PERSEPSI NELAYAN TERHADAP RUMPON PORTABLE DI PELABUHAN PERIKANAN PANTAI LARANGAN, KABUPATEN TEGAL

Perairan Karang Jeruk merupakan kawasan konservasi ekosistem terumbu karang yang terletak di Dukuh Larangan (Desa Munjungagung, Kabupaten Tegal, di Provinsi Jawa Tengah) yang memiliki kekayaan sumber daya perikanan yang baik. Alat tangkap yang banyak terdapat di perairan Karang Jeruk adalah payang gemplo dan mini purse seine. Penggunaan teknologi rumpon portable diharapkan dapat menciptakan daerah penangkapan ikan dan mengantisipasi timbulnya degradasi daerah penangkapan ikan. Tujuan dari kegiatan ini adalah menganalisis persepsi nelayan terhadap penggunaan inovasi rumpon portable di perairan Karang Jeruk, Kabupaten Tegal. Penelitian ini menggunakan metode wawancara dan experimental fishing. Data persepsi nelayan dilakukan dengan cara wawancara menggunakan kuesioner kepada 50 nelayan payang gemplo dan mini purse seine, dengan penentuan responden secara accidental sampling. Seluruh nilai persepsi nelayan terhadap rumpon portable dikelompokkan menjadi 3 kategori, sebagian besar nelayan memiliki persepsi pada tingkat tinggi sebanyak 38 orang (76%), tingkat sedang sebanyak 11 orang (22%), dan tingkat rendah hanya 1 orang (2%). Penggunaan rumpon portable memiliki keunggulan diantaranya: produktivitas tangkapan yang banyak, jenis tangkapan beragam, dan komposisi ikan kategori layak tangkap yang banyak

Aedes Larva Detection Using Ensemble Learning to Prevent Dengue Endemic

Dengue endemicity has become regular in recent times across the world. The numbers of cases and deaths have been alarmingly increasing over the years. In addition to this, there are no direct medications or vaccines to treat this viral infection. Thus, monitoring and controlling the carriers of this virus which are the Aedes mosquitoes become specially demanding to combat the endemicity, as killing all the mosquitoes regardless of their species would destroy ecosystems. The current approach requires collecting a larva sample from the hatching sites and, then, an expert entomologist manually examining it using a microscope in the laboratory to identify the Aedes vector. This is time-consuming, labor-intensive, subjective, and impractical. Several automated Aedes larvae detection systems have been proposed previously, but failed to achieve sufficient accuracy and reliability. We propose an automated system utilizing ensemble learning, which detects Aedes larvae effectively from a low-magnification image with an accuracy of over 99%. The proposed system outperformed all the previous methods with respect to accuracy. The practical usability of the system is also demonstrated

Assessment of flood vulnerability of riverine island community using a composite flood vulnerability index

The devastating impact of flooding is gradually increasing worldwide including riverine islands of Bangladesh due to climate change issue. Riverine islands and coastal communities are the primary victims due to their geographical position. The riverine islands (char) of Bangladesh are frequently flooded, necessitating context-specific flood management policies and actions that require an in-depth investigation of household vulnerability level. Therefore, this study assesses the vulnerability level of riverine island dwellers to flooding. Data were collected from 384 household heads living in geographically isolated char areas. A context-specific composite flood vulnerability index was developed under the IPCC framework. The results reveal that all households are vulnerable to flooding and are poorly able to cope with its adverse effect. Households living near the mainland have a somewhat more adaptive capacity than distant households. Flood vulnerability is mainly determined by char households' flood perception, damage, and access to food, water and health resources during flooding. Riverbank erosion, recurrent floods, a lack of employment, and limited access to essential public services were also identified as the primary socio-economic and natural causes of flood vulnerability. To decrease the livelihood risk and promote char dwellers’ resilience, a char-based policy plan with both a short- and a long-term focus is required

Infrastructure alone cannot ensure resilience to weather events in drinking water supplies

Climate resilient water supplies are those that provide access to drinking water that is sustained through seasons and through extreme events, and where good water quality is also sustained. While surface and groundwater quality are widely understood to vary with rainfall, there is a gap in the evidence on the impact of weather and extremes in rainfall and temperature on drinking water quality, and the role of changes in water system management. A three-country (Bangladesh, Nepal and Tanzania) observational field study tracked 2353 households clustered around 685 water sources across seven different geographies over 14 months. Water quality (E. coli) data was modelled using GEE to account for clustering effects and repeated measures at households. All types of infrastructure were vulnerable to changes in weather, with differences varying between geographies; protected boreholes provided the greatest protection at the point of collection (PoC). Water quality at the point of use (PoU) was vulnerable to changes in weather, through changes in PoC water quality as well as changes in management behaviours, such as safe storage, treatment and cleaning. This is the first study to demonstrate the impact of rainfall and temperature extremes on water quality at the PoC, and the role that weather has on PoU water quality via management behaviours. Climate resilience for water supplies needs to consider the infrastructure as well as the management decisions that are taking place at a community and household level

Epidemiology and outcomes of hospital-acquired bloodstream infections in intensive care unit patients: the EUROBACT-2 international cohort study

Purpose In the critically ill, hospital-acquired bloodstream infections (HA-BSI) are associated with significant mortality. Granular data are required for optimizing management, and developing guidelines and clinical trials. Methods We carried out a prospective international cohort study of adult patients (≥ 18 years of age) with HA-BSI treated in intensive care units (ICUs) between June 2019 and February 2021. Results 2600 patients from 333 ICUs in 52 countries were included. 78% HA-BSI were ICU-acquired. Median Sequential Organ Failure Assessment (SOFA) score was 8 [IQR 5; 11] at HA-BSI diagnosis. Most frequent sources of infection included pneumonia (26.7%) and intravascular catheters (26.4%). Most frequent pathogens were Gram-negative bacteria (59.0%), predominantly Klebsiella spp. (27.9%), Acinetobacter spp. (20.3%), Escherichia coli (15.8%), and Pseudomonas spp. (14.3%). Carbapenem resistance was present in 37.8%, 84.6%, 7.4%, and 33.2%, respectively. Difficult-to-treat resistance (DTR) was present in 23.5% and pan-drug resistance in 1.5%. Antimicrobial therapy was deemed adequate within 24 h for 51.5%. Antimicrobial resistance was associated with longer delays to adequate antimicrobial therapy. Source control was needed in 52.5% but not achieved in 18.2%. Mortality was 37.1%, and only 16.1% had been discharged alive from hospital by day-28. Conclusions HA-BSI was frequently caused by Gram-negative, carbapenem-resistant and DTR pathogens. Antimicrobial resistance led to delays in adequate antimicrobial therapy. Mortality was high, and at day-28 only a minority of the patients were discharged alive from the hospital. Prevention of antimicrobial resistance and focusing on adequate antimicrobial therapy and source control are important to optimize patient management and outcomes

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

Background: Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods: WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings: Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0-4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2-6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation: In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates. Funding: European Society of Intensive Care Medicine, European Respiratory Society

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

Background Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0–4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2–6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates