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This paper proposes an optimal cascaded fractional order controller (CC-FOC) having disturbance observer (DOB) to minimize the frequency deviation of an autonomous wind-diesel-generator (WDG) system in the wake of load variation and random wind power output. The model of WDG consists of a variable-speed wind turbine (VSWT) and a diesel engine generator to match the ever-rising load demand. To regulate the frequency of the WDG system, fractional-order proportional-integral-derivative (FOPID) and tilt-integral-derivative (TID) controllers are simultaneously used as master and slave controllers, respectively, for developing the CC-FOC. An improved squirrel search algorithm (SSA) with quasi-oppositional-based learning (QOSSA) is applied to explore the optimum gains of the proposed non-integer controller. The performance of the developed controller is compared with the outputs of FOPID, TID, and PID controllers. The result demonstrates the mastery and effectiveness of the proposed controller against random load and wind power fluctuations. Finally, Kharitonov's stability theorem is applied to ensure the robustness margin of the studied WDG plant for a wide range of system parameters variation. [ABSTRACT FROM AUTHOR]

Summary: This paper presents the design and development of an improved high‐gain buck‐boost converter (HGBBC) with optimized Type III controller suitable for power supplies in various electrical/electronics devices. The proposed HGBBC produces higher efficiency, exhibits better performance, is less bulky, and is compact in size. The voltage gain of the proposed HGBBC is the squared times the voltage gain of the conventional buck‐boost converter (BBC). The polarity of source and load (output) voltages are the same (ie, noninverting polarity). This added advantage of the proposed converter allows it to operate the positive load voltage variation in a wider range even with small variation of duty cycle ratio of the power switches. Therefore, its application may be advantageous for electronics/electrical equipment. The proposed converter's validity is determined by its steady‐state analysis, small‐signal analysis, and closed loop control operation. A closed‐loop controlled of HGBBC utilizing optimized Type III controller has been fabricated and tested in the laboratory. The comparative studies in terms of efficiency, dynamic response, and percentage ripple content of the proposed HGBBC and existing converters have been performed. From the results, it is seen that the proposed HGBBC is performed better than other existing quadratic types of BBCs. [ABSTRACT FROM AUTHOR]

Summary: The electrical power generation from conventional thermal power plants needs to be interconnected with natural resources like solar, wind, hydro units with all‐day planning, and operation strategies to save mother nature and meet the current electricity demand. The complexity and size of the power network are increasing rapidly day by day. The enhanced power transfer from one section to another section in the existing grid system is the subject of available transfer capability (ATC), which is the modern power system's critical factor. In this paper, the minimisation of power generation cost of the thermal power units is achieved by incorporating renewable sources, says hydro, winds, and solar plants for 24 hours scheduled, and ATC calculation is the prime objective. In recent literature, the Mayfly algorithm (MA) optimisation approach, which combines the advantages of evolutionary algorithms and swarms intelligence to attend better results, is successfully implemented. In this article, optimum power flow (OPF) based ATC is enforced under various conditions with hydro‐thermal‐solar‐wind scheduling concept on the IEEE 9, IEEE 39, and IEEE 118 test bus systems to check the performance of the proposed chaotic MA. The chaotic MA is a hybridised format of the MA and chaotic map (C‐MAP) method with opposition based learning. It is noted from the simulation study that the suggested hybrid C‐MAP approach has a dominant nature over other well‐established optimisation algorithms. In case of single objective function, the optimum value of the cost function is better than 13% to its nearest competitor approach. For multi‐objective, it is improved by more than 19% and ATC value is enhanced by near about 56% and more. [ABSTRACT FROM AUTHOR]

Summary: This article maidenly presents a resilient hybrid fractional‐order controller (hy‐FOC) comprised of fractional‐order proportional‐integral‐derivative (FOPID) controller and fractional‐order sliding mode controller (FOSMC) for frequency regulation of an islanded hybrid power system (HPS) integrated with a doubly‐fed induction generator (DFIG)‐driven wind power generator. The slime mould algorithm is applied to obtain near‐optimum gains of the hy‐FOC via the minimization of an integral error criterion. Moreover, a Luenberger disturbance observer (Dob) is designed to estimate uncertain plant disturbances and incorporate estimated output into the control law to alleviate chattering in the output of sliding mode controller (SMC). The acceptability and superiority of the proposed hy‐FOC are established by performing an extensive comparative study with the results of PI‐derivative (PID), SMC, FOPID, and FOSMC under diverse operating conditions (model uncertainties and uncertain external disturbances). The simulation results are presented and discussed to authenticate proficiency of the proposed resilient control methodology over its other integral‐order and fractional‐order counterparts. Governor dead‐band and generation rate constraint (thermal unit) as a provenance of physical limitations are also considered in the model to show the proposed controller's effectiveness for handling the practical challenges. Lastly, the sensitivity and robustness of the proposed approach have been affirmed by varying system parameters between ±25% of nominal settings. [ABSTRACT FROM AUTHOR]

