The Nonlinear Relationship Between Body Mass Index (BMI) and Perceived Depression in the Chinese Population.

Purpose: Existing studies on the association between BMI and depression report conflicting results with some demonstrating a positive relationship, while others a negative link or insignificant correlation. Very limited research on the nonlinear relationship between BMI and depression has yet to clarify the reliability and robustness of the potential nonlinearity and whether a more complex association exists. This paper aims to systematically investigate the nonlinear relationship between the two factors applying rigorous statistical methods, as well as explore the heterogeneity of their association. Materials and Methods: A large-scale nationally representative dataset, Chinese General Social Survey, is used to empirically analyze the nonlinear relationship between BMI and perceived depression. Various statistical tests are employed to check the robustness of the nonlinearity. Results: Results indicate that there is a U-shaped relationship between BMI and perceived depression, with the turning point (25.718) very close to while slightly larger than the upper limit of the range of healthy weight (18.500 ≤ BMI < 25.000) defined by World Health Organization. Both very high and low BMIs are associated with increased risk for depressive disorders. Furthermore, perceived depression is higher at almost all BMI levels among individuals who are older, female, lower educated, unmarried, in rural areas, belonging to ethnic minorities, non-Communist Party of China members, as well as those with lower income and uncovered by social security. In addition, these subgroups have smaller inflection points and their self-rated depression is more sensitive to BMI. Conclusion: This paper confirms a significant U-shaped trend in the association between BMI and depression. Therefore, it is important to account for the variations in this relationship across different BMI categories when using BMI to predict depression risk. Besides, this study clarifies the management goals for achieving an appropriate BMI from a mental health perspective and identifies vulnerable subgroups at higher risk of depression.

Plasma cell-free DNA promise monitoring and tissue injury assessment of COVID-19.

Coronavirus 2019 (COVID-19) is a complex disease that affects billions of people worldwide. Currently, effective etiological treatment of COVID-19 is still lacking; COVID-19 also causes damages to various organs that affects therapeutics and mortality of the patients. Surveillance of the treatment responses and organ injury assessment of COVID-19 patients are of high clinical value. In this study, we investigated the characteristic fragmentation patterns and explored the potential in tissue injury assessment of plasma cell-free DNA in COVID-19 patients. Through recruitment of 37 COVID-19 patients, 32 controls and analysis of 208 blood samples upon diagnosis and during treatment, we report gross abnormalities in cfDNA of COVID-19 patients, including elevated GC content, altered molecule size and end motif patterns. More importantly, such cfDNA fragmentation characteristics reflect patient-specific physiological changes during treatment. Further analysis on cfDNA tissue-of-origin tracing reveals frequent tissue injuries in COVID-19 patients, which is supported by clinical diagnoses. Hence, our work demonstrates and extends the translational merit of cfDNA fragmentation pattern as valuable analyte for effective treatment monitoring, as well as tissue injury assessment in COVID-19.

Effectiveness of simultaneous multislice accelerated readout-segmented echo planar imaging for the assessment of rectal cancer.

PURPOSE: To investigate the effectiveness of simultaneous multislice (SMS) accelerated readout-segmented echo planar imaging (RESOLVE) DWI for assessing rectal cancer in the clinic. METHOD: Sixty consecutive histologically proven rectal cancer patients were enrolled. They all received MRI examinations, including both SMS-RESOLVE and RESOLVE sequences. Two readers visually assessed the overall image quality, distinction of anatomical structures, lesion conspicuity, and artifacts of two sequences by using a qualitative 4-point Likert scale. The quantitative ADC value, lesion contrast, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and temporal SNR (tSNR) were independently calculated in rectal cancer on the largest slice of the tumor. RESULTS: The scan time was shortened from 3 min and 50 s to 1 min and 47 s. The interobserver agreement of visual and quantitative assessments between the two readers was good overall. There were no differences in overall image quality, lesion conspicuity or artifact scores between the two sequences in both readers (all p > 0.05). The lesion contrast (p = 0.013) was significantly higher in SMS-RESOLVE, and the CNR was similar in the two DWIs. The scores of distinctions of anatomical structures in SMS-RESOLVE were lower (all p < 0.05) in both readers. The SNR of SMS-RESOLVE was lower than that of RESOLVE (p = 0.004), and the tSNR of SMS-RESOLVE was significantly higher (p < 0.001). The ADC value of the tumor was lower in SMS-RESOLVE (p = 0.001), but the ADC values of the normal rectal wall showed no difference between the two DWIs. CONCLUSION: SMS-RESOLVE allowed a substantial reduction in acquisition time while maintaining overall image quality and lesion conspicuity in rectal cancer. It also had a higher contrast of the lesion and a higher temporal SNR.

Epidemiology of Coronavirus Disease 2019 (COVID-19) Caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2).

