Reduce Resource Utilization Research Articles

Impact of organic practices on growth, yield, and greenhouse gas emissions by pea landraces

Legume crops constitute an essential component of rotations in organic farming systems due to their ability to provide plant available nitrogen to agricultural ecosystems arising from symbiotic N2 fixation. However, there is a general need to increase grain legume protein production in Europe so as to meet the increasing demand while reducing resource utilization, thereby contributing to mitigation of global climate change. Taking this need into consideration, a field-based experiment with pea (Pisum sativum L.) was carried out in a field certified for organic agriculture from November 2014 to June 2015. The experiment was laid out in a split-plot design with two main treatments (conventional and organic farming system) and four sub-plots per main plot corresponding to four different pea genotypes, particularly one commercial cultivar ('Onward'), and three local landraces ('Amorgos', 'Andros' and 'Schinousa'). Standard inorganic fertilizer (11-15-15, N:P2O5:K2O) and sheep manure were used as base dressings in the conventional and the organically-treated plots, respectively. The aim of the experiment was to test the performance of each pea genotype in organic farming crops as compared to conventional cropping, in terms of: green seed yield, and greenhouse gas (GHG) emissions. The results of this study indicate that 'Andros' increased significantly the above-ground biomass and the fresh green seed production on the harvesting date when compared with all the other genotypes. In addition, there were significant differences in cumulative N2O fluxes between the pea cultivars with 'Schinousa' producing the highest N2O amounts and 'Andros' the lowest. In conclusion, the pea genotype seems to have a strong influence on both GHG emissions and production and therefore, appropriate selection of cultivars is imperative for efficient use of this legume in organic cropping systems.

A randomized controlled trial of a preoperative patient education program to improve satisfaction and reduce resource utilization

A randomized controlled trial of a preoperative patient education program to improve satisfaction and reduce resource utilization

Early Intervention With Live Donor Liver Transplantation Reduces Resource Utilization in NASH: The Toronto Experience.

BackgroundIn parallel with the obesity epidemic, liver transplantation for nonalcoholic steatohepatitis (NASH) is increasing dramatically in North America. Although survival outcomes are similar to other etiologies, liver transplantation in the NASH population has been associated with significantly increased resource utilization. We sought to compare outcomes between live donor liver transplantation (LDLT) and deceased donor liver transplantation (DDLT) at a high volume North American transplant center, with a particular focus on resource utilization.MethodsThe study population consists of primary liver transplants performed for NASH at Toronto General Hospital from 2000 to 2014. Recipient characteristics, perioperative outcomes, graft and patient survivals, and resource utilization were compared for LDLT versus DDLT.ResultsA total of 176 patients were included in the study (48 LDLT vs 128 DDLT). LDLT recipients had a lower model for end-stage liver disease score and were less frequently hospitalized prior to transplant. Estimated blood loss and early markers of graft injury were lower for LDLT. LDLT recipients had a significantly shorter hospitalization (intensive care unit, postoperative, and total hospitalization).ConclusionsLDLT for NASH facilitates transplantation of patients at a less severe stage of disease, which appears to promote a faster postoperative recovery with less resource utilization.

Characterization of Planned and Unplanned 30-Day Readmissions Following Vascular Surgical Procedures

Causes for readmission of vascular surgery patients are multifactorial. Infections, both those related and unrelated to the surgical site, remain common reasons for readmission and represent an opportunity for improvement strategies. Improved understanding of readmissions after vascular surgery could help adjust policy benchmarks for targeted readmission rates and help reduce resource utilization.

