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Background: Manual objective assessment of skill and errors in minimally invasive surgery have been validated with correlation to surgical expertise and patient outcomes. However, assessment and error annotation can be subjective and are time-consuming processes, often precluding their use. Recent years have seen the development of artificial intelligence models to work towards automating the process to allow reduction of errors and truly objective assessment. This study aimed to validate surgical skill rating and error annotations in suturing gestures to inform the development and evaluation of AI models., Methods: SAR-RARP50 open data set was blindly, independently annotated at the gesture level in Robotic-Assisted Radical Prostatectomy (RARP) suturing. Manual objective assessment tools and error annotation methodology, Objective Clinical Human Reliability Analysis (OCHRA), were used as ground truth to train and test vision-based deep learning methods to estimate skill and errors. Analysis included descriptive statistics plus tool validity and reliability., Results: Fifty-four RARP videos (266 min) were analysed. Strong/excellent inter-rater reliability (range r = 0.70-0.89, p < 0.001) and very strong correlation (r = 0.92, p < 0.001) between objective assessment tools was demonstrated. Skill estimation of OSATS and M-GEARS had a Spearman's Correlation Coefficient 0.37 and 0.36, respectively, with normalised mean absolute error representing a prediction error of 17.92% (inverted "accuracy" 82.08%) and 20.6% (inverted "accuracy" 79.4%) respectively. The best performing models in error prediction achieved mean absolute precision of 37.14%, area under the curve 65.10% and Macro-F1 58.97%., Conclusions: This is the first study to employ detailed error detection methodology and deep learning models within real robotic surgical video. This benchmark evaluation of AI models sets a foundation and promising approach for future advancements in automated technical skill assessment., (© 2024. Crown.)

Background: The proper completion of death certificates (DCs) is of paramount importance for physicians, as they serve as vital medico-legal documents. The information contained within these certificates holds great significance in health statistics, as it serves as a crucial tool for epidemiological research and analysis., Methods: This study comprises a descriptive cross-sectional analysis of all DCs issued in 2019 for approximately 1104 deceased patients at a teaching hospital in Mazandaran Province, in northern Iran. To conduct this research, a checklist was implemented, which contained comprehensive categories, including essential public information, and the primary and underlying causes of death (UCOD)., Results: The results of this study indicate that out of the 618 cases of deceased individuals, 273 (44.2 %) were women and 345 (55.8 %) were men. Notably, a total of 61 cases (9.9 %) exhibited an error in the writing of the primary cause of death (COD). Specifically, the UCOD was erroneously recorded as cardio-pulmonary arrest in 13.2 % of all DCs, thus resulting in an error in the main COD., Conclusion: The findings of this study disclosed a high incidence of errors in the completion of DCs, particularly in the determination of the UCOD, which is universally recognized as the most critical aspect of these documents., Competing Interests: Declaration of competing interest The authors have no competing interests to declare., (Copyright © 2024 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.)

The term "event" covers a wide range of concrete situations in radiation oncology, from particularly intense radiation-related side effects to the possibility of technical or human error. Although quality procedures are an integral part of radiotherapy oncology department operations ensuring the analysis and prevention of such events, their occurrence during radiation treatment still has a significant impact on patients and their experience of the treatment process, as well as on health professionals. These practical, emotional and symbolic impacts are all the greater when the event occurs in the aftermath of an error. The ethical approach therefore comprises three essential stages: recognizing the event as such, informing those involved of the event and, finally, creating conditions for the continuation of care. Each of these stages is marked by specific issues and questions, requiring a complex ethical approach that constantly involves reconciling the possible divergent perceptions of patients and health professionals. The occurrence of an event can also lead to a genuine crisis of confidence with multiple dimensions, which health professionals will also have to face and to support. Finally, the occurrence of an event calls into question not only our responsibility towards patients, but also our ideal of control. We need to criticize our culture of performance, rethink our approach to events and errors, and see them also as opportunities for positive change., (Copyright © 2024 Société française de radiothérapie oncologique (SFRO). Published by Elsevier Masson SAS. All rights reserved.)

Adverse events have a profound impact on surgeons. This impact extends to physical and mental health, psychological wellbeing, and professional performance. Surgeons are ill prepared for these consequences of adverse events and are under-supported when they inevitably occur. Here we review the data on how adverse events affect surgeons. We explore the efforts made to date to both prepare surgeons before and support them after such events and we make recommendations regarding how this should and could be done better., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Crown Copyright © 2024. Published by Elsevier Inc. All rights reserved.)

Introduction: A pharmacy information system (PIS) is a crucial tool for preventing errors and enhancing patient safety. This study aims to assess the influence of a PIS on workflow and medication errors (MEs) within the pharmacy department of a medical city in Saudi Arabia. The analysis encompasses an evaluation of the current workflow within pharmacy modules (in-patient, out-patient, and clinical pharmacy modules) and an exploration of associated challenges and inefficiencies., Method: The study employed both qualitative and quantitative methodologies, incorporating structured interview techniques and the review of system records, such as logs, incident reports, and ME databases., Results: Respondents recognized the benefits of the PIS, including the management of high-quality real-time data (26%), reduction of MEs (25%), acceleration of healthcare practices (23%), and absence of space-time constraints (14%). The study highlighted the role of PIS in addressing medication stock control and shortage issues, thereby improving overall medication availability. Furthermore, PIS significantly enhanced safety (93.3%), efficiency (80%), reliability, accuracy, ease of use (56.7%, 56.7%), and cost-effectiveness (53.7%). Following the implementation of the PIS, there was an increase in ME reporting, indicating improved error detection and management., Conclusion: The research revealed an increase in ME reporting rates in hospitals after PIS installation, attributed to improved medication management processes resulting in higher detection rates. As healthcare facilities increasingly embrace electronic medical records, the understanding of patient care quality will be significantly impacted. Consequently, further research is warranted to explore the role of PIS in reporting, detecting, analyzing, and mitigating MEs, as well as their influence on the work environment to promote a secure and efficient patient journey., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. King Fahad Medical City - Riyadh Second Cluster issued approval 24-141. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Alanazi et al.)

Purpose: We compared the rate of errors in genome sequencing (GS) result disclosures by genetic counselors (GC) and trained non-genetics healthcare professionals (NGHPs) in SouthSeq, a randomized trial utilizing GS in critically ill infants., Methods: Over 400 recorded GS result disclosures were analyzed for major and minor errors. We used Fisher's exact test to compare error rates between GCs and NGHPs and performed a qualitative content analysis to characterize error themes., Results: Major errors were identified in 7.5% of disclosures by NGHPs and in no disclosures by GCs. Minor errors were identified in 32.1% of disclosures by NGHPs and in 11.4% of disclosures by GCs. Although most disclosures lacked errors, NGHPs were significantly more likely to make any error than GCs for all result types (positive, negative, or uncertain). Common major error themes include omission of critical information, overstating a negative result, and overinterpreting an uncertain result. The most common minor error was failing to disclose negative secondary findings., Conclusion: Trained NGHPs made clinically significant errors in GS result disclosures. Characterizing common errors in result disclosure can illuminate gaps in education to inform the development of future genomics training and alternative service delivery models., Competing Interests: Conflict of Interest All authors declare no competing financial interests in relation to the work described., (Copyright © 2024 American College of Medical Genetics and Genomics. Published by Elsevier Inc. All rights reserved.)

