| 1. |
- Stanaway, Jeffrey D., et al.
(författare)
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Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017
- 2018
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Ingår i: The Lancet. - 1474-547X .- 0140-6736. ; 392:10159, s. 1923-1994
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Tidskriftsartikel (refereegranskat)abstract
- Background The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk-outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk-outcome pairs, and new data on risk exposure levels and risk- outcome associations. Methods We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017.
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| 2. |
- Abbafati, Cristiana, et al.
(författare)
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- 2020
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Tidskriftsartikel (refereegranskat)
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| 3. |
- Chaudhari, Rakesh, et al.
(författare)
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A parametric study and experimental investigations of microstructure and mechanical properties of multi-layered structure of metal core wire using wire arc additive manufacturing
- 2023
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Ingår i: Journal of Advanced Joining Processes. - : Elsevier. - 2666-3309. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- In the present study, the Gas metal arc welding (GMAW) based Wire-arc additive manufacturing (WAAM) process was preferred for the fabrication of multi-layered structures and their investigations of mechanical properties on metal core wire. Based on literature work, preliminary trials, machine limits, travel speed (TS), voltage (V), and gas mixture ratio (GMR) were identified as machining parameters along with output factors of bead width (BW), bead height (BH), and depth-of-penetration (DOP). Experiments were conducted by following the Box-Behnken design. The feasibility of the generated non-linear regression models has been validated through the statistical analysis of variance and residual plots. The multi-layered structure has been successfully fabricated at the optimized parametric settings of TS at 24 mm/s; the voltage at 24 V, and GMR at 1 which was obtained through the heat transfer search (HTS) algorithm. The fabricated structure was observed to be uniform. The structure exhibited uniform bead-on-bead deposition for the deposited layers. The fabricated multi-layered structure underwent a detailed microstructural and mechanical examinations. Microstructural examination revealed dense needles at the bottom section of the structure as compared to the top section, as the bottom section undergoes multiple heating and cooling cycles. When comparing the multilayer structure to the metal core wire, all the properties exhibited favorable tensile characteristics. The obtained strength from the impact test results highlights the impressive ductility of the multi-layer deposition. Fractography of tensile and impact test specimens has shown the occurrences of larger dimples and suggested a ductile fracture. Lastly, the hardness value in all the sections of the built structure was observed to be uniform, suggesting uniform deposition across the built multi-layer structure. The authors consider the current work will be highly beneficial for users in fabricating multi-layer structures at optimized parametric settings and their investigations for mechanical properties for metal core wire.
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| 4. |
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| 5. |
- Lozano, Rafael, et al.
(författare)
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Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017
- 2018
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Ingår i: The Lancet. - : Elsevier. - 1474-547X .- 0140-6736. ; 392:10159, s. 2091-2138
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Tidskriftsartikel (refereegranskat)abstract
- Background: Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of “leaving no one behind”, it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990–2017, projected indicators to 2030, and analysed global attainment. Methods: We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health-related SDG index, we transformed the value for each indicator on a scale of 0–100, with 0 as the 2·5th percentile and 100 as the 97·5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator. Findings: The global median health-related SDG index in 2017 was 59·4 (IQR 35·4–67·3), ranging from a low of 11·6 (95% uncertainty interval 9·6–14·0) to a high of 84·9 (83·1–86·7). SDG index values in countries assessed at the subnational level varied substantially, particularly in China and India, although scores in Japan and the UK were more homogeneous. Indicators also varied by SDI quintile and sex, with males having worse outcomes than females for non-communicable disease (NCD) mortality, alcohol use, and smoking, among others. Most countries were projected to have a higher health-related SDG index in 2030 than in 2017, while country-level probabilities of attainment by 2030 varied widely by indicator. Under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria indicators had the most countries with at least 95% probability of target attainment. Other indicators, including NCD mortality and suicide mortality, had no countries projected to meet corresponding SDG targets on the basis of projected mean values for 2030 but showed some probability of attainment by 2030. For some indicators, including child malnutrition, several infectious diseases, and most violence measures, the annualised rates of change required to meet SDG targets far exceeded the pace of progress achieved by any country in the recent past. We found that applying the mean global annualised rate of change to indicators without defined targets would equate to about 19% and 22% reductions in global smoking and alcohol consumption, respectively; a 47% decline in adolescent birth rates; and a more than 85% increase in health worker density per 1000 population by 2030. Interpretation: The GBD study offers a unique, robust platform for monitoring the health-related SDGs across demographic and geographic dimensions. Our findings underscore the importance of increased collection and analysis of disaggregated data and highlight where more deliberate design or targeting of interventions could accelerate progress in attaining the SDGs. Current projections show that many health-related SDG indicators, NCDs, NCD-related risks, and violence-related indicators will require a concerted shift away from what might have driven past gains—curative interventions in the case of NCDs—towards multisectoral, prevention-oriented policy action and investments to achieve SDG aims. Notably, several targets, if they are to be met by 2030, demand a pace of progress that no country has achieved in the recent past. The future is fundamentally uncertain, and no model can fully predict what breakthroughs or events might alter the course of the SDGs. What is clear is that our actions—or inaction—today will ultimately dictate how close the world, collectively, can get to leaving no one behind by 2030.