Reducing Resource Utilization and Improving Efficiency Using A Separate Activation for Emergent Large Vessel Occlusion Ischemic Strokes (P5.264)

Reducing Resource Utilization and Improving Efficiency Using A Separate Activation for Emergent Large Vessel Occlusion Ischemic Strokes (P5.264)

Prompt transition from intravenous nicardipine to oral antihypertensives reduces resource utilization for patients with hypertensive intracerebral hemorrhage. (P5.063)

Prompt transition from intravenous nicardipine to oral antihypertensives reduces resource utilization for patients with hypertensive intracerebral hemorrhage. (P5.063)

RECONFIGURABLE FPGA BASED SOFT-CORE PROCESSOR FOR SIMD APPLICATIONS

Objective: The prospective need of SIMD (Single Instruction and Multiple Data) applications like video and image processing in single system requires greater flexibility in computation to deliver high quality real time data. This paper performs an analysis of FPGA (Field Programmable Gate Array) based high performance Reconfigurable OpenRISC1200 (ROR) soft-core processor for SIMD.Methods: The ROR1200 ensures performance improvement by data level parallelism executing SIMD instruction simultaneously in HPRC (High Performance Reconfigurable Computing) at reduced resource utilization through RRF (Reconfigurable Register File) with multiple core functionalities. This work aims at analyzing the functionality of the reconfigurable architecture, by illustrating the implementation of two different image processing operations such as image convolution and image quality improvement. The MAC (Multiply-Accumulate) unit of ROR1200 used to perform image convolution and execution unit with HPRC is used for image quality improvement.Result: With parallel execution in multi-core, the proposed processor improves image quality by doubling the frame rate up-to 60 fps (frames per second) with peak power consumption of 400mWatt. Thus the processor gives a significant computational cost of 12ms with a refresh rate of 60Hz and 1.29ns of MAC critical path delay.Conclusion:This FPGA based processor becomes a feasible solution for portable embedded SIMD based applications which need high performance at reduced power consumptions

Understanding the burden of focal epilepsy as a function of seizure frequency in the United States, Europe, and Brazil.

SummaryObjectiveTo understand the current burden of focal epilepsy (FE) as a function of seizure frequency.MethodsPatients were identified from the United States (2011, 2012, and 2013), five European countries (EU; France, Germany, Italy, Spain, United Kingdom) (2011 and 2013), and Brazil (2011 and 2012) National Health and Wellness Survey (NHWS), a nationally representative, Internet‐based survey of adults (18+ years). The NHWS collected data on respondents’ quality of life (QoL), health utilities, productivity loss, and healthcare resource utilization. Indirect and direct costs were calculated from the literature. Altogether, 345 of 176,093 (U.S.A.), 73 of 30,000 (United Kingdom), 53 of 30,001 (Germany), 53 of 30,000 (France), 41 of 12,011 (Spain), 37 of 17,500 (Italy), and 71 of 24,000 (Brazil) respondents self‐reported a diagnosis of FE.ResultsMany respondents (U.S.A.: 56.2%; 5EU: 41.6%; Brazil + 5EU: 40.5%) reported persistent seizures (≥1 per year). Over 60% to just over 71% of respondents with FE were treated with antiepileptic drugs (AEDs). In the United States, seizure frequency was associated with hospitalizations, indirect costs (ages 18–60), and total direct costs. For the 5EU and Brazil + 5EU, seizure frequency was associated with physical QoL, health utilities, activity impairment, and emergency room (ER) visits. Additional associations were observed for the 5EU on hospitalizations, indirect costs (ages 18–60), ER visit costs, and total direct costs and for Brazil + 5EU on absenteeism, overall work impairment, and provider visits. Costing was not performed for Brazil + 5EU.SignificanceAround half of the patients had persistent seizures despite most taking an AED in this 2011–2013 dataset. The results support the hypothesis that reducing seizures can improve productivity and reduce resource utilization and associated costs. Regional differences may reflect differences in healthcare systems and selected patient populations. Overall, the results suggest that additional treatment options are needed to improve seizure control and reduce related costs.

