bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring recent patterns of migration of doctors to the United Kingdom: A mixed-methods study
Authors: Brennan N , Langdon N , Gale T , Humphries N , Knapton A , Bryce M 
Published: July 2023

Abstract
Introduction

A shortage of doctors is currently one of the biggest challenges faced by the healthcare workforce in the United Kingdom (UK). While plans are in place to increase the number of medical school places, in the short-term this gap will need to continue to be filled by the international recruitment of doctors. The aim of this study is to identify key factors that explain the patterns of migration of doctors to the UK, in order to aid the development of policies to recruit and retain a sustainable workforce.

Methods

We analysed General Medical Council (GMC) secondary data on the patterns of migration of internationally trained doctors (2009-2019). Qualitative interviews were conducted with 17 stakeholders by videoconferencing which were audio-recorded, transcribed and thematically analysed using NVivo.

Results

In 2019, 34.5% of UK doctors were trained internationally mainly in India, Pakistan, Italy, Nigeria, Greece, Romania and Egypt. Most new registrations by internationally trained doctors from 2009-2019 did not have a specialty at the time of initial registration (96.2% in 2019). Only a relatively small number of these doctors go on to gain specialist or GP registration (11.6% within 5 years and 27.2% within 10 years of registration). The stakeholder interviews highlighted training opportunities and career progression as the main drivers of migration. The barriers internationally trained doctors face regarding specialty training included differences between UK and destination health systems, systematic bias, bureaucracy and selection processes not being accessible.

Conclusion

This study makes a contribution to the literature by identifying recent patterns in the migration of doctors to the UK. The UK’s dependence on internationally trained doctors has important global implications as source countries are losing skilled health workers which is undermining their health systems. In keeping with the WHO Global Code on the International Recruitment of Healthcare Personnel, policymakers need to consider how to reduce the UK’s reliance on internationally trained doctors, particularly from countries on the safeguard list whilst continuing the drive to increase medical school places. Additional support is required for internationally trained doctors, to ensure that they get on the training programmes they seek, enabling their career progression.
An operational risk assessment method for petrochemical plants based on deep learning
Authors: liu zhipeng 
Published: July 2023

Abstract
Petrochemical plants are an important guarantee for the development of people's lives, and the most important thing in petrochemical plants is the risk assessment method in operations. Based on the research of deep learning algorithms, this paper innovatively proposes a risk assessment method for petrochemical plants based on the combination of human motion simulation based on the micro-Doppler effect and fuzzy hierarchical analysis. The original monitoring image of the petrochemical plant is invoked to identify the target of human movement in the job site and generate the spectral diagram of human movement, and the operation safety risk of the petrochemical plant is assessed through the combination of fuzzy function and hierarchical analysis, which can effectively prevent the illegal actions of the on-site operators and provide protection for the personal safety of the on-site operators. This method plays an important role in improving the safety of petrochemical plants.
Addressing Domestic Violence in Antenatal Care Environments in Nepal (ADVANCE) – Study Protocol for a Randomized Controlled Trial Evaluating a Video Intervention on Domestic Violence among Pregnant Women
Authors: Chalise P , Manandhar P , JJ Infanti , Campbell J , Henriksen L , SK Joshi , Koju R , KD Pun , Rishal P , MR Simpson , Skovlund E , Swahnberg K , Schei B , Lukasse M 
Published: July 2023

