Response to food restriction, but not social information use, varies seasonally in captive cardueline finches.

For songbirds, temperate winters can impose severe conditions on songbirds that threaten survival, including shorter days and often lower temperature and food availability. One well-studied mechanism by which songbirds cope with such conditions is seasonal acclimatization of thermal metabolic traits, with strong evidence for both preparative and responsive changes in thermogenic capacity (i.e., the ability to generate heat) to low winter temperature. However, a bird's ability to cope with seasonal extremes or unpredictable events is likely dependent on a combination of behavioral and physiological traits that function to maintain allostatic balance. The ability to cope with reduced food availability may be an important component of organismal response to temperate winters in songbirds. Here we compare responses to experimentally reduced food availability at different times of year in captive red crossbills (Loxia curvirostra) and pine siskins (Spinus pinus) - two species that cope with variable food resources and live in cold places - to investigate seasonal changes in the organismal response to food availability. Further, red crossbills are known to use social information to improve response to reduced food availability, so we also examine whether use of social information in this context varies seasonally in this species. We find that pine siskins and red crossbills lose less body mass during time-restricted feedings in late winter compared to summer, and that red crossbills further benefit from social information gathered from observing other food restricted red crossbills in both seasons. Observed changes in body mass were only partially explained by seasonal differences in food intake. Our results demonstrate seasonal acclimation to food stress and social information use across seasons in a controlled captive environment and highlight the importance of considering diverse physiological systems (e.g., thermogenic, metabolic, digestive, etc) to understand organismal responses to environmental challenges.

Research and evidence-based practice in clinical radiography: A systematic review of barriers and recommendations for a new direction.

INTRODUCTION: Existing literature provides valuable insight into the application of evidence-based practice (EBP) in Radiography; however, it primarily focuses on localised, context-specific scenarios within individual countries or institutions. This review aims to systematically explore the barriers to EBP and research implementation in clinical Radiography practice internationally. METHODOLOGY: A mixed-method systematic review was implemented to obtain data from primary studies of qualitative, quantitative and mixed-methods designs. Articles were searched between June and July 2023 from the following scientific databases: PubMed, Medline, CINAHL, Science Direct and manual search dating from 2003 to July 2023. The reviewed studies were subjected to data extraction and results-based convergent synthesis. RESULTS: A total of 376 articles were identified through electronic database search and citation screening after the removal of duplicates. Thirty-one studies met the predetermined inclusion criteria and were included for this review. The challenges to EBP implementation in clinical Radiography are broadly themed around professional and personal obligations, motivation and organisational culture, knowledge and skill gaps, resources and opportunities, and institutional governance. CONCLUSION: Globally, clinical radiographers perceived a high level of motivation and interest towards research activities. However, numerous barriers were reported such as insufficient time allocation for research, lack of resources, lack of research culture and inadequate research-related skills and knowledge. A transition towards greater evidence-based practice precipitates the quality of clinical Radiography services, augmenting efficiency in the workflow process and enriching patient experience. IMPLICATIONS FOR PRACTICE: Radiography managers must develop strategies that aim to stimulate radiographers to initiate research projects. Beyond allocation of protected time, managers should inspire staff participation in research activities through implementation of effective departmental level culture and governance for quality service delivery and improved patient care.

Evidence based practice, research and the diagnostic radiographer role. An exploration of engagement, expectations and attitudes at a single centre.

