Search results for: project based learning

Authors: Wei Yao

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A steerable and flexible drill is needed in orthopaedic surgery. For example, osteoarthritis is a common condition affecting millions of people for which joint replacement is an effective treatment which improves the quality and duration of life in elderly sufferers. Conventional surgery is not very accurate. Computer navigation and robotics can help increase the accuracy. For example, In Total Hip Arthroplasty (THA), robotic surgery is currently practiced mainly on acetabular side helping cup positioning and orientation. However, femoral stem positioning mostly uses hand-rasping method rather than robots for accurate positioning. The other case for using a flexible drill in surgery is Anterior Cruciate Ligament (ACL) Reconstruction. The majority of ACL Reconstruction failures are primarily caused by technical mistakes and surgical errors resulting from drilling the anatomical bone tunnels required to accommodate the ligament graft. The proposed new steerable drill system will perform orthopedic surgery through curved tunneling leading to better accuracy and patient outcomes. It may reduce intra-operative fractures, dislocations, early failure and leg length discrepancy by making possible a new level of precision. This technology is based on a robotically assisted, steerable, hand-held flexible drill, with a drill-tip tracking device and a multi-modality navigation system. The critical differentiator is that this robotically assisted surgical technology now allows the surgeon to prepare 'patient specific' and more anatomically correct 'curved' bone tunnels during orthopedic surgery rather than drilling straight holes as occurs currently with existing surgical tools. The flexible and steerable drill and its navigation system for femoral milling in total hip arthroplasty had been tested on sawbones to evaluate the accuracy of the positioning and orientation of femoral stem relative to the pre-operative plan. The data show the accuracy of the navigation system is better than traditional hand-rasping method.

Keywords: navigation, robotic orthopedic surgery, steerable drill, tracking

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Authors: Raana Babadi Fathipour

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The production of dairy holds significant importance in the sustenance of billions of individuals worldwide, as they rely on milk and its derived products for daily consumption. In addition to being a source of essential nutrients crucial for human well-being, such as proteins, fats, vitamins, and minerals; dairy items are witnessing an increasing demand worldwide. Amongst all the factors contributing to the quality and safety assurance of dairy products, the strong focus lies on maintaining high standards in raw milk procurement. Raw milk serves as an externally nutritious medium for various microorganisms due to its inherent properties. This poses a considerable challenge for the dairy industry in ensuring that microbial contamination is minimized throughout every stage of the value chain. Despite implementing diverse process technologies—both conventional and innovative—the occurrence of microbial spoilage still results in substantial losses within this industry context. Moreover, milk and dairy products have been associated with numerous cases of foodborne illnesses across the globe. Various pathogens such as Salmonella serovars, Campylobacter spp., Shiga toxin-producing Escherichia coli, Listeria monocytogenes, and enterotoxin producing Staphylococcus aureus are commonly identified as the culprits behind these outbreaks in the dairy industry. The effective management of food safety within this sector necessitates a proactive and risk-based approach to reform. However, this strategy presents difficulties for developing nations where informal value chains dominate the dairy sector. Whether operating on a small or large scale or falling within formal or informal realms, it is imperative that the dairy industry adheres to principles of good hygiene practices and good manufacturing practices. Additionally, identifying and managing potential sources of contamination is crucial in mitigating challenges pertaining to quality and safety precautions.

Keywords: dairy value chain, microbial contamination, food safety, hygiene

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Authors: Mapatsakon Sarapat, Mongkol Ketwongsa, Somchat Sonasang, Preecha Yupapin

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The designed and performed preliminary tests on a space-time control circuit using a two-level system circuit with a 4-5 cm diameter microstrip for realistic teleportation have been demonstrated. It begins by calculating the parameters that allow a circuit that uses the alternative current (AC) at a specified frequency as the input signal. A method that causes electrons to move along the circuit perimeter starting at the speed of light, which found satisfaction based on the wave-particle duality. It is able to establish the supersonic speed (faster than light) for the electron cloud in the middle of the circuit, creating a timeline and propulsive force as well. The timeline is formed by the stretching and shrinking time cancellation in the relativistic regime, in which the absolute time has vanished. In fact, both black holes and white holes are created from time signals at the beginning, where the speed of electrons travels close to the speed of light. They entangle together like a capsule until they reach the point where they collapse and cancel each other out, which is controlled by the frequency of the circuit. Therefore, we can apply this method to large-scale circuits such as potassium, from which the same method can be applied to form the system to teleport living things. In fact, the black hole is a hibernation system environment that allows living things to live and travel to the destination of teleportation, which can be controlled from position and time relative to the speed of light. When the capsule reaches its destination, it increases the frequency of the black holes and white holes canceling each other out to a balanced environment. Therefore, life can safely teleport to the destination. Therefore, there must be the same system at the origin and destination, which could be a network. Moreover, it can also be applied to space travel as well. The design system will be tested on a small system using a microstrip circuit system that we can create in the laboratory on a limited budget that can be used in both wired and wireless systems.

Keywords: quantum teleportation, black-white hole, time, timeline, relativistic electronics

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Authors: Stefanache Stefania, Ioana R. Podina

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Background: Embodied Conversational Agents (ECAs) are revolutionizing education and healthcare by offering cost-effective, adaptable, and portable solutions. Research on the Uncanny Valley effect (UVE) involves various embodied agents, including ECAs. Achieving the optimal level of anthropomorphism, no consensus on how to overcome the uncanniness problem. Objectives: This systematic review aims to identify the user characteristics, agent features, and context factors that influence the UVE. Additionally, this review provides recommendations for creating effective ECAs and conducting proper experimental studies. Methods: We conducted a systematic review following the PRISMA 2020 guidelines. We included quantitative, peer-reviewed studies that examined human-ECA interaction. We identified 17,122 relevant records from ACM Digital Library, IEE Explore, Scopus, ProQuest, and Web of Science. The quality of the predictors, mediators, and moderators adheres to the guidelines set by prior systematic reviews. Results: Based on the included studies, it can be concluded that females and younger people perceive the ECA as more attractive. However, inconsistent findings exist in the literature. ECAs characterized by extraversion, emotional stability, and agreeableness are considered more attractive. Facial expressions also play a role in the UVE, with some studies indicating that ECAs with more facial expressions are considered more attractive, although this effect is not consistent across all studies. Few studies have explored contextual factors, but they are nonetheless crucial. The interaction scenario and exposure time are important circumstances in human-ECA interaction. Conclusions: The findings highlight a growing interest in ECAs, which have seen significant developments in recent years. Given this evolving landscape, investigating the risk of the UVE can be a promising line of research.

