Search results for: audit report lag

Authors: Ziwei Xu

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The increasing emphasis on mobility has driven the application of innovative communication technologies across various industries. In the retail sector, Near Field Communication (NFC) has emerged as a significant and transformative technology, particularly in the payment and retail supermarket sectors. NFC enables new payment methods, such as electronic wallets, and enhances information management in supermarkets, contributing to the growth of the trade. This report presents a comprehensive analysis of NFC technology, focusing on five key aspects. Firstly, it provides an overview of NFC, including its application methods and development history. Additionally, it incorporates Arthur's work on combinatorial evolution to elucidate the emergence and impact of NFC technology, while acknowledging the limitations of the model in analyzing NFC. The report then summarizes the positive influence of NFC on the retail industry along with its associated constraints. Furthermore, it explores the adoption of NFC from both organizational and individual perspectives, employing the Best Predictors of organizational IT adoption and UTAUT2 models, respectively. Finally, the report discusses the potential future replacement of NFC with biometrics technology, highlighting its advantages over NFC and leveraging Arthur's model to investigate its future development prospects.

Keywords: innovation, NFC, industry, biometrics

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Authors: Nureni O. Adeboye, Dawud A. Agunbiade

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This research attempts to investigate the effects of heteroscedasticity and periodicity in a Panel Data Regression Model (PDRM) by extending previous works on balanced panel data estimation within the context of fitting PDRM for Banks audit fee. The estimation of such model was achieved through the derivation of Joint Lagrange Multiplier (LM) test for homoscedasticity and zero-serial correlation, a conditional LM test for zero serial correlation given heteroscedasticity of varying degrees as well as conditional LM test for homoscedasticity given first order positive serial correlation via a two-way error component model. Monte Carlo simulations were carried out for 81 different variations, of which its design assumed a uniform distribution under a linear heteroscedasticity function. Each of the variation was iterated 1000 times and the assessment of the three estimators considered are based on Variance, Absolute bias (ABIAS), Mean square error (MSE) and the Root Mean Square (RMSE) of parameters estimates. Eighteen different models at different specified conditions were fitted, and the best-fitted model is that of within estimator when heteroscedasticity is severe at either zero or positive serial correlation value. LM test results showed that the tests have good size and power as all the three tests are significant at 5% for the specified linear form of heteroscedasticity function which established the facts that Banks operations are severely heteroscedastic in nature with little or no periodicity effects.

Keywords: audit fee lagrange multiplier test, heteroscedasticity, lagrange multiplier test, Monte-Carlo scheme, periodicity

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Authors: Satoshi Furukawa, Satomu Morita, Katsuji Nishi, Masahito Hitosugi

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A 75-year-old woman took thyroidectomy forty years previously. Enlarged masses were seen at autopsy just above and below the left clavicle. We proved the diagnosis of papillary thyroid cancer (PTC) and lung metastasis by histological examinations. The prognosis of PTC is excellent; the 10-year survival rate ranges between 85 and 99%. Lung metastases may be found in 10% of the patients with PTC. We report an unusual case of recurrence of PTC with metastasis to the lung.

Keywords: papillary thyroid cancer, lung metastasis, autopsy, histopathological findings

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Authors: Aisling Eves, Andrew Pieri, Ross McLean, Nerys Forester

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Background: The breast unit local guideline recommends that 12 cores should be used in a stereotactic-guided biopsy to diagnose DCIS. Twelve cores are regarded to provide good diagnostic value without removing more breast tissue than necessary. This study aimed to determine compliance with guidelines and investigated how the number of cores impacted upon the re-excision rate and size discrepancies. Methods: This single-centre retrospective cohort study of 72 consecutive breast screened patients with <15mm DCIS on radiological report underwent stereotactic-guided core biopsy and subsequent surgical excision. Clinical, radiological, and histological data were collected over 5 years, and ASCO guidelines for margin involvement of <2mm was used to guide the need for re-excision. Results: Forty-six (63.9%) patients had <12 cores taken, and 26 (36.1%) patients had ≥12 cores taken. Only six (8.3%) patients had 12 cores taken in their stereotactic biopsy. Incomplete surgical excision was seen in 17 patients overall (23.6%), and of these patients, twelve (70.6%) had fewer than 12 cores taken (p=0.55 for the difference between groups). Mammogram and biopsy underestimated the size of the DCIS in this subgroup by a median of 15mm (range: 6-135mm). Re-excision was required in 9 patients (12.5%), and five patients (6.9%) were found to have invasive ductal carcinoma on excision (80% had <12 cores, p=0.43). Discussion: There is poor compliance with the breast unit local guidelines and higher rates of re-excision in patients who did not have ≥12 cores taken. Taking ≥12 cores resulted in fewer missed invasive cancers lower incomplete excision and re-excision rates.

Keywords: stereotactic core biopsy, DCIS, breast screening, Re-excision rates, core biopsy

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Authors: B. Kenny, M. Dixon, A. Boshell

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The use of alcoholic surgical prep was recently introduced into the Royal Newcastle Center for elective procedures. In the past 3 months there have been a significant number of burns believed to be related to ‘pooling’ of this surgical prep in patients undergoing procedures where they are placed in the lateral position with hip bolsters. The aim of the audit was to determine the reason for the burns, analyze what pre-existing factors may contribute to the development of the burns and what can be changed to prevent further burns occurring. All patients undergoing a procedure performed on the hip who were placed in the lateral position with sacral and anterior, superior iliac spine (ASIS) support with ‘bolsters’ were included in the audit. Patients who developed a ‘burn’ were recorded, details of the surgery, demographics, surgical prep used and length of surgery were obtained as well as photographs taken to document the burn. Measures were then taken to prevent further burns and the efficacy was documented. Overall 14 patients developed burns over the ipsilateral ASIS. Of these, 13 were Total Hip Arthroplasty (THA) and 1 was a removal of femoral nail. All patients had Chlorhexidine 0.5% in Alcohol 70% Tinted Red surgical preparation or Betadine Alcoholic Skin Prep (70% etoh). Patients were set up in the standard lateral decubitus position with sacral and bilateral ASIS bolsters with a valband covering. 86% of patients were found to have pre-existing hypersensitivities to various substances. There is very little literature besides a few case reports on surgical prep-related burns. The case reports that do exist are related to the use of tourniquet-related burns and there is no mention in the literature examining ‘bolster’ related burns. The burns are hypothesized to be caused by pooling of the alcoholic solution which is amplified by the use of Valband.

