Deep learning-enabled MRI-only photon and proton therapy treatment planning for paediatric abdominal tumours

Purpose: To assess the feasibility of magnetic resonance imaging (MRI)-only treatment planning for photon and proton radiotherapy in children with abdominal tumours. Materials and methods: The study was conducted on 66 paediatric patients with Wilms' tumour or neuroblastoma (age 4 +/- 2 years) who underwent MR and computed tomography (CT) acquisition on the same day as part of the clinical protocol. MRI intensities were converted to CT Hounsfield units (HU) by means of a UNet-like neural network trained to generate synthetic CT (sCT) from T1- and T2-weighted MR images. The CT-to-sCT image similarity was evaluated by computing the mean error (ME), mean absolute error (MAE), peak signal-to-noise ratio (PSNR) and Dice similarity coefficient (DSC). Synthetic CT dosimetric accuracy was verified against CT-based dose distributions for volumetric-modulated arc therapy (VMAT) and intensity-modulated pencil-beam scanning (PBS). Relative dose differences (D-diff) in the internal target volume and organs-at-risk were computed and a three-dimensional gamma analysis (2 mm, 2%) was performed. Results: The average +/- standard deviation ME was -5 +/- 12 HU, MAE was 57 +/- 12 HU, PSNR was 30.3 +/- 1. 6 dB and DSC was 76 +/- 8% for bones and 92 +/- 9% for lungs. Average D-diff were 99% (range [85; 100]%) for VMAT and >96% (range [87; 100]%) for PBS. Conclusion: The deep learning-based model generated accurate sCT from planning T1w- and T2w-MR images. Most dosimetric differences were within clinically acceptable criteria for photon and proton radiotherapy, demonstrating the feasibility of an MRI-only workflow for paediatric patients with abdominal tumours. (C) 2020 The Authors. Published by Elsevier B.V

Gender differences in characteristics of violent and sexual victimization in patients with psychosis:a cross-sectional study

Abstract Introduction Various studies have demonstrated that individuals with a psychotic disorder are at an increased risk of becoming a victim of crime. Little is known about gender differences in victimization types and in specific characteristics of victimization (e.g., perpetrator, location or disclosure). Knowledge on characteristics of victimization would provide clinicians with more insight which may be especially useful for tailoring interventions. The aim of this study is to examine gender differences in characteristics of violent and sexual victimization in patients with a psychotic disorder. Methods Information on violent (threats, physical abuse) and sexual victimization (harassment, assault) was assessed in 482 individuals with a psychotic disorder who received mental health care. Patients were recruited through a routine outcome monitoring study and a clinical trial. Results Men reported more threats with violence (20.7% vs. 10.5%, x2 = 7.68, p = 0.01), whereas women reported more sexual assault (13.3% vs. 3.6%, x2 = 15.43, p < 0.001). For violent victimization, women were more likely than men to be victimized by a partner, friend or family member (52.9% vs. 30.6%) as opposed to a stranger (11.8% vs. 40.3%; O.R. = 52.49) and to be victimized at home (60.0% vs. 29.3%) as opposed to on the street or elsewhere (40.0% vs. 70.3%; O.R. = 0.06). For sexual victimization, there was no difference in location and perpetrator between men and women. For sexual victimization and physical violence, no differences in disclosure were found, but women were more likely not to disclose threats with violence or to disclose threats to a professional or police (52.9% vs. 45.2%; O.R. = 30.33). All analyses were controlled for age, diagnosis and employment. Discussion Gender patterns of victimization types and characteristics are similar for individuals with a psychotic disorder in comparison to the general population. Men were at higher risk of violent victimization, whereas women were at higher risk for sexual victimization. Men were more likely to become victimized in the streets or elsewhere by a stranger, whereas women seemed to be more often victimized at home by a partner, friend or a family member. Future studies may tailor interventions preventing victimization in psychosis according to gender

Measuring the Autistic Women's Experience (AWE)

We developed a Dutch questionnaire called the Autistic Women's Experience (AWE) and compared its psychometric properties to the Autism Spectrum Quotient (AQ). Whilst attenuated gender differences on the AQ have been widely replicated, this instrument may not fully capture the unique experience of autistic women. The AWE was co-developed with autistic women to include items that reflect autistic women's experience. We investigated the AWE (49 items) and compared it with the AQ (50 items) in Dutch autistic individuals ( N = 153, n = 85 women) and in the general population ( N = 489, n = 246 women) aged 16+. Both the AQ and AWE had excellent internal consistency and were highly and equally predictive of autism in both women and men. Whilst there was a gender difference on the AQ among non-autistic people (men &gt; women), there was no gender difference among autistic people, confirming all earlier studies. No gender differences were detected on the AWE overall scale, yet subtle gender differences were observed on the subscales. We conclude that the AQ is valid for both genders, but the AWE provides an additional useful perspective on the characteristics of autistic women. The AWE needs further validation in independent samples using techniques that allow for testing gender biases, as well as a confirmatory factor analysis in a larger sample. </p

Zijn complotdenkers psychotisch? Een vergelijking tussen complottheorieën en paranoïde wanen

Complotdenken komt veel voor in onzekere omstandigheden. Het geeft mensen houvast, zekerheid, morelesuperioriteit en sociale steun. Extreem complotdenken lijkt te passen binnen de gangbare psychiatrische definities van paranoïde wanen, maar toch zijn er ook belangrijke verschillen. Om onderscheid te kunnen maken met complotdenken behoeven gangbare definities van wanen verdieping. In plaats van de sterke focus op de foutieve inhoud van waanideeën zou er meer aandacht moeten zijn voor de onderliggende idiosyncratische, veranderde vorm van de werkelijkheidsbeleving.Security and Global Affair

Are conspiracy theorists psychotic?:A comparison between conspiracy theories and paranoid delusions

Achtergrond Complottheorieën zijn populair tijdens de coronapandemie. Complotdenken wordt gekenmerkt door de sterke overtuiging dat een bepaalde, als onrechtvaardig ervaren situatie, het resultaat is van een doelbewuste samenzwering van een groep mensen met kwade bedoelingen. Complotdenken lijkt veel overeenkomsten te hebben met paranoïde wanen.Doel Verkennen van aard, gevolgen en sociaalpsychologische dimensies van complotdenken en beschrijven van overeenkomsten en verschillen met paranoïde wanen.Methode Kritisch beschouwen van relevante literatuur over complotdenken en paranoïde wanen.Resultaten Complotdenken voorziet in epistemische, existentiële en sociale behoeften. Het geeft duidelijkheid in onzekere tijden en aansluiting bij een groep van gelijkgestemden. Bij zowel complotdenken als paranoïde wanen gaat het om een onjuiste, hardnekkige en soms bizarre overtuiging. In tegenstelling tot complotdenkers zijn mensen met een paranoïde waan echter vrijwel altijd alleen het doelwit van de veronderstelde samenzwering en staan ze grotendeels alleen in hun overtuiging. Tevens zijn complotideeën minder gebaseerd op ongewone ervaringen van het zelf, de werkelijkheid of intermenselijke contacten. Conclusies Complotdenken komt veel voor in onzekere omstandigheden. Het geeft mensen houvast, zekerheid, morele superioriteit en sociale steun. Extreem complotdenken lijkt te passen binnen de gangbare psychiatrische definities van paranoïde wanen, maar toch zijn er ook belangrijke verschillen. Om onderscheid te kunnen maken met complotdenken behoeven gangbare definities van wanen verdieping. In plaats van de sterke focus op de foutieve inhoud van waanideeën zou er meer aandacht moeten zijn voor de onderliggende idiosyncratische, veranderde vorm van de werkelijkheidsbeleving.BACKGROUND: Conspiracy theories are popular during the COVID-19 pandemic. Conspiratorial thinking is characterised by the strong conviction that a certain situation that one sees as unjust is the result of a deliberate conspiracy of a group of people with bad intentions. Conspiratorial thinking appears to have many similarities with paranoid delusions.AIM: To explore the nature, consequences, and social-psychological dimensions of conspiratorial thinking, and describe similarities and differences with paranoid delusions.METHOD: Critically assessing relevant literature about conspiratorial thinking and paranoid delusions.RESULTS: Conspiratorial thinking meets epistemic, existential, and social needs. It provides clarity in uncertain times and connection with an in-group of like-minded people. Both conspiratorial thinking and paranoid delusions involve an unjust, persistent, and sometimes bizarre conviction. Unlike conspiracy theorists, people with a paranoid delusion are almost always the only target of the presumed conspiracy, and they usually stand alone in their conviction. Furthermore, conspiracy theories are not based as much on unusual experiences of their inner self, reality, or interpersonal contacts. CONCLUSIONS Conspirational thinking is common in uncertain circumstances. It gives grip, certainty, moral superiority and social support. Extreme conspirational thinking seems to fit current psychiatric definitions of paranoid delusions, but there are also important differences. To make a distinction with regard to conspiratorial thinking, deepening of conventional definitions of delusions is required. Instead of the strong focus on the erroneous content of delusions, more attention should be given to the underlying idiosyncratic, changed way of experiencing reality.</p

