The objective of this study was to compare the effectiveness of face-to-face and distance learning in interprofessional education. We conducted a survey using the Japanese version of the Readiness for Interprofessional Learning Scale (RIPLS) to compare face-to-face and distance learning among students from four joint medical and welfare universities participating in interprofessional education (IPE). Faculty members who participated in both face-to-face and distance learning were also surveyed for free descriptions of the advantages and disadvantages of face-to-face and distance learning; their responses were then coded and categorized. In both face-to-face and distance learning, the RIPLS overall and "teamwork and collaboration" scores significantly increased after class compared to before class. There was a significant increase in "IPE opportunities" in face-to-face learning. There was little change in "uniqueness of profession" before and after class in both face-to-face and distance learning. The difference in the overall scores before and after class was significantly larger in face-to-face learning than in distance learning. The advantages of face-to-face learning included smooth communication and discussions. Distance learning was useful for connecting universities across large distances; however, there were disadvantages, such as less smooth communication and discussions and difficulty maintaining concentration. Face-to-face learning may be more effective than distance learning. Distance learning had issues with "IPE opportunities," while both face-to-face and distance classes had issues with "uniqueness of profession."
Background/Objectives: Providing an appropriate diet to older adults with dysphagia can prevent aspiration, choking, and nutritional deficiencies and help preserve their quality of life. Therefore, assessments for determining the appropriateness of food types are required. This multicenter study aimed to determine the reliability and validity of the Meal Rounds Observation Form (MROF), which was developed to identify food forms that can be safely consumed by older adults with dysphagia. Methods: We analyzed 532 food-texture observations obtained from 155 participants (114 men and 41 women). The reliability and validity of the MROF were compared with those of videofluoroscopic (VF) or videoendoscopic (VE) examinations of swallowing. Results: The food-form categories were water (108 pairs), 0j (54 pairs), 0t (118 pairs), 1j (20 pairs), 2-1 (28 pairs), 2-2 (37 pairs), 3 (68 pairs), 4 (67 pairs), and normal food (32 pairs) based on JDD 2021 codes. The AUC was lowest for the water (0.568) category and highest for food forms requiring chewing, such as those of the 4 and normal food (0.678) categories. The sensitivity and specificity of the Gugging Swallowing Screen were 60.1% and 69.1%, respectively (p < 0.001). The agreement between the Gugging Swallowing Screen and the MROF evaluation for food types requiring mastication was 73.2%. Logistic regression analysis revealed asymmetric movement of the corners of the mouth and coughing as important indicators when evaluating food types requiring mastication. Conclusions: The MROF is useful for determining food intake safety when VF or VE tests cannot be performed in medical and nursing care settings and can guide clinical decision-making. However, caution is required in applying it clinically because of its relatively low specificity.
Epigenetic aging biomarkers are promising novel biological age indicators derived from algorithms based on DNA methylation patterns. Since epigenetic age was first described over a decade ago, it has been used as an exposure or an outcome in biomedical research to address the fundamental question of "aging". Yet, a critical question remains unresolved: how epigenetic age mediates the effects of exposures on health outcomes. Mediation analysis provides a rigorous statistical framework for decomposing total effects into direct and indirect pathways, thereby testing the extent to which epigenetic age deviation explains exposure-outcome relationships. Meanwhile, the reporting quality using mediation analysis varied across studies. This scoping review provides a methodological primer on causal mediation analysis and a literature review using epigenetic age as a mediator with quality assessment. We conducted an initial literature search through four online databases (PubMed, Embase, MEDLINE, and CINAHL) at the beginning of September 2025. We identified 22 studies (published since 2022) examining epigenetic aging as a mediator between environmental/lifestyle exposures and health outcomes. Most studies used blood-based DNA methylation and applied causal mediation frameworks. GrimAge, PhenoAge, and DunedinPACE were more frequently used. Outcomes primarily included mortality and cardiovascular disease, while exposures covered smoking, diet, socioeconomic factors, clinical biomarkers, and environmental pollutants. Although causal mediation analysis suggested that epigenetic aging could be a possible mechanistic mediator linking exposures to disease risk, many studies lacked methodological rigor. To enhance epigenetic evaluation in broad settings, further work should apply causal mediation analysis to epigenetic aging markers with a rigorous methodology.