As sleep problems can impair quality of work, an online questionnaire was used to examine relationships between sleepiness and decision making while obtaining unobtrusive indices of performance. Participants ( N  = 344) completed the Insomnia Severity Index, Epworth Sleepiness Scale, and the Melbourne Decision Making Questionnaire in a Qualtrics survey while reporting mobile phone use. Qualtrics recorded the time and the number of clicks required to complete each page of the survey. Multiple regression indicated that insomnia was associated with daytime sleepiness and Hypervigilance, and mobile phone use before bed. Participants with moderate sleepiness required a greater number of clicks to complete the questionnaire. Greater sleepiness was associated with longer times to complete these self-assessment tasks. Clinically significant sleepiness produces changes in performance that can be detected from online responsivity. As sleepy individuals can be appreciably and quantitatively slower in performing subjective self-assessment tasks, this argues for objective measures of sleepiness and automated interventions and the design of systems that allow better quality sleep. Practitioner summary : Work can require processing of electronic messages, but 24/7 accessibility increases workload, causes fatigue and potentially creates security risks. Although most studies use people's self-reports, this study monitors time and clicks required to complete self-assessment rating scales. Sleepiness affected online responsivity, decreasing online accuracy and increasing response times and hypervigilance.

Triage systems, crucial for Emergency Departments, face unresolved doubts and issues that have not been addressed, coupled with increasing fragmentation due to a growing body of new evidence. International collaboration is essential for evidence-based triage solutions., (© 2024. The Author(s).)

Models of heuristics are often predicated on the desideratum that they should possess no free parameters. As a result, heuristic implementations are usually deterministic and do not allow for any choice errors, as the latter would require a parameter to regulate the magnitude of errors. We discuss the implications of this in light of research that highlights the evidence supporting stochastic choice and its dependence on preferential strength. We argue that, in principle, the existing models of deterministic heuristics should, and can, be quite easily modified to stochastic counterparts through the addition of an error mechanism. This requires a single free parameter in the error mechanism, whilst otherwise retaining the parameter-free cognitive processes in the deterministic component of existing heuristics. We present various types of error mechanisms applicable to heuristics and discuss their comparative virtues and drawbacks, paying particular attention to their impact on model comparisons between heuristics and parameter-rich models., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Spiliopoulos and Hertwig.)

A simple replacement-most likely due to a linguistic error-of the Greek letter beta (β) by the German letter Eszett (ß), has led to the introduction of an error in a body of literature related to beta (β)-catenin, resulting in the "creation" of a non-existent compound and false positive, Eszett (ß)-catenin. A search on 9 December 2023 in PubMed for ß-catenin and β-catenin revealed 395 and 45,919 results, respectively. The 25 results of ß-catenin published in 2023 were examined in more detail to appreciate the location(s) in each paper where this error had occurred. While the scientific findings of these studies do not seem to be impacted by this error, authors and editors would need to weigh the need or benefit of correcting this error., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Radiological interpretations, while essential, are not infallible and are best understood as expert opinions formed through the evaluation of available evidence. Acknowledging the inherent possibility of error is crucial, as it frames the discussion on improving diagnostic accuracy and patient care. A comprehensive review of error classifications highlights the complexity of diagnostic errors, drawing on recent frameworks to categorize them into perceptual and cognitive errors, among others. This classification underpins an analysis of specific error types, their prevalence, and implications for clinical practice. Additionally, we address the psychological impact of radiological practice, including the effects of mental health and burnout on diagnostic accuracy. The potential of artificial intelligence (AI) in mitigating errors is discussed, alongside ethical and regulatory considerations in its application. This research contributes to the body of knowledge on radiological errors, offering insights into preventive strategies and the integration of AI to enhance diagnostic practices. It underscores the importance of a nuanced understanding of errors in radiology, aiming to foster improvements in patient care and radiological accuracy.

Objective: The study aimed to investigate the subjective method of estimating linear breast dimensions in comparison to the objective method., Methods: The reproducibility and accuracy of the subjective method of estimating linear breast dimensions during a simplified breast shape analysis were examined. Four linear breast dimensions including the distance from the sternal notch to the nipple, distance from the nipple to the inframammary fold, distance from the nipple to the midline and under-breast width were evaluated based on subjective estimates. Images from 100 women with natural breasts and without any history of breast surgery were reviewed by two examiners three times each. The cases were obtained from a large database of breast images captured using the Vectra Camera System (Canfield Scientific Inc., USA). The subjective data were then compared with the objective linear data from the Vectra Camera System in the automated analysis. Statistical evaluation was conducted between the three repeated estimates of each examiner, between the two examiners and between the objective and subjective data., Results: The intra-individual variations of the three subjective estimates were significantly greater in one examiner than in the other. This trend was consistent across all eight parameters in the majority of the comparisons of the standard deviations and variation coefficients, and the differences were significant in 14 out of 16 comparisons (p<0.05). Conversely, in the comparison between the subjective and objective data, the estimates were closer to the measurements in one examiner than the other. In contrast to the reproducibility observed, the assessment of the accuracy revealed that the examiner who previously presented with less reproducibility of the estimated data overall showed better accuracy in comparison to the objective data. The overall differences were inconsistent, with some being positive and others being negative. Regarding the distances from the sternal notch to the nipple and breast width, both examiners underestimated the values. However, the deviations were at different levels, particularly when considering the objective data from the Vectra Camera System as the gold standard data for comparison. Regarding the distance from the nipple to the inframammary fold, one examiner underestimated the distance, while the other overestimated it. An opposite trend was noted for the distance from the nipple to the midline. There were no differences in the estimates between the right and left sides of the breasts. The correlations between the measured and estimated distances were positive: as the objective distances increased, the subjective distances also increased. In all cases, the correlations were significant. However, the correlation for the breast width was notably weaker than that for the other distances., Conclusions: The error assessment of the subjective method reveals that it varies significantly and unsystematically between examiners. This is true when assessing the reproducibility as well as the accuracy of the method in comparison to the objective data obtained with an automated system., Competing Interests: The authors declare that they have no competing interests. This study is an independent investigation into subjective and objective assessments of linear breast dimensions., (Copyright © 2024 Karavasili et al.)

Background: Mistrust of doctors and the desire for compensation are driving a rise in malpractice litigation worldwide., Aim: To estimate the extent to which Italians view birth complications as malpractice in obstetric care, and how widespread this perception is., Method: WhatsApp® and Facebook® contacts of one of the authors were invited to respond to an online questionnaire. The answers of 265 Italian respondents were used to estimate how common the perception of obstetric staff errors is and how this perception spreads over time: the denigration curve. To test if the denigration curve is reliable, the curve has been plotted along with the trend of the rate of litigation in Italy., Results: Almost a 50% of respondents deemed that birth complications are due to obstetric staff errors. The likelihood of the percep-tion that one has experienced a birth complication was 64.5%. The communication of obstetric staff error seemed low overall among the respondents. The denigration curve shape is almost coincident with the curve of claim rates in Italy, proving that it would be reliable., Conclusion: The respondents provided an estimate of the rate of birth complications that was higher than the real occurrence rate, and attributed these complications to obstetric staff errors. The denigration curve could predict whether and when there might be litigation related to any birth complications (both error related and non-error related).

Objectives: Cognitive and affective factors have been implicated in verbal fluency (VF) performance in Parkinson's disease (PD). This exploratory study aimed to investigate the relationships between cognitive and affective variables on traditional ("core") and "process" (error and interval) scores of VF and elucidate unique information these scores may provide regarding mechanisms underlying VF., Methods: Sixty-two PD patients without dementia completed clinical neuropsychological examinations consisting of attention, processing speed, language, executive functioning, visuospatial, memory, and mood measures. Hierarchical regression and negative binomial regression analyses were used to evaluate relationships between outcome and predictor variables., Results: Generativity results revealed that processing speed and working memory explained up to 34% of the variance of total letter fluency responses ( p = <.001) and processing speed explained 24% of the variance for total semantic fluency ( p = .003). For category switching generativity, only age predicted 20% of the variance ( p = .01). Two executive functioning measures were negatively associated with error production over the duration ( b  = -.055, p = .028; b  = -.062, p = .004) and final 45-second interval ( b  = -.072, p = .003; b  = -.044, p = .033) of the category switching task. In the initial 15-second task interval, a positive predictive relationship between error production and indifference apathy ( b = .616, p = .044) was demonstrated., Conclusions: Findings demonstrate the potential utility of "process" scores in detecting subtle cognitive impairment in Parkinson's disease patients without dementia and tentatively evidence the role of indifference apathy in task initiation.

Background: Intracavernosal injection therapy (ICI) is a well-established therapeutic strategy for men with erectile dysfunction. Complications are often related to patient error when performong ICI., Aim: The objective of this study was to examine patient errors in an established patient training program for performing ICI and identify factors that could predict major errors., Methods: Patients enrolled in our ICI program are trained on technical aspects, and dose titration is begun. Patients are given explicit instructions during training, both verbally and in written form. Records were reviewed for men using ICI for ≥6 months. Multivariable analysis was used to define predictors of major errors., Outcomes: Errors were listed as minor (zero-response injection, penile bruising, expired medication) and major (errors potentially leading to priapism: dose self-titration, double injecting)., Results: Overall, 1368 patients met the inclusion criteria and were included in the analysis. The mean patient age was 66 ± 22 (range 29-91) years. Regarding education, 41% of patients had graduate-level education, 48% had college education, and 11% high school education. Mean follow-up was 3.2 ± 7.6 (range 0.5-12) years. The agents used were trimix (62%), bimix (35%), papaverine (2%), and prostaglandin E1 monotherapy (1%). At least 1 error occurred during self-administration in 42% of patients during their time in the program. Errors included zero response to medication due to technical error (8% of patients), penile bruising (34%), use of an expired bottle (18%), self-titration (5%), and double injecting (4% of patients); 12% of men committed ≥1 error during their time in the program. On multivariable analysis, independent predictors of the occurrence of a major error included: young age, graduate-level education, and <12 months of injection use., Clinical Implications: To the best of our knowledge, this is the first reported study to investigate ICI errors and risk factors. The identification of factors predictive of major errors allows for more tailored and intensive training in this subset of patients., Strengths and Limitations: Strengths of this study include a large patient population (1386 men) with a considerable follow-up time. Additionally, the rigorous training, education, and monitoring of the participants, as well as the use of formal definitions, enhances the accuracy and reliability of the results. Despite the strengths of the study, recall bias may be a limitation concern., Conclusion: The majority of patients were error free, and the majority of the errors were minor in nature. Major errors occurred in <10% of patients. Younger age, graduate-level education, and less experience with ICI were independent predictors of major errors., (© The Author(s) 2024. Published by Oxford University Press on behalf of The International Society of Sexual Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: It is important to accurately determine the blood ethanol concentration (BEC) to ensure appropriate diagnosis and treatment of patients in the emergency department (ED) and protect their legal rights. This study aimed to determine whether sterilization of venipuncture site with ethanol, which is frequently used in practice in the ED would affect BEC., Methods: Venous blood samples were collected by two consecutive techniques from 94 individuals who were admitted to the ED, had an indication for BEC measurement, and volunteered to participate in the study. The reference technique involved applying 3 cc of 10 % povidone-iodine solution to a gauze pad, cleaning the right arm antecubital region, and performing phlebotomy. The index technique used 3 cc of alcohol-based antiseptic (89 % ethanol) on another gauze for cleaning the left arm antecubital region. Both techniques allowed the antiseptic to air-dry for 30 s before phlebotomy. Two blood sample tubes per patient were sent to the laboratory, and BEC were measured using the alcohol dehydrogenase enzymatic method., Results: 94 patients were included in the study. The mean age was 37.8 years (±15.7), with 77 % (n = 72) of them were male. The median BEC levels measured by both the reference and index techniques were 2 mg/dL (IQR: 0.97-16.25) and 2 mg/dL (IQR: 0.90-15.22), respectively, with no significant statistical difference (p = 0.536). 72 (77 %) of the patients had a BEC level below the legal driving limit of 20 mg/dL. Bland-Altman analysis, performed on these patients, revealed a small negative bias, -0.116 mg/dL with a standard deviation of 1.13 mg/dL. The upper and lower limit of the agreement was 2.092 and -2.323 respectively., Conclusion: In patients with a BEC level of less than 20 mg/dL, using ethanol-containing antiseptics before blood sampling does not lead to erroneously elevated BEC levels., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

According to its own description, the biomedical meta-database PubMed exists "with the aim of improving health-both globally and personally." Unfortunately, PubMed contains an increasing amount of low-quality research that may detract from this goal. Currently, PubMed warns its users and protects itself from such problems with a disclaimer stating that the presence of any article, book, or document in PubMed does not imply an endorsement of, or concurrence with, its contents by the NLM, the National Institutes of Health (NIH), or the U.S. Federal Government. However, we are critical of a "disclaimer-only" stance and encourage PubMed to take further action against low-quality research being found and indexed in its database, and thus available for use. To address this problem, we offer two lines of reasoning to argue that PubMed should not function merely as a passive index of health-related research. Instead, we first argue that only trustworthy published research is able to further PubMed's goal of health improvement. Secondly, on the basis of surveys, we argue that researchers place a high level of trust in articles that are referenced in this meta-database. We cannot expect any one set of actors to ensure trustworthy content on PubMed, which requires collective responsibility among authors, peer reviewers, editors, and indexers alike. Instead, we propose a curation-based model that incorporates three mechanisms of collaborative content curation: open expert feedback on indexed content, journal auditing, and constant transparent reassessment of indexed entities.

The authors of the manuscript 'Complementary and alternative medicine - practice, attitudes, and knowledge among healthcare professionals in New Zealand: an integrative review' [1] disagree with the assertion by McDowell et al. that our manuscript has extrapolation errors., (© 2024. The Author(s).)

Background: Interest in the potential of learning from errors to benefit innovation and organizational and personal growth is currently increasing. In practice, individuals frequently do not appear to learn spontaneously from errors and setbacks without support. Based on prior work, this paper considers antecedents and consequences of adaptive responses to errors., Aims: Two experiments with undergraduate students aimed to identify the causal link between beliefs and maintained motivation and the adaptation of actions to the end of analysing and effectively correcting errors., Samples and Methods: In Study 1 (N = 195, 72% female, M = 20.7 years, SD = 3.0), we experimentally manipulated learners' beliefs around the importance of errors to learning, after which they completed a 50-min learning session on research methods and statistics. In Study 2 (N = 67, 58% female, M = 21.8 years, SD = 3.99), we intertwined the manipulation more closely with the actual learning process by using prompts about adaptive responses to errors immediately after error feedback., Results: In Study 1, those to whom we stressed the negative effects of errors showed significantly fewer adaptive action-related responses to errors, less persistence, and less use of metacognitive strategies after errors. In Study 2, we found significant positive effects on the learners' persistence, their metacognitive control, and effort investment., Conclusions: Our results support and expand previous, mostly correlational, research findings on individuals' adaptive responses to errors., (© 2024 The Authors. British Journal of Educational Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.)

