Short-term Observations Research Articles

Admission characteristics of patients with short term hospitalization

BackgroundSheba Medical Center (SMC) is the largest hospital in Israel and has been coping with a steady increase in total Emergency Department (ED) visits. Over 140,000 patients arrive at the SMC's ED every year. Of those, 19% are admitted to the medical wards. Some are very short hospitalizations (one night or less). This puts a heavy burden on the medical wards. We aimed to identify the characteristics of short hospitalizations.MethodsWe retrospectively retrieved data of consecutive adult patients admitted to our hospital during January 1, 2013, to December 31, 2019. We limited the cohort to patients who were admitted to the medical wards. We divided the study group into those with short, those with non-short hospitalization and those who were discharged from the ED.ResultsOut of 133,126 admissions, 59,994 (45.0%) were hospitalized for short term. Patients in the short hospitalization group were younger and had fewer comorbidities. The highest rate of short hospitalization was recorded during night shifts (58.4%) and the rate of short hospitalization was associated with the ED daily patient load (r = 0.35, p < 0.001). The likelihood of having a short hospitalization was most prominent in patients with suicide attempt (80.0% of those admitted for this complaint had a short hospitalization), followed by hypertension (68.6%). However, these complaints accounted for only 0.7% of the total number of short hospitalizations. Cardiac and neurological complaints however, made up 27.4% of the short hospitalizations. The 30-days mortality rate was 7.0% in the non-short hospitalization group, 4.3% in the short hospitalization group and 0.9% in those who were discharged from the ED.ConclusionsShort hospitalizations in medical wards have special characteristics that may render them predictable. Increasing the rate of treating personnel per patient during peak hours and referring subsets of patients with cardiac and neurological complaints to ED-associated short term observation units may decrease short admissions to medical departments.

Land use transformations in the Brazilian Savanna: A decade of soil erosion and runoff measurements

Changes in land cover and land use (LULC) are one of the main drivers of erosion and runoff. How ever, most research has relied on short-term observations and only focused on one or two land cover types. We investigated the long-term trade-off between common agricultural land covers (sugarcane, pasture, and soybean), runoff, and soil loss rates. We compared these to native forest (wooded Cerrado) and bare soil. The field observations were done in 100 m2 experimental plots in Brazil maintained during the past 10 years. The paper provides three main contributions: (1) long-term runoff and soil loss rates of plots under different LULCs, (2) comparison of runoff, soil loss, and pedological characteristics between plots constructed 10 years apart, and (3) analysis of the trade-off between different LULCs. When ranking land covers based on runoff and soil loss rates, there is a shift in ranking positions, making it difficult to determine which one is more environmentally harmful. However, it is evident that whatever agricultural practice is used, there is a significant impact when compared to native forest. For example, the area converted to pasture resulted in almost 20 times higher runoff, while conversion to sugarcane resulted in 5 times higher soil loss. Not only land cover plays a major influencing factor, but also weathering exposing time. Areas under the same land cover and environmental conditions had different rates of soil loss and runoff due to long-term exposure effects such as soil crusting. Our findings have high relevance for the hydrological and agricultural community by demonstrating (i) the magnitude of trade-off in terms of soil loss and runoff due to land cover changes and (ii) that soil loss should not be assumed to be a linear process over time, as it is commonly assumed.

Evaluation of the efficiency of rehabilitation interventions in patients after unilateral biportal endoscopic discectomy

Background. Unilateral bi-portal endoscopic discectomy (UBED), as other surgical methods of treatment, may require the use of additional rehabilitation interventions in the recovery process of patients. Unfortunately, studies on the effectiveness of nonpharmacological methods in the postoperative period for these patients are insufficient. The study purposed to evaluate the effectiveness of a rehabilitation intervention program in the patients who have undergone UBED. Materials and methods. The study was conducted at the Department of Neurosurgery of the Spine and Spinal Cord of the Ivano-Frankivsk Regional Clinical Hospital in 2022–2023. The sample consisted of the main group (MG, n = 74) — patients who underwent removal of the hernia of the intervertebral disc used UBED and complex rehabilitation and control group (CG, n = 68) — UBED was performed without a rehabilitation course. Study methods: we used visual-analogue scale (VAS) and Oswestry questionnaire before surgery and after it (in 1 day and 1, 6 and 12 months). Results. In the preoperative period, the back pain index was 5.3 ± 1.4 and 5.6 ± 1.1 cm in MG and CG, respectively. In the postoperative period the back pain index according to the VAS decreased to 1.5 ± 0.4 cm in one day after surgery in the MG with its positive dynamics during the year of observation. In CG this index also decreased to 1.4 ± 0.9 cm with a gradual improvement to 0.3 ± 0.1 cm in 12 months. At the 12 months after the surgery the Oswestry index demonstrated that quality of life was better in the subjects of MG compared to the CG (5.4 ± 3.2 and 17.4 ± 3.3 %, respectively). Conclusions. The use of physical ­exercises in combination with massage and hardware physiotherapy in patients who have UBED improved the quality of life of the patients in the long-term observation period, but did not affect the reduction of pain after the surgery in both short-term and long-term observation

