Case Report: Transcatheter aortic valve implantation using balloon-expandable bioprosthesis in patients with severe pure aortic regurgitation on noncalcified native valves: a series of cases.

Background: For individuals with pure aortic regurgitation (AR), transcatheter aortic valve implantation (TAVI) is cautiously recommended only for those with a high or prohibitive surgical risk. We aimed to describe the results of a case series of transcatheter implantation of a balloon-expandable aortic valve bioprosthesis (BEV) for the treatment of noncalcified native valve AR. Methods: From February 2022-November 2022, we performed TAVI in patients with severe pure AR. Cases were indicated on the basis of symptoms, high/prohibitive surgical risk, or patient refusal of conventional treatment. Results: Five patients underwent successful TAVI. The mean age was 81.9 ± 6.6 years, 3 (60%) female and 5 (100%) in NYHA class III or IV. The baseline echocardiogram showed an ejection fraction of 49.0 ± 10.6% and left ventricular end-systolic diameter 28.5 ± 4.7 mm/m². The average area of the aortic annulus was 529.1 ± 47.0mm² and the area oversizing index was 17.6 ± 1.2%. In the 30-day follow-up, there were no cases of prosthesis embolization, annulus rupture, stroke, acute myocardial infarction, acute renal failure, hemorrhagic complication or death. One patient required a permanent pacemaker and another had a minor vascular complication. The clinical follow-up were 19.8 months (16.7-21.8). During this period, all patients remained alive and in NYHA class I or II. One of the patients developed a moderate paravalvular leak. Conclusion: TAVI with a BEV proved to be safe and effective in this small case series of patients with noncalcified native valve AR in a follow-up longer than 1 year.

Can Acupuncture Improve the Flexibility of Hamstring Muscles? A Randomized, Blinded, and Controlled Pilot Study.

(1) Background: The lack of flexibility is frequently reported as a risk factor for hamstring muscle damage. Acupuncture, a therapeutic tool of traditional Chinese medicine (TCM), may play a role in both treatment and prevention by improving muscle strength, microcirculation, and reducing muscle soreness. The primary objective of this pilot study was to examine the immediate effects of acupuncture on hamstring muscle stretching and on the pain or discomfort reported during stretching. (2) Methods: To mitigate heterogeneity effects, and due to the small sample size, the study employed a crossover design in which each participant was tested at three different moments of the experimental period with verum (true acupuncture in selected acupoints), sham (fake acupuncture in zones of the skin not corresponding to any known acupoint but near the selected acupoints), and placebo (stimulation of the selected acupoints with a stainless steel wire and cannula, without puncturing) stimulations. Flexibility and pain or discomfort were assessed using the seat and reach test (SR) and a visual analogic scale (VAS). (3) Results: Significant changes in flexibility were observed after verum acupuncture (p = 0.03), while no significant changes were seen in sham and placebo (p = 0.86 and p = 0.18, respectively). No significant differences were found in pain or discomfort during any of the stimulations (verum, p = 0.55; sham, p = 0.50; placebo, p = 0.58). (4) Conclusions: The results of this pilot study suggest that acupuncture may improve flexibility in the hamstring muscles, though it does not significantly affect pain or discomfort during stretching.

Can Yoga, Qigong, and Tai Chi Breathing Work Support the Psycho-Immune Homeostasis during and after the COVID-19 Pandemic? A Narrative Review.

Breathing is crucial in life; nevertheless, the healthcare community often overlooks the health potential of breathing techniques. Conscious manipulation of breathing to achieve specific health goals is found in yoga, Qigong and Tai Chi. This paper reviews the value of breathing exercises as a foremost mechanism for promoting, recuperating and maintaining health. Practices involving breathing techniques are described, and their prophylactic or therapeutic characteristics are explored. The main goals of this review are: (i) to summarize the evidence supporting the hypothesis that breathing practices have a significant beneficial impact on human health; (ii) to provide a deeper understanding of traditional biofeedback practices, particularly yoga, Qigong and Tai Chi, and outline their focus on breathing techniques; (iii) to outline specific immune-related responses, relevant for COVID-19 disorders; and (iv) to call for committed attention and action from the scientific community and health agencies in promoting the implementation of a practical and costless health program based on breathing techniques. This review shows the health potentials of breathing practices and exercises, which, by having a high benefit-cost ratio, could be selected and implemented as a primary standard routine in public health programs.

Qigong in Perceptual Auditory Attention: Tool to Improve Sound Integration in Autism Spectrum Disorders.

