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To assess prevalence of missed outpatient radiology appointments and sociodemographic factors associated with no-shows vs. cancellations. Adults with outpatient radiology appointments in 2022 and January 2023 at a single tertiary academic health center were included. Generalized estimating equation regression was used to evaluate sociodemographic factors associated with missed vs. completed appointments, no-shows vs. cancellations and time interval between cancellations and appointments. 19,262 (24.3%) examinations were either a cancellation (22.3%) or no-show (2.0%) among 9713 patients (mean age 60.8 ± 15.5; 67.1% female, 63.9% White, 20.0% Asian, 22.0% Hispanics). Among cancellations, 70.19% were patient-initiated. Age ≥ 65 significantly decreased the probability of missed appointments by 5.4% point (pp) (95% CI: 3.7–7.2) or no-shows (4.2 pp; 95% CI, 1.4–6.9), while being single increased probability of missed appointments (2.2 pp; 95% CI, 1.2–3.1) or no-shows (2.6 pp; 95% CI, 1.2–4.1). Those uninsured or with public insurance were 1.3–4.9 pp more likely to miss appointments than commercial insurance, and 2.2–7.6 pp more likely to have no-shows than cancellations. Living in disadvantaged neighborhoods 4.9 pp (95% CI, 3.9–6.0) increased likelihood of missing appointment and was associated with shorter time interval between cancellation and appointment. English speakers were 2.2 pp (95% CI, 1.1–3.3) more likely to miss their exam, while 2.7 pp (95% CI, 1.1–0.4.3) less likely to be a no-show than cancellation. Cancellations represented a significant portion of missed appointments. Specific sociodemographic subgroups exhibited higher tendencies for having missed appointments and no-shows. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to identify risk factors for delays in planned total shoulder arthroplasty (TSA) and determine the perioperative outcomes of TSAs that experienced a delay. Methods: The American College of Surgeons National Quality Improvement Program (NSQIP) database was queried from 2006 to 2019 for primary TSA. Delayed TSA was defined as surgery that occurred greater than one day after hospital admission. Patient demographics, comorbidities, and post-operative complications were collected and compared; the incidence of delayed TSA was analyzed. Results: The delayed patients were older, had a higher BMI, a higher rate of recent prior major surgery, and more comorbidities. Delayed patients had higher rates of postoperative complications, return to the OR, and 30-day readmission. Between 2006 and 2019, the rate of delayed TSA decreased. Conclusion: Surgeons should take care to ensure that patients with comorbidities undergo thorough preoperative clearance to prevent same-day cancellations and postoperative complications. [ABSTRACT FROM AUTHOR]

Background: Operative procedure cancellations are a dilemma for the healthcare system as well as for the patients. It causes increased workload and cost to our system. For patients, it has major financial, psychological as well as medical consequences. We aim to self-identify the causes of cancellations for efficient operation room management. Methods: We performed a retrospective chart review in a tertiary academic medical center for the last 66 months of operative records. Subsequently, we performed thematic coding to categorize causes into distinct categories. Results: Our records showed 5153 cancellations which represent (7.3%) of the total booked procedures. Of these cancellations 91% were ordered before the day of surgery, compared to 9% for same-day cancellations. Cancellations were 58% female patients and 40% male patients. The number one reason for cancellations for both same-day and prior cancellations is the unavailability of the surgical consultant. Conclusion: Surgical procedure cancellations profile is unique among our settings and has changed over time. Over the last 5 years, the number one reason is unavailability of the surgical consultant. Efforts should be made to identify and correct the underlying reasons to improve patient outcomes in our evolving healthcare system.

Background: Operative procedure cancellations are a dilemma for the healthcare system as well as for the patients. It causes increased workload and cost to our system. For patients, it has major financial, psychological as well as medical consequences. We aim to self-identify the causes of cancellations for efficient operation room management. Methods: We performed a retrospective chart review in a tertiary academic medical center for the last 66 months of operative records. Subsequently, we performed thematic coding to categorize causes into distinct categories. Results: Our records showed 5153 cancellations which represent (7.3%) of the total booked procedures. Of these cancellations 91% were ordered before the day of surgery, compared to 9% for same-day cancellations. Cancellations were 58% female patients and 40% male patients. The number one reason for cancellations for both same-day and prior cancellations is the unavailability of the surgical consultant. Conclusion: Surgical procedure cancellations profile is unique among our settings and has changed over time. Over the last 5 years, the number one reason is unavailability of the surgical consultant. Efforts should be made to identify and correct the underlying reasons to improve patient outcomes in our evolving healthcare system. [ABSTRACT FROM AUTHOR]

Aims: This is a multicentre, prospective assessment of a proportion of the overall orthopaedic trauma caseload of the UK. It investigates theatre capacity, cancellations, and time to surgery in a group of hospitals that is representative of the wider population. It identifies barriers to effective practice and will inform system improvements. Methods: Data capture was by collaborative approach. Patients undergoing procedures from 22 August 2022 and operated on before 31 October 2022 were included. Arm one captured weekly caseload and theatre capacity. Arm two concerned patient and injury demographics, and time to surgery for specific injury groups. Results: Data was available from 90 hospitals across 86 data access groups (70 in England, two in Wales, ten in Scotland, and four in Northern Ireland). After exclusions, 709 weeks' of data on theatre capacity and 23,138 operations were analyzed. The average number of cases per operating session was 1.73. Only 5.8% of all theatre sessions were dedicated day surgery sessions, despite 29% of general trauma patients being eligible for such pathways. In addition, 12.3% of patients experienced at least one cancellation. Delays to surgery were longest in Northern Ireland and shortest in England and Scotland. There was marked variance across all fracture types. Open fractures and fragility hip fractures, influenced by guidelines and performance renumeration, had short waits, and varied least. In all, nine hospitals had 40 or more patients waiting for surgery every week, while seven had less than five. Conclusion: There is great variability in operative demand and list provision seen in this study of 90 UK hospitals. There is marked variation in nearly all injuries apart from those associated with performance monitoring. There is no evidence of local network level coordination of care for orthopaedic trauma patients. Day case operating and pathways of care are underused and are an important area for service improvement. Cite this article: Bone Jt Open 2023;4(6):463–471.

Newsvendor models have been developed to determine the optimal overbooking level of hotel rooms to manage no-shows and cancellations. This research note extends the newsvendor model to a restaurant context by taking into account the "stretched capacity" of restaurants to determine the optimal overbooking levels for restaurant seats. Data were collected from a restaurant in Taiwan to illustrate the model. The percentage of no-shows per day in this restaurant ranged from 11% to 16%. Utilizing its stretched capacity, the restaurant can overbook up to five more seats than the estimated number of no-shows. The extended model will be most suitable for restaurants that largely depend on reservations (rather than walk-ins), such as luxury or fine-dining restaurants. Directions for future research on restaurant overbooking are provided. [ABSTRACT FROM AUTHOR]

Cancellations, often referred to derogatively as "cancel culture", are becoming increasingly pervasive in public discourse, political debate, and the marketing field. Cancellations pose a clear threat to established market actors and have the potential to re-organize institutional structures. However, empirical work investigating this phenomenon is limited. This study adopts an institutional theory lens to investigate how calls for brand cancellation unfold. In doing so, it provides insight into how markets are shaped to realign with prevailing institutional logics around political ideology, race, gender, sexuality, abuse, and corporate greed. Further, it outlines the triggers that prompt institutional entrepreneurs to attempt to delegitimize the existence of incumbent brands. It also reveals how various actors (consumers, brands, media, affiliates, influencers, opponents) engage in institutional work to disrupt, create, or maintain institutional logics, as well as their own legitimacy. Macro implications for social values, political factions, markets, marketing practices, and brands are discussed. [ABSTRACT FROM AUTHOR]

• There is significant mismatch in Day-case trauma patient management and resource availability. • Day-case trauma patients make up nearly one third of general trauma patients requiring surgery. • Day-case trauma lists are widely underutilised in the united Kingdom, with a median of zero lists available. • Day-case trauma patients experience higher case cancellation and escalation to elective lists, which disrupts scheduled elective activity. • There is marked variation in day-case trauma patient routes to surgery. ORTHOPOD: Day Case Trauma is a multicentre prospective service evaluation of day-case trauma surgery across four countries. It is an epidemiological assessment of injury burden, patient pathways, theatre capacity, time to surgery and cancellation. It is the first evaluation of day-case trauma processes and system performance at nationwide scale. Data was prospectively recorded through a collaborative approach. Arm one captured weekly caseload burden and operating theatre capacity. Arm two detailed patient and injury demographics, and time to surgery for specific injury groups. Patients scheduled for surgery between 22/08/22 and 16/10/22 and operated on before 31/10/22, were included. For this analysis, hand and spine injuries were excluded. Data was obtained from 86 Data Access Groups (70 in England, 2 in Wales, 10 in Scotland and 4 in Northern Ireland). After exclusions, 709 weeks worth of data representing 23,138 operative cases were analysed. Day-case trauma patients (DCTP) accounted for 29.1% of overall trauma burden and utilised 25.7% of general trauma list capacity. They were predominantly adults aged 18 to 59 (56.7%) with upper limb Injuries (65.7%). Across the four nations, the median number of day-case trauma lists (DCTL) available per week was 0 (IQR 1). 6 of 84 (7.1%) hospitals had at least five DCTLs per week. Rates of cancellation (13.2% day-case; 11.9% inpatient) and escalation to elective operating lists (9.1% day-case; 3.4% inpatient) were higher in DCTPs. For equivalent injuries, DCTPs waited longer for surgery. Distal radius and ankle fractures had median times to surgery within national recommendations: 3 days and 6 days respectively. Outpatient route to surgery was varied. Dominant pathways (>50% patients listed at that episode) in England and Wales were uncommon but the most frequently seen was listing patients in the emergency department, 16 of 80 hospitals (20%). There is significant mismatch in DCTP management and resource availability. There is also considerable variation in DCTP route to surgery. Suitable DCTL patients are often managed as inpatients. Improving day-case trauma services reduces the burden on general trauma lists and this study demonstrates there is considerable scope for service and pathway development and improved patient experience. [ABSTRACT FROM AUTHOR]

