Genetic characterization of human echinococcosis in Southern Punjab, Pakistan

IntroductionEchinococcosis is a neglected tropical zoonotic infection that affects both the human and livestock populations. In Pakistan, the infection is long-standing, but data on its molecular epidemiology and genotypic characterization in the southern Punjab region are limited. The aim of the current study was the molecular characterization of human echinococcosis in southern Punjab, Pakistan.MethodsEchinococcal cysts were obtained from a total of 28 surgically treated patients. Patients’ demographic characteristics were also recorded. The cyst samples were subjected to further processing to isolate DNA in order to probe the Nad1 and Cyt-b genes, followed by DNA sequencing and phylogenetic analysis for genotypic identification.ResultsThe majority of the echinococcal cysts were from male patients (60.7%). The liver was the most commonly infected organ (60.71%), followed by the lungs (25%), spleen (7.14%), and the mesentery (7.14%). Molecular and genotypic identification through sequencing and phylogenetic tree analysis showed that most of the cysts (24/28, 85.7%) were caused by the species Echinococcus granulosus sensu stricto (E. granulosus s.s.) (G1 and G3), followed by Echinococcus multilocularis (E. multilocularis) and Echinococcus canadensis (E. canadensis) (G6/G7) (3/28, 10.8%, and 1/28, 3.5%, respectively).ConclusionThe current study concluded that the majority of human infections were caused by E. granulosus s.s., followed by the E. multilocularis and E. canadensis species (G6/G7). Genotypic characterization among both human and livestock populations is needed to explore the genetic diversity of echinococcosis

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

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

Design and Thermal Modeling of Modular Hybrid Excited Double-Sided Linear Flux Switching Machine

This paper presents a Hybrid Excited Double-Sided Linear Flux Switching Machine (HEDSLFSM) with a crooked tooth modular stator. Generally, the conventional stators are made of a full-length iron core, increasing manufacturing costs and iron losses. Higher iron losses result in lower efficiency and lower overall performance. A U-shaped modular stator with a crooked tooth is used to lower iron consumption and increase the machine’s efficiency. Ferrite magnets are used to replace rare earth magnets, which also reduces the machine cost. Two DC excitation windings are used above and below the ferrite magnet to reduce the PM volume. 2D electromagnetic performance analysis is done to observe the key performance indices. Geometric optimization is used to optimize the Split Ratio (S.R), DC winding slot area (DCw), and AC winding slot area (ACw). Stator Tooth Width (STW), space between the modules (S.S.), and crooked angle (α) are optimized through JMAG in-built Genetic Algorithm (G.A.) optimization. High thrust force density and modular stator make it a good candidate for long-stroke applications like railway transits. The thermal analysis of the machine is performed by FEA analysis and then validated by 2D LPMC (Lumped Parametric Magnetic Equivalent Circuit) model. Both analyses are compared, and an error percentage of less than 4% is achieved

Design and Thermal Modeling of Modular Hybrid Excited Double-Sided Linear Flux Switching Machine

This paper presents a Hybrid Excited Double-Sided Linear Flux Switching Machine (HEDSLFSM) with a crooked tooth modular stator. Generally, the conventional stators are made of a full-length iron core, increasing manufacturing costs and iron losses. Higher iron losses result in lower efficiency and lower overall performance. A U-shaped modular stator with a crooked tooth is used to lower iron consumption and increase the machine’s efficiency. Ferrite magnets are used to replace rare earth magnets, which also reduces the machine cost. Two DC excitation windings are used above and below the ferrite magnet to reduce the PM volume. 2D electromagnetic performance analysis is done to observe the key performance indices. Geometric optimization is used to optimize the Split Ratio (S.R), DC winding slot area (DCw), and AC winding slot area (ACw). Stator Tooth Width (STW), space between the modules (S.S.), and crooked angle (α) are optimized through JMAG in-built Genetic Algorithm (G.A.) optimization. High thrust force density and modular stator make it a good candidate for long-stroke applications like railway transits. The thermal analysis of the machine is performed by FEA analysis and then validated by 2D LPMC (Lumped Parametric Magnetic Equivalent Circuit) model. Both analyses are compared, and an error percentage of less than 4% is achieved

Performance Analysis and Optimization of a Novel Outer Rotor Field-Excited Flux-Switching Machine with Combined Semi-Closed and Open Slots Stator

