126 research outputs found
Semantic Image Synthesis via Adversarial Learning
In this paper, we propose a way of synthesizing realistic images directly
with natural language description, which has many useful applications, e.g.
intelligent image manipulation. We attempt to accomplish such synthesis: given
a source image and a target text description, our model synthesizes images to
meet two requirements: 1) being realistic while matching the target text
description; 2) maintaining other image features that are irrelevant to the
text description. The model should be able to disentangle the semantic
information from the two modalities (image and text), and generate new images
from the combined semantics. To achieve this, we proposed an end-to-end neural
architecture that leverages adversarial learning to automatically learn
implicit loss functions, which are optimized to fulfill the aforementioned two
requirements. We have evaluated our model by conducting experiments on
Caltech-200 bird dataset and Oxford-102 flower dataset, and have demonstrated
that our model is capable of synthesizing realistic images that match the given
descriptions, while still maintain other features of original images.Comment: Accepted to ICCV 201
Development of a psychological intervention for post-stroke fatigue
Background
Post-stroke fatigue (PSF) is a common and distressing problem after stroke. It
impedes patients’ participation in daily activities and is associated with higher risks
of institutionalisation and death following stroke. Despite its high prevalence and
detrimental consequences, little research has been conducted to develop effective
treatments for PSF. Psychological interventions are effective in treating fatigue in
other conditions such as cancer and chronic fatigue syndrome. This thesis described
the development of a psychological intervention for PSF.
Methods
This thesis was based on the theoretical, modelling and part of the piloting phases of
the Medical Research Council (MRC) framework for designing and evaluating
complex interventions. This intervention was developed in collaboration with a
multidisciplinary group of stroke clinicians, clinical psychologists, a psychotherapist,
and stroke survivors. Both qualitative and quantitative methods were used.
Systematic reviews were conducted to explore the natural history of PSF and to
identify potential targets for a psychological intervention for PSF. The format of the
intervention was adapted from existing psychological interventions for cancer-related
fatigue and chronic fatigue syndrome. The intervention was delivered by a clinical
psychologist (i.e. the therapist) to 12 patients with PSF (i.e. the participants) to test
its acceptability and feasibility in the local health system. After the feasibility study,
the intervention was refined according to the feedback from the participants and the
therapist. A Cochrane review of interventions for PSF was updated to identify any
new evidence that could inform future studies.
Results
Systematic reviews suggested that PSF often occurred early after stroke and persisted
over time (which justified the need for interventions for PSF) and that PSF was
associated with distressed mood, lower self-efficacy, reduced physical activity and
sleeping problems (which were potential targets for the treatment of PSF). Based on
interventions that have been used to treat fatigue in other conditions, these
psychological and behavioural factors could be addressed by psychological
interventions that challenge patients’ thoughts and behaviours (i.e. the cognitive
behavioural therapy, CBT). Thus a manualised CBT was developed for PSF. This
CBT was delivered to each participant individually, through six face-to-face
treatment sessions over a period of 12 weeks, followed by a telephone-delivered
review session one month later. Both the participants and the therapist gave
favourable opinions on the acceptability of the intervention. The recruitment and
follow-up procedures were feasible in the local health system. Following the
feedback from participants and therapist, the intervention manual was refined for
future use, where the last two treatment sessions will be combined to a single session
and the review session will be delivered in person by the therapist. There were
statistically significant improvements in fatigue, mood, mobility, and participation in
social activity from baseline to three months after the end of treatment. The updated
Cochrane review concluded that there was insufficient evidence to recommend any
specific intervention for PSF; psychological interventions are one type of
interventions worth being investigated in future trials.
Conclusions
PSF is associated with distressed mood, lower self-efficacy, reduced physical activity
and sleeping problems, which are potential targets for the treatment of PSF.
Although there was insufficient evidence to recommend any intervention for the
treatment of PSF, psychological interventions are one type of promising
interventions worth future investigation. The promising results from this
uncontrolled feasibility study support the need for a subsequent exploratory
randomised controlled trial (RCT) of this brief psychological intervention
Regulation of triggering receptor expressed on myeloid cells-2 (TREM2) expression in microglia
Background: Activation of microglia is a feature of several neurodegenerative
diseases. TREM2 is an immune receptor expressed by macrophages and microglia,
which negatively regulates immune responses of these cells. Microglia-associated
brain inflammation may be alleviated by up-regulation of microglial TREM2.
However, it is unclear whether regulation of TREM2 expression in microglia is
consistent with classical (M1) and alternative (M2) activation pathways of
macrophages. Aims: To determine if microglial expression of TREM2 and its adaptor
protein DAP12 is regulated by M1 or M2 activation. Methods: BV2 microglial cells
were stimulated by LPS, IL-4, or HMGB1, respectively, with PBS as control. 6-hour
and 24-hour stimulations were applied to each treatment. Expression of TREM2,
DAP12, iNOS, IL-1β and Arg-1 was analysed by quantitative real-time PCR. Relative
quantification of results was performed using delta delta Ct method. One-sample
Student’s t-test was used to detect difference between treatment and control.
