Search Results (60,250)

Background: Asthma is a chronic respiratory disease shaped by environmental, meteorological, and behavioral factors. Few approaches combine population-level surveillance with individual-level monitoring within a single analytical framework. Methods: This work developed a dual machine learning framework. Study 1 modeled the daily count of respiratory admissions (chapter X of the ICD-10) in São Paulo, Brazil, from 2017 to 2022 as a nowcasting task, combining ElasticNet, residual CatBoost, direct CatBoost, and adaptive blending, validated by walk-forward over 30 bimonthly windows. Study 2 applied an XGBoost and Random Forest pipeline to 913 diaphragmatic-breathing sessions from 17 patients aged 9 to 16 years in the Respire Bem system, with Asthma Control Test and salivary cortisol represented using evidence-based synthetic simulation. Results: Study 1 achieved a mean MAE of 18.22, RMSE of 23.99, and R² of 0.675, exceeding the seasonal baseline by 41.5%, with a significant advantage over all three baselines (Wilcoxon and Diebold–Mariano, p ≤ 0.038). Ablation showed each single-component configuration to be significantly worse than the full hybrid, but removing the environmental block cost only 0.27 admissions per day, an effect indistinguishable from zero. SHAP rankings were stable across windows (Kendall W = 0.640), led by NO₂, PM2.5, and temperature. In Study 2 the pipeline ran end-to-end on real behavioral data, but because the outcomes were simulated, no predictive-accuracy metric is reported. Conclusions: Study 1 delivers a validated population-level nowcasting model whose accuracy rests mainly on the temporal structure of the series. Study 2 contributes a real behavioral dataset and a reproducible pipeline; the clinical validity of the digital biomarkers remains open and requires prospective work with directly measured outcomes. Full article

Background/Objectives: Inpatient falls are an important patient-safety concern in rehabilitation hospitals; however, factors determining whether a fall results in fracture remain poorly understood. This study investigated clinical factors associated with radiographically confirmed fracture after inpatient falls, evaluated the fracture-discrimination performance of the Morse Fall Scale and Hendrich II Fall Risk Model, and characterized the resulting orthopaedic burden. Methods: This single-center retrospective cohort study included adults who experienced a documented fall while hospitalized in a tertiary physical medicine and rehabilitation hospital. Patients with and without radiographically confirmed fractures were compared regarding demographic characteristics, comorbidity burden, bone health, continence, mobility, medication exposure, laboratory findings, and fall circumstances. Factors associated with fracture were evaluated using univariable analyses and a parsimonious Firth penalized logistic regression model. Discrimination of the Morse and Hendrich II scores was assessed using receiver operating characteristic analysis. Results: Among 91 adult inpatient fall events, 51 (56.0%) resulted in fracture. In unadjusted analyses, patients with fractures had lower lumbar spine T-scores and higher frequencies of urinary and fecal incontinence, whereas age, sex, femoral T-score, mobility status, fall location, and fall mechanism did not differ significantly between groups. In the adjusted Firth model comprising 87 complete cases and 49 fracture events, no variable reached independent statistical significance; lower lumbar T-score (adjusted odds ratio [aOR], 0.74; 95% confidence interval [CI], 0.52–1.05; p = 0.073) and urinary incontinence (aOR, 2.30; 95% CI, 0.87–6.12; p = 0.082) showed the strongest associations. The Morse and Hendrich II scores demonstrated poor fracture discrimination, with AUCs of 0.372 (95% CI, 0.255–0.489) and 0.411 (95% CI, 0.295–0.526), respectively, without a significant difference between them (p = 0.500). Among patients with fractures, 41.2% sustained major fractures, 27.5% underwent surgery, and 11.8% developed complications. Conclusions: Among documented inpatient falls in this rehabilitation cohort, fractures were common and imposed a clinically important orthopaedic burden. Conventional fall-risk scores did not distinguish falls resulting in fracture, suggesting that prediction of fall occurrence and prediction of orthopaedic injury represent distinct clinical objectives. Fracture-prevention strategies in rehabilitation settings should therefore complement general fall-risk assessment with targeted evaluation of skeletal and functional vulnerability. Full article

