Micromechanics of seismic wave propagation in granular materials

In this study experimental data on a model soil in a cubical cell are compared with both discrete element (DEM) simulations and continuum analyses. The experiments and simulations used point source transmitters and receivers to evaluate the shear and compression wave velocities of the samples, from which some of the elastic moduli can be deduced. Complex responses to perturbations generated by the bender/extender piezoceramic elements in the experiments were compared to those found by the controlled movement of the particles in the DEM simulations. The generally satisfactory agreement between experimental observations and DEM simulations can be seen as a validation and support the use of DEM to investigate the influence of grain interaction on wave propagation. Frequency domain analyses that considered filtering of the higher frequency components of the inserted signal, the ratio of the input and received signals in the frequency domain and sample resonance provided useful insight into the system response. Frequency domain analysis and analytical continuum solutions for cube vibration show that the testing configuration excited some, but not all, of the system’s resonant frequencies. The particle scale data available from DEM enabled analysis of the energy dissipation during propagation of the wave. Frequency domain analysis at the particle scale revealed that the higher frequency content reduces with increasing distance from the point of excitation

Transcranial magnetic stimulation: Improved coil design for deep brain investigation

This paper reports on a design for a coil for transcranial magnetic stimulation. The design shows potential for improving the penetration depth of the magnetic field, allowing stimulation of subcortical structures within the brain. The magnetic and induced electric fields in the human head have been calculated with finite element electromagnetic modeling software and compared with empirical measurements. Results show that the coil design used gives improved penetration depth, but also indicates the likelihood of stimulation of additional tissue resulting from the spatial distribution of the magnetic field

Investigating the micro mechanics of cemented sand using DEM

The discrete element method has been used to investigate the micro mechanics of cemented sand. High pressure drained triaxial tests are modelled in 3D using a flexible membrane which allows the correct deformation to develop. Simulations with up to 12 MPa confining pressure are presented, which are compared with laboratory experiments on a sand with a range of cement contents. Cementation is modelled using ‘parallel bonds’, and various parameters and strength distributions are investigated. Varying levels of cementation are successfully modelled, with the correct qualitative behaviour observed, and the separate effects of cementation and confining pressures demonstrated. The triaxial behaviour is found to be highly influenced by the distribution of bond strengths

A TOOL FOR COLLECTING, QUERYING AND MINING MACROSEISMIC DATA

SEISMO-SURFER is a tool for collecting, querying and mining seismic data being developed in Java programming language using Oracle database system. The objective is to combine recent research trends and results in the fields of spatial and spatio-temporal databases, data warehouses and data mining, as well as well established visualization techniques for geographical information. The database of the tool is automatically updated from remote sources while existing possibilities allow the querying on different earthquakes parameters, the analysis of the data for extraction of useful information and the graphical representation of the results via maps, charts etc. In the present work, we extend SEISMO-SURFER to include macroseismic data collected by the Geodynamic Institute and filled in a relative database. More specifically, the seismic parameters of the strong earthquakes, stored into the SEISMO-SURFER database, are linked to the macroseismic intensities observed at different sites. Administrative information for each site, local surface geology, tectonic lines, damage photographs and detailed descriptions from newspapers are also included. University of Piraeus and Geodynamic Institute are working together to continuously update and develop SEISMO-SURFER, concerning the data included, the variety of parameters stored and the mining algorithms supported for exploiting knowledge

POTRESI I KUGA U VRIJEME BIZANTSKOGA CARSTVA: MOGU LI POVIJESNE LEKCIJE POBOLJŠATI PRIPREMLJENOST ZA EPIDEMIJE?

