Process Technicians Research Articles

Simple Modification of a DSAEK Carrier Enables Graft Insertion by Injection Without Compromising Endothelial Cell Viability.

We evaluate the quality and feasibility of preloading Descemet stripping automated endothelial keratoplasty (DSAEK) grafts into a modified EndoGlide Ultrathin system for graft injection. DSAEK grafts were prepared by experienced processing technicians at 2 separate locations, loaded into a modified EndoGlide Ultrathin, and placed in storage media. Grafts processed at one location were shipped cross-country overnight to the other location and were examined on arrival for positioning within the modified EndoGlide Ultrathin. All grafts were ejected and analyzed for endothelial cell loss (ECL) with calcein acetoxymethyl staining and FIJI segmentation. A subset of grafts was measured by optical coherence tomography for graft thickness 1 hour after cut, 1 hour after loading, and 1 day after loading. No grafts were displaced from the modified carrier over 3 shipping events (n = 9), and all grafts (n = 18) were successfully ejected. Grafts loaded into the modified carrier and ejected exhibited no more cell loss than grafts loaded into the standard carrier and removed by pull-through (14.0% ± 2.8% vs. 12.2% ± 3.4%, respectively, P = 0.24). Carrier modification skills can be successfully transferred as grafts loaded by a processing technician new to carrier modification were within the acceptable limit of 25% ECL for transplant DSAEK grafts. Graft thickness increased significantly (P < 0.05) between the postcut and 1-hour postload measurement and the postcut and 24-hour postload measurement. The EndoGlide Ultrathin can be modified to enable its use for graft injection while not compromising the ability to use the pull-through method for graft delivery. Preloaded DSAEK grafts swell significantly during the 24-hour storage period, and patterns of ECL may be linked to swelling.

Surgical outreach for the Americas: a self-sustainable model for partnership and education.

It is estimated that up to 28% of global disease burden is surgical with hernias representing a unique challenge as the only definitive treatment is surgery. Surgical Outreach for the Americas (SOfA) is a nongovernmental organization focused primarily on alleviating the disease burden of inguinal and umbilical hernias in Central America. We present the experience of SOfA, a model focused on partnership and education. SOfA was established in 2009 to help individuals recover from ailments that are obstacles to working and independent living. Over the past 15years, SOfA has partnered with local healthcare providers in the Dominican Republic, El Salvador, Honduras, and Belize. The SOfA team consists of surgeons, surgery residents, triage physicians, an anesthesiologist, anesthetists, operating room nurses, recovery nurses, a pediatric critical care physician, sterile processing technicians, interpreters, and a team coordinator. Critical partnerships required include the CMO, internal medicine, general surgery, nursing, rural health coordinators and surgical training programs at public hospitals. SOfA has completed 24 trips, performing 2074 procedures on 1792 patients. 71.4% of procedures were hernia repairs. To enhance sustainability of healthcare delivery, SOfA has partnered with the local facilities through capital improvements to include OR tables, OR lights, anesthesia machines, monitors, hospital beds, stretchers, sterilizers, air conditioning units, and electrosurgical generators. A lecture series and curriculum on perioperative care, anesthesia, anatomy, and operative technique is delivered. Local surgery residents and medical students participated in patient care, learning alongside SOfA teammates. Recently, SOfA has partnered with SAGES Global Affairs Committee to implement a virtual Global Laparoscopic Advancement Program, a simulation-based laparoscopic training curriculum for surgeons in El Salvador. A sustainable partnership to facilitate surgical care in low resource settings requires longitudinal, collaborative relationships, and investments in capital improvements, education, and partnership with local healthcare providers, institutions, and training programs.

First person – Emily Harders

ABSTRACT First Person is a series of interviews with the first authors of a selection of papers published in Biology Open, helping researchers promote themselves alongside their papers. Emily Harders is first author on ‘ Avian extraembryonic membranes respond to yolk corticosterone early in development’, published in BiO. Emily conducted the research described in this article while a master's student in Dr Ryan Paitz's lab at Illinois State University, Normal, USA. She is now currently a specimen processing technician at Nebraska Medicine in Omaha, Nebraska, while she applies for PhD programs. She is interested in understanding how maternal/fetal signalling is regulated in extraembryonic tissues.

