Search Results (11,163)

Background/Objectives: Birooted mandibular canines are a rare but clinically significant variation that is often underdiagnosed and may complicate dental treatment. The aim of this review was to conduct a comprehensive meta-analysis to estimate the prevalence of birooted and multirooted mandibular canines, and to address the research question of whether geographical region, sex, or side predilections significantly influence these anatomical variations. Methods: A systematic search was performed on 4 September 2025 across five databases: BASE, Scopus, PubMed, DOAJ, and Scielo. Studies on permanent mandibular canines with at least 10 cases, assessed radiologically or in vitro, were included. Reports without detailed root number data or based only on two-dimensional imaging were excluded. Meta-analysis estimated prevalence and odds ratios by sex and geographic region, with results shown in tables and graphs. Risk of bias was assessed using the Joanna Briggs Institute appraisal tools. Results: Eighteen studies met the inclusion criteria, of which seventeen were classified as population studies and one case as a series. The pooled prevalence of birooted mandibular canines was 2.71%. A female predilection was statistically significant in four modern cohorts. Only one case of a three-rooted mandibular canine was documented. No clinical outcome data were available regarding endodontic success or extraction complications. Conclusions: Birooted mandibular canines represent a relatively common anatomical variant, especially in females and on the right side of the jaw. However, clinical implications related to treatment outcomes remain underreported, emphasizing the need for future clinical and radiological investigations. Full article

Objective: To report on a series of three cases in which problems with rotating magnets (blocked rotation, demagnetization) occurred in cochlear implants and to resolve these problems without surgical intervention. Methods: Of the 3635 devices with rotating magnets implanted at this tertiary referral hospital, 2 exhibited rotation blockage (associated with misalignment of the coil or audio processor), and 1 was partially demagnetized in a 1.5 T MRI scanner. Results: One blockage resolved spontaneously without intervention. The second blockage was resolved in the static field of a 3T MRI scanner, where the demagnetized magnet was also re-magnetized to its original strength. Surgical intervention or re-implantation was not necessary in either case. Conclusions: Surgical intervention or re-implantation is not primarily required in the event of problems with the rotating implant magnet. Prior to surgery, technical analysis can lead to a conservative solution. Full article

In this paper, a new class of special polynomials, called the Sheffer-type general-$\lambda$-matrix polynomials, is introduced within the framework of the monomiality principle. This family is obtained by combining the structure of Sheffer sequences with the theory of general-$\lambda$ matrix polynomials, which leads to a unified formulation encompassing several polynomial families. Fundamental properties of the proposed polynomials are established, including their generating function, explicit series representation, summation formulas, quasi-monomial structure, differential relations, and determinant representation. The proposed framework addresses an important problem in the theory of special functions: the systematic construction of matrix-valued polynomial families that simultaneously generalize both classical scalar polynomials and existing matrix polynomial hierarchies. Such a unified structure is of broad significance, with applications in quantum mechanics (wave function expansions), mathematical physics (matrix differential equations and spectral problems), approximation theory, and the study of special functions in the matrix domain. Several hybrid forms of the proposed family are derived through appropriate choices of the defining functions, which yield polynomial subclasses related to classical families such as Hermite, Laguerre, Bessel, and Poisson–Charlier polynomials. These subclasses illustrate how the proposed framework provides a systematic approach for constructing and studying generalized polynomial structures. In each case, the matrix parameter L introduces a new layer of structural richness not present in the scalar setting, enabling the modelling of phenomena governed by matrix-valued spectral data. Furthermore, a numerical and graphical investigation of selected hybrid forms is carried out using Mathematica(version 14.3, 2025; Wolfram Research, Inc.). Surface plots, distributions of complex zeros, and real-zero patterns are presented for different parameter values, highlighting the influence of the parameters on the behavior and structural characteristics of the polynomials. Full article