Natural disasters have always been followed by a fear of infectious diseases. This raised historical debate about one of the most feared scenarios: the outbreak of bubonic plague caused by Yersinia pestis. One such event was recorded in the Indian state Maharashtra in 1994 after an earthquake. In multidisciplinary historical approach to the evolution of plague, many experts ignore the possibility of natural foci and their activation. This article presents historical records from the Byzantine Empire about outbreaks of the Plague of Justinian occurring months or even up to a year after high-magnitude earthquakes. Historical records of plague outbreaks can be used to document existence of natural foci all over the world. Knowledge of these historical records and the contemporary examples of plague support the assumption that, in terms of organising humanitarian aid, poor monitoring of natural foci could lead to unpredictable epidemiological consequences after high-magnitude earthquakes.Nakon prirodnih katastrofa uvijek slijedi strah od zaraznih bolesti. Otuda i povijesni prijepor o jednom od najgorih mogućih scenarija – pojavi jersinije pestis odnosno bubonske kuge, kakva je 1994. nakon potresa izbila u indijskoj država Maharashtra. U multidisciplinarnome, povijesnom istraživanju razvoja kuge, mnogi stručnjaci zanemaruju mogućnost prirodnih žarišta bolesti i njihova aktiviranja. Ovaj članak donosi povijesne bilješke iz doba Bizantskoga Carstva o izbijanju Justinijanove kuge mjesecima pa čak do godine dana nakon snažnih potresa. Povijesni dokumenti mogu poslužiti kao pokazatelji mogućih prirodnih žarišta kuge diljem svijeta. Uvid u te dokumente i suvremene primjere izbijanja kuge potvrđuju pretpostavku da, vezano uz organiziranje humanitarne pomoći, nedovoljan nadzor nad prirodnim žarištima može dovesti do nepredvidljivih epidemioloških posljedica nakon snažnih potresa

A TOOL FOR COLLECTING, QUERYING AND MINING MACROSEISMIC DATA

SEISMO-SURFER is a tool for collecting, querying and mining seismic data being developed in Java programming language using Oracle database system. The objective is to combine recent research trends and results in the fields of spatial and spatio-temporal databases, data warehouses and data mining, as well as well established visualization techniques for geographical information. The database of the tool is automatically updated from remote sources while existing possibilities allow the querying on different earthquakes parameters, the analysis of the data for extraction of useful information and the graphical representation of the results via maps, charts etc. In the present work, we extend SEISMO-SURFER to include macroseismic data collected by the Geodynamic Institute and filled in a relative database. More specifically, the seismic parameters of the strong earthquakes, stored into the SEISMO-SURFER database, are linked to the macroseismic intensities observed at different sites. Administrative information for each site, local surface geology, tectonic lines, damage photographs and detailed descriptions from newspapers are also included. University of Piraeus and Geodynamic Institute are working together to continuously update and develop SEISMO-SURFER, concerning the data included, the variety of parameters stored and the mining algorithms supported for exploiting knowledge

Prevalence and clinical implications of Scleroderma specific autoantibodies in Sjögren's syndrome.