Schizophrenia is a chronic, debilitating psychiatric disorder with high heritability. We have previously established Arhgap10 S490P/NHEJ (Arhgap10) mice, a schizophrenia-related mouse model carrying Japanese schizophrenia patient-derived ARHGAP10 variants. These mice exhibited activated Rho-kinase (ROCK) signaling, schizophrenia-related behavioral and neurobiological phenotypes that were ameliorated by the ROCK inhibitor fasudil. Although phospho-signaling is increasingly implicated in schizophrenia pathophysiology, comprehensive phosphoproteomic profiling in the brain of Arhgap10 mice has not yet been performed, leaving key downstream ROCK-dependent targets unidentified. Here, we conducted unbiased phosphoproteomic analysis of the medial prefrontal cortex (mPFC) of wild-type (WT) and Arhgap10 mice, treated with or without fasudil. We identified 15 phosphoproteins that were significantly upregulated in the mPFC of Arhgap10 mice compared with WT controls. Among these, phosphorylated microtubule-associated protein tau at serine 404 (pTau_S404), phosphorylated autophagy-related protein 9 A at serine 828 (pATG9A_S828), and phosphorylated serine/threonine-protein kinase WNK2 at threonine 282 (pWNK2_T282) were markedly reduced to control levels by fasudil treatment. Upstream kinase enrichment analysis, together with targeted validation, revealed alterations in the AKT/GSK3β signaling node as the context for these fasudil-responsive candidates. Since these phosphoproteins are linked to autophagy-related processes, we further examined autophagy-lysosome-associated readouts. Arhgap10 mice showed autophagy-associated alterations in the mPFC, while fasudil increased autophagosome- and autolysosome-associated vesicle puncta in primary cortical neurons. This study provides the first phosphoproteomic network map of the mPFC in the Arhgap10 mouse model of schizophrenia, identifying ROCK-responsive phosphoproteins along with autophagy-associated alterations and fasudil-responsive changes.
Amid growing calls for respect for gender diversity, Japanese law restricts midwifery qualifications to women, excluding individuals assigned male at birth. By contrast, in some countries, all individuals can pursue midwifery qualifications regardless of gender. These differences highlight varying institutional frameworks and levels of social acceptance. To clarify nursing students' acceptance of midwifery qualification acquisition across gender identities and sexual orientations. An anonymous online survey was conducted from April to May 2024 among 98 undergraduate nursing students (10 men and 88 women) enrolled at a single anonymous health sciences university in Japan. Acceptance of midwifery qualification acquisition was assessed using the proportion of positive evaluations for nine gender identity and sexual orientation categories. Evaluations were measured on a 4-point Likert scale. Data were analyzed using descriptive statistics, cross-tabulation, and χ2 tests. Heterosexual women had the highest level of acceptance (96.9% positive evaluations), while heterosexual and bisexual men had the lowest (46.9%). There were substantial gender differences in the level of acceptance for different sexual orientations; however, none were statistically significant. Acceptance of midwifery qualification acquisition varied by gender identity and sexual orientation categories, suggesting that gender roles and cultural perspectives may influence attitudes. The findings indicate that systems should be reviewed to allow anyone, regardless of gender, to qualify and work as a midwife. They also highlight the importance of fostering an understanding of diversity through education.
