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Shlobin NA, Rosseau G. Opportunities and Considerations for the Incorporation of Artificial Intelligence into Global Neurosurgery: A Generative Pretrained Transformer Chatbot-Based Approach. World Neurosurg 2024:S1878-8750(24)00535-7. [PMID: 38561032 DOI: 10.1016/j.wneu.2024.03.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVE Global neurosurgery is a public health focus in neurosurgery that seeks to ensure safe, timely, and affordable neurosurgical care to all individuals worldwide. Although investigators have begun to explore the promise of artificial intelligence (AI) for neurosurgery, its applicability to global neurosurgery has been largely hypothetical. We characterize opportunities and considerations for the incorporation of AI into global neurosurgery by synthesizing key themes yielded from a series of generative pretrained transformers (GPTs), discuss important limitations of GPTs and cautions when using AI in neurosurgery, and develop a framework for the equitable incorporation of AI into global neurosurgery. METHODS ChatGPT, Bing Chat/Copilot, You, Perplexity.ai, and Google Bard were queried with the prompt "How can AI be incorporated into global neurosurgery?" A layered ChatGPT-based thematic analysis was performed. The authors synthesized the results into opportunities and considerations for the incorporation of AI in global neurosurgery. A Pareto analysis was conducted to determine common themes. RESULTS Eight opportunities and 14 important considerations were synthesized. Six opportunities related to patient care, 1 to education, and another to public health planning. Four of the important considerations were deemed specific to global neurosurgery. The Pareto analysis included all 8 opportunities and 5 considerations. CONCLUSIONS AI may be incorporated into global neurosurgery in a variety of capacities requiring numerous considerations. The framework presented in this manuscript may facilitate the incorporation of AI into global neurosurgery initiatives while balancing contextual factors and the reality of limited resources.
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Affiliation(s)
- Nathan A Shlobin
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
| | - Gail Rosseau
- Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA; Barrow Global, Barrow Neurological Institute, Phoenix, Arizona, USA
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Esen Aydin A, Gazioglu N, Tasiou A, Mihaylova S, Salokorpi N, Karampouga M, Broekman MLD, Janssen IK, Magnadottir HB, Somma T, Pajaj E, Hernandez Duran S, Vayssiere P, Rodríguez-Hernández A, Lambrianou X, Tsianaka E, Rosseau G, Murphy M. European Medical Students' Views on Neurosurgery, with Emphasis on South-East Europe (Albania, Greece, Serbia, and Turkey). World Neurosurg 2024:S1878-8750(24)00262-6. [PMID: 38382757 DOI: 10.1016/j.wneu.2024.02.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 02/11/2024] [Accepted: 02/12/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND Neurosurgery, an intricate and dynamic surgical specialty, faces challenges in attracting medical graduates. Despite its potential appeal, a decreasing trend in medical students opting for surgical specialties, including neurosurgery, is noted. This study aims to assess European medical students' perceptions of neurosurgery, focusing on South-East Europe, and address concerns about the declining interest in this field. METHODS A comprehensive digital survey, comprising 33 questions, was distributed to 1115 medical students across 17 European countries. The survey, conducted over 9 months, gathered responses through European neurosurgical societies, the European Association of Neurosurgical Societies (EANS), and university channels. Statistical analysis utilized IBM Statistical Package for the Social Sciences, presenting data through counts, proportions, and χ2 tests. RESULTS The study reveals that, over the survey period, 834 medical students completed the questionnaire, with a predominant representation from South-East Europe. While 43.2% of participants were considering a surgical career, neurosurgery emerged as the most preferred specialty (26.37%). Despite this interest, 80.2% reported insufficient knowledge about pursuing a neurosurgical career, with limited exposure during medical education. Concerns about work-life balance, heavy workload, and hierarchical structures were prominent among respondents. CONCLUSIONS The findings underscore the need for targeted interventions to address concerns influencing medical students' decisions regarding neurosurgery. Improving neurosurgical education, dispelling misconceptions, and creating a supportive work environment are crucial steps to attract and retain diverse talented individuals in neurosurgery. These efforts will be vital in narrowing the gap between the demand for neurosurgeons and the number of medical graduates entering the field, ensuring a sustainable future for this essential surgical specialty.
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Affiliation(s)
- Aysegul Esen Aydin
- Department of Neurosurgery, Arnavutkoy State Hospital, Istanbul, Turkey.
| | - Nurperi Gazioglu
- Department of Neurosurgery, Medical Faculty, Istinye University, Istanbul, Turkey
| | - Anastasia Tasiou
- Department of Neurosurgery, University Hospital of Larissa, Larissa, Greece
| | - Stiliana Mihaylova
- Clinic of Neurosurgery, St. Ivan Rilski University Hospital, Medical University of Sofia, Sofia, Bulgaria
| | - Niina Salokorpi
- Department of Neurosurgery, Oulu University Hospital, Oulu, Finland, and Research Unit of Clinical Neuroscience, Medical Research Center, Oulu University, Oulu, Finland
| | - Maria Karampouga
- Neurosurgery Department, Nicosia General Hospital, Nicosia, Cyprus
| | - Marike L D Broekman
- Department of Neurosurgery, Haaglanden Medical Center and Leiden University Medical Center, Leiden, The Netherlands
| | - Insa K Janssen
- Department of Neurosurgery, HôpitauxUniversitaires de Genève, Geneva, Switzerland
| | - Hulda B Magnadottir
- Department of Neurosurgery, Upper Valley Neurology Neurosurgery, Lebanon, New Hampshire, USA
| | - Teresa Somma
- Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Università Degli Studi Di Napoli Federico II, Naples, Italy
| | - Ermira Pajaj
- Department of Neurosurgery, Spitali Rajonal Memorial Fier, Fier, Albania
| | | | - Pia Vayssiere
- Department of Neurosurgery, Hôpitaux Universitaires de Genève (HUG), Geneva, Switzerland
| | - Ana Rodríguez-Hernández
- Department of Neurological Surgery, Germans Trias i Pujol University Hospital, Universidad Autónoma, Barcelona, Spain
| | | | - Eleni Tsianaka
- Neurosurgery Department, International Hospital, Salmiya, Kuwait
| | - Gail Rosseau
- Department of Neurosurgery, George Washington University School of Medicine and Health SciencesWashington, Washington, District of Columbia, USA
| | - Mary Murphy
- Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom
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Joannides AJ, Korhonen TK, Clark D, Gnanakumar S, Venturini S, Mohan M, Bashford T, Baticulon R, Bhagavatula ID, Esene I, Fernández-Méndez R, Figaji A, Gupta D, Khan T, Laeke T, Martin M, Menon D, Paiva W, Park KB, Pattisapu JV, Rubiano AM, Sekhar V, Shabani HK, Sichizya K, Solla D, Tirsit A, Tripathi M, Turner C, Depreitere B, Iaccarino C, Lippa L, Reisner A, Rosseau G, Servadei F, Trivedi RA, Waran V, Kolias A, Hutchinson P. Consensus-Based Development of a Global Registry for Traumatic Brain Injury: Establishment, Protocol, and Implementation. Neurosurgery 2024; 94:278-288. [PMID: 37747225 DOI: 10.1227/neu.0000000000002661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 07/05/2023] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Global disparity exists in the demographics, pathology, management, and outcomes of surgically treated traumatic brain injury (TBI). However, the factors underlying these differences, including intervention effectiveness, remain unclear. Establishing a more accurate global picture of the burden of TBI represents a challenging task requiring systematic and ongoing data collection of patients with TBI across all management modalities. The objective of this study was to establish a global registry that would enable local service benchmarking against a global standard, identification of unmet need in TBI management, and its evidence-based prioritization in policymaking. METHODS The registry was developed in an iterative consensus-based manner by a panel of neurotrauma professionals. Proposed registry objectives, structure, and data points were established in 2 international multidisciplinary neurotrauma meetings, after which a survey consisting of the same data points was circulated within the global neurotrauma community. The survey results were disseminated in a final meeting to reach a consensus on the most pertinent registry variables. RESULTS A total of 156 professionals from 53 countries, including both high-income countries and low- and middle-income countries, responded to the survey. The final consensus-based registry includes patients with TBI who required neurosurgical admission, a neurosurgical procedure, or a critical care admission. The data set comprised clinically pertinent information on demographics, injury characteristics, imaging, treatments, and short-term outcomes. Based on the consensus, the Global Epidemiology and Outcomes following Traumatic Brain Injury (GEO-TBI) registry was established. CONCLUSION The GEO-TBI registry will enable high-quality data collection, clinical auditing, and research activity, and it is supported by the World Federation of Neurosurgical Societies and the National Institute of Health Research Global Health Program. The GEO-TBI registry ( https://geotbi.org ) is now open for participant site recruitment. Any center involved in TBI management is welcome to join the collaboration to access the registry.