Objective: This study aimed to investigate the predictive value of preoperative prognostic nutritional index (PNI) and intraoperative modified surgical Apgar score (mSAS) for severe complications (Clavien–Dindo grade ≥ III) after curative-intent surgery in patients with malignant obstructive jaundice (MOJ) and to construct a nomogram prediction model. Methods: The clinical data of 308 patients who underwent curative-intent surgery for MOJ at the First Affiliated Hospital of Soochow University from January 2019 to January 2024 were retrospectively collected. Independent predictive factors were screened using univariate and multivariate logistic regression; the dose–response relationship between PNI and complication risk was analyzed using restricted cubic spline (RCS); subgroup analysis was conducted to evaluate the consistency of predictive effects; procedure-specific sensitivity analyses were performed separately for patients undergoing pancreaticoduodenectomy (PD) and hepatectomy with extrahepatic bile duct resection (HCAE); a nomogram was constructed based on the independent predictive factors, and the performance of the model was evaluated using receiver operating characteristic (ROC), calibration curve, and decision curve analysis (DCA). Results: Among the 308 patients, 65 (21.1%) had severe complications. The PNI (40.30 ± 4.19 vs. 45.91 ± 4.75) and mSAS (5.28 ± 1.28 vs. 7.28 ± 1.34) in the severe complication group were significantly lower than those in the non-severe complication group (all p < 0.001). After multivariable adjustment including surgical approach, higher PNI (OR = 0.73, 95% CI 0.66–0.82, p < 0.001) and higher mSAS (OR = 0.30, 95% CI 0.21–0.44, p < 0.001) were independently associated with lower odds of severe complications. The quartile analysis of PNI showed a graded inverse association (p for trend < 0.001). Multivariable-adjusted RCS analysis demonstrated a significant overall inverse association between PNI and severe complication risk (p for overall < 0.001), with no significant evidence of nonlinearity (p for nonlinearity = 0.425). In procedure-specific sensitivity analyses, the PNI–mSAS model achieved an AUC of 0.959 (95% CI 0.921–0.997) in the PD subgroup and 0.901 (95% CI 0.837–0.965) in the HCAE subgroup. The AUC of the nomogram prediction model was 0.924; the calibration curve indicated good agreement, and DCA suggested potential clinical utility. Conclusion: Preoperative PNI and intraoperative mSAS are independently associated with severe complications after curative-intent surgery in patients with MOJ. The PNI–mSAS nomogram showed good internal discrimination and calibration and may assist perioperative risk stratification; however, external validation is required before routine clinical application. Full article

