Pollinator and habitat-mediated selection as potential contributors to ecological speciation in two closely related species.

In ecological speciation, incipient species diverge due to natural selection that is ecologically based. In flowering plants, different pollinators could mediate that selection (pollinator-mediated divergent selection) or other features of the environment that differ between habitats of 2 species could do so (environment-mediated divergent selection). Although these mechanisms are well understood, they have received little rigorous testing, as few studies of divergent selection across sites of closely related species include both floral traits that influence pollination and vegetative traits that influence survival. This study employed common gardens in sites of the 2 parental species and a hybrid site, each containing advanced generation hybrids along with the parental species, to test these forms of ecological speciation in plants of the genus Ipomopsis. A total of 3 vegetative traits (specific leaf area, leaf trichomes, and photosynthetic water-use efficiency) and 5 floral traits (corolla length and width, anther insertion, petal color, and nectar production) were analyzed for impacts on fitness components (survival to flowering and seeds per flower, respectively). These traits exhibited strong clines across the elevational gradient in the hybrid zone, with narrower clines in theory reflecting stronger selection or higher genetic variance. Plants with long corollas and inserted anthers had higher seeds per flower at the Ipomopsis tenuituba site, whereas selection favored the reverse condition at the Ipomopsis aggregata site, a signature of divergent selection. In contrast, no divergent selection due to variation in survival was detected on any vegetative trait. Selection within the hybrid zone most closely resembled selection within the I. aggregata site. Across traits, the strength of divergent selection was not significantly correlated with width of the cline, which was better predicted by evolvability (standardized genetic variance). These results support the role of pollinator-mediated divergent selection in ecological speciation and illustrate the importance of genetic variance in determining divergence across hybrid zones.

Effects of experimental warming on floral scent, display, and rewards in two subalpine herbs.

BACKGROUND AND AIMS: Floral volatiles, visual traits, and rewards mediate attraction and defense in plant-pollinator and plant-herbivore interactions, but these floral traits may be altered by global warming through direct effects of temperature or longer term impacts on plant resources. We examined the effect of warming on floral and leaf volatile emissions, floral morphology, plant height, nectar production, and oviposition by seed predators. METHODS: We used open-top chambers that warmed plants in the field +2-3 °C on average (+6-11 °C increase in daily maxima) for 2-4 weeks across 1-3 years at 3 sites in Colorado, USA. Volatiles were sampled from two closely related species of subalpine Ipomopsis with different pollinators: I. aggregata ssp. aggregata, visited mainly by hummingbirds, and I. tenuituba ssp. tenuituba, often visited by hawkmoths. KEY RESULTS: While warming had no detected effects on leaf volatiles, the daytime floral volatiles of both I. aggregata and I. tenuituba responded in subtle ways to warming, with impacts that depended on the species, site, and year. In addition to the long-term effect of warming, temperature at the time of sampling independently affected the floral volatile emissions of I. aggregata during the day and I. tenuituba at night. Warming had little effect on floral morphology for either species, and no effect on nectar concentration, maximum inflorescence height, or flower redness in I. aggregata. However, warming increased nectar production in I. aggregata by 41%, a response that would attract more hummingbird visits, and reduced oviposition by fly seed predators by at least 72%. CONCLUSIONS: Our results suggest that floral traits can show different levels of plasticity to temperature changes in subalpine environments, with potential effects on animal behaviors that help or hinder plant reproduction. They also illustrate the need for more long-term field warming studies, as shown by responses of floral volatiles in different ways to weeks of warming versus temperature at the time of sampling.

Evolvability and trait function predict phenotypic divergence of plant populations.

