. Never again with Stultoâs bloom. Never again on what was already a bad night. My hand brushed the doorknob, and the high abruptly faded into only a persistent hum-buzz twirling around my brain. The portraits returned to their typical depressionâSpes posing with her ax, Ariâs school photo, and myself in the cap I wore when addressing the military with the Verbis emblem embroidered in its center. All lifeless shots. Who were they for when they captured not the subjectâs essence but only some fragment of their identity? They used to feel personal, not advertisements of some supposed characters. Servants, babysitters, and likewise civilian guests, I reminded myself, mustnât forget whose home theyâre in. Yet my body moved independently, taking Ariâs from its hook and laying it backward against the wall to hide her distant grin and tamed posture. It was time for new pictures. Sweet ones, real ones; time was ticking. I approached my own when the stirring began again. Groans and squeals erupted from the vents as if someone had set a pen of pigs loose in my crawlspace. No, not the crawlspace, my bedroom door. I turned the ruby knob. Underneath a blanket wrestled my two squealing piglets, their skins melting together beneath the layer of duvet. Fishnet leggings and manicured nails outstretched and scraped at the sheet beneath them. One raised its head, a salmon-colored man with sweat running down his forehead. Through the crack in the door, we met eyes, his Infran Dr. Sesuss nose flaring its narrow nostrils. No mark of the Spoiled Purity existed carved onto his naked body. My chest felt tight. I stepped back. I was suffocating. Spes emerged from the linens, her hair flowing down her back and her dark skin glistening in front of the bedroom window. She giggled and held the man, the blanket falling and revealing inches of her body I had not seen in months. âDarling,â whispered the rosy-faced man, âlook.â He was unfathomably ugly and grotesquely young, with beady, lifeless pupils that dilated when he faced me. The excess flesh on his face sagged while he bit down on his thin lips. My wife faced me, gasped, and strained to cover herself. Suddenly, I was a stranger. A small child who had walked into his parents having sex. I unfurled the door completely. âGet out of my house,â I said. The man stayed in place. âGet out of my house,â I repeated. âKnox,â Spes began. Tears ran down her round cheeks. âShut up!â I turned to the man, picking up a marble trophy from on top of my dresser. âGet out of my house! Iâll kill you!â âKnox!â Spes sobbed. âGod damn it! I hate you! You barely look at me. Every day, thereâs less passion. God, God, God, I donât want to fuck a dead man!â she screamed, âYou get out! Get! Get!â My hands wrapped tighter around the statue. That pig of a man was attached to her at the side, his face equipped with a scowl that challenged mine. He thought I was weak; frail like a decaying dementia-ridden senior. I imagined his skull bashed in, his scowl gone, and the feist and confidence in his face beaten into numbness. A new portrait was in order of such brutality, him as a splintered slab of wood, rashed and beaten, a carcass licking my boot. The churning in my brain had come back. Every wall shook. Clock faces came to life and rang in alarm. Indescribable noises caressed my eardrum before breaking into sorrowful weeps. Was it my own? I stared at Spes in motionless frenzy, clenched my teeth, and screamed like a siren. Passionless. What a lie! An excuse, more like. One that erased all my ventures, reducing me to a nobody. But I was not a nobody. I thought of my sect, my campaigns, my endurance through the political brutality of my empty hive-mind worldâeven my collection of literature, maps, and artifacts. I thought of daring nights alone with Spes when we were young, ravaging each other, two sardonic eggheads suddenly overcome with desire. The veins in my neck throbbed as I gasped for air. It was all I had. I threw the figurine at the manâs head. Eye shut, I heard the thud. A million singing voices of victory flooded out of the cracks in the floorboard. Proving myself a man to the woman I loved in a display of fervent violence was passion. I strained my ears for his cries, though I did not look yet. There had to be a pause, a moment of relief, where I stood tall as a skyscraper and seemingly fought to stay contained in front of my wife and her wounded, quivering paramour. Frantic footsteps rushed off the bed and past my side. I turned and grappled against myself to seize my wifeâs shoulder. âSpes!â My eyelids lifted. Escaping was the man with that same numb expression in which I had imagined him. âYouâre insane,â he said. I swiveled back towards the bed. With her curly locks flowing over her breasts and her limbs bent at her sides, Spes sat limp pressed against the headboard, her forehead bludgeoned and the statue resting on her stomach. Lips pursed and sweet, my Renaissance beauty reclined there in the guise of a squashed bug. But she was not dead. The desk ornament I flung was only the size of my shoe. Spes, that dramatist, may have been slightly hurt but was far from dead. She only wanted me to think she was to observe me at my most distraught, like a leech feeding on misery. âGet up.â Staggering toward the bed, I said. âYou wanted passion? I showed you passion. âShoved it right into your head. Of course, we both know who that gesture was meant for. . .â I fumbled to find my wit. Cold skin met my hands as I stroked her face, unable to resist checking her pulse, even though she was not dead. âI love you, Spes,â I said. Rain pelted against a nearby window. âSpes, please. Please.â No vibration answered my plea. I lifted my hand, sitting next to her now. Tears did not come. There was not any blood on the trophy, but when I picked it up, it felt to be now only a cruel instrument. It depicted a younger me in white marble, with my glasses and collared shirt being the only things painted. Both were in pink. It was a favorable color. I scrambled from the bed to vomit pure digestive bile on the rug. My stomach heaved. I ran my nails along every piece of myself I saw, a dog chasing my tail. As I slammed myself against walls and convulsed, my own heart grew ever louder in my chest. âDad? I heardââ Ariâs slippered feet hammered across the floor. âMom? Mom?â I kept my eyes on the storm. Silence fell. âShe-She isnâtâyourâ.â Gasps interrupted every syllable she spoke. âYouâre a murderer. Bad. Like they said,â she breathed, â You beat her!â The words became mush, alphabet soup. Ari ran back down the hall. âMy-My mom is dead. . . .Yes. . . Manor of the Trials Sovereignty. . .Ari Sorkin. . . Iâm afraid heâs going to hurt me,â she said, presumably over the phone. It was all too fast. I crawled onto the windowsill, opened the glass, and let myself plummet into the alley below. Gusts of wind howled. The lack of motion or sensation informed me I had passed and again lived. Another Palatium Infra, another strange planet in which the celestial endowed rotting men with the opportunity to inhabit. Was this it? Was it all just an impossible limbo of galactic traveling? My surroundings were overwhelmingly gray, an abyss of clouds. Perhaps I had now met the real coming world, and my family and old friends lived here, ready to rush to my sides, lift me up, and jump for joy. Spes would be there. She would be enraged, but at least sheâd be there. You are a bad man. You are a bad man. My eyelashes fluttered. There was a tugging sensation in my leg. The fog was wavering along with my ascendance. âNo,â I yearned, trying to grip the clouds and stick them in place. âStay with me.â But the peace was fleeting. I felt the cement under me and the moist garments clinging to my figure. My leg burned. Carefully, I craned my neck, only to observe the promenade as my surroundings. The most underwhelming of filth and danger, individually Infran. Forever my coming world. What a fool I was, having forgotten my blessing. Those idiot Gods could not tell the difference between assassination and self-infliction; a faulty insurance plan. The urge to cry at last set over me, and so I sat and wailed hot salvia into my palm, shielding my mouth to muffle the noise. Thunder echoed my hushed howling. Raindrops turned to pebbles. Under the ambiance of the stormy night, I could have sworn I heard troops stomping, guns cocking, and the chanting of my name. They had all been waiting for this. Billboards came to life, and I could only sit and spectate as the scenery flashed red. I inhaled fear and sobriety through runny nostrils. âTrials Sovereign Vsevolod âKnoxâ Sorkin is currently at large for the suspected homicide of Spes Sorkin, breaking the first term of the Sovereignty Charter. We now instruct you to report any sightings of the Earth-born, caucasian, roughly 195 centimeters tall, brown-haired, and brown-eyed man to your local Guard post. One can identify the suspected convict specifically by an occult tattoo of Purityâs Coronet on his lower back. No attempted execution or elongated punishment will take place until our Guards conduct an autopsy proving his guilt, per Lifeâs 1238 commandment. We cannot be sure when or if the Gods will revoke his blessing. Remember, when Gods frown upon strife, opt for a peaceful life. We permit all grieving festivities until Cagidus 4th. Good year!â towering buildings sang out in broadcast, repeating that same convoluted message quicker the instant it ended. Sometimes, the announcer spoke in Latin for the Infran children, other times in Chinese, Hindi, or Spanish to cater to those of irrelevant tongues. You arenât a bad man. You are a stupid boy. Puddles sloshed. Somebody was approaching. I didnât dare waste any remaining energy avoiding the Guards and their prodding blades. How did that phrase go? You dug your grave. Now lie in it. And so I embraced the cement. âKnox?â said the Guard. No, her tone was too sincere, and no authority would proceed in such a manner. There wasnât confirmation on whether or not I was armed, and it wasnât as if she could shoot me first. She was a partygoer, having just left from the cellarâs backdoor. I shooed her away with my hand. She hovered, and I discerned her shadow hesitating over my body. A man could not rot in peace. âCome on, get up! Theyâre after you!â Hands reached around my torso, struggling to handle my weight as they urged me onto my feet. That leg, the burning one, my right, trembled and bent unnaturally upon impact with the ground. The partygoer slung my arm over her shoulder, balancing me. My eyes caught a glimpse of a cyan mop. âAnwen?â I rasped, âhu-who let you out?â Keys jangled in her handsâmy keys. âI escaped,â she said casually, coercing me to walk beside her. âQuicken your pace. I just heard somebody on your front porch. âYou see that compost bin down the alley? Weâre gonna burrow right down into the depth of that. If they open it and uncover us, Iâll be on top, and I can hide you and act like Iâm just a homeless amica trying to take a nap.â With a tightening grip, she led me like livestock to the stinking crate. âI donât understand, Anwen,â I said. âTheyâre going to torture and kill you, stupid. You know theyâve been wanting to, and you just handed the opportunity to them!â âI understand that.â It was becoming increasingly challenging to hide the fragility emerging in my voice. âYou said you were escaping. Why stop and help your captor?â âWhat else could I do? Leave you there?â Attempts to shove my wounded body inside its mass of discarded fruits and vegetables began. She yanked down upon my head and submerged me in the fertilizer sea. The evidence grows indisputable, I thought as I stared at the abruptly humane Infran girl, diving in after me, that I belong here. âDamn me to hell! Iâve killed her! My love is dead!â an uncontrollable cry leaped from my mouth. âShut up! Soon youâll be, too, if you donât quiet down.â The actual noise of the Guards darted past us: disorientated marching, guns clanking against each other, cluttered belts rattling, the Latin squawking. One paused to open the binâs lid, though only rummaged through the surface layer of peat before carrying on. âWhat are they talking about? I struggle with my Latin,â I whispered. âThe search, mainly.â Aggression remained firey in Anwenâs clenched jaw. Though she sat on top of me, there was a monumental distance between our rain-soaked forms. I curled up into a ball, ducked my head between my knees, and dreamt of Spes, ignoring the stench of spoiled food rising from every crevice of my dwelling. The next coming world was due to adopt me again as I forced sleep. I prayed for a canyon of fluffy haze, where I waltzed with pale memories but found nothing but the petrifying stillness of my mind. Killed and ran. Violent as a Guard just to prove a point and watch it backfire. Why would any heaven want to welcome me? I clung to the picture of Spes in my head like it was the last ember of an extinguished flame. âDid you mean to kill her?