Low Turnover Research Articles

Hydroxyurea blunts mitochondrial energy metabolism and osteoblast and osteoclast differentiation exacerbating trabecular bone loss in sickle cell mice

Sickle cell disease (SCD) is a severe hematological disorder characterized by erythrocyte sickling that causes significant morbidity and mortality. Skeletal complications of SCD include a high incidence of bone loss, especially in vertebrae, leading to fragility fractures that contribute to disease burden. Whether hydroxyurea (HU), a front-line therapy for SCD ameliorates bone disease has not been established. To investigate HU action on SCD-related vertebral defects, we used HU-treated “Townes” mice, an SCD animal model and performed high-resolution micro-computed tomography (µCT) imaging to resolve bone volume and micro-architectural structure of cortical and trabecular bone, the two major compartments contributing to bone mass and strength. Our data revealed that cortical bone was significantly diminished in the vertebrae of skeletally mature (representing adults) and immature (representing children) SCD mice, while only mature mice lost trabecular bone mass. Administration of HU ameliorated cortical bone loss in mature SCD mice, but paradoxically promoted trabecular bone decline in both groups. We further investigated the mechanisms of HU action in wild-type C57BL6/J mice. HU caused dose-dependent trabecular bone loss due to diminished osteoclast and osteoblast function, indicative of a low bone turnover state. Mechanistic investigations in vitro revealed that HU impeded osteoblast-progenitor proliferation and early differentiation, and diminished osteoclastogenic cytokine production, blunting osteoclast formation as well as the activity of mature osteoclasts. HU further, suppressed mitochondrial, but not glycolytic energy metabolism in both differentiating osteoblasts and differentiated osteoclasts. Collectively, these findings reveal that despite ameliorating cortical bone loss, HU inhibits trabecular bone formation and resorption, by suppressing mitochondrial energy metabolism and blunting the differentiation and/or activity of osteoblasts and osteoclasts. Together HU drives a low bone turnover state culminating in trabecular bone loss. Further investigation into HU’s impact on bone in SCD patients is warranted for understanding and managing skeletal complications in this population.

Exploring the Challenges and Opportunities of Employing Persons with Disabilities

Background To supplement the extant literature on the economics of employing persons of disability, the present study explores the challenges and opportunities companies face with the employment of people with disabilities. Despite legal frameworks and growing awareness, individuals with disabilities often face significant barriers to securing meaningful employment. Misconceptions about their capabilities and concerns over potential costs persist, overshadowing evidence of economic and social benefits. This study explores these dynamics, emphasizing the potential advantages of inclusive hiring practices for organizations. Methods Semi-structured expert interviews were conducted with HR managers from five South Tyrolean companies across diverse industries. Participants were selected based on criteria such as company size (minimum 35 employees) and HR management experience (at least 3 years). Interviews focused on exploring workplace adjustments, employment motivations, challenges, and barriers, generating qualitative insights into inclusion practices. Results The study identified several advantages of employing individuals with disabilities, including low turnover rates, increased employee motivation, and a positive workplace atmosphere. Most companies incurred minimal costs for workplace adjustments. Challenges included insufficient understanding among staff, difficulty matching job roles with capabilities, and bureaucratic obstacles. The experts also noted a lack of job applications from individuals with disabilities, potentially due to low confidence or family overprotection. Conclusions Employing people with disabilities can be economically profitable and is not limited to social aspects alone. Existing barriers can often be dismantled without significant financial or time investment, with obstacles being readily overcome. This article contributes to a better understanding of challenges and opportunities of employing staff with disabilities and demonstrates the conditions under which economic benefits emerge for companies. The findings are discussed from an economical and social/cultural perspective with practical implications for human resource practice and operation management.

公共衛生護理人員高工作倦怠但低離職率之現象探究：焦點團體之應用

公共衛生護理人員高工作倦怠但低離職率之現象探究：焦點團體之應用

Short-term momentum and reversals, turnover, and a stock’s price-to-52-week-high ratio

We show that short-term reversal behavior declines with a stock’s turnover and the prior month’s price-to-52-week-high ratio (PTH), shifting to momentum for stocks with both a relatively high turnover and PTH. This behavior of consecutive one-month individual stock returns is robust to subperiod analysis, risk adjustments, and alternative methodologies. Our findings suggest opposing channels. First, promoting short-term momentum, our evidence implies a PTH-anchoring underreaction to recent news, consistent with the short-term contrarian price-dampening channel of Atmaz et al. (2024) with higher turnover implying a stronger contrarian-induced underreaction. Second, promoting short-term reversals, our evidence reinforces the importance of the well-known liquidity-provision-compensation channel. Reversals are especially strong for low-PTH, low-turnover stocks, where the lower PTH implies a generally smaller-cap, less-liquid stock and the lower turnover implies a weaker contrarian-induced underreaction. We also find that the return behaviors vary with dispersion in analysts’ earnings forecasts and with market-wide sentiment, in a manner consistent with these channels.

Ecology and biogeochemistry of the microbial underworld in two sister soda lakes

BackgroundApproximately 3.7 billion years ago, microbial life may have emerged in phosphate-rich salty ponds. Surprisingly, analogs of these environments are present in alkaline lake systems, recognized as highly productive biological ecosystems. In this study, we investigate the microbial ecology of two Canadian soda lake sediment systems characterized by naturally high phosphate levels.ResultsUsing a comprehensive approach involving geochemistry, metagenomics, and amplicon sequencing, we discovered that groundwater infiltration into Lake Goodenough sediments supported stratified layers of microbial metabolisms fueled by decaying mats. Effective degradation of microbial mats resulted in unexpectedly low net productivity. Evaporation of water from Last Chance Lake and its sediments led to saturation of brines and a habitat dominated by inorganic precipitation reactions, with low productivity, low organic matter turnover and little biological uptake of phosphorus, leading to high phosphate concentrations. Highly alkaline brines were found to be dominated by potentially dormant spore-forming bacteria. These saturated brines also hosted potential symbioses between Halobacteria and Nanoarchaeaota, as well as Lokiarchaea and bacterial sulfate reducers. Metagenome-assembled genomes of Nanoarchaeaota lacked strategies for coping with salty brines and were minimal for Lokiarchaea.ConclusionsOur research highlights that modern analogs for origin-of-life conditions might be better represented by soda lakes with low phosphate concentrations. Thus, highly alkaline brine environments could be too extreme to support origin of life scenarios. These findings shed light on the complex interplay of microbial life in extreme environments and contribute to our understanding of early Earth environments.

Talent retention in Asian emerging markets: evidence from China and Malaysia

Purpose The purpose of this paper is to study talent retention, which has long been an important area of inquiry across many industries. Consistently, both academicians and practitioners have recommended several “posthire” solutions to retain employees, such as allowing employees to work from home, providing them with flexible work schedules, promoting a work–life balance and rewarding good performance. In this study, the authors focus on how the “prehire” career-related characteristics of call center agents and their personality traits relate to their turnover intentions. This is important because selecting the right person at the employee selection stage can prevent firms from trying to retain someone who is likely to quit his/her job. Design/methodology/approach The authors surveyed 442 employees working in the call centers of a major multinational logistics company across China and Malaysia and used covariance-based structural equation modeling (CB-SEM) to test the model. Findings The results showed that call center agents who reapplied for a job in the current company had lower turnover intentions than first-time applicants. Similarly, call center agents who provided supplementary information during their application had lower turnover intentions than the ones who did not provide any such information. As for the personality traits, the results indicated that while the call center agents’ agreeableness and openness to experience were positively associated with their turnover intentions, their consciousness and emotional stability were negatively associated with them. Originality/value This study shows the uniqueness of Asian emerging markets and the call center industry by presenting several interesting patterns that are different from those that have been found in other industries.

Profile and Phenotypes of Chronic Kidney Disease-Mineral and Bone Disorders in Chronic Haemodialysis Patients

Background: Chronic kidney disease-mineral and bone disorder (CKD-MBD) significantly affects haemodialysis patients, impacting prognosis and quality of life. This study examines CKD-MBD profiles and phenotypes to guide intervention strategies.Methods: We conducted a cross-sectional study at Dr. Soetomo Hospital, Surabaya, from August to October 2023, involving 111 haemodialysis patients. Data collected included demographic characteristics, CKD etiology, nutritional status, and bone mineral markers (calcium, phosphate, parathyroid hormone, and vitamin D3). Statistical analyses are used to assess relationships between bone mineral biochemistry and factors like age, dialysis duration, and diabetes presence.Results: The study found a balanced gender distribution and median age consistent with global CKD trends. Hypertension was the most common CKD cause (48.6%). The prevalence of high turnover, low turnover, and mixed turnover is 54.95%, 23.42%, and 21.62%, respectively. Longer dialysis duration and absence of diabetes correlated with higher levels of calcium, iPTH, and ALP. Older patients showed significantly lower iPTH and ALP levels.Conclusions: CKD-MBD in chronic haemodialysis patients shows varied and complex patterns, highlighting the need for personalized treatment approaches.

ESG practices through the lens of employees in hospitality: Insights from employee-generated data

Environmental, social, and governance (ESG) practices are garnering increased attention from hospitality companies, accompanied by a notable rise in awareness and expectations from key stakeholders. Nevertheless, research exploring how internal stakeholders perceive ESG initiatives and how such perceptions affect them is still scarce. This paper attempts to shed light on this area by analyzing 195,530 employee online reviews from 4182 U.S. hotel companies over 15 years. We measure employees’ perceptions of ESG practices by constructing a novel ESG lexicon using a word-embedding approach. Our results reveal that (a) employees’ perceived ESG practices increase gradually over the years, (b) perceived ESG practices are higher among current (vs. former) employees and managers (vs. non-managers), and increase with organizational tenure, (c) perceived ESG practices are related to higher job satisfaction and lower employee turnover, with organizational tenure and position level moderating these relationships.

Employment status of multiple sclerosis patients in Japan

Aims We conducted a questionnaire survey on Japanese MS patients to determine the relationship of fatigue, depression, and physical activity limitations with employment status. Materials and methods The study was conducted to assess the Patient Reported Outcome of MS patients treated with disease-modifying drug ≥6 months by recruiting MS patients from a web-based patient panel. Multiple regression analysis was performed by using items described in the Work Productivity and Activity Impairment Questionnaire-General Health Version 2.0 (WPAI-GH) and Fatigue Severity Scale (FSS), Quick Inventory of Depressive Symptomatology (Self-Report) (QIDS-SR), and Patient Determined Disease Step (PDDS). Results Employment rates decreased after MS development and were more pronounced in the group with advanced physical disability with PDDS score ≥ 3. Health-related activity limitations were higher with advanced disability. In the analysis of the five subdomains of WPAI-GH by FSS score, the domains “due to health reasons,” “disability rates during work,” “overall work disability among the employed,” and “health-related limitations’ all increased with higher FSS scores.” In WPAI-GH by QIDS-SR, the work disability rate was higher in the depressed group than in the normal group, and health-related activity limitations increased with greater depression. Limitations This is a cross-sectional survey and data are based on PRO, hence are subjective and are collected based on patients’ overall responses. Some bias could be attributed to memory and literacy rates as this is an online survey. Conclusions The results suggested that the onset of MS prevented patients from working and forced them to resign from their jobs or give up full-time work. The rate of employment tended to be lower in the group with advanced limitations; suggesting that controlling the progression of limitations may lead to lower turnover, and the rate of health-related activity limitations was correlated with the degree of physical activity limitations, depression, and fatigue, respectively.

