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Intracranial Stenting: Angioplasty Basic Technique, Indications, and Sizing: 2-Dimensional Operative Video.

Oper Neurosurg (Hagerstown) 2021 May 6. Epub 2021 May 6.

Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA.

Intracranial atherosclerotic disease (ICAD) is a common cause of stroke. Antiplatelet therapy is the mainstay for symptomatic ICAD treatment. Endovascular management with submaximal angioplasty and/or intracranial stenting is reserved for patients with repeated ischemic events despite optimal medical therapy. Read More

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Infantile Rhabdomyosarcomas With VGLL2 Rearrangement Are Not Always an Indolent Disease: A Study of 4 Aggressive Cases With Clinical, Pathologic, Molecular, and Radiologic Findings.

Am J Surg Pathol 2021 Jun;45(6):854-867

Genetics Unit, Department of Tumor Biology.

VGLL2-rearranged rhabdomyosarcomas (RMS) are rare low-grade tumors with only favorable outcomes reported to date. We describe 4 patients with VGLL2-rearranged RMS confirmed by molecular studies, who experienced local progression and distant metastases, including 2 with fatal outcomes. Tumors were diagnosed at birth (n=3) or at 12 months of age (n=1), and were all localized at initial diagnosis, but unresectable and therefore managed with chemotherapy and surveillance. Read More

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Vaginal mucositis related to immunotherapy in endometrial cancer.

Gynecol Oncol Rep 2021 May 31;36:100742. Epub 2021 Mar 31.

Rutgers Cancer Institute of New Jersey, United States.

Immunotherapy, specifically immune checkpoint inhibitors (ICPi), has revolutionized our approach to treating all solid tumors, including gynecologic malignancies. Compared to standard chemotherapy, the adverse events associated with immunotherapies, are often mild and localized, although more severe systemic responses can also occur. While dermatitisdermatitis is a most commonly reported side effect of ICPi therapy, cutaneous toxicities have a range of clinical manifestations and can provide a challenge in an otherwise favorable treatment protocol. Read More

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A Phase I study of alpelisib in combination with trastuzumab and LJM716 in patients with -mutated HER2-positive metastatic breast cancer.

Clin Cancer Res 2021 May 4. Epub 2021 May 4.

Medicine, Memorial Sloan-Kettering Cancer Center/Weill Cornell Medical College

Purpose: Activating mutations in PIK3CA promote resistance to HER2-targeted therapy in breast cancer, however inhibition of PI3K alone leads to escape via feedback upregulation of HER3. Combined inhibition of HER2, HER3 and PI3K overcomes this mechanism preclinically.

Experimental Design: This phase I study investigated the maximum tolerated dose (MTD) of alpelisib given in combination with trastuzumab and LJM716 (a HER3-targeted antibody) in patients with PIK3CA-mutant HER2-positive metastatic breast cancer (MBC) using the continual reassessment method. Read More

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Childhood vesiculobulous disorder (toxic epidermal necrolysis) in a resource constrained setting.

Acta Biomed 2021 Apr 30;92(S1):e2021085. Epub 2021 Apr 30.

ABIA STATE UNIVERSITY TEACHING HOSPITAL ABA.

We report a case of childhood vesiculobulous disorder of the severity of Toxic Epidermal Necrolysis(TEN) in a 4 year ten month old female child resulting from caregiver prescribed medication. She is one of 4 children of a non consanguineous marriage with no family history of similar adverse drug reactions. She was initially managed in a private hospital before referral to our centre where we observed constraints of funds and crisis of confidence on the part of the parents. Read More

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Transitional states of sarcopenia: the trajectory of fat accumulation and glucose fluctuation on risk of metabolic syndrome.

Ann N Y Acad Sci 2021 May 4. Epub 2021 May 4.

Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.

The association between sarcopenia and metabolic syndrome (MetS) has been well established. Nevertheless, the transition process between normal and low muscle mass (LMM) states and the effect of this transition on MetS has been less explored. Our study here examined whether the direction toward or away from LMM alters the risks of MetS. Read More

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Proof-of-concept for clinical effects of oral rilzabrutinib, the first Bruton tyrosine kinase inhibitor for pemphigus vulgaris: the phase 2 BELIEVE study.

Br J Dermatol 2021 May 3. Epub 2021 May 3.

