Failure of non-vacuum steam sterilization processes for dental handpieces

Background: Dental handpieces are used in critical and semi-critical operative interventions. Although a number of dental professional bodies recommend that dental handpieces are sterilized between patient use there is a lack of clarity and understanding of the effectiveness of different steam sterilization processes. The internal mechanisms of dental handpieces contain narrow lumens (0·8-2·3mm) which can impede the removal of air and ingress of saturated steam required to achieve sterilization conditions. Aim: To identify the extent of sterilization failure in dental handpieces using a non-vacuum process. Methods: In-vitro and in-vivo investigations were conducted on commonly used UK benchtop steam sterilizers and three different types of dental handpieces. The sterilization process was monitored inside the lumens of dental handpieces using thermometric (TM) methods (dataloggers), chemical indicators (CI) and biological indicators (BI). Findings: All three methods of assessing achievement of sterility within dental handpieces that had been exposed to non-vacuum sterilization conditions demonstrated a significant number of failures (CI=8/3,024(fails/n tests); BI=15/3,024; TM=56/56) compared to vacuum sterilization conditions (CI=2/1,944; BI=0/1,944; TM=0/36). The dental handpiece most likely to fail sterilization in the non-vacuum process was the surgical handpiece. Non-vacuum sterilizers located in general dental practice had a higher rate of sterilization failure (CI=25/1,620; BI=32/1,620; TM=56/56) with no failures in vacuum process. Conclusion: Non-vacuum downward/gravity displacement, type-N steam sterilizers are an unreliable method for sterilization of dental handpieces in general dental practice. The handpiece most likely to fail sterilization is the type most frequently used for surgical interventions

Investigating steam penetration using thermometric methods in dental handpieces with narrow internal lumens during sterilizing processes with non-vacuum or vacuum processes

Background: Dental handpieces are required to be sterilized between patient use. Vacuum steam sterilization processes with fractionated pre/post-vacuum phases or unique cycles for specified medical devices, are required for hollow instruments with internal lumens to assure successful air removal. Entrapped air will compromise achievement of required sterilization conditions. Many countries and professional organisations still advocate non-vacuum sterilization processes for these devices. Aim: To investigate non-vacuum downward/gravity displacement, type-N steam sterilization of dental handpieces, using thermometric methods to measure time to achieve sterilization temperature at different handpiece locations. Methods: Measurements at different positions within air turbines were undertaken with thermocouples and dataloggers. Two examples of commonly used UK benchtop steam sterilizers were tested; a non-vacuum benchtop sterilizer (Little Sister 3, Eschmann, UK) and a vacuum benchtop sterilizer (Lisa, W&H, Austria). Each sterilizer cycle was completed with three handpieces and each cycle in triplicate. Findings: A total of 140 measurements inside dental handpiece lumens were recorded. We demonstrate that the non-vacuum process fails (time range 0-150 seconds) to reliably achieve sterilization temperatures within the time limit specified by the International standard (15 seconds equilibration time). The measurement point at the base of the handpiece failed in all test runs (n=9) to meet the standard. No failures were detected with the vacuum steam sterilization type B process with fractionated pre-vacuum and post-vacuum phases. Conclusion: Non-vacuum downward/gravity displacement, type-N steam sterilization processes are unreliable in achieving sterilization conditions inside dental handpieces and the base of the handpiece is the site most likely to fail

A pilot study of a mindfulness informed yoga intervention in young people with psychosis

Aim: To determine the acceptability and safety of a mindfulness informed yoga intervention as adjunct to usual care for young people with early psychosis. Methods: People aged 16–25 years attending a community-based specialist early psychosis clinic were invited to participate in a 12-week yoga intervention. The intervention consisted of 1-h weekly classes of mindfulness informed yoga. Acceptability was measured by uptake, attendance and participants' satisfaction. Safety was measured by incidence of physical injury, participants' level of comfort, distress and anxiety during the sessions, and the following mental health outcomes: positive and negative psychotic, depression, anxiety and stress symptoms, sleep quality and functioning. Results: Of those who consented to the study, 80% (12) participated and on average attended 4.4 yoga classes. There were no physical injuries and participants reported minimal distress and anxiety. Post-intervention, there was a significant reduction in anxiety symptoms and an improvement in function. Conclusions: Mindfulness-based yoga interventions are both acceptable and safe as an intervention for youth with early psychosis. Though numbers were small, the study shows promise for yoga as a potentially useful intervention. Importantly, there was no deterioration in mental health outcomes. A larger trial evaluating clinical effectiveness is now timely

Fighting with the Sparsity of Synonymy Dictionaries

Graph-based synset induction methods, such as MaxMax and Watset, induce synsets by performing a global clustering of a synonymy graph. However, such methods are sensitive to the structure of the input synonymy graph: sparseness of the input dictionary can substantially reduce the quality of the extracted synsets. In this paper, we propose two different approaches designed to alleviate the incompleteness of the input dictionaries. The first one performs a pre-processing of the graph by adding missing edges, while the second one performs a post-processing by merging similar synset clusters. We evaluate these approaches on two datasets for the Russian language and discuss their impact on the performance of synset induction methods. Finally, we perform an extensive error analysis of each approach and discuss prominent alternative methods for coping with the problem of the sparsity of the synonymy dictionaries.Comment: In Proceedings of the 6th Conference on Analysis of Images, Social Networks, and Texts (AIST'2017): Springer Lecture Notes in Computer Science (LNCS

Small scale heater tests in argillite of the Eleana Formation at the Nevada Test Site

Near-surface heater tests were run in the Eleana Formation at the Nevada Test Site, in an effort to evaluate argillaceous rock for nuclear waste storage. The main test, which employed a full-scale heater with a thermal output approximating commercial borosilicate waste, was designed to operate for several months. Two smaller, scaled tests were run prior to the full-scale test. This report develops the thermal scaling laws, describes the pretest thermal and thermomechanical analysis conducted for these two tests, and discusses the material properties data used in the analyses. In the first test, scaled to a large heater of 3.5 kW power, computed heater temperatures were within 7% of measured values for the entire 96-hour test run. The second test, scaled to a large heater having 5.0 kW power, experienced periodic water in-flow onto the heater, which tended to damp the temperature. For the second test, the computed temperatures were within 7% of measured for the first 20 hours. After this time, the water effect became significant and the measured temperatures were 15 to 20% below those predicted. On the second test, rock surface spallation was noted in the bore hole above the heater, as predicted. The scaled tests indicated that in-situ argillite would not undergo major thermostructural failure during the follow-on, 3.5 kW, full-scale test. 24 figures, 6 tables

GPR35 as a Novel Therapeutic Target

G protein-coupled receptors (GPCRs) remain the best studied class of cell surface receptors and the most tractable family of proteins for novel small molecule drug discovery. Despite this, a considerable number of GPCRs remain poorly characterized and in a significant number of cases, endogenous ligand(s) that activate them remain undefined or are of questionable physiological relevance. GPR35 was initially discovered over a decade ago but has remained an “orphan” receptor. Recent publications have highlighted novel ligands, both endogenously produced and synthetic, which demonstrate significant potency at this receptor. Furthermore, evidence is accumulating which highlights potential roles for GPR35 in disease and therefore, efforts to characterize GPR35 more fully and develop it as a novel therapeutic target in conditions that range from diabetes and hypertension to asthma are increasing. Recently identified ligands have shown marked species selective properties, indicating major challenges for future drug development. As we begin to understand these issues, the continuing efforts to identify novel agonist and antagonist ligands for GPR35 will help to decipher its true physiological relevance; translating multiple assay systems in vitro, to animal disease systems in vivo and finally to man