BACKGROUND Bilateral internal mammary arteries(BIMAs)as the most advanced surgical option for coronary artery bypass grafting(CABG)are usually recommended for younger patients without traditional risk factors.This stu...BACKGROUND Bilateral internal mammary arteries(BIMAs)as the most advanced surgical option for coronary artery bypass grafting(CABG)are usually recommended for younger patients without traditional risk factors.This study compares outcomes in propensity score-matched patients aged over 70 years who received BIMAs versus those who received a single internal mammary artery(SIMA).METHODS From 2013 to 2024,8123 patients underwent primary CABG for multivessel coronary artery disease at our institution.BIMA grafting was performed in 1233 patients(15.17%),with in situ BIMA grafting in 290 patients(3.57%).For in situ BIMA group,the right internal mammary artery was used to revascularize the right coronary artery,while the left internal mammary artery was utilized for the left anterior descending artery.BIMA patients aged over 70 years(n=79)were compared with SIMA patients(n=79)using propensity score matching.Primary outcome was all-cause mortality at 30 days and 8 years.Secondary outcomes included length of hospital stay,incidence of postoperative major adverse cardiovascular and cerebrovascular events,sternal wound infection and the need for subsequent percutaneous revascularization.RESULTS There was no difference in immediate postoperative primary and secondary outcomes.Mean follow-up was 8.3±1.0 years with an 8-year freedom from death of 67.08%±1.1%in the BIMA group versus 58.22%±0.9%in the SIMA group(P<0.05).CONCLUSIONS BIMAs as in situ grafts can be successfully used in CABG for patients aged 70 years and older.Consequently,the refined techniques for constructing internal mammary artery grafts used in this study challenge traditionally accepted limitations regarding the use of BIMAs.展开更多
Objective:To evaluate the effectiveness of the internal limiting membrane(ILM)flipping and covering technique in the treatment of patients with high myopic macular hole(HMMH).Methods:One hundred and two patients with ...Objective:To evaluate the effectiveness of the internal limiting membrane(ILM)flipping and covering technique in the treatment of patients with high myopic macular hole(HMMH).Methods:One hundred and two patients with HMMH who were admitted to the hospital from June 2019 to June 2024 were selected.The minimum diameter of the macular hole(MH)in all patients was≤500μm.The patients were randomly divided into two groups.The experimental group received 25G pars plana vitrectomy(PPV)combined with ILM flipping and covering technique,while the reference group received PPV combined with ILM peeling.The efficacy indicators and best corrected visual acuity levels were compared between the two groups.Results:The MH closure rate and retinal reattachment rate were higher in the experimental group than in the reference group at 3 and 6 months postoperatively(P<0.05).The best corrected visual acuity level was higher in the experimental group than in the reference group at 3 and 6 months postoperatively(P<0.05).The Chinese version of the Visual Function-Related Quality of Life Questionnaire-25(CVRQOL-25)score was higher in the experimental group than in the reference group at 3 and 6 months postoperatively(P<0.05).No serious complications were observed in both groups postoperatively,and there was no difference between the two groups(P>0.05).Conclusion:The ILM flipping and covering technique can improve the MH closure rate and retinal reattachment rate in patients with HMMH(diameter≤500μm),enhance the best corrected visual acuity level,and improve the quality of life related to visual function,with fewer postoperative complications.展开更多
BACKGROUND Internal hernia(IH)is a rare culprit of small bowel obstruction(SBO)with an incidence of<1%.It poses a considerable diagnostic challenge requiring a high index of suspicion to prevent misdiagnosis,improp...BACKGROUND Internal hernia(IH)is a rare culprit of small bowel obstruction(SBO)with an incidence of<1%.It poses a considerable diagnostic challenge requiring a high index of suspicion to prevent misdiagnosis,improper treatment,and subsequent morbidity and mortality.AIM To determine the clinico-demographic profile,radiological and operative findings,and postoperative course of patients with IH and its association with SBO.METHODS Medical records of 586 patients with features of SBO presenting at a tertiary care centre at Lucknow,India between September 2010 and August 2023 were reviewed.RESULTS Out of 586 patients,7(1.2%)were diagnosed with IH.Among these,4 had congenital IH and 3 had acquired IH.The male-to-female ratio was 4:3.The median age at presentation was 32 years.Contrast-enhanced computed tomography(CECT)was the most reliable investigation for preoperative identification,demonstrating mesenteric whirling and clumped-up bowel loops.Left paraduodenal hernia and transmesenteric hernia occurred with an equal frequency(approximately 43%each).Intraoperatively,one patient was found to have bowel ischemia and one had associated malrotation of gut.During follow-up,no recurrences were reported.CONCLUSION IH,being a rare cause,must be considered as a differential diagnosis for SBO,especially in young patients in their 30s or with unexplained abdominal pain or discomfort post-surgery.A rapid imaging evaluation,preferably with CECT,is necessary to aid in an early diagnosis and prompt intervention,thereby reducing financial burden related to unnecessary investigations and preventing the morbidity and mortality associated with closed-loop obstruction and strangulation of the bowel.展开更多
An internal state variable(ISV)model was established according to the experimental results of hot plane strain compression(PSC)to predict the microstructure evolution during hot spinning of ZK61 alloy.The effects of t...An internal state variable(ISV)model was established according to the experimental results of hot plane strain compression(PSC)to predict the microstructure evolution during hot spinning of ZK61 alloy.The effects of the internal variables were considered in this ISV model,and the parameters were optimized by genetic algorithm.After validation,the ISV model was used to simulate the evolution of grain size(GS)and dynamic recrystallization(DRX)fraction during hot spinning via Abaqus and its subroutine Vumat.By comparing the simulated results with the experimental results,the application of the ISV model was proven to be reliable.Meanwhile,the strength of the thin-walled spun ZK61 tube increased from 303 to 334 MPa due to grain refinement by DRX and texture strengthening.Besides,some ultrafine grains(0.5μm)that played an important role in mechanical properties were formed due to the proliferation,movement,and entanglement of dislocations during the spinning process.展开更多
Internal learning-based video inpainting methods have shown promising results by exploiting the intrinsic properties of the video to fill in the missing region without external dataset supervision.However,existing int...Internal learning-based video inpainting methods have shown promising results by exploiting the intrinsic properties of the video to fill in the missing region without external dataset supervision.However,existing internal learning-based video inpainting methods would produce inconsistent structures or blurry textures due to the insufficient utilisation of motion priors within the video sequence.In this paper,the authors propose a new internal learning-based video inpainting model called appearance consistency and motion coherence network(ACMC-Net),which can not only learn the recurrence of appearance prior but can also capture motion coherence prior to improve the quality of the inpainting results.In ACMC-Net,a transformer-based appearance network is developed to capture global context information within the video frame for representing appearance consistency accurately.Additionally,a novel motion coherence learning scheme is proposed to learn the motion prior in a video sequence effectively.Finally,the learnt internal appearance consistency and motion coherence are implicitly propagated to the missing regions to achieve inpainting well.Extensive experiments conducted on the DAVIS dataset show that the proposed model obtains the superior performance in terms of quantitative measurements and produces more visually plausible results compared with the state-of-the-art methods.展开更多
