Predictors of Participant Development Through Adventure Programs: Replication and Extension of Previous Findings from NOLS

This study continues the examination of one of the largest and most established adventure education programs in the world, the National Outdoor Leadership School (NOLS). Founded in 1965, NOLS has developed 11 branches worldwide and has graduated over 75,000 students. NOLS was originally known as a wilderness skills school, but quickly expanded their program goals and emphases to include leadership training, communication skills, expedition behavior, environmental awareness, and safety and judgment. NOLS courses include those for youth, adults, and intact groups who contract with NOLS for topic-specific courses. Courses range from eight days to months long semester courses. College credit is also available for some courses. As part of an on-going relationship between the University of Utah and NOLS, the study reported here is part of a series of efforts to develop and test a predictive model that would increase understanding of the relationships between participant characteristics, program components, and program outcomes for NOLS specifically. Such a predictive model would help explain how the NOLS process produces outcomes and how that process might be modified to produce additional or different outcomes. The model may also assist other adventure programs in better understanding how their programs produce outcomes

Building Cultural Heritage Resilience through Remote Sensing: An Integrated Approach Using Multi-Temporal Site Monitoring, Datafication, and Web-GL Visualization

In the American West, wildfires and earthquakes are increasingly threatening the archaeological, historical, and tribal resources that define the collective identity and connection with the past for millions of Americans. The loss of said resources diminishes societal understanding of the role cultural heritage plays in shaping our present and future. This paper examines the viability of employing stationary and SLAM-based terrestrial laser scanning, close-range photogrammetry, automated surface change detection, GIS, and WebGL visualization techniques to enhance the preservation of cultural resources in California. Our datafication approach combines multi-temporal remote sensing monitoring of historic features with legacy data and collaborative visualization to document and evaluate how environmental threats affect built heritage. We tested our methodology in response to recent environmental threats from wildfire and earthquakes at Bodie, an iconic Gold Rush-era boom town located on the California and Nevada border. Our multi-scale results show that the proposed approach effectively integrates highly accurate 3D snapshots of Bodie’s historic buildings before/after disturbance, or post-restoration, with surface change detection and online collaborative visualization of 3D geospatial data to monitor and preserve important cultural resources at the site. This study concludes that the proposed workflow enhances the monitoring of at-risk California’s cultural heritage and makes a call to action to employ remote sensing as a pathway to advanced planning. View Full-Tex

Developing an interoperable cloud-based visualization workflow for 3D archaeological heritage data. The Palenque 3D Archaeological Atlas

In archaeology, 3D data has become ubiquitous, as researchers routinely capture high resolution photogrammetry and LiDAR models and engage in laborious 3D analysis and reconstruction projects at every scale: artifacts, buildings, and entire sites. The raw data and processed 3D models are rarely shared as their computational dependencies leave them unusable by other scholars. In this paper we outline a novel approach for cloud-based collaboration, visualization, analysis, contextualization, and archiving of multi-modal giga-resolution archaeological heritage 3D data. The Palenque 3D Archaeological Atlas builds on an open source WebGL systems that efficiently interlink, merge, present, and contextualize the Big Data collected at the ancient Maya city of Palenque, Mexico, allowing researchers and stakeholders to visualize, access, share, measure, compare, annotate, and repurpose massive complex archaeological datasets from their web-browsers

Multi organ assessment of compensated cirrhosis patients using quantitative magnetic resonance imaging