Slotting effect in electric machines reduces flux per pole that effect magnetic flux density distribution in the air gap which induces harmonics in magnetic flux density causing flux pulsation, that in turn generates dominant torque pulsation in the form of cogging torque and torque ripples. To overcome the abovesaid demerits, a novel outer rotor field-excited flux-switching machine (OR-FSFSM) with a combined semi-closed and open slots stator is proposed in this study. The developed OR-FEFSM offers a high-power factor, due to the utilization of the semi-closed slot for armature coils. The open slot stator structure was chosen for the field excitation coil, which effectively suppresses leakage reluctance that causes flux pulsation. Thus, the influence of torque ripples is reduced, and the average torque is improved. In order to investigate the effectiveness of the proposed OR-FEFSM, a detailed study of stator slot and rotor pole combinations are performed. Based on simplified mathematical formulation, 12S/7P (stator slot/rotor poles), 12S/11P, 12S/13P, and 12S/17P are the most feasible combinations. Finite Element Analysis (FEA) based on comprehensive electromagnetic performance is performed on each combination, and found that 12S/13P offers the highest average torque of 4.62 Nm, whereas 3.72 Nm, 2.72Nm, and 1.68 Nm average torque is offered by 12S/17P, 12S/7P, and 12S/11P, respectively. Based on the initial analysis, 12S/13P was considered for further analysis and optimized using JMAG built-in Genetic Algorithm (GA). Moreover, thermal analysis was performed, and the proposed design was compared with the conventional design

Design and Analysis of an Asymmetric Spoke and Delta-Shape Interior Permanent Magnet Synchronous Machine

This paper proposes a design of an asymmetric spoke and delta-shape interior permanent magnet (AIPM-P) synchronous machine for electric vehicles that use the magnetic-field-shifting (MFS) technique to improve the average torque and reduce torque ripples. The asymmetry of the AIPM-P is due to the asymmetric rotor structure, asymmetric permanent magnet (PM) placement, and asymmetric flux barriers (AFB). Due to this asymmetry, the MFS is utilized, which decreases the current angle difference between the peak PM torque ( $T_{PM}$ ) and reluctance torque ( $T_{r}$ ) components. In the delta-shape, the bar magnet helps reduce the d-axis inductance, which helps in increasing the reluctance torque, ultimately increasing synthetic torque. Furthermore, the combination of delta-shape and spoke shape PM makes the novel hybrid layer structure that improves the average torque. The proposed AIPM-P is then compared with the conventional designs in the literature having the same stator and rotor radius, with a 4-pole and 24-slot combination. The open circuit, on-load characteristics, efficiency, copper, and iron loss maps of the proposed and conventional designs are investigated and compared. Compared to the conventional designs, the proposed AIPM-P synchronous machine has high efficiency and a good torque profile, which is suitable for EV applications

Design and Thermal Analysis of Linear Hybrid Excited Flux Switching Machine Using Ferrite Magnets

This paper presents a novel linear hybrid excited flux switching permanent magnet machine (LHEFSPMM) with a crooked tooth modular stator. Conventional stators are made up of a pure iron core, which results in high manufacturing costs and increased iron core losses. Using a modular stator lowers the iron volume by up to 18% compared to a conventional stator, which minimizes the core losses and reduces the machine’s overall cost. A crooked angle is introduced to improve the flux linkage between the stator pole and the mover slot. Ferrite magnets are used with parallel magnetization to reduce the cost of the machine. Two-dimensional FEA is performed to analyze and evaluate various performance parameters of the proposed machine. Geometric optimization is used to optimize the split ratio (S.R) and winding slot area (Slotarea). Genetic algorithm (GA) is applied and is used to optimize stator tooth width (STW), space between the modules (SS), crooked angle (α), and starting angle (θ). The proposed model has a high thrust density (306.61 kN/m3), lower detent force (8.4 N), and a simpler design with higher efficiency (86%). The linear modular structure makes it a good candidate for railway transportation and electric trains. Thermal analysis of the machine is performed by FEA and then the results are validated by an LPMEC model. Overall, a very good agreement is observed between both the analyses, and relative percentage error of less than 3% is achieved, which is considerable since the FEA is in 3D while 2D temperature flow is considered in the LPMEC model