Results: Induced polarisation toward M1 and M2 activation phenotypes were
confirmed in microglia. TREM2 was down regulated by LPS (Mean ± SD: 0.95±0.56
for 6h and 0.40±0.07 for 24h) and up regulated by IL-4 (6h: 4.36±2.99; 24h:
1.74±0.68) and HMGB1 (6h: 4.56±4.20; 24h: 1.20±0.20). DAP12 presented no
obvious difference between treatments. Conclusion: Microglia are subjected to M1
and M2 polarisation. M2 cytokine IL-4 up regulates both TREM2 and Arg-1, which
attenuate brain inflammation. Regulation of microglial TREM2 provides a promising
target for treatment of neurodegenerative diseases
Application of computational media art in fashion design
This paper explores computational media art and its applications in innovative design in the fashion field, focusing on algorithmic creativity in digital fashion design. Computational media art provides a new perspective for exploring and expressing cultural and national aesthetics, from element-based inspiration extraction to algorithm-based generation and hybrid design exploration. From the perspective of computational aesthetics, research on the evolution of artists, works of art, and emerging art styles is a significant trend and direction of contemporary fashion design research
Interventions for post-stroke fatigue
BACKGROUND: Post-stroke fatigue (PSF) is a common and distressing problem after stroke. The best ways to prevent or treat PSF are uncertain. Several different interventions can be argued to have a rational basis.
OBJECTIVES: To determine whether, among people with stroke, any intervention reduces the proportion of people with fatigue, fatigue severity, or both; and to determine the effect of intervention on health-related quality of life, disability, dependency and death, and whether such intervention is cost effective.
SEARCH METHODS: We searched the Cochrane Stroke Group Trials Register (last searched May 2014), Cochrane Central Register of Controlled Trials (The Cochrane Library, 2014, Issue 4), MEDLINE (1950 to May 2014), EMBASE (1980 to May 2014), CINAHL (1982 to May 2014), AMED (1985 to May 2014), PsycINFO (1967 to May 2014), Digital Dissertations (1861 to May 2014), British Nursing Index (1985 to May 2014), PEDro (searched May 2014) and PsycBITE (searched May 2014). We also searched four ongoing trials registries, scanned reference lists, performed citation tracking of included trials and contacted experts.
SELECTION CRITERIA: Two review authors independently scrutinised all titles and abstracts and excluded obviously irrelevant studies. We obtained the full texts for potentially relevant studies and three review authors independently applied the inclusion criteria. We included randomised controlled trials (RCTs) that compared an intervention with a control, or compared different interventions for PSF.
DATA COLLECTION AND ANALYSIS: Two review authors independently extracted data and assessed risk of bias for each included trial. The primary outcomes were severity of fatigue, or proportion of people with fatigue after treatment. We performed separate analyses for trials investigating efficacy in treating PSF, trials investigating efficacy in preventing PSF and trials not primarily investigating efficacy in PSF but which reported fatigue as an outcome. We pooled results from trials that had a control arm. For trials that compared different potentially active interventions without a control arm, we performed analyses for individual trials without pooling.We calculated standardised mean difference (SMD) as the effect size for continuous outcomes and risk ratio (RR) for dichotomous outcomes. We pooled the results using a random-effects model and assessed heterogeneity using the I(2) statistic. We performed separate subgroup analyses for pharmacological and non-pharmacological interventions. We also performed sensitivity analyses to assess the influence of methodological quality.
