Frequency Of Interruptions Research Articles

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.

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.

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.

Uncovering and Visualizing Work Process Interruptions through Quantitative Workflow Analysis

Question: Continuous improvement requires visualizing process constraints which interrupt workflows. Production control from a management perspective often operates at lower levels of information granularity than required at operational levels to perform work without interruptions. How can workflow interruptions in plumbing work be analysed and explained? How can an analysis of workflow interruptions help to close the information granularity gap between operational and management levels? Purpose: The purpose of this paper is to evaluate methods for their fit in revealing and closing the information granularity gap between between operational and management levels. Research Method: The paper examines workflows of plumbing work from video footage. This video data is classified and analyzed for frequency, causes, and effects of work interruptions. Findings: Results indicate that value-supporting activities caused the largest proportion of interruptions. Moreover, the proportion of non-value-adding activities increases when durations of interruptions rise. Limitations: The analyzed and tested data includes one working day of one worker in one certain construction project, which limits the meaningfulness of these results and explanations. Implications: The conducted time-motion-study and its classified data set made it possible to develop an agent-based simulation model of construction workers behavior. Value for authors: This paper provides a framework to examine workflow interruptions in craft work so that the information gap between operational and management levels is closed. Keywords: continuous improvement, production control, time-motion study, workflow. Paper type: Full paper

Impact of implementing an evidence-based definition of enteral nutrition intolerance on nutrition delivery: A prospective, cross-sectional cohort study.

Enteral nutrition (EN) interruptions because of EN intolerance impede nutrient delivery. We aimed to examine whether revising the EN intolerance definition of an algorithm would decrease EN interruptions and improve nutrient delivery in critically ill children. We performed a cross-sectional cohort study including patients who were admitted to our intensive care unit (ICU) for >24 h and received EN. The EN intolerance definition in our nutrition algorithm was modified to include two symptoms of EN intolerance. We compared time to 60% EN adequacy (EN delivered/EN prescribed x 100) and EN interruptions before and after this intervention. We included 150 eligible patients, 78 and 72 patients in the preimplementation and postimplementation cohorts, respectively. There were no significant differences in demographics and clinical characteristics. The preimplementation and postimplementation cohorts achieved 60% EN adequacy 4 (2-5) days and 3 (2-5) days after ICU admission, respectively (P = 0.59). The preimplementation cohort had a median of 1 (1-2) interruption per patient and the postimplementation cohort 2 (1-3; P = 0.08). The frequency of interruptions because of EN intolerance within the first 8 days of ICU admission was 17 in the preimplementation and 10 in the postimplementation cohorts. Modifying the EN intolerance definition of a nutrition algorithm did not change the time to 60% EN adequacy or total number of EN interruptions in critically ill children. EN intolerance and interruptions continue to limit nutrient delivery. Research on the best definition for EN intolerance and its effect on nutrition outcomes is needed.

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.

Особливості преморбідного фону, акушерські та перинатальні наслідки розродження жінок із перинатальними втратами в анамнезі

Purpose - to conduct a clinical and statistical analysis of the premorbid background, obstetric and perinatal consequences of childbirth in women with a history of perinatal losses. Materials and methods. Control group (CG) - 50 obstetrically and somatically healthy pregnant women, delivered through the natural birth canal. The main group (MG) - 50 pregnant women with a history of perinatal losses. Data processing was carried out using the «Stat Soft Statistica 8.0» software package. Results. The average period between pregnancies in MG was 2.1±0.2 years; 42.0% of patients received various rehabilitation measures, the most common of which were antibiotic therapy 6 (12.0%); psychoprophylactic effect 5 (10.0%); sedative therapy 4 (8.0%); immunocorrection 4 (8.0%) and spa treatment 2 (4.0%). Peculiarities of the course of the 1st half of pregnancy in pregnant women of the MG: a significantly high level of threat of abortion 10 (20.0%); bacterial vaginosis 26 (52.0%) and gestational anemia 28 (56.0%) p<0.05. II half of pregnancy: significantly higher frequency of the following complications: gestational anemia 28 (60.9%), secondary placental insufficiency 12 (26.1%) p<0.05, bacterial vaginosis 15 (32.6%) and preeclampsia 8 (17.4%) p<0.05. As a consequence of such a high specific gravity of various obstetric complications, we observed a significantly high frequency of cesarean sections in this group of pregnant women - 16 (39.1%) versus 3 (6.0%) cases in pregnant women of CG, p<0.05. It is necessary to note the high level in the MG of medium-severe forms of asphyxia of newborns 10 (21.7%); fetal growth retardation 15 (32.6%) versus 2 (4.0%) in CG p<0.05, and clear signs of intra-amniotic infection 5 (10.9%). Perinatal losses among women of the MG amounted to 65.2‰ (3 cases). Conclusions. Pregnancy in women with a history of perinatal losses is accompanied by a high frequency of early interruption due to the diagnosis of abnormalities of fetal development and spontaneous abortions, as well as a significant level of anemia in pregnancy, placental insufficiency, fetal growth retardation syndrome, bacterial vaginosis and preeclampsia. The birth of women with a history of perinatal losses occurs against the background of a high frequency of premature rupture of membranes, fetal distress, anomalies of labor, premature detachment of the placenta, which leads to a significant level of premature births and cesarean sections. Perinatal pathology in women with a history of fetal loss is characterized by a high frequency of perinatal mortality, as well as a significant level of medium-severe forms of asphyxia, posthypoxic encephalopathy and intrauterine infection. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

