| 1. |
- Feigin, Valery L., et al.
(author)
-
Global, regional, and national burden of stroke and its risk factors, 1990-2019 : a systematic analysis for the Global Burden of Disease Study 2019
- 2021
-
In: Lancet Neurology. - : Elsevier. - 1474-4422 .- 1474-4465. ; 20:10, s. 795-820
-
Journal article (peer-reviewed)abstract
- Background Regularly updated data on stroke and its pathological types, including data on their incidence, prevalence, mortality, disability, risk factors, and epidemiological trends, are important for evidence-based stroke care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) aims to provide a standardised and comprehensive measurement of these metrics at global, regional, and national levels. Methods We applied GBD 2019 analytical tools to calculate stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and the population attributable fraction (PAF) of DALYs (with corresponding 95% uncertainty intervals [UIs]) associated with 19 risk factors, for 204 countries and territories from 1990 to 2019. These estimates were provided for ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, and all strokes combined, and stratified by sex, age group, and World Bank country income level. Findings In 2019, there were 12.2 million (95% UI 11.0-13.6) incident cases of stroke, 101 million (93.2-111) prevalent cases of stroke, 143 million (133-153) DALYs due to stroke, and 6.55 million (6.00-7.02) deaths from stroke. Globally, stroke remained the second-leading cause of death (11.6% [10.8-12.2] of total deaths) and the third-leading cause of death and disability combined (5.7% [5.1-6.2] of total DALYs) in 2019. From 1990 to 2019, the absolute number of incident strokes increased by 70.0% (67.0-73.0), prevalent strokes increased by 85.0% (83.0-88.0), deaths from stroke increased by 43.0% (31.0-55.0), and DALYs due to stroke increased by 32.0% (22.0-42.0). During the same period, age-standardised rates of stroke incidence decreased by 17.0% (15.0-18.0), mortality decreased by 36.0% (31.0-42.0), prevalence decreased by 6.0% (5.0-7.0), and DALYs decreased by 36.0% (31.0-42.0). However, among people younger than 70 years, prevalence rates increased by 22.0% (21.0-24.0) and incidence rates increased by 15.0% (12.0-18.0). In 2019, the age-standardised stroke-related mortality rate was 3.6 (3.5-3.8) times higher in the World Bank low-income group than in the World Bank high-income group, and the age-standardised stroke-related DALY rate was 3.7 (3.5-3.9) times higher in the low-income group than the high-income group. Ischaemic stroke constituted 62.4% of all incident strokes in 2019 (7.63 million [6.57-8.96]), while intracerebral haemorrhage constituted 27.9% (3.41 million [2.97-3.91]) and subarachnoid haemorrhage constituted 9.7% (1.18 million [1.01-1.39]). In 2019, the five leading risk factors for stroke were high systolic blood pressure (contributing to 79.6 million [67.7-90.8] DALYs or 55.5% [48.2-62.0] of total stroke DALYs), high body-mass index (34.9 million [22.3-48.6] DALYs or 24.3% [15.7-33.2]), high fasting plasma glucose (28.9 million [19.8-41.5] DALYs or 20.2% [13.8-29.1]), ambient particulate matter pollution (28.7 million [23.4-33.4] DALYs or 20.1% [16.6-23.0]), and smoking (25.3 million [22.6-28.2] DALYs or 17.6% [16.4-19.0]). Interpretation The annual number of strokes and deaths due to stroke increased substantially from 1990 to 2019, despite substantial reductions in age-standardised rates, particularly among people older than 70 years. The highest age-standardised stroke-related mortality and DALY rates were in the World Bank low-income group. The fastest-growing risk factor for stroke between 1990 and 2019 was high body-mass index. Without urgent implementation of effective primary prevention strategies, the stroke burden will probably continue to grow across the world, particularly in low-income countries.
|
|
| 4. |
- Li, G., et al.
