Pengaruh Jiwa Kewirausahaan dan Manajemen Agribisnis terhadap Keberhasilan Gapoktan Simantri di Kabupaten Tabanan

Bali Provincial Government has been implementing a program Simantri since 2009, until now reached the number of 419 units Simantri. Simantri program is a groundbreaking effort to further streamline farm through crop and livestock waste utilization with concept of no waste (zero waste). Simantri success is influenced by many factors, among others the ability of entrepreneurship and agribusiness management.The purpose of this study was to analyze the effect of entrepreneurship and agribusiness management towards the successful of Simantri in Tabanan. The study was conducted on Gapoktan Simantri from 2009-2011. The unit of analysis is the study Poktan Simantri executor. The number of samples was determined by 21 Poktan executive with 84 respondents consisting of administrators and members representing. Engineering analysis data using Partial Least Square (PLS) with the help of Smart PLS program . The results showed that the entrepreneurial spirit is very significant positive effect on the success of Simantri, as well as the management of agribusiness. Agribusiness management turns a very significant positive effect on the success of Simantri. This suggests that the entrepreneurial spirit of great influence in shaping the quality of human resources so as to implement agribusiness management and eager to achieve the performance in implementing Simantri. Suggestions for implementing Poktan of Simantri members is that the entrepreneurial spirit should grow or strengthened, especially in changing the mindset of associating with a more flexible search for information to Simantri who has managed to be more motivated to be successful running the Simantri. Poktan Simantri implementing institutional groups should also increasing so as to innovate in developing technology based agribusiness innovation with the development of diversified products in Simantri

Penerapan Tri Hita Karana terhadap Kawasan Agrowisata Buyan dan Tamblingan di Desa Pancasari, Kecamatan Sukasada, Kabupaten Buleleng

Agro-tour is one of the alternative developments of tour destination in Indonesia, especially in Bali which has high number of devotees. The agro-tour area in Buyan/Tamblingan is one of the agro-tour areas which is developed intensively in Bali. The value of this agro-tour will be higher if it is focused on its management. The relevant basis used to manage and keep the viability of this agro-tour is named Tri Hita Karana. Besides as being a guidance for managing, the aspects of Tri Hita Karana is also considered as tourism value which is divided into three aspects, namely parhyangan, pawongan, and palemahan. Based on this situation, this study aimed at understanding the effect of Tri Hita Karana implementation simultaneously or partially toward the agro-tour area of Buyan/Tamblingan. The population of this study was the community of Pancasari village with 1.100 KK. The sample of this study was 110 people chosen by using simple random sampling technique. The data was analyzed by using multiple regressions analysis, correlation analysis, determination analysis, F-test analysis, and standardized coefficient beta through SPP 17.0 program. The result of this study shows that the implementation of Tri Hita Karana consisting of parhyangan, pawongan, and palemahan simultaneously influences positively and significantly toward the agro-tour area of Buyan/Tamblingan with Fcounted of 86.659 and significance degree of 0.000 which is beneath from 5%. Partially, the aspect of parhyangan has positive and significant influence toward the agro-tour area of Buyan/Tamblingan with tcounted > ttabel (3.708 > 1.659) with probability value (? = 5%) is 0.000 which is beneath from 0.05. The aspect of pawongan has positive and significant influence toward agro-tour area of Buyan/Tamblingan with tcounted > ttabel (2.604 > 1.659) with probability value (? = 5%) is 0.011 which is beneath from 0.05. The aspect of palemahan has positive and significant influence toward agro-tour area of Buyan/Tamblingan with tcounted > ttabel (4.519 > 1.659) with probability value (? = 5%) is 0.000 which is beneath from 0.05. Thus, the most influent variable is palemahan which has the highest standardized coefficient beta of 0.389 with the highest determination influence of 38.9%.Based on the result of this study, it is expected for the tourism manager and community appliance that the management of agro-tour area of Buyan/Tamblingan as a tour destination pays attention on the aspects of Tri Hita Karana as a philosophy in keeping, protecting, employing, and developing this agro-tour area since these aspects of Tri Hita Karana is proven to have significant effect simultaneously and partially

Five endometrial cancer risk loci identified through genome-wide association analysis.