In December, 2019, an infectious outbreak of unknown cause occurred in Wuhan, which attracted intense attention. Shortly after the virus was identified as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the epidemic of coronavirus disease 2019 (COVID-19) broke out, and an information storm occurred. At that time, 2 important aspects, that is, the stages of spread and the components of the epidemic, were unclear. Answers to the questions (1) what are the sources, (2) how do infections occur, and (3) who will be affected should be clarified as the outbreak continues to evolve. Furthermore, components of the epidemic and the stages of spread should be explored and discussed. Based on information of SARS, Middle East respiratory syndrome (MERS), and COVID-19, the components of the epidemic (the sources, the routes of infection, and the susceptible population) will be discussed, as well as the role of natural and social factors involved. Epidemiologic characteristics of patients will be traced based on current information.

Assessment of right ventricular dysfunction in end-stage renal disease patients on maintenance haemodialysis by cardiac magnetic resonance imaging.

PURPOSE: To assess right ventricular (RV) dysfunction in end-stage renal disease (ESRD) patients on maintenance haemodialysis (HD) by cardiac magnetic resonance (CMR) imaging and determined the risk factors associated with RV dysfunction. MATERIALS AND METHODS: Fifty ESRD patients on maintenance HD and 16 age- and gender-matched healthy individuals were prospectively enrolled and underwent CMR imaging. Left ventricular (LV) and RV function parameters, including end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV) and ejection fraction (EF), were measured and compared. Independent sample t-test and Mann-Whitney U-test were used to compare the differences between healthy individuals and ESRD patients. Pearson correlation and multiple linear regression analyses were used to assess risk factors associated with RV dysfunction. RESULTS: Significantly lower RVEF and LVEF were observed in ESRD patients than in the control group (all p < 0.001). RVEDV, RVESV and RVSV in ESRD patients were also lower than those in the control group (all p < 0.05). Meanwhile, higher LVESV, LV mass and interventricular septum thickness were found in ESRD patients than in the control group (all p < 0.05). RVEF was positively correlated with LVEF (r = 0.37, p = 0.008) and negatively correlated with the duration of renal insufficiency (r = -0.53, p < 0.001) and dialysis (r = -0.63, p < 0.001). Moreover, multiple linear regression analyses revealed that the duration of dialysis and LVEF were independently associated with decreased RVEF (adjusted R2 = 0.53, p < 0.001). CONCLUSIONS: In ESRD patients on maintenance HD, RV function was impaired and associated with the deterioration of LV function. More importantly, the duration of dialysis was considered as a risk factor independently associated with RV dysfunction.

Defining and characterizing the critical transition state prior to the type 2 diabetes disease.

BACKGROUND: Type 2 diabetes mellitus (T2DM), with increased risk of serious long-term complications, currently represents 8.3% of the adult population. We hypothesized that a critical transition state prior to the new onset T2DM can be revealed through the longitudinal electronic medical record (EMR) analysis. METHOD: We applied the transition-based network entropy methodology which previously identified a dynamic driver network (DDN) underlying the critical T2DM transition at the tissue molecular biological level. To profile pre-disease phenotypical changes that indicated a critical transition state, a cohort of 7,334 patients was assembled from the Maine State Health Information Exchange (HIE). These patients all had their first confirmative diagnosis of T2DM between January 1, 2013 and June 30, 2013. The cohort's EMRs from the 24 months preceding their date of first T2DM diagnosis were extracted. RESULTS: Analysis of these patients' pre-disease clinical history identified a dynamic driver network (DDN) and an associated critical transition state six months prior to their first confirmative T2DM state. CONCLUSIONS: This 6-month window before the disease state provides an early warning of the impending T2DM, warranting an opportunity to apply proactive interventions to prevent or delay the new onset of T2DM.

[Clinical Study of Rs-EPI DWI to Improve Imaging Quality and Assessment on Intracranial Mass Lesions].

OBJECTIVES: To explore the clinical value of readout-segmented echo planar imaging (Rs-EPI) sequence in the assessment of intracranial mass lesions compared to the standard single-shot EPI (Ss-EPI) sequence. METHODS: We included 21 patients with intracranial mass lesions who underwent both Ss-EPI diffusion weighted imaging (DWI) and Rs-EPI DWI at 3.0T MR scanner with a twenty-channel head-neck coil. The quality of images was assessed by two experienced radiologists independently. The differences in image quality between two sequences were analyzed using Wilcoxon signed-rank test. Inter-observer agreements were analyzed using interclass correlation coefficient (ICC) and Kappa test. RESULTS: All objectives were completed on 3.0T MR. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) in Rs-EPI DWI were higher than those in Ss-EPI DWI (130.46±49.10 vs. 71.58±30.43, P=0.000; 33.22±18.86 vs. 17.92±18.72, P=0.003). The scores of overall image quality, ghost artifact where next to the paranasal sinuses, mastoid air cells and frontal sinus of Rs-EPI DWI were significantly higher than those of Ss-EPI DWI. Meanwhile, the geometric distortion of anatomical structures of Rs-EPI DWI were significantly lower compared to Ss-EPI DWI sequence (0.016±0.021 vs. 0.037±0.069, P=0.00). The inter-reader and intra-reader agreements for the assessment of qualitative parameters were good [0.74≤Kappa value or ICC≤0.92]. CONCLUSIONS: Rs-EPI DWI sequence is a potential technique to improve the imaging quality in the diagnosis of intracranial mass lesions.