The Variational Homoencoder: Learning to learn high capacity generative models from few examples

Hierarchical Bayesian methods can unify many related tasks (e.g. k-shot classification, conditional and unconditional generation) as inference within a single generative model. However, when this generative model is expressed as a powerful neural network such as a PixelCNN, we show that existing learning techniques typically fail to effectively use latent variables. To address this, we develop a modification of the Variational Autoencoder in which encoded observations are decoded to new elements from the same class. This technique, which we call a Variational Homoencoder (VHE), produces a hierarchical latent variable model which better utilises latent variables. We use the VHE framework to learn a hierarchical PixelCNN on the Omniglot dataset, which outperforms all existing models on test set likelihood and achieves strong performance on one-shot generation and classification tasks. We additionally validate the VHE on natural images from the YouTube Faces database. Finally, we develop extensions of the model that apply to richer dataset structures such as factorial and hierarchical categories.Comment: UAI 2018 oral presentatio

Nasal lysine aspirin challenge in the diagnosis of aspirin - exacerbated respiratory disease

Background Aspirin-exacerbated respiratory disease is under-diagnosed and therefore effective and inexpensive therapy with aspirin desensitization is rarely performed. Methods We present an audit of 150 patients with difficult to treat nasal polyposis, 132 of whom also had asthma, 131 of whom underwent challenge with the only soluble form of aspirin, lysine aspirin (LAS), to confirm or exclude the diagnosis of aspirin-exacerbated respiratory disease (AERD). Results One hundred patients proved positive on nasal challenge, 31 who were negative went onto oral LAS challenge and a further 14 gave positive results, leaving 17 who were negative to a dose equivalent to over 375 mg of aspirin. Nineteen were not challenged because of contraindications. With the exception of one patient who developed facial angioedema and two patients with > 20% drop in FEV1 (following nasal plus oral challenge) no other severe adverse events occurred. No hospitalization was required for these three patients. Nasal inspiratory peak flow monitoring was less sensitive to obstruction caused by aspirin than was acoustic rhinometry – which should be employed when aspirin challenge is an outpatient procedure. Conclusions Provided patients are carefully chosen and monitored LAS challenge is suitable for ENT day case practice where respiratory physician help with asthma is available and should reduce the under-diagnosis of this condition

Prevalence, incidence, and risk factors for shoulder and neck dysfunction after neck dissection: a systematic review

Introduction Shoulder pain and dysfunction may occur following neck dissection among people being treated for head and neck cancer. This systematic review aims to examine the prevalence and incidence of shoulder and neck dysfunction after neck dissection and identify risk factors for these post-operative complications. Methods Electronic databases (Pubmed, CINAHL, EMBASE, Cochrane) were searched for articles including adults undergoing neck dissection for head and neck cancer. Studies that reported prevalence, incidence or risk factors for an outcome of the shoulder or neck were eligible and assessed using the Critical Review Form – Quantitative Studies. Results Seventy-five articles were included in the final review. Prevalence rates for shoulder pain were slightly higher after RND (range, 10–100%) compared with MRND (range, 0–100%) and SND (range, 9–25%). The incidence of reduced shoulder active range of motion depended on surgery type (range, 5–20%). The prevalence of reduced neck active range of motion after neck dissection was 1–13%. Type of neck dissection was a risk factor for shoulder pain, reduced function and health-related quality of life. Conclusions The prevalence and incidence of shoulder and neck dysfunction after neck dissection varies by type of surgery performed and measure of dysfunction used. Pre-operative education for patients undergoing neck dissection should acknowledge the potential for post-operative shoulder and neck problems to occur and inform patients that accessory nerve preservation lowers, but does not eliminate, the risk of developing musculoskeletal complications

Insights into the molecular triggers of parosmia based on gas chromatography olfactometry

Background Parosmia is a debilitating condition in which familiar smells become distorted and disgusting, with consequences for diet and mental health. It is a feature of post-infectious olfactory loss, particularly resulting from COVID-19. There is currently little understanding of its pathophysiology, and the prevailing hypothesis for the underlying mechanism is aberrant growth of regenerating olfactory sensory neurons after damage. Methods We use gas-chromatograph olfactometry to individually present components of a complex olfactory mixture as a rapid screening tool for assessment of both quantitative and qualitative olfactory dysfunction in those with and without parosmia. This allows them to report the associated sensory effects and to identify those molecules which are altered or parosmic in nature. Results Here we show 15 different molecular triggers of this symptom. These trigger molecules are common to many in the parosmic volunteer group and share certain characteristics such as extremely low olfactory threshold and common molecular structure Conclusions We posit that specific highly odour-active molecules are the cause of the parosmic symptom in most cases and initiate the sense of disgust, suggesting that parosmia is, at least in part, a receptor-level phenomenon

Fragile X Newborn Screening: Lessons Learned From a Multisite Screening Study

BACKGROUND: Delays in the diagnosis of children with fragile X syndrome (FXS) suggest the possibility of newborn screening as a way to identify children earlier. However, FXS does not have a proven treatment that must be provided early, and ethical concerns have been raised about the detection of infants who are carriers. This article summarizes major findings from a multisite, prospective, longitudinal pilot screening study. METHODS: Investigators in North Carolina, California, and Illinois collaborated on a study in which voluntary screening for FXS was offered to parents in 3 birthing hospitals. FXS newborn screening was offered to >28 000 families to assess public acceptance and determine whether identification of babies resulted in any measurable harms or adverse events. Secondary goals were to determine the prevalence of FMR1 carrier gene expansions, study the consent process, and describe early development and behavior of identified children. RESULTS: A number of publications have resulted from the project. This article summarizes 10 "lessons learned" about the consent process, reasons for accepting and declining screening, development and evaluation of a decision aid, prevalence of carriers, father participation in consent, family follow-up, and maternal reactions to screening. CONCLUSIONS: The project documented public acceptance of screening as well as the challenges inherent in obtaining consent in the hospital shortly after birth. Collectively, the study provides answers to a number of questions that now set the stage for a next generation of research to determine the benefits of earlier identification for children and families

