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The article analyzes the street network of 25 cities of Krasnodar region, reveals the reasons and prerequisites for the classification of cities by the degree of orthogonality of the street network. The article also describes a technique for determining the orthogonality of an urban street network using the python programming language.

The tracers L15N-proline and L(1-13C)-leucine were used to explore the synthesis of skin proteins in vivo in rabbits. They orally received a single dose containing an equimolecular mixture of L(1-13C)-leucine and L15N-proline. The changes in the amounts of these tracers in blood and skin were monitored for a total of 8 h. The data showed the appearance of the two tracers in blood within 15 min and their clearance in 8h. They were both rapidly (15 min) incorporated into skin proteins, but more proline was incorporated than leucine. We therefore consider L15N-proline to be a better tracer than L(1-13C)-leucine for studying protein metabolism in the skin. [ABSTRACT FROM AUTHOR]

Abstract Background The Activity of Daily Living (ADL) is an instrument that screens elderly respondents for physical functioning and assesses whether they are dependent or independent in their daily activities. This study demonstrates a translation procedure and obtains the reliability and validity of a translated, Arabic ADL. Methods The ADL was translated to Arabic through a forward translation method followed by a committee-consensual approach. The ADL and the Arabic Mini-Mental State Examination (AMMSE) were administered to an opportunistic sample of 354 Lebanese elderly living in nursing homes who did not have dementia. Results Reliability split half measures, sensitivity, and negative predictive values were high across all dimensions of the ADL with the exception of feeding. There were non-significant differences on the scored ADL between the three age groups: young age, middle age and older old. In addition, a non-significant difference was found on the scored ADL between the high and low AMMSE scores. Conclusion Overall, the translated ADL was consistent and valid measure for assessing daily activities in elderly nursing home residents. As it is quick and easy to use, the ADL in Arabic could help caregivers and doctors to prescribe appropriate physical exercise for elderly Arabic speaking patients.

Background: The Activity of Daily Living (ADL) is an instrument that screens elderly respondents for physical functioning and assesses whether they are dependent or independent in their daily activities. This study demonstrates a translation procedure and obtains the reliability and validity of a translated, Arabic ADL.Methods: The ADL was translated to Arabic through a forward translation method followed by a committee-consensual approach. The ADL and the Arabic Mini-Mental State Examination (AMMSE) were administered to an opportunistic sample of 354 Lebanese elderly living in nursing homes who did not have dementia.Results: Reliability split half measures, sensitivity, and negative predictive values were high across all dimensions of the ADL with the exception of feeding. There were non-significant differences on the scored ADL between the three age groups: young age, middle age and older old. In addition, a non-significant difference was found on the scored ADL between the high and low AMMSE scores.Conclusion: Overall, the translated ADL was consistent and valid measure for assessing daily activities in elderly nursing home residents. As it is quick and easy to use, the ADL in Arabic could help caregivers and doctors to prescribe appropriate physical exercise for elderly Arabic speaking patients. [ABSTRACT FROM AUTHOR]

Background: Mislabeling is a type of fraud, that can lead to major health concerns, especially when used on staple foods like bread. This study aimed to assess the compliance of nutrition claims on pre-packaged Pita bread in Mount Lebanon with national (LIBNOR; NL 661:2017) and international (CODEX; CAC/GL -2-1985) standards., Methods: A cross-sectional study was conducted and Lebanese bread samples (n = 75) were collected from all the registered bakeries in Mount Lebanon directorate (n = 25). The claim compliance assessment was based on values of the nutrition facts panel and standard nutrient analyses, following official methods., Results: Of all assessed breads, 84% carried nutrition claims, and 25.3% carried health claims. Among nutrition claims, 70.7% had non-addition claims, 56.0% had nutrient content claims, and 1.3% had comparative claims. The results showed a high prevalence of nutrition claims with majority non-compliant. Based on the nutrition facts panel, only 32.4% of the sugar related claims, 45.5% of the fiber claims, and 54.4% of salt claims were eligible to make those statements. Based on the chemical nutrient analyses, only 47.0% of sugar claims, 16.1% of fiber claims, and 37.5% of salt claims were compliant. All the claims related to protein (n = 7) were compliant., Conclusions: These results suggest the urgent need to develop clear guidelines for the effective implementation of the current standard; in order to prevent mislead consumers from making poor decisions at the point-of-sale, which might affect their overall health and efforts towards proper nutrition., (© 2022. The Author(s).)

