Patienten mit schweren Herzerkrankungen, wie z.B. Herzinsuffizienz (HI), zählen zu Risikopatienten in der zahnärztlichen Praxis und erfordern eine besondere Aufmerksamkeit in der zahnärztlichen Betreuung (Prävention, Behandlung und Nachsorge). Das Endstadium der HI führt häufig zur Notwendigkeit einer Kreislaufunterstützung im Sinne eines Herzunterstützungssystems, insbesondere eines sog. left ventricular assist devices (LVAD), und/oder zu einer Herztransplantation (HTx) [4-6] . Patienten nach HTx sind u.a. aufgrund der lebenslangen Immunsuppression als Risikopatienten einzustufen. Auch bei Patienten mit LVAD-Systemen besteht durch die Verbindung der extrakorporalen Steuereinheit nach endothorakal eine erhöhte Infektionsgefahr. In diesem Kontext wurde jedoch festgestellt, dass betroffene Patienten dieser Klientel einen hohen parodontalen Behandlungsbedarf und eine hohe Prävalenz moderater bis schwerer Parodontitis aufweisen. Zudem zeigt sich ein unzureichendes Mundgesundheitsverhalten. Parodontitis erhöht nachweislich das Risiko einer oralen Bakteriämie und schlussendlich das Risiko infektiöser Komplikationen, wie beispielsweise einer Endokarditis. Eine frühzeitige zahnärztliche Behandlung mit langfristiger präventiver Betreuung der genannten Risikopatienten ist daher zu fordern. Die vorliegende Beobachtungsstudie mit prospektiver Verlaufsbeurteilung verfolgte das Ziel festzustellen, ob eine standardisierte (bedarfsorientierte) Zuweisung zum (Haus-)Zahnarzt zu einer verbesserten Mundgesundheitssituation bei Patienten mit HI bzw. Z. n. HTx und LVAD-Implantation führt. Zudem sollten mögliche Ursachen für eine ausbleibende Verbesserung der Mundgesundheit bzw. unzureichende zahnärztliche Therapie aufgezeigt werden. Hierzu wurden zweihunderteins Patienten der Universitätsklinik für Herzchirurgie des Herzzentrums Leipzig im Rahmen einer Querschnittsstudie mit prospektiver Verlaufskontrolle zunächst (standardisiert) zahnärztlich untersucht und befragt (Baseline). Die klinisch-zahnärztliche Untersuchung umfasste die dentale und parodontale Beurteilung der Patienten. Hierfür wurden zum einen fehlende, kariöse und gefüllte Zähne (DMF-T-Index) erfasst und im Weiteren Sondierungstiefen (ST) und Attachmentverlust (AV) erhoben. Aus ST und AV wurde der Schweregrad einer vorliegenden Parodontitis ermittelt (keine/milde, moderate oder schwere Parodontitis). Zudem wurden der dentale und parodontale Behandlungsbedarf aus den vorliegenden Befunden abgeleitet: dentaler Behandlungsbedarf = Vorliegen mindestens einer behandlungsbedürftigen kariösen Läsion (D-T>0), parodontaler Behandlungsbedarf = Sondierungstiefe von ≥3.5mm in mindestens zwei Sextanten. Aus Vorliegen des dentalen und/oder parodontalen Behandlungsbedarfes wurde der gesamtheitliche zahnärztliche Behandlungsbedarf bestimmt. Weiterhin wurde das Mundgesundheits- und Inanspruchnahmeverhalten zahnärztlicher Leistungen mit einem standardisierten Fragebogen ermittelt. Zudem wurde das Mundhygieneverhalten der Patienten (Häufigkeit der täglichen Mundhygiene, Mundhygienehilfsmittel) erfasst. Anschließend erfolgte die standardisierte, zielgerichtete Zuweisung zum (Haus-)Zahnarzt mit einem Arztbrief, welcher die Information über die erfolgte zahnärztliche Untersuchung beinhaltete sowie den aktuell vorliegenden zahnärztlichen Behandlungsbedarf aufzeigte. Nach zwölf Monaten konnten achtundachtzig (HTx = 31, LVAD = 43, HI= 14) der initial untersuchten Patienten erneut unter standardisierten Bedingungen untersucht werden (Follow-up). Hierbei wurden die gleichen Parameter erfasst wie zum Zeitpunkt der Baseline- Untersuchung. Zusätzlich wurden sie in Bezug auf die Zahnarztkonsultation mittels eines standardisierten Fragebogens befragt. Dabei richtete sich die Befragung inhaltlich nach fünf thematischen Schwerpunkten aus: Auswirkung des zahnärztlichen Empfehlungsschreibens auf ein Vorstellen des Patienten beim (Haus-)Zahnarzt, Inhalt des Zahnarztbesuches (z.B. Erfragung der stattgefundenen Therapiemaßnahmen), Antibiotika-Prophylaxe beim (Haus-)Zahnarzt, Fachlicher Kenntnisstand des (Haus-)Zahnarztes in Bezug auf den Umgang mit der Grunderkrankung des Patienten (z.B. regelmäßiges Aktualisieren der Medikamentenanamnese des Patienten), Individuelles Mundgesundheitsverhalten im Zusammenhang mit der Grunderkrankung (z.B. Veränderungen in der persönlichen Mundhygiene seit Diagnosestellung) Die statistische Analyse wurde mit SPSS für Windows, Version 24.0 (SPSS, Inc., US) durchgeführt. Für metrische Parameter wurde der Mann-Whitney-U-Test angewandt. Kategorische Daten wurden mittels Chi-Quadrat- und Fischer-Test analysiert (p<0.05). Zum Zeitpunkt der Eingangsuntersuchung (Baseline) lag der parodontale Behandlungsbedarf der gesamten Patientengruppe bei 91%, die Anzahl der zerstörten Zähne (D-T) bei 0.4 ± 1.5 und die Anzahl fehlender Zähne (M-T) bei 10.7 ± 9.0. Die Auswertung der Fragebögen zeigte, dass die Mehrheit der Patienten (79,5%) der Zuweisung zum (Haus-)Zahnarzt folgte. Dabei waren keine signifikanten Unterschiede in den einzelnen Patientengruppen (HTx: 87%, LVAD: 74%, HI: 79%, p=0.41) festzustellen. Am häufigsten wurde nach Angaben der Patienten, die ihren (Haus-)Zahnarzt besucht hatten, eine professionelle Zahnreinigung (PZR) durchgeführt (53% aller Patienten). In der Gruppe der LVAD-Patienten erhielten jedoch signifikant weniger Patienten eine PZR (40%) als in der Gruppe der HTx- und HI-Patienten (68% und 64%, p=0.04). Lediglich 10% der gesamten Patientengruppe gaben trotz hohem parodontalen Behandlungsbedarf (Baseline 91%) an, dass während der letzten zwölf Monate eine Parodontitistherapie beim (Haus-)Zahnarzt eingeleitet bzw. erfolgt sei. Insbesondere HTx-Patienten gaben an, das Mundgesundheitsverhalten (Häufigkeit der täglichen Mundhygiene, Mundhygienehilfsmittel) seit Beginn der Herzerkrankung konsequenter umzusetzen (HTx: 52% vs. LVAD: 21% und HI: 36%, p=0.03). Ebenso räumten HTx-Patienten der Mundhygiene seit Beginn der Diagnosestellung einen größeren Stellenwert ein (61%), im Vergleich zu LVAD- und HI-Patienten (LVAD: 26% und HI: 21%, p˂0.01). Der Vergleich zwischen Mundgesundheit zum Zeitpunkt der Ausgangsuntersuchung (Baseline) und Kontrolluntersuchung nach zwölf Monaten (Follow-up) zeigt einige Veränderungen: Dabei war ein Anstieg der Karies (D-T; Baseline: 0.4 ± 1.5, Follow-up: 0.6 ± 1.1, p=0.03) und der fehlenden Zähne (M-T; 10.7 ± 9.0 vs. 11.1 ± 9.2, p<0.01) auffällig. Zudem war nur eine geringfügige Reduktion des parodontalen Behandlungsbedarfes der gesamten Kohorte von 91% (Baseline) zu 75% (Follow-up) festzustellen. In der Gruppe der Patienten mit HTx konnten jedoch keine bedeutenden Unterschiede der Mundgesundheits-parameter zwischen Baseline und Follow-up evaluiert werden. In der Gruppe der Patienten mit LVAD zeigte sich im Vergleich Follow-up und Baseline ein leichter Anstieg der fehlenden Zähne (M T; 13.9 ± 8.8 vs. 14.4 ± 9.0, p˂0.01) sowie ein reduzierter parodontaler Behand-lungsbedarf zum Zeitpunkt der Nachuntersuchung (88% vs. 70%, p=0.01). Die HI-Patienten-klientel fällt lediglich durch