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Anatomy of Free Flap.Failures: Dissection of a Series

Modern p.astic Surgery 2013年第3期3卷 89-95页

作者： steven p. davison Mark W. Clemens Andrew L. Kochuba Dep.rtment of p.astic Surgery Georgetown University Hospital Washington DC USA

Introduction: Free flap.success rates have remained stable in recent years ranging 93% to 98%. Historically, the causes of free flap.failures were attributed to the surgeon’s inexp.rience and technique. However, there are factors beyond the surgical anastomosis that contribute to flap.failure. The p.rp.se of this study is to review each case of total flap.loss in detail to develop.a better understanding of comp.ications. Methods: A retrosp.ctive study was p.rformed over eleven years in a single surgeon’s p.actice, a p.edominantly head and neck reconstructive p.actice. All charts were indep.ndently reviewed. In p.tients who sustained total flap.loss, a review was conducted of p.tient comorbidites, anesthesia records, p.riop.rative and follow-up.notes. Results: A total of 514 free flap. were p.rformed. 76% (392) of these flap. were for head and neck reconstruction. There were 22 total flap.losses (4%) and 26 p.rtial flap.losses (5%). Of the 22 total flap.losses, four flap. were avulsed, five flap. were in p.tients later found to have coagulation disorders (homozygous mutations of the MTHFR gene and factor V Leiden), four p.tients were exp.sed to neosynep.rine, two p.tients remained hyp.tensive p.riop.ratively, and four delayed flap.losses were attributed to p.eudomonal infection. Five losses were technical or related to flap.inexp.rience. Several rep.esentative case scenarios are illustrated. Conclusion: Careful review of free flap.failures indicates that a thorough workup.(p.rticularly coagulation disorders), flap.selection, surgeon to anesthesia communication, p.op.r securing of the flap. and p.stop.rative p.tient blood p.essure and infection control have a greater p.rt to p.ay in this new era of anastomotic success.

关键词： Free Flap. Flap Loss Head and Neck Reconstruction Coagulop.thy MTHFR Factor V Leiden

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Relational and Euclidean Temp.ral Sp.ce

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Journal of Ap.lied Mathematics and p.ysics 2024年第2期12卷 683-719页

作者： steven D. p. Moore Indep.ndent Researcher Milton Canada

In mathematics, sp.ce encomp.sses various structured sets such as Euclidean, metric, or vector sp.ce. This article introduces temp.ral sp.ce—a novel concep. indep.ndent of traditional sp.tial dimensions and frames of reference, accommodating multip.e object-oriented durations in a dynamical system. The novelty of building temp.ral sp.ce using finite geometry is rooted in recent advancements in the theory of relationalism which utilizes Euclidean geometry, set theory, dimensional analysis, and a causal signal system. Multip.e indep.ndent and co-existing cyclic durations are measurable as a network of finite one-dimensional timelines. The work aligns with Leibniz’s comments on relational measures of duration with the addition of using discrete cyclic relational events that define these finite temp.ral sp.ces, ap.licable to quantum and classical p.ysics. Ancient formulas have symmetry along with divisional and subdivisional orders of op.rations that create discrete and ordered temp.ral geometric elements. Elements have cyclically conserved symmetry but unique cyclic dimensional quantities ap.licable for anchoring temp.ral equivalence relations in linear time. We p.esent both fixed equivalences and exp.nded p.riods of temp.ral sp.ce offering a non-Greek calendar methodology consistent with ancient global timekeep.ng descrip.ions. Novel ap.lications of Euclid’s division algorithm and Cantor’s p.iring function introduce a novel p.ired function equation. The mathematical descrip.ion of finite temp.ral sp.ce within relationalism theory offers an alternative discrete geometric methodology for examining ancient timekeep.ng with new hyp.theses for Egyp.ian calendars.

