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Method for prediction of protein function from sequence using the sequence-to-structure-to-function paradigm with application to glutaredoxins/thioredoxins and T1 ribonucleases.

The practical exploitation of the vast numbers of sequences in the genome sequence databases is crucially dependent on the ability to identify the function of each sequence. Unfortunately, current methods, including global sequence alignment and local sequence motif identification, are limited by the extent of sequence similarity between sequences of unknown and known function; these methods increasingly fail as the sequence identity diverges into and beyond the twilight zone of sequence identity. To address this problem, a novel method for identification of protein function based directly on the sequence-to-structure-to-function paradigm is described. Descriptors of protein active sites, termed "fuzzy functional forms" or FFFs, are created based on the geometry and conformation of the active site. By way of illustration, the active sites responsible for the disulfide oxidoreductase activity of the glutaredoxin/thioredoxin family and the RNA hydrolytic activity of the T1 ribonuclease family are presented. First, the FFFs are shown to correctly identify their corresponding active sites in a library of exact protein models produced by crystallography or NMR spectroscopy, most of which lack the specified activity. Next, these FFFs are used to screen for active sites in low-to-moderate resolution models produced by ab initio folding or threading prediction algorithms. Again, the FFFs can specifically identify the functional sites of these proteins from their predicted structures. The results demonstrate that low-to-moderate resolution models as produced by state-of-the-art tertiary structure prediction algorithms are sufficient to identify protein active sites. Prediction of a novel function for the gamma subunit of a yeast glycosyl transferase and prediction of the function of two hypothetical yeast proteins whose models were produced via threading are presented. This work suggests a means for the large-scale functional screening of genomic sequence databases based on the prediction of structure from sequence, then on the identification of functional active sites in the predicted structure.

Algorithms↗

Using neural networks for (13)c NMR chemical shift prediction-comparison with traditional methods.

Interpretation of (13)C chemical shifts is essential for structure elucidation of organic molecules by NMR. In this article, we present an improved neural network approach and compare its performance to that of commonly used approaches. Specifically, our recently proposed neural network (J. Chem. Inf. Comput. Sci. 2000, 40, 1169-1176) is improved by introducing an extended hybrid numerical description of the carbon atom environment, resulting in a standard deviation (std. dev.) of 2.4 ppm for an independent test data set of approximately 42,500 carbons. Thus, this neural network allows fast and accurate (13)C NMR chemical shift prediction without the necessity of access to molecule or fragment databases. For an unbiased test dataset containing 100 organic structures the accuracy of the improved neural network was compared to that of a prediction method based on the HOSE code (hierarchically ordered spherical description of environment) using SPECINFO. The results show the neural network predictions to be of quality (std. dev. = 2.7 ppm) comparable to that of the HOSE code prediction (std. dev. = 2.6 ppm). Further we compare the neural network predictions to those of a wide variety of other (13)C chemical shift prediction tools including incremental methods (CHEMDRAW, SPECTOOL), quantum chemical calculation (GAUSSIAN, COSMOS), and HOSE code fragment-based prediction (SPECINFO, ACD/CNMR, PREDICTIT NMR) for the 47 (13)C-NMR shifts of Taxol, a natural product including many structural features of organic substances. The smallest standard deviations were achieved here with the neural network (1.3 ppm) and SPECINFO (1.0 ppm).

Journal Article↗

Computer simulation to predict patient responses to alterations in the ventilation regime.

We have developed a technique for simulating artificially ventilated patients using a computer model of the respiratory system and have investigated its ability to predict the patient's response to alterations in the ventilation regime. The majority of those studied were in a stable condition following cardiac surgery. Predictions for PaO2 showed a reasonable correlation with measured values (r = 0.94), although individual predictions could differ appreciably (SEE = +/- 17.3 mmHg). Predictions for PaCO2 correlated less well (r = 0.89, SEE = +/- 2.0 mmHg) and there was a consistent tendency to overestimate this variable. The least accurate predictions were those for PvO2 (r = 0.61, SEE = +/- 3.8 mmHg). Errors in prediction were attributable to deficiencies in the model (most importantly the three-compartment lung and the modelling of CO2 production, storage and excretion), compounded by unpredictable alterations in the patient's physiology (mainly Vo2, Vco2 and Qt). However, allowing for accepted clinical variability and routine measurement accuracy, the predictions are generally reasonable. This suggests that, with some further modifications, computer modelling of this, and other, systems may prove to be a clinically and educationally useful technique.

