This paper illustrates how community-based ecotourism (CBET) is a site of experiential learning which may encourage transformative learning for visitors. An experiential CBET curriculum is identified ...which is centred on ecotourists' nature, adventure and cultural experiences. In this curriculum, Nature Shock, Adventure Shock and Culture Shock serve as Concrete Experiences in Kolb's 1984. Experiential learning. Englewood Cliffs, NJ: Prentice-Hall experiential learning cycle, and may potentially act as disorienting dilemmas to stimulate transformative learning. These three types of disorienting dilemmas are discussed with reference to literature on wildlife and nature tourism, adventure tourism and outdoor education, and international volunteer tourism, respectively. Three empirical case studies of CBET in Southeast Asia are used to provide context to the discussion. Finally, the paper provides an elaboration of six pedagogical themes pertaining to how the transformative learning of visitors to CBET projects might be enhanced.
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BFBNIB, NUK, PILJ, SAZU, UL, UM, UPUK
This study examines how tourists experience authenticity and the ethics of “hill tribe” trekking in northern Thailand, and what they learn as a result of their touristic encounters. A “netnography” ...methodology was used to analyze on-line data from travelers’ touristic encounters with highland people in two sites. The first was the on-line reviews, blogs, and videos of travelers’ experiences in Baan Tong Luang, a multi-ethnic “hill tribe village” tourist attraction outside of Chiang Mai. The second was the blog and video reviews of visitors to three exemplary “community-based tourism” highland village sites. Findings show a variety of complex understandings of authenticity, both “objective” and “constructivist.” For community-based tourism reviewers in particular, authenticity was understood as a hybrid, fluid concept which derived from meanings ascribed to objects, practices, and place; personal relationships with hosts; and opportunities for cultural learning afforded visitors.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
Ketorolac has been associated with a lower risk of recurrence in retrospective studies, especially in patients with positive inflammatory markers. It is still unknown whether a single dose of ...pre-incisional ketorolac can prolong recurrence-free survival.
The KBC trial is a multicenter, placebo-controlled, randomized phase III trial in high-risk breast cancer patients powered for 33% reduction in recurrence rate (from 60 to 40%). Patients received one dose of ketorolac tromethamine or a placebo before surgery. Eligible patients were breast cancer patients, planned for curative surgery, and with a Neutrophil-to-Lymphocyte Ratio≥4, node-positive disease or a triple-negative phenotype. The primary endpoint was Disease-Free Survival (DFS) at two years. Secondary endpoints included safety, pain assessment and overall survival.
Between February 2013 and July 2015, 203 patients were assigned to ketorolac (n = 96) or placebo (n = 107). Baseline characteristics were similar between arms. Patients had a mean age of 55.7 (SD14) years. At two years, 83.1% of the patients were alive and disease free in the ketorolac vs. 89.7% in the placebo arm (HR: 1.23; 95%CI: 0.65-2.31) and, respectively, 96.8% vs. 98.1% were alive (HR: 1.09; 95%CI: 0.34-3.51).
A single administration of 30 mg of ketorolac tromethamine before surgery does not increase disease-free survival in high risk breast cancer patients. Overall survival difference between ketorolac tromethamine group and placebo group was not statistically significant. The study was however underpowered because of lower recurrence rates than initially anticipated. No safety concerns were observed.
ClinicalTrials.gov NCT01806259.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The immunogenicity of malignant cells has recently been acknowledged as a critical determinant of efficacy in cancer therapy. Thus, besides developing direct immunostimulatory regimens, including ...dendritic cell-based vaccines, checkpoint-blocking therapies, and adoptive T-cell transfer, researchers have started to focus on the overall immunobiology of neoplastic cells. It is now clear that cancer cells can succumb to some anticancer therapies by undergoing a peculiar form of cell death that is characterized by an increased immunogenic potential, owing to the emission of the so-called "damage-associated molecular patterns" (DAMPs). The emission of DAMPs and other immunostimulatory factors by cells succumbing to immunogenic cell death (ICD) favors the establishment of a productive interface with the immune system. This results in the elicitation of tumor-targeting immune responses associated with the elimination of residual, treatment-resistant cancer cells, as well as with the establishment of immunological memory. Although ICD has been characterized with increased precision since its discovery, several questions remain to be addressed. Here, we summarize and tabulate the main molecular, immunological, preclinical, and clinical aspects of ICD, in an attempt to capture the essence of this phenomenon, and identify future challenges for this rapidly expanding field of investigation.