Background: The incidence of diabetes-related chronic wounds has been increasing annually, characterized by delayed wound healing due to persistent inflammatory responses. To alleviate patient suffering, there is an urgent need to discover novel wound-healing agents that reduce local inflammatory reactions. Animal peptides emerge as promising candidates due to their low molecular weight, low toxicity, low resistance potential, high sensitivity, potent activity, and ease of transmembrane absorption. However, the precise mechanism by which animal peptides accelerate skin wound healing remains unclear. Method: Scorpion peptides were extracted using ultrafiltration, followed by de novo analysis after library searching with Peaks 8 software and combined LC-MS/MS detection to identify peptide components in scorpions. A full-thickness skin defect model in diabetic mice was established to evaluate the wound-healing promotion capacity of scorpion peptides. In vitro experiments were conducted using mouse monocyte–macrophage leukemia cells (RAW264.7 cells). Enzyme-linked immunosorbent assay (ELISA) evaluated inflammatory cytokine expression, flow cytometry analyzed macrophage phenotypes, Western blotting (WB) measured P-P65 and P65 protein levels, immunofluorescence to observe P-P65 nuclear translocation, molecular docking and molecular dynamics simulations, and the Cellular Thermal Shift Assay (CETSA) to evaluate the binding capacity of scorpion peptides to target proteins, and the TUNEL assay to detect apoptosis, among other methods, to investigate the mechanisms by which scorpion peptides promote wound healing. Result: This study successfully identified 2331 peptides from a scorpion peptide extract. In a full-thickness skin defect model in diabetic mice, treatment with scorpion peptides significantly promoted wound healing and induced M2 polarization of macrophages at the wound site. Further in vitro mechanism studies were conducted using a RAW264.7 cell inflammation model established by combining lipopolysaccharide (LPS) with high glucose. The results showed that scorpion peptide reduced the pro-inflammatory cytokine tumor necrosis factor-α (TNF-α), increased the anti-inflammatory cytokine interleukin-10 (IL-10), downregulate the P-P65/P65 protein expression ratio, and reduce the number of TUNEL-positive apoptotic cells, suggesting that the NF-κB pathway may be involved in mediating its anti-inflammatory and anti-apoptotic effects. To further identify the target, molecular docking and molecular dynamics simulations showed that the active peptide segments PPPPPP and GPPPPP adopt stable binding conformations with the P65 protein; CETSA further validated that they enhance the thermal stability of the P-P65 protein. Through repeated validation using active peptide fragments, ELISA, flow cytometry, Western blot, and immunofluorescence assays consistently confirmed that scorpion peptide, PPPPPPP, and GPPPPP not only inhibit P65 phosphorylation but also inhibit the nuclear translocation of P-P65, and exhibit anti-inflammatory, macrophage M2 polarization-promoting, and anti-apoptotic effects. Conclusions: Scorpion peptides and their active peptide fragments block the activation of the NF-κB pathway by interfering with P65 phosphorylation and nuclear translocation, effectively inducing M2 polarization of macrophages, reducing inflammation and apoptosis, and ultimately promoting the healing of diabetic wounds. Full article

Precision livestock technologies play a critical role in determining animal behavior and welfare. This study aimed to determine the effects of physiological stage, parity, lactation number, and milking frequency on the locomotor, resting, and inactive time behaviors of Holstein dairy cows. The behavioral data and step counts of the animals were continuously recorded using neck collars and foot pedometers, and a total of 8698 raw daily cow-level behavioral records were analyzed. In the statistical model, the days in milk and daily milk yield were included as fixed effects. Heifers and dry cows showed greater similarity in behavioral duration than primiparous and multiparous cows. There were highly significant differences between the groups in terms of rumination, lying, standing duration, and number of steps (p < 0.001). In lactating cows, no statistically significant differences were found in behavioral durations according to lactation number (p > 0.05); however, milking frequency had a significant association across groups (p < 0.001). This study highlights the determining and interrelated effects of physiological stages and management factors on the locomotor and resting behaviors of cattle, thereby providing a behavioral framework for interpreting sensor-derived data in precision livestock farming and supporting data-driven herd management. Full article

Fibroblast growth factor receptor 2 (FGFR2) fusions are identified in approximately 10–16% of patients with intrahepatic cholangiocarcinoma (iCCA) and represent actionable targets, with several FGFR inhibitors approved for clinical use. To evaluate the clinical utility and assay performance of an amplicon-based next-generation sequencing (NGS) approach in this setting, we assessed FGFR2 fusion detection using the Oncomine Comprehensive Assay Plus (OCA-P). A total of 75 formalin-fixed paraffin-embedded (FFPE) specimens from biliary, pancreatic, and ampullary malignancies submitted for FGFR2 fusion testing between 1 March 2023 and 30 June 2024 were retrospectively analyzed, including 40 cases of iCCA. All iCCA specimens were successfully analyzed. FGFR2 fusions were detected exclusively in iCCA, yielding a detection rate of 20%. RNA concentrations in iCCA specimens ranged from 0.02 ng/µL to 104 ng/µL; six cases (15%) exhibited yields below 1 ng/µL and 10 cases (25%) ranged between 1 and 2 ng/µL. Despite limited RNA input, OCA-P demonstrated robust performance, successfully identifying FGFR2 fusions at concentrations below 2 ng/µL, levels typically considered suboptimal for partner-agnostic NGS approaches. These findings support the robustness and clinical utility of the OCA-P assay for reliable FGFR2 fusion detection in iCCA, particularly in specimens with limited RNA input. Full article

