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The human community confronts a plethora of disasters, including man-made epidemics like COVID-19, environmental problems such as water and food resource depletion, biochemical warfare, and even threats from human-created artificial intelligence. Consequently, it is appropriate to term our current community a "disaster community". This paper delves into the issue of diaspora, intrinsically linked to the fragmentation problem in the disaster community, where each subgroup tends to focus solely on its own community. This issue is scrutinized by categorizing the diaspora into larger and smaller categories, with cases from both the international and domestic levels examined respectively within each category. Among the many Daoist philosophical concepts, this paper focuses on the Daoist principle of interconnectedness. In examining Daoist thought on interconnectedness, it also confirms that the notion of interconnectedness is being increasingly emphasized in modern society and across various academic disciplines. This perspective affirms the pluralistic nature of existence, while also underscoring the fundamental interconnectedness that underpins the myriad forms and phenomena. It provides a framework for addressing the challenges faced by the disaster community, particularly in relation to issues of diaspora, by emphasizing the need for coexistence and collective responsibility within a web of mutual relations. The philosophy innovatively applied from Daoism emphasizes "recognizing diversity based on Dao, while acknowledging that each existence is interconnected". Here, "recognition of diversity based on Dao" underpins pluralism, and "interconnectedness of all existence" forms the fundamental solution to the diaspora problem. This approach could be extended as a strategic response to various disasters that the human community encounters. Therefore, this paper assesses the current state of the disaster community, the severity of the diaspora issue, and some cases both between and within nations. It also discusses the core of Daoist philosophy and its creative application to overcome these challenges. The disaster community should transition towards a sustainable and open community, and on this journey, by acknowledging our interconnectedness, we can find solutions to not only the disasters we confront but also to the diaspora problem. [ABSTRACT FROM AUTHOR]

Recently, several previously undiscussed concerns in acupuncture research have been brought to light. Among these, the core issue stems from the ambiguity surrounding the identity of acupoints. Hence, the question "What is the identity of acupoints?" remains of particular importance in acupuncture research. To answer this question, we reviewed the original concept of acupoints explained in Oriental medicine, from which acupuncture treatment originated, and examined scientific research on acupuncture and acupoints. We then proposed a perspective on the identity of acupoints and speculated about a possible reason for their elusive nature: qi, which congregates at and flows in and out of acupoints, might be bioelectricity, making these points inherently difficult to measure anatomically or histologically. Consequently, acupoints are suggested to be spaces where bioelectricity congregates, thus inevitably exhibiting electrical characteristics. [ABSTRACT FROM AUTHOR]

The Umwelt investigated in this essay is a textualized world that a person dwells in, perceives, and experiences, as presented through classical Chinese poetry. It is a world formed and shared among other things and creatures in nature and it is a network of renewed correlations not so much descriptive of qualities as evocative of an environing world in which one feels himself as being-there disposed and attuned to things. What is universal is also mediated by the experience of a particular person at a specific moment. In this essay, I shall delve into the correlation and the interaction between the environing world in reality and the Umwelt constructed in poetry in the Chinese context. I will examine the experiential patterns of the subject through various examples provided by the seventeenth-century poet and critic Ye Xie, and discuss how they coordinate and account for the Umwelt textualized in classical Chinese poetry. I shall probe particularly the notion qi for the construction of the Umwelt, and examine Ye Xie's argument that the truth of the universe is revealed in poetry. I argue that nature does not appear in the poetic world as respective objects, but particular aspects or shades of things from the first-person point of view. The Chinese thought of "Being-in-the-world" means much more than the spatial location, but a sense of engagement and involvement. The oppositional relationship between the subject and the object is superseded by the resonance of oneself with his Umwelt through personal life experience. Ye Xie proposes that the highest function of poetry is to convey the ultimate truth of the universe. However, the truth expressed through poetry is not the transcendent order of reason; it is inherent in phenomena in the instance rather than being permanently universal. This is a Chinese way of truth setting itself into work, as truth is not a universal or definitive understanding of the world, but a guidepost and stimulus for the personalistic and concrete experience of one's life. [ABSTRACT FROM AUTHOR]

Copyright of China Terminology is the property of China Terminology Magazine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction Methods Results Conclusions Clinical Relevance Many papers reporting on QI projects are not publishable for a variety of reasons. We compared manuscripts submitted as QI reports between June 2014 and June 2016 (prior to publication of the revised Standards for Quality Improvement Reporting Excellence (SQUIRE 2.0) with papers submitted to the American Journal of Nursing between July 2016 and December 2022). The aim was to evaluate any changes in the quality of manuscripts and identify problems that led to rejection; we also compared the quality of students with non‐student submissions.We conducted a non‐randomized descriptive study to evaluate 349 papers submitted as QI project reports between June 2014 and December 2022 using screening templates based on the SQUIRE 2.0 checklist and findings of the INANE Working Group on Student Papers.Manuscripts designated as QI reports accepted for publication increased from 4% during 2014–2016 (T1) to 14% during 2016–2022 (T2); one student submission was accepted. There was a slight decrease in submissions designated as QI that were not QI: 36% of student submissions during T1 and 31% of student submissions during T2. Among clinician submissions, 44% in T1 designated as QI reports were not QI versus 31% submitted during T2. There was a decrease in student submissions that followed the SQUIRE guidelines (36% during T1 to 24% during T2).Findings demonstrate that by following the SQUIRE 2.0 guidelines, authors submit more complete manuscripts with fewer missing components. However, there are still misconceptions about what constitutes QI versus research and how to report QI initiatives. After comparing the findings from both periods, it is noteworthy that there is essentially the same level of inaccuracy and lack of acceptable manuscripts.Sharing findings from QI activities through presentations and publications is a vital way of helping spread the learnings from these projects and improve health care for a wider audience. Clinicians, academicians, and students must understand the elements of the SQUIRE guidelines and ensure that this framework is used for both designing and submitting QI projects for publication. [ABSTRACT FROM AUTHOR]

The reporting of errors resulting in dose deviations are well-studied. Less studied is the amount of inconsequential errors that will not harm the patient but could lead to inefficiency. This paper reports an institutional effort to quantify and reduce these less significant errors. Dosimetry items discovered during physicist plan/record and verify (R&V) check prior to treatment were recorded in a shared document and called Therapy Anomaly Gathering System (THANGS) and individual items were called a "thang." Items were categorized to 1 of 4 types: Treatment Plan, Plan Document, R&V, and Secondary MU. The aggregate numbers were presented to the dosimetry staff at regular staff meetings. It was emphasized to the staff that this was a Quality Improvement (QI) study and would not be used punitively. Thangs were tracked over a 4-year period. In Q1 of year 1 of the study, the average number of errors identified was 179/month. This was reduced to 114/month by Q4 of year 1 and 68/month by the end of year 4, a 62% reduction. The number of errors/plan in Q1 Year 1 was 1.25, and that was reduced by Q4 Year 4 to 0.4, a 68% reduction. The percentage of errors by type did not vary much over the 4 years. By far, R&V errors were the most common, and QI efforts were primarily aimed at them. We have developed a simple method to identify areas in dosimetric work that are vulnerable to minor errors and, through consistent reminders, drastically reduce them. This leads to a seamless throughput for a given plan ultimately resulting in improved physics, therapist, and most importantly patient satisfaction. [ABSTRACT FROM AUTHOR]

In 2014, we developed a QI-directed Morbidity and Mortality (M&M) Conference, prioritizing discussion of individual and system failures, as well as development of action items to prevent failure recurrence. However, due to a reliance on individual electronic documents to store M&M data, our ability to assess trends in failures and action item implementation was hindered. To address this issue, in 2019, we created a secure electronic health record (EHR)-integrated web application (web app) to store M&M data. In this study, we assessed the impact of our web app on efficient review and tracking of M&M data, including system failure occurrence and closure of action items. Additionally, in 2021, it was discovered that a backlog of action items existed. To address this issue, we implemented a QI initiative to reduce the backlog, and used the web app to compare action item closure over time. Use of the web app dramatically improved review of M&M data. During the study period, there was a 67.0% reduction in the occurrence of the most common system failures. Additionally, our QI initiative resulted in a 97.7% reduction in the duration of time to complete a single action item and a 61.1% increase in the on-time closure rate for action items. Integration of a web app into a QI-directed M&M Conference enhanced our ability to track system level failures and action item closure over time. Using this web app, we demonstrated that our M&M Conference achieved its intended goal of improving the quality of patient care. IV. [ABSTRACT FROM AUTHOR]

Abstract Background Acute kidney injury is a common disorder that is associated with significant morbidity and mortality. Point-of-care ultrasonography (PoCUS) is an imaging modality performed at the bedside and is used to assess for obstructive causes of acute kidney injury. Little is known about the test characteristics of PoCUS in patients with acute kidney injury. Objective Our primary objective was to describe the test characteristics of PoCUS for the detection of hydronephrosis in patients presenting with acute kidney injury at our centre. Our secondary objective was to describe the current rate of use of PoCUS for this indication. Results In total, 7873 patients were identified between June 1, 2019 and April 30, 2021, with 4611 meeting inclusion criteria. Of these, 94 patients (2%) underwent PoCUS, and 65 patients underwent both PoCUS and reference standard, for a total of 124 kidneys included in our diagnostic accuracy analysis. The prevalence of hydronephrosis in our cohort was 33% (95% CI 25–41%). PoCUS had a sensitivity of 85% (95% CI 71–94%) and specificity of 78% (95% CI 68–87%) for the detection of hydronephrosis. Conclusion We describe the test characteristics of PoCUS for the detection of hydronephrosis in a cohort of patients with acute kidney injury. The low uptake of this test presents an opportunity for quality improvement work to increase its use for this indication.

This paper argues that correlative thinking, a fundamental aspect of Chinese thought often distinguished from rational thinking, is rooted in our situated bodily experiences, constituting a unique mode of sensemaking. It performs a comparative analysis between Zhuangzi's Fish Parable and Merleau‐Ponty's philosophy of embodied perception, focusing on the self‐attunement in our embodied experience and Dao, which remains invisible but gradually reveals its presence as the parable unfolds. The paper illuminates the embodied nature of correlative thinking by exposing the intricate interplay between the self and others, as well as the self and its lived environment. This analysis underscores the reciprocal relationship between Dao and correlative thinking: Dao acts as the origin of correlative thinking, while correlative thinking, in turn, unveils the presence of Dao. This analysis could enrich our understanding of the interplay between the self, others, and the world they inhabit. [ABSTRACT FROM AUTHOR]

I detail how a return to Asia as a third-generation Chinese American grants me the cultural resources to be in fluid relation with others. This article illustrates how the cultivation of one's vital energy or qi life force can serve as an onto-epistemology and a methodological orientation, given its unique existence as both movement and substance, offering up a perspective to live within the interstices of the potential and the actual. In this autoethnography, I detail how local Taiwanese dynamics illustrate the vitality of qi's characteristics, often demonstrating a socially embedded pedagogy of cultivating a heightened awareness of others, in essence, issuing dynamic invitations to kinship. Last, this article issues a call to open to a spirit of continual activation of possibility as a radical replacement to a perception of reality as a series of arrivals at static conditions. [ABSTRACT FROM AUTHOR]

Adult-onset Still's disease (AOSD) is a rare yet well-documented polygenic and systemic autoinflammatory disease characterized by recurrent spiking fever, transient skin rash, arthralgia, and sore throat. Traditional Chinese medicine (TCM) holds a significant role in complementary and alternative medicine. This study presents a unique case of a female AOSD patient with concurrent Qi and fluid deficiency syndrome who received combined treatment with formulated Zhu Ye Shi Gao Decoction (ZYSGD). In this case, a 28-year-old female patient presented with a 15-day history of fever and skin rash accompanied by sore throat, fatigue, myalgia, and arthralgia. Additionally, leucocytosis, aminotransferase abnormalities, and elevated inflammatory factor levels were observed. Infectious diseases, solid tumors, and hematological disorders were all ruled out. Anti-infective treatments proved ineffective, leading to the final diagnosis of AOSD. Glucocorticoid therapy provided only partial relief. Consequently, formulated ZYSGD and hepatoprotective drugs were added to the glucocorticoid treatment. Subsequently, the patient's symptoms and inflammatory biomarkers showed improvement. After discharge, the patient's condition remained stable while continuing the formulated ZYSGD in combination with 4 mg of Medrolol (qd) during a 10-month follow-up period. This case report suggests that formulated ZYSGD could be a viable option for complementary and alternative therapy for late-stage AOSD, especially in cases involving both Qi and body fluid imbalances. [ABSTRACT FROM AUTHOR]

Background: Acute kidney injury is a common disorder that is associated with significant morbidity and mortality. Point-of-care ultrasonography (PoCUS) is an imaging modality performed at the bedside and is used to assess for obstructive causes of acute kidney injury. Little is known about the test characteristics of PoCUS in patients with acute kidney injury. Objective: Our primary objective was to describe the test characteristics of PoCUS for the detection of hydronephrosis in patients presenting with acute kidney injury at our centre. Our secondary objective was to describe the current rate of use of PoCUS for this indication. Results: In total, 7873 patients were identified between June 1, 2019 and April 30, 2021, with 4611 meeting inclusion criteria. Of these, 94 patients (2%) underwent PoCUS, and 65 patients underwent both PoCUS and reference standard, for a total of 124 kidneys included in our diagnostic accuracy analysis. The prevalence of hydronephrosis in our cohort was 33% (95% CI 25–41%). PoCUS had a sensitivity of 85% (95% CI 71–94%) and specificity of 78% (95% CI 68–87%) for the detection of hydronephrosis. Conclusion: We describe the test characteristics of PoCUS for the detection of hydronephrosis in a cohort of patients with acute kidney injury. The low uptake of this test presents an opportunity for quality improvement work to increase its use for this indication. [ABSTRACT FROM AUTHOR]