Abstract
Background Domestic violence (DV) prior to, and during pregnancy is associated with increased risks for morbidity and mortality. As pregnant women routinely attend antenatal care this environment can be used to offer support to women experiencing DV. We have developed a video intervention that focuses on the use of behavioral coping strategies, particularly regarding disclosure of DV experiences. The effectiveness of this intervention will be evaluated through a randomized controlled trial (RCT) and a concurrent process evaluation.Methods All pregnant women between 12–22 weeks of gestation attending routine antenatal care at two tertiary level hospitals in Nepal are invited to participate. DV is measured using the Nepalese version of the Abuse Assessment Screen (N-AAS). Additionally, we measure participants’ mental health, use of coping strategies, physical activity, and food security through a Color-coded Audio Computer Assisted Self Interview (C-ACASI). Irrespective of DV status, women are randomized into the intervention or control arm using a computer-generated randomization program. The intervention arm views a short video providing information on DV, safety improving actions women can take with an emphasis on disclosing the violence to a trusted person along with utilizing helplines available in Nepal. The control group watches a video on maintaining a healthy pregnancy and when to seek healthcare. The primary outcome is the proportion of women disclosing their DV status to someone. Secondary outcomes are symptoms of anxiety and depression, coping strategies, the use of safety measures and attitudes towards acceptance of abuse. Follow-up is conducted after 32 weeks of gestation, where both the intervention and control group participants view the intervention video after completing the follow-up questionnaire. Additionally, a mixed methods process evaluation of the intervention will be carried out to explore factors influencing the acceptability of the intervention and the disclosure of DV, including a review of project documents, individual interviews, and focus group discussions with members of the research team, healthcare providers, and participants.Discussion This study will provide evidence on whether pregnant women attending regular antenatal visits can enhance their safety by disclosing their experiences of violence to a trusted person after receiving a video intervention.Trial registration The study is registered in ClinicalTrial.gov with identifier NCT05199935.
Spatio-temporal variation and future multi-scenario simulation of carbon storage in Bailong River Basin using GeoSOS-FLUS and InVEST models
Authors: Wang Wanli , Zhang Zhen , Ding Jing , Liu Xiaopeng , Sun Heling , Li Guolong , Deng Chao 
Published: July 2023

Abstract
By providing a scientific foundation for managing regional ecosystem carbon (C) pools, research on the spatial distribution characteristics of regional C stocks can assist in the development of policies on C emissions reduction and sequestration enhancement. Using the GeoSOS-FLUS and InVEST models and explorations of the Bailong River Basin in the past 20 years, the influence of three future scenarios of land use change—natural development (ND), ecological protection (EP) and arable land protection (ALP)—on C storage was modelled. Between 2000 and 2020, there was a gradual increase in C storage in the BRB with a total increase of 5.58 Tg (3.19%), showing notable spatial heterogeneity. The increase in C storage was attributed to land use conversion among woodland, arable land and grassland, with the conversion between woodland and arable land being the primary factor contributing to the increase in C storage. By 2050, C storage under the EP, ALP and NP scenarios was 183.915, 183.108 and 183.228 Tg, respectively. In 2050, C storage under the EP scenario increased by 0.37% compared with that in 2020, and decreased by 0.07% and 0.005% under the ALP and NP scenarios, respectively. In contrast to the other scenarios, the EP scenario prioritised the protection of the woodland and grassland C sinks, which has significant implications for future planning.
Tunnelling of electrons via the neighboring atom
Authors: Yang Weifeng , Zhu Ming , Tong Jihong , Liu Xiwang , Gong Xiaochun , Jiang Wenyu , Lu Peifen , Song Xiaohong , Wu Jian 
Published: July 2023

Abstract
As compared to the intuitive process that the electron emits straight to the continuum from its parent ion, there is an alternative route that the electron may transfer to and be trapped by a neighboring ionic core before the eventual release. Here, we demonstrate that electron tunnelling via the neighboring atomic core is a pronounced process in light-induced tunnelling ionization of molecules by absorbing multiple near-infrared photons. We devised a site-resolved tunnelling experiment using an Ar-Kr+ ion as a prototype system to track the electron tunnelling dynamics from the Ar atom towards the neighboring Kr+ by monitoring its transverse momentum distribution, which is temporally captured into the resonant excited states of the Ar-Kr+ before its eventual releasing. The influence of the Coulomb potential of neighboring ionic cores promises new insights into the understanding and controlling of tunnelling dynamics in complex molecules or environment.
Continuous shear wave measurements for dynamic cardiac stiffness evaluation in pigs
Authors: Caenen Annette , Keijzer Lana , Bézy Stéphanie , Duchenne Jürgen , Orlowska Marta , Steen Antonius F. W. , Jong Nico , Bosch Johan G. , Voigt Jens-Uwe , D’hooge Jan , Vos Hendrik J. 
Published: July 2023

