Stenting performs better than drug-coated balloon angioplasty in popliteal lesions.

BACKGROUND: Peripheral arterial disease (PAD) is a common and highly morbid disease. Although there have been recent advancements in the endovascular modalities to treat PAD, comparisons of these strategies, especially in the popliteal region, remain underinvestigated. The objective of this study was to compare midterm outcomes in patients with PAD undergoing treatment with both novel and SS compared with drug-coated balloon (DCB) angioplasty. METHODS: All patients at a multi-institution health system treated for PAD in the popliteal region from 2011 to 2019 were identified. Presenting features, operative details, and outcomes were included in the analysis. Patients who underwent popliteal revascularization with stents were compared with DCB. SS were compared separately with novel dedicated stents. Two-year primary patency was the primary outcome. RESULTS: We included 408 patients (72.7 ± 11.8 years old; 57.1% men) in the analysis. There were 221 (54.7%) patients who underwent popliteal stenting and 187 (45.3%) who underwent popliteal DCB. There were high rates of tissue loss in both groups (57.9% vs 50.8%; P = .14). Stented patients had longer lesions (112.4 ± 3.2 vs 100.2 ± 5.8 mm; P = .03) and higher rates of concomitant superficial femoral artery treatment (88.2% vs 39.6%; P < .01). Chronic total occlusions accounted for the majority of lesions treated (stent 62.4%, DCB 64.2%). Perioperative complications were similar between groups. Primary patency for the stented group was higher at two years than the DCB group (61.0% vs 46.1%; P = .03). When evaluating stented patients only, SS had higher 2-year patency than novel stents in the popliteal segment (69.6% vs 51.4%; P = .04). On multivariable analysis, stenosis, as opposed to chronic total occlusion, was associated with improved patency (hazard ratio, 0.49; 95% confidence interval, 0.25-0.96; P = .04), whereas novel stents were associated with worse primary patency (hazard ratio, 2.01; 95% confidence interval, 1.09-3.73; P = .03). CONCLUSIONS: In a population of patients with severe vascular disease, stents do not have inferior patency and limb salvage rates compared with DCB angioplasty when treating the popliteal region. For patients with advanced vascular disease, and especially tissue loss, stents and DCB are both beneficial when treating popliteal lesions.

Eco-evolutionary significance of "loners".

Loners-individuals out of sync with a coordinated majority-occur frequently in nature. Are loners incidental byproducts of large-scale coordination attempts, or are they part of a mosaic of life-history strategies? Here, we provide empirical evidence of naturally occurring heritable variation in loner behavior in the model social amoeba Dictyostelium discoideum. We propose that Dictyostelium loners-cells that do not join the multicellular life stage-arise from a dynamic population-partitioning process, the result of each cell making a stochastic, signal-based decision. We find evidence that this imperfectly synchronized multicellular development is affected by both abiotic (environmental porosity) and biotic (signaling) factors. Finally, we predict theoretically that when a pair of strains differing in their partitioning behavior coaggregate, cross-signaling impacts slime-mold diversity across spatiotemporal scales. Our findings suggest that loners could be critical to understanding collective and social behaviors, multicellular development, and ecological dynamics in D. discoideum. More broadly, across taxa, imperfect coordination of collective behaviors might be adaptive by enabling diversification of life-history strategies.

Enhanced species coexistence in Lotka-Volterra competition models due to nonlocal interactions.

We introduce and analyze a spatial Lotka-Volterra competition model with local and nonlocal interactions. We study two alternative classes of nonlocal competition that differ in how each species' characteristics determine the range of the nonlocal interactions. In both cases, nonlocal interactions can create spatial patterns of population densities in which highly populated clumps alternate with unpopulated regions. These non-populated regions provide spatial niches for a weaker competitor to establish in the community and persist in conditions in which local models predict competitive exclusion. Moreover, depending on the balance between local and nonlocal competition intensity, the clumps of the weaker competitor vary from M-like structures with higher densities of individuals accumulating at the edges of each clump to triangular structures with most individuals occupying their centers. These results suggest that long-range competition, through the creation of spatial patterns in population densities, might be a key driving force behind the rich diversity of species observed in natural ecological communities.

