Room For Error Research Articles

Prevalence of anemia in school children in the age group of 8 to 14 years in Thiruvarur, Tamilnadu, India

Background: Iron deficiency is responsible for most of the nutritional anemia. Hemoglobin concentration is a reliable indicator of anemia at the population level, as opposed to clinical measures which are subjective and therefore have more room for error. Measuring Hemoglobin concentration is relatively easy and inexpensive, and this measurement is frequently used as a proxy indicator of iron deficiency. To study the association of certain risk factors with the prevalence of anemia in school children in the age group of 8-14 years.Methods: The study was conducted from April 2017 to March 2018 in Department of Paediatrics, Government Thiruvarur Medical College, Thiruvarur. The study population consisted of school children in the age group of 8 to 14 years fulfilling the inclusion and exclusion criteria. The sample size was 250. Complete hematological investigations was done to each child for differential diagnosis of anemia.Results: Majority of the children studied had a normal BMI 38.4% (n=96), 16.8% (n=42) were classified as overweight, 9.2% (n=23) were classified as obese. 22.8% (n=57) were classified as having thinness. 12.8% (n=32) were classified as having severe thinness. Of the 132 children with anemia, majority had mild anemia 64.39% (n=85) followed by moderate 28.03% (n=37) and severe anemia 7.58% (n=10). Of the 132 children with anemia, majority had mild anemia 64.39% (n=85) followed by moderate 28.03% (n=37) and severe anemia 7.58% (n=10).Conclusions: The prevalence of anemia was significantly higher in female children (64.91%) compared to male children (42.65%). The prevalence of anemia is highest in children with severe thinness (78.13%) followed by children with obesity (73.91%). The most common type of anemia in our study was iron deficiency anemia. Majority of the children were suffering from anemia of mild severity. There was no statistically significant correlation between the prevalence of anemia in children and age and socioeconomic status.

The Role of Powered Surgical Instruments in Ear Surgery: An Acoustical Blessing or a Curse?

Ear surgery in many ways lagged behind other surgical fields because of the delicate anatomical structures within the ear which leave surgeons with little room for error. Thus, while surgical instruments have long been available, their use in the ear would most often do more damage than good. This state of affairs remained the status quo well into the first half of the 20th century. However, the introduction of powered surgical instruments, specifically the electric drill used in conventional microscopic ear surgery (MES) and the ultrasonic aspirator, the Sonopet® Omni, in transcanal endoscopic ear surgery (TEES) marked major turning points. Yet, these breakthroughs have also raised concerns about whether the use of these powered surgical instruments within the confines of the ear generated so much noise and vibrations that patients could suffer sensorineural hearing loss as a result of the surgery itself. This paper reviews the intersection between the noise and vibrations generated during surgery; the history of surgical instruments, particularly powered surgical instruments, used in ear surgeries and the two main types of surgical procedures to determine whether these powered surgical instruments may pose a threat to postoperative hearing.

The Wests: Decline Management and Geopolitics

ABSTRACTThe ebbing power of the United States signals the end of the period in which a series of “Wests” have created, globalized, and dominated an international order. Each “West” has had its own norms of authority and coercive utopia, but they shared in common the projection of a sense of modernity, technical proficiency, and inevitable, invincible authority. The two current Wests, the European Union and the United States, boast a partial normative overlap but have different creation myths. American fumbling of its hegemonic moments highlights the narrowing of room for error that defines decline. Still, decline does not necessarily lead to collapse, and skillful management could mitigate its effect. In part, this depends on whether Washington can come to rely less on neo-Wilsonian nostrums and more on the creative side of the American record.

