Selective effects of 5-HT2C receptor modulation on performance of a novel valence-probe visual discrimination task and probabilistic reversal learning in mice.

RATIONALE: Dysregulation of the serotonin (5-HT) system is a pathophysiological component in major depressive disorder (MDD), a condition closely associated with abnormal emotional responsivity to positive and negative feedback. However, the precise mechanism through which 5-HT tone biases feedback responsivity remains unclear. 5-HT2C receptors (5-HT2CRs) are closely linked with aspects of depressive symptomatology, including abnormalities in reinforcement processes and response to stress. Thus, we aimed to determine the impact of 5-HT2CR function on response to feedback in biased reinforcement learning. METHODS: We used two touchscreen assays designed to assess the impact of positive and negative feedback on probabilistic reinforcement in mice, including a novel valence-probe visual discrimination (VPVD) and a probabilistic reversal learning procedure (PRL). Systemic administration of a 5-HT2CR agonist and antagonist resulted in selective changes in the balance of feedback sensitivity bias on these tasks. RESULTS: Specifically, on VPVD, SB 242084, the 5-HT2CR antagonist, impaired acquisition of a discrimination dependent on appropriate integration of positive and negative feedback. On PRL, SB 242084 at 1 mg/kg resulted in changes in behaviour consistent with reduced sensitivity to positive feedback. In contrast, WAY 163909, the 5-HT2CR agonist, resulted in changes associated with increased sensitivity to positive feedback and decreased sensitivity to negative feedback. CONCLUSIONS: These results suggest that 5-HT2CRs tightly regulate feedback sensitivity bias in mice with consequent effects on learning and cognitive flexibility and specify a framework for the influence of 5-HT2CRs on sensitivity to reinforcement

OPT-IML: Scaling Language Model Instruction Meta Learning through the Lens of Generalization

Recent work has shown that fine-tuning large pre-trained language models on a collection of tasks described via instructions, a.k.a. instruction-tuning, improves their zero and few-shot generalization to unseen tasks. However, there is a limited understanding of the performance trade-offs of different decisions made during the instruction-tuning process. These decisions include the scale and diversity of the instruction-tuning benchmark, different task sampling strategies, fine-tuning with and without demonstrations, training using specialized datasets for reasoning and dialogue, and finally, the fine-tuning objectives themselves. In this paper, we characterize the effect of instruction-tuning decisions on downstream task performance when scaling both model and benchmark sizes. To this end, we create OPT-IML Bench: a large benchmark for Instruction Meta-Learning (IML) of 2000 NLP tasks consolidated into task categories from 8 existing benchmarks, and prepare an evaluation framework to measure three types of model generalizations: to tasks from fully held-out categories, to held-out tasks from seen categories, and to held-out instances from seen tasks. Through the lens of this framework, we first present insights about instruction-tuning decisions as applied to OPT-30B and further exploit these insights to train OPT-IML 30B and 175B, which are instruction-tuned versions of OPT. OPT-IML demonstrates all three generalization abilities at both scales on four different evaluation benchmarks with diverse tasks and input formats -- PromptSource, FLAN, Super-NaturalInstructions, and UnifiedSKG. Not only does it significantly outperform OPT on all benchmarks but is also highly competitive with existing models fine-tuned on each specific benchmark. We release OPT-IML at both scales, together with the OPT-IML Bench evaluation framework.Comment: 55 page

Feasibility of achieving the 2025 WHO global tuberculosis targets in South Africa, China, and India: a combined analysis of 11 mathematical models.

BACKGROUND: The post-2015 End TB Strategy proposes targets of 50% reduction in tuberculosis incidence and 75% reduction in mortality from tuberculosis by 2025. We aimed to assess whether these targets are feasible in three high-burden countries with contrasting epidemiology and previous programmatic achievements. METHODS: 11 independently developed mathematical models of tuberculosis transmission projected the epidemiological impact of currently available tuberculosis interventions for prevention, diagnosis, and treatment in China, India, and South Africa. Models were calibrated with data on tuberculosis incidence and mortality in 2012. Representatives from national tuberculosis programmes and the advocacy community provided distinct country-specific intervention scenarios, which included screening for symptoms, active case finding, and preventive therapy. FINDINGS: Aggressive scale-up of any single intervention scenario could not achieve the post-2015 End TB Strategy targets in any country. However, the models projected that, in the South Africa national tuberculosis programme scenario, a combination of continuous isoniazid preventive therapy for individuals on antiretroviral therapy, expanded facility-based screening for symptoms of tuberculosis at health centres, and improved tuberculosis care could achieve a 55% reduction in incidence (range 31-62%) and a 72% reduction in mortality (range 64-82%) compared with 2015 levels. For India, and particularly for China, full scale-up of all interventions in tuberculosis-programme performance fell short of the 2025 targets, despite preventing a cumulative 3·4 million cases. The advocacy scenarios illustrated the high impact of detecting and treating latent tuberculosis. INTERPRETATION: Major reductions in tuberculosis burden seem possible with current interventions. However, additional interventions, adapted to country-specific tuberculosis epidemiology and health systems, are needed to reach the post-2015 End TB Strategy targets at country level. FUNDING: Bill and Melinda Gates Foundation

WMO assessment of weather and climate mortality extremes : lightning, tropical cyclones, tornadoes, and hail

