Introduction: Brugada syndrome is associated with ventricular arrhythmia leading to sudden cardiac death. Risk stratification is challenging, as major arrhythmic events (MAE) are rare. We assessed the utility of drug challenge testing in Brugada syndrome by a systematic review and meta-analysis. Methods and results: We comprehensively searched the databases of MEDLINE and EMBASE from inception to May 2019. Included studies compared the incidence of MAE between spontaneous and drug challenge induced Type-1. Data were combined using the random-effects, generic inverse variance method, to calculate pooled incidence and odds ratio (OR). Mixed-effects Poisson regression was used to calculated incidence rate ratio (IRR). Eighteen studies from 2006 to 2018 were included (4,099 patients, mean follow-up 4.5 years). Pooled annual incidences of MAE in spontaneous, drug challenge induced (regardless of symptoms), asymptomatic drug challenge induced, and symptomatic drug challenge induced Type-1 were 23.8 (95% confidence interval [CI]: 19.8-27.8), 6.5 (95% CI: 3.9-9.1), 2.1 (95% CI: -0.3-4.4), and 19.6 (95% CI: 9.9-29.3) per 1,000 person-years respectively. The incidence of MAE between symptomatic drug challenge induced and asymptomatic spontaneous Type-1 was not statistically different (IRR=1.0, 95%CI: 0.6-1.7). The presence of ventricular tachyarrhythmia during drug challenge testing was a predictor of MAE (OR=3.73, 95% CI: 1.77-7.86, p=0.001). Conclusions: The incidence of MAE in drug challenge induced Type-1 in asymptomatic patients is low. The incidence of MAE between symptomatic drug challenge induced and asymptomatic spontaneous Type-1 was similar. Ventricular tachyarrhythmia during drug challenge testing could be a useful risk marker for MAE in Brugada syndrome.