The compatibility of exoskeletons in perioperative environments and workflows: an analysis of surgical team members’ perspectives and workflow simulation

Surgical team members in perioperative environments experience high physical demands. Interventions such as exoskeletons, external wearable devices that support users, have the potential to reduce these work-related physical demands. However, barriers such as workplace environment and task compatibility may limit exoskeleton implementation. This study gathered the perspectives of 33 surgical team members: 12 surgeons, four surgical residents, seven operating room (OR) nurses, seven surgical technicians (STs), two central processing technicians (CPTs), and one infection control nurse to understand their workplace compatibility. Team members were introduced to passive exoskeletons via demonstrations, after which surgical staff (OR nurses, STs, and CPTs) were led through a simulated workflow walkthrough where they completed tasks representative of their workday. Five themes emerged from the interviews (workflow, user needs, hindrances, motivation for intervention, and acceptance) with unique subthemes for each population. Overall, exoskeletons were largely compatible with the duties and workflow of surgical team members.

Physical Work Demands of Maintenance Workers on Onshore Petroleum Facilities in Norway: An Observational Study Utilizing Wearable Sensor Technology.

High physical work demands can cause musculoskeletal disorders and sick leave in petroleum workers. However, our knowledge of their physical work demands is scarce and based on self-report. The objective of our study is to work towards closing this knowledge gap by assessing the physical work demands of onshore petroleum maintenance workers using body-worn sensors. A total of 46 of 69 eligible maintenance workers (37 mechanics and 9 process technicians) from three onshore petroleum facilities in Norway filled in a questionnaire and diary and wore five accelerometers and a heart rate sensor for up to six consecutive workdays. Work-related physical activity and postures were classified using rule-based modelling in a modified version of the validated Acti4 software. The onshore maintenance petroleum workers were working an average of 10 h a day and spent on average this time with 48% (SD = 16.5) sitting, 1% (SD = 2.8) lying down, 39% (SD = 16.2) in light physical activity, and 9% (SD = 3.8) in moderate to vigorous physical activity. During work hours while at feet, we found arm elevation ≥60° to be 11% (SD = 7.1) (68 min), and forward bending of the trunk ≥60° to be 2% (SD = 2.2) (14 min). The workers spent 2% (SD = 2.5) (12 minu) of the workhours kneeling. We observed a high inter-individual variation for all these work exposures. Moreover, 26% (12) of the workers conducted static standing for >30% of the workday, and 17% (8) spent more than half of the work hours >33% of their estimated maximal cardiovascular capacity. While onshore maintenance petroleum workers on average spend about half of the workday sitting or lying down, the remaining worktime is spent with a rather high duration of arm elevation and forward bending. Quite high fraction of the workers spends much of the workhours in static standing and kneeling. We see a substantial variation in these work exposures between the workers. The findings indicate a need for preventive measures in how work is organized and performed.

Teaching for chemical process technicians

In recent years, a talent shortage has been one of the biggest threats facing chemical and petrochemical organizations. This, together with declining employment, looming retirements, and large demographic age gaps in the workforce has made us, together with industry, determine to tackle the problem and bridge the gap by developing a formal course between a low-skill operator level and that of the process engineer. The course needed to address the technical knowledge of introductory chemical and mechanical engineering principles, the chemistry involved in process chemistry, and mathematics. On the 'softer’ side, modules such as Academic and Professional Skills and essential Computer Skills were introduced to develop an all-round chemical operator / technician. This paper describes the course materials in brief to provide insight into how this course has been developed and implemented. Feedback from student groups and industry partners on course content and relevance to today’s industry needs confirms the relevance and value of the course.

