Commercial laying hen housing is shifting from traditional cages to non-cage housing systems, such as the aviary, which has gained popularity due to potential for more species-typical behavior. However, birds housed in aviaries may have difficulties moving through the vertical tiers of the system leading to health problems such as keel bone fracture (KBF). One possible way to improve movement is to add ramps into an aviary system, allowing hens to walk between tiers rather than jump or fly. The objective of this study was to evaluate the impact of adding ramps to rearing and laying aviaries on bird health, production, and movement across vertical tiers of the aviary. Lohmann Selected Leghorn pullets were raised in 2 treatments: 4 pens (600 birds/pen) were raised with wire mesh ramps to aid movement between aviary tiers (RR) and 4 pens (600 birds/pen) were raised without ramps (RO). At 17 wk of age (WOA), birds were moved to the laying facility, in which 16 aviary pens with 225 birds/pen were populated. Half the pens (n = 8) were supplemented with wire mesh ramps (LR) and the other half were not (LO). Within each laying treatment group, 4 pens were populated with RR hens and 4 pens were populated with RO hens, creating 4 treatment combinations (RRLR, RRLO, ROLR, ROLO). From each pen, 15 focal hens were selected for radiographic imaging of their keel bones taken at 21, 36, 45, and 60 WOA and the images were subsequently scored for KBF severity. Focal hens were also scored for feather condition and footpad quality at 36 and 60 WOA using a standardized welfare assessment protocol. The number of downward transitions among aviary areas and falls were recorded at 19 to 20 and 30 to 31 WOA. Data were analyzed using (generalized) linear mixed models in R software. When ramps were available, they were used in most of the observed downward transitions (79% in ROLR and 86% in RRLR). Hens who received ramps in lay (i.e., RRLR and ROLR) showed more transitions immediately after lights on compared to midday or dusk phases (p < 0.001), performed more transitions from the first aviary tier compared to nest or top tier (p = 0.013) and had lower KBF severity than those who did not receive ramps in the laying aviaries (ROLO, RRLO; p < 0.001). At 60 WOA, hens in the RRLR treatment had greater feather coverage than those in ROLR and RRLO treatments (p < 0.001). Birds in the RRLR treatment had better foot health overall than those in treatments without ramps in lay (p = 0.018). Providing ramps to hens in aviaries appeared to be the preferred means of transitioning between aviary tiers though had positive effects on welfare parameters such as food health, feather coverage, and KBF severity, without negative impacts on production. Benefits were seen primarily when ramps were provided in lay, though their installation in rearing provided evidence of easier adaptation to the laying barn. Our study supports providing ramps throughout the lifetime of the bird to accommodate hens\' preferred means of moving vertically in aviaries and deliver consequent benefits to health and welfare.

Tanshinone, a lipophilic component of Salvia miltiorrhiza, is used to treat diseases like atherosclerosis, hypertension, Alzheimer\'s disease, and diabetes mellitus through its pharmacological activities like anti-inflammatory, anti-oxidant, and anti-tumor. Excessive inflammation is the primary cause of bone diseases such as osteoporosis and rheumatoid arthritis, affecting more than millions of people across the globe. Recently, tanshinone has shown potential benefits against bone diseases by modulating signaling pathways accountable for the proliferation and differentiation of bone cells. In vitro and in vivo studies reported that tanshinone promotes osteoblast formation and mineralization and suppresses excessive bone resorption during disease conditions. In this review, we have summarized the beneficial effects of tanshinone and other extracts of Salvia miltiorrhiza for bone health and their potential molecular targets in signaling.

BACKGROUND: The bone status of postmenopausal women is worsening. In fact, postmenopausal period is the high incidence stage of osteoporosis and falls. Notably, a recent study has pointed out that exercise can improve bone health in postmenopausal women. However, the effect of Tai Chi exercise on postmenopausal women is controversial. Therefore, a meta-analysis was designed to analyze the effect of Tai Chi exercise on bone health and fall prevention in postmenopausal women.
METHODS: The researches on Tai Chi improving the bone health of postmenopausal women before August 31, 2023 were collected from Chinese and English databases, such as PubMed, Embase, and Web of Science, etc. The risk of bias of the included studies was assessed using the Cochrane risk-of-bias tool for randomized trials. Besides, R software 4.3.1 was employed to analyze the effect sizes in the meta-analysis to summarize the impact of Tai Chi on vertebral bone mineral density, serum calcium, clinical balance scores, the number of falls, total falls, and health status scores in postmenopausal women.
RESULTS: There were 12 studies eventually included in this meta-analysis. A total of 1,272 postmenopausal women were involved, including 628 in the experimental group (intervention with Tai Chi exercise) and 644 in the control group (without any intervention). Briefly, postmenopausal women practicing Tai Chi presented a significant increase in vertebral bone density [standardized mean difference (SMD) = 0.37, 95% confidence interval (CI) (0.04-0.71), P = 0.03] and health status score [SMD = 0.25, 95% CI (0.01-0.49), P = 0.04]. In contrast, there were no significant differences for postmenopausal women between the two groups in terms of serum calcium [SMD = -0.01, 95% CI (-0.39, 0.36), P = 0.77], clinical balance [SMD = 0.17, 95% CI (-0.01, 0.46), P = 0.23], number of falls [SMD = -0.61, 95% CI (-1.24, 0.02), P = 0.06] and total falls [odds ratio = 0.35, 95% CI (0.11-1.12), P = 0.07].
CONCLUSIONS: Tai Chi exercise can improve the bone mineral density of postmenopausal women, thereby maintaining bone health. Hence, Tai Chi exercise is necessary to prevent osteoporosis.

Osteoporosis in menopausal women requires alternatives to current medications, considering their adverse effects. In this context, probiotics and isoflavone products are promising dietary interventions. The objective of our study was to examine the impacts of Lactobacillus acidophilus and its combination with daidzein and tempeh on calcium status, calcium transporters, and bone metabolism biomarkers in a post-menopausal osteoporotic rat model. A total of 48 female Wistar rats were exposed to a two-stage experiment involving calcium deficit induction and subsequent dietary interventions across six groups. Calcium levels, the gene expression of TRPV5 and TRPV6 calcium transporters, bone histopathology, serum bone metabolism markers, and blood biochemistry were evaluated. The results revealed that, while decreasing serum calcium levels, the groups that received the probiotic L. acidophilus and isoflavone combination exhibited increased bone metabolism biomarkers and decreased calcium transporter expressions, akin to the effects of bisphosphonate. Additionally, significant improvements in bone histopathology were observed in these groups. However, the group receiving probiotic L. acidophilus alone did not exhibit significant changes in bone resorption biomarkers, calcium transporter expression, or various blood parameters. Meanwhile, the combination of probiotic L. acidophilus with tempeh positively influenced hematological parameters and reduced cholesterol and triglyceride levels, but it led to elevated blood glucose levels. Correlation analyses highlighted associations between serum calcium levels, calcium transporter expression, and bone metabolism biomarkers. In conclusion, our findings suggest that the daily consumption of probiotic L. acidophilus in combination with isoflavone products may improve bone health in ovariectomized rats, warranting further research to elucidate potential interactions with other nutrients.

In people with chronic kidney disease (CKD), the physiology of vitamin D is altered and leads to abnormalities in bone and mineral metabolism which contribute to CKD mineral and bone disorder (CKD-MBD). Observational studies show an association between vitamin D deficiency and increased risk of mortality, cardiovascular disease and fracture in CKD. Although vitamin D therapy is widely prescribed in people with CKD, clinical trials to date have failed to demonstrate a clear benefit of either nutritional vitamin D supplementation or active vitamin D therapy in improving clinical outcomes in CKD. This review provides an updated critical analysis of recent trial evidence on vitamin D therapy in people with CKD.

