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Shih-Lung Cheng,1,2 Ming-Lin Ho,3 Yun-Fa Lai,4 Hao-Chien Wang,5 Jeng-Yuan Hsu,6 Shih-Feng Liu,7,8 Ming-Shyang Huang,9 Cheng-Hung Lee,10 Ching-Hsiung Lin,3,11 Liang-Wen Hang,12,13 Yu-Chih Liu,14 Kuang-Yao Yang,15,16,* Jia-Horng Wang14,17,* 1Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan; 2Department of Chemical Engineering and Materials Science, Yuan-Ze University, Taoyuan, Taiwan; 3Division of Chest Medicine, Kuang Tien General Hospital, Taichung, Taiwan; 4Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan; 5Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; 6Division of Clinical Research, Taichung Veterans General Hospital, Taichung, Taiwan; 7Department of Respiratory Therapy, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; 8Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; 9Department of Internal Medicine, E-DA Cancer Hospital and Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; 10Division of Chest Medicine, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 11Division of Chest Medicine, Changhua Christian Hospital, Changhua, Taiwan; 12School of Nursing & Graduate Institute of Nursing, China Medical University, Taichung, Taiwan; 13Sleep Medicine Center, China Medical University Hospital, Taichung, Taiwan; 14Department of Internal Medicine, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; 15Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; 16Institute of Emergency and Critical Care Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan; 17Hyperbaric Oxygen Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan*These authors contributed equally to this workCorrespondence: Kuang-Yao Yang; Jia-Horng Wang Tel +886-2-28757455Fax +886-2-28757610Email kyyang@vghtpe.gov.tw; jiahorng.wang@gmail.comIntroduction: In the prospective, observational, 16-week REACT study conducted between October 21, 2008 and May 12, 2011, we compared the real-world effectiveness of anti-inflammatory reliever and maintenance therapy with budesonide/formoterol (Symbicort® Turbuhaler) and maintenance therapy with fixed-dose fluticasone/salmeterol (Seretide®) plus as-needed, short-acting β2 agonists (SABAs) in Taiwanese patients with inadequate asthma control.Methods: Asthma control was assessed using the five-item Asthma Control Questionnaire (ACQ-5) and standardized pulmonary function testing. Assessments were performed at baseline and at weeks 4– 5 and 12– 16. Overall, we enrolled 842 patients at 11 clinics, 723 of whom were included in analyses (budesonide/formoterol, 563.3± 1.3 μg/d, n=551; fluticasone/salmeterol, 1013.8± 1.4 μg/d, n=172).Results: At baseline, 72.5% and 27.5% of all patients had “partly” and “uncontrolled” asthma, respectively. Mean±SD ACQ-5 scores were 1.54± 1.06 and 1.46± 1.28 in the budesonide/formoterol and fluticasone/salmeterol groups, respectively. ACQ-5 scores significantly improved from baseline (ie, decreased) in both groups at weeks 4 and 16. ACQ-5 difference scores were significantly lower in the budesonide/formoterol group (− 0.91± 1.11) than the fluticasone/salmeterol group (− 0.69± 1.27) at the end of the study (p=0.027). Peak expiratory flow rate significantly improved from baseline in the budesonide/formoterol but not the fluticasone/salmeterol group at the end of the study. Severe exacerbation rates and medical resource utilization were comparable between the budesonide/formoterol and fluticasone/salmeterol groups.Conclusion: Collectively, results indicate the real-world effectiveness of budesonide/formoterol anti-inflammatory reliever and maintenance therapy is better than fixed-dose fluticasone/salmeterol plus as-needed SABA.Trial Registration: ClinicalTrials.gov registration number: NCT00784953.Keywords: budesonide/formoterol, fluticasone propionate/salmeterol, anti-inflammatory reliever and maintenance, real-world

Cheng SL, Ho ML, Lai YF, et al. Drug Des Devel Ther. 2020;14:5441–5450.The authors have advised there is an error in the formatting of the paper title on page 5441, the title “Budesonide/Formoterol Anti-Inflammatory Reliever and Maintenance or Fluticasone Propionate/Salmeterol Plus As-Needed, Short-Acting β2 Agonist: Real-World Effectiveness in pAtients without Optimally Controlled asThma (REACT) Study” should read “Budesonide/Formoterol Anti-Inflammatory Reliever and Maintenance or Fluticasone Propionate/Salmeterol Plus As-Needed, Short-Acting β2 Agonist: Real-world Effectiveness in pAtients without optimally Controlled asThma (REACT) Study”.The authors have also advised the affiliation list on page 5441 is incorrect. Read the original article

Radiative decays of the radially excited charmonium resonance, (Formula presented) into (Formula presented) (Formula presented) and (Formula presented) final states have been measured in a sample of (Formula presented) (Formula presented) events collected by the BES Collaboration. The branching ratios (Formula presented) and (Formula presented) are obtained. When compared to the corresponding radiative (Formula presented) decays, the observed (Formula presented) radiative decay rates into (Formula presented) and (Formula presented) are consistent with the prediction of the “12%” rule. © 2003 The American Physical Society.

Radiative decays of the radially excited charmonium resonance, (Formula presented) into (Formula presented) (Formula presented) and (Formula presented) final states have been measured in a sample of (Formula presented) (Formula presented) events collected by the BES Collaboration. The branching ratios (Formula presented) and (Formula presented) are obtained. When compared to the corresponding radiative (Formula presented) decays, the observed (Formula presented) radiative decay rates into (Formula presented) and (Formula presented) are consistent with the prediction of the “12%” rule. © 2003 The American Physical Society.