Keywords: human-computer interaction, uncanny valley effect, embodied conversational agent, systematic review

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Authors: Sachin Kamble, Raghothama Anekal, Shivakumar Bhavi

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Thermal management of electronic components packaged inside an IP65 rated enclosure is of prime importance in industrial applications. Electrical enclosure protects the multiple board configurations such as inverter, power, controller board components, busbars, and various power dissipating components from harsh environments. Industrial environments often experience relatively warm ambient conditions, and the electronic components housed in the enclosure dissipate heat, due to which the enclosures and the components require thermal management as well as reduction of internal ambient temperatures. Design of Experiments based thermal simulation approach with MOSFET arrangement, Heat sink design, Enclosure Volume, Copper and Aluminum Spreader, Power density, and Printed Circuit Board (PCB) type were considered to optimize air temperature inside the IP65 enclosure to ensure conducive operating temperature for controller board and electronic components through the different modes of heat transfer viz. conduction, natural convection and radiation using Ansys ICEPAK. MOSFET’s with the parallel arrangement, IP65 enclosure molded heat sink with rectangular fins on both enclosures, specific enclosure volume to satisfy the power density, Copper spreader to conduct heat to the enclosure, optimized power density value and selecting Aluminum clad PCB which improves the heat transfer were the contributors towards achieving a conducive operating temperature inside the IP-65 rated Motor Inverter enclosure. A reduction of 52 ℃ was achieved in internal ambient temperature inside the IP65 enclosure between baseline and final design parameters, which met the operative temperature requirements of the electronic components inside the IP-65 rated Motor Inverter.

Keywords: Ansys ICEPAK, aluminium clad PCB, IP 65 enclosure, motor inverter, thermal simulation

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Authors: Thomas Nally, Jane Ireland, Roxanne Khan, Philip Birch

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Intimate Partner Violence (IPV), a significant societal problem, affects individuals worldwide. However, the strategies victims use to keep safe are under-researched. IPV is significantly under-reported, and services often are not able to be accessed by all victims. Thus they are likely to use their own strategies to manage their victimization before being able to seek support. Two studies were completed to understand these strategies. A systematic review of the literature and study completed with professionals who work with victims was undertaken to understand this area. In study one, a systematic review of the literature (n=61 papers), were analyzed using Thematic Analysis. The results indicated that victims use a large array of behaviors to increase their sense of safety and coping with emotions but also experience significant barriers to help-seeking. In study 2, sixty-nine professionals completed a measure exploring the likelihood and effectiveness of various victim strategies regarding increasing their sense of safety. Strategies included in the measure were obtained from those identified in study 1. Findings indicated that professionals perceived victims of IPV to be more likely to employ safety strategies and coping behaviors that may be ineffective but not help-seeking behaviors. Further, the responses were analyzed using Cluster Analysis. Safety strategies resulted in five clusters; perpetrator-directed strategies, prevention strategies, cognitive reappraisal, safety planning and avoidance strategies. Help-Seeking resulted in six clusters; information or practical support, abuse-related support, emotional support, secondary support and informal support. Finally, coping resulted in four clusters; emotional coping, self-directed coping, thought recording/change and cognitive coping. Both studies indicate that victims may use a variety of strategies to manage their safety besides seeking help. Professionals working with victims, using a strength-based approach, should understand what is used and is effective for victims who are unable to leave the relationships or access external support.

Keywords: intimate partner violence, help-seeking, professional support, victims, victim coping, victim safety

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Authors: Ana Mafalda Silva, Rebeca Fontes, Ana Paula Vaz, Carla Carreira, Ana Corte-Real

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Decades of research on the topic of interpersonal violence against minors highlight five main conclusions: 1) it causes harmful effects on children's development and health; 2) it is prevalent; 3) it violates children's rights; 4) it can be prevented and 5) parents are the main aggressors. The child abuse scenario is identified through clinical observation, administrative data and self-reports. The most used instruments are self-reports; however, there are no valid and reliable self-report instruments for minors, which consist of a retrospective interpretation of the situation by the victim already in her adult phase and/or by her parents. Clinical observation and collection of information, namely from the orofacial region, are essential in the early identification of these situations. The management of medical data, such as personal data, must comply with the General Data Protection Regulation (GDPR), in Europe, and with the General Law of Data Protection (LGPD), in Brazil. This review aims to answer the question: In a situation of medical assistance to minors, in the suspicion of interpersonal violence, due to mistreatment, is it necessary for the guardians to provide consent in the registration and sharing of personal data, namely medical ones. A scoping review was carried out based on a search by the Web of Science and Pubmed search engines. Four papers and two documents from the grey literature were selected. As found, the process of identifying and signaling child abuse by the health professional, and the necessary early intervention in defense of the minor as a victim of abuse, comply with the guidelines expressed in the GDPR and LGPD. This way, the notification in maltreatment scenarios by health professionals should be a priority and there shouldn’t be the fear or anxiety of legal repercussions that stands in the way of collecting and treating the data necessary for the signaling procedure that safeguards and promotes the welfare of children living with abuse.

Keywords: child abuse, disease notifications, ethics, healthcare assistance

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Authors: Nurul Azmawati Mohamed, Zarini Ismail, Shalinawati Ramli, Nurul Hayati Chamhuri, Nur Syahrina Rahim, K. Omar

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Choosing a career is one of the most important decisions in our life. A right career leads a person to grow with that career and achieve success through the decision. Thus, career suitability assessment is important to help individuals to understand how a variety of personal attributes can impact their potential success and satisfaction with different career options and work environments. Some career needs specific personality trait that relates to attributes of job requirements and commitments. For medicine, being caring, approachable, inquisitive, able to listen and understand patients’ pain, anxiety and sorrow are important. The aim of this study was to evaluate the career suitability of pre-clinical students. This was a cross sectional study conducted among pre-clinical medical students in Universiti Sains Islam Malaysia. 'Sidek Career Interest Inventory’ was used to assess the students’ suitability for the course. This instrument had been validated locally to suit the local social and cultural context. It assessed the students’ personality trait based on Holland’s theory and their interests. For students to pursue in the medical course, two main personality trait are believed to be essential namely investigative and social trait personalities. Some of the characteristics of investigative trait are analytical, rational, intellectual and curious, while the characteristics of social trait personality include empathy, friendly, understanding and accommodating. The score for each personality trait were categorized as low (0-3.99), moderate (4-6.99) and high (7-10). A total of 81 pre-clinical medical students were included in this study. About two third (93.8%) of them were female and all of them are from 20 to 21 of age. Approximately, half of the students (47.5%) scored high and another 46.3% scored moderate for investigative trait. For social trait, only 13.8% scored high while 31.3% scored moderate. Only 12.5% (10) students had high scores for both investigative and social traits. Most of the pre-clinical medical students scored high in the investigative sections, however their social values were inadequate (low scores). For them to become good medical doctors, they should be good in both investigative and social skills to enhance their suitability for this career. Therefore, there is a need to nurture these medical students with appropriate social values and soft skills.