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Affiliation(s)
- Alexis J Joannides
- NIHR Global Health Research Group on Acquired Brain and Spine Injury, University of Cambridge, Cambridge , Cambridgeshire , UK
| | - Tommi K Korhonen
- NIHR Global Health Research Group on Acquired Brain and Spine Injury, University of Cambridge, Cambridge , Cambridgeshire , UK
- Neurocenter, Neurosurgery, Oulu University Hospital & University of Oulu, Oulu , Finland
| | - David Clark
- NIHR Global Health Research Group on Acquired Brain and Spine Injury, University of Cambridge, Cambridge , Cambridgeshire , UK
| | - Sujit Gnanakumar
- NIHR Global Health Research Group on Acquired Brain and Spine Injury, University of Cambridge, Cambridge , Cambridgeshire , UK
| | - Sara Venturini
- NIHR Global Health Research Group on Acquired Brain and Spine Injury, University of Cambridge, Cambridge , Cambridgeshire , UK
| | - Midhun Mohan
- NIHR Global Health Research Group on Acquired Brain and Spine Injury, University of Cambridge, Cambridge , Cambridgeshire , UK
| | - Thomas Bashford
- NIHR Global Health Research Group on Acquired Brain and Spine Injury, University of Cambridge, Cambridge , Cambridgeshire , UK
- Division of Anaesthesia, Department of Medicine, University of Cambridge & Cambridge University Hospitals NHS Foundation Trust, Cambridge , Cambridgeshire , UK
- Health Systems Design Group, Department of Engineering, University of Cambridge, Cambridge , UK
| | - Ronnie Baticulon
- Division of Neurosurgery, Department of Neurosciences, Philippine General Hospital & University of the Philippines Manila, Manila , Philippines
| | - Indira Devi Bhagavatula
- Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences, NIMHANS, Bengaluru , Karnataka , India
| | - Ignatius Esene
- Division of Neurosurgery, Faculty of Health Sciences, The University of Bamenda, Bambili , Cameroon
| | - Rocío Fernández-Méndez
- NIHR Global Health Research Group on Acquired Brain and Spine Injury, University of Cambridge, Cambridge , Cambridgeshire , UK
| | - Anthony Figaji
- Division of Neurosurgery, Neurosciences Institute, University of Cape Town, Cape Town , South Africa
| | - Deepak Gupta
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi , India
| | - Tariq Khan
- Department of Neurosurgery, North Western General and Research Hospital, Peshawar , Pakistan
| | - Tsegazeab Laeke
- Division of Neurosurgery, Department of Surgery, College of Health Sciences, Addis Ababa University, Addis Ababa , Ethiopia
| | - Michael Martin
- Orion MedTech Ltd. CIC, Cambridge , Cambridgeshire , UK
- Obex Technologies Ltd., Cambridge , Cambridgeshire , UK
| | - David Menon
- Division of Anaesthesia, Department of Medicine, University of Cambridge & Cambridge University Hospitals NHS Foundation Trust, Cambridge , Cambridgeshire , UK
| | - Wellingson Paiva
- Division of Neurosurgery, Department of Neurology, School of Medicine, University of São Paulo, São Paulo , Brazil
| | - Kee B Park
- Department of Global Health and Social Medicine, Global Neurosurgery Initiative-Program in Global Surgery and Social Change, Harvard Medical School, Boston , Massachusetts , USA
| | - Jogi V Pattisapu
- University of Central Florida College of Medicine, Orlando , Florida , USA
- Department of Neurosurgery, King George Hospital, Visakhapatnam , Andhra Pradesh , India
| | - Andres M Rubiano
- Neurosciences Institute, El Bosque University, Bogotá , Colombia
| | - Vijaya Sekhar
- Department of Neurosurgery, King George Hospital, Visakhapatnam , Andhra Pradesh , India
- Current Affiliation: Department of Neurosurgery, Government General Hospital & Rangaraya Medical College, Kakinada , Andhra Pradesh , India
| | - Hamisi K Shabani
- Department of Neurosurgery, Muhimbili Orthopaedic Institute, Dar es Salaam , Tanzania
| | - Kachinga Sichizya
- Department of Neurosurgery, University Teaching Hospital, Lusaka , Zambia
| | - Davi Solla
- Division of Neurosurgery, Department of Neurology, School of Medicine, University of São Paulo, São Paulo , Brazil
| | - Abenezer Tirsit
- Division of Neurosurgery, Department of Surgery, College of Health Sciences, Addis Ababa University, Addis Ababa , Ethiopia
| | - Manjul Tripathi
- Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh , India
| | - Carole Turner
- NIHR Global Health Research Group on Acquired Brain and Spine Injury, University of Cambridge, Cambridge , Cambridgeshire , UK
| | | | - Corrado Iaccarino
- Department of Biomedical, Metabolic and Neural Sciences, School of Neurosurgery, University of Modena and Reggio Emilia, Modena , Italy
- Division of Neurosurgery, University Hospital of Modena, Modena , Italy
- Emergency Neurosurgery Unit, AUSL RE IRCCS, Reggio Emilia , Italy
| | - Laura Lippa
- Department of Neurosurgery, Ospedale Niguarda, Milan , Italy
| | - Andrew Reisner
- Departments of Neurosurgery and Pediatrics, Children's Healthcare of Atlanta & Emory University School of Medicine, Atlanta , Georgia , USA
| | - Gail Rosseau
- Barrow Global, Barrow Neurological Institute, Phoenix , Arizona , USA
- Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington , District of Columbia , USA
| | - Franco Servadei
- Humanitas Research Hospital-IRCCS & Humanitas University, Rozzano, Milan , Italy
| | - Rikin A Trivedi
- NIHR Global Health Research Group on Acquired Brain and Spine Injury, University of Cambridge, Cambridge , Cambridgeshire , UK
| | - Vicknes Waran
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur , Malaysia
| | - Angelos Kolias
- NIHR Global Health Research Group on Acquired Brain and Spine Injury, University of Cambridge, Cambridge , Cambridgeshire , UK
| | - Peter Hutchinson
- NIHR Global Health Research Group on Acquired Brain and Spine Injury, University of Cambridge, Cambridge , Cambridgeshire , UK
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Spiliotopoulos T, Kalogeras A, Shlobin NA, Tasiou A, Paschalis T, Alexiou GA, Fratzoglou M, Paleologos TS, Vasilios P, Prassas A, Tsitsopoulos PP, Vlachos K, Voulgaris S, Rosseau G, Fountas KN. Neurosurgery Training in Greece. World Neurosurg 2024:S1878-8750(24)00076-7. [PMID: 38244686 DOI: 10.1016/j.wneu.2024.01.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/11/2024] [Indexed: 01/22/2024]
Abstract
OBJECTIVE The structure and specifics of neurosurgery residency training vary substantially across programs and countries, potentially leading to differences in clinical reasoning, surgical skills, and professionalism. The Greek neurosurgical training system is unique in numerous respects. This manuscript delineates the current state of neurosurgical residency training in Greece and outlines future directions. METHODS A narrative review was conducted to describe the Greek neurosurgical residency training structure. The perspectives of the authors regarding challenges in training and future directions were synthesized. RESULTS This manuscript describes the neurosurgery residency curriculum and board certification process, existing training programs, and key challenges in neurosurgery residency training in Greece. The authors propose future directions to reform neurosurgical training in Greece. CONCLUSIONS Neurosurgery residency training in Greece has been largely unchanged for many years. This review leads to suggested modification of the existing training process may improve the quality of training and equip neurosurgeons to respond to the rapidly changing landscape of the field.