Geological Modeling Technology and Application Based on Seismic Interpretation Results under the Background of Artificial Intelligence

The development of seismic technology has made seismic data to be widely used in the interpretation of stratigraphic sequence frames, reservoir identification, fluid detection, and other research fields involved in reservoir description. The 3D technology reservoirs have always been the focus, as well as difficulty, of research. With the rapid development of information technology and the continuous improvement of seismic exploration level, people have put forward higher requirements for the accuracy of seismic data interpretation results. Aiming at the large number of structural and unstructured data in seismic, logging, geology, and other disciplines involved in seismic interpretation, how to effectively organize and coordinate analysis to discover the hidden reservoir structure and oil and gas distribution information has always been a geological and important topic for information processing technicians. This thesis is aimed at the current high-water-phase development of Shengtuo Oilfield reservoir and the problems existing in geological research. Based on seismic structural interpretation and attribute analysis, this paper analyzes the reservoir structural characteristics, sedimentary characteristics, and reservoir physical parameter characteristics based on geology, logging interpretation, core analysis, drilling, and seismic interpretation. Using the kriging method with external drift can cooperate with seismic variables to establish a reservoir geological model to study the Shengtuo Oilfield reservoir. We combine artificial intelligence technology with geological modeling technology of seismic interpretation results to explore the best method for predicting earthquakes. The research results in this paper show that the relative error of the model established by the kriging method in the article is relatively small for thinning wells, mainly concentrated around 1%. Examination of the thinning wells of 45 wells shows that the model established is basically good and the example has high accuracy. The research results in this paper have a guiding study of distribution and tapping potentials in the study area, formulating reasonable development and adjustment plans and improving oil recovery.

Work systems analysis of sterile processing: assembly

BackgroundSterile processing departments (SPDs) play a crucial role in surgical safety and efficiency. SPDs clean instruments to remove contaminants (decontamination), inspect and reorganise instruments into their correct trays (assembly), then...

Impact of Industrial Revolutions on Food Machinery - An Overview

The industrial revolutions occurring at specific periods impacted differently on food industry machinery, including analytical and innovative scientific equipment, and had significant effects on food manufacturing. The fourth industrial revolution (4IR) unlike the other industrial revolutions (1IR, 2IR, and 3IR) has a faster significant impact and niches on artificial intelligence (AI), machine learning (ML), blockchain, robotics, the internet of things (IoT), digitalization, big data, autonomous vehicles, additive manufacturing, nanotechnology, biotechnology, and 3D food printing technologies. Going forward would require more mechatronic engineers as process technicians, particularly in paperless processes and automation of the digital rich future.

Efficacy of Cleaning Methods for Ophthalmic Microscopic Instruments: A Comparison Study.

The combination of silicone oil and blood is difficult to remove from ophthalmic surgical instruments during cleaning and decontamination processes. We sought to establish the most efficient cleaning procedure for this type of contaminated instrument. We uniformly contaminated microscopic instruments made of titanium alloy and stainless steel with either blood alone or blood and silicone oil. We randomly assigned each instrument to one of four types of cleaning procedures that involved combinations of water, a multi-enzyme detergent, or an alkaline detergent. After completing the designated cleaning procedure, a sterile processing technician used an adenosine triphosphate cleaning verification test to evaluate the cleaning efficacy. When cleaning blood- and silicone oil-contaminated titanium-alloy and stainless-steel instruments, the alkaline detergent immersion followed by a multi-enzyme detergent ultrasonic cleaning yielded the highest cleaning effectiveness score (92.5%), which indicates this was the most effective of the four cleaning procedures that we tested.

Nondestructive Methods for Characterizing Copper Electrofilled through Silicon Vias

