Estimating tree-based dynamic treatment regimes using observational data with restricted treatment sequences

A dynamic treatment regime (DTR) is a sequence of decision rules that provide guidance on how to treat individuals based on their static and time-varying status. Existing observational data are often used to generate hypotheses about effective DTRs. A common challenge with observational data, however, is the need for analysts to consider “restrictions” on the treatment sequences. Such restrictions may be necessary for settings where (1) one or more treatment sequences that were offered to individuals when the data were collected are no longer considered viable in practice, (2) specific treatment sequences are no longer available, or (3) the scientific focus of the analysis concerns a specific type of treatment sequences (eg, “stepped-up” treatments). To address this challenge, we propose a restricted tree–based reinforcement learning (RT-RL) method that searches for an interpretable DTR with the maximum expected outcome, given a (set of) user-specified restriction(s), which specifies treatment options (at each stage) that ought not to be considered as part of the estimated tree-based DTR. In simulations, we evaluate the performance of RT-RL versus the standard approach of ignoring the partial data for individuals not following the (set of) restriction(s). The method is illustrated using an observational data set to estimate a two-stage stepped-up DTR for guiding the level of care placement for adolescents with substance use disorder.     

Relationships between mutans streptococci and perceived treatment need of primary root-caries lesions.

A total of 447 primary root-caries lesions from 169 dental patients was studied to determine the relationships between mutans streptococci and the perceived treatment need of primary root-caries lesions. Samples of this altered dentine for microbiological culture were obtained. Lesions were classified into 5 treatment categories; soft and restore, leathery and restore, leathery and debride of caries, leathery and treat chemotherapeutically, and hard, to receive no treatment. The total numbers of mutans streptococci decreased significantly with decreased treatment need. The percentage of mutans streptococci from lesions requiring no treatment was significantly less than from lesions requiring treatment. The frequency of isolation of mutans streptococci was significantly greater from lesions requiring more treatment. Significantly more lesions containing > 10² mutans streptococci were distributed in the groups with a greater perceived treatment need or with larger dimensions occlusogingivally and/or mesio-distally or bucco-lingually or with a closer proximity to the gingival margin.     

Future directions for root caries research

Interest among researchers in the diagnosis, aetiology, prevention, and treatment of root caries has increased substantially over the past two decades. However, there are some fundamental problems impeding the advancement of the field which remain to be addressed and resolved. A universally acceptable definition of root caries is not yet available. The relationship of root caries to coronal caries has not been established. The underlying disease process is still not clearly understood. The optimal utilisation of preventive/therapeutic agents for the treatment or prevention of root caries has not been determined. New treatment materials and preventive agents have not yet been tested in controlled clinical trials. These are a few of the issues and problems which we address in this paper.     

Occurrence of a novel group of hemagglutinins extractable by Pronase treatment in marine algae

Nine species of marine algae have been assessed for the presence of novel hemagglutinins not extractable with buffer, unless the algal tissue was pretreated with Pronase. All species examined contained hemagglutinins, indicating the existence of a novel group of hemagglutinins which differed from those reported previously in marine algae.     

Biotechniques for air pollution control

This paper gives an overview of present biological techniques for the treatment of off-gases and the techniques that are being developed at the moment. The characteristics, advantages, disadvantages, costs and application area are discussed and compared. Biological off-gas treatment is based on the absorption of volatile contaminants in an aqueous phase or biofilm followed by oxidation by the action of microorganisms. Biofilters, bioscrubbers and biotrickling filters are used for elimination of odour and bioconvertable volatile organic and inorganic compounds and are enjoying increasing popularity. This popularity is a result of the low investment and operational costs involved compared to physico-chemical techniques and the elimination efficiencies that can be obtained. The operational envelop is still extending to higher concentrations and gas flow rates (exceeding 200,000 m³ h^–1) and a broader spectrum of degradable compounds. Research and development on the use of membranes and the addition of activated carbon or a second liquid phase to the biological systems may lead to a more efficient elimination of hydrophobic compounds and buffering of fluctuating loads. Shorter adaptation periods can be obtained by inoculation with specialized microorganisms. Improved design and operation are made possible by the growing insights in the kinetics and microbiology and supported by the development of models describing biological off-gas treatment. In conclusion, biotechniques are efficient and cost effective in treating off-gases with concentrations of biodegradable contaminants up to 1–5 g/m³. They could play a justified and important role in air pollution control in the coming years.Abbreviations VOC volatile organic compound - NO _x gaseous oxides of nitrogen     

