Bone Reports最新文献

{"title":"Voluntary exercise in mice triggers an anti-osteogenic and pro-tenogenic response in the ankle joint without affecting long bones","authors":"Anne Briolay ,&nbsp;François Duboeuf ,&nbsp;Séverine Delplace ,&nbsp;Leyre Brizuela ,&nbsp;Olivier Peyruchaud ,&nbsp;David Magne ,&nbsp;Carole Bougault","doi":"10.1016/j.bonr.2024.101810","DOIUrl":"10.1016/j.bonr.2024.101810","url":null,"abstract":"<div><div>Biomechanical stimulation is proposed to occupy a central place in joint homeostasis, but the precise contribution of exercise remains elusive. We aimed to characterize in vivo the impact of mechanical stimulation on the cell-controlled regulation of ossification within the ankles of healthy mice undergoing mild physical activity. DBA/1 male mice were subjected to voluntary running exercise for two weeks, and compared to mice housed in standard conditions (<em>n</em> = 20 per group). Free access to activity wheels resulted in a running exercise of 5.5 ± 0.8 km/day at 14.5 ± 0.5 m/min. Serum levels of alkaline phosphatase, IL-6, IL-8/Kc, IL-17a, and TNF-α were measured. No change in systemic inflammation was detected. The bone architecture of the femur and the calcaneus was unchanged, as revealed by μCT and histology of the enthesis of the Achilles tendon. mRNAs were extracted from femurs, tibias, and ankle joints before RT-qPCR analysis. The expression of the mechanosensitive genes <em>Sclerostin</em> (<em>Sost</em>) and <em>Periostin</em> (<em>Postn</em>) was not impacted by the exercise in long bones. Oppositely, <em>Sost</em> and <em>Postn</em> levels were modulated by exercise in joints, and osteogenic markers (<em>Col10a1</em>, <em>Runx2</em>, <em>Osx</em>, and <em>Dmp1</em>) were downregulated in the exercise group. In addition, the tenogenic markers <em>Scx</em>, <em>Mkx</em>, and <em>Tnmd</em> were upregulated by exercise. Thus, voluntary exercise affected the phenotype of joint cells without impacting long bones. As gene expression of <em>Bmp2</em>, <em>Bmp4</em>, and <em>Id1</em> was also reduced in these cells, an off-regulation of BMP signaling could be partly responsible for their mechanosensitive response. Running exercise seemed to preserve the tendon from its progressive ossification, as seen in numerous enthesopathies. This study paves the way to future experiments for investigating the effects of mechanical stimulation in various mouse models.</div></div>","PeriodicalId":9043,"journal":{"name":"Bone Reports","volume":"23 ","pages":"Article 101810"},"PeriodicalIF":2.1,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142441449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delineating the nexus between gut-intratumoral microbiome and osteo-immune system in bone metastases","authors":"Shreya Kapoor,&nbsp;Muskan Gupta ,&nbsp;Leena Sapra ,&nbsp;Taranjeet Kaur,&nbsp;Rupesh K. Srivastava","doi":"10.1016/j.bonr.2024.101809","DOIUrl":"10.1016/j.bonr.2024.101809","url":null,"abstract":"<div><div>Emerging insights in osteoimmunology have enabled researchers to explore in depth the role of immune modulation in regulating bone health. Bone is one of the common sites of metastasis notably in case of breast cancer, prostate cancer and several other cancer types. High calcium ion concentration and presence of several factors within the mineralized bone matrix including TGF-β, BMP etc., aid in tumor growth and proliferation. Accumulating evidence has substantiated the role of the gut-microbiota (GM) in tumorigenesis, further providing a strong impetus for the growing “immune-cancer-gut microbiota” relationship. Recent advancements in research further highlight the importance of the intra-tumor microbiota in conjunction with GM in cancer metastasis. Intratumoral microbiota owing to their ability to cause genetic instability, mutations, and epigenetic modifications within the tumor microenvironment, has been recognized to affect cancer cell physiology. The host microbiota and immune system crosstalk shapes the innate and adaptive arms of the immune system, which is the key player in cancer progression. In this review, we aim to decipher the role of microorganisms mediating bone metastasis by shedding light on the immuno-onco-microbiome (IOM) axis. We discussed the feasible cancer therapeutic interventions based on the modulation of the microbiome-immune cell axis which includes prebiotics, probiotics, and postbiotics. Here, we leverage the conceptual framework based on the published articles on microbiota-based therapies to target bone metastases. Understanding this complicated nexus will provide insights into fundamental factors governing bone metastases which will subsequently help in managing this malignancy with better efficacy.