In this paper, we establish the results of multiple solutions for a class of modified nonlinear Schr\”{o}dinger equation involving the $p$-Laplacian. The main tools used for analysis is the critical points theorems by Ricceri and the dual approach.

We consider a SEIR-SEI Vector-host mathematical model of malaria transmission described and built on 7-dimensional nonlinear ordinary differential equations. We compute the basic reproduction number of the model, examine the positivity and boundedness of the model compartments in a region, verify the existence of the Disease-Free (DFE) and Endemic (EDE) equilibrium points. Using the Gaussian elimination method and the Routh-hurwitz criterion, we convey stability analyses at DFE and EDE points which indicates that the DFE (malaria-free) and the EDE (epidemic outbreak) point occurs when the basic reproduction number is less than one and greater than one respectively. We obtain a solution to the model using the Variational iteration method (VIM) (an unprecedented method) and verify the efficiency, reliability and validity of the proposed method by comparing the respective solutions via tables and combined plots with the computer in-built Runge-kutta-Felhberg of fourth-fifths order (RKF-45). We speculate that VIM is efficient to conduct analysis on Malaria models and other epidemiological models.

Utilizing the model of novel coronavirus given by Chen {\it et al.} [A mathematical model for simulating the phase-based transmissibility of a novel coronavirus, Infectious Diseases of Poverty, (2020) 9:24], we intend to generalize the model to fractional order derivative in Atangana-Baleanu sense and to show the existence of solution for the fractional model using Schaefer’s fixed point theorem and for the uniqueness of solution we make use of Banach fixed point theorem. By using Shehu transform and Picard successive iterative procedure, we explore the iterative solutions and its stability for the considered fractional model.

Ataxia-telangiectasia (A-T) is a multi-system disorder, resulted from the mutation in the ATM gene. Its mortality is largely related to some other disorders. Therefore, the management of its complications significantly improves patient quality of life. We studied a pediatric patient with A-T who one of his relatives had A-T.

Coronary-subclavian steal syndrome (CSSS) describes the condition whereby haemodynamically significant proximal subclavian artery stenosis results in flow limitation or reversal within the left internal mammary artery (LIMA) graft, classically precipitated by upper limb exertion. We report an unusual presentation, where a patient developed pronounced ST-depression and haemodynamic instability immediately following weaning from bypass. The patient was subsequently found to have occlusion of their left subclavian artery. Despite its incidence, there are currently no recommendations for screening for subclavian artery stenosis. We propose a preoperative screening algorithm that may allow for intervention prior to CABG, enabling risk-free use of the LIMA.

Background and Aim Endoscopic radial artery (RA) harvest (ERAH) is an alternative to open RA harvest (ORAH) technique. Our aim was to compare clinical outcome, patent satisfaction and 1-year angiographic patency rates after ERAH and ORAH. Patients and methods 50 patients undergoing multivessel CABG were prospectively randomized to two groups. In the ERAH group (25 patients) the RA was harvested endoscopically and in the ORAH group (25 patients) openly. Results There were not differences between the groups in preoperative characteristics. Length of skin incision was shorter in ERAH (p<0.001) but there were not differences in the length of RA, harvest time, blood flow and pulsatility index after ERAH and ORAH. Wound healing was uniformly smooth in ERAH and there were 2 haematomas and 1 infection in ORAH. Postoperatively, major neuralgias were present in 5 patients in ORAH and none in ERAH (p=0.05) and minor neuralgias in 11 and 3 patients (p=0.02) respectively. Twenty-four patients in ERAH and 4 in ORAH graded their experience as excellent (p<00001). One-year angiographic RA patency was 90% without intergroup difference. Target vessel stenosis < 90% adversely affected RA patency (p<0.0001). Conclusions In expert center, ERAH has no negative impact on time harvest, length and quality of RA conduit. Moreover, ERAH may provide better wound healing, and is associated with less neuralgias, excellent cosmetic result and better patient satisfaction. RA graft patency is unaffected by the harvesting technique and is excellent when placed to a target coronary artery vessel with stenosis > 90%.