â Anwen interrogated. âSomeone like you would immutably believe yes.â âAnd who is someone like me? You canât even treat me like a person for a moment, can you?â grating drama decorated her words. âYou know my opinions. I have not seen much of your or your breedâs faces besides that of cruelty and ignorance.â I retorted. âI just saved you! Does that make me cruel and ignorant?â âIt makes you an idiot, which is another word for somebody ignorant.â âAnd why am I an idiot?â She asked. âBecause you helping me does no good. Thank you anyhow. Now, do yourself a favor and scram.â As she bent her leg in anticipation, preparing to strike me on the forehead, I sensed an invisible withdrawal widening the gap between us. âYou never answered my question,â Anwen took me by the end of my tattered tie suddenly and started her game of shepherd and sheep over again, pulling me back up to the crateâs exit. It appeared as a shining light at the end of a maze of rubbish and mold. âNo. Of course not. Spes was my everything,â I sniffled. âI knew it. You couldnât even bring yourself to hit us, let alone murder your wife. The girls and I always figured you were sensitive.â My heart rate quickened. Today was one of humbling and miseryâone to pray a hail spike would fall from the sky as sharp as a needle, pierce into my eyelid, and lobotomize me. I wished I could have merely died or hit my head hard enough not to have to deal with it all. No, I wished I was Anwen with her snarky, careless glow and lack of depth in her eyes. As we emerged from the compost bin together, I fantasized about strangling her until her face turned purple, her weakening spirit no longer categorizing me as âsensitiveâ, but the thought could only remind me of wielding that trophy and the microscopic traces of my wifeâs tender skin tainting it, which turned my guts inside out. âThatâs why I think you could use a little help,â Anwen said, âIt seems like you canât walk, either. Your leg is all twisted up.â She undid one of her trim pigtails and handed me the band. âTake off your tie and put up your hair. âWill make you less recognizable. Then swallow your pride and stick with me.âMake a multiple choice quiz for my year 8 science students based on the science in this transcript from a video: 3°C 0:04 It can be the difference between snow and sleet 0:08 Wearing a jacket or not 0:11 In your day-to-day life, it may not seem significant 0:15 But 3°C of global warming would be catastrophic 0:20 Heatwaves, droughts, extreme precipitation, even fire 0:25 3°C of warming is really disastrous 0:28 The scary thing is, the world is well on its way there 0:32 Since the industrial revolution, the Earth has warmed between 1.1°C and 1.3°C 0:40 This is a problem that babies you pass in the street will have to live with 0:46 Children born today... 0:47 ...are up to seven times more likely to face extreme weather than their grandparents 0:52 If global temperatures do rise by 3°C... 0:55 ...what would their world look like? Climate change is already having devastating effects 1:03 Rising sea levels 1:05 Desertification 1:07 Hollywood has always enjoyed imagining the end of the world 1:11 While blockbusters like this are clearly fiction... 1:14 ...this film will show the scenario we all face... 1:17 ...unless more drastic measures are taken to stop burning fossil fuels 1:30 In some parts of the world the effects of inaction are already clear 1:35 The slums of Bangladeshâs capital are filling up with climate migrants 1:41 Minara comes from Bhola District, an area in southern Bangladesh 1:46 There, like many other parts of the country... 1:49 ...rivers swollen by heavier rain and melting Himalayan glaciers... 1:53 ...are washing away peopleâs homes 1:56 Many, like her, have lost everything 2:00 Our home in Bhola had endless amounts of land 2:03 There was lots of space for farming, we had a spacious house 2:08 There were different types of fruits, vegetation and trees growing at home 2:12 We used to eat the fruit from our own trees 2:18 I canât eat them now because they don't exist anymore 2:21 Since the river flooded for the third time, I had to flee to Dhaka 2:26 Life was much better back home 2:29 It was unbearable to live through, truly intolerable 2:33 We didnât have the time to save anything at all 2:38 1.1°C to 1.3°C of global warming has already transformed Minaraâs life 2:45 Itâs one of the reasons why so many migrants like her... 2:47 ...are moving to the city each year... 2:50 ...nearly 400,000 according to the last estimate 2:53 And climate models show there could be much worse to come How climate modelling works 3:02 Climate scientist Joeri Rogelj... 3:04 ...has spent the last ten years modelling future climate scenarios... 3:08 ...for the United Nations 3:10 The models we use to carry out this exercise... 3:13 ...really represent the state of the art... 3:15 ...of our current knowledge of climate change and where we are heading 3:19 Joeriâs projections use data collected by hundreds of scientists around the world 3:26 Here this is the 3°C level... 3:28 ...and so there is at least a one-in-four chance that under current policies... 3:32 ...we would hit 3°C by the end of the century 3:36 This is just one of the scenarios Joeri looks at 3:40 Another one imagines that all policy promises are kept 3:44 The most optimistic assumes that all promises have been kept... 3:47 ...and net-zero targets are met 3:50 Where our best estimate ends up around 2°C at the end of the century... 3:54 ...there is still a one-in-20 chance that we end up with 3°C instead 3:59 One would not be entering a plane if there is a one-in-20 chance... 4:03 ...that the plane will crash Nowhere is safe from global warming 4:07 A rise of 3°C would affect everyone 4:10 Even wealthy cities in rich countries wouldnât be immune to the consequences 4:15 European capitals like Paris and Berlin... 4:18 ...would bake under more extreme heatwaves 4:22 Frequent storm-surges in New York could turn parts of the city desolate 4:27 In many ways, cities magnify, intensify climate events 4:33 Cities are hotter than the places around them... 4:36 ...they tend to be more vulnerable to flooding 4:39 And you can get a really bad event in a city in a way that you canât in the countryside 4:46 And because of their denser populations... 4:49 ...disasters in a city affect far more people 4:52 Some cities might be badly prepared for the changes coming 4:56 But they have the means to adapt 4:59 Cities tend to be wealthier than surrounding places 5:03 They have a lot of amenities 5:05 A city that has taken seriously the risks of a 3°C world... 5:08 âŠwouldnât necessarily be a worse place to be in a 3°C world 5:12 But a city that hasnât prepared for these sort of eventualities... 5:16 ...that might be a really nasty place The impact of prolonged droughts 5:20 So far, many developed cities have got off lightly... 5:24 ...but some rural parts of the world are suffering disproportionately 5:29 Smallholdersâsmall-scale farmersâare particularly vulnerable to climate change 5:35 And there are over 600 million around the world 5:38 Smallholders with farms under two hectares... 5:40 ...produce around a third of the global food supply 5:46 Central Americaâs âDry Corridorâ... 5:48 ...supports a mix of smallholdings and medium-sized farms 5:53 Sandwiched between the Pacific Ocean and the Caribbean Sea... 5:56 ...the area is prone to droughts 6:08 Israel RamĂrez Rivera is a smallholder in Guatemala 6:12 Here, climate change is making the dry seasons longer, and more severe 6:18 This is the biggest ear of maize that this plot could deliver 6:23 He depends on his crops of corn and beans 6:26 But theyâre getting harder to grow 6:30 The surrounding mountains... 6:32 ...used to provide us with native food... 6:38 ...and now that isnât an option anymore... 6:41 ...due to climate change and its effects 6:46 Nearly two-thirds of the smallholders in the Dry Corridor now live in poverty 6:52 The impact of all of this for us... 6:59 ...malnutrition among children 7:03 Weâve lost a few 7:07 For my crops especially, the midsummer heat is harder than before 7:16 The plant dries up and canât provide us... 7:19 ...with the necessary food provision 7:24 Severe droughts in Central America... 7:26 ...are now four times more likely than they were last century 7:30 Many families from here have gone to the States 7:37 The economic despair and debts... 7:44 ...have pushed many people from this community to do this journey 7:53 Migration from Guatemala to the United States has quadrupled since 1990 7:59 Not all of this has been due to climate change 8:02 But longer droughts would force even more to move 8:05 In a 3°C world, annual rainfall in this region... 8:09 ...could drop by up to 14% 8:12 At 3°C, over a quarter of the worldâs population... 8:16 ...could endure extreme droughts for at least a month of the year 8:19 Northern Africa could see droughts that last for years at a time Rising sea levels, storm surges and flooding 8:24 But for some, too much water will be the problem 8:29 10% of the worldâs population lives on a coastline... 8:32 ...thatâs less than 10 metres above sea level 8:35 For these coastal inhabitants, a 3°C world would spell disaster 8:40 By 2100, global sea levels could have climbed by half a metre from 2005 levels 8:46 Low-lying cities like Lagos would be especially vulnerable... 8:49 ...with up to up to a third of the population displaced 8:54 And in Fiji, rising waters are already upending lives 9:04 You can see the graveyard there, itâs all under water now... 9:08 ...due to this rising sea level and climate change 9:15 The village of Togoru in Fiji is being swallowed by the sea 9:19 Barney Dunn, the village headman, has seen over half the village disappear 9:24 Relativesâ houses have been abandoned, and family graves are now under water 9:29 We have been asked by the government to relocate... 9:32 ...but no one wants to relocate... 9:34 ...because we have our great-great-grandparents down there in the sea 9:39 This is the place weâve been brought up in 9:41 ...itâs not easy to leave 9:44 Past attempts to build a seawall havenât worked 9:48 But Barney sees building a new one as the villageâs only hope 9:52 If they do that, maybe we can save whatever is left 9:56 But if we donât have the seawall, then it will be keep eroding and time will come... 10:01 ...maybe in ten,15 years, Togoru will be all eroded 10:05 Rising seas also mean storms cause more floods 10:11 And many more countries could suffer 10:14 The Philippines and Myanmar are just two countries... 10:17 ...that will also see an increase in storm surges in a 3°C world 10:21 To escape, many will move⊠10:24 âŠoften, to urban areas Extreme heat and wet-bulb temperatures 10:27 Half the worldâs population already lives in cities... 10:31 ...almost a third in slums 10:36 For them, a 3°C world could be deadly 10:40 Minara has moved to Dhaka to escape the impact of climate change 10:44 But life could get even worse for her 10:47 Iâm struggling a lot nowadays 10:49 The heat during the day is unbearable 10:52 Even late at night it doesnât cool down 10:57 The heat is getting more intense every day 10:59 I mean, itâs going to get much worse 11:03 I can barely survive it now, how will I live through it in the future? 11:08 Dhaka is getting hotter 11:11 In the last 20 years the average daytime temperature... 11:13 ...has crept up by nearly half a degree 11:17 Days that approach 40°C are now being reported 11:20 And high so-called wet-bulb temperatures are on the rise 11:26 A wet-bulb temperature is a measure of heat and humidity 11:30 Humans cool themselves by sweating⊠11:32 But in these conditions, when relative humidity is near 100%... 11:36 ...sweat doesnât evaporate well 11:38 So people canât cool down⊠11:41 ...even if given unlimited shade and water 11:45 At a high wet-bulb temperature, the body canât lose heat... 11:49 ...and so it gets hotter and hotter... 11:51 ...and the body is designed to work at a given temperature 11:53 And if it gets too hot inside, you will die 11:58 The human limit for wet-bulb temperatures is 35°C... 12:02 ...around skin temperature 12:04 Dhaka will have a much higher chance... 12:05 ...of reaching dangerous wet-bulb temperatures... 