Aim: The aims of the study are to audit the default rate of the provisional date of elective surgery in pediatric urology private practice and to study the factors involved in the postponement of elective operation dates by patients. Patients and Methods: The audit involved analysis of reasons behind patients defaulting from elective pediatric urology procedures between January 2019 and December 2019 at a tertiary private teaching hospital in South India. The details were obtained from the outpatient register kept for elective booking. The details of actual procedures performed were obtained from OT records. From the defaulters, the reasons for postponement were obtained through personal/telephonic interview. Results: A total of 289 patients were given dates for elective procedures. Among this, 72 (24.9%) defaulted, leaving 217 patients who underwent elective surgery. Among those who underwent surgery, 90 (41%) were elective day case (DC) procedures, whereas 127 (59%) were inpatient (IP) procedures. The default rate was 26/116 (22.4%) for DC procedures, whereas 46/173 (26.6%) for IP procedures, with no significant difference between them (P = 0.64). Among the 72 defaulters, the reasons for cancellation were as follows: financial factors (FFs) 22 (30.6%), lack of family support 19 (26.4%), function/grievance in house 10 (13.9%), respiratory illness 14 (19.4%), and treatment at a different center 7 (9.7%). FF (insurance denial) was significantly higher (P = 0.001) in crucial IP procedures at 19/46 (41%) compared to DC procedures at 3/26 (12%). The various diagnoses denied insurance were UPJO (7), VUR (6), hypospadias (4), UDT (3), and PUV (2). Conclusions: FFs were mainly responsible for parents postponing their children's elective pediatric urology procedures in India. Universal insurance coverage for congenital anomalies might help overcome this most important cause of cancellations. [ABSTRACT FROM AUTHOR]

Last-minute cancellations in urological surgery are a global issue, resulting in the wastage of resources and delays to patient care. In addition to non-cessation of anticoagulants and inadequately treated medical comorbidities, untreated urinary tract infections are a significant cause of last-minute cancellations. This study aimed to ascertain whether the introduction of a specialist nurse clinic resulted in a reduction of last-minute cancellations of elective urological surgery as part of our elective recovery plan following the Coronavirus disease 2019, the contagious disease caused by severe acute respiratory syndrome coronavirus 2 or SARS-CoV-2 pandemic. A specialist urology nurse-led clinic was introduced to review urine culture results preoperatively. Specialist nurses contacted patients with positive urine cultures and their general practitioners by telephone and email to ensure a minimum of 2 days of 'lead-in' antibiotics were given prior to surgery. Patients unfit for surgery were postponed and optimized, and vacant slots were backfilled. A new guideline was created to improve the timing and structure of the generic preassessment. Between 1 January 2021 and 30 June 2021, a mean of 40 cases was booked each month, with average cancellations rates of 9.57/40 (23.92%). After implementing changes on 1 July 2021, cancellations fell to 4/124 (3%) for the month. On re-audit, there was a sustained and statistically significant reduction in cancellation rates: between 1 July 2021 and 31 December 2021 cancellations averaged 4.2/97.5 (4.3%, P  < .001). Two to nine (2%–16%) patients were started on antibiotics each month, while another zero to two (0%–2%) were contacted for other reasons. The implementation of a specialist urology nurse-led preassessment clinic resulted in a sustained reduction in cancellations of last-minute elective urological procedures. [ABSTRACT FROM AUTHOR]

One strategy to reduce inventories and increase on-time delivery is to use Advanced Demand Information (ADI) in which customers place their orders ahead of their due date. ADI can be divided into perfect or imperfect information. Under perfect ADI, customers send accurate demand information to the suppliers, specifying exact quantities and due dates. Under imperfect ADI, customer orders' quantities and/or due dates may change over time or order cancellations may occur. This research focuses on the effects of three types of imperfect ADI on different production systems: changing due dates, changing order quantities, and cancellations. Three different model variations simulate a pull system, a push system, and a hybrid system. We found that only cancellations and changing order quantities had a significant effect on system performance. Generally, the pull and the hybrid system behaved similarly and proved to be more suitable for managing imperfect ADI than the push system. [ABSTRACT FROM AUTHOR]

PurposeMagnetic resonance imaging (MRI) is a high-cost imaging modality, and an optimized encounter ideally provides high-quality care, patient satisfaction, and capacity utilization. Our purpose was to assess the effectiveness of team training and its impact on patient show-up and completion rates for their MRI examinations.Materials and methodsA total of 97,712 patient visits from three tertiary academic medical centers over 1-year intervals were evaluated, totaling 49,733 visits at baseline and 47,979 after training. Each center's MRI team received team training skill training including advanced communication and team training techniques training. This training included onsite instruction including case simulation with scenarios requiring appropriate behavioral and communicative interventions. Orientation and training also utilized customized online tools and proctoring. The study completion rate and patient show-up rate during consecutive year-long intervals before and after team training were compared to assess its effectiveness. Two-sided chi-square tests for proportions using were applied at a 0.05 significance level.ResultsDespite differing no-show rates (5-22.2%) and study incompletion rates (0.7-3.7%) at the three academic centers, the combined patients' data showed significant (P < 0.0001) improvement in the patients' no-show rates (combined decreases from 11.2% to 8.7%) and incompletion rates (combined decreases from 2.3% to 1.4%).ConclusionOur preliminary results suggest training of the imaging team can improve the no-show and incompletion rates of the MRI service, positively affecting throughput and utilization. Team training can be readily implemented and may help address the needs of the current cost-conscious and consumer-sensitive healthcare environment. J. MAGN. RESON. IMAGING 2016;44:1040-1047.

Background: Equity in access to scheduled surgery has been a topic of attention of researchers and decision-makers on healthcare. Most studies analyse the number of days that patients wait before undergoing surgery, and ignore patients that have been on the waiting list but have not benefited from surgery. This study contributes to the existing literature on waiting lists by analysing cancellations along with surgery episodes. Methods: We use a database comprising all patients that entered the waiting list for scheduled surgeries in the Portuguese National Health Service from 2011 to 2015 (around 3 million observations) and estimate survival models to explain waiting times, where cancellations are introduced as censored data. Results: The cancellation rate is significant (around 14%), and has a considerable impact on results: ignoring cancellations biases estimates, in particular for gender differences (that are overestimated without cancelations), and for the age effect (that is underestimated). Conclusion: Thus, our approach provides a more accurate understanding of the impact that several factors have on overall access to scheduled surgery. [ABSTRACT FROM AUTHOR]

Little is known about cancellation frequencies in telemedicine vs. in-person appointments and its impact on clinical outcomes. Our objective was to examine differences between in-person and video telemedicine appointments in terms of cancellation rates by age, race, ethnicity, gender, and insurance, and compare 30-day inpatient hospitalizations rates and 30-day emergency department visit rates between the two visit types. Demographic characteristics and comorbidities for adults scheduled for an Emory Healthcare ambulatory clinic appointment from June 2020 to December 2020 were extracted from the electronic medical record. Each appointment was identified as either a video telemedicine or in-person clinic appointment. The outcomes were ambulatory clinic cancellation rates, 30-day hospitalization rates, and 30-day emergency department visit rates. Multivariable logistic regression was used to assess differences between appointment types. A total of 1,652,623 ambulatory clinic appointments were scheduled. Ambulatory appointment cancellations rates were significantly lower among telemedicine compared to in-person appointments overall (20.4% vs. 31.0%, p

Introduction: Cancellation of elective surgical operations is defined as an elective operation which is not performed on the scheduled date. The rates and the reasons for cancellation vary in different parts of the world. Cancellation causes increased cost of treatment, loss of daily wage and mental trauma. It also causes under utilisation of hospital resources and loss of training opportunities to surgical trainees. Aim: To estimate the rate of cancellation of elective surgical operations in a tertiary care centre in North-East India and determine the reasons for cancellation. Materials and Methods: A prospective cross-sectional study was conducted at a 500 bedded, North-Eastern Indira Gandhi Regional Institute of Health and Medical Sciences. Shillong, Meghalaya, India, from January 2018 to September 2018. All consecutive elective surgical cases scheduled during this period were included in the study. The rate and the reasons for cancellation were noted. Descriptive statistics was used for analysis of the results. Results: Out of 1812 elective surgical operations scheduled during the study period, 491 operations (27.10%) were cancelled. The most common reasons for cancellation were shortage of time (78.62%), medical causes (10.79%) and administrative problems (4.48%). Cancellation rate was highest in the Department of Surgical Oncology (40.23%), followed by Departments of Orthopaedics (34.51%) and Obstetrics and Gynaecology (OG) (31.02%). Conclusion: The rate of cancellation of elective surgical operation was high (27.10%) and the most common reason was shortage of time and Surgical Oncology Department had highest rate of cancellation. [ABSTRACT FROM AUTHOR]

Pandemic measures to mitigate the outbreak of SARS-CoV-2 in Germany led to cancellations of routine vaccination appointments for both adults and children. Survey data indicate that, with easing pandemic restrictions, many cancelled appointments were rescheduled or caught up. Nevertheless, 40% of cancelled appointments were still not rescheduled and were primarily cancelled by patients. Therefore, doctors should regularly remind patients of vaccinations and use every visit to improve their vaccination statuses.

Objective: To determine whether delayed or canceled elective procedures due to COVID-19 resulted in higher rates of ED utilization and/or increased mortality. Summary of Background Data: On March 15, 2020, the VA issued a nationwide order to temporarily pause elective cases due to COVID-19. The effects of this disruption on patient outcomes are not yet known. Methods: This retrospective cohort study used data from the VA Corporate Data Warehouse. Surgical procedures canceled due to COVID-19 in 2020 (n ¼ 3326) were matched to similar completed procedures in 2018 (n ¼ 151,863) and 2019 (n ¼ 146,582). Outcome measures included 30- and 90-day VA ED use and mortality in the period following the completed or canceled procedure. We used exact matching on surgical procedure category and nearest neighbor matching on patient characteristics, procedure year, and facility. Results: Patients with elective surgical procedures canceled due to COVID19 were no more likely to have an ED visit in the 30- [Difference: –4.3% pts; 95% confidence interval (CI): –0.078, –0.007] and 90 days (–0.9% pts; 95% CI: –0.068, 0.05) following the expected case date. Patients with cancellations had no difference in 30- (Difference: 0.1% pts; 95% CI: –0.008, 0.01) and 90-day (Difference: –0.4% pts; 95% CI: –0.016, 0.009) mortality rates when compared to similar patients with similar procedures that were completed in previous years. Conclusions: The pause in elective surgical cases was not associated with short-term adverse outcomes in VA hospitals, suggesting appropriate surgical case triage and management. Further study will be essential to determine if the delayed cases were associated with longer-term effects. [ABSTRACT FROM AUTHOR]

While cancellations of "Big Deals" at research institutions are making the headlines, small- and medium-sized schools are also addressing the issue of managing their journal packages by cancelling or unbundling major publishers' journal packages. Although "Big Deals" were advantageous when first acquired, as the years passed, large publishers absorbed more publications annually, which brought higher costs and titles of lower relevance to the library. Each year librarians at Pepperdine University have analyzed cost per use, and each year the cost per use increased on many packages until these increases became unsustainable. Coinciding with this tipping point, alternatives to licensing entire packages emerged or became more viable. Libraries across the country realize that they no longer need to own everything. The authors go into details for each of the publishers' "Big Deals," present reasons why they were cancelled or restructured, the alternative solutions implemented, and what the reaction has been. [ABSTRACT FROM AUTHOR]

Background: Colonoscopy is a critical diagnostic and therapeutic procedure that is challenging to access in northern Canada. In part, this is due to frequent cancellations. We sought to understand the trends and reasons for colonoscopy cancellations in the Northwest Territories (NWT). Methods: A retrospective review of colonoscopy cancellations January, 2018 to May, 2019 was conducted at Stanton Territorial Hospital, NWT. Cancellation details and rationale were captured from the endoscopy cancellation logs. Thematic analysis was used to group cancellation reasons. Descriptive statistics were generated, and trends were analysed using run chart. Results: Of the scheduled colonoscopies, 368(28%) were cancelled during the 16 month period, and cancellations occurred, on average, 27 days after booking. Cancellation reasons were grouped into 15 themes, encompassing personal, social, geographic and health system factors. The most frequently cited theme was work/other commitments (69 respondents; 24%). Cancellations due to travel and accommodation issues occurred more frequently in the winter. Conclusion: Over one in four booked colonoscopies were cancelled and the reasons for cancellations were complex. Initiatives focusing on communication and support for patients with personal or occupational obligations could dramatically reduce cancellations. Ongoing collaborative efforts are needed to inform and optimise access to colonoscopy in this region. [ABSTRACT FROM AUTHOR]

Background: Colonoscopy is a critical diagnostic and therapeutic procedure that is challenging to access in northern Canada. In part, this is due to frequent cancellations. We sought to understand the trends and reasons for colonoscopy cancellations in the Northwest Territories (NWT). Methods: A retrospective review of colonoscopy cancellations January, 2018 to May, 2019 was conducted at Stanton Territorial Hospital, NWT. Cancellation details and rationale were captured from the endoscopy cancellation logs. Thematic analysis was used to group cancellation reasons. Descriptive statistics were generated, and trends were analysed using run chart. Results: Of the scheduled colonoscopies, 368(28%) were cancelled during the 16 month period, and cancellations occurred, on average, 27 days after booking. Cancellation reasons were grouped into 15 themes, encompassing personal, social, geographic and health system factors. The most frequently cited theme was work/other commitments (69 respondents; 24%). Cancellations due to travel and accommodation issues occurred more frequently in the winter. Conclusion: Over one in four booked colonoscopies were cancelled and the reasons for cancellations were complex. Initiatives focusing on communication and support for patients with personal or occupational obligations could dramatically reduce cancellations. Ongoing collaborative efforts are needed to inform and optimise access to colonoscopy in this region.

Dispatch reliability – is one of the key criteria of aircraft technical operation process efficiency which reflects economic efficiency of airline activity. The higher the operational reliability, the better the level of aircraft operation in airline, the higher maintenance quality and safety policy is more effective. Due to the lack of unified procedure of dispatch reliability control both for aircraft manufacturers and Russian Federation aircraft operators and based on international experience it was concluded that there is a need for dispatch reliability specification by introducing a number of parameters, definitions and development, thereby the unified updated methodic of calculation. In this work six basic and three auxiliary parameters are introduced, the following terms and definitions are established: dispatch reliability, operational reliability, ground operational interruptions, operational interruptions, in-flight interruptions. A unified actualized methodic of dispatch reliability and operational reliability calculation is developed, which is reasonable and more accurate. Since the aircraft dispatch reliability includes the notion of Regularity and Punctuality, definitions and criteria calculation are given. The detailed example of criteria calculation is shown: dispatch reliability, dispatch regularity, flight punctuality, operational reliability, flight delays for a hundred landings, aircraft changes for a hundred landings, flight cancellations for a hundred landings.

In the school choice market, where scarce public school seats are assigned to students, a key operational issue is how to reassign seats that are vacated after an initial round of centralized assignment. Practical solutions to the reassignment problem must be simple to implement, truthful, and efficient while also alleviating costly student movement between schools. We propose and axiomatically justify a class of reassignment mechanisms, the permuted lottery deferred acceptance (PLDA) mechanisms. Our mechanisms generalize the commonly used deferred acceptance (DA) school choice mechanism to a two-round setting and retain its desirable incentive and efficiency properties. School choice systems typically run DA with a lottery number assigned to each student to break ties in school priorities. We show that under natural conditions on demand, the second-round tie-breaking lottery can be correlated arbitrarily with that of the first round without affecting allocative welfare and that reversing the lottery order between rounds minimizes reassignment among all PLDA mechanisms. Empirical investigations based on data from New York City high school admissions support our theoretical findings. This paper was accepted by Gad Allon, operations management. [ABSTRACT FROM AUTHOR]

Introduction: Thousands of elective day-case procedures are cancelled in the National Health Service (NHS) annually on the day of surgery resulting in significant financial loss. The aim of this study is to determine the rate of cancellations and identify contributing factors in order to minimise and the number of cancellations Methods: Hospital data were collated on all patients undergoing elective-day case surgery across all surgical specialties at our institution over a 2-year period from September 2015 to August 2017. Reasons for cancellation were categorised as due to patient factors, hospital, administration/organisational factors. Results: Over this time period, a total of 1,692 cases were cancelled, giving a cancellation rate of approximately 8.0%. The majority of these were Orthopaedic (32.1%, n=543/1,692), Ophthalmology (26.4%, n=446/1,692) and General Surgery cases (14.9%, n=252/1,692). The median number of cancellations were 75 cases per month. Cancellations appeared to be lower in the summer months of July and August (112 and 134 respectively, p=0.03). The majority of patients were cancelled due to patient reasons (49.1%, n=831/1,692). A further 33.4% (n=565/1,692) were due to medical reasons and 17.5% (n=296/1,692) were due to hospital/ administrative reasons. Conclusions: The majority of same-day cancellations are due to patient factors, although a substantial proportion is due to hospital and medical reasons which can and should be pre-empted. Robust measures are required to address the multi-factorial nature of the problem and although internationally there is substantial variation in healthcare systems, sharing experiences can provide insight and enhance quality improvement strategies that could be locally adapted. [ABSTRACT FROM AUTHOR]

This paper studies joint quality and refund policy design for service products in the presence of customer valuation uncertainty. Customers often exhibit considerable uncertainty in their service valuations. In response, firms may tailor their products and allow service cancellations. We consider the joint product customization and refund policy decisions of a monopolistic firm selling to a heterogeneous customer population with imperfect signals on their valuations. Our results shed light on how customers' valuation uncertainty, characterized by the valuation heterogeneity and signal quality, drives the interaction between product line and refund policy designs. In particular, when the valuation heterogeneity is high, the firm may choose to offer a single quality level with a full refund, leading to a variety reduction in the product line. In contrast, when the valuation heterogeneity is low, the firm will always offer a full product line without any refund. At moderate valuation heterogeneity, both qualities and refunds are subject to more customization, and a partial refund can be optimal when the signal quality is high, even though our setup does not involve aggregate demand uncertainty, capacity limitations, competition, or channel conflicts. Interestingly, despite its appeal, generous refund terms do not increase aggregate customer surplus. Furthermore, the firm may not have incentives to reduce customers' valuation uncertainty even if doing so is costless. We verify the robustness of our results and discuss their practical implications. [ABSTRACT FROM AUTHOR]