Context: Qigong, a mind-body practice in traditional Chinese medicine (TCM), can improve cognitive functions, emotional balance, attention, multitask management, stress-coping, and well-being. One limitation of Qigong research is a lack of adequate controls. Objective: The current study intended to evaluate whether a single 5-min practice of a White Ball (WB) Qigong exercise could improve the perceptual auditory attention, divided and focused, in adults and whether obtaining potential effects would require a minimum level of training. Design: The research team designed a prospective, randomized, placebo-controlled, and single-blinded study. Setting: The study took place at the Institute of Biomedical Sciences (ICBAS) at the University of Porto in Porto, Portugal. Participants: Participants were 55 students at the University of Porto, 30 of whom were students attending the second year of medical school at ICBAS with no experience in Qigong and 25 of whom were students in the specialization and Master's programs in TCM with experience in Qigong. Intervention: The research team randomly distributed the 30 participants without experience into two groups, a negative control group (n = 15), who watched a wildlife video for 5 min in an orthostatic position, and a positive control group , the verum Qigong group (n = 15), who participated in 5 min of Qigong practice. The Qigong-practitioner group (n = 25), the intervention group, participated in the same 5-min Qigong, doing it with expertise. Outcome Measures: The study measured reaction time (RT) under two experimental conditions, one an auditory RT task and the second an auditory RT task with visual distraction. The procedure was constant for all the studied groups. Results: Postintervention, the reaction time (RT) in the negative control and the verum Qigong groups hadn't changed significantly (P > .05), while that of the Qigong-practitioner group had decreased significantly, with shorter RTs under the two experimental conditions, with P = .006 for the auditory RT and P = .003 for the auditory + visual distraction. Qigong may induce a conditioning effect that comes with regular practice. Conclusions: The WB Qigong had a positive effect on the AA mechanism, with a significant reduction in RT. The results support the importance of practice to achieve positive effects. People with neurodevelopmental disorders, such as autism and ADHD, struggle every day for sensory integration of AA mechanisms. Qigong can be taught and easily learned from the age of 2 years until senior ages, and it's a safe and very low-cost intervention that deserves to be researched further in clinical trials. These potential benefits of Qigong should be confirmed by future studies.

Emerging drying techniques for food safety and quality: A review.

The new trends in drying technology seek a promising alternative to synthetic preservatives to improve the shelf-life and storage stability of food products. On the other hand, the drying process can result in deformation and degradation of phytoconstituents due to their thermal sensitivity. The main purpose of this review is to give a general overview of common drying techniques with special attention to food industrial applications, focusing on recent advances to maintain the features of the active phytoconstituents and nutrients, and improve their release and storage stability. Furthermore, a drying technique that extends the shelf-life of food products by reducing trapped water, will negatively affect the spoilage of microorganisms and enzymes that are responsible for undesired chemical composition changes, but can protect beneficial microorganisms like probiotics. This paper also explores recent efficient improvements in drying technologies that produce high-quality and low-cost final products compared to conventional methods. However, despite the recent advances in drying technologies, hybrid drying (a combination of different drying techniques) and spray drying (drying with the help of encapsulation methods) are still promising techniques in food industries. In conclusion, spray drying encapsulation can improve the morphology and texture of dry materials, preserve natural components for a long time, and increase storage times (shelf-life). Optimizing a drying technique and using a suitable drying agent should also be a promising solution to preserve probiotic bacteria and antimicrobial compounds.

The impact of low income on long-term mortality of myocardial infarction patients: results from the Brazilian Heart Study.

BACKGROUND: Low socioeconomic status has for long been considered an important modifiable risk factor for developing cardiovascular disease, plausibly by lower access to healthcare, lower therapeutic adhesion, and overlapping of other known risk factors. Nevertheless, whether family income and social isolation of poor communities seen in Brazil impact outcomes following ST-segment elevation myocardial infarction (STEMI) remain scarcely understood. METHODS: STEMI diagnosed patients were consecutively enrolled from the Brazilian Heart Study (ClinicalTrials.gov Identifier: NCT02062554) and categorized according to median family income (US$350), address-based human development index (HDI), and distance between communities and a tertiary hospital (DCTH). Incidence of death after 48 months was compared by using adjusted Cox regressions. p-alues < .05 were considered significant. RESULTS: Among 542 subjects, there were 69 deaths (13.2%) after a median follow-up time of 611 d (IQR = 724). The low-income group had a higher incidence of all-cause mortality compared to high income (18.4 vs. 7.1%; p = .001), with an adjusted HR of 2.16 (95%CI: 1.25-3.75; p = .006). Compared to high-income, low-income individuals had the worst clinical presentation of myocardial infarction and less frequently received dual antiplatelet therapy and statins at hospital discharge. The population attributable risk of low income was 44.8%. HDI and DCTH did not influence the delay to reperfusion therapy nor the risk of death. CONCLUSIONS: Low income was independently associated with a higher long-term mortality rate, lower prescription of guidelines-recommended therapy, and worst clinical presentation of myocardial infarction in STEMI patients.

