Lessons learned in multilingual grounded language learning

Recent work has shown how to learn better visual-semantic embeddings by leveraging image descriptions in more than one language. Here, we investigate in detail which conditions affect the performance of this type of grounded language learning model. We show that multilingual training improves over bilingual training, and that low-resource languages benefit from training with higher-resource languages. We demonstrate that a multilingual model can be trained equally well on either translations or comparable sentence pairs, and that annotating the same set of images in multiple language enables further improvements via an additional caption-caption ranking objective.Comment: CoNLL 201

Coordinate Regulation of G Protein Signaling via Dynamic Interactions of Receptor and GAP

Signal output from receptor–G-protein–effector modules is a dynamic function of the nucleotide exchange activity of the receptor, the GTPase-accelerating activity of GTPase-activating proteins (GAPs), and their interactions. GAPs may inhibit steady-state signaling but may also accelerate deactivation upon removal of stimulus without significantly inhibiting output when the receptor is active. Further, some effectors (e.g., phospholipase C-β) are themselves GAPs, and it is unclear how such effectors can be stimulated by G proteins at the same time as they accelerate G protein deactivation. The multiple combinations of protein–protein associations and interacting regulatory effects that allow such complex behaviors in this system do not permit the usual simplifying assumptions of traditional enzyme kinetics and are uniquely subject to systems-level analysis. We developed a kinetic model for G protein signaling that permits analysis of both interactive and independent G protein binding and regulation by receptor and GAP. We evaluated parameters of the model (all forward and reverse rate constants) by global least-squares fitting to a diverse set of steady-state GTPase measurements in an m1 muscarinic receptor–Gq–phospholipase C-β1 module in which GTPase activities were varied by ∼104-fold. We provide multiple tests to validate the fitted parameter set, which is consistent with results from the few previous pre-steady-state kinetic measurements. Results indicate that (1) GAP potentiates the GDP/GTP exchange activity of the receptor, an activity never before reported; (2) exchange activity of the receptor is biased toward replacement of GDP by GTP; (3) receptor and GAP bind G protein with negative cooperativity when G protein is bound to either GTP or GDP, promoting rapid GAP binding and dissociation; (4) GAP indirectly stabilizes the continuous binding of receptor to G protein during steady-state GTPase hydrolysis, thus further enhancing receptor activity; and (5) receptor accelerates GDP/GTP exchange primarily by opening an otherwise closed nucleotide binding site on the G protein but has minimal effect on affinity (Kassoc = kassoc/kdissoc) of G protein for nucleotide. Model-based simulation explains how GAP activity can accelerate deactivation >10-fold upon removal of agonist but still allow high signal output while the receptor is active. Analysis of GTPase flux through distinct reaction pathways and consequent accumulation of specific GTPase cycle intermediates indicate that, in the presence of a GAP, the receptor remains bound to G protein throughout the GTPase cycle and that GAP binds primarily during the GTP-bound phase. The analysis explains these behaviors and relates them to the specific regulatory phenomena described above. The work also demonstrates the applicability of appropriately data-constrained system-level analysis to signaling networks of this scale

Using smartphones in cities to crowdsource dangerous road sections and give effective in-car warnings

The widespread day-to-day carrying of powerful smartphones gives opportunities for crowd-sourcing information about the users' activities to gain insight into patterns of use of a large population in cities. Here we report the design and initial investigations into a crowdsourcing approach for sudden decelerations to identify dangerous road sections. Sudden brakes and near misses are much more common than police reportable accidents but under exploited and have the potential for more responsive reaction than waiting for accidents. We also discuss different multimodal feedback conditions to warn drivers approaching a dangerous zone. We believe this crowdsourcing approach gives cost and coverage benefits over infrastructural smart-city approaches but that users need incentivized for use

Beyond the ecological fallacy: potential problems when studying healthcare organisations.

Ecological studies, which consider patient groups rather than individuals, are common in health policy research. The ‘ecological fallacy’ is a well-recognised methodological concern, but in this perspectives paper, we focus on less often appreciated but equally important limitations of such studies. In particular, we consider reliability and power as they apply to ecological studies, and make recommendations to inform the appropriate design and interpretation of these increasingly popular studies.This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. GL is supported by a Cancer Research UK Clinician Scientist Fellowship (A18180). The views expressed in this publication are those of the authors and not necessarily those of any funder or any other organisation or institution.This is the author accepted manuscript. The final version is available from SAGE via http://dx.doi.org/10.1177/014107681561057

