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We effect the thermodynamical formalism for the non-uniformly hyperbolic $C^{\infty }$ map of the two-dimensional torus known as the Katok map [Katok. Bernoulli diffeomorphisms on surfaces. Ann. of Math. (2) 110 (3) 1979, 529–547]. It is a slow-down of a linear Anosov map near the origin and it is a local (but not small) perturbation. We prove the existence of equilibrium measures for any continuous potential function and obtain uniqueness of equilibrium measures associated to the geometric $t$ -potential $\unicode[STIX]{x1D711}_{t}=-t\log \mid df|_{E^{u}(x)}|$ for any $t\in (t_{0},\infty)$ , $t\neq 1$ , where $E^{u}(x)$ denotes the unstable direction. We show that $t_{0}$ tends to $-\infty$ as the domain of the perturbation shrinks to zero. Finally, we establish exponential decay of correlations as well as the central limit theorem for the equilibrium measures associated to $\unicode[STIX]{x1D711}_{t}$ for all values of $t\in (t_{0},1)$. [ABSTRACT FROM AUTHOR]

Corrosion studies have been carried out on dental amalgams with and without additions of stannous fluoride to the alloy before trituration. Corrosion studies also were carried out with additions of sodium fluoride and stannous fluoride to test solutions. When added to the amalgam, stannous fluoride caused a decided increase in its deterioration. Addition of stannous fluoride to the test solution had no effect on corrosion, whereas addition of sodium fluoride to the solution decidedly increased the corrosion rate. [ABSTRACT FROM AUTHOR]

U.S. veterans have historically experienced more mental health concerns as compared to the general population, yet face a variety of barriers to accessing care. Evidence-based and accessible resources, such as mobile apps, are needed to respond to the unique needs of a diverse veteran population. The U.S. Department of Veterans Affairs (VA's) National Center for Posttraumatic Stress Disorder has created a one-of-a-kind portfolio of mental health apps to target the needs of veterans and support the self-management of common concerns related to posttraumatic stress disorder. Using data from a nationally representative sample of U.S. veterans, the present study sought to examine how veterans perceived the importance of making each self-management app available to other Veterans; factors impacting veterans' intent to try each app; and actual uptake of each app. Results revealed that while 46.7%-75.0% of veterans reported that the apps are important for veterans, 5.8%-19.2% reported that they would be likely to download the apps, and only 5.0% reported having ever used any of them. Veterans who used any of the apps were more likely to be employed, have served two or more deployments, be married or partnered, use the VA as their primary source of health care, had more medical conditions, and were less likely to identify as Black. With respect to future app use, Black veterans were to 2-5 times more likely than White veterans to indicate a desire to download each of the apps. Other variables that showed consistent associations with increased likelihood of app download included greater smartphone utilization, being married or having a partner, lower household income, and history of mental health treatment. Implications of these results for the broader dissemination of mental health apps and promotion of their uptake are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The purpose of this study was to investigate the depth-dependent biomechanical properties of the human corneal stroma under uniaxial tensile loading. Human stroma samples were obtained after the removal of Descemet's membrane in the course of Descemet's membrane endothelial keratoplasty (DMEK) transplantation. Uniaxial tensile tests were performed at three different depths: anterior, central, and posterior on 2 × 6 × 0.15 mm strips taken from the central DMEK graft. The measured force-displacement data were used to calculate stress-strain curves and to derive the tangent modulus. The study showed that mechanical strength decreased significantly with depth. The anterior cornea appeared to be the stiffest, with a stiffness approximately 18% higher than that of the central cornea and approximately 38% higher than that of the posterior layer. Larger variations in mechanical response were observed in the posterior group, probably due to the higher degree of alignment of the collagen fibers in the posterior sections of the cornea. This study contributes to a better understanding of the biomechanical tensile properties of the cornea, which has important implications for the development of new treatment strategies for corneal diseases. Accurate quantification of tensile strength as a function of depth is critical information that is lacking in human corneal biomechanics to develop numerical models and new treatment methods., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: The production of lipid-laden cells in macrophages after significant ingestion of oxidized low-density lipoprotein is considered the most critical phase in the creation of atherosclerotic lesions, which is known as foam cell formation. Targeting foam cell development to find a potential therapeutic strategy for the management of atherosclerosis has yielded numerous promising outcomes. Multiple variables influence foam cell growth, including scavenger receptor expression, cholesterol transporter expression acyl CoA: cholesterol acyltransferase activity, and neutral cholesteryl ester hydrolase activity. Plants used during herbal therapy have been shown to assist with a variety of ailments., Result: In this study, we found medicinal plants and their bioactive components suppress foam cell formation in a variety of ways; some inhibit cholesterol transporter and lectin-like oxidized low-density lipoprotein receptor-1 upregulation, while others inhibit the function of acyl CoA: cholesterol acyltransferase activity, and neutral cholesteryl ester hydrolase activity., Conclusion: Recent study findings related to the synthesis of the new active component from plant sources by focusing on the typical process involved in the generation of foam cells. We're also looking at using a cellular target-based therapeutic approach to generate novel plant-based medications for the cure of atherosclerosis., (© 2021. The Author(s), under exclusive licence to Springer Nature B.V.)