Despite extreme and undeniable progress in the concept of implantable cardioverter defibrillator (ICD) therapy over the last 40 years, the endocardial lead is still the weakest link of the system. Many efforts have been taken to improve the construction and consequently the durability of the lead. Not all of them were successful and some of the lead models proved to be technically imperfect, resulting in formal recalls. Similarly, patient- and procedure-related factors may strongly affect the lead reliability. The implantation of cardiac electronic devices (CIED) is considered to be a quite common vascular intervention. Also, there are strongly established opinions of best procedural manners, including the most optimal methods of vascular access during the CIED implantations.In this issue of the Journal of Cardiovascular Electrophysiology, Barbhaiya et al. present an interesting retrospective analysis of 660 patients who underwent the ICD implantations in one center from 2011-2017. The goal of the study was to determine the risk factors for premature lead failure. Four implanted leads models were assessed: Biotronik Linox, Sprint Quattro, Durata and Endotak.The main findings include:The ICD lead implantation via cephalic access in multi-lead ICD systems may be a risk factor for premature ICD lead failure (p<0.001).The overall risk of premature ICD lead failure was similar for all the analyzed lead models.Concerns regarding the durability of Biotronik Linox were discussed and the study showed its equal reliability compared to the other leads.Neither age nor gender were the risk factors for premature lead failure.An optimal vascular access for the endocardial lead implantation was investigated in many studies.1-4 So far, cephalic vein cutdown (CVC) was considered to be the method of choice, with the lowest rate of possible complications.2,4,5 Meta-analysis performed by Benz et al. (30 000 patients, more than 50 000 leads) compared CVC and subclavian puncture (SP) and demonstrated lower risk of lead failure when CVC was adopted.2 Axillary vein puncture (AP), especially when ultrasonography-guided, is a feasible technique and significantly reduces the probability of subclavian crush syndrome.6-8 Unfortunately this method is not used by many operators. EHRA survey from 2013 showed that in more than 80% of participating centers, the preferred method for venous access was either CVC or SP.9 What is worth emphasizing, in the study of Barbhaiya et al., axillary access was most often used for lead insertion – 76.8% (61-88%, dependently on the lead model). This fact may potentially explain the main study finding. It is also consistent with the interesting results of the PAIDLESS study presented in the paper of Shaikh et al.3 They showed that experienced operators preferably choose subclavian and/or axillary access (62% of implants), whereas low-volume implanters generally use cephalic vein approach (63%). High-volume operators are also less likely to experience lead failure.An important issue to discuss is the number of leads inserted via cephalic vein. The routine practice, also applied by Barbhaiya and colleagues, includes the placing of atrial and right ventricular leads via cephalic access, if possible. Inserting one or two leads is usually not a problem. There are many inventive ways for doing this, described in literature. Some operators go even further – they use cephalic vein to implant all three leads of cardiac resynchronization therapy (CRT) systems with the success rate of 87.7% - 91.7%.10,11The question of long-term reliability of the leads implanted in such a way is still open. They are tightly packed in one small vessel and possible lead - lead interaction may contribute to their failure. Especially the ICD leads, by definition more complex and sensitive, are prone to damage in these circumstances.Another possible locus minoris resistentiae is the site of cephalic vein ligation after the lead insertion. The line between an adequate and too strong suture tightening is quite narrow. The effort to stop the bleeding from the vein may cause ligation-induced lead insulation damage. Recently, Kajiyama et al. proposed a novel technique for the ligation of the cephalic vein during a two-in-one insertion of the leads.12 It reduces hemorrhaging without decreasing the lead safety.The discussion about the benefits of different vascular access should include the potential disadvantages of future lead extraction, especially in the multi-lead systems. Inserting more than one lead via cephalic vein may determine more problematic transvenous lead extraction procedure (TLE). It may also necessitate the extraction of the functioning lead because of its periprocedural damage during the TLE of the initially targeted lead.The reliability of ICD leads is certainly the most important feature. During the last decades several lead models produced by different manufacturers were recalled because of their serious technical defects. Numerous concerns and divergent literature data regarding the durability of the Linox lead were the premise for the authors to conduct the discussed study. An important observation is that all analyzed lead models, including Linox, were similar in terms of performance (p=0.769).Young and physically active patients were traditionally believed to have a higher risk of lead damage because of the intensive mechanical interaction between the lead and anatomical structures of costoclavicular space. This observation was not confirmed by the authors of the commented paper.The study has several limitations and they are all listed by the authors. The lack of multivariate risk factors analysis is the most important drawback. It could not be performed due to the low overall event rate. All interesting study findings require validation and further investigation.As the ICD lead failure is still a serious problem, the study investigating possible risk factors is always of great importance. With all the limitations, the paper presented by Barbhaiya et al. may be an important guide in dealing with the vascular access during CIED implantations. It sheds new light on the dogma of superiority of cephalic access. What is particularly important in the study outcome and what I personally find a very strong recommendation – is the conclusion that the multiple lead systems should be avoided, if not indicated, especially when combined with cephalic venous access. One possible solution is to use cephalic vein for one lead only. Prospective randomized studies directly comparing axillary and cephalic access would be highly desirable in order to come closer to the idea of the best vascular approach for the endocardial lead implantation.1. Knight BP, Curlett K, Oral H, Pelosi F, Morady F, Strickberger SA. Clinical predictors of successful cephalic vein access for implantation of endocardial leads. J Interv Card Electrophysiol.2002;7(2):177-180.2. Benz AP, Vamos M, Erath JW, Hohnloser SH. Cephalic vs. subclavian lead implantation in cardiac implantable electronic devices: a systematic review and meta-analysis. Europace.2019;21(1):121-129.3. Shaikh ZA, Chung JA, Kersten DJ, et al. Differences in Approaches and Outcomes of Defibrillator Lead Implants Between High-Volume and Low-Volume Operators: Results From the Pacemaker and Implantable Defibrillator Leads Survival Study (”PAIDLESS”). J Invasive Cardiol. 2017;29(12):E184-E189.4. Chan NY, Kwong NP, Cheong AP. Venous access and long-term pacemaker lead failure: comparing contrast-guided axillary vein puncture with subclavian puncture and cephalic cutdown. Europace.2017;19(7):1193-1197.5. Gallik DM, Ben-Zur UM, Gross JN, Furman S. Lead fracture in cephalic versus subclavian approach with transvenous implantable cardioverter defibrillator systems. Pacing Clin Electrophysiol.1996;19(7):1089-1094.6. Belott P. How to access the axillary vein. Heart Rhythm.2006;3(3):366-369.7. Liccardo M, Nocerino P, Gaia S, Ciardiello C. Efficacy of ultrasound-guided axillary/subclavian venous approaches for pacemaker and defibrillator lead implantation: a randomized study. J Interv Card Electrophysiol. 2018;51(2):153-160.8. Squara F, Tomi J, Scarlatti D, Theodore G, Moceri P, Ferrari E. Self-taught axillary vein access without venography for pacemaker implantation: prospective randomized comparison with the cephalic vein access. Europace. 2017;19(12):2001-2006.9. Bongiorni MG, Proclemer A, Dobreanu D, et al. Preferred tools and techniques for implantation of cardiac electronic devices in Europe: results of the European Heart Rhythm Association survey.Europace. 2013;15(11):1664-1668.10. Vogler J, Geisler A, Gosau N, et al. Triple lead cephalic versus subclavian vein approach in cardiac resynchronization therapy device implantation. Sci Rep. 2018;8(1):17709.11. Hadjis A, Proietti R, Essebag V. Implantation of cardiac resynchronization therapy devices using three leads by cephalic vein dissection approach. Europace. 2017;19(9):1514-1520.12. Kajiyama T, Ueda M, Ishimura M, et al. A novel technique for ligation of the cephalic vein reduces hemorrhaging during a two-in-one insertion of dual cardiac device leads. Indian Pacing Electrophysiol J. 2018;18(4):152-154.

