Unilateral Maxillary First Molar Extraction in Class II Subdivision:An Unconventional Treatment Alternative

The asymmetrical intra-arch relationship in Class II subdivision malocclusion poses challenges in the treatment planning and mechanotherapy of such cases. This case report demonstrates a treatment technique engaging unilateral extraction of a maxillary first molar and Begg fixed appliances. The outcome stability and the enhancing effect on the eruption of the third molar in the extraction segment were confirmed by a 4-year follow-up examination

Reflections on psychological resilience:a comparison of three conceptually different operationalizations in predicting mental health

BACKGROUND: Psychological resilience refers to the ability to maintain mental health or recover quickly after stress. Despite the popularity of resilience research, there is no consensus understanding or operationalization of resilience. OBJECTIVE: We plan to compare three indicators of resilience that each involve a different operationalization of the construct: a) General resilience or one’s self-reported general ability to overcome adversities; b) Daily resilience as momentarily experienced ability to overcome adversities; and c) Recovery speed evident in the pattern of negative affect recovery after small adversities in daily life. These three indicators are constructed per person to investigate their cross-sectional associations, stability over time, and predictive validity regarding mental health. METHODS: Data will be derived from the prospective MIRORR study that comprises 96 individuals at different levels of psychosis risk and contains both single-time assessed questionnaires and 90-days intensive longitudinal data collection at baseline (T0) and three yearly follow-up waves (T1–T3). General resilience is assessed using the Brief Resilience Scale (BRS) at baseline. Daily resilience is measured by averaging daily resilience scores across 90 days. For recovery speed, vector-autoregressive models with consecutive impulse response simulations will be applied to diary data on negative affect and daily stressors to calculate pattern of affect recovery. These indicators will be correlated concurrently (at T0) to assess their overlap and prospectively (between T0 and T1) to estimate their stability. Their predictive potential will be assessed by regression analysis with mental health (SCL-90) as an outcome, resilience indicators as predictors, and stressful life events as a moderator. CONCLUSION: The comparison of different conceptualizations of psychological resilience can increase our understanding of its multifaceted nature and, in future, help improve diagnostic, prevention and intervention strategies aimed at increasing psychological resilience

The added value of daily diary data in 1- and 3-year prediction of psychopathology and psychotic experiences in individuals at risk for psychosis

This study aimed to assess whether adding information on psychological experiences derived from a daily diary to baseline cross-sectional data could improve short- (1-year) and long-term (3-years) prediction of psychopathology and positive psychotic experiences (PEs). We used 90-day daily diary data from 96 individuals in early subclinical risk stages for psychosis. Stepwise linear regression models were built for psychopathology and PEs at 1- and 3-years follow-up, adding: (1) baseline questionnaires, (2) the mean and variance of daily psychological experiences, and (3) individual symptom network density. We assessed whether similar results could be achieved with a subset of the data (7-14- and 30-days). The mean and variance of the diary improved model prediction of short- and long-term psychopathology and PEs, compared to prediction based on baseline questionnaires solely. Similar results were achieved with 7-14- and 30-day subsets. Symptom network density did not improve model prediction except for short-term prediction of PEs. Simple metrics, i.e., the mean and variance from 7 to 14 days of daily psychological experiences assessments, can improve short- and long-term prediction of both psychopathology and PEs in individuals in early subclinical stages for psychosis. Diary data could be a valuable addition to clinical risk prediction models for psychopathology development.</p

Clinical and Physiological Correlates of Irritability in Depression: Results from the Netherlands Study of Depression and Anxiety

Objective. Irritable and nonirritable depressed patients differ on demographic and clinical characteristics. We investigated whether this extends to psychological and physiological measures. Method. We compared irritable and nonirritable unipolar depressed patients on symptomatology, personality, and (psycho)physiological measures (cortisol, cholesterol, and heart rate variability). Symptomatology was reassessed after one year, and we also compared depressed patients who were irritable or non-irritable at both time points (Irr++ versus Irr−−). Results. Almost half (46%; N = 420) of the sample was classified as irritable. These patients scored higher on depression severity, anxiety, hypomanic symptoms, and psychological variables. No differences were observed on physiological markers after correction for depression severity. The same pattern was found when comparing Irr++ and Irr−− groups. Conclusion. Irritable and non-irritable depressed patients differ on clinical and psychological variables, but not on the currently investigated physiological markers. The clinical relevance of the distinction and the significance of the hypomanic symptoms remain to be demonstrated

