New York State Climate Impacts Assessment Chapter 02: New York State's Changing Climate.

Many fundamental aspects of New York State's climate have already begun to change, and the changes are projected to continue-and in some cases, accelerate-throughout the 21st century. This chapter explores observed and projected changes in a variety of physical variables that relate directly to weather and climate, starting with average and extreme air temperature and proceeding to the associated effects on precipitation, extreme events, and core properties of New York's coastal and inland waters. These climate attributes and hazards lead to impacts throughout the eight sectors of this assessment.

Construction and validation of an instrument for event-related sterility of processed healthcare products.

Objective: To construct and validate an instrument to assess events related to maintaining the sterility of processed healthcare products.

Methods: This methodological study developed the instrument through analysis by a panel of experts, focusing on the integrity of commonly used packaging: spunbond-meltblown-spunbond and medical-grade paper. The instrument was analyzed using the Content Validity Index and Content Validity Ratio (≥ 0.

Evaluation of cleaning and sterilization of liposuction cannulas after intentional contamination with human fat, Mycobacterium abscessus subspecies bolletii, and Geobacillusstearothermophilus.

Background: The complex design of cannulas is a major challenge for reprocessing due to the retention and accumulation of fat residues.

Aim: To evaluate the cleaning of liposuction cannulas and the protective effects of the remaining fat residues on Mycobacterium abscessus subspecies bolletii (MASB) and Geobacillus stearothermophilus inactivation during steam sterilization.

Methods: In phase 1, six standard operating procedures were evaluated for cleaning of liposuction cannulas.

Efficacy of Disinfection of Rigid Endoscope by Ethyl Alcohol 70.

 Currently, there is no safe, affordable, and ecologically-sustainable guideline that helps prevent contamination through endoscopy. We evaluated the safety of intermediate-level disinfection with 70% ethyl alcohol (w/v) based on biological-load recovery from rigid endoscopes after nasal endoscopy.  To demonstrate the efficacy of 70% ethanol in disinfecting rigid endoscopes (REs) to reduce microbial growth in microbiological cultures.

Making waves: Uses of real-time, hyperlocal flood sensor data for emergency management, resiliency planning, and flood impact mitigation.

Flooding is expected to increase due to intensification of extreme precipitation events, sea-level rise, and urbanization. Low-cost water level sensors have the ability to fill a critical data gap on the presence, depth, and duration of street-level floods by measuring flood profiles (i.e.

Protein detection by fluorescence of manually cleaned high-speed dental handpieces.

We analyzed the effectiveness of manual cleaning protocols performed on high-speed dental handpieces, using protein identification by fluorescence. Although one protocol was able to able to lower the amount of protein, >40% of the handpieces showed amounts of residual protein at unacceptable levels.

Decontamination of stainless-steel bowls with 80% (w/v) alcohol for 30 s and 60 s: randomized experimental study.

Objective: to compare the efficacy of 80% (w/v) alcohol, rubbed for 30 and 60 seconds, in the manual processing of stainless-steel wash bowls, after cleaning with running water and neutral detergent.

Method: experimental study conducted in a hospital in the state of São Paulo, Brazil, on 50 bowls randomly divided into two groups of 25 bowls each for interventions of 30 and 60 seconds of rubbing with 80% (w/v) alcohol.

Results: based on the microbiological analyses collected, before and after the interventions for both groups, partial efficacy of the disinfectant was observed even when extending rubbing time.

SARS-CoV-2 aerosol generation during respiratory equipment reprocessing.

Aerosolization may occur during reprocessing of medical devices. With the current coronavirus disease 2019 pandemic, it is important to understand the necessity of using respirators in the cleaning area of the sterile processing department. To evaluate the presence of severe acute respiratory syndrome coronavirus (SARS-CoV-2) in the air of the sterile processing department during the reprocessing of contaminated medical devices.

Impact of negative pressure system on microbiological air quality in a Central Sterile Supply Department.

Objective: Guidelines recommend that the cleaning area in a Central Sterile Supply Department (CSSD) maintain a negative pressure of the environmental air, but how much this system can impact the contamination of the air by bioaerosols in the area is not known. The objective of this study was to assess the impact of negative pressure on CSSD by evaluating the microbiological air quality of this sector.

Methods: Microbiological air samples were collected in two CSSD in the same hospital: one with and one without a negative air pressure system.

Reuse of pacemakers and implantable cardioverter-defibrillators: systematic review, meta-analysis and quality assessment of the body of evidence.

Background: Pacemakers (PMs) and implantable cardioverter-defibrillators (ICDs) have reduced mortality and improved the quality of life of cardiac patients. However, the high cost of these devices prevents their large-scale incorporation, particularly in low-income countries, where reusing explanted PMs/ICDs has become an alternative.

Methods: A systematic review and meta-analysis were conducted of studies that compare infection rates, device-related deaths, malfunction and premature battery depletion in patients with reused PM and ICD implants and those with new devices.

Melaleuca alternifolia essential oil soap: a potential alternative for hand hygiene.

This study aimed to compare the antimicrobial action of three soaps for hand hygiene (HH): 2.0% Tea Tree Oil (TTO); 0.5% triclosan; 2.

Performance evaluation of chemical, biological and physical indicators in the process of sterilization under the effect of non-condensable gases.

Background: The risk concerning the presence of non-condensable gases (NCGs) has already been demonstrated, but routine monitoring still requires further research to be implemented in each sterilization cycle.

Aim: Performance evaluation of the physical, chemical and biological indicators used in monitoring in comparison with a sterilizer integrated detector for NCG in the Sterilization Process.