INTRODUCTION: The benefits of evidence-based practice (EBP) and research in healthcare are widely accepted for the patient, professional and organisation. However, allied health professional and radiographer activity remains lacking; this study aimed to explore this at a local level. METHODS: This single centre study utilised mixed methods research methodology to triangulate findings from three parallel data collections. Document analysis of radiographer job descriptions (JDs) and appraisal frameworks, retrospective review of completed research activities, and a survey of radiographer perspectives were undertaken. Data analysis included content analysis, thematic analysis and descriptive statistics. RESULTS: In three years (2018-2020), 290 EBP activities were completed; 287 were audit and three were service evaluations. There were no documented research projects and no entry level radiographer involvement. The survey response rate was 65.3% (n = 77/118). All JDs describe research engagement, but 50.6% of survey respondents did not realise this. There were inconsistencies and lack of clear progression in these expectations and no direct reference to research in the standard appraisal documentation. Radiographers demonstrated a positive attitude towards research and EBP but felt there were barriers preventing activity. Generally, they did not perceive a strong research culture in their department. CONCLUSION: As part of EBP, research is a requirement for diagnostic radiographers of all levels. There is widespread enthusiasm and a positive attitude from radiographers to engage, yet activity remains low. IMPLICATIONS FOR PRACTICE: A strong evidence-based culture needs to be prioritised, to embrace the current enthusiasm from radiographers to engage, and accordingly bridge the gap between aspirations of their professional body and actual clinical practice.

Publisher's Note: Hydrogen Bonds in Excited State Proton Transfer [Phys. Rev. Lett. 117, 163002 (2016)].

This corrects the article DOI: 10.1103/PhysRevLett.117.163002.

Creating a Culture of Accurate and Precise Data.

There are many stakeholders for school health data. Each one has a stake in the quality and accuracy of the health data collected and reported in schools. The joint NASN and NASSNC national school nurse data set initiative, Step Up & Be Counted!, heightens the need to assure accurate and precise data. The use of a standardized terminology allows the data on school health care delivered in local schools to be aggregated for use at the local, state, and national levels. The use of uniform terminology demands that data elements be defined and that accurate and reliable data are entered into the database. Barriers to accurate data are misunderstanding of accurate data needs, student caseloads that exceed the national recommendations, lack of electronic student health records, and electronic student health records that do not collect the indicators using the standardized terminology or definitions. The quality of the data that school nurses report and share has an impact at the personal, district, state, and national levels and influences the confidence and quality of the decisions made using that data.

Hydrogen Bonds in Excited State Proton Transfer.

Hydrogen bonding interactions between biological chromophores and their surrounding protein and solvent environment significantly affect the photochemical pathways of the chromophore and its biological function. A common first step in the dynamics of these systems is excited state proton transfer between the noncovalently bound molecules, which stabilizes the system against dissociation and principally alters relaxation pathways. Despite such fundamental importance, studying excited state proton transfer across a hydrogen bond has proven difficult, leaving uncertainties about the mechanism. Through time-resolved photoelectron imaging measurements, we demonstrate how the addition of a single hydrogen bond and the opening of an excited state proton transfer channel dramatically changes the outcome of a photochemical reaction, from rapid dissociation in the isolated chromophore to efficient stabilization and ground state recovery in the hydrogen bonded case, and uncover the mechanism of excited state proton transfer at a hydrogen bond, which follows sequential hydrogen and charge transfer processes.

Step Up and Be Counted! Update: The National Standardized School Nurse Data Set.

There is a significant gap in meaningful school health data in the current national education and health data sets. Current data sets do not sufficiently capture the number and credentials of school health providers, the health of students who receive care at school, or the outcomes of school nurse interventions. Since 2014, school nurses across the United States have embraced Step Up and Be Counted!: A National Standardized School Nurse Data Set. The goal of Step Up is to collect school nurse data in a standardized, uniform format. Prior to the project, no data were recorded in a uniform manner across states and health services delivery models. Data have been reported for two years on who is delivering health care in school, selected student chronic conditions, and the disposition of students once they leave the school health office. Professional development sessions have been conducted at the national conferences of both the NASN and the NASSNC and at the state level. As the project matures, steps are being taken to increase the number of school nurses and states participating and to assure data accuracy and validity.

What's Up With "Step Up"? Step Up and Be Counted: The National Uniform School Nurse Data Set.

The health and well-being of children who attend school is not collected in any national data sets. To effectively advocate for the health needs of children where they live, learn, and play, it is essential to build a National Uniform School Nurse Data Set. In 2014, school nurses nationwide were invited to join the Step Up and Be Counted! initiative. To prepare nurses for data collection and reporting, an informational website was established, a marketing campaign was launched, and a data collection tool was developed. Trainings were held at the national conferences of both the National Association of School Nurses and the National Association of State School Nurse Consultants, and locally by state school nurse consultants and champions. The goal of the 2014-2015 academic year was to establish the processes for such a large-scale effort. In Year 1, only three initial data sets were collected from participating school nurses from 37 states. The first year yielded much data, and challenges have been identified and addressed.

The Role of the Designated State Data Champion.

Step Up & Be Counted! (Step Up!) is a joint project of the National Association of School Nurses (NASN) and the National Association of State School Nurse Consultants (NASSNC). The goal of the initiative is to develop a National School Nurse Standardized Data Set that will be used by nurses across the country to uniformly collect data the same way. The data will be used to determine the health of children and youth, the care that is delivered in schools, and the impact of school nurses on academic success and well-being. This article focuses on the role of the Designated State Data Champion in the initiative.

Alteration in cytochrome P450 3A4 activity as measured by a urine cortisol assay in HIV-1-infected pregnant women and relationship to antiretroviral pharmacokinetics.

OBJECTIVES: Pregnancy results in physiological changes altering the pharmacokinetics of drugs metabolized by cytochrome P450 3A4 (CYP3A4). The urinary ratio of 6-ß hydroxycortisol to cortisol (6ßHF : F) is a marker of CYP3A4 induction. We sought to evaluate its change in antiretroviral (ARV)-treated HIV-1-infected women and to relate this change to ARV pharmacokinetics. METHODS: Women receiving various ARVs had pharmacokinetic evaluations during the third trimester of pregnancy (>30 weeks) and postpartum with determination of 6ßHF : F carried out on the same days. The Wilcoxon signed rank test was used to compare the ratio antepartum to postpartum. The relationship between the change in ratio and the change in pharmacokinetics was analysed using Kendall's tau. RESULTS: 6ßHF : F ratios were available for 107 women antepartum, with 54 having postpartum values. The ratio was higher antepartum (P=0.033) (median comparison 1.35; 95% confidence interval 1.01, 1.81). For 71 women taking a protease inhibitor (PI), the antepartum vs. postpartum 6ßHF : F comparison was marginally significant (P=0.058). When the change in the 6ßHF : F ratio was related to the change in the dose-adjusted ARV area under the plasma concentration vs. time curve (AUC) between antepartum and postpartum, the 35 subjects in the lopinavir/ritonavir (LPV/r) arms demonstrated an inverse relationship (P=0.125), albeit this correlation did not reach statistical significance. CONCLUSIONS: A 35% increase in the urinary 6ßHF : F ratio was measured during late pregnancy compared with postpartum, indicating that CYP3A induction occurs during pregnancy. The trend towards an inverse relationship between the change in the 6ßHF : F ratio and the change in the LPV AUC antepartum vs. postpartum suggests that CYP3A induction may be one mechanism behind altered LPV exposure during pregnancy.

Prostate cancer cell malignancy via modulation of HIF-1α pathway with isoflurane and propofol alone and in combination.