Reduction in resource utilization and increase in patient satisfaction two years after implementation of Perioperative Surgical Home

Introduction: Perioperative Surgical Home (PSH) provides coordinated, team-based care that is patient-centered, designed to guide patients efficiently through the surgical experience. We applied several changes to our anesthesia practice during 2014 and evaluated outcomes for all orthopedic major joint replacement surgeries completed in 2015. Since this was a quality improvement/utilization study, we were granted approval from our institutional review board to retrospectively review these data.Methods: We conducted a utilization review of all 1,356 patients who received total knee, hip, or shoulder joint replacement from 4 major surgical providers in 2015. Preoperative evaluation was limited and focused to each patient’s unique medical conditions. Additionally, we reduced intraoperative fluid use, reduced continuous femoro-sciatic nerve or brachial plexus blocks by increasing the administration of single-shot regional blocks, limited transfusion, and minimized urinary catheter use. We improved pain consult response time and provided timely discharges.Results: We noted 9% reduction in preoperative imaging per case, 22% decrease in average number of tests per case, 87% fewer average units of red blood cell used per case, and a 0.4 day reduction in average length of stay (LOS). Patient satisfaction data showed constant improvement in pain management, and doctor communication.Conclusions: Numerous small modifications to patient care collectively contributed to these progressive observed changes in patient outcomes from quarter to quarter.

Self adaptable high throughput reconfigurable bilateral filter architectures for real-time image de-noising

A bilateral filter is a local, non-iterative and non-linear technique which aids in removing the noise while preserving edges and details. This work proposes novel highly parallel-pipelined low complex bilateral filter architectures to achieve high throughput, high efficiency, self adaptability and reconfigurability in a real-time noisy environment. The design implements true bilateral filter by adaptively varying the filter parameters to achieve error tolerance less than \(4\%\). The proposed architecture can denoise up to 4K UHD (2160 p @ 53 fps) video stream at real-time. The design improves the throughput by \(88\%\), reduces resource utilization and latency by 30 and \(60\%\) respectively than the state of the art architectures. The proposed fixed and floating point implementation achieves a power efficiency of 318 GOPS/W and 37 GFLOPS/W respectively. The dynamic reconfigurability of the design allows to switch from high efficiency to high throughput mode in less than 4.2 ms. The evaluation of a real time denoising system on FullHD (1080 p) video stream is performed on Virtex-7 FPGA. A comparison with Virtex-5 FPGA implementation shows the robust performance of the architecture across different FPGA families.

Modified Eversion Carotid Endarterectomy (mECEA): Analysis of Clinical and Financial Outcomes

Several carotid endarterectomy techniques have been described, including conventional carotid endarterectomy (CCEA) performed with patch repair and eversion carotid endarterectomy (ECEA) performed with transection of the internal carotid artery. We describe our simplified technique of modified eversion carotid endarterectomy (mECEA) with longitudinal arteriotomy limited to the carotid bulb, without transection of the internal carotid artery and present our analysis of its safety, efficacy, and cost effectiveness. A retrospective review of all carotid endarterectomies performed by 3 vascular surgeons over a 3-year period was completed. About 197 mECEA were performed during the study period. Follow-up data were obtained on 77.7% of patients. A comparison was made with the contemporary literature with respect to outcomes for both CCEA and ECEA. Between January 2012 and December 2014, a total of 197 mECEA were performed. The perioperative stroke and death rates for those undergoing mECEA was 0.5% and 0.5%, respectively. Late stroke and death rates were 3.0% and 5.1%, respectively. Perioperative rate of myocardial infarction was 1.0%. Early restenosis rates of >70% occurred in 1.4%, whereas late restenosis of >70% occurred in 2.7%. Mean operating time for those undergoing mECEA was 57.9min. Average costs savings for mECEA compared to CCEA were $5,835. This simplified technique has comparable outcomes to those described in the contemporary literature for both CCEA and ECEA with respect to postoperative neurologic events as well as restenosis rates. In our institution, the short mean operative times with mECEA has led to reduced resource utilization.

