Demand Function Research Articles

Does the unusual phenomenon of sustained force circumvent the speed-endurance trade off in the jaw muscle of the southern alligator lizard (Elgaria multicarinata)?

The jaw muscles of the southern alligator lizard, Elgaria multicarinata, are used in prolonged mate-holding behavior, and also to catch fast prey. In both males and females, these muscles exhibit an unusual type of high endurance known as sustained force in which contractile force does not return to baseline between subsequent contractions. This phenomenon is assumed to facilitate the prolonged mate-holding observed in this species. Skeletal muscle is often subject to a speed-endurance trade off. Here we determine the isometric twitch, tetanic, and isotonic force-velocity properties of the jaw muscles at ∼24°C as metrics of contractile speed and compare these properties to a more typical thigh locomotory muscle, to determine whether endurance by sustained force allows for circumvention of the speed-endurance trade-off. The specialized jaw muscle is generally slower than the more typical thigh muscle; time to peak twitch force, twitch 90% relaxation time (p<0.01), and tetanic 90% and 50% relaxation times (p<0.001) are significantly longer, and force-velocity properties are significantly slower (p<0.001), in the jaw than the thigh muscle. However, there seem to be greater effects on relaxation rates and shortening velocity that on force rise times; there was no effect of muscle on time to peak, or 50% of tetanic force. Hence, the jaw muscle of the southern alligator lizard does not seem to circumvent the speed-endurance trade-off. However, the maintenance of force rise times despite slow relaxation, potentially enabled by the presence of hybrid fibers, may allow this muscle to meet the functional demand of prey capture.

Quantitiev Conjectural Variations in Oligopoly Games with Different Demand and Cost Functions and Multi-Level Leadership

Quantitiev Conjectural Variations in Oligopoly Games with Different Demand and Cost Functions and Multi-Level Leadership

A user-centered approach in complex engineering design environments

In complex engineering design environments, the demand for high quality products and high functionality are critical, the end-user requirements have to be integrated into the design process since the earliest design stages. In such contexts, strict design requirements related to quality, safety, and usability must be taken into account concurrently. To this aim, in this work, an integrated user-centered decision-based design method is proposed in the medical design environment context. This work is aimed at proposing a design method to be applied to complex design environments. The proposed case study is the design of an intercom device, aimed at improving patient-doctor communication in the case of bedridden patients on with helmet for Continuous Positive Airway Pressure (CPAP) therapy during SARS- CoV2 pandemic emergency. Patients undergoing helmet-assisted ventilation are often immersed in a highly noisy environment, unable to fully communicate their needs to the doctors. A three-steps decision based integrated product design and process simulation are used in the early design stages, to gain optimal product designs in a user-centered design viewpoint, for novel industrial products. The first step, modular design, is aimed at defining relations between the components of the assembly in a user centered approach. Design alternatives are generated in a Design for Manufacturing and Assembly DFMA viewpoint. In the second step, the group decision making step, in a multiple criteria context, the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) is applied together with the fuzzy set theory, to overcome uncertainties in the verbal judgments of the decision makers. The third step is related to the simulation of the assembly and manufacturing process, with the aim of defining a final optimal design. The proposed group multicriteria decision making based design method proved to be efficient in complex user centered engineering design contexts.

REVITALIZING KELANTAN MALAY TRADITIONAL ARCHITECTURE: THE ADAPTATION OF MALAY TRADITIONAL ARCHITECTURE DESIGN FEATURES IN KELANTAN TO MODERN CONTEMPORARY ARCHITECTURAL SCHEME

The highlighted issue in reforming traditional Malaysian architecture into modern contemporary architectural design is maintaining the cultural and historical integrity of traditional Malaysian architecture elements while adapting them to meet contemporary architecture's functional, aesthetic, and sustainability demands. This paper examines the possibility of adapting traditional Kelantanese Malay architectural elements into modern contemporary architectural design, emphasizing the preservation of key features that reflect the region's rich cultural and historical identity. Distinctive components such as entrance gates (pintu gerbang), decorative wall panels (dinding janda berhias), major pillars (tiang seri), and handcrafted details are highlighted, alongside the symbolic and aesthetic significance of ekor itik (duck tail end gables), kayu tunjuk langit (sky-pointing beams) and buah butung (beautiful finials). In terms of sustainable design approach, the features of tebuk tembus (pierced carvings) enhance ventilation and light penetration. The study's objectives involve documenting notable examples of traditional Kelantanese buildings, analyzing their design features, and proposing a framework for incorporating these elements into modern architecture. Methodologically, the research employs case studies of selected buildings to examine their architectural features, spatial layouts, material choices, and cultural significance. The findings suggest that architectural elements like pierced carvings (tebuk tembus), decorative panels, and finials (buah butung) can seamlessly integrate into modern contemporary architectural design. Ultimately, the paper advocates revitalizing Kelantanese Malay architecture through a balanced synthesis of tradition and modernity.

