Background
Comorbidity between depressive and anxiety disorders is common. From network perspective, mental disorders arise from direct interactions between symptoms and comorbidity is due to direct interactions between depression and anxiety symptoms. The current study investigates the network structure of depression and anxiety symptoms in Chinese female nursing students and identifies the central and bridge symptoms as well as how other symptoms in present network are related to depression symptom “thoughts of death”.
Methods
To understand the full spectrum of depression and anxiety, we recruited 776 Chinese female nursing students with symptoms of depression and anxiety that span the full range of normal to abnormal. Depression symptoms were measured by Patient Health Questionnaire-9 while anxiety symptoms were measured by Generalized Anxiety Disorder 7-Item Questionnaire. Network analysis was used to construct networks. Specifically, we computed the predictability, expected influence and bridge expected influence for each symptom and showed a flow network of “thoughts of death”.
Results
Nine strongest edges existed in network were from the same disorder. Four were between depression symptoms, like “sleep difficulties” and “fatigue”, and “anhedonia” and “fatigue”. Five were between anxiety symptoms, like “nervousness or anxiety” and “worry too much”, and “restlessness” and “afraid something will happen”. The symptom “fatigue”, “feeling of worthlessness” and “irritable” had the highest expected influence centrality. Results also revealed two bridge symptoms: “depressed or sad mood” and “irritable”. As to “thoughts of death”, the direct relations between it and “psychomotor agitation/retardation” and “feeling of worthlessness” were the strongest direct relations.
Conclusions
The current study highlighted critical central symptoms “fatigue”, “feeling of worthlessness” and “irritable” and critical bridge symptoms “depressed or sad mood” and “irritable”. Particularly, “psychomotor agitation/retardation” and “feeling of worthlessness” were identified as key priorities due to their strongest associations with suicide ideation. Implications for clinical prevention and intervention based on these symptoms are discussed.
Background
Preoperative discrimination between nonmuscle‐invasive bladder carcinomas (NMIBC) and the muscle‐invasive ones (MIBC) is very crucial in the management of patients with bladder cancer (BC).
Purpose
To evaluate the discriminative performance of multiparametric MRI radiomics features for precise differentiation of NMIBC from MIBC, preoperatively.
Study Type
Retrospective, radiomics.
Population
Fifty‐four patients with postoperative pathologically proven BC lesions (24 in NMIBC and 30 in MIBC groups) were included.
Field Strength/Sequence
3.0T MRI/T2‐weighted (T2W) and multi‐b‐value diffusion‐weighted (DW) sequences.
Assessment
A total of 1104 radiomics features were extracted from carcinomatous regions of interest on T2W and DW images, and the apparent diffusion coefficient maps. Support vector machine with recursive feature elimination (SVM‐RFE) and synthetic minority oversampling technique (SMOTE) were used to construct an optimal discriminative model, and its performance was evaluated and compared with that of using visual diagnoses by experts.
Statistical Tests
Chi‐square test and Student's t‐test were applied on clinical characteristics to analyze the significant differences between patient groups.
Results
Of the 1104 features, an optimal subset involving 19 features was selected from T2W and DW sequences, which outperformed the other two subsets selected from T2W or DW sequence in muscle invasion discrimination. The best performance for the differentiation task was achieved by the SVM‐RFE+SMOTE classifier, with averaged sensitivity, specificity, accuracy, and area under the curve of receiver operating characteristic of 92.60%, 100%, 96.30%, and 0.9857, respectively, which outperformed the diagnostic accuracy by experts.
Data Conclusion
The proposed radiomics approach has potential for the accurate differentiation of muscle invasion in BC, preoperatively. The optimal feature subset selected from multiparametric MR images demonstrated better performance in identifying muscle invasiveness when compared with that from T2W sequence or DW sequence only.
Level of Evidence: 3
Technical Efficacy: Stage 2
J. Magn. Reson. Imaging 2019;49:1489–1498.
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