Despite extensive development of anticancer agents, there remains a critical need for therapeutics with novel mechanisms of action. This study reports the potent anticancer activity and mechanistic analysis of highly water-soluble dopa-melanin (DM) prepared through a unique synthetic process. DM exhibits distinctive structural and chemical properties that contribute to its exceptional aqueous solubility (≥ 50 mg/mL) and may underlie its enhanced biological activity. DM reduced cell viability in multiple cancer cell lines. Using HeLa cells as a representative model, DM suppressed cell migration and three-dimensional growth. Fractionation revealed that activity was associated with polymers larger than 30 kDa, suggesting a critical role for high-molecular-weight species. Mechanistic studies showed that DM induced S/G2/M arrest followed by cell death with minimal apoptotic body formation. DM rapidly decreased cyclin D1 and D3 protein and mRNA levels. A pan-caspase inhibitor significantly suppressed DM's inhibitory effect on cell viability but did not prevent cyclin D degradation. Cyclin D degradation was mediated through calcium-dependent calpain activation triggered by endoplasmic reticulum Ca2+ release via IP3 receptors, and inhibition of this pathway attenuated DM's activity. In a mouse syngeneic tumor model, oral administration of DM significantly inhibited tumor growth without apparent toxicity. These results demonstrate that both caspase-dependent apoptosis and a caspase-independent cyclin D degradation pathway contribute to DM-induced cell death. Its high solubility, oral efficacy, and unique mechanism of action make DM a promising candidate for therapeutic development.
In 2016, the Japan Children's Cancer Group launched a nationwide research initiative to provide central diagnosis incorporating pathology review and molecular profiling for pediatric central nervous system (CNS) tumors. Over the first eight years, 2224 cases were registered. Non-next-generation sequencing analyzes, such as pyrosequencing and NanoString, were routinely performed, mainly for glioma, medulloblastoma, and ependymoma. Additional analyzes, including methylation profiling and RNA sequencing, were conducted for selected diagnostically challenging cases. The most common diagnoses were low-grade glioma (26%), medulloblastoma (18%), germ cell tumor (16%), high-grade glioma (12%), and ependymoma (11%). Diagnostic or targetable alterations were detected in nearly half of the glioma samples. Among medulloblastomas, Group 4 was the most prevalent subgroup (48%), followed by SHH-activated (28%), Group 3 (14%), and WNT-activated (11%). Among ependymomas, 95% of posterior fossa ependymomas were classified as PFA, and 72% of supratentorial ependymomas were positive for ZFTA fusion. Methylation-based classification enabled diagnostic refinement and identification of recently recognized novel subtypes. The integration of histopathological review by central pathologists and detailed molecular analyzes facilitated the recognition of rare tumors not yet defined in the World Health Organization classification. Our experience underscores the value of integrated diagnosis, which is now regarded as standard practice for pediatric CNS tumors, and highlights the urgent need for a sustainable clinical framework that incorporates molecular testing. This report represents the first comprehensive overview of the pediatric CNS tumor landscape in Japan in the molecular era.
Prostaglandin E-major urinary metabolite (PGE-MUM) may be a useful biomarker for assessing muscle inflammation caused by physical exercise. To explore this, both male and female volunteer university students (n = 18) performed gradual loading treadmill tests. Peripheral blood and urine samples were obtained before (T1) and immediately after physical exercise (T2), and 2 h later (T3) for measurement of PGE-MUM. PGE-MUM∙Cr (corrected by urinary creatinine) showed a significant stepwise increase from T1 to T3 in females (p = 0.0171) and the same tendency without significance was observed in males (p = 0.1533). Serum myoglobin showed the same trend, increasing from T1 to T3 in both males and females (p = 0.1690, 0.0443 respectively); Of note, females had a significant correlation between myoglobin and PGE-MUM∙Cr, (p = 0.0456), suggesting the involvement of muscle damage, but not between PGE-MUM∙Cr and peripheral leukocytosis after physical exercise. PGE-MUM∙Cr had no independent association with serum myoglobin after accounting for total muscle weight and maximal oxygen uptake/BW(VO2max/BW). Observable gender differences, with males showed significantly higher values of PGE-MUM∙Cr, myoglobin and creatinine in serum, and VO2max/BW than females, suggest a possible relation of PGE-MUM∙Cr with muscle weight and inflammation.