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Affiliation(s)
- Theodosios Spiliotopoulos
- Department of Neurosurgery, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece.
| | - Adamantios Kalogeras
- Department of Neurosurgery, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - Nathan A Shlobin
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Anastasia Tasiou
- Department of Neurosurgery, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - Thanasis Paschalis
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, Cambridgeshire, UK
| | - George A Alexiou
- Department of Neurosurgery, University Hospital of Ioannina, Ioannina, Greece
| | - Moschos Fratzoglou
- Department of Neurosurgery, General Hospital of Nikaia-Piraeus, Athens, Greece
| | | | | | - Aristeidis Prassas
- Department of Neurosurgery, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Parmenion P Tsitsopoulos
- Department of Neurosurgery, Hippokratio General Hospital, Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece
| | | | - Spyridon Voulgaris
- Department of Neurosurgery, University Hospital of Ioannina, Ioannina, Greece
| | - Gail Rosseau
- Department of Neurological Surgery, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA; Barrow Global, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Kostas N Fountas
- Department of Neurosurgery, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
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Covell MM, Naik A, Shaffer A, Cramer SW, Alan N, Shabani HK, Rabiel H, Rosseau G, Arnold PM. Social Determinants of Health Impact Spinal Cord Injury Outcomes in Low- and Middle-Income Countries: A Meta-Epidemiological Study. Neurosurgery 2023:00006123-990000000-00960. [PMID: 37962339 DOI: 10.1227/neu.0000000000002765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 10/02/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Traumatic spinal cord injuries (SCI), which disproportionally occur in low- and middle-income countries (LMICs), pose a significant global health challenge. Despite the prevalence and severity of SCI in these settings, access to appropriate surgical care and barriers to treatment remain poorly understood on a global scale, with data from LMICs being particularly scarce and underreported. This study sought to examine the impact of social determinants of health (SDoH) on the pooled in-hospital and follow-up mortality, and neurological outcomes, after SCI in LMICs. METHODS A systematic review was conducted in adherence to the Preferred Reporting in Systematic Review and Meta-Analysis-guidelines. Multivariable analysis was performed by multivariable linear regression, investigating the impact of the parameters of interest (patient demographics, country SDoH characteristics) on major patient outcomes (in-hospital/follow-up mortality, neurological dysfunction). RESULTS Forty-five (N = 45) studies were included for analysis, representing 13 individual countries and 18 134 total patients. The aggregate pooled in-hospital mortality rate was 6.46% and 17.29% at follow-up. The in-hospital severe neurological dysfunction rate was 97.64% and 57.36% at follow-up. Patients with rural injury had a nearly 4 times greater rate of severe in-hospital neurological deficits than patients in urban areas. The Gini index, reflective of income inequality, was associated with a 23.8% increase in in-hospital mortality, a 20.1% decrease in neurological dysfunction at follow-up, and a 12.9% increase in mortality at follow-up. CONCLUSION This study demonstrates the prevalence of injury and impact of SDoH on major patient outcomes after SCI in LMICs. Future initiatives may use these findings to design global solutions for more equitable care of patients with SCI.
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Affiliation(s)
- Michael M Covell
- School of Medicine, Georgetown University, Washington, District of Columbia, USA
| | - Anant Naik
- Carle Illinois College of Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Annabelle Shaffer
- Carle Illinois College of Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Samuel W Cramer
- Department of Neurosurgery, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| | - Nima Alan
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California, USA
| | - Hamisi K Shabani
- Department of Neurosurgery, Muhimbili Orthopaedic Institute, Dar es Salaam, Tanzania
| | - Happiness Rabiel
- Department of Neurosurgery, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Gail Rosseau
- Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Paul M Arnold
- Department of Neurosurgery, Carle Foundation Hospital, Urbana, Illinois, USA
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Reynolds RA, Vance EH, Shlobin NA, Bowman R, Rosseau G. Transitioning care for adolescents with spina bifida in the US: challenges for management. Childs Nerv Syst 2023; 39:3123-3130. [PMID: 37099139 DOI: 10.1007/s00381-023-05955-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 04/05/2023] [Indexed: 04/27/2023]
Abstract
Open spina bifida (OSB) is a common neural tube defect. Medical and surgical care involves addressing the baseline orthopedic, urologic, and neurological dysfunction as well as the changes or declines that may occur as the patient ages. Given the complexity of this disease, coordinated, multidisciplinary care involving specialists in neurosurgery, orthopedics, urology, rehabilitation and physical medicine, pediatrics, and psychology is necessary to establish and optimize baseline function. Traditionally in the US, pediatric multispecialty spina bifida clinics have provided the patient with a coordinated medical support system. Unfortunately, this coordinated, medical home has been difficult to establish during the transition from pediatric to adult care. Medical professionals must have a strong understanding of OSB to properly manage the disease and detect and prevent associated complications. In this manuscript, we (1) describe the changing needs and challenges of people living with OSB over a lifespan, (2) delineate current practices in the transition of care for people with OSB from childhood to adulthood, and (3) provide recommendations for best practices in navigating the transition process for clinicians who provide care for those afflicted with this most complex congenital abnormality of the nervous system compatible with long term survival.
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Affiliation(s)
- Rebecca A Reynolds
- Department of Neurological Surgery, Johns Hopkins All Children's Hospital, 601 5th Street South, Suite 511, Saint Petersburg, FL, 33705, USA.
| | - E Haley Vance
- Department of Neurological Surgery, Johns Hopkins All Children's Hospital, 601 5th Street South, Suite 511, Saint Petersburg, FL, 33705, USA
| | - Nathan A Shlobin
- Division of Pediatric Neurosurgery, Department of Neurological Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Robin Bowman
- Division of Pediatric Neurosurgery, Department of Neurological Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Gail Rosseau
- Department of Neurological Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
- Barrow Neurological Institute, Phoenix, AZ, USA
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Uwishema O, Frederiksen KS, Badri R, Pradhan AU, Shariff S, Adanur I, Dost B, Esene I, Rosseau G. Epidemiology and etiology of brain cancer in Africa: A systematic review. Brain Behav 2023; 13:e3112. [PMID: 37312649 PMCID: PMC10498065 DOI: 10.1002/brb3.3112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 04/07/2023] [Accepted: 05/23/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND Cancer is a significant threat to public health and a leading cause of morbidity across the globe. Of all cancers, brain cancer can be particularly catastrophic as treatment often fails to achieve the desired degree of effectiveness and diagnosis remains associated with a high mortality rate. Africa, as a continent with resource-limited countries, needs to allocate the necessary proper healthcare infrastructure to significantly reduce cancer rates and improve patient survival. In addition, the relative paucity of data within this field in Africa makes effective management a challenge. OBJECTIVE This review is aimed at elucidating the currently available evidence base with regard to the epidemiology and etiology of brain cancer within resource-limited African countries. This review hopes to bring to the attention of the wider clinical community the growing burden of brain cancer within Africa and to encourage future research into this field of research. METHODS The available literature for this Systematic Review was searched on two bibliographic databases, PubMed and Scopus, using an individually verified, prespecified approach. In addition, the Global Cancer Observatory and Global Burden of Disease databases were also utilized. Studies reporting on the epidemiology, etiology, and impact of brain cancer in Africa were suitable for inclusion. The level of evidence of the included studies was considered as per the Centre for Evidence-Based Medicine recommendations. RESULTS Out of the four databases searched, 3848 articles were initially screened rigorously, filtered into 54 articles, and finally assessed qualitatively and quantitatively. We have demonstrated a poor survival rate and lack of proper funds/resources necessary to report, identify, and treat cases, as well as the dearth of comprehensive research on the subject of brain cancer that has become a challenging healthcare concern in many African developing nations. Also, because of the gradual improvement in healthcare facilities and the increasing population within many countries in Africa, the number of patients with central nervous system and intracranial tumors is rising specifically in the elder population. In addition, the population in West Africa is at a higher risk of HIV-related malignancies due to the high prevalence of HIV in West Africa. The burden of brain cancer in Africa is increasing in comparison with the developed parts of the world in which it is decreasing. Moreover, the mismanagement of cancers in Africa leads to higher morbidity and mortality and decreased quality of life. CONCLUSION This study addresses the burden of brain cancer as a major public health crisis in Africa. Improved treatment modalities and access to screening are required to better address the burden of this disease. Therefore, there is a clear need for more substantial and comprehensive research on etiology, epidemiology, and treatment of brain cancer within Africa to understand its epidemiological distribution and provide a means for managing and reducing the associated morbidity and mortality.
