Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Detailed, comprehensive, and timely reporting on population health by underlying causes of disability and premature death is crucial to understanding and responding to complex patterns of disease and injury burden over time and across age groups, sexes, and locations. The availability of disease burden estimates can promote evidence-based interventions that enable public health researchers, policy makers, and other professionals to implement strategies that can mitigate diseases. It can also facilitate more rigorous monitoring of progress towards national and international health targets, such as the Sustainable Development Goals. For three decades, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) has filled that need. A global network of collaborators contributed to the production of GBD 2021 by providing, reviewing, and analysing all available data. GBD estimates are updated routinely with additional data and refined analytical methods. GBD 2021 presents, for the first time, estimates of health loss due to the COVID-19 pandemic. Methods: The GBD 2021 disease and injury burden analysis estimated years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries using 100 983 data sources. Data were extracted from vital registration systems, verbal autopsies, censuses, household surveys, disease-specific registries, health service contact data, and other sources. YLDs were calculated by multiplying cause-age-sex-location-year-specific prevalence of sequelae by their respective disability weights, for each disease and injury. YLLs were calculated by multiplying cause-age-sex-location-year-specific deaths by the standard life expectancy at the age that death occurred. DALYs were calculated by summing YLDs and YLLs. HALE estimates were produced using YLDs per capita and age-specific mortality rates by location, age, sex, year, and cause. 95% uncertainty intervals (UIs) were generated for all final estimates as the 2·5th and 97·5th percentiles values of 500 draws. Uncertainty was propagated at each step of the estimation process. Counts and age-standardised rates were calculated globally, for seven super-regions, 21 regions, 204 countries and territories (including 21 countries with subnational locations), and 811 subnational locations, from 1990 to 2021. Here we report data for 2010 to 2021 to highlight trends in disease burden over the past decade and through the first 2 years of the COVID-19 pandemic. Findings: Global DALYs increased from 2·63 billion (95% UI 2·44–2·85) in 2010 to 2·88 billion (2·64–3·15) in 2021 for all causes combined. Much of this increase in the number of DALYs was due to population growth and ageing, as indicated by a decrease in global age-standardised all-cause DALY rates of 14·2% (95% UI 10·7–17·3) between 2010 and 2019. Notably, however, this decrease in rates reversed during the first 2 years of the COVID-19 pandemic, with increases in global age-standardised all-cause DALY rates since 2019 of 4·1% (1·8–6·3) in 2020 and 7·2% (4·7–10·0) in 2021. In 2021, COVID-19 was the leading cause of DALYs globally (212·0 million [198·0–234·5] DALYs), followed by ischaemic heart disease (188·3 million [176·7–198·3]), neonatal disorders (186·3 million [162·3–214·9]), and stroke (160·4 million [148·0–171·7]). However, notable health gains were seen among other leading communicable, maternal, neonatal, and nutritional (CMNN) diseases. Globally between 2010 and 2021, the age-standardised DALY rates for HIV/AIDS decreased by 47·8% (43·3–51·7) and for diarrhoeal diseases decreased by 47·0% (39·9–52·9). Non-communicable diseases contributed 1·73 billion (95% UI 1·54–1·94) DALYs in 2021, with a decrease in age-standardised DALY rates since 2010 of 6·4% (95% UI 3·5–9·5). Between 2010 and 2021, among the 25 leading Level 3 causes, age-standardised DALY rates increased most substantially for anxiety disorders (16·7% [14·0–19·8]), depressive disorders (16·4% [11·9–21·3]), and diabetes (14·0% [10·0–17·4]). Age-standardised DALY rates due to injuries decreased globally by 24·0% (20·7–27·2) between 2010 and 2021, although improvements were not uniform across locations, ages, and sexes. Globally, HALE at birth improved slightly, from 61·3 years (58·6–63·6) in 2010 to 62·2 years (59·4–64·7) in 2021. However, despite this overall increase, HALE decreased by 2·2% (1·6–2·9) between 2019 and 2021. Interpretation: Putting the COVID-19 pandemic in the context of a mutually exclusive and collectively exhaustive list of causes of health loss is crucial to understanding its impact and ensuring that health funding and policy address needs at both local and global levels through cost-effective and evidence-based interventions. A global epidemiological transition remains underway. Our findings suggest that prioritising non-communicable disease prevention and treatment policies, as well as strengthening health systems, continues to be crucially important. The progress on reducing the burden of CMNN diseases must not stall; although global trends are improving, the burden of CMNN diseases remains unacceptably high. Evidence-based interventions will help save the lives of young children and mothers and improve the overall health and economic conditions of societies across the world. Governments and multilateral organisations should prioritise pandemic preparedness planning alongside efforts to reduce the burden of diseases and injuries that will strain resources in the coming decades. Funding: Bill & Melinda Gates Foundation

