Junjie Lu

All Publications

• China's 2017 Censorship Policy and Attitudes Towards Same-Sex Behavior: An Interrupted Time Series Analysis. Archives of sexual behavior Lu, J., Rehkopf, D. H., Bendavid, E. 2026

  Abstract

  Public attitudes toward sexual and gender minority (SGM) populations have important implications for health outcomes and human rights. This study examined how China's 2017 censorship policy restricting media portrayals of SGM populations was associated with attitudes towards same-sex behavior using data from the Chinese General Social Survey (2010-2021, N = 66,057). Using interrupted time series analysis, we found that the policy was associated with a significant shorter-term decrease in positive attitudes (OR = 0.73, 95% CI: 0.62 to 0.85, p < 0.001), with males (38% lower odds, OR = 0.62, 95% CI: 0.44 to 0.88, p = 0.007) showing larger decreases than females (17% lower odds, OR = 0.83, 95% CI: 0.68 to 1.01, p = 0.065; interaction OR = 0.75, 95% CI: 0.56 to 0.99, p = 0.048). In the longer term, trajectories diverged by internet usage: frequent internet users' annual increase in positive attitudes slowed from 14% (OR = 1.14, 95% CI: 1.11 to 1.17, p < 0.001) before the policy to 7% after (OR = 1.07, 95% CI: 0.90 to 1.28, p = 0.453), while infrequent users' increase accelerated from 14% (OR = 1.14, 95% CI: 1.11 to 1.17, p < 0.001) to 23% (OR = 1.23, 95% CI: 1.09 to 1.38, p < 0.001; interaction OR = 0.87, 95% CI: 0.77 to 0.99, p = 0.037). These findings highlight complex relationships between media censorship and attitude formation, with relevance for understanding how information control policies may shape societal acceptance of SGM populations.

  View details for DOI 10.1007/s10508-026-03498-y

  View details for PubMedID 42587257

  View details for PubMedCentralID 5407170

• Gestational Diabetes and Postpartum Cardiovascular, Kidney, and Metabolic Disorders. JAMA network open Liu, L., Lu, J. A., Velasquez, E. E., Ananth, C. V., Nguyen, M. H., Williams, M. A. 2026; 9 (8): e2628578

  Abstract

  Gestational diabetes is associated with future cardiometabolic risk, but postpartum evidence across the cardiovascular-kidney-metabolic (CKM) disorder spectrum remains limited.To characterize the timing and magnitude of incident postpartum CKM disorders after a pregnancy complicated by gestational diabetes.This retrospective cohort study used data from April 1, 2007, to October 12, 2023, from the Merative MarketScan commercial database. Participants were commercially insured females aged 12 to 55 years with a single delivery and no preexisting CKM disorders before delivery. Follow-up began after delivery and continued until incident diagnosis, disenrollment, or end of data availability. Data were analyzed from August 2025 to March 2026.Gestational diabetes, identified using diagnosis codes requiring 1 or more inpatient claims or 2 or more outpatient claims during pregnancy.Incident postpartum diagnoses of obesity, hypertension, hyperlipidemia, prediabetes, type 2 diabetes, metabolic syndrome, chronic kidney disease, and cardiovascular disease. Cox proportional hazards regression models estimated adjusted hazard ratios (AHRs) and 95% CIs. Temporal patterns were assessed using postpartum interval-specific HRs and year-specific incidence rate ratios.Of 1 153 998 females (mean [SD] age, 28.0 [5.8] years), 95 103 (8.2%) had gestational diabetes; median follow-up was 2.4 years (IQR, 1.6-3.8 years). Compared with individuals without gestational diabetes, those with gestational diabetes had higher crude incidence rates per 1000 person-years of type 2 diabetes (9.9 vs 1.0), prediabetes (12.9 vs 2.5), hyperlipidemia (19.9 vs 10.1), hypertension (13.9 vs 8.1), and obesity (26.3 vs 15.2). In adjusted models, gestational diabetes was associated with dysglycemia, including type 2 diabetes (time-averaged AHR, 10.02; 95% CI, 9.53-10.52) and prediabetes (AHR, 5.32; 95% CI, 5.12-5.53), metabolic syndrome (AHR, 2.72, 95% CI, 2.49-2.98), hyperlipidemia (AHR, 2.00; 95% CI, 1.95-2.06), hypertension (AHR, 1.76; 95% CI, 1.70-1.82), and obesity (AHR, 1.75; 95% CI, 1.71-1.79). Composite cardiovascular disease risk was elevated (AHR, 1.28; 95% CI, 1.18-1.40), whereas chronic kidney disease was not (AHR, 0.96; 95% CI, 0.76-1.22).In this cohort study, gestational diabetes was associated with increased postpartum risk across multiple metabolic disorders. These findings suggest that postpartum care after gestational diabetes may need to extend beyond glucose monitoring to include broader cardiometabolic risk surveillance.

  View details for DOI 10.1001/jamanetworkopen.2026.28578

  View details for PubMedID 42584895

• Association Between Screen Exposure and Insomnia Among Patients With Breast Cancer: Cross-Sectional Study. Journal of medical Internet research Liu, L., Yang, M., Ye, M., Lu, J. A., Dong, Y., Zhang, S., Chow, S. T., Hu, J., Jiang, S., Wang, X., Cheng, A., Huai, Y., Guo, Z., Fan, Q., Chen, Y., Yin, P. 2026; 28: e85837

  Abstract

  Insomnia burdens patients with breast cancer, exceeding its prevalence in other malignancies. While excessive screen time is known to disrupt sleep in children and adolescents, its impact on patients with breast cancer remains underexplored, particularly regarding how perceived stigma may modify screen-related sleep disruption.This study aimed to investigate the associations between both objectively measured total daily screen time and self-reported presleep screen time and insomnia in patients with breast cancer while assessing the effect measure modification by perceived stigma.This cross-sectional study recruited 778 patients with breast cancer from the Department of Breast Surgery, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, between August 1, 2023, and February 20, 2024. Total daily and presleep screen time were assessed as exposures, whereas insomnia, diagnosed using a standardized clinical assessment based on Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, criteria, served as the main outcome. Multivariable logistic regression models were used to estimate odds ratios and 95% CIs for the associations between screen time and insomnia using hierarchical adjustment across 3 models.Of the 240 participants with complete data on total daily screen time (mean age 51.82, SD 10.62 years), 186 (77.5%) were diagnosed with insomnia. Of the 644 participants with data on presleep screen time (mean age 53.46, SD 10.76 years), 419 (65.1%) met the criteria for insomnia. The median total daily screen time was 334.00 (IQR 232.50-440.25) minutes, whereas the median presleep screen time was 30.00 (IQR 10.00-120.00) minutes. Each 30-minute increase in total daily and presleep screen time was associated with higher odds of insomnia (adjusted odds ratio [aOR] 1.14, 95% CI 1.05-1.23, and aOR 1.41, 95% CI 1.26-1.57, respectively). High exposure was associated with 2.46-fold (more than the median [334 minutes per day]) and 3.22-fold (more than the median [30 minutes]) higher odds of insomnia. Stratified by perceived stigma, participants with both high daily screen time and high stigma had the highest odds of insomnia (aOR 4.53, 95% CI 1.42-14.49). A similar pattern was observed for high presleep screen time and high stigma (aOR 2.59, 95% CI 1.54-4.37). However, effect measure modification was not significant on either the multiplicative or additive scale.This cross-sectional study revealed associations between screen time exposure and insomnia in patients with breast cancer, with more consistent findings for presleep screen time. Findings for total daily screen time should be interpreted cautiously because of extensive missing objective screen time data. These findings support further longitudinal studies and suggest that reducing presleep screen exposure may be considered in supportive oncology care.