Introduction: Chinese medicine, rooted in a rich history dating back thousands of years, offers a holistic approach to healthcare that has endured the test of time. This comprehensive review explores the ancient wisdom and modern relevance of Chinese medicine, shedding light on its principles, practices, and adaptability in contemporary healthcare. Methods: This review employs a multidisciplinary approach, drawing upon ancient texts, modern scientific research, and clinical studies to elucidate the core tenets of Chinese medicine. A comprehensive literature search was conducted in various databases, including PubMed, Web of Science, and traditional Chinese medical databases, to identify relevant articles, books, and historical documents. Results: The review synthesizes the fundamental concepts of Chinese medicine, such as Qi, Yin-Yang, the five elements, and meridian system, while examining their physiological and clinical significance in the context of modern medicine. It also delves into the integration of Chinese Medicine into mainstream healthcare systems worldwide, highlighting its growing acceptance and utilization in the treatment of various conditions, including chronic pain, mental health disorders, and complementary cancer care. Discussion: The discussion section explores the synergy between traditional Chinese medicine and contemporary medical practices, emphasizing the potential for a complementary approach that bridges the gap between Eastern and Western healthcare. It addresses the challenges and opportunities in integrating Chinese medicine into evidence-based medicine, emphasizing the importance of rigorous research and standardization. Conclusion: In conclusion, this review underscores the enduring wisdom of Chinese medicine, showcasing its adaptability and relevance in the modern healthcare landscape. It advocates for continued collaboration between traditional Chinese medicine and conventional medical systems, fostering a more holistic and patient-centered approach to healthcare. By embracing the ancient wisdom of Chinese medicine alongside modern medical advancements, we can pave the way for a healthier and more balanced future.

The human community confronts a plethora of disasters, including man-made epidemics like COVID-19, environmental problems such as water and food resource depletion, biochemical warfare, and even threats from human-created artificial intelligence. Consequently, it is appropriate to term our current community a “disaster community”. This paper delves into the issue of diaspora, intrinsically linked to the fragmentation problem in the disaster community, where each subgroup tends to focus solely on its own community. This issue is scrutinized by categorizing the diaspora into larger and smaller categories, with cases from both the international and domestic levels examined respectively within each category. Among the many Daoist philosophical concepts, this paper focuses on the Daoist principle of interconnectedness. In examining Daoist thought on interconnectedness, it also confirms that the notion of interconnectedness is being increasingly emphasized in modern society and across various academic disciplines. This perspective affirms the pluralistic nature of existence, while also underscoring the fundamental interconnectedness that underpins the myriad forms and phenomena. It provides a framework for addressing the challenges faced by the disaster community, particularly in relation to issues of diaspora, by emphasizing the need for coexistence and collective responsibility within a web of mutual relations. The philosophy innovatively applied from Daoism emphasizes “recognizing diversity based on Dao, while acknowledging that each existence is interconnected”. Here, “recognition of diversity based on Dao” underpins pluralism, and “interconnectedness of all existence” forms the fundamental solution to the diaspora problem. This approach could be extended as a strategic response to various disasters that the human community encounters. Therefore, this paper assesses the current state of the disaster community, the severity of the diaspora issue, and some cases both between and within nations. It also discusses the core of Daoist philosophy and its creative application to overcome these challenges. The disaster community should transition towards a sustainable and open community, and on this journey, by acknowledging our interconnectedness, we can find solutions to not only the disasters we confront but also to the diaspora problem.

This case report describes a patient in whom debilitating lower back pain that always occurred during menses resolved when she received treatment for subclinical temporomandibular disorder (TMD). The patient was diagnosed with subclinical TMD and facial myalgia based on the results of clinical and radiographic examinations. She was treated with maxillary (nighttime) and mandibular (daytime) dental orthotics to provide stabilization and decompression of the temporomandibular joints. After 12 weeks of appliance therapy, which resulted in resolution of the TMD symptoms, the patient reported that the debilitating lower back pain she experienced during menses had ceased. Her back pain did not return after the use of the mandibular appliance was discontinued. The authors discuss how neurologic, postural, inflammatory, and qi flow changes attributed to the patient's TMD treatment may have contributed to the cessation of the patient's menses-related lower back pain. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the ability of a long-term technologist coaching program to sustain gains in mammography quality made by a previously implemented quality improvement (QI) initiative. Methods: Mammography quality metrics from July 2014 to June 2020 were reviewed. Numbers of screening mammograms performed/audited, monthly average mammogram overall quality pass rates, changes in facilities/staffing, and technical recall rates were evaluated. Performance metrics at baseline (July 2013), during the improvement (July 2014 to January 2015), postimprovement (February 2015 to August 2015), and sustained coaching periods (after initiation of the technologist coaching model, from September 2015 to June 2020) were compared. Results: During the postimprovement and sustained coaching periods, 93% (501/541) and 90% (8902/9929) of audited mammograms, respectively, met overall passing criteria, achieving or exceeding the QI goal of 90%, and results for both periods were significantly higher than that during the improvement period (74%, 1098/1489), at P < 0.0001 and P < 0.0001, respectively. The technical recall rates during the improvement and postimprovement periods were 2.6% (85/3321) and 1.7% (54/3236), respectively; the rate during the sustained coaching period was significantly lower than these, at 1.2% (489/40 440) (P < 0.0001 and P = 0.0232, respectively). Sustained quality passing rates and lower technical recall rates were observed despite statistically significantly increases in screening volumes. Conclusion: A technologist coaching program resulted in sustained high mammographic quality for almost 5 years. [ABSTRACT FROM AUTHOR]

Abstract Background Return on Investment (ROI), whereby the ratio of costs to benefits is assessed, is encouraged in-order to justify the value of Quality Improvement (QI) programmes. We previously performed a literature review to develop a ROI conceptual framework for QI programmes. We concluded that, QI-ROI is conceptualised as any monetary and non-monetary benefit. In the current study, we explored if this finding is shared by mental healthcare leaders. We also investigated the stability of this conceptualisation against influencing factors and potential for disinvestment. Methods We performed qualitative interviews with leaders in an NHS mental health organisation. There were 16 participants: nine board members and seven senior leaders. The interviews were held online via Microsoft Teams and lasted an hour on average. We performed deductive-inductive analysis to seek data from our initial ROI framework and any new data. Results We found that in mental healthcare, QI-ROI is also conceptualised as any valued monetary and non-monetary benefits. There was a strong emphasis on benefits to external partners and a de-emphasis of benefit monetisation. This conceptualisation was influenced by the 1) perceived mandates to improve quality and manage scarce resources, 2) expectations from QI, 3) health and social care values, 4) ambiguity over expectations, and 5) uncertainty over outcomes. Uncertainty, ambiguity, and potential for disinvestment posed a threat to the stability of this conceptualisation but did not ultimately change it. Health and social care values supported maintaining the QI-ROI as any benefit, with a focus on patients and staff outcomes. Socio-political desires to improve quality were strong drivers for QI investment. Conclusion Mental healthcare leaders primarily conceptualise QI-ROI as any valued benefit. The inclusion of externalised outcomes which are hard to attribute may be challenging. However, mental healthcare services do collaborate with external partners. The de-emphases of benefit monetisation may also be controversial due to the need for financial accountability. Mental healthcare leaders recognise the importance of efficiency savings. However, they raised concerns over the legitimacy and utility of traditional ROI as a tool for assessing QI value. Further research is needed to bring more clarity on these aspects of the QI-ROI concept.

Background: Return on Investment (ROI), whereby the ratio of costs to benefits is assessed, is encouraged in-order to justify the value of Quality Improvement (QI) programmes. We previously performed a literature review to develop a ROI conceptual framework for QI programmes. We concluded that, QI-ROI is conceptualised as any monetary and non-monetary benefit. In the current study, we explored if this finding is shared by mental healthcare leaders. We also investigated the stability of this conceptualisation against influencing factors and potential for disinvestment. Methods: We performed qualitative interviews with leaders in an NHS mental health organisation. There were 16 participants: nine board members and seven senior leaders. The interviews were held online via Microsoft Teams and lasted an hour on average. We performed deductive-inductive analysis to seek data from our initial ROI framework and any new data. Results: We found that in mental healthcare, QI-ROI is also conceptualised as any valued monetary and non-monetary benefits. There was a strong emphasis on benefits to external partners and a de-emphasis of benefit monetisation. This conceptualisation was influenced by the 1) perceived mandates to improve quality and manage scarce resources, 2) expectations from QI, 3) health and social care values, 4) ambiguity over expectations, and 5) uncertainty over outcomes. Uncertainty, ambiguity, and potential for disinvestment posed a threat to the stability of this conceptualisation but did not ultimately change it. Health and social care values supported maintaining the QI-ROI as any benefit, with a focus on patients and staff outcomes. Socio-political desires to improve quality were strong drivers for QI investment. Conclusion: Mental healthcare leaders primarily conceptualise QI-ROI as any valued benefit. The inclusion of externalised outcomes which are hard to attribute may be challenging. However, mental healthcare services do collaborate with external partners. The de-emphases of benefit monetisation may also be controversial due to the need for financial accountability. Mental healthcare leaders recognise the importance of efficiency savings. However, they raised concerns over the legitimacy and utility of traditional ROI as a tool for assessing QI value. Further research is needed to bring more clarity on these aspects of the QI-ROI concept. [ABSTRACT FROM AUTHOR]

Background: The volume of cardiac imaging continues to increase, with many tests performed for rarely appropriate indications. Appropriate use criteria (AUC) documents were published by the American Society of Echocardiography and American College of Cardiology, with quality improvement (QI) interventions developed in various institutions. However, the effectiveness of these interventions has not been assessed in a systematic fashion. Methods: We searched Ovid MEDLINE, EMBASE, Scopus, Web of Science, Google Scholar, and EBSCO CINAHL for studies reporting association between cardiac imaging, AUC and QI. The search was not restricted to time or publication status. We selected studies assessing the effect of QI interventions on performance of rarely appropriate echocardiograms. The primary endpoint was reduction of rarely appropriate testing. Results: Nine studies with 22,070 patients met inclusion criteria. Mean follow up was 15 months (1–60 months). QI interventions resulted in statistically significant reduction in rarely appropriate tests (OR 0.52, 95% CI:.41–.66; p <.01). The effects of QI interventions were analyzed over both the short (<3 months) and long‐term (>3 months) post intervention (OR 0.62, 95% CI:.49–.79; p <.01 in the short term, and OR 0.47, 95% CI:.35–.62; p <.01 in the long term). Subgroup analysis of the type of intervention, classified as education tools or decision support tools showed both significantly reduced rarely appropriate testing (OR 0.54, 95% CI:.41–.73; p <.01; OR.47, 95% CI:.36–.61; p <.01). Adding a feedback tool did not change the effect compared to not using a feedback tool (OR 0.49 vs. 0.57, 95% CI:.36–.68 vs. 39–.84; p >.05). Conclusion: QI interventions are associated with a significant reduction in performance of rarely appropriate echocardiography testing, the effects of which persist over time. Both education and decision support tools were effective, while adding feedback tools did not result in further reduction of ordering rarely appropriate studies. [ABSTRACT FROM AUTHOR]

This paper documents the long history of feng shui belief and practice in Chinese culture, and its spread worldwide in the past half century. It shows that commitment to the peculiar qi or chi entity is central to feng shui and more generally to traditional Chinese writings on medicine, astrology, philosophy, politics, literature, natural philosophy and science. Despite their centrality and omnipresence, chi claims have rarely been scientifically appraised. This is, in part, because they are stated so vaguely and mysteriously that no definite test is possible. This paper examines, and refutes, the claims of one rare but well-credentialled, multi-university-based research programme affirming the reality of chi. The paper shows that the cost of seriously endorsing a chi-based explanation of any putative effect is a rejection of the entire ontological, epistemological and methodological edifice of modern science. Chi explanations are incompatible with both a methodological and an ontological naturalist understanding of science. [ABSTRACT FROM AUTHOR]

Philosophies in the East and West have favored wisdom in their search for truths. The Chinese civilization has sought holistic wisdom in its long history of absorbing the Abrahamic faiths since the seventh century. This paper aims to investigate how the Abrahamic faiths have interacted with ancient Chinese culture. In particular, this paper will examine the earliest written records in Chinese of the Luminous Religion (or Jingjiao), the earliest Jews in Kaifeng, and the earliest Muslims in China. By analyzing their theology of creation with reference to the Holy Spirit and qi (wind/breath/pneuma), this paper attempts a constructive Chinese natural theology based on a sympathetic and critical assessment of Alister McGrath's natural theology but makes up for his spirit deficit. This paper argues that the holistic wisdom achieved in the early integration process of the Abrahamic faiths with the Chinese culture is closely intertwined with the Spirit and qi, which provides a fruitful ground to construct a Chinese natural theology. The contribution of this paper lies in its original research into the earliest written records of the three Abrahamic faiths in China from the perspective of the doctrine of creation and its relationship with the Spirit and qi. [ABSTRACT FROM AUTHOR]