Examining the myths of connected and autonomous vehicles: analysing the pathway to a driverless mobility paradigm

Connected and autonomous vehicles (CAVs) could become the most powerful mobility intervention in the history of human race; possibly greater than the conception of the wheel itself or the shift from horse-carriages to automobiles. Despite CAVs' likely traffic safety, economic, environmental, social inclusion and network performance benefits their full-scale implementation may not be as predictable, uncomplicated, acceptable and risk-free as it is often communicated by a large share of automotive industries, policy-makers and transport experts. Framing an 'unproven', 'disruptive' and 'life-changing' intervention, primarily based on its competitive advantages over today's conventional automobile technologies, may create misconceptions, overreaching expectations and room for errors that societies need to be cautious about. This article 'tests' eleven myths referring to an overly optimistic CAVs' development and adoption timeline. This approach highlights unresolved issues that need to be addressed before an inescapable CAV-based mobility paradigm transition takes place and provides relevant policy recommendations on how to achieve that.

Consolidation in Provider and Insurer Markets: Enforcement Issues and Priorities

Consolidation in Provider and Insurer Markets: Enforcement Issues and Priorities

Humanoid Identification of Fabric Material Properties by Vibration Spectrum Analysis.

In daily contexts, fabrics embodied in garments are in contact with human body all the time. Since fabric material properties—such as softness or fineness—can be easily sensed by human fingertips, fabric materials can be roughly identified by fingertip sliding. Identification by simply touching and sliding is convenient and fast, although the room for error is always very large. In this study, a highly discernible fabric humanoid identification method with a fingertip structure inspired tactile sensor is designed to investigate the fabric material properties by characterizing the power spectrum integral of vibration signal basing on fast Fourier transform integral S(FFT), which is generated from a steel ball probe rubbing against a fabric surface at an increasing sliding velocity and normal load, respectively. kv and kw are defined as the slope values to identify the fabric surface roughness and hardness. A sample of 21 pieces of fabric categorized by yarn weight, weave pattern, and material were tested by this method. It was proved that the proposed humanoid sensing method has more efficient compared with fingertip sliding while it is also much more accurate for fabric material identification. Our study would be discussed in light of textile design and has a great number of potential applications in humanoid tactile perception technology.

Do Pedicle Screws in Concave Apex of Scoliosis Offer Any Advantages?

Study Design Retrospective analysis of prospectively collected data.Purpose To assess the relative advantages of implant constructs with and without pedicle screws in the concave apex for correcting scoliosis.Overview of Literature Concave apical pedicles in scoliosis can be narrow and dysplastic. Neural structures also migrate toward concavity, leaving little room for error while inserting pedicle screws into the concave apex.Methods Patients (n=35) undergoing scoliosis surgery from September 2004 to September 2009 with minimum 5-year follow-up period were included. Exclusion criteria were pseudarthrosis, implant failure, infection, anterior release surgery, corrective osteotomies, incomplete data, constructs not involving anchors at the apex of the curve, and kyphoscoliosis. Curves were classified into two groups as follows: group A, with screws alone anchoring the convex apex and the correction performed from the convex side and group B, with screws anchoring the concave apex with or without convex apex purchase and the correction performed from the concave side.Results Twenty-two of 35 patients were selected. In these patients, 29 individual curves were selected and classified into groups A (n=15) and B (n=14). Both groups were comparable in terms of age, sex, and etiology (idiopathic and nonidiopathic). However, group A had larger (68.53°±26.29°) and more rigid (29.04%±18.22% flexibility) curves than group B (50.14°±16.89° with 49.87%±25.01% flexibility) (two-tailed p <0.05). Despite this, the immediate postoperative correction was comparable between the two groups (A, 57.98%±16.28%; B, 62.76%±13.13%; two-tailed p =0.39). Interestingly, group A showed significantly better results in terms of the gain of instrumented correction over and above preoperative flexibility (A, 28.94%±8.51%; B, 12.89%±23.06%; two-tailed p =0.03). There was no statistically significant difference in the correction percentage of sagittal profile between the two groups and in the loss of correction at follow-up or Scoliosis Research Society-22 scores.Conclusions Present study could not demonstrate any advantages associated with use of apical concave pedicle screws.

