Interruption Duration Research Articles

Factors Associated with Interruptions of Enteral Nutrition and the Impact on Macro- and Micronutrient Deficits in ICU Patients

Feeding interruptions in critical care patients are often unjustified. We aimed to determine the causes, duration, and frequency of enteral nutrition interruptions (ENIs) and to assess macronutrients and antioxidant deficits according to European Society of Parenteral Enteral Nutrition (ESPEN) guidelines. We prospectively enrolled Intensive Care Unit (ICU) patients admitted for more than 48 h with an inability to orally eat from April to December 2019. The type of enteral nutrition, the number of calories administered, the time of feeding initiation, the reasons for delaying feeding, and the causes for ENI were recorded. 81 patients were enrolled, with a median duration of ENIs of 5.2 (3.4-7.4) hours/day. Gastric residual volume (GRV) monitoring-a highly controversial practice-was the most common cause of ENI (median duration 3 (2.3-3) hours/day). The mean energy intake was 1037 ± 281 kcal/day, while 60.5% of patients covered less than 65% of the total energy needs (1751 ± 295 kcal/day, according to mean Body Mass Index (BMI)). The median daily protein intake did not exceed 0.43 ± 0.3 gr/kg/day of the actual body weight (BW), whereas ESPEN recommends 1.3 gr/kg/day for adjusted BW (p < 0.001). The average administration of micronutrients and antioxidants (arginine, selenium, zinc, vitamins) was significantly less than the dietary reference intake (p < 0.01). ENIs lead to substantial caloric, protein, and antioxidant deficits.

Clinical Impact of Drug Adherence of Tyrosine Kinase Inhibitors in Children with Ph-Positive Acute Lymphoblastic Leukemia.

This study aimed to explore the impact of ABL1-tyrosine kinase inhibitors (TKIs) adherence on the survival of chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL) children and clarify the potential predictors of patients' prognosis from TKIs intake practices. Ninety newly diagnosed Ph+ ALL patients who received TKIs were enrolled. We collected the baseline characteristics and adverse events in all children; moreover, TKIs adherence was measured by an eight-item Morisky medication adherence scale (MMAS-8). Progression-free survival (PFS) and overall survival (OS) analysis were performed, and risk factors for PFS and OS were evaluated. Among all patients, 69 cases were regarded as adherers, while 21 were non-adherers. The median duration of TKIs interruption was significantly prolonged in the non-adherence group than in the adherence group (13 [0-101] vs. 56 [11-128], p < 0.001). Additionally, dose reduction occurred in 55.2% of non-adherers versus 23.0% of adherers (p=0.002). The PFS and OS in adherers were significantly higher versus non-adherers (p=0.020 and p=0.039). MMAS-8 score was an independent risk factor for PFS (p=0.010) and OS (p=0.031). Among non-adherers, the median OS was only 23.1% (4.2%-42%) in patients aged ≤ 10 years versus 54.4% (38.8%-70%) in adolescents. Most of the patients who experienced TKIs non-adherence suffered pancytopenia. TKIs adherence during treatment significantly influenced the survival of pediatric Ph+ ALL patients, and non-adherers with age ≤ 10 years were more vulnerable to TKIs disruption. The cumulative TKIs dose should be especially emphasized to patients with age ≤ 10 years, which may result in an inferior achievement of relevant treatment milestones.

Factors Influencing the Interruption of Nursing Document Writing in the Intensive Care Unit: A Cross-Sectional Survey.

To explore the current status of interruption events in nursing document writing in the intensive care unit (ICU) using a cross-sectional survey. Between May and October 2021, the convenience sampling method was used to observe the interruption events in nursing document writing in the ICU. A total of 54 nurses and 7 indicators were observed: the start time, end time, interruption period, source, type, duration and outcome of interruption events. A total of 438 interruption events in nursing document writing occurred in 85.955 hours, with a frequency of 5.093 times/hour and a duration of 4787.00 (1152.00, 13,109.00) seconds. The frequency of interruption events in nursing document writing was the highest (11 times/hour) and the duration was the longest (9581.50 seconds) from 08:00 to 12:00. The main sources of interruptions for nurses with 10 or more years of service or with the professional title of nurse are nurses themselves and their colleagues. The main sources of interruptions for nurses who have been in charge for 10 years or over are the working environment and doctors.This intervention in work continuity occurs unexpectedly; however, if adjustments are made to nursing procedures, the interruption can be terminated rapidly or adverse consequences can be avoided. Years of working experience, seniority level, interruption time periods and professional titles were independent factors influencing the number of interruption events, and they were all positively correlated. The results of this study show that there were statistically significant differences in the incidence of negative outcomes among ICU nurses with varying years of working experience and professional titles. Interruptions in nursing document writing have high frequency, complex sources and multiple types. For senior nurses, the outcome was predominantly positive, while for junior nurses, it was predominantly negative.

