Short-term Damage Research Articles

Towards posthuman climate change education

ABSTRACT Climate change is one of the most critical challenges of our time, requiring significant responses from all aspects of society, including education. The prevailing responses to climate change tend towards treating the crisis as a predominantly scientific and managerial issue that requires technological solutions or behaviour changes. Correspondingly, climate change education (CCE) often focuses on teaching climate science and (predominantly individual) behaviour change. We argue that CCE, as part of a broader environmental and sustainability education (ESE), needs, in addition to a short-term damage limitation response, a simultaneous, longer-term, transformational approach that goes beyond critical humanism and engages with posthumanism. We explore ideas about human continuity with the more-than-human world, and the relationality and materiality of humans. Drawing on recent developments within posthuman pedagogies research, we consider how posthumanism might influence ESE/CCE, focussing on how two sustainability competency frameworks, UNESCO’s key competencies and the EU’s GreenComp, might be posthumanised.

Comparison of the incidence and causes of injuries in stand-up and ground combat-sport fighters – a narrative review

Injuries in combat sports can happen to any athlete, regardless of gender, age, training experience or whether he or she is an amateur or a professional. The range of injuries varies from superficial, short-term damage to severe injuries with serious consequences, including death. There are many types of combat sports, each with different rules and specific injuries. Amongst various divisions of combat sports, one of the basic ones is the division into ground and stand-up sports. In the following work, using the available literature, we wanted to present the specifications of several of the most popular combat sports and compare their most common locations of injuries, types of injuries and mechanisms of their formation, paying attention to which of these categories a given sport belongs to. We also discuss differences in the rate of injury for different age, genders, prevalence of injuries during situations of practice and competition. In the end, it is presented what are the possible long-term complications of injuries in combat sports and which actions such as protective gear, bans on certain techniques or behavioural changes might reduce the injury rate to protect the athletes health, well-being and decrease the economic burden on healthcare systems.

Uncertainty quantification of wind turbine fatigue lifetime predictions through binning

Aging wind energy assets demand the development of methods able to effectively support informed decision-making. These needs have inspired the use of data-driven methodologies, which offer valuable insights to wind turbine owners and/or operators. Many approaches can be found in the literature for extrapolating fatigue damage measurements to estimate the lifetime of wind turbines. In some cases, resampling approaches are proposed to compute the confidence levels associated with the generated projections, yet a standardized framework has not been adopted. Most reported studies identify the relationship between short-term damage and long-term Environmental and Operational Conditions (EOCs) by mainly rendering mean lifetime predictions and their associated confidence levels, whereas additional predicted lifetime statistical information is usually overlooked. In this work, we showcase the importance of properly accounting for the variability in lifetime predictions, describe how to summarize binned damages using statistical estimators and investigate bootstrapping variants for computing the confidence levels in the generated damage estimators.

Explainable hypoglycemia prediction models through dynamic structured grammatical evolution

Effective blood glucose management is crucial for people with diabetes to avoid acute complications. Predicting extreme values accurately and in a timely manner is of vital importance to them. People with diabetes are particularly concerned about suffering a hypoglycemia (low value) event and, moreover, that the event will be prolonged in time. It is crucial to predict hyperglycemia (high value) and hypoglycemia events that may cause health damages in the short term and potential permanent damages in the long term. This paper describes our research on predicting hypoglycemia events at 30, 60, 90, and 120 minutes using machine learning methods. We propose using structured Grammatical Evolution and dynamic structured Grammatical Evolution to produce interpretable mathematical expressions that predict a hypoglycemia event. Our proposal generates white-box models induced by a grammar based on if-then-else conditions using blood glucose, heart rate, number of steps, and burned calories as the inputs for the machine learning technique. We apply these techniques to create three types of models: individualized, cluster, and population-based. They all are then compared with the predictions of eleven machine learning techniques. We apply these techniques to a dataset of 24 real patients of the Hospital Universitario Principe de Asturias, Madrid, Spain. The resulting models, presented as if-then-else statements that incorporate numeric, relational, and logical operations between variables and constants, are inherently interpretable. The True Positive Rate and True Negative Rate metrics are above 0.90 for 30-minute predictions, 0.80 for 60 min, and 0.70 for 90 min and 120 min for the three types of models. Individualized models exhibit the best metrics, while cluster and population-based models perform similarly. Structured and dynamic structured grammatical evolution techniques perform similarly for all forecasting horizons. Regarding the comparison of different machine learning techniques, on the shorter forecasting horizons, our proposals have a high probability of winning, a probability that diminishes on the longer time horizons. Structured grammatical evolution provides advanced forecasting models that facilitate model explanation, modification, and retesting, offering flexibility for refining solutions post-creation and a deeper understanding of blood glucose behavior. These models have been integrated into the glUCModel application, designed to serve people with diabetes.

