{
  "abstract": "Thalidomide reduces the limb bones in a puzzling order, starting with the thumb, the radius and the humerus and then returning to the ulna and the ulnar digits. To understand that order we analysed 435 thalidomide-affected limbs from the published record (1962-2025), of which 269 were upper limbs - 142 human and 127 non-human primate. Reconstructed by forward-chain assembly the reduction order runs: Digit 1 [->] Radius [->] Humerus [->] Digit 2 [->] Ulna [->] Digit 3 [->] Digit 4 [->] Digit 5. The co-reductions resolved into two rules. Within a segment (autopod, zeugopod), no bone is reduced before every bone anterior to it. Among the most posterior bones of the three segments (digit 5, ulna, humerus): no bone is reduced before every bone proximal to it. Behind these antero-posterior (A-P) and proximo-distal (P-D) reduction rules stands a maturation wave advancing postero-anteriorly and disto-proximally. In developmental terms the bone precursors exit their sensitive windows after the autopod is built, in a biaxial order: from digit 5 towards digit 1, from the ulna to radius, and across segments from the autopod towards the stylopod (Digit 5 [->] Digit 4 [->] Digit 3 [->] Ulna [->] Digit 2 [->] Humerus [->] Radius [->] Digit 1). A co-reduction is therefore a snapshot of the prospective bones still sharing a sensitive window before their sequential biaxial maturation: exposure during elongation truncates the limb proximal to the progress zone, while later exposure reduces only the bones still immature at the time of exposure.",
  "abstract_shown": true,
  "affiliations": [
    "Adelson School of Medicine, Ariel University, Ariel, Israel; Institute of Hematology, Sanz Medical Center-Laniado Hospital, Netanya, Israel"
  ],
  "article_type": "New results",
  "arxiv": null,
  "author_total": 1,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Y. Cohen"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/4kjcsmcndraa5.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.09.07.749812",
  "fulltext_url": "https://www.biorxiv.org/content/10.64898/2026.09.07.749812v1.full",
  "id": "4kjcsmcndraa5",
  "issns": [],
  "landing_url": "https://www.biorxiv.org/content/10.64898/2026.09.07.749812v1",
  "language": null,
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "biorxiv",
      "developmental biology"
    ],
    [
      "openalex",
      "1309|Congenital limb and hand anomalies"
    ]
  ],
  "openalex": "W7212802973",
  "pdf_url": "https://www.biorxiv.org/content/10.64898/2026.09.07.749812v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-07",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/4kjcsmcndraa5.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:21:59Z",
      "native_id": "10.64898/2026.09.07.749812",
      "source": "biorxiv",
      "url": "https://www.biorxiv.org/content/10.64898/2026.09.07.749812v1"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "biorxiv:developmental biology",
      "subfield": "developmental-biology"
    }
  ],
  "title": "The enigmatic bone reduction pattern of thalidomide embryopathy is set by sequential exit from the sensitive window",
  "title_text": "The enigmatic bone reduction pattern of thalidomide embryopathy is set by sequential exit from the sensitive window",
  "type": "preprint",
  "updated_at": "2026-10-30T12:21:59Z",
  "url": "https://research.draconitic.com/paper/4kjcsmcndraa5",
  "venue": "bioRxiv",
  "versions": []
}