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- Ostergaard, H. B., et al.
(författare)
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Estimating individual lifetime risk of incident cardiovascular events in adults with Type 2 diabetes: an update and geographical calibration of the DIAbetes Lifetime perspective model (DIAL2)
- 2023
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Ingår i: European Journal of Preventive Cardiology. - : Oxford University Press (OUP). - 2047-4873 .- 2047-4881. ; 30:1, s. 61-69
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Tidskriftsartikel (refereegranskat)abstract
- Aims The 2021 European Society of Cardiology cardiovascular disease (CVD) prevention guidelines recommend the use of (lifetime) risk prediction models to aid decisions regarding intensified preventive treatment options in adults with Type 2 diabetes, e.g. the DIAbetes Lifetime perspective model (DIAL model). The aim of this study was to update the DIAL model using contemporary and representative registry data (DIAL2) and to systematically calibrate the model for use in other European countries. Methods and results The DIAL2 model was derived in 467 856 people with Type 2 diabetes without a history of CVD from the Swedish National Diabetes Register, with a median follow-up of 7.3 years (interquartile range: 4.0-10.6 years) and comprising 63 824 CVD (including fatal CVD, non-fatal stroke and non-fatal myocardial infarction) events and 66 048 non-CVD mortality events. The model was systematically recalibrated to Europe's low- and moderate-risk regions using contemporary incidence data and mean risk factor distributions. The recalibrated DIAL2 model was externally validated in 218 267 individuals with Type 2 diabetes from the Scottish Care Information-Diabetes (SCID) and Clinical Practice Research Datalink (CPRD). In these individuals, 43 074 CVD events and 27 115 non-CVD fatal events were observed. The DIAL2 model discriminated well, with C-indices of 0.732 [95% confidence interval (CI) 0.726-0.739] in CPRD and 0.700 (95% CI 0.691-0.709) in SCID. Conclusion The recalibrated DIAL2 model provides a useful tool for the prediction of CVD-free life expectancy and lifetime CVD risk for people with Type 2 diabetes without previous CVD in the European low- and moderate-risk regions. These long-term individualized measures of CVD risk are well suited for shared decision-making in clinical practice as recommended by the 2021 CVD ESC prevention guidelines.
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- Lauritzen, P. H., et al.
(författare)
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Reconciling and Improving Formulations for Thermodynamics and Conservation Principles in Earth System Models (ESMs)
- 2022
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Ingår i: Journal of Advances in Modeling Earth Systems. - 1942-2466. ; 14:9
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Tidskriftsartikel (refereegranskat)abstract
- This paper provides a comprehensive derivation of the total energy equations for the atmospheric components of Earth System Models (ESMs). The assumptions and approximations made in this derivation are motivated and discussed. In particular, it is emphasized that closing the energy budget is conceptually challenging and hard to achieve in practice without resorting to ad hoc fixers. As a concrete example, the energy budget terms are diagnosed in a realistic climate simulation using a global atmosphere model. The largest total energy errors in this example are spurious dynamical core energy dissipation, thermodynamic inconsistencies (e.g., coupling parameterizations with the host model) and missing processes/terms associated with falling precipitation and evaporation (e.g., enthalpy flux between components). The latter two errors are not, in general, reduced by increasing horizontal resolution. They are due to incomplete thermodynamic and dynamic formulations. Future research directions are proposed to reconcile and improve thermodynamics formulations and conservation principles.
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