Functional Difficulties Research Articles

Trauma-Related Nightmares Among U.S. Veterans: Findings from a Nationally Representative Study

Study ObjectivesTrauma-exposed veterans may be at an increased risk for nightmares. To date, however, no known study has examined the prevalence, risk factors, and comorbidities of nightmares in a nationally representative sample of veterans. MethodsA nationally representative sample of 4,069 US military veterans completed a survey that assessed trauma-related nightmares, health histories, and functioning. Multivariable analyses examined the association between trauma-related nightmares, and sociodemographic, military, and trauma characteristics, and psychiatric and functioning measures. ResultsLifetime trauma-related nightmares were endorsed by 15.0% of the sample, with 6.4% endorsing nightmares in the past month. Sociodemographic factors, exposure to adverse childhood events, number of deployments, and index trauma type were all associated with trauma-related nightmares. In addition, nightmares were associated with elevated odds of psychiatric conditions, worse health and psychosocial functioning, and suicidal ideation and future suicidal intent. A "dose-response" association was observed between nightmare severity and suicidal ideation, even after controlling for sociodemographic characteristics, trauma exposure, and psychiatric and medical conditions. ConclusionsNearly 1-in-6 veterans experience trauma-related nightmares in their lifetime, which is associated with adverse mental health, functional difficulties, and increased suicide risk. Results underscore the importance of transdiagnostic assessment, monitoring, and treatment of trauma-related nightmares in this population.

Listening to the voices of adolescents with inflammatory bowel disease after returning to school: a qualitative study

BackgroundThe prevalence of inflammatory bowel disease (IBD) among Chinese adolescents has continued to increase in recent years. Adolescents with IBD interrupted their schooling due to the diagnosis and treatment of...

Association of Self-Recognition of Hearing Loss With Hospitalizations in Older Adults in the United States.

Hearing loss is highly prevalent and associated with increased health care utilization. Recognition of hearing loss may play an important role in self-advocacy in difficult communication situations and prevent negative outcomes. To investigate the associations between self-recognition of hearing loss and hospitalization outcomes. This is a cross-sectional analysis of 1766 participants from the National Health and Aging Trends Study. The exposure, recognition of hearing loss, was constructed using participants' self-reported functional hearing difficulty, audiometric hearing loss, and self-reported hearing aid use. Primary outcomes included self-reported hospital stay occurrence and number of hospital stays within the last year. Regression models were adjusted for demographic, socioeconomic, and health characteristics and further stratified by severity of hearing loss. Among 1766 participants with hearing loss, those with unrecognized hearing loss [60.1% (n=1062)] had higher but statistically insignificant odds of any hospitalization [odds ratio (OR)=1.32; 95% CI: 0.96, 1.81] or higher count of hospitalizations [incident rate ratio (IRR)=1.13; 95% CI: 0.85, 1.51] compared with those with recognized hearing loss (39.9%, n=704). Among participants with mild hearing loss, those with unrecognized hearing loss demonstrated significantly higher odds of any hospitalization occurrence (OR=2.50; 95% CI: 1.26-4.97) and a higher count of hospitalizations (IRR=2.00, 95% CI: 1.00-4.01) than those with recognized hearing loss. There were no significant differences in hospitalization outcomes among participants with moderate or greater hearing loss. In a nationally representative sample of older adults, individuals with unrecognized hearing loss compared with those with self-recognized hearing loss may be at increased odds of adverse hospitalization outcomes.

