The multimodality cell segmentation challenge: toward universal solutions.

Cell segmentation is a critical step for quantitative single-cell analysis in microscopy images. Existing cell segmentation methods are often tailored to specific modalities or require manual interventions to specify hyper-parameters in different experimental settings. Here, we present a multimodality cell segmentation benchmark, comprising more than 1,500 labeled images derived from more than 50 diverse biological experiments. The top participants developed a Transformer-based deep-learning algorithm that not only exceeds existing methods but can also be applied to diverse microscopy images across imaging platforms and tissue types without manual parameter adjustments. This benchmark and the improved algorithm offer promising avenues for more accurate and versatile cell analysis in microscopy imaging.

Differential requirements for P stalk components in activating yeast protein kinase Gcn2 by stalled ribosomes during stress.

The General Amino Acid Control is a conserved response to amino acid starvation involving activation of protein kinase Gcn2, which phosphorylates eukaryotic initiation factor 2 (eIF2α) with attendant inhibition of global protein synthesis and increased translation of yeast transcriptional activator GCN4. Gcn2 can be activated by either amino acid starvation or conditions that stall elongating ribosomes without reducing aminoacylation of tRNA, but it is unclear whether distinct molecular mechanisms operate in these two circumstances. We identified three regimes that activate Gcn2 in yeast cells by starvation-independent (SI) ribosome-stalling: treatment with tigecycline, eliminating the sole gene encoding tRNAArgUCC, and depletion of translation termination factor eRF1. We further demonstrated requirements for the tRNA- and ribosome-binding domains of Gcn2, the positive effector proteins Gcn1/Gcn20, and the tethering of at least one of two distinct P1/P2 heterodimers to the uL10 subunit of the ribosomal P stalk, for detectable activation by SI-ribosome stalling. Remarkably, no tethered P1/P2 proteins were required for strong Gcn2 activation elicited by starvation for histidine or branched-chain amino acids isoleucine/valine. These results indicate that Gcn2 activation has different requirements for the P stalk depending on how ribosomes are stalled. We propose that accumulation of deacylated tRNAs in amino acid-starved cells can functionally substitute for the P stalk in binding to the histidyl-tRNA synthetase-like domain of Gcn2 for eIF2α kinase activation by ribosomes stalled with A sites devoid of the eEF1A∙GTP∙aminoacyl-tRNA ternary complex.

Self-Sustaining Triboelectric Nanosensors for Real-Time Urine Analysis in Smart Toilets.

Healthcare has undergone a revolutionary shift with the advent of smart technologies, and smart toilets (STs) are among the innovative inventions offering non-invasive continuous health monitoring. The present technical challenges toward this development include limited sensitivity of integrated sensors, poor stability, slow response and the requirement external energy supply alongside manual sample collection. In this article, triboelectric nanosensor array (TENSA) is introduced featuring electrodes crafted from laser-induced 3D graphene with functional polymers like polystyrene, polyimide, and polycaprolactone for real-time urine analysis while generating 50 volts output via urine droplet-based triboelectrification. Though modulating interfacial double-layer capacitance, these sensors exhibit exceptional sensitivity and selectivity in detecting a broad spectrum of urinary biomarkers, including ions, glucose, and urea with a classification precision of 95% and concentration identification accuracy of up to 0.97 (R2), supported by artificial neural networks. Upon exposure to urine samples containing elevated levels of Na+, K+, and NH4 +, a notable decrease (ranging from 32% to 68%) is observed in output voltages. Conversely, urea induces an increase up to 13%. Experimental validation confirms the stability, robustness, reliability, and reproducibility of TENSA, representing a significant advancement in healthcare technology, offering the potential for improved disease management and prevention strategies.

Thickness-Dependent Charge Transport in Three Dimensional Ru(II)- Tris(phenanthroline)-Based Molecular Assemblies.