This article shares preliminary results from current research on Chinese medicine in Nashville, Tennessee, a city in the American South known both as "Music City, USA" and "The Buckle of the Bible Belt." The author has interviewed dozens of patients and practitioners in Nashville to understand how Chinese medicine came to the city, what styles of practice are present, and whether or not new understandings of Chinese medicine's fundamental concept of qi might emerge from the unique cultural setting of the American South. While Chinese medicine is flourishing in the city, because of complexities at the intersection of religion, science, and the experience of healing, the clinical encounter between patients and practitioners is not typically characterized by a mutual embrace of a language of qi. [ABSTRACT FROM AUTHOR]

ObjectiveTo describe the development of the Pediatric Epilepsy Outcome-Informatics Project (PEOIP) at Alberta Children's Hospital (ACH), which was created to provide standardized, point-of-care data entry; near-time data analysis; and availability of outcome dashboards as a baseline on which to pursue quality improvement.MethodsStakeholders involved in the PEOIP met weekly to determine the most important outcomes for patients diagnosed with epilepsy, create a standardized electronic note with defined fields (patient demographics, seizure and syndrome type and frequency and specific outcomes- seizure type and frequency, adverse effects, emergency department visits, hospitalization, and care pathways for clinical decision support. These were embedded in the electronic health record from which the fields were extracted into a data display platform that provided patient- and population-level dashboards updated every 36 hours. Provider satisfaction and family experience surveys were performed to assess the impact of the standardized electronic note.ResultsIn the last 5 years, 3,245 unique patients involving 13, 831 encounters had prospective, longitudinal, standardized epilepsy data accrued via point-of-care data entry into an electronic note as part of routine clinical care. A provider satisfaction survey of the small number of users involved indicated that the vast majority believed that the note makes documentation more efficient. A family experience survey indicated that being provided with the note was considered "valuable" or "really valuable" by 86% of respondents and facilitated communication with family members, school, and advocacy organizations.SignificanceThe PEOIP serves as a proof of principle that information obtained as part of routine clinical care can be collected in a prospective, standardized, efficient manner and be used to construct filterable process/outcome dashboards, updated in near time (36 hours). This information will provide the necessary baseline data on which multiple of QI projects to improve meaningful outcomes for children with epilepsy will be based.

Chan chuang, a psychophysical practice renowned for its beneficial effects, has been favored by martial artists and traditional Chinese medicine practitioners since ancient times. With the onset of the COVID-19 pandemic, chan chuang has garnered increased attention and recognition. However, existing research primarily focuses on the efficacy of chan chuang, rather than exploring the practice itself. Consequently, there is a dearth of scientific and experiential guidance available to current practitioners of chan chuang. To address this gap, the present study employs an in-depth interview method within a qualitative research framework, conducting follow-up interviews with eight martial artists who regularly engage in chan chuang practice. By gaining insights into the physical and mental states of these practitioners, this paper aims to elucidate their embodied experiences of chan chuang from the perspective of “body perception”. The findings reveal that the practitioners’ perception of their bodies during chan chuang practice can be characterized by three key aspects: stillness, naturalness, and qi. The sense of stillness signifies a state of tranquility in both body and mind. The sense of naturalness represents a harmonious equilibrium of body and mind, at times even resulting in a loss of self-awareness. Finally, the sense of qi conveys a serene mental state accompanied by the smooth flow of life energy and blood. These three dimensions guide chan chuang practitioners toward attaining physical and mental well-being. [ABSTRACT FROM AUTHOR]

In this study, I draw upon Endarkened Feminist Epistemology (Dillard, 2012) and Decolonial Feminist Research (Rhee, 2020) to explore the epistemology of my mother, a first-generation Chinese immigrant. Based on data generated from the video-cued qi ethnography methodology, I pay attention to my Mama's ways of knowing as she cooks in the kitchen. Qi is a Chinese concept that means breath, spirit, and life force. I draw on qi as the ongoing connectivity toward wholeness and movement toward harmony in the way I collected and analyzed data. I share my findings as a series of interconnected poetry, images, and narratives to (re)member my mother's life as well as mine as we (re)claim what we have forgotten and (re)turn to a place of wholeness. I conclude the article by exploring the implications for the Asian American Pacific Islander community and beyond, as we conduct the work of collective rememory. [ABSTRACT FROM AUTHOR]

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Green infrastructure network plays an important role in improving urban environment for resource-based city of Qitaihe, a typical coal resource-based city. The evolvement rules of green infrastructure network in Qitaihe from 2000 to 2018 is analyzed. The main driving factors of the evolution through the collation and analysis of the socioeconomic statistics of Qitaihe is summarized, with the understanding of urban development policy. The results showed that the area of green infrastructure land increased first and then decreased in Qitaihe during this period. The green infrastructure network was rapidly broken at first and then gradually stabilized. The green infrastructure network of Qitaihe expenienced the evolution of “fragmentation-restoration-stabilization” during this period population and industrial factors, urbanrural changes and other industrial factors, primary industry factors were the main driving factors. Green infrastructure network is always influenced by the urban development policies and transformation policies. [ABSTRACT FROM AUTHOR]

The human papillomavirus (HPV) causes genitourinary and oropharyngeal cancers. The HPV vaccine is safe and effective in preventing those diseases; however, vaccine series completion rates remain low in the United States. Our quality improvement (QI) project aimed to increase HPV-vaccination series completion rates to 70% from 2017 to 2020 for the 13-year patient population in an extensive academic pediatric primary care network that serves predominantly minority and Medicaid-insured children in Columbus, OH. The outcome measure was the percentage of 13-years Nationwide Children's Hospital Primary Care Network patients who completed the two-dose vaccine series by their 13th birthday. Four QI implemented interventions were utilized. Electronic medical records alert informed providers when the HPV vaccines are due. We studied monthly data for the network and for individual clinics using statistical process control, displaying data on a control chart. We followed two process measures, captured opportunity rate, and the number of HPV vaccines given. We substantially increased HPV-vaccination series completion rates overall in the 13-year teen population from 27% to 65%, and three clinics reached the 70% goal for at least one quarter. Latino children had the highest completion rate of 80% and White children had the lowest completion rate at 64%. Our QI project used four measures to improve HPV-vaccination series completion rates in the 13-year patient population that serves minority and low-income teens predominantly. Further QI studies are needed to improve HPV vaccine completion rates in teens. [ABSTRACT FROM AUTHOR]

