Prognostic Importance of the Cuse of Renal Failure in Patients With Cirrhosis

BACKGROUND & AIMS: The prognostic value of the different causes of renal failure in cirrhosis is not well established. This study investigated the predictive value of the cause of renal failure in cirrhosis. METHODS: Five hundred sixty-two consecutive patients with cirrhosis and renal failure (as defined by serum creatinine 1.5 mg/dL on 2 successive determinations within 48 hours) hospitalized over a 6-year period in a single institution were included in a prospective study. The cause of renal failure was classified into 4 groups: renal failure associated with bacterial infections, renal failure associated with volume depletion, hepatorenal syndrome (HRS), and parenchymal nephropathy. The primary end point was survival at 3 months. RESULTS: Four hundred sixty-three patients (82.4%) had renal failure that could be classified in 1 of 4 groups. The most frequent was renal failure associated with infections (213 cases; 46%), followed by hypovolemia-associated renal failure (149; 32%), HRS (60; 13%), and parenchymal nephropathy (41; 9%). The remaining patients had a combination of causes or miscellaneous conditions. Prognosis was markedly different according to cause of renal failure, 3-month probability of survival being 73% for parenchymal nephropathy, 46% for hypovolemia-associated renal failure, 31% for renal failure associated with infections, and 15% for HRS (P .0005). In a multivariate analysis adjusted for potentially confounding variables, cause of renal failure was independently associated with prognosis, together with MELD score, serum sodium, and hepatic encephalopathy at time of diagnosis of renal failure. CONCLUSIONS: A simple classification of patients with cirrhosis according to cause of renal failure is useful in assessment of prognosis and may help in decision making in liver transplantation.

Sociodemographic, behavioral and genetic determinants of allostatic load in a Swiss population-based study.

Allostatic load (AL) is a marker of physiological dysregulation which reflects exposure to chronic stress. High AL has been related to poorer health outcomes including mortality. We examine here the association of socioeconomic and lifestyle factors with AL. Additionally, we investigate the extent to which AL is genetically determined. We included 803 participants (52% women, mean age 48±16years) from a population and family-based Swiss study. We computed an AL index aggregating 14 markers from cardiovascular, metabolic, lipidic, oxidative, hypothalamus-pituitary-adrenal and inflammatory homeostatic axes. Education and occupational position were used as indicators of socioeconomic status. Marital status, stress, alcohol intake, smoking, dietary patterns and physical activity were considered as lifestyle factors. Heritability of AL was estimated by maximum likelihood. Women with a low occupational position had higher AL (low vs. high OR=3.99, 95%CI [1.22;13.05]), while the opposite was observed for men (middle vs. high OR=0.48, 95%CI [0.23;0.99]). Education tended to be inversely associated with AL in both sexes(low vs. high OR=3.54, 95%CI [1.69;7.4]/OR=1.59, 95%CI [0.88;2.90] in women/men). Heavy drinking men as well as women abstaining from alcohol had higher AL than moderate drinkers. Physical activity was protective against AL while high salt intake was related to increased AL risk. The heritability of AL was estimated to be 29.5% ±7.9%. Our results suggest that generalized physiological dysregulation, as measured by AL, is determined by both environmental and genetic factors. The genetic contribution to AL remains modest when compared to the environmental component, which explains approximately 70% of the phenotypic variance.

Définition et prise en charge de l'échec d'une première injection de toxine botulique Botox(®) 200 U pour hyperactivité détrusorienne neurogène : résultats de l'enquête DETOX [Definition of botulinum toxin failure in neurogenic detrusor overactivity: Preliminary results of the DETOX survey].

OBJECTIVE: There is currently no guideline regarding the management of neurogenic detrusor overactivity (NDO) refractory to intra-detrusor botulinum toxin injections. The primary objective of the present study was to find a consensus definition of failure of botulinum toxin intra-detrusor injections for NDO. The secondary objective was to report current trends in the managment of NDO refractory to botulinum toxin. METHODS: A survey was created, based on data drawn from current literature, and sent via e-mail to all the experts form the Group for research in neurourology in french language (GENULF) and from the comittee of neurourology of the French urological association (AFU). The experts who did not answer to the first e-mail were contacted again twice. Main results from the survey are presented and expressed as numbers and proportions. RESULTS: Out of the 42 experts contacted, 21 responded to the survey. Nineteen participants considered that the definition of failure should be a combination of clinical and urodynamics criteria. Among the urodynamics criteria, the persistence of a maximum detrusor pressure>40cm H2O was the most supported by the experts (18/21, 85%). According to the vast majority of participants (19/21, 90.5%), the impact of injections on urinary incontinence should be included in the definition of failure. Regarding the management, most experts considered that the first line treatment in case of failure of a first intra-detrusor injection of Botox(®) 200 U should be a repeat injection of Botox(®) at a higher dosage (300 U) (15/20, 75%), regardless of the presence or not of urodynamics risk factors of upper tract damage (16/20, 80%). CONCLUSION: This work has provided a first overview of the definition of failure of intra-detrusor injections of botulinum toxin in the management of NDO. For 90.5% of the experts involved, the definition of failure should be clinical and urodynamic and most participants (75%) considered that, in case of failure of a first injection of Botox(®) 200 U, repeat injection of Botox(®) 300 U should be the first line treatment. Level of proof 4.

Presence of Leishmania RNA Virus 1 in Leishmania guyanensis Increases the Risk of First-Line Treatment Failure and Symptomatic Relapse.

Treatment failure and symptomatic relapse are major concerns in American tegumentary leishmaniasis (TL). Such complications are seen frequently in Leishmania guyanensis infections, in which patients respond variously to first-line antileishmanials and are more prone to develop chronic cutaneous leishmaniasis. The factors underlying this pathology, however, are unknown. Recently, we reported that a double-stranded RNA virus, Leishmania RNA virus 1 (LRV1), nested within L. guyanensis parasites is able to exacerbate experimental murine leishmaniasis by inducing a hyperinflammatory response. This report investigates the prevalence of LRV1 in human L. guyanensis infection and its effect on treatment efficacy, as well as its correlation to symptomatic relapses after the completion of first-line treatment. In our cohort of 75 patients with a diagnosis of primary localized American TL, the prevalence of LRV1-positive L. guyanensis infection was elevated to 58%. All patients infected with LRV1-negative L. guyanensis were cured after 1 dose (22 of 31 [71%]) or 2 doses (31 of 31 [100%]) of pentamidine. In contrast, 12 of 44 LRV1-positive patients (27%) presented with persistent infection and symptomatic relapse that required extended therapy and the use of second-line drugs. Finally, LRV1 presence was associated with a significant increase in levels of intra-lesional inflammatory markers. In conclusion, LRV1 status in L. guyanensis infection is significantly predictive (P = .0009) of first-line treatment failure and symptomatic relapse and has the potential to guide therapeutic choices in American TL.

Impact of Aldosterone Antagonists on Sudden Cardiac Death Prevention in Heart Failure and Post-Myocardial Infarction Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

BACKGROUND AND OBJECTIVES: Sudden cardiac death (SCD) is a severe burden of modern medicine. Aldosterone antagonist is publicized as effective in reducing mortality in patients with heart failure (HF) or post myocardial infarction (MI). Our study aimed to assess the efficacy of AAs on mortality including SCD, hospitalization admission and several common adverse effects. METHODS: We searched Embase, PubMed, Web of Science, Cochrane library and clinicaltrial.gov for randomized controlled trials (RCTs) assigning AAs in patients with HF or post MI through May 2015. The comparator included standard medication or placebo, or both. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Event rates were compared using a random effects model. Prospective RCTs of AAs with durations of at least 8 weeks were selected if they included at least one of the following outcomes: SCD, all-cause/cardiovascular mortality, all-cause/cardiovascular hospitalization and common side effects (hyperkalemia, renal function degradation and gynecomastia). RESULTS: Data from 19,333 patients enrolled in 25 trials were included. In patients with HF, this treatment significantly reduced the risk of SCD by 19% (RR 0.81; 95% CI, 0.67-0.98; p = 0.03); all-cause mortality by 19% (RR 0.81; 95% CI, 0.74-0.88, p<0.00001) and cardiovascular death by 21% (RR 0.79; 95% CI, 0.70-0.89, p<0.00001). In patients with post-MI, the matching reduced risks were 20% (RR 0.80; 95% CI, 0.66-0.98; p = 0.03), 15% (RR 0.85; 95% CI, 0.76-0.95, p = 0.003) and 17% (RR 0.83; 95% CI, 0.74-0.94, p = 0.003), respectively. Concerning both subgroups, the relative risks respectively decreased by 19% (RR 0.81; 95% CI, 0.71-0.92; p = 0.002) for SCD, 18% (RR 0.82; 95% CI, 0.77-0.88, p < 0.0001) for all-cause mortality and 20% (RR 0.80; 95% CI, 0.74-0.87, p < 0.0001) for cardiovascular mortality in patients treated with AAs. As well, hospitalizations were significantly reduced, while common adverse effects were significantly increased. CONCLUSION: Aldosterone antagonists appear to be effective in reducing SCD and other mortality events, compared with placebo or standard medication in patients with HF and/or after a MI.