Psychological harm, causes and response to sexual assault of females in developing country

In many developing countries, due to the lack of sex education and knowledge about sex, sex can not be openly discussed and even becomes a topic that people avoid talking about. As a result, the severe consequences, core causes and effective solutions have not been displayed clearly yet. This dissertation focuses firstly on the psychological damage that occurs when women are sexually assaulted in developing countries, specifically discussing the short-term damage and phenomena like emotional damage and changes, the long-term damage and phenomena like Post-traumatic stress disorder(PTSD), and the social constraints on seeking counselling like lacking of formal psychological clinics. It then discusses the causes of the criminalization of sexual assault. These include the shortage of sex education in the family and at school, regional gender inequalities and inadequate legal provisions against sexual assault. Finally, the response to sexual assault is discussed, divided into seeking help from the law and its advantages and disadvantages, seeking help from medication and psychiatric treatment, and awareness-raising on sexuality, the importance of this response is emphasized in each of these areas. For the meaning of the paper, it can provide help and instruction for people who are really attacked by sexual assault and people who want to make a contribution to improving the situation of fearful sexual assault.

Investigating the supply chain agility–Innovation link: The role of organizational context

Previous literature provides ample analyses of the antecedents of supply chain agility, but the organizational context has generally been neglected. Setting up the right organizational context is important for dynamic capabilities such as supply chain agility, especially in turbulent times. In this research, we study organizational context from two aspects as antecedents of supply chain agility, i.e., a firm’s performance orientation context and its social orientation context. Based on the dynamic capabilities view, the literature on organizational context, supply chain agility, and innovation, we develop our hypotheses. We investigate the previously overlooked impact of supply chain agility on innovation performance, as we find that supply chain agility not only helps to prevent and repair short-term damage but also promotes innovation in the long term. We also consider the moderating role of the organization’s complementarity with its key suppliers in this relationship. Structural equation modeling is applied to investigate the proposed research hypotheses using lagged survey data with multiple respondents from the manufacturing sector in Pakistan.

Fatigue degradation of wind turbines considering dynamic wake meandering effects

This paper systematically investigates the effects of six factors, namely wind shear, ambient turbulence, wake meandering, wake-added turbulence, turbulence intensities, and wind speed, on the dynamic responses and fatigue degradation of wind turbines in the wake region. An improved mid-fidelity code, FAST.Farm, is used, which considers wake-added turbulence by adopting an additional wind domain with the Mann model. Different distributions of short-term damage equivalent stresses are found in two selected components, namely figure-8 and elliptical distributions, respectively, for nonturbulent and turbulent inflows at the blade root and a consistent ∞-distribution at the tower section for different inflows. An apparent lifetime reduction is observed at the blade root and tower base after the introduction of ambient turbulence, wake meandering, and wake-added turbulence. This lifetime reduction is more critical at the tower bases of downstream wind turbines, where the fatigue lifetime can be shorter than the designed service lifetime (20 years) owing to the wake effect. Considering a Rayleigh distribution with an average wind speed of 8.5 m/s, the fatigue lifetimes of turbines located 4D and 8D downstream of another turbine are approximately 45.86 % and 13.12 %, respectively, lower than the fatigue lifetime of the upstream turbine, whereas the reductions are 38.80 % and 5.03 %, respectively, for an average wind speed of 10.0 m/s. Given that the wake effect on the fatigue lifetime has already been highlighted in recent design standards, the findings of the present study are expected to provide guidance for fatigue evaluation in practice, which will help improve fatigue estimations, extend turbine lifetimes, and reduce the construction costs.

