The Initial Slope of the Variogram, Foundation of the Trabecular Bone Score, Is Not or Is Poorly Associated With Vertebral Strength.

Trabecular bone score (TBS) rests on the textural analysis of dual-energy X-ray absorptiometry (DXA) to reflect the decay in trabecular structure characterizing osteoporosis. Yet, its discriminative power in fracture studies remains incomprehensible because prior biomechanical tests found no correlation with vertebral strength. To verify this result possibly owing to an unrealistic setup and to cover a wide range of loading scenarios, the data from three previous biomechanical studies using different experimental settings were used. They involved the compressive failure of 62 human lumbar vertebrae loaded 1) via intervertebral discs to mimic the in vivo situation ("full vertebra"); 2) via the classical endplate embedding ("vertebral body"); or 3) via a ball joint to induce anterior wedge failure ("vertebral section"). High-resolution peripheral quantitative computed tomography (HR-pQCT) scans acquired from prior testing were used to simulate anterior-posterior DXA from which areal bone mineral density (aBMD) and the initial slope of the variogram (ISV), the early definition of TBS, were evaluated. Finally, the relation of aBMD and ISV with failure load (Fexp ) and apparent failure stress (σexp ) was assessed, and their relative contribution to a multilinear model was quantified via ANOVA. We found that, unlike aBMD, ISV did not significantly correlate with Fexp and σexp , except for the "vertebral body" case (r(2) = 0.396, p = 0.028). Aside from the "vertebra section" setup where it explained only 6.4% of σexp (p = 0.037), it brought no significant improvement to aBMD. These results indicate that ISV, a replica of TBS, is a poor surrogate for vertebral strength no matter the testing setup, which supports the prior observations and raises a fortiori the question of the deterministic factors underlying the statistical relationship between TBS and vertebral fracture risk. © 2015 American Society for Bone and Mineral Research

Head-Neck Osteoplasty has Minor Effect on the Strength of an Ovine Cam-FAI Model: In Vitro and Finite Element Analyses

Background Osteochondroplasty of the head-neck region is performed on patients with cam femoroacetabular impingement (FAI) without fully understanding its repercussion on the integrity of the femur. Cam-type FAI can be surgically and reproducibly induced in the ovine femur, which makes it suitable for studying corrective surgery in a consistent way. Finite element models built on quantitative CT (QCT) are computer tools that can be used to predict femoral strength and evaluate the mechanical effect of surgical correction. Questions/purposes We asked: (1) What is the effect of a resection of the superolateral aspect of the ovine femoral head-neck junction on failure load? (2) How does the failure load after osteochondroplasty compare with reported forces from activities of daily living in sheep? (3) How do failure loads and failure locations from the computer simulations compare with the experiments? Methods Osteochondroplasties (3, 6, 9 mm) were performed on one side of 18 ovine femoral pairs with the contralateral intact side as a control. The 36 femurs were scanned via QCT from which specimen-specific computer models were built. Destructive compression tests then were conducted experimentally using a servohydraulic testing system and numerically via the computer models. Safety factors were calculated as the ratio of the maximal force measured in vivo by telemeterized hip implants during the sheep’s walking and running activities to the failure load. The simulated failure loads and failure locations from the computer models were compared with the experimental results. Results Failure loads were reduced by 5% (95% CI, 2%–8%) for the 3-mm group (p = 0.0089), 10% (95% CI, 6%–14%) for the 6-mm group (p = 0.0015), and 19% (95% CI, 13%–26%) for the 9-mm group (p = 0.0097) compared with the controls. Yet, the weakest specimen still supported more than 2.4 times the peak load during running. Strong correspondence was found between the simulated and experimental failure loads (R2 = 0.83; p < 0.001) and failure locations. Conclusions The resistance of ovine femurs to fracture decreased with deeper resections. However, under in vitro testing conditions, the effect on femoral strength remains small even after 9 mm correction, suggesting that femoral head-neck osteochondroplasty could be done safely on the ovine femur. QCT-based finite element models were able to predict weakening of the femur resulting from the osteochondroplasty. Clinical Relevance The ovine femur provides a seemingly safe platform for scientific evaluation of FAI. It also appears that computer models based on preoperative CT scans may have the potential to provide patient-specific guidelines for preventing overcorrection of cam FAI