Monitoring of the training load and recovery parameters in competitive swimmers

Nombreux sont les groupes de recherche qui se sont intéressés, ces dernières années, à la manière de monitorer l'entraînement des sportifs de haut niveau afin d'optimaliser le rendement de ce dernier tout en préservant la santé des athlètes. Un des problèmes cardinaux d'un entraînement sportif mal conduit est le syndrome du surentraînement. La définition du syndrome susmentionné proposée par Kreider et al. est celle qui est actuellement acceptée par le « European College of Sport Science » ainsi que par le « American College of Sports Medicine», à savoir : « An accumulation of training and/or non-training stress resulting in long-term decrement in performance capacity with or without related physiological and psychological signs and symptoms of maladaptation in which restoration of performance capacity may take several weeks or months. » « Une accumulation de stress lié, ou non, à l'entraînement, résultant en une diminution à long terme de la capacité de performance. Cette dernière est associée ou non avec des signes et des symptômes physiologiques et psychologiques d'inadaptation de l'athlète à l'entraînement. La restauration de ladite capacité de performance peut prendre plusieurs semaines ou mois. » Les recommandations actuelles, concernant le monitoring de l'entraînement et la détection précoce du syndrome du surentrainement, préconisent, entre autre, un suivi psychologique à l'aide de questionnaires (tel que le Profile of Mood State (POMS)), un suivi de la charge d'entraînement perçue par l'athlète (p.ex. avec la session rating of perceived exertion (RPE) method selon C. Foster), un suivi des performances des athlètes et des charges d'entraînement effectuées ainsi qu'un suivi des problèmes de santé (blessures et maladies). Le suivi de paramètres sanguins et hormonaux n'est pas recommandé d'une part pour des questions de coût et de faisabilité, d'autre part car la littérature scientifique n'a, jusqu'ici, pas été en mesure de dégager des évidences à ce sujet. A ce jour, peu d'études ont suivi ces paramètres de manière rigoureuse, sur une longue période et chez un nombre d'athlète important. Ceci est précisément le but de notre étude.

Taajuusmuttajan vanheneminen syklisissä käytöissä

Tässä työssä tarkastellaan taajuusmuuttajan vanhenemista syklisissä käytöissä puolijohdetehokomponenttien osalta. Laitteiden vikaantumisprosessien analysoimiseksi työssä suunnitellaan syklinen kestotestausjärjestelmä, joka mahdollistaa useamman taajuusmuuttajan yhtäaikaisen vanhentamisen. Jaksottaisesti toistuvat kuormitussyklit rasittavat termomekaanisesti taajuusmuuttajan tehomoduulin sisäisiä rakenteita suurten lämpötilavaihtelujen johdosta. Teoriaosuuden pääpaino kohdistuu puolijohdetehokomponenttien rakenteeseen, vikaantumisprosesseihin ja eliniän kartoittamiseen. Työssä käydään läpi yleisimpien pienijännitteisten moottorinohjausinverttereiden tehomoduulien mekaaniset rakenteet, tyypillisemmät syklisestä kuormituksesta johtuvat vikaantumisprosessit sekä puolijohdetehokomponenttivalmistajien käyttämät syklisen eliniän testausmenetelmät. Loppuosassa työtä suunnitellaan taajuusmuuttajan syklinen kestotestausjärjestelmä laitteiden keinotekoista vanhentamista varten. Testausjärjestelmällä voidaan kuormittaa useampaa taajuusmuuttajaa vuorottain mielivaltaisella kuormitusvirtaprofiililla. Laitteita vanhennettiin kaksi testierää kuormittamalla niitä jaksottaisesti hissikäytön tyypillisellä kuormitusprofiililla. Puolijohdetehokomponentin vanhenemisen edistystä seurattiin termisen impedanssiketjun mittausmenetelmällä, joka perustuu IGBT:n kollektoriemitterijännitteen lämpötilariippuvuuteen. Testilaitteiden puolijohdetehokomponentit hajosivat syklisen eliniän päättymiseen teoriassa esitettyjen vikaantumisprosessien seurauksesta. Tehomoduulien vika-analyysi osoittaa syklisen kestotestausjärjestelmän soveltuvaksi menetelmäksi tutkia erilaisten kuormitusprofiilien vaikutusta taajuusmuuttajan vanhenemiseen.

