Multiple Mixed Models Research Articles

Adaptability and stability of eucalypt clones at different ages across environmental gradients in Brazil

The genetic gains from eucalypt breeding programs have decreased compared to previous decades while productivity reduced in recent years. This decrease is mainly attributed to climate change that, according to studies, has been limiting productivity and changing the adaptation of forest species. But other aspects can be listed, as pests and diseases and decreasing gains with the advance of breeding programs. The objective of this work is to investigate the genotype × site × age interaction in a multi-environment trial with eucalypt clones to verify the adaptability and stability of the genotypes and, finally, to identify mega-environments over time, as well as the influence of climate variables on the genotype performances. The trait diameter at breast height (DBH) of 11 Eucalyptus commercial clones at 11 sites (range from −0.84 to −24.23 latitude and from −39.60 to −52.59 longitude) and three evaluated ages (Age 1 – ranging from 13 to 17 months after planting; Age 2 – from 31 to 34 months; Age 3 – from 48 to 53 months old) was measured and analyzed by factor analytic multiplicative mixed (FAMM) model associated with the GGE biplot and multivariate regression tree using climate variables. A significant G × E interaction and genotypes with different performance across environments and ages were observed. There are clones with high adaptability to specific sites while others show good stability. The results clustered the sites into three mega-environments according to a latitude gradient, over time. The performance of Eucalyptus clones over time indicate precisely either roughly similar or extremely contrasting environments. Temperature affected the most the clustering of the studied sites followed by the latitudinal gradient, impacting productivity negatively, regardless of age. These results may help future studies on the development of selection strategies in tropical regions to address climate change and assist forest breeding programs to deal with the effect of climate change on eucalypt productivity.

Recovering the capability to work among patients with chronic low Back pain after a four-week, multidisciplinary biopsychosocial rehabilitation program: 18-month follow-up study

BackgroundChronic low back pain (LBP) is a leading cause of disability worldwide. Biopsychosocial rehabilitation programs have been advocated for its management, especially since the widespread acceptance of the biopsychosocial model of chronic pain. Despite extensive evidence of its short-term benefits, few studies have reported on its long-term effect and more specifically on indirect outcomes such as return to work and quality of life (QoL). The present study evaluated the long-term effect of a multidisciplinary biopsychosocial rehabilitation (MBR) program for patients with chronic LBP, for which short- and intermediate-term efficacy had been established, with an emphasis on recovering work capability.MethodsThis prospective cohort study enrolled 201 patients on a four-week MBR program incorporating physical and occupational therapies and psychological counselling. Assessments occurred at program admission and discharge and at 6 and 18 months. Work capability, Oswestry Disability Index, Tampa Scale for Kinesiophobia, Core Outcome Measures Index (COMI), and Hospital Anxiety and Depression Scale were assessed. Multiple mixed models were used to detect changes in each outcome. Logistic regressions were calculated to identify predictors of recovery of work capability.ResultsOf the 201 patients who fulfilled the eligibility criteria, 160 (79.8%) attended the discharge assessment, 127 (63.2%) attended the 6-month follow-up, and 107 (53.3%) continued to the 18-month follow-up. Initially, 128 patients (71.5%) had been on sick leave. At 6 and 18 months, 72 (56.7%) and 84 (78.5%) participants had recovered their work capability, respectively. There were significant improvements in pain, disability, kinesiophobia, and anxiety and depression scores over time. Patients who recovered work capability showed significantly greater improvements in their total COMI score, general QoL, and disability, which were the best three predictors of recovering work capability.ConclusionsThis study extends previous results confirming the program’s contribution to recovering work capability among chronic LBP patients.

Fast hybrid Bayesian integrative learning of multiple gene regulatory networks for type 1 diabetes.

Motivated by the study of the molecular mechanism underlying type 1 diabetes with gene expression data collected from both patients and healthy controls at multiple time points, we propose a hybrid Bayesian method for jointly estimating multiple dependent Gaussian graphical models with data observed under distinct conditions, which avoids inversion of high-dimensional covariance matrices and thus can be executed very fast. We prove the consistency of the proposed method under mild conditions. The numerical results indicate the superiority of the proposed method over existing ones in both estimation accuracy and computational efficiency. Extension of the proposed method to joint estimation of multiple mixed graphical models is straightforward.

