Uniform Guidelines Research Articles

APPLICATION OF NEW REQUIREMENTS FOR STANDARDIZED TRANSFER PRICING DOCUMENTATION IN THE REPUBLIC OF BULGARIA – ADVANTAGES AND BENEFITS FOR TAX AUTHORITIES AND TAXPAYERS

Transfer pricing raises a number of issues and challenges for companies operating transfer operations and for the tax administrations of the countries in which they operate. Along with the increasing role of international transfer pricing on a global scale, increasing attention is paid to possible improvements in the control in this area and improving the regulatory measures in the individual countries aimed at limiting and countering the attempts at manipulation by companies in order to reduce paid profit taxes, customs duties, etc. through the transfer pricing. In modern conditions of continuously increasing globalization, more and more perceivable is the need for application of uniform, internationally recognized requirements and rules to documentation and control of transfer prices.
 The main purpose of this scientific paper is to examine the major rules and requirements related to the preparation of standardized transfer pricing documentation in the Republic of Bulgaria in the contemporary conditions. It discusses the increasing role and significance of international transfer pricing in the context of globalization and the necessity for application of uniform international guidelines on transfer pricing. A special attention is paid to the systematization of significant advantages and benefits of the application of standardized, globally recognized requirements in the field of transfer pricing in the Republic of Bulgaria both for companies -taxpayers and for tax administrations.
 The methodology of research of the issues in the paper involves the application of the historical-logical and systematic approaches and the methods of observation, comparison, analogy, analysis and synthesis, induction and deduction, etc. In accordance with the systematic approach, the information for transfer pricing of the different constituent entities of the multinational groups is considered as an integral part of the information for transfer pricing of the group as a whole.
 As a result of the research made, it is concluded that the implementation of the standardized rules for documentation that multinational groups must prepare in order to justify the methodology for determining transfer prices used in their international intra-group transactions provides valuable advantages and benefits both for the tax administrations of the relevant countries and for the taxpayers.
 From the perspective of tax authorities, the adoption of standardized requirements achieves improvement of the methodology of transfer pricing and tax audit in this area, higher degree of reliability, comparability and transparency of information provided by taxpayers for control over transactions between related parties. Through these requirements are achieved also better results in the tax discipline, the prevention of tax evasion and effective tools for avoidance and resolution of transfer pricing disputes.
 From the position of the taxpayers it is of utmost importance that through the uniform, internationally recognized requirements for documentation and tax audit of transfer prices the burden and costs in preparing the documentation on pricing in international transactions between related parties are significantly reduced. The introduction of these rules creates clarity and predictability with regard to information required to prove that their transactions with related parties satisfy the arm’s length principle. The standardized documentation enables taxpayers to defend their tax position, provides guarantees for the tax treatment of the transactions between related parties, possibilities for advance compliance with the requirements and hence for avoidance of penalties and transfer pricing disputes with tax administrations.

Improving Consumers’ Understanding and Use of Carbon Footprint Labels on Food: Proposal for a Climate Score Label

SummaryToday, the food sector is largely excluded from climate protection policies. Nevertheless, the food sector is responsible for about 20 per cent of greenhouse gases. Food policies could substantially contribute to the EU’s ambitious climate goals. Currently, the debate on CO2‐e labelling is gaining momentum. Consumers know very little about the climate footprint associated with food choices. A climate label would strengthen consumer knowledge, may eventually influence food choices, could trigger reformulation efforts, raises awareness, and contribute to better informed discussions about climate policy. Based on a review of the current state of research and industry developments on designing CO2 footprint labels, this article provides recommendations on how to develop a clearly understood and trustworthy label. We propose a government approved, multi‐level, and categorical CO2‐e label, with colour coding and numeric CO2 equivalents; primarily based initially on median values. The design of the label should allow for an adoption of other environmental dimensions in the future. It should be scaled to weight (CO2‐e per kg) and apply to food products and meals. In the proposed form, a CO2‐e label is a low‐cost instrument. As more and more companies are already starting to label their products in different ways, consumer confusion is likely to rise if no uniform guidelines are established.

Karl Popper 120th anniversary: Some reflections on the decision-making process in medicine.

Rereading Popper’s “The Logic of scientific discovery”, at his 120th anniversary, brings some thoughts regarding the diagnostic process and decision making in medicine from the viewpoint of the classical scientific method. In recent years physicians are increasingly becoming technical experts who base their decision-making on uniform criteria, guidelines and classifications but unfortunately have moved away from understanding the basic concepts in the philosophy of science. This raises an ethically and philosophically important issue; what does a medical diagnosis mean? Is this an absolute or a relative truth? The implications of this question are enormous in terms of prognosis and treatment. Both patients and physicians should be educated about the nature of the diagnostic process.

Lung Cancer Risk in Suspicious Lung Nodules With Negative Positron Emission Tomography

BackgroundLung CT Screening Reporting and Data System (LungRADS) Category 4 represents lung nodules with the highest likelihood of cancer. For LungRADS-4 lesions, if positron emission tomography (PET) is negative, no uniform guideline currently exists on subsequent follow-up, particularly whether the surveillance interval can be extended. We sought to investigate the incidence of cancer, our surveillance practice, and any clinical factors associated with cancer in this patient subset. MethodsWe retrospectively stratified LungRADS-4 patients screened at our institution from March 2015 to February 2019 into subgroups: PET positive, PET negative, and no PET performed. PET negativity was defined as the absence of a radiologist’s suspicion or a maximum standardized uptake value at or below the mediastinal value. ResultsOf the 191 LungRADS-4 patients identified, 67 (35.1%) met the criteria for PET negativity. Cancer was diagnosed in 28.8% of the entire cohort (55/191), 77.8% of the PET-positive subgroup (35/45), 22.4% of the PET-negative subgroup (15/67), and 6.3% of the no PET subgroup (5/79). The most common follow-up modality after a negative PET was a computed tomography (47/67, 70.1%), with a median interval of 3.1 months. Clinical variables including nodule location/size, chronic obstructive pulmonary disease, family history of lung cancer, pack-years, and number of years quit in former smokers were not significantly associated with greater cancer risk among the PET-negative subgroup. ConclusionsFor LungRADS-4/PET-negative lesions the cancer risk remained high despite a lack of activity on PET. As such we believe the current surveillance practice of continuing to follow LungRADS-4/PET-negative patients as LungRADS-4 patients is appropriate.

Ruggedness Evaluation and Precision Estimates for Newly Developed Test Methods for Asphalt-Treated Cold Recycled Pavements

Asphalt-treated cold recycled pavements, including cold in place recycling, full depth reclamation, and cold central plant recycling, are becoming popular rehabilitation options because they are economical, sustainable, and provide good performance. Because asphalt-treated cold recycled pavements use foamed or emulsified binder, they require a curing period post-construction before being opened to traffic or surfaced. Uniform guidelines on when an asphalt-treated cold recycled roadway can be opened to traffic or surfaced are not widely established, many are based on time or moisture content, and extreme ranges exist among agency specifications. Mixture designs also vary widely among agencies with regard to active filler use and asphalt recycling agents, further complicating the determination of necessary curing time. NCHRP Project 09-62 investigated a variety of test methods for determining when a recycled roadway could be opened to traffic or surfaced. This included extensive laboratory and field evaluations. New shear strength and raveling test methods were developed. For each test method a ruggedness study and inter-laboratory study were performed. The ruggedness study revealed critical test fixture and operation parameters. Six asphalt-treated cold recycled pavement process/material combinations were tested by three entities to develop precision estimates and statements (i.e., repeatability and reproducibility) for the new test methods. Tools and information from this study provide a rational basis for establishing specifications, which will help reduce pavement damage from early traffic and minimize roadway closures and delays.

Ethical issues on artificial intelligence in radiology: how is it reported in research articles? The current state and future directions

Background. This paper evaluates the status of reporting information related to the usage and ethical issues of artificial intelligence (AI) procedures in clinical trial (CT) papers focussed on radiology issues as well as other (non-trial) original radiology articles (OA). Material and Methods. The evaluation was performed by three independent observers who were, respectively physicist, physician and computer scientist. The analysis was performed for two groups of publications, i.e., for CT and OA. Each group included 30 papers published from 2018 to 2020, published before guidelines proposed by Liu et al. (Nat Med. 2020; 26:1364-1374). The set of items used to catalogue and to verify the ethical status of the AI reporting was developed using the above-mentioned guidelines. Results. Most of the reviewed studies, clearly stated their use of AI methods and more importantly, almost all tried to address relevant clinical questions. Although in most of the studies, patient inclusion and exclusion criteria were presented, the widespread lack of rigorous descriptions of the study design apart from a detailed explanation of the AI approach itself is noticeable. Few of the chosen studies provided information about anonymization of data and the process of secure data sharing. Only a few studies explore the patterns of incorrect predictions by the proposed AI tools and their possible reasons. Conclusion. Results of review support idea of implementation of uniform guidelines for designing and reporting studies with use of AI tools. Such guidelines help to design robust, transparent and reproducible tools for use in real life.

NTCP Modeling of Late Effects for Head and Neck Cancer: A Systematic Review.

NTCP Modeling of Late Effects for Head and Neck Cancer: A Systematic Review.

Literature Review for Office-Based Anesthesia

Literature Review for Office-Based Anesthesia

Valuation inaccuracy, approaches, basis and procedures for judgment execution in Ethiopia

PurposeThe causes of valuation inaccuracy, the approaches, basis and procedures used for value estimation were not profoundly identified in Ethiopia. Particularly, the causes of property valuation inaccuracy for court decisions have not been assiduously studied by scholars. Hence, the ultimate goal of this study aims to identify the determinant variables of valuation inaccuracy, the approaches, basis and procedures used for court execution purposes.Design/methodology/approachThis study employed both qualitative and quantitative approaches. The target populations of the study were the courts at the federal and regional levels. A purposive sampling technique was employed to undertake this study. The survey data was analyzed using the Relative Importance Index (RII).FindingsThe finding of this research revealed that courts have not outshined and uniform valuation manuals and guidelines that clearly state the approaches, procedures and bases of valuation. As a consequence, courts execute based on the opinion of value determined by other institutions. The insignificant numbers of independent valuation institution with the lack of uniform standards in the country prejudice the implementation of the decision of the court and faced injustice. The finding also reveals as there are several causative variables for real property valuation inaccuracy.Practical implicationsTo alleviate the problem, the government should strengthen the valuation sector by creating an independent institution for advancing valuation regulation and policymaking.Originality/valueThis study was the first of all and could be a pointer for different government and non-government bodies regarding the limitations of valuation for judgment execution purposes.

Medication of Hydroxychloroquine, Remdesivir and Convalescent Plasma during the COVID-19 Pandemic in Germany-An Ethical Analysis.

This paper aims to analyze the ethical challenges in experimental drug use during the early stage of the COVID-19 pandemic, using Germany as a case study. In Germany uniform ethical guidelines were available early on nationwide, which was considered as desirable by other states to reduce uncertainties and convey a message of unity. The purpose of this ethical analysis is to assist the preparation of future guidelines on the use of medicines during public health emergencies. The use of hydroxychloroquine, remdesivir and COVID-19 convalescent plasma in clinical settings was analyzed from the perspective of the ethical principles of beneficence, non-maleficence, justice and autonomy. We observed that drug safety and drug distribution during the pandemic affects all four ethical principles. We therefore recommend to establish ethical guidelines (i) to discuss experimental treatment options with patients from all population groups who are in urgent need, (ii) to facilitate the recording of patient reactions to drugs in off-label use, (iii) to expand inclusion criteria for clinical studies to avoid missing potentially negative effects on excluded groups, and (iv) to maintain sufficient access to repurposed drugs for patients with prior conditions.

Driveline exit-site care protocols in patients with left ventricular assist devices: a systematic review.

OBJECTIVESDriveline infections continue to be a significant complication following left ventricular assist device (LVAD) implantation. Driveline exit-site care is crucial for the prevention of infections; however, there are no uniform guidelines. The goal of this study was to provide an overview of the currently published driveline exit-site care protocols in patients with LVAD.METHODSA systematic literature review was performed. Studies before 15 December 2020 were included if the number of driveline infections was a primary outcome and the driveline exit-site care protocol was explained.RESULTSEleven articles were included in the systematic review, including 1602 patients with LVADs. The median of the frequency of driveline infections in the articles was 13.8% with a range of 0–52.6%. There was a marked variability in the methods of care of driveline exit sites, without a standardized driveline dressing technique in patients with LVADs. The frequency of driveline infections was 6–7.5% in studies using a dressing kit that included chlorhexidine, a silver-based dressing and an anchoring device. Furthermore, there was variability in the anchoring devices and the frequency of dressing changes, which varied from daily to weekly. No specific anchoring device or change frequency was found to be superior.CONCLUSIONSBased on this systematic review, driveline exit care protocols that included chlorhexidine, a silver-based dressing, the use of an anchoring device and dressing kits might be best in reducing driveline infection rates. However, prospective studies with larger cohorts are needed to establish the optimal protocol for driveline exit-site care.

Current status on treatment of uterine adenosarcoma: updated literature review

Background and Objective: Adenosarcoma is a rare subtype of uterine sarcoma, composed by a combination of a benign epithelial and a malignant, but generally low grade, mesenchymal component and it is considered the least aggressive form of its epithelial counterpart, uterine carcinosarcoma. The presence of myometrial invasion and the extent of disease outside the uterus determines the stage of disease, while the presence of sarcomatous overgrowth represents the most important histological prognostic factor, correlating with the grade of disease. Because of the extreme rarity of UAS, most available literature data arise from retrospective case series and reports, while uniform clinical guidelines are still lacking. We herein review current literature date regarding the management of this rare tumor, with emphasis on surgical and medical treatment.

Nutritional Assessment and Preparation for Adult Bariatric Surgery Candidates: Clinical Practice

Bariatric surgery (BS) has proven to be highly efficacious in the treatment of obesity and its comorbidities. However, careful patient selection is critical for its success. Thus, patients should undergo medical, behavioral, and nutritional assessment by a multidisciplinary team. From the nutritional point of view, BS candidates should undergo nutritional assessment, preparation, and education by a registered dietitian in the preoperative period. Currently, detailed specified and comprehensive information on these topics is lacking. The present narrative review aimed to summarize the available literature concerningboth the preoperative nutritional assessment components and the preoperative nutritional preparation and education components of patients planning to undergo BS. Current literature indicates that proper management before BS should include a comprehensive nutritional assessment, in which it is advisable toperform a clinical interview to assess patients' medical background, weight management history, eating patterns and pathologies, oral health, physical activity habits, nutritional status, supplementation usage, BS knowledge, surgery expectations and anthropometric measurements. Nutritional preparation and educational strategies should include an individualized preoperative weight-loss nutrition program, improvement of glycemic control, micronutrients deficiencies correction, eating and lifestyle habits adaptation, physical activity initiation, and strengthening knowledge on obesity and BS. At this stage, more well-designed intervention and long-term cohort studies are needed in order to formulate uniform evidence-based nutritional guidelines for patients who plan to undergo BS, including populations at higher nutritional risk. Moreover, postoperative outcomes of presurgical nutritional intervention programs should be studied.

The Interconnectedness of Disability and Trauma in Foster and Kinship Care: The Importance of Trauma-Informed Care

ABSTRACT A high prevalence of maltreatment, abuse, neglect and the onset of subsequent trauma has been well-documented among both young people with disability and young people residing in foster and kinship care. However, no uniform policies or guidelines currently exist for the delivery of trauma-informed models of care to build the capacity of foster and kinship carers in responding to and supporting the complex needs of children and young people in their care with disability who may have been exposed to trauma. While no evidence of the application of trauma-informed models of care for this cohort exists, some evidence of trauma-informed models of care to support people with disability beyond the scope of out-of-home care has recently emerged. The authors discuss this emerging work and recognise an opportunity to leverage this evidence to guide the practices of foster and kinship carers. Clearly, there is an opportunity to work towards improving the development and wellbeing of children and young people with disability in foster and kinship care through the development, implementation, and evaluation of a tailored trauma-informed model of care that is co-designed and grounded in the underlying theoretical principles of disability and trauma.

Indian Debt Market: Need for More Reforms

The Indian debt market while made out of securities, both Government and Corporate, is really overwhelmed by G-Sec with more than 90 per cent of Indian debt market, leaving little space for corporate securities. The focal government securities are the dominating and most fluid segments of the security market. Nonetheless, regardless of the expanded volumes, the quantity of members is restricted to around two dozen dynamic players. The focal government securities are the dominating and most fluid segments of the security market. Nonetheless, regardless of the expanded volumes, the quantity of members is restricted to around two dozen dynamic players. Since a lion's share of members is AAA – evaluated and 80 per cent of exchange is immediate, there exist settlement hazards. The market would further develop once uniform guidelines on accounting, valuation and so on are in place. Therefore, this paper highlights the need for more reform in Indian debt market.

A Systematic Framework for Collecting Site-Specific Sampling and Survey Data to Support Analyses of Health Impacts from Land-Based Pollution in Low- and Middle-Income Countries.