Smart Fault Monitoring and Normalizing of a Power Distribution System Using IoT

Conventional outage management practices in distribution systems are tedious and complex due to the long time taken to locate the fault. Emerging smart technologies and various cloud services offered could be utilized and integrated into the power industry to enhance the overall process, especially in the fault monitoring and normalizing fields in distribution systems. This paper introduces smart fault monitoring and normalizing technologies in distribution systems by using one of the most popular cloud service platforms, the Microsoft Azure Internet of Things (IoT) Hub, together with some of the related services. A hardware prototype was constructed based on part of a real underground distribution system network, and the fault monitoring and normalizing techniques were integrated to form a system. Such a system with IoT integration effectively reduces the power outage experienced by customers in the healthy section of the faulted feeder from approximately 1 h to less than 5 min and is able to improve the System Average Interruption Duration Index (SAIDI) and System Average Interruption Frequency Index (SAIFI) in electric utility companies significantly.

Analysis of the Effectiveness of Using Digital Filters in Electronic Stethoscopes

The heart sound produced in some cases of the disease shows a certain pattern. The purpose of this study was to design an electronic stethoscope for cardiac auscultation with the following display. The contribution in this study is being able to show certain patterns that can be diagnosed in the sound signal. So that the pattern can be known when there is a heart disease disorder, an electronic stethoscope will be made for auscultation of the next display, making it easier for users to diagnose heart disease. The heart sound is obtained from the mechanical activity of the heart which is tapped by a condenser mic. The heart sound will be held in a pre-amp circuit, then the filters used are High Pass Filters and Low Pass Filters with an interrupted frequency of 20-95 Hz. The output of the filter circuit will enter the booster circuit. Then it will be processed by the microcontroller. In processing the data that will be displayed on Nextion and Speaker, the author uses Arduino Mega. Based on the test, it can be seen that the digital filter has a slight error rate because it removes the most noise, while in the analog filter there is still a lot of noise. The results of the research that has been done can be implemented using a system that really supports the needs.

Reliability Analysis of 20 kV Medium Voltage Air Line Distribution System at Semangga Switch Substation in Merauke Regency

The breakdown of electrical energy can be caused by the unwanted failures that occur in the electric power system, especially in the distribution system, and have an impact on service continuity which can be a permanent failure, temporary failure, three phase short circuit failure, double phase short circuit failure, and black out. To anticipate this, a study needs to be done to analyze and find out how well the distribution system reliability index. Determination of the analysis was done by the method of data retrieval related to the analysis variable. Besides, in determining the results of the analysis, calculations using System Average Interruption Frequency Index (SAIFI), Customer Interruption Frequency Index (CAIFI), System Average Interruption Duration Index (SAIDI) and Customer Average Interruption Duration Index (CAIDI) analyses were performed. Based on the reliability of the distribution network, the SAIFI and CAIDI maximum threshold value setup by PT. PLN (The National Electricity Company) at the Semangga substation each worth 3.00 failures/customer.year and 3.00 failures/customerr while SAIDI and CAIDI each worth value of 3.40 hours/customer.year and 3.40 hours/customer.failure. All feeders installed at Semangga switch substation in realization gives reliability indices smaller than the target that has been set., it is mean that 20 kV medium voltage air line distribution system at Semangga switch substation still reliable and the duration of the failure time for each feeder was an average of 3 minutes of each failure and the number of failures every month was an average of 15 times of each feeder.