We describe here the fabrication of large-area molecular junctions with a configuration of ITO/[Ru(Phen)3]/Al to understand temperature- and thickness-dependent charge transport phenomena. Thanks to the electrochemical technique, thin layers of electroactive ruthenium(II)-tris(phenanthroline) [Ru(Phen)3] with thicknesses of 4-16 nm are covalently grown on sputtering-deposited patterned ITO electrodes. The bias-induced molecular junctions exhibit symmetric current-voltage (j-V) curves, demonstrating highly efficient long-range charge transport and weak attenuation with increased molecular film thickness (ß = 0.70 to 0.79 nm-1). Such a lower ß value is attributed to the accessibility of Ru(Phen)3 molecular conduction channels to Fermi levels of both the electrodes and a strong electronic coupling at ITO-molecules interfaces. The thinner junctions (d = 3.9 nm) follow charge transport via resonant tunneling, while the thicker junctions (d = 10-16 nm) follow thermally activated (activation energy, Ea ∼ 43 meV) Poole-Frenkel charge conduction, showing a clear "molecular signature" in the nanometric junctions.

The Use of Hyaluronidase in Aesthetic Practice: A Comparative Study of Practitioner Usage in Elective and Emergency Situations.

BACKGROUND: Hyaluronic acids (HAs) continue to be the fillers of choice worldwide and their popularity is growing. Adverse events (AEs) are able to be resolved through the use of hyaluronidase (HYAL). However, routine HYAL use has been at issue due to perceived safety issues. OBJECTIVES: There are currently no guidelines on the use of HYAL in aesthetic practice, leading to variability in storage, preparation, skin testing, and beliefs concerning AEs. This manuscript interrogated the use of this agent in daily practice. METHODS: A 39-question survey concerning HYAL practice was completed by 264 healthcare practitioners: 244 from interrogated databases and 20 from the consensus panel. Answers from those in the database were compared to those of the consensus panel. RESULTS: Compared to the database group, the consensus group was more confident in the preparation of HYAL, kept reconstituted HYAL for longer, and was less likely to skin test for HYAL sensitivity and more likely to treat with HYAL in an emergency, even in those with a wasp or bee sting anaphylactic history. Ninety-two percent of all respondents had never observed an acute reaction to HYAL. Just over 1% of respondents had ever observed anaphylaxis. Five percent of practitioners reported longer-term adverse effects, including 3 respondents who reported loss of deep tissues. Consent before injecting HA for the possible requirement of HYAL was always obtained by 74% of practitioners. CONCLUSIONS: Hyaluronidase would appear to be an essential agent for anyone injecting hyaluronic acid filler. However, there is an absence of evidence-based recommendations with respect to the concentration, dosing, and treatment intervals of HYAL, and these should ideally be available.

Integrated single-cell transcriptome analysis of CD34 + enriched leukemic stem cells revealed intra- and inter-patient transcriptional heterogeneity in pediatric acute myeloid leukemia.

To gain insights into the idiosyncrasies of CD34 + enriched leukemic stem cells, we investigated the nature and extent of transcriptional heterogeneity by single-cell sequencing in pediatric AML. Whole transcriptome analysis of 28,029 AML single cells was performed using the nanowell cartridge-based barcoding technology. Integrated transcriptional analysis identified unique leukemic stem cell clusters of each patient and intra-patient heterogeneity was revealed by multiple LSC-enriched clusters differing in their cell cycle processes and BCL2 expression. All LSC-enriched clusters exhibited gene expression profile of dormancy and self-renewal. Upregulation of genes involved in non-coding RNA processing and ribonucleoprotein assembly were observed in LSC-enriched clusters relative to HSC. The genes involved in regulation of apoptotic processes, response to cytokine stimulus, and negative regulation of transcription were upregulated in LSC-enriched clusters as compared to the blasts. Validation of top altered genes in LSC-enriched clusters confirmed upregulation of TCF7L2, JUP, ARHGAP25, LPAR6, and PRDX1 genes, and serine/threonine kinases (STK24, STK26). Upregulation of LPAR6 showed trend towards MRD positive status (Odds ratio = 0.126; 95% CI = 0.0144-1.10; p = 0.067) and increased expression of STK26 significantly correlated with higher RFS (HR = 0.231; 95% CI = 0.0506-1.052; p = 0.04). Our findings addressed the inter- and intra-patient diversity within AML LSC and potential signaling and chemoresistance-associated targets that warrant investigation in larger cohort that may guide precision medicine in the near future.

