Kidney Failure due to Diabetic Kidney Disease Among Australians Aged ≤ 45 Years, 2000-2022: A Population-Based Geospatial Analysis.

Aim: Evaluate the area-level incidence of kidney failure due to diabetes among Australians aged ≤ 45 years.

Methods: Using Australian registry and census data (2000-2022), incidence rates and prevalence of kidney failure (defined as commencing kidney replacement therapy) due to diabetes among people aged ≤ 45 years were compared by geographical region.

Results: Incidence (per 100 000/year, 95% confidence interval) of kidney failure due to diabetes among people aged ≤ 45 years in Australia was 0.

Strategies to Prevent Hemodialysis Catheter Dysfunction.

Millions of patients with kidney failure rely on hemodialysis (HD) central venous catheters (CVC) for their life-sustaining dialysis treatments. CVC dysfunction necessitates removal of up to 20% of CVCs and is an important problem for patients with kidney failure. Thrombosis and fibrin sheath formation are the most common mechanisms of CVC dysfunction beyond the first week after insertion.

Replacement Strategies for Tunneled Hemodialysis Catheters with Complications: A Nationwide Cohort Study.

Key Points: Replacement strategies for hemodialysis catheters with mechanical failure differed widely between services, which suggests clinical equipoise. For mechanical hemodialysis catheter failure, exchange did not result in more dysfunction or infection than removal and separate replacement. In Australia, infected catheters were almost universally removed and then replaced through a separate tunnel tract.

Tunneled Hemodialysis Catheter Tip Design and Risk of Catheter Dysfunction: An Australian Nationwide Cohort Study.

Rationale & Objective: Hemodialysis catheter dysfunction is an important problem for patients with kidney failure. The optimal design of the tunneled catheter tip is unknown. This study evaluated the association of catheter tip design with the duration of catheter function.

Effect of a Multifaceted Intervention on the Incidence of Hemodialysis Catheter Dysfunction in a National Stepped-Wedge Cluster Randomized Trial.

Introduction: Effective strategies to prevent hemodialysis (HD) catheter dysfunction are lacking and there is wide variation in practice.

Methods: In this analysis of the REDUcing the burden of dialysis Catheter ComplicaTIOns: a national (REDUCCTION) stepped-wedge cluster randomized trial, encompassing 37 Australian nephrology services, 6361 participants, and 9872 catheters, we investigated whether the trial intervention, which promoted a suite of evidence-based practices for HD catheter insertion and management, reduced the incidence of catheter dysfunction, which is defined by catheter removal due to inadequate dialysis blood flow. We also analyzed outcomes among tunneled cuffed catheters and sources of event variability.

Multifaceted Quality Improvement Interventions to Prevent Hemodialysis Catheter-Related Bloodstream Infections: A Systematic Review.

Rationale & Objective: Central venous catheters (CVCs) are widely used for hemodialysis but are prone to burdensome and costly bloodstream infections. We determined whether multifaceted quality improvement interventions in hemodialysis units can prevent hemodialysis catheter-related bloodstream infections (HDCRBSI).

Study Design: Systematic review.

Jackfruit: Composition, structure, and progressive collapsibility in the largest fruit on the Earth for impact resistance.

The jackfruit is the largest fruit on the Earth, reaching upwards of 35 kg and falling from heights of 25 m. To survive such high energy impacts, it has evolved a unique layered configuration with a thorny exterior and porous tubular underlayer. During compression, these layers exhibit a progressive collapse mechanism where the tubules are first to deform, followed by the thorny exterior, and finally the mesocarp layer in between.

Energy Absorption and Ballistic Performance of Epoxy Composite Reinforced with Arapaima Scales.

Arapaima scales possess a hierarchical structure capable of absorbing a considerable amount of energy before fracture. These natural dermal armors present significant potential in the sustainable development of cost-effective composites. This work aimed, for the first time, to analyze the impact resistance and ballistic performance of arapaima scale-reinforced epoxy composites and their potential application in multilayered armor systems (MAS).

