Microbiological evaluation of different reprocessing methods for cuffed and un-cuffed tracheostomy tubes in home-care and hospital setting

Background: Manufacturers’ recommendations on cleaning of tracheostomy tubes focus on general warning information and non-specific manual cleaning procedures. The aim of this experimental study was to evaluate different reprocessing methods and to determine the mechanical integrity and functionality of tracheostomy tubes following reprocessing. Methods: Sixteen cuffed or un-cuffed tracheostomy tubes obtained from hospital in-patients were reprocessed using one of the following reprocessing methods: a) manual brushing and rinsing with tap water, b) manual brushing followed by disinfection with a glutaraldehyde solution, c) manual brushing followed machine-based cleaning in a dishwasher, and d) manual brushing followed by ultrasound cleaning in a commercially available ultrasound device. Microbial burden of the tubes before and after reprocessing was assessed by measurement of microbial colony-forming units per mL (CFU/mL) of rinsing fluid. After cleaning, tracheostomy tubes were investigated for loss of functionality. Findings: Manual brushing and rinsing with tap water reduced microbial colonization in average by 102 CFU/mL, but with poor reproducibility and reliability. Complete microbial reduction was achieved only with additional chemical or machine-based thermal disinfection. Ultrasound sonification yielded no further microbial reduction after manual brushing. Conclusion: Manual brushing alone will not result in complete eradication of microorganism colonising cuffed or un-cuffed tracheostomy tubes. However, manual cleaning followed by chemical or thermal disinfection may be regarded as safe and reproducible reprocessing method. If a machine-based reprocessing method is used for cuffed tubes, the cuffs’ ventilation hose must be secured in a safe position prior to thermal disinfection

Reconstituted asbestos matrix for fuel cells

Method is described for reprocessing commercially available asbestos matrix stock to yield greater porosity and bubble pressure (due to increased surface tension), improved homogeneity, and greater uniformity

The X-ray emission lines in GRB afterglows: the evidence for the two-component jet model

Recently, X-ray emission lines have been observed in X-ray afterglows of several $\gamma$-ray bursts. It is a major breakthrough for understanding the nature of the progenitors. It is proposed that the X-ray emission lines can be well explained by the Geometry-Dominated models, but in these models the illuminating angle is much larger than that of the collimated jet of the $\gamma$-ray bursts(GRBs). For GRB 011211, we obtain the illuminating angle is about $\theta\sim45^{\circ}$, while the angle of GRB jet is only $3.6^{\circ}$, so we propose that the outflow of the GRBs with emission lines should have two distinct components. The wide component illuminates the reprocessing material, and produces the emission lines, while the narrow one produces the $\gamma$-ray bursts. The observations show that the energy for producing the emission lines is higher than that of the GRBs. In this case, when the wide component dominates the afterglows, a bump will appear in the GRBs afterglows. For GRB 011211, the emergence time of the bump is less than 0.05 days after the GRB, it is obviously too early for the observation to catch it. With the presence of the X-ray emission lines there should also be a bright emission component between the UV and the soft X-rays. These features can be tested by the $Swift$ satellite in the near future.Comment: 10 pags, 1 figure, ChJAA in pres

The Thorium Molten Salt Reactor : Moving on from the MSBR

A re-evaluation of the Molten Salt Breeder Reactor concept has revealed problems related to its safety and to the complexity of the reprocessing considered. A reflection is carried out anew in view of finding innovative solutions leading to the Thorium Molten Salt Reactor concept. Several main constraints are established and serve as guides to parametric evaluations. These then give an understanding of the influence of important core parameters on the reactor's operation. The aim of this paper is to discuss this vast research domain and to single out the Molten Salt Reactor configurations that deserve further evaluation.Comment: 11 pages, 8 figures, 6 table