Background and Objectives: Pulsed radiofrequency (PRF) of the cervical medial branches is a non-destructive neuromodulatory option for chronic cervical facet joint pain, yet evidence regarding the durability of clinical response and factors associated with sustained benefit remains limited. This study aimed to characterize the 6-month trajectory of pain and disability after fluoroscopy-guided cervical medial branch PRF and to explore baseline factors associated with meaningful pain relief (MPR). Materials and Methods: In this retrospective single-center cohort study, 75 patients with chronic cervical facet joint pain who achieved ≥50% temporary pain relief following a diagnostic medial branch block underwent fluoroscopy-guided cervical medial branch PRF, followed by injection of local anesthetic and corticosteroid at the treated levels. Numeric Rating Scale (NRS) and Neck Disability Index (NDI) scores were evaluated at baseline and at 1, 3, and 6 months. MPR was defined as ≥50% reduction in NRS from baseline. Global Perceived Effect (GPE) and changes in analgesic medication use were assessed as complementary clinical outcomes. An exploratory multivariable logistic regression analysis was performed to examine factors independently associated with MPR at 6 months. Results: Median NRS scores decreased from 7.0 at baseline to 4.0, 4.0, and 5.0 at 1, 3, and 6 months, respectively, while median NDI scores decreased from 30.0 to 14.0, 16.0, and 20.0 (both overall p < 0.001). Despite sustained improvement relative to baseline, MPR progressively declined from 57.3% at 1 month to 49.3% at 3 months and 36.0% at 6 months (overall p < 0.001). Favorable GPE and reduced analgesic medication use showed parallel declines, supporting attenuation of overall clinical benefit over time. In the exploratory multivariable model, fibromyalgia was independently associated with 75% lower odds of 6-month MPR (OR = 0.25, 95% CI: 0.088–0.709; p = 0.009). Age, sex, and baseline NRS were not significantly associated with 6-month MPR. No serious acute periprocedural adverse events were documented during the 2 h observation period. Conclusions: Fluoroscopy-guided cervical medial branch PRF, combined with post-procedural corticosteroid and local anesthetic administration, was associated with clinically meaningful improvements in both pain and neck-related disability, with the greatest benefit during the first 3 months and partial attenuation by 6 months. The progressive decline across pain response, patient-reported global improvement, and analgesic-use outcomes highlights the time-dependent nature of the benefit associated with the combined intervention. Fibromyalgia was independently associated with substantially lower odds of 6-month MPR in this exploratory analysis; this association should be interpreted cautiously and requires prospective validation before it can inform patient selection, although it may be relevant when counseling patients regarding the durability of response. Full article

Background: Pathological response after neoadjuvant chemoradiotherapy for esophageal squamous cell carcinoma may differ between the primary tumor and regional lymph nodes. We evaluated pretreatment factors associated with pathological complete response (pCR) and the anatomical distribution of residual disease after esophagectomy. Methods: This retrospective single-center cohort included 100 patients treated with neoadjuvant chemoradiotherapy followed by esophagectomy. pCR was defined as ypT0N0. Associations with pCR were evaluated using logistic regression. Results: Among 99 response-evaluable patients, 59 achieved pCR (59.6%; 95% CI, 49.7–68.7%). Of 40 patients with non-pCR, residual disease involved only the primary tumor in 26 (65%), both primary and nodal compartments in 10 (25%), and only regional lymph nodes despite complete primary tumor regression in 4 (10%). Overall, 14 patients with non-pCR (35%) had residual nodal disease. In an exploratory adjusted analysis that could not account for baseline cT and cN categories, lower pretreatment lactate dehydrogenase (OR per 10 U/L increase, 0.93; 95% CI, 0.86–0.99; p = 0.026) and female sex (OR, 2.72; 95% CI, 1.02–7.24; p = 0.045) were associated with pCR. Conclusions: Response was heterogeneous across primary tumor and nodal compartments. Primary tumor regression did not invariably indicate nodal clearance, supporting compartment-specific response assessment. The lactate dehydrogenase and sex associations may reflect residual confounding by baseline disease extent and require external validation. Full article