The branching fraction of the ψ(2S) decay into τ+τ - has been measured for the first time using the BES detector at the Beijing Electron-Positron Collider. The result is Bττ=(2.710. 43±0.55)× 10-3, where the first error is statistical and the second is systematic. This value, along with those for the branching fractions into e+e- and μ+ μ- of this resonance, satisfy well the relation predicted by the sequential lepton hypothesis. Combining all these values with the leptonic width of the resonance, the total width of the ψ(25) is determined to be (252±37) keV. ©2002 The American Physical Society.

The Beijing Spectrometer (BES) detector is a general purpose solenoid detector at the Beijing Electron Positron Collider in Beijing, China. The recent upgrade of the initial BES detector to the improved BES II detector is described. A new drift chamber, time-of-flight counter, luminosity monitor compatible with a low-β lattice was built as well as the vertex chamber.

The Beijing Spectrometer (BES) detector is a general purpose solenoid detector at the Beijing Electron Positron Collider in Beijing, China. The recent upgrade of the initial BES detector to the improved BES II detector is described. A new drift chamber, time-of-flight counter, luminosity monitor compatible with a low-β lattice was built as well as the vertex chamber.

The first measurement of (Formula presented) and an upper limit for (Formula presented) are determined from 22.3 (Formula presented) of (Formula presented) annihilation data at a c.m. energy of 4.03 GeV. The data were recorded by the Beijing Spectrometer (BES) at BEPC. A recoil charge method is applied to charm threshold data to determine the charge of the D meson in the recoil from (Formula presented) reconstructed (Formula presented) (Formula presented) mesons. The branching fractions (Formula presented) and (Formula presented) are determined from 10 events with a reconstructed D and a recoiling (Formula presented) In addition, a 90% C.L. upper limit of (Formula presented) is determined from a search for semileptonic decays of the (Formula presented) © 2000 The American Physical Society.

Using a sample of 3.8 M (Formula presented) events accumulated with the BES detector, the process (Formula presented) is studied. The angular distributions are compared with the general decay amplitude analysis of Cahn. We find that the dipion system requires some D wave amplitude, as well as S wave. On the other hand, the (Formula presented) relative angular momentum is consistent with being pure S wave. The decay distributions have been fit to heavy quarkonium models, including the Novikov-Shifman model. This model, which is written in terms of the parameter (Formula presented) predicts that D wave pions should be present. We determine (Formula presented) based on the joint (Formula presented) distribution. The fraction of D wave amplitude as a function of (Formula presented) is found to decrease with increasing (Formula presented) in agreement with the model. We have also fit the Mannel-Yan model, which is another model that allows D wave pions. © 2000 The American Physical Society.

The cross section for charmed meson production at √s=4.03 and 4.14 GeV has been measured with the Beijing Spectrometer. The measurement was made using 22.3 pb-1 of e+e- data collected at 4.03 GeV and 1.5 pb-1 of e+e- data collected at 4.14 GeV. Inclusive observed cross sections for the production of charged and neutral D mesons and momentum spectra are presented. Observed cross sections were radiatively corrected to obtain tree level cross sections. Measurements of the total hadronic cross section are obtained from the charmed meson cross section and an extrapolation of results from below the charm threshold. ©2000 The American Physical Society.

Using a sample of 3.8 M (Formula presented) events accumulated with the BES detector, the process (Formula presented) is studied. The angular distributions are compared with the general decay amplitude analysis of Cahn. We find that the dipion system requires some D wave amplitude, as well as S wave. On the other hand, the (Formula presented) relative angular momentum is consistent with being pure S wave. The decay distributions have been fit to heavy quarkonium models, including the Novikov-Shifman model. This model, which is written in terms of the parameter (Formula presented) predicts that D wave pions should be present. We determine (Formula presented) based on the joint (Formula presented) distribution. The fraction of D wave amplitude as a function of (Formula presented) is found to decrease with increasing (Formula presented) in agreement with the model. We have also fit the Mannel-Yan model, which is another model that allows D wave pions. © 2000 The American Physical Society.

The first measurement of (Formula presented) and an upper limit for (Formula presented) are determined from 22.3 (Formula presented) of (Formula presented) annihilation data at a c.m. energy of 4.03 GeV. The data were recorded by the Beijing Spectrometer (BES) at BEPC. A recoil charge method is applied to charm threshold data to determine the charge of the D meson in the recoil from (Formula presented) reconstructed (Formula presented) (Formula presented) mesons. The branching fractions (Formula presented) and (Formula presented) are determined from 10 events with a reconstructed D and a recoiling (Formula presented) In addition, a 90% C.L. upper limit of (Formula presented) is determined from a search for semileptonic decays of the (Formula presented) © 2000 The American Physical Society.

Hadronic decays of the P-wave spin-triplet charmonium states (Formula presented) are studied using a sample of (Formula presented) decays collected by the BES detector operating at the BEPC storage ring. Branching fractions for the decays (Formula presented) (Formula presented) (Formula presented) (Formula presented) (Formula presented) and (Formula presented) are measured for the first time, and those for (Formula presented) (Formula presented) (Formula presented) and (Formula presented) are measured with improved precision. In addition, we determine the masses of the (Formula presented) and (Formula presented) to be (Formula presented) and (Formula presented) © 1999 The American Physical Society.

A sample of 3.79 × 106ψ(2S) events is used to study the decays of charmonium to axial-vector plus pseudoscalar mesons. The branching fraction for the decay ψ(2S) → b±1(1235)π∓ agrees with expectations based on scaling the corresponding J/ψ branching fraction. Flavor-SU(3)-violating K1(1270)- K1(1400) asymmetries with opposite character for ψ(2S) and J/ψ decays are observed. This contrasting behavior cannot be accommodated by adjustments of the singlet-triplet mixing angle. © 1999 The American Physical Society.