Assessment of Qigong Effects on Anxiety of High-school Students: A Randomized Controlled Trial.

CONTEXT: Students are vulnerable to developing anxiety, a psychiatric disorder closely related to emotional stress, when systematically stressed by classes, homework, and evaluations. Qigong integrates physical, respiratory, and mental exercises, inducing vegetative biofeedback with significant effects on physiological regulation. OBJECTIVE: The current study aimed to assess the potential effects of specific Qigong exercises on students' anxiety levels and evaluate the feasibility of practical integration in a daily school context. DESIGN: The research team developed a randomized controlled trial. SETTING: This study was performed in Cedros and Horizonte private schools located in Vila Nova de Gaia in Portugal. PARTICIPANTS: Participants were 104 high-school students at the schools. INTERVENTION: Participants were randomly divided into three groups: (1) an intervention group, the Qigong (QG) group (n = 34), which performed Qigong exercises; (2) a control group, the TV documentary (TVD) group (n = 34), which watched a TV documentary; and (3) a second control group, the typical school duties (TSD) group (n = 36), which performed regular school duties. OUTCOME MEASURES: Anxiety levels were assessed through a psychological test, the State-Trait Anxiety Inventory (STAI) and salivary cortisol tests. RESULTS: Psychological and biochemical variables assessed at baseline and postintervention showed a greater decrease in anxiety levels in the QG group than in the other two groups. CONCLUSIONS: Qigong seems to be an efficient tool to reduce anxiety and control the stress of high-school students.

Perspectives, Measurability and Effects of Non-Contact Biofield-Based Practices: A Narrative Review of Quantitative Research.

Practices such as "Reiki", therapeutic touch, healing touch, and external "Qigong" have been regarded as some form of "energy medicine" or "biofield therapy". The biofield concept has been studied and debated by researchers of distinct areas of expertise, and although the phenomenon was sometimes described as physically related to electromagnetics, other factors such as "subtle energy" and focused intention might be involved. These nonconventional practices integrate contact and non-contact techniques, and those dealing with so-called distant healing interventions are perhaps the most difficult to understand and accept. Practitioners describe these so-called nonlocal interventions as involving intentional factors and particular states of consciousness. With a spiritual mindset and a particular state of awareness, compassion is said to work out as a catalyst to produce physiological and physical changes through mechanisms that are still unknown. At the body level, these vegetative changes might be related to individual self-perception variations as part of the body neurovegetative feedback system of regulation. Further mechanisms are difficult to document and measure, and might be more accessible to research by using physical signal detectors, chemical dynamics methods, detectors using biological materials, detectors using living sensors, and detectors using the human body. The growing interest in these practices and the considerable amount of research exploring their effects and clinical applications encouraged this narrative review, which aims to provide an easy to consult partial overview of the history, theory and findings of quantitative research strategies exploring non-contact biofield-based practices. This work also aims to stimulate the reader's mind with the raised hypotheses, catalyzing further research on the subject to confirm or deny the reported outcomes.

Can the electrical potential of acupoints be used to assess the functional state of meridians and the effects of therapeutics? An exploratory data analysis.

INTRODUCTION: Acupoints have bioelectrical properties distinct from common skin. Besides the higher electrical conductivity and lower resistance, acupoints show capacitor-like properties, which can be related to their endogenous electrical potential. Traditional Chinese Medicine (TCM) postulates that meridians are physiological structures connecting acupoints and working as a conduit for the flow of two essential substances known as qi and xue. OBJECTIVES: This pilot study was focused in evaluating whether the electrical potential of acupoints can be correlated objectively to the functional properties as described by ancient Chinese medical theories, such as the theories of coupled meridians of the same phase ('elements'), and the principle of coupled points. METHODS: Direct needle moxibustion on LU5 and needle dispulsion of LI4 were performed in 21 subjects. The electrical potential of each acupoint was measured with a high-resolution data acquisition system taking to reference the acupoint SP6 of the Spleen conduit. RESULTS: The results may indicate a functional relationship between the therapeutics and the electrical potential response on the selected acupoints. These effects seem to be explainable considering the specific properties of each acupoint, the relationship between TCM phases, and the dynamics between coupled conduits. CONCLUSION: The evaluation of the endogenous electrical potential of acupoints and the changes caused by an external stimulus might contribute to the understanding of TCM concepts, mechanisms, and the effects of associated therapeutics. The observed phenomena encourage the systematic assessment of the functional vegetative status via skin electrophysiology and using objective measurements.