How range residency and long-range perception change encounter rates.

Encounter rates link movement strategies to intra- and inter-specific interactions, and therefore translate individual movement behavior into higher-level ecological processes. Indeed, a large body of interacting population theory rests on the law of mass action, which can be derived from assumptions of Brownian motion in an enclosed container with exclusively local perception. These assumptions imply completely uniform space use, individual home ranges equivalent to the population range, and encounter dependent on movement paths actually crossing. Mounting empirical evidence, however, suggests that animals use space non-uniformly, occupy home ranges substantially smaller than the population range, and are often capable of nonlocal perception. Here, we explore how these empirically supported behaviors change pairwise encounter rates. Specifically, we derive novel analytical expressions for encounter rates under Ornstein-Uhlenbeck motion, which features non-uniform space use and allows individual home ranges to differ from the population range. We compare OU-based encounter predictions to those of Reflected Brownian Motion, from which the law of mass action can be derived. For both models, we further explore how the interplay between the scale of perception and home-range size affects encounter rates. We find that neglecting realistic movement and perceptual behaviors can lead to systematic, non-negligible biases in encounter-rate predictions.

Cell adhesion and fluid flow jointly initiate genotype spatial distribution in biofilms.

Biofilms are microbial collectives that occupy a diverse array of surfaces. It is well known that the function and evolution of biofilms are strongly influenced by the spatial arrangement of different strains and species within them, but how spatiotemporal distributions of different genotypes in biofilm populations originate is still underexplored. Here, we study the origins of biofilm genetic structure by combining model development, numerical simulations, and microfluidic experiments using the human pathogen Vibrio cholerae. Using spatial correlation functions to quantify the differences between emergent cell lineage segregation patterns, we find that strong adhesion often, but not always, maximizes the size of clonal cell clusters on flat surfaces. Counterintuitively, our model predicts that, under some conditions, investing in adhesion can reduce rather than increase clonal group size. Our results emphasize that a complex interaction between fluid flow and cell adhesiveness can underlie emergent patterns of biofilm genetic structure. This structure, in turn, has an outsize influence on how biofilm-dwelling populations function and evolve.

Fitness tradeoffs between spores and nonaggregating cells can explain the coexistence of diverse genotypes in cellular slime molds.

Cellular slime molds, including the well-studied Dictyostelium discoideum, are amoebae whose life cycle includes both a single-cellular and a multicellular stage. To achieve the multicellular stage, individual amoebae aggregate upon starvation to form a fruiting body made of dead stalk cells and reproductive spores, a process that has been described in terms of cooperation and altruism. When amoebae aggregate they do not perfectly discriminate against nonkin, leading to chimeric fruiting bodies. Within chimeras, complex interactions among genotypes have been documented, which should theoretically reduce genetic diversity. This is however inconsistent with the great diversity of genotypes found in nature. Recent work has shown that a little-studied component of D. discoideum fitness--the loner cells that do not participate in the aggregation--can be selected for depending on environmental conditions and that, together with the spores, they could represent a bet-hedging strategy. We suggest that in all cellular slime molds the existence of loners could resolve the apparent diversity paradox in two ways. First, if loners are accounted for, then apparent genotypic skew in the spores of chimeras could simply be the result of different investments into spores versus loners. Second, in an ecosystem with multiple local environments differing in their food recovery characteristics and connected globally via weak-to-moderate dispersal, coexistence of multiple genotypes can occur. Finally, we argue that the loners make it impossible to define altruistic behavior, winners or losers, without a clear description of the ecology.

Seasonality can induce coexistence of multiple bet-hedging strategies in Dictyostelium discoideum via storage effect.

The social amoeba Dictyostelium discoideum has been recently suggested as an example of bet-hedging in microbes. In the presence of resources, amoebae reproduce as unicellular organisms. Resource depletion, however, leads to a starvation phase in which the population splits between aggregators, which form a fruiting body made of a stalk and resistant spores, and non-aggregators, which remain as vegetative cells. Spores are favored when starvation periods are long, but vegetative cells can exploit resources in environments where food replenishes quickly. The investment in aggregators versus non-aggregators can therefore be understood as a bet-hedging strategy that evolves in response to stochastic starvation times. A genotype (or strategy) is defined by the balance between each type of cells. In this framework, if the ecological conditions on a patch are defined in terms of the mean starvation time (i.e. time between the onset of starvation and the arrival of a new food pulse), a single genotype dominates each environment, which is inconsistent with the huge genetic diversity observed in nature. Here we investigate whether seasonality, represented by a periodic, wet-dry alternation in the mean starvation times, allows the coexistence of several strategies in a single patch. We study this question in a non-spatial (well-mixed) setting in which different strains compete for a common pool of resources over a sequence of growth-starvation cycles. We find that seasonality induces a temporal storage effect that can promote the stable coexistence of multiple genotypes. Two conditions need to be met in our model. First, there has to be a temporal niche partitioning (two well-differentiated habitats within the year), which requires not only different mean starvation times between seasons but also low variance within each season. Second, each season's well-adapted strain has to grow and create a large enough population that permits its survival during the subsequent unfavorable season, which requires the number of growth-starvation cycles within each season to be sufficiently large. These conditions allow the coexistence of two bet-hedging strategies. Additional tradeoffs among life-history traits can expand the range of coexistence and increase the number of coexisting strategies, contributing toward explaining the genetic diversity observed in D. discoideum. Although focused on this cellular slime mold, our results are general and may be easily extended to other microbes.

Lack of Ecological and Life History Context Can Create the Illusion of Social Interactions in Dictyostelium discoideum.

Studies of social microbes often focus on one fitness component (reproductive success within the social complex), with little information about or attention to other stages of the life cycle or the ecological context. This can lead to paradoxical results. The life cycle of the social amoeba Dictyostelium discoideum includes a multicellular stage in which not necessarily clonal amoebae aggregate upon starvation to form a possibly chimeric (genetically heterogeneous) fruiting body made of dead stalk cells and spores. The lab-measured reproductive skew in the spores of chimeras indicates strong social antagonism that should result in low genotypic diversity, which is inconsistent with observations from nature. Two studies have suggested that this inconsistency stems from the one-dimensional assessment of fitness (spore production) and that the solution lies in tradeoffs between multiple life-history traits, e.g.: spore size versus viability; and spore-formation (via aggregation) versus staying vegetative (as non-aggregated cells). We develop an ecologically-grounded, socially-neutral model (i.e. no social interactions between genotypes) for the life cycle of social amoebae in which we theoretically explore multiple non-social life-history traits, tradeoffs and tradeoff-implementing mechanisms. We find that spore production comes at the expense of time to complete aggregation, and, depending on the experimental setup, spore size and viability. Furthermore, experimental results regarding apparent social interactions within chimeric mixes can be qualitatively recapitulated under this neutral hypothesis, without needing to invoke social interactions. This allows for simple potential resolutions to the previously paradoxical results. We conclude that the complexities of life histories, including social behavior and multicellularity, can only be understood in the appropriate multidimensional ecological context, when considering all stages of the life cycle.

Synthesis and magnetic properties of cobalt-iron/cobalt-ferrite soft/hard magnetic core/shell nanowires.