The role of p27kip1 in Chronic Myeloid Leukemia (CML) has been well studied in relation to its function as a cell cycle inhibitor. However, its cytoplasmic function especially in CML remains to be seen. We studied the localization of p27kip1 and its function during the progression of CML from chronic to blast phase. Our investigations revealed an increased localization of p27kip1 in the cytoplasm of CD34+ cells in the blast phase compared to chronic phase. Cytoplasmic p27kip1 was found to modulate RhoA activity in CD34+ stem and progenitor cells. Further, RhoA activity was shown to be dependent on cytoplasmic p27kip1 which in turn was dependent on p210Bcr-Abl kinase activity. Interestingly, RhoA activity was observed to affect cell survival in the presence of imatinib through the SAPK/JNK pathway. Accordingly, inhibition of SAPK/JNK pathway using SP600125 increased apoptosis of K562 cells in presence of imatinib. Our results, for the first time, thus reveal a crucial link between cytoplasmic p27kip1, RhoA activity and SAPK/JNK signalling. To this effect we observed a correlation between increased cytoplasmic p27kip1, increased RhoA protein levels, decreased RhoA-GTP levels and increased SAPK/JNK phosphorylation in blast phase CD34+ cells compared to chronic phase CD34+ cells. [ABSTRACT FROM AUTHOR]

A statistical signal processing approach has been made to study the dynamics of the speed of steady flow of hot plasma from the corona of sun known as solar wind generated in Solar Cycle 23. A long time series of solar wind speed of length 2492 days from 1st Jan, 1997 to 28th October, 2003 collected from Coordinated Heliospheric Observations (COHO) data base at NASA's National Space Science Data Center (NSSDC) is investigated for this purpose. Detection of nonlinearity and chaos in dynamics of solar wind speed is the prime objective of this work. In the present analysis delay vector variance (DVV) method is used to detect the existence of nonlinearity within the dynamics of solar wind speed. To explore the signature of the chaos in it multiple statistical methodologies like '0-1' test, the correlation dimension analysis, computation of Information Entropy of the time series and Largest Lyapunov Exponent method have been applied. It has been observed that though the coronal plasma i.e. solar wind flow rate has a nonlinear dynamics but without any chaos. The absence of chaos indicates a probable regular behaviour of the series. The unit magnitude of the Correlation dimension indicates the presence of the deterministic component of the series. Embedding Dimension obtained argues that the deterministic component has dimension of six. The nearly zero value of the Lyapunov exponent claims that the system is conservative and exhibits Lyapunov stability. These revelations establish that not only the solar wind speed alone but the solar wind-magnetosphere coupling is also contributing towards the complexity of the magnetospheric plasma dynamics. [ABSTRACT FROM AUTHOR]

