Operator Training Research Articles

Automated Weld Path Generation in Cluttered Environments Using Segmentation and Iterative Closest Point Workpiece Localization

Abstract A significant amount of manufacturing is performed by small to medium enterprises (SMEs), but these manufacturers often have lower adoption rates of automation. The cost and complexity associated with traditional robot systems slow the adoption of robotic welding operations for SMEs. The recent increase in collaborative robotic welding systems is bridging the gap, however, by reducing the complexity of installing, maintaining, and training operators to perform weld operations with collaborative robotics. These systems add flexibility in the range of operator use and ease of deployment. These systems however still rely on kinematic registration between the robot-mounted torch and workpiece on any open-loop weld. This requires precise placement of the workpiece prior to performing a weld. This work will discuss a method for part identification and registration in a welding task as a step toward automated weld path generation. The method is based on lower-resolution 3D cameras (RGBD cameras) using a combination of color and depth information. This information is used to both identify the workpiece within a workspace that may have other, non-workpiece items, and then provide registration or localization information of the workpiece within a resolution that could allow follow-on near-position strategies to achieve final weld path identification.

The second Latin American catheter ablation registry ("II LAHRS EP registry").

Patient's clinical characteristics, technical resources, center and operator volume, and operator experience and training are known variables impacting outcomes. Although international standards have been agreed to maximize the benefits of this therapy, regional and global differences still exist. Latin American information has not been updated in the last 10years. This study aimed to analyze current information on operators, centers, and CA in Latin America. Observational, retrospective study collecting Latin American information on operators and centers participating in CA, and procedures performed in 2023, from January 1 to December 31. Electrophysiologists 178 (18 countries). Mean age 46,8 ± 9,2 (28-74) years. Male 86,5%. AFib, VT, and cardioneuroablation were performed by 80,2%, 70,9%, and 35,5% of operators respectively. Centers 175 (17 countries). Private 79,4% and academic 44,0%. Low volume (< 50/year) represented 36,6% and 38,3% performed ≥ 100 ablations/year. Procedures 7.595 (8.284 arrhythmias, 17 countries, 134 centers, 76 electrophysiologists). Patients mean age 51,5 ± 19,3 (1-95) years, male 55,3%, and 77,5% had a structurally normal heart. RF was the energy in 95,6% of procedures, cryoablation in 4,7%, and PFA in 0,2%. The most frequently treated arrhythmias were AFib (28,2%), AVNRT (20,9%), APs (15,8%), and PVC/NSVT (8,3%). Global success and complication rates were 93,6% and 3,0%, respectively and mortality 0,05%. II LAHRS EP Registry brings new and interesting data related to EP in Latin America. Electrophysiologists showed acceptable levels of experience, skills, and qualification. Although centers revealed an under-ideal availability of infrastructure and technical resources, the results of CA were comparable to other registries worldwide.

Complication Rates After Ultrasonography-Guided Nerve Blocks Performed in the Emergency Department.

Ultrasonography-guided nerve blocks (UGNBs) have become a core component of multimodal analgesia for acute pain management in the emergency department (ED). Despite their growing use, national adoption of UGNBs has been slow due to a lack of procedural safety in the ED. To assess the complication rates and patient pain scores of UGNBs performed in the ED. This cohort study included data from the National Ultrasound-Guided Nerve Block Registry, a retrospective multicenter observational registry encompassing procedures performed in 11 EDs in the US from January 1, 2022, to December 31, 2023, of adult patients who underwent a UGNB. UGNB encounters. The primary outcome of this study was complication rates associated with ED-performed UGNBs recorded in the National Ultrasound-Guided Nerve Block Registry from January 1, 2022, to December 31, 2023. The secondary outcome was patient pain scores of ED-based UGNBs. Data for all adult patients who underwent an ED-based UGNB at each site were recorded. The volume of UGNB at each site, as well as procedural outcomes (including complications), were recorded. Data were analyzed using descriptive statistics of all variables. In total, 2735 UGNB encounters among adult patients (median age, 62 years [IQR, 41-77 years]; 51.6% male) across 11 EDs nationwide were analyzed. Fascia iliaca blocks were the most commonly performed UGNBs (975 of 2742 blocks [35.6%]). Complications occurred at a rate of 0.4% (10 of 2735 blocks). One episode of local anesthetic systemic toxicity requiring an intralipid was reported. Overall, 1320 of 1864 patients (70.8%) experienced 51% to 100% pain relief following UGNBs. Operator training level varied, although 1953 of 2733 procedures (71.5%) were performed by resident physicians. The findings of this cohort study of 2735 UGNB encounters support the safety of UGNBs in ED settings and suggest an association with improvement in patient pain scores. Broader implementation of UGNBs in ED settings may have important implications as key elements of multimodal analgesia strategies to reduce opioid use and improve patient care.

