Miracle-dz/UniFAR-FTUs huggingface dataset:
Hospital nurse leaders' experiences with digital technologies: A qualitative descriptive study

Abstract Aim To describe hospital nurse leaders' experiences with digital technologies. Design A qualitative descriptive study. Methods Semi‐structured focus group interviews in one university‐affiliated hospital in Finland. Data were collected from October to November 2021 and analysed using content analysis an e‐leadership framework. Results A total of 20 frontline nurse leaders and middle‐managers participated. Leaders had different kinds of experiences that concerned their traits, cognition, affect and behaviour with digital technologies. Leaders experienced that they needed to be open‐minded towards digitalization, which sometimes eased their work by making it more efficient. Occasionally, they also got frustrated with digitalization, which caused them stress. Leading digital technologies required collaboration with several different stakeholders, and leaders were especially responsible for ensuring nurses' digital competence. Also, leaders own digital capability was highlighted, although some leaders experienced that their digital capability was low. Conclusion The e‐leadership framework is useful for describing the conduct of leadership roles in the context of digital services. Digitalization has transformed leadership, yet nurse leaders' education and training do not seem to have been sufficiently modified to these rapid changes. In addition, more attention should be given to how nurse leaders can be distressed by digitalization. Impact This study provides insight into leadership in the context of digitalized specialized medical care based on nurse leaders' direct statements. Furthermore, the results highlight nurse leaders' educational needs concerning digitalization. Adequately educating nurse leaders to become e‐leaders is crucial to successful digitalization in the nursing domain. Patient or Public Contribution The study focused on nurse leaders' experiences.
A Network Analysis of the Relationship Between Mental and Physical Health in Unsheltered Homeless Persons in Los Angeles County

Homelessness is a public health crisis both nationally, in the United States, and internationally. Nevertheless, due to the hidden vulnerabilities of persons who are without shelter, little is known about their experiences during periods of homelessness. The present research adopts a network approach that conceptualizes how the major risk factors of homelessness interact, namely substance abuse problems, poor mental health, disability, and exposure to physical or sexual violence by an intimate partner. Our analysis draws on a large demographic survey of over 5,000 unsheltered homeless persons conducted in 2017 by the Los Angeles Homeless Services Authority. We estimated a network structure for 12 survey items tapping individual risk using the graphical least absolute shrinkage and selection operator algorithm. We then examined network centrality metrics and implemented a community detection algorithm to detect communities in the network. Our results indicated that mental illness and intimate partner violence (IPV) are central measures that connect all other mental and physical health variables together and that post-traumatic stress disorder and IPV are both highly affected by changes in any part of the network and, in turn, affect changes in other parts of the network. A community detection analysis derived four communities characterized by disability, sexual victimization and health, substance use, and mental health issues. Finally, a directed acyclic graph revealed that drug abuse and physical disability were key drivers of the overall system. We conclude with a discussion of the major implications of our findings and suggest how our results might inform programs aimed at homelessness prevention and intervention.
The Current Status of Telemedicine Technology Use Across the World Health Organization European Region: An Overview of Systematic Reviews

