Obstetric management for pregnant women with Klippel-Trenaunay syndrome: A UK case report and review of the literature.

Klippel-Trenaunay Syndrome (KTS) is a rare congenital vascular disorder characterized by extensive capillary and venous malformations that pose unique challenges during pregnancy. This case report discusses the successful management of a 34-year-old pregnant woman with KTS who had two caesarean sections, resulting in the birth of two healthy babies. Despite the lack of evidence-based guidelines for obstetrical management in KTS, a multidisciplinary team collaborated to devise a high-risk thrombosis management plan, involving the use of compression stocking and low molecular weight heparin prophylaxis. The patient's elevated risk of thrombosis, exacerbated during pregnancy, informed the decision of caesarean sections, aligning with finding that in most KTS pregnancies, this method of delivery based on obstetric indications and arteriovenous malformations is chosen. This case highlights the importance of systematic and patient-centered care, advocating for comprehensive obstetric management guidelines to address the unique challenges posed by KTS during pregnancy. Further research is warranted to enhance our understanding and refine guidelines for individuals with vascular abnormalities linked to KTS.

Cognitive outcomes in late-onset versus adult-onset Multiple Sclerosis.

INTRODUCTION: Recent studies show that cognitive impairment is more prevalent in older patients with Multiple Sclerosis (MS). However, whether this is the result of several years of a chronic disease or specific age-related changes is still unclear. Therefore, we aim to assess the outcomes in both classic and social cognition in late-onset MS (LOMS) and compare them to adult-onset MS (AOMS) when accounting for age and disease duration. METHODS: In this cross-sectional study, a group of 27 LOMS patients (age of disease onset >50 years) was compared with patients with AOMS (age of disease onset between 18 and 50 years). Patients with AOMS were grouped based on age (AOAMS, n = 27) and on disease duration (AODMS, n = 27) in order that these variables are matched with LOMS. Their cognitive performance was evaluated using the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) and the Revised "Reading the Mind in the Eyes" Test (RMET). Clinical and demographic variables were collected and analysed. RESULTS: In general, both classic and social cognitive performance was inferior in the LOMS group when accounting for age and disease duration. We found a statistically significant negative correlation between age of disease onset and performance in all cognitive domains except for verbal memory. The presence of at least one vascular risk factor (VRF) was associated with slower information-processing speed (SDMT) (p = 0.006) and poorer RMET performance (p = 0.020). DISCUSSION: A later age of MS is associated with worse cognitive functioning possibly due to the loss of neuroplasticity in an already aged brain. CONCLUSION: Patients with LOMS have worse cognitive outcomes than AOMS in both classic and social domains, especially when associated with the presence of VRF. Hence, health care providers and patients should not undervalue the importance of cognitive stimulating activities, management of VFR and socialization in this specific group of patients.

A Proteogenomic Pipeline for the Analysis of Protein Biosynthesis Errors in the Human Pathogen Candida albicans.

Candida albicans is a diploid pathogen known for its ability to live as a commensal fungus in healthy individuals but causing both superficial infections and disseminated candidiasis in immunocompromised patients where it is associated with high morbidity and mortality. Its success in colonizing the human host is attributed to a wide range of virulence traits that modulate interactions between the host and the pathogen, such as optimal growth rate at 37 °C, the ability to switch between yeast and hyphal forms, and a remarkable genomic and phenotypic plasticity. A fascinating aspect of its biology is a prominent heterogeneous proteome that arises from frequent genomic rearrangements, high allelic variation, and high levels of amino acid misincorporations in proteins. This leads to increased morphological and physiological phenotypic diversity of high adaptive potential, but the scope of such protein mistranslation is poorly understood due to technical difficulties in detecting and quantifying amino acid misincorporation events in complex protein samples. We have developed and optimized mass spectrometry and bioinformatics pipelines capable of identifying rare amino acid misincorporation events at the proteome level. We have also analyzed the proteomic profile of an engineered C. albicans strain that exhibits high level of leucine misincorporation at protein CUG sites and employed an in vivo quantitative gain-of-function fluorescence reporter system to validate our LC-MS/MS data. C. albicans misincorporates amino acids above the background level at protein sites of diverse codons, particularly at CUG, confirming our previous data on the quantification of leucine incorporation at single CUG sites of recombinant reporter proteins, but increasing misincorporation of Leucine at these sites does not alter the translational fidelity of the other codons. These findings indicate that the C. albicans statistical proteome exceeds prior estimates, suggesting that its highly plastic phenome may also be modulated by environmental factors due to translational ambiguity.

Is There Evidence of Crohn's Disease Exclusion Diet (CDED) in Remission of Active Disease in Children and Adults? A Systematic Review.

Crohn's disease (CD) is an inflammatory bowel disease. Previous research has explored the impact of diet on CD, as specific dietary components can influence gut microbiota and immune responses, contributing to damage in the gastrointestinal tract. The Crohn's Disease Exclusion Diet (CDED) is based on an exclusion diet; it is a recent dietary approach that is often used alongside partial enteral nutrition (PEN) and aims to induce disease remission by excluding certain dietary components. This study assesses the current evidence for the effectiveness of the CDED + PEN in achieving remission in both children and adults with active CD. Our systematic review followed PRISMA recommendations and was registered in PROSPERO with CRD number 42022335076. The searched databases were PubMed/MEDLINE, Cochrane Library, Scopus, and Web of Science. The included studies were analyzed using Rayyan software, and the risk of bias was assessed with Cochrane RevMan 5.0 software. The primary assessed outcome was clinical remission, evaluated with validated questionnaire scores such as PCDAI, CDAI, or HBI. All analyzed papers yielded promising results. Notably, the CDED + PEN demonstrated better tolerance than exclusive enteral nutrition (EEN), resulting in higher adherence rates. Therefore, the CDED + PEN appears to be a viable alternative for induction remission in active disease for both children and adults with CD.

Cardiorespiratory fitness and muscular fitness correlates in youth: A hierarchy of behavioral, contextual, and health-related outcomes.

OBJECTIVES: Despite the health importance of identifying correlates of physical fitness in youth, no investigation to date has explored the influence of behavioral, health-related, and contextual correlates simultaneously. We investigated the hierarchical relationship of multiple modifiable correlates favoring or diminishing cardiorespiratory and muscular fitness in youth. DESIGN: Cross-sectional investigation. METHODS: In a sample of 5174 children and adolescents, 31 correlates were hierarchized according to their impact on cardiorespiratory and muscular fitness assessed using the FITESCOLA® fitness battery. A Chi-squared Automatic Interaction Detection approach was employed and measures of correlation and association were used to investigate the relationship between physical fitness and correlates. RESULTS: In children, body mass index was the most relevant factor to discriminate between high and low cardiorespiratory and muscular fitness of the upper, middle, and lower body. While body mass index was more important than any other correlate to differentiate levels of upper and lower body muscular fitness during adolescence, specific characteristics of sports participation emerged as key factors to discriminate between high and low cardiorespiratory fitness and middle body muscular fitness. Other correlates, including the self-report of active recess time, active commuting to school, favorable neighborhood conditions, and limited time on screens and cellphones, were demonstrative of favorable physical fitness levels. CONCLUSIONS: Both body composition and sports-related characteristics emerged as the two most relevant factors of physical fitness in youth. Additional health benefits may be obtained from building supportive environments for sports and healthy exercise habits within the household and at different school education levels.

Natalizumab extended interval dosing: what about wearing-off effect?

BACKGROUND: Up to two thirds of patients with multiple sclerosis (MS) under natalizumab report a resurgence of symptoms at the end of the natalizumab cycle (wearing-off (WO) effect). At the outbreak of COVID-19, in line with the international recommendations for MS management, our centre switched all clinically stable patients on natalizumab therapy for more than one year from standard interval dosing (SID) to extended interval dosing (EID) with every six weeks infusions. This study aimed to evaluate the impact of EID in WO in MS patients under natalizumab. METHODS: An observational retrospective study in patients with MS under natalizumab on EID was conducted. A questionnaire regarding current (on EID) and past (on SID) experience of WO effect was applied. RESULTS: Seventy-six patients were included. No significant differences were found in the annual relapse rate after the switch to EID (p = 0.083). However, there was a significant increase in the proportion of patients complaining of WO from 38.2% to 56.6% (p = 0.001). Moreover, patients with WO on SID, referred a significant increase in severity (p = 0.019) and duration of WO symptoms (p = 0.029), due to an anticipation of the symptoms relative to the day of natalizumab infusion (p = 0.019), when switching to EID. Symptoms improved with treatment maintenance in 23.3% of patients; instead, a reduction in interval dosing was needed in 54.8% with symptom improvement. CONCLUSION: WO affects a significant proportion of MS patients under natalizumab. Its prevalence, severity, and duration increase on EID, therefore despite clinical effectiveness maintenance of this posology should be individualized.

Limb-specific isometric and isokinetic strength in adults: The potential role of regional bioelectrical impedance analysis-derived phase angle.

BACKGROUND & AIMS: It is not yet known whether regional bioelectrical impedance (BIA) phase angle (PhA) may be informative of different types of strength performed by the lower and upper limbs, independently of lean soft tissue mass (LSTM). Using a sample of healthy adults, we aimed to examine the association and relevance of regional PhA relative to isometric and isokinetic strength of each limb. METHODS: A total of 57 participants (32.7 ± 12.9 years; 24.7 ± 3.5 kg/m2) were included in the present investigation. Regional raw BIA variables were determined using a phase-sensitive BIA device. Dual-energy X-ray absorptiometry was used to evaluate LSTM. Absolute isometric and isokinetic (i.e., 60°/s and 180°/s) strength of each limb (extension and flexion) was assessed using an isokinetic dynamometer and used to calculate relative strength. RESULTS: In absolute strength, only dominant leg PhA was associated with isometric extension strength (ß = 0.283) and isokinetic 180°/s flexion strength (ß = 0.354), regardless of LSTM (p < 0.05). In relative strength, a significant association of regional PhA was found for dominant arm flexion isometric strength (ß = 0.336), and non-dominant arm and dominant leg extension isometric strength (ß = 0.377, ß = 0.565, respectively; p < 0.05), independently of LSTM. Similarly, for isokinetic 180°/s strength, regional PhA significantly explained the variance in the relative strength of both arms and dominant leg (ß = 0.350 to 0.506), regardless of LSTM (p < 0.05). Relative isokinetic 60°/s strength was not consistently associated with regional PhA (p ≥ 0.05). CONCLUSIONS: Regional PhA significantly explained relative (isometric and 180°/s isokinetic strength of both arms and dominant leg), but not absolute muscle strength, independently of regional LSTM. Thus, after accounting for body size, regional PhA seems to have its own characteristics that explain relative strength independently of LSTM.

Prevalence, Incidence, and Mortality of Multiple Sclerosis in Coimbra, Portugal.

Multiple sclerosis (MS) is the most common chronic inflammatory, demyelinating, and neurodegenerative disease of the central nervous system in young adults, representing the leading cause of nontraumatic disability in this population. The rising prevalence of MS worldwide makes it critical to recognize the absolute number of patients with MS, demanding the execution of a sustainable healthcare policy. In Portugal, only six studies evaluating MS rates were published, disclosing a prevalence of 64 cases per 100,000 persons and an incidence of 3.1 cases per 100,000 persons/year, but the mortality rates have not been reported. Thus, this observational, cross-sectional study aimed to assess MS prevalence, incidence, and mortality in the city of Coimbra, a region in the center of Portugal. Patients who fulfilled McDonald's Diagnosis Criteria (2017) for MS were recruited. Inclusion criteria were defined according to prevalence, incidence, and mortality studies. The baseline demographic and clinical characterization of the prevalence study population was performed. The MS prevalence rate in Coimbra was 143.45 cases per 100,000 inhabitants. Between 2018 and 2021, the cumulative incidence was 8.52 new cases per 100,000 persons/year. The mortality rate between 2018 and 2021 was 2.84 deaths per 100,000 inhabitants. MS prevalence and incidence in Coimbra are higher than reported in previous similar studies and comparable to Europe's mean prevalence and incidence.

Functional fitness trends among older adults in Portugal between 2008 and 2018: Keeping up with a healthy aging process.