The impact of glucose metabolism on inflammatory processes in sepsis-induced acute lung injury

Acute lung injury (ALI) is a prevalent and critical complication of sepsis, marked by high incidence and mortality rates, with its pathogenesis still not being fully elucidated. Recent research has revealed a significant correlation between the metabolic reprogramming of glucose and sepsis-associated ALI (S-ALI). Throughout the course of S-ALI, immune cells, including macrophages and dendritic cells, undergo metabolic shifts to accommodate the intricate demands of immune function that emerge as sepsis advances. Indeed, glucose metabolic reprogramming in S-ALI serves as a double-edged sword, fueling inflammatory immune responses in the initial stages and subsequently initiating anti-inflammatory responses as the disease evolves. In this review, we delineate the current research progress concerning the pathogenic mechanisms linked to glucose metabolic reprogramming in S-ALI, with a focus on the pertinent immune cells implicated. We encapsulate the impact of glucose metabolic reprogramming on the onset, progression, and prognosis of S-ALI. Ultimately, by examining key regulatory factors within metabolic intermediates and enzymes, We have identified potential therapeutic targets linked to metabolic reprogramming, striving to tackle the inherent challenges in diagnosing and treating Severe Acute Lung Injury (S-ALI) with greater efficacy.

Laser land leveling technology for paddy production in Vietnam: impact on efficient irrigation and water conservation.

This research investigates the empirical effects of the laser land leveling (LLL) adoption on irrigation water and water efficiency in paddy production in the Mekong Delta region (MDR), using the randomized controlled trial (RCT) approach incorporated into input demand function models. The descriptive analysis highlights the potential for water reuse through farmers' drainage practices. However, the dependence on experiential methods for applying technology in paddy production poses challenges that could compromise long-term sustainability. The regression results indicate that the LLL treatment leads to savings of 1975 m3ha-1 and 1299.35 m3ha-1 in irrigation water and net water use in paddy production, respectively, compared to the control. These savings account for 20.52% of total irrigation water use and 28.64% of net water use. The projected savings on average are 375.51 and 247.05 million m3, respectively, for irrigation water and net water use with 5% implementation of the technology in the MDR. The research highlights the environmental benefits of the LLL technology and underscores the need for its promotion to achieve water conservation in paddy production, offering policymakers insights to enhance sustainable agriculture amid climate change and water scarcity. The study addresses significant gaps in the existing literature by providing an in-depth analysis of LLL technology's impact on irrigation water and efficiency by extending the drainage performance within the paddy mono-cropping context and employing RCT methodology combined with input demand function models to comprehensively evaluate its impact on irrigation water usage.

The relationship of changes in insulin demand and insulin adequacy over the life course.