Spin-dependent electrified protein interfaces for probing the CISS effect.

Bio-spinterfaces present numerous opportunities to study spintronics across the biomolecules attached to (ferro)magnetic electrodes. While it offers various exciting phenomena to investigate, it is simultaneously challenging to make stable bio-spinterfaces as biomolecules are sensitive to many factors that it encounters during thin-film growth to device fabrication. The chirality-induced spin-selectivity effect is an exciting discovery, demonstrating an understanding that a specific electron's spin (either up or down) passes through a chiral molecule. The present work utilizes Ustilago maydis Rvb2 protein, an ATP-dependent DNA helicase (also known as Reptin), to fabricate bio-spintronic devices to investigate spin-selective electron transport through the protein. Ferromagnetic materials are well-known for exhibiting spin-polarization, which many chiral and biomolecules can mimic. We report herein spin-selective electron transmission through Rvb2 that exhibits 30% spin polarization at a low bias (+0.5 V) in a device configuration, Ni/Rvb2 protein/indium tin oxide measured under two different magnetic configurations. Our findings demonstrate that biomolecules can be put in circuit components without any expensive vacuum deposition for the top contact. The present study holds a remarkable potential to advance spin-selective electron transport in other biomolecules, such as proteins and peptides, for biomedical applications.

Trends of humoral immune responses to heterologous antigenic exposure due to vaccination & omicron SARS-CoV-2 infection: Implications for boosting.

Background & objectives: Vaccination and natural infection can both augment the immune responses against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), but how omicron infection has affected the vaccine-induced and hybrid immunity is not well studied in Indian population. The present study was aimed to assess the durability and change in responses of humoral immunity with age, prior natural infection, vaccine type and duration with a minimum gap of six months post-two doses with either ChAdOx1 nCov-19 or BBV152 prior- and post-emergence of the omicron variant. Methods: A total of 1300 participants were included in this observational study between November 2021 and May 2022. Participants had completed at least six months after vaccination (2 doses) with either ChAdOx1 nCoV-19 or an inactivated whole virus vaccine BBV152. They were grouped according to their age (≤ or ≥60 yr) and prior exposure of SARS-CoV-2 infection. Five hundred and sixteen of these participants were followed up after emergence of the Omicron variant. The main outcome was durability and augmentation of the humoral immune response as determined by anti-receptor-binding domain (RBD) immunoglobulin G (IgG) concentrations, anti-nucleocapsid antibodies and anti-omicron RBD antibodies. Live virus neutralization assay was conducted for neutralizing antibodies against four variants - ancestral, delta and omicron and omicron sublineage BA.5. Results: Before the omicron surge, serum anti-RBD IgG antibodies were detected in 87 per cent participants after a median gap of eight months from the second vaccine dose, with a median titre of 114 [interquartile range (IQR) 32, 302] BAU/ml. The levels increased to 594 (252, 1230) BAU/ml post-omicron surge (P<0.001) with 97 per cent participants having detectable antibodies, although only 40 had symptomatic infection during the omicron surge irrespective of vaccine type and previous history of infection. Those with prior natural infection and vaccination had higher anti-RBD IgG titre at baseline, which increased further [352 (IQR 131, 869) to 816 (IQR 383, 2001) BAU/ml] (P<0.001). The antibody levels remained elevated after a mean time gap of 10 months, although there was a decline of 41 per cent. The geometric mean titre was 452.54, 172.80, 83.1 and 76.99 against the ancestral, delta, omicron and omicron BA.5 variants in the live virus neutralization assay. Interpretation & conclusions: Anti-RBD IgG antibodies were detected in 85 per cent of participants after a median gap of eight months following the second vaccine dose. Omicron infection probably resulted in a substantial proportion of asymptomatic infection in the first four months in our study population and boosted the vaccine-induced humoral immune response, which declined but still remained durable over 10 months.

