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

Cycles of construing in radicalization and deradicalization: a study of Salafist Muslims.

© Taylor & Francis Group, LLC.This article explores radicalization and deradicalization by considering the experiences of six young Tunisian people who had become Salafist Muslims. Their responses to narrative interviews and repertory grid technique are considered from a personal construct perspective, revealing processes of construing and reconstruing, as well as relevant aspects of the structure and content of their construct systems. In two cases, their journeys involved not only radicalization but self-deradicalization, and their experiences are drawn on to consider implications for deradicalization.Peer reviewedFinal Accepted Versio

Workflow level interoperation of grid data resources

The lack of widely accepted standards and the use of different middleware solutions divide today’s Grid resources into non-interoperable production Grid islands. On the other hand, more and more experiments require such a large number of resources that the interoperation of existing production Grids becomes inevitable. This paper, based on the current results of grid interoperation studies, defines generic requirements towards the workflow level interoperation of grid solutions. It concentrates on intra-workflow interoperation of grid data resources, as one of the key areas of generic interoperation, and describes through an example how existing tools can be extended to achieve the required level of interoperation

Design of a Biologically Inspired Underwater Burrowing Robot That Utilizes Localized Fluidization

The Atlantic razor clam (Ensis directus) digs by contracting its valves, fluidizing the surrounding soil and reducing burrowing drag. Moving through a fluidized, rather than static, soil requires energy that scales linearly with depth, rather than depth squared. In addition to providing an advantage for the animal, localized fluidization may provide significant value to engineering applications such as vehicle anchoring and underwater pipe installation. This paper presents the design of a self-actuated, radially expanding burrowing mechanism that utilizes E. directus burrowing methods. The device is sized to be a platform for an anchoring system for autonomous underwater vehicles. Scaling relationships presented allow for design of burrowing systems of different sizes for a variety of applications. The motion to sufficiently create soil fluidization is presented. Max force for the actuator to contract is based on force to pump fluid out of the device, and max expansion force is determined by the soil. Friction force in the device and potential considerations for increased force are presented. Data from laboratory tests are used to characterize how power is split between pumping water out of the device versus accelerating the mechanism itself. These relationships provide the optimal sizing and power needs for various size subsea burrowing systems.National Science Foundation (U.S.) (Graduate Research Fellowship under Grant No. 1122374)Bluefin Robotic

MiCADO – Towards a Microservice-based Cloud Application-level Dynamic Orchestrator

In order to satisfy end-user requirements, many scientific and commercial applications require access to dynamically adjustable infrastructure resources. Cloud computing has the potential to provide these dynamic capabilities. However, utilising these capabilities from application code is not trivial and requires application developers to understand low-level technical details of clouds. This paper investigates how a generic framework can be developed that supports the dynamic orchestration of cloud applications both at deployment and at run-time. The advantages and challenges of designing such framework based on microservices is analysed, and a generic framework, called MiCADO – (Microservices-based Cloud Application-level Dynamic Orchestrator) is proposed. A first prototype implementation of MiCADO to support data intensive commercial web applications is also presented