Background Several systematic reviews evaluating the use of telemedicine by clinicians, patients, and health authorities to improve the delivery of care in the 53 member states of the World Health Organization (WHO) European Region have been conducted in recent years. However, a study summarizing the findings of these reviews has not been conducted. Objective This overview of systematic reviews aimed to summarize findings regarding the use of telemedicine across the 53 member states and identify the medical fields and levels of care in and at which the effectiveness, feasibility, and applicability of telemedicine have been demonstrated. The barriers to and facilitators of telemedicine use were also evaluated and collated to help with the design and implementation of telemedicine interventions. Methods Through a comprehensive systematic evaluation of the published and unpublished literature, we extracted clinical, epidemiological, and technology-related data from each review included in the study. We focused on evaluating the barriers to and facilitators of the use of telemedicine apps across the 53 member states considered. We rated the methodological quality of each of the included reviews based on A Measurement Tool to Assess Systematic Review 2 approach and judged the overall certainty of evidence by using the Grading of Recommendations, Assessment, Development, and Evaluations methodology. The entire process was performed by 2 independent authors. Results This overview drew on data from >2239 primary studies, with >20,000 enrolled patients in total, within the WHO European Region. On the basis of data from randomized trials, observational studies, and economic evaluations from several countries, the results show a clear benefit of telemedicine technologies in the screening, diagnosis, management, treatment, and long-term follow-up of a series of chronic diseases. However, we were unable to pool the results into a reliable numeric parameter because of the high heterogeneity of intervention methodologies, scheduling, primary study design discrepancies, settings, and geographical locations. In addition to the clinical outcomes of the interventions, the social and economic outcomes are highlighted. Conclusions The application of telemedicine is well established across countries in the WHO European Region; however, some countries could still benefit from the many uses of these digital solutions. Barriers related to users, technology, and infrastructure were the largest. Conversely, the provision of health services using technological devices was found to significantly enhance patients’ clinical outcomes, improve the long-term follow-up of patients by medical professionals, and offer logistical benefits for both patients and health workers. Trial Registration PROSPERO (International Prospective Register of Systematic Reviews) CRD42022309375; https://www.crd. york.ac. uk/prospero/display_record. php? RecordID=309375
Explosion of red-supergiant stars: Influence of the atmospheric structure on shock breakout and early-time supernova radiation

Early-time observations of Type II supernovae (SNe) 2013cu and 2013fs have revealed an interaction of ejecta with material near the star surface. Unlike Type IIn SN 2010jl, which interacts with a dense wind for ~1 yr, the interaction ebbs after 2–3 d, suggesting a dense and compact circumstellar envelope. Here, we use multi-group radiation hydrodynamics and non-local-thermodynamic-equilibrium radiative transfer to explore the properties of red-supergiant (RSG) star explosions embedded in a variety of dense envelopes. We consider the cases of an extended static atmosphere or a steady-state wind, adopting a range of mass loss rates. The shock breakout signal, luminosity and color evolution up to 10 d, and ejecta dynamics are strongly influenced by the properties of this nearby environment. This compromises the use of early-time observations to constrain R ⋆ . For dense circumstellar envelopes, the time-integrated luminosity over the first 10−15 d can be boosted by a factor of a few. The presence of narrow lines for 2–3 d in 2013fs and 2013cu require a cocoon of material of ~0.01 M ⊙ out to 5−10 R ⋆ . Spectral lines evolve from electron scattering to Doppler broadened with a growing blueshift of their emission peaks. Recent studies propose a super-wind phase with a mass loss rate from 0.001 up to 1 M ⊙ yr -1 in the last months or years of the life of a RSG, although there is no observational constraint that this external material is a steady-state outflow. Alternatively, observations may be explained by the explosion of a RSG star inside its complex atmosphere. Indeed, spatially resolved observations reveal that RSG stars have extended atmospheres, with the presence of downflows and upflows out to several R ⋆ , even in a standard RSG such as Betelgeuse. Mass loading in the region intermediate between star and wind can accommodate the 0.01 M ⊙ needed to explain the observations of 2013fs. Signatures of interaction in early-time spectra of RSG star explosions may therefore be the norm, not the exception, and a puzzling super-wind phase prior to core collapse may be superfluous.
The Changing Epidemiology of Hepatitis C Virus Acquisition Among HIV-Infected Individuals in Brazil

Identification of mechanisms of hepatitis C virus (HCV) acquisition among HIV-infected people is critical for prevention guidance. The aim of this study was to investigate risk factors for HCV infection and variations in HCV genotype distribution in a cohort of HIV-HCV coinfected patients in Brazil. This was a cross-sectional observational epidemiological study of a cohort of HIV-HCV coinfected individuals seen at a referral center for HIV-infected patients in the city of São Paulo between January and December 2017. The time of HCV acquisition, as determined by chart review, was categorized as before 2000, between 2000 and 2009, and from 2010 onward. HCV genotypes were determined by gene amplification and analysis. Among 3,143 HIV-infected individuals analyzed, 362 (11.5%) were HCV-HIV coinfected. Overall, the reported modes of HCV acquisition were sexual exposure in 172 (47.5%), injection drug use (IDU) in 86 (23.8%), use of inhaled drugs in 67 (18.5%) and blood transfusion in 10 (2.8%) individuals. All individuals who acquired HCV after IDU became infected before 2010. HCV acquisition by sexual contact was reported by 26.4%, 65.9%, and 63.8% of patients before 2000, between 2000 and 2009, and from 2010, respectively. There was an increase (p < .001) in the proportion of cases due to sexual transmission from the period before 2000 (26.4%) to between 2000 and 2009 (65.9%). There was no corresponding increase from 2000 and 2009 to after 2010 (p = .751). HCV genotype 1 was most prevalent at all time periods. The genotype 3 frequency decreased over time (test for trend p < .001), whereas genotype 4, extremely uncommon before 2010, became the second most prevalent genotype from 2010 onward. In HIV-infected individuals in Sao Paulo, Brazil, sexual transmission has replaced IDU as the most frequent mode of HCV acquisition.
Prevalence and Correlates of Long COVID Symptoms Among US Adults

Key Points Question How common are COVID-19 symptoms lasting longer than 2 months, also known as long COVID, among adults in the United States, and which adults are most likely to experience long COVID? Findings In this cross-sectional study of more than 16 000 individuals, 15% of US adults with a prior positive COVID-19 test reported current symptoms of long COVID. Those who completed a primary vaccination series prior to infection were less likely to report long COVID symptoms. Meaning This study suggests that long COVID is prevalent and that the risk varies among individual subgroups in the United States; vaccination may reduce this risk.
ALMA view of RX J1131-1231: Sub-kpc CO (2-1) mapping of a molecular disk in a lensed star-forming quasar host galaxy

We present ALMA 2-mm continuum and CO (2-1) spectral line imaging of the gravitationally lensed z=0.654 star-forming/quasar composite RX J1131-1231 at 240-400 mas angular resolution. The continuum emission is found to be compact and coincident with the optical emission, whereas the molecular gas forms a complete Einstein ring, which shows strong differential magnification. The de-lensed source structure is determined on 400-pc resolution using a visibility-fitting lens modelling technique. The reconstructed molecular gas velocity-field is consistent with a rotating disk with a maximum rotational velocity of 280 km/s. From dynamical model fitting we find an enclosed mass M(r<5 kpc)=(1.46+/-0.31)*10^11 M_sol. The molecular gas distribution is highly structured, with clumps that are co-incident with higher gas velocity dispersion regions 40-50 km/s and with the intensity peaks in the optical emission, which are associated with sites of on-going turbulent star-formation. The peak in the CO (2-1) distribution is not co-incident with the AGN, where there is a paucity of molecular gas emission, possibly due to radiative feedback from the central engine. The intrinsic molecular gas luminosity is L'_CO=(1.2+/-0.3)*10^10 K km/s pc^2 and the inferred gas mass is M(H2)=(8.3+/-3.0)*10^10 M_sol, which given its dynamical mass is consistent with a CO-H2 conversion factor of alpha = 5.5+/-2.0 M_solar(K km/s pc^2)^-1. This suggests that the star-formation efficiency is dependent on the host galaxy morphology as opposed to the nature of the AGN. The far-infrared continuum spectral energy distribution shows evidence for heated dust, equivalent to an obscured star-formation rate of SFR=69^(+41)_(-25)*(7.3/u_IR)M_sol/yr, which demonstrates the composite star-forming/AGN nature of this system. RX J1131-1231
Adjuvant nivolumab versus placebo following radical surgery for high-risk muscle-invasive urothelial carcinoma: a subgroup analysis of Japanese patients enrolled in the phase 3 CheckMate 274 trial

Abstract Background The phase 3 CheckMate 274 trial demonstrated superiority of adjuvant nivolumab over placebo after radical surgery in patients with high-risk muscle-invasive urothelial carcinoma. However, the efficacy and safety of adjuvant nivolumab in Japanese patients with muscle-invasive urothelial carcinoma have not been clarified. Methods Patients with muscle-invasive urothelial carcinoma were randomized to adjuvant nivolumab 240 mg or placebo (every 2 weeks via intravenous infusion) up to 120 days after radical surgery in CheckMate 274. Results Of 49 patients in the Japanese subgroup, 27 and 22 patients were randomized to nivolumab and placebo, respectively. Eleven and 8 patients, respectively, had tumor PD-L1 expression level of 1% or more. The median disease-free survival times in the nivolumab and placebo groups were 29.67 months (95% confidence interval 7.79–not reached) and 9.72 months (95% confidence interval 4.73–not reached), respectively (hazard ratio 0.77, 95% confidence interval 0.35–1.69). The corresponding values in patients with tumor PD-L1 expression level of 1% or more were 29.67 months (95% confidence interval 2.63–not reached) and 25.95 months (95% confidence interval 5.59–not reached) (hazard ratio 1.10, 95% confidence interval 0.31–3.92), respectively. Treatment-related adverse events of Grade 3–4 occurred in 25.9 and 13.6% of patients in the nivolumab and placebo groups, respectively. The most common treatment-related adverse events in the nivolumab group were lipase increased, amylase increased and diarrhea. The changes in quality of life scores from baseline over time were similar in both groups. Conclusions The efficacy and safety results in the Japanese subgroup were consistent with the overall population of CheckMate 274.
Optical Follow-up of Gravitational-wave Events during the Second Advanced LIGO/VIRGO Observing Run with the DLT40 Survey

We describe the gravitational-wave (GW) follow-up strategy and subsequent results of the Distance Less Than 40 Mpc survey (DLT40) during the second science run (O2) of the Laser Interferometer Gravitational-wave Observatory and Virgo collaboration (LVC). Depending on the information provided in the GW alert together with the localization map sent by the LVC, DLT40 would respond promptly to image the corresponding galaxies selected by our ranking algorithm in order to search for possible electromagnetic (EM) counterparts in real time. During the LVC O2 run, DLT40 followed 10 GW triggers, observing between ∼20 and 100 galaxies within the GW localization area of each event. From this campaign, we identified two real transient sources within the GW localizations with an appropriate on-source time—one was an unrelated SN Ia (SN 2017cbv), and the other was the optical kilonova, AT 2017fgo/SSS17a/DLT17ck, associated with the binary neutron star (BNS) coalescence GW170817 (a.k.a gamma-ray burst GRB 170817A). We conclude with a discussion of the DLT40 survey’s plans for the upcoming LVC O3 run, which include expanding our galaxy search fields out to D ≈ 65 Mpc to match the LVC’s planned three-detector sensitivity for BNS mergers.
The interaction between drought stress and nodule formation under multiple environments in chickpea

Environmental stresses, particularly drought, limit symbiotic nitrogen fixation in legumes, resulting in decreased yielding capacity. Drought is one of the most important constraints limiting yield potential in crops and it is the major abiotic stress that can cause more than 70% yield loss in chickpea. In this study, a total of two hundred four chickpea (Cicer arietinum L.) genotypes were selected to study the interaction between drought stress and nodule formation. This interaction was assessed by using morphological, yield and yield components. The field experiments were laid out in two locations (Terbol and Kfardan stations, Bekaa valley, Lebanon) using Alpha lattice design with two replications and two watering treatments (irrigation and rainfed) during 2016 and 2017 seasons. Parameters that were measured include days to 50% flowering (DFL), day to maturity (DM), plant height (PLH), nodule biomass (NB), nodule fresh weight (NFW), nodule dry weight (NDW), grain yield (GY), Biological yield (BY), 100 seed weight (100SW) and drought tolerance stress (DTS). The results indicated a significant variation between genotypes, environments and other morphological, yield and yield components traits. Drought stress reduced significantly the yield and the nodule’s characteristics, biological and grain yield. The genotypes with the highest levels of drought tolerance, such as IG70399, IG8256, IG71832, IG70270, and IG70272, showed a minimal decrease in yield and nodule biomass. Nodule observations significantly and positively correlated with GY (0.36-0.38) under drought stress treatment. The correlation values for nodule characteristics with DFL and DM were higher under drought stress compared to irrigated conditions. This is a comparative study between drought stress and nodule formation traits associated with morphological, yield and yield components traits.
Improvement of head and neck symptoms in patients with atopic dermatitis treated with baricitinib based on five Phase III clinical trials

