Miracle-dz/UniFAR-FTUs huggingface dataset:
Understanding the outdoor play environment for preschool children in child care: should we just let 'em go?

viii CHAPTER 1. GENERAL INTRODUCTION 1 Inspiration 1 Purpose 6 Method 7 Significance 8 Setting 8 Dissertation Organization 11 CHAPTER! LITERATURE REVIEW 13 Understanding Outdoor Environments 13 Historical Perspective on the Design of the Outdoor Environment 13 Types of playgrounds 17 Loose parts 19 Children's Outdoor Play from an Historical Perspective 21 Play Outdoors Today 25 A connection to nature 25 Indoor-Outdoor 27 Environmental stewardship 30 Play settings 31 Flow 32 Affordances 32 Aesthetics 33 Movement 34 Interaction 36 Including and accommodating children with special needs 36 Safety 40 Assessment 41 Teacher training 42 Summary and Conclusion 43 CHAPTER 3. UNDERSTANDING A QUALITY OUTDOOR ENVIRONMENT 47 FOR PRESCHOOL CHILDREN IN CHILD CARE Abstract 47 Introduction 48 Method 56 Findings 86 Discussion 94 References 102
Three patients with homozygous familial hypercholesterolemia: Genomic sequencing and kindred analysis

Homozygous Familial Hypercholesterolemia (HoFH) is an inherited recessive condition associated with extremely high levels of low‐density lipoprotein (LDL) cholesterol in affected individuals. It is usually caused by homozygous or compound heterozygous functional mutations in the LDL receptor (LDLR). A number of mutations causing FH have been reported in literature and such genetic heterogeneity presents great challenges for disease diagnosis.
Fear of cancer recurrence in lymphoma survivors: A descriptive study

Abstract Objectives: Fear of cancer recurrence (FCR) is a common experience among cancer survivors and often persists after the termination of cancer treatments. The purpose of this paper was to evaluate FCR in survivors of Hodgkin’s and diffuse large B-cell lymphomas, given a high rate of survivorship in this patient population. Research Approach: The parent study was a multi-site, cluster-randomized trial to assess a communication skills intervention: survivorship planning consultation (versus a time-attention control - wellness rehabilitation intervention) to promote transition to survivorship. Participants & Methodological Approach: 199 patients enrolled in the study and completed a survivorship (or control) consultation one-month after receiving the news of their survivorship status; 141 of those patients (n = 92 experimental arm, n = 49 control arm) completed an interview at their 6-month follow-up consultation. In the interview, participants described frequency of FCR, causes of FCR, coping mechanisms, and specific things oncologists said to reduce FCR. Both qualitative and quantitative methods were utilized for analyzing participant responses. Findings: The majority (88%) of participants reported experiencing FCR, with a higher number of participants in the experimental arm significantly more likely to endorse FCR compared to the control group participants. The main causes of FCR were having medical appointments and concerns about potential relapse and secondary cancers. Participants endorsed utilizing self-sufficient coping mechanisms. As well, participants reported that oncologists most frequently cited specific cure rates of lymphoma to reduce patients’ FCR. Interpretation & Implications for Psychosocial Providers: Communication skills training programs should emphasize FCR in survivorship consultations.
Clinical significance of ‘double-hit’ and ‘double-expression’ lymphomas

Background ‘Double-hit’ lymphoma (DHL) and ‘double-expression’ lymphoma (DEL) involving gene rearrangement and protein expression of MYC and BCL2/BCL6 have recently become the most commonly used terms to describe the poor prognostic types of diffuse large B-cell lymphoma (DLBCL). However, the clinical and pathological spectra of these rare entities have not been well defined. The aim of this study was to determine the frequency of DHL and DEL in DLBCL and their prognostic impacts in the era of cyclophosphamide, doxorubicin, vincristine and prednisone plus rituximab therapy. Methods The data and tissues from 98 patients diagnosed with DLBCL were used in this study. Formalin-fixed and paraffin-embedded tissues were constructed for immunohistochemistry (IHC) and interphase fluorescene in situ hybridisation (FISH) analysis for MYC, BCL6 and BCL2 rearrangements. Results There were 14 cases (14.29%, 14/98) and 34 cases (34.70%, 34/98) of lymphomas with the DHL and DEL of MYC and BCL2/BCL6, respectively. DLBCL patients with MYC/BCL2 rearrangements more frequently had bone marrow involvement (p=0.002), and their tumours were commonly of the germinal centre B cell (GCB) subtype. Patients with MYC+/BCL2 +coexpression were more often assessed using the International Prognostic Index (IPI), (Performance Status) PS score and bone marrow involvement. Patients with MYC+/BCL6 +coexpression were associated with their IPI values, Eastern Cooperative Oncology Group scores and occurrence of B symptoms. Their lymphomas were more often of the non-GCB subtype (p=0.010). Multivariate analysis showed that IPI, bone marrow involvement, rearrangements of BCL2, BCL6 and MYC, expression concurrent with rearrangements and coexpression were all significantly associated with overall survival and progression-free survival, with the exception of MYC+/BCL6 +coexpression. Conclusions MYC/BCL2 DHL, MYC/BCL6 DHL and MYC/BCL2 DEL are an aggressive B cell lymphoma and patients have a poor prognosis. IPI and bone marrow involvement were independent prognostic factors for DHL and DEL. BCL2, BCL6 and MYC rearrangements translocation, expression concurrent rearrangements and coexpression were were independent prognostic factors for survival. Potential implications The present study analysed the genomic alterations and protein expression levels of MYC, BCL2 and BCL6 using FISH and IHC in Chinese patients with DLBCL.We assessed the frequency, clinicopathological features and the prognostic impacts of DHL and DEL in a cohort of de novo DLBCL patients and evaluated the role of each genetic translocation separately and in combination in order to provide reliable conclusions and practical recommendations for diagnostic workups and prognostic predictions.
Development of the Fitness Education Index: A Scale of Organizational Level Capacity

ABSTRACT Purpose: Fitness education is essential for children’s health, but determining the effectiveness of instruction related to health-related fitness is difficult. The present study developed and confirmed the validity of a 20-item scale, adapted from the School Health Index (Centers for Diseases Control and Prevention [CDC], 2014), to evaluate the success of fitness education portion of the Presidential Youth Fitness Program (PYFP) across a sample of 785 teachers. Method: The initial subset (n = 373) represented 353 schools and was used for conducting an exploratory factor analysis. The second subset (n = 412) representing 404 schools, was used to conduct the confirmatory factor analysis. Teachers self-assessed their perceived degree of implementation of fitness education (full, partial, under development, not in place) within their school (i.e., teachers helped students set fitness goals). Results: An initial exploratory factor analysis revealed that the Fitness Education Index questions clustered into six factors. A subsequent confirmatory factor analysis conducted using Mplus concluded the six-factor solution was a good fit (CFI = 0.90, TLI = 0.88, RMSEA = 0.08, SRMR = 0.06). Conclusion: This scale is a valid measure of a school’s readiness to initiate and track progress toward the full implementation of fitness education.
Safinamide in Clinical Practice: A Spanish Multicenter Cohort Study

Background: Safinamide is an approved drug for the treatment of motor fluctuations of Parkinson’s Disease (PD) patients with a potential benefit on non-motor symptoms (NMS). Methods: A retrospective multicenter cohort study was conducted, in which the clinical effect of safinamide on both motor and NMS was assessed by the Clinical Global Impression of Change scale. Furthermore, we assessed the appearance of adverse events (AEs) and its effect on dyskinesia, that were also recorded in non-fluctuating PD patients and in those previously treated with rasagiline. Results: We included 213 PD patients who received safinamide in addition to their regular levodopa therapy. Thirty-five withdrew prematurely from safinamide, mainly because of AEs. Out of 178, clinical improvement on motor and NMS was found in 76.4% and 26.2%, respectively. A total of 44 reported AEs of mild intensity. We did not find a difference concerning the clinical benefit or AEs when comparing either patients who had or had not been taking Monoamine Oxidase B Inhibitor (MAOB-I) previously or between patients with and without motor complications. Conclusions: Safinamide is an effective and safe add-on to levodopa drug for PD patients. Moreover, safinamide could elicit an additional clinical improvement in PD patients previously treated with other MAOB-I and in non- fluctuating patients with suboptimal motor control.
The Impact of Obesity on the Association between Vitamin D Deficiency and Cardiovascular Disease

The aim of this article is to review the literature regarding the relationship between vitamin D deficiency and cardiovascular disease (CVD) and its modification in the presence of obesity. Despite the strong association between vitamin D status and cardiovascular outcomes, vitamin D supplementation trials in the general population have failed to decrease the incidence of cardiovascular events and mortality. A comprehensive study of the published literature and a comparison with experimental data lead to the conclusion that obesity, due to its high prevalence and strong association with both vitamin D deficiency and CVD, may act as a critical confounder, which is responsible for the different results on this association. Adoption of a vitamin D preventive supplementation strategy for CVD is unlikely to yield any benefit to the general population. However, it might be particularly useful in obese adults with increased risk for CVD.
Flexible Piezoelectric Acoustic Sensors and Machine Learning for Speech Processing

Flexible piezoelectric acoustic sensors have been developed to generate multiple sound signals with high sensitivity, shifting the paradigm of future voice technologies. Speech recognition based on advanced acoustic sensors and optimized machine learning software will play an innovative interface for artificial intelligence (AI) services. Collaboration and novel approaches between both smart sensors and speech algorithms should be attempted to realize a hyperconnected society, which can offer personalized services such as biometric authentication, AI secretaries, and home appliances. Here, representative developments in speech recognition are reviewed in terms of flexible piezoelectric materials, self‐powered sensors, machine learning algorithms, and speaker recognition.
Low-Power Hardware Implementation of a Support Vector Machine Training and Classification for Neural Seizure Detection

In this paper, a low power support vector machine (SVM) training, feature extraction, and classification algorithm are hardware implemented in a neural seizure detection application. The training algorithm used is the sequential minimal optimization (SMO) algorithm. The system is implemented on different platforms: such as field programmable gate array (FPGA), Xilinx Virtex-7 and application specific integrated circuit (ASIC) using hardware-calibrated UMC 65 nm CMOS technology. The implemented training hardware is introduced as an accelerator intellectual property (IP), especially in the case of large number of training sets, such as neural seizure detection. Feature extraction and classification blocks are implemented to achieve the best trade-off between sensitivity and power consumption. The proposed seizure detection system achieves a sensitivity around 96.77% when tested with the implemented linear kernel classifier. A power consumption evaluation is performed on both the ASIC and FPGA platforms showing that the ASIC power consumption is improved by a factor of 2X when compared with the FPGA counterpart.
Career Development Support, Job Adaptation, and Withdrawal Intention of Expatriates: A Multilevel Analysis of Environmental Factors

The present study aims to explore the impact of career development support on job adaptation and withdrawal intention, and the multilevel moderating role of host country environmental factors. Through the questionnaire survey, we collected 242 expatriates’ data of 25 countries from China’s multinational corporations. Based on the constructed multilevel analysis model, we find: (1) career development support has a significant impact on job adaptation and withdrawal intention of expatriates; (2) job adaptation plays a mediating role between career development support and withdrawal intention; and (3) host country environment plays the multilevel moderating role between career development support and job adaptation. Through the multilevel model of host country environment, this study explores the mechanism of how career development support affects job adaptation and withdrawal intention. The conclusions enhance the understanding of the adaptation of expatriates and have important theoretical and practical reference value to achieve successful expatriate in the context of host country environment.
A 3D Follow-Up Study of Cranial Asymmetry from Early Infancy to Toddler Age after Preterm versus Term Birth

Preterm infants are at higher risk for both symmetrical and asymmetrical head molding. This study involved 3D stereophotogrammetry to assess the cranial growth, molding, and incidence of deformational plagiocephaly (DP) in preterm children compared to term born children. Thirty-four preterm infants and 34 term born controls were enrolled in this study from Oulu University Hospital, Finland. Three-dimensional head images were obtained at the age of 2–4 months (T1), 5–7 months (T2), 11–13 months (T3), and 2.5–3 years (T4) from the term equivalent age (TEA). There was no statistically significant difference in oblique cranial length ratio (OCLR), cephalic index (CI), or weighted asymmetry score (wAS) between the two groups. Occipital flattening, defined by flatness score (FS) was statistically significantly greater in the preterm group than in the term group at T1–T4 (p < 0.05). In both groups, OCLR improved gradually over time. There were no instances, in either group, of severe DP and no moderate DP after T2. Results indicate that DP affects preterm and full-term children almost equally during the first three years of life, and cranial asymmetry resolves at a similar rate in both preterm and term groups after three months of corrected age. Preterm infants present with more occipital flattening than full-term children.
The prevalence of intimate partner violence among couples signing up for universally offered parent preparation

