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Custom foot orthoses for chronic metatarsalgia: Study protocol for a participant- and assessor-blinded superiority randomized controlled trial
Background Chronic metatarsalgia (CM) causes significant pain and disability, affecting quality of life. Foot orthoses (FOs) including medially wedged designs with a metatarsal pad decrease excessive plantar pressure under the metatarsal heads, which is a suggested risk factor for developing CM. This FOs model may be effective in diminishing pain and improving function in these individuals. Thus, the objective of this trial will be to compare the effects of medially wedged FOs with a metatarsal pad and sham FOs on pain and foot function in individuals with CM. Methods/design This participant- and assessor-blinded superiority randomized controlled trial (RCT) with two parallel groups will be conducted in Trois-Rivières, Canada. Sixty-four participants with CM will be recruited from the Université du Québec à Trois-Rivières outpatient podiatry clinic and via social media invitations. They will be randomized into intervention (customized FOs) or control (sham FOs) groups and will be evaluated at baseline and after 6 and 12 weeks. The primary outcome will be: (1) mean pain during walking for the most painful foot during the past week. The secondary outcomes will be: (1) Foot Function Index, (2) Global rating of change and (3) the 5-level EQ-5D. Discussion Medially wedged FOs with a metatarsal pad are expected to provide a greater reduction in pain and improvement in foot function compared to sham FOs. This trial will help guide FOs prescription recommendations for managing foot pain in individuals with CM in the future. Trial registration ClinicalTrials.gov NCT06962475
Ensuring reliable cave temperature data for climate change research
Increasing the working hours of nurses and teachers: Evidence from a discrete choice experiment
The healthcare and education sectors suffer from shortages of nurses and teachers. Extending their working hours has often been proposed as a solution to reduce shortages. In this study, we conduct a discrete choice experiment (DCE) in the Netherlands to elicit nurses’ and teachers’ preferences for different jobs and working conditions. We present both nurses and teachers with nine hypothetical choice sets, each consisting of two jobs that differ in seven observable job attributes. From the DCE, we infer workers’ willingness to pay for these different job characteristics. Moreover, we calculate how many additional hours they would be willing to work if a specific workplace condition were met. We find that both nurses and teachers most negatively value high work pressure. Spending a lot of time on patient-related tasks is highly valued by nurses, followed by having more control over working hours. Next to work pressure, teachers place significant importance on receiving social support from both colleagues and managers. Part-time teachers and nurses require a 23 and 21 percent increase in net hourly wages to accept a full-time working contract, respectively.
Visible-light photocatalytic mineralization of 4-Chlorophenol over ZnO-loaded sulfonated carbonaceous bentonite: kinetic analysis, pathway elucidation, and catalyst reusability
Electrochemical Shortcut Denitrification Coupled with Chemical Diazotization for Low‐Carbon Nitrate Wastewater Treatment
Abstract Efficient treatment of nitrate (NO 3 − ) wastewater with low carbon emission is a tough challenge because traditional multiple‐effect evaporation and biological denitrification are carbon‐intensive, especially in the case of NO 3 − concentration higher than 1000 mg‐N L −1 . In this study, we demonstrate a low‐carbon and high‐energy‐efficiency denitrification strategy by coupling electrochemical shortcut denitrification (NO 3 − ‐to‐NO 2 − conversion) with chemical diazotization (ESD‐CD), where NO 3 − is first electrochemically reduced to NO 2 − by an oxide‐derived Cu foam electrode, which then reacts with sulfamate (NH 2 SO 3 − ) via chemical diazotization to rapidly generate N 2 . For 5000 mg‐N L −1 simulated NO 3 − wastewater, the ESD‐CD achieved 98.8% NO 3 − removal efficiency, 99.9% N 2 selectivity, and 95.3% Faradaic efficiency. Impressively, its energy consumption was as low as 9.97 kWh kg‐N −1 , and its denitrification rate reached an unprecedented record of 24.87 g‐N m −2 h −1 . Driven by photovoltaic cells, the ESD‐CD process maintained stable performance in treating industrial NO 3 − wastewater (3085.2 mg‐N L −1 ) with over 96.6% NO 3 − removal efficiency and 99.2% N 2 selectivity, and also reduced operational costs by 64.4% and 74.9%, and CO 2 emissions by 79.5% and 93.3% in comparison with biological denitrification and multiple‐effect evaporation, underscoring the promising potential of coupling selective electrochemical NO 3 − reduction with chemical diazotization for sustainable treatment of high‐concentration NO 3 − wastewater.
A note on a generalized double series
By employing contour integration the derivation of a generalized double finite series involving the Hurwitz-Lerch zeta function is used to derive closed form formulae in terms of special functions. We use this procedure to find special cases of the summation and product formulae in terms of the Hurwitz-Lerch zeta function, trigonometric functions and the gamma function. A short table of quotient gamma functions and plots are produced for easy reading by interested readers.
