SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18–49, 50–69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population

Urinary catheterization in gynecological surgery: When should it be removed?

Background: The aim of this study was to determine the most appropriate time for urinary catheter removal following a gynecological surgery.Methods: Critical appraisal of clinical trial articles were conducted. It was aimed to answer our clinical question whether 24-hour postoperative urinary catheter removal is superior compared to other durations in avoiding postoperative urinary retention (PUR) and urinary tract infection (UTI). The search was conducted on the Cochrane Library® and PubMed® using keywords “postoperative urinary retention”, “postoperative catheterization” and “urinary retention AND catheterization”. Reference lists of relevant articles were searched for other possibly relevant trials.Results: Seven articles were available as full text, then appraisals of six prospective RCTs involving 846 women underwent hysterectomy and vaginal prolapse surgery were performed finding at the re-catheterization and UTI rate. Subjects in earlier-removal groups were 3 to 4 times more likely to have re-catheterization (OR = 3.10-4.0) compared to later-removal groups, while they who have it removed on 5th day were 14 times more likely to develop UTI compared with immediate group (OR = 14.786, 95% CI 3.187- 68.595).Conclusion: The 24-hour catheterization policy in hysterectomy and vaginal prolapse surgery remains most appropriate although associated with an increased risk of re-catheterization. The removal of catheter before 24 hour (6 or 12 hour) could be considered to be used as one of interventions in further RCT(s) to find out the best duration which would result in lowest incidence in both of UTI and  PUR. (Med J Indones. 2013;22:183-8. doi: 10.13181/mji.v22i3.589)Keywords: Catheter, hysterectomy, prolapse, urinary tract infection</p

Zooplankton capturing by Nile Tilapia, Oreochromis niloticus (Teleostei: Cichlidae) throughout post-larval development

ABSTRACT The Nile tilapia, Oreochromis niloticus (Linnaeus, 1758), uses filter feeding and visual predation to catch prey. In filter feeding, the mucus secreted in their gill rakers traps planktonic organisms. In visual predation, the fish spot and capture food, eating it directly. At different ontogenetic stages, the Nile tilapia may impact the zooplankton community differently, since it changes how it captures its prey. The objective in this study was to verify which zooplankton groups contribute to the diet of O. niloticus at the post-larval stage, and if the way they capture food may determine prey size. We evaluated the diet of Nile tilapia kept in ponds for four months. We randomly removed one fish per pond every month. Stomach contents and gills of fish were extracted, fixed in formaldehyde and then analyzed with an optical microscope and stereomicroscope with a micrometric ocular in order to measure the zooplankton and the gill rakers. Fish increased consumption of rotifers, and decreased the consumption of microcrustaceans considerably up to zero in the last month. The gill raker size, nevertheless, increased as tilapia grew. Therefore, negative correlations were found between raker size and size of ingested zooplankton, showing that the size of ingested prey decreases throughout this cichlid's life. Juveniles filter feed on rotifers, and actively prey on microcrustaceans. As adults, fish stop preying visually and the mucus secreted by the gill rakers trap only small individuals. Juvenile Nile tilapia filter feed and visually prey on zooplankton. However, when adults, filter-feeding plays a more important role in the way the zooplankton community is affected. The increase in the size of the Nile tilapia's gill raker does not determine the consumption of larger zooplankton prey, and the presence of mucus in these structures plays a major role for the capture of zooplankton during the cichlid's adult stage

High preterm birth at Cipto Mangunkusumo Hospital as a national referral hospital in Indonesia

Background: Preterm birth is the leading direct that causes neonatal death. Indonesia was listed as one of the countries with the greatest number of preterm birth in 2010. This study aims to identify the prevalence and the potential risk factors of preterm birth among women underwent delivery in Cipto Mangunkusumo Hospital, an Indonesian national reference hospital. Methods: This retrospective cohort study involved 2,612 women who delivered between January and December 2013. Any clinical data which related to the potential risk factors and outcomes were recorded. The data were managed using chi-square for bivariate analysis and t-test or Mann-Whitney for numerical data followed by multiple logistic regression for multivariate analysis in SPSS version 20.0. Results: Preterm birth affected 1,020 of 2,616 pregnancies (38.5%). Non-booked patients increased nearly twice risk for preterm delivery (OR 1.89, 95% CI 1.37–2.61). While women with singleton pregnancy (OR 0.17, 95% CI 0.12–0.25), head presentation (OR 0.75, 95% CI 0.63–0.89), and regular ANC (OR 0.67, 95% CI 0.54–0.84) had lower risk for preterm birth. Apgar score, birthweight, and mode of delivery were significantly different between the pre-term group and the full-term group. Conclusion: Prevalence of preterm birth in Cipto Mangunkusumo Hospital was approximately 2.5 times higher compared to the national number. Several factors reducing preterm birth rate include singleton pregnancy, head presentation, and regular ANC

Determinants of low APGAR score among preeclamptic deliveries in Cipto Mangunkusumo Hospital: a retrospective cohort study in 2014