BACKGROUND: Surgery is considered to be the first line treatment for solid tumours. Recently, retrospective studies reported that general anaesthesia was associated with worse long-term cancer-free survival when compared with regional anaesthesia. This has important clinical implications; however, the mechanisms underlying those observations remain unclear. We aim to investigate the effect of anaesthetics isoflurane and propofol on prostate cancer malignancy. METHODS: Prostate cancer (PC3) cell line was exposed to commonly used anaesthetic isoflurane and propofol. Malignant potential was assessed through evaluation of expression level of hypoxia-inducible factor-1α (HIF-1α) and its downstream effectors, cell proliferation and migration as well as development of chemoresistance. RESULTS: We demonstrated that isoflurane, at a clinically relevant concentration induced upregulation of HIF-1α and its downstream effectors in PC3 cell line. Consequently, cancer cell characteristics associated with malignancy were enhanced, with an increase of proliferation and migration, as well as development of chemoresistance. Inhibition of HIF-1α neosynthesis through upper pathway blocking by a PI-3K-Akt inhibitor or HIF-1α siRNA abolished isoflurane-induced effects. In contrast, the intravenous anaesthetic propofol inhibited HIF-1α activation induced by hypoxia or CoCl2. Propofol also prevented isoflurane-induced HIF-1α activation, and partially reduced cancer cell malignant activities. CONCLUSIONS: Our findings suggest that modulation of HIF-1α activity by anaesthetics may affect cancer recurrence following surgery. If our data were to be extrapolated to the clinical setting, isoflurane but not propofol should be avoided for use in cancer surgery. Further work involving in vivo models and clinical trials is urgently needed to determine the optimal anaesthetic regimen for cancer patients.

Xenon treatment protects against cold ischemia associated delayed graft function and prolongs graft survival in rats.

Prolonged hypothermic storage causes ischemia-reperfusion injury (IRI) in the renal graft, which is considered to contribute to the occurrence of the delayed graft function (DGF) and chronic graft failure. Strategies are required to protect the graft and to prolong renal graft survival. We demonstrated that xenon exposure to human proximal tubular cells (HK-2) led to activation of range of protective proteins. Xenon treatment prior to or after hypothermia-hypoxia challenge stabilized the HK-2 cellular structure, diminished cytoplasmic translocation of high-mobility group box (HMGB) 1 and suppressed NF-κB activation. In the syngeneic Lewis-to-Lewis rat model of kidney transplantation, xenon exposure to donors before graft retrieval or to recipients after engraftment decreased caspase-3 expression, localized HMGB-1 within nuclei and prevented TLR-4/NF-κB activation in tubular cells; serum pro-inflammatory cytokines IL-1ß, IL-6 and TNF-α were reduced and renal function was preserved. Xenon treatment of graft donors or of recipients prolonged renal graft survival following IRI in both Lewis-to-Lewis isografts and Fischer-to-Lewis allografts. Xenon induced cell survival or graft functional recovery was abolished by HIF-1α siRNA. Our data suggest that xenon treatment attenuates DGF and enhances graft survival. This approach could be translated into clinical practice leading to a considerable improvement in long-term graft survival.

Obligate versus rich patch opportunism: evolution and endocrine mechanisms.

Opportunistic breeding has been hypothesized to evolve in response to rare or unpredictable resource pulses. In this traditional view of opportunism, individuals invest heavily in reproduction whenever conditions are permissive for breeding, perhaps at the expense of investment in survival. We term this strategy 'obligate opportunism' (OBO). We also present an additional strategy that could account for the evolution of opportunism. High mobility may allow individuals to move between rich patches of resources that are spatially or temporally unpredictable, reducing exposure to food scarcity and taking advantage of breeding opportunities. This strategy, which we term 'rich patch exploiter' (RPE), predicts that investment in survival-enhancing processes may occur at the expense of reproduction despite high resource availability. We review examples to determine which opportunists better match predictions from the OBO strategy or the RPE strategy and then review endocrine profiles in the context of the two strategies.

Differential effects of amyloid-ß peptide aggregation status on in vivo retinal neurotoxicity.

