Analysis of Bone Samples from Patients with Spondyloarthritides—Identifying Causes of New Bone Formation in Axial Spondyloarthritis
Bibliographic record
Abstract
Ankylosing spondylitis (AS) is a chronic inflammatory disease predominantly affecting the axial skeleton, leading potentially to bone erosions, new bone formation, and ankylosis of the spine. The burden of disease is determined by the grade of acute inflammation causing pain and stiffness and by new bone formation causing a reduction in spinal mobility1. Histopathological studies from intervertebral discs2, femoral heads3,4, sacroiliac joints5,6, manubriosternal junction7, and zygapophyseal joints8,9,10 enabled us in the past to define characteristic histomorphological and immunohistochemical features of acute inflammation in bony samples from patients with AS: enthesitis and subchondral inflammation at the interface between bone and cartilage — subchondral osteitis — are the primary events in AS immunopathology. Cytokines such as tumor necrosis factor-α (TNF-α)5, interleukin 17 (IL-17)11, and IL-239 seem to be triggering factors during inflammatory processes. The rather unexpected observation that TNF-α blocking therapy did not reduce new bone formation and radiographic progression in patients with AS underscored the need for a better pathophysiological understanding of osteoproliferative mechanisms in AS. Currently, investigations are focused on 2 major hypotheses. The first is that new bone formation is an independent feature uncoupled from inflammation triggered by mechanical stress. Microdamage and/or cell stress at the enthesial site trigger both an inflammatory and an anabolic process in the bone, i.e., through bone morphogenic protein signaling, leading to typical clinical signs of AS12,13. The second is that new bone formation is closely linked to inflammation through initial … Address correspondence to Dr. H. Appel, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Rheumatology, Hindenburgdamm 30, 12200 Berlin, Germany. E-mail: heiner.appel{at}charite.de
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".