Advancements in equine ophthalmic imaging enhance understanding of ocular and orbital anatomy and disease in standing sedated horses.

To review data on the advances in equine ophthalmic imaging that have been made during the past 5 years and highlight advantages of using multiple imaging modalities to improve clinical observational skills and improve diagnostic accuracy. A literature review from 2019 through 2024 of equine ophthalmic digital photography, fundus photography, ocular and orbital ultrasonography (US), ultrasound biomicroscopy (UBM), confocal microscopy (CM), spectral domain optical coherence tomography (SD-OCT), radiography, CT, and MRI. Digital photography remains the cornerstone of equine ophthalmic imaging for documenting examination findings, sharing information with colleagues, and consulting with specialists. Digital images also allow for in-depth postexamination review and evaluation, often revealing subtleties that may have otherwise gone undetected during the ophthalmic examination. Advanced imaging modalities are being used more frequently in equine ophthalmology, especially those that can be used with the horses standing under sedation, including US, UBM, SD-OCT, CM, and CT. Advances in equine ophthalmic imaging have led to many new clinical discoveries and to an increase in our knowledge of ocular anatomy and diseases in the horse. Many of these advanced diagnostic imaging modalities, such as MRI, CT, SD-OCT, and CM, are cost prohibitive and require substantial operator training to ensure proficiency. However, their availability in tertiary referral centers, such as veterinary teaching hospitals and large equine clinics/practices, is becoming more widespread. Advanced equine ophthalmic imaging data contributes substantially to our general understanding of clinical and applied anatomy and improves our understanding of the underlying pathogenesis associated with specific diseases.

A novel machine-learning aided platform for rapid detection of urine ESBLs and carbapenemases: URECA-LAMP.

Pathogenic gram-negative bacteria frequently carry genes encoding extended-spectrum beta-lactamases (ESBL) and/or carbapenemases. Of great concern are carbapenem resistant Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii. Despite the need for rapid AMR diagnostics globally, current molecular detection methods often require expensive equipment and trained personnel. Here, we present a novel machine-learning-aided platform for the rapid detection of ESBLs and carbapenemases using Loop-mediated isothermal Amplification (LAMP). The platform consists of (i) an affordable device for sample lysis, LAMP amplification, and visual fluorometric detection; (ii) a LAMP screening panel to detect the most common ESBL and carbapenemase genes; and (iii) a smartphone application for automated interpretation of results. Validation studies on clinical isolates and urine samples demonstrated percent positive and negative agreements above 95% for all targets. Accuracy, precision, and recall values of the machine learning model deployed in the smartphone application were all above 92%. Providing a simplified workflow, minimal operation training, and results in less than an hour, this study demonstrated the platform's feasibility for near-patient testing in resource-limited settings.IMPORTANCEExtended-spectrum beta-lactamases (ESBL) and carbapenemases confer resistance to third-generation cephalosporins and carbapenems in pathogenic Gram-negative bacteria such as Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii. Conventional antimicrobial susceptibility testing is based on phenotypic methods, and results can take several days to be obtained. Current genotypic detection methods can be rapid but require expensive equipment and trained personnel. In this study, we present a novel machine learning-aided platform for the rapid detection of ESBLs and carbapenemases using Loop-mediated isothermal Amplification (LAMP). The validation of the platform demonstrated percent positive and negative agreements above 95% for all targets. The newly developed platform provided a simplified workflow, minimal technical training, and results in less than an hour. This study demonstrated the platform's feasibility for rapid testing of ESBL and carbapenemases in bacteria and urine specimens.

