| 1. |
- Forouzanfar, Mohammad H, et al.
(författare)
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Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013 : a systematic analysis for the Global Burden of Disease Study 2013.
- 2015
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Ingår i: The Lancet. - 0140-6736 .- 1474-547X. ; 386:10010, s. 2287-2323
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the first of a series of annual updates of the GBD. Risk factor quantification, particularly of modifiable risk factors, can help to identify emerging threats to population health and opportunities for prevention. The GBD 2013 provides a timely opportunity to update the comparative risk assessment with new data for exposure, relative risks, and evidence on the appropriate counterfactual risk distribution.METHODS: Attributable deaths, years of life lost, years lived with disability, and disability-adjusted life-years (DALYs) have been estimated for 79 risks or clusters of risks using the GBD 2010 methods. Risk-outcome pairs meeting explicit evidence criteria were assessed for 188 countries for the period 1990-2013 by age and sex using three inputs: risk exposure, relative risks, and the theoretical minimum risk exposure level (TMREL). Risks are organised into a hierarchy with blocks of behavioural, environmental and occupational, and metabolic risks at the first level of the hierarchy. The next level in the hierarchy includes nine clusters of related risks and two individual risks, with more detail provided at levels 3 and 4 of the hierarchy. Compared with GBD 2010, six new risk factors have been added: handwashing practices, occupational exposure to trichloroethylene, childhood wasting, childhood stunting, unsafe sex, and low glomerular filtration rate. For most risks, data for exposure were synthesised with a Bayesian meta-regression method, DisMod-MR 2.0, or spatial-temporal Gaussian process regression. Relative risks were based on meta-regressions of published cohort and intervention studies. Attributable burden for clusters of risks and all risks combined took into account evidence on the mediation of some risks such as high body-mass index (BMI) through other risks such as high systolic blood pressure and high cholesterol.FINDINGS: All risks combined account for 57·2% (95% uncertainty interval [UI] 55·8-58·5) of deaths and 41·6% (40·1-43·0) of DALYs. Risks quantified account for 87·9% (86·5-89·3) of cardiovascular disease DALYs, ranging to a low of 0% for neonatal disorders and neglected tropical diseases and malaria. In terms of global DALYs in 2013, six risks or clusters of risks each caused more than 5% of DALYs: dietary risks accounting for 11·3 million deaths and 241·4 million DALYs, high systolic blood pressure for 10·4 million deaths and 208·1 million DALYs, child and maternal malnutrition for 1·7 million deaths and 176·9 million DALYs, tobacco smoke for 6·1 million deaths and 143·5 million DALYs, air pollution for 5·5 million deaths and 141·5 million DALYs, and high BMI for 4·4 million deaths and 134·0 million DALYs. Risk factor patterns vary across regions and countries and with time. In sub-Saharan Africa, the leading risk factors are child and maternal malnutrition, unsafe sex, and unsafe water, sanitation, and handwashing. In women, in nearly all countries in the Americas, north Africa, and the Middle East, and in many other high-income countries, high BMI is the leading risk factor, with high systolic blood pressure as the leading risk in most of Central and Eastern Europe and south and east Asia. For men, high systolic blood pressure or tobacco use are the leading risks in nearly all high-income countries, in north Africa and the Middle East, Europe, and Asia. For men and women, unsafe sex is the leading risk in a corridor from Kenya to South Africa.INTERPRETATION: Behavioural, environmental and occupational, and metabolic risks can explain half of global mortality and more than one-third of global DALYs providing many opportunities for prevention. Of the larger risks, the attributable burden of high BMI has increased in the past 23 years. In view of the prominence of behavioural risk factors, behavioural and social science research on interventions for these risks should be strengthened. Many prevention and primary care policy options are available now to act on key risks.FUNDING: Bill & Melinda Gates Foundation.
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| 2. |
- Naghavi, Mohsen, et al.
