Muhammadiyah University of Surakarta

Colorectal cancer (CRC) is the second most deadly cancer. Global incidence and mortality are likely to be increased in the coming decades. Although the deaths associated with CRC are very high in high-income countries, the incidence and fatalities related to CRC are growing in developing countries too. CRC detected early is entirely curable by surgery and subsequent medications. However, the recurrence rate is high, and cancer drug resistance increases the treatment failure rate. Access to early diagnosis and treatment of CRC for survival is somewhat possible in developed countries. However, these facilities are rarely available in developing countries. Highlighting the current status of CRC, its development, risk factors, and management is crucial in creating public awareness. Therefore, in this review, we have comprehensively discussed the current global epidemiology, drug resistance, challenges, risk factors, and preventive and treatment strategies of CRC. Additionally, there is a brief discussion on the CRC development pathways and recommendations for preventing and treating CRC.

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2-to end preventable child deaths by 2030-we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000-2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations.

Gratitude therapy is a positive psychotherapy approach given to victims of sexual abuse to generate positive thinking by expressing gratitude to the environment, God and other people. This research aims to test gratitude intervention as a religious activity undertaken to reduce negative emotions in victims of sexual abuse. A total of 104 such victims were identified using the snowball sampling method who were divided into an experimental group (N=52) and a control group (N=52). They were diagnosed as having negative emotions based on the child Trauma Questionnaire Shot-Focus (CTQ-SF) and Gratitude Questioner-6 (GQ-6) with triple ANOVA data analysis. The study’s results demonstrate a significant influence of gratitude on negative emotion, with values of F(39,037) = 4.71, p .01, and ηp2 = 0.113. It can increase feelings of gratitude and reduce negative emotions in victims of sexual abuse. Gratitude therapy helps reduce negative emotions and foster positive emotions amongst such victims. The study could be implemented in people who experience negative emotions related to clinical and non-clinical disorders.

