Short Needle Research Articles

Pen needle preference in a population of Canadians with diabetes: results from a recent patient survey.

To evaluate the safety and efficacy of insulin injections in patients using 8 mm 31 gauge vs. 5mm 31 gauge pen needles, as determined by A1C results and to measure individual patient satisfaction and compare overall satisfaction regarding the use of the 2 needles. The study was completed as a substudy of a single-site, open-label, randomized, 6-month comparative study consisting of 66 obese patients. Prior to the study, all individuals had treated their diabetes with either long-acting insulin glargine or insulin detemir. At the onset of the study, patients were randomized 1:1 to either insulin glargine or neutral protamine Hagedorn insulin. All patients used an 8 mm pen needle for the first 3 months and a 5 mm pen needle for the remaining 3 months. At the conclusion of the trial, patients completed a questionnaire regarding pen needle satisfaction. The 5 mm needle was preferred by 41.8% of study subjects, while the 8 mm needle was preferred by 27.9% of subjects. For other attributes (i.e. overall injection comfort, pain when inserting the needle into the skin and length of needle), the 5 mm needle scored higher than the 8 mm needle and higher also than the percentage of individuals who indicated no preference. In patients with insulin-treated type 2 diabetes with a mean single-injection volume dose of basal insulin of 50.2 units, the 5 mm needle was generally preferred over the 8 mm needle. The shorter needle was more comfortable and easier to use while being equally effective in delivering insulin.

Cloned foal derived from in vivo matured horse oocytes aspirated by the short disposable needle system.

Transvaginal ultrasound-guided follicle aspiration is one method of obtaining recipient oocytes for equine somatic cell nuclear transfer (SCNT). This study was conducted: (1) to evaluate the possibility of oocyte aspiration from pre-ovulatory follicles using a short disposable needle system (14-G) by comparing the oocyte recovery rate with that of a long double lumen needle (12-G); (2) to investigate the developmental competence of recovered oocytes after SCNT and embryo transfer. The recovery rates with the short disposable needle vs. the long needle were not significantly different (47.5% and 35.0%, respectively). Twenty-six SCNT embryos were transferred to 13 mares, and one mare delivered a live offspring at Day 342. There was a perfect identity match between the cloned foal and the cell donor after analysis of microsatellite DNA, and the mitochondrial DNA of the cloned foal was identical with that of the oocyte donor. These results demonstrated that the short disposable needle system can be used to recover oocytes to use as cytoplasts for SCNT, in the production of cloned foals and for other applications in equine embryology

Current perspectives on psychological insulin resistance: primary care provider and patient views.

Psychological insulin resistance (PIR) refers to reluctance of providers to prescribe and patients to take insulin. Processes and tools have been developed to address PIR. The purpose of this qualitative study was to examine current understanding and opinions of insulin therapy of primary care providers (PCPs) and patients with type 2 diabetes (both naive to insulin and insulin users). Providers (n=23 PCPs) and patients (n=96) participated in 1:1 interviews and 12 racially/ethnically diverse focus groups, respectively, conducted by trained qualitative researchers using pilot-tested scripts. Participants examined insulin devices and needles while specific questions were asked about insulin therapy. Recorded sessions were transcribed and analyzed. Salient themes related to injection resistance, patient adherence, health system barriers, and education emerged during the sessions. Provider knowledge about insulin injection devices and approaches varied and was often limited, particularly regarding needle sizes, which influenced prescribing practices and patient education. Other barriers included limited time and personnel. However, PCPs placed priority on continuing education on devices, needles, insulin adjustment, educational approaches, and cost. Patient focus groups revealed a strong desire for knowledge on injection logistics, particularly by insulin users who felt that they had received inadequate education. Most patients had limited experience with tools like shorter needles but would consider injecting if presented. Those who had self-injection experience were more willing to accept insulin. Cost concerns and need for information were frequently reported. Findings reveal that programs and tools designed to address problems associated with PIR have yet to be fully realized.

