Blood transfer devices for malaria rapid diagnostic tests : evaluation of accuracy, safety and ease of use

Background: Malaria rapid diagnostic tests (RDTs) are increasingly used by remote health personnel with minimal training in laboratory techniques. RDTs must, therefore, be as simple, safe and reliable as possible. Transfer of blood from the patient to the RDT is critical to safety and accuracy, and poses a significant challenge to many users. Blood transfer devices were evaluated for accuracy and precision of volume transferred, safety and ease of use, to identify the most appropriate devices for use with RDTs in routine clinical care. Methods: Five devices, a loop, straw-pipette, calibrated pipette, glass capillary tube, and a new inverted cup device, were evaluated in Nigeria, the Philippines and Uganda. The 227 participating health workers used each device to transfer blood from a simulated finger-prick site to filter paper. For each transfer, the number of attempts required to collect and deposit blood and any spilling of blood during transfer were recorded. Perceptions of ease of use and safety of each device were recorded for each participant. Blood volume transferred was calculated from the area of blood spots deposited on filter paper. Results: The overall mean volumes transferred by devices differed significantly from the target volume of 5 microliters (p < 0.001). The inverted cup (4.6 microliters) most closely approximated the target volume. The glass capillary was excluded from volume analysis as the estimation method used is not compatible with this device. The calibrated pipette accounted for the largest proportion of blood exposures (23/225, 10%); exposures ranged from 2% to 6% for the other four devices. The inverted cup was considered easiest to use in blood collection (206/ 226, 91%); the straw-pipette and calibrated pipette were rated lowest (143/225 [64%] and 135/225 [60%] respectively). Overall, the inverted cup was the most preferred device (72%, 163/227), followed by the loop (61%, 138/227). Conclusions: The performance of blood transfer devices varied in this evaluation of accuracy, blood safety, ease of use, and user preference. The inverted cup design achieved the highest overall performance, while the loop also performed well. These findings have relevance for any point-of-care diagnostics that require blood sampling.

Next generation low-cost motion capture systems can provide comparable spatial accuracy to high-end systems

The objective quantification of three-dimensional kinematics during different functional and occupational tasks is now more in demand than ever. The introduction of new generation of low-cost passive motion capture systems from a number of manufacturers has made this technology accessible for teaching, clinical practice and in small/medium industry. Despite the attractive nature of these systems, their accuracy remains unproved in independent tests. We assessed static linear accuracy, dynamic linear accuracy and compared gait kinematics from a Vicon MX20 system to a Natural Point OptiTrack system. In all experiments data were sampled simultaneously. We identified both systems perform excellently in linear accuracy tests with absolute errors not exceeding 1%. In gait data there was again strong agreement between the two systems in sagittal and coronal plane kinematics. Transverse plane kinematics differed by up to 3 at the knee and hip, which we attributed to the impact of soft tissue artifact accelerations on the data. We suggest that low-cost systems are comparably accurate to their high-end competitors and offer a platform with accuracy acceptable in research for laboratories with a limited budget.

Flexural-torsional buckling tests of cold-formed steel compression members at elevated temperatures

Current design standards do not provide adequate guidelines for the fire design of cold-formed steel compression members subject to flexural-torsional buckling. Eurocode 3 Part 1.2 (2005) recommends the same fire design guidelines for both hot-rolled and cold-formed steel compression members subject to flexural-torsional buckling although considerable behavioural differences exist between cold-formed and hot-rolled steel members. Past research has recommended the use of ambient temperature cold-formed steel design rules for the fire design of cold-formed steel compression members provided appropriately reduced mechanical properties are used at elevated temperatures. To assess the accuracy of flexural-torsional buckling design rules in both ambient temperature cold-formed steel design and fire design standards, an experimental study of slender cold-formed steel compression members was undertaken at both ambient and elevated temperatures. This paper presents the details of this experimental study, its results, and their comparison with the predictions from the current design rules. It was found that the current ambient temperature design rules are conservative while the fire design rules are overly conservative. Suitable recommendations have been made in relation to the currently available design rules for flexural-torsional buckling including methods of improvement. Most importantly, this paper has addressed the lack of experimental results for slender cold-formed steel columns at elevated temperatures.

Detecting conversing groups of chatters : a model, algorithms, and tests

Chatrooms, for example Internet Relay Chat, are generally multi-user, multi-channel and multiserver chat-systems which run over the Internet and provide a protocol for real-time text-based conferencing between users all over the world. While a well-trained human observer is able to understand who is chatting with whom, there are no efficient and accurate automated tools to determine the groups of users conversing with each other. A precursor to analysing evolving cyber-social phenomena is to first determine what the conversations are and which groups of chatters are involved in each conversation. We consider this problem in this paper. We propose an algorithm to discover all groups of users that are engaged in conversation. Our algorithms are based on a statistical model of a chatroom that is founded on our experience with real chatrooms. Our approach does not require any semantic analysis of the conversations, rather it is based purely on the statistical information contained in the sequence of posts. We improve the accuracy by applying some graph algorithms to clean the statistical information. We present some experimental results which indicate that one can automatically determine the conversing groups in a chatroom, purely on the basis of statistical analysis.

