Computer-assisted three-dimensional individualized extreme liver resection for hepatoblastoma in proximity to the major liver vasculature

BACKGROUND The management of hepatoblastoma(HB)becomes challenging when the tumor remains in close proximity to the major liver vasculature(PMV)even after a full course of neoadjuvant chemotherapy(NAC).In such cases,extreme liver resection can be considered a potential option.AIM To explore whether computer-assisted three-dimensional individualized extreme liver resection is safe and feasible for children with HB who still have PMV after a full course of NAC.METHODS We retrospectively collected data from children with HB who underwent surgical resection at our center from June 2013 to June 2023.We then analyzed the detailed clinical and three-dimensional characteristics of children with HB who still had PMV after a full course of NAC.RESULTS Sixty-seven children diagnosed with HB underwent surgical resection.The age at diagnosis was 21.4±18.8 months,and 40 boys and 27 girls were included.Fifty-nine(88.1%)patients had a single tumor,39(58.2%)of which was located in the right lobe of the liver.A total of 47 patients(70.1%)had PRE-TEXT III or IV.Thirty-nine patients(58.2%)underwent delayed resection.After a full course of NAC,16 patients still had close PMV(within 1 cm in two patients,touching in 11 patients,compressing in four patients,and showing tumor thrombus in three patients).There were 6 patients of tumors in the middle lobe of the liver,and four of those patients exhibited liver anatomy variations.These 16 children underwent extreme liver resection after comprehensive preoperative evaluation.Intraoperative procedures were performed according to the preoperative plan,and the operations were successfully performed.Currently,the 3-year event-free survival of 67 children with HB is 88%.Among the 16 children who underwent extreme liver resection,three experienced recurrence,and one died due to multiple metastases.CONCLUSION Extreme liver resection for HB that is still in close PMV after a full course of NAC is both safe and feasible.This approach not only reduces the necessity for liver transplantation but also results in a favorable prognosis.Individualized three-dimensional surgical planning is beneficial for accurate and complete resection of HB,particularly for assessing vascular involvement,remnant liver volume and anatomical variations.

Diagnostic efficacy of virtual organ computer-assisted analysis in measuring the volume ratio of subchorionic hematoma with serum progesterone

BACKGROUND Subchorionic hematoma(SCH)is a common complication in early pregnancy characterized by the accumulation of blood between the uterine wall and the chorionic membrane.SCH can lead to adverse pregnancy outcomes such as miscarriage,preterm birth,and other complications.Early detection and accurate assessment of SCH are crucial for appropriate management and improved pregnancy outcomes.AIM To evaluate the diagnostic efficacy of virtual organ computer-assisted analysis(VOCAL)in measuring the volume ratio of SCH to gestational sac(GS)combined with serum progesterone on early pregnancy outcomes in patients with SCH.METHODS A total of 153 patients with SCH in their first-trimester pregnancies between 6 and 11 wk were enrolled.All patients were followed up until a gestational age of 20 wk.The parameters of transvaginal two-dimensional ultrasound,including the circumference of SCH(Cs),surface area of SCH(Ss),circumference of GS(Cg),and surface area of GS(Sg),and the parameters of VOCAL with transvaginal three-dimensional ultrasound,including the three-dimensional volume of SCH(3DVs)and GS(3DVg),were recorded.The size of the SCH and its ratio to the GS size(Cs/Cg,Ss/Sg,3DVs/3DVg)were recorded and compared.RESULTS Compared with those in the normal pregnancy group,the adverse pregnancy group had higher Cs/Cg,Ss/Sg,and 3DVs/3DVg ratios(P<0.05).When 3DVs/3DVg was 0.220,the highest predictive performance predicted adverse pregnancy outcomes,resulting in an AUC of 0.767,and the sensitivity,specificity were 70.2%,75%respectively.VOCAL measuring 3DVs/3DVg combined with serum progesterone gave a diagnostic AUC of 0.824 for early pregnancy outcome in SCH patients,with a high sensitivity of 82.1%and a specificity of 72.1%,which showed a significant difference between AUC.CONCLUSION VOCAL-measured 3DVs/3DVg effectively quantifies the severity of SCH,while combined serum progesterone better predicts adverse pregnancy outcomes.

Computer-assisted rescue of the inferior mesenteric artery in a child with a giant ganglioneuroblastoma: A case report

BACKGROUND Ganglioneuroblastoma(GNB)is a peripheral neuroblastoma(NB)with malignant degree between highly malignant NB and benign ganglioma(GN).Pathology is the gold standard of diagnosis.Although GNB is not uncommon in children,biopsy alone may lead to an inaccurate diagnosis,especially for giant tumors.However,surgical resection may be associated with significant complications.Here,we report a case of computer-assisted surgical resection of a giant GNB in a child and successful rescue of the inferior mesenteric artery.CASE SUMMARY A 4-year-old girl was admitted to our department for a giant retroperitoneal lesion,which was considered to be an NB by her local hospital.The symptoms of the girl disappeared spontaneously without treatment.On physical examination,a mass of about 10 cm×7 cm could be palpated in her abdomen.Ultrasonography and contrast-enhanced computed tomography performed in our hospital also showed an NB,and there was a very thick blood vessel inside the tumor.However,aspiration biopsy revealed GN.Surgical resection is the best treatment option for this giant benign tumor.For precise preoperative evaluation,threedimensional reconstruction was performed.It was clear that the tumor was close to the abdominal aorta.The superior mesenteric vein was pushed forward,and the inferior mesenteric artery passed through the tumor.Because GN generally does not invade blood vessels,we split the tumor with a CUSA knife during the operation and found that there was indeed a straight and intact vascular sheath.Arterial pulsation was observed in the completely exposed inferior mesenteric artery.The pathologists interpreting the tissue finally diagnosed it as a mixed GNB(GNBi),which is more malignant than GN.However,both GN and GNBi usually have a good prognosis.CONCLUSION This was a case of successful surgical resection of a giant GNB,and aspiration biopsy underestimated the pathological staging of the tumor.Preoperative three-dimensional reconstruction assisted with the radical resection of the tumor and rescue of the inferior mesenteric artery.

Assessment of Appropriateness of Diagnostic Lymph Node Tissue Collection from the Operating Theater and by Interventional Radiologist. A Clinical Audit

Background: Appropriate sample requesting, collecting and timely dispatch to the appropriate laboratory is essential in establishing diagnosis of pathologies with lesions. Much time and effort may be wasted if this is not done according to certain standards. We conducted this study to assess the route of lymph node samples from requests to reaching the laboratories. Methods: We conducted an audit over a period from 4th June until 10th Aug 2023. Data for all the procedures performed over this period on lymph node samples (was entered into and analysed using Excel. Results: A total of eighteen samples for sixteen patients were obtained during this period. Median age of the patients was 34 years (19 - 73) with a M:F ratio of 5:11. Among the IR samples, nine samples were from the neck, three from inguinal area and one from axilla. Seven samples (53.8%) were tru-cut biopsies, six samples (46.15%) were FNA. All samples were sent to the pathology laboratory fixed in formalin. Samples for TB were sent only for five cases (31.25%) and for only two cases (12.5%) were samples sent for bacterial culture. For the OR samples, none were sent for either bacterial culture or TB. Overall, eight patients (50%) were not investigated for any infectious etiologies like brucella, toxoplasmosis, CMV, EBV plus other possible causes. Repeat sampling was required for 25% of patients (within and out of the audit period). Conclusions: to avoid delays in making diagnoses, it is paramount to consider infectious etiologies as possible diagnosis for lymphadenopathy and request appropriate investigations. This requires liaising with infectious diseases/clinical microbiology experts to guide regarding types of samples, types of media and timely dispatch to the correct laboratory.

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.

Sec-Auditor:A Blockchain-Based Data Auditing Solution for Ensuring Integrity and Semantic Correctness

Currently,there is a growing trend among users to store their data in the cloud.However,the cloud is vulnerable to persistent data corruption risks arising from equipment failures and hacker attacks.Additionally,when users perform file operations,the semantic integrity of the data can be compromised.Ensuring both data integrity and semantic correctness has become a critical issue that requires attention.We introduce a pioneering solution called Sec-Auditor,the first of its kind with the ability to verify data integrity and semantic correctness simultaneously,while maintaining a constant communication cost independent of the audited data volume.Sec-Auditor also supports public auditing,enabling anyone with access to public information to conduct data audits.This feature makes Sec-Auditor highly adaptable to open data environments,such as the cloud.In Sec-Auditor,users are assigned specific rules that are utilized to verify the accuracy of data semantic.Furthermore,users are given the flexibility to update their own rules as needed.We conduct in-depth analyses of the correctness and security of Sec-Auditor.We also compare several important security attributes with existing schemes,demonstrating the superior properties of Sec-Auditor.Evaluation results demonstrate that even for time-consuming file upload operations,our solution is more efficient than the comparison one.