Keywords: arthroplasty, chemical burns, wounds, rehabilitation

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Authors: Adeyinka Adesanya, Isaac Bamgboye

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There is a growing need to develop the processes to produce renewable fuels and chemicals due to the economic, political, and environmental concerns associated with fossil fuels. Lignocellulosic biomass is an excellent renewable feedstock because it is both abundant and inexpensive. This project aims at producing bioethanol from lignocellulosic plants (Sorghum Arundinacieum and Heteropogon Contortus) by biochemical means, computing the energy audit of the process and determining the fuel properties of the produced ethanol. Acid pretreatment (0.5% H2SO4 solution) and enzymatic hydrolysis (using malted barley as enzyme source) were employed. The ethanol yield of wild sorghum was found to be 20% while that of spear grass was 15%. The fuel properties of the bioethanol from wild sorghum are 1.227 centipoise for viscosity, 1.10 g/cm3 for density, 0.90 for specific gravity, 78 °C for boiling point and the cloud point was found to be below -30 °C. That of spear grass was 1.206 centipoise for viscosity, 0.93 g/cm3 for density 1.08 specific gravity, 78 °C for boiling point and the cloud point was also found to be below -30 °C. The energy audit shows that about 64 % of the total energy was used up during pretreatment, while product recovery which was done manually demanded about 31 % of the total energy. Enzymatic hydrolysis, fermentation, and distillation total energy input were 1.95 %, 1.49 % and 1.04 % respectively, the alcoholometric strength of bioethanol from wild sorghum was found to be 47 % and the alcoholometric strength of bioethanol from spear grass was 72 %. Also, the energy efficiency of the bioethanol production for both grasses was 3.85 %.

Keywords: lignocellulosic biomass, wild sorghum, spear grass, biochemical conversion

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Authors: Raja Ezman Raja Shariff

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Acute kidney injury (AKI) is commonly seen in inpatients, and places a great cost on the NHS and patients. Timely and appropriate management is both nephron sparing and potentially life-saving. Ultrasound scanning (USS) is a well-recognised method for stratifying patients. Subsequently, the NICE AKI guidance has defined groups in whom scanning is recommended within 6 hours of request (pyonephrosis), within 24 hours (obstruction/cause unknown), and in whom routine scanning isn't recommended (cause for AKI identified). The audit looks into whether Stockport NHS Trust USS practice was in line with such recommendations. The audit evaluated 92 patients with AKI who had USS, between 01/01/14 to 30/04/14. Data collection was divided into 2 parts. Firstly, radiology request cards and the online imaging software (PACS) were evaluated. Then, the electronic case notes (ADVANTIS) was evaluated further. Based on request cards, 10% of requests were for pyonephrosis. Only 33% were scanned within 6hours and a further 33% within 24hours. 75% were requested for possible obstructions and unknown cause collectively. Of those due to possible obstruction, 71% of patients were scanned within 24 hours. Of those with unknown cause, 50% were scanned within 24 hours. 15% of requests had a cause declared and so potentially did not require scanning. Evaluation of the patients’ notes suggested further interesting findings. Firstly, potentially 39% of patients had a known cause for AKI, therefore, did not need USS. Subsequently, the cohort of unknown cause and possible obstruction was collectively reduced to 45%. Alarmingly the patient cohort with possible pyonephrosis went up to 16%, suggesting an under-recognition of this life-threatening condition. We plan to highlight these findings within our institution and make changes to encourage more appropriate requesting and timely scanning. Time will tell if we manage to save or increase our costs in this cost-conscious NHS. Patient benefits, though, seem to be guaranteed.

Keywords: AKI, ARF, kidney, renal

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Authors: Jasmine Renner, Alice Njuguna

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The booming technological revolution is driving a change in the mode of delivery systems especially for e-learning and distance learning in higher education. The report and findings of the study; an assessment of digital platforms, student online learning, teaching pedagogies, research and training at Kenya College of Accounting University (hereinafter 'KCA') was undertaken as a joint collaboration project between the Carnegie African Diaspora Fellowship and input from the staff, students and faculty at KCA University. The participants in this assessment/research met for selected days during a six-week period during which, one-one consultations, surveys, questionnaires, foci groups, training, and seminars were conducted to ascertain 'online learning and teaching, curriculum development, research and training at KCA.' The project was organized into an eight-week project workflow with each week culminating in project activities designed to assess digital online teaching and learning at KCA. The project also included the training of distance learning instructors at KCA and the evaluation of KCA’s distance platforms and programs. Additionally, through a curriculum audit and redesign, the project sought to enhance the curriculum development activities related to of distance learning at KCA. The findings of this assessment/research represent the systematic deliberate process of gathering, analyzing and using data collected from DL students, DL staff and lecturers and a librarian personnel in charge of online learning resources and access at KCA. We engaged in one-on-one interviews and discussions with staff, students, and faculty and collated the findings to inform practices that are effective in the ongoing design and development of eLearning earning at KCA University. Overall findings of the project led to the following recommendations. First, there is a need to address infrastructural challenges that led to poor internet connectivity for online learning, training needs and content development for faculty and staff. Second, there is a need to manage cultural impediments within KCA; for example fears of vital change from one platform to another for effectiveness and Institutional goodwill as a vital promise of effective online learning. Third, at a practical and short-term level, the following recommendations based on systematic findings of the research conducted were as follows: there is a need for the following to be adopted at KCA University to promote the effective adoption of online learning: a) an eLearning compatible faculty lab, b) revision of policy to include an eLearn strategy or strategic management, c) faculty and staff recognitions engaged in the process of training for the adoption and implementation of eLearning and d) adequate website resources on eLearning. The report and findings represent a comprehensive approach to a systematic assessment of online teaching and learning, research and training at KCA.