Developments in through silicon via (TSV) fabrication and filling have allowed for significant advancements in the microelectronics industry by enabling compact 3D integration. Copper, due to its desirable electrical properties, is the most commonly used metal for TSVs filling. TSVs are filled electrochemically by selectively reducing solvated metal ions in an electrolyte solution to confined TSV geometries via the addition of organic and inorganic additives (halides, suppressors, accelerators, levelers). Optimization of this mechanism can often be temperamental requiring alterations in the solution’s chemical makeup as well as electrical bias and fluid flow parameters. Therefore, consistent and reliable methods of characterizing electrochemical copper fill quality is critical to provide feedback necessary for process adjustments. Historically, characterizing TSV fill profile has relied on physical cross sectioning by mechanical grinding, planarization and polishing (Figure 1). These methods are effective in that they offer direct visualization of the TSV fill quality; however, they have certain inherent drawbacks. The most critical drawback is that mechanical cross sectioning is a destructive process and can only be used in process development and not on deliverable parts. Also, mechanical material removal can often be time consuming and inconsistent requiring significant effort by process technicians to generate desirable results. Implementing non-destructive methods for characterization is necessary for the advancement of TSV technology and has been explored in an effort to make TSV research more streamline and efficient. Recent work at Sandia National Laboratories has evaluated non-destructive TSV characterization processes through X-Ray Computed Tomography (CT), digital radiographs and X-ray Phase Contrast Imaging (XPCI). The benefit of X-ray evaluation of TSV filling is batch level processing of many TSVs at once (Figure 2A), digital model rendering for multidimensional analysis (Figure 2B), and complete preservation of the physical integrity of test pieces and deliverables. Each nondestructive technique for TSV characterization will be directly compared and contrasted to conventional grinding and polishing on the merits of defect detection, resolution, time consumption and reproducibility. This talk will outline the development of non-destructive methods for TSV characterization and evaluate the reliability and consistency of these approaches. Sandia National Laboratories, a multimission laboratory managed and operated by National Technology and Engineering Solutions of Sandia, LLC., a wholly owned subsidiary of Honeywell International, Inc., for the U.S. Department of Energy’s National Nuclear Security Administration under contract DE-NA-0003525. This paper describes objective technical results and analysis. Any subjective views or opinions that might be expressed in the paper do not necessarily represent the views of the U.S. Department of Energy or the United States Government. Figure 1

From aseptic processing to enrichment of virus-specific Tcells: nationwide children's hospital and the ohio state university are increasing cGMP training efficacy through a competency-based learning management system for cell processing specialists

Background & Aim Our innovative technician training program provides a competency-based, blended-learning model that creates flexibility in pace, content, and place of learning while increasing accountability and standardization. The initial thirty training modules comprise the full training plan of a new cell processing technician. Examples of initial training modules include: aseptic technique to ensure the integrity, viability and sterility of cellular products, QC testing: cytotoxicity assay, PCR and endotoxin, CofA generation and product release. Additionally, there are ten specialized cell manipulation modules. Personalized learning pathways support the participants’ unique training needs and learning style preferences. The content of each module is developed by subject-matter experts. Modules include cGMP skills in a variety of formats: interactive simulations, video, text, and assessments. The consistency of content delivery increases the fidelity and efficiency of cGMP training. The anytime, anywhere learning design provides flexibility with staff allocation and learner engagement. Embedded assessments calibrate levels of mastery in each competency with alternative resources and additional remedial assessment opportunities. Mastery of a module results in a digital badge which is sharable social platforms. Methods, Results & Conclusion Here we present our initial specialized module: Expansion, Purification, and Functional Assessment of Human Peripheral Blood Natural Killer (NK) Cells. Limited ability to expand in vitro has restricted development of NK cell immunotherapy. This module describes a method to efficiently expand vast quantities of functional NK cells ex vivo using K562 cells expressing membrane-bound IL21, as an artificial antigen-presenting cell. This module will be deployed online via a Learning Management System March 2019. This process utilizes prerequisite cGMP module skills and is designed for cell technicians manufacturing NK therapeutics for early Phase I clinical trials. Nationwide Children's Hospital and The Ohio State University utilize the manufacturing process described in this module for multiple Phase I investigator initiated expanded NK cell clinical trials. Additional discussion of the process to identify the appropriate training components, define the learning outcomes, ensure an appropriate duration for each module, calibrate a reliable assessment component, and our lessons learned will be shared.