Structure model index does not measure rods and plates in trabecular bone

Structure model index (SMI) is widely used to measure rods and plates in trabecular bone. It exploits the change in surface curvature that occurs as a structure varies from spherical (SMI = 4), to cylindrical (SMI = 3) to planar (SMI = 0). The most important assumption underlying SMI is that the entire bone surface is convex and that the curvature differential is positive at all points on the surface. The intricate connections within the trabecular continuum suggest that a high proportion of the surface could be concave, violating the assumption of convexity and producing regions of negative differential. We implemented SMI in the BoneJ plugin and included the ability to measure the amounts of surface that increased or decreased in area after surface mesh dilation, and the ability to visualize concave and convex regions. We measured SMI and its positive (SMI+) and negative (SMI-) components, bone volume fraction (BV/TV), the fraction of the surface that is concave (CF), and mean ellipsoid factor (EF) in trabecular bone using 38 X-ray microtomography (XMT) images from a rat ovariectomy model of sex steroid rescue of bone loss, and 169 XMT images from a broad selection of 87 species' femora (mammals, birds, and a crocodile). We simulated bone resorption by eroding an image of elephant trabeculae and recording SMI and BV/TV at each erosion step. Up to 70%, and rarely less than 20%, of the trabecular surface is concave (CF 0.155 – 0.700). SMI is unavoidably influenced by aberrations from SMI-, which is strongly correlated with BV/TV and CF. The plate-to-rod transition in bone loss is an erroneous observation resulting from SMI's close and artefactual relationship with BV/TV. SMI cannot discern between the distinctive trabecular geometries typical of mammalian and avian bone, whereas EF clearly detects birds' more plate-like trabeculae. EF is free from confounding relationships with BV/TV and CF. SMI results reported in the literature should be treated with suspicion. We propose that EF should be used instead of SMI for measurements of rods and plates in trabecular bone

Principales resultados de la Encuesta Nacional a Instituciones Educativas de Nivel Inicial, Primaria y Secundaria 2017

El Instituto Nacional de Estadística e Informática (INEI) órgano rector del Sistema Estadístico Nacional, en el marco del Programa Logros de Aprendizaje de los Estudiantes de Educación Básica Regular, ejecutó del 02 de octubre al 02 de diciembre del año 2017 la Encuesta Nacional a Instituciones Educativas de Nivel Inicial, Primaria y Secundaria. La encuesta tiene por finalidad obtener información para estimar indicadores que permitan evaluar la aplicación del Programa Logros de Aprendizaje de los Estudiantes de Educación Básica Regular, en las instituciones educativas públicas de nivel inicial, primaria y secundaria. La encuesta se aplicó a una muestra de instituciones educativas de nivel inicial, primaria y secundaria, con representatividad nacional, regional, por área urbana y rural y recopiló información sobre: Cumplimiento de horas lectivas normadas, Acompañamiento Pedagógico de Soporte Pedagógico de Primaria, Programa de Formación Docente en Servicio, Tecnologías Digitales para el Aprendizaje, Materiales Educativos, Asistencia Técnica para la Implementación del Currículo Nacional, Disponibilidad y Uso de los Resultados de la Evaluación Censal de Estudiantes de Primaria y Secundaria, Programa de Mantenimiento de la Infraestructura y Mobiliario del Local Escolar

Principales resultados de la Encuesta Nacional a Instituciones Educativas de Nivel Inicial, Primaria y Secundaria 2017

El Instituto Nacional de Estadística e Informática (INEI) órgano rector del Sistema Estadístico Nacional, en el marco del Programa Logros de Aprendizaje de los Estudiantes de Educación Básica Regular, ejecutó del 02 de octubre al 02 de diciembre del año 2017 la Encuesta Nacional a Instituciones Educativas de Nivel Inicial, Primaria y Secundaria. La encuesta tiene por finalidad obtener información para estimar indicadores que permitan evaluar la aplicación del Programa Logros de Aprendizaje de los Estudiantes de Educación Básica Regular, en las instituciones educativas públicas de nivel inicial, primaria y secundaria. La encuesta se aplicó a una muestra de instituciones educativas de nivel inicial, primaria y secundaria, con representatividad nacional, regional, por área urbana y rural y recopiló información sobre: Cumplimiento de horas lectivas normadas, Acompañamiento Pedagógico de Soporte Pedagógico de Primaria, Programa de Formación Docente en Servicio, Tecnologías Digitales para el Aprendizaje, Materiales Educativos, Asistencia Técnica para la Implementación del Currículo Nacional, Disponibilidad y Uso de los Resultados de la Evaluación Censal de Estudiantes de Primaria y Secundaria, Programa de Mantenimiento de la Infraestructura y Mobiliario del Local Escolar