Understanding the causes and limits of population divergence in phenotypic traits is a fundamental aim of evolutionary biology, with the potential to yield predictions of adaptation to environmental change. Reciprocal transplant experiments and the evaluation of optimality models suggest that local adaptation is common but not universal, and some studies suggest that trait divergence is highly constrained by genetic variances and covariances of complex phenotypes. We analyze a large database of population divergence in plants and evaluate whether evolutionary divergence scales positively with standing genetic variation within populations (evolvability), as expected if genetic constraints are evolutionarily important. We further evaluate differences in divergence and evolvability-divergence relationships between reproductive and vegetative traits and between selfing, mixed-mating, and outcrossing species, as these factors are expected to influence both patterns of selection and evolutionary potentials. Evolutionary divergence scaled positively with evolvability. Furthermore, trait divergence was greater for vegetative traits than for floral (reproductive) traits, but largely independent of the mating system. Jointly, these factors explained ~40% of the variance in evolutionary divergence. The consistency of the evolvability-divergence relationships across diverse species suggests substantial predictability of trait divergence. The results are also consistent with genetic constraints playing a role in evolutionary divergence.

Genetic potential for changes in breeding systems: Predicted and observed trait changes during artificial selection for male and female allocation in a gynodioecious species.

PREMISE: Evolution of separate sexes from hermaphroditism often proceeds through gynodioecy, but genetic constraints on this process are poorly understood. Genetic (co-)variances and between-sex genetic correlations were used to predict evolutionary responses of multiple reproductive traits in a sexually dimorphic gynodioecious species, and predictions were compared with observed responses to artificial selection. METHODS: Schiedea (Caryophyllaceae) is an endemic Hawaiian lineage with hermaphroditic, gynodioecious, subdioecious, and dioecious species. We measured genetic parameters of Schiedea salicaria and used them to predict evolutionary responses of 18 traits in hermaphrodites and females in response to artificial selection for increased male (stamen) biomass in hermaphrodites or increased female (carpel, capsule) biomass in females. Observed responses over two generations were compared with predictions in replicate lines of treatments and controls. RESULTS: In only two generations, both stamen biomass in hermaphrodites and female biomass in females responded markedly to direct selection, supporting a key assumption of models for evolution of dioecy. Other biomass traits, pollen and ovule numbers, and inflorescence characters important in wind pollination evolved indirectly in response to selection on sex allocation. Responses generally followed predictions from multivariate selection models, with some responses unexpectedly large due to increased genetic correlations as selection proceeded. CONCLUSIONS: Results illustrate the power of artificial selection and utility of multivariate selection models incorporating sex differences. They further indicate that pollen and ovule numbers and inflorescence architecture could evolve in response to selection on biomass allocation to male versus female function, producing complex changes in plant phenotype as separate sexes evolve.

Genetic and spatial variation in vegetative and floral traits across a hybrid zone.

PREMISE: Genetic variation influences the potential for evolution to rescue populations from impacts of environmental change. Most studies of genetic variation in fitness-related traits focus on either vegetative or floral traits, with few on floral scent. How vegetative and floral traits compare in potential for adaptive evolution is poorly understood. METHODS: We measured variation across source populations, planting sites, and genetic families for vegetative and floral traits in a hybrid zone. Seeds from families of Ipomopsis aggregata, I. tenuituba, and F1 and F2 hybrids of the two species were planted into three common gardens. Measured traits included specific leaf area (SLA), trichomes, water-use efficiency (WUE), floral morphology, petal color, nectar, and floral volatiles. RESULTS: Vegetative traits SLA and WUE varied greatly among planting sites, while showing weak or no genetic variation among source populations. Specific leaf area and trichomes responded plastically to snowmelt date, and SLA exhibited within-population genetic variation. All aspects of floral morphology varied genetically among source populations, and corolla length, corolla width, and sepal width varied genetically within populations. Heritability was not detected for volatiles due to high environmental variation, although one terpene had high evolvability, and high emission of two terpenes, a class of compounds emitted more strongly from the calyx than the corolla, correlated genetically with sepal width. Environmental variation across sites was weak for floral morphology and stronger for volatiles and vegetative traits. The inheritance of three of four volatiles departed from additive. CONCLUSIONS: Results indicate stronger genetic potential for evolutionary responses to selection in floral morphology compared with scent and vegetative traits and suggest potentially adaptive plasticity in some vegetative traits.

Feasibility and efficacy of a remotely delivered fall prevention exercise program for community-dwelling older adults with cancer: Protocol for the STABLE trial.