(författare)
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Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013
- 2015
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Ingår i: The Lancet. - 1474-547X .- 0140-6736. ; 385:9963, s. 117-171
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Tidskriftsartikel (refereegranskat)abstract
- Background Up-to-date evidence on levels and trends for age-sex-specifi c all-cause and cause-specifi c mortality is essential for the formation of global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013) we estimated yearly deaths for 188 countries between 1990, and 2013. We used the results to assess whether there is epidemiological convergence across countries. Methods We estimated age-sex-specifi c all-cause mortality using the GBD 2010 methods with some refinements to improve accuracy applied to an updated database of vital registration, survey, and census data. We generally estimated cause of death as in the GBD 2010. Key improvements included the addition of more recent vital registration data for 72 countries, an updated verbal autopsy literature review, two new and detailed data systems for China, and more detail for Mexico, UK, Turkey, and Russia. We improved statistical models for garbage code redistribution. We used six different modelling strategies across the 240 causes; cause of death ensemble modelling (CODEm) was the dominant strategy for causes with sufficient information. Trends for Alzheimer's disease and other dementias were informed by meta-regression of prevalence studies. For pathogen-specifi c causes of diarrhoea and lower respiratory infections we used a counterfactual approach. We computed two measures of convergence (inequality) across countries: the average relative difference across all pairs of countries (Gini coefficient) and the average absolute difference across countries. To summarise broad findings, we used multiple decrement life-tables to decompose probabilities of death from birth to exact age 15 years, from exact age 15 years to exact age 50 years, and from exact age 50 years to exact age 75 years, and life expectancy at birth into major causes. For all quantities reported, we computed 95% uncertainty intervals (UIs). We constrained cause-specific fractions within each age-sex-country-year group to sum to all-cause mortality based on draws from the uncertainty distributions. Findings Global life expectancy for both sexes increased from 65.3 years (UI 65.0-65.6) in 1990, to 71.5 years (UI 71.0-71.9) in 2013, while the number of deaths increased from 47.5 million (UI 46.8-48.2) to 54.9 million (UI 53.6-56.3) over the same interval. Global progress masked variation by age and sex: for children, average absolute diff erences between countries decreased but relative diff erences increased. For women aged 25-39 years and older than 75 years and for men aged 20-49 years and 65 years and older, both absolute and relative diff erences increased. Decomposition of global and regional life expectancy showed the prominent role of reductions in age-standardised death rates for cardiovascular diseases and cancers in high-income regions, and reductions in child deaths from diarrhoea, lower respiratory infections, and neonatal causes in low-income regions. HIV/AIDS reduced life expectancy in southern sub-Saharan Africa. For most communicable causes of death both numbers of deaths and age-standardised death rates fell whereas for most non-communicable causes, demographic shifts have increased numbers of deaths but decreased age-standardised death rates. Global deaths from injury increased by 10.7%, from 4.3 million deaths in 1990 to 4.8 million in 2013; but age-standardised rates declined over the same period by 21%. For some causes of more than 100 000 deaths per year in 2013, age-standardised death rates increased between 1990 and 2013, including HIV/AIDS, pancreatic cancer, atrial fibrillation and flutter, drug use disorders, diabetes, chronic kidney disease, and sickle-cell anaemias. Diarrhoeal diseases, lower respiratory infections, neonatal causes, and malaria are still in the top five causes of death in children younger than 5 years. The most important pathogens are rotavirus for diarrhoea and pneumococcus for lower respiratory infections. Country-specific probabilities of death over three phases of life were substantially varied between and within regions. Interpretation For most countries, the general pattern of reductions in age-sex specifi c mortality has been associated with a progressive shift towards a larger share of the remaining deaths caused by non-communicable disease and injuries. Assessing epidemiological convergence across countries depends on whether an absolute or relative measure of inequality is used. Nevertheless, age-standardised death rates for seven substantial causes are increasing, suggesting the potential for reversals in some countries. Important gaps exist in the empirical data for cause of death estimates for some countries; for example, no national data for India are available for the past decade.
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| 3. |
- Daelman, Bo, et al.
(författare)
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Frailty and cognitive function in middle-aged and older adults with congenital heart disease
- 2024
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Ingår i: Journal of the American College of Cardiology. - : Elsevier. - 0735-1097 .- 1558-3597. ; 83:12, s. 1149-1159
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Tidskriftsartikel (refereegranskat)abstract
- Background: Life expectancy of patients with congenital heart disease (CHD) has increased rapidly, resulting in a growing and aging population. Recent studies have shown that older people with CHD have higher morbidity, health care use, and mortality. To maintain longevity and quality of life, understanding their evolving medical and psychosocial challenges is essential.Objectives: The authors describe the frailty and cognitive profile of middle-aged and older adults with CHD to identify predictor variables and to explore the relationship with hospital admissions and outpatient visits.Methods: Using a cross-sectional, multicentric design, we included 814 patients aged ≥40 years from 11 countries. Frailty phenotype was determined using the Fried method. Cognitive function was assessed by the Montreal Cognitive Assessment.Results: In this sample, 52.3% of patients were assessed as robust, 41.9% as prefrail, and 5.8% as frail; 38.8% had cognitive dysfunction. Multinomial regression showed that frailty was associated with older age, female sex, higher physiologic class, and comorbidities. Counterintuitively, patients with mild heart defects were more likely than those with complex lesions to be prefrail. Patients from middle-income countries displayed more prefrailty than those from higher-income countries. Logistic regression demonstrated that cognitive dysfunction was related to older age, comorbidities, and lower country-level income.Conclusions: Approximately one-half of included patients were (pre-)frail, and more than one-third experienced cognitive impairment. Frailty and cognitive dysfunction were identified in patients with mild CHD, indicating that these concerns extend beyond severe CHD. Assessing frailty and cognition routinely could offer valuable insights into this aging population.