Nuclear Material Monitoring for the Reprocessing Plant RT-1 at Mayak

C

Quasar optical variability: searching for interband time delays

Aims. The main purpose of this paper is to study time delays between the light variations in different wavebands for a sample of quasars. Measuring a reliable time delay for a large number of quasars may help constraint the models of their central engines. The standard accretion disk irradiation model predicts a delay of the longer wavelengths behind the shorter ones, a delay that depends on the fundamental quasar parameters. Since the black hole masses and the accretion rates are approximately known for the sample we use, one can compare the observed time delays with the expected ones. Methods. We applied the interpolation cross-correlation function (ICCF) method to the Giveon et al. sample of 42 quasars, monitored in two (B and R) colors, to find the time lags represented by the ICCF peaks. Different tests were performed to assess the influence of photometric errors, sampling, etc., on the final result. Results. We found that most of the objects show a delay in the red light curve behind the blue one (a positive lag), which on average for the sample is about +4 days (+3 for the median), although the scatter is significant. These results are broadly consistent with the reprocessing model, especially for the well-sampled objects. The normalized time-lag deviations do not seem to correlate significantly with other quasar properties, including optical, radio, or X-ray measurables. On the other hand, many objects show a clear negative lag, which, if real, may have important consequences for the variability models.Comment: 5 pages, 4 figures, accepted in A&

X-rays from Radio-Galaxies: BeppoSAX Observations

We briefly review BeppoSAX observations of X-ray bright radio-galaxies. Their X-ray spectra are quite varied, and perhaps surprisingly, any similarity between radio-loud AGN and Seyfert galaxies is the exception rather than the rule. When detected, reprocessing features (iron line and reflection) are generally weak, suggesting two possible scenarios: either: (1) non-thermal (jet?) radiation dilutes the X-ray emission from the disk in radio-loud objects, or (2) the solid angle subtended by the X-ray reprocessing material is smaller in radio-loud than in radio-quiet AGN due to different characteristics of the accretion disk itself.Comment: 6 pages, to appear in `Life Cycles of Radio Galaxies', ed. J. Biretta et al., New Astronomy Review

Implant Prophylaxis: The Next Best Practice Toward Asepsis in Spine Surgery.

Study designA literature review.ObjectivesAn evaluation of the contaminants prevalent on implants used for surgery and the aseptic methods being employed against them.MethodsPubMed was searched for articles published between 2000 and 2017 for studies evaluating the contaminants present on spine implants, and associated pre- and intraoperative implant processing and handling methodology suggested to avoid them. Systematic reviews, observational studies, bench-top studies, and expert opinions were included.ResultsEleven studies were identified whose major focus was the asepsis of implants to reduce the incidence of surgical site infection incidences during surgery. These studies measured the colony forming units of bacteria on sterilized implants and/or gloves from the surgeon, scrub nurse, and assistants, as well as reductions of surgical site infection rates in spine surgery due to changes in implant handling techniques. Additionally, the search included assessments of endotoxins and carbohydrates present on reprocessed implants. The suggested changes to surgical practice based on these studies included handling implants with only fresh gloves, keeping implants covered until the immediate time of use, reducing operating room traffic, avoiding reprocessing of implants (ie, providing terminally sterilized implants), and avoiding touching the implants altogether.ConclusionsBoth reprocessing (preoperative) and handling (intraoperative) of implants seem to lead to contamination of sterilized implants. Using a terminally sterilized device may mitigate reprocessing (preoperative implant prophylaxis), whereas the use of fresh gloves for handling each implant and/or a permanent shielding technique (intraoperative implant prophylaxis) could potentially avoid recontamination at the theatre

Frying Doughnuts: What can the reprocessing of X-rays to IR tell us about the AGN environment?

Active galactic nuclei (AGN) produce vast amounts of high energy radiation deep in their central engines. X-rays either escape the AGN or are absorbed and re-emitted mostly as IR. By studying the dispersion in the ratio of observed mid-IR luminosity to observed 2-10keV X-ray luminosity (R_{ir/x}) in AGN we can investigate the reprocessing material (possibly a torus or donut of dust) in the AGN central engine, independent of model assumptions. We studied the ratio of observed mid-IR and 2-10keV X-ray luminosities in a heterogeneous sample of 245 AGN from the literature. We found that when we removed AGN with prominent jets, ~90% of Type I AGN lay within a very tight dispersion in luminosity ratio (1<R_{ir/x}<30). This implies that the AGN central engine is extremely uniform and models of the physical AGN environment (e.g. cloud cover, turbulent disk, opening angle of absorbing structures such as dusty tori) must span a very narrow range of parameters. We also found that the far-IR(100um) to mid-IR (12um) observed luminosity ratio is an effective descriminator between heavily obscured AGN and relatively unobscured AGN.Comment: 12 pages, MNRAS accepte