eine Zunahme der Anzahl fehlender Zähne auf (M-T; 9.8 ± 9.9 vs. 10.3 ± 9.9; p=0.03). Bei der Analyse der Mundgesundheitsparameter unter Berücksichtigung der Ergebnisse der Befragung konnten keine signifikanten Zusammenhänge gezeigt werden; so zeigte beispielsweise der parodontale Behandlungsbedarf keine Assoziationen zu einer nach Angaben der Patienten erfolgten Parodontaltherapie (p=0.69) bzw. zu einem Zahnarztbesuch im Allgemeinen (p=0.54). Des Weiteren gibt es ebenso keine Assoziationen zwischen dentalem Behandlungsbedarf und restaurativen zahnärztlichen Therapiemaßnahmen (p=0.72) sowie Zahnextraktionen (p=0.71). Die einmalige bedarfsorientierte Zuweisung zum (Haus-)Zahnarzt ist schlussendlich nicht ausreichend, um stabile mundgesunde Verhältnisse, insbesondere in Bezug auf die parodontale Behandlungsbedürftigkeit bei Patienten mit schweren Herzerkrankungen zu gewährleisten. Insgesamt liegt ein Verbesserungsbedarf sowohl im Mundgesundheitsverhalten als auch im Mundgesundheitszustand bei Patienten mit HI, LVAD und HTx vor. Obwohl der Status als Risikopatient eine intensive zahnärztliche Betreuung erfordern würde, scheinen die (Haus-)Zahnärzte unter den aktuellen Voraussetzungen nicht imstande zu sein, den derzeitigen parodontalen Versorgungsbedarf schwer Herzerkrankter abzudecken. Eine multidisziplinäre zahnmedizinische Betreuung mit Aufbau und Etablierung von „Special Care“- Einrichtungen mit spezialisierten Zahnärzten ist daher ein zu empfehlender Ansatz. Diese sollten im interdisziplinären Team mit Kardiologen/ Herzchirurgen und anderen beteiligten Fachdisziplinen eine präventionsorientierte Versorgung unter Berücksichtigung der Besonderheiten schwer herzerkrankter Patienten gewährleisten.:Inhaltsverzeichnis Abkürzungsverzeichnis Abbildungsverzeichnis 1 Einleitung 1.1 Einführung 1.2 Risikopatienten in der zahnärztlichen Praxis 1.2.1 Allgemeine Zusammenhänge 1.2.2 Patienten mit schweren Herzerkrankungen (HI, LVAD und HTx) 1.3 Mundgesundheit bei zahnmedizinischen Risikopatienten mit Schwerpunkt auf HI, LVAD und HTx 1.3.1 Bedeutung der Mundgesundheit bei Patienten mit schweren Herzerkrankungen 1.3.2 Mundgesundheitszustand bei Patienten mit schweren Herzerkrankungen (HI, LVAD und HTx/Tx) . . . 1.4 Zahnmedizinische Behandlungsempfehlungen bei Risikopatienten mit Schwerpunkt auf HI, LVAD und HTx 1.5 Ursachenforschung im Hinblick auf eine Verbesserung der Mundgesundheits-situation der Patienten mit schweren Herzerkrankungen . . . . . 1.6 Zielsetzung . . . . . . . . . . . . . 2 Publikationsmanuskript 3 Zusammenfassung der Arbeit 4 Ausblick 5 Literaturverzeichnis 6 Wissenschaftliche Präsentationen 7 Darstellung des eigenen Beitrags 8 Erklärung über die eigenständige Abfassung der Arbeit 9 Lebenslauf 10 Danksagung

The objective of the thesis was to evaluate the possibility to calculate the unloading distribution between a ventilator and a patient using a new mathematical modelling of the breathing patterns. The modelling used today is considered to lack sufficient precision for clinical use, and is a somewhat simplified model. To evaluate the possibility of a new model, a volunteer test was carried out - recording data such as Edi, pressure, volume and flow. Using this data, and by using a more complex model, tidal volume was estimated and compared to the measured data. The results did not imply any improvement compared to the simpler model regarding the accuracy and the variability. However, more work should be done in this area, as time deficiency prevented further analysis.

A uniaxial High-Velocity Compaction (HVC) process for polymer powder using a cylindrical, hardened steel die and a new technique with relaxation assist was tested with a focus on the compactibility characteristics and surface morphology of the compacted materials using various heights of relaxation assist device with different compacting profiles. Relaxation assist device was presented as a new technique to reduce springback, pull-out phenomenon and to improve the compaction process. The basic phenomena associated with HVC are explained and the general energy principle is introduced to explain pull-out phenomenon during the decompacting stage. In this study, polyamide-11 powders with different particle size distributions have been compacted with the application of different compaction profiles, e.g. different energies and velocities. It was found that the relative green density is influenced more by the pre-compacting (primary compaction step) than by the post-compacting (secondary compaction step). Experimental results for different compaction profiles were presented showing the effect of varying the opposite velocity during the decompacting stage and how to improve the homogeneous densification between the upper and lower surface and the evenness of the upper surface of the compacted powder bed by using relaxation assists, and the influences of the relaxation assist device on the process characteristics. It was found that the relaxation assist improves the compaction of the polymer powder by locking the powder bed in the compacted form. In addition, the relative times of the compacting stage, decompacting stage and the reorganisation of the particles can be controlled by altering the height of the relaxation assist. It was found that the high-velocity compaction process is an interruption process and that the delay times between the pressure waves can be reduced by increasing the height of the relaxation assist device. Furthermore, the first gross instantaneous springback and the total elastic springback are reduced. Two bonding strain gauges and a high-speed video camera system were used to investigate the springback phenomenon during the compaction process. Scanning electron microscopy (SEM) and image computer board Camera (IC-PCI Imaging Technology) were used to the study the morphological characteristics, the limit of plastic deformation and particle bonding by plastic flow at contact points, and pull-out phenomena. / QC 20100506

A Left Ventricular Assist Device (LVAD) is a mechanical pump that helps patients with heart failure conditions. This rotary pump works in parallel to the ailing heart and provides an alternative path for blood flow from the weak left ventricle to the aorta. The LVAD is controlled by the power supplied to the pump motor. An increase in the pump motor power increases the pump speed and the pump flow. The LVAD is typically controlled at a fixed setting of pump power. This basically means that the controller does not react to any change in the activity level of the patient. An important engineering challenge is to develop an LVAD feedback controller that can automatically adjusts its pump motor power so that the resulting pump flow matches the physiological demand of the patient. To this end, the development of a mathematical model that can be used to accurately simulate the interaction between the cardiovascular system of the patient and the LVAD is essential for the controller design. The use of such a dynamic model helps engineers and physicians in testing their theories, assessing the effectiveness of prescribed treatments, and understanding in depth the characteristics of this coupled bio-mechanical system. The first contribution of this dissertation is the development of a pump power-based model for the cardiovascular-LVAD system. Previously, the mathematical models in the literature assume availability of the pump speed as an independent control variable. In reality, however, the device is controlled by pump motor power which, in turn, produces the rotational pump speed. The nonlinear relationship between the supplied power and the speed is derived, and interesting observations about the pump speed signal are documented. The second contribution is the development of a feedback controller for patients using an LVAD as either a destination therapy or a bridge to transplant device. The main objective of designing this controller is to provide a physiological demand of the patient equivalent of that of a healthy individual. Since the device is implanted for a long period of time, this objective is chosen to allow the patient to live a life as close to normal as possible. The third contribution is an analysis of the aortic valve dynamics under the support of an LVAD. The aortic valve may experiences a permanent closure when the LVAD pump power is increased too much. The permanent closure of the aortic valve can be very harmful to the patients using the device as a bridge to recovery treatments. The analysis illustrates the various changes in the hemodynamic variables of the patient as a result of aortic valve closing. The results establish the relationship between the activity level and the heart failure severity with respect to the duration of the aortic valve opening.

