bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combined Gas Tungsten Arc Welding and Shielded Metal Arc Welding Processes for Joining Tube to Tubesheet in Shell and Tube Heat Exchangers
Authors: Saffiudeen Mohamed Fayas , Thekkuden Dinu Thomas , Mourad Abdel-Hamid Ismail , Mohammed Fasil T. , Syed Abdullah , Abdulrahman Al-Sayed Khalid , Alamri Yassir A. , Al Qahtani Mohammad N. 
Published: May 2024

Abstract
Flawless tube and tubesheet joints are necessary for shell and tube heat exchanger with high leakproof ability and durability. The consequence of mixing of transfer fluids due to the defective welded or expanded tube-to-tubesheet joint results in complete malfunctioning of the heat exchange process. In this case, there is a high demand for quality assessment of the fabricated tube-to-tubesheet joints (TTS) based on the international standards. Additionally, the literature on assessing the mechanical and metallurgical characteristics of tube-to-tubesheet joints using any one welding technique is available; however, articles dealing with the use of multiple welding techniques are scanty. In the current work, the quality assessment of strength welded and light expanded (3%) tube-to-tubesheet joints followed by light expansion was performed whereas for welding, combined gas tungsten arc welding (GTAW) and shielded metal arc welding (SMAW) as root pass and cap pass were adopted in the fabrication stage. Quality and sound tube-to-tubesheet joints were produced using welding and tube expansion process. Linear and circular indications representing the cracks were absent on the developer in the liquid penetration test. The minimum leak path (MLP) was greater than the two-third of tube wall thickness. The results strongly qualify the use of combined gas tungsten inert gas and shielded metal arc welding process for manufacturing of tube-to-tubesheet joints. The methodology and results in the current article are beneficial for researchers and industrialists working close to shell and tube heat exchangers and boilers.
Adaptive attenuation of virulence in hypervirulent carbapenem-resistant
Klebsiella pneumoniae
Authors: Teng Gaoqin , Zhang Meng , Fu YingYing , Yang Xiaoqiang , Kang Yanhua , Qin Qiuying , Jin Ye , Huang Man , Xu Yongchang 
Published: May 2024

ABSTRACT

The emergence of nosocomial infections caused by hypervirulent and carbapenem-resistant
K. pneumoniae
(hv-CRKP) has become a significant public health challenge. The genetic traits of virulence and resistance plasmids in hv-CRKP have been extensively studied; however, research on the adaptive evolution strategies of clinical strains inside the host was scarce. This study aimed to understand the effects of antibiotic treatment on the phenotype and genotype characteristics of hv-CRKP. We investigated the evolution of hv-CRKP strains isolated from the same patient to elucidate the transition between hospital invasion and colonization. A comparative genomics analysis was performed to identify single nucleotide polymorphisms in the
rmpA
promoter. Subsequent validation through RNA-seq and gene deletion confirmed that distinct
rmpA
promoter sequences exert control over the mucoid phenotype. Additionally, biofilm experiments, cell adhesion assays, and animal infection models were conducted to illuminate the influence of
rmpA
promoter diversity on virulence changes. We demonstrated that the P12T and P11T promoters of
rmpA
possess strong activity, which leads to the evolution of CRKP into infectious and virulent strains. Meanwhile, the specific sequence of polyT motifs in the
rmpA
promoter led to a decrease in the lethality of hv-CRKP and enhanced cell adhesion and colonization. To summarize, the
rmpA
promoter of hv-CRKP is utilized to control capsule production, thereby modifying pathogenicity to better suit the host’s ecological environment.

