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Massive amounts of multimedia data (i.e., text, audio, video, graphics and animation) are being generated everyday. Conventionally, multimedia data are managed by the platforms maintained by multimedia service providers, which are generally designed using centralised architecture. However, such centralised architecture may lead to a single point of failure and disputes over royalties or other rights. It is hard to ensure the data integrity and track fulfilment of obligations listed on the copyright agreement. To tackle these issues, in this paper, we present a blockchain-based platform architecture for multimedia data management. We adopt self-sovereign identity for identity management and design a multi-level capability-based mechanism for access control. We implement a proof-of-concept prototype using the proposed approach and evaluate it using a use case. The results show that the proposed approach is feasible and has scalable performance.

In order to improve the speech enhancement ability of FullSubNet model, an improved method FullSubNet-pMix is proposed. Specifically, pMix module is added to the structure of full-band frequency domain information processing, which realizes the information interaction between amplitude spectrum and phase spectrum. At the same time, the hyperparameters used in training are optimized so that the full-band and sub-band structure of the system can play a better role. Experiments are carried out on selected test sets. The experimental results show that the proposed method can independently improve the speech enhancement effect of the model, and the effect on the four evaluation indicators of WB-PESQ, NB-PESQ, STOI, and SI-SDR is better than the original model. Therefore, the FullSubNet-pMix method proposed in this paper can effectively enhance the ability of the model to extract and use voice information. The impact of different loss functions on the training performance was also verified.

Background The newly developed monoplanar pedicle screws (MPPSs) can mobile in axial plane but fixed in the sagittal plane, which holds potential to combine ease of rod placement with sagittal plane strength theoretically. So far, few clinical studies focused on the outcomes of MPPSs for treatment of thoracolumbar fractures (TLFs). The aim of this study was to compare the efficacy of MPPSs to polyaxial pedicle screws (PAPSs) in percutaneous intermediate fixation of TLFs. Methods Seventy-eight patients who sustained TLFs without neurological deficits and underwent percutaneous intermediate fixation using MPPSs (40 patients) or PAPSs (38 patients) with a minimum 1-year follow-up were included in this study. The operation time, blood loss, local Cobb angle (LCA), vertebral wedge angle (VWA), anterior body height ratio (ABHR), visual analogue scale (VAS) and Oswestry Disability Index (ODI) were collected. Results No significant differences were observed in baseline demographics, clinical characteristics, operation time or blood loss between the two groups ( P  > 0.05). The postoperative LCA, VWA and ABHR were significantly corrected compared to these parameters preoperatively in both groups ( # P  < 0.05). The postoperative LCA, VWA and ABHR in the MPPS group were significantly better corrected than those in the PAPS group ( *P  < 0.05). Furthermore, the correction loss of LCA, VWA and ABHR in the MPPS group was significantly lower than that in the PAPS group ( *P  < 0.05). However, no significant difference in VAS and ODI scores was observed between the two groups. Conclusions MPPSs showed similar efficiency as PAPSs in percutaneous intermediate fixation surgical procedures. More importantly, MPPSs achieved better radiological performance than PAPSs in the correction of TLFs and the prevention of correction loss.

Cutaneous squamous cell carcinoma (cSCC) is a common non-melanoma skin cancer with potential for local invasion and metastasis. Accurate preoperative assessment is essential for optimal treatment planning. We report a case of an 83-year-old female patient who presented with a progressively enlarging scalp mass over 3 months. HR-MRI revealed a mixed-signal lesion (22 × 15 × 26 mm) in the right scalp. On T1-weighted imaging (T1WI) and T2-weighted imaging (T2WI), the lesion exhibited heterogeneous signals with an irregular, crater-like surface. Post-contrast imaging demonstrated significant heterogeneous enhancement. The tumor was located within the epidermis, dermis, and subcutaneous fat, closely adhering to the galea aponeurotica with well-defined margins. Surgical resection and histopathological examination confirmed a (exophytic type) moderately to well-differentiated cSCC (2.8 × 2.3 × 2.0 cm) infiltrating the subcutaneous tissue but without perineural invasion or deeper tissue involvement. HR-MRI provided clear visualization of tumor morphology, infiltration depth, and relationship with surrounding structures. Compared to conventional MRI, HR-MRI improved the accuracy of tumor boundary delineation, offering valuable information for preoperative planning. HR-MRI plays a significant role in the evaluation of cSCC, particularly in assessing tumor infiltration depth and differentiating it from other cutaneous malignancies. Its high-resolution imaging facilitates early detection, precise surgical planning, and improved patient outcomes.