Falls are a major issue in older adults with cancer due to the effects of cancer and its treatments. Ample evidence in the general population of older adults has demonstrated the effectiveness of strength and balance training in reducing fall rates in older adults. However, data on effective fall prevention interventions in the oncology setting are lacking. The objective of this study is to evaluate the feasibility and efficacy of a remotely delivered, partially-supervised, resistance and balance training program on lower body strength, balance, and falls in community-dwelling older adults with cancer. The proposed study is an observer-blinded, parallel group (intervention group vs. control group) randomized controlled trial (ClinicalTrials.gov Identifier: NCT04518098). This study will recruit 74 eligible community-dwelling older adults with cancer from a comprehensive cancer centre. Intervention includes a remotely delivered exercise program for 3 months. Outcome measures include feasibility measures, lower body strength, balance, and fall rates. Research ethics approval has been granted by the Biomedical Research Ethics Boards of the University of Saskatchewan. If found effective, findings from this study will inform a subsequent, phase III definitive trial, with the ultimate goal to reduce falls and reduce impact on cancer treatment. Study findings will be disseminated through presentation at community level and scientific conferences, and in scientific journals. Trial registration: ClinicalTrials.gov identifier: NCT04518098.

Selection of Floral Traits by Pollinators and Seed Predators during Sequential Life History Stages.

AbstractOrganismal traits often influence fitness via interactions with multiple species. That selection is not necessarily predictable from pairwise interactions, such as when interactions occur during different life cycle stages. Theoretically, directional selection during two sequential episodes (e.g., pollination and seed survival) can generate quadratic or correlational selection for a set of traits that passes both selective filters. We compared strength of selection during pollination versus seed predation in the field and tested whether interactions with multiple species give rise to nonlinear selection on floral traits. We planted common gardens with seeds of two species of Ipomopsis and hybrids at sites where pollination was primarily by hummingbirds or also included hawk moths. We examined selection on six floral traits, including corolla width, sepal width, color, nectar, and two scent compounds. Female fitness (seeds) was broken down into fitness during (1) pollination (seeds initiated) and (2) seed predation (proportion of seeds escaping fly predation). All traits showed evidence of selection. Directional and quadratic selection were stronger during seed initiation than during seed predation. Correlational selection occurred mostly during seed initiation rather than arising from combining species interactions at two points in the life cycle. These results underscore how multispecies interactions can combine to exert selection on trait combinations.

Phenotypic plasticity and selection on leaf traits in response to snowmelt timing and summer precipitation.

Vegetative traits of plants can respond directly to changes in the environment, such as those occurring under climate change. That phenotypic plasticity could be adaptive, maladaptive, or neutral. We manipulated the timing of spring snowmelt and amount of summer precipitation in factorial combination and examined responses of specific leaf area (SLA), trichome density, leaf water content (LWC), photosynthetic rate, stomatal conductance and intrinsic water-use efficiency (iWUE) in the subalpine herb Ipomopsis aggregata. The experiment was repeated in three years differing in natural timing of snowmelt. To examine natural selection, we used survival, relative growth rate, and flowering as fitness indices. A 50% reduction in summer precipitation reduced stomatal conductance and increased iWUE, and doubled precipitation increased LWC. Combining natural and experimental variation, earlier snowmelt reduced soil moisture, photosynthetic rate and stomatal conductance, and increased trichome density and iWUE. Precipitation reduction reversed the mortality selection favoring high stomatal conductance under normal and doubled precipitation, and higher LWC improved growth. Earlier snowmelt is a strong signal of climate change and can change expression of leaf morphology and gas exchange traits, just as reduced precipitation can. Stomatal conductance and SLA showed adaptive plasticity under some conditions.

Multiparametric ultrasound versus multiparametric MRI to diagnose prostate cancer (CADMUS): a prospective, multicentre, paired-cohort, confirmatory study.