Coati optimization algorithm for brain tumor identification based on MRI with utilizing phase-aware composite deep neural network

ABSTRACT Brain tumors can cause difficulties in normal brain function and are capable of developing in various regions of the brain. Malignant tumours can develop quickly, pass through neighboring tissues, and extend to further brain regions or the central nervous system. In contrast, healthy tumors typically develop slowly and do not invade surrounding tissues. Individuals frequently struggle with sensory abnormalities, motor deficiencies affecting coordination, and cognitive impairments affecting memory and focus. In this research, Utilizing Phase-aware Composite Deep Neural Network Optimized with Coati Optimized Algorithm for Brain Tumor Identification Based on Magnetic resonance imaging (PACDNN-COA-BTI-MRI) is proposed. First, input images are taken from the brain tumour Dataset. To execute this, the input image is pre-processed using Multivariate Fast Iterative Filtering (MFIF) and it reduces the occurrence of over-fitting from the collected dataset; then feature extraction using Self-Supervised Nonlinear Transform (SSNT) to extract essential features like model, shape, and intensity. Then, the proposed PACDNN-COA-BTI-MRI is implemented in Matlab and the performance metrics Recall, Accuracy, F1-Score, Precision Specificity and ROC are analysed. Performance of the PACDNN-COA-BTI-MRI approach attains 16.7%, 20.6% and 30.5% higher accuracy; 19.9%, 22.2% and 30.1% higher recall and 16.7%, 21.9% and 30.8% higher precision when analysed through existing techniques brain tumor identification using MRI-Based Deep Learning Approach for Efficient Classification of Brain Tumor (MRI-DLA-ECBT), MRI-Based Brain Tumor Detection using Convolutional Deep Learning Methods and Chosen Machine Learning Techniques (MRI-BTD-CDMLT) and MRI-Based Brain Tumor Image Detection using CNN-Based Deep Learning Method (MRI-BTID-CNN) methods, respectively.

Investigation of the effectiveness of parent-child interaction therapy on adjustment and behavioral problems in children with subthreshold autism

BackgroundAutism Spectrum Disorder (ASD) is an increasingly prevalent neurodevelopmental disorder. However, the number of children who exhibit subthreshold levels of ASD symptoms, significant enough to experience functional and adaptive difficulties, is also substantial. These children require early interventions, similar to those diagnosed with ASD, due to their exhibited adaptive and behavioral challenges. PCIT offers a unique opportunity for children and their parents exhibiting subthreshold ASD to address such challenges through its practices and techniques.AimThis study aims to assess the initial result effectiveness of standard PCIT on the adaptive skills and school refusal behaviors of children exhibiting subthreshold ASD, as well as on the levels of parental stress and caregiving burden. The study intends to test these effects and report the outcomes.MethodThis study is a case study, and it involves three children with subthreshold ASD symptoms and their parents. The therapy processes were conducted for approximately 1 year.ResultResults obtained from this study revealed that PCIT holds promising prospects for improving adaptive and interaction skills, reducing school refusal, and alleviating parental stress and caregiving burden among children exhibiting subthreshold ASD.DiscussionPCIT is considered a functional approach for children and parents demonstrating subthreshold ASD symptoms, besides interventions addressing diagnosed ASD children. It is suggested that future studies should evaluate the effectiveness and sustainability of PCIT through randomized controlled trials in the context of subthreshold ASD.

Providing appropriate health and social care for people with dementia or mild cognitive impairment in the criminal justice system of England and Wales: a thematic analysis of prisoner and staff interview data

BackgroundThe number of older adults entering the criminal justice system is growing. Approximately 8% of older prisoners in England and Wales have suspected dementia or mild cognitive impairment (MCI) and experience difficulties in everyday functioning, and disruption to their daily life. At present, no specific dementia/MCI care pathway has been implemented that is applicable and appropriate for use across different prisons in England and Wales. The aim of this paper is to explore the experiences of older adults with dementia/MCI in prison, and a range of key stakeholders, around the day-to-day issues faced by people with dementia/MCI and prison, healthcare, and third sector staff regarding the delivery of support for individuals with dementia/MCI.MethodsThirty-two semi structured interviews were conducted with prison, local authority, and healthcare staff; peer supporters; third sector care providers; and individuals with dementia/MCI themselves, across five establishments, to provide multidimensional perspectives of dementia/MCI in criminal justice settings. The data obtained during interviews were thematically analysed.ResultsFrom the data, six key themes emerged: (I) ethical concerns around trial, sentencing and detainment for people with dementia/MCI; (II) An unforgiving prison system, providing physical and social environments incompatible with supporting individuals with dementia/MCI; (III) An unprepared workforce requiring training in dementia/MCI. (IV) A lack of collaboration leading to sub-optimum management of the support needs of people with dementia/MCI in prison; (V) Peer support ‘plugging the gap’; and (VI) staff ‘hands tied behind back’.ConclusionsResults point towards a pressing need to develop more appropriate support systems for individuals with dementia/MCI throughout the criminal justice system. Ethical concerns around the judicial process for individuals with diminished cognitive capacity must be considered. Prison governors should examine ways to make the living environment more appropriate for these individuals, and a joined-up collaborative approach to health and social care should be adopted. Staff must be appropriately trained to support and identify individuals with dementia/MCI. Peer support schemes require formal evaluation, and training/oversight of these schemes should be comprehensive.

