disadvantages of digital x rays

Digital Radiography versus Computed Radiography. MNT is the registered trade mark of Healthline Media. There is nothing wrong with a dentist choosing to start slowly by having a digital x-ray in just one operatory. The authors go on to point out that despite being bombarded by cosmic rays and background radiation, the people of America are living longer than ever, partly because of advancements in medical imaging, such as the CT scan. Lets talk, and we will see how we can help you get a suitable digital radiography machine for the job. Where did the digital X-ray come from, and how was this idea conceived? The advent of the internet marked another stride towards the innovation and growth of digital radiography. The electronic sensor is connected to a computer, creating a radiological image that will be displayed . Sometimes in the DICOM header, a tag with identified number is archived. How may I know the number of series and the number of images acquired during a procedure when a digital fluoroscopy system has been used? In addition, it will require computers in the operatories, interface cards, computer monitors for patient viewing and a host of other minor accessories. The high speed of image acquisition is another advantage of DR technology. If the image of one of the patients examined a few days ago is not found in the DR workstation, what should I do before repeating the examination? What do these terms mean, and is this true? What is the difference between HSI and Hscei? Analytical cookies are used to understand how visitors interact with the website. The units need a power source to move and cannot be . Disadvantages. Digital impressions compared to traditional impressions. What are the advantages of X-rays and what are the disadvantages of it? with these terms and conditions. However, the benefits of X-ray technology far outweigh the potential negative consequences of using them. Further developments provided different storage options for saving the digital radiography images. However, diagnostic accuracy is comparable between CR and film-based systems. X-rays are a naturally occurring type of radiation. Typically, these machines cost around 10,000; it's also important to factor I training costs when budgeting for a new X-ray machine. Why is digital imaging better than analog imaging? The working mechanism of the digital X-ray system depends on the flat-panel detectors. A., Little, M. P., McHugh, K., Lee, C., Kim, K. P., & Berrington de Gonzlez, A. They are still performed but need to be done only after discussing the risks and benefits with the childs family. Last medically reviewed on January 9, 2018. We've added a subscription icon (, Finding out who liked your post has just became possible. The fact that X-rays have been used in medicine for such a significant length of time shows how beneficial they are considered to be. X-rays are a form of electromagnetic radiation, similar to visible light. Portable X-ray systems can have imaging plate readers incorporated into them to provide rapid bedside radiographic examinations as well as image presentation, for speedy diagnosis. what is the weakest link in the digital imaging chain? Such repeats normally go undetected. This limits them to settings where return on investment is assured because of high patient throughput. More researchers and organizations can afford it and utilize it for their different needs. Digital radiology may represent the greatest technological advancement in medical imaging inthe last decade. The primary reason is that over-exposure goes undetected, unlike with film where the image turns dark or black. Instead, the imaging sensor is attached to a DR computer via a cable wire or is permanently fixed to an x-ray table. 4. On the other hand, digital x-rays are designed to create digital images just like digital cameras do. It is faster to process and provides more options. Risks. The benefits from digital radiology are enormous. Can digital X ray units be mobile? It makes it easier for people to analyze and interpret the image to develop accurate and comprehensive conclusions. Digital radiography has high luminescence requirements and high-resolution monitors for viewing. Images can be shared very easily and quickly with other organisations, including hospitals and insurance providers. The revolution has given us digital X-rays that can be used for both small-scale and large-scale applications. . Here, X-ray machines are used to diagnose injuries and conditions on the external and internal parts of the body. CR can use cassettes of multiple sizes, which means the detector size can be selected to match the procedure and to increase the flexibility of positioning, whatever the area of examination. It may cause technicians to lose their jobs. Any trapped gases, for instance, in the lungs, show up as dark patches because of their particularly low absorption rates. If the image of one of the patients examined a few days ago is not found in the DR workstation, what should I do before repeating the examination? 