Methods: Chemical indicators (type 2 Bowie-Dick test, type 5 and type 6 models), self-contained biological indicators and physical indicators (temperature, pressure, thermal qualification and a patented integrated air detector) were used to monitor the steam sterilization process in two situations of controlled failure: chamber leakage and door seal failure.

Review: Trends in Processing Prion-Contaminated Surgical Instruments.

This review sought to provide an overview of proposed methods and protocols for processing surgical instruments contaminated with prions. A search of PubMed was conducted to identify studies published between January 1, 2012, and January 2, 2019, with no language restrictions and using varying combinations of the following terms: prions (Medical Subject Heading [MeSH]) OR decontamination (MeSH) OR cleaning OR disinfection OR sterilization. Articles were excluded if they did not involve medical device surfaces or describe the processing protocol.

Steam Sterilization Chemical Indicators Are Not Adequate for Monitoring Real Steam Sterilization Cycles.

Chemical indicators are commonly used in hospitals to monitor steam sterilization conditions, indicating that medical devices are safe to be used. The results are stored for future evidence in the event of an infection incident root cause analysis. This type of indicator is also becoming an option for cycle monitoring in pharmaceutical steam sterilizers, improving cycle control.

The Effect of Brush Motion and Rinsing When Manually Cleaning Cannulated Medical Devices.

Cleaning cannulated medical devices can be challenging for perioperative and sterile processing department personnel. We performed a laboratory experimental study to evaluate differences in cleaning effectiveness using either a back-and-forth or helical spinning brushing motion and the effect of rinsing the bristles at each reintroduction of the brush in the lumen. We also tested the lumen cleanliness after high-pressure water cleansing without brushing.

Steam sterilization chemical indicators are not adequate for monitoring real steam sterilization cycles.

Chemical indicators are commonly used in hospitals to monitor steam sterilization conditions, indicating that medical devices are safe to be used. The results are stored for future evidence in the event of an infection incident root cause analysis. This type of indicator is also becoming an option for cycle monitoring in pharmaceutical steam sterilizers, improving cycle control.

False positive results of Bowie and Dick type test used for hospital steam sterilizer with slower come-up ramps: A case study.

Objective: To determine if the standardized B&D type test for hospital steam sterilizer is correctly indicating cycle failures in slower come-up ramps cycles.

Methods: Two commercially available B&D type test were challenged in a quality control sterilizer. A common failure was simulated in triplicate cycles, using a standardized cycle configuration, and then compared to triplicate cycles of a common cycle configuration.

The polytetrafluoroethylene (PTFE) channel model of cyclic-buildup biofilm and traditional biofilm: The impact of friction, and detergent on cleaning and subsequent high-level disinfection.

Objective: To evaluate the efficacy of detergent and friction on removal of traditional biofilm and cyclic-buildup biofilm (CBB) from polytetrafluoroethylene (PTFE) channels and to evaluate the efficacy of glutaraldehyde to kill residual bacteria after cleaning.

Methods: PTFE channels were exposed to artificial test soil containing 108 CFU/mL of Pseudomonas aeruginosa and Enterococcus faecalis, followed by full cleaning and high-level disinfection (HLD) for five repeated rounds to establish CBB. For traditional biofilm, the HLD step was omitted.

: Recovery of Microorganisms in Nonsterile, Reusable, Loaned Orthopedic Implants.

Currently, there are two orthopedic implant types: (1) Sterile implants (e.g., joint prostheses) are distributed in a ready-for-use sterile fashion, and (2) nonsterile implants (e.

Norovirus recovery from floors and air after various decontamination protocols.

Background: The dispersal of airborne norovirus (NoV) particles from the floor after contamination with faeces or vomit is a challenge for infection control, as this pathogen is infectious at low doses. Therefore, it is imperative to establish a safe protocol for floor decontamination.

Aim: To assess the presence of residual NoV-GII particles on floors and airborne particles following various floor decontamination procedures.

Manual and Automated Cleaning Are Equally Effective for the Removal of Organic Contaminants From Laparoscopic Instruments.

OBJECTIVE To compare the effectiveness of manual and automated methods for cleaning laparoscopic instruments. DESIGN Experimental laboratory study. METHODS We evaluated 4 methods of cleaning laparoscopic instruments: (1) manual-only cleaning and rinsing with potable tap water; (2) manual cleaning and rinsing with potable tap water, followed by ultrasonic cleaning without rinsing; (3) manual cleaning and rinsing with potable tap water followed by ultrasonic cleaning and rinsing with potable tap water; and (4) manual cleaning and rinsing with potable tap water, followed by ultrasonic cleaning and rinsing: first with potable tap water and then with sterile distilled water.

Microbiological evaluation of the steam sterilization of assembled laparoscopic instruments.

Objective: assess the safety of steam sterilization of assembled laparoscopic instruments with challenge contamination.

Method: a laboratory experimental study, using as test samples trocars and laparoscopic graspers. Geobacillus stearothermophillus ATCC-7953 was used, with a microbial population of 106UFC/Filter paper substrate, removed from the biological indicator.

The practice of disinfection of high-speed handpieces with 70% w/v alcohol: An evaluation.

A high-speed handpiece is used in several dental procedures and the official recommendation for safe decontamination consists of rinsing with water, washing with detergent, mechanical friction, and sterilization; however, many professionals only apply 70% w/v alcohol without also cleaning the tool between patients. We performed an analysis of high-speed handpieces reprocessed only with 70% w/v alcohol and found that the methods used in clinical practice are not safe.