UJI AKTIVITAS ANTIMIKROBA EKSTRAK DAN FRAKSI ALGA Turbinaria ornata (Turner) J.Argadh DARI PERAIRAN DESA TUMBAK, MINAHASA TENGGARA TERHADAP Staphylococcus aureus, Escherichia coli dan Candida albicans

ABSTRACTAlgae are chromista that live in the ocean, some are stranded on the beach, attached to rocks with a kind of root adhesives. Algae produce many compounds, which can be used as antimicrobial and anticancer. This study aims to determine the antimicrobial activity of the extracts and fractions of Turbinaria ornata algae collected from the of Ponteng Island waters, Tumbak, Southeast Minahasa against Staphylococcus aureus, Escherichia coli and Candida albicans. Turbinaria ornata algae were extracted using maceration method with 96% of ethanol solvent and fractionation using a partition method with n-hexane, chloroform and methanol as well as antimicrobial testing using the Kirby Bauer diffusion method. The results of this study indicate that ethanol extract of algae Turbinaria ornata has moderate category of antimicrobial activity in methanol, n-hexane and chloroform fractions with an average inhibition of 7.33 mm against Staphylococcus aureus, Escherichia coli and Candida albicans. Keywords: Antimicrobials, Extraction, Fractionation, Turbinaria ornata  ABSTRAKAlga merupakan chromista yang hidup lautan ada yang terdampar di pinggir pantai, melekat pada batu-batuan dengan alat pelekat semacam akar. Alga banyak menghasilkan senyawa yang dapat digunakan sebagai antimikroba dan antikanker, Penelitian ini bertujuan untuk mengetahui aktivitas antimikroba ekstrak dan fraksi alga Turbinaria ornata yang dikoleksi dari perairan pulau Ponteng, desa Tumbak, Minahasa Tenggara terhadap Staphylococcus aureus, Escherichia coli dan Candida albicans. Alga Turbinaria ornata diekstraksi menggunakan metode maserasi dengan pelarut etanol 96% dan fraksinasi menggunakan metode partisi dengan pelarut n-heksan, kloroform dan metanol serta pengujian antimikroba menggunakan metode difusi agar Kirby Bauer. Hasil dari penelitian ini menunjukkan bahwa ekstrak etanol Alga Turbinaria ornata memiliki aktivitas antimikroba  kategori sedang pada fraksi metanol, n-heksan dan kloroform dengan daya hambat rata-rata 7,33 mm terhadap Staphylococcus aureus, Escherichia coli dan Candida albicans. Kata kunci: Antimikroba, Ekstraksi, Fraksinasi, Turbinaria ornat

Active transmission of Trypanosoma brucei gambiense Dutton, 1902 sleeping sickness in Abraka, Delta State, Nigeria

Active surveillance of Human African trypanosomiasis (HAT) or sleeping sickness was undertaken in 3 agrarian villages in Ethiope East Local Government Area of Delta State, Nigeria. Card Agglutination Trypanosomiasis Test (CATT) was used qualitatively for mass screening with undiluted fresh whole blood (WB) and quantitatively for diagnosis in serum dilution tests. Thereafter, palpation for enlarged cervical lymph gland (ECLG) was followed by parasitological examination of aspirate using wet film, haematocrit centrifugation technique (HCT) and mini-anion exchange centrifugation technique (mAECT). Only one confirmed case of sleeping sickness was diagnosed out of the 491 samples screened. The results showed 43 (9.8%) serological positive cases in WB/ CATT test. 12 (27.9%) suspected cases that reacted at &lt1/4 titre in serum dilution test were highly suspected serological positive but parasitological negative cases. The study indicates that there is ongoing active transmission of Gambian type sleeping sickness in Abraka focus of Nigeria. The highly suspected cases will be followed up. Many cases might have gone undetected and more villages within the same focus were not covered. Moreover, a large-scale multi-disciplinary disease surveillance, vector and animal reservoir studies are required to determine the true situation of HAT in this focus. KEY-WORDS: Transmission, Gambian Trypanosomiasis, Screening, Blood, Serum, Diagnosis

Self-citations at the meso and individual levels: effects of different calculation methods

This paper focuses on the study of self-citations at the meso and micro (individual) levels, on the basis of an analysis of the production (1994–2004) of individual researchers working at the Spanish CSIC in the areas of Biology and Biomedicine and Material Sciences. Two different types of self-citations are described: author self-citations (citations received from the author him/herself) and co-author self-citations (citations received from the researchers’ co-authors but without his/her participation). Self-citations do not play a decisive role in the high citation scores of documents either at the individual or at the meso level, which are mainly due to external citations. At micro-level, the percentage of self-citations does not change by professional rank or age, but differences in the relative weight of author and co-author self-citations have been found. The percentage of co-author self-citations tends to decrease with age and professional rank while the percentage of author self-citations shows the opposite trend. Suppressing author self-citations from citation counts to prevent overblown self-citation practices may result in a higher reduction of citation numbers of old scientists and, particularly, of those in the highest categories. Author and co-author self-citations provide valuable information on the scientific communication process, but external citations are the most relevant for evaluative purposes. As a final recommendation, studies considering self-citations at the individual level should make clear whether author or total self-citations are used as these can affect researchers differently