A straightforward method for the synthesis of CoFe2.7/CoFe2O4 core/shell nanowires is described. The proposed method starts with a conventional pulsed electrodeposition procedure on alumina nanoporous template. The obtained CoFe2.7 nanowires are released from the template and allowed to oxidize at room conditions over several weeks. The effects of partial oxidation on the structural and magnetic properties were studied by x-ray spectrometry, magnetometry, and scanning and transmission electron microscopy. The results indicate that the final nanowires are composed of 5 nm iron-cobalt alloy nanoparticles. Releasing the nanowires at room conditions promoted surface oxidation of the nanoparticles and created a CoFe2O4 shell spinel-like structure. The shell avoids internal oxidation and promotes the formation of bi-magnetic soft/hard magnetic core/shell nanowires. The magnetic properties of both the initial single-phase CoFe2.7 nanowires and the final core/shell nanowires, reveal that the changes in the properties from the array are due to the oxidation more than effects associated with released processes (disorder and agglomeration).

Demographic effects of aggregation in the presence of a component Allee effect.

The component Allee effect (AE) is the positive correlation between an organism's fitness component and population density. Depending on the population spatial structure, which determines the interactions between organisms, a component AE might lead to positive density dependence in the population per-capita growth rate and establish a demographic AE. However, existing spatial models impose a fixed population spatial structure, which limits the understanding of how a component AE and spatial dynamics jointly determine the existence of demographic AEs. We introduce a spatially explicit theoretical framework where spatial structure and population dynamics are emergent properties of the individual-level demographic and movement rates. This framework predicts various spatial patterns depending on its specific parametrization, including evenly spaced aggregates of organisms, which determine the demographic-level by-products of the component AE. We find that aggregation increases population abundance and allows population survival in harsher environments and at lower global population densities when compared with uniformly distributed organisms. Moreover, aggregation can prevent the component AE from manifesting at the population level or restrict it to the level of each independent aggregate. These results provide a mechanistic understanding of how component AEs might operate for different spatial structures and manifest at larger scales.

Optimizing the search for resources by sharing information: Mongolian gazelles as a case study.

We investigate the relationship between communication and search efficiency in a biological context by proposing a model of Brownian searchers with long-range pairwise interactions. After a general study of the properties of the model, we show an application to the particular case of acoustic communication among Mongolian gazelles, for which data are available, searching for good habitat areas. Using Monte Carlo simulations and density equations, our results point out that the search is optimal (i.e., the mean first hitting time among searchers is minimum) at intermediate scales of communication, showing that both an excess and a lack of information may worsen it.

Spatial patterns in mesic savannas: the local facilitation limit and the role of demographic stochasticity.

We propose a model equation for the dynamics of tree density in mesic savannas which considers long-range competition among trees and the effect of fire indirectly acting as a local facilitation mechanism. Despite the fact that we take short-range facilitation to the local-range limit, the standard full spectrum of spatial structures already obtained in self-organization models of vegetation is recovered. Nonlocal competition, in the limit of infinitesimally short facilitation, promotes the clustering of trees. The long time coexistence between trees and grass, and how fires affect the survival of trees as well as the maintenance of the patterns is studied. The influence of demographic noise is analyzed. The stochastic system, under the parameter constraints typical of mesic savannas, shows non-homogeneous patterns characteristic of realistic situations. The coexistence of trees and grass still remains at reasonable noise intensities.

A Lagrangian model for drifting ecosystems reveals heterogeneity-driven enhancement of marine plankton blooms.

Marine plankton play a crucial role in carbon storage, global climate, and ecosystem function. Planktonic ecosystems are embedded in patches of water that are continuously moving, stretching, and diluting. These processes drive inhomegeneities on a range of scales, with implications for the integrated ecosystem properties, but are hard to characterize. We present a theoretical framework that accounts for all these aspects; tracking the water patch hosting a drifting ecosystem along with its physical, environmental, and biochemical features. The theory resolves patch dilution and internal physical mixing as a function of oceanic strain and diffusion. Ecological dynamics are parameterized by an idealized nutrient and phytoplankton population and we specifically capture the time evolution of the biochemical spatial variances to represent within-patch heterogeneity. We find that, depending only on the physical processes to which the water patch is subjected, the plankton biomass response to a resource perturbation can vary in size up to six times. This work indicates that we must account for these processes when interpreting and modeling marine ecosystems and provides a framework with which to do so.