12:07 ...if global warming reaches 3°C 12:12 You canât really adapt to that 12:14 You have to get out. If the temperature is so high that you canât work... 12:20 ...canât do hard manual labour outside for significant parts of the year... 12:25 ...then many places will become functionally no longer part of the economy 12:33 Jacobabad in Pakistan, and Ras al Khaimah, in the United Arab Emirates... 12:37 ...have already recorded deadly wet-bulb temperatures 12:40 More of the tropics and the Persian Gulf... 12:43 ...as well as parts of Mexico and the south-eastern United States... 12:47 ...could all get to this threshold by the end of the century 12:50 Climate modelling might show us the weather Increased migration and conflict 12:52 But it doesnât show us its other effects on society 12:56 Established migration patterns could change 12:59 Climate disasters may exacerbate reasons people cross borders 13:03 Within countries, more people will move to cities 13:07 In a 3°C world, tens of millions of people a year... 13:10 ...could be displaced by disasters made worse by climate change 13:15 When people are displaced by climate... 13:18 âŠthey may well go to cities... 13:19 ...because cities are the places that attract people from the countryside already 13:25 A lot of people who can get to the developed world... 13:28 ...not least because the developed world tends to be less hot, will give that a go 13:35 As migration around the world increases... 13:38 ...there could be more competition for fewer resources 13:42 Waterâalready a highly contested resourceâwill be a focal point 13:47 Turkeyâs new Ilisu dam has reduced the flow of water into Iraq 13:53 China lays claim to rivers vital to India and Pakistan 13:57 The prospect of a water-conflict makes people very uneasy 14:03 How national tensions would exacerbate those sorts of reactions... 14:08 ...in a 3°C world... 14:09 ...is the sort of thing that no one should really want to find out 14:14 I think youâd have to be incredibly sanguine... 14:16 ...not to think that the sort of climate extremes that we talk about... 14:19 ...in a 3°C world wouldnât lead some places... 14:22 ...to the brink of societal collapse 14:25 Those lucky enough to escape unrest... Adaptation and mitigation are crucial 14:28 ...would still have to adapt to a radically different world 14:32 People can adapt to climate change in all sorts of ways, one of the most obvious ones... 14:37 ...is air conditioning 14:39 But other ways to adapt at a local or regional level... 14:42 ...I mean, one of the most obvious is diversifying agriculture 14:47 There are physical things you can do, like seawalls 14:52 The fact that people can adapt and that adaptation will reduce suffering... 14:57 ...doesnât mean that it will eliminate suffering 15:00 Suffering is built into this whole process of heating up the planet 15:06 Adaptation will only get the world so far 15:09 The best way to deal with a 3°C world... 15:12 ...is not to go to a 3°C world 15:14 And thatâs why increasing efforts on mitigation are important 15:17 Itâs why working towards negative emissions... 15:20 ...that could bring down the temperature after it peaks are important 15:25 Once you get to a 3°C world, you are in real bad global trouble 15:33 The scale of change needed... 15:35 ...and the slow progress of governments so far... 15:38 ...means 3°C of warming is uncomfortably likely unless more is done 15:44 Despite existing pledges, greenhouse-gas emissions... 15:48 ...are still set to rise by 16% from 2010 levels by 2030 15:54 The need to act has never been clearer 15:57 Thereâs still time to reduce emissions, so that a 3°C world remains fiction... 16:02 ...rather than becoming factEarlier in 2019 there was a lot of femicide uh girls being killed by their boyfriends because they did one or two things there are also cultures of if there is violence in terms of a marital relationship that that is fine if there's a marital rape that that is fine so you find such situations being normalized and it being also a taboo to speak about those issues the 2030 agenda for sustainable development is grounded in respect for human rights and the power of people to change the world every individual on the planet has the right to health and well-being in all aspects of their sexuality their body and their reproductive choices ensuring these rights is integral to addressing poverty education violence against women and gender equality sexual and reproductive health rights are agreed in international law they were fought for by courageous women's rights activists and advocates across a broad range of professional fields and frontline experiences by movements of all ages levels and backgrounds they are still being fought for while progress has been made globally many barriers remain especially for those most marginalized excluded or discriminated against human rights are central to delivering the 17 sustainable development goals in the sustainable development agenda indeed each sdg target is simultaneously a metric and a claim for human rights the interplay between these political commitments and human rights obligations is particularly important when it comes to achieving sexual and reproductive health rights for decades human rights-based tactics have been used to drive progress in this episode of right to a better world experts share challenges they have faced and tactics they have used to address them the challenges they describe occur in settings all around the world the strategies used are ones that they have found to be successful in their own settings viewers are encouraged to learn from these experiences and consider how tactics could be adapted to their own context when sexual and reproductive health begins with equality the discussions decisions programs and policies which follow can build towards a future where every individual is not only born free but lives free and equal in dignity and rights without violence or discrimination the time to take action is now violence against women is any act that results in or is likely to result in physical sexual or psychological harm or suffering to women this includes threats of such acts coercion or arbitrary deprivation of liberty in public or private life it happens everywhere in every country in the home in communities at work and at school crises including health and humanitarian crises frequently contribute to higher rates of violence against women violence against women is directed at women because of their status as women the consequences are dire jeopardizing women's health including sexual and reproductive health and mental health hampering their ability to participate fully in society causing tremendous physical and psychological suffering for both women and their children the majority of women survivors of violence do not disclose or seek any type of services efforts to address violence against women must recognize the many different contexts in which it occurs and the many different forms it can take the majority of violence against women is committed by an intimate partner her current or previous boyfriend or husband globally around 30 of women have experienced physical and or sexual violence by an intimate partner in their lifetime this increases the risk of acquiring an sti or in some regions hiv by 1.5 fold when a woman is experiencing violence especially from her partner she's really unable to keep safe from hiv men have power to decide how when and where sex should be done and the woman is at risk of being infected because she cannot say no schools are another setting where violence against girls can take place assault and harassment during their commute bullying sexual harassment and mental or physical abuse on school property are all challenges across various country contexts this has a direct impact on girls access to inclusive quality education a target of sdg4 and an indirect impact on many of their other human rights young girls are taking advantage of at a very young age and they do not understand the choices and the avenues whereby they can exercise their rights when it comes to sexual productive health and rights and so you find a lot of dropouts and a lot of girls also going through a lot of traumatic experiences that would be avoided if they had guidance promoting a safe and secure working environment for all is a cornerstone of sdg 8. this includes a workplace free from sexual harassment and violence but for many women especially women migrant workers and others in precarious employment this is far from reality so we went to naivasha which is a flower farm and we've met the informal workers the casual liberals working for the flower farms when for example the sexual violence cases are reported companies don't take them very seriously a wide range of tactics have been used to prevent and address violence against women and girls and to recognize it as a fundamental violation of human rights prevention of intimate partner violence is possible when interventions are informed by evidence of what works we started out by describing the problem we've now moved to research on what works what are the kinds of interventions that are successful both for preventing the problem from happening in the first place and also from interventions to respond the respect women framework on preventing violence against women developed by the who un women ohchr and other international agencies promotes seven strategies which focus on relationship skills strengthening empowerment of women services for health justice police and social sector poverty reduction environments made safer including schools workplaces and public spaces child and adolescence abuse prevented and transformation of gender attitudes beliefs and norms this action-oriented framework can enable policy makers and health implementers to design plan implement monitor and evaluate interventions and programs to prevent violence against women we have come a long way for sure we still have some ways to go and we need to do more to stop this violence from happening in the first place this involves addressing the social norms that still prevail in many settings that make this form of violence acceptable women are not exposed to gender-based violence by accident all because of an inbuilt vulnerability violence against women is rooted in discriminatory social norms and power dynamics dismantling these underlying causes of violence against women and girls is at the heart of achieving gender equality and empowering all women and girls as set out in the targets and indicators of sdg 5 ensuring healthy lives in sdg3 and reducing inequalities in sdg 10. women and men are valued differently society has heap privileges on the men while the women are looked at as subordinate power is not only the problem but also the solution to preventing violence against women we are making it personal everyone connects with power every day people living with power or grappling with power they find themselves within this whole conversation if you're working to create gnome change there has to be change at all levels strategies to raise awareness in communities about violence against women and girls are critical as there is still a lot of stigma and shame which inhibits many women and girls from talking about it intervention is like a big complicated word sometimes it's just about talking about dialogue i mean the fact that we went into schools and just began a conversation with parents um bringing them together in the school along with the school personnel and then having the conversation start from there and we also sort of train providers within schools to appropriately refer children to health facilities for care what we found was that this dialogue began to spark other conversations in the community and i guess they just felt that oh it's actually okay to talk about this openly rather than pretend that nothing is going on sassa is a community mobilization approach to prevent violence against women and hiv and aids it is activist led it's not workshop heavy based it comes away from the traditional programming of organizations going to do things themselves instead they support activists who do the activities with their friends and neighbors health systems play a critical role in responding to violence wherever it occurs supporting health workers to respond appropriately to violence as well as ensuring their work environment enables them to provide safe effective and quality survivor centred care are important strategies for better addressing violence against women and girls um we came to learn not to ask direct questions not to give our opinion or our judgment on them and let her speak and once with that flow starts once that connection is established that doctor-patient relationship emotionally is established she will actually