Adult↗

Individualizing theophylline dosage: evaluation of a single-point maintenance dose prediction method.

A dosage prediction method to estimate theophylline clearance and dose requirement was evaluated in 22 outpatients with partly reversible obstructive airways disease. The steady state theophylline dose required to achieve a target concentration (Css) was predicted using a single serum theophylline determination 8 h after a single oral test dose. In 17 nonsmoking patients a mean absolute deviation of 8.2% (range 0.0-21.7%) between predicted and observed Css was found, and in 5 smoking patients the mean deviation was 34.0% (range 2.2-53.8%). In 17 healthy smokers the single-point method was found to predict theophylline clearance at a sampling time of 8 h with a prediction error of 11.3 (range 0.8-25.3%) compared to the clearance determination using the area under the curve. In addition, a numerical simulation program to assess the influence of absorption, elimination and sampling time on predictive accuracy showed that the method could be successfully applied to a patient population with elimination rate constants between 0.07 1/h and 0.25 1/h, allowing a mean prediction error of 15%.

Adolescent↗

Treadmill validation of an over-ground walking test to predict peak oxygen consumption.

The purpose of this study was to determine whether a test developed to predict maximal oxygen consumption (VO2max) during over-ground walking, was similarly valid as a predictor of peak oxygen consumption (VO2) when administered during a 1-mile (1.61 km) treadmill walk. Treadmill walk time, mean heart rate over the last 2 full min of the walk test, age, and body mass were entered into both generalized (GEN Eq.) and gender-specific (GSP Eq.) prediction equations. Overall results indicated a highly significant linear relationship between observed peak VO2 and GEN Eq. predicted values (r = 0.91), a total error (TE) of 5.26 ml.kg-1.min-1 and no significant difference between observed and predicted peak VO2 mean values. The peak VO2 for women (n = 75) was predicted accurately by GSP Eq. (r = 0.85; TE = 4.5 ml.kg-1.min-1), but was slightly overpredicted by GEN Eq. (overall mean difference = 1.4 ml.kg-1.min-1; r = 0.86; TE = 4.56 ml.kg-1.min-1). No significant differences between observed peak VO2 and either GEN Eq. (r = 0.85; TE = 4.3 ml.kg-1.min-1) or GSP Eq. (r = 0.85; TE = 4.8 ml.kg-1.min-1) predicted values were noted for men (n = 48) with peak VO2 values less than or equal to 55 ml.kg-1.min-1. However, both equations significantly underpredicted peak VO2 for the remaining high peak VO2 men (n = 22). In conclusion, the over-ground walking test, when administered on a treadmill, is a valid method of predicting peak VO2 but underpredicts peak VO2 of subjects with observed high peak VO2 values.

Adult↗

Rapid prediction of steady-state serum theophylline concentration in patients treated with intravenous aminophylline.

In 15 acutely ill asthmatics the steady-state serum theophylline concentration was predicted by the method of Chiou et al. using two serum concentration measurements obtained 1 and 5 h after starting a continuous infusion of aminophylline. Two theophylline assays with different precision characteristics were compared. With a precise HPLC-assay the prediction was excellent: prediction error (predicted minus measured concentration) = -0.22 +/- 1.97 mg/l (mean +/- SD); r = 0.922. When the theophylline concentration was determined by a rapid enzyme immunoassay of lower precision, but convenient for clinical use, the prediction was less accurate (prediction error = 0.58 +/- 3.88, r = 0.852). However, it was still clearly superior to dosing recommendations based on the population average of theophylline clearance, even after taking into consideration the effect of smoking, congestive heart failure and cirrhosis (prediction error = 3.62 +/- 13.36, r = 0.560). As employed in this study, the method may be useful in helping the physician to choose the optimal dose in severely ill asthmatics.

Aminophylline↗

Some suggestions for measuring predictive performance.

The performance of a prediction or measurement model is often evaluated by computing the correlation coefficient and/or the regression of predictions on true (reference) values. These provide, however, only a poor description of predictive performance. The mean square prediction error (precision) and the mean prediction error (bias) provide better descriptions of predictive performance. These quantities are easily computed, and can be used to compare prediction methods to absolute standards or to one another. The measures, however, are unreliable when the reference method is imprecise. The use of these measures is discussed and illustrated.