The Impact of Multiple Prostate Needle Biopsies on Long-Term Erectile Dysfunction

IntroductionThe impact of transrectal ultrasound guided prostate needle biopsy on erectile dysfunction remains uncertain. We examined whether transrectal ultrasound guided prostate needle biopsy contributes to the development or worsening of erectile dysfunction as assessed by IIEF-5 scores in patients who underwent multiple prostate needle biopsies. MethodsThe study population consisted of 826 men who underwent transrectal ultrasound guided 10 to 12-core prostate needle biopsy for suspicion or surveillance of prostate cancer. Men were evaluated for erectile dysfunction using the IIEF-5 questionnaire. Erectile dysfunction was modeled as a categorical variable, defined as any (0 to 20), mild (16 to 20), mild to moderate (11 to 15), moderate (6 to 10) or severe (0 to 5). The impact of multiple prostate needle biopsies was also evaluated. ResultsOf 826 men who underwent prostate needle biopsy 240 (29%) had undergone 1 or more and 168 (20%) had undergone 2 or more biopsies. Mean patient age was 63 years and mean IIEF-5 score was 16. On univariate analysis age (OR 1.11, 95% CI 1.09–1.14, p <0.001), and 1 (OR 1.79, 95% CI 1.06–3.03, p=0.03) or 2 (OR 1.80, 95% CI 1.02–3.17, p=0.04) prior prostate needle biopsies were associated with erectile dysfunction. On multivariate analysis age alone was predictive of severe erectile dysfunction (OR 1.09, 95% CI 1.05–1.12, p=0.002). A repeat prostate needle biopsy within 12 months was associated with worse erectile dysfunction (OR 1.55, 95% CI 1.08–2.93, p=0.02). When long-term erectile function was evaluated, prostate needle biopsy was not significant after adjustment for covariates. ConclusionsIn the short term prostate needle biopsy may be important in predicting transient (less than 1 year) erectile dysfunction. However, in the long term prostate needle biopsy does not predict erectile dysfunction in aging men.

Development and assessment of a new dermal attachment for short‐term tagging studies of baleen whales

Summary Current studies of fine‐scale baleen whale diving and foraging behaviour rely on archival suction cup tags that remain attached over time scales of hours. However, skin irregularities can make suction cup attachment unreliable, and traditional pole deployment of suction cup tags is challenging in moderate sea conditions or when whales are evasive. We developed a new tag attachment to overcome these limitations. The attachment features a short (6·5–7·5 cm) needle that anchors in the whale's dermis (epidermis and blubber) to which a free‐floating tag is attached via a severable tethered link. The needle, tag and a detachable ‘carrier rocket’ with fletching are fitted together to form a projectile that can be deployed at distances of up to 20 m using a compressed‐air launcher. A corrosive release mechanism allows the tag to separate from the needle after a specified period of time so that the tag can be recovered. The dermal attachment was evaluated during a study of humpback whales (Megaptera novaeangliae) in the Gulf of Maine and then subsequently deployed on bowhead whales (Balaena mysticetus) near Barrow, Alaska. Monitoring of tagged humpback whales indicated that the needle was shed several days after deployment, the attachment site healed shortly thereafter, and there were no discernible behavioural or health effects over time scales of days to months after tagging. Bowhead whales showed little immediate reaction to tagging; the most common response was a prolonged dive right after tag deployment. On average, respiration rates of tagged bowhead whales were elevated after tag attachment, but returned to the same rate as undisturbed bowheads within 1–1·5 h. When compared to suction cups, the dermal anchor provided a more reliable attachment and it can be applied from greater distances and in rougher sea conditions; it is therefore a useful alternative in circumstances where suction cup tags cannot be easily deployed.

Сравнительная оценка приживаемости сеянцев сосны обыкновенной выращенных с открытой и закрытой корневой системой высаженных в приовражных защитных насаждениях близ села Сардаусь муниципального района Кукморский Республики Татарстан

This article is devoted to the problem of protective plantings seedlings growing and creating, grown with closed root system, both in the world and in Russia. The paper gives a comprehensive comparative evaluation of the pine seedlings survival, grown with closed root system compared with seedlings, grown with open root system in protective gullies and ravines plantations, which were established in the spring of 2012. Research has shown that in the same natural climatic and soil conditions the best survival was kept by pine seedlings, grown with closed root system from Sabinskiy selection center compared with open root system (seedlings from the nursery). Pine seedlings with open root system were exposed to stress in the first year of planting, which was characterized by the emergence of more frequent and of short needles on the trunks and branches – “goose neck”. &#x0D;