IMPORTANCE

The prevalence of hospital-acquired illness caused by hypervirulent carbapenem-resistant
Klebsiella pneumoniae
(hv-CRKP) is significant, leading to prolonged antibiotic treatment. However, there are few reports on the phenotypic changes of hv-CRKP in patients undergoing antibiotic treatment. We performed a comprehensive examination of the genetic evolutionary traits of hv-CRKP obtained from the same patient and observed variations in the promoter sequences of the virulence factor
rmpA
. The strong activity of the promoter sequences P11T and P12T enhances the consistent production of capsule polysaccharides, resulting in an invasive strain. Conversely, weak promoter activity of P9T and P10T is advantageous for exposing pili, hence improving bacterial cell attachment ability and facilitating bacterial colonization. This finding also explains the confusion of some clinical strains carrying wild-type
rmpA
but exhibiting a low mucoid phenotype. This adaptive alteration facilitates the dissemination of
K. pneumoniae
within the hospital setting.
The shifts in intergenerational relations in Cameroon and their potential impact on the health of older adults
Authors: Gouttefarde Pauline , Gay Elsa , Guyot Jessica , Kamdem Odette , Socpa Antoine , Tchundem Guylène , Dupré Caroline , Nkenfou Céline , Bongue Bienvenu , Barth Nathalie , Adam Stéphane 
Published: May 2024

IntroductionAfrica is experiencing a gradual demographic shift due to rising life expectancy and increasing urbanisation. In sub-Saharan Africa, elderly individuals typically reside with their children. The rise in life expectancy by almost a decade and the prevalence of precarious living conditions raise concerns about the sustainability of the healthcare system, which has traditionally relied on intergenerational solidarity.MethodsThe research aims to analyse the evolving role of older adults in Cameroonian society and to examine the potential impact of this change on intergenerational relationships and the health of older adults. A qualitative methodology was employed, using intergenerational focus groups in Cameroon.ResultsTraditionally, older adults held a central role in knowledge transmission through discourse. However, the modernisation of society is challenging this position.The emergence of new technologies, particularly communication tools, is leading to a questioning of older adults’ experiential knowledge. Societal changes are contributing to a decline in respect for older adults in discourse. Older adults deplore these societal changes and fear for their place in society while young people are questioning the central role of older people in society.DiscussionThese changes could reduce the sense of usefulness of older people, with negative consequences for their health. Several studies have highlighted the impacts of ageism on the health of older adults in industrialised countries. However, there are little data on the impact of the marginalisation of older adults on their health in industrialising societies. Further research is needed to study the impact on the health of older adults.
Recreational nitrous oxide and thrombotic events: a case series
Authors: Patyjewicz Marta , Mair Devan , Zaloum Safiya A , Onen Barbara , Walton Joseph , Dobson Ruth , Joerres Christine , Shah Apeksha Madhusudan , MacCallum Peter , Massey Thomas H , Bariana Tadbir , White Veronica , De Freitas Sarah A , Noyce Alastair 
Published: May 2024

BackgroundThe study aimed to elucidate the prevalence of nitrous oxide (N2O) usage in patients with unexplained venous thromboembolism (VTE), highlighting the potential association with hyperhomocysteinaemia (HHcy).MethodsWe conducted a retrospective study at the Royal London Hospital, examining cases of N2O-related VTE from March to August 2023. Among 50 patients identified, four (8%) had recent unprovoked VTE. Patient data were collected based on N2O ambulatory emergency care pathway admissions.ResultsAmong the 50 patients identified, four (8%) had recent or concurrent VTE. Three were male (75%), with an ethnic distribution of 50% Asian or Asian British and 50% Black or Black British. Patients were distributed across quintiles of the index of multiple deprivation. All had actual or functional vitamin B12 deficiency.DiscussionThe association between N2O use and VTE requires further investigation, though a plausible mechanism involving HHcy has been proposed. Clinicians should be vigilant for VTE in N2O users, especially those presenting with unexplained symptoms. VTE prophylaxis may be worth considering, particularly if continued exposure to nitrous oxide is anticipated.ConclusionN2O misuse may increase the risk of VTE, warranting attention from healthcare providers. Further research is needed to elucidate this association and inform preventive strategies. Public awareness about the risks of N2O remains essential.
Oral Chinese herbal medicine for psoriasis vulgaris: protocol for a randomised, double-blind, double-dummy, multicentre clinical trial
Authors: Deng Jingwen , Yao Danni , Lu Chuanjian , Wen Zehuai , Yan Yuhong , He Ziyang , Wu Huimei , Deng Hao 
Published: May 2024

