Background. Until now, cost of allergy treatment in insured public health care system and non-insured self-financing private health care system in Indonesia has not been well documented and published, as well as the cost of allergy treatment with subcutaneous immunotherapy. Objective. To evaluate the clinical and cost benefits of allergic rhinitis treatment in children with subcutaneous immunotherapy in non-insured self-financing private health care system. Methods. A retrospective cohort study conducted from 2015 until 2020, compared clinical improvement and health care costs over 18 months in newly diagnosed AR children who received SCIT versus matched AR control subjects who did not receive SCIT, with each group consisting of 1,098 subjects Results. Decrease of sp-HDM-IgE level (kU/ml) from 20.5 + 8.75 kU/ml to 12.1 + 3.07 kU/ml had been observed in the SCIT group. To reduce the symptom score of allergic rhinitis by 1.0 with SCIT it costs IDR 21,753,062.7 per child, for non SCIT it costs IDR 104,147,878.0 per child. Meanwhile, to reduce the medication score (MS) by 1.0 with SCIT it costs Rp. 17,024,138.8 while with non SCIT it costs Rp. 104,147,878.0. Meanwhile, to lower combination symptoms and medication score (CSMS) by 1.0, with SCIT it costs IDR 9,550,126.6, while with non SCIT it costs IDR 52,073,938.9. Conclusion. In conclusion, this first Indonesia-based study demonstrates substantial health care cost savings associated with SCIT for children with AR in an uninsured private health care system and provides strong evidence for the clinical benefits and cost-savings benefits of AR treatment in children.

Hematite (-Fe2O3) with uniform hexagonal flakes morphology has been successfully synthesized using a combination of gelatin as natural template with F127 via hydrothermal method. The resulting hematite was investigated as adsorbent and photocatalyst for removal of ibuprofen as pharmaceutical waste. Hexagonal flake-like hematite was obtained following calcination at 500 oC with the average size was measured at 1-3 µm. Increasing the calcination temperature to 700 oC transformed the uniform hexagonal structure into cubic shape morphology. Hematite also showed high thermal stability with increasing the calcination temperatures, however, the surface area was reduced from 47 m2/g to 9 m2/g. FTIR analysis further confirmed the formation Fe-O-Fe bonds, and the main constituent elements of Fe and O were observed in EDX analysis for all samples. Fe2O3-G samples have an average adsorption capacity of 55-25.5 mg/g at 12-22% of removal efficiency when used as adsorbent for ibuprofen. The adsorption capacity was reduced with increasing the calcination temperatures due to the reduction of available surface area of the hexagonal flakes when transformed into cube. Photocatalytic degradation of ibuprofen using hematite flakes achieved 50% of removal efficiency meanwhile combination of adsorption and photocatalytic degradation further removed 80% of ibuprofen in water/hexane mixtures.

Myocardial infarction is an uncommon manifestation in anomalous coronary artery (ACA). As usual, the electrocardiogram (ECG) was used to detect myocardial infarction. Unfortunately, the ECG’s pattern could not reveal the ACA’s condition. Some investigators tried to describe the pattern in ECG in ACA’s patients. Due to the rare patients of ACA, it was not yet found.

Since the systematic evolution of ligands by exponential enrichment (SELEX) method was developed, aptamers have made significant contributions as bio-recognition sensors. Microdevice systems allow for low reagent consumption, high-throughput of samples, and disposability. Due to these advantages, there has been an increasing demand to develop microfluidic-based aptasensors for analytical technique applications. This review introduces the principal concepts of aptasensors and then presents some advanced applications of microdevice-based aptasensors on several platforms. Highly sensitive detection techniques such as electrochemical and optical detection have been integrated into lab-on-a-chip devices and researchers have moved towards the goal of establishing point-of-care diagnoses for target analyses.