Near future projections of tropical cyclone tracks over the Bay of Bengal using high resolution CMIP6 models
Mono‐Materials Created by Engineering a Continuum of P3HB Stereomicrostructures in a One‐Step Catalytic Process
Abstract Multi‐material products that combine multiple complementary polymers can create products with desired performance but present challenges to end‐of‐life (EoL) management. The emerging mono‐material product design based on a single polymer type addresses the fundamental EoL issue, but challenges of delivering vastly tunable material properties by the single polymer still remain. Here, we introduce a simple strategy to produce biodegradable poly(3‐hydroxybutyrate) (P3HB) materials with a wide range of material properties by engineering a stereomicrostructure continuum, achieved through polymerizing diastereomeric mixtures of racemic and meso ‐dimethyl diolides at various feed ratios with a single catalyst. This one‐step, one‐pot process produces biodegradable P3HB mono‐materials ranging from rigid to flexible thermoplastics, to tough thermoplastic elastomers, to a pressure‐sensitive adhesive (PSA), which have been then combined to fabricate prototype all‐P3HB PSA tapes, demonstrating the feasibility of designing mono‐material products through engineering polymer stereomicrostructures.
Lack of social support associated with major depressive disorder in middle-aged and older adults from the United States: A propensity score-matched cohort study
Background and objective Current widely used depression assessment criteria may not accurately reflect the true prevalence of depression, and previous studies have insufficiently addressed the multidimensional nature of social support . Research on the relationship between depression and specific dimensions of social support remains limited, which impedes the targeted allocation of scarce social resources to mitigate the disease burden. This study aimed to explore the association between multi-dimensional social support and major depressive disorder (MDD) in the US population, using depression assessment criteria consistent with current epidemiological data. Method We analyzed data from the National Health and Nutrition Examination Survey (NHANES). After propensity score matching (PSM), 123 participants with MDD (Patient Health Questionnaire-9 score ≥15) and 543 without MDD were included. Social support was assessed using five-dimensional questionnaires and each dimension was dichotomously scored (1 = presence of support, 0 = absence of support), yielding a total score ranging from 0 to 5. Participants were categorized into three social support groups: Low group (0–1), Middle group (2–3), and High group (4–5). Logistic regression models were used to examine the association between social support and MDD, and subgroup analyses were performed to assess consistency across populations. Results Compared with participants without MDD, those with MDD had significantly lower proportions of adequate social support across all five dimensions. Binary logistic regression analyses showed that higher social support levels were associated with a reduced risk of MDD (Middle vs Low group: odds ratio [OR], 0.40; 95% CI, 0.22–0.73; P = 0.003; High vs Low group: OR, 0.15; 95% CI, 0.08–0.29; P < 0.001). Financial support exhibited the strongest inverse association with MDD, while adequate religious activity showed the weakest inverse association. The relationship between social support and MDD remained consistent across all subgroup analyses. Conclusions In brief, sufficient social support, especially financial support, was linked to a significantly lower risk of MDD among the middle-aged and elderly population in the United States.
Genetic diversity of Pseudomonas aeruginosa isolated from clinical samples with ISSR molecular marker in a tertiary care teaching hospital
A practical optimization method for enhancing drilling efficiency in panel furniture manufacture
Drilling is one of the most complex processes in the manufacturing of panel-type furniture and has a significant impact on both production efficiency and takt-time stability. With the growing demand for large-scale customized furniture, the complexity of drilling operations has increased substantially. Moreover, variations in equipment capabilities further hinder the automation and standardization of this process. In this technical note, we ad-dress three common challenges in the drilling process of panel furniture: the inability to process horizontal holes located on fixed reference edges, low slotting efficiency, and pro-longed idle time of drilling equipment. To resolve these issues, we propose a set of strategies based on flipping, slot extension, and hole-slot logic transformation. The proposed methods have been successfully implemented in a large-scale customized panel furniture production line. Practical results demonstrate their effectiveness in improving drilling efficiency. Specifically, for panel components previously limited by low slotting efficiency, the optimization was applicable to 42.30% of the parts. Additionally, for panels that previously suffered from long idle periods during processing, the drilling efficiency increased by 56.01%. These findings confirm the practical value and applicability of the proposed approach in industrial settings, particularly in enhancing operational consistency and promoting automation in mass-customized furniture manufacturing.
Periapical healing after single-visit non-surgical endodontic retreatment in patients with hypertension: a retrospective study
Machine learning and network pharmacology identify keloid biomarkers (AMPH, TNFRSF9) and therapeutic targets (IL6, HAS2) for aloe-derived quercetin
Objective This study aimed to identify diagnostic biomarkers for keloid and explore potential therapeutic agents from traditional Chinese medicine (TCM) by integrating network pharmacology approaches. Specifically, we sought to uncover key molecular targets for Aloe vera and validate their roles in keloid pathogenesis. Methods We integrated keloid transcriptome datasets (GSE218007 and GSE237752) by merging GEO data, and identifying differentially expressed genes (DEGs). Functional enrichment analysis (GO, GSEA) and machine learning approaches were applied to select diagnostic biomarkers. Candidate genes were validated via Receiver Operating Characteristic (ROC) curves in training and independent cohorts (GSE44270). PPI networks and Cytohubba algorithms identified hub genes, while TCMSP-screened compounds from Aloe vera were docked with targets using molecular docking. Results 91 Identified DEGs enriched in fibrosis-related pathways. Machine learning prioritized two diagnostic biomarkers: AMPH and TNFRSF9 (AUC > 0.85 in training/testing). PPI analysis revealed IL6 as a hub gene. Aloe vera-derived quercetin targeted HAS2 and IL6 (both P < 0.05 in validation), with molecular docking confirming stable binding (binding energy <−7 kcal/mol). IL6 emerged as both a key network hub and a therapeutic target, linking keloid and TCM mechanisms. Conclusion AMPH and TNFRSF9 are promising diagnostic biomarkers for keloid, while quercetin from Aloe vera targets HAS2 and IL6, offering therapeutic potential. The dual role of IL6 underscores its centrality in keloid pathogenesis, connecting bioinformatics predictions with TCM pharmacology. This study provides a foundation for clinical prediction and targeted treatment strategies.
QPSODRL: an improved quantum particle swarm optimization and deep reinforcement learning based intelligent clustering and routing protocol for wireless sensor networks
In Cellulo Peptide Cyclization via Gene‐Encoded Proximity‐Induced Proline‐Isothiocyanate Crosslinking
Abstract Cyclic peptides represent a very useful modality in modern drug discovery. However, there remain substantial technical challenges in the de novo biosynthesis of complex cyclic peptides particularly in an intracellular manner. Herein, we demonstrate that an isothiocyanate (ITC) group encoded via genetic code expansion could selectively and efficiently crosslink to proximal N‐terminal Pro (P‐ITC crosslinking) and affords cyclic peptides without obvious limitations related to amino acid composition (including Lys and Cys) or sequence length. Notably via P‐ITC crosslinking, a disulfide‐bridged 13‐mer bicyclic peptide is facilely constructed in E. coli , thus lending us the ability to intracellularly construct and select complex cyclic peptides.
Development and evaluation of a modular smoke evacuator for surgical smoke control
Background Surgical smoke generated during energy-based operations is a known hazard containing particulate matter (PM), volatile organic compounds (VOCs), and biological debris, with insufficient adoption of commercial smoke evacuators due to cost and complexity. Objective This study aimed to develop a cost-effective, modular and passive smoke evacuator and evaluate its efficacy in reducing PM and VOC levels during simulated laparoscopic procedures. Methods A prototype smoke evacuator incorporating a distilled water bubbling trap, activated carbon filter, and ULPA filter was tested in a sealed chamber simulating laparoscopic surgery using porcine liver tissue. The system was connected to a laparoscopic port through a three-way valve, allowing manual, on-demand smoke evacuation without continuous suction. Air quality metrics, including PM 1.0 , PM 2.5 , PM 10 , VOC, and CO₂, were measured continuously. Results were compared to baseline and performance benchmarks from commercial smoke evacuation systems. Statistical analysis was performed using paired t-tests. Results The prototype evacuator reduced PM 2.5 levels by >99.5% and VOC concentrations by >95% compared to no-evacuation control trials (p < 0.01). CO₂ concentrations returned to baseline following evacuation, indicating minimal disturbance of chamber atmosphere. PM 2.5 and VOC levels were restored to near-baseline values. Conclusion The developed modular passive smoke evacuator offers a promising and cost-effective solution to improve air quality and enhance occupational safety in operating rooms. The model represents an idealized simulation of laparoscopic smoke evacuation; further clinical validation in live surgical environments is warranted.
Monitoring environmental heat on urban green infrastructure in central Italy based on the florence case study
Abstract Urban green infrastructures (GI) are increasingly affected by environmental fluctuations which may impair photosynthetic performance and reduce ecosystem services. This study aimed to assess the health state of urban GI ecosystems in Florence, Italy, from May to October 2023, using different plant species ( Arundo donax , Laurus nobilis and Artemisia verlotiorum) as bio-indicators monitored throughout their entire vegetative season. To this end, chlorophyll-a fluorescence (JIP-test), optical leaf traits, and meteorological indicators were integrated. Climate data showed frequent heat stress conditions, with 70–87% of summer days exceeding 30 °C and up to 45% surpassing 35 °C. L. nobilis exhibited the strongest heat sensitivity in July–August, showing a reduction in PI ABS , whereas A. donax and A. verlotiorum maintained FV/FM values within optimal ranges (0.75–0.85). Energy fluxes (ABS/RC, TRo/RC, DIo/RC) peaked in summer across species, indicating increased excitation pressure on PSII. Optical traits revealed species-specific strategies: A. donax , showed the highest chlorophyll content, particularly in October (1.1 ru, p < 0.001), while A. verlotiorum accumulated the most flavonols, with peak values in May and August (1.65 ru, p = 0.003), highlighting their photoprotective role under high irradiance and temperature. Linear models confirmed strong associations between heat predictors and variables such as PI ABS and FV/FM, supporting their value as indicators of thermal stress. Exploratory heat impact models revealed a clear relationship between environmental temperature and fluorescence-derived parameters, supporting their potential as sensitive indicators of urban thermal stress. These findings provide the basis for developing precision urban heat models for green infrastructures using chlorophyll fluorescence parameters combined with environment-based predictors.
Anion‐Shielded Porous Organic Cages for High‐Performance Xenon/Krypton Separation
Abstract The separation of Xe and Kr poses a significant industrial challenge. Herein, we demonstrate an anionic shielding strategy that effectively spatially confines anions within the cage's cavities, constructing unprecedented individually positively charged channel‐based adsorbents for Xe/Kr separation. Building on this approach, the obtained POC‐TG Cl achieved high Xe uptake (75.1 cm 3 g −1 ), remarkably IAST selectivity (23.4), and a record‐breaking dynamic selectivity of 15.4 among porous organic materials. These results achieve a superior trade‐off between adsorption capacity and selectivity compared to all reported Xe‐selective adsorbents. Notably, this is the first Xe/Kr adsorbent to use organic cations as binding sites, offering a new category of adsorbents for Xe/Kr separation. Theoretical calculations and in situ spectroscopic characterizations reveal that the presence of cationic sites accounts for the high performance of POC‐TG Cl . Moreover, unlike conventional ionic materials that are easily affected by water and ion interference, POC‐TG Cl , with its hydrophobic surface and anionic shielding, can effectively prevent the competitive adsorption of water and potential ion exchanges, enabling efficient ppm‐level Xe capture from nuclear waste off‐gas. Our work not only develops high‐performance adsorbents for Xe/Kr separation, but also provides a solution for constructing pure positively charged channels based porous materials for various application.
SmUDo (Smart Unit-Dose): Redefining efficiency, quality, and staffing strategies for optimized processes
Background The implementation of unit-dose dispensing systems (UDDS) in hospital pharmacies represents a major milestone in the digital transformation of medication therapy management, operational efficiency, and improving patient safety. However, the absence of standardized metrics for workforce planning and cost assessment has limited widespread adoption. This gap makes it increasingly challenging for healthcare stakeholders to optimize the allocation of limited medical and financial resources. Methods Using data from a 1,800-bed tertiary care hospital with 1,680 UDDS beds (2021–2024), this study establishes benchmarks for staffing requirements and associated costs. The following key performance metrics were analyzed: task-specific work times, unit-dose machine utilization, and productivity indicators such as blistered tablet output and blister bag production per full-time equivalent (FTE). Results The findings indicate a staffing benchmark of 0.45 FTE per 100 UDDS-covered hospital beds to support both implementation and routine operations. Workforce efficiency improved significantly, with the number of FTEs per 1 million blistered tablets decreasing from 3.2 in 2021 to 1.7 in 2024. Concurrently, the cost per blister bag improved from €0.55 in 2021 to €0.22 in 2024, well within the optimal unit target price range of €0.20-€0.25; blistered tablet production tripled, rising from 1.5x10 6 to 4.7x10 6 between 2021 and 2024 respectively. A gold standard of 1 FTE per 10,000 cases was established to optimize staffing and operational workflows. The sharp decline in FTE per 1 million requirements from 5.45 to 2.29 underscores the pivotal role of experienced clinical pharmacists in ensuring safe, accurate, and resource-optimized prescription validation. Conclusion The proposed benchmarks provide practical guidance for improving UDDS productivity, optimizing resource allocation, and strengthening workforce management. Our findings provide a framework that supports continuous UDDS improvement in hospital pharmacy operations and evidence-based decision-making for key stakeholders. By establishing clear UDDS benchmarks, this study supports cost-efficient UDDS operations while providing surrogate indicators of patient safety and clinical quality.