Effects of the Desiccation Duration on the Dynamic Responses of Biofilm Metabolic Activities to Rewetting

Global climate changes have increased the duration and frequency of river flow interruption, affecting the physical and community structure of benthic biofilms. However, the dynamic responses of biofilm metabolism during the dry-wet transition remain poorly understood. Herein, the dynamic changes in biofilm metabolic activities were investigated through mesocosm experiments under short-term (25 day) and long-term drought (90 day), followed by a 20 day rewetting. The biofilm ecosystem metabolism, as measured by gross primary production and community respiration, was significantly inhibited and turned heterotrophic during the desiccation phase and then recovered, becoming autotrophic during the rewetting period regardless of the desiccation periods due to the high resilience of the autotrophic community. However, long-term drought decreased the recovery rate of the ecosystem metabolism and also caused irreparable damage to the biofilm carbon metabolism, measured using Biolog Eco Plates. Specifically, the recovery of the total carbon metabolic activity is related to the specific carbon source utilized by biofilm microorganisms, such as polymers, carbohydrates, and carboxylic acids. However, the divergent changes of amino acids caused the failure of the total carbon metabolism in long-term drought treatments to recover to the control level even after 20 days of rewetting. This research provides direct evidence that the increased duration of non-flow periods affects biofilm-mediated carbon biogeochemical processes.

Temporal Resolution of Input Weather Data Strongly Affects an Off-Grid PV System Layout and Reliability

Renewable energy systems design using average year weather data is a standard approach that works well for grid-tied systems, but for stand-alone ones, it leads to dramatic mistakes. We considered the effect of meteorological data temporal resolution (5, 10, 15, 20, 30 min; 1, 2, 3, 4 h) on a stand-alone hybrid system’s layout in terms of equipment cost, power supply reliability and maximum duration of interruption for monitoring equipment in the Alps. We have shown that lifecycle costs could be strongly (order of magnitude) underestimated for off-grid systems, as well as their reliability overestimated. Lower temporal resolution data lead to the underestimation of energy storage charge–discharge cycles (considering depth of discharge too)—real batteries are to be replaced more often, which matches our practical experience as well. Even a 5 to 10 min decrease in weather data temporal resolution leads to the estimated annual expenses being halved. In general, we recommend using 30 min. resolution.

Distributed fault-passage indicators versus central fault location: Comparison for reliability centred planning of resonant-earthed distribution systems

Fault location methods are crucial for reducing fault restoration time, and thus improving a network’s system average interruption duration index (SAIDI) and customer outage cost. Resonant-earthed systems pose problems for traditional fault location methods, leading to poor accuracy and a need for additional complexity. In this context, methods that detect fault direction (fault-passage indicators, FPI) at multiple points in the network may show advantages over a central distance-estimation method using fault locators (FL) of poor accuracy. This paper includes a comparative study of these two major fault location methods, comparing the reliability benefit from a varied number of FPIs or a central method. The optimal placement of the fault locating devices is found by formulating a mixed-integer linear programming (MILP) optimization approach that minimizes both outage and investment costs and assesses SAIDI. This approach has been tested on an example distribution system. However, to justify the universality of the algorithm, the RBTS reliability test system has also been analysed. The comparison of location methods and placement method of FPIs are useful for reliability centred planning of resonant-earthed distribution systems where fault location is to be used. Results show that a small number of FPIs that give accurate identification of direction may give more cost effective increase in reliability than a distance estimate by FL with typical levels of inaccuracy.

Interruption Value Type and Source Matter in Different Phases of an Interruption Process: Emotional/Cognitive Impact and Neural Evidence.

To examine the effect of interruption value type (utilitarian, hedonic) and source (external, internal) in different phases of an interruption process. Prior studies on interruption mostly focused on the cognitive outcomes of utilitarian interruptions. Hedonic interruptions are common in life; however, they are not sufficiently explored through research. Hedonic value is closely associated with emotional experiences, and, in turn, influences behaviors. Moreover, the way the effect of values is moderated by interruptions initiated by intrinsic motives is worth exploring. A 2 × 2 mixed design experiment was conducted with 48 participants who were asked to respond to instant messages during the writing task. The interruption value was induced by work or non-work tasks. The interruption source was manipulated by providing an alert. Functional near-infrared spectroscopy, behavioral data, and subjective measurements were collected and analyzed. Hedonic interruptions increased emotional valence, while utilitarian interruptions decreased it. These effects were strengthened by internal interruptions. The effect of interruption value type on work exhaustion was also moderated by the source. Interruption value type and source influenced the attention allocation before an interruption occurred. Hedonic interruptions led to longer resumption lags, whereas utilitarian interruptions required longer interruption durations. Internal interruptions led to improved performance in the resumed task. Interruption source modulate the effect of interruption value type, especially on emotional experience and attention allocation before an interruption occurs. Self-initiated hedonic interruptions have emotional benefits, while alerts for utilitarian interruptions will improve attention on the main task before interruptions.

On the MILP Modeling of Remote-Controlled Switch and Field Circuit Breaker Malfunctions in Distribution System Switch Placement

Installing sectionalizing switches and field circuit breakers (FCBs) is vital for the fast restoration of customer electricity supply in distribution systems. However, the high capital costs of these protection devices, especially remote-controlled switches (RCSs) and FCBs, necessitate finding a trade-off between their costs and financial benefits. In this study, we propose a mixed-integer linear programming (MILP) model for optimizing switch planning in distribution systems. The proposed model determines the optimal allocation of manual switches, RCSs, and FCBs to minimize the costs of switches and the reliability-oriented expenses. While the former includes the costs of installing and operating the switches, the latter consists of the distribution company’s lost revenue due to the undelivered energy and the regulatory incentives (or penalties) associated with service reliability indices. Two penalty-reward mechanisms are used to account for the financial benefits of increasing the service reliability through reducing the duration and frequency of interruptions. Proposing a novel reliability assessment model, we consider the possibility of malfunctions in both RCSs and FCBs in a highly efficient manner, which is a major contribution of this work. The proposed MILP model is applied to three test networks to validate its applicability and efficacy. The results show the importance of considering the possibility of switch malfunctions in distribution networks.

A Tabu-search-based Algorithm for Distribution Network Restoration to Improve Reliability and Resiliency

Fault restoration techniques have always been crucial for distribution system operators (DSOs). In the last decade, it started to gain more and more importance due to the introduction of output-based regulations where DSO performances are evaluated according to frequency and duration of energy supply interruptions. The paper presents a tabu-search-based algorithm able to assist distribution network operational engineers in identifying solutions to restore the energy supply after permanent faults. According to the network property, two objective functions are considered to optimize either reliability or resiliency. The mathematical formulation includes the traditional feeders, number of switching operation limit, and radiality constraints. Thanks to the DSO of Milan, Unareti, the proposed algorithm has been tested on a real distribution network to investigate its effectiveness.

ФАКТОРЫ РИСКА НЕУДАЧИ ЛЕЧЕНИЯ ТУБЕРКУЛЕЗА ОРГАНОВ ДЫХАНИЯ У ДЕТЕЙ И ПОДРОСТКОВ

Objective: to identify the major risk factors for treatment failure among children and adolescents with pulmonary TB. Materials and methods: aretrospective comparative study enrolled 141 patients aged 2–17 years with different forms of pulmonary TB. Upon completion of the main chemotherapy course consisting of the intensive and continuation phases, the patients were divided into two groups: group 1 – patients with treatment failure, group 2 – patients with treatment success. We compared the patients’ gender and age, social status of the families, the presence of medical or biological risk factors (the absence of anti-TB vaccination, concomitant chronic diseases, acute infectious diseases during the treatment, TB process at detection, drug resistance patterns in the patients and infection sources, the time of drug resistance development, the information about chemotherapy regimens and treatment administration, the occurrence and duration of treatment interruptions) in the groups. The obtained data were processed using binary logistic regression carried out by the SPSS 21.0 software. Results: we built a mathematical statistical model of the individual risk for treatment failure among children and adolescents with pulmonary TB. Conclusion: the major risk factors for treatment failure among children andadolescents with pulmonary TB were associated with inadequate chemotherapy: ignorance of drug resistance patterns on the initial treatment phase, defective use of chemotherapy potentials, wrong choice of treatment administration form. Late detection of TB (lung destruction, advanced TB process) was a more frequent factor in group 2 than group 1 but did not significantly influence treatment outcome.

