More comprehensive facial inversion for more effective expression recognition

Facial expression recognition (FER) plays a significant role in the ubiquitous application of computer vision. We revisit this problem with a new perspective on whether it can acquire useful representations that improve FER performance in the image generation process, and propose a novel generative method based on the image inversion mechanism for the FER task, termed Inversion FER (IFER). Particularly, we devise a novel Adversarial Style Inversion Transformer (ASIT) towards IFER to comprehensively extract features of generated facial images. In addition, ASIT is equipped with an image inversion discriminator that measures the cosine similarity of semantic features between source and generated images, constrained by a distribution alignment loss. Finally, we introduce a feature modulation module to fuse the structural code and latent codes from ASIT for the subsequent FER work. We extensively evaluate ASIT on facial datasets such as FFHQ and CelebA-HQ, showing that our approach achieves state-of-the-art facial inversion performance. IFER also achieves competitive results in facial expression recognition datasets such as RAF-DB, SFEW and AffectNet. The code and models are available at https://github.com/Talented-Q/IFER-master

Smoking Cessation With 20 Hz Repetitive Transcranial Magnetic Stimulation (rTMS) Applied to Two Brain Regions: A Pilot Study

Chronic smoking impairs brain functions in the prefrontal cortex and the projecting meso-cortical limbic system. The purpose of this pilot study is to examine whether modulating the frontal brain activity using high-frequency repetitive transcranial magnetic stimulation (rTMS) can improve smoking cessation and to explore the changing pattern of the brain activity after treatment. Fourteen treatment-seeking smokers were offered a program involving 10 days of rTMS treatment with a follow-up for another 25 days. A frequency of 20 Hz rTMS was sequentially applied on the left dorso-lateral prefrontal cortex (DLPFC) and the superior medial frontal cortex (SMFC). The carbon monoxide (CO) level, withdrawal, craving scales, and neuroimaging data were collected. Ten smokers completed the entire treatment program, and 90% of them did not smoke during the 25-day follow-up time. A significant smoking craving reduction and resting brain activity reduction measured by the cerebral blood flow (CBF) and brain entropy (BEN) were observed after 10 days of 20 Hz rTMS treatments compared to the baseline. Although limited by sample size, these pilot findings definitely showed a high potential of multiple-target high-frequency rTMS in smoking cessation and the utility of fMRI for objectively assessing the treatment effects

Actively implementing an evidence-based feeding guideline for critically ill patients (NEED): a multicenter, cluster-randomized, controlled trial

Background: Previous cluster-randomized controlled trials evaluating the impact of implementing evidence-based guidelines for nutrition therapy in critical illness do not consistently demonstrate patient benefits. A large-scale, sufficiently powered study is therefore warranted to ascertain the effects of guideline implementation on patient-centered outcomes. Methods: We conducted a multicenter, cluster-randomized, parallel-controlled trial in intensive care units (ICUs) across China. We developed an evidence-based feeding guideline. ICUs randomly allocated to the guideline group formed a local "intervention team", which actively implemented the guideline using standardized educational materials, a graphical feeding protocol, and live online education outreach meetings conducted by members of the study management committee. ICUs assigned to the control group remained unaware of the guideline content. All ICUs enrolled patients who were expected to stay in the ICU longer than seven days. The primary outcome was all-cause mortality within 28 days of enrollment. Results: Forty-eight ICUs were randomized to the guideline group and 49 to the control group. From March 2018 to July 2019, the guideline ICUs enrolled 1399 patients, and the control ICUs enrolled 1373 patients. Implementation of the guideline resulted in significantly earlier EN initiation (1.20 vs. 1.55 mean days to initiation of EN; difference − 0.40 [95% CI − 0.71 to − 0.09]; P = 0.01) and delayed PN initiation (1.29 vs. 0.80 mean days to start of PN; difference 1.06 [95% CI 0.44 to 1.67]; P = 0.001). There was no significant difference in 28-day mortality (14.2% vs. 15.2%; difference − 1.6% [95% CI − 4.3% to 1.2%]; P = 0.42) between groups. Conclusions: In this large-scale, multicenter trial, active implementation of an evidence-based feeding guideline reduced the time to commencement of EN and overall PN use but did not translate to a reduction in mortality from critical illness. Trial registration: ISRCTN, ISRCTN12233792. Registered November 20th, 2017

Actively implementing an evidence-based feeding guideline for critically ill patients (NEED): a multicenter, cluster-randomized, controlled trial.

BackgroundPrevious cluster-randomized controlled trials evaluating the impact of implementing evidence-based guidelines for nutrition therapy in critical illness do not consistently demonstrate patient benefits. A large-scale, sufficiently powered study is therefore warranted to ascertain the effects of guideline implementation on patient-centered outcomes.MethodsWe conducted a multicenter, cluster-randomized, parallel-controlled trial in intensive care units (ICUs) across China. We developed an evidence-based feeding guideline. ICUs randomly allocated to the guideline group formed a local "intervention team", which actively implemented the guideline using standardized educational materials, a graphical feeding protocol, and live online education outreach meetings conducted by members of the study management committee. ICUs assigned to the control group remained unaware of the guideline content. All ICUs enrolled patients who were expected to stay in the ICU longer than seven days. The primary outcome was all-cause mortality within 28 days of enrollment.ResultsForty-eight ICUs were randomized to the guideline group and 49 to the control group. From March 2018 to July 2019, the guideline ICUs enrolled 1399 patients, and the control ICUs enrolled 1373 patients. Implementation of the guideline resulted in significantly earlier EN initiation (1.20 vs. 1.55 mean days to initiation of EN; difference - 0.40 [95% CI - 0.71 to - 0.09]; P = 0.01) and delayed PN initiation (1.29 vs. 0.80 mean days to start of PN; difference 1.06 [95% CI 0.44 to 1.67]; P = 0.001). There was no significant difference in 28-day mortality (14.2% vs. 15.2%; difference - 1.6% [95% CI - 4.3% to 1.2%]; P = 0.42) between groups.ConclusionsIn this large-scale, multicenter trial, active implementation of an evidence-based feeding guideline reduced the time to commencement of EN and overall PN use but did not translate to a reduction in mortality from critical illness.Trial registrationISRCTN, ISRCTN12233792 . Registered November 20th, 2017

