Objective:To investigate the prevalence and influencing factors of depression,anxiety and comorbid depression-anxiety symptoms among college freshmen,providing a theoretical basis for promoting their mental health.Methods:From Jan to Feb 2022,an online questionnaire survey was conducted,involving 483 online questionnaires from college freshmen(184 males,299 females).The depression-anxiety-stress self-rating scale,smartphone dependence self-rating scale for adolescents,and Pittsburgh sleep quality index(PSQI)were used for online surveys.The influencing factors of depression,anxiety,and their comorbidity among college freshmen were analyzed by multivariable logistic regression analysis.Results:The detection rates of smartphone dependence,sleep disorders,depression,anxiety and comorbid depression-anxiety symptoms among college freshmen were 26.1%,12.8%,26.3%,32.1%,and 23.6%,respectively.The detection rates of depression,anxiety and comorbid depression-anxiety symptoms in male students were significantly higher than those in female students(P＜0.05).Multivariable logistic regression analysis showed that self-perceived poor mental health,smartphone dependence and sleep disorders were risk factors for depression,anxiety and comorbid depression-anxiety symptoms.Low satisfaction with college life was a risk factor for depression.Medical specialty was a risk factor for anxiety and comorbid depression-anxiety symptoms(P＜0.05).Conclusions:Male college freshmen show higher rates of depression,anxiety,and their comorbidity.Low satisfaction with college life,self-perceived poor mental health,high academic pressure,smartphone dependence,medical specialty,and sleep disorders may be risk factors for depression,anxiety and comorbid depression-anxiety symptoms among college freshmen.

Objective:To explore the cognition of nursing undergraduate students towards learner reputation in the digital education environment, providing a basis for the construction of learner reputation incentive mechanisms.Methods:This study was descriptive and qualitative. Purposive sampling was used to select 26 nursing undergraduate students from six schools of nursing for the study from July to November 2023 for semi-structured interviews. Traditional content analysis method was used to analyze the data.Results:A total of three themes and 7 sub-themes were refined, including personal literacy reputation (self-directed learning ability in online learning, integrity quality in digital learning environment, learning potential stimulated by digital resources), behavioral competence reputation (role positioning and responsibility in digital learning tasks, outcome benefits in digital learning tasks), and interactive identity reputation (shaping professional image and self-identity, obtaining external evaluation and good reputation) .Conclusions:Building learner reputation incentive mechanism is crucial in digital education, which motivates nursing students, empowers professional development, and lays a solid foundation for personal growth and future career development.

ObjectiveTo evaluate the efficacy of Sanhua essential oil inhalation as aromatherapy in patients with breast cancer-related depression.MethodsIn total, 144 patients with breast cancer-related depression who underwent postoperative chemotherapy were recruited. The participants in the control group (n = 52) were offered a placebo (sunflower oil) daily, whereas those in the essential oil group (n = 52) were administered Sanhua essential oil. This study evaluated depression improvement, Hamilton Depression Scale score, scores of symptoms in traditional Chinese medicine (TCM), Pittsburgh Sleepiness Quotient Index score, incidence of nausea and vomiting, and signal changes on functional magnetic resonance imaging.ResultsDepression improved by 48.1% and 21.2% in the essential oil and control groups, respectively (P = .010). The Hamilton Depression Scale score (P = .017), scores for symptoms in TCM (P = .002), and the incidence of nausea and vomiting in the acute and delayed phases were lower in the essential oil group than in the control group (nausea in the acute phase, P = .017; nausea in the delayed phase, P = .039; vomiting in the acute phase, P = .008; vomiting in the delayed phase, P = .081). The Pittsburgh Sleepiness Quotient Index score was lower in the essential oil group than in the control group (P = .005). Significant differences existed between the two groups in the left superior parietal gyrus, right precuneus, left dorsolateral superior frontal gyrus, and right precentral gyrus according to functional connectivity on functional magnetic resonance imaging.ConclusionInhalation of Sanhua essential oil alleviated depression in patients undergoing chemotherapy for breast cancer, improved sleep quality, relieved TCM symptoms, reduced nausea and vomiting, and regulated activities in the brain regions.