tell you the whole history legal frameworks to promote enforce and monitor equality and non-discrimination on the basis of sex are an important sdg 5 indicator but putting laws in place does not automatically make them effective there are existing protections for women in the workplace or for individuals in the workplace in relation to harassment but we know from our call for evidence that they are not actually addressing the problem the recommendations that we developed included government implementing a mandatory duty for employers to take preventative steps to address harassment in the workplace so what we would like to see is government implement a much stronger legislative duty it has taken decades of struggle by the women's rights movement to persuade the international community to view violence against women as a human rights concern and a sustainable development priority not a private matter governments have obligations to respect protect and fulfill the right to a life free of violence and to provide for sanctions when they fail when seeking accountability the priority consideration must always be the safety and well-being of survivors respecting their wishes and autonomy and supporting them to make informed choices about the type of justice they want context is vitally important there are many strategies to hold perpetrators accountable including strategic litigation and public campaigns when the teachers impregnate the girls that means the system has failed and okay what they do is they blacklist the teachers and they are always removed from the payroll but we think that is not enough the case that was quite interesting is where one of the judges she did find a ruling against the teacher service commission the commission that is responsible for hiring teachers asking them that they must take responsibility and they were ordered to pay compensation to the girls who had gotten pregnant while in school the justice police issue came about a few years back when a young girl was raped and the punishment for her being ripped was that harappa she was gang-ripped and therapists were told to slash grass feminist organizations and young women organizations came back to the police and the police commissioner to ask and request that the people who are found to be perpetrators should be punished according to our constitution and according to the laws of the land and those are very big campaigns to get better justice so consequently they were jailed but also it was a sign that the system the police system had to be checked in terms of when someone reports a case any case of violence what happens and how is it followed through the maria pedra is another example of litigation that became a political mobilizer so this was a case from the inter-american commission that really galvanized a change in public policy a huge change because it was a case that addressed gender-based violence intimate partner violence it called on responsibility of brazil also for not having prevented this kind of violence the reality of a case that says you have the right to not be bruised you have the right to be free of physical psychological violence it's powerful it can change women's lives investing in autonomous women's movements has been one of the most important drivers of changes in laws and policies to address violence against women over the past 40 years according to data from over 70 countries women organizing to advance women's status define the very concept of violence against women raised awareness of the issue and put it on national and global policy agendas often we thought that it takes generations or centuries to change working intensely with the communities we can actually see change coming violence against women and girls is a violation of fundamental human rights to life and to physical and psychological integrity not to be tortured or treated in an inhuman and degrading way to respect for private and family life and the right not to be discriminated against this understanding is more than theoretical human rights-based tactics can offer a practical route to addressing systemic challenges across all the circumstances where violence against women and girls occurs including but not limited to at the hands of their partners at school and in the workplace by using evidence-informed prevention strategies addressing power relations and social norms community mobilizing and dialogue supporting health systems and professionals putting in place strong legal frameworks accessing justice and ending impunity feminist organizing and mobilizing every individual can help to deliver the 2030 agenda for sustainable development building a world in which women and girls are free from all forms of violence and discrimination [Music] you Received: 26 November 2019 Revised: 10 January 2020 Accepted: 19 January 2020 DOI: 10.1111/obr.13005 PEDIATRICS/PHYSIOLOGY Adipokines: A gear shift in puberty DesirĂ©e Nieuwenhuis | NatĂ lia Pujol-Gualdo Amanda J. Kiliaan Department of Anatomy, Radboud university medical center, Donders Institute for Brain, Cognition and Behaviour, Preclinical Imaging Center PRIME, Nijmegen, The Netherlands Correspondence Amanda J. Kiliaan, PhD, Associate Professor, Department of Anatomy, Donders Institute for Brain, Cognition, and Behaviour, Preclinical Imaging Center PRIME, Radboud university medical center, 6500 HB Nijmegen, Geert Grooteplein 21N 6525 EZ Nijmegen, The Netherlands. Email: amanda.kiliaan@radboudumc.nl Funding information Europees Fonds voor Regionale Ontwikkeling (EFRO), Grant/Award Number: BriteN 2016 1 | INTRODUCTION The prevalence of obesity in adolescents and children is increasing in | Ilse A.C. Arnoldussen | Summary In this review, we discuss the role of adipokines in the onset of puberty in children with obesity during adrenarche and gonadarche and provide a clear and detailed overview of the biological processes of two major players, leptin and adiponectin. Adipokines, especially leptin and adiponectin, seem to induce an early onset of puberty in girls and boys with obesity by affecting the hypothalamic-pituitary- gonadal (HPG) axis. Moreover, adipokines and their receptors are expressed in the gonads, suggesting a role in sexual maturation and reproduction. All in all, adipokines may be a clue in understanding mechanisms underlying the onset of puberty in child- hood obesity and puberty onset variability. KEYWORDS adipokines, obesity, puberty 1,2 the age of 5 years were overweight or were with obesity in 2016, and 3 Obesity is defined by an excessive accumulation of white adipose tissue (WAT), and it is often indicated by a body mass index (BMI) 4 above 30. Two main types of adipose tissue were described: WAT and brown adipose tissue (BAT), which differ in morphology and func- 5-7 Ilse A.C. Arnoldussen and Amanda J. Kiliaan contributed equally to this work. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. © 2020 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity Federation Obesity Reviews. 2020;21:e13005. wileyonlinelibrary.com/journal/obr 1 of 10 https://doi.org/10.1111/obr.13005 alarming rates. Specifically, worldwide, 41 million children below this number is expected to increase to 70 million in 2025. obesity is associated with various severe health complications, includ- ing increased risk of diabetes mellitus type 2, hypertension, heart dis- eases, and disturbances in sex hormone levels. 5,6 and mitochondria and plays a role in thermogenesis. Adipocytes in tion. BAT consists of adipocytes containing multiple lipid droplets WAT contain only a few mitochondria and a single lipid droplet. Adipose tissue has several functions including the storage of energy, thermogenesis, and the production and secretion of adipokines Generally, two physiological processes, adrenarche and gonadarche, 11,24 Childhood 5,7,8 a key role in puberty onset. Puberty is known as a period through which the body changes physically, being a physiological process resulting in the maturation of children, i.e. they develop sexual characteristics and obtain reproduc- 9,11 Adipokines are involved in a number of physiological processes including blood pressure, metabo- lism, glucose, and vascular homeostasis and may play amongst others 8-10 (hormones, cytokines, and peptides). tive functions. between obesity and puberty,2,12-23 the biological mechanisms under- lying obesity and puberty onset remain unclear. Hereafter, we review in detail the role of adipokines in the onset of puberty in childhood obesity. Although many studies have shown associations 2 | INITIATION OF PUBERTY PHYSIOLOGICAL PROCESSES IN THE interact to regulate the onset of puberty. During adrenarche, the adrenal cortex secretes steroid hormones (including 2 of 10 NIEUWENHUIS ET AL. androstenedione, dehydroepiandrosterone, dehydroepiandrosterone sulfate (DHEAS), androstenedione, and cortisol), insulin-like growth factor, and growth hormone, which contribute to the pubertal insights on new genetic loci (e.g. melanocortin-4 receptor, mitochon- drial carrier 2, and mitogen-activated protein kinase 13) and on sev- eral pathways that regulate the timing of puberty; however, it partly 34 9,24,25 Both adrenarche and gonadarche are involved in the development growth spurt, body odor, skin oiliness, and skeletal maturation. explains puberty timing variation. Thereby, defining the role of 25 adipokines is of importance in elucidating the variability in puberty as the expression of adipokines is sex-specific and is altered with body composition, adiposity, and during growth spurts. Moreover, adipokines and their receptors are expressed in gonads and several brain regions suggesting involvement in the onset of puberty and sex- ual maturation. Lastly, adipokines interfere in processes regulating timing and duration of puberty, for instance in the HPA and HPG axes which are both key players during adrenarche and gonadarche. Involvement of adipokines in the onset of puberty and specifically in individuals with obesity will be further reviewed in the next 2,24 3 | Puberty onset in girls is assessed using different markers, such as thelarche (breast development), menarche (the start of of pubic hair. pituitary-gonadal (HPG) axis is activated,2,26 and several hormones have been identified to participate in the activation of the HPG axis During gonadarche (Figure 1), the hypothalamic- 2,27 Kisspeptin, neurokinin B, and dynorphin are released by specialized including kisspeptin, neurokinin B, dynorphin, leptin, and ghrelin. 28 key regulator of the pulsatile secretion of gonadotropin releasing neurons, the KNDy neurons in the hypothalamus. Kisspeptin is a 29,30 B stimulates, and dynorphin inhibits the release of kisspeptin, which hormone (GnRH) from the hypothalamus. In addition, neurokinin implies that both coordinate a pulsatile release of kisspeptin. 31 Sub- sections. sequently, the activated HPG axis induces the pituitary gland to secrete luteinising hormone (LH) and follicle stimulating hormone (FSH). As a result, gametogenesis occurs, and the gonads will release sex hormones. Consequently, secondary sex characteristics develop including breast development in girls and an increased testicular vol- 2,26,32 is possibly due to differences in levels of body fat, hypothalamic-pitui- THE ONSET OF PUBERTY IN GIRLS ume in boys. The age at puberty onset varies greatly among individuals, which 19 35 menstruation), and pubic hair development. 33 genome-wide association studies have provided important new tary-adrenal (HPA) axis activity, and genetic background. Recent The average age of However, this age differs between cultures and ethnicities, and since 1980, age at menarche is girls at start of menarche is 12.4 years. 36 significantly decreasing. 