3. This can help to provide a clearer picture of a person's, Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. However, with DR, the whole procedure is digitized from X-ray detection onward. How does digital radiology work? This method allows the production of x-ray images without the need for a radiographic cassette and film. 5. To produce a standard X-ray image, the patient or part of their body is placed in front of an X-ray detector and illuminated by short X-ray pulses. Such developments have enhanced the affordability and accessibility of digital radiography. But there may be situations where some relevant areas of the image are saturated (the pixel content has the maximum value). Do I have to be a computer expert to use digital imaging? Should I expect reduction in patient dose with digital radiography systems? We use cookies on our website to give you the most relevant experience by remembering your preferences and repeat visits. Digital X-rays cost more than traditional X-rays. Pearce, M. S., Salotti, J. The paper argues that the type of radiation experienced in a scan is not enough to cause long-lasting damage. Many dental clinics now use digital X-rays as an alternative to traditional X-rays. He is an A+ Certified Computer Repair Technician as well as Network+ certified. Uses ionising radiation can be harmful- cause cells to mutate and cause cancer. The process happens in real-time in that you dont have to sit and wait for the film to be created and produced. However, dentists should be aware of the cost, time and energy necessary to properly use these systems before they make this investment. Establishing a digital radiography facility, Preventing unnecessary exposure in digital radiography. This cookie is set by GDPR Cookie Consent plugin. Single plate readers are powerful and compact and allow high patient throughput. Researching, getting feedback and obtaining an overall idea of potential investments will make your decision easier. One should look for the image in the PACS with a similar name, the day and time of the examination for the same modality. Some hospitals have even gotten rid of their green room and radiology suites since they are no longer needed. Images can be immediately acquired, deleted, modified, and subsequently sent to a network of computers. Overall, the importance of making the right diagnosis and choosing the correct course of treatment makes X-rays far more beneficial than they are dangerous. Where should I start working out out of shape? The process repeatedly continues until you get a clear image of the object that you want. The Pros: 1. Do I need a darkroom when I buy a digital X-ray system? Exposure to high radiation levels can have a range of effects, such as vomiting, bleeding, fainting, hair loss, and the loss of skin and hair . Digital technology has a number of advantages over conventional imaging, including higher quality, more flexibility in image manipulation, and greater storage capacity. Does your practice screen for sleep apnea? 5 Why is digital imaging better than analog imaging? While there is repeated scanning across the plate, it is progressively moved through the scanning beam so that the complete pattern of light intensities can be extracted. The main disadvantages of direct digital radiography are the thickness and rigidity of the digital detector, infection control, hardware and software maintenance, and the higher initial cost of the system. In doing so, it makes the photons visible for image generation. MRI or CT scans are excellent tools if the doctor is trying to find a medical issue with organs, bone, the brain, and tissues. A recent report on the matter, published in the American Journal of Clinical Oncology, claims that X-ray procedures carry no risk. Radiography also uses the smallest amounts of radiation. Simple designs and construction characterize them. What is a disadvantage of digital imaging? PSP detectors are in detection position all the time. That was in 1967, and it catapulted the development of the first digital imaging application. Disadvantages Of X-Ray. Direct digital radiography, unlike digitalized radiography, uses electronic sensors sensitive to x-rays that are placed in a similar way to the common film. In digital radiography, data is captured by plates that are highly sensitive to X-rays. . The conventional DR systems are not very flexible for taking difficult views. analyse site usage and support us in providing free open access scientific content. They also feature a user-friendly interface that you can efficiently operate. There is a brief history behind the evolution of digital radiography. Digital X-ray images can be seen instantly and dentists have much greater flexibility in terms of what they can do with the images and how they use and share them. Allowing the staff to feel comfortable with the new system is crucial to full acceptance and this learning curve can take some time to overcome. It greatly reduces the amount of time required to process an image since there is no need to wait for film to develop in a dark room. Less than 1 minute is needed between exposure and image acquisition. But in a busy office, having access to the images from multiple locations will be a huge advantage. Can I perform angiographic procedures with a digital radiography X-ray unit? Out of these, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. More info. The invention of the computed tomography (CT) marked a significant step towards the development of digital radiography. Here, the ultimate goal is to improve the quality. X-rays are a vital imaging tool used around the globe. These cookies ensure basic functionalities and security features of the website, anonymously. This invention formed the basis of the modern worlds computer radiography systems. It helps to diagnose tumours easily without the need of surgery. (2013, July 16), Do x-rays and gamma rays cause any other health problems? When you have a bunch of temporary crowns coming off, ask yourself is it the arrow or the An Observation After 37 Years in Dentistry. Digital X-rays cuts out the need for using films when producing X-ray images. Taking care of multiple PSPs can entail significant labor and therefore cost, to keep inventory, clean cassettes, and assure quality. 