MSADCN:Multi-Scale Attentional Densely Connected Network for Automated Bone Age Assessment

Bone age assessment(BAA)helps doctors determine how a child’s bones grow and develop in clinical medicine.Traditional BAA methods rely on clinician expertise,leading to time-consuming predictions and inaccurate results.Most deep learning-based BAA methods feed the extracted critical points of images into the network by providing additional annotations.This operation is costly and subjective.To address these problems,we propose a multi-scale attentional densely connected network(MSADCN)in this paper.MSADCN constructs a multi-scale dense connectivity mechanism,which can avoid overfitting,obtain the local features effectively and prevent gradient vanishing even in limited training data.First,MSADCN designs multi-scale structures in the densely connected network to extract fine-grained features at different scales.Then,coordinate attention is embedded to focus on critical features and automatically locate the regions of interest(ROI)without additional annotation.In addition,to improve the model’s generalization,transfer learning is applied to train the proposed MSADCN on the public dataset IMDB-WIKI,and the obtained pre-trained weights are loaded onto the Radiological Society of North America(RSNA)dataset.Finally,label distribution learning(LDL)and expectation regression techniques are introduced into our model to exploit the correlation between hand bone images of different ages,which can obtain stable age estimates.Extensive experiments confirm that our model can converge more efficiently and obtain a mean absolute error(MAE)of 4.64 months,outperforming some state-of-the-art BAA methods.

Anti-Interference Study on Radiographic Bone Age Estimation Based on Artificial Intelligence Model

In this paper, the interferences of X-ray image noise on a bone age model, Xception model, were studied. We conduct a comparative experiment test according to the output performance of the neural network model using both the original image training and noise-added (Gaussian noise plus salt-pepper noise) training, and analyze the anti-interference ability of the Xception model, hoping to improve it through noise enhancement training and generalize the application ability of the model. The results show that the model trained with noise-added (Gaussian noise plussalt-pepper noise) images can make predictions that are more robust and less affected by the image disturbances, such as image noise.

The dependences of osteocyte network on bone compartment, age, and disease

Osteocytes, the most abundant bone cells, form an interconnected network in the lacunar-canalicular pore system （LCS） buried within the mineralized matrix, which allows osteocytes to obtain nutrients from the blood supply, sense external mechanical signals, and communicate among themselves and with other cells on bone surfaces. In this study, we examined key features of the LCS network including the topological parameter and the detailed structure of individual connections and their variations in cortical and cancellous compa~ tments, at different ages, and in two disease conditions with altered mechanosensing （perlecan deficiency and diabetes）. LCS network showed both topological stability, in terms of conservation of connectivity among osteocyte lacunae （similar to the ＂nodes＂ in a computer network）, and considerable variability the pericellular annular fluid gap surrounding lacunae and canaliculi （similar to the ＂bandwidth＂ of individual links in a computer network）. Age, in the range of our study （15-32 weeks）, affected only the pericellular fluid annulus in cortical bone but not in cancellous bone. Diabetes impacted the spacing of the lacunae, while the perlecan deficiency had a profound influence on the pericellular fluid annulus. The LCS network features play important roles in osteocyte signaling and regulation of bone growth and adaptation.

Bone Density and Mechanical Properties in Femoral Bone of Swim Loaded Aged Mice

Effects of swirnming on bone density and mechanical properties of femur were investigated in aged male and female mice. R/1 strain of senescence accelerated mouse (SAM) at eleven months old was used. Two groups of males and two groups of females each consisting of 7 mice were used. One male and one female groups were loaded with a swim regiment of 40 min a day, 5 days a week for 6 consecutive weeks. The remaining groups were used as the controls. All mice were fed with the standard diet and water ad libitum during the experiments.The results of this study indicated that (i) the hady weight was significantly (P<0.05) lower in the swimming groups than in the control groups in boh sexes. (ii) The bone density was significantly higher (P <0.05) in the swimming groups than in the control groups in boh sexes. However, there was no sighficant difference in cortical thickness index. (iii) In the mechanical properties of bone, there were no significant differences in the level of the maximum breaking force, the ultimate stress and the deformation between the swimndng and the contro groups in beth sexes. However, the elasticity of the bone of the female hoce in the swimming group was significantly higher (P<0.05) than that of the control group.These results suggest that regimented swimming for the aged mice might suppress age-associated bone loss, and the effect of exercise in the females is greater that in the males.