36-39 F I G U R E 1 Hormonal regulation in the initiation of puberty in boys and girls. The secretion of kisspeptin, neurokinin B, and dynorphin from KNDy neurons initiate the release of gonadotropin releasing hormone (GnRH) from the hypothalamus. This activates the pituitary gland to produce and secrete luteinising hormone (LH) and follicle stimulating hormone (FSH), which in turn stimulate the gonads to produce estrogen and testosterone in girls and boys, respectively 1467789x, 2020, 6, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/obr.13005, Wiley Online Library on [10/03/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License NIEUWENHUIS ET AL. 3 of 10 T A B L E 1 Summary of included studies Authors Year Country Study Design Primary Outcome Sex Sample Size (n) Age (y) Data Collection Lian et al21 2019 China Cross-sectional Puberty starts earlier in Chinese Han girls with obesity compared with Chinese Han girls with normal weight. Girls 2996 9-19 2012 and 2013 Biro et al12 Lazzeri et al20 2018 USA 2018 Italy Longitudinal Cross-sectional Body mass index had a greater effect on age at menarche than did race and ethnicity. Girls 946 6-16 2004-2014 Li et al23 2018 China Longitudinal For both, boys and girls, a higher BMI (ie, overweight and obese) is associated with earlier onset of puberty Girls Girls Boys Girls 542 Deng et al22 Flom et al15 2017 China Cross-sectional Increased BMI is associated with early timing spermarche and menarche. Boys Girls Girls 1278258 9-15 2005-2012 He et al24 Holmgren et al17 2017 China 2017 Sweden Cross-sectional Longitudinal Onset of puberty is not related to obesity in boys. Boys Boys Girls Girls 782 7-17 972 929 5839 Kelly et al19 2017 UK 2016 Brazil 2016 USA Longitudinal prospective cohort Higher BMI in girls is associated with the onset of menstruation at an earlier age. 11 10-18 11-17 Barcellos Gemelli et al25 Cross-sectional Longitudinal Excess weight is associated with early age of menarche. Girls 727 2014 2003-2009 Glass et al16 Lee et al26 In girls, but not in boys, greater adiposity is associated with the earlier onset of puberty. Boys Girls 135 Cabrera et al27 Leonibus et al14 2014 USA 2013 Italy Cross-sectional Longitudinal Thelarche occurred earlier than recently reported, while age of menarche remained unchanged. Girls 610 3-17.9 2007 2005-2012 Currie et al13 2012 Europe, USA, Canada Cross-sectional Overweight/obesity during childhood predicts the early onset of puberty in girls. Girls 20410 11, 13, 15 2005-2006 2017 USA Prospective birth cohort Overweight/obese status at the age of 7 ye was associated with increased risk of early menarche 788 From birth to menarche occurred Pregnancies 1959-1966 2016 USA Cross-sectional Boys with overweight enter puberty earlier compared with boys with normal weight or obesity, while puberty starts later in boys with obesity compared with boys with normal weight and overweight. Boys 3872 6-16 2005-2010 Overweight during childhood shows a relation with the early onset of puberty in girls. 6535 4259 695 11 15 5.8-12.2 2009/2010 2013/2014 2014-2017 Higher BMI during childhood is associated with early puberty. 2008 and 2009 2000-2002 Obesity during childhood is related to the earlier onset of puberty. Boys Girls 84 123 71 (Continues) 1467789x, 2020, 6, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/obr.13005, Wiley Online Library on [10/03/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License 4 of 10 NIEUWENHUIS ET AL. 3.1 | Fat storage For the initiation of puberty, the timing of stimulation and/or inhibi- tion of different hormones is important, and additionally, a certain amount and distribution of body fat is needed in order to start menar- che, which emphasizes the importance of body fat. From an evolution- ary point of view, body fat increases in mammalian females during puberty onset, and it highlights the need to guarantee a healthy preg- 40 women with anorexia nervosa. particularly body fat localized predominantly on the gluteofemoral fat depots, is profoundly associated with start of menarche, more than nancy, offspring, and maternal survival. fat, sex-hormones, and neuroendocrine alterations can evolve in men- strual dysfunction, for instance, in women with severe obesity or in 41-43 44-46 to gluteofemoral fat depots suggesting that leptin may convey infor- amount of total body fat. mation on body fat distribution to the hypothalamus during puberty. An improper level of body Importantly, body fat distribution, Blood leptin levels are strongly related 45 3.2 | HPG axis The HPG axis is activated by the release of kisspeptin resulting in the release of GnRH from the hypothalamus, and LH and FSH from the pituitary gland. In girls, FSH is involved in the development of the folli- cles in the ovaries, and it promotes the secretion of estrogen. LH stim- ulates the production of androgen hormones and induces ovulation 48 9,47 the release of kisspeptin and neurokinin B, and kisspeptin thereby (Figure 1). The secretion of estrogen has an inhibitory effect on inhibits the GnRH release from the hypothalamus. pattern of GnRH is important for the regulation of the menstrual cycle. This roughly 28-day-cycle comprises several phases, including the follicular phase and luteal phase. During the follicular phase, increasing levels of FSH stimulate the maturation of follicles and the production of estrogen from the ovaries. This in turn inhibits the release of FSH from the pituitary gland. A high level of estrogen will induce the production of LH by the pituitary gland, resulting in ovula- tion. The matured follicle secretes progesterone thereby inhibiting the release of GnRH. When the corpus luteum is demolished, there is less 48 3.3 | Adipokines According to results from studies reported in Table 1, girls with obe- sity enter puberty earlier compared with girls with normal higher leptin concentrations inhibit the intake of food and increases inhibition of GnRH. As a consequence, the cycle will start again. whole process, starting from the activated HPG axis, results in the development of the secondary sex characteristics in girls including 9,47 thelarche and menarche. 13,14,16-23,49-51 weight. these girls might be found in the secretion of adipokines. For instance, leptin is positively associated with the amount of body fat. Generally, energy expenditure. 9,52-54 An explanation for the early onset of puberty in The expression This TABLE 1 (Continued) Authors Year Country Study Design Primary Outcome Sample Sex Size (n) Age (y) Data Collection Herman-Giddens et al28 2012 USA Cross-sectional Observed mean ages of beginning genital and pubic hair growth and early testicular volumes were earlier than in past studies, depending on the characteristic and race/ethnicity. Boys 4131 6-16 2005-2010 Sorensen et al29 Aksglaede et al30 2010 2009 Denmark Denmark Cross-sectional/longitudinal Longitudinal Puberty onset at earlier ages was associated with an increased BMI in boys. Boys 1528 5.8-19.9 1991-1993/2006-2008 1930-1969 Juul et al31 Ribeiro et al32 2007 2006 Denmark Portugal Retrospective cohort Cross-sectional Higher BMI is associated with early voice break. 11-15 10-15 1990-1999 Kaplowitz et al18 Abbreviation: BMI, body mass USA Cross-sectional The early onset of puberty in Caucasian girls is likely related to an increased BMI. 5-12 1992-1993 2001 index. The higher BMI in boys and girls at 7 y of age, the earlier they enter puberty. Boys 21 612 Girls 135 223 Boys 463 Boys 382 Girls 437 Girls 10 750 Early sexual maturation in boys and girls is associated with overweight. 1467789x, 2020, 6, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/obr.13005, Wiley Online Library on [10/03/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License NIEUWENHUIS ET AL. 5 of 10 Leptin may possibly play a role in adrenarche as its plasma level increases with higher levels of body fat and as it can modulate both girls. 33 ing adrenarche. In coherence, in children with obesity, the androgen These findings suggested that lower reproductive status was associated with higher total adiponectin concentrations and that a higher reproductive status was related to higher HMW adiponectin the HPA and HPG axes. These axes are functionally integrated dur- DHEAS was positively associated with leptin levels. Nevertheless, concentrations in girls. In addition, individuals with obesity often another study showed that enhanced adrenal androgen secretion in girls with premature adrenarche was not explained by leptin or BMI 55 ated with androgen levels in girls ; however, it was not related to levels. and IL-6. TNF-α alters, and IL-6 inhibits the expression of 56 8 In addition, the adipokine adiponectin was negatively associ- 57 differences of adiponectin seem to develop during the progression of 56 adiponectin (Figure 2). Thereby, a low level of total adiponectin and/or high levels of inflammatory cytokines in individuals with obe- sity can promote the onset of puberty. Many more adipokines are secreted by WAT including omentin, 52,65-67 9,36,62,68 adrenarche in girls with Prader-Willi syndrome. Interestingly, sex puberty. adrenarche; however, both are not required factors. Thus, leptin and adiponectin might be able to influence In gonadarche, leptin can stimulate the secretion of kisspeptin, and subsequently activation of the HPG axis, which eventually increases the expression of estrogen and androstenedione in the ova- 58 2,60 65-67 The expression of these ries (Figure 2). Ob gene in WAT, resulting in the synthesis and secretion of leptin. Thus, high levels of leptin promote onset of puberty in girls via secre- tion of kisspeptin, and estrogen stimulates leptin secretion addition- ally. Moreover, adiponectin can affect the HPG axis due to the expression of adiponectin receptors in the hypothalamus, pituitary In return, estrogen stimulates the expression of the 59 gland, and gonads. onset as it inhibits the secretion of kisspeptin and GnRH in the hypo- thalamus and the release of GH and LH in the pituitary gland, and 2,60-62 52,60 63 girls with central precocious puberty (CPP). Moreover, total adiponectin had negative correlations with progression of puberty in girls (defined by Tanner stages), whereas HMW adiponectin had FIGURE 2 Adipokinesaffectingthe initiation of puberty in girls. Leptin stimulates the release of kisspeptin in KNDy neurons, which activates the hypothalamus to produce gonadotropin releasing hormone (GnRH). In response to the release of GnRH, the pituitary gland secretes follicle stimulating hormone (FSH) and luteinising hormone (LH), which stimulates the ovaries to release estrogen resulting in the formation of secondary sex characteristics in girls. Estrogen stimulates the production of leptin. Adiponectin inhibits GnRH release resulting in reduced levels of GnRH and thereby a delayed onset of puberty. TNF- α and IL-6 inhibit the production of adiponectin and therefore stimulate the onset of puberty In detail, adiponectin is a regulator of puberty thereby inhibiting the onset of puberty (Figure 2). with obesity often have low levels of adiponectin. et al. showed that total adiponectin was significantly lower, whereas high molecular weight (HMW) adiponectin was significantly higher in ment. 55 63 develop a chronic low-grade inflammatory state, which can be indi- cated by a high level of circulating inflammatory cytokines like TNF-α 64 Individuals Sitticharoon positive associations with LH levels and the progression of puberty in 63 visfatin, resistin, and chemerin. and visfatin are expressed in the ovaries. adipokines in the ovaries suggests a role within the reproductive sys- tem; however, the exact biological processes have to be examined. Thus, specifically leptin, adiponectin, and inflammatory cytokines pro- duced by WAT could be permissive key players during an early onset of puberty in girls with obesity. As an exception, HMW adiponectin seems to have a stimulatory effect on peripheral repro- ductive function as HMW is not able to cross the blood brain 63 barrier. 4 | Markers that are used to assess puberty onset in boys are THE ONSET OF PUBERTY IN BOYS spermarche, voice break, testicular volume, and pubic hair develop- 35 spermarche develop in the early stages of puberty onset, voice In women, omentin, chemerin, While pubic hair development, larger testicular volume, and 69 testicular volume increases, which occurs at an average age of break usually appears in later stages of puberty. Generally, first 1467789x, 2020, 6, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/obr.13005, Wiley Online Library on [10/03/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License 6 of 10 NIEUWENHUIS ET AL. 11.9 years, followed by the development of pubic hair at 12.2 years of average, and lastly, boys experience spermarche around an aver- 55 related with leptin levels. Thereby, leptin plausibly has a minor impact in adrenarche in boys. Since leptin receptors are found in the hypothalamus, pituitary gland, and testes, they might be involved in the onset of puberty by affecting the HPG axis during gonadarche. Leptin stimulates the release of kisspeptin and GnRH, and as a consequence, it accelerates the onset of puberty (Table 1, Figure 3). In contrast, adiponectin inhibits the secretion of GnRH, GH, LH, and FSH therewith delaying the onset of puberty. However, adiponectin levels are generally lower in men compared with women and even lower in men with obe- age age of 13.4 years. 