Clinical reasoning: The relative contribution of identification, interpretation and hypothesis errors to misdiagnosis

The aim of this study was to identify and describe the types of errors in clinical reasoning that contribute to poor diagnostic performance at different levels of medical training and experience. Three cohorts of subjects, second- and fourth- (final) year medical students and a group of general practitioners, completed a set of clinical reasoning problems. The responses of those whose scores fell below the 25th centile were analysed to establish the stage of the clinical reasoning process - identification of relevant information, interpretation or hypothesis generation - at which most errors occurred and whether this was dependent on problem difficulty and level of medical experience. Results indicate that hypothesis errors decrease as expertise increases but that identification and interpretation errors increase. This may be due to inappropriate use of pattern recognition or to failure of the knowledge base. Furthermore, although hypothesis errors increased in line with problem difficulty, identification and interpretation errors decreased. A possible explanation is that as problem difficulty increases, subjects at all levels of expertise are less able to differentiate between relevant and irrelevant clinical features and so give equal consideration to all information contained within a case. It is concluded that the development of clinical reasoning in medical students throughout the course of their pre-clinical and clinical education may be enhanced by both an analysis of the clinical reasoning process and a specific focus on each of the stages at which errors commonly occur.

Distributed Source Coding for Sensor Data Model and Estimation of Cluster Head Errors Using Bayesian and K-Near Neighborhood Classifiers in Deployment of Dense Wireless Sensor Networks

The lifetime calculation of large dense sensor networks with fixed energy resources and the remaining residual energy have shown that for a constant energy resource in a sensor network the fault rate at the cluster head is network size invariant when using the network layer with no MAC losses.Even after increasing the battery capacities in the nodes the total lifetime does not increase after a max limit of 8 times. As this is a serious limitation lots of research has been done at the MAC layer which allows to adapt to the specific connectivity, traffic and channel polling needs for sensor networks. There have been lots of MAC protocols which allow to control the channel polling of new radios which are available to sensor nodes to communicate. This further reduces the communication overhead by idling and sleep scheduling thus extending the lifetime of the monitoring application. We address the two issues which effects the distributed characteristics and performance of connected MAC nodes. (1) To determine the theoretical minimum rate based on joint coding for a correlated data source at the singlehop, (2a) to estimate cluster head errors using Bayesian rule for routing using persistence clustering when node densities are the same and stored using prior probability at the network layer, (2b) to estimate the upper bound of routing errors when using passive clustering were the node densities at the multi-hop MACS are unknown and not stored at the multi-hop nodes a priori. In this paper we evaluate many MAC based sensor network protocols and study the effects on sensor network lifetime. A renewable energy MAC routing protocol is designed when the probabilities of active nodes are not known a priori. From theoretical derivations we show that for a Bayesian rule with known class densities of omega1, omega2 with expected error P* is bounded by max error rate of P=2P* for single-hop. We study the effects of energy losses using cross-layer simulation of - large sensor network MACS setup, the error rate which effect finding sufficient node densities to have reliable multi-hop communications due to unknown node densities. The simulation results show that even though the lifetime is comparable the expected Bayesian posterior probability error bound is close or higher than Pges2P*.

Optical frequency metrology with an Rb-stabilized ring-cavity resonator-study of cavity-dispersion errors

We have developed a technique to measure the absolute frequencies of optical transitions by using an evacuated Rb-stabilized ring-cavity resonator as a transfer cavity. The absolute frequency of the Rb D-2 line (at 780 nm) used to stabilize the cavity is known and allows us to determine the absolute value of the unknown frequency. We study wavelength-dependent errors due to dispersion at the cavity mirrors by measuring the frequency of the same transition in the Cs D-2 line (at 852 nm) at three cavity lengths. The spread in the values shows that dispersion errors are below 30 kHz, corresponding to a relative precision of 10(-10). We give an explanation for reduced dispersion errors in the ring-cavity geometry by calculating errors due to the lateral shift and the phase shift at the mirrors, and show that they are roughly equal but occur with opposite signs. We have earlier shown that diffraction errors (due to Guoy phase) are negligible in the ring-cavity geometry compared to a linear cavity; the reduced dispersion error is another advantage. Our values are consistent with measurements of the same transition using the more expensive frequency-comb technique. Our simpler method is ideally suited for measuring hyperfine structure, fine structure, and isotope shifts, up to several hundreds of gigahertz.