The surgical interval between robot-assisted SEEG and epilepsy resection surgery is an influencing factor of SSI

BackgroundIn recent years, the development of robotic neurosurgery has brought many benefits to patients, but there are few studies on the occurrence of surgical site infection (SSI) after robot-assisted stereoelectroencephalography (SEEG). The purpose of this study was to collect relevant data from robot-assisted SEEG over the past ten years and to analyze the influencing factors and economic burden of surgical site infection.MethodsBasic and surgical information was collected for all patients who underwent robot-assisted SEEG from January 2014 to December 2023. Logistic regression was used to analyze the factors influencing SSI according to different subgroups (radiofrequency thermocoagulation or epilepsy resection surgery).ResultsA total of 242 subjects were included in this study. The risk of SSI in the epilepsy resection surgery group (18.1%) was 3.5 times greater than that in the radiofrequency thermocoagulation group (5.1%) (OR 3.49, 95% CI 1.39 to 9.05); this difference was statistically significant. SSI rates in the epilepsy resection surgery group were associated with shorter surgical intervals (≤ 9 days) and higher BMI (≥ 23 kg/m2) (6.1 and 5.2 times greater than those in the control group, respectively). Hypertension and admission to the intensive care unit (ICU) were risk factors for SSI in the radiofrequency thermocoagulation group. Patients with SSIs had $21,231 more total hospital costs, a 7-day longer hospital stay, and an 8-day longer postoperative hospital stay than patients without SSI.ConclusionsThe incidence of SSI in patients undergoing epilepsy resection after stereoelectroencephalography was higher than that in patients undergoing radiofrequency thermocoagulation. For patients undergoing epilepsy resection surgery, prolonging the interval between stereoelectroencephalography and epilepsy resection surgery can reduce the risk of SSI; At the same time, for patients receiving radiofrequency thermocoagulation treatment, it is not recommended to enter the ICU for short-term observation if the condition permits.

Impacts and Correlations on Corneal Biomechanics, Corneal Optical Density and Intraocular Pressure after Cataract Surgery.

The study aimed to investigate the extended effects and interrelations of corneal biomechanics, corneal optical density (COD), corneal thickness (CT), and intraocular pressure (IOP) following cataract surgery. Sixteen eyes were analyzed prospectively. The Corneal Visualization Scheimpflug Technology (Corvis ST) device assessed corneal biomechanics, while the Pentacam AxL® (Pentacam) measured COD and CT. Postoperative data were collected around six months after surgery, with a subgroup analysis of data at nine months. The Pearson correlation was used to examine the relationship between surgical-induced changes in corneal biomechanics and COD. At six months, significant postoperative differences were observed in various biomechanical indices, including uncorrected IOP (IOPuct) and biomechanics-corrected IOP (bIOP). However, many indices lost statistical significance by the nine-month mark, suggesting the reversibility of postoperative corneal changes. Postoperative COD increased at the anterior layer of the 2-6 mm annulus and incision site. The changes in COD correlated with certain biomechanical indices, including maximal (Max) deformative amplitude (DA) and stiffness parameter (SP). In conclusion, despite significant immediate postoperative changes, corneal biomechanics, COD, and IOP experienced a gradual recovery process following cataract surgery. Clinicians should maintain vigilance for any unusual changes during the short-term observation period to detect abnormalities early.

