[Reducing Abnormal Culture Rates of Digestive Endoscopy in a Health Management Center].

BACKGROUND: Endoscopic evaluation plays an indispensable role in medical treatments designed to prevent, diagnose, and cure gastrointestinal disease. Surveillance culture monitoring may be useful in monitoring the outcome of reprocessing. PURPOSE: In this project, microbiologic surveillance cultures were employed to improve the quality of flexible endoscope disinfection. RESOLUTION: This project, implemented from February 1st, 2018 to February 28th, 2019, used several approaches to improve the positive culture rate. We redesigned and implemented the standard operating procedures for endoscope reprocessing, established an in-service training course, provided education materials on reprocessing, and installed a storage cabinet that custom-built to accommodate the endoscope. RESULTS: The positive culture rate was reduced from 5.8% to 0%. CONCLUSIONS: Endoscopy culturing is a useful method to assess the effectiveness of standard reprocessing procedures. The development of guidelines and skill practices should follow current, evidence-based practice and infection prevention principles, and related documents should be organized. We suggest regularly deploying quality-improvement techniques to improve performance and service delivery.

Two-dimensional gas chromatography with electron capture detection for the analysis of atmospheric ozone depleting halocarbons.

This study is to develop a GC×GC method with electron capture detection (ECD) to analyze atmospheric halocarbons in the concentration range of parts per trillion by volume (pptv). To enrich atmospheric halocarbons a home-built thermal desorption (TD) device was coupled to the GC×GC-ECD. The technique of flow modulation was adopted using a Deans switch for GC×GC. Several column combinations of first and second dimensions were tested and the column set of DB-5×TG-1301 was found to show the best orthogonality for halocarbons. A series of modulation parameters were tested for their optimal settings. The modulation period (PM) was found to have minimal wrap-around when set at 3s. The modulation ratio (MR) was determined to be 7.82 to ensure reproducible results and maximum sensitivity. The modulation duty cycle (DC) was calculated to be approximately 0.17. Nine halocarbons were separated successfully and seven were calibrated with the use of a certified standard gas mixture. The correlation coefficients (R2) were greater than 0.9972. The reproducibility was better than 1.90% as expressed in relative standard deviation (RSD; N=30) and the detection limits were in the range of pptv for the target halocarbons. A field test by continuous analyzing ambient air with hourly resolution was performed to show the stability of the method as suggested by the homogeneity of certain halocarbons, while also reflecting concentration variation for others when emissions did arise.

Microwave-enhanced persulfate oxidation to treat mature landfill leachate.

Microwave oxidation process (MOP) was evaluated for treatment of landfill leachate. Kinetics of persulfate oxidation in MOP, effects of pH and persulfate doses on fates of derivative organic acids, and the energy cost of MOP were evaluated. The results showed that total organic carbon (TOC) removal of 79.4%, color removal of 88.4%, and UV254 removal of 77.1% were reached at MOP 550 W/85 °C within 30 min. The kinetics of oxidation by MOP followed the first-order reaction. For a given persulfate dose, the reaction rate increased with the microwave power setting (775 W>550 W>325 W>128 W) with reaction rate constants ranging from 10(-5) to 10(-2) min(-1). The adverse effects on reaction rates under higher microwave power settings and high persulfate doses are plausibly caused by excessive persulfate oxidation and self-scavenging termination of free radicals. During the MOP treatment, TOC/COD ratio dropped with time and an 86.7% reduction in TOC/COD ratio after 120 min at pH 7. Oxalic acid was the major derivative and its concentrations were higher under acidic conditions. Malic, lactic, and acetic acids were formed and soon degraded, and the solution pH has an insignificant effect on their fates. The energy cost of MOP (USD$6.03/m(3)) is essentially similar to that of conventional heating oxidation (CHO) (USD$6.10/m(3)).

A study on microwave oxidation of landfill leachate--contributions of microwave-specific effects.

Microwave oxidation process (MOP) was evaluated for treatment of landfill leachate. The experimental parameters include pH, temperature, oxidant doses, microwave power setting, and irradiation time. The study explored the microwave-specific effects of the MOP. The contributions of pure thermal, persulfate oxidation and microwave irradiation on TOC removal were quantified. It was then found the combinations of them were usually synergistic in MOP except two of them were antagonistic (128 W/85°C/1M Na(2)S(2)O(8) and 128 W/85°C/2M Na(2)S(2)O(8)). At the highest temperature tested (85°C) in this study, microwave irradiation may cause generation and termination of oxidizing radicals at adverse rates. The study also found that persulfate decayed rapidly in either MOP or conventional heating oxidation (CHO) treatment of landfill leachate.

Derivative mechanisms of organic acids in microwave oxidation of landfill leachate.

This study compared formation and degradation behaviors of organic acids in landfill leachate under microwave oxidation process (MOP) and under conventional heating oxidation (CHO) and explored derivative mechanisms of organic acids in MOP. The results showed that formation and degradation behaviors of oxalic acid were very similar under CHO and MOP, in which its concentrations decreased in the temperature-raising period, then increased due to decomposition of TOC from 10 to 70 min, decreased due to persulfate oxidation from 70 to 130 min, and stayed the same afterwards. The pH values of the leachate solution dropped 0.51 and 0.65 pH units after MOP and CHO treatment, respectively. Oxalic acid was the dominant organic acid formed in MOP. The derivative mechanisms of organic acids were developed using the experimental results. Lactic acid was generated from decomposition of malic acid, and oxalic acid was formed from oxidation of its precursors. Acetic acid was formed and soon decomposed. Lactic acid had its maximum concentration with a persulfate dose of 0.5M, while lower or higher persulfate doses yielded few or no lactic acid in MOP.