The Application of Augmented Reality (AR) and Virtual Reality (VR) in Apparel Manufacturing and Operator Training

The integration of Augmented Reality (AR) and Virtual Reality (VR) into various industries has revolutionized training, production processes, and operational efficiency. The apparel industry faces challenges in operator training, resulting in decreased productivity and increased errors when frequent style change occurs. The creation of an AR/VR system for training purposes could serve as a valuable tool. In the sewing and apparel industry, these technologies have been gaining attention for their potential to streamline processes, enhance skill development, and optimize operator training. This study contributes to the apparel industry by introducing innovative education and training methods, enhancing the skills and knowledge of professionals, and improving manufacturing efficiency and quality and the other broader benefits these technologies offer.

Dynamic sequential cross-sectional scanning increases detection rate of congenital heart disease in sonographers: a prenatal ultrasound training program

BackgroundPrenatal ultrasound is the preferred modality for diagnosing fetal congenital heart disease. Given issues of physician proficiency and hospital distribution, we propose a dynamic sequential cross-sectional scanning (SCS) to explore the feasibility of cardiac screening by sonographers with less than 5 years of experience in ultrasound.Materials and methodsTwenty residents were randomly divided into two groups, receiving training in the American Institute of Ultrasound in Medicine (AIUM) fetal echocardiography and the SCS method. According to the needs of training, the professional staff developed the theoretical knowledge question bank, the CHD ultrasonic video disease bank, and the assessment scale. Trainees completed the pre-training examination, theory and skill operation training, and post-training assessment. For the two groups, the theoretical knowledge, skill operation and disease diagnosis were analyzed statistically before and after training.ResultsAfter training, the trainees in both groups had significantly improved knowledge and diagnostic abilities, their diagnostic thinking about CHD was clear, and they could identify major or even all structural abnormalities and make a definite diagnosis. In terms of skill operation, both groups could complete all required scanning within the specified time. The scanning time of the SCS group was significantly lower than that of the AIUM group, and the effect of the receptor site in the AIUM group was significantly higher than that in the SCS group.ConclusionSCS can be used as a new rapid fetal cardiac scanning method and try to popularize among echocardiographer.

Advancements and challenges in Shear-Wave Elastography of tendons: a comprehensive review.

Shear-Wave Elastography (SWE) has emerged as a promising non-invasive imaging technique for assessing the mechanical properties of tendons, particularly larger and more superficially located tendons of the body. Despite its potential, significant variability in SWE measurements exists due to differences in protocols, positioning, and equipment. Standardizing these factors, enhancing operator training, and reporting reliability metrics are crucial to improve the consistency and comparability of SWE data. This review aims to synthesize current knowledge and report on the existing practices in tendon SWE. By addressing the current challenges and variability, SWE has the potential to become a reliable tool for diagnosing and monitoring tendon pathologies, ultimately enhancing patient care and outcomes.

Simulation of Coherent Excavator Operations in Earthmoving Tasks Based on Reinforcement Learning

Earthwork operations are critical to construction projects, with their safety and efficiency influenced by factors such as operator skill and working hours. Pre-construction simulation of these operations is essential for optimizing outcomes, providing key training for operators and improving safety awareness and operational efficiency. This study introduces a hierarchical cumulative reward mechanism that decomposes complex operational behaviors into simple, fundamental actions. The mechanism prioritizes reward function design elements, including order, size, and form, thus simplifying excavator operation simulation using reinforcement learning (RL) and enhancing policy network reusability. A 3D model of a hydraulic excavator was constructed with six degrees of freedom—comprising the boom, arm, bucket, base, and left/right tracks. The Proximal Policy Optimization (PPO) algorithm was applied to train four basic behaviors: scraping, digging, throwing, and turning back. Motion simulation was successfully achieved using diggable terrain resources. Results demonstrate that the simulated excavator, powered by RL neural networks, can perform coordinated actions and maintain smooth operational performance. This research offers practical implications by rapidly illustrating the full operational process before construction, delivering immersive movies, and enhancing worker safety and operational efficiency.