Short-term time-series observations of phytoplankton light-absorption and productivity in Prydz Bay, coastal Antarctica

The optical characteristics of coastal Antarctic waters exhibit complexity due to the dynamic hydrography influenced by meltwater intrusion, which alters nutrient levels, thermohaline structure, and optically active substances (OAS) regimes. Studies on bio-optical variability and its implications on phytoplankton productivity (PP) are scanty in coastal polar regions. On this backdrop, time-series measurements (72 h at 6 h intervals) of bio-optical properties such as phytoplankton biomass (chlorophyll-a), absorption (aph), and total suspended matter (TSM) concurrently with PP were measured to understand their interplay and variability in relation to the ambient physicochemical settings in the under-sampled Prydz Bay, coastal Antarctica. Our findings revealed thermohaline stratification within the bay, likely attributed to the inflow of less saline meltwater from nearby glaciers and minimal wind activity. The consistent presence of sub-surface chlorophyll maximum (SCM) beneath the stratified layer underscored the light-acclimatization response of shade-adapted phytoplankton. Surface waters exhibited higher TSM compared to deeper layers, indicating glacial melt influence, while the depth of the sunlit layer remained relatively stable, suggesting limited water mass movement and/or variability in OAS at the study site. An inverse relation between chlorophyll-a and chlorophyll-a-specific phytoplankton light absorption (a*ph(λ)) manifested ‘pigment package effect’ within the prevailing phytoplankton community, implying reduced light-absorption efficiency and consequent lower PP. Compared to chlorophyll-a, the phytoplankton light absorption (aph(λ)) emerged as a better proxy for explaining PP variability. Nutrient availability was not limiting, which was conducive to micro (large) phytoplankton growth. Classification of phytoplankton size classes (micro, nano, and pico) based on the B/R ratio (aph at Blue (443 nm)/Red (676 nm) region) confirmed the dominance of larger (micro) phytoplankton that are more susceptible to package effect, thus have implications on reduced PP potential of this polar marine ecosystem.

Using Trastuzumab Deruxtecan to treat advanced metastatic breast cancer in patients with varying HER2 expression levels: A single-center experience in Taiwan.

To observe the clinical outcomes of patients diagnosed with metastatic breast cancer undergoing Trastuzumab Deruxtecan (T-DXd) therapy in a real-world setting. The study retrospectively reviewed and collected medical data from 13 patients at Shin Kong Wu Ho-Su Memorial Hospital who underwent T-DXd treatment over a period from April 2022 to June 2023. Demographics, pathological characteristics, treatment patterns, and outcomes were descriptively analyzed. Thirteen patients diagnosed with metastatic breast cancer underwent T-DXd treatment between April 2022 and June 2023. This study observed that T-DXd was effective in patients with high human epidermal growth factor receptor 2 (HER2) levels. In patients with low HER2, the majority also experienced favorable responses. Only 2 patients exhibited poor or no response: one was a BRCA2 carrier with unmanageable disease progression, and the other had a HER2 1 + status with multiorgan metastases whose cancer was not controlled by T-DXd. Additionally, 2 patients with no HER2 expression responded well to T-DXd treatment. T-DXd is a valuable treatment alternative for patients with breast cancer, including those with HER2-high, HER2-low, and HER2-negative statuses. In this study, the majority of patients experienced positive therapeutic effects. However, this evaluation relied on a limited sample size and short-term observations. Additional studies involving larger and more diverse patient groups and long follow-up durations are required.

Impact of HIV coinfection on tuberculosis treatment outcomes in Ethiopia: a systematic review and meta-analysis

ObjectivesDespite the implementation of a short-term direct observation treatment programme, HIV coinfection is one of the main determinants of tuberculosis (TB) treatment success. This meta-analysis was conducted to report the...

Evaluation of masticatory muscle function in the treatment dynamics of patients with myofascial pain syndrome