OBJECTIVE: The relationship between body fat mass and bone mineral density (BMD) remains controversial. This research aimed to explore the linear or non-linear relationship between body fat mass and BMD among adults in the United States.
METHODS: This cross-sectional study identified adults aged 18 years or older in the National Health and Nutrition Examination Survey from 2011 to 2018. After adjusting for covariates, linear relationships between body fat mass and BMD in different genders were tested by generalized linear models, and potential non-linear relationships were explored by generalized additive models and piecewise linear regression models.
RESULTS: The research included 4691 (57.9% of the total sample) males and 3417 (42.1% the of total sample) females. In both males and females, we found a negative association between android or total body fat mass and lumbar spine BMD and a positive association between appendicular, android, gynoid, or total body fat mass and whole body BMD (all P < 0.05). The relationships between body fat mass in all regions and lumbar spine BMD were U-shaped in males and inverted U-shaped in females (all Pnon-linear < 0.05). Inverted U-shaped relationships existed between body fat mass in all regions and whole body BMD in females (all Pnon-linear < 0.05).
CONCLUSIONS: Body fat mass was negatively and linearly associated with lumbar spine BMD, but positively associated with whole body BMD. Body fat mass had a U-shaped relationship with lumbar spine BMD in males and an inverted U-shaped association with lumbar spine and whole body BMD in females.

BACKGROUND: Exercise reduces adiposity, but its influence on bone marrow fat fraction (BMFF) is unknown; nor is it known whether a reduction in liver fat content mediates this reduction.
OBJECTIVE: (i) To determine whether incorporating exercise into a lifestyle program reduces the lumbar spine (LS)-BMFF, and (ii), to investigate whether changes in liver fat mediate any such effect.
METHODS: Ancillary analysis of a two-arm, parallel, non-randomized clinical trial.
METHODS: Primary care centres in Vitoria-Gasteiz (Spain).
METHODS: A total of 116 children with overweight/obesity were assigned to a 22-week family-based lifestyle program (control group [n=57]) or the same program plus an exercise intervention (exercise group [n=59].
METHODS: The compared interventions consisted of a family-based lifestyle program (two 90-minute sessions/month) and the same program plus supervised exercise (three 90-minute sessions/week).
METHODS: The primary outcome examined was the change in LS-BMFF between baseline and 22 weeks, as estimated by MRI. The effect of changes in hepatic fat on LS-BMFF were also recorded.
RESULTS: Mean weight loss difference between groups was 1.4±0.5 kg favour of the exercise group. Only the children in the exercise group experienced a reduction in LS-BMFF (effect size [Cohen d] -0.42, CI: -0.86, -0.01). Importantly, 40.9% of the reductions in LS-BMFF were mediated by changes in percentage hepatic fat (indirect effect: β=-0.104, 95%CI=-0.213, -0.019). The impact of changes in hepatic fat on LS-BMFF was independent of weight loss.
CONCLUSIONS: The addition of exercise to a family-based lifestyle program designed to reduce cardiometabolic risk improves bone health by reducing LS-BMFF in children with overweight or obesity. This beneficial effect on bone marrow appears to be mediated by reductions in liver fat.

UNASSIGNED: The Consortium for Spinal Cord Medicine\'s inaugural Clinical Practice Guideline for Bone Health and Osteoporosis Management for Individuals with Spinal Cord Injury or Disease (CSCM-CPG) was published in 2022 for a clinician audience. The aim of this project was to develop a podcast series to ensure people with lived experience with Spinal Cord Injury or Disease (PLEX) understand the CSCM-CPG content and know how to act to reduce their fracture risk.
UNASSIGNED: The \"Bare Bones Podcast Series\" consists of nine episodes; one related to each CSCM-CPG chapter. The podcast content and the questions asked in each podcast were co-developed by PLEX partners (PLEX-P) and the project team. Two PLEX-P acted as co-hosts for the series. The invited speaker(s) were CSCM-CPG expert panel members who participated in an informal dialogue with the hosts. Each podcast closes with a specific action a listener can do to advance their bone health. The related Educational Action Planning Tool (EAT) handouts contain text and infographic information specific to each podcast episode and include key concepts and a specific actionable take-home message. Local PLEX reviewers (PLEX-R) were invited to review podcast episodes and EATs and provide their feedback through focus group participation or one-on-one (1:1) interviews. The project team revised the podcast episodes and the EATs based on feedback from the PLEX-R prior to releasing them online.
UNASSIGNED: Nine podcast episodes and related EATs were designed and created collaboratively with 3 PLEX-P, 22 PLEX-R, 11 CSCM-CPG expert panel members, and the project team. The episodes were titled: \"Introduction to the Bare Bones of Bone Health\"; \"Fracture 101\"; \"Blood Tests-a Window into You\"; \"I See Your Skeleton\"; \"Vitamin D for all, Calcium for Some\"; \"Get Moving and Loading\"; \"Pills or Poisons & Atomic Habits\"; \"Snap and Crack\"; and \"Directions for Research\". The Bare Bones Podcast Series was shared through the project website.
UNASSIGNED: The podcasts will aid PLEX and their family caregivers to advocate for ongoing bone health assessments and to promote an ongoing dialogue with care team members regarding how to prevent fractures and fracture-related morbidity and mortality.