Understanding Traditional Chinese Medicine Therapeutics: An Overview of the Basics and Clinical Applications.

Traditional Chinese medicine (TCM) is a systematic healthcare system developed from clinical experience based on a scientific model of regulation. TCM relies on unique theories and practices to treat diseases and enhance health. These practices include Chinese herbal medicine and dietetics, acupuncture and moxibustion, and other non-medication therapies such as Chinese bodywork or manual therapy, known as "Tuina", and traditional biofeedback exercises, known as "Qigong" and "Taijiquan". The integration of TCM in Western health systems and research requires a rational communicable theory, scientific proof of efficacy and safety, and quality control measures. Understanding the structural concepts of the TCM language makes possible the parallelism to Western physiology, and the inherent rational use of the reflex therapeutic systems, anti-inflammatory mechanisms and mental training involved, for example, in acupuncture and "Qigong". The results of TCM clinical trials and fundamental research on its nature and mechanisms have encouraged the development and application of well-designed research strategies such as double blinding in acupucture to overcome limitations and resistances in integrating these practices into the existing biomedical paradigms of the West. This review aims to overview some TCM theoretical concepts and the evidence-based clinical application of TCM's leading practices to create an easy-to-consult and condensed source of information, available for the healthcare community, facilitating the understanding and communication between conventional health professionals and TCM practitioners and acupuncturists.

Gensini Score and Thrombus Burden Add Predictive Value to the SYNTAX Score in Detecting No-Reflow after Myocardial Infarction. / O Escore Gensini e a Carga Trombótica Adicionam Valor Preditivo ao Escore SYNTAX na Detecção de No-Reflow após Infarto do Miocárdio.

BACKGROUND: No-reflow after percutaneous coronary intervention is associated with poor prognosis in patients with ST-segment elevation myocardial infarction (STEMI). SYNTAX score is a good predictor of no-reflow. OBJECTIVE: We aimed to evaluate whether atherosclerotic burden (Gensini score) and thrombus burden in the culprit coronary artery would improve the ability of the SYNTAX score to detect no-reflow. METHODS: In this prospective cohort study, consecutive patients with STEMI who presented within 12 h of onset of symptoms were selected for this study. No-reflow was defined as TIMI flow < 3 o r TIMI flow = 3 but myocardial blush grade <2. Thrombus burden was quantified according to the TIMI thrombus grade scale (0 to 5). RESULTS: A total of 481 patients were included (mean age 61±11 years). No-reflow occurred in 32.8%. SYNTAX score (OR=1.05, 95%CI 1.01-1.08, p<0.01), thrombus burden (OR=1.17, 95%CI 1.06-1.31, p<0.01), and Gensini score (OR=1.37, 95%CI 1.13-1.65, p<0.01) were independent predictors of no-reflow. Combined scores had a larger area under the curve than the SYNTAX score alone (0.78 [0.73-0.82] vs 0.73 [0.68-0.78], p=0.03). Analyses of both categorical (0.11 [0.01-0.22], p=0.02), and continuous net reclassification improvement (NRI>0) (0.54 [0.035-0.73], p<0.001) showed improvement in the predictive ability of no-reflow in the combined model, with integrated discrimination improvement (IDI) of 0.07 (0.04-0.09, p<0.001). CONCLUSIONS: Our findings suggest that, in patients with STEMI undergoing percutaneous coronary intervention, atherosclerotic burden and thrombus burden in the culprit artery add predictive value to the SYNTAX score in detecting the no-reflow phenomenon. (Arq Bras Cardiol. 2021; [online].ahead print, PP.0-0).