Objective To develop an automated system that can accurately determine the relationship between the mandibular third molar and the mandibular nerve canal from panoramic images.Methods A dataset consisting of 600 panoramic images of the oral cavi-ty was selected,and the positions of the mandibular third molar and the mandibular nerve canal were accurately labeled.We compared the research designed TI-YOLOv5 with PANet,Faster R-CNN,Mask R-CNN,ResNeSt-101,and the original YOLOv5 in image seg-mentation tasks,with evaluation metrics of AP and AP50.Results TI-YOLOv5 achieved AP(average precision)54.0％and AP5094.9％,an increase of 4.9 and 6.7 percentage points respectively compared to the original YOLOv5(AP 49.1％,AP50 88.2％),and surpassed other SOTA methods such as Mask R-CNN(AP 45.1％,AP50 84.2％).Conclusion TI-YOLOv5 is significantly superior to mainstream networks in automatic positioning and relationship classification of mandibular wisdom teeth and neural tubes,with high de-tection accuracy and discrimination accuracy,and can provide reliable technical support for preoperative risk assessment of mandibular wisdom tooth extraction.

Objective:To explore the clinical features of nivolumab-induced Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN).Methods:Relevant databases at home and abroad (as of December 31, 2023) were searched to collect case reports of nivolumab-induced SJS/TEN, and the demographic characteristics, nivolumab application, combination drugs, clinical manifestations, intervention measures, and outcomes were extracted and analyzed descriptively and statistically.Results:A total of 27 case reports were included and 29 patients were enrolled in the study, including 18 males and 11 females. The age ranged from 45 to 86 years, with an average age of 67 years. The primary diseases were mainly melanoma, stomach cancer, and lung cancer. Twelve patients had records of nivolumab administration, and the dosage was within the recommended range in the labels; 13 patients had records of combination drugs, mainly other antineoplastic drugs, hypoglycemic drugs, antihypertensive drugs, lipid-regulating drugs, etc. The time from using nivolumab to the diagnosis of SJS/TEN was 7 d to 3 years, and 20 patients were <8 weeks. The clinical manifestations were mainly diffuse erythema, flaky skin peeling and erosion, mucosal involvement, etc. Sixteen patients had skin biopsy records, all of which met the histopathological characteristics of SJS/TEN. After the diagnosis of SJS/TEN, 17 patients discontinued nivolumab and received symptomatic treatments, of which 15 patients had improved skin symptoms, one patient had worsened skin symptoms, and one patient had no record of skin outcome; 12 patients had no record of whether or not discontinuing nivolumab, of which 8 patients had improved skin symptoms, 2 patients had worsened skin symptoms, one patient had no record of skin outcome, and one had no record of prognosis. One patient rechallenged nivolumab, severe SJS/TEN recurred. Thirteen of 29 patients died. Of them, 1 died due to cardiac arrest, 4 due to worsened skin rash, and 8 due to primary disease progression.Conclusions:SJS/TEN caused by nivolumab mostly occurs within 8 weeks of treatment, and the clinical manifestations were similar to those caused by other drugs. The mortality rate of nivolumab-induced SJS/TEN is high, and skin rash could be improved after withdrawal of nivolumab and symptomatic treatments.

Objective:To explore the cognition of nursing undergraduate students towards learner reputation in the digital education environment, providing a basis for the construction of learner reputation incentive mechanisms.Methods:This study was descriptive and qualitative. Purposive sampling was used to select 26 nursing undergraduate students from six schools of nursing for the study from July to November 2023 for semi-structured interviews. Traditional content analysis method was used to analyze the data.Results:A total of three themes and 7 sub-themes were refined, including personal literacy reputation (self-directed learning ability in online learning, integrity quality in digital learning environment, learning potential stimulated by digital resources), behavioral competence reputation (role positioning and responsibility in digital learning tasks, outcome benefits in digital learning tasks), and interactive identity reputation (shaping professional image and self-identity, obtaining external evaluation and good reputation) .Conclusions:Building learner reputation incentive mechanism is crucial in digital education, which motivates nursing students, empowers professional development, and lays a solid foundation for personal growth and future career development.