Keywords: e-learning, digital platforms, student online learning, online teaching pedagogies

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Authors: Emma Carr, Bilal Aslam-Pervez, David Laraway

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Litigation against surgeons and hospitals continues to increase in Western countries. While verbal consent is all that is required legally, it has for a long time been considered that written consent offers proof of discussion and interaction between the surgeon and the patient. Inadequate consenting of patients continues in the United Kingdom leaving surgeons and Health Trusts open to litigation. We present a standardised consent form which improves patient autonomy and engagement. The General Medical Council recommends that all material risks relevant to the patient are discussed and recorded prior to undergoing surgery, regardless of how likely they are to occur. Current literature was reviewed to evaluate complications associated with surgical management of mandible fractures. Analysis of risks on 52 consent forms were analysed within the Glasgow OMFS department, leading to a procedure-specific form being designed and implemented. This audit showed that the documentation of risks on consent forms was extremely variable- with uncommon risks not being recorded. Interestingly, not a single consent form was found which highlighted all the risks associated with mandible fractures. Our re-audit data confirms 100% of risks being discussed when a procedure specific form is utilised. Our hope, is to introduce further forms for inclusion on the BAOMS website and peripheral distribution. The forms are quick and easy to print and leave more time for consultation with the patient. Whilst we are under no illusion that the forms may not decrease the incidence of intended litigation, we feel confident that they will decrease the chances of it being successful.

Keywords: consent, litigation, mandible fracture, surgery

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Authors: Jong-Hyo Park, Eunyoung Choi, Jae-Yeon Lim, Seon-Suk Lee, Yeong-Rong Koo, Ji-Ung Kwon, Kyung-Sung Kim, Jong-Ik Lee, Juhan Park, Hyun-Kyu Lee, Won-Kyoung Oh, Jisang Lee, Jiwon Choe

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Due to COVID-19, cyber violence among youths has soared as they spend more time online than before. In contrast to the deepening concerns, measurement tools that can assess the vulnerability of cyber violence in individual youths still need to be supplemented. The measurement tools lack consideration of various factors related to cyber violence among youths. Most of the tools are self-report questionnaires, and these adolescents' self-report questionnaire forms can underestimate the harmful behavior and overestimate the damage experience. Therefore, this study aims to develop a multi-report measurement tool for youths that can reliably measure individuals' ecological factors related to cyber violence. The literature review explored factors related to cyber violence, and the questions were constructed. The face validity of the questions was confirmed by conducting focus group interviews. Exploratory and confirmatory factor analyses (N=671) were also conducted for statistical validation. This study developed a multi-report measurement tool for cyber violence with 161 questions, consisting of six domains: online behavior, cyber violence awareness, victimization-perpetration-witness experience, coping efficacy (individuals, peers, teachers, and parents), psychological characteristics, and pro-social capabilities. In addition to self-report from a youth respondent, this measurement tool includes peers, teachers, and parents reporting for the respondent. It is possible to reliably measure the ecological factors of individual youths who are vulnerable or highly resistant to cyber violence. In schools, teachers could refer to the measurement results for guiding students, better understanding their cyber violence conditions, and assessing their pro-social capabilities. With the measurement results, teachers and police officers could detect perpetrators or victims and intervene immediately. In addition, this measurement tool could analyze the effects of the prevention and intervention programs for cyber violence and draw appropriate suggestions.

Keywords: adolescents, cyber violence, cyber violence measurement tool, measurement tool, multi-report measurement tool, youths

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Authors: jihen ayadi sellami

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The rapid evolution of the global financial landscape has led to increased attention to corporate tax policies and the need to understand the factors that influence their tax behavior. In order to mitigate any residual loss for shareholders resulting from tax aggressiveness and resolve the agency problem, appropriate systems that separate the function of management from that of controlling are needed. In this context of growing concerns to limit aggressive corporate taxation practices through governance, this study discusses. Its aims is to examine the influence of six key characteristics of the board of directors (board size, diligence, CEO duality, presence of audit committees, gender diversity and independence of directors), given a governance mechanism, on the tax decisions of non-financial corporations in the United State. In fact, using a sample of 90 non-financial US firms from S&P 500 over a period of 4 years going from 2014 to 2017, the results based on a multivariate linear regression highlight significant associations between these characteristics and corporate tax policy. Notably, larger board, gender diversity, diligence and increased director independence appear to play an important role in reducing aggressive taxation. While duality has a positive and significant correlation with tax aggressiveness, that can be explained by the fact that the manager did properly exploit his specific position within the company. These findings contribute to a deeper understanding of how board characteristics can influence corporate tax management, providing avenues for more effective corporate governance and more responsible tax decision-making

Keywords: tax aggressiveness, board of directors, board size, CEO duality, audit committees, gender diversity, director independence, diligence, corporate governance, united states

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Authors: Aarati Susan Mathew, Radhika Narendra Patel, Jiji Mathew