Soft tissue profile around dental implants placed in the aesthetic zone — a biological update

Abstract: The success attained with endosseous implants is well documented in the literature but complications are inevitable due to high risk factors associated with bacterial related breakdown of osseointegration and peri-implant mucosa. It is now apparent that maintenance of a complete seal of the gingival cuff around implants is paramount for achieving predictable outcomes, as there is no room for error when multiple implants are being placed in the maxillary anterior region. However, the restorative dentist not only faces a challenge in restoring missing teeth but also the missing volume of three-dimensional gingival envelope encompassing them. CPD/Clinical Relevance: This article has focused on the comprehensive understanding and integration of various biological elements that are imperative in the rapidly advancing field of implantology.

A New Method for Change Detection in Stone and Concrete Structures with Digital Photogrammetry

Point clouds, generated by Photogrammetry and LiDAR, allow us to detect far more complex deformation processes, with greater speed and accuracy, than previous surveying techniques. The accuracy of any monitoring is determined, in part, by the method used to align the two epochs in the same space. Surveying equipment can be used to stake-out ground control points visible in either the laser scan or the photogrammetry and so provide absolute positioning for each epoch. As an alternative, 3D shape-matching algorithms like RANSAC and Iterative Closest Point (ICP) can be used downstream to align the two epochs based only on the invariant features visible in the dense clouds. Shape-matching is, however, limited in accuracy because a) operator proficiency in guiding the algorithms leaves room for error, and b) the point clouds used for alignment are usually insufficiently dense to guarantee sub-centimeter change detection. Proposed is a new method of alignment between monitoring epochs for photogrammetry. Photogrammetry has the ability to match features between images down to the accuracy of 0.15 pixels, and provides us with a robust statistical model to predict both accuracy and error. Using invariant features in photographs shared between monitoring epochs, we can use the algorithms of Normalized Cross Correlation and Least-Squares Matching to very accurately "pin" one monitoring epoch to another. In a series of simple experiments we demonstrate that sub-centimeter change detection is easily accomplished on highly textured surfaces such as stone and concrete. This has applications in Archaeology, Architecture, and Civil Engineering surveys.

Non-invasive hemodynamic evaluation by Doppler echocardiography.

The approach for treating a hemodynamically unstable patient remains a diagnostic and therapeutic challenge. Stabilization of the patient should be rapid and effective, but there is not much room for error. This narrow window of intervention makes it necessary to use rapid and accurate hemodynamic evaluation methods. Echocardiography is the method of choice for the bedside evaluation of patients in circulatory shock. In fact, it was intensive care physicians who recognized the potential of Doppler echocardiography for the initial approach to patients in circulatory failure. An echocardiogram allows rapid anatomical and functional cardiac evaluation, which may include non-invasive hemodynamic evaluation using a Doppler study. Such an integrated study may provide data of extreme importance for understanding the mechanisms underlying the hemodynamic instability of the patient to allow the rapid institution of appropriate therapeutic measures. In the present article, we describe the most relevant echocardiographic findings using a practical approach for critical patients with hemodynamic instability.

A hardware in the loop emulator for a satellite control system

Design and testing of algorithms for satellite attitude control is not an easy task. Once the system is deployed (the satellite is launched), there is no room for error or system modifications. That, of course, requires extensive testing and simulation before deployment. However, simulation can not capture all aspects of system operation. For example, capturing jitter in the system due to hardware issues such as cache miss, interrupts, dynamic scheduling, or instruction prediction is almost impossible. In such a case, hardware in the loop (HiL) simulation platform is used to capture real-time system behaviour. In this paper, we propose and implement a HiL simulator for a small satellite on FPGA. The model implements the satellite dynamics as well as jitter and noise added to the signal. We use our emulator to study the effect of fixed point implementation on the controller performance. Our results indicate that we can achieve a 50% power saving using fixed point implementation (as compared to floating point implementation) with almost no performance degradation. We also use the HiL platform to test the effect of noise and jitter on the system performance.