A diverse collection of Teff [Eragrostis tef (Zucc.)Trotter] lines was characterized for a wide range of traits, ranging from agronomic to final Injera sensory parameters, under well-irrigated Mediterranean spring conditions. The lines tested were collected from single plants presenting lodging resistance at the site of collection and their traits were characterized herein. An early type of lodging was observed, which was most likely triggered by a fast and sharp inflorescence weight increase. Other lines were ‘strong’ enough to carry the inflorescence most of the grain-filling period, up to a point where strong lodging occurred and plants where totally bent to the ground. Three mixed color seeds lines were found at single plant collection or after propagation. These were separated into ‘white’ and ‘brown’ seeds and were characterized separately under field conditions. The newly ‘brown’ lines appear to be the result of a rather recent non-self (external) airborne fertilization from a dark pollen donor. Some of these hybrids were found to be promising in terms of Injera sensory traits. Integration between a wide range of parameters and the correlations obtained between agronomic and sensory traits may improve our ability to breed towards a “real world” better end-product.

As the pandemic of Coronavirus Disease 2019 (COVID-19) rages throughout the world, accurate modeling of the dynamics thereof is essential. However, since the availability and quality of data varies dramatically from region to region, accurate modeling directly from a global perspective is difficult, if not altogether impossible. Nevertheless, via local data collected by certain regions, it is possible to develop accurate local prediction tools, which may be coupled to develop global models. In this study, we analyze the dynamics of local outbreaks of COVID-19 via a coupled system of ordinary differential equations (ODEs). Utilizing the large amount of data available from the ebbing outbreak in Hubei, China as a testbed, we estimate the basic reproductive number, R0 of COVID-19 and predict the total cases, total deaths, and other features of the Hubei outbreak with a high level of accuracy. Through numerical experiments, we observe the effects of quarantine, social distancing, and COVID-19 testing on the dynamics of the outbreak. Using knowledge gleaned from the Hubei outbreak, we apply our model to analyze the dynamics of outbreak in Turkey. We provide forecasts for the peak of the outbreak and the total number of cases/deaths in Turkey, for varying levels of social distancing, quarantine, and COVID-19 testing.

The coronavirus disease 2019 (COVID-19) is an infectious disease which has rapidly evolved into a pandemic. Though it has affected all disciplines of medical sciences but it has some serious implications pertaining to cardiovascular sciences which have presented unique challenges in front of cardiac surgeons in particular. To flatten the curve of this pandemic, routine cardiac surgeries are being deferred indefinitely resulting in the pool of sick cardiac patients rising day by day. A different perspective is presented on this global catastrophe from the viewpoint of a cardiac surgeon.

There remains a significant paucity of information evaluating the effect of glycated HbA1c levels and its theorized effect on mortality and morbidity rates following cardiac surgery. Diabetes is a very common comorbidity in patients undergoing open heart surgery as there is shift in patient characteristics and being higher risk. Currently, the evidences are controversial and there is no clear consensus that increased HbA1c levels is associated with an increased perioperative mortality rate. However, reported literature are more commonly able to demonstrate elevated HbA1c levels to be associated with increased rates of wound infection, cardiovascular events and renal failure; thus, higher morbidities postoperatively. This literature review aims to examine the evidence synthesis behind each of morbidities and mortalities associated with open heart surgery and the impact of high HbA1c on the reported outcomes.

Device embolization is a rare major complication of atrial septal defect percutaneous closures that requires surgical management if non-invasive retrieval fails. We report a symptomatic delayed embolization of an Amplatzer septal occluder device into the left ventricle outflow tract tangled with the mitral valve, complicated with ventricular arrhythmias and cardiac tamponade during percutaneous retrieval attempt. Emergent surgical treatment was performed, requiring combined approach through the right atrium and the aorta for surgical removal.

This case showed that an elderly patient presented severe bradycardia concomitantly with consciousness lost, during the measuring of carotid-femoral Pulse Wave Velocity (c-fPWV). We propose that a single measure of c-f PWV is enough for older people.

Pheochromocytoma is a rare catecholamine-secreting tumor derived from chromaffin cells in the adrenal glands. A pheochromocytoma ‘crisis’ (PCC) can cause haemodynamic instability and end-organ damage or dysfunction. An excessive stimulation of cardiac myocytes could lead to myocardial damage with cardiogenic shock (CS). Use of mechanical circulatory support (MCS) might find an indication in this scenario as a bridge to myocardial recovery. We present the case of a patient successfully supported with ECMO (ExtraCorporeal Membrane Oxygenation) combined with IMPELLA CP heart pump (Abiomed Danvers, MA), for left ventricular (LV) unloading. MCS was used to favour myocardial recovery and avoid cardiac remodeling.

Abstract The posterior rupture of the left ventricle has been a complication recognized since the beginning of mitral valve surgery and, despite advances in cardiac surgery, the outcome of the rupture of the left ventricle has remained tragic. During mitral valve surgery, care must be taken not to traumatize the free wall of the left ventricle. On the other side, septal Myectomy is performed on hypertrophied septums to address the left ventricular outflow tract obstruction. In this article I have presented a theory that could give a part of the explanation of the resistance of the interventricular septum of surgical trauma unlike the ventricular wall.

