Randomized controlled trial of daily teriparatide, weekly high-dose teriparatide, or bisphosphonate in patients with postmenopausal osteoporosis: The TERABIT study

Purpose: The effects of daily teriparatide (20 μg) (D-PTH), weekly high-dose teriparatide (56.5 μg) (W-PTH), or bisphosphonates (BPs) on areal bone mineral density (aBMD), bone turnover markers (BTMs), volumetric BMD (vBMD), microarchitecture, and estimated strength were investigated in postmenopausal osteoporosis patients.Methods: The study participants were 131 women with a history of fragility fractures. They were randomized to receive D-PTH, W-PTH, or BPs (alendronate or risedronate) for 18 months. Dual-energy X-ray absorptiometry (DXA), BTMs, and high-resolution peripheral quantitative CT (HR-pQCT) parameters were evaluated at baseline and after 6 and 18 months of treatment. The primary endpoint was the change (%) in cortical thickness (Ct.Th) after 18 months\u27 treatment compared with baseline.Results: DXA showed that D-PTH, W-PTH, and BPs increased lumbar spine aBMD (+12.0%, +8.5%, and +6.8%) and total hip aBMD (+3.0%, +2.1%, and +3.0%), but D-PTH and W-PTH decreased 1/3 radius aBMD (− 4.1%, − 3.0%, − 1.4%) after 18 months. On HR-pQCT, D-PTH increased trabecular vBMD (Tb.vBMD) at the distal radius and tibia after 18 months (+6.4%, +3.7%) compared with the BPs group, decreased cortical volumetric tissue mineral density (Ct.vTMD) (− 1.8%, − 0.9%) compared with the other groups, increased Ct.Th (+1.3%, +3.9%), and increased failure load (FL) (+4.7%, +4.4%). W-PTH increased Tb.vBMD (+5.3%, +1.9%), maintained Ct.vTMD (− 0.7%, +0.2%) compared with D-PTH, increased Ct.Th (+0.6%, +3.6%), and increased FL (+4.9%, +4.5%). The BPs increased Tb.vBMD only in the radius (+2.0%, +0.2%), maintained Ct.vTMD (− 0.6%, +0.3%), increased Ct.Th (+0.5%, +3.4%), and increased FL (+3.9%, +2.8%).Conclusions: D-PTH and W-PTH comparably increased Ct.Th, the primary endpoint. D-PTH had a strong effect on trabecular bone. Although D-PTH decreased Ct.vTMD, it increased Ct.Th and total bone strength. W-PTH had a moderate effect on trabecular bone, maintained Ct.vTMD, and increased Ct.Th and total bone strength to the same extent as D-PTH

Development of a structural growth curve model that considers the causal effect of initial phenotypes

International audienceAbstractBackgroundGrowth curves have been widely used in genetic analyses to gain insights into the growth characteristics of both animals and plants. However, several questions remain unanswered, including how the initial phenotypes affect growth and what is the duration of any such impact. For beef cattle production in Japan, calves are procured from farms that specialize in reproduction and then moved to other farms where they are fattened to achieve their market/purchase value. However, the causal effect of growth, while calves are on the reproductive farms, on their growth during fattening remains unclear. To investigate this, we developed a model that combines a structural equation with a growth curve model. The causal effect was modeled with B-splines, which allows inference of the effect as a curve. We fitted the proposed structural growth curve model to repeated measures of body weight from a Japanese beef cattle population (n = 3831) to estimate the curve of the causal effect of the calves’ initial weight on their trajectory of growth when they are on fattening farms.ResultsMaternal and reproduction farm effects explained 26% of the phenotypic variance of initial weight at fattening farms. The structural growth curve model was fitted to remove the effects of these factors in growth curve analysis at fattening farms. The estimated curve of causal effects remained at approximately 0.8 for 200 d after the calves entered the fattening farms, which means that 64% of the phenotypic variance was explained by the initial weight. Then, the effect decreased linearly and disappeared approximately 620 d after entering the fattening farms, which corresponded to an average age of 871.5 d.ConclusionsThe proposed model is expected to provide more accurate estimates of genetic values for growth patterns because the confounding causal factors such as maternal and reproduction farm effects are removed. Moreover, examination of the inferred curve of the causal effect enabled us to estimate the effect of a calf’s initial weight at arbitrary times during growth, which could provide suitable information for decision-making when shifting the time of slaughter, building models for genetic evaluation, and selecting calves for market

Evaluation of workplace infection prevention and control measures for COVID-19: A prospective cohort study in Japan

Background: Encouraging the implementation of infection prevention and control (IPC) measures has been necessary to prevent workplace infections caused by the coronavirus disease 2019 (COVID-19). However, the effectiveness of these measures in reducing infections has not been thoroughly evaluated. We evaluated employees’ COVID-19 infection rates in relation to the implementation of IPC measures at their workplaces to identify effective workplace measures. Methods: This prospective cohort study was conducted between December 2020 and December 2021 using Internet-based self-assessment questionnaires, with 11,982 participants included from the baseline. To estimate whether implementing workplace IPC measures was associated with COVID-19 incidence rates among participants, we estimated multivariate-adjusted relative risk (RR) using a log-binomial model. Results: After adjusting for sex, age, education, household members, occupation-related factors, and personal preventive behaviors, requesting ill employees to refrain from going to work showed significantly lower COVID-19 infection rates than not requesting it (RR: 0.56, 95% CI: 0.34–0.91, p = 0.019). Conclusions: Employees restricted from reporting to work when ill had significantly lower COVID-19 infection rates than those who did not follow this measure. The results indicated that not coming to work when ill was effective in reducing COVID-19 infections at the workplace. We suggest that companies proactively adopt this policy and encourage their employees to comply with it