Background: Family physicians' (FPs) long‐term relationships with their oncology patients position them ideally to provide primary palliative care, yet their involvement is variable. We examined perceptions of FP involvement among outpatients receiving palliative care at a cancer center and identified factors associated with this involvement. Methods: Patients with advanced cancer attending an oncology palliative care clinic (OPCC) completed a 25‐item survey. Eligible patients had seen an FP within 5 years. Binary multivariable logistic regression analyses were conducted to identify factors associated with (1) having seen an FP for palliative care within 6 months, and (2) having a scheduled/planned FP appointment. Results: Of 258 patients, 35.2% (89/253) had seen an FP for palliative care within the preceding 6 months, and 51.2% (130/254) had a scheduled/planned FP appointment. Shorter travel time to FP (odds ratio [OR] = 0.67, 95% confidence interval [CI] = 0.48–0.93, p = 0.02), the FP having a 24‐h support service (OR = 1.96, 95% CI = 1.02–3.76, p = 0.04), and a positive perception of FP's care (OR = 1.05, 95% CI = 1.01–1.09, p = 0.01) were associated with having seen the FP for palliative care. English as a first language (OR = 2.90, 95% CI = 1.04–8.11, p = 0.04) and greater ease contacting FP after hours (OR = 1.33, 95% CI = 1.08–1.64, p = 0.008) were positively associated, and female sex of patient (OR = 0.51, 95% CI = 0.30–0.87, p = 0.01) and travel time to FP (OR = 0.66, 95% CI = 0.47–0.93, p = 0.02) negatively associated with having a scheduled/planned FP appointment. Number of OPCC visits was not associated with either outcome. Conclusion: Most patients had not seen an FP for palliative care. Accessibility, availability, and equity are important factors to consider when planning interventions to encourage and facilitate access to FPs for palliative care. [ABSTRACT FROM AUTHOR]

This work concentrates on designing and applying an adaptive cyber-tolerant finite-time frequency control framework for smart power systems under state-dependent sensor deception and periodic denial-of-service (DoS) attacks. An adaptive radial-basis function neural network (RBFNN)-based disturbance observer (DO) is designed to estimate undeniable plant disturbances, which includes structural uncertainties and unmodelled dynamics. Then, the DO-based resilient secondary control law based on the adaptive nonlinear sliding mode strategy for the cyber-physical power system (CPPS) is derived to guarantee global uniform asymptotic stability of the parametric error and the selected nonlinear sliding manifold. Furthermore, an in-depth analysis of uniformly ultimately boundedness (UUB) of the estimation error of RBFNN has been demonstrated. Numerical simulation and qualitative assessment have revealed the proficiency of the applied feedback control framework for the undertaken CPPS and a high-degree of cyber-tolerance against malicious attacks. • Adaptive cyber-tolerant finite-time frequency controllers for smart power systems have been extensively assessed. • Dynamical performances of cyber-physical power systems under sensor deception and periodic DoS attacks have been evaluated. • RBFNN is designed and applied to compensate for the adverse impacts of cyber-threats and physical uncertainties. • In-depth global uniformly asymptotic stability and UUB stability of the developed control framework have been illustrated. [ABSTRACT FROM AUTHOR]

The Notch signaling pathway, a known regulator of cell fate decisions, proliferation, and apoptosis, has recently been implicated in the regulation of glycolysis, which affects tumor progression. However, the impact of Notch on other metabolic pathways remains to be elucidated. To gain more insights into the Notch signaling and its role in regulation of metabolism, we studied the mitochondrial proteome in Notch1-activated K562 cells using a comparative proteomics approach. The proteomic study led to the identification of 10 unique proteins that were altered due to Notch1 activation. Eight of these proteins belonged to mitochondria-localized metabolic pathways like oxidative phosphorylation, glutamine metabolism, Krebs cycle, and fatty acid oxidation. Validation of some of these findings showed that constitutive activation of Notch1 deregulated glutamine metabolism and Complex 1 of the respiratory chain. Furthermore, the deregulation of glutamine metabolism involved the canonical Notch signaling and its downstream effectors. The study also reports the effect of Notch signaling on mitochondrial function and status of high energy intermediates ATP, NADH, and NADPH. Thus our study shows the effect of Notch signaling on mitochondrial proteome, which in turn affects the functioning of key metabolic pathways, thereby connecting an important signaling pathway to the regulation of cellular metabolism. [ABSTRACT FROM AUTHOR]

This article proposes a non-fragile control model approach for the design of an event-triggered control (ETC) for frequency and tie-line power regulation in a networked power system with communication delays. The proposed non-fragile control approach can tolerate controller parameter variations without any degradation in the system performance. The event condition is designed based on the relationship between the ETC and the non-fragile system. The effectiveness of the proposed design is validated with three-area interconnected power systems under load disturbances. The superiority of the proposed work is shown by comparative analysis with recently reported works. Furthermore, system robustness is validated with random step load disturbance, matched uncertainty, power system nonlinearities, communication link noise, integration of renewable energy resources, and with the IEEE 39 bus system. The closed-loop system stability is theoretically proved using the Lyapunov candidate function and verified by simulations. [ABSTRACT FROM AUTHOR]