Advancing Nuclear Research and Education in Slovenia and EU: From Operating the TRIGA Reactor to Building a New Generation Facility

AbstractThe TRIGA Mark II research reactor at the Jožef Stefan Institute in Slovenia achieved first criticality in 1966. Since then, the reactor has been playing an important role in developing nuclear technology. The reactor has been mainly used for research, education of university students, training of operators of the Krško nuclear power plant (start of operation in 1983) and other nuclear specialists, isotope production and beam applications. The reactor is experiencing a high level of activity today, engaging in a diverse range of experiments and studies across reactor physics, environmental research, radiation hardness testing as well training and education. The future of nuclear technology in Slovenia is focused on new NPPs, while the research community is looking forward to a possible new nuclear reactor. The basic initiatives are at a very preliminary stage: the primary choice is dual-core pool-type reactor, with a zero-power core and a separate MW-size core, cooled and moderated with light water. Such a dual-core configuration is designed to meet the varied requirements of the European Union member states. Another option would be hosting one or more micro-reactors with electrical and/or heating power producing capability that could offer stronger support toward demonstration of prototype small modular reactors in prototype future electrical grids.

Unlocking the power of immersive learning: The FAIRI instructional design proposition for adaptive immersive virtual reality

Immersive Virtual Reality (IVR) is a promising tool for providing immersive and adaptive learning experiences by simulating realistic work environments and gathering data on learner's interactions to offer personalized instructional content. However, IVR-supported instruction presents unique challenges due to its heightened immersion, including managing the learner's cognitive load and self-regulation. Incorporating adaptivity into IVR can mitigate these challenges by regulating the complexity of the virtual environment, reducing cognitive strain, and maintaining learner focus through real-time feedback for both learners and instructors. However, recent reviews highlight the underutilization of adaptivity within IVR research, making it difficult to inform the design of adaptive IVR instruction.This paper proposes FAIRI, an instructional design for adaptive IVR in domain-specific training. FAIRI synthesizes recent IVR research relevant to the design of adaptivity for IVR through a purposive literature review, guided by the instructional design elements of the Four-Component Instructional Design-model (4C/ID) and Intelligent Tutoring Systems (ITS). The instructional design elements of the 4C/ID-model and ITS are evaluated for their potential viability and further refined for adaptive IVR-supported instruction based on recent IVR studies. Two key design principles are identified for adaptive IVR: limiting IVR to tasks that benefit from its heightened realism and leveraging its adaptive features to manage the intensity of the experience. Additionally, the application of FAIRI's design principles and elements are demonstrated through a forklift operator training case in IVR. FAIRI aims to catalyse further research into adaptivity for IVR by proposing and aligning promising instructional design elements for adaptive IVR instruction.

From knowledge to action: Assessing the effectiveness of immersive virtual reality training on safety behaviors in confined spaces using the Kirkpatrick model

Safety in the industrial sector is paramount, with national legislations establishing specific regulations to reduce accidents. These regulations emphasize risk removal and proper operator training as preventive measures. However, traditional training can be time-consuming and costly, leading companies to meet only the minimum requirements. In particular, confined spaces pose significant dangers, often resulting in fatal, cascading accidents due to a lack of proper safety procedures. Therefore, effective training is crucial to mitigate these risks.Advanced technologies like Immersive Virtual Reality (IVR) present new opportunities for cost-effective and extensive training campaigns by eliminating the risks associated with real environment training, offering a safe yet realistic experience.Despite the widespread adoption of IVR training applications in industrial research, there is a notable lack of systematic approaches to evaluate their effectiveness. Conducting such evaluations is crucial to ascertain their impact on essential training outcomes, including participant engagement, knowledge transfer, and enhanced safety behavior during work activities.To address this gap, we developed an IVR-based training platform for confined space safety procedures and established a systematic validation procedure using the Kirkpatrick model to assess its effectiveness compared to conventional training methods. Results demonstrate that IVR training provides an excellent user experience, better knowledge transfer than the traditional approach, and improved performance in simulated procedures, reducing execution errors and completion times. This dual focus on creating and validating the IVR system underscores its potential as an effective training tool in hazardous environments such as confined spaces, where proper training can prevent tragic fatalities.

A Comprehensive Review of Unmanned Aerial Vehicle (UAV) Sprayers Used in Modern Agriculture

Global demand for food is increasing daily due to increase in population growth. Hence to meet these food demands for the growing population crop productivity must be enhanced. Plant pests and diseases are major threats to crop productivity causing an annual reduction of 20 to 40% in global crop production. For management of these pest and diseases spraying using manual sprayers is quite laborious and also not precise. Further manual spraying is hazardous to farmer’s health, World Health Organization (WHO) reported one million incidences of illness as a result of manually application of insecticides to crop fields. As a result, new automated drone technology techniques were unveiled. This review examines the application of Unmanned Aerial Vehicle (UAV) sprayers in modern agriculture, highlighting their transformative role in enhancing crop management and increasing efficiency. UAV technology has emerged as a vital tool for precision agriculture, offering benefits such as targeted pesticide and fertilizer application, reduced labor costs, and minimized environmental impact. This paper discusses the various types of UAV sprayers, their operational mechanisms, and the advantages they provide over traditional methods. Additionally, we explore challenges associated with UAV adoption, including regulatory issues, technical limitations, and the need for operator training. The review emphasizes the future potential of UAV sprayers in sustainable agriculture, suggesting that continued advancements in technology and regulatory frameworks will further integrate UAVs into mainstream agricultural practices.

Village Asset Management Innovations Through Application-Based Systems

Background: Effective asset management in rural areas is vital for transparency and accountability in village governance. Specific Background: This study examines the management of village assets through the Village Asset Management System (SIPADES). Knowledge Gap: Despite its implementation, many villages struggle with systematic asset management, raising concerns about regulatory compliance and efficiency. Aims: The research aims to analyze current asset management practices using SIPADES and identify challenges faced by local administrators. Results: Findings reveal that while SIPADES offers a structured framework, issues with data collection and adherence to regulations hinder its effectiveness. Novelty: This study highlights the need for improved training for local operators in digital asset management. Implications: Enhancing administrators' capacity in SIPADES can lead to better asset management outcomes, promoting accountability in rural governance and aligning practices with national regulations, crucial for sustainable development. Highlights : Structured Framework: SIPADES provides a systematic approach to asset management in villages. Training Needs: Enhanced training for local administrators is essential for effective system utilization. Regulatory Alignment: Addressing compliance issues is crucial for promoting accountability and sustainable development. Keywords: asset management, rural governance, SIPADES, regulatory compliance, transparency

A-247 Performance and Compatibility Assessment of Serially Diluted Microbix QAPTM Controls with Seegene NovaplexTM Assays

Abstract Background Choosing high-quality external (third-party) controls like Microbix QAPTM PROCEEDxTM Controls and REDxTM Controls is crucial during test development, validation of Laboratory Developed Tests (LDTs), performance verification, proficiency testing, instrument qualifications, operator training and R&amp;D testing. Laboratories may prefer to include multiple positive controls at varying concentrations to achieve reliable performance across a broad range of detection concentrations. In this study, we assess the performance and compatibility of Microbix QAPTM PROCEEDxTM liquid Controls and REDxTM swabs with Seegene’s real time qPCR assays that utilize TOCE and MuDTTM technologies. TOCE and MuDTTM technologies achieve multiple reads in a single channel and are the backbone of Seegene’s wide coverage panel assays. Methods The controls below were reconstituted and/or diluted in Copan UTM and extracted on the Seegene STARlet liquid handler using Seegene’s STARmag Universal extraction kit. After extraction, PCR was run on the Bio-Rad CFX 96 Opus Dx and analyzed using the Seegene Viewer software. Results Microbix QAPsTM liquid formulations were tested at various dilutions from stock up to 1/2048 with N=5per dilution. The VP-13-01 Flu A control was detected up to a concentration of1/2048 and at this dilution had Ct values of 30 + 0.3 for the Novaplex Respiratory Panel 1A (RP1A) Assay, 28.6 + 0.3 cycles for the Seegene SARS-CoV-2/FluA/FluB/RSV (Quad) Assay, and 27.9 + 0.3 for the Respiratory Virus Master (RVM) Assay. The Microbix VP-14-01 Flu B control was detected up to 1/2048 with Ct values of 34.3 + 0.3 for the RP1A Assay, 30 + 0.5 for the Quad Assay, and 30.3 + 0.3 for the RVM Assay. The VP-07-01 RSV A control was also detected at a 1/2048 dilution with Ct values of 32.7 + 0.3 for RP1A, 30.6 + 0.6 for Quad Assay, and 29.2 + 0.4 for RVM. The VP-61-01 Trichomonas vaginalis (TV) control was detected up to a dilution of 1/128 with a Ct value of 37.3 + 0.4 when tested with the Seegene Sexually Transmitted Infection Essential (STI) Assay. The VP-02-M1 HSV1 control was detected up to a dilution of 1/128 with a Ct value of 31.3 + 0.7 for the Seegene Genital Ulcer (GU) Assay. The VP-23-M1 HSV2 control was detected p to a dilution of 1/128 with a Ct value of 31.9 + 0.5 for the GU Assay. Microbix also makes a dry swab formulation product line that we tested in 3mL of UTM. Of these we tested the RED-S-10-M1 swab covering the SARS-CoV-2, Flu A, Flu B, and RSV controls. The VP-S-12-M5 swab covering the Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Mycoplasma genitalium (MG), and TV controls. We also tested the VP-S-03-M1 swab covering HSV1, HSV2, VZV and syphilis controls. When tested with various assays all swabs were detected at the stock formulation. Conclusions Microbix QAPsTM are inactivated whole-organism controls, mimicking patient samples, and meet the stringent demand for quality or performance assessments. Their compatibility with Seegene’s Assays over a range of dilutions and formulations makes them ideal for ensuring reliable detection across multiple diagnostic needs.

A-133 Trusted Test Goes Awry: Investigating Dilution Aberrations for Total Bilirubin

Abstract Background A patient with acute decompensated cirrhosis was hospitalized due to lightheadedness and jaundice, undergoing evaluation for a liver transplant. The attending physician brought to the laboratory’s attention a perplexing pattern in the patient's total bilirubin results. Initially, the patient displayed a consistent trend of elevated total bilirubin levels above the upper limit of linearity, ULOL (&amp;gt; 30 mg/dL), which then plummeted to under the limit of quantification (&amp;lt; 0.1 mg/dL) before surging back to &amp;gt; 30 mg/dL. Methods The total bilirubin in heparinized plasma was measured on the AU5800 by Beckman Coulter. Samples &amp;gt; ULOL are diluted automatically 1:3 utilizing the instrument’s on-board dilution feature. The final test results are reported automatically to an electronic medical record. Following the reported incident, an investigation and troubleshooting plan was developed, encompassing the following steps: Repeat patient testing with total bilirubin concentration &amp;gt; 30 mg/dL and &amp;lt;0.1 mg/dL; Rule out the previously reported potential interferences, including Immunoglobin M and acetaminophen; Conduct a 90-day quality control (QC) review; Perform split test analysis on two instruments within the laboratory and at a reference laboratory; Conduct patient chart reviews to identify discrepancies based on previously reported values; Complete a root cause analysis and develop corrective/preventive action plan. Results Patient sample &amp;lt; 0.1 mg/dL was tested on an alternative instrument, resulting &amp;gt; 30 mg/dL. Patient with normal IgM of 161 mg/dL didn’t reveal any other potential drug interferences in chart review. The 3-month QC review found consistent with peer performance. Split comparison of 6 patients revealed discrepancies for samples &amp;gt; 30 mg/dL on one of the two instrument units. When total bilirubin &amp;gt; 30 mg/dL, the malfunctioning unit erroneously reported values &amp;lt; 0.1 mg/dL after dilution. Review of 34 patient charts showed the impact dates were spanned for 39 days. Since the on-board dilution feature is utilized by 10 other analytes, 892 diluted samples were analyzed for discrepancies. 36 discrepant results were identified among 4 affected assays including total bilirubin, direct bilirubin, creatine kinase, and alanine aminotransferase. These results were corrected, and providers were notified. Conclusions The root cause was traced to a malfunction in one instrument unit, despite no malfunction flags. The laboratory QC concentrations fell within the analytical measurement range, missing the dilution issue during the daily QCs. During an extensive repair period, the on-board dilution was disabled on the affected unit and samples were re-routed to alternative instrument for testing. Policy changes and operator training were initiated for a new result verification process, impacting the laboratory productivity. Autoverification of diluted sample results was disabled for all chemistry analyzers. The vendor identified the issue as sample transfer unit crane misalignment in the up/down direction. It is worth noting that proficiency testing or QCs often do not extend beyond the analytical measurement ranges, leading to undetected incidents. Additional quality measures like periodic patient chart reviews, patient sample comparisons, and other quality assurance tools can aid in on-going dilution performance verification. Open communication between the physicians and laboratories is crucial for prompt issue identification and resolution.

