Bone Strengthening Research Articles

The Influential Role of Baduanjin on the Mental Health of Medical Students: A Review

Baduanjin, a traditional Chinese health care practice, not only promotes muscle relaxation and bone strengthening while preventing and treating illnesses but also contributes positively to mental nourishment and emotional regulation. This paper employs a literature review and logical analysis to comprehensively assess the impact of Baduanjin on the mental health of medical students in higher education institutions. The findings indicate a significant prevalence of mental health issues among medical students in recent years, with a myriad of complex influencing factors. Furthermore, interventions aimed at enhancing the mental well-being of college students have become increasingly diverse. Notably, Baduanjin stands out as a traditional physical activity intervention that is both straightforward to implement and effective in bolstering students' mental health. Moving forward, it may serve as a preventive measure for mental wellness in the physical education curricula of universities, fostering the holistic development of both physical and mental health.

Green synthesis of carbon dots nanoparticles from edible swiftlet nest and evaluation of their antioxidant activity

Edible swiftlet nest (ESN) confers various health benefits to humans, including immune system enhancement, anti-inflammatory properties, bone strengthening, and antioxidative effect. ESN is notably rich in protein and minerals, with its proteins serving as non-enzymatic antioxidants capable of binding free radicals. However, the antioxidant capacity of ESN is comparatively lower than that of other free radical scavengers, such as carbon dots nanoparticles (CNPs). CNPs features charged ligands on their surface that act as electron donors for free radical binding. The presence of the carbon chain forming proteins in ESN suggests their potential as the primary source for CNPs formation. The enhancement of hydroxyl groups and delocalized electrons is imperative for enhancing the antioxidant activity of ESN. This study aims to enhance the antioxidant activity of ESN by converting it into CNPs nanoparticles. The results demonstrated the effective synthesis of CNPs from the ESN solution using microwave methods. This was evidenced by XRD patterns indicating CNPs formation, and an average particle size of 4.86 nm as indicated by TEM analysis. The optimal microwave heating duration of 30 min yielded CNPs with a prominent emission spectrum peak at 425 nm and significantly high intensity. Absorbance data revealed the presence of C=C bonds, consistent with aromatic CNPs bonds observed in FTIR studies. CNPs possessed hydroxyl and carboxyl linkages, suggesting their potential as antioxidants. The percent inhibition results indicated that CNPs exhibited a substantial percentage (62.5%) at a concentration of 50 mg ml−1. The free radical scavenging activity of the CNPs significantly elevated compared to ESN.

Moving beyond moderate-to-vigorous physical activity: A longitudinal study on adherence to 24-hour Movement Guidelines in adolescents

ObjectivesLow adherence to 24-hour Movement Guidelines for moderate-to-vigorous physical activity, screen time and sleep during adolescence is well documented, yet recommendations regarding light physical activity, vigorous physical activity and muscle and bone strengthening activities have received less attention. This study comprehensively examined adherence to seven components of the movement guidelines in adolescents and analysed disparities by age and gender. DesignLongitudinal study with two assessment time points, separated by one year. MethodsData were collected in 216 New Zealand adolescents aged 12–17 years, and at 1-year follow-up in 167 participants (77 %), using thigh-worn accelerometers and a self-reported diary. ResultsAdherence rates were 3.7 % for moderate-to-vigorous physical activity, 13.0 % for screen time, 44.0 % for sleep, 14.4 % for light physical activity, 36.1 % for vigorous physical activity, 30.6 % for bone and muscle strengthening activities, and 4.6 % for consistent bedtimes. Less than 1 % of participants met all seven recommendations. Adherence was disproportionately low amongst older adolescents for light physical activity, screen time and consistent bedtimes, and amongst girls for vigorous physical activity and muscle and bone strengthening activities. Over one year, adherence declined for light physical activity (15.0 %–7.2 %) and screen time (15.6 %–6.0 %). ConclusionsNew Zealand adolescents are not adhering to recommendations for a healthy balance of time use outlined in the 24-h Movement Guidelines. These findings highlight the need for adolescents to increase their daily movement, with a particular focus on light physical activity amongst older adolescents and muscle and bone strengthening activities amongst girls.