Keywords: career suitability, career interest, medical students, personality trait

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Authors: Shanakr Bhattarai, V. S. Tiwari, Barak Akabayov

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The plummeting number of infections and death is due to the development of drug-resistant bacteria. In addition, the number of approved antibiotic drugs by the Food and Drug Administration (FDA) is insufficient. Therefore, developing new drugs and finding novel targets for central metabolic pathways in bacteria is urgently needed. One of the promising targets is DNA replication machinery which consists of many essential proteins and enzymes. DnaG primase is an essential enzyme and a central part of the DNA replication machinery. DnaG primase synthesizes short RNA primers that initiate the Okazaki fragments by the lagging strand DNA polymerase. Therefore, it is reasonable to assume that inhibition of primase activity will stall DNA replication and prevent bacterial proliferation. We did the expression and purification of eight different bacterial DnaGs (Mycobacterium tuberculosis(Mtb), Bacillus anthracis (Ba), Mycobacterium smegmatis (Msmeg), Francisella tularencis (Ft), Vibrio cholerae (Vc) and Yersinia pestis (Yp), Staphylococcus aureus(Saureus), Escherichia coli(Ecoli)) followed by the radioactive activity assay. After obtaining the pure and active protein DnaG, we synthesized the inhibitors for them. The inhibitors were divided into five different groups, each containing five molecules, and the cocktail inhibition assay was performed against each DnaGs. The groups of molecules inhibiting the DnaGs were further tested with individual molecules belonging to inhibiting groups. Each molecule showing inhibition was titrated against the corresponding DnaGs to find IC50. We got a molecule(VS167) that acted as broad inhibitors, inhibiting all eight DnaGs. Molecules VS180 and VS186 inhibited seven DnaGs (except Saureus). Similarly, two molecules(VS 173, VS176) inhibited five DnaGs (Mtb, Ba, Ft, Yp, Ecoli). VS261 inhibited four DnaGs (Mtb, Ba, Ft, Vc). MS50 inhibited Ba and Vc DnaGs. And some of the inhibitors inhibited only one DnaGs. Thus we found the broad and specific inhibitors for different bacterial DnaGs, and their Structure-activity analysis(SAR) was done. Further, We tried to explain the similarities among the enzyme DnaGs from different bacteria based on their inhibition pattern.

Keywords: DNA replication, DnaG, okazaki fragments, antibiotic drugs

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Authors: Titus A. Beu

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Many modern gene-delivery protocols rely on condensed complexes of DNA with polycations to introduce the genetic payload into cells by endocytosis. In particular, polyethyleneimine (PEI) stands out by a high buffering capacity (enabling the efficient condensation of DNA) and relatively simple fabrication. Realistic computational studies can offer essential insights into the formation process of DNA-PEI polyplexes, providing hints on efficient designs and engineering routes. We present comprehensive computational investigations of solvated PEI and DNA-PEI polyplexes involving calculations at three levels: ab initio, all-atom (AA), and coarse-grained (CG) molecular mechanics. In the first stage, we developed a rigorous AA CHARMM (Chemistry at Harvard Macromolecular Mechanics) force field (FF) for PEI on the basis of accurate ab initio calculations on protonated model pentamers. We validated this atomistic FF by matching the results of extensive molecular dynamics (MD) simulations of structural and dynamical properties of PEI with experimental data. In a second stage, we developed a CG MARTINI FF for PEI by Boltzmann inversion techniques from bead-based probability distributions obtained from AA simulations and ensuring an optimal match between the AA and CG structural and dynamical properties. In a third stage, we combined the developed CG FF for PEI with the standard MARTINI FF for DNA and performed comprehensive CG simulations of DNA-PEI complex formation and condensation. Various technical aspects which are crucial for the realistic modeling of DNA-PEI polyplexes, such as options of treating electrostatics and the relevance of polarizable water models, are discussed in detail. Massive CG simulations (with up to 500 000 beads) shed light on the mechanism and provide time scales for DNA polyplex formation independence of PEI chain size and protonation pattern. The DNA-PEI condensation mechanism is shown to primarily rely on the formation of DNA bundles, rather than by changes of the DNA-strand curvature. The gained insights are expected to be of significant help for designing effective gene-delivery applications.

Keywords: DNA condensation, gene-delivery, polyethylene-imine, molecular dynamics.

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Authors: Amit G. Dhorde

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It is now well established that the global surface air temperatures have increased significantly during the period that followed the industrial revolution. One of the main predictions of climate change is that the occurrences of extreme weather events will increase in future. In many regions of the world, high-temperature extremes have already started occurring with rising frequency. The main objective of the present study is to understand spatial and temporal changes in days with heat and cold wave conditions over southern India. The study area includes the region of India that lies to the south of Tropic of Cancer. To fulfill the objective, daily maximum and minimum temperature data for 80 stations were collected for the period 1969-2006 from National Data Center of India Meteorological Department. After assessing the homogeneity of data, 62 stations were finally selected for the study. Heat and cold waves were classified as slight, moderate and severe based on the criteria given by Indias' meteorological department. For every year, numbers of days experiencing heat and cold wave conditions were computed. This data was analyzed with linear regression to find any existing trend. Further, the time period was divided into four decades to investigate the decadal frequency of the occurrence of heat and cold waves. The results revealed that the average annual temperature over southern India shows an increasing trend, which signifies warming over this area. Further, slight cold waves during winter season have been decreasing at the majority of the stations. The moderate cold waves also show a similar pattern at the majority of the stations. This is an indication of warming winters over the region. Besides this analysis, other extreme indices were also analyzed such as extremely hot days, hot days, very cold nights, cold nights, etc. This analysis revealed that nights are becoming warmer and days are getting warmer over some regions too.

Keywords: heat wave, cold wave, southern India, decadal frequency

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Authors: Razia Sultana

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The chapter investigates the roles of local Non-Governmental Organisations (NGOs) and Community Based Organisations (CBOs) in climate change adaptation through grassroots innovation in urban slums in Dhaka, Bangladesh. The section highlights green infrastructure as an innovative process to mitigate the challenges emanating from climate change at the bottom of the pyramid. The research draws on semi-structured in-depth interviews with 11 NGOs and 2 CBOs working in various slums in Dhaka. The study explores the activities of local agencies relating to urban green infrastructure (UGI) and its possible mitigation of a range of climate change impacts: thermal discomfort, heat stress, flooding and the urban heat island. The main argument of the chapter is unlike the Global North stakeholders’ activities relating to UGI in cities of the Global South have not been expanded on a large scale. Moreover, UGI as a risk management strategy is underutilised in the developing countries. The study finds that, in the context of Bangladesh, climate change adaptation through green infrastructure in cities is still nascent for local NGOs and CBOs. Mostly their activities are limited to addressing the basic needs of slum communities such as water and sanitation. Hence urban slum dwellers have been one of the most vulnerable groups in that they are deprived of the city’s basic ecological services. NGOs are utilizing UGI in an innovative way despite various problems in slums. For instance, land scarcity and land insecurity in slums are two key areas where UGI faces resistance. There are limited instances of NGOs using local and indigenous techniques to encourage slum dwellers to adopt UGI for creating sustainable environments. It is in this context that the paper is an attempt to showcase some of the grassroots innovation that NGOs are currently adopting in slums. Also, some challenges and opportunities are discussed to address UGI as a strategy for climate change adaptation in slums.

Keywords: climate change adaptation, green infrastructure, Dhaka, slums, NGOs

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Authors: Neslihan Sahin Celik, Ali Eraslan

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As a result of PISA (Program for International Student Assessments) survey that tests how well students can apply the knowledge and skills they have learned at school to real-life challenges, the new and redesigned mathematics education programs in many countries emphasize the necessity for the students to face complex and multifaceted problem situations and gain experience in this sense allowing them to develop new skills and mathematical thinking to prepare them for their future life after school. At this point, mathematical models and modeling approaches can be utilized in the analysis of complex problems which represent real-life situations in which students can actively participate. In particular, model eliciting activities that bring about situations which allow the students to create solutions to problems and which involve mathematical modeling must be used right from primary school years, allowing them to face such complex, real-life situations from early childhood period. A qualitative study was conducted in a university foundation primary school in the city center of a big province in 2013-2014 academic years. The participants were 4th grade students in a primary school. After a four-week preliminary study applied to a fourth-grade classroom, three students included in the focus group were selected using criterion sampling technique. A focus group of three students was videotaped as they worked on the Crime Problem. The conversation of the group was transcribed, examined with students’ written work and then analyzed through the lens of Blum and Ferri’s modeling processing cycle. The results showed that primary fourth-grade students can successfully work with model eliciting problem while they encounter some difficulties in the modeling processes. In particular, they developed new ideas based on different assumptions, identified the patterns among variables and established a variety of models. On the other hand, they had trouble focusing on problems and occasionally had breaks in the process.

Keywords: primary school, modeling, mathematical modeling, crime problem

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Authors: R. Estrada, A. Henriquez, R. Becerra, C. Laguna

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Spatial Augmented Reality is a variation of Augmented Reality where the Head-Mounted Display is not required. This variation of Augmented Reality is useful in cases where the need for a Head-Mounted Display itself is a limitation. To achieve this, Spatial Augmented Reality techniques substitute the technological elements of Augmented Reality; the virtual world is projected onto a physical surface. To create an interactive spatial augmented experience, the application must be aware of the spatial relations that exist between its core elements. In this case, the core elements are referred to as a projection system and an input system, and the process to achieve this spatial awareness is called system calibration. The Spatial Augmented Reality system is considered calibrated if the projected virtual world scale is similar to the real-world scale, meaning that a virtual object will maintain its perceived dimensions when projected to the real world. Also, the input system is calibrated if the application knows the relative position of a point in the projection plane and the RGB-depth sensor origin point. Any kind of projection technology can be used, light-based projectors, close-range projectors, and screens, as long as it complies with the defined constraints; the method was tested on different configurations. The proposed procedure does not rely on a physical marker, minimizing the human intervention on the process. The tests are made using a Kinect V2 as an input sensor and several projection devices. In order to test the method, the constraints defined were applied to a variety of physical configurations; once the method was executed, some variables were obtained to measure the method performance. It was demonstrated that the method obtained can solve different arrangements, giving the user a wide range of setup possibilities.

Keywords: color depth sensor, human computer interface, interactive surface, spatial augmented reality

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Authors: Judith Mogouong, Philippe Constant, Robert Lavallee, Claude Guertin

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The emerald ash borer (EAB) is an exotic wood borer insect native from China, which is associated with important environmental and economic damages in North America. Beetles are known to be vectors of microbial communities related to their adaptive capacities. It is now established that environmental stress factors may induce physiological events on the host trees, such as phytochemical changes. Consequently, that may affect the establishment comportment of herbivorous insect. Considering the number of insects collected on ash trees (insects’ density) as an abiotic factor related to stress damage, the aim of our study was to explore the dynamic of EAB gut microbial community genome (microbiome) when facing that factor and to monitor its diversity. Insects were trapped using specific green Lindgren© traps. A gradient of the captured insect population along the St. Lawrence River was used to create three levels of insects’ density (low, intermediate, and high). After dissection, total DNA extracted from insect guts of each level has been sent for amplicon sequencing of bacterial 16S rRNA gene and fungal ITS2 region. The composition of microbial communities among sample appeared largely diversified with the Simpson index significantly different across the three levels of density for bacteria. Add to that; bacteria were represented by seven phyla and twelve classes, whereas fungi were represented by two phyla and seven known classes. Using principal coordinate analysis (PCoA) based on Bray Curtis distances of 16S rRNA sequences, we observed a significant variation between the structure of the bacterial communities depending on insects’ density. Moreover, the analysis showed significant correlations between some bacterial taxa and the three classes of insects’ density. This study is the first to present a complete overview of the bacterial and fungal communities associated with the gut of EAB base on culture-independent methods, and to correlate those communities with a potential stress factor of the host trees.

