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Background: Exercise training (ET) is a promising rehabilitation approach for long-term negative consequences of traumatic brain injury (TBI). However, little is known regarding overall rates of attrition, adherence, and compliance to ET in TBI. Objective: The purpose of this systematic review was to estimate average attrition, adherence, and compliance rates in ET studies in persons with TBI. Methods: Databases were searched from inception to April 15, 2024. Two authors independently extracted data related to attrition, adherence, compliance, and possible moderators identified a priori. Results: The average rate of attrition from 45 studies was 14.4%, although the majority of studies had small sample sizes (i.e. n < 42). Based on hierarchical linear regression, the most influential predictors of attrition were sample size and study design. A minority of studies reported adherence (44.4%) or compliance (22.2%) but those that did reported good average adherence (85.1%) and compliance (77.7%). These studies support the ability of persons with TBI to complete an ET intervention as prescribed. Conclusions: Researchers can use this information to ensure adequate power to detect a true effect of ET in persons with TBI. Researchers conducting ET studies in persons with TBI should clearly and thoroughly report data on attrition, adherence, and compliance. [ABSTRACT FROM AUTHOR]

Objective The genesis of both osteoporosis and sarcopenia is multifactorial, complicated, and interrelated. The present study has been undertaken to analyze the prevalence of low bone mineral density (BMD) and the pattern of imaging markers of sarcopenia (paraspinal skeletal muscle area [SMA] and skeletal muscle index [SMI] with respect to clinicodemographic profile in middle-aged patients (30–45 years) undergoing evaluation for low back pain (LBP). Materials and Methods Magnetic resonance imaging (MRI) of the lumbosacral spine and/or sacroiliac joints was done on 3T MRI. BMD of the lumbar spine (L1 to L4) was assessed using a dual-energy X-ray absorptiometry scan. SMA was calculated by measuring the cross-sectional area of paraspinal muscles (bilateral psoas, erector spinae, and multifidus), and SMI was calculated by dividing SMA by height 2. Results The prevalence of osteoporosis was 12.1% in patients of age 30 to 45 years presenting with LBP. Both osteoporosis and paraspinal muscle mass were statistically associated with the duration of symptoms (p -value <0.05). No statistically significant difference was observed in different MRI findings, that is, normal, inflammatory, infective, and degenerative etiology. Conclusion Low BMD and loss of muscle mass in cases with LBP are more related to duration of disease rather than etiology or gender in middle-aged subjects. Early intervention to manage LBP may prevent progression to osteoporosis and sarcopenia in young adults. [ABSTRACT FROM AUTHOR]

Background: Vitamin B12 (B12), playing the role of a coenzyme in one-carbon metabolism, is an important vitamin necessary for human health., Objectives: To systematically review evidence to identify the complications of B12 deficiency among women., Methods: We conducted a systematic search of quantitative studies on disorders associated with B12 deficiency among women, published in English in the last 25 years (1999-2024), using electronic databases such as Scopus, Web of science, CINAHL, PubMed, and Medline., Conclusion: The search produced 28 full-text articles. B12 deficiency prevalence among women identified by the selected studies ranges from 0.6% to 45.5%. The deficiency of B12 is connected with the risk for depression/post-partum depression, breast cancer, recurrent pregnancy loss, gestational diabetes mellitus, insulin resistance, and obesity among women. It is necessary to monitor and correct the B12 deficiency among women in order to prevent complications., (© 2025 Wiley Periodicals LLC.)

Introduction: In Iran, the assessment of osteoporosis through tools like dual-energy X-ray absorptiometry poses significant challenges due to their high costs and limited availability, particularly in small cities and rural areas. Our objective was to employ a variety of machine learning (ML) techniques to evaluate the accuracy and precision of each method, with the aim of identifying the most accurate pattern for diagnosing the osteoporosis risks., Methods: We analysed the data related to osteoporosis risk factors obtained from the Fasa Adults Cohort Study in eight ML methods, including logistic regression (LR), baseline LR, decision tree classifiers (DT), support vector classifiers (SVC), random forest classifiers (RF), linear discriminant analysis (LDA), K nearest neighbour classifiers (KNN) and extreme gradient boosting (XGB). For each algorithm, we calculated accuracy, precision, sensitivity, specificity, F1 score and area under the curve (AUC) and compared them., Results: The XGB model with an AUC of 0.78 (95% confidence interval [CI]: 0.74-0.82) and an accuracy of 0.79 (0.75-0.83) demonstrated the best performance, while AUC and accuracy values of RF were achieved (0.78 and 0.77), LR (0.78 and 0.77), LDA (0.78 and 0.76), DT (0.76 and 0.79), SVC (0.71 and 0.64), KNN (0.63 and 0.59) and baseline LR (0.72 and 0.82), respectively., Conclusion: The XGB model had the best performance in assessing the risk of osteoporosis in the Iranian population. Given the disadvantages and challenges associated with traditional osteoporosis diagnostic tools, the implementation of ML algorithms for the early identification of individuals with osteoporosis can lead to a significant reduction in morbidity and mortality related to this condition. This advancement not only alleviates the substantial financial burden placed on the healthcare systems of various countries due to the treatment of complications arising from osteoporosis but also encourages health policies to shift toward more preventive approaches for managing this disease., (© 2024 The Author(s). Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd.)

