Table 2-8. – Number of DALYs and age-standardized DALY rates (per 100 000) for stroke and stroke subtypes for women, in Brazil and its Federative Units, 1990 and 2017, and percent change.
Cause of death and location | 1990 | 2017 | Percent change (95% UI) | ||
---|---|---|---|---|---|
Number (95% UI) | Rate (95% UI) | Number (95% UI) | Rate (95% UI) | ||
B.2.3- Stroke | |||||
Acre | 1767.8 (1667.5;1870.6) | 1862.6 (1754.2;1968.1) | 3210.2 (2987;3441.9) | 1026.8 (954.3;1102.8) | -44.9 (-49.1;-40.5) |
Alagoas | 20195.9 (18814.5;21710) | 2493.7 (2346.1;2633.1) | 24797.1 (23207.9;26570.3) | 1438.5 (1347.2;1540) | -42.3 (-46.8;-36.9) |
Amapá | 885.9 (829.3;941.5) | 1535.4 (1426.6;1629.7) | 2656 (2406.8;2886.7) | 998.8 (904.3;1088) | -34.9 (-40.6;-29) |
Amazonas | 8123.3 (7479.5;8682.2) | 1784.6 (1640.3;1906.5) | 14351.6 (13285.1;15406.9) | 1007.4 (932.8;1079.1) | -43.5 (-48.1;-38.3) |
Bahia | 77106.2 (71098.5;83950.6) | 1933.3 (1780.5;2103.5) | 89411.6 (83626.9;95362.2) | 1033.8 (966.7;1102) | -46.5 (-51.4;-41.3) |
Brazil | 1107653.4 (1072336.2;1140018.5) | 2162.9 (2095.1;2225.5) | 1228780.5 (1175631.6;1283687.7) | 990.7 (947.7;1034.7) | -54.2 (-55.9;-52.7) |
Ceará | 37337.5 (33441.1;40681.5) | 1555.4 (1404.6;1695.6) | 51423.9 (47690.4;54659.7) | 951.5 (881.9;1012.3) | -38.8 (-44.5;-32.1) |
Distrito Federal | 8067.4 (7639.3;8468) | 2039.3 (1936;2134.4) | 10665.5 (9807.7;11556.2) | 770.8 (709.6;836.4) | -62.2 (-65.4;-58.8) |
Espírito Santo | 21284.7 (20412.8;22164.8) | 2644.9 (2544.4;2750.1) | 21595.1 (20097.5;23121.8) | 941.9 (877;1008) | -64.4 (-67;-61.7) |
Goiás | 23755.9 (22547.1;25022.6) | 2280.3 (2172.2;2397.1) | 30858.1 (28577.4;33385.6) | 870.2 (806.8;940.7) | -61.8 (-64.7;-58.9) |
Maranhão | 26645.2 (23289;30127.1) | 1598.1 (1391.9;1827.3) | 38732.2 (35890.3;42214.2) | 1118.5 (1036;1221.3) | -30 (-37.8;-20.8) |
Mato Grosso | 7767.3 (7044.7;8529.5) | 1700 (1544;1865.8) | 14325.6 (13207.9;15664.7) | 918.2 (846.6;1003.1) | -46 (-52.2;-38.9) |
Mato Grosso do Sul | 10877.7 (10222.6;11460.6) | 2195.2 (2083.8;2306.8) | 15366.3 (14302.6;16510.3) | 1046.1 (973.5;1122.9) | -52.3 (-56.3;-48.4) |
Minas Gerais | 123754.1 (117958.9;129630.2) | 2196.3 (2102.1;2298.1) | 127819.1 (119352.2;136487.9) | 939 (876.7;1002.2) | -57.2 (-60.1;-54.4) |
Pará | 25165.5 (23222.5;26905.8) | 2068.3 (1909.5;2211.6) | 37338 (34648.9;39990.2) | 1071.3 (992.2;1149.1) | -48.2 (-52.7;-43.4) |
Paraíba | 22951.4 (21103.1;24889.3) | 1790 (1649;1937.3) | 27800.7 (25165.5;30858.9) | 1093.1 (988.4;1214.1) | -38.9 (-45.7;-30.9) |
