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Aims: Carotid intima media thickness (CIMT) predicts cardiovascular (CVD) events, but the predictive value of CIMT change is debated. We assessed the relation between CIMT change and events in individuals at high cardiovascular risk.
Methods and results: From 31 cohorts with two CIMT scans (total n = 89070) on average 3.6 years apart and clinical follow-up, subcohorts were drawn: (A) individuals with at least 3 cardiovascular risk factors without previous CVD events, (B) individuals with carotid plaques without previous CVD events, and (C) individuals with previous CVD events. Cox regression models were fit to estimate the hazard ratio (HR) of the combined endpoint (myocardial infarction, stroke or vascular death) per standard deviation (SD) of CIMT change, adjusted for CVD risk factors. These HRs were pooled across studies.
In groups A, B and C we observed 3483, 2845 and 1165 endpoint events, respectively. Average common CIMT was 0.79mm (SD 0.16mm), and annual common CIMT change was 0.01mm (SD 0.07mm), both in group A. The pooled HR per SD of annual common CIMT change (0.02 to 0.43mm) was 0.99 (95% confidence interval: 0.95–1.02) in group A, 0.98 (0.93–1.04) in group B, and 0.95 (0.89–1.04) in group C. The HR per SD of common CIMT (average of the first and the second CIMT scan, 0.09 to 0.75mm) was 1.15 (1.07–1.23) in group A, 1.13 (1.05–1.22) in group B, and 1.12 (1.05–1.20) in group C.
Conclusions: We confirm that common CIMT is associated with future CVD events in individuals at high risk. CIMT change does not relate to future event risk in high-risk individuals.
Good quality data on precipitation are a prerequisite for applications like short-term weather forecasts, medium-term humanitarian assistance, and long-term climate modelling. In Sub-Saharan Africa, however, the meteorological station networks are frequently insufficient, as in the Cuvelai-Basin in Namibia and Angola. This paper analyses six rainfall products (ARC2.0, CHIRPS2.0, CRU-TS3.23, GPCCv7, PERSIANN-CDR, and TAMSAT) with respect to their performance in a crop model (APSIM) to obtain nutritional scores of a household’s requirements for dietary energy and further macronutrients. All products were calibrated to an observed time series using Quantile Mapping. The crop model output was compared against official yield data. The results show that the products (i) reproduce well the Basin’s spatial patterns, and (ii) temporally agree to station records (r = 0.84). However, differences exist in absolute annual rainfall (range: 154 mm), rainfall intensities, dry spell duration, rainy day counts, and the rainy season onset. Though calibration aligns key characteristics, the remaining differences lead to varying crop model results. While the model well reproduces official yield data using the observed rainfall time series (r = 0.52), the products’ results are heterogeneous (e.g., CHIRPS: r = 0.18). Overall, 97% of a household’s dietary energy demand is met. The study emphasizes the importance of considering the differences among multiple rainfall products when ground measurements are scarce.