Keywords: gut microbiome, DNA, 16S rRNA sequences, emerald ash borer

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Authors: L. A. Ostrovsky, Yu. A. Stepanyants

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Effect of Earth rotation on nonlinear waves is a practically important and theoretically challenging problem of fluid mechanics and geophysics. Whereas the large-scale, geostrophic processes such as Rossby waves are a classical object of oceanic and atmospheric physics, rotation effects on mesoscale waves are not well studied. In particular, the Coriolis force can radically modify the behavior of nonlinear internal gravity waves in the ocean having spatial scales of 1-10 kilometers and time durations of few hours. In the last decade, such a non-trivial behavior was observed more than once. Similar effects are possible for magnetic sound in the ionosphere. Here we outline the main physical peculiarities in the behavior of nonlinear internal waves due to the rotation effect and present some results of our recent studies. The consideration is based on the fourth-order equation derived by one of the authors as a rotation-modified Korteweg–de Vries (rKdV) equation which includes two types of dispersion: one is responsible for the finiteness of depth as in the classical KdV equation; another is due to the Coriolis effect. This equation is, in general, non-integrable; moreover, under the conditions typical of oceanic waves (positive dispersion parameter), it does not allow solitary solutions at all. In the opposite case (negative dispersion) which is possible for, e.g., magnetic sound, solitary solutions do exist and can form complex bound states (multisoliton). Another non-trivial properties of nonlinear internal waves with rotation include, to name a few, the ‘terminal’ damping of the initial KdV soliton disappearing in a finite time due to radiation losses caused by Earth’s rotation, and eventual transformation of a KdV soliton into a wave packet (an envelope soliton). The new results to be discussed refer to the interaction of a soliton with a long background wave. It is shown, in particular, that in this case internal solitons can exist since the radiation losses are compensated by energy pumping from the background wave. Finally, the relevant oceanic observations of rotation effect on internal waves are briefly described.

Keywords: Earth rotation, internal waves, nonlinear waves, solitons

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Authors: Marta Skwarecka, Patrycja Bloch, Rafal Walkusz, Oliwia Urbanowicz, Grzegorz Zielinski, Sabina Zoledowska, Dawid Nidzworski

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Upper respiratory tract infections are one of the most common reasons for visiting a general doctor. Streptococci are the most common bacterial etiological factors in these infections. There are many different types of Streptococci and infections vary in severity from mild throat infections to pneumonia. For example, S. pyogenes mainly contributes to acute pharyngitis, palatine tonsils and scarlet fever, whereas S. Streptococcus pneumoniae is responsible for several invasive diseases like sepsis, meningitis or pneumonia with high mortality and dangerous complications. There are only a few diagnostic tests designed for detection Streptococci from the infected throat of patients. However, they are mostly based on lateral flow techniques, and they are not used as a standard due to their low sensitivity. The diagnostic standard is to culture patients throat swab on semi selective media in order to multiply pure etiological agent of infection and subsequently to perform antibiogram, which takes several days from the patients visit in the clinic. Therefore, the aim of our studies is to develop and implement to the market a Point of Care device for the rapid identification of Streptococcus pyogenes and Streptococcus pneumoniae with simultaneous identification of antibiotic resistance genes. In the course of our research, we successfully selected genes for to-species identification of Streptococci and genes encoding antibiotic resistance proteins. We have developed a reaction to amplify these genes, which allows detecting the presence of S. pyogenes or S. pneumoniae followed by testing their resistance to erythromycin, chloramphenicol and tetracycline. What is more, the detection of β-lactamase-encoding genes that could protect Streptococci against antibiotics from the ampicillin group, which are widely used in the treatment of this type of infection is also developed. The test is carried out directly from the patients' swab, and the results are available after 20 to 30 minutes after sample subjection, which could be performed during the medical visit.

Keywords: antibiotic resistance, Streptococci, respiratory infections, diagnostic test

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Authors: Layaly Ayoub, Mariana Ribeiro

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Introduction: Breast cancer is currently considered the leading cause of cancer-related deaths among women in Brazil. Mastectomy, essential in this treatment, often necessitates subsequent breast reconstruction to restore physical appearance and aid in the emotional and psychological recovery of patients. The choice between immediate or delayed reconstruction is influenced by factors such as the type and stage of cancer, as well as the patient's overall health. The decision between autologous breast reconstruction or implant-based reconstruction requires a detailed analysis of individual conditions and needs. Objectives: This study analyzes the techniques and indications used in post-mastectomy breast reconstruction. Methodology: Literature review conducted in the PubMed and SciELO databases, focusing on articles that met the inclusion and exclusion criteria and descriptors. Results: After mastectomy, breast reconstruction is commonly performed. It is necessary to determine the type of technique to be used in each case depending on the specific characteristics of each patient. The tissue expander technique is indicated for patients with sufficient skin and tissue post-mastectomy, who do not require additional radiotherapy, and who opt for a less complex surgery with a shorter recovery time. This procedure promotes the gradual expansion of soft tissues where the definitive implant will be placed. Both temporary and permanent expanders offer flexibility, allowing for adjustment in the expander size until the desired volume is reached, enabling the skin and tissues to adapt to the breast implant area. Conversely, autologous reconstruction is indicated for patients who will undergo radiotherapy, have insufficient tissue, and prefer a more natural solution. This technique uses the transverse rectus abdominis muscle (TRAM) flap, the latissimus dorsi muscle flap, the gluteal flap, and local muscle flaps to shape a new breast, potentially combined with a breast implant. Conclusion: In this context, it is essential to conduct a thorough evaluation regarding the technique to be applied, as both have their benefits and challenges.

Keywords: indications, post-mastectomy, breast reconstruction, techniques

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Authors: Pranita Shivankar, Arun Suryawanshi, Prabodhachandra Deshmukh, S. V. C. Kameswara Rao

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Many undesirable significant changes in landscapes and the regions in the vicinity of historically important structures occur as impacts due to anthropogenic activities over a period of time. A better understanding of such influences using recently developed satellite remote sensing techniques helps in planning the strategies for minimizing the negative impacts on the existing environment. In 1982, a fossilized hominid skull cap was discovered at a site located along the northern bank of the east-west flowing river Narmada in the village Hathnora. Close to the same site, the presence of Late Acheulian and Middle Palaeolithic tools have been discovered in the immediately overlying pebbly gravel, suggesting that the ‘Narmada skull’ may be from the Middle Pleistocene age. The reviews of recently carried out research studies relevant to hominid remains all over the world from Late Acheulian and Middle Palaeolithic sites suggest succession and contemporaneity of cultures there, enhancing the importance of Hathnora as a rare precious site. In this context, the maximum likelihood classification using digital interpretation techniques was carried out for this study area using the satellite imagery from Landsat ETM+ for the year 2006 and Landsat TM (OLI and TIRS) for the year 2016. The overall accuracy of Land Use Land Cover (LULC) classification of 2016 imagery was around 77.27% based on ground truth data. The significant reduction in the main river course and agricultural activities and increase in the built-up area observed in remote sensing data analysis are undoubtedly the outcome of human encroachments in the vicinity of the eminent heritage site.