Hadronic decays of the P-wave spin-triplet charmonium states (Formula presented) are studied using a sample of (Formula presented) decays collected by the BES detector operating at the BEPC storage ring. Branching fractions for the decays (Formula presented) (Formula presented) (Formula presented) (Formula presented) (Formula presented) and (Formula presented) are measured for the first time, and those for (Formula presented) (Formula presented) (Formula presented) and (Formula presented) are measured with improved precision. In addition, we determine the masses of the (Formula presented) and (Formula presented) to be (Formula presented) and (Formula presented) © 1999 The American Physical Society.

The decays of the ψ(2S) into vector plus tensor meson final states have been studied for the first time using the BES detector. We determine upper limits on branching fractions for ψ(2S) decays into ωf2, ρa2, K*0K*02 + c.c., and φf'2(1525) that are, in each case, significantly smaller than the corresponding branching fractions for the J/ψ meson, scaled according to the expectations of perturbative QCD. © 1998 The American Physical Society.

The processes ψ(2S) → I π+ π−, γK+ K−, and γpp¯ have been studied using a sample of 3.79 × 106 ψ(2S) decays. We determine the total width of the χc0 to be γtotχc0 = 14.3 ± 2.0 ± 3.0 MeV. We present the first measurement of the branching fraction B(χc0 → pp¯) = (15.9 ± 4.3 ± 5.3) × 10−5, where the first error is statistical and the second one is systematic. Branching fractions of χc0, 2 → π+ π− and K+ K− are also reported. © 1998 American Physical Society.

Purely leptonic decays of the charged D meson have been studied using the reaction e+e- → D*+D- at a center of mass energy of 4.03 GeV. A search was performed for D → μνμ recoiling against a D0 or D+ which had been reconstructed from its hadronic decay products. A single event candidate was found in the reaction e+e- → D*+D-, where D*+ → π+D0 with the D0 → K-π+, and the recoiling D- decaying via D- → μ-ν̄μ. This yields a branching fraction value B(D → μνμ) = 0.08+0.16+0.05-0.05-0.02%, and a corresponding value of the pseudoscalar decay constant fD = 300+180+80-150-40 MeV. © 1998 Elsevier Science B.V. All rights reserved.

Purely leptonic decays of the charged D meson have been studied using the reaction e+e- → D*+D- at a center of mass energy of 4.03 GeV. A search was performed for D → μνμ recoiling against a D0 or D+ which had been reconstructed from its hadronic decay products. A single event candidate was found in the reaction e+e- → D*+D-, where D*+ → π+D0 with the D0 → K-π+, and the recoiling D- decaying via D- → μ-ν̄μ. This yields a branching fraction value B(D → μνμ) = 0.08+0.16+0.05-0.05-0.02%, and a corresponding value of the pseudoscalar decay constant fD = 300+180+80-150-40 MeV. © 1998 Elsevier Science B.V. All rights reserved.

A search is performed for the production of the (Formula presented) in (Formula presented) annihilation at a center-of-mass energy of 4.03 GeV using the BES detector operated at the Beijing Electron Positron Collider (BEPC). The kinematic features of the reconstructed (Formula presented) signal are consistent with its being produced only in association with an energetic photon resulting from initial state radiation (ISR). Limits are placed on (Formula presented) production from the decay of unknown charmonia or metastable hybrids that might be produced in (Formula presented) annihilations at 4.03 GeV. Under the assumption that the observed cross section for (Formula presented) production is due entirely to ISR, the partial width (Formula presented) of the (Formula presented) is measured to be (Formula presented). © 1998 The American Physical Society.

The absolute inclusive branching fraction of (Formula presented) has been measured from data collected by the BES detector at a center-of-mass energy of 4.03 GeV, corresponding to an integrated luminosity of 22.3 pb(Formula presented). At this energy, direct pair production (Formula presented) has been observed. We have selected (Formula presented) candidate events by reconstructing five hadronic decay modes (Formula presented), (Formula presented), (Formula presented), (Formula presented) and (Formula presented) and have searched for inclusive (Formula presented)’s in the recoiling (Formula presented). We observed three recoiling (Formula presented)’s in the 166.4 (Formula presented) 31.8 (Formula presented) candidate events, which leads to the absolute branching fraction (Formula presented) and (Formula presented). © 1998 The American Physical Society.

The absolute inclusive branching fraction of (Formula presented) has been measured from data collected by the BES detector at a center-of-mass energy of 4.03 GeV, corresponding to an integrated luminosity of 22.3 pb(Formula presented). At this energy, direct pair production (Formula presented) has been observed. We have selected (Formula presented) candidate events by reconstructing five hadronic decay modes (Formula presented), (Formula presented), (Formula presented), (Formula presented) and (Formula presented) and have searched for inclusive (Formula presented)’s in the recoiling (Formula presented). We observed three recoiling (Formula presented)’s in the 166.4 (Formula presented) 31.8 (Formula presented) candidate events, which leads to the absolute branching fraction (Formula presented) and (Formula presented). © 1998 The American Physical Society.

A search is performed for the production of the (Formula presented) in (Formula presented) annihilation at a center-of-mass energy of 4.03 GeV using the BES detector operated at the Beijing Electron Positron Collider (BEPC). The kinematic features of the reconstructed (Formula presented) signal are consistent with its being produced only in association with an energetic photon resulting from initial state radiation (ISR). Limits are placed on (Formula presented) production from the decay of unknown charmonia or metastable hybrids that might be produced in (Formula presented) annihilations at 4.03 GeV. Under the assumption that the observed cross section for (Formula presented) production is due entirely to ISR, the partial width (Formula presented) of the (Formula presented) is measured to be (Formula presented). © 1998 The American Physical Society.