Rapid Power Restoration and Network Reconfiguration for Power Distribution System Reliability Enhancement: A Case Study on Bahir Dar Power Distribution Systems

Reliability improvement of power distribution systems is pre-request for economic and social development of any country. Currently, there is rapid growth of industrial, commercial, residential and other service providing institutions. All of these institutions need reliable power supply. Due to this, utilities must work hard and ensure that the customers are getting the reliable power supply. However, higher power interruption frequency and longer interruption duration is the most serious problem facing Ethiopian power distribution systems and this problem affects day to day activity of customers. In this paper, rapid power restoration and network reconfiguration using optimal placement of switching/automating devices is performed. Network reconfiguration and rapid power restoration is performed to improve the reliability problem of Bahir Dar power distribution system. Optimal placement of switching/automating devices for network reconfiguration is determined by Genetic Algorithm (GA) optimization technique using MAT LAB software and rapid power restoration is carried out by Prim’s Algorithm (PA) used for constructing Minimum Spanning Tree (MST) in MAT LAB software. The study is tested at Bata 34-bus feeder of Bahir Dar distribution system. The existing network is assessed and the reliability indices such as SAIFI, SAIDI, ASAI, CAIDI and EENS are evaluated using ETAP 12.6.0 software.

CHARACTERISTICS OF REFUSALS IN LOW-VOLTAGE DISTRIBUTION SYSTEMS

This paper focuses on the determination of the characteristics of refusals in low voltage electrical distribution systems. In order to solve this problem, the phenomena of occurrence of refusals in low-voltage electrical distribution systems, conditioned by different influencing factors, processed and mathematically modelled. The main results of the research consist in establishing the static characteristics of the refusals, the mathematical models that determine the occurrence of the cause phenomena and the parameters that characterize the distributions of the refusals, depending on the occurrence per system, depending on the occurrence per season, depending of interruptions duration and the number of affected consumers. The significance of the results obtained consists in solving a number of problems faced by the operating services of electrical distribution systems, concerning the assurance of reliability of operation, providing the possibility of forecasting and preventing the occurrence of the phenomena of occurrence of refusals, which enable the justified planning of prophylactic measures and ensuring the reliability level.

Optimal Location of Reclosers in Electrical Distribution Systems Considering Multicriteria Decision Through the Generation of Scenarios Using the Montecarlo Method

This work presents a novel methodology for the optimal location of reclosers in electric distribution systems. The proposal uses a multicriteria analysis to evaluate the reliability indicators for this level 3 (distribution) by generating scenarios from pseudo-random variables. The reliability indicators considered in the study are the System Average Interruption Frequency Index (SAIFI), System Average Interruption Duration Index (SAIDI), Customer Average Interruption Duration Index (CAIDI), and Average Energy Not Supplied (AENS). It is employed a deterministic random generation in a defined range associated with each analysis variable (failure rate by elements and loads, failure duration, number of customers per load point, mean power consumed at each load point, etc.) The reliability indicators (criteria) are calculated for every possible location of a recloser in the candidate primary sections, thus obtaining the decision matrix, normalized and weighted by the CRITIC method to find the optimal location according to a minimum criterion. This analysis is repeated N times through the generation of scenarios using the Montecarlo method, establishing the probability of occurrence of each winning alternative and choosing the final optimal location of the first recloser within the distribution system. The methodology also proposes the switching coordination repeating the previously described analysis for locating a second recloser considering that the first was already a winning alternative within the generation of “many” scenarios. The scope of the proposed methodology is the number of reclosers that it is desired to analyze considering cost constraints and is general for any distribution system. The analysis is carried out with comprehensive programming in the Matlab software environment. The results successfully respond to the maneuver and switching tests with the joint criterion of minimizing all reliability indicators for level 3 (distribution). With this proposal, knowledge gaps in reliability studies are solved. The absence of data is completed with generations of pseudo-random variables, and the optimal location of the reclosers responds to all reliability criteria in distribution with weighting alternatives. The novel proposed methodology is validated with an exhaustive search analysis where all possible single or multiple reconnection scenarios are analyzed. The winning location alternative found coincides with the one determined by the proposed methodology in more than 90% of the generated random scenarios.

Dampak Metode Zero Downtime Maintenance terhadap Penurunan Saidi pada Gardu Distribusi Tipe Beton

Maintenance of distribution substations is a mandatory activity to minimize damage to electrical equipment. The state electricity company (PLN) of Ciputat's customer service implementing unit (UP3) as the executor is currently carrying out preventive maintenance with the total blackout method, this causes electricity distribution to consumers to be cut off. As a result, PLN suffers losses in terms of achieving the system average interruption duration index (SAIDI). So, we need a zero-downtime maintenance method in order to improve the maintenance of concrete type distribution substations without turning off the electricity supply to consumers and suppressing the SAIDI value of maintenance. Maintenance observation methods, trials, SAIDI values from the results of maintenance are used as references and assumptions for the maintenance plan of distribution substations for the following year. The zero-downtime maintenance method was successfully applied to the CP227 substation without going out on the consumer side, resulting in a maintenance SAIDI value of 0 (zero) minutes per customer and successfully reducing the duration of outages during maintenance by 100%. The total SAIDI value is 56.04 minutes per customer per year from the maximum SAIDI limit for maintaining PLN UP3 Ciputat which is 81.5 minutes per customer per year.

Smartphone Mediated Tracking and Analysis of Sleep Patterns in Indian College Students

Sleep is one of the essential bio-makers for human health. Poor sleep is associated with reduced cognitive performance. With most smartphone users in India being college students, the focus is now on exploring smartphone usage’s impact on students’ sleep. Umpteen news articles in India have reported binge-watching, social media use during the night, and other mobile phone-related interruptions as causes of improper sleep and irregular sleep patterns. However, such studies may involve bias while self-reporting and are limited to a one-time exercise. To understand the reality, we need to accurately quantify the sleep duration, patterns, mobile usage before and after bedtime, number and duration of interruptions. In this first-of-its-kind study in India, we infer novel insights into the sleep patterns of a cohort of 40 college students. We implement a mobile sensing-based approach for the study by installing a custom-developed mobile app on all phones. We extract sleep activity and infer the sleep duration, bed-in and wake-up times, and interruption duration from the sensor data collected from the phone’s built-in sensors. The study brings about new insights into college student sleep patterns and, interestingly, shows that students have a regular sleep cycle and good sleep quality. Only one-fourth of the students revealed irregular sleep patterns, and we did not observe any mobile-related interruptions 30 min past bedtime.

CRIB: A Novel Method for Device-Based Physical Behavior Analysis

Physical behaviors (e.g., sleep, sedentary behavior, and physical activity) often occur in sustained bouts that are punctuated with brief interruptions. To detect and classify these interrupted bouts, researchers commonly use wearable devices and specialized algorithms. Most algorithms examine the data in chronological order, initiating and terminating bouts whenever specific criteria are met. Consequently, the bouts may encapsulate or overlap with later periods that also meet the activation and termination criteria (i.e., alternative bout solutions). In some cases, it is desirable to compare these alternative bout solutions before making a final classification. Thus, comparison-focused algorithms are needed, which can be used in isolation or in concert with their chronology-focused counterparts. In this technical note, we present a comparison-focused algorithm called CRIB (Clustered Recognition of Interrupted Bouts). It uses agglomerative hierarchical clustering to facilitate the comparison of different bout solutions, with the final classification being made in favor of the smallest number of bouts that comply with user-specified criteria (i.e., limits on the number, individual duration, and cumulative duration of interruptions). For demonstration, we use CRIB to assess bouts of moderate to vigorous physical activity in accelerometer data from the National Health and Nutrition Examination Survey, and we include a comparison against results from two established chronology-focused algorithms. Our discussion explores strengths and limitations of CRIB, as well as potential considerations and applications for using it in future studies. An online vignette (https://github.com/paulhibbing/PBpatterns/blob/main/vignettes/CRIB.pdf) is available to assist users with implementing CRIB in R.

Variance reduction technique in reliability evaluation for distribution system by using sequential Monte Carlo simulation

This paper discusses the need for variance reduction in simulations in order to reduce the time required to compute a simulation. The large and complex network is commonly evaluated using a large-scale Monte Carlo simulation. Unfortunately, due to the different sizes of the network, it takes some time to complete a simulation. However, variance reduction techniques (VRT) can help to solve the issues. The effect of VRT changes the behaviors of a simulation, particularly the time required to run the simulation. To evaluate the reliability indices, two sequential Monte Carlo (SMC) methods are used. SMC with VRT and SMC without VRT are the two options. The presence of VRT in the simulation distinguishes the two simulations. Finally, reliability indices: system average interruption frequency index (SAIFI), system average interruption duration index (SAIDI), and customer average interruption duration index (CAIDI) will be calculated at the end of the simulation to determine the efficiency for the SMC with and without VRT. Overall, the SMC with VRT is more efficient because it is more convenient and saves time than the SMC without VRT.

