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Background: Diabetes, a currently threatening disease, has severe consequences for individuals' health conditions. The present study aimed to investigate the factors affecting the changes in the longitudinal outcome of blood sugar using a three-level analysis with the presence of missing data in diabetic patients. Methods: A total of 526 diabetic patients were followed longitudinally selected from the annual data collected from the rural population monitored by Tonekabon health centers in the North of Iran during 2018-2019 from the Iranian Integrated Health System (SIB) database. In analyzing this longitudinal data, the three-level model (level 1: observation (time), level 2: subject, level 3: health center) was carried out with multiple imputations of possible missing values in longitudinal data. Results: Results of fitting the three-level model indicated that every unit of change in the body mass index (BMI) significantly increased the fasting blood sugar by an average of 0.5 mg/dl (p=0.024). The impact of level 1 (observations) was insignificant in the three-level model. Still, the random effect of level 3 (healthcare centers) showed a highly significant measure for health centers (14.62, p<0.001). Conclusion: The BMI reduction, the healthcare centers' socioeconomic status, and the health services provided have potential effects in controlling diabetes. [ABSTRACT FROM AUTHOR]

Background: Tumor necrosis factor alpha (TNF-α) produces an inflammatory process and plays a critical role against infection and in the control of viral infection. The present study was conducted to determine the status of serum TNF-α in hospitalized patients with coronavirus disease-2019 (COVID-19). Methods: In this cross-sectional study the serum TNF-α level, sex, and age, were determined in patients with COVID-19. The association between variables was determined using the student t-test, analysis of variance (ANOVA) test, multiple logistic regression analysis, and the statistical package for the Social Sciences (SPSS)- 18 (p < 0.05). Results: A total of 91 (women 41.75%, and men 58.24%) patients with a mean serum TNF-α level of 9.9 picograms per milliliter (pg/mL) were considered. In all (100%) patients, the TNF-α serum level was more than the normal limit (P=0.95). 95.60% of patients suffered severe COVID-19, with a TNF-a serum level of 10.20 pg/mL (P=0.87). Mean TNF-α serum levels in women and men were 11.37 pg/mL and 8.8 pg/mL, respectively (P= 0.17). In the age group of > 70 years (11.30 pg/mL), serum TNF-α concentration was higher than the other age groups (p>0.05). Conclusion: A significant proportion of women and men patients with COVID-19 in the middle and old age had a high concentration of serum TNF-α which may indicate the severity of the disease. Serum TNF-α level is different in women and men of different ages, so it can contribute to treatment strategies. [ABSTRACT FROM AUTHOR]

Protein phosphatase 2A (PP2A) is a strongly conserved and major protein phosphatase in all eukaryotes. The canonical PP2A complex consists of a catalytic (C), scaffolding (A), and regulatory (B) subunit. Plants have three groups of evolutionary distinct B subunits: B55, B' (B56), and B". Here, the Arabidopsis B' group is reviewed and compared with other eukaryotes. Members of the B'α/B'β clade are especially important for chromatid cohesion, and dephosphorylation of transcription factors that mediate brassinosteroid (BR) signaling in the nucleus. Other B' subunits interact with proteins at the cell membrane to dampen BR signaling or harness immune responses. The transition from vegetative to reproductive phase is influenced differentially by distinct B' subunits; B'α and B'β being of little importance, whereas others (B'γ, B'ζ, B'η, B'θ, B'κ) promote transition to flowering. Interestingly, the latter B' subunits have three motifs in a conserved manner, i.e., two docking sites for protein phosphatase 1 (PP1), and a POLO consensus phosphorylation site between these motifs. This supports the view that a conserved PP1-PP2A dephosphorelay is important in a variety of signaling contexts throughout eukaryotes. A profound understanding of these regulators may help in designing future crops and understand environmental issues. [ABSTRACT FROM AUTHOR]

Background and Objectives: The utility of anticyclic citrullinated peptide (anti-CCP) antibody in the diagnosis of rheumatoid arthritis (RA) varies across different studies. We determined the diagnostic performance and predictive ability of anti-CCP for RA. Methods : We studied 201 patients with RA and compared them with 208 non-RA patients as controls. RA patients included in the study fulfilled the American College of Rheumatology revised criteria and patients with other diseases as well as those with undifferentiated arthritis (UIA) were used as controls. Anti-CCP was measured by enzyme-linked immunosorbent assay (ELISA) and rheumatoid factor (RF) by the agglutination method. The optimal cutoff value and diagnostic accuracy were determined using receiver operating characteristics (ROC) curve and area under the curve (AUC).The sensitivity and specificity were determined by comparison of RA patients with non-RA controls. Results : The anti-CCP test was positive in 164 patients with RA for a sensitivity of 81.6%, specificity of 87.5%, and overall accuracy of 84.6%. The respective values for RF were 75.6%, 86.5% and 84.4%. The anti-CCP test discriminated RA from non-RA patients with high accuracy (AUC=0.889 [0.017] 95% CI, 0.856-0.952, P=.001), and predicted progression of UIA to RA with moderate accuracy (AUC=0.733 [0.069], 95% CI 0.60-0.87, P< .006) at a sensitivity of 75% and a specificity of 68.1%. Among 60 UIA patients, in 16 (26.7%) who differentiated to RA, the mean (standard deviation) for anti-CCP was significantly higher than in 24 (40%) patients who progressed to non-RA (134.8 [172] vs 46 [86] U/mL, P< .01). Conclusion : These findings indicate that anti-CCP yields higher sensitivity and overall accuracy, but slightly greater specificity than RF for diagnosis of RA. Anti-CCP positivity, particularly a higher level of serum antibody in patients with UIA, may be a predictor of subsequent RA.

Introduction: Depression and anxiety share similar symptoms with rheumatoid arthritis (RA) and these conditions are often not diagnosed or overlooked in RA. This study aimed to determine the prevalence of depression/anxiety in RA and their correlation with RA activity. Material and methods: Rheumatoid arthritis patients who presented at a rheumatology clinic were selected consecutively. The diagnosis of RA was confirmed by the ACR/EULAR criteria, disease activity was assessed by Disease Activity Score based on the 28-joint count (DAS28) and patients with DAS28 > 2.6 were considered to have active RA. The diagnosis of depression and anxiety was made by the Hospital Anxiety and Depression Scale (HADS). The Pearson test was used to determine the correlation between DAS28 and HADS scores. Results: Two-hundred patients (female, 82%) with a mean age of 53.5 ±10.1 years and mean disease duration of 6.6 ±6.8 years were studied. Depression was diagnosed in 27 (13.5%) patients and anxiety in 38 (19%) patients. The DAS28 score correlated positively with depression (r = 0.173, p = 0.014) and anxiety score (r = 0.229, p = 0.001). In multiple logistic regression analysis after adjustment for all covariates, age < 40 years and female sex were independently associated with RA activity in patients with depression, with OR = 4.21 (p = 0.002) and OR = 3.56 (p = 0.028) respectively. Conclusions: These findings indicate that depression and anxiety are prevalent in RA and correlate positively with active disease in particular in depressive female patients aged < 40 years. [ABSTRACT FROM AUTHOR]

Heart valve tissue engineering (HVTE) aims to provide living autologous heart valve implants endowed with regenerative capabilities and life‐long durability. However, fabrication of biomimetic scaffolds capable of providing the required functionality in terms of mechanical performance and tunable porosity to enable cellular infiltration remains a major challenge. Here, the additive manufacturing of bioinspired, spatially heterogeneous, tubular scaffolds enclosing the leaflets, inter‐leaflet triangles, and their interface for in situ HVTE using melt electrowriting (MEW) is demonstrated. The innovative platform enables the digital fabrication of scaffolds with ad hoc architecture (e.g., tunable location, specific fiber pattern, and orientation) and customizable geometry via a custom‐made control software. The user‐friendly interface allows for the definition of areas of the scaffold with specific patterns to obtain properties such as tunable J‐shaped stress–stain curve and anisotropy typical of the heart valve leaflet, compliant inter‐leaflet triangles, and reinforced curvilinear boundary between them. Heterogeneous, tubular, heart valve MEW scaffolds are then embedded with a microporous elastin‐like recombinamer (ELR) hydrogel to develop a soft‐network composite favoring cell infiltration and ensuring hemocompatibility. The acute systolic hemodynamic functionality of the MEW/ELR composite satisfies the ISO 5840 requirements, under aortic and pulmonary conditions. [ABSTRACT FROM AUTHOR]

Background: The predictive power of obesity measures varies according to the presence of coexistent measures. The present study aimed to determine the predictive power of combinations of obesity measures for diabetes by calculation of a linear risk score. Methods: Data from a population-based cross-sectional study of 994 representative samples of Iranian adults in Babol, Iran were analyzed. Measures of obesity including waist circumference (WC), body mass index (BMI), waist--to--height ratio (WHtR), and waist to hip ratio (WHR) were calculated, and diabetes was diagnosed by fasting blood sugar >126 mg/dl or taking antidiabetic medication. Multiple logistic regression model was used to develop a logit risk score based on BMI, WC, WHtR, and WHR. The ROC analysis was applied to determine the priority of every single index and combined logit score for the prediction of diabetes. Results: All four measures of general and abdominal obesity were predictors of diabetes individually in both sexes (P=0.0001). Calculation of risk score for a combination of all measures use full model improved predictive power. Adjustment for age resulted in further improvement in diagnostic power and combined novel risk score differentiated individuals with and without diabetes with an accuracy of 0.747 (95%CI: 0.690-0.808) in men and 0.789 (95%CI: 0.740, 0.837) in women. Conclusion: These findings indicate that the simultaneous calculation of age-adjusted risk score for all measures provides stronger diagnostic accuracy in both sexes. This issue suggests the calculation of combined risk scores for all obesity indices especially in a population at borderline risk. [ABSTRACT FROM AUTHOR]