Objectives: The purpose of this study was to investigate the effects of contamination of venous blood with a lipid-containing solution on parameters measured by a modern blood gas analyzer., Methods: We collected venous blood from 17 healthcare workers (46 ± 11 years; 53 % women) into three blood gas syringes containing 0 , 5 and 10 % lipid-containing solution. Blood gas analysis was performed within 15 min from sample collection on GEM Premier 5000, while triglycerides and serum indices were assays on Roche COBAS C702., Results: Triglycerides concentration increased from 1.0 ± 0.3 mmol/L in the uncontaminated blood gas syringe, to 39.4 ± 7.8 and 65.3 ± 14.4 mmol/L (both p<0.001) in syringes with 5 and 10 % final lipid contamination. The lipemic and hemolysis indices increased accordingly. Statistically significant variation was noted for all analytes except hematocrit and COHb in the syringe with 5 % lipids, while only COHb did not vary in the syringe with 10 % lipids. Significant increases were observed from 5 % lipid contamination for pO 2 , SO 2 and lactate, while the values of pH, pCO 2 , sodium, potassium, chloride, ionized calcium, glucose, hematocrit (10 % contamination), hemoglobin and MetHB decreased. All these changes except lactate and CoHb exceeded their relative performance specifications., Conclusions: Artifactual hyperlipidemia caused by contamination with exogenous lipids can have a clinically significant impact on blood gas analysis. Manufacturers of blood gas analyzers must be persuaded to develop new instruments equipped with serum indices., Competing Interests: Competing interests: The authors state no conflict of interest., (© 2024 the author(s), published by De Gruyter, Berlin/Boston.)

Background: Many people fear failure and making mistakes. This fear can be transmitted from parents to children, suggesting that parental communication regarding failures and setbacks may play a critical role in shaping a child's perception of mistakes., Aims: In this study, we investigated how everyday parent-child conversations about setbacks influence children's fear of making mistakes., Sample: Drawing on the large pre-birth Growing Up in New Zealand cohort, we focused on a sub-sample of 231 mother-child dyads who engaged in a recorded conversations about a "recent disappointment or setback" when the children were 8 years old., Method: Conversations between mothers and children about the recent disappointments were coded to identify whether parents recognised or acknowledge their child's emotional response, if action plans were discussed, and the types of resources that the child could draw on. The children also completed a questionnaire about their global self-worth and their fear of making mistakes., Results and Conclusions: The discussion of clear action plans, in the absence of a discussion about collaborative resources, was found to be associated with an increased fear of making mistakes among children. Conversely, when mothers clearly acknowledged their child's emotions and discussed ways to work collaboratively with their child on future problems, there was a notable decrease in the child's fear of mistakes. However, it is noteworthy that many mothers in our study either minimally acknowledged or dismissed their child's emotions(40%), rarely discussed action plans (55%), or collaborative resources (79%)when discussing the recent setback., (© 2024 The Authors. British Journal of Educational Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.)

In human-robot collaboration, failures are bound to occur. A thorough understanding of potential errors is necessary so that robotic system designers can develop systems that remedy failure cases. In this work, we study failures that occur when participants interact with a working system and focus especially on errors in a robotic system's knowledge base of which the system is not aware. A human interaction partner can be part of the error detection process if they are given insight into the robot's knowledge and decision-making process. We investigate different communication modalities and the design of shared task representations in a joint human-robot object organization task. We conducted a user study ( N = 31) in which the participants showed a Pepper robot how to organize objects, and the robot communicated the learned object configuration to the participants by means of speech, visualization, or a combination of speech and visualization. The multimodal, combined condition was preferred by 23 participants, followed by seven participants preferring the visualization. Based on the interviews, the errors that occurred, and the object configurations generated by the participants, we conclude that participants tend to test the system's limitations by making the task more complex, which provokes errors. This trial-and-error behavior has a productive purpose and demonstrates that failures occur that arise from the combination of robot capabilities, the user's understanding and actions, and interaction in the environment. Moreover, it demonstrates that failure can have a productive purpose in establishing better user mental models of the technology., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Frijns, Hirschmanner, Sienkiewicz, Hönig, Indurkhya and Vincze.)

Copying information is vital for life's propagation. Current life forms maintain a low error rate in replication, using complex machinery to prevent and correct errors. However, primitive life had to deal with higher error rates, limiting its ability to evolve. Discovering mechanisms to reduce errors would alleviate this constraint. Here, we introduce a new mechanism that decreases error rates and corrects errors in synthetic self-replicating systems driven by self-assembly. Previous work showed that macrocycle replication occurs through the accumulation of precursor material on the sides of the fibrous replicator assemblies. Stochastic simulations now reveal that selective precursor binding to the fiber surface enhances replication fidelity and error correction. Centrifugation experiments show that replicator fibers can exhibit the necessary selectivity in precursor binding. Our results suggest that synthetic replicator systems are more evolvable than previously thought, encouraging further evolution-focused experiments., (© 2024 The Authors. Angewandte Chemie International Edition published by Wiley-VCH GmbH.)

Background: Students make many errors in visual programming. In order to learn from these, it is important that students regulate their emotions and view errors as learning opportunities., Aims: This study aimed to explore to what extent momentary emotions, specifically enjoyment, anxiety and boredom, as well as the error learning orientation of students, interacted during a 1-day course on visual programming in an out-of-school learning environment., Samples: The sample consisted of 269 lower secondary school students (grades 7-9)., Methods: The data were collected in an intervention study, with questionnaires applied directly before and after the course, and with four measurements of state emotions during the course., Results: The results showed that error learning orientation had an expected effect on the students' emotions at the beginning of the course. The emotions changed positively over the course of the workshop, while the error learning orientation remained stable. No differences in error learning orientation were found between the control and intervention groups. An expected, reciprocal effect of students' emotions on their error learning orientation at the end of the course day could not be found., Conclusion: Changes in error learning orientation are difficult to achieve during 1-day courses. Nevertheless, through targeted, pedagogical approaches, which aim to minimize the influence of unfavourable emotions that occur in problem-oriented learning situations, teachers could help students develop a positive error learning orientation in the long term, whereby errors are viewed as an opportunity for learning., (© 2024 The Authors. British Journal of Educational Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.)

Purpose: Dual-energy X-ray absorptiometry (DXA) is the gold standard for measuring bone mineral density (BMD) with tolerable error rate, high precision, and excellent consistency. Our objective was to investigate the frequency and distribution of errors in a cohort of patients with Thalassemia major (TM)., Methods: We reviewed the DXA examinations of 340 patients with β-TM followed by our institution, acquired in different imaging centers between 2009 and 2019. We collected sex and age at the time of the first examination and at the last visit, as well as BMD, T-score, and Z-score values. Errors were analyzed by anatomical site (lumbar spine, total hip, femoral neck)., Results: Out of 5099 total DXA scans, 11.85% presented one or more errors. Specifically, the incorrect examinations were 315 out of 1707 (18.45%) at the lumbar spine level, 113 out of 1697 (6.66%) at the total hip, 176 out of 1695 (10.38%) at the femoral neck. Errors in vertebral inclusion were the most frequently registered (45.86%). A significant difference resulted from the comparison of the T-score and Z-score median values of all the lumbar spine DXA examinations and the correct ones (p value 0.037 and 0.0003, respectively)., Conclusion: Although not directly involved in the performance and interpretation of DXA, physicians interested in osteoporosis management should be familiar with the protocols to minimize errors and allow the proper use of bone densitometry. DXA obtained at the spine level is more frequently affected by errors in patients with TM, potentially influencing the diagnostic assessment of bone health status., (© 2024. Italian Society of Medical Radiology.)