Samia ricini, a gigantic saturniid moth, has the potential to be a novel lepidopteran model species. Since S. ricini is much more tough and resistant to diseases than the current model species Bombyx mori, the former can be easily reared compared to the latter. In addition, genetic resources available for S. ricini rival or even exceed those for B. mori: at least 26 eco-races of S. ricini are reported and S. ricini can hybridise with wild Samia species, which are distributed throughout Asian countries, and produce fertile progenies. Physiological traits such as food preference, integument colour, larval spot pattern, etc. are different between S. ricini and wild Samia species so that those traits can be the target for forward genetic analysis. In order to facilitate genetic research in S. ricini, we determined the whole genome sequence of S. ricini. The assembled genome of S. ricini was 458 Mb with 155 scaffolds, and the N50 length of the assembly was approximately 21 Mb. 16,702 protein coding genes were predicted in the assembly. Although the gene repertoire of S. ricini was not so different from that of B. mori, some genes, such as chorion genes and fibroin genes, seemed to have specifically evolved in S. ricini.

The effects of forest conversion from natural forest to agricultural system on soil microbial composition still need further study. Especially, impact on soil function after forest conversion is not yet known. In this study, by using metagenomic sequencing as well as 16S and ITS sequencing technology, we evaluated the soil microbial composition, diversity and functions based on a large number of soil samples of tropical rainforest and rubber plantation across the whole island of Hainan, south China. The results showed that (1) forest conversion changed microbial composition from bacterial groups of Proteobacteria to Chloroflexi, and fungal groups from Basidiomycota to Ascomycota. (2) The bacterial alpha diversity, beta diversity as well as the total diversity did not decrease after forest conversion. However, beta diversity of fungal community reduced resulting a net loss of total OTU richness. (3) There was no difference in soil functional compositions and diversity between rubber plantations and rainforest, however, the relative gene abundance of most COG functions, KEGG functions, CAZy functions as well as Antibiotic gene were significantly different between rubber plantation and tropical rainforest. (4) Soil pH and environmental heterogeneity were the main driver for microbial taxonomic composition and gene functional composition. Land use did not result in changes of functional gene composition, but the relative abundance of functional gene. The changed relative abundance gene would alter the ecosystem processes. In conclusion, our results confirmed that land use changes alter the soil microbial community structure and can have profound effects on ecosystem functions and processes.

