Cause Of Failure Research Articles

Research on the failure mechanisms and preventive actions of tunnels under butterfly load in loess regions

The results of surrounding rock pressure measurements from numerous loess tunnels exhibit a butterfly distribution pattern, subsequently referred to as ’butterfly load’. This pattern significantly deviates from the load distribution and magnitude—referred to as ’specification load’—calculated by current Chinese tunnel design specifications. By means of model experimental and numerical simulation, the mechanical behavior, failure cause, failure mechanism and preventive actions of tunnel structure under different load distribution are studied. The experimental results indicate that the ultimate bearing capacity of the tunnel structure under the butterfly load is significantly lower than that under the specification load, with the ultimate bearing capacity decreasing as load unevenness increases. The butterfly load increases the unevenness of the axial force distribution throughout the annular structure and also causes the structure to produce reverse moments in the vault and arch shoulder. Similarly, the morphological characteristics of the cracks show that the butterfly load most significantly influences the tunnel vault and arch shoulder. Under the influence of the butterfly load, the lining structure is prone to developing cracks at the arch shoulder and arch foot positions, with tensile cracks located at the vault position. Aiming at the failure mechanism of tunnel structure under butterfly load, it is suggested to implement advanced small conduit grouting at the tunnel arch to suppress the dislocation of the formation and to lay root piles at the arch foot to improve the bearing capacity of the tunnel bottom. The prevention effect of this technology in different loess regions is sandy loess > general loess > clay loess.

Numerical Study of Vortex-Induced Vibration Characteristics of a Long Flexible Marine Riser

In ocean engineering, interactions between ocean currents and risers lead to regular vortex shedding on both sides of the riser, causing structural deformation. When the frequency of vortex shedding approaches the natural frequency of the structure, resonance occurs, significantly increasing deformation. This phenomenon is a critical cause of riser failure. Therefore, the dynamic response of flexible risers to vortex-induced vibrations (VIV) is crucial for their structural safety. This paper employs the finite-volume method to integrate over control volumes to solve for forces, such as pressure and shear stress, on the surface of the riser, while the finite-element method discretizes the continuous structural body into elements and nodes to solve for structural displacements and stresses. A strongly coupled method is utilized at each timestep to iteratively transfer load-displacement data between the fluid and structural fields, updating the boundary conditions of the fluid domain to achieve a bidirectional fluid–structure interaction simulation of vortex-induced vibrations in a seawater environment for flexible risers. The study finds that the three-dimensional flexible riser exhibits multi-frequency vibration phenomena and broadband vibration response characteristics under high flow velocity conditions. As the flow velocity increases, the vortex-shedding mode is observed to transition from the simple two single (2S) mode to the more complex pair + single (P + S) and two pair (2P) modes. In addition, the stiffness at the ends is enhanced by the fixed boundary conditions, and the coupling between the natural frequency of the ends and the vortex-shedding frequency triggers complex vortex-shedding phenomena in these regions. At higher flow velocities, these boundary effects result in more complex vortex-shedding modes and stronger vibration responses at both ends of the riser.

Targeting Mitochondrial Cholesterol Efflux via TCF21/ABCA10 Pathway to Enhance Cisplatin Efficacy in Ovarian Cancer.

