Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Utilization of Solar Energy for Water Heating Application to Improve Building Energy Efficiency: An Experimental Study

The manuscript is written for flow escalation based on an experimental data for a Solar Assisted Heat Pump Water Heater (SAHPWH) increasing building energy efficiency. For the investigation, a Solar Assisted Heat Pump (SAHP) was conceived, manufactured, and tested in real time. The findings of the experiments shows that single glazing with average sun radiation of 600–750 W/m2, COP of approx. 6 can be obtained with identical heat gains. This study shows that when a flat plate collector of area 1.83 m (L) × 1.22 m (W) × 0.1 m (T) with a 0.5-mm-thick black copper plate absorber with clear glazing as a cover receives average radiation of 700 W/m2, then setup can supply 60 litres of water for residential use from 15 °C to 45 °C in approx. 70 min. In addition, the study finds that the collector efficiency factor F’ is likewise shown to have a direct connection with the absorber and an inverse relationship of tube spacing. The findings indicated that the technology has significant commercial potential, particularly in sectors such as with solar resources for improving building energy efficiency

Utilization of Solar Energy for Water Heating Application to Improve Building Energy Efficiency: An Experimental Study

The manuscript is written for flow escalation based on an experimental data for a Solar Assisted Heat Pump Water Heater (SAHPWH) increasing building energy efficiency. For the investigation, a Solar Assisted Heat Pump (SAHP) was conceived, manufactured, and tested in real time. The findings of the experiments shows that single glazing with average sun radiation of 600–750 W/m2, COP of approx. 6 can be obtained with identical heat gains. This study shows that when a flat plate collector of area 1.83 m (L) × 1.22 m (W) × 0.1 m (T) with a 0.5-mm-thick black copper plate absorber with clear glazing as a cover receives average radiation of 700 W/m2, then setup can supply 60 litres of water for residential use from 15 °C to 45 °C in approx. 70 min. In addition, the study finds that the collector efficiency factor F’ is likewise shown to have a direct connection with the absorber and an inverse relationship of tube spacing. The findings indicated that the technology has significant commercial potential, particularly in sectors such as with solar resources for improving building energy efficiency

Recent Advancements in Augmentation of Solar Water Heaters Using Nanocomposites with PCM: Past, Present, and Future

Energy consumption in India is massive, and even the quantity used for household tasks is substantial. The majority of the requirement is satisfied by using fossil fuels, which are the traditional methods. Heating water is the most frequent home application. Accordingly, this article examines studies from the previous ten years. The information in this article demonstrates that using renewable energy is the greatest way to cut back on both the use of fossil fuels and carbon emissions while heating water for residential use. Solar, hydroelectric, wind, and biofuels are the most significant renewable sources for improving building efficiency that can be used for an extended period of time. The solar water heater is a common example of how solar energy is being used in homes more frequently. In order to identify key issues and solutions related to employing solar water heaters as an effective water heating application in both commercial and residential buildings, this article compiles research data from earlier studies (2012–2022). The literature survey was carried out using Scopus, a specialized database. Sixty-six dedicated research publications having search keywords plus recently published articles that matched the inclusion criteria were chosen for this review study. The study’s findings show that there is a greater inclination of researchers towards research and development in the field of domestic solar water heaters. The research publications that are being presented are all from the past 10 years (2012–2022) and stress the use of solar energy in increasing building efficiency. The study highlights how flat plate solar collectors with distilled water as the heat transfer fluid and a phase-changing substance as the thermal energy storage could potentially be enhanced. The thermal conductivity of paraffin wax and distilled water was improved by 75% of the researchers by using 0.05 to 0.5% concentrations of Al and Cu oxide nanoparticles, making it useful in solar water heaters. A total of 78% of researchers are interested in domestic water heating applications since they use a lot of energy in both urban and rural settings

Experimental Study to Evaluate the Wear Performance of UHMWPE and XLPE Material for Orthopedics Application

