Elevating the standard of endoscope processing: Terminal sterilization of duodenoscopes using a hydrogen peroxide-ozone sterilizer.

BACKGROUND: The health care community is increasingly aware of the processing challenges and infection risks associated with duodenoscopes owing to published reports of outbreaks and regulatory recalls. Studies have demonstrated that the current practices are inadequate for consistently producing patient-ready endoscopes. Alternatively, terminal sterilization would offer a greater margin of safety and potentially reduce the risk of patient infection. The purpose of this study was to evaluate the efficacy of a hydrogen peroxide-ozone sterilizer with regulatory clearance for terminal sterilization of duodenoscopes. METHODS AND RESULTS: Validation studies were performed under laboratory simulated-use and clinical in-use conditions. The overkill method study demonstrated a reduction of at least 6-log of Geobacillus stearothermophilus spores at half-cycle, providing a sterility assurance level of 10-6. In addition, the sterilizer achieved a 6-log reduction of G stearothermophilus in the presence of inorganic and organic soils in a simulated-use study. The clinical in-use study confirmed that the sterilizer achieved sterilization of patient-soiled duodenoscopes under actual use conditions. CONCLUSIONS: Simulated-use and clinical in-use studies demonstrated the efficacy of a hydrogen peroxide-ozone sterilizer for terminal sterilization of duodenoscopes. This offers health care facilities a viable alternative for duodenoscope processing to enhance patient safety as part of a comprehensive infection control strategy.

"That's really clever!" Ironic hyperbole understanding in children.

Hyperbole supports irony comprehension in adults by heightening the contrast between what is said and the actual situation. Because young children do not perceive the communication situation as a whole, but rather give precedence to either the utterance or the context, we predicted that hyperbole would reduce irony comprehension in six-year-olds (n = 40) by overemphasizing what was said. By contrast, ten-year-olds (n = 40) would benefit from hyperbole in the way that adults do, as they would perceive the utterance and context as a whole, highlighted by the speaker's ironic intent. Short animated cartoons featuring ironic criticisms were shown to participants. We assessed comprehension of the speaker's belief and speaker's intent. Results supported our predictions. The development of mentalization during school years and its impact on the development of irony comprehension is discussed.

Acoustic analysis of oral productions of infants later diagnosed with autism and their mother.

Research on early signs of autism in social interactions often focuses on infants' motor behaviors; few studies have focused on speech characteristics. This study examines infant-directed speech of mothers of infants later diagnosed with autism (LDA; n = 12) or of typically developing infants (TD; n = 11) as well as infants' productions (13 LDA, 13 TD). Since LDA infants appear to behave differently in the first months of life, it can affect the functioning of dyadic interactions, especially the first vocal productions, sensitive to expressiveness and emotions sharing. We assumed that in the first 6 months of life, prosodic characteristics (mean duration, mean pitch, and intonative contour types) will be different in dyads with autism. We extracted infants' and mothers' vocal productions from family home movies and analyzed the mean duration and pitch as well as the pitch contours in interactive episodes. Results show that mothers of LDA infants use relatively shorter productions as compared to mothers talking to TD infants. LDA infants' productions are not different in duration or pitch, but they use less complex modulated productions (i.e., those with more than two melodic modulations) than do TD. Further studies should focus on developmental profiles in the first year, analyzing prosody monthly.