Pemberian Kompos Tkks dan Pupuk N, P, K pada Tanaman Bawang Merah (Allium Ascalonicum L.)

This study aims to determine the effect of dosage compost TKKS and ZA, TSP, KCl fertilizer on the growth and production of shallots. This research was conducted in experimental garden of Faculty of Agriculture Universitas Riau, Tampan, Pekanbaru in October - December 2015. The design used in this research is arranged in Factorial Random Design (RAK) Factorial consisting of 2 factors with 3 replications. Factor I: compost TKKS (C) with 4 doses (ton / ha) ie C1 (10), C2 (15), C3 (20), C4 (25) and factor II: ZA, TSP, KCl (K) With 3 doses (kg / ha): K0 (0), K1 (250 kg ZA / ha + 150 kg TSP / ha + 100 kg KCl / ha), K2 (500kg ZA / ha + 300kg TSP / ha + 200 kg KCl / ha). The data obtained were analyzed using multipurpose test with Duncan multiple test at 5% level. Compost TKKS and ZA, TSP, KCl fertilizer had significant effect on tuber diameter per sample clump, tuber weight per plot, and tuber weight per plot, Not significant to plant height and number of tubers per sample clump. The compost of TKKS 1.5 kg / plot was added ZA50 g / plot, TSP 30 g / plot and KCl 20 g / plot resulted in the highest onion production of 487.67 g / plot or equal to 4,8767 ton / ha compared with other treatment

Penetapan Rekomendasi Pemupukan N, P, Dan K Tanaman Duku Berdasarkan Analisis Daun

Duku mempunyai perakaran yang dalam, sehingga sulit untuk memperoleh sampel tanah yang representatif pada daerah tersebut, sehingga lebih tepat menggunakan analisis daun. Status hara daun merupakan gambaran status hara aktual dalam tanah. Penelitian bertujuan untuk menentukan kategori status hara N, P, dan K, serta rekomendasi pemupukan optimum berdasarkan status hara tersebut pada tanaman duku. Penelitian dilaksanakan di Kecamatan Kumpeh Ulu, Kabupaten Muaro, Jambi pada Bulan Desember 2008 sampai dengan April 2012. Rancangan penelitian menggunakan acak kelompok dengan lima ulangan. Perlakuan dosis pupuk N (0, 400, 800, 1.200, dan 1.600 g N) , P (0, 500, 1.000, 1.500, dan 2.000 g P2O5), K (0,600, 1.200, 1.800, dan 2.400 g K2O/tanaman/tahun). Hasil penelitian menunjukkan bahwa status hara N sangat rendah (< 1,81%), rendah (1,81 ≤ N < 2,82%), dan sedang (≥ 2,82%), status hara P sangat rendah (< 0,09%), rendah (0,09 ≤ P < 0,17%), dan sedang (≥ 0,17%), serta status hara K sangat rendah (< 1,16%), rendah (1,16 ≤ K < 2,19%), dan sedang (≥ 2,19%). Rekomendasi pemupukan pada tanaman duku untuk status hara sangat rendah yaitu 858 g N, 1.770 g P2O5, dan 1.900 g K2O/tanaman/tahun, untuk status hara rendah, 588 g N, 1.335 g P2O5, dan 1.107 g K2O/tanaman/tahun, sedangkan berdasarkan pendekatan multinutrien 920 g N, 1.565 g P2O5, dan 1.488 g K2O/tanaman/tahun (biaya produksi terendah). Rekomendasi pemupukan N, P, dan K berdasarkan analisis daun dapat diterapkan pada pertanaman duku di Indonesia dan meningkatkan produksi serta kualitas buah duku. Duku has been deep roots making it difficult to obtain a representative sample of soil at the root zone, so the more appropriate used of leaf analysis. Leaf nutrient status was picture of the actual nutrient status of the soil. The aimed of this study was to determine leaf N, P, K level category and recommendation study determine the optimum fertilizer rate for each nutrient level category on duku plant. The experiment was conducted at Kumpeh Ulu District, Muaro Jambi Regency, in Jambi Province, from December 2008 to April 2012. Each treatments were arranged in randomized block design with five replications. The treatments were N (0, 400, 800, 1,200, 1,600 g N/plant/year), P (0, 500, 1,000, 1,500, 2,000 g P2O5/plant/year), and K (0, 600, 1,200, 1,800, 2,400 g K2O/plant/year). The results showed that leaf nutrient status of N was very low (< 1.81%), low (1.81 ≤ N < 2.82%), and medium (≥ 2.82%), status of P was very low (< 0.09%), low (0.09 ≤ P < 0.17%), and medium (≥ 0.17%); status of K was very low (< 1.16%), low (1.16 ≤ K < 2.19%), and medium (≥ 2.19%). Fertilizer recommendation rate on duku plant for very low nutrient status were 858 g N, 1,770 g P2O5, and 1,900 g K2O/plant/year, low nutrient status were 588 g N, 1,335 g P2O5, and 1,107 g K2O/plant/year, multinutrient approach were 920 g N, 1,565 g P2O5, dan 1,488 g K2O/plant/year (lower production cost). Recommendation of fertilizer N, P, and K based on leaves analysis can be applied on duku in Indonesia and increase production and fruit quality of duku