Our sensory system is able to build a unified perception of the world, which although rich, is limited and inaccurate. Sometimes, features from different objects are erroneously combined. At the neural level, the role of the parietal cortex in feature integration is well-known. However, the brain dynamics underlying correct and incorrect feature integration are less clear. To explore the temporal dynamics of feature integration, we studied the modulation of different frequency bands in trials in which feature integration was correct or incorrect. Participants responded to the color of a shape target, surrounded by distractors. A calibration procedure ensured that accuracy was around 70% in each participant. To explore the role of expectancy in feature integration, we introduced an unexpected feature to the target in the last blocks of trials. Results demonstrated the contribution of several frequency bands to feature integration. Alpha and beta power was reduced for hits compared to illusions. Moreover, gamma power was overall larger during the experiment for participants who were aware of the unexpected target presented during the last blocks of trials (as compared to unaware participants). These results demonstrate that feature integration is a complex process that can go wrong at different stages of information processing and is influenced by top-down expectancies., (© 2023 The Authors. Psychophysiology published by Wiley Periodicals LLC on behalf of Society for Psychophysiological Research.)

Diverse errors occur in a pathology laboratory and manual mistakes are the most common. There are various advancements to replace manual procedures with digitized automation techniques. Guidelines and protocols are available to run a standard pathology laboratory. But, even with such attempts to reinforce and strengthen the protocols, the complete elimination of errors is yet not possible. Root cause analysis (RCA) is the best way forward to develop an error-free laboratory, In this review, the importance of RCA, common errors taking place in laboratories, methods to carry out RCA, and its effectiveness are discussed in detail. The review also highlights the potential of RCA to provide long-term quality improvement and efficient laboratory management., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Srinivasaragavan et al.)

The use of artificial intelligence (AI) has become widespread in many areas of science and medicine, including laboratory medicine. Although it seems obvious that the analytical and post-analytical phases could be the most important fields of application in laboratory medicine, a kaleidoscope of new opportunities has emerged to extend the benefits of AI to many manual labor-intensive activities belonging to the pre-analytical phase, which are inherently characterized by enhanced vulnerability and higher risk of errors. These potential applications involve increasing the appropriateness of test prescription (with computerized physician order entry or demand management tools), improved specimen collection (using active patient recognition, automated specimen labeling, vein recognition and blood collection assistance, along with automated blood drawing), more efficient sample transportation (facilitated by the use of pneumatic transport systems or drones, and monitored with smart blood tubes or data loggers), systematic evaluation of sample quality (by measuring serum indices, fill volume or for detecting sample clotting), as well as error detection and analysis. Therefore, this opinion paper aims to discuss the state-of-the-art and some future possibilities of AI in the preanalytical phase., Competing Interests: All the authors declare that they have no conflict of interest in this work.Conflict of Interest: The authors stated that they have no conflicts of interest regarding the publication of this article., (2024 Giuseppe Lippi, Camilla Mattiuzzi, Emmanuel J. Favaloro, published by CEON/CEES.)

Artificial intelligence (AI)-based diagnostic tools can offer numerous benefits to the field of histopathology, including improved diagnostic accuracy, efficiency and productivity. As a result, such tools are likely to have an increasing role in routine practice. However, all AI tools are prone to errors, and these AI-associated errors have been identified as a major risk in the introduction of AI into healthcare. The errors made by AI tools are different, in terms of both cause and nature, to the errors made by human pathologists. As highlighted by the National Institute for Health and Care Excellence, it is imperative that practising pathologists understand the potential limitations of AI tools, including the errors made. Pathologists are in a unique position to be gatekeepers of AI tool use, maximizing patient benefit while minimizing harm. Furthermore, their pathological knowledge is essential to understanding when, and why, errors have occurred and so to developing safer future algorithms. This paper summarises the literature on errors made by AI diagnostic tools in histopathology. These include erroneous errors, data concerns (data bias, hidden stratification, data imbalances, distributional shift, and lack of generalisability), reinforcement of outdated practices, unsafe failure mode, automation bias, and insensitivity to impact. Methods to reduce errors in both tool design and clinical use are discussed, and the practical roles for pathologists in error minimisation are highlighted. This aims to inform and empower pathologists to move safely through this seismic change in practice and help ensure that novel AI tools are adopted safely., (© 2023 The Authors. Histopathology published by John Wiley & Sons Ltd.)

Background: Adherence to inhaled medications is key to chronic obstructive pulmonary disease (COPD) control and management., Objective: To assess errors and adherence to inhalation therapy in COPD patients, and identify potential factors associated with poor adherence., Methods: This cross-sectional study was conducted from October 1, 2022, to November 30, 2022, in 24 hospital outpatient departments in different cities of Hunan Province, China. Adherence to inhaled medications was measured using the 10-item Test of Adherence Inventory, and the results were expressed using both descriptive and inferential statistics., Results: A total of 2218 clinically confirmed adult COPD patients completed the questionnaires, and 1423 patients with more than a 3-month history of inhalation therapy were analyzed. This study found that 61.3% of patients made one or more use errors. Not holding the breath after inhalation or holding the breath for less than 3 s had the highest reporting rate (30.7%). A considerable proportion of patients (66.6%) demonstrated suboptimal adherence to inhaled medications. Patients who resided in rural areas (OR 1.45, 95% CI 1.12-1.88), used dual therapy (OR 1.47, 95% CI 1.05-2.05), and exhibited common use errors (OR 3.02, 95% CI 2.39-3.82) were more likely to present suboptimal adherence. Patients with CAT (Chronic Obstructive Pulmonary Disease Assessment Test) score < 10 (OR 0.73, 95% CI 0.56-0.94), a junior high school education and above (OR 0.73, 95% CI 0.57-0.94), and duration of inhaled medication use > 3 years (OR 0.63, 95% CI 0.47-0.83) were associated with better adherence., Conclusion: Suboptimal adherence to inhaled medications and many inhalation therapy errors were identified among COPD patients. Common use errors in inhaled medications, CAT score, and education background were predictive of and influenced adherence to inhaled medications. It is necessary to strengthen training in Chinese patients about inhaler use and follow-up intensively with patients throughout treatment, especially for patients with risk factors., (© 2023. The Author(s), under exclusive licence to Society of General Internal Medicine.)

This article discusses the ways in which nineteenth-century geodesists reflected on precision as an epistemic virtue in their measurement practice. Physical geodesy is often understood as a quintessential nineteenth-century precision science, stimulating advances in instrument making and statistics, and generating incredible quantities of data. Throughout most of the nineteenth century, geodesists indeed pursued their most prestigious research problem - the exact determination of the earth's polar flattening - along those lines. Treating measurement errors as random, they assumed that remaining discordances could be overcome by manufacturing better instruments and extending statistical analysis to a larger amount of data. In the second half of the nineteenth century, however, several German geodesists developed sophisticated methodological critiques of their discipline, in which they diagnosed a too-narrow focus on precision among their peers. On their account, geodesists urgently needed to identify and anticipate the causes of the remaining measurement errors that arose from the earth's little understood interior constitution. While mostly overlooked in the literature, these critiques paved the way for many empirical successes in late nineteenth- and early twentieth-century geodesy, including the first convergent measurements of the earth's polar flattening.