Cisplatin (DDP) resistance is one of the causes of treatment failure for ovarian cancer (OV). Mitochondrial cholesterol level was reported to be associated with OV chemoresistance. We found that ABCA10, a potential cholesterol transport protein, was highly expressed in ovarian tissues and downregulated in OV tissues. Our study aimed to explore TCF21/ABCA10 axis resistance to DDP therapy in ovarian cancer based on regulating mitochondrial cholesterol efflux. Thirty epithelial ovarian cancer tumors and thirty ovarian tissues from non-cancer patients were collected. Western blot and RT-qPCR were used to measure ABCA10 and TCF21 expression levels in these tissues, as well as in a human ovarian epithelial cell line (IOSE-80), OV cells (A2780 and SKOV3), and DDP-resistant OV cell lines (A2780/DDP and SKOV3/DDP). IOSE-80 cells were also infected with ABCA10 knockdown lentivirus to identify the most effective ABCA10 knockdown plasmid. Lentiviral infection was used to create ABCA10 knockdown, ABCA10 overexpression, and TCF21 overexpression anti-DDP OV cell lines. Cell proliferation was detected by CCK-8 and EDU staining, flow cytometry for apoptosis, MTT for metabolic activity, calcium-induced Cytochrome C release, and mitochondrial matrix swelling for mitochondrial function and Oil Red O staining for lipid accumulation. Cholesterol metabolism was evaluated by measuring mitochondrial cholesterol and cholesterol efflux. Protein concentration was determined using the BCA method. A dual-luciferase reporter assay confirmed TCF21's interaction with ABCA10. ChIP also verified this interaction. The mRNA level (P < 0.01) and protein level (P < 0.001) of ABCA10 were downregulated in cancer tissues of OV patients relative to normal ovarian tissues. Relative to human ovarian epithelial cells, ABCA10 expression was significantly downregulated in OV cells (P < 0.01) and even more significantly downregulated in DDP-resistant OV cells (P < 0.001). Compared to the group treated solely with DDP, the overexpression of ABCA10 significantly inhibited the proliferation of DDP-resistant OV cells (P < 0.01), markedly reduced the staining intensity of EDU in these cells (P < 0.05), and substantially accelerated apoptosis in DDP-resistant OV cells (P < 0.01).Overexpression of ABCA10 further accelerated Cytochrome C expression and mitochondrial matrix swelling in DDP-resistant OV cells compared to the DDP-alone group (P < 0.01). The addition of cholesterol reversed the decrease in lipid accumulation, the decrease in mitochondrial cholesterol levels (P < 0.05), and the increase in cholesterol efflux (P < 0.01) in DDP-resistant OV cells caused by overexpression of ABCA10. The transcription factor TCF21 was bound to the promoter of ABCA10. Overexpression of TCF21 significantly increased ABCA10 expression in DDP-resistant OV cells (P < 0.01) and increased cytochrome C expression in A2780/DDP (P < 0.05) and SKOV3/DDP (P < 0.01) cells, with accelerated mitochondrial matrix swelling in A2780/DDP (P < 0.01) and SKOV3/DDP (P < 0.001) cells, while knockdown of ABCA10 reversed these effects. Our study found that TCF21 boosts ABCA10 expression, which in turn reduces DDP resistance in OV cells by enhancing mitochondrial cholesterol efflux. This mechanism increases the sensitivity of DDP-resistant OV cells to DDP. Our findings will provide new therapeutic targets for the treatment of ovarian cancer.

Acquired immunostimulatory phenotype of migratory CD103+ DCs promotes alloimmunity following corneal transplantation.

After transplantation, Th1-mediated immune rejection is the predominant cause of graft failure. Th1 cell sensitization occurs through complex and context-dependent interaction among antigen-presenting cell subsets, particularly CD11b+ DCs (DC2) and CD103+ DCs (DC1). This interaction necessitates further investigation in the context of transplant immunity. We used well-established preclinical models of corneal transplantation and identified distinct roles of migratory CD103+ DC1 in influencing the outcomes of the grafted tissue. In recipients with uninflamed corneal beds, migratory CD103+ DC1 demonstrate a tolerogenic phenotype that modulates the immunogenic capacity of CD11b+ DC2 primarily mediated by IL-10, suppressing alloreactive CD4+ Th1 cells via the PD-L1/PD-1 pathway and enhancing Treg-mediated tolerance via αvβ8 integrin-activated TGF-β1, thus facilitating graft survival. Conversely, in recipients with inflamed and vascularized corneal beds, IFN-γ produced by CD4+ Th1 cells induced migratory CD103+ DC1 to adopt an immunostimulatory phenotype, characterized by the downregulation of regulatory markers, including αvβ8 integrin and IL-10, and the upregulation of IL-12 and costimulatory molecules CD80/86, resulting in graft failure. The adoptive transfer of ex vivo induced tolerogenic CD103+ DC1 (iDC1) effectively inhibited Th1 polarization and preserved the tolerogenic phenotype of their physiological counterparts. Collectively, our findings underscore the essential role played by CD103+ DC1 in modulating host alloimmune responses.