Shaping urban traffic patterns through congestion charging : What factors drive success or failure?

Congestion costs are emerging as one of the most important challenges faced by metropolitan planners and transport authorities in first world economies. In US these costs were as high as 78 million dollars in 2005 and are growing due to fast increases in travel delays. In order to solve the current and severe levels of congestion the US department of transportation have recently started a program to initiate congestion pricing in five metropolitan areas. In this context it is important to determine those factors helping its implementation and success, but also the problems or difficulties associated with charging projects. In this article we analyze worldwide experiences with urban road charging in order to extract interesting and helpful lessons for policy makers engaged in congestion pricing projects and for those interested in the introduction of traffic management tools to regulate the entrance to big cities.

A Practical Micro Mechanical Model Based Local Approach Methodology for the Analysis of Ductile Fracture of Welded T-Joints

This thesis concentrates on developing a practical local approach methodology based on micro mechanical models for the analysis of ductile fracture of welded joints. Two major problems involved in the local approach, namely the dilational constitutive relation reflecting the softening behaviour of material, and the failure criterion associated with the constitutive equation, have been studied in detail. Firstly, considerable efforts were made on the numerical integration and computer implementation for the non trivial dilational Gurson Tvergaard model. Considering the weaknesses of the widely used Euler forward integration algorithms, a family of generalized mid point algorithms is proposed for the Gurson Tvergaard model. Correspondingly, based on the decomposition of stresses into hydrostatic and deviatoric parts, an explicit seven parameter expression for the consistent tangent moduli of the algorithms is presented. This explicit formula avoids any matrix inversion during numerical iteration and thus greatly facilitates the computer implementation of the algorithms and increase the efficiency of the code. The accuracy of the proposed algorithms and other conventional algorithms has been assessed in a systematic manner in order to highlight the best algorithm for this study. The accurate and efficient performance of present finite element implementation of the proposed algorithms has been demonstrated by various numerical examples. It has been found that the true mid point algorithm (a = 0.5) is the most accurate one when the deviatoric strain increment is radial to the yield surface and it is very important to use the consistent tangent moduli in the Newton iteration procedure. Secondly, an assessment of the consistency of current local failure criteria for ductile fracture, the critical void growth criterion, the constant critical void volume fraction criterion and Thomason's plastic limit load failure criterion, has been made. Significant differences in the predictions of ductility by the three criteria were found. By assuming the void grows spherically and using the void volume fraction from the Gurson Tvergaard model to calculate the current void matrix geometry, Thomason's failure criterion has been modified and a new failure criterion for the Gurson Tvergaard model is presented. Comparison with Koplik and Needleman's finite element results shows that the new failure criterion is fairly accurate indeed. A novel feature of the new failure criterion is that a mechanism for void coalescence is incorporated into the constitutive model. Hence the material failure is a natural result of the development of macroscopic plastic flow and the microscopic internal necking mechanism. By the new failure criterion, the critical void volume fraction is not a material constant and the initial void volume fraction and/or void nucleation parameters essentially control the material failure. This feature is very desirable and makes the numerical calibration of void nucleation parameters(s) possible and physically sound. Thirdly, a local approach methodology based on the above two major contributions has been built up in ABAQUS via the user material subroutine UMAT and applied to welded T joints. By using the void nucleation parameters calibrated from simple smooth and notched specimens, it was found that the fracture behaviour of the welded T joints can be well predicted using present methodology. This application has shown how the damage parameters of both base material and heat affected zone (HAZ) material can be obtained in a step by step manner and how useful and capable the local approach methodology is in the analysis of fracture behaviour and crack development as well as structural integrity assessment of practical problems where non homogeneous materials are involved. Finally, a procedure for the possible engineering application of the present methodology is suggested and discussed.