Response rates to patient surveys

BACKGROUND: Patient surveys typically have variable response rates between organizations, leading to concerns that such differences may affect the validity of performance comparisons. OBJECTIVE: To explore the size and likely sources of associations between hospital-level survey response rates and patient experience. RESEARCH DESIGN, SUBJECTS, AND MEASURES: Cross-sectional mail survey including 60 patient experience items sent to 101,771 cancer survivors recently treated by 158 English NHS hospitals. Age, sex, race/ethnicity, socioeconomic status, clinical diagnosis, hospital type, and region were available for respondents and nonrespondents. RESULTS: The overall response rate was 67% (range, 39% to 77% between hospitals). Hospitals with higher response rates had higher scores for all items (Spearman correlation range, 0.03-0.44), particularly questions regarding hospital-level administrative processes, for example, procedure cancellations or medical note availability.From multivariable analysis, associations between individual patient experience and hospital-level response rates were statistically significant (P<0.05) for 53/59 analyzed questions, decreasing to 37/59 after adjusting for case-mix, and 25/59 after further adjusting for hospital-level characteristics.Predicting responses of nonrespondents, and re-estimating hypothetical hospital scores assuming a 100% response rate, we found that currently low performing hospitals would have attained even lower scores. Overall nationwide attainment would have decreased slightly to that currently observed. CONCLUSIONS: Higher response rate hospitals have more positive experience scores, and this is only partly explained by patient case-mix. High response rates may be a marker of efficient hospital administration, and higher quality that should not, therefore, be adjusted away in public reporting. Although nonresponse may result in slightly overestimating overall national levels of performance, it does not appear to meaningfully bias comparisons of case-mix-adjusted hospital results.GL is supported by a Cancer Research UK Clinician Scientist Fellowship (A18180).This is the final version of the article. It first appeared from Wolters Kluwer via http://dx.doi.org/10.1097/MLR.000000000000045

Le Long Covid: étude d'un cas en médecine générale

Résumé INTRODUCTION On estime aujourd’hui à plus de 65 millions le nombre de patients présentant un syndrome du Long Covid dans le monde. Ce chiffre est probablement sous-estimé, et en augmentation constante. Une grande partie de ces patients risquent d’être handicapés à vie, ce qui fait du long Covid un enjeu majeur de santé publique. LE LONG COVID Le long Covid est un syndrome multisystémique de physiopathologie complexe de présentation clinique hétérogène. Les symptômes les plus fréquemment reportés sont la fatigue, l’essoufflement à l’effort, des douleurs musculaires et articulaires, des troubles gastro-intestinaux et une variété de troubles neurocognitifs pouvant gravement impacter la qualité de vie des individus. MATÉRIEL ET MÉTHODES Une revue succincte de la littérature actuelle sur la maladie est réalisée, à titre informatif à destination des médecins généralistes. Nous présenterons le chemin diagnostique d’une patiente de 44 ans, suivie en maison médicale et atteinte du syndrome du long Covid. Deux questionnaires ont été complétés lors du suivi afin d’évaluer l’impact de la maladie sur sa vie. DISCUSSION Le cas présenté nous montre la nécessité d’écouter les patients, et de remettre en question nos connaissances médicales. Le long Covid est une maladie multisystémique encore peu connue et comprise. À l’heure actuelle, les outils technologiques semblent dépassés, et le médecin généraliste est le médecin le plus propice à identifier et prendre en charge cette maladie, qui doit faire l’objet d’une reconnaissance médico-légale. CONCLUSION Dans le contexte de l’émergence d’une nouvelle maladie, le cas décrit remet en perspective la rencontre entre le médecin d’une part, et le patient souffrant de symptômes médicalement inexpliqués d’autre part, avec une cassure nette de sa santé.Summary INTRODUCTION It is estimated that over 65 million patients worldwide suffer from Long Covid Syndrome. This figure is probably underestimated and is constantly rising. A large proportion of these patients are at risk of lifelong disability, making Long Covid a major public health issue. LONG COVID Long Covid is a multisystem syndrome with a complex pathophysiology and a heterogeneous clinical presentation. heterogeneous clinical presentation. The symptoms most frequently reported are shortness of breath on exertion, muscle and joint pain, gastrointestinal problems and a variety of gastrointestinal disorders and a variety of neurocognitive disorders that can have a serious impact on an individual's quality of life. MATERIAL AND METHODS A brief review of the current literature on the disease was carried out, for the information of general practitioners. We will present the diagnostic pathway of a 44-year-old female patient, followed in a medical home and suffering from long Covid syndrome. Two questionnaires were completed during follow-up to assess the impact of the disease on her life. DISCUSSION This case study demonstrates the need to listen to patients and to question our medical knowledge. Long Covid is a multisystem disease that is still little known or understood. At present, technological tools appear to be outdated, and the general practitioner is the doctor best placed to identify and manage this disease, which must be recognised medico legally. CONCLUSION In the context of the emergence of a new disease, the case described puts into perspective the encounter between the doctor on the one hand, and the patient suffering from medically unexplained symptoms on the other, with a clear break in his health