Bone Strengthening Exercise: A Key to Boosting Metabolism and Reducing Body Fat in Older Adults

Bone Strengthening Exercise: A Key to Boosting Metabolism and Reducing Body Fat in Older Adults

Challenges and Pitfalls of Research Designs Involving Magnesium-Based Biomaterials: An Overview.

Magnesium-based biomaterials hold remarkable promise for various clinical applications, offering advantages such as reduced stress-shielding and enhanced bone strengthening and vascular remodeling compared to traditional materials. However, ensuring the quality of preclinical research is crucial for the development of these implants. To achieve implant success, an understanding of the cellular responses post-implantation, proper model selection, and good study design are crucial. There are several challenges to reaching a safe and effective translation of laboratory findings into clinical practice. The utilization of Mg-based biomedical devices eliminates the need for biomaterial removal surgery post-healing and mitigates adverse effects associated with permanent biomaterial implantation. However, the high corrosion rate of Mg-based implants poses challenges such as unexpected degradation, structural failure, hydrogen evolution, alkalization, and cytotoxicity. The biocompatibility and degradability of materials based on magnesium have been studied by many researchers in vitro; however, evaluations addressing the impact of the material in vivo still need to be improved. Several animal models, including rats, rabbits, dogs, and pigs, have been explored to assess the potential of magnesium-based materials. Moreover, strategies such as alloying and coating have been identified to enhance the degradation rate of magnesium-based materials in vivo to transform these challenges into opportunities. This review aims to explore the utilization of Mg implants across various biomedical applications within cellular (in vitro) and animal (in vivo) models.

1969 Assessing the acute hospital care of patients with a diagnosis of a learning disability and hip fracture

Abstract Introduction Patients with learning disabilities (LD) often have complex medical needs resulting in onset of frailty at younger ages. This increases risk of morbidity and mortality following emergency admissions, such as acute fractured neck of femur (FNOF). This risk is further increased by communication difficulties experienced in this group. There is little information about how LD affects the quality of care of patients with FNOF as defined by the national hip fracture standards (NHFS). Methods This retrospective audit reviewed notes of patients with LD admitted to a teaching hospital with FNOF over 5 years. The audit examined whether the care of patients with LD complied with the NHFS and best practice tariff guidelines, regardless of age. The audit sought to explore potential disparities between patients with LD and the general population. It assessed whether steps were taken to optimise care as defined by the Royal College of Physicians toolkit for LD. Results 46 patients were included; 22% were under the age of 60. Operative management was in line with recommendations. However, 37% did not receive appropriate bone strengthening treatment and 37% were not mobilised within the first 24 hours. This correlated with fewer patients remaining freely mobile following the admission (8.7% post-operatively vs 41.3% pre-operatively). Documentation of LD severity LD and usual behaviours was unreliable, as was documentation of key conversations, such as those regarding capacity or resuscitation. Conclusions This highlights the importance of addressing the increased needs of patients with LD regardless of age, to better facilitate holistic assessment and treatment of this vulnerable population. Locally we plan to minimise variation by utilising LD nurses and providing comprehensive geriatric review of all patients with LD admitted with FNOF. We recommend that data collection, including 120-day follow-up, be incorporated into routine practice for all patients with LD admitted with FNOF.

Cross-sectional and longitudinal associations between the 24-hour movement behaviours, including muscle and bone strengthening activity, with bone and lean mass from childhood to adolescence

