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The emerging demands for healthcare where access is limited due to political, environmental, or socio-economic factors have been driving research into bio-medical devices that perform in both diagnostic and therapeutic roles at lower costs and greater accessibility. Paper microfluidic devices are used in many applications, particularly medical diagnostics and offer an excellent combination of utility and low cost making them particularly valuable in resource-limited applications and point-of-care usage across a wide variety environmental conditions. Microfluidic biological diagnostics continue to mature as researchers discover new ways to exploit the technological possibilities, and address liabilities. The increasing complexity of paper-based microfluidic devices beyond home pregnancy tests is driving the need to produce new tools and methodologies that enable more robust biological diagnostics and potential therapeutic applications. However, the process of developing new paper microfluidic devices is limited due to having to manually design and fabricate designs to research. Often, researchers must design scores of different devices to find a combination of parameters that functions as expected. In this work, a novel software framework to support automated development of paper-based microfluidic devices is introduced to facilitate both research and fabrication to accelerate the investigative process and reduce material utilization and manpower. Unlike to existing lab-on-a-chip technologies, paper-based microfluidics differs in terms of substrate technologies and use a passive flow method to deliver fluids and reagents for assays. While numerous analogies between microfluidics and semiconductor technologies have been espoused, the physical differences between the fluid dynamics and electrical current are significant which suggests that current trends in physical design for microfluidics must change course in order to be of practical use to designers. Within this framework, a methodology is introduced to address design automation such as dynamically placing and routing microfluidic components in a non-discrete design space while avoiding invalid design layouts, accounting for fluid volume usage, surface area utilization, and the timing required to perform specified biological assays and also optimizing device parameters, enabling researchers to focus on the science and thereby accelerating the development of new, low-resource paper microfluidic devices for a developing world.

Made available in DSpace on 2022-04-29T08:31:12Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-10-01 Organization and planning of reverse logistics networks make sustainable processes more efficient. Thus, an important sector for connecting the collection and waste paper recycling echelons is the intermediate center. In this study, a Mixed Integer Linear Programming model, which is multi-objective, multi-product, multi-level and multi-period, was developed to optimize the waste paper logistics processes of intermediate centers. The formulation includes the following echelons: collection, considering vehicle routing with different capacities; inventory of non-baling materials; baling sorted waste and inventory of bales; selling bales; disposal of non-recyclable waste. The aims of the model include: maximizing the collected waste; minimizing distances; maximizing both the production and sale of bales, and minimizing costs. According to research carried out in the literature, the developed model is a new proposal and to implement it, the Weighted Goal Programming and Revised Multi-Choice Goal Programming approaches were used to deal with multiple objectives and incorporate uncertainty into the quantity of waste available for collection. To analyze the proposed model, computational tests were executed with instances based on real data from a Brazilian company in the sector. For all performed tests, General Algebraic Modeling System 23.6.5 modeling language and CPLEX 12.2.0.2 solver were used for modeling and optimization. The results show that this study presents formulation and technological approaches that represent real situations and provide competitive solutions to the problem. Sáo Paulo State University “Júlio de Mesquita Filho” [Universidade Estadual Paulista Júlio de Mesquita Filho] School of Engineering of Guaratinguetá [Faculdade de Engenharia de Guaratinguetá] Production Department, Av. Ariberto Pereira da Cunha, 333, Portal das Colinas Agulhas Negras Military Academy [Academia Militar das Agulhas Negras] Rodovia Presidente Dutra, km 306, s/n Escola Preparatória de Cadetes do Exército Avenida Papa Pio XII 350 Jardim Chapadão Campinas - SP Brazil, Avenida Papa Pio XII, 350, Jardim Chapadão, Campinas - SP Sáo Paulo State University “Júlio de Mesquita Filho” [Universidade Estadual Paulista Júlio de Mesquita Filho] School of Engineering of Guaratinguetá [Faculdade de Engenharia de Guaratinguetá] Production Department, Av. Ariberto Pereira da Cunha, 333, Portal das Colinas

The pulp and paper industry is highly energy-intensive. In mills that use chemical pulping, roughly half of the higher heating value of the cellulosic material used to manufacture the product typically is incinerated to generate steam and electricity that is needed to run the processes. Additional energy, much of it non-renewable, needs to be purchased. This review considers publications describing steps that pulp and paper facilities can take to operate more efficiently. Savings can be achieved, for instance, by minimizing unnecessary losses in exergy, which can be defined as the energy content relative to a standard ambient condition. Throughout the long series of unit operations comprising the conversion of wood material to sheets of paper, there are large opportunities to more closely approach a hypothetical ideal performance by following established best-practices.

The appearance and quick spread of the new severe acute respiratory syndrome coronavirus disease, COVID-19, brought major societal challenges. Importantly, suitable medical diagnosis procedures and smooth clinical management of the disease are an emergent need, which must be anchored on novel diagnostic methods and devices. Novel molecular diagnostic tools relying on nucleic acid amplification testing have emerged globally and are the current gold standard in COVID-19 diagnosis. However, the need for widespread testing methodologies for fast, effective testing in multiple epidemiological scenarios remains a crucial step in the fight against the COVID-19 pandemic. Biosensors have previously shown the potential for cost-effective and accessible diagnostics, finding applications in settings where conventional, laboratorial techniques may not be readily employed. Paper- and cellulose-based biosensors can be particularly relevant in pandemic times, for the renewability, possibility of mass production with sustainable methodologies, and safe environmental disposal. In this review, paper-based devices and platforms targeting SARS-CoV-2 are showcased and discussed, as a means to achieve quick and low-cost PoC diagnosis, including detection methodologies for viral genomic material, viral antigen detection, and serological antibody testing. Devices targeting inflammatory markers relevant for COVID-19 are also discussed, as fast, reliable bedside diagnostic tools for patient treatment and follow-up., The authors acknowledge funding through projects Eco2Covid (POCI-01-02B7-FEDER-068174) and TecniCov (POCI-01-02B7-FEDER-069745), co-funded by FEDER through COMPETE2020 and Lisboa2020. T.P., A.R.C. and A.C.M. acknowledge funding to National Foundation for Science and Technology, I.P., FCT, through their PhD grants, references DFA/BD/8606/2020, SFRH/BD/130107/2017 and SFRH/BD/115173/2016, respectively, info:eu-repo/semantics/publishedVersion

Graphical abstract Enzyme-linked immunosorbent assay (ELISA) is widely used for the detection of disease biomarkers. However, it utilizes time-consuming procedures and expensive instruments, making it infeasible for point-of-care (POC) analysis especially in resource-limited settings. In this work, a multicolorimetric ELISA biosensor integrated on a paper/polymer hybrid microfluidic device was developed for rapid visual detection of disease biomarkers at point of care, without using costly equipment. This multicolormetric ELISA platform was built on multiple distinct color variants resulted from the catalytic oxidation of 3,3′,5,5′-tetramethylbenzidine (TMB) and the etching of gold nanorods (AuNRs). The vivid color changes could be easily distinguished by the naked eye, and their red mean values allowed quantitative biomarker detection, without using any sophisticated instruments. When this multicolorimetric ELISA was integrated on a paper/polymer hybrid analytical device, it not only provided integrated processing and high portability but also enabled fast assays in about 50 min due to the unique advantages of paper/polymer hybrid devices. The limit of detection of 9.1 ng/μL of the hepatitis C virus core antigen, a biomarker for hepatitis C, was achieved using this multicolorimetric ELISA platform. This multicolor ELISA analytical device provides a new versatile, user-friendly, affordable, and portable immunosensing platform with high potential for on-site detections of various viruses, proteins, and biomarkers for low-resource settings such as at home, public venues, rural areas, and developing nations. Supplementary Information The online version contains supplementary material available at 10.1007/s00216-021-03359-8.

In the tourism industry, the sales of local specialties is an important part, and the package design and integrity of the specialties are very important. This paper first introduced the support vector machine (SVM) algorithm that was used for detecting defects on the surface of paper packages. Then, the design of red wind packages was briefly described, and the simulation experiment was carried out on SVM algorithm using red wine packages with different degrees of surface defects. Proper parameters were tested using the k-fold cross-validation method. The results demonstrated that the properties of paper improved the value of packages and the SVM algorithm had better accuracy than artificial recognition in recognizing different degrees of defects on the surface of packages. In conclusion, this paper describes the application of paper in packages and provides an effective method for the defection of defects on the surface of packages. This study provides an effective references to the improvement of package values and the enhancement of package integrity.

Teaching about biodiversity and its conservation could be an effective way to teach the importance of different species and human dependence on ecological support systems. This study compares the effectiveness of a digital and a paper-based dichotomous identification key for teaching pre-service teachers about plantspecies diversity. Twenty-four Slovenian teachers in pre-service training used a digital version of the key on tablet computers and twenty-nine used a paper-based version to identify woody species in the garden near their university faculty. Both keys contained the same species, identical photographs and the same sequence of steps to identify the species. The accuracy and time taken to identify the five species were measured. The participants also completed a questionnaire about the usability of the identification key. Overall, both versions of the key were equally good for determining species names. The digital version of the key was found to be more time-effective than the paper version only when multiple identification steps were required to identify species. The results confirm that those who scored better on the identification tasks have a better general opinion about the usability of the key especially students using digital version of the key. Implications for teachers using or creating identification keys are discussed in the conclusion.

Continuous manufacturing is an indicator of a maturing industry, as can be seen by the example of the petrochemical industry. Patent expiry promotes a price competition between manufacturing companies, and more efficient and cheaper processes are needed to achieve lower production costs. Over the last decade, continuous biomanufacturing has had significant breakthroughs, with regulatory agencies encouraging the industry to implement this processing mode. Process development is resource and time consuming and, although it is increasingly becoming less expensive and faster through high‐throughput process development (HTPD) implementation, reliable HTPD technology for integrated and continuous biomanufacturing is still lacking and is considered to be an emerging field. Therefore, this paper aims to illustrate the major gaps in HTPD and to discuss the major needs and possible solutions to achieve an end‐to‐end Integrated Continuous Biomanufacturing, as discussed in the context of the 2019 Integrated Continuous Biomanufacturing conference. The current HTPD state‐of‐the‐art for several unit operations is discussed, as well as the emerging technologies which will expedite a shift to continuous biomanufacturing., With an ever‐growing interest in shifting to integrated continuous biomanufacturing (ICB), the major gaps and state‐of‐the‐art perceived by academia and industry members in high‐throughput process development (HTPD) technologies for the development and implementation of this type of operation (ICB) are debated in this paper, with a special focus on the HT tools for the different unit operations in a typical biopharmaceutical process. The current needs in ICB and possible solutions to fulfill these needs are also highlighted

Microfluidic paper-based analytical devices (μPADs) have developed rapidly in recent years, because of their advantages, such as small sample volume, rapid detection rates, low cost, and portability. Due to these characteristics, they can be used for in vitro diagnostics in the laboratory, or in the field, for a variety of applications, including food evaluation, disease screening, environmental monitoring, and drug testing. This review will present various detection methods employed by μPADs and their respective applications for the detection of target analytes. These include colorimetry, electrochemistry, chemiluminescence (CL), electrochemiluminescence (ECL), and fluorescence-based methodologies. At the same time, the choice of labeling material and the design of microfluidic channels are also important for detection results. The construction of novel nanocomponents and different smart structures of paper-based devices have improved the performance of μPADs and we will also highlight some of these in this manuscript. Additionally, some key challenges and future prospects for the use of μPADs are briefly discussed.

In this paper, the implementation of artificial neural networks (multilayer perceptron [MLP] and radial base functions [RBF]) and the upgraded Markov chain model have been studied and performed to identify the human behavior patterns during rock, paper, and scissors game. The main motivation of this research is the design and construction of an intelligent robot with the ability to defeat a human opponent. MATLAB software has been used to implement intelligent algorithms. After implementing the algorithms, their effectiveness in detecting human behavior pattern has been investigated. To ensure the ideal performance of the implemented model, each player played with the desired algorithms in three different stages. The results showed that the percentage of winning computer with MLP and RBF neural networks and upgraded Markov model, on average in men and women is 59%, 76.66%, and 75%, respectively. Obtained results clearly indicate a very good performance of the RBF neural network and the upgraded Markov model in the mental modeling of the human opponent in the game of rock, paper, and scissors. In the end, the designed game has been employed in both hardware and software which include the Zana intelligent robot and a digital version with a graphical user interface design on the stand. To the best knowledge of the authors, the precision of novel presented method for determining human behavior patterns was the highest precision among all of the previous studies.

In this paper, we present a system for automatic evaluation of the quality of a question paper. Question paper plays a major role in educational assessment. The quality of a question paper is crucial to fulfilling the purpose of the assessment. In many education sectors, question papers are prepared manually. A prior analysis of a question paper might help in finding the errors in the question paper, and better achieving the goals of the assessment. In this experiment, we focus on higher education in the technical domain. First, we conducted a student survey to identify the key factors that affect the quality of a question paper. The top factors we identified are question relevance, question difficulty, and time requirement. We explored the strategies to handle these factors and implemented them. We employ various concepts and techniques for the implementation. The system finally assigns a numerical quality score against these factors. The system is evaluated using a set of question papers collected from various sources. The experimental results show that the proposed system is quite promising.

The development of industry and of the Internet of Things (IoTs) have brought energy issues and huge challenges to the environment. The emergence of triboelectric nanogenerators (TENGs) has attracted wide attention due to their advantages, such as self-powering, lightweight, and facile fabrication. Similarly to paper and other fiber-based materials, which are biocompatible, biodegradable, environmentally friendly, and are everywhere in daily life, paper-based TENGs (P-TENGs) have shown great potential for various energy harvesting and interactive applications. Here, a detailed summary of P-TENGs with two-dimensional patterns and three-dimensional structures is reported. P-TENGs have the potential to be used in many practical applications, including self-powered sensing devices, human–machine interaction, electrochemistry, and highly efficient energy harvesting devices. This leads to a simple yet effective way for the next generation of energy devices and paper electronics.

This study aims at understanding the role of the tools chosen throughout the processes of solving a non-routine mathematical problem and communicating its solution. In assuming that problem-solving is a synchronous activity of mathematization and expression of mathematical thinking we take our proposed Mathematical Problem Solving with Technology (MPST) model to analyze the processes of solving-and-expressing-problems. Resorting to qualitative methods for data collection and analysis, we report on the case of an 8th grader working on a covariation problem to examine the role that paper-and-pencil and digital tools play in the development of a conceptual model of the situation. We found that the resources used throughout the solving-and-expressing activity influenced the depth of the conceptual model developed, within a process of progressive mathematization. Whereas paper-and-pencil led to the emergence of a conceptual model based on exploring particular cases, the digital transformation of the solution was triggered by the process of communicating its mathematical justification and expanded the previous model. Moreover, the complexity of this activity is evidenced by its multiple sequences of processes. Finally, the integration process seems crucial as the concomitant use of technological and mathematical resources precedes major advancements in the expansion of the conceptual model.

Tissue biomarkers have been of increasing utility for scientific research, diagnosing disease, and treatment response prediction. There has been a steady shift away from qualitative assessment toward providing more quantitative scores for these biomarkers. The application of quantitative image analysis has thus become an indispensable tool for in-depth tissue biomarker interrogation in these contexts. This white paper reviews current technologies being employed for quantitative image analysis, their application and pitfalls, regulatory framework demands, and guidelines established for promoting their safe adoption in clinical practice.

Papers are the most commonly used substrates. A printable paper must have certain properties. These properties include surface smoothness, air permeability, surface energy, colour of the paper, opacity, whiteness, light fastness, gloss, and coefficient of elongation under force. In addition, a good printable paper should not allow ink to pass between its two surfaces. After the papers are produced, they are subjected to surface treatments in order to improve the above-mentioned properties and to provide extra specification. Surface treatments include calendering, surface sizing and coating processes. While filling the recesses and protrusions on the surface with the coating process, the paper's affinity for the ink is increased, and the penetration of the ink to the other surface of the paper is prevented. In the coating process basically, a filler is dispersed in a binder. In this study, it is aimed to obtain the highest quality and most printable paper by changing the type of binder used in the coating. In this study, equal amount (5% w/w) titanium dioxide filler was used in all coating formulations. In coating formulations; cationic starch, hydroxy ethyl cellulose and polyvinyl alcohol polymers were used as binders. Binder amounts are adjusted according to optimum viscosity. The obtained coating formulations were coated on the paper surface with a laboratory type coating device. Colour, gloss, surface smoothness, air permeability, surface energy and surface morphology of the coated papers were determined. It was printed with magenta offset printing ink on three different types of paper coated with different binders, using the IGT C1 offset printability test device, under 400 N/m2 pressure printing conditions. Colour and gloss measurements of the prints were made. As a result; It was determined that three different binders improved the printability parameters.

Antimicrobial resistance is increasingly recognized as a major threat to global health. To combat this emerging threat, accessible antimicrobial susceptibility testing should be prioritized as a key component of stewardship efforts. In this work, we developed a user-friendly paper-based test that provides visual readout of bacterial antibiotic susceptibility in a semiquantitative format. We leveraged on-chip paper microfluidics to enable multiplexed testing of multiple antibiotic dilutions with a single sample addition step, replicating the functionality of traditional broth-dilution-based susceptibility testing in a simplified format. Our paper-based test offers several advantages including low sample volume requirement and lack of need for humidity control during incubation, an innovation that addresses a key limitation of conventional paper-microfluidic devices. Using several clinically relevant bacterial organisms and antimicrobial agents, we demonstrate that our colorimetric readout approach provides a strong predictor of susceptibility category.

Introduction We developed low-cost, portable paper-based diagnostic devices for detection of human immunoglobulin M (IgM) and immunoglobulin G (IgG) in serum without any sample preparation. These devices can be used to help identify presence of diseases, used to provide rapid results ( Materials and Methods We successfully accomplished colorimetric detection of human IgG and human IgM using a sandwich-style assay within the microfluidic paper device via vertical flow immunoassay configuration. The reaction zone in the wax printed paper layer is a small circular pattern. Gold nanoparticles conjugated with anti-human IgG and IgM antibodies have been used for colorimetric detection of IgG or IgM by naked eye. Colorimetric signal can be precisely quantified through implementation of image analysis software which can be developed as an app for a smartphone. The size of the device is 2 cm × 2 cm × 1 mm. Results Colorimetric detection of human IgG was accomplished at 100 fg/mL concentration using a gold nanoparticle–conjugated anti-human IgG antibody. The developed platform has a dynamic range of IgM and IgG concentrations between 0.1 pg/mL and 100 μg/mL. These devices provided a color readout in Conclusions Because of the inherent simplicity of the device operation and their ease of use, there is no variation between samples and users of the device. This low-cost approach enables multiplexing with >1 measurement performed in parallel at the same time. We anticipate that because of the sensitivity, specificity, ease of use, and overall reliability, this approach will become a standard for diagnosis of diseases and health conditions.

Cocaine (COC) is one of the most widely consumed illegal drugs around the world. Street COC is commonly adulterated with pharmaceutical compounds that mimic or intensify the COC's sensory effect. Adulteration is performed to increase the profit of criminal organizations and each one has their own way of doing it. Therefore, determining the composition of seized COC samples (chemical profile) provides evidence for the police to track criminal organization networks and their activity patterns. Using filter paper as a substrate, we developed a multiple detection paper-based analytical device (PAD) that combines colorimetric and electrochemical measurements to discriminate COC samples according to adulterant's content. A regular graphite lead modified with a gold film made from Au leaf (graphite/Au) to improve electron transfer was used as a working electrode. Silver and Ag/AgCl were used as auxiliary and reference electrodes, respectively. The colorimetric device was patterned using a laser cutter and coupled to the electrochemical device using a double-sided tape, allowing simultaneous analysis to gather more analytical information about COC samples. Graphite/Au was characterized by scanning and transmission electron microscopies and electrochemical assays. The simultaneous colorimetric and electrochemical analyses combined to principal component analysis improved the analytical characterization of COC trial samples and provided a fast discrimination based on the assembled database.

Zinc and its compounds, alloys and composites play an important role in the modern day world and find application in almost every aspect that can improve the quality of our lives. This ranges from supplements and pharmaceuticals that are meant to improve our health and wellbeing to additives meant to guard or reduce corrosion in metals. However, over the past several years, a new area of technology has been garnering a great deal of attention and has made use of zinc and its compounds. This is with reference to paper-based microfluidic technology that offers several advantages and that keeps expanding in the amount of applications it covers. In this paper, a review is offered for the applications that have used zinc or zinc compounds in paper-based microfluidic devices.

Herein, we describe the development of a paper-based device to detect nucleic acids of pathogens of interest in complex samples using loop-mediated isothermal amplification (LAMP) by producing a colorimetric response visible to the human eye. To demonstrate the utility of this device in emerging public health emergencies, we developed and optimized our device to detect SARS-CoV-2 in human saliva without preprocessing. The resulting device was capable of detecting the virus within 60 min and had an analytical sensitivity of 97% and a specificity of 100% with a limit of detection of 200 genomic copies/μL of patient saliva using image analysis. The device consists of a configurable number of reaction zones constructed of Grade 222 chromatography paper separated by 20 mil polystyrene spacers attached to a Melinex® backing via an ARclean® double-sided adhesive. The resulting device is easily configurable to detect multiple targets and has the potential to detect a variety of pathogens simply by changing the LAMP primer sets.

Introduction: Water is essential for normal functioning of the human body. Total fluid intake assessment using fluid record method is considered to be a burden for respondents, and the development of technology is expected to contribute favourably to this issue. My Fluid Diary is a smartphone-based application developed by the researcher as a fluid intake recording tool. This study aimed to evaluate the acceptance of manual, paper-based fluid intake recording compared to using My Fluid Diary as a trial among Indonesian vocational female students. Methods: A qualitative study was conducted to explore students’ acceptance of fluid intake recording using the smartphone-based application. An exploratory case study approach involving 38 female students as key informants was used via focus group discussion and in-depth interview as a method of triangulation. Results: Based on the data, female adolescents admitted that the application was more acceptable for fluid intake than recording manually using a book, in consideration of three aspects - the benefits, the easiness, and the application display or features. Based on its benefits, My Fluid Diary was mentioned as easy to learn and use. However, in order to improve the application, there is still a need for research development. Conclusion: My Fluid Diary was an application with respectable acceptance for fluid record compared to the manual, paper-based method among female adolescents.

Physical paper puppets are inanimate objects, but when we’re speaking in terms of the production of traditional paper cut out animation, they become the actors and the souls that drive the movie. When shooting and animating traditional paper cut out animation, the puppets are laid flat on a surface so they can only move in limited directions compared to conventional 2D or 3D animation. As we know, each character in animated movie has its own personality and unique to each other. The challenge lays in bringing out the characteristics and personality of the character through the limited medium of paper puppet. In this qualitative research, puppet movements will be applied to quadruped cat characters in a public service announcement titled “Spay & Neuter”. The puppet along with the visual design, segmentations, and joints were done in previous research. Qualitative observations and audio-visual materials are used to collect the data for references. Literature review will study the characteristics of cats, body language, behaviour, and principles of animation especially timing and exaggeration. Observation is conducted by studying the movements of real cats from online videos and direct observations and also studying how other animators animate cat characters in animated films. In the exploration stage, paper puppets will be animated according to the movement design while experimenting with the timing and frame rate of the stop motion to achieve the final results.

Up to 90% of the human genome is transcribed into Long-noncoding RNAs (lncRNAs) that longer than 200 nucleotides but do not code for proteins. LncRNAs play a vital role in a broad range of biological process, it’s dysregulations and mutations are linked to the development and progression of various complex human diseases. Given the dramatic changes and growing scientific outputs in lncRNAs field, using a quantitative measurement to analyze and characterize the existing studies has become imperative.Bibliometric analysis is a widely used tool to assess the academic influence of a publication or a country in a specific field. However, a bibliometric analysis of the top 100 most-cited papers in lncRNAs area has not been conducted. Thus, we executed a bibliometric study to identify the authors, journals, countries and institutions that contributed most to the top 100 lncRNAs list, characterize the key words and focus of top 100 most-cited papers, and detect the factors related to their successful citation. This study provides a comprehensive list of the most influential papers on lncRNAs research and demonstrates the important advances in this field, which might be benefit to researchers in their paper publication and scientific cooperation.

BackgroundAntimicrobial surveillance and antimicrobial stewardship (AMS) are essential pillars in the fight against antimicrobial resistance (AMR), but practical guidance on how surveillance data should be linked to AMS activities is lacking. This issue is particularly complex in the hospital setting due to structural heterogeneity of hospital facilities and services. The JPIAMR ARCH and COMBACTE-MAGNET EPI-Net networks have joined efforts to formulate a set of target actions for linking surveillance data with AMS activities.MethodsA scoping review of the literature was carried out addressing research questions on three areas: (i) AMS leadership and accountability; (ii) antimicrobial usage and AMS; (iii) AMR and AMS. Consensus on the target actions was reached through a RAND-modified Delphi process involving over 40 experts in different fields from 18 countries.ResultsEvidence was retrieved from 51 documents. Initially 38 targets were proposed, differentiated as essential or desirable according to clinical relevance, feasibility and applicability to settings and resources. In the first consultation round, preliminary agreement was reached for 32 targets. Following a second consultation, 27 targets were approved, 11 were deleted and 4 were suggested for rephrasing, leading to a final approved list of 34 target actions in the form of a practical checklist.ConclusionsThis White Paper provides a pragmatic and flexible tool to guide the development of calibrated hospital-surveillance-based AMS interventions. The strength of this tool is that it is a comprehensive perspective that takes into account the hospital patient case-mix and the related epidemiology, which ultimately drives antimicrobial usage, and the feasibility in low-resource settings.

This study aimed to describe the worksheet's appearance and analyze the worksheet's validation test result based on POE (Predict, Observe, Explain). This research's objectives were to describe the development of a worksheet used in creating indicator papers from Aerva sanguinolenta plants and analyze the feasibility test result on its format. The stages of developing worksheets consist of preparation (define) the stage by analyzing research literature on indicator papers from Aerva sanguinolenta , planning stage by designing laboratory activities in worksheets, and development stage by conducting trials on worksheet products. The worksheet's feasibility was then tested. The results were validated with the average r- count value from the validators of 0.92, the average feasibility value percentage of 92%, the average r- count value from the students of 0.93, and the average feasibility value percentage of 93%. Therefore, the worksheet can be used as a learning aid for students in conducting experiments.