Harvesting of Residual Soil Phosphorus on Intensive Shallot Farming in Brebes, Indonesia

Accumulated residual soil phosphorus (P) on shallots farming in Brebes can be harvested through the application of ameliorants or bio-fertilizers. The information on the effect of ameliorants and bio-fertilizers on soil P fractions is limited. The study objective was to evaluate the transformation of accumulated P to available forms by adding humic substance (CHS), bio-fertilizers (CBF), phosphate solubilizing bacteria (PSB), or phosphate solubilizing fungi (PSF) on soil from Brebes. The experiment was conducted in rhizobox that has two compartments, namely inner compartment (rooting area) and outside compartment (non-rooting area). Shallots were planted for 26 days, observed for their growth, and analyzed for their P absorption. Soil samples in rooting and non-rooting area were analyzed for their P fractions after planting. The results indicated that the addition of CHS, CBF, PSB or PSF increased the harvesting of residual soil P through its transformation to a more labile P as high as 0.67% in rooting area. The dynamic of transformation in rooting area gave better information of harvesting P. The capability of harvesting accumulated P was in the order of CBF, CHS, PSF and PSB. For harvesting residual P, addition of humic substance or bio-fertilizers should be made in the rooting area

Pencapaian Standar Indonesian Sustainable Palm Oil (ISPO) Dalam Pengelolaan Perkebunan Kelapa Sawit Di Kalimantan Timur / Achievement of Indonesian Sustainable Palm Oil Standards of Palm Oil Plantation Management in East Borneo Indonesia

Strong opinions have been expressed toward oil palm plantation industry in Indonesia, and these opinions portray that oil palm plantation development in Indonesia has caused the destruction of the environment. One of the efforts currently undertaken by the Indonesian government to ensure the sustainability of the palm oil industry is establishing sustainability standard called the Indonesian Sustainable Palm Oil (ISPO) which is mandatory. ISPO is "guidance" for sustainable oil palm development as well as a commitment based on the laws and regulations aplication of some licenses in Indonesia. The purpose of this study was to determine the capability of oil palm plantation companies in the regional to meet the standards of the Indonesian Sustainable Palm Oil (ISPO) and to identify the problems faced in achieving these standards. This research was conducted in East Kalimantan province on the period June 2012-May 2013. Evaluation of the capability of the companies to achieve the ISPO standards was performed by the audit method, assessment results of all parameters that had been established in accordance with the Principles, Criteria and Indicators in the provision of ISPO which were assessed in a percent unit. The research results showed that the capability of the plantation companies in East Kalimantan in meeting the ISPO standards reached 79,14%, and this capability can be improved up to 100% by increasing efforts to comply with the principles, criteria and indicators that are still not in accordance with the provisions of ISPO are as follows: 1). Licence system and plantation management, 2). Aplication guidance cultivation technics and processing palm fruit, 3). Management and monitoring invironment, 4). Resposibility to workers, and 5). Social resposibility and community. The determantion factor performance on ISPO standard is the commitment of plantation company as a business stakeholder that supported by capable human resources to create the sustainable plantation development and also the goverment action in charge as the regulator in supervising the policy that has been set. Socialization and training about principles and criteria ISPO standard to plantation company needs soon and more intensively done by the government association with ISPO commission to accelerate the application of the ISPO. Socialization and training also are required in order to overcome the constraints in attainment of principles and criteria of the Indonesian Sustainable Palm Oil standard, because of the mentioned efforts are the part of success factors to apply the ISPO

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Global injury morbidity and mortality from 1990 to 2017 : results from the Global Burden of Disease Study 2017

Correction:Background Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries. Methods We reviewed results for injuries from the GBD 2017 study. GBD 2017 measured injury-specific mortality and years of life lost (YLLs) using the Cause of Death Ensemble model. To measure non-fatal injuries, GBD 2017 modelled injury-specific incidence and converted this to prevalence and years lived with disability (YLDs). YLLs and YLDs were summed to calculate disability-adjusted life years (DALYs). Findings In 1990, there were 4 260 493 (4 085 700 to 4 396 138) injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554) deaths in 2017, while age-standardised mortality decreased from 1079 (1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were 354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802) new cases of injury globally, which increased to 520 710 288 (493 430 247 to 547 988 635) new cases in 2017. During this time, age-standardised incidence decreased non-significantly from 6824 (6534 to 7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017, age-standardised DALYs decreased from 4947 (4655 to 5233) per 100 000 to 3267 (3058 to 3505). Interpretation Injuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017. Future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care.Peer reviewe

Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic

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

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries