Equivalent Procedure Research Articles

CHALLENGES IN DERIVING EQUIVALENT MODELS OF ACTIVE DISTRIBUTION GRIDS FROM OPERATIONAL DATA

Wide area monitoring systems equipped with phasor measurement unit technology allow measurement and logging of time-synchronous operational data inside modern power systems. The usage of those operational data also for deriving equivalent models of active distribution networks (ADN) for power system stability studies therefore comes naturally. This paper consists of the analysis of the behaviour of ADN and the analysis of the properties of common equivalent model types and procedures with regard to their parameterization using operational measurement data. In the analysis of the behaviour the quasi-stationary nonlinearity between the input and output variables of the active distribution network is proposed as a measure of its complexity or the complexity of the identification problem of a distribution network in general. The discussion of the emergence of this nonlinearity, depending on the behaviour of distributed generation (DG) controls, thus allows to generalize the findings collected here to other distribution networks of different composition. In the determination of equivalent models the properties and conditions for the parameterization of the quasi-stationary nonlinearity is discussed into the most common equivalent model types in literature, the black-box models based on artificial neural networks (ANN) and the grey-box models based on parametric models.

Analysis of Mathematical Connection Skills Using Realistic Mathematical Education

Connection ability is the ability to associate between topics in mathematics, associate mathematics in other sciences, and with everyday life. This research aims to find out the ability of mathematical connections by using the realistic mathematical education of the concept of Social Arithmetic in class VII of SMP Negeri 209 Jakarta. This type of research is qualitative descriptive with the selection of subjects based on the results of interviews. The main instrument in the study was the researchers themselves. Instruments for discovering mathematical connection skills are tests and interviews. Data collection techniques with observation guidelines, tests, interviews, and documentation. Data analysis used is qualitative analysis i.e. data collection, presentation of data, and withdrawal of conclusions. The results of the analysis showed that subjects included students who had the ability of mathematical connections that met 4 indicators of mathematical connections, namely recognizing the equivalent representation of the same concept, recognizing the relationship of a mathematical procedure of a representation to an equivalent representation procedure, using and assessing the relationship between topics with other disciplines, using mathematics in everyday life

Seismic design and evaluation of controlled outriggered rocking wall (CORW) using equivalent energy design procedure (EEDP)

Next-generation earthquake engineering design seeks to develop robust structural systems to limit structural and non-structural damage after strong earthquake shaking. In this study, an innovative high-performance tall building, named Controlled outriggered rocking wall (CORW) system is proposed. The CORW system improves the conventional reinforced concrete (RC) core wall by adding a damped outrigger system and a damped controlled rocking base. The CORW is designed using the novel Equivalent energy design procedure (EEDP) to meet different performance objectives for different shaking intensities. Detailed EEDP for the CORW system is presented in this paper. Three prototype buildings (with 25, 35, and 45 stories) located in Vancouver Canada were designed using the proposed procedure. Robust finite element models of the CORW systems were developed in OpenSees and subjected to a series of nonlinear time history analysis. The results of the nonlinear time history analysis indicate that the CORW system designed using EEDP performs well under different levels of earthquake intensities, where it can be used reliably as an effective seismic force resisting system for high-rise application.

Towards gender equity in procedure compensation: how far have we come in 20 years?