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Affiliation(s)
- Olivier Uwishema
- Department of Research and EducationOli Health Magazine OrganizationKigaliRwanda
- Department of Research and ProjectClinton Global Initiative UniversityNew YorkNew YorkUSA
- Faculty of MedicineKaradeniz Technical UniversityTrabzonTurkey
| | | | - Rawa Badri
- Department of Research and EducationOli Health Magazine OrganizationKigaliRwanda
- Mycetoma Research CentreKhartoumSudan
- Faculty of MedicineUniversity of KhartoumKhartoumSudan
| | | | - Sanobar Shariff
- Department of Research and EducationOli Health Magazine OrganizationKigaliRwanda
- Faculty of medicineYerevan State Medical UniversityYerevanArmenia
| | - Irem Adanur
- Department of Research and EducationOli Health Magazine OrganizationKigaliRwanda
- Faculty of MedicineKaradeniz Technical UniversityTrabzonTurkey
| | - Burhan Dost
- Department of Anaesthesiology and ReanimationOndokuz Mayis University Faculty of MedicineSamsunTurkey
| | - Ignatius Esene
- Neurosurgery Division, Faculty of Health SciencesUniversity of BamendaBambiliCameroon
| | - Gail Rosseau
- Department of NeurosurgeryGeorge Washington University School of Medicine and Health SciencesWashington, D.C.USA
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Poon MTC, Piper RJ, Thango N, Fountain DM, Marcus HJ, Lippa L, Servadei F, Esene IN, Freyschlag CF, Neville IS, Rosseau G, Schaller K, Demetriades AK, Robertson FC, Hutchinson PJ, Price SJ, Baticulon RE, Glasbey JC, Bhangu A, Jenkinson MD, Kolias AG. Variation in postoperative outcomes of patients with intracranial tumors: insights from a prospective international cohort study during the COVID-19 pandemic. Neuro Oncol 2023; 25:1299-1309. [PMID: 37052643 PMCID: PMC10326494 DOI: 10.1093/neuonc/noad019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND This study assessed the international variation in surgical neuro-oncology practice and 30-day outcomes of patients who had surgery for an intracranial tumor during the COVID-19 pandemic. METHODS We prospectively included adults aged ≥18 years who underwent surgery for a malignant or benign intracranial tumor across 55 international hospitals from 26 countries. Each participating hospital recorded cases for 3 consecutive months from the start of the pandemic. We categorized patients' location by World Bank income groups (high [HIC], upper-middle [UMIC], and low- and lower-middle [LLMIC]). Main outcomes were a change from routine management, SARS-CoV-2 infection, and 30-day mortality. We used a Bayesian multilevel logistic regression stratified by hospitals and adjusted for key confounders to estimate the association between income groups and mortality. RESULTS Among 1016 patients, the number of patients in each income group was 765 (75.3%) in HIC, 142 (14.0%) in UMIC, and 109 (10.7%) in LLMIC. The management of 200 (19.8%) patients changed from usual care, most commonly delayed surgery. Within 30 days after surgery, 14 (1.4%) patients had a COVID-19 diagnosis and 39 (3.8%) patients died. In the multivariable model, LLMIC was associated with increased mortality (odds ratio 2.83, 95% credible interval 1.37-5.74) compared to HIC. CONCLUSIONS The first wave of the pandemic had a significant impact on surgical decision-making. While the incidence of SARS-CoV-2 infection within 30 days after surgery was low, there was a disparity in mortality between countries and this warrants further examination to identify any modifiable factors.
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Affiliation(s)
- Michael T C Poon
- Usher Institute, University of Edinburgh, Edinburgh, UK
- Department of Clinical Neurosciences, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Rory J Piper
- Department of Neurosurgery, John Radcliffe Hospital, Oxford, UK
| | - Nqobile Thango
- Department of Surgery, Division of Neurosurgery, University of Cape Town, Cape Town, South Africa
| | - Daniel M Fountain
- Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, Salford, UK
| | - Hani J Marcus
- National Hospital for Neurology and Neurosurgery, London, UK
- UCL Queen Square Institute of Neurology, London, UK
| | - Laura Lippa
- Department of Neurosurgery, Grande Ospedale Metropolitano Niguarda Milan, Italy
| | - Franco Servadei
- Department of Biomedical Sciences, Humanitas University and IRCCS Humanitas Research Hospital, Milano, Italy
| | - Ignatius N Esene
- Neurosurgery Division, Faculty of Health Sciences, University of Bamenda, Bambili, Cameroon
| | - Christian F Freyschlag
- Department of Neurosurgery, Medical University of Innsbruck, Anichstr. 35, 6020 Innsbruck, Austria
| | - Iuri S Neville
- Instituto do Cancer do Estado de Sao Paulo, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Gail Rosseau
- George Washington University School of Medicine and Health Sciences, Washington, DC, United States
| | - Karl Schaller
- Department of Clinical Neurosciences, Geneva University Medical Center, Geneva, Switzerland
| | | | - Faith C Robertson
- Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts, United States
| | - Peter J Hutchinson
- Academic Division of Neurosurgery, Addenbrooke's Hospital, Cambridge, UK
| | - Stephen J Price
- Department of Clinical Neurosciences, Division of Neurosurgery, Cambridge, UK
| | - Ronnie E Baticulon
- Division of Neurosurgery, Department of Neurosciences, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - James C Glasbey
- NIHR Global Health Research Unit on Global Surgery, University of Birmingham, Birmingham, UK
| | | | - Michael D Jenkinson
- Department of Neurosurgery, Walton Centre & University of Liverpool, Liverpool, UK
| | - Angelos G Kolias
- Department of Clinical Neurosciences, Division of Neurosurgery, Cambridge, UK
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9
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Joannides A, Korhonen TK, Clark D, Gnanakumar S, Venturini S, Mohan M, Bashford T, Baticulon R, Bhagavatula ID, Esene I, Fernández-Méndez R, Figaji A, Gupta D, Khan T, Laeke T, Martin M, Menon D, Paiva W, Park KB, Pattisapu JV, Rubiano AM, Sekhar V, Shabani H, Sichizya K, Solla D, Tirsit A, Tripathi M, Turner C, Depreitere B, Iaccarino C, Lippa L, Reisner A, Rosseau G, Servadei F, Trivedi R, Waran V, Kolias A, Hutchinson P. An international, prospective observational study on traumatic brain injury epidemiology study protocol: GEO-TBI: Incidence. NIHR Open Res 2023; 3:34. [PMID: 37881453 PMCID: PMC10593326 DOI: 10.3310/nihropenres.13377.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/16/2023] [Indexed: 10/27/2023]
Abstract
Background The epidemiology of traumatic brain injury (TBI) is unclear - it is estimated to affect 27-69 million individuals yearly with the bulk of the TBI burden in low-to-middle income countries (LMICs). Research has highlighted significant between-hospital variability in TBI outcomes following emergency surgery, but the overall incidence and epidemiology of TBI remains unclear. To address this need, we established the Global Epidemiology and Outcomes following Traumatic Brain Injury (GEO-TBI) registry, enabling recording of all TBI cases requiring admission irrespective of surgical treatment. Objective The GEO-TBI: Incidence study aims to describe TBI epidemiology and outcomes according to development indices, and to highlight best practices to facilitate further comparative research. Design Multi-centre, international, registry-based, prospective cohort study. Subjects Any unit managing TBI and participating in the GEO-TBI registry will be eligible to join the study. Each unit will select a 90-day study period. All TBI patients meeting the registry inclusion criteria (neurosurgical/ICU admission or neurosurgical operation) during the selected study period will be included in the GEO-TBI: Incidence. Methods All units will form a study team, that will gain local approval, identify eligible patients and input data. Data will be collected via the secure registry platform and validated after collection. Identifiers may be collected if required for local utility in accordance with the GEO-TBI protocol. Data Data related to initial presentation, interventions and short-term outcomes will be collected in line with the GEO-TBI core dataset, developed following consensus from an iterative survey and feedback process. Patient demographics, injury details, timing and nature of interventions and post-injury care will be collected alongside associated complications. The primary outcome measures for the study will be the Glasgow Outcome at Discharge Scale (GODS) and 14-day mortality. Secondary outcome measures will be mortality and extended Glasgow Outcome Scale (GOSE) at the most recent follow-up timepoint.
