Patients with diffuse idiopathic skeletal hyperostosis do not have increased peripheral bone mineral density and geometry

Recent studies have suggested that areal BMD (aBMD) measured by DXA is elevated in patients with DISH. We used peripheral QCT (pQCT) to assess volumetric BMD (vBMD) and bone geometry of the radius, tibia and the third metacarpal bone.

Prediction of bone strength at the distal tibia by HR-pQCT and DXA

Areal bone mineral density (aBMD) at the distal tibia, measured at the epiphysis (T-EPI) and diaphysis (T-DIA), is predictive for fracture risk. Structural bone parameters evaluated at the distal tibia by high resolution peripheral quantitative computed tomography (HR-pQCT) displayed differences between healthy and fracture patients. With its simple geometry, T-DIA may allow investigating the correlation between bone structural parameter and bone strength.

Human-environment interactions in pre-Columbian Amazonia: The case of the Llanos de Moxos, Bolivia

The reconstruction of past environmental and historical events is much needed in Amazonia, a region at the centre of heated debates about the extent of pre-Columbian human disturbance of the natural ecosystems. Important aspects of this debate are to establish to what extent the rise of social complexity was influenced by the local geo-ecology; and what productive strategies were adopted in order to sustain these societies. The Llanos de Moxos (LM), in the Bolivian Amazon, is a vast floodplain made up of a variety of geo-ecological sub regions that host many different types of pre-Columbian earthworks. Therefore, it offers an excellent opportunity to compare different kinds of archaeological landscapes and their relationship to different pre-Columbian cultures and environmental settings. This paper analyses the links between pre-Columbian earthworks and the local geo-ecology in two regions of the LM: 1) the platform field region (PFR) in the north of Santa Ana de Yacuma, where the highest concentration of raised fields has been documented, and 2) the monumental mounds region (MMR) south and east of Trinidad, where >100 pre-Columbian monumental mounds are found. The study draws from remote sensing and GIS analysis, field work in the Bolivian lowlands, and laboratory analysis. Differences in the way people transformed the landscape in the PFR and MMR seem to respond to differences in the local geo-ecology of the two sites. The results also suggest that environmental conditions exerted an important, though not exclusive, control over the levels of social complexity that were reached in different areas of the LM.

English in England

The intention of the present volume is to unite the research of a range of scholars who have been working on features of non-standard, vernacular English which show an areal distribution, i.e. which cluster geographically across the world. Features common to an area can be due to (i) shared dialect input, (ii) common but separate innovations after settlement, or (iii) area-internal diffusion from one variety to another and/or others. The relative weighting of these factors is an important topic in the book and is a key focus in the 17 chapters. The book is divided into two large blocks, the first one consisting of case studies (8 chapters) and the second with features complexes (9 chapters). The former look at major anglophone locations from an areal perspective while the latter examine linguistic categories and features with a view to determine whether these could be areally based or not.

Finite element analysis for prediction of bone strength

Article preview View full access options BoneKEy Reports | Review Print Email Share/bookmark Finite element analysis for prediction of bone strength Philippe K Zysset, Enrico Dall'Ara, Peter Varga & Dieter H Pahr Affiliations Corresponding author BoneKEy Reports (2013) 2, Article number: 386 (2013) doi:10.1038/bonekey.2013.120 Received 03 January 2013 Accepted 25 June 2013 Published online 07 August 2013 Article tools Citation Reprints Rights & permissions Abstract Abstract• References• Author information Finite element (FE) analysis has been applied for the past 40 years to simulate the mechanical behavior of bone. Although several validation studies have been performed on specific anatomical sites and load cases, this study aims to review the predictability of human bone strength at the three major osteoporotic fracture sites quantified in recently completed in vitro studies at our former institute. Specifically, the performance of FE analysis based on clinical computer tomography (QCT) is compared with the ones of the current densitometric standards, bone mineral content, bone mineral density (BMD) and areal BMD (aBMD). Clinical fractures were produced in monotonic axial compression of the distal radii, vertebral sections and in side loading of the proximal femora. QCT-based FE models of the three bones were developed to simulate as closely as possible the boundary conditions of each experiment. For all sites, the FE methodology exhibited the lowest errors and the highest correlations in predicting the experimental bone strength. Likely due to the improved CT image resolution, the quality of the FE prediction in the peripheral skeleton using high-resolution peripheral CT was superior to that in the axial skeleton with whole-body QCT. Because of its projective and scalar nature, the performance of aBMD in predicting bone strength depended on loading mode and was significantly inferior to FE in axial compression of radial or vertebral sections but not significantly inferior to FE in side loading of the femur. Considering the cumulated evidence from the published validation studies, it is concluded that FE models provide the most reliable surrogates of bone strength at any of the three fracture sites.