Static histomorphometry parameters can identify bone turnover status in children and adults with chronic kidney disease

IntroductionTetracycline labeling for bone biopsy facilitates quantification of the pace of new bone production. As tetracycline labeling needs to be done prior to biopsy, it cannot be used to assess bone turnover in patients presenting with fractures, yet knowing turnover rate in patients experiencing fractures - especially in those with chronic kidney disease (CKD) - may guide appropriate medical therapy after surgical repair. Therefore, we sought to determine the diagnostic accuracy of static markers of bone turnover relative to tetracycline labeling in a pediatric and adult cohort of patients with chronic kidney disease (CKD) undergoing iliac crest biopsy with histomorphometry. MethodsWe evaluated two cohorts, one of 147 children and young adults ages 18±10 and another of 151 adults ages 49±13 who had undergone iliac crest biopsy with tetracycline labeling for clinical indications of CKD-mineral and bone disorders. We used bone formation rate relative to bone surface (BFR/BS) based on double tetracycline labeling as our gold standard marker of bone turnover. A blinded investigator used light microscopy without fluorescence to measure static bone turnover parameters. We compared the area under the ROC curve (AUC), sensitivity, and specificity of each static parameter with low and high bone turnover based on BFR/BS. ResultsIn the pediatric and adult cohorts, 35 (24 %) and 70 (46 %) had low bone turnover, respectively, and 18 (12 %) and 30 (20 %) had high bone turnover, respectively. The static parameters with the greatest AUCs for low and high turnover were osteoblasts surface/bone surface (Ob.S/BS), osteoclasts surface/bone surface (Oc.S/BS), eroded surface/bone surface (ES/BS), osteoid surface/bone surface (OS/BS), osteoid volume/bone volume (OV/BV), and osteoid thickness (O.Th.) in both cohorts. Ob.S/BS had the highest AUC for low and high turnover in the pediatric cohort (0.8204 and 0.8678, respectively) whereas Oc.S/BS had the highest AUC for low turnover (0.8325) and ES/BS had the highest AUC for high turnover (0.7360) in the adult cohort. DiscussionStatic measures of histomorphometry that do not rely on tetracycline bone labeling can identify low and high bone turnover in children and adults with CKD with moderate to high accuracy. This approach may allow assessment of bone turnover in the setting of clinical fractures where clinicians may have access to bone tissue but where tetracycline labeling is not possible.

The Untapped Potential of Mature Talent: Making the Business Case for an Aging Workforce

Abstract: This article argues that organizations should embrace hiring and retaining older workers due to the many benefits they provide. It dispels common myths that skills and abilities necessarily decline with age by reviewing research showing cognitive abilities remain strong into one's 60s and experience can offset physical declines. The article then presents five key advantages of older workers: they excel at soft skills like leadership and problem-solving; have lower turnover rates which save on training costs; can mentor younger employees and transfer institutional knowledge; bring diversity of perspectives that fuels innovation; and through experience, are able to offset potential physical job limitations. Industry examples from sectors like pharmaceuticals, consumer goods, consulting and retail are given. Overall, the article makes the case that an age-diverse workforce maximizes talent if organizations adopt policies like flexible work arrangements, ongoing skills training, leadership promoting inclusion, and fair performance reviews.

Longitudinal stability of molecular endotypes of knee osteoarthritis patients

ObjectiveTo assess the longitudinal stability of biomarker-based molecular endotypes of knee osteoarthritis (KOA) participants from APPROACH and to evaluate the consistency of findings in an independent KOA population. MethodsNineteen biomarkers were measured longitudinally in 295 KOA participants from the APPROACH cohort. K-means clustering was used to identify the structural damage, inflammation, and low tissue turnover endotypes at the six-, 12-, and 24-month follow-ups. Endotype stability was defined as having the same independent endotype assignment longitudinally for patients with complete data (n = 226). Clinical and biochemical characteristics were compared between participants with longitudinally stable and unstable endotypes. The presence and longitudinal stability of the endotypes were evaluated in a different KOA population from the placebo arm of the oral salmon calcitonin trials. ResultsAn average overall longitudinal endotype stability of 55% (Fleiss’ Kappa of 0.53; 95% CI: 0.46, 0.60) was demonstrated. An average stability of 59% (range: 54% - 59%) was observed for the structural damage endotype (Fleiss’ Kappa 0.52; 95% CI: 0.45, 0.60), 54% (52% - 56%) for the inflammatory (Fleiss’ Kappa 0.61; 95% CI: 0.53, 0.68), and 50% (49% - 52%) for the low tissue turnover endotype (Fleiss’ Kappa 0.46; 95% CI: 0.39, 0.54). Participants with longitudinally unstable endotypes exhibited molecular properties of more than one endotype, which were detectable already at the first visit. ConclusionsOur study showed for the first time that more than half of KOA participants exhibited a longitudinally stable endotype, highlighting the applicability of biomarker-based endotyping in a clinical trial setting.