Fluoride is one of the most abundant elements found in nature. Water is the major dietary source of fluoride. The only known association with low fluoride intake is the risk of dental caries. Initially, fluoride was considered beneficial when given systemically during tooth development, but later research has shown the importance and the advantages of its topical effects in the prevention or treatment of dental caries and tooth decay. Water fluoridation was once heralded as one of the best public health achievements in the twentieth century. Since this practice is not feasible or cost effective in many regions, especially rural areas, researchers and policy makers have explored other methods of introducing fluoride to the general population such as adding fluoride to milk and table salt. Lately, major concerns about excessive fluoride intake and related toxicity were raised worldwide, leading several countries to ban fluoridation. Health-care professionals and the public need guidance regarding the debate around fluoridation. This paper reviews the different aspects of fluoridation, their effectiveness in dental caries prevention and their risks. It was performed in the PubMed and the Google Scholar databases in January 2018 without limitation as to the publication period., Competing Interests: AUTHOR DISCLOSURE STATEMENT The authors declare no conflict of interest.

Background: Cardiac arrhythmias and sudden cardiac death are more frequent in patients with obstructive sleep apnea (OSA). OSA is associated with QT prolongation, and QT prolongation is an independent risk factor for sudden cardiac death. Because QT prolongation can be mediated by potassium channel loss of function, we tested whether OSA or continuous positive airway pressure therapy altered mRNA expression of circulating white blood cell potassium channels., Methods and Results: In total, 28 patients with OSA newly diagnosed by polysomnogram and 6 participants without OSA were enrolled. Potassium channel levels in white blood cells at baseline and at a 4-week follow-up visit were compared. There was a significant inverse correlation between the severity of the OSA stratified by apnea-hypopnea index and mRNA expression of the main potassium channels assessed: KCNQ1 (r=-0.486, P=0.007), KCNH2 (r=-0.437, P=0.016), KCNE1 (r=-0.567, P=0.001), KCNJ2 (r=-0.442, P=0.015), and KCNA5 (r=-0.468, P=0.009). In addition, KCNQ1, KCNH2, and KCNE1 inversely correlated with the oxygen desaturation index 4. After 4 weeks of continuous positive airway pressure therapy, circulating KCNQ1 and KCNJ2 were increased 1.4±0.4-fold (P=0.040) and 2.1±1.4-fold (P=0.046) in the moderate OSA group. Compared with patients with mild or moderate OSA, patients with severe OSA had a persistently higher apnea-hypopnea index (mild 2.0±1.8, moderate 1.0±0.9, severe 5.8±5.6; P=0.015), perhaps explaining why the potassium channel changes were not seen in the severe OSA group., Conclusions: The mRNA expression of most potassium channels inversely correlates with the severity of OSA and hypoxemia. Continuous positive airway pressure therapy improves circulating KCNQ1 and KCNJ2 in patients with moderate OSA., (© 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.)

IN BRIEF Obstructive sleep apnea (OSA) alters glucose metabolism, promotes insulin resistance, and is associated with development of type 2 diabetes. Obesity is a key moderator of the effect of OSA on type 2 diabetes. However, chronic exposure to intermittent hypoxia and other pathophysiological effects of OSA affect glucose metabolism directly, and treatment of OSA can improve glucose homeostasis.

Onychodystrophy is the temporary or permanent change in the nail structures. It can be secondary to an inflammatory condition or infectious disease, however many cases of onychodystrophy are idiopathic in nature. In secondary onychodystrophy the treatment is directed towards the underlying process, with subsequent improvement in the appearance of the affected nails depending on the etiology. Dystrophy secondary to onychomycosis is particularly difficult to treat. In permanent idiopathic nail dystrophy, treatment is often unsatisfactory. Destructive nail changes are not only cosmetically displeasing, but also at times physically painful and socially embarrassing. The literature on the treatment of purely idiopathic nail dystrophy is extremely scarce. To our knowledge there exists only one report of two cases of idiopathic onychodystrophy successfully treated with fractional carbon dioxide laser and topical corticosteroids. In this report, we present the first cases of idiopathic onychodystrophy successfully treated with a 1064 nm neodymium-doped yttrium aluminum garnet laser.

Aim: To assess if certain triaging rules could be established to optimize the yield of mesenteric angiography., Methods: Medical records of 101 patients were retrospectively reviewed and parameters relating to age, gender, pulse rate, blood pressure, serum hemoglobin, intensive care unit (ICU) admission, and the number of packed red blood cells (PRBC) transfused in the 12 and 24 h prior to the angiography were tabulated in two groups with positive and negative angiography results., Results: We found no correlation between gender, pulse rate, blood pressure or serum hemoglobin and positivity of the mesenteric angiogram. But patients with positive angiogram were found to be on average 7 years older (73.2 years vs 65.9 years old) (P = 0.02). Angiogram was positive in 39.3 % (11/28) of patients admitted in ICU vs 23.2% (17/73) who were admitted elsewhere in the hospital (P = 0.03). In the 12 and 24 h prior to angiography, patients with a positive angiogram received a mean of 2.7 ± 2.3 and 3.3 ± 2.6 units of PRBC s respectively, while patients with a negative angiogram had a mean of 1.6 ± 1.9 (P = 0.02) and 2.1 ± 2.6 units (P = 0.04) received respectively in the same period., Conclusion: Older age, ICU admission, having received at least 4 units PRBC over 12 h or 5 units over 24 h prior to angiogram are leading indicators for a positive study.