Kinetics↗

Predicting survival time for cold exposure.

The prediction of survival time (ST) for cold exposure is speculative as reliable controlled data of deep hypothermia are unavailable. At best, guidance can be obtained from case histories of accidental exposure. This study describes the development of a mathematical model for the prediction of ST under sedentary conditions in the cold. The model is based on steady-state heat conduction in a single cylinder comprised of a core and two concentric annular shells representing the fat plus skin and the clothing plus still boundary layer, respectively. The ambient condition can be either air or water; the distinction is made by assigning different values of insulation to the still boundary layer. Metabolic heat production (M) is comprised of resting and shivering components with the latter predicted by temperature signals from the core and skin. Where the cold expousure is too severe for M to balance heat loss, ST is largely determined by the rate of heat loss from the body. Where a balance occurs, ST is govedrned by the endurance time for shivering. End of survival is marked by the deep core temperature reacing a value of 30 degrees C. Th emodel was calibrated against survival data of cold water (0 to 20 degrees C) immersion and then applied to cold air exposure. A sampling of ST predictions for the nude exposure of an average healthy male in relatively calm air (1 km/h wind speed) are the following: 1.8, 2.5, 4.1, 9.0, and > 24 h for -30, -20, -10, 0 and 10 degrees C, respectively. With two layers of loose clothing (average thickness of 1 mm each) in a 5 km/h wind, STs are 4.0, 5.6, 8.6, 15.4, and > 24 h for -50, -40, -30, -20, and -10 degrees C. The predicted STS must be weighted against the extrapolative nature of the model. At present, it would be prudent to use the predictions in a relative sense, that is, to compare or rank-order predicted STs for various combinations of ambient conditions and clothing protection.

Adult↗

Predictive factors for the effect of gonadotrophin releasing hormone analogue therapy on the height of girls with idiopathic central precocious puberty.

The factors influencing the final height of central precocious puberty patients treated with gonadotrophin releasing hormone (GnRH) analogues remain a critical issue. This study compares the predicted final height before and after GnRH analogue therapy to identify predictive factors for final height. Fourteen girls with idiopathic central precocious puberty were treated with a GnRH analogue. All had an active non-regressive form before therapy, full and permanent suppression of oestrogenic activity during therapy (duration greater than 2 years, 3.1 +/- 0.3 years, mean +/- SEM), and the pubertal pituitary-ovarian axis had normalized in all of them 1 year after the cessation of therapy. The mean predicted final height increased from 152 +/- 1.8 cm before therapy to 162.2 +/- 1.2 cm (P less than 0.01) at the last evaluation performed 4.5 +/- 0.3 years after the onset of therapy. The mean gain in predicted final height between the onset of therapy and the last evaluation was 10.2 +/- 1.1 cm. It was correlated with the following data recorded at the onset of therapy: bone age advance over chronological age (r = 0.66, P less than 0.02), predicted final height at the onset of therapy (r = -0.76, P less than 0.001), and the difference between the target height and the predicted height at onset of therapy (r = 0.76, P less than 0.001). We conclude that GnRH analogue therapy is more likely to improve final height prognosis in girls who initially present with a markedly advanced bone age and a great difference between their target and predicted heights. Both these parameters reflect the severity of the disease at diagnosis.

Body Height↗

Improvement of walking speed prediction by accelerometry and altimetry, validated by satellite positioning.

Activity monitors based on accelerometry are used to predict the speed and energy cost of walking at 0% slope, but not at other inclinations. Parallel measurements of body accelerations and altitude variation were studied to determine whether walking speed prediction could be improved. Fourteen subjects walked twice along a 1.3 km circuit with substantial slope variations (-17% to +17%). The parameters recorded were body acceleration using a uni-axial accelerometer, altitude variation using differential barometry, and walking speed using satellite positioning (DGPS). Linear regressions were calculated between acceleration and walking speed, and between acceleration/altitude and walking speed. These predictive models, calculated using the data from the first circuit run, were used to predict speed during the second circuit. Finally the predicted velocity was compared with the measured one. The result was that acceleration alone failed to predict speed (mean r = 0.4). Adding altitude variation improved the prediction (mean r = 0.7). With regard to the altitude/acceleration-speed relationship, substantial inter-individual variation was found. It is concluded that accelerometry, combined with altitude measurement, can assess position variations of humans provided inter-individual variation is taken into account. It is also confirmed that DGPS can be used for outdoor walking speed measurements, opening up new perspectives in the field of biomechanics.