Airborne collision scenario flight tests : impact of angle measurement errors on reactive vision-based avoidance control

The future emergence of many types of airborne vehicles and unpiloted aircraft in the national airspace means collision avoidance is of primary concern in an uncooperative airspace environment. The ability to replicate a pilot’s see and avoid capability using cameras coupled with vision based avoidance control is an important part of an overall collision avoidance strategy. But unfortunately without range collision avoidance has no direct way to guarantee a level of safety. Collision scenario flight tests with two aircraft and a monocular camera threat detection and tracking system were used to study the accuracy of image-derived angle measurements. The effect of image-derived angle errors on reactive vision-based avoidance performance was then studied by simulation. The results show that whilst large angle measurement errors can significantly affect minimum ranging characteristics across a variety of initial conditions and closing speeds, the minimum range is always bounded and a collision never occurs.

Predicting the likelihood of QA failure using treatment plan accuracy metrics

This study used automated data processing techniques to calculate a set of novel treatment plan accuracy metrics, and investigate their usefulness as predictors of quality assurance (QA) success and failure. 151 beams from 23 prostate and cranial IMRT treatment plans were used in this study. These plans had been evaluated before treatment using measurements with a diode array system. The TADA software suite was adapted to allow automatic batch calculation of several proposed plan accuracy metrics, including mean field area, small-aperture, off-axis and closed-leaf factors. All of these results were compared the gamma pass rates from the QA measurements and correlations were investigated. The mean field area factor provided a threshold field size (5 cm2, equivalent to a 2.2 x 2.2 cm2 square field), below which all beams failed the QA tests. The small aperture score provided a useful predictor of plan failure, when averaged over all beams, despite being weakly correlated with gamma pass rates for individual beams. By contrast, the closed leaf and off-axis factors provided information about the geometric arrangement of the beam segments but were not useful for distinguishing between plans that passed and failed QA. This study has provided some simple tests for plan accuracy, which may help minimise time spent on QA assessments of treatments that are unlikely to pass.

Clinical Accuracy of the MedGem Indirect Calorimeter for Measuring Resting Energy Expenditure in Cancer Patients

OBJECTIVE: To compare, in patients with cancer and in healthy subjects, measured resting energy expenditure (REE) from traditional indirect calorimetry to a new portable device (MedGem) and predicted REE. DESIGN: Cross-sectional clinical validation study. SETTING: Private radiation oncology centre, Brisbane, Australia. SUBJECTS: Cancer patients (n = 18) and healthy subjects (n = 17) aged 37-86 y, with body mass indices ranging from 18 to 42 kg/m(2). INTERVENTIONS: Oxygen consumption (VO(2)) and REE were measured by VMax229 (VM) and MedGem (MG) indirect calorimeters in random order after a 12-h fast and 30-min rest. REE was also calculated from the MG without adjustment for nitrogen excretion (MGN) and estimated from Harris-Benedict prediction equations. Data were analysed using the Bland and Altman approach, based on a clinically acceptable difference between methods of 5%. RESULTS: The mean bias (MGN-VM) was 10% and limits of agreement were -42 to 21% for cancer patients; mean bias -5% with limits of -45 to 35% for healthy subjects. Less than half of the cancer patients (n = 7, 46.7%) and only a third (n = 5, 33.3%) of healthy subjects had measured REE by MGN within clinically acceptable limits of VM. Predicted REE showed a mean bias (HB-VM) of -5% for cancer patients and 4% for healthy subjects, with limits of agreement of -30 to 20% and -27 to 34%, respectively. CONCLUSIONS: Limits of agreement for the MG and Harris Benedict equations compared to traditional indirect calorimetry were similar but wide, indicating poor clinical accuracy for determining the REE of individual cancer patients and healthy subjects.

Property cash flow studies : focusing on model consistency and data accuracy

The high degree of variability and inconsistency in cash flow study usage by property professionals demands improvement in knowledge and processes. Until recently limited research was being undertaken on the use of cash flow studies in property valuations but the growing acceptance of this approach for major investment valuations has resulted in renewed interest in this topic. Studies on valuation variations identify data accuracy, model consistency and bias as major concerns. In cash flow studies there are practical problems with the input data and the consistency of the models. This study will refer to the recent literature and identify the major factors in model inconsistency and data selection. A detailed case study will be used to examine the effects of changes in structure and inputs. The key variable inputs will be identified and proposals developed to improve the selection process for these key variables. The variables will be selected with the aid of sensitivity studies and alternative ways of quantifying the key variables explained. The paper recommends, with reservations, the use of probability profiles of the variables and the incorporation of this data in simulation exercises. The use of Monte Carlo simulation is demonstrated and the factors influencing the structure of the probability distributions of the key variables are outline. This study relates to ongoing research into functional performance of commercial property within an Australian Cooperative Research Centre.