Frequency of Device-Related Interruptions Using a Scalable Assessment Tool.

Surgical devices are implicated in approximately 15% of intraoperative interruptions and 25% of errors. Device-related interruptions (DRIs) are therefore an important target for surgical quality improvement, but scalable measurement methodologies are lacking. The researchers therefore developed, pilot tested, and refined a simple tool for assessing intraoperative DRIs. Five DRI categories achieved face validity with frontline providers and surgical safety experts: improper/challenging assembly, device failure, loss of sterility, disconnection, and absent/wrong device. A data collection tool was created based on these categories as well as a free-text section to capture emergent DRI categories. After a brief training session, the tool was pilot tested by observers at a large academic referral center. In a sample of 210 operations, observers noted 66 DRIs across 39 cases. DRIs were most common in colorectal (38.0 per 100 cases), gynecologic (33.3 per 100 cases), and hepatopancreatobiliary surgery (32.1 per 100 cases). Device failure accounted for 30.3% of observed DRIs. Three emergent categories were identified: user unfamiliarity with the device (15.2%), video display malfunction (4.5%), and physical breakage of the device (1.5%). Measurement of DRIs by novice observers is a feasible and scalable approach to support quality improvement efforts focusing on surgical devices. This approach could provide actionable insights to improve device safety, such as informing educational and training programs, optimizing surgical tray composition, and improving the physical layout of the operating room.

Измерение эквивалентного последовательного сопротивления химических источников тока методом прерывания тока на заданное время

It is proposed to measure the equivalent series resistance of various chemical current sources by the method of periodic interruption of the charge current or of the discharge current for a given time period. The current interruption frequency and duration could be selected from a wide range of values. By changing the current interruption duration, it becomes possible to significantly vary conditions in measuring the equivalent series resistance. Thus, when the current is interrupted for 0.5 ms, the proposed method approaches the resistance measurement by the alternating current method with a frequency of 1000 Hz. With current interruption durations of 0.5 s or more, the method under consideration becomes equivalent to the direct current method. The proposed method allows measuring the resistance both once and periodically with a given repetition period. Based on the results obtained, dependences of the equivalent series resistance on the charge level of the chemical current source, its residual resource, temperature, and other parameters were plotted. The method obtains several advantages, is easy to implement, misses errors inherent in other methods of measuring resistance and makes it possible to measure the equivalent series resistance directly in the process of charging and discharging the chemical current source under testing

Optimal Operational Reliability and Reconfiguration of Electrical Distribution Network Based on Jellyfish Search Algorithm

In this paper, the electricity network automation based on Power Network Reconfiguration (PNR) is implemented to improve the operational reliability of distribution systems using jellyfish search algorithm. For this purpose, system average interruption frequency index (SAIFI), system average interruption unavailability index (SAIUI) and total energy not supplied (TENS) are critical measures. In this paper, a new optimization technique of jellyfish search (JFS) algorithm is employed for distribution network reconfiguration for reliability improvement. It is concerned with the moving patterns of jellyfish. They are divided into three categories. The jellyfish could flow towards the ocean current or between its own swarm. Meanwhile, whenever the food supply is adequate, the jellyfishes are attracted to its location. It is formulated considering the three reliability indices of SAIFI, SAIUI and TENS, simultaneously in a multi-objective model based on the weight factors. The proposed methodology based on the JFS optimizer is implemented on an IEEE 33-node distribution network. According to the numerical results, the SAIFI, SAIUI and TENS is improved by 36.44%, 34.11% and 33.35%, compared to the initial condition. For comparison purposes, tuna swarm optimizer and tunicate swarm algorithm, besides the JFS algorithm, are implemented as well. The simulation results declare the significant outperformance of the JFS algorithm compared to TUNA and TSA in terms of the obtained improvements and the regarding convergence properties.

A global and local perspective of interruption frequency in a visual search task.

We investigated the impact of frequency of interruptions in a simulated medical visual search task. Participants (N = 150) performed the visual search task during which they were interrupted by a number-classification task in 25, 50, or 75% of all trials, respectively, reflecting the frequency conditions (i.e., low, mid, high). Target presence (i.e., present vs. absent) and interruption (i.e., uninterrupted vs. interrupted) were varied within-subjects, and interruption frequency was varied between-subjects. Globally, on a frequency condition level, participants in the low frequency condition had longer mean response times (RT) for the primary visual search task than in the high condition, but there were no other performance differences between the three frequency conditions. Locally, on the level of specific interruption effects, accuracy decreased directly after interruptions for target present but not for target absent trials. Furthermore, interruptions caused significant interruption costs, reflected in slower overall RTs in interrupted than in uninterrupted trials. The combined findings show that especially for critical visual search tasks as in the medical field, interruptions—regardless of frequency—should be avoided.