Regional differences in heart failure hospitalizations, mortality, and readmissions in Slovenia 2004-2012.

AimsHeart failure (HF) burden is displaying significant inter‐regional differences within Europe and within countries. Due to limited data focusing on regional differences, our aim was to evaluate HF hospitalizations, readmissions, and mortality burden in Slovenian statistical regions.Methods and resultsThe Slovenian National Hospitalization Discharge Registry was searched for HF hospitalizations in patients 20 years or over in the period 2004–12. Annual sex and age‐standardized HF hospitalizations, mortality, and HF readmissions rates were calculated for Slovenia and for each Slovenian statistical region. Trends were evaluated using ANOVA. Multiple mixed effect logistic regression models, which included statistical region, admission year, sex, age, intensive care unit treatment, and co‐morbidities as a fixed effect and hospital identifier as a random effect, were calculated for mortality and readmissions. Overall, 156 859 HF hospitalizations (55 522 where HF was coded as a main diagnosis and 43 606 as first HF hospitalizations) were recorded. Annual standardized rates varied considerably between statistical regions for main (220–511) and first HF hospitalization (392–721), 30 day (12.6–27.1) and 1 year mortality (66–117), and 30 day (31–80.8) and 1 year readmission (99–24) (per 100 000 patient years in 2012). Yearly decline in HF hospitalization rates was seen for national main (3.6; 0.001) and first (8.4; 0.083) HF hospitalizations, while individual regional main and first HF hospitalization trends mostly did not reach statistical significance. No relevant differences in mortality and readmission endpoints for statistical regions were seen when adjusted for patient demographics and specific co‐morbidities.ConclusionsSignificant regional differences in standardized HF hospitalization, mortality, and readmissions between the regions were seen. There were no differences in mortality and readmissions between statistical regions for individual similar patients.

The Role of Socioeconomic Status in the Association of Lung Function and Air Pollution-A Pooled Analysis of Three Adult ESCAPE Cohorts.

Ambient air pollution is a leading environmental risk factor and its broad spectrum of adverse health effects includes a decrease in lung function. Socioeconomic status (SES) is known to be associated with both air pollution exposure and respiratory function. This study assesses the role of SES either as confounder or effect modifier of the association between ambient air pollution and lung function. Cross-sectional data from three European multicenter adult cohorts were pooled to assess factors associated with lung function, including annual means of home outdoor NO2. Pre-bronchodilator lung function was measured according to the ATS-criteria. Multiple mixed linear models with random intercepts for study areas were used. Three different factors (education, occupation and neighborhood unemployment rate) were considered to represent SES. NO2 exposure was negatively associated with lung function. Occupation and neighborhood unemployment rates were not associated with lung function. However, the inclusion of the SES-variable education improved the models and the air pollution-lung function associations got slightly stronger. NO2 associations with lung function were not substantially modified by SES-variables. In this multicenter European study we could show that SES plays a role as a confounder in the association of ambient NO2 exposure with lung function.

The Mixed Assessor Model and the multiplicative mixed model

A novel possibility for easy and open source based analysis of sensory profile data by a formal multiplicative mixed model (mumm) with fixed product effects and random assessor effects is presented by means of the generic statistical R-package mumm. The package is using likelihood principles and is utilizing newer developments within Automatic Differentiation by means of the Template Model Builder R-package. We compare such formal likelihood based analysis with the Mixed Assessor Model (MAM) analysis, where MAM is a linear approximation of the multiplicative mixed model. We use real sensory data as examples together with simulated data. We found that the formal mumm approach for hypothesis testing more resembles the MAM than the standard 2-way mixed model, and that both the mumm approach and the MAM give a higher power to detect product differences than the 2-way mixed model, when a “scaling effect” is present. We also validated that the novel contrast confidence limit method suggested previously for the MAM performs well and in line with the formal likelihood based confidence intervals of the mumm. Finally, the likelihood based mumm approach suggests that the more proper test for product difference would be a test that has a “joint product and scaling effect” interpretation.