Background and Aims: Advancing liver disease results in deleterious changes in a number of critical organs. The ability to measure structure, blood flow and tissue perfusion within multiple organs in a single scan has implications for determining the balance of benefit versus harm for therapies. Our aim was to establish the feasibility of Magnetic Resonance Imaging to assess changes in compensated cirrhosis (CC), and relate this to disease severity and future liver related outcomes (LROs). Methods: 60 CC patients, 40 healthy volunteers and 7 decompensated cirrhotics were recruited. In a single scan session, MRI measures comprised phase-contrast MRI vessel blood flow, arterial spin labelling tissue perfusion, T1 longitudinal relaxation time and volume assessment of liver, spleen and kidneys, heart rate and cardiac index. We explore MRI parameters with disease severity and differences in baseline MRI parameters in those 11 (18%) of CC patients who had future LROs. Results: In the liver compositional changes were reflected by increased T1 in progressive disease (p<0.001) and an increase in liver volume in CC (p=0.006), with associated progressive reduction in liver (p < 0.001) and splenic (p<0.001) perfusion. A significant reduction in renal cortex T1 and increase in cardiac index and superior mesenteric arterial (SMA) blood flow was seen with increasing disease severity. Baseline liver T1 (p=0.01) and perfusion (p< 0.01), and renal cortex T1 (p<0.01) were significantly different in CC patients who subsequently developed negative LROs. Conclusions: MRI allows the contemporaneous assessment of organs in liver cirrhosis in a single scan without the requirement of contrast agent. MRI parameters of liver T1, renal T1, hepatic and splenic perfusion, and SMA blood flow were related to risk of LROs

A core microbiome associated with the peritoneal tumors of pseudomyxoma peritonei

Pseudomyxoma peritonei (PMP) is a malignancy characterized by dissemination of mucus-secreting cells throughout the peritoneum. This disease is associated with significant morbidity and mortality and despite effective treatment options for early-stage disease, patients with PMP often relapse. Thus, there is a need for additional treatment options to reduce relapse rate and increase long-term survival. A previous study identified the presence of both typed and non-culturable bacteria associated with PMP tissue and determined that increased bacterial density was associated with more severe disease. These findings highlighted the possible role for bacteria in PMP disease. To more clearly define the bacterial communities associated with PMP disease, we employed a sequenced-based analysis to profile the bacterial populations found in PMP tumor and mucin tissue in 11 patients. Sequencing data were confirmed by in situ hybridization at multiple taxonomic depths and by culturing. A pilot clinical study was initiated to determine whether the addition of antibiotic therapy affected PMP patient outcome. We determined that the types of bacteria present are highly conserved in all PMP patients; the dominant phyla are the Proteobacteria, Actinobacteria, Firmicutes and Bacteroidetes. A core set of taxon-specific sequences were found in all 11 patients; many of these sequences were classified into taxonomic groups that also contain known human pathogens. In situ hybridization directly confirmed the presence of bacteria in PMP at multiple taxonomic depths and supported our sequence-based analysis. Furthermore, culturing of PMP tissue samples allowed us to isolate 11 different bacterial strains from eight independent patients, and in vitro analysis of subset of these isolates suggests that at least some of these strains may interact with the PMP-associated mucin MUC2. Finally, we provide evidence suggesting that targeting these bacteria with antibiotic treatment may increase the survival of PMP patients. Using 16S amplicon-based sequencing, direct in situ hybridization analysis and culturing methods, we have identified numerous bacterial taxa that are consistently present in all PMP patients tested. Combined with data from a pilot clinical study, these data support the hypothesis that adding antimicrobials to the standard PMP treatment could improve PMP patient survival.https://doi.org/10.1186/1750-1172-8-10

Is the Kaiser Permanente model superior in terms of clinical integration?: a comparative study of Kaiser Permanente, Northern California and the Danish healthcare system

<p>Abstract</p> <p>Background</p> <p>Integration of medical care across clinicians and settings could enhance the quality of care for patients. To date, there is limited data on the levels of integration in practice. Our objective was to compare primary care clinicians' perceptions of clinical integration and three sub-aspects in two healthcare systems: Kaiser Permanente, Northern California (KPNC) and the Danish healthcare system (DHS). Further, we examined the associations between specific organizational factors and clinical integration within each system.</p> <p>Methods</p> <p>Comparable questionnaires were sent to a random sample of primary care clinicians in KPNC (n = 1103) and general practitioners in DHS (n = 700). Data were analysed using multiple logistic regression models.</p> <p>Results</p> <p>More clinicians in KPNC perceived to be part of a clinical integrated environment than did general practitioners in the DHS (OR = 3.06, 95% CI: 2.28, 4.12). Further, more KPNC clinicians reported timeliness of information transfer (OR = 2.25, 95% CI: 1.62, 3.13), agreement on roles and responsibilities (OR = 1.79, 95% CI: 1.30, 2.47) and established coordination mechanisms in place to ensure effective handoffs (OR = 6.80, 95% CI: 4.60, 10.06). None of the considered organizational factors in the sub-country analysis explained a substantial proportion of the variation in clinical integration.</p> <p>Conclusions</p> <p>More primary care clinicians in KPNC reported clinical integration than did general practitioners in the DHS. Focused measures of clinical integration are needed to develop the field of clinical integration and to create the scientific foundation to guide managers searching for evidence based approaches.</p

Transcriptional Responses of Cultured Rat Sympathetic Neurons during BMP-7-Induced Dendritic Growth

Dendrites are the primary site of synapse formation in the vertebrate nervous system; however, relatively little is known about the molecular mechanisms that regulate the initial formation of primary dendrites. Embryonic rat sympathetic neurons cultured under defined conditions extend a single functional axon, but fail to form dendrites. Addition of bone morphogenetic proteins (BMPs) triggers these neurons to extend multiple dendrites without altering axonal growth or cell survival. We used this culture system to examine differential gene expression patterns in naïve vs. BMP-treated sympathetic neurons in order to identify candidate genes involved in regulation of primary dendritogenesis.To determine the critical transcriptional window during BMP-induced dendritic growth, morphometric analysis of microtubule-associated protein (MAP-2)-immunopositive processes was used to quantify dendritic growth in cultures exposed to the transcription inhibitor actinomycin-D added at varying times after addition of BMP-7. BMP-7-induced dendritic growth was blocked when transcription was inhibited within the first 24 hr after adding exogenous BMP-7. Thus, total RNA was isolated from sympathetic neurons exposed to three different experimental conditions: (1) no BMP-7 treatment; (2) treatment with BMP-7 for 6 hr; and (3) treatment with BMP-7 for 24 hr. Affymetrix oligonucleotide microarrays were used to identify differential gene expression under these three culture conditions. BMP-7 significantly regulated 56 unique genes at 6 hr and 185 unique genes at 24 hr. Bioinformatic analyses implicate both established and novel genes and signaling pathways in primary dendritogenesis.This study provides a unique dataset that will be useful in generating testable hypotheses regarding transcriptional control of the initial stages of dendritic growth. Since BMPs selectively promote dendritic growth in central neurons as well, these findings may be generally applicable to dendritic growth in other neuronal cell types

Risks to Effective Knowledge Sharing in Agile Software Teams: A Model for Assessing and Mitigating Risks

We present an empirically grounded and theoretically informed model for the assessment and mitigation of risks to effective knowledge sharing in agile development. The model is anchored in empirical insights from four agile projects across two software companies and in extant research on risk‐strategy analysis and knowledge sharing in software development. We develop the model as part of the long‐standing tradition of presenting risk management models dedicated to specific issues in software development and confirm its practical usefulness in one of the software companies studied. The model offers concepts and processes to assess a project's knowledge sharing risk profile and articulate an overall resolution strategy plan to mitigate the risks. The results highlight how different knowledge sharing risk management profiles can lead to different project performance outcomes. We conclude with a discussion of research opportunities that the results offer software development scholarship

Serelaxin as a potential treatment for renal dysfunction in cirrhosis: Preclinical evaluation and results of a randomized phase 2 trial

<div><p>Background</p><p>Chronic liver scarring from any cause leads to cirrhosis, portal hypertension, and a progressive decline in renal blood flow and renal function. Extreme renal vasoconstriction characterizes hepatorenal syndrome, a functional and potentially reversible form of acute kidney injury in patients with advanced cirrhosis, but current therapy with systemic vasoconstrictors is ineffective in a substantial proportion of patients and is limited by ischemic adverse events. Serelaxin (recombinant human relaxin-2) is a peptide molecule with anti-fibrotic and vasoprotective properties that binds to relaxin family peptide receptor-1 (RXFP1) and has been shown to increase renal perfusion in healthy human volunteers. We hypothesized that serelaxin could ameliorate renal vasoconstriction and renal dysfunction in patients with cirrhosis and portal hypertension.</p><p>Methods and findings</p><p>To establish preclinical proof of concept, we developed two independent rat models of cirrhosis that were characterized by progressive reduction in renal blood flow and glomerular filtration rate and showed evidence of renal endothelial dysfunction. We then set out to further explore and validate our hypothesis in a phase 2 randomized open-label parallel-group study in male and female patients with alcohol-related cirrhosis and portal hypertension. Forty patients were randomized 1:1 to treatment with serelaxin intravenous (i.v.) infusion (for 60 min at 80 μg/kg/d and then 60 min at 30 μg/kg/d) or terlipressin (single 2-mg i.v. bolus), and the regional hemodynamic effects were quantified by phase contrast magnetic resonance angiography at baseline and after 120 min. The primary endpoint was the change from baseline in total renal artery blood flow.</p><p>Therapeutic targeting of renal vasoconstriction with serelaxin in the rat models increased kidney perfusion, oxygenation, and function through reduction in renal vascular resistance, reversal of endothelial dysfunction, and increased activation of the AKT/eNOS/NO signaling pathway in the kidney. In the randomized clinical study, infusion of serelaxin for 120 min increased total renal arterial blood flow by 65% (95% CI 40%, 95%; <i>p <</i> 0.001) from baseline. Administration of serelaxin was safe and well tolerated, with no detrimental effect on systemic blood pressure or hepatic perfusion. The clinical study’s main limitations were the relatively small sample size and stable, well-compensated population.</p><p>Conclusions</p><p>Our mechanistic findings in rat models and exploratory study in human cirrhosis suggest the therapeutic potential of selective renal vasodilation using serelaxin as a new treatment for renal dysfunction in cirrhosis, although further validation in patients with more advanced cirrhosis and renal dysfunction is required.</p><p>Trial registration</p><p>ClinicalTrials.gov <a href="https://clinicaltrials.gov/ct2/show/NCT01640964" target="_blank">NCT01640964</a></p></div

A People’s History of Leisure Studies : Old Knowledge, New Knowledge and The Philadelphia Negro as a Foundational Text

There is a great realization that a professor teaching an introductory or philosophical foundations course in the field of leisure studies comes to, if that professor may not be from the dominant culture of most Western societies. This realization is as stark as their numerical presence in their respective departments. Why are the philosophical foundations of the field devoid of the experiences, voices, and perspectives populations of color, or even more broadly, the populations of the global majority? And, why is there an absence of historical discussions on the field’s role in perpetrating or condoning activities that hindered or constrained populations of color full access, enjoyment, and articulation of leisure? As we move forward in the field more globally, thinking and discussing the new and progressive ways that we can conceive the sociology of leisure, it is imperative that we rethink our philosophical foundations in reconciliation of the potential harm it may have caused (and may continue to harm) and the actual good it can invoke in assisting the myriad of scholars who are pushing more progressive efforts for a critical leisure paradigm (Spracklen, Lashua, Sharpe and Swain, 2017). The objectives of this manuscript are: 1) to briefly categorize the research in the field on Race and ethnicity; 2) to outline the key canonical texts of the field; 3) to consider and reconceptualize a racially and ethnically inclusive foundation for the field utilizing The Philadelphia Negro: A Social Study as an example; and, 4) to identify some of the specific areas that this change and inclusion would impact or realign the field’s history