We conducted a meta-analysis of three endometrial cancer genome-wide association studies (GWAS) and two follow-up phases totaling 7,737 endometrial cancer cases and 37,144 controls of European ancestry. Genome-wide imputation and meta-analysis identified five new risk loci of genome-wide significance at likely regulatory regions on chromosomes 13q22.1 (rs11841589, near KLF5), 6q22.31 (rs13328298, in LOC643623 and near HEY2 and NCOA7), 8q24.21 (rs4733613, telomeric to MYC), 15q15.1 (rs937213, in EIF2AK4, near BMF) and 14q32.33 (rs2498796, in AKT1, near SIVA1). We also found a second independent 8q24.21 signal (rs17232730). Functional studies of the 13q22.1 locus showed that rs9600103 (pairwise r(2) = 0.98 with rs11841589) is located in a region of active chromatin that interacts with the KLF5 promoter region. The rs9600103[T] allele that is protective in endometrial cancer suppressed gene expression in vitro, suggesting that regulation of the expression of KLF5, a gene linked to uterine development, is implicated in tumorigenesis. These findings provide enhanced insight into the genetic and biological basis of endometrial cancer.I.T. is supported by Cancer Research UK and the Oxford Comprehensive Biomedical Research Centre. T.H.T.C. is supported by the Rhodes Trust and the Nuffield Department of Medicine. Funding for iCOGS infrastructure came from the European Community's Seventh Framework Programme under grant agreement 223175 (HEALTH-F2-2009-223175) (COGS), Cancer Research UK (C1287/A10118, C1287/A10710, C12292/A11174, C1281/A12014, C5047/A8384, C5047/A15007, C5047/A10692 and C8197/A16565), the US National Institutes of Health (R01 CA128978, U19 CA148537, U19 CA148065 and U19 CA148112), the US Department of Defense (W81XWH-10-1-0341), the Canadian Institutes of Health Research (CIHR) for the CIHR Team in Familial Risks of Breast Cancer, the Susan G. Komen Foundation for the Cure, the Breast Cancer Research Foundation and the Ovarian Cancer Research Fund. SEARCH recruitment was funded by a programme grant from Cancer Research UK (C490/A10124). Stage 1 and stage 2 case genotyping was supported by the NHMRC (552402 and 1031333). Control data were generated by the WTCCC, and a full list of the investigators who contributed to the generation of the data is available from the WTCCC website. We acknowledge use of DNA from the British 1958 Birth Cohort collection, funded by UK Medical Research Council grant G0000934 and Wellcome Trust grant 068545/Z/02; funding for this project was provided by the Wellcome Trust under award 085475. NSECG was supported by the European Union's Framework Programme 7 CHIBCHA grant and Wellcome Trust Centre for Human Genetics Core Grant 090532/Z/09Z, and CORGI was funded by Cancer Research UK. BCAC is funded by Cancer Research UK (C1287/A10118 and C1287/A12014). OCAC is supported by a grant from the Ovarian Cancer Research Fund thanks to donations by the family and friends of Kathryn Sladek Smith (PPD/RPCI.07) and the UK National Institute for Health Research Biomedical Research Centres at the University of Cambridge.This is the author accepted manuscript. The final version is available from Nature Publishing Group via http://dx.doi.org/10.1038/ng.356

Polygenic risk modeling for prediction of epithelial ovarian cancer risk

Polygenic risk scores (PRS) for epithelial ovarian cancer (EOC) have the potential to improve risk stratification. Joint estimation of Single Nucleotide Polymorphism (SNP) effects in models could improve predictive performance over standard approaches of PRS construction. Here, we implemented computationally efficient, penalized, logistic regression models (lasso, elastic net, stepwise) to individual level genotype data and a Bayesian framework with continuous shrinkage, "select and shrink for summary statistics" (S4), to summary level data for epithelial non-mucinous ovarian cancer risk prediction. We developed the models in a dataset consisting of 23,564 non-mucinous EOC cases and 40,138 controls participating in the Ovarian Cancer Association Consortium (OCAC) and validated the best models in three populations of different ancestries: prospective data from 198,101 women of European ancestries; 7,669 women of East Asian ancestries; 1,072 women of African ancestries, and in 18,915 BRCA1 and 12,337 BRCA2 pathogenic variant carriers of European ancestries. In the external validation data, the model with the strongest association for non-mucinous EOC risk derived from the OCAC model development data was the S4 model (27,240 SNPs) with odds ratios (OR) of 1.38 (95% CI: 1.28-1.48, AUC: 0.588) per unit standard deviation, in women of European ancestries; 1.14 (95% CI: 1.08-1.19, AUC: 0.538) in women of East Asian ancestries; 1.38 (95% CI: 1.21-1.58, AUC: 0.593) in women of African ancestries; hazard ratios of 1.36 (95% CI: 1.29-1.43, AUC: 0.592) in BRCA1 pathogenic variant carriers and 1.49 (95% CI: 1.35-1.64, AUC: 0.624) in BRCA2 pathogenic variant carriers. Incorporation of the S4 PRS in risk prediction models for ovarian cancer may have clinical utility in ovarian cancer prevention programs

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone