Search Results (1,923)

Chronic diseases affect more than 80% of older adults. One modifiable risk factor for secondary prevention is physical activity. Public parks are an essential resource for physical activity, but environmental features may limit participation. Our aims were (1) to assess the feasibility and utility of the Path Environment Audit Tool (PEAT) for use in a larger-scale study focused on older adults and (2) to examine the physical activity-promoting features of five public parks. Methods: A descriptive study design was used to assess five public parks in Riyadh, Saudi Arabia, from April to June 2022. Additionally, process, resource, and management assessments were also conducted. Results: The PEAT was easy to use, but additions are recommended to increase relevance to older adults with chronic disease. Descriptive analyses revealed positive features, such as adequate lighting, but other features such as path slope were more variable. Conclusions: Study findings can guide the future use of the PEAT for older adult participants and inform environmental modifications. Full article

Because the PCAOB was unable to inspect audits of Chinese accounting firms until recently, regulators introduced legislation (HFCAA) potentially forcing Chinese companies to delist for non-compliance with PCAOB audit requirements. To understand the equity markets’ response to this legislation, we analyze the short-term (event study) and long-term stock performance of U.S.-listed Chinese firms relative to the stock performance of other foreign companies. We find that Chinese companies outperform other Asian firms for the Pre-HFCAA Period, but they underperform other Asian firms from the time the HFCAA was introduced (28 March 2019) until an agreement was reached (26 August 2022). For the post-agreement period (26 August 2022 to 31 December 2022), the performance of Chinese and other Asian stocks is similar. Between 28 March 2019 and 31 December 2022, a typical shareholder lost 76% of wealth, and, compared to other Asian companies, the losses were around 87%. The findings highlight the importance of regulatory compliance and transparency in maintaining investor confidence and protecting shareholders’ interests. Full article

Background/Objectives: Integrated orthogeriatric care has demonstrated benefits in hip fracture management for older patients. Comprehensive care pathways are essential for effective integrated care delivery, yet local variability in care pathways persists. We assessed the current hip fracture care pathways in the Netherlands, focusing on the variability between these care pathways and the degree of implementation of orthogeriatric care. Methods: A nationwide inventory study was conducted. A survey was sent to all hospitals in the Netherlands to collect the care pathways or local protocols for hip fracture care. All care elements reported in the care pathways and protocols were systematically analyzed by two independent researchers. Furthermore, an assessment was performed to determine which model of orthogeriatric care was applied. Results: All 71 Dutch hospitals were contacted, and 56 hospitals responded (79%), of which 46 (82%) provided a care pathway or protocol. Forty-one care elements were identified in total. In the care pathways and protocols, the variability in the description of these individual care elements ranged from 7% to 87%. Twenty-one hospitals had an integrated care model with shared responsibility, while an equal number followed an orthopedic trauma surgeon-led care model. Conclusions: These findings provide a detailed description of the hip fracture care pathways in the Netherlands. Variations were observed concerning the care elements described in the care pathways, the structure of the care pathway, and the specification of several elements. The implementation of integrated care with shared responsibilities, as recommended by the international literature, has not been achieved nationwide. The clinical implications of the variability between care pathways, such as the influence on the quality of care, need to be further investigated. Full article

Screening mammography is considered to be the most effective means for the early detection of breast cancer. However, epidemiological studies suggest that longitudinal exposure to screening mammography may raise breast cancer radiation-induced risk, which begs the need for optimization and internal auditing. The present work aims to establish a comprehensive well-structured Diagnostic Reference Level (DRL) system that can be confidently used to highlight healthcare centers in need of urgent action, as well as cases exceeding the dose notification level. Screening mammographies from a total of 2048 women who underwent screening mammography at seven different healthcare centers were collected and retrospectively analyzed. The typical DRL for each healthcare center was established and defined as per (A) bilateral image view (left craniocaudal (LCC), right craniocaudal (RCC), left mediolateral oblique (LMLO), and right mediolateral oblique (RMLO)) and (B) structured compressed breast thickness (CBT) criteria. Following this, the local DRL value was established per the bilateral image views for each CBT group. Screening mammography data from a total of 8877 images were used to build this comprehensive DRL system (LCC: 2163, RCC: 2206, LMLO: 2288, and RMLO: 2220). CBTs were classified into eight groups of <20 mm, 20–29 mm, 30–39 mm, 40–49 mm, 50–59 mm, 60–69 mm, 70–79 mm, 80–89 mm, and 90–110 mm. Using the Kruskal–Wallis test, significant dose differences were observed between all seven healthcare centers offering screening mammography. The local DRL values defined per bilateral image views for the CBT group 60–69 mm were (1.24 LCC, 1.23 RCC, 1.34 LMLO, and 1.32 RMLO) mGy. The local DRL defined per bilateral image view for a specific CBT highlighted at least one healthcare center in need of optimization. Such comprehensive DRL system is efficient, easy to use, and very clinically effective. Full article