The impact COVID-19 has had on the live music industry has been well documented. An unprecedented number of events have been canceled, postponed, or rescheduled. While ticket refund policies under normal circumstances are familiar, this paper addresses how ticket refund policies were applied during the pandemic. After a discussion of the economic impact of the pandemic on the live music industry, this paper provides a chronology of significant cancellations and offers a qualitative analysis and visual representation of the 261 major music events affected by the pandemic as reported by Billboard.1 The paper then extends upon the existing Billboard data by leveraging modern technological tools to make this data more complete and publicly available for research purposes. Following is an outline of the ticket refund policies of major promoters, independent promoters, and festival promoters and a review of some of the alternatives and incentives offered to ticket holders. The paper concludes with a summary of some of the legal and reputational ramifications faced by promoters and discusses questions for further research. [ABSTRACT FROM AUTHOR]

Cancellations of elective operations have negative consequences, both for patients and the NHS. For the latter, reducing waiting times for surgical procedures remains a pressing concern, as does maintenance of adequate staffing. This study aimed to identify factors contributing to the cancellation of elective operations on the day of the procedure in order to suggest measures that could be taken to reduce these incidents. The retrospective details of just over 11 000 patients awaiting theatre admission for elective operations over a period of 1 year were obtained. The reasons behind last-minute operation cancellations were categorised as either patient factors or hospital factors. Data analysis suggested that the number of cancellations could be reduced by scheduling appointments with a senior doctor closer to the operation date. [ABSTRACT FROM AUTHOR]

Current practice following injury within the United Kingdom is to receive surgery, at the institution of first contact regardless of ability to provide timely intervention and inconsiderate of neighbouring hospital resource and capacity. This can lead to a mismatch of demand and capacity, delayed surgery and stress within hospital systems, particularly with regards to elective services. We demonstrate through a multicentre, multinational study, the impact of this at scale. ORTHOPOD data collection period was between 22/08/2022 and 16/10/2022 and consisted of two arms. Arm 1 captured orthopaedic trauma caseload and capacity in terms of sessions available per centre and patients awaiting surgery per centre per given week. Arm 2 recorded patient and injury demographics, time of decision making, outpatient and inpatient timeframes as well as time to surgery. Hand and spine cases were excluded. For this regional comparison, regional trauma networks with a minimum of four centres enroled onto the ORTHOPOD study were exclusively analysed. Following analysis of 11,202 patient episodes across 30 hospitals we found no movement of any patient between hospitals to enable prompt surgery. There is no current system to move patients, between regional centres despite clear discrepancies in workload per capacity across the United Kingdom. Many patients wait for days for surgery when simple transfer to a neighbouring hospital (within 10 miles in many instances) would result in prompt care within national guidelines. Most trauma patients in the United Kingdom are managed exclusively at the place of first presentation, with no consideration of alternative pathways to local hospitals that may, at that time, offer increased operative capacity and a shorter waiting time. There is no oversight of trauma workload per capacity at neighbouring hospitals within a regional trauma network. This leads to a marked disparity in waiting time to surgery, and subsequently it can be inferred but not proven, poorer patient experience and outcomes. This inevitably leads to a strain on the overall trauma system and across several centres can impact on elective surgery recovery. We propose the consideration of inter-regional network collaboration, aligned with the Major Trauma System. [ABSTRACT FROM AUTHOR]

In today's borderless business era, arbitration is a very popular dispute settlement institution used by businesses. However, it is not uncommon for business people, especially those who win cases, to be frustrated when faced with the implementation of arbitration rulings involving the courts. The process of dispute resolution at the National Arbitration Institute, as it is commonly known in the Court, dispute resolution will lead to a decision (National Arbitration Award). Article 70 of Law no. 30 of 1999 on Arbitration and Alternative Dispute Settlement, affirming that the arbitral award can only be canceled if it is suspected to contain elements of fake Letter / Document, or found documents hidden by the opponent or a judgment taken from the guile by one of the parties in Examination, but the fact in practice the court still receives the request and cancels the arbitration decision outside the context of that article which is the basis of the reference for the cancellation of the arbitral award.