A-331 Monitoring Operators Proficiency at Point of Care is Crucial for Reliable Patient Values. A Practical Example with Patient Blood Chloride, Potassium and Sodium Measurands Assayed with i-STAT®

Abstract Background While i-STAT® cartridges offer the Physician a spectrum of analytical methods at the point of care for prompt diagnosis and interventions, these methods have to be harmonized with the laboratory methods in order to reliably detect shifts and trends. With this practical example we illustrate the importance of a program of routine comparisons between the i-STAT® and laboratory methods to detect analytical differences exceeding the CLIA’s criterion and potentially having adverse clinical implications. Methods Patient blood chloride (Cl), potassium (K) and sodium (Na) values as obtained by nurses with i-STAT Chem 8 ™ cartridges (Abbott Laboratories) at the point of care, where daily compared with the values as obtained with the Laboratory method (two cobas 6000®, Roche Diagnostics) using green top BD® lithium heparin tubes (Becton Dickinson) collected within thirty minutes of the i-STAT assay. The data were electronically stored in RALS™ (RALS Informatics) and transferred to Minitab® (Version 21, Minitab Inc.) statistical software. The two analytical methods were compared using the orthogonal and the polynomial ordinary least squares (POLS) regression models and their graphic representations. The aptness of the methods was evaluated with the standardized residuals diagnostics for normality, independence, outliers (Standardized residual &amp;gt;|3|) and influential observations (Hi&amp;gt;0.5). For acceptance of the differences the CLIA’s total error criterion was employed. (CI: target value ± 5%; K: target value ± 0.5 mmol/L; Na: target value ± 4 mmol/L). Results In the first four months of the study the number of differences exceeding the CLIA’s criterion was not acceptable. [Cl: 10% (165/1564); K: 7% (109/1593); Na: 4% (66/1586)]. These differences were occurring throughout the analytical range (AMR). Consequently, the operator’s technique was suspected and the POCT senior technologists (CA, FA) adopted operator specific interventions. This strategy was effective in the following month and the improvements were maintained for seven consecutive months. Monthly differences exceeding the CLIA’s criterion decreased significantly [Cl:1.9% (52/2777): K:0.9% (25/2868): Na:0.5% (15/2896)]. This was clearly illustrated with the dot plot by date and the parallel box plots by month. Regression analysis showed that the orthogonal and the OLS models were equivalent. Cl: Orthogonal y=1.7+0.99x, OLS y=12+0.88x. K; Orthogonal y=0.2+1.2x, OLS y=0.1+0.96x. Na: orthogonal y=3+0.98x, OLS y=14+0.9x. Additionally, the POLS model showed a linear relationship within the AMR intervals with few outliers (Cl=11; K=7; Na=9), no influential observations (Hi&amp;lt;0.5) and equality of monthly regression lines (P&amp;gt;0.05). Conclusions The implementation of daily comparisons between patient values as obtained with the i-STAT method and those as obtained by the Laboratory method in the interval of thirty minutes, allowed the identification of individual operators requiring additional training. This strategy ensured reliable performance for eight consecutive months. This study clearly showed that the addition of continuous supervision and training of operators to quality control and quality assurance practices, ensured the interchangeability of patient values as obtained with i-STAT and those as obtained with the Laboratory method. Electronic collection of data and analysis with appropriate statistical software, such as Minitab, was crucial for the implementation of this program.