Background: Peripartum cardiomyopathy (PPCM) is a rare, life-threatening form of heart disease, frequently associated with gene alterations and, in some cases, presenting with advanced heart failure. Little is known about ventricular assist device (VAD) implantation in severe PPCM cases. We describe long-term follow-up of PPCM patients who were resistant to medical therapy and received mechanical circulatory support or heart transplant. Methods and results: A total of 13 patients were included with mean follow-up of eight years. Mean age of PPCM onset was 33.7 ± 7.7 years. All patients were initially treated with angiotensin-converting enzyme inhibitors and beta-blockers, and four received bromocriptine. Overall, five patients received VADs (three biventricular, two isolated left ventricular) at median 27 days (range: 3 to 150) following childbirth. Two patients developed drive line infection. Due to the short support time, none of those patients had a stroke or VAD thrombosis. In total, five patients underwent heart transplantation, of which four previously had implanted VADs. Median time to transplantation from PPCM onset was 140 days (range: 43 to 776), and time to transplantation from VAD implantation were 7, 40, 132, and 735 days, respectively. All patients survived until most recent follow up, with the exception of one patient who died following unrelated abdominal surgery two years after PPCM recovery. Conclusions: In patients with severe, life-threatening PPCM refractory to medical management, mechanical circulatory support with or without heart transplantation is a safe therapeutic option.

Background: To assess whether the standardized recommendation of patients with heart failure (HF), left-ventricular assist device (LVAD) and heart transplantation (HTx) to visit their dentist leads to improved oral conditions after 12 months. Methods: Patients from the Department of Cardiothoracic Surgery, Leipzig Heart Centre, Germany were examined at baseline and after 12 months. A dental (decayed-, missing-, and filled-teeth index (DMF-T)) and periodontal examination (periodontal probing depth, clinical attachment loss) was performed. At baseline, patients received a standardized recommendation to visit their dentist. At follow-up, a standardized questionnaire regarding the dental consultation was applied. Results: Eighty-eight participants (HTx: 31, LVAD: 43, HF: 14) were included. The majority of patients (79.5%) followed the recommendation to visit their dentist. Within the total cohort, periodontal treatment need was significantly reduced from 91% (baseline) to 75% (follow-up; p < 0.01). Only 10% of total cohort stated that they received periodontal treatment. The outcome in periodontal and dental treatment need at follow-up appointment revealed no statistically significant associations to the questionnaire regarding dentist consultation (p > 0.05). Conclusions: The simple recommendation to visit the dentist appears not enough to obtain sufficient dental and periodontal conditions in patients with severe heart diseases. Thereby, a lack in periodontal treatment of patients with HF, HTx and LVAD was identified, making interdisciplinary dental special care programs recommendable.

Ventricle Assist Devices (VADs), which are typically either axial or centrifugal flow pumps implanted on the aortic arch, have been used to support patients who are awaiting cardiac transplantation. Success of the apparatus in the short term has led to long term use. Despite anticoagulation measures, blood clots (thrombi) have been known to form in the device itself or inside of the heart. The Ventricle Assist Devices supply blood flow via a conduit (cannula) implanted on the ascending aorta. Currently, the implantation angle of the VAD cannula is not taken into consideration. Since the VADs supply a significant amount of blood flow to the aorta, the implantation angle can greatly affect the trajectory of the formed thrombi as well as the cardiac flow field inside of the aortic arch. This study aims to vary the implantation angle of a pediatric Left Ventricle Assist Device (LVAD) through a series of computational fluid dynamics (CFD) software simulations focusing on the aortic arch and its branching arteries of a 20 kg pediatric patient in order to reduce the occurrence of stroke.