Cancellous bone and theropod dinosaur locomotion. Part I—an examination of cancellous bone architecture in the hindlimb bones of theropods

This paper is the first of a three-part series that investigates the architecture of cancellous (‘spongy’) bone in the main hindlimb bones of theropod dinosaurs, and uses cancellous bone architectural patterns to infer locomotor biomechanics in extinct non-avian species. Cancellous bone is widely known to be highly sensitive to its mechanical environment, and has previously been used to infer locomotor biomechanics in extinct tetrapod vertebrates, especially primates. Despite great promise, cancellous bone architecture has remained little utilized for investigating locomotion in many other extinct vertebrate groups, such as dinosaurs. Documentation and quantification of architectural patterns across a whole bone, and across multiple bones, can provide much information on cancellous bone architectural patterns and variation across species. Additionally, this also lends itself to analysis of the musculoskeletal biomechanical factors involved in a direct, mechanistic fashion. On this premise, computed tomographic and image analysis techniques were used to describe and analyse the three-dimensional architecture of cancellous bone in the main hindlimb bones of theropod dinosaurs for the first time. A comprehensive survey across many extant and extinct species is produced, identifying several patterns of similarity and contrast between groups. For instance, more stemward non-avian theropods (e.g. ceratosaurs and tyrannosaurids) exhibit cancellous bone architectures more comparable to that present in humans, whereas species more closely related to birds (e.g. paravians) exhibit architectural patterns bearing greater similarity to those of extant birds. Many of the observed patterns may be linked to particular aspects of locomotor biomechanics, such as the degree of hip or knee flexion during stance and gait. A further important observation is the abundance of markedly oblique trabeculae in the diaphyses of the femur and tibia of birds, which in large species produces spiralling patterns along the endosteal surface. Not only do these observations provide new insight into theropod anatomy and behaviour, they also provide the foundation for mechanistic testing of locomotor hypotheses via musculoskeletal biomechanical modelling

A robust anisotropic hyperelastic formulation for the modelling of soft tissue

The Holzapfel–Gasser–Ogden (HGO) model for anisotropic hyperelastic behaviour of collagen fibre reinforced materials was initially developed to describe the elastic properties of arterial tissue, but is now used extensively for modelling a variety of soft biological tissues. Such materials can be regarded as incompressible, and when the incompressibility condition is adopted the strain energy Ψ of the HGO model is a function of one isotropic and two anisotropic deformation invariants. A compressible form (HGO-C model) is widely used in finite element simulations whereby the isotropic part of Ψ is decoupled into volumetric and isochoric parts and the anisotropic part of Ψ is expressed in terms of isochoric invariants. Here, by using three simple deformations (pure dilatation, pure shear and uniaxial stretch), we demonstrate that the compressible HGO-C formulation does not correctly model compressible anisotropic material behaviour, because the anisotropic component of the model is insensitive to volumetric deformation due to the use of isochoric anisotropic invariants. In order to correctly model compressible anisotropic behaviour we present a modified anisotropic (MA) model, whereby the full anisotropic invariants are used, so that a volumetric anisotropic contribution is represented. The MA model correctly predicts an anisotropic response to hydrostatic tensile loading, whereby a sphere deforms into an ellipsoid. It also computes the correct anisotropic stress state for pure shear and uniaxial deformation. To look at more practical applications, we developed a finite element user-defined material subroutine for the simulation of stent deployment in a slightly compressible artery. Significantly higher stress triaxiality and arterial compliance are computed when the full anisotropic invariants are used (MA model) instead of the isochoric form (HGO-C model)