Metaheuristic with Deep Learning Enabled Biomedical Bone Age Assessment and Classification Model

The skeletal bone age assessment(BAA)was extremely implemented in development prediction and auxiliary analysis of medicinal issues.X-ray images of hands were detected from the estimation of bone age,whereas the ossification centers of epiphysis and carpal bones are important regions.The typical skeletal BAA approaches remove these regions for predicting the bone age,however,few of them attain suitable efficacy or accuracy.Automatic BAA techniques with deep learning(DL)methods are reached the leading efficiency on manual and typical approaches.Therefore,this study introduces an intellectual skeletal bone age assessment and classification with the use of metaheuristic with deep learning(ISBAAC-MDL)model.The presented ISBAAC-MDL technique majorly focuses on the identification of bone age prediction and classification process.To attain this,the presented ISBAAC-MDL model derives a mask Region-related Convolutional Neural Network(Mask-RCNN)with MobileNet as baseline model to extract features.Followed by,the whale optimization algorithm(WOA)is implemented for hyperparameter tuning of the MobileNet method.At last,Deep Feed-Forward Module(DFFM)based age prediction and Radial Basis Function Neural Network(RBFNN)based stage classification approach is utilized.The experimental evaluation of the ISBAAC-MDL model is tested using benchmark dataset and the outcomes are assessed over distinct factors.The experimental outcomes reported the better performances of the ISBAACMDL model over recent approaches with maximum accuracy of 0.9920.

Bone mineral density in Iranian patients: Effects of age, sex, and body mass index

Introduction: Osteoporosis is a multifactorial skeletal disease that is characterized by reduced bone mineral density (BMD). BMD values depend on several factors such as age, sex and age at menopause. The purpose of this study was to determine the prevalence and changes in bone mineral density in Iranian patients. Methods: Three hundred patients were selected through random sampling technique in 2009. BMD was assessed by Norland (Excell) technique at the lumbar and femoral neck. Weight and height were measured through standard methods. A thorough history was taken from each patient. The data was analyzed using SPSS software version 13.0. P-values less than 0.05 were considered statistically significant. Results: From among the 300 studied patients, 86.6% were female. their mean age was 52.7 years. Their average body mass index (BMI) was 28.14 kg/m2. Mean T-Score at lumbar spine and femoral neck was -1.07 ±1.19 and -1.75 ± 1.33 respectively. Mean BMD value at lumbar spine and femoral neck was 0.92 ± 0.19 and 0.77 ± 0.16 respectively. The prevalence of osteoporosis at lumbar spine and femoral neck was 33.7% and 16.7, respectively. There was a significant correlation between age, BMI and BMD values (P-Value Conclusion: This study shows that ageing and low BMI are risk factors associated with bone loss. it is recommended to measure BMD and implement prevention programs for high-risk people.

Radiological Estimation of Age from Hand Bone in Sudanese Infants and Toddlers

Age determination is one of the most important factors for identification. Unfortunately, births are not recorded regularly in Sudan, especially in rural areas. However, identification of age is very important for a variety of reasons, including identifying legal and criminal responsibility, and for many other social events such as beginning a job, marriage, retirement and joining the army. The study aimed to find the reliability of using international methods to estimate bone age of people through hand bone radiograph in Sudanese people by studying the reliability of using hand bone age “the digital atlas of hand age” which depended on Greulich and Pyle (GP) and Tanner and Whitehouse (TW2/3) methods in Sudanese people in exact group of age, and to compare the hand and wrist bone development between Caucasian and Sudanese people. The study was conducted on 48 samples (26 males and 22 females) from the center of Sudan. The study was made by conventional X-Ray taken from Sudanese newborn babies to 2 and 3 years old for males and females respectively. Those images were taken mostly from the emergency and orthopedic outpatient departments. The ages were grouped in the same ways and periods used in the atlas. So the criteria were tested, and the outcomes were compared with international standards in the atlas of hand bone age. There is evidence that skeletal maturation may vary between difference ethnic and socioeconomic groups of children or among children living in various geographical locations. It is found that there is reliability and applicability of using the atlas in Sudanese people with considering that there might be mild variations between Sudanese and Caucasian people’s hand and wrist bone development in which Caucasian people bone growth was earlier than the Sudanese people bones about 1 - 2 months.