OBJECTIVES: Maintaining a healthy aging process is vital to combating and delaying the adverse health outcomes faced by the growing older adult population, where a key aspect to achieving healthy aging is the preservation of functional fitness. This study aims to present trends on the functional fitness of Portuguese older adults between 2008 and 2018 and build new normative reference standards for the Senior Fitness Battery Tests. DESIGN: Cross-sectional study. METHODS: Functional fitness was measured with the Senior Fitness Battery Tests in two national representative cohorts of the Portuguese older adult population (≥65 years) using the 2008 (n = 4712) and 2018 (n = 2717) surveys. Changes were assessed according to sex and age group. Sex and age-group normative fitness scores were developed. RESULTS: Overall findings suggested that older adults' point prevalence for arm-curl, 8-ft up-and-go, and 30-s chair sit-to-stand remained stable between 2008 and 2018, with declining trends being observed for the 6-min walk and back-scratch tests. However, results for trends varied when stratified by sex and age categories. CONCLUSIONS: Our results suggest a trend toward a stabilization of most of the functional fitness tests over the past decade, but with a critical decline in the 6-min walk test. Thus, this test should be targeted by future health-care policies. Moreover, this investigation provides new and updated normative reference standards for the Senior Fitness Battery Tests that should be used as a tool to promote a healthy aging process among Portuguese older adults.

Effects of exercise training on cancer patients undergoing neoadjuvant treatment: A systematic review.

OBJECTIVES: This systematic review aimed to analyze the effects of different exercise protocols on physical fitness (cardiorespiratory fitness, muscle strength, and body composition), quality of life, cancer-related fatigue, and sleep quality in patients with different types of cancer undergoing neoadjuvant treatment. DESIGN: Systematic review. METHOD: A comprehensive search of existing literature was carried out using four electronic databases: PubMed, Scopus, Web of Science, and Cochrane Library (published until October 19, 2022). All databases were searched for randomized controlled trials, quasi-experimental investigations, and pre-post investigations assessing the effects of exercise in cancer patients during neoadjuvant treatment. Excluded articles included multicomponent interventions, such as exercise plus diet or behavioral therapy, and investigations performed during adjuvant treatment or survivorship. The methodological quality of each study was assessed using the Physiotherapy Evidence Database (PEDro) scale. RESULTS: Twenty-seven trials involving 999 cancer patients were included in this review. The interventions were conducted in cancer patients undergoing neoadjuvant treatment for rectal (n = 11), breast (n = 5), pancreatic (n = 4), esophageal (n = 3), gastro-esophageal (n = 2), and prostate (n = 1) cancers, and leukemia (n = 1). Among the investigations included, 14 utilized combined exercise protocols, 11 utilized aerobic exercise, and two utilized both aerobic and resistance training separately. Exercise interventions appeared to improve cardiorespiratory fitness, muscle strength, body composition, and quality of life, although many investigations lacked a between-group analysis. CONCLUSION: Despite limited evidence, exercise interventions applied during neoadjuvant treatment demonstrate promising potential in enhancing cardiorespiratory fitness, muscle strength, body composition, and overall quality of life. However, a scarcity of evidence remains on the effects of exercise on cancer-related fatigue and sleep quality. Further research with high-quality randomized controlled trials is warranted.

Screening for diminished ovarian reserve in Portugal: a cost-saving answer to shorten the fertility journey.

Aim: Assess the budget impact of nationwide screening for diminished ovarian reserve (OR), via anti-Müllerian hormone (AMH) levels, to the Portugal National Health System (NHS). Patients & methods: The clinical journey was determined using literature and the family planning decision-making process/response using survey results. A panel of four local clinicians validated all assumptions/inputs. Results: Screening for OR led to an expected savings of € 9.4 million for the NHS, driven by a 24% reduction in medically assisted reproduction (MAR) use. When needed, referral for MAR was earlier and more women used first-line versus second-line techniques. The model estimated a 12% decrease in failure. Conclusion: This model shows AMH screening may allow more informed decisions, leading to a shorter fertility journey, more efficient use of treatments, and substantial cost-savings for the NHS.

Physical fitness trends in a nationally representative sample of Portuguese youth: What has changed from 2008 to 2018?

This investigation aimed to describe the current physical fitness (PF) status of Portuguese youth, compare secular trends from 2008 and 2018, and establish updated age- and sex-specific percentile values for distinct PF tests. In 2008 and 2018, 22 048 and 8960 children and adolescents (10-18 years) were included in two national cross-sectional investigations. PF was evaluated using the FITESCOLA® battery tests and the handgrip strength test. Independent sample t-tests and chi-squared tests were used to model the results. Weight smoothed percentile values were calculated using Cole's Lambda-Mu-Sigma (LMS) method. All analyses were weighted according to age, sex, and geographic region. In 2018, boys surpassed girls in the 20-m shuttle run, curl-ups, push-ups, standing long, and vertical jump tests, while girls performed better in the sit-and-reach (p < 0.05). The percentage of boys and girls meeting the healthy zone in the 20-min shuttle run test did not differ between 2008 and 2018 (p ≥ 0.05). In boys, a higher percentage fell in the healthy zone for the curl-up and push-up tests in 2018 compared to 2008 (85.8% vs. 83.4%, and 57.8% vs. 53.8%; p < 0.05). Girls improved their flexibility component (sit-and-reach test), with a higher percentage meeting the healthy zone in 2018 (32.6% vs. 36.9%; p < 0.05); an opposite trend was seen for boys (65.5% vs. 50.1%; p < 0.05). The present investigation provides new and updated PF percentile curves for Portuguese youth, which can be used as a general overview of the current PF state among the Portuguese young population.