Background and objectives: Valve-in-valve transcatheter aortic valve replacement (ViV TAVR) has become an established treatment for failed surgical bioprostheses in patients at high surgical risk. However, procedures performed in degenerated stentless aortic valves remain particularly challenging because of the absence of a radiopaque frame, variable surgical implantation techniques, and a potentially increased risk of coronary obstruction. Evidence in this specific setting is limited. We conducted a systematic review of the literature to identify studies reporting ViV TAVI in degenerated stentless surgical bioprostheses. Materials and methods: Case reports and case series were included when patient-level or clearly identifiable data were available. Baseline characteristics, anatomical features, procedural strategies, and clinical outcomes were extracted and analyzed using a descriptive approach. A total of 54 studies were included, encompassing 294 ViV TAVI procedures performed in failed stentless aortic valves. Results: The mean patient age was 73.9 years, and the average STS-PROM score was 13.45%, reflecting a high-risk population. The most frequently treated prosthesis was the Medtronic Freestyle valve, and the predominant mechanism of failure was regurgitation. Transfemoral access represented the most common approach, while balloon-expandable and self-expanding transcatheter valves were used with similar frequency. Coronary protection strategies were adopted in a minority of procedures, whereas adjunctive procedural techniques such as pre- or post-dilation were relatively common. Device-related complications were mainly driven by coronary obstruction, while cardiac complications included myocardial infarction and unplanned coronary intervention. Overall, VARC-3 device success was achieved in the majority of procedures, with acceptable short-term mortality despite the complexity of the treated population. Conclusions: ViV TAVR in degenerated stentless bioprostheses appears feasible and generally effective but remains associated with specific procedural challenges, particularly related to coronary obstruction risk. Careful anatomical assessment and tailored procedural planning are essential, and larger contemporary studies are needed to better define optimal management strategies in this complex setting. Full article

Intravenous lipid therapy (ILE) is used to treat neurotoxicosis in companion animals, but clinical evidence for in vivo xenobiotic partitioning and benefit remains limited. This study evaluated associations between the log n-octanol/water partition coefficient (log P), in vivo plasma partitioning, and early neurological outcome. In this case series from eight veterinary hospitals, dogs and cats with suspected neurotoxicosis received ILE. Blood collected before and at the end of infusion was separated into lipid and aqueous fractions and analyzed by gas chromatography–mass spectrometry. Log P values were retrieved from PubChem. Outcome (improvement vs. no-improvement) was the change from ILE-start to 4–6 h later. Thirty-four cases were analyzed (27 dogs and seven cats; 17 different xenobiotics were identified). At the end of infusion, xenobiotic lipid fraction concentrations exceeded aqueous concentrations in 28/34 cases, and log P did not correlate with the lipid-to-aqueous ratio. Improvement occurred in 14/34 animals and was associated with higher lipid-to-aqueous xenobiotic ratios (geometric mean ratio 5.7; 95% CI 1.73–19.05; p = 0.007). Overall, in vivo lipid sequestration was frequent and was associated with early neurological improvement, whereas log P alone did not predict partitioning or outcome. Full article

The present work examines a severe, long-lived bow echo in South China during 12–13 April 2016 and investigates the favorable factors for its strength and longevity using a series of 20 cloud-resolving ensemble experiments. Analysis of observational data indicated that this system developed near a surface front under unstable and favorable conditions with dynamic uplifting by approaching troughs at 500–700 hPa. After formation, it propagated rapidly toward the east–southeast across South China and made landfall in Southern Taiwan. The ensemble used four different datasets as initial and boundary conditions and started at five different initial times, whereby comparing the better-performing members with worse ones, four key factors promoting its strength and longevity were identified: (1) A stronger and moister low-level southwesterly flow to the south of the front to enhance convergence and moisture flux at the leading edge—where a stronger inflow with higher equivalent potential temperature (θ_e) values could feed into the bow echo—leading to a stronger and taller updraft and overall more abundant hydrometeors and rainfall; (2) stronger northwesterly to westerly winds near 700 hPa and thus stronger low-level vertical wind shear, resulting in a stronger rear inflow jet (RIJ), bookend vortices behind the bow apex, and, eventually, a faster propagation speed; (3) a deeper low to the northeast of the bow echo near 850 hPa, where its circulation also helped to bring in low-θ_e air from farther away and enhance the RIJ and cold pool; and (4) a convective initiation location farther to the east in a more favorable environment, with higher θ_e and a faster speed to remain in such a better environment. Helped by the above factors, the bow echo in the present case could reach the observed severity and long duration (~15 h) through interactions and reinforcement among its structural components, including the tilted updraft/downdraft, the low-level inflow and stratiform region, the RIJ and bookend vortices, and the cold pool and gust front. Full article