Despite the increased use of diagnostic imaging in Africa, the completion of the Radiology Request Form (RRF) remains suboptimal, often relying on paper-based communication. To examine the practices surrounding RRF completion in the African continent, on 25 March 2024, we conducted a systematic review of peer-reviewed articles describing the practice in African settings. Non-African studies, studies involving non-human subjects, and articles examining the practice of the RRF for interventional usage were excluded. Our search involves PubMed/MEDLINE, ScienceDirect, Scopus, Web of Science, Google Scholar, and African Journals Online. The included studies were 3004, of which 30 met the inclusion criteria. These studies span eight countries and highlighted several shortcomings, including the usage of informal forms, unconventional abbreviations, illegibility, inaccuracy, and the lack of important fields from institutional forms, commonly the last menstrual period and the referrer’s contact details. We also found widespread non-compliance in all RRF fields; half of the studies did not have an adequately filled form. Incomplete RRFs lead to delayed imaging, increased workloads for radiographers and radiologists, and potential misdiagnoses due to insufficient information. It will also impede the application of radiation protection principles. To address these challenges, empowering radiographers and radiologists and encouraging best practices is essential. Regular audits and educational initiatives aimed at clinicians are recommended. While transitioning to a paperless communication system might help, implementing nationwide quality improvement projects to standardise radiology request forms is currently more feasible. Full article

This study employs a robust quantitative ex post facto research design to investigate the complex relationship between audit fees and earnings management. The financial information of 164 firms admitted to the Tehran Stock Exchange (TSE) was used from 2010 to 2019 (pre-COVID period) to achieve the research goal. Analysing data from the Tehran Stock Exchange firms, the study uncovers an inverted U-shaped relationship between audit fees and earnings management. This suggests that moderate audit fees can lead to higher earnings management. Key contributions of this paper include highlighting the role of audit fees in influencing financial reporting quality and risk management, providing empirical evidence on the asymmetric effects of normal and abnormal audit fees on earnings management, and emphasising the need for balanced audit fee structures to ensure financial transparency and mitigate risk. The findings offer valuable insights for academics, practitioners, and policymakers in understanding the nuances of audit fees and their impact on corporate financial practices. This study advances the literature on financial risk management and corporate finance. It emphasises the importance of balanced audit fee structures for management teams, auditors, and policymakers to ensure transparent financial reporting practices. Full article

The board of directors appoints the audit committee to assess the financial performance of the firm. The audit committee uses reports provided by audit firms, such as Form 10Ks, and annual reports to assess firm financial performance. The degree of audit oversight quality is a governance measure, which, if effective, may reduce firm risk. This study measures the effect of three measures of audit oversight quality on insolvency risk, systematic risk, and volatility of return on assets for a sample of U.S. pharmaceutical firms and energy firms from 2010 to 2022. All measures of audit oversight quality reduced firm risk, with the first measure reducing both systematic risk and volatility of return on assets, the second measure reducing systematic risk, and the third measure reducing volatility of return on assets. As institutional ownership is also a governance measure, we tested whether its joint effect with audit oversight quality reduced firm risk. This hypothesis was supported for all three measures of audit oversight quality for systematic risk and for the third audit oversight quality measure for volatility of assets. Robustness was established by replicating the regressions with an alternate governance measure, which yielded similar results. Endogeneity of all audit oversight quality measures was absent due to lack of significance of leverage, firm size, equity multiplier, and firm value in reducing risk through their effect on audit oversight quality. Full article

IT governance is a framework that manages the efficient use of information technology within an organization, focusing on strategic alignment, risk management, resource management, performance measurement, compliance, and value delivery. This study investigates the role of IT governance in integrating artificial intelligence (AI) in accounting and auditing operations. Data were collected from 228 participants from Saudi Arabia using a combination of convenience sampling and snowball sampling methods. The collected data were then analyzed using structural equation modeling. Unexpectedly, the results demonstrate that AI, big data analytics, cloud computing, and deep learning technologies significantly enhance accounting and auditing functions’ efficiency and decision-making capabilities, leading to improved financial reporting and audit processes. The results highlight that IT governance plays a crucial role in managing the complexities of AI integration, aligning business strategies with AI-enabled technologies, and facilitating these advancements. This research fills a gap in previous research and adds significantly to the academic literature by improving the understanding of integrating AI into accounting and auditing processes. It builds on existing theoretical frameworks by investigating the role of IT governance in promoting AI adoption. The findings provide valuable insights for accounting and auditing experts, IT specialists, and organizational leaders. The study provides practical insights on deploying AI-driven technology in organizations to enhance auditing procedures and financial reporting. In a societal context, it highlights the broader implications of AI on transparency, accountability, and trust in financial reporting. Finally, the study offers practitioners, policymakers, and scholars valuable insights on leveraging AI advancements to optimize accounting and auditing operations. It highlights IT governance as an essential tool for effectively integrating AI technologies in accounting and auditing operations. However, successful implementation encounters significant organizational challenges like organizational support, training, data sovereignty, and regulatory compliance. Full article