BackgroundThis study aimed to assess whether moderate-to-vigorous physical activity (MVPA), sport and exercise as a proxy measure of muscle and bone strengthening activity, sedentary behaviour, and sleep were associated with total-body-less-head (TBLH) bone mineral content (BMC) and TBLH lean mass cross-sectionally and longitudinally from age 6 to 9 years and age 9 to 11 years to age 15 to 17 years.MethodsWe used longitudinal data from a population sample of Finnish children from the Physical Activity and Nutrition in Children study (age 6 to 9 years: n = 478, 229 females; age 9 to 11 years: n = 384, 197 females; age 15 to 17 years: n = 222, 103 females). Linear regression analysed the cross-sectional and longitudinal associations between accelerometer-assessed MVPA, sedentary time and sleep, and questionnaire-assessed sport and exercise participation and screen time with dual-energy X-ray absorptiometry-assessed TBLH BMC and lean mass.ResultsIn females, MVPA at age 6 to 9 years was positively associated with TBLH BMC at age 15 to 17 years (β = 0.008, p = 0.010). Sport and exercise at age 9 to 11 years was positively associated with TBLH BMC (β = 0.020, p = 0.002) and lean mass (β = 0.343, p = 0.040) at age 15 to 17 years. MVPA at age 9 to 11 years was positively associated with TBLH lean mass (β = 0.272, p = 0.004) at age 15 to 17 years. In males, sleep at age 6 to 9 years was positively associated with TBLH lean mass (β = 0.382, p = 0.003) at age 15 to 17 years. Sport and exercise at age 9 to 11 years was positively associated with TBLH BMC (β = 0.027, p = 0.012) and lean mass (β = 0.721, p < 0.001) at age 15 to 17 years.ConclusionsPromoting engagement in the 24-hour movement behaviours in childhood, particularly sport and exercise to strengthen muscle and bone, is important in supporting bone and lean mass development in adolescence.Trial registrationNCT01803776; first trial registration date: 04/03/2013.

Revisión crítica de los ensayos clínicos publicados sobre la suplementación con vitamina D

ABSTRACT. Vitamin D is supplemented in individuals with or without risk factors for deficiency, although its effects at specific doses and frequency are controversial. In consequence, we aimed to perform an exhaustive review on the effects of vitamin D supplementation in randomized clinical trials in adult patients, grouped by target system and the evaluation criteria established in the objectives, by searching clinical trials published in the last 5 years in PubMed and EBSCO are included, with the keywords "vitamin D supplementation" AND effect, in English or Spanish, excluding participants &lt;19 years Our initial search yielded 91 results from two databases, of which 71 included studies. A total of 24 articles published a significant effect of vitamin D supplementation. Significant effects were identified in 3 of 4 studies in postmenopausal patients on bone density and/or strengthening of the musculoskeletal system. Other statistically significant effects were observed with supplementation in patients with high body mass index, in glucose control and glycosylated hemoglobin levels. We conclude that randomized clinical trials show significant effects in different organs and systems, the effect on glycemic control is promising, even when overrepresenting specific human groups.

Clinical Application of “Brain Strengthening and Bone Strengthening Mixture” in Children with Autism and Comorbidities

Clinical Application of “Brain Strengthening and Bone Strengthening Mixture” in Children with Autism and Comorbidities

Introduction to Osteoporosis, Osteomalacia, and Fragility Fractures.

Osteoporosis is a disease of the bones leading to decreased bone mineral density, leading to fragility fractures. This article is an overview of osteoporosis, osteomalacia and fragility fractures and serves as an introductory article for this special issue on osteoporosis. This is a short, comprehensive account of the given conditions with concepts and a review from the recent literature. The authors provide relevant references from the literature in the bibliography. The sections herein have also been deliberated in the meetings of experts of osteoporosis. An overview of osteoporosis, osteomalacia and fragility fractures is provided, including definitions and summaries of aetiology, pathophysiology, diagnosis, prevention, and management. A detailed account of some of these topics will be provided in subsequent chapters. Osteoporosis is a silent disease with the potential to cause significant morbidity and mortality if not detected early. It is important to differentiate from and diagnose associated osteomalacia to provide accurate therapy. It is also important to identify the type of fragility fractures and initiate treatment for bone strengthening to prevent subsequent fractures.

THU425 Brief, Low-impact, High-intensity Osteogenic Loading Training Utilizing Proprietary Osteostrong Devices With Once-A-Week, 10 Minute Treatments Improves Bone Mineral Density In Women With Osteoporosis Of The Lumbar Spine