COVID-19 was first reported in Wuhan, China, in December 2019; it rapidly spread around the world and was declared a global pandemic by the World Health Organization in March 2020. The palliative care program at the Princess Margaret Cancer Centre, Toronto, Canada, provides comprehensive care to patients with advanced cancer and their families, through services including an acute palliative care unit, an inpatient consultation service, and an ambulatory palliative care clinic. In the face of a global pandemic, palliative care teams are uniquely placed to support patients with cancer who also have COVID-19. This may include managing severe symptoms such as dyspnea and agitation, as well as guiding advance care planning and goals of care conversations. In tandem, there is a need for palliative care teams to continue to provide care to patients with advanced cancer who are COVID-negative but who are at higher risk of infection and adverse outcomes related to COVID-19. This paper highlights the unique challenges faced by a palliative care team in terms of scaling up services in response to a global pandemic while simultaneously providing ongoing support to their patients with advanced cancer at a tertiary cancer center. [ABSTRACT FROM AUTHOR]

Background/Aim: The recent pandemic of Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2) is yet another scourge from the coronaviridae family that causes illnesses ranging from common cold to more severe diseases such as Middle East respiratory syndrome (MERS-CoV) and severe acute respiratory syndrome (SARS-CoV). The numbers are still on the rise, despite a country wide lockdown and yet no definitive drugs and or/vaccines are available to manage the active COVID-19 cases. Methods: The present research design was a hospital based observational descriptive study conducted at S. M. S. Medical College and Attached hospitals, Jaipur, that analysed data of all the patients with COVID-19 related mortality, admitted between 1 April to 4 May 2020. Patients included in this study were RT-PCR confirmed cases of SARS-CoV-2 using nasopharyngeal and oropharyngeal swab samples. Results: The mean age of patients with COVID-19 related mortality was 53.41 ± 18.42 year with majority of patients belonging to age group of more than 60 years (41.18 %) followed closely by COVID-19 positive patients in age range of 45 to 60 years (33.33 %). The male to female ratio was 1.68: 1. Mean time lag between hospitalization and death reported was 6.18 days. Majority of the patients admitted (72.5 %) succumbed within 3 days of hospitalization. Eleven patients (21 %) were brought dead to the hospital who were tested COVID-19 positive after death. Most common comorbidity reported in patients with COVID-19 related mortality was hypertension (30 %) followed by diabetes mellitus (27.5 %). Conclusion: Hypertension and diabetes mellitus might be independent risk factors making an individual susceptible to COVID-19 related death. Elderly patients also have a greater risk of mortality. The non-availability of definitive management protocol and/or vaccine against COVID-19 makes public health preventive measures of social distancing, use of masks and frequent handwashing an important modality in the fight against COVID-19. [ABSTRACT FROM AUTHOR]

Context: Performance status measures are increasingly completed by patients in outpatient cancer settings, but are not well validated for this use.Objectives: We assessed performance of a patient-reported functional status measure (PRFS, based on the Eastern Cooperative Oncology Group [ECOG]), compared with the physician-completed ECOG, in terms of agreement in ratings and prediction of survival.Methods: Patients and physicians independently completed five-point PRFS (lay version of ECOG) and ECOG measures on first consultation at an oncology palliative care clinic. We assessed agreement between PRFS and ECOG using weighted Kappa statistics, and used linear regression to determine factors associated with the difference between PRFS and ECOG ratings. We used the Kaplan-Meier method to estimate the patients' median survival, categorized by PRFS and ECOG, and assessed predictive accuracy of these measures using the C-statistic.Results: For the 949 patients, there was moderate agreement between PRFS and ECOG (weighted Kappa 0.32; 95% CI: 0.28-0.36). On average, patients' ratings of performance status were worse by 0.31 points (95% CI: 0.25-0.37, P < 0.0001); this tendency was greater for younger patients (P = 0.002) and those with worse symptoms (P < 0.0001). Both PRFS and ECOG scores correlated well with overall survival; the C-statistic was higher for the average of PRFS and ECOG scores (0.619) than when reported individually (0.596 and 0.604, respectively).Conclusion: Patients tend to rate their performance status worse than physicians, particularly if they are younger or have greater symptom burden. Prognostic ability of performance status could be improved by using the average of patients and physician scores. [ABSTRACT FROM AUTHOR]