The Impact of Food Deprivation and Starvation on Mental Health: Blockade on Artsakh (Nagorno - Karabakh)

Starvation is the deliberate deprivation of food that occurs when perpetrators impede the victims from accessing the necessities to sustain life. Throughout history, starvation had been utilized as a form of genocide by many past regimes. It is used as a method to enforce a surrender from the victim or as a military strategy during warfare. Genocide, one of the most devasting crimes against humanity, as defined by Rafael Lempkin and categorized by the United Nations Genocide Convention, is the deliberate attempt to annihilate a certain ethnic, religious, or social group of people. The purpose of this article is to examine the immediate and lasting effects of the cognitive, psychological, and mental aspects of starvation. In this current blockade of Artsakh, a dispute arises in the Artsakh region, also known as the Nagorno-Karabakh region, between Azerbaijan and the Republic (unrecognized) of Artsakh. Since December 12, 2022, ecologists from Azerbaijan have blocked the Berdzor (Lachin) Corridor, the only route that linked Artsakh to the world, thus preventing the transportation of fuel, medicine, and food. Russian peacekeepers have been stationed at the Corridor in Artsakh; however, the Azerbaijan government has consolidated its blockade and has disregarded the appeals made by the Russian peacekeepers. In this article, the effects of starvation on the cognitive, psychological, and mental functioning of the human body are presented as they related to historical genocide. The impacts of starvation and malnutrition can be highly detrimental, leading to long-lasting impacts, and can disrupt the balance of essential nutrients and neurotransmitters in the brain, such as serotonin and dopamine. Malnourishment also impairs cognitive function, leading to symptoms like fatigue, weakness, irritation, poor memory, and attention deficit. Fluctuating blood sugar levels and imbalanced hormones caused by starvation impact emotional regulation and increase the risk of developing mood disorders. The blockade of Artsakh could potentially cause both severe short term and long-term damage to the mental health of the victims. Since the blockade occurred more than 250 days ago, detrimental damages have already occurred. This article strongly calls upon the international community to take immediate action against this blockade and help prevent future genocide. Keywords: Starvation, Genocide, Artsakh (Nagorno-Karabakh), blockade, Lachin corridor, bioactive compound, functional foods

Urban Planning of Coastal Adaptation under Sea-Level Rise: An Agent-Based Model in the VIABLE Framework

Coastal flood risk and sea-level rise require decisions on investment in coastal protection and, in some cases, the relocation of urban areas. Models that formalize the relations between flooding costs, protective investments, and relocation can improve the analysis of the processes and issues involved and help to support decision-making better. In this paper, an agent-based model of a coastal city is represented in NetLogo. This model is based on the VIABLE modeling framework and describes adaptive dynamic agent behavior in a changing system. The hypothetical city faces damage caused by gradually rising sea levels and subsequent extreme sea-level events. To mitigate these risks, an “urban planner” agent has two adaptation measures at their disposal: developing coastal defenses or, as a more extreme measure, relocating vulnerable areas inland. As the simulation progresses and the decisions change with rising sea levels, the agent alters investments in these two measures to increase its value function, resulting in dynamic reactive behavior. Additionally, gradual sea-level rise is implemented in various modes, along with extreme sea-level events that cause severe short-term damage. The results of simulations under these modes and with multiple scenarios of agent action are presented. On average, agent behavior is quite reactive under limited foresight. Individual simulations yield a ‘priming’ effect when comparing different timings of extreme sea-level events, wherein an earlier extreme event primes the agent to adapt and thus be better prepared for subsequent events. Agent success with adaptation is also found to be sensitive to the costs involved, and these varying degrees of adaptation success are quantified using three parameters of adaptation success.

Effects of Aqueous Dispersions of C60, C70, and Gd@C82 Fullerenes on DNA Oxidative Damage/Repair and Apoptosis in Human Embryonic Lung Fibroblasts.

Fullerenes and metallofullerenes play an active role in homeostasis of reactive oxygen species and may cause oxidative damage to cells. As pristine fullerenes are a basis for derivatization, studying oxidative DNA damage/repair and apoptosis is important in terms of genotoxicity and cytotoxicity for their biomedical application. Aqueous dispersions of C60, C70, and Gd@C82 (5 nM and 1.5 μM) were cultured with human fetal lung fibroblasts for 1, 3, 24, and 72 h. Oxidative DNA damage/repair was assessed through concentration of 8-oxodG, double-strand breaks, and activation of BRCA1. Activity of apoptosis was assessed through the BCL2/BAX ratio. All three fullerenes caused oxidative modification of DNA at the early stages; C60 caused the most long-term damage, Gd@C82 caused the most short-term damage, and C70 caused "wave-like" dynamics. The dynamics of DNA repair correlated with the dynamics of oxidative damage, but Gd@C82 caused more prolonged activation of the repair system than C60 or C70. The oxidative toxicity of Gd@C82, is minor and the oxidative toxicity of C60 is mild and short-term, in contrast to C70. In relation to the studied effects, the fullerenes can be arranged in a safety row of Gd@C82 > C60 > C70.

