Multiple modes of selection can influence the role of phenotypic plasticity in species' invasions: Evidence from a manipulative field experiment

In exploring the roles of phenotypic plasticity in the establishment and early evolution of invading species, little empirical attention has been given to the importance of correlational selection acting upon suites of functionally related plastic traits in nature. We illustrate how this lack of attention has limited our ability to evaluate plasticity's role during invasion and also, the costs and benefits of plasticity. We addressed these issues by transplanting clones of European-derived Plantago lanceolata L. genotypes into two temporally variable habitats in the species' introduced range in North America. Phenotypic selection analyses were performed for each habitat to estimate linear, quadratic, and correlational selection on phenotypic trait values and plasticities in the reproductive traits: flowering onset and spike and scape lengths. Also, we measured pairwise genetic correlations for our "colonists." Results showed that (a) correlational selection acted on trait plasticity after transplantation, (b) selection favored certain combinations of genetically correlated and uncorrelated trait values and plasticities, and (c) using signed, instead of absolute, values of plasticity in analyses facilitated the detection of correlational selection on trait value-plasticity combinations and their adaptive value. Based on our results, we urge future studies on species invasions to (a) measure correlational selection and (b) retain signed values of plasticity in order to better discriminate between adaptive and maladaptive plasticity.

The Authors Respond

DISCLOSURES

No outside funding supported this study. The authors have nothing to disclose.

Effect of Pharmacist-Driven Professional Continuous Glucose Monitoring in Adults with Uncontrolled Diabetes

BACKGROUND

Diabetes requires close monitoring to achieve optimal outcomes and avoid adverse effects. Continuous glucose monitoring (CGM) is one approach to measuring glycemia and has become more widespread with recent advances in technology; however, ideal implementation of CGM into clinical practice is unknown. CGM can be categorized as personal CGM, which can be for at-home use to replace self-monitoring of blood glucose, or professional CGM (proCGM), which is used intermittently under the direction of a health care professional. The expanding role of the clinical pharmacist allows pharmacists to be at the forefront of implementing proCGM technology, but literature on the effect of pharmacist-driven proCGM is lacking. Pharmacists and physicians within 1 physician-owned clinic used proCGM technology differently. Pharmacists conducted 1 or 2 office visits to interpret data and make interventions, while physicians interpreted data 1 time and relayed interventions via phone.

OBJECTIVES

To (a) compare the change in hemoglobin A1c from baseline to 6 months between the different methods of proCGM implementation, and (b) describe and compare the clinical interventions made as a result of the different methods of proCGM implementation.

METHODS

In this retrospective cohort study, adults identified in the electronic medical record via Current Procedural Terminology code 95250 or 95251 undergoing proCGM with CGM data interpreted and baseline A1c ≥ 7% were included. Patients with additional CGM use within the 6-month follow-up period were excluded. Data collection included demographics, A1c at baseline and during the 6-month follow-up period, and CGM-associated interventions. Patients were categorized as undergoing 1 pharmacist-driven encounter (RPh1), 2 pharmacist-driven encounters (RPh2), or 1 physician-driven encounter (MD1) for proCGM implementation. Combined RPh1 and RPh2 (cRPh) data were also used for analysis. The primary outcome was change in A1c from baseline to 6 months, which was evaluated by analysis of covariance.

RESULTS

Of 378 patient charts reviewed, 315 instances of proCGM implementation met inclusion criteria (58 RPh1, 35 RPh2, 222 MD1), and 253 had post-implementation A1c data for analysis of the primary outcome (52 RPh1, 30 RPh2, 171 MD1). Baseline A1c was 8.4%, 8.8%, and 9.1% with mean reduction from baseline to 6 months of 1.0%, 1.3%, and 0.6%, respectively. cRPh patients experienced a greater mean reduction in A1c compared with MD1 (P = 0.002). RPh2 patients had a statistically significant reduction compared with MD1 (P = 0.005), but RPh1 patients did not (P = 0.054). The number of CGM-associated pharmacological interventions was 1.33 for RPh1 patients, 1.63 for RPh2 at the first encounter and 1.34 at the second, and 1.17 for MD1.