Hierarchical modeling of elastic moduli of equine hoof wall.

This study predicts analytically effective elastic moduli of substructures within an equine hoof wall. The hoof wall is represented as a composite material with a hierarchical structure comprised of a sequence of length scales. A bottom-up approach is employed.

Development and Characterization of LLDPE Blends with Different UHMWPE Concentrations Obtained by Hot Pressing.

To modify its characteristics, expand its applicability, and, in some cases, its processability, new blends using ultra-high-molecular-weight polyethylene (UHMWPE) have been developed. In this study, three different formulations of linear low-density polyethylene (LLDPE) and UHMWPE blends were prepared with 15, 30, and 45% (% /) UHMWPE in the LLDPE matrix. All mixtures were prepared by hot pressing and were immersed in water for one hour afterwards at a controlled temperature of 90 °C to relieve the internal stresses that developed during the forming process.

Equine hoof wall: Structure, properties, and bioinspired designs.

The horse hoof wall exhibits exceptional impact resistance and fracture control due to its unique hierarchical structure which contains tubular, lamellar, and gradient configurations. In this study, structural characterization of the hoof wall was performed revealing features previously unknown. Prominent among them are tubule bridges, which are imaged and quantified.

Polymeric Composite Reinforced with PET Fiber Waste for Application in Civil Construction as a Cladding Element.

The construction industry contributes enormously to the high levels of carbon dioxide on the planet. For this reason, the sector has been investing in the development of new products that reduce the environmental impact. This study developed a fibrous polymeric composite using industrial residues of polyethylene terephthalate (PET) fibers for application in civil construction as a cladding element.

The Effect of Dialkyl Peroxide Crosslinking on the Properties of LLDPE and UHMWPE.

Peroxide has been considered a chemical agent that can be used to tune the properties of polymeric materials. This research evaluated the influence of different concentrations of dialkyl peroxides on the mechanical, thermal, and morphological properties of linear low-density polyethylene (LLDPE) and ultra-high molecular weight polyethylene (UHMWPE). The neat polymer, as well as those with the addition of 1% and 2% by mass of dialkyl peroxides, were subjected to compression molding and immersion in water for 1 h, under controlled temperatures of 90 °C.

Engineering with keratin: A functional material and a source of bioinspiration.

Keratin is a highly multifunctional biopolymer serving various roles in nature due to its diverse material properties, wide spectrum of structural designs, and impressive performance. Keratin-based materials are mechanically robust, thermally insulating, lightweight, capable of undergoing reversible adhesion through van der Waals forces, and exhibit structural coloration and hydrophobic surfaces. Thus, they have become templates for bioinspired designs and have even been applied as a functional material for biomedical applications and environmentally sustainable fiber-reinforced composites.

Pregnancy Prolongation After Eculizumab Use in Early-Onset Preeclampsia.

Background: Untreated microangiopathic hemolytic anemia in pregnancy is associated with adverse maternal and perinatal outcomes. Accurate diagnosis is challenging owing to nonspecific clinical features and pathologic findings. Timely initiation of appropriate management is essential to optimize maternal and perinatal outcomes.

Association of Metformin Use With Risk of Lactic Acidosis Across the Range of Kidney Function: A Community-Based Cohort Study.

Importance: Approximately 1 million patients in the United States with type 2 diabetes mellitus and mild-to-moderate kidney disease do not receive guideline-directed therapy with metformin. This may reflect uncertainty regarding the risk of acidosis in patients with chronic kidney disease.

Objective: To quantify the association between metformin use and hospitalization with acidosis across the range of estimated glomerular filtration rate (eGFR), accounting for change in eGFR stage over time.

Proton Pump Inhibitor Use and the Risk of Chronic Kidney Disease.

Importance: Proton pump inhibitors (PPIs) are among the most commonly used drugs worldwide and have been linked to acute interstitial nephritis. Less is known about the association between PPI use and chronic kidney disease (CKD).

Objective: To quantify the association between PPI use and incident CKD in a population-based cohort.