Video coding for compression and content-based functionality

The lifetime of this research project has seen two dramatic developments in the area of digital video coding. The first has been the progress of compression research leading to a factor of two improvement over existing standards, much wider deployment possibilities and the development of the new international ITU-T Recommendation H.263. The second has been a radical change in the approach to video content production with the introduction of the content-based coding concept and the addition of scene composition information to the encoded bit-stream. Content-based coding is central to the latest international standards efforts from the ISO/IEC MPEG working group. This thesis reports on extensions to existing compression techniques exploiting a priori knowledge about scene content. Existing, standardised, block-based compression coding techniques were extended with work on arithmetic entropy coding and intra-block prediction. These both form part of the H.263 and MPEG-4 specifications respectively. Object-based coding techniques were developed within a collaborative simulation model, known as SIMOC, then extended with ideas on grid motion vector modelling and vector accuracy confidence estimation. An improved confidence measure for encouraging motion smoothness is proposed. Object-based coding ideas, with those from other model and layer-based coding approaches, influenced the development of content-based coding within MPEG-4. This standard made considerable progress in this newly adopted content based video coding field defining normative techniques for arbitrary shape and texture coding. The means to generate this information, the analysis problem, for the content to be coded was intentionally not specified. Further research work in this area concentrated on video segmentation and analysis techniques to exploit the benefits of content based coding for generic frame based video. The work reported here introduces the use of a clustering algorithm on raw data features for providing initial segmentation of video data and subsequent tracking of those image regions through video sequences. Collaborative video analysis frameworks from COST 21 l qual and MPEG-4, combining results from many other segmentation schemes, are also introduced

Effect of general anaesthesia on functional outcome in patients with anterior circulation ischaemic stroke having endovascular thrombectomy versus standard care: a meta-analysis of individual patient data

Background: General anaesthesia (GA) during endovascular thrombectomy has been associated with worse patient outcomes in observational studies compared with patients treated without GA. We assessed functional outcome in ischaemic stroke patients with large vessel anterior circulation occlusion undergoing endovascular thrombectomy under GA, versus thrombectomy not under GA (with or without sedation) versus standard care (ie, no thrombectomy), stratified by the use of GA versus standard care. Methods: For this meta-analysis, patient-level data were pooled from all patients included in randomised trials in PuMed published between Jan 1, 2010, and May 31, 2017, that compared endovascular thrombectomy predominantly done with stent retrievers with standard care in anterior circulation ischaemic stroke patients (HERMES Collaboration). The primary outcome was functional outcome assessed by ordinal analysis of the modified Rankin scale (mRS) at 90 days in the GA and non-GA subgroups of patients treated with endovascular therapy versus those patients treated with standard care, adjusted for baseline prognostic variables. To account for between-trial variance we used mixed-effects modelling with a random effect for trials incorporated in all models. Bias was assessed using the Cochrane method. The meta-analysis was prospectively designed, but not registered. Findings: Seven trials were identified by our search; of 1764 patients included in these trials, 871 were allocated to endovascular thrombectomy and 893 were assigned standard care. After exclusion of 74 patients (72 did not undergo the procedure and two had missing data on anaesthetic strategy), 236 (30%) of 797 patients who had endovascular procedures were treated under GA. At baseline, patients receiving GA were younger and had a shorter delay between stroke onset and randomisation but they had similar pre-treatment clinical severity compared with patients who did not have GA. Endovascular thrombectomy improved functional outcome at 3 months both in patients who had GA (adjusted common odds ratio (cOR) 1·52, 95% CI 1·09–2·11, p=0·014) and in those who did not have GA (adjusted cOR 2·33, 95% CI 1·75–3·10, p<0·0001) versus standard care. However, outcomes were significantly better for patients who did not receive GA versus those who received GA (covariate-adjusted cOR 1·53, 95% CI 1·14–2·04, p=0·0044). The risk of bias and variability between studies was assessed to be low. Interpretation: Worse outcomes after endovascular thrombectomy were associated with GA, after adjustment for baseline prognostic variables. These data support avoidance of GA whenever possible. The procedure did, however, remain effective versus standard care in patients treated under GA, indicating that treatment should not be withheld in those who require anaesthesia for medical reasons