Weathering the Recession-Time for More Efficiency in Project Management

Throughout career, project management practitioners have tried and will continue to make a case for instituting project management as a discipline for all kinds of projects. This recurring need is ever present and will not end anytime soon whether in vibrant times or turbulent times, but more especially for the latter times when the value of project management practice is glaring as a strategic competence for success. The need to efficiently meet strategic goals has arguably never been greater in this time of economic uncertainty. Organizations do not have a lot of room for error in their project and program execution. Business owners need to focus, embrace and implement project management as a strategic competence to weather the lean times in the country. Project management practitioners need to demonstrate the value of the practice to help organizations realize the benefits by using well-tested project management methodologies, thereby further enhancing the practice in Nigeria for the greater good – the social value, a noble cause. Using Earned Value Management to monitor time, scope, and budget goals, sometimes called ‘project efficiency’ goals, is neither the only dimension of project success nor a dimension of project success that can be ignored any longer. Hopefully, this effort will contribute to the growing awareness of the value of project management practice to minimize money wasted due to poor project performance.

Preparing our next generation of pathologists: The criticality of critical reading.

Preparing our next generation of pathologists: The criticality of critical reading.

The room of errors, a fun learning tool

Simulation in health care, a source of innovative pedagogical developments, is particularly well-suited to the training of nursing teams. It enables them to acquire or reinforce their knowledge, without any risk for the patients, in a calm and reassuring environment. In psychiatry in particular, the use of a room of errors constitutes a useful learning tool for professionals.

Five ways digital incentives are changing market research

Incentives are crucial to market research. But physical incentives like checks, gift cards, and cash can be time consuming and expensive. Delivering physical incentives also leaves more room for error, which can cause you to spend even more time resolving issues and delays in delivery to participants.

K. Perkins v Sheffield City Council [2016

Thankfully, party wall court cases are relatively low in number, which may be attributed to their prescriptive nature thus operating within well-defined parameters. This means that when the rules are followed, there is little room for error and the parties (often represented by their surveyors) can deal amicably with the relevant matters. However, periodically, unwarranted deviations from the Party Wall Act result in disputes with unpredictable results. The case described in this paper, which was meant to be no more than a routine party wall dispute, illustrates how reckless deviation from a party wall award could result in legal proceedings causing loss of faith in law, undue stress to the adjoining owner and waste of parties’ resources. From start to completion the process took over 15 months and involved three separate in-house lawyers, a barrister, three court hearings (involving two district judges and a deputy district judge) and an inordinate amount of the adjoining owner’s surveyor’s time. As it is often promulgated, there are no clear winners in such cases and even a seemingly outright winner may have lost something through the process.

An Early Identification Tool for Sepsis in the Obstetric Population

Implementation, Outcomes and Evaluation A simulated patient room in the maternal-child health inpatient unit was staged with multiple potential safety hazards derived from current evidence-based guidelines for the promotion of perinatal safety and previously identified risks such as medication errors and patient safety reporting system data. A multidisciplinary team, including doctors, midwives, nurses, operating room technicians, students, and housekeeping staff were brought into the “room of errors” and given 2 minutes to identify as many errors as possible.

The flashing of fireflies

Purpose This paper aims to identify the characteristics of enduring audience engagement through social media. Design/methodology/approach The approach is to examine recent examples of successful social media practices to identify common characteristics. Findings The most common characteristics of successful social media engagement include continuous beta, co-ownership, room for error and convenor-ship. Originality/value The author’s analogy of successful social media to the biophysical phenomenon of entrainment is an original insight into social engagement.