</div></div>","PeriodicalId":9043,"journal":{"name":"Bone Reports","volume":"23 ","pages":"Article 101809"},"PeriodicalIF":2.1,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142446865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Administration of low intensity vibration and a RANKL inhibitor, alone or in combination, reduces bone loss after spinal cord injury-induced immobilization in rats","authors":"Yuanzhen Peng ,&nbsp;Helen M. Bramlett ,&nbsp;W. Dalton Dietrich ,&nbsp;Alex Marcillo ,&nbsp;Juliana Sanchez-Molano ,&nbsp;Ofelia Furones-Alonso ,&nbsp;Jay J. Cao ,&nbsp;Jenney Huang ,&nbsp;Andrew A. Li ,&nbsp;Jian Q. Feng ,&nbsp;William A. Bauman ,&nbsp;Weiping Qin","doi":"10.1016/j.bonr.2024.101808","DOIUrl":"10.1016/j.bonr.2024.101808","url":null,"abstract":"<div><div>We previously reported an ability of low-intensity vibration (LIV) to improve selected biomarkers of bone turnover and gene expression and reduce osteoclastogenesis but lacking of evident bone accrual. In this study, we demonstrate that a prolonged course of LIV that initiated at 2 weeks post-injury and continued for 8 weeks can protect against bone loss after SCI in rats. LIV stimulates bone formation and improves osteoblast differentiation potential of bone marrow stromal stem cells while inhibiting osteoclast differentiation potential of marrow hematopoietic progenitors to reduce bone resorption. We further demonstrate that the combination of LIV and RANKL antibody reduces SCI-related bone loss more than each intervention alone. Our findings that LIV is efficacious in maintaining sublesional bone mass suggests that such physical-based intervention approach would be a noninvasive, simple, inexpensive and practical intervention to treat bone loss after SCI. Because the combined administration of LIV and RANKL inhibition better preserved sublesional bone after SCI than either intervention alone, this work provides the impetus for the development of future clinical protocols based on the potential greater therapeutic efficacy of combining non-pharmacological (e.g., LIV) and pharmacological (e.g., RANKL inhibitor or other agents) approaches to treat osteoporosis after SCI or other conditions associated with severe immobilization.</div></div>","PeriodicalId":9043,"journal":{"name":"Bone Reports","volume":"23 ","pages":"Article 101808"},"PeriodicalIF":2.1,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142428820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of ultrasound imaging in monitoring fracture healing in rat femur: Comparison with other imaging modalities","authors":"Satoshi Inoue ,&nbsp;Michinori Mori ,&nbsp;Masaya Yasui ,&nbsp;Miwako Matsuki-Fukushima ,&nbsp;Kentaro Yoshimura ,&nbsp;Naoko Nonaka","doi":"10.1016/j.bonr.2024.101807","DOIUrl":"10.1016/j.bonr.2024.101807","url":null,"abstract":"<div><h3>Objective</h3><div>Fractures are common injuries and various imaging modalities are employed to diagnose and monitor bone union. However, the follow-up of fracture healing using ultrasound imaging (US) remains a topic of debate. In this study, we analyzed of fracture healing process and compared US and radiological analyses with histological analyses to clarify the characteristics and limitations of each modality.</div></div><div><h3>Methods</h3><div>An osteotomy model was created using the femur of Wistar rats, and US, radiological (radiography and micro-computed tomography (micro-CT)), and histological analyses were performed. Radiological assessments were conducted for the evaluation of calcified tissue. The gap between the bony callus and cartilaginous callus was measured.