Abstract 131: Association Between Limited Left Ventricle Ejection Fraction (LVEF) Transthoracic Echocardiograms (TTEs) and Overall TTE Utilization

Objectives: To evaluate the change in utilization of TTEs associated with introduction of limited LVEF TTEs. Methods: We measured the number of total, full and limited TTEs before (2005) and after (2006-2015) implementation of limited LVEF TTEs at the Palo Alto VA Hospital (PAVA) and compared to other VA hospitals. We estimated the association between introduction of the LVEF TTEs at PAVA and TTEs volume using a linear regression model with other facilities as controls adjusted for facility, number of outpatients and average patient age. Results: There were 119 VA facilities that performed over 100 TTEs in 2005. Between PAVA and 118 control VA facilities, there was no significant difference in the number of outpatients (52,654 vs. 44,552 +/- 25,342[SD], p=0.37), average age (61.4 vs. 61.8 years +/- 2.5, p=0.44) total TTEs in 2005 (2,395 vs. 1,594.8 +/- 1,069.6, p=0.23) or limited TTEs (19 vs. 25.8 +/-101.5, p=0.48) in 2005. In 2005, limited TTEs were 0.8% of all TTEs at PAVA and 1.2% at controls. Between 2006-2010, limited TTEs were 8.3% of total at PAVA and 1.7% at controls. Between 2011-2015, limited TTEs were 19.5% of total at PAVA and 2.2% at controls. In 2005, total TTEs per outpatient were 4.5 per 100 at PAVA and 3.5 per 100 at other VA hospitals. Between 2006-2010, total TTEs were 4.5 per 100 patient-years at PAVA and 3.9 per 100 patient-years at controls. Between 2011-2015, total TTEs per capita were 4.6 per 100 patient-years at PAVA and 4.3 per 100 patient-years at controls. In an adjusted model, limited LVEF TTE introduction was associated with an average of -383 (CI: -554 to -211) annual full TTEs with no significant difference in total TTEs (-26.8; CI: -156 to 102). The decrease in full TTEs increased each year with an estimated -67.0 (CI: -97 to -37) full TTEs per year after 2006. This was equivalent to 683 fewer full TTEs (30.0% of total) in 2015. Conclusion: The introduction of limited LVEF TTEs at PAVA was associated with an increase in limited TTEs, a decrease in full TTEs, and no significant change in total TTEs when compared with control facilities. This suggests the introduction of LVEF studies was associated with substitution of limited TTEs for full studies. This could lead to substantial reductions in resource utilization and costs. We did not evaluate potential changes in outcomes associated with this change in TTE utilization.

FPGA implementation of hardware efficient adaptive filter robust to impulsive noise

Adaptive filters are prevalent in many real-time signal processing applications. Many adaptive algorithms already exist, but most of them assume white Gaussian noise as disturbance. However, for many applications such as electrocardiogram, foetus heart rate measurement, low frequency atmospheric noise, underwater acoustic noise and signal measurement in instrumentation, the impulsive noise is more common. This study presents a modified robust mixed norm (MRMN) adaptive filter algorithm robust to impulsive noise with higher convergence rate and lower steady state error (SSE). MRMN adaptive filter algorithm has been simulated using Matlab and Xilinx system generator high level synthesis tool and a significant improvement in SSE and convergence speed is obtained compared with the existing adaptive filter algorithms for similar specifications. The proposed algorithm is also described using VHDL and synthesised using Xilinx synthesiser tool in order to implement on field-programmable gate array (FPGA). The FPGA post route and place implementation results show nearly 90% reduction in resource utilisation and nearly 2.6 times improvement in clock frequency as compared with the existing FPGA based implementation for similar specifications.

Patient Blood Management.