Parental Leave Policy and Long-run Earnings of Mothers

Paid parental leave schemes have been shown to increase women’s employment rates but to decrease their wages in case of extended leave duration. In view of these potential trade-offs, many countries are discussing the optimal design of parental leave policies. We analyze the impact of a major parental leave reform on mothers’ long-term earnings. The 2007 German parental leave reform replaced a means-tested benefit with a more generous earnings-related benefit that is granted for a shorter period of time. Additionally, a ”daddy quota” of two months was introduced. To identify the causal effect of this policy mix on long-run earnings of mothers, we use a difference-in-differences approach that compares labor market outcomes of mothers who gave birth just before and right after the reform and nets out seasonal effects by including the year before. Using administrative social security data, we confirm previous findings and show that the average duration of employment interruptions increased for mothers with high pre-birth earnings. Nevertheless, we find a positive long-run effect on earnings for mothers in this group. This effect cannot be explained by changes in the selection of working mothers, working hours or changes in employer stability. Descriptive evidence suggests that the stronger involvement of fathers, incentivized by the ”daddy months”, could have facilitated mothers’ re-entry into the labor market and thereby increased earnings. For mothers with low pre-birth earnings, however, we do not find beneficial long-run effects of this parental leave reform.

Elucidating the impact of power interruptions on microbial electromethanogenesis

The need to accommodate power fluctuations intrinsic to high-renewable systems will demand in the future the implementation of large quantities of energy storage capacity. Microbial electromethanogenesis (EM) can potentially absorb the excess of renewable energy and store it as CH₄. However, it is still unknown how power fluctuations impact on the performance of EM systems. In this study, power gaps from 24 to 96 h were applied to two 0.5 L EM reactors to assess the effect of power interruptions on current density, methane production and current conversion efficiency. In addition, the cathodes were operated with and without external H₂ supplementation during the power-off periods to analyse how power outages affect the two main metabolic stages of the EM (i.e.: the hydrogenic and methanogenic steps).Methane production rates kept around 1000 mL per m2 of electrode and per day regardless of the duration of the power interruptions and of the supplementation of hydrogen. Interestingly, current density increased in the absence of hydrogen (averaged current density during hydrogen supplementation was 0.36 A·m−2, increasing up to 0.58 A·m−2 without hydrogen). However current was less efficiently used in the production of methane with no hydrogen supplementation. Nevertheless, when the electrical power was restored after the power interruption experiments, performance parameters were similar to those observed before. These results indicate that EM is resilient to power fluctuations, which reinforces the opportunity of using EM as a technology for renewable energy storage.

Periprocedural Management of Patients With Atrial Fibrillation Receiving a Direct Oral Anticoagulant Undergoing a Digestive Endoscopy.

The periprocedural management of patients with atrial fibrillation (AF) using a direct oral anticoagulant (DOAC) undergoing elective gastrointestinal (GI) endoscopic procedure remains uncertain. We investigated the safety of a standardized periprocedural DOAC management strategy. The Periprocedural Anticoagulation Use for Surgery Evaluation cohort study enrolled adult patients receiving a DOAC (apixaban, rivaroxaban, or dabigatran) for AF scheduled for an elective procedure or surgery. This analysis addresses patients undergoing digestive endoscopy. Standardized periprocedural management consisted of DOAC interruption 1 day preendoscopy with resumption 1 day after procedure at low-moderate risk of bleeding or 2 days in case of a high bleeding risk. Thirty-day outcomes included GI bleeding, thromboembolic events, and mortality. Of 556 patients on a DOAC (mean [SD] age of 72.5 [8.6] years; 37.4% female; mean CHADS 2 score 1.7 [1.0]), 8.6% were also on American Society of Anesthesiology (ASA) and 0.7% on clopidogrel. Most of the patients underwent colonoscopies (63.3%) or gastroscopies (14.0%), with 18.9% having both on the same procedural day. The mean total duration of DOAC interruption was 3.9 ± 1.6 days. Four patients experienced an arterial thromboembolic event (0.7%, 0.3%-1.8%) within 24.2 ± 5.9 days of DOAC interruption. GI bleeding events occurred in 2.5% (1.4%-4.2%) within 11.1 ± 8.1 days (range: 0.6; 25.5 days) of endoscopy, with major GI bleeding in 0.9% (0.4%-2.1%). Three patients died (0.5%; 0.2%-1.6%) 15.6-22.3 days after the endoscopy. After a contemporary standardized periprocedural management strategy, patients with AF undergoing DOAC therapy interruption for elective digestive endoscopy experienced low rates of arterial thromboembolism and major bleeding.