BACKGROUND: Timely and comprehensive analyses of causes of death stratified by age, sex, and location are essential for shaping effective health policies aimed at reducing global mortality. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 provides cause-specific mortality estimates measured in counts, rates, and years of life lost (YLLs). GBD 2023 aimed to enhance our understanding of the relationship between age and cause of death by quantifying the probability of dying before age 70 years (70q0) and the mean age at death by cause and sex. This study enables comparisons of the impact of causes of death over time, offering a deeper understanding of how these causes affect global populations. METHODS: GBD 2023 produced estimates for 292 causes of death disaggregated by age-sex-location-year in 204 countries and territories and 660 subnational locations for each year from 1990 until 2023. We used a modelling tool developed for GBD, the Cause of Death Ensemble model (CODEm), to estimate cause-specific death rates for most causes. We computed YLLs as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. Probability of death was calculated as the chance of dying from a given cause in a specific age period, for a specific population. Mean age at death was calculated by first assigning the midpoint age of each age group for every death, followed by computing the mean of all midpoint ages across all deaths attributed to a given cause. We used GBD death estimates to calculate the observed mean age at death and to model the expected mean age across causes, sexes, years, and locations. The expected mean age reflects the expected mean age at death for individuals within a population, based on global mortality rates and the population's age structure. Comparatively, the observed mean age represents the actual mean age at death, influenced by all factors unique to a location-specific population, including its age structure. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 250-draw distribution for each metric. Findings are reported as counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2023 include a correction for the misclassification of deaths due to COVID-19, updates to the method used to estimate COVID-19, and updates to the CODEm modelling framework. This analysis used 55 761 data sources, including vital registration and verbal autopsy data as well as data from surveys, censuses, surveillance systems, and cancer registries, among others. For GBD 2023, there were 312 new country-years of vital registration cause-of-death data, 3 country-years of surveillance data, 51 country-years of verbal autopsy data, and 144 country-years of other data types that were added to those used in previous GBD rounds. FINDINGS: The initial years of the COVID-19 pandemic caused shifts in long-standing rankings of the leading causes of global deaths: it ranked as the number one age-standardised cause of death at Level 3 of the GBD cause classification hierarchy in 2021. By 2023, COVID-19 dropped to the 20th place among the leading global causes, returning the rankings of the leading two causes to those typical across the time series (ie, ischaemic heart disease and stroke). While ischaemic heart disease and stroke persist as leading causes of death, there has been progress in reducing their age-standardised mortality rates globally. Four other leading causes have also shown large declines in global age-standardised mortality rates across the study period: diarrhoeal diseases, tuberculosis, stomach cancer, and measles. Other causes of death showed disparate patterns between sexes, notably for deaths from conflict and terrorism in some locations. A large reduction in age-standardised rates of YLLs occurred for neonatal disorders. Despite this, neonatal disorders remained the leading cause of global YLLs over the period studied, except in 2021, when COVID-19 was temporarily the leading cause. Compared to 1990, there has been a considerable reduction in total YLLs in many vaccine-preventable diseases, most notably diphtheria, pertussis, tetanus, and measles. In addition, this study quantified the mean age at death for all-cause mortality and cause-specific mortality and found noticeable variation by sex and location. The global all-cause mean age at death increased from 46·8 years (95% UI 46·6-47·0) in 1990 to 63·4 years (63·1-63·7) in 2023. For males, mean age increased from 45·4 years (45·1-45·7) to 61·2 years (60·7-61·6), and for females it increased from 48·5 years (48·1-48·8) to 65·9 years (65·5-66·3), from 1990 to 2023. The highest all-cause mean age at death in 2023 was found in the high-income super-region, where the mean age for females reached 80·9 years (80·9-81·0) and for males 74·8 years (74·8-74·9). By comparison, the lowest all-cause mean age at death occurred in sub-Saharan Africa, where it was 38·0 years (37·5-38·4) for females and 35·6 years (35·2-35·9) for males in 2023. Lastly, our study found that all-cause 70q0 decreased across each GBD super-region and region from 2000 to 2023, although with large variability between them. For females, we found that 70q0 notably increased from drug use disorders and conflict and terrorism. Leading causes that increased 70q0 for males also included drug use disorders, as well as diabetes. In sub-Saharan Africa, there was an increase in 70q0 for many non-communicable diseases (NCDs). Additionally, the mean age at death from NCDs was lower than the expected mean age at death for this super-region. By comparison, there was an increase in 70q0 for drug use disorders in the high-income super-region, which also had an observed mean age at death lower than the expected value. INTERPRETATION: We examined global mortality patterns over the past three decades, highlighting-with enhanced estimation methods-the impacts of major events such as the COVID-19 pandemic, in addition to broader trends such as increasing NCDs in low-income regions that reflect ongoing shifts in the global epidemiological transition. This study also delves into premature mortality patterns, exploring the interplay between age and causes of death and deepening our understanding of where targeted resources could be applied to further reduce preventable sources of mortality. We provide essential insights into global and regional health disparities, identifying locations in need of targeted interventions to address both communicable and non-communicable diseases. There is an ever-present need for strengthened health-care systems that are resilient to future pandemics and the shifting burden of disease, particularly among ageing populations in regions with high mortality rates. Robust estimates of causes of death are increasingly essential to inform health priorities and guide efforts toward achieving global health equity. The need for global collaboration to reduce preventable mortality is more important than ever, as shifting burdens of disease are affecting all nations, albeit at different paces and scales. FUNDING: Gates Foundation.

Infectious disease (ID) is one of the top-most serious threats to human health globally, further aggravated by antimicrobial resistance and lack of novel immunization options. Andrographis paniculata (Burm. f.) Wall. ex Nees and its metabolites have been long used to treat IDs. Andrographolide, derived from A. paniculata, can inhibit invasive microbes virulence factors and regulate the host immunity. Controlled clinical trials revealed that A. paniculata treatment is safe and efficacious for acute respiratory tract infections like common cold and sinusitis. Hence, A. paniculata, mainly andrographolide, could be considered as an excellent candidate for antimicrobial drug development. Considering the importance, medicinal values, and significant role as antimicrobial agents, this study critically evaluated the antimicrobial therapeutic potency of A. paniculata and its metabolites, focusing on the mechanism of action in inhibiting invasive microbes and biofilm formation. A critical evaluation of the secondary metabolites with the aim of identifying pure compounds that possess antimicrobial functions has further added significant values to this study. Notwithstanding that A. paniculata is a promising source of antimicrobial agents and safe treatment for IDs, further empirical research is warranted.