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•ZnO/TiO2 nanostructures fabricated by electrospinning modified method.•TiO2 deposited onto the surface of ZnO-PVA nanofibers by using an electric field.•ZnO/TiO2 nanostructures used ...to descontaminated methyl orange in water.
In this work, ZnO/TiO2 nanostructures were fabricated by an electrostatically modified electrospinning technique using zinc acetate and commercially available TiO2-P25, polyvinyl alcohol, and a solvent. The ZnO/TiO2 nanostructures were fabricated on fluorine-doped tin oxide (FTO) glass substrate by electrospinning of aqueous solution containing different amounts of zinc acetate. The TiO2-P25 nanoparticles were immobilized within zinc acetate/PVA nanofibers. The precursor nanofibers obtained were converted into polycrystalline ZnO and ZnO/TiO2 by calcination at 600°C. The structure and morphology of the obtained nanostructures were characterized by X-ray diffraction and field emission scanning electron microscopy, respectively. It was found that the TiO2-P25 nanoparticles were attached to the ZnO nanostructures, and the mean diameter of the nanoparticles forming the nanostructures ranged from 31 to 52nm with increasing the amount of zinc acetate. The incident photon-to-current efficiency (IPCE) spectra of the fabricated nanostructures were measured in a three-electrode cell. The photocatalytic activities of ZnO and ZnO/TiO2 nanostructures were evaluated toward the decomposition of methyl orange. The obtained results evidenced that the coupling of TiO2 with ZnO enhanced the IPCE and improved the photocatalytic activity of ZnO. Particularly, the ZnO/TiO2 nanostructures fabricated with a zinc acetate-to-PVA ratio of 2:3 exhibited the highest IPCE and photocatalytic activity.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Intracellular oxygen (O 2 ) availability and the impact of ambient hypoxia have far reaching ramifications in terms of cell signalling and homeostasis;
however, in vivo cellular oxygenation has been ...an elusive variable to assess. Within skeletal muscle the extent to which myoglobin desaturates
(deoxy-Mb) and the extent of this desaturation in relation to O 2 availability provide an endogenous probe for intracellular O 2 partial pressure ( P iO 2 ). By combining proton nuclear magnetic resonance spectroscopy ( 1 H NMRS) at a high field strength (4 T), assessing a large muscle volume in a highly efficient coil, and extended signal averaging
(30 min) we assessed the level of skeletal muscle deoxy-Mb in 10 healthy men (30 ± 4 years) at rest in both normoxia and hypoxia
(10% O 2 ). In normoxia there was an average deoxy-Mb signal of 9 ± 1%, which, when converted to P iO 2 using an O 2 /Mb half-saturation ( P 50 ) of 3.2 mmHg, revealed an P iO 2 of 34 ± 6 mmHg. In ambient hypoxia the deoxy-Mb signal rose to 13 ± 3% ( P iO 2 = 23 ± 6 mmHg). However, intersubject variation in the defence of arterial oxygenation ( S aO 2 ) in hypoxia ( S aO 2 range: 86â67%) revealed a significant relationship between the changes in S aO 2 and P iO 2 ( r 2 = 0.5). These data are the first to document resting intracellular oxygenation in human skeletal muscle, highlighting the
relatively high P iO 2 values that contrast markedly with those previously recorded during exercise (â¼2â5 mmHg). Additionally, the impact of ambient
hypoxia on P iO 2 and the relationship between changes in S aO 2 and P iO 2 stress the importance of the O 2 cascade from air to cell that ultimately effects O 2 availability and O 2 sensing at the cellular level.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Visitor learning is the central aim in almost all definitions of ecotourism. However, theorising and research on visitor learning has largely been confined to behaviourist traditions of learning and ...education in only one type of ecotourism; namely, wildlife ecotourism. This paper argues for an expansion in the theoretical scope of visitor learning to include other forms of ecotourism, and other models of learning. To this end, the paper hypothesises forms of visitor learning associated with wildlife, adventure and community-based ecotourism, respectively, and positions them within a typology of philosophical traditions in environmental education for adults. The educational aims, curriculum, role of guides, learning activities, and learning outcomes for the three types of ecotourism are elaborated, and relevant theories of learning discussed for each. This paper concludes with recommendations for research and educational practice in ecotourism.
