Periodontal therapy for hopeless mandibular anterior teeth: a retrospective case report with a multidisciplinary approach and a 20-year follow-up

Introduction: This case report presents the intentional periodontal maintenance of two periodontal hopeless lower central incisors with a multidisciplinary approach and 20-year follow-up. Case presentation: A 36-year-old male, in 2001, was diagnosed with aggressive periodontitis, gingival swelling, bleeding, and mandibular central incisors with mobility and poor prognosis. Following periodontal therapy (phase I), root canal treatment, and occlusal adjustment, #31 and #41 were gently extracted to remove the granulation tissues, calculus, and infected cementum from the root surface. Then, tetracycline-HCl was applied for 5 minutes on the root surfaces. The teeth were repositioned into the sockets and splinted with a lingual bar. At 3 months, the bar was removed, and a free gingival autogenous graft was done to improve the local keratinized tissue width. Mobility scores, pocket depths, and clinical attachment levels were recorded, and radiographs were taken at 1, 5, and 20 years. The 5-year follow-up showed that the teeth were clinically and radiographically in function. There was a reduction in probing depth and a gain in clinical attachment and radiographic alveolar bone levels. After 20 years, #41 was stable, but #31 had external root resorption, leading to a new treatment plan (dental implants) and extraction. Conclusion: The clinical result of this case was satisfactory for 20 years. Intentional periodontal maintenance of the teeth may be an alternative treatment, even considering the high level of complexity.

A methodological framework for estimating ambient PM2.5 particulate matter concentrations in the UK.

Scientific evidence sustains PM2.5 particles' inhalation may generate harmful impacts on human beings' health; therefore, their monitoring in ambient air is of paramount relevance in terms of public health. Due to the limited number of fixed stations within the air quality monitoring networks, development of methodological frameworks to model ambient air PM2.5 particles is primordial to providing additional information on PM2.5 exposure and its trends. In this sense, this work aims to offer a global easily-applicable tool to estimate ambient air PM2.5 as a function of meteorological conditions using a multivariate analysis. Daily PM2.5 data measured by 84 fixed monitoring stations and meteorological data from ERA5 (ECMWF Reanalysis v5) reanalysis daily based data between 2000 and 2021 across the United Kingdom were attended to develop the suggested approach. Data from January 2017 to December 2020 were employed to build a mathematical expression that related the dependent variable (PM2.5) to predictor ones (sea-level pressure, planetary boundary layer height, temperature, precipitation, wind direction and speed), while 2021 data tested the model. Evaluation indicators evidenced a good performance of model (maximum values of RMSE, MAE and MAPE: 1.80 µg/m3, 3.24 µg/m3, and 20.63%, respectively), compiling the current legislation's requirements for modelling ambient air PM2.5 concentrations. A retrospective analysis of meteorological features allowed estimating ambient air PM2.5 concentrations from 2000 to 2021. The highest PM2.5 concentrations relapsed in the Mid- and Southlands, while Northlands sustained the lowest concentrations.

Quantitative impacts of meteorology and emissions on the long-term trend of O3 in the Yangtze River Delta (YRD), China from 2015 to 2022.

Extensive spatiotemporal analyses of long-trend surface ozone in the Yangtze River Delta (YRD) region and its meteorology-related and emission-related have not been systematically analyzed. In this study, by using 8-year-long (2015-2022) surface ozone observation data, we attempted to reveal the variation of multiple timescale components using the Kolmogorov-Zurbenko filter, and the effects of meteorology and emissions were quantitatively isolated using multiple linear regression with meteorological variables. The results showed that the short-term, seasonal, and long-term components accounted for daily maximum 8-hr average O3 (O3-8 hr) concentration, 46.4%, 45.9%, and 1.0%, respectively. The meteorological impacts account for an average of 71.8% of O3-8 hr, and the YRD's eastern and northern sections are meteorology-sensitive areas. Based on statistical analysis technology with empirical orthogonal function, the contribution of meteorology, local emission, and transport in the long-term component of O3-8 hr were 0.21%, 0.12%, and 0.6%, respectively. The spatiotemporal analysis indicated that a distinct decreasing spatial pattern could be observed from coastal cities towards the northwest, influenced by the monsoon and synoptic conditions. The central urban agglomeration north and south of the YRD was particularly susceptible to local pollution. Among the cities studied, Shanghai, Anqing, and Xuancheng, located at similar latitudes, were significantly impacted by atmospheric transmission-the contribution of Shanghai, the maximum accounting for 3.6%.

