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Abstract Purpose This study aimed to assess how a Zentangle intervention influences cognitive focus, emotional well‐being, stress levels, and neural activity patterns across brain regions and frequency bands. Method A cohort of 30 healthy adults, all without prior Zentangle experience, participated in this study. Electroencephalography (EEG) was used to measure their brain activity, and self‐reported data were collected through questionnaires to assess subjects’ concentration levels, emotional calm, and stress and anxiety. Findings Participants reported enhanced cognitive focus and emotional well‐being, evidenced by increased self‐reported concentration and emotional calmness, and reduced stress and anxiety levels during the intervention. EEG analyses revealed notable changes in neural activity patterns, including decreased delta power and increased theta, alpha, beta, and gamma bands. Functional connectivity analysis also highlighted alterations in the brain's functional connectivity, suggesting potential effects on neural communication and information processing. Conclusion This study provides compelling evidence of Zentangle's impact on EEG data, aligning it with equanimity and tranquility consistent with previous mindfulness research. These findings underscore Zentangle as an effective mindfulness practice, potentially enhancing cognitive focus and emotional well‐being, and emerging as a valuable intervention for improving mental health and overall well‐being.

BackgroundDepressive symptoms are common among patients with lung cancer. We aimed to assess the effects of esketamine on postoperative depressive symptoms after thoracoscopic lung cancer surgery.MethodsIn this randomized, double-blind, placebo-controlled trial, 156 patients undergoing thoracoscopic lung cancer surgery were randomly allocated in a 1:1 ratio to receive intravenous esketamine (intraoperatively and in patient-controlled analgesia until 48 h postoperatively) or normal saline placebo. The primary outcome was the proportion of patients with depressive symptoms at 1 month postoperatively, assessed using the Beck Depression Inventory-II (BDI-II). Secondary outcomes included depressive symptoms at 48 h postoperatively, hospital discharge and 3 months postoperatively, BDI-II scores, anxious symptoms, Beck Anxiety Inventory scores, Quality of Recovery-15 (QoR-15) scores, and 1- and 3-month mortality.Main resultsA total of 151 patients (75 in the esketamine group and 76 in the normal saline group) completed the 1-month follow-up. The esketamine group had a significantly lower incidence of depressive symptoms at 1 month compared to the normal saline group (1.3% vs. 11.8%; risk difference = -10.5, 95%CI = -19.6% to -0.49%; p = 0.018). After excluding patients without lung cancer diagnosis, the incidence of depressive symptoms was also lower in the esketamine group (1.4% vs. 12.2%; risk difference = -10.8, 95%CI = -20.2% to -0.52%; p = 0.018). The secondary outcomes were similar between groups, except that the esketamine group had higher QoR-15 scores at 1 month postoperatively (median difference = 2; 95%CI = 0 to 5; p = 0.048). The independent risk factors for depressive symptoms were hypertension (odds ratio = 6.75, 95%CI = 1.13 to 40.31; p = 0.036) and preoperative anxious symptoms (odds ratio = 23.83, 95%CI = 3.41 to 166.33; p = 0.001).ConclusionPerioperative administration of esketamine reduced the incidence of depressive symptoms at 1 month after thoracoscopic lung cancer surgery. History of hypertension and preoperative anxious symptoms were independent risk factors for depressive symptoms.Clinical trial registration: Chinese Clinical Trial Registry http://www.chictr.org.cn, Identifier (ChiCTR2100046194).