BACKGROUND: Multiparametric MRI of the prostate followed by targeted biopsy is recommended for patients at risk of prostate cancer. However, multiparametric ultrasound is more readily available than multiparametric MRI. Data from paired-cohort validation studies and randomised, controlled trials support the use of multiparametric MRI, whereas the evidence for individual ultrasound methods and multiparametric ultrasound is only derived from case series. We aimed to establish the overall agreement between multiparametric ultrasound and multiparametric MRI to diagnose clinically significant prostate cancer. METHODS: We conducted a prospective, multicentre, paired-cohort, confirmatory study in seven hospitals in the UK. Patients at risk of prostate cancer, aged 18 years or older, with an elevated prostate-specific antigen concentration or abnormal findings on digital rectal examination underwent both multiparametric ultrasound and multiparametric MRI. Multiparametric ultrasound consisted of B-mode, colour Doppler, real-time elastography, and contrast-enhanced ultrasound. Multiparametric MRI included high-resolution T2-weighted images, diffusion-weighted imaging (dedicated high B 1400 s/mm2 or 2000 s/mm2 and apparent diffusion coefficient map), and dynamic contrast-enhanced axial T1-weighted images. Patients with positive findings on multiparametric ultrasound or multiparametric MRI underwent targeted biopsies but were masked to their test results. If both tests yielded positive findings, the order of targeting at biopsy was randomly assigned (1:1) using stratified (according to centre only) block randomisation with randomly varying block sizes. The co-primary endpoints were the proportion of positive lesions on, and agreement between, multiparametric MRI and multiparametric ultrasound in identifying suspicious lesions (Likert score of ≥3), and detection of clinically significant cancer (defined as a Gleason score of ≥4 + 3 in any area or a maximum cancer core length of ≥6 mm of any grade [PROMIS definition 1]) in those patients who underwent a biopsy. Adverse events were defined according to Good Clinical Practice and trial regulatory guidelines. The trial is registered on ISRCTN, 38541912, and ClinicalTrials.gov, NCT02712684, with recruitment and follow-up completed. FINDINGS: Between March 15, 2016, and Nov 7, 2019, 370 eligible patients were enrolled; 306 patients completed both multiparametric ultrasound and multiparametric MRI and 257 underwent a prostate biopsy. Multiparametric ultrasound was positive in 272 (89% [95% CI 85-92]) of 306 patients and multiparametric MRI was positive in 238 patients (78% [73-82]; difference 11·1% [95% CI 5·1-17·1]). Positive test agreement was 73·2% (95% CI 67·9-78·1; κ=0·06 [95% CI -0·56 to 0·17]). Any cancer was detected in 133 (52% [95% CI 45·5-58]) of 257 patients, with 83 (32% [26-38]) of 257 being clinically significant by PROMIS definition 1. Each test alone would result in multiparametric ultrasound detecting PROMIS definition 1 cancer in 66 (26% [95% CI 21-32]) of 257 patients who had biopsies and multiparametric MRI detecting it in 77 (30% [24-36]; difference -4·3% [95% CI -8·3% to -0·3]). Combining both tests detected 83 (32% [95% CI 27-38]) of 257 clinically significant cancers as per PROMIS definition 1; of these 83 cancers, six (7% [95% CI 3-15]) were detected exclusively with multiparametric ultrasound, and 17 (20% [12-31]) were exclusively detected by multiparametric MRI (agreement 91·1% [95% CI 86·9-94·2]; κ=0·78 [95% CI 0·69-0·86]). No serious adverse events were related to trial activity. INTERPRETATION: Multiparametric ultrasound detected 4·3% fewer clinically significant prostate cancers than multiparametric MRI, but it would lead to 11·1% more patients being referred for a biopsy. Multiparametric ultrasound could be an alternative to multiparametric MRI as a first test for patients at risk of prostate cancer, particularly if multiparametric MRI cannot be carried out. Both imaging tests missed clinically significant cancers detected by the other, so the use of both would increase the detection of clinically significant prostate cancers compared with using each test alone. FUNDING: The Jon Moulton Charity Trust, Prostate Cancer UK, and UCLH Charity and Barts Charity.

Variation in floral volatiles across time, sexes, and populations of wind-pollinated Schiedea globosa.