Exceeding the guideline-recommended maximum daily dose of opioids for long-term treatment of non-cancer pain in Germany - a large retrospective observational study.

BACKGROUND: High-dose long-term opioid therapy (LTOT) has been associated with increased mortality and hospitalizations. Therefore, the evidence-based German guideline on LTOT for chronic non-cancer pain (CNCP) recommends to only exceed the maximum daily dose (MDD) of opioids in exceptional cases. This study aimed to determine the portion of LTOT patients who exceeded the guideline-recommended MDD and identify predictors of exceeding in administrative claims data. METHODS: The retrospective observational analysis of opioid prescriptions in patients receiving LTOT for CNCP was based on administrative claims by a large German statutory health insurance company. Patients with at least two quarters of opioid prescriptions between January 2018 and June 2019 were included and followed up for two years. Predictors were identified by logistic regression. In addition, the number of patients still in opioid therapy and the extent of exceeded MDDs were analyzed over time. RESULTS: The sample consisted of 113,475 patients. Overall, 10.5% of the patients exceeded the guideline-recommended MDD averaged over the observation period. Strong predictors for exceeding the MDD were receiving opioid prescriptions from > 7 physicians (OR = 7.66, p < .001), receiving predominantly strong opioids (OR = 6.79, p < .001) and receiving opioids for at least one year prior to inclusion (OR = 5.35, p < .001). Within the non-exceeding group, 28.1% discontinued opioid therapy. In contrast, 9.9% of patients in the exceeding group discontinued opioid therapy, whereas the vast majority remained on treatment until the end of the observation period. Furthermore, a slight increase in prescribed doses was observed over time. CONCLUSIONS: The results indicate that a moderate proportion of patients exceeded the guideline-recommended MDD. However, certain patient groups were more likely to receive high doses. This applied in particular to those who were already on treatment at the time of inclusion and continued to receive opioids until the end of the observation period. Further research should examine whether the continuous opioid therapy among the patients with exceeding the guideline-recommended MDD might be related to specific indications, a lack of therapeutic options or avoidance of withdrawal. TRIAL REGISTRATION: German Clinical Trials Register (drks.de/search/en). Identifier: DRKS00024854. Registered 28 April 2021.

Functional dependence following intensive care unit-treated sepsis: three-year follow-up results from the prospective Mid-German Sepsis Cohort (MSC).

Background: Surviving sepsis can lead to chronic physical, psychological and cognitive impairments, which affect millions of patients worldwide, including survivors after COVID-19 viral sepsis. We aimed to characterize the magnitude and trajectory of functional dependence and new impairments post-sepsis. Methods: We conducted a prospective cohort study including sepsis survivors who had been discharged from five German intensive care units (ICUs), until 36 months post-discharge. Primary outcome was functional dependence, defined as ≥1 impaired activity of daily living (ADL; 10-item ADL score <100), self-reported nursing care dependence or nursing care level. Secondary outcome was post-sepsis morbidity in the physical, psychological or cognitive domain. We used a multistate, competing risk model to address competing events in the course of dependence, and conducted multiple linear regression analyses to identify predictors associated with the ADL score. Findings: Of 3210 sepsis patients screened, 1968 survived the ICU treatment (61.3%). A total of 753 were included in the follow-up assessments of the Mid-German Sepsis cohort. Patients had a median age of 65 (Q1-Q3 56-74) years, 64.8% (488/753) were male and 76.1% (573/753) had a septic shock. Considering competing risk modelling, the probability of still being functional dependent was about 25%, while about 30% regained functional independence and 45% died within the three years post-sepsis. Patients reported a high burden of new and often overlapping impairments until three years post-sepsis. In the subgroup of three-year survivors (n = 330), new physical impairments affected 91.2% (n = 301) while new cognitive and psychological impairments were reported by 57.9% (n = 191) and 40.9% (n = 135), respectively. Patients with pre-existing functional limitations and higher age were at risk for low ADL scores three years after sepsis. Interpretation: Sepsis survivorship was associated with a broad range of new impairments and led to functional dependence in around one quarter of patients. Targeted measures are needed to mitigate the burden of this Post-Sepsis-Syndrome and increase the proportion of patients that achieve functional improvements. Funding: This work was supported by the Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC) at the Jena University Hospital funded by the German Ministry of Education and Research and by the Rudolf Presl GmbH & Co, Kreischa, Germany.

