PENGEMBANGAN UMKM MELALUI PROGRAM KERJA SOSIALIASASI LEGALITAS USAHA DAN MEREK DAGANG DAN PENDAFTARAN PRODUK HALAL

  Kegiatan Pengabdian di Desa Cisalada kecamatan Cigombong dilakukan untuk mensosialisasikan permasalahan yang dihadapi para pelaku UMKM, termasuk dalam pembuatan Izin usaha, menyusun dokumen untuk sertifikasi halal, serta membuat brand atau label usaha. Mekanisme kegiatan pengabdian meliputi Tahapan persiapan, Tahapan pendataan, dan sosialisasi legalitas UMKM . Hasil dari kegiatan  sosialisasi ini, para pelaku UMKM Desa Cisalada memberikan respon positif. Hal ini disebabkan karena melalui kegiatan ini dapat meningkatkan pengetahuan bagaimana pengurusan untuk mendapatkan sertifikat halal untuk produknya serta penting sertifikat halal dalam Upaya meningkatkan penjualan. Output lainnya pada pengembangan UMKM yang ada di Desa Cisalada seperti terdaftarnya Nomor izin berusaha para pelaku umkm, proses sertifikasi halal dan adanya brand atau label usaha

IMPLEMENTASI ALAT PEMANTAUAN AKTIVITAS DAN PELACAKAN LOKASI JATUH (E-CARE) UNTUK LANSIA DI DAERAH CIKUTRA KOTA BANDUNG

Indonesia has a percentage of an elderly population of as much as 9.03%, so it can be stated that Indonesia is a country with an old structure. This makes Indonesia pay attention to the health, activity, and productivity of the elderly. Changes in physical condition can affect the activities of the elderly significantly and increase the risk of falling. Therefore, a monitoring tool for elderly activities and location points for elderly falls was developed called e-care for the elderly. E-care Elderly is designed to be able to monitor the position of the elderly via GPS and detect if the elderly have fallen. This tool is connected to the application installed on the smartphone. In addition, this elderly E-care is equipped with a camera that can monitor the situation around the elderly. This service will be given to 10 elderly in Cikutra Village, Cibeunying Kidul District, Bandung City. There will be several preparations, implementation, and assistance activities for E-care for the Elderly. According to a survey of respondents who took part in this community service, more than 80% felt the tool had a performance that followed the needs, and 100% thought it was appropriate and very suitable for this activity with the goals and conditions of the community and it was hoped that the continuity of this activity. The survey results illustrate that the community understands all community service activities and how to use and benefit from E-Care tools.  ---  Indonesia memiliki persentase penduduk lansia sebanyak 9,03%, sehingga dapat dinyatakan indonesia merupakan negara berstruktur tua. Hal tersebut membuat Indonesia harus memperhatikan  kesehatan, keaktifan, dan produktivitas dari lansia. Perubahan kondisi fisik dapat mempengaruhi aktivitas lansia terutama dan menambah resiko jatuh. Oleh karena itu dikembakan alat pemantau aktivitas lansia dan titik lokasi jatuh lansia yang dimamakan e-care lansia. E-care Lansia dirancang agar dapat memantau posisi lansia melalui GPS dan mendeteksi jika lansia terjatuh. Alat ini terhubung ke aplikasi yang terpasang pada telepon pintar. Selain itu, E-care lansia ini dilengkapi dengan kamera yang dapat memantau keadaan di sekitar lansia. Pada abdimas ini akan diberikan kepada 10 lansia di Kelurahan Cikutra, Kecamatan Cibeunying Kidul, Kota Bandung.  Akan ada beberapa kegiatan persiapan, pengimplementasian dan pendampingan penggunaan E-care Lansia. Menurut survei responden yang mengikuti kegiatan abdimas lebih dari 80 % merasa alat memiliki kinerja yang sesuai dengan kebutuhan dan 100 % merasa sesuai dan sangat sesuai kegiatan ini dengan tujuan dan kebutuhan masyarakat dan diharapkan keberlangsungan kegiatan ini. Dari hasil survei tersebut juga bisa menggambarkan bahwa masyarakat sasar paham tentang seluruh kegiatan abdimas dan paham cara penggunaan dan manfaat dari alat E-Care