No description available.

In recent years there has been a shift in the way consumer products are being purchased shifting from physical in-store shopping to online shopping. A vast amount of goods, express deliveries and simple returns have led to the need for new tools and methods for the delivery industry. At the same time, the environmental crisis is ongoing, and preventive regulations are being implemented in countries worldwide, directly affecting the urban transport sector. One step that has been taken by the urban transportation sector is the implementation of different types of electric vehicles for last mile deliveries of goods. The Swedish motorcycle manufacturer Cake launched their first motorcycle in 2017 and have since then launched other models. More recently Cake has brought products to the market that aim toward business to business. As a part of this effort, Cake was interested in the development of a concept within the last mile delivery sector. The purpose of the project was to investigate last mile deliveries in urban environments to learn what requirements there were on light electric freight vehicles being used. The goal was to define and develop a light electric freight vehicle concept for Cake. Following the double diamond methodology, research was conducted on state of theart, stakeholder needs and EU regulations leading to user insights and a requirements specification. Based on the insights and requirements, concepts were developed through an iterative process, leading to a final concept. The final concept was a 800mm wide trike operated by pedal assist, with the capability to transport cargo that has the area of an EUR pallet behind the driver while still being allowed in bicycle lanes. The concept was validated by building a full scale prototype and conducting tests on it against the insights and requirements specification. / De senaste åren har beteenden kring köp av konsumentprodukter fundamentalt förändrats, där handeln stadigt går från butikshandel till onlinehandel. Till följd av de stora godsmängder som cirkulerar, i kombination med att tjänster så som expressleveranser och snabba returer blir allt vanligare, så har leverans branschens behov av nya verktyg och metoder ökat. Samtidigt har den pågående miljökrisen lett till att många länder i världen implementerar en allt hårdare miljöpolitik som direkt påverkar den urbana transportsektorn. Ett steg som tagits av den urbanatransportsektorn är att implementera av olika typer av elektriska fordon ämnade för leveranser i urbana miljöer, så kallat “last mile deliveries”. Svenska motorcykeltillverkaren Cake lanserade deras första motorcykel 2017. Sedan dess har de släppt ett flertal modeller samt lanserat produkter ämnade för företagsverksamheter, även kallat“business to business”. Som en del av utvecklingen mot “business to business” var Cake intresserade av att utveckla ett koncept riktat mot “last mile deliveries”. Syftet med projektet var att undersöka “last mile deliveries” i stadsmiljöer för att förstå vilka krav som finns på lätta elektriska fraktfordon inom branschen. Målet med projektet var att definiera och utveckla ett koncept av en lätt elektrisk fraktfordon till Cake. Designprocessen strukturerades enligt “double diamond” metodologin, där forskningen bestod avanalyser av befintliga produkter på marknaden, intervjuer av personer på olika fraktbolag, samt litteraturstudier av forskningsrapporter samt EU-regler. Insikterna ledde till användar-insikter samt en kravspecifikation. Baserat på insikterna och kravspecifikationen utvecklades ett koncept genom en iterativ process. Slutkonceptet var en 800mm bred trehjulig eldriven cykel med en lastkapacitet på minst 1 kubikmeter. Konceptet validerades med tester på en fullskalig prototyp, där funktioner och geometri utvärderades mot kravspecifikationen.