Background. Polytetrafluoroethylene (PTFE) patch is commonly used during surgical closure for atrial septal defect (ASD) and/or ventricular septal defect (VSD). It has several limitations such as inability to grow, repair, and remodel. Aneurysm formation, thrombosis, and the inability of patches to grow or remodel are usual, especially in children and young adults. To tackle these limitations, we try to use fibronectin and human adipose-derived mesenchymal stem cells (hAMSCs) in PTFE patch. Objective. To understanding positive impact of fibronectin to enhance hAMSCs cell-to-cell adherence and cell-to-patch surface attachment into PTFE patch for future ASD or VSD closure. Methods. Cultured of hAMSCs cells were fixated with 15 mL methanol and CD90+, CD105+, CD45- antibodies were labeled FITC, rinsed with PBS and analyzed under fluorescence microscope for 15 minutes. Fibronectin solution 0.1% were used to soak patch scaffolds for approximately 2 hours duration, and then dried for 20 minutes for treatment group. As for control group, Fibronectin solution was not added on the culture. The samples were examined with scanning electron microscope (SEM). Results. SEM examination showed incomplete attachment of the cells even after 10 days on control group at 1.14 ±1.13 (Figure 2). In contrast, treatment group showed more cells attached to the patch surface at 31.25 ±13.28 (p 0.000) (Figure 3). Observation at 5 days was 17.67 ± 20.21, at 7 days was 12.11 ± 10.94, at 10 days was 18.83 ± 23.25. No significant statistical difference of mean cell per view among each treatment group (p 0.802). Conclusion. Fibronectin has a positive impact on hAMSCs attachment seeded onto PTFE patch. These properties, in combination with their developmental plasticity, have generated tremendous interest because of the potential use of hAMSCs in regenerative medicine to replace damaged tissues.

Background: Obtaining adipose-derived stem cells is limited by its capacity to differentiate. Stimulation by platelet-rich fibrin appears to have the beneficial effects to accelerate differentiation. Objective: To obtain immunohistochemistry evidence of platelet-rich fibrin to accelerate differentiation of adipose-derived stem cells. Methods: We used post-test only controlled-group design. Adipose-derived stem cells were isolated and cultured until 4 passages in α-MEM culture medium. Results: GATA-4 expression increased in platelet-rich fibrin group compared with control group (68.20±6.82 vs 58.15±1.23 counts; p<0.05; 68.20±6.82 vs 52.96±2.02 counts; p<0.05). Troponin expression also increased in platelet-rich fibrin group (50.66±7.2 vs 10.73±2.39 counts; p<0.05; 50.66±7.2 vs 26.00±0.4 counts; p<0.05). Conclusion: There is an immunohistochemistry benefit of platelet-rich fibrin to accelerate differentiation of adipose-derived stem cells into cardiomyocyte-like cells.

Background: There is several challenges to solve irreversible loss of cardiomyocytes due to myocardial infarction. Cell therapy is believed as an ideal treatment for cardiac regeneration in the infarct area. Obtaining adipose-derived stem cells increases seems to be promising, however it is limited by the capacity to differentiate. Stimulation by injectable platelet-rich fibrin appears to have the beneficial effects to accelerate cardiomyocyte-like cells differentiation. Objective: To analyse the benefit of injectable platelet-rich fibrin to accelerate differentiation of adipose-derived mesenchymal stem cells into cardiomyocyte-like cells. Methods: This study is a true experimental randomized post-test design study. Adipose-derived mesenchymal stem cells were isolated from adipose tissues and cultured until 4 passages. The characteristics of adipose-derived mesenchymal stem cells were measured by the expression of CD 34-, CD 45-, and CD 105+ using flowcytometry. The samples were divided into 3 groups, i.e. negative control (α-MEM), positive control (differentiation medium) and treatment group (platelet-rich fibrin). The assessment of GATA-4 marker expression was conducted using flowcytometry on the fifth day and troponin was conducted using immunocytochemistry on the tenth day to determine the differentiation to cardiomyocyte. Data analysis was conducted using T-test and One-Way ANOVA on normally distributed data determined through Shapiro-Wilk test. Results: Flowcytometry on GATA-4 expression revealed significant difference on addition of platelet-rich fibrin compared with negative and positive controls (68.20 ± 6.82 vs 58.15 ± 1.23; p<0.05; 68.20 ± 6.82 vs 52.96 ± 2.02; p<0.05). This was supported by the results of immunocytochemistry on troponin expression which revealed significant difference between platelet-rich fibrin group compared with negative and positive controls (50.66 ± 7.2 vs 10.73 ± 2.39; p<0.05; 50.66 ± 7.2 vs 26.00 ± 0.4; p<0.05). Conclusion: Injectable platelet-rich fibrin has beneficial effect to accelerate differentiation of adipose-derived mesenchymal stem cells into cardiomyocyte-like cells.