Mapping ecologically sensitive, significant and salient areas of Western Ghats: proposed protocols and methodology

The Western Ghats Ecology Expert Panel (WGEEP) of the Ministry of Environment and Forests, Government of India (GOI) has been asked to identify ecologically sensitive areas (ESAs) along the Western Ghats, and to suggest how to manage them. The concept of ESAs has been extensively discussed in the literature. Several ESAs have been set up in India over the last 22 years under the Environment Protection Act, 1986, and a GOI committee under the chairmanship of Pranob Sen has proposed certain criteria for identification of ESAs. However, WGEEP noted that we still lack a global consensus either on the criteria to define ESAs or on a workable methodology to identify them. Furthermore, there are no clear guidelines on the management regime that should prevail in ESAs, and the Pranob Sen Committee has not addressed this issue at all. Hence, WGEEP decided to undertake an exercise of defining ESAs and developing a workable methodology to assign levels of ecological significance/sensitivity as a first step towards putting ESAs on the map of the Western Ghats. This article provides a report on the outcome of a series of discussions and consultations held by WGEEP to build a consensus on defining and mapping ESAs. It hopes to provoke discussion and feedback from a wider section of experts, with the aim of finalizing a generic methodology for mapping ESAs in other ecologically sign ificant, biodiversity-rich areas within and outside the country. We hope to shortly prepare a companion paper that will address the equally vital management issues

‘Media events’ reconsidered: from ritual theory to simulation and performativity

This paper re-examines the long-established notion of ‘media events’ by contrasting and critically appraising three distinct approaches to the question of media events. These are: ritual theory associated with Daniel Dayan and Elihu Katz, secondly, Jean Baudrillard’s approach rooted in his notions of simulation and ‘non-events’ and, finally, the more recent performative approaches to media and mediation. I take Sarah Kember and Joanna Zylinska’s reading of media events presented in Life After New Media (2012) as exemplary of the performative approach. An argument is made that the accounts of media events offered by performative approaches add very little, and, indeed, lack the critical insightfulness of the earlier approaches. Both ritual theory and Baudrillard’s thought are briefly reappraised and, against Nick Couldry, I try to show that these accounts are not characterised by binary and reductive thinking. The major misunderstandings concern the nature of the sacred and profane dualism and the further dualisms developed in Baudrillard’s thought, particularly the figures of implosion and reversibility. Finally, Baudrillard’s position on technology is addressed and the paper concludes with the suggestion that his account is not solely negative, since technological developments are not only at the mercy of ironic reversals they may also enable new rituals of disappearance

Human and value sensitive aspects of mobile app design: a Foucauldian perspective

Value sensitive concerns remain relatively neglected by software design processes leading to potential failure of technology acceptance. By drawing upon an inter-disciplinary study that employed participatory design methods to develop mobile apps in the domain of youth justice, this paper examines a critical example of an unintended consequence that created user concerns around Focauldian concepts including power, authority, surveillance and governmentality. The primary aim of this study was to design, deploy and evaluate social technology that may help to promote better engagement between case workers and young people to help reduce recidivism, and support young people’s transition towards social inclusion in society. A total of 140 participants including practitioners (n=79), and young people (n=61) contributed to the data collection via surveys, focus groups and one-one interviews. The paper contributes an important theoretically located discussion around both how co-design is helpful in giving ‘voice’ to key stakeholders in the research process and observing the risk that competing voices may lead to tensions and unintended outcomes. In doing so, software developers are exposed to theories from social science that have significant impact on their product

Hepatitis C virus cell-cell transmission and resistance to direct-acting antiviral agents

Hepatitis C virus (HCV) is transmitted between hepatocytes via classical cell entry but also uses direct cell-cell transfer to infect neighboring hepatocytes. Viral cell-cell transmission has been shown to play an important role in viral persistence allowing evasion from neutralizing antibodies. In contrast, the role of HCV cell-cell transmission for antiviral resistance is unknown. Aiming to address this question we investigated the phenotype of HCV strains exhibiting resistance to direct-acting antivirals (DAAs) in state-of-the-art model systems for cell-cell transmission and spread. Using HCV genotype 2 as a model virus, we show that cell-cell transmission is the main route of viral spread of DAA-resistant HCV. Cell-cell transmission of DAA-resistant viruses results in viral persistence and thus hampers viral eradication. We also show that blocking cell-cell transmission using host-targeting entry inhibitors (HTEIs) was highly effective in inhibiting viral dissemination of resistant genotype 2 viruses. Combining HTEIs with DAAs prevented antiviral resistance and led to rapid elimination of the virus in cell culture model. In conclusion, our work provides evidence that cell-cell transmission plays an important role in dissemination and maintenance of resistant variants in cell culture models. Blocking virus cell-cell transmission prevents emergence of drug resistance in persistent viral infection including resistance to HCV DAAs