This essay will review the earliest case that documents a patient's experience of qi, one found on a bamboo text buried with the patient who died in the 318 BCE. Details of the healing encounter and of concepts of illness show how non-transmitted documents hidden from later editors in tombs preserve an older layer of medical understanding than that in transmitted canons, such as the Huang Di Nei Jing (Inner Canon of the Yellow Emperor). The 4th-century BCE case record described below is the longest early medical record concerning the treatment of a specific individual. It is also an account of failure formally recorded for the sake of the survivors and buried with the dead to be transmitted to the world of the spirits. The essay begins with a reevaluation of ancient concept of qi and then moves on to the individual case record. [ABSTRACT FROM AUTHOR]

Labor pain is among the most severe types of physical pain that women may experience during their lifetime. Thus, pain relief is an essential part of medical care during childbirth. Epidural analgesia is considered to be the most efficient method of pain relief during labor. Nevertheless, patient preferences, contraindications, limited availability, and technical failure may require the use of alternative pain reliving methods during labor including systemic pharmacologic agents, and nonpharmacologic methods. Nonpharmacologic methods for pain alleviation during vaginal birth have become popular over the years, either as a complement to pharmacologic agents or at times as the principal therapy. Methods such as relaxation techniques (ie, yoga, hypnosis, and music), manual techniques (ie, massage, reflexology, and shiatsu), acupuncture, birthing ball, and transcutaneous electrical nerve stimulation are considered safe, although the evidence supporting their effectiveness for pain relief is not as robust as it is for pharmacologic agents. Systemic pharmacologic agents are mostly administered by inhalation (nitrous oxide) or through the parenteral route. These agents include opioids such as meperidine, nalbuphine, tramadol, butorphanol, morphine, and remifentanil, and non-opioid agents such as parenteral acetaminophen and nonsteroidal anti-inflammatory drugs. Systemic pharmacologic agents suggest a diverse armamentarium of medication for pain management during labor. Their efficacy in treating pain associated with labor varies, and some continue to be used even though they have not been proven effective for pain relief. In addition, the maternal and perinatal side effects differ markedly among these agents. There is a relative abundance of data regarding the effectiveness of analgesic drugs compared with epidural, but the data regarding comparisons among the different types of alternative analgesic agents are scarce, and there is no consistency regarding the drug of choice for women who do not receive epidural pain management. This review aims to present the available data regarding the effectiveness of the different methods of relieving pain during labor other than epidural. The data presented are mainly based on recent level I evidence regarding pharmacologic and nonpharmacologic methods for pain relief during labor. [ABSTRACT FROM AUTHOR]

From the perspective of mysticism, the interpretation of zuowang 坐忘 as the breath-meditation technique with a transcendental goal establishes the religious basis of Zhuangzi's cultivation. In contrast, most Chinese scholars argue instead that zuowang is primarily the mental state independent of meditative techniques, and that the techniques are devoid of philosophical significance. The pivot of the two seemingly irreconcilable views is the holistic concept of qi 氣. Combining the two interpretations can lead to a consummate understanding. There is an innate connection between the physical and nonphysical qi, and the latter can be considered as the root and basis. Deep exploration of the mysticism paradigm represented by Harold Roth reveals that the interpretation of meditative techniques is a necessary step in gaining mystical experiences not contradictory to the one that construes it as mental cultivation. The mind–body transformation shows that the pursuit of authenticity and wholeness of humanity can broaden one's concern with fellow human beings and other realms of existence, as the same process is followed in the perpetual growth and change of the universe. This allows us to experience resonance with the universe toward the goal of "the unity of self" so to speak. The religiousness of Zhuangzi's cultivation is, thus, substantiated. [ABSTRACT FROM AUTHOR]

Morbidity and mortality conferences are common among emergency medicine residency programs and are an important part of quality improvement initiatives. Here we review the key components of running an effective morbidity and mortality conference with a focus on goals and objectives, case identification and selection, session structure, and case presentation.

Low Back Pain (LBP) is a symptom of the disease that is most often found in daily practice. About 80% of the world's population has felt this complaint, which makes it important to solve this problem not only from the Western Medical side but also TCM using qualitative research methods where research understands human or social phenomena by creating a comprehensive and complex picture that can be presented in words, reporting detailed views obtained from informant sources, and carried out in a natural setting, especially for the Law Back Pain case in question, by presenting how the description of this case is viewed from Western Medical and TCM terminology, and it can be seen that the etiological mindset of Law Back Pain is indeed not the same from the TCM point of view that the author is currently studying, that Law Back pain where in TCM theory, Qi is considered a form of balancing energy that flows through the body. Qi keeps the body in tune with the internal and external environment which brings together overall well-being for a person to achieve his or her state of health optimally. The balance between Yin and Yang that make up Qi can reflect cellular activity, which balances the actions of endogenous agonists and antagonists, as well as the sympathetic and parasympathetic nervous systems. [ABSTRACT FROM AUTHOR]

Aim: It has been reported that the expression level of BNIP‐3 mRNA increases by antidepressants and Hochu‐ekki‐To (HET), suggesting that BNIP‐3 may be a candidate depression‐related factor. Therefore, in order to examine the relationship between BNIP‐3 and Qi, the expression levels of BNIP‐3 mRNA were examined using 22 newly extracted crude drugs which were selected from the previous library results on 120 crude drugs in the neuronal cell line N18TG‐2 and in the glial cell line C6Bu‐1. Methods: Based on the results on 120 kinds of crude drugs in a cDNA library, 22 kinds were selected and newly extracted, and then cells were re‐treated with them for a secondary assay by real‐time polymerase chain reaction (PCR) methods. Results: Many of the herbal medicines contained in HET increased BNIP‐3 mRNA expression overall. On the other hand, in the results with especially the neuronal cell line N18TG‐2, the herbal medicines that make up Oren‐gedoku‐To (OGT) and San‐o‐shashin‐To (SOST) strongly showed suppressive effects on the expression. Conclusion: Since HET clinically has the effect of raising mood, while an effect of OGT and SOST is to suppress the rise of mood, the result of this study may be of interest regarding the link between control of the direction of Qi and the expression of BNIP‐3 mRNA. [ABSTRACT FROM AUTHOR]

The association between emotions and the directional movement of qi is one of the most important theories in Chinese medicine psychology. While the ancient classics were not explicit in their definition of qi movements, they may have been a conceptualisation of the physiological changes in the body sensed during emotions. These sensations can be explained by changes in cardiovascular, respiratory, muscular and brain activities, which implies a shift from a metaphysical to a physiological understanding of qi. This approach supports and provides guidance for further research on the differentiation of emotions as pathological factors and provides a theoretical basis for Chinese medicine emotion-regulation techniques and Chinese medicine therapies in general. [ABSTRACT FROM AUTHOR]

