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- Kaptoge, S., et al.
(författare)
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World Health Organization cardiovascular disease risk charts: revised models to estimate risk in 21 global regions
- 2019
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Ingår i: Lancet Global Health. - : Elsevier BV. - 2214-109X. ; 7:10
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Tidskriftsartikel (refereegranskat)abstract
- Background To help adapt cardiovascular disease risk prediction approaches to low-income and middle-income countries, WHO has convened an effort to develop, evaluate, and illustrate revised risk models. Here, we report the derivation, validation, and illustration of the revised WHO cardiovascular disease risk prediction charts that have been adapted to the circumstances of 21 global regions. Methods In this model revision initiative, we derived 10-year risk prediction models for fatal and non-fatal cardiovascular disease (ie, myocardial infarction and stroke) using individual participant data from the Emerging Risk Factors Collaboration. Models included information on age, smoking status, systolic blood pressure, history of diabetes, and total cholesterol. For derivation, we included participants aged 40-80 years without a known baseline history of cardiovascular disease, who were followed up until the first myocardial infarction, fatal coronary heart disease, or stroke event. We recalibrated models using age-specific and sex-specific incidences and risk factor values available from 21 global regions. For external validation, we analysed individual participant data from studies distinct from those used in model derivation. We illustrated models by analysing data on a further 123 743 individuals from surveys in 79 countries collected with the WHO STEPwise Approach to Surveillance. Findings Our risk model derivation involved 376 177 individuals from 85 cohorts, and 19 333 incident cardiovascular events recorded during 10 years of follow-up. The derived risk prediction models discriminated well in external validation cohorts (19 cohorts, 1 096 061 individuals, 25 950 cardiovascular disease events), with Harrell's C indices ranging from 0.685 (95% CI 0 . 629-0 741) to 0.833 (0 . 783-0- 882). For a given risk factor profile, we found substantial variation across global regions in the estimated 10-year predicted risk. For example, estimated cardiovascular disease risk for a 60-year-old male smoker without diabetes and with systolic blood pressure of 140 mm Hg and total cholesterol of 5 mmol/L ranged from 11% in Andean Latin America to 30% in central Asia. When applied to data from 79 countries (mostly low-income and middle-income countries), the proportion of individuals aged 40-64 years estimated to be at greater than 20% risk ranged from less than 1% in Uganda to more than 16% in Egypt. Interpretation We have derived, calibrated, and validated new WHO risk prediction models to estimate cardiovascular disease risk in 21 Global Burden of Disease regions. The widespread use of these models could enhance the accuracy, practicability, and sustainability of efforts to reduce the burden of cardiovascular disease worldwide. Copyright (C) 2019 The Author(s). Published by Elsevier Ltd.
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| 2. |
- Bolton, Kim, 1964, et al.
(författare)
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Atomistic simulations of catalyzed carbon nanotube growth
- 2006
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Ingår i: JOURNAL OF NANOSCIENCE AND NANOTECHNOLOGY. - : American Scientific Publishers. - 1533-4880 .- 0000-0000. ; 6:5, s. 1211-1224
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Tidskriftsartikel (refereegranskat)abstract
- We review the advances made in understanding the mechanism of catalyzed carbon nanotube growth, with the main focus on direct dynamics and molecular dynamics studies of single-walled carbon nanotube (SWNT) growth. These studies have deepened our understanding of the catalytic SWNT nucleation and growth mechanisms, but more accurate and efficient methods are required for a complete investigation at experimental growth conditions.
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- Bolton, Kim, 1964, et al.
(författare)
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SimChemistry as an active learning tool in chemical education.
- 2008
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Ingår i: Chemistry Education Research and Practice. - : Royal Society of Chemistry (RSC). - 1756-1108 .- 1109-4028. ; 9:3, s. 277-284
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Tidskriftsartikel (refereegranskat)abstract
- The publicly available free computer program, SimChemistry, was used as an active learning tool in the chemical engineering curriculum at the University College of Borås, Sweden. The activity involved students writing their own simulation programs on topics in the area of molecular structure and interactions. Evaluation of the learning experience was done using interviews and by comparing learning outcomes with previous teachings of the topics. Overall, the outcome was interactively engaging group work, high quality construction of simulations, and a much better ability to explain molecular-level chemical concepts and their relations. An interesting perception that emerged during the interviews was that many of the students were unable to explicitly describe the improvement in learning that they had experienced. However, they did recognize that learning had occurred, and all firmly and positively recommended that the initiative be continued for subsequent courses.
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