Epidemiology and Burden of Astigmatism: A Systematic Literature Review.

SIGNIFICANCE: This is the first literature review to report the epidemiology, patient burden, and economic burden of astigmatism in the general adult population. The unmet needs of astigmatism patients with coexisting ocular conditions (cataract, glaucoma, dry eye, presbyopia, or macular degeneration) and risks associated with untreated astigmatism are also reviewed and reported. PURPOSE: This study aimed to identify, report, and summarize the published literature on epidemiology, patient burden, and economic burden of astigmatism using a systematic literature review. METHODS: MEDLINE, EMBASE, and Cochrane Library databases were searched (January 1996 to May 2021). Search results were limited to the English language. Proceedings (2018 to 2021) from ophthalmology congresses were searched along with gray literature using the Google Scholar platform. RESULTS: The literature search yielded 6804 citations, of which 125 met the inclusion criteria (epidemiology, 68; patient burden, 60; economic burden, 6). Astigmatism prevalence in the general population varied from 8 to 62%, with higher rates in individuals 70 years or older. The prevalence of with-the-rule astigmatism was higher in individuals 40 years or younger, whereas rates of against-the-rule and oblique astigmatism increased with age. Astigmatic patients experienced decreased vision quality, increased glare (53 to 77%), haloes (28 to 80%), night-time driving difficulties (66%), falls, and spectacle dependence (45 to 85%). Astigmatic patients performed vision-related tasks slower (1 D, 9% slower; 2 D, 29% slower) and made more errors (1 D, 38% more errors; 2 D, 370% more errors) compared with fully corrected individuals. In cataract patients with astigmatism, the annual mean per-patient productivity loss costs ranged from €55 ($71) to €84 ($108), and mean informal care costs ranged from €30 ($39) to €55 ($71) with a mean of 2.3 to 4.1 hours spent on informal care. CONCLUSIONS: Uncorrected astigmatism decreases patients' vision-related quality of life, decreases productivity among working-age adults, and poses an economic burden on patients and their families.

A Study on Vitamin B12 Levels in Hypothyroid Patients Presenting to a Tertiary Care Teaching Hospital.

INTRODUCTION: Prevalence of vitamin B12 deficiency is occasionally found to be coexisting in patients with hypothyroidism causing persistence of symptoms concomitant to both diseases even on adequate thyroxine supplementation. MATERIALS: A single-centric non-interventional cross sectional study was carried over a period of 1 year. 100 hypothyroid patients were evaluated for prevalence of anemia, and investigated for the etiology. Serum Vitamin B12 was obtained and an association was studied between Vitamin B12 and anti TPO and anti Thyroglobulin antibodies. Here, vitamin B12 deficiency was defined as <160 pg/mL. RESULT: Among 100 hypothyroid patients, 31% were males and 69% were females. The mean age of patients was 36.09±12.864 years. 68% patients were found to be Vitamin B12 deficient, and 73.5% of this deficient population were females. 78.6% patients with raised Anti TPO antibodies had vitamin B12 deficiency (p-value = 0.01), while 78% patients with raised Anti Thyroglobulin antibodies were vitamin B12 deficient (p-value = 0.07). The Pearson correlation coefficient (r) was -0.302 (p = 0.002) and -0.253 (p = 0.011) between Vitamin B12 anti anti TPO and anti Thyroglobulin antibodies respectively, thus showing a negative correlation between both. CONCLUSION: Thyroid hormones affect erythropoiesis, thus causing anemia in a deficient condition. In iodine sufficient areas, most common cause of hypothyroidism is autoimmune, predisposing individuals to other autoimmune diseases, one being pernicious anemia. In the studied anemic hypothyroid population, Vitamin B12 deficiency was found correlated with raised levels of serum anti-TPO and anti-Thyroglobulin antibodies. Supplementation of B12 may alleviate hypothyroid symptoms, thus making itself a novel addition in the routine hypothyroid prescription. References Aon M, Taha S, Mahfouz K, et al. Vitamin B12 (cobalamin) deficiency in overt and subclinical primary hypothyroidism. Clin Med Insights Endocrinol Diabetes 2022;15:11795514221086634. Ness-Abramof R, Nabriski DA, Shapiro MS, et al. Prevalence and evaluation of B12 deficiency in patients with autoimmune thyroid disease. Am J Med Sci;332(3):119-122.