Το σύνδρομο Sjögren’s (σS) είναι μια χρόνια αυτοάνοση ασθένεια με βραδεία εξέλιξη που χαρακτηρίζεται από συμπτώματα ξηροφθαλμίας και ξηροστομίας ως αποτέλεσμα λεμφοκυτταρικής διήθησης των σιελογόνων και δακρυικών αδένων. Παρότι κατά βάσιν θεωρείται ένα καλόηθες σύνδρομο, το οποίο προσβάλλει κυρίως γυναίκες μέσης ηλικίας, πολλοί ασθενείς υποφέρουν από κόπωση, πόνο, και εξωαδενικά συμπτώματα, τα οποία συχνά οδηγούν σε επιδείνωση της ποιότητας ζωής τους. Αν και η ακριβής παθογέννεση του συνδρόμου είναι ακόμη αδιευκρίνιστη, κατά τις τελευταίες δεκαετίες έχει επανειλημμένα δειχθεί ότι η ενεργοποίηση του μονοπατιού της ιντερφερόνης τύπου Ι αποτελεί καίριο γεγονός καθώς τα επαγόμενα από ιντερφερόνη τύπου Ι γονίδια υπερεκφράζονται τόσο σε περιφερικό αίμα όσο και ιστούς σιελογόνων αδένων των ασθενών αυτών, οδηγώντας σε ενεργοποίηση Β λεμφοκυττάρων και παραγωγή αυτοαντισωμάτων έναντι Ro/SSA και La/SSB αντιγόνων. Παρότι τα anti-Ro/SSA και/ή anti-La/SSB αντισώματα αποτελούν σημαντικό στοιχείο των παλαιότερων κριτηρίων ταξινόμησης για σS, αυτά είναι απόντα σε ένα σημαντικό μέρος των ασθενών με σS. Επιπλέον, οι ασθενείς με συστηματικό σκληρόδερμα (ΣΣκ) -κλασσικά χαρακτηριζόμενο από φαινόμενο Raynaud και σκλήρυνση του δέρματος- έχει δειχθεί ότι εμφανίζουν συμπτώματα ξηρότητας, ενώ ένα μέρος των ασθενών με σS έχουν στον ορό τους αντισώματα έναντι κεντρομεριδίου. Κατά τα τελευταία χρόνια μια σειρά από νέα ειδικά αντισώματα ΣΣκ έχουν αναγνωριστεί σε σχέση με διακριτούς κλινικούς και προγνωστικούς φαινότυπους μεταξύ των ασθενών με ΣΣκ. Ενόψει αυτών των δεδομένων, αποφασίσαμε να μελετήσουμε τον επιπολασμό και πιθανές κλινικές επιπτώσεις αυτών των ειδικών αυτοαντισωμάτων ΣΣκ σε διαδοχικούς ασθενείς που παραπονούνται για συμπτώματα ξηρότητας. Για το σκοπό αυτό, μελετήθηκαν διαδοχικοί ασθενείς με συμπτώματα ξηρότητας που είχαν παραπεμφθεί στη Μονάδα Μοριακής και Εφαρμοσμένης Φυσιολογίας, στο Εργαστήριο Φυσιολογίας, της Ιατρικής Σχολής, του Εθνικού και Καποδιστριακού Πανεπιστημίου Αθηνών. Φάνηκε ότι τα ειδικά αυτοαντισώματα ΣΣκ ήταν συχνά παρόντα σε άτομα με συμπτώματα ξηρότητας [41.7% (90/216) ατόμων που εκτιμήθηκαν (19% ισχυρώς θετικά, 22.7% μετρίως θετικά)]. Να σημειωθεί ότι ειδικά αυτοαντισώματα ΣΣκ σε ισχυρούς τίτλους ανιχνεύονταν στατιστικά σημαντικά πιο συχνά σε ασθενείς με βιοψίες ελασσόνων σιελογόνων αδένων (ΕΣΑ) που πληρούσαν τα ισχύοντα παθολογοανατομικά κριτήρια για σS (30% έναντι 12.5%, p=0.009), μια συσχέτιση που παρέμενε στατιστικά σημαντική ακόμα και μετά τροποποίηση για αντισώματα έναντι Ro/SSA και La/SSB αυτοαντιγόνα [OR 95% (CI): 4.1 (1.5-10.6)]. Θεωρητικά, αν τα ειδικά αυτοαντισώματα ΣΣκ σε ισχυρούς τίτλους είχαν την ίδια βαρύτητα στην κατάταξη ασθενών με σS, περίπου ένα τρίτο των οροαρνητικών (anti-Ro/SSA αρνητικών) ατόμων με αρνητική ή μη διαθέσιμη βιοψία ΕΣΑ θα κατατάσσονταν ως σS. Επιπλέον, παρατηρήσαμε ότι βιοψίες ΕΣΑ ασθενών με συμπτώματα ξηρότητας που είχαν ισχυρά θετικά αυτοαντισώματα ΣΣκ παρουσίαζαν στοιχεία περιπορικής ίνωσης εκτός από λεμφοκυτταρική διήθηση όπου αυτή υπήρχε. Το εξαιρετικό αυτό εύρημα δίνει βάση σε εναλλακτική υπόθεση του μηχανισμού δυσλειτουργίας των ΕΣΑ στο σS, άγνωστο προς το παρόν αν αφορά μια καινούργια νοσολογική οντότητα ή μια υποκατηγορία των ασθενών με σS. Διενεργώντας μια προοπτική, σταθμισμένη και τυφλή μελέτη θα μπορούσε να διερευνηθεί περαιτέρω αυτή η υπόθεση. Τα βασικά ευρήματά μας συνοψίζονται στις ακόλουθες περιλήψεις ήδη δημοσιευμένων άρθρων: Περίληψη του άρθρου “ Η υπογραφή ιντερφερόνης τύπου Ι στο σύνδρομο Sjögren’s: παθοφυσιολογικές και κλινικές επιπλοκές” https://pubmed-ncbi-nlm-nih-gov.e.bibl.liu.se/31376268/ Συγγραφείς: Νικόλαος Μαρκέτος, Ηλίας Cinoku, Άννα Ράπτη, Κλειώ Π. Μαυραγάνη Οι ιντερφερόνες τύπου Ι έχουν από καιρού αναγνωριστεί ως μεσολαβητές των αμυντικών μηχανισμών φυσικής ανοσίας έναντι απειλών από ιούς. Ακράδαντα στοιχεία κατά τα τελευταία 15 έτη αποκαλύπτουν το σηματικό τους ρόλο στην παθογένεση συστηματικών αυτοανόσων νοσημάτων, συμπεριλαμβανομένων του συστηματικού ερυθηματώδους λύκου (ΣΕΛ) και του συνδρόμου Sjögren’s (σS). Παρόλη την πρόοδο, μέθοδοι για την ανίχνευση, αρχικοί εκκινητές, βιολογική λειτουργία, και κλινικές συσχετίσεις τους στα πλαίσια της αυτοανοσίας δεν έχουν εξακριβωθεί πλήρως. Καθώς οι θεραπευτικές επιλογές για το σS παραμένουν περιορισμένες, η αδρανοποίηση συγκεκριμένων στόχων της ιντερφερόνης τύπου Ι φαίνονται ως μια υποσχόμενη επιλογή. Σε αυτή την ανασκόπηση συνοψίζουμε τα μέχρι στιγμής δεδομένα σχετικά με τον ρόλο