Patient Blood Management is a book that considers a concept that transcends transfusion medicine. It is solely aimed at disease management rather than focusing on a single therapeutic modality, transfusion.The foreword by Denton A. Cooley sums up the essence of patient blood management (PBM) by stating that it is a “compelling concept to preempt anemia, correct bleeding disorders, and minimize blood loss.” He continues by stating that this is an evidence-based approach that has yielded the desired outcomes of improved patient’s health and reduced resource utilization. The preface, written by the three editors, expands on the concept and focuses on the intent of this PBM “book” by addressing the multiprofessional and multidisciplinary approach that spans a multitude of topics from preoperative anemia management to management of patients for whom blood is not an option. Although referred to as a book, this publication is more appropriately described as a “manual” on PBM. Recognizing the burgeoning data on patient outcome associated with a large number of possible interventions (beyond the current single approach—transfusion) applied together or as a single modality, this bundled care includes identification, diagnosis and treatment of anemia, blood conservation both surgical and phlebotomy, and “tolerating” anemia, while therapeutic modalities other than transfusions are implemented effectively. The manual’s content would encourage the reader to explore elsewhere for more detailed data and newer data that are constantly being added to the literature.The editors have gathered a long list of both new and senior contributors to PBM. Although these contributors have been asked to address specific topics, their knowledge of PBM extends far beyond the contributions seen in this manual.Knowing that this publication is an expansion of the original German version of this book, the extensive list of topics is impressive and covers most if not all related PBM topics and issues.To the casual reader, the history and development of PBM and additional material on the future of PBM in the new healthcare milieu would be of value. These items are not included in this book. While they are not necessarily needed in this manual, they would help explain the evolution of PBM and are addressed in other PBM textbooks. Offering the long view in medicine can usually explain the present and help form the future.Each of the chapters is well organized, and for the most part, presents the current thinking in PBM. Although weighted toward transfusion medicine, the editors’ reminder to focus on patients and improved outcome resonates throughout the manual.Despite overall enthusiasm expressed for PBM, some sections of the text offer recommendations that can be challenged since significant controversy exists on these topics. As an example, the sections on pharmacologic agents, parenteral iron, and erythroid-stimulating agents represent conclusions on the basis of old data that have been challenged and are in need of fresh interpretation. Other recommendations ignore the inconsistency of the data used to make a recommendation such as those present in section “transfusion guidelines.” In regard to transfusion indication, the threshold (“trigger”) in patients with coronary artery disease has not been established. Although addressed in the text, table 5.2 appears to present the information in what seems to be a more conclusive manner. Regardless, most of the recommendations are sound and useful.Although open to all disciplines of clinical medicine, the surgical approach to PBM dominates throughout the book. One can extrapolate to other patient populations since PBM is written as disease management of entities such as anemia, coagulation defects, and other hematologic conditions rather than concentrating solely on transfusion as a therapy.Caught between informative and instructive, the manual serves best as an initial overview of each of the topics. It does not lend itself as a guide to therapy nor does it fully expose all of the data and challenges of PBM in an in-depth fashion. The chapters address each topic in a thoughtful and balanced fashion without exposing areas on controversy in any details.There is no question in this reviewer’s mind that the primary audience is anesthesiologists and surgeons followed by internal medicine and others in related fields. Reading through the stimulating chapters and sections, one quickly finds oneself seeking to attain more information—which can be found, for example, in the section on PBM at www.blood.gov.au—to enhance their knowledge and repertoire on PBM. This manual is an essential step in increasing awareness on PBM and helps organize the topic, resulting in easy reading and, in turn, better patient care and outcome.

Single-Dose Oritavancin Compared to Standard of Care IV Antibiotics for Acute Bacterial Skin and Skin Structure Infection in the Outpatient Setting: A Retrospective Real-World Study.