Chemical Approach Towards Broadband Spintronics on Nanoscale Pyrene Films.

The injection of pure spin current into the non-magnetic layer plays a crucial role in transmitting, processing, and storing data information in the realm of spintronics. To understand broadband molecular spintronics, pyrene oligomer film (≈20 nm thickness) was prepared using an electrochemical method forming indium tin oxide (ITO) electrode/pyrene covalent interfaces. Permalloy (Ni80 Fe20 ) films with different nanoscale thicknesses were used as top contact over ITO/pyrene layers to estimate the spin pumping efficiency across the interfaces using broadband ferromagnetic resonance spectra. The spintronic devices are composed of permalloy/pyrene/ITO orthogonal configuration, showing remarkable spin pumping from permalloy to pyrene film. The large spin pumping is evident from the linewidth broadening of 5.4 mT at 9 GHz, which is direct proof of spin angular momentum transfer across the interface. A striking observation is made with the high spin-mixing conductance of ≈1.02×1018  m-2 , a value comparable to the conventional heavy metals. Large spin angular moment transfer was observed at the permalloy-pyrene interfaces, especially at the lower thickness of permalloy, indicating a strong spinterface effect. Pure spin current injection from ferromagnetic into electrochemically grown pyrene films ensures efficient broadband spin transport, which opens a new area in molecular broadband spintronics.

Bendamustine in combination with pomalidomide and dexamethasone in relapsed/refractory multiple myeloma: A phase II trial.

Treatment of patients with resistant/refractory multiple myeloma (MM) is an unmet need. In this phase II study, we evaluated the role of bendamustine, pomalidomide and dexamethasone combination in this setting. Between February 2020 and December 2021, 28 patients were recruited. Patients received bendamustine 120 mg/m2 day 1, pomalidomide 3 mg days 1-21, and dexamethasone 40 mg days 1, 8, 11, 22, regimen given for a maximum of six cycles. The median (range) age of the patients was 54 (30-76) years and 15 (53.6%) were males. Patients had received a median (range) of three (two-six) prior lines and 85.7% were refractory to both lenalidomide and bortezomib. The primary end-point was the overall response rate (ORR) defined as ≥partial response after at least three cycles. Secondary objectives were toxicity, progression-free survival (PFS), time to progression and overall survival (OS). An intent-to-treat analysis was done. An ORR of 57.6% was achieved. Patients with extramedullary myeloma had a better response rate. At a median follow-up of 8.6 months, the median PFS and OS were 6.2 and 9.7 months respectively. Toxicity was manageable; mainly haematological (neutropenia, 46.4%; anaemia, 42.8%; and thrombocytopenia, 7.1%). Bendamustine, pomalidomide and dexamethasone could be a novel combination for the heavily pretreated, lenalidomide-refractory myeloma population.

Variants of concern responsible for SARS-CoV-2 vaccine breakthrough infections from India.

Emerging reports of SARS-CoV-2 breakthrough infections entail methodical genomic surveillance for determining the efficacy of vaccines. This study elaborates genomic analysis of isolates from breakthrough infections following vaccination with AZD1222/Covishield and BBV152/Covaxin. Variants of concern B.1.617.2 and B.1.1.7 responsible for cases surge in April-May 2021 in Delhi, were the predominant lineages among breakthrough infections.