BACKGROUND Pain in the back or pelvis or fear of back pain may affect the timing or cocontraction of the core muscles.In both static and dynamic movements,the Sahrmann core stability test provides an assessment of cor...BACKGROUND Pain in the back or pelvis or fear of back pain may affect the timing or cocontraction of the core muscles.In both static and dynamic movements,the Sahrmann core stability test provides an assessment of core muscle activation and a person's ability to stabilize the lumbopelvic complex.Preparatory cues and images can be used to increase the activation of these muscles.To attain optimal movement patterns,it will be necessary to determine what cueing will give the most effective results for core stability.AIM To investigate the effects of external and internal cues on core muscle activation during the Sahrmann five-level core stability test.METHODS Total 68 participants(21.83±3.47 years)were randomly allocated to an external(n=35)or internal cue group(n=33).Participants performed the Sahrmann fivelevel core stability test without a cue as baseline and the five-level stability exercises with an internal or external cue.External cue group received a pressure biofeedback unit(PBU),and the internal cue group received an audio cue.A Delsys Trigno^(TM)surface electromyography unit was used for muscle activation from the rectus abdominis,external oblique,and transverse abdominis/internal oblique muscles.RESULTS Linear mixed effects model analysis showed that cueing had a significant effect on core muscle activation(P=0.001);however,there was no significant difference between cue types(internal or external)(P=0.130).CONCLUSION Both external and internal cueing have significant effects on core muscle activation during the Sahrmann five-level core stability test and the PBU does not create higher muscle activation than internal cueing.展开更多
Developing an efficient photocatalyst is the key to realize the practical application of photocatalysis.The S-scheme heterojunction has great potential in photocatalysis due to its unique charge-carrier migration path...Developing an efficient photocatalyst is the key to realize the practical application of photocatalysis.The S-scheme heterojunction has great potential in photocatalysis due to its unique charge-carrier migration pathway,effective light absorption and high redox capacity.However,further enhancing the built-in electric field of the S-scheme,accelerating carrier separation,and achieving higher photocatalytic performance remain unresolved challenges.Herein,based on the continuously adjustable band structure of continuous solid-solution,a novel 0D/2D all solid-solution S-scheme heterojunction with adjustable internal electric field was designed and fabricated by employing a solid-solution of ZnxCd_(1–x)S and Bi_(2)MoyW_(1–y)O_(6)respectively as reduction and oxidation semiconductors.The synergistic optimization of effective light absorption,fast photogenerated carrier separation,and high redox potential leads can be tuned to promote photocatalytic activity.Under visible light,the S-scheme system constructed by Zn_(0.4)Cd_(0.6)S quantum dot(QDs)and Bi_(2)Mo_(0.2)W_(0.8)O_(6)monolayer exhibits a high rate for photocatalytic degradation C_(2)H_(4)(150.6×10^(–3)min^(–1)),which is 16.5 times higher than that of pure Zn_(0.4)Cd_(0.6)S(9.1×10^(–3)min^(–1))and 53.8 times higher than pure Bi_(2)Mo_(0.2)W_(0.8)O_(6)(2.8×10^(–3)min^(–1)).Due to the unique charge-carrier migration pathway,photo-corrosion of Zn_(x)Cd_(1–x)S is further inhibited simultaneously.In-situ irradiation X-ray photoelectron spectroscopy,photoluminescence spectroscopy,time-resolved photoluminescence,transient absorption spectroscopy and electron paramagnetic resonance provide compelling evidence for interfacial charge transfer via S-scheme pathways,while in-situ diffuse reflectance infrared Fourier transform spectroscopy identifies the reaction pathway for C_(2)H_(4)degradation.This novel S-scheme photocatalysts demonstrates excellent performance and potential for the practical application of the fruits and vegetables preservation at room temperatures.展开更多
Double bonds of internal olefins can be efficiently migrated to the terminal carbons and regioselectively hydroesterified with formates in the presence of Pd(OAc)_(2) and 1,2-DTBPMB under mild reaction conditions,prov...Double bonds of internal olefins can be efficiently migrated to the terminal carbons and regioselectively hydroesterified with formates in the presence of Pd(OAc)_(2) and 1,2-DTBPMB under mild reaction conditions,providing a wide variety of corresponding linear carboxylic esters bearing various functional groups in good yields and>20:1 linear/branch ratios.The reaction is optionally simple and does not need to use CO gas and acid co-catalysts.展开更多
Migration is a complex demographic phenomenon.Its dynamics can be explained by several factors whose spatial and temporal evolution is not easy to control.That is why this article aims to understand the factors of mig...Migration is a complex demographic phenomenon.Its dynamics can be explained by several factors whose spatial and temporal evolution is not easy to control.That is why this article aims to understand the factors of migration from a spatiotemporal perspective to fill the gaps in the literature.The aim of this article is to analyse the spatiotemporal dynamics of internal migration factors to deduce the zones of origin and destination in Burkina Faso.To do this,several types of data were used.These included secondary,spatial,statistical and survey data.The results of this study show that the influence of internal migration factors is uneven.The spatial distribution of internal migration factors follows a north-south gradient,with favourable conditions in the south.In fact,the northern part is characterised by a large population exodus,with around 42.6%of outgoing internal migrants,and the southern part by a large population influx.This southern part of the country receives around 34.6%of internal migrants.The areas from which migrants depart have unfavourable climatic,environmental,or socio-economic conditions,whereas the areas to which migrants migrate are characterised by favourable conditions for these factors.展开更多
This paper examines the role of internal audit and the incorporation of Environmental,Social,and Governance(ESG)factors within the corporate governance frameworks of Greek firms in mitigating their financial risk.Time...This paper examines the role of internal audit and the incorporation of Environmental,Social,and Governance(ESG)factors within the corporate governance frameworks of Greek firms in mitigating their financial risk.Time series econometric analysis was performed to determine the factors that influence financial stability,transparency,and regulatory compliance in Greek Firms.Data were collected from 120 internal auditors and financial professionals employed in organizations across multiple sectors of the Greek economy.In line with existing literature,findings show that robust internal audit and ESG practices are essential in promoting financial stability,transparency,and regulatory compliance.The paper provides empirical evidence that well-structured internal audit mechanisms and effective ESG initiatives reduce financial risks,while enhancing organizational sustainability and resilience.The results emphasize the growing importance of ESG considerations in corporate governance and suggest that improvements in both internal audit systems,as well as robust ESG policies,can strengthen risk management strategies and improve long-term financial performance.While previous research has thoroughly investigated the impact of internal audits on financial stability and the influence of ESG on corporate sustainability,this paper specifically examines their combined effect on financial risk management.Using firm level data across various sectors of the Greek economy,this study provides insights into how internal audit and ESG policies can jointly contribute towards enhancing financial resilience,transparency,and regulatory compliance.展开更多