Fast-growing teak is widely cultivated in Indonesia to address the supply and demand of teak trees. However, efforts still need to be made to evaluate the condition of standing teak trees during their growth period. Studies on nondestructive testing (NDT) of wood based on electrical properties through dielectric spectroscopy (DS) are recently being developed, especially for standing tree evaluation. The study aimed to analyze the dielectric value of a fast-growing standing teak tree at frequency ranges 250 kHz – 60 MHz and to understand the relationships between physical and anatomical properties. Dielectric spectroscopy data were collected directly on the trees 4, 5, and 7 years old using a capacitance measurement system. Meanwhile, physical and anatomical samples were taken using a Ø 0.5 cm increment borer. The results showed that fiber length (FL), lumen diameter (LD), and fiber wall thickness (FWT) were significantly different at each tree age. This research found the optimal dielectric frequency to discriminate the wood properties in standing trees. There is a weak relationship (R= 0.2) in predicting the anatomical wood properties, while moderate to strong relationships (R= 0.4 to R= 0.8) are found in predicting wood density based on the selected frequency and moisture content variables. Further analyses and data processing can be improved by finding significant variables in the capacitance measurement system.

This study aimed to determine the correlation of colour M-mode velocity propagation in the assessment of left ventricular diastolic function among acute decompensated heart failure patients with preserved ejection fraction (HFpEF). This research is an observational analytical study using a cross–sectional study design conducted from April to June 2022. The subjects of this study were patients diagnosed with acute HFpEF and treated at Dr. Soetomo General Academic Hospital, Surabaya. Patients with heart rhythm disturbances, moderate to severe valvular heart disease, and congenital heart defects were excluded from this study. Patients were measured for diastolic function including mitral valve early mitral inflow velocity (MV E Velocity), mitral peak velocity of early filling (E’) (E' Septal and E' Lateral), left atrial volume index (LAVI), The maximal tricuspid regurgitation velocity (TR V Max), Vp, the ratio of early diastolic mitral inflow velocity to early diastolic mitral annulus velocity (E/E'), the ratio between early and late ventricular filling velocity (E/A) and E/Vp Ratio. N-terminal-pro hormone B-type natriuretic peptide (NT–ProBNP) examination was also performed on study subjects as an additional diagnosis of acute heart failure. There were 33 patients who met the inclusion and exclusion criteria and were included in our study. There were 26 patients (78.8%) with grade I diastolic dysfunction, 4 patients (12.1%) with grade II diastolic dysfunction, and 3 patients (9.1%) with grade III diastolic dysfunction. There is a strong positive correlation between Vp with parameters E' Septal (p = &lt; 0.001; r = 0.636) and E' Lateral (p = &lt; 0.001; r = 0.650). Vp is negatively correlated with the ratio E/E' (p = 0.029; r = –0.37). The PCWP estimate with E/Vp ratio had a strong correlation with the NT–Pro BNP value &gt; 300 pg/ml in acute HFpEF patients (p = &lt; 0.001; r = 0.726) compared to the PCWP estimate with E/E' (p = &lt; 0.001; r = 0.549). There is no correlation between Vp value and degree of diastolic dysfunction in patients with acute HFpEF.

Background. Recent studies revealed that differentiation of valvular interstitial cell into myofibroblasts played an important role in pathological valve remodeling in rheumatic valvular disease. Objective. To investigate effects of atorvastatin, olmesartan, and resveratrol on Transforming Growth Factor β1-induced fibrosis. Methods. Valvular interstitial cell was isolated from 12-weeks male New Zealand rabbit (Oryctolagus cuniculus). Culture cells was divided into 4 groups, control group, group I (0.5 mg/mL Atorvastatin), group II (100 nmol/L Olmesartan), group III (50 μM/L Resveratrol) and group IV (combinations). All group were exposed to 100 nM Transforming Growth Factor β1 for 24 hours. Results. Immunochemical staining demonstrated that cells were completely differentiated into myofibroblasts with mean expression of α-smooth muscle actin 24522.64±4566.994. Atorvastatin, olmesartan, resveratrol, and its combination significantly reduced α-smooth muscle actin expression (6823±1735.3, 6942.7±2455.9, 14176.2±3343.3, 5051.8±1612.2 respectively (p&lt;0.001). Conclusion. Our data showed atorvastatin, olmesartan, resveratrol, and its combination significantly reduce Transforming Growth Factor β1-induced valvular fibrosis.