Micro-computed tomography assessment of human femoral trabecular bone for two disease groups(fragility fracture and coxarthrosis):Age and gender related effects on the microstructure

The aim of this study was to identify three-dimensional microstructural changes of trabecular bone with age and gender, using micro-computed tomography. Human trabecular bone from two disease groups, osteoporosis and osteoarthritis was analyzed. A prior analysis of the effects of some procedure variables on the micro-CT results was performed. Preliminary micro-CT scans were performed with three voxel resolutions and two acquisition conditions. On the reconstruction step, the image segmentation was performed with three different threshold values. Samples were collected from patients, with coxarthrosis (osteoarthritis) or fragility fracture (osteoporosis). The specimens of the coxarthrosis group include twenty females and fifteen males, while the fragility fracture group was composed by twenty three females and seven males. The mean age of the population was 69 ± 11 (females) and 67 ± 10 years (males), in the coxarthrosis group, while in the fragility fracture group was 81 ± 6 (females) and 78 ± 6 (males) years. The 30 μm voxel size provided lower percentage difference for the microarchitecture parameters. Acquisition conditions with 160 μA and 60 kV permit the evaluation of all the volume’s sample, with low average values of the coefficients of variation of the microstructural parameters. No statistically significant differences were found between the two diseases groups, neither between genders. However, with aging, there is a decrease of bone volume fraction, trabecular number and fractal dimension, and an increase of structural model index and trabecular separation, for both disease groups and genders. The parameters bone specific surface, trabecular thickness and degree of anisotropy have different behaviors with age, depending on the type of disease. While in coxarthrosis patients, trabecular thickness increases with age, in the fragility fracture group, there is a decrease of trabecular thickness with increasing age. Our findings indicate that disease, age and gender do not provide significant differences in trabecular microstructure. With aging, some parameters exhibit different trends which are possibly related to different mechanisms for different diseases.

Assessment of the relationship between body mass index (BMI) and dental age

The aim of the study was to determine the rela-tionship between Body Mass Index (BMI) and accelerated dental development. The dental developmental ages of 100 children aged between 8 and 12 years were determined using the Demirjian method and panoramic radiographs. BMI status was determined for each subject on the basis of the system developed by the International Obesity Task Force. There was a significant direct relationship between dental development and BMI (P < 0.01). Obese children have a higher rate of dental development compared to normal children. CLINICAL RELEVANCE: This is an important variable to be considered when planning for dental and orthodontic treatments in obese children. Brief objectives statement: Overweight or obesity can accelerate dental development. Accelerated dental development in overweight children is important to be considered in pediatric dentistry and orthodontics.

Nanomechanical Characterization of Bone Quality Depending on Tissue Age via Bimodal Atomic Force Microscopy

Characterization of bone quality during the healing process is crucial for successful implantation procedures and patient comfort.In this study,a bone implant specimen that underwent a 4-week healing period was investigated.Bimodal atomic force microscopy(AFM)was employed to simultaneously obtain the morphology and elastic modulus maps of the newly formed and pre-existing bone regions within the sample.Results indicate that the new bone matrix possessed lower miner-alization levels and presented larger,uneven mineral grains,exhibiting the attributes of a woven bone.On the other hand,the old bone matrix exhibited a more uniform and mineralized structure,which is characteristic of lamellar bones.The new bone had a lower overall elastic modulus than the old bone.Bimodal AFM further confrmed that the new bone displayed three regions comprising unmineralized,partially mineralized,and fully matured sections,which indicate a turbulent change in its composition.Meanwhile,the old bone exhibited two sections comprising partially mineralized and matured bone parts,which denote the fnal phase of mineralization.This study provides valuable insights into the morphological and nanome-chanical diferences between the old and new bone matrixes and presents a novel approach to investigate bone quality at diferent phases of the bone-healing process.

The Effect of Acupuncture on Bone Mineral Density in Postmenopausal Women

According to the TCM theory that the kidney is in charge of the bone, the authors carried out a study on the effect of acupuncture on bone mineral density in 40 postmenopausal women with osteoporosis treated by the method of reinforcing the kidney to strengthen the bone, with satisfactory therapeutic results reported as follows.……

An Enzymologic Study on Bone Marrow Cells in Patients with Aplastic Anemia Treated by Supplementing the Kidney and Removing Blood Stasis

The content of cytochrome oxidase (CCO), succinate dehydrogenase (SDH) and neutrophil alkaline phosphatase (NAP) in bone marrow cells in 68 cases of aplastic anemia before and after treatment was determined by computerized graphical analysis and compared with that of normal volunteers (control group). The significantly lowered CCO and SDH levels and the markedly increased NAP content before treatment (P<0.01) became approximately normal after that of supplementing the kidney and removing blood stasis (P >0.05).