La poésie de François Cheng se caractérise par sa richesse et par sa nouvelle vision poétique unissant la langue, la culture, la philosophie et l'écologie. Double Chant est l'un des recueils les plus importants dans la production poétique de François Cheng. Ce recueil est composé de deux parties: " Un jour les pierres " et " L'arbre en nous a parlé" encadrant la pensée poétique de Cheng, située entre l'arbre et le rocher. Le titre du recueil manifeste le nœud de la pensée de Cheng qui enchante la double perception de la nature, de l'écologie et de la vie. Il manifeste l'expression de l'intimité poétique en français mais vêtue d'une référence culturelle chinoise. Dans cet article, nous adaptons l'analyse lexico-sémantique dépendant des théories de Michel Deguy, de Nicolas Journet et de Henri Boyer manifestant la relation écologie, culture, identité et langue. Cette théorie montre la variété des composantes du lexique poétique de François Cheng et de toutes ses figurations langagières. Toutes ces composantes disparates produisent un langage poétique écarté de la norme commune et présentent un nouvel univers poétique, basé sur le dialogue intime entre l'homme et l'écologie. يتميز شعر فرانسوا شانج بثرائه ورؤيته الشعرية الجديدة ، التي توحد بين اللغة والثقافة والفلسفة والبيئة، والمجموعة الشعرية "الأنشودة المزدوجة" هي واحدة من أهم المجموعات في الإنتاج الشعري للشاعر ، وتتکون من جزأين: "الأحجار ذات يوم " و"الشجرة التي تتکلم فينا " وهذان الجزآن يؤطران للمفهوم الشعري لشانج المحصور بين الشجرة والصخرة، ويظهر عنوان المجموعة جوهر فکره ، الذي يوضح الإدراک المزدوج للطبيعة والبيئة والحياة. ويتجلى جمال الأسلوب الشعرى لشانج بأنه أسلوب فرنسي بنکهة ثقافية صينية. يعتمد هذا البحث على التحليل الدلالي المعجمي لتوضيح دور اللغة والثقافة والهوية في التعبير الشعرى، مستندا على نظريات ثلاثة من منظري علم اللغة الاجتماعي الحديث : ميشيل ديغي ، نيکولاس جورنيت و هنري بوير والتي تقوم على توضيح العلاقة بين البيئة والثقافة والهوية واللغة، وقد اعتمدنا ايضا في هذا البحث على المفهوم النفسي کأساس للعلاقة الوطيدة بين الشاعر المرتبط بثقافته وأصله العرقي وتعبيره اللغوي الشعرى. ويقدم عالما شعريا جديدا ، يقوم على الحوار بين الإنسان والبيئة، مما يتيح أشکال مختلفة من اللغة الفرنسية ، فنرى لغة فرنسية زنجية، وأخرى تمل الطابع الثقافي الکاريبي أو الأسيوي ، مما يتيح الفرصة للتداخل الثقافي وانعکاسه على لغة التعبير.

Bordered pit membranes of angiosperm xylem are anisotropic, mesoporous media between neighbouring conduits, with a key role in long distance water transport. Yet, their mechanical properties are poorly understood. Here, we aim to quantify the stiffness of intervessel pit membranes over various growing seasons. By applying an AFM-based indentation technique "Quantitative Imaging" we measured the effective elastic modulus (Eeffective) of intervessel pit membranes of Clematis vitalba in dependence of size, age, and hydration state. The indentationdeformation behaviour was analysed with a non-linear membrane model, and paired with magnetic resonance imaging to visualise sap-filled and embolised vessels, while geometrical data of bordered pits were obtained using electron microscopy. Eeffective was transformed to the geometrically independent apparent elastic modulus Eapparent and to aspiration pressure Pb. The material stiffness (Eapparent) of fresh pit membranes was with 57 MPa considerably lower than previously suggested. The estimated pressure for pit membrane aspiration was 2.20+28 MPa. Pit membranes from older growth rings were shrunken, had a higher material stiffness and a lower aspiration pressure than current year ones, suggesting an irreversible, mechanical ageing process. This study provides an experimental-stiffness analysis of hydrated intervessel pit membranes in their native state. The estimated aspiration pressure suggests that membranes are not deflected under normal field conditions. Although absolute values should be interpreted carefully, our data suggest that pit membrane shrinkage implies increasing material stiffness, and highlight the dynamic changes of pit membrane mechanics and their complex, functional behaviour for fluid transport. [ABSTRACT FROM AUTHOR]

In the civilizations of the axial age, Chinese and Western cultures gave birth to different scientific traditions—the image sciences and the natural sciences—within the knowledge frameworks of the union of man and nature and of the subject–object dichotomy respectively. Therefore, there are inevitably insurmountable barriers to explaining the differences between Chinese and Western cultures in terms of a natural science concerned with "things." However, human nature is universal, and it is possible to make direct comparisons and interpretations of the differences between Chinese and Western cultures in terms of the cognitive sciences dealing with the mind. One important way to compare and interpret Chinese culture and cognitive science is the mutual interpretation of Chinese and Western cultures. In view of this, we have integrated enactive cognition (the frontier of cognitive science) and the free energy principle to propose the predictive mind model of enactive cognition and have used this mutual interpretation to study the two cultures using this model of cognitive science as a truly unified cross-cultural paradigm for cognitive science. First, the theory of enaction embedded in Chinese culture is actually closely related to enactive cognition, the frontier of Western cognitive science. Laozi's theory of universal enaction (cosmology) shows that Chinese culture has an ancient theory of enaction. He firmly planted in the minds of Chinese people a way of thinking dealing with union of man and nature. Western enactive cognition, as a modern theory, advocates continuity of life and mind and emphasizes that life is both autopoietic and cognitive, which is actually a scientific cognitive expression of the Chinese cultural idea of the harmony of man and nature. This is actually a scientific cognitive expression of Chinese culture's idea of the harmony of man and nature. Second, the qi in Chinese culture is similar to the free energy in Western cognitive science. In terms of concept definition, qi is a mixture of matter, function and principles (information), while free energy is the synthesis of energy and information. From the point of view of the mode of operation, qi is the contradictory harmony between yin and yang, while free energy is the unity of top-down and bottom-up approaches. In terms of kinetic purpose, the kinetic purpose of qi is the doctrine of benevolence, while the kinetic purpose of free energy has gradually changed from representation of nature to construction of meaning. Through comparison and interpretation, we find that enactive cognition is closely related to Chinese culture on the cognitive science route, in what will be a practical path for the rejuvenation of Chinese culture. In addition, through the association of qi in Chinese culture and free energy in Western cognitive science, Chinese and Western cultures can be expected to be truly connected through cognitive science. [ABSTRACT FROM AUTHOR]

