•Robust assessment of NIR predictive performance using three statistical metrics.•Use of a control calibration set provides a baseline for comparing accuracy outputs.•Location is an important factor ...that affects predictive performance.•Accuracy was improved when calibrated with fruit from more established trees.•NIR-based prediction can be applied in the WABP to predict DMC.
Conventional assessments of postharvest traits, like dry matter concentration (DMC) require destructive sampling that can often be limited by fruit availability of apple trees in early years. Alternatively, nondestructive prediction of postharvest traits using NIR spectroscopy has been demonstrated to be rapid and robust in various fruits and vegetables, including apples. With most prediction models built using one to few cultivars, it remains largely unknown if NIR-based prediction can be applied in an apple breeding program with numerous selections that are added, replicated, and evaluated annually. In this study, 2252 fruit from 58 accessions grown at three orchard sites were destructively measured for DMC, and nondestructively measured for NIR spectra. Nondestructive prediction of DMC exhibited high accuracies in most analyses. In characterizing DMC predictive performance of within- versus between-years, both models were highly predictive and comparable, albeit slightly higher for the former. Further analysis of location × year effects revealed that location was a more important factor than year in influencing predictive performance. Finally, in cultivar-specific models, prediction made using fruit from more established trees as a calibration set consistently yielded higher prediction accuracy. Overall, the use of three statistical metrics enhanced our understanding of NIR prediction accuracy, while a control calibration set in all analyses provided a statistical baseline for comparing accuracy outputs. This study provides a framework for understanding the impacts of location, year and tree age on NIR prediction accuracy of DMC in diverse apple breeding accessions. In addition, this study demonstrates the importance of assessing predictive performance using multiple statistical metrics.
Quitting smoking improves patients' clinical outcomes, yet smoking is not commonly addressed as part of cancer care. The Cancer Center Cessation Initiative (C3I) supports National Cancer ...Institute-designated cancer centers to integrate tobacco treatment programs (TTPs) into routine cancer care. C3I centers vary in size, implementation strategies used, and treatment approaches. We examined associations of these contextual factors with treatment reach and smoking cessation effectiveness.
This cross-sectional study used survey data from 28 C3I centers that reported tobacco treatment data during the first 6 months of 2021. Primary outcomes of interest were treatment reach (reach)-the proportion of patients identified as currently smoking who received at least one evidence-based tobacco treatment component (eg, counseling and pharmacotherapy)-and smoking cessation effectiveness (effectiveness)-the proportion of patients reporting 7-day point prevalence abstinence at 6-month follow-up. Center-level differences in reach and effectiveness were examined by center characteristics, implementation strategies, and tobacco treatment components.
Of the total 692,662 unique patients seen, 44,437 reported current smoking. Across centers, a median of 96% of patients were screened for tobacco use, median smoking prevalence was 7.4%, median reach was 15.4%, and median effectiveness was 18.4%. Center-level characteristics associated with higher reach included higher smoking prevalence, use of center-wide TTP, and lower patient-to-tobacco treatment specialist ratio. Higher effectiveness was observed at centers that served a larger overall population and population of patients who smoke, reported a higher smoking prevalence, and/or offered electronic health record referrals via a closed-loop system.
Whole-center TTP implementation among inpatients and outpatients, and increasing staff-to-patient ratios may improve TTP reach. Designating personnel with tobacco treatment expertise and resources to increase tobacco treatment dose or intensity may improve smoking cessation effectiveness.
To directly compare the 90-day outcomes of patients with symptomatic intracranial atherosclerotic disease (ICAD), extracranial carotid atherosclerotic disease (ECAD), and ICAD with concomitant ECAD.
...From 2017-2021, patients who had (1) a transient ischemic attack or ischemic stroke within 30 days of admission as evaluated by a stroke neurologist and (2) ipsilateral ICAD and/or ECAD were prospectively enrolled. The cohort was divided into three groups: ICAD, ECAD, and ICAD with concomitant ECAD. The primary outcome assessed was 90-day ischemic stroke recurrence. Secondary outcomes included 90-day myocardial infarction (MI), all-cause mortality, and major adverse cardiovascular events (MACE, including cardiovascular death, nonfatal MI, and/or nonfatal ischemic stroke).
Of 371 patients included in the analysis, 240 (64.7%) patients had ICAD only, 93 (25.0%) patients had ECAD only, and 38 (10.3%) patients had ICAD with concomitant ECAD. On multivariate time-to-event analysis adjusting for potential confounders and with ICAD as the reference comparator, the risk of 90-day clinical outcomes was highest among patients with ICAD and concomitant ECAD, with adjusted hazard ratios of 4.54 (95% CI=1.45, 14.2; p = 0.006), 9.32 (95% CI=1.58, 54.8; p = 0.014), and 8.52 (95% CI=3.54, 20.5; p < 0.001) for 90-day ischemic stroke, MI, and MACE, respectively.