Physical Activity and Sedentary Behavior in the Portuguese Population: What Has Changed from 2008 to 2018?

PURPOSE: Assessment of trends in physical activity (PA) and sedentary time (ST) is important for evaluating the effectiveness of national policies and setting goals to improve population PA. This study describes changes in measured PA and ST through motion sensors of the Portuguese population from 2008 to 2018. METHODS: PA and ST were measured with accelerometry from individuals (≥10 yr) participating in the 2008 ( n = 4 532) and 2018 ( n = 6 369) Portuguese PA Surveillance Systems. Changes were analyzed using generalized linear and logistic models adjusted for accelerometer wear time. A weight factor was applied to all analyses in order to achieve national representativeness of the present results. RESULTS: In 2018, 15.4%, 71.2%, and 30.6% of Portuguese youth, adults, and older adults met the PA recommendations. Compared with 2008, the percentage meeting the PA guidelines increased in youth females (4.7% vs 7.7%, P < 0.05) and adult males (72.2% vs 79.4%, P < 0.05). A decrease in ST was observed for adult males, whereas ST increased in all youth. Male youth decreased the number of breaks in ST (BST per hour), whereas a favorable increase was found for both adult and older adult males and females. CONCLUSIONS: PA has remained fairly stable between 2008 and 2018 for all groups, except for youth females and adult males. For ST, a favorable decrease was observed for adult males; however, an inverse trend was found in youth. These results are relevant for policy makers to develop health care policies aimed at promoting PA and reducing ST across all age-groups.

Effects of home-based exercise programs on physical fitness in cancer patients undergoing active treatment: A systematic review and meta-analysis of randomized controlled trials.

OBJECTIVES: This systematic review and meta-analysis aimed to investigate the effects of home-based exercise on physical fitness (cardiorespiratory fitness, muscle strength, and body composition) in cancer patients undergoing active treatment. DESIGN: Systematic review with meta-analysis and Grading Recommendations Assessment, Development, and Evaluation of the evidence. METHODS: A comprehensive search of existing literature was carried out in four electronic databases: PubMed, Web of Science, Scopus, and PEDro. All databases were searched for randomized controlled trials assessing the effects of home-based exercise on physical fitness outcomes in cancer patients during active treatment. Multicomponent interventions (i.e., exercise plus diet/behavioral therapy) were excluded. The methodological quality of each study was assessed using the Revised Cochrane risk-of-bias tool for randomized trials. Meta-analytical procedures were performed when appropriate and standardized mean differences (SMD) were calculated. RESULTS: Twenty-eight randomized controlled trials (n = 2424 cancer patients) were included. Most of the interventions were conducted in breast cancer patients (n = 13) during the adjuvant treatment period (n = 17); 18 studies included a walking component in their home-based protocol. Home-based exercise was effective at improving the distance of the 6-minute walk test (k = 6; SMD = 0.321, p = 0.010). However, the results were no longer significant when performing sensitivity analysis based on exclusively walking (k = 1) and non-exclusively walking interventions (k = 5; SMD = 0.258; p = 0.072). No effects were found for muscle strength and body composition outcomes (p > 0.05). CONCLUSIONS: Regular home-based exercise programs are an effective strategy to improve 6-minutes walk test in cancer patients undergoing active treatment. Conversely, no alterations were found in muscle strength and body composition.

Compensatory mechanisms from different exercise intensities in type 2 diabetes: a secondary analysis of a 1-year randomized controlled trial.