The process of using robotic technology to examine underwater systems is still a difficult undertaking because the majority of automated activities lack network connectivity. Therefore, the suggested approach finds the main hole in undersea systems and fills it using robotic automation. In the predicted model, an analytical framework is created to operate the robot within predetermined areas while maximizing communication ranges. Additionally, a clustering algorithm with a fuzzy membership function is implemented, allowing the robots to advance in accordance with predefined clusters and arrive at their starting place within a predetermined amount of time. A cluster node is connected in each clustered region and provides the central control center with the necessary data. The weights are evenly distributed, and the designed robotic system is installed to prevent an uncontrolled operational state. Five different scenarios are used to test and validate the created model, and in each case, the proposed method is found to be superior to the current methodology in terms of range, energy, density, time periods, and total metrics of operation., Competing Interests: Rajanikanth Aluvalu is an Academic Editor for PeerJ., (© 2023 Manoharan et al.)

Background and Rationale: Recent research has called for further resident training in coping with errors and adverse events in the operating room. To the best of our knowledge, there currently exists no evidence-based curriculum or training on this topic., Materials and Methods: Synthesizing three prior studies on how experienced surgeons react to errors and adverse events, we developed the STOPS framework for handling surgical errors and adverse events (Stop, Talk to your team, Obtain help, Plan, Succeed). This material was presented to residents in two teaching sessions., Results and Conclusion: In this paper, we describe the presentation of, and the uniformly positive resident reaction to, the STOPS framework: an empirically based psychological tool for surgeons who experience operative errors or adverse events., (Copyright © 2023 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)

Introduction: We used an educational healthcare simulation tool called room of errors (ROE) to raise pharmacy operators' awareness of potential errors in a chemotherapy production process and assessed its impact on their knowledge and satisfaction., Methods: Twenty-five errors (compiled from internal procedures, literature and our hospital's reported incidents) were categorised as static ( n  = 7, visible by the participant anytime) and dynamic ( n  = 18, made by a pseudooperator in front of the participant). Our simulated cytotoxic production unit (CPU) hosted the 1 h-simulation. Two pharmacists (supervisor/pseudo-operator) welcomed the trainee for a 10-min briefing. During the 20-min simulation, participants watched the pseudo-operator's gestures in a simulated chemotherapy production process. Participants called out each error observed (recorded by the supervisor). A 20-min debriefing followed. ROE's impact on knowledge was measured through participants' answers to a before-and after 18-item questionnaire about CPU's procedures and certainty about answers on a scale (0%-100%). Participants evaluated the training using a satisfaction questionnaire (Likert scale, 1-6)., Results: The 14 participants detected 70.4% ± 11.4% of errors. Least-detected errors were "using non-disinfected vials" (42.9%) and "touching syringe plunger" (0%). Critical errors (expired leftovers or glucose instead of sodium chloride) were detected at 57.1%. Knowledge improved from 60.3% to 94.1% (p < 0.001) and certainty from 75.3% to 98.8% (p < 0.001). Participants appreciated this non-judgmental, informative, and original training (satisfaction 95.7%). Some pointed out difficulties settling into the game quickly and visualising static and dynamic errors simultaneously., Conclusion: This ROE simulation improved operators' knowledge and certainty. Longer-term testing should be done to measure knowledge retention over time., Competing Interests: Author ContributionsAG and LBu designed the study. LBu collected the data and performed the analysis. AG and LBu interpreted the results. All authors reviewed and approved the final version of the manuscript. Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background and Objectives : The fatigue, stress, and burnout of nurses lead to them frequently making mistakes, which have a negative impact not only on the safety of the patients but also on their psychology. The ability to bounce back from mistakes is crucial for nurses. Nursing staff members' physical and mental health, particularly their depression, is far from ideal, and this ill health is directly correlated with the frequency of self-reported medical errors. The nurses' mental and physical health are also positively correlated with their perception of wellness support at work. This cross-sectional study aimed to investigate the status of nurses' mental and physical health regarding clinical errors and the impact of resilience on coping with these situations. Materials and Methods : A total of 364 healthcare professionals participated in this research; 87.5% of them were females and 12.5% of them were males. Most of the participants were 22-35 years old. The median number of years of employment was nine. Clinical nurses anonymously and voluntarily completed a special structured questionnaire that included questions from different validated tools in order to assess their state of physical and mental wellbeing after events of stress and errors made during their practice. Results : In total, 49.4% of the nurses had made an error on their own, and 73.2% had witnessed an error that someone else had made. At the time of the error, 29.9% of the participants were in charge of more than 20 patients, while 28.9% were responsible for a maximum of three patients. Participants who were 36-45 years old had more resilience ( p = 0.049) and experienced fewer negative emotions than participants who were 22-35 years old. The participants who mentioned more positive feelings according to their mental state had greater resilience ( p > 0.001). Conclusions : Errors were likely to happen during clinical practice due to nurses' negative experiences. The level of resilience among the nursing population was found to play a very important role not only in making mistakes but also in coping with errors during their daily routine. Wellness and prevention must be given top priority in all healthcare systems across the country in order to promote nurses' optimal health and wellbeing, raise the standard of care, and reduce the likelihood of expensive, avoidable medical errors. Healthcare administrations should promote prevention programs for stress occurrence in order to support nurses' wellbeing maintenance.

Background and Purpose: Hepato-pancreato-biliary (HPB) surgeries are one of the most challenging and complex procedures. Intraoperative frozen section (IFS) diagnosis plays a pivotal role in management decisions. Comprehensive large cohort studies evaluating utility of IFS in HPB malignancies are lacking. This study aimed to evaluate the accuracy of frozen section analysis and to analyse discrepancies and impact of IFS on the surgical decisions., Patients and Methods: This was a retrospective study of IFS received for the HPB specimens between years 2009 and 2021. The results were compared to the permanent sections to evaluate diagnostic accuracy, sensitivity and specificity. Indications, disagreements and impact on the surgical management were analysed., Results: A total of 1008 specimens were evaluated: bile duct margin (279; 27.7%), gallbladder (203; 20.1%), liver lesions (125 cases; 12.4%), lymph nodes (147; 14.6%), pancreatic margin (120; 11.9%) and deposits (134; 13.3%). IFS were diagnosed as negative for malignancy (805; 79.9%), positive for dysplasia (8; 0.8%), suspicious for malignancy (6; 0.6%) and positive for malignancy (189; 18.8%). The overall diagnostic accuracy was 98.4%, and the discordant rate was 1.6%. The sensitivity, specificity, positive predictive value and negative predictive value were 94.7%, 99.4%, 97.5% and 98.6% respectively. The most important reason of discordant results was technical, followed by interpretational and sampling errors., Conclusion: The study demonstrates high diagnostic accuracy (98.4%) of IFS in a large dataset of HPB specimens. This comprehensive analysis apprises of the indications, errors and the impact of IFS diagnosis on subsequent HPB surgical management., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The analysis of nonlinear elliptic PDEs representing stationary convection-dominated diffusion equation, Sine-Gordon equation, Helmholtz equation, and heat exchange diffusion model in a battery often lacks in closed-form solutions. For the long-term behaviour and to assess the quantitative behaviour of the model, numerical treatment is necessary. A novel numerical approach based on arithmetic average compact discretization employing a quasi-variable grid network is proposed for a wide class of nonlinear three-dimensional elliptic PDEs. The method's key benefit is that it applies to singular models and only needs nineteen-point grids with seven functional approximations. Additionally, the suggested method disseminates the truncation error across the domain, which is unrealistic for finite-difference discretization with a fixed step length of grid points. Often, small diffusion anticipates strong oscillation, and tuning the grid stretching parameter helps error dispersion over the domain. The scheme is examined for maximal error bounds and convergence property with the help of a monotone matrix and its irreducible character. The metrics of solution accuracies, mainly root-mean-squared and absolute errors alongside numerical convergence rate, are inspected by different types of variable coefficients, singular and non-singular 3D elliptic PDEs appearing in a convection-diffusion phenomenon. The performance of the numerical solution corroborates the fourth-order convergence on a quasi-variable grid network., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Author(s).)

Background: The non-punitive approach to error investigation in most safety culture surveys have been relatively low. Most of the current patient safety culture measurement tools also lack the ability to directly gauge concepts important to a just culture (i.e. perceptions of fairness and trust). The purpose of this study is to assess nurses' perceptions of the six just culture dimensions using the validated Just Culture Assessment Tool (JCAT)., Methods: This descriptive, cross-sectional study was conducted between November and December 2020. Data from 212 staff nurses in a large referral hospital in Qatar were collected. A validated, self-reported survey called the JCAT was used to assess the perception of the just culture dimensions including feedback and communication, openness of communication, balance, quality of event reporting process, continuous improvement, and trust., Results: The study revealed that the overall positive perception score of just culture was (75.44%). The strength areas of the just culture were "continuous improvement" dimension (88.44%), "quality of events reporting process" (86.04%), followed by "feedback and communication" (80.19%), and "openness of communication" (77.55%) The dimensions such as "trust" (68.30%) and "balance" (52.55%) had a lower positive perception rates., Conclusion: A strong and effective just culture is a cornerstone of any organization, particularly when it comes to ensuring safety. It places paramount importance on encouraging voluntary error reporting and establishing a robust feedback system to address safety-related events promptly. It also recognizes that errors present valuable opportunities for continuous improvement. Just culture is more than just a no-blame practice. By prioritizing accountability and responsibility among front-line workers, a just culture fosters a sense of ownership and a commitment to improve safety, rather than assigning blame., (© 2023. BioMed Central Ltd., part of Springer Nature.)

There are several pitfalls in the publication process that researchers can fall victim to, and these can occur knowingly or unknowingly. Although some of these errors may have occurred in good faith, disregard of publication governance is a dangerous practice and could bring authors and their co-authors into disrepute. We highlight some of these potential pitfalls, acquaint the reader with some rules that need to be adhered to in research and publishing, and help the reader learn how to avoid tripping-up on the road to publication., Competing Interests: Declaration of competing interest The authors declare no conflicts of interest., (Copyright © 2023 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)

Background: Good clinical practices and strict vigilance are needed, especially for patients receiving chemotherapy. Regular audits using a specially developed tool need to be conducted in the oncology wards to identify lapses in the use of chemotherapy drugs., Methodology: Observational study was conducted in the adult and paediatric oncology inpatient settings in an Indian tertiary care hospital for a period of 2.5 years. It was an audit of case files of chemotherapy patients for their drug prescriptions, medication reconciliation records and adverse drug reports. Data was presented as frequencies and percentages., Results: 1.3% medication errors and 0.23% adverse drug reactions were reported during the study period. Majority were transcription (38%) and drug reconstitution errors (29%) and were either in the near-miss or no-harm category., Conclusion: Medication errors were found in the oncology wards, but due to the vigilance of clinical pharmacists, none of the patients were harmed as a consequence of these errors., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Purpose: Previous investigations into the causes of error by radiologists have addressed work schedule, volume, shift length, and sub-specialization. Studies regarding possible associations between radiologist errors and radiologist age and timing of residency training are lacking in the literature, to our knowledge. The aim of our study was to determine if radiologist age and residency graduation date is associated with diagnostic errors., Methods: Our retrospective analysis included 1.9 million preliminary interpretations (out of a total of 5.2 million preliminary and final interpretations) of imaging examinations by 361 radiologists in a US-based national teleradiology practice between 1/1/2019 and 1/1/2020. Quality assurance data regarding the number of radiologist errors was generated through client facility feedback to the teleradiology practice. With input from both the client radiologist and the teleradiologist, the final determination of the presence, absence, and severity of a teleradiologist error was determined by the quality assurance committee of radiologists within the teleradiology company using standardized criteria. Excluded were 3.2 million final examination interpretations and 93,963 (1.8%) of total examinations from facilities reporting less than one discrepancy in examination interpretation in 2019. Logistic regression with covariates radiologist age and residency graduation date was performed for calculation of relative risk of overall error rates and by major imaging modality. Major errors were separated from minor errors as those with a greater likelihood of affecting patient care. Logistic regression with covariates radiologist age, residency graduation date, and log total examinations interpreted was used to calculate odds of making a major error to that of making a minor error., Results: Mean age of the 361 radiologists was 51.1 years, with a mean residency graduation date of 2001. Mean error rate for all examinations was 0.5%. Radiologist age at any residency graduation date was positively associated with major errors (p < 0.05), with a relative risk 1.021 for each 1-year increase in age and relative risk 1.235 for each decade as well as for minor errors (p < 0.05, relative risk 1.007 for each year, relative risk 1.082 for each decade). By major imaging modality, radiologist age at any residency graduation date was positively associated with computed tomography (CT) and X-ray (XR) major and minor error, magnetic resonance imaging (MRI) major error, and ultrasound (US) minor error (p < 0.05). Radiologist age was positively associated with odds of making a major vs. minor error (p < 0.05)., Conclusions: The mean error rate for all radiologists was low. We observed that increasing age at any residency graduation date was associated with increasing relative risk of major and minor errors as well as increasing odds of a major vs. minor error among providers. Further study is needed to corroborate these results, determine clinical relevance, and highlight strategies to address these findings., (© 2023. The Author(s), under exclusive licence to American Society of Emergency Radiology (ASER).)

Objective: Parkinson's disease (PD) and essential tremor (ET) involve neuroanatomical circuitry that impact frontal lobe functioning, via the striatum and cerebellum, respectively. The aim of this exploratory study was to investigate quantitative and qualitative performance between and within these groups on measures of verbal fluency. Method: Sixty-three PD and 53 ET patients completed neuropsychological testing. Linear regression models with robust variance estimation compared verbal fluency performance between groups related to correct responses and errors. Paired t -tests investigated within group error rates. Results: PD patients gave more correct responses for phonological ( β ̂   =5.3, p =.01) and category fluency ( β ̂   =4.1, p =.01) than ET patients; however, when processing speed was added as a covariate, this attenuated performance on both measures and only phonological fluency remained significant ( β ̂   =4.0, p =.04). There were no statistical differences in error scores between groups. Error rates within groups suggested that PD patients had higher error rates in total errors and perseveration errors on phonological fluency ( M  = 2.6, p =.00; M  = 1.6, p =.00) and higher total errors and set-loss error rates on category switching ( M  = 5.1, p <.001; M  = 4.1, p <.001). ET patients had higher error rate with relation to total errors and set-loss errors on phonological fluency ( M  = 2.5, p =.00; M  = 1.5, p =.02) and category switching ( M  = 3.9, p =,00; M  = 3.9, p <.001). Conclusions: PD patients performed better than ET patients on phonological fluency. PD patients appear to make more perseveration errors on phonological fluency, while ET patients made more set-loss errors. Implications for frontal lobe dysfunction and clinical impact are discussed.