Digital Drone Education in Sarawak: Enhancing STEM Learning through Hands-on Training for School Students

In Sarawak, concerns about low STEM enrolment, digital inclusivity gaps for rural children, and the transition from digital consumption to digital creation led to the introduction of the Drone Education Program. Participants began with foundational drone operation training, advancing to capturing images and videos. Subsequently, they were acquainted with elementary photo and video editing techniques, enabling them to enhance their drone-generated content. The aim of this research is to gauge the impact of the Drone Education Program on refining drone operations, bolstering digital editing competencies, and stimulating STEM engagement in students. In our methodology, we employed tailored pre- and post-surveys for evaluation, and younger students provided feedback via an emoji-based survey. Further analytical methods encompassed non-parametric tests, Exploratory Factor Analysis (EFA), and linear mixed-effect modelling. Results indicated significant post-intervention improvements in the targeted skills. The EFA grouped 21 Likert items into five distinct learning domains. Notable insights include district-wise variances in learning outcomes and the influential role of gender. The initiative showcases promise in confronting Sarawak's educational barriers, championing digital inclusivity, and preparing a digitally proficient generation.

An Operations Chain Model for Automatic Assessment of Operation Procedure for Equipment Operators

Automatic assessment of the operation ability of operators based on computers is an essential approach for improving the effectiveness of equipment operation training and enhancing equipment safety. Present methods primarily focus on the operation results but pay less attention to the operation procedure. One reason is that there is a lack of a model that has the ability to describe all probable paths to accomplish the same task. Therefore, an operations chain model is put forward for the first time to describe the standard operation procedure and relationships among operations based on the decomposition of operational tasks and the relationships among the various operations required to fulfill the task. A specific operation task corresponds to an operations chain, which will form one or multiple standard operation sequences that will allow trainees to complete the same task through different paths. The Needleman–Wunsch sequence alignment algorithm is introduced to match the trainees’ operation sequence with all standard sequences. The maximum alignment result is the score of the trainees’ operations. An example shows that the operations chain model can accurately describe the complex structure of the standard operating procedures. The Needleman–Wunsch sequence alignment algorithm can objectively evaluate the trainee’s operation capabilities. The combination of the operations chain model and sequence alignment algorithm can form a complete operation procedure assessment method that is friendlier to trainees and has more objective evaluation results. The method will help to improve the effectiveness of the competency assessment of equipment operators.

Boredom, vigilance, and repetition during remote control room work for autonomous ships

Abstract Introduction: Remote Operating Centers (ROCs) enable human oversight of remotely operated and autonomous ships. However, the “human-in-the-loop” model of automated control oversight implies prolonged periods of inactivity punctuated by safety-critical action. This paper investigates the extent to which this role is aligned with humans’ innate attentional resources in terms of boredom, vigilance, and repetition. Method: A simulator study was completed with ROC operators (volunteer participants with relevant expertise). One group completed a short scenario (5 minutes; N = 16); the other completed a long scenario (30 minutes; N = 16). The duration marked the onset of a stimulus (an alarm), prompting manual takeover. In a mixed method approach, four sources of data were collected, consisting of pupillometry, questionnaire, interview, and video data. Results: Pupillometry data showed larger pupillary constrictions in the 30-minute group, indicative of decreased cognitive activity (effect size 0.25 mm). The questionnaire showed that operators in the 30-minute scenario were more likely to experience their tasks as unchallenging, understimulating, and lacking in meaning. Finally, a relationship was found between repetitive content and varying perceptions of time duration. Moreover, operators perceived scenarios as longer when they detected an “oddball” in the repetitive series (a gorilla passenger). Conclusion: ROC work as currently imagined is prone to boredom, vigilance decrement, and suppression of repetition. The study adds to the empirical research about boredom and its associated cognitive states in control room work. The study also contributes to design considerations impacting safety and organizational aspects like operator training and retention.