Insulin requirements in the human body undergo continuous changes in response to growth and development. We assessed the life course relationships between insulin demand and insulin adequacy. Three independent Chinese cohorts (204 children, aged [mean ± SD] 7.0 ± 0.5 years; 214 adolescents, aged 15.0 ± 1.8 years; 605 adults, aged 41.5 ± 9.3 years), recruited between 1998 and 2013, underwent OGTT tests. Indices of insulin sensitivity and insulin secretion were calculated based on paired glucose/insulin values during fasting, early phase and late phase of OGTT. Insulin demand and insulin adequacy were calculated by standardised major axis (SMA) regression from the paired insulin sensitivity and secretion indices. We derived the natural logarithm of ratio between the exponential functions of insulin adequacy and insulin demand (RAD) index for further evaluating the relationship between insulin demand and adequacy. The risk of abnormal glucose tolerance (AGT) was evaluated by logistic regression analyses. Area under the receiver-operating characteristic curve (AUC-ROC) analyses, net reclassification improvement (NRI) and integrated discrimination improvement (IDI) indices were used to demonstrate the discriminative value of the RAD method model. Adolescents had the lowest insulin sensitivity and the highest insulin secretion in all phases (fasting, early and late phase) of the OGTT, as compared with children and adults in each phase (all p<0.001). Adolescents had the highest insulin demand in all phases and lowest insulin adequacy in the fasting phase (p<0.001). In general, adults had the lowest insulin adequacy in both the early phase (p>0.05) and late phase (p<0.001) of the OGTT. Adolescents had negative RAD values irrespective of overweight and obesity, while, in general, children and adults had positive RAD values (p<0.001 between age groups in each of the fasting, early and late phases of the OGTT). Participants with RAD values below the 25th percentile had a higher risk of AGT compared with those above the 25th percentile (fasting-phase OR 1.86 [95% CI 1.18, 2.91]; early-phase OR 1.99 [95% CI 1.24, 3.19]; late-phase OR 2.49 [95% CI 1.57, 3.97]). The late-phase RAD index had the best performance in evaluating the risk of AGT compared with the fasting- and early-phase RAD indices (late-phase AUC-ROC = 0.635 [95% CI 0.583, 0.687]; late-phase NRI = 0.350 [95% CI 0.190, 0.510]; late-phase IDI = 0.033 [95% CI 0.015, 0.050]). The relationship between insulin demand and insulin adequacy changed throughout the life course. Adolescents had an imbalanced relationship between insulin demand and insulin adequacy, while, in general, children and adults had a balanced relationship. RAD is a novel index that was used to efficiently describe this relationship and evaluate the risk of AGT.

On the Invariance Result of Liability Rules in Oligopoly

Abstract In this paper, we revisit the invariance result of liability rules established by Polinsky (1980. “Strict Liability vs. Negligence in a Market Setting.” The American Economic Review 70: 363–7) and Shavell (1980. “Strict Liability Versus Negligence.” Journal of Legal Studies 9: 1–25) in oligopoly. We show that in the case of linear demand functions, symmetric duopoly firms produce less than the efficient quantity levels under all of the no liability rule, the strict liability rule and the negligence rule but they take the efficient level of care under the strict liability rule and the negligence rule whereas they take no care under no liability rule. Thus, the invariance result does not hold in the case of duopoly. So, contrary to the invariance result, our result has an important implication that the liability rule in addition to the price plays a crucial role in providing a proper incentive to duopoly firms. Instead, we establish a weaker version of invariance result between the strict liability rule and the negligence rule in oligopoly with general demand functions.

Uncertainty and Money Demand Function in Developing Countries

As monetary policy authorities influence many macroeconomic variables by determining monetary aggregates, their relationships with other macroeconomic variables are critical in setting the most appropriate monetary policy rules. Identifying the variables affecting money demand and having a stable money demand function is essential for monetary policy. This paper examines the stability of the money demand function for 12 developing countries over the sample 2006.Q1-2023.Q3. We employ the Autoregressive Distributed Lag Model and the Cross-Sectionally Autoregressive Distributed Lag Model because of the different degrees of integration of the selected variables. According to the results, there is a stable long-run relation in the money demand function for selected developing countries. The uncertainty variable, which is the study’s primary objective, affects money demand negatively in the long run; it does not temporarily affect the demand for money. The findings also indicate that the real GDP (inflation) positively (negatively) impacts demand for real monetary aggregates as expected. The real interest rate measuring the opportunity cost of holding money does not significantly affect money demand. Although the effect of the exchange rate is positive in the short run, it turns negative as time passes and in the long run. This finding supports the ‘wealth effect’ in developing countries.

Optimizing continuous passive motion duration following arthroscopic release of elbow contracture: a retrospective study.

The anatomical structure of the elbow joint makes it vulnerable to contractures. While elbow arthroscopy minimizes soft tissue damage and enhances early rehabilitation, the optimal duration for postoperative Continuous Passive Motion (CPM) therapy is unclear. This retrospective study aims to establish the appropriate duration of CPM following arthroscopic elbow contracture release. We analyzed postoperative outcomes from patients undergoing CPM rehabilitation for 1, 3, or 5 months. Metrics such as ASES, VAS, DASH, MEPS scores, grip strength, and range of motion were assessed before surgery and at 1,3,6 and 12 months post-surgery. Patients who received 3 or 5 months of CPM therapy showed statistically significant improvements in elbow flexion-extension, range of motion, and functional scores (ASES, VAS, DASH, MEPS) compared to the 1-month group (p < 0.05). However, no significant differences were observed between the 3- and 5-month groups. A 3-month CPM period is effective for patients with higher functional demands, with no additional benefit from extending therapy to 5 months.