The absolute inclusive semileptonic branching fraction of the [Formula presented] meson has been measured based on [Formula presented] of [Formula presented] collision data collected with the Beijing Spectrometer at [Formula presented] At this energy, the [Formula presented] are produced in pairs: [Formula presented] We reconstructed [Formula presented] [Formula presented] events in five hadronic decay modes. In the recoil system of these events, several [Formula presented] inclusive semileptonic decays were observed and the branching fraction is estimated to be [Formula presented] © 1997 The American Physical Society.

The absolute inclusive semileptonic branching fraction of the [Formula presented] meson has been measured based on [Formula presented] of [Formula presented] collision data collected with the Beijing Spectrometer at [Formula presented] At this energy, the [Formula presented] are produced in pairs: [Formula presented] We reconstructed [Formula presented] [Formula presented] events in five hadronic decay modes. In the recoil system of these events, several [Formula presented] inclusive semileptonic decays were observed and the branching fraction is estimated to be [Formula presented] © 1997 The American Physical Society.

The cross section for e+e-→ρπ has been measured by the BES detector at BEPC at center-of-mass energies covering a 40 MeV interval spanning the J/ψresonance. The data are used to search for the vector gluonium state hypothesized by Brodsky, Lepage, and Tuan as an explanation of the ρπ puzzle in charmonium physics. The shape of the ρπ cross section is compatible with that of the total hadronic cross section. No distortions indicating the presence of a vector glueball are seen. © 1996 The American Physical Society.

A data-driven energy scan in the immediate vicinity of the τ pair production threshold has been performed using the Beijing Spectrometer at the Beijing Electron-Positron Collider. Approximately 5pb-1 of data, distributed over 12 scan points, have been collected. A previous mass value for the τ lepton, obtained using only the eµ final state, has been published. In this paper, the final BES result on the mass measurement is presented. The analysis is based on the combined data from the ee, eµ, eh, µµ, µh, and hh final states, where h denotes a charged Π or K. A maximum likelihood fit to the τ pair production cross section data yields the value mT=1776.96-0.21 -0.17+0.18+0.25. © 1995 The American Physical Society.

A data-driven energy scan in the immediate vicinity of the τ pair production threshold has been performed using the Beijing Spectrometer at the Beijing Electron-Positron Collider. Approximately 5pb-1 of data, distributed over 12 scan points, have been collected. A previous mass value for the τ lepton, obtained using only the eµ final state, has been published. In this paper, the final BES result on the mass measurement is presented. The analysis is based on the combined data from the ee, eµ, eh, µµ, µh, and hh final states, where h denotes a charged Π or K. A maximum likelihood fit to the τ pair production cross section data yields the value mT=1776.96-0.21 -0.17+0.18+0.25. © 1995 The American Physical Society.

The Beijing Spectrometer (BES) experiment has observed purely leptonic decays of the Ds meson in the reaction e+e-→Ds+Ds- at a c.m. energy of 4.03 GeV. Three events are observed in which one Ds decays hadronically to φπ, K̄*0K, or K̄0K, and the other decays leptonically to μνμ or τντ. With the assumption of μ-τ universality, values of the branching fraction, B(Ds→μνμ)=(1.5-0.6-0.2+1.3+0.3)%, and the Ds pseudoscalar decay constant, fDs=(4.3-1.3-0.4+1.5+0.4)×102 MeV, are obtained. © 1995 The American Physical Society.

Assessing the bioaccessibility and bioavailability of cadmium (Cd) is crucial for effective evaluation of the exposure risk associated with intake of Cd-contaminated rice. However, limited studies have investigated the influence of gut microbiota on these two significant factors. In this study, we utilized in vitro gastrointestinal simulators, specifically the RIVM-M (with human gut microbial communities) and the RIVM model (without gut microbial communities), to determine the bioaccessibility of Cd in rice. Additionally, we employed the Caco-2 cell model to assess bioavailability. Our findings provide compelling evidence that gut microbiota significantly reduces Cd bioaccessibility and bioavailability (p<0.05). Notably, strong in vivo-in vitro correlations (IVIVC) were observed between the in vitro bioaccessibilities and bioavailabilities, as compared to the results obtained from an in vivo mouse bioassay (R 2  = 0.63-0.65 and 0.45-0.70, respectively). Minerals such as copper (Cu) and iron (Fe) in the food matrix were found to be negatively correlated with Cd bioaccessibility in rice. Furthermore, the results obtained from the toxicokinetic (TK) model revealed that the predicted urinary Cd levels in the Chinese population, based on dietary Cd intake adjusted by in vitro bioaccessibility from the RIVM-M model, were consistent with the actual measured levels (p > 0.05). These results indicated that the RIVM-M model represents a potent approach for measuring Cd bioaccessibility and underscore the crucial role of gut microbiota in the digestion and absorption process of Cd. The implementation of these in vitro methods holds promise for reducing uncertainties in dietary exposure assessment., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

