Integrating electronic geriatric assessment and frailty screening for adults with acute myeloid leukemia to drive personalized treatment decisions.

Purpose: Evidenced based guidelines for patients with Acute Myeloid Leukemia (AML) acknowledge increasing importance of frailty assessment when deciding on treatment, yet comprehensive geriatric assessment (GA) results are not easily incorporated into clinic workflows and the electronic health record. This study assessed the feasibility of electronic GA use in a real-world environment.

Methods: Patients with AML, ≥ 60 years and at a treatment decision-making point were recruited at three academic institutions.

Goals, preferences, and concerns of patients with acute myeloid leukemia at time of treatment decision.

Introduction: Current cancer value-based models require documentation of patient goals of care and an evidence-based treatment course commensurate with patient goals. This feasibility study assessed the utility of an electronic tablet-based questionnaire to elicit patient goals, preferences, and concerns at a treatment decision making time point in patients with acute myeloid leukemia.

Materials And Methods: Seventy-seven patients were recruited from three institutions prior to seeing the physician for treatment decision-making visit.

Context-dependent concordance between physiological divergence and phenotypic selection in sister taxa with contrasting phenology and mating systems.

Premise: The study of phenotypic divergence of, and selection on, functional traits in closely related taxa provides the opportunity to detect the role of natural selection in driving diversification. If the strength or direction of selection in field populations differs between taxa in a pattern that is consistent with the phenotypic difference between them, then natural selection reinforces the divergence. Few studies have sought evidence for such concordance for physiological traits.

Could seasonally deteriorating environments favour the evolution of autogamous selfing and a drought escape physiology through indirect selection? A test of the time limitation hypothesis using artificial selection in Clarkia.

Background And Aims: The evolution of selfing from outcrossing may be the most common transition in plant reproductive systems and is associated with a variety of ecological circumstances and life history strategies. The most widely discussed explanation for these associations is the reproductive assurance hypothesis - the proposition that selfing is favoured because it increases female fitness when outcross pollen receipt is limited. Here an alternative explanation, the time limitation hypothesis, is addressed, one scenario of which proposes that selfing may evolve as a correlated response to selection for a faster life cycle in seasonally deteriorating environments.

Functional role of long-lived flowers in preventing pollen limitation in a high elevation outcrossing species.

Low pollinator visitation in harsh environments may lead to pollen limitation which can threaten population persistence. Consequently, avoidance of pollen limitation is expected in outcrossing species subjected to habitually low pollinator service. The elevational decline in visitation rates on many high mountains provides an outstanding opportunity for addressing this question.

Plastic Responses Contribute to Explaining Altitudinal and Temporal Variation in Potential Flower Longevity in High Andean Rhodolirion montanum.

The tendency for flower longevity to increase with altitude is believed by many alpine ecologists to play an important role in compensating for low pollination rates at high altitudes due to cold and variable weather conditions. However, current studies documenting an altitudinal increase in flower longevity in the alpine habitat derive principally from studies on open-pollinated flowers where lower pollinator visitation rates at higher altitudes will tend to lead to flower senescence later in the life-span of a flower in comparison with lower altitudes, and thus could confound the real altitudinal pattern in a species´ potential flower longevity. In a two-year study we tested the hypothesis that a plastic effect of temperature on flower longevity could contribute to an altitudinal increase in potential flower longevity measured in pollinator-excluded flowers in high Andean Rhodolirium montanum Phil.

Interoceptive awareness and its relationship to hippocampal dependent processes.

Many neuropsychological and animal lesion studies point to the hippocampus as being critical for mediating interoceptive awareness, while neuroimaging studies have been used to argue for the importance of the insula and anterior cingulate cortex. Here, using healthy young adults - as with the neuroimaging data - we tested for an association between performance on a hippocampal dependent learning and memory (HDLM) measure (logical memory percent retention) and interoceptive awareness assessed on three tasks - heart rate tracking, water loading and the Multidimensional Assessment of Interoceptive Awareness questionnaire (MAIA). After controlling for other relevant potentially confounding variables, we found significant associations between both the water loading and MAIA measures (which were both correlated) and HDLM performance.