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Affiliation(s)
- Alexis Joannides
- NIHR Global Health Research Group on Acquired Brain & Spine Injury, University of Cambridge, Cambridge, UK
| | - Tommi Kalevi Korhonen
- NIHR Global Health Research Group on Acquired Brain & Spine Injury, University of Cambridge, Cambridge, UK
- Neurocenter, Neurosurgery, Oulu University Hospital & University of Oulu, Oulu, Pohjois-Pohjanmaa, Finland
| | - David Clark
- NIHR Global Health Research Group on Acquired Brain & Spine Injury, University of Cambridge, Cambridge, UK
| | - Sujit Gnanakumar
- NIHR Global Health Research Group on Acquired Brain & Spine Injury, University of Cambridge, Cambridge, UK
| | - Sara Venturini
- NIHR Global Health Research Group on Acquired Brain & Spine Injury, University of Cambridge, Cambridge, UK
| | - Midhun Mohan
- NIHR Global Health Research Group on Acquired Brain & Spine Injury, University of Cambridge, Cambridge, UK
| | - Thomas Bashford
- Health Systems Design Group, Department of Engineering, University of Cambridge, Cambridge, UK
- Division of Anaesthesia, Department of Medicine, University of Cambridge & Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Ronnie Baticulon
- Division of Neurosurgery, Department of Neurosciences, Philippine General Hospital & University of the Philippines Manila, Manila, Philippines
| | - Indira Devi Bhagavatula
- Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences, NIMHANS, Bengaluru, Karnataka, India
| | - Ignatius Esene
- Division of Neurosurgery, Faculty of Health Sciences, The University of Bamenda, Bambili, Cameroon
| | - Rocío Fernández-Méndez
- NIHR Global Health Research Group on Acquired Brain & Spine Injury, University of Cambridge, Cambridge, UK
| | - Anthony Figaji
- Division of Neurosurgery and Neurosciences Institute, University of Cape Town, Cape Town, South Africa
| | - Deepak Gupta
- Department of neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Tariq Khan
- Department of Neurosurgery, North Western General and Research Hospital, Peshawar, Pakistan
| | - Tsegazeab Laeke
- Division of Neurosurgery, Department of Surgery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - David Menon
- Division of Anaesthesia, Department of Medicine, University of Cambridge & Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Wellingson Paiva
- Division of Neurosurgery, Department of Neurology, School of Medicine, University of Sao Paulo, São Paulo, Brazil
| | - Kee B. Park
- Global Neurosurgery Initiative-Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Jogi V. Pattisapu
- University of Central Florida College of Medicine, Orlando, Florida, USA
- Department of Neurosurgery, King George Hospital, Visakhapatnam, Andra Pradesh, India
| | | | - Vijaya Sekhar
- Department of Neurosurgery, King George Hospital, Visakhapatnam, Andra Pradesh, India
| | - Hamisi Shabani
- Department of Neurosurgery, Muhimbili Orthopaedic Institute, Dar es Salaam, Tanzania
| | - Kachinga Sichizya
- Department of Neurosurgery, University Teaching Hospital, Lusaka, Zambia
| | - Davi Solla
- Division of Neurosurgery, Department of Neurology, School of Medicine, University of Sao Paulo, São Paulo, Brazil
| | - Abenezer Tirsit
- Division of Neurosurgery, Department of Surgery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Manjul Tripathi
- Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India
| | - Carole Turner
- NIHR Global Health Research Group on Acquired Brain & Spine Injury, University of Cambridge, Cambridge, UK
| | - Bart Depreitere
- Department of Neurosciences, University Hospital Leuven, UZ, Leuven, Belgium
| | - Corrado Iaccarino
- School of Neurosurgery, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Division of Neurosurgery, University Hospital of Modena, Modena, Italy
- Emergency Neurosurgery Unit, AUSL RE IRCCS, Reggio Emilia, Italy
| | - Laura Lippa
- Department of Neurosurgery, Ospedale Niguarda, Milan, Italy
| | - Andrew Reisner
- Departments of Neurosurgery and Pediatrics, Children's Healthcare of Atlanta & Emory University School of Medicine, Atlanta, Georgia, USA
| | - Gail Rosseau
- Barrow Global, Barrow Neurosurgical Institute, Phoenix, Arizona, USA
- Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Franco Servadei
- Department of Neurosurgery, Humanitas Research Hospital-IRCCS & Humanitas University, Rozzano, Milan, Italy
| | - Rikin Trivedi
- NIHR Global Health Research Group on Acquired Brain & Spine Injury, University of Cambridge, Cambridge, UK
| | - Vicknes Waran
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Angelos Kolias
- NIHR Global Health Research Group on Acquired Brain & Spine Injury, University of Cambridge, Cambridge, UK
| | - Peter Hutchinson
- NIHR Global Health Research Group on Acquired Brain & Spine Injury, University of Cambridge, Cambridge, UK
| | - NIHR Global Health Research Group on Acquired Brain and Spine Injury
- NIHR Global Health Research Group on Acquired Brain & Spine Injury, University of Cambridge, Cambridge, UK
- Neurocenter, Neurosurgery, Oulu University Hospital & University of Oulu, Oulu, Pohjois-Pohjanmaa, Finland
- Health Systems Design Group, Department of Engineering, University of Cambridge, Cambridge, UK
- Division of Anaesthesia, Department of Medicine, University of Cambridge & Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Division of Neurosurgery, Department of Neurosciences, Philippine General Hospital & University of the Philippines Manila, Manila, Philippines
- Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences, NIMHANS, Bengaluru, Karnataka, India
- Division of Neurosurgery, Faculty of Health Sciences, The University of Bamenda, Bambili, Cameroon
- Division of Neurosurgery and Neurosciences Institute, University of Cape Town, Cape Town, South Africa
- Department of neurosurgery, All India Institute of Medical Sciences, New Delhi, India
- Department of Neurosurgery, North Western General and Research Hospital, Peshawar, Pakistan
- Division of Neurosurgery, Department of Surgery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Orion MedTech Ltd. CIC, Cambridge, UK
- Division of Neurosurgery, Department of Neurology, School of Medicine, University of Sao Paulo, São Paulo, Brazil
- Global Neurosurgery Initiative-Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
- University of Central Florida College of Medicine, Orlando, Florida, USA
- Department of Neurosurgery, King George Hospital, Visakhapatnam, Andra Pradesh, India
- Neurosciences Institute, El Bosque University, Bogotá, Colombia
- Department of Neurosurgery, Muhimbili Orthopaedic Institute, Dar es Salaam, Tanzania
- Department of Neurosurgery, University Teaching Hospital, Lusaka, Zambia
- Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India
- Department of Neurosciences, University Hospital Leuven, UZ, Leuven, Belgium
- School of Neurosurgery, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Division of Neurosurgery, University Hospital of Modena, Modena, Italy
- Emergency Neurosurgery Unit, AUSL RE IRCCS, Reggio Emilia, Italy
- Department of Neurosurgery, Ospedale Niguarda, Milan, Italy
- Departments of Neurosurgery and Pediatrics, Children's Healthcare of Atlanta & Emory University School of Medicine, Atlanta, Georgia, USA
- Barrow Global, Barrow Neurosurgical Institute, Phoenix, Arizona, USA
- Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
- Department of Neurosurgery, Humanitas Research Hospital-IRCCS & Humanitas University, Rozzano, Milan, Italy
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - The GEO-TBI Collaborative
- NIHR Global Health Research Group on Acquired Brain & Spine Injury, University of Cambridge, Cambridge, UK
- Neurocenter, Neurosurgery, Oulu University Hospital & University of Oulu, Oulu, Pohjois-Pohjanmaa, Finland
- Health Systems Design Group, Department of Engineering, University of Cambridge, Cambridge, UK
- Division of Anaesthesia, Department of Medicine, University of Cambridge & Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Division of Neurosurgery, Department of Neurosciences, Philippine General Hospital & University of the Philippines Manila, Manila, Philippines
- Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences, NIMHANS, Bengaluru, Karnataka, India
- Division of Neurosurgery, Faculty of Health Sciences, The University of Bamenda, Bambili, Cameroon
- Division of Neurosurgery and Neurosciences Institute, University of Cape Town, Cape Town, South Africa
- Department of neurosurgery, All India Institute of Medical Sciences, New Delhi, India
- Department of Neurosurgery, North Western General and Research Hospital, Peshawar, Pakistan
- Division of Neurosurgery, Department of Surgery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Orion MedTech Ltd. CIC, Cambridge, UK
- Division of Neurosurgery, Department of Neurology, School of Medicine, University of Sao Paulo, São Paulo, Brazil