The short-term effect of COVID-19 on the cochleovestibular system in pediatric patients

The audio-vestibular equivalent of neurological symptoms secondary to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has been discussed; however, it has not been fully clarified. Although it has been reported that the vestibulocochlear system is affected in adult coronavirus disease-2019 (COVID-19) patients, there is no study in the literature in which the pediatric patient group with COVID-19 was evaluated comprehensively with auditory and vestibular tests. In this study, the short-term damage caused by SARS-CoV-2 in the vestibulocochlear system in pediatric patients was examined. This study aimed to evaluate the vestibulocochlear system of pediatric patients (aged 9-15 years) with a recent history of COVID-19. The study included 35 individuals with a recent history of COVID-19 and 35 age-gender-matched healthy individuals (control group). Pure tone audiometry, suppressed otoacoustic emission (OAE), video head impulse test (VHIT), and cervical and ocular vestibular evoked myogenic potentials (c/o-VEMP) tests were administered to all participants following their otoscopic examinations, and the obtained data were compared between the two groups. When the data obtained with pure tone audiometry were compared, statistically significant differences were found between the groups at four different frequencies (1000, 2000, 4000, and 8000Hz) in favor of the control group. There was a statistically significant difference between the groups in the signal-to-noise ratio (SNR) values obtained before noise at 2800Hz and before and after noise at 4000Hz. VHIT lateral gain, LARP gain, and RALP gain were statistically significantly lower in the COVID-19 group than in the control group (p<0.05). VHIT lateral asymmetry parameter was measured higher in the COVID-19 group than in the control group, and this difference was statistically significant (p<0.05). In the VHIT test, the asymmetry parameter was significantly higher in the COVID-19 group (p<0.05). In the o-VEMP test, n10 latency, p15 latency, n10-p15 interlatency, n10-p15 interpeak amplitude, and asymmetry parameters were measured, and no statistically significant difference was found between the COVID-19 group and the control group (p>0.05). Evidence was obtained that the cochleovestibular system was damaged in pediatric patients in the early post-COVID-19 period.

Preliminary efficacy of [90Y]DOTA-biotin-avidin radiotherapy against non-muscle invasive bladder cancer.

Bladder cancer represents 3% of all new cancer diagnoses per year. We propose intravesical radionuclide therapy using the β-emitter 90Y linked to DOTA-biotin-avidin ([90Y]DBA) to deliver short-range radiation against non-muscle invasive bladder cancer (NMIBC). Image-guided biodistribution of intravesical DBA was investigated in an animal model by radiolabeling DBA with the 68Ga and dynamic microPET imaging following intravesical infusion of [68Ga]DBA for up to 4h and post-necropsy γ-counting of organs. The antitumor activity of [90Y]DBA was investigated using an orthotopic MB49 murine bladder cancer model. Mice were injected with luciferase-expressing MB49 cells and treated via intravesical administration with 9.2MBq of [90Y]DBA or unlabeled DBA 3days after the tumor implantation. Bioluminescence imaging was conducted after tumor implantation to monitor the bladder tumor growth. In addition, we investigated the effects of [90Y]DBA radiation on urothelial histology with immunohistochemistry analysis of bladder morphology. Our results demonstrated that DBA is contained in the bladder for up to 4h after intravesical infusion. A single dose of [90Y]DBA radiation treatment significantly reduced growth of MB49 bladder carcinoma. Attaching 90Y-DOTA-biotin to avidin prevents its re-absorption into the blood and distribution throughout the rest of the body. Furthermore, immunohistochemistry demonstrated that [90Y]DBA radiation treatment did not cause short-term damage to urotheliumat day 10, which appeared similar to the normal urothelium of healthy mice. Our data demonstrates the potential of intravesical [90Y]DBA as a treatment for non-muscle invasive bladder cancer.

Radiation Testing of Commercial Rechargeable Lithium Polymer Batteries for Small Satellite Applications

Commercial off-the-shelf (COTS) electrical components are becoming of interest for small satellite applications due to their accessibility, good performance, and low cost. We quantify the performance of Lithium Polymer (LiPo) COTS batteries under irradiation to assess their reliability. LiPo battery cells with LiCoO2 cathodes, nominal voltages of 3.7 V, and rated capacities of 6000 mAh are irradiated with a 30 MeV proton beam from the Middle East Technical University Defocusing Beamline, which delivers a maximum of 73 krad primary dose. Results show protons cause short-term damage, resulting in up to 17% faster discharge rates, which decreases after six months depending on the cell’s position and primary and secondary deposited dose. Additionally, a consumption rate increase of up to 42% occurs for the cells under prolonged secondary irradiation (1.2 krad). The separating polypropylene layer undergoes thinning and discoloration mainly due to secondary particles like neutrons and gammas. Finally, the LiCoO2 cathode of two batteries show dried polyvinylidene fluoride surface build-up, both potentially caused by discharge in a radioactive environment. Damaged cells do not suffer leakage.