Peripheral intravenous catheters (PIVCs) are used in neonatal intensive care units (NICUs) and growing care units (GCUs). However, neonates/infants in these units frequently experience catheter failure (CF) because of complications, such as extravasation and phlebitis. Nonetheless, data on PIVCs from Japan remain limited. Therefore, this study aimed to investigate the use of infusion catheters and the incidence, characteristics, and risk factors of PIVC-related catheter failure in Japanese NICUs and GCUs. This study was conducted between August 2024 and February 2025 using cross-sectional and prospective surveys. Data from 600 hospitalized neonates/infants and 259 PIVC cases were analyzed. CF was defined as unplanned catheter removal before the completion of therapy owing to loss of function or an inability to administer fluids. Overall, 48.0% of neonates/infants had infusion catheters. The incidence proportion of CF was 47.1%, with an incidence density of 173.1/1,000 catheter-days. Extravasation was the most frequently identified cause of CF (95.9%), and swelling and leaking were primary symptoms. Multivariate Cox regression showed that gestational age (hazard ratio=0.96, p=.03) and infusion flow volume at the time of PIVC removal (hazard ratio=1.28/1 mL/h, p<.01) were significant risk factors. Long PIVCs had significantly longer dwell times than PIVCs (log-rank p=.01). CF is highly prevalent in Japanese infants in NICUs/GCUs, with a rate similar to that reported internationally. Long PIVCs may help extend the catheter dwell times. These findings highlight the need for standardized prevention strategies and improved catheter management protocols.
To determine safety and efficacy of exclusive human milk diet (EHMD) for very low birth weight (VLBW, <1500 g) infants. Prospective, controlled, open trial of VLBW infants randomized to EHMD (mother's own milk [MOM]/donor milk [DM] with human milk-based fortifiers) or Standard Diet (MOM/DM with cow milk-based fortifier/formula). Outcomes included superiority of weight gain velocity from birth to 34 weeks gestational age, time to full feeds, and safety. In total, 147 infants received EHMD (n = 77) or Standard Diet (n = 70). The EHMD group had superior mean weight gain velocity versus the Standard Diet (13.44 vs 11.96 g/kg/day, p = 0.006) and earlier mean time to full feeds (20.0 vs 25.9 days, p = 0.03); adverse events were not significantly different (32.5% vs 21.4%, p = 0.13). EHMD is viable for management of VLBW infants, providing improved growth without reduced safety. Japan Registry of Clinical Trials: jRCT2031210384.
Children in low- and middle-income countries experience a greater burden of rotavirus infection relative to developed countries. Malaysia is a middle-income country; however, like other South East Asian countries, studies on rotavirus are scarce. In an effort to understand the strain diversity, we performed a study in children under five years old who attended 4 health care centers in the Papar district of Sabah state of Malaysian Borneo and collected samples from 2020 to 2021. This study provides robust molecular evidence that strains detected in Sabah, Malaysia, were generated by intergenogroup reassortment. Reassortment is one of the evolutionary mechanisms that generate diversity in rotavirus strains. We characterized a rotavirus which possessed a long RNA pattern and an unusual combination of G6P[9]. These strains have a unique constellation of G6-P[9]-I2-R3-C3-M3-A3-N2-T6-E3-H6 with an AU1-like backbone and components from DS-1, indicating an intergenogroup reassortant. Of the 11 gene segments, five were closest to feline and 2 were closest to human strains, respectively; the rest were related to human-animal strains. Novel rotaviruses generated by reassortment might influence the disease outcome and vaccination effort.
To clarify the practical actions that experienced nurses working at community general support centers perform to provide comprehensive community care that supports the lifestyles of residents, including older adults. The participants were full-time nurses with at least 9 years of experience working at community general support centers in Japan. Semi-structured in-person interviews were conducted between August and December 2023, and the results underwent qualitative descriptive analysis. Ten core categories, twenty-six categories, and eighty-eight subcategories were identified as actions that nurses at community general support centers performed. The 10 core categories were assessment for care prevention, communication that builds trust, networking, promotion of nursing care prevention, coordination of the care team, creation of projects and resources that can be locally implemented, creation of a local care system, teamwork among professions at the community general support center, self-improvement to improve one's expertise, and operational management for implementing effective support. Nurses performed practical actions to both provide individual support and community development. The results suggested that nurses used the networks they had built through performing their daily work duties, including providing support to individuals, to support community resources. They also utilized community resources in local communities to create care systems in the community.
