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  1. Article ; Online: The Complex Task of Measuring the Value of Laboratory Investigations and Other Diagnostic Tests: Commentary on Srivastava and Nair.

    Lawrence, Ryan E

    Psychiatric services (Washington, D.C.)

    2022  Volume 73, Issue 10, Page(s) 1177–1178

    MeSH term(s) Humans ; Mental Disorders/diagnosis ; Psychiatry
    Language English
    Publishing date 2022-06-23
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 1220173-x
    ISSN 1557-9700 ; 1075-2730
    ISSN (online) 1557-9700
    ISSN 1075-2730
    DOI 10.1176/appi.ps.20220076
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 416: Show issues Location:
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  2. Article ; Online: Ethics in placebo-controlled, acute treatment trials in schizophrenia: Two rival ethical frameworks.

    Lawrence, Ryan E / Appelbaum, Paul S

    Schizophrenia research

    2024  Volume 264, Page(s) 372–377

    Abstract: Placebo-controlled, acute treatment trials in schizophrenia enroll acutely symptomatic persons, randomize them to receive placebo or antipsychotic medication for several weeks, and evaluate whether symptoms improve. These trials can have scientific ... ...

    Abstract Placebo-controlled, acute treatment trials in schizophrenia enroll acutely symptomatic persons, randomize them to receive placebo or antipsychotic medication for several weeks, and evaluate whether symptoms improve. These trials can have scientific benefits, especially when they test drugs with novel mechanisms of action. However, the use of placebo is ethically problematic inasmuch as standard treatment is withheld and participants are subjected to prolonged psychotic symptoms and associated risks. We propose that both deontological (duty-based) and utilitarian analyses are relevant, that it may be impossible to satisfy the ideals of both frameworks, and that researchers who conduct these trials will unavoidably encounter ethical tension and criticism even when they give careful attention to ethical aspects of study design.
    MeSH term(s) Humans ; Schizophrenia/drug therapy ; Schizophrenia/diagnosis ; Antipsychotic Agents/therapeutic use ; Psychotic Disorders/drug therapy ; Research Design
    Chemical Substances Antipsychotic Agents
    Language English
    Publishing date 2024-01-17
    Publishing country Netherlands
    Document type Randomized Controlled Trial ; Journal Article
    ZDB-ID 639422-x
    ISSN 1573-2509 ; 0920-9964
    ISSN (online) 1573-2509
    ISSN 0920-9964
    DOI 10.1016/j.schres.2024.01.018
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  3. Article ; Online: Barriers to Expanding the Role of Nonprescribing Clinicians in Emergency Settings.

    Lawrence, Ryan E

    Psychiatric services (Washington, D.C.)

    2021  Volume 72, Issue 4, Page(s) 464–465

    MeSH term(s) Emergency Service, Hospital ; Humans ; Psychiatry
    Language English
    Publishing date 2021-03-31
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 1220173-x
    ISSN 1557-9700 ; 1075-2730
    ISSN (online) 1557-9700
    ISSN 1075-2730
    DOI 10.1176/appi.ps.72302
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  4. Article ; Online: Schizophrenia and Emergency Medicine.

    Lawrence, Ryan E / Bernstein, Adam

    Emergency medicine clinics of North America

    2023  Volume 42, Issue 1, Page(s) 93–104

    Abstract: Schizophrenia is a chronic condition characterized by positive symptoms (auditory hallucinations, delusion), negative symptoms (avolition, social withdrawal), and disorganized thoughts/behaviors. Although the pathophysiology is incompletely understood, ... ...

    Abstract Schizophrenia is a chronic condition characterized by positive symptoms (auditory hallucinations, delusion), negative symptoms (avolition, social withdrawal), and disorganized thoughts/behaviors. Although the pathophysiology is incompletely understood, several neurobiological mechanisms have been proposed. Treatment usually involves antipsychotic medication as well as psychotherapy and supportive services. When evaluating patients in the emergency department, acute safety considerations are paramount. Patients should be assessed for suicide risk, violence risk, inability to care for self, and the risk of being the victim of a crime. Persons with schizophrenia are at an increased risk of substance use and a variety of medical problems.
    MeSH term(s) Humans ; Schizophrenia/therapy ; Schizophrenia/drug therapy ; Hallucinations/diagnosis ; Hallucinations/etiology ; Hallucinations/therapy ; Violence ; Antipsychotic Agents/therapeutic use ; Emergency Medicine
    Chemical Substances Antipsychotic Agents
    Language English
    Publishing date 2023-07-28
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 605637-4
    ISSN 1558-0539 ; 0733-8627
    ISSN (online) 1558-0539
    ISSN 0733-8627
    DOI 10.1016/j.emc.2023.06.012
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    Zs.A 1919: Show issues Location:
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  5. Article ; Online: In clinical trials, efficacy vs. effectiveness language is confusing.