Statin and aspirin as adjuvant therapy in hospitalised patients with SARS-CoV-2 infection: a randomised clinical trial (RESIST trial).

BACKGROUND: Statins and aspirin have been proposed for treatment of COVID-19 because of their anti-inflammatory and anti-thrombotic properties. Several observational studies have shown favourable results. There is a need for a randomised controlled trial. METHODS: In this single-center, open-label, randomised controlled trial, 900 RT-PCR positive COVID-19 patients requiring hospitalisation, were randomly assigned to receive either atorvastatin 40 mg (Group A, n = 224), aspirin 75 mg (Group B, n = 225), or both (Group C, n = 225) in addition to standard of care for 10 days or until discharge whichever was earlier or only standard of care (Group D, n = 226). The primary outcome variable was clinical deterioration to WHO Ordinal Scale for Clinical Improvement ≥ 6. The secondary outcome was change in serum C-reactive protein, interleukin-6, and troponin I. RESULTS: The primary outcome occurred in 25 (2.8%) patients: 7 (3.2%) in Group A, 3 (1.4%) in Group B, 8 (3.6%) in Group C, and 7 (3.2%) in Group D. There was no difference in primary outcome across the study groups (P = 0.463). Comparison of all patients who received atorvastatin or aspirin with the control group (Group D) also did not show any benefit [Atorvastatin: HR 1.0 (95% CI 0.41-2.46) P = 0.99; Aspirin: HR 0.7 (95% CI 0.27-1.81) P = 0.46]. The secondary outcomes revealed lower serum interleukin-6 levels among patients in Groups B and C. There was no excess of adverse events. CONCLUSIONS: Among patients admitted with mild to moderate COVID-19 infection, additional treatment with aspirin, atorvastatin, or a combination of the two does not prevent clinical deterioration. Trial Registry Number CTRI/2020/07/026791 ( http://ctri.nic.in ; registered on 25/07/2020).

ARCANE-ROG: Algorithm for reconstruction of cancer evolution from single-cell data using robust graph learning.

Tumor heterogeneity, marked by the presence of divergent clonal subpopulations of tumor cells, impedes the treatment response in cancer patients. Single-cell sequencing technology provides substantial prospects to gain an in-depth understanding of the cellular phenotypic variability driving tumor progression. A comprehensive insight into the intra-tumor heterogeneity may further assist in dealing with the treatment-resistant clones in cancer patients, thereby improving their overall survival. However, this task is hampered due to the challenges associated with the single-cell data, such as false positives, false negatives and missing bases, and the increase in their size. As a result, the computational cost of the existing methods increases, thereby limiting their usage. In this work, we propose a robust graph learning-based method, ARCANE-ROG (Algorithm for Reconstruction of CANcer Evolution via RObust Graph learning), for inferring clonal evolution from single-cell datasets. The first step of the proposed method is a joint framework of denoising with data imputation for the noisy and incomplete matrix while simultaneously learning an adjacency graph. Both the operations in the joint framework boost each other such that the overall performance of the denoising algorithm is improved. In the second step, an optimal number of clusters are identified via the Leiden method. In the last step, clonal evolution trees are inferred via a minimum spanning tree algorithm. The method has been benchmarked against a state-of-the-art method, RobustClone, using simulated datasets of varying sizes and five real datasets. The performance of our proposed method is found to be significantly superior (p-value < 0.05) in terms of reconstruction error, False Positive to False Negative (FPFN) ratio, tree distance error and V-measure compared to the other method. Overall, the proposed method is an improvement over the existing methods as it enhances cluster assignment and inference on clonal hierarchies.

Metal organic frameworks for electrochemical sensor applications: A review.