To examine the relationship between the difficulty of teaching infusion-management techniques during skills training and clinical practicum phases, the factors influencing this relationship, and the status of students' ability to implement infusion-management skills (implementation ability), as perceived by educators. Educators at three-year basic nursing education institutions nationwide were surveyed and their multiple-choice and open-ended responses to a web survey, which ran from May to September 2023, were analyzed quantitatively and qualitatively. During the skills training phase, the difficulty of replicating infusion insertion was associated with the difficulty of teaching infusion-management skills acquisition, and the higher the instructional difficulty, the lower the students' implementation ability. In the clinical practicum stage, the lack of opportunities to practice infusion management, students' lack of knowledge of it and its necessity were associated with difficulties in teaching infusion management implementation. Additionally, the higher the difficulty of teaching, the lower the student's implementation ability (under supervision). Moreover, the difficulty of teaching during the skills training phase was also associated with the clinical practicum phase. These instructional difficulties were driven by the lack of reality of educational materials, restrictions on safety and ethical considerations, lack of human resources, and difficulty in coordinating with training facilities. Difficulties in reproducing educational materials, limited opportunities to implement infusion management, and students' lack of infusion-management knowledge and skills influenced the difficulty of teaching infusion-management techniques. From an educational perspective, developing educational materials with increased visibility and coordinating with training facilities could help mitigate these challenges.
With recent advances in chemotherapy for unresectable pancreatic ductal adenocarcinoma (PDAC) with liver metastasis (LM), attempts have been made to resect the primary tumor in patients showing favorable responses to anti-cancer treatment (so-called "conversion surgery"; CS). This study aimed to clarify the outcomes of CS for PDAC with LM in a nationwide multicenter study. This retrospective, multicenter study was conducted as a project study of the Japan Pancreas Society and included patients with PDAC with LM at initial diagnosis, diagnosed radiologically or intraoperatively (occult LM), who underwent CS after at least 4 months of chemotherapy between 2010 and 2022. Survival outcomes and prognostic factors were analyzed. 90 patients were enrolled from 31 Japanese institutions. Median duration of preoperative chemotherapy was 10.4 (range, 4.2-58.5) months, and gemcitabine plus nab-paclitaxel was the most common first-line regimen, followed by folinic acid, 5-fluorouracil, irinotecan, and oxaliplatin. Liver metastasectomy was performed in 27 patients (30%). 82 patients (91.1%) initiated adjuvant chemotherapy, and 41 (45.6%) completed it. Overall survival (OS) from initial treatment was 53.1 (95% CI 41.6-65.7) months; OS after CS was 39.7 (95% CI 24.4-55.9) months, and disease-free survival was 14.7 (95% CI 9.3-23.4) months. Preoperative normalization of carbohydrate antigen 19-9 and pathologic negative lymph node metastasis were independent prognostic factors for OS. CS may provide a survival benefit for highly selected patients with PDAC and LM, including those with occult lesions, who respond well to multidisciplinary treatment.