PREMISE: Floral scent is a key aspect of plant reproduction, but its intraspecific variation at multiple scales is poorly understood. Sexual dimorphism and temporal regulation of scent can be shaped by evolution, and interpopulation variation may be a bridge to species differences. We tested whether intraspecific chemical diversity in a wind-pollinated species where selection from biotic pollination is absent is associated with genetic divergence across the Hawaiian archipelago. METHODS: Floral volatiles from females, males, and hermaphrodites of subdioecious Schiedea globosa grown in a common environment from 12 populations were sampled day and night and analyzed by gas chromatography-mass spectrometry. Variation among groups was analyzed by constrained ordination. We also examined the relationships of scent dissimilarity to geographic and genetic distance between populations. RESULTS: Flowers increased total emissions at night through higher emissions of several ketones, oximes, and phenylacetaldehyde. Females emitted less total scent per flower at night but more of some aliphatic compounds than males, and males emitted more ketones and aldoximes. Scent differed among populations during day and night. Divergence in scent produced at night increased with geographic distance within 70-100 km and increased with genetic distance for males during the day and night, but not for females. CONCLUSIONS: Schiedea globosa exhibits diel and sex-based variation in floral scent despite wind pollination and presumed loss of biotic pollination. In males, interpopulation scent differences are correlated with genetic differences, suggesting that scent evolved with dispersal within and across islands.

Earlier snow melt and reduced summer precipitation alter floral traits important to pollination.

Climate change can cause changes in expression of organismal traits that influence fitness. In flowering plants, floral traits can respond to drought, and that phenotypic plasticity has the potential to affect pollination and plant reproductive success. Global climate change is leading to earlier snow melt in snow-dominated ecosystems as well as affecting precipitation during the growing season, but the effects of snow melt timing on floral morphology and rewards remain unknown. We conducted crossed manipulations of spring snow melt timing (early vs. control) and summer monsoon precipitation (addition, control, and reduction) that mimicked recent natural variation, and examined plastic responses in floral traits of Ipomopsis aggregata over 3 years in the Rocky Mountains. We tested whether increased summer precipitation compensated for earlier snow melt, and if plasticity was associated with changes in soil moisture and/or leaf gas exchange. Lower summer precipitation decreased corolla length, style length, corolla width, sepal width, and nectar production, and increased nectar concentration. Earlier snow melt (taking into account natural and experimental variation) had the same effects on those traits and decreased inflorescence height. The effect of reduced summer precipitation was stronger in earlier snow melt years for corolla length and sepal width. Trait reductions were explained by drier soil during the flowering period, but this effect was only partially explained by how drier soils affected plant water stress, as measured by leaf gas exchange. We predicted the effects of plastic trait changes on pollinator visitation rates, pollination success, and seed production using prior studies on I. aggregata. The largest predicted effect of drier soil on relative fitness components via plasticity was a decrease in male fitness caused by reduced pollinator rewards (nectar production). Early snow melt and reduced precipitation are strong drivers of phenotypic plasticity, and both should be considered when predicting effects of climate change on plant traits in snow-dominated ecosystems.

Feasibility of a Remotely Delivered Strength and Balance Training Program for Older Adults with Cancer.

Falls are a major issue among older adults with cancer and lead to interruptions in cancer treatment. Resistance and balance training can prevent falls in older adults, but minimal evidence is available regarding the older cancer population, who often have unique risk factors. We used a pre-post design to assess the feasibility of a remotely delivered exercise program that progressed in difficulty and its efficacy on lower body strength, balance, and falls in older adults with cancer who had prior in-person exercise experience. Twenty-six older adults with cancer completed the intervention. Attendance rate for the virtual component was 97.6% and for the independent component was 84.7%. Participants perceived the program as rewarding and enjoyable (100%), felt this program prepared them to exercise on their own (92%), were confident to continue exercising on their own (81%), and would recommend the program to other patients (100%). The median balance score at baseline and end-of-study was 4 (IQR = 0). The median chair-stand time decreased from 9.2 s (IQR = 3.13) to 7.7 s (IQR = 4.6). A statistically significant difference in lower body strength (r = 0.68, p = 0.001) was detected post-intervention. The findings from this study can inform the design of a larger randomized trial.