Metal-organic frameworks (MOFs) are broadly known as porous coordination polymers, synthesized by metal-based nodes and organic linkers. MOFs are used in various fields like catalysis, energy storage, sensors, drug delivery etc., due to their versatile properties (tailorable pore size, high surface area, and exposed active sites). This review presents a detailed discussion of MOFs as an electrochemical sensor and their enhancement in the selectivity and sensitivity of the sensor. These sensors are used for the detection of heavy metal ions like Cd2+, Pb2+, Hg2+, and Cu2+ from groundwater. Various types of organic pollutants are also detected from the water bodies using MOFs. Furthermore, electrochemical sensing of antibiotics, phenolic compounds, and pesticides has been explored. In addition to this, there is also a detailed discussion of metal nano-particles and metal-oxide based composites which can sense various compounds like glucose, amino acids, uric acid etc. The review will be helpful for young researchers, and an inspiration to future research as challenges and future opportunities of MOF-based electrochemical sensors are also reported.

Evaluation of serum glucose-regulated protein 78 (GRP78) as a biomarker of treatment response to bortezomib-based induction regimen in multiple myeloma: A cross-sectional pilot study.

GRP78 overexpression in myeloma cells has been associated with bortezomib resistance in multiple myeloma (MM). However, serum GRP78 as a maker of bortezomib-based treatment response remains unexplored. The objective of the study was to evaluate serum GRP78 levels in MM patients who underwent a bortezomib-based induction regimen. This cross-sectional study included adult MM patients (n=30) who completed at least four cycles of bortezomib-based induction therapy. Healthy volunteers (n=30) and newly diagnosed MM patients (n=19) were also recruited to identify the disease-associated change in GRP78 levels. Serum GRP78 was estimated by ELISA. Surface and intracellular expression of GRP78 in bone marrow plasma cells was evaluated in ten MM patients by flow cytometry. Among 30 MM patients [median (range): 52 (38-68) years; 20 males] who completed at least four cycles of bortezomib-based induction therapy, 20 were responders and 10 were non-responders. Serum GRP78 levels were not significantly different between responders [median (IQR): 5.2 (3.1, 8.0) µg/ml] and non-responders [median (IQR): 4.3 (0.1, 7.1) µg/ml] (p=0.4). Although non-significant (p=0.3), median serum GRP78 was higher in newly diagnosed patients when compared to healthy volunteers. Bone marrow plasma cells ranged from 0.2 to 57.8% in the analyzed samples. Intracellular GRP78 expression in bone marrow plasma cells was higher (1.6 to 5 times) when compared to surface expression. To conclude, serum GRP78 levels vary widely in different MM patient groups but did not correlate with response to a bortezomib-based induction regimen.

Study of Clinical Profile and Risk Factors for Ischemic Stroke in Young Adults.

Stroke in young adults has become a rising concern in developing countries as it leads to large economic impact by causing disability in the most economically productive years.Although stroke is uncommon in young age group, we are facing patients with ischemic stroke in young adults in daily practice. MATERIAL: It is a prospective observational study in which patients with ischemic stroke fulfilling the inclusion criteria were evaluated for risk factors and clinical profile was assessed.Chi-square test was used to compare data and p value<0.05 was considered to be significant. OBSERVATION: In this study 73 patients with ischemic stroke between 15-49 years were evaluated. Most of the patients were male (63%).The most common risk factors were dyslipidemia (67.1%), metabolic syndrome (64.3%), hyperhomocysteinemia (58.9%), smoking (52%) and hypertension (44.2%). Patients were further divided into two age groups (16-32 years and 33-49 years) for comparison. Metabolic syndrome and hypertension were significantly more frequent in age group of 33-49 years with p value of <0.05 but we could not find difference between two age groups for rest of the risk factors. CONCLUSION: Most of these are traditional risk factors which were previously seen in older age group, but now we are encountering these risk factors in younger age group also. As most of them are modifiable risk factors health education regarding lifestyle modification, health programs for screening and treating these risk factors should be started to reduce the mortality and morbidity of stroke among socioeconomically active age group.

