Junjie Lu

All Publications

• 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 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