Nowadays the phenomenon of flight delays and cancellations is becoming more and more serious. Flight delays and cancellations not only waste transportation resources, but also affect passengers' travel plans, which cause an increase in passenger discontent and complaint rates[2]. The passengers' dissatisfaction and distrust of airlines seriously damage the airlines' corporate reputation and then affect passengers' loyalty. Therefore, based on the information of 5 million flight data in the United States in 2016, we predicted the flight cancellations based on four classification algorithms: logistics regression, support vector machine (SVM), naive bayes and decision tree. We compared the training time of these algorithms by changing the number of nodes in the Spark cluster[9], and we also compared the classification accuracy, AUC (Area Under Curve) and PR(Precision-Recall). Experimental results show that: (1) When the number of nodes was 1, the average training time of these algorithms was 460 seconds. When the number of nodes was 3,5,7,9, the corresponding average training time were 207.25 seconds, 89.75 seconds, 44 seconds, 42 seconds, and when the number of nodes was 11, the average training time was 43.5 seconds; (2) Starting from 7 nodes, as the number of nodes increased while the decline rate of the average training time slowed down; (3) When the number of nodes was 1 and 3, the training time of naive bayes was the shortest, which were 386 seconds and 185 seconds respectively. When the number of nodes was 5,7,9 and11, the training time of SVM was the shortest, which were 72 seconds, 21seconds, 19 seconds and 18 seconds respectively; (4) the classification accuracy of SVM and decision tree was almost 90%, but naive bayes was just about 50.8% and logistics regression was only about 62.4%; (5) Both the AUC and PR of the decision tree algorithm were the highest: AUC was 0.558 and PR was 0.439. Therefore, the decision tree algorithm was the most suitable for predicting whether the flight would be cancelled or not, and there was a 90% probability that the prediction would be successful. [ABSTRACT FROM AUTHOR]

Contemporary academic libraries' collection development practices are influenced by limited space, complicated access models, and shrinking budgets that are competing for interests in print and electronic, and other outside forces. Librarians responsible for collections make tough decisions that unintentionally threaten to change how academic libraries build and curate collections for longevity. Much of today's discussion deals with immediate problems and offers few considerations about how these collection decisions will affect the availability and potentially the existence of historical evidence. Among the issues highlighted in this commentary are definitions of primary sources, researchers-used historical materials, and solutions for the identified problems. [ABSTRACT FROM AUTHOR]

We have seen many times over the years where bid prices drop precipitously in the last few days of the booking process, thus potentially opening up cheap seats at a time when passengers with the greatest willingness to pay are shopping. The research question studied here is whether an airline can effectively apply a bid price floor or freeze, in the last week or two of the booking process to increase revenue in a competitive environment with four competing airlines. This paper will provide the answer to the above question in the Passenger Origin-Destination Simulator (PODS) Network U10 (a large international network with 572 origin-destination markets, including a low-cost carrier). The results show how challenging it is to find a combination of O-D optimization method, overbooking level, and time-frame that are effective. In fact, only unbucketed dynamic programming (vector) and overbooking with a floor or freeze in the last 7 days is consistently revenue positive. [ABSTRACT FROM AUTHOR]

Background: The operation theater (OT) complex is a costly component of a hospital budget expenditure. This area of hospital activity requires maximum utilization to ensure optimum cost benefit. To achieve a high level of utilization in the OT, it is necessary to efficiently coordinate number of activities and personnel. Methods: This study was conducted in a 1000-bedded tertiary care teaching hospital in rural maharashtra over aperiod of two months. The OT complex consists of eight major OTs. Normal working hours for routine scheduled cases on all working days except Sundays and public holidays. Results: Total study period consisted of 96 working days. There were a total of eight OT tables of various specialties, and parameters were observed during the routine hours excluding Sundays and holidays. The total procedure time was maximum for ENT followed by orthopedics and least for obstetrics. Room turnover time was maximum for obstetrics followed by general and oncosurgery. Case delays were maximum in general surgery and least for ophthalmology. The most common reason for delay in starting the operation table was patient getting shifted late from the ward and administrative causes. The most prominent reasons for cancellation were lack of operating room time followed by medical reasons of the patient. Conclusion: We concluded that most of the causes of delays and cancellations of surgeries were avoidable with proper preoperative planning and optimization of patients and resources and good communication between surgeon anesthesiologists and the nursing staff. [ABSTRACT FROM AUTHOR]

This article summarizes the North Carolina Serials Conference presentation "Green, Yellow, Red: Implementing a New Workflow for Collection Management at College of Charleston Libraries," a case study evaluating a new workflow created by the Collection and Content Services Department at the College of Charleston Libraries to streamline the renewals process after significant departmental and staff changes. The librarians involved in creating the workflow found that they could not only use it to organize their renewals processes, but also to open communication with faculty regarding underutilized resources. [ABSTRACT FROM AUTHOR]

The present paper discusses, from the perspective of legal techniques, the growing trend towards inconsistency in the legal sub-systems in the Spanish legal system. This trend is fundamentally visible in all those sub-systems (mortgage, consumer affairs, real estate, etc.) bordering on the economy in financial law. Consistency as the axis structuring legal certainty and, therefore, economic certainty in a country has to be the principle inspiring any legal system. It is an essential value for public safety and justice. [ABSTRACT FROM AUTHOR]