Background: The ''Hand as Foot'' teaching method, an innovative approach in medical education, utilizes hand gestures to simulate anatomical structures and functions. This study aimed to assess the effectiveness of the ''Hand as Foot'' teaching method compared to traditional method in the ''Human Physiology'' course. Methods: During the 2023 spring semester, a randomized controlled trial involved 84 health management students. Participants were randomly assigned to the ''Hand as Foot” teaching group or the traditional teaching group. A self-designed Likert scale was used to evaluate students' perceptions of teaching effectiveness, covering dimensions such as engagingness, intuitiveness, facilitation of understanding, enhancement of memorization, and effortlessness of learning. Additionally, a knowledge assessment test was administered to measure knowledge acquisition. Results: The ''Hand as Foot teaching method'' group (41 students) reported significantly higher ratings for all dimensions of teaching effectiveness compared to the traditional teaching group (43 students) (p ≤ 0.01). Despite the lack of statistical significance, the experimental group's test scores were notably superior (Mean = 6.35 vs. Mean = 5.94). Discussion: The ''Hand as Foot'' teaching method demonstrated superior effectiveness in engaging students, facilitating comprehension, and enhancing memorization. Its interactive and tangible nature provided a holistic learning experience, enabling students to visualize complex physiological mechanisms. Additionally, it fostered active student participation and a desire for deeper understanding. Conclusion: While the ''Hand as Foot'' teaching method demonstrated strengths in engaging students and aiding comprehension, further researches with larger and diverse cohorts are needed to gauge its impact on learning outcomes and broader applicability.

Background: Same-day esophagogastroduodenoscopy and colonoscopy procedures under sedation have been increasingly performed. This study aims to assess the effects of esketamine combined with ciprofol (a novel anesthetic/sedative agent) or propofol on respiratory and hemodynamic adverse events in patients undergoing same-day bidirectional endoscopy. Methods: This is a prospective, randomized, double-blind, placebo-controlled, 2 × 2 factorial trial. A total of 180 adult patients scheduled for same-day bidirectional endoscopy under sedation will be randomized, in a 1:1:1:1 ratio, to receive 1 of 4 sedation regimens: 1) ciprofol and esketamine, 2) propofol and esketamine, 3) ciprofol and normal saline placebo, or 4) propofol and normal saline placebo. The primary outcome is a composite of desaturation [peripheral oxygen saturation (SpO2) < 95%] and hypotension [mean blood pressure (MBP) < 65 mmHg or decrease in MBP ≥20% of baseline] during the sedation and in the recovery room. Secondary outcomes include episodes of desaturation, severe desaturation (SpO2 < 90%), hypotension, severe hypotension (decrease in MBP ≥30% of baseline), bradycardia, postoperative nausea and vomiting, dizziness or headache, hallucination or nightmare, injection pain, pain scores and fatigue scores, endoscopist satisfaction, and patient satisfaction. Data will be analyzed on the modified intention-to-treat basis. Discussion: We hypothesize that esketamine as an adjuvant to ciprofol or propofol sedation would improve cardiorespiratory stability. In addition, the potential interactions between interventions will be explored using the factorial design. The results of this trial will provide evidence for daily practice of sedation regimens for same-day bidirectional endoscopy. Clinical Trial Registration: Chinese Clinical Trials Registry, Identifier ChiCTR2100052523.

BackgroundVideo-assisted thoracoscopic surgery (VATS) has been widely performed for patients with lung cancer. Splenic rupture after VATS lung procedures is a very rare and serious event.Case presentationWe reported a case with hemodynamic instability after left lower VATS lobectomy. There was no evidence of diaphragmatic injury during the surgery. Computed tomography (CT) showed spleen injury and large amount of fluid in the abdominal cavity. Emergent laparotomy was performed, and splenic rupture was diagnosed. The patient underwent splenectomy, with two lacerations at the diaphragmatic surface of the spleen. The patient did well postoperatively and was discharged from the hospital on postoperative day 5.ConclusionThere are few similar cases reported in the literature. Persistent hemodynamic instability due to the rupture of spleen is life-threatening. In the situation of unexplained hypotension during VATS procedures (especially left-sided approaches), the possibility of splenic injury and rupture should be considered. Abdominal ultrasonography and/or CT examinations should be carried out for prompt diagnosis and treatment of such rare complication.