Oncology clinic nurses' attitudes and perceptions regarding implementation of routine fall assessment and fall risk screening: A survey study.

Falls in older adults with cancer are often under-recognized and under-reported. The objective of this study was to explore oncology clinic nurses' willingness and perceived barriers to implement routine falls assessment and falls screening in their practice. Nurses working in outpatient oncology clinics were invited to complete an online survey. Data were analyzed using descriptive statistics and sorted into thematic categories. The majority of respondents indicated willingness to routinely ask older patients about falls (85.7%) and screen for fall risks (73.5%). The main reasons for unwillingness included: belief that patients report falls on their own, lack of time, and lack of support staff. Findings from this study show many oncology nurses believe in the importance of routine fall assessment and screening and are willing to implement them routinely, although falls are not routinely asked about or assessed. Future work should explore strategies to address barriers nurses face given the implications of falls amongst this vulnerable population.

Water availability affects the relationship between pollen intensity and seed production.

Seed production can be affected by water availability and also depend on the amount (pollen intensity) and quality of pollen deposited. The way pollen receipt on the stigma translates into seeds produced follows that of a saturating dose-response. Not only can water availability and pollen intensity each influence seed production, these factors could interact in their effects on seed production. Changes to the relationship between seed production and pollen intensity can in turn influence pollinator effectiveness and pollinator-mediated selection. We asked how water availability affected indices of plant fitness (seed set, fruit set and seed mass) and the relationship between pollen intensity and seed production in Phacelia parryi. We conducted a greenhouse experiment where we manipulated water availability (either high- or low-water) to pollen recipient plants and hand-pollinated each plant with a range of pollen intensities. We conducted 703 hand-pollinations on 30 plants. For each hand-pollinated flower we measured pollen deposited, seed production and seed mass. We then generated a piecewise regression of the relationship between pollen intensity and seed production, and determined average effects of water on plant fitness measures. This experiment was paired with a field observational study aimed to document natural variation in pollen deposition. Average seed production per fruit was 21 % higher in the high-watered plants. The relationship between pollen intensity and seed production differed between the two water treatments. Plants under high-water exhibited a wider range in which pollen deposition increased seed production. Average natural pollen intensities fell within different regions of the piecewise regression for low- and high-water plants. Water availability can alter the efficiency by which pollen received is translated into seeds produced. Our greenhouse data suggest that only under certain pollen intensity environments will water availability affect how pollen received is translated into seeds produced.

Floral Scent Composition and Fine-Scale Timing in Two Moth-Pollinated Hawaiian Schiedea (Caryophyllaceae).

Floral scent often intensifies during periods of pollinator activity, but the degree of this synchrony may vary among scent compounds depending on their function. Related plant species with the same pollinator may exhibit similar timing and composition of floral scent. We compared timing and composition of floral volatiles for two endemic Hawaiian plant species, Schiedea kaalae and S. hookeri (Caryophyllaceae). For S. kaalae, we also compared the daily timing of emission of floral volatiles to evening visits of their shared pollinator, an endemic Hawaiian moth (Pseudoschrankia brevipalpis; Erebidae). The identity and amount of floral volatiles were measured in the greenhouse during day and evening periods with dynamic headspace sampling and GC-MS (gas chromatography - mass spectrometry). The timing of emissions (daily rise, peak, and fall) was measured by sampling continuously for multiple days in a growth chamber with PTR-MS (proton transfer reaction mass spectrometry). Nearly all volatiles detected underwent strong daily cycles in emission. Timings of floral volatile emissions were similar for S. kaalae and S. hookeri, as expected for two species sharing the same pollinator. For S. kaalae, many volatiles known to attract moths, including several linalool oxides and 2-phenylacetaldehyde, peaked within 2 h of the peak visitation time of the moth which pollinates both species. Floral volatiles of both species that peaked in the evening were also emitted several hours before and after the brief window of pollinator activity. Few volatiles followed a daytime emission pattern, consistent with increased apparency to visitors only at night. The scent blends of the two species differed in their major components and were most distinct from each other in the evening. The qualitative difference in evening scent composition between the two Schiedea species may reflect their distinct evolutionary history and may indicate that the moth species uses several different floral cues to locate rewards.