Introduction. Recent studies revealed that differentiation of valvular interstitial cell into myofibroblasts played an important role in pathological valve remodeling in rheumatic valvular disease. Objective. To investigate effects of atorvastatin, olmesartan, and resveratrol on Transforming Growth Factor β1-induced fibrosis. Methods. Valvular interstitial cell was isolated from 12-weeks male New Zealand rabbit (Oryctolagus cuniculus). Culture cells was divided into 4 groups, control group, group I (0.5 mg/mL Atorvastatin), group II (100 nmol/L Olmesartan), group III (50 μM/L Resveratrol) and group IV (combinations). All group were exposed to 100 nM Transforming Growth Factor β1 for 24 hours. Results. Immunochemical staining demonstrated that cells were completely differentiated into myofibroblasts with mean expression of α-smooth muscle actin 24522.64±4566.994. Atorvastatin, olmesartan, resveratrol, and its combination significantly reduced α-smooth muscle actin expression (6823±1735.3, 6942.7±2455.9, 14176.2±3343.3, 5051.8±1612.2 respectively (p<0.001). Conclusion. Our data showed atorvastatin, olmesartan, resveratrol, and its combination significantly reduce Transforming Growth Factor β1-induced valvular fibrosis.

Implementation of waterflood is with injected pressured water to reservoir to escalation oil production. Produced water is the dominated result from oil and gas mechanism in this world meanwhile 65% of water is injected back to the well for pressure maintenance, 30% for discharge aquifier condition and surface. For shaly sand, produced water usually bring coarse and suspended sand to the surface. Therefore, this sand level is needed to declining to avoid plugging in injection well until certain economic condition.

The aim of this systematic review is to describe and to identify prospect of β-Tricalcium Phosphate (β-TCP) as Alveolar Bone Grafting (ABG) in Cleft Lip/Palate (CL/P) or alveolar bone cleft defect. A systematic review protocol based on Preferred Reporting Items for Systematic Reviews and Meta Analyses 2020 (PRISMA 2020) was drafted. The literature search was conducted with MEDLINE/PubMed, Web of Science/ ISI-Web of Knowledge, Scopus and Cochrane Library with English language and no publication year limits. The keywords yielded a total of 5824 publications. There are 3196 suitable articles to evaluate after removing duplicates and languages. Afterward, 1315 studies left after doing title and abstract reading. In addition, 85 full-articles were assessed for eligibility. The read the complete texts of those papers and eventually chose 20 that matched the inclusion requirements. Thirteen of the twenty studies included in this systematic review had a low risk of bias, one had a high risk of bias, and six had moderate bias which not report the randomization. β-TCP as ABG is biocompatible, visible and practical, offers a less invasive procedure, and does not interfere with orthodontic treatment. β-TCP as synthetic ABG can be the alternative to autologous bone grafts with several terms and conditions. Improvement of β-TCP efficacy for ABG in CL/P or alveolar bone cleft defects can be done by a tissue engineering approach combining β-TCP with growth factor, mesenchymal stem cells, or other graft materials and modification of β-TCP physical properties.

Skipjack tuna supports a valuable commercial fishery in Indonesia. Skipjack tuna are exploited in the Indian and Pacific Oceans with a variety of gear but drifting gillnets are a common method used by Indonesian fishers. However, despite of its importance, little information on the drifting gillnet fishery is available. This study describes a preliminary examination of the catch and effort data from the Indonesian skipjack drifting gillnet fishery. Utilizing daily landing report from 2010-2015, nominal catch per unit of effort (CPUE) data were calculated as kg/day at sea. Generalized Linear Models (GLM) were used to standardize the CPUE, using year, quarter, day at sea, and area as fixed variables. Model Goodness-of-fit and model comparison was carried out with the Akaike Information Criteria (AIC), the pseudo coefficient of determination (R²) and model validation with a residual analysis. The final estimation of abundance indices was calculated by least square means (LSMeans) or Marginal Means. The results showed that days accounted for most of the variation in CPUE, followed by year, quarter, and area. In general, there were no noticeable trends indicative of over exploitation or population depletion suggesting a sustainable fishery for Skipjack tuna in Indonesian waters.