Critical Success and Failure Factors of Knowledge Management Implementation in a Large Multinational Company

More and more companies are interested in implementing knowledge management. However, the majority of knowledge management initiatives will fail to have any significant impact. In this study, theories regarding knowledge management implementation and adoption are investigated further. The objective of this study is to deepen understanding regarding the critical factors that contribute to successful knowledge management adoption in large multinational companies. The study is formulated around the following four research questions: 1. What are the key success and failure factors in knowledge management implementation? 2. How can knowledge management adoption be improved at the individual, group and organizational levels of the company? 3. What are the critical factors that hinder knowledge management adoption in the case company? 4. How can the case company promote the adoption of knowledge management among company personnel? The methodology used in this study is a combination of a literature review and an explanatory, exploratory, qualitative single-case study. The literature review answers the first and second research questions. Based on the literature review, a framework is presented to illustrate the factors contributing to the success of knowledge management implementation. The framework also links together knowledge management implementation and adoption. The third research question is answered by revealing the relevant findings from 21 expert interviews and 2 online questionnaires with 42 respondents in total. By comparing and contrasting the results of the literature review with the findings of the empirical case study, the fourth research question is answered. The concrete outcomes of this study are a framework to elucidate the factors contributing to the success of knowledge management implementation, a case study highlighting the issues that hinder knowledge management adoption within the case company, and recommendations for the case company.

Non-resorbable glass fibre-reinforced composite with porous surface as bone substitute material: Experimental studies in vitro and in vivo focused on bone-implant interface

The development of load-bearing osseous implant with desired mechanical and surface properties in order to promote incorporation with bone and to eliminate risk of bone resorption and implant failure is a very challenging task. Bone formation and resoption processes depend on the mechanical environment. Certain stress/strain conditions are required to promote new bone growth and to prevent bone mass loss. Conventional metallic implants with high stiffness carry most of the load and the surrounding bone becomes virtually unloaded and inactive. Fibre-reinforced composites offer an interesting alternative to metallic implants, because their mechanical properties can be tailored to be equal to those of bone, by the careful selection of matrix polymer, type of fibres, fibre volume fraction, orientation and length. Successful load transfer at bone-implant interface requires proper fixation between the bone and implant. One promising method to promote fixation is to prepare implants with porous surface. Bone ingrowth into porous surface structure stabilises the system and improves clinical success of the implant. The experimental part of this work was focused on polymethyl methacrylate (PMMA) -based composites with dense load-bearing core and porous surface. Three-dimensionally randomly orientated chopped glass fibres were used to reinforce the composite. A method to fabricate those composites was developed by a solvent treatment technique and some characterisations concerning the functionality of the surface structure were made in vitro and in vivo. Scanning electron microscope observations revealed that the pore size and interconnective porous architecture of the surface layer of the fibre-reinforced composite (FRC) could be optimal for bone ingrowth. Microhardness measurements showed that the solvent treatment did not have an effect on the mechanical properties of the load-bearing core. A push-out test, using dental stone as a bone model material, revealed that short glass fibre-reinforced porous surface layer is strong enough to carry load. Unreacted monomers can cause the chemical necrosis of the tissue, but the levels of leachable resisidual monomers were considerably lower than those found in chemically cured fibre-reinforced dentures and in modified acrylic bone cements. Animal experiments proved that surface porous FRC implant can enhance fixation between bone and FRC. New bone ingrowth into the pores was detected and strong interlocking between bone and the implant was achieved.

A Thermodynamically Consistent Damage Model for Advanced Composites

A continuum damage model for the prediction of damage onset and structural collapse of structures manufactured in fiber-reinforced plastic laminates is proposed. The principal damage mechanisms occurring in the longitudinal and transverse directions of a ply are represented by a damage tensor that is fixed in space. Crack closure under load reversal effects are taken into account using damage variables established as a function of the sign of the components of the stress tensor. Damage activation functions based on the LaRC04 failure criteria are used to predict the different damage mechanisms occurring at the ply level. The constitutive damage model is implemented in a finite element code. The objectivity of the numerical model is assured by regularizing the dissipated energy at a material point using Bazant’s Crack Band Model. To verify the accuracy of the approach, analyses ofcoupon specimens were performed, and the numerical predictions were compared with experimental data