人上皮细胞角蛋白纤维结构转化的分析

用0℃冷冻处理2—3 h,一些PcaSE-1和BEL-7404细胞的角蛋白纤维能部分地转化成凝聚颗粒,但在HeLa 和CNE 细胞中不发生这种角蛋白纤维结构转化。当回复温度到37℃15—30 min 时,PcaSE-1 和BEL-7404细胞的这种结构转化能快速回复。相反,在HeLa 和CNE 细胞有丝分裂时,角蛋白纤维能转化成凝聚颗粒,但PcaSE-1细胞和BEL-7404细胞的角蛋白纤维网始终维持纤维状态,且围绕纺锤体分布。上述结果表明:两类上皮细胞角蛋白纤维结构的转化似由不同因子所引起。我们的结果还指出:(1)单用秋水仙素或用秋水仙素和细胞松弛素D 合并处理PcaSE-1细胞不能引起角蛋白纤维凝聚。但经秋水仙素解聚微管后,会增强细胞对冷处理的凝聚反应。(2)冷处理时角蛋白纤维凝聚的形成与细胞是否具有两套不同的中间纤维无关。(3)予先用TritonX-100抽提细胞,角蛋白纤维在冷冻后不能转化成凝聚颗粒。(4)冷冻处理引起的结构转化可能是某些上皮细胞系的角蛋白纤维的一种特殊性质。     

侵袭性牙周炎伴错牙合畸形患者牙周-正畸联合治疗前后血清SAA、leptin的变化及与牙周指标和辅助性T细胞亚群的相关性分析

摘要 目的：探讨侵袭性牙周炎伴错牙合畸形患者牙周-正畸联合治疗前后血清淀粉样蛋白A（SAA）、瘦素（leptin）的变化及与牙周指标和辅助性T细胞（Th）亚群的相关性。方法：选择2020年6月-2022年8月解放军总医院京中医疗区黄寺门诊部口腔科收治的80例侵袭性牙周炎伴错牙合畸形患者（牙周炎组）和65例于口腔门诊检查的健康志愿者（对照组）。所有患者均接受牙周-正畸联合治疗,治疗前后分别检测血清SAA、leptin水平以及外周血中Th1、Th2、Th17细胞占比,并评估牙周指标变化。Pearson相关性分析血清SAA、leptin水平与牙周指标以及外周血中Th1、Th2、Th17细胞占比的相关性。结果：牙周炎组治疗前血清SAA、leptin水平,外周血Th1、Th17细胞占比,出血指数（SBI）、菌斑指数（PLI）、附着丧失（AL）、牙周探诊深度（PD）高于对照组（P＜0.05）,外周血Th2细胞占比低于对照组（P＜0.05）。牙周炎组治疗后血清SAA、leptin水平,外周血Th1、Th17细胞占比,PLI、SBI、AL、PD较治疗前降低（P＜0.05）,外周血Th2细胞占比较治疗前增高（P＜0.05）。牙周炎组血清SAA、leptin与PLI、SBI、AL、PD,外周血Th1、Th17细胞占比呈正相关,与外周血Th2细胞占比呈负相关（P＜0.05）。结论：侵袭性牙周炎伴错牙合畸形患者血清SAA、leptin水平增高,经牙周-正畸联合治疗后下降,高水平SAA、leptin与牙周组织破坏程度以及Th亚群紊乱有关,检测血清SAA、leptin水平可评估侵袭性牙周炎牙周组织破坏程度以及细胞免疫状态。     

Substance use disorders: a comprehensive update of classification,epidemiology, neurobiology,clinical aspects,treatment and prevention

Substance use disorders (SUDs) are highly prevalent and exact a large toll on individuals’ health, well-being, and social functioning. Long-lasting changes in brain networks involved in reward, executive function, stress reactivity, mood, and self-awareness underlie the intense drive to consume substances and the inability to control this urge in a person who suffers from addiction (moderate or severe SUD). Biological (including genetics and developmental life stages) and social (including adverse childhood experiences) determinants of health are recognized factors that contribute to vulnerability for or resilience against developing a SUD. Consequently, prevention strategies that target social risk factors can improve outcomes and, when deployed in childhood and adolescence, can decrease the risk for these disorders. SUDs are treatable, and evidence of clinically significant benefit exists for medications (in opioid, nicotine and alcohol use disorders), behavioral therapies (in all SUDs), and neuromodulation (in nicotine use disorder). Treatment of SUDs should be considered within the context of a Chronic Care Model, with the intensity of intervention adjusted to the severity of the disorder and with the concomitant treatment of comorbid psychiatric and physical conditions. Involvement of health care providers in detection and management of SUDs, including referral of severe cases to specialized care, offers sustainable models of care that can be further expanded with the use of telehealth. Despite advances in our understanding and management of SUDs, individuals with these conditions continue to be stigmatized and, in some countries, incarcerated, highlighting the need to dismantle policies that perpetuate their criminalization and instead develop policies to ensure support and access to prevention and treatment.     

吖啶橙失活处理应用于不对称融合初步探讨

马铃薯栽培种和野生种叶肉原生质体经过吖啶橙（ＡＯ）处理后,暗培养两天,再光照４ｈ而失活．失活程度取决于ＡＯ处理时间、ＡＯ浓度、光照时机等．四倍体失活浓度高于二倍体,处理后马上光照失活效果最强烈,８ｄ后光照其小细胞团同未光照处理相差不大。ＡＯ失活的栽培种ＮＯ７同罗丹明６Ｇ（Ｒ６Ｇ）失活的Ｓｏｌａｎｕｍｂｕｌｂｏｃａｓｔａｎｕｍ融合后可以发生代谢互补恢复分裂,已得到假定的杂种小愈伤组织．