Genetics in nephrology - any news?

While genetic kidney diseases were long regarded as a rare cause of kidney failure, it has been shown in recent years that they account for a relevant proportion of cases. In cohorts of kidney transplant recipients, a monogenic cause is found in up to 30% of cases. Identifying the genetic cause of kidney disease has become much easier thanks to technological advances in DNA sequencing. The focus has now shifted to understanding the significance of the findings and identifying diagnostic gaps. It is still not possible to clarify all CKD cases of unclear aetiology. Besides very effective generic treatments for monogenic kidney disease (e.g., ACE-inhibitor use in Alport Syndrome), increasing knowledge of the pathophysiology of genetic kidney diseases has led to a growing number of targeted therapies. These include the treatment of ADPKD with Tolvaptan, which has now been in use for 10 years. Recently, exciting, and completely new approaches have been added, such as the first siRNA therapies in nephrology for primary hyperoxaluria type 1, the targeted treatment of hyperphagia in Bardet-Biedl syndrome, the therapy of APOL1-associated kidney disease or the use of the HIF-2 antagonist Belzutifan for renal cell carcinoma associated with Von-Hippel-Lindau syndrome. The new possibilities in the treatment of patients with genetic kidney diseases have also clearly revealed deficits in current patient care. Centers of excellence with extensive experience in this area therefore play an important role in improving care. This also applies to the further training of colleagues in the field. In Germany, the National Action Alliance for People with Rare Diseases (NAMSE) and the nationwide establishment of - to date - 36 centers for rare diseases play an important role in this regard.

Review of alternative medicine (AM) treatments for diabetes

In the US, diabetes is a signification public health issue. It is one of the leading causes of death and number one cause of kidney failure. Even with increased awareness and medical advances, the diabetic trends with the US adult population are not very encouraging. The number of diabetes cases in the US the last twenty years has more than doubled and out of the 37.3 million adults in the US with diabetes, 20% of them don’t even know that they have it.1 Diabetes is a chronic disease with no available cure, medical practitioners and researchers have focused on controlling it with through medicine and lifestyle changes. Diet, exercise and healthy lifestyle are the most important factors on managing diabetes. There are several Alternative Medicine (AM) treatments that are available to manage diabetes today. Diet, exercise, herbs and supplements, yoga and meditation are some of the available AM treatments for diabetes. Herbs and supplements do not come under the purview of the U.S. Food and Drug Administration (FDA) because they are not classified as medicines. Moreover, there are not enough definitive research that proves the efficiency and efficacy of AM treatments. In this paper, I have described AM treatments available today and their impact on diabetes management.

Integrin alpha1 beta1 promotes interstitial fibrosis in a mouse model of polycystic kidney disease.

Fibrosis is the cause of end-stage kidney failure in patients with Autosomal Dominant Polycystic Kidney Disease (ADPKD). The molecular and cellular mechanisms involved in fibrosis are complex and anti-fibrotic therapies have so far failed to make an impact on patient welfare. Using unbiased proteomics analysis on the Pkd1 nl/nl mouse, we found that expression of the integrin α1 subunit is increased in this model of ADPKD. In human ADPKD tissue and two single cell RNA kidney disease datasets, ITGA1 was also upregulated. To investigate the functional role of this integrin subunit in ADPKD, we generated a Pkd1 nl/nl Itga1 -/- mouse. We observed a significant reduction in kidney volume and kidney dysfunction in mice lacking the integrin α1 subunit. Kidneys from Pkd1 nl/nl Itga1 -/- mice had smaller cysts and reduced interstitial expansion and tubular atrophy. Picrosirius red staining identified a restriction in collagen staining in the interstitium and the myofibroblast marker α smooth muscle actin was also downregulated. Myofibroblast cell proliferation was reduced in Pkd1 nl/nl Itga1 -/- mice and primary fibroblast cultures demonstrated an abrogated fibrogenic phenotype in integrin α1-depleted fibroblasts. These results highlight a previously unrecognised role for the integrin α1 subunit in kidney fibrosis.

Osteogenesis imperfecta as a cause of respiratory failure.