A Comparative Study of the Patterns of Mortality in COVID-19 Patients in Juxtaposition with Non-COVID-19 Mortality in the First and Second Waves of the Pandemic.

BACKGROUND AND OBJECTIVES: The Coronavirus disease 2019 (COVID-19) pandemic has posed an unprecedented challenge to the public healthcare system worldwide like none before, producing far-reaching global economic, humanitarian, and social crises. It is estimated to have affected more than 1.8 million people worldwide. India has faced two phases of the pandemic, being the country with 2nd most number of deaths with varying mortality patterns across the two waves. In this study, we compare the patterns of mortality between the two phases of pandemics in association with COVID-19 and non-COVID-19 deaths. MATERIALS AND METHODS: A retrospective observational study at a tertiary care center in Central India was carried out. Demographic patterns of mortality have been studied in each of the groups, and a comparative analysis was done between COVID-19 and non-COVID-19 mortality patterns in each phase of the study, that is, from 20th March 2020 to 19th September 2020 and from 20th September 2020 to May 2021, as well as between the two phases. RESULTS: The case fatality rate of COVID-19 positive patients in the second phase of the study was 22.04%, whereas the those of non-COVID-19 patients in the second phase were found to be 15.95%. A maximum number of COVID-19 positive deaths during the first wave of the pandemic occurred in September 2020 and during the second wave in April 2021. In the first phase of the study, 69.6% of patients who died were males, and 30.3% were females, whereas in the second phase among COVID-19 positive subjects, 65% deaths were among males, and 35% deaths were among females. COVID-19 positive mortality in the second phase showed, 26.53% to be hypertensive, while 13.8% were diabetic. CONCLUSION: It was found that most of the deaths in both phases of COVID-19 amongst COVID-19 positive patients and non-COVID patients were amongst the elderly population (>60 years) with male predominance. Most deaths in both populations occurred during the first 3 days of admission whereas it was relatively less in the second phase. Noncommunicable diseases like systemic hypertension, and DM had a significant influence on all-cause mortality and morbidity in both COVID-19 positive and non-COVID-19 patients in the first and second waves of COVID-19. Noncommunicable diseases thus played a major role in mortality among both the populations under study.

Methylated PP2A stabilizes Gcn4 to enable a methionine-induced anabolic program.

Methionine, through S-adenosylmethionine, activates a multifaceted growth program in which ribosome biogenesis, carbon metabolism, and amino acid and nucleotide biosynthesis are induced. This growth program requires the activity of the Gcn4 transcription factor (called ATF4 in mammals), which facilitates the supply of metabolic precursors that are essential for anabolism. However, how Gcn4 itself is regulated in the presence of methionine is unknown. Here, we discover that Gcn4 protein levels are increased by methionine, despite conditions of high cell growth and translation (in which the roles of Gcn4 are not well-studied). We demonstrate that this mechanism of Gcn4 induction is independent of transcription, as well as the conventional Gcn2/eIF2α-mediated increased translation of Gcn4. Instead, when methionine is abundant, Gcn4 phosphorylation is decreased, which reduces its ubiquitination and therefore degradation. Gcn4 is dephosphorylated by the protein phosphatase 2A (PP2A); our data show that when methionine is abundant, the conserved methyltransferase Ppm1 methylates and alters the activity of the catalytic subunit of PP2A, shifting the balance of Gcn4 toward a dephosphorylated, stable state. The absence of Ppm1 or the loss of the PP2A methylation destabilizes Gcn4 even when methionine is abundant, leading to collapse of the Gcn4-dependent anabolic program. These findings reveal a novel, methionine-dependent signaling and regulatory axis. Here methionine directs the conserved methyltransferase Ppm1 via its target phosphatase PP2A to selectively stabilize Gcn4. Through this, cells conditionally modify a major phosphatase to stabilize a metabolic master regulator and drive anabolism.