Technical Validation of a Spatial Tracking Configuration for Augmented and Co-Localized Medical Assistance Under Gravity Variations in Parabolic Flights.

Augmented reality is a promising technology for enhancing remote medical assistance. It assists users by directly projecting the relevant virtual assistance in the real world at the right moment and at the right location. This modality is called colocalization but has not been validated in parabolic flights. Our hypothesis was that this modality is technically feasible in weightlessness and is superior to a paper checklist in assisting a caregiver during a simulated medical emergency. During parabolic flight campaigns, we conducted an abdominal pain simulation scenario and sought to compare procedural assistances. Participants performed a basic medical examination using either classic cognitive aids (such as a paper checklist) or an augmented-reality device projecting visual co-localized (situated or embedded) assistance. Gravity variations induced technical difficulties in the nominal functioning of augmented-reality headsets due to the native accelerometers in these devices. Clinical data were not interpretable due to small sample size secondary to the technical difficulties encountered. Finally, an efficient and stable spatial tracking configuration was found during the last flight, offering future research perspectives. Our study validated the first achievement of a stable co-localized assistance under gravity variation. The augmented-reality headset required an external tracking system based on surrounding infrared cameras and an in-flight calibration to recreate the virtual environment (spatial mapping) independently of gravity conditions. Further studies are needed to clinically validate the potential benefits of co-localized augmented reality for space medicine.

The impact of ovulation-suppressing contraceptives on behavioral and functional difficulties in borderline personality disorder.

Borderline Personality Disorder (BPD) is characterized by rapidly shifting emotional, interpersonal, and behavioral symptoms, often co-morbid with mood and anxiety disorders. Females are more likely to be diagnosed with BPD than males and exhibit greater functional impairment. Hormonal fluctuations may influence the manifestation of BPD symptoms. Here, we investigated the influence of ovulation-suppressing contraceptives on behavioral and functional difficulties in BPD. The sample included 348 females ages 18-50 undergoing residential treatment for psychiatric disorders, with 131 having a BPD diagnosis. Patients were categorized by their contraceptive method: Ovulation-suppressing contraceptives (N = 145) and naturally cycling (N = 203). Interaction models tested the impact of ovulation-suppressing contraceptives on the relationship between BPD diagnosis and behavioral and functional difficulties at admission and discharge, assessed by the four Behavior and Symptom Identification Scale (BASIS-32) domains: difficulties in relationships, daily living, depression/anxiety, and impulsivity. Females with a BPD diagnosis were more likely to use ovulation-suppressing contraceptives compared to those without BPD (p = 0.04). However, ovulation-suppressing contraceptive use was not associated with behavioral and functional difficulties at admission, discharge, or over time. Ovulation-suppressing contraceptives moderated the association between BPD diagnosis and difficulties in relationships (p = 0.004), difficulties in daily living (p = 0.01), and depression/anxiety symptoms (p = 0.004). Specifically, patients with BPD experienced more behavioral and functional difficulties only if naturally cycling, whereas patients without BPD showed higher symptom severity only if using ovulation-suppressing contraceptives. Our findings suggest that the impact of ovulation-suppressing contraceptives on behavioral and functional difficulties varies depending on BPD diagnosis and underscores the need for further clinical studies.