BACKGROUND: Drowning is a leading cause of injury-related mortality globally. Unintentional drowning (International Classification of Diseases (ICD) 10 codes W65-74 and ICD9 E910) is one of the 30 mutually exclusive and collectively exhaustive causes of injury-related mortality in the Global Burden of Disease (GBD) study. This study's objective is to describe unintentional drowning using GBD estimates from 1990 to 2017. METHODS: Unintentional drowning from GBD 2017 was estimated for cause-specific mortality and years of life lost (YLLs), age, sex, country, region, Socio-demographic Index (SDI) quintile, and trends from 1990 to 2017. GBD 2017 used standard GBD methods for estimating mortality from drowning. RESULTS: Globally, unintentional drowning mortality decreased by 44.5% between 1990 and 2017, from 531 956 (uncertainty interval (UI): 484 107 to 572 854) to 295 210 (284 493 to 306 187) deaths. Global age-standardised mortality rates decreased 57.4%, from 9.3 (8.5 to 10.0) in 1990 to 4.0 (3.8 to 4.1) per 100 000 per annum in 2017. Unintentional drowning-associated mortality was generally higher in children, males and in low-SDI to middle-SDI countries. China, India, Pakistan and Bangladesh accounted for 51.2% of all drowning deaths in 2017. Oceania was the region with the highest rate of age-standardised YLLs in 2017, with 45 434 (40 850 to 50 539) YLLs per 100 000 across both sexes. CONCLUSIONS: There has been a decline in global drowning rates. This study shows that the decline was not consistent across countries. The results reinforce the need for continued and improved policy, prevention and research efforts, with a focus on low- and middle-income countries.

BACKGROUND: Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries. METHODS: We reviewed results for injuries from the GBD 2017 study. GBD 2017 measured injury-specific mortality and years of life lost (YLLs) using the Cause of Death Ensemble model. To measure non-fatal injuries, GBD 2017 modelled injury-specific incidence and converted this to prevalence and years lived with disability (YLDs). YLLs and YLDs were summed to calculate disability-adjusted life years (DALYs). FINDINGS: In 1990, there were 4 260 493 (4 085 700 to 4 396 138) injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554) deaths in 2017, while age-standardised mortality decreased from 1079 (1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were 354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802) new cases of injury globally, which increased to 520 710 288 (493 430 247 to 547 988 635) new cases in 2017. During this time, age-standardised incidence decreased non-significantly from 6824 (6534 to 7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017, age-standardised DALYs decreased from 4947 (4655 to 5233) per 100 000 to 3267 (3058 to 3505). INTERPRETATION: Injuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017. Future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care.

Anemia is a globally widespread condition in women and is associated with reduced economic productivity and increased mortality worldwide. Here we map annual 2000-2018 geospatial estimates of anemia prevalence in women of reproductive age (15-49 years) across 82 low- and middle-income countries (LMICs), stratify anemia by severity and aggregate results to policy-relevant administrative and national levels. Additionally, we provide subnational disparity analyses to provide a comprehensive overview of anemia prevalence inequalities within these countries and predict progress toward the World Health Organization's Global Nutrition Target (WHO GNT) to reduce anemia by half by 2030. Our results demonstrate widespread moderate improvements in overall anemia prevalence but identify only three LMICs with a high probability of achieving the WHO GNT by 2030 at a national scale, and no LMIC is expected to achieve the target in all their subnational administrative units. Our maps show where large within-country disparities occur, as well as areas likely to fall short of the WHO GNT, offering precision public health tools so that adequate resource allocation and subsequent interventions can be targeted to the most vulnerable populations.