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A retrospective study conducted at Christian Medical College (CMC) Teaching Hospital, Vellore, India on 14th August 2014 to assess the accuracy of clinically estimated foetal weight upon labour admission. Estimating foetal weight is a crucial factor in assessing maternal and foetal complications during and after labour. Medical notes of ninety-eight postnatal women who fulfilled the inclusion criteria were studied to evaluate the correlation between their recorded Estimated Foetal Weight (EFW) on admission and actual birth weight (ABW) of the newborn after delivery. Data concerning maternal and foetal demographics was also noted. Accuracy was determined by absolute percentage error and proportion of estimates within 10% of ABW. Actual birth weights ranged from 950-4080g. A strong positive correlation between EFW and ABW (r=0.904) was noted. Term deliveries (≥40 weeks) in the normal weight range (2500-4000g) had a 59.5% estimation accuracy (n=74) compared to pre-term (<40 weeks) with an estimation accuracy of 0% (n=2). Out of the term deliveries, macrosomic babies (>4000g) were underestimated by 25% (n=3) and low birthweight (LBW) babies were overestimated by 12.7% (n=9). Registrars who estimated foetal weight were accurate in babies within normal weight ranges. However, there needs to be an improvement in predicting weight of macrosomic and LBW foetuses. We have suggested the use of an amended version of the Johnson’s formula for the Indian population for improvement and a need to re-audit once implemented.

Keywords: clinical palpation, estimated foetal weight, pregnancy, India, Johnson’s formula

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Authors: Rafael Ricieri, Rogerio Barros, Francisco Clovis

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Objective– The Objective of this is study is to report a rare case of dermoid cyst, with a sublingual location and cutaneous fistula in a 4 year-old child.Methods: This study is a case report. The main study instrument was the medical record and the radiological and intraoperative image bank. Results: Infants with congenital cervical lesions eventually need tomography for diagnostic elucidation, and health services should be structured to perform sedation and thin tomographic sections in order to reduce morbidity.

Keywords: congenital, sublingual dermoid cyst, fistula, pediatric surgery, head and kneck surgery

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Authors: Rizwan Iqbal

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Introduction: Re-TURBT has been recommended by international guidelines for patients with non-muscle invasive bladder cancer (NMIBC) who are deemed high-risk. Indications for re-TURBTs remain controversial and studies show mixed outcomes. It should be performed when the initial TURBT specimen lacks detrusor muscle, has tumor stage pT1 or G3/high-grade, or where resection is deemed incomplete. This ensures complete resection of tumors that have a high risk of recurrence as well as accurately identifying any tumors which have been upstaged. The aim of this audit was to evaluate the quality of re-TURBTs in a district general hospital. Method: Data were retrospectively collected from 31 patients who had re-TURBTs between April 2021 and September 2022. Data included baseline demographics, time from initial to re-TURBT, quality of operation note, presence of residual tumor, complications, and administration of chemotherapy within 24 hours of the initial TURBT. Data collection remains ongoing at the time of writing. Results: The mean age was 76 years old and 71.0% of patients were male. 32.3% of patients had their re-TURBT within six weeks and 32.3% had intravesical chemotherapy administered within 24 hours of the initial TURBT. 74.2% of initial TURBTs had detrusor muscle present in the specimen. 48.4% of patients had residual disease following re-TURBT. Just one patient had their pathology upstaged at re-TURBT. The use of the TURBT proforma on the operation note was variable, with 51.6% and 38.7% of surgeons using the proforma after the initial and re-TURBT. Conclusion: Re-TURBT improves bladder cancer staging and is necessary in patients who are deemed high-risk in order to identify any upstaging or recurrence of the disease.

Keywords: urology, bladder cancer, turbt, cancer

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Authors: Prashant Neupane, Asmi Pandey, Mumna Ehsan, Katie Davies, Richard Lowsby

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Introduction/Background & aims: Safe and effective prescribing in hospitals, directly and indirectly, impacts the health of the patients. Even though digital prescribing in the National Health Service (NHS), UK has been used in lots of tertiary centers along with district general hospitals, a significant number of NHS trusts are still using paper prescribing. We came across lots of irregularities in our daily clinical practice when we are doing paper prescribing. The main aim of the study was to assess how safely and effectively are we prescribing at our hospital where there is no access to digital prescribing. Method/Summary of work: We conducted a prospective audit in the critical care department at Mid Cheshire Hopsitals NHS Foundation Trust in which 20 prescription charts from different patients were randomly selected over a period of 1 month. We assessed 16 multiple categories from each prescription chart and compared them to the standard trust guidelines on prescription. Results/Discussion: We collected data from 20 different prescription charts. 16 categories were evaluated within each prescription chart. The results showed there was an urgent need for improvement in 8 different sections. In 85% of the prescription chart, all the prescribers who prescribed the medications were not identified. Name, GMC number and signature were absent in the required prescriber identification section of the prescription chart. In 70% of prescription charts, either indication or review date of the antimicrobials was absent. Units of medication were not documented correctly in 65% and the allergic status of the patient was absent in 30% of the charts. The start date of medications was missing and alternations of the medications were not done properly in 35%of charts. The patient's name was not recorded in all desired sections of the chart in 50% of cases and cancellations of the medication were not done properly in 45% of the prescription charts. Conclusion(s): From the audit and data analysis, we assessed the areas in which we needed improvement in prescription writing in the Critical care department. However, during the meetings and conversations with the experts from the pharmacy department, we realized this audit is just a representation of the specialized department of the hospital where access to prescribing is limited to a certain number of prescribers. But if we consider bigger departments of the hospital where patient turnover is much more, the results could be much worse. The findings were discussed in the Critical care MDT meeting where suggestions regarding digital/electronic prescribing were discussed. A poster and presentation regarding safe and effective prescribing were done, awareness poster was prepared and attached alongside every bedside in critical care where it is visible to prescribers. We consider this as a temporary measure to improve the quality of prescribing, however, we strongly believe digital prescribing will help to a greater extent to control weak areas which are seen in paper prescribing.

Keywords: safe prescribing, NHS, digital prescribing, prescription chart

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Authors: Aakriti Chetan Shah, Elle Sein

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Background/purpose: Group B Streptococcus(GBS) is the leading cause of severe early onset infection in newborns, with the incidence of Early Onset Group B Streptococcus (EOGBS) in the UK and Ireland rising from 0.48 to 0.57 per 1000 births from 2000 to 2015. A WHO study conducted in 2017, has shown that 38.5% of cases can result in stillbirth and infant deaths. This is an important problem to consider as 20% of women worldwide have GBS colonisation and can suffer from these detrimental effects. Current Royal College of Obstetricians and Midwives (RCOG) guidelines do not recommend bacteriological screening for pregnant women due to its low sensitivity in antenatal screening correlating with the neonate having GBS but advise a patient information leaflet be given to pregnant women. However, a Healthcare Safety Investigation Branch (HSIB) 2019 learning report found that only 50% of trusts and health boards reported giving GBS information leaflets to all pregnant mothers. Therefore, this audit aimed to assess current practices of information dissemination about GBS at Chelsea & Westminster (C&W) Hospital. Methodology: A quantitative cross-sectional study was carried out using a questionnaire based on the RCOG GBS guidelines and the HSIB Learning report. The study was conducted in antenatal clinics at Chelsea & Westminster Hospital, from 29th January 2021 to 14th February 2021, with twenty-two practicing obstetricians and midwives participating in the survey. The main outcome measure was the proportion of obstetricians and midwives who disseminate information about GBS to pregnant women, and the reasons behind why they do or do not. Results: 22 obstetricians and midwives responded with 18 complete responses. Of which 12 were obstetricians and 6 were midwives. Only 17% of clinical staff routinely inform all pregnant women about GBS, and do so at varying timeframes of the pregnancy, with an equal split in the first, second and third trimester. The primary reason for not informing women about GBS was influenced by three key factors: Deemed relevant only for patients at high risk of GBS, lack of time in clinic appointments and no routine NHS screening available. Interestingly 58% of staff in the antenatal clinic believe it is necessary to inform all women about GBS and its importance. Conclusion: It is vital for obstetricians and midwives to inform all pregnant women about GBS due to the high prevalence of incidental carriers in the population, and the harmful effects it can cause for neonates. Even though most clinicians believe it is important to inform all pregnant women about GBS, most do not. To ensure that RCOG and HSIB recommendations are followed, we recommend that women should be given this information at 28 weeks gestation in the antenatal clinic. Proposed implementations include an information leaflet to be incorporated into the Mum and Baby app, an informative video and end-to-end digital clinic documentation to include this information sharing prompt.

Keywords: group B Streptococcus, early onset sepsis, Antenatal care, Neonatal morbidity, GBS

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Authors: Aroob Binhimd, Lyan Sayoti, Rana Almansour

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In recent years, artificial intelligence has grown drastically. This has led to the growth of educational programs to help students in solving educational problems and assist them in understanding certain topics. The purpose of this report is to investigate the Mathway application. Mathway is a mathematics software that teaches students how to solve and handle mathematical issues. The app allows students to insert questions manually on the platform or take a picture of the question, and then they get an answer to this mathematical question. It helps students enhance their performance in mathematics. This app can also be used to verify or check if their answers are correct. The report will include a questionnaire to collect data and analyze the users of this application.

Keywords: artificial intelligence, Mathway, mathematics, mathematical problems

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Authors: Ernest Nweke

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The work of Professional Accountants and Corporate governance are synonymous and cannot be divorced from each other. Organizations, profit and non-profit alike cannot implement sound corporate practices without inputs from Professional Accountants. In today’s dynamic corporate world, good corporate governance practice is a sine qua non. More so, following the corporate failures of the past decades like Enron and WorldCom, governments around the world, including Mongolia are becoming more proactive in ensuring sound corporate governance mechanisms. In the past fifteen years, the Mongolian government has taken several measures to establish and strengthen internal corporate governance structures in firms. This paper highlights the role of professional accountants and auditors play in ensuring that good corporate governance mechanisms are entrenched in listed companies in Mongolia. Both primary and secondary data are utilized in this research. In collection of primary data, Delphi method was used, securing responses from only knowledgeable senior employees, top managers, and some CEOs. Using this method, a total of 107 top-level company employees and executives randomly selected from 22 companies were surveyed; maximum of 5 and minimum of 4 from each company. These companies cut across several sectors. It was concluded that Professional Accountants play key roles in setting and maintaining firm governance. They do this by ensuring full compliance with all the requirements of good and sound corporate governance, establishing reporting, monitoring and evaluating standards, assisting in the setting up of proper controls, efficient and effective audit systems, sound fraud risk management and putting in place an overall vision for the enterprise. Companies with effective corporate governance mechanisms are usually strong and fraud-resilient. It was also discovered that companies with big 4 audit firms tend to have better governance structures in Mongolia.

Keywords: accountants, corporate disclosure, corporate failure, corporate governance

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Authors: Chyng Sun

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This brief report examines correlations between Korean men’s interest in gonzo pornography, perceptions of pornography’s functional value, and use of condoms. The report found that, neither a higher interest in gonzo or the perception that pornography is a source of sexual information was directly related to condom utilization. However, interest in gonzo pornography interacted with pornography perceptions to predict condomless sex. The findings suggest that Korean men who 1) had higher interest in viewing gonzo pornography, and 2) had a tendency to view pornography as a source of sexual information, are more likely to have sex without condoms. That is, when viewers consider pornography to be a form of sexual education, they are more likely to use the learned pornographic script to inform their sexual behavior.