This work presents design and theoretical analysis of an adaptive fractional-order sliding-mode disturbance observer (FO-SM-DOB)-aided fractional-order robust controller for frequency regulation of a hybrid wind-diesel based power system, considering endogenous/exogenous system disturbances. Adaptive FO-SM-DOB is designed to estimate unknown/uncertain lumped system disturbances, including parametric uncertainty and exogenous disturbances. Afterwards, an improved fractional-order sliding mode controller (FOSMC) augmented with the estimated output of FO-SM-DOB is designed and applied to accelerate system dynamics with minimum chattering in the control effort. The Mittag-Leffler stability theorem affirms the finite-time convergence of disturbance estimation error. Moreover, the closed-loop asymptotic stability of the overall control system has been guaranteed by applying Lyapunov argument. The effectiveness of the suggested resilient fractional-order nonlinear frequency controller is theoretically validated by performing an extensive comparative study with SMC, FOSMC (without DOB), state observer-based SMC (SOB-SMC), second-order SMC (without DOB), and conventional integer/fractional-order controllers. Simulation results establish the supremacy of the proposed resilient fractional-order nonlinear frequency controller over its other counterparts concerning fast disturbance rejection, weaker chattering, and a high degree of robustness against unknown lumped system disturbances. Further, to demonstrate the practicability and validate the effectiveness of the proposed control strategy, magnetic levitation system and IEEE 39-bus New England power system are considered and successfully tested on MATLAB platform., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 ISA. Published by Elsevier Ltd. All rights reserved.)

Multiple myeloma (MM), second most common hematological malignancy, still remains beyond cure because of acquirement of drug resistance. Proteasome inhibitor such as carfilzomib (Cfz) therapy which has been used as one of the key therapies against MM recently, is obstructed by the incidence of Cfz resistance. The underlying mechanism of this acquired Cfz resistance in MM is very little understood. Therefore, the current study was aimed to investigate the differentially expressed genes (DEGs), associated micro RNAs (miRNAs), and transcription factors (TFs) from the microarray datasets of Cfz resistant and Cfz sensitive MM cell lines, obtained from Gene Expression Omnibus (GEO) database. DEGs were detected using GEO2R tool from two datasets and common DEGs were identified through Venn diagram. Gene ontology (GO) and pathway enrichment analysis were performed on DAVID database. Through STRING database and Cytoscape tool, protein-protein interaction (PPI) network of DEGs was constructed. Genetic alterations in DEGs were investigated using COSMIC database. Interaction network between DEGs and miRNAs as well as TFs were obtained and constructed by using mirDIP, TRRUST, and miRNet tools. Drug gene interaction analysis was performed to identify potential drug molecules on DGIdb tool. Several common DEGs were identified in Cfz resistant MM. PDGF, VEGF, and Wnt signaling pathways were significantly enriched and might be involved in MM progression. miRNA analysis identified hsa-mir-124-3p, hsa-mir-26a-5p that can target DEGs. Various drug molecules such as dabrafenib, vemurafenib, and venetoclax that could potentially attenuate the MM pathophysiology, were detected. The entire study might provide a new understanding about the Cfz resistance in MM.

Multiple myeloma (MM), second most common hematological malignancy, still remains irremediable because of acquisition of drug resistance. Glucocorticoid (GC) therapy, which is used as one of the key therapies against MM, is hindered by the incidence of GC resistance. The underlying mechanism of this acquired GC resistance in MM is not fully elucidated. Therefore, the present study was aimed to identify the differentially expressed genes (DEGs), associated micro RNAs (miRNAs), and transcription factors (TFs) from the microarray datasets of GC-resistant and GC-sensitive MM cell lines, obtained from Gene Expression Omnibus (GEO) database. DEGs were identified using GEO2R tool from two datasets and common DEGs were obtained by constructing Venn diagram. Then the Gene ontology (GO) and pathway enrichment analysis were performed using DAVID database. Genetic alterations in DEGs were examined using COSMIC database. Protein-protein interaction (PPI) network of DEGs was constructed using STRING database and Cytoscape tool. Network of interaction of DEGs and miRNAs as well as TFs were obtained and constructed using mirDIP, TRRUST, and miRNet tools. Drug gene interaction was studied to identify potential drug molecules by DGIdb tool. Six common DEGs, CDKN1A, CDKN2A, NLRP11, BTK, CD52, and RELN, were found to be significantly upregulated in GC-resistant MM and selected for further analysis. miRNA analysis detected hsa-mir-34a-5p that could interact with maximum target DEGs. Two TFs, Sp1 and Sp3, were found to regulate the expression of selected DEGs. The entire study may provide a new understanding about the GC resistance in MM., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The work described herein compares the performance of different optimized controllers, viz. proportional-integral, proportional-integral-derivative (PID) with filter, two-degree-of-freedom (2DOF)-PID, 3DOF-PID, fractional-order-PID, cascade PI-PID, tilt-integral-derivative (TID), and cascade-TID (CC-TID) controllers in frequency regulation of a hybrid energy distributed power system (HEDPS). The HEDPS is integrated with a multi-unit hydrothermal power plant for ensuring stable power supply. Crow search algorithm has been adopted with chaotic mapping (CCSA) for fine-tuning of the controller settings mentioned above. Extensive analysis has been presented to confirm the superiority of the CC-TID controller compared to other prevalent controllers of state-of-art in terms of different performance specifications. The tuning competence of the CCSA has been demonstrated over conventional CSA and other available optimization techniques. To enhance the mastery of the controller, disturbance-observer (Dob) is developed to estimate fast-changing disturbance profiles and subsequently refines the control law. The controller's robustness is affirmed under random perturbations, presence of nonlinearities, and variation of parameters. The effect of integration of a geothermal power plant on the system performance has also been outlined. The efficacy of Dob-aided CC-TID controller in frequency regulation is validated thereof., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 ISA. Published by Elsevier Ltd. All rights reserved.)

Objectives: Patients who do not attend outpatient palliative care clinic appointments ('no-shows') may have unmet needs and can impact wait times. We aimed to describe the characteristics and outcomes associated with no-shows., Methods: We retrospectively reviewed new no-show referrals to the Princess Margaret Cancer Centre Oncology Palliative Care Clinic (OPCC) in Toronto, Canada, between January 2017 and December 2018, compared with a random selection of patients who attended their first appointment, in a 1:2 ratio. We collected patient information, symptoms, performance status (Eastern Cooperative Oncology Group (ECOG) and outcomes. Univariable and multivariable logistic regression analyses were used to identify significant factors., Results: Compared with those who attended (n=214), no-shows (n=103), on multivariable analysis, were at higher odds than those who attended of being younger (OR 0.98, 95% CI 0.96 to 1.00, p=0.019), living outside Toronto (OR 2.67, 95% CI 1.54 to 4.62, p<0.001) and having ECOG ≥2 (OR 2.98, 95% CI 1.41 to 6.29, p=0.004). No-shows had a shorter median survival compared with those who attended their first appointment (2.3 vs 8.7 months, p<0.001)., Conclusion: Compared with patients who attended, no-shows lived further from the OPCC, were younger, and had a poorer ECOG. Strategies such as virtual visits should be explored to reduce no-shows and enable attendance at OPCCs., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.)

We analyzed the data of 102 confirmed patients with novel Coronavirus 2 infection (COVID-19) during the early period of nationwide lockdown announced in India after the declaration of pandemic. We analyzed epidemiological, clinical characteristics and outcome of hospitalization in 102 patients with positive results for novel corona virus (SARS-CoV-2) RNA testing which were traced on the basis of history of travel, contact with a confirmed COVID-19 case, resident of hotspot areas or presence of symptoms, thus providing an accurate estimate of the proportion of asymptomatic cases in the initial population. Of 102 patients enrolled in the study, 83.3% (85/102) were asymptomatic and 16.67% (17/102) were symptomatic. Seventy-seven (75.49%) were males and 24.50% (25/102) were females. Eighteen (17.6%) patients had associated comorbidities, the most prevalent of which were diabetes mellitus 10.8% (11/102), hypertension 7.8% (8/102), chronic obstructive pulmonary disease (COPD) in 3.92% (4/102), chronic kidney Disease (CKD) 0.98% (1/102), coronary artery Disease (CAD) 0.98% (1/102) and cerebro-vascular disease (CVD) 0.98% (1/102). The clinical spectrum among symptomatic COVID-19 patients varied from dry cough and fever to respiratory failure and multi-organ failure. Twelve (11.76%) patients were kept in intensive care unit (ICU). Ninety-nine (97.05%) patients recovered while three (2.94%) died during hospital stay. With majority of COVID-19 cases in India being asymptomatic, changes in biochemical and inflammatory profile were small and insignificant in asymptomatic patients when compared to symptomatic patients. Elevated NLR, lymphopenia, age and presence of comorbidities were associated with increased severity and poor outcome.