CONCLUSIONS

Pharmacist-driven implementation of proCGM was associated with greater A1c reductions and more pharmacological interventions versus physician-driven implementation. This study demonstrated improved clinical outcomes with pharmacists providing direct patient care through implementation of new diabetes technology.

DISCLOSURES

No outside funding supported this study. The authors have nothing to disclose. Preliminary results of this work were presented at the American College of Clinical Pharmacy Virtual Poster Symposium, May 28-29, 2019. The abstract was not peer-reviewed because of enrollment in the Mentored Research Investigator Training (MeRIT) program. Final peer-reviewed results were presented at the American College of Clinical Pharmacy Annual Meeting; October 26-29, 2019; New York, NY.

Feasibility of a bilateral 4000-6000 Hz notch as a phenotype for genetic association analysis

OBJECTIVE

Noise-induced hearing loss (NIHL) is a worldwide health problem and a growing concern among young people. Although some people appear to be more susceptible to NIHL, genetic association studies lack a specific phenotype. We tested the feasibility of a bilateral 4000-6000 Hz audiometric notch as a phenotype for identifying genetic contributions to hearing loss in young adults.

DESIGN

A case-control-control study was conducted to examine selected SNPs in 52 genes previously associated with hearing loss and/or expressed in the cochlea. A notch was defined as a minimum of a 15-dB drop at 4000-6000 Hz from the previous best threshold with a 5-dB 'recovery' at 8000 Hz.

STUDY SAMPLE

Participants were 252 individuals of European descent taken from a population of 640 young adults who are students of classical music. Participants were grouped as No-notch (NN), Unilateral Notch (UN), or Bilateral Notch (BN).

RESULTS

The strongest evidence of a genetic association with the 4000-6000 Hz notch was a nonsynonymous SNP variant in the ESRR- gene (rs61742642:C> T, P386S). Carriers of the minor allele accounted for 26% of all bilateral losses.

CONCLUSION

This study indicates that the 4000-6000 Hz bilateral notch is a feasible phenotype for identifying genetic susceptibility to hearing loss.

Multiple Plantago species (Plantaginaceae) modify floral reflectance and color in response to thermal change

PREMISE OF THE STUDY

Understanding how plant reproduction responds to temperature has become increasingly important because of global climate change. Temperature-sensitive plasticity in floral reflectance is likely involved in some of these responses. Such plasticity, which underlies thermoregulatory ability, affects reproductive success in Plantago lanceolata. To see whether other Plantago species also show thermal plasticity in reflectance, we measured plasticity in P. lagopus, P. coronopus, P. major, P. subulata, P. albicans, P. tomentosa, P. maritima, and P. weldenii.

METHODS

We induced plants to flower at two temperatures in growth chambers and recorded floral reflectance (362-800 nm).

KEY RESULTS

All species were thermally plastic in visible and near-IR regions. Species and populations differed in response. Some showed greater variation in reflectance at warm temperature, while the reverse was true for others. Plasticity was greatest in the P. lanceolata clade. Cosmopolitan species were not more plastic than were geographically restricted species.

CONCLUSIONS

The data suggest that (1) thermal plasticity is an ancestral trait for Plantago, (2) plasticities in visible and near-IR regions have evolved along different pathways within the genus, and (3) phylogenetic history partially explains this evolutionary divergence. Our data combined with those of previous studies suggest that global climate change will modify floral reflectance and color in many plant species. These modifications are likely to affect plant reproductive success.

Evaluation of the effectiveness of anterior cruciate ligament injury prevention programme training components: a systematic review and meta-analysis

BACKGROUND

Anterior cruciate ligament (ACL) injury prevention programmes have shown mixed results, which may be due to differing emphasis on training components. The purpose of this study was to (1) quantify the overall and relative duration of each training component encompassed within these programmes and (2) examine the effect of these durations on ACL injury rates.

METHODS

A systematic review was completed and meta-analyses performed on eligible studies to produce a pooled OR estimate of the effectiveness of these programmes. Meta-regression was used to detect any relationship that programme duration and the duration of individual training components had on ACL injury rates.

RESULTS

13 studies were included for review. Results of the meta-analyses revealed a significant reduction of injuries after preventative training programmes for all ACL injuries (pooled OR estimate of 0.612, 95% CI 0.44 to 0.85; p=0.004) and for non-contact ACL injuries (OR 0.351, 95% CI 0.23 to 0.54; p<0.001). Results of meta-regression analysis revealed that a greater duration of balance training was associated with a higher injury risk for ACL injury (p=0.04), while greater durations of static stretching was associated with a lower injury risk for non-contact ACL injuries (p=0.04).

CONCLUSIONS

While ACL prevention programmes are successful in reducing the risk of ACL injury, the ideal combination and emphasis of training components within these programmes remains unclear. Evidence indicates that greater emphases on balance training and static stretching may be associated with an increase and decrease in injury risk, respectively.

Using the Tukey-Kramer omnibus test in the Hayter-Fisher procedure

Using Tukey-Kramer versus the ANOVA F-test as the omnibus test of the Hayter-Fisher procedure for comparing all pairs of normally distributed means, when sample sizes are unequal, is investigated. Simulation results suggest that using Tukey-Kramer leads to as much or more any-pairs power compared to using the F-test for certain patterns of mean differences, and equivalent per-pair and all-pairs power for all cases. Furthermore, using Tukey-Kramer results in a consonant test procedure, where there cannot be disagreement between the results of the omnibus test and the subsequent pairwise tests. The results suggest that when sample sizes are unequal, Tukey-Kramer may be preferred over the F-test as the omnibus test for the Hayter-Fisher procedure.

Fitness effects of floral plasticity and thermoregulation in a thermally changing environment

To better understand the evolution of phenotypic plasticity and thermoregulation and their potential value for ectotherms in the face of global warming, we conducted field experiments to measure their effects on fitness and their association with reproductive phenology in Plantago lanceolata in a thermally variable environment. We measured the reproductive timing and success of genotypes varying in thermoregulation, as mediated by floral-reflectance plasticity. Results were consistent with the hypothesis that thermoregulation is more adaptive when thermally variable reproductive seasons are shorter and cooler. Strong thermoregulation/plasticity increased reproductive success during the cool portion of the reproductive season but not during the warm portion. Directional selection that favored strongly thermoregulating genotypes early in the season shifted to stabilizing selection that favored genotypes with weaker thermoregulation later in the season. Thermoregulation and reproductive phenology were negatively correlated. Although reproductive onset and duration were similar between genotypes, strong thermoregulators produced more and larger spikes (clutches) early; weak thermoregulators produced more spikes late. Results suggest that with atmospheric warming, the benefit of raising body temperature via thermoregulation when it is cool should decline in extant populations. The negative correlation between thermoregulation and phenology should accelerate the evolutionary shift toward thermoconformity, that is, reduced plasticity.

Synergy-directed fractionation of botanical medicines: a case study with goldenseal (Hydrastis canadensis)

It is often argued that the efficacy of herbal medicines is a result of the combined action of multiple constituents that work synergistically or additively. Determining the bioactive constituents in these mixtures poses a significant challenge. We have developed an approach to address this challenge, synergy-directed fractionation, which combines comprehensive mass spectrometry profiling with synergy assays and natural products isolation. The applicability of synergy-directed fractionation was demonstrated using the botanical medicine goldenseal (Hydrastis canadensis) as a case study. Three synergists from goldenseal were identified, sideroxylin, 8-desmethyl-sideroxylin, and 6-desmethyl-sideroxylin. These flavonoids synergistically enhance the antimicrobial activity of the alkaloid berberine (also a constituent of H. canadensis) against Staphylococcus aureus by inhibition of the NorA multidrug resistance pump. The flavonoids possess no inherent antimicrobial activity against S. aureus; therefore, they could have been missed using traditional bioactivity-directed fractionation. The flavonoid synergists are present at higher concentration in extracts from H. canadensis leaves, while the antimicrobial alkaloid berberine is present at higher levels in H. canadensis roots. Thus, it may be possible to produce an extract with optimal activity against S. aureus using a combination of goldenseal roots and leaves.