Keywords: Korean, male, pornography, sexuality

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Authors: Kritchakhris Na-Wattanaprasert

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The objective of this research is to design and develop a prototype of a key performance indicator system this is suitable for warehouse management in a case study and use requirement. In this study, we design a prototype of key performance indicator system (KPI) for warehouse case study of furniture business by methodology in step of identify scope of the research and study related papers, gather necessary data and users requirement, develop key performance indicator base on balance scorecard, design pro and database for key performance indicator, coding the program and set relationship of database and finally testing and debugging each module. This study use Balance Scorecard (BSC) for selecting and grouping key performance indicator. The system developed by using Microsoft SQL Server 2010 is used to create the system database. In regard to visual-programming language, Microsoft Visual C# 2010 is chosen as the graphic user interface development tool. This system consists of six main menus: menu login, menu main data, menu financial perspective, menu customer perspective, menu internal, and menu learning and growth perspective. Each menu consists of key performance indicator form. Each form contains a data import section, a data input section, a data searches – edit section, and a report section. The system generates outputs in 5 main reports, the KPI detail reports, KPI summary report, KPI graph report, benchmarking summary report and benchmarking graph report. The user will select the condition of the report and period time. As the system has been developed and tested, discovers that it is one of the ways to judging the extent to warehouse objectives had been achieved. Moreover, it encourages the warehouse functional proceed with more efficiency. In order to be useful propose for other industries, can adjust this system appropriately. To increase the usefulness of the key performance indicator system, the recommendations for further development are as follows: -The warehouse should review the target value and set the better suitable target periodically under the situation fluctuated in the future. -The warehouse should review the key performance indicators and set the better suitable key performance indicators periodically under the situation fluctuated in the future for increasing competitiveness and take advantage of new opportunities.

Keywords: key performance indicator, warehouse management, warehouse operation, logistics management

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Authors: Igor Miňo, Lenka Lešková

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Over the past 80 years, open-field method has evolved as a commonly used tool for the analysis of animal behaviour. The study was carried out using 50 kennel-reared purebred puppies of the German Shepherd dog breed. All dogs were tested in 5^th, 7^th, and 9^th week of age. For the purpose of behavioural analysis, an open-field evaluation report was designed prior to testing to ensure the most convenient, rapid, and suitable way to assess selected behavioural patterns in field conditions. Onset of vocalisation, intensity of vocalisation, level of physical activity, response to sound, and overall behaviour was monitored in the study. Correlations between measures of height, weight and chest circumference, and behavioural characteristics in the 5^th, 7^th, and 9^th week of age were not statistically significant. Onset of vocalisation, intensity of vocalisation, level of physical activity and response to sound differed on statistically significant level between 5^th, 7^th, and 9^th week of age. Results suggest that our practical assessment report may be used as an applicable method to evaluate the suitability of service dog puppies for future working roles.

Keywords: dog, behaviour, open-field, testing

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Authors: Felix O. Omosele

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Several studies have established that electronic voting machines are prone to multi-faceted challenges. One of which is their capacity to lose votes after the ballots might have been cast. Therefore, the international consensus appears to favour the use of electronic voting machines that are accompanied with verifiable audit paper audit trail (VVPAT). At present, there is no known study that has evaluated the impacts (or otherwise) of this verification and auditing on the authentication, admissibility and evidential weight of electronically-obtained electoral data. This legal inquiry is important as elections are sometimes won or lost in courts and on the basis of such data. This gap will be filled by the present research work. Using the United States of America as a case study, this paper employed a qualitative legal analysis of several of its appellate courts’ judicial opinions. This analysis equally unearths the necessary statutory rules and regulations that are important to the research problem. The objective of the research is to highlight the roles played by VVPAT on electoral evidence- as seen from the eyes of the court. The preliminary outcome of this qualitative analysis shows that the admissibility and weight attached to ‘Computer Evidence from e-voting machines (CEEM)’ are often treated with general standards applied to other computer-stored evidence. These standards sometimes fail to embrace the peculiar challenges faced by CEEM, particularly with respect to their tabulation and transmission. This paper, therefore, argues that CEEM should be accorded unique consideration by courts. It proposes the development of a legal standard which recognises verification and auditing as ‘weight enhancers’ for electronically-obtained electoral data.

Keywords: admissibility of computer evidence, electronic voting, qualitative legal analysis, voting machines in the USA

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Authors: Muhammad Afiq Anaqi Bin Baharudin, Muhammad Izamuddin Bin Mohd Nasir, Syarifuddin Bin Sujuanda, Muhammad Syahmi Rusyaidi Bin Sham Suddin, Danish Hakimi Bin Kamaruzaman, Muhammad Haqimi Nazim Bin Hasmanizam, Mohammad Akmal Zakwan Bin Amran, Muhammad Alparizi Bin Latif

Abstract:

By improving efficiency and production, information technology (IT) has transformed working environments, but it has also created new threats to occupational safety and health (OSH). This study evaluates the literature that has already been written on the subject of IT and OSH, identifies major findings and discussion points, and highlights gaps in the material that call for additional research. The study's findings, which look at how IT affects OSH in a sizable multinational organization, are also presented in the report. According to the report, IT poses a number of OSH problems, such as ergonomic dangers, eye strain, dangers related to cybersecurity, and psychological hazards. The report suggests using tactics like providing comfortable workstations, encouraging a healthy balance between work and life, and putting strong cybersecurity safeguards in place to reduce these dangers. The implications of these findings for OSH and IT are discussed in the paper's conclusion, and it emphasizes the need for more study and action to address these dangers and promote healthy and secure working environments in the age of digitization.

