Successful rehabilitation approach for sustainable regain in cocoa production systems in South-East Asia

In Malaysia an intensively managed high input full sun cacao (Theobroma cacao L.) plantation can reach high yields of 1.5 to 2 t dry beans per ha. Following a high production period of 10 years the yields often decrease markedly. Focusing on leading depleted cacao plantations sustainably back to full production a research project was initiated in June 2011 using a diversification approach with agroforestry systems. The experimental site is located on a large commercial farm in the humid tropical lowlands of peninsular Malaysia, in the region of Kuala Lipis. In a field trial with a strip-split-plot design, three different production systems are compared under two tree age conditions: newly planted and old rehabilitated cacao trees, after the removal of the original canopy back to the leader structure. The examined production systems are: i) high external inputs in a mono crop full sun system representing the common practice of large cacao plantations in South-East Asia (COM); ii) medium level of external inputs in an agroforestry system of low diversity focusing on leguminous and timber trees (AF LD); iii) low external inputs in an agroforestry system of high diversity and high density shade trees including annual crops and fruit trees (AF HD). The existing twenty-two-year-old plantation with the original canopy and a high input level serves as control treatment (REF). When cocoa yields decline after the initial high production period trees are often replanted. This results in a non-productive phase lasting several years before the young trees start to develop pods and even longer before yields reach a remunerative level. Rehabilitating old low producing trees on the other hand, as practiced in the present experiment, is expected to re-establish higher yields more quickly than re-planting. The first full harvest in the trial started in September 2012, 15 months after the rehabilitation pruning. Between October 2012 and June 2013 (main harvest) an average of 471.2 kg dry beans per ha were harvested in the control treatment. The yields of the common practice treatments already amounted to 41.6 % of the control. This is a very promising result, especially in view of the development of young trees which will take at least another year before the first pod development. Yields in the agroforestry systems increased less quickly as tree development under shade and with lower fertilizer input is inherently slower

Rehabilitation Approach for quick and sustainable regain in cocoa production in declining full sun plantations

In Malaysia an intensively managed high input full sun cocoa plantation can reach high yields of 1.5 to 2 t dry beans per ha. Following a high production period of 10 years the yields often decrease markedly. Focusing on leading depleted cacao plantations sustainably back to full production a research project was initiated in June 2011 using a diversification approach with agroforestry systems. The experimental site is located on a large commercial farm in the humid tropical lowlands of peninsular Malaysia, in the region of Kuala Lipis. In a field trial with a strip-split-plot design, three different production systems, mainly characterised by diversification levels (mono culture to high diversity agroforestry) and accordingly different external input levels (high to low), are compared under two tree age conditions: newly planted and old rehabilitated cocoa trees, after the removal of the original canopy back to the leader structure. The existing twenty-two-year-old plantation with the original canopy and a high input level serves as control treatment. When cacao yields decline after the initial high production period trees are often replanted. This results in a non-productive phase lasting several years before the young trees start to develop pods and even longer before yields reach a remunerative level. Rehabilitating old low producing trees on the other hand, as practised in the present experiment, is expected to re-establish higher yields more quickly than re-planting. The first full harvest in the trial started in September 2012, 15 months after the rehabilitation pruning. Between September 2012 and March 2013 (main harvest) an average of 462 kg dry beans per ha were harvested in the control treatment. The yields of the common practice treatment already amounted to 24.9 % of the control. This is a very promising result, especially in view of the development of young trees which will take at least another year before the first pod development. Yields in the agroforestry systems increased less quickly as tree development under shade and with lower fertiliser input is inherently slower

Admission kidney function is a strong predictor for the response to nutritional support in patients at nutritional risk.

BACKGROUND Patients with chronic kidney disease (CKD) are at substantial risk of malnutrition, which negatively affects clinical outcomes. We investigated the association of kidney function assessed at hospital admission and effectiveness of nutritional support in hospitalized medical patients at risk of malnutrition. METHODS This is a secondary analysis of an investigator-initiated, randomized-controlled, Swiss multicenter trial (EFFORT) that compared individualised nutritional support with usual hospital food on clinical outcomes. We compared effects of nutritional support on mortality in subgroups of patients stratified according to kidney function at the time of hospital admission (estimated glomerular filtration rates [eGFR] <15, 15-29, 30-59, 60-89 and ≥ 90 ml/min/1.73 m2). RESULTS We included 1943 of 2028 patients (96%) from the original trial with known admission creatinine levels. Admission eGFR was a strong predictor for the beneficial effects of nutritional support in regard to lowering of 30-day mortality. Patients with an eGFR <15, 15-29 and 30-59 had the strongest mortality benefit (odds ratios [95%CI] of 0.24 [0.05 to 1.25], 0.37 [0.14 to 0.95] and 0.39 [0.21 to 0.75], respectively), while patients with less severe impairment in kidney function had a less pronounced mortality benefits (p for interaction 0.001). A similar stepwise association of kidney function and response to nutritional support was found also for other secondary outcomes. CONCLUSION In medical inpatients at nutritional risk, admission kidney function was a strong predictor for the response to nutritional therapy. Initial kidney function may help to individualize nutritional support in the future by identification of patients with most clinical benefit. CLINICAL TRIAL REGISTRATION Registered under ClinicalTrials.gov Identifier no. NCT02517476