<h3>Objectives:</h3> Discrepancies in the reimbursement of gender-specific procedures have been reported since the beginning of the fee-for-service model. Procedure-based reimbursement is mediated by both work relative value unit (wRVU) and a specialty-specific compensation rate. Whether gender-based discrepancies in reimbursement have improved over time and which of these factors, wRVUs assigned per procedure or dollars per RVU, are the driver of these discrepancies in unknown. We aim to describe how wRVUs for gender-specific procedures have changed over time and to compare time-based compensation for gender-specific procedures. <h3>Methods:</h3> Using the National Surgical Quality Improvement Program (NSQIP) 2015-2018 we compared operative time and wRVUs for twelve pairs of gender-specific procedures. Only cases with a primary current procedural terminology (CPT) code and without any other procedure or concurrent procedure CPT codes were included in the analysis. Procedures were matched to be anatomically and technically similar. We further compared procedure assigned RVUs in 2015 to those assigned in 1997. We also evaluated procedure-based compensation. Procedure compensation was determined using median dollars per RVU for Urology and Gynecology provided in SullivanCotter's 2018 Physician Compensation and Productivity Survey. This was compared with specialty-specific McGraw-Hill per RVU data from 1994. Wilcoxon rank sum test was used to examine associations. <h3>Results:</h3> A total of 12,120 patients underwent 6,217 male-specific procedures and 5,903 female-specific procedures between 2015-2018. Male-specific procedures had a median wRVU of 25.2 (IQR 21.4-25.2), significantly higher than the median wRVU of 7.5 (IQR 7.5-23.4) for female-specific procedures (p<0.001). Evaluation of wRVUs for paired procedures matched by technical complexity (e.g. exenteration for prostate versus cervix cancer) revealed that in 6 cases (50%), male versus female procedures had higher wRVUs. This is a change from 1997 when the majority (75%) of male-specific procedures had higher assigned wRVUs. Male-specific procedures were longer, lasting a median of 79 minutes more than female-specific procedures (male 136 mins [IQR 98-186] versus female 57 mins [IQR 25-125], p<0.001). Comparing gender-specific procedures by wRVU/hr female-specific procedures were reimbursed at a higher rate (10.6 RVU/hr [IQR 7.2-16.2] versus 9.7 RVU/hr [IQR 7.4-12.8], p<0.001) than male-specific procedures. However, when compensation was accounted for, male-specific procedures were better reimbursed ($599/hr [IQR $457-790] versus $555/hr [IQR $377-843], p<0.001). Overall, per procedure wRVUs for male-specific surgeries have increased 13% over the past two decades while per procedure wRVUs for female-specific surgeries have increased 26%. Reimbursement for male-specific procedures has decreased 8% ($67.30 to $61.65 per RVU) while reimbursement for female-specific procedures has increased 14% ($44.50 to $52.02 per RVU) over the past 20 years. <h3>Conclusions:</h3> Over the past two decades increases in wRVUs for female-specific procedures and specialty-specific per RVU reimbursement have resulted in more equitable reimbursement for female-specific procedures compared with male-specific procedures. However, even with these changes, our findings support an overall lower relative value of work and reimbursement for procedures performed for women-only when compared with equivalent procedures performed for men-only.

Technical Note: Quantification of blood-spinal cord barrier permeability after application of magnetic resonance-guided focused ultrasound in spinal cord injury.

To demonstrate that magnetic resonance-guided focused ultrasound (MRgFUS) facilitates blood-spinal cord barrier (BSCB) permeability and develop observer-independent MRI quantification of BSCB permeability after MRgFUS for spinal cord injury (SCI). Noninjured Sprague-Dawley rats (n = 3) underwent MRgFUS and were administered Evans blue post-MRgFUS to confirm BSCB opening. Absorbance was measured by spectrophotometry and correlated with its corresponding image intensity. Rats (n = 21) underwent T8-T10 laminectomy and extradural compression of the spinal cord (23g weighted aneurysm-type clip, 1 min). The intervention group (n = 11) was placed on a preclinical MRgFUS system, administered microbubbles (Optison, 0.2 mL/kg), and received 3 MRgFUS sonications (25 ms bursts, 1 Hz pulses for 3 min, 3 acoustic W, approximately 1.0-2.1 MPa peak pressure as measured via hydrophone). The sham group (n = 10) received equivalent procedures with no sonications. T1w MRI was obtained both pre- and post-MRgFUS BSCB opening. Spinal cords were segmented manually or semiautomatically and a Pearson correlation with P ≤ 0.001 was used to correlate the two segmentation methods. MRgFUS sonication and control regions intensity values were evaluated with a paired t-test with a P ≤ 0.01. Semiautomatic segmentation reduced computational time by 95% and was correlated with manual segmentation (Pearson = 0.92, P < 0.001, n = 71 regions). In the noninjured rat group, Evans blue absorbance correlated with image intensity in the MRgFUS and control regions (Pearson = 0.82, P = 0.02, n = 6). In rats that underwent the SCI procedure, an increase in signal intensity in the MRgFUS targeted region relative to control was seen in all SCI rats (10.65 ± 12.4%, range: 0.96-43.9%, n = 11, P = 0.002). SCI sham MRgFUS revealed no change (0.63 ± 0.52%, 95% CI 0.320.95, n = 10). This result was significant between both groups (P = 0.003). The implemented semiautomatic segmentation procedure improved data analysis efficiency. Quantitative methods using contrast-enhanced MRI with histological validation are sensitive for detection of blood-spinal cord barrier opening induced by magnetic resonance-guided focused ultrasound.

PNS17 Value of a Comprehensive Ophthalmology Custom Pack in a Canadian Setting

To estimate the economic impact of custom surgical packs, sets of disposables and sterile supplies optimally arranged and customized for each surgeon, on cataract and vitreoretinal (vit-ret) surgeries across accounting, materials management, and operating room (OR) departments at hospital and aggregate group levels in Canada. A self-reported time and motion study was conducted in the USA in 2019 among surgical technicians and supply chain managers. Current surgery preparation and materials management practices data were collected via an online survey by surgical technicians (27 cataract/26 vit-ret) and supply chain managers (19 cataract/15 vit-ret). Technicians timed 140 cataract and 140 vit-ret surgeries, recording surgical supply use from a comprehensive pack (Alcon’s Custom Pak®) and other sources. Using these inputs and Canadian facility and labor parameters, a budget impact model (BIM) was developed to estimate time and labor costs across three departments. Assuming 100% use of “generic commodity packs” (no equipment-specific supplies), we explored the impact of transitioning to 100% use of a “comprehensive pack” (Custom Pak®) in one vit-ret and two cataract scenarios. Switching from generic commodity pack use to 100% comprehensive pack use in 1,000 community hospital vit-ret cases saves 27 materials management labor hours and 11 surgery preparation hours annually, translating to 13 additional procedures or CAD$23,853 – primarily OR costs. Implementing this change in 2,500 community hospital cataract cases saves 186 materials management hours and 78 preparation hours annually, or 196 equivalent procedures totaling CAD$53,819. Transitioning from generic commodity pack use to exclusive comprehensive pack use in 50,000 cataract cases at the aggregate group level saves 3,588 materials management hours and 1,550 OR labor hours yearly, gaining 3,916 procedures and saving CAD$1,070,609. Comprehensive surgical pack use improves cataract and vit-ret surgery efficiency, saving substantial operating room and materials management time and cost in Canadian hospitals.

Alleviating confounding in spatio-temporal areal models with an application on crimes against women in India

Assessing associations between a response of interest and a set of covariates in spatial areal models is the leitmotiv of ecological regression. However, the presence of spatially correlated random effects can mask or even bias estimates of such associations due to confounding effects if they are not carefully handled. Though potentially harmful, confounding issues have often been ignored in practice leading to wrong conclusions about the underlying associations between the response and the covariates. In spatio-temporal areal models, the temporal dimension may emerge as a new source of confounding, and the problem may be even worse. In this work, we propose two approaches to deal with confounding of fixed effects by spatial and temporal random effects, while obtaining good model predictions. In particular, restricted regression and an apparently—though in fact not—equivalent procedure using constraints are proposed within both fully Bayes and empirical Bayes approaches. The methods are compared in terms of fixed-effect estimates and model selection criteria. The techniques are used to assess the association between dowry deaths and certain socio-demographic covariates in the districts of Uttar Pradesh, India.