Background: The novel coronavirus (Covid-19) continues to wreck havoc across China, European countries, USA and now seems to gain a strong foothold in India. The aim of this report is to describe the clinical profiles of these Covid-19 infected patients admitted in Sawai Mansingh Hospital(S.M.S), Jaipur ranging from their age, sex, travel history, clinical symptoms, laboratory evaluation, radiological characteristics, treatment provided along with common side effects and the final outcome. The described cases are one of the earliest cases of Covid-19 in the Indian subcontinent., Methods: Epidemiological, clinical, laboratory, and radiological characteristics and treatment and outcomes data were obtained with data collection forms from electronic medical records and history given by 21 Covid-19 infected patients admitted in S.M.S., Jaipur. Patients were tested for Covid-19 by real-time reverse transcription polymerase chain reaction (RT-PCR) assay of 2019-nCoVRNA., Results and Discussion: During the course of this study 21 Covid-19 positive patients were admitted in S.M.S Hospital, Jaipur. Male patients constituted 66.66% of total patients and majority of the patients (80.90%) were below 60 years of age. Most of the patients (71.40%) were either foreigners or had a history of foreign travel suggesting that these cases were not community acquired except for 4 cases from textile producing district Bhilwara (known as Manchester of India), an epicenter of North India. Approximately 33.33% patients were completely asymptomatic and of those who were symptomatic cough was the most common symptom (85.71%) followed by fever (78.57%), myalgia (64.28%), headache (28.57%) and dyspnea (28.57%). Three patients (14.28 %) had underlying co morbidity in the form of hypertension, diabetes mellitus, hypothyroidism, chronic kidney disease or coronary artery disease. 11 patients (52.38%) had lymphopenia in their hemogram during the course of admission. 3 patients (14.28%) had leucocytosis and 4 patients (19.04%) presented with thrombocytopenia. All 4 patients in the severe category had raised FDP, D-Dimer levels and they needed oxygen support. These patients had deranged liver functions and had elevated pro-calcitonin levels, serum ferritin levels and LDH levels. 1 out of the these 4 cases went into ARDS during the course of treatment. 10 patients yielded negative results for Covid-19. The mean duration from admission to getting 1st Covid-19 sample negative was 8.3 days. 18 patients (85.71%) are still under treatment., Conclusion: Clinical investigations in initial Covid-19 patients in the Indian subcontinent reveal lymphopenia as predominant finding in hemogram. Patients with older age and associated comorbid conditions (COPD and diabetes) seem to have greater risk for lung injury thereby requiring oxygen support during the course of disease and these patients also had greater derangement in their biochemical profile., (© Journal of the Association of Physicians of India 2011.)

Epstein Barr Virus (EBV) is a human herpesvirus, and has been reported to be associated with nasopharyngeal carcinoma, gastric carcinoma, Burkitt's lymphoma and Hodgkin's lymphoma. In most of the associated tumors, the virus remains in a latently infected state. During latency, EBV expresses Latent Membrane Protein 2A (LMP2A) along with few other genes. We previously showed that LMP2A causes downregulation of HLA-ABC surface expression in EBV associated gastric carcinomas. However, the mechanism that leads to this downregulation remain unclear. We therefore analyzed methylation-mediated regulation of HLA-ABC expression by LMP2A. Interestingly, according to the 'missing self' hypothesis, when there is a decrease in HLA-ABC surface expression, expression of NKG2D ligands' must be upregulated to facilitate killing by Natural Killer (NK) cells. Analysis of NKG2D ligands' expression, revealed downregulation of MIC-A/B surface expression in response to LMP2A. Furthermore, the role of Unfolded Protein Response (UPR) in the regulation of MIC-A/B surface expression in cells expressing LMP2A was also investigated. Protein Disulfide Isomerase (PDI) mediated inhibition of MIC-A/B surface expression was observed in LMP2A expressing cells. Our current findings provide new insights in LMP2A arbitrated dysregulation of host immune response in epithelial cell carcinomas.