Single-use autoinjector for once-weekly intramuscular injection of IFNβ-1a

Introduction: IFNβ products and glatiramer acetate are established treatment first-line options in long-term disease-modifying therapy of multiple sclerosis (MS). These self-injectable medications are used once weekly to once daily. Injection-related issues are common patient-cited reasons for nonadherence. Autoinjectors have been shown to support long-term adherence to injectable medications. The ability to self-inject in MS patients has been associated with a reduced risk of missed injections and drug discontinuation, and a beneficial effect on patient independence.Areas covered: The recently introduced easy-to-use prefilled once-weekly pen is a safe and effective device for intramuscular (IM) IFNβ-1a application and provides a convenient method for self-injection. We reviewed the available published evidence on the characteristics of this device. The once-weekly pen facilitates self-injection and was preferred over prefilled syringes by patients in a prospective open-label, multicenter Phase IIIb trial in MS patients who had been using IM IFNβ-1a in prefilled syringes.Expert opinion: The simple and safe handling, shielded short needle, single-use disposable design and virtually painless injection by the device may contribute to adherence, quality of life and independence in patients using IM IFNβ-1a.

SKINNY – SKIN thickness and Needles in the Young

Background . Intensive diabetes management requires the use of multiple daily injections. Inappropriate insulin injection technique, inadvertent intramuscular (IM) injections, needle phobia and insulin omission negatively affect glucose control. Objectives . To document skin and skin plus subcutaneous skin thickness using high resolution ultrasound (US) in a group of children and adolescents with type 1 diabetes. In addition, injection technique, needle re-use and injection site analysis was performed. Methods . Commonly recommended injection sites were examined using high-resolution US. Patient characteristics such as age, body mass index, frequency of injections and favoured sites were analysed. Results . A total of 40 paediatric and adolescent children aged 4 years 3 months to 18 years were examined. The maximum skin thickness at any site was 2.93 mm. A high rate of IM injection was predicted with the standard 8 mm needle and was reduced but not eliminated with the use of the shortest available 4 mm needle. As the subcutaneous skin thickness increased across injection sites in the following order: arm, thigh, abdomen and buttocks, the risk of IM injection declined. Conclusion . Choice of needle length, injection site and injection technique are important considerations in diabetes management in the paediatric population and are likely to affect quality of glycaemic control. Shorter needles are more acceptable and reduce the risk of IM injections.

ZONIFICACIÓN ALTITUDINAL PROVISIONAL DE Abies religiosa EN UN ÁREA CERCANA A LA RESERVA DE LA BIÓSFERA DE LA MARIPOSA MONARCA, MICHOACÁN

El objetivo del presente trabajo fue determinar la existencia de diferenciación morfológica (como indicador de variación genética) entre poblaciones de Abies religiosa, con la finalidad de delimitar una zonificación altitudinal para decidir el movimiento de semillas en los programas de reforestación. Se recolectaron y analizaron morfológicamente ramas y conos de 11 individuos de 15 poblaciones de A. religiosa en el cerro de San Andrés, municipio de Hidalgo, Michoacán (cercano a la Reserva de la Biósfera de la Mariposa Monarca), a lo largo de un transecto altitudinal (2,850-3,550 m, una población cada 50 m). La diferenciación morfológica significativa entre poblaciones se determinó a lo largo del gradiente altitudinal; las poblaciones de baja altitud tienen acículas más cortas y conos más largos que las poblaciones de elevada altitud. Se sugiere delimitar tres zonas altitudinales provisionales: 2,800 a 3,050; 3,050 a 3,300; y 3,300 a 3,550 m. Ignorando el cambio climático, se sugiere reforestar cada zona con planta originada de la semilla en la misma zona. Considerando el cambio climático, se sugiere realizar migración asistida altitudinalmente, plantando sitios en la zona inmediata superior a la zona donde la semilla se recolecte.

Hydrogel Microneedle Arrays for Transdermal Drug Delivery

Stratum corneum is the main obstacle for drugs to pass through the skin. Microneedles are composed of arrays of micro-projections formed with different materials, generally ranging from 25–2000 μm in height. Microneedles straightly pierce the skin with its short needle arrays to overcome this barrier. Microneedles can be divided into several categories, for instance, solid microneedles, coated microneedles, and hollow microneedles and so on. However, all these types have their weak points related to corresponding mechanisms. In recent years, pioneering scientists have been working on these issues and some possible solutions have been investigated. This article will focus on the microneedle arrays consisting of hydrogels. Hydrogels are commonly used in drug delivery field. Hydrogel microneedles can be further divided into dissolving and degradable microneedles and phase transition microneedles. The former leaves drug with matrix in the skin. The latter has the feature that drugs in the matrix are delivered while the remaining ingredients can be easily removed from the skin after usage. For drugs which are required to be used every day, the phase transition microneedles are more acceptable. This article is written in order to summarize the advantages of these designs and summarize issues to be solved which may hinder the development of this technology.

Hydrogel Microneedle Arrays for Transdermal Drug Delivery

Abstract Stratum corneum is the main obstacle for drugs to pass through the skin. Microneedles are composed of arrays of micro-projections formed with different materials, generally ranging from 25–2000 μm in height. Microneedles straightly pierce the skin with its short needle arrays to overcome this barrier. Microneedles can be divided into several categories, for instance, solid microneedles, coated microneedles, and hollow microneedles and so on. However, all these types have their weak points related to corresponding mechanisms. In recent years, pioneering scientists have been working on these issues and some possible solutions have been investigated. This article will focus on the microneedle arrays consisting of hydrogels. Hydrogels are commonly used in drug delivery field. Hydrogel microneedles can be further divided into dissolving and degradable microneedles and phase transition microneedles. The former leaves drug with matrix in the skin. The latter has the feature that drugs in the matrix are delivered while the remaining ingredients can be easily removed from the skin after usage. For drugs which are required to be used every day, the phase transition microneedles are more acceptable. This article is written in order to summarize the advantages of these designs and summarize issues to be solved which may hinder the development of this technology.

The rheological properties of hydrogenated castor oil crystals

The present study focuses on the rheological performance of a surfactant-rich aqueous suspension containing hydrogenated castor oil (HCO) crystals. HCO can be typically crystallized in five distinct shapes: spherically shaped, irregularly shaped, star-shaped (also called rosettes), short needles, and thick or thin fibers. The effect of the differences in shape on the rheological performance is studied, and the rheological properties are compared to the behavior of other triacylglycerol’s (TAG) suspensions. A suspension of TAG crystals usually behaves as a colloidal gel wherein a colloidal gel is defined as a network of flocs, with each floc being an aggregate of smaller subunits. All of these surfactant-rich aqueous suspensions of HCO crystals behaved according to a colloidal gel in the transient regime, independent of the studied crystal shapes, except the long thin fibers at a concentration above 0.1 wt% HCO transitioning from a heterogeneous fractal rod network to a homogeneous rod network, shifting from a colloidal gel to a glass.

A Design of Miniature Wideband Patch Antenna Based on Computer Simulation Technology

in this paper, based on the finite element method, using the high frequency simulation software HFSS, set up simulation model, by changing the antenna model substrate medium, using slot loaded with a short needle, simulated and achieved a miniature wideband patch antenna for WCDMA, The computer simulation technology has greatly reduced the antenna design cycle and cost.

Comparison of Inferior Dental Nerve Block Injections in Child Patients Using 30-Gauge and 27-Gauge Short Needles

Introduction: The purpose of the present study was to record their pain sensation and to assess children`s reaction objectively and subjectively while receiving dental local anesthesia with 27- and 30-gauge needles. Methods: Forty children (24 boys and 16 girls) participated in this study. A random double-blinded crossover design was used so that each child served as his or her own control, receiving each treatment on the same sides of the same arch at different sessions. Each patient received an injection either with a 27- or 30-gauge needle during the second visit and during the third visit with the other needle. Objective and subjective evaluations were performed. Results: Children`s reactions to mandibular nerve block with 27- or 30-gauge needle regarding SEM scale and Face scale demonstrated significant difference, whereas children receiving the injection with a 27-gauge needle presented more sensation of pain objectively and subjectively. Conclusion: Significant difference was demonstrated concerning pain when 27-gauge or 30-gauge needle was used, and no difference was found in success of local anesthesia. As to these two variables, measured and reported in this study, it can be concluded that 30-gauge needle exhibit clinical advantage in inferior dental injection in children.

PDB97 - Pen needle length and persistence among insulin pen users with type 2 diabetes mellitus

To assess the impact of insulin pen needle (PN) length on persistence of prescribed insulin therapy among patients recently diagnosed with type 2 diabetes mellitus (T2DM). Patients 18 years and older diagnosed with T2DM who had at least one indexed claim from May 2009 through September 2010 were assessed from the Truven Health MarketScan Research Database. Inclusion required 1 year continuous enrollment pre and post-index insulin claim with ≤ 1 prescription for an oral anti-diabetic drug during the pre-index period. Patients diagnosed with T1DM or using specialty self-injectables during the pre-index period were excluded. Patients were grouped into three PN length cohorts: short (4 & 5mm), intermediate (6mm) and long (8 & 12.7mm) needle initiators. Persistence was evaluated at 6 and 12 months by the absence of 90 day gaps between insulin prescriptions. Differences in persistence between cohorts were compared for statistical significance using a Fisher’s exact test (95% CI, two-tail). The study included 21,622 patients with an average age of 59.1 years (SD=11.4). Most patients were within the long needle group (67.6%); followed by the short (21.5%) and intermediate (10.8%) needle users. The majority of patients were non-persistent at the end of the first year of insulin use, with only 38.4% being persistent. Within the first 6 months only 46.5% of patients were found to be persistent. However, of those patients who were persistent within first 6 months, the likelihood of them remaining persistent was high with 82.6% of users reporting no gaps at 1 year. When examining the correlation between needle length and persistence, short needle users were 4.9% (p<0.001) and 2.7% (p=0.001) more persistent at 6 months than intermediate and long needle users, respectively. Persistence rates were higher for those patients using shorter needles, particularly early on at earlier phases of insulin adoption.

Evaluation of the effect of polymeric microneedle arrays of varying geometries in combination with a high-velocity applicator on skin permeability and irritation.

Polymeric microneedles offer the advantages of being both mass-producible and inexpensive. However, their weakness lies in the fact that they are not adequate for sharp fabrication of a needle tip, which is an important factor for effective penetration. We hypothesized that effective penetration can be achieved using a high-velocity application system. Therefore, in the present study, we investigated the influence of various polymeric microneedle array geometries on skin permeability and irritation using such a system. Volar forearms of 16 healthy volunteers were treated using the microneedle system with four different parameters: applicator velocity (4.3, 6, and 8.5m/s), tip radius (10, 15, and 20μm), length (100, 200, and 300μm), and number of needles (189 and 305 on a 50-mm(2) area). A higher velocity of piercing clearly enhanced skin permeability and damage. A larger tip radius resulted in lower skin permeability and irritation at an applicator velocity of 4.3m/s but did not have an effect at 6m/s. Skin permeability was positively variable, ranging from 100 to 200μm of needle length, and needle number showed no influence in the range investigated. In conclusion, a faster application speed could significantly enhance skin permeability and damage and compensate for insufficient penetration of the larger tip radius and shorter needles, which are also important factors for effective insertion.

Three dimensional MRI study: Safety of short versus long needle peribulbar anesthesia

BackgroundThe standard technique of Peribulbar block is to use 25g 25mm needle at the junction between the lateral one third and medial two third of the lower orbital rim in the infero-temporal quadrant of the orbit. Theoretically, insertion of longer needles increases the potential of injury to important structure; however, safety of the shorter needle had never been demonstrated. This study describes the anatomy of the orbital structures with magnetic resonance imaging (MRI) using the three-dimensional constructive interference in steady state (3D CISS) sequence to present a morphological basis for needle entry at 12.5 and 25mm lengths. Statistical comparisons were performed at the 12.5 versus 25mm depths. Statistical significance was indicated by P<0.05. MethodFifty patients free of orbital pathology with normal axial length were selected for MRI with the 3D CISS sequence. Original axial and multiplanar image reconstruction (MPR) images were selected for image interpretation. Orbital structures were identified at 12.5 and 25mm depths from the orbital rim to compare significant differences in anatomy between the two imaging planes at the expected needle depth and to assess the size of the globe and the orbit. ResultsThe cross sectional area of the extraocular muscles were statistically significantly smaller at the 12.5mm plane (P=0.001). The area of inferotemporal fat was statistically significantly larger at the 12.5mm plane (P=0.033). There was no statistical difference in the inferonasal and superonasal fat areas at different depths (P=0.34, P=0.35 respectively). The size of the orbit and globe was significantly larger at 12.5mm (P=0.001). There was no difference between depths in the presence or absence of neurovascular bundles and supporting structures including the intramuscular septae. ConclusionThere is a larger structure-free space at a depth of 12.5mm than at 25mm. Therefore, the inference is that a needle inserted in the infero-temporal zone to a depth of 12.5mm is less likely to injure the eyeball or extra-ocular muscles than one advanced to 25mm.