  View details for DOI 10.2196/85837

  View details for PubMedID 42490566

  View details for PubMedCentralID PMC13394888

• Factors associated with mood and anxiety disorders in cancer survivors: A systematic review and meta-analysis. Li, M., Zhou, X., Deng, Z., Jung, M., Lu, J., Spiegel, D., Langston, M., Chung, B. I., Bondy, M. LIPPINCOTT WILLIAMS & WILKINS. 2026: e24106

  View details for DOI 10.1200/JCO.2026.44.16_suppl.e24106

  View details for Web of Science ID 001780622400008

• Estimating depression risk differences between sexual minority and heterosexual young adults using targeted maximum likelihood estimation and Super Learner SSM-MENTAL HEALTH Lu, J., Rehkopf, D. H., Odden, M. C. 2026; 9

  View details for DOI 10.1016/j.ssmmh.2026.100649

  View details for Web of Science ID 001766047000002

• Performance of Large Language Models in Detecting Explicit and Implicit Colorism in Skin-Lightening Product Advertisements: A Validation Study. American journal of preventive medicine Chua, S. N., Lu, J. A., Fu, X., Kavanaugh, J. R., Austin, S. B. 2026: 108379

  View details for DOI 10.1016/j.amepre.2026.108379

  View details for PubMedID 42001915

• Individual-, institutional-, and societal-level factors and their interactions in the association between minority ethnicity and self-reported health outcomes in China, 2010-2021: a repeated cross-sectional study. BMC public health Lu, J., Yang, J., Zhong, J., Liu, L., Rehkopf, D. H. 2025

  Abstract

  Ecosocial theory emphasizes examining individual-, institutional-, and societal-level factors-and their interactions-when investigating racial and ethnic health disparities. This study evaluated the relationship between minority group ethnicity and self-reported health outcomes by comparing ethnic minorities (as a combined group) with the Han majority population in China.Cross-sectional data from seven waves (2010-2021) of the nationally representative Chinese General Social Survey were analyzed. Among 66,057 respondents (61,036 Han and 5,021 ethnic minorities), we first described temporal trends in self-reported overall health, social functioning, and depressive symptoms by ethnicity. We then used mixed-effects ordinal regression models to assess associations between minority (comparison group) versus Han (reference) ethnicity and these three health outcomes. Models were adjusted for individual-level factors (e.g., sociodemographic), institutional factors (e.g., healthcare resources), societal factor (living region), and interactions (minority ethnicity status, living region, and institutional factors). McFadden's pseudo-R-squared was calculated to determine the relative contributions of individual-, institutional-, and societal-level factors, as well as their interactions.Among 66,057 respondents (92.4% Han, 7.6% ethnic minorities), minority ethnicity compared to Han ethnicity was associated with better overall health (Odds Ratio [OR] 2.15, 95% CI 1.52-3.05), social function (OR: 1.68, 95% CI 1.18-2.39), and lower frequency of depressive symptoms (OR: 0.64, 95% CI 0.47-0.86) after adjustments for potential confounding variables. Individual-level factors explained most of the variance: 94.2% (overall health), 90.0% (social function), and 75.0% (frequency of depressive symptoms). Institutional- and societal-level factors contributed 3.0%, 6.1%, and 7.0%, while interactions accounted for 2.8%, 3.8%, and 18%, respectively.As a group, ethnic minorities in China were associated with better health outcomes versus the Han majority. While individual-level factors accounted for most of the variation in health outcomes, institutional- and societal-level factors, as well as their interactions, also contributed. Findings demonstrate context-specific applications of social epidemiological theories in China.

  View details for DOI 10.1186/s12889-025-25743-0

  View details for PubMedID 41350818

• Global, regional, and national estimates of burden and risk factors of female cancers in child-bearing age: A systematic analysis for Global Burden of Disease Study and Bayesian projection to 2030. Translational oncology Chen, G., Zhou, S., Shi, Q., Xun, Y., Fong, T. L., Xiong, R., Sun, Y. X., Lu, J., Li, Y., Li, Z., Zhu, G., Wu, Y., Zhou, Y., Feng, Y., Chan, K. K. 2025; 60: 102473

  Abstract

  The prevention, management, and treatment of female cancers among women of childbearing age (WCBA) are crucial strategies for achieving the objectives outlined in the World Health Organization (WHO) Global Breast Cancer Initiative and Cervical Cancer Elimination Initiative. This review aims to provide comprehensive global, regional, and national estimates of the burden of female cancers in women of childbearing age, as well as their attributable risk factors, from 1990 to 2021.According to the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 methodology, we estimated the incidence, disability-adjusted life-years (DALYs), and mortality of breast, cervical, ovarian, and uterine cancer among women of childbearing age. Temporal trends were assessed using the age-adjusted percentage change (AAPC). Risk factors were estimated using the population attributable fraction, stratified by socio-demographic index (SDI). Projections to 2030 were generated using a Bayesian model.In 2021, the global incidence of breast, uterine, cervical, and ovarian cancer among WCBA was 561,438 (95 % Uncertainty Interval [UI]: 523,147-602,978), 58,860 (95 % UI: 50,765-65,452), 307,428 (95 % UI: 280,667-335,692), and 85,749 (95 % UI: 75,169-95,090), respectively, corresponding to age-standardized rates per 100,000 population of 28.1 (95 % Confidence Interval [CI]: 28.0-28.1), 2.9 (95 % CI: 2.9-3.0), 15.4 (95 % CI: 15.4-15.5), and 4.3 (95 % CI: 4.3-4.4). Breast cancer accounted for the highest number of DALYs at 6659,460 (95 % UI: 6192,226-7145,549), followed by cervical cancer at 4184,314 (95 % UI: 3779,640-4629,604). Diets high in red meat, smoking, and alcohol consumption contributed to 11.2 %, 2.5 %, and 2.6 % of breast cancer deaths, respectively, while unprotected sex accounted for majority of cervical cancer deaths. Obesity was responsible for 30.2 % of both ovarian and uterine cancer deaths. Bayesian projection models indicated that by 2030, the global age-standardized incidence rates of breast and ovarian cancers among WCBA will reach 31.5 and 4.7 per 100,000 population, respectively.Globally, the number of breast, uterine, and ovarian cancer cases among WCBA has increased over the past decade, accompanied by a steady rise in age-standardized incidence rates. In contrast, while the absolute number of cervical cancer cases has risen, its age-standardized incidence rate has declined. Mortality rates for both breast and cervical cancers have generally decreased worldwide; however, in countries within the lower SDI quintile, mortality rates for these cancers continue to rise. Therefore, priority should be given to initiatives such as smoking cessation programs, alcohol reduction strategies, HPV vaccination campaigns, and safe sex education, particularly in lower SDI countries.