Keywords: cultural succession, digital interpretation, Hathnora, Homo Sapiens, Late Acheulian, Middle Palaeolithic

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Authors: Hafiz Atif Iqbal

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It is a confirmed historical fact that Pakistan is an ideological state, and religion has played a very important and vital role in the establishment of Pakistan. This is the reason why the slogan "What does Pakistan mean is "la ilaha illa Allah" is embedded in the heart of every Muslim. This slogan became so popular in the dimensions of India that Movement of Pakistan and this slogan became inseparable, and that is why Quaid-e-Azam said: "Twenty-five percent share in Movement of Pakistan belongs to the creator of this slogan, Asghar Soudai Sialkoti." This slogan later formed the basis of the two-nation theory, whereby the Hindus and Muslims of the sub-continent were declared to be two separate and complete nations, completely different from each other in terms of their religion, affairs, dress, lifestyle, and values. In this regard, on March 23, 1940, at the historic meeting of the Muslim League in Lahore, in which the Lahore Resolution was passed, Quaid-e-Azam said: Islam and Hinduism are not just religions, but actually two different social systems. Therefore, this desire should be called a dream and a dream that Hindus and Muslims will be able to create a common nationality together. These people do not marry each other, nor do they eat at the same table. I say in a nutshell that they belong to two different civilizations, and these civilizations are based on concepts and facts that contradict each other and are against each other. Quaid-e-Azam, while addressing Peshawar in January 1948, said: "We did not demand Pakistan just to get a separate piece of land, but we wanted to get a laboratory where we can test the principles of Islam. The distinction of the concept of Islamic government should be kept in mind that the authority of obedience and loyalty in it is God Almighty, whose practical means of compliance are the rules and principles of the Holy Quran. Only the rules of the Holy Quran can determine the limits of our freedom and restrictions in the state and society. In other words, the Islamic government is the government of Quranic principles and rules. All these facts make it clear that religion has played a fundamental and important role in the establishment of Pakistan.

Keywords: la ilaha illa allah, asghar soudai sialkoti, lahore resolution, quaid-e-azam

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Authors: Eric Lee G. Escobedo-Wu, Nidhi Rohatgi, Fouzel Dhebar

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It is challenging for patients to navigate through healthcare systems after-hours. This leads to delays in care, patient/provider dissatisfaction, inappropriate resource utilization, readmissions, and higher costs. It is important to provide patients and providers with effective clinical decision-making tools to allow seamless connectivity and coordinated care. In August 2015, patient-centric Stanford Health Care established Clinical Advice Services (CAS) to provide clinical decision support after-hours. CAS is founded on key Lean principles: Value stream mapping, empathy mapping, waste walk, takt time calculations, standard work, plan-do-check-act cycles, and active daily management. At CAS, Clinical Assistants take the initial call and manage all non-clinical calls (e.g., appointments, directions, general information). If the patient has a clinical symptom, the CAS nurses take the call and utilize standardized clinical algorithms to triage the patient to home, clinic, urgent care, emergency department, or 911. Nurses may also contact the on-call physician based on the clinical algorithm for further direction and consultation. Since August 2015, CAS has managed 228,990 calls from 26 clinical specialties. Reporting is built into the electronic health record for analysis and data collection. 65.3% of the after-hours calls are clinically related. Average clinical algorithm adherence rate has been 92%. An average of 9% of calls was escalated by CAS nurses to the physician on call. An average of 5% of patients was triaged to the Emergency Department by CAS. Key learnings indicate that a seamless connectivity vision, cascading, multidisciplinary ownership of the problem, and synergistic enterprise improvements have contributed to this success while striving for continuous improvement.

Keywords: after hours phone calls, clinical advice services, nurse triage, Stanford Health Care

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Authors: Beatrice Fenu, Francesco Niosi, Giovanni Bracco, Giuliana Mattiazzo

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In recent years, Europe has seen a great development of renewable energy, in a perspective of reducing polluting emissions and transitioning to cleaner forms of energy, as established by the European Green New Deal. Wind energy has come to cover almost 15% of European electricity needs andis constantly growing. In particular, far-offshore wind turbines are attractive from the point of view of exploiting high-speed winds and high wind availability. Considering offshore wind turbine siting that combines the resources analysis, the bathymetry, environmental regulations, and maritime traffic and considering the waves influence in the stability of the platform, the hydrodynamic characteristics of the platform become fundamental for the evaluation of the performances of the turbine, especially for the pitch motion. Many platform's geometries have been studied and used in the last few years. Their concept is based upon different considerations as hydrostatic stability, material, cost and mooring system. A new method to reach a high-performances substructure for different kinds of wind turbines is proposed. The system that considers substructure, mooring, and wind turbine is implemented in Orcaflex, and the simulations are performed considering several sea states and wind speeds. An external dynamic library is implemented for the turbine control system. The study shows the comparison among different substructures and the new concepts developed. In order to validate the model, CFD simulations will be performed by mean of STAR CCM+, and a comparison between rigid and elastic body for what concerns blades and tower will be carried out. A global model will be built to predict the productivity of the floating turbine according to siting, resources, substructure, and mooring. The Levelized Cost of Electricity (LCOE) of the system is estimated, giving a complete overview about the advantages of floating offshore wind turbine plants. Different case studies will be presented.

Keywords: aero-hydrodynamic model, computational fluid dynamics, floating offshore wind, siting, verification, and validation

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Authors: Miriam Fahmy, Shalini Fernando

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Educational links between teaching hospitals and universities can provide visits with great impact for both sides. As a visitor, one is responsible for the content, respecting current practice while offering guidance from a completely different perspective. There is little documented guidance for establishing links with universities in developing countries and providing meaningful teaching and exchange programmes. An initial contact retrieved one response with regards to written curriculum. The otolaryngology department from a Swansea teaching hospital visited a university in the Gambia. A consultant and clinical fellow visited with medical students to deliver lectures, clinical skills and informal teaching such as bedside and small group teaching. Students who had participated in teaching provided by the visiting university were asked to give feedback. This information was collated and used to evaluate the impact, and to guide future visits, including thinking of establishing a curriculum tailored to the West Africa region. The students felt they gained the most from informal sessions such as bedside teaching and felt that more practical experience on real patients and pathology would be most beneficial to them. Given that internet is poor, they also suggested a video library for their reference. Many of them look forward to visiting Swansea and are interested in the differences in practice and technologies. The findings are limited to little previous literature and student feedback. Student feedback sparked further questions and careful contemplation. There is great scope for introducing a range of teaching resources but it is important to avoid assumptions and imposition of a western curriculum and education system, a larger sample is needed with input from lecturers and curriculum writers in leading universities. In conclusion, more literature and guidance needs to be established for future visitors contemplating an educational link.

Keywords: education, impact, West Africa, university links

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Authors: Yulia Eka Putrie, Widjaja Martokusumo

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The development of architecture today indicates that an architectural object often does not represent one single identity only. One architectural object could represents layers of multiple identities of an increasingly complex society. Mosque architecture for example, is mainly associated with one religious identity; that mosque architecture serves as the representation of Islamic identity. However, on many occasions, mosque architecture also serves as the representation of other motives, such as political, social, even individual identity. In normal circumstances, these layers of identities are not always seen or realized by common people outside the community. They are only represented implicitly in some symbolic forms, activities, and events. On the other hand, in specific circumstances, these kinds of identities were represented explicitly in mosque architecture. This paper is a part of an initial research on the representation of socio-political identities in Nahdliyyin mosques in East Java, Indonesia. Nahdliyyin mosques were chosen as the object of research because of its significance in Indonesian socio-political context, because majority of Indonesian muslims are culturally associated with Nahdlatul Ulama (NU) with its aswaja doctrine. Some frictions in mosque ownership and management between Nahdliyyin and other islamic school of thoughts, has resulted in preventive efforts, where some of the efforts are related to the representation of their identity in their mosque architecture. The research is a field research that took place in Malang, East Java. Malang is one of main cities in East Java; a cultural and regional basis of NU and Nahdliyyin people. Formal analysis were conducted in ten large Nahdliyyin mosques in Malang. Some structured and in-depth interviews were also held to explore the motives of identity representation in some architectural aspects of the mosques. The result of this initial study indicates that there are layers of identities which were manifested in the studied mosques. These layers of identities in Nahdliyyin mosques were based on the same main values, but represented through various formal expressions. Furthermore, the study also brings the deeper understanding on socio-political context of mosques in Nahdliyyin culture.

Keywords: Nahdliyyin mosque architecture, layers of identities, representation, Nahdlatul Ulama

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Authors: Lindy Adoma Dampare, Marina Aferiba Tandoh

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Sickle cell disease (SCD) is an inherited blood disorder that mostly affects individuals in sub-Saharan Africa. Nutritional deficiencies have been well established in SCD patients. In Ghana, studies have revealed the prevalence of malnutrition, especially amongst children with SCD and hence the need to develop an evidence-based comprehensive nutritional therapy for SCD to improve their nutritional status. The aim of the study was to develop and assess the effect of a nutrition education material on the nutritional status of SCD patients in Ghana. This was a pre-post interventional study. Patients between the ages of 2 to 60 years were recruited from the Tema General Hospital. Following a baseline nutrition knowledge (NK), beliefs, sanitary practice and dietary consumption pattern assessment, a twice-monthly nutrition education was carried out for 3 months, followed by a post-intervention assessment. Nutritional status of SCD patients was assessed using a 3-days dietary recall and anthropometric measurements. Nutrition education (NE) was given to SCD adults and caregivers of SCD children. Majority of the caregivers (69%) and SCD adult (82%) at baseline had low NK. The level of NK improved significantly in SCD adults (4.18±1.83 vs. 10.00±1.00, p<0.001) and caregivers (5.58 ± 2.25 vs.10.44± 0.846, p<0.001) after NE. Increase in NK improved dietary intake and dietary consumption pattern of SCD patients. Significant increase in weight (23.2±11.6 vs. 25.9±12.1, p=0.036) and height (118.5±21.9 vs. 123.5±22.2, p=0.011) was observed in SCD children at post intervention. Stunting (10.5% vs. 8.6%, p=0.62) and wasting (22.1% vs. 14.4%, p=0.30) reduced in SCD children after NE although not statistically significant. Reduction (18.2% vs. 9.1%) in underweight and an increase (18.2% vs. 27.3%) in overweight SCD adults was recorded at post intervention. Fat mass remained the same while high muscle mass increased (18.2% vs. 27.3%) at post intervention in SCD adult. Anaemic status of SCD patients improved at post intervention and the improvement was statistically significant amongst SCD children. Nutrition education improved the NK of SCD caregivers and adults hence, improving the dietary consumption pattern and nutrient intake of SCD patients. Overall, NE improved the nutritional status of SCD patients. This study shows the potential of nutrition education in improving the nutritional knowledge, dietary consumption pattern, dietary intake and nutritional status of SCD patients, and should be further explored.

Keywords: sickle cell disease, nutrition education, dietary intake, nutritional status

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Authors: Ankita Tiwari, Jyoti Saini, Subhasis Ghosh

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For many years, researchers have been fascinated by the subject of how properties evolve as dimensionality is lowered. Early on, it was shown that the presence of a significant magnetic anisotropy might compensate for the lack of long-range (LR) magnetic order in a low-dimensional system (d < 3) with continuous symmetry, as proposed by Hohenberg-Mermin and Wagner (HMW). Strong magnetic anisotropy allows an LR magnetic order to stabilize in two dimensions (2D) even in the presence of stronger thermal fluctuations which is responsible for the absence of Heisenberg ferromagnetism in 2D. Van der Waals (vdW) ferromagnets, including CrI₃, CrTe₂, Cr₂X₂Te₆ (X = Si and Ge) and Fe₃GeTe₂, offer a nearly ideal platform for studying ferromagnetism in 2D. Fe₃GeTe₂ is the subject of extensive investigation due to its tunable magnetic properties, high Curie temperature (Tc ~ 220K), and perpendicular magnetic anisotropy. Many applications in the field of spintronics device development have been quite active due to these appealing features of Fe₃GeTe₂. Although it is known that LR-driven ferromagnetism is necessary to get around the HMW theorem in 2D experimental realization, Heisenberg 2D ferromagnetism remains elusive in condensed matter systems. Here, we show that Fe₃GeTe₂ hosts both localized and delocalized spins, resulting in itinerant and local-moment ferromagnetism. The presence of LR itinerant interaction facilitates to stabilize Heisenberg ferromagnet in 2D. With the help of Rhodes-Wohlfarth (RW) and generalized RW-based analysis, Fe₃GeTe₂ has been shown to be a 2D ferromagnet with itinerant magnetism that can be modulated by an external magnetic field. Hence, the presence of both local moment and itinerant magnetism has made this system interesting in terms of research in low dimensions. We have also rigorously performed critical analysis using an improvised method. We show that the variable critical exponents are typical signatures of 2D ferromagnetism in Fe₃GeTe₂. The spontaneous magnetization exponent β changes the universality class from mean-field to 2D Heisenberg with field. We have also confirmed the range of interaction via the renormalization group (RG) theory. According to RG theory, Fe₃GeTe₂ is a 2D ferromagnet with LR interactions.