Penelitian ini bertujuan untuk mengembangkan modul pembelajaran matematika yang layak untuk pembelajaran siswa SMP N 1 Pomalaa kelas VII Sulawesi Tenggara. Penelitian pengembangan ini menggunakan model Borg Gall. Subjek coba penelitian ini adalah siswa SMP N 1 Pomalaa kelas VII sejumlah 31 siswa, yang terdiri dari 6 siswa untuk uji coba terbatas dan 25 siswa untuk uji lapangan. Hasil penelitian menunjukkan bahwa modul pembelajaran geometri pada aspek kelayakan isi berkategori baik, pada aspek kelayakan bahasa dan gambar berkategori sangat baik, pada aspek penyajian berkategori sangat baik, dan pada aspek kegrafisan berkategori baik serta pembelajaran matematika yang menggunakan modul lebih baik dibandingkan kelas yang tidak menggunakan modul.Kata kunci: pengembangan, modul pembelajaran, pemahaman konsep dan minat Developing a Module to Improve Concept Understanding and Interest of Students of SMP AbstractThe study aimed to develop appropiate mathematics instructional module for mathematics instruction for seventh grade students of SMP N 1 Pomalaa South-East Sulawesi. This research and development study used Borg and Gall model. Subject of research were 31 students of SMPN 1 Pomalaa. Specifically, 6 students participated in the limited try-out and 25 students participated in the extended try-out. The result of study shows that the module of geometry learning for seventh grade students of SMP N 1 Pomalaa in terms of the aspect of content was categorized good, from the aspect of language and pictures was categorized very good, from the aspect of lay-out was categorized very good, and from the aspect of graphic design was categorized good, and also mathematics learning using learning module was better than without module.Keywords : development, learning module, concept undertanding, interest

Exclusive breastfeeding (EBF)-giving infants only breast-milk for the first 6 months of life-is a component of optimal breastfeeding practices effective in preventing child morbidity and mortality. EBF practices are known to vary by population and comparable subnational estimates of prevalence and progress across low- and middle-income countries (LMICs) are required for planning policy and interventions. Here we present a geospatial analysis of EBF prevalence estimates from 2000 to 2018 across 94 LMICs mapped to policy-relevant administrative units (for example, districts), quantify subnational inequalities and their changes over time, and estimate probabilities of meeting the World Health Organization's Global Nutrition Target (WHO GNT) of ≥70% EBF prevalence by 2030. While six LMICs are projected to meet the WHO GNT of ≥70% EBF prevalence at a national scale, only three are predicted to meet the target in all their district-level units by 2030.

Changed synapse density has been suggested to be involved in the altered brain connectivity underlying schizophrenia (SCZ) pathology. However, postmortem studies addressing this topic are heterogeneous and it is not known whether changes are restricted to specific brain regions. Using meta-analysis, we systematically and quantitatively reviewed literature on the density of postsynaptic elements in postmortem brain tissue of patients with SCZ compared to healthy controls. We included 3 outcome measurements for postsynaptic elements: dendritic spine density (DSD), postsynaptic density (PSD) number, and PSD protein expression levels. Random-effects meta-analysis (31 studies) revealed an overall decrease in density of postsynaptic elements in SCZ (Hedges's g: -0.33; 95% CI: -0.60 to -0.05; P = .020). Subgroup analyses showed reduction of postsynaptic elements in cortical but not subcortical tissues (Hedges's g: -0.44; 95% CI: -0.76 to -0.12; P = .008, Hedges's g: -0.11; 95% CI: -0.54 to 0.35; P = .671) and specifically a decrease for the outcome measure DSD (Hedges's g: -0.81; 95% CI: -1.37 to -0.26; P = .004). Further exploratory analyses showed a significant decrease of postsynaptic elements in the prefrontal cortex and cortical layer 3. In all analyses, substantial heterogeneity was present. Meta-regression analyses showed no influence of age, sex, postmortem interval, or brain bank on the effect size. This meta-analysis shows a region-specific decrease in the density of postsynaptic elements in SCZ. This phenotype provides an important cellular hallmark for future preclinical and neuropathological research in order to increase our understanding of brain dysconnectivity in SCZ.

Purpose This paper aims to explore social responsibility reporting of full-fledged Islamic banks in two developing countries, namely, Indonesia and Malaysia. Corporate social responsibility (CSR) has become an important aspect of business society. As such, companies have shown a growing interest in reporting their social and environmental initiatives. Design/methodology/approach Content analysis of the annual reports for three full-fledged local Islamic banks in Indonesia and three Islamic banks in Malaysia was carried out for the period of 2007-2011. Findings Results of the study revealed that CSR disclosure of Islamic banks has generally grown both in Malaysia and Indonesia. More specifically, it was found that workplace and community dimensions were the most highly disclosed areas by the Islamic banks in both countries. Research limitations/implications The current study provides a cross-cultural perspective on social responsibility disclosure in Islamic banks across two countries. The study is limited by investigating a five-year time frame. Practical implications By discussing the findings according to the stages of growth model for CSR, the authors suggest that Islamic banks can enhance their responsiveness, and transform their role from being CSR reporters of social responsibility to responders. Originality/value While the tenets of CSR have a lot in common with Islamic moral law (Shariah), little is known about CSR disclosure of Islamic banks.

