Update on the clinical use of trabecular bone score (TBS) in the management of osteoporosis: results of an expert group meeting organized by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO), and the International Osteoporosis Foundation (IOF) under the auspices of WHO Collaborating Center for Epidemiology of Musculoskeletal Health and Aging

Purpose Trabecular bone score (TBS) is a grey-level textural measurement acquired from dual-energy X-ray absorptiometry lumbar spine images and is a validated index of bone microarchitecture. In 2015, a Working Group of the European Society on Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) published a review of the TBS literature, concluding that TBS predicts hip and major osteoporotic fracture, at least partly independent of bone mineral density (BMD) and clinical risk factors. It was also concluded that TBS is potentially amenable to change as a result of pharmacological therapy. Further evidence on the utility of TBS has since accumulated in both primary and secondary osteoporosis, and the introduction of FRAX and BMD T-score adjustment for TBS has accelerated adoption. This position paper therefore presents a review of the updated scientific literature and provides expert consensus statements and corresponding operational guidelines for the use of TBS. Methods An Expert Working Group was convened by the ESCEO and a systematic review of the evidence undertaken, with defined search strategies for four key topics with respect to the potential use of TBS: (1) fracture prediction in men and women; (2) initiating and monitoring treatment in postmenopausal osteoporosis; (3) fracture prediction in secondary osteoporosis; and (4) treatment monitoring in secondary osteoporosis. Statements to guide the clinical use of TBS were derived from the review and graded by consensus using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach. Results A total of 96 articles were reviewed and included data on the use of TBS for fracture prediction in men and women, from over 20 countries. The updated evidence shows that TBS enhances fracture risk prediction in both primary and secondary osteoporosis, and can, when taken with BMD and clinical risk factors, inform treatment initiation and the choice of antiosteoporosis treatment. Evidence also indicates that TBS provides useful adjunctive information in monitoring treatment with long-term denosumab and anabolic agents. All expert consensus statements were voted as strongly recommended. Conclusion The addition of TBS assessment to FRAX and/or BMD enhances fracture risk prediction in primary and secondary osteoporosis, adding useful information for treatment decision-making and monitoring. The expert consensus statements provided in this paper can be used to guide the integration of TBS in clinical practice for the assessment and management of osteoporosis. An example of an operational approach is provided in the appendix. Summary This position paper presents an up-to-date review of the evidence base, synthesised through expert consensus statements, which informs the implementation of Trabecular Bone Score in clinical practice

Triassic sedimentation and postaccretionary crustal evolution along the Solonker suture zone in Inner Mongolia, China

Detrital zircon U-Pb dating of the Xingfuzhilu Formation in southern Inner Mongolia yields a maximum depositional age of around 220 Ma. The predominantly Permian and Triassic zircons are characterized by oscillatory zoning and euhedral shapes, with mostly positive zircon εHf(t) values (+2.0 to +16.4), indicating that they were derived from a proximal magmatic source. Early-Middle Paleozoic zircons have variable zircon εHf(t) values from −6.2 to +11.2 and are characterized by weak oscillatory zoning and subhedral-subrounded shapes, suggesting that the sources are a proximal magmatic arc, possibly mixed with components of the Ondor Sum magmatic arc and the magmatic arc at the northern margin of the North China Craton. The remnants of Precambrian blocks in the southeastern Central Asian Orogenic Belt (CAOB), and the North China Craton may also have been a minor source region for the Xingfuzhilu succession. These results, combined with regional data, indicate that a closing remnant ocean basin or narrow seaway possibly existed in the Middle Permian (Guadalupian) immediately prior to final collision of the CAOB and closure of the Paleo-Asian Ocean. Subsequent collision resulted in the crustal uplift and thickening along the Solonker suture zone, accompanied by possible slab break-off and lithospheric delamination during the Latest Permian to Middle Triassic. The resultant orogen in the Late Triassic underwent exhumation and denudation of rocks in response to the postorogenic collapse and regional extension. Vertical crustal growth in the Triassic is documented by detrital zircons from the Xingfuzhilu Formation and appears to have been widespread across entire eastern CAOB

Metamorphic and structural evolution of the Maures-Tanneron massif (SE Variscan chain): evidence of doming along a transpressional margin

International audienceThe Variscan metamorphic and structural evolution of the Maures-Tanneron massif is divided in two main post-collisional phases: (1) a MP-MT regional gradient is developed during nappe-piling process between 350 and 320 Ma, followed by (2) LP-HT regional gradient coeval with doming between 320 and 300 Ma. During this late phase, the tectonic context was dominated by E-W shortening, which produced crustal-scale upright folds and major strike-slip displacement along trans-crustal faults. Symmetric extensional fabrics are observed on the limbs of crustal-scale anticlines, and are ascribed to local accommodation of lower crust exhumation. Heat and magma transfer are allowed by these large vertical strike-slip faults, and are thought to be the cause of the late metamorphic evolution. Therefore, structures and metamorphism argue for a transpressional context at the SE branch of the Variscan chain. Comparisons with current collisional settings such as syntaxial domains of the Himalayan belt show that the timing and PT conditions of metamorphic events are similar. These observations lead us to propose that the situation of the Variscan chain during the period 320-300 Ma was still a syn-convergent setting similar to the current situation of the Himalayan-Tibet system, and that extensional movements are not the cause of, but the result of exhumation of the lower crust in this ongoing shortening context along a transpressional wrench boundary

