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Bone loss below the level of neurological lesion is a well-known complication of spinal cord injury (SCI). To date, most research has focused on pharmaceutical intervention using antiresorptives to prevent bone loss during the acute phase of SCI; however, limited research has investigated treatments for established osteoporosis during chronic SCI. Romosozumab, a monoclonal antibody with both antiresorptive and anabolic effects, has demonstrated significant increases in BMD for women with established PMO. Therefore, the purpose of this study was to examine the efficacy of monthly treatment with romosozumab to improve DXA-derived areal BMD at the hip, and CT-derived BMC and strength at the hip and knee in women with chronic SCI and an inability to ambulate. Twelve female participants with chronic SCI were recruited to receive 1 yr of monthly subcutaneous injections of romosozumab (210 mg). DXA and CT scans were taken at baseline, and months 3, 6, and 12 to quantify bone mineral, and finite element (FE) analysis was used to predict bone strength. Longitudinal mixed effects models were employed to determine the impact of treatment on bone properties. After 12 mo of treatment, areal BMD at the lumbar spine and total hip were significantly increased with median changes of 10.2% (IQR: 8.3–15.2%, p <.001) and 4.2% (IQR: 3.4–7.7%, p  = .009), respectively. Improvements at the hip were primarily due to increases in trabecular, not cortical, bone and effects were sufficient to significantly increase FE-predicted strength by 20.3% (IQR: 9.5–37.0%, p  = .004). Treatment with romosozumab did not lead to any significant improvement in bone mineral at the distal femur or proximal tibia. These findings provide promising results for romosozumab treatment to improve bone mineral and reduce fracture risk at the hip, but not the knee, in women with chronic SCI. [ABSTRACT FROM AUTHOR]

The recipe for making Turkish coffee in some parts of former Yugoslavia calls for the dilution of the turbid liquid with lukewarm water just before the boiling point is reached. The enigmatic gastronomic purpose of this step notwithstanding, here it is being used as an inspiration for deriving a simple stabilization step for protocols for the synthesis of fine particle colloids. The dilution step inspired by coffee-making was performed in a protocol for the synthesis of hydroxyapatite nanoparticles by their precipitation from supersaturated alkaline aqueous solutions. The implementation of this step in the post-precipitation stage, concurrently with boiling, evidently improved the stability of the nanoparticle colloids. The stabilization effect was limited to the suspensions where the parent solution was equilibrated with the fresh precipitate and was not reproduced in colloids comprising HAp nanoparticles redispersed in deionized water. The dilution step produced a mild and counterintuitive increase in crystallinity, suggesting complex recrystallization mechanisms driven by mutually antagonistic dissolution caused by the dilution and reprecipitation caused by the heating to be responsible for the observed increase in stability. Incongruent dissolution favoring a less entropic surface order and reduced charge screening entailing the expansion of the Debye lengths were suggested as complementary mechanisms explaining the improvements in stability caused by adding this simple and economical, yet very efficacious touch to the synthesis. It is concluded that unconventional protocols in spheres other than the scientific and heritages routinely discarded as disreputable could be sources of insight relevant to a plethora of distant domains and disciplines. [ABSTRACT FROM AUTHOR]

Background: Aromatase inhibitor (AI) was received by breast cancer women with estrogen receptor-positive. The estrogen is the main stimulator for receptor-positive breast cancer cells development and growth, the adjuvant hormone ablation targeting estrogen can decrease the likelihood of cancer recurrence and prolong cancer-free survival. Objective: To determine the effect of this therapy on bone mineral density of women who received it. Patients and Methods: It was identified 100 women with local or regional breast cancer diagnosed and who received AI therapy in the January 2022 to February 2023 from Baqubah teaching hospital/Oncology Centre. It was used DEXA scan to determine the bone minerals density of 50 women after different years from receiving hormonal therapy and other 50 breast cancer women before receiving hormonal therapy. Results: It was shown that there is a significant difference (p<0.0001) in the spine and hip density of breast cancer women who received AIs compare with the bone density of other breast cancer women who did not receive it. Conclusion: It can conclude that Als plays an essential role for osteoporosis that reduce the quality of health and increase the risk of fraction in the breast cancer women. [ABSTRACT FROM AUTHOR]

This work used a straightforward solvent casting approach to synthesize bone whitlockite (WH) based PVA/Gelatin composites. WH nanoparticles (NPs) were synthesized using the wet precipitation method, followed by their addition into the PVA/Gelatin matrix at concentrations from 1% to 10%. The physicochemical characterization of the prepared PVA/Gelatin/WH composite was carried out using ATR-FTIR, Optical profilometry, a Goniometer, a Universal tensile testing machine (UTM), and scanning electron microscopy (SEM) techniques. The ATRFTIR analysis confirmed the formation of noncovalent interactions between polymeric chains and WH NPs and the incorporation of WH NPs into the polymer cavities. SEM analysis demonstrated increased surface roughness with the addition of WH NPs, supporting the results obtained through optical profilometry analysis. The mechanical properties of the prepared composite showed an increase in the tensile strength with the addition of WH filler up to 7% loading. The prepared composite has demonstrated an excellent swelling ability and surface wettability. The reported results demonstrate the exceptional potential of the prepared composite for bone tissue regeneration. [ABSTRACT FROM AUTHOR]

This work used a straightforward solvent casting approach to synthesize bone whitlockite (WH) based PVA/Gelatin composites. WH nanoparticles (NPs) were synthesized using the wet precipitation method, followed by their addition into the PVA/Gelatin matrix at concentrations from 1% to 10%. The physicochemical characterization of the prepared PVA/Gelatin/WH composite was carried out using ATR-FTIR, Optical profilometry, a Goniometer, a Universal tensile testing machine (UTM), and scanning electron microscopy (SEM) techniques. The ATR-FTIR analysis confirmed the formation of noncovalent interactions between polymeric chains and WH NPs and the incorporation of WH NPs into the polymer cavities. SEM analysis demonstrated increased surface roughness with the addition of WH NPs, supporting the results obtained through optical profilometry analysis. The mechanical properties of the prepared composite showed an increase in the tensile strength with the addition of WH filler up to 7% loading. The prepared composite has demonstrated an excellent swelling ability and surface wettability. The reported results demonstrate the exceptional potential of the prepared composite for bone tissue regeneration.