    Lawrence, Ryan E / Bernstein, Adam / Jaffe, Chaya / Goldberg, Terry E

    Journal of clinical epidemiology

    2023  Volume 159, Page(s) 345–347

    MeSH term(s) Humans ; Language ; Clinical Trials as Topic
    Language English
    Publishing date 2023-05-30
    Publishing country United States
    Document type Letter ; Research Support, Non-U.S. Gov't
    ZDB-ID 639306-8
    ISSN 1878-5921 ; 0895-4356
    ISSN (online) 1878-5921
    ISSN 0895-4356
    DOI 10.1016/j.jclinepi.2023.05.022
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  6. Article ; Online: Clinical Trials Studying Suicide Risk Reduction: Who is Excluded From Participation.

    Lawrence, Ryan E / Jaffe, Chaya / Zhao, Yinjun / Wang, Yuanjia / Goldberg, Terry E

    Archives of suicide research : official journal of the International Academy for Suicide Research

    2024  , Page(s) 1–14

    Abstract: ... as a primary or secondary outcome. After research fundamentals (e.g. informed consent, language fluency ...

    Abstract Objective: The use of exclusion criteria in clinical trials can cause research participants to differ markedly from clinical populations, which negatively impacts generalizability of results. This study identifies and quantifies common and recurring exclusion criteria in clinical trials studying suicide risk reduction, and estimates their impact on eligibility among a clinical sample of adults in an emergency department with high suicide risk.
    Method: Recent trials were identified by searching PubMed (terms suicide, efficacy, effectiveness, limited to clinical trials in prior 5 years). Common exclusion criteria were identified using Qualitative Content Analysis. A retrospective chart review examined a one-month sample of all adults receiving psychiatric evaluation in a large urban academic emergency department.
    Results: The search yielded 27 unique clinical trials studying suicide risk reduction as a primary or secondary outcome. After research fundamentals (e.g. informed consent, language fluency), the most common exclusion criteria involved psychosis (77.8%), cognitive problems (66.7%), and substance use (63.0%). In the clinical sample of adults with high suicide risk (
    Conclusions: Recent clinical trials studying suicide risk reduction have low generalizability to emergency psychiatry patients with high suicide risk. Trials enrolling persons with psychosis and substance use in particular are needed to improve generalizability to this clinical population.
    Language English
    Publishing date 2024-02-28
    Publishing country England
    Document type Journal Article
    ZDB-ID 1283671-0
    ISSN 1543-6136 ; 1381-1118
    ISSN (online) 1543-6136
    ISSN 1381-1118
    DOI 10.1080/13811118.2024.2322128
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    Zs.A 4465: Show issues Location:
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  7. Article ; Online: Persons Who Engage in Self-Harm While in the Emergency Department: A Case-Control Analysis.

    Lawrence, Ryan E / Krumheuer, Aaron / Loh, Ryan / Stanley, Barbara / Simpson, Scott A

    The Journal of nervous and mental disease

    2022  Volume 210, Issue 10, Page(s) 736–740

    Abstract: Abstract: Some patients engage in self-harm behaviors while in the emergency department. Risk factors for self-harm have been described for inpatient and outpatient/community settings, but not among emergency department patients. Authors conducted case- ... ...

    Abstract Abstract: Some patients engage in self-harm behaviors while in the emergency department. Risk factors for self-harm have been described for inpatient and outpatient/community settings, but not among emergency department patients. Authors conducted case-control, retrospective reviews of medical records and incident reports for emergency department patients in two academic medical centers. Variables were analyzed using conditional logistic regression. There were 113 individuals who engaged in self-harm while in the emergency department and 226 individuals who did not. Four variables were significant in the final model: a history of nonsuicidal self-harm (odds ratio [OR], 4.28; 95% confidence interval [CI], 1.95-9.41), opioid use in the prior 2 weeks (OR, 2.89; CI, 1.19-7.02), current manic episode (OR, 3.59; CI, 1.33-9.70), and a history of seizures (OR, 4.19; CI, 1.16-15.14). Risk of self-harm while in the emergency department may be mitigated with interventions that support adaptive coping skills, promptly address pain and withdrawal symptoms, and treat mania.
    MeSH term(s) Analgesics, Opioid ; Emergency Service, Hospital ; Humans ; Odds Ratio ; Retrospective Studies ; Self-Injurious Behavior/diagnosis ; Self-Injurious Behavior/epidemiology
    Chemical Substances Analgesics, Opioid
    Language English
    Publishing date 2022-04-05
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 3020-x
    ISSN 1539-736X ; 0022-3018
    ISSN (online) 1539-736X
    ISSN 0022-3018
    DOI 10.1097/NMD.0000000000001528
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Ui II Zs.22: Show issues Location:
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  8. Article ; Online: Eligibility of emergency psychiatry patients for clinical trials studying depression.

    Lawrence, Ryan E / Bernstein, Adam / Jaffe, Chaya / Zhao, Yinjun / Wang, Yuanjia / Goldberg, Terry E

    Journal of affective disorders

    2023  Volume 342, Page(s) 10–15

    Abstract: Background: Differences often exist between people with depression who are eligible for clinical trials and those seen in clinical practice. The impact of exclusion criteria on eligibility has been previously reported for inpatients and outpatients, but ...