Ultrasound-detected structural anomalies have an impact on fetal mortality and morbidity. Prenatal Exome Sequencing is incorporated into clinical care pathways for paediatric populations but maybe used to delineate the prognosis of fetal structural anomalies. This paper reviews the literature defining the clinical utility of prenatal ES and discusses the potential promise and challenges for implementation of this technology into clinical practice. Prospective case selection with accurate and informative pre-test counselling by multidisciplinary, clinical genetic-led teams is imperative. Robust, regulated laboratory sequencing, informative bioinformatic pathways with variant identification and conservative matching with the phenotype (within clinical review panels) is also important.

The aim of this multicenter retrospective study was to evaluate the incidence of hyperprogressive disease after treatment with pembrolizumab as a second-line treatment in patients (n=167) with non-small-cell lung cancer (NSCLC) with metastatic disease whose tumors expressed programmed death-ligand-1 in ≥1% and to search for factors associated with its development. All patients received platinum-containing chemotherapy as a first-line treatment. The neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and their derivations were retrospectively analyzed. The psoas major muscle area (PMMA) was calculated at the L3 position on computed tomography before chemotherapy and immunotherapy. Patients with ∆PMMA≥10% were considered to have sarcopenia (low muscle mass). We also performed multinomial logistic regression to estimate the effects of hematological biomarkers and ∆PMMA on the response to immunotherapy. Hyperprogressors (HPs) had significantly higher NLRs, PLRs and ∆PMMA levels than the other patients. Moreover, in multivariate regression analysis, higher levels of ∆PMMA were associated with a decreased likelihood of being a progressor (P) (OR, 0.81; 95% CI, 0.65-0.99; p=0.047) or a nonprogressor (NP) (OR, 0.76; 95% CI, 0.62-0.94; p=0.012) vs an HP. In multivariate analysis, higher NLRs tended to decrease the likelihood of being a P vs an HP (OR, 0.66; 95% CI, 0.42-1.06; p=0.09) and significantly decrease the likelihood of being an NP vs an HP (OR, 0.44; 95% CI, 0.28-0.69; p<0.0001). Our data suggest that a high pre-immunotherapy NLR and the presence of sarcopenia are potential risk factors for the development of hyperprogressive disease.

LS is a 39-year-old woman with systolic heart failure secondary to viral myocarditis (EF 10-15%). She was transitioned from IABP support to LVAD. Five weeks postoperatively she experienced progressive low flow alarms and underwent pericardial release via left mini-thoracotomy. Flows immediately improved postoperatively.

Protein lipoylation is essential for the function of many key enzymes, but barely studied kinetically. Here, the two-step reaction cascade of H protein lipoylation catalyzed by the multifunctional enzyme lipoate-protein ligase A (LplA) was quantitatively and differentially studied. We discovered new phenomena and unusual kinetics of the cascade: (1) the speed of the first reaction is faster than the second one by two orders of magnitude, leading to high accumulation of the intermediate Lip-AMP; (2) Lip-AMP is hydrolyzed, but only significantly at the presence of H protein and in competition with the lipoylation; (3) both the lipoylation of H protein and its hydrolysis are enhanced by the apo and lipoylated forms of H protein and a mutant without the lipoylation site. A conceptual mechanistic model is proposed to explain these experimental observations in which conformational change of LplA upon interaction with H protein and competitive nucleophilic attacks play key roles.

Phenotypic divergence in response to divergent natural selection between environments is a common phenomenon in species of freshwater fishes. Intraspecific differentiation is often pronounced between individual inhabiting lakes versus stream habitats. The different hydrodynamic regimes in the contrasting habitats may promote a variation of body shape, but this could be intertwined with morphological adaptions to a specific foraging mode. Herein, I studied the divergence pattern of the European minnow (Phoxinus phoxinus), a common freshwater fish that has paid little attention despite its large distribution. In many Scandinavian mountain lakes, they are considered as being invasive and were found to pose threats to the native fish populations due to dietary overlap. Minnows were recently found to show phenotypic adaptions in lake versus stream habitats, but the question remained if this divergence pattern is related to trophic niche partitioning. I therefore studied the patterns of minnow divergence in morphology (i.e. using geometric morphometrics) and trophic niches (i.e. using stomach content analyses) in the lake Ånnsjön and its tributaries to link the changes in body morphology to the feeding on specific resources. Lake minnows showed a strong reliance on zooplankton and a more streamlined body shape with an upward facing snout, whereas stream minnows fed on macroinvertebrates (larvae and adults) to a higher degree and had a deeper body with a snout that was pointed down. Correlations showed a significant positive relationship of the proportion of zooplankton in the gut and morphological features present in the lake minnows. The results of this study highlight the habitat-specific divergence pattern in morphology and resource use in this ubiquitous freshwater fish, which may promote contrasting inter-specific interactions in the respective food webs.

Aim: Infantile haemangioma (IH) is the most common benign tumour in children. Since 2014, propranolol has become the first-choice therapy and currently Hemangiol® is the only approved drug for complicated haemangioma. This post-marketing study reported the use of Hemangiol® for IH in paediatric practice. Method and Results: From January 2014 to November 2018, 94 children (median age 4 [0;21] months; 75% female) treated with Hemangiol® for proliferative IH were enrolled in the study. The systematic paediatric cardiology consultation never contraindicated beta-blockers. Two Hemangiol® initiation protocols were used: a conventional ambulatory 3-week titration phase protocol (N=76, 80.9%), and a rapid initiation protocol with a 48-hour dose escalation in conventional hospitalization for severe proliferative IH (N=18, 19.1%). In both protocols, the haemodynamic tolerance was good. The mean maintenance dose of Hemangiol® was 2.7±0.8 mg/kg/day, with a median treatment duration of 7 [1.5;19] months. Adverse events (AEs) have been found in 25 (26,6%) patients including 8 (8.5%) patients with serious AEs (uncontrolled bronchial hyperreactivity, N=5; serious hypoglycaemia, N=3). Some patients had one or more AEs, a total of 24 non-serious AEs was reported in 19 patients (sleep disturbances, N=9; respiratory disorders, N=5; digestive disorders, N=6). No cardiac adverse event was reported. Conclusion: This post-marketing surveillance drug study supports the good tolerance of Hemangiol® in children with IH. A rapid initiation protocol is of interest when treatment is urgent. The pre-therapeutic paediatric cardiology consultation should not be systematic but only indicated on specific patients. ClinicalTrials.gov: NCT 04105517.

Aims In the absence of a commonly agreed dosing protocol based on pharmacokinetic considerations, the dose and treatment duration for hydroxychloroquine (HCQ) COVID-19 disease currently vary across national guidelines and clinical study protocols. We have used a model-based approach to explore the relative impact of alternative dosing regimens proposed in different dosing protocols for hydroxychloroquine in COVID-19. Methods We compared different PK exposures using Monte Carlo simulations based on a previously published population pharmacokinetic model in patients with rheumatoid arthritis, externally validated using both independent data in lupus erythematous patients and recent data in French COVID-19 patients. Clinical efficacy and safety information from COVID-19 patients treated with HCQ were used to contextualize and assess the actual clinical value of the model predictions. Results Literature and observed clinical data confirm the variability in clinical responses in COVID-19 when treated with the same fixed doses. Confounding factors were identified that should be taken into account for dose recommendation. For 80% of patients, doses higher than 800mg day on D1 followed by 600mg daily on following days might not be needed for being cured. Limited adverse drug reactions have been reported so far for this dosing regimen, most often confounded by co-medications, comorbidities or underlying COVID-19 disease effects. Conclusion Our results were clear indicating the unmet need for characterization of target PK exposures to inform HCQ dosing optimization in COVID-19. Dosing optimization for HCQ in COVID-19 is still an unmet need. Efforts in this sense are a prerequisite for best the benefit/risk balance.