MAIN RESULTS: We retrieved 12,490 citations, obtained full texts for 58 studies and included 12 trials (three from the 2008 search and nine from the 2014 search) with 703 participants. Eight trials primarily investigated the efficacy in treating PSF, of which six trials with seven comparisons provided data suitable for meta-analysis (five pharmacological interventions: fluoxetine, enerion, (-)-OSU6162, citicoline and a combination of Chinese herbs; and two non-pharmacological interventions: a fatigue education programme and a mindfulness-based stress reduction programme). The fatigue severity was lower in the intervention groups than in the control groups (244 participants, pooled SMD -1.07, 95% confidence interval (CI) -1.93 to -0.21), with significant heterogeneity between trials (I(2) = 87%, degrees of freedom (df) = 6, P value < 0.00001). The beneficial effect was not seen in trials that had used adequate allocation concealment (two trials, 89 participants, SMD -0.38, 95% CI -0.80 to 0.04) or trials that had used adequate blinding of outcome assessors (four trials, 198 participants, SMD -1.10, 95% CI -2.31 to 0.11).No trial primarily investigated the efficacy in preventing PSF.Four trials (248 participants) did not primarily investigate the efficacy on fatigue but other symptoms after stroke. None of these interventions showed any benefit on reducing PSF, which included tirilazad mesylate, continuous positive airway pressure for sleep apnoea, antidepressants and a self management programme for recovery from chronic diseases. AUTHORS'
CONCLUSIONS: There was insufficient evidence on the efficacy of any intervention to treat or prevent fatigue after stroke. Trials to date have been small and heterogeneous, and some have had a high risk of bias. Some of the interventions described were feasible in people with stroke, but their efficacy should be investigated in RCTs with a more robust study design and adequate sample sizes
Post stroke intervention trial in fatigue (POSITIF):Randomised multicentre feasibility trial
OBJECTIVE: To test the feasibility of a telephone delivered intervention, informed by cognitive behavioural principles, for post-stroke fatigue, and estimated its effect on fatigue and other outcomes. DESIGN: Randomised controlled parallel group trial. SETTING: Three Scottish stroke services. SUBJECTS: Stroke survivors with fatigue three months to two years post-stroke onset. INTERVENTIONS: Seven telephone calls (fortnightly then a ‘booster session’ at 16 weeks) of a manualised intervention, plus information about fatigue, versus information only. MAIN MEASURES: Feasibility of trial methods, and collected outcome measures (fatigue, mood, anxiety, social participation, quality of life, return to work) just before randomisation, at the end of treatment (four months after randomisation) and at six months after randomisation. RESULTS: Between October 2018 and January 2020, we invited 886 stroke survivors to participate in postal screening: 188/886 (21%) returned questionnaires and consented, of whom 76/188 (40%) were eligible and returned baseline forms; 64/76 (84%) returned six month follow-up questionnaires. Of the 39 allocated the intervention, 23 (59%) attended at least four sessions. At six months, there were no significant differences between the groups (adjusted mean differences in Fatigue Assessment Scale −0.619 (95% CI −4.9631, 3.694; p = 0.768), the Generalised Anxiety Disorder 7 −0.178 (95% CI −3.823, 3.467, p = 0.92), and the Patient Health Questionnaire −0.247 (95% CI −2.935, 2.442, p = 0.851). There were no between-group differences in quality of life, social participation or return to work. CONCLUSION: Patients can be recruited to a trial of this design. These data will inform the design of further trials in post-stroke fatigue
Factors Associated with Poststroke Anxiety:A Systematic Review and Meta-Analysis
Background and Purpose. Anxiety affects 25% of stroke survivors. There are no effective treatments. Poststroke depression, prestroke anxiety and depression, locus of control, coping, confidence, fatigue, and sleep are factors that may be associated with poststroke anxiety and can potentially be targeted by therapy. We systematically reviewed the literature and performed a meta-analysis to identify associations with these factors. Methods. We searched electronic databases from January 2014 to July 2015 to complement a literature search performed from inception to May 2014. Study quality was assessed using an internationally endorsed checklist. We used odds ratios (ORs) to estimate the strength of associations and random-effects modelling to calculate summary effect sizes. Results. There were 24 studies recruiting 15448 patients. Quality of reporting was satisfactory. 13 studies with 2408 patients reported associations between poststroke anxiety and poststroke depression (OR=4.66, 95% confidence interval: 2.23, 9.74). One study reported association with prestroke anxiety, three with prestroke depression, one with fatigue, and two with sleep. No studies reported on locus of control, coping, or confidence. Conclusion. Poststroke anxiety was associated with depression but there are limited data on other modifiable associations. Further research is needed to identify potential targets for treatment
The impact of long-term care insurance in China on beneficiaries and caregivers: A systematic review
Background
China’s long-term care insurance (LTCI) policy has been minimally evaluated. This systematic review aimed to assess the impact of China’s LTCI pilot on beneficiaries and their caregivers.
Methods
This review is based on a search of peer-reviewed studies in English (Embase, MEDLINE, Web of Science) and Chinese (China National Knowledge Infrastructure [CNKI], VIP, Wanfang) databases from January 2016 through July 2020, with all studies published in English or Chinese included. We included quantitative analyses of beneficiary-level data that assessed the impact of LTCI on beneficiaries and their caregivers, with no restriction placed on the outcomes studied.
Results
Nine studies met our inclusion criteria. One study was a randomised trial and two used quasi-experimental approaches. Four studies examined LTCI’s effect on beneficiaries’ quality of life, physical pain, and health service utilisation; one study reported the effect on beneficiaries’ healthcare expenditures; and one study evaluated the impact on caregivers’ care tasks. These studies generally found LTCI to be associated with an improvement in patients’ quality of life (including decreased physical pain), a reduction in the number of outpatient visits and hospitalisations, decreased patient-level health expenditures (e.g. one study reported a reduction in the length of stay, inpatient expenditures, and health insurance expenditures in tertiary hospitals by 41.0%, 17.7%, and 11.4%, respectively), and reduced informal care tasks for caregivers. In addition, four out of four studies that evaluated this outcome found that beneficiaries’ overall satisfaction with LTCI was high.
Conclusion
The current evidence base for the effects of LTCI in China on beneficiaries and their caregivers is sparse. Nonetheless, the existing studies suggest that LTCI has positive effects on beneficiaries and their caregivers. Further rigorous research on the impacts of LTCI in China is needed to inform the future expansion of the program
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