Incidence and Surgical Outcome of the Intracranial Epidermoid Cyst at Punjab Institute of Neurosciences Lahore, Pakistan

Objectives:  The incidence and microsurgical outcomes of intracranial epidermoid cysts in the Department of Neurosurgery III, Punjab Institute of Neurosciences (PINS), Lahore, Pakistan, are described in this case series. Materials and Methods:  This study was a data analysis of a case series of 15 patients (mean age, 40 years) of both gender with intracranial epidermoid cysts who had microsurgical surgical excision over five years. Results:  This study comprised 11 (73.3%) male and 4 (26.7%) female patients, 11 (73.3%) cases were infratentorial and 4 (26.7%) cases were in supratentorial region. The epidermoid was located in the CP angle in 11 (73.3%) patients, 3 (20%) in the midline supra sellar region, and 1 (6.66%) in the frontotemporal region. The presenting complaints were mainly headache in 11 (73.33%), cranial nerve palsy and cerebellar signs in 8 (53.3%) patients, Trigeminal neuralgia in 3 (20%) patients, Fits and hydrocephalus in 2 (13.3%) patients. There were 14 (93.3%) patients with GTR (gross total resection), 1 (6.6%) patients STR (subtotal resection). According to Karnofsky's performance scoring (KPS), 3 (20%) patients improved, 11 (73.3%) patients had the same KPS, and 1 (6.6%) patient had a lower KPS. Conclusion:  The epidermoid cysts in the brain are usually found in the infratentorial region rather than the supratentorial region. Infratentorial lesions typically cause cranial nerve deficits, whereas the supratentorial area symptom is a headache

Our Experience of Posterior Fossa Tumors Surgeries

Objective:  In Neurosurgery Unit III, Punjab Institute of Neurosciences, Lahore, we evaluated our posterior fossa tumor surgery results, complications, and surgical outcomes. Materials and Methods:  Between January 2017 and September 2021, 80 patients with posterior fossa tumors who underwent surgical excision at the Neurosurgery Department-III of the Punjab Institute of Neurosciences in Lahore were studied retrospectively. For each patient, the diagnosis was made clinically and confirmed radiologically and histopathologically. Results:  Males comprised 47 percent (37) of the 80 cases, while females made up 53 percent (43). The average age was 15 (with a range of 6 – 30 years). Medulloblastomas were the most frequent pathology in 25 patients (31%), followed by ependymomas in 21 patients (26%), pilocytic astrocytomas in 19 patients (24%), and hemangioblastomas in 7 individuals (8.8%). There were four cases of metastatic brain cancers (5%), two cases of choroid plexus papilloma (2.5%), one case of ganglioglioma (1.3%), and one case of Dermoid cyst (1.3%). In 90 percent of the cases (72 cases), gross total resection was obtained, while subtotal excision was performed in 10% of the cases (8 cases). The best results were seen in pilocytic astrocytoma surgery, followed by ependymoma surgery, whereas the worst results were seen in medulloblastoma surgery. Conclusion:  The surgical treatment of posterior fossa tumors still poses a significant challenge to neurosurgeons. Our experience shows that accepted results, complications, and surgical outcomes can be obtained by meticulous surgical techniques from previous clinical studies

Agrovoltaic and Smart Irrigation: Pakistan Perspective

The present study aims to investigate the prospects and challenges that need to be encountered for the adaptation of the novel agrovoltaic irrigation system (AVIS) in Pakistan. The agro-production scenario in Pakistan is periodically declining and leading toward the high delta crops, which develop severe pressure on the conventional energy and water resources. Groundwater might be a viable water source, but its pumping requires massive energy. In addition, excessive pumping declines the water table at a higher pace as compared to the recharge rate hence leading the country toward the exploitation of the valuable reservoir. The AVIS could be an energy-efficient and reliable irrigation solution in a manner of harvesting solar energy for driving smart irrigation systems capable to pumps the metered groundwater according to field requirements. Lack of local understanding, skilled/technical personnel, dependence on local technology, and major capital expenditures might impede technological adaption. The government should take necessary measures to replenish the groundwater reservoirs and also execute research projects that strengthen ground knowledge of AVIS

Burden of non-communicable diseases among adolescents aged 10–24 years in the EU, 1990–2019: a systematic analysis of the Global Burden of Diseases Study 2019