Background: The total number of thyroidectomies performed worldwide both for benign and malignant disease has increased dramatically during the past few decades. Gestational hypothyroidism has deleterious effects on the fetus. Objective: The aim of this study was to assess the extent of thyroid function control among pregnant women who had previously undergone a therapeutic thyroidectomy. Methods: This retrospective cohort study included all female patients insured in the largest health maintenance organization in Israel who were pregnant between May, 2001 and September, 2012 and had a medical history of thyroid surgery. The thyroid-stimulating hormone (TSH) levels throughout the pregnancy were compared to recommended trimestral values. A multivariate analysis was performed to determine risk factors for not attaining TSH recommended range. Results: A total of 477 females with a history of thyroid surgery had given 701 births during the study period. Forty-three percent (n= 203), had thyroidal malignancy. Nearly half of the women underwent total thyroidectomy (43.4% n=207). The women’s TSH values were within the recommended range in only 60% (n= 350) of the pregnancies during the first trimester (0.1-2.5 mIU/L), in 61% (n=335) during the second trimester (0.2–3 mIU/L), and in 70% (n=338) during the third trimester (0.3–3 mIU/L). In multivariate analysis, women that underwent a total thyroidectomy due to a benign thyroid disease, were at the highest risk for not attaining target TSH levels. Conclusions: This very large cohort of pregnant women with a past history of thyroid surgery demonstrated a significant percentage of pregnancies with TSH values above the recommended range. Women that underwent a total thyroidectomy due to benign thyroid disease were at the highest risk for gestational hypothyroidism.

Otic lichen planus (LP) is rare and associated with stenosis of external auditory canal, conductive hearing loss (HL) and otorrhea. We report the case of a 78 years old woman affected by otic LP complaining mixed HL. We successfully treated the patients with local therapy and with bone-anchored hearing device.

Extensive range loss for the Golden-winged Warbler (Vermivora chrysoptera) has occurred in areas of intrusion by the Blue-winged Warbler (V. cyanoptera) potentially related to their close genetic relationship. We compiled data on social pairing from nine studies for 2,679 resident Vermivora to assess evolutionary divergence. Hybridization between pure phenotypes occurred with 1.2% of resident males for sympatric populations. Pairing success rates for Golden-winged Warblers was 83% and for Blue-winged Warblers was 77%. Pairing success for the hybrid Brewster’s Warbler was significantly lower from both species at 54%, showing sexual selection against hybrids. Backcross frequencies for Golden-winged Warblers at 4.9% was significantly higher than for Blue-winged Warblers at 1.7%. More frequent backcrossing by Golden-winged Warblers, which produces hybrid phenotypes, may contribute to the replacement of Golden-winged by Blue-winged Warblers. Reproductive isolation due to behavioral isolation plus sexual selection against hybrids was 0.966. Our analyses suggest that plumage differences are the main driving force for this strong isolation with reduced hybrid fitness contributing to a lesser degree. The major impact of plumage differences to reproductive isolation is compatible with genomic analyses (Toews et al. 2016), which showed the largest genetic difference between these phenotypes occurred with plumage genes. These phenotypes have maintained morphological, behavioral, and ecological differences during two centuries of hybridization. Our estimate of reproductive isolation supports recognition of these phenotypes as two species. The decline and extirpation of the Golden-winged Warbler in almost all areas of recent sympatry suggest that continued coexistence of both species will require eco-geographic isolation.

