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All these factors impact the effectiveness of sterilization EXCEPT

  1. Temperature

  2. Time

  3. Pressure

  4. Instructions in Manufacturer's IFU

The correct answer is: Instructions in Manufacturer's IFU

Factors such as temperature, time, and pressure are crucial in determining the effectiveness of sterilization processes. The correct answer, D, 'Instructions in Manufacturer's IFU,' is the exception because these instructions are essential for ensuring proper usage of sterilization equipment according to the manufacturer's recommendations. Following the instructions in the Manufacturer's Instructions for Use (IFU) is necessary for maintaining the effectiveness of the sterilization process and ensuring the safety of the equipment and the items being sterilized. Therefore, while temperature, time, and pressure directly impact the sterilization process, following the manufacturer's instructions is also vital for successful sterilization outcomes.