Aperiodic neural activity is a biomarker for depression severity

A reliable physiological biomarker for Major Depressive Disorder (MDD) is necessary to improve treatment success rates by shoring up variability in outcome measures. In this study, we establish a passive biomarker that tracks with changes in mood on the order of minutes to hours. We record from intracranial electrodes implanted deep in the brain - a surgical setting providing exquisite temporal and spatial sensitivity to detect this relationship in a difficult-to-measure brain area, the ventromedial prefrontal cortex (VMPFC). The aperiodic slope of the power spectral density captures the balance of activity across all frequency bands and is construed as a putative proxy for excitatory/inhibitory balance in the brain. This study demonstrates how shifts in aperiodic slope correlate with depression severity in a clinical trial of deep brain stimulation for treatment-resistant depression (TRD). The correlation between depression severity scores and aperiodic slope is significant in N=5 subjects, indicating that flatter (less negative) slopes correspond to reduced depression severity, especially in the ventromedial prefrontal cortex. This biomarker offers a new way to track patient response to MDD treatment, facilitating individualized therapies in both intracranial and non-invasive monitoring scenarios.

Monkeypox 2022: Another global outbreak

In May 2022, a global outbreak of monkeypox was identified in Europe and North America in individuals most of whom had no history of travel from monkeypox-endemic countries. This article provides an overview of monkeypox disease prevention guidance and treatment options available.

Melioidosis: Emerging beyond endemic areas

ABSTRACT

Recent cases suggest that melioidosis, an infection caused by Burkholderia pseudomallei, is an emerging infectious disease. Nurses have a key role in the care of patients with melioidosis. This article provides an overview of the epidemiology, clinical presentation, diagnosis, treatment, and prevention of melioidosis, and discusses unusual, non-travel-related cases of melioidosis.

Participation in sports after total knee replacement

Return to regular sports activity was evaluated in a retrospective review of 160 patients who had undergone total knee replacement surgery by a single surgeon (208 knee replacements). Mean age of the patients was 68 years (range, 27 to 87) at surgery and 73 years (range, 33 to 91) at review at a mean follow-up of 5 years (range, 3 to 7). Seventy-nine patients regularly participated in sports, at least once per week, before surgery, and 51 patients regularly participated in sports after surgery. Only eight patients took up sports after surgery who were not regularly involved in sports in the year before surgery. Patients were more likely to return to low-impact activities such as bowls (29 of 32, or 91%) than to high-impact activities such as tennis (6 of 30, or 20% returned). Forty-three of 56 patients (77%) who had participated in regular exercise in the year before surgery returned to sports. Eighty patients did not participate in sports before surgery and 54 of these had coexisting disease that prevented sports. None of these patients returned to sports.

Distal forearm fractures in children: the role of hand dominance

A survey of 426 children with unilateral distal forearm fractures was performed to examine the role of hand dominance. Results showed a significant preponderance of fractures occurring in the non-dominant arm (p < .01). This finding has implications for possible preventive strategies in these common injuries.

Pes planus in childhood due to tibialis posterior tendon injuries. Treatment by flexor hallucis longus tendon transfer

Flat foot due to rupture of the tibialis posterior tendon has not previously been described in children. We present three young patients who developed unilateral pes planus after old undiagnosed lacerations of the tendon. Transfer of the flexor hallucis longus to the distal stump of the tibialis posterior tendon achieved good results in all three cases.

Pes planus in childhood due to tibialis posterior tendon injuries. Treatment by flexor hallucis longus tendon transfer

Flat foot due to rupture of the tibialis posterior tendon has not previously been described in children. We present three young patients who developed unilateral pes planus after old undiagnosed lacerations of the tendon. Transfer of the flexor hallucis longus to the distal stump of the tibialis posterior tendon achieved good results in all three cases.

Peroneus longus tendon sling in revision surgery for congenital vertical talus: a new surgical technique

When faced with revision surgery for recurrent congenital vertical talus deformity, the tibialis anterior tendon may be deficient or absent as a result of the initial procedure. This tendon cannot then be used as a dynamic sling to dorsiflex the talar neck. We present two cases in which the peroneus longus tendon was transferred dorsally into the talar neck as an alternative to an absent tibialis anterior tendon. Excellent corrections were achieved and maintained. The use of this tendon has not been described previously in surgery for this condition.

Victims of our climate

In order to test the hypothesis that the volume of paediatric orthopaedic trauma is related to the weather, we analysed all children with fractures admitted to our unit over a 3-year period and correlated this information with local meteorological data. The average number of children admitted per month with fractures showed a strong positive correlation with mean monthly sunshine hours (Pearson correlation coefficient 0.91) and a weak negative correlation with mean monthly rainfall (-0.24). The summer peak in the incidence of fractures persisted when the effect of school holidays was eliminated. Fractures involving the radius accounted for 48.7 per cent of all fracture admissions and correlation with sunshine hours was highest in this group. Almost two-thirds of all fracture admissions were male and these had a slightly higher mean age (8.2 years) than females (7.6 years). This data has implications for bed management and staffing levels in a paediatric orthopaedic unit.

Keeping volunteers in EMS* (*emergency medical services)

The EMS system is widely dependent on the use of volunteers. This report of a study of EMS in Genesee County, Michigan, covers the volunteers' point of view on their attraction to the field and job satisfaction as well as the agency's response to recruitment and retention issues.