Keywords: information technology, occupational safety and health (OSH), ergonomic, hazards, workplace.

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Authors: Diab Z., Hamad A., Dixit A., Al-Rikabi M., Keshaverzi F.

Abstract:

Introduction: According to the NICE guidelines, 2020Prasugrel is the recommended first line treatment in adults with acute coronary syndromes (ACS) in patients with ST-segment-elevation myocardial infarction (STEMI), defined as ST elevation or new left bundle branch block on ECG , that cardiologists intend to treat with primary percutaneous coronary intervention (PCI). The current literature suggests that this is largely due to safety and efficacy, and cost effectiveness. We wanted to do an audit to examine the adherence of the MRI hospital with guidelines in using prasugrel as first-line therapy in patients with STEMI and undergoing PPCI. AIM: To examine the adherence of the MRI hospital with guidelines in using prasugrel as first-line therapy in patients with STEMI and undergoing PPCI Methods: We looked at the patients presented to MRI during1^st of January 2022 to 28th February 2022. We included all the people who were above 18 and were brought to the hospital through the PPCI pathway and diagnosed as ACS and underwent PPCI. We excluded Patients who were brought to the hospital through the PPCI pathway and underwent coronary angiography and their diagnosis was found other than STEMI or if the outcome was death before discharge or they were above age >75 (as per guideline increase bleeding risk of prasugrel in a person aged 75 or older). Results: The total number of patients was 100. There were a total of seventy patients who had STEMI and fit the criteria for inclusion. Out of these, only 72.9% (51) were given Prasugrel as a first line. Seventeen (17) 24.3% STEMI patients were candidates for prasugrel as first-line therapy but were instead offered (clopidogrel/ticagrelor). Two 2 (2.9%) STEMI patients were not given prasugrel as first-line therapy because of C/I (CVA) or the use of anticoagulant Nine 9 (9%) of them died before discharge. Eleven 11 (11%) were above the age of 75. Ten 10 (10%) of patients had a diagnosis other than STEMI. Conclusions and recommendations: Our audit has shown the need to increase awareness amongst staff re: the first line use of Prasugrel as per NICE guidelines. We aim to arrange awareness sessions for staff and increase visibility of the guidelines for the staff to encourage them to adhere to the guideline. Further research is needed to find the optimum treatment in patients above 75.

Keywords: pasurgrel, PCI, NICE, STEMI

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Authors: Yousef Alwashahi, Ahmed Almoqbali, Mayar Albahrani, Asma Alajmi

Abstract:

We report a rare case of a 49-year-old Omani woman who is a known case of primary anti-phospholipid syndrome, glucose-6-phosphate dehydrogenase deficiency, and iron deficiency anaemia. During cannulation, she was found to develop bulla that progressed to ulcerations. With chronicity and recurrent abscess formation that usually increase after surgical intervention, a pathergy phenomenon was postulated. High suspicion of pyoderma gangrenosum was considered. Fortunately, the rapid progression of the disease was slowed down with corticosteroids, cyclosporin, and biological agents.

Keywords: anti-phospholipid syndrome, pyoderma gangrenosum, bullous pyoderma gangrenosum, pathergy, pathergy phenomenon

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Authors: Naser Shagerdi Esmaeli, Mohsen Hamidpour, Parisa Hasankhani Tehrani

Abstract:

Background And Objective: Haematopoietic stem cell transplant is a potentially curative treatment option in various benign and malignant haematological diseases. Patients undergoing stem cell transplant procedure require blood transfusion on a daily basis. Currently, there is paucity of data from developing countries on transfusion practices. This audit was undertaken to determine the consumption of packed red blood cells (PRBCs) transfusion in the bone marrow transplant unit of the Shahid Ghazi Tabatabaei Hospital, Tabriz, Iran. Subjects And Methods: A retrospective audit was conducted for packed red cell transfusion ordering practice over a period from March 2017 to march 2018. All consecutive patients admitted for stem cell transplant procedure for various underlying diseases were included. Outcome measures used in this study were (i) cross match to transfusion (C: T) ratio and (ii) transfusion trigger. Results: During the study period, n=13 patients underwent a haematopoietic stem cell transplant. There were n=10 males and n=3 females. One patient was less than 15 years of age, while rests were adults. Median age±SD was 26.5±14.5 years (12∼54 years). The underlying diagnosis included Aplastic anemia (n=4), Thalassemia major (n=1), Multiple Myeloma (n=3), Acute leukemia (n=3), Hodgkin's lymphoma (n=1), PRCA (n=1). Grand total consumption of PRBCs during the study period was 204, while 258 products were crossmatch. The C:T ratio was 1.26. The transfusion trigger was Hb level of less than 8 gr/dl. Conclusion: The results of our BMT unit indicate that the C:T ratio and transfusion trigger is comparable to the international criteria and pioneer country in BMT transplantation. Also, we hope that our blood consumption become less than it is now.

Keywords: blood consumption, C: T ratio, PRBCs, stem cell transplant, tabriz, Iran

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Authors: Mayar Almasri, Rosa Helmi, Rayana Enany

Abstract:

This report describes the features of AutoCAD software released by Adobe. It explains how the program makes it easier for engineers and designers and reduces their time and effort spent using AutoCAD. Moreover, it highlights how AutoCAD works, how some of the commands used in it, such as Shortcut, make it easy to use, and features that make it accurate in measurements. The results of the report show that most users of this program are designers and engineers, but few people know about it and find it easy to use. They prefer to use it because it is easy to use, and the shortcut commands shorten a lot of time for them. The feature got a high rate and some suggestions for improving AutoCAD in Aperture, but it was a small percentage, and the highest percentage was that they didn't need to improve the program, and it was good.

