Patient satisfaction and follow-up adherence to glaucoma case management clinic in China

AIM:To assess glaucoma patient satisfaction and follow-up adherence in case management and identify associated predictors to improve healthcare quality and patient outcomes.METHODS:In this cross-sectional study,a total of 119 patients completed a Patient Satisfaction Questionnaire-18 and a sociodemographic questionnaire.Clinical data was obtained from the case management system.Follow-up adherence was defined as completing each follow-up within±30d of the scheduled time set by ophthalmologists during the study period.RESULTS:Average satisfaction scored 78.65±7,with an average of 4.39±0.58 across the seven dimensions.Age negatively correlated with satisfaction(P=0.008),whilst patients with follow-up duration of 2 or more years reported higher satisfaction(P=0.045).Multivariate logistics regression analysis revealed that longer follow-up durations were associated with lower follow-up adherence(OR=0.97,95%CI,0.95-1.00,P=0.044).Additionally,patients with suspected glaucoma(OR=2.72,95%CI,1.03-7.20,P=0.044)and those with an annual income over 100000 Chinese yuan demonstrated higher adherence(OR=5.57,95%CI,1.00-30.89,P=0.049).CONCLUSION:The case management model proves effective for glaucoma patients,with positive adherence rates.The implementation of this model can be optimized in the future based on the identified factors and extended to glaucoma patients in more hospitals.

Loss to Specialized Cardiology Follow-Up in Adults Living with Congenital Heart Disease

Background:Much has been written about the loss to follow-up in the transition between pediatric and adult Congenital Heart Disease(CHD)care centers.Much less is understood about the loss to follow-up(LTF)after a successful transition.This is critical too,as patients lost to specialised care are more likely to experience mor-bidity and premature mortality.Aims:To understand the prevalence and reasons for loss to follow-up(LTF)at a large Australian Adult Congenital Heart Disease(ACHD)centre.Methods:Patients with moderate or highly complex CHD and gaps in care of>3 years(defined as LTF)were identified from a comprehensive ACHD data-base.Structured telephone interviews examined current care and barriers to clinic attendance.Results:Overall,407(22%)of ACHD patients(n=1842)were LTF.The mean age at LTF was 31(SD 11.5)years and 54%were male;311(76%)were uncontactable.Compared to adults seen regularly,lost patients were younger,with a greater socio-economic disadvantage,and had less complex CHD(p<0.05 for all).We interviewed 59 patients(14%).The top 3 responses for care absences were“feeling well”(61%),losing track of time(36%),and not needing fol-low-up care(25%).Conclusions:A large proportion of the ACHD population becomes lost to specialised cardiac care,even after a successful transition.This Australian study reports younger age,moderate complexity defects,and socio-economic disadvantage as predictive of loss to follow-up.This study highlights the need for novel approaches to patient-centered service delivery even beyond the age of transition and resources to maintain patient engagement within the ACHD service.

Essential role of postoperative follow-up in the management of clear cell sarcoma

Clear cell sarcoma(CCS)is a rare melanocytic soft tissue sarcoma known for itspropensity to metastasize to the lymph nodes and typically has an unfavorableprognosis.Currently,surgical resection is the primary treatment for localizedCCS,while radiotherapy and chemotherapy are preferred for metastatic cases.The roles of adjuvant chemotherapy,radiotherapy,and lymph node dissection arecontroversial.Although immunotherapy has emerged as a promising avenue inCCS treatment research,there are no established clinical standards for postoperativefollow-up.This editorial discusses a recent article by Liu et al,with afocus on current diagnostic modalities,treatment approaches,and the challengingprognosis associated with CCS.Our aim is to underscore the importance of longtermpatient follow-up in CCS management.

A Federated Learning Framework with Blockchain-Based Auditable Participant Selection

Federated learning is an important distributed model training technique in Internet of Things(IoT),in which participant selection is a key component that plays a role in improving training efficiency and model accuracy.This module enables a central server to select a subset of participants to performmodel training based on data and device information.By doing so,selected participants are rewarded and actively perform model training,while participants that are detrimental to training efficiency and model accuracy are excluded.However,in practice,participants may suspect that the central server may have miscalculated and thus not made the selection honestly.This lack of trustworthiness problem,which can demotivate participants,has received little attention.Another problem that has received little attention is the leakage of participants’private information during the selection process.We will therefore propose a federated learning framework with auditable participant selection.It supports smart contracts in selecting a set of suitable participants based on their training loss without compromising the privacy.Considering the possibility of malicious campaigning and impersonation of participants,the framework employs commitment schemes and zero-knowledge proofs to counteract these malicious behaviors.Finally,we analyze the security of the framework and conduct a series of experiments to demonstrate that the framework can effectively improve the efficiency of federated learning.

SHT-based public auditing protocol with error tolerance in FDL-empowered IoVs

With the intelligentization of the Internet of Vehicles(lovs),Artificial Intelligence(Al)technology is becoming more and more essential,especially deep learning.Federated Deep Learning(FDL)is a novel distributed machine learning technology and is able to address the challenges like data security,privacy risks,and huge communication overheads from big raw data sets.However,FDL can only guarantee data security and privacy among multiple clients during data training.If the data sets stored locally in clients are corrupted,including being tampered with and lost,the training results of the FDL in intelligent IoVs must be negatively affected.In this paper,we are the first to design a secure data auditing protocol to guarantee the integrity and availability of data sets in FDL-empowered IoVs.Specifically,the cuckoo filter and Reed-Solomon codes are utilized to guarantee error tolerance,including efficient corrupted data locating and recovery.In addition,a novel data structure,Skip Hash Table(SHT)is designed to optimize data dynamics.Finally,we illustrate the security of the scheme with the Computational Diffie-Hellman(CDH)assumption on bilinear groups.Sufficient theoretical analyses and performance evaluations demonstrate the security and efficiency of our scheme for data sets in FDL-empowered IoVs.

Long-term assessment of collagenase treatment for Dupuytren’s contracture:A 10-year follow-up study

BACKGROUND Enzymatic fasciotomy with collagenase clostridium histolyticum(CCH)has revolutionized the treatment for Dupuytren’s contracture(DC).Despite its benefits,the long-term outcomes remain unclear.This study presented a comprehensive 10-year follow-up assessment of the enduring effects of CCH on patients with DC.AIM To compare the short-term(12 wk)and long-term(10 years)outcomes on CCH treatment in patients with DC.METHODS A cohort of 45 patients was treated with CCH at the metacarpophalangeal(MCP)joint and the proximal interphalangeal(PIP)joint and underwent systematic reevaluation.The study adhered to multicenter trial protocols,and assessments were conducted at 12 wk,7 years,and 10 years post-surgery.RESULTS Thirty-seven patients completed the 10-year follow-up.At 10 years,patients treated at the PIP joint exhibited a 100%recurrence.However,patients treated at the MCP joint only showed a 50%recurrence.Patient satisfaction varied,with a lower satisfaction reported in PIP joint cases.Recurrence exceeding 20 degrees on the total passive extension deficit was observed,indicating a challenge for sustained efficacy.Significant differences were noted between outcomes at the 7-year and 10-year intervals.CONCLUSION CCH demonstrated sustained efficacy when applied to the MCP joint.However,caution is warranted for CCH treatment at the PIP joint due to a high level of recurrence and low patient satisfaction.Re-intervention is needed within a decade of treatment.

Environmental Impact Assessment Follow-Up of Seismic Survey Offshore Activities in Brazil

Follow-up of environmental impacts is an integral part of the Environmental Impact Assessment (EIA) process, closely related to the effectiveness of the instrument. EIA follow-up has been receiving a lot of interest from scientists and practitioners, though it is recognized as one of the weakest points of EIA systems globally. Also, EIA follow-up is influenced by the context, mainly in terms of the types of projects or activities and their related impacts on the environment. Therefore, the present paper is focused on the investigation of the follow-up stage applied to the activity of seismic survey coupled with offshore oil & gas exploitation in Brazil. Research was based on a qualitative approach that included document analysis and semi-structured interviews with analysts involved in EIA processes, and sought to generate evidence of effectiveness of the EIA follow-up as conducted by the Federal Environment Agency (Ibama) in order to situate the practice of follow-up in the broader context of international best practice principles. Based on the findings, it was concluded that, due to the peculiarities of offshore seismic survey, it is necessary to promote adaptations in the procedures for monitoring impacts in order to ensure proper alignment with the principles and conceptual foundations that guide EIA practice. Specifically, the timing of the execution of the activity imposes challenges for its integration into the “conventional” cycle that has guided the monitoring of the impacts in the EIA of projects.

Does the Internal Audit Function Play a Role in Mitigating Earnings Management?

This paper aims to investigate the effect of the characteristics of the internal audit function(IAF)on earnings management(EM)for a sample of 27 Tunisian listed companies.The authors employed the Correlated Panels Corrected Standard Errors model to estimate the regression equation.The results showed that EM is negatively associated with internal audit effectiveness,frequency of audit committee meetings with Chief Audit Executives(CAEs),the partial outsourcing of internal audit,and the firm’s size.Moreover,the authors found a positive relationship between EM and the use of IAF as a training ground for management and the private sector.This study is important to academics,regulators,and policymakers in introducing new governance reforms to strengthen the IAF as an important internal governance mechanism to reduce earnings management practices in emerging countries.The results also provide useful information for investors to examine the effect of internal audit characteristics on earnings management.

The Effects of Competence and Auditor Training on Fraud Detection Within Multinational Companies in Sub-Saharan Africa

The aim of this study is to examine the qualities that auditors engaged in detecting potential fraud within multinational corporations in Sub-Saharan Africa should possess.To achieve this goal,a quantitative approach was used to develop and test a research model based on three theories:agency theory,attribution theory,and cognitive dissonance theory.Responses from a panel of two hundred and nine(209)auditors who conducted a legal audit mission in a Sub-Saharan multinational were analyzed using SmartPLS 3.3.3 software.The results emphasize the crucial importance of auditors’competence and continuous training in fraud detection.However,professional skepticism and time pressure were found to be non-significant in this context.This conclusion provides essential insights for auditors,highlighting the key qualities needed to effectively address fraud detection within multinational corporations in Sub-Saharan Africa.

Innovation of Audit Business Management Models under the Conditions of Information Technology

This paper focuses on the innovation of audit business management in the information technology era.In the wave of digitalization,audit companies need to adjust their management mode to take advantage of the advantages of informatization.The key is to use digital tools to strengthen data analysis and reshape the audit process.This not only improves efficiency and accuracy but also improves the overall audit quality.The article also highlights the importance of developing a culture of continued auditor learning and skills development to ensure competitiveness in the digital age.At the end of the paper,the success of audit companies depends on innovation ability and the importance of combining management mode with technological innovation.

Analysis of the Impact of Big Data Technology on Environmental Pollution Control Audit

As China strives towards the second centenary goal,increasing attention is being paid to environmental pollution and other related issues.Concurrently,with the rapid development of big data technology,many big data solutions have been applied to environmental pollution control audits,exerting a significant impact.This paper presents the current situation of environmental pollution audits,summarizing the application of big data from the perspectives of both domestic and international research.In terms of data collection and data analysis for environmental pollution audits,cloud platform technology,and visualization technology are selected based on multiple data sources.The impact in the field of environmental pollution control audits is further analyzed.It is found that the environmental pollution audit cloud platform is not yet perfect,the technical skills of audit personnel are insufficient,and some technologies are not mature.Relevant suggestions are put forward to provide a reference for the future development of big data technology and its integration with environmental pollution control audits.

Audit审核在车辆质检工作中的使用方法研析

Audit审核起源于德国大众,是企业模拟用户对自己的产品质量进行内部监督的觉行为。通过Audit审核在车辆质检工作中的应用,企业可以更加全面地了解车辆的质量状况,及时发现并解决问题,提升车辆的整体质量水平,从而满足消费者的需求,增强市场竞争力。Audit审核是站在用户的角度对成品车辆进行质量检查/测量的方法(内部和外部),获得汽车制造厂的广泛应用。Audit审核是在与用户相对的汽车制造厂里进行的审核检验,只有站在用户角度提升产品质量,才能发挥Audit审核的最佳作用。

Developing a GIS Audit Framework in the Context of Information Technology though a Reductive Model Approach

A GIS audit framework is necessary considering the diverse nature of GIS with regard to components, applications and industry. In practice, checklists are generated during the audit process based on specific objectives. There is no standardized list of items that can be used as a reference. The purpose of this study was to develop a GIS audit framework as a foundation for GIS audits. The framework provides that comprehensive approach to various GIS aspects during the audit process. The design builds on a developed conceptual framework where most significant categories of GIS audit parameters namely data quality, software utilization, GIS competency and procedures (work flows) were identified. The study adopted a reductive model approach to simplify the complexity associated with each category of GIS audit parameter. The resultant audit elements for each category are organized in a matrix that forms an integral part of the framework. The columns comprise audit goal, audit questions and audit subjects as indicators which are qualitatively measured. The rows comprise the parameters (data quality, software utilization, personnel competency and procedure (workflows)). To use the framework, an auditor only needs to create an audit checklist that consists of particular parameters and indicators from the framework depending on audit objective. As part of an on-going research, the next step will involve validating the framework through a mock testing process.

Intensive follow-up vs conventional follow-up for patients with nonmetastatic colorectal cancer treated with curative intent:A metaanalysis

BACKGROUND The frequency and content of follow-up strategies remain controversial for colorectal cancer(CRC),and scheduled follow-ups have limited value.AIM To compare intensive and conventional follow-up strategies for the prognosis of non-metastatic CRC treated with curative intent using a meta-analysis.METHODS PubMed,Embase,and the Cochrane Library databases were systematically searched for potentially eligible randomized controlled trials(RCTs)from inception until April 2023.The Cochrane risk of bias was used to assess the methodological quality of the included studies.The hazard ratio,relative risk,and 95%confidence interval were used to calculate survival and categorical data,and pooled analyses were performed using the random-effects model.Additional exploratory analyses were performed for sensitivity,subgroups,and publication bias.RESULTS Eighteen RCTs involving 8533 patients with CRC were selected for the final analysis.Intensive follow-up may be superior to conventional follow-up in improving overall survival,but this difference was not statistically significant.Moreover,intensive follow-up was associated with an increased incidence of salvage surgery compared to conventional follow-up.In addition,there was no significant difference in the risk of recurrence between intensive and conventional follow-up strategies,whereas intensive follow-up was associated with a reduced risk of interval recurrence compared to conventional follow-up.Finally,the effects of intensive and conventional follow-up strategies differed when stratified by tumor location and follow-up duration.CONCLUSION Intensive follow-up may have a beneficial effect on the overall survival of patients with non-metastatic CRC treated with curative intent.

The natural course of bacillus Calmette-Guerin induced bladder lesions:A long-term follow-up study and systematic review

Objective:Bacillus Calmette-Gue´rin(BCG)instillation is the standard adjuvant treatment for intermediate-and high-risk non-muscle-invasive bladder cancer after transurethral resection.Nevertheless,its toxicity often causes bladder complications.On follow-up cystoscopy,post-BCG bladder lesions can be pathologically benign,urothelial carcinoma recurrence,or other types of bladder malignancy.Only a small number of case reports have been published on post-BCG bladder lesions.Their clinical features,natural course,and management remain unknown.Methods:We retrospectively studied cystoscopic videos and medical records of BCG-treated bladder cancer patients at our center.During a long-term follow-up,we took biopsies on tumor-like lesions and described their changes.In addition,we summarized previous studies on post-BCG bladder lesions by systematic literature searching and review.Results:We described a series of three cases with post-BCG bladder lesions mimicking tumor recurrence from a total of 38 cases with follow-up data for more than 5 years.Those lesions could last,grow,or disappear spontaneously,and remain pathological benign for years.In systematic review,we identified and analyzed a total of 15 cases with post-BCG bladder lesions with detailed clinical information.Eleven of the 15 were benign and have a good prognosis with nephrogenic adenoma being the most common pathological type.Conclusion:Based on previous studies and our experience,benign lesions after BCG instillation cannot distinguish with cancer recurrence by cystoscopy alone,even under narrow band imaging mode.Nonetheless,given most of them have a good prognosis,random biopsy or transurethral resection might be spared in the patients with long-term negative biopsy and urine cytology.

