Pengaruh Komposisi Media Terhadap Induksi Tunas Dan Akar Lima Genotipe Tanaman Agave Pada Kultur in Vitro; the Effect of Media Composition on the Induction of Shoot and Roots and of Five Agave Clones on in Vitro Culture

Agave (Agave sisalana Perrine) merupakan tanaman penghasil serat alam. Pengembangan agave terkendala penyediaan bahan tanam bermutu. Teknik kultur jaringan dapat menghasilkan benih agave dalam jumlah banyak dengan kualitas yang seragam. Tujuan penelitian adalah untuk mendapatkan komposisi media terbaik dalam induksi tunas dan akar lima genotipe agave pada kultur in vitro. Penelitian dilaksanakan di Laboratorium Kultur Jaringan Balittas dari bulan Juli 2015 sampai Juni 2016. Sumber eksplan adalah tunas aseptik agave genotipe Balittas 10, Balittas 12, Balittas 13, Balittas 14, dan H-11648 dari kultur in vitro. Rancangan penelitian yang digunakan rancangan acak lengkap faktorial (dua faktor, tiga ulangan). Faktor I adalah komposisi media dan faktor II adalah genotipe. Komposisi media induksi tunas: M1 (MS + BAP 0,5 mg/l + IBA 0,5 mg/l); M2 (MS + BAP 1 mg/l + IBA 0,5 mg/l), dan M3 (MS + BAP 1,5 mg/l + IBA 0,5 mg/l). Komposisi media perakaran: M1 (MS + arang aktif 2 g/l); M2 (MS + arang aktif 2 g/l + IBA 0,5 mg/l); M3 (MS + arang aktif 2 g/l + IBA 1 g/l); M4 (MS + arang aktif 2 g/l + NAA 0,5 mg/l), dan M5 (MS + arang aktif 2 g/l + NAA 1 mg/l). Hasil penelitian menunjukkan komposisi media induksi tunas menghasilkan jumlah tunas (1,09–1,33) dan kecepatan induksi (4 minngu) yang tidak berbeda nyata. Komposisi media induksi akar yang terbaik adalah media M4 (MS + arang aktif 2 g/l + NAA 0,5 mg/l) dengan jumlah akar 4,53. Genotipe Balittas 14 menghasilkan jumlah tunas dan jumlah akar yang paling tinggi dibandingkan genotipe lain (1,56 tunas dan 4,59 akar). Agave (Agave sisalana Perrine) is a plant that producenaturalfibre. Agave cultivation for commercial use is still limited by the availability of good plant materials. In vitro culture technique can produce a large amount of plant material with same quality in relatively short time. The study aimed to obtain a suitable medium composition for in vitro shoot multiplication and root induction for five agave genotypes. The experiment was conducted from July 2015 to June 2016 in Tissue Culture Laboratory of Indonesian Sweetener and Fibre Crops Research Institute. Explant source derived from aseptic shoot of agave genotypesBalittas 10, 12, 13, 14, andH-11648 in in vitro ISFCRI germplasm collection. The experiment was arranged in factorial complete random design (two factors: media composition, genotype, and three replication). Shoot induction media: M1 (MS + BAP 0.5 mg/l + IBA 0.5 mg/l); M2 (MS + BAP 1 mg/l + IBA 0.5 mg/l);and M3 (MS + BAP 1.5 mg/l + IBA 0.5 mg/l). Root induction media: M1 (MS + active carbon(AC) 2 g/l); M2 (MS + AC2 g/l + IBA 0,5 mg/l); M3 (MS + AC 2 g/l + IBA 1 g/l); M4 (MS + AC 2 g/l + NAA 0,5 mg/l);and M5 (MS + AC 2 g/l + NAA 1 mg/l). The results showed that the shoot induction media compositions were not differ significantly on shoot numbers (1.09–1.33) and time for shoot induction (4 weeks). The best composition medium of root induction was M4 (MS + AC 2 g/l + NAA 0.5 mg/l), that yielded 4.53 root numbers. Balittas 14 genotype yielded the highest shoot and root numbers (1,56 shoot numbers and 4.59 root numbers)

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

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

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

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

Peningkatan Kemampuan Keluarga Merawat Klien Gangguan Jiwa Melalui Kelompok Swabantu

Gangguan jiwa dialami 81 jiwa dari 13764 jiwa penduduk di Kelurahan Sindang Barang, Bogor. Pelayanan kesehatan jiwamasyarakat melalui puskesmas belum berjalan optimal dan belum ada kelompok swabantu (self help group). Kelompok swabantumerupakan satu pendekatan untuk mempertemukan kebutuhan keluarga dan sebagai sumber penting untuk keluarga klien dengangangguan jiwa. Penelitian ini bertujuan mengidentifikasi pengaruh kelompok swabantu terhadap kemampuan keluarga dalammerawat klien gangguan jiwa. Desain penelitian kuasi eksperimen dengan pendekatan pre-post test without control group inimelibatkan 18 keluarga yang diberikan intervensi berupa kelompok swabantu. Analisis menggunakan t paired, Anova danindependent t test. Hasil penelitian menunjukkan peningkatan kemampuan kognitif dan psikomotor keluarga dalam merawatklien gangguan jiwa secara bermakna. Direkomendasikan membentuk dan melaksanakan kelompok swabantu bagi keluargayang memiliki anggota keluarga dengan gangguan jiwa

The Effectiveness of Cardiopulmonary Resuscitation Training Using Feedback System on Chest Compression: A Comparative Study Between Doctor and Nurse

High-quality chest compression, adequate depth and rate, and minimal interruption are needed to improve the survival rate of cardiopulmonary resuscitation (CPR). Currently, CPR training with feedback system is considered to give high-quality CPR. Although doctor and nurse have a different educational background, both professions require proficiency in delivering CPR. This study aimed to compare the effectiveness of CPR training with a feedback system to the quality, depth, and rate of chest compression between doctors and nurses. This study was a cross-sectional study that involved 16 doctors and 19 nurses in CPR training with CPR feedback system. The quality, depth, and rate of chest compression performing by a group of doctors and a group of nurses were analyzed before and after CPR training. Data were collected and analyzed statistically. The results show that in the nurse group, there was a significant difference in quality, depth, and rate of compression before and after the training (p=0.000, p=0.000, p=0.000). In the doctor group, there was a significant difference of depth and quality of chest compression before and after the training (p=0.010, p=0.001). When comparing doctor and nurse group after training, no significant differences were observed in doing CPR (p=0.310, p=0.288, p=0.440)

Acute Kidney Injury and Risk of Death After Elective Surgery: Prospective Analysis of Data From an International Cohort Study

This was an investigator-initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (United Kingdom) Professorship held by R.M.P. H.C. was part-supported for this research project by the John Snow Award jointly administered by the Royal College of Anaesthetics, the British Journal of Anaesthesia, and the National Institute of Academic Anaesthesia. This study was sponsored by Queen Mary University of London