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| 6. |
- Bremer, Troy, et al.
(författare)
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A Biological Signature for Breast Ductal Carcinoma In Situ to Predict Radiotherapy Benefit and Assess Recurrence Risk
- 2018
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Ingår i: Clinical cancer research : an official journal of the American Association for Cancer Research. - 1078-0432 .- 1557-3265. ; 24:23, s. 5895-5901
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Ductal carcinoma in situ (DCIS) patients and their physicians currently face challenging treatment decisions with limited information about the individual's subsequent breast cancer risk or treatment benefit. The DCISionRT biological signature developed in this study provides recurrence risk and predicts radiotherapy (RT) benefit for DCIS patients following breast-conserving surgery (BCS).EXPERIMENTAL DESIGN: A biological signature that calculates an individualized Decision Score (DS) was developed and cross-validated in 526 DCIS patients treated with BCS ± RT. The relationship was assessed between DS and 10-year risk of invasive breast cancer (IBC) or any ipsilateral breast event (IBE), including IBC or DCIS. RT benefit was evaluated by risk group and as a function of DS.RESULTS: The DS was significantly associated with IBC and IBE risk, HR (per 5 units) of 4.2 and 3.1, respectively. For patients treated without RT, DS identified a Low Group with 10-year IBC risk of 4% (7% IBE) and an Elevated Risk Group with IBC risk of 15% (23% IBE). In analysis of DS and RT by group, the Elevated Risk Group received significant RT benefit, HR of 0.3 for IBC and IBE. In a clinicopathologically low-risk subset, DS reclassified 42% of patients into the Elevated Risk Group. In an interaction analysis of DS and RT, patients with elevated DS had significant RT benefit over baseline.CONCLUSIONS: The DS was prognostic for risk and predicted RT benefit for DCIS patients. DS identified a clinically meaningful low-risk group and a group with elevated 10-year risks that received substantial RT benefit over baseline.
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| 7. |
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| 8. |
- Chaudhari, Rakesh, et al.
(författare)
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Effect of multi-walled structure on microstructure and mechanical properties of 1.25Cr-1.0Mo steel fabricated by GMAW-based WAAM using metal-cored wire
- 2022
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Ingår i: Journal of Materials Research and Technology. - : Elsevier. - 2238-7854. ; 21, s. 3386-3396
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Tidskriftsartikel (refereegranskat)abstract
- Wire-arc additive manufacturing (WAAM) offers multiple benefits, such as high metal deposition, low capital cost, suitable mechanical properties, and reasonable costs. In the present work, Gas metal arc welding (GMAW) based WAAM was employed to manufacture a multi-walled component of 1.25Cr-0.5Mo at optimized parameters using metal-cored wire. The fabricated multi-walled structure was observed with seamless fusion and free from disbonding. The fabricated multi-walled component was studied through microstructure investigations, mechanical properties such as microhardness (MH), tensile test, and impact test at various positions (top side, middle side, and bottom side) of the built structure. Microstructure results have shown a tempered martensite structure in the bottom zone with coarse grains and finer microstructures in the middle and top zones. MH values throughout the component were uniform and thus indicated a similar nature to the multi-walled component. A comparison of tensile properties was carried out among the results of metal-cored wires and multi-walled structures to check the internal eminence of the obtained component. For all sides of the multi-walled structure, all the tensile properties were found to be in the range values of 1.25Cr-0.5Mo metal-cored wire. The results of all three conditions for impact toughness showed far better strength than the requirement. Fracture surface morphologies of tensile and impact test parts showed the presence of large dimples with the homogenous distribution. Thus, all the obtained results have suggested the suitability of the GMAWAM process for the fabrication of a multi-walled structure of 1.25Cr-0.5Mo metal-cored wire for various industrial applications.