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| 4. |
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| 5. |
- Abdalmoaty, Mohamed, 1986-, et al.
(författare)
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Privacy and Security in Network Controlled Systems via Dynamic Masking
- 2023
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Ingår i: IFAC-PapersOnLine. - : Elsevier. - 2405-8963. ; 56:2, s. 991-996
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Tidskriftsartikel (refereegranskat)abstract
- In this paper, we propose a new architecture to enhance the privacy and security of networked control systems against malicious adversaries. We consider an adversary which first learns the system using system identification techniques (privacy), and then performs a data injection attack (security). In particular, we consider an adversary conducting zero-dynamics attacks (ZDA) which maximizes the performance cost of the system whilst staying undetected. Using the proposed architecture, we show that it is possible to (i) introduce significant bias in the system estimates obtained by the adversary: thus providing privacy, and (ii) efficiently detect attacks when the adversary performs a ZDA using the identified system: thus providing security. Through numerical simulations, we illustrate the efficacy of the proposed architecture
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| 6. |
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| 7. |
- Anderson, James, et al.
(författare)
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Dynamical System Decomposition Using Dissipation Inequalities
- 2011
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Ingår i: Proceedings of the 50th IEEE Conference on Decision and Control and European Control Conference, Orlando, Florida. - 9781612848006
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Konferensbidrag (refereegranskat)abstract
- In this paper we investigate stability and inter-action measures for interconnected systems that have beenproduced by decomposing a large-scale linear system into aset of lower order subsystems connected in feedback. We beginby analyzing the requirements for asymptotic stability throughgeneralized dissipation inequalities and storage functions. Usingthis insight we then describe various metrics based on a system’senergy dissipation to determine how strongly the subsystemsinteract with each other. From these metrics a decompositionalgorithm is described.
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| 8. |
- Andersson, G., et al.
(författare)
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Cyber-security of SCADA systems
- 2012
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Ingår i: 2012 IEEE PES Innovative Smart Grid Technologies, ISGT 2012. - : IEEE. - 9781457721588 ; , s. 6175543-
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Konferensbidrag (refereegranskat)abstract
- After a general introduction of the VIKING EU FP7 project two specific cyber-attack mechanisms, which have been analyzed in the VIKING project, will be discussed in more detail. Firstly an attack and its consequences on the Automatic Generation Control (AGC) in a power system are investigated, and secondly the cyber security of State Estimators in SCADA systems is scrutinized.
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| 9. |
- Araújo, José, et al.
(författare)
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A down-sampled controller to reduce network usage with guaranteed closed-loop performance
- 2014
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Ingår i: Decision and Control (CDC), 2014 IEEE 53rd Annual Conference on. - : IEEE conference proceedings. - 9781479977468 ; , s. 6849-6856
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Konferensbidrag (refereegranskat)abstract
- We propose and evaluate a down-sampled controller which reduces the network usage while providing a guaranteed desired linear quadratic control performance. This method is based on fast and slow sampling intervals, as the closed-system benefits by being brought quickly to steady-state conditions while behaving satisfactorily when being actuated at a slow rate once at those conditions. This mechanism is shown to provide large savings with respect to network usage when compared to traditional periodic time-triggered control and other aperiodic controllers proposed in the literature.
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| 10. |
- Arghavani, Abbas, et al.
(författare)
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A Game-theoretic Approach to Covert Communications in the Presence of Multiple Colluding Wardens
- 2021
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Ingår i: 2021 IEEE WIRELESS COMMUNICATIONS AND NETWORKING CONFERENCE (WCNC). - : Institute of Electrical and Electronics Engineers (IEEE). - 9781728195056
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Konferensbidrag (refereegranskat)abstract
- In this paper, we address the problem of covert communication under the presence of multiple wardens with a finite blocklength. The system consists of Alice, who aims to covertly transmit to Bob with the help of a jammer. The system also consists of a Fusion Center (FC), which combines all the wardens' information and decides on the presence or absence of Alice. Both Alice and jammer vary their signal power randomly to confuse the FC. In contrast, the FC randomly changes its threshold to confuse Alice. The main focus of the paper is to study the impact of employing multiple wardens on the trade-off between the probability of error at the FC and the outage probability at Bob. Hence, we formulate the probability of error and the outage probability under the assumption that the channels from Alice and jammer to Bob are subject to Rayleigh fading, while we assume that the channels from Alice and jammer to the wardens are not subject to fading. Then, we utilize a two-player zero-sum game approach to model the interaction between joint Alice and jammer as one player and the FC as the second player. We derive the pay-off function that can be efficiently computed using linear programming to find the optimal distributions of transmitting and jamming powers as well as thresholds used by the FC. The benefit of using a cooperative jammer is shown by means of analytical results and numerical simulations to neutralize the advantage of using multiple wardens at the FC.
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