Kurikulum memiliki peranan penting berbentuk perangkat pembelajaran yang berisi tentang perencanaan kegiatan pembelajaran dalam bentuk suatu proses pemerolehan pengetahuan dan pengalaman yang didapatkan melalui rangkaian kegiatan pembelajaran. Penelitian ini bertujuan untuk menganalisis kurikulum merdeka lebih lanjut dengan memfokuskan perencanaan implementasi kurikuum merdeka dan perencanaan pembelajaran pada kurikulum merdeka di jenjang sekolah dasar. Jenis penelitian ini merupakan penelitian kualitatif dengan pendekatan fenomenologi. Desain kualitatif diimplementasikan dan dilakukan pada kepala sekolah dan guru kelas 1 dan guru kelas 4. Teknik pengumpulan data menggunakan wawancara dan analisis dokumen. Teknik analisis data yang digunakan yaitu model interactive model yang mana unsur-unsurnya meliputi reduksi data, penyajian data, dan penarikan kesimpulan data. Hasil penelitian menunjukkan bahwa dalam penerapan kurikulum merdeka membutuhkan kesiapan kepala sekolah dan guru untuk mempelajari hal baru. Pada proses perencanaan, guru masih mengandalkan modul ajar yang disediakan oleh pusat. Terdapat hal baru yang harus diperhatikan di dalam kurikulum merdeka dengan adanya project penguatan profil pelajar Pancasila. Implikasi penelitian ini diharapkan guru dapat menggunakan model pembelajaran abad ke 21 dalam penerapan kurikulum merdeka belajar di sekolah.

Peneltian ini bertujuan memberikan memberikan gambaran yang jelas mengenai efisiensi penggunaan Panel Surya sebagai sumber energi alternatif jika dibandingkan dengan penggunaan generator/Genset sebagai sumber energi untuk peralatan listrik. Dalam penelitian ini, digunakan Panel Surya dengan kapasitas 100 WP, yang mana energy yang dihasilkan Panel Surya tersebut kemudian disimpan dalam baterai (accu) dengan kapasitas 12 volt 70 Ah. Energi listrik yang dihasilkan oleh Panel Surya tersebut masih berupa energi listrik dengan tegangan searah. Oleh karena kebanyakan peralatan listrik yang ada menggunakan tegangan bolak-balik, maka diperlukan sebuah inverter untuk mengubah tegangan searah yang dihasilkan oleh Panel Surya menjadi tegangan bolak balik. Inverter yang digunakan dalam penelitian iniberkapasitas 2000 watt sebagai pengubah tegangan DC 12 volt ke AC 220 vol, yang kemudian akan digunakan sebagai sumber energi listrik untuk peralatan listrik yang berupa blender dan lampu listrik.

Kebijakan “Merdeka Belajar, Kampus Merdeka” digagas oleh Menteri Pendidikan dan Kebudayaan yang meliputi 1) pembukaan program studi baru, 2) sistem akreditasi perguruan tinggi, 3) kebebasan menjadi PTN-BH, dan 4) hak belajar tiga semester di luar program studi. Empat kebijakan fundamental ini memberikan harapan besar bagi Perguruan Tinggi Swasta berkembang dan berdaya saing nasional maupun internasional.Kebijakan Menteri Pendidikan dan Kebudayaan ini layak disebut dengan perubahan yang cukup ekstrim, hal ini kemudian memunculkan beberapa keraguan di benak akademisi. Diantara pertanyaan besar yang mucul dari kebijakan merdeka Belajar, Kampus Merdeka” adalah 1) Bagaimana mekanisme implementasi kerjasama kampus dengan pihak eksternal dengan latar belakang kampus yang berbeda-beda?; 2) Bagaimana mekanisme pertukaran pelajar dan magang dengan kondisi geografis, mutu SDM, dan ondisi perekonomian yang berbeda-beda masing-masing individu?; 3) Bagaimana mekanisme penjaminan mutu institusi dengan kebijakan akreditasi yang baru?.Kebijakan visioner Menteri Pendidikan dan Kebudayaan ini layak untuk diapresiasi, akan tetapi muncul beberapa persoalan dari penerapan kebijakan “Merdeka Belajar, Kampus Merdeka” yang harus segera dicarikan solusinya. Maka dari itu artikel ini berusaha mengulas bentuk kebijakan Merdeka Belajar dan tantangan pelaksanaannya.

The purpose of this study is to describe the division of roles of husband and wife in Javanese family. This study uses a phenomenological qualitative method. The subjects of this study consisted of six couples of Javanese residing in Surakarta. Data was collected using a semi-structured interview technique. Data analysis method used is descriptive analysis. The results showed that: (1) the couple shared a role in three areas namely decision-making, management of family finances, and parenting; (2) the process of the implementation of these roles is flexible; (3) The husband has a greater role in decision- making while wife in financial management and parenting. Efforts have always been made to maintain the harmony of the relationship as a partner in the implementation of these roles. It can be concluded that the philosophy of harmony remain the pillars of the guidelines in the relationship of married couples in the Javanese family.

BACKGROUND: Smoking is the leading behavioural risk factor for mortality globally, accounting for more than 175 million deaths and nearly 4·30 billion years of life lost (YLLs) from 1990 to 2021. The pace of decline in smoking prevalence has slowed in recent years for many countries, and although strategies have recently been proposed to achieve tobacco-free generations, none have been implemented to date. Assessing what could happen if current trends in smoking prevalence persist, and what could happen if additional smoking prevalence reductions occur, is important for communicating the effect of potential smoking policies. METHODS: In this analysis, we use the Institute for Health Metrics and Evaluation's Future Health Scenarios platform to forecast the effects of three smoking prevalence scenarios on all-cause and cause-specific YLLs and life expectancy at birth until 2050. YLLs were computed for each scenario using the Global Burden of Disease Study 2021 reference life table and forecasts of cause-specific mortality under each scenario. The reference scenario forecasts what could occur if past smoking prevalence and other risk factor trends continue, the Tobacco Smoking Elimination as of 2023 (Elimination-2023) scenario quantifies the maximum potential future health benefits from assuming zero percent smoking prevalence from 2023 onwards, whereas the Tobacco Smoking Elimination by 2050 (Elimination-2050) scenario provides estimates for countries considering policies to steadily reduce smoking prevalence to 5%. Together, these scenarios underscore the magnitude of health benefits that could be reached by 2050 if countries take decisive action to eliminate smoking. The 95% uncertainty interval (UI) of estimates is based on the 2·5th and 97·5th percentile of draws that were carried through the multistage computational framework. FINDINGS: Global age-standardised smoking prevalence was estimated to be 28·5% (95% UI 27·9-29·1) among males and 5·96% (5·76-6·21) among females in 2022. In the reference scenario, smoking prevalence declined by 25·9% (25·2-26·6) among males, and 30·0% (26·1-32·1) among females from 2022 to 2050. Under this scenario, we forecast a cumulative 29·3 billion (95% UI 26·8-32·4) overall YLLs among males and 22·2 billion (20·1-24·6) YLLs among females over this period. Life expectancy at birth under this scenario would increase from 73·6 years (95% UI 72·8-74·4) in 2022 to 78·3 years (75·9-80·3) in 2050. Under our Elimination-2023 scenario, we forecast 2·04 billion (95% UI 1·90-2·21) fewer cumulative YLLs by 2050 compared with the reference scenario, and life expectancy at birth would increase to 77·6 years (95% UI 75·1-79·6) among males and 81·0 years (78·5-83·1) among females. Under our Elimination-2050 scenario, we forecast 735 million (675-808) and 141 million (131-154) cumulative YLLs would be avoided among males and females, respectively. Life expectancy in 2050 would increase to 77·1 years (95% UI 74·6-79·0) among males and 80·8 years (78·3-82·9) among females. INTERPRETATION: Existing tobacco policies must be maintained if smoking prevalence is to continue to decline as forecast by the reference scenario. In addition, substantial smoking-attributable burden can be avoided by accelerating the pace of smoking elimination. Implementation of new tobacco control policies are crucial in avoiding additional smoking-attributable burden in the coming decades and to ensure that the gains won over the past three decades are not lost. FUNDING: Bloomberg Philanthropies and the Bill & Melinda Gates Foundation.