Understanding the influence of perceived fatigue on coordination during endurance running

ABSTRACT During the course of a training programme, runners will typically increase running velocity and volume possibly encountering fatigue during a run, which is characterised as a feeling of general tiredness. The purpose of the current study was to identify whether or not level of perceived fatigue affects coordination and coordination variability in healthy runners during the recovery velocity of an endurance interval run. A total of 20 endurance runners completed a 1-hour run that included running velocity intervals at 75% of estimated 10 k race pace (5 minutes) and estimated 10 k race pace (1 minute). After each run, participants completed a fatigue questionnaire and were grouped based on their post-run self-reported perceived fatigue. 3D motion capture data were collected during the run and analysed to generate coordination patterns and variability of the patterns as dependent variables. Multiple mixed model ANOVAs were conducted to test for differences between perceived fatigue groups. Coordination and variability differences were reported in a number of couplings during transition phases (late and early stance) and events (toe-off and foot contact) of the gait cycle. It was concluded that the level of perceived fatigue affected coordination and coordination variability during the recovery velocity of a 1-hour interval run.

Acceptance and Commitment Therapy for Trichotillomania: A Randomized Controlled Trial of Adults and Adolescents.

The purpose of this study was to examine acceptance and commitment therapy (ACT) as a standalone treatment for trichotillomania in a randomized controlled trial of adults and adolescents. Participants consisted of a community sample of treatment seeking adults and adolescents with trichotillomania. Of the eligible 39 participants randomized into treatment and waitlist groups, 25 completed treatment and were included in the final analysis. Treatment consisted of a 10-session ACT protocol. Multiple mixed models repeated measures analyses were utilized to evaluate changes in trichotillomania symptom severity, daily number of hairs pulled and urges experienced, and experiential avoidance from pretreatment to posttreatment. Findings indicated significant changes in symptom severity and daily hairs pulled, but not daily urges experienced or psychological flexibility. However, psychological flexibility saw a 24.5% decrease in the treatment group and reduced from clinical to subclinical levels on average. This study suggests that ACT alone is an effective treatment for adults and adolescents with trichotillomania. Outcomes appear to be similar to trials that combined ACT and habit reversal training (HRT).

Association of Thyroid Function and Autoimmunity with Ovarian Reserve in Women Seeking Infertility Care.

While overt thyroid disease is a well known risk factor for infertility, the potential consequences of mild thyroid dysfunction or thyroid autoimmunity remain unknown. Experimental studies suggest a considerable role for thyroid hormone in the physiological mechanisms of ovarian reserve, but translation of such findings to human studies remains rare. A potential role for thyroid function in female reproduction could be especially relevant when the cause of infertility remains unknown, such as in women with diminished ovarian reserve (DOR) or unexplained infertility. The aims of this study were to investigate the association of thyroid function and autoimmunity with markers of ovarian reserve day 3 follicle-stimulating hormone (FSH) concentrations and antral follicle count (AFC), and to investigate whether thyroid function or autoimmunity may have different effects in women with DOR or unexplained infertility. Thyrotropin, free thyroxine, thyroxine, free triiodothyronine (fT3), triiodothyronine, thyroid peroxidase antibodies (TPOAbs), and thyroglobulin antibodies (TgAbs), as well as AFC and the day 3 FSH concentration, were measured among women seeking fertility treatment at the Massachusetts General Hospital Fertility Center. Multiple linear or mixed regression models were used to study the association of thyroid function or autoimmunity with AFC or day 3 FSH. In the total study population (436 women, 530 AFC measurements), there was no association of thyroid function or TPOAb positivity with AFC. However, TgAb positivity was associated with a higher AFC (mean difference = 3.4 [95% confidence interval (CI) 1.8-5.1], p < 0.001). In women with DOR or unexplained infertility, lower fT3 and TPOAb positivity were associated with a lower AFC (fT3: continuous nonlinear association, p = 0.009; TPOAb positivity: -2.3 follicles [confidence interval -3.8 to -0.5], p = 0.01), while TgAb positivity was not associated with AFC. Neither thyroid function nor thyroid antibody positivity was associated with the day 3 FSH concentration. This study found that lower fT3 and TPOAb positivity are associated with a lower AFC in women with DOR or unexplained infertility. Future studies are required to replicate these findings and further elucidate the role of TgAbs and underlying mechanisms through which thyroid function and autoimmunity is associated with ovarian reserve.

Exercise-specific volition and motivation for weight loss maintenance following an intensive lifestyle intervention.

The present study investigated the influence of exercise-specific motivation and volition on weight loss maintenance following an intensive lifestyle intervention (ILI). The study participants were 164 individuals with obesity (body mass index [BMI] > 30 kg/m2) that participated in an ILI. Participants' exercise-specific volition and motivation were assessed before and after the intervention as well as 3 and 12 months after completion. Volition was measured with the Volition in Exercise Questionnaire and motivation was measured with the context translated Sport Motivation Scale. Mixed model analysis revealed that when adjusting for gender, age, and education, the 6 volitional scales and intrinsic motivation predicted BMI across the 4 time points, whereas 6 volitional scales and 2 extrinsic regulation scales showed a time interaction. Backward elimination multiple mixed model analysis revealed that Volitional Inhibition - Postponing Training and Volitional Facilitation - Self-Confidence predicted BMI development, whereas Volitional Inhibition - Unrelated Thoughts, Identified Regulation, and Introjected Regulation showed a time interaction above and beyond the other scales. Exercise-specific volition and motivation influence weight loss maintenance following an ILI. Volitional self-confidence and the tendency to postpone training are of importance above and beyond the previously identified predictor of autonomous exercise motivation. Results of the study also indicate that extrinsic motivation can be either facilitating or counterproductive depending on the level of self-determination. (PsycINFO Database Record

Sample Size Determination for a 3-Treatment 3-Period Crossover Trial in Frequency Data

To reduce the number of patients needed or increase the power of hypothesis testing for the parallel groups design, the crossover design has been often employed when one is studying noncurable chronic diseases. This article focuses attention on sample size calculation for testing non-inferiority and equality in frequency data under a 3-treatment 3-period crossover trial. Under a multiplicative mixed effects model, this article provides asymptotic sample size calculation procedures for testing non-inferiority of an experimental treatment to a control treatment, as well as for simultaneously testing either of 2 treatments versus a placebo. To improve the performance of these asymptotic procedures in small-sample cases, this article further suggests a simple ad hoc adjustment. On the basis of Monte Carlo simulation, we demonstrate that the asymptotic test procedures proposed here can perform well with respect to Type I error. We find that the asymptotic sample size calculation procedures can generally perform well with respect to power when the resulting sample size is moderate or large. We further find that using the simple ad hoc adjustment can improve the performance of the proposed sample size calculation procedures, which are derived from large-sample theory, in small-sample cases.

Improving accuracies of genomic predictions for drought tolerance in maize by joint modeling of additive and dominance effects in multi-environment trials.