</div></div><div><h3>Results</h3><div>US effectively captured changes on the fracture surface, potentially reflecting the early healing processes. Both US and radiographic findings showed strong correlation in terms of the decrease in the bony callus gap. US was unable to distinguish cartilaginous callus from the surrounding soft tissue. During the remodeling stage, micro-CT offered a detailed assessment of the internal fracture surface, whereas US was limited to evaluating the outer bone surface and lacked accuracy in visualizing the entire fracture site. Radiography provided a general overview of the fractures. The decrease in the bony callus gap measured using US correlated with the reduction in cartilaginous callus observed histologically.</div></div><div><h3>Conclusion</h3><div>This study demonstrated that US could be a valuable tool for evaluating fracture healing. Combining fracture management with US and radiological examinations may provide a more accurate assessment of healing progress.</div></div>","PeriodicalId":9043,"journal":{"name":"Bone Reports","volume":"23 ","pages":"Article 101807"},"PeriodicalIF":2.1,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352187224000743/pdfft?md5=b4602ad835bfbf30c300979e46abe843&pid=1-s2.0-S2352187224000743-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142312380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between trabecular bone score, 10-year probability risk for fracture, and vertebral fractures in rheumatoid arthritis","authors":"Houssam Boutaibi,&nbsp;Hamida Azzouzi,&nbsp;Fadoua Chennouf,&nbsp;Linda Ichchou","doi":"10.1016/j.bonr.2024.101806","DOIUrl":"10.1016/j.bonr.2024.101806","url":null,"abstract":"<div><h3>Objectives</h3><div>The aim was to assess the association and predictive value of trabecular bone score (TBS), fracture risk assessment tool (FRAX), and TBS-adjusted FRAX with prevalent vertebral fractures (VFs) in patients with rheumatoid arthritis (RA).</div></div><div><h3>Methods</h3><div>Patients diagnosed with RA were included in this cross-sectional study. Clinical data and laboratory tests were collected on the same day as the dual-energy x-ray absorptiometry (DXA) scan. TBS, bone mineral density (BMD), and vertebral fracture assessment (VFA) were obtained from the DXA scan. We used the FRAX tool to assess the 10-year probability of major osteoporotic fracture (MOF-FRAX) and hip fracture (HF-FRAX) with and without BMD. These parameters were further adjusted for TBS. Patients with prevalent VFs were defined as those with moderate to severe VFs from T4 to L4. VFs presence was used as the binary variable in the logistic regressions and receiving operator characteristics (ROC) curves analysis.</div></div><div><h3>Results</h3><div>Sixty-nine patients were enrolled, with 55.1 % being postmenopausal. The mean TBS was 1.328 ± 0.104. Osteoporosis according to the WHO criteria was present in 39 patients (56.5 %), and six patients (8.7 %) had VFs with thoracic predominance (66.67 %). Univariate and multivariate logistic regression analyses did not show an association between TBS and vertebral fractures, but FRAX scores indicated such an association. The area under the curve (AUC) with 95 % confidence intervals (CI) for the MOF-FRAX score with BMD, MOF-FRAX score without BMD, TBS-adjusted MOF-FRAX score, and TBS were 0.837 [0.686–0.988], 0.795 [0.629–0.961], 0.778 [0.571–0.984], and 0.515 [0.298–0.731], respectively.</div></div><div><h3>Conclusion</h3><div>In our RA patients, FRAX scores were associated with vertebral fractures (VFs), while TBS was not. The MOF-FRAX score combined with BMD, showed the best AUC for VFs in this population.