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Noha Yahia Ebaid,1 Dalia Nabil Khalifa,1 Ahmad Sabry Ragheb,1 Magdy Mohamad Abdelsamie,2 Ahmed Mohamed Alsowey1 1Department of Radiology, Faculty of Medicine, Zagazig University, Zagazig, Egypt; 2Department of Cardiology, Faculty of Medicine, Zagazig University, Zagazig, EgyptCorrespondence: Noha Yahia EbaidDepartment of Radiology, Faculty of Medicine, Zagazig University, Zagazig, EgyptTel +201064422995Email nohayahiaradio@gmail.comBackground and Objectives: The coronary artery disease reporting and data system (CAD-RADS) is intended to standardize the reporting of CCTA and the subsequent management guidelines of CAD. The present study was conducted to investigate the validation of CAD-RADS and the application of coronary calcium grading in CAD management.Patients and Methods: The current study is a single-center prospective study that involved 177 participants with chest pain who were submitted to coronary CT angiography (CCTA). Two reviewers independently assessed CCTA results and gave each patient a CAD-RADS category. The reference standard for determining the clinical utility of CAD-RADS was invasive coronary angiography (ICA). The inter-reviewer agreement (IRA) was tested using the intra-class correlation (ICC).Results: The study enrolled 111 cases with non-significant CAD and 66 cases with significant CAD based on ICA findings. According to the reviewer, the CAD-RADS had a sensitivity, specificity, and accuracy of 90.9 to 100%, 89.2 to 94.6%, and 93.16 to 93.2%, respectively, for predicting severe CAD. The IRA for CAD-RADS categories was excellent (ICC = 0.960). The best cut-off value for predicting severe CAD was CAD-RADS > 3. Significant relation between Ca and severe CAD (p< 0.001) was detected.Conclusion: The current study provides a good understanding of CAD-RADS as a standard tool with high diagnostic accuracy.Keywords: coronary, cardiovascular disease, Agatston, computed tomography, stenosis

In returning the outpatient medical record file to thesection of the Medical Record Unit, Assembling there was a delay. This is because the return of medical record files has not been carried out according to Standard Operating Procedures, as a result, causing delays in the reporting system. The method used is qualitative using a descriptive approach. Data collection techniques by observation, interviews and literature study. This study aims to determine the return of former medical records of outpatients at Dayeuhkolot Health Center. The results of the study prove that the delay in returning outpatient medical record files at the Dayeuhkolot Health Center with presentations during the 1 week study amounted to 63 or 22% of 285 medical record files. Efforts have been made to disseminate information to all officers related to the efforts made by the person in charge of COVID-19 patients in returning medical record files on time.

Background and aim In 2011, the Accreditation Council for Graduate Medical Education (ACGME) restricted the first-year residents' duty-hour to less than 16-hour shifts, decreased the maximum shift duration for senior residents, and increased minimum time off after on-call duties. Whether these changes may have impacted the outcomes in cardiac surgery remains unclear. Methods We performed a difference-in-difference analysis of the New York State Cardiac Surgery Reporting System data in 2004-2006 (before the duty-hour policies change) and 2014-2016 (after the change). We evaluated differences in 30-day risk-adjusted mortality rates (RAMR) in coronary artery bypass grafting (CABG) and valve surgeries, stratifying data by hospital type: teaching hospitals (TH) versus nonteaching hospitals (NTH). NTH served as the control not affected by the duty-hour policies. Results (1) The overall surgical volume for CABG surgery has decreased over time (37,645-24,991), while the volume for valve surgery remained similar (20,969-21,532); (2) TH had better short-term outcomes for CABG procedures during 2014-2016 (median RAMR: 1.01% vs. 1.55% in TH vs. NTH, respectively; p = .025) as well as for valve procedures during both 2004-2006 (5.16% vs. 7.49%, p = .020) and 2014-2016 (2.59% vs. 4.09%, p = .033); (3) at difference-in-difference analysis, trainees' duty-hour regulations were not associated with worsening short-term outcomes in both CABG (p = .296) and valve (p = .651) procedures performed in TH. Conclusion The introduction of the 2011 trainees' duty-hour regulations was not associated with worse short-term outcomes for CABG and valve surgery performed in the State of NY by TH.

Though a handful of studies have explored the relationship between farm characteristics and theft of farm equipment, all have been focused at the micro level. Put differently, they have sought to determine whether a relationship exists between likelihood of theft victimization and the characteristics (e.g., size, location) of individual farming operations. The current study builds upon this work by seeking to determine whether county-level factors (in line with the routine activity theory framework) serve to influence the incidence of farm equipment theft within counties. Data are derived from the National Incident-Based Reporting System, the Census of Agriculture and the United States Census of the Population. Results are on the whole supportive of the theory's application to the problem and suggest that macro-level investigations constitute a worthwhile approach to better understanding agricultural victimization.