Effects of different doses of long-acting growth hormone in treating children with growth hormone deficiency

BACKGROUND With the improvement of economy and living standards,the attention paid to short stature in children has been increasingly highlighted.Numerous causes can lead to short stature in children,among which growth hormone deficiency(GHD)is a significant factor.AIM To investigate the long-term efficacy and safety of different doses of long-acting polyethylene glycol recombinant human growth hormone(PEG-rhGH)in the treatment of GHD in children.METHODS We selected 44 pediatric patients diagnosed with GHD who were treated at Wuhu First People's Hospital from 2014 to 2018.Total 23 patients were administered a high dose of long-acting PEG-rhGH at 0.2 mg/kg subcutaneously each week,forming the high-dose group.Meanwhile,21 patients were given a lower dose of long-acting PEG-rhGH at 0.14 mg/kg subcutaneously each week,establishing the low-dose Group.The total treatment period was 2 years,during which we monitored the patients’height,annual growth velocity(GV),height standard deviation score(HtSDS),chronological age(CA),bone age(BA),and serum levels of insulin-like growth factor-1(IGF-1)and insulin-like growth factor-binding protein-3(IGFBP-3)before treatment and at 6 mo,1 year,and 2 years after treatment initiation.We also monitored thyroid function,fasting plasma glucose,fasting insulin,and other side effects.Furthermore,we calculated the homeostatic model assessment for insulin resistance.RESULTS After 1 year of treatment,the GV,HtSDS,IGF-1,BA,and IGFBP-3 in both groups significantly improved compared to the pre-treatment levels(P<0.05).Moreover,when comparing GV,HtSDS,IGF-1,BA,and IGFBP-3 between the two groups,there were no statistically significant differences either before or after the treatment(P>0.05).During the treatment intervals of 0-1.0 years and 1.0-2.0 years,both patient groups experienced a slowdown in GV and a decline in HtSDS improvement(P<0.05).CONCLUSION The use of PEG-rhGH in treating GHD patients was confirmed to be effective,with similar outcomes observed in both the high-dose group and low-dose groups,and no significant differences in the main side effects.

Computerized geometric features of carpal bone for bone age estimation

Background Bone age development is one of the significant indicators depicting the growth status of children. However, bone age assessment is an heuristic and tedious work for pediatricians. We developed a computerized bone age estimation system based on the analysis of geometric features of carpal bones. Methods The geometric features of carpals were extracted and analyzed to judge the bone age of children by computerized shape and area description. Four classifiers, linear, nearest neighbor, back-propagation neural network, and radial basis function neural network, were adopted to categorize bone age. Principal component and discriminate analyses were employed to improve assorting accuracy. Results The hand X-ray films of 465 boys and 444 girls served as our database. The features were extracted from carpal bone images, including shape, area, and sequence. The proposed normalization area ratio method was effective in bone age classification by simulation. Besides, features statistics showed similar results between the standard of the Greulich and Pyle atlas and our database. Conclusions The bone area has a higher discriminating power to judge bone age. The ossification sequence of trapezium and trapezoid bones between Taiwan Residents and the atlas of the GP method is quite different. These results also indicate that carpal bone assessment with classification of neural networks can be correct and practical.

Establishment of induced pluripotent stem cells from aged mice using bone marrow-derived myeloid cells

If induced pluripotent stem(iPS)cells are to be used to treat damaged tissues or repair organs in elderly patients,it will be necessary to establish iPS cells from their tissues.To determine the feasibility of using this technology with elderly patients,we asked if it was indeed possible to establish iPS cells from the bone marrow(BM)of aged mice.BM cells from aged C57BL/6 mice carrying the green fluorescence protein(GFP)gene were cultured with granulocyte macrophage-colony stimulating factor(GM-CSF)for 4 days.Four factors(Oct3/4,Sox2,Klf4 and c-Myc)were introduced into the BM-derived myeloid(BM-M)cells.The efficiency of generating iPS cells from aged BM cultured in GM-CSF was low.However,we succeeded in obtaining BM-M-iPS cells from aged C57BL/6 mice,which carried GFP.Our BM-M-iPS cells expressed SSEA-1 and Pou5f1 and were positive for alkaline phosphatase staining.The iPS cells did make teratoma with three germ layers following injection into syngeneic C57BL/6 mice,and can be differentiated to three germ layers in vitro.By co-culturing with OP9,the BM-M-iPS cells can be differentiated to the myeloid lineage.The differentiated BM-M-iPS cells proliferated well in the presence of GM-CSF,and lost expression of Nanog and Pou5f1,at least in part,due to methylation of their promoters.On the contrary,Tnf and Il1b gene expression was upregulated and their promoters were hypomethylated.