Objectives: Skeletal indicators of developmental stress are commonly used to assess health, disease, and patterns of morbidity and mortality in past populations. Incorporating information about individual life history, such as adverse life events, allows for a more thorough understanding of their etiology. This paper adopts the double lens of ontogeny and the life course to analyze indicators of developmental stress in relation to known individual pathologies and developmental patterns of the cranium, vertebrae, and long bones., Material and Methods: Six skeletal indicators were collected on CT scans or virtual skeletal reconstructions of 1033 contemporary deceased male and female individuals aged between 0 and 20 years from New Mexico: cribra orbitalia, porotic hyperostosis, Harris lines, stunting, vertebral neural canal diameters, and bone mineral density. Autopsy reports provided information on age, sex, disease type, and duration. Polychoric and polyserial correlations, boxplots, balloon plots, factor analyses of mixed data, and cluster analyses were used to explore patterns among indicators, ontogeny, sex, and disease., Results: The presence and prevalence of indicators varied depending on age and disease: Harris lines, stunted growth, and cribra orbitalia were common in younger age groups and in cases of long-term or respiratory illnesses, while porotic hyperostosis was more prevalent in adolescent and young adult males., Discussion: Skeletal indicators of developmental stress are most likely associated with the timing of adverse life events in relation to the corresponding ontogenetic patterns, developmental sensitivity to stressors, and developmental plasticity/canalization of the different skeletal elements that bear them., (© 2024 Wiley Periodicals LLC.)

Introduction and Background: Experiencing illnesses or other stressors may disrupt processes of growth and development throughout the different stages of prepubertal development. Stunted stature for age is one potential outcome from such disruption, with both the nature and timing of stressors playing a role in the development of stunting. This study explores whether stress events in utero or during birth, and prepubertal development have an impact on stature, by examining associations between experience of prenatal or birth issues, postnatal stressor exposure by severity, and stature at time-of-death, with the impact of different stress experiences compared., Methods: A coronial pediatric dataset of individuals aged 0-20.9 years (280 male, 195 female) who died in the state of New Mexico from years 2011 to 2019 was assessed for presence/absence of stunting associated with physiological stress exposure type whilst controlling for low socioeconomic status (as inferred by housing type) and sex using two multiple logistic regression models for ages < 12, and for ages 12+. Broad postnatal condition categories were then investigated, again controlling for socioeconomic status and sex for these two cohorts. A linear regression model was also used to assess relationships between stunting, physiological stress, low socioeconomic status housing, and age-at-death., Results and Discussion: For both groups aged < 12 and 12+, experiencing moderate to severe illness prior to 12 years of age increased the odds of being stunted at death. Only experience of prenatal or birth issues was associated with younger age-at-death, but stunting itself was not, potentially reflecting the prolonged exposure to severe stressors necessary for stunted growth., (© 2024 Wiley Periodicals LLC.)

Adults with Down syndrome (DS) have unique health care needs with evidence-based care guidelines to address these. Yet, the 2020 adult guidelines were unstudied; we aimed to assess adherence to these guidelines. We reviewed clinical and demographic data from medical charts of 327 adults with DS who were seen in the MGH DSP. We calculated adherence to care guidelines and analyzed correlations between both demographic traits and clinical results. Mean adherence rate to each of the nine adult guidelines was 67.3%. Adherence rates that were below our mean adherence rate included colonoscopy (42.9%), iron (41.9%), audiology specialist (35.8%), and audiogram (35.2%). We found four significant correlations: assigned females at birth had a significantly higher body mass index (BMI) than assigned males at birth (p < 0.001), Hispanic patients had a significantly higher BMI than other patients (p = 0.015), Hispanic patients had a significantly higher rate of diabetes than other patients (p = 0.036), and Black patients had a significantly lower rate of hypothyroidism than other patients (p = 0.004). We assessed the adherence rates to adult DS guidelines and highlighted disparities in healthcare for patients with DS to inform clinicians on how to improve care for patients with DS., (© 2024 Wiley Periodicals LLC.)