Influence of Ageing on the Pharmacodynamics and Pharmacokinetics of Chronically Administered Medicines in Geriatric Patients: A Review.

As people age, the efficiency of various regulatory processes that ensure proper communication between cells and organs tends to decline. This deterioration can lead to difficulties in maintaining homeostasis during physiological stress. This includes but is not limited to cognitive impairments, functional difficulties, and issues related to caregivers which contribute significantly to medication errors and non-adherence. These factors can lead to higher morbidity, extended hospital stays, reduced quality of life, and even mortality. The decrease in homeostatic capacity varies among individuals, contributing to the greater variability observed in geriatric populations. Significant pharmacokinetic and pharmacodynamic alterations accompany ageing. Pharmacokinetic changes include decreased renal and hepatic clearance and an increased volume of distribution for lipid-soluble drugs, which prolong their elimination half-life. Pharmacodynamic changes typically involve increased sensitivity to various drug classes, such as anticoagulants, antidiabetic and psychotropic medications. This review examines the primary age-related physiological changes in geriatrics and their impact on the pharmacokinetics and pharmacodynamics of medications.

Impact of Older Adults' Internet Use on Economic Burden of Informal Caregiving.

This study examines the impact of older adults' Internet use on care hours and its influence on estimating national cost savings with active and potential Internet users. Using data from the 2015 National Health and Aging Trends Study (n = 1,806), we employed a survey weighted two-part model with gamma distribution. The cost savings were estimated by a replacement approach. Older adults' health-related Internet use was associated with a substantially reduced hours of informal care by 27.7% (19.8 hours per month, p < .05). An annually estimated cost reduction of informal caregiving was US$3,094 per older adult with functional difficulties by replacing the 2020 median wage of home health aide workers. The annual cost savings in informal caregiving are estimated to be US$8.1 billion with active users and US$20.1 billion with potential health-related Internet users. Promoting health-related Internet use among older adults with functional difficulties could help relieve the economic burden of informal caregiving.

Impact of exposure to opioids in pregnancy on offspring developmental outcomes in the preschool years: an umbrella review

BackgroundEarly child development sets the course for optimal outcomes across life. Increasing numbers of children worldwide are exposed to opioids in pregnancy and frequently live in environments associated with adverse...

How does family functioning contribute to child externalizing and internalizing behavior problems after childhood TBI? Evidence from a prospective cohort study.

Despite a well-documented association between childhood traumatic brain injury and elevated risk for internalizing and externalizing behavior problems, the mechanisms through which family functioning contributes to individual variation in these behavioral outcomes remains poorly understood. This prospective cohort study aimed to assess the respective contribution of family functioning and child emotion regulation (ER) to post-injury behavior problems at 1-year follow-up, with a specific focus on evaluating the role of emotional dysregulation in mediating the effects of familial affective responsiveness and communication on child behavioral outcomes. The study included 129 participants, comprising 86 children with medically confirmed mild-to-severe TBI, identified from consecutive hospital admissions, and 43 typically developing (TD) control children, of similar age and sex. Participants ranged in age from 6 to 15 years (mean age = 11.2 years). Parents completed validated assessments of post-acute family functioning and child emotion regulation difficulties at 6 months post-injury, as well as measures of child behavior problems at 1-year post-injury. Although group differences in internalizing behaviors did not reach statistical significance, the TBI group exhibited significantly higher overall externalizing symptoms and was significantly more likely to display clinically elevated symptoms than TD controls at 1-year post-injury. Compared to TD controls, the TBI group displayed significantly greater ER problems, which mediated the effects of lower familial affective responsiveness and communication on child behavior problems 1-year-post-injury. Evidence for these robust, prospective associations suggests that child emotional dysregulation plays a key role in mediating the effect of post-acute family functioning on long-term behavior problems in children with TBI. Early assessment and screening for relevant risk factors may help identify those children and families who could benefit from therapeutic interventions designed to address emotional dysregulation and mitigate risk for post-injury behavioral problems. Importantly, these findings underscore the value of adopting family-centred care approaches in rehabilitation, where involving families in therapeutic processes and addressing family dynamics may enhance child emotion regulation and improve long-term behavioral outcomes.