Recent studies have indicated that the Rho GTPase family and Rho-kinases are associated with psychiatric diseases, such as schizophrenia. Two subtypes of Rho-kinase, Rho-kinases 1 and 2, regulate actin dynamics and mediate neurite outgrowth, spine morphology in neurons, and neurotransmitter release in vitro and ex vivo. However, the precise role of Rho-kinases in neurotransmitter release in vivo remains unclear. To clarify the role of Rho-kinases 1 and 2 in serotonin and dopamine release in the nucleus accumbens (NAc) of mice in vivo, we investigated the effect of a nonselective Rho-kinase inhibitor, fasudil, and a selective Rho-kinase 2 inhibitor, KD025, using an in vivo microdialysis technique. Fasudil perfusion (1-20 μM) into the NAc increased the basal extracellular serotonin level but did not affect dopamine levels, whereas KD025 (10-20 μM) had little effect on basal serotonin and dopamine levels. Notably, fasudil perfusion into the NAc suppressed depolarization-induced serotonin and dopamine release in a dose-dependent manner, whereas KD025 selectively suppressed depolarization-induced serotonin release. Our results suggested that Rho-kinases 1 and 2 are associated with dopamine and serotonin release, respectively, and that both may have significant but distinct roles in the regulation of serotonin and dopamine release in the NAc.
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Insulin-derived amyloidosis (IDA) reduces insulin absorption, increasing the risk of poor glycemic control; however, early detection remains challenging. Although ultrasound can identify IDA, the effectiveness of portable pocket-sized devices has not been evaluated. This study was performed to evaluate the detectability of findings suggestive of IDA using a pocket-sized ultrasound device on the abdominal region, the most common site for stable insulin absorption in patients with diabetes mellitus. This cross-sectional observational study was conducted in the diabetes ward of a university hospital between July and December 2024. The participants were inpatients with diabetes who had been receiving insulin injections for more than 1 month. Findings suggestive of IDA were assessed through visual inspection and palpation, magnetic resonance imaging (MRI), high-performance ultrasonography, and a pocket-sized ultrasound device. The concordance rate between the pocket-sized ultrasound device and other assessment methods was calculated. Of the 20 participants enrolled, 5 met the exclusion criteria; thus, data from 15 participants were included in the final analysis. Findings suggestive of IDA were identified in nine patients (60.0%) by visual inspection and palpation and in eight patients (53.3%) by the pocket-sized ultrasound device, high-performance ultrasound, and MRI. The concordance rate among the pocket-sized ultrasound device, high-performance ultrasound, and MRI was 100%, while the concordance rate between visual inspection with palpation and the pocket-sized ultrasound device was 80%. These findings suggest that a pocket-sized ultrasound device has the potential to detect findings suggestive of IDA and may be suitable for use in clinical practice.
Stress granules (SGs) are membraneless ribonucleoprotein condensates that form under stress and dissolve during recovery. While assembly mechanisms are well characterized, the temporal organization of disassembly remains incompletely understood. Here, we performed time-resolved proximity proteomics across SG disassembly (0-50 min recovery; n = 3) using G3BP1 as bait, identifying 79 proteins with robust temporal dynamics. Unsupervised clustering resolved five kinetic modules: early-increase, early-decrease/late-increase, transient-drop at ∼40 min, early-decrease, and zig-zag patterns. The transient-drop module was enriched for RNA-processing factors, consistent with transient changes in RNA-processing factor engagement. SYNCRIP, an hnRNP family protein in the early-decrease/late-increase module, showed characteristic biphasic dynamics during recovery. Functional validation demonstrated that SYNCRIP knockdown specifically impairs late-phase SG clearance-increasing granule size at 50 min recovery-without affecting formation. Together, our data provide a modular temporal map of SG disassembly and establish SYNCRIP as a functionally validated factor required for late-phase clearance.