The objective was to assess if post-exercise ingestion of carbonated water in a hot environment ameliorates hypotension, enhances cerebral blood flow and heat loss responses, and positively modulates perceptions and mood states. Twelve healthy, habitually active young adults (five women) performed 60 min of cycling at 45% peak oxygen uptake in a hot climate (35°C). Subsequently, participants consumed 4°C carbonated or non-carbonated (control) water (150 and 100 mL for males and females regardless of drink type) at 20 and 40 min into post-exercise periods. Mean arterial pressure decreased post-exercise at 20 min only (P = 0.032) compared to the pre-exercise baseline. Both beverages transiently (∼1 min) increased mean arterial pressure and middle cerebral artery mean blood velocity (cerebral blood flow index) regardless of post-exercise periods (all P ≤ 0.015). Notably, carbonated water ingestion led to greater increases in mean arterial pressure (2.3 ± 2.8 mmHg vs. 6.6 ± 4.4 mmHg, P < 0.001) and middle cerebral artery mean blood velocity (1.6 ± 2.5 cm/s vs. 3.8 ± 4.1 cm/s, P = 0.046) at 20 min post-exercise period compared to non-carbonated water ingestion. Both beverages increased mouth exhilaration and reduced sleepiness regardless of post-exercise periods, but these responses were more pronounced with carbonated water ingestion at 40 min post-exercise (mouth exhilaration: 3.1 ± 1.4 vs. 4.7 ± 1.7, P = 0.001; sleepiness: -0.7 ± 0.91 vs. -1.9 ± 1.6, P = 0.014). Heat loss responses and other perceptions were similar between the two conditions throughout (all P ≥ 0.054). We show that carbonated water ingestion temporarily ameliorates hypotension and increases the cerebral blood flow index during the early post-exercise phase in a hot environment, whereas it enhances mouth exhilaration and reduces sleepiness during the late post-exercise phase., (© 2024 The Author(s). Experimental Physiology published by John Wiley & Sons Ltd on behalf of The Physiological Society.)

Hyperthermia stimulates ventilation in humans. This hyperthermia-induced hyperventilation may be mediated by the activation of peripheral chemoreceptors implicated in the regulation of respiration in reaction to various chemical stimuli, including reductions in arterial pH. Here, we investigated the hypothesis that during passive heating at rest, the increases in arterial pH achieved with sodium bicarbonate ingestion, which could attenuate peripheral chemoreceptor activity, mitigate hyperthermia-induced hyperventilation. We also assessed the effect of sodium bicarbonate ingestion on cerebral blood flow responses, which are associated with hyperthermia-induced hyperventilation. Twelve healthy men ingested sodium bicarbonate (0.3 g/kg body weight) or sodium chloride (0.208 g/kg). One hundred minutes after the ingestion, the participants were passively heated using hot-water immersion (42°C) combined with a water-perfused suit. Increases in esophageal temperature (an index of core temperature) and minute ventilation (V̇ E ) during the heating were similar in the two trials. Moreover, when V̇ E is expressed as a function of esophageal temperature, there were no between-trial differences in the core temperature threshold for hyperventilation (38.0 ± 0.3 vs. 38.0 ± 0.4°C, P = 0.469) and sensitivity of hyperthermia-induced hyperventilation as assessed by the slope of the core temperature-V̇ E relation (13.5 ± 14.2 vs. 15.8 ± 15.5 L/min/°C, P = 0.831). Furthermore, middle cerebral artery mean blood velocity (an index of cerebral blood flow) decreased similarly with heating duration in both trials. These results suggest that sodium bicarbonate ingestion does not mitigate hyperthermia-induced hyperventilation and the reductions in cerebral blood flow index in resting heated humans. NEW & NOTEWORTHY Hyperthermia leads to hyperventilation and associated cerebral hypoperfusion, both of which may impair heat tolerance. This hyperthermia-induced hyperventilation may be mediated by peripheral chemoreceptors, which can be activated by reductions in arterial pH. However, our results suggest that sodium bicarbonate ingestion, which can increase arterial pH, is not an effective intervention in alleviating hyperthermia-induced hyperventilation and cerebral hypoperfusion in resting heated humans.

Electron-induced dissociation of a fluorocarbon adsorbate CF 3 (ad) at 4.6 K is shown by Scanning Tunnelling Microscopy (STM) to form directed energetic F-atom 'projectiles' on Cu(110). The outcome of a collision between these directed projectiles and stationary co-adsorbed allyl 'target' molecules was found through STM to give rotational excitation of the target allyl, clockwise or anti-clockwise, depending on the chosen collision geometry. Molecular dynamics computation linked the collisional excitation of the allyl target to an 'abortive chemical reaction', in which the approach of the F-projectile stretched an H-C bond lifting the allyl above the surface, facilitating isomerization from 'Across' to 'Along' a Cu row.

Purpose: We evaluated (1) whether participating in middle- and long-distance running races augments muscle soreness, oxygen cost, respiration, and exercise exertion during subsequent running, and (2) if post-race menthol application alleviates these responses in long-distance runners., Methods: Eleven long-distance runners completed a 1500-m race on day 1 and a 3000-m race on day 2. On day 3 (post-race day), either a 4% menthol solution (Post-race menthol) or a placebo solution (Post-race placebo) serving as a vehicle control, was applied to their lower leg skin, and their perceptual and physiological responses were evaluated. The identical assessment with the placebo solution was also conducted without race participation (No-race placebo)., Results: The integrated muscle soreness index increased in the Post-race placebo compared to the No-race placebo (P < 0.001), but this response was absent in the Post-race menthol (P = 0.058). Oxygen uptake during treadmill running tended to be higher (4.3%) in the Post-race placebo vs. No-race placebo (P = 0.074). Oxygen uptake was 5.4% lower in the Post-race menthol compared to the Post-race placebo (P = 0.018). Minute ventilation during treadmill running was 6.7-7.6% higher in the Post-race placebo compared to No-race placebo, whereas it was 6.6-9.0% lower in the Post-race menthol vs. Post-race placebo (all P ≤ 0.001). The rate of perceived exertion was 7.0% lower in the Post-race menthol vs. Post-race placebo (P = 0.007)., Conclusions: Middle- and long-distance races can subsequently elevate muscle soreness and induce respiratory and metabolic stress, but post-race menthol application to the lower legs can mitigate these responses and reduce exercise exertion in long-distance runners., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

In Singapore, an ageing population with increasing chronic disease burden and complex social circumstances have strained the healthcare system. For the health system to run more efficiently, patients should be appropriately sited according to their medical needs. In Singapore, community hospitals serve as an intermediate inpatient facility managing patients with sub-acute and rehabilitation care needs. Our policy brief uncovers the gaps in transforming community hospital care models and offers actionable steps to unlock the community hospital chokepoints in Singapore's health system. The future community hospitals can accommodate higher acuity but medically stable patients, while patients who do not require inpatient rehabilitation care can be appropriately sited to community partners, if policy, resourcing and technology factors are addressed. An evidence-based, stepwise approach involving all stakeholders will be required to pilot and evaluate new models before large-scale change., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Foo, Chia, Tan, Lai, Khoo, Tee, Lim and Teo.)

Background: Acne vulgaris is a prevalent skin condition. We have found that some acromegaly patients have acne. However, no study has examined the relationship between acromegaly and acne., Objective: To explore prevalence and correlation of adult acne in patients with acromegaly., Methods: For this cross-sectional study, we collected questionnaires, clinical information, and laboratory test results of acromegaly patients from January 2022 to December 2022 at Huashan Hospital. Of the 133 questionnaires returned, 123 had valid responses., Results: Of the 123 patients with acromegaly enrolled in this study, 54.5% had adult acne. No statistically significant difference was found in prevalence between male and female patients. 61.2% of adult acne patients reported late-onset acne. Late-onset acne patients first developed acne years before acromegaly diagnosis (mean of 5.6 years for male and 4.5 years for female patients). Some acne patients have received traditional anti-acne treatment. Moreover, 31% of the patients reported no improvement, and only 3.5% of patients claimed complete resolution of acne after treatment. Before acromegaly treatment, the prevalence of adult acne was 51.2%, with mild acne accounting for 73.0%, moderate acne accounting for 23.8%, and severe acne accounting for 3.2%. After acromegaly treatment, the prevalence of adult acne was significantly decreased to 37.4% (P = 0.007). An overall decrease in acne severity was noted, with 93.5%, 6.5%, and 0% having mild, moderate, and severe acne, respectively. A total of 83.6% of the patients had self-assessed acne remission, and 33.3% of the patients reported complete acne resolution. However, 9.0% of patients reported that their condition had worsened after acromegaly treatment. After treatment, GH, IGF-1, IGF-1 index, insulin levels, and HOMA-IR decreased significantly in all patients with acromegaly (P < 0.05). Acne remission correlated positively with IGF-1 levels, but not with GH levels. The relationship between acromegaly and acne remains to be elucidated., Conclusions: Our findings provide preliminary evidence of the high prevalence of adult acne in acromegaly patients, and a high rate of late-onset acne as well. Traditional anti-acne treatments are less effective. Acne could be considerably relieved by treating acromegaly. Acne remission positively correlated with IGF-1 decline as well, which revealed the correlation between acne and IGF-1., (© 2023. The Author(s), under exclusive licence to Italian Society of Endocrinology (SIE).)

Background: DEHP, a common plasticizer known for its hormone-disrupting properties, has been associated with asthma. However, a significant proportion of adult asthma cases are "non-atopic", lacking a clear etiology., Methods: In a case-control study conducted between 2011 and 2015, 365 individuals with current asthma and 235 healthy controls from Kaohsiung City were enrolled. The control group comprised individuals without asthma, Type 2 Diabetes Mellitus (T2DM), hypertension, or other respiratory/allergic conditions. The study leveraged asthma clusters (Clusters A to F) established in a prior investigation. Analysis involved the examination of urinary DEHP metabolites (MEHP and MEHHP), along with the assessment of oxidative stress, sphingolipid metabolites, and inflammatory biomarkers. Statistical analyses encompassed Spearman's rank correlation coefficients, multiple logistic regression, and multinomial logistic regression., Results: Asthma clusters (E, D, C, F, A) exhibited significantly higher ORs of MEHHP exposures compared to the control group. When considering asthma-related comorbidities (T2DM, hypertension, or both), patients without comorbidities demonstrated significantly higher ORs of the sum of primary and secondary metabolites (MEHP + MEHHP) and MEHHP compared to those with asthma comorbidities. A consistent positive correlation between urinary HEL and DEHP metabolites was observed, but a consistent negative correlation between DEHP metabolites and selected cytokines was identified., Conclusion: The current study reveals a heightened risk of MEHHP and MEHP + MEHHP exposure in specific asthma subgroups, emphasizing its complex relationship with asthma. The observed negative correlation with cytokines suggests a new avenue for research, warranting robust evidence from epidemiological and animal studies., (© 2024. The Author(s).)