To address underutilization of breast cancer screening among Latines, one solution may be to identify participants, at baseline, who are likely to promote breast health after participation. We sought to (1) describe breast health promotion at baseline and (2) examine relevant predictors, using self-report data from 400 Latine participants. Breast health and mammography promotion were binary outcomes and validated with environmental data (message, modality, time). Predictors were measured with validated instruments, including (1) acceptability of breast health promotion (Likert items); (2) breast cancer screening knowledge (count); (3) limited cultural misconceptions (count); (4) knowing a health advocate/professional (binary); and (5) non-health volunteerism history (binary). About 35% of participants had promoted breast health, and 14% had promoted mammography. Modified Poisson regressions found that perceived acceptability predicted breast health (PR = 1.53, 95% CI [1.17, 1.99], p = 0.002) and mammography promotion (PR = 1.61, 95% CI [1.02, 2.55], p = 0.04), after accounting for age, nativity, education, income, and mammography history. Knowing a health advocate/professional also predicted breast health promotion (PR = 1.53, 95% CI [1.18, 1.98], p = 0.001). Our findings highlight potential factors to consider for future interventions to train participants to promote breast health. Full article

This study explores the adsorption performance of clean peanut husk (CPH) as a sustainable and low-cost biosorbent for removing methylene blue (MB) from aqueous solutions. Batch experiments investigated the effects of dye concentration, biosorbent dosage, pH, particle size, and temperature. FT-IR analysis confirmed the involvement of hydroxyl, carbonyl, and aromatic groups, with spectral changes indicating both physical and chemical adsorption mechanisms. Adsorption capacity increased with initial dye concentration and decreased with larger particle size or excessive adsorbent dosage. The process was highly pH-sensitive, favoring adsorption under neutral to alkaline conditions, while temperature had minimal influence, a finding compatible with a physisorption-dominated contribution to the overall process. Kinetic data were best described by the pseudo-second-order model, and equilibrium behavior was best described by the Langmuir isotherm; however, these mathematical fits are interpreted here as indicative of, rather than definitive proof of, the specific molecular mechanism, and the overall adsorption process is best described as involving a combination of physisorption and chemisorption contributions. The separation factor (RL) values indicated favorable adsorption. Furthermore, an exploratory artificial neural network (ANN) analysis, based on a limited dataset of 39 experimental observations, achieved a high goodness-of-fit (R² = 0.99) in describing the nonlinear relationships between each individual operational parameter and the adsorption capacity; given the small sample size and limited validation strategy employed, these results should be regarded as a preliminary demonstration of feasibility rather than evidence of robust predictive generalization. The findings support the potential of CPH as an efficient biosorbent for dye-contaminated wastewater. Full article

Selenium (Se) and cadmium (Cd) have contrasting implications for agricultural land quality. We integrated 25 unpaired rock samples and 149 soil records, including 106 paired soil–crop observations from Zhijin County, Guizhou, China, to characterise element distributions and evaluate static predictive models under spatially blocked cross-validation. Crop Se values below detection were treated as LOD/√2; models used 88 numerical Se records and 106 Cd records across five spatial KMeans blocks. Rock, soil and crop data showed element-specific concentration patterns, bioconcentration factors and soil associations. The highest pooled out-of-fold performance was obtained for Crop Se (R² = 0.831, RMSE = 0.220 log10 mg kg⁻¹), whereas Crop Cd showed weaker performance (R² = 0.233, RMSE = 0.495 log10 mg kg⁻¹). Crop Se robustness analyses showed sensitivity to censoring treatment and crop-group structure, and fold-contained within-crop residual prediction was weak (R² = 0.007). Fitted associations involved soil Se, soil Cd, pH, MgO, organic C and crop group, conditional on correlated environmental and management factors. These findings support crop-stratified sampling across representative geological and soil settings for Se monitoring, while Cd surveillance remains centred on direct crop measurement. The models provide a transparent basis for sampling design and targeted field verification. Full article

Background/Objectives: Microsurgery is the principal treatment for large vestibular schwannomas (VS) causing symptomatic brainstem compression. Koos grade 4 tumors remain anatomically heterogeneous. We evaluated surgical and functional outcomes and explored whether a study-specific subdivision, adapted from the Hannover T4a/T4b distinction, provides prognostic information beyond established clinical and surgical variables. Methods: This retrospective single-center study included 139 adults treated for unilateral Koos grade 4 VS between January 2013 and December 2024. Tumors were categorized as Koos 4a (brainstem compression without fourth ventricular compression) or Koos 4b (brainstem displacement with fourth ventricular compression). The primary endpoint was facial nerve function at the last documented clinical follow-up. Resection extent was determined by preoperative and early postoperative contrast-enhanced MRI. Results: Seventy-five patients (54.0%) had Koos 4a and 64 (46.0%) Koos 4b tumors. Koos 4b tumors were larger (median 38 vs. 30 mm; p < 0.001). Gross-total resection was achieved in 73.5%, and complications occurred in 13.7%. Favorable facial nerve function (House–Brackmann grades I–II) decreased from 98.5% preoperatively to 36.0% immediately postoperatively and was documented in 58.7% at the last available follow-up. In exploratory complete-case multivariable analysis (n = 104), longer operative duration was associated with lower odds of favorable facial nerve function (adjusted OR per 30 min, 0.84; 95% CI, 0.74–0.95; p = 0.005). This association should not be interpreted causally because operative duration likely reflects tumor complexity. The study-specific subtype was not associated with outcome after adjustment, but collinearity with tumor diameter and limited model precision preclude a definitive conclusion. Conclusions: This study-specific subdivision describes differences in anatomical extent and preoperative clinical burden. Its independent prognostic value was not demonstrated in this single-center cohort and requires external validation. Operative duration appears to be a marker of surgical complexity rather than an actionable causal risk factor. Full article

Finswimming is a high-intensity aquatic sport in which performance is influenced by the interaction between biomechanical and physiological factors, particularly during underwater apnea sprint events. This study compared performance, kinematic characteristics, cardiovascular responses, metabolic responses, and perceived exertion during a maximal 50 m monofin sprint performed under three conditions: underwater apnea swimming (UW), surface swimming without a snorkel (SN), and surface swimming with a closed snorkel (SC). Ten highly trained young male national-level finswimmers completed a randomized repeated-measures protocol. Performance time, dolphin kick number and frequency, heart rate (HR), blood lactate concentration, blood glucose concentration, and rating of perceived exertion (RPE) were assessed. Sprint performance was significantly faster during UW (17.38 ± 1.32 s) than during both SN (19.20 ± 1.64 s) and SC (19.39 ± 1.53 s; p < 0.001), with a very large condition effect (ηp² = 0.882). This was accompanied by fewer dolphin kicks during UW (40 ± 5) than during SN (44 ± 6) and SC (44 ± 5), with a large condition effect (ηp² = 0.651), whereas kick frequency did not differ significantly among conditions (~137–140 kicks·min⁻¹; ηp² = 0.038). HR exhibited a biphasic recovery pattern across all conditions, declining rapidly from peak exercise values (HRpeak: ~169–171 bpm) to HRlow (~141–147 bpm) before increasing to HRhigh (~160–162 bpm) during early recovery, with a very large main effect of time (p < 0.001; ηp² = 0.823). Post-exercise blood lactate concentration increased significantly in all conditions from ~1.3–1.5 to ~10.7–11.9 mmol·L⁻¹ (p < 0.001), with a very large time effect (ηp² = 0.954) and no significant between-condition differences. Blood glucose concentration (~5.4–5.9 mmol·L⁻¹) and RPE (7–8 a.u.) showed no statistically significant condition-specific differences. In conclusion, underwater apnea swimming was associated with faster 50 m sprint performance and fewer dolphin kicks than the surface swimming conditions in highly trained young male national-level finswimmers. These performance and kick characteristics are consistent with potential biomechanical and hydrodynamic explanations described in previous research, although propulsive efficiency and hydrodynamic resistance were not directly measured in the present study. A biphasic HR recovery pattern was observed across conditions; however, the autonomic mechanisms underlying this response cannot be determined from the present measurements. Full article

