Global, regional, and national burden of neurological disorders, 1990–2016 : a systematic analysis for the Global Burden of Disease Study 2016

Background: Neurological disorders are increasingly recognised as major causes of death and disability worldwide. The aim of this analysis from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 is to provide the most comprehensive and up-to-date estimates of the global, regional, and national burden from neurological disorders. Methods: We estimated prevalence, incidence, deaths, and disability-adjusted life-years (DALYs; the sum of years of life lost [YLLs] and years lived with disability [YLDs]) by age and sex for 15 neurological disorder categories (tetanus, meningitis, encephalitis, stroke, brain and other CNS cancers, traumatic brain injury, spinal cord injury, Alzheimer's disease and other dementias, Parkinson's disease, multiple sclerosis, motor neuron diseases, idiopathic epilepsy, migraine, tension-type headache, and a residual category for other less common neurological disorders) in 195 countries from 1990 to 2016. DisMod-MR 2.1, a Bayesian meta-regression tool, was the main method of estimation of prevalence and incidence, and the Cause of Death Ensemble model (CODEm) was used for mortality estimation. We quantified the contribution of 84 risks and combinations of risk to the disease estimates for the 15 neurological disorder categories using the GBD comparative risk assessment approach. Findings: Globally, in 2016, neurological disorders were the leading cause of DALYs (276 million [95% UI 247–308]) and second leading cause of deaths (9·0 million [8·8–9·4]). The absolute number of deaths and DALYs from all neurological disorders combined increased (deaths by 39% [34–44] and DALYs by 15% [9–21]) whereas their age-standardised rates decreased (deaths by 28% [26–30] and DALYs by 27% [24–31]) between 1990 and 2016. The only neurological disorders that had a decrease in rates and absolute numbers of deaths and DALYs were tetanus, meningitis, and encephalitis. The four largest contributors of neurological DALYs were stroke (42·2% [38·6–46·1]), migraine (16·3% [11·7–20·8]), Alzheimer's and other dementias (10·4% [9·0–12·1]), and meningitis (7·9% [6·6–10·4]). For the combined neurological disorders, age-standardised DALY rates were significantly higher in males than in females (male-to-female ratio 1·12 [1·05–1·20]), but migraine, multiple sclerosis, and tension-type headache were more common and caused more burden in females, with male-to-female ratios of less than 0·7. The 84 risks quantified in GBD explain less than 10% of neurological disorder DALY burdens, except stroke, for which 88·8% (86·5–90·9) of DALYs are attributable to risk factors, and to a lesser extent Alzheimer's disease and other dementias (22·3% [11·8–35·1] of DALYs are risk attributable) and idiopathic epilepsy (14·1% [10·8–17·5] of DALYs are risk attributable). Interpretation: Globally, the burden of neurological disorders, as measured by the absolute number of DALYs, continues to increase. As populations are growing and ageing, and the prevalence of major disabling neurological disorders steeply increases with age, governments will face increasing demand for treatment, rehabilitation, and support services for neurological disorders. The scarcity of established modifiable risks for most of the neurological burden demonstrates that new knowledge is required to develop effective prevention and treatment strategies. Funding: Bill & Melinda Gates Foundation

Simultaneous line Raman/Rayleigh measurements for mixture fraction determination in turbulent, partially premixed slot burner flames

International audienc

Simultaneous line Raman/Rayleigh measurements for mixture fraction determination in turbulent, partially premixed slot burner flames

International audienc

Simultaneous line Raman/Rayleigh measurements for mixture fraction determination in turbulent, partially premixed slot burner flames

International audienc

Evaluation of partially premixed flame stability from mixture fraction statistics in a turbulent slot burner

International audienc

Experimental study and kinetic analysis of the laminar burning velocity of NH3/syngas/air, NH3/CO/air and NH3/H2/air premixed flames at elevated pressures

Mixing ammonia with syngas can be a promising way to overcome the low reactivity of ammonia, allowing it to find usage in IGCC (Integrated Gasification Combined Cycle) systems and gas turbines for power generation. However, fundamental experimental data on laminar burning velocity of NH3/syngas/air are rather scarce, especially at elevated pressures. This information is critical for the development and validation of reaction mechanisms and advances in combustor design. In the present work, measurements of the laminar burning velocities (SL) of NH3/syngas/air, NH3/CO/air, and NH3/H2/air premixed flames were performed by the heat flux method at pressures up to 5 atm, equivalence ratios ranging from 0.7 to 1.6, ammonia mole fractions in the fuel mixture from 0.2 to 1.0 in the NH3/syngas/air mixtures and 0.03–1.0 in the NH3/CO/air mixtures. Several recently published ammonia oxidation mechanisms were tested against the present experimental data. The measurements and predictions of SL exhibit discrepancies especially for NH3/H2/air flames at elevated pressures. The pressure exponent factors, β, characterizing burning velocity at elevated pressure via empirical power-law correlation SL/SL0 = (P/P0)β are extracted from the measured SL and compared with the numerical results. The thermal, diffusion, and chemical effects of blending syngas with ammonia on SL of the mixtures are distinguished, and the dominant role of the adiabatic flame temperature on the variation of the pressure exponent β is discussed. Kinetic modeling and sensitivity analyses showed that reactions of NHi to N2Hi (i = 0–4) species affect the predicted SL under rich conditions. At elevated pressures, these reactions also affect the NO formation via third-body collision reactions and NHi + NO reactions. Even for rich flames, the ammonia consumption is favored with the addition of syngas which also promotes NO formation by enriching the H and OH radical pools and increasing the flame temperature. The addition of hydrogen or carbon monoxide has equally promoting effect on the ammonia decomposition and NOx formation although their flame speed differs a lot