Intestinal flora variation reflects the short-term damage of microplastic to the intestinal tract in mice

The potential toxicity of microplastic (MPs) to organisms has attracted extensive attention. However, due to the subacute toxicity of MPs, the biological effect is hard to verify in short-term exposure experiment. Here, by tracking the dynamics of gut microbes, mice model was utilized to evaluate the toxicity of compositional MPs (PE, PET, PP, PS and PVC). After 7 days digestive exposure, the physiological indicators were normal as the control group that the body weight and serum cholesterol levels were insignificant change. Whereas, through histopathological examination, all the treatment groups suffered colon tissue damage, among which PS had the most inflammatory cells. Moreover, the high-throughput sequencing results revealed great variation of intestinal flora in treated mice. The ratio of Bacteroidetes and Firmicutes in PE, PET and PP treatment groups heighten, and the relative abundance of Ruminococcaceae and Lachnospiraceae increased significantly at family levels. At the genus level, Alistipes bacteria in PS treatment group significantly decreased that is associated with obesity risk. It indicated that MPs induced inflammatory response would further interfere the dynamics of intestinal flora causing health effect in living organisms. This work shed light on MPs toxicity in short-term exposure and supplied research paradigm of MPs health risk assessment.

Understandings and applications of rural community resilience amongst Scottish stakeholders: Introducing dual discourses

ABSTRACT This paper seeks to examine understandings and applications of rural community resilience. Scottish policy has shifted toward neoliberalismand community empowerment, with communities encouraged to play a proactive rolein enhancing their own resilience. We argue that it is important to understandthe perspectives of multiple stakeholders to identify what practical factorsthey believe enhance community resilience and to provide a greaterunderstanding of the mechanisms through which community resilience can bedelivered. Drawing on qualitative data collection, we question what resiliencemeans and what factors can facilitate it in practice. We find that dualdiscourses of resilience emerge: the emergency which reflects the policy focuson short-term damage reduction, and the everyday which reflects the desire formore long-term adaptive capacities developing in response to gradual change inrural communities. We conclude that the discourse which stakeholders align withwill affect how they understand, adopt, and practice the concept.

Environmental Warfare Tactics in Irregular Conflicts

This article considers how, and under what conditions, actors in irregular conflicts weaponize nature. When do insurgents and counterinsurgents pursue environmental degradation—ranging from limited and short-term damage to ecocidal violence—as a tactic of war? To what extent do we see variation in the frequency and form of environmental warfare? And when do conflict actors exercise restraint in their use of violence against the natural environment? Often, the intentional destruction of the natural landscape is difficult to explain by reference to operational strategy or tactical logic alone. Deliberate attacks on the natural landscape, the frequency with which these tactics are deployed, and the diverse forms they take are conditioned by context-specific incentives, constraints, and intervening variables. I identify six categories of incentives and constraints that influence the decision to engage in environmental destruction: strategic, tactical, political, ideological, cultural, and technological. Using suggestive evidence from multiple case studies, I theorize some possible interactions between incentives and constraints that help to explain variation in the form and frequency of environmental warfare tactics.

Short-term damage and its mechanism of a CaF2 window for a DUV lithography machine

The CaF2 window is the laser exit of the DUV lithography machine as well as its sealing component. Bearing the irradiation, high pressure, and discharging pollutants, the window is easy to damage and directly deteriorate the performance and reliability of the laser. In this paper, considering the effects of the above factors, two typical short-term damages to the CaF2 window - high energy induced damage and pollutant-induced damage are studied quantitatively. Using an experimental design, theoretical calculation, characterization analysis, and numerical simulation, we found that the damage induced by high-energy irradiation is dominated by defect propagation at the initial stage. At the later stage, it is dominated by heat and thermal stress with thermal melting and evenly distributed microcracks of 1∼10 µm in size. Low-energy irradiation only causes expansion and deformation of the window, but the highly absorbent electrode discharging particles with a diameter of 0.1∼1 µm strongly absorb the laser. Strong local heat is caused during the melting and gasification of the particles, which easily leads to ablation and cracks. The damaged area is proportional to the particle size, and the damaged rate is proportional to the average power density at a high repetition frequency. High energy density and the defects with high absorptivity, the electrode discharging particles, and the heat accumulation effect, are the main factors for the two short-term damage, respectively.