Surgical tray optimization as a simple means to decrease perioperative costs

BackgroundHealth care spending in the US remains excessively high. Aside from complicated, large-scale efforts at health care cost reduction, there are still relatively simple ways in which individual hospitals can cut unnecessary costs from everyday operations. Inspired by recent publications, our group sought to decrease the costs associated with surgical instrument processing at a large, multihospital academic center. MethodsThis was a single-site observational study conducted at a large academic medical center. At the study start, all attending surgeons within the section of pediatric surgery agreed to standardize the pediatric surgery trays and to eliminate instruments that were deemed unnecessary from each tray. A multidisciplinary start-up meeting was held, and this meeting included stakeholders from central sterile processing, operating room nursing, scrub technicians, and materials management along with all five pediatric surgeons. Each tray was addressed individually. Instruments were eliminated from trays only if there was unanimous agreement among all the surgeons in the group. If no instruments in a given surgical tray were deemed necessary, the entire tray was eliminated from sterile processing rotation. Feedback questionnaires were drafted by the multidisciplinary team that participated in the start-up meeting. Surgeons were allowed to request for certain instruments to be placed back into the trays at any time, and the questionnaires also allowed for free-hand comments. Surgical kit preparation time was obtained from the institutional barcode scanning system. The cost per second of sterile processing labor was calculated using regional median salary for sterile processing technicians in the state of Connecticut. Using the pediatric surgery section as the model unit, this method was then applied to pediatric urology, neurosurgery, spine surgery, and orthopedics. ResultsThe pediatric surgery section eliminated an average of 59.5% of instruments per tray, resulting in an overall reduction of 1826 (39.5%) instruments from rotation, 45,856 fewer instruments processed per year, and nine trays eliminated completely from regular rotation. Processing time for six commonly used trays was reduced by an average of 28.7%. The urology section eliminated 18 trays from regular rotation and 179 (10.1%) instruments in total. Pediatric orthopedics, neurosurgery, and spine sections eliminated 708 (17.1%), 560 (92.7%), and 31 (32.2%) instruments, respectively, resulting in approximately 18,804 fewer instruments processed per year. Among all five surgical sections, annual instrument cost avoidance after tray optimization was estimated at $53,193 to $531,929 using average instrument life spans ranging from 1-10 y. Negative feedback and requests for instrument replacement were both minimal on feedback questionnaires. ConclusionsSurgical tray optimization represents a relatively simple microsystem improvement that could result in significant hospital cost reduction. Although difficult to quantify, other gains from surgical kit optimization include decreased weight per tray, decreased materials cost, and decreased labor required to count, decontaminate, and pack surgical trays.

Low personal exposure to benzene and 1,3-butadiene in the Swedish petroleum refinery industry

PurposePetroleum refinery workers are exposed to the carcinogens benzene and 1,3-butadiene. Declining exposures have been reported internationally but information on current exposure in the Swedish refinery industry is limited. The aim was to examine refinery workers’ personal exposure to benzene and 1,3-butadiene and increase awareness of exposure conditions by collaboration with involved refineries.MethodsAltogether 505 repeated personal exposure measurements were performed among workers at two refineries. Full-shift measurements were conducted in different exposure groups using Perkin Elmer diffusive samplers filled with Carbopack X. Mean levels were calculated using mixed-effects models. A large fraction of measurements below the limit of detection (LOD) required imputation of computer-generated data.ResultsMean benzene exposure among process technicians was 15.3 µg/m3 (95% CI 10.4–22.5 µg/m3) and 13.7 µg/m3 (95% CI 8.3–22.7 µg/m3) for Refinery 1 and 2, respectively. Process technicians working outdoors had higher exposure than maintenance workers (20.7 versus 5.9 µg/m3, p < 0.01). Working in the harbour and tank park (Refinery 1), compared with the process area, was associated with higher exposure. The 1,3-butadiene exposure was low, 5.4 and 1.8 µg/m3, respectively. The total variation was generally attributed to within-worker variability.ConclusionsLow benzene and 1,3-butadiene levels were found among refinery workers. Mean benzene exposure was about 1% of the Swedish occupational limit (1500 µg/m3) and for 1,3-butadiene, exposure was even lower. A large fraction of values below the LOD can be managed by carefully modelled, computer-generated data.

Challenges and Solutions for Autonomous Robotic Mobile Manipulation for Outdoor Sample Collection

In refinery, petrochemical, and chemical plants, process technicians collect uncontaminated samples to be analyzed in the quality control laboratory all time and all weather. This traditionally manual operation not only exposes the process technicians to hazardous chemicals, but also imposes an economical burden on the management. The recent development in mobile manipulation provides an opportunity to fully automate the operation of sample collection. This paper reviewed the various challenges in sample collection in terms of navigation of the mobile platform and manipulation of the robotic arm from four aspects, namely mobile robot positioning/attitude using global navigation satellite system (GNSS), vision-based navigation and visual servoing, robotic manipulation, mobile robot path planning and control. This paper further proposed solutions to these challenges and pointed the main direction of development in mobile manipulation.