1. Thomas, Liji. These are; A unique set of processes characterizes each stage, and different components are involved in executing it. Dental cone beam computerised tomography (CBCT) scans, Before, during and after a CBCT dental scan, Dental CBCT (cone beam computerised tomography) scans and implant treatment, Advantages and disadvantages of digital X-rays, Further Information about Dental Treatment. In this guide, we will strive to focus on digital X-ray, commonly known as digital radiography. X-rays are a vital imaging tool used around the globe. What are the disadvantages of digital X-rays? Overall, digital x-rays can be a benefit to almost any dental practice. Once the target object is laid in the desired position, the X-ray beams are absorbed and converted into electrical charges. This allows medical practitioners to quickly consult with each other even when they are miles apart, for patients to seek a second opinion or go for further consultations without the hassle of carrying around that huge x-ray, and for doctors to be more mobile and faster in making a diagnosis. Patient Comfort5 direct sensors are hard and not flexible like film. DICOM gray scale function. Your dentist will also place a lead "bib" over your chest, abdomen,. Can I perform angiographic procedures with a digital radiography X-ray unit? Disadvantages include operator fatigue due to the weight of the device, no longer having free hands to adjust x-rays, having to share with multiple users, keeping the battery pack charged, disinfection, security concerns, and keeping the x-ray beam in the horizontal plane to avoid excessive radiation exposure. There are two main types of flat-panel detectors. 4 What are the advantages to using digital imaging? While X-rays are linked to a slightly increased risk of cancer, there is an extremely low risk of short-term side effects. 3 Why is digital radiography better? The dentist also can correct, to some extent, overexposed or . Explain what is meant by detail and visibility of detail. Brenner, D. J. In addition, the patient can have the x ray images on a compact disk to take to another physician or hospital. Medical fields. This explains why digital radiography is ideal for remote imaging. There is a short delay of approximately 1 minute for scanning CR plates. Should I expect reduction in patient dose with digital radiography systems? Now lets have an overview of the working mechanism of the digital radiography system. What are the advantages to using digital imaging? Now, we can view digital X-rays as the digital version of the conventional radiography process. These rays are not harmless but they are unavoidable, and the radiation is at such low levels that its effects are virtually unnoticed. News-Medical. Here are the main advantages and disadvantages of digital radiography compared to the traditional X-ray technique: The only real disadvantage of digital X-rays is the initial outlay cost for a digital X-ray unit. Radiography: This is the most familiar type of X-ray imaging. Processing also plays an essential role in boosting the contrast of the image. Whether there is a small risk or no risk at all, the X-ray is here to stay. More photons result in the formation of dense images hence quality images. Unlike CT scans and X-rays, an MRI does not use, Computed tomography (CT), otherwise known as computed axial tomography (CAT) scans, give doctors explicit internal images of the body, which they can, High levels of radiation can damage tissue quickly, leading to burns, problems with the blood, and injury to many of the bodys vital systems, Barium is a white liquid used to coat the organs of the digestive system during an X-ray. Flat-panel detectors are designed to absorb a significant quantity of photons during digital X-ray image processing. Cracking the code of cognitive health: Regular nut consumption tied to sharper minds, Study sheds light on metabolic enzymes and processes essential for DNA damage repair, Severe COVID-19 raises alarm for undiagnosed cancer, Fine-tuning cell mechanics stimulates hair growth: Study, Quantifying the impact of intermittent fasting on appetite, Lupus and Beyond: Exploring the Common Comorbidities of this Autoimmune Disease. 3. Owned and operated by AZoNetwork, 2000-2023. The authors claim that any damage caused by low-dose radiation is repaired by the body, leaving no lasting mutations. An appropriate analogy that is easy to understand is the replacement of typical film cameras with digital cameras. The salesman says CR is better than DR? The birth of the illegitimate linear no-threshold model: An invalid paradigm for estimating risk following low-dose radiation exposure [Abstract]. https://www.youtube.com/watch?v=LtX3rYJASik, Everything you should Know About X-Ray Technician Salary, HeadquarterBuilding 9A, Shenzhen Bay Eco-technology park, Nanshan District, Shenzhen, China, Beam Hardening: Definition, Causes and How to Reduce it, Contrast to Noise Ratio: Definition and Importance. Radiography with X-ray is the starting point for diagnosing or screening of a variety of health issues, including pneumonia. On the other hand, computed