Relevance. Myofascial pain syndrome (MPS) often progresses to a chronic form that is challenging to treat with established methods. This issue is well known to dentists and frequently leads to frustration despite significant efforts to advance knowledge in the fields of etiopathogenesis, diagnosis, and therapy. Most treatment protocols focus on normalizing physiological parameters, such as restoring masticatory function, achieving stable occlusal relationships, alleviating pain, and enhancing the psychological well-being of these patients. Therefore, the need for non-invasive diagnostics to assess functional activity and monitor the condition of masticatory muscles during treatment is crucial. This study aims to address this need.Materials and methods. The examination and treatment of 64 patients with myofascial pain syndrome were conducted in two stages—clinical and electromyographic. During the clinical examination, tenderness of the masticatory muscles during palpation and the degree of mouth opening were assessed. The electromyographic research was also conducted in two stages. The first stage assessed the average amplitude and total biopotential of the masticatory and temporal muscles on both the right and left sides. The second stage evaluated the symmetry index of the masticatory muscles, as well as torsion and masseter indices. The first group received conventional treatment combined with laser therapy, while the second group received ozone therapy and kinesiology taping in addition to the conventional therapy.Results. In the short-term observations over 14 days, both groups achieved positive results. However, patients undergoing ozone therapy and kinesiology taping showed statistically significant improvements in their parameters by the third day of observation compared to their baseline values.Conclusion. For diagnosing this pathology, it is advisable to incorporate electromyography into the examination protocol to allow non-invasive evaluation of the functional activity of the masticatory muscles. For treating myofascial pain syndrome, minimally invasive methods with anti-inflammatory, analgesic, and muscle relaxant effects are recommended. While all treatment methods yielded favorable results, ozone therapy combined with kinesiology taping effectively eliminated both subjective and objective symptoms in this patient category.

Chinese expert consensus on radiofrequency therapy for gastroesophageal reflux disease 2024

ObjectiveRadiofrequency (RF) therapy is a minimally invasive procedure used to treat gastroesophageal reflux disease (GERD). During the procedure, electrodes are meticulously inserted into the lower esophageal sphincter and cardiac muscle through a gastroscope. By applying heat at various layers and sites around the gastroesophageal junction, the treatment intends to augment the junction's pressure and reduce tissue compliance. This process may also desensitize the esophagus, thereby preventing reflux and relieving symptoms. RF therapy boasts a high success rate and a low risk of adverse effects, making it an increasingly popular choice. However, there is a lack of consensus regarding its indications, contraindications, and the evaluation processes for pre- and postoperative care. To enhance the precision of patient selection and the technical execution of RF therapy, it is imperative to consolidate and standardize its clinical application in China. This will ensure the therapy's safety and efficacy are optimized. MethodsBetween December 2022 and April 2024, a group of 25 Chinese endoscopists, each with experience in over 50 radiotherapy procedures, engaged in six rounds of consensus discussions. The discussions focused on several key aspects of the procedure. During these discussions, each item was put to a vote among the experts. A consensus was reached when an item received agreement from at least 80 ​% of the participants. ResultsThe expert group, comprising 25 specialists from 22 different institutions, had an average experience of over 50 RF procedures. These experts engaged in comprehensive discussions on a total of eight critical items, covering the full spectrum of the procedure, including indications, contraindications, basic working conditions and preparation, preoperative preparation, surgical process and technical skills, postoperative management, therapeutic effects, complications and prevention. The group successfully reached a consensus on all these items, ensuring a standardized approach to RF procedures. ConclusionThis consensus summarized and standardized the clinical application of anti-reflux RF therapy in China. Adoption of this consensus will improve the precision of patient selection and technical implementation, thereby enhancing the safety and effectiveness of anti-reflux radiofrequency therapy.

Computer-aided design and 3D printing for a stable construction of segmental bone defect model in Beagles: a short term observation

ObjectiveSegmental bone defect animal studies require stable fixation which is a continuous experimental challenge. Large animal models are comparable to the human bone, but with obvious drawbacks of housing and costs. Our study aims to utilize CAD and 3D printing in the construction of a stable and reproducible segmental bone defect animal mode.MethodsCAD-aided 3D printed surgical instruments were incorporated into the construction of the animal model through preoperative surgical emulation. 20 3D printed femurs were divided into either experimental group using 3D surgical instruments or control group. In Vitro surgical time and accuracy of fixation were analysed and compared between the two groups. A mature surgical plan using the surgical instruments was then utilized in the construction of 3 segmental bone defect Beagle models in vivo. The Beagles were postoperatively assessed through limb function and imaging at 1, 2 and 3 months postoperatively.ResultsIn vitro experiments showed a significant reduction in surgical time from 40.6 ± 14.1 (23–68 min) to 26 ± 4.6 (19–36 min) (n = 10, p < 0.05) and the accuracy of intramedullary fixation placement increased from 71.6 ± 23.6 (33.3–100) % to 98.3 ± 5.37 (83–100) %, (n = 30, p < 0.05) with the use of CAD and 3D printed instruments. All Beagles were load-bearing within 1 week, and postoperative radiographs showed no evidence of implant failure.ConclusionIncorporation of CAD and 3D printing significantly increases stability, while reducing the surgical time in the construction of the animal model, significantly affecting the success of the segmental bone defect model in Beagles.

New rat model of spinal cord infarction with long-lasting functional disabilities generated by intraspinal injection of endothelin-1

BackgroundThe current method for generating an animal model of spinal cord (SC) infarction is highly invasive and permits only short-term observation, typically limited to 28 days.ObjectiveWe aimed to establish a...

Hepatic artery infusion chemotherapy (HAIC) combined with tislelizumab and lenvatinib for initial unresectable hepatocellular carcinoma (HCC) with portal vein tumor thrombus: A prospective, single-arm phase II trial.

4103 Background: The combination of immune checkpoint blockade and multikinase inhibitor has been proven to improve clinical outcomes of advanced HCC. Hepatic arterial infusion chemotherapy is an intra-arterial procedure that has been widely used in Asia, with high response rate. The aim of this trial was to evaluate the efficacy and safety of HAIC combined with tislelizumab and lenvatinib for initial unresectable HCC with portal vein tumor thrombus (PVTT). Methods: This is a prospective, single-arm phase II study. Patients with histologically or cytologically diagnosed or clinically confirmed hepatocellular carcinoma and accompanied by PVTT, no previous systemic treatment were eligible for inclusion. Patients received HAIC(FOLOFOX), combined with intravenous tislelizumab (200mg, q3w) and lenvatinib (8/12mg, qd) for six cycles, followed by maintenance therapy with tislelizumab and lenvatinib until disease progression or unacceptable toxicity. The primary endpoint was objective response rate (ORR) per RECIST 1.1 and mRECIST. Results: Between Sep, 2021 to Nov, 2023, a total of 29 eligible patients were enrolled and evaluable for efficacy analyses: median age 54 years (M/F:25/4; CNLC stage IIIa/IIIb: 24/ 5). Portal vein tumor thrombus PVTT Ⅰ-Ⅱ/PVTT Ⅲ-Ⅳ:19/10. An average of 4.35 times of HAIC were underwent in these patients. With a median follow-up of 11 months (interquartile range [IQR] 7.5-21.5), the confirmed ORR was 68.97% (95%CI 49.19-84.72)and 58.62%(95%CI 38.94-76.48)per mRECIST and RECIST v1.1, respectively. The disease control rate (DCR) according to mRECIST and RECIST v1.1 were both 93.10% (95%CI 77.23-99.15). Median progression-free survival (PFS) was 15 months (95%CI 10-22). Median overall survival (OS) was not reached. 7(24.1%) patients became eligible for surgical resection. 1 of them received surgical resection and was confirmed as pathological CR; 6 of them refused surgical treatment and received tislelizumab and lenvatinib treatment continuously. 27(93.1%) patients had mild treatment related adverse events (TRAEs) (grade 0-2). Common TRAEs included hypoproteinemia (93.10%), abdominal pain (72.41%), nausea (68.97%) and leukopenia (65.52%). There were no deaths due to TRAEs. Conclusions: HAIC (FOLOFOX) combined with tislelizumab and lenvatinib afforded promising efficacy and safety in tumor control in patients with advanced HCC with PVTT in short-term observation and an eligible surgical conversion rate was observed. Clinical trial information: CHiCTR2100051717.

Ecological problems of the plant cover of the northeastern slope of Great Caucasus (within Azerbaijan)

Highlight the purpose. Plant cover of our republic, especially forest ecosystems, has lost its original state as a result of the influence of natural and anthropogenic factors. The study of the impact of these factors on biodiversity has been the focus of many experts. The settlement of the studied area since ancient times and the good development of agriculture have caused the degradation and erosion of the forest cover that covers large areas, as well as the vegetation that replaces each other in the altitude zones here. For this reason, the issues of protection and protection of vegetation are distinguished by their relevance. The main goal of our research is to protect the vegetation of forests that have changed their initial state. Objectives. Mountain geosystems of the northeastern slope of the Greater Caucasus are bordered by the Russian Federation to the north, northwest, and west, the Samur-Devachi plain to the east, and the watershed line of the Greater Caucasus Range and Atachay to the south and southeast. Methods. Field studies were organized to solve the issues raised during the research period. Short-term visual observations of the existing geoecological conditions were carried out, from topographic maps and other maps (landscape, vegetation, etc.) of various scales, as well as from 1:25000 scale aerial and space images in the fund of the Institute of Ecology of MAKA, “Google” and “Bing” space images with a resolution of 1 meter in the funds, taken in the visible zone of the spectrum, obtained from various satellites in 2020-2023 and based on the application of SASPlanet, ArcGIS processing programs were used. With the help of these materials, the vegetation degradation and erosion processes of the research area were studied. Results. The northeast part of the Great Caucasus differs from the other mountainous regions for its appropriation features. For a long time appropriation of the investigated zone by the various farming areas caused a serious change in the natural geosystems. Thus, the zones where a hypsometric height of 200-500 m are mainly replaced by agro-complexes, the parts within 500-1800 m turned into a life and rest objects together with the arable and pastures, an irregular use from the summer pastures in cattle-breeding in the zones higher than 1800 m was completed by exposing of the plant cover to transformation. During assimilation, activation of ecological problems like decreased plant productivity, intensification of the erosion process, acceleration of degradation, and so on activates a problem of rational use. Defining importance, sensitiveness of plant cover, and rational use ways as protection, refusal of usage, extensive use of protection, development, extensive use, improvement, and development were determined.

Design and Development of a Quality Evaluation and Monitoring System for the Short-term Weather Forecast in Gansu Province

In order to further improve the development of the meteorological observation quality management system in Gansu Province, this article takes the organic integration of quality management and meteorological observation as the concept, and combines practical business applications to develop a scoring model to quantitatively evaluate the quality of short-term warning signals and observation data transmission in Gansu Province. At the same time, a visual model is developed to achieve a personalized monitoring and analysis system for the entire process of “monitoring warning service”. System users can monitor the actual situation of various meteorological disasters, analyze disasters, and assess risks in the system, and display and apply decision information, thereby improving the scientific and standardized level of meteorological observation business management.

Unraveling the Major Determinants behind Price Changes in Four Selected Representative Agricultural Products

This study aims to analyze the drivers behind price changes in agricultural products in Türkiye from 2002 to 2021, considering the impacts of three crises of different causes which are the global food crisis, the Russia–Türkiye aircraft crisis, and the COVID-19 pandemic. The potential factors are categorized into four subgroups: governmental effects, agricultural inputs, macroeconomic indicators, and climatic conditions. The selected agricultural goods for price change measurement include wheat and maize representing subsistence goods, and olive oil and cotton as marketing goods. The autoregressive distributed lag (ARDL) model is applied to observe both the short- and long-term impacts of the variables on price developments. The results suggest that government effectiveness, regulatory quality, nitrogen use, water price, money supply, exchange rate, and GDP under the related categories are the most effective factors in price changes. Among the variables under the category of climatic conditions, significant values are obtained only in the analysis of the temperature impact on olive oil. The analysis also reveals the variable impact of crises on the prices of the chosen products, depending on the goods involved. The maize and wheat analyses yield particularly noteworthy results. In the long run, nitrogen use demonstrates a substantial positive impact, registering at 29% for wheat and 19.47% for maize, respectively. Conversely, GDP exhibits a significant negative impact, with 26.15% and 20.08%. Short-term observations reveal that a unit increase in the governmental effect leads to a reduction in inflation for these products by 17.01% and 21.42%. However, changes in regulatory quality result in an increase in inflation by 25.45% and 20.77% for these products, respectively.

Subtle Radiographic Progression at Six Months Can Be Detected Using Automated Quantitative Software in Rheumatoid Arthritis While Receiving Tocilizumab.

We investigated whether our in-house software equipped with partial image phase-only correlation (PIPOC) can detect subtle radiographic joint space narrowing (JSN) progression at six months and predict JSN progression in rheumatoid arthritis (RA) patients receiving Tocilizumab. The study included 39 RA patients who were treated with Tocilizumab. Radiological progression of the metacarpophalangeal and the proximal interphalangeal joints was evaluated according to the Genant-modified Sharp score (GSS) at 0, 6, and 12 months. Automatic measurements were performed with the software. We validated the software in terms of accuracy in detecting the JSN progression. The success rate of the software for joint space width (JSW) measurement was 96.8% (449/464). The 0-12-month JSW change by the software was significantly greater in joints with the 0-6-month PIPOC (+) group than the 0-6-month PIPOC (-) group (p < 0.001). The 0-12-month JSW change by the software was 0-12-month GSS (+) than with 0-12-month GSS (-) (p = 0.02). Here, "(+)" indicates the JSN progression during the follow-up period. Meanwhile, "(-)" indicates no JSN progression during the follow-up period. Linear regression tests showed significant correlations between the 0-6-month and the 0-12-month PIPOC in the left 2nd and 3rd MCP joints (R2 = 0.554 and 0.420, respectively). Our in-house software equipped with PIPOC could predict subsequent JSN progression with only short-term observations.

Safety and Efficacy of VIT against Wasp Venom in Ultra-Rush Protocols in Patients Older Than 60 Years.

Allergen immunotherapy remains a widely recognized and widely used method for the treatment of selected allergic diseases. Currently, according to the European Academy Of Allergy and Clinical Immunology (EAACI) guidelines, venom immunotherapy (VIT) may be considered for patients over 60. Nevertheless, no separate studies have confirmed the efficacy and safety of this therapy. This study aimed to evaluate the short-term effectiveness of VIT against wasp allergens in an ultra-rush protocol for older patients compared to young patients. Among the 113 patients included in this study, 51 were older than 60 years (Group A), and 62 formed the control "young group" (age range: 18-35 years). All patients were desensitized to wasp venom using the ultra-rush protocol according to Muller and aqueous solutions of vaccines containing wasp venom. A basophil activation test (Basotest, Orpegen Pharma, Germany) and intracutaneous tests with dilutions of wasp allergen and specific IgE to extract wasp venom were performed at the start and after six months of VIT. The safety of VIT was assessed on the basis of the international Mueller scale. One hundred and eleven patients with confirmed wasp allergies completed six months of VIT: 51 participants over 60 years of age (Group A) and 60 young people (Group B). No systemic adverse reactions were observed during the VIT induction phase. However, large local reactions were noted in 17% of older patients and 20% of young patients at a similar level (p > 0.05). During maintenance VIT, two mild grade I systemic reactions were confirmed in young patients. These symptoms resolved spontaneously. There were no such reactions in older patients. The effectiveness of VIT was tested using BAT. There was a statistically significant reduction in CD63 reactivity in 86% of patients in Group A, and a comparable and substantial decrease in 84% of young patients in Group B. According to the BAT test, the mean reductions in the area under the curve (AUC) after six months of VIT were significant (p < 0.05) and comparable between Groups A and B: -6.52 vs. 7.21. VIT against wasp venom is safe and effective in short-term observation, and is comparable to that used for young patients.

Understanding the key determinants of Fiji's renewable energy

In this research, we reassess the interplay between renewable energy consumption and key economic indicators in Fiji, using data spanning 1991 to 2020. Applying the ARDL bounds test for cointegration, we detect a long-run correlation among renewable energy use, service sector labor productivity, urbanization, ICT exports, and unemployment. Our analysis reveals significant long-term effects: higher labor productivity and unemployment rates encourage renewable energy consumption, whereas urbanization and ICT exports tend to decrease it. At the same time, short-term observations indicate that unemployment is negatively correlated with renewable energy adoption. Our study contributes fresh perspectives on sustainable growth amidst climate change for island countries like Fiji.

Community Based Tourism: A Global South Perspective

The analysis of the impact of Community Based Tourism (CBT) has revealed a significant divergence in assessments. This paper aims to analyse the factors contributing to the observed "Duality Dilemma" in CBT projects. The research seeks to leave behind a simplistic binary perspective that categorises CBT solely as either beneficial or problematic. The paper identifies three key variables contributing to this dual perspective: a) the Context Variable, which displays how the outcomes of CBT projects m can vary based on the specific circumstances in which they are implemented; b) the Methodological Variable, which underlines the importance of developing long-term and longitudinal fieldwork to avoid a biased analysis based on the short-term observations; c) the Paradigm Variable which takes into account that the researcher's theoretical framework inevitably shapes their focus, potentially emphasising certain outcomes over others. Finally, the paper draws on empirical evidence based on a 30-year longitudinal ethnographic study conducted on Amantaní island (Lake Titicaca, Peruvian Andes)