Carbapenem-resistant Enterobacterales (CRE) pose a global threat due to limited treatment options and high mortality. Difficult-to-treat resistance (DTR), defined as non-susceptibility to all conventional β-lactams and fluoroquinolones, has primarily been applied to Pseudomonas aeruginosa. However, its relevance for Enterobacterales remains unclear, particularly in regions with a distinct carbapenemase landscape, such as Japan where IMP-type metallo-β-lactamases predominate. We analyzed the MultiDrug-Resistant organisms clinical research network (MDRnet) cohort, a multicenter prospective study conducted at 13 Japanese hospitals between April 2019 and March 2024. This analysis included patients with clinically indicated cultures yielding CRE. Clinical characteristics and outcomes assessed using the desirability of outcome ranking (DOOR) framework and genomic epidemiology characterized by whole-genome sequencing were compared between DTR and non-DTR groups. Among 196 CRE cases, 64 (32.7%) represented infections, including 12 DTR cases (18.8%). Carbapenemase genes were detected in 34/64 infections (53.1%), with similar prevalence in the DTR and non-DTR groups (50.0% vs 53.8%). blaIMP-1 was the most frequently identified carbapenemase gene (n = 28). The overall 30-day mortality rate was 21.9%, with 16.7% (95% confidence interval [CI], 2.1%-48.4%) in the DTR group and 23.1% (95% CI, 12.5%-36.8%) in the non-DTR group. DOOR outcomes were similar between groups. Appropriate empiric and definitive therapy was less frequently administered in the DTR group. In this cohort, where IMP-type carbapenemases and non-DTR CRE are prevalent, DTR classification did not appear to correlate with 30-day mortality or DOOR outcomes. These findings underscore the importance of regional molecular epidemiology when interpreting clinical outcomes of CRE infections.IMPORTANCEDifficult-to-treat resistance (DTR) is increasingly used to assess the clinical impact of antimicrobial resistance, but its significance in carbapenem-resistant Enterobacterales (CRE) may vary across molecular epidemiologic settings. In this prospective multicenter study from Japan, where IMP-type carbapenemases predominated, most CRE infections were classified as non-DTR. Whole-genome sequencing also revealed a distinct local clonal structure. DTR was not associated with 30-day mortality or desirability of outcome ranking despite lower rates of appropriate empiric and definitive therapy. Our study highlights the importance of interpreting DTR in CRE within the context of regional molecular epidemiology and supports the need for continued regional multicenter studies to evaluate its clinical utility.
To investigate the characteristics, surgery incidence, and outcomes of pigmentary glaucoma (PG), compared with primary open-angle glaucoma (POAG). Retrospective cohort study SUBJECTS: Eyes with PG and POAG defined by diagnosis codes (2013-2025) in the IRIS® Registry (Intelligent Research in Sight). Cumulative incidence of procedures (trabeculectomy, tube shunt surgery, minimally invasive glaucoma surgery (MIGS), laser trabeculoplasty (LTP), and cyclophotocoagulation) was estimated using the Kaplan-Meier method. Cumulative failure probability was estimated for matched eyes. Cumulative incidence of procedures in each diagnosis group. We identified 49,171 eyes with PG and 2,546,775 eyes with POAG. Compared to the POAG group, the PG group had more non-Hispanic White patients (89.2% vs 69.0%, P < 0.001). In the PG group, the percentage of severe stage was the highest in non-Hispanic Black patients (25.1%), followed by Asian (20.2%), Hispanic (19.7%), and non-Hispanic White patients (14.6%). The 4-year cumulative incidence of procedures, including LTP, was 22.2% (95% confidence interval: 21.8-22.6%) in PG and 19.5% (19.4-19.5%) in POAG (log-rank test, P < 0.001), with the highest incidence observed in the severe stage. Filtering or cyclodestructive procedures accounted for 12.8% and 10.3% of procedures in PG and POAG, respectively (P < 0.001). The cumulative probability of failure following LTP and MIGS was statistically higher in PG than in POAG (60.7% vs 58.2% and 66.7% vs 60.8% at 1 year, both P < 0.001). Combined trabeculectomy-cataract surgery had higher 1-year failure rates than standalone trabeculectomy in both PG (56.4% vs. 33.5%) and POAG (49.1% vs. 34.9%, both P < 0.001). Eyes with PG underwent glaucoma-related procedures more frequently than those with POAG, including filtering and cyclodestructive procedures. Although the proportion of Black or Asian patients among PG is relatively small compared to White patients, they are more frequently categorized as having severe disease, underscoring the need for closer monitoring and tailored management in these populations. Surgical failure was more frequent after LTP and MIGS in PG than in POAG. Combined trabeculectomy and cataract surgery had higher failure probability than standalone trabeculectomy in both the PG and POAG groups.