FUNDAMENTO: O fenômeno de no-reflow após a intervenção coronária percutânea está associado a um pior prognóstico em pacientes com infarto do miocárdio com supradesnivelamento do segmento ST (IAMCSST). O escore SYNTAX é um bom preditor de no-reflow. OBJETIVO: Nosso objetivo foi avaliar se a carga aterosclerótica (escore Gensini) e a carga trombótica na artéria coronária culpada melhorariam a capacidade do escore SYNTAX para detectar o no-reflow. MÉTODOS: Neste estudo coorte prospectivo, foram estudados pacientes com IAMCSST consecutivos que se apresentaram dentro de 12 horas a partir do início dos sintomas. O no-reflow foi definido como fluxo TIMI < 3 ou fluxo TIMI =3 mas grau de blush miocárdico (myocardial blush grade) < 2. A carga trombótica foi quantificada de acordo com o grau TIMI de trombo (0 a 5). RESULTADOS: Foram incluídos 481 pacientes no estudo, com idade média de 61±11 anos. O fenômeno de no-reflow ocorreu em 32,8% dos pacientes. O escore SYNTAX (OR=1,05, IC95% 1,01­1,08, p<0,01), a carga trombótica (OR=1,17, IC95% 1,06­1,31, p<0,01), e o escore Gensini (OR=1,37, IC95% 1,13­1,65, p<0,01) foram preditores independentes do no-reflow. Os escores combinados apresentaram uma maior área sob a curva quando comparados ao escore SYNTAX isolado (0,78 [0,73­0,82] vs 0,73 [0,68­0,78], p=0,03). A análise da melhora da reclassificação líquida (NRI) categórica (0,11 [0,01­0,22], p=0,02) e contínua (NRI>0) (0,54 [0,035­0,73], p<0.001) mostrou melhora na capacidade preditiva do no-reflow no modelo combinado, com melhora da discriminação integrada (IDI) de 0,07 (0,04­0,09, p<0,001). CONCLUSÕES: Nossos achados sugerem que, em pacientes com IAMCSST submetidos à intervenção coronária percutânea, a carga aterosclerótica e a carga trombótica na artéria culpada adicionam valor preditivo ao escore SYNTAX na detecção do fenômeno no-reflow. (Arq Bras Cardiol. 2021; [online].ahead print, PP.0-0).

O Escore Gensini e a Carga Trombótica Adicionam Valor Preditivo ao Escore SYNTAX na Detecção de No-Reflow após Infarto do Miocárdio / Gensini Score and Thrombus Burden Add Predictive Value to the SYNTAX Score in Detecting No-Reflow after Myocardial Infarction

Resumo Fundamento O fenômeno de no-reflow após a intervenção coronária percutânea está associado a um pior prognóstico em pacientes com infarto do miocárdio com supradesnivelamento do segmento ST (IAMCSST). O escore SYNTAX é um bom preditor de no-reflow. Objetivo Nosso objetivo foi avaliar se a carga aterosclerótica (escore Gensini) e a carga trombótica na artéria coronária culpada melhorariam a capacidade do escore SYNTAX para detectar o no-reflow. Métodos Neste estudo coorte prospectivo, foram estudados pacientes com IAMCSST consecutivos que se apresentaram dentro de 12 horas a partir do início dos sintomas. O no-reflow foi definido como fluxo TIMI < 3 ou fluxo TIMI =3 mas grau de blush miocárdico (myocardial blush grade) < 2. A carga trombótica foi quantificada de acordo com o grau TIMI de trombo (0 a 5). Resultados Foram incluídos 481 pacientes no estudo, com idade média de 61±11 anos. O fenômeno de no-reflow ocorreu em 32,8% dos pacientes. O escore SYNTAX (OR=1,05, IC95% 1,01-1,08, p<0,01), a carga trombótica (OR=1,17, IC95% 1,06-1,31, p<0,01), e o escore Gensini (OR=1,37, IC95% 1,13-1,65, p<0,01) foram preditores independentes do no-reflow. Os escores combinados apresentaram uma maior área sob a curva quando comparados ao escore SYNTAX isolado (0,78 [0,73-0,82] vs 0,73 [0,68-0,78], p=0,03). A análise da melhora da reclassificação líquida (NRI) categórica (0,11 [0,01-0,22], p=0,02) e contínua (NRI>0) (0,54 [0,035-0,73], p<0.001) mostrou melhora na capacidade preditiva do no-reflow no modelo combinado, com melhora da discriminação integrada (IDI) de 0,07 (0,04-0,09, p<0,001). Conclusões Nossos achados sugerem que, em pacientes com IAMCSST submetidos à intervenção coronária percutânea, a carga aterosclerótica e a carga trombótica na artéria culpada adicionam valor preditivo ao escore SYNTAX na detecção do fenômeno no-reflow. (Arq Bras Cardiol. 2021; [online].ahead print, PP.0-0)