Modeling the effect of transmission errors on TCP controlled transfers over infrastructure 802.11 wireless LANs

There have been several studies on the performance of TCP controlled transfers over an infrastructure IEEE 802.11 WLAN, assuming perfect channel conditions. In this paper, we develop an analytical model for the throughput of TCP controlled file transfers over the IEEE 802.11 DCF with different packet error probabilities for the stations, accounting for the effect of packet drops on the TCP window. Our analysis proceeds by combining two models: one is an extension of the usual TCP-over-DCF model for an infrastructure WLAN, where the throughput of a station depends on the probability that the head-of-the-line packet at the Access Point belongs to that station; the second is a model for the TCP window process for connections with different drop probabilities. Iterative calculations between these models yields the head-of-the-line probabilities, and then, performance measures such as the throughputs and packet failure probabilities can be derived. We find that, due to MAC layer retransmissions, packet losses are rare even with high channel error probabilities and the stations obtain fair throughputs even when some of them have packet error probabilities as high as 0.1 or 0.2. For some restricted settings we are also able to model tail-drop loss at the AP. Although involving many approximations, the model captures the system behavior quite accurately, as compared with simulations.

Regenerating codes for errors and erasures in distributed storage

Regenerating codes are a class of codes proposed for providing reliability of data and efficient repair of failed nodes in distributed storage systems. In this paper, we address the fundamental problem of handling errors and erasures at the nodes or links, during the data-reconstruction and node-repair operations. We provide explicit regenerating codes that are resilient to errors and erasures, and show that these codes are optimal with respect to storage and bandwidth requirements. As a special case, we also establish the capacity of a class of distributed storage systems in the presence of malicious adversaries. While our code constructions are based on previously constructed Product-Matrix codes, we also provide necessary and sufficient conditions for introducing resilience in any regenerating code.

Optimal Binary Power Control for Underlay CR With Different Interference Constraints and Impact of Channel Estimation Errors

Adapting the power of secondary users (SUs) while adhering to constraints on the interference caused to primary receivers (PRxs) is a critical issue in underlay cognitive radio (CR). This adaptation is driven by the interference and transmit power constraints imposed on the secondary transmitter (STx). Its performance also depends on the quality of channel state information (CSI) available at the STx of the links from the STx to the secondary receiver and to the PRxs. For a system in which an STx is subject to an average interference constraint or an interference outage probability constraint at each of the PRxs, we derive novel symbol error probability (SEP)-optimal, practically motivated binary transmit power control policies. As a reference, we also present the corresponding SEP-optimal continuous transmit power control policies for one PRx. We then analyze the robustness of the optimal policies when the STx knows noisy channel estimates of the links between the SU and the PRxs. Altogether, our work develops a holistic understanding of the critical role played by different transmit and interference constraints in driving power control in underlay CR and the impact of CSI on its performance.

Impact Time Guidance for Large Heading Errors Using Sliding Mode Control

In this paper, sliding mode control-based impact time guidance laws are proposed. Even for large heading angle errors and negative initial closing speeds, the desired impact time is achieved by enforcing a sliding mode on a switching surface designed by using the concepts of collision course and estimated time-to-go. Unlike existing guidance laws, the proposed guidance strategy achieves impact time successfully even when the estimated interception time is greater than the desired impact time. Simulation results are also presented.

Influence of Indenter Tip Roundness on Hardness Behavior in Nanoindentation

In this paper. the effect of indenter tip roundness on hardness behavior for two typical elastic perfectly plastic materials is studied by means of finite element simulation. A rigid conical indenter of semi apex angle 70.3 degrees fitted smoothly with a spherical tip is employed. It is shown that as the indentation depth increases hardness first rises from zero, reaches a maximum and then decreases slowly approaching asymptotically the limiting value equal to that due to a conical indenter of ideally sharp tip. The range within which hardness varies appreciably is comparable to the radius of the indenter tip. The difference between the maximum value and the limiting value depends on the yield stress over the Young's modulus ratio. The smaller this ratio the greater the difference is. Numerical simulation also provides an opportunity for checking the accuracy and limitations of the widely used Oliver-Pharr method.