In the event of a worldwide pandemic,the government will of course continue to draft laws to address the problems caused by the corona virus in Indonesia's tax system.Some of its policies,particularlyi nthe area of taxation,are designed to create incentives.Incentives to collect taxes and levies are additional money offered in exchange for a certain level of performance in enforcing taxes and levies.Government incentives are intended to boost the country's economy.This study uses a descriptive research design and empirical normative research techniques.This research includes some original data,such as source interviews,as well as secondary data,such asprimary,secondary,and tertiary legal publications.The government through the Directorate General of Taxes has developed a reporting system for the use of tax incentives for taxpayers that facilitates reporting.However,there are still many obstacles in its implementation at KPP Pratama Medan,and many taxpayers are not aware of the tax incentives available during theCOVID-19 pandemic.Keywords: Economic Stimulus,Tax Incentives,Corona Virus Pandemi

Purpose This paper aims to assess how patient safety culture and incident reporting differs across different professional groups and between long-term and acute care. The Hospital Survey On Patient Safety Culture (HSPOSC) questionnaire was used to assess patient safety culture. Data from the organizations’ incident reporting system was also used to determine the number of reported patient safety incidents. Design/methodology/approach Patient safety culture is part of the organizational culture and is associated for example to rate of pressure ulcers, hospital-acquired infections and falls. Managers in health-care organizations have the important and challenging responsibility of promoting patient safety culture. Managers generally think that patient safety culture is better than it is. Findings Based on statistical analysis, acute care professionals’ views were significantly positive in 8 out of 12 composites. Managers assessed patient safety culture at a higher level than other professional groups. There were statistically significant differences (p = 0.021) in frequency of events reported between professional groups and between long-term and acute care (p = 0.050). Staff felt they did not get enough feedback about reported incidents. Originality/value The study reveals differences in safety culture between acute care and long-term care settings, and between professionals and managers. The staff felt that they did not get enough feedback about reported incidents. In the future, education should take these factors into consideration.

The objective of this manuscript was to describe the clinical incidents that were sent to the voluntary reporting system during 2020 at the National Children's Hospital of Costa Rica, belonging to the Costa Rican Social Security Fund. A descriptive observational study of the consolidated data that was sent during the months of January to December of the year 2020 was carried out. During 2020, 1.6% of the patients treated in the hospital experienced some type of clinical incident. The total discharges decreased by 38.4% compared to the discharges of the year 2019, however, the reported clinical incidents increased in the year 2020 by 37.6%, especially from the month of August. Sentinel events were not reported this year. The services that made the highest number of reports were Intensive Care (14.3%), General Surgery (12%), Neonatology (9.8%) and Infectiology (9%). The day on which the most incidents were reported was Wednesday (27.8%), in the first hospital shift most of the cases were reported (48.1%) and these incidents occurred predominantly to male individuals (66%). Regarding the age of the patients, the majority were in the age range from 1 year to less than 5 years (36.1%), followed by the age range from over 29 days to under 1 year (24, 1%). Most of the cases were related to the care provided to the patient (63.9%). 41.4% of the incidents required clinical measures but the sequelae were transitory. 51.1% of the cases merited some type of additional medical care to their therapeutic scheme upon admission. 96% of clinical incidents were reported by nursing staff. Most of the clinical incidents (35.3%) in this period were errors related to notes in the digital file.

The Italian SIAPEC-AIT 2014 classification, the 2017 Bethesda System for Reporting Thyroid Cytology (TBSRTC), the 2016 UK Royal College of Pathologists (RCPath) thyroid reporting system, and the 2019 Japanese reporting system for thyroid aspiration cytology (JRSTAC2019) represent the most widely used reporting systems among clinicians and pathologists for the purpose of cytologically diagnosing, estimating the potential risk of malignancy (ROM), and defining the most appropriate treatment for a patient with a thyroid nodule. Although all the systems use overlapping diagnostic categories and morphologic criteria, they differ on the basis of the criteria for inclusion in the cytologic categories, which may, in turn, affect the ROM of a given category and the clinical management of the patient, particularly with regard to the “indeterminate” categories. The aim of this review is to analyze the main differences that emerge between the systems and to propose possible solutions for a comprehensive reporting system that integrates and harmonizes all the criteria of the Italian classification and the Bethesda system, also taking into account the impact that the new tumor entity NIFTP (non-invasive follicular tumor with papillary-like nuclear features) that has, in many instances, replaced the non-invasive form of the follicular variant of papillary carcinoma, has had on the modification of malignancy risks.

The article, based on the theoretical analysis and study of management reporting practices, presents the place and role of the inter-organizational management reporting system in the system of inter-organizational management accounting in the framework of partner interaction. The composition of management reports of agricultural organizations in the framework of business partnerships is proposed, the advantages of using this composition of reports are identified, and the possible difficulties of implementing such a system of reporting forms are identified. On the example of agricultural enterprises, the structure and content of management reports for use in inter-organizational cooperation are disclosed.