A small world of citations? The influence of collaboration networks on citation practices

This paper examines the proximity of authors to those they cite using degrees of separation in a co-author network, essentially using collaboration networks to expand on the notion of self-citations. While the proportion of direct self-citations (including co-authors of both citing and cited papers) is relatively constant in time and across specialties in the natural sciences (10% of citations) and the social sciences (20%), the same cannot be said for citations to authors who are members of the co-author network. Differences between fields and trends over time lie not only in the degree of co-authorship which defines the large-scale topology of the collaboration network, but also in the referencing practices within a given discipline, computed by defining a propensity to cite at a given distance within the collaboration network. Overall, there is little tendency to cite those nearby in the collaboration network, excluding direct self-citations. By analyzing these social references, we characterize the social capital of local collaboration networks in terms of the knowledge production within scientific fields. These results have implications for the long-standing debate over biases common to most types of citation analysis, and for understanding citation practices across scientific disciplines over the past 50 years. In addition, our findings have important practical implications for the availability of 'arm's length' expert reviewers of grant applications and manuscripts

Elective surgery system strengthening: development, measurement, and validation of the surgical preparedness index across 1632 hospitals in 119 countries

Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index to support local elective surgical system strengthening and address growing backlogs. Methods First, we performed an international consultation through a four-stage consensus process to develop a multidomain index for hospital-level assessment (surgical preparedness index; SPI). Second, we measured surgical preparedness across a global network of hospitals in high-income countries (HICs), middle-income countries (MICs), and low-income countries (LICs) to explore the distribution of the SPI at national, subnational, and hospital levels. Finally, using COVID-19 as an example of an external system shock, we compared hospitals' SPI to their planned surgical volume ratio (SVR; ie, operations for which the decision for surgery was made before hospital admission), calculated as the ratio of the observed surgical volume over a 1-month assessment period between June 6 and Aug 5, 2021, against the expected surgical volume based on hospital administrative data from the same period in 2019 (ie, a pre-pandemic baseline). A linear mixed-effects regression model was used to determine the effect of increasing SPI score. Findings In the first phase, from a longlist of 103 candidate indicators, 23 were prioritised as core indicators of elective surgical system preparedness by 69 clinicians (23 [33%] women; 46 [67%] men; 41 from HICs, 22 from MICs, and six from LICs) from 32 countries. The multidomain SPI included 11 indicators on facilities and consumables, two on staffing, two on prioritisation, and eight on systems. Hospitals were scored from 23 (least prepared) to 115 points (most prepared). In the second phase, surgical preparedness was measured in 1632 hospitals by 4714 clinicians from 119 countries. 745 (45·6%) of 1632 hospitals were in MICs or LICs. The mean SPI score was 84·5 (95% CI 84·1–84·9), which varied between HIC (88·5 [89·0–88·0]), MIC (81·8 [82·5–81·1]), and LIC (66·8 [64·9–68·7]) settings. In the third phase, 1217 (74·6%) hospitals did not maintain their expected SVR during the COVID-19 pandemic, of which 625 (51·4%) were from HIC, 538 (44·2%) from MIC, and 54 (4·4%) from LIC settings. In the mixed-effects model, a 10-point increase in SPI corresponded to a 3·6% (95% CI 3·0–4·1; p<0·0001) increase in SVR. This was consistent in HIC (4·8% [4·1–5·5]; p<0·0001), MIC (2·8 [2·0–3·7]; p<0·0001), and LIC (3·8 [1·3–6·7%]; p<0·0001) settings. Interpretation The SPI contains 23 indicators that are globally applicable, relevant across different system stressors, vary at a subnational level, and are collectable by front-line teams. In the case study of COVID-19, a higher SPI was associated with an increased planned surgical volume ratio independent of country income status, COVID-19 burden, and hospital type. Hospitals should perform annual self-assessment of their surgical preparedness to identify areas that can be improved, create resilience in local surgical systems, and upscale capacity to address elective surgery backlogs. Funding National Institute for Health Research (NIHR) Global Health Research Unit on Global Surgery, NIHR Academy, Association of Coloproctology of Great Britain and Ireland, Bowel Research UK, British Association of Surgical Oncology, British Gynaecological Cancer Society, and Medtronic.publishedVersio

Elective surgery system strengthening: development, measurement, and validation of the surgical preparedness index across 1632 hospitals in 119 countries

Background: The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index to support local elective surgical system strengthening and address growing backlogs. Methods: First, we performed an international consultation through a four-stage consensus process to develop a multidomain index for hospital-level assessment (surgical preparedness index; SPI). Second, we measured surgical preparedness across a global network of hospitals in high-income countries (HICs), middle-income countries (MICs), and low-income countries (LICs) to explore the distribution of the SPI at national, subnational, and hospital levels. Finally, using COVID-19 as an example of an external system shock, we compared hospitals' SPI to their planned surgical volume ratio (SVR; ie, operations for which the decision for surgery was made before hospital admission), calculated as the ratio of the observed surgical volume over a 1-month assessment period between June 6 and Aug 5, 2021, against the expected surgical volume based on hospital administrative data from the same period in 2019 (ie, a pre-pandemic baseline). A linear mixed-effects regression model was used to determine the effect of increasing SPI score. Findings: In the first phase, from a longlist of 103 candidate indicators, 23 were prioritised as core indicators of elective surgical system preparedness by 69 clinicians (23 [33%] women; 46 [67%] men; 41 from HICs, 22 from MICs, and six from LICs) from 32 countries. The multidomain SPI included 11 indicators on facilities and consumables, two on staffing, two on prioritisation, and eight on systems. Hospitals were scored from 23 (least prepared) to 115 points (most prepared). In the second phase, surgical preparedness was measured in 1632 hospitals by 4714 clinicians from 119 countries. 745 (45·6%) of 1632 hospitals were in MICs or LICs. The mean SPI score was 84·5 (95% CI 84·1–84·9), which varied between HIC (88·5 [89·0–88·0]), MIC (81·8 [82·5–81·1]), and LIC (66·8 [64·9–68·7]) settings. In the third phase, 1217 (74·6%) hospitals did not maintain their expected SVR during the COVID-19 pandemic, of which 625 (51·4%) were from HIC, 538 (44·2%) from MIC, and 54 (4·4%) from LIC settings. In the mixed-effects model, a 10-point increase in SPI corresponded to a 3·6% (95% CI 3·0–4·1; p<0·0001) increase in SVR. This was consistent in HIC (4·8% [4·1–5·5]; p<0·0001), MIC (2·8 [2·0–3·7]; p<0·0001), and LIC (3·8 [1·3–6·7%]; p<0·0001) settings. Interpretation: The SPI contains 23 indicators that are globally applicable, relevant across different system stressors, vary at a subnational level, and are collectable by front-line teams. In the case study of COVID-19, a higher SPI was associated with an increased planned surgical volume ratio independent of country income status, COVID-19 burden, and hospital type. Hospitals should perform annual self-assessment of their surgical preparedness to identify areas that can be improved, create resilience in local surgical systems, and upscale capacity to address elective surgery backlogs. Funding: National Institute for Health Research (NIHR) Global Health Research Unit on Global Surgery, NIHR Academy, Association of Coloproctology of Great Britain and Ireland, Bowel Research UK, British Association of Surgical Oncology, British Gynaecological Cancer Society, and Medtronic

COVID-19-related absence among surgeons: development of an international surgical workforce prediction model

Background: During the initial COVID-19 outbreak up to 28.4 million elective operations were cancelled worldwide, in part owing to concerns that it would be unsustainable to maintain elective surgery capacity because of COVID-19-related surgeon absence. Although many hospitals are now recovering, surgical teams need strategies to prepare for future outbreaks. This study aimed to develop a framework to predict elective surgery capacity during future COVID-19 outbreaks. Methods: An international cross-sectional study determined real-world COVID-19-related absence rates among surgeons. COVID-19-related absences included sickness, self-isolation, shielding, and caring for family. To estimate elective surgical capacity during future outbreaks, an expert elicitation study was undertaken with senior surgeons to determine the minimum surgical staff required to provide surgical services while maintaining a range of elective surgery volumes (0, 25, 50 or 75 per cent). Results Based on data from 364 hospitals across 65 countries, the COVID-19-related absence rate during the initial 6 weeks of the outbreak ranged from 20.5 to 24.7 per cent (mean average fortnightly). In weeks 7–12, this decreased to 9.2–13.8 per cent. At all times during the COVID-19 outbreak there was predicted to be sufficient surgical staff available to maintain at least 75 per cent of regular elective surgical volume. Overall, there was predicted capacity for surgeon redeployment to support the wider hospital response to COVID-19. Conclusion: This framework will inform elective surgical service planning during future COVID-19 outbreaks. In most settings, surgeon absence is unlikely to be the factor limiting elective surgery capacity