Abstract Background No-reflow after percutaneous coronary intervention is associated with poor prognosis in patients with ST-segment elevation myocardial infarction (STEMI). SYNTAX score is a good predictor of no-reflow. Objective We aimed to evaluate whether atherosclerotic burden (Gensini score) and thrombus burden in the culprit coronary artery would improve the ability of the SYNTAX score to detect no-reflow. Methods In this prospective cohort study, consecutive patients with STEMI who presented within 12 h of onset of symptoms were selected for this study. No-reflow was defined as TIMI flow < 3 o r TIMI flow = 3 but myocardial blush grade <2. Thrombus burden was quantified according to the TIMI thrombus grade scale (0 to 5). Results A total of 481 patients were included (mean age 61±11 years). No-reflow occurred in 32.8%. SYNTAX score (OR=1.05, 95%CI 1.01-1.08, p<0.01), thrombus burden (OR=1.17, 95%CI 1.06-1.31, p<0.01), and Gensini score (OR=1.37, 95%CI 1.13-1.65, p<0.01) were independent predictors of no-reflow. Combined scores had a larger area under the curve than the SYNTAX score alone (0.78 [0.73-0.82] vs 0.73 [0.68-0.78], p=0.03). Analyses of both categorical (0.11 [0.01-0.22], p=0.02), and continuous net reclassification improvement (NRI>0) (0.54 [0.035-0.73], p<0.001) showed improvement in the predictive ability of no-reflow in the combined model, with integrated discrimination improvement (IDI) of 0.07 (0.04-0.09, p<0.001). Conclusions Our findings suggest that, in patients with STEMI undergoing percutaneous coronary intervention, atherosclerotic burden and thrombus burden in the culprit artery add predictive value to the SYNTAX score in detecting the no-reflow phenomenon. (Arq Bras Cardiol. 2021; [online].ahead print, PP.0-0)

Can Traditional Chinese Medicine Diagnosis Be Parameterized and Standardized? A Narrative Review.

The integration of Traditional Chinese Medicine (TCM) in Western health systems and research requires a rational communicable theory, scientific proof of efficacy and safety, and quality control measures. The existence of clear definitions and the diagnosis standardization are critical factors to establish the patient's vegetative functional status accurately and, therefore, systematically apply TCM therapeutics such as the stimulation of reflex skin areas known as acupoints. This science-based conceptualization entails using validated methods, or even developing new systems able to parameterize the diagnosis and assess TCM related effects by objective measurements. Traditionally, tongue and pulse diagnosis and the functional evaluation of action points by pressure sensitivity and physical examination may be regarded as essential diagnostic tools. Parameterizing these techniques is a future key point in the objectification of TCM diagnosis, such as by electronic digital image analysis, mechanical pulse diagnostic systems, or the systematic evaluation of acupoints' electrophysiology. This review aims to demonstrate and critically analyze some achievements and limitations in the clinical application of device-assisted TCM diagnosis systems to evaluate functional physiological patterns. Despite some limitations, tongue, pulse, and electrophysiological diagnosis devices have been reported as a useful tool while establishing a person's functional status.

Problems of scientific methodology related to placebo control in Qigong studies: A systematic review.

INTRODUCTION: Qigong is widespread in the West and used for preventive care, stress-induced conditions, emotional and vegetative symptoms like migraine and hypertension, as well as for better coordination in the elderly and quality of life enhancement in severe disease such as cancer. Adequate controls for Qigong research are lacking, compromising the level of efficacy evidence. Adequate Qigong placebo control exercises should match clear and standardized criteria. METHODS: Three computerized databases were assessed in January 2018 (Scopus, Web of Science and MEDLINE on PubMed) using the following keywords or their combinations: (Qigong OR Qi Gong OR Gong Qi OR Chi Kung OR Kung Chi OR Kiko OR Ki Gong OR Ki Kong) AND placebo. In addition, all reference lists were scanned for further relevant articles. Literature was examined for the effects of Qigong as compared to a control intervention. RESULTS: 110 articles were found, 78 of which were excluded after examining the title and abstract, and 16 because they were duplicates. Four more articles were found by searching in the bibliographies of published papers. A total of 20 studies were included in this systematic review. We found that, to the best of our knowledge, no criteria for placebo controls have been published in peer-reviewed journals so far. CONCLUSION: Placebo controls should be developed by the usage of vegetative functional assessments such as heart rate variability, thermography, and electrophysiological measurements, thus excluding major vegetative effects of the exercise, as well as by the usage of psychometric tests and other quantitative evaluations.

