The Final Rule mandates that organ allocation not be based on the transplant candidate's place of residence or listing, except as required by sound medical judgment and best use donated organs, to avoid wasting organs futile transplants, promote access efficiency. Current Organ Procurement Transplantation Network (OPTN) policies donation service areas OPTN regions distribute allocate for transplant. These have recently been called into question meeting requirements Rule. Therefore, we...

Acuity circles (AC), the new liver allocation system, was implemented on February 4, 2020. Difference-in-differences analyses estimated effect of AC adjusted deceased donor transplant and offer rates across Pediatric End-Stage Liver Disease (PELD) Model for (MELD) categories types exception statuses. The were number first offers, top 5 10 offers match run per person-year. Each analysis candidate characteristics only used active time waiting list. before-AC period 2019, to 3, 2020, after-AC...

There is a perception that transplanting high-risk kidneys causes programs to be identified as underperforming, thereby increasing the frequency of discards and diminishing access transplant. Thus, Organ Procurement Transplantation Network (OPTN) has considered excluding transplants using from donors with high Kidney Donor Profile Index (KDPI) scores (≥0.85) when assessing program performance. We examined whether accepting highrisk (KDPI ≥0.85) for transplant yields worse outcome...

The paper presents an approach for identifying the most effective flexible AC transmission system (FACTS) controllers, locations, types and ratings that increase asset utilization of power systems. is a combined static/dynamic procedure based on use continuation flow, optimal flow eigenvalue analysis. application this representative studied has resulted in maximum stable loadability limit by 6.7%. finally shows proposed helpful coordinating functionality FACTS controllers to enhance dynamics.

The laryngeal mask airway (LMA) has been used in adult and pediatric populations for decades. While the familiarity of its use neonatal population is increasing, there are few data investigating this.The objective this study was to determine feasibility LMA placement neonates by time number attempts required successful physiologic stability during device.This one component a national, multicenter, randomized controlled trial surfactant administration through an neonates. Videotape reviewed...

We developed a kidney offer acceptance decision tool to predict the probability of graft survival and patient for first-time kidney-alone candidates after an is accepted or declined, we characterized effect restricting donor pool with maximum acceptable profile index (KDPI). For offers, Cox proportional hazards models estimated these probabilities using transplanted kidneys. declined were by considering experience similar who offers that declining would lead outcomes. randomly selected 5000...

Abstract We assessed the extent to which parents of children with autism spectrum disorder report that they are engaged in shared decision making. measured association between making and (a) satisfaction care, (b) perceived guidance regarding controversial issues disorder, (c) assistance navigating multitude treatment options. Surveys assessing primary medical care decision-making processes were developed on basis U.S. Department Health Human Service's Consumer Assessment Healthcare...

For estimating conditional survival functions, non-parametric estimators can be preferred to parametric and semi-parametric due relaxed assumptions that enable robust estimation. Yet, even when misspecified, possess better operating characteristics in small sample sizes smaller variance than estimators. Fundamentally, this is a bias–variance trade-off situation the size not large enough take advantage of low bias Stacked models estimate an optimally weighted combination span parametric,...

Every 6 months, the Scientific Registry of Transplant Recipients (SRTR) publishes evaluations every solid organ transplant program in United States, including 1-year patient and graft survival. The Centers for Medicare & Medicaid Services (CMS) Organ Procurement Transplantation Network (OPTN) Membership Professional Standards Committee (MPSC) use SRTR's regulatory review programs. Concern has been growing that scrutiny programs with lower-than-expected outcomes is harmful, causing to...

Objective To better inform health care consumers by identifying differences in transplant program performance. Data Source Adult kidney transplants performed the United States, January 1, 2012–June 30, 2014. Study Design In December 2016, Scientific Registry of Transplant Recipients instituted a five‐tier system for reporting We compare differentiation performance and simulated misclassification rate with previous three‐tier based on 95 percent credible interval. Collection database....

On December 23, 2019, the US Centers for Medicare and Medicaid Services proposed 2 new standards that organ procurement organizations (OPOs) must meet recertification. An OPO's donation rate (deceased donors/potential donors) transplant (organs transplanted/potential not fall significantly below 75th percentile rates among all OPOs. We examined how OPOs would have fared under performance in 2016-2017. Data on donors transplants were from Organ Procurement Transplantation Network; donor...

To estimate possible differences in skeletal asymmetry between patients with Class I and II relationships.Cone beam computed tomography (CBCT) images were examined from 70 consecutive who presented for orthodontic care fit the inclusion criteria. Asymmetry was quantified using an index developed by Katsumata et al. Anatomic landmarks defined reference planes established to determine of a constructed coordinate plane system. Thirty randomly selected reanalyzed assess reliability...

We investigated associations of deceased donor kidney offer acceptance with likelihood the being discarded, cold ischemia time at transplant (CIT), and exported outside donation service area (DSA). used offers from donors in Scientific Registry Transplant Recipients July 1, 2015-June 30, 2016, a stratified logistic regression to estimate odds ratios for candidates wait-listed DSA. estimated between these discard or export CIT transplant. Approximately 0.50 kidneys were discarded per donor;...

The Scientific Registry of Transplant Recipients (SRTR) is mandated by the National Organ Act, Final Rule, and SRTR contract with Health Resources Services Administration to report program-specific information on performance transplant programs. Following a consensus conference in 2012, developed new version public website improve reporting often complex metrics, including changing from 3-tier 5-tier summary metric for first-year posttransplant survival. After its release December 2016,...

On May 31, 2018, the US Department of Health and Human Services received a critical comment raising concerns that existing deceased donor liver allocation policy may not have been in compliance with Organ Procurement Transplantation Network (OPTN) Final Rule on organ

Abstract Background More patients are waitlisted for solid organs than transplants performed each year. The COVID‐19 pandemic immediately increased waitlist mortality and decreased listings. Methods To calculate the number of candidate listings after began short‐term changes that may affect waiting time, we conducted a Scientific Registry Transplant Recipients surveillance study from January 1, 2012 to February 28, 2021. Results candidates on liver continued steady decline before pandemic....

Procurement biopsy is performed to determine kidney quality, but evidence supporting such association poor. We investigated the impact of glomerulosclerosis percentage (GS%) on yield and patient outcomes. Information deceased donors from July 1, 2017, June 30, 2019, was collected. Association between GS% (number kidneys procured per donor) posttransplant graft outcomes were studied. Maximal minimal calculated relationship yield; only for correlation with Multinomial logistic regression Cox...