The mode is a fundamental descriptive statistic in data analysis, signifying the most frequent element within a dataset. The range mode query (RMQ) problem expands upon this concept by preprocessing an array A containing n natural numbers. This allows for the swift determination of the mode within any subarray A[a..b], thus optimizing the computation of the mode for a multitude of range queries. The efficacy of this process bears considerable importance in data analytics and retrieval across diverse platforms, including but not limited to online shopping experiences and financial auditing systems. This study is dedicated to exploring and benchmarking different algorithms and data structures designed to tackle the RMQ problem. The goal is to not only address the theoretical aspects of RMQ but also to provide practical solutions that can be applied in real-world scenarios, such as the optimization of an online shopping platform’s understanding of customer preferences, enhancing the efficiency and effectiveness of data retrieval in large datasets. Full article

This research examines the effect of ESG disclosure on the cost of capital for non-financial firms in the UK, indexed by the FTSE All-Share Index, during the period from 2014 to 2018. Using multivariate analysis with ordinary least squares (OLS), fixed effects, robust regression, and Tobit models, this research assesses the effect of ESG reporting, governance, and the cost of capital, including robustness checks using an alternative ESG indicator, the environmental pillar score. Contrary to expectations, ESG reporting is positively associated with the cost of capital. However, corporate governance moderates this relationship, weakening the positive correlation and reversing it to a negative association for firms with strong governance practices, consistent with the hypotheses. This research also finds that firm size, liquidity, profitability, and leverage, positively affect the cost of capital, while board size, independent board composition, audit committee independence, and auditor type do not significantly influence it. Notably, non-executive directors on the audit committee have a significant negative effect on the cost of capital. These findings are valuable for investors, companies, regulators, auditors, policymakers, and the academic and research community. Specifically, for investors, this study provides insights into how ESG disclosures can influence investment risks and returns, highlighting the importance of robust corporate governance. Companies can leverage these insights to enhance their governance practices and optimize their capital costs. Regulators and policymakers can use the findings to develop guidelines that encourage transparent ESG reporting and strong governance frameworks, thereby improving market stability and investor confidence. Auditors can utilize the results to better understand the effect of non-financial reporting on financial metrics, helping to provide more accurate audits and assessments. These findings inform investors, companies, regulators, auditors, and academia, in fostering a more sustainable and transparent financial environment. Full article

Currently, the decision boundary of the multi-class anomaly detection algorithm based on deep learning does not sufficiently capture the positive class region, posing a risk of abnormal sample features falling into the domain of normal sample features and potentially leading to misleading outcomes in practical applications. In response to the above problems, this paper proposes a new method called multi-class hypersphere anomaly detection (MMHAD) based on the edge outlier exposure set and margin. The method aims to utilize convolutional neural networks for joint training of all normal object classes, identifying a shared set of outlier exposures, learning compact identification features, and setting appropriate edge parameters to guide the model in mapping outliers outside the hypersphere. This approach enables more comprehensive detection of various types of exceptions. The experiments demonstrate that the algorithm is superior to the most advanced baseline method, with an improvement of 26.0%, 8.2%, and 20.1% on CIFAR-10 and 14.8%, 12.0%, and 20.1% on FMNIST in the cases of (2/8), (5/5), and (9,1), respectively. Furthermore, we investigate the challenging (2/18) case on CIFAR-100, where our method achieves approximately 17.4% AUROC gain. Lastly, for a recycling waste dataset with the (4/1) case, our MMHAD yields a notable 22% enhancement in performance. Experimental results show the effectiveness of the proposed model in multi-classification anomaly detection. Full article

Although financial statements are extremely important to investors in decision-making processes, their reliability can be affected by earnings management (EM) practices, which involve manipulating financial reports in order to achieve managerial benefits. This study explores the relationship between earnings management and firm valuation, based on accounting information’s predictive value, specifically investigating how EM influences the value relevance (VR) of earnings on share price. The research focuses on a sample of audited companies listed on the Bucharest Stock Exchange (BSE) between 2019 and 2021, comprising 62 entities. Using regression analysis, we explored the importance of accounting information for investors following Ohlson’s research and examined the relationship between EM and VR based on Jones’s model. The findings indicate that earnings significantly impact stock prices, highlighting their value relevance in the Romanian stock market. However, the practice of earnings management reduces the value relevance of earnings because it decreases the reliability of the accounting information. The main contribution of this analysis is to provide a fresh perspective on earnings management (EM) within the BVB framework by highlighting its pivotal role in shaping the motivation and behavior of corporate managers. Full article