Moottoripyörän rungon muuntelun valvontakriteerit muutoskatsastuksessa

Muutoskatsastusta koskeva lainsäädäntö aiheuttaa tulkintavaikeuksia ja rajoitteita moottoripyöräharrastajille ja alan toimijoille. Nykyinen asetus edellyttää tarvittaessa asiantuntijaselvitystä rakennemuutoksen lujuudesta ja hitsaustyöstä. Moottoripyörän geometria on laissa rajattu akselivälin ja emäputken kulman osalta. Moottoripyörien runkoja valmistetaan hitsaamalla seostamattomista teräksistä ja lämpökäsiteltävistä alumiini- ja terässeoksista. Runkojen muuntelu suoritetaan myös yleisesti hitsaamalla. Turvallisuuden kannalta tärkeiltä hitsausliitoksilta vaaditaan hyvää laatua, joka saavutetaan oikeilla hitsausparametreilla ja -suorituksella. Vaatimukset seostamattomalle teräkselle voidaan täyttää pätevöityneen hitsaajan toimesta. Lämpökäsiteltävät seokset vaativat lisäksi jälkilämpökäsittelyn, mikä edelleen vaikeuttaa runkojen hitsausta. Hitsien laadun merkitystä moottoripyörän rungossa tutkittiin soveltamalla rajoitetun vahingon periaatetta. Vauriotapauksena mallinnettiin satunnaisen rungon hitsausliitoksen murtuminen. Eri kuormitustilanteissa elementtimenetelmää hyödyntäen todettiin chopper-tyyppisten moottoripyörien runkojen olevan osittain vauriosietoisia ja havaittiin kriittiset hitsausliitokset emä- ja vaakaputken alueilla. Moottoripyörien runkojen kriittisiä hitsausliitoksia tarkasteltiin väsymisen kannalta. Soveltamalla tehollista lovijännitystä, vertailtiin emäputken hitsausliitosten väsymiskestävyyttä oletetulla kuormituksella. Tulosten perusteella muunneltu moottoripyörän runko voi olla alkuperäisrunkoa kestävämpi tai heikompi. Moottoripyörän akseliväli tai emäputken kulma eivät määrää kestävyyttä, vaan rakenteen yksityiskohtainen suunnittelu. Kriittisten liitosten väsymiskestävyyksissä havaittiin merkittäviä eroja eri mallien välillä.

Fatigue analysis of brackets with and without scallop for bridge and other deck structure using effective notch stress.

Due to functional requirement of a structural detail brackets with and without scallop are frequently used in bridges, decks, ships and offshore structure. Scallops are designed to serve as passage way for fluids, to reduce weld length and plate distortions. Moreover, scallops are used to avoid intersection of two or more welds for the fact that there is the presence of inventible inherent initial crack except for full penetrated weld and the formation of multi-axial stress state at the weld intersection. Welding all around the scallop corner increase the possibility of brittle fracture even for the case the bracket is not loaded by primary load. Avoiding of scallop will establish an initial crack in the corner if bracket is welded by fillet welds. If the two weld run pass had crossed, this would have given a 3D residual stress situation. Therefore the presences and absence of scallop necessitates the 3D FEA fatigue resistance of both types of brackets using effective notch stress approach ( ). FEMAP 10.1 with NX NASTRAN was used for the 3D FEA. The first and main objective of this research was to investigate and compare the fatigue resistance of brackets with and without scallop. The secondary goal was the fatigue design of scallops in case they cannot be avoided for some reason. The fatigue resistance for both types of brackets was determined based on approach using 1 mm fictitiously rounded radius based on IIW recommendation. Identical geometrical, boundary and loading conditions were used for the determination and comparison of fatigue resistance of both types of brackets using linear 3D FEA. Moreover the size effect of bracket length was also studied using 2D SHELL element FEA. In the case of brackets with scallop the flange plate weld toe at the corner of the scallop was found to exhibit the highest and made the flange plate weld toe critical for fatigue failure. Whereas weld root and weld toe at the weld intersections were the highly stressed location for brackets without scallop. Thus weld toe for brackets with scallop, and weld root and weld toe for brackets without scallop were found to be the critical area for fatigue failure. Employing identical parameters on both types of brackets, brackets without scallop had the highest except for full penetrated weld. Furthermore the fatigue resistance of brackets without scallop was highly affected by the lack of weld penetration length and it was found out that decreased as the weld penetration was increased. Despite the fact that the very presence of scallop reduces the stiffness and also same time induce stress concentration, based on the 3D FEA it is worth concluding that using scallop provided better fatigue resistance when both types of brackets were fillet welded. However brackets without scallop had the highest fatigue resistance when full penetration weld was used. This thesis also showed that weld toe for brackets with scallop was the only highly stressed area unlike brackets without scallop in which both weld toe and weld root were the critical locations for fatigue failure when different types of boundary conditions were used. Weld throat thickness, plate thickness, scallop radius, lack of weld penetration length, boundary condition and weld quality affected the fatigue resistance of both types of brackets. And as a result, bracket design procedure, especially welding quality and post weld treatment techniques significantly affect the fatigue resistance of both type of brackets.