The American Journal of Psychiatry presents this review of the most compelling articles that were covered in 2022: The Molecular and Cellular Alterations That Underpin Psychiatric Illnesses Shared and Distinct Neurobiological Mechanisms of PTSD Cognitive Deficits in Long-Term Cannabis Users Longitudinal Outcomes of Duration of Untreated Psychosis Accelerating TMS in the Treatment of Depression Infant Brain Development, Fragile X Syndrome, and Autism Spectrum Disorder Combining Computational Modeling and Postmortem Human Brain Studies to Uncover Synaptic Variability Contributions to Cortical Gamma Oscillation From the AJP Residents’ Journal: Identity and Stigma

A poll conducted in 2021 shed light on the terrible state of many nurses’ mental health, and this story may be a reflection of those thoughts. When more than 9,500 critical care nurses were polled last October, more than half of them admitted to being “not emotionally well,” a trend that was most pronounced among younger nurses between the ages of 25 and 34 (Michael Odell was 27 years old at the time of his death).

Today’s understanding is that “pimping” on rounds and similar tactics tend to inhibit rather than promote learning. Yet residents and fellows, and to a lesser extent medical students, continue to complain of demeaning interactions in medical learning environments. Icahn School of Medicine instituted a system to take in reports of such behavior in an attempt to improve the educational environment there. In their model, the instructor is informed that an individual perceived a degrading interaction. The purpose is to allow the instructor to be aware and make changes as needed. But institutions who want to follow the example of the school need to be prepared to allocate the needed resources to do this follow up if the system is to have any benefit.

Given the global shortage of nirmatrelvir–ritonavir for COVID, alternative antivirals are in demand. This phase 3 randomized trial compared VV116 to nirmatrelvir–ritonavir for adults with mild-to-moderate COVID-19 at risk for progression. The trial was conducted during Omicron strain prevalence (B.1.1.529). Time to clinical recovery was 4 days with VV116 versus 5 days with nirmatrelvir–ritonavir. AEs were seen in 67.4% and 77.3% of the VV116 nirmatrelvir–ritonavir groups, respectively.

Commotio cordis — cardiac arrest after a blunt force trauma to the chest — is thought to occur because a hard object strikes the chest in a vulnerable moment in the cardiac cycle, setting off ventricular fibrillation. The rare condition has been described with a ball strike to the chest, but primarily in young men whose chests haven’t fully developed, making them more susceptible to the blunt force of a ball.

This neurology news roundup from MedPage Today includes four highlights of note: First, a JAMA Internal Medicine article pointing out that gabapentin will not solve the opioid crisis in the US. Second, ublituximab, approved for relapsing MS at the end of December, has been included in the Institute for Clinical and Economic Review’s report on comparative effectiveness. Third, the same organization says that the newly approved Alzheimer’s drug lecanemab will need to be priced below $21,000 per year to be cost effective. And finally, a link to Neurology‘s crystal ball view into neurology education in the coming decade.