Association of Retinal Nerve Fiber Layer (RNFL) Thickness with Smoking Using Optical Coherence Tomography (OCT) in Pakistani Population

Background: Smoking has multisystem effects on human body due to hypoxia and systemic inflammation, which it produces. This contributory effect is observed in ocular tissues as well. The aim of the study was to evaluate retinal nerve fiber layer (RNFL) thickness in healthy individuals with a history of smoking, using optical coherence tomography (OCT). Methods: Patients healthy eyes n=300 were examined. Two groups were made; Group A with history of smoking (n=50) and Group B with no history of smoking (n=250). Subjects with a history of diabetes, hypertension, raised intra ocular pressure (IOP >21 mmHg), any neurological disease or family history of glaucoma were excluded from the study. Independent t-test was used to assess the thickness variation with smoking status. ANOVA was used to analyze the differences in both groups. p value <0.05 was taken as significant. Results: The mean retinal nerve fiber layer (RNFL) thickness was found to be 96.44 ± 9.32 μm in Group A eyes. It was found to be significantly increased (p=0.02) in Group B 99.54 ± 9.32 μm. The mean RNFL thickness 93.52 ± 8.60 μm in smokers with history of more than 10 years was found decreased compared to the thickness 98.66 ± 3.96 μm in those with history of smoking less than 10 years. Conclusion: Retinal nerve fiber layer (RNFL) was found to be decreased in subjects with positive history of smoking. This difference signifies that smoking is associated with ocular pathologies. Future protocols may be included in screening for RNFL thickness in smokers for early detection and prevention of optical diseases. Keywords: Smoking; Retina; Retinal Nerve Fiber Layer (RNFL); Retinal Damage; Optical Coherence Tomography (OCT)

Crimean-Congo hemorrhagic fever outbreak in Chakwal, Pakistan

CCHF, tick, livestock, diagnostics, геморрагическая лихорадка Крым-Конго, клещи, домашний скот, диагностика, клинические симптомы, летальный исходCrimean-Congo hemorrhagic fever (CCHF) is the most fatal viral disease with extensive geographical distribution. In Pakistan it is being reported with sporadic outbreaks in cattle rearing areas. The authors in this study presented a clinical case of CCHF in one of cattle rearing district Chakwal of Punjab rovince. The serums and plasma samples from suspected patients along with Hyalomma ticks from reported area were collected and diagnosed for CCHF antigen and IgG antibodies by two step sandwich enzyme-linked immunosorbent assay (ELISA) using Vector BEST Company, Crimean-CHF-antigen kit, Novosibirsk, Russia. Crimean-Congo hemorrhagic fever (CCHF) was suspected in three patients among which two patients died. The only survived patient was diagnosed for CCHF by detecting IgG. Out of 62 Hyalomma ticks collected from livestock of endemic area, 9.67% (6/62) were positive for the CCHF virus. This confirms the emergence of CCHF virus in new areas and the potential risk of its wide spread in different areas of Punjab, Pakistan.Геморрагическая лихорадка Крым-Конго (CCHF) является наиболее смертельным вирусным заболеванием с обширным географическим распространением. В Пакистане сообщается о спорадических вспышках в районах, где интенсивно выращивается крупный рогатый скот. Авторы данного исследования представили клинический случай CCHF в одном из районов, специализирующемся на разведении крупного рогатого скота - район Чаквал провинции Пенджаб. Сыворотки и образцы плазмы у подозреваемых пациентов вместе с клещами Hyalomma из сообщаемой области были собраны и диагностированы на антиген CCHF и IgG-антител с помощью двухступенчатого сэндвич-фермент-связанного иммуносорбентного анализа (ELISA) с использованием Vector BEST Company, набора крымских-CHF-антигенов, Новосибирск, Россия. Геморрагическая лихорадка Крым-Конго (CCHF) подозревалась у трех пациентов, из которых умерли два пациента. Единственный выживший пациент был диагностирован на CCHF по обнаружению IgG. Из 62 клещей Hyalomma, обнаруженных на крупном рогатом скоте эндемического района, 9,67% (6/62) дали положительный результат на наличие вируса CCHF. Это подтверждает появление вируса CCHF в новых областях и указывает на потенциальный риск его широкого распространения в разных районах Пенджаба, Пакистан