Experimental dynamic characterization of friction brace dampers and application to the seismic retrofit of RC buildings

Previous earthquakes have caused extensive damage to reinforced concrete (RC) structures with insufficient lateral force resistance or energy dissipation capacity. There is a need to retrofit vulnerable existing RC buildings, particularly those not originally designed for seismic effects or designed to an outdated seismic specification. This study investigates the use of friction dampers as displacement-dependent energy dissipation devices to retrofit RC moment frame structures. First, an experimental program was conducted to characterize the dynamic behavior of friction brace dampers with several different materials, finding that a sintered metal compound provided a stable friction coefficient of 0.4. A strength-based equivalent linearization design procedure was then developed based on the required friction slip force and considering the cracked state of the existing RC structure. A four-story RC school building was then designed using the proposed retrofit design method, validated using nonlinear response history analysis and compared to a previous retrofit scheme that employed buckling-restrained braces (BRBs) and a stiffness-based equivalent linearization design method. The analysis results suggest that the proposed retrofit design method and friction brace dampers are effective in reducing the maximum story drift.

Cost efficacy of wide local excision of pT1a melanoma in office versus operating room settings

Cost efficacy of wide local excision of pT1a melanoma in office versus operating room settings

Clinical relevance of a degree of extracapsular extension in a sentinel lymph node in breast cancer patients: a single-centre study

In some breast cancer (BC) patients, an examination of lymph nodes dissected during sentinel lymph node biopsy (SLNB) demonstrates a presence of metastatic lesions and extracapsular extension (ECE) in a SLN. This study aimed to evaluate clinical relevance of ECE in BC patients. This is a retrospective analysis of 891 patients with cancer metastases to SLN, referred to supplementary axillary lymph node dissection (ALND), hospitalized between Jan 2007 and Dec 2017. Clinical and epidemiological data was evaluated. Long-term treatment outcomes were analysed. In 433 (48.6%) patients, cancer metastases were limited to the SLN (group I), in 61 (6.8%) patients the SLN capsule was exceeded focally (≤ 1 mm—group II). In 397 (44.6%) patients, a more extensive ECE was found (> 1 mm—group III). Metastases to non-sentinel lymph nodes (nSLNs) were diagnosed in 27.0% patients from group I, 44.3% patients from group II and in 49.6% patients from group III. No statistically significant differences were observed in long-term treatment outcomes for compared groups. The presence of ECE is accompanied by a higher stage of metastatic lesions in the lymphatic system. The differences in this respect were statistically significant, when compared to the group of ECE(−) patients. ECE, regardless of its extent, did not impact the long-term treatment results. ECE remains an indication for supplementary ALND and for other equivalent cancer treatment procedures, regardless of ECE size.

Extremely High-Throughput Parallel Microfluidic Vortex-Actuated Cell Sorting.

We demonstrate extremely high-throughput microfluidic cell sorting by making a parallel version of the vortex-actuated cell sorter (VACS). The set-up includes a parallel microfluidic sorter chip and parallel cytometry instrumentation: optics, electronics and control software. The result is capable of sorting lymphocyte-sized particles at 16 times the rate of our single-stream VACS devices, and approximately 10 times the rate of commercial cell sorters for an equivalent procedure. We believe this opens the potential to scale cell sorting for applications requiring the processing of much greater cell numbers than currently possible with conventional cell sorting.