Objectives: Given the shift towards value-based healthcare and the increasing recognition of generalist care, enacting value-based healthcare for generalist care is critical. This work aims to shed light on how to conduct performance management of generalist care to facilitate value-based care, with a focus on medical care of hospitalised patients., Design and Setting: A scoping review of published literature was conducted. 30 publications which were relevant to performance management of generalist medical inpatient care were included in the review., Outcome Measures: The performance measures used across the studies were analysed and other qualitative findings were also obtained., Results: We report an overall lack of research on performance management methods for generalist inpatient care. Relevant performance measures found include both outcome and process of care measures and both clinical and reported measures, with clinical outcome measures the most frequently reported. Length of stay, readmission rates and mortality were the most frequently reported. The insights from the papers emphasise the relevance of process of care measures for performance management, the advantages and disadvantages of types of measures and provide suggestions relevant for performance management of generalist inpatient care., Conclusion: The findings of this scoping review outline a variety of performance measures valuable for generalist inpatient care including clinical outcome measures, reported outcome measures and process of care measures. The findings also suggest directions for implementation of such performance management, including emphasis on physician level performance management and the importance of documentation training. Further research for selecting and operationalising the measures for specific contexts and developing a comprehensive performance management system involving these measures will be important for achieving value-based healthcare for generalist inpatient care., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Khoo, Lim and Lai.)

Introduction: Multiple Cochrane Reviews have demonstrated 'hospital at home' (HaH) as a promising healthcare model to be explored, with benefits such as higher care quality, reduced readmissions, shorter lengths of stay, lower cost and greater patient satisfaction. While there have been many reviews focusing on the quantitative clinical outcomes of HaH, there is generally a lack of collation of qualitative insights from stakeholders and lessons learnt from past HaH implementation., Methods: We performed a systematic literature search on four databases and included 17 papers involving the provision of acute and/or subacute care by healthcare professionals in patients' homes. Review characteristics and relevant outcomes were extracted from the reported findings and tables in the reviews, and these included stakeholder attitudes and factors contributing to the success of HaH implementation., Results: Factors relating to patients and caregivers included home setup, preference for care and death settings, and support for caregiver. Factors involving the healthcare professionals and intervention included a multidisciplinary care team, accessibility to emergency care and support, training of providers and patients, adequate manpower allocation, robust eligibility and referral criteria, sufficient awareness of the HaH referral pathway, communication and medication management., Conclusion: HaH presents a promising alternative care model, and many of the success factors identified, including the strong push for multidisciplinary single care teams, existing frameworks for data sharing and strong community network, are already present today. As such, Singapore appears to be well positioned to adopt a new care model like HaH., (Copyright © 2024 Copyright: © 2024 Singapore Medical Journal.)

In this paper, we construct the first provably-secure isogeny-based (partially) blind signature scheme. While at a high level the scheme resembles the Schnorr blind signature, our work does not directly follow from that construction, since isogenies do not offer as rich an algebraic structure. Specifically, our protocol does not fit into the linear identification protocol abstraction introduced by Hauck, Kiltz, and Loss (EUROCYRPT'19), which was used to generically construct Schnorr-like blind signatures based on modules such as classical groups and lattices. Consequently, our scheme is provably secure in the random oracle model (ROM) against poly-logarithmically-many concurrent sessions assuming the subexponential hardness of the group action inverse problem. In more detail, our blind signature exploits the quadratic twist of an elliptic curve in an essential way to endow isogenies with a strictly richer structure than abstract group actions (but still more restrictive than modules). The basic scheme has public key size 128 B and signature size 8 KB under the CSIDH-512 parameter sets-these are the smallest among all provably secure post-quantum secure blind signatures. Relying on a new ring variant of the group action inverse problem ( rGAIP ), we can halve the signature size to 4 KB while increasing the public key size to 512 B. We provide preliminary cryptanalysis of rGAIP and show that for certain parameter settings, it is essentially as secure as the standard GAIP . Finally, we show a novel way to turn our blind signature into a partially blind signature, where we deviate from prior methods since they require hashing into the set of public keys while hiding the corresponding secret key-constructing such a hash function in the isogeny setting remains an open problem., Competing Interests: Conflict of interestThe authors declare that they have no financial or non-financial interests., (© The Author(s) 2024.)

This study proposes a paper/PMMA hybrid device designed to isolate exosomes and extract exosomal miRNA, followed by quantitative analysis. It aims to provide simplified and convenient sample preparation for potential point-of-care testing (POCT) processes. In contrast to previous work conducted by our research team, which focused on isolating exosomes and exosomal nucleic acids, this study introduces a novel approach by integrating paper and a PMMA mold with a microvalve controlled design. This innovative method enables the entire process to be performed on paper. The pressure on the paper could be adjusted by turning the screw upon the valve to change the pore size and permeability of the paper, which achieved the effect of controlling the flow rate of fluids. The paper was designed to have an immunoaffinity area for capturing exosomes and a sol-gel silica coating area for extracting miRNA. The paper-based ELISA (p-ELISA) exhibited a limit of detection and a limit of quantitation of 6 × 10 7 and 5.4 × 10 8 particles/mL, respectively, for exosome measurement. The reverse transcription quantitative polymerase chain reaction (RT-qPCR) revealed that the Ct (threshold cycle) value for quantifying the miR-21 in the miRNAs extracted by the proposed paper/PMMA hybrid device was comparable to the Ct value of the commercial extraction kit. The developed paper/PMMA hybrid device with a microvalve-controlled design should be incorporated into the POCT system to extract exosomal miRNAs., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

In this study, a morphological diagram was constructed for quantitatively predicting various modes of surface instabilities caused by the dynamic interfacial release of strain in initially flat bilayer composites comprising an elastomer and a capping layer. Theory, experiment, and simulation were combined to produce the diagram, which enables systematic generation of the following instability patterns: wrinkle, fold, period-double, delamination, and coexisting patterns. The pattern that forms is most strongly affected by three experimental parameters: the elastic modulus of the elastomer, the elastic modulus of the capping layer, and the thickness of the capping layer. The morphological diagram offers understanding of the formation of complex patterns and development of their applications. Critically, the wrinkle alignment can be well controlled by changing the direction of the interfacial release to enable the creation of centimeter-sized and highly ordered lamellar wrinkled patterns with a single orientation on a soft elastomer without the need for costly high-vacuum instruments or complex fabrication processes. The method and diagram have great potential for broad use in many practical applications ranging from flexible electronic devices to smart windows.