Can measurements be physically conditioned by thought? Further observations following a focused intention experiment.

Background The biofield is a controversial concept among the scientific community. Some aspects of this phenomenon relate to measurable factors of mainstream science such as electromagnetics, while others, involving nonlocal interventions, intention, and consciousness, seem to produce physical changes through mechanisms that are still unknown, making the outcomes of many studies not fully explained by our current state of scientific understanding. This study explored the hypothetical effects of intention on the conditioning of a pH system with continuous data acquisition for real-time measurements. As a follow-up study, those effects were related to changes in the physicochemical properties of water samples chosen as a target in a previous large-scale intervention of focused intention. Methods The intention experiments were conducted under controlled conditions from the 8th to September 11, 2015. During this period, 286 qualified biofield therapy practitioners meditated at a distance with the intention of changing the vibrational state of the water molecules contained in specific flasks. Several variables were evaluated, including the magnetic field and ultraviolet-visible (UV-VIS) radiation from 175 to 954 nm near the experimental spot, as well as Raman spectra, pH, and electrical conductivity of all the water samples. After this period, real-time pH measurements of water samples were taken with the same equipment and under the same experimental conditions, except for the practitioners' awareness of those experiments, and without their focused intention. Real-time pH, electrical conductivity and the concentration of cations and anions measured by ion chromatography in the water samples were used to test the proposed hypothesis. Results Real-time pH was responsive during the intention experiments and after this period. Further continuous measurements performed after the 11th September showed that the pH variations overtime kept a systematic and consistent tendency similar to the one observed during the experimental activities involving focused intention. After the replacement of the electrode internal electrolyte, this behavior was no longer verified, and the pH was stable as the initial tests to evaluate the equipment sensitivity. Conclusions After the experimental period involving focused intention, the pH system maintained a systematic and consistent behavior while measuring the pH of new water samples. An eventual intention-mediated conditioning of the pH measurement system occurred because of changes in the properties of the electrode internal electrolyte.

Can Qigong improve attention in adolescents? A prospective randomised controlled trial.

INTRODUCTION: The ability to direct and maintain attention is a prerequisite for learning. Qigong exercises are already commonly practiced in many developed countries to increase attention and memory. The main goal of this study was to examine whether Qigong would improve the attention levels of adolescents (12-14 years of age) when practiced as part of their physical education course. METHOD: Three groups of 22 individuals were considered: the verum group, which performed true Qigong; the control group, which performed sham, or placebo Qigong; and the waiting list group. In order to evaluate Qigong effects, attention tests (d2) were applied to all groups before the intervention period (t1) and after two and four weeks of practice (t2 and t3, respectively). RESULTS: At t1, there was no significant difference between the verum, control and waiting list groups in all measurable features. After 4 weeks of exercise, the verum group was significantly superior in all measurable features in comparison to the control group and the waiting list group. Values in the waiting list group were generally worse than in the control group (placebo Qigong), but there was no significant difference between the control and waiting list group, showing that the placebo offered an effect that was not significantly greater than the effect of no intervention at all. CONCLUSION: 'White Ball' Qigong was able to improve attention in adolescents after 4 weeks of practice, leading us to conclude that it may be a useful tool when integrated into physical education classes.

Acupuncture can be beneficial for exercise-induced muscle soreness: A randomised controlled trial.

INTRODUCTION: Strenuous physical exercise may cause acute muscle soreness (AMS), which occurs directly after exercise, as well as delayed onset muscle soreness (DOMS), which occurs about 24 h after exercise. Studies of acupuncture's effect on DOMS have had contradictory results, whereas its effect on AMS has not been extensively studied. The main goal of this study was to evaluate acupuncture's effects on AMS and DOMS and on the prevention of DOMS. METHOD: 45 volunteers were randomised into a verum acupuncture group, a sham acupuncture group and a control group. After exercise-induced muscle damage was elicited, muscle soreness and pressure pain threshold were assessed at different time points. The outcome assessments were performed before (T1) and 20 min after the first acupuncture treatment (T2); then, 24 h later, they were performed before (T3) and 20 min after the second acupuncture treatment (T4). In the verum and sham acupuncture groups, acupuncture was performed for 2 min, immediately after T1 and T3 assessments, whereas subjects in the control group simply rested for 2 min without treatment. Verum acupuncture was given at ST34, ST36 and LR3, whereas sham acupuncture was given at three nontraditional points. RESULTS: We found that verum acupuncture can reduce the occurrence of AMS by one-half and DOMS by one-third. We also found specific and nonspecific acupuncture effects in AMS and DOMS. CONCLUSION: The uneven induction of muscle damage identified by our study, as shown by heterogeneity in pressure pain threshold values, may have led to the contradictory results in published studies on DOMS.