Outcrossing and photosynthetic rates vary independently within two Clarkia species: implications for the joint evolution of drought escape physiology and mating system.

Background and Aims Mating systems of plants are diverse and evolutionarily labile. Abiotic environmental factors, such as seasonal drought, may impose selection on physiological traits that could lead to transitions in mating system if physiological traits are genetically correlated with traits that influence mating system. Within Clarkia, self-fertilizing taxa have higher photosynthetic rates, earlier flowering phenology, faster individual floral development and more compressed flowering periods than their outcrossing sister taxa, potentially reducing the selfing taxa's exposure to drought.

Seasonal changes in physiological performance in wild Clarkia xantiana populations: Implications for the evolution of a compressed life cycle and self-fertilization.

Premise Of The Study: One explanation for the evolution of selfing, the drought escape hypothesis, proposes that self-fertilization may evolve under conditions of intensifying seasonal drought as part of a suite of traits that enable plants to accelerate the completion of their life cycle, thereby escaping late-season drought. Here, we test two fundamental assumptions of this hypothesis in Clarkia xantiana: (1) that a seasonal decline in precipitation causes an increase in drought stress and (2) that this results in changes in physiological performance, reflecting these deteriorating conditions.

Methods: We examined seasonal and interannual variation in abiotic environmental conditions (estimated by ambient temperature, relative humidity, predawn leaf water potentials, and carbon isotope ratios) and physiological traits (photosynthesis, conductance, transpiration, instantaneous water-use efficiency, ascorbate peroxidase and glutathione reductase activities, quantum yield of photosystem II, PSII potential efficiency) in field populations of C.

Temperature-driven flower longevity in a high-alpine species of Oxalis influences reproductive assurance.

How high-alpine plants confront stochastic conditions for animal pollination is a critical question. We investigated the effect of temperature on potential flower longevity (FL) measured in pollinator-excluded flowers and actual FL measured in pollinated flowers in self-incompatible Oxalis compacta and evaluated if plastically prolonged potential FL can ameliorate slow pollination under cool conditions. Pollinator-excluded and hand-pollinated flowers were experimentally warmed with open-top chambers (OTCs) on a site at 3470 m above sea level (asl).

Physiological performance and mating system in Clarkia (Onagraceae): does phenotypic selection predict divergence between sister species?

Premise Of The Study: The evolution of self-fertilization often occurs in association with other floral, life history, and fitness-related traits. A previous study found that field populations of Clarkia exilis (a predominantly autogamous selfer) and its sister species, Clarkia unguiculata (a facultative outcrosser) differ in mean photosynthetic rates and instantaneous water use efficiency (WUE(i)). Here, we investigate the strength and direction of selection on these traits in multiple populations of each taxon to determine whether natural selection may contribute to the phenotypic differences between them.

Stability of pollen-ovule ratios in pollinator-dependent versus autogamous Clarkia sister taxa: testing evolutionary predictions.

It has been proposed that natural selection should favor distinct temporal patterns of sex allocation in selfing vs pollinator-dependent taxa. In autogamous selfers in which pollen receipt is highly reliable, selection should favor genotypes that maintain low and stable pollen to ovule (P : O) ratios throughout flowering. By contrast, in outcrossers the optimum P : O ratio of an individual's flowers will depend on pollinator abundances and mating opportunities, both of which may vary over time.

Stage-dependent patterns of drought tolerance and gas exchange vary between sexes in the alpine willow, Salix glauca.

Females and males of sexually dimorphic species have distinct resource demands due to differential allocation to reproduction. Sexual allocation theory predicts that functional traits will diverge between sexes to support these demands. However, such dimorphism may be masked by the impact of current reproduction on source-sink interactions between vegetative and reproductive organs.

Ecological correlates of secondary sexual dimorphism in Salix glauca (Salicaceae).

The ecological causation hypothesis for secondary sexual dimorphism was tested in Salix glauca, a dioecious willow shrub. Plants growing in a Colorado Rocky Mountain (USA) krummholz mosaic of mesic and xeric patches were monitored for four consecutive years. Ecological causation is predicated on unique resource demands associated with sexual function.