Smart Contract Based DDoS Attack Traceability Audit Mechanism in Intelligent IoT

In this paper,we focus on providing data provenance auditing schemes for distributed denial of service(DDoS)defense in intelligent internet of things(IoT).To achieve effective DDoS defense,we introduce a two-layer collaborative blockchain framework to support data auditing.Specifically,using data scattered among intelligent IoT devices,switch gateways self-assemble a layer of blockchain in the local autonomous system(AS),and the main chain with controller participation can be aggregated by its associated layer of blocks once a cycle,to obtain a global security model.To optimize the processing delay of the security model,we propose a process of data pre-validation with the goal of ensuring data consistency while satisfying overhead requirements.Since the flood of identity spoofing packets,it is difficult to solve the identity consistency of data with traditional detection methods,and accountability cannot be pursued afterwards.Thus,we proposed a Packet Traceback Telemetry(PTT)scheme,based on in-band telemetry,to solve the problem.Specifically,the PTT scheme is executed on the distributed switch side,the controller to schedule and select routing policies.Moreover,a tracing probabilistic optimization is embedded into the PTT scheme to accelerate path reconstruction and save device resources.Simulation results show that the PTT scheme can reconstruct address spoofing packet forward path,reduce the resource consumption compared with existing tracing scheme.Data tracing audit method has fine-grained detection and feasible performance.

Governance of artificial intelligence applications in a business audit via a fusion fuzzy multiple rule‑based decision‑making model

A broad range of companies around the world has welcomed artificial intelligence(AI)technology in daily practices because it provides decision-makers with comprehensive and intuitive messages about their operations and assists them in formulating appropriate strategies without any hysteresis.This research identifies the essential components of AI applications under an internal audit framework and provides an appropriate direction of strategies,which relate to setting up a priority on alternatives with multiple dimensions/criteria involvement that need to further consider the interconnected and intertwined relationships among them so as to reach a suitable judgment.To obtain this goal and inspired by a model ensemble,we introduce an innovative fuzzy multiple rule-based decision making framework that integrates soft computing,fuzzy set theory,and a multi-attribute decision making algorithm.The results display that the order of priority in improvement—(A)AI application strategy,(B)AI governance,(D)the human factor,and(C)data infrastructure and data quality—is based on the magnitude of their impact.This dynamically enhances the implementation of an AI-driven internal audit framework as well as responds to the strong rise of the big data environment.Highlights Artificial intelligence(AI)promotes the sustainability development of audit tasks.A fuzzy MRDM model extracts key factors from large amounts of data.Fuzzy decision-making trial and evaluation laboratory analysis accounts for dependence and feedback among factors.An effective framework of AI-driven business audit is proposed in which“AI cognition of senior executives”is the most important criterion.

Stent-assisted coiling of intracranial carotid ophthalmic segment aneurysm segment aneurysms:Long-term follow-up from a single center