Background Intimate partner violence (IPV) during pregnancy can have serious health consequences for mothers and the unborn child. Nevertheless, IPV is seldom addressed in the context of parent preparation. Aim This study aimed to map the prevalence, direction, and severity of IPV in a sample of expectant couples signing up for universally-offered parent preparation. Method A total of 1726 Danish couples expecting their first child provided data on physical and psychological IPV by completing the Family Maltreatment measure during the second trimester of pregnancy. Results In 18.5% of the couples, at least one partner reported psychological or physical IPV acts during the past year. In more than 8% of couples, one or both partners reported acts and impacts above the ICD-11 threshold for clinically-significant IPV (CS-IPV) during the past year (3.6% physical CS-IPV, 5.3% psychological CS-IPV, and 0.8% both physical and psychological CS-IPV). Among couples with physical IPV below the clinical threshold, pregnant-woman-to-partner (50%) and bidirectional (38.2%) IPV were more common than partner-to-pregnant-woman IPV (11.8%). Among couples with physical CS-IPV, pregnant-woman-to-partner (36.1%), partner-to-pregnant-women (29.1%) and bidirectional (34.4%) forms were equally common. Among couples with psychological IPV, pregnant-woman-to-partner (54.9%) and partner-to-pregnant-woman (39.6%) IPV were more common than bidirectional IPV (5.5%). Discussion The prevalence of violence was markedly higher in this study compared with previous reports from the Nordic region and highlights a previous oversight of a substantial and clinically significant level of pregnant-woman-to-partner IPV—as well as the reverse. Data from this study call for IPV to be addressed in universally offered parent preparation programs.
Acute Metabolic Changes with Lower Leg-Positioned Wearable Resistances during Submaximal Running in Endurance-Trained Runners

The aim of this study was to determine the acute metabolic effects of different magnitudes of wearable resistance (WR) attached to the lower leg during submaximal running. Fifteen endurance-trained runners (37.8 ± 6.4 years; 1.77 ± 0.7 m; 72.5 ± 9.8 kg; 58.9 ± 7.4 L/min VO2max; 45.7 ± 5.8 min 10 K run time) completed seven submaximal running trials with WR loads of 0, 0.5, 1, 1.5, 2, 2.5 and 3% body mass (BM). Based on regression data, for every 1% BM increase of additional load, oxygen consumption (VO2) increased by 2.56% and heart rate increased by 1.16%. Inferential based analysis identified that ≤1% BM were enough to elicit responses in VO2, with a possible small increase (effect size (ES), 90% confidence interval (CI): 0.22, 0.17 to 0.39), while 3% BM loads produced a most likely very large increase (ES, 90% CI: 0.51, 0.42 to 0.60). A training load score was extrapolated using heart rate data to determine the amount of internal stress. An additional 1% BM resulted in an extra 0.39 (0.29 to 0.47) increase in internal stress over five minutes. Lower leg WR elicited substantial increases in lactate production from the lightest loading (0.5% BM), with a likely moderate increase (ES, 90% CI: 0.49, 0.30 to 0.95). Lower-leg positioned WR provides a running-specific overload with loads ≥ 1% BM resulting in substantial changes in metabolic responses.
Diversity, Distribution, and Ecology of Fungi in the Seasonal Snow of Antarctica