BACKGROUND: As global rates of mortality decrease, rates of non-fatal injury have increased, particularly in low Socio-demographic Index (SDI) nations. We hypothesised this global pattern of non-fatal injury would be demonstrated in regard to bony hand and wrist trauma over the 27-year study period. METHODS: The Global Burden of Diseases, Injuries, and Risk Factors Study 2017 was used to estimate prevalence, age-standardised incidence and years lived with disability for hand trauma in 195 countries from 1990 to 2017. Individual injuries included hand and wrist fractures, thumb amputations and non-thumb digit amputations. RESULTS: The global incidence of hand trauma has only modestly decreased since 1990. In 2017, the age-standardised incidence of hand and wrist fractures was 179 per 100 000 (95% uncertainty interval (UI) 146 to 217), whereas the less common injuries of thumb and non-thumb digit amputation were 24 (95% UI 17 to 34) and 56 (95% UI 43 to 74) per 100 000, respectively. Rates of injury vary greatly by region, and improvements have not been equally distributed. The highest burden of hand trauma is currently reported in high SDI countries. However, low-middle and middle SDI countries have increasing rates of hand trauma by as much at 25%. CONCLUSIONS: Certain regions are noted to have high rates of hand trauma over the study period. Low-middle and middle SDI countries, however, have demonstrated increasing rates of fracture and amputation over the last 27 years. This trend is concerning as access to quality and subspecialised surgical hand care is often limiting in these resource-limited regions.

Abstract The safe, highly effective measles vaccine has been recommended globally since 1974, yet in 2017 there were more than 17 million cases of measles and 83,400 deaths in children under 5 years old, and more than 99% of both occurred in low- and middle-income countries (LMICs) 1–4 . Globally comparable, annual, local estimates of routine first-dose measles-containing vaccine (MCV1) coverage are critical for understanding geographically precise immunity patterns, progress towards the targets of the Global Vaccine Action Plan (GVAP), and high-risk areas amid disruptions to vaccination programmes caused by coronavirus disease 2019 (COVID-19) 5–8 . Here we generated annual estimates of routine childhood MCV1 coverage at 5 × 5-km 2 pixel and second administrative levels from 2000 to 2019 in 101 LMICs, quantified geographical inequality and assessed vaccination status by geographical remoteness. After widespread MCV1 gains from 2000 to 2010, coverage regressed in more than half of the districts between 2010 and 2019, leaving many LMICs far from the GVAP goal of 80% coverage in all districts by 2019. MCV1 coverage was lower in rural than in urban locations, although a larger proportion of unvaccinated children overall lived in urban locations; strategies to provide essential vaccination services should address both geographical contexts. These results provide a tool for decision-makers to strengthen routine MCV1 immunization programmes and provide equitable disease protection for all children.

Penelitian ini dilatar belakangi karena kurang aktifnya siswa dalam kegiatan pembelajaran. Hal ini terjadi karena guru masih dominan dalam menggunakan metode ceramah dan kurang dalam memanfaatkan media pembelajaran. Tujuan penelitian ini untuk meningkatkan keaktifan belajar siswa dalam proses pembelajaran di kelas. Penelitian ini menggunakan model discovery learning dengan metode penelitian tindakan kelas sebanyak dua siklus. Setiap siklus dilaksanakan dalam dua pertemuan dengan empat tahap kegiatan yaitu, perencanaan, tindakan, observasi, dan refleksi. Subjek penelitian adalah siswa kelas III SD Negeri 3 Pandean dengan jumlah 35 orang. Teknik pengumpulan data yang digunakan adalah observasi, dokumentasi, dan tes. Hasil penelitian pra siklus menunjukkan bahwa hasil rata-rata keaktifan siswa sebesar 41,53%, sedangkan pada siklus I memperoleh persentase 60,91% dan meningkat sebesar 82,89% pada siklus II. Dengan demikian dapat disimpulkan bahwa penggunaan model discovery learning dapat meningkatkan keaktifan belajar siswa pada tema perkembangan teknologi