Search results for: Mauricio Casas Cruz
Commenced in January 2007
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Edition: International
Paper Count: 221

Search results for: Mauricio Casas Cruz

11 Emotions Aroused by Children’s Literature

Authors: Catarina Maria Neto da Cruz, Ana Maria Reis d'Azevedo Breda

Abstract:

Emotions are manifestations of everything that happens around us, influencing, consequently, our actions. People experience emotions continuously when socialize with friends, when facing complex situations, and when at school, among many other situations. Although the influence of emotions in the teaching and learning process is nothing new, its study in the academic field has been more popular in recent years, distinguishing between positive (e.g., enjoyment and curiosity) and negative emotions (e.g., boredom and frustration). There is no doubt that emotions play an important role in the students’ learning process since the development of knowledge involves thoughts, actions, and emotions. Nowadays, one of the most significant changes in acquiring knowledge, accessing information, and communicating is the way we do it through technological and digital resources. Faced with an increasingly frequent use of technological or digital means with different purposes, whether in the acquisition of knowledge or in communicating with others, the emotions involved in these processes change naturally. The speed with which the Internet provides information reduces the excitement for searching for the answer, the gratification of discovering something through our own effort, the patience, the capacity for effort, and resilience. Thus, technological and digital devices are bringing changes to the emotional domain. For this reason and others, it is essential to educate children from an early age to understand that it is not possible to have everything with just one click and to deal with negative emotions. Currently, many curriculum guidelines highlight the importance of the development of so-called soft skills, in which the emotional domain is present, in academic contexts. The technical report “OECD Survey on Social and Emotional Skills”, developed by OECD, is one of them. Within the scope of the Portuguese reality, the “Students’ profile by the end of compulsory schooling” and the “Health education reference” also emphasizes the importance of emotions in education. There are several resources to stimulate good emotions in articulation with cognitive development. One of the most predictable and not very used resources in the most diverse areas of knowledge after pre-school education is the literature. Due to its characteristics, in the narrative or in the illustrations, literature provides the reader with a journey full of emotions. On the other hand, literature makes it possible to establish bridges between narrative and different areas of knowledge, reconciling the cognitive and emotional domains. This study results from the presentation session of a children's book, entitled “From the Outside to Inside and from the Inside to Outside”, to children attending the 2nd, 3rd, and 4th years of basic education in the Portuguese education system. In this book, rationale and emotion are in constant dialogue, so in this session, based on excerpts from the book dramatized by the authors, some questions were asked to the children in a large group, with an aim to explore their perception regarding certain emotions or events that trigger them. According to the aim of this study, qualitative, descriptive, and interpretative research was carried out based on participant observation and audio records.

Keywords: emotions, basic education, children, soft skills

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10 Methodology to Assess the Circularity of Industrial Processes

Authors: Bruna F. Oliveira, Teresa I. Gonçalves, Marcelo M. Sousa, Sandra M. Pimenta, Octávio F. Ramalho, José B. Cruz, Flávia V. Barbosa

Abstract:

The EU Circular Economy action plan, launched in 2020, is one of the major initiatives to promote the transition into a more sustainable industry. The circular economy is a popular concept used by many companies nowadays. Some industries are better forwarded to this reality than others, and the tannery industry is a sector that needs more attention due to its strong environmental impact caused by its dimension, intensive resources consumption, lack of recyclability, and second use of its products, as well as the industrial effluents generated by the manufacturing processes. For these reasons, the zero-waste goal and the European objectives are further being achieved. In this context, a need arises to provide an effective methodology that allows to determine the level of circularity of tannery companies. Regarding the complexity of the circular economy concept, few factories have a specialist in sustainability to assess the company’s circularity or have the ability to implement circular strategies that could benefit the manufacturing processes. Although there are several methodologies to assess circularity in specific industrial sectors, there is not an easy go-to methodology applied in factories aiming for cleaner production. Therefore, a straightforward methodology to assess the level of circularity, in this case of a tannery industry, is presented and discussed in this work, allowing any company to measure the impact of its activities. The methodology developed consists in calculating the Overall Circular Index (OCI) by evaluating the circularity of four key areas -energy, material, economy and social- in a specific factory. The index is a value between 0 and 1, where 0 means a linear economy, and 1 is a complete circular economy. Each key area has a sub-index, obtained through key performance indicators (KPIs) regarding each theme, and the OCI reflects the average of the four sub-indexes. Some fieldwork in the appointed company was required in order to obtain all the necessary data. By having separate sub-indexes, one can observe which areas are more linear than others. Thus, it is possible to work on the most critical areas by implementing strategies to increase the OCI. After these strategies are implemented, the OCI is recalculated to check the improvements made and any other changes in the remaining sub-indexes. As such, the methodology in discussion works through continuous improvement, constantly reevaluating and improving the circularity of the factory. The methodology is also flexible enough to be implemented in any industrial sector by adapting the KPIs. This methodology was implemented in a selected Portuguese small and medium-sized enterprises (SME) tannery industry and proved to be a relevant tool to measure the circularity level of the factory. It was witnessed that it is easier for non-specialists to evaluate circularity and identify possible solutions to increase its value, as well as learn how one action can impact their environment. In the end, energetic and environmental inefficiencies were identified and corrected, increasing the sustainability and circularity of the company. Through this work, important contributions were provided, helping the Portuguese SMEs to achieve the European and UN 2030 sustainable goals.

Keywords: circular economy, circularity index, sustainability, tannery industry, zero-waste

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9 The Shrinking of the Pink Wave and the Rise of the Right-Wing in Latin America

Authors: B. M. Moda, L. F. Secco

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Through free and fair elections and others less democratic processes, Latin America has been gradually turning into a right-wing political region. In order to understand these recent changes, this paper aims to discuss the origin and the traits of the pink wave in the subcontinent, the reasons for its current rollback and future projections for left-wing in the region. The methodology used in this paper will be descriptive and analytical combined with secondary sources mainly from the social and political sciences fields. The canons of the Washington Consensus was implemented by the majority of the Latin American governments in the 80s and 90s under the social democratic and right-wing parties. The neoliberal agenda caused political, social and economic dissatisfaction bursting into a new political configuration for the region. It started in 1998 when Hugo Chávez took the office in Venezuela through the Fifth Republic Movement under the socialist flag. From there on, Latin America was swiped by the so-called ‘pink wave’, term adopted to define the rising of self-designated left-wing or center-left parties with a progressive agenda. After Venezuela, countries like Chile, Brazil, Argentina, Uruguay, Bolivia, Equator, Nicaragua, Paraguay, El Salvador and Peru got into the pink wave. The success of these governments was due a post-neoliberal agenda focused on cash transfers programs, increasing of public spending, and the straightening of national market. The discontinuation of the preference for the left-wing started in 2012 with the coup against Fernando Lugo in Paraguay. In 2015, the chavismo in Venezuela lost the majority of the legislative seats. In 2016, an impeachment removed the Brazilian president Dilma Rousself from office who was replaced by the center-right vice-president Michel Temer. In the same year, Mauricio Macri representing the right-wing party Proposta Republicana was elected in Argentina. In 2016 center-right and liberal, Pedro Pablo Kuczynski was elected in Peru. In 2017, Sebastián Piñera was elected in Chile through the center-right party Renovación Nacional. The pink wave current rollback points towards some findings that can be arranged in two fields. Economically, the 2008 financial crisis affected the majority of the Latin American countries and the left-wing economic policies along with the end of the raw materials boom and the subsequent shrinking of economic performance opened a flank for popular dissatisfaction. In Venezuela, the 2014 oil crisis reduced the revenues for the State in more than 50% dropping social spending, creating an inflationary spiral, and consequently loss of popular support. Politically, the death of Hugo Chavez in 2013 weakened the ‘socialism of the twenty first century’ ideal, which was followed by the death of Fidel Castro, the last bastion of communism in the subcontinent. In addition, several cases of corruption revealed during the pink wave governments made the traditional politics unpopular. These issues challenge the left-wing to develop a future agenda based on innovation of its economic program, improve its legal and political compliance practices, and to regroup its electoral forces amid the social movements that supported its ascension back in the early 2000s.

Keywords: Latin America, political parties, left-wing, right-wing, pink wave

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8 Validation of an Educative Manual for Patients with Breast Cancer Submitted to Radiation Therapy

Authors: Flavia Oliveira de A. M. Cruz, Edison Tostes Faria, Paula Elaine D. Reis

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When the breast is submitted to radiation therapy (RT), the most common effects are pain, skin changes, mobility restrictions, local sensory alteration, and fatigue. These effects, if not managed properly, may reduce the quality of life of cancer patients and may lead to the treatment discontinuation. Therefore, promoting knowledge and guidelines for symptom management remain a high priority for patients and a challenge for health professionals, due to the need to handle side effects in a population with a life-threatening disease. Printed materials are important strategies for supporting educative activities since they help the individual to assimilate and understand the amount of information transmitted. Nurses' behavior can be systematized through the use of an educative manual, which may be effective in promoting information regarding the treatment, self-care and how to control the effects of RT at home. In view of the importance of guaranteeing the validity of the material before its use, the objective of this research was to validate the content and appearance of an educative manual for breast cancer patients undergoing RT. The Theory of Psychometrics was used for the validation process in this descriptive methodological research. A minimum agreement rate (AR) of 80% was considered to guarantee the validity of the material. The data were collected from October to December 2017, by means of two assessments tools, constructed in the form of a Likert scale, with five levels of understanding. These instruments addressed different aspects of the evaluation, in view of two different groups of participants; 17 experts in the theme area of the educative manual, and 12 women that received RT previously to treat breast cancer. The manual was titled 'Orientation Manual: radiation therapy in breast', and was focused on breast cancer patients attended at the Department of Oncology of the Brasília University Hospital (UNACON/HUB). The research project was submitted to the Research Ethics Committee at the School of Health Sciences of the University of Brasília (CAAE: 24592213.1.0000.0030). Only two items of the assessment tool for the experts, one related to the manual's ability to promote behavioral and attitude changes and the other related to the extent of its use for other health services, obtained AR < 80% and were reformulated based on the participants' suggestions and in the literature. All other items were considered appropriate and/or complete appropriate in the three blocks proposed for the experts: objectives - 89%, structure and form - 93%, and relevance - 93%; and good and/or very good in the five blocks of analysis proposed for patients: objectives - 100%, organization - 100%, writing style - 100%, appearance - 100%, and motivation. The appearance and content validation of the educative manual proposed were attended to. The educative manual was considered relevant and pertinent and may contribute to the understanding of the therapeutic process by breast cancer patients during RT, as well as support clinical practice through the nursing consultation.

Keywords: oncology nursing, nursing care, validation studies, educational technology

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7 Phenotypic and Molecular Heterogeneity Linked to the Magnesium Transporter CNNM2

Authors: Reham Khalaf-Nazzal, Imad Dweikat, Paula Gimenez, Iker Oyenarte, Alfonso Martinez-Cruz, Domonik Muller

Abstract:

Metal cation transport mediator (CNNM) gene family comprises 4 isoforms that are expressed in various human tissues. Structurally, CNNMs are complex proteins that contain an extracellular N-terminal domain preceding a DUF21 transmembrane domain, a ‘Bateman module’ and a C-terminal cNMP-binding domain. Mutations in CNNM2 cause familial dominant hypomagnesaemia. Growing evidence highlights the role of CNNM2 in neurodevelopment. Mutations in CNNM2 have been implicated in epilepsy, intellectual disability, schizophrenia, and others. In the present study, we aim to elucidate the function of CNNM2 in the developing brain. Thus, we present the genetic origin of symptoms in two family cohorts. In the first family, three siblings of a consanguineous Palestinian family in which parents are first cousins, and consanguinity ran over several generations, presented a varying degree of intellectual disability, cone-rod dystrophy, and autism spectrum disorder. Exome sequencing and segregation analysis revealed the presence of homozygous pathogenic mutation in the CNNM2 gene, the parents were heterozygous for that gene mutation. Magnesium blood levels were normal in the three children and their parents in several measurements. They had no symptoms of hypomagnesemia. The CNNM2 mutation in this family was found to locate in the CBS1 domain of the CNNM2 protein. The crystal structure of the mutated CNNM2 protein was not significantly different from the wild-type protein, and the binding of AMP or MgATP was not dramatically affected. This suggests that the CBS1 domain could be involved in pure neurodevelopmental functions independent of its magnesium-handling role, and this mutation could have affected a protein partner binding or other functions in this protein. In the second family, another autosomal dominant CNNM2 mutation was found to run in a large family with multiple individuals over three generations. All affected family members had hypomagnesemia and hypermagnesuria. Oral supplementation of magnesium did not increase the levels of magnesium in serum significantly. Some affected members of this family have defects in fine motor skills such as dyslexia and dyslalia. The detected mutation is located in the N-terminal part, which contains a signal peptide thought to be involved in the sorting and routing of the protein. In this project, we describe heterogenous clinical phenotypes related to CNNM2 mutations and protein functions. In the first family, and up to the authors’ knowledge, we report for the first time the involvement of CNNM2 in retinal photoreceptor development and function. In addition, we report the presence of a neurophenotype independent of magnesium status related to the CNNM2 protein mutation. Taking into account the different modes of inheritance and the different positions of the mutations within CNNM2 and its different structural and functional domains, it is likely that CNNM2 might be involved in a wide spectrum of neuropsychiatric comorbidities with considerable varying phenotypes.

Keywords: magnesium transport, autosomal recessive, autism, neurodevelopment, CBS domain

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6 Edible Active Antimicrobial Coatings onto Plastic-Based Laminates and Its Performance Assessment on the Shelf Life of Vacuum Packaged Beef Steaks

Authors: Andrey A. Tyuftin, David Clarke, Malco C. Cruz-Romero, Declan Bolton, Seamus Fanning, Shashi K. Pankaj, Carmen Bueno-Ferrer, Patrick J. Cullen, Joe P. Kerry

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Prolonging of shelf-life is essential in order to address issues such as; supplier demands across continents, economical profit, customer satisfaction, and reduction of food wastage. Smart packaging solutions presented in the form of naturally occurred antimicrobially-active packaging may be a solution to these and other issues. Gelatin film forming solution with adding of natural sourced antimicrobials is a promising tool for the active smart packaging. The objective of this study was to coat conventional plastic hydrophobic packaging material with hydrophilic antimicrobial active beef gelatin coating and conduct shelf life trials on beef sub-primal cuts. Minimal inhibition concentration (MIC) of Caprylic acid sodium salt (SO) and commercially available Auranta FV (AFV) (bitter oranges extract with mixture of nutritive organic acids) were found of 1 and 1.5 % respectively against bacterial strains Bacillus cereus, Pseudomonas fluorescens, Escherichia coli, Staphylococcus aureus and aerobic and anaerobic beef microflora. Therefore SO or AFV were incorporated in beef gelatin film forming solution in concentration of two times of MIC which was coated on a conventional plastic LDPE/PA film on the inner cold plasma treated polyethylene surface. Beef samples were vacuum packed in this material and stored under chilling conditions, sampled at weekly intervals during 42 days shelf life study. No significant differences (p < 0.05) in the cook loss was observed among the different treatments compared to control samples until the day 29. Only for AFV coated beef sample it was 3% higher (37.3%) than the control (34.4 %) on the day 36. It was found antimicrobial films did not protect beef against discoloration. SO containing packages significantly (p < 0.05) reduced Total viable bacterial counts (TVC) compared to the control and AFV samples until the day 35. No significant reduction in TVC was observed between SO and AFV films on the day 42 but a significant difference was observed compared to control samples with a 1.40 log of bacteria reduction on the day 42. AFV films significantly (p < 0.05) reduced TVC compared to control samples from the day 14 until the day 42. Control samples reached the set value of 7 log CFU/g on day 27 of testing, AFV films did not reach this set limit until day 35 and SO films until day 42 of testing. The antimicrobial AFV and SO coated films significantly prolonged the shelf-life of beef steaks by 33 or 55% (on 7 and 14 days respectively) compared to control film samples. It is concluded antimicrobial coated films were successfully developed by coating the inner polyethylene layer of conventional LDPE/PA laminated films after plasma surface treatment. The results indicated that the use of antimicrobial active packaging coated with SO or AFV increased significantly (p < 0.05) the shelf life of the beef sub-primal. Overall, AFV or SO containing gelatin coatings have the potential of being used as effective antimicrobials for active packaging applications for muscle-based food products.

Keywords: active packaging, antimicrobials, edible coatings, food packaging, gelatin films, meat science

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5 Re-Creating Women of the Past in Historical Series on Mexican Television: The Work of Patricia Arriaga Jordan

Authors: Maria De Los Angeles Rodriguez Cadena

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This paper discusses how the fictional versions of women of the past contribute to advance today’s ideas of social justice, personal freedom and emancipation as well as to highlight the creative challenge of constructing people and events on fictional narratives on television that incorporate multiple and simultaneous layers of meaning and complexity. This project builds on existing scholarship on audiovisual texts by exploring an influential but under-studied director. In two Mexican television series, Patricia Arriaga Jordan, an award-winning television producer, scriptwriter and director, constructs the life of two outstanding women that have played an influential role in national history and captured Mexican’s popular imagination for generations: Sor Juana Inés de la Cruz, and Malinche. Malinche (2018) tells the story of an extraordinary indigenous woman, Malintzin, during the Spanish Conquest (1511-1550) that is considered to have played a key role in the fall of the Aztec empire by acting as translator, negotiator and cultural mediator for the Spanish conquerors. Juana Ines (2016) portrays Sor Juana, a poet, essayist, playwright, theologian, philosopher, nun, of XVII century colonial Mexico, one of the brightest minds of her time, and now recognized as the first feminist of the Americas who wrote on the rights of women to an education, religious authority and feminist advocacy. Both series, as fictional narratives that recreate defining historical periods, specific events and relevant characters in the History of Mexico can be read as an example of what is called texts of cultural memory. A cultural memory text is a narrative that bonds the concepts of history, identity and belonging, and that is realized and disseminated through symbolic systems such as written documents, visual images, and dramatic representation. Cultural memory, through its narratives of historical fiction, emphasizes memory processes (historiography) and its implications and artifacts (cultural memory) mainly through the medial frameworks of remembering, which are the medial process by which memories (narratives, documents) participate in public knowledge and become collective memory. Historical fiction on television not only creates a portrayal of the past related to the real lives of protagonists, but it also significantly contributes to understand the past as an ever-evolving entity that highlights both, the necessary connection with the present as part of a developing sense of collective identity and belonging, as well as the relevance of the medium in which the past is represented and that ultimately supports the process of historical awareness. Through the emblematic recreation of national heroines and historical events in the unique context of historical drama on television, those texts constitute a venue where concepts of the past and the traditionally established ideas about history and heroines are highlighted, questioned and transformed.

Keywords: cultural memory, historical fiction, Mexico, television, women directors

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4 Combination of Modelling and Environmental Life Cycle Assessment Approach for Demand Driven Biogas Production

Authors: Juan A. Arzate, Funda C. Ertem, M. Nicolas Cruz-Bournazou, Peter Neubauer, Stefan Junne

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— One of the biggest challenges the world faces today is global warming that is caused by greenhouse gases (GHGs) coming from the combustion of fossil fuels for energy generation. In order to mitigate climate change, the European Union has committed to reducing GHG emissions to 80–95% below the level of the 1990s by the year 2050. Renewable technologies are vital to diminish energy-related GHG emissions. Since water and biomass are limited resources, the largest contributions to renewable energy (RE) systems will have to come from wind and solar power. Nevertheless, high proportions of fluctuating RE will present a number of challenges, especially regarding the need to balance the variable energy demand with the weather dependent fluctuation of energy supply. Therefore, biogas plants in this content would play an important role, since they are easily adaptable. Feedstock availability varies locally or seasonally; however there is a lack of knowledge in how biogas plants should be operated in a stable manner by local feedstock. This problem may be prevented through suitable control strategies. Such strategies require the development of convenient mathematical models, which fairly describe the main processes. Modelling allows us to predict the system behavior of biogas plants when different feedstocks are used with different loading rates. Life cycle assessment (LCA) is a technique for analyzing several sides from evolution of a product till its disposal in an environmental point of view. It is highly recommend to use as a decision making tool. In order to achieve suitable strategies, the combination of a flexible energy generation provided by biogas plants, a secure production process and the maximization of the environmental benefits can be obtained by the combination of process modelling and LCA approaches. For this reason, this study focuses on the biogas plant which flexibly generates required energy from the co-digestion of maize, grass and cattle manure, while emitting the lowest amount of GHG´s. To achieve this goal AMOCO model was combined with LCA. The program was structured in Matlab to simulate any biogas process based on the AMOCO model and combined with the equations necessary to obtain climate change, acidification and eutrophication potentials of the whole production system based on ReCiPe midpoint v.1.06 methodology. Developed simulation was optimized based on real data from operating biogas plants and existing literature research. The results prove that AMOCO model can successfully imitate the system behavior of biogas plants and the necessary time required for the process to adapt in order to generate demanded energy from available feedstock. Combination with LCA approach provided opportunity to keep the resulting emissions from operation at the lowest possible level. This would allow for a prediction of the process, when the feedstock utilization supports the establishment of closed material circles within a smart bio-production grid – under the constraint of minimal drawbacks for the environment and maximal sustainability.

Keywords: AMOCO model, GHG emissions, life cycle assessment, modelling

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3 Optimizing Productivity and Quality through the Establishment of a Learning Management System for an Agency-Based Graduate School

Authors: Maria Corazon Tapang-Lopez, Alyn Joy Dela Cruz Baltazar, Bobby Jones Villanueva Domdom

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The requisite for an organization implementing quality management system to sustain its compliance to the requirements and commitment for continuous improvement is even higher. It is expected that the offices and units has high and consistent compliance to the established processes and procedures. The Development Academy of the Philippines has been operating under project management to which is has a quality management certification. To further realize its mandate as a think-tank and capacity builder of the government, DAP expanded its operation and started to grant graduate degree through its Graduate School of Public and Development Management (GSPDM). As the academic arm of the Academy, GSPDM offers graduate degree programs on public management and productivity & quality aligned to the institutional trusts. For a time, the documented procedures and processes of a project management seem to fit the Graduate School. However, there has been a significant growth in the operations of the GSPDM in terms of the graduate programs offered that directly increase the number of students. There is an apparent necessity to align the project management system into a more educational system otherwise it will no longer be responsive to the development that are taking place. The strongly advocate and encourage its students to pursue internal and external improvement to cope up with the challenges of providing quality service to their own clients and to our country. If innovation will not take roots in the grounds of GSPDM, then how will it serve the purpose of “walking the talk”? This research was conducted to assess the diverse flow of the existing internal operations and processes of the DAP’s project management and GSPDM’s school management that will serve as basis to develop a system that will harmonize into one, the Learning Management System. The study documented the existing process of GSPDM following the project management phases of conceptualization & development, negotiation & contracting, mobilization, implementation, and closure into different flow charts of the key activities. The primary source of information as respondents were the different groups involved into the delivery of graduate programs - the executive, learning management team and administrative support offices. The Learning Management System (LMS) shall capture the unique and critical processes of the GSPDM as a degree-granting unit of the Academy. The LMS is the harmonized project management and school management system that shall serve as the standard system and procedure for all the programs within the GSPDM. The unique processes cover the three important areas of school management – student, curriculum, and faculty. The required processes of these main areas such as enrolment, course syllabus development, and faculty evaluation were appropriately placed within the phases of the project management system. Further, the research shall identify critical reports and generate manageable documents and records to ensure accuracy, consistency and reliable information. The researchers had an in-depth review of the DAP-GSDPM’s mandate, analyze the various documents, and conducted series of focused group discussions. A comprehensive review on flow chart system prior and various models of school management systems were made. Subsequently, the final output of the research is a work instructions manual that will be presented to the Academy’s Quality Management Council and eventually an additional scope for ISO certification. The manual shall include documented forms, iterative flow charts and program Gantt chart that will have a parallel development of automated systems.

Keywords: productivity, quality, learning management system, agency-based graduate school

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2 Design of DNA Origami Structures Using LAMP Products as a Combined System for the Detection of Extended Spectrum B-Lactamases

Authors: Kalaumari Mayoral-Peña, Ana I. Montejano-Montelongo, Josué Reyes-Muñoz, Gonzalo A. Ortiz-Mancilla, Mayrin Rodríguez-Cruz, Víctor Hernández-Villalobos, Jesús A. Guzmán-López, Santiago García-Jacobo, Iván Licona-Vázquez, Grisel Fierros-Romero, Rosario Flores-Vallejo

Abstract:

The group B-lactamic antibiotics include some of the most frequently used small drug molecules against bacterial infections. Nevertheless, an alarming decrease in their efficacy has been reported due to the emergence of antibiotic-resistant bacteria. Infections caused by bacteria expressing extended Spectrum B-lactamases (ESBLs) are difficult to treat and account for higher morbidity and mortality rates, delayed recovery, and high economic burden. According to the Global Report on Antimicrobial Resistance Surveillance, it is estimated that mortality due to resistant bacteria will ascend to 10 million cases per year worldwide. These facts highlight the importance of developing low-cost and readily accessible detection methods of drug-resistant ESBLs bacteria to prevent their spread and promote accurate and fast diagnosis. Bacterial detection is commonly done using molecular diagnostic techniques, where PCR stands out for its high performance. However, this technique requires specialized equipment not available everywhere, is time-consuming, and has a high cost. Loop-Mediated Isothermal Amplification (LAMP) is an alternative technique that works at a constant temperature, significantly decreasing the equipment cost. It yields double-stranded DNA of several lengths with repetitions of the target DNA sequence as a product. Although positive and negative results from LAMP can be discriminated by colorimetry, fluorescence, and turbidity, there is still a large room for improvement in the point-of-care implementation. DNA origami is a technique that allows the formation of 3D nanometric structures by folding a large single-stranded DNA (scaffold) into a determined shape with the help of short DNA sequences (staples), which hybridize with the scaffold. This research aimed to generate DNA origami structures using LAMP products as scaffolds to improve the sensitivity to detect ESBLs in point-of-care diagnosis. For this study, the coding sequence of the CTM-X-15 ESBL of E. coli was used to generate the LAMP products. The set of LAMP primers were designed using PrimerExplorerV5. As a result, a target sequence of 200 nucleotides from CTM-X-15 ESBL was obtained. Afterward, eight different DNA origami structures were designed using the target sequence in the SDCadnano and analyzed with CanDo to evaluate the stability of the 3D structures. The designs were constructed minimizing the total number of staples to reduce costs and complexity for point-of-care applications. After analyzing the DNA origami designs, two structures were selected. The first one was a zig-zag flat structure, while the second one was a wall-like shape. Given the sequence repetitions in the scaffold sequence, both were able to be assembled with only 6 different staples each one, ranging between 18 to 80 nucleotides. Simulations of both structures were performed using scaffolds of different sizes yielding stable structures in all the cases. The generation of the LAMP products were tested by colorimetry and electrophoresis. The formation of the DNA structures was analyzed using electrophoresis and colorimetry. The modeling of novel detection methods through bioinformatics tools allows reliable control and prediction of results. To our knowledge, this is the first study that uses LAMP products and DNA-origami in combination to delect ESBL-producing bacterial strains, which represent a promising methodology for diagnosis in the point-of-care.

Keywords: beta-lactamases, antibiotic resistance, DNA origami, isothermal amplification, LAMP technique, molecular diagnosis

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1 Improving Patient Journey in the Obstetrics and Gynecology Emergency Department: A Comprehensive Analysis of Patient Experience

Authors: Lolwa Alansari, Abdelhamid Azhaghdani, Sufia Athar, Hanen Mrabet, Annaliza Cruz, Tamara Alshadafat, Almunzer Zakaria

Abstract:

Introduction: Improving the patient experience is a fundamental pillar of healthcare's quadruple aims. Recognizing the importance of patient experiences and perceptions in healthcare interactions is pivotal for driving quality improvement. This abstract centers around the Patient Experience Program, an endeavor crafted with the purpose of comprehending and elevating the experiences of patients in the Obstetrics & Gynecology Emergency Department (OB/GYN ED). Methodology: This comprehensive endeavor unfolded through a structured sequence of phases following Plan-Do-Study-Act (PDSA) model, spanning over 12 months, focused on enhancing patient experiences in the Obstetrics & Gynecology Emergency Department (OB/GYN ED). The study meticulously examined the journeys of patients with acute obstetrics and gynecological conditions, collecting data from over 100 participants monthly. The inclusive approach covered patients of different priority levels (1-5) admitted for acute conditions, with no exclusions. Historical data from March and April 2022 serves as a benchmark for comparison, strengthening causality claims by providing a baseline understanding of OB/GYN ED performance before interventions. Additionally, the methodology includes the incorporation of staff engagement surveys to comprehensively understand the experiences of healthcare professionals with the implemented improvements. Data extraction involved administering open-ended questions and comment sections to gather rich qualitative insights. The survey covered various aspects of the patient journey, including communication, emotional support, timely access to care, care coordination, and patient-centered decision-making. The project's data analysis utilized a mixed-methods approach, combining qualitative techniques to identify recurring themes and extract actionable insights and quantitative methods to assess patient satisfaction scores and relevant metrics over time, facilitating the measurement of intervention impact and longitudinal tracking of changes. From the themes we discovered in both the online and in-person patient experience surveys, several key findings emerged that guided us in initiating improvements, including effective communication and information sharing, providing emotional support and empathy, ensuring timely access to care, fostering care coordination and continuity, and promoting patient-centered decision-making. Results: The project yielded substantial positive outcomes, significantly improving patient experiences in the OB/GYN ED. Patient satisfaction levels rose from 62% to a consistent 98%, with notable improvements in satisfaction with care plan information and physician care. Waiting time satisfaction increased from 68% to a steady 97%. The project positively impacted nurses' and midwives' job satisfaction, increasing from 64% to an impressive 94%. Operational metrics displayed positive trends, including a decrease in the "left without being seen" rate from 3% to 1%, the discharge against medical advice rate dropping from 8% to 1%, and the absconded rate reducing from 3% to 0%. These outcomes underscore the project's effectiveness in enhancing both patient and staff experiences in the healthcare setting. Conclusion: The use of a patient experience questionnaire has been substantiated by evidence-based research as an effective tool for improving the patient experience, guiding interventions, and enhancing overall healthcare quality in the OB/GYN ED. The project's interventions have resulted in a more efficient allocation of resources, reduced hospital stays, and minimized unnecessary resource utilization. This, in turn, contributes to cost savings for the healthcare facility.

Keywords: patient experience, patient survey, person centered care, quality initiatives

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