Every year, approximately 34,000 individuals are fatally injured in crashes on US roads [1]. These fatalities occur across many types of crash scenarios, each with its own causation factors. One way to prioritize research on a preventive technology is to compare the number of occupant fatalities relative to the total number of occupants involved in a crash scenario. Four crash modes are overrepresented among fatalities: single vehicle road departure crashes, control loss crashes, cross-centerline head-on crashes, and pedestrian/cyclist crashes [2]. Interestingly, three of these crash scenarios require the subject vehicle to depart from the initial lane of travel. Lane departure warning (LDW) systems track the vehicle lane position and can alert the driver through audible and haptic feedback before the vehicle crosses the lane line. Lane departure prevention (LDP) systems can perform an automatic steering maneuver to prevent the departure. Another method of prioritizing research is to determine factors common among the fatal crashes. In 2017, 30.4% of passenger vehicle crash fatalities involved a vehicle rollover [1]. Half of all fatal single vehicle road departure crashes resulted in a rollover yet only 12% of fatal multi-vehicle crashes involved a rollover [1]. These often occur after the driver has lost control of the vehicle and departed the road. Electronic stability control (ESC) can provide different braking to each wheel and allow the vehicle to maintain heading. While ESC is a promising technology, some rollover crashes still occur. Passive safety systems such as seat belts, side curtain airbags, and stronger roofs work to protect occupants during rollover crashes. Seat belts prevent occupants from moving inside the occupant compartment during the rollover and both seat belts and side curtain airbags can prevent occupants from being ejected from the vehicle. Stronger roofs ensure that the roof is not displaced during the rollover and the integrity of the occupant compartment is maintained to prevent occupant ejection. The focus of this dissertation is to evaluate the effectiveness of vehicle-based countermeasures, such as lane departure warning and electronic stability control, for preventing or mitigating single vehicle road departure crashes, cross-centerline head-on crashes, and single vehicle rollover crashes. This was accomplished by understanding how drivers respond to both road departure and cross-centerline events in real-world crashes. These driver models were used to simulate real crash scenarios with LDW/LDP systems to quantify their potential crash reduction. The residual crashes, which are not avoided with LDW/LDP systems or ESC, were analyzed to estimate the occupant injury outcome. For rollover crashes, a novel injury model was constructed that includes modern passive safety countermeasures such as seat belts, side curtain airbags, and stronger roofs. The results for road departure, head-on, and control loss rollover crashes were used to predict the number of crashes and injured occupants in the future. This work is important for identifying the residual crashes that require further research to reduce the number of injured crash occupants. / Doctor of Philosophy / Every year in the US, approximately 34,000 individuals are fatally injured in many different types of crashes. However, some crash types are more dangerous than other crash types. Drift-out-of-lane (DrOOL) road departure crashes, control loss road departure crashes, head-on crashes, and pedestrian crashes are more likely to result in an occupant fatality than other crash modes. In three of these more dangerous crash types, the vehicle departs from the lane before the crash occurs. Lane departure warning (LDW) systems can detect when the vehicle is about to cross the lane line and notify the driver with beeping or vibrating the steering wheel. A different system, called lane departure prevention (LDP), can provide automatic steering to prevent the vehicle from leaving the lane or return lane. In control loss crashes, the vehicle's motion is in a different direction than the vehicle's heading. During control loss, it is easier for the vehicle to roll over which is very dangerous. Electronic stability control (ESC) can prevent control loss by applying selective braking to each tire to keep the vehicle's motion in the same direction as the vehicle's heading. If a rollover still occurs, vehicles are equipped with passive safety systems and designs such as seat belts, side curtain airbags, and stronger roofs to protect the people inside. Seat belts can prevent occupants from striking the vehicle interior during the rollover and both seat belts and side curtain airbags can prevent occupants from being ejected from the vehicle. Stronger roofs ensure that the roof is not displaced during the rollover to prevent occupants from being ejected from the vehicle. The focus of this dissertation is to estimate how many crashes LDW, LDP, and ESC systems could prevent. This was accomplished by understanding how drivers respond after leaving their lane in real crashes. Then, these real crash scenarios were simulated with an LDW or LDP system to estimate how many crashes were prevented. The occupants of residual crashes, which were not prevented by the simulated systems, were analyzed to estimate the number of occupants with at least one moderate injury. Understanding which crashes and injuries that were not prevented with this technology can be used to decide where future research should occur to prevent more fatalities in road departure, head-on and control loss crashes.