Spatial patterns in ecological systems: from microbial colonies to landscapes.

Self-organized spatial patterns are ubiquitous in ecological systems and allow populations to adopt non-trivial spatial distributions starting from disordered configurations. These patterns form due to diverse nonlinear interactions among organisms and between organisms and their environment, and lead to the emergence of new (eco)system-level properties unique to self-organized systems. Such pattern consequences include higher resilience and resistance to environmental changes, abrupt ecosystem collapse, hysteresis loops, and reversal of competitive exclusion. Here, we review ecological systems exhibiting self-organized patterns. We establish two broad pattern categories depending on whether the self-organizing process is primarily driven by nonlinear density-dependent demographic rates or by nonlinear density-dependent movement. Using this organization, we examine a wide range of observational scales, from microbial colonies to whole ecosystems, and discuss the mechanisms hypothesized to underlie observed patterns and their system-level consequences. For each example, we review both the empirical evidence and the existing theoretical frameworks developed to identify the causes and consequences of patterning. Finally, we trace qualitative similarities across systems and propose possible ways of developing a more quantitative understanding of how self-organization operates across systems and observational scales in ecology.

Foraging behaviour and patch size distribution jointly determine population dynamics in fragmented landscapes.

Increased fragmentation caused by habitat loss represents a major threat to the persistence of animal populations. How fragmentation affects populations depends on the rate at which individuals move between spatially separated patches. Whereas negative effects of habitat loss on biodiversity are well known, the effects of fragmentation per se on population dynamics and ecosystem stability remain less well understood. Here, we use a spatially explicit predator-prey model to investigate how the interplay between fragmentation and optimal foraging behaviour affects predator-prey interactions and, subsequently, ecosystem stability. We study systems wherein prey occupies isolated patches and are consumed by predators that disperse following Lévy random walks. Our results show that the Lévy exponent and the degree of fragmentation jointly determine coexistence probabilities. In highly fragmented landscapes, Brownian and ballistic predators go extinct and only scale-free predators can coexist with prey. Furthermore, our results confirm that predation causes irreversible habitat loss in fragmented landscapes owing to overexploitation of smaller patches of prey. Moreover, we show that predator dispersal can reduce, but not prevent or minimize, the amount of lost habitat. Our results suggest that integrating optimal foraging theory into population and landscape ecology is crucial to assessing the impact of fragmentation on biodiversity and ecosystem stability.

Species exclusion and coexistence in a noisy voter model with a competition-colonization tradeoff.

We introduce an asymmetric noisy voter model to study the joint effect of immigration and a competition-dispersal tradeoff in the dynamics of two species competing for space in regular lattices. Individuals of one species can invade a nearest-neighbor site in the lattice, while individuals of the other species are able to invade sites at any distance but are less competitive locally, i.e., they establish with a probability g≤1. The model also accounts for immigration, modeled as an external noise that may spontaneously replace an individual at a lattice site by another individual of the other species. This combination of mechanisms gives rise to a rich variety of outcomes for species competition, including exclusion of either species, monostable coexistence of both species at different population proportions, and bistable coexistence with proportions of populations that depend on the initial condition. Remarkably, in the bistable phase, the system undergoes a discontinuous transition as the intensity of immigration overcomes a threshold, leading to a half loop dynamics associated to a cusp catastrophe, which causes the irreversible loss of the species with the shortest dispersal range.

Future paths for the 'exploitative segregation of plant roots' model.

The exploitative segregation of plant roots (ESPR) is a theory that uses a game-theoretical model to predict plant root foraging behavior in space. The original model returns the optimal root distribution assuming exploitative competition between a pair of identical plants in soils with homogeneous resource dynamics. In this short communication, we explore avenues to develop this model further. We discuss: (i) the response of single plants to soil heterogeneity; (ii) the variability of the plant response under uneven competition scenarios; (iii) the importance of accounting for the constraints and limitations to root growth that may be imposed from the plant shoot; (iv) the importance of root functional traits to predict root foraging behavior; (v) potential model extensions to investigate facilitation by incorporating facilitative traits to roots, and (vi) the possibility of allowing plants to tune their response by accounting for non-self and non-kin root recognition. For each case, we introduce the topic briefly and present possible ways to encode those ingredients in the mathematical equations of the ESPR model, providing preliminary results when possible.