Seismic performance of controlled-rocking concentrically braced frames designed by the equivalent energy procedure

Recent earthquakes in New Zealand and Japan showed that structures designed according to modern building codes might suffer significant damages with hefty financial and social losses. The primary reason lies in the seismic design approach, where most seismic force resisting systems (SFRS) were designed to prevent structures from collapse during strong earthquake shaking, without considering the damage and the usability of the structure after an earthquake. In this paper, a controlled rocking-concentrically braced frame (CR-CBF) is proposed. CR-CBF is a fused structural system that uses a combination of post-tensioned tendons (PTs) and energy dissipation devices (EDs) to create a controlled-rocking mechanism to minimize structural repair costs and down time after a strong earthquake. PTs are placed in the structure to provide the restoring forces and to minimize any residual deformation in the structure, while EDs are placed at the base of a structure to dissipate the earthquake energy. To ensure the CR-CBF can achieve high performance, two (CR-CBF) prototypes with different heights are designed using the novel equivalent energy design procedure (EEDP). The EEDP procedure allows designers to select different performance objectives at different shaking intensities. The results of nonlinear dynamic analyses of the CR-CBFs show that CR-CBFs have superior seismic performances as intended and can be efficiently designed using EEDP. Finally, the seismic performance of CR-CBF against collapse is assessed using incremental dynamic analysis (IDA) outlined in the FEMA-P695 methodology. The results show that the CR-CBFs designed by EEDP have sufficient safety against collapse, hence it can be used as an efficient seismic force resisting system.

Basics of teaching electrochemical impedance spectroscopy of electrolytes for ion-rechargeable batteries – part 1: a good practice on estimation of bulk resistance of solid polymer electrolytes

Abstract In this publication, we present the basic to characterize the electrical properties of electrolytes that are widely used in ion-rechargeable batteries using electrochemical impedance spectroscopy (EIS). This simplified yet insightful background provided may be used for educational purposes, especially for beginners or young researchers for both undergraduate and postgraduate students. We start with introduction of electrolytes and electrochemical impedance spectroscopy (EIS) instrumentation, following with the step-by-step guidelines using three different procedures to estimate the bulk resistance (R b) of the electrolytes, which is inversely proportional to the conductivity (σ DC) of the materials R b ∝ 1 / σ DC $\left({R}_{\mathrm{b}}\propto 1/{\sigma }_{\mathrm{DC}}\right)$ . Several examples and exercises on estimation of quantity R b are supplemented for educational purposes. Comparison was made on estimation of R b using manual graphical procedures, mathematical regression procedures using commercial graphical software and equivalent circuit fitting procedures using exclusive EIS software. The results suggest that the manual graphical technique may serves as a useful approach for beginners before venturing to exclusive software. Besides, the instructors may use the procedures to coach the users to extract reliable and reproducible data before data interpretation. Lastly, the phenomenological approach on dielectric relaxation for solid polymer electrolytes [poly(ethylene oxide) (PEO) + lithium salt] and non-solid polymer electrolytes [poly(methyl acrylate) (PMA) + lithium salt], in the classic sense will be addressed in terms of impedance (Z*), permittivity (ε*), tangent loss (tan δ), modulus (M*) and conductivity (σ*) spectra in Part 2.

Performance of high-damping rubber bearings for seismic isolation of residential buildings in Turkey

The applicability of high-damping rubber bearings for seismic isolation of residential buildings in Turkey is studied using numerical and experimental approaches. Seismic isolation system composed of high-damping rubber bearings is designed according to the recently updated Turkish Building Seismic Code-2018 (TBSC2018). Three model buildings of different height at assumed seismically active area are chosen from an actual building database, on which, equivalent lateral force procedure, and time history analyses are carried out.The seismic responses of the buildings are evaluated and the seismic isolation system's efficiency is confirmed. It is pointed out that the requirements in the new code in terms of the maximum allowable shear strain of elastomeric isolators are excessively conservative for those isolators with much larger capacity which is verified by sufficient test data, and as a result, designed isolator size becomes larger than necessary from a practical aspect. In order to verify the isolator design without compliance of shear strain limitation in the code, full-scale prototypes of high-damping rubber bearings are specially designed, developed and are subjected to dynamic loading test under test protocol specified in the code. The specific values of test conditions, such as compressive force, shear displacement and frequency, are developed referring several projects in Turkey. The results are comprehensively discussed and the applicability of high-damping rubber bearing for seismic isolation of residential buildings in Turkey is concluded with numerical and experimental approaches and a possible modification of TBSC2018 regarding maximum shear strain is proposed.