We characterized the fungal community found in the winter seasonal snow of the Antarctic Peninsula. From the samples of snow, 234 fungal isolates were obtained and could be assigned to 51 taxa of 26 genera. Eleven yeast species displayed the highest densities; among them, Phenoliferia glacialis showed a broad distribution and was detected at all sites that were sampled. Fungi known to be opportunistic in humans were subjected to antifungal minimal inhibition concentration. Debaryomyces hansenii, Rhodotorula mucilaginosa, Penicillium chrysogenum, Penicillium sp. 3, and Penicillium sp. 4 displayed resistance against the antifungals benomyl and fluconazole. Among them, R. mucilaginosa isolates were able to grow at 37 °C. Our results show that the winter seasonal snow of the Antarctic Peninsula contains a diverse fungal community dominated by cosmopolitan ubiquitous fungal species previously found in tropical, temperate, and polar ecosystems. The high densities of these cosmopolitan fungi suggest that they could be present in the air that arrives at the Antarctic Peninsula by air masses from outside Antarctica. Additionally, we detected environmental fungal isolates that were resistant to agricultural and clinical antifungals and able to grow at 37 °C. Further studies will be needed to characterize the virulence potential of these fungi in humans and animals.
Increased hypoxic proliferative response and gene expression in erythroid progenitor cells of Andean highlanders with chronic mountain sickness

Excessive erythrocytosis (EE) is the main sign of chronic mountain sickness (CMS), a maladaptive clinical syndrome prevalent in Andean and other high-altitude populations worldwide. The pathophysiological mechanism of EE is still controversial, as physiological variability of systemic respiratory, cardiovascular, and hormonal responses to chronic hypoxemia complicates the identification of underlying causes. Induced pluripotent stem cells derived from CMS highlanders showed increased expression of genes relevant to the regulation of erythropoiesis, angiogenesis, cardiovascular, and steroid-hormone function that appear to explain the exaggerated erythropoietic response. However, the cellular response to hypoxia in native CMS cells is yet unknown. This study had three related aims: to determine the hypoxic proliferation of native erythroid progenitor burst-forming unit-erythroid (BFU-E) cells derived from CMS and non-CMS peripheral blood mononuclear cells; to examine their sentrin-specific protease 1 (SENP1), GATA-binding factor 1 (GATA1), erythropoietin (EPO), and EPO receptor (EPOR) expression; and to investigate the functional upstream role of SENP1 in native progenitor differentiation into erythroid precursors. Native CMS BFU-E colonies showed increased proliferation under hypoxic conditions compared with non-CMS cells, together with an upregulated expression of SENP1, GATA1, EPOR; and no difference in EPO expression. Knock-down of the SENP1 gene abolished the augmented proliferative response. Thus, we demonstrate that native CMS progenitor cells produce a larger proportion of erythroid precursors under hypoxia and that SENP1 is essential for proliferation. Our findings suggest a significant intrinsic component for developing EE in CMS highlanders at the cellular and gene expression level that could be further enhanced by systemic factors such as alterations in respiratory control, or differential hormonal patterns.
Does the evidence support the importance of high transfusion ratios of plasma and platelets to red blood cells in improving outcomes in severely injured patients: a systematic review and meta‐analyses

Deaths by exsanguination in trauma are preventable with hemorrhage control and resuscitation with allogeneic blood products (ABPs). The ideal transfusion ratio is unknown. We compared efficacy and safety of high transfusion ratios of FFP:RBC and PLT:RBC with low ratios in trauma.
Genome-Wide Identification and Characterization of Cucumber BPC Transcription Factors and Their Responses to Abiotic Stresses and Exogenous Phytohormones

BASIC PENTACYSTEINE (BPC) is a small transcription factor family that functions in diverse growth and development processes in plants. However, the roles of BPCs in plants, especially cucumber (Cucumis sativus L.), in response to abiotic stress and exogenous phytohormones are still unclear. Here, we identified four BPC genes in the cucumber genome, and classified them into two groups according to phylogenetic analysis. We also investigated the gene structures and detected five conserved motifs in these CsBPCs. Tissue expression pattern analysis revealed that the four CsBPCs were expressed ubiquitously in both vegetative and reproductive organs. Additionally, the transcriptional levels of the four CsBPCs were induced by various abiotic stress and hormone treatments. Overexpression of CsBPC2 in tobacco (Nicotiana tabacum) inhibited seed germination under saline, polyethylene glycol, and abscisic acid (ABA) conditions. The results suggest that the CsBPC genes may play crucial roles in cucumber growth and development, as well as responses to abiotic stresses and plant hormones. CsBPC2 overexpression in tobacco negatively affected seed germination under hyperosmotic conditions. Additionally, CsBPC2 functioned in ABA-inhibited seed germination and hypersensitivity to ABA-mediated responses. Our results provide fundamental information for further research on the biological functions of BPCs in development and abiotic stress responses in cucumber and other plant species.