Osteogenesis imperfecta as a cause of respiratory failure.

PRINCIPAIS CAUSAS DA PERDA PRECOCE DOS IMPLANTES DENTÁRIOS OSSEOINTEGRADOS

Osseointegration, crucial for implant success, can be compromised by biological, mechanical, and systemic factors. The study aimed to investigate the main causes of early failure of osseointegrated dental implants, which, despite advances in implantology, still present a clinical challenge. The methodology consisted of a comprehensive literature review, using articles published between 2014 and 2024, from databases such as Scielo and Google Scholar. Relevant studies were selected using the descriptors “dental implant,” “subperiosteal implant,” and “osseointegration,” addressing causes such as peri-implantitis, insufficient bone quality, and technical failures during installation. The results indicate that early implant failure is associated with inflammatory complications, such as peri-implantitis and peri-implant mucositis, as well as factors like low bone density, inadequate immune response, and occlusal overload. Systemic conditions, such as diabetes and smoking, were also highlighted as significant risk factors for implant failure. Correct technical execution, combined with proper planning, proved to be essential in minimizing failures and ensuring long-term success.

The Impact of Perioperative Bilirubin and Albumin Levels on Postoperative Early Complications in Adult Liver Transplantation.

Postoperative complications persist as a significant cause of graft failure in liver transplantation. Identifying circulatory markers that predict such complications holds excellent clinical value. This study aimed to investigate serological indicators that can indicate early complications in adult liver transplantation. This study included 436 patients who underwent liver transplantation at our hospital, along with corresponding monitoring protocols. The differences and interactions of circulating indicators at various time points were analyzed using repeated measures analysis of variance. Post-hoc multiple comparisons were adjusted using the Bonferroni method. Restricted cubic spline regression models assessed non-linear associations between circulating markers, complications, and mortality. This study demonstrated significant time effects for all related markers, with substantial differences in complications and mortality for direct bilirubin and albumin. The restricted cubic spline model revealed a significant positive association between direct bilirubin and complications across three postoperative phases (p postoperative phase 1 = 0.0011, p postoperative phase 2 = 0.0001, p postoperative phase 3 = 0.0020). Conversely, albumin showed a significant negative association with complications in phases 1 and 2 (p postoperative phase 1 = 0.0001, p postoperative phase 2 = 0.0009). Furthermore, direct bilirubin was significant associated with increased mortality of postoperative phase 2 and phase 3 (p postoperative phase 2 < 0.0001, p postoperative phase 3 < 0.0001), while albumin showed a significant negative association with mortality (p postoperative phase 1 = 0.0306). Direct bilirubin and albumin are potential critical factors affecting early complications after liver transplantation. Close monitoring of these markers within 24-72 postoperative hours may help predict the occurrence of complications.

3D-printed one-piece versus two-piece orthodontic clear aligner attachments bonded with provisional crowns: A proof of concept

ObjectivesThis study aimed to introduce a novel technique for fabricating provisional crowns integrated as a single unit with aligner attachments. MethodsA total of 60 crowns with attachments were prepared: 20 conventional (Protemp) and 40 3D-printed (20 bonded with attachments; 20 integrated with composite attachments as a single unit) using NextDent resin. Two central incisors were scanned (once without attachments and once with attachments) to create STL files for specimen printing. Half of the specimens (30, n = 10 per group) underwent thermal cycling (5000 cycles). Shear bond strengths (MPa) were evaluated using a universal testing machine. The debonded areas and attachment failures were analyzed to determine the fracture type. Data analyses were performed using ANOVA and post hoc Tukey tests (α = 0.05). ResultsThe 3D-printed specimens showed higher strength values than the bonded attachments per group (P < 0.001). The 3D-printed crowns with attachments demonstrated the highest strength (12.39 ± 1.92 MPa). Thermal cycling significantly decreased the bond strength of the attachments (P < 0.001), except in the 3D-printed crowns with composite attachments as a single unit, which showed no significant change after thermal cycling (P = 0.643). In the bonded attachment groups, the adhesive type was the predominant failure mode, while in the 3D-printed groups, attachment fractures were the primary cause of failure. ConclusionThe 3D-printed provisional crowns with attachments have high strength and is clinically appropriate for orthodontic treatment when temporization of teeth is indicated. Clinical SignificanceThe developed technique for fabricating 3D-printed provisional restorations with orthodontics attachments as a single unit is a promising approach. The technique may be incorporated into the digital orthodontic treatment workflow when temporization is indicated.