Objectives: There is limited information on the influence of collecting small amounts of blood on the quality of blood gas analysis. Therefore, the purpose of this study was to investigate the effects of different degrees of underfilling of syringes on test results of venous blood gas analysis., Methods: Venous blood was collected by venipuncture from 19 healthcare workers in three 1.0 mL syringes for blood gas analysis, by manually aspirating different volumes of blood (i.e., 1.0, 0.5 and 0.25 mL). Routine blood gas analysis was then immediately performed with GEM Premier 5,000. The results of the two underfilled syringes were compared with those of the reference syringe filled with appropriate blood volume., Results: The values of most assayed parameters did not differ significantly in the two underfilled syringes. Statistically significant variations were found for lactate, hematocrit and total hemoglobin, the values of which gradually increased as the fill volume diminished, as well as for sodium concentration, which decreased in both insufficiently filled blood gas syringes. The bias was clinically meaningful for lactate in syringe filled with 0.25 mL of blood, and for hematocrit, total hemoglobin and sodium in both syringes containing 0.5 and 0.25 mL of blood., Conclusions: Collection of smaller volumes of venous blood than the specified filling volume in blood gas syringes may have an effect on the quality of some test results, namely lactate, hematocrit, total hemoglobin and sodium. Specific indications must be given for standardizing the volume of blood to be collected within these syringes., (© 2023 Walter de Gruyter GmbH, Berlin/Boston.)

Background: Inborn errors of immunity (IEIs) are considered significant challenges for children with IEIs, their families, and their medical providers. Infections are the most common complication of IEIs and children can acquire coronavirus disease 2019 (COVID-19) even when protective measures are taken., Objectives: To estimate the incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children with IEIs and analyse the demographic parameters, clinical characteristics and treatment outcomes in children with IEIs with COVID-19 illness., Methods: For this systematic review, we searched ProQuest, Medline, Embase, PubMed, CINAHL, Wiley online library, Scopus and Nature through the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guideline for studies on the development of COVID-19 in children with IEIs, published from December 1, 2019 to February 28, 2023, with English language restriction., Results: Of the 1095 papers that were identified, 116 articles were included in the systematic review (73 case report, 38 cohort 4 case-series and 1 case-control studies). Studies involving 710 children with IEIs with confirmed COVID-19 were analyzed. Among all 710 IEIs pediatric cases who acquired SARS-CoV-2, some children were documented to be admitted to the intensive care unit (ICU) (n = 119, 16.8%), intubated and placed on mechanical ventilation (n = 87, 12.2%), suffered acute respiratory distress syndrome (n = 98, 13.8%) or died (n = 60, 8.4%). Overall, COVID-19 in children with different IEIs patents resulted in no or low severity of disease in more than 76% of all included cases (COVID-19 severity: asymptomatic = 105, mild = 351, or moderate = 88). The majority of children with IEIs received treatment for COVID-19 (n = 579, 81.5%). Multisystem inflammatory syndrome in children (MIS-C) due to COVID-19 in children with IEIs occurred in 103 (14.5%). Fatality in children with IEIs with COVID-19 was reported in any of the included IEIs categories for cellular and humoral immunodeficiencies (n = 19, 18.6%), immune dysregulatory diseases (n = 17, 17.9%), innate immunodeficiencies (n = 5, 10%), bone marrow failure (n = 1, 14.3%), complement deficiencies (n = 1, 9.1%), combined immunodeficiencies with associated or syndromic features (n = 7, 5.5%), phagocytic diseases (n = 3, 5.5%), autoinflammatory diseases (n = 2, 3%) and predominantly antibody deficiencies (n = 5, 2.5%). Mortality was COVID-19-related in a considerable number of children with IEIs (29/60, 48.3%). The highest ICU admission and fatality rates were observed in cases belonging to cellular and humoral immunodeficiencies (26.5% and 18.6%) and immune dysregulatory diseases (35.8% and 17.9%) groups, especially in children infected with SARS-CoV-2 who suffered severe combined immunodeficiency (28.6% and 23.8%), combined immunodeficiency (25% and 15%), familial hemophagocytic lymphohistiocytosis (40% and 20%), X-linked lymphoproliferative diseases-1 (75% and 75%) and X-linked lymphoproliferative diseases-2 (50% and 50%) compared to the other IEIs cases., Conclusion: Children with IEIs infected with SARS-CoV-2 may experience higher rates of ICU admission and mortality in comparison with the immunocompetent pediatric populations. Underlying immune defects does seem to be independent risk factors for severe SARS-CoV-2 infection in children with IEIs, a number of children with SCID and CID were reported to have prolonged infections-though the number of patients is small-but especially immune dysregulation diseases (XLP1 and XLP2) and innate immunodeficiencies impairing type I interferon signalling (IFNAR1, IFNAR2 and TBK1)., (© 2023. Canadian Society of Allergy & Clinical Immunology.)

Human skills are composed of sequences of individual actions performed with utmost precision. When occasional errors occur, they may have serious consequences, for example, when pilots are manually landing a plane. In such cases, the ability to predict an error before it occurs would clearly be advantageous. Here, we asked whether it is possible to predict future errors in a keyboard procedural human motor skill. We report that prolonged keypress transition times (KTTs), reflecting slower speed, and anomalous delta-band oscillatory activity in cingulate-entorhinal-precuneus brain regions precede upcoming errors in skill. Combined anomalous low-frequency activity and prolonged KTTs predicted up to 70% of future errors. Decoding strength (posterior probability of error) increased progressively approaching the errors. We conclude that it is possible to predict future individual errors in skill sequential performance., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2023. Published by Elsevier Inc.)

Eighty Woodcock-Johnson IV Tests of Achievement protocols from 40 test administrators were examined to determine the types and frequencies of administration and scoring errors made. Non-critical errors (e.g., failure to record verbatim) were found on every protocol ( M = 37.2). Critical (e.g., standard score, start point) errors were found on 98.8% of protocols ( M = 15.3). Additionally, a series of paired samples t-test were conducted to determine differences in total, critical, and non-critical errors pre- and during-COVID-19. No statistic differences were found. Our findings add to a growing body of research that suggests that errors on norm-referenced tests of achievement are pervasive. However, the frequency of errors did not appear to be affected by COVID-19 stressors or social distancing requirements. Implications of these findings for training and practice are discussed. Suggestions for future research are also provided., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)

Purpose: This study investigates a new approach for estimating the planning target volume (PTV) margin for moving tumors treated with robotic stereotactic body radiotherapy (SBRT)., Methods: In this new approach, the covariance of modeling and prediction errors was estimated using error propagation and implemented in the Van Herk formula to form a Modified Van Herk formula (MVHF). To perform a retrospective multi-center analysis, the MVHF was studied using 163 patients treated with different system versions of robotic SBRT (G3 version 6.2.3, VSI version 8.5, and VSI version 9.5) and compared with two established PTV margins estimation methods: The original Van Herk Formula (VHF) and the Uncertainty Estimation Method (UEM)., Results: Overall, the PTV margins provided by the three formalisms are similar with 4-5 mm in the lung region and 4 mm in abdomen region to the PTV margins used in clinical. Furthermore, when analyzing individual patients, a difference of up to 1 mm was found between the PTV margin estimations using MVHF and VHF. The corresponding average discrepancies for the superior-inferior (SI) direction ranged between -0.19 mm to 0.38 mm in CK G3 version 6.2.3, -0.36 mm to 0.33 mm in CK VSI version 8.5, and -0.34 mm to 0.40 mm in CK VSI version 9.5., Conclusions: It was found that for the lower left lung, upper left lung, lower right lung, upper right lung, central liver, and upper liver, the effect of covariance between model and prediction errors in SI direction was around 20%, 30%, 25%, 25%, 25%, and 30%, respectively. Notable covariance effects between model and prediction errors can be considered in PTV margin estimation using a modified VHF, which allowed for more precise target localization in robotic SBRT for moving tumors. Overall, in each of the three directions, the difference between MVHF and utilized clinical margins is 0.65 mm in the lung and abdominal region. Therefore, to improve the clinical PTV margins with the new approach, it is suggested to use the adaptive PTV margins in the next fractions., (© 2023 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, LLC on behalf of The American Association of Physicists in Medicine.)