Constructing a Triangular Linkage Model of Government Audit,Social Audit,and Internal Audit to Promote High-Quality Development of Audit Services

It is a complex and important topic to study the linkage mechanism of government audit,social audit,and internal audit in the context of China’s high-quality economic development.The implementation of measures,such as establishing a sound and perfect organizational safeguard mechanism,strengthening project collaborative audit mechanism,enhancing the mechanism for utilizing audit results,and establishing an audit and rectification joint mechanism can promote the efficient operation of the audit supervision system and the high-quality development of audit services.

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.

Impact of an official accountability audit on industrial structure adjustment:a case study of environmental regulation in China

As a unique environmental regulation in China,the official accountability audit was piloted in 2014.With a focus on prioritizing the ecological environment,officials in pilot districts have implemented economic construction,adjusted industrial structures,and promoted coordinated development between the economy and environment.The effects of implementation have garnered widespread attention from society.However,there is limited research on the impact of an accountability audit on industrial structure adjustments.Using the“Accountability Audit of Officials for Natural Resource Assets(Trial)”released in 2015 as a quasi-natural experiment,this study collected panel data from 279 cities between 2013 and 2017.It then empirically analyzed the impact mechanism and effects of the accountability audit on industrial structure adjustment using the Propensity Score Matching and Difference-in-Differences model.The research findings indicate that the accountability audit directly impacted industrial structure adjustment,promoting the upgrading of the primary industry to the secondary industry and restricting the development of the tertiary industry.In addition,the audit is beneficial for enterprise entry,but not conducive to technological innovation,and has no significant impact on foreign direct investment.This conclusion fills a gap in the existing research and provides valuable insights for policymakers.

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.

Research on Audit Risks in the Recognition of Data Assets on Financial Statements

This paper explores the audit risks associated with the recognition of data assets on financial statements,focusing on the complexities arising from their replicability,unique valuation patterns,and contextual dependencies.It identifies major misstatement risks at both the financial statement and assertion levels,including the potential for management to exaggerate data asset values,uncertainties in valuation methods,and deficiencies in data governance and internal controls.Additionally,auditors’lack of professional knowledge and inappropriate audit methods can lead to inspection risks.The paper emphasizes the urgent need for enhanced accounting standards for data assets,effective guidelines for their recognition and measurement,and robust internal controls.Furthermore,it advocates for the exploration of effective valuation methods and the incorporation of advanced technologies,such as big data and AI,into auditing practices.By improving auditor training and methodologies,organizations can better manage the inherent risks associated with data asset auditing.

Exploration of Interdisciplinary Integration in Teaching Reform of Legal Studies and Auditing

This paper attempts to explore interdisciplinary integration from four aspects:the necessity of interdisciplinary integration between legal studies and auditing,the difficulties and challenges encountered in this integration,the ideas for teaching reform in the context of interdisciplinary integration,and the expected outcomes.The aim is to achieve an organic integration of legal studies and auditing through systematic teaching reforms,thereby providing students with comprehensive and integrated knowledge and skills training,ensuring the quality of talent cultivation,and adapting to the needs of social development.

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。

Computer-assisted Surgery for Scaphoid Fracture

The computer-assisted surgery (CAS)has significantly improved the accuracy, reliability and outcomes of traumatic,spinal,nerve surgery and many other operations with a less invasive way.The application of CAS for scaphoid fractures remains experimental.The related studies are scanty and most of them are cadaver researches.Some intrinsic defects from the registration procedure,scan and immobilization of limbs may inevitably result in deviations. Some deviations become more obvious with operations of small bones (such as scaphoid)although they are acceptable for spine and other orthopedic surgeries.We reviewed the current literatures on the applications of CAS for scaphoid operation and summarized technical principles,scan and registration methods,immobilization of limbs and their outcomes.On the basis of the data,we analyzed the limitations of this technique and envisioned its future development.