Minimally Invasive All Arthroscopic Broström With InternalBrace Augmentation: A Technique Tip

Minimally invasive and all-arthroscopic lateral ligament repairs are increasingly popular in the ankle. These techniques are biomechanically and clinically as successful as their equivalent open procedures. Open lateral ligament repairs have benefitted by the inclusion of a suture tape to augment the strength of the repair and allow for earlier, accelerated rehabilitation. We present an arthroscopic technique to incorporate the benefits of minimally invasive ligament repair with the inclusion of the suture tape augmentation. This allows for immediate postoperative weight bearing, accelerated rehabilitation, and rapid return to function while minimizing scarring and wound complications. Level of Evidence: Diagnostic Level V, expert opinion. See Instructions for Authors for a complete description of levels of evidence.

Typical air kerma area product values for trauma orthopaedic surgical procedures.

BackgroundThe aim of study was to establish the typical radiation quantity values for the most common trauma orthopaedic surgical procedures and to compare them with reference values of equivalent procedures performed in other institutions. In addition, we assess the impact of image intensifier and flat panel detector technology used for fluoroscopically guidance on patient exposure.Materials and methodsFive most frequently performed fluoroscopically guided trauma orthopaedic procedures in University Medical Centre Ljubljana were analysed. Data on 199 cases over a 6 months period from December 2016 to June 2017 were gathered retrospectively. Study covered 40 dynamic hip screw fixations (DHS), 23 proximal femoral nail insertions (PFN), 20 proximal humeral nail insertions (PHN), 77 partial hip endoprosthesis implantations (PEP) and 39 percutaneous posterior spine fixations (PPS). The median and average along with the first and third quartile values of air kerma area product (KAP) for each procedure type were calculated as well as median and average value of fluoroscopy screening time.ResultsTypical KAP value for dynamic hip screw fixation was set at 0.52 Gycm2; for proximal femoral nail insertion at 0.53 Gycm2 and for proximal humeral nail insertion at 0.26 Gycm2. For implantation of partial endoprosthesis typical KAP value utilizing flat panel technology was set at 0.08 Gycm2 and at 0.21 Gycm2 when the image intensifier technology was used. Typical KAP value for percutaneous posterior spine fixation was set at 1.26 Gycm2, using flat panel technology and at 3.98 Gycm2 using image intensifier technology.ConclusionsEstablished typical KAP levels of surgical orthopaedic procedures in traumatology will serve as a valuable tool for further radiation exposure optimization.

Evaluation of Seismic Site Amplification Using 1D Site Response Analyses at Ba Dinh Square Area, Vietnam

This study presents a case study on ground response analysis of one of the important cultural heritages in Hanoi, Vietnam. One‐dimensional nonlinear and equivalent linear site response analyses which are commonly applied to solve the problem of seismic stress wave propagation are performed at the Ba Dinh square area. A measured in‐situ shear wave velocity profile and corresponding geotechnical site investigation and laboratory test data are utilized to develop the site model for site‐specific ground response analysis. A suite of earthquake records compatible with Vietnamese Design Code TCVN 9386: 2012 rock design spectrum is used as input ground motions at the bedrock. A few concerns associated with site‐specific ground response evaluation are analyzed for both nonlinear and equivalent linear procedures, including shear strains, mobilized shear strength, and peak ground acceleration along with the depth. The results show that the mean maximum shear strains at any soil layer are less than 0.2% in the study area. A deamplification portion within the soil profile is observed at the layer interface with shear wave velocity reversal. The maximum peak ground acceleration (PGA) at the surface is about 0.2 g for equivalent linear analysis and 0.16 g for nonlinear analysis. The ground motions are amplified near the site natural period 0.72 s. The soil factors calculated in this study are 1.95 and 2.07 for nonlinear and equivalent linear analyses, respectively. These values are much different from the current value of 1.15 for site class C in TCVN 9386: 2012. A comparison of calculated response spectra and amplification factors with the local standard code of practice revealed significant discrepancies. It is demonstrated that the TCVN 9386: 2012 soil design spectrum is unable to capture the calculated site amplification in the study area.