Paraná | 68876 (65849.9;71792.3) | 2694.2 (2581.2;2801.1) | 70346.7 (65904.8;75129.8) | 1027.9 (964.2;1097.5) | -61.8 (-64.3;-59.1) |
Pernambuco | 65476.7 (62212.1;68590.4) | 2548.1 (2424;2666.7) | 66471.3 (61893.2;70853.2) | 1189.6 (1108.5;1266.9) | -53.3 (-56.3;-50) |
Piauí | 14762.7 (13259.2;16152.3) | 1745.7 (1576.7;1913.4) | 21016.8 (19347.1;23129.4) | 1080.9 (996;1188.6) | -38.1 (-44;-30.8) |
Rio de Janeiro | 163177.5 (155826.3;170272.8) | 2857.2 (2732.3;2972.6) | 135969.3 (127343.8;144657.3) | 1113.5 (1043.6;1182.9) | -61 (-63.6;-58.3) |
Rio Grande do Norte | 12237.7 (11243.8;13264.5) | 1354.1 (1243.1;1464.4) | 16462.8 (15243.4;17811.1) | 800.9 (741;867.3) | -40.9 (-46.3;-34.5) |
Rio Grande do Sul | 82214.5 (78371.8;85849.8) | 2219.2 (2112.8;2314.9) | 84773.5 (78795.6;90367.8) | 1020.9 (950.7;1088.9) | -54 (-57.2;-50.6) |
Rondônia | 4807.8 (4391.3;5259.5) | 2385 (2193.9;2590.8) | 7762.8 (6762.2;8807.3) | 1058.4 (926.2;1198.1) | -55.6 (-62.1;-48.7) |
Roraima | 619.9 (547.3;696.3) | 2014.6 (1792.5;2238) | 1500.1 (1285.1;1737.4) | 914.8 (787.5;1048.3) | -54.6 (-62;-45.2) |
Santa Catarina | 32138 (30574;33582.2) | 2345.2 (2228.7;2447.9) | 34801.4 (32383.6;37454.8) | 846.2 (788.9;910.2) | -63.9 (-66.6;-61.2) |
São Paulo | 233492.6 (222621.3;243756.9) | 2013.9 (1920.5;2105.9) | 257929.8 (239779.5;274998.1) | 894 (832.2;952.5) | -55.6 (-58.7;-52.6) |
Sergipe | 9537.5 (8911.3;10080.5) | 1935.3 (1815.6;2042.8) | 13345 (12402.1;14314.6) | 1112.9 (1034.8;1191.9) | -42.5 (-47.1;-37.1) |
Tocantins | 4626.6 (3885.4;5271.5) | 2097.4 (1835.7;2348.9) | 8049.8 (7349.6;8763.6) | 1151.2 (1051.9;1253.8) | -45.1 (-52.1;-36.8) |
B.2.3.1- Ischemic stroke | |||||
Acre | 444.9 (409.5;479.3) | 608.7 (561.8;654.7) | 902.7 (811.5;996.9) | 326.8 (294.5;360.3) | -46.3 (-51.5;-40.3) |
Alagoas | 6023.2 (5547.1;6516) | 856.7 (788.5;926.5) | 7766.5 (7055.1;8495.2) | 470.6 (428;514.9) | -45.1 (-50.8;-38.9) |
Amapá | 265.9 (242.6;289.3) | 581.6 (530;629.3) | 765.2 (674.4;854.7) | 336.3 (297;375.7) | -42.2 (-48.1;-35.8) |
Amazonas | 2290.6 (2070;2488.4) | 624 (566.8;677.8) | 4150 (3727.4;4582.2) | 329.5 (295.8;363.5) | -47.2 (-52.5;-41.2) |
Bahia | 22713.7 (20772.4;24878.4) | 623.8 (569.8;683.6) | 27251.9 (24803.3;29866.6) | 310.7 (282.1;341) | -50.2 (-55.4;-44.5) |
Brazil | 331981.3 (316368.4;347711) | 747.7 (713.7;780.1) | 401935.6 (371989.2;433351) | 326.3 (302.2;351.8) | -56.4 (-58.8;-54.1) |
Ceará | 10460.7 (9309.4;11614.4) | 483.2 (430.3;536) | 17418.5 (15794.8;18990.5) | 315.7 (285.6;344.3) | -34.7 (-42.2;-25.5) |
