Very high plant stanol intake and serum plant stanols and non-cholesterol sterols

Background  

Today, consumers meet abundant supply of functional foods with plant stanol increments for serum cholesterol lowering purposes. However, efficacy and safety of plant stanols intake beyond 4 g/day have remained unexplored.     

Memory-based detection of rare sound feature combinations in anesthetized rats

It is unclear whether the ability of the brain to discriminate rare from frequently repeated combinations of sound features is limited to the normal sleep/wake cycle. We recorded epidural auditory event-related potentials in urethane-anesthetized rats presented with rare tones ('deviants') interspersed with frequently repeated ones ('standards'). Deviants differed from standards either in frequency alone or in frequency combined with intensity. In both cases, deviants elicited event-related potentials exceeding in amplitude event-related potentials to standards between 76 and 108 ms from the stimulus onset, suggesting the independence of the underlying integrative and memory-based change detection mechanisms of the brain from the normal sleep/wake cycle. The relations of these event-related potentials to mismatch negativity and N1 in humans are addressed.     

Ampicillin versus penicillin in the empiric therapy of extremely low‐birthweight neonates at risk of early onset sepsis

Background: There are no comparative data on the impact of different empiric antibiotic regimens on early bowel colonization as well as on clinical efficacy in extremely low‐birthweight (ELBW) neonates at risk of early onset sepsis (EOS). Methods: A subgroup analysis was carried out of ELBW neonates recruited into a two‐center, prospective, cluster randomized study comparing ampicillin and penicillin both combined with gentamicin, within the first 72 h of life. A composite primary end‐point (need for change of antibiotics within 72 h and/or 7 day all‐cause mortality) and the rate and duration of colonization by opportunistic aerobic microorganisms were assessed using hierarchical models corrected for study center and period. Results: In the ampicillin (n= 36) and penicillin (n= 39) groups change of antibiotics, 7 day mortality and the composite end‐point occurred at similar rates. Neonatal intensive care unit mortality for infants with gestational age <26 weeks was lower in the ampicillin group. Ampicillin treatment was associated with a higher colonization rate by Klebsiella pneumoniae, including ampicillin‐resistant strains. Conclusion: Preliminary data indicate an urgent need for adequately powered studies of early antibiotic therapy in the subpopulation of ELBW neonates at risk of EOS.     

Post-exercise heart rate variability of endurance athletes after different high-intensity exercise interventions

Methodological problems have limited the number of studies on heart rate variability (HRV) dynamics immediately after exercise. We used the short-time Fourier transform method to study immediate (5 min) and slow (30 min) recovery of HRV after different high-intensity exercise interventions. Eight male athletes performed two interval interventions at 85% and 93% (IV₈₅ and IV₉₃) and two continuous interventions at 80% and 85% (CO₈₀ and CO₈₅) of the velocity at VO_2max (vVO_2max). We found no increase in high frequency power (HFP), but low frequency (LFP) and total power (TP) increased ( P <0.05) during the first 5 min of the recovery after each intervention. During the 30-min recovery, HFP, LFP and TP (1) increased slowly toward resting values, but HFP remained lower ( P <0.01) than at rest, (2) were lower ( P <0.05) after IV₉₃ and CO₈₅ when compared with IV₈₅ and CO₈₀, respectively and (3) were lower ( P <0.01) after CO₈₅ when compared with IV₈₅. HRV recovery was detected during the immediate recovery after interventions. Increased exercise intensity resulted in lower HRV both in interval and in continuous interventions. In addition, when interval and continuous interventions were performed at a similar workload, HRV was lower after continuous intervention.     

Determinants for preventive oral health care need among community‐dwelling older people: a population‐based study

The aim was to study the determinants of preventive oral health care need among community‐dwelling old people. The study population consisted of 165 participants, a subpopulation in the Geriatric Multidisciplinary Strategy for Good Care of Elderly People (GeMS) study. Fifty‐five percent of the edentate participants with full dentures and 82% of the dentate had a need for preventive oral health care. In the total study population, the need for preventive care was associated with co‐morbidity (measured by means of the Modified Functional Co‐morbidity Index) odds ratios (OR) 1.2 (confidence intervals [CI] 1.0–1.5), being pre‐frail or frail, OR 2.5 (CI 1.2–5.1), presence of natural teeth, OR 4.8 (CI 2.2–10.4), and among dentate participants, the use of a removable partial denture, OR 12.8 (CI 1.4–114.4). Primary care clinicians should be aware of the high need for preventive care and the importance of nonoral conditions as determinants of preventive oral health care need.     

Competition and quality in a physiotherapy market with fixed prices

Our study focuses on competition and quality in physiotherapy organized and regulated by the Social Insurance Institution of Finland (Kela). We first derive a hypothesis with a theoretical model and then perform empirical analyses of the data. Within the physiotherapy market, prices are regulated by Kela, and after registration eligible firms are accepted to join a pool of firms from which patients choose service providers based on their individual preferences. By using 2SLS estimation techniques, we analyzed the relationship among quality, competition and regulated price. According to the results, competition has a statistically significant (yet weak) negative effect (p = 0.019) on quality. The outcome for quality is likely caused by imperfect information. It seems that Kela has provided too little information for patients about the quality of the service.     

Optimizing bevacizumab dosing in glioblastoma: less is more

Medulloblastoma is the most common form of brain malignancy of childhood. The mainstay of epidemiological data regarding childhood medulloblastoma is derived from case series, hence population-based studies are warranted to improve the accuracy of survival estimates. To utilize a big-data approach to update survival estimates in a contemporary cohort of children with medulloblastoma. We performed a population-based retrospective observational cohort study utilizing the Surveillance, Epidemiology, and End Results Program database that captures all children, less than 20 years of age, between 1973 and 2012 in 18 geographical regions representing 28% of the US population. We included all participants with a presumed or histologically diagnosis of medulloblastoma. The main outcome of interest is survivors at 1, 5 and 10 years following diagnosis. A cohort of 1735 children with a median (interquartile range) age at diagnosis of 7 (4–11) years, with a diagnosis of medulloblastoma were identified. The incidence and prevalence of pediatric medulloblastoma has remained stable over the past 4 decades. There is a critical time point at 1990 when the overall survival has drastically improved. In the contemporary cohort (1990 onwards), the percentage of participants alive was 86, 70 and 63% at 1, 5 and 10 years, respectively. Multivariate Cox-Regression model demonstrated Radiation (HR 0.37; 95% CI 0.30–0.46, p?<?0.001) and Surgery (HR 0.42; 95% CI 0.30–0.58, p?<?0.001) independently predict survival. The probability of mortality from a neurological cause is <5% in patients who are alive 8 years following diagnosis. The SEER cohort analysis demonstrates significant improvements in pediatric medulloblastoma survival. In contrast to previous reports, the majority of patients survive in the modern era, and those alive 8 years following initial diagnosis are likely a long-term survivor. The importance of minimizing treatment-related toxicity is increasingly apparent given the likelihood of long-term survival.