Adaptive chunking improves effective working memory capacity in a prefrontal cortex and basal ganglia circuit.

How and why is working memory (WM) capacity limited? Traditional cognitive accounts focus either on limitations on the number or items that can be stored (slots models), or loss of precision with increasing load (resource models). Here we show that a neural network model of prefrontal cortex and basal ganglia can learn to reuse the same prefrontal populations to store multiple items, leading to resource-like constraints within a slot-like system, and inducing a trade-off between quantity and precision of information. Such "chunking" strategies are adapted as a function of reinforcement learning and WM task demands, mimicking human performance and normative models. Moreover, adaptive performance requires a dynamic range of dopaminergic signals to adjust striatal gating policies, providing a new interpretation of WM difficulties in patient populations such as Parkinson's disease, ADHD and schizophrenia. These simulations also suggest a computational rather than anatomical limit to WM capacity.

Geospatially Informed Water Pricing for Sustainability: A Mixed Methods Approach to the Increasing Block Tariff Model for Groundwater Management in Arid Regions of Northwest Bangladesh

Groundwater depletion in arid regions poses a significant threat to agricultural sustainability and rural livelihoods. This study employs geospatial analysis and economic modeling to address groundwater depletion in the arid Barind region of Northwest Bangladesh, where 84% of the rural population depends on agriculture. Using remote sensing and GIS, we developed an elevation map revealing areas up to 60 m above sea level, exacerbating evaporation and aquifer dryness. Field data collected through Participatory Rural Appraisal tools showed farmers exhibiting “ignorant myopic” behavior, prioritizing short-term profits over resource conservation. To address this, an Increasing Block Tariff (IBT) water pricing model was developed, dividing water usage into three blocks based on irrigation hours: 1–275 h, 276–550 h, and 551+ h. The proposed IBT model significantly increases water prices across the three blocks: 117 BDT/hour for the first block (from current 100–110 BDT/hour), 120 BDT/hour for the second block, and 138 BDT/hour for the third block. A demand function (y = −0.1178x + 241.8) was formulated to evaluate the model’s impact. The results show potential reductions in groundwater consumption: 59 h in the first block, 26 h in the second block, and 158 h in the third block. These reductions align with the principles of integrated water resource management (IWRM): social equity, economic efficiency, and environmental integration. The model incorporates economic externalities (e.g., well lifting costs) and environmental externalities (e.g., crop pattern shifts), with total costs reaching 92,709,049 BDT for environmental factors. This research provides a framework for sustainable groundwater management in arid regions, potentially reducing overextraction while maintaining agricultural productivity. The proposed IBT model offers a locally driven solution to balance resource conservation with the livelihood needs of farming communities in the Barind tract. By combining remote sensing, GIS, and economic modeling, this research provides a framework for sustainable groundwater management in arid regions, demonstrating the power of geospatial technologies in addressing complex water resource challenges.

Effect of masticatory muscle function on the craniofacial sutures of the anterior viscerocranium in growing rats.

The transverse dimensions of internasal and nasopremaxillary sutures in rats were assessed at different ages and following different dietary functional demands.Eighty-four male Wistar rats were divided into two groups fed either a hard or a soft diet from 4 weeks of age, and sacrificed at 4weeks (baseline: n=12),16weeks (n=24), 26weeks (n=24), or 38weeks (n=24) of age. High-resolution micro-computed tomograms of the internasal and left nasopremaxillary sutures were obtained with 10µm voxel size and 5×5mm field of view. The endocranial and ectocranial suture widths, the mean suture width, and the suture height were measured. Linear regression analysis was used to estimate the effects of age and type of diet on suture dimensions. Internasal and nasopremaxillary suture dimensions were influenced by age, with a generally lower width and a larger height in the older animal. Regarding diet consistency, internasal suture widths were on average larger in the hard-diet group (e.g., mean suture width 43µm in the hard- versus 30µm in the soft-diet group at 26weeks). In conclusion, the internasal and nasopremaxillary sutures tend to become narrower with age, while being influenced by masticatory functional demands.