Changes of skin electrical potential in acupoints from Ren Mai and Du Mai conduits during Qigong practice: Documentation of a clinical phenomenon.

Qigong is a therapeutic method of traditional Chinese medicine (TCM) that combines slow, soft movements and postures with breath control and a special mental state of 'awareness'. TCM holds that the practice of Qigong promotes the 'circulation of qi' in the human body, the 'flow' of upward yang qi and downward yin qi to establish 'balance'. In Western terms, this may be generally equivalent to vegetative homeostasis and the emotionally balanced state induced thereby. Researchers have often attempted to evaluate the functional movements of qi using measurements of the skin's electrical resistance. However, these methodologies have proven difficult to gauge, validate, repeat, and interpret. We aimed to overcome these limitations by measuring the skin's electrical potential between two points of the same system. The main goal of this study was to assess the skin's electrical potential changes in acupoints from the Ren Mai and Du Mai conduits, or meridians, as well as in other points of interest, during Qigong practice. While participants performed a specific Qigong exercise called 'White Ball', we observed significant changes in the skin electrical potential on Mìngmén (GV 4), Shèndáo (GV 11) and Baihuì (GV 20), from the Du Mai conduit, as well as on Huiyin (CV 1), Qìhai (CV 6), Zhongwan (CV 12) and Dànzhong (CV 17), from Ren Mai. These observations are in accordance with TCM theory and may contribute to the explanation of the vegetative physiological changes that are associated with 'qi flow' in TCM.

Effects of taijiquan and qigong practice over behavioural disorders in school-age children: A pilot study.

Child development and wellness are strictly dependent on several factors among them physical activity, a proper nutrition and, of critical importance, a healthy mind. Psychopathologies like attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD) and conduct disorder (CD) have a direct negative impact on social, academic or occupational functioning of the affected children. If left untreated, these pathologies may progress to adulthood, thus requiring research strategies on conventional and nonconventional modalities of treatment. In this pilot study, conducted during the academic year 2015/2016, a combination of exercises of TaijiQuan (TJQ) and Qi Gong (QG) were taught to four selected children, three males and one female, aged between 6 and 10, suffering from the above mentioned behavioural disorders. The main goal was to understand if it is possible to achieve any kind of improvement in their condition, by evaluating the scores of the Achenbach Teacher's Report Form (TRF) in the beginning and ending of the experimental period. Results showed very interesting improvements in symptoms of CD, ODD and ADHD-HI (hyperactive-impulsive), while ADHD-PI (predominantly inattentive) showed only minor improvements. The overall symptom improvement was 43% across pathologies, which demonstrates that TJQ and QG may be a promising treatment of symptoms for children with behavioural disorders. More research is needed with controlled experimental designs and statistically representative samples in order to fully comprehend the versatility of these modalities.

Does auriculotherapy have therapeutic effectiveness? An overview of systematic reviews.

BACKGROUND AND PURPOSE: Auriculotherapy is a therapeutic technique used for a wide variety of conditions. Nevertheless, similarly to any health related intervention, the clinical use of this therapy requires scientific evidence of effectiveness in order to support its rational use. The main goal of this article is to critically analyze published literature on auriculotherapy and to provide an overview of the effectiveness of this technique in the management of health disorders. METHODS: The inventory of published reviews on this subject was carried out in November 2017, by assessing the following computerized databases: PubMed, MEDLINE, PsycINFO, EBMR, Cochrane Database of Systematic Reviews, CINAHL Plus NRC and Science Direct. Were only considered the systematic reviews based on meta-analysis with high methodological quality described according to AMSTAR (Assessment of Multiple Systematic Reviews). The eligible articles were systematically reviewed to find out in which health conditions auriculotherapy can be used with effectiveness. RESULTS: A total of 14 reviews were eligible according to the inclusion and exclusion criterions. Those reviews were focused on the management of insomnia, smoking cessation and pain, within the clinical scope of Neurology, Orthopaedics and Rheumatology. CONCLUSIONS: Auriculotherapy has shown to have positive effects while associated to conventional treatments of insomnia, chronic and acute pain. Further well designed studies are required to evaluate the effectiveness of this technique in the treatment of other health conditions.