Department of Dermatology, Rouen University Hospital, Centre de Référence des Maladies Bulleuses Autoimmunes, and INSERM U1234, Normandie University, Rouen, France.

Background: Bruton tyrosine kinase (BTK) inhibition targets B-cell and other non-T-cell immune cells implicated in pemphigus pathophysiology, an autoimmune disease driven by anti-desmoglein autoantibodies. Rilzabrutinib is a new reversible, covalent BTK inhibitor demonstrating preclinical efficacy as monotherapy in canine pemphigus foliaceus.

Objectives: Evaluate efficacy and safety of oral rilzabrutinib in pemphigus vulgaris patients in a multicenter, proof-of-concept, phase 2 trial. Read More

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Intraoperative radiotherapy boost as part of breast-conservation therapy for breast cancer: a single-institution retrospective analysis.

Strahlenther Onkol 2021 Apr 30. Epub 2021 Apr 30.

Department of Radiation Oncology, University Hospital of Freiburg, Robert-Koch-Straße 3, 79106, Freiburg, Germany.

Background: There are currently no data from randomized controlled trials on the use of intraoperative radiotherapy (IORT) as a tumor bed boost as part of a breast-conservation approach for breast cancer. This study retrospectively reviewed the safety and efficacy of IORT as a boost treatment at a tertiary cancer center.

Methods: From 2015 to 2019, patients underwent breast-conserving surgery with axillary lymph node staging and a single dose of 20 Gy IORT with 50-kV photons, followed by whole-breast irradiation (WBI) and adjuvant systemic therapy (if applicable). Read More

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Targeted Therapy in Cardiovascular Disease: A Precision Therapy Era.

Front Pharmacol 2021 16;12:623674. Epub 2021 Apr 16.

State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Targeted therapy refers to exploiting the specific therapeutic drugs against the pathogenic molecules (a protein or a gene) or cells. The drug specifically binds to disease-causing molecules or cells without affecting normal tissue, thus enabling personalized and precision treatment. Initially, therapeutic drugs included antibodies and small molecules, (e. Read More

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Levetiracetam versus fosphenytoin as a second-line treatment after diazepam for status epilepticus: study protocol for a multicenter non-inferiority designed randomized control trial.

Trials 2021 May 2;22(1):317. Epub 2021 May 2.

Department of Emergency and Critical Care Medicine, Tsukuba University Hospital, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8577, Japan.

Background: Status epilepticus (SE) is an emergency condition for which rapid and secured cessation is important. Phenytoin and fosphenytoin, the prodrug of phenytoin with less severe adverse effects, have been recommended as second-line treatments. However, fosphenytoin causes severe adverse events, such as hypotension and arrhythmia. Read More

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Operating room team training using simulation: Hope or hype?

Am J Surg 2021 Feb 6. Epub 2021 Feb 6.

Beth Israel Deaconess Medical Center Division of Bariatric and Minimally Invasive Surgery, United States. Electronic address:

Background: This study sought to determine the long-term impact of multidisciplinary simulated operating room (OR) team training.

Method: Two-wave survey study (immediate post-training survey 2010-2017, follow-up 2018). Differences across time, specialty, and experience with adverse events were assessed using chi-square and t -tests. Read More

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February 2021

US Case Reports of Cerebral Venous Sinus Thrombosis With Thrombocytopenia After Ad26.COV2.S Vaccination, March 2 to April 21, 2021.

JAMA 2021 Apr 30. Epub 2021 Apr 30.

Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta, Georgia.

Importance: Cerebral venous sinus thrombosis (CVST) with thrombocytopenia, a rare and serious condition, has been described in Europe following receipt of the ChAdOx1 nCoV-19 vaccine (Oxford/AstraZeneca), which uses a chimpanzee adenoviral vector. A mechanism similar to autoimmune heparin-induced thrombocytopenia (HIT) has been proposed. In the US, the Ad26. Read More

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A Machine Learning Decision Support System (DSS) for Neuroendocrine Tumor Patients Treated with Somatostatin Analog (SSA) Therapy.

Diagnostics (Basel) 2021 Apr 28;11(5). Epub 2021 Apr 28.

Medical Oncology Unit, Careggi University Hospital, Largo Brambilla 4, 50134 Florence, Italy.