关键词： Relationalism p.iring Function Equation Discrete Euclidean Timelines Ancient Timekeep.ng

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Multip.e interface coup.ing on natural tourmaline enables high-efficiency removal of antibiotic:Sup.rior p.op.rty and mechanism

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Journal of Environmental Sciences 2024年第6期140卷 242-254页

作者： Jingjing Cui Xiangyu Liu Feifan Qie Chengzhe Xie Qingdong He Jian Liu steven L.Suib Wenbo Wang College of Chemistry and Chemical Engineering Inner Mongolia UniversityHohhot 010021China Dep.rtment of Chemistry University of ConnecticutStorrsCT 06269-3060United States

Reasonably designing highly active,environmentally friendly,and cost-effective catalysts for efficient elimination of p.llutants from water is desirable but ***,an efficient heterogeneous p.oto-Fenton catalyst tourmaline(TM)/tungsten oxide(WO_(3-x))(named TW10)containing tungsten/boron/iron(W/B/Fe)synergistic active centers and 90%of cheap.natural tourmaline(TM)mineral rich in Fe and B *** TW10 catalyst can quickly activate p.roxymonosulfate(p.S)to generate massive active free radicals,which may induce the rap.d and efficient degradation of tetracycline(TC).The TW10/p.S/Visible light system can effectively degrade up.to 98.7%of tetracycline(TC)in actual waters(***,Yellow River,and Yangtze River water),and the catalytic degradation rates reach 1.65,5.569,and 2.38 times higher than those of TM,WO_(3-x),and commercial p.5(Degussa,Germany),*** addition,the catalyst can be recycled and reused multip.e *** sp.n resonance sp.ctroscop.(Ep.),X-ray p.otoelectron sp.ctroscop.(Xp.),and liquid chromatograp.-mass sp.ctrometer(LC-MS)analyses confirm that the synergistic catalytic effect of W/B/Fe sites on the TW10 catalyst accelerates the electron transfer between Fe(Ⅱ)and Fe(Ⅲ),as well as between W(Ⅴ)and W(Ⅵ),and thus p.omotes the rap.d degradation of *** catalytic reaction mechanism and degradation p.thway of TC were *** work p.ovides a feasible route for the design and develop.ent of new eco-friendly and efficient catalyst.

关键词： Tourmaline(TM) Fenton-like catalyst Tungsten oxide p.roxymonosulfate Antibiotic

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Better renal rep.acement therap. to imp.ove sexual function in female p.tients with end-stage renal disease:A cross-sectional study

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Current Urology 2024年第3期18卷 232-236页

作者： Tjahjodjati Tjahjodjati steven steven Urology Dep.rtment Hasan Sadikin Academic Medical CenterUniversitas PadjadjaranBandungIndonesia

Background Sexual dysfunction is commonly observed in p.tients with end-stage renal disease(ESRD).Sexual dysfunction in correlation with ESRD is associated with p.ysiological and p.ychological p.oblems resulting in low sexual desire,arousal,difficulties in achieving orgasm,and p.in during *** on female sexual dysfunction(FSD)in correlation with renal rep.acement therap. are limited,and p.evious studies rep.rting contradictive results have indicated that the best modality for p.oviding better outcomes(esp.cially on FSD)remains ***,this study aimed to comp.re the sexual function between female p.tients with ESRD who were on continuous ambulatory p.ritoneal dialysis(CAp.)and those on hemodialysis(HD).Materials and methods This study enrolled female p.tients who were randomly selected from the urology and renal division of the Internal Medicine Outp.tient Clinic of our hosp.tal from January 2020 to August 2021 and divided into the following group.:p.edialysis,HD,CAp.,and control *** p.rticip.nts were asked to fill out the Female Sexual Function Index(FSFI)questionnaires,and their data were recorded and analyzed using Grap.p.d p.ism *** Of the 280 p.tients,200 female p.tients were included in this *** rate of FSD(cutoff:26.55)was 42%in the control group.72%in the p.edialysis group.62%in the CAp. group.and 66%the in HD *** control group.had a higher mean score in all p.rameters(p.0.05).The total FSFI mean score indicated no significant difference(p.0.05)between the p.tients on HD and those on CAp.;the mean of each p.int was almost identical excep. for satisfaction,which was higher among p.tients on CAp.(p.0.05).Significant differences in the comp.nents of desire,arousal,orgasm,and satisfaction were observed between the *** p.tients on CAp. had better FSFI scores than the female p.tients with ESRD who were on HD,and the scores of both group. of p.tients were better than those of the p.edialysis group.

关键词： Female sexual dysfunction Chronic kidney disease Continuous ambulatory p.ritoneal dialysis Hemodialysis

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Adding Value to Crop.p.oduction Systems by Integrating Forage Cover Crop.Grazing

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American Journal of p.ant Sciences 2024年第3期15卷 180-192页

作者： Robert B. Mitchell Daren D. Redfearn Kenneth p. Vogel Terry J. Klop.enstein Galen Erickson p. Step.en Baenziger Bruce E. Anderson Mary E. Drewnoski Jay p.rsons steven D. Masterson Marty R. Schmer Virginia L. Jin USDA-ARS Wheat Sorghum and Forage Research Unit University of Nebraska-Lincoln Lincoln NE USA Dep.rtment of Agronomy and Horticulture University of Nebraska-Lincoln Lincoln NE USA Dep.rtment of Animal Science University of Nebraska-Lincoln Lincoln NE USA Dep.rtment of Agricultural Economics University of Nebraska-Lincoln Lincoln NE USA USDA-ARS Agroecosystem Management Research Unit University of Nebraska-Lincoln Lincoln NE USA

In addition to their value as cereal grains, wheat (Triticum aestivum L.) and triticale (× Triticosecale Wittmack) are imp.rtant cool-season annual forages and cover crop.. Yearling steer (Bos taurus) p.rformance was comp.red in the sp.ing following autumn establishment as for age cover crop. after soybean [Glycine max (L.) Merr.] grain harvest. Rep.icated p.stures (0.4 ha) were no-till seeded in three consecutive years into soybean stubble in autumn, fertilized, and grazed the following sp.ing near Ithaca, NE, USA. Each p.sture (n = 3) was continuously stocked in sp.ing with four yearling steers (380 ± 38 kg) for 17, 32, and 28 d in 2005, 2006, and 2007, resp.ctively. In 2005, average daily gain (ADG) for steers grazing triticale exceeded the ADG for wheat by 0.31 kghdp.-1p.dp.-1p.. In 2006, wheat ADG exceeded that for triticale by 0.12 kghdp.-1p.dp.-1p.. In 2007, steers grazing wheat lost weight, while steers grazing triticale gained 0.20 kghdp.-1p.dp.-1p.. Based on the 3-year average animal gains valued at $1.32 kgp.-1p., mean net return ($ hap.-1p. yrp.-1p.) was $62.15 for triticale and $22.55 for wheat. Since these grazed cover crop. p.ovide ecosystem services in addition to forage, grazing could be viewed as a mechanism for recovering costs and adds additional value to the system. Based on this 3-year grazing trial, triticale was sup.rior to wheat and likely will p.ovide the most stable beef yearling p.rformance across years with variable weather for the western Cornbelt USA.

关键词： Cover crop. Soybean Triticale Wheat

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Develop.ent and ap.lication of p.otocatalytic coating for roadside NO_(x) mitigation in Hong Kong

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Chinese Chemical Letters 2024年第3期35卷 153-157页

作者： Xinwei Li p.ngge Wang Shuwen Han Yu Huang Wingkei Ho steven Sai Hang Ho Shun-cheng Lee Meng Wang Dep.rtment of Civil and Environmental Engineering The Hong Kong Polytechnic UniversityHong KongChina State Key Laboratory of Loess and Quaternary Geology(SKLLQG)and Key Laboratory of Aerosol Chemistry and p.ysics Institute of Earth EnvironmentChinese Academy of SciencesXi'an 710061China Dep.rtment of Science and Environmental Studies The Education University of Hong KongHong KongChina Division of Atmosp.eric Sciences Desert Research InstituteRenoNV 89512United States

A facile chemical method for the develop.ent of p.otocatalytic coating p.oducts was p.op.sed based on p.actical ap.lication p.rsp.ctive for the Hong Kong roadside nitrogen oxides(NO_(x))***_(2)-based p.otocatalytic coating p.-C film with crystallized size of around 5–6 nm was synthesized with the p.p.ization of H_(2)O_(2).The p.-C coating p.ssesses a sup.r-hydrop.ilicity surface and is p.oven to have a NO_(x)degradation rate of 46.8%with an op.imum p. level of *** addition,the p.-C coating p.esents a p.omising p.otocatalytic NO_(x)degradation comp.red with other commercially available coating p.oducts and p.5 when ap.lied on two building materials of p.ly-methyl methacrylate(p.MA)and concrete surface.A weather resistance simulation and a 180-day on-site field trial were carried out the attenuation effects of p.otocatalytic coating ap.lied in outdoor *** on ep.demiological estimation and field investigation,hosp.tal admissions for resp.ratory diseases(HARD)and mortality cases(MC)could be reduced with the ap.lication of p.-C coating along the street *** work demonstrates the feasibility of air p.llution control measures for the local roadside NO_(x)using p.otocatalytic technology,offering p.omising health benefits with environmental remediation.

关键词： p.otocatalysis Coating NO_(x) mitigation Hong Kong Roadside

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Ap.lication of sentiment and word frequency analysis of p.ysician review sites to evaluate refractive surgery care

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Advances in Op.thalmology p.actice and Research 2024年第2期4卷 78-83页

作者： Victoria Vought Rita Vought Andrew S.Lee Irene Zhou Mansi Garneni steven A.Greenstein Institute of Op.thalmology and Visual Science Rutgers New Jersey Medical SchoolNewarkNJUSA Washington University School of Medicine St.LouisMOUSA Cornea and Laser Eye Institute TeaneckNJUSA

Background:Online p.ysician reviews increase transp.rency in health care,help.ng p.tients make informed de-cisions about their *** p.ocessing techniques can quantify this data and allow p.oviders to better understand p.tients'exp.riences,p.rsp.ctives,and *** objective of this study was to assess p.tient satisfaction and understand the asp.cts of care that are valued by p.tients seeking refractive care using sentiment and word frequency ***:Written reviews and Star ratings for members of the Refractive Surgery Alliance Society p.acticing in the United States were collected from Healthgrades,a p.p.lar p.ysician rating *** with at least one written review were included in the *** were scored from-1(most negative)to+1(most p.sitive)using Valence Aware Dictionary sEntiment Reasoner(VADER).Reviews were stratified by demograp.ic charac-teristics,namely gender,region,and years in *** frequency analysis was ap.lied to find the most common words and ***:A total of 254 sp.cialists and 3104 reviews were analyzed,with an average of 4.4/5 stars and mean 48 ratings *** p.ysicians had p.sitive reviews(96%,average VADER=0.69).Younger p.ysicians(p.ers(>20 years)(p.0.001).A similar trend was observed in VADER score(0.71 vs 0.69),although not statistically significant(p.0.06).No statistical differences were observed between Stars rating and VADER score by gender(p.0.66,p.0.83)or by geograp.ical region(p.0.74,p.0.07)."Staff"(n=1269),"p.ofessional"(n=631),"office"(n=523),"questions"(n=424),and"friendly"(n=386)were frequently used in reviews,along with p.rases such as"the staff"(n=273)and"my questions"(n=174)."Surgery"(n=719),"staff"(n=576),"p.ocedure"(n=251),"exp.rience"(n=243),and"p.ofessional"(n=240)were the most common words in p.sitive reviews,while"surgery"(n=147),"office"(n=86),"staff"(n=54),"time"(n=47),and"insurance"(

关键词： p.tient sentiment Quality imp.ovement p.ysician reviews

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Calcium/calcimimetic via calcium-sensing recep.or ameliorates cholera toxin-induced secretory diarrhea in mice

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World Journal of Gastroenterology 2024年第3期30卷 268-279页

作者： Lie-Qi Tang Johnathan Fraebel Shi Jin steven p.Winesett Jane Harrell Wen-Han Chang Sam Xianjun Cheng Dep.rtment of p.diatrics University of FloridaGainesvilleFL 32610United States College of Medicine University of FloridaGainesvilleFL 32610United States Ap.lied p.ysiology and Kinesiology University of FloridaGainesvilleFL 32610United States Brain Rehabilitation Research Center Malcom Randall VA Medical CenterGainesvilleFL 32610United States Dep.rtment of Medicine Endocrine Research UnitVeterans Affairs Medical CenterUniversity of CaliforniaSan FranciscoSan FranciscoCA 94121United States Dep.rtment of p.diatric Gastroenterology Hepatologyand NutritionUniversity of Florida Shands Children’s HospitalGainesvilleFL 32608United States

BACKGROUND Enterotoxins p.oduce diarrhea through direct ep.thelial action and indirectly by activating the enteric nervous ***-sensing recep.or(CaSR)inhibits both *** latter has been well documented in vitro but not in *** hyp.thesis to be tested was that activating CaSR inhibits diarrhea in *** To determine whether CaSR agonists ameliorate secretory diarrhea evoked by cholera toxin(CTX)in *** CTX was given orally to C57BL/6 mice to induce *** and calci-mimetic R568 were used to activate *** maximize their local intestinal actions,calcium was administered luminally via oral rehydration solution(ORS),whereas R568 was ap.lied serosally using an intrap.ritoneal *** verify that their actions resulted from the intestine,effects were also examined on Cre-lox intestine-sp.cific CaSR *** outcome was measured biochemically by monitoring changes in fecal Cl-or clinically by assessing stool consistency and weight *** CTX induced secretory diarrhea,as evidenced by increases in fecal Cl-,stool consistency,and weight loss following CTX exp.sure,but did not alter CaSR,neither in content nor in ***,calcium and R568 were each able to ameliorate diarrhea when ap.lied to diseased *** CaSR involvement is suggested by gene knockout exp.riments where the anti-diarrheal actions of R568 were lost in intestinal ep.thelial CaSR knockouts(villinCre/Casrflox/flox)and neuronal CaSR knockouts(nestinCre/Casrflox/flox).CONCLUSION Treatment of acute secretory diarrheas remains a global *** advances in diarrhea research,few have been made in the realm of diarrhea *** therap. has remained the standard of care,although it does not halt the losses of intestinal fluid and ions caused by *** is no cost-effective therap.utic for *** and other studies suggest that adding calcium to ORS or using calcimimetics to activate intestinal CaSR might

关键词： Cholera Enteric nervous system Secretory diarrhea Oral rehydration solution Calcium-sensing recep.or Gene knockout

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Develop.ent,validation,and transp.rtability of several machine-learned,non-exercise-based VO_(2max)p.ediction models for older adults

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Journal of Sp.rt and Health Science 2024年第5期13卷 611-620页

作者： Benjamin T.Schumacher Michael J.LaMonte Andrea Z.LaCroix Eleanor M.Simonsick steven p.Hooker Humberto p.rada Jr. John Bellettiere Arun Kumar Herbert Wertheim School of p.blic Health and Human Longevity Science University of California San DiegoLa JollaCA 92093USA Dep.rtment of Ep.demiology and Environmental Health School of Public Health and Health ProfessionsUniversity at BuffaloState University of New YorkBuffaloNY 14214USA Translational Gerontology Branch Intramural Research ProgramNational Institute on AgingNational Institutes of HealthBaltimoreMD 21225USA College of Health and Human Services San Diego State UniversitySan DiegoCA 92182USA Division of Ep.demiology and Biostatistics School of Public HealthSan Diego State UniversitySan DiegoCA 92182USA University of California San Diego Moores Cancer Center La JollaCA 92093USA Comp.ter Science and Engineering and Halicioglu Data Science Institute University of California San DiegoLa JollaCA 92093USA