Patients with ICAD and concomitant ECAD have a poorer prognosis and are at significantly higher risk for 90-day ischemic stroke, MI, and MACE. Further research should focus on the evaluation of coronary atherosclerotic disease and more intensive medical therapy in this population.
In the current era of rapid culprit vessel revascularization in acute myocardial infarction, ventricular free wall rupture is becoming increasingly uncommon. In rare cases adherent pericardium may ...contain this rupture, creating a temporary stable pseudoaneurysm. With the aid of intraoperative pictures, we describe herein a left thoracotomy approach for the surgical correction of a left ventricular pseudoaneurysm secondary to free wall rupture.
The nature of the atomic configuration and the bonding within epitaxial Pt‐graphene films is investigated. Graphene‐templated monolayer/few‐multilayers of Pt, synthesized as contiguous 2D films by ...room temperature electrochemical methods, is shown to exhibit a stable {100} structure in the 1–2 layer range. The fundamental question being investigated is whether surface Pt atoms rendered in these 2D architectures are as stable as those of their bulk Pt counterparts. Unsurprisingly, a single layer Pt on the graphene (Pt_1ML/GR) shows much larger Pt dissociation energy (−7.51 eV) than does an isolated Pt atom on graphene. However, the dissociation energy from Pt_1ML/GR is similar to that of bulk Pt(100), −7.77 eV, while in bi‐layer Pt on the graphene (Pt_2ML/GR), this energy changes to −8.63 eV, surpassing its bulk counterpart. At Pt_2ML/GR, the dissociation energy also slightly surpasses that of bulk Pt(111). Bulk‐like stability of atomically thin Pt–graphene results from a combination of interplanar PtC covalent bonding and inter/intraplanar metallic bonding. This unprecedented stability is also accompanied by a metal‐like presence of electronic states at the Fermi level. Such atomically thin metal‐graphene architectures can be a new stable platform for synthesizing 2D metallic films with various applications in catalysis, sensing, and electronics.
Graphene‐templated monolayer to few‐multilayers of Pt, synthesized as contiguous 2D films by room temperature electrochemical methods, exhibits a {100} structure where the surface Pt atoms are more stable than their bulk Pt {100} or Pt {111} counterparts. This supra‐bulk stability of the 2D Pt/graphene results from a combination of inter‐planar PtC covalent bonding and inter/intraplanar metallic bonding.
The relationship between von Willebrand factor antigen (VWF:Ag), VWF propeptide (VWFpp), VWFpp/VWF:Ag ratio, ADAMTS13 activity, and microembolic signal (MES) status in carotid stenosis is unknown.
...This prospective, multicenter study simultaneously assessed plasma VWF:Ag levels, VWFpp levels and ADAMTS13 activity, and their relationship with MES in asymptomatic versus symptomatic moderate-to-severe (≥50-99%) carotid stenosis patients. One-hour transcranial Doppler ultrasound of the middle cerebral arteries classified patients as MES+ve or MES-ve.
Data from 34 asymptomatic patients were compared with 43 symptomatic patients in the "early phase" (≤4 weeks) and 37 patients in the "late phase" (≥3 months) after transient ischemic attack (TIA)/ischemic stroke. VWF:Ag levels were higher (
= 0.049) and VWFpp/VWF:Ag ratios lower (
= 0.006) in early symptomatic than in asymptomatic patients overall, and in early symptomatic versus asymptomatic MES-ve subgroups (
≤0.02). There were no intergroup differences in VWFpp expression or ADAMTS13 activity (
≥0.05). VWF:Ag levels and ADAMTS13 activity decreased (
≤ 0.048) and VWFpp/VWF:Ag ratios increased (
= 0.03) in symptomatic patients followed up from the early to late phases after TIA/stroke. Although there were no differences in the proportions of symptomatic and asymptomatic patients with blood group O, a combined analysis of early symptomatic and asymptomatic patients revealed lower median VWF:Ag levels in patients with blood group O versus those without blood group O (9.59 vs. 12.32 µg/mL,
= 0.035).
VWF:Ag expression, a marker of endothelial ± platelet activation, is enhanced in recently symptomatic versus asymptomatic carotid stenosis patients, including in MES-ve patients, and decreases with ADAMTS13 activity over time following atherosclerotic TIA/ischemic stroke.
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