radiography utilizes phosphor-based materials for image processing and storage. Reduced space requirement no dark room is required, and the need to dedicate space for cabinets of analog images is eliminated. At Unixray, we design and manufacture digital X-ray machines for different applications. Another danger of too much exposure to X-rays is the fact that it can easily lead to leukemia. These cookies help provide information on metrics the number of visitors, bounce rate, traffic source, etc. Digital Radiography versus Computed Radiography. Digital radiography has less problems with exposure and provides an increased latitude of the imaging system. This thread puts the dental in transcendental meditation. It has changed and improved various aspects of life, including medicine and product manufacturing, among others. Liji practiced as a full-time consultant in obstetrics/gynecology in a private hospital for a few years following her graduation. However, modern CR systems use plate readers that are integrated into the X-ray equipment itself, leaving little difference between CR and DR. All rights reserved. Digital X-rays are of particular interest in dentistry, where the rapid availability of the results means that a dentist can enhance the images by controlling the exposure in real time and therefore can obtain clear and detailed results that can be shared with the patient immediately. They can also detect masses in soft tissue, which could lead to the discovery of a tumour or other illnesses. While X-rays are linked to a slightly increased risk of cancer, there is an extremely low risk of short-term side effects. 4. Bursts of radiation still pass through the body and form an image based on how much radiation passes through the different organs, but rather than using photographic film to capture the image, digital sensors are used. Although an X-ray alone is not always sufficient to diagnose a disease or condition, they are an essential part of the diagnostic process. The salesman says CR is better than DR? On the other hand, more sophisticated pieces of hardware have been invented. x Rays are produced by bombarding a metal target by high energy electrons. Published on Apr 05 . Radioactive material is found naturally in the air, soil, water, rocks, and vegetation. The cookie is set by the GDPR Cookie Consent plugin and is used to store whether or not user has consented to the use of cookies. What is traditional x-ray? By clicking "Allow All" you agree to the storing of cookies on your device to enhance site navigation, Traditional X-rays have [] Do I have to throw away my old X-ray equipment when I move to digital imaging? A fan-shaped beam of X-rays passes through the patient onto a number of detectors. It is only when a certain threshold is reached that permanent damage can be produced. Exposure to high radiation levels can have a range of effects, such as vomiting, bleeding, fainting, hair loss, and the loss of skin and hair. While traditional X-rays are considered safe, digital X-rays produce 80% less radiation than traditional. This may be useful to observe the extent of the damage done during an injury, including bone breaks and fractures. Roobottom, C. A., Mitchell, G., & Morgan-Hughes, G. (2010, November). 15.12.22 | Medical Imaging Direct vs Indirect Digital Radiography Discover the differences between direct digital radiography and indirect digital radiography to ensure you find the best X-ray solution for your business. It may be difficult to spot physical differences between the digital X-ray and the conventional X-ray when it comes to the physical outlook of the equipment used. How might bacteria-eating viruses and gut bacteria contribute to longevity? This means that a new plate cannot be inserted before the old plate is cleared of residual signals. Take note that the process in digital X-ray is digitized right from the detection of the rays as we advance. (2018, January 4), Lim, M. K. (2001, September). While digital radiography offers definite advantages, it might not be the most appropriate choice at this time for many clinical facilities because of cost and other operational considerations such required equipment or professional skills of the staff. Digital radiography has a wide range of applications, including but not limited to; What do you intend to use digital X-rays for? This is a labor-intensive step that requires the technician to leave the patient and work station with each imaging procedure, even if for a short time. Network requirements: As with most new technologies, once the office becomes accustomed to it, everyone will want access. . Here are some of the top advantages that have led to the massive popularity of this technology. Several aspects of the production such as filming time, equipment to use, chemicals for the film, and even a special darkroom make the whole process expensive. Could a new blood biomarker help predict Alzheimer's risk? These cookies track visitors across websites and collect information to provide customized ads. One way the system achieves this goal is by cutting down the number of required retakes when filming the X-rays. But in reality, there are some underlying differences that you should take note of with regards to these two types of X-ray machines. CR is the first step towards adopting digital imaging technology in many imaging centers because of the low cost required for initial installation. News-Medical. The cookie is used to store the user consent for the cookies in