Time-dependent reliability analysis of flood defenses under cumulative internal erosion

Internal erosion is a significant cause of failure in dams, levees and other hydraulic structures. This article studies the time-dependent reliability of such structures under Backward Erosion Piping (BEP), a form of internal erosion in the foundation. First, a physics-based time-dependent piping failure model is presented. Second, a time-variant reliability analysis method is presented which allows to quantify how the reliability evolves over the years due to cumulative pipe growth over multiple flood events. Finally, these models are used to study the importance of time-dependence for reliability estimates of flood defenses in The Netherlands. The findings show that, particularly in coastal areas, incorporating time-dependence significantly reduces the computed failure probability. Reductions vary widely, ranging from a factor of 5 to more than 10 6 , depending on flood duration and levee properties. Therefore, reliability estimates for levees can be improved by incorporating time-dependent pipe development in the BEP failure model, and thereby contribute to avoiding unnecessary reinforcements.

Access to Waitlisting and Posttransplant Outcomes in Patients With Failed Kidney Allografts Secondary to Recurrent Glomerulonephritis.

Recurrent glomerulonephritis (GN) is an important cause of allograft loss after transplantation when GN is the primary cause of kidney failure. Retransplantation after allograft loss from recurrent disease requires careful consideration. We aimed to determine the probability of relisting and the risk of allograft loss after retransplantation in recipients with prior allograft loss from recurrent GN. Using data from the Australia and New Zealand Dialysis and Transplant Registry and multivariable Cox modeling, we compared the probability of waitlisting and allograft loss after second transplantation between those with and without prior allograft loss from recurrent disease. Of 3276 patients who received a second kidney transplant, 179 (5%) lost their first allograft from recurrent GN. Between 2006 and 2021, 1524 patients with failed first allografts (6% with recurrent GN, 45% with primary GN but no disease recurrence) were relisted for transplantation. Compared with patients without primary GN, the adjusted hazard ratios (95% confidence intervals) for relisting in patients with primary GN, with and without disease recurrence, were 1.09 (0.88-1.34) and 1.16 (1.05-1.29), respectively. The respective adjusted hazard ratios for allograft loss after repeat transplantation were 0.77 (0.59-1) and 1.02 (0.9-1.16). Of the 81 patients who received a second allograft after losing their first allograft to GN recurrence, 18 patients (22%) also lost their second allograft because of recurrent GN. Patients with prior allograft loss from GN recurrence were not disadvantaged, with comparable waitlist potential and allograft outcome after repeat transplantation. However, >20% of those with prior allograft loss from disease recurrence also lost their second allografts from recurrent disease.

A Caspase 3‐Hijacking Nanosystem Enhances Cancer Radiotherapy by Suppressing Tumor Repopulation

AbstractRadiotherapy is used in the treatment of ≈50% of patients with cancer. However, tumor repopulation is a major cause of treatment failure after radiotherapy. It is observed that apoptotic tumor following ionizing radiation (IR) accelerated the growth of surviving tumor cells. Here a Gasdermin E and Tannic acid‐based nanoassembly (GT) loaded with manganese tetroxide (Mn3O4) (termed as Mn3O4@GT) is developed to suppress tumor repopulation and improve the treatment outcome of radiotherapy. Mn3O4@GT enables an increase in the reactive oxygen species accumulation in tumor cells, enhancing radiotherapy‐mediated tumor killing. What's more, it can hijack activated caspase 3 to induce tumor pyroptosis, reversing apoptosis‐mediated tumor repopulation. In vivo results shows that Mn3O4@GT significantly reduced the IR induced tumor repopulation by 2.7 fold, resulting in 92% complete regression of tumors. In addition, Mn3O4@GT can sensitize tumors to anti‐PD‐L1 therapy by inducing immunogenic pyroptosis with 85% regression of distant tumors. The caspase 3‐hijacking nanosystem holds a great potential for improving the clinical benefits of radiotherapy.

