差分——指数平滑预测模型在门诊人次预测中的应用

目的探讨差分-指数平滑预测模型在医院管理中的应用价值。方法建立差分-指数平滑预测模型对某院2008年门诊诊次进行定量预测,并对预测模型的预测精度进行评价。结果差分-指数平滑预测模型预测门诊诊次的结果满意。通过计算机反复试算,可获得最佳的平滑常数（α）,使预测模型的预测误差最小。本例预测平均绝对百分误差（MAPE）4．4040％〈10％,预测精度较高。结论差分-指数平滑预测模型预测精度较高,计算简便且具有递推性质,在医院管理中有应用价值。     

我国医药制造业区域差异性分析

基于基尼系数与泰尔指数等测度方法,对我国2003-2009年医药制造业总产值、主营业务收入和利润总额三方面指标进行区域差异分析得出:我国各省医药制造业的绝对差异在逐年扩大,而相对差异在总体上有逐年减小的趋势,东部、中部和西部三大区域间的差异是构成总差异的主要因素,西部地区的内部差异比东、中部地区要小。     

Impulsivity and risk-taking behavior in focal frontal lobe lesions

Frontal lobe dysfunction may underlie excessively impulsive and risky behavior observed in a range of neurological disorders. We devised a gambling task to examine these behavior tendencies in a sample of patients who had sustained focal damage to the frontal lobes or nonfrontal cortical regions as well as in a matched sample of healthy control subjects. The main objectives of the study were: (1) to behaviorally dissociate impulsivity and risk-taking; (2) to examine potential associations between specific frontal lesion sites and impulsivity or risk-taking; (3) to investigate the influence of reinforcement and trial timing on both behaviors. Our results indicated that patients and controls were equally likely to perform impulsively. Risk-taking performance strategies, however, were related to left ventrolateral and orbital lesion sites. Moreover, risk-taking was also associated with blunted response alteration following a nonrewarded trial. Patients and control subjects showed identical responses to reward-timing manipulations consistent with formal decision-making theory. These findings suggest that ventrolateral and orbital lesions are related to the reward-based aspects of decision-making (risk-taking) rather than to simple response disinhibition (impulsivity). Reduced reaction to the negative consequences of one's actions may underlie this behavior pattern.     

Effects of virtual reality-based telerehabilitation for stroke patients: A systematic review and meta-analysis of randomized controlled trials

BackgroundTelerehabilitation provides an essential opportunity to deliver continuous rehabilitation services for stroke patients at home, especially amid a global pandemic. Virtual reality is a simulation technology that has shown promising outcomes in stroke rehabilitation. Combining telerehabilitation and virtual reality is an emerging and innovative approach that enriches the rehabilitation experience and potentially enhances functional recovery outcomes. This review synthesized current evidence of using virtual reality-based telerehabilitation for patients after stroke and compared it with conventional in-person rehabilitation.MethodsRandomized controlled trials were searched across six databases published after 2000. Two independent reviewers conducted study selection, data extraction and quality assessment. The Physiotherapy Evidence Databases scale was used to evaluate the methodological quality. Qualitative synthesis and meta-analysis were conducted to compare functional outcomes after Virtual reality-based telerehabilitation with conventional in-person rehabilitation.ResultsNine studies including 260 participants were selected from 933 relevant records. Seven studies met the criteria for good quality based on the Physiotherapy Evidence Databases scale, two studies were fair quality. Compared with conventional in-person rehabilitation, the meta-analysis indicated that virtual reality-based telerehabilitation had comparable outcomes of upper extremity function and balance function. Both groups demonstrated similar effects on outcomes in mobility, cognition, activities of daily life, and quality of life.ConclusionsVirtual reality-based telerehabilitation is an effective alternative approach for patients with stroke, given the barriers and restrictions of traditional in-person rehabilitation.     

Implementation of repairs in dental practice: Randomized behavior simulation trial

BackgroundDespite increasing evidence, dentists have not widely adopted repairs. The authors aimed to develop and test potential interventions targeting dentists’ behavior.MethodsProblem-centered interviews were performed. Emerging themes were linked to the Behavior Change Wheel to develop potential interventions. The efficacy of 2 interventions was then tested in a postally delivered behavioral change simulation trial among German dentists (n = 1,472 per intervention). Dentists’ stated repair behavior regarding 2 case vignettes was assessed. Statistical analysis was performed using McNemar test, Fisher exact test, and a generalized estimating equation model (P < .05).ResultsTwo interventions (guideline, treatment fee item) were developed on the basis of identified barriers. A total of 504 dentists participated in the trial (17.1% response rate). Both interventions significantly changed dentists’ behavior toward repairs of composite and amalgam restorations, respectively (guideline: difference [Δ] = +7.8% and Δ = +17.6%, treatment fee item: Δ = +6.4% and Δ = +31.5%; adjusted P < .001). Dentists were more likely to consider repairs if they already performed repairs frequently (odds ratio [OR], 1.23; 95% CI, 1.14 to 1.34) or sometimes (OR, 1.08; 95% CI, 1.01 to 1.16), if they regarded repairs as highly successful (OR, 1.24; 95% CI, 1.04 to 1.48), if their patients preferred repairs over total replacements (OR, 1.12; 95% CI, 1.03 to 1.23), for partially defective composite restorations (OR, 1.46; 95% CI, 1.39 to 1.53), and after receiving 1 of the 2 behavioral interventions (OR, 1.15; 95% CI, 1.13 to 1.19).ConclusionsSystematically developed interventions targeting dentists’ repair behaviors are likely efficacious to promote repairs.Practical ImplicationsMost partially defective restorations are replaced completely. Effective implementation strategies are required to change dentists’ behavior.This trial was registered at https://www.clinicaltrials.gov. The registration number is NCT03279874 for the qualitative phase and NCT05335616 for the quantitative phase.     

Effects of in-office bleaching agents on polished and unpolished nanofilled resin composite

BackgroundThis study investigates the effects of in-office bleaching agents on the color change and surface roughness of nanofilled resin composite finished by various polishing procedures.MethodsThe authors made 108 specimens from nanofilled resin composite, and the finishing and polishing procedures were performed with either Sof-Lex (3M ESPE) or OneGloss (Shofu). The specimens were then immersed in tea or coffee solution for 1 week, after which in-office bleaching agents were applied (n = 9). After polishing and bleaching, the surface roughness was measured with a surface profilometer. The specimen color parameters were measured with the Commission Internationale de l’Eclairage L1a1b1 system in 3 stages, namely after polishing, after staining, and at the end of the bleaching procedure. The total color changes (ΔE_ab1) were calculated, and ΔE_ab1 not exceeding 2.7 was considered a clinically acceptable threshold.ResultsThe highest initial roughness value was observed on surfaces polished with OneGloss. In all groups, the surface roughness increased significantly after bleaching. For the Sof-Lex group specimens stained in both tea and coffee solutions, bleaching agent Opalescence Boost (Ultradent) reduced the color change value to 2.7 or less after bleaching.ConclusionsIn-office bleaching agents increased surface roughness in all groups, especially on unpolished surfaces. However, surface roughness was at an acceptable threshold for the multistep polished group, Sof-Lex, after bleaching. Nanofilled resin composite staining can be partially reduced by in-office bleaching agents but not completely removed.Practical ImplicationsTo reduce the increase in surface roughness of composite restorations due to bleaching, polishing should be applied before and after bleaching.