70 4.1 | Fat storage Many aspects of the reproductive physiology are energetically demanding,71 and therefore, an adequate energy level is necessary. In boys, a dynamic change in body composition occurs around the age of 10 to 13 years, in which they gain approximately 40% of sity. culating inflammatory cytokines. levels can stimulate the HPG axis and therewith an early onset of puberty in boys. Nevertheless, leptin can inhibit the production of tes- 72 mostly consisting of lean mass, which causes exhaustion of most of fat. Subsequently, a growth spurt follows in which they gain tissue 72 in boys, an adequate amount of body fat is important in the onset of their body fat. These alterations in amount of body fat indicate that 4.2 | Puberty in boys is initiated by the release of kisspeptin. As mentioned before, this activates the HPG axis, resulting in the release of GnRH from the hypothalamus, and consequently the release of LH and FSH 9,74 puberty. tosterone from the testes, to estrogen (Figure 3). of the development of secondary sex characteristics in boys. Additionally, leptin can affect fertility in men as it can modulate the nutritional support of spermatogenesis, and moreover, dysfunction of spermatogenesis is associated with an increased leptin level and 73 58 2,60-62 HPG axis from the pituitary gland (Figure 1). and LH stimulates the secretion of testosterone from the testes, which inhibits the release of kisspeptin from the KNDy neurons and 9,48 in men, the release of kisspeptin is more consistent, causing a con- 29,48 subsequently GnRH from the hypothalamus. receptors expressed on KNDy neurons. In humans, KNDy neurons Contrarily to women, LH-induced testosterone levels lead to the stant release of LH. development of secondary sex characteristics in boys. differences between sexes in kisspeptin release are related to a sex- specific and sex steroid-dependent kisspeptin system as estrogen and progesterone modulate kisspeptin activity through the sex-steroid 48 in the infundibular nucleus are involved in negative and positive sex- 48 tal exposure to sex steroids and result in sex-specific differences in steroid feedbacks. kisspeptin release. These sexual dimorphisms are induced by perina- 75,76 4.3 | Adipokines The association between obesity and puberty onset in boys is rather controversial compared with findings in girls. Most studies reported an early onset of puberty in boys associated with increased ate adipose tissue from actual breast tissue. stages are more difficult to assess than female stages as boys lack a more determined marker such as menarche. Thirdly, puberty onset can be indicated by the activation of the HPG axis, and the presence of these secondary sex characteristics is the result of hormonal 2 14,17,22,23,50,51,77,78 BMI, 20,49 all while others reported no associations at Current markers used 79 16,80 or a delayed onset of puberty (Table 1). The presence of excessive adipose tissue can be involved in puberty onset in boys as the secretion of adipokines can modulate both adrenarche and gonadarche. Leptin can affect adrenarche by modulating both the HPG and HPA axes,33 and moreover, androgen levels were positively 55 nal androgen secretion in boys with premature adrenarche was not associated with plasma leptin levels. Nevertheless, enhanced adre- 9 In more detail, 61,62 adiponectin, and individuals with obesity often have high levels of cir- Moreover, inflammatory cytokines, TNF-α, and IL-6, inhibit expression of the leptin receptor in the testis. FSH induces spermatogenesis, too. function and role still have to be examined. 64 High leptin and low adiponectin and fat tissue can convert testosterone Both processes might result in the delay 29,61,79 81,82 In men, other adipokines like chemerin are found in the gonads 65 Thus, particularly high leptin and low adiponectin levels stimulate the HPG axis and thereby accelerate the onset of puberty in boys. Additionally, leptin can dysregulate the development of secondary sex characteristics and spermatogenesis by affecting testosterone levels and nutritional sup- port of spermatogenesis. 5 | LIMITATIONS AND FUTURE RESEARCH DIRECTIONS Even though multiple epidemiological studies have shown the link between puberty onset and obesity, there are some important limita- tions. Firstly, determining both the onset and stage of puberty is rather difficult. For instance, assessing the stage of breast develop- ment in girls with obesity is complicated as clinicians should differenti- 2 changes in response to the activated HPG axis. to determine the onset of puberty refer to secondary sex characteris- tics, such as testicular volume in boys and breast development in girls. A more accurate measurement of puberty onset would be to combine secondary sex characteristics with plasma or serum hormone level measurements such as LH, FSH, adipokines, e.g. leptin. Thereby, differences in puberty measurements could explain variations in the age of puberty onset between boys and girls within different Thereby, resistin is expressed in the testes of rats, but its exact 83 Secondly, male pubertal 1467789x, 2020, 6, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/obr.13005, Wiley Online Library on [10/03/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License NIEUWENHUIS ET AL. 7 of 10 FIGURE 3 Adipokines affecting the initiation of puberty in boys. Leptin activates kisspeptin secretion in KNDy neurons, this activates the production of gonadotropin releasing hormone (GnRH) from the hypothalamus. GnRH stimulates the pituitary gland to secrete follicle stimulating hormone (FSH) and luteinising hormone (LH), activating the production of testosterone from the testes allowing the development of secondary sex characteristics. Leptin also inhibits the production of testosterone, which may cause a delayed onset of puberty. Adiponectin inhibits GnRH release. Low levels of adiponectin, as a result of TNF-α and IL-6 expression, lead to a reduced inhibition of GnRH. In response to GnRH release, the pituitary gland will secrete FSH and LH, and the testes will produce testosterone resulting in the development of secondary sex characteristics in boys countries, and In addition, the inclusion of a of puberty. ferent time points is complicated, as subjects examined several decades ago presented pronounced differences concerning lifestyle patterns such as nutrition and exercise habits. Lastly, obesity or over- weight is often determined by BMI, a classification based on weight and height measurements. Additionally, it is important that all studies studies or across continents, ethnicities proper age range (8-16 years) is important when assessing the onset (Figure 4). 12-15,17,20-23,49,77-79,84,85 30,47 Furthermore, comparison between studies from dif- 86 Specifically in children, BMI is often dependent on age and growth use the same anthropometric standards and sex-specific cut-offs. 13,14,16-23,49-51,77-80 fat and would represent a more accurate measurement in its regard. Based on this review, several suggestions can be made for further research. Firstly, the roles of adipokines like resistin, chemerin, visfatin, and omentin in puberty onset, fertility, and sexual maturation should be examined in detail. Secondly, future research examining the onset of puberty should combine indicators of puberty onset (e.g. breast development or testicular volume) with plasma or serum hor- mone measurements such as LH, FSH, sex-steroids, adipokines (e.g. spurts. ment in case of growth spurts. distribution of body fat should be taken into account in determining puberty and obesity in children. For instance, the body adiposity index (BAI), which was introduced in 2011 by Bergman et al.,87 uses hip cir- cumference and height in order to estimate the percentage of body 87 Thereby, BMI is a less accurate measure- F I G U R E 4 87,88 Therefore, both percentage and Average age of puberty onset in Europe, China, and the United States according to several studies from Table 1. Age of puberty onset ranges from 8.47 to 13.33 years in girls and from 8.63 leptin), and body fat distribution (e.g. BAI,87 waist-hip ratio's and/or dual-energy X-ray absorptiometry (DXA)2). Additionally, defining con- sistent and general measurements of puberty in both boys and girls, combined with a proper age range (8-16 years), would facilitate the comparisons between different studies and their results. 12-15, 17, 20-23, 25-29, 31 to 13.7 years in boys. included if average age of markers used to assess puberty was not reported. Pink: girls. Blue: boys Studies (Table 1) were not 39, 56 1467789x, 2020, 6, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/obr.13005, Wiley Online Library on [10/03/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License 8 of 10 NIEUWENHUIS ET AL. 6 | CONCLUSION In conclusion, epidemiological data regarding obesity and puberty onset in girls show similar outcomes as adiposity results in the early onset of puberty in girls. The majority of the studies examining boys with obesity indicate an early onset of puberty, while not all reported an earlier onset of puberty. In detail, high leptin, TNF-α, and IL-6 levels combined with low adiponectin levels stimulate the activation of the HPG axis in girls and boys with obesity, and 5, 45, 50, 51 REFERENCES 1. Kumar S, Kelly AS. Review of childhood obesity: from epidemiology, etiology, and comorbidities to clinical assessment and treatment. May- o Clin Proc. 2017;92(2):251-265. 2. Reinehr T, Roth CL. Is there a causal relationship between obesity and puberty? The Lancet Child & adolescent health. 2019;3(1):44-54. 3. WorldHealthOrganization. Facts and figures on childhood obesity. 2017. 4. Guglielmi V, Sbraccia P. Obesity phenotypes: depot-differences in adipose tissue and their clinical implications. Eat Weight Disord. 2018; 23(1):3-14. 5. Gomez-Hernandez A, Beneit N, Diaz-Castroverde S. Escribano O. Dif- ferential role of adipose tissues in obesity and related metabolic and vas- cular complications. 2016;2016:1-15, 1216783. 6. Zwick RK, Guerrero-Juarez CF, Horsley V, Plikus MV. Anatomical, physiological, and functional diversity of adipose tissue. Cell Metab. 2018;27(1):68-83. 7. Gulyaeva O, Dempersmier J, Sul HS. Genetic and epigenetic control of adipose development. Biochimica et Biophysica Acta (BBA)â Molecular and Cell Biology of Lipids. 2019;1864:3-12. 8. Khan M, Joseph F. Adipose tissue and adipokines: the association with and application of adipokines in obesity. Forensic Sci. 2014;2014: 711-724, 328592. 9. Alotaibi MF. Physiology of puberty in boys and girls and pathological disorders affecting its onset. J Adolesc. 2019;71:63-71. 10. Cousminer DL, Stergiakouli E, Berry DJ, et al. Genome-wide associa- tion study of sexual maturation in males and females highlights a role for body mass and menarche loci in male puberty. Hum Mol Genet. 2014;23(16):4452-4464. 11. Ahmed ML, Ong KK, Dunger DB. Childhood obesity and the timing of puberty. Trends in endocrinology and metabolism: TEM. 2009;20(5): 237-242. 12. Biro FM, Pajak A, Wolff MS, et al. Age of menarche in a longitudinal US cohort. J Pediatr Adolesc Gynecol. 2018;31(4):339-345. 13. Currie C, Ahluwalia N, Godeau E, Nic Gabhainn S, Due P, Currie DB. Is obesity at individual and national level associated with lower age at menarche? Evidence from 34 countries in the Health Behaviour in School-aged Children Study. The Journal of adolescent health: official publication of the Society for Adolescent Medicine. 2012;50(6): 621-626. 14. De Leonibus C, Marcovecchio ML, Chiavaroli V, de Giorgis T, Chiarelli F, Mohn A. Timing of puberty and physical growth in obese children: a longitudinal study in boys and girls. Pediatr Obes. 2014; 9(4):292-299. 15. Flom JD, Cohn BA, Tehranifar P, et al. Earlier age at menarche in girls with rapid early life growth: cohort and within sibling analyses. Ann Epidemiol. 2017;27(3):187-93.e2. 16. Glass NA, Torner JC, Letuchy EM, et al. The relationship between greater prepubertal adiposity, subsequent age of maturation, and bone strength during adolescence. Journal of bone and mineral research: the official journal of the American Society for Bone and Min- eral Research. 2016;31(7):1455-1465. 17. Holmgren A, Niklasson A, Nierop AF, et al. Pubertal height gain is inversely related to peak BMI in childhood. Pediatr Res. 2017;81(3): 448-454. 18. Kaplowitz PB, Slora EJ, Wasserman RC, Pedlow SE, Herman- Giddens ME. Earlier onset of puberty in girls: relation to increased body mass index and race. Pediatrics. 2001;108(2):347-353. 19. Kelly Y, Zilanawala A, Sacker A, Hiatt R, Viner R. Early puberty in 11-year-old girls: Millennium Cohort Study findings. Arch Dis Child. 2017;102(3):232-237. 20. Lazzeri G, Tosti C, Pammolli A, et al. Overweight and lower age at menarche: evidence from the Italian HBSC cross-sectional survey. BMC Womens Health. 