Coronary calcium scores on dual-source photon-counting computed tomography:an adapted Agatston methodology aimed at radiation dose reduction

OBJECTIVES: The aim of this study was to determine mono-energetic (monoE) level-specific photon-counting CT (PCCT) Agatston thresholds, to yield monoE level independent Agatston scores validated with a dynamic cardiac phantom. Also, we examined the potential of dose reduction for PCCT coronary artery calcium (CAC) studies, when reconstructed at low monoE levels. METHODS: Theoretical CAC monoE thresholds were calculated with data from the National Institute of Standards and Technology (NIST) database. Artificial CAC with three densities were moved in an anthropomorphic thorax phantom at 0 and 60-75 bpm, and scanned at full and 50% dose on a first-generation dual-source PCCT. For all densities, Agatston scores and maximum CT numbers were determined. Agatston scores were compared with the reference at full dose and 70 keV monoE level; deviations (95% confidence interval) < 10% were deemed to be clinically not-relevant. RESULTS: Averaged over all monoE levels, measured CT numbers deviated from theoretical CT numbers by 6%, 13%, and - 4% for low-, medium-, and high-density CAC, respectively. At 50% reduced dose and 60-75 bpm, Agatston score deviations were non-relevant for 60 to 100 keV and 60 to 120 keV for medium- and high-density CAC, respectively. CONCLUSION: MonoE level-specific Agatston score thresholds resulted in similar scores as in standard reconstructions at 70 keV. PCCT allows for a potential dose reduction of 50% for CAC scoring using low monoE reconstructions for medium- and high-density CAC. KEY POINTS: • Mono-energy level-specific Agatston thresholds allow for reproducible coronary artery calcium quantification on mono-energetic images. • Increased calcium contrast-to-noise ratio at reduced mono-energy levels allows for coronary artery calcium quantification at 50% reduced radiation dose for medium- and high-density calcifications

Dynamic symptom networks across different at-risk stages for psychosis:An individual and transdiagnostic perspective

The clinical staging model distinguishes different stages of mental illness. Early stages, are suggested to be more mild, diffuse and volatile in terms of expression of psychopathology than later stages. This study aimed to compare individual transdiagnostic symptom networks based on intensive longitudinal data between individuals in different early clinical stages for psychosis. It was hypothesized that with increasing clinical stage (i) density of symptom networks would increase and (ii) psychotic experiences would be more central in the symptom networks. Data came from a 90-day diary study, resulting in 8640 observations within N = 96 individuals, divided over four subgroups representing different early clinical stages (n1 = 25, n2 = 27, n3 = 24, n4 = 20). Sparse Time Series Chain Graphical Models were used to create individual contemporaneous and temporal symptom networks based on 10 items concerning symptoms of depression, anxiety, psychosis, non-specific and vulnerability domains. Network density and symptom centrality (strength) were calculated individually and compared between and within the four subgroups. Level of psychopathology increased with clinical stage. The symptom networks showed large between-individual variation, but neither network density not psychotic symptom strength differed between the subgroups in the contemporaneous (pdensity = 0.59, pstrength > 0.51) and temporal (pdensity = 0.75, pstrength > 0.35) networks. No support was found for our hypothesis that higher clinical stage comes with higher symptom network density or a more central role for psychotic symptoms. Based on the high inter-individual variability, our results highlight the importance of individualized assessment of symptom networks