The main objective of this study is to perform an abrasive wear resistance study of UMHWPE and XLPE by using different grades of abrasive paper (grade 100 (190 µm), grade 220 (50 µm), and grade 400 (40 µm)) with minor (10 N) and major (15 N) loading conditions. In this article, wear performance of the UMHWPE and XLPE materials compared to the bio-tribological data as reported earlier in the clinical studies has been investigated. The experimental result shows that the loss of materials for the XLPE was much higher than the UHMWPE under similar loading conditions. UHMWPE shows a 34% reduction in wear at minor loading conditions and a 53% reduction in wear at major loading conditions. From experimental results it was concluded that Cross-link PE has better wear resistance than UHMWPE in minor wear conditions, whereas UHMWPE shows better wear resistance under major loading conditions. Based upon these results, UHMWPE and XLPE have been recommended for use as bearing materials in orthopedics. The experimental results of this study were validated using results from the available literature

Performance Optimization of Solar-Assisted Heat Pump System for Water Heating Applications

The use of solar energy in water heating applications, such as in solar-assisted heat pump systems, has great benefits, such as reductions in heat transfer losses, control over incident solar heat, and generation of environmentally benign water heat. In the present study, we performed parametric optimization based on an experimental model of a solar-assisted heat pump system for water heating (SAHPSWH) in the context of colder climatic regions receiving minimal solar radiation. Various parameters were investigated, such as the different glazing arrangements, the distances between fluid-circulating tubes, and the absorber sheet arrangement. The results showed that double glazing was more efficient than single glazing, with average COP values of 3.37 and 2.69, respectively, and with similar heat gain rates. When the evaporator tube was soldered below the absorber plate, the COP was 1.19 times greater than when the tube was soldered above the absorber plate. We also analyzed whether the collector efficiency factor F′ has an inverse relationship with the tube distance and a direct relationship with the absorber plate thickness. Through this experimental study, we verified that the SAHPSWH is reliable if designed judiciously. This promising energy-saving system is particularly suitable for areas abundant in solar radiation, such as in India, where the needs for space conditioning and water heating are constant

Estimation of Carbon Footprint of Residential Building in Warm Humid Climate of India through BIM

In recent years Asian Nations showed concern over the Life Cycle Assessment (LCA) of their civil infrastructure. This study presents a contextual investigation of a residential apartment complex in the territory of the southern part of India. The LCA is performed through Building Information Modelling (BIM) software embedded with Environmental Product Declarations (EPDs) of materials utilized in construction, transportation of materials and operational energy use throughout the building lifecycle. The results of the study illustrate that cement is the material that most contributes to carbon emissions among the other materials looked at in this study. The operational stage contributed the highest amount of carbon emissions. This study emphasizes variation in the LCA results based on the selection of a combination of definite software-database combinations and manual-database computations used. For this, three LCA databases were adopted (GaBi database and ecoinvent databases through One Click LCA software), and the ICE database was used for manual calculations. The ICE database showed realistic value comparing the GaBi and ecoinvent databases. The findings of this study are valuable for the policymakers and practitioners to accomplish optimization of Greenhouse Gas (GHG) emissions over the building life cycle

Potential and Future Prospects of Geothermal Energy in Space Conditioning of Buildings: India and Worldwide Review

This paper presents modern trends in geothermal energy utilization, mainly focusing on ground source heat (GSH) pumps for space conditioning in buildings. This paper focuses on India along with a general review of studies around the world. Space conditioning of a building contributes to about 40–50% of the total energy consumed in buildings and has an adverse impact on the environment and human health. The India Cooling Action Plan (ICAP) estimates that the demand for electricity for heating and cooling of buildings will increase by over 700% in India at current levels by 2047 with an additional 800 GW of power generation capacity needed just to meet heating and cooling needs by 2050, of which about 70% is required for the residential sector only. It further intensifies as the demand for peak electric load sharply increases in summer because of the extensive use of building air conditioning systems. Researchers across the globe have tried different cooling systems and found that some systems can offer a certain amount of energy-efficient performance, and also occupant comfort. Therefore, this article examines the geothermal potential in buildings for space conditioning by critically reviewing experimental and numerical studies along with the future prospects of GSH pumps