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The remission rate in children with Graves' disease (GD) after 2-6 years of antithyroid drug (ATD) treatment is 40-50%. It has been reported that it is difficult to predict the GD prognosis based on the TSH receptor antibody (TRAb) level at the cessation of ATD treatment. We studied whether the persistence of negative TRAb at ATD treatment cessation increased the remission rate in pediatric patients with GD.

We included 22 patients diagnosed with GD who discontinued ATD treatment after confirmation of negative TRAb on two or more consecutive tests. Remission was defined as the maintenance of normal thyroid function, including serum TSH level, with negative TRAb more than 2 years after ATD discontinuation.

Of the 22 patients, 12 achieved remission (remission rate 54.5%), with no significant between-group difference in the median duration of ATD treatment in the remission and relapse groups (4.4 vs 3.9 years). Of the 10 patients who relapsed, 4 (40.0%) relapsed within 2 years after ATD discontinuation, and 4 (40.0%) relapsed more than 5 years after ATD discontinuation.

The persistence of negative TRAb at ATD treatment cessation might indicate prolonged duration of remission but does not increase the final remission rate in patients with childhood-onset GD.

The persistence of negative TRAb at ATD treatment cessation might indicate prolonged duration of remission but does not increase the final remission rate in patients with childhood-onset GD.Absence of dissolved oxygen (anoxia) in the hypolimnion of lakes can eliminate habitat for sensitive species and may induce the release of sediment-bound phosphorus. Lake anoxia generally results from decomposition of organic matter, which is exacerbated by high nutrient loads. https://www.selleckchem.com/products/danicopan.html Total phosphorus (TP) in lakes is regulated by static aspects of the lake's watershed, but lake TP can be readily increased by human activities. In some low-nutrient lakes, basin morphometry may induce naturally occurring anoxia. The occurrence of natural anoxia is especially important to consider in lake water quality assessments that compare observed conditions to expected reference conditions. To investigate the occurrence of natural vs. anthropogenically influenced anoxia, we constructed a logistic regression model to calculate the probability of low-nutrient lakes (TP less then 15 µg/L) developing aerial anoxic extent ≥10% by testing the predictive potential of variables related to basin morphometry, depths of lake thermal stratbut lake morphometry and stratification dynamics are the most important factors in the development of anoxic extent in low-nutrient temperate lakes. Our approach informs studies concerned with identifying key factors that influence regime shifts in a variety of ecosystems.

There is increasing evidence for oxytocin as a neurotransmitter in spinal nociceptive processes. Hypothalamic oxytocinergic neurons project to the spinal dorsal horn, where they activate GABA-ergic inhibitory interneurons. The present study tested whether the long-acting oxytocin-analogue carbetocin has anti-nociceptive effects in multi-modal experimental pain in humans.

Twenty-five male volunteers received carbetocin 100 mcg and placebo (0.9% NaCl) on two different sessions in a randomized, double-blinded, cross-over design. Multi-modal quantitative sensory testing (QST) including a model of capsaicin-induced hyperalgesia and allodynia were performed at baseline and at 10, 60 and 120min after drug administration. QST data were analysed using mixed linear and logistic regression models. Carbetocin plasma concentrations and oxytocin receptor genotypes were quantified and assessed in an exploratory fashion.

An anti-nociceptive effect of carbetocin was observed on intramuscular electrical temporal summation (estimated difference 1.26mA, 95% CI 1.01 to 1.56mA, p=.04) and single-stimulus electrical pain thresholds (estimated difference 1.21mA, 95% CI 1.0 to 1.47mA, p=.05). Furthermore, the area of capsaicin-induced allodynia was reduced after carbetocin compared to placebo (estimated difference -6.5 cm

, 95% CI -9.8 to -3.2 cm

, p<.001).

This study provides evidence of an anti-nociceptive effect of carbetocin on experimental pain in humans.

This study provides evidence of the anti-nociceptive effect of intravenous administration of the oxytocin agonist carbetocin in healthy male volunteers.

This study provides evidence of the anti-nociceptive effect of intravenous administration of the oxytocin agonist carbetocin in healthy male volunteers.

In-hospital cardiac arrest is a medical emergency that occurs on a regular basis. As patients most at risk for an in-hospital cardiac arrest are usually positioned on a dynamic mattress, it is important to measure the effect of mattress compressibility on chest compression quality during cardiopulmonary resuscitation (CPR). High-quality CPR is essential for patient survival and good neurological outcome.

To examine the effect of an inflated dynamic overlay mattress on chest compression quality during CPR and to explore the predictive effect of health care providers' anthropometric factors, hand positioning and mattress type on chest compression frequency and depth.

Manikin-based single-blinded randomised controlled trial.

Nursing students (N = 70) were randomised to a control (viscoelastic foam mattress) or intervention group (inflated dynamic overlay mattress on top of a viscoelastic foam mattress) and had to perform chest compressions over a 2-minute period. Compression rate, depth and hand positionattention must be paid to correct hand positioning during CPR.The impact of shifting disturbance regimes on soil carbon (C) storage is a key uncertainty in global change research. Wildfires in coniferous forests are becoming more frequent in many regions, potentially causing large C emissions. Repeated low-intensity prescribed fires can mitigate wildfire severity, but repeated combustion may decrease soil C unless compensatory responses stabilize soil organic matter. Here, we tested how 30 years of decadal prescribed burning affected C and nitrogen (N) in plants, detritus, and soils in coniferous forests in the Sierra Nevada mountains, USA. Tree basal area and litter stocks were resilient to fire, but fire reduced forest floor C by 77% (-36.4 Mg C/ha). In mineral soils, fire reduced C that was free from minerals by 41% (-4.4 Mg C/ha) but not C associated with minerals, and only in depths ≤ 5 cm. Fire also transformed the properties of remaining mineral soil organic matter by increasing the proportion of C in a pyrogenic form (from 3.2% to 7.5%) and associated with minerals (from 46% to 58%), suggesting the remaining soil C is more resistant to decomposition.