The rise of small-scale and localized economic activities in low- and middle-income countries (LMICs) has led to increased exposures to contaminants associated with these processes and the potential for resulting adverse health effects in exposed communities. Risk assessment is the process of building models to predict the probability of adverse outcomes based on concentration-response functions and exposure scenarios for individual contaminants, while epidemiology uses statistical methods to explore associations between potential exposures and observed health outcomes. Neither approach by itself is practical or sufficient for evaluating the magnitude of exposures and health impacts associated with land-based pollution in LMICs. Here we propose a more pragmatic framework for designing representative studies, including uniform sampling guidelines and household surveys, that draws from both methodologies to better support community health impact analyses associated with land-based pollution sources in LMICs. Our primary goal is to explicitly link environmental contamination from land-based pollution associated with specific localized economic activities to community exposures and health outcomes at the household level. The proposed framework was applied to the following three types of industries that are now widespread in many LMICs: artisanal scale gold mining (ASGM), used lead-acid battery recycling (ULAB), and small tanning facilities. For each activity, we develop a generalized conceptual site model (CSM) that describes qualitative linkages from chemical releases or discharges, environmental fate and transport mechanisms, exposure pathways and routes, populations at risk, and health outcomes. This upfront information, which is often overlooked, is essential for delineating the contaminant zone of influence in a community and identifying relevant households for study. We also recommend cost-effective methods for use in LMICs related to environmental sampling, biological monitoring, survey questionnaires, and health outcome measurements at contaminated and unexposed reference sites. Future study designs based on this framework will facilitate consistent, comparable, and standardized community exposure, risk, and health impact assessments for land-based pollution in LMICs. The results of these studies can also support economic burden analyses and risk management decision-making around site cleanup, risk mitigation, and public health education.

Drug survival of systemic and biologic monotherapy treatments for pityriasis rubra pilaris: A retrospective observational study

To the Editor: Pityriasis rubra pilaris (PRP) is a rare, inflammatory skin condition characterized by erythematous papulosquamous plaques with islands of sparing. Currently, there are no uniform guidelines for the management of PRP.1 Although studies and case series have suggested off-label biologics, there is a need for consensus on the treatment regimens and a comparison of the existing systemics is yet to be conducted.2-5 Our study aimed to characterize drug survival, a reflection of the drug performance in routine medical practice, and the treatment failures for patients with PRP treated with systemic therapies at the University of Pittsburgh Medical Center.

Bundling method to treat extensive thumb fingertip pulp incisions: A case report

Introduction. Thumb fingertip injuries, often combined with phalanx fracture or torn ligament, are very common. The focus of treatment is on how to rebuild the function and shape of the thumb. Single thumb fingertip pulp injury is more common. However, due to the diverse type of injury, no uniform treatment guideline is described in the literature. Case report. A patient with extensive thumb fingertip pulp incisions, which looked like multiple parallel wounds, was admitted to our Emergency Department. We used the method of bundling to maintain the shape of the fingertip. A single suture to pass through all the incisions was performed and then the suture was tied outside the skin. After that, we bandaged them with sterile bandages. Finally, good contour and fingertip function were restored. Conclusion. We successfully used the bundling method to treat patient with extensive thumb fingertip pulp incisions.

Survey based cross-sectional study to analyse the variation of practices at blood centres during COVID-19 pandemic in India

India has almost 3,000 blood centres collecting more than 11 million units annually. Maintaining blood supply during the COVID-19 pandemic is a huge challenge. We conducted a cross-sectional study by an online survey to analyse the variation of practices across blood centers of India during this pandemic. A total of 196 blood centers completely responded to the online survey. Most of the blood centres who responded were part of Government hospitals (60 %), part of an academic institutes (55.6 %) and were directly supporting a COVID hospital (67.5 %). Almost 95.4 % blood centers reported reduction of blood donation mainly due to lockdown (50 %) and inability to conduct camps (17.3 %). Scheduling blood donations was one of the most difficult to implement strategy for maintaining adequate blood donation (40.2 %). Blood center manpower management was also a challenge and upto 48 % blood centers operated in two batches to ensure social distancing in blood banks and reduce the risk of exposure. Hemato-oncology (36.8 %) and obstetrics (33.7 %) were major utilizer of blood during the pandemic. There were marked variations in use of PPE by blood banks staff as well as strategies adopted while conducting immunohematology tests on COVID-19 positive patients samples. This pandemic has highlighted some of the major limitations of the health services but blood services have risen to the challenge and strived to maintain the blood supply chain while ensuring blood donor and staff safety. The wide variations in the practices adopted highlights the need for uniform guidelines for blood services in future pandemics.

Expert consensus on the clinical diagnosis and treatment of eye burns in China (2021)

Eye burns, which are usually caused by chemicals such as acidic, alkaline and heat-related substances, are true medical emergencies. These substances can lead to potential permanent damage to the eyelids, cornea, ocular surface and intraocular tissues. In severe cases, eye burns may result in blindness. Currently, there is a lack of uniform and standardized guidelines for the diagnosis and treatment of eye burns. As a result, a considerable number of patients have a poor prognosis. Therefore, the Cornea Group of Chinese Ophthalmological Society has developed this consensus statement after thorough discussions, hoping to provide guiding opinions on the clinical diagnosis and treatment of eye burns. (Chin J Ophthalmol, 2021, 57:254-260).