DensiProbe Spine: an intraoperative measurement of bone quality in spinal instrumentation. A clinical feasibility study

BACKGROUND CONTEXT A new device, DensiProbe, has been developed to provide surgeons with intraoperative information about bone strength by measuring the peak breakaway torque. In cases of low bone quality, the treatment can be adapted to the patient's condition, for example, by improving screw-anchorage with augmentation techniques. PURPOSE The objective of this study was to investigate the feasibility of DensiProbe Spine in patients undergoing transpedicular fixation. STUDY DESIGN Prospective feasibility study on consecutive patients. PATIENT SAMPLE Fourteen women and 16 men were included in this study. OUTCOME MEASURES Local and general bone quality. METHODS These consecutive patients scheduled for transpedicular fixation were evaluated for bone mineral density (BMD), which was measured globally by dual-energy X-ray absorptiometry and locally via biopsies using quantitative microcomputed tomography. The breakaway torque force within the vertebral body was assessed intraoperatively via the transpedicular approach with the DensiProbe Spine. The results were correlated with the areal BMD at the lumbar spine and the local volumetric BMD (vBMD) and a subjective impression of bone strength. The feasibility of the method was evaluated, and the clinical and radiological performance was evaluated over a 1-year follow-up. This study was funded by an AO Spine research grant; DensiProbe was developed at the AO Research Institute Davos, Switzerland; the AO Foundation is owner of the intellectual property rights. RESULTS In 30 patients, 69 vertebral levels were examined. The breakaway torque consistently correlated with an experienced surgeon's quantified impression of resistance as well as with vBMD of the same vertebra. Beyond a marginal prolongation of surgery time, no adverse events related to the usage of the device were observed. CONCLUSIONS The intraoperative transpedicular measurement of the peak breakaway torque was technically feasible, safe, and reliably predictive of local vBMD during dorsal spinal instrumentations in a clinical setting. Larger studies are needed to define specific thresholds that indicate a need for the augmentation or instrumentation of additional levels.

Are great Cascadia earthquakes recorded in the sedimentary records from small forearc lakes?

Here we investigate sedimentary records from four small inland lakes located in the southern Cascadia forearc region for evidence of earthquakes. Three of these lakes are in the Klamath Mountains near the Oregon–California border, and one is in the central Oregon Coast range. The sedimentary sequences recovered from these lakes are composed of normal lake sediment interbedded with disturbance event layers. The thickest of these layers are graded, and appear to be turbidites or linked debrites (turbidites with a basal debris-flow deposit), suggesting rapid deposition. Variations in particle size and organic content of these layers are reflected in the density and magnetic susceptibility data. The frequency and timing of these events, based on radiocarbon ages from detrital organics, is similar to the offshore seismogenic turbidite record from trench and slope basin cores along the Cascadia margin. Stratigraphic correlation of these anomalous deposits based on radiocarbon ages, down-core density, and magnetic susceptibility data between lake and offshore records suggest synchronous triggering. The areal extent and multiple depositional environments over which these events appear to correlate suggest that these deposits were most likely caused by shaking during great Cascadia earthquakes.

DXA predictions of human femoral mechanical properties depend on the load configuration

The aim of this study was to evaluate the ability of dual energy X-rays absorptiometry (DXA) areal bone mineral density (aBMD) measured in different regions of the proximal part of the human femur for predicting the mechanical properties of matched proximal femora tested in two different loading configurations. 36 pairs of fresh frozen femora were DXA scanned and tested until failure in two loading configurations: a fall on the side or a one-legged standing. The ability of the DXA output from four different regions of the proximal femur in predicting the femoral mechanical properties was measured and compared for the two loading scenarios. The femoral neck DXA BMD was best correlated to the femoral ultimate force for both configurations and predicted significantly better femoral failure load (R2=0.80 vs. R2=0.66, P<0.05) when simulating a side than when simulating a standing configuration. Conversely, the work to failure was predicted similarly for both loading configurations (R2=0.54 vs. R2=0.53, P>0.05). Therefore, neck BMD should be considered as one of the key factors for discriminating femoral fracture risk in vivo. Moreover, the better predictive ability of neck BMD for femoral strength if tested in a fall compared to a one-legged stance configuration suggests that DXA's clinical relevance may not be as high for spontaneous femoral fractures than for fractures associated to a fall.