Bordered pit membranes of angiosperm xylem are anisotropic, mesoporous media between neighbouring conduits, with a key role in long distance water transport. Yet, their mechanical properties are poorly understood. Here, we aim to quantify the stiffness of intervessel pit membranes over various growing seasons. By applying an AFM-based indentation technique “Quantitative Imaging” we measured the effective elastic modulus (Eeffective) of intervessel pit membranes of Clematis vitalba in dependence of size, age, and hydration state. The indentation-deformation behaviour was analysed with a non-linear membrane model, and paired with magnetic resonance imaging to visualise sap-filled and embolised vessels, while geometrical data of bordered pits were obtained using electron microscopy. Eeffective was transformed to the geometrically independent apparent elastic modulus Eapparent and to aspiration pressure Pb. The material stiffness (Eapparent) of fresh pit membranes was with 57 MPa considerably lower than previously suggested. The estimated pressure for pit membrane aspiration was 2.20+28 MPa. Pit membranes from older growth rings were shrunken, had a higher material stiffness and a lower aspiration pressure than current year ones, suggesting an irreversible, mechanical ageing process. This study provides an experimental-stiffness analysis of hydrated intervessel pit membranes in their native state. The estimated aspiration pressure suggests that membranes are not deflected under normal field conditions. Although absolute values should be interpreted carefully, our data suggest that pit membrane shrinkage implies increasing material stiffness, and highlight the dynamic changes of pit membrane mechanics and their complex, functional behaviour for fluid transport.

In his paper, the author describes his own personal journey of discovering and understanding of subtle energy (Zh. Qi; Sa. prāna) as a way of furthering the virtual dialogue between natural sciences and spirituality. Using his own personal experiences from yoga and meditation as motivation, he discusses the way he has come to understand subtle energy in terms of the various scientific definitions and types of energy. In this regard, he considers the correspondence between subtle energy and the bioelectromagnetic field of the body, as well as how some physical effects could be understood if, under particular circumstances, this field came into body-wide coherence or resonance. Different types of energy are also explored as corresponding to the Qi of the meridian channels of Traditional Chinese Medicine. In conclusion, the author comes to such understanding of the notion of energy, which reaches the limits of language-based definitions, and this limit points at the potential of a more holistic understanding of energy and the nature of the Universe.

Abstract Background COVID-19 has impacted the context in which healthcare staff and teams operate and this has implications for quality improvement (QI) work. Contrary to the usual ambivalent relationship staff have with QI work, there have been examples of unprecedented staff engagement in implementing rapid changes during the pandemic indicating a change in important underlying factors that impact staff involvement in QI. The purpose of this study is to explore staff perspectives about how experience and skills of QI methods supported them in implementing innovative practices during COVID-19. Methods This is a qualitative narrative study based on narrative interviews to collect healthcare staff stories of implementing rapid change. The stories were identified through social media (Twitter) and a national health magazine issued by the Irish health service. Twenty staff members participated in the interviews. Interviews were audio recorded, transcribed, and anonymised. A four-step thematic analysis was conducted. Results The analysis revealed the transformational journey of healthcare staff from the initial shock and anxiety caused by COVID-19 to making sense of the situation, implementing rapid changes, and acknowledging COVID as a learning experience. Six themes were evident from the analysis: COVID anxiety and fear, emotional supports and coping mechanisms, person-centric changes, COVID as a ‘forcing function’ for change, a collective way of working and looking back and thinking ahead. Conclusions While most rapid changes during COVID-19 did not represent a systematic and explicit QI application, QI principles were evident throughout the stories and actions taken, including making small changes, testing changes, learning, reflecting as a team, and improving. Many staff members were able to retrospectively identify the relevance of QI principles. COVID-19 eliminated some traditional barriers to change leading to efficient solutions, thus highlighting a need to sustain these positive changes into routine practice to develop an adaptive healthcare system receptive to QI.

Qi and qi transformation are the essence of the principles in traditional Chinese medicine (TCM). TCM takes ‘qi’ as the origin of everything and the combination of ‘zhen qi (genuine qi)’ and ‘ling qi (spiritual qi)’ as the vitality of the human body, which is the expression of the natural connection between physical and mental health. It also takes ‘chong qi (clashing qi)’ as harmony and dialectical unity in clinical practice. Qi is Xiang (manifestation), a kind of systematic information. Qi should be understood based on its original creativity and the original Xiang of Taixu (the great void). This paper theoretically explored qi from different dimensions: the interpretation and extension of the essence of qi, the treatment of physical and mental diseases with emphasis on qi regulation, and the way to maintain health by paying attention to the harmony between the genuine qi and spiritual qi. In particular, this paper expounded in detail the key points of diagnosis and treatment of the five zang organs injured by abnormal emotions and the regulation of emotional diseases with emphasis on treating the liver and unblocking the qi movement, aiming to provide a reference for TCM clinicians and researchers to fully understand the theory and application value of qi. [ABSTRACT FROM AUTHOR]

There is strong scientific evidence that intelligence remains stable from childhood to adulthood; however, no study has examined the generalizability of these findings for native Brazilian samples. Here we present a study carried out in 2002 and from 2014-2017 (average timespan of 15 years) in order to verify the stability of psychometric intelligence. A sample of 120 participants (mean age Time 1=10.0 yrs, mean age Time 2=23.6 yrs) was assessed using the Raven's Progressive Matrices and verbal subtests from the WISC-III and WAIS-III. The results indicated a moderate coefficient (around .50) for intelligence differential stability independent of the measurement administered. Regarding absolute stability, real cognitive gains were observed from Time 1 to Time 2, despite controlling the effect of the regression toward the mean. Finally, sex (female) and intelligence were statistically significant predictors of rapid educational progression. [ABSTRACT FROM AUTHOR]

Under the guidance of the traditional pattern differentiation system of wei, qi, ying and blood, most TCM doctors believe that a critical condition appears when the pathogenic factor enters the blood level in the development of warm diseases, while ignore that it could also occur in a qi level pattern. Based on Professor Jiang Liangduo's new view that " severe warm diseases could occur at qi level" developed based on his experience in the prevention and treatment of Corona Virus Disease 2019 (COVID-19), combined with the theory of " differentiation and treatment based on one ' s body condition", this paper elaborates on the theoretical basis, pathogenesis evolution, prevention and treatment method of severe warm diseases at qi level, and points out that the occurrence of severe warm diseases at qi level is closely related to the physiological dysfunction of lung qi. Thus, this paper summarizes the pathogenesis of severe COVID-19 cases at qi level as follows: dampness toxic epidemic pathogenic factors attack the lung, damaging the lung and making it unable to disperse and descend qi and body fluids as normal. The debilitated lung qi can neither promote body fluid circulation nor constrain fluids, which in turn leads to the expiry of lung qi. Correspondingly, the main principle of treatment is to diffuse the lung, replenish lung qi and constrain body fluids. [ABSTRACT FROM AUTHOR]