Keeping Students with Long-term Conditions Connected with Schools: Facilitators for Sustainable Virtual Connections.

Students with Long-Term Conditions (LTCs) experience prolonged absences that can impact their school connectedness and belonging. Inclusive education policies in New Zealand advocate for equitable learning opportunities for students with disabilities. Students with LTCs are included under this purview, but responses to their unique learning and connectedness needs are not well articulated. Literature suggests the potential of technology to enable virtual connections to keep these students' continued presence and engagement in class (i.e., sustainable connections). Studies internationally and in New Zealand, argue that virtual connections with schools can enhance educational opportunities and a sense of belonging for students with LTCs. However, limited research is available on developing and nurturing such ongoing connections with schools. This article reports on a qualitative study investigating New Zealand stakeholder perspectives on the facilitators of virtual connection with schools for students with LTCs. Findings from a thematic analysis of 18 individual interviews with stakeholders highlighted six facilitators for virtually connecting these students with schools, indicating the need for a flexible approach tailored to students' needs, strong support systems and purposeful, safe and inclusive connection opportunities. The stakeholders indicated these facilitators as essential for the virtual school connections to be sustainable and enhance students with LTCs' presence, belonging and social connection in schools.

Adult day services: a potential antidote to social isolation and loneliness in marginalized older adults.

Loneliness and social isolation affect more than 1 in 4 community-dwelling older adults in the United States, who may also require long-term care support. Despite being seen as a solution to the long-term care crisis, most older adults prefer to age in place rather than using skilled nursing facilities. However, in-home care is unsustainable due to a shortage of direct care workers and may exacerbate social isolation by confining older adults to their homes. Adult Day Services (ADS) addresses both issues. ADS provides care to adults with physical, functional, and or cognitive limitations in non-residential, congregate, community-based settings. ADS also provides daily cognitive and physical stimulation, often with medical support, in a social and supported environment, centered around the needs and preferences of participants. Before the COVID-19 pandemic, nearly 5,000 ADS centers were widely available. However, with limited public support, the ADS industry has struggled as demand by the growing number of older adults and families need health and social support. The ADS industry must be recognized for its unique ability to buffer social isolation and loneliness in chronically ill older adults while serving as an effective platform for chronic disease management. This perspective piece highlights the critical role of ADS centers in reducing loneliness and social isolation and promoting healthy equity. We also explore the benefits of ADS, the financial, policy, and societal barriers to utilizing ADS, and the potential solutions to ensure its sustainability and growth.

Dementia-focused programs in older adult centers and health care use among individuals with dementia.

There is growing attention to community-based services for preventing adverse health care outcomes among people aging with dementia. We explored whether the availability of dementia-centered programming within older adult centers (ie, senior centers)-specifically, adult day services (ADS), social adult day centers (SADCs), memory cafes, and caregiver support-is associated with reduced hospitalization, emergency room use, and total Medicare costs for community-dwelling individuals ages 75 and older with Alzheimer's disease and related dementias (ADRD), and whether associations differ by the relative size of the local jurisdiction. We used a novel dataset that links Medicare claims data with data from an organizational census of municipally based Massachusetts older adult centers. Living in a community with an older adult center that facilitates access to ADS and/or SADCs was associated with reduced hospital utilization and costs among residents in smaller jurisdictions. We found no evidence for associations concerning memory cafes or support groups. These findings underscore the potential of older adult centers in curbing health care costs and acute care usage among individuals with ADRD, particularly in smaller communities with centers that provide access to ADS.

Integrating Residents' Rights and Infection Prevention in Nursing Homes: Summary of the Infection Control Advocate and Resident Education (ICARE) Learning Modules Pilot for Long-term Care Ombudsmen, Residents, and Other Nursing Home Advocates.

The Infection Control Advocate and Resident Education (ICARE) educational modules integrate and promote infection prevention and control (IPC) measures and residents' rights in nursing homes, targeting long-term care ombudsmen, residents, families, and other resident advocates. Survey respondents (N=102) reported increased knowledge in understanding IPC and preserving resident rights. Integrating these topics and identifying barriers to promoting IPC is necessary for implementing quality IPC in nursing homes.

Clinical and Sociodemographic Characteristics of New Residents of Assisted Living: A Nested Case-Control Study.

OBJECTIVE: To examine transitions to an assisted living facility among community-dwelling older adults who received publicly funded home care services. DESIGN: Nested case-control study. SETTING AND PARTICIPANTS: Linked, population-level health system administrative data were obtained from adults aged 65 years and older who received home care services in Ontario, Canada, from April 1, 2018, to December 31, 2019. New residents of assisted living were matched on age, sex, and initiation date of home care ( ± 7 days) to community-dwelling home care recipients in a 1:4 ratio. METHODS: Clinical and functional status, health service use, sociodemographic variables, and community-level characteristics were examined; conditional logistic regression was used to model associations with a transition to an assisted living facility. RESULTS: There were 2427 new residents of assisted living who were matched to 9708 home care recipients (mean [SD] age 85.5 [6.02] years, 72% female). Most of the new residents were concentrated in urban communities and communities with higher income quintiles. New residents had an increased rate of physician-diagnosed dementia (adjusted hazard ratio [aHR], 1.28; 95% CI, 1.14-1.43), mood disorders (aHR, 1.17; 95% CI, 1.05-1.29), and cardiac arrhythmias (aHR, 1.19; 95% CI, 1.07-1.32). They also had higher rates of mild cognitive impairment (aHR, 1.43; 95% CI, 1.24-1.66), 2 or more falls (aHR, 1.29; 95% CI, 1.11-1.51), participation in activities of long-standing interest in the past 7 days (aHR, 1.29; 95% CI, 1.11-1.50), and a lower rate of a spouse or partner unpaid caregiver vs a child (aHR, 0.66; 95% CI, 0.56-0.79). CONCLUSIONS AND IMPLICATIONS: New residents of assisted living were mostly women, were cognitively impaired, had clinical comorbidities that could increase their risk of injuries, and had caregivers who were their children. These findings stress the importance of upscaling memory and dementia care in assisted living to address the needs of this population.

Conceptual masking disrupts change-detection performance.

The present study investigated the effects of long-term knowledge on backward masking interference in visual working memory (VWM) by varying the similarity of mask stimuli along categorical dimensions. To-be-remembered items and masks were taken from categories controlled for perceptual distinctiveness and distinctiveness in kinds (e.g., there are many kinds of cars and few kinds of coffee mugs). Participants completed a change-detection task in which the memory array consisted of exemplars from either a similar or distinctive category, followed by a mask array of items from the same category (conceptually similar versus conceptually distinct categories), a different category, or no mask. The results over two experiments showed greater interference from conceptually similar masks as compared with the other conditions across stimulus onset asynchrony (SOA) conditions, suggesting masking with conceptually similar categories leads to more interference even when masks are shown well after the stimulus. These results have important implications for both the nature and time course of long-term conceptual knowledge influencing VWM, particularly when using complex real-world objects.

Long-Term Outcomes of Diastasis Recti Abdominis in Postpartum Women: A Retrospective Cohort Study.

INTRODUCTION AND HYPOTHESIS: The objective was to investigate whether diastasis recti abdominis (DRA) can cause adverse outcomes for different long-term postpartum women. METHODS: We recruited 437 long-term postpartum women at five different time points (3, 5, 10, 20, and 30 years postpartum respectively). Inter-recti distance (IRD) and linea alba or umbilical hernia were measured by ultrasound. Strength of abdominal muscle was measured by a manual muscle test. Low back pain (LBP), urinary incontinence (UI) and quality of life (QOL) were measured by questionnaires including the Oswestry Disability Index, the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form, 36-Item Short Form Health Survey respectively. RESULTS: Women with DRA experienced more severe LBP, and poorer QOL only 10 years postpartum according to the diagnostic criterion of IRD > 2cm. However, when the diagnostic criterion was raised to IRD > 3cm, women with DRA reported weaker abdominal muscle strength, more severe LBP 3, 5, and 10 years postpartum, poorer QOL 3, 5, 10, and 20 years postpartum, and higher incidence of linea alba or umbilical hernia 5 and 20 years postpartum. CONCLUSIONS: When using IRD > 2cm as the diagnostic criterion, the impact of DRA is minimal. However, when utilizing IRD > 3cm as the diagnostic criterion, DRA is associated with increased linea alba or umbilical hernia, weakened abdominal muscle strength, increased LBP, and decreased QOL. Most of the effects are particularly evident within 3-10 years postpartum, but becomes insignificant 20 and 30 years postpartum. Therefore, it is necessary to consider whether the diagnostic criterion of DRA need to be improved.