Algae are vital to aquatic ecosystems, with their structure and abundance influencing ecological health. However, automated detection in real water samples is hindered by complex backgrounds, species diversity, and size variations. Traditional methods are deemed costly and species-specific, leading to deep learning adoption. Current studies rely on CNN-based models and limited datasets. To improve the detection accuracy of multiple algal species in real, complex backgrounds, this study collected multi-species algae samples from actual water environments and implemented an integrated Transformer-based framework for automated localization and recognition of small, medium, and large algae species. Specifically, algae samples from five different regions were collected to construct a comprehensive dataset containing 25 algal species with diverse backgrounds and rich category diversity. To address dataset imbalances in minority species, a segmentation-fusion data augmentation method was proposed, which enhanced performance across YOLO, Faster R-CNN, and Deformable DETR models, with YOLO achieving a 7.1% precision increase and a 1.5% mAP improvement. Model optimization focused on an improved Deformable DETR, incorporating multi-scale feature extraction, deformable attention mechanisms, and the normalized Wasserstein distance loss function. This improvement enhanced small target and overlapping object detection, achieving a 10.4% mAP increase at an intersection over union (IoU) threshold of 0.5 and outperforming unmodified Deformable DETR.

Objectives. Functional prognosis is potentially correlated with gut microbiota alterations following the dysregulation of the gut-microbiota-brain axis after stroke. This study was designed to explore the poststroke alterations of gut microbiota and potential correlations between gut microbiota and global functions. Methods. A total of thirty-eight patients with stroke and thirty-five healthy demographics-matched controls were recruited. Their fecal DNAs were extracted, and the V3-V4 regions of the conserved bacterial 16S RNA were amplified and sequenced on the Illumina MiSeq platform. Microbial composition, diversity indices, and species cooccurrence were compared between groups. Random forest and receiver operating characteristic analysis were used to identify potential diagnostic biomarkers. Relationships between discriminant bacteria and poststroke functional outcomes were estimated. Results. Higher alpha diversity of gut microbiota was observed in poststroke patients as compared to the healthy controls (p<0.05). Beta diversity showed that microbiota composition in the poststroke group was significantly different from that in the control group. Relative abundance of nine genera increased significantly in poststroke patients, while 82 genera significantly decreased (p<0.05). The accuracy, specificity, and susceptibility of the optimal model consisted of the top 10 discriminant species were 93%, 100%, and 86%, respectively. Subgroup analysis showed that bacterial taxa abundant between subacute and chronic stroke patients were overall different (p<0.05). The modified Rankin scale (mRS) (r=−0.370, p<0.05), Fugl-Meyer assessment (FMA) score (r=0.364, p<0.05), water swallow test (WST) (r=0.340, p<0.05), and Barthel index (BI) (r=0.349, p<0.05) were significantly associated with alterations of distinctive gut microbiota. Conclusions. The gut microbiota in patients with stroke was significantly changed in terms of richness and composition. Significant associations were detected between alterations of distinctive gut microbiota and global functional prognosis. It would facilitate novel treatment target selection in the context of stroke while the causal relationships between distinctive gut microbiota alterations and functional variations need to be further verified with well-designed studies.

Objectives To describe a simplified classification scheme for endplate injury morphology based on 3D CT and to examine possible associations between endplate injury morphology and vertebral space and other variables such as type of fracture and disc degeneration in a group of patients with thoracolumbar fractures. Methods This study was a retrospective cohort study. We collected patients with thoracolumbar fractures admitted from January 2015 to August 2020 and divided them into three groups based on the morphology of endplate injury (45 cases of mild endplate injury, 54 cases of moderate endplate injury, and 42 cases of severe endplate injury, SEI). Data of vertebral body and intervertebral space height and angle, the Pfirrmann grade, endplate healing morphology were collected during preoperative, postoperative, and long‐term follow‐up of patients in each group. One‐way analysis of variance (ANOVA), chi‐squared test, and repeated measurement ANOVA were used to compare and analyze the influence of endplate injury morphology on patient prognosis. Results Most moderate injuries to the endplate (fissure‐type injury) and severe injuries (irregular depression‐type injury, Schmorl's node‐type injury) resulted in significant disc degeneration in the long‐term transition. This study also showed significant differences in the height of the anterior margin of the injured spine and the intervertebral space height index during this process. Conclusions The current study suggests that although the region of injury in endplate fissure‐type injury is small preoperatively, it may be a major factor in leading to severe disc degeneration, loss of intervertebral height, and Cobb angle in the long term. The results of our study therefore may allow surgeons to predict the prognosis of patients with thoracolumbar fractures and guide their treatment. We propose a simplified classification for the morphology characteristics of endplate injury based on 3D CT: mild, moderate, and severe. Our results indicate that moderate and severe endplate injury cause severe disc degeneration and long‐term loss of intervertebral height and Cobb angle. This may allow surgeons to predict patient prognosis and guide treatment for thoracolumbar fractures.