Keywords: Van der Waal ferromagnet, 2D ferromagnetism, phase transition, itinerant ferromagnetism, long range order

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Authors: Sehrish Qayyum

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In this age of constant technology, asymmetrical warfare could not be won. Attuned psychometric study confirms that screaming sometimes is more productive than active retaliation against strong adversaries. Asymmetric warfare is a game of nerves and thoughts with least vigorous participation for large anticipated losses. It creates the condition of paraplegia with partial but permanent immobility, which effects the core warfare operations, being screams rather than active retaliation. When one’s own power is doubted, it gives power to one’s own doubt to ruin all planning either done with superlative cost-benefit analysis. Strategically calculated estimation of asymmetric warfare since the early WWI to WWII, WWII-to Cold War, and then to the current era in three chronological periods exposits that courage makes nations win the battle of warriors to battle of comrades. Asymmetric warfare has been most difficult to fight and survive due to unexpectedness and being lethal despite preparations. Thoughts before action may be the best-assumed strategy to mix Regional Security Complex Theory and OODA loop to develop the Paraplegic Resilience Policy Plan (PRPP) to win asymmetric warfare. PRPP may serve to control and halt the ongoing wave of terrorism, guerilla warfare, and insurgencies, etc. PRPP, along with a strategic work plan, is based on psychometric analysis to deal with any possible war condition and tactic to save millions of innocent lives such that lost in Christchurch New Zealand in 2019, November 2015 Paris attacks, and Berlin market attacks in 2016, etc. Getting tangled into self-imposed epistemic dilemmas results in regret that becomes the only option of performance. It is a descriptive psychometric analysis of war conditions with generic application of probability tests to find the best possible options and conditions to develop PRPP for any adverse condition possible so far. Innovation in technology begets innovation in planning and action-plan to serve as a rheostat approach to deal with asymmetric warfare.

Keywords: asymmetric warfare, psychometric analysis, PRPP, security

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Authors: Shih-Wen Hsiao, Yi-Cheng Tsao

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In the field of reverse engineering and creative industries, applying 3D scanning process to obtain geometric forms of the objects is a mature and common technique. For instance, organic objects such as faces and nonorganic objects such as products could be scanned to acquire the geometric information for further application. However, although the data resolution of 3D scanning device is increasing and there are more and more abundant complementary applications, the penetration rate of 3D scanning for the public is still limited by the relative high price of the devices. On the other hand, Kinect, released by Microsoft, is known for its powerful functions, considerably low price, and complete technology and database support. Therefore, related studies can be done with the applying of Kinect under acceptable cost and data precision. Due to the fact that Kinect utilizes optical mechanism to extracting depth information, limitations are found due to the reason of the straight path of the light. Thus, various angles are required sequentially to obtain the complete 3D information of the object when applying a single Kinect for 3D scanning. The integration process which combines the 3D data from different angles by certain algorithms is also required. This sequential scanning process costs much time and the complex integration process often encounter some technical problems. Therefore, this paper aimed to apply multiple Kinects simultaneously on the field of developing a rapid 3D mannequin scan platform and proposed suggestions on the number and angles of Kinects. In the content, a method of establishing the coordination based on the relation between mannequin and the specifications of Kinect is proposed, and a suggestion of angles and number of Kinects is also described. An experiment of applying multiple Kinect on the scanning of 3D mannequin is constructed by Microsoft API, and the results show that the time required for scanning and technical threshold can be reduced in the industries of fashion and garment design.

Keywords: 3D scan, depth sensor, fashion and garment design, mannequin, multiple Kinect sensor

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Authors: Elena Masi, Adolfo Morrone

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Migration has recently become a mainstream development sector and is currently at the forefront in institutional and civil society context. However, no consensus exists on how the link between migration and development operates, that is how development is related to migration and how migration can promote development. On one hand, Official Development Assistance is recognized to be one of the levers to development. On the other hand, the debate is focusing on what should be the scope of aid programs targeting migrants groups and in general the migration process. This paper provides a descriptive analysis on how development aid for migration was allocated in the recent past, focusing on the actions that were funded and implemented by the international donor community. In the absence of an internationally shared methodology for defining the boundaries of development aid on migration, the analysis based on lexical hypotheses on the title or on the short description of initiatives funded by several Organization for Economic Co-operation and Development (OECD) countries. Moreover, the research describes and quantifies aid flows for each country according to different criteria. The terms migrant and refugee are used to identify the projects in accordance with the most internationally agreed definitions and only actions in countries of transit or of origin are considered eligible, thus excluding the amount sustained for refugees in donor countries. The results show that the percentage of projects targeting migrants, in terms of amount, has followed a growing trend from 2009 to 2016 in several European countries, and is positively correlated with the flows of migrants. Distinguishing between programs targeting migrants and programs targeting refugees, some specific national features emerge more clearly. A focus is devoted to actions targeting the root causes of migration, showing an inter-sectoral approach in international aid allocation. The analysis gives some tentative solutions to the lack of consensus on language on migration and development aid, and emphasizes the need to internationally agree on a criterion for identifying programs targeting both migrants and refugees, to make action more transparent and in order to develop effective strategies at the global level.

Keywords: migration, official development assistance, ODA, refugees, time series

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Authors: Chairun Wiedyaningsih, Sri Suryawati, Yati Soenarto, Muhammad Hakimi

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Background: Many drugs used in paediatrics are not commercially available in suitable dosage forms. Therefore, the drugs often prescribed in extemporaneous compounding dosage form. Compounding can pose health risks include poor quality and unsafe products. Studies of compounding dosage form have primarily focused on prescription profiles, reasons of prescribing never be explored. Objectives: The study was conducted to identify factors influencing physicians’ decision to prescribe extemporaneous compounding dosage form for paediatric outpatients. Setting: Daerah Istimewa Yogyakarta (DIY) province, Indonesia. Method: Qualitative semi-structured interviews were conducted with 15 general physicians and 7 paediatricians to identify the reason of prescribing extemporaneous compounding dosage form. The interviews were transcribed and analysed using thematic analysis. Results: Factors underlying prescribing of compounding could be categorized to therapy, healthcare system, patient and past experience. The primary reasons of therapy factors were limited availability of drug compositions, dosages or formulas specific for children. Beliefs in efficacy of the compounding forms were higher when the drugs used primarily to overcome complex cases. Physicians did not concern about compounding form containing several active substances because manufactured syrups may also contain several active substances. Although medicines were available in manufactured syrups, limited institutional budget was healthcare system factor of compounding prescribing. The prescribing factors related to patients include easy to use, efficient and lower price. The prescribing factors related to past experience were physicians’ beliefs to the progress of patient's health status. Conclusions: Compounding was prescribed based on therapy-related factors, healthcare system factors, patient factors and past experience.

Keywords: compounding dosage form, interview, physician, prescription

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