Steroid pulse therapy in idiopathic nephrotic syndrome in the era of modern immunosuppressive treatment-still up to date?

BACKGROUND: Intravenous steroid pulses (SP) are successfully used for the treatment of patients with idiopathic nephrotic syndrome (INS) resistant to oral prednisone. METHODS: We performed a retrospective analysis of all patients in the three pediatric nephrology centers of the Paris region from 2002 to 2022 who were resistant to a 30-day course of oral prednisone and who received SP for their first INS flare and analyzed their disease course over 4 years. RESULTS: Forty-seven patients (17 girls), median age 3.4 years, were analyzed. Of them, 68% reached remission within 7 days of SP. No significant short-term side effects were noted. Half of the patients started immunosuppressive treatment immediately after their first remission and 62% of them relapsed at least once, whereas all the patients who did not receive immunosuppressive treatment since their first remission relapsed. Among the SP-sensitive patients, 75% needed calcineurin inhibitor (CNI) or B-cell depletion during their disease course to achieve stable remission. Forty-two percent of the whole cohort received B-cell-depleting agents. Among the 15 SP-resistant patients, all received CNI. Twelve/fifteen patients reached remission. After 4 years, 68% among the SP-sensitive patients and 87% of SP-resistant patients still had an active disease. CONCLUSIONS: SP are helpful to obtain rapid remission in pediatric INS patients resistant to oral steroids. However, as most SP-sensitive patients need immunosuppressive drugs, mainly CNI and B-cell-depleting agents it could be interesting to discuss the possibility to start CNI directly after the 30-day course of prednisone instead of SP.

Assessing the cost-effectiveness of replacing antimetabolites with mTOR inhibitors in heart transplant immunosuppression in China: a network meta-analysis-based economic evaluation.

BACKGROUND: Although several pharmacoeconomic studies have assessed the cost-effectiveness of maintenance immunosuppressive regimens for heart transplant recipients, economic comparisons between various combination drug therapies remain sparse. AIM: This study used an economic evaluation based on network meta-analysis to assess the cost-effectiveness of four immunosuppressive regimens for adult heart transplant recipients in China. METHOD: We conducted a systematic search for clinical trials in PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Data, and VIP database. A validated Markov model was adapted to reflect the Chinese medical landscape. Four maintenance immunosuppression regimens were considered: tacrolimus/mycophenolate mofetil (TAC/MMF), cyclosporine/mycophenolate mofetil (CSA/MMF), everolimus/cyclosporine (EVL/CSA), and sirolimus/tacrolimus (SRL/TAC). The probabilities of health events were derived from a comprehensive literature review. Direct medical costs, adjusted for 2022 values, were from public documents and websites, while utilities for quality-adjusted life-years (QALYs) were taken from previous studies. Primary outcomes were mean lifetime cost, QALYs, and cost-effectiveness, with a willingness-to-pay (WTP) threshold set at three times China's GDP per capita in 2022. Sensitivity analyses were conducted to test the robustness of the results. RESULTS: The base case analysis identified TAC/MMF as the most cost-effective regimen, producing a mean of 6.31 QALYs per patient at a cost of Chinese Yuan (CNY) 534,182.89. Sensitivity analyses consistently reinforced TAC/MMF as the most cost-effective and robust choice. CONCLUSION: TAC/MMF is the most cost-effective maintenance immunosuppressive regimen for heart transplant recipients within the Chinese health system. The study findings are reinforced by sensitivity analyses, affirming their robustness amid various uncertainties.

Can long-term care insurance prevent worsening of frailty among older Chinese adults? A difference-in-differences study based on CHARLS data.