Transitions Into Freezing Environments Linked With Shifts in Phylogenetic Integration Between Vitaceae Leaf Traits.

Understanding how the intrinsic ability of populations and species to meet shifting selective demands shapes evolutionary patterns over both short and long timescales is a major question in biology. One major axis of evolutionary flexibility can be measured by phenotypic integration and modularity. The strength, scale, and structure of integration may constrain or catalyze evolution in the face of new selective pressures. We analyze a dataset of seven leaf measurements across Vitaceae to examine how correlations in trait divergence are linked to transitions between freezing and nonfreezing habitats. We assess this by applying a custom algorithm to compare the timing of habitat shifts to changes in the structure of evolutionary trait correlation at discrete points along a phylogeny. We also explore these patterns in relation to lineage diversification rates to understand how and whether patterns in the evolvability of complex multivariate phenotypes are linked to higher-level macroevolutionary dynamics. We found that shifts in the structure, but not the overall strength, of phylogenetic integration of leaves precipitate colonization of freezing climates. Lineages that underwent associated shifts in leaf trait integration and subsequent movement into freezing habitats also displayed lower turnover and higher net diversification, suggesting a link among shifting vectors of selection, internal constraint, and lineage persistence in the face of changing environments.

Risk parity portfolio optimization under heavy‐tailed returns and dynamic correlations

Risk parity portfolio optimization, using expected shortfall as the risk measure, is investigated when asset returns are fat‐tailed and heteroscedastic with regime switching dynamic correlations. The conditional return distribution is modeled by an elliptical multi‐variate generalized hyperbolic distribution, allowing for fast parameter estimation via an expectation‐maximization algorithm, and a semi‐closed form of the risk contributions. A new method for efficient computation of non‐Gaussian risk parity weights sidesteps the need for numerical simulations or Cornish–Fisher‐type approximations. Accounting for fat‐tailed returns, the risk parity allocation is less sensitive to volatility shocks, thereby generating lower portfolio turnover, in particular during market turmoils such as the global financial crisis or the COVID shock. While risk parity portfolios are rather robust to the misuse of the Gaussian distribution, a sophisticated time series model can improve risk‐adjusted returns, strongly reduces drawdowns during periods of market stress and enables to use a holistic risk model for portfolio and risk management.

Modulation of p300 acetylation to protect against doxorubicin-induced cardiotoxicity