Routine Use of Ex Vivo Dermoscopy With “Derm Dotting” in Dermatopathology

Routine Use of Ex Vivo Dermoscopy With “Derm Dotting” in Dermatopathology

Proposal of the Learning Method for IT Personnel Resources Development by Using TVML

Using the animations made as learning materials is an effective learning method. However, we thought that the more effective learning method is to create them by the learner themselves. The learners themselves must learn the item and must understand it well to create and present to the others. The purpose of this study is to propose the collaborative learning technique by co-creating the animations made as learning materials. We used the T2V player to create and view an animations based on TVML a TV program description language. As a result, we could create the animations with the learning effect for National Examination for Information Processing Technicians, and there was the learning effect at the creation process.

Reducing pollution from the deliming–bating operation in a tannery. Wastewater reuse by microfiltration membranes

This paper presents experimental results from the implementation of two measures aimed at reducing the nitrogen concentration in a tannery wastewater. Specifically, this research has focused on the wastewater from the deliming/bating operations. The proposed measures are the replacement of ammonium salts by carbon dioxide in the deliming process and the reuse of wastewater and chemicals after membrane filtration of the deliming/bating liquor. The experimental study covered different wastewater pretreatment alternatives and experiments with two membranes (with different separation properties): one in the range of microfiltration (MF) and one in the range of the ultrafiltration (UF). Results of the pretreatment study indicated that neither settling nor protein precipitation were feasible. Only a security filtration prior to membrane filtration was recommended. The tested MF membrane was selected due to the higher flux (around 25L/(m2h)) in comparison with the UF membrane. The MF permeate was successfully reused in the deliming/bating process. The delimed leather quality was excellent according to both visual and organoleptic inspection from process technicians and phenolphthalein test, confirming the technical feasibility of the proposal. Globally, the implementation of the above mentioned two measures resulted in 53% total nitrogen reduction.

‘An Obligation to Join Forces’

Editor's Note: Michele DeMeo wrote this letter for the AAMI/FDA International Conference on Medical Device Standards and Regulation, held March 21–22 in Reston, VA.Dear attendees,Good morning/afternoon and thank you for this opportunity and your time. My name is Michele DeMeo. I was a hospital manager, independent consultant, a committee member for several AAMI work groups, a member of AORN' sterile processing and materials management's specialty assembly, a SGE and committee member for the FDA, and a healthcare author and columnist and an approved IAHCSMM instructor, among other obligations until recently. My 20-year healthcare career has been stalled due to my terminal ALS health status.However, I heard of this summit and felt the need to reach out since I cannot join you. I am impressed by this joint meeting and effort. Our citizens deserve the very best care in the world, which means improving on good and even great; there is always room for improvement. We have an obligation to join forces and work with all critical stakeholders, including manufactures, hospitals and other healthcare providers, standard developers, and lawmakers. We owe this to not only consumers of care, but to those who provide care and those who support care providers, such as sterile processing technicians. One example would be appropriate cleaning, disinfection and sterilization instructions that are available, make sense, are easy to comply with in our healthcare facilities, and are understood by those selling the products to help reduce the spread of misinformation. That's one example out of many.This message is nothing new or else you would not be here, but I wanted you to know in the face of dying, I needed to use my energy that I do have left to voice just how important and time sensitive this topic is for all of us who make healthcare processing an imperative. Our issues related to what needs improvement are not insurmountable. I wish I could be here and be a part of your hard work. I will provide my information if any member here has any questions about our opportunities and areas for improvement. My email is mddemeo@yahoo.com. With every ounce I have left, I remain passionate for our mutual goals for this profession and related interdependences. I have full faith in you, my peers, that progress has begun and will remain moving forward because of your passion, commitment, and sheer talent. Thank you for your work. It is needed more than ever. I am proud you are here today and send my best wishes for a productive session!Thank you for ear and time.Respectfully,Michele DeMeo

Responsibilities for Effective Medical Device Reprocessing Procedures and Instructions

Responsibilities for Effective Medical Device Reprocessing Procedures and Instructions