Abstract Disclosure: N. Papadopoulou-Marketou: None. A. Papageorgiou: None. G. Vavetsis: None. T. Panagiotis: None. G.P. Chrousos: None. Introduction: Osteoporosis is a chronic condition characterized by a decrease in bone density and deterioration of microarchitecture. It has been associated with a high bone-fracture risk, an increased mortality, and vast health-care costs. Pharmaceutical treatment along with resistance exercise are usually prescribed. “Osteostrong” is a type of bone strengthening that uses brief (12 min), weekly, low-impact, high-intensity osteogenic loading. Aim: to investigate the therapeutic impact of Osteostrong in people with osteoporosis. Methods: In total, 140 postmenopausal women with osteoporosis of the lumbar spine, followed at the Unit on Clinical and Translational Research in Endocrinology, University of Athens, Athens, Greece, were enrolled. They were divided into 2 groups. Group A (GA) included 70 women who were treated with Osteostrong (mean age: 57,7 y, 95% CI 54, 9-60,6 y); Group B (GB) included 70 women who had no exercise intervention (mean age 59,2 y, 95% CI 55,6-61,9 y). All the participants had a complete physical examination, an assessment for exclusion of secondary osteoporosis, bone markers CTX1 and PINP, and a DXA examination [Horizon W (S/N 300472M], twice, at the time of inclusion in the trial, at 9 and 12 months after onset of intervention. Preliminary data at 9 months are shown. Statistical analysis, Medcalc version 20.2. Results: Paired Student t-test (chi-squared) of Bone Mass Density (BMD) and T-score before (1) and after intervention (2) in GA and GB showed: BMD lumbar spine (L1-L4) and T-score L1-L4: GA1 (mean:0.815), GA2 (mean:0.833) (p&amp;lt;0.0007) and GA1 (mean: −2.27), GA2 (mean: −1.93) (p&amp;lt;0.0001)/ GB1 (mean: 0.852), GB2 (mean: 0.851) (p=0.93) and GB1 (mean: −1.98), GB2 (mean: −1.80) (p=0.054), respectively. Trabecular bone score (TBS) and T-score TBS: GA1 (mean: 1.217), GA2 (mean: 1.238), (p=0.036) and GA1 (mean: −2.76), GA2 (mean: −2.52), (p=0.045)/ GB1 (mean:1.22), GB2 (mean: 1.204) (p=0.14) and GB1 (mean: −2.75), GB2 (mean: −2.85), (p= 0.560), respectively. The CTX1 and PINP values were within normal reference range at 9 months. Discussion: The study showed a statistically significant improvement of BMD in the lumbar spine and TBS in people with osteoporosis treated with Osteostrong. The Osteostrong method may have a synergistic effect with anti-osteoporotic medication, significantly reducing bone fracture risk. Conservative therapeutic interventions are important challenges to minimize the osteoporosis-related poor quality of life and mortality. Presentation: Thursday, June 15, 2023

Effect of an after-school physical activity program on physical fitness and academic performance of socioeconomically vulnerable children

Aim: To promote the practice of physical activity (PA) after school hours and verify the effects on the physical fitness and academic performance of children with socioeconomic vulnerability. Methods: The non-randomized experimental study was carried out in a school in a vulnerable area. Eighteen children performed 60 minutes of moderate-vigorous PA and 15 minutes of circuit exercise (muscle and bone strengthening) three times a week. The control group (n=10) only had school physical education as a weekly PA routine. To assess the program's impact, physical aptitude tests (pre- and post-test) were carried out in accordance with the recommendations of PROESP-Br and the School Performance Test, which assesses learning in three categories: reading, writing, and arithmetic. Results: Abdominal strength, flexibility, sprint, and lower limb power increased (d-Cohen&gt;0.20). Regarding academic performance, the effect was moderate (d-Cohen&gt;0.50) for reading and total scores. The effect size was small (d-Cohen&lt;0.50) for arithmetic and writing. Conclusion: An after-school PA program positively impacts physical fitness and academic performance in socioeconomically vulnerable children. The level of impact varies between small and medium according to different physical fitness capacities. School is an enabling environment for children to meet the World Health Organization PA recommendations.

Physical activity in infancy and early childhood: a narrative review of interventions for prevention of obesity and associated health outcomes.

In the context of the childhood obesity epidemic, this narrative review aims to explore opportunities to promote physical activity (PA) between birth and age 5 years as well as the health outcomes associated with PA in early childhood. Although early childhood is an ideal time to promote healthy habits, guidelines for PA have often ignored early childhood given the limited evidence for children <5 years old. Herein we discuss and highlight infant, toddler and preschool age interventions to promote PA and prevent obesity both in the short and long-term. We describe novel and modified interventions to promote improved early childhood health outcomes, encompassing cardiorespiratory, muscle, and bone strengthening components necessary for short-term motor development and long-term health. We call for new research aimed at developing and testing innovative early childhood interventions that may be performed in home or childcare settings, monitored by parents or caregivers.

