Genomic prediction for complex traits across multiples harvests in alfalfa (Medicago sativa L.) is enhanced by enviromics

Abstract Breeding for dry matter yield and persistence in alfalfa (Medicago sativa L.) can take several years as these traits must be evaluated under multiple harvests. Therefore, genotype‐by‐harvest interaction should be incorporated into genomic prediction models to explore genotypes’ adaptability and stability. In this study, we investigated how enviromics could help to predict the genotypic performance under multiharvest alfalfa breeding trials by evaluating 177 families across 11 harvests under four cross‐validation scenarios. All scenarios were analyzed using six models in a Bayesian mixed model framework. Our results demonstrate that models accounting to the enviromics information led to an increase of genetic variance and a decrease in the error variance, indicating better biological explanation when the enviromic information was incorporated. Furthermore, models that accounted for enviromic data led to higher predictive ability (PA) in a reduced number of harvests used in the training data set. The best enviromic models (M2 and M3) outperformed the base model (GBLUP model—M0) for predicting adaptability and persistence across all cross‐validation scenarios. Incorporating environmental covariates also provided higher PA for persistence compared with the base model, as predictions increased from 0 to 0.16, 0.20, 0.56, and 0.46 for CV00, CV1, CV0, and CV2. The results also demonstrate that GBLUP without enviromics term has low power to predict persistence, thus the adoption of enviromics is a cheap and efficient alternative to increase accuracy and biological meaning

Global Survey of Outcomes of Neurocritical Care Patients: Analysis of the PRINCE Study Part 2

BACKGROUND: Neurocritical care is devoted to the care of critically ill patients with acute neurological or neurosurgical emergencies. There is limited information regarding epidemiological data, disease characteristics, variability of clinical care, and in-hospital mortality of neurocritically ill patients worldwide. We addressed these issues in the Point PRevalence In Neurocritical CarE (PRINCE) study, a prospective, cross-sectional, observational study. METHODS: We recruited patients from various intensive care units (ICUs) admitted on a pre-specified date, and the investigators recorded specific clinical care activities they performed on the subjects during their first 7 days of admission or discharge (whichever came first) from their ICUs and at hospital discharge. In this manuscript, we analyzed the final data set of the study that included patient admission characteristics, disease type and severity, ICU resources, ICU and hospital length of stay, and in-hospital mortality. We present descriptive statistics to summarize data from the case report form. We tested differences between geographically grouped data using parametric and nonparametric testing as appropriate. We used a multivariable logistic regression model to evaluate factors associated with in-hospital mortality. RESULTS: We analyzed data from 1545 patients admitted to 147 participating sites from 31 countries of which most were from North America (69%, N = 1063). Globally, there was variability in patient characteristics, admission diagnosis, ICU treatment team and resource allocation, and in-hospital mortality. Seventy-three percent of the participating centers were academic, and the most common admitting diagnosis was subarachnoid hemorrhage (13%). The majority of patients were male (59%), a half of whom had at least two comorbidities, and median Glasgow Coma Scale (GCS) of 13. Factors associated with in-hospital mortality included age (OR 1.03; 95% CI, 1.02 to 1.04); lower GCS (OR 1.20; 95% CI, 1.14 to 1.16 for every point reduction in GCS); pupillary reactivity (OR 1.8; 95% CI, 1.09 to 3.23 for bilateral unreactive pupils); admission source (emergency room versus direct admission [OR 2.2; 95% CI, 1.3 to 3.75]; admission from a general ward versus direct admission [OR 5.85; 95% CI, 2.75 to 12.45; and admission from another ICU versus direct admission [OR 3.34; 95% CI, 1.27 to 8.8]); and the absence of a dedicated neurocritical care unit (NCCU) (OR 1.7; 95% CI, 1.04 to 2.47). CONCLUSION: PRINCE is the first study to evaluate care patterns of neurocritical patients worldwide. The data suggest that there is a wide variability in clinical care resources and patient characteristics. Neurological severity of illness and the absence of a dedicated NCCU are independent predictors of in-patient mortality.status: publishe