Cognitive reserve and its impact on cognitive and functional abilities, physical activity and quality of life following a diagnosis of dementia: longitudinal findings from the Improving the experience of Dementia and Enhancing Active Life (IDEAL) study.

The concept of cognitive reserve may explain inter-individual differences in susceptibility to neuropathological changes. Studies suggest that experiences over a lifetime impact on cognitive reserve, and it is hypothesised that following a dementia diagnosis, greater reserve levels are linked to accelerated disease progression. To investigate the longitudinal impact of cognitive reserve on cognitive and functional abilities, physical activity and quality of life in people with dementia. Longitudinal cohort design. Participants were 1537 people with mild-to-moderate dementia at baseline, 1183 at 12 months follow-up and 851 at 24 months follow-up, from the IDEAL study. A comprehensive latent measure of cognitive reserve incorporated domains from all stages of life: education, occupational attainment and later-life engagement in leisure activities. The impact of cognitive reserve on cognition, functional abilities, physical activity and quality of life at baseline and over time was investigated using latent growth curve modelling. Higher cognitive reserve was associated with better cognition, fewer functional difficulties, more physical activity and better quality of life at baseline but was associated with accelerated cognitive decline and greater dependence over time. After 2 years, those with higher initial reserve were estimated to still have better cognition than those with low reserve. Cognitive reserve may be important in initially delaying dementia progression but is linked with accelerated deterioration once dementia becomes clinically evident, likely because of the more advanced neuropathological stage of the condition. Engagement in leisure activities is a potentially modifiable domain of cognitive reserve warranting further investigation.

Social cognition in autism and ADHD.

Social cognition is a crucial capacity for social functioning. The last decades have seen a plethora of social cognition research in neurodevelopmental conditions, foremost autism and, to a lesser extent, ADHD, both characterized by social challenges. Social cognition is a multifaceted construct comprising various overlapping subdomains, such as Theory of Mind/mentalizing, emotion recognition, and social perception. Mechanisms underpinning social cognition are complex, including implicit and explicit, cognitive and affective, and hyper- and hypo-social information processing. This review explores the intricacies of social cognition in the context of autism and ADHD. Research indicates altered performance on social cognition tests in autism, compared to neurotypical groups, with social cognition alterations having a small but robust effect on the defining features of autism. The nature of such alterations in autism appears primarily in relation to implicit processing. ADHD groups show intermediate social cognition performance, appearing to be influenced by executive function difficulties. Social cognition varies with intellectual and verbal abilities and seems to improve with age in autism and ADHD. Social skills interventions in autism, and stimulant medication in ADHD have been shown to improve social cognition test performance, while mentalizing training effects in autism are less conclusive. A limitation of the field is that social cognition constructs and tests are not well delineated. Further, most research has been embedded in a nativist approach rather than a constructivist approach. The former has been questioned for ignoring environmental contributions, especially the dimension of mutual miscommunication between neurodivergent and neurotypical individuals.

Predictors of Psychosocial Functioning Among Long-stay Schizophrenia Patients in a Malaysian Mental Institution.