Simultaneous confidence intervals for ranks using the partitioning principle

We consider the problem of constructing simultaneous confidence intervals (CIs) for the ranks of n means based on their estimates together with the (known) standard errors of those estimates. We present a generic method based on the partitioning principle in which the parameter space is partitioned into disjoint subsets and then each one of them is tested at level α. The resulting CIs have then a simultaneous coverage of 1−α. We show that any procedure which produces simultaneous CIs for ranks can be written as a partitioning procedure. We present a first example where we test the partitions using the likelihood ratio (LR) test. Then, in a second example we show that a recently proposed method for simultaneous CIs for ranks using Tukey’s honest significant difference test has an equivalent procedure based on the partitioning principle. By embedding these two methods inside our generic partitioning procedure, we obtain improved variants. We illustrate the performance of these methods through simulations and real data analysis on hotel ratings. While the novel method that uses the LR test and its variant produce shorter CIs when the number of means is small, the Tukey-based method and its variant produce shorter CIs when the number of means is high.

Performance Based Seismic Assessment of Masonry Infilled RCC Building with Diaphragm Discontinuity

In multistoreyed RCC framed buildings, critical damages are due to seismic ground excitations, which cause catastrophic failuresat the weaker locations. Buildings with two types of structural irregularities namely diaphragm discontinuity and open ground story are considered. Assessment of seismic vulnerability of these buildings is done by using Nonlinear Static Pushover Analysis (NSPA). Performance Based Seismic Design of masonry infilled RCC buildings with two different shape of openings in the diaphragm is considered here with Design Basis Earthquake(DBE) and Maximum Considered Earthquake(MCE) where by selecting appropriate performance criteria in terms of Inter-story drift ratio(IDR) and Inelastic displacement demand ratio(IDDR) are critically observed. The Equivalent Linearization Procedure of Pushover analysis presented in FEMA 440, which is a modification of Capacity Spectrum Method based on ATC-40 guidelines, is performed in ETABS-2016 to study the performance of R.C.C. buildings with diaphragm discontinuity, designed as per IS-1893-2016.

Retrospective Review of Interventional Radiology Treatment and Outcomes in Pediatric Liver Disease

Background: Interventional radiology (IR) procedures offer less invasive and low risk options for the treatment of pediatric liver abnormalities, as well as life sustaining measures to bridge patients to transplant. Literature regarding IR interventions for pediatric liver disease is limited. Common conditions that can be treated with IR procedures include vascular anomalies: congenital portosystemic shunts, arteriovenous malformations (AVM), and Budd-Chiari malformation. Transjugular intrahepatic portosystemic shunt (TIPS) can be used to prevent recalcitrant variceal bleeding in portal HTN. Liver biopsy (percutaneous and transjugular) is used to sample the liver and can be targeted to tumors and other lesions. Percutaneous approaches to image biliary abnormalities and treat strictures are useful in children after liver transplant and also without., &#x0D; &#x0D; Objective: describe liver IR procedures and their outcomes in a single-center cohort study &#x0D; &#x0D; Methods: Patients will be identified through retrospective chart review at Riley Hospital for Children to identify and record the diagnoses, interventions, and relevant outcomes for eligible patients. Descriptive statistics can then be performed. This data set can be used to help inform clinicians on indications and expected outcomes for relevant hepatic IR procedures. &#x0D; &#x0D; Conclusion: It is anticipated that data collected for this project will show increased utilization of these procedures at the end of the study period compared to the beginning, and the complication rate for the IR procedure will be lower when compared to equivalent traditional procedures to treat the same condition.