Acceleration↗

Prognostic factors in the prediction of chronic wound healing by electrical stimulation.

The aim of the study is to determine the effects of wound, patient and treatment attributes on the wound healing rate and to propose a system for wound healing rate prediction. Predicting the wound healing rate from the initial wound, patient and treatment data collected in a database of 300 chronic wounds is not possible. After considering weekly follow-ups, it was determined that the best prognostic factors are weekly follow-ups of the wound healing process, which alone were found to predict accurately the wound healing rate after a minimum follow-up period of four weeks (at least five measurements of wound area). After combining the follow-ups with wound, patient and treatment attributes, the minimum follow-up period was reduced to two weeks (at least three measurements of wound area). After a follow-up period of two weeks, it was possible to predict the wound healing rate of an independent test set of chronic wounds with a relative squared error of 0.347, and after three weeks, with a relative squared error of 0.181 (using regression trees with linear equations in its leaves). Regression trees with a relative squared error close to 0 produce better prediction than with an error closer to 1. Results show that the type of treatment is just one of many prognostic factors. Arranged in order of decreasing prediction capability, prognostic factors are: wound size, patient's age, elapsed time from wound appearance to the beginning of the treatment, width-to-length ratio, location and type of treatment. The data collected support former findings that the biphasic- and direct-current stimulation contributes to faster healing of chronic wounds. The model of wound healing dynamics aids the prediction of chronic wound healing rate, and hence helps with the formulation of appropriate treatment decisions.

Adult↗

New method to predict patients' intravenous heparin dose requirements.

OBJECTIVE: To predict intravenous heparin dose requirements of patients treated for thromboembolic disorders. DESIGN: A retrospective cohort study in which we used simple linear regression to predict patients' effective maintenance dose (EMD) of heparin (units/kg/hour needed to achieve and maintain APTT therapeutic range) from patients' "heparin responsiveness" (the APTT increase after the initial 6 hours of heparin treatment per units/kg/hour received). SETTING/PATIENTS: The model was derived from 46 patients treated at one hospital (Hospital A) and then tested in 42 patients treated at another hospital (Hospital B). MEASUREMENTS AND MAIN RESULTS: Among Hospital A patients, there was a strong linear correlation (r = -.880; p < .001) between EMD (mean 16.02 units/kg/hour; 95% CI 14.9, 17.15) and "heparin responsiveness" (HR): EMD = 25.651 - [95.118 x HR]. This model accurately predicted Hospital B patients' EMD: 97% (37/38) fell within the model's 95% prediction interval; the mean absolute difference between predicted and actual EMD was 1.73 units/kg/hour (95% CI 1.39, 2.08); and only 16% of patients had EMD's more than 3 units/kg/hour different from that predicted by the regression model. The model's accuracy was comparable to that of our gold standard, the weight-based heparin dosing nomogram. CONCLUSION: The infusion dose of intravenous heparin effective for an individual patient can be predicted accurately from the patient's body weight and APTT response to the initial 6 hours of treatment. Especially in hospitals where validated heparin dosing nomograms are not used, clinicians may find this simple technique useful in achieving timely therapeutic anticoagulation.

Anticoagulants↗

Can clinicians predict ICU length of stay following cardiac surgery?

PURPOSE: To determine whether a group of experienced clinicians can predict intensive care unit (ICU) length of stay (LOS) following cardiac surgery. METHODS: A cohort of 265 adult patients undergoing cardiac surgery at St. Michael's Hospital, Toronto, Ontario, between January 2, 1992, and June 26, 1992, were seen preoperatively by the clinicians participating in the study and ICU length of stay was predicted based on the clinicians' preoperative assessment and/or information recorded in the patient's chart. RESULTS: Five hundred and ten ICU length of stay predictions were obtained from a group of eight experienced clinicians (anaesthetists/intensivists, cardiologists, nurses). The clinicians predicted the exact ICU length of stay (in days) correctly 51.2% of the time and were within +/- 1 day 84.5% of the time. The clinicians correctly predicted short ICU stays (< or = 2 days) for 87.6% of the patients who had short ICU stays but only predicted long ICU stays (> 2 days) in 39.4% of the patients who had long ICU stays. CONCLUSIONS: Experienced clinicians can predict preoperatively with a considerable degree of accuracy patients who will have short ICU lengths of stay following cardiac surgery. However, many patients who had long ICU stays were not correctly identified preoperatively. Unidentified preoperative risk factors or unanticipated intraoperative/postoperative events may be causing these patients to have longer than expected ICU stays.