Abstract Background Doxorubicin (DOX) is a widely-used anti-neoplastic agent, but the most common adverse reaction to its use is cardiotoxicity(1). DOX acts by producing reactive oxygen species (ROSs) that cause DNA damage(1,2), which activates various proteins, including the tumour suppressor p53 and the acetyltransferase p300. When activated, p300 acetylates and increases the activity of p53 which leads to increased apoptotic activity(3). Cardiotoxicity results because the heart has limited mechanisms to dispose of ROSs(4), and because cardiomyocytes have a low turnover rate(5). Purpose We examined the p300 inhibitor Theracurmin (THR)(6,7) as a candidate to prevent DOX cardiotoxicity using an in-vivo mouse model, and sought to elucidate the underlying molecular mechanisms using in-vitro studies. Methods C57BL/6 mice were pre-treated with THR or vehicle (as control), then administered DOX or vehicle. Cardiac function was evaluated by echocardiography and cardiac catheterization. In vitro studies used cardiac fibroblasts (FBs) and cardiac endothelial cells (ECs) pre-treated with THR, then with DOX, as in the animal studies. Western blotting and rt-qPCR was used to quantify protein and mRNA levels of genes in the p53-p300 pathway or related to apoptosis, oxidative stress, and cell cycle control. Results DOX-treated mice showed significant decreases in left ventricular (LV) ejection fraction (LVEF, p=0.0004), fractional shortening (FS, p=0.0012), and a significant increase in end-systolic volume (ESV, p=0.0004). We also showed a significant decrease in anterior (LVAW;d, p=0.005) and posterior (LVPW;d, p=0.005) wall thickness of the LV in these mice. However, when mice were pre-treated with THR prior to DOX administration, we saw significant increases in LVEF (p=0.045) and LVPW;d (p=0.015), and a significant decrease in ESV (p=0.0047) compared to those that were not pre-treated. In-vitro analyses demonstrated a significant increase in cleaved caspase 3 protein expression in DOX-treated ECs (p=0.007), that was not prevented by THR pre-treatment. In DOX-treated FBs, we saw a reduction in AKT mRNA (p=0.017) and increases in BAX 9p=0.008), P21 (p=0.0001), and GADD45 (0.037) mRNA expression. In DOX-treated ECs, we also saw significant increases in BAX (p=0.015) and P21 (p=0.011) mRNA expression. These changes in mRNA expression were not reversed with THR pre-treatment in either cell type. Conclusion THR pre-treatment successfully mitigated functional deficits and structural deficits associated with DOX cardiotoxicity. In-vitro studies show that THR pre-treatment was not sufficient to significantly prevent changes in key molecular targets associated with apoptosis. Further studies are required to elucidate the mechanism behind the observed functional changes.Abstract OverviewAbstract Results

Impact of fluoride and aluminum co-exposure on bone growth and quality in juvenile rats: dose and duration effects

This study aimed to investigate the impact of the dosage and duration of fluoride and aluminum(F and Al) co-exposure on the skeletal growth and bone quality of juvenile rats. Forty-eight 8-week-old Sprague-Dawley rats were randomly assigned to normal control, low F and Al exposure, and high F and Al exposure groups, with 45-day and 90-day subgroups established for each. We measured body length, tibia length, conducted bone histomorphometric analysis of the proximal tibia, performed micro-CT scans and three-point bending tests of the femur. Compared to the age-matched control group, the low F and Al group at 45 days exhibited increased bone formation and stiffness; the low F and Al group at 90 days and the high F and Al group at 45 days showed increases in body length, tibia length, growth plate width, longitudinal bone growth rate, bone turnover, and improved microstructure. Notably, bone elastic stress only elevated in the high F and Al group at 45 days. Conversely, the high F and Al exposure group at 90 days experienced decreases in the aforementioned parameters, with the exception of growth plate width, and displayed abnormal hypertrophic chondrocyte morphology in the growth plate. In summary, long-term exposure to low levels of F and Al and short-term exposure to high levels of F and Al promote bone formation followed by bone resorption in juvenile rats, stimulating bone growth and enhancing bone quality. However, long-term exposure to high levels F and Al results in low bone turnover, slow bone growth, and reduced bone property.

Mid-level healthcare providers: Making a fresh case for modern Indian healthcare.