This study aimed to investigate the diagnostic potential of circulating microRNAs (miRNAs) for detecting early myocardial fibrosis development in HFpEF patients. This observational study used a case-control research design. Peripheral blood samples were isolated from 25 HFpEF patients and 25 normal patients. They were measured for NTproBNP levels using ELISA, as well as MicroRNA-1, 21, and 29 levels using RT-PCR. All patients also underwent echocardiography for global longitudinal strain (GLS) to measure the myocardial fibrosis progression. Data were analyzed using SPSS 25.0. HFpEF patients had significantly higher GLS compared to the normal patients (-13±2.4% vs -19±3.2%; p &lt; 0.05), suggesting HFpEF patients tended to have myocardial fibrosis. HFpEF patients also had significantly higher microRNA-1 and microRNA-21 compared to the normal patients (p &lt; 0.05), but they had lower microRNA-1 (p &lt; 0.05). There was a positive correlation between microRNA-1 (r = 0.753; p &lt; 0.05) and microRNA-21 (r = 0.675; p &lt; 0.05) and an inverse correlation with microRNA-29 (r = -0.653; p &lt; 0.05) based on the GLS findings. By using a GLS cutoff of -15% for myocardial fibrosis, microRNA-1, microRNA-21, and microRNA-29 were found to be able to predict myocardial fibrosis based on GLS with a specificity of 78% and sensitivity of 75%. Increasing microRNA-1 and microRNA-21 followed by decreasing microRNA-29 in HFpEF patients suggest early myocardial fibrosis.

Myocardial involvement among critical patients with coronavirus disease 2019 (COVID-19) has a worse outcome. The occurrence of an imbalance in oxygen supply results in the release of pro-inflammatory cytokines which leads to increased ventilation support requirement and increase risk of mortality. Our aim was to evaluate the association between hs-Troponin I level and global longitudinal strain as evidence of myocardial involvement among critical COVID-19 patients. Methods. We performed prospective cohort study from February 1st – July 31st, 2021 at Dr. Soetomo General Hospital, Surabaya as referral center for COVID-19 care. Of the 65 critical COVID-19 included, 41 (63.1%) were men, with a median (interquartile range) age of 51.0 years (20.0-75.0).Subjects were recruited according to WHO criteria for severe COVID-19 and CDC criteria for myocarditis. All subjects recruited were examined using echocardiography to measure global longitudinal strain (GLS) and blood samples were taken to measure hs-Troponin. Subjects were then followed to assess their needs for mechanical ventilation and in-hospital mortality. Severe COVID-19 subjects with cardiac injury were associated with an increased need for intubation (78.5%) and an increased incidence of myocarditis (50.8%). There was an association between the use of intubation and the risk of mortality in patients (66.7% vs. 33.3%, p-value &lt;0.001). Both reduced GLS and increased hs-troponin are associated with increased myocarditis (p-value &lt;0.001 and 0.004 respectively). Reduced GLS is associated with higher mechanical ventilation needs (12.17 + 4.79 vs.15.65 + 4.90, p-value 0.02) and a higher mortality rate (11.36 + 4.64 vs. 14.74 + 4.82; p-value 0.005). Increased hs-troponin is associated with higher mechanical ventilation needs (25.33% vs. 3.56%, p-value 0.002) and a higher mortality rate (34.57% vs. 5.76%, p-value 0.002). Compared with contemporary controls, critical COVID-19 patients with myocardial involvement and elevated cardiac troponin level are associated with higher mechanical ventilation needs and a higher mortality rate.