IntroductionCost-containment strategies are shifting the treatment of acute bacterial skin and skin structure infections (ABSSSI) from inpatient to outpatient settings. Current standard of care (SoC) requires multiple-dose regimens, which are associated with high hospitalization rates and high costs. Oritavancin, a new single-dose antibiotic for ABSSSI, may be suitable for outpatient therapy. This analysis evaluates the effectiveness, costs, and resource utilization of oritavancin vs. SoC in a real-world, outpatient setting.MethodsA single-site, retrospective chart review was conducted of 118 adult patients diagnosed with ABSSSI and treated with either single-dose oritavancin or multi-dose SoC therapy between 6 August 2014 and 30 June 2015. Patients were assigned to two matched cohorts: oritavancin and SoC. Primary clinical effectiveness endpoints was the success (cured or improved) at 5–30 days after the course of antibiotic therapy has been completed. Secondary economic endpoints were total costs and healthcare resource utilization.ResultsOritavancin showed comparable clinical effectiveness vs. multi-dose SoC in the outpatient setting. A similar percentage of patients in the oritavancin (90.2%) and SoC cohorts (77.4%) achieved successful outcomes (“cure” or “improved”), with the cure rate higher for oritavancin (73.2%) vs. SoC (48.4%; P = 0.0315). Oritavancin’s clinical effectiveness was consistent across patient subgroups with varying demographic, clinical, and ABSSSI characteristics. Oritavancin was consistently associated with lower costs (per-patient savings $2319) and reduced resource utilization measures, and it required just 1.0 day of therapy vs. 7.2 days for SoC.ConclusionOritavancin is well suited for the outpatient treatment of ABSSSI. Compared with SoC, oritavancin offers comparable effectiveness, is more economical, and requires fewer healthcare resources.

Firefly Resources Optimization Technique for Data Delivery in Wireless Multimedia Sensor Networks

Wireless Multimedia Sensor Networks (WMSNs) isconsists of small embedded audio/video motes capable of extracting the surrounding environmental information, locally processing it and then wirelessly broadcasting it to sink/base station. Multimedia data such as image, audio and video is bigger in quantity than scalar data like temperature, pressure and humidity. Thus, to transmit multimedia information, more resources (i.e. energy, bandwidth, memory, buffer size and processing capability)are required. Recently, many research works has been developed for optimizing the resource constrained in WMSNs. But, WMSNs still needs a new resource optimization technique for effective multimedia data delivery with reduced resource utilization. In order to overcome such limitation, a novel Firefly Resource Optimized Data Delivery (FRODD) technique is proposed in this paper. FRODD technique is designed for efficient transmission of multimedia data with higher scalability and stable quality of service in WMSNs surveillance applications. In FRODD technique, Firefly Resource Optimization (FRO) algorithm is designed for exploring the optimized resource routing path and transmitting the incoming data streams according to their demand requirements. The main goal of proposed FRODD technique is to reduce resources utilization of sensor nodes while delivering multimedia data from the source node to destination in WMSNs. Experimental evaluation of FRODD technique is done with the performance metrics such as scalability, stability, accuracy of multimedia data content, energy utilization rate, bandwidth availability. Experimental analysis shows that the FRODD technique is able to improve the scalability rateby 18% and also reduce the energy utilization rateby 25% when compared to the state-of-the-art works.

A Reinforcement Learning Approach to Call Admission Control in HAPS Communication System

The large changing of link capacity and number of users caused by the movement of both platform and users in communication system based on high altitude platform station (HAPS) will resulting in high dropping rate of handover and reduce resource utilization. In order to solve these problems, this paper proposes an adaptive call admission control strategy based on reinforcement learning approach. The goal of this strategy is to maximize long-term gains of system, with the introduction of cross-layer interaction and the service downgraded. In order to access different traffics adaptively, the access utility of handover traffics and new call traffics is designed in different state of communication system. Numerical simulation result shows that the proposed call admission control strategy can enhance bandwidth resource utilization and the performances of handover traffics.

A Method to Detect Hazards in Pipeline Processor

In order to improve the throughput of the processors, pipeline technique is widely used to implement the instruction-level parallelism. However, this technique also leads to data hazards which has a great influence on the performance. This paper proposed a method called supply-matching to detect and solve data hazards efficiently. The logic of bypassing and stalling can be easily realized through this method. Furthermore, an RTL description of instructions was also introduced in this paper to reduce resource utilization. The case study was conducted through a five-stage microprocessor based on the PowerPC architecture with different approaches. Experiment results show our method requires less resources and achieves better performance.