Passive sampling and benchmarking to rank HOC levels in the aquatic environment

The identification and prioritisation of water bodies presenting elevated levels of anthropogenic chemicals is a key aspect of environmental monitoring programmes. Albeit this is challenging owing to geographical scales, choice of indicator aquatic species used for chemical monitoring, and inherent need for an understanding of contaminant fate and distribution in the environment. Here, we propose an innovative methodology for identifying and ranking water bodies according to their levels of hydrophobic organic contaminants (HOCs) in water. This is based on a unique passive sampling dataset acquired over a 10-year period with silicone rubber exposures in surface water bodies across Europe. We show with these data that, far from point sources of contamination, levels of hexachlorobenzene (HCB) and pentachlorobenzene (PeCB) in water approach equilibrium with atmospheric concentrations near the air/water surface. This results in a relatively constant ratio of their concentrations in the water phase. This, in turn, allows us to (i) identify sites of contamination with either of the two chemicals when the HCB/PeCB ratio deviates from theory and (ii) define benchmark levels of other HOCs in surface water against those of HCB and/or PeCB. For two polychlorinated biphenyls (congener 28 and 52) used as model chemicals, differences in contamination levels between the more contaminated and pristine sites are wider than differences in HCB and PeCB concentrations endorsing the benchmarking procedure

Reproducibility of coronary artery calcium quantification on dual-source CT and dual-source photon-counting CT:a dynamic phantom study

To systematically compare coronary artery calcium (CAC) quantification between conventional computed tomography (CT) and photon-counting CT (PCCT) at different virtual monoenergetic (monoE) levels for different heart rates. A dynamic (heart rates of 0,  75 bpm) anthropomorphic phantom with three calcification densities was scanned using routine clinical CAC protocols with CT and PCCT. In addition to the standard clinical protocol of 70 keV, PCCT images were reconstructed at monoE levels of 72, 74, and 76 keV. CAC was quantified using Agatston, volume, and mass scores. Agatston scores 95% confidence intervals (CI) were calculated and compared between PCCT and CT. Volume and mass scores were compared with physical quantities. For all CAC densities, routine clinical protocol Agatston scores of static CAC were higher for PCCT compared to CT. At < 60 bpm, Agatston scores at 74 and 76 keV reconstructions were reproducible (overlapping CI) for PCCT and CT. Increased heart rates yielded different Agatston scores for PCCT in comparison with CT, for all monoE levels. Low density CAC volume scores showed the largest deviation from physical volume, with mean deviations of 59% and 77% for CT and PCCT, respectively. Overall, mass scores underestimated physical mass by 10%, 38%, and 59% for low, medium, and high density CAC, respectively. PCCT allows for reproducible Agatston scores for dynamic CAC (< 60 bpm) when reconstructed at monoE levels of 74 or 76 keV, regardless of CAC density. Deviations from physical volume and mass were, in general, large for both CT and PCCT

The Influence of Long-Acting Somatostatin Analogs on 68 Ga-DOTATATE Uptake in Patients With Neuroendocrine Tumors

Purpose A high SUVmax tumor-to-liver ratio (TLR) of 68Ga-DOTATATE can be used to select patients with neuroendocrine tumors (NETs) for peptide receptor radionuclide therapy (PRRT). In addition, an SUVmax TLR ≥ 8.1 is associated with increased progression-free survival in NET patients treated with somatostatin analogs (SSAs). To avoid a theoretical interaction, several guidelines recommend performing PET/CT just before the monthly administration of long-acting SSAs. We aimed to investigate the effect of SSA on the SUVmax of 68Ga-DOTATATE in patients with NET and to identify independent predictors for high SUVmax TLR. Patients and Methods For this retrospective study, 192 68Ga-DOTATATE PET/CT scans of 165 patients without (n = 115) and with (n = 77) SSA (octreotide or lanreotide) in the 3 months before PET/CT were collected and reviewed. The effect of SSA on SUVmax values was analyzed by a maximum likelihood mixed model. Results Patients with SSA had a significantly higher median SUVmax TLR than patients without SSA (4.7 [IQR], 3.1-7.7) versus 3.2 [IQR, 2.0-5.4]; P < 0.001). Multivariable logistic regression analysis showed that SSA use was an independent predictor for SUVmax TLR ≥ 8.1 (odds ratio, 2.91; 95% confidence interval, 1.26-6.72; P = 0.012). Conclusions Our data suggest that higher SSA concentrations do not have a negative effect on 68Ga-DOTATATE uptake in tumor lesions. In addition, we found that only SSA use was associated with SUVmax TLR ≥ 8.1. Our results are consistent with previously conducted studies and in line with the recently published guideline that suggests that the relatively recent use of SSA does not necessitate any delay in 68Ga-DOTATATE PET/CT imaging