Study on Prevention and Treatment of Diabetes in Middle and Aged Women with Kidney Deficiency and Bone Metabolic Disturbance

Objective: To study the therapeutic effect of Chinese herbal medicine (CHM) for supplementing Qi, activating blood circulation and tonifying Kidney on prevention and treatment of diabetes in middle and aged women with Kidney Deficiency and bone metabolic disturbance. Methods: Clinical observation was taken in 52 patients, who were divided into two groups, the control group (treated with hypoglycemic agent alone) and the treated group (treated with hypoglycemic agent and CHM). Results: Before treatment, patients in both groups showed obviously higher blood alkaline phosphatase, β2-microglobulin (β2-MG) level, urinary β2-MG, calcium and phosphorus level, but lower serum estradiol level than those in normal subjects. After 3 months' treatment, no apparent change in serum estradiol level was observed, but other parameters were all lowered obviously in the two groups, with the changes revealed more obviously in the treated group. The symptoms of Kidney Deficiency, such as lumbodorsal pain, fatigue, palpitation and vertigo, were improved after treatment, which was also more obviously in the treated group. Conclusion: CHM for supplementing Qi, activating blood circulation and tonifying Kidney was effective in improving Kidney Deficiency and mineral substance loss in bones in middle and aged diabetic women patients. The CHM and western drugs acted synergistically.

A Report of Bone Age Determination for 11 Immigrants

This paper reported the results of bone age determination for 11 immigrants with X—ray examination . It is found that the actual age of 6 persons didn’t coincide with as claimed , occupying 54.55% of total determined people . The authors also discussed the concept ,singnificance and method of bone age determination . Presented here is Standard Atlas method, which is exact, fast and easy to manoeuver.

THE ANIMAL BONES FROM A FURTHER GROUP OF EARLY BRONZE AGE PITS AT OSTIANO, S. SALVATORE (Cremona)

The faunal remains from a group of pits excavated at Ostiano, S. Salvatore (Cremona- Northern Italy) are represented by bones of cattle, sheep/goat, pig and hare. Together with the archaeo-botanical and archaeological data, they reveal a well balanced, mixed subsistence strategy, combiningcereal agriculture and stock raising, adapted to the geographical and environmental location of this EarlyBronze Age settlement. I resti faunistici di un altro gruppo di pozzetti del sito del Bronzo antico di Ostiano,S. Salvatore (Cremona). I reperti faunistici di Ostiano, S. Salvatore sono rappresentati da resti di bovini,capra/pecora, maiale e lepre. Unitamente ai reperti archeobotanici ed archeologici, questi docmnentanouna strategia di sussistenza ben bilanciata fra allevamento ed agricoltura che concorda con la localizza-zione geografico-ambientale del sito dell’età del Bronzo antica.

Prevalence rate of osteoporosis in the mid-aged and elderly in selected parts of China

OBJECTIVE: To understand the distribution of prevalence rate of osteoporosis in the middle - aged and elderly in parts of China. METHODS: Bone mineral density (BMD) was measured and questionnaires were taken for 5593 people aged above 40 years in five administrative areas in China selected by the stratified - multi - steps - cluster sampling method. RESULTS: The total prevalence rate of osteoporosis was 16.1%. The prevalence rate among males was 11.5% and among females was 19.9% (P

Crohn's disease and risk of fracture: does thyroid disease play a role?

AIM: To assess the role of thyroid disease as a risk for fractures in Crohn's patients.METHODS: A cross-sectional study was conducted from 1998 to 2000. The study group consisted of 210 patients with Crohn's disease. A group of 206 patients without inflammatory bowel disease served as controls. Primary outcome was thyroid disorder. Secondary outcomes included use of steroids, immunosuppressive medications, surgery and incidence of fracture.RESULTS: The prevalence of hyperthyroidism was similar in both groups. However, the prevalence of hypothyroidism was lower in Crohn's patients (3.8 % vs 8.2 %, P=0.05).Within the Crohn's group, the use of immunosuppressive agents (0 % vs11 %), steroid usage (12.5 % vs37 %), small bowel surgery (12.5 % vs 28 %) and large bowel surgery (12.5 % vs27 %) were lower in the hypothyroid subset as compared to the euthyroid subset. Seven (3.4 %) Crohn'spatients suffered fracture, all of whom were euthyroid.CONCLUSION: Thyroid disorder was not found to be associated with Crohn's disease and was not found to increase the risk for fractures. Therefore, screening for thyroid disease is not a necessary component in the management of Crohn's disease.