(author)
-
The influence of passenger car front shape on pedestrian injury risk observed from German in-depth accident data
- 2017
-
In: Accident Analysis and Prevention. - : Elsevier BV. - 0001-4575. ; 101, s. 11-21
-
Journal article (peer-reviewed)abstract
- Quantified relationships between passenger car front shape and pedestrian injury risk derived fromaccident data are sparse, especially considering the significant recent changes in car front design. Thepurpose of this paper is therefore to investigate the detailed effects of passenger car front shape oninjury risk to a pedestrian’s head, thorax, pelvis and leg in the event of a vehicle pedestrian impact.Firstly, an accident sample of 594 pedestrian cases captured during 2000–2015 from the German In-Depth Accident Study (GIDAS) database was employed. Multicollinearity diagnostic statistics were thenused to detect multicollinearity between the predictors. Following this, logistic regression was appliedto quantify the effects of passenger car front shape on injury risks while controlling for impact speedand pedestrian age. Results indicate that the bumper lower depth (BLD), bumper lower height (BLH),bumper upper height (BUH) and normalised bumper lower/upper height (NBLH/NBUH) are statisticallysignificant for AIS2+ leg injury risk. The normalised bonnet leading edge height (NBLEH) has a statisticallysignificant influence on AIS2+ femur/pelvis injury occurrence. The passenger car front shape did notshow statistical significance for AIS3+ thorax and head injuries. The impact speed and pedestrian age aregenerally significant factors influencing AIS2+ leg and pelvis injuries, and AIS3+ thorax and head injuries.However, when head impacts are fixed on the central windscreen region both pedestrian age and impactspeed are not statistically significant for AIS3+ head injury. For quantified effects, when controlling forspeed, age and BUH, an average 7% and 6% increase in AIS2+ leg injury odds was observed for every 1 cmincrease in BLD and BLH respectively; 1 cm increase in BUH results in a 7% decrease in AIS2+ leg injuryodds when the BLD or BLH are fixed respectively (again controlling for impact speed and pedestrian age);the average AIS2+ femur/pelvis injury odds increase by 74% for a 10% increase in NBLEH. These findingssuggest that passenger car bumpers should support the lower leg with a low and flat lower bumper andeven contact up to the femur area with a high upper bumper which extends above the knee to protectthe pedestrian’s leg. A low passenger car bonnet leading edge helps to reduce femur/pelvis injury risk.The passenger car front shape parameters are less influential than impact speed and pedestrian age forpedestrian injury risk.
|
|
| 5. |
- Wang, Fang, et al.
(author)
-
A Study on Influence of Minivan Front-End Design and Impact Velocity on Pedestrian Thorax Kinematics and Injury Risk
- 2018
-
In: Applied Bionics and Biomechanics. - : Hindawi Limited. - 1754-2103 .- 1176-2322. ; 2018
-
Journal article (peer-reviewed)abstract
- Thoracic injuries occur frequently in minivan-to-pedestrian impact accidents and can cause substantial fatalities. The present research work investigates the human thoracic responses and injury risks in minivan-to-pedestrian impacts, when changing the minivan front-end design and the impact velocity, by using computational biomechanics model. We employed three typical types of minivan model of different front-end designs that are quite popular in Chinese market and considered four impact velocities (20, 30, 40, and 50 km/h). The contact time of car to thorax region (CTCTR), thorax impact velocity, chest deformation, and thoracic injury risks were extracted for the investigation. The results indicate that the predicted pedestrian kinematics, injury responses, and thoracic injury risks are strongly affected by the variation of the minivan front-end design and impact velocity. The pedestrian thoracic injury risks increase with the increasing vehicle impact velocity. It is also revealed that the application of the extra front bumper is beneficial for reducing the thoracic injury risk, and a relatively flatter minivan front-end design gives rise to a higher thoracic injury risk. This study is expected to be served as theoretical references for pedestrian protection design of minivans.
|
|