Background: Nasal valve dysfunction (NVD) is a common yet underrecognized cause of nasal airway obstruction, with a significant impact on quality of life. Despite its clinical relevance, no universally accepted diagnostic standard exists, and optimal management remains debated. Multiple diagnostic tools and surgical or minimally invasive treatments have been proposed. This systematic review and meta-analysis aimed to evaluate current evidence regarding diagnostic approaches and treatment outcomes in NVD. Methods: A systematic search of PubMed/MEDLINE, Embase, and Cochrane Library was performed for studies published between January 1990 and January 2026, in accordance with PRISMA 2020 guidelines. Randomized controlled trials, non-randomized comparative studies, cohort studies, and case series (≥10 patients) assessing diagnostic methods or therapeutic interventions for NVD were included. Diagnostic data were synthesized narratively. The primary surgical outcome was change in the Nasal Obstruction Symptom Evaluation (NOSE) score. Risk of bias was assessed using RoB 2, ROBINS-I, and QUADAS-2 tools. Results: Seventy-two primary clinical studies were included (15 diagnostic, 57 treatment-focused). Objective airflow measurements, particularly rhinomanometry and peak nasal inspiratory flow, showed greater reliability than isolated clinical maneuvers. Imaging modalities provided anatomical detail but correlated inconsistently with symptoms. Meta-analysis of 12 studies (n = 1210 patients) suggests that both traditional surgical and minimally invasive interventions can substantially improve nasal breathing, with mean NOSE score reductions of 40–55 points, though heterogeneity precludes direct comparison of their relative effectiveness. Conclusions: Diagnosis of NVD requires a multimodal approach combining clinical assessment, validated symptom scores, and selective objective testing. Surgical and minimally invasive treatments provide substantial symptom improvement when appropriately indicated. Evidence is constrained by the predominance of observational data, emphasizing the need for standardized diagnostics and robust comparative trials. Full article

This narrative review evaluates the current role of interventional radiology in the diagnosis and treatment of parathyroid disorders. In patients with biochemically confirmed hyperparathyroidism but inconclusive or discordant preoperative localization imaging, image-guided interventions can help establish a diagnosis that can alter management. This review outlines the current diagnostic and therapeutic modalities for the study of parathyroid pathology from the interventional radiologist’s perspective, highlighting novel techniques and their growing clinical adoption. The combination of ultrasound-guided fine-needle aspiration biopsy and measurement of parathyroid hormone (PTH) in the needle washout fluid can improve diagnostic specificity by providing biochemical evidence of parathyroid tissue. This is particularly useful for lesions that are difficult to differentiate from thyroid nodules or cervical lymph nodes based solely on imaging characteristics. Despite this, no widely accepted cut-off washout PTH level has yet been established. Due to the differences in assay techniques and laboratory procedures, results should be interpreted in conjunction with clinical findings and concomitant biochemical parameters. Ultrasound-guided thermal ablation techniques, especially radiofrequency and microwave ablation, have recently been reported as minimally invasive alternatives or adjuvants to surgery in appropriately selected patients. Evidence supporting parathyroid embolization is limited, but it may be considered a potential salvage option for persistent or recurrent disease. Given that most of the current evidence is derived from retrospective case series, multicenter prospective studies for technical standardization and long-term outcomes evaluation are clearly needed. Full article

Coastal bottom dissolved oxygen (DO) depletion poses a serious threat to marine ecosystems and aquaculture, and hypoxic events in the semi-enclosed Jinhae Bay, Korea, repeatedly cause large-scale damage to fish farms. Accurate DO prediction models are therefore crucial for ecosystem management and loss mitigation. This study analyzes how different tidal input representations affect the performance of data-driven DO prediction models in a tide-dominated coastal environment. Using time-series data of oceanographic and meteorological variables from nearby observation sites, we develop an long short-term memory (LSTM)-based neural network ensemble model with four experimental configurations. These include not only water level but also tidal envelope, tidal-intensity proxy, and temporal differences in water level and DO (Δtide, ΔDO) as additional inputs. Compared with the baseline configuration, the full tide-informed input case reduced the 72 h mean root mean square error (RMSE) from 1.16 to 1.12 and increased the Pearson correlation coefficient from 0.873 to 0.883. It also improved the representation of intraday variability and prediction stability. These results show that tide-derived variables help the model more effectively capture tidal-phase-locked DO fluctuations, while temporal-difference inputs further strengthen short-term variability and sensitivity to DO changes. These results indicate that properly representing tidal forcing is essential for learning the temporal structure and variability of coastal bottom DO. Full article