Floral reflectance, color, and thermoregulation: what really explains geographic variation in thermal acclimation ability of ectotherms?

Adaptive phenotypic plasticity in thermally sensitive traits, that is, thermal acclimation, generally increases with increasing latitude and altitude. The presumed explanation is that high-latitude/altitude organisms have evolved greater acclimation ability because of exposure to greater temperature fluctuations. Using a conceptual model of the thermal environment during the reproductive season, we tested this hypothesis against an alternative that plasticity is greater because of increased exposure to specific temperatures that strongly select for thermal acclimation. We examined geographic variation in floral reflectance/color plasticity among 29 European populations of a widespread perennial herb, Plantago lanceolata. Individuals partially thermoregulate reproduction through temperature-sensitive plasticity in floral reflectance/color. Plasticity was positively correlated with latitude and altitude. Path analyses support the hypothesis that the thermal environment mediates these geographic effects. Plasticity declined as seasonal temperature range increased, and it increased as duration of the growing season shortened and as the proportion of time exposed to temperatures favoring thermoregulation increased. Data provide evidence that floral reflectance/color plasticity is adaptive and that it has evolved in response not to the magnitude of temperature variation during the reproductive season but rather to the relative exposure to low temperatures, which favor thermoregulation.

Voiced initial consonant perception deficits in older listeners with hearing loss and good and poor word recognition

PURPOSE

This study examined differences in voiced consonant-vowel (CV) perception in older listeners with normal hearing and in 2 groups of older listeners with matched hearing losses: those with good and those with poor word recognition scores.

METHOD

Thirty-six participants identified CVs from an 8-item display from the natural voiced initial consonants/b, d, g, m, n, eth, v and z/in three vowel contexts (/a, o, u/) spoken by a male and a female talker.

RESULTS

The listeners with hearing loss and poor word recognition scores (WRS) made more of the same types of errors, as well as errors not made by listeners with hearing loss and good word recognition. Errors above chance rates for these listeners were highest in the context of /a/ and were similar in the contexts of /o/ and /u/. Sequential information analyses (SINFAs) verified that information was transmitted least efficiently in the context of /a/. The results yielded a list of consonant confusions unique to listeners with poor WRS.

CONCLUSIONS

Listeners with poor WRS have more difficulty identifying voiced initial consonants in CV syllables than do listeners with good WRS. These listeners made some systematic errors, but most errors were nonsystematic, perhaps due to the low level of feature information transmitted.

Temperature-sensitive alternative oxidase protein content and its relationship to floral reflectance in natural Plantago lanceolata populations

In many plant species, the alternative respiratory pathway consisting of alternative oxidase (AOX) is affected by growth temperature. The adaptive significance of this temperature-sensitivity is unresolved. Here, leaf and spike (flower cluster) AOX protein content and spike/floral reflectance of genotypes from European Plantago lanceolata populations found in regions differing in reproductive season temperatures were measured. Cloned genotypes grown at controlled warm and cool temperatures were used to assess the natural within- and between-population variation in AOX content, temperature-sensitive phenotypic plasticity in content, and the relationship between AOX and temperature-sensitive floral/spike reflectance. AOX content and plasticity were genetically variable. Leaf AOX content, although greater at cool temperature, was relatively low and not statistically different across populations. Spike AOX content was greater than in leaves. Spike AOX plasticity differed significantly among populations and climate-types and showed significant negative correlation with floral reflectance plasticity, which also varied among populations. Genotypes with more AOX at cool than at warm temperature had greater floral reflectance plasticity; genotypes with relatively more AOX at warm temperature had less floral reflectance plasticity. The data support the hypothesis that plasticity of AOX content in reproductive tissues is associated with long-term thermal acclimatization.

Biogeo-optics: particle optical properties and the partitioning of the spectral scattering coefficient of ocean waters

We propose a direct method of partitioning the particulate spectral scattering coefficient of the marine hydrosol based on the concurrent determination of the concentrations of particulate mineral and organic matter (the total mass of optically active scattering material exclusive of water) with the particulate spectral scattering coefficient. For this we derive a Model II multiple linear regression model. The multiple linear regression of the particulate spectral scattering coefficient against the independent variables, the concentrations of particulate inorganic matter and particulate organic matter, yields their mass-specific spectral scattering cross sections. The mass-specific spectral scattering cross section is simply the particle scattering cross section normalized to the particle mass, a fundamental optical efficiency parameter for the attenuation of electromagnetic radiation [Absorption and Scattering of Light by Small Particles, (Wiley-Interscience, 1983), pp. 80-81, 289]. It is possible to infer the optical properties of the suspended matter from the mass-specific spectral scattering cross sections. From these cross sections we partition the particulate spectral scattering coefficient into its major components.

Histological alterations in male A/J mice following nose-only exposure to tobacco smoke

The incidence and multiplicity of grossly observed and microscopic lesions of the respiratory tract of A/J mice exposed nose-only to mainstream smoke (50, 200, or 400 mg total particulate matter/m3 from 2R4F cigarettes) was compared to those of filtered air controls. Animals were necropsied at the end of exposure (5 mo) or following 4 or 7 mo of recovery. Lungs were visually inspected for tumors at all necropsies and examined histopathologically at 9 and 12 mo. At 5 mo no tumors were recorded. No significant elevations in tumor incidence or multiplicity were recorded although at 9 mo multiplicity was elevated in the mid-exposure group (0.90 versus 0.55 tumors per animal for controls). At 12 mo, multiplicity was increased over the 9-mo necropsy at all exposures except 200 mg/m3; however, there were no dose-related trends in multiplicity or incidence. Histopathological alterations included hyperplasia, metaplasia, and inflammation of the nose and larynx and proliferative lesions of the lungs. At 9 mo, the multiplicity of focal lung lesions was 1.4 per animal in controls but averaged 1.0 among smoke-exposed groups. There was an inverse relation (p < .059) between smoke concentration and the percentage of hyperplastic lesions at 9 mo. At 12 mo the high-exposure group had slightly increased multiplicity of 2.3 lesions compared with 1.6 among controls, while the percentage of hyperplasic lesions was similar between groups. Nose-only inhalation of mainstream tobacco smoke resulted in chronic inflammatory changes of the respiratory tract yet failed to produce statistically significant changes in tumor incidence or multiplicity.

Transformations of count data for tests of interaction in factorial and split-plot experiments

In applied entomological experiments, when the response is a count-type variable, certain transformation remedies such as the square root, logarithm (log), or rank transformation are often used to normalize data before analysis of variance. In this study, we examine the usefulness of these transformations by reanalyzing field-collected data from a split-plot experiment and by performing a more comprehensive simulation study of factorial and split-plot experiments. For field-collected data, significant interactions were dependent upon the type of transformation. For the simulation study, Poisson distributed errors were used for a 2 by 2 factorial arrangement, in both randomized complete block and split-plot settings. Various sizes of main effects were induced, and type I error rates and powers of the tests for interaction were examined for the raw response values, log-, square root-, and rank-transformed responses. The aligned rank transformation also was investigated because it has been shown to perform well in testing interactions in factorial arrangements. We found that for testing interactions, the untransformed response and the aligned rank response performed best (preserved nominal type I error rates), whereas the other transformations had inflated error rates when main effects were present. No evaluations of the tests for main effects or simple effects have been conducted. Potentially these transformations will still be necessary when performing these tests.

Poor long-term patient and graft survival after primary percutaneous coronary intervention for acute myocardial infarction due to saphenous vein graft occlusion