A World Meteorological Organization (WMO) Commission for Climatology international panel was convened to examine and assess the available evidence associated with five weather-related mortality extremes: 1) lightning (indirect), 2) lightning (direct), 3) tropical cyclones, 4) tornadoes, and 5) hail. After recommending for acceptance of only events after 1873 (the formation of the predecessor of the WMO), the committee evaluated and accepted the following mortality extremes: 1) ''highest mortality (indirect strike) associated with lightning'' as the 469 people killed in a lightning-caused oil tank fire in Dronka, Egypt, on 2 November 1994; 2) ''highest mortality directly associated with a single lightning flash'' as the lightning flash that killed 21 people in a hut in Manica Tribal Trust Lands, Zimbabwe (at time of incident, eastern Rhodesia), on 23 December 1975; 3) ''highest mortality associated with a tropical cyclone'' as the Bangladesh (at time of incident, East Pakistan) cyclone of 12-13 November 1970 with an estimated death toll of 300 000 people| 4) ''highest mortality associated with a tornado'' as the 26 April 1989 tornado that destroyed the Manikganj district, Bangladesh, with an estimated death toll of 1300 individuals| and 5) ''highest mortality associated with a hailstorm'' as the storm occurring near Moradabad, India, on 30 April 1888 that killed 246 people. These mortality extremes serve to further atmospheric science by giving baseline mortality values for comparison to future weather-related catastrophes and also allow for adjudication of new meteorological information as it becomes available.https://www.ametsoc.org/ams/index.cfm/publications/journals/weather-climate-and-society2018-01-30hj2017Geography, Geoinformatics and Meteorolog

Cost-effectiveness and resource implications of aggressive action on tuberculosis in China, India, and South Africa: a combined analysis of nine models.

BACKGROUND: The post-2015 End TB Strategy sets global targets of reducing tuberculosis incidence by 50% and mortality by 75% by 2025. We aimed to assess resource requirements and cost-effectiveness of strategies to achieve these targets in China, India, and South Africa. METHODS: We examined intervention scenarios developed in consultation with country stakeholders, which scaled up existing interventions to high but feasible coverage by 2025. Nine independent modelling groups collaborated to estimate policy outcomes, and we estimated the cost of each scenario by synthesising service use estimates, empirical cost data, and expert opinion on implementation strategies. We estimated health effects (ie, disability-adjusted life-years averted) and resource implications for 2016-35, including patient-incurred costs. To assess resource requirements and cost-effectiveness, we compared scenarios with a base case representing continued current practice. FINDINGS: Incremental tuberculosis service costs differed by scenario and country, and in some cases they more than doubled existing funding needs. In general, expansion of tuberculosis services substantially reduced patient-incurred costs and, in India and China, produced net cost savings for most interventions under a societal perspective. In all three countries, expansion of access to care produced substantial health gains. Compared with current practice and conventional cost-effectiveness thresholds, most intervention approaches seemed highly cost-effective. INTERPRETATION: Expansion of tuberculosis services seems cost-effective for high-burden countries and could generate substantial health and economic benefits for patients, although substantial new funding would be required. Further work to determine the optimal intervention mix for each country is necessary. FUNDING: Bill & Melinda Gates Foundation

Pathogenic Huntingtin Repeat Expansions in Patients with Frontotemporal Dementia and Amyotrophic Lateral Sclerosis.

We examined the role of repeat expansions in the pathogenesis of frontotemporal dementia (FTD) and amyotrophic lateral sclerosis (ALS) by analyzing whole-genome sequence data from 2,442 FTD/ALS patients, 2,599 Lewy body dementia (LBD) patients, and 3,158 neurologically healthy subjects. Pathogenic expansions (range, 40-64 CAG repeats) in the huntingtin (HTT) gene were found in three (0.12%) patients diagnosed with pure FTD/ALS syndromes but were not present in the LBD or healthy cohorts. We replicated our findings in an independent collection of 3,674 FTD/ALS patients. Postmortem evaluations of two patients revealed the classical TDP-43 pathology of FTD/ALS, as well as huntingtin-positive, ubiquitin-positive aggregates in the frontal cortex. The neostriatal atrophy that pathologically defines Huntington's disease was absent in both cases. Our findings reveal an etiological relationship between HTT repeat expansions and FTD/ALS syndromes and indicate that genetic screening of FTD/ALS patients for HTT repeat expansions should be considered

Trans-ancestry meta-analyses identify rare and common variants associated with blood pressure and hypertension

High blood pressure is a major risk factor for cardiovascular disease and premature death. However, there is limited knowledge on specific causal genes and pathways. To better understand the genetics of blood pressure, we genotyped 242,296 rare, low-frequency and common genetic variants in up to ~192,000 individuals, and used ~155,063 samples for independent replication. We identified 31 novel blood pressure or hypertension associated genetic regions in the general population, including three rare missense variants in RBM47, COL21A1 and RRAS with larger effects (>1.5mmHg/allele) than common variants. Multiple rare, nonsense and missense variant associations were found in A2ML1 and a low-frequency nonsense variant in ENPEP was identified. Our data extend the spectrum of allelic variation underlying blood pressure traits and hypertension, provide new insights into the pathophysiology of hypertension and indicate new targets for clinical intervention