Background: Burnout is a major challenge to the ongoing viability of the nursing workforce. However, only a limited number of studies have integrated work shift characteristics, satisfaction with work–life balance, and chronic illness into the same model. Aim: To examine whether shift work patterns, satisfaction with work–life balance, and chronic illness are independently associated with burnout among nurses. Methods: Between March and May of 2025, an analytical cross-sectional study was conducted on 100 nurses in two Egyptian military hospitals. Burnout was measured with the 20-item Burnout Syndrome Assessment Scale (BOSAS; Cronbach’s α = 0.832 in the present sample). Unadjusted associations were examined using univariable linear regression with HC3 robust standard errors, and hierarchical multiple linear regression was used to identify factors independently associated with the total burnout score. Results: The reported prevalence of burnout was 30.0% mild, 57.0% moderate, and 13.0% severe. The mean total burnout score was 46.72 ± 11.55. The final model of the regression explained 43.9% of the variance in burnout. Work–life balance satisfaction showed the strongest association with burnout among the variables in the model (standardized β = −0.479, p < 0.001), with each one-category increase in satisfaction corresponding, on average, to a 4.49-point lower burnout score. Chronic illness showed a borderline association with higher burnout (B = 4.40, p = 0.0499). In addition, nurses aged 36–45 years had lower scores than those aged 18–25 years. Shift duration, gender, and physical activity were not independently associated with burnout, although the near-uniform shift patterns in this sample limited the ability to detect an effect of shift length. Conclusions: In this sample, greater work–life balance satisfaction was associated with lower burnout, while the near-uniformity of shift exposure limited what could be concluded about shift duration. The cross-sectional design precludes causal inference and the direction of these relationships cannot be established. Preventive measures that protect work–life balance, such as predictable rosters, sufficient recovery time, and staffing that eases competing work and family demands, warrant evaluation, as does early support for nurses living with chronic disease. Full article

Municipal sewage sludge contains carbon and mineral constituents that can be recovered as water-treatment materials. This study compared four silicon-rich carbons prepared under different carbon dioxide activation and nitric-acid modification conditions to examine whether material properties ranked arsenic(V) and lead(II) removal consistently. Pre-contact characterisation combined spectroscopy, microscopy, elemental analysis, nitrogen sorption and surface-charge assessment. Separate model-groundwater solutions containing each contaminant were treated in triplicate at pH 6.0, 6.5 and 7.0. Mean removal ranged from 47.8 to 76.2% for As(V) and from 68.8 to 96.3% for Pb(II). Two-factor analyses detected no significant material, pH or interaction effects at the 5% level. Averaged across the three pH levels, M3 had the highest numerical As(V) removal (71.7%), whereas M1 had the highest numerical Pb(II) removal (92.2%). A separate low-concentration test with M3 reported final concentrations of 0.0080 ± 0.0006 mg L⁻¹ As(V) and 0.0041 ± 0.0004 mg L⁻¹ Pb(II). Fifth-cycle removal remained above 80% for both contaminants, with 88.2% dry sorbent mass recovery after five cycles. The different material rankings indicate that total surface area alone does not describe performance across both contaminants. Further analytical, leaching and natural-water assessments are needed before application to drinking-water treatment. Full article