- Global Neurosurgery Initiative-Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
- University of Central Florida College of Medicine, Orlando, Florida, USA
- Department of Neurosurgery, King George Hospital, Visakhapatnam, Andra Pradesh, India
- Neurosciences Institute, El Bosque University, Bogotá, Colombia
- Department of Neurosurgery, Muhimbili Orthopaedic Institute, Dar es Salaam, Tanzania
- Department of Neurosurgery, University Teaching Hospital, Lusaka, Zambia
- Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India
- Department of Neurosciences, University Hospital Leuven, UZ, Leuven, Belgium
- School of Neurosurgery, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Division of Neurosurgery, University Hospital of Modena, Modena, Italy
- Emergency Neurosurgery Unit, AUSL RE IRCCS, Reggio Emilia, Italy
- Department of Neurosurgery, Ospedale Niguarda, Milan, Italy
- Departments of Neurosurgery and Pediatrics, Children's Healthcare of Atlanta & Emory University School of Medicine, Atlanta, Georgia, USA
- Barrow Global, Barrow Neurosurgical Institute, Phoenix, Arizona, USA
- Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
- Department of Neurosurgery, Humanitas Research Hospital-IRCCS & Humanitas University, Rozzano, Milan, Italy
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Shlobin NA, Savage S, Savage A, Torbati T, Wang Z, Salas-Vega S, Mota M, Pando A, Sheldon B, Westrup AM, Ogulnick J, Zreik J, AlKahtani NAH, Jesuyajolu D, Larrey KK, Fadalla T, Mahajan U, Manijla N, Singh R, Wang A, Kanmounye US, Moore C, Benzel EC, Rosseau G. The World Neurosurgery Global Champions Program: First-Year Experience of a Model Initiative for Reducing Disparities in Global Neurosurgical Literature. World Neurosurg 2023:S1878-8750(23)00783-0. [PMID: 37301534 DOI: 10.1016/j.wneu.2023.06.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Most surgical journals are published in English, representing a challenge for researchers from non-Anglophone countries. We describe the implementation, workflow, outcomes, and lessons learned from the World Neurosurgery Global Champions Program (GCP), a novel journal-specific English language editing program for articles rejected because of poor English grammar or usage. METHODS The GCP was advertised via the journal website and social media. Applicants were selected to be a reviewer for the GCP if they demonstrated English proficiency on writing samples supplied in their application. The demographics of GCP members and characteristics and outcomes of articles edited by the GCP during its first year were reviewed. Surveys of GCP members and authors who used the service were conducted. RESULTS Twenty-one individuals became part of the GCP, representing 8 countries and 16 languages apart from English. A total of 380 manuscripts were peer-reviewed by the editor-in-chief, who determined these manuscripts to have potentially worthwhile content but needed to be rejected due to poor language. The authors of these manuscripts were informed of the existence of this language assistance program. Forty-nine articles (12.9%) were edited by the GCP in 41.6 ± 22.8 days. Of 40 articles resubmitted to World Neurosurgery, 24 (60.0%) were accepted. GCP members and authors understood the purpose and workflow of the program and recognized improvements in article quality and the probability of acceptance through their participation. CONCLUSION The World Neurosurgery Global Champions Program mitigated a critical barrier to publication in an English language journal for authors from non-Anglophone countries. This program promotes research equity by providing a free, largely medical student and trainee operated, English language editing service. This model or a similar service can be replicated by other journals.
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Affiliation(s)
- Nathan A Shlobin
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Simon Savage
- Department of Medicine, Monash University, Melbourne, Australia
| | | | - Tania Torbati
- Department of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA, USA
| | - Zhe Wang
- Department of Neurological Surgery, University of Chicago School of Medicine, Chicago, IL
| | | | - Marcella Mota
- Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil
| | - Alejandro Pando
- Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Breanna Sheldon
- Department of Neurological Surgery, University of Arizona Tucson, Tucson, AZ, USA
| | - Alison M Westrup
- Department of Neurosurgery, University of Oklahoma College of Medicine, Oklahoma City, OK, USA
| | | | - Jad Zreik
- Central Michigan University College of Medicine, Mount Pleasant, MI, USA
| | - Nada A H AlKahtani
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Damilola Jesuyajolu
- Department of Neurological Surgery, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Manchester, UK
| | - Kasereka Kamabu Larrey
- Division of Neurosurgery, Department of Surgery, College of Medicine, Makerere University, Uganda
| | - Tarig Fadalla
- Soba University of Hospital, University of Khartoum, Khartoum, Sudan
| | - Uma Mahajan
- School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | | | - Rohin Singh
- Department of Neurological Surgery, Mayo Clinic, Phoenix, AZ, USA
| | - Andrew Wang
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | | | | | - Edward C Benzel
- Department of Neurosurgery, Cleveland Clinic, Cleveland, OH, USA
| | - Gail Rosseau
- Department of Neurological Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA and Barrow Global, Barrow Neurological Institute, Phoenix, AZ
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11
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Vooijs M, Robertson FC, Rosseau G, Tasiou A, Rodríguez-Hernández A, Mihaylova SI, Murphy M, Broekman MLD. Ethical challenges of travel for experimental therapy in malignant brain tumor patients. J Neurosurg 2023; 139:1802-1806. [PMID: 37310061 DOI: 10.3171/2023.4.jns2369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Manuela Vooijs
- 1VU University Amsterdam, Amsterdam UMC, VU Medical Center, Amsterdam, The Netherlands
- 2Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Faith C Robertson
- 2Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Gail Rosseau
- 3Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Anastasia Tasiou
- 4Department of Neurosurgery, University Hospital of Larissa, Greece
| | - Ana Rodríguez-Hernández
- 5Department of Neurological Surgery, Germans Triasi Pujol University Hospital, Barcelona, Spain
| | - Stiliana I Mihaylova
- 6Department of Neurosurgery, University Hospital St. Ivan Rilski, Sofia, Bulgaria
| | - Mary Murphy
- 7Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | - Marike L D Broekman
- 8Department of Neurosurgery, Haaglanden Medical Center, Den Haag, The Netherlands; and
- 9Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands
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12
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Figueroa EL, Veilleux C, Angelov L, Brien S, Fournier-Gosselin MP, Kiss ZHT, Long M, Marcoux J, Poon K, Stiver S, Tsai E, Woodrow S, Rosseau G. Canadian Women in Neurosurgery: From early pioneers to world leaders. World Neurosurg 2023; 175:78-97. [PMID: 37024081 DOI: 10.1016/j.wneu.2023.03.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 03/26/2023] [Indexed: 04/08/2023]
Abstract
BACKGROUND Since the emergence of neurosurgery as a distinct specialty about 100 years ago in Canada, it took over forty years for Canadian women to enter the field in the province of Quebec, and longer in other provinces. METHODS We provide a historical overview of Canadian women in neurosurgery, from the early pioneers to the modern-day leaders and innovators in the field. This manuscript also defines the current participation of women in Canadian neurosurgery. Chain-referral sampling, historical books, interviews, personal communications, and online resources were used as data sources. RESULTS The historical review highlights the exceptional journey and unique experiences of female neurosurgeons, describes their achievements, and identifies career obstacles and enabling factors. We also incorporate comments from Canadian women neurosurgeons, both retired and in active practice, addressing gender inequities in the field and provide advice and encouragement to the new generations to come. Despite the achievements of these female trailblazers, women represent a small proportion of the Canadian neurosurgery trainees and the active workforce in stark contrast to the increasing number of females in medical school. CONCLUSIONS This study represents the first historical overview of women neurosurgeons in Canada. Providing a historical context will help us to better understand the important role of women in modern neurosurgery, to identify persistent gender issues in the field and to provide a vision for aspiring women neurosurgeons.