IntroductionPsoriasis vulgaris is a common skin disease that is characterised by persistent localised erythematous scaly plaques. Yinxieling is a Chinese herbal formula for psoriasis that has been used for more than 20 years in China. To facilitate application, PSORI-CM01 was developed based on the optimisation and simplification of Yinxieling tablets performed in a previous study and in clinical practice. However, the scientific evidence regarding whether PSORI-CM01 is more effective for psoriasis than the original Yinxieling remains insufficient. Therefore, we designed a randomised clinical trial to investigate the effect, safety and cost-effectiveness of PSORI-CM01 granules compared with those of Yinxieling tablets for the treatment of patients with psoriasis.Methods and analysisThis ongoing study is a two-arm parallel, randomised, double-blind, double-dummy clinical trial. Five hundred and fifty-six participants with psoriasis will be recruited and then randomly allocated into two groups in a 1:1 ratio. Participants in PSORI-CM01 group will receive a 5.5 g granule of PSORI-CM01 two times daily and five placebo tablets three times daily for 12 weeks. The participants in the Yinxieling group will receive five Yinxieling tablets three times daily and a placebo granule two times daily for 12 weeks. The primary outcome is the reduction of the Psoriasis Area and Severity Index. The secondary outcomes include relapse rate, Visual Analogue Scale scores, body surface area and the Dermatology Life Quality Index. Cost-effectiveness analysis will be performed from a health and community care provider perspective.Ethics and disseminationThis research protocol had been reviewed and approved by the institutional review boards of three trial centres (Guangdong Provincial Hospital of Chinese Medicine (B2014-026-01), Affiliated Hospital of Tianjin Chinese Medicine Academy (2014-KY-001) and Third Hospital of Hangzhou (B2014-026-01)). The findings will be disseminated to the public through conference presentations and open-access journals.Trial registration numberChinese Clinical Trial Registry (ChiCTR-TRC-14005185); Pre-results.
100: PROFESSIONAL VALUES OF THE NURSING STUDENTS' PERSPECTIVE: DO NURSING EDUCATION PREPARE STUDENTS FOR APPLYING OF PROFESSIONAL VALUES IN CLINICAL PRACTICE?
Authors: Poorchangizi Batool , Farokhzadian Jamileh , Borhani Fariba , Abbaszadeh Abbas , Mirzaee Moghaddameh 
Published: May 2024

Background and aims:Professional values of undergraduate nursing students are considerably to changes made by educational programs. Therefore, this is important to integrate professional values in nursing curricula and study about professional values of nursing students in applying them in their professional future. The aim of this study was to examine the professional values from perspective undergraduate nursing students.Methods:This study was a descriptive-analytical research. A total of 100 undergraduate nursing students by stratified random sampling participated from a university in Kerman, Iran in 2016. Data were collected by Persian version of the Nurses Professional Values Scale-Revised (NPVS-R) Weis and Schank. Data analyzed by SPSS version 19.Results:The findings showed that student's mean score of professional values were high (101.79±12.42). The four most important professional values identified by students were maintaining confidentiality of patients, safeguarding patients' right to privacy, assuming responsibility for meeting health needs of the culturally diverse population, maintain competency in area of practice and accepting responsibility and accountability for own practice. The four least important values include participating in public policy decisions affecting distribution of resources, participating in peer review, recognizing role of professional nursing associations in shaping healthcare policy and participating in nursing research and/or implement research findings appropriate to practice. Score of values had statistically significant relationship with classroom grade average and economic status of family of students (P<0.05).Conclusion:The high total score students' professional values could indicate impact of education and role of educators in formation and instillation of professional values in classrooms and clinical settings. Regarding low importance of some values for undergraduate nursing students, this is necessary to institutionalize comprehensive of professional values in nursing students as future nurses.
103: PSYCHOMETRIC PROPERTIES OF THE PERSIAN VERSION OF THE PATIENT SATISFACTION QUESTIONNAIRE
Authors: Nouri Mahdi , Ghaffarifar Saeideh , Bazargani Homayoun Sadeghi , Ghaffari Reza 
Published: May 2024

Background and aims:to explore the psychometric properties of the Persian version of the Patient Satisfaction Questionnaire (PSQ).Methods:In this cross-sectional study in 2015, the psychometric properties of the Persian version of the PSQ were determined by participation of 10 patients, 14 experts and 488 residents. Impact score, content validity index, content validity ratio of the items were calculated. Construct validity and reliability of the scale were examined conducting exploratory factor analysis and Cronbach's Alpha and Inter class correlation coefficient (ICC), respectively, using STATA, version 13. This research project was approved by the Ethics Committee of Tabriz University of Medical Sciences.Results:Based on the findings, questionnaire had: CVI=0.94, CVR=0.84, Impact Score=4.61, Cronbach's Alpha=0.93 and ICC=0.513 (Sig.0.00). A single factor was identified according to the eigenvalue distribution of PSQ. That factor could predict about 93% of the variance.Conclusion:Persian version of PSQ had satisfactory reliability and validity, as well as adequate feasibility based on the field results. Medical teachers and managers at every Persian-speaking country can reliably evaluate residents' communication skills, applying the Persian version of PSQ.
117: THE ASSESSMENT OF PERFORMANCE AND EFFICIENCY OF TEHRAN PUBLIC AND PRIVATE HOSPITALS IN 2015
Authors: Forootan Sara , Forootan Mohammad Reza , Mousazadeh Yalda 
Published: May 2024

Background and aims:The presence or absence of efficient performance assessment system is directly related to the organizations life or death. Because of Hospitals importance role in community health the need to assess the performance and efficiency improvement feels more than others and to assess health care units quantitative indicators were used. The proper techniques for comparing hospitals performance based on three indicators of bed occupancy rate, average length of stay, bed occupancy turnover, is “PABON LASSO” graphical models. The aim of this study was The Assessment of Performance and Efficiency of Tehran Public and Private Hospitals by Pabon Lasso Model in 2015.Methods:This cross-sectional descriptive study was carried out in 16 public and private hospitals in Tehran in 2015.Pabon Lasso model was used and to analysis of data spss 18.0 was applied.Results:The average of bed occupancy rate, length of stay and bed turnover rate in hospitals were respectively 58.46%, 3.84 days and 64.51 per year. In this study, three hospitals in the first region, five hospitals in the second region, two hospitals in third region and six hospitals were located in the fourth region. Just two hospitals were efficient.Conclusion:Results of this study indicated that only two hospitals (12.5% from a total of 16 hospitals) had the desired performance. In conjunction with hospitals that are located in the first region, manager's serious act to analyzing the root causes of poor performance and corrective actions to optimize the use of limited resources is necessary.
123: THE EFFECT OF 12 WEEKS AEROBIC TRAINING WITH MODERATE TO SEVERE INTENSITY ON SERUM TNF-α AND INSULIN RESISTANCE IN MALES WITH TYPE II DIABETES
Authors: Eizadi Mojtaba 
Published: May 2024

Background and aims:Clinical studies support the role of inflammatory mediators in the relationship between obesity with insulin resistance and type2 diabetes. This study aimed to determine the effect of long term aerobic training program on serum levels of Tumor necrosis factor-alpha (TNF-α) and insulin resistance in males with type II diabetic.Methods:For this purpose, thirty inactive adult obese men with type II diabetes were participated in study by accessible samples and divided into experimental (n=15) and control (n=15) groups by randomly. Then experimental subjects were participated in three months aerobic training program (3 times weekly) at 60–75 (%) of maximal heart rate and subjects in control group continued inactive lifestyle. To determine the effect of training program on serum TNF-α, fasting glucose and insulin resistance, fasting blood samples were collected before and 48 hours after lased exercise session. Independent T test used to compare variables between two groups at baseline paired T test to determine the effect of training program on independent variables.Results:serum TNF-α did not significant change by three months aerobic training (p=0.83). Fasting glucose and insulin resistance decreased significantly after exercise program when compared with baseline (p<0.05).Conclusion:despite improved glucose and insulin resistance, three months aerobic training does not affect serum TNF-α in type II diabetes patients. Therefore, improved insulin resistance and glucose can be attributing to the change in other hormonal or inflammatory mediators in response to exercise program.
138: THE EVALUATION OF CONCENTRATION OF CALPROTECTIN, IN PLEURAL FLUID WITH CAUSES OF EXUDATIVE PLEURAL EFFUSION IN THE PATIENTS REFERRED TO SHAHID SAYYAD SHIRAZI HOSPITAL OF GORGAN IN 2014
Authors: Asgharzade Ali Zhiani , Mostafavi S , Zare M , Abbasi F , Karimi M , Kiani M , Mehrjerdian M 
Published: May 2024

Background and aims:Nowadays, routine invasive techniques to diagnose the causes of exudative pleural effusion are going to be replaced by new noninvasive methods such as biomarkers which with the same diagnostic accuracy can confirm malignant situations at least in a group of cases who do not need more invasive means.Methods:In this descriptive-analytical and case-control study, the calprotectin concentrations in pleural fluid was evaluated in 90 patients with exudative pleural effusion, and compared among two groups Including 34 patients with malignant pleural effusion (MPE) and 56 patients with benign pleural effusion (BPE). All patients underwent examination and the necessary laboratory tests were done and Closed pleural biopsy was performed if necessary. Collected Data were analyzed by SPSS-21statistical software and chi-square, t-test, ANOVA and logistic regression analysis.Results:Calprotectin concentration was (107.72±10.59) in patients with malignant causes and (114.42±23.95) in others. Calprotectin concentration was (122.34±27.03) in patient with TB. The results showed that this difference was statistically significant (p=0.05) and calprotectin rate, is lower in the malignant pleural effusion. Especially, when the results were compared with patients with TB, this difference was more prominent (p=0.01).Conclusion:According to higher levels of calprotectin in tuberculous pleural effusions, maybe we can achieve important results in differentiating between malignant and non-malignant pleural exudate, without the need for invasive procedures, by putting together the clinical symptoms, the calprotectin concentration in pleural fluid and pleural fluid cytology results.
158: ASSESSING THE QUALITY OF SEARCH STRATEGIES IN DECISION SUPPORT SYSTEM (DSS) SYSTEMATIC REVIEWS
Authors: Fathifar Zahra , Hasankandi Hossein Saeedi , Sadeghi-Ghyassi Fatemeh 
Published: May 2024

Background and aims:Search strategies play a major role in developing a systematic review. A comprehensive literature search dramatically reduces publication bias. The higher sensitive search leads to a more well-prepared systematic review. The aim of this study is evaluating the quality of search strategies in decision support system (DSS) systematic reviews.Methods:A comprehensive literature search using MEDLINE (via Ovid), Embase, Pubmed and Cochrane Library was conducted until September August 2016. The search was limited to systematic reviews and with no language restriction. Meta-reviews were excluded. Only results of searching for “decision support systems” or “decision support system” keywords and limited to title of documents were included in this study. Two independent authors screened the results. Disagreement was resolved by discussion. The search strategies of the included studies were assessed with a nine-question checklist prepared by Faggionet al1. Data were extracted into Excel.Results:A total of 47 systematic reviews (SRs) were included. There was a dramatic increase in the number of SRs in recent decade; however no significant improvement was seen in search strategies during the time. The mean score of search strategies among SRs was 4.63 (out of 9). The highest score was 7 (21.2%) and more than 53% of SRs obtained a score between 5 and 7. In 74.4% of SRs, 3–8 databases were searched which 40.4% were considered 4 databases. About 55% of SRs reported search keywords and using Boolean operators that has increased in recent years. Near to 98% of studies were not conducted in duplicate. In near to 75% of studies hand-searching was performed but instead, in 72.3% grey literature was not searched and in 65.9% the authors of studies were not contacted for further relevant information. Fortunately, in about 60% of studies the literature search was performed without language restriction.Conclusions:Lack of duplicate literature searching in systematic reviews was notable. Although most of SRs were searched more than four databases but it seems that in most of them the major databases were not searched and instead, local or specialized databases were considered. Low tendency to grey literature searching was remarkable. It seems that the quality of reporting search strategies in the field of DSS is poor or moderate.