Characterization of Planned and Unplanned 30-Day Readmissions Following Vascular Surgical Procedures.

Thirty-day readmission is increasingly used as a quality of care indicator. Patients undergoing vascular surgery have historically been at high risk for readmission. We analyzed hospital readmission details to identify patients at high risk for readmission in order to better understand these readmissions and improve resource utilization in this patient population. A retrospective review and analysis of our medical center's admission and discharge data were conducted from October 2012 to March 2015. All patients who were discharged from the vascular surgery service and subsequently readmitted as an inpatient within 30 days were included. We identified 649 vascular surgery discharges with 135 (21%) readmissions. Common comorbidities were diabetes (56%), coronary artery disease (40%), congestive heart failure (CHF; 24%), and chronic obstructive pulmonary disease (19%). Index vascular operations included open lower extremity procedures (39%), diagnostic angiograms (35%), endovascular lower extremity procedures (16%), dialysis access procedures (7%), carotid/cerebrovascular procedures (7%), amputations (6%), and abdominal aortic procedures (5%). Average index length of stay (LOS) was 7.48 days (±6.73 days). Reasons for readmissions were for medical causes (43%), surgical complications (35.5%), and planned procedures (21.5%). Reasons for medical readmissions most commonly included malaise or failure to thrive (28%), unrelated infection (24%), and hypoxia/CHF complications (21%). Common surgical causes for readmission were surgical site infections (69%), graft failure (19%), and bleeding complications (8%). Of the planned readmissions, procedures were at the same site (79%), a different site (14%), and planned podiatry procedures (7%). Readmission LOS was on average 7.43 days (±7.22 days). Causes for readmission of vascular surgery patients are multifactorial. Infections, both related and unrelated to the surgical site, remain common reasons for readmission and represent an opportunity for improvement strategies. Improved understanding of readmissions following vascular surgery could help adjust policy benchmarks for targeted readmission rates and help reduce resource utilization.

Reducing resource utilization during non-operative treatment of pediatric proximal humerus fractures

IntroductionThe majority of proximal humeral fractures in the skeletally immature are treated non-operatively. Operative indications vary but are largely based on degree of displacement. Non-union is rare. Non-operatively treated fractures are typically monitored radiographically to assess healing. HypothesisWe hypothesize that the decision to treat fractures operatively is made at the time of first imaging and that follow-up X-rays do not lead to a change in management. Material and methodsWe retrospectively reviewed the records of 239 patients treated for proximal humerus fractures over a 5-year period. There were 225 who were treated non-operatively. Records were reviewed for the number of clinic visits and radiographs, as well as any change to operative management based on follow-up X-rays. ResultsThe primary outcome of the study was the proportion of proximal humerus fractures, initially treated non-operatively, for which displacement or angulation on follow-up radiographs led to a change to operative treatment. Secondary outcomes were the number of follow-up radiographs obtained after the initial diagnosis and initiation of non-operative treatment. Of the 225 patients that were initially managed non-operatively, only 1 patient required subsequent surgical management. This patient underwent a proximal humerus epiphysiodesis 365 days from injury after development of a partial growth arrest. The mean number of fracture clinic visits for patients managed non-operatively was 2.67 (±1.24). The mean number of radiology department visits and radiographs obtained was 3.57 (±1.44) and 8.36 (±3.89) respectively. No clinical or radiographic non-unions were identified in these patients. No patients suffered a refracture during the review period. DiscussionThis study shows that of the 239 uncomplicated pediatric proximal humerus fractures treated at our hospital over a 5-year period, only 1 had a change in treatment plan, from non-operative to operative, based on follow-up radiographs. These data suggest that non-operative treatment of proximal humerus fractures seldom results in displacement that warrants operative intervention. Moreover, they suggest that there is little utility to the routine use of postoperative radiographs in follow-up of these patients. Study designRetrospective case series. Level of evidenceIV.