ABCA3 c.838C>T (p.Arg280Cys, R280C) and c.697C>T (p.Gln233Ter, Q233X, Q233*) as Causative Variants for RDS: A Family Case Study and Literature Review.

Background: Respiratory distress syndrome (RDS) is the primary cause of respiratory failure in preterm infants, but it also affects 5-7% of term infants. Dysfunctions in pulmonary surfactant metabolism, resulting from mutations of the lung surfactant genes, are rare diseases, ranging from fatal neonatal RDS to interstitial lung disease, associated with increased morbidity and mortality. This study aims to clarify the clinical significance of ABCA3 variants found in a specific family case, as existing data in the literature are inconsistent. Material and Methods: A family case report was conducted; targeted panel genetic testing identified a variant of the SFTPB gene and two variants of ABCA3 genes. Comprehensive research involving a systematic review of PubMed, Google Scholar databases, and genome browsers was used to clarify the pathogenicity of the two ABCA3 variants found in the index patient. Advanced prediction tools were employed to assess the pathogenicity of the two ABCA3 variants, ensuring the validity and reliability of our findings. Results: The index case exhibited fatal neonatal RDS. Genetic testing revealed the presence of the SFTPB p.Val267Ile variant, which was not previously reported but is a benign variant based on family genetic testing and history. Additionally, two ABCA3 gene variants were identified: c.697C>T, not yet reported, and c.838C>T. These variants were found to affect ABCA3 protein function and were likely associated with neonatal RDS. Prediction tools and data from nine other cases in the literature supported this conclusion. Conclusions: Based on in silico predictors, an analysis of the presented family, and cases described in the literature, it is reasonable to consider reclassifying the two ABCA3 variants identified in the index case as pathogenic/pathogenic. Reclassification will improve genetic counseling accuracy and facilitate correct diagnosis.

Experimental and Numerical Analysis of Bolted Repair for Composite Laminates with Delamination Damage

Composite materials are widely used in aircraft due to the urgent need for high-quality structures in aerospace engineering. In order to verify the effectiveness of complex bolt repairs on composite structures, compression tests have been performed on three types (intact, damaged, and repaired) of composite plate specimens, and finite element simulation results of these three types’ specimens were obtained. The experimental results show that for damaged composite laminates, the strength recovery after bolt repair can reach an impressive 107%, and the delamination propagation caused by over-buckling deformation is considered to be the main cause of failure, which also suggests that although bolt repair can improve the strength of the specimens, it has a limited ability to inhibit delamination propagation. The simulation results of the finite element model in this paper are in good agreement with the actual experimental results, and the maximum error does not exceed 7.9%. In conclusion, this paper verifies the suitability of the proposed repair scheme in engineering applications and the correctness of the modeling method for repaired composite laminates.

Teachers’ perspectives on determinants of educational (under)achievement of Cigano/Roma students in Portugal

ABSTRACT The presence of Cigano/Roma students in secondary education in Portugal is still a rarity, considering that less than 3% of young Ciganos/Roma attend secondary education. This article aims to highlight the need for a comprehensive understanding of the perceptions of school teachers and principals on educational (under)achievement, absenteeism and school integration of Cigano students. To this end, we analyse data from an online questionnaire survey of a sample of 819 teachers, school principals and deputy principals and other senior management staff in schools of the Metropolitan Areas. These respondents express persistent representations and stereotypes in relation to the educational trajectories of Cigano students, especially in assigning prime causes of school failure to factors relating to the students’ family or own intrinsic issues, rarely indicating institutional factors or those linked to their teaching practices. Although this is a study centred on Portugal, the lessons drawn from it can point to new directions for other contexts, as the educational achievement of Cigano students represents an opportunity and an invitation to transform and upgrade school institutions as well as the educational system as a whole, which should be more innovative, reflexive and increasingly open to the community.