Pollinator visitation rate and effectiveness vary with flowering phenology.

PREMISE: Flowering time may influence pollination success and seed set through a variety of mechanisms, including seasonal changes in total pollinator visitation or the composition and effectiveness of pollinator visitors. METHODS: We investigated mechanisms by which changes in flowering phenology influence pollination and reproductive success of Mertensia ciliata (Boraginaceae). We manipulated flowering onset of potted plants and assessed the frequency and composition of pollinator visitors, as well as seed set. We tested whether floral visitors differed in their effectiveness as pollinators by measuring pollen receipt and seed set resulting from single visits to virgin flowers. RESULTS: Despite a five-fold decrease in pollinator visitation over four weeks, we detected no significant difference in seed set among plants blooming at different times. On a per-visit basis, each bumblebee transferred more conspecific pollen than did a solitary bee or a fly. The proportion of visits by bumblebees increased over the season, countering the decrease in visitation rate so that flowering time had little net effect on seed set. CONCLUSIONS: This work illustrates the need to consider pollinator effectiveness, along with changes in pollinator visitation and species composition to understand the mechanisms by which phenology affects levels of pollination.

Noninvasive Detection of Clinically Significant Prostate Cancer Using Circulating Tumor Cells.

PURPOSE: Prostate specific antigen testing results in unnecessary biopsy and over diagnosis with consequent overtreatment. Tissue biopsy is an invasive procedure associated with significant morbidity. More accurate noninvasive or minimally invasive diagnostic approaches should be developed to avoid unnecessary prostate biopsy and over diagnosis. We investigated the potential of using circulating tumor cell analysis in cancer diagnosis, particularly to predict clinically significant prostate cancer in prebiopsy cases. MATERIALS AND METHODS: We enrolled 155 treatment naïve patients with prostate cancer and 98 before biopsy for circulating tumor cell enumeration. RNA was extracted from circulating tumor cells of 184 patients for gene expression analysis. The Kruskal-Wallis and Spearman rank tests, multivariate logistic regression and the random forest method were applied to assess the association of circulating tumor cells with aggressive prostate cancer. RESULTS: Of patients with localized prostate cancer 54% were scored as having positive circulating tumor cells, which was associated with a higher Gleason score (p=0.0003), risk group (p <0.0001) and clinically significant prostate cancer (p <0.0001). In the prebiopsy group a positive circulating tumor cell score combined with prostate specific antigen predicted clinically significant prostate cancer (AUC 0.869). A 12-gene panel prognostic for clinically significant prostate cancer was also identified. When combining the prostate specific antigen level, the circulating tumor cell score and the 12-gene panel, the AUC of clinically significant prostate cancer prediction was 0.927. Adding those data to cases with available multiparametric magnetic resonance imaging data significantly increased prediction accuracy (AUC 0.936 vs 0.629). CONCLUSIONS: Circulating tumor cell analysis has the potential to significantly improve patient stratification by prostate specific antigen and/or multiparametric magnetic resonance imaging for biopsy and treatment.

Early snowmelt projected to cause population decline in a subalpine plant.

How climate change influences the dynamics of plant populations is not well understood, as few plant studies have measured responses of vital rates to climatic variables and modeled the impact on population growth. The present study used 25 y of demographic data to analyze how survival, growth, and fecundity respond to date of spring snowmelt for a subalpine plant. Fecundity was estimated by seed production (over 15 y) and also divided into flower number, fruit set, seeds per fruit, and escape from seed predation. Despite no apparent effects on flower number, plants produced more seeds in years with later snowmelt. Survival and probability of flowering were reduced by early snowmelt in the previous year. Based on demographic models, earlier snowmelt with warming is expected to lead to negative population growth, driven especially by changes in seedling establishment and seed production. These results provide a rare example of how climate change is expected to influence the dynamics of a plant population. They furthermore illustrate the potential for strong population impacts even in the absence of more commonly reported visual signs, such as earlier blooming or reduced floral display in early melting years.