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Shlobin NA, Ghotme K, Caceres A, Ocal E, Pattisapu JV, Rosseau G, Blount JP, Boop FA. Neurosurgeon-Led Advocacy for Folic Acid Fortification to Prevent Spina Bifida. World Neurosurg 2023; 172:96-97. [PMID: 36758793 DOI: 10.1016/j.wneu.2023.02.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Affiliation(s)
- Nathan A Shlobin
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Division of Pediatric Neurosurgery, Lurie Children's Hospital, Chicago, Illinois, USA
| | - Kemel Ghotme
- Faculty of Medicine, Universidad de La Sabana, Neurosurgery Unit, Fundacion Santafe de Bogota, Bogota, Colombia
| | - Adrian Caceres
- Department of Neurosurgery, National Children's Hospital of Costa Rica, "Dr. Carlos Saenz Herrera", San José, Costa Rica
| | - Eylem Ocal
- Department of Neurosurgery, Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Jogi V Pattisapu
- Department of Paediatric Neurosurgery, University of Central Florida College of Medicine, Orlando, Florida, USA
| | - Gail Rosseau
- Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington, D.C., USA; Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Jeffrey P Blount
- Department of Neurosurgery, University of Alabama at Birmingham/Children's of Alabama, Birmingham, Alabama, USA
| | - Frederick A Boop
- Department of Neurosurgery, University of Tennessee Health Sciences Center, Memphis, Tennessee, USA
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14
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Shlobin NA, Ghotme K, Caceres A, Ocal E, Pattisapu JV, Rosseau G, Blount JP, Boop FA. Neurosurgeon-Led Advocacy for Folic Acid Fortification to Prevent Spina Bifida. World Neurosurg 2023:S1878-8750(23)00083-9. [PMID: 36682528 DOI: 10.1016/j.wneu.2023.01.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The Publisher regrets that this article is an accidental duplication of an article that has already been published, http://doi.org/10.1016/j.wneu.2023.02.013. The duplicate article has therefore been withdrawn. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/policies/article-withdrawal.
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Affiliation(s)
- Nathan A Shlobin
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Division of Pediatric Neurosurgery, Lurie Children's Hospital, Chicago, Illinois, USA
| | - Kemel Ghotme
- Faculty of Medicine, Universidad de La Sabana, Neurosurgery Unit, Fundacion Santafe de Bogota, Bogota, Colombia
| | - Adrian Caceres
- Department of Neurosurgery, National Children's Hospital of Costa Rica, "Dr. Carlos Saenz Herrera", San José, Costa Rica
| | - Eylem Ocal
- Department of Neurosurgery, Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Jogi V Pattisapu
- Department of Paediatric Neurosurgery, University of Central Florida College of Medicine, Orlando, Florida, USA
| | - Gail Rosseau
- Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA; Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Jeffrey P Blount
- Department of Neurosurgery, University of Alabama at Birmingham/Children's of Alabama, Birmingham, Alabama, USA
| | - Frederick A Boop
- Department of Neurosurgery, University of Tennessee Health Sciences Center, Memphis, Tennessee, USA
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15
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Rallo MS, Strong MJ, Teton ZE, Murazsko K, Nanda A, Liau L, Rosseau G. Targeted Public Health Training for Neurosurgeons: An Essential Task for the Prioritization of Neurosurgery in the Evolving Global Health Landscape. Neurosurgery 2023; 92:10-17. [PMID: 36519856 DOI: 10.1227/neu.0000000000002169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/29/2022] [Indexed: 12/23/2022] Open
Abstract
The gap between the tremendous burden of neurological disease requiring surgical management and the limited capacity for neurosurgical care has fueled the growth of the global neurosurgical movement. It is estimated that an additional 23 300 neurosurgeons are needed to meet the burden posed by essential cases across the globe. Initiatives to increase neurosurgical capacity through systems strengthening and workforce development are key elements in correcting this deficit. Building on the growing interest in global health among neurosurgical trainees, we propose the integration of targeted public health education into neurosurgical training, in both high-income countries and low- and middle-income countries. This effort will ensure that graduates possess the fundamental skillsets and experience necessary to participate in and lead capacity-building efforts in the developing countries. This additional public health training can also help neurosurgical residents to achieve the core competencies outlined by accreditation boards, such as the Accreditation Committee on Graduate Medical Education in the United States. In this narrative review, we describe the global burden of neurosurgical disease, establish the need and role for the global neurosurgeon, and discuss pathways for implementing targeted global public health education in the field of neurosurgery.
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Affiliation(s)
- Michael S Rallo
- Department of Neurological Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Michael J Strong
- Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Zoe E Teton
- Department of Neurosurgery, University of California - Los Angeles, Los Angeles, California, USA
| | - Karin Murazsko
- Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Anil Nanda
- Department of Neurological Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Linda Liau
- Department of Neurosurgery, University of California - Los Angeles, Los Angeles, California, USA
| | - Gail Rosseau
- Department of Neurological Surgery, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
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16
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Shlobin NA, Roach JT, Kancherla V, Caceres A, Ocal E, Ghotme KA, Lam S, Park KB, Rosseau G, Blount JP, Boop FA. The role of neurosurgeons in global public health: the case of folic acid fortification of staple foods to prevent spina bifida. J Neurosurg Pediatr 2023; 31:8-15. [PMID: 36334286 DOI: 10.3171/2022.9.peds22188] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 09/26/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The global neurosurgery movement arose at the crossroads of unmet neurosurgical needs and public health to address the global burden of neurosurgical disease. The case of folic acid fortification (FAF) of staple foods for the prevention of spina bifida and anencephaly (SBA) represents an example of a new neurosurgical paradigm focused on public health intervention in addition to the treatment of individual cases. The Global Alliance for the Prevention of Spina Bifida-F (GAPSBiF), a multidisciplinary coalition of neurosurgeons, pediatricians, geneticists, epidemiologists, food scientists, and fortification policy experts, was formed to advocate for FAF of staple foods worldwide. This paper serves as a review of the work of GAPSBiF thus far in advocating for universal FAF of commonly consumed staple foods to equitably prevent SBA caused by folic acid insufficiency. METHODS A narrative review was performed using the PubMed and Google Scholar databases. RESULTS In this review, the authors describe the impact of SBA on patients, caregivers, and health systems, as well as characterize the multifaceted requirements for proper spina bifida care, including multidisciplinary clinics and the transition of care, while highlighting the role of neurosurgeons. Then they discuss prevention policy approaches, including supplementation, fortification, and hybrid efforts with folic acid. Next, they use the example of FAF of staple foods as a model for neurosurgeons' involvement in global public health through clinical practice, research, education and training, and advocacy. Last, they describe mechanisms for involvement in the above initiatives as a potential academic tenure track, including institutional partnerships, organized neurosurgery, neurosurgical expert groups, nongovernmental organizations, national or international governments, and multidisciplinary coalitions. CONCLUSIONS The role of neurosurgeons in caring for children with spina bifida extends beyond treating patients in clinical practice and includes research, education and training, and advocacy initiatives to promote context-specific, evidence-based initiatives to public health problems. Promoting and championing FAF serves as an example of the far-reaching, impactful role that neurosurgeons worldwide may play at the intersection of neurosurgery and public health.