Abstract P2-06-01: Improving the health of women on Aromatase Inhibitors: A pilot controlled dietary and exercise intervention trial

Abstract Background: In spite of aromatase inhibitors reducing risk of recurrence and mortality, painful side effects often cause women to discontinue use of the drug. Side effects of aromatase inhibitors include joint and muscle pain, loss of bone mineral density, and impairment of heart functioning. Discontinuation of aromatase inhibitors due to these side effects occur in up to 40% of breast cancer survivors, and consequently risks of recurrence and mortality increase. Objective: We developed two interventions designed to reduce inflammation, alleviate pain and stabilize bone mineral density. Methods: We are currently conducting a pilot parallel intervention trial that is targeted toward alleviating side effects from aromatase inhibitors through dietary and exercise controlled interventions lasting for three months. The dietary intervention is an anti-inflammatory Mediterranean diet designed to decrease inflammation and lessen joint and muscle pain. Participants randomized to the Mediterranean dietary intervention are exclusively consuming food provided by Territory Foods®, an outside food preparation and delivery service, local to Los Angeles. Our exercise intervention is designed to mobilize the joints, and strengthen and reduce bone loss. Participants are visiting the UCLA Kinross gym for three days per week and are undergoing tailored exercise sessions delivered from personal trainers following our bone strengthening intervention protocol. Anthropometric measures, muscle strength, DXA scanning of bone mineral density, peripheral arterial tonometry, pulse wave velocity and biomarkers of inflammation, bone turnover and heart functioning are conducted at baseline, mid- and end of intervention. Results: Our trial is targeted to accrue 20 participants. Thus far we enrolled six participants, with three participants completing the trial. Analysis is ongoing and preliminary results will be presented at the San Antonio Breast Cancer Symposium in December, 2022. Post intervention reports from participants have noted a reduction in pain symptoms, moderate weight loss and increase in muscle strength. Citation Format: Catherine L. Carpenter, Aashini K. Master, Olivia Julian, Dina Ben-Nissan, Michele Rakoff, Gail Thames, Zhaoping Li. Improving the health of women on Aromatase Inhibitors: A pilot controlled dietary and exercise intervention trial [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P2-06-01.

Yoga

Cardiovascular morbidity is the leading cause of death worldwide. Physical activity, including aerobic, balance, flexibility, and muscle and bone strengthening, can prevent cardiovascular disease (CVD) at lower cost. Yoga is a natural treatment option that does not involve taking medications or other artificial substances, which may be appealing to some people who prefer to use natural remedies whenever possible. In addition to lowering blood pressure, yoga has many other health benefits, such as improving flexibility, strength, and stress management. This paper aims to discuss the role of yoga in preventing various CVDs. We aimed to review the studies on the various forms of yoga and the mechanisms that lead to cardioprotective advantages. We also discussed some of yoga's harmful side effects. We have covered two types of yoga in depth: Hatha Yoga (HY) and pranayama. We have done a thorough review of the literature using a PubMed search. Different keywords such as Yoga, cardiovascular disease (CVD), pranayama, Hatha Yoga (HY), Kapālabhāti, stress, anxiety, hypertension, coronary artery disease, asana, rate pressure product (RPP), and Double Product (DoP) were used to write the review. Yoga is a form of physical exercise that involves a series of postures, breathing techniques, and meditation practices. Recent research suggests that practicing it has potential benefits for cardiovascular health, including reducing blood pressure, improving heart rate variability, and reducing cholesterol levels. This may make it a more attractive option for people who want to improve their health and well-being. Here, we report that, according to current evidence, yoga has reduced mortality by preventing conditions that lead to the development of CVDs. However, further study is necessary to provide more convincing evidence for the widespread implementation of yoga as a treatment for CVDs.

Exercise effects on glucocorticoid-induced bone loss in adults: a systematic review and meta-analysis.