Are conspiracy theorists psychotic?:A comparison between conspiracy theories and paranoid delusions

Achtergrond Complottheorieën zijn populair tijdens de coronapandemie. Complotdenken wordt gekenmerkt door de sterke overtuiging dat een bepaalde, als onrechtvaardig ervaren situatie, het resultaat is van een doelbewuste samenzwering van een groep mensen met kwade bedoelingen. Complotdenken lijkt veel overeenkomsten te hebben met paranoïde wanen.Doel Verkennen van aard, gevolgen en sociaalpsychologische dimensies van complotdenken en beschrijven van overeenkomsten en verschillen met paranoïde wanen.Methode Kritisch beschouwen van relevante literatuur over complotdenken en paranoïde wanen.Resultaten Complotdenken voorziet in epistemische, existentiële en sociale behoeften. Het geeft duidelijkheid in onzekere tijden en aansluiting bij een groep van gelijkgestemden. Bij zowel complotdenken als paranoïde wanen gaat het om een onjuiste, hardnekkige en soms bizarre overtuiging. In tegenstelling tot complotdenkers zijn mensen met een paranoïde waan echter vrijwel altijd alleen het doelwit van de veronderstelde samenzwering en staan ze grotendeels alleen in hun overtuiging. Tevens zijn complotideeën minder gebaseerd op ongewone ervaringen van het zelf, de werkelijkheid of intermenselijke contacten. Conclusies Complotdenken komt veel voor in onzekere omstandigheden. Het geeft mensen houvast, zekerheid, morele superioriteit en sociale steun. Extreem complotdenken lijkt te passen binnen de gangbare psychiatrische definities van paranoïde wanen, maar toch zijn er ook belangrijke verschillen. Om onderscheid te kunnen maken met complotdenken behoeven gangbare definities van wanen verdieping. In plaats van de sterke focus op de foutieve inhoud van waanideeën zou er meer aandacht moeten zijn voor de onderliggende idiosyncratische, veranderde vorm van de werkelijkheidsbeleving.BACKGROUND: Conspiracy theories are popular during the COVID-19 pandemic. Conspiratorial thinking is characterised by the strong conviction that a certain situation that one sees as unjust is the result of a deliberate conspiracy of a group of people with bad intentions. Conspiratorial thinking appears to have many similarities with paranoid delusions.AIM: To explore the nature, consequences, and social-psychological dimensions of conspiratorial thinking, and describe similarities and differences with paranoid delusions.METHOD: Critically assessing relevant literature about conspiratorial thinking and paranoid delusions.RESULTS: Conspiratorial thinking meets epistemic, existential, and social needs. It provides clarity in uncertain times and connection with an in-group of like-minded people. Both conspiratorial thinking and paranoid delusions involve an unjust, persistent, and sometimes bizarre conviction. Unlike conspiracy theorists, people with a paranoid delusion are almost always the only target of the presumed conspiracy, and they usually stand alone in their conviction. Furthermore, conspiracy theories are not based as much on unusual experiences of their inner self, reality, or interpersonal contacts. CONCLUSIONS Conspirational thinking is common in uncertain circumstances. It gives grip, certainty, moral superiority and social support. Extreme conspirational thinking seems to fit current psychiatric definitions of paranoid delusions, but there are also important differences. To make a distinction with regard to conspiratorial thinking, deepening of conventional definitions of delusions is required. Instead of the strong focus on the erroneous content of delusions, more attention should be given to the underlying idiosyncratic, changed way of experiencing reality.</p