Background Disability and mortality burden of non-communicable diseases (NCDs) have risen worldwide; however, the NCD burden among adolescents remains poorly described in the EU. Methods Estimates were retrieved from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Causes of NCDs were analysed at three different levels of the GBD 2019 hierarchy, for which mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) were extracted. Estimates, with the 95% uncertainty intervals (UI), were retrieved for EU Member States from 1990 to 2019, three age subgroups (10–14 years, 15–19 years, and 20–24 years), and by sex. Spearman's correlation was conducted between DALY rates for NCDs and the Socio-demographic Index (SDI) of each EU Member State. Findings In 2019, NCDs accounted for 86·4% (95% uncertainty interval 83·5–88·8) of all YLDs and 38·8% (37·4–39·8) of total deaths in adolescents aged 10–24 years. For NCDs in this age group, neoplasms were the leading causes of both mortality (4·01 [95% uncertainty interval 3·62–4·25] per 100 000 population) and YLLs (281·78 [254·25–298·92] per 100 000 population), whereas mental disorders were the leading cause for YLDs (2039·36 [1432·56–2773·47] per 100 000 population) and DALYs (2040·59 [1433·96–2774·62] per 100 000 population) in all EU Member States, and in all studied age groups. In 2019, among adolescents aged 10–24 years, males had a higher mortality rate per 100 000 population due to NCDs than females (11·66 [11·04–12·28] vs 7·89 [7·53–8·23]), whereas females presented a higher DALY rate per 100 000 population due to NCDs (8003·25 [5812·78–10 701·59] vs 6083·91 [4576·63–7857·92]). From 1990 to 2019, mortality rate due to NCDs in adolescents aged 10–24 years substantially decreased (–40·41% [–43·00 to –37·61), and also the YLL rate considerably decreased (–40·56% [–43·16 to –37·74]), except for mental disorders (which increased by 32·18% [1·67 to 66·49]), whereas the YLD rate increased slightly (1·44% [0·09 to 2·79]). Positive correlations were observed between DALY rates and SDIs for substance use disorders (rs=0·58, p=0·0012) and skin and subcutaneous diseases (rs=0·45, p=0·017), whereas negative correlations were found between DALY rates and SDIs for cardiovascular diseases (rs=–0·46, p=0·015), neoplasms (rs=–0·57, p=0·0015), and sense organ diseases (rs=–0·61, p=0·0005)

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

Development and Experiments on a Batch-Type Solar Roaster—An Innovative Decentralized System for Coffee Roasting

Gefördert durch den Publikationsfonds der Universität Kasse

Development and Experiments on a Batch-Type Solar Roaster—An Innovative Decentralized System for Coffee Roasting

About 70% of the harvested coffee is exported to the industrialized nations for value addition due to lack of processing and logistic facilities in developing coffee producer countries, thus leaving behind a marginal economic return for the growers. This research was conducted to investigate the roasting capacity of an innovatively developed batch-type directly solar radiated roasting system for the decentralized processing of coffee using solar energy. Central composite rotatable design (CCRD) was employed to design the experiments to optimize the coffee roasting process. Experimental results revealed that with an average solar direct normal irradiance (DNI) of 800 W/m2, the roaster was capable of roasting a batch of 2 kg coffee beans in 20, 23, and 25 min subjected to light roasts, medium roasts, and dark roasts, respectively at a drum speed of two revolutions per minute (rpm). The batch-type solar roaster has the capacity to roast 28.8–36 kg of coffee beans depending on dark to light roasting conditions on a clear sunny day with DNI ranging from 650 to 850 W/m2. The system thermal efficiency during coffee roasting was determined to be 62.2%, whereas the roasting efficiency at a corresponding light roast, medium roast, and dark roast was found to be 97.5%, 95.2%, and 91.3%, respectively. The payback period of the solar roaster unit was estimated to be 1038 working sunshine hours, making it viable for commercialization

Multi-Objective Optimal Design and Development of a Four-Bar Mechanism for Weed Control

Gefördert durch den Publikationsfonds der Universität Kasse

Multi-Objective Optimal Design and Development of a Four-Bar Mechanism for Weed Control

Weeds compete with crops for water, nutrients, and light consequently, have adverse effects on the crop yield and overall productivity. Mechanical weeding is the most common non-chemical method for weed control, which is applied in organic farming, and the weed cultivator is the most common implement in mechanical weeding. This study aimed to design and develop an innovative active tool to optimize the cultivation depth, which can avoid damage to crop roots and improve the key performance indicators of an inter-row cultivator. A quasi-Newton optimization method and a hybrid of the non-dominated sorting genetic algorithm (NSGA-II) and goal attainment method were separately applied to synthesize and develop a four-bar mechanism for weeding requirements. The transmission angle of the mechanism and the desired path of the weeding blade were simultaneously optimized using these multi-objective optimization techniques. The performance of the developed four-bar cultivator based on the optimization techniques was compared with the ones developed based on the classic methods and also with several conventional tools evaluated in other studies. The results showed that applying the quasi-Newton optimization method and hybrid genetic algorithm can propose a more effective weed cultivator in terms of performance indicators, namely weeding performance, mechanical damage to crop plants and cultivation depth. In addition, the optimization of the transmission angle guaranteed the smooth rotations in the mechanism’s joints