Background: Identification of women with DCIS who have a very low risk of local recurrence risk (LRR) after breast-conserving surgery (BCS) is needed to de-escalate therapy. We evaluated the impact of 10-year LRR estimates after BCS, calculated by the integration of a 12-gene molecular expression assay (Oncotype Breast DCIS Score ® ) and clinicopathological features (CPFs), on its ability to change radiation oncologists' recommendations for RT after BCS for DCIS., Methods: Prospective cohort study of women with DCIS treated with BCS. Eligibility criteria were as follows: age > 45 years, tumor ≤ 2.5 cm, and margins ≥ 1 mm. Radiation oncologists provided 10-year LRR estimates without RT and recommendation for RT pre- and post-assay. Primary outcome was change in RT recommendation., Results: 217 patients were evaluable, with mean age = 63 years, mean tumor size = 1.1 cm, and mean DCIS Score = 32; 140 (64%) were in the low-risk (<39), 32 (15%) were in the intermediate-risk (39-54), and 45 (21%) were in the high-risk groups (≥55). The assay led to a change in treatment recommendation in 76 (35.2%) (95%CI 29.1-41.8%) patients. RT recommendations decreased from 79% pre-assay to 50% post-assay (difference = 29%; 95%CI 22-35%) due to a significant increase in the proportion of patients with a predicted low LRR (< 10%) post-assay and recommendations to omit RT for those with a low predicted risk. The assay was associated with improved patient satisfaction and reduced decisional conflict., Conclusion: The DCIS Score assay combined with CPFs identified more women with an estimated low (<10%) 10-yr LR risk after BCS, leading to a significant decrease in recommendations for RT compared to estimates based on CPFs alone.

Background: Higher life expectancy in the general population entails a growing interest in the surgical management of diseases affecting elderly patients. Preoperative assessment when planning surgery needs to carefully evaluate physical and functional status of the patient. This review aims to describe the most commonly used scales in the evaluation of elderly patients scheduled for surgery and provides a useful tool to decide the scales that would be better to assess these specific patients., Methods: According to the PRISMA statement of publications published, we have carried out a systematic review focused on elderly patients who underwent surgical procedures in General and Surgery. Using Medline, Embase, and Cochrane library, a systematic search of the literature from 1992 to 2018 was performed. This enabled us to retrieve information from the selected articles on scales to evaluate medical fitness, functional status, or both, in the elderly or frail patients., Results: We reviewed 102 articles and selected the most frequently used assessment scales or indexes. After this extensive analysis, we selected 4 functional scales (Katz Index, Barthel Scale, Karnofsky Performance Score, and Vulnerable Elders Survey), 4 clinical scales (American Society of Anaesthesiologists Index, Charlson Comorbidity Index, Pfeiffer Test, and Physiological and Operative Severity Score for the enumeration of Mortality and Morbidity Scale) and finally, 2 mixed scales (American College of Surgeons National Surgical Quality Improvement Program Surgical Risk Calculator and Edmonton Frail Scale)., Conclusions: No consensus on the use of a unified assessment scale for elderly patients exists. However, with this review, we provide a brief guideline about the most useful and used scales to perform a comprehensive assessment of geriatric patients undergoing surgery., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Studies of caregivers of orphans and vulnerable children (OVC) rarely examine the role religion plays in their lives. We conducted qualitative interviews of 69 caregivers in four countries: Ethiopia, Kenya, Cambodia, and India (Hyderabad and Nagaland), and across four religious traditions: Christian (Orthodox, Roman Catholic, and Protestant), Muslim, Buddhist, and Hindu. We asked respondents to describe the importance of religion for their becoming a caregiver, the way in which religion has helped them make sense of why children are orphans, and how religion helps them face the challenges of their occupation. Using qualitative descriptive analysis, three major themes emerged. Respondents discussed how religion provided a strong motivation for their work, reported that religious institutions were often the way in which they were introduced to caregiving as an occupation, and spoke of the ways religious practices sustain them in their work. They rarely advanced religion as an explanation for why OVC exist-only when pressed did they offer explicitly religious accounts. This study has implications for OVC care, including the importance of engaging religious institutions to support caregivers, the significance of attending to local religious context, and the vital need for research outside of Christian contexts.

Ancient Egyptian human remains have been of interest in the fields of both medical and Egyptological research for decades. However, canopic jar holders for internal organs (liver, lungs, stomach, intestines) of Egyptian mummies appear to be but a very occasional source of data for such investigations. The few medical approaches focusing on the content of these jars are summarized and listed according to pathogens and diseases to give a structured overview of this field of study. An extensive search of the literature has been conducted from different bibliographic databases with a total of n = 26 studies found. The majority of diseases found consisted of infectious diseases and internal medicine conditions such as schistosomiasis or emphysema. These are just 2 examples of many that, instead of primarily affecting bone, muscle or skin, specifically target internal organs. Hence, a better understanding of the evolution of diseases that still affect mankind could be gained. In conclusion, this reassessment shows that canopic jars represent a highly underestimated source for histological, radiological and ancient DNA examination of Ancient Egyptian remains and should, thus, be more and more brought back into the focus of retrospective medical research., (© 2018 S. Karger AG, Basel.)

Objectives: This prospective, cross-sectional study sought to determine an association between the level of long-term physical activity as well as other clinical and angiographic variables and an index of collateral flow to the vascular region undergoing percutaneous transluminal coronary angioplasty (PTCA)., Background: There is limited and conflicting information about the effect of physical exercise on the coronary collateral circulation in humans, partly because previous studies lacked a quantitative means of assessing collateral channels., Methods: In 79 patients (mean [+/-SD] age 58 +/- 10 years) with coronary artery disease undergoing PTCA (no transmural myocardial infarction), a coronary collateral flow index was determined as the ratio between the intracoronary (IC) distal flow velocity time integral during (Vi(occl)[cm]) and after (Vi(occl) [cm]) PTCA of the stenosis. Vi(occl)/Vi(occl) was measured by a 0.014-in. Doppler guide wire, from which an IC electrocardiogram (ECG) was also recorded. Patients without ECG ST-T wave changes during PTCA were considered to have sufficient collateral channels (n = 29); those with ST-T wave changes were considered to have insufficient collateral channels (n = 50). The level of long-term physical activity was determined by a structured interview (score from 1 to 4). Univariate and multivariate analyses were used to find associations between physical activity as well as 30 other clinical and angiographic variables and the collateral flow index., Results: Long-term physical activity during leisure time, but not during work hours, and the severity of the stenosis undergoing PTCA were found to be independently and directly associated with sufficient versus insufficient collateral channels and with Vi(occl) Vi(occl) (leisure time physical activity [LTPA] score 3.3 +/- 0.9 vs. 2.4 +/- 1.0, p = 0.0002; percent diameter stenosis 88 +/- 12% vs. 80 +/- 14%, p = 0.001; Vi(occl)/Vi(occl) = 0.1 +/- 0.1 LTPA score, p = 0.0002 for trend)., Conclusions: In patients with coronary artery disease, the level of long-term physical activity during leisure time and the severity of the stenosis undergoing PTCA are directly associated with the quantitative degree of collateral flow.

Case reports of three patients with idiopathic Addison's disease combined with other associated autoimmune endocrine and non-endocrine disorders are presented. In the first patient, a young man with a long-standing history of mucocutaneous candidiasis, latent Addison's disease was discovered by diagnostic screening tests. In the two other patients, women aged 39 and 20 respectively, overt Addison's disease combined with primary hypothyroidism was diagnosed. One of them also had a pre-existing ovarian failure. The polyglandular autoimmune syndromes with Addison's disease are classified into two different subtypes, on the basis of characteristic patterns of disease combinations and on different modes of inheritance. Patients with autoimmune Addison's disease are at relatively high risk for other endocrine disorders or non-endocrine autoimmune diseases. Therefore, these patients--and in some instances also their relatives--need lifelong supervision and advice to ensure timely recognition of any associated diseases.