2018;18(1):168-174. thereby an early onset of obesity. leptin can inhibit the production of testosterone in boys and subse- quently inhibit the development of secondary sex characteristics affecting spermatogenesis. for other adipokines, like resistin and omentin, are present in the testes and ovaries suggesting a role in puberty or reproduction; 58, 71 however, their plausible function is still unknown. that adipokines may be key regulators in an early onset of puberty in both girls and boys with obesity, specifically by affecting the HPG axis during gonadarche. Future research should focus on assessing puberty onset by measuring consistent puberty markers and determine the percentage of body fat and its distribution and adipokines and hormone serum levels particularly involved in the HPG axis. CONFLICTS OF INTEREST The authors declare no conflict of interest. FUNDING INFORMATION This research was funded by Europees Fonds voor Regionale Ontwikkeling (EFRO), project BriteN 2016. ORCID Ilse A.C. Arnoldussen Amanda J. Kiliaan https://orcid.org/0000-0002-7395-5284 https://orcid.org/0000-0002-2158-6210 13, 14, 16-26, 29-32 Furthermore, several receptors Nevertheless, We conclude Search strategy We searched PubMed for articles published before Novem- ber 15th, 2019 using relevant keywords, including âonset of puberty and adiposity/obesityâ, âonset of pubertyâ, âchildren with obesityâ, âadipose tissueâ, âchildhood obesityâ, âadiposityâ, âobesityâ, âadipokine(s)â, âHPG axisâ, âadipokines ovary/ova- riesâ, or âadipokines testesâ, either alone or in combination. Selection criteria used were English language, longitudinal or cross-sectional studies assessing the onset of puberty, including menarche, thelarche, spermarche, or voice break, combined with high BMI or obesity/adiposity, and articles assessing or reviewing adipokines and its effects on the reproductive system. 1467789x, 2020, 6, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/obr.13005, Wiley Online Library on [10/03/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License NIEUWENHUIS ET AL. 9 of 10 21. Lian Q, Mao Y, Luo S, et al. Puberty timing associated with obesity and central obesity in Chinese Han girls. BMC Pediatr. 2019; 19(1):1-7. 22. Deng Y, Liang J, Zong Y, et al. Timing of spermarche and menarche among urban students in Guangzhou, China: trends from 2005 to 2012 and association with Obesity. Sci Rep. 2018;8(1):263-270. 23. Li W, Liu Q. Association of prepubertal obesity with pubertal devel- opment in Chinese girls and boys: a longitudinal study. 2018;30: e23195. 24. Mendle J, Beltz AM, Carter R, Dorn LD. Understanding puberty and its measurement: ideas for research in a new generation. Journal of research on adolescence: the official journal of the Society for Research on Adolescence. 2019;29(1):82-95. 25. Pagani S, Meazza C, Gertosio C, Bozzola E, Bozzola M. Growth hor- mone receptor gene expression in puberty. Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme. 2015;47:581-584. 26. Abreu AP, Kaiser UB. Pubertal development and regulation. Lancet Diabetes Endocrinol. 2016;4(3):254-264. 27. Aguirre RS, Eugster EA. Central precocious puberty: from genetics to treatment. Best Pract Res Clin Endocrinol Metab. 2018;32(4): 343-354. 28. Sultan C, Gaspari L, Maimoun L, Kalfa N, Paris F. Disorders of puberty. Best Pract Res Clin Obstet Gynaecol. 2018;48:62-89. 29. Skorupskaite K, George JT, Anderson RA. The kisspeptin-GnRH path- way in human reproductive health and disease. Hum Reprod Update. 2014;20(4):485-500. 30. Dahl SK, Amstalden M, Coolen L, Fitzgerald M, Lehman M. Dynorphin immunoreactive fibers contact GnRH neurons in the human hypothal- amus. Reprod Sci. 2009;16(8):781-787. 31. Navarro VM, Gottsch ML, Chavkin C, Okamura H, Clifton DK, Steiner RA. Regulation of gonadotropin-releasing hormone secretion by kisspeptin/dynorphin/neurokinin B neurons in the arcuate nucleus of the mouse. J Neurosci. 2009;29(38):11859-11866. 32. Zhai L, Liu J, Zhao J, et al. Association of obesity with onset of puberty and sex hormones in chinese girls: a 4-year longitudinal study. PLoS ONE. 2015;10(8):1-12, e0134656. 33. Cizza G, Dorn LD, Lotsikas A, Sereika S, Rotenstein D, Chrousos GP. Circulating plasma leptin and IGF-1 levels in girls with premature adrenarche: potential implications of a preliminary study. Horm Metab Res. 2001;33(3):138-143. 34. Cousminer DL, WidĂ©n E, Palmert MR. The genetics of pubertal timing in the general population: recent advances and evidence for sex-spec- ificity. Curr Opin Endocrinol Diabetes Obes. 2016;23(1):57-65. 35. Marshall WA, Tanner JM. Variations in pattern of pubertal changes in girls. Arch Dis Child. 1969;44(235):291-303. 36. Lacroix AE, Whitten R. Physiology. Treasure Island (FL): Menarche. StatPearls. StatPearls Publishing; 2018. 37. McDowell MA, Brody DJ, Hughes JP. Has Age at Menarche Chan- ged? Results from the National Health and Nutrition Examination Sur- vey (NHANES) 1999â2004. J Adolesc Health. 2007;40(3):227-231. 38. de Muinich Keizer SM, Mul D. Trends in pubertal development in Europe. Hum Reprod Update. 2001;7(3):287-291. 39. Talma H, Schönbeck Y, van Dommelen P, Bakker B, van Buuren S, Hirasing RA. Trends in menarcheal age between 1955 and 2009 in the Netherlands. PLoS ONE. 2013;8:e60056-e60056. 40. Kaplan HS, Lancaster JB. An evolutionary and ecological analysis of human fertility, mating patterns, and parental investment. Off- spring: Human fertility behavior in biodemographic perspective. 2003;1: 170-223. 41. Mitan LA. Menstrual dysfunction in anorexia nervosa. J Pediatr Adolesc Gynecol. 2004;17(2):81-85. 42. Xu H, Li P-H, Barrow TM, et al. Obesity as an effect modifier of the association between menstrual abnormalities and hypertension in young adult women: Results from Project ELEFANT. PLoS ONE. 2018; 13(11):e0207929-e0207929. 43. Tauqeer Z, Gomez G, Stanford FC. Obesity in women: insights for the clinician. J Womens Health (Larchmt). 2018;27(4):444-457. 44. de Ridder CM, Thijssen JH, Bruning PF, Van den Brande JL, Zonderland ML, Erich WB. Body fat mass, body fat distribution, and pubertal development: a longitudinal study of physical and hormonal sexual maturation of girls. J Clin Endocrinol Metab. 1992;75(2): 442-446. 45. Lassek W, Gaulin S. Brief communication: menarche is related to fat distribution. Am J Phys Anthropol. 2007;133(4):1147-1151. 46. Loomba-Albrecht LA, Styne DM. Effect of puberty on body composi- tion. Curr Opin Endocrinol Diabetes Obes. 2009;16:10-15. 47. Simonneaux V, Bahougne T. A multi-oscillatory circadian system times female reproduction. Front Endocrinol. 2015;6:1-15. 48. Marques P, Skorupskaite K, George JT, Anderson RA. Physiology of GNRH and gonadotropin secretion. In: Feingold KR, Anawalt B, Boyce A, et al., eds. Endotext. Endotext.org: South Dartmouth (MA); 2000. 49. Barcellos Gemelli IF, Farias EDS, Souza OF. Age at menarche and its association with excess weight and body fat percentage in girls in the Southwestern Region of the Brazilian Amazon. J Pediatr Adolesc Gynecol. 2016;29(5):482-488. 50. Aksglaede L, Juul A, Olsen LW, Sorensen TI. Age at puberty and the emerging obesity epidemic. PLoS ONE. 2009;4:1-6, e8450. 51. Ribeiro J, Santos P, Duarte J, Mota J. Association between over- weight and early sexual maturation in Portuguese boys and girls. Ann Hum Biol. 2006;33(1):55-63. 52. Budak E, Fernandez Sanchez M, Bellver J, Cervero A, Simon C, Pellicer A. Interactions of the hormones leptin, ghrelin, adiponectin, resistin, and PYY3-36 with the reproductive system. Fertil Steril. 2006;85(6):1563-1581. 53. Castellano JM, Tena-Sempere M. Metabolic control of female puberty: potential therapeutic targets. Expert Opin Ther Targets. 2016; 20(10):1181-1193. 54. Venancio JC, Margatho LO, Rorato R, et al. Short-term high-fat diet increases leptin activation of CART neurons and advances puberty in female mice. Endocrinology. 2017;158(11):3929-3942. 55. l'Allemand D, Schmidt S, Rousson V, Brabant G, Gasser T, Gruters A. Associations between body mass, leptin, IGF-I and circulating adrenal androgens in children with obesity and premature adrenarche. Eur J Endocrinol. 2002;146(4):537-543. 56. Böttner A, Jr K, MĂŒller G, et al. Gender Differences of adiponectin levels develop during the progression of puberty and are related to serum androgen levels. J Clin Endocrinol Metabol. 2004;89(8):4053- 4061. 57. Unanue N, Bazaes R, Iñiguez G, Cortes F, Avila A, Mericq V. Adre- narche in Prader-Willi syndrome appears not related to insulin sensi- tivity and serum adiponectin. Horm Res. 2007;67(3):152-158. 58. Michalakis K, Mintziori G, Kaprara A, Tarlatzis BC, Goulis DG. The complex interaction between obesity, metabolic syndrome and repro- ductive axis: a narrative review. Metabolism: clinical and experimental. 2013;62(4):457-478. 59. Machinal-Quelin F, Dieudonne MN, Pecquery R, Leneveu MC, Giudicelli Y. Direct in vitro effects of androgens and estrogens on ob gene expression and leptin secretion in human adipose tissue. Endo- crine. 2002;18(2):179-184. 60. Dobrzyn K, Smolinska N, Kiezun M. Adiponectin: A new regulator of female reproductive system. Int J Endocrinol. 2018;2018:1-12, 7965071. 61. Martin LJ. Implications of adiponectin in linking metabolism to testic- ular function. Endocrine. 2014;46(1):16-28. 62. Mathew H, Castracane VD, Mantzoros C. Adipose tissue and repro- ductive health. Metabolism: clinical and experimental. 2018;86:18-32. 1467789x, 2020, 6, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/obr.13005, Wiley Online Library on [10/03/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License 10 of 10 NIEUWENHUIS ET AL. 63. Sitticharoon C, Sukharomana M, Likitmaskul S, Churintaraphan M, Maikaew P. Corrigendum to: Increased high molecular weight adiponectin, but decreased total adiponectin and kisspeptin, in central precocious puberty compared with aged-matched prepubertal girls. Reprod Fertil Dev. 2017;29:2506-2517. 64. Das UN. Is obesity an inflammatory condition? Nutrition. 2001; 17(11-12):953-966. 65. Comninos AN, Jayasena CN, Dhillo WS. The relationship between gut and adipose hormones, and reproduction. Hum Reprod Update. 2014; 20(2):153-174. 66. Singh A, Choubey M, Bora P, Krishna A. Adiponectin and chemerin: contrary adipokines in regulating reproduction and metabolic disor- ders. Reproductive sciences (Thousand Oaks, Calif). 2018;25:1462- 1473. 67. Tsatsanis C, Dermitzaki E, Avgoustinaki P, Malliaraki N, Mytaras V, Margioris AN. The impact of adipose tissue-derived factors on the hypothalamic-pituitary-gonadal (HPG) axis. Hormones (Athens). 2015; 14:549-562. 68. Kang MJ, Oh YJ, Shim YS, Baek JW, Yang S. Hwang IT. The usefulness of circulating levels of leptin, kisspeptin, and neurokinin B in obese girls with precocious puberty. 2018;34:627-630. 69. Lee J, Song J, Hootman JM, et al. Obesity and other modifiable fac- tors for physical inactivity measured by accelerometer in adults with knee osteoarthritis: data from the osteoarthritis initiative (OAI). Arthritis Care Res (Hoboken). 2012;53-61. 70. Bramswig J, Dubbers A. Disorders of pubertal development. Deutsches Arzteblatt international. 2009;106:295-303. quiz 04 71. Elias CF, Purohit D. Leptin signaling and circuits in puberty and fertil- ity. Cell Mol Life Sci. 2013;70(5):841-862. 72. Riumallo J, Durnin JV. Changes in body composition in adolescent boys. Eur J Clin Nutr. 1988;42(2):107-112. 73. Siervogel RM, Demerath EW, Schubert C, et al. Puberty and body composition. Horm Res. 2003;60(Suppl 1):36-45. 74. Zhang J. Gong M. Andrologia: Review of the role of leptin in the regu- lation of male reproductive function; 2018. 75. Kauffman AS, Gottsch ML, Roa J, et al. Sexual differentiation of Kiss1 gene expression in the brain of the rat. Endocrinology. 2007;148(4): 1774-1783. 76. Zeydabadi Nejad S, Ramezani Tehrani F, Zadeh-Vakili A. The role of kisspeptin in female reproduction. Int J Endocrinol Metab. 2017;15:1- 11, e44337. 77. Sorensen K, Aksglaede L, Petersen JH, Juul A. Recent changes in pubertal timing in healthy Danish boys: associations with body mass index. J Clin Endocrinol Metab. 2010;95(1):263-270. 78. Juul A, Magnusdottir S, Scheike T, Prytz S, Skakkebaek NE. Age at voice break in Danish boys: effects of pre-pubertal body mass index and secular trend. Int J Androl. 2007;30(6):537-542. 79. Lee JM, Wasserman R, Kaciroti N, et al. Timing of puberty in overweight versus obese boys. Pediatrics. 2016;137(2):137-146, e20150164. 80. He F, Guan P, Liu Q, Crabtree D, Peng L, Wang H. The relationship between obesity and body compositions with respect to the timing of puberty in Chongqing adolescents: a cross-sectional study. BMC Pub- lic Health. 2017;17:664-673. 