Soil nitrogen storage and availability to crops are increased by conservation agriculture practices in rice - based cropping systems in the Eastern Gangetic Plains

On-farm adoption of minimum soil disturbance and increased residue retention will alter nitrogen (N) dynamics in soils and N fertiliser management in the intensive rice–based triple cropping systems of the Eastern Gangetic Plains. However, the consequences of changes in N forms, N mineralisation and its availability for crops have not been determined. Field experiments were conducted at two locations (Alipur and Digram) of north–west Bangladesh (NWB) to examine N cycling under three planting practices (conventional tillage (CT), strip planting (SP) and bed planting (BP)) with increased (HR) or low residue retention (LR– the current practice) on Calcareous Brown Flood Plain and Grey Terrace soils. Total N and available N were measured on soil samples as was N uptake by crops at different growth stages in the 13–14th (Alipur) and 12–13th (Digram) crops since treatments commenced. At each location (0–10 cm soil depth), SP, including non–puddled transplanting of rice seedlings (NP), together with HR increased total N by 9 and 32 % relative to BPHR, and CTHR and by 62 % relative to the current farm practice (CTLR). In general, the cumulative available N in soils during mustard and rice cropping under CT with HR was higher than other crop establishment and residue retention practices while under wheat and jute, total availability of N did not vary among crop establishment types with increased residue retention. Nitrogen availability in the initial phase of crop growth (0–60 DAS) was generally higher with CT than SP and BP. By contrast, for all crops, the estimated potentially mineralisable N was higher and its decay rate was lower under SPHR than other crop establishment and residue retention practices. Conservation Agriculture practices (SP, and NP of rice, together with HR) have altered the N cycling by reducing the level of mineral N available to plants in the early growing season when crop demand is low, but by increasing soil total N (0−10 cm) and plant N uptake which enhanced the synchrony between crop demand and available N supply

Cost efficiency and board composition under different takaful insurance business models

Belgium Herbarium image of Meise Botanic Garden

Response of Potato to Ash as an Alternative Source of Potassic Fertilizer

An experiment was carried out during rabi season of 2011-2012 in the experimental field of Soil Science, Bangladesh Agricultural University (BAU), Mymensingh. The objectives of present research work was to evaluate ash as an alternative source of potassic fertilizer for potato cultivation. The treatment combinations were i) Control (No K), ii) 100% K of recommended dose from muriate of potash (MoP), iii) 75% K from MoP+ 25% K from ash, iv) 50% K from MoP + 50% K from ash, v) 25% K from MoP + 75% K from ash, and vi) 100% K from ash. The result of the experiment indicated that various combinations of ash and MoP influenced the yield, yield contributing characters (length of the tubers, breadth of the tubers, number of tubers per hill, weight of tubers per hill, weight of ten tubers and gross yield of tubers per plot), K content of po tato as well as weed infestation. Among the treatments the highest yield was obtained from 50% K from MoP + 50% from ash (T3) treated plot. The K content in the potato tuber and weed infestation was also highest for that plot. Considering the yield contributing parameters, yield and number of weeds the T3 (50% K from MoP + 50% K from ash) treatment was found more suitable than others

Long - term conservation agriculture increases nitrogen use efficiency by crops, land equivalent ratio and soil carbon stock in a subtropical rice - based cropping system

Conservation Agriculture (CA) is still a relatively new approach for intensively cultivated (3 crops yr-1) rice-based cropping systems that produce high crop yield and amounts of residues annually. With the recent development of transplanting of rice into tilled strips on non-puddled soil, CA could become feasible for rice-based cropping patterns. However, the effect of increased retention of crop residues on crop response to nitrogen (N) fertilization rate in strip tilled systems with the transplanted rice and other crops grown in the annual rotation is yet to be determined. For nine years, we have examined the effects of soil disturbance levels - strip tillage (ST) and conventional tillage (CT), two residue retention levels –15% residue by height (low residue, LR) and 30% residue (high residue, HR) and five N rates (60%, 80%, 100%, 120%, and 140% of the recommended N fertilizer doses (RFD)) for a rice-wheat-mungbean cropping sequence. The 100% RFD was 75, 100 and 20 kg N ha-1for rice, wheat, and mungbean, respectively. Rice yields were comparable between the two tillage systems for up to year-6, wheat for up to year-3 but mungbean yield markedly increased in ST from year-1; however, the land equivalent ratio increased from year-1, principally because of higher mungbean yield. Introduction of ST increased land equivalent ratio by 26% relative to CT, N use efficiency and partial factor productivity. Nitrogen fertilizer demand for maximum yield in ST was increased by about 10% for rice and 5% for mungbean but decreased by 5% for wheat. Although fertilizer N demand had increased in ST system due to higher yield than CT, the N requirement declined by50–90% when the same yield goal is considered for ST as for CT. The soil organic carbon stock (0–15 cm) after 8 years increased from 21.5 to 30.5 t ha-1 due to the effect of ST plus high crop residue retention. Annual gross margin increased by 57% in ST over CT practice and 26% in HR over LR retention. In conclusion, after 9 years practicing CA with increased residue retention under strip tillage, the crops had higher N use efficiency, grain yield, land equivalent ratio and annual gross margin in the rice-wheat-mungbean cropping system while the N fertilizer requirement increased minimally

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

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

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 middle-income 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 low-income 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 low-income, 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