Multi response optimization of injection moulding process parameters of polystyrene and polypropylene to minimize surface roughness and shrinkage’s using integrated approach of S/N ratio and composite desirability function

The present study is intended to optimize and develop a prediction model for horizontal injection moulding process parameters. The processing materials are polystyrene (PS) and polypropylene (PP), while the final products are cups. The mould material used is aluminum alloy 6061-T651. The process parameters investigated are injection temperature, injection pressure, injection speed and mould temperature while the response variables are surface roughness, shrinkage inflow and cross-flow directions. Taguchi orthogonal array L9 is designed for experimental runs, while the levels are defined based on screening experiments. For optimization of process parameters, an integrated approach of signal to noise (S/N) ratio and composite desirability function is applied. The results show that injection temperature has a significant effect on surface roughness, shrinkage inflow and cross-flow directions for both polystyrene and polypropylene. Injection pressure has a significant effect on surface roughness and shrinkage in parallel flow direction for PS, while for polypropylene PP it has a significant effect on surface roughness and shrinkage in cross-flow direction. The optimal process parameters identified for PS are injection temperature at 533.15 K, injection pressure at 60 MPa, injection speed at 80 mm/s and mould temperature at 313.15 K. While for PP the optimal process parameters are injection temperature at 513.15 K, injection pressure at 60 MPa, injection speed at 70 MPa, mould temperature at 313.15 K. The novelty of this paper lies by optimizing injection moulding process parameters to minimize surface roughness and shrinkages using proposed integrated approach for the said mould

Waste reduction of polypropylene bag manufacturing process using Six Sigma DMAIC approach: A case study

In the current study, minimization of waste in terms of sack rejection at a polypropylene bag manufacturing process is achieved. The Six Sigma DMAIC (Define, Measure, Analyze, Improve, Control) approach is adopted which results in 50% waste reduction and a considerable cost saving. The sack rejection is brought to 1.20% from the previous average waste of 2.80% using DMAIC. It is found that this high rejection rate of 2.80% is due to the low fabric strength obtained at the weaving section, which in turn occurred due to the lower tape tenacity values obtained from the extrusion section. Hence, experimental design is conducted at the extrusion department and it is found that the two interacting factors are playing a significant contribution to the process variation and hence result in lower tape-tenacity (i.e., less than 6 g/denier). The two interacting factors included the “water bath temperature” and “line speed” of the extrusion process, with a p-value less than 5%. By further analysis, the optimal level of these significant factors is found. They are 300 m/min for “line speed” and 40⁰C for “water bath temperature. At these settings, the extrusion process produces optimal tape-tenacity results (i.e., at least 6 g/denier), which ultimately results in minimum waste in terms of sack rejection waste. The objective of the study includes finding the significant factors contributing to the process variation. Also controlling those factors to the optimal levels to achieve minimum wastage and considerable cost saving. The methodology and findings of the present study can be generalized to the polypropylene bag manufacturing plants and the process efficiency can be enhanced.</p

Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

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