</div></div>","PeriodicalId":9043,"journal":{"name":"Bone Reports","volume":"23 ","pages":"Article 101806"},"PeriodicalIF":2.1,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142328284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Romosuzumab used to treat a 29-year-old patient with anorexia nervosa related osteoporosis – A case report","authors":"Pashija Demolli,&nbsp;Diana Frey","doi":"10.1016/j.bonr.2024.101803","DOIUrl":"10.1016/j.bonr.2024.101803","url":null,"abstract":"<div><h3>Summary</h3><p>Osteoporosis and decreased bone density is a frequent complication of anorexia nervosa (AN). As of yet, there have been no studies of accomplished treatment of AN-related osteoporosis with romosuzumab, a monoclonal antibody to sclerostin. We report the first case of a premenopausal, 29-year old patient in Switzerland with decreased bone density and osteoporotic fractures due to anorexia nervosa, who completed the treatment with romosuzumab. There was a significant increase in bone mineral density (BMD) after 12 months of therapy. No serious side effects were reported. To date, only bisphosphonates, denosumab and teriparatide have been evaluated in treatment of AN-related osteoporosis in adolescents and premenopausal individuals respectively. Our report demonstrates that romosuzumab might be an alternative treatment option in patients with anorexia nervosa who are at high risk for osteoporotic fractures. To assess the efficacy and safety of romosuzumab in individuals with AN further studies are needed.</p></div>","PeriodicalId":9043,"journal":{"name":"Bone Reports","volume":"22 ","pages":"Article 101803"},"PeriodicalIF":2.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352187224000706/pdfft?md5=787d170bc85bba3b4eb5a7451b1d87ba&pid=1-s2.0-S2352187224000706-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142232007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case report of Tumor-Induced Osteomalacia (TIO) caused by central giant cell granuloma","authors":"Sevil Ghaffarzadeh Rad ,&nbsp;Amir Bahrami ,&nbsp;Jalil Houshyar ,&nbsp;Nazila Farrin ,&nbsp;Farzad Najafipour ,&nbsp;Halimeh Amirazad","doi":"10.1016/j.bonr.2024.101804","DOIUrl":"10.1016/j.bonr.2024.101804","url":null,"abstract":"<div><h3>Introduction</h3><p>Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome defined by severe hypophosphatemia, bone loss, fractures, and muscle weakness. Identifying of the tumor site is often difficult. The primary treatment for Tumor-induced osteomalacia (TIO) is currently surgical resection. Removing the primary tumor is the most definitive treatment for this disease.</p></div><div><h3>Methods</h3><p>Here we describe the case of a 32-year-old man who exhibited sever muscle weakness and pain that had continued for three years. The patient has three sisters and one brother, all of whom are completely healthy and free of bone and muscle problems.</p><p>Laboratory data indicate low serum phosphorus, normal serum and urine calcium level, besides raised alkaline phosphatase level. Due to elevated phosphorus levels in the urine and the lack of an alternative source for phosphorus excretion, along with the absence of short stature, bone deformities, and a negative family history that might suggest the potential for Tumor-induced osteomalacia (TIO), an octreotide scan was performed to the localized the tumor site. The scan, corroborated by CT and MRI scans, displayed absorption in the right maxillary sinus. Surgical excision of the lesion confirmed it to be a central giant cell granuloma.</p></div><div><h3>Results</h3><p>Following surgery and without receiving any other treatment, the patient's phosphorus levels and clinical condition improved compared to before the surgical treatment. Subsequently, the symptoms of muscle weakness and skeletal pain significantly diminished, and the patient regained the ability to move.</p></div><div><h3>Conclusion</h3><p>Tumor enucleation was conducted, and the pathological examination of the maxillary sinus lesion unveiled a central Giant cell granuloma. The patient had clinical and laboratory improvement after surgery. This finding confirmed our diagnosis of a paraneoplastic hypophosphatemia associated with a giant cell granuloma.</p></div>","PeriodicalId":9043,"journal":{"name":"Bone Reports","volume":"22 ","pages":"Article 101804"},"PeriodicalIF":2.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352187224000718/pdfft?md5=cad58d6071f6d3513eb0fec85bd4ba4d&pid=1-s2.0-S2352187224000718-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142232008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Classification of AO/OTA 31A/B femur fractures in X-ray images using YOLOv8 and advanced data augmentation techniques","authors":"Giorgia Marullo ,&nbsp;Luca Ulrich ,&nbsp;Francesca Giada Antonaci ,&nbsp;Andrea Audisio ,&nbsp;Alessandro Aprato ,&nbsp;Alessandro Massè ,&nbsp;Enrico Vezzetti","doi":"10.1016/j.bonr.2024.101801","DOIUrl":"10.1016/j.bonr.2024.101801","url":null,"abstract":"<div><p>Femur fractures are a significant worldwide public health concern that affects patients as well as their families because of their high frequency, morbidity, and mortality. When employing computer-aided diagnostic (CAD) technologies, promising results have been shown in the efficiency and accuracy of fracture classification, particularly with the growing use of Deep Learning (DL) approaches. Nevertheless, the complexity is further increased by the need to collect enough input data to train these algorithms and the challenge of interpreting the findings. By improving on the results of the most recent deep learning-based Arbeitsgemeinschaft für Osteosynthesefragen and Orthopaedic Trauma Association (AO/OTA) system classification of femur fractures, this study intends to support physicians in making correct and timely decisions regarding patient care. A state-of-the-art architecture, YOLOv8, was used and refined while paying close attention to the interpretability of the model. Furthermore, data augmentation techniques were involved during preprocessing, increasing the dataset samples through image processing alterations. The fine-tuned YOLOv8 model achieved remarkable results, with 0.9 accuracy, 0.85 precision, 0.85 recall, and 0.85 F1-score, computed by averaging the values among all the individual classes for each metric. This study shows the proposed architecture's effectiveness in enhancing the AO/OTA system's classification of femur fractures, assisting physicians in making prompt and accurate diagnoses.</p></div>","PeriodicalId":9043,"journal":{"name":"Bone Reports","volume":"22 ","pages":"Article 101801"},"PeriodicalIF":2.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352187224000688/pdfft?md5=c156380142f0c7a0c683d11234b52bc2&pid=1-s2.0-S2352187224000688-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142242209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delineating the relationship between circulating osteoprotegerin and bone health in women with a pathogenic variant in BRCA1: A cross-sectional analysis","authors":"Aghaghia Mokhber ,&nbsp;Elizabeth Hall ,&nbsp;Aleksandra Uzelac ,&nbsp;Leonardo Salmena ,&nbsp;Angela Cheung ,&nbsp;Jan Lubinski ,&nbsp;Steven A. Narod ,&nbsp;Joanne Kotsopoulos","doi":"10.1016/j.bonr.2024.101802","DOIUrl":"10.1016/j.bonr.2024.101802","url":null,"abstract":"<div><h3>Purpose</h3><p>Osteoprotegerin (OPG) plays an important role in the inhibition of osteoclast formation and bone resorption. Studies have reported lower OPG levels among women with a pathogenic variant (mutation) in the <em>BRCA1</em> gene, and thus, may be at greater risk for skeletal bone loss. Thus, we investigated the association between circulating OPG and two validated markers of bone health: 1) bone fracture risk score (FRAX) and 2) bone mineral density (BMD), among <em>BRCA</em> mutation carriers.</p></div><div><h3>Methods</h3><p>Women with a blood sample and clinical data were included in this analysis. An enzyme-linked immunosorbent assay (ELISA) was used to quantify serum OPG (pg/mL) and the 10-year risk of <em>major</em> osteoporotic fracture (FRAXmajor) and <em>hip</em> fracture (FRAXhip) (%) was estimated using a web-based algorithm. For a subset of women, lumbar spine BMD was previously assessed by dual x-ray absorptiometry (DXA)(T-score). A Mann–Whitney <em>U</em> test was used to evaluate the association between OPG and FRAX score, while linear regression was used to assess the association of OPG and BMD.</p></div><div><h3>Results</h3><p>Among 701 women with a <em>BRCA1</em> mutation, there was a significant (and unexpected) positive association between OPG levels and FRAX score (FRAXmajor: 2.12 (low OPG) vs. 2.53 (high OPG) <em>P</em> &lt; 0.0001; FRAXhip: 0.27 (low OPG) vs. 0.44 (high OPG) <em>P</em> &lt; 0.0001). In a subset with BMD measurement (<em>n</em> = 50), low serum OPG was associated with a significantly lower BMD T-score (−1.069 vs. -0.318; <em>P</em> = 0.04).