In adults with atopic dermatitis (AD), head and/or neck involvement is frequent, bothersome, and impacts quality of life, however, long-term topical corticosteroids (TCS) are contraindicated for this difficult-to-treat region. Baricitinib, an oral, selective, reversible inhibitor of Janus kinase 1/2 has demonstrated efficacy in adult patients with moderate-to-severe AD. For this post hoc analysis, data from five Phase III trials were used to investigate the efficacy of baricitinib in patients with head and neck involvement. Data were obtained from BREEZE-AD1, -AD2, -AD4, -AD5, and -AD7; Phase III, multicenter, randomized, double-blind, placebo-controlled studies conducted in patients ≥18 years with moderate-to-severe AD. BREEZE-AD1, -AD2, and -AD5 evaluated baricitinib as monotherapy, and BREEZE-AD4 and -AD7 evaluated baricitinib in combination with TCS, topical calcineurin inhibitors, or topical PDE-4 inhibitors, where available. The proportion of patients with improvement of Eczema Area and Severity Index (EASI) total score from baseline of ≥50% (EASI50) and ≥75% (EASI75), as well as head/neck EASI50 and EASI75 and erythema head/neck EASI50 and EASI75 response rates were assessed up to Week 16. Across the studies, 93–98% of patients had head/neck involvement at baseline (EASI head/neck score ≥1). Baricitinib was similarly effective based on EASI total score for the entire body in all studies. In the monotherapy studies, the proportion of patients achieving head/neck EASI50 and EASI75 scores was significantly higher for baricitinib 2-mg and 4-mg versus placebo at Weeks 1 and 16. Baricitinib 2-mg and 4-mg treatment showed rapid and substantial reduction in AD head and neck severity, including erythema.
A classification framework for identifying bronchitis and pneumonia in children based on a small-scale cough sounds dataset

Bronchitis and pneumonia are the common respiratory diseases, of which pneumonia is the leading cause of mortality in pediatric patients worldwide and impose intense pressure on health care systems. This study aims to classify bronchitis and pneumonia in children by analyzing cough sounds. We propose a Classification Framework based on Cough Sounds (CFCS) to identify bronchitis and pneumonia in children. Our dataset includes cough sounds from 173 outpatients at the West China Second University Hospital, Sichuan University, Chengdu, China. We adopt aggregation operation to obtain patients’ disease features because some cough chunks carry the disease information while others do not. In the stage of classification in our framework, we adopt Support Vector Machine (SVM) to classify the diseases due to the small scale of our dataset. Furthermore, we apply data augmentation to our dataset to enlarge the number of samples and then adopt Long Short-Term Memory Network (LSTM) to classify. After 45 random tests on RAW dataset, SVM achieves the best classification accuracy of 86.04% and standard deviation of 4.7%. The precision of bronchitis and pneumonia is 93.75% and 87.5%, and their recall is 88.24% and 93.33%. The AUC of SVM and LSTM classification models on the dataset with pitch-shifting data augmentation reach 0.92 and 0.93, respectively. Extensive experimental results show that CFCS can effectively classify children into bronchitis and pneumonia.
Diversification dynamics in the Neotropics through time, clades, and biogeographic regions

The origins and evolution of the outstanding Neotropical biodiversity are a matter of intense debate. A comprehensive understanding is hindered by the lack of deep-time comparative data across wide phylogenetic and ecological contexts. Here, we quantify the prevailing diversification trajectories and drivers of Neotropical diversification in a sample of 150 phylogenies (12,512 species) of seed plants and tetrapods, and assess their variation across Neotropical regions and taxa. Analyses indicate that Neotropical diversity has mostly expanded through time (70% of the clades), while scenarios of saturated and declining diversity account for 21% and 9% of Neotropical diversity, respectively. Five biogeographic areas are identified as distinctive units of long-term Neotropical evolution, including Pan-Amazonia, the Dry Diagonal, and Bahama-Antilles. Diversification dynamics do not differ across these areas, suggesting no geographic structure in long-term Neotropical diversification. In contrast, diversification dynamics differ across taxa: plant diversity mostly expanded through time (88%), while a substantial fraction (43%) of tetrapod diversity accumulated at a slower pace or declined towards the present. These opposite evolutionary patterns may reflect different capacities for plants and tetrapods to cope with past climate changes.