Objective:To investigate the causal impact of maternal smoking around birth(MSAB)on off-spring's risk of attention deficit hyperactivity disorder(ADHD),autism spectrum disorder(ASD),bipolar disorder(BD),and major depressive disorder(MDD).Methods:The datasets for MSAB and 4 psychiatric disorders were extracted from genome-wide association studies(GWAS).Mendelian randomization(MR)was employed,using in-verse variance weighting(IVW)as the primary analysis method.Sensitivity analyses and outlier correction were conducted using weighted median(WM),MR-Egger regression,and MR-PRESSO.The results were expressed as odds ratios(OR)and corrected for false discovery rate(FDR).Results:MR analysis showed significant causal re-lationships between MSAB and increased risk of ADHD(OR=5.36,95％CI=2.58-7.63,PFDR=0.003),MDD(OR=1.92,95％CI=1.29-2.88,PFDR=0.003),and BD(OR=6.33,95％CI=1.56-8.73,PFDR=0.013).However,no statistically significant association was found between MSAB and ASD(OR=1.66,95％CI=0.23-5.87,PFDR=0.616).Conclusion:This study suggests a potential causal link between maternal smoking around the time of birth and an increased risk of attention deficit hyperactivity disorder,bipolar disorder,and major depressive disorder in offspring.

With the rapid development of digital technology, digital twin technology shows great potential for application in the medical and nursing fields. This paper reviews the main elements and key aspects of digital twins, their application scenarios and effects in medicine and nursing, and application challenges faced, with a view to providing innovative solution ideas for healthcare professionals and promoting the application and development of digital twins in medicine and nursing.

Objective:To investigate the prevalence and influencing factors of depression,anxiety and comorbid depression-anxiety symptoms among college freshmen,providing a theoretical basis for promoting their mental health.Methods:From Jan to Feb 2022,an online questionnaire survey was conducted,involving 483 online questionnaires from college freshmen(184 males,299 females).The depression-anxiety-stress self-rating scale,smartphone dependence self-rating scale for adolescents,and Pittsburgh sleep quality index(PSQI)were used for online surveys.The influencing factors of depression,anxiety,and their comorbidity among college freshmen were analyzed by multivariable logistic regression analysis.Results:The detection rates of smartphone dependence,sleep disorders,depression,anxiety and comorbid depression-anxiety symptoms among college freshmen were 26.1%,12.8%,26.3%,32.1%,and 23.6%,respectively.The detection rates of depression,anxiety and comorbid depression-anxiety symptoms in male students were significantly higher than those in female students(P＜0.05).Multivariable logistic regression analysis showed that self-perceived poor mental health,smartphone dependence and sleep disorders were risk factors for depression,anxiety and comorbid depression-anxiety symptoms.Low satisfaction with college life was a risk factor for depression.Medical specialty was a risk factor for anxiety and comorbid depression-anxiety symptoms(P＜0.05).Conclusions:Male college freshmen show higher rates of depression,anxiety,and their comorbidity.Low satisfaction with college life,self-perceived poor mental health,high academic pressure,smartphone dependence,medical specialty,and sleep disorders may be risk factors for depression,anxiety and comorbid depression-anxiety symptoms among college freshmen.

Objective:To investigate the causal impact of maternal smoking around birth(MSAB)on off-spring's risk of attention deficit hyperactivity disorder(ADHD),autism spectrum disorder(ASD),bipolar disorder(BD),and major depressive disorder(MDD).Methods:The datasets for MSAB and 4 psychiatric disorders were extracted from genome-wide association studies(GWAS).Mendelian randomization(MR)was employed,using in-verse variance weighting(IVW)as the primary analysis method.Sensitivity analyses and outlier correction were conducted using weighted median(WM),MR-Egger regression,and MR-PRESSO.The results were expressed as odds ratios(OR)and corrected for false discovery rate(FDR).Results:MR analysis showed significant causal re-lationships between MSAB and increased risk of ADHD(OR=5.36,95％CI=2.58-7.63,PFDR=0.003),MDD(OR=1.92,95％CI=1.29-2.88,PFDR=0.003),and BD(OR=6.33,95％CI=1.56-8.73,PFDR=0.013).However,no statistically significant association was found between MSAB and ASD(OR=1.66,95％CI=0.23-5.87,PFDR=0.616).Conclusion:This study suggests a potential causal link between maternal smoking around the time of birth and an increased risk of attention deficit hyperactivity disorder,bipolar disorder,and major depressive disorder in offspring.