Keywords: artificial intelligence, design, planning, commands, autodesk, dimensions

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Authors: Jibran Abbasy, Rizwan Sultan, Ammar Humayun, Tabish Chawla

Abstract:

Background: Hydatid disease caused by Echinococcus Granulosus affects liver in 70-90% of cases. Dogs are the definitive host while humans are the accidental host. Modalities used for its treatment are especially important for our population as the disease is endemic in many Asian countries. The aim of the study was to perform an audit of the various modalities used for treatment of hydatid disease of liver and the response to each modality in tertiary care center of Pakistan. Materials and Methods: Retrospective audit of patients diagnosed and treated for Hydatid disease of the liver at Aga Khan University Hospital from 1st January 2007 to 31st December 2014 was completed. All patients aged 16 and above were included. Patients who had extra hepatic disease and missing records were excluded. Outcome measures were morbidity, mortality and recurrence of the disease. Results: During the study period 56 patients were treated for isolated hepatic hydatid disease and were included. Mean age was 39 years with 48% being females and 52% males. Most common presenting complaint was abdominal pain seen in 53% of patients(n=41). Duration of symptoms was less than 6 months in 74% (n=38). Mostly right lobe was involved in 69% (n=38).Most common treatment modality used was surgery in 34 patients followed by PAIR in 14 patients while 8 patients were treated medically. At a median follow up of 34 months recurrence was seen in 2 patients treated with PAIR while no patient treated with surgery had recurrence with the median follow up of 20 months. While no morbidity and mortality were observed in PAIR, but in surgery 5 patients had morbidity while 1 patient had mortality. Conclusion: Our data is comparative to other studies in terms of morbidity, mortality, and recurrence. We had adequate follow up. In our study PAIR and surgery both are effective and have less complications and recurrence rate. Surgery is still the gold standard in terms of recurrence.

Keywords: echinococcous granulosus, puncture aspiration irrigation reaspiration (PAIR), surgery, hydatid disease

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Authors: Andrew White, Abigail Lowe, Kory Watkins, Hamed Akhlaghi, Nicole Winter

Abstract:

The timing and appropriateness of diagnostic imaging are critical to the evaluation and management of traumatic injuries. Within the subclass of trauma patients, the prevalence of c-spine injury is less than 4%. However, the incidence of delayed diagnosis within this cohort has been documented as up to 20%, with inadequate radiological examination most cited issue. In order to assess those in which c-spine injury cannot be fully excluded based on clinical examination alone and, therefore, should undergo diagnostic imaging, a set of criteria is used to provide clinical guidance. The NEXUS (National Emergency X-Radiography Utilisation Study) criteria is a validated clinical decision-making tool used to facilitate selective c-spine radiography. The criteria allow clinicians to determine whether cervical spine imaging can be safely avoided in appropriate patients. The NEXUS criteria are widely used within the Emergency Department setting given their ease of use and relatively straightforward application and are used in the Victorian State Trauma System’s guidelines. This audit utilized retrospective data collection to examine the concordance of c-spine imaging in trauma patients to that of the NEXUS criteria and assess compliance with state guidance on diagnostic imaging in trauma. Of the 183 patients that presented with trauma to the head, neck, or face (244 excluded due to incorrect triage), 98 did not undergo imaging of the c-spine. Out of those 98, 44% fulfilled at least one of the NEXUS criteria, meaning the c-spine could not be clinically cleared as per the current guidelines. The criterion most met was intoxication, comprising 42% (18 of 43), with midline spinal tenderness (or absence of documentation of this) the second most common with 23% (10 of 43). Intoxication being the most met criteria is significant but not unexpected given the cohort of patients seen at St Vincent’s and within many emergency departments in general. Given these patients will always meet NEXUS criteria, an element of clinical judgment is likely needed, or concurrent use of the Canadian C-Spine Rules to exclude the need for imaging. Midline tenderness as a met criterion was often in the context of poor or absent documentation relating to this, emphasizing the importance of clear and accurate assessments. The distracting injury was identified in 7 out of the 43 patients; however, only one of these patients exhibited a thoracic injury (T11 compression fracture), with the remainder comprising injuries to the extremities – some studies suggest that C-spine imaging may not be required in the evaluable blunt trauma patient despite distracting injuries in any body regions that do not involve the upper chest. This emphasises the need for standardised definitions for distracting injury, at least at a departmental/regional level. The data highlights the currently poor application of the NEXUS guidelines, with likely common themes throughout emergency departments, highlighting the need for further education regarding implementation and potential refinement/clarification of criteria. Of note, there appeared to be no significant differences between levels of experience with respect to inappropriately clearing the c-spine clinically with respect to the guidelines.

Keywords: imaging, guidelines, emergency medicine, audit

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Authors: Ceri McIntosh

Abstract:

A 25-year-old male was referred to the Maxillofacial department by his general dental practitioner with a complaint of mobile teeth. Medically he was well though he took mirtazapine for anxiety. He was found to have had previous extractions of the lower right second premolar and first molar, with grade 2 mobility of the upper right first and second molars and lower right lateral incisor. Radiographically there was significant external root resorption of these teeth, which were subsequently extracted. Over the next 18 months, the resorption continued around multiple teeth on the right side, and when the mobile teeth were removed, they showed no remaining root, including loss of coronal dentine, leaving only an enamel shell. No cause has been identified either histologically or in the patient’s blood work. A review of relevant literature will be included in this case report.

Keywords: case report, idiopathic resorption, idiopathic root resorption, external resorption

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