Adult↗

Prediction of massive blood transfusion in cardiac surgery.

PURPOSE: In cardiac surgery with cardiopulmonary bypass (CPB), excessive blood loss requiring the transfusion of multiple red blood cell (RBC) units is a common complication that is associated with significant morbidity and mortality. The objective of this study was to develop a prediction rule for massive blood transfusion (MBT) that could be used to optimize the management of, and research on, at-risk patients. METHODS: Data were collected prospectively over the period from 2000 to 2005, on patients who underwent surgery with CPB at one hospital. Patients who received > or = five units of RBC within one day of surgery were classified as MBT. Logistic regression was used to appropriately select and weigh perioperative variables in the prediction rule, which was developed on the initial 60% of the sample and validated on the remaining 40%. RESULTS: Of the 10,667 patients included, 925 (8.7%) had MBT. The clinical prediction rule included 12 variables (listed in order of predictive value: CPB duration, preoperative hemoglobin concentration, body surface area, nadir CPB hematocrit, previous sternotomy, preoperative shock, preoperative platelet count, urgency of surgery, age, surgeon, deep hypothermic circulatory arrest, and type of procedure) and was highly discriminative (c-index = 0.88). In the validation set, those classified as low-, moderate-, and high-risk by a simple risk score derived from the prediction rule had a 5%, 27%, and 58% chance of MBT, respectively. CONCLUSION: A clinical prediction rule was developed that accurately identified patients at low-risk or high-risk for MBT. Studies are needed to determine the external generalizability and clinical utility of the prediction rule.

Age Factors↗

[Predictability and precision of "target-controlled infusion" (TCI) of propofol with the "Disoprifusor TCI" system].

UNLABELLED: In Germany a TCI-system for propofol (Disoprifusor-TCI) has been commercially available since spring 1997. We investigated the prediction error and precision of this TCI system as part of a multicentre study. Bias, precision, blood concentrations and dosage of propofol were compared with patients receiving propofol via a manually controlled infusion device. METHODS: After approval by the local Ethics Committee and written informed consent, 21 patients of ASA-classification I to III scheduled for major abdominal surgery received either a target controlled infusion (group T, Disoprifusor-TCI) or a manually controlled infusion (group M) of propofol. The propofol plasma concentrations were measured by HPLC. The prediction error for each measurement, the median prediction error (MDPE) or bias, the median absolute prediction error (MDAPE) or precision and the divergence (change of the prediction error over infusion time) were calculated for both groups. RESULTS: For all patients in group T (n = 12) the bias of the TCI system was 6.7% and the precision 27.5%. For 70% of all measured plasma concentrations the absolute prediction error was < or = 37%. The divergence was -5.4% per hour. For all patients in group M (n = 9) the bias was 44.2% and the precision 50%. The mean amount of propofol infused per kilogram body weight and hour was significant higher in T (9.0 +/- 1.2 mg/kg/h) than in M (6.6 +/- 1.2 mg/kg/h, p < 0.005). CONCLUSIONS: With a precision of 27.5% the investigated TCI system (Diprifusor-TCI) showed an acceptable inaccuracy, as for TCI-systems a median prediction error of +/- 30% has to be expected due to the inherent variability of pharmacokinetic parameters. Further studies will be necessary to find out whether the investigated TCI system for propofol may offer substantial advantages.

Abdomen↗

Prediction of single-cross hybrid performance for grain yield and grain dry matter content in maize using AFLP markers associated with QTL.