Safe Practices in Drilling and Completion of Sour Gas Wells

This paper examines the current status of the global market of sour fields. In particular, it clarifies on the existing methods, standards, and technologies applied for drilling, cementing, and completing a well with high H2S concentration, with view of recommending the minimum health, environmental, and safety (HSE) protocols or standards required when dealing with sour environments. The overall approach for this study was literature review. This will involve exploration of various exploitation case studies from the region and the globe meant for improving the economics of developing sour reservoirs in this cost sensitive time for the industry. Literature on current status of methods and technologies applied for drilling, cementing and completing high H2S concentration wells will be reviewed. Standards and recommendations set by the American Petroleum Institute (API) and National Association of Corrosion Engineers (NACE) on the minimum Health, Environmental, and Safety (HSE) for use in sour environments will also be reviewed. The findings of this study informed of the fact that there is very small even any room for error when it comes with exploiting high H2S concentration well reservoirs. The results of the study established that dealing with sour fields is a challenge the industry will face more often, and in increasing magnitudes over time. In particular, it was established that the best approach for meeting this challenge is for companies in the industry to acquire knowledgeable personnel, an element that dictates for consulted investing in the proper training of employees. In order to ensure proper training of personnel, core areas of the training should encompass best practices on the selection of materials, planning operations, and the swift planning and executing of operation plans and incidents. This study will have implication for unlocking the full potential of the sour environments frontier for the region. The findings of this study will provide drilling and completions engineers with insightful knowledge on best practices in dealing with sour fields.

Dear Clarice

Dear Clarice Adrienne Celt (bio) Click for larger view View full resolution © Quinn Dombrowski, CC BY-SA 2.0 via Flickr YOU ARE THE LAST PERSON I EXPECT to be interested in my explanations and confessions, and yet you’re the only person I can think of to address them to. As I write, I imagine the ballet of reactions on your face; that familiar mix of—forgive me—envy and disgust. Exhaustion. I imagine each upcurled lip and puckered brow, and feel them play out across my own features. You know we made identical faces at one another, always. It was our only real common ground as sisters: being so different that we responded to one another in exactly the same baffled way. [End Page 113] So I’m sending you these pages, because I know you’ll be compelled to read them all the way through, by your parallel senses of duty and dread. Not a compliment, but not an insult either, whatever you may think. I’m grateful for the chance to offer someone what I feel to be the whole truth. THE INTERNET WAS, OF COURSE, INSUFFERABLE in the days that followed the event. All the social media outlets and special-interest blogs were flooded with some version of this sentiment: “I’m so happy I got to visit France before all this happened. It was a lifelong dream, and le château de Versailles will live forever in my heart. #blessed” Or alternatively: “Those socialist elitist fucks had it coming. You want to eat snails? Well, you’re asking for something bad to happen. Just my opinion.” Or even: “You all know the government is behind this, right? It’s a systematic depopulation program, and we’re next. You’ll see.” Not one of these people had any idea what they were talking about. But that was to be expected, really. We’re the ones who should’ve known. OUR PROJECT, AS I’M SURE YOU’RE AWARE BY NOW, was called the Cooperative International Thermonuclear Reactor Assessment, CITRA for short. “Cooperative” because it was built and funded by a number of different international agencies. “Assessment” because, in the early stages, it was unclear when, if ever, it would work.1 The other pieces, I think even you can figure out. Fusion energy was still a pie-in-the-sky proposition back then, but we were cocky—no surprise to you, I’m sure—and convinced ourselves that we could transform our theories into reality by sheer will. The world needed a safe alternative to gas, coal, and oil—and we would give it to them. No more exhaust fumes, no more fission plants blowing good country people to kingdom come. It wasn’t easy, though. There was no room for error. We couldn’t afford even a millimeter of discrepancy between the plans and the product. Like anything so precise, CITRA at work was worthy of awe. The force of the reaction could only be contained within a subzero vacuum, supported by powerful electromagnets. It was hotter than any natural phenomenon on Earth. It was a small terrestrial star. BUT I’M FORGETTING—or, as you’d more likely say, ignoring—you. The things that fill each of us with awe are not the same, are they? Always, you loved the Pentecost, the long hand of God. The descent of the Holy Spirit onto the body of the Earth. We both preferred to love things that the other [End Page 114] could not understand. So when I speak of CITRA, I know I risk boring you. Me and my scientific mumbo-jumbo, the kind of talk that was over your head and beneath your concern. After seven years, and a promise of confession, I don’t mean to be so disappointing. I want to hold your attention, Clarice, I really do—after all, these may be my last words. And I think there’s a way. The personal, you always said. The personal, and the providential. Dancing in our bedroom slippers, singing at the top of our lungs—to you, the point wasn’t to annoy our parents into sending us to summer camp...