Background:There exist few maximal oxygen up.ake(VO_(2max))non-exercise-based p.ediction equations,fewer using machine learning(ML),and none sp.cifically for older *** direct measurement of VO_(2max)is infeasible in large ep.demiologic cohort studies,we sought to develop.validate,comp.re,and assess the transp.rtability of several ML VO_(2max)p.ediction ***:The Baltimore Longitudinal Study of Aging(BLSA)p.rticip.nts with valid VO2_(max)tests were included(n=1080).Least absolute shrinkage and selection op.rator,linear-and tree-boosted extreme gradient boosting,random forest,and sup.ort vector machine(SVM)algorithms were trained to p.edict VO_(2max)*** develop.d these algorithms for:(a)the overall BLSA,(b)by sex,(c)using all BLSA variables,and(d)variables common in aging ***,we quantified the associations between measured and p.edicted VO_(2max)and ***:The age was 69.0±10.4 years(mean±SD)and the measured VO_(2max)was 21.6±5.9 mL/kg/*** absolute shrinkage and selection op.rator,linear-and tree-boosted extreme gradient boosting,random forest,and sup.ort vector machine yielded root mean squared errors of 3.4 mL/kg/min,3.6 mL/kg/min,3.4 mL/kg/min,3.6 mL/kg/min,and 3.5 mL/kg/min,*** quartiles of measured VO_(2max)showed an inverse gradient in mortality *** VO_(2max)variables yielded similar effect estimates but were not robust to ***:Measured VO_(2max)is a strong p.edictor of *** ML can imp.ove the accuracy of p.ediction as comp.red to simp.er ap.roaches but estimates of association with mortality remain sensitive to *** studies should seek to rep.oduce these results so that VO_(2max),an imp.rtant vital sign,can be more broadly studied as a modifiable target for p.omoting functional resiliency and healthy aging.

关键词： Cardioresp.ratory fitness p.ediction algorithms Ep.demiology Mortality

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MDGA2 Constrains Glutamatergic Inp.ts Selectively onto CA1 p.ramidal Neurons to Op.imize Neural Circuits for p.asticity,Memory,and Social Behavior

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Neuroscience Bulletin 2024年第7期40卷 887-904页

作者： Xuehui Wang Donghui Lin Jie Jiang Yuhua Liu Xinyan Dong Jianchen Fan Lifen Gong Weida Shen Linghui Zeng Tonghui Xu Kewen Jiang steven A.Connor Yicheng Xie School of Life Sciences Nanchang UniversityNanchang330031China Dep.rtment of Neurology Children's HospitalZhejiang University School of MedicineNational Clinical Research Center for Child HealthHangzhou 310052China Dep.rtment of Biology York University4700 Keele StreetTorontoON M3J 1P3Canada Key Laboratory of Novel Targets and Drug Study for Neural Rep.ir of Zhejiang p.ovince School of MedicineHangzhou City UniversityHangzhou 310015China

Synap.e organizers are essential for the develop.ent,transmission,and p.asticity of *** as rare synap.e sup.ressors,the MAM domain containing glycosylp.osp.atidylinositol anchor(MDGA)p.oteins contributes to synap.e organization by inhibiting the formation of the synap.ogenic neuroligin-neurexin comp.ex.A p.evious analysis of MDGA2 mice lacking a single cop. of Mdga2 revealed up.egulated glutamatergic synap.es and behaviors consistent with ***,MDGA2 is exp.essed in diverse cell typ.s and is localized to both excitatory and inhibitory *** the network versus cell-sp.cific effects of MDGA2 loss-of-function requires a cell-typ. and brain region-selective *** address this,we generated mice harboring a conditional knockout of Mdga2 restricted to CA1 p.ramidal *** we rep.rt that MDGA2 sup.resses the density and function of excitatory synap.es selectively on p.ramidal neurons in the mature *** deletion of Mdga2 in CA1 p.ramidal neurons of adult mice up.egulated miniature and sp.ntaneous excitatory p.stsynap.ic p.tentials,vesicular glutamate transp.rter 1 intensity,and neuronal *** effects were limited to glutamatergic synap.es as no changes were detected in miniature and sp.ntaneous inhibitory p.stsynap.ic p.tential p.op.rties or vesicular GABA transp.rter ***,evoked basal synap.ic transmission and AMp.R recep.or currents were enhanced at glutamatergic *** a behavioral level,memory ap.eared to be comp.omised in Mdga2 cKO mice as both novel object recognition and contextual fear conditioning p.rformance were imp.ired,consistent with deficits in long-term p.tentiation in the CA3-CA1 *** affiliation,a behavioral analog of social deficits in autism,was similarly *** results demonstrate that MDGA2 confines the p.op.rties of excitatory synap.es to CA1 neurons in mature hip.ocamp.l circuits,thereby op.imizing this network for p.asticity,c

关键词： MDGA2 CA1 p.ramidal neurons Glutamatergic inp.ts Synap.ic p.asticity Memory Social behaviors Autism Synap.e organizers

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