Background: Preeclampsia has great implication on adverse neonatal outcome. Appearance, pulse, grimace, activity, respiration (APGAR) score at 1 or 5 minutes is one of the indicators of physiologic maturity of the infant. Therefore, the aim of this study was to know the correlation of APGAR score in preeclamptic deliveries with its risk factors. Methods: This study was a retrospective cohort. Data were collected from January to December 2013 including all preeclamptic women with singleton live pregnancies who delivered their babies in Cipto Mangunkusumo Hospital, Jakarta. The primary outcome was APGAR score. There were some determinants conducted in this study. Binary logistic was used as multivariate analysis to analyze the correlation between APGAR score and risk factors of preeclampsia, data were analyzed using chi square test. Results: Out of 450 preeclamptic women, 446 of them met the inclusion criteria. Low APGAR scores at 1 and 5 minutes were found in 19% (86/446) and 5.4% (24/446) of neonates respectively. Early onset of preeclampsia (adjusted OR = 4.577; 95% CI = 2.147 - 9.757), white blood cell ≥ 15,000/μL (adjusted OR = 3.315; 95% CI = 1.738 – 6.324), HELLP syndrome (adjusted OR = 2.00; 95% CI = 1.38 – 2.91) were independent risk factors for having infant with low APGAR score at 1 minute. Meanwhile, there was no significant risk factors at 5 minutes APGAR score after adjustment.Conclusion: Leukocytosis, early onset preeclampsia, preterm birth, and thrombocytopenia, severity of preeclampsia, and HELLP syndrome are independent risks of having infant born with low APGAR score at 1 minute in preeclamptic deliveries.</p

Spectrophotometric determination of erbium using kojic acid dye in different rare earth concentrates

A sensitive and selective spectrophotometric method was studied for the determination of erbium (Er) with kojic acid dye (koj) and cetylpyridinium chloride (CPC) as a cationic surfactant from Egyptian monazite and xenotime concentrates using third derivative spectrophotometry. The calibration curve was linear from 1 to 150 µg/mL erbium. The influence of various parameters and reaction conditions for optimum complex formation were investigated. The relative standard deviation for determination of 1 µg/mL erbium was found to be 1.5 after 5 repeated determinations with percentage error for Er determination from monazite and xenotime concentrates 6.4% and 4.48% respectively. The molar absorptivity of conventional and third derivative spectrum were 0.14 × 103 M−1 cm−1 and 0.13 × 103 M−1 cm−1 respectively and the detection limit was 1 µg/mL. Keywords: Erbium, Kojic acid dye, Cetylpyridinium chloride, Egyptian monazite, Xenotim

Mediating mechanism of customer satisfaction on customer relationship management implementation and customer loyalty among consolidated banks

The aim of this study is to investigate the mediating mechanism of customer satisfaction (CS) on customer relationship management (CRM) and customer loyalty (CL) among Nigerian consolidated banks. This paper used a survey research design, and the study unit of analysis consists of selected customers among Nigerian consolidated banks. This study used a purposive sampling technique whereby structured questionnaires were used to collect data from 750 customers of the 5 focused banks in Kano State, Nigeria. Partial least square-structural equation modelling (PLS-SEM) was used to evaluate the study hypotheses. The outcome of the study revealed that CRM has a significant effect on CL while CS partially mediates CRM and CL relationship. This paper provides substantial results to practitioners to realize the role of developing a CRM strategy in the Nigerian banking industry. In line with that, the management of the banks should build sound CRM components such as process fit, customer information quality and information system support to deliver sound services in order to operate and compete in the banking ecosystem effectively. This paper has made a substantial contribution to the body of knowledge in the CS, CL, and CRM literature by operationalizing it within the Nigerian banking industry

Indonesian local fetal-weight standard: a better predictive ability for low Apgar score of SGA neonates

Background: Accurate assessment of fetal growth is one of crucial components of antenatal care. A generic reference for fetal-weight and birthweight percentiles that can be easily adapted to local populations have been developed by Mikolajczyk and colleagues. This study aimed to validate our own local percentile standard by evaluating the odds ratio (OR) of low 1st and 5th minute Apgar score for small-for-gestational age (SGA) versus those not SGA. Methods: We used the generic reference tools for fetal-weight and birthweight percentiles developed by Mikolajczyk and colleagues to create our own local standard and then defined the SGA neonates. For validation, we used the database of singleton live deliveries (2,139 birth) during January 1st to December 31st 2013 in Cipto Mangunkusumo Hospital, Jakarta, Indonesia. We compared our reference with that of Hadlock and colleagues. For every reference, the OR of Apgar score <7 at 1st and 5th minutes for infants who were SGA versus those not estimated with bivariate and multivariate analyses. Results: SGA found in 35% (748/2,139) and 13% (278/2,139) of neonates using the definition derived from Indonesian standard and Hadlock’s. OR of Apgar score <7 at 1st and 5th minutes were 3.45 (95% CI=2.56–4.65) and 3.05 (95% CI=1.92–4.83) for the Indonesian local fetal-weight standard compared with respectively 2.14 (95% CI=1.65–2.76) and 1.83 (95% CI=1.21–2.77) for Hadlock and collegues’ reference. Conclusion: Indonesian local fetal-weight standard has a better ability to predict low 1st and 5th minutes Apgar scores of SGA neonates than has the Hadlock and collegues’ reference