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BFBNIB, NUK, PILJ, SAZU, UL, UM, UPUK
PURPOSEAt exercise onset, intramuscular oxidative energy production responds relatively slowly in comparison with the change in adenosine triphosphate demand. To determine whether the slow kinetics ...of oxidative adenosine triphosphate production is due to inadequate O2 supply or metabolic inertia, we studied the kinetics of intramyocellular deoxygenation (deoxy-myoglobin (Mb)) and metabolism (phosphocreatine (PCr)) using proton (H) and phosphorus (P) magnetic resonance spectroscopy in six healthy subjects (33 ± 5 yr).
METHODSSpecifically, using dynamic plantarflexion exercise, rest to exercise and recovery were assessed at both 60% of maximum work rate (moderate intensity) and 80% of maximum work rate (heavy intensity).
RESULTSAt exercise onset, PCr fell without delay and with a similar time constant (τ) at both exercise intensities (approximately 33 s). In contrast, the increase in deoxy-Mb was delayed at exercise onset by 5–7 s, after which it increased with kinetics (moderate τ = 37 ± 9 s; heavy τ = 29 ± 6 s) that was not different from τPCr (P > 0.05). At cessation, deoxy-Mb recovered without time delay and more rapidly (τ = ∼20 s) than PCr (τ = ∼33 s) (P < 0.05).
CONCLUSIONSUsing a unique combination of in vivo magnetic resonance spectroscopy techniques with high time resolution, this study revealed a delay in intramuscular deoxygenation at the onset of exercise and rapid reoxygenation kinetics upon cessation. Together, these data imply that intramuscular substrate–enzyme interactions, and not O2 availability, determine the exercise onset kinetics of oxidative metabolism in healthy human skeletal muscles.
This paper draws on practice-based theorising in workplace education to conceptualise the learning of hosts in homestay provision in community-based ecotourism (CBET). The paper first discusses the ...spatial and social dimensions of community homestays, reviews literature on homestay tourism, cultural commodification and colonialisation of local communities, and argues that agency is due homestay hosts in negotiating CBET on their own terms. Billet's model of workplace learning - describing curriculum practices, pedagogic practices and epistemological practices - is then used to conceptualise host learning in CBET, drawing on a comprehensive review of published research on homestays in CBET. The paper argues that host learning and education give hosts the capacity for local self-determination and control of ecotourism development and management. The conclusion offers directions for further research and practice.
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BFBNIB, NUK, PILJ, SAZU, UL, UM, UPUK
•Initial diagnosis does not predict subsequent pattern of muscle weakness in dysferlinopathy.•Pattern of weakness is an overlapping continuum that does not form two distinct subgroups.•MM is a more ...common diagnosis in Japan than in Europe or the USA, but patients are not weaker distally.•Patients should not be split into MM and LGMDR2 subgroups for clinical trials.
This study aims to determine clinically relevant phenotypic differences between the two most common phenotypic classifications in dysferlinopathy, limb girdle muscular dystrophy R2 (LGMDR2) and Miyoshi myopathy (MMD1). LGMDR2 and MMD1 are reported to involve different muscles, with LGMDR2 showing predominant limb girdle weakness and MMD1 showing predominant distal lower limb weakness. We used heatmaps, regression analysis and principle component analysis of functional and Magnetic Resonance Imaging data to perform a cross-sectional review of the pattern of muscle involvement in 168 patients from the Jain Foundation's international Clinical Outcomes Study for Dysferlinopathy. We demonstrated that there is no clinically relevant difference in proximal vs distal involvement between diagnosis. There is a continuum of distal involvement at any given degree of proximal involvement and patients do not fall into discrete distally or proximally affected groups. There appeared to be geographical preference for a particular diagnosis, with MMD1 being more common in Japan and LGMDR2 in Europe and the USA. We conclude that the dysferlinopathies do not form two distinct phenotypic groups and therefore should not be split into separate cohorts of LGMDR2 and MM for the purposes of clinical management, enrolment in clinical trials or access to subsequent treatments.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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