438 An efficacious cosmetic formulation for managing barrier damage following mild-moderate skin disruption

Stratum Corneum is a compacted layer of corneocytes embedded in a lipid matrix, that forms a semipermeable barrier on the surface of the skin. Despite its seemingly delicate thinness of 10-30 μm, the Stratum Corneum [SC] plays a vital role in serving as a first line of defense to protect against external environmental stressors. Even minor disruption to this layer can lead to a loss of barrier integrity that manifest as an increase in Transepidermal Water Loss [TEWL]. Many common cosmetic dermatological treatments can inflict varying degrees of short-term damage to the SC. In order to help the SC maintain and restore barrier function, a topical serum was developed containing a combination of Macrocystis pyrifera ferment and other ingredients. This preparation is shown in clinical studies to strengthen the barrier of intact skin, making the barrier not only more robust against mild skin disruption but also to enhance barrier recovery even after the intense effects of cosmetic dermatological treatments such as peels and laser treatment. Moreover, this barrier repair serum is shown to be more effective at helping the barrier recover than a conventional moisturizing lotion during post-treatment recovery. Through a series of in vivo evaluations, this serum is shown to reduce TEWL of intact skin, to help build back SC quality, to reduce the immediate barrier disruption caused by cosmetic glycolic peel or laser procedures and to help SC barrier recovery post-procedure. To build upon the in vivo findings, immunohistochemical analysis of ex vivo skin demonstrated that 70 % glycolic acid acutely disrupts the tight junction protein, claudin-1 and filaggrin. Ex vivo skin pretreated with the serum exhibited intact claudin-1 morphology and showed a greater signal intensity of both claudin-1 and filaggrin compared to ex vivo skin treated with glycolic acid alone, suggesting that the serum may contribute to accelerated barrier recovery.

Mental Harassment at Workplace: Are We Aware?

Mental harassment at the workplaces is an abuse and inflicted invisible wound that a person experiences and is not blatantly visible. This case study is to give an insight about mental harassment in the workplaces and its short term and long term damage to the psychological and physical health of the sufferer. It is presenting the lack of awareness on mental harassment in the workplaces and workplace’s negligence towards harassment culture. Mental harassment at the workplaces is mostly studied under quantitative methods. However, the objective of this study is to reveal a unique and individual experience of a mental health professional who has undergone mental harassment at the workplace. Keywords: Mental harassment at workplace, awareness, case study.

Systemic lupus erythematosus diagnosed during hospitalization: Greater baseline disease activity, short-term damage, and death

ObjectivesTo analyze initial and follow-up features of patients with systemic lupus erythematosus (SLE) diagnosed during hospitalization. MethodsRetrospective analysis of medical records: two groups were studied, a) SLE diagnosed during hospitalization (SLEin), b) SLE diagnosed on an outpatient basis (SLEout). Results123 patients were assessed, 87% female, mean age at diagnosis was 34 years and 45 (37%) of them were SLEin. Patients in the SLEin group had a median of 144 days from the onset of symptoms to diagnosis of SLE vs. 287 days in the SLEout group (p = 0.04). Initially, SLEin had an average SLEDAI of 10 vs. 8 in SLEout (p = 0.004) and anti-dsDNA was positive in 71% vs. 53% in SLEout (p = 0.07). Within the first 6 months, the average cumulative glucocorticoid dose was 6493 mg in SLEin patients vs. 3563 mg in SLEout (p < 0.001) and immunosuppressant usage was higher in SLEin: 62% vs. 26% in SLEout (p < 0.001). Within the first year, SLEin’s kidney biopsies showed lupus nephritis III or IV in 31% vs. 12% in SLEout (p = 0.003, log-rank test). Within the first 2 years, 6 SLEin patients died vs. 1 SLEout patient (p = 0.02) and SLEin patients had more damage as measured by SLICC/ACR Damage Index (median 0, range 25%–75% 0–1 vs. median 0, range 25%–75% 0–0 in SLEout; p = 0.04). ConclusionsSLEin are initially more active, require higher doses of glucocorticoids and immunosuppressants, have more significant kidney involvement, and present more damage and greater mortality in the short term.