Dynamic Models of Mechanical Seals for Turbomachinery Application

One of the primary causes of mechanical face seal failure is rotor vibration. Traditional dynamic seal models often cannot fully explain failure mechanisms. The dynamic models of seals proposed in this paper, including those developed by the authors, are valuable for predicting seal dynamics during operation in specific turbomachinery and for explaining the causes of seal failure. The single-mass dynamic model is suitable for analyzing the dynamics of contact mechanical face seals and simply designed dry gas seals. The two-mass dynamic model is used to investigate the operational dynamics processes of classical dry gas seals under complex loading conditions. The three-mass dynamic model is used to study various complex types of mechanical face seals. This model can determine the normal operating condition range and explain leakage mechanisms in the presence of excessive rotor vibrations.

Comparison of Iridex MP3 and P3 probes on long-term intraocular pressure control after MicroPulse Transscleral-Cyclophotocoagulation

PurposeMicropulse transscleral cyclophotocoagulation (MP-TSCPC) is a glaucoma procedure that delivers energy to the ciliary body with minimal collateral-damage. We aim to assess the long-term effectiveness of MP-TSCPC using the original MP3 and revised P3 probe. Methods and designBaseline Retrospective cohort study was performed to obtain baseline characteristics, intraocular pressure (IOP), number of IOP-lowering medications, and best-corrected visual acuity (BCVA) were obtained from pre- and post-operative visits of patients treated with MP-TSCPC. Failure was defined as IOP>21 mmHg, reduced IOP<20% below baseline, or IOP<5 mmHg on 2 consecutive follow-up visits after post-operative month 1, reoperation for glaucoma, or loss of vision to no light perception. ResultsA total of 113 eyes were enrolled, 44 using the MP3 probe and 69 with the revised P3 probe. Survival analysis found a 75% failure rate in patients treated with the revised P3 probe by the final visit with a mean time to failure (MTTF) of 4.8 ± 0.7 months which was higher than the original probe at 66% failure rate with a MTTF of 6.1 ± 1.1 months (p = 0.04). All causes of failure were due to high IOP and 67% required repeat treatment with MP-TSCPC or incisional surgery. Prior to censure of data from failure, both probes had significant reduction in IOP compared to pre-operative IOP at all time points. No significant changes in BCVA were found. Both groups were associated with low rates of complications. ConclusionBoth probes had a very low rate of visually significant complications when performed in a standardized method in accordance with surgical procedure and power settings recommended by Iridex; however, were associated with a high rate of single procedure failure due to uncontrolled IOP over the long term. The revised P3 probe was associated with a higher rate of failure. Patients experienced a reduction in IOP; however, a large proportion required additional treatment compared to the original MP3 probe.

Gender-associated features in diabetic kidney disease

Diabetic kidney disease (DKD) is the leading cause of end-stage renal failure. Evidence indicates gender differences in the progression of this disease. This study aimed to determine gender differences in prevalence and identify gender-associated risk factors contributing to the development of diabetic kidney disease in individuals with type 2 diabetes mellitus (T2DM). The cross-sectional study included 132 patients with T2DM ranging in age from 50 to 65 years. Subjects were stratified by sex (80 women and 52 men). Gender differences have been studied in relation to the incidence and prevalence of DKD, their phenotypes and clinical manifestations, and several risk factors that have different effects on both sexes. The outcome of clinical kidney function assessment showed that 70% subjects were diagnosed with DKD (71% of women and 67% of men). The study indicated an association between the duration of T2DM and urinary albumin levels, as well as between arterial hypertension and triglyceride levels, which are independent risk factors for DKD development. Notably, older women with T2DM have a higher prevalence of DKD than older men. The albuminuric component of DKD was more frequently observed in men. Additionally, men were more likely to have adverse risk factors, including dyslipidemia, lower high-density lipoprotein cholesterol, and glomerular filtration rate, which are factors involved in the mechanisms of DKD. In summary, the results indicate that: 1) women with type 2 diabetes mellitus are at a higher risk of developing a normoalbuminuric phenotype of diabetic kidney disease, while men are at a higher risk of developing an albuminuric phenotype of diabetic kidney disease leading to renal failure and end-stage renal disease; 2) gender differences are most noticeable among older adults and may have significant implications for the development of more effective diagnostic and treatment methods for diabetic kidney disease, tailored to individual needs.