Pulsed electromagnetic field (PEMF), as a non-invasive, safe and effective physical therapy, is first applied in treating patients with delayed healing and non-union of fractures, and is now used as a clinical adjunct in the treatment of osteoporosis. In vitro and animal studies have demonstrated that PEMF stimulates bone formation by osteoblasts and inhibits bone resorption by osteoclasts, ultimately achieving structural integrity of bone and preservation of bone mass and bone strength. A large number of clinical studies have also shown that PEMF has satisfactory therapeutic effect on increasing bone mineral density, relieving pain, and improving life quality of patients with osteoporosis. However, the certainty of the positive effects of PEMF on osteoporosis still needs to be further investigated. In this review, we summarize the relevant clinical literature on PEMF for the treatment of osteoporosis in the domestic and overseas, and discuss the possible mechanisms, aiming to provide some reference for future clinical studies. [ABSTRACT FROM AUTHOR]

Summary: Rapid bone loss can occur after spinal cord injury (SCI) and a standard of care to prevent or treat this phenomenon is an active area of research. Using advanced analysis techniques, this study demonstrates that zoledronic acid, a possible treatment, prevented loss of bone strength at the hip following SCI. Introduction: Bone loss below the level of neurological lesion is a well-known complication of spinal cord injury (SCI), and effective preventive treatment for this phenomenon is an active area of research. Zoledronic acid has demonstrated efficacy to attenuate bone loss at the hip after SCI, but previous studies relied on measurements from dual-energy X-ray absorptiometry. The purpose of this investigation was to more thoroughly characterize changes to bone mineral and strength at the proximal femur in individuals receiving zoledronic acid in the acute SCI stage; we also examined the influence of ambulatory ability on bone outcomes. Methods: Participants randomized to either zoledronic acid (n = 29) or placebo (n = 30) received computed tomography (CT) scans and ambulatory assessments at baseline and 6 and 12 months following drug infusion. CT-based finite element (FE) modeling was used to predict changes in proximal femoral strength associated with treatment. Results: After 12 months, FE-predicted bone strength was reduced by a mean (SD) of 9.6 (17.9)% in the zoledronic acid group versus 24.6 (24.5)% in the placebo group (p = 0.007). These differences in strength were explained by reductions in CT measurements of both trabecular (p < 0.001) and cortical (p ≤ 0.021) bone at the femoral neck and trochanteric region. Ambulation ability influenced select trabecular and cortical parameters, but we were unable to detect an impact on FE-predicted bone strength. Conclusion: These findings demonstrate that treatment with zoledronic acid in acute SCI attenuates losses in proximal femoral strength, which may reduce the risk of hip fractures across patients with varying degrees of ambulatory abilities. [ABSTRACT FROM AUTHOR]

Bone mineral loss is a serious health issue all over the globe resulting in osteoporosis, without showing any pre-indication of its occurrence. Dual Energy X-ray Absorptiometry test is a widely accepted method for its diagnosis which gives areal information about the bone mineral. Other methods like Quantitative Computed Tomography (QCT) and Peripheral QCT give volumetric information. Application of these methods for mass screening is not recommended due to the use of ionizing radiations. Few non-ionizing methods, namely Bioelectric Impedance Analysis and Quantitative Ultrasound, have evolved in the past few decades. Bioelectric Impedance Analysis, a non-invasive and low-cost tool, has been immensely recognized for its promising use in estimating body composition and body fluids. Similarly, Quantitative Ultrasound is another non-invasive technique for determining bone density at fixed locations, making noninvasive assessment much faster, easier to use, and portable. A multi-parametric approach combining these two modalities has yielded higher efficiency for the detection of bone mineral loss. These developments are briefly reviewed in this paper.

Steven M Falowski,1 Sebastian F Koga,2 Trent Northcutt,3 Laszlo Garamszegi,3 Jeremi Leasure,3 Jon E Block4 1Argires-Marotti Neurosurgical Associates of Lancaster, Lancaster, PA, USA; 2Koga Neurosurgery, Covington, LA, USA; 3Aurora Spine, Carlsbad, CA, USA; 4Independent Clinical Consultant, San Francisco, CA, USACorrespondence: Jon E BlockIndependent Clinical Consultant, 2210 Jackson Street, Ste. 401, San Francisco, CA, 94115, USATel +1 415-775-7947Email jb@drjonblock.comAbstract: With an increasingly aging population globally, a confluence has emerged between the rising prevalence of degenerative spinal disease and osteoporosis. Fusion of the anterior spinal column remains the mainstay surgical intervention for many spinal degenerative disorders. However, decreased vertebral bone mineral density (BMD), quantitatively measured by dual x-ray absorptiometry (DXA), complicates treatment with surgical interbody fusion as weak underlying bone stock increases the risk of post-operative implant-related adverse events, including cage subsidence. There is a necessity for developing cages with advanced structural designs that incorporate bioengineering and architectural principles to tailor the interbody fusion device directly to the patient’s BMD status. Specifically, lattice-designed cages that mimic the web-like structure of native cancellous bone have demonstrated excellent resistance to post-operative subsidence. This article provides an introductory profile of a spinal interbody implant designed intentionally to simulate the lattice structure of human cancellous bone, with a similar modulus of elasticity, and specialized to match a patient’s bone status across the BMD continuum. The implant incorporates an open pore design where the degree of pore compactness directly corresponds to the patient’s DXA-defined BMD status, including patients with osteoporosis.Keywords: osteoporosis, interbody fusion, bone mineral, cage, degenerative disc disease

One of the most common scientific methods to study the chemical composition of bone matter is energy-dispersive X-ray spectroscopy (EDS). However, interpretation of the data obtained can be quite complicated and require a thorough understanding of bone structure. This is especially important when evaluating subtle changes of chemical composition, including the age-related ones. The aim of current study is to create a method of processing the obtained data that can be utilized in clinical medicine and use it to evaluate the age evolution of bone chemical composition. To achieve this goal, an elemental composition of 62 samples of cadaver compact bone, taken from the skull base (age: Me = 57.5; 21/91(min/max); Q1 = 39.5, Q3 = 73.75), was studied with EDS. We used the original method to estimate the amount of Mg2+ cations. We detected and confirmed an increase of Mg2+ cation formula amount in the bone apatite, which characterizes age-related resorption rate. Analysis of cation estimated ratio in a normative bone hydroxylapatite showed an increase of Mg2+ amount (R = 0.43, p = 0.0005). Also, Ca weight fraction was shown to decrease with age (R = − 0.43, p = 0.0005), which in turn confirmed the age-dependent bone decalcification. In addition, electron probe microanalysis (EPMA) and X-ray diffraction analysis (XRD) were performed. EDS data confirmed the EPMA results (R = 0.76, p = 0.001). In conclusion, the proposed method can be used in forensic medicine and provide additional data to the known trends of decalcification and change of density and crystallinity of mineral bone matter. [ABSTRACT FROM AUTHOR]

Introduction/background: Bone mineral content (BMC) is most commonly evaluated using dual-energy X-ray absorptiometry (DXA), but there are several challenges that limit use of DXA during routine care. Breakthroughs in digital imaging now allow smartphone applications to automate important anthropometrics that can predict several body composition components. However, it is unknown whether the anthropometrics automated using smartphone applications can predict DXA-derived BMC., Methodology: A total of 214 participants (129 F, 85 M) had BMC measurements collected from an existing proprietary prediction equation, embedded within a smartphone application (MeThreeSixty), and evaluated against DXA. LASSO regression was then used to develop a new BMC prediction equation using the anthropometric estimates produced by the smartphone application in a portion of the participants (n = 174), which was subsequently evaluated against DXA in the remaining sample (n = 40). BMC z-scores were calculated and used to identify the prevalence of low BMC for the existing and newly developed smartphone prediction equations and evaluated against DXA-derived z-scores., Results: Neither BMC estimates (R 2 : 0.72; RMSE: 376 g) nor BMC z-scores (R 2 : 0.55; RMSE: 1.09 SD) produced from the existing propriety prediction equation demonstrated equivalence with DXA in the combined sample. Moreover, the existing prediction equation had a 69.6 % accuracy of identifying low BMC. LASSO regression for the newly developed smartphone prediction model produced the following equation: BMC (g) = -2020.769 + 60.902(Black=1, 0=all other races) - 180.364(Asian=1, 0=all other races) + 24.433(height) + 1.702(weight) + 2.92(shoulder circumference) + 0.258(arm surface area) - 715.29(waist circumference/(BMI 2/3 x height 1/2 )). BMC (R 2 : 0.91; RMSE: 209 g) and BMC z-scores (R 2 : 0.85; RMSE: 0.61) produced from the newly developed equation in the testing sample demonstrated equivalence with DXA and had a 92.5 % accuracy of identifying low BMC., Conclusions: Smartphone anthropometrics provide accurate and clinically relevant BMC measurements outside of an advanced setting through the use of our newly-developed smartphone prediction model., Competing Interests: Declaration of competing interest The funding agency (National Institute of General Medical Sciences) had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication. There are no other conflicts of interest to declare., (Copyright © 2024 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.)

Interventions for bone diseases (e.g. osteoporosis) require testing in animal models before clinical translation and the mouse tibia is among the most common tested anatomical sites. In vivo micro-Computed Tomography (microCT) based measurements of the geometrical and densitometric properties are non-invasive and therefore constitute an important tool in preclinical studies. Moreover, validated micro-Finite Element (microFE) models can be used for predicting the bone mechanical properties non-invasively. However, considering that the image processing pipeline requires operator-dependant steps, the reproducibility of these measurements has to be assessed. The aim of this study was to evaluate the intra- and inter-operator reproducibility of several bone parameters measured from microCT images. Ten in vivo microCT images of the right tibia of five mice (at 18 and 22 weeks of age) were processed. One experienced operator (intra-operator analysis) and three different operators (inter-operator) aligned each image to a reference through a rigid registration and selected a volume of interest below the growth plate. From each image the following parameters were measured: total bone mineral content (BMC) and density (BMD), BMC in 40 subregions (ten longitudinal sections, four quadrants), microFE-based stiffness and failure load. Intra-operator reproducibility was acceptable for all parameters (precision error, PE < 3.71%), with lowest reproducibility for stiffness (3.06% at week 18, 3.71% at week 22). The inter-operator reproducibility was slightly lower (PE < 4.25%), although still acceptable for assessing the properties of most interventions. The lowest reproducibility was found for BMC in the lateral sector at the midshaft (PE = 4.25%). Densitometric parameters were more reproducible than most standard morphometric parameters calculated in the proximal trabecular bone. In conclusion, microCT and microFE models provide reproducible measurements for non-invasive assessment of the mouse tibia properties. [ABSTRACT FROM AUTHOR]

PURPOSE. Masticatory loading triggers active bone remodeling, altering alveolar bone mineral density (BMD). While dental implants are placed to bear masticatory loading, their influence on changing bone properties has not been fully investigated. Objective of this pilot study was to examine whether the dental implantation has an effect on BMD distribution of bone by comparing dentate, edentulous, and edentulous patients with implants. MATERIALS AND METHODS. Cone beam computed tomography (CBCT) images of 19 partially edentulous patients (Dent), 19 edentulous patients (Edent), and 16 edentulous patients who received implants in the mandible (Edent+Im), were obtained. CBCT images were also obtained from 5 patients within Edent+Im group, before implant placement and after implant loading. Basal cortical bone region of the mandible was digitally isolated. A histogram of gray levels proportional to BMD was obtained to assess mean, histogram standard deviation (HSD), fifth percentile of low and high values (Low5 and High5) of the BMD distribution. Multivariate analysis of variance and paired t-test were used to compare the BMD parameters among the 3 dental status groups and between pre- and post-implantation, respectively. RESULTS. Edentulous patients with implants had significantly greater HSD and High5 values compared to edentulous patients ( P < .013). All other comparisons were not significant ( P > .097). Mean, HSD, and High5 values significantly increased after receiving implants ( P < .022). CONCLUSION. The current findings suggested that receiving dental implants promoted oral bone mineralization for edentulous patients. The longitudinal investigation could provide valuable information on understanding the effects of implantation on the behavior of oral bone quality. [ABSTRACT FROM AUTHOR]

Interventions for bone diseases (e.g. osteoporosis) require testing in animal models before clinical translation and the mouse tibia is among the most common tested anatomical sites. In vivo micro-Computed Tomography (microCT) based measurements of the geometrical and densitometric properties are non-invasive and therefore constitute an important tool in preclinical studies. Moreover, validated micro-Finite Element (microFE) models can be used for predicting the bone mechanical properties non-invasively. However, considering that the image processing pipeline requires operator-dependant steps, the reproducibility of these measurements has to be assessed. The aim of this study was to evaluate the intra- and inter-operator reproducibility of several bone parameters measured from microCT images. Ten in vivo microCT images of the right tibia of five mice (at 18 and 22 weeks of age) were processed. One experienced operator (intra-operator analysis) and three different operators (inter-operator) aligned each image to a reference through a rigid registration and selected a volume of interest below the growth plate. From each image the following parameters were measured: total bone mineral content (BMC) and density (BMD), BMC in 40 subregions (ten longitudinal sections, four quadrants), microFE-based stiffness and failure load. Intra-operator reproducibility was acceptable for all parameters (precision error, PE < 3.71%), with lowest reproducibility for stiffness (3.06% at week 18, 3.71% at week 22). The inter-operator reproducibility was slightly lower (PE < 4.25%), although still acceptable for assessing the properties of most interventions. The lowest reproducibility was found for BMC in the lateral sector at the midshaft (PE = 4.25%). Densitometric parameters were more reproducible than most standard morphometric parameters calculated in the proximal trabecular bone. In conclusion, microCT and microFE models provide reproducible measurements for non-invasive assessment of the mouse tibia properties.

Bone whitlockite (WH) is an important calcium phosphate (CaP) owing to its excellent biological properties. It is the second most abundant bone inorganic phase. A lot of work has been done on other CaPs like hydroxyapatite (HA) and β-tricalcium phosphate (β-TCP) that are easy to synthesize. The synthesis of bone whitlockite is challenging due to its instability in comparison to other CaPs and its synthesis and presence in the body have not been fully acknowledged yet. Synthesis of WH using liquid precipitation method and effect of different parameters on its phase stabilization has been reported earlier. In this study, we are reporting a facile synthesis method for WH using a solid-state reaction. The reaction was carried out by mixing, grinding, and heat-treating the precursors at high temperatures without any medium under the ambient environment. The product obtained was characterized by using x-ray diffraction (XRD), Fourier transforms infrared spectroscopy (FTIR), Raman spectroscopy, Scanning electron microscopy (SEM), and thermogravimetric (TGA) analysis. XRD analysis confirmed that the synthesized material has a whitlockite crystalline phase while FTIR and Raman spectroscopic analysis confirmed the presence of HOP 4 2− a peak that is a characteristic of bone whitlockite. The particles synthesized have a size below 50 nm and are stable below 700 °C. The reported method provides a facile synthetic route for mass production of WH. [ABSTRACT FROM AUTHOR]

Hydroxyapatite (HA) is a complex material, which is often nanocrystalline when found within a biological setting. This work has directly compared the structural characteristics derived from data collected using a conventional laboratory‐based X‐ray diffractometer with those collected from a dedicated pair distribution function (PDF) beamline at Diamond Light Source. In particular, the application of PDF analysis methods to carbonated HA is evaluated. 20 synthetic samples were measured using both X‐ray diffraction (XRD) and PDFs. Both Rietveld refinement (of laboratory XRD data) and real‐space refinement (of PDF data) were used to analyse all samples. The results of Rietveld and real‐space refinements were compared to evaluate their application to crystalline and nanocrystalline hydroxyapatite. Significant relationships were observed between real‐space refinement parameters and increasing carbonate substitution. Understanding the local order of synthetic hydroxyapatite can benefit several fields, including both biomedical and clinical settings. [ABSTRACT FROM AUTHOR]

Bone is a dynamic tissue with a quarter of the trabecular and a fifth of the cortical bone being replaced continuously each year in a complex process that continues throughout an individual’s lifetime. Bone has an important role in homeostasis of minerals with non-stoichiometric hydroxyapatite bone mineral forming the inorganic phase of bone. Due to its crystal structure and chemistry, hydroxyapatite (HA) and related apatites have a remarkable ability to bind molecules. This review article describes the accretion of trace elements in bone mineral giving a historical perspective. Implanted HA particles of synthetic origin have proved to be an efficient recruiting moiety for systemically circulating drugs which can locally biomodulate the material and lead to a therapeutic effect. Bone mineral and apatite however also act as a waste dump for trace elements and drugs, which significantly affects the environment and human health.

Solid-state NMR spectroscopy has played an important role in multidisciplinary studies of the extracellular matrix. Here we review how solid-state NMR has been used to probe collagen molecular conformations, dynamics, post-translational modifications and non-enzymatic chemical changes, and in calcified tissues, the molecular structure of bone mineral and its interface with collagen. We conclude that NMR spectroscopy can deliver vital information that in combination with data from structural imaging techniques, can result in significant new insight into how the extracellular matrix plays its multiple roles.

Currently, Hodgkin’s lymphoma (HL) is considered as a potentially curable disease. The polychemotherapy including various combinations of cytostatic drugs and glucocorticoids appears the standard of treatment in patients with HL. Patients with early stage disease (stage I to II) receive several cycles of chemotherapy followed by the radiotherapy. The possibility of achieving persistent disease-free survival poses a problem of ensuring a satisfactory quality of life and preventing the long-term consequences of antitumor therapy. One of those consequences may be a change in bone mineral density (BMD). Aim of the study was to assess the BMD in patients with HL. Material and methods. BMD was measured by dual-energy X-ray absorbtiometry using a stationary LunarProdigy bone densitometer (GE, USA). The Russian FRAX model was used in this study. The model uses clinical data to calculate the major low-energy fractures and the hip fractures. Results. The decreased BMD was revealed in 36 observed HL subjects (48.6 %). Patients with osteoporosis were generally older, had a lower body mass index as compared to patients with normal BMD (p < 0.05). Based on FRAX assessment, the 10-year risk of major low-energy fractures and the hip fractures was expectedly higher in patients with osteoporosis and osteopenia as compared to subjects with normal BMD (p < 0.05). More patients with radiotherapy in anamnesis had decreased BMD compared to patients who received chemotherapy only (χ2 = 5.47; р = 0.0194). More than half of the patients (59.1 %) receiving regimens containing glucocorticosteroids had BMD decrease. A comparative analysis revealed that patients younger than 50 years old had lower values of BMD and Z-score of the lumbar spine in the early stages of HL as compared to patients with stage III-IV. In turn, in patients older 50 years and postmenopausal women at the early stages of HL was a significant decrease of BMD and T-score of the femoral neck as compared to patients with advanced stages of the disease. This research suggests that the decrease in BMD in stages I-II of HL can be associated with radiotherapy as the generally accepted standard for the treatment of early stages of the disease.

The disadvantages of surgical sutures, such as secondary tissue damage, surgical site infection, and liquid leaking, can be reduced by biological soft‐tissue adhesives. Although non‐bioresorbable bone substitute materials sufficiently adhere to soft tissues, enabling immobilization of implantable devices, their non‐bioresorbable property limits their clinical use. This study reports the excellent adhesion properties of octacalcium phosphate (OCP), a bioresorbable mineral analogue of immature bone. Blocks of OCP strongly adhere to mouse dermal tissues, enhancing their protein adsorption capacity as demonstrated in ex vivo shear adhesion tests. When soaked in antibacterial solution, the OCP blocks easily adsorb the antibacterial agents in their internal nano‐pores and on their surfaces, imbuing them with antibacterial ability. Therefore, the OCP blocks are a solid‐state material with strong adherence to biological soft tissues and, are especially promising for detachable body‐implantable and/or external devices. [ABSTRACT FROM AUTHOR]

PURPOSE OF THE STUDY To improve the important torsional, bending and compressive stability in femoral neck fixation, locking plates have been the latest contribution. However, increased strength by restricted fracture motion may come at expense of an altered load distribution and failure patterns. Within locking plate technology, the important intermediate fracture compression may principally be achieved by multiple sliding screws passing through a sideplate fixed to the femur or connected to an interlocking plate not fixed to the femur laterally, sliding “en bloc” with the plate. While biomechanical studies may deliver the short-time patient safety requirements in implant development, no adequate failure evaluation has been performed with interlocking devices ex vivo in this setting. In the present biomechanical study, we analysed if a novel femoral neck interlocking plate with pins could improve fixation performance by changing the parameters involved in the failure mechanism in terms of fixation strength, fracture motion, load distribution and failure pattern. MATERIAL AND METHODS Sixteen pairs of human femurs with stable subcapital osteotomies were fixated by 2 pins or 3 pins interlocked in a plate using a paired design. Femurs were loaded non-destructively to 10° torsion around the neck axis, 200 N anteroposterior bending and 500 N vertical compression in 7° adduction with 1 Hz in 20 000 cycles, and were subsequently subjected to destructive compression to evaluate failure patterns. Bending stiffness, compressive stiffness and displacement from compressive testing reflected fracture motion. Torque and compression to failure replicated known failure mechanisms and defined strength. To evaluate load distribution, associations between biomechanical parameters and measured local bone mineral measurements by quantitative CT were analysed. RESULTS Interlocked pins increased mean strength 73% in torsion and 39% in compression (p = 0.038). Strength was related to all 4 regional mineral masses from the femoral head to subtrochanterically with interlocking (r = 0.64–0.83, p = 0.034), while only to mineral masses in the femoral head in compression and to the head, neck and trochanterically in torsion with individual pins (r = 0.67–0.78, p = 0.024). No difference was detected in fracture motion or failure pattern. DISCUSSION Within the last decade, angular stable implants have expanded our therapeutic arsenal of femoral neck fractures. Increased stability at the expense of altered devastating failure patterns was not retrieved in our study. The broadened understanding of the effect of interlocking pins by an isolated plate as in the current study involved the feature to gain fixation strength. By permitting fracture compression, and through a significant change of correlations between mechanical parameters and local bone mineral factors, a lateral redistribution of load with interlocked pins from the fragile bone medially to the more solid lateral bone was demonstrated. Regarding the long-term patient safety of interlocked pins and healing complications of non-union and segmental collapse of the femoral head, a definite conclusion may be premature. However, the improved biomechanics of an interlocking plate must be considered a favourable development of the pin concept. CONCLUSIONS Interlocked pins may improve fixation performance by a better load distribution, not by restricting fracture motion with corresponding altered failure patterns. This is encouraging and a challenge to complete further studies of the interlocking plate technology in the struggle to find the optimal treatment of the femoral neck fracture. [ABSTRACT FROM AUTHOR]

Osteoporosis (OP) remains a major public health problem worldwide. The most serious complications of this disease are fragility fractures, which increase morbidity and mortality. Management of OP represents an economic burden for health systems. Therefore, it is necessary to develop new screening strategies to identify the population at risk and implement preventive measures. We previously identified the SNPs rs3801387 in WNT16, rs7108738 in SOX6, rs10036727 in SLIT3 and rs7584262 in PKDCC as associated with bone mineral density in postmenopausal women through a genome-wide association study. The aim of this study was to validate those SNPs in two independent cohorts of non-related postmenopausal women. We included 1160 women classifying them as normal, osteopenic or osteoporotic and a group with hip fragility fracture. Genotyping was performed using predesigned TaqMan assays. The variants rs10036727 and rs7108738 showed a significant association with BMD at the femoral neck. SLIT3 has been previously proposed as a potential biomarker and therapeutic resource. Our results provide new evidence regarding a possible involvement of SLIT3 in bone metabolisms and encourage the development of more studies in different populations to support these observations. [ABSTRACT FROM AUTHOR]

Whole-body vibration training (WBVT) offers a potential auxiliary treatment method for the rehabilitation of motor disabilities to address a reduction in bone minerals and lean mass caused by motor-disability rehabilitation. The aim of this review was to analyze the efficacy of WBVT in muscle–bone rehabilitation. In order to investigate the potential effect of WBVT on children and adolescents with motor disabilities, a meta-analysis was carried out. From January 2006 to June 2021, studies that met certain criteria were searched for in the Scopus, PubMed, Web of Science, and EBSCO databases. An analysis of standardized mean differences was performed using the STATA 15.1 software with a 95% confidence interval (PROSPERO registration number: CRD42021258538). Eight studies were selected that included 179 male and 139 female children and adolescents suffering from motor disabilities. The results of the meta-analysis showed that WBVT significantly improved femur bone-mineral density ((p < 0.01, z = 2.66), standardized mean difference (SMD) (95% CI) = 0.41 (0.11, 0.72)), total body–bone mineral content ((p < 0.01, z = 3.08), SMD (95% CI) = 0.26 (0.10, 0.43)), and lean mass ((p < 0.01, z = 2.63), SMD (95% CI) = 0.22 (0.06, 0.39)). In addition, there was no significant effect of WBVT on lumbar spine bone mineral density in the disabled children and adolescents ((p = 0.21, z = 1.25), SMD (95% CI) = 0.17 (−0.10, 0.43)). WBVT can improve femur bone density, total body bone mineral content, and lean mass in children and adolescents suffering from motor disabilities, while there is no effect on lumbar-spine bone density. WBVT can be used as a potential program to improve bone minerals in children and adolescents with motor disabilities.

A four-compartment (4C) model quantifies fat, water, mineral and residual. As such, 4C models are more accurate than two-compartment (2C) models based off cadaver reference values (RV), which necessitate assumptions regarding fat-free mass (FFM) characteristics. Nonetheless, research has yet to determine whether the FFM characteristics of Hispanics are similar to non-Hispanic Caucasians and RV. The aim of this analysis was to compare the FFM characteristics of Hispanics to non-Hispanic Caucasians and cadaver RV. Data from 2 separate research centers were pooled to create a sample of 100 and 119 Hispanic males and females (age: 18–54 yrs; BMI: 16.46–42.27 kg/m2), respectively, and 47 and 55 non-Hispanic Caucasian males and females (age: 18–54 yrs; BMI: 16.00–36.67 kg/m2), respectively (n = 331). A 4C model was determined using bioimpedance analysis for hydration, dual energy X-ray absorptiometry for mineral, and air displacement plethysmography for body density (4C-ADP). FFM was calculated via the 4C-ADP and FFM characteristics (i.e., density [D FFM ], water [TBW:FFM], bone mineral [Mo:FFM], and residual [R:FFM]) were compared between sexes and ethnicities using a one-way ANOVA and against RV via a one sample t -test. In Hispanics, all FFM characteristics significantly differed from cadaver RV (all p < 0.05). In contrast, D FFM and TBW:FFM of non-Hispanic Caucasians were similar to cadaver RV for both sexes (all p > 0.05). Moreover, the R:FFM of non-Hispanic Caucasian females did not differ from cadaver RV (p = 0.403) whereas all other comparisons were significantly different (all p < 0.05). Sex comparisons within Hispanic participants revealed FFM characteristics were similar between males and females other than Mo:FFM (p < 0.001) whereas all FFM characteristics were similar between non-Hispanic Caucasian males and females (all p > 0.05). All of the ethnicity comparisons within males were statistically significant (all p < 0.05). Moreover, ethnicity comparisons within females were statistically significant for all comparisons other than Mo:FFM (p = 0.258). The observed differences in FFM characteristics of Hispanics as compared to non-Hispanics Caucasians and reference values indicate that allied health professionals should employ appropriate caution when estimating body composition via 2C models in Hispanic populations. [ABSTRACT FROM AUTHOR]

The abundance of bird bones in archeological contexts of high salt is potentially impacted by salinization, which can affect bone preservation. We exposed wing elements (humeri, ulnae, and radii) of domestic chicken (Gallus gallus domesticus) to laboratory conditions simulating a saline lake substrate with overlaying saltwater for up to 32 weeks. Our analyses based on bone ashing and elemental concentration using ICP-OES are reported. The data provide useful taphonomic information regarding changes in bone mineral content, element concentrations, and element to phosphorus ratios of bird bones exposed to saline environments. Results showed that all exposed wing bones increased significantly in bone mineral content, which indicated that wing bones most likely became stronger. Overall, ionic concentrations of Ca2+, K+, Mg2+, Na+, P5+, Sr2+, and Si4+, except Fe3+, changed significantly among all wing bones with saline exposure. These changes in ion concentration took place in as little as 4 weeks. Element to phosphorus ratios provided insight into potential ionic substitutions between the bone and the saline substrate and solution exposure. The results from our study provide direct evidence that the chemical composition of bird bones deposited along saline lake shorelines quickly become altered. [ABSTRACT FROM AUTHOR]

Bone is primarily composed of collagen and apatite, two materials which exhibit a high sensitivity to pH dysregulation. As a result, acid exposure of bone, both clinically and in the laboratory is expected to cause compositional and mechanical changes to the tissue. Clinically, Metabolic acidosis (MA), a condition characterized by a reduced physiological pH, has been shown to have negative implications on bone health, including a decrease in bone mineral density and volume as well as increased fracture risk. The addition of bone-like apatite to ionic solutions such as phosphate buffered saline (PBS) and media has been shown to acidify the solution leading to bone acid exposure. Therefore, is it essential to understand how reduced pH physiochemically affects bone composition and in turn its mechanical properties. This study investigates the specific changes in bone due to physiochemical dissolution in acid. Excised murine bones were placed in PBS solutions at different pHs: a homeostatic pH level (pH 7.4), an acidosis equivalent (pH 7.0), and an extreme acidic solution (pH 5.5). After 5 days, the bones were removed from the solutions and characterized to determine compositional and material changes. We found that bones, without cells, were able to regulate pH via buffering, leading to a decrease in bone mineral content and an increase in collagen denaturation. Both of these compositional changes contributed to an increase in bone toughness by creating a more ductile bone surface and preventing crack propagation. Therefore, we conclude that the skeletal systems' physiochemical response to acid exposure includes multifaceted and spatially variable compositional changes that affect bone mechanics. [ABSTRACT FROM AUTHOR]

Mineralized collagen fibrils are the building block units of bone at the nanoscale. While it is known that collagen fibrils are mineralized both inside their gap zones (intra-fibrillar mineralization) and on their outer surfaces (extra-fibrillar mineralization), a clear visualization of this architecture in three dimensions (3D), combining structural and compositional information over large volumes, but without compromising the resolution, remains challenging. In this study, we demonstrate the use of on-axis Z -contrast electron tomography (ET) with correlative energy-dispersive X-ray spectroscopy (EDX) tomography to examine rod-shaped samples with diameters up to 700 nm prepared from individual osteonal lamellae in the human femur. Our work mainly focuses on two aspects: (i) low-contrast nanosized circular spaces ("holes") observed in sections of bone oriented perpendicular to the long axis of a long bone, and (ii) extra-fibrillar mineral, especially in terms of morphology and spatial relationship with respect to intra-fibrillar mineral and collagen fibrils. From our analyses, it emerges quite clearly that most "holes" are cross-sectional views of collagen fibrils. While this had been postulated before, our 3D reconstructions and reslicing along meaningful two-dimensional (2D) cross-sections provide a direct visual confirmation. Extra-fibrillar mineral appears to be composed of thin plates that are interconnected and span over several collagen fibrils, confirming that mineralization is cross-fibrillar, at least for the extra-fibrillar phase. EDX tomography shows mineral signatures (Ca and P) within the gap zones, but the signal appears weaker than that associated with the extra-fibrillar mineral, pointing toward the existence of dissimilarities between the two types of mineralization.

Coccidiosis penalizes calcium (Ca), phosphorus (P), and fat-soluble vitamin status, as well as bone mineralization in broiler chickens. We hypothesized that dietary vitamin D (VitD) supplementation in the form of 25-hydroxycholecalciferol (OHD), compared to cholecalciferol (D3), would improve bone mineralization in broilers receiving marginally deficient Ca/P diets, with more pronounced effects during malabsorptive coccidiosis. In a 2 VitD source × 2 Ca/P levels × 2 levels of infection factorial experiment (n = 6 pens per treatment, 6 birds/pen), Ross 308 broilers were assigned to an Aviagen-specified diet supplemented with 4,000 IU/kg of either OHD or D3 between days 11 and 24 of age. The diet contained adequate (A; 8.7:4.4 g/kg) or marginally deficient (M; 6.1:3.1 g/kg) total Ca and available (av)P levels. At day 12 of age, birds were inoculated with water (C) or 7,000 Eimeria maxima oocysts (I). Pen performance was measured over 12 days post-infection (pi). One bird per pen was assessed for parameters of bone mineralization and intestinal histomorphometric features (day 6 and 12 pi), as well as E. maxima replication and gross lesions of the small intestine (day 6 pi). There was no interaction between infection status and Ca/avP level on bone mineralization. Bone breaking strength (BS), ash weight (AW), and ash percentage (AP) were highest in broilers fed the OHD-supplemented A diets irrespective of infection status. Eimeria maxima infection impaired (P < 0.05) ADG and FCR pi; Ca and P status at day 6 pi; OHD status, BS, AW, and AP at day 12 pi; and intestinal morphology at day 6 and 12 pi. A- compared to M-fed broilers had higher BS, AW, and AP at day 6 pi, and AW at day 12 pi. VitD source affected only OHD status, being higher (P < 0.001) for OHD- than D3-fed broilers at day 6 and 12 pi. In conclusion, offering OHD and adequate levels of Ca and P improved bone mineralization, with no effect on performance. Dietary D3 and OHD supplemented at 4,000 IU/kg had similar effects on coccidiosis-infected and uninfected broilers, which led to the rejection of our hypothesis. [ABSTRACT FROM AUTHOR]

Bone responds to mechanical loading by increasing bone mineral density (BMD) and/or bone area to enhance bone strength at the site of the greatest strain. Such localised adaptation has not been demonstrated at the spine. The aim of this study is to determine if BMD and/or bone mineral content (BMC) differs between dominant (ipsilateral to bowling/throwing arm) and non-dominant sides of the vertebrae in cricket fast bowlers, and whether this asymmetry differs according to stress fracture or disc injury history. A further aim was to determine if regional BMD and BMC in the lumbar spine differ between fast bowlers, other cricketers, rugby players and non-active controls, to highlight the site-specific response of lumbar vertebra to unilateral activity. 23 fast bowlers, 14 other cricketers, 22 rugby players and 20 controls underwent an antero-posterior (AP) and lateral DXA scans of their lumbar spine to assess BMD, BMC and area. A custom analysis measured BMD and BMC of the dominant and non-dominant sides (lateral 33%) of the AP lumbar spine. BMD and BMC were compared between groups, injury status, vertebrae and sides using ANOVA. Analysis of medical records showed that 6 fast bowlers had a history of lumbar stress fracture. Significantly greater BMD and BMC was found in the L4 non-dominant vertebra compared with the dominant vertebra in fast bowlers. BMD and BMC differed significantly according to vertebra, side and group, with fast bowlers having significantly greater BMD and BMC at the L3 and L4 non-dominant vertebra compared with other groups (L3: 13.3%–45.3%, L4: 15.7%–44.0%) compared with other groups. Fast bowlers who never suffered lumbar stress fracture had 3.6% and 1.7% greater BMD in the dominant and non-dominant sides of lumbar vertebrae respectively compared with those who did suffer lumbar stress fracture, but evidence of this was weaker (P = 0.08). The lumbar spine responds to a unique unilateral high loading activity through site-specific increased bone mass at the site of most strain. Fast bowlers had increased lumbar BMD, particularly on the non-dominant side of L4, although this adaptation was less marked in those with history of lumbar stress fracture. Site-specific low bone mineral density within the lumbar side may be implicated in the aetiology of lumbar stress fracture. • Cricket fast bowlers have greater BMD and BMC at the non-dominant (contralateral to bowling arm) side of the lumbar spine • This asymmetry increases in magnitude caudally, significantly differing to the dominant side at L4 • Fast bowlers have significantly greater BMD and BMC than rugby players at the non-dominant side of L2, L3 and L4 only • Reduced site-specific bone mineral accrual may be a risk factor to lumbar stress fracture in fast bowlers [ABSTRACT FROM AUTHOR]

Laying hen skeletal health continues to be an industry priority. Bone ash and bone Ca quantification in laying hen long bones provides valuable information on skeletal health. Unfortunately, these measurements can only be accomplished by sacrificing hens, thus making longitudinal measurements on the same hen impossible. Quantitative computed tomography (QCT), used with a calcium hydroxyapatite phantom, has been used to determine bone density of wings and legs as well as live hens throughout the production cycle by scanning with a calcium hydroxyapatite phantom. QCT has also been used to scan live hens throughout the production cycle. The purpose of this study was to determine how QCT calculated bone mineral content (QCT BMC) corresponds to analytical bone Ca and bone ash. Wing and leg quarters from 72-wk-old W-36 hens were QCT scanned along with a QCT Phantom. After scanning, humeri, femurs, and tibias were cleaned, divided into epiphysis (E) and diaphysis (D), fat extracted, ashed, and digested under nitric acid, and Ca was determined by atomic absorption spectroscopy was used to determine E, D, and whole bone Ca. Four bones/type were used for E and D, while 6 bones/type were used for whole bone measurements. A second set of bones were prepared to determine correlation of BMC to bone ash. QCT scans were analyzed with Mimics software (Materialise NV, Leuven, Belgium) to calculate bone volume and density in Hounsfield units. Utilizing the QCT phantom and bone volume, BMC was calculated for E, D, and whole bone. Data were analyzed with regression analysis and Pearson correlation coefficients were determined. Analytical Ca was correlated to QCT BMC for E (R = 0.84, P < 0.01), D (R = 0.99, P < 0.01), and whole bone (R = 0.97, P < 0.01). Whole bone ash was highly correlated to QCT BMC for femur (N = 47, R = 0.97, P < 0.001), tibia (N = 50, R = 0.94, P < 0.001), and keel (N 50, R = 0.94, P < 0.001). Whole bone ash and QCT BMC values of femur and tibia were not different (P = 0.39 and 0.22 respectively). Based on this information, QCT could provide relative quantitative assessment of total bone mineral in live birds proving useful in long-term studies. [ABSTRACT FROM AUTHOR]