Breeding for drought tolerance is a challenging task that requires costly, extensive, and precise phenotyping. Genomic selection (GS) can be used to maximize selection efficiency and the genetic gains in maize (Zea mays L.) breeding programs for drought tolerance. Here, we evaluated the accuracy of genomic selection (GS) using additive (A) and additive + dominance (AD) models to predict the performance of untested maize single-cross hybrids for drought tolerance in multi-environment trials. Phenotypic data of five drought tolerance traits were measured in 308 hybrids along eight trials under water-stressed (WS) and well-watered (WW) conditions over two years and two locations in Brazil. Hybrids' genotypes were inferred based on their parents' genotypes (inbred lines) using single-nucleotide polymorphism markers obtained via genotyping-by-sequencing. GS analyses were performed using genomic best linear unbiased prediction by fitting a factor analytic (FA) multiplicative mixed model. Two cross-validation (CV) schemes were tested: CV1 and CV2. The FA framework allowed for investigating the stability of additive and dominance effects across environments, as well as the additive-by-environment and the dominance-by-environment interactions, with interesting applications for parental and hybrid selection. Results showed differences in the predictive accuracy between A and AD models, using both CV1 and CV2, for the five traits in both water conditions. For grain yield (GY) under WS and using CV1, the AD model doubled the predictive accuracy in comparison to the A model. Through CV2, GS models benefit from borrowing information of correlated trials, resulting in an increase of 40% and 9% in the predictive accuracy of GY under WS for A and AD models, respectively. These results highlight the importance of multi-environment trial analyses using GS models that incorporate additive and dominance effects for genomic predictions of GY under drought in maize single-cross hybrids.

An exact approach for tactical planning and patient selection for elective surgeries

The allocation of operating theatres plays a crucial role in hospital management. This paper describes the elective surgery planning problem at a tactical level, motivated by a case study in a local hospital in Melbourne. In this paper, we define a unique problem for determining an allocation of blocks of time on each day of a four-week cycle to surgical units while also selecting patient types to treat. A unique aspect of the problem is that a base Master Surgery Schedule (MSS) is given, and that the difference between the new optimal plan and the current MSS is bounded by a specified allowance.We take into account a range of constraints related to availability of resources (human and material), multiple (possibly conflicting) objectives, as well as regulatory and legal controls. We assume similar patients in each surgical unit are grouped together and each patient waiting to have surgery is classified to a given surgery group that has a given resource demand, including duration of surgery and length of stay in the hospital. We present a multiple objective mixed integer programming model of this problem including some computational results. This model can provide insightful information to decision makers in the hospital whether they can meet their KPIs with their current resources and also the effect of increasing resources on various KPIs. Computational results show that most solutions can be obtained in a reasonable amount of time in multiple scenarios which is a significant result from computational and practical point view.

The dimensionality of individual niche variation.

The inherently multidimensional nature of the niche has not yet been integrated into the investigation of individual niche specialization within populations. We propose a framework for modeling the between- and within-individual components of the population niche as a set of variance-covariance matrices, which can be visualized with ellipses or ellipsoids. These niche components can be inferred using multiple response mixed models, and can incorporate diverse types of data, including diet composition, stable isotopes, spatial location, and other continuous measures of niche dimensions. We outline how considering both individual and population niches in multiple dimensions may enhance our understanding of key concepts in ecology and evolution. Considering multiple dimensions as well as the within-individual component of variation can lead to more meaningful measures of niche overlap between species. The impact of a population on its food web or ecosystem can depend on the degree of individual variation (via Jensen's inequality), and we suggest how the dimensionality of individual specialization could amplify this effect. Finally, we draw from concepts in quantitative genetics and the study of animal personalities to propose new hypotheses about the ecological and evolutionary basis of niche shifts in multiple dimensions. We illustrate key ideas using empirical data from sea otters, wetland frogs, and threespine stickleback, and discuss outstanding questions about the consequences of multidimensional niche variation. Setting variation among individuals in an explicitly multivariate framework has the potential to transform our understanding of a range of ecological and evolutionary processes.

Bronze Age subsistence strategies in the southeastern Carpathian Bend area, Romania: Results from stable isotope analyses

Here we report the results of stable carbon and nitrogen isotope analyses of human and faunal remains from two Bronze Age (Monteoru culture) sites near Buzău in Romania, in the eastern foothills of the Carpathian Mountains. The results for 54 humans from Sărata Monteoru and 10 from Cârlomăneşti indicate diets that were dominated by C3 terrestrial resources, consistent with the archaeofaunal inventories from the sites and archaeobotanical data from the wider region. Statistically significant differences in the average δ15N values of the two skeletal populations hint at a change in economic practices between early and late phases of the Monteoru culture. Consumer diets at the two sites were quantified using multiple mixing models generated with the Bayesian statistical program FRUITS (Food Reconstruction Using Isotopic Transferred Signals). The model outputs suggest the inhabitants of the later settlement, Sărata Monteoru, were less dependent on animal-derived products and relied more on cereals and legumes for energy and protein, compared to their predecessors at Cârlomăneşti. Based on changes in the faunal record we speculate that dairying may also have increased in importance between the early and later phases of the Monteoru culture.