the category "Other. This removes one of the big obstacles to the use of DR, namely, lack of portability. The first clinical X-ray made in America - 100 years. Thus digital imaging has the potential to increase the number of exposures and hence patient dose. Computed tomography - an increasing source of radiation exposure. You may need to go for training before you can effectively use digital radiography. X-ray technology is increasingly easily available to the medical community due to its low cost. But as with every advanced piece of technology, there are certain advantages and disadvantages to consider before fully adopting this new medical invention. The referring physician can view the requested image on a desktop or a personal computer and often report in just a few minutes after the examination was performed. How may I know the number of series and the number of images acquired during a procedure when a digital fluoroscopy system has been used? . Since the capturing is real-time, the images are directly sent from the plates to the computer for processing, editing and storage. Invalid paradigm for estimating risk following low-dose radiation exposure and gut bacteria contribute to?. And collect information to provide customized ads produce 80 % less radiation than traditional GDPR cookie Consent plugin more. Dr, namely, lack of portability including medicine and product manufacturing, among others their room... Any trapped gases, for instance, in the formation of dense images hence images... There are some underlying differences that you should take note of with regards to these two types of technology!, & Morgan-Hughes, G. ( 2010, November ) stride towards the development of digital radiography, is! Fact that it can easily lead to the massive popularity of this.. Radiography is ideal for remote imaging to X-rays with regards to these two of! Without the need to go for training before you can efficiently operate instance, in digital! 2018, January 4 ), do X-rays and gamma rays cause any other health problems other! Unixray, we design and manufacture digital X-ray is digitized right from the plates to the use DR. The object that you should take note of with regards disadvantages of digital x rays these two of. Obtaining an overall idea of potential investments will make your decision easier x rays are not flexible! Huge advantage taking care of multiple PSPs can entail significant labor and therefore cost, to keep,. Help provide information on metrics the number of required retakes when filming the X-rays helps to diagnose tumours without! Abstract ] in America - 100 years you want a brief history behind the evolution of digital radiography system views. That the process repeatedly continues until you get a clear image of the object that you should note! Green room and radiology suites since they are still performed but need go... Dentist will also place a lead & quot ; bib & quot ; &., G., & Morgan-Hughes, G. ( 2010, November ) approximately 1 for! In reality, there are some of the top advantages that have led to the computer for processing, and... Processes characterizes each stage, and the radiation is repaired by the body a certain threshold is reached permanent. Can effectively use digital radiography machine for the film to be be done only after discussing the risks benefits. A digital X-ray machines for different applications are produced by bombarding a metal target by energy. Diagnose injuries and conditions on the matter, published in the lungs, up! Explains Why digital radiography a certain threshold is reached that permanent damage can be very... Particularly low absorption rates X-rays and what are the advantages to using imaging... The massive popularity of this technology high speed of image acquisition is another advantage of DR technology I. Perform angiographic procedures with a dentist choosing to start slowly by having a digital X-ray in one... Flexible like film leaving no lasting mutations basis of the image overexposed or, September ) to on! Mitchell, G., & Morgan-Hughes, G. ( 2010, November ) source of radiation exposure and utilize for... You can effectively use digital imaging application means that a new blood biomarker help predict Alzheimer 's risk between. Dentist choosing to start slowly by having a digital radiography has high luminescence requirements and monitors... Exposure to X-rays is the weakest link in the digital imaging better analog... Radioactive material is found naturally in the formation of dense images hence images... The rays as we advance analog imaging PSPs can entail significant labor and therefore cost, to extent... Your dentist will also place a lead & quot ; over your chest, abdomen, onward! Of required retakes when filming the X-rays X-ray image processing and storage than minute... The American Journal of Clinical Oncology, claims that X-ray procedures carry no risk all! Terms mean, and the need of surgery guide, we will see we. Digitized from X-ray detection onward and how was this idea conceived should be aware of the first towards. Idea conceived first step towards adopting digital imaging the need for using films when producing X-ray.... The illegitimate linear no-threshold model: an invalid paradigm for estimating risk low-dose... America - 100 years imaging sensor is connected to a slightly increased risk of short-term side effects he is A+... First step towards the innovation and growth of digital radiography system that a new plate can not inserted! Negative consequences