AIMS: This investigation aimed to determine the effect of different intensities of training on non-exercise physical activity (NEPA) and estimated thermogenesis (NEAT) from a 1-year exercise randomized controlled trial (RCT) in individuals with type 2 diabetes mellitus (T2DM) on non-training days. Additionally, changes in NEPA and estimated NEAT in those who failed (low-responders) or succeeded (high-responders) in attaining exercise-derived clinically meaningful reductions in body weight (BW) and fat mass (FM) (i.e., 6% for FM and 3% for BW) was assessed. METHODS: Individuals with T2DM (n = 80) were enrolled in a RCT with three groups: resistance training combined with moderate-intensity continuous training (MICT) or high-intensity interval training (HIIT) and a control group. Of the 80 participants, 56 (completed data) were considered for this secondary analysis. NEPA and estimated NEAT were obtained by accelerometry and body composition through dual-energy X-ray absorptiometry. RESULTS: After adjustments, no time*group interactions were found for estimated NEAT in the MICT (ß = - 5.33, p = 0.366) and HIIT (ß = - 5.70, p = 0.283), as well as for NEPA in the MICT (ß = - 452.83, p = 0.833) and HIIT (ß = - 2770.76, p = 0.201), when compared to controls. No compensatory changes in NEPA and estimated NEAT were observed when considering both low-responders and high-responders to FM and BW when compared to controls. CONCLUSIONS: Both MICT and HIIT did not result in any compensatory changes in estimated NEAT and NEPA with the intervention on non-training days. Moreover, no changes in estimated NEAT and NEPA were found when categorizing our participants as low-responders and high-responders to FM and BW when compared to controls. Trial registration clinicaltrials.gov ID. NCT03144505.

Breaking-Up Sedentary Behavior and Detraining Effects on Glycemic Control: A Randomized Crossover Trial in Trained Older Adults.

In a randomized crossover trial, we examined the effects of interrupting sedentary behavior on glycemic control in trained older adults, before and after 2 weeks of detraining. Fourteen participants (65-90 years old) completed two 7-hr conditions before and after 2 weeks of detraining: (a) uninterrupted sitting (SIT) and (b) sitting plus 2 min of moderate-intensity activity every 30 min (INT). Both before and after detraining, no differences were observed for 7-hr glucose area under the curve (7 hr AUC) and mean glucose between sitting plus 2 min of moderate-intensity activity and uninterrupted sitting conditions. After detraining and for the SIT condition, higher values of 7-hr AUC (p = .014) and mean glucose (p = .015) were observed, indicating worsened glycemic control. No changes were observed in INT condition between both time points. Frequent interruptions in sedentary behavior had no effect on glycemic control, prior to or after detraining. Even so, older adults experiencing a short-term detraining period should avoid prolonged bouts of sedentary behavior that may jeopardize their glycemic control.

Development and validation of bioelectrical impedance prediction equations estimating regional lean soft tissue mass in middle-aged adults.

BACKGROUND/OBJECTIVES: Bioelectrical impedance (BIA) whole-body and regional raw parameters have been used to develop prediction models to estimate whole-body lean soft tissue (LSTM), with less attention being given to the development of models for regional LSTM. Therefore, we aimed to develop and validate BIA-derived equations predicting regional LSTM against dual x-ray absorptiometry (DXA) in healthy adults. SUBJECTS/METHODS: 149 adults were included in this cross-sectional investigation. Whole-body and regional LSTM were assessed by DXA, and raw bioelectrical parameters of distinct body regions were measured using a 50 kHz phase sensitive BIA analyzer. BIA-derived equations were developed using a stepwise multiple linear regression approach in 2/3 of the sample and cross-validated in the remaining sample. RESULTS: Slopes and intercepts of predicted LSTM and DXA measured LSTM did not differ from 1 and 0, respectively, for each region (p ≥ 0.05), with the exception for the trunk (p < 0.05). The BIA-derived equations exhibited a strong relationship (p < 0.001) between the predicted and measured LSTM for each of the following body regions: right and left arms (R = 0.94; R = 0.96), right and left legs (R = 0.88; R = 0.88), upper body (R = 0.96), lower body (R = 0.89), right and left sides of the body (R = 0.94; R = 0.94), and trunk (R = 0.90). Agreement analyses revealed no associations between the differences and the means of the predicted and DXA-derived LSTM. CONCLUSION: The developed BIA-derived equations provide a valid estimate of regional LSTM in middle-aged healthy adults, representing a cost-effective and time-efficient alternative to DXA for the assessment and identification of LSTM imbalances in both clinical and sport-specific contexts.