Background: Yellow nail syndrome (YNS) is a rare clinical entity of unknown etiology that is characterized by a triad of yellow nails, respiratory manifestations, and lymphedema. The condition appears in the mid- to later years of life and only rarely in childhood. We describe a rare case of YNS with an atypical clinical presentation consisting of only yellow and dystrophic nails in a 2-year-old female since birth., Objective: A case of congenital YNS with only dystrophic and yellow nails is reported., Methods and Results: A 2-year-old female presented with yellow nails since birth. There was no positive family history. Physical examination revealed 20 thickened, dystrophic, yellow nails with onycholysis. There was no evidence of respiratory manifestations or lymphedema., Conclusion: Although rare, YNS can present as a congenital clinical entity and persist after birth. Pediatric patients with YNS show different clinical manifestations than the classic adult patient. The presence of yellow and dystrophic nails in the absence of respiratory and lymphatic manifestations may be the only sign of pathology and warrants close monitoring as progression to more serious complications can occur.

Background: A punch biopsy is a common therapeutic and diagnostic procedure that is routinely performed by dermatologists. A thin cylinder of tissue is removed with a biopsy punch, which creates a full-thickness wound. Sutures are used for primary closure as part of standard practice and are removed in follow-up 5 to 14 days later. The biopsy site heals with a small linear scar. In the past, punch biopsies were often left to heal by secondary intention, but given the extended healing time, this has fallen out of practice among dermatologists., Objective: The purpose of this case report is to introduce a new quick and cost-effective approach to accelerate secondary intention healing following punch biopsies in busy dermatology clinics., Results/conclusion: We present a case where Dynaclose tape (Canica Design Inc, Almonte, ON) was used as an alternative to sutures for biopsy site closure. Dynaclose tape is a strip with adhesive ends and a clear center composed of silicone elastomer. The silicone elastomer promotes wound closure by pulling the opposing margins together. The tape maintains excellent adhesion and follows the natural shape of the skin to maximize patient comfort and mobility.

Background: Dimethyl fumarate has been successfully used in the treatment of psoriasis in the past. Despite its clinical use, cutaneous contact with this molecule may cause contact dermatitis., Objective: We report a case in which skin exposure to a synthetic fabric sofa containing dimethyl fumarate made by a Chinese furniture manufacturer resulted in a severe, pruritic, papulovesicular, eczematous dermatitis to the sites of contact with the sofa., Methods: The patient was patch-tested with serial dilutions of dimethyl fumarate., Results: Patch testing results revealed strong positive reactions to dimethyl fumarate at different concentrations., Conclusion: Dimethyl fumarate is a potent contact sensitizer and is commonly found in sachets inside furniture and footwear boxes.

Background: Patch testing is routinely used in contact dermatitis clinics because it is the gold standard for the evaluation of potential allergic contact dermatitis., Objective: The study was undertaken to evaluate possible differences in reactivity between the Finn Chamber and IQ-Ultra patch-testing methodologies., Methods: Patients were patch-tested simultaneously with the Finn Chamber and IQ-Ultra patch tests. Ten standard allergens set by the North American Contact Dermatitis Group were used for both techniques., Results: Both patch tests had a significant agreement in detecting all of the allergens. An "almost perfect agreement" was noted for ethylenediamine dihydrochloride, quaternium-15, mercapto mix, black rubber mix, balsam of Peru, and nickel sulfate; "substantial agreement" for formaldehyde, bisphenol A epoxy resin, and 4-tert-butylphenol formaldehyde resin; and "moderate agreement" for potassium dichromate., Conclusion: The Finn Chamber and IQ-Ultra patch tests had a good agreement in the detection of the 10 standard allergens that were tested.

Purpose: The purpose of this study is to establish a set of measurable criteria for elderly nursing homes (ENHs) in Lebanon. Donabedian's model known by structure/process/outcome was used as the driving conceptual framework for the study., Design/methodology/approach: The study reports on a panel discussion where administrators, caregivers and specialists, separately established and exchanged key information on best practice approach. The work was carried out in the summer of 2008, using the consensus panel method. A group of expert opinions (Dalkey) made up of elderly home administrators and caregivers, policy makers, and academics discussed specific key issues related to elderly health and quality of life., Findings: A total of 40 criteria were retained along seven main dimensions: types of elderly homes; funding; health services; boarding services; activities; structures; and elderly rights., Research Limitations/implications: A major limitation in this study is that elderly were not part of the consensus making process. Thus, including elderly in the process would have substantiated and added validity to the established criteria., Practical Implications: The criteria developed in this study can be turned into key performance standards for elderly homes in Lebanon, other Mediterranean and Arab countries. These criteria would greatly benefit elderly homes if validated and used as guidelines for quality care., Originality/value: The study is original in the sense that it seeks to establish measures for criteria, a blueprint, and benchmarks for ENH standards.