Internal solitary waves(ISWs) are a common phenomenon beneath the ocean surface and represent a significant environmental hazard that must be considered for the safe navigation of submersibles. A numerical simulation ...Internal solitary waves(ISWs) are a common phenomenon beneath the ocean surface and represent a significant environmental hazard that must be considered for the safe navigation of submersibles. A numerical simulation model for the interaction of solitary waves with submersibles at a large scale has been developed. The Miyata-ChoiCamassa(MCC) equation serves as the basis for generating ISWs. The impacts of the submergence depth, wave amplitude, and advancing velocity on the motion response and load characteristics of the submersible are examined in detail. This study elucidates the governing laws and mechanisms underlying the impact of ISWs on submersibles.The research findings indicate that shorter distances to the undisturbed surface, higher wave amplitudes, and fasteradvancing speeds result in greater effects on submersibles. For a submersible operating in the lower layer, both the alteration in density near the wave interface and the dynamic pressure induced by ISWs can reduce its lift, potentially resulting in a rapid descent. It is imperative to pay considerable attention to the impact of ISWs, as they have the potential to precipitate a loss of control of the submersible.展开更多
BACKGROUND Hemorrhoids,a prevalent chronic condition globally,significantly impact patients'quality of life.While various surgical interventions,such as external stripping and internal ligation,procedure for prola...BACKGROUND Hemorrhoids,a prevalent chronic condition globally,significantly impact patients'quality of life.While various surgical interventions,such as external stripping and internal ligation,procedure for prolapse and hemorrhoids,and tissue selecting technique,are employed for treatment,they are often associated with postoperative complications,including unsatisfactory defecation,bleeding,and anal stenosis.In contrast,Xiaozhiling injection,a traditional Chinese medicine-based therapy,has emerged as a minimally invasive and effective alternative for internal hemorrhoids.This treatment offers distinct advantages,such as reduced dietary restrictions,broad applicability,and minimal induction of systemic inflammatory responses.Additionally,Xiaozhiling injection effectively eliminates hemorrhoid nuclei,prevents local tissue necrosis,preserves anal cushion integrity,and mitigates postoperative complications,including bleeding and prolapse.Despite its clinical efficacy,the molecular mechanisms underlying its therapeutic effects remain poorly understood,warranting further investigation.AIM To investigate the molecular mechanism underlying the therapeutic effect of Xiaozhiling injection in the treatment of internal hemorrhoids.METHODS An internal hemorrhoid model was established in rats,and the rats were randomly divided into a modeling group[control group(CK group)]and a treatment group.One week after injection,Stereo-seq and electron microscopy were used to study the changes in gene expression and subcellular structures in fibroblasts.RESULTS Single-cell sequencing revealed differences in the expression and transcript levels of the genes collagen 3 alpha 1,decorin,and actin alpha 2 in fibroblasts between the CK group and the treatment group.Spatial transcriptome analysis revealed that genes of the sphingosine kinase 1(Sphk1)/sphingosine-1-phosphate(S1P)pathway spatially overlapped with key genes of the transforming growth factor beta 1 pathway,namely,Sphk1,S1P receptor,and transforming growth factor beta 1,in the treatment group.The proportion of fibroblasts was lower in the treatment group than in the CK group,and Xiaozhiling treatment had a significant effect on the proportion of fibroblasts in hemorrhoidal tissue.Immunohistochemistry revealed a significant increase in the expression of a fibroblast marker.Electron microscopy showed that the endoplasmic reticulum of fibroblasts contained a large amount of glycogen,indicating cell activation.Fibroblast activation and the expression of key genes of the Sphk1-S1P pathway could be observed at the injection site,suggesting that after Xiaozhiling intervention,the Sphk1-S1P pathway could be activated to promote fibrosis.CONCLUSION Xiaozhiling injection exerts its therapeutic effects on internal hemorrhoids by promoting collagen synthesis and secretion in fibroblasts.After Xiaozhiling intervention,the Sphk1-S1P pathway can be activated to promote fibrosis.展开更多
In the Arctic Ocean,turbulent mixing drives vertical heat flux,thereby affecting the sea ice variability.Internal wave is regarded as one of the important energy sources of mixing in this region.The high latitude and ...In the Arctic Ocean,turbulent mixing drives vertical heat flux,thereby affecting the sea ice variability.Internal wave is regarded as one of the important energy sources of mixing in this region.The high latitude and sea ice cover make internal wave in the Arctic Ocean apparently differs from that in mid-and low-latitude oceans.However,the internal wave and its underlying mechanism are less understood due to the lack of observations.This paper briefly reviews the recent studies and unresolved questions on the internal wave in the Arctic Ocean,including wind-driven near-inertial wave,internal tide,and high-frequency internal wave.The aim is to provide new insights for in-depth research in the future,with a focus on the mechanisms responsible for the evolution of internal wave under the rapidly changing Arctic climate.展开更多
Objectives:This study aimed to investigate the dual mediating roles of psychological safety and reporting attitudes in the association between ethics-centered leadership and internal whistleblowing among nurses.Method...Objectives:This study aimed to investigate the dual mediating roles of psychological safety and reporting attitudes in the association between ethics-centered leadership and internal whistleblowing among nurses.Methods:A multicenter,cross-sectional study design was employed,involving a convenience sample of 273 nurses among five university hospitals from August to October 2024.Data were collected using a demographic questionnaire,Ethical Leadership Scale,Psychological Safety Scale,Positive Attitudes Toward Whistleblowing Scale,and Internal Whistleblowing Scale.Pearson correlation and structural equation model were conducted to test the hypothesized dual mediation model.Results:The average score of nurses for ethical leadership was 4.14±0.57,psychological safety was 3.80±0.64,reporting attitudes was 4.12±0.67,internal whistleblowing was 3.93±0.52.Ethical leadership had a significant effect on psychological safety(β=0.38,P<0.001),reporting attitudes(β=0.44,P<0.001),and internal whistleblowing(β=0.21,P=0.009).Furthermore,psychological safety(β=0.26,P<0.001)and reporting attitudes(β=0.27,P<0.001)significantly influenced internal whistleblowing among the nurses.The indirect effect of ethics-centered leadership on internal whistleblowing intermediated by psychological safety was significant(β=0.10,P<0.001).Similarly,reporting attitudes demonstrated a significant mediating effect(β=0.12,P=0.003).Conclusions:Ethical leadership encourages internal whistleblowing among nurses by fostering psychological safety and positive reporting attitudes.Therefore,healthcare managers should prioritize ethical leadership development,enhance psychological safety,and foster constructive reporting attitudes that enable nurses to report ethical violations confidently,without apprehension.展开更多