We study the phase-space dynamics of quantum systems with $\mathrm{SU}(1,1)$ group symmetry using coherent-state representations on the Poincaré disk. The resulting evolution equation combines transport terms with nonlocal contributions generated with the spectral functions of the Casimir operator, which admit a natural interpretation as pseudodifferential operators associated with the hyperbolic Laplace–Beltrami operator. Using this pseudodifferential structure, we classify the phase-space generators according to the type of the underlying PDE: compact quadratic dynamics ($\widehat{H}\propto {\widehat{K}}_0^2$) yield a degenerate hyperbolic operator of the transport type, and noncompact dynamics ($\widehat{H}\propto {\widehat{K}}_2^2$) give rise to a mixed-order differential–pseudodifferential operator. For numerical evaluation, we reformulate the propagator as an oscillatory integral and develop two complementary strategies: a Fourier-series reduction exploiting the periodicity of compact orbits and a Levin-type spectral collocation method for the noncompact case. Both approaches are stable, accurate, and free of the stiffness issues that afflict direct PDE evolution on the Poincaré disk. Full article

In this study, we analyze the solution characteristics and dynamics of a variable-order fractional (V-OF) Arneodo system using the Liouville–Caputo fractional operator with variable order. The V-OF operator is used to describe the time-dependent memory effect in the system, which leads to more complex and diverse dynamics compared to integer-order systems. In this work, numerical simulations are performed to observe the effect of the order functions on the dynamic behaviors of the system. In addition, the phase portraits, time series graphs, and three-dimensional diagrams are used to analyze the dynamic behaviors and different types of oscillations present in the system. Furthermore, the bifurcations, chaotic behaviors, and stability of the system with variable orders are studied, and it is found that the system has more complex dynamics compared to the integer-order case. In this case, the Lyapunov exponents indicate that the system under investigation is sensitive to the initial conditions, and the memory effect can control the chaotic oscillation depending on the order of the functions. Full article

Background and Objectives: Chronic headache after craniotomy is common and may include neuropathic subtypes (scar neuroma pain, occipital neuralgia). However, no large series has quantified these phenotypes. We conducted a single-center retrospective review (n = 5624 adult craniotomy patients) to estimate the prevalence of post-craniotomy neuropathic pain and to describe its characteristics. Materials and Methods: Institutional records were screened to identify craniotomy patients referred to a multidisciplinary pain clinic (n = 272). Eligible cases were reviewed in tiers: (1) exclusion of primary headache and noncranial pain; (2) identification of “probable neuropathic cranial pain” based on documented neuropathic features (lancinating/scalp pain, trigger tenderness, dermatomal distribution); and (3) subgroup categorization into occipital neuralgia-like, supraorbital/supratrochlear neuralgia-like, and scar-site neuropathic pain phenotypes. The supraorbital/supratrochlear subgroup was defined by frontal or frontotemporal postoperative pain in the supraorbital region, local tenderness or Tinel-like hypersensitivity over the supraorbital/supratrochlear course, and/or response to supraorbital–supratrochlear nerve block. Data extracted included demographics, timing (surgery to pain referral), pain characteristics, and treatments (blocks, radiofrequency, medications). Results: Of 5624 craniotomy patients, 272 (4.8%) had pain clinic encounters. The initial review identified 124 cases with chronic post-craniotomy headache requiring follow-up; after detailed chart classification, probable neuropathic cranial pain was present in 111 cases (2% of the cohort). Among the 111 probable neuropathic cranial pain cases, the dominant regional phenotype was occipital neuralgia-like pain. In addition, eight patients (7.2%) demonstrated a supraorbital/supratrochlear neuralgia-like phenotype, predominantly after frontal or frontotemporal craniotomies. Scar-site neuropathic pain frequently coexisted with both regional phenotypes, supporting a partially overlapping spectrum rather than mutually exclusive categories. The median time from surgery to pain referral was several months (≈12–18 months). Management commonly included occipital nerve blocks (±steroid); some patients received pulsed radiofrequency ablation of the occipital nerves, and most were trialed on neuropathic analgesics (gabapentinoids, SNRIs, etc., according to neuropathic pain guidelines). Conclusions: A clinically meaningful subset of post-craniotomy patients develops chronic neuropathic cranial pain, most commonly with occipital, supraorbital/supratrochlear, or scar-related features. Because most postoperative headaches are managed through neurosurgical follow-up and improve without pain clinic referral, the present cohort likely underestimates the true burden of neuropathic post-craniotomy pain while enriching for its most refractory neuralgic presentations. This is nevertheless the subgroup that must be recognized, discussed with patients, studied prospectively, and targeted in future prevention strategies. Full article

This exploratory study examines how complex non-linear television narratives support viewers’ cognitive processing through embedded compensatory mechanisms. Using Season 1 of the Netflix series Dark as a case study, we conducted a quantitative content analysis examining temporal structure across 10 episodes. The series presents interconnected timelines (1953, 1986, 2019), creating substantial cognitive demands for viewers. Statistical analyses revealed a significant negative correlation (r = −0.745, p < 0.05) between spatial fragmentation (number of locations) and scene duration, suggesting systematic compensatory editing strategies. Despite high temporal complexity, the narrative maintains a hierarchical timeline structure with 2019 serving as the primary temporal anchor (59% of screen time). These preliminary findings suggest that complex storytelling incorporates built-in cognitive scaffolding mechanisms that may facilitate comprehension despite exceeding traditional working memory constraints. The study contributes to understanding how narrative design can support distributed cognition and has implications for theories of cognitive load and multimedia learning. Full article

Background. Post-intubation cicatricial laryngeal stenosis (PICLS) represents one of the most severe long-term complications of pediatric airway management. By systematically analyzing clinical and procedural variables across different grades of PICLS, this study addresses a critical gap in pediatric airway research and provides clinically relevant descriptive data on stenosis severity. Materials and methods. A retrospective single-center case-series study was conducted and included pediatric patients (0–18 years) treated for PICLS at a tertiary referral pediatric otolaryngology center between 2016 and 2024. Spearman correlation and multiple regression analyses were used to evaluate possible associations between clinical factors and stenosis grade. Results. Among 172 children with PICLS, severe forms of stenosis (Grades 3–4) were observed in 37.2%, with predominant subglottic localization (85.3%). Age at primary intubation (p = 0.02) and the type of intubation (emergency/elective; p = 0.04) were the only variables significantly associated with stenosis severity in this cohort, whereas sex, reintubation, comorbidities, and delivery-related factors showed no significant associations. Mild stenosis (Grades 1–2) more frequently followed intubation for elective surgery and infections, whereas severe stenosis was more commonly associated with intubation due to central nervous system pathology and infections. Conclusions. Age at primary intubation and the type of intubation (emergency/elective) were associated with stenosis severity in this cohort. These findings should be interpreted in light of the retrospective case-series design and the absence of a control group, but they may contribute to improved clinical characterization of PICLS severity in children. Full article

Background/Objectives: Fungal peritonitis is a severe complication of peritoneal dialysis (PD) associated with catheter removal, technique failure, and increased mortality. Although Candida albicans was traditionally the predominant pathogen, non-albicans Candida (NAC) species are increasingly reported. This review summarizes the epidemiology and outcomes of PD-associated NAC peritonitis. Methods: A systematic review was performed following PRISMA guidelines. PubMed/MEDLINE, Scopus, and Google Scholar were searched (January 1990–March 2026) for NAC peritonitis studies. Case reports and series with species-level identification were included. Results: 31 studies met the inclusion criteria, comprising 25 individual case reports and 6 case series, totaling 89 NAC isolates. Candida parapsilosis was the most frequently reported species (n = 50), followed by Candida tropicalis (n = 15). Other pathogens included Candida glabrata, Candida guilliermondii, and several rare NAC species. Fluconazole was the most commonly used initial antifungal therapy. Catheter removal was performed in most cases, with the majority of patients requiring transition to hemodialysis. Overall mortality was 20% among individual case reports vs. 24% across case series. Species-specific differences were observed: C. parapsilosis and C. guilliermondii were generally associated with favorable outcomes, whereas infections involving C. glabrata and other emerging NAC species more frequently required treatment escalation and were linked to poorer outcomes. Conclusions: NAC species are an important cause of fungal peritonitis in PD patients and show considerable heterogeneity in clinical outcomes and antifungal susceptibility. Early species-level identification and prompt catheter removal remain essential for optimal management. Full article