To compensate for physician shortage, many countries around the world have introduced a cadre of mid-level healthcare providers (MLHPs) into their health systems to shoulder many of the conventional responsibilities of a physician. Besides backing their clinical competence and service quality, evidence and experience on MLHPs also supports their lower turnover and higher rural retention rates. In India, mainstreaming of MLHPs has time and again been met with resistance from organized medicine. We explore a fresh case for MLHPs in India in view of some recent developments and the probable future contours that Indian healthcare is likely to assume. Aided by global precedents, we broaden the rationale for mainstreaming MLHPs, address some common misunderstandings, and describe the conducive emergent legal and policy landscape. We also explain how a possible reorganization of Indian healthcare, highly likely under expanded publicly financed health insurance and value-based healthcare regimes, can warrant greater health workforce differentiation and an expanded role of MLHPs in mainstream healthcare delivery. We also touch upon important political economy considerations, including the need for navigating organized medical opposition, involving medical stakeholders in the MLHP mainstreaming process, autonomous regulation of MLHP professions, streamlining MLHP competencies, and inclusive health financing systems.

In or out of reach? Long-term trends in the reach of health assessments in the Swedish occupational setting.

This study aimed to investigate the reach of a large-scale health assessment delivered by the occupational health service in Sweden for almost 30 years. A total of 418 286 individuals who participated in a health assessment (Health Profile Assessment, HPA) between 1995-2021 were included. A comparative sample was obtained from Statistics Sweden, comprising the entire working population for each year (4 962 127-6 011 829 unique individuals per time period). Sociodemographic and work organization characteristics were compared between the HPA and comparative population for six different periods. Under- and overrepresented groups in the private and public sectors were identified using the most recent data (2015-2021). With negative per cent indicating underrepresentation, the most notable changes over time in representation in the HPA population compared to the comparative were observed for women (-1.2% to -12.8%), private sector employees (-9.4% to 14.9%), individuals with ≥3 years of employment (14.5% to 0.9%), in personal care (0.8% to -8.8%) and manufacturing (0.7% to 6.4%) occupations. Consistently overrepresented groups (median representation across periods) included individuals who had a single income source (6.3%) and were middle-aged (10.8%), born in Sweden (5.9%), associate professionals (8.7%), and employed in companies with high operating profit (17.9%) and low staff turnover (14.3%). Conversely, individuals with low income (-34.0%) and employed in small companies/organizations (-10.9%) were consistently underrepresented. Middle-aged women in education occupations were most underrepresented in the public sector, while in the private sector, it was young women in service and shop sales occupations. This health assessment has reached many professionals, including hard-to-reach groups, but did not fully represents the Swedish workforce throughout the years.

Mining and analysis of adverse event signals for alendronate based on the real-world data of FDA adverse event reporting system database

ABSTRACT Objective Our study aims to assess alendronate-related adverse events (AEs) from the US FDA adverse event reporting system database. Methods The AE data associated with alendronate between the first quarter of 2004 and the first quarter of 2024 were selected. Various signal quantification methods, including the ROR, PRR, BCPNN, and EBGM, were applied for analysis. Results In 34,943 reports where alendronate was the primary suspected drug for the AE, 24 affected system organ classes and 1046 significant preferred terms were identified in this study. Several significant AEs beyond drug instructions with strong signals were determined, including low turnover osteopathy, fracture delayed union, fracture nonunion, loss of anatomical alignment after fracture reduction, fracture malunion, periprosthetic fracture, carotid bruit, oral fibroma, traumatic occlusion, and phlebolith. The median time to onset of alendronate-related AEs was 306 days (interquartile range [IQR] 12–1,461 days), and the majority of cases occurred 2 years later (18.80%) and within 30 days (14.49%). Conclusions The current study detected multiple potential new AE signals for alendronate, and more clinical researches are required to further validate our results and clarify their associations.

Balancing the scale: Investigating the effect of frontloading and backloading salary structures on teacher turnover

This study investigates the impact of frontloading salary structures (higher early-career salaries) on teacher turnover using data from South Carolina public school districts in the U.S. from FY2014- FY2023. Employing a Difference-in-Differences (DID) model, the analysis reveals that frontloading salary schedules is associated with lower turnover among novice teachers but have a less pronounced effect on seasoned educators. The study highlights that the impact of frontloading varies by district demographics and teacher qualifications. Results indicate that higher experience premiums for early-career teachers can increase turnover when compared to mid-career premiums, suggesting a need for balanced salary structures, targeted financial incentives.