The application of machine learning (ML) techniques could facilitate the identification of predictive biomarkers of somatostatin analog (SSA) efficacy in patients with neuroendocrine tumors (NETs). We collected data from 74 patients with a pancreatic or gastrointestinal NET who received SSA as first-line therapy. We developed three classification models to predict whether the patient would experience a progressive disease (PD) after 12 or 18 months based on clinic-pathological factors at the baseline. Read More

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Role of Ranolazine in the Prevention and Treatment of Atrial Fibrillation in Patients with Left Ventricular Systolic Dysfunction: A Meta-Analysis of Randomized Clinical Trials.

Diseases 2021 Apr 16;9(2). Epub 2021 Apr 16.

Cardiac Center, Division of Cardiovascular Medicine, Department of Internal Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand.

Background: Ranolazine has the potential to prevent atrial fibrillation (AF) and plays a role in rhythm control strategy for atrial fibrillation in various clinical settings. However, data on the use of ranolazine in patients with left ventricular (LV) systolic dysfunction are limited. The aims of this meta-analysis of randomized clinical trials are to investigate the efficacy and safety of ranolazine in AF patients with LV systolic dysfunction. Read More

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Therapeutic Drug Monitoring of Isavuconazole: Serum Concentration Variability and Success Rates for Reaching Target in Comparison with Voriconazole.

Antibiotics (Basel) 2021 Apr 23;10(5). Epub 2021 Apr 23.

Unit of Mycology, Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Artillerivej 5, 2300 Copenhagen, Denmark.

Isavuconazole (ISZ) is used in the treatment of aspergillosis and mucormycosis. The purpose of this study was to evaluate the therapeutic drug monitoring (TDM) of ISZ samples from a clinical setting performed at Statens Serum Institut. Isavuconazole serum concentrations were determined by fluorescent detection on a UHPLC. Read More

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Evaluations of Muscular Strength, Ability to Balance and Health Status in Prisoners during COVID-19.

Int J Environ Res Public Health 2021 04 19;18(8). Epub 2021 Apr 19.

Department of Sport Sciences and Wellness, University of Naples "Parthenope", Via Medina 40, 80133 Naples, Italy.

Recent events in prisons during the COVID-19 pandemic showed how the health situation and overcrowding in prisons are a source of high risk to the health and physical and mental well-being of the prison population and how this has become an important medical problem. The original purpose of this study, which was initially planned to last 6 months, was to examine the effects of a training program on cardio-respiratory capacity, resistance to dynamic strength of the upper and lower body and muscle mass. Following the COVID-19 pandemic, the purpose was subsequently modified by highlighting whether and which deficiencies occurred as a result of the absence of physical activity. Read More

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Human Allogeneic Bone Marrow-Derived Mesenchymal Stem Cell Therapy for Cerebellar Ataxia: A Case Report.

Medicina (Kaunas) 2021 Apr 1;57(4). Epub 2021 Apr 1.

Department of Neurology, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu 41404, Korea.

To date, there is no curable treatment option for non-hereditary degenerative cerebellar ataxia. Here we report the case of a patient with sporadic adult-onset ataxia (SAOA) who underwent allogeneic bone marrow-derived mesenchymal stem cell (MSC) therapy via the intrathecal route. A 60-year-old male patient visited our clinic complaining of progressive gait disturbance that commenced two years ago. Read More

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Dorsal striatum and the temporal expectancy of an aversive event in Pavlovian odor fear learning.

Neurobiol Learn Mem 2021 Apr 26:107446. Epub 2021 Apr 26.

Lyon Neuroscience Research Center, INSERM U1028, CNRS UMR 5292, University Lyon 1, Lyon 69366, France.

Interval timing, the ability to encode and retrieve the memory of intervals from seconds to minutes, guides fundamental animal behaviors across the phylogenetic tree. In Pavlovian fear conditioning, an initially neutral stimulus (conditioned stimulus, CS) predicts the arrival of an aversive unconditioned stimulus (US, generally a mild foot-shock) at a fixed time interval. Although some studies showed that temporal relations between CS and US events are learned from the outset of conditioning, the question of the memory of time and its underlying neural network in fear conditioning is still poorly understood. Read More

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Effects of Plyometric Jump Training on Repeated Sprint Ability in Athletes: A Systematic Review and Meta-Analysis.

Sports Med 2021 Apr 28. Epub 2021 Apr 28.

School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Crawley, WA, Australia.

