Standard hospital blanket warming cabinets can be utilized for complete moist heat SARS-CoV2 inactivation of contaminated N95 masks for re-use

Shortages of personal protective equipment for use during the SARS-CoV-2 pandemic continue to be an issue among health-care workers globally. Extended and repeated use of N95 filtering facepiece respirators without adequate decontamination is of particular concern. Although several methods to decontaminate and re-use these masks have been proposed, logistic or practical issues limit adoption of these techniques. In this study, we propose and validate the use of the application of moist heat (70 °C with humidity augmented by an open pan of water) applied by commonly available hospital (blanket) warming cabinets to decontaminate N95 masks. This report shows that a variety of N95 masks can be repeatedly decontaminated of SARS-CoV-2 over 6 h moist heat exposure without compromise of their filtering function as assessed by standard fit and sodium chloride aerosol filtration efficiency testing. This approached can easily adapted to provide point-of-care N95 mask decontamination allowing for increased practical utility of mask recycling in the health care setting.

VeriMask

The US CDC has recognized moist-heat as one of the most effective and accessible methods of decontaminating N95 masks for reuse in response to the persistent N95 mask shortages caused by the COVID-19 pandemic. However, it is challenging to reliably deploy this technique in healthcare settings due to a lack of smart technologies capable of ensuring proper decontamination conditions of hundreds of masks simultaneously. To tackle these challenges, we developed an open-source wireless sensor platform---VeriMask1 ---that facilitates per-mask verification of the moist-heat decontamination process. VeriMask is capable of monitoring hundreds of masks simultaneously in commercially available heating systems and provides a novel throughput-maximization functionality to help operators optimize the decontamination settings. We evaluate VeriMask in laboratory and real-scenario clinical settings and find that it effectively detects decontamination failures and operator errors in multiple settings and increases the mask decontamination throughput. Our easy-to-use, low-power, low-cost, scalable platform integrates with existing hospital protocols and equipment, and can be broadly deployed in under-resourced facilities to protect front-line healthcare workers by lowering their risk of infection from reused N95 masks. We also memorialize the design challenges, guidelines, and lessons learned from developing and deploying VeriMask during the COVID-19 Pandemic. Our hope is that by reflecting and reporting on this design experience, technologists and front-line health workers will be better prepared to collaborate for future pandemics, regarding mask decontamination, but also other forms of crisis tech.

Thermal Disinfection Validation: The Relationship Between A0 and Microbial Reduction

Validating a thermal disinfection process for the processing of medical devices using moist heat via direct temperature monitoring is a conservative approach and has been established as the A0 method. Traditional use of disinfection challenge microorganisms and testing techniques, although widely used and applicable for chemical disinfection studies, do not provide as robust a challenge for testing the efficacy of a thermal disinfection process. Considerable research has been established in the literature to demonstrate the relationship between the thermal resistance of microorganisms to inactivation and the A0 method formula. The A0 method, therefore, should be used as the preferred method for validating a thermal disinfection process using moist heat.

Effect of Baihu and Guizhi Decoction in acute gouty arthritis: a randomized, double-blind, controlled clinical study

Background The prevalence rates of gout worldwide have increased annually. Acute gouty arthritis (AGA) accounts for a large proportion of gout patients and causes severe physical and mental pain in patients. Controlling the occurrence and development of gout inflammation is the first step in the treatment of gout. The main treatment drugs in gout are Non-Steroid Anti-Inflammatory Drugs (NSAIDS), colchicine and glucocorticoids, but these treatments have many adverse reactions which limit their clinical application. Baihu and Guizhi decoction (BHGZ) is one of the classic prescriptions in the Synopsis of the Golden Chamber, and is a good prescription for AGA. Previous clinical studies have shown that BHGZ confers a strong benefit for treating AGA. However, the literature shows a lack of high-quality RCT research on BHGZ with respect to AGA. Therefore, in this study, we use a randomized, double-blind, controlled study with a placebo to evaluate the clinical efficacy and safety of BHGZ on the AGA of moist heat arthralgia spasm syndrome. Methods This study is a randomized, double-blind, controlled clinical trial. A total of 102 adult participants with AGA of moist heat arthralgia spasm syndrome will be enrolled, with balanced treatment allocation (1:1). The experimental intervention will be BHGZ plus the low-dose colchicine and the control intervention will be placebo plus the low-dose colchicine for 10 days. To study the clinical efficacy (including VAS score; joint tenderness, joint swelling, joint movement disorder; TCM evidence efficacy score) and the changes of inflammatory indexes. At the same time, the improvement of joint inflammation in patients with AGA will be observed from musculoskeletal ultrasound imaging, and the safety evaluation will be carried out. Discussion This study will be the first placebo-controlled RCT to assess whether BHGZ plus low-dose colchicine have beneficial effects on changing reducing inflammation of joints for patients with AGA of moist heat arthralgia spasm syndrome. The results of this trial will help to provide evidence-based recommendations for clinicians. Trial registration: Chinese Clinical Trials Register, ChiCTR1900024974. Registered on 5 August 2019.