Abstract
Ultrasound-based shear wave elastography is a promising technique to non-invasively assess the dynamic stiffness variations of the heart. The technique is based on tracking the propagation of acoustically induced shear waves in the myocardium of which the propagation speed is linked to tissue stiffness. This measurement is repeated multiple times across the cardiac cycle to assess the natural variations in wave propagation speed. The interpretation of these measurements remains however complex, as factors such as loading and contractility affect wave propagation. We therefore applied transthoracic shear wave elastography in 13 pigs to investigate the dependencies of wave speed on pressure-volume derived indices of loading, myocardial stiffness, and contractility, while altering loading and inducing myocardial ischemia/reperfusion injury. Our results show that diastolic wave speed correlates to a pressure-volume derived index of operational myocardial stiffness (R = 0.75, p < 0.001), suggesting that both loading and intrinsic properties can affect diastolic wave speed. Additionally, the wave speed ratio, i.e. the ratio of systolic and diastolic speed, correlates to a pressure-volume derived index of contractility, i.e. preload-recruitable stroke work (R = 0.67, p < 0.001). Measuring wave speed ratio might thus provide a non-invasive index of contractility during ischemia/reperfusion injury.
Construction and evaluation of a 180-day readmission prediction model for chronic heart failure patients based on sCD40L
Authors: Zhang Peng , Lin Hui , Meng Liping , Xing Yangbo , Peng Fang 
Published: July 2023

Abstract
Background
The high readmission rate of patients with chronic heart failure can cause waste of medical resources and economic losses. Establishing an effective heart failure readmission model can effectively alleviate medical pressure and improve the quality of treatment.
Methods
In this study, we conducted a comprehensive analysis of clinical and laboratory data from 248 patients with chronic heart failure who received treatment at our medical center between January 2021 to January 2023. We also measured sCD40L levels to determine their association with readmission due to heart failure during follow-up. To analyze the data, we employed various statistical methods including independent sample t-test, correlation analysis, univariate COX regression, and LASSO COX regression. Using these techniques, we organized the data and constructed a predictive model that was both trained and validated.
Results
We developed a nomogram to assess the likelihood of readmission within 180 days for patients with chronic heart failure. Our findings revealed that monocytes, creatinine, sCD40L, and hypertension history were all independent risk factors for 180-day heart failure readmissions. Additionally, our model's area under the curve was 0.731 in the training dataset and 0.704 in the validation dataset.
Conclusion
This study provides new insights for predicting readmission within 180 days for patients with chronic heart failure. And sCD40L is an important predictive indicator for readmission of heart failure patients within 180 days, and clinical doctors can develop appropriate treatment plans based on sCD40L.
Nurses’ Competency on Electrocardiography Interpretation in Adult Emergency Room: Addis Ababa, Ethiopia, 2021. Multicenter Cross-sectional Study
Authors: Belay Yegremew Haimanot , Gezahegn Demmelash , Melaku Birhanu , Tegegne ousman adal 
Published: July 2023

Abstract

Background: Electrocardiography is a graphic representation of the electrical activity of the heart. According to previous literature, nurses have poor knowledge and skills about basic electrocardiography interpretation. For instance, a previous survey conducted in Turkey showed that only 38.1 percent of nurses were able to recognize ventricular fibrillation, 54.3% myocardial infarction, and 33.3% third-degree atrioventricular block.
Objective: This study was aimed at assessing Nurses’ competency in electrocardiography interpretation in adult emergency rooms in Addis Ababa, Ethiopia, in 2021.
Method: An institutional-based descriptive, cross-sectional study design was used to conduct the study. A total of 175 nurses in five randomly selected hospitals with adult emergency rooms were included in this study. Semi-structured, self-administered questionnaires were used to collect the data. Data were entered into Epi data and analyzed using SPSS version 26. A Fisher’s exact test was used to identify the relationship between dependent and independent variables.
Results: Of 203 respondents, 175 actively participated, for a response rate of 86.2%. From those 175 nurses, 159 (90.9%) were not competent (scored < 65%), and the mean score was 6.82 ± 3.65 SD.
Conclusion: The overall level of competency of nurses in electrocardiography interpretation is low. This implies most nurses in the emergency room do not monitor and manage a patient's electrocardiography for manifestations of arrhythmias, electrolyte disturbance and other cardiac abnormalities. Level of education and training were a determinant factor to enhance their competency.
Biomimetic supramolecular protein matrix restores structure and properties of human dental enamel
Authors: Mata Alvaro , Hasan Abshar , Chuvilin Andrey , Teijlingen Alexander , Parmenter Christopher , Venturi Federico , Fay Mike , Greco Gabriele , Pugno Nicola , Ruben Jan , Edwards-Gayle Charlotte , Myers Benjamin , Dreveny Ingrid , Cowieson Nathan , Winter Adam , Gamea Sara , Walboomers X. Frank , Hussain Tanvir , Rodríguez-Cabello José Carlos , Rawson Frankie , Tuttle Tell , Elsharkawy Sherif , Banerjee Avijit , habelitz Stefan 
Published: July 2023

Abstract
The authors have requested that this preprint be removed from Research Square.
A National Audit of Facilities, Human and Material Resources for the Comprehensive Management of Diabetes Mellitus in Ghana-A 2023 Update
Authors: Yorke Ernest , Akpalu Josephine , Johnson Gwendolyn de-Graft , Atiase Yacoba , Reynolds Margaret , Laryea Ruth , Tetteh John , Yawson Alfred E. , Amoah Albert G. B 
Published: July 2023

Abstract
Background
It is expected that Sub-Saharan African countries are expected to experience the largest increases in the prevalence and complications of diabetes by the year 2045. However, the human and material resources as well as the systems for managing diabetes in Africa are inadequate.
Thus, this study or needs assessment, aimed at updating the human and material resources, identifying the gaps and unmet needs for comprehensive diabetes care in Ghana.
Methods: We conducted a national audit of 122 facilities in all 16 administrative regions of Ghana comprising 6 Teaching, 10 Regional, 100 Municipal/District Hospitals, and 6 private and quasi-government hospitals. Information obtained covered areas on personnel and multidisciplinary teams, access to medications, access to laboratory services, financing, screening services, management of diabetes complications, and availability/use of diabetes guidelines or protocols. Data was analysed using STATA version 16.1. P-values <0.05 were set as significant.
Results:
Only 85(69.7%) out of the 122 surveyed facilities had a dedicated centre or service for diabetes care. Twenty-eight (23%) had trained diabetes doctors/specialists; and whilst most centres had ophthalmic nurses and dieticians, majority of them did not have trained diabetes educators (nurses), psychologists, ophthalmologists, podiatrists, and foot/vascular surgeons. Also, 13.9% had monofilaments, none could perform urine dipstick for microalbumin; 5 (4.1%) and just over 50% could perform laboratory microalbumin estimation and glycated haemoglobin respectively. Access to and supply of human insulins was better than analogue insulin in most centres. Nearly 100% of the institutions surveyed had access to metformin and sulphonylurea with good to excellent supply in most cases, whilst access to Sodium Glucose Transporter-2 inhibitors and Glucagon-like peptide-1 analogues were low, and moderate for Dipeptidyl peptidase-4 inhibitors and thiazolidinediones.
Overwhelming majority of the health facilities (95.1%) offered NHIS as payment mechanism for clients, whilst 68.0% and 30.3% of the patients paid for services using out-of-pocket and private insurance respectively. Also, 91.8% surveyed used the National Treatment Guideline in their practice and 15 (12.3%) had Diabetes Support Groups in their locality and catchment areas.
Conclusion: Significant gaps remain in human and material resources, which requires urgent multisectoral collaboration to promote and achieve acceptable comprehensive diabetes care.
Unlocking Sub-Saharan Africa's Export Potential: A Reassessment of the Influence of Manufacturing Firms Access to finance
Authors: Oduola Musa Olanrewaju 
Published: July 2023

Abstract
Enhancing sub-Saharan Africa's manufacturing exports is an imperative necessity, given its numerous economic and developmental benefits. While significant scholarly contributions have explored the factors influencing firms' exporting activities, further research is needed to deepen our understanding of the access to finance perspective. Despite previous studies examining the link between access to finance and exporting activities, a lack of consensus persists in the existing literature. Moreover, the majority of these studies have focused primarily on formal finance, neglecting the role of informal finance. Therefore, this study fills this gap by investigating the impact of access to finance on the exporting activities of manufacturing firms in sub-Saharan Africa. The World Bank Enterprise Survey data for 38 sub-Saharan African countries is utilised to measure firm exporting, employing the extended probit regression model for empirical testing. The findings reveal a direct relationship between access to formal finance and manufacturing firms' exports, indicating that improved access to formal finance increases the likelihood of exporting for firms in sub-Saharan Africa. We found a similar result for the effect of access to informal finance. To ensure the robustness of our results, we employ alternative measures of firm exporting in terms of export value and apply instrumental variable Tobit and Heckman selection two-step regression models. The results remain consistent with our initial findings. Based on these findings, policy recommendations are provided to support and enhance manufacturing exports in sub-Saharan Africa.
JEL Classification: C36, D22, F14, G23, L60, M20
Exploring Nonlinear Optical Properties of Perylene Diimide Derivatives and Biomolecules: A Computational Supramolecular Study
Authors: Hussain Wajid , Iqbal Muhammad Shahid , Bashir Muhammad Rashid , Khan Maroof Ahmad , Ali Hafiz Saqib , Hanif muhammad 
Published: July 2023

Abstract
This study investigates the supramolecular interactions between perylene diimides (PDI) and nucleotides, specifically adenosine monophosphate (AMP) and cytidine monophosphate (CMP). The study uses five PDIs (L6, L7, L8, L9, L10) that were previously studied. Ten complexes (complex 1 (L-ala-PDI-AMP), complex 2 (B-ala-PDI-AMP), complex 3 (GLY-PDI-AMP), complex 4 (IMI- PDI -AMP), complex 5 (PYR-PDI-AMP, complex 6 (L-ala-PDI-CMP), complex 7 (B-ala-PDI-CMP), complex 8 (GLY-PDI-CMP), complex 9 (IMI-PDI-CMP), and complex 10 (PYR-PDI-CMP) labeled 1-10, were obtained using the B3LYP/6-31G basis set, and their weak interactions were studied through Density Functional Theory (DFT). The study aimed to optimize the supramolecular complexes formed between PDI and nucleotides by placing the molecules parallel to each other without bond formation before the optimization process. The study explores the properties of these complexes through various methods such as NMR, IR, UV, Hyperpolarizabilities, frontier molecular orbitals (FMOs), density of states (DOS), noncovalent interactions (NCI), Iso-surface analysis, atom in molecule (AIM), dipole moment (µ), electron density distribution map (EDDM), transition density matrix (TDM), Molecular electrostatic potential (MEP), and Electron-hole analysis (EHA) using DFT. The weak bonds formed among PDI and nucleotide in all ten complexes were visualized using Discovery Studio Visualizer. The electronic properties of the complexes were examined through Natural Bond Orbital (NBO) and Natural Population Analysis (NPA), leading to Non-Linear Optics (NLO) study. The study provides insight into the nature of weak interactions between PDI and nucleotide, as well as the electronic properties of these complexes, which could have implications for future studies in the field of supramolecular chemistry.
PMSM Sliding Mode Control Based on Improved Reaching Law
Authors: Wang Shijiao , jiang chengming , Tu Qunzhang , Zhu Changlin 
Published: July 2023

Abstract
This paper proposes a novel adaptive reaching law-based sliding mode control (SMC) method for maintaining favorable velocity control performance of permanent magnet synchronous motors (PMSMs) under internal and external perturbations. A new sliding mode reaching law (NSMRL) is designed, which contains adaptive terms and state variables of the sliding mode surface function. This augmented reaching law decreases the chatter of the control system and increases the rate at which the state variables of the system reach the sliding mode surface. Additionally, a Luenberger observer load torque (LOLT) is designed to observe the external load and provide feedback to the velocity controller, reducing the impact of load disturbances and improving the jamming performance of the controller. Simulation experiments confirm that NSMRL reduces buffeting, decreases overshoot, and shortens response time, demonstrating its advantages in PMSM control.