Since the mid-20th century,the Mongolian Plateau(MP)has experienced decadal droughts coupled with extreme heatwaves,severely affecting regional ecology and social development.However,the mechanisms behind these decada...Since the mid-20th century,the Mongolian Plateau(MP)has experienced decadal droughts coupled with extreme heatwaves,severely affecting regional ecology and social development.However,the mechanisms behind these decadalscale compound heatwavedrought events remain debated.Here,using reconstructions and simulations from the Community Earth System Model Last Millennium Ensemble,we demonstrate that,over the last millennium,decadal droughts on the MP occurred under both warm and cold conditions,differing from recent compound heatwavedrought events.We found that by examining temperature changes during these drought periods,the distinct influences of external forcings and internal variability can be simply and effectively distinguished.Specifically,colddry events were primarily driven by volcanic eruptions that weakened the East Asian summer monsoon and midlatitude westerlies,reducing moisture transport to the MP.In contrast,warmdry events were predominantly induced by internal variability,notably the negative phase of the Atlantic Multidecadal Oscillation and the expansion of the Barents Sea ice extent.The recent extreme compound event was probably influenced by the combined effects of anthropogenic forcings and internal variability.These findings deepen our understanding of how external forcings and internal variability affect decadal drought events on the MP and highlight that recent compound events are unprecedented in the context of the last millennium.展开更多
Radioactive microspheres have demonstrated excellent therapeutic effects and good tolerance in the treatment of unresectable primary and secondary liver malignancies.This is attributed to precise embolization and pote...Radioactive microspheres have demonstrated excellent therapeutic effects and good tolerance in the treatment of unresectable primary and secondary liver malignancies.This is attributed to precise embolization and potent anti-tumor effect.However,certain limitations such as unstable loading,perfusion stasis,heterogeneous distribution,ectopic distribution,and insufficient dosage,restrict their clinical application.Herein,a novel personalized Y-90 carbon microsphere with high uniformity,high specific activity and high availability(^(90)Y-HUACM)is presented.It is synthesized through planar molecular complex adsorption and chemical deposition solidification.^(90)Y-HUACM exhibited controllable size,excellent biocompatibility,outstanding in vitro and in vivo stability.The radiolabeling efficiency of Y-90 exceeded 99%and the leaching rate of Y-90 is far below 0.1%.Furthermore,the excellent anti-tumor effect,nuclide loading stability,anti-reflux characteristics,precise embolization,and biosafety of^(90)Y-HUACM were validated in a rabbit VX2liver tumor model.In summary,this new,high-performance,and customizable radioactive microsphere provides a superior choice for selective internal radiation treatment of advanced liver cancer is expected to be rapidly applied in clinical practice.展开更多
Understanding the coupling relationships among lake physicochemical properties,internal nutrient recycling,and related microbes is key for the control of freshwater eutrophication.In this study,seasonal variations in ...Understanding the coupling relationships among lake physicochemical properties,internal nutrient recycling,and related microbes is key for the control of freshwater eutrophication.In this study,seasonal variations in microorganisms at the sediment–water interface(SWI)of the eutrophic Lake Chaohu in China were analyzed,in order to reveal changes in phosphorus(P)-cycling-related microbes in the sediments and its association with internal P release during the cyanobacterial life cycle.The identified P-cycling-related microbes include phosphorus-solubilizing bacteria(PSB)(dominant of Bacillus,Thiobacillus and Acinetobacter),sulfate-reducing bacteria(SRB)(dominant of Sva0081_sediment_group,norank_c__Thermodesulfovibrionia and Desulfatiglans)and iron-reducing bacteria(FeRB)(dominant of Geothermobacter,Anaeromyxobacter,Thermoanaerobaculum and Clostridium_sensu_stricto_1).Increased PSB and reduced proportions of iron-aluminum–bound P(Fe/Al-P)and calcium–bound P(Ca-P)from the benthic stage to initial cyanobacterial growth indicated that internal phosphorus was released through the solubilization of Fe/Al-P and Ca-P by PSB.Growth of cyanobacteria was accompanied by cyanobacteria death,deposition,and degradation during early algal blooms,which increased SRB caused by high organic matter and the net deposition of phosphorus in the western lake.Conversely,phosphorus release in eastern lake was observed because of organic phosphorus mineralization.High linear discriminant analysis effect size of SRB and FeRB and the decreased Fe/Al-P in sediments indicated sulfide-mediated chemical iron reduction(SCIR)and FeRB-mediated microbial iron reduction mechanisms for internal phosphorus release during late algal blooms.The observed seasonal pattern of P-cycling-related microbes and its mediation on internal phosphorus release provides a foundation for internal P management in Lake Chaohu.展开更多
Internal audit plays a strategic role in ensuring the reliability of government financial statements,which are essential tools for achieving public financial accountability and transparency.This study aims to analyze ...Internal audit plays a strategic role in ensuring the reliability of government financial statements,which are essential tools for achieving public financial accountability and transparency.This study aims to analyze the role of internal audit in improving the quality of government financial reporting using a literature review approach based on agency theory.The method employed is a systematic literature review of 12 scholarly articles(7 national and 5 international),as well as relevant books and official reports published within the last five years(2019-2024).The findings indicate that an effective and independent internal audit can reduce information asymmetry between the government(agent)and the public(principal),enhance compliance with Government Accounting Standards(SAP),and strengthen internal controls and financial governance.This study concludes that a competent internal audit function is a critical prerequisite for producing reliable,relevant,and accountable financial statements.The findings support agency theory and offer key recommendations for strengthening internal audit practices in the public sector.展开更多
BACKGROUND Atrial fibrillation(AF)is the most common cardiac arrhythmia worldwide,hosting numerous serious possible complications such as stroke and heart failure.In the past two decades,managing rhythm control was mo...BACKGROUND Atrial fibrillation(AF)is the most common cardiac arrhythmia worldwide,hosting numerous serious possible complications such as stroke and heart failure.In the past two decades,managing rhythm control was more successful via pulmonary vein isolation(PVI)ablation,generally performed via transfemoral access.Patients with anatomical variations may necessitate a dose of creativity and evidence-based techniques.To our knowledge,we present the first PVI case in a patient with AF via right internal jugular(IJ)vein access using pulse field ablation.CASE SUMMARY A 76-year-old male with an extensive medical history notable for type 2 diabetes and severe peripheral vascular disease requiring vascular bypass surgery is identified to have paroxysmal AF.Given functional decline and worsening arrhythmia burden refractory to oral antiarrhythmics,an initial PVI ablation was attempted but failed as the catheter could not be advanced secondary to bilateral iliac vein occlusions.This necessitated a novel approach and a subsequent PVI ablation via the right IJ vein was successful without any complications.The success of this case highlights the feasibility of an IJ approach for PVI in patients where traditional access is not possible.This case can be used as a reference for other practitioners who may face similar challenges when attempting to perform PVI for AF or similar procedures requiring access to similar anatomical locations.CONCLUSION The success of this case highlights the feasibility of an IJ approach for PVI when traditional access is impossible.展开更多
Using real fields instead of complex ones, it was recently claimed, that all fermions are made of pairs of coupled fields (strings) with an internal tension related to mutual attraction forces, related to Planck’s co...Using real fields instead of complex ones, it was recently claimed, that all fermions are made of pairs of coupled fields (strings) with an internal tension related to mutual attraction forces, related to Planck’s constant. The solution to Dirac equation gives four, real, 2-vectors solutions ψ1=(U1D1)ψ2=(U2D2)ψ3=(U3D3)ψ4=(U4D4)where (ψ1,ψ4) are coupled via linear combinations to yield spin-up and spin-down fermions. Likewise, (ψ2,ψ3) are coupled via linear combinations to represent spin-up and spin-down anti-fermions. Here, a deeper investigation of the free fermion internal frequency is discussed, hinting to an exchange interaction between the two components of which a fermion is made of. An upper limit estimate is given to the strength of this interaction.展开更多