Variscan evolution of the Tanneron Massif, SE France, examined through U-Pb monazite ages

Journal of the Geological Society of London, v. 165, n. 2, p. 467-478, 2008. http://dx.doi.org/10.1144/0016-76492007-045International audienc

Exhumation processes during post-collisional stage in the Variscan belt revealed by detailed 40Ar/39Ar study (Tanneron Massif, SE France)

International audienceDetailed 40Ar/39Ar geochronology on single grains of muscovite was performed in the Variscan Tanneron Massif (SE France) to determine the precise timing of the post-collisional exhumation processes. Thirty-two plateau ages, obtained on metamorphic and magmatic rocks sampled along an east–west transect through the massif, vary from 302 ± 2 to 321 ± 2 Ma, and reveal a heterogeneous exhumation of the lower crust that lasted about 20 Ma during late Carboniferous. In the eastern part of the massif, the closure of the K–Ar isotopic system is at 311–315 Ma, whereas in the middle part of the massif it closes earlier at 317–321 Ma. These cooling paths are likely to be the result of differential exhumation processes of distinct crustal blocks controlled by a major ductile fault, the La Moure fault that separates both domains. In the western part of the massif, the ages decrease from 318 to 303 Ma approaching the Rouet granite, which provides the youngest age at 303.6 ± 1.2 Ma. This age distribution can be explained by the occurrence of a thermal structure spatially associated to the magmatic complex. These ages argue in favour of a cooling of the magmatic body at around 15 Ma after the country rocks in the western Tanneron. The emplacement of the Rouet granite in the core of an antiform is responsible for recrystallization and post-isotopic closure disturbances of the K–Ar chronometer in the muscovite from the host rocks. These new 40Ar/39Ar ages clearly outline that at least two different processes may contribute to the exhumation of the lower crust in the later stage of collision. During the first stage between 320 and 310 Ma, the differential motion of tectonic blocks limited by ductile shear zones controls the post-collisional exhumation. This event could be related to orogen parallel shearing associated with crustal-scale strike-slip faults and regional folding. The final exhumation stages at around 300 Ma take place within the tectonic doming associated to magmatic intrusions in the core of antiformal structures. Local ductile to brittle normal faulting is coeval to Upper Carboniferous intracontinental basins opening

Detrital and xenocrystic zircon ages from Neoproterozoic to Palaeozoic arc terranes of Mongolia: Significance for the origin of crustal fragments in the Central Asian Orogenic Belt

The Central Asian Orogenic Belt contains many Precambrian crustal fragments whose origin is unknown, and previous speculations suggested these to be derived from either Siberia, Tarim or northern Gondwana. We present an age pattern for detrital and xenocrystic zircons from Neoproterozoic to Palaeozoic arc and microcontinental terranes in Mongolia and compare this with patterns for Precambrian rocks in southern Siberia, the North China craton, the Tarim craton and northeastern Gondwana in order to define the most likely source region for the Mongolian zircons. Our data were obtained by SHRIMP II, LA-ICP-MS and single zircon evaporation and predominantly represent arc-related low-grade volcanic rocks and clastic sediments but also accretionary wedges and ophiolitic environments. The Mongolian pattern is dominated by zircons in the age range ca. 350-600 and 700-1020. Ma as well as minor peaks between ca. 1240 and 2570. Ma. The youngest group reflects cannibalistic reworking of the Palaeozoic arc terranes, whereas the Neoproterozoic to late Mesoproterozoic peak reflects both reworking of the arc terranes as well as Neoproterozoic rifting and a Grenville-age crust-formation event. The 700-1020. Ma peak does not exist in the age spectra of the Siberian and North China cratons and thus effectively rules out these basement blocks as potential source areas for the Mongolian zircons. The best agreement is with the Tarim craton where a major Grenville-age orogenic event and early Neoproterozoic rifting have been identified. The age spectra also do not entirely exclude northeastern Gondwana as a source for the Mongolian zircons, but here the Neoproterozoic age peak is related to the Pan-African orogeny, and a minor Grenville-age peak may reflect a controversial orogenic event in NW India. Our Mongolian detrital and xenocrystic age spectrum suggests that the Tarim craton was the main source, and we favour a tectonic scenario similar to the present southwestern Pacific where fragments of Australia are rifted off and become incorporated into the Indonesian arc and microcontinent amalgamation that will evolve into a future orogenic belt. © 2010 International Association for Gondwana Research.link_to_subscribed_fulltex

Age and Sources of Late Precambrian Sedimentary Sequences of the Southern Baikal Region: Results of the U–Pb LA-ICP-MS Dating of Detrital Zircons

The first data on the age of detrital zircons are given for Late Precambrian terrigenous rocks of the Baikal Group and Ushakovka Formation of the southern flank of the Siberian Craton. The ages obtained for 348 zircons cover the Paleoarchean to Late Ediacaran period, demonstrate the dynamics of change of sources of the clastic material in the sedimentation basin, and mark the changes of the Late Precambrian tectonic regimes. The age of the youngest group of detrital zircons extracted from the rocks of the Kachergat Formation allows us to restrict the upper age limit of accumulation of the rocks of the Baikal Group to the Late Ediacaran (Late Vendian)