Background: There is a growing body of research examining the effects of plyometric jump training (PJT) on repeated sprint ability (RSA) in athletes. However, available studies produced conflicting findings and the literature has not yet been systematically reviewed. Therefore, the effects of PJT on RSA indices remain unclear. Read More

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Diversity of phosphoinositide binding proteins in Entamoeba histolytica.

Parasitol Int 2021 Apr 24;83:102367. Epub 2021 Apr 24.

Department of Biomedical Chemistry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. Electronic address:

Phosphatidylinositol phosphates (PIPs, phosphoinositides) are localized to the membranes of all cellular compartments, and play pivotal roles in multiple cellular events. To fulfill their functions, PIPs that are located to specific organelles or membrane domains bind to and recruit various proteins in spatiotemporal specific manner via protein domains that selectively bind to either a single or an array of PIPs. In Entamoeba histolytica, the human intestinal protozoan parasite, PIPs and PIP-binding proteins have been shown to be involved in their virulence-associated mechanisms such as cell motility, vesicular traffic, trogo- and phagocytosis. Read More

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Endoscopic Sleeve Gastroplasty (ESG) for High-Risk Patients, High Body Mass Index (> 50 kg/m) Patients, and Contraindication to Abdominal Surgery.

Obes Surg 2021 Apr 27. Epub 2021 Apr 27.

Center for Bariatric and Metabolic Surgery, Klinikum Ernst von Bergmann, Charlottenstraße 72, 14467, Potsdam, Germany.

Background: For high-risk classified patients, patients with superobesity and in cases of contraindication to abdominal surgery, traditional bariatric surgery might lead to potential morbidity and mortality. Endoscopic sleeve gastroplasty (ESG) is a novel and effective bariatric therapy for morbidly obese patients. Our research group initially evaluated the safety, feasibility, and efficacy of ESG for high-risk, high body mass index (BMI) patients, and patients contraindicated to abdominal surgeries. Read More

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Impact of the development of immune related adverse events in metastatic melanoma treated with PD -1 inhibitors.

Melanoma Res 2021 06;31(3):258-263

Department of Oncology.

Some clinical trials have described improved outcomes in patients who develop immune-related adverse events (irAEs) while receiving immune checkpoint inhibitors for advanced melanoma. It is unknown if this effect would be seen in a real-world population. This is a single-center retrospective analysis of all patients receiving single-agent PD-1 inhibitor for unresectable stage III or stage IV melanoma between 2012 and 2018. Read More

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A multi-stakeholder multicriteria decision analysis for the reimbursement of orphan drugs (FinMHU-MCDA study).

Orphanet J Rare Dis 2021 Apr 26;16(1):186. Epub 2021 Apr 26.

Pharmacoeconomics & Outcomes Research Iberia (PORIB), Calle Paseo Joaquín Rodrigo, 4I. 28224, Pozuelo de Alarcón, Madrid, Spain.

Background: Patient access to orphan medicinal products (OMPs) is limited and varies between countries, reimbursement decisions on OMPs are complex, and there is a need for more transparent processes to know which criteria should be considered to inform these decisions. This study aimed to determine the most relevant criteria for the reimbursement of OMPs in Spain, from a multi-stakeholder perspective, and using multicriteria decision analysis (MCDA).

Methods: An MCDA was developed in 3 phases and included 28 stakeholders closely related to the field of rare diseases (6 physicians, 5 hospital pharmacists, 7 health economists, 4 patient representatives and 6 members from national and regional health authorities). Read More

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Paraneoplastic Neurological Syndromes and Beyond Emerging With the Introduction of Immune Checkpoint Inhibitor Cancer Immunotherapy.

Front Neurol 2021 9;12:642800. Epub 2021 Apr 9.

Departments of Neurology and Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN, United States.

Paraneoplastic neurological syndromes are more commonly seen with malignancies such as small cell lung cancer, thymoma, gynecological malignancies, and breast cancer as well as seminoma. With the introduction of immune checkpoint inhibitor (ICI) cancer immunotherapy we see an increase of autoimmune neurological complications in patients with malignancies not traditionally associated with paraneoplastic neurological syndromes, such as melanoma and renal cell carcinoma. Immune checkpoint inhibitors enhance antitumor immune responses resulting often in immune-related adverse effects that can affect any organ, including the central and peripheral nervous system, neuromuscular junction and muscle. Read More

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IL17A/F nanobody sonelokimab in patients with plaque psoriasis: a multicentre, randomised, placebo-controlled, phase 2b study.