  View details for DOI 10.1016/j.tranon.2025.102473

  View details for PubMedID 40690821

• Photon-Counting Detector CT Allows Abdominal Virtual Monoenergetic Imaging at Lower Kiloelectron Volt Level with Lower Noise Using Lower Radiation Dose: A Prospective Matched Study Compared to Energy-Integrating Detector CT. Journal of imaging informatics in medicine Zhang, H., Hu, Y., Wang, L., Xing, Y., Xu, Z., Lu, J., Yang, J., Ding, B., Yuan, F., Zhong, J. 2025

  Abstract

  Our study aimed to assess the image quality of lower kiloelectron volt (keV) level abdominal virtual monoenergetic imaging (VMI) with lower radiation dose on photon-counting detector computed tomography (PCD-CT), in comparison to energy-integrating detector computed tomography (EID-CT). We prospectively included three matched groups, each with 59 participants, to undergo contrast-enhanced abdominal CT scans using EID-CT with full-dose (EID_FD), PCD-CT with full-dose (PCD_FD), and PCD-CT with low-dose (PCD_LD) protocols, respectively. The data of portal-venous phase were reconstructed into VMI at 40, 50, 60, and 70keV, respectively. The standard deviation of CT values in liver parenchyma was measured as image noise. The signal-to-noise ratio (SNR) of liver parenchyma and contrast-to-noise ratio (CNR) of liver-portal vein were calculated. Three radiologists assessed the image noise, vessel sharpness, and overall quality, and rated the hepatic lesion conspicuity if possible. Our study found that the PCD_LD significantly reduced the radiation dose than EID_FD or PCD_FD (p<0.001). The noise was significantly decreased by PCD_FD and PCD_LD compared to EID_FD, but SNR values were significantly increased (p≤0.006). The CNR values were significantly increased by PCD_FD and PCD_LD compared to EID_FD in VMI at 40keV and 50keV (p≤0.010). The ratings of image noise, vessel sharpness, overall quality, and lesion conspicuity were significantly greater in PCD_FD and PCD_LD compared to EID_FD (p≤0.001). There was no significant difference detected in rating of lesion conspicuity between PCD_FD and PCD_LD (p≥0.259). In conclusion, PCD-CT allows abdominal VMI with lower keV and lower noise using lower radiation dose, to provide better visualization of the hepatic lesions.

  View details for DOI 10.1007/s10278-025-01593-5

  View details for PubMedID 40601213

• Overlooked and underpowered: a meta-research addressing sample size in radiomics prediction models for binary outcomes. European radiology Zhong, J., Liu, X., Lu, J., Yang, J., Zhang, G., Mao, S., Chen, H., Yin, Q., Cen, Q., Jiang, R., Song, Y., Lu, M., Chu, J., Xing, Y., Hu, Y., Ding, D., Ge, X., Zhang, H., Yao, W. 2025

  Abstract

  To investigate how studies determine the sample size when developing radiomics prediction models for binary outcomes, and whether the sample size meets the estimates obtained by using established criteria.We identified radiomics studies that were published from 01 January 2023 to 31 December 2023 in seven leading peer-reviewed radiological journals. We reviewed the sample size justification methods, and actual sample size used. We calculated and compared the actual sample size used to the estimates obtained by using three established criteria proposed by Riley et al. We investigated which characteristics factors were associated with the sufficient sample size that meets the estimates obtained by using established criteria proposed by Riley et al. RESULTS: We included 116 studies. Eleven out of one hundred sixteen studies justified the sample size, in which 6/11 performed a priori sample size calculation. The median (first and third quartile, Q1, Q3) of the total sample size is 223 (130, 463), and those of sample size for training are 150 (90, 288). The median (Q1, Q3) difference between total sample size and minimum sample size according to established criteria are -100 (-216, 183), and those differences between total sample size and a more restrictive approach based on established criteria are -268 (-427, -157). The presence of external testing and the specialty of the topic were associated with sufficient sample size.Radiomics studies are often designed without sample size justification, whose sample size may be too small to avoid overfitting. Sample size justification is encouraged when developing a radiomics model.Question Sample size justification is critical to help minimize overfitting in developing a radiomics model, but is overlooked and underpowered in radiomics research. Findings Few of the radiomics models justified, calculated, or reported their sample size, and most of them did not meet the recent formal sample size criteria. Clinical relevance Radiomics models are often designed without sample size justification. Consequently, many models are too small to avoid overfitting. It should be encouraged to justify, perform, and report the considerations on sample size when developing radiomics models.

  View details for DOI 10.1007/s00330-024-11331-0

  View details for PubMedID 39789271

  View details for PubMedCentralID 4533986

• Mental Health Disparities by Sexual Orientation and Gender Identity in the All of Us Research Program. JAMA network open Lu, J. A., Soltani, S., Austin, S. B., Rehkopf, D. H., Lunn, M. R., Langston, M. E. 2025; 8 (1): e2456264