της ιντερφερόνης τύπου Ι στο σS. Περίληψη του άρθρου: “Αυτοαντισώματα ειδικά του σκληροδέρματος: θα έπρεπε να συμπεριλαμβάνονται στο διαγνωστικό αλγόριθμο του συνδρόμου Sjögren’s?” https://doi.org/10.1016/j.semarthrit.2022.152026 Συγγραφείς: Νικόλαος Μαρκέτος, Βασιλική Κουλούρη, Ευαγγελία Π. Πιπέρη, Μαρία Ε. Γεωργάκη, Νικόλαος Γ. Νικητάκης, Κλειώ Π. Μαυραγάνη Σκοπός: Τα συμπτώματα ξηρότητας αποτελούν συχνό αίτιο παραπομπής σε ρευματολόγο. Ο έλεγχος για τα ειδικά αντισώματα έναντι Ro/SSA και La/SSB αντιγόνων καθώς και βιοψία ελασσόνων σιελογόνων αδένων (ΕΣΑ) αποτελούν κύρια εργαλεία που χρησιμοποιούνται στη διαγνωστική προσέγγιση. Αντικεντρομεριδιακά αντισώματα και εκδηλώσεις ξηρότητας ανιχνεύονται συχνά σε σύνδρομο Sjögren’s (σS) και συστηματικό σκληρόδερμα (ΣΣκ), αντίστοιχα. Επί του παρόντος, στοχεύσαμε στη διευκρίνιση της συχνότητας και των κλινικών συσχετίσεων ενός ευρεός φάσματος ειδικών αυτοαντισωμάτων ΣΣκ σε διαδοχικούς ασθενείς που παραπέμφθηκαν προς διερεύνηση πιθανού σS. Μέθοδοι: Καταγράφηκαν δημογραφικά, κλινικοπαθολογικά, και εργαστηριακά δεδομένα 216 διαδοχικών ασθενών με συμπτώματα ξηρότητας. Όλοι οι συμμετέχοντες ελέγχθηκαν για ειδικά αυτοαντισώματα ΣΣκ (έναντι CENP, PM/Scl, Scl-70, Ku, NOR90, RP11, RP155, fibrillarin, PDGFR, and Th/To) χρησιμοποιώντας ένα εμπορικά διαθέσιμο κιτ ανοσοαποτύπωσης. Σύμφωνα με την ένταση του σήματος, τα αναγνωρισμένα αυτοαντισώματα κατετάγησαν περαιτέρω σε εκείνα με ισχυρώς θετικούς και μετρίως θετικούς τίτλους. Αποτελέσματα: Ειδικά αυτοαντισώματα ΣΣκ ανιχνεύθηκαν σε 41.7% (90/216) ασθενείς που αξιολογήθηκαν (19% σε ισχυρά θετικούς, 22.7% σε μετρίως ισχυρά θετικούς τίτλους) χωρίς σημαντικές διαφορές μεταξύ anti-Ro/SSA θετικών και αρνητικών ομάδων. Ισχυρά θετικοί τίτλοι ήταν σημαντικά συχνότεροι σε ασθενείς με βιοψίες ΕΣΑ που πληρούσαν τα ιστοπαθολογικά κριτήρια για σS (30% έναντι 12.5%, p=0.009). Αυτή η συσχέτιση παρέμεινε σημαντική μετά από τροποποίηση για αντισώματα έναντι Ro/SSA και La/SSB αυτοαντιγόνα [OR 95% (CI): 4.1 (1.5-10.6)]. Συμπεράσματα: Τα ειδικά αυτοαντισώματα ΣΣκ ανιχνεύονται συχνά σε ασθενείς που προσέρχονται με συμπτώματα ξηρότητας, και σε ισχυρά θετικούς αλλά όχι μετρίως ισχυρά θετικούς τίτλους εμφανίζουν συσχέτιση με τη θετικότητα βιοψίας ΕΣΑ. Συνολικά, τα δεδομένα αυτά υπονοούν ένα χρήσιμο ρόλο του ελέγχου για αντισώματα ΣΣκ στη διαγνωστική προσέγγιση και πιθανότατα στα διαγνωστικά κριτήρια για σS.Sjögren’s syndrome (SS) is a chronic, autoimmune disease with an indolent course characterized by ocular and oral dryness, as a result of lymphocytic infiltration of salivary and lachrymal glands. Although it is generally considered a benign syndrome affecting mainly middle-aged women, many patients suffer from fatigue, pain, and extra glandular symptoms, often worsening quality of life. Τhough exact pathogenesis is still unclear, over the last decades, it was consistently shown that type I interferon (IFN) pathway activation is a crucial event with type I IFN inducible genes being upregulated in both peripheral blood and salivary gland tissues derived from these patients contributing to B cell activation and autoantibody production against Ro/SSA and La/SSB antigens. While anti-Ro/SSA and/or anti-La antibodies have been a major component in previously adopted classification criteria for SS, in a significant subset of SS patients these are absent. Moreover, patients with systemic sclerosis (SSc) classicaly characterized by Raynaud’s phenomenon and hardening of the skin have been also shown to display sicca symptomatology, with a subset of SS pateints having in their serum antibodies against centromere antigens. Over the last years, an array of novel specific SSc antibodies was identified in association with distinct clinical and prognostic phenotypes among patients with SSc. In view of this data, we aimed to elucidate the prevalence and possible clinical implications of these SSc-specific autoantibodies in consecutive patients presenting with sicca complaints. Towards this end, we evaluated the presence of serum specific autoantibodies in consecutive patients with sicca complaints referred to the Molecular and Applied Physiology Unit, Department of Physiology, Medical School of Athens, National and Kapodistrian University of Athens, Greece. We found that SSc-specific autoantibodies were often present in sicca individuals [41.7% (90/216) patients evaluated (19% at strong, 22.7% at medium titers)]. Of note, SSc-specific autoantibodies at strong