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| 9. |
- Chaudhari, Rakesh, et al.
(författare)
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Effect of WEDM Process Parameters on Surface Morphology of Nitinol Shape Memory Alloy.
- 2020
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Ingår i: Materials. - : MDPI AG. - 1996-1944. ; 13:21
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Tidskriftsartikel (refereegranskat)abstract
- Nickel-titanium shape memory alloys (SMAs) have started becoming popular owing to their unique ability to memorize or regain their original shape from the plastically deformed condition by means of heating or magnetic or mechanical loading. Nickel-titanium alloys, commonly known as nitinol, have been widely used in actuators, microelectromechanical system (MEMS) devices, and many other applications, including in the biomedical, aerospace, and automotive fields. However, nitinol is a difficult-to-cut material because of its versatile specific properties such as the shape memory effect, superelasticity, high specific strength, high wear and corrosion resistance, and severe strain hardening. There are several challenges faced when machining nitinol SMA with conventional machining techniques. Noncontact operation of the wire electrical discharge machining (WEDM) process between the tool (wire) and workpiece significantly eliminates the problems of conventional machining processes. The WEDM process consists of multiple input parameters that should be controlled to obtain great surface quality. In this study, the effect of WEDM process parameters on the surface morphology of nitinol SMA was studied using 3D surface analysis, scanning electron microscopy (SEM), and energy-dispersive X-ray (EDX) analysis. 3D surface analysis results indicated a higher value of surface roughness (SR) on the top of the work surface and a lower SR on the bottom portion of the work surface. The surface morphology of the machined sample obtained at optimized parameters showed a reduction in microcracks, micropores, and globules in comparison with the machined surface obtained at a high discharge energy level. EDX analysis indicated a machined surface free of molybdenum (tool electrode).
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| 10. |
- Chaudhari, Rakesh, et al.
(författare)
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Experimental investigations on microstructure and mechanical properties of wall structure of SS309L using wire-arc additive manufacturing
- 2024
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Ingår i: Journal of Advanced Joining Processes. - : Elsevier B.V.. - 2666-3309. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- In present study, a wall structure of SS309L was constructed through Gas metal arc welding based Wire-arc additive manufacturing process. The wall structure of SS309L underwent investigation for microstructure and mechanical properties at three positions along the horizontal deposition direction. Mechanical assessments, including microhardness testing, impact testing, tensile testing, and fractography, were conducted at three positions of walls. Microstructure study has shown a fine granular structure in addition to colony of columnar dendrites in bottom section, a columnar dendrites in middle section, and a mix of dendritic structure with even coarser structures in top section. The mean microhardness values were observed to be 159 ± 4.21 HV, 162 ± 3.89 HV, and 168 ± 5.34 HV for the top, middle, and bottom sections, respectively. Results of impact testing for the wall structure indicated greater strength compared to wrought SS309L. The tensile strength of the built structure showed average values of yield strength, ultimate tensile strength, and elongation to be 409.33 ± 7.66 MPa, 556.66 ± 6.33 MPa, and 39.66 ± 2.33 %, respectively. In comparison, wrought 309 L steel typically exhibits tensile strengths in the range of 360–480 MPa for yield strength, 530–650 MPa for ultimate tensile strength, and 35–45 % elongation. Thus, the obtained tensile strength results for the wall structure fall within the range of tensile strength observed in wrought 309 L steel. Fractography of the tensile and impact specimens, as obtained through Scanning Electron Microscopy, revealed the superior ductility of the fabricated component. This study contributes valuable insights into the manufacturing of wall structure and their analysis regarding mechanical characteristics.
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