Medical error is frequently the result of latent systems factors. Incident reporting systems face many challenges including inability of the system to process reports adequately, inadequate feedback mechanisms and lack of staff engagement especially from doctors. This paper describes a pragmatic physician-led desktop approach to a systems analysis of anaesthesia-related critical incidents which could be used to enhance incident reporting processing within the existing national incident reporting system. Anaesthesiologists within a university teaching hospital were encouraged to report incidents anonymously during the 6-month study period from July 2019 to January 2020. Information was collected on incident details, outcome and preventability. A desktop systems analysis was performed to categorise incidents and to determine contributory factors. Latent errors were considered according to the level of the organisational hierarchy at which they occurred and solutions directed accordingly. Seventy cases were included giving a reporting rate of 1.76%. Airway/breathing circuit problems (34%) were most frequently cited incidents, followed by other equipment (27%), medication errors (20%) and airway events (19%). The vast majority of events were considered preventable. Most incidents were near misses or of negligible adverse effect with only 6% requiring more than minor treatment. Organisational and strategic contributory factors were identified in 83% of cases, 93% of which were addressable within the department. Implementing local incident reporting systems can be used to complement existing systems at the macro and mesolevel and can be used to improve system processing, create a phased response to latent errors and enhance engagement.

Abstract. Airline safety can be improved when errors and incidents by aircrew are openly reported and justly investigated. Trust and functioning of the reporting system are critical for the success of a just safety culture. In this study, interviews and surveys were used to investigate the similarities and/or differences in perceptions of pilots and managers within several airlines about perceived just culture. Results indicate that decisions about culpability, the line between acceptable an unacceptable behavior, and the result of introducing more consequences are perceived differently by pilots and managers.

Introduction To evaluate the performance of the Vesical Imaging-Reporting and Data System (VIRADS) in differentiating muscle-invasive and non-muscle-invasive bladder cancer and whether this reporting system improves inter-reader agreement. Methods Sixty-four cases of multiparametric 3 tesla bladder MRI from January 2014 to May 2020 were reviewed retrospectively. T2-weighted, diffusion and post-contrast images were reviewed. All magnetic resonance images were reported by a radiologist with 15 years' experience (Reader 1) and a final year radiology trainee with a special interest in urogenital imaging with 3 years of experience (Reader 2). Both readers were blinded to clinical history and histopathology results when scoring each lesion. Results The sensitivity and specificity for differentiating MIBC and NMIBC were 91% and 68%, respectively, for Reader 1 and 91% and 63%, respectively, for Reader 2. The inter-reader agreement for assigning VIRADS scores was 0.79. The area under the receiver operator curve for Reader 1 and 2 were not significantly different (Reader 1 = 0.79, Reader 2 = 0.77, P = 0.83). Conclusions Staging of bladder cancer prior to treatment can be accurately and reliably diagnosed using VIRADS, a novel, standardised reporting system for bladder MRI.

In the evolving situation of highly infectious coronavirus, the number of confirmed cases in India has largely increased, which has resulted in a shortage of health care resources. Thus, the Ministry of Health and Family Welfare- Government of India issued guidelines for the ‘Home isolation of COVID-19 positive patients’ methodology for asymptomatic patients or with mild symptoms. During home isolation, the patients are required to monitor and record the pulse rate, body temperature, and oxygen saturation three times a day. This paper proposes a system that can request data from the required sensor to measure the pulse rate, body temperature, or oxygen saturation. The requested data is sensed by the respective sensor placed near the patients’ body and sent to the CAN data logger over the CAN bus. The CAN data logger live streams the sensor values and stores the same to an excel sheet along with details like the patient’s name, patient’s age, and date. The physicians can then access this information.

Objective To conduct a longitudinal national survey of cochlear implantation (CI) in Japan from 1985 through 2017. Methods A retrospective analysis of adult and pediatric CI cases from 1985 to 2017 using the Oto-Rhino-Laryngological Society of Japan CI registration database was conducted. Surgical statistics were obtained, including number of surgeries, age, implanted side, facilities, and preoperative threshold levels for CI. Results Since 1985, more than 11,100 CI surgeries have been conducted in Japan. The number exceeded 500 in 2005 and 1,000 in 2015. Since 2007, pediatric cases consistently surpassed adult cases until 2016. More facilities meet criteria for conducting CI as determined by Ministry of Health, Labor and Welfare and have now reached more than 100. Adult patients over 70 years old have become proportionally higher. Age at implantation steadily reduced in accordance with modifications of Japanese CI guidelines for children but is still not comparable to that in other developed countries. Although the number of CI surgeries for patients with moderate to severe hearing loss increased in the past ten years, the proportion was small. Conclusions The CI database in Japan is quite unique in that it documents almost all the CI surgeries in Japan, allowing us to summarize the present situation as follows: fewer CI surgeries occur than are necessary, and children receiving implants are older than those in other developed countries. Continuous improvement of CI awareness is needed in Japan.

The China National Center for Food Safety Risk Assessment (CFSA) uses the Foodborne Disease Monitoring and Reporting System (FDMRS) to monitor outbreaks of foodborne diseases across the country. However, there are problems of underreporting or erroneous reporting in FDMRS, which significantly increase the cost of related epidemic investigations. To solve this problem, we designed a model to identify suspected outbreaks from the data generated by the FDMRS of CFSA. In this study, machine learning models were used to fit the data. The recall rate and F1-score were used as evaluation metrics to compare the classification performance of each model. Feature importance and pathogenic factors were identified and analyzed using tree-based and gradient boosting models. Three real foodborne disease outbreaks were then used to evaluate the best performing model. Furthermore, the SHapley Additive exPlanation value was used to identify the effect of features. Among all machine learning classification models, the eXtreme Gradient Boosting (XGBoost) model achieved the best performance, with the highest recall rate and F1-score of 0.9699 and 0.9582, respectively. In terms of model validation, the model provides a correct judgment of real outbreaks. In the feature importance analysis with the XGBoost model, the health status of the other people with the same exposure has the highest weight, reaching 0.65. The machine learning model built in this study exhibits high accuracy in recognizing foodborne disease outbreaks, thus reducing the manual burden for medical staff. The model helped us identify the confounding factors of foodborne disease outbreaks. Attention should be paid not only to the health status of those with the same exposure but also to the similarity of the cases in time and space.

It is perhaps surprising that we lack complete national information about why children enter foster care. While the annual Adoption and Foster Care Analysis Reporting System (AFCARS) report is informative, it leaves many questions unanswered, particularly “how many children enter foster care by means other than Child Protective Services (CPS) reports?” Drawing from a unique new integrated dataset, we examined foster care data (AFCARS) and CPS report data (National Child Abuse and Neglect Data System Child File). The linked dataset included 210,062 children with foster care placements in 2017 and no placements in the prior 5 years. We categorized each placed child along two dimensions of four levels each: Time since prior CPS report (if any) and stated AFCARS placement reason, ranging from clearly maltreated to clearly not maltreated. We also tracked the siblings of placed children, to see if non-maltreated children entered care because of maltreated siblings. We find that between 8–35% of children enter foster care for reasons other than maltreatment, depending how thresholds are set. These numbers decline somewhat when siblings are considered. A meaningfully large number of children are placed in foster care for reasons other than maltreatment investigated by CPS. Further research into these children is warranted to better inform foster care policy.

Objectives/hypothesis Neck Imaging Reporting and Data System (NI-RADS) is a radiology reporting system developed for head and neck cancer surveillance imaging, using standardized terminology, numeric levels of suspicion, and linked management recommendations. Through a multidisciplinary, interdepartmental quality improvement initiative, we implemented NI-RADS for the reporting of head and neck cancer surveillance CT. Our objective is to summarize our initial experience from the standpoints of head and neck cancer providers and radiologists. Study design Quality improvement study. Methods Before and 3 months post-implementation, surveys were offered to referring physicians (n = 21 pre-adoption; 22 post-adoption) and radiologists (n = 17 pre- and post-adoption). NI-RADS utilization was assessed over time. Results Survey response rates were 62% (13/21) and 73% (16/22) for referring physicians pre- and post-adoption, respectively, and 94% (16/17) for radiologists pre- and post-adoption. Among post-adoption provider respondents, 100% (16/16) strongly agreed or agreed with "I want our radiologists to continue using NI-RADS," "The NI-RADS numerical rating of radiologic suspicion is helpful," and "The language and style of NI-RADS neck CT reports are clear and understandable." Among radiologist respondents, 88% (14/16) strongly agreed or agreed with "NI-RADS improves consistency among our radiologists in the reporting of surveillance neck CTs." Radiologist NI-RADS utilization increased over time (46% month 1; 72% month 3). Conclusions Most referring physicians and radiologists preferred NI-RADS. Head and neck cancer providers indicated that NI-RADS reports are clear, understandable, direct, and helpful in guiding clinical management. Radiologists indicated that NI-RADS improves radiologist consistency in the reporting of surveillance neck CT, and radiologists increasingly used NI-RADS over time. Level of evidence Level 4 Laryngoscope, 2021.

Subject. This article deals with the structuring of the organization's cost information, which can help set up and develop a system of strategic management reporting on financial responsibility centers. Objectives. The article aims to develop directions for structuring the information flow in the strategic management reporting system for the account cost center in the context of decentralization of the strategic management system on financial responsibility centers. Methods. To develop practical recommendations, I used the methods of analysis, synthesis, and generalization. Results. The article presents certain directions to structure information flow on the account cost center determining the areas of financial responsibility, objects of strategic control and management, and the structure and content of the center's strategic management reporting. Conclusions and Relevance. The presented areas of structuring the information flow of the account cost center can contribute to the development of strategic management accounting and reporting, improve the quality of information support for the strategic management system, and rise the efficiency of management decisions. The results of the study are of practical importance for optimizing the system of strategic management accounting and cost control of the production sector companies, and they may contribute to improving the effectiveness and efficiency of the business process strategy implementation.

A significant rise in the number of road accidents has been observed due to the increasing number of vehicles. Significant research has been conducted on accident for the rescue, particularly on the use of Information and also Communication Technologies for efficient and prompt rescue or saving operations. The majority of such works will provide us the sophisticated solutions that focus on reducing response times. However, such solutions can be very expensive and are not available in all forms of vehicles. Our approach aims to take advantage of the advanced specifications of smartphones to design and develop a low-cost solution for enhanced transportation systems that are deployable in legacy vehicles. In this topic, a customized Android application is developed to collect information regarding speed, attraction, pressure, sound, and location. Speed is one of the factor which is used to improve the identification of the accidents. It arises because of clear differences in environmental conditions or changes (e.g., noise, deceleration rate) that arise in low-speed collisions, versus higher-speed collisions). The information collected is again further processed to detect road incidents. Furthermore, a navigation system is also constructed to report the incident to the nearby hospital. Furthermore, a navigation system is constructed to send and report the accident location and patients details to the nearby hospital! The proposed approach is validated through simulations and comparison with a real data set of road accidents acquired from the Road Safety Open Repository and shows promising results in terms of accuracy.

The article considers the stages and characteristics of the modern system of regulatory regulation and the use of simplified methods of accounting and reporting in Russia. The paper outlines the circle of economic entities, that have the right to use them. The author carries out the classification of existing simplified methods, as well as presents the criteria for their application by organizations. The study gives a recommendation for the preparation of a single national standard for the use of simplified methods of accounting and accounting reporting. The paper considers and systematizes the regulatory legal acts, recommendations of the regulatory state body and accounting associations, as well as other documents related to the application and use of simplified accounting methods in Russia. For each of these documents, the author gives a brief analysis of the key provisions on the use of simplified methods.

Purpose The purpose of this evidence-based practice project was to reduce the incidence of pressure injuries (PIs) from the use of graduated compression stockings in patients on a gastrointestinal (GI) sarcoma surgery unit. Before this project, the standard of care for preventing deep vein thrombosis (DVT) included the use of graduated compression stockings, anticoagulation therapy, and intermittent pneumatic compression devices. We sought to examine the impact on PI and DVT risk of using only anticoagulation therapy and intermittent pneumatic compression devices. Methods The pilot phase of the project began in June 2017 when nurses on the GI sarcoma surgery unit initiated a practice change in which graduated compression stockings were removed during the 7 AM shift change and put back on the patient before bedtime. Data on the incidence of DVTs and PIs were already being collected in our institution's electronic health record and safety intelligence reporting system. The project team monitored the incidence of PIs and DVTs throughout the project. After the pilot project concluded in August 2017, the GI sarcoma surgery unit staff continued the practice of taking off graduated compression stockings during the day, until on June 2018 the use of graduated compression stockings was formally discontinued for all surgical patients, both during the day and night. Results Data collected during the pilot phase revealed that no PIs or DVTs occurred among the 497 study patients on the GI sarcoma surgery unit. From June to October 2017, the unit cared for a total of 856 patients and PI and DVT rates remained at zero. From the start of the pilot project in June 2017 to October 2018 (five months after the discontinuation of graduated compression stockings on all surgical units) the unit cared for 3,141 patients-an average of 174 patients per month-and had a zero rate of PIs and DVTs. Conclusions We found that the use of graduated compression stockings confers more risks than benefits for patients. Our findings prompted the discontinuation of graduated compression stockings use in postoperative patients throughout our institution. In the 17 months after the pilot project was initiated, no PIs occurred among patients in the GI sarcoma surgery unit, which also maintained a zero rate of DVTs.

Background The Paris System for Reporting Urinary Cytology (TPS) is a recently developed standardized terminology system. It is well-established that urine cytology has low sensitivity for detecting low-grade urothelial neoplasia (LGUN). Though the majority of tumors are low-grade, surveillance of these lesions is important to monitor for possible progression. Herein, we compared TPS to our veteran integrated system network (VISN) to assess its applicability. We also introduced semi-quantitative scoring to further evaluate cytomorphologic features of high-grade urothelial carcinoma (HGUC). Materials and methods Voided and instrumented urine cytology specimens and concurrent biopsies were reviewed from Sept 2018 – Jan 2020. Cytologic diagnoses reported using the VISN institutional system were reevaluated by staff cytopathologists and categorized according to TPS. A semi-quantitative scoring system to evaluate cytomorphologic features was devised. Results Cytology and surgical specimens from 105 patients were reviewed. The VISN and TPS reporting systems were compared and showed similar sensitivities and specificities for the detection of HGUC. Rates of biopsy-proven LGUN were high for the negative for high-grade urothelial carcinoma category (NHGUC; 27/53, 50.9%) and atypical urothelial cells (AUC; 14/30; 46.7%) compared to suspicious/positive (0/22, 0%) categories. Major and minor criteria as outlined in TPS were evaluated semi-quantitatively. Conclusions Urine cytology has limited sensitivity for LGUN regardless of the cytologic reporting system used. There was a high rate of LGUN following NHGUC/AUC diagnoses in the Veteran population. Coarse chromatin was determined to be the least sensitive criterion for the detection of high-grade lesions and irregular chromatin rim was most specific.

In India, transport becomes a basic commodity of daily life. As transportation starts increasing, safety has become a major concern for consumers. This paper mainly aims at reducing the fatalities caused due to accidents occurring in roadways. In general, many lives could be saved if emergency service could get accurate accident location and rescue the injured people at the minimum possible time. The Internet of Things has revlontinsed the modern world in recent times. As Global Positioning System has become an integral part of any vehicle system, this effective method is utilized to monitor the location of vehicles and send accident locations to an Accidents Monitoring and Rescue Services Centre (AMRSC) using GSM. The Accelerometer located in the vehicle system gives the live status of the vehicle position while the vehicle is in motion. Whenever an accident occurs, the signal from the accelerometer is fed to the controller. The Node MCU controller is programmed to check whether the accident has occurred and given the information to the user and AMRSC as soon as possible. Now, the system will also send the accident location acquired from the GPS along with the vehicle details through the GSM network to AMRSC. After receiving the alert message from the infected user vehicle system, the rescue team will reach the accident location as soon as possible by reading the data from the server.

OBJECTIVE Homicide of healthcare workers has been reported but little is known about psychologists as victims of homicide. This study aimed to investigate what is known about homicide of psychologists. METHODS The Centers for Disease Control and Prevention's National Center for Injury Prevention and Control's National Violent Death Reporting System (NVDRS) provides insights into violent deaths, including homicide. This study interrogated the NVDRS and conducted Internet searches about psychologist decedents of homicide. RESULTS Between 2003 and 2018 the NVDRS identified 12 psychologist homicides. Internet searches revealed 15 psychologist homicides. Only three (11.1%) were known to have been killed by current or former patients. Another was by a colleague's patient. Another assailant was suspected to be a patient. We summarize patterns and circumstances of deaths, address issues related to violence in healthcare, and review selected resources addressing violence prevention. CONCLUSION Psychologists, like other health professionals, may be victims of homicide. Such deaths have diverse contributing factors and are rarely perpetrated by patients. As concern about health professional safety mounts and the NVDRS becomes better established, it will hopefully become a more sensitive, precise, comprehensive and useful mechanism for tracking trends in violent deaths of psychologists and other health professionals and ultimately inform preventative strategies.

Aim: To find out the prevalence of needle stick injury, its reporting system and the reasons behind it. Study design: Descriptive cross-sectional Place and duration of study: Study was conducted at Jinnah post-graduate medical center (JPMC) Karachi during the period of March to September 2019 Methodology: A self-designed, self-explanatory questionnaire was used, consisting of two parts, the first part was about demographic information while second part is for information related to needle stick injury like probable cause, frequency, response after injury, post-exposure prophylaxis and about reporting of the incident. Questionnaire was validated by calculating the Cronbach’s alpha which was 0.78. data was analyzed by using the Statistical Package for the Social Sciences (SPSS) version 20. Results: Majority of the study participants were female (67.2%) and about 50% were postgraduate students. Out of total 134 doctors about 64.2% of the doctors had needle stick injury during their career. Finding out the most probable cause of needle stick injury during the survey it was found out that increased work load and prolonged working hours were the main reasons. Majority of the cases occurred in emergency department (41.9%). About 95.5% of the doctors didn’t get any post-exposure prophylaxis. Majority of the participants (96.3%) did not report to any authority because of the lack of knowledge about the reporting policy, it was noted that about 38.8% were confused either the reporting system exist or not. Most of the injuries occur during the procedure of suturing followed by recapping syringes. Conclusion: It has been concluded that majority of the doctors had faced needle stick injury during their career and a very negligible number of them got any post-exposure prophylaxis. Majority of them did not report to any authority. So there is a need of implication of safety measures and reporting policies for early detection and treatment of infections after needle stick injury.