Due to their pronounced anti-inflammatory and immunosuppressive effects, glucocorticoids (GCs) are widely used in inflammatory conditions and organ transplants. Unfortunately, GC-induced osteoporosis is one of the most common causes of secondary osteoporosis. The aim of the present systematic review and meta-analysis was to determine the effect of exercise added to GC therapy on BMD at the lumbar spine or femoral neck in people on GC therapy. A systematic literature search of five electronic databases included controlled trials with a duration of >6 months and at least two study arms [glucocorticoids (GCs) and GCs and exercise (GC + EX)] were conducted up to 20 September 2022. Studies involving other pharmaceutical therapies with relevant effects on bone metabolism were excluded. We applied the inverse heterogeneity model. Outcome measures were standardized mean differences (SMDs) with 95% CIs for BMD changes at the lumbar spine (LS) and femoral neck (FN). We identified three eligible trials with a total of 62 participants. In summary, the GC + EX intervention indicated statistically significantly higher SMDs for LS-BMD [SMD 1.50 (95% CI 0.23, 2.77)] but not for FN-BMD [0.64 (95% CI -0.89, 2.17)] compared with GC treatment alone. We observed substantial heterogeneity (LS-BMD I 2 = 71%, FN-BMD I 2 = 78%) between the study results. Although more well-designed exercise studies are needed to address the issue of exercise effects on GC-induced osteoporosis (GIOP) in more detail, upcoming guidelines should pay more attention to the aspect of exercise for bone strengthening in GIOP. PROSPERO: CRD42022308155.

A qualitative exploration of English black adults’ views of strength and balance activities in mid-life

BackgroundPublic health guidelines state that all adults should undertake muscle and bone strengthening and balance training activities at least twice a week to support their physical function and maintain independent health. This is intended to maintain strength in adulthood and offset natural declines in bone density and muscle mass. Most older adults do not meet this guideline with low levels of compliance among older black people. This study explored the experiences of physical activity relating to strength and balance activities, amongst black men and women living in England, aged 50–70.MethodsParticipants were recruited by phone via a network of research recruitment specialists across England. In-depth qualitative interviews were conducted with 25 black people aged 50–70 living in England. An inductive thematic analysis was conducted.ResultsWe found there was only a very general understanding of the importance of maintaining body strength and balance, and low salience: strength and balance activities were not seen to be an important part of participants’ lives. Most participants only wanted to be strong enough to get on with ‘normal life’ and not to build strength or balance. Participants aged 50–70 were likely to think they were too young to worry about strength and balance, which tended to be mentioned only if someone had experienced a problem. Participants reported that NHS staff, especially physiotherapists are a key source of information on the topic and could therefore be useful in future prevention strategies.ConclusionPublic health recommendations stress the importance of increasing participation in regular strength and balance activities as people age, to reduce the risk of falls and maintain independence. This study has shown that among the black middle-aged adults we interviewed, the knowledge and salience of this message is low. Public health approaches should be taken to communicate the importance of enhancing strength and balance as people approach older age, including communication and education programmes led by health professionals, who were viewed with authority amongst these participants.

P06-09 Data processing with the short questionnaire to assess health enhancing physical activity (SQUASH): an update

BackgroundThe Short Questionnaire to Assess Health Enhancing Physical Activity (SQUASH) is a widely used questionnaire, and used for monitoring prevalence rates of physical activity(PA) in the Netherlands. To provide a standardized protocol for data processing and analysis of the SQUASH, an analysis guide was published in 2004. However, since then, the compendium of Metabolic Equivalent (MET) values of PA has been updated, and new PA guidelines have been developed. The new PA guidelines differ from the old ones in terms of the appropriate amount of active time (150 minutes/week versus 5 days/week 30 minutes), decrease in cut-off point for moderate intensity (adults 18-54 years of age) and adding a bone- and muscle strengthening component. Therefore, the protocol for data processing and analysis of the SQUASH needs to be updated. In this study, results from the old and new protocol demonstrate the differences in adherence rates between the two sets of guidelines in the Netherlands for the adult population.MethodsData of a nationally representative sample of 6942 participants aged 18 years and older were used to calculate adherence to the old and the new PA guidelines by using the original and the updated protocol. In the new protocol, the MET-values of the activities including sports were adjusted according to the 2011 Compendium. Moderate intense activity was defined as ≥ 3.0 MET irrespective of age and the bone and muscle strengthening component was added.ResultsAdherence to the old Dutch PA guidelines is 48.1% among adults aged 18-54 years, and 74.4% among adults 55 years and older. For the new PA guidelines the adherence is 48.4% and 38.1% respectively. The large difference for adults 55 years and older is due to changes in the cut-off values for moderate-to-vigorous intensity PA and the addition of bone and muscle strengthening exercises.ConclusionsThe updated protocol for data processing and analysis of the SQUASH describes the steps to calculate the new PA guidelines in a structured way and gives researchers the opportunity to work with the data from the SQUASH in a uniform way. The SPSS syntax for data processing is available at: www.sportenbewegenincijfers.nl/methoden.

Zhuanggu Zhitong Capsule alleviates postmenopausal osteoporosis in ovariectomized rats by regulating autophagy through AMPK/mTOR signaling pathway.

BackgroundPostmenopausal osteoporosis (PMOP) is the most common primary osteoporosis, which is prone to fractures and affect the health and quality of life of the elderly and even shorten their lifetime. Traditional Chinese medicine can not only effectively improve osteoporosis and reduce fracture rate, but also have tonifying and analgesic effects. The purpose of this study was to investigate the effects of Zhuanggu Zhitong (ZGZT) Capsule on autophagy related genes and proteins in PMOP rats, so as to elucidate the molecular mechanism of tonifying deficiency and regulating stasis in the treatment of osteoporosis and analgesia.MethodsThe PMOP rat model was established by bilateral oophorectomy, and then the rats were randomly divided into control group, PMOP group, PMOP + ZGZT group and PMOP + E2 group. The changes of mechanical pain threshold of rats were detected by von Frey filaments, and the changes of mechanical pain threshold of rats in each group were compared. Computed tomography (CT) and dual-energy X-ray were used to measure the bone mineral density of lumbar bone tissue. Enzyme-linked immunosorbent assay (ELISA) and tartrate-resistant acid phosphatase (TRAP) staining were used to detect inflammatory factors and bone metabolism related indicators. Hematoxylin-eosin (HE) staining was used to observe the tissue morphology of lumbar vertebra tissue. Western blot (WB) and quantitative polymerase chain reaction (qPCR) were used to detect AMPK/mTOR pathway- and autophagy-related factor expression.ResultsZGZT can effectively restore the bone mineral density (BMD) of PMOP rats, improve the microstructure of lumbar vertebra of PMOP rats, restore the balance of bone metabolism, promote the expression of AMPK and autophagy related factors, inhibit the expression of mTOR and the release of inflammatory factors, and increase the mechanical pain threshold of PMOP rats, so as to effectively improve osteoporosis and relieving osteoporosis pain in PMOP rats.ConclusionsZGZT affects autophagy by regulating AMPK/mTOR pathway, restores the homeostasis of bone metabolism and inhibits the release of inflammatory factors. Moreover, the regulation of feedback pathways between bone metabolism and inflammatory factors finally plays the role of “bone strengthening” and “pain relieving”. ZGZT may be a new treatment for PMOP and relieving osteoporotic pain.

The Need for a National Guideline for the Management of NSCLC ALK-Positive Lung Cancer in the UK: Results of Patient-Driven Surveys

Introduction: There are currently no national guidelines specifically for the management of NSCLC ALK-positive lung cancer in the UK. National guidelines exist for lung cancer in general and reference is made to ALK-positive lung cancer. However, the generic nature of these guidelines is not sufficient for the optimal management of this specific type of lung cancer, with its unique disease management requirements. Method: In 2021, members of the charity ALK POSITIVE LUNG CANCER (UK) completed anonymised surveys to gather real-world data about their treatment. Results: Data were gathered on the prescribing of blood thinners (n = 127); frequency of brain MRI scans (n = 123); prescribing bone strengthening medication (n = 127); frequency of CT scans (n = 123); mental health (n = 132). There was significant variation in each of these five aspects of treatment. Conclusions: The findings, from a representative population of ALK-positive patients, provide new information on the significant disparities in the treatment that patients receive. This health inequality is likely to have a detrimental effect on the survival outcomes for some of these patients. It would improve patient outcomes and overall survival if ALK-positive lung cancer disease management national guidelines were established and utilised across the NHS in the UK. The evidence presented.