Distrito Federal | 1824.5 (1676.1;1966.4) | 685.8 (636.7;737.7) | 3106.5 (2760.9;3501.9) | 266.2 (237.8;298.3) | -61.2 (-65.4;-56.8) |
Espírito Santo | 6145.4 (5729.6;6600.7) | 927.7 (871.2;989.9) | 6859.1 (6208.3;7536.9) | 304 (275.3;334.3) | -67.2 (-70.2;-63.9) |
Goiás | 6143.4 (5644.8;6602.7) | 804.8 (746.4;862.9) | 9041.8 (8039.9;10070.3) | 277 (247.5;307) | -65.6 (-69;-61.8) |
Maranhão | 6015.4 (5053;7099.9) | 444.2 (367.5;530.1) | 10822.4 (9615.6;12156.4) | 324.4 (288.3;364.7) | -27 (-37.1;-14.1) |
Mato Grosso | 1936.9 (1730.7;2144.1) | 579.9 (519.9;639.6) | 4094.2 (3653.7;4555.7) | 300.5 (269;333.6) | -48.2 (-54.3;-40.9) |
Mato Grosso do Sul | 2719.9 (2519.2;2923.8) | 696.2 (644.8;746.8) | 4484.7 (4031.8;4957.1) | 324.5 (292.4;358.5) | -53.4 (-58.3;-48.2) |
Minas Gerais | 35992.5 (33442.6;38488.3) | 745.3 (697.4;793.9) | 41120.2 (37036.1;45138.4) | 296.9 (267;326.4) | -60.2 (-63.8;-56.4) |
Pará | 8549.8 (7800.8;9221) | 821.7 (750.3;883.5) | 11848 (10668.4;13072.2) | 370.9 (334.4;408.8) | -54.9 (-60;-49.8) |
Paraíba | 6790.1 (6100.7;7542.4) | 562.3 (505.8;621.7) | 9145.2 (8214.6;10210.5) | 345.4 (310;386.5) | -38.6 (-46.9;-30) |
Paraná | 21328.3 (19837.5;22825.2) | 1018.3 (954.7;1085.5) | 25351.3 (22978.4;27818.6) | 381.4 (346;418.7) | -62.5 (-65.9;-58.8) |
Pernambuco | 20813.8 (19337.3;22311.5) | 897.4 (835.9;959.7) | 20486 (18571.5;22484.9) | 371.3 (336.9;407.6) | -58.6 (-62.6;-54.3) |
Piauí | 3806.7 (3359.2;4298.2) | 518 (458.2;583.8) | 6861.3 (6175.8;7614.2) | 348.2 (313.2;386.4) | -32.8 (-40.7;-24) |
Rio de Janeiro | 45951.2 (42906.6;49127.3) | 911.1 (852.2;970.1) | 42263.4 (38418.9;46502.1) | 336.1 (305.4;369.6) | -63.1 (-66.4;-59.5) |
Rio Grande do Norte | 4389.4 (3954;4826.9) | 516.8 (465.8;567.9) | 5556.1 (4975.4;6161.1) | 265.8 (237.2;294.6) | -48.6 (-54.5;-41.7) |
Rio Grande do Sul | 29458.4 (27295.1;31550.4) | 895.7 (833.5;953.9) | 31776.4 (28691.4;34814.6) | 367.6 (331.6;403.4) | -59 (-62.7;-55.1) |
Rondônia | 1058.6 (955.1;1174.3) | 804 (731.9;882.3) | 2282.1 (1981;2588.8) | 357.4 (311.9;404) | -55.5 (-62.1;-48.7) |
Roraima | 140 (122.6;157.4) | 739.9 (656.3;827) | 433 (371.9;499.1) | 331.8 (287.4;379.6) | -55.2 (-62.2;-46.2) |
Santa Catarina | 10349.1 (9571.8;11121) | 910.1 (847;972.5) | 12306.8 (11098;13645.2) | 310.4 (281;342.7) | -65.9 (-69.2;-62.4) |
São Paulo | 72124.2 (66732.6;77418.9) | 733.7 (681.9;784.3) | 89212.1 (80399.2;97949) | 310.1 (280.1;340.3) | -57.7 (-61.6;-53.7) |
Sergipe | 3143.7 (2870.4;3420.7) | 683.8 (624.9;743.8) | 4299.2 (3883.7;4707.7) | 372 (335.7;406.8) | -45.6 (-51.6;-39.2) |
Tocantins | 1101.1 (958.3;1252.5) | 685.3 (606.7;768.8) | 2331.2 (2078.4;2585.9) | 360.1 (321.8;399.9) | -47.5 (-54.6;-39.4) |
B.2.3.2- Intracerebral hemorrhage | |||||
Acre | 874.7 (812.9;936.3) | 923.1 (856.1;989.3) | 1599.2 (1461.9;1744.8) | 505.7 (461;552.2) | -45.2 (-51.2;-39.3) |
Alagoas | 9872.6 (9062.5;10730.1) | 1226.4 (1127.7;1322.2) | 12763.3 (11791.5;13850.8) | 733.8 (676.7;796.4) | -40.2 (-46.2;-33.1) |
Amapá | 439.7 (406.5;470) | 729.9 (668.2;779.6) | 1319.2 (1165.7;1460.5) | 485.9 (429.7;538.1) | -33.4 (-40.7;-24.9) |
Amazonas | 4241.5 (3841.4;4559.2) | 918 (830.8;989.4) | 7271.3 (6627.5;7883.3) | 503.5 (459.3;545.9) | -45.1 (-50.5;-38.7) |
Bahia | 39495.1 (36010.5;43294.5) | 993.4 (903.6;1090.2) | 44388.6 (40962.7;47759) | 515.9 (475.7;555.3) | -48.1 (-53.8;-42.1) |
Brazil | 563999.7 (545387.7;584682.8) | 1070.2 (1035.3;1106.6) | 580172.8 (555092.6;606176.7) | 465.2 (445;485.9) | -56.5 (-58.7;-54.5) |
Ceará | 18233.6 (16299.5;20228.9) | 772.8 (688.7;861.4) | 24338.9 (22304.9;26159.7) | 453.1 (415.4;487.5) | -41.4 (-48.8;-33.2) |
Distrito Federal | 4240.9 (3979.9;4508.9) | 1005.6 (949;1069.6) | 4945.6 (4453.2;5505.7) | 345.3 (314.1;384.1) | -65.7 (-69.4;-61.7) |
Espírito Santo | 11142.1 (10603;11788.2) | 1321.2 (1257.8;1394.8) | 10272.9 (9453.4;11232.8) | 445.3 (409.9;487.5) | -66.3 (-69.3;-63.3) |
Goiás | 12855.7 (12049.1;13698) | 1147.9 (1079.5;1224.7) | 15021.7 (13681.7;16488.2) | 415.3 (379.8;455) | -63.8 (-67.3;-60.4) |
Maranhão | 12042.9 (9978.3;14209.6) | 765.5 (599.9;923.2) | 19249 (17310;21828.7) | 557.1 (499.7;633.4) | -27.2 (-37.8;-11.3) |
Mato Grosso | 3853.5 (3437.3;4288.6) | 817 (728.9;905.6) | 6957.4 (6329.9;7833.2) | 433.6 (394.8;486.6) | -46.9 (-54.1;-38.6) |
Mato Grosso do Sul | 5943.8 (5561.7;6313.3) | 1148.3 (1080.5;1215) | 7653.1 (7025.6;8338.4) | 513.4 (471.2;560.2) | -55.3 (-59.8;-50.7) |
Minas Gerais | 64366 (60674.3;68220.4) | 1099.1 (1037.2;1163.7) | 60695 (56080.7;65783.6) | 445.7 (411.9;483) | -59.4 (-63;-55.4) |
Pará | 12175.4 (11139.9;13184) | 978.4 (892.1;1059.1) | 18001 (16375.4;19576.3) | 509.9 (464;555.1) | -47.9 (-54;-41.2) |
Paraíba | 11111.2 (10082.5;12219.4) | 868.2 (787.5;953.5) | 13504.5 (12040;15189.3) | 535.8 (476.9;602.6) | -38.3 (-46.7;-28.4) |
Paraná | 35261.9 (33355.6;37203.2) | 1301.5 (1228.2;1375.8) | 31095.5 (28671.9;33664.6) | 447.4 (412.9;484.6) | -65.6 (-68.7;-62.4) |
Pernambuco | 35167.1 (32910.5;37242.7) | 1332.3 (1249;1406.7) | 33631.6 (31062.3;36327.8) | 599.2 (553.1;646.5) | -55 (-59;-50.7) |