Purpose Reporting of adverse drug reactions (ADRs) by patients is essential for a comprehensive risk–benefit evaluation of drugs after marketing, but only few data are available regarding patient-centred web-based ADR reporting systems. Hence, we aimed to analyze ADRs reported by patients with a particular emphasis on novel drugs and serious ADRs not yet labelled in the respective summary of product characteristics (SPC). Methods All ADR reports received by a web-based, patient-centred platform (www.nebenwirkungen.de) between April 1, 2019, and September 1, 2020, were descriptively analyzed. ADRs and drugs were coded automatically according to MedDRA and ATC classification system. SPC labelling of reported ADRs for novel drugs marketed since 2015 was checked manually. Results In total, 13,515 patient reports including 29,529 ADRs were received during the study period (serious ADRs [SADRs] n = 1,318; 4.5%). Women were affected in more than two-thirds of ADR reports. The most common patient-reported ADRs were nausea, dizziness and headache, whereas arrhythmia, intestinal obstruction and erectile dysfunction were the most frequent SADRs. Ciprofloxacin, levothyroxine and venlafaxine were the compounds most frequently suspected for causing both ADRs and SADRs. Regarding novel compounds, 289 reports including 739 ADRs were received (mainly fatigue, headache and myalgia). Three hundred thirty-one (44.8%) out of those ADRs were not yet labelled in the respective SPC, whereof twelve were SADRs. Conclusion The majority of patient-reported ADRs were non-serious. However, a relevant number of non-labelled even serious ADRs was reported for novel compounds by patients. Despite well-known limitations of patient-reported ADRs, this web-based ADR reporting system contributes to the identification of new ADRs and thus can help to improve patients’ safety complementing other pharmacovigilance instruments.

BACKGROUND Recently the International Academy of Cytology (IAC) introduced a new reporting system for breast fine-needle aspiration cytology that classifies cytologic diagnoses into five-categories: (I) insufficient material, (II) benign, (III) atypical, (IV) suspicious of malignancy, and (V) malignant. The current study was undertaken to categorize the breast lesions utilizing the newly proposed IAC Yokohama classification system and evaluate the risk of malignancy (ROM) for respective categories and the diagnostic yield of this technique. METHODS All FNAs of breast lesions over 2.5 years were categorized retrospectively using the newly proposed IAC Yokohama reporting system. The ROM was calculated along with sensitivity, specificity, positive and negative predictive value, diagnostic accuracy, false positive, and false-negative rate using the histological diagnosis as the gold standard. RESULTS The 512 cases were distributed as follows: Category I (insufficient material) 7.4%, Category II (benign) 74%, Category III (atypical) 5.7%, Category IV(suspicious) 1.4%, and Category V (malignant) 11.5%. Histopathological correlation was available in 285 (55.7%) cases. The respective ROM calculated was 33.3%, 0.5%, 13.3%, 83.3%, and 100% for Category I-V. The Sensitivity, Specificity, Positive and Negative Predictive Value, and Diagnostic accuracy were 95%, 99.5%, 98.27%, 98.6, and 98.5% respectively. CONCLUSIONS Despite previous attempts to establish a standardized diagnostic terminology, there has been a lack of a single internationally approved standardized reporting system allowing substantial diagnostic clarity and incorporating distinct diagnostic categories, each linked with a specific ROM and recommended management. This System also provides enhanced communication between pathologists and attending clinicians for the benefit of the patient.

Work accidents in coal mining still occur frequently, so an accident reporting system is needed as an effort to prevent work accidents. This study aims to explain the perceptions of coal mining employees on the reporting system for work accidents and potential hazards. The research design was descriptive with a sample size of 55 people. Data collection was carried out using a questionnaire. Data were analyzed descriptively. As many as 67.3 % of employees have positive perceptions and 32.7 % of employees have negative perceptions of the work accident reporting system and potential hazards. There are 72.7% of employees consider it important to report accidents and potential hazards. It was found that 30.9 % of employees had experienced work accidents and only 5.4 % of them reported accidents. Employees consider a good accident reporting system, among others, digitally 84.6 % and manually 9.1 %. As many as 90.9 % of employees agree and 81.8 % of employees are willing to report accidents and potential hazards if the company implements a digital-based reporting system. There are still employees who have negative perceptions of the work accident reporting system and potential hazards in coal mining. Therefore, efforts are needed to increase employee perceptions from negative to positive perceptions of the work accident reporting system and potential hazards in coal mining companies.

This study aimed to investigate the characteristics of chest compressions performed in dental chairs (DCs) with 2 different structural support designs and on the floor. This randomized prospective study was conducted to compare the effectiveness of chest compressions (rate and depth) using a feedback device and a manikin reporting system. The mean anterior chest wall motion measurements captured using the feedback device were significantly increased in the DCs than on the floor, whereas the percentage of net chest compression depths ≥5 cm as measured using the manikin reporting system were significantly decreased in the DCs than on the floor. These findings suggest that cardiopulmonary resuscitation performed in a DC without the use of a supporting stool or stiff backboard is not likely to be effective even if a DC design that incorporates a supportive steel column is utilized.

