UA12/9 March Newsletter

Newsletter produced and distributed by the WKU Counseling & Testing Center

An investigation of the relationship between thermal imaging and digital thermometer

BACKGROUND: A number of research papers and theoretical clinical models summarising how temperature of the skin over the knee may be altered according to different pathological processes have been published. Thermal imaging (TI) is generally regarded as the ‘Gold’ or ‘reference’ standard for measuring skin temperature, however this technology is not widely accessible to most musculoskeletal physiotherapists working in clinical environments. This is largely due to the time required for analysis of the thermal images and high cost of the equipment. A digital thermometer (DT) is portable with a convenient display of results which could offer an inexpensive substitute. AIM: This study determined interchangeability between thermal imaging and a digital thermometer, using Bland-Altman limits of agreement, to determine skin temperature differences between right and left knees. METHOD: 71 healthy participants in the age group of 8 to 40 participated in the study. Data were collected in two phases. The first phase was as part of a public engagement event at the Lancashire Science Festival where school children were invited to learn about science. The second phase of data collection took place as part of a PhD study where staff and students at the university were recruited via electronic advert and posters displayed around the campus. All subjects were free from lower back or lower limb problems and had not had any previous lower limb surgery. RESULTS: Matched paired t tests showed no significant difference between temperature difference between right and left using DT and TI (t= 1.41, df= 69, P= 0.08). The DT and TI were interchangeable to measure knee skin temperature difference with a limit of agreement of -0.64 and 0.75; this limit of agreement is acceptable based on previous literature where skin temperature differences between affected and non-affected knees are equal to or greater than 1°C. CONCLUSION: This study concludes that an inexpensive handheld digital thermometer shows acceptable agreement with a thermal imaging camera. Clinically a handheld digital thermometer has the potential to play an important role in the localized assessment of skin temperature in physiotherapy and can offer an inexpensive substitute to thermal imaging; due to the massive difference in cost it is worth considering the adoption of digital thermometry in routine musculoskeletal physiotherapy practice

Automated Repair of Layout Cross Browser Issues Using Search-Based Techniques

A consistent cross-browser user experience is crucial for the success of a website. Layout Cross Browser Issues (XBIs) can severely undermine a website’s success by causing web pages to render incorrectly in certain browsers, thereby negatively impacting users’ impression of the quality and services that the web page delivers. Existing Cross Browser Testing (XBT) techniques can only detect XBIs in websites. Repairing them is, hitherto, a manual task that is labor intensive and requires significant expertise. Addressing this concern, our paper proposes a technique for automatically repairing layout XBIs in websites using guided search-based techniques. Our empirical evaluation showed that our approach was able to successfully fix 86% of layout XBIs reported for 15 different web pages studied, thereby improving their cross-browser consistency

Model Systems of Human Intestinal Flora, to Set Acceptable Daily Intakes of Antimicrobial Residues

The veterinary use of antimicrobial drugs in food producing animals may result in residues in food, that might modify the consumer gut flora. This review compares three model systems that maintain a complex flora of human origin: (i) human flora associated (HFA) continuous flow cultures in chemostats, (ii) HFA mice, and (iii) human volunteers. The "No Microbial Effect Level" of an antibiotic on human flora, measured in one of these models, is used to set the accept¬able daily intake (ADI) for human consumers. Human volunteers trials are most relevant to set microbio¬log¬ical ADI, and may be considered as the "gold standard". However, human trials are very expensive and unethical. HFA chemostats are controlled systems, but tetracycline ADI calculated from a chemostat study is far above result of a human study. HFA mice studies are less expensive and better controlled than human trials. The tetracycline ADI derived from HFA mice studies is close to the ADI directly obtained in human volunteers

Proficiency Testing of Viral Marker Screening in African Blood Centers - Seven African Countries, 2017.

A 2014 report evaluating accuracy of serologic testing for transfusion-transmissible viruses at African blood center laboratories found sensitivities of 92%, 87%, and 90% for detecting infections with human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV), respectively (1). Following substantial investments in national blood transfusion service (NBTS) laboratories, in 2017 investigators tested proficiency at 84 blood center laboratories (29 NBTS and 55 non-NBTS) in seven African countries. A blinded panel of 25 plasma samples was shipped to each participating laboratory for testing with their usual protocols based on rapid diagnostic tests (RDTs) (2) and third and fourth generation enzyme immunoassays (EIA-3 and EIA-4). Sensitivity and specificity were estimated using separate regression models that clustered assays by laboratory and adjusted for assay type and NBTS laboratory status. Mean specificities were ≥95% for all three viruses; however, mean sensitivities were 97% for HIV-positive, 76% for HBV-positive, and 80% for HCV-positive samples. Testing sensitivities for all viruses were high when EIA-3 assays were used (≥97%). Lower sensitivities for HBV-positive samples and HCV-positive samples were associated with assay types other than EIA-3, used primarily by non-NBTS laboratories. Proficiency for HIV testing has improved following international investments, but proficiency remains suboptimal for HBV and HCV testing. In sub-Saharan African blood centers, the quality of rapid tests used for HBV and HCV screening needs to be improved or their use discouraged in favor of EIA-3 tests

Certified reference material against PR3 ANCA IgG autoantibodies. From development to certification.

Background The importance of the standardisation of immunoassays for autoantibodies has been widely discussed. The appropriate use of certified reference materials (CRM) could contribute to a more accurate diagnosis and follow-up of a series of diseases such as small vessel-associated vasculitis. This is a systemic autoimmune disorder during which two autoantibodies can be present, MPO ANCA IgG and PR3 ANCA IgG. Results from different commercially available immunoassays used for PR3 ANCA IgG measurement can vary significantly. Therefore the potential for improvement using a suitable certified reference material was assessed and led to the development of a CRM. Methods Thirty clinical samples were evaluated using 10 immunoassays. The correlation between results from these assays was assessed in a pairwise manner. Feasibility studies were conducted in order to find a reference material format most suitable for the preparation of a CRM. Results The evaluation of two sets of 30 clinical samples with 10 assays showed that differences between assays can result in different interpretations for individual clinical samples. Most of the samples had the same result classification in all assays. However, six of the samples tested led to inconsistent results. Conclusions The correlation between results from clinical samples was systematically good for combinations of eight of those assays. Therefore, it should be possible to improve the comparability of results using a commutable CRM for calibration. Based on these studies, a final format for the CRM was selected and eventually produced and certified for its PR3 ANCA IgG content