Prenatal TVOCs exposure negatively influences postnatal neurobehavioral development

Prenatal exposure to volatile organic compounds may restrict fetal development and adversely influence infants' life. Therefore, we investigated the relationship between prenatal exposure to total volatile organic compounds (TVOC) and postnatal neurobehavioral development.A subsample of 383 pregnant participants was chosen from the prospective birth cohort study of Mother and Children’s Environmental Health Study; MOCEH (N=1,751) from three regions of the Republic of Korea (Seoul, Cheon-an, and Ulsan). Participants were enrolled during their first trimester with informed consent. We investigated maternal characteristics including socio-economic and obstetrical history using questionnaires. An environmental hygienist measured participating mothers' personal TVOC exposure using passive samplers during pregnancy. Participants visited the research center at 6, 12, 24 and 36 months. At each visit, questionnaires about infantile environment and health conditions were answered and a neurobehavioral test (BSID-II) was conducted by certified investigators.We conducted multiple general linear and mixed model analyses to investigate the relationship between TVOC and infantile neurobehavioral development (SAS 9.3). Mean prenatal TVOC exposure was 284.2μg/m3. In longitudinal analyses on infantile neurobehavioral development, adjusted mean psychomotor development index and mental developmental index scores in high TVOC exposure group (cut off at Q3: 374.0 ug/m3) were 3 points lower than the low exposure group. Results suggested exposure to higher TVOC during the fetal period may adversely influence neurobehavioral development in the early life stage.

High-functioning autism patients share similar but more severe impairments in verbal theory of mind than schizophrenia patients.

Evidence suggests that autism and schizophrenia share similarities in genetic, neuropsychological and behavioural aspects. Although both disorders are associated with theory of mind (ToM) impairments, a few studies have directly compared ToM between autism patients and schizophrenia patients. This study aimed to investigate to what extent high-functioning autism patients and schizophrenia patients share and differ in ToM performance. Thirty high-functioning autism patients, 30 schizophrenia patients and 30 healthy individuals were recruited. Participants were matched in age, gender and estimated intelligence quotient. The verbal-based Faux Pas Task and the visual-based Yoni Task were utilised to examine first- and higher-order, affective and cognitive ToM. The task/item difficulty of two paradigms was examined using mixed model analyses of variance (ANOVAs). Multiple ANOVAs and mixed model ANOVAs were used to examine group differences in ToM. The Faux Pas Task was more difficult than the Yoni Task. High-functioning autism patients showed more severely impaired verbal-based ToM in the Faux Pas Task, but shared similar visual-based ToM impairments in the Yoni Task with schizophrenia patients. The findings that individuals with high-functioning autism shared similar but more severe impairments in verbal ToM than individuals with schizophrenia support the autism-schizophrenia continuum. The finding that verbal-based but not visual-based ToM was more impaired in high-functioning autism patients than schizophrenia patients could be attributable to the varied task/item difficulty between the two paradigms.

Validation of a Geriatric Trauma Prognosis Calculator: A P.A.L.Li.A.T.E. Consortium Study.

