Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: Rigorous analysis of levels and trends in exposure to leading risk factors and quantification of their effect on human health are important to identify where public health is making progress and in which cases current efforts are inadequate. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a standardised and comprehensive assessment of the magnitude of risk factor exposure, relative risk, and attributable burden of disease. Methods: GBD 2019 estimated attributable mortality, years of life lost (YLLs), years of life lived with disability (YLDs), and disability-adjusted life-years (DALYs) for 87 risk factors and combinations of risk factors, at the global level, regionally, and for 204 countries and territories. GBD uses a hierarchical list of risk factors so that specific risk factors (eg, sodium intake), and related aggregates (eg, diet quality), are both evaluated. This method has six analytical steps. (1) We included 560 risk–outcome pairs that met criteria for convincing or probable evidence on the basis of research studies. 12 risk–outcome pairs included in GBD 2017 no longer met inclusion criteria and 47 risk–outcome pairs for risks already included in GBD 2017 were added based on new evidence. (2) Relative risks were estimated as a function of exposure based on published systematic reviews, 81 systematic reviews done for GBD 2019, and meta-regression. (3) Levels of exposure in each age-sex-location-year included in the study were estimated based on all available data sources using spatiotemporal Gaussian process regression, DisMod-MR 2.1, a Bayesian meta-regression method, or alternative methods. (4) We determined, from published trials or cohort studies, the level of exposure associated with minimum risk, called the theoretical minimum risk exposure level. (5) Attributable deaths, YLLs, YLDs, and DALYs were computed by multiplying population attributable fractions (PAFs) by the relevant outcome quantity for each age-sex-location-year. (6) PAFs and attributable burden for combinations of risk factors were estimated taking into account mediation of different risk factors through other risk factors. Across all six analytical steps, 30 652 distinct data sources were used in the analysis. Uncertainty in each step of the analysis was propagated into the final estimates of attributable burden. Exposure levels for dichotomous, polytomous, and continuous risk factors were summarised with use of the summary exposure value to facilitate comparisons over time, across location, and across risks. Because the entire time series from 1990 to 2019 has been re-estimated with use of consistent data and methods, these results supersede previously published GBD estimates of attributable burden. Findings: The largest declines in risk exposure from 2010 to 2019 were among a set of risks that are strongly linked to social and economic development, including household air pollution; unsafe water, sanitation, and handwashing; and child growth failure. Global declines also occurred for tobacco smoking and lead exposure. The largest increases in risk exposure were for ambient particulate matter pollution, drug use, high fasting plasma glucose, and high body-mass index. In 2019, the leading Level 2 risk factor globally for attributable deaths was high systolic blood pressure, which accounted for 10·8 million (95% uncertainty interval [UI] 9·51–12·1) deaths (19·2% [16·9–21·3] of all deaths in 2019), followed by tobacco (smoked, second-hand, and chewing), which accounted for 8·71 million (8·12–9·31) deaths (15·4% [14·6–16·2] of all deaths in 2019). The leading Level 2 risk factor for attributable DALYs globally in 2019 was child and maternal malnutrition, which largely affects health in the youngest age groups and accounted for 295 million (253–350) DALYs (11·6% [10·3–13·1] of all global DALYs that year). The risk factor burden varied considerably in 2019 between age groups and locations. Among children aged 0–9 years, the three leading detailed risk factors for attributable DALYs were all related to malnutrition. Iron deficiency was the leading risk factor for those aged 10–24 years, alcohol use for those aged 25–49 years, and high systolic blood pressure for those aged 50–74 years and 75 years and older. Interpretation: Overall, the record for reducing exposure to harmful risks over the past three decades is poor. Success with reducing smoking and lead exposure through regulatory policy might point the way for a stronger role for public policy on other risks in addition to continued efforts to provide information on risk factor harm to the general public

Optimal Speed Control Humps Design Based on Driver Comfort

The purpose of this study is to optimise the different speed control humps by considering the vertical and horizontal acceleration of the driver’s head. In previous researches, the main focus was only on vertical acceleration, but in this study, horizontal acceleration of the head is also considered. Here, the root mean square (RMS) of acceleration of head is considered as a measure of occupant comfort. The modelling is performed by a non-linear half-car suspension system (4-DOF) with a linear model of a driver (10-DOF) and a seat. The hamps under study are circular, sinusoidal, half-sinusoidal, and trapezoidal. Finally, by analysing the results, the optimal design of each type of hump is performed. The objective function used is a combination of horizontal and vertical acceleration which is performed using MATLAB genetic algorithm. The results show a significant reduction in horizontal and vertical acceleration at all speeds. From this modelling, it is possible to extract a suitable range for passing the speed of cars over different types of humps. In this study, it is shown that the acceleration values for the circular and half-sinusoidal humps at all speeds are quite close to each other.</jats:p

Hybrid adaptive battery parameter estimation approach for equivalent circuit model toolbox

This article presents a software tool for estimating the equivalent circuit model (ECM) of lithium-ion batteries using battery voltage and current datasets based on dynamic and static RC loop curve fitting techniques. This tool calculates the state of charge (SOC) of a battery and clusters experimental data based on the SOC. This provides the possibility of determining the equivalent circuit of the battery. Also, by leveraging the unique structure of the equivalent circuit, the method of estimating the effectiveness of this tool is integrated. The supplementary idea of this article is based on the calculation of the best method of estimating the equivalent circuit based on the hybrid adaptive battery parameter estimation (HABPE) based on model architecture and fitting it accordingly. By comparing the data from the extracted model with the experimental data of the battery, an accuracy of 82–87 % has been achieved, depending on the type of battery model. This method provides an easy and accurate approach to obtaining battery parameters and constructing its equivalent circuit for future applications

Development of an optimized game controller for energy saving in a novel interconnected air suspension system

In this study, the focus is on reducing the energy that is consumed by a compressor for providing high air pressure in the reservoir. A new air suspension configuration is presented that is titled active interconnected air suspension with outsourced air pressure. In this configuration, a compressor is used to charge the tank; meanwhile, the air springs are connected. For minor excitation, first, the air flows between air springs to control roll angle and height adjustment. If the situation of body position gets worse, the compressed air tank compensates to keep the body not generating roll angle and bounce. This methodology has a benefit. This configuration conserves compressed air in the tank in minor road elevation. The optimized controllers are designed to control roll angle and bounce, but they determine the outsourced air mass flow rate. For switching between interconnection and outsourced mode, there are some rules defined based on game theory for a trade-off between high dynamical performance quality of the vehicle and reduction of energy consumption. The optimization is done on the rules to keep both aspects minimum as much as possible. A three-axle heavy truck is used, and its performance is under discussion on an uneven rough road. Roll angle is improved progressively in novel air suspension configuration, and the energy consumption is reduced. In the default condition, the roll angle is improved 72% from the passive case and 39% from the conventional configuration. Furthermore, the energy consumption optimized version reduces 14% from the non-optimized case and 46% from the outsourced mode. By importing road power spectral density type E and type G, as the short domain and high-frequency vibrations, to two sides of the truck, it is inferred that the vehicle could remain on interconnection mode entirely without using the compressor.</jats:p