</p></div><div><h3>Conclusion</h3><p>Our findings suggest that women with inherently lower OPG may be at risk of lower BMD, the gold standard marker of bone disease. Due to the young age of our cohort, on-going studies are warranted to re-evaluate the association between OPG and FRAX in <em>BRCA</em> mutation carriers.</p></div>","PeriodicalId":9043,"journal":{"name":"Bone Reports","volume":"22 ","pages":"Article 101802"},"PeriodicalIF":2.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S235218722400069X/pdfft?md5=e860742d60e78effd5cdbe332f2d03d6&pid=1-s2.0-S235218722400069X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142151919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A staged approach using machine learning and uncertainty quantification to predict the risk of hip fracture","authors":"Anjum Shaik ,&nbsp;Kristoffer Larsen ,&nbsp;Nancy E. Lane ,&nbsp;Chen Zhao ,&nbsp;Kuan-Jui Su ,&nbsp;Joyce H. Keyak ,&nbsp;Qing Tian ,&nbsp;Qiuying Sha ,&nbsp;Hui Shen ,&nbsp;Hong-Wen Deng ,&nbsp;Weihua Zhou","doi":"10.1016/j.bonr.2024.101805","DOIUrl":"10.1016/j.bonr.2024.101805","url":null,"abstract":"<div><p>Hip fractures present a significant healthcare challenge, especially within aging populations, where they are often caused by falls. These fractures lead to substantial morbidity and mortality, emphasizing the need for timely surgical intervention. Despite advancements in medical care, hip fractures impose a significant burden on individuals and healthcare systems. This paper focuses on the prediction of hip fracture risk in older and middle-aged adults, where falls and compromised bone quality are predominant factors.</p><p>The study cohort included 547 patients, with 94 experiencing hip fracture. To assess the risk of hip fracture, clinical variables and clinical variables combined with hip DXA imaging features were evaluated as predictors, followed by a novel staged approach. Hip DXA imaging features included those extracted by convolutional neural networks (CNNs), shape measurements, and texture features. Two ensemble machine learning models were evaluated: Ensemble 1 (clinical variables only) and Ensemble 2 (clinical variables and imaging features) using the logistic regression as the base classifier and bootstrapping for ensemble learning. The staged approach was developed using uncertainty quantification from Ensemble 1 which was used to decide if hip DXA imaging features were necessary to improve prediction for each subject. Ensemble 2 exhibited the highest performance, achieving an Area Under the Curve (AUC) of 0.95, an accuracy of 0.92, a sensitivity of 0.81, and a specificity of 0.94. The staged model also performed well, with an AUC of 0.85, an accuracy of 0.86, a sensitivity of 0.56, and a specificity of 0.92, outperforming Ensemble 1, which had an AUC of 0.55, an accuracy of 0.73, a sensitivity of 0.20, and a specificity of 0.83. Furthermore, the staged model suggested that 54.49 % of patients did not require DXA scanning, effectively balancing accuracy and specificity, while offering a robust solution when DXA data acquisition is not feasible. Statistical tests confirmed significant differences between the models, highlighting the advantages of advanced modeling strategies.</p><p>Our staged approach offers a cost-effective holistic view of patient health. It can identify individuals at risk of hip fracture with a high accuracy while reducing unnecessary DXA scans. This approach has great promise to guide the need for interventions to prevent hip fracture while reducing diagnostic cost and exposure to radiation.</p></div>","PeriodicalId":9043,"journal":{"name":"Bone Reports","volume":"22 ","pages":"Article 101805"},"PeriodicalIF":2.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S235218722400072X/pdfft?md5=8f8063473a9a18e01b505633107f75a5&pid=1-s2.0-S235218722400072X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142242208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}