Background: Inflammatory plays critical role in myocardial infarction as a critical process in the development of heart failure, involving the development of cardiac fibrosis. Colchicine is a well-established anti-inflammatory drug, but its scientific application in controlling post-acute myocardial infarction remodelling processes has not been established. IL-10, a key cytokine in modulating inflammatory responses, underscoring its potential as a crucial therapeutic target of colchicine. Objectives: To explore the protective role of IL-10 modulated by colchicine in myocardial healing and repair following AMI, particularly cardiac fibrosis. Materials and Methods: The predicted protein of Colchicine was assessed using WAY2DRUG PASS as probability active value. Proteins associated with Colchicine, cardiac fibrosis and acute myocardial infarction were analysed with DisGeNET and Open Target databases. Analysis and visualization of protein-protein interactions were conducted using STRING and Cytoscape. A 3T3 cell line treated with CoCl2 was used to mimic hypoxic. HIF-1α and IL-10 expression were measured by flow cytometry and analysed using a one-way ANOVA test. This observational clinical trial examined acute myocardial infarction patients undergoing immediate and delayed primary percutaneous coronary interventions. Subjects were randomized into control groups receiving placebo and intervention groups treated with Colchicine. Assessments occurred at 24 hours and five days after the intervention. IL-10 expression in the clinical trial was measured by ELISA assay and analysed using a T-test. Results: Colchicine demonstrates promising bioactivity in treating acute myocardial infarction, with notable probability active values as a tubulin antagonist (0.744), beta-tubulin antagonist (0.673), and NOS2 inhibitor (0.529). Its primary action targets IL-10, with protein-protein interactions analysis indicating interactions between IL-10 and key inflammatory mediators—IL-1β, IFN-γ, CCL2, TNF, and TGF-β1—during acute myocardial infarction and cardiac fibrosis. Hypoxic conditions in the CoCl2-induced 3T3 cell model show significantly elevated HIF-1α compared to controls (p&lt;0.0001). Acute myocardial infarction patients were predominantly from high-risk populations, with notable smoking prevalence in the early Colchicine group (72%). Hypertension prevalence was significantly different, with 67.31% in the late Colchicine group compared to 38% in the early Colchicine and 39.80% in the early placebo groups. Both early and late Colchicine groups exhibited a higher prevalence of diabetes mellitus. Colchicine use, either early or late, did not significantly alter major adverse cardiovascular events incidence compared to placebo (p&gt;0.05). However, Colchicine significantly increased IL-10 expression in CoCl2-treated cells (p&lt;0.0001) and in acute myocardial infarction patients within five days (p&lt;0.05). Conclusions: Colchicine may bolster the anti-inflammatory response post-myocardial infarction by activating IL-10 pathways in fibroblasts and in clinical settings, potentially reducing major adverse cardiovascular events. Further investigation into broader aspects of this pathway, particularly in cardiac fibroblasts, is required.

This study focuses on land cover and land management changes in relation to food security and environmental services in a semi-arid area of East Nusa Tenggara (ENT) – Indonesia. The study was conducted in Central Sumba District of ENT Province. Classification and regression tree (CART) for land cover classification has been analyzed using machine learning techniques using Google Earth Engine. A survey with Focus Group Discussion (FGD) and followed with in-depth interviews were conducted for primary data collection involving a total of 871 respondents. The Socio-economic data analyzed statistics descriptively and non-parametric tests. The study showed that: 1). There has been a substantial land use change during the devo-lution era that has both positive and negative implications for food security and envi-ronmental services. 2). There has been population pressure in the fertile or agricultur-al land as the direct impact of the development of city infrastructures; and 3). Nation-al intervention through the Food Estate program has fostered and shaped land use change and land management in Central Sumba District. The study highlights the importance that the devolution spirit should help to well manage the limited ara-ble/agricultural land in dominated semi-arid to ensure food security and environment services.

Agroforestry is often seen as a sustainable land-use system for agricultural production providing ecosystem services. Intercropping with food crops leads to equal or higher productivity than monoculture and results in food production for industry and subsistence. Low rubber price and low labor productivity in smallholdings have led to a dramatic conversion of rubber plantations to more profitable crops. The literature analysis performed in this paper aimed at better understanding the ins and outs that could make rubber-based agroforestry more attractive for farmers. A library was set-up consisting of 415 scientific references. Of the 232 journal articles, 141 studies were carried out on rubber agroforestry. Since 2011, the number of studies per year has increased. Studies on rubber-based agroforestry systems are performed in most rubber producing countries, in particular in Indonesia, Thailand, China and Brazil. These studies focus more or less equally on perennials (forest species and fruit trees), annual intercrops and mixed plantations. Of the 47 annual crops associated with rubber in the literature, 20 studies dealt with rice, maize, banana and cassava. Agronomy is the main discipline in the literature followed by socio-economy and then ecology. Only 4 papers are devoted to plant physiology and breeding. The discussion section has attempted to analyze the evolution of rubber agroforestry research, progress in the selection of food crop varieties adapted to agroforestry systems, and to draw some recommendations for rubber-based agroforestry systems associated with food crops.