Piauí | 7420.7 (6473.6;8346.5) | 888.3 (775.7;998.5) | 10247.3 (9366.6;11531.5) | 529 (483;595.7) | -40.4 (-47.8;-31.4) |
Rio de Janeiro | 88936.8 (84337.9;93896) | 1501.8 (1423.9;1582.9) | 68013.5 (62977;73431) | 555.9 (515.3;599.1) | -63 (-66.3;-59.6) |
Rio Grande do Norte | 5639.4 (5056.1;6175) | 626.4 (561.9;686.3) | 7840.9 (7108.5;8599.3) | 383.7 (347.4;421.2) | -38.7 (-46.2;-29.8) |
Rio Grande do Sul | 40495.5 (37779.2;42885.8) | 1036.9 (967.6;1098.7) | 39133.7 (35903.4;42395.5) | 472.7 (432.7;511.1) | -54.4 (-58.6;-49.5) |
Rondônia | 2628.7 (2371.6;2911.8) | 1227.9 (1117.7;1354.8) | 3779.6 (3245.4;4369.3) | 501 (433.1;579.1) | -59.2 (-65.6;-51.6) |
Roraima | 328.6 (286.2;373.3) | 992.7 (870.9;1116.1) | 736.9 (617.6;867) | 430 (361.4;504.1) | -56.7 (-64.8;-46.4) |
Santa Catarina | 16220.7 (15245.9;17192.1) | 1118.6 (1052.1;1188.3) | 15768.8 (14405.3;17123) | 377.2 (345.2;409.4) | -66.3 (-69.7;-62.9) |
São Paulo | 113907.8 (107421.3;120928.2) | 942.3 (886.5;1000.5) | 111325 (103027.9;120702.2) | 383.3 (354.6;414.6) | -59.3 (-63;-55.4) |
Sergipe | 4704.6 (4381.8;5022.3) | 963.7 (897.4;1029.7) | 6663.5 (6108.6;7225.7) | 552.1 (505.7;600.2) | -42.7 (-48.5;-35.7) |
Tocantins | 2399.1 (1989.3;2787) | 1052.1 (902.5;1202.8) | 3955.6 (3568.2;4425.3) | 560.4 (506.6;627.1) | -46.7 (-54.7;-36.9) |
B.2.3.3- Subarachnoid hemorrhage | |||||
Acre | 448.2 (407.7;497.6) | 330.8 (302.6;363.3) | 708.2 (638.6;792.2) | 194.2 (174.9;216.9) | -41.3 (-48.2;-34) |
Alagoas | 4300.1 (3589.8;5036.8) | 410.6 (351;468.2) | 4267.3 (3820.8;4772.1) | 234.1 (208.7;261.8) | -43 (-52.3;-29.4) |
Amapá | 180.3 (163.7;201.9) | 223.8 (202.9;252.3) | 571.6 (511;643.2) | 176.7 (158;198.7) | -21.1 (-31.2;-9.9) |
Amazonas | 1591.2 (1418;1789.1) | 242.6 (217.8;270.9) | 2930.3 (2642.6;3273.2) | 174.4 (156.1;192.6) | -28.1 (-37.5;-18.8) |
Bahia | 14897.5 (13287.5;16507.2) | 316.1 (283.5;351.9) | 17771.1 (16139.9;19611.7) | 207.1 (188.6;228.5) | -34.5 (-42.6;-24.3) |
Brazil | 211672.4 (199208.9;221899.8) | 345.1 (324.7;363.2) | 246672.1 (231937.6;260803.4) | 199.2 (187.4;210.1) | -42.3 (-46.1;-39) |
Ceará | 8643.3 (6852.4;10486.6) | 299.4 (244.9;357.4) | 9666.5 (8677.7;10600.5) | 182.6 (164.3;200.1) | -39 (-50.4;-26.6) |
Distrito Federal | 2002 (1803;2168.1) | 347.8 (316.2;375.5) | 2613.4 (2319;2911.4) | 159.4 (141;177.5) | -54.2 (-59.3;-47.8) |
Espírito Santo | 3997.2 (3523.8;4296.8) | 396 (345.6;425) | 4463.2 (4009.2;4908.2) | 192.6 (173.2;211.2) | -51.4 (-56.9;-43.7) |