Genomic and biological characterization of Newcastle disease viruses isolated from migratory mallards (Anas platyrhynchos)

Given the global evolutionary dynamics of Newcastle disease viruses (NDVs), it is imperative to continue extensive surveillance, routine monitoring and characterization of isolates originating from natural reservoirs (waterfowls). In this report, we isolated and characterized two virulent NDV strains from clinically healthy mallard (Anas platyrhynchos). Both isolates had a genome of 15,192 nucleotides encoding six genes in an order of 3´-NP-P-M-F-HN-L-5´. The biological characteristics (mean death time: 49.5-50 hr, EID50108.5 ml-1) and presence of a typical cleavage site in the fusion (F) protein (112R-R-Q-K-R↓F117) confirmed the velogenic nature of these isolates. Phylogenetic analysis classified both isolates as members of genotype VII within class-II. Furthermore, based upon the hypervariable region of the F gene (375 nt), isolates showed clustering within sub-genotype VIIi. Similarity index and parallel comparison revealed a higher nucleotide divergence from commonly used vaccine strains; LaSota (21%) and Mukteswar (17%). A comparative residues analysis with representative strains of different genotypes, including vaccine strains, revealed a number of substitutions at important structural and functional domains within the F and hemagglutinin-neuraminidase (HN) proteins. Together, the results highlight consistent evolution among circulating NDVs supporting extensive surveillance of the virus in waterfowl to better elucidate epidemiology, evolutionary relationships and their impacts on commercial and backyard poultry

Burden of disease scenarios for 204 countries and territories, 2022–2050: a forecasting analysis for the Global Burden of Disease Study 2021