Primary percutaneous coronary intervention (PCI) for ST segment elevation myocardial infarction (STEMI) due to saphenous vein graft (SVG) occlusion has been associated with poor procedural results and poor short-term outcomes, but long-term graft patency and patient survival have not been evaluated. Consecutive patients (n = 2,240) with STEMI treated with primary PCI from 1984 to 2003 were followed for 6.6 years (median). Follow-up angiography was obtained in 80% of hospital survivors following primary PCI for SVG occlusion at 2.3 years (median). Patients with primary PCI for SVG occlusion (n = 57) vs. native artery occlusion had more prior MI, advanced Killip class, and three-vessel coronary disease and lower acute ejection fraction (EF). Patients with SVG occlusion had lower rates of TIMI 3 flow post-PCI (80.7% vs. 93.6%; P = 0.0001), higher in-hospital mortality (21.1% vs. 8.0%; P = 0.0004), and lower follow-up EF (49.3% vs. 54.7%; P = 0.055). Culprit SVGs were patent in 64% of patients at 1 year and 56% at 5 years. Late survival was strikingly worse in patients with primary PCI for SVG occlusion vs. native vessel occlusion (49% vs. 76% at 10 years), and SVG occlusion was the second strongest predictor of late cardiac mortality by multivariate analysis (HR = 2.11; 95% CI = 1.38-3.23; P = 0.0006). Patients with STEMI due to SVG occlusion treated with primary PCI have poor acute procedural results, frequent late reocclusion, and very high late mortality. The introduction of new adjunctive therapies (distal protection, thrombectomy, and drug-eluting stents) may improve short-term outcomes, but improved long-term outcomes may require new and more durable revascularization strategies.

Complex Data Produce Better Characters

Two studies were conducted to explore the use of complex data in character description and hybrid identification. In order to determine if complex data allow the production of better characters, eight groups of plant systematists were given two classes of drawings of plant parts, and asked to divide them into character states (clusters) in two separate experiments. The first class of drawings consisted only of cotyledons. The second class consisted of triplets of drawings: a cotyledon, seedling leaf, and inflorescence bract. The triplets were used to simulate complex data such as might be garnered by looking at a plant. Each experiment resulted in four characters (groups of clusters), one for each group of systematists. Visual and statistical analysis of the data showed that the systematists were able to produce smaller, more precisely defined character states using the more complex drawings. The character states created with the complex drawings also were more consistent across systematists, and agreed more closely with an independent assessment of phylogeny. To investigate the utility of complex data in an applied task, four observers rated 250 hybrids of Dubautia ciliolata X arborea based on the overall form (Gestalt) of the plants, and took measurements of a number of features of the same plants. A composite score of the measurements was created using principal components analysis. The correlation between the scores on the first principal component and the Gestalt ratings was computed. The Gestalt ratings and PC scores were significantly correlated, demonstrating that assessments of overall similarity can be as useful as more conventional approaches in determining the hybrid status of plants.

Atypical herpetic endotheliitis

BACKGROUND

Three patients ranging in age from 26 to 40 years presented with unilateral posterior stromal lesions with diffuse stromal edema. There was no history of prior surgery, trauma, infectious disease, dystrophy or exposure to noxious agents. Only one patient had signs of anterior chamber reaction and none of the patients showed any sign of epithelial involvement or of associated blood vessels or scarring. All three patients presented with features atypical of herpetic disease, such as lack of epithelial involvement and posterior stromal opacification. They also demonstrated many of the typical characteristics of herpetic disease, however, and thus were diagnosed as having herpetic endotheliitis.

RESULTS

All three patients were treated with a regimen of antiviral agents and corticosteroids. Two patients improved, although the time frame differed in each. One patient subjectively improved, then worsened 1 month later after discontinuing treatment on her own. She was lost to subsequent follow-up.

CONCLUSIONS

Young patients presenting with unilateral posterior stromal opacification and stromal edema in the absence of epithelial involvement are likely to have endotheliitis of herpetic origin.

The differential diagnosis of visual disorders in patients presenting with marked symptoms but with no observable ocular abnormality

A differential diagnosis of nine conditions which sometimes produce distressing symptoms without overt signs is presented. Sophisticated tests, especially electrodiagnostic ones, can aid the optometrist in making the correct decision. The selected procedures and the expected results are summarized in a table. The conditions reviewed are Stargardt's macular degeneration, Leber's congenital amaurosis, albinism, foveal hypoplasia, retinitis pigmentosa, retrobulbar neuritis, amblyopia, and problems of psychogenic origin.

Electro-oculography, dark adaptometry, and laser interferometry

This paper discusses the basic concepts of electrooculography (E.O.G.), dark adaptometry, and laser interferometry. Included is the clinical relevance of each procedure.