995P Effectiveness of combination of osimertinib with another targeted therapy in advanced EGFR mutated non-small cell lung cancer harbouring other oncogenic drivers: The real-world COMPOSIT study

Identification of resistance mechanisms is crucial to guide therapeutic approaches in patients receiving osimertinib (O). The COMPOSIT study is a French national cohort reporting the effectiveness and tolerance of O in combination with another targeted therapy (TT) in patients with advanced EGFR mutated NSCLC harboring other oncogenic drivers. Patients (pts) treated with O between 01.01.2017 and 30.04.2021 who received a combination of O with another TT were included. Clinical pathological and molecular data were retrospectively collected. The primary endpoint was real-world progression free survival (rwPFS). 55 pts were included from 14 centers. Median age was 59 years (range 29-83); 56.3% were women, 60% never smokers and DelEx19 of EGFR was observed in 69% of cases. Combination therapy was administered to 23 pts who received O as 1st line (41.8%) and to 32 pts in whom O was administrated after receiving chemotherapy and/or 1st or 2nd generation EGFR TT (58.2%). MET pathway was the most targeted mechanism by combination therapies (66.1%). Real world PFS data was available for 54 combinations. Median follow-up was 16.7 months (95% CI; 13.3-19.1). The median rwPFS was 4.1 months (95% CI; 3.2-5.5). Overall response rate (ORR) was 49.0% (95% CI; 35.3-62.7%). The median overall survival (OS) was 11.9 months (95% CI; 8.6-19.6). In MET pathway alterations, rwPFS was 5.3 months (95 CI; 3.9-6.7), ORR 59.4% (95% CI; 42.4-76.4) and OS 14.8 months (95% CI; 7.4-33.2). Adverse events (AE) of grade >2 were reported in 13 patients (23.6%), mainly not related to O (93%). The frequency of drug interruption due to AE was 12.7%.Table: 995PCombination therapies with osimertinib (O) evaluated in COMPOSIT StudyPatients (n=55)Alteration targetedO + Targeted therapy36MET amplificationO + crizotinib (n=19) O + capmatinib (n=7) O + savolitinib (n=4) O + tepotinib (n=5) O + crizotinib then O + capmatinib (n=1)5BRAF fusionO + trametinib5BRAF V600EO + trametinib (n=1) O + dabrafenib (n=2) O + dabrafenib Trametinib (n=2)2EGFR C797S + T790MO + brigatinib1EGFR C797S + T790M cisO + gefitinib1EGFR L861Q + G724S + T790MO + afatinib2RET rearrangementO + praseltinib1ALK rearrangementO + crizotinib1FGFR1 amplificationO + erdafitinib1HER2 amplificationO + trastuzumab Open table in a new tab To our knowledge, this is the largest real-world study of combination therapies in patients with advanced EGFR-mutated NSCLC harboring other oncogenic drivers. Combination approaches with O are already used to overcome resistance by clinicians.

Examining the effects of interruption timing and frequency on performance: An update

The present study re-examined how the timing and frequency of interruptions impact performance on a planning and decision-making task. Undergraduates performed a trip planning task and were interrupted at coarse breakpoints, fine breakpoints, or not at all. Additionally, interruptions occurred at either a low or high frequency. Based on the memory for goals and event segmentation theories, it was predicted that a higher number of interruptions would be more disruptive than fewer interruptions, and that this effect would be more pronounced at the fine breakpoints. The results supported these predictions. Participants took longer to resume the primary task and experienced higher mental workload and frustration when interruptions occurred at fine breakpoints and at a higher frequency. Overall, these results demonstrate that the disruptiveness of interruptions is tied to their frequency and the point within the task hierarchy at which they occur.

Independent Predictors for Hospitalization-Associated Radiation therapy Interruptions

PurposeRadiation treatment interruption associated with unplanned hospitalization remains understudied. The intent of this study was to benchmark the frequency of hospitalization-associated radiation therapy interruptions (HARTI), characterize disease processes causing hospitalization during radiation, identify factors predictive for HARTI, and localize neighborhood environments associated with HARTI at our academic referral center. Methods and MaterialsThis retrospective review of electronic health records provided descriptive statistics of HARTI event rates at our institutional practice. Uni- and multivariable logistic regression models were developed to identify significant factors predictive for HARTI. Causes of hospitalization were established from primary discharge diagnoses. HARTI rates were mapped according to patient residence addresses. ResultsBetween January 1, 2015, and December 31, 2017, 197 HARTI events (5.3%) were captured across 3729 patients with 727 total missed treatments. The 3 most common causes of hospitalization were malnutrition/dehydration (n = 28; 17.7%), respiratory distress/infection (n = 24; 13.7%), and fever/sepsis (n = 17; 9.7%). Factors predictive for HARTI included African-American race (odds ratio [OR]: 1.48; 95% confidence interval [CI], 1.07-2.06; P = .018), Medicaid/uninsured status (OR: 2.05; 95% CI, 1.32-3.15; P = .0013), Medicare coverage (OR: 1.7; 95% CI, 1.21-2.39; P = .0022), lung (OR: 5.97; 95% CI, 3.22-11.44; P < .0001), and head and neck (OR: 5.6; 95% CI, 2.96-10.93; P < .0001) malignancies, and prescriptions >20 fractions (OR: 2.23; 95% CI, 1.51-3.34; P < .0001). HARTI events clustered among Medicaid/uninsured patients living in urban, low-income, majority African-American neighborhoods, and patients from middle-income suburban communities, independent of race and insurance status. Only the wealthiest residential areas demonstrated low HARTI rates. ConclusionsHARTI disproportionately affected socioeconomically disadvantaged urban patients facing a high treatment burden in our catchment population. A complementary geospatial analysis also captured the risk experienced by middle-income suburban patients independent of race or insurance status. Confirmatory studies are warranted to provide scale and context to guide intervention strategies to equitably reduce HARTI events.

Statins increase pathological response in locally advanced rectal cancer treated with chemoradiation: a multicenter experience.

Aims: To investigate the influence of various concomitant medications on outcomes in patients with locally advanced rectal cancer undergoing neoadjuvant chemoradiation. Materials & methods: The authors retrospectively identified 246 patients from 2003 to 2018, collecting demographic and clinicopathological data of interest. Odds ratio (OR) was used to assess the association between concomitant drugs and outcomes. Results: The authors found an association between statins and a Dworak regression grade of 3-4 (OR=8.78; p=0.01). Furthermore, statins were significantly associated with more frequent chemoradiation-related toxicity (OR=2.39; p=0.0098) and chemotherapy dose reduction or discontinuation (OR=2.26; p=0.03). Conclusion: Despitehigher frequency of radiotherapy and chemotherapy interruption or dose reduction, the concomitant use of statins during neoadjuvant chemoradiation proved to be associated with better tumor regression.

Workflow Interruptions and Effect on Study Interpretation Efficiency

BackgroundInterruptions have been shown to adversely impact efficiency, accuracy, and patient safety. ObjectiveTo analyze the frequency and types of interruptions and effect on report interpretation efficiency. Materials and methodsA business process improvement team was consulted to make detailed recordings of the activities of the radiologists. Activities were categorized as interpreting studies, active interruptions initiated by the radiologist, and passive interruptions initiated by an external source. ResultsThirteen board-certified, pediatric radiologists were observed for 61 hours. Radiologists spent 52% of their time interpreting studies, 29% on active interruptions, and 18% on passive interruptions. Approximately 50% of non-interpretive time involved in-person conversations or consults and 16% involved phone calls of which 67% were incoming. The longest time period without an interruption was 20 minutes. 85% of the time, an interruption came within 3 minutes of beginning an interpretation and lasted 1 minute or less 70% of the time. Interruptions increased the time a radiologist needed to read a study by 1 minute for radiographs, 2 minutes for ultrasounds, 6 minutes for CTs, and 10 minutes for magnetic resonance imaging. ConclusionTotal interruption time nearly equaled the total time interpreting studies for radiologists, and interruptions decreased efficiency and increased report interpretation times for all modalities studied. This study highlights the type and extent of interruptions in radiology and examines the effect on report interpretation times. With the frequency of interruptions and impact on efficiency, there is a need to dedicate resources to manage the radiologist workflow. Strategic interventions may ultimately improve outcomes, efficiency, and the overall work environment.