Background: Medical training through specialization and even subspecialization has contributed significantly to clinical excellence in treating single acute conditions. However, the needs of complex patients go beyond single diseases, and there is a need to identify a group of generalists who are able to deliver cost-effective, holistic care to patients with multiple comorbidities and multi-faceted needs. Community hospitals (CHs) are a critical part of Singapore's shift toward a community-centric care model as the population ages. Community Hospitals of the Future ("CHoF") represent a series of emerging conversations around approaches to reimagine and redesign care delivery in a CH setting in response to changing care needs., Methods: An environmental scan in the CH landscape using semi-structured interviews was conducted with 26 senior management, management, and working-level staff from seven community hospitals in Singapore. This environmental scan aims to understand the current barriers and future opportunities for CHs; to guide how CHs would have to shift in terms of (i) care delivery and resourcing, (ii) information flow, and (iii) financing; and to conceptualize CHoF to meet the changing care needs in Singapore., Findings: The analysis of all transcripts revealed four broad sections of themes: (i) current care delivery in CHs, (ii) current challenges of CHs, (iii) future opportunities, and (iv) challenges in reimagining CHs. An emerging theme regarding the current key performance indicators used also surfaced. Resource limitations and financing structure of CH surfaced as limitations to expanding its capability. However, room for expansion of CH roles tapping on the current expertise were acknowledged and shared., Conclusion: With the current issues of (i) rapidly aging population, (ii) specialist-centric healthcare system, and (iii) fragmentation of care ecosystem, there is a need to further understand how CHoF can be modeled to better tackle them. Therefore, several important questions have been devised to land us in a microscopic view on how to develop CHoF in the right constructs. Demographic changes, patient segmentation, service and regulatory parameters, patient's perspective, care delivery, and financial levers (or lack of) are some of the categories that the interview questions looked into. Therefore, the data gathered would be used to guide and refine the concept of CHoF., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Phang, Lin, Kho, Toh, Kuah, Lai and Xie.)

Hyperthermia stimulates ventilation (hyperthermia-induced hyperventilation). In exercising humans, once the core temperature reaches ∼37°C, minute ventilation (V̇e) increases linearly with rising core temperature, and the slope of the relation between V̇e and core temperature reflects the sensitivity of the response. We previously reported that sodium bicarbonate ingestion reduces V̇e during prolonged exercise in the heat without affecting the sensitivity of hyperthermia-induced hyperventilation. Here, we hypothesized that reductions in V̇e associated with sodium bicarbonate ingestion reflect elevation of the core temperature threshold for hyperthermia-induced hyperventilation. Thirteen healthy young males ingested sodium bicarbonate (0.3 g/kg body wt) (NaHCO 3 trial) or sodium chloride (0.208 g/kg body wt) (NaCl trial), after which they performed a cycle exercise at 50% of peak oxygen uptake in the heat (35°C and 50% relative humidity) following a pre-cooling. The pre-cooling enabled detection of an esophageal temperature (T es : an index of core temperature) threshold for hyperthermia-induced hyperventilation. The T es thresholds for increases in V̇e were similar between the two trials ( P = 0.514). The slopes relating V̇ E to T es also did not differ between trials ( P = 0.131). However, V̇e was lower in the NaHCO 3 than in the NaCl trial in the range of T es = 36.8-38.4°C ( P = 0.007, main effect of trial). These results suggest that sodium bicarbonate ingestion does not alter the core temperature threshold or sensitivity of hyperthermia-induced hyperventilation during prolonged exercise in the heat; instead, it downshifts the exercise hyperpnea.

Nitrite (NO 2 - ) is one of the common salts in aqueous aerosols, and its photolytic products, nitric oxide (NO) and hydroxyl radical (OH), have potential for use in the oxidation of organic matter, such as dissolved formaldehyde, methanediol (CH 2 (OH) 2 ), which is regarded as the precursor of atmospheric formic acid. In this work, the simulation of UVA irradiation in an aqueous mixture of NaNO 2 /CH 2 (OH) 2 was carried out via continuous exposure with a 365 nm LED lamp, and the reaction evolutions were probed by in situ and real-time infrared and Raman spectroscopy, which provided multiplexity in the identification of the relevant species and the corresponding reaction evolution. Although performing infrared absorption measurements in aqueous solution seemed impracticable due to the strong interference of water, the multiplexity of the vibrational bands of parents and products in the non-interfered infrared regimes and the conjunction with Raman spectroscopy still make it possible to perform in situ and real-time characterization of the photolytic reaction in the aqueous phase, supplementary to chromatographic approaches. During the 365 nm irradiation, NO 2 - and CH 2 (OH) 2 gradually decreased, concomitant with the formation of nitrous oxide (N 2 O) and formate (HCOO - ) in the early period and carbonate (CO 3 2- ) in the late period, as revealed by the vibrational spectra. The losses or the gains of the aforementioned species increased with increases in the concentration of CH 2 (OH) 2 and the irradiation flux of the 365 nm UV light. The ionic product HCOO - was also confirmed by ion chromatography, but oxalate (C 2 O 4 2- ) was absent in the vibrational spectra and ion chromatogram. The reaction mechanism is reasonably proposed on the basis of the evolutions of the aforementioned species and the predicted thermodynamic favorableness.