The present study examined the relationship between amyloid beta (Aß)-peptide aggregation state and neurotoxicity in vivo using the rat retinal-vitreal model. Following single unilateral intravitreal injection of either soluble Aß1-42 or Aß1-42 preaggregated for different periods, retinal pathology was evaluated at 24 hours, 48 hours, and 1-month postinjection. Injection of either soluble Aß (sAß) or preaggregated Aß induced a rapid reduction in immunoreactivity (IR) for synaptophysin, suggesting that direct contact with neurons is not necessary to disrupt synapses. Acute neuronal ionic and metabolic dysfunction was demonstrated by widespread loss of IR to the calcium buffering protein parvalbumin (PV) and protein gene product 9.5, a component of the ubiquitin-proteosome system. Injection of sAß appeared to have a more rapid impact on PV than the preaggregated treatments, producing a marked reduction in PV cell diameters at 48 hours, an effect that was only observed for preaggregated Aß after 1-month survival. Extending the preaggregation period from 4 to 8 days to obtain highly fibrillar Aß species significantly increased the loss of choline acteyltransferase IR, but had no effect on PV-IR. These findings prompt the conclusion that Aß assembly state has a significant impact on in vivo neurotoxicity by triggering distinct molecular changes within the cell.

Chronic administration of nevirapine during pregnancy: impact of pregnancy on pharmacokinetics.

OBJECTIVES: To determine the impact of pregnancy on the pharmacokinetics (PK) of nevirapine (NVP) during chronic dosing in HIV-infected women and appropriate NVP dosing in this population. METHODS: Twenty-six pregnant women participating in two open-label Pediatric AIDS Clinical Trials Group studies (P1022 and P1026S) were evaluated. Each patient received 200 mg NVP every 12 h and had PK evaluations during the second or third trimester; these evaluations were repeated postpartum. Paired maternal and cord blood NVP concentrations were collected at delivery in nine patients. Ante- and postpartum comparisons were made using paired t-tests and using a 'bioequivalence' approach to determine confidence interval (CI). RESULTS: The average NVP Area Under the Curve (AUC) was 56 +/- 13 mcg(*)h/mL antepartum and 61 +/- 15 mcg(*)h/mL postpartum. The typical parameters +/- standard error were apparent clearance (CL/F)=3.51 +/- 0.18 L/h and apparent volume of distribution (Vd/F)=121 +/- 19.8 L. There were no significant differences between antepartum and postpartum AUC or pre-dose concentrations. The AUC ratio was 0.90 with a 90% CI of the mean equal to 0.80-1.02. The median (+/- standard deviation) cord blood to maternal NVP concentration ratio was 0.91 +/- 0.90. CONCLUSIONS: Pregnancy does not alter NVP PK and the standard dose (200 mg every 12 h) is appropriate during pregnancy.

A novel retrograde-viewing auxiliary imaging device (Third Eye Retroscope) improves the detection of simulated polyps in anatomic models of the colon.

BACKGROUND: Colonoscopy is the "gold standard" for colorectal polyp and cancer detection, but important lesions may be missed on the proximal aspect of haustral folds, rectal valves, or flexures. OBJECTIVE: Our purpose was to evaluate a prototype auxiliary imaging device that extends beyond the colonoscope's tip, providing a continuous retrograde view to detect lesions missed by the forward-viewing colonoscope. DESIGN: Three anatomic models of the colon were prepared with simulated polyps, 32% in obvious locations and 68% on the proximal aspect of folds. Six endoscopists examined each model with two methods. Method A used a standard video colonoscope. Method B involved an identical colonoscope with a retrograde-viewing auxiliary device positioned within its instrument channel. Order of testing was randomized and blinded. SETTING: Laboratory bench. MAIN OUTCOME MEASUREMENTS: Detection rates for simulated polyps. RESULTS: Of 78 "obvious" polyps, 69 (88%) and 70 (90%) were detected by methods A and B, respectively (P > .9). In contrast, of 162 polyps on proximal aspects of folds, 20 (12%) and 131 (81%) were detected by methods A and B, respectively (P < .00001). LIMITATIONS: Limitations resulted from (1) use of commercially available anatomic models in which haustral folds are less prominent and more rigid than in humans and (2) evaluation of a prototype device that had larger size and narrower angle of view than the planned production model and that was fixed in relation to the colonoscope. CONCLUSIONS: In simulated testing, a retrograde-viewing auxiliary imaging device used with a standard video colonoscope significantly improves detection rates of simulated polyps and promises to enhance the diagnostic yield of colonoscopy in humans.