OBJECTIVE The number of unsolicited patient complaints (UPCs) about surgeons correlates with surgical complications and malpractice claims. Using a large, national patient complaint database, the authors sought to do the following: 1) compare the rates of UPCs for neurosurgeons to those for other physicians, 2) analyze the risk of UPCs with individual neurosurgeon characteristics, and 3) describe the types of UPCs made about neurosurgeons. METHODS Patient and family complaint reports among 36,265 physicians, including 423 neurosurgeons, 8292 other surgeons, and 27,550 nonsurgeons who practiced at 33 medical centers (22 academic and 11 regional) from January 1, 2014, to December 31, 2017, were coded with a previously validated Patient Advocacy Reporting System (PARS) algorithm. RESULTS Among 423 neurosurgeons, 93% were male, and most (71%) practiced in academic medical centers. Neurosurgical subspecialties included general practice (25%), spine (25%), tumor (16%), vascular (13%), functional (10%), and pediatrics (10%). Neurosurgeons had more average total UPCs per physician (8.68; 95% CI 7.68–9.67) than nonsurgeons (3.40; 95% CI 3.33–3.47) and other surgeons (5.01; 95% CI 4.85–5.17; p < 0.001). In addition, a significantly higher percentage of neurosurgeons received at least one UPC (71.6%; 95% CI 67.3%–75.9%) than did nonsurgeons (50.2%; 95% CI 49.6%–50.8%) and other surgeons (58.2%; 95% CI 57.1%–59.3%; p < 0.001). Factors most associated with increased average UPCs were younger age, measured as median medical school graduation year (1990.5 in the 0-UPC group vs 1993 in the 14+-UPC group, p = 0.009) and spine subspecialty (13.4 mean UPCs in spine vs 7.9 mean UPCs in other specialties, 95% CI 2.3–8.5, p < 0.001). No difference in complaints was seen in those who graduated from non-US versus US medical schools (p = 0.605). The most common complaint types were related to issues surrounding care and treatment, communication, and accessibility, each of which was significantly more common for neurosurgeons than other surgical specialties (p < 0.001). CONCLUSIONS Neurosurgeons were more likely to generate UPCs than other surgical specialties, and almost 3 out of 4 neurosurgeons (71.6%) had at least one UPC during the study period. Prior studies have shown that feedback to physicians about behavior can result in fewer UPCs. These results suggest that neurosurgeons have opportunities to reduce complaints and potentially improve the overall quality of care delivered.

The scientific contribution focuses on the statistical analysis of selected indicators of the financial performance of enterprises, which within the same accounting period are reported according to national accounting legislation and according to IAS/IFRS. Due to the different approach to the reporting of asset and liability items, individual items of the statements change, which is the reason for achieving different values of financial liquidity indicators, or the golden balance rule and other financial indicators. In the introduction to the article, we will present similar research in this area. In this paper we will deal with statistical testing of absolute changes of indicators using the Wilcoxon test and t-test. The main hypothesis of the paper is to examine whether there are statistically significant differences between the values of the indicator according to national accounting legislation and IAS/IFRS.

Critical incident reporting systems (CIRS) have become the most common patient safety tools in healthcare. The purpose of this study was to present the development of CIRS in Georgia. A quantitative approach using a cross-sectional survey was adopted. Critical incidents were mainly derived from surgical disciplines. The highest number of cases was registered by nurses. The most common critical incidents were due to lack of personal attention. CIRS can be seen as an effective clinical risk management tool that can be used to identify potential sources of critical incidents and help ensure patient safety at a healthcare organization.

BACKGROUND: The National Safety Reporting System, which is developed for Turkey, aims to classify medical errors with a coding methodology that handles errors in subcategories. Error entries done via the system are added to the statistics immediately by advanced live data reporting capabilities of the software. OBJECTIVE: Our aim was to provide information about the Turkey local reporting system to ensure patient safety by detecting medical errors. METHODS: The data used for analyses were obtained from https://www.grs.saglik.gov.tr and the web service used by hospital information systems. The error reporting time, most commonly reported errors, errors by professions and errors by location were examined under the major error categories and percentages that have been used in relevant data. RESULTS: In total, 53,477 errors were submitted to the National Safety Reporting System in 2016. When these entries were split into relevant categories such as drug errors, laboratory errors, surgical errors and patient safety errors, the most common errors were wrong dosage order, hemolyzed sample, not marking the side to be operated on and patient fall (patient/caretaker related), respectively. CONCLUSION: In order to reduce medical errors and provide patient safety, every institution must first of all do its own self-assessment. New user-friendly systems can be developed in order to increase medical error notifications and thus institutions can improve their healthcare quality.

Japan’s financial reporting system during the 1930s is an essential analytical subject as it provides an indispensable opportunity for scholars to identify the determinants of financial reporting p...