The primary aim of this study was to explore the effects of team sports practice on bone health indices in adults engaged in team sports. The secondary aim was to investigate the osteogenic effects of each type of team sport. This systematic literature search was conducted using common electronic databases from inception in June 2023, using key terms (and synonyms searched for by the MeSH database) that were combined using the operators \"AND\", \"OR\", \"NOT\": (``men\'\' OR ``man\'\' OR ``women\'\' OR ``woman\'\') AND (``bone mineral density\'\' OR ``BMD\'\' OR ``bone mineral content\'\' OR ``BMC\'\' OR ``peak bone mass\'\' OR ``mechanical loading\'\' OR ``osteoporosis\'\' OR ``bone geometry\'\' OR ``bone resistance\'\') AND (``team sport\'\' OR ``sport\'\' OR rugby OR basketball OR volleyball OR handball OR soccer OR football OR ``players\'\'). After screening, 16 studies were included in the final analysis (5 continents, 2740 participants). The training duration lasted 1 to 13 years. Team sport training had a moderate impact on whole body bone mineral density (WB BMD) (1.07 SMD; 95 % [0.77, 1.37], p < 0.00) but a more significant impact on whole body bone mineral content (WB BMC) (1.3 SMD; 95 % [0.81, 1.79], p < 0.00). Subgroup analyses indicated that rugby training had a moderate but non-significant impact on WB BMD (1.19 SMD; 95 % [-0.13, 2.52], p = 0.08) but a greater impact on WB BMC (2.12 SMD; 95 % [0.84, 3.39], p < 0.00); basketball training had a moderate but significant impact on WB BMD (1 SMD; 95 % [0.35, 1.64], p < 0.00) and a trivial non-significant impact on WB BMC (0.18 SMD; 95 % [-1.09, 1.46], p = 0.78); volleyball training had a moderate but non-significant impact on WB BMD (0.63 SMD; 95 % [-0.22, 1.49], p = 0.15) and a significant impact on WB BMC (2.39 SMD; 95 % [1.45, 3.33], p < 0.00). Handball training produced a moderate significant impact on WB BMD (1.02 SMD; 95 % [0.33, 1.71], p < 0.00) and WB BMC (0.97 SMD; 95 % [0.47, 1.48], p < 0.00), and soccer training led to moderate but significant effects on WB BMD (1.16 SMD; 95 % [0.88, 1.44], p < 0.00) and a large effect on WB BMC (1.34 SMD; 95 % [0.92, 1.77], p < 0.00). Rugby training was associated with a higher WB BMC compared to basketball training (p = 0.03). Our systematic review and meta-analysis suggests that team sports, such as rugby, basketball, volleyball, handball and soccer have moderate to large effects on WB BMD and WB BMC. Specifically, our findings indicate that handball and soccer enhance WB BMD and WB BMC, whereas rugby only increases WB BMC. There is currently insufficient evidence indicating the superiority of any type of sport training that improves bone health in adults.

Sports endocrinology holds a unique importance in understanding and optimizing an active and healthy lifestyle. Active patients with diabetes will need to consider modifying medications, especially insulin. The use of the dual energy x-ray absorptiometry and Fracture Risk Assessment Tool scores is important as both initiate and monitor bone health treatment. Menstrual disorders and energy imbalances are some special concerns when treating female athletes, calling for a multidisciplinary treatment team. Performance agents are popular and have made their way into recreational sports.