Establishment and validation of a computer-assisted colonic polyp localization system based on deep learning

BACKGROUND Artificial intelligence in colonoscopy is an emerging field,and its application may help colonoscopists improve inspection quality and reduce the rate of missed polyps and adenomas.Several deep learning-based computer-assisted detection(CADe)techniques were established from small single-center datasets,and unrepresentative learning materials might confine their application and generalization in wide practice.Although CADes have been reported to identify polyps in colonoscopic images and videos in real time,their diagnostic performance deserves to be further validated in clinical practice.AIM To train and test a CADe based on multicenter high-quality images of polyps and preliminarily validate it in clinical colonoscopies.METHODS With high-quality screening and labeling from 55 qualified colonoscopists,a dataset consisting of over 71000 images from 20 centers was used to train and test a deep learning-based CADe.In addition,the real-time diagnostic performance of CADe was tested frame by frame in 47 unaltered full-ranged videos that contained 86 histologically confirmed polyps.Finally,we conducted a selfcontrolled observational study to validate the diagnostic performance of CADe in real-world colonoscopy with the main outcome measure of polyps per colonoscopy in Changhai Hospital.RESULTS The CADe was able to identify polyps in the test dataset with 95.0%sensitivity and 99.1%specificity.For colonoscopy videos,all 86 polyps were detected with 92.2%sensitivity and 93.6%specificity in frame-by-frame analysis.In the prospective validation,the sensitivity of CAD in identifying polyps was 98.4%(185/188).Folds,reflections of light and fecal fluid were the main causes of false positives in both the test dataset and clinical colonoscopies.Colonoscopists can detect more polyps(0.90 vs 0.82,P<0.001)and adenomas(0.32 vs 0.30,P=0.045)with the aid of CADe,particularly polyps<5 mm and flat polyps(0.65 vs 0.57,P<0.001;0.74 vs 0.67,P=0.001,respectively).However,high efficacy is not realized in colonoscopies with inadequate bowel preparation and withdrawal time(P=0.32;P=0.16,respectively).CONCLUSION CADe is feasible in the clinical setting and might help endoscopists detect more polyps and adenomas,and further confirmation is warranted.

A comparison of conventional and computer-assisted semen analysis.（CRISMAS software） using samples from 166 young Danish men

The aim of the present study was to compare assessments of sperm concentration and sperm motility analysed by conventional semen analysis with those obtained by computer-assisted semen analysis （CASA） （Copenhagen Rigshospitalet Image House Sperm Motility Analysis System （CRISMAS） 4.6 software） using semen samples from 166 young Danish men. The CRISMAS software identifies sperm concentration and classifies spermatozoa into three motility categories. To enable comparison of the two methods, the four motility stages obtained by conventional semen analysis were, based on their velocity classifications, divided into three stages, comparable to the three CRISMAS motility categories： rapidly progressive （A）, slowly progressive （B） and non-progressive （C＋ D）. Differences between the two methods were large for all investigated parameters （P〈0.001）. CRISMAS overestimated sperm concentration and the proportion of rapidly progressive spermatozoa and, consequently, underestimated the percentages of slowly progressive and non-progressive spermatozoa, compared to the conventional method. To investigate whether results drifted according to time of semen analysis, results were pooled into quarters according to date of semen analysis. CRISMAS motility results appeared more stable over time compared to the conventional analysis; however, neither method showed any trends. Apparently, CRISMAS CASA results and results from the conventional method were not comparable with respect to sperm concentration and motility analysis. This needs to be accounted for in clinics using this software and in studies of determinants of these semen characteristics.

Glutathione Peroxidase Revisited—Simulation of the Catalytic Cycle by Computer-Assisted Molecular Modelling

Glutathione peroxidase, the first example of selenoproteins identified in mammals, was subjected to force field calculations and molecular dynamics in order to enable a clearer comprehension of enzymatic selenium catalysis. Starting from the established X-ray structure of bovine GPX, all kinetically defined intermediates and enzyme substrate complexes were modelled. The models thus obtained support the hypothesis that the essential steps of the catalysis are three distinct redox changes of the active site selenium which, in the ground state, presents itself at the surface of selenoperoxidases as the center of a characteristic triad built by selenocysteine, glutarnine and tryptophan. In GPX, four arginine residues and a lysine residue provide an electrostatic architecture which, in each reductive step, directs the donor substrate GSH towards the catalytic center in such a way that 1ts sulfhydryl group must react with the selenium moiety. To this end, different equally efficient modes of substrate binding appear possible. The models are consistent with substrate specificity data, kinetic pattern and other functional characteristics of the enzyme. Comparison of molecular models of GPX with those of other members of the GPX superfamily reveals that the cosubstrate binding mechanisrns are unique for the classical type of cytosolic glutathione peroxidases but cannot operate e. g. in plasma GPX and phospholipid hydroperoxide GPX. The structural differences between the selenoperoxidases, shown to be relevant to their specificities, are discussed in terms of functional diversification within the GPX superfamily