Frailty, which is accompanied by negative health outcomes associated with aging, is an increasingly serious public health problem. Long-term care insurance (LTCI) is an effective intervention for frailty in older adults, but few studies have linked LTCI to frailty prevention. This study aimed to determine the role of LTCI in preventing worsening of frailty in older adults. This study used five-wave panel data from the China Health and Retirement Longitudinal Study (CHARLS) 2011 to 2020 to construct an indicator system to assess the frailty index (FI) of surveyed older adults and used a difference-in-differences (DID) method to assess the policy effect of LTCI on frailty among older adults. We found that the full-sample mean of the FI of older adults in China was 0.196, and the implementation of LTCI had a significant negative effect on the FI of older adults. The effect was heterogeneous across sex, age, education and medical insurance groups. LTCI had a more significant negative effect on male group, the middle-aged group, the less educated group, and the URRBMI group, while the effect was less significant for the female and the UEBMI group, and not significant for the more educated and other age groups. That is to say, older Chinese adults are generally frail to different degrees, and the implementation of a LTCI system can prevent worsening of frailty among them, but the effect is not equal across populations. The institutional coverage of LTCI should be further strengthened in the future to slow down the frailty process of the enrollees, so as to promote healthy aging.

Endoscopic Outcomes Before and Five Years After Laparoscopic Sleeve Gastrectomy: Is There a Significant Impact?

Laparoscopic sleeve gastrectomy (LSG) is a popular bariatric procedure with significant effects on weight and metabolic health. However, its impact on gastroesophageal reflux disease (GERD) and esophageal symptoms remains debated. This study aims to evaluate the endoscopic changes five years post-LSG. We conducted a retrospective analysis of patients who underwent LSG at our center between June 2017 and June 2019. Inclusion criteria included preoperative and at least five-year follow-up esophagogastroduodenoscopy (EGD). We analyzed demographic factors, esophageal symptoms, and endoscopic findings. Out of 118 patients who underwent LSG, 24 met the inclusion criteria. Two patients were excluded due to conversion to Roux-en-Y gastric bypass (RYGB). The final cohort included 22 patients with a mean age of 42 ± 10 years and a mean BMI of 45 ± 7 kg/m². Preoperative EGD showed no GERD in 21 patients (95.5%) and GERD in 1 patient (4.5%). At five-year follow-up, 14 patients (63.6%) had no GERD, 7 (31.8%) had GERD A, and 1 (4.5%) had GERD B. Esophageal symptoms included heartburn (54.5%), nausea (36.4%), regurgitation (31.8%), and epigastric pain (22.7%). PPI or antacid use was reported in 10 patients (45.5%). Extra-esophageal symptoms were rare. BMI was significantly higher in patients with GERD (34.5 ± 6.3 kg/m²) compared to those without GERD (30.2 ± 5.1 kg/m², p = 0.04). LSG may lead to the development or worsening of GERD in a subset of patients, despite the majority showing no significant GERD changes over five years. Continuous monitoring and tailored management strategies are essential for optimizing outcomes.

Ongoing and emerging issues for residential long-term care in the context of Covid-19.

Background: Long-term care facilities have been confronted with various workforce challenges, including a poor image within the nursing profession, a shortage of staff, and a growing demand for long-term care. Furthermore, these facilities have been significantly impacted by the pandemic and the respective measures with detrimental effects on residents, staff, and their family members. Aim: This study explored issues in working in residential long-term care from the perspective of nurses and their perception on amplifying and additional effects of Covid-19. Methods: It applied a qualitative design focusing on experiences and views of 25 LTC nurses working in Austrian long term care facilities during the pandemic. Data were collected by conducting in-depth interviews either virtually or in presence. The data analysis was conducted by applying a thematic analysis. Results: The four identified themes are: (1) Work motivation, (2) Dealing with vulnerability, (3) Human Resource Planning and (4) External view on long-term care. For each theme it was delineated which aspects have been present in the pre-Covid-19 situation and which became more visible or arose additionally. Conclusions: Nurturing connection between LTC nurses and with residents and relatives as well as signaling the positive aspects of LTC such as relationships, challenge and responsibility may allow to tackle Human Resource Planning issues.

The effect of traumatic brain injury on learning and memory: A synaptic focus.