Background:To evaluate the efficacy of stent-assisted coiling(SAC)for the treatment of carotid ophthalmic segment aneurysm segment aneurysms(OSAs)of the internal carotid artery(ICA)through detailed long-term follow-up of a large patient cohort.Methods:We retrospectively analyzed 88 consecutive patients with OSAs between January 2009 and January 2020 at our center.Angiographic results were evaluated using the modified Raymond grading system and clinical outcomes were evaluated using the mRS scale.The primary endpoints were major aneurysm recurrence and poor clinical outcomes for at least 18 months of follow-up.The patients were asked to attend clinical follow-up assessments and possibly undergo DSA or MR via telephone.Results:We enrolled 88 patients with 99 OSAs treated with coiling,of whom 76 were treated with SAC.The coiling procedures were successful in all 88 patients.Overall,complications occurred in 8 patients(9.1%).No procedure-related mortality was observed.67(76.1%)experienced immediate aneurysm occlusion at the end of the procedure.Long-term angiographic follow-up(18 months)was available in 45/88 aneurysms(51%)(average 18.7±5.2 months).Four patients continued their follow-up for 5 years after initial aneurysm treatment.After a clinical follow-up time of 28.7 months(range,12-51 months),85 patients(95.5%)achieved favorable clinical outcomes(mRS scores of 0-2).Conclusions:This study indicates that SAC treatment is a safe and effective therapeutic alternative for ruptured and unruptured OSAs.The procedural risks are low with relatively long-term effectiveness.

Effects of an Omaha System-based follow-up regimen on self-care and quality of life in gastrointestinal surgery patients

BACKGROUND Currently,a variety of new nursing methods and routine nursing have been widely used in the nursing of gastrointestinal surgery patients.AIM To investigate the effect of follow-up protocol based on the Omaha System on self-care ability and quality of life of gastrointestinal surgery patients.METHODS A total of 128 patients with inflammatory bowel disease in gastrointestinal surgery in gastrointestinal surgery from March 2019 to August 2021 were divided into A(n=64)and B(n=64)groups according to different nursing methods.The group A received a follow-up program Omaha System-based intervention of the group B,whereas the group B received the routine nursing intervention.Medical Coping Modes Questionnaire,Crohn’s and Colitis Knowledge Score(CCKNOW),inflammatory bowel disease questionnaire(IBDQ),Exercise of Self-nursing Agency Scale(ESCA),The Modified Mayo Endoscopic Score,and Beliefs about Medicine Questionnaire(BMQ)were compared between the two groups.RESULTS Following the intervention,the group A were facing score significantly increased than group B,while the avoidance and yield scores dropped below of group B(all P<0.05);in group A,the level of health knowledge,personal care abilities,self-perception,self-awareness score and ESCA total score were more outstanding than group B(all P<0.05);in group A the frequency of defecation,hematochezia,endoscopic performance,the total evaluation score by physicians and the disease activity were lower than group B(all P<0.05);in the group A,the total scores of knowledge in general,diet,drug,and complication and CCKNOW were higher than group B(all P<0.05);in group A,the necessity of taking medicine,score of medicine concern and over-all score of BMQ were more significant than group B(all P<0.05);at last in the group A,the scores of systemic and intestinal symptoms,social and emotional function,and IBDQ in the group A were higher than group B(all P<0.05).CONCLUSION For gastrointestinal surgery patients,the Omaha System-based sequel protocol can improve disease awareness and intervention compliance,help them to face the disease positively,reduce disease activity,and improve patients’self-nursing ability and quality of life.

Assessment of the Implementation of Energy Conservation Opportunities Arising from Energy Audits;A Study of Four-Star and Five-Star Hotels in Nairobi Kenya

This study assesses the implementation of energy conservation opportunities in four-star and five-star hotels in Nairobi. The Covid-19 pandemic had a significant impact on the Hospitality Industry. Currently, there is a growing inclination to furnish guests with superior and sustainable services in an energy-efficient and eco-friendly way. Comprehensive research was conducted from energy audits gathered from the establishments and contracted auditing companies, on top of this, hotel staff were given digital questionnaires. To add to the data, the researcher surveyed the hotels with engineering managers. The Energy Audits found that all 10 hotels had adopted Energy Conservation Opportunities (ECOs). After further analysis, the mean adoption rate of Energy Conservation Opportunities (ECOs) during the past three years was 55.83%, which was below the aim of 100%. According to studies, hotel staff manages energy to cut costs. The researcher found that hotels use up a lot of energy. However, they have conservation potential, depending on government policies, costs, ease of implementation, and management commitment to sustainable practices. Essentially, Energy Conservation Opportunities (ECOs) reduce energy expenditures and boost reliable revenues, especially during high energy prices and uncertainty.