Members of the low-density lipoprotein receptor-related protein (LRP) family are involved in metabolic stress and resistance phenotypes of cancer cells. New breakthroughs in brain cancer therapy have exploited that molecular signature and proved that efficient delivery of therapeutic agents involve LRP-mediated mechanisms. We performed gene expression profiling of CD133, a cell surface cancer stem cell marker, and of LRP in response to in vitro nutrient deprivation. We found that CD133 was selectively induced in serum-starved DAOY medulloblastoma cells but not in U87MG glioblastoma cells. Such CD133 induction was correlated to increases in LRP-1 and LRP-1b gene and protein expression. When a specific CD133(+) DAOY cell population was sorted from parental DAOY, we found increases in LRP-5 and LRP-8. Uptake of alpha(2)-macroglobulin, a specific LRP-1/1b ligand, was increased in serum-starved parental DAOY cells but not in CD133(+) DAOY cells, and receptor-associated protein (RAP), which binds to all cell surface LRPs, was able to compete for that uptake. Conversely, RAP binding was increased in serum-starved parental DAOY but alpha(2)-macroglobulin was unable to compete for such uptake. Strategies aiming at targeting cancer stem cell metabolic adaptative responses, such as that through LRP differential expression within the brain tissue microenvironmental niche, can now be envisioned.

[This corrects the article DOI: 10.1007/s11552-009-9239-y.].

Purpose: The purpose of this paper is to assess quality of life in relation to wellbeing among Lebanese nursing home elderly residents. The study attempts to understand the impact of structures, processes and skills on elderly health status., Design/methodology/approach: In this paper, 220 normally functioning elderly respondents from 33 nursing homes were studied. A quasi-experimental approach measured psychological and health-related factors using the Geriatric Depression Scale, Activity of Daily Living, EuroQol EQ-5D and the Mini-Nutritional Assessment (MNA) instruments., Findings: A relatively high level of mild depression among elderly residents and a lack of mobility were found. Generally, normally functioning elderly residents were well nourished and had moderate daily activity levels., Originality/value: The study is original in the sense that it assesses elderly residents' psychological and physical health status in relation to institutional structures, processes, and skills.

Background: Restorative proctocolectomy with ileal pouch-anal anastomosis is the surgical treatment of choice in patients with ulcerative colitis. Strictures can occur at the inlet and outlet of the pouch. Endoscopic balloon dilation has been successfully used in patients with Crohn's strictures at the small intestine and colon. There are no published trials on endoscopic balloon therapy of ileal pouch strictures., Aim: To evaluate outpatient endoscopic balloon dilation of strictures in ileal pouches., Methods: Patients underwent nonfluoroscopy-guided, nonsedated, outpatient endoscopic dilations with an 8.6-mm upper endoscope and through-the-scope balloons (size: 11-18 mm). Pre- and posttreatment Pouchitis Disease Activity Index symptom scores (range: 0-6), endoscopic stricture scores based on resistance in passing the endoscope (range: 0-4), and Cleveland Global Quality of Life were compared., Results: Nineteen patients with pouch strictures who had concurrent Crohn's disease of the pouch (n = 11), cuffitis (n = 5), and pouchitis (n = 3), including 14 inlet and 14 outlet strictures, were enrolled. The mean number of strictures for each patient was 1.61 +/- 0.78. All strictures were successfully dilated with the through-the-scope balloon, with a mean of 1.74 +/- 1.19 (range: 1-5) sessions for each patient. Nine patients had a second endoscopy at 8 wk and five patients had a third pouch endoscopy at 16 wk after the initial endoscopic dilation. Endoscopic stricture scores immediately (0.30 +/- 0.47), 8 wk (0.40 +/- 0.51), and 16 wk (0.44 +/- 0.76) after the dilation were significantly improved compared to the predilation stricture scores (2.67 +/- 0.78). The symptom scores and quality-of-life (QOL) scores improved at week 8 and 16 following dilation, with a mean follow-up of 6.10 +/- 5.83 months (2-25 months). No complications were experienced with the procedure. One patient with CD who failed endoscopic and medical therapy underwent pouch resection., Conclusion: In conjunction with medical therapy, outpatient endoscopic balloon dilation appears safe and effective in treating pouch inlet and outlet strictures, by relieving symptoms, restoring pouch patency, and improving QOL in the majority of patients.