Actively implementing an evidence-based feeding guideline for critically ill patients (NEED): a multicenter, cluster-randomized, controlled trial (vol 26, 46, 2022)

BackgroundPrevious cluster-randomized controlled trials evaluating the impact of implementing evidence-based guidelines for nutrition therapy in critical illness do not consistently demonstrate patient benefits. A large-scale, sufficiently powered study is therefore warranted to ascertain the effects of guideline implementation on patient-centered outcomes.MethodsWe conducted a multicenter, cluster-randomized, parallel-controlled trial in intensive care units (ICUs) across China. We developed an evidence-based feeding guideline. ICUs randomly allocated to the guideline group formed a local "intervention team", which actively implemented the guideline using standardized educational materials, a graphical feeding protocol, and live online education outreach meetings conducted by members of the study management committee. ICUs assigned to the control group remained unaware of the guideline content. All ICUs enrolled patients who were expected to stay in the ICU longer than seven days. The primary outcome was all-cause mortality within 28 days of enrollment.ResultsForty-eight ICUs were randomized to the guideline group and 49 to the control group. From March 2018 to July 2019, the guideline ICUs enrolled 1399 patients, and the control ICUs enrolled 1373 patients. Implementation of the guideline resulted in significantly earlier EN initiation (1.20 vs. 1.55 mean days to initiation of EN; difference - 0.40 [95% CI - 0.71 to - 0.09]; P = 0.01) and delayed PN initiation (1.29 vs. 0.80 mean days to start of PN; difference 1.06 [95% CI 0.44 to 1.67]; P = 0.001). There was no significant difference in 28-day mortality (14.2% vs. 15.2%; difference - 1.6% [95% CI - 4.3% to 1.2%]; P = 0.42) between groups.ConclusionsIn this large-scale, multicenter trial, active implementation of an evidence-based feeding guideline reduced the time to commencement of EN and overall PN use but did not translate to a reduction in mortality from critical illness.Trial registrationISRCTN, ISRCTN12233792 . Registered November 20th, 2017

Improvements to Self-Supervised Representation Learning for Masked Image Modeling

This paper explores improvements to the masked image modeling (MIM) paradigm. The MIM paradigm enables the model to learn the main object features of the image by masking the input image and predicting the masked part by the unmasked part. We found the following three main directions for MIM to be improved. First, since both encoders and decoders contribute to representation learning, MIM uses only encoders for downstream tasks, which ignores the impact of decoders on representation learning. Although the MIM paradigm already employs small decoders with asymmetric structures, we believe that continued reduction of decoder parameters is beneficial to improve the representational learning capability of the encoder . Second, MIM solves the image prediction task by training the encoder and decoder together , and does not design a separate task for the encoder . To further enhance the performance of the encoder when performing downstream tasks, we designed the encoder for the tasks of comparative learning and token position prediction. Third, since the input image may contain background and other objects, and the proportion of each object in the image varies, reconstructing the tokens related to the background or to other objects is not meaningful for MIM to understand the main object representations. Therefore we use ContrastiveCrop to crop the input image so that the input image contains as much as possible only the main objects. Based on the above three improvements to MIM, we propose a new model, Contrastive Masked AutoEncoders (CMAE). We achieved a Top-1 accuracy of 65.84% on tinyimagenet using the ViT-B backbone, which is +2.89 outperforming the MAE of competing methods when all conditions are equal. Code will be made available

Medical supervised masked autoencoders: Crafting a better masking strategy and efficient fine-tuning schedule for medical image classification

Masked autoencoders (MAEs) have displayed significant potential in the classification and semantic segmentation of medical images in the last year. Due to the high similarity of human tissues, even slight changes in medical images may represent diseased tissues, necessitating fine-grained inspection to pinpoint diseased tissues. The random masking strategy of MAEs is likely to result in areas of lesions being overlooked by the model. At the same time, inconsistencies between the pre-training and fine-tuning phases impede the performance and efficiency of MAE in medical image classification. To address these issues, we propose a medical supervised masked autoencoder (MSMAE) in this paper. In the pre-training phase, MSMAE precisely masks medical images via the attention maps obtained from supervised training, contributing to the representation learning of human tissue in the lesion area. During the fine-tuning phase, MSMAE is also driven by attention to the accurate masking of medical images. This improves the computational efficiency of the MSMAE while increasing the difficulty of fine-tuning, which indirectly improves the quality of MSMAE medical diagnosis. Extensive experiments demonstrate that MSMAE achieves state-of-the-art performance in case with three official medical datasets for various diseases. Meanwhile, transfer learning for MSMAE also demonstrates the great potential of our approach for medical semantic segmentation tasks. Moreover, the MSMAE accelerates the inference time in the fine-tuning phase by 11.2% and reduces the number of floating-point operations (FLOPs) by 74.08% compared to a traditional MAE