Lancet 2021 Apr;397(10284):1564-1575

Translational Research in Inflammatory Skin Diseases, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Background: Sonelokimab (also known as M1095) is a novel trivalent nanobody comprised of monovalent camelid-derived (ie, from the Camelidae family of mammals, such as camels, llamas, and alpacas) nanobodies specific to human interleukin (IL)-17A, IL-17F, and human serum albumin. Nanobodies are a novel class of proprietary therapeutic proteins based on single-domain, camelid, heavy-chain-only antibodies. We assessed the efficacy, safety, and tolerability of sonelokimab across four dosage regimens compared with placebo in patients with plaque-type psoriasis. Read More

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Validation of the Framingham hypertension risk score in a middle eastern population: Tehran lipid and glucose study (TLGS).

BMC Public Health 2021 Apr 24;21(1):790. Epub 2021 Apr 24.

Department of Epidemiology and Biostatistics, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: The Framingham hypertension risk score is a well-known and simple model for predicting hypertension in adults. In the current study, we aimed to assess the predictive ability of this model in a Middle Eastern population.

Methods: We studied 5423 participants, aged 20-69 years, without hypertension, who participated in two consecutive examination cycles of the Tehran Lipid and Glucose Study (TLGS). Read More

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Use of dexamethasone and a 5-HT3 receptor antagonist with or without aprepitant to prevent chemotherapy-induced nausea and vomiting among patients with lung cancer who are treated with platinum-based chemotherapy: a systematic review and meta-analysis of randomized controlled trials.

Ann Palliat Med 2021 Apr 15. Epub 2021 Apr 15.

Department of Thoracic Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, China.

Background: Researchers have not clearly determined whether adding aprepitant (ADH) to dexamethasone and one 5-HT3 receptor antagonist (DH) is clinically effective at preventing chemotherapyinduced nausea and vomiting (CINV) among patients with lung cancer (LC) treated with platinum-based chemotherapy (PBC). Therefore, we conducted a meta-analysis to examine the efficacy and safety of ADH and DH.

Methods: We searched the PubMed, ScienceDirect, Cochrane Library, and Scopus databases, among others, for relevant studies. Read More

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Icosapent ethyl: scientific and legal controversies.

Open Heart 2021 04;8(1)

Yale University Law School, New Haven, Connecticut, USA.

Icosapent ethyl (Vascepa) is a purified preparation of the omega-3 fatty acid eicosapentaenoic acid, which is marketed by Amarin Pharma based in Ireland. The product was initially approved by the US Food and Drug Administration for the use of a high dose (4 g/day) in the treatment of hypertriglyceridaemia. On the basis of the results of the REDUCE-IT (Reduction of Cardiovascular Events with Icosapent Ethyl Intervention Trial), the agency later granted a label extension to include the additional indication of a reduction in risk of cardiovascular events in persons with serum triglyceride levels of 150 mg/dL or greater and established cardiovascular disease or diabetes. Read More

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Newly detected rapid eye movement associated sleep apnea after coronavirus disease 2019 as a possible cause for chronic fatigue: two case reports.

J Med Case Rep 2021 Apr 22;15(1):211. Epub 2021 Apr 22.

Department of Pneumology and Intensive Care Medicine, University Hospital Aachen, Aachen, Germany.

Background: Coronavirus disease 2019 has become a health problem spreading worldwide with pandemic characteristics since March 2020. Post coronavirus disease 2019 symptoms are more frequent than initially expected, with fatigue as an often-mentioned issue.

Case Presentations: We describe a 32-year-old white male and a 55-year-old white female who suffered from post coronavirus disease 2019 fatigue syndrome. Read More

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Contingency of semantic generalization on episodic specificity varies across development.

Curr Biol 2021 Apr 19. Epub 2021 Apr 19.

Department of Psychology, Temple University, Philadelphia, PA, USA.

Semantic memory-general knowledge of ideas and concepts-includes generalization processes that support inference. Episodic memory, on the other hand, preserves the specificity of individual events by binding together unique combinations of elements from an episode and relies on pattern separation to distinguish similar experiences. These two memory systems play complementary roles, supporting different mnemonic goals, but the nature and extent of their interdependence is unclear. Read More

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