  Abstract

  Limited research explores mental health disparities between individuals in sexual and gender minority (SGM) populations and cisgender heterosexual (non-SGM) populations using national-level data.To explore mental health disparities between SGM and non-SGM populations across sexual orientation, sex assigned at birth, and gender identity within the All of Us Research Program.This cross-sectional study used survey data and linked electronic health records of eligible All of Us Research Program participants from May 31, 2017, to June 30, 2022.Self-identified SGM status.Prevalence of common mental health conditions identified from linked electronic health records. Logistic regression adjusted for age, race and ethnicity, educational level, income, employment status, and geographic region was used to assess the association between SGM status and mental health conditions.Among 413 457 participants, 269 947 (65.3%) were included in the analysis (median age, 59 [IQR, 43-70] years), with 22 189 (8.2%) self-identified as SGM. Men with cisgender sexual minority identity had higher odds of bipolar disorder (adjusted odds ratio [AOR], 1.87; 95% CI, 1.70-2.56) compared with cisgender heterosexual men. Women with cisgender sexual minority identity had higher odds of bipolar disorder (AOR, 2.09; 95% CI, 1.95-2.25) compared with cisgender heterosexual women. Gender diverse people assigned female sex at birth had higher odds of posttraumatic stress disorder (PTSD) compared with both cisgender heterosexual men (AOR, 3.67; 95% CI, 2.99-4.50) and cisgender heterosexual women (AOR, 2.77; 95% CI, 2.26-3.40). Gender diverse individuals assigned male sex at birth had higher odds of bipolar disorder (AOR, 2.35; 95% CI, 1.66-3.33) compared with cisgender heterosexual men and higher odds of attention-deficit/hyperactivity disorder (AOR, 2.19; 95% CI, 1.48-3.23) compared with cisgender heterosexual women. Transgender men had higher odds of depression (AOR, 2.11; 95% CI, 1.80-2.49) compared with cisgender heterosexual men, while transgender women had higher odds of any personality disorder (AOR, 2.71; 95% CI, 1.84-3.99) compared with cisgender heterosexual women.In this cross-sectional study of participants in the All of Us Research Program, there were significant mental health disparities between participants in SGM and non-SGM groups. These findings underscore the need for tailored mental health interventions to improve the well-being of SGM populations, while noting that the associations do not imply causality but reflect the stigma and minority stress experienced by these individuals.

  View details for DOI 10.1001/jamanetworkopen.2024.56264

  View details for PubMedID 39878980

• #Skin-Lightening: A content analysis of the most popular videos promoting skin-lightening products on TikTok. Body image Santoso, M., Duran, V., Lu, J., Austin, S. B., Raffoul, A. 2024; 52: 101846

  Abstract

  Highly visual and appearance-focused social media often exhibit appearance ideals that center around fairness and whiteness, resulting in the promotion of dangerous over-the-counter skin-lightening products to consumers to achieve such ideals. Our study aims to better understand the skin-lightening claims and products that TikTok users are exposed to on the platform. We conducted a cross-sectional content analysis to examine the top 100 most-viewed videos across the most popular skin-lightening hashtag (#skinlightening) through the TikTok website interface (N = 79) and generated descriptive statistics. Results illustrate that most individuals depicted in videos had a feminine gender expression (72.2 %), lighter skin tones (49.4 %), and were presumably South Asian (e.g., Indian, Sri Lankan) (43.0 %) and African American or Black (30.4 %). Adults ages 25-59 were the largest group depicted (40.5 %). Most videos provided no scientific evidence of efficacy (98.7 %) nor stated the credentials of the influencer promoting the product (88.6 %). The targeting of people of color and women in TikTok videos promoting skin lightening highlights the need for body image researchers and practitioners to assess social media use and its risks relative to skin shade dissatisfaction, as well as calls for platforms to instill community guidelines that prevent the spread of colorist ideals.

  View details for DOI 10.1016/j.bodyim.2024.101846

  View details for PubMedID 39731984

• Node-RADS: a systematic review and meta-analysis of diagnostic performance, category-wise malignancy rates, and inter-observer reliability. European radiology Zhong, J., Mao, S., Chen, H., Wang, Y., Yin, Q., Cen, Q., Lu, J., Yang, J., Hu, Y., Xing, Y., Liu, X., Ge, X., Jiang, R., Song, Y., Lu, M., Chu, J., Zhang, H., Zhang, G., Ding, D., Yao, W. 2024

  Abstract

  OBJECTIVE: To perform a systematic review and meta-analysis to estimate diagnostic performance, category-wise malignancy rates, and inter-observer reliability of Node Reporting and Data System 1.0 (Node-RADS).METHODS: Five electronic databases were systematically searched for primary studies on the use of Node-RADS to report the possibility of cancer involvement of lymph nodes on CT and MRI from January 1, 2021, until April 15, 2024. The study quality was assessed by modified Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) and Quality Appraisal of Diagnostic Reliability (QAREL) tools. The diagnostic accuracy was estimated with bivariate random-effects model, while the pooled category-wise malignancy rates were obtained with random-effects model.RESULTS: Six Node-RADS-CT studies and three Node-RADS-MRI studies covering nine types of cancer were included. The study quality was mainly damaged by inappropriate index test and unknown timing according to QUADAS-2, and unclear blindness during the rating process according to QAREL. The area under hierarchical summary receiver operating characteristic curve (95% conventional interval) was 0.92 (0.89-0.94) for Node-RADS≥3 as positive and 0.91 (0.88-0.93) for Node-RADS≥4 as positive, respectively. The pooled malignancy rates (95% CIs) of Node-RADS 1 to 5 were 4% (0-10%), 31% (9-58%), 55% (34-75%), 89% (73-99%), and 100% (97-100%), respectively. The inter-observer reliability of five studies was interpreted as fair to substantial.CONCLUSION: Node-RADS presented a promising diagnostic performance with an increasing probability of malignancy along higher category. However, the evidence for inter-observer reliability of Node-RADS is insufficient, and may hinder its implementation in clinical practice for lymph node assessment.KEY POINTS: Question Node-RADS is designed for structured reporting of the possibility of cancer involvement of lymph nodes, but the evidence supporting its application has not been summarized. Findings Node-RADS presented diagnostic performance with AUC of 0.92, and malignancy rates for categories 1-5 ranged from 4% to 100%, while the inter-observer reliability was unclear. Clinical relevance Node-RADS is a useful tool for structured reporting of the possibility of cancer involvement of lymph nodes with high diagnostic performance and appropriate malignancy rate for each category, but unclear inter-observer reliability may hinder its implementation in clinical practice.

  View details for DOI 10.1007/s00330-024-11160-1

  View details for PubMedID 39505734

• Ultra-High-Resolution Photon-Counting Detector CT Benefits Visualization of Abdominal Arteries: A Comparison to Standard-Reconstruction. Journal of imaging informatics in medicine Zhang, H., Xing, Y., Wang, L., Hu, Y., Xu, Z., Chen, H., Lu, J., Yang, J., Ding, B., Hu, W., Zhong, J. 2024

  Abstract

  This study aimedto investigate the potential benefit of ultra-high-resolution (UHR) photon-counting detector CT (PCD-CT) angiography in visualization of abdominal arteries in comparison to standard-reconstruction (SR) images of virtual monoenergetic images (VMI) at low kiloelectron volt (keV).We prospectively included 47 and 47 participants to undergo contrast-enhanced abdominal CT scans within UHR mode on a PCD-CT systemusing full-dose (FD) and low-dose (LD) protocols, respectively. The data were reconstructed into six series of images: FD_UHR_Br48, FD_UHR_Bv56, FD_UHR_Bv60, FD_SR_Bv40, LD_UHR_Bv48, and LD_SR_Bv40. The UHR reconstructions were performed with three kernels (Bv48, Bv56, and Bv60) within 0.2mm. The SR were virtual monoenergetic imaging reconstruction with Bv40 kernel at 40-keV within 1mm. Each series of axial images were reconstructed into coronal and volume-rendered images. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of seven arteries were measured. Three radiologists assessed the image quality, and visibility of nine arteries on all the images.SNR and CNR values of SR images were significantly higher than those of UHR images (P<0.001). The SR images have higher ratings in image noise (P<0.001), but the FD_UHR_Bv56 and FD_UHR_Bv60 images has higher rating in vessel sharpness (P<0.001). The overall quality was not significantly different among FD_VMI_40keV, LD_VMI_40keV, FD_UHR_Bv48, and LD_UHR_Bv48 images (P>0.05) but higher than those of FD_UHR_Bv56 and FD_UHR_Bv60 images (P<0.001). There is no significant difference of nine abdominal arteries among six series of images of axial, coronal and volume-rendered images (P>0.05).To conclude, 1-mm SR image of VMI at 40-keV is superior to 0.2-mm UHR regardless of which kernel is used to visualize abdominal arteries, while 0.2-mm UHR image using a relatively smooth kernel may allow similar image quality and artery visibility when thinner slice image is warranted.

  View details for DOI 10.1007/s10278-024-01232-5

  View details for PubMedID 39455541

• Is there enough evidence supporting the clinical adoption of clear cell likelihood score (ccLS)? An updated systematic review and meta-analysis. Insights into imaging Zhong, J., Hu, Y., Xing, Y., Liu, X., Ge, X., Wang, Y., Shi, Y., Lu, J., Yang, J., Song, Y., Lu, M., Chu, J., Zhang, H., Ding, D., Yao, W. 2024; 15 (1): 242

  Abstract

  To review the evidence for clinical adoption of clear cell likelihood score (ccLS) for identifying clear cell renal cell carcinoma (ccRCC) from small renal masses (SRMs).We distinguished the literature on ccLS for identifying ccRCC via systematic search using PubMed, Embase, Web of Science, China National Knowledge Infrastructure, and Wanfang Data until 31 March, 2024. The risk of bias and concern on application was assessed using the modified quality assessment of diagnostic accuracy studies (QUADAS-2) tool. The level of evidence supporting the clinical adoption of ccLS for identifying ccRCC was determined based on meta-analyses.Eight MRI studies and three CT studies were included. The risk of bias and application were mainly related to the index test and flow and timing, due to incomplete imaging protocol, unclear rating process, and inappropriate interval between imaging and surgery. The diagnostic odds ratios (95% confidence intervals) of MRI and CT ccLS were 14.69 (9.71-22.22; 6 studies, 1429 SRM, 869 ccRCC), and 5.64 (3.34-9.54; 3 studies, 296 SRM, 147 ccRCC), respectively, for identifying ccRCC from SRM. The evidence level for clinical adoption of MRI and CT ccLS were both rated as weak. MRI ccLS version 2.0 potentially has better diagnostic performance than version 1.0 (1 study, 700 SRM, 509 ccRCC). Both T2-weighted-imaging with or without fat suppression might be suitable for MRI ccLS version 2.0 (1 study, 111 SRM, 82 ccRCC).ccLS shows promising diagnostic performance for identifying ccRCC from SRM, but the evidence for its adoption in clinical routine remains weak.Although clear cell likelihood score (ccLS) demonstrates promising performance for detecting clear cell renal cell carcinoma, additional evidence is crucial to support its routine use as a tool for both initial diagnosis and active surveillance of small renal masses.Clear cell likelihood score is designed for the evaluation of small renal masses. Both CT and MRI clear cell likelihood scores are accurate and efficient. More evidence is necessary for the clinical adoption of a clear cell likelihood score.

  View details for DOI 10.1186/s13244-024-01829-y

  View details for PubMedID 39382764

  View details for PubMedCentralID 4707715

• Impact of Digital Advertising Policy on Harmful Product Promotion: Natural Language Processing Analysis of Skin-Lightening Ads. American journal of preventive medicine Lu, J., Chua, S. N., Kavanaugh, J. R., Prashar, J., Ndip-Agbor, E., Santoso, M., Jackson, D. A., Chakraborty, P., Raffoul, A., Austin, S. B. 2024

  Abstract

  Starting June 30, 2022, Google implemented its revised Inappropriate Content Advertising Policy, targeting discriminatory skin-lightening ads that suggest superiority of certain skin shades. This study evaluates the ad content changes from 2 weeks before to 2 weeks after the policy's enforcement.Text ads from Google searches in eight countries (Bahamas, Germany, India, Malaysia, Mexico, South Africa, United Arab Emirates, and United States) were collected in 2022, totaling 1,974 prepolicy and 3,262 post-policy ads, and analyzed in 2023. A gold standard database was established by two coders who labeled 707 ads, which trained five natural language processing models to label the ads, covering content and target demographics. The descriptive statistics and multivariable logistic models were applied to analyze content before versus after policy implementation, both globally and by country.Vertex AI emerged as the best natural language processing model with the highest F1 score of 0.87. There were significant decreases from pre- to post-policy implementation in the prevalence of labels of "Racial or Ethnic Identification" and "Ingredients: Natural" by 47% and 66%, respectively. Notable differences were identified from pre- to post-policy implementation in India, Mexico, and Germany.The study observed changes in skin-lightening product advertisement labels from pre- to post-policy implementation, both globally and within countries. Considering the influence of digital advertising on colorist norms, assessing digital ad policy changes is crucial for public health surveillance. This study presents a computational method to help monitor digital platform policies for consumer product advertisements that affect public health.

  View details for DOI 10.1016/j.amepre.2024.08.006

  View details for PubMedID 39306774

• The policies on the use of large language models in radiological journals are lacking: a meta-research study. Insights into imaging Zhong, J., Xing, Y., Hu, Y., Lu, J., Yang, J., Zhang, G., Mao, S., Chen, H., Yin, Q., Cen, Q., Jiang, R., Chu, J., Song, Y., Lu, M., Ding, D., Ge, X., Zhang, H., Yao, W. 2024; 15 (1): 186