Repository (R)evolution: Metadata, Interoperability, and Sustainability

Introduction: Successfully managing an open-access repository requires constant attention to user community priorities in order to inform the development or selection of a platform that fulfills constantly evolving functional demands in an increasingly complex operational environment. This paper uses AgEcon Search (AES) as an example of the way that varying platforms address the metadata and other platform needs of a repository. AES is a successful subject repository with an international scope that has resided on several different platforms in its 25-year lifespan. Elements and Considerations: Critical among the technical requirements of a repository is interoperability with other information sources and the ability to accommodate and describe different types of objects, including data. Experienced in the use of easy and widely used Dublin Core (DC), as well as Machine-Readable Cataloging 21 (MARC 21)-based repository platforms, we discuss both metadata schemas from administrative and user perspectives. Reconsidering underlying metadata issues might positively impact both technical and administrative issues that are currently restricting the development of robust, interoperable systems. As managers of AES, we are uniquely placed to discuss both technical and sustainability issues. Conclusions: Although many institutional and subject repositories are on platforms that use DC for their metadata, other options are available. MARC, the well-established library standard, can provide the wide range of fields needed to fully and accurately describe the variety of document and data types that are included in repositories.

EFFECTS OF CONSUMERS’ SENSORY ATTRIBUTES ON THEIR WILLINGNESS TO PAY AND THE OPTIMUM PRICE FOR ICED COFFEE DRINKS

The growing competition among coffee shops demands effective strategies, including the development of optimal pricing. An optimal pricing strategy must account for both changes in coffee ingredients and consumers' willingness to pay (WTP). This study investigated the factors influencing consumers' WTP and determined optimal prices through sensory evaluations of iced coffee. This study explored how demographic factors and sensory characteristics affect consumer WTP. This study involved direct consumer tastings, where participants provided subjective ratings of iced coffee and indicated their WTP. The coffee samples included variations in milk (white and black coffee) and sugar content (granulated sugar, palm sugar, and no sugar). To measure WTP, the Becker-DeGroot-Marschak (BDM) mechanism was employed, while a demand function was used to determine the optimal price. Stepwise backward logistic regression further analyzed the factors affecting WTP. The factors influencing willingness to pay were further analyzed using stepwise backward logistic regression. The findings reveal that optimal pricing varies, with iced coffee that includes both granulated sugar and milk commanding the highest WTP. Consumer WTP is significantly influenced by factors such as gender, frequency of coffee consumption, and individual taste preferences. There was a marked difference in WTP based on the amount of milk and sugar added, with coffee variations containing both granulated sugar and milk achieving the highest WTP. These results can serve as a valuable reference for coffee shops, helping them to determine the ideal product composition and pricing strategies to maximize revenue.

EXPRESS: Identifying Competitors in Geographical Markets Using the CSIS Method

Identifying the most relevant competitors in a geographical market is crucial for businesses with a significant offline presence, such as hotels, restaurants, and retail stores. The specific location of a business and the geographical density of potential competitors are critical factors in determining the competitive structure. However, this task can be challenging when the potential number of competitors is large and the competition is asymmetric. In this study, we apply the Conditional Sure Independence Screening (CSIS) method to a system of demand functions for competitor identification. This method offers significant computational efficiency by estimating a marginal regression for each potential competitor, rather than a full model consisting of all potential competitors. To validate the effectiveness of the CSIS method and explore the boundary conditions of its performance, we conduct extensive simulation analyses under different spatial data-generating processes. Our findings demonstrate that the CSIS method outperforms multiple other variable selection methods and remains robust under spatial misspecifications. Then we apply the CSIS method to hotel competition in two U.S. geographical regions, illustrating how the competitive structure varies across geographical densities and market segments. Finally, we highlight how managers can strategically use the results and outline the potential of the method for other non-geographical applications.

Optimizing Treatment Strategies for Distal Radius Fractures in Osteoporosis: A Comparative Review.

Osteoporosis is a common yet underdiagnosed condition that increases the risk of fractures, contributing to substantial morbidity, mortality, and healthcare costs. Distal radius fractures (DRFs) are some of the most common fractures associated with osteoporosis and often precede more severe fractures. Managing DRFs in patients with osteoporosis can be a challenge due to altered bone quality, which can affect healing and surgical fixation. This review examines both operative and nonoperative management strategies for DRFs in osteoporotic patients, emphasizing the importance of individualized treatment. Surgical interventions, like open reduction and internal fixation (ORIF) with plating, can facilitate early mobilization and improved alignment, especially in more active patients. However, osteoporosis poses risks such as hardware failure, infection, and malunion, calling for careful patient selection. Conversely, nonoperative management may be more suitable for patients with lower functional demands or higher surgical risks, despite the increased risk of malunion. By adapting treatment strategies to individual patient characteristics, orthopedic surgeons can optimize outcomes, minimize complications, and potentially prevent future fractures. Both operative and nonoperative treatments can yield positive outcomes when personalized to the patient's needs.