A considerable number of schizophrenia patients still require long-term hospital care despite psychiatric deinstitutionalisation, especially in developing nations. Prolonged hospitalisation is associated with greater impairment in psychosocial functioning. This study aimed to determine the level of psychosocial functioning and its predictors among long-stay schizophrenia patients in a Malaysian mental institution. This cross-sectional study included 138 patients selected through universal sampling. Data on socio-demographics, illness characteristics such as psychopathology and illness severity [measured using the Brief Psychiatric Rating Scale (BPRS)], and cognitive function [assessed using the Montreal Cognitive Assessment (MoCA)] were collected. The Personal and Social Performance (PSP) scale was used to evaluate psychosocial functioning. Pearson correlation coefficients and multiple linear regression analyses were applied to identify the correlates and predictors of psychosocial functioning. This study found that 47.8% and 16.7% of the patients had moderate and severe cognitive impairments, respectively. The mean PSP score was 69.68 (standard deviation (SD) = 15.48). Female gender, previous unemployment and more severe cognitive impairments were significantly associated with poorer psychosocial functioning. Meanwhile, negative symptoms and age of onset were negatively correlated with psychosocial functioning. By contrast, the duration of illness was positively correlated with psychosocial functioning. The regression model indicated that being female (β = -7.32, p < 0.001), previously unemployed (β = -3.67, p < 0.047), having negative symptoms (β = -4.18, p < 0.001), experiencing a longer illness duration (β = -0.60, p = 0.004), and the presence of severe cognitive impairment (β = -9.80, p < 0.001) significantly predicted poorer psychosocial functioning. Long-stay schizophrenia patients experience substantial difficulties in psychosocial functioning. Factors such as gender, last employment status, negative symptoms, illness duration, and cognitive function affect psychosocial functioning.

Development of Speech and Communication in Polish Children with 22q11.2 Deletion Syndrome: A Cross-Sectional Study.

22q11.2 microdeletion syndrome (22q11DS) is a genetic disease caused by aberration of chromosome 22 that results in some phenotypic features and developmental disorders. This paper presents a cross-sectional study on speech and communication of Polish children with 22q11DS. Individuals affected with 22q11DS may show difficulties in functioning, including speech and hearing. Therefore, we prepared a speech development questionnaire and employed it to obtain data from parents (or legal guardians) of 54 children with 22q11DS. The questionnaire covered the following speech and communication development stages: babbling, using first words, first sentences, verbal and non-verbal communication, speech disfluencies, hearing loss, speech intelligibility, difficulties in interpersonal contact, and participation in speech therapy. The obtained answers underwent statistical analysis to verify relationships between the stages of personal development and selected dysfunctions and disorders. In the study group we observed delays in achieving subsequent speech developmental stages and that hearing loss was associated with delays in producing first words. Hearing loss was reported in about a quarter of cases, but a significant proportion of children (55.56%) reported speech disfluencies, which had not been emphasized in previous works, where hearing loss is considered a common co-occurring disorder. Our findings suggest that this may represent a phenomenon associated with 22q11DS that warrants further investigation using standardized tests for assessing disfluencies. Additionally, we observed that speech therapists and caregivers were perceived as not fully aware of the speech development impairments caused by 22q11DS. These preliminary observations point to the need for future studies and increased awareness efforts in this area.

Does disability modify the association between poor mental health and violence victimisation over adolescence? Evidence from the CoVAC cohort study in Uganda.

We aimed to estimate the impact of poor mental health in early adolescence on subsequent poor mental health, depression, and violence victimisation in late adolescence and to determine whether young people living with disabilities experienced a stronger relationship between mental health and these outcomes. Data from two waves of a longitudinal cohort study of 2773 Ugandan adolescents were used to assess the impact of mental health difficulties in early adolescence (aged 11-14) on presence of subsequent mental health difficulties, depression and past year violence victimisation in later adolescence (aged 15-18). We used g-computation to examine how these outcomes changed dependent on levels of poor mental health in early adolescence and explored functional difficulties as an effect modifier. This study demonstrates high prevalence of mental health difficulties in adolescence. There is a positive association between mental health difficulties in early adolescence and experience of mental health difficulties, depression, and past year violence in later adolescence. The risk of poor outcomes is greater for individuals experiencing poorer mental health in early adolescence. The relationships between early mental health difficulties and both mental health difficulties in later adolescence and past year violence are stronger in young people with functional difficulties. Poor mental health in early adolescence is associated with depression and violence victimisation in later adolescence, and the association is stronger among adolescents living with disabilities. School-aged adolescents would benefit from violence prevention and mental health promotion interventions which are inclusive and engage and respond to the needs and rights of adolescents with disabilities.

Predictors of return to work after multidisciplinary rehabilitation program for patients with chronic low back pain.

Patients with chronic low back pain face functional, psychological, social and professional difficulties. Multidisciplinary Rehabilitation Programs (MRP) can be an effective treatment to help these patients to improve their condition and return to work. To determine baseline predictors for return to work after an MRP for patients with chronic low back pain struggling to maintain their job. A monocentric cohort study was conducted. Patients who had followed a MRP between January 2015 and December 2020 were included. The program consisted of physical activities and different workshops inspired by behavioural therapy, at full time during one month. Pain, lifestyle, history of the disease, function, psycho-social characteristics were evaluated at baseline. Return to work at different possible time point after the MRP was collected. A bivariate and a multivariate analysis were performed to evaluate which factors were associated with return to work. Overall, 251 patients were included. Professional status, duration off-work, intensity of low back pain, self-perceived disability, fear-avoidance beliefs at work were associated with return to work after the MRP on bivariate analysis. Having worked in the past 6 months and the absence of high fear-avoidance beliefs at work at baseline were associated with return to work on multivariate analysis. This study suggests that patients with chronic low back pain and professional difficulties need to be included quickly in a MRP, with specific attention to beliefs about pain.

Calibrated Equilibrium Estimation and Double Selection for High-dimensional Partially Linear Measurement Error Models

In practice, measurement error data is frequently encountered and needs to be handled appropriately. As a result of additional bias induced by measurement error, many existing estimation methods fail to achieve satisfactory performances. This article studies high-dimensional partially linear measurement error models. It proposes a calibrated equilibrium (CARE) estimation method to calibrate the bias caused by measurement error and overcomes the technical difficulty of the objective function unbounded from below in high-dimensional cases due to non-convexity. To facilitate the applications of the CARE estimation method, a bootstrap approach for approximating the covariance matrix of measurement errors is introduced. For the high-dimensional or ultra-high dimensional partially linear measurement error models, a novel multiple testing method, the calibrated equilibrium multiple double selection (CARE–MUSE) algorithm, is proposed to control the false discovery rate (FDR). Under certain regularity conditions, we derive the oracle inequalities for estimation error and prediction risk, along with an upper bound on the number of falsely discovered signs for the CARE estimator. We further establish the convergence rate of the nonparametric function estimator. In addition, FDR and power guarantee for the CARE–MUSE algorithm are investigated under a weaker minimum signal condition, which is insufficient for the CARE estimator to achieve sign consistency. Extensive simulation studies and a real data application demonstrate the satisfactory finite sample performance of the proposed methods.

Immediate Complete Overdenture: optimizing patient’s quality of life with endodontic - prosthodontic approach

Background: Immediate complete overdentures are designed for placement denture immediately following the extraction or decapitation of natural teeth. This procedure overcome the challenges associated of esthetic problems, including functional difficulties and psychological issues. Purpose: The article aims to highlight the advantages of endodontic-prosthodontic approach through immediate overdenture, such as the preservation of alveolar bone and improvement in patient’s psychological well-being and quality of life. Case: A 60-years-old female came into Universitas Airlangga Dental Hospital with the chief complaint of missing multiple teeth with upper front teeth becoming loose and desire to replace them because of difficulty in chewing food. Case Management: Diagnostic impressions were taken using irreversible hydrocolloid material, then poured in the dental stone to create final impression. The treatment plan included endodontic treatment, scaling and root planning for 11. The vertical dimension of occlusion was established using a bite rim and mounted on an articulator. Then, the immediate overdenture was created by arranging artificial teeth. Before the denture insertion, 11 was decapitated and filled the orifice with glass ionomer cement. Extraction of 21, 22, 23 was carried out and after ensuring hemostasis, the immediate overdenture was inserted. To finalize the denture insertion, occlusion was assessed using articulating paper. Control was done after day 1,3 and 7 after denture insertion. Conclusion: This case report describes the effectiveness of immediate overdentures as a valuable treatment option through endodontic-prosthodontic approach. By providing a functional and aesthetic solution while minimizing the edentulous period, immediate dentures significantly enhance patient’s quality of life.