Deficits in learning and memory are some of the most commonly reported symptoms following a traumatic brain injury (TBI). We will examine whether the neural basis of these deficits stems from alterations to bidirectional synaptic plasticity within the hippocampus. Although the CA1 subregion of the hippocampus has been a focus of TBI research, the dentate gyrus should also be given attention as it exhibits a unique ability for adult neurogenesis, a process highly susceptible to TBI-induced damage. This review examines our current understanding of how TBI results in deficits in synaptic plasticity, as well as how TBI-induced changes in endocannabinoid (eCB) systems may drive these changes. Through the synthesis and amalgamation of existing data, we propose a possible mechanism for eCB-mediated recovery in synaptic plasticity deficits. This hypothesis is based on the plausible roles of CB1 receptors in regulating inhibitory tone, influencing astrocytes and microglia, and modulating glutamate release. Dysregulation of the eCBs may be responsible for deficits in synaptic plasticity and learning following TBI. Taken together, the existing evidence indicates eCBs may contribute to TBI manifestation, pathogenesis, and recovery, but it also suggests there may be a therapeutic role for the eCB system in TBI.

Long-term arsenic exposure decreases mice body weight and liver lipid droplets.

Arsenic (As) is a widespread global pollutant, and there is significant controversy surrounding its complex relationship with obesity, primarily focused on short-term exposure. Recognizing the prolonged nature of dietary arsenic exposure, this study involved feeding mice with arsenic-contained food for 14 months. The results showed that mice exposed to arsenic developed a non-alcoholic fatty liver condition, characterized by a light-yellow hue on the liver surface and various pathological alterations in the liver cells, including enlarged nuclei, cellular necrosis, inflammatory infiltration, dysfunctional mitochondria, and endoplasmic reticulum disorganization. There were also disruptions in biochemistry indices, with a significant increase in total cholesterol (TC) level and a decrease in high-density lipoprotein (HDL) level. However, some contradictory observations occurred, such as a significant decrease in body weight, triglyceride (TG) level, and the numbers of lipid droplets. Several genes related to lipid metabolism were tested, and a model was used to explain these discrepancies. Besides, examinations of the colon revealed compromised intestinal barrier function and signs of inflammation. Fecal 16S rRNA sequencing and pseudo-targeted metabolomics revealed disruptions in internal homeostasis, such as modules, nodes, connections, and lipid-related KEGG pathways. Fecal targeted metabolomics analyses of short-chain fatty acids (SCFAs) and bile acids (BAs) demonstrated a significant upregulation in three primary bile acids (CA, CDCA, TCDCA), four secondary bile acids (TUDCA, DCA, LCA, GUDCA), and total SCFAs level. Oxidative stress and inflammation were also evident. Additionally, based on correlation analysis and mediation analysis, it was assumed that changes in the microbiota (e.g., Dubosiella) can impact the liver metabolites (e.g., TGs) through alterations in fecal metabolites (e.g., LPCs). These findings provide a theoretical reference for the long-term effect of arsenic exposure on liver lipid metabolism.

Did H.M. exhibit accelerated long-term forgetting? Measuring forgetting in amnesia.

The early investigations of patient H.M. inaugurated the modern era of memory research. During the 1970s and 1980s, a key debate over whether H.M. with bilateral medial temporal lobe lesions exhibited accelerated long-term forgetting attracted an increasing interest in forgetting research among amnestic patients. Huppert and Piercy (1979) examined H.M.'s performance in visual recognition at 10-minute, 1-day, and 7-day intervals and suggested that H.M. was subjected to rapid forgetting compared with Korsakoff patients and healthy participants reported in Huppert and Piercy (1978). In contrast, Freed et al. (1987) employed the same experimental paradigm and concluded that forgetting rates in H.M. did not differ from those in healthy controls. These incompatible findings highlighted a methodological challenge in measuring forgetting in the cross-group comparison design, where closely equalising the initial performance between patient and control groups is usually suggested. The re-analysis in this viewpoint, using both linear- and nonlinear-based modelling, reconciled the discrepancy between the aforementioned studies. Our results indicated that the rate of forgetting in H.M. did not differ from that in healthy controls, regardless of whether the initial performance was closely matched. Here, we suggest that the cross-group comparisons in forgetting studies do not necessarily seek a perfect match in initial performance unless the risks of confounding encoding and retrieval processes can be effectively controlled.