Prediction methods to identify single-cross hybrids with superior yield performance have the potential to greatly improve the efficiency of commercial maize (Zea mays L.) hybrid breeding programs. Our objectives were to (1) identify marker loci associated with quantitative trait loci for hybrid performance or specific combining ability (SCA) in maize, (2) compare hybrid performance prediction by genotypic value estimates with that based on general combining ability (GCA) estimates, and (3) investigate a newly proposed combination of the GCA model with SCA predictions from genotypic value estimates. A total of 270 hybrids was evaluated for grain yield and grain dry matter content in four Dent x Flint factorial mating experiments, their parental inbred lines were genotyped with 20 AFLP primer-enzyme combinations. Markers associated significantly with hybrid performance and SCA were identified, genotypic values and SCA effects were estimated, and four hybrid performance prediction approaches were evaluated. For grain yield, between 38 and 98 significant markers were identified for hybrid performance and between zero and five for SCA. Estimates of prediction efficiency (R (2)) ranged from 0.46 to 0.86 for grain yield and from 0.59 to 0.96 for grain dry matter content. Models enhancing the GCA approach with SCA estimates resulted in the highest prediction efficiency if the SCA to GCA ratio was high. We conclude that it is advantageous for prediction of single-cross hybrids to enhance a GCA-based model with SCA effects estimated from molecular marker data, if SCA variances are of similar or larger importance as GCA variances.

Biomass↗

Assessment of genomic prediction capabilities of transcriptome data in a barley multi-parent RIL population.

Low-cost and high-throughput RNA sequencing data for barley RILs achieved GP performance comparable to or better than traditional SNP array datasets when combined with parental whole-genome sequencing SNP data. The field of genomic selection (GS) is advancing rapidly on many fronts including the utilization of multi-omics datasets with the goal of increasing prediction ability and becoming an integral part of an increasing number of breeding programs ensuring future food security. In this study, we used RNA sequencing (RNA-Seq) data to perform genomic prediction (GP) on three related barley RIL populations. We investigated the potential of increasing prediction ability by combining genomic and transcriptomic datasets, adding whole-genome sequencing (WGS) SNP data, functional annotation-based filtering, and empirical quality filtering. Our RNA-Seq data were generated cost-efficiently using small-footprint plant cultivation, high-throughput RNA extraction, and Library preparation miniaturization. We also examined sequencing depth reduction as an additional cost-saving measure. We used fivefold cross-validation to evaluate the prediction ability of the gene expression dataset, the RNA-Seq SNP dataset, and the consensus SNP dataset between the RNA-Seq and parental WGS data, resulting in prediction abilities between 0.73 and 0.78. The consensus SNP dataset performed best, with five out of eight traits performing significantly better compared to a 50K SNP array, which served as a benchmark. The advantage of the consensus SNP dataset was most prominent in the inter-population predictions, in which the training and validation sets originated from different RIL sub-populations. We were therefore able to not only show that RNA-Seq data alone are able to predict various complex traits in barley using RILs, but also that the performance can be further increased with WGS data for which the public availability will steadily increase.

Hordeum↗

Heel bone ultrasound predicts non-spine fracture in Japanese men and women.

A number of prospective studies in the USA and Europe have demonstrated that quantitative ultrasound (QUS) measurements predict fracture risk. To our knowledge, there has been no such study in a Japanese population, and very few studies have measured the prognostic value of QUS measurements among men, even in the USA and Europe. We performed a three-center prospective study to investigate the relationship between baseline heel QUS measurements and non-spine fracture risk. There were 4,028 subjects (1,004 men and 3,024 women), 67.5+/-8.9 years [mean +/- standard deviation (SD)] of age), who underwent heel QUS (Achilles device) at three centers between 1993 and 2000. In 2002, the subjects were mailed a standardized questionnaire that asked about their history of fracture. The mean follow-up period was approximately 5 years. The Achilles measured speed of sound (SOS) and broadband ultrasound attenuation (BUA). We used Cox regression analysis to determine the hazard ratio (HR), using weighted coefficients. SOS, BUA, and stiffness index (SI) predicted self-reported hip, wrist, and total non-spine fractures. After we had adjusted for age, gender, and weight, the HRs of total non-spine fracture were 1.54 [95% confidence interval (CI) 1.39-1.69], 1.53 (1.37-1.70), and 1.80 (1.62-1.98) for 1 SD decrease in SOS, BUA, and SI, respectively. In men, SOS and SI also predicted total non-spine fractures with HRs similar to those in women. The HR of prediction for hip fracture by SOS and SI was better in the short term than in the long term, and the prediction for hip, wrist, and non-spine fracture remained significant between 5 to 10 years of follow-up. Measurements obtained from heel QUS predicted non-spine fracture in Japanese men and women, and the HRs of Japanese of both genders was similar to the risk ratio (RR) of Caucasian men and women. QUS parameters can predict hip, wrist, and non-spine fracture up to 10 years.

Adult↗