Goiás | 4756.8 (4346.9;5221.2) | 327.6 (300.5;359.9) | 6794.6 (6134.7;7577.9) | 177.8 (160.7;197.9) | -45.7 (-51.6;-38.3) |
Maranhão | 8586.9 (6391.4;11138.3) | 388.5 (299.2;491.9) | 8660.9 (7731.3;9594.6) | 237 (211.2;263.3) | -39 (-51.4;-23.6) |
Mato Grosso | 1976.9 (1748.4;2227.8) | 303.1 (269.1;341.7) | 3274 (2926.5;3658.6) | 184.1 (165.4;204.9) | -39.2 (-47.7;-29.8) |
Mato Grosso do Sul | 2214 (1954.7;2430) | 350.7 (315.4;383.4) | 3228.6 (2883.8;3619.9) | 208.3 (186.4;233) | -40.6 (-48.1;-31.7) |
Minas Gerais | 23395.6 (21454;25318.2) | 351.9 (322.6;381.9) | 26003.9 (23613.8;28559.9) | 196.4 (178.8;214.9) | -44.2 (-50;-37.7) |
Pará | 4440.4 (3942.4;4957.1) | 268.2 (240.2;299.8) | 7488.9 (6775.2;8285.9) | 190.5 (171.6;211.1) | -29 (-37.1;-19.3) |
Paraíba | 5050.1 (4155.5;5968.1) | 359.5 (295.4;422.2) | 5151 (4436.2;5838.5) | 211.9 (182.7;240.2) | -41.1 (-53;-27.7) |
Paraná | 12285.8 (11347.4;13264.7) | 374.4 (343.4;405.7) | 13900 (12510.5;15373.5) | 199.1 (179.6;219.1) | -46.8 (-53;-40.1) |
Pernambuco | 9495.7 (8636;10672.6) | 318.4 (290.2;361.1) | 12353.7 (11186.9;13775.6) | 219.1 (198.7;243.7) | -31.2 (-39.6;-22.6) |
Piauí | 3535.2 (2860;4197.6) | 339.4 (278.5;403.6) | 3908.2 (3521;4310.2) | 203.7 (183.8;224.5) | -40 (-49.9;-27.8) |
Rio de Janeiro | 28289.5 (25607.4;30525.9) | 444.3 (403.8;479.4) | 25692.3 (23122.1;28299.6) | 221.6 (200.2;244.4) | -50.1 (-55.6;-43.3) |
Rio Grande do Norte | 2208.9 (1905.2;2660.8) | 210.9 (182.9;259.7) | 3065.8 (2734.3;3771.2) | 151.5 (135.3;186) | -28.2 (-39.4;-16.6) |
Rio Grande do Sul | 12260.7 (11247.3;14498.1) | 286.6 (262.9;339.3) | 13863.3 (12280.1;15559.9) | 180.6 (160.3;202.5) | -37 (-44.8;-29) |
Rondônia | 1120.6 (1002.6;1250.6) | 353.1 (315.9;395.2) | 1701.2 (1439.6;1988.5) | 200 (169.9;234.3) | -43.4 (-53.1;-32.1) |
Roraima | 151.2 (130.8;181.3) | 282 (242.8;345.6) | 330.2 (273;406.4) | 153 (127.5;188.8) | -45.8 (-56.1;-32.4) |
Santa Catarina | 5568.2 (5137.7;6024.6) | 316.5 (290.8;342.4) | 6725.8 (6071.4;7486.2) | 158.6 (143.3;176.2) | -49.9 (-55.5;-43.4) |
São Paulo | 47460.6 (43883.2;51172.3) | 337.9 (312.7;365.3) | 57392.7 (51539.2;62558) | 200.5 (180.5;218) | -40.7 (-47.3;-33.9) |
Sergipe | 1689.1 (1486.9;1900.9) | 287.8 (256.9;325.8) | 2382.3 (2149.2;2638.5) | 188.8 (170.3;210.1) | -34.4 (-43.9;-25.1) |
Tocantins | 1126.4 (839.2;1386.1) | 360 (280.2;438.7) | 1763.1 (1534.2;1962.8) | 230.6 (201.3;256.2) | -35.9 (-48.5;-18.3) |
Source: Global Burden of Disease Study 2017, Institute for Health Metrics and Evaluation.109