81. Ishikawa T, Fujioka H, Ishimura T, Takenaka A, Fujisawa M. Expres- sion of leptin and leptin receptor in the testis of fertile and infertile patients. Andrologia. 2007;39(1):22-27. 82. Martins AD, Moreira AC, Sa R, et al. Leptin modulates human Sertoli cells acetate production and glycolytic profile: a novel mechanism of obesity-induced male infertility? Biochim Biophys Acta. 1852;2015: 1824-1832. 83. Morash BA, Willkinson D, Ur E, Wilkinson M. Resistin expression and regulation in mouse pituitary. FEBS Lett. 2002;526(1-3):26-30. 84. Cabrera SM, Bright GM, Frane JW, Blethen SL, Lee PA. Age of thelarche and menarche in contemporary US females: a cross- sectional analysis. Journal of pediatric endocrinology & metabolism: JPEM. 2014;27(1-2):47-51. 85. Herman-Giddens ME, Steffes J, Harris D, et al. Secondary sexual characteristics in boys: data from the Pediatric Research in Office Settings Network. Pediatrics. 2012;130(5):e1058-e1068. 86. WHO. Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organ Tech Rep Ser. 1995;854:1-452. 87. Akin I, Tolg R, Hochadel M, et al. No evidence of âobesity paradoxâ after treatment with drug-eluting stents in a routine clinical practice: results from the prospective multicenter German DES.DE (German Drug-Eluting Stent) Registry. JACC Cardiovasc Interv. 2012;5(2): 162-169. 88. Marcovecchio ML, Chiarelli F. Obesity and growth during childhood and puberty. World Rev Nutr Diet. 2013;106:135-141. How to cite this article: Nieuwenhuis D, Pujol-Gualdo N, Arnoldussen IAC, Kiliaan AJ. Adipokines: A gear shift in puberty. Obesity Reviews. 2020;21:e13005. https://doi.org/ 10.1111/obr.13005 1467789x, 2020, 6, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/obr.13005, Wiley Online Library on [10/03/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are goverCreate questions based on the following text Not long ago, I grabbed breakfast at a hotel in southern Spain. The only cereal available was a local version of frosted corn flakes, so I readied myself to enjoy a bowl of my childhood favorite. But my sweet indulgence wasn't what I'd expected: The cereal milk was heated â apparently standard in this part of Spain â and my poor frosted flakes immediately turned to mush. Not so grrrrrrreat. Soggy flakes or not, I find breakfast to be a fun part of my travel day, especially because the experience varies so much from one country's breakfast table to the next. The farther north you go in Europe, the heartier the breakfasts. The heaviest is the traditional British "fry." Also known as a "Plate of Cardiac Arrest," the fry is a fundamental part of the bed-and-breakfast experience, and is generally included in your room price. A standard fry comes with cereal or porridge, a fried egg, Canadian-style bacon or sausage (and sometimes mackerel or haggis), a grilled tomato, sautĂ©ed mushrooms, baked beans, and fried bread or toast. This protein-stuffed meal can tide me over until dinner. You'll quickly figure out which parts of the fry you like. Your host will likely ask you up front which breakfast items you actually like, rather than serve you the whole shebang and risk having to throw out uneaten food. The Scandinavian breakfasts buffet is the perennial favorite for the "most food on the table" award. It pays to take advantage of breakfast smorgasbords when you can. For about $20 (a cheap meal in these parts), you can dig into an all-you-can-eat extravaganza of fresh bread, cheeses, yogurt, cereal, boiled eggs, herring, cold cuts, and coffee or tea. In place of cereal and milk, Scandinavians like to pour thick yogurt over their granola. Throughout the Netherlands, Belgium, Germany, Austria, Switzerland, and most points east of there, expect a more modest buffet â but still plenty of options (rolls, bread, jam, cold cuts, cheeses, fruit, yogurt, and cereal). In these countries, there's a good chance of finding hard-boiled eggs, but scrambled or fried eggs are relatively rare. In Poland, track down jajecznica, the local wake-up call of eggs scrambled with kielbasa sausage, served with a side of potato pancakes. The breakfast of choice in Russia is oladi, pancakes perfectly fried to be crisp on the outside but soft in the middle, then topped with sour cream, honey, or berries. Germans have an endearing habit of greeting others in the breakfast room with a slow and dour "Morgen" ("Morning" â short for "good morning"), though they have plenty to be happy about. Breakfast is usually included, and offers hearty fuel for the day: ham, eggs, cheese, bread, rolls, and pots of coffee. In Switzerland, don't miss an opportunity to try Bircher Muesli, a healthful mix of oats, nuts, yogurt, and fruit that tastes far more delicious than it looks. If breakfast is optional, take a walk to the nearest bakery â every German, Austrian, and Swiss town has at least a few bakeries offering a world of enticing varieties of bread and pastries, baked fresh every morning. As you move south and west (France, Italy, Spain, and Portugal), skimpier "continental" breakfasts are the norm. You'll mostly likely get a roll with marmalade or jam, occasionally a slice of ham or cheese, and coffee or tea. The good news? These little breakfasts compel you to sample regional favorites: In Spain, look for chocolate con churros (fritters served with a thick, warm chocolate drink), pan con tomate (a toasted baguette rubbed with fresh garlic and ripe tomato), or a tortilla española (a hearty slice of potato omelet). Italian breakfasts are particularly tiny, but the delicious red orange juice you get is made from Sicilian blood oranges. And you can buy a delightful toasted sandwich from a corner bar anywhere, anytime in Italy to make up for the minuscule breakfast. In France, locals just grab a warm croissant and coffee on the way to work. Queue up with the French and consider the yummy options: croissants studded with raisins, packed with crushed almonds, or filled with chocolate or cream. If you expect breakfast to be too sparse, plan ahead to supplement it with a piece of fruit and a wrapped chunk of cheese from a local market. Being a juice man, I keep a liter box of OJ in my room for a morning eye-opener. Coffee drinkers know that breakfast is the only cheap time to caffeinate yourself. Some hotels will serve you a bottomless cup of a rich brew only with breakfast. After that, the cups acquire bottoms and refills will cost you. Juice is generally available at breakfast, but in Mediterranean countries, you have to askâŠand you'll probably be charged. In many countries, breakfast is included in your hotel bill, though if you make prior arrangements with the hotelier, you may be able to skip breakfast and pay a lower price for the room. If breakfast costs extra, it's often optional, and you can usually save money and gain atmosphere by buying coffee and a roll or croissant at the cafĂ© down the street or by brunching picnic-style in the park. When deciding whether to request breakfast, consider your timing; if you need to get an early start, skip the breakfast â few hotel breakfasts are worth waiting around for. Come to the European breakfast table with an adventurous spirit. I'm a big-breakfast traditionalist at home, but when I feel the urge for an American breakfast in Europe, I beat it to death with a hard roll.Not long ago, I grabbed breakfast at a hotel in southern Spain. The only cereal available was a local version of frosted corn flakes, so I readied myself to enjoy a bowl of my childhood favorite. But my sweet indulgence wasn't what I'd expected: The cereal milk was heated â apparently standard in this part of Spain â and my poor frosted flakes immediately turned to mush. Not so grrrrrrreat. Soggy flakes or not, I find breakfast to be a fun part of my travel day, especially because the experience varies so much from one country's breakfast table to the next. The farther north you go in Europe, the heartier the breakfasts. The heaviest is the traditional British "fry." Also known as a "Plate of Cardiac Arrest," the fry is a fundamental part of the bed-and-breakfast experience, and is generally included in your room price. A standard fry comes with cereal or porridge, a fried egg, Canadian-style bacon or sausage (and sometimes mackerel or haggis), a grilled tomato, sautĂ©ed mushrooms, baked beans, and fried bread or toast. This protein-stuffed meal can tide me over until dinner. You'll quickly figure out which parts of the fry you like. Your host will likely ask you up front which breakfast items you actually like, rather than serve you the whole shebang and risk having to throw out uneaten food. The Scandinavian breakfasts buffet is the perennial favorite for the "most food on the table" award. It pays to take advantage of breakfast smorgasbords when you can. For about $20 (a cheap meal in these parts), you can dig into an all-you-can-eat extravaganza of fresh bread, cheeses, yogurt, cereal, boiled eggs, herring, cold cuts, and coffee or tea. In place of cereal and milk, Scandinavians like to pour thick yogurt over their granola. Throughout the Netherlands, Belgium, Germany, Austria, Switzerland, and most points east of there, expect a more modest buffet â but still plenty of options (rolls, bread, jam, cold cuts, cheeses, fruit, yogurt, and cereal). In these countries, there's a good chance of finding hard-boiled eggs, but scrambled or fried eggs are relatively rare. In Poland, track down jajecznica, the local wake-up call of eggs scrambled with kielbasa sausage, served with a side of potato pancakes. The breakfast of choice in Russia is oladi, pancakes perfectly fried to be crisp on the outside but soft in the middle, then topped with sour cream, honey, or berries. Germans have an endearing habit of greeting others in the breakfast room with a slow and dour "Morgen" ("Morning" â short for "good morning"), though they have plenty to be happy about. Breakfast is usually included, and offers hearty fuel for the day: ham, eggs, cheese, bread, rolls, and pots of coffee. In Switzerland, don't miss an opportunity to try Bircher Muesli, a healthful mix of oats, nuts, yogurt, and fruit that tastes far more delicious than it looks. If breakfast is optional, take a walk to the nearest bakery â every German, Austrian, and Swiss town has at least a few bakeries offering a world of enticing varieties of bread and pastries, baked fresh every morning. As you move south and west (France, Italy, Spain, and Portugal), skimpier "continental" breakfasts are the norm. You'll mostly likely get a roll with marmalade or jam, occasionally a slice of ham or cheese, and coffee or tea. The good news? These little breakfasts compel you to sample regional favorites: In Spain, look for chocolate con churros (fritters served with a thick, warm chocolate drink), pan con tomate (a toasted baguette rubbed with fresh garlic and ripe tomato), or a tortilla española (a hearty slice of potato omelet). Italian breakfasts are particularly tiny, but the delicious red orange juice you get is made from Sicilian blood oranges. And you can buy a delightful toasted sandwich from a corner bar anywhere, anytime in Italy to make up for the minuscule breakfast. In France, locals just grab a warm croissant and coffee on the way to work. Queue up with the French and consider the yummy options: croissants studded with raisins, packed with crushed almonds, or filled with chocolate or cream. If you expect breakfast to be too sparse, plan ahead to supplement it with a piece of fruit and a wrapped chunk of cheese from a local market. Being a juice man, I keep a liter box of OJ in my room for a morning eye-opener. Coffee drinkers know that breakfast is the only cheap time to caffeinate yourself. Some hotels will serve you a bottomless cup of a rich brew only with breakfast. After that, the cups acquire bottoms and refills will cost you. Juice is generally available at breakfast, but in Mediterranean countries, you have to askâŠand you'll probably be charged. In many countries, breakfast is included in your hotel bill, though if you make prior arrangements with the hotelier, you may be able to skip breakfast and pay a lower price for the room. If breakfast costs extra, it's often optional, and you can usually save money and gain atmosphere by buying coffee and a roll or croissant at the cafĂ© down the street or by brunching picnic-style in the park. When deciding whether to request breakfast, consider your timing; if you need to get an early start, skip the breakfast â few hotel breakfasts are worth waiting around for. Come to the European breakfast table with an adventurous spirit. I'm a big-breakfast traditionalist at home, but when I feel the urge for an American breakfast in Europe, I beat it to death with a hard roll. Can you make 5 questions based on the text