titers were significantly more often detected in patients with minor salivary gland (MSG) biopsies compliant with current SS histopathological criteria (30% vs. 12.5%, p=0.009), an association that remained significant after adjustment for antibodies against Ro/SSA and La/SSB autoantigens [OR 95% (CI): 4.1 (1.5-10.6)]. Theoretically, if SSc-specific autoantibodies at strong titers held the same burden in SS classification as anti-Ro/SSA antibodies, approximately one-third of seronegative (anti-Ro/SSA negative) sicca patients with negative or unknown MSG biopsy would be characterized as suffering from SS. Furthermore, MSG biopsies from sicca patients with strong positive SSc-specific autoantibodies weew characterized by remarkable periductal fibrosis independently of the presence of lymphocytic infiltration. This finding fuels an alternative hypothesis of the mechanism of MSG dysfunction in SS, remaining unknown at present if we are upon a distinct clinical entity or a subgroup of SS. A prospective matched and blinded study quantitating the amount of fibrosis in MSG biopsies from sicca patients with distinct serological reactivities would help elucidate this hypothesis. Our main findings are summarized in the following previously presented abstracts in the published articles: Abstract of the article “Type I interferon signature in Sjögren’s Syndrome: Pathophysiological and clinical implications.” https://pubmed-ncbi-nlm-nih-gov.e.bibl.liu.se/31376268/ Reference: Nikolaos Marketos, Ilir Cinoku, Anna Rapti, Clio P. Mavragani Type I interferons (IFN) have long been recognized as mediators of innate immune defense mechanisms against viral threats. Robust evidence over the last 15 years revealed their significant role in the pathogenesis of systemic autoimmune diseases, including systemic lupus erythematosus (SLE) and Sjögren’s syndrome (SS). Despite the progress, methods of detection, initial triggers, biological functions, and clinical associations in the setting of autoimmunity remain to be fully clarified. As therapeutic options for SS are currently limited, neutralizing specific targets of the type I IFN pathway seems a promising alternative. In this review, we summarize the current evidence regarding the role of type I IFN in SS. Abstract of the article: “Scleroderma-specific autoantibodies: Should they be included in the diagnostic work-up for Sjögren’s syndrome?” https://doi.org/10.1016/j.semarthrit.2022.152026 Reference: Nikolaos Marketos , Vasiliki Koulouri , Evangelia P. Piperi , Maria E. Georgaki , Nikolaos G. Nikitakis , Clio P. Mavragani Objectives: Sicca complaints are a frequent reason for rheumatologic consultation. Testing for specific antibodies against Ro/SSA and La/SSB antigens and minor salivary gland (MSG) biopsy are among the main tools implemented in the diagnostic work-up. Anticentromere antibodies and sicca manifestations are frequently detected in Sjögren’s syndrome (SS) and systemic sclerosis (SSc), respectively. Herein, we aimed to determine the frequency and clinical associations of a wide spectrum of scleroderma (SSc)-specific autoantibodies in consecutive patients referred for evaluation of possible SS. Methods: Demographic, clinicopathological, and laboratory data were recorded in 216 consecutive patients with sicca complaints. All study participants were tested for SSc-specific autoantibodies (against CENP, PM/Scl, Scl-70, Ku, NOR90, RP11, RP155, fibrillarin, PDGFR, and Th/To) using a commercially available immunoblot kit. According to band intensity, the identified autoantibodies were further classified in those with strong and medium titers. Results: SSc-specific autoantibodies were detected in 41.7% (90/216) patients evaluated (19% at strong, 22.7% at medium titers) without significant differences between anti-Ro/SSA positive and negative groups. At strong titers was significantly higher in patients with MSG biopsies fulfilling SS histopathological criteria (30% vs. 12.5%, p=0.009). This association remained significant after adjustment for antibodies against Ro/SSA and La/SSB autoantigens [OR 95% (CI): 4.1 (1.5-10.6)]. Conclusion: SSc-specific autoantibodies are frequently detected among patients presenting with sicca complaints and at strong but not medium titers are independently associated with MSG biopsy positivity. Taken together, these data imply a useful role of SSc antibody testing in the diagnostic work-up and possibly in the classification criteria for SS

Brief, Low-impact, High-intensity Osteogenic Loading in Postmenopausal Osteoporosis: A Quasi-experimental Case-series Study

Background Osteoporosis is characterized by reduced bone mineral density (BMD) and disrupted microarchitecture estimated by trabecular bone score (TBS). Osteostrong® is a bone-strengthening system implementing 4 devices and incorporating brief (10-minute), weekly, low-impact, high-intensity osteogenic loading exercises. The aim of this study was to assess changes in BMD and TBS in the lumbar spine and/or hip over 12 months in peri-/post menopausal women with Osteoporosis following Osteostrong® intervention and to compare these outcomes with women who did not receive such intervention. Methods and Subjects A quasi-experimental case-series study in which 147 participants were separated into 2 groups, following informed consent: 75 in group A receiving Osteostrong® (subgroup G1 without and G2 with antiresorptive medication); and 72 in group B without Osteostrong® (subgroup G3 without and G4 with antiresorptive medication). Changes in lumbar spine and hip BMD and/or TBS were assessed at inclusion and 12 months later. Bonferroni-adjusted non-parametric paired tests examined for significant paired mean differences within each subgroup. Results After Bonferroni adjustment, significant increases were observed in lumbar spine BMD in G2 (mean paired change: 0.029 g/cm2; Bonferroni-adjusted p < 0.001), and G4 (mean paired change: 0.025 g/cm2; Bonferroni-adjusted p = 0.05) as well as BMD-total hip left in G2 (mean paired change: 0.028 g/cm2; Bonferroni-adjusted p = 0.05). Other within-group changes in femoral neck BMD, total hip BMD, and TBS did not retain significance following Bonferroni correction. Conclusion The Osteostrong® intervention showed modest lumbar spine BMD improvements over 12 months; some subgroup effects were significant but not when Bonferroni-adjusted, warranting cautious interpretation and further randomized trials