Direct-to-Consumer Advertising Survey of Psychiatrists in Massachusetts and Michigan.

PURPOSES/BACKGROUND: The goals of this preliminary study were to survey psychiatrists and to examine the impact of advertisements on their prescription of psychotropic medications. The study specifically looked at psychiatrists in Massachusetts and Michigan, as the authors were able to readily contact the members of their respective state psychiatric societies. METHODS/PROCEDURES: We used the survey software, Quatrics, to create an online survey that was sent via email link to the members of the Massachusetts Psychiatric Society (1400 estimated members), and the Michigan Psychiatric Society (700 estimated members). Details were obtained about how challenging it was for the psychiatrist to convince the patient that a medication was not indicated. Information regarding how the psychiatrist first heard about new medications and where they go to learn more about these medications was included in the survey. FINDINGS/RESULTS: We received 162 partial or full responses to our survey, representing a response rate of 8%. Those who were less than 10 years out of training were less likely to find it "easy" to change the minds of these patients, when compared with those more than 10 years out of training (Fisher exact test, P = 0.0396). The most frequent medication named as a response to "which medications do patients request" was Rexulti (brexpiprazole), followed by Vraylar (cariprazine), Caplyta (lumateperone), and aripiprazole. IMPLICATIONS/CONCLUSIONS: This survey points to the prevalence of psychiatrists getting requests for these advertised medications and illustrates that those with fewer years out of training may have a more difficult time redirecting patients from medications that are not indicated for their illness.

Human circadian rhythm studies: Practical guidelines for inclusion/exclusion criteria and protocol.

As interest in circadian rhythms and their effects continues to grow, there is an increasing need to perform circadian studies in humans. Although the constant routine is the gold standard for these studies, there are advantages to performing more naturalistic studies. Here, a review of protocols for such studies is provided along with sample inclusion and exclusion criteria. Sleep routines, drug use, shift work, and menstrual cycle are addressed as screening considerations. Regarding protocol, best practices for measuring melatonin, including light settings, posture, exercise, and dietary habits are described. The inclusion/exclusion recommendations and protocol guidelines are intended to reduce confounding variables in studies that do not involve the constant routine. Given practical limitations, a range of recommendations is provided from stringent to lenient. The scientific rationale behind these recommendations is discussed. However, where the science is equivocal, recommendations are based on empirical decisions made in previous studies. While not all of the recommendations listed may be practical in all research settings and with limited potential participants, the goal is to allow investigators to make well informed decisions about their screening procedures and protocol techniques and to improve rigor and reproducibility, in line with the objectives of the National Institutes of Health.

A rapidly resorbable hemostatic biomaterial based on dihydroxyacetone.

We have developed a rapid acting, rapidly resorbable, non-toxic, topical hemostatic agent comprised of a PEGylated, polymerized sequence of dihydroxyacetone (MPEG-pDHA) that is highly effective in vivo. Twenty-eight Sprague-Dawley rats underwent left lateral hepatectomy. To the cut edge of the liver, rats received MPEG-pDHA (50 mg), normal saline (0.5 mL), or Instat (50 mg), a commercially available hemostatic compound. Bleeding time and total blood loss were quantified. Coagulation studies and scanning electron microscopy were performed on phlebotomized blood combined with MPEG-pDHA. Rats treated with MPEG-pDHA had significantly decreased bleeding time (97 s) and total blood loss (1.35 g) compared to normal saline (464 s and 3.83 g, p < 0.05 for each), and a significantly shorter bleeding time compared to Instat (165 s, p < 0.05). Histology confirmed that all MPEG-pDHA was metabolized within 3 weeks. The addition of MPEG-pDHA to whole blood did not significantly affect prothrombin time (12.0 s vs. 13.2 s, p = 0.130), partial thromboplastin time (27.0 s vs. 21.8 s, p = 0.118), or thrombin clotting time. MPEG-pDHA is an effective and rapidly resorbable hemostatic agent that may find broad hemostatic application in a wide range of surgical procedures.