文摘BACKGROUND Bilateral internal mammary arteries(BIMAs)as the most advanced surgical option for coronary artery bypass grafting(CABG)are usually recommended for younger patients without traditional risk factors.This study compares outcomes in propensity score-matched patients aged over 70 years who received BIMAs versus those who received a single internal mammary artery(SIMA).METHODS From 2013 to 2024,8123 patients underwent primary CABG for multivessel coronary artery disease at our institution.BIMA grafting was performed in 1233 patients(15.17%),with in situ BIMA grafting in 290 patients(3.57%).For in situ BIMA group,the right internal mammary artery was used to revascularize the right coronary artery,while the left internal mammary artery was utilized for the left anterior descending artery.BIMA patients aged over 70 years(n=79)were compared with SIMA patients(n=79)using propensity score matching.Primary outcome was all-cause mortality at 30 days and 8 years.Secondary outcomes included length of hospital stay,incidence of postoperative major adverse cardiovascular and cerebrovascular events,sternal wound infection and the need for subsequent percutaneous revascularization.RESULTS There was no difference in immediate postoperative primary and secondary outcomes.Mean follow-up was 8.3±1.0 years with an 8-year freedom from death of 67.08%±1.1%in the BIMA group versus 58.22%±0.9%in the SIMA group(P<0.05).CONCLUSIONS BIMAs as in situ grafts can be successfully used in CABG for patients aged 70 years and older.Consequently,the refined techniques for constructing internal mammary artery grafts used in this study challenge traditionally accepted limitations regarding the use of BIMAs.
文摘Objective:To evaluate the effectiveness of the internal limiting membrane(ILM)flipping and covering technique in the treatment of patients with high myopic macular hole(HMMH).Methods:One hundred and two patients with HMMH who were admitted to the hospital from June 2019 to June 2024 were selected.The minimum diameter of the macular hole(MH)in all patients was≤500μm.The patients were randomly divided into two groups.The experimental group received 25G pars plana vitrectomy(PPV)combined with ILM flipping and covering technique,while the reference group received PPV combined with ILM peeling.The efficacy indicators and best corrected visual acuity levels were compared between the two groups.Results:The MH closure rate and retinal reattachment rate were higher in the experimental group than in the reference group at 3 and 6 months postoperatively(P<0.05).The best corrected visual acuity level was higher in the experimental group than in the reference group at 3 and 6 months postoperatively(P<0.05).The Chinese version of the Visual Function-Related Quality of Life Questionnaire-25(CVRQOL-25)score was higher in the experimental group than in the reference group at 3 and 6 months postoperatively(P<0.05).No serious complications were observed in both groups postoperatively,and there was no difference between the two groups(P>0.05).Conclusion:The ILM flipping and covering technique can improve the MH closure rate and retinal reattachment rate in patients with HMMH(diameter≤500μm),enhance the best corrected visual acuity level,and improve the quality of life related to visual function,with fewer postoperative complications.
文摘BACKGROUND Internal hernia(IH)is a rare culprit of small bowel obstruction(SBO)with an incidence of<1%.It poses a considerable diagnostic challenge requiring a high index of suspicion to prevent misdiagnosis,improper treatment,and subsequent morbidity and mortality.AIM To determine the clinico-demographic profile,radiological and operative findings,and postoperative course of patients with IH and its association with SBO.METHODS Medical records of 586 patients with features of SBO presenting at a tertiary care centre at Lucknow,India between September 2010 and August 2023 were reviewed.RESULTS Out of 586 patients,7(1.2%)were diagnosed with IH.Among these,4 had congenital IH and 3 had acquired IH.The male-to-female ratio was 4:3.The median age at presentation was 32 years.Contrast-enhanced computed tomography(CECT)was the most reliable investigation for preoperative identification,demonstrating mesenteric whirling and clumped-up bowel loops.Left paraduodenal hernia and transmesenteric hernia occurred with an equal frequency(approximately 43%each).Intraoperatively,one patient was found to have bowel ischemia and one had associated malrotation of gut.During follow-up,no recurrences were reported.CONCLUSION IH,being a rare cause,must be considered as a differential diagnosis for SBO,especially in young patients in their 30s or with unexplained abdominal pain or discomfort post-surgery.A rapid imaging evaluation,preferably with CECT,is necessary to aid in an early diagnosis and prompt intervention,thereby reducing financial burden related to unnecessary investigations and preventing the morbidity and mortality associated with closed-loop obstruction and strangulation of the bowel.
基金supported by the National Natural Science Foundation of China(No.51905123)Major Scientific and Technological Innovation Program of Shandong Province,China(Nos.2020CXGC010303,2022ZLGX04)Key R&D Programme of Shandong Province,China(No.2022JMRH0308).
文摘An internal state variable(ISV)model was established according to the experimental results of hot plane strain compression(PSC)to predict the microstructure evolution during hot spinning of ZK61 alloy.The effects of the internal variables were considered in this ISV model,and the parameters were optimized by genetic algorithm.After validation,the ISV model was used to simulate the evolution of grain size(GS)and dynamic recrystallization(DRX)fraction during hot spinning via Abaqus and its subroutine Vumat.By comparing the simulated results with the experimental results,the application of the ISV model was proven to be reliable.Meanwhile,the strength of the thin-walled spun ZK61 tube increased from 303 to 334 MPa due to grain refinement by DRX and texture strengthening.Besides,some ultrafine grains(0.5μm)that played an important role in mechanical properties were formed due to the proliferation,movement,and entanglement of dislocations during the spinning process.
基金Shenzhen Science and Technology Programme,Grant/Award Number:JCYJ202308071208000012023 Shenzhen sustainable supporting funds for colleges and universities,Grant/Award Number:20231121165240001Guangdong Provincial Key Laboratory of Ultra High Definition Immersive Media Technology,Grant/Award Number:2024B1212010006。
文摘Internal learning-based video inpainting methods have shown promising results by exploiting the intrinsic properties of the video to fill in the missing region without external dataset supervision.However,existing internal learning-based video inpainting methods would produce inconsistent structures or blurry textures due to the insufficient utilisation of motion priors within the video sequence.In this paper,the authors propose a new internal learning-based video inpainting model called appearance consistency and motion coherence network(ACMC-Net),which can not only learn the recurrence of appearance prior but can also capture motion coherence prior to improve the quality of the inpainting results.In ACMC-Net,a transformer-based appearance network is developed to capture global context information within the video frame for representing appearance consistency accurately.Additionally,a novel motion coherence learning scheme is proposed to learn the motion prior in a video sequence effectively.Finally,the learnt internal appearance consistency and motion coherence are implicitly propagated to the missing regions to achieve inpainting well.Extensive experiments conducted on the DAVIS dataset show that the proposed model obtains the superior performance in terms of quantitative measurements and produces more visually plausible results compared with the state-of-the-art methods.
文摘BACKGROUND Pain in the back or pelvis or fear of back pain may affect the timing or cocontraction of the core muscles.In both static and dynamic movements,the Sahrmann core stability test provides an assessment of core muscle activation and a person's ability to stabilize the lumbopelvic complex.Preparatory cues and images can be used to increase the activation of these muscles.To attain optimal movement patterns,it will be necessary to determine what cueing will give the most effective results for core stability.AIM To investigate the effects of external and internal cues on core muscle activation during the Sahrmann five-level core stability test.METHODS Total 68 participants(21.83±3.47 years)were randomly allocated to an external(n=35)or internal cue group(n=33).Participants performed the Sahrmann fivelevel core stability test without a cue as baseline and the five-level stability exercises with an internal or external cue.External cue group received a pressure biofeedback unit(PBU),and the internal cue group received an audio cue.A Delsys Trigno^(TM)surface electromyography unit was used for muscle activation from the rectus abdominis,external oblique,and transverse abdominis/internal oblique muscles.RESULTS Linear mixed effects model analysis showed that cueing had a significant effect on core muscle activation(P=0.001);however,there was no significant difference between cue types(internal or external)(P=0.130).CONCLUSION Both external and internal cueing have significant effects on core muscle activation during the Sahrmann five-level core stability test and the PBU does not create higher muscle activation than internal cueing.
文摘Developing an efficient photocatalyst is the key to realize the practical application of photocatalysis.The S-scheme heterojunction has great potential in photocatalysis due to its unique charge-carrier migration pathway,effective light absorption and high redox capacity.However,further enhancing the built-in electric field of the S-scheme,accelerating carrier separation,and achieving higher photocatalytic performance remain unresolved challenges.Herein,based on the continuously adjustable band structure of continuous solid-solution,a novel 0D/2D all solid-solution S-scheme heterojunction with adjustable internal electric field was designed and fabricated by employing a solid-solution of ZnxCd_(1–x)S and Bi_(2)MoyW_(1–y)O_(6)respectively as reduction and oxidation semiconductors.The synergistic optimization of effective light absorption,fast photogenerated carrier separation,and high redox potential leads can be tuned to promote photocatalytic activity.Under visible light,the S-scheme system constructed by Zn_(0.4)Cd_(0.6)S quantum dot(QDs)and Bi_(2)Mo_(0.2)W_(0.8)O_(6)monolayer exhibits a high rate for photocatalytic degradation C_(2)H_(4)(150.6×10^(–3)min^(–1)),which is 16.5 times higher than that of pure Zn_(0.4)Cd_(0.6)S(9.1×10^(–3)min^(–1))and 53.8 times higher than pure Bi_(2)Mo_(0.2)W_(0.8)O_(6)(2.8×10^(–3)min^(–1)).Due to the unique charge-carrier migration pathway,photo-corrosion of Zn_(x)Cd_(1–x)S is further inhibited simultaneously.In-situ irradiation X-ray photoelectron spectroscopy,photoluminescence spectroscopy,time-resolved photoluminescence,transient absorption spectroscopy and electron paramagnetic resonance provide compelling evidence for interfacial charge transfer via S-scheme pathways,while in-situ diffuse reflectance infrared Fourier transform spectroscopy identifies the reaction pathway for C_(2)H_(4)degradation.This novel S-scheme photocatalysts demonstrates excellent performance and potential for the practical application of the fruits and vegetables preservation at room temperatures.
基金financial support from the National Natural Science Foundation of China(Nos.22271024,21632005)Changzhou University.
文摘Double bonds of internal olefins can be efficiently migrated to the terminal carbons and regioselectively hydroesterified with formates in the presence of Pd(OAc)_(2) and 1,2-DTBPMB under mild reaction conditions,providing a wide variety of corresponding linear carboxylic esters bearing various functional groups in good yields and>20:1 linear/branch ratios.The reaction is optionally simple and does not need to use CO gas and acid co-catalysts.
文摘Migration is a complex demographic phenomenon.Its dynamics can be explained by several factors whose spatial and temporal evolution is not easy to control.That is why this article aims to understand the factors of migration from a spatiotemporal perspective to fill the gaps in the literature.The aim of this article is to analyse the spatiotemporal dynamics of internal migration factors to deduce the zones of origin and destination in Burkina Faso.To do this,several types of data were used.These included secondary,spatial,statistical and survey data.The results of this study show that the influence of internal migration factors is uneven.The spatial distribution of internal migration factors follows a north-south gradient,with favourable conditions in the south.In fact,the northern part is characterised by a large population exodus,with around 42.6%of outgoing internal migrants,and the southern part by a large population influx.This southern part of the country receives around 34.6%of internal migrants.The areas from which migrants depart have unfavourable climatic,environmental,or socio-economic conditions,whereas the areas to which migrants migrate are characterised by favourable conditions for these factors.
文摘This paper examines the role of internal audit and the incorporation of Environmental,Social,and Governance(ESG)factors within the corporate governance frameworks of Greek firms in mitigating their financial risk.Time series econometric analysis was performed to determine the factors that influence financial stability,transparency,and regulatory compliance in Greek Firms.Data were collected from 120 internal auditors and financial professionals employed in organizations across multiple sectors of the Greek economy.In line with existing literature,findings show that robust internal audit and ESG practices are essential in promoting financial stability,transparency,and regulatory compliance.The paper provides empirical evidence that well-structured internal audit mechanisms and effective ESG initiatives reduce financial risks,while enhancing organizational sustainability and resilience.The results emphasize the growing importance of ESG considerations in corporate governance and suggest that improvements in both internal audit systems,as well as robust ESG policies,can strengthen risk management strategies and improve long-term financial performance.While previous research has thoroughly investigated the impact of internal audits on financial stability and the influence of ESG on corporate sustainability,this paper specifically examines their combined effect on financial risk management.Using firm level data across various sectors of the Greek economy,this study provides insights into how internal audit and ESG policies can jointly contribute towards enhancing financial resilience,transparency,and regulatory compliance.