Background: Future trends in disease burden and drivers of health are of great interest to policy makers and the public at large. This information can be used for policy and long-term health investment, planning, and prioritisation. We have expanded and improved upon previous forecasts produced as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) and provide a reference forecast (the most likely future), and alternative scenarios assessing disease burden trajectories if selected sets of risk factors were eliminated from current levels by 2050. Methods: Using forecasts of major drivers of health such as the Socio-demographic Index (SDI; a composite measure of lag-distributed income per capita, mean years of education, and total fertility under 25 years of age) and the full set of risk factor exposures captured by GBD, we provide cause-specific forecasts of mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) by age and sex from 2022 to 2050 for 204 countries and territories, 21 GBD regions, seven super-regions, and the world. All analyses were done at the cause-specific level so that only risk factors deemed causal by the GBD comparative risk assessment influenced future trajectories of mortality for each disease. Cause-specific mortality was modelled using mixed-effects models with SDI and time as the main covariates, and the combined impact of causal risk factors as an offset in the model. At the all-cause mortality level, we captured unexplained variation by modelling residuals with an autoregressive integrated moving average model with drift attenuation. These all-cause forecasts constrained the cause-specific forecasts at successively deeper levels of the GBD cause hierarchy using cascading mortality models, thus ensuring a robust estimate of cause-specific mortality. For non-fatal measures (eg, low back pain), incidence and prevalence were forecasted from mixed-effects models with SDI as the main covariate, and YLDs were computed from the resulting prevalence forecasts and average disability weights from GBD. Alternative future scenarios were constructed by replacing appropriate reference trajectories for risk factors with hypothetical trajectories of gradual elimination of risk factor exposure from current levels to 2050. The scenarios were constructed from various sets of risk factors: environmental risks (Safer Environment scenario), risks associated with communicable, maternal, neonatal, and nutritional diseases (CMNNs; Improved Childhood Nutrition and Vaccination scenario), risks associated with major non-communicable diseases (NCDs; Improved Behavioural and Metabolic Risks scenario), and the combined effects of these three scenarios. Using the Shared Socioeconomic Pathways climate scenarios SSP2-4.5 as reference and SSP1-1.9 as an optimistic alternative in the Safer Environment scenario, we accounted for climate change impact on health by using the most recent Intergovernmental Panel on Climate Change temperature forecasts and published trajectories of ambient air pollution for the same two scenarios. Life expectancy and healthy life expectancy were computed using standard methods. The forecasting framework includes computing the age-sex-specific future population for each location and separately for each scenario. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline. Findings: In the reference scenario forecast, global and super-regional life expectancy increased from 2022 to 2050, but improvement was at a slower pace than in the three decades preceding the COVID-19 pandemic (beginning in 2020). Gains in future life expectancy were forecasted to be greatest in super-regions with comparatively low life expectancies (such as sub-Saharan Africa) compared with super-regions with higher life expectancies (such as the high-income super-region), leading to a trend towards convergence in life expectancy across locations between now and 2050. At the super-region level, forecasted healthy life expectancy patterns were similar to those of life expectancies. Forecasts for the reference scenario found that health will improve in the coming decades, with all-cause age-standardised DALY rates decreasing in every GBD super-region. The total DALY burden measured in counts, however, will increase in every super-region, largely a function of population ageing and growth. We also forecasted that both DALY counts and age-standardised DALY rates will continue to shift from CMNNs to NCDs, with the most pronounced shifts occurring in sub-Saharan Africa (60·1% [95% UI 56·8–63·1] of DALYs were from CMNNs in 2022 compared with 35·8% [31·0–45·0] in 2050) and south Asia (31·7% [29·2–34·1] to 15·5% [13·7–17·5]). This shift is reflected in the leading global causes of DALYs, with the top four causes in 2050 being ischaemic heart disease, stroke, diabetes, and chronic obstructive pulmonary disease, compared with 2022, with ischaemic heart disease, neonatal disorders, stroke, and lower respiratory infections at the top. The global proportion of DALYs due to YLDs likewise increased from 33·8% (27·4–40·3) to 41·1% (33·9–48·1) from 2022 to 2050, demonstrating an important shift in overall disease burden towards morbidity and away from premature death. The largest shift of this kind was forecasted for sub-Saharan Africa, from 20·1% (15·6–25·3) of DALYs due to YLDs in 2022 to 35·6% (26·5–43·0) in 2050. In the assessment of alternative future scenarios, the combined effects of the scenarios (Safer Environment, Improved Childhood Nutrition and Vaccination, and Improved Behavioural and Metabolic Risks scenarios) demonstrated an important decrease in the global burden of DALYs in 2050 of 15·4% (13·5–17·5) compared with the reference scenario, with decreases across super-regions ranging from 10·4% (9·7–11·3) in the high-income super-region to 23·9% (20·7–27·3) in north Africa and the Middle East. The Safer Environment scenario had its largest decrease in sub-Saharan Africa (5·2% [3·5–6·8]), the Improved Behavioural and Metabolic Risks scenario in north Africa and the Middle East (23·2% [20·2–26·5]), and the Improved Nutrition and Vaccination scenario in sub-Saharan Africa (2·0% [–0·6 to 3·6]). Interpretation: Globally, life expectancy and age-standardised disease burden were forecasted to improve between 2022 and 2050, with the majority of the burden continuing to shift from CMNNs to NCDs. That said, continued progress on reducing the CMNN disease burden will be dependent on maintaining investment in and policy emphasis on CMNN disease prevention and treatment. Mostly due to growth and ageing of populations, the number of deaths and DALYs due to all causes combined will generally increase. By constructing alternative future scenarios wherein certain risk exposures are eliminated by 2050, we have shown that opportunities exist to substantially improve health outcomes in the future through concerted efforts to prevent exposure to well established risk factors and to expand access to key health interventions

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

Background: Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. Methods: The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk–outcome pairs. Pairs were included on the basis of data-driven determination of a risk–outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk–outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of risk–outcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws. Findings: Among the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7–9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4–9·2]), smoking (5·7% [4·7–6·8]), low birthweight and short gestation (5·6% [4·8–6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8–6·0]). For younger demographics (ie, those aged 0–4 years and 5–14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9–27·7]) and environmental and occupational risks (decrease of 22·0% [15·5–28·8]), coupled with a 49·4% (42·3–56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9–21·7] for high BMI and 7·9% [3·3–12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6–1·9) for high BMI and 1·3% (1·1–1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4–78·8) for child growth failure and 66·3% (60·2–72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP). Interpretation: Substantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century