  Abstract

  To evaluate whether and how the radiological journals present their policies on the use of large language models (LLMs), and identify the journal characteristic variables that are associated with the presence.In this meta-research study, we screened Journals from the Radiology, Nuclear Medicine and Medical Imaging Category, 2022 Journal Citation Reports, excluding journals in non-English languages and relevant documents unavailable. We assessed their LLM use policies: (1) whether the policy is present; (2) whether the policy for the authors, the reviewers, and the editors is present; and (3) whether the policy asks the author to report the usage of LLMs, the name of LLMs, the section that used LLMs, the role of LLMs, the verification of LLMs, and the potential influence of LLMs. The association between the presence of policies and journal characteristic variables was evaluated.The LLM use policies were presented in 43.9% (83/189) of journals, and those for the authors, the reviewers, and the editor were presented in 43.4% (82/189), 29.6% (56/189) and 25.9% (49/189) of journals, respectively. Many journals mentioned the aspects of the usage (43.4%, 82/189), the name (34.9%, 66/189), the verification (33.3%, 63/189), and the role (31.7%, 60/189) of LLMs, while the potential influence of LLMs (4.2%, 8/189), and the section that used LLMs (1.6%, 3/189) were seldomly touched. The publisher is related to the presence of LLM use policies (p < 0.001).The presence of LLM use policies is suboptimal in radiological journals. A reporting guideline is encouraged to facilitate reporting quality and transparency.It may facilitate the quality and transparency of the use of LLMs in scientific writing if a shared complete reporting guideline is developed by stakeholders and then endorsed by journals.The policies on LLM use in radiological journals are unexplored. Some of the radiological journals presented policies on LLM use. A shared complete reporting guideline for LLM use is desired.

  View details for DOI 10.1186/s13244-024-01769-7

  View details for PubMedID 39090273

  View details for PubMedCentralID 9792370

• Robustness of radiomics among photon-counting detector CT and dual-energy CT systems: a texture phantom study. European radiology Zhu, L., Dong, H., Sun, J., Wang, L., Xing, Y., Hu, Y., Lu, J., Yang, J., Chu, J., Yan, C., Yuan, F., Zhong, J. 2024

  Abstract

  To evaluate the robustness of radiomics features among photon-counting detector CT (PCD-CT) and dual-energy CT (DECT) systems.A texture phantom consisting of twenty-eight materials was scanned with one PCD-CT and four DECT systems (dual-source, rapid kV-switching, dual-layer, and sequential scanning) at three dose levels twice. Thirty sets of virtual monochromatic images at 70 keV were reconstructed. Regions of interest were delineated for each material with a rigid registration. Ninety-three radiomics were extracted per PyRadiomics. The test-retest repeatability between repeated scans was assessed by Bland-Altman analysis. The intra-system reproducibility between dose levels, and inter-system reproducibility within the same dose level, were evaluated by intraclass correlation coefficient (ICC) and concordance correlation coefficient (CCC). Inter-system variability among five scanners was assessed by coefficient of variation (CV) and quartile coefficient of dispersion (QCD).The test-retest repeatability analysis presented that 97.1% of features were repeatable between scan-rescans. The mean ± standard deviation ICC and CCC were 0.945 ± 0.079 and 0.945 ± 0.079 for intra-system reproducibility, respectively, and 86.0% and 85.7% of features were with ICC > 0.90 and CCC > 0.90, respectively, between different dose levels. The mean ± standard deviation ICC and CCC were 0.157 ± 0.174 and 0.157 ± 0.174 for inter-system reproducibility, respectively, and none of the features were with ICC > 0.90 or CCC > 0.90 within the same dose level. The inter-system variability suggested that 6.5% and 12.8% of features were with CV < 10% and QCD < 10%, respectively, among five CT systems.The radiomics features were non-reproducible with significant variability in values among different CT techniques.Radiomics features are non-reproducible with significant variability in values among photon-counting detector CT and dual-energy CT systems, necessitating careful attention to improve the cross-system generalizability of radiomic features before implementation of radiomics analysis in clinical routine.CT radiomics stability should be guaranteed before the implementation in the clinical routine. Radiomics robustness was on a low level among photon-counting detectors and dual-energy CT techniques. Limited inter-system robustness of radiomic features may impact the generalizability of models.

  View details for DOI 10.1007/s00330-024-10976-1

  View details for PubMedID 39048741

  View details for PubMedCentralID 4533986

• Just give the contrast? Appraisal of guidelines on intravenous iodinated contrast media use in patients with kidney disease. Insights into imaging Zhong, J., Chen, L., Xing, Y., Lu, J., Shi, Y., Wang, Y., Deng, Y., Jiang, R., Lu, W., Wang, S., Hu, Y., Ge, X., Ding, D., Zhang, H., Zhu, Y., Yao, W. 2024; 15 (1): 77

  Abstract

  To appraise the quality of guidelines on intravenous iodinated contrast media (ICM) use in patients with kidney disease, and to compare the recommendations among them.We searched four literature databases, eight guideline libraries, and ten homepages of radiological societies to identify English and Chinese guidelines on intravenous ICM use in patients with kidney disease published between January 2018 and June 2023. The quality of the guidelines was assessed with the Scientific, Transparent, and Applicable Rankings (STAR) tool.Ten guidelines were included, with a median STAR score of 46.0 (range 28.5-61.5). The guidelines performed well in "Recommendations" domain (31/40, 78%), while poor in "Registry" (0/20, 0%) and "Protocol" domains (0/20, 0%). Nine guidelines recommended estimated glomerular filtration rate (eGFR) < 30 mL/min/1.73 m2 as the cutoff for referring patients to discuss the risk-benefit balance of ICM administration. Three guidelines further suggested that patients with an eGFR < 45 mL/min/1.73 m2 and high-risk factors also need referring. Variable recommendations were seen in the acceptable time interval between renal function test and ICM administration, and that between scan and repeated scan. Nine guidelines recommended to use iso-osmolar or low-osmolar ICM, while no consensus has been reached for the dosing of ICM. Nine guidelines supported hydration after ICM use, but their protocols varied. Drugs or blood purification therapy were not recommended as preventative means.Guidelines on intravenous ICM use in patients with kidney disease have heterogeneous quality. The scientific societies may consider joint statements on controversial recommendations for variable timing and protocols.The heterogeneous quality of guidelines, and their controversial recommendations, leave gaps in workflow timing, dosing, and post-administration hydration protocols of contrast-enhanced CT scans for patients with kidney diseases, calling for more evidence to establish a safer and more practicable workflow.• Guidelines concerning iodinated contrast media use in kidney disease patients vary. • Controversy remains in workflow timing, contrast dosing, and post-administration hydration protocols. • Investigations are encouraged to establish a safer iodinated contrast media use workflow.

  View details for DOI 10.1186/s13244-024-01644-5

  View details for PubMedID 38499879

  View details for PubMedCentralID PMC10948651

• The association of sexual minority status and bullying victimization is modified by sex and grade: findings from a nationally representative sample BMC PUBLIC HEALTH Lu, J., Yang, J., Sadikova, E., Tiemeier, H. 2024; 24 (1): 504

  Abstract

  Sexual minority status is associated with face-to-face bullying and cyberbullying victimization. However, limited studies have investigated whether such a relationship differs by sex or grade in a nationally representative sample.We concatenated the national high school data from the Youth Risk Behavior Surveillance System (YRBSS) chronologically from 2015 to 2019, resulting in a sample of 32,542 high school students. We constructed models with the interaction term between sexual minority status and biological sex assigned at birth to test the effect modification by sex on both the multiplicative and additive scales. A similar method was used to test the effect modification by grade.Among heterosexual students, females had a higher odds of being bullied than males, while among sexual minority students, males had a higher odds of being bullied. The effect modification by sex was significant on both the multiplicative and additive scales. We also found a decreasing trend of bullying victimization as the grade increased among both heterosexual and sexual minority students. The effect modification by the grade was significant on both the multiplicative and the additive scale.Teachers and public health workers should consider the difference in sex and grade when designing prevention programs to help sexual minority students.

  View details for DOI 10.1186/s12889-024-17988-y

  View details for Web of Science ID 001163711300019

  View details for PubMedID 38365609

  View details for PubMedCentralID PMC10874033

• The endorsement of general and artificial intelligence reporting guidelines in radiological journals: a meta-research study. BMC medical research methodology Zhong, J., Xing, Y., Lu, J., Zhang, G., Mao, S., Chen, H., Yin, Q., Cen, Q., Jiang, R., Hu, Y., Ding, D., Ge, X., Zhang, H., Yao, W. 2023; 23 (1): 292

  Abstract

  Complete reporting is essential for clinical research. However, the endorsement of reporting guidelines in radiological journals is still unclear. Further, as a field extensively utilizing artificial intelligence (AI), the adoption of both general and AI reporting guidelines would be necessary for enhancing quality and transparency of radiological research. This study aims to investigate the endorsement of general reporting guidelines and those for AI applications in medical imaging in radiological journals, and explore associated journal characteristic variables.This meta-research study screened journals from the Radiology, Nuclear Medicine & Medical Imaging category, Science Citation Index Expanded of the 2022 Journal Citation Reports, and excluded journals not publishing original research, in non-English languages, and instructions for authors unavailable. The endorsement of fifteen general reporting guidelines and ten AI reporting guidelines was rated using a five-level tool: "active strong", "active weak", "passive moderate", "passive weak", and "none". The association between endorsement and journal characteristic variables was evaluated by logistic regression analysis.We included 117 journals. The top-five endorsed reporting guidelines were CONSORT (Consolidated Standards of Reporting Trials, 58.1%, 68/117), PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses, 54.7%, 64/117), STROBE (STrengthening the Reporting of Observational Studies in Epidemiology, 51.3%, 60/117), STARD (Standards for Reporting of Diagnostic Accuracy, 50.4%, 59/117), and ARRIVE (Animal Research Reporting of In Vivo Experiments, 35.9%, 42/117). The most implemented AI reporting guideline was CLAIM (Checklist for Artificial Intelligence in Medical Imaging, 1.7%, 2/117), while other nine AI reporting guidelines were not mentioned. The Journal Impact Factor quartile and publisher were associated with endorsement of reporting guidelines in radiological journals.The general reporting guideline endorsement was suboptimal in radiological journals. The implementation of reporting guidelines for AI applications in medical imaging was extremely low. Their adoption should be strengthened to facilitate quality and transparency of radiological study reporting.

  View details for DOI 10.1186/s12874-023-02117-x

  View details for PubMedID 38093215

  View details for PubMedCentralID 2874506

• A marginal structural model analysis for the effect modification by education on the association between cancer diagnosis history and major depressive symptoms: Findings from Midlife Development in the U.S. (MIDUS). Journal of affective disorders Liu, L., Lu, J., Yang, J., Dong, Y., Yin, P., Chen, Y. 2023; 341: 202-210

  Abstract

  BACKGROUND: Limited research has employed a longitudinal approach to investigate the role of education level as an effect modifier on the relationship between cancer diagnosis history and the experience of major depressive disorder (MDD) with a nationally representative sample.METHODS: We harnessed data from three installments of the MIDUS Longitudinal study (n=7108). A Marginal Structural Model facilitated the investigation of associations between a history of cancer diagnosis, MDD, and potential modifying effects of education level. Inverse probability weighting helped manage confounding factors.RESULTS: Findings indicated that a cancer diagnosis made one year prior was linked with 3.741 times greater odds of experiencing MDD (95% CI: 1.411-9.918, p<0.01). This connection was absent for diagnoses made two years earlier. Among individuals with education up to high school, a recent cancer diagnosis significantly increased the likelihood of MDD in the subsequent wave by 3.45 times (95% CI: 1.31-9.08, p<0.05). This pattern was not apparent among better-educated individuals.LIMITATIONS: As the exposure variable was dependent on self-reported questionnaires, recall bias could be a potential limitation. Moreover, unaccounted variables like genetic factors could introduce confounding.CONCLUSIONS: A recent cancer diagnosis, particularly among less educated individuals, correlated with an increased probability of MDD, while the impact was not observed for older diagnoses. These findings emphasize that the timing of a cancer diagnosis and education level need consideration in the mental health assessment of cancer survivors.

  View details for DOI 10.1016/j.jad.2023.08.123

  View details for PubMedID 37640112

• An overview of meta-analyses on radiomics: more evidence is needed to support clinical translation INSIGHTS INTO IMAGING Zhong, J., Lu, J., Zhang, G., Mao, S., Chen, H., Yin, Q., Hu, Y., Xing, Y., Ding, D., Ge, X., Zhang, H., Yao, W. 2023; 14 (1): 111

  Abstract

  To conduct an overview of meta-analyses of radiomics studies assessing their study quality and evidence level.A systematical search was updated via peer-reviewed electronic databases, preprint servers, and systematic review protocol registers until 15 November 2022. Systematic reviews with meta-analysis of primary radiomics studies were included. Their reporting transparency, methodological quality, and risk of bias were assessed by PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) 2020 checklist, AMSTAR-2 (A MeaSurement Tool to Assess systematic Reviews, version 2) tool, and ROBIS (Risk Of Bias In Systematic reviews) tool, respectively. The evidence level supporting the radiomics for clinical use was rated.We identified 44 systematic reviews with meta-analyses on radiomics research. The mean ± standard deviation of PRISMA adherence rate was 65 ± 9%. The AMSTAR-2 tool rated 5 and 39 systematic reviews as low and critically low confidence, respectively. The ROBIS assessment resulted low, unclear and high risk in 5, 11, and 28 systematic reviews, respectively. We reperformed 53 meta-analyses in 38 included systematic reviews. There were 3, 7, and 43 meta-analyses rated as convincing, highly suggestive, and weak levels of evidence, respectively. The convincing level of evidence was rated in (1) T2-FLAIR radiomics for IDH-mutant vs IDH-wide type differentiation in low-grade glioma, (2) CT radiomics for COVID-19 vs other viral pneumonia differentiation, and (3) MRI radiomics for high-grade glioma vs brain metastasis differentiation.The systematic reviews on radiomics were with suboptimal quality. A limited number of radiomics approaches were supported by convincing level of evidence.The evidence supporting the clinical application of radiomics are insufficient, calling for researches translating radiomics from an academic tool to a practicable adjunct towards clinical deployment.

  View details for DOI 10.1186/s13244-023-01437-2

  View details for Web of Science ID 001015034300003

  View details for PubMedID 37336830

  View details for PubMedCentralID PMC10279606

• INVESTIGATING THE PROMOTION OF DIETING-RELATED PRODUCTS ON TIKTOK: A PILOT STUDY Raffoul, A., Santoso, M., Lu, J., Duran, V., Austin, S. ELSEVIER SCIENCE INC. 2023: S60

  View details for Web of Science ID 000995238000104

• The descriptive analysis of depressive symptoms and White Blood Cell (WBC) count between the sexual minorities and heterosexual identifying individuals in a nationally representative sample: 2005-2014 BMC PUBLIC HEALTH Lu, J., Yang, J., Liang, J., Mischoulon, D., Nyer, M. 2023; 23 (1): 294

  Abstract

  Sexual minorities are at a higher risk of suffering from depressive symptoms compared with heterosexual individuals. Only a few studies have examined the conditions of having depressive symptoms within different sexual minority groups, especially people with sexual orientation uncertainty in a nationally representative sample. Furthermore, few studies have explored whether the mean white blood count (WBC) is different between people with and without depressive symptoms among different sexual minority groups in a nationally representative sample.We analyzed the National Health and Nutrition Examination Survey (NHANES) data from 2005 to 2014 with a sample of 14,090 subjects. We compared the prevalence of depressive symptoms in subpopulations stratified by sex, sexual minority status, and race. We also examined the difference in mean WBC count between depressed and non-depressed people among heterosexual individuals and different sexual minority groups. Additionally, two multivariable logistic regression models were used to explore the association between sexual minority status and depressive symptoms, treating sexual minority status as both a binary and categorical variable.Female sex (OR: 1.96, 95% CI: 1.72-2.22) and sexual minority status (OR: 1.79, 95% CI: 1.47-2.17) were both independently associated with depressive symptoms. Within the sexual minority population, subjects who were unsure about their sexual identities had the highest odds of having depressive symptoms (OR: 2.56, 95% CI: 1.40-4.68). In the subgroup analysis considering intersectionality, black sexual minority females had the highest rate of depressive symptoms (19.4%, 95% CI: 7.72-40.98). Finally, the mean WBC count differed significantly between people with and without depressive symptoms among male heterosexual individuals, female heterosexual individuals, and female sexual minorities, but not among male sexual minorities.Based on sex, race, and sexual minority status, black females of sexual minority status had the highest rate of depressive symptoms. Within sexual minority groups, participants who were unsure about their sexual identities had the highest odds of having depressive symptoms. Finally, the mean WBC count was significantly higher among people with depressive symptoms than those without depressive symptoms only among male heterosexuals, female heterosexuals, and female sexual minorities, but not among male sexual minorities. Future research should investigate the social and biological mechanisms of the differences.

  View details for DOI 10.1186/s12889-022-14847-6

  View details for Web of Science ID 000931457900006

  View details for PubMedID 36759803

  View details for PubMedCentralID PMC9909981

• Does the association between Herpes Simplex 2 infection and depressive symptoms vary among different sexual minority statuses and sex groups? Findings from a nationally representative sample JOURNAL OF AFFECTIVE DISORDERS Lu, J., Liang, J., Yang, J., Mischoulon, D., Nyer, M. 2023; 327: 226-229

  Abstract

  Herpes Simplex Virus Type 2 (HSV-2) has been associated with depression, but the relationship has yet to be explored with respect to gender and sexual orientation in a nationally representative sample to help identify individuals at higher risk for depression.A dataset from National Health and Nutrition Examination Survey 2009-2014 was used in this study. Multivariable logistic regression models were constructed to test effect modification on both the multiplicative and additive scale using a sample of 57,684 subjects.Effect modification by sexual minority status was not significant on either the multiplicative scale (Ratio of ORs: 0.74, 95 % CI: 0.37-1.50, p = 0.395) or the additive scale (RERI: -0.22, 95%CI: -2.27-1.84, p = 0.833). Meanwhile, biological sex assigned at birth was a significant modifier only on the additive scale (RERI: 0.82, 95 % CI: 0.004-1.64, P = 0.049). Specifically, females (OR: 1.43, 95 % CI: 1.03-1.97, P = 0.032) had greater odds of having depressive symptoms compared with males (OR: 1.20, 95 % CI: 0.69-2.08, p = 0.509) after the HSV-2 infection.The analysis was based on a cross-sectional study; further investigation using longitudinal datasets might be beneficial.Sexual minority status did not modify the association between HSV-2 infection and having depressive symptoms. However, biological sex assigned at birth was a modifier only on the additive but not the multiplicative scale. Health workers should be alert for depression symptoms in females with HSV-2 infection.

  View details for DOI 10.1016/j.jad.2023.01.008

  View details for Web of Science ID 000991739100001

  View details for PubMedID 36623565

• Clinical Observation on Auricular Acupressure for Primary Dysmenorrhea: A Study Protocol for a Randomized Clinical Trial JOURNAL OF PAIN RESEARCH Liu, L., Hu, J., Lu, J., Yang, J. 2023; 16: 3217-3225

  Abstract

  The objective of this study is to evaluate the immediate and time-dependent effects of AA in treating PD and assess its safety.This study is a randomized, single-blinded, controlled trial that will enroll 92 patients in a 1:1 allocation ratio. Patients will be assigned to either the treatment group (n=46) or the control group (n=46). During the first menstrual period, the treatment group will receive AA treatment, while the control group will receive sham AA treatment for 7 days. The second menstrual period will serve as the follow-up period. The primary outcome measure is the Visual Analog Scale (VAS) score 30 min after the first treatment. Secondary outcome measures include the VAS score immediately after the first treatment, onset time of analgesic effect, duration of pain, extra dosing rate of ibuprofen, and change of the Menstrual Distress Questionnaire (MDQ) score. The outcomes will be assessed at baseline, during the intervention period, and during the follow-up period.The study results will provide evidence on the efficacy and safety of AA in managing PD by analyzing its immediate effect, time-effect relationship, and reduction of painkiller use.Chinese Clinical Trial Registry (ChiCTR2300069741).

  View details for DOI 10.2147/JPR.S414416

  View details for Web of Science ID 001075253300001

  View details for PubMedID 37753489

  View details for PubMedCentralID PMC10519210