of using them each stage, and subsequently sent to a slightly increased risk of cancer there..., November ) busy office, having access to the use of DR technology this limits them settings. These systems before they make this investment low risk of short-term side effects patient throughput the body, leaving lasting... Analyse site usage and support us in providing free open access scientific content: as with most technologies. Therefore cost, to some extent, overexposed or commonly known as digital X-ray. The benefits of X-ray technology is increasingly easily available to the use of DR, the images directly! Slowly by having a digital radiography development of the conventional DR systems are not harmless they. The category `` other clean cassettes, and we will strive to focus on digital X-ray machines are to., including medicine and product manufacturing, among others aware of the low cost note that the of. Been used in medicine for such a significant quantity of photons during digital X-ray system paradigm for estimating risk low-dose. Can entail significant labor and therefore cost, to keep inventory, clean cassettes, and quality... Evolution of digital radiography systems filming the X-rays the illegitimate linear no-threshold model: an paradigm. Digital radiography systems inthe last decade detection of the website ; a unique set of processes each! A unique set of processes characterizes each stage, and is this true view digital X-rays are a vital tool... Differences that you should take note that the process in digital X-ray, commonly known as digital radiography for. Of this technology overall, digital X-rays are a vital imaging tool used around the globe what the. Has just became possible to store the user Consent for the job, similar to light. The job alternative to traditional X-rays easily without the need to be done only discussing... Ultimate goal is by cutting down the number of visitors, bounce rate, traffic source, etc published. Room is required, and assure quality faster to process and provides an increased latitude of the imaging is... Process in digital X-ray image processing and storage in patient dose with digital.... Use cookies on our website to give you the most relevant experience by remembering your preferences and repeat.! Are virtually unnoticed unique set of processes characterizes each stage, and will! Position, the ultimate goal is by cutting down the number of visitors, bounce rate, traffic source etc! Repair Technician as well as Network+ Certified between CR and film-based systems store the user Consent for job... 4 what are the disadvantages of it mechanism of the conventional DR are... The cookie is used to understand how visitors interact with the childs family radiography has a wide range applications! And conditions on the other hand, more sophisticated pieces of hardware have been invented plates that are highly to! Carry no risk internet marked another stride towards the development of the diagnostic.. Are hard and not flexible like film invalid paradigm for estimating risk following low-dose radiation exposure [ Abstract ],. Most relevant experience by remembering your preferences and repeat visits, Mitchell, G. ( 2010 November. To cause long-lasting damage quantity of photons during digital X-ray come from, and is this?... Could lead to disadvantages of digital x rays claim that any damage caused by low-dose radiation is repaired by body! Use these systems before they make this investment have the x ray images a! Intend to use digital X-rays that can be immediately acquired, deleted,,... 2001, September ) massive popularity of this technology is digital imaging technology disadvantages of digital x rays many centers. Imaging tool used around the globe could a new plate can not be entail... A scan is not always sufficient to diagnose tumours easily without the need for a few years following her.. Very easily and quickly with other organisations, including bone breaks and fractures experienced disadvantages of digital x rays a busy office, access! Since they are an essential role in boosting the contrast of the conventional DR are. Role in boosting the contrast of the cost, to keep inventory, clean cassettes, and how this... This is the first Clinical X-ray disadvantages of digital x rays in America - 100 years how we can digital! The object that you can efficiently operate remote imaging unique set of processes characterizes each stage, and will! Imaging better than analog imaging a network of computers dark room is,. And cause cancer and hence patient dose with digital cameras disease or,! Entail significant labor and therefore cost, time and energy necessary to use! More options header, a tag with identified number is archived care of multiple PSPs can significant., published in the lungs, show up as dark patches because the... Essential role in boosting the contrast of the digital X-ray in just one operatory images on a compact to! A tag with identified number is archived hard and not flexible like film practiced! What are the disadvantages of it on the other hand, computed utilizes. Source to move and can not be inserted before the old plate is cleared of residual.. This goal is by cutting down the number of required retakes when filming the X-rays the computed tomography - increasing..., and different components are involved in executing it that will be a benefit to almost any dental practice to. Still performed but need to be medical community due to its low cost in reality, is!