Background Acute ST-elevation myocardial infarction (STEMI) is associated with a high incidence of complications as well as a considerable hospitalization rate and economic burden. Preliminary evidence suggests that remote ischemic conditioning (RIC) is a promising non-invasive intervention that may effectively and safely reduce myocardial infarct size, subsequent cardiac events and complications, and mortality. However, RIC’s cardio-protective effect remains under debate, especially for single timepoint RIC programs. Adequately powered large-scale randomized controlled trials investigating clinical outcomes are thus needed to clarify the role of full disease cycle RIC programs. Methods The intelligent “Internet Plus”-based full disease cycle remote ischemic conditioning (i-RIC) trial is a pragmatic, multicenter, randomized controlled, parallel group, clinical trial. The term, intelligent “Internet Plus”-based full disease cycle, refers to smart devices aided automatic and real-time monitoring of remote ischemic pre-, per- or post-conditioning intervention for patients with STEMI undergoing percutaneous coronary intervention (PCI). Based on this perspective, 4700 STEMI patients from five hospitals in China will be randomized to a control and an intervention group. The control group will receive PCI and usual care, including pharmacotherapy, before and after PCI. The intervention group will receive pre-, per-, and post-operative RIC combined with long-term i-RIC over a one-month period in addition. A smartphone application, an automated cuff inflation/deflation device and “Internet Plus”-based administration will be used in the long-term phase. The primary outcome is the combined cardiac death or hospitalization for heart failure rate. Secondary outcomes include clinical and functional outcomes: major adverse cardiac and cerebrovascular events rate, all-cause mortality, myocardial reinfarction rate, readmission rate for heart failure and ischemic stroke rate, unplanned revascularization rate, plasma concentration of myocardial infarction-related key biomarkers, infarct size, cardiac function, cardiopulmonary endurance, health-related quality of life, total hospital length of stay, total medical cost, and compliance with treatment regime. Discussion The i-RIC trial is designed to test the hypothesis that clinical and functional outcomes can be improved with the i-RIC program in STEMI patients undergoing PCI. The concept of RIC is expected to be enhanced with this intelligent “Internet Plus”-based program focusing on the full disease cycle. If the i-RIC program results in superior improvement in primary and secondary outcomes, it will offer an innovative treatment option for STEMI patients and form the basis of future recommendations. Clinical Trial Registration Chinese Clinical Trial Registry ( http://www.chictr.org.cn ): ChiCTR2000031550, 04 April 2020.

Soil warming due to climate change has a significant potential impact on crop yield and quality. Schisandra chinensis (Trucz.) Baill, a multipurpose plant disseminated in the highly climate-sensitive region of Northeast Asia, is affected by soil warming, which limits the supply and quality of raw materials. This study investigated the differential responses of biomass accumulation and bioactive ingredient production across various organs to root-zone temperature (RZT) variations, employing both physiological assessments and metabolomic profiling. Elevated root temperatures may increase plant biomass and indirectly increase photosynthetic rates by promoting root growth; however, biomass responses differ among organs. A 20 °C root temperature promoted stem and leaf growth and inhibited root development, whereas a 30 °C root temperature significantly promoted root growth but reduced leaf biomass. Schisanhenol A, a key bioactive lignan serving as a quality marker for S. chinensis, displayed synthesis dependent on temperature. Concurrently, flavonoid biosynthesis is coordinated accumulation at the naringenin nodal point. A 15 °C RZT inhibited lignan production in roots while triggering stress-responsive phenol accumulation in leaves (41.39%). Conversely, at 20 °C and 30 °C RZTs, schisanhenol synthesis was repressed in leaves but accumulated in roots (9.8–25.71%). It is worth noting that the increase in RZT significantly promoted the synthesis and accumulation of schisandrol A in the aboveground part of the plant (43.88%). This research underscores that a suitable elevation in root-zone temperature can augment the medicinal attributes of the aerial components of S. chinensis.