Since coronavirus disease 2019 (COVID-19) was reported globally pandemic, dentistry is known as one of the most critical disciplines. Teledentistry as a sub branch of telemedicine which can be a useful modality is defined by using any telecommunication technology facility, including digital photo and video to deliver oral care to isolated patients in distant places by low cost(1). Although teledentistry has been introduced as a valid tool to prevent unnecessary referrals, policy makers have not shown much interest on it yet (2,3).Diagnosis, treatment, and monitoring could be performed, meanwhile research and continuing education or public education could be done via teledentistry. In COVID-19 pandemic, teledentistry can prevent human and non-human resources burden. Oral chronic diseases like vesiculobullous and painful conditions are so dreadful and exhausting needing more care. Pediatric patients and those who are suffering from cancer are no more exceptions to this point. Tablets, smart phones, and all types of electronic gadgets can facilitate virtual communication which is helpful in telehealth.Traditional visual examination is a gold standard, in order to reach a better diagnosis and treatment plan. In teledentistry, intra oral or other high quality cameras can provide essential documents. There are so many investigations to compare visual and virtual examination, which showed only some problems in diagnosing interproximal carious lesions which is solved by digital radiography (3).Teledentistry examinations are valid, feasible, and comparable to visual examination for oral screening. Data storage is another crucial part in teledentistry due to privacy policies (2,3).Pediatric dentistry, oral medicine, orthodontics, and periodontics are the most common disciplines that have studied the efficacy of teledentistry rather than effectiveness. In developing countries, where emergency care is more important than preventive care, conservatism of decision makers, lack of resources and ICT infrastructure are the most common problems in providing teledentistry (4).Meanwhile there is a hidden advantage for teledentistry and telemedicine that it can avoid feelings of isolation and stress for patients; so, it can be more useful during COVID-19 quarantine (5).Teledentistry performs in two ways; asynchronous by transmission intraoral or extraoral images that are not used in real time; also, known as the store and forward method, synchronous by use of real-time interactive technologies, such as video or photoconferencing, and mobile health care services via smartphone apps and text messages.All the process should be recorded in patients file for further information. Accurate triage is another prominent advantage of teledentistry, which is so important during COVID-19.For people in need of care like geriatrics or patients with special needs telemedicine can eliminate some barriers (6).Besides to teledentirstry’s advantages, especially in a situation like a pandemic infection even with very primary facilities teledentistry can be performed and be useful for triage. By introducing dentistry as a very dangerous discipline, teledentistry can play a very specific role to solve the majority of patients’ problems as a helpful facility in this crisis and may be it can also persuade policy makers to perform teledentistry in a vast program.

This paper is concerned with the bounded fractal and Hausdorff dimension of the pullback attractors for 2D non-autonomous incompressible Navier-Stokes equations with constant delay terms. Using the construction of trace formula with two bases for phase spaces of product flow, the upper boundedness of fractal dimension has been achieved.

We study the dependence of the eigenvalues of time-harmonic Maxwell's equations in a cavity upon variation of its shape. The analysis concerns all eigenvalues both simple and multiple. We provide analyticity results for the dependence of the elementary symmetric functions of the eigenvalues splitting a multiple eigenvalue, as well as a Rellich-Nagy-type result describing the corresponding bifurcation phenomenon. We also address an isoperimetric problem and characterize the critical cavities for the symmetric functions of the eigenvalues subject to isovolumetric or isoperimetric domain perturbations and prove that balls are critical. We include known formulas for the eigenpairs in a ball and calculate the first one.

In this paper, an inverse time-fractional Schr$\ddot{o}$dinger problem of potential-free field is studied. This problem is ill-posed, i.e, the solution (if it exists) does not depend continuously on the data. Based on an a priori bound condition, the optimal error bound analysis is given. Moreover, a modified kernel method is introduced. The convergence error estimate obtained by this method under the priori regularization parameter selection rule is optimal, and the convergence error estimate obtained under the posteriori regularization parameter selection rule is order-optimal. Finally, some numerical examples are given to illustrate the effectiveness and stability of this method.