This article examines illicit financial flows (IFFs) perpetuated in financial statements to develop a framework to curb IFFs. IFFs create opacity, impeding economic progress through investment deterrents and financial uncertainty. Through a comprehensive literature review and the synthesis of sets of qualitative propositions, the researchers previously developed a conceptual framework to address IFFs, and the purpose of the present article is to strengthen and validate the framework among stakeholders in the financial and audit sectors. Following a mixed inductive and deductive research approach and a qualitative methodological choice, the researchers conducted interviews among practitioners to enhance the framework, followed by a focus group to validate the framework. IFF challenges that emerged are tax evasion, for example, investments in untraceable offshore accounts, harming the economy, and bitcoins not being subject to regulation everywhere in the world and being used by cryptocurrency criminals to transfer IFFs to nations with lax regulations. Internationally, IFF risks are also determined by geographical position, trade links, and porous borders among countries that emerged as further challenges, calling for entities to execute existing policies, improve tax enforcement methods, apply cross-border coordination, and practice financial reporting transparency aimed at combatting IFF practices. On the strength of these, the industry surveys significantly enhanced the conceptual framework. Full article

This paper aims to evaluate corporate governance in relation to enterprise performance indicators in order to enhance it. The intention is not only to align with the interests of shareholders, but also to foster competitive, sustainable, and inclusive growth. For this purpose, the leading energy producer in each of the five countries—Denmark, Estonia, Latvia, Lithuania, and Sweden—was investigated to evaluate their corporate governance performance. An analysis was conducted, employing regression analysis, Pearson correlation, and descriptive statistics. The influence of corporate governance on the performance of chosen enterprises was examined, utilising specifically developed models. The findings reveal that the corporate governance variables are diverse, and financial metrics exhibit significant variability, reflecting the complexity of the energy industry. The research results confirm that larger and more varied boards positively impact the performance of state-owned power suppliers and increase their net income. The presence of independent members was also found to contribute to the net income growth of state-owned power suppliers. However, the study indicated that the frequency of audit meetings does not necessarily increase earnings. Still, larger audit committees can contribute to CG decision-making processes concerning debt management. The results also implied the need to consider the qualifications of the board members and its composition for proper power interruption management to minimise the frequency and duration of power outages. Therefore, it must be of pivotal focus for respective corporate governance duties. In this respect, the need for more specific and regular assessments was also found to be justified regarding industry-specific challenges related to power system disruptions. Customer-centric strategies should deserve relevant attention as well. The enforcement of the management audit function could be a solution. Consequently, assessing the governance structures and decision-making processes must be systematic for energy producers due to the business dynamics leading to the revaluation of the evolving challenges and possible solutions aimed at the competitive and sustainable development of the energy sector. Full article

Introduction: The difference in incidence and severity of anti-PD-1 therapy-related adverse events (irAEs) between adjuvant and advanced treated melanoma patients remains unclear, as no head-to-head studies have compared these groups. Methods: This multi-center cohort study analyzed melanoma patients treated with anti-PD-1 in adjuvant or advanced settings between 2015 and 2021. Comorbidities and ECOG performance status were assessed before treatment, and grade III-IV irAEs were monitored during treatment. Univariate and multivariate regression analyses were conducted to identify factors associated with irAE development. Results: A total of 1465 advanced melanoma patients and 908 resected melanoma patients received anti-PD-1 therapy. Adjuvant-treated patients were younger, with a median age of 63 years compared to 69 years in the advanced group (p < 0.01), and had a better ECOG performance status (p < 0.01). Comorbidities were seen more frequently in advanced melanoma patients than in those receiving adjuvant treatment, 76% versus 68% (p < 0.01). Grade III-IV irAEs occurred in 214 (15%) advanced treated patients and in 119 (13%) adjuvant-treated patients. Multivariate analysis showed an increased risk of severe irAE development with the presence of any comorbidity (adjusted OR 1.22, 95% CI 1.02–1.44) and ECOG status greater than 1 (adjusted OR 2.00, 95% CI 1.20–3.32). Adjuvant therapy was not associated with an increased risk of irAE development compared to advanced treatment (adjusted OR 0.95, 95% CI 0.74–1.21) after correcting for comorbidities and ECOG performance score. Anti-PD-1 therapy was halted due to toxicity (any grade irAE) more often in the adjuvant setting than in the advanced setting, 20% versus 15% (p < 0.01). Conclusions: Higher ECOG performance status and presence of any comorbidity were independently associated with an increased risk of Grade III-IV irAE in adjuvant and advanced treated melanoma patients. Patients treated in the adjuvant setting did not have an increased risk of developing severe irAEs compared to advanced melanoma patients. These findings are of clinical significance in consulting patients for adjuvant anti-PD-1 treatment. Full article