The sodium/ascorbic acid co-transporter SVCT2 distributes in a striated membrane-enriched domain at the M-band level in slow-twitch skeletal muscle fibers

BackgroundVitamin C plays key roles in cellular homeostasis, functioning as a potent antioxidant and a positive regulator of cell differentiation. In skeletal muscle, the vitamin C/sodium co-transporter SVCT2 is preferentially expressed in oxidative slow fibers. SVCT2 is up-regulated during the early fusion of primary myoblasts and decreases during initial myotube growth, indicating the relevance of vitamin C uptake via SVCT2 for early skeletal muscle differentiation and fiber-type definition. However, our understanding of SVCT2 expression and function in adult skeletal muscles is still limited.ResultsIn this study, we demonstrate that SVCT2 exhibits an intracellular distribution in chicken slow skeletal muscles, following a highly organized striated pattern. A similar distribution was observed in human muscle samples, chicken cultured myotubes, and isolated mouse myofibers. Immunohistochemical analyses, combined with biochemical cell fractionation experiments, reveal a strong co-localization of SVCT2 with intracellular detergent-soluble membrane fractions at the central sarcomeric M-band, where it co-solubilizes with sarcoplasmic reticulum proteins. Remarkably, electrical stimulation of cultured myofibers induces the redistribution of SVCT2 into a vesicular pattern.ConclusionsOur results provide novel insights into the dynamic roles of SVCT2 in different intracellular compartments in response to functional demands.

A Dynamic Game Analysis of Hospitals’ Quality-Improving and Congestion-Reducing with Corresponding Knowledge Accumulations Effects

In this paper, we develop a dynamic control to investigate the hospitals’ quality improvement and congestion reduction, along with corresponding knowledge accumulations. The main features of our work are: (i) developing a dynamic analysis model of the hospitals’ quality improvement and congestion reduction, considering knowledge accumulations in health care markets; (ii) the demand function for medical treatment depends on treatment quality, congestion degree, price, and traveling cost; (iii) each hospital’s instantaneous costs of quality improvement and congestion reduction depend on treatment quality, quality-improving investment, corresponding knowledge accumulation as well as congestion degree, congestion-reducing investment and the corresponding knowledge accumulation; (iv) the hospitals’ dynamic competitions are not only in treatment quality and congestion degree but also in treatment prices. Our results show that (i) there exists a unique saddle-stable steady-state equilibrium under hospital optimum and social optimum; (ii) knowledge accumulation and the complementarity or substitutability affect the hospitals’ decision behavior; (iii) whether the price and the hospitals’ investments in quality improvement and congestion reduction are higher or lower under hospital optimum than that under social optimum depends on the parameter regions of complementarity or substitutability.

The effectiveness of shoe modifications and foot orthoses in conservative treatment of lesser toe deformities: a review of literature.

Forefoot disorders are prevalent in the general population, with an incidence between 2 and 20%. Among them, lesser toe deformities (hammer, claw, and mallet toes) are frequent disorders, and their conservative management is often not adequately considered but usually attempted before surgical indication. Among conservative treatments, shoe modifications and the application of orthoses may, in most cases, alleviate symptoms. From a careful analysis of the available literature, it emerged that treatment approaches should be individualized, and patient education has to be a central aspect of therapy. Proper footwear includes rocker and cushioned soles shoes, a wide toe box, proper length, and a lowered heel, eventually combined with the placement of a felt pad. Narrowed shoes must be avoided, limiting the impaction of the distal phalanx and toenail into the ground. A custom-made silicone orthosis applied at the second digit metatarsophalangeal (MTP) joint in a hammer or claw toe seems to reduce mean peak plantar pressure in the rigid stage of deformity but not the flexible one. A metatarsal pad placed 6.5mm proximal to the second metatarsal head was demonstrated to diminish peak pressures by 33%, and a 12.5-mm insole further reduced peak metatarsal head pressures by 23% compared with a 2.5-mm insole. The best comfort of orthoses seems to be given by treating metatarsalgia resulting from deformities such as MTP joint instability, mallet, and claw toe. Little orthotic relevance is given to deformities such as hammer toes. Although the most significant obstacle appears to be the psychological aspect of patients, who must accept the placement of compensatory orthoses, some studies show that all these management appear to be often beneficial for the treatment of these disorders. However, none of them are permanent solutions to the deformity and they can be treatment of choice just in advanced stages, in elderly and low functional demand patients.