基金financially supported by the National Natural Science Foundation of China (Grant No. 52201380)Fundamental Research Funds for the Central Universities (Grant No. D5000230080)+2 种基金Innovation Foundation for Doctor Dissertation of Northwestern Polytechnical University (Grant Nos. CX 2024049 and CX2023006)the Chunhui Program of Ministry of Education of China (Grant No. HZKY20220538)the Practice and Innovation Funds for Graduate Students of Northwestern Polytechnical University (Grant No. PF2023057)。
文摘Internal solitary waves(ISWs) are a common phenomenon beneath the ocean surface and represent a significant environmental hazard that must be considered for the safe navigation of submersibles. A numerical simulation model for the interaction of solitary waves with submersibles at a large scale has been developed. The Miyata-ChoiCamassa(MCC) equation serves as the basis for generating ISWs. The impacts of the submergence depth, wave amplitude, and advancing velocity on the motion response and load characteristics of the submersible are examined in detail. This study elucidates the governing laws and mechanisms underlying the impact of ISWs on submersibles.The research findings indicate that shorter distances to the undisturbed surface, higher wave amplitudes, and fasteradvancing speeds result in greater effects on submersibles. For a submersible operating in the lower layer, both the alteration in density near the wave interface and the dynamic pressure induced by ISWs can reduce its lift, potentially resulting in a rapid descent. It is imperative to pay considerable attention to the impact of ISWs, as they have the potential to precipitate a loss of control of the submersible.
基金Supported by the National Natural Science Foundation of China,No.81774118the Foreign Cooperation Project of Science and Technology Department of Fujian Province,No.2023I0021the Medical Innovation Project of Fujian Province,No.2024CXB013.
文摘BACKGROUND Hemorrhoids,a prevalent chronic condition globally,significantly impact patients'quality of life.While various surgical interventions,such as external stripping and internal ligation,procedure for prolapse and hemorrhoids,and tissue selecting technique,are employed for treatment,they are often associated with postoperative complications,including unsatisfactory defecation,bleeding,and anal stenosis.In contrast,Xiaozhiling injection,a traditional Chinese medicine-based therapy,has emerged as a minimally invasive and effective alternative for internal hemorrhoids.This treatment offers distinct advantages,such as reduced dietary restrictions,broad applicability,and minimal induction of systemic inflammatory responses.Additionally,Xiaozhiling injection effectively eliminates hemorrhoid nuclei,prevents local tissue necrosis,preserves anal cushion integrity,and mitigates postoperative complications,including bleeding and prolapse.Despite its clinical efficacy,the molecular mechanisms underlying its therapeutic effects remain poorly understood,warranting further investigation.AIM To investigate the molecular mechanism underlying the therapeutic effect of Xiaozhiling injection in the treatment of internal hemorrhoids.METHODS An internal hemorrhoid model was established in rats,and the rats were randomly divided into a modeling group[control group(CK group)]and a treatment group.One week after injection,Stereo-seq and electron microscopy were used to study the changes in gene expression and subcellular structures in fibroblasts.RESULTS Single-cell sequencing revealed differences in the expression and transcript levels of the genes collagen 3 alpha 1,decorin,and actin alpha 2 in fibroblasts between the CK group and the treatment group.Spatial transcriptome analysis revealed that genes of the sphingosine kinase 1(Sphk1)/sphingosine-1-phosphate(S1P)pathway spatially overlapped with key genes of the transforming growth factor beta 1 pathway,namely,Sphk1,S1P receptor,and transforming growth factor beta 1,in the treatment group.The proportion of fibroblasts was lower in the treatment group than in the CK group,and Xiaozhiling treatment had a significant effect on the proportion of fibroblasts in hemorrhoidal tissue.Immunohistochemistry revealed a significant increase in the expression of a fibroblast marker.Electron microscopy showed that the endoplasmic reticulum of fibroblasts contained a large amount of glycogen,indicating cell activation.Fibroblast activation and the expression of key genes of the Sphk1-S1P pathway could be observed at the injection site,suggesting that after Xiaozhiling intervention,the Sphk1-S1P pathway could be activated to promote fibrosis.CONCLUSION Xiaozhiling injection exerts its therapeutic effects on internal hemorrhoids by promoting collagen synthesis and secretion in fibroblasts.After Xiaozhiling intervention,the Sphk1-S1P pathway can be activated to promote fibrosis.
基金supported by the National Natural Science Foundation of China(Grant no.42176244)CAS Key Deployment Project of Centre for Ocean Mega-Research of Science(Grant no.COMS2020Q07)。
文摘In the Arctic Ocean,turbulent mixing drives vertical heat flux,thereby affecting the sea ice variability.Internal wave is regarded as one of the important energy sources of mixing in this region.The high latitude and sea ice cover make internal wave in the Arctic Ocean apparently differs from that in mid-and low-latitude oceans.However,the internal wave and its underlying mechanism are less understood due to the lack of observations.This paper briefly reviews the recent studies and unresolved questions on the internal wave in the Arctic Ocean,including wind-driven near-inertial wave,internal tide,and high-frequency internal wave.The aim is to provide new insights for in-depth research in the future,with a focus on the mechanisms responsible for the evolution of internal wave under the rapidly changing Arctic climate.
文摘Objectives:This study aimed to investigate the dual mediating roles of psychological safety and reporting attitudes in the association between ethics-centered leadership and internal whistleblowing among nurses.Methods:A multicenter,cross-sectional study design was employed,involving a convenience sample of 273 nurses among five university hospitals from August to October 2024.Data were collected using a demographic questionnaire,Ethical Leadership Scale,Psychological Safety Scale,Positive Attitudes Toward Whistleblowing Scale,and Internal Whistleblowing Scale.Pearson correlation and structural equation model were conducted to test the hypothesized dual mediation model.Results:The average score of nurses for ethical leadership was 4.14±0.57,psychological safety was 3.80±0.64,reporting attitudes was 4.12±0.67,internal whistleblowing was 3.93±0.52.Ethical leadership had a significant effect on psychological safety(β=0.38,P<0.001),reporting attitudes(β=0.44,P<0.001),and internal whistleblowing(β=0.21,P=0.009).Furthermore,psychological safety(β=0.26,P<0.001)and reporting attitudes(β=0.27,P<0.001)significantly influenced internal whistleblowing among the nurses.The indirect effect of ethics-centered leadership on internal whistleblowing intermediated by psychological safety was significant(β=0.10,P<0.001).Similarly,reporting attitudes demonstrated a significant mediating effect(β=0.12,P=0.003).Conclusions:Ethical leadership encourages internal whistleblowing among nurses by fostering psychological safety and positive reporting attitudes.Therefore,healthcare managers should prioritize ethical leadership development,enhance psychological safety,and foster constructive reporting attitudes that enable nurses to report ethical violations confidently,without apprehension.