Bronchial artery aneurysms are a rare vascular entity. They can have various presentations ranging from an incidental finding on radiological examination to life-threatening hemoptysis. We report the case of a 60-year old woman with three posterior mediastinal bronchial artery aneurysms who presented with unilateral periscapular pain, shortness of breath, hoarseness, and dysphagia. The bronchial artery aneurysms were removed successfully via thoracotomy, with excellent recovery and relief of the periscapular pain. We use this case as a platform to discuss unilateral periscapular pain as an atypical referral pattern for a bronchial artery aneurysm, as well as implications for treatment.

A quarter of coronary arteriovenous fistulas may present aneurysmal dilatation; however, spontaneous rupture of the aneurysm is rare. We present a rare case of ruptured coronary artery aneurysm (CAA) associated with coronary fistulas that presented cardiac tamponade. Subsequent to pericardial drainage, surgical repair of the CAA associated with coronary fistulas was performed electively. The aneurysm was located on the left anterior aspect of the pulmonary artery trunk. It communicated with both the left and right coronary arteries by anomalous fistulous vessels that drained into the pulmonary artery trunk. The feeding arteries and fistulous opening were ligated and closed, respectively, from within the aneurysm. Intraoperative fluorescence imaging was performed pre- and postoperatively to ensure no residual coronary fistulas were present. Although the rupture of CAA associated with coronary fistulas is rare, it should be considered as one of the potential causes of acute cardiac tamponade.

Flood is one of the severest natural disasters in the world and causes huge losses to human life and property. Previous studies usually focus on flood peak and its occurrence at event scale which are insufficient to contain entire behavior characteristics of flood events and their spatio-temporal variations. In our study, 12 behavior metrics in five categories (e.g. magnitude, duration, timing, rating of changes and variability) are adopted to fully describe the flood event. Regional and interannual variations of representative flood classes are investigated based on behavior similarity classification of numerous events by principal component analysis and hierarchical clustering. Contributions of geographical, land use, hydrometeorological and human regulation on these variations are explored by rank analysis method. There are 342 flood events from 2006 to 2015 at 39 stations across the upper and middle Huai River Basin of China selected for our study. Results show that: five representative classes are identified, namely conventional events (Class 1, 61.7% of total), low volume events with multiple peaks (Class 2, 5.3%), low volume events with low ratings of changes (Class 3, 18.1%), low volume events with high ratings of changes (Class 4, 10.8%) and high volume events with long durations (Class 5, 4.1%). Classes 1 and 3 are the major flood events, distributed across the whole region. Class 4 mainly distributes in river sources, while Classes 2 and 5 distribute in middle and down streams. Moreover, the class is the most diverse in normal precipitation years (2006, 2008-2010 and 2015), followed by wet years (2007, 2013-2014), but it is the most homogeneous in dry years (2011 and 2012). All the impact factor categories explain 34.0—84.1% of individual flood class variations. The hydrometeorological category (7.2-56.9%) is the most important, followed by geographical (1.0-6.3%), regulation (1.7-5.1%) and land use (0.9-2.2%) categories. This study could provide new insights into the flood event variations in a comprehensive manner, and provide decision-making basis for flood control and resource utilization at basin scale.

Background Telehealth post-operative visits are an attractive strategy to minimize exposure, especially during the SARS-CoV-2 (COVID-19) pandemic. The use of a surgical drain often prevents this minimal-exposure approach in that patients return to the outpatient clinic for drain removal. Methods and Results Following unilateral neck dissection, the customary closed-suction drain was replaced with a self-removing, passive drain dressing to facilitate same-day discharge and telehealth post-operative follow-up. The patient removed the dressing and drain at home during a telehealth visit on post-operative day four and she healed favorably without signs of infection or seroma. Conclusions When thoughtfully applied in the appropriate clinical context, small practice adaptations like this can facilitate telehealth solutions that diminish unnecessary exposure for patients, their caregivers, and healthcare staff.

Brett A. Miles DDS MD1, Bradley Schiff MD2, Ian Ganly MD MS PhD3, Thomas Ow MD MS2, Erik Cohen MD5, Eric Genden MD MPH1, Bruce Culliney MD1, Bhoomi Mehrotra MD6, Steven Savona MD6, Richard J. Wong MD3, Missak Haigentz MD5, Salvatore Caruana MD7, Babak Givi MD8, Kepal Patel MD8, Kenneth Hu MD81Icahn School of Medicine at Mount Sinai, New York, NY2Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY3Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York,4Cancer Institute at St. Francis Hospital, New York, NY5Morristown Medical Center, Leonard B. Kahn Head and Neck Cancer Institute, Morristown, NJ6Northwell Cancer Institute, Monter Cancer Center, Lake Success, NY7Columbia University, New York, NY8NYU Langone Health, New York, NY

Background. The firsts European case series are detecting a very high frequency of chemosensitive disorders in COVID-19 patients, ranging between 19.4% and 88%.Methods. Olfactory and gustatory function was objectively tested in 72 COVID-19 patients treated at University Hospital of Sassari.Results Overall, 73.6% of the patients reported having or having had chemosensitive disorders. Olfactory assessment showed variable degree hyposmia in 60 cases and anosmia in 2 patients. Gustatory assessment revealed hypogeusia in 33 cases and complete ageusia in 1 patient. Statistically significant differences in chemosensitive recovery were detected based on age and distance from the onset of clinical manifestations.Conclusion. Olfactory and gustatory dysfunctions represent common clinical findings in COVID-19 patients. Otolaryngologists and head-neck surgeons must by now keep this diagnostic option in mind when evaluating cases of ageusia and nonspecific anosmia that arose suddenly and are not associated with rhinitis symptoms

The 2019 novel coronavirus (COVID-19) pandemic has created significant challenges to the delivery of care for patients with advanced head and neck cancer requiring multimodality therapy. Performing major head and neck ablative surgery and reconstruction is a particular concern given the extended duration and aerosolizing nature of these cases. In this manuscript, we describe our surgical approach to provide timely reconstructive care and minimize infectious risk to both the providers, patients, and families.  

Health crises have become a popular topic of discussion. In the wave of the ongoing pandemic, experts have suggested the role of vaping and other tobacco product use exemplifying the vulnerability of the population to contract the COVID-19. We discuss some of the events that led up to these conclusions and also offer a unique insight into another form of tobacco use that is potentially propagating its spread especially in the South Asian region – chewed tobacco. Both of these have been a perennial issue that head and neck cancer surgeons have been dealing with. Governments and Head and Neck cancer care providers now have an opportunity to deal with a common enemy in the midst of this pandemic.

Background: Pulmonary complications and infections frequently affect patients with head and neck squamous cell carcinoma (HNSCC). Common characteristics can predispose these patients to the development of severe respiratory illness, which may be particularly relevant during the  2019 coronavirus disease (COVID-19) pandemic. Methods: A scoping review was performed to assess the impact of pulmonary comorbidities and adverse respiratory outcomes in HNSCC patients. Results: Advanced age, history of tobacco and alcohol abuse, and cardiopulmonary comorbidities are significant risk factors for the development of adverse respiratory outcomes. Treatment  toxicities from radiation or chemoradiation therapy significantly increase these risks.  Conclusion: Respiratory complications are a frequent cause of morbidity and mortality among HNSCC patients, and the COVID-19 pandemic may disproportionately affect this population.  Interventions designed to decrease smoking and alcohol use, improve oral hygiene, and aggressively manage medical comorbidities are important to the long-term management and health of these patients.  

Coronavirus disease 2019 (COVID-19) has been declared a pandemic of 2020 by World Health Organization (WHO). Due to its novelty there is very little knowledge available about it, and thus there is a great need of collection of data related to COVID-19, from all around the world. Hence, we have conducted this study, collecting daily data on COVID-19 from National Institute of Health (NIH) Pakistan and WHO, to map the epidemiology of COVID-19 outbreak, forecast its trajectory from 4th April till 30th April, and review the preventive measures taken by government of Pakistan. The data was collected from NIH-Pakistan and WHO official released reports, analysis was done using SPSS version 23 and forecasting was made using time series modeler / expert modeler. The purpose of this study is to draw the attention of international as well as national governing bodies towards the rapidly rising number of COVID-19 cases in Pakistan, and the urgency to evaluate the efficacy of currently implemented strategy against COVID-19. According to this study, the spread of COVID-19 is slower than predicted, but there is an alarming increase in growth rate now, and the predicted COVID-19 cases by the end of April can go up to around 8,000 or higher. Hence, it is crucial for the governing bodies to re-evaluate the current situation and implemented strategy. Discussions should be conducted by the administrators and researchers for any change in the strategy if required, before the situation further aggravates.