An expanding role for interventional radiology: Medicare trends in fluoroscopic, endoscopic, and surgical enteric tube placement and maintenance from 2010 to 2018.

BACKGROUND: The purpose of this study is to provide an update on trends in physician volume and payments for enteric tube placement and maintenance procedures by method, provider specialty, and practice setting amongst Medicare beneficiaries from 2010 to 2018. MATERIALS AND METHODS: Claims from the Medicare Part B Physician/Supplier Procedure Summary Master File (PSPSMF) for the years 2010 to 2018 were extracted using current procedural terminology (CPT) codes for gastrostomy and jejunostomy placement, as well as conversion of gastrostomy to gastrojejunostomy, fluoroscopy guided and non-image guided replacement. Total volumes and provider reimbursement were analyzed by provider specialty and practice setting. RESULTS: Volume of de novo placement of all enteric tubes decreased from 157,123 to 106,549 (-32.2%). While endoscopic placement decreased from 133,658 to 81,171 (-39.3%), the volume of fluoroscopic placement increased from 17,999 to 21,277 (18.2%). Fluoroscopic placement was largely performed by interventional radiology (IR) (91.7% in 2018). Surgical placement decreased from 5466 to 4101 (-25.0%). Volume of fluoroscopic replacement increased from 24,799 to 38,470 (55.1%), while non-image guided replacements decreased from 61,377 to 55,116 (-10.2%). Share of both fluoroscopic and non-image guided replacements by advanced practice providers (APPs) more than doubled over this time period. CONCLUSION: De novo placement of enteric tubes decreased from 2010 to 2018, likely related to increased awareness of the complications and limited benefits in scenarios such as end of life care. In contrast to the diminishing volume for gastroenterologists, there was increased participation by IR in both placement and maintenance procedures under fluoroscopic guidance. SUMMARY STATEMENT: Decreasing placement of enteric tubes suggests shifting attitudes and recommendations around end-of-life care. Increase in role by IR/APPs highlights the need for comprehensive care in these patients.

The exploitative segregation of plant roots.

Plant roots determine carbon uptake, survivorship, and agricultural yield and represent a large proportion of the world's vegetation carbon pool. Study of belowground competition, unlike aboveground shoot competition, is hampered by our inability to observe roots. We developed a consumer-resource model based in game theory that predicts the root density spatial distribution of individual plants and tested the model predictions in a greenhouse experiment. Plants in the experiment reacted to neighbors as predicted by the model's evolutionary stable equilibrium, by both overinvesting in nearby roots and reducing their root foraging range. We thereby provide a theoretical foundation for belowground allocation of carbon by vegetation that reconciles seemingly contradictory experimental results such as root segregation and the tragedy of the commons in plant roots.

Spatial eco-evolutionary feedbacks mediate coexistence in prey-predator systems.

Eco-evolutionary frameworks can explain certain features of communities in which ecological and evolutionary processes occur over comparable timescales. Here, we investigate whether an evolutionary dynamics may interact with the spatial structure of a prey-predator community in which both species show limited mobility and predator perceptual ranges are subject to natural selection. In these conditions, our results unveil an eco-evolutionary feedback between species spatial mixing and predators perceptual range: different levels of mixing select for different perceptual ranges, which in turn reshape the spatial distribution of prey and its interaction with predators. This emergent pattern of interspecific interactions feeds back to the efficiency of the various perceptual ranges, thus selecting for new ones. Finally, since prey-predator mixing is the key factor that regulates the intensity of predation, we explore the community-level implications of such feedback and show that it controls both coexistence times and species extinction probabilities.