基金supported by the National Natural Science Foundation of China(Grant Nos.42130604)the National Key Research and Development Program of China(Grant No.2023YFF0804704)+2 种基金the National Natural Science Foundation of China(Grant Nos.42105044)Swedish STINT(Grant No.CH2019-8377)the Priority Academic Program Development of Jiangsu Higher Education Institutions(Grant No.164320H116)。
文摘Since the mid-20th century,the Mongolian Plateau(MP)has experienced decadal droughts coupled with extreme heatwaves,severely affecting regional ecology and social development.However,the mechanisms behind these decadalscale compound heatwavedrought events remain debated.Here,using reconstructions and simulations from the Community Earth System Model Last Millennium Ensemble,we demonstrate that,over the last millennium,decadal droughts on the MP occurred under both warm and cold conditions,differing from recent compound heatwavedrought events.We found that by examining temperature changes during these drought periods,the distinct influences of external forcings and internal variability can be simply and effectively distinguished.Specifically,colddry events were primarily driven by volcanic eruptions that weakened the East Asian summer monsoon and midlatitude westerlies,reducing moisture transport to the MP.In contrast,warmdry events were predominantly induced by internal variability,notably the negative phase of the Atlantic Multidecadal Oscillation and the expansion of the Barents Sea ice extent.The recent extreme compound event was probably influenced by the combined effects of anthropogenic forcings and internal variability.These findings deepen our understanding of how external forcings and internal variability affect decadal drought events on the MP and highlight that recent compound events are unprecedented in the context of the last millennium.
基金supported by the National Major Scientific and Technological Special Project for“Significant New Drugs Development”(No.2018ZX09201018–028)the nuclear energy development projects of China during the 13thFive Year Plan periodthe key research and development project of the Sichuan Provincial Department of Science and Technology(No.18ZDYF1466)。
文摘Radioactive microspheres have demonstrated excellent therapeutic effects and good tolerance in the treatment of unresectable primary and secondary liver malignancies.This is attributed to precise embolization and potent anti-tumor effect.However,certain limitations such as unstable loading,perfusion stasis,heterogeneous distribution,ectopic distribution,and insufficient dosage,restrict their clinical application.Herein,a novel personalized Y-90 carbon microsphere with high uniformity,high specific activity and high availability(^(90)Y-HUACM)is presented.It is synthesized through planar molecular complex adsorption and chemical deposition solidification.^(90)Y-HUACM exhibited controllable size,excellent biocompatibility,outstanding in vitro and in vivo stability.The radiolabeling efficiency of Y-90 exceeded 99%and the leaching rate of Y-90 is far below 0.1%.Furthermore,the excellent anti-tumor effect,nuclide loading stability,anti-reflux characteristics,precise embolization,and biosafety of^(90)Y-HUACM were validated in a rabbit VX2liver tumor model.In summary,this new,high-performance,and customizable radioactive microsphere provides a superior choice for selective internal radiation treatment of advanced liver cancer is expected to be rapidly applied in clinical practice.
基金supported by the National Natural Science Foundation of China(No.U22A20616).
文摘Understanding the coupling relationships among lake physicochemical properties,internal nutrient recycling,and related microbes is key for the control of freshwater eutrophication.In this study,seasonal variations in microorganisms at the sediment–water interface(SWI)of the eutrophic Lake Chaohu in China were analyzed,in order to reveal changes in phosphorus(P)-cycling-related microbes in the sediments and its association with internal P release during the cyanobacterial life cycle.The identified P-cycling-related microbes include phosphorus-solubilizing bacteria(PSB)(dominant of Bacillus,Thiobacillus and Acinetobacter),sulfate-reducing bacteria(SRB)(dominant of Sva0081_sediment_group,norank_c__Thermodesulfovibrionia and Desulfatiglans)and iron-reducing bacteria(FeRB)(dominant of Geothermobacter,Anaeromyxobacter,Thermoanaerobaculum and Clostridium_sensu_stricto_1).Increased PSB and reduced proportions of iron-aluminum–bound P(Fe/Al-P)and calcium–bound P(Ca-P)from the benthic stage to initial cyanobacterial growth indicated that internal phosphorus was released through the solubilization of Fe/Al-P and Ca-P by PSB.Growth of cyanobacteria was accompanied by cyanobacteria death,deposition,and degradation during early algal blooms,which increased SRB caused by high organic matter and the net deposition of phosphorus in the western lake.Conversely,phosphorus release in eastern lake was observed because of organic phosphorus mineralization.High linear discriminant analysis effect size of SRB and FeRB and the decreased Fe/Al-P in sediments indicated sulfide-mediated chemical iron reduction(SCIR)and FeRB-mediated microbial iron reduction mechanisms for internal phosphorus release during late algal blooms.The observed seasonal pattern of P-cycling-related microbes and its mediation on internal phosphorus release provides a foundation for internal P management in Lake Chaohu.
文摘Internal audit plays a strategic role in ensuring the reliability of government financial statements,which are essential tools for achieving public financial accountability and transparency.This study aims to analyze the role of internal audit in improving the quality of government financial reporting using a literature review approach based on agency theory.The method employed is a systematic literature review of 12 scholarly articles(7 national and 5 international),as well as relevant books and official reports published within the last five years(2019-2024).The findings indicate that an effective and independent internal audit can reduce information asymmetry between the government(agent)and the public(principal),enhance compliance with Government Accounting Standards(SAP),and strengthen internal controls and financial governance.This study concludes that a competent internal audit function is a critical prerequisite for producing reliable,relevant,and accountable financial statements.The findings support agency theory and offer key recommendations for strengthening internal audit practices in the public sector.
文摘BACKGROUND Atrial fibrillation(AF)is the most common cardiac arrhythmia worldwide,hosting numerous serious possible complications such as stroke and heart failure.In the past two decades,managing rhythm control was more successful via pulmonary vein isolation(PVI)ablation,generally performed via transfemoral access.Patients with anatomical variations may necessitate a dose of creativity and evidence-based techniques.To our knowledge,we present the first PVI case in a patient with AF via right internal jugular(IJ)vein access using pulse field ablation.CASE SUMMARY A 76-year-old male with an extensive medical history notable for type 2 diabetes and severe peripheral vascular disease requiring vascular bypass surgery is identified to have paroxysmal AF.Given functional decline and worsening arrhythmia burden refractory to oral antiarrhythmics,an initial PVI ablation was attempted but failed as the catheter could not be advanced secondary to bilateral iliac vein occlusions.This necessitated a novel approach and a subsequent PVI ablation via the right IJ vein was successful without any complications.The success of this case highlights the feasibility of an IJ approach for PVI in patients where traditional access is not possible.This case can be used as a reference for other practitioners who may face similar challenges when attempting to perform PVI for AF or similar procedures requiring access to similar anatomical locations.CONCLUSION The success of this case highlights the feasibility of an IJ approach for PVI when traditional access is impossible.
文摘Using real fields instead of complex ones, it was recently claimed, that all fermions are made of pairs of coupled fields (strings) with an internal tension related to mutual attraction forces, related to Planck’s constant. The solution to Dirac equation gives four, real, 2-vectors solutions ψ1=(U1D1)ψ2=(U2D2)ψ3=(U3D3)ψ4=(U4D4)where (ψ1,ψ4) are coupled via linear combinations to yield spin-up and spin-down fermions. Likewise, (ψ2,ψ3) are coupled via linear combinations to represent spin-up and spin-down anti-fermions. Here, a deeper investigation of the free fermion internal frequency is discussed, hinting to an exchange interaction between the two components of which a fermion is made of. An upper limit estimate is given to the strength of this interaction.