The P.A.L.Li.A.T.E. (prognostic assessment of life and limitations after trauma in the elderly) consortium has previously created a prognosis calculator for mortality after geriatric injury based on age, injury severity, and transfusion requirement called the geriatric trauma outcome score (GTOS). Here, we sought to create and validate a prognosis calculator called the geriatric trauma outcome score ii (GTOS II) estimating probability of unfavorable discharge. Retrospective cohort. Four geographically diverse Level 1 trauma centers. Trauma admissions aged 65 to 102 years surviving to discharge from 2000 to 2013. None. Age, injury severity score (ISS), transfusion at 24 hours post-admission, discharge dichotomized as favorable (home/rehabilitation) or unfavorable (skilled nursing/long term acute care/hospice). Training and testing samples were created using the holdout method. A multiple logistic mixed model (GTOS II) was created to estimate the odds of unfavorable disposition then re-specified using the GTOS II as the sole predictor in a logistic mixed model using the testing sample. The final dataset was 16,114 subjects (unfavorable discharge status = 15.4%). Training (n = 8,057) and testing (n = 8,057) samples had similar demographics. The formula based on the training sample was (GTOS II = Age + [0.71 × ISS] + 8.79 [if transfused by 24 hours]). Misclassification rate and AUC were 15.63% and 0.67 for the training sample, respectively, and 15.85% and 0.67 for the testing sample. GTOS II estimates the probability of unfavorable discharge in injured elders with moderate accuracy. With the GTOS mortality calculator, it can help in goal setting conversations after geriatric injury.

A mixed model to multiple harvest-location trials applied to genomic prediction in Coffea canephora

Genomic selection (GS) has been studied in several crops to increase the rates of genetic gain and reduce the length of breeding cycles. Despite its relevance, there are only a modest number of reports applied to the genus Coffea. Effective implementation depends on the ability to consider genomic models, which correctly represent breeding scenario in which the species are inserted. Coffee experimentation, in general, is represented by evaluations in multiple locations and harvests to understand the interaction and predict the performance of untested genotypes. Therefore, the main objective of this study was to investigate GS models suitable for use in Coffea canephora. An expansion of traditional GBLUP was considered and genomic analysis was performed using a genotyping-by-sequencing (GBS) approach, showed good potential to be used in coffee breeding programs. Interactions were modeled using the multiplicative mixed model theory, which is commonly used in multi-environment trials (MET) analysis in perennial crops. The effectiveness of the method used was compared with other genetic models in terms of goodness-of-fit statistics and prediction accuracy. Different scenarios that mimic coffee breeding were used in the cross-validation process. The method used had the lowest AIC and BIC values and, consequently, the best fit. In terms of predictive ability, the incorporation of the MET modeling showed higher accuracy (on average 10–17% higher) and lower prediction errors than traditional GBLUP. The results may be used as basis for additional studies into the genus Coffea and can be expanded for similar perennial crops.

Dysglycemia, Glycemic Variability, and Outcome After Cardiac Arrest and Temperature Management at 33°C and 36°C.

Dysglycemia and glycemic variability are associated with poor outcomes in critically ill patients. Targeted temperature management alters blood glucose homeostasis. We investigated the association between blood glucose concentrations and glycemic variability and the neurologic outcomes of patients randomized to targeted temperature management at 33°C or 36°C after cardiac arrest. Post hoc analysis of the multicenter TTM-trial. Primary outcome of this analysis was neurologic outcome after 6 months, referred to as "Cerebral Performance Category." Thirty-six sites in Europe and Australia. All 939 patients with out-of-hospital cardiac arrest of presumed cardiac cause that had been included in the TTM-trial. Targeted temperature management at 33°C or 36°C. Nonparametric tests as well as multiple logistic regression and mixed effects logistic regression models were used. Median glucose concentrations on hospital admission differed significantly between Cerebral Performance Category outcomes (p < 0.0001). Hyper- and hypoglycemia were associated with poor neurologic outcome (p = 0.001 and p = 0.054). In the multiple logistic regression models, the median glycemic level was an independent predictor of poor Cerebral Performance Category (Cerebral Performance Category, 3-5) with an odds ratio (OR) of 1.13 in the adjusted model (p = 0.008; 95% CI, 1.03-1.24). It was also a predictor in the mixed model, which served as a sensitivity analysis to adjust for the multiple time points. The proportion of hyperglycemia was higher in the 33°C group compared with the 36°C group. Higher blood glucose levels at admission and during the first 36 hours, and higher glycemic variability, were associated with poor neurologic outcome and death. More patients in the 33°C treatment arm had hyperglycemia.