The appropriateness of the length of insulin needles based on determination of skin and subcutaneous fat thickness in the abdomen and upper arm in patients with type 2 diabetes.

BackgroundLonger needle and complicated insulin injection technique such as injecting at a 45-degree angle and making skinfolds may decrease patient compliance to insulin injection therapy. In this light, shorter insulin needles have been recently developed. However, it is necessary to ascertain that such shorter needles are appropriate for Korean patients with diabetes as well.MethodsFirst, the diverse demographic and diabetic features of 156 Korean adults with diabetes were collected by a questionnaire and a device unit of body fat measurement. The skin and subcutaneous fat thicknesses of each subject were measured by Ultrasound device with a 7- to 12-MHz probe. Data were analyzed using analysis of variance and multiple linear regression.ResultsThe mean skin thickness was 2.29±0.37 mm in the abdomen and 2.00±0.34 mm in the upper arms, and the mean subcutaneous fat thickness was to 10.15±6.54 mm in the abdomen and 5.50±2.68 mm in the upper arms. Our analysis showed that the factors affecting the skin thickness of the abdomen and upper arms were gender and body mass index (BMI), whereas the factors influencing the subcutaneous fat thickness in the abdomen were gender and BMI, and the factors influencing the subcutaneous fat thickness in the upper arms were gender, BMI, and age. Insulin fluids may not appear to be intradermally injected into the abdomen and upper arms at any needle lengths. The risk of intramuscular injection is likely to increase with longer insulin needles and lower BMI.ConclusionIt is recommended to fully inform the patients about the lengths of needles for insulin injections. As for the recommended needle length, the findings of this study indicate that needles as short as 4 mm are sufficient to deliver insulin for Korean patients with diabetes.

Effect of reflow temperature and substrate roughness on wettability, IMC growth and shear strength of SAC387/Cu bonds

The effect of reflow temperature and substrate surface roughness on wettability, intermetallics and shear strength of Sn–3.8Ag–0.7Cu solder alloy on copper (Cu) substrate was studied. It was found that increase in reflow temperature and substrate surface roughness improved the wettability of solder alloy. The size of needle shaped Cu6Sn5 IMCs (intermetallic compounds) increased with increase in temperature. The morphology of IMCs transformed from long to short needles with increase in substrate roughness. Shear strength and shear energy of the solder bond on rough Cu surfaces were found to be higher than that on smooth Cu surfaces. However, the sheared surfaces of the solder bond on rough Cu surface exhibited a transition ridge characterised by sheared IMCs whereas solder bond on smooth Cu surfaces exhibited completely ductile failure. Although, rough surface exhibited higher shear strength and shear energy, smoother surface is preferable due to its predominant bond failure in the solder matrix.

Inter-specific competition and management modify the morphology, nutrient content and resorption in Scots pine needles

Influence of tree-to-tree competition on nutrient resorption is still not well understood. To contribute filling this gap, we assessed the effects of thinning (0, 20 and 30 % extraction of basal area) and canopy type (beech–pine vs. pine subplots) on needle dry weight, needle length, nutrient content and nutrient resorption (N, P and K) in Scots pine (Pinus sylvestris) needles of different cohorts, 8–9 years after thinning. Thinning and canopy type often concurrently affected needle morphology (e.g. lighter and shorter needles in 30 % thinning, heavier and longer needles in pine canopy on the first year of study) and nutrient content (e.g. decrease in N, P and K in 30 %; N, P and K higher in pine canopy on the first year of study). However, effects of thinning appeared only in older cohorts for N and P but were found in old and new cohorts for needle dry weight, needle length and K, indicating that some thinning effects remained after 8–9 years. Canopy effects on morphology and nutrient content were more frequent in recent cohorts, in relation to an increase in beech cover over time. While no clear effects of thinning on the nutrient resorption were observed, higher values were observed in the pine than in the mixed canopy, which could be related to a higher Scots pine stem growth in those patches. The observed differences between treatments will likely increase as the stand develops, probably leading to beech trees being dominant, and as future thinnings are carried out.