    Abstract Background: Differences often exist between people with depression who are eligible for clinical trials and those seen in clinical practice. The impact of exclusion criteria on eligibility has been previously reported for inpatients and outpatients, but has not been assessed for emergency psychiatry patients; a group that overlaps with inpatients and outpatients but also has important distinctives. Understanding the frequencies of commonly used exclusion criteria in this population could inform interpretation of existing data (generalizability) and highlight opportunities/needs for future trials.
    Methods: We reviewed 67 clinical trials studying depression using Qualitative Content Analysis to identify common and recurring exclusion criteria. We examined the frequency of these exclusion criteria among a clinical sample of emergency psychiatry patients.
    Results: Most clinical trials had exclusions for basic research requirements, age, symptom severity, psychosis, and substance use. Applying 9 commonly used exclusion criteria to the clinical population resulted in a 3.3 % eligibility rate (95 % CI 1.2 %-7.0 %). Exclusions for psychosis (85.1 % of trials), substance use (83.6 % of trials), and suicide risk (65.7 % of trials) would likely exclude 93 % of emergency psychiatry patients. The prevalence of psychosis, substance use, and suicide risk was much higher among emergency psychiatry patients than among previously studied populations.
    Limitations: Some eligibility criteria could not be measured. The Qualitative Content Analysis consolidated similar exclusion criteria, losing potentially important nuances in wordings.
    Conclusions: Exclusion criteria commonly used in contemporary clinical trials of depression limit generalizability to emergency psychiatry patients, due in large part to exclusions for psychosis, substance use, and suicide risk.
    MeSH term(s) Humans ; Depression ; Outpatients ; Patient Selection ; Psychiatry ; Research Design ; Clinical Trials as Topic
    Language English
    Publishing date 2023-09-07
    Publishing country Netherlands
    Document type Review ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 135449-8
    ISSN 1573-2517 ; 0165-0327
    ISSN (online) 1573-2517
    ISSN 0165-0327
    DOI 10.1016/j.jad.2023.09.010
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1485: Show issues Location:
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  9. Article ; Online: The prevalence of Dupuytren's disease in patients with diabetes mellitus.

    Ganesan, Sandhya / Tantone, Ryan P / Komatsu, David E / Hurst, Lawrence C

    Communications medicine

    2023  Volume 3, Issue 1, Page(s) 96

    Abstract: Background: Dupuytren's disease (DD) is a fibroproliferative hand disorder associated with various medical conditions, including diabetes mellitus (DM). The reported prevalence of DM among DD patients varies widely, primarily due to small sample sizes ... ...

    Abstract Background: Dupuytren's disease (DD) is a fibroproliferative hand disorder associated with various medical conditions, including diabetes mellitus (DM). The reported prevalence of DM among DD patients varies widely, primarily due to small sample sizes in previous studies.
    Methods: This was a retrospective cohort study using data from the TriNetX Research Database. We analyzed the overall prevalence of DD between 2010 and 2020, comparing the DM, type 1 diabetes mellitus (T1DM), and type 2 diabetes mellitus (T2DM) cohorts. Within the DM group, patients were further categorized based on hemoglobin A1c (HbA1c) values and prescribed anti-diabetic agents (insulin or metformin). We compared the prevalence of DD diagnosis in each group using prevalence ratios and differences.
    Results: There is a higher prevalence of DD in patients with T2DM than in patients with T1DM (relative risk [RR]: 1.641; 95% confidence interval [CI]: [1.356, 1.986]). Among patients with diabetes, there is a higher prevalence of DD in those taking insulin compared to those taking metformin (RR: 0.801, 95% CI: [0.774, 0.83]). The prevalence of DD varies depending on HbA1c levels, with a prevalence of 0.463% in patients having levels within the diabetic range, while lower prevalences of 0.392% and 0.416% are found in patients with prediabetes or uncontrolled diabetes, respectively.
    Conclusions: This study provides further insight into the relationship between DM and DD. These findings may be attributed to the increased accumulation of advanced glycosylated end products (AGEs) in patients with diabetes. Future research exploring the connection between AGE accumulation and DD development may enhance our understanding of the relationship between DD and DM.
    Language English
    Publishing date 2023-07-13
    Publishing country England
    Document type Journal Article
    ISSN 2730-664X
    ISSN (online) 2730-664X
    DOI 10.1038/s43856-023-00332-7
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  10. Article: Cicinnus chambersi

    Laurent, Ryan A St / Reeves, Lawrence E / Kawahara, Akito Y

    ZooKeys

    2020  Volume 931, Page(s) 49–71

    Abstract: A new species of cicinnine Mimallonidae, ...

    Abstract A new species of cicinnine Mimallonidae,
    Language English
    Publishing date 2020-04-30
    Publishing country Bulgaria
    Document type Journal Article
    ZDB-ID 2445640-8
    ISSN 1313-2970 ; 1313-2989
    ISSN (online) 1313-2970
    ISSN 1313-2989
    DOI 10.3897/zookeys.931.50203
    Database MEDical Literature Analysis and Retrieval System OnLINE

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