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Launched in October 2003, the Hospital Quality Incentive Demonstration (HQID) pay-for-performance project was designed to determine if economic incentives to hospitals were effective at improving the quality of inpatient care. Approximately 250 hospitals—small/large, urban/rural, teaching/non-teaching facilities—across 36 U.S. states participated in the demonstration.

The Healthcare Quality Improvement Partnership (HQIP) was established in April 2008 to promote quality in UK health services, by increasing the impact that clinical audit has on healthcare quality in England and Wales. It is led by a consortium of the Academy of Medical Royal Colleges, Royal College of Nursing and National Voices.

The Partnership holds the contract to manage the National Clinical Audit and Patient Outcomes Programme (NCAPOP). This consists of more than 25 clinical audits that cover a range of medical, surgical and mental health conditions. Their purpose is to engage clinicians across England and Wales in systematic evaluation of their clinical practice against standards, and to encourage improvement in the quality of care. This programme is gradually being extended to other areas of healthcare, working with clinical and professional advisory groups.

HQIP also runs the National Clinical Audit Forum (NCAF) for online communication among those interested in clinical audit, cooperates with regulatory bodies, issues guidance on good clinical audit practice and hosts events that bring national and local clinical audit practitioners together. Additionally, the Partnership works closely with the National Clinical Audit Advisory Group (NCAAG), which advises the Department of Health on clinical audit and is central to commissioning new national clinical audits.

In November 2012 the HQIP won contracts from the Department of Health to manage the National Clinical Audit and Patient Outcomes Programme (NCAPOP) and the Clinical Outcome Review Programme (CORP). It is centrally involved in the publication of consultant level quality and mortality data.

The Chief Executive Officer is Jane Ingham. The Trustee Board of HQIP includes the following members: Professor Carrie MacEwen - chair, Alistair Henderson - vice chair, Phil Baker, Sheila Marriott, Victoria Tzortziou Brown, Sarah Dunnett, Michael Chapman, Susan Masters, Miles Sibley.

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Breathing (or ventilation) is the process of moving air out and in the lungs to facilitate gas exchange with the internal environment, mostly to flush out carbon dioxide and bring in oxygen.

All aerobic creatures need oxygen for cellular respiration, which extracts energy from the reaction of oxygen with molecules derived from food and produces carbon dioxide as a waste product. Breathing, or "external respiration", brings air into the lungs where gas exchange takes place in the alveoli through diffusion. The body's circulatory system transports these gases to and from the cells, where "cellular respiration" takes place.

The breathing of all vertebrates with lungs consists of repetitive cycles of inhalation and exhalation through a highly branched system of tubes or airways which lead from the nose to the alveoli. The number of respiratory cycles per minute is the breathing or respiratory rate, and is one of the four primary vital signs of life. Under normal conditions the breathing depth and rate is automatically, and unconsciously, controlled by several homeostatic mechanisms which keep the partial pressures of carbon dioxide and oxygen in the arterial blood constant. Keeping the partial pressure of carbon dioxide in the arterial blood unchanged under a wide variety of physiological circumstances, contributes significantly to tight control of the pH of the extracellular fluids (ECF). Over-breathing (hyperventilation) and under-breathing (hypoventilation), which decrease and increase the arterial partial pressure of carbon dioxide respectively, cause a rise in the pH of ECF in the first case, and a lowering of the pH in the second. Both cause distressing symptoms.

Breathing has other important functions. It provides a mechanism for speech, laughter and similar expressions of the emotions. It is also used for reflexes such as yawning, coughing and sneezing. Animals that cannot thermoregulate by perspiration, because they lack sufficient sweat glands, may lose heat by evaporation through panting.

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Remdesivir, sold under the brand name Veklury, is a broad-spectrum antiviral medication developed by the biopharmaceutical company Gilead Sciences. It is administered via injection into a vein. During the COVID-19 pandemic, remdesivir was approved or authorized for emergency use to treat COVID‑19 in around 50 countries. Updated guidelines from the World Health Organization in November 2020 include a conditional recommendation against the use of remdesivir for the treatment of COVID-19.

Remdesivir was originally developed to treat hepatitis C, and was subsequently investigated for Ebola virus disease and Marburg virus infections before being studied as a post-infection treatment for COVID-19.

The most common side effect in healthy volunteers is raised blood levels of liver enzymes (a sign of liver problems). The most common side effect in people with COVID‑19 is nausea. Side effects may include liver inflammation and an infusion-related reaction with nausea, low blood pressure, and sweating.

Remdesivir is a prodrug that is intended to allow intracellular delivery of GS-441524 monophosphate and subsequent biotransformation into GS-441524 triphosphate, a ribonucleotide analogue inhibitor of viral RNA polymerase.

The U.S. Food and Drug Administration (FDA) considers it to be a first-in-class medication.

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Hypertrophic cardiomyopathy (HCM, or HOCM when obstructive) is a condition in which the heart becomes thickened without an obvious cause. The parts of the heart most commonly affected are the interventricular septum and the ventricles. This results in the heart being less able to pump blood effectively and also may cause electrical conduction problems.

People who have HCM may have a range of symptoms. People may be asymptomatic, or may have fatigue, leg swelling, and shortness of breath. It may also result in chest pain or fainting. Symptoms may be worse when the person is dehydrated. Complications may include heart failure, an irregular heartbeat, and sudden cardiac death.

HCM is most commonly inherited from a person's parents in an autosomal dominant pattern. It is often due to mutations in certain genes involved with making heart muscle proteins. Other inherited causes of left ventricular hypertrophy may include Fabry disease, Friedreich's ataxia, and certain medications such as tacrolimus. Other considerations for causes of enlarged heart are athlete's heart and hypertension (high blood pressure). Making the diagnosis of HCM often involves a family history or pedigree, an electrocardiogram, echocardiogram, and stress testing. Genetic testing may also be done. HCM can be distinguished from other inherited causes of cardiomyopathy by its autosomal dominant pattern, whereas Fabry disease is X-linked and Friedreich's Ataxia is inherited in an autosomal recessive pattern.

Treatment may depend on symptoms and other risk factors. Medications may include the use of beta blockers or disopyramide. An implantable cardiac defibrillator may be recommended in those with certain types of irregular heartbeat. Surgery, in the form of a septal myectomy or heart transplant, may be done in those who do not improve with other measures. With treatment, the risk of death from the disease is less than one percent per year.

HCM affects about one in 500 people. Rates in men and women are about equal. People of all ages may be affected. The first modern description of the disease was by Donald Teare in 1958.

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