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Affiliation(s)
- Nathan A Shlobin
- 1Division of Pediatric Neurosurgery, Lurie Children's Hospital, Chicago, Illinois
- 2Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Jordan T Roach
- 3College of Medicine, University of Tennessee Health Sciences Center, Memphis, Tennessee
- 4Graduate School of Biomedical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Vijaya Kancherla
- 5Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Adrian Caceres
- 6Department of Neurosurgery, National Children's Hospital of Costa Rica, "Dr. Carlos Saenz Herrera," San José, Costa Rica
| | - Eylem Ocal
- 7Department of Neurosurgery, Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Kemel A Ghotme
- 8Translational Neuroscience Research Lab, Faculty of Medicine, Universidad de La Sabana, Chía, Colombia
- 9Pediatric Neurosurgery, Department of Neurosurgery, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Sandi Lam
- 1Division of Pediatric Neurosurgery, Lurie Children's Hospital, Chicago, Illinois
- 2Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Kee B Park
- 10Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts
| | - Gail Rosseau
- 11Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Jeffrey P Blount
- 12Department of Neurosurgery, University of Alabama at Birmingham/Children's of Alabama, Birmingham, Alabama; and
| | - Frederick A Boop
- 13Department of Neurosurgery, University of Tennessee Health Sciences Center, Memphis, Tennessee
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17
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Tshimbombu TN, Kalubye AB, Hoffman C, Kanter JH, Rosseau G, Nteranya DS, Nyalundja AD, Kalala Okito JP. Review of Neurosurgery in the Democratic Republic of Congo: Historical Approach of a Local Context. World Neurosurg 2022; 167:81-88. [PMID: 35948213 DOI: 10.1016/j.wneu.2022.07.113] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 07/23/2022] [Accepted: 07/25/2022] [Indexed: 11/26/2022]
Abstract
Neurosurgical practice in the Democratic Republic of Congo (DRC) is challenged by limited resources and infrastructure. The DRC has 16 local residing neurosurgeons for 95 million inhabitants, a ratio of 1 neurosurgeon per 5.9 million Congolese citizens. This is attributable to decades of political unrest and a loosely regulated health care system. Understanding the role of neurosurgery in a historical context is necessary to appreciate and overcome current challenges in the delivery of neurosurgical care. We describe past and present political, social, and economic challenges surrounding the development of neurosurgical practice and training. Highlights of early innovators, current challenges, and a suggested framework to guide future advances in neurosurgical practice are provided. Interviews with Dr. Antoine Beltchika Kalubye, the oldest living neurosurgeon in the DRC, and Dr. Jean-Pierre Kalala Okito, current president of the Congolese Society of Neurosurgery, provide a detailed account of events. Firsthand narrative was supplemented via literature review and collaboration with registrars in the DRC to review current neurosurgery programs. Our discussions revealed that decades of political unrest and inconsistent management of health care resources are responsible for the current state of healthcare, including the dearth of local neurosurgeons. The neurosurgery workforce deficit in the DRC remains substantial. It is essential to understand local neurosurgical history, in its present state and breadth of challenges, to inform future development of neurosurgical care and to secure equitable partnerships between local stakeholders and the international community.
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Affiliation(s)
| | | | - Caitlin Hoffman
- Department of Neurological Surgery, New York-Presbyterian Hospital, Weill Cornell Medical College, New York, New York
| | - John H Kanter
- Section of Neurosurgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - Gail Rosseau
- George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Daniel Safari Nteranya
- Surgery Department, Official University of Bukavu, University Clinics of Bukavu, Democratic Republic of Congo
| | - Arsene Daniel Nyalundja
- Center for Tropical Diseases and Global Health, Faculty of Medicine, Université Catholique de Bukavu, Democratic Republic of Congo
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18
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Kancherla V, Botto LD, Rowe LA, Shlobin NA, Caceres A, Arynchyna-Smith A, Zimmerman K, Blount J, Kibruyisfaw Z, Ghotme KA, Karmarkar S, Fieggen G, Roozen S, Oakley GP, Rosseau G, Berry RJ. Mandatory food fortification with folic acid – Authors' reply. The Lancet Global Health 2022; 10:e1391-e1392. [DOI: 10.1016/s2214-109x(22)00375-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 08/18/2022] [Accepted: 08/19/2022] [Indexed: 01/10/2023] Open
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19
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Affiliation(s)
- Gail Rosseau
- Department of Neurosurgery, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
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20
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Hoffman C, Härtl R, Shlobin NA, Tshimbombu TN, Elbabaa SK, Haglund MM, Rubiano AM, Dewan MC, Stippler M, Mahmud MR, Barthélemy EJ, Griswold DP, Wohns R, Shabani HK, Rocque B, Sandberg DI, Lafuente J, Dempsey R, Rosseau G. Future Directions for Global Clinical Neurosurgical Training: Challenges and Opportunities. World Neurosurg 2022; 166:e404-e418. [PMID: 35868506 DOI: 10.1016/j.wneu.2022.07.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/05/2022] [Accepted: 07/06/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Expanded access to training opportunities is necessary to address 5 million essential neurosurgical cases not performed annually, nearly all in low- and middle-income countries. To target this critical neurosurgical workforce issue and advance positive collaborations, a summit (Global Neurosurgery 2019: A Practical Symposium) was designed to assemble stakeholders in global neurosurgical clinical education to discuss innovative platforms for clinical neurosurgery fellowships. METHODS The Global Neurosurgery Education Summit was held in November 2021, with 30 presentations from directors and trainees in existing global neurosurgical clinical fellowships. Presenters were selected based on chain referral sampling from suggestions made primarily from young neurosurgeons in low- and middle-income countries. Presentations focused on the perspectives of hosts, local champions, and trainees on clinical global neurosurgery fellowships and virtual learning resources. This conference sought to identify factors for success in overcoming barriers to improving access, equity, throughput, and quality of clinical global neurosurgery fellowships. A preconference survey was disseminated to attendees. RESULTS Presentations included in-country training courses, twinning programs, provision of surgical laboratories and resources, existing virtual educational resources, and virtual teaching technologies, with reference to their applicability to hybrid training fellowships. Virtual learning resources developed during the coronavirus disease 2019 pandemic and high-fidelity surgical simulators were presented, some for the first time to this audience. CONCLUSIONS The summit provided a forum for discussion of challenges and opportunities for developing a collaborative consortium capable of designing a pilot program for efficient, sustainable, accessible, and affordable clinical neurosurgery fellowship models for the future.
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Affiliation(s)
- Caitlin Hoffman
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Roger Härtl
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Nathan A Shlobin
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Tshibambe N Tshimbombu
- Department of Neurosurgery, Geisel School of Medicine, Dartmouth University, Hannover, New Hampshire, USA
| | - Samer K Elbabaa
- Section of Pediatric and Fetal Neurosurgery, Orlando Health Arnold Palmer Hospital for Children, Orlando, Florida, USA
| | - Michael M Haglund
- Division of Global Neurosurgery and Neurology and Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA
| | - Andrés M Rubiano
- Neurosciences Institute, Neurosurgery Service, El Bosque University, El Bosque Clinic, MEDITECH-INUB Research Group, Bogotá, Colombia
| | - Michael C Dewan
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Martina Stippler
- Division of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Muhammad Raji Mahmud
- Neurosurgery Unit, Department of Surgery, Ahmadu Bello University, Zaria Kaduna, Nigeria; Division of Neurosurgery, Department of Surgery, SUNY Downstate Health Sciences University, Brooklyn, New York, USA; Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK; NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK; School of Medicine, Stanford School of Medicine, Stanford, California, USA
| | - Ernest J Barthélemy
- Division of Neurosurgery, Department of Surgery, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Dylan P Griswold
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK; NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK; School of Medicine, Stanford School of Medicine, Stanford, California, USA
| | | | - Hamisi K Shabani
- Department of Neurosurgery, Muhimbili Orthopaedic Institute, Dar es Salaam, Tanzania
| | - Brandon Rocque
- Division of Pediatric Neurosurgery, Department of Neurosurgery, Children's of Alabama, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - David I Sandberg
- Division of Pediatric Neurosurgery, University of Texas Health Sciences Center, McGovern Medical School and Children's Memorial Hermann Hospital, Houston, Texas, USA
| | - Jesús Lafuente
- Department of Neurosurgery, Hospital Universitario del Mar, Barcelona, Spain
| | - Robert Dempsey
- Department of Neurological Surgery, University of Wisconsin, Madison, Wisconsin, USA
| | - Gail Rosseau
- Department of Neurological Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
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21
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Shlobin NA, Punchak MA, Boyke AE, Beestrum M, Gutzman K, Rosseau G. Language and Geographic Representation of Neurosurgical Journals: A Meta-Science Study. World Neurosurg 2022; 166:171-183. [PMID: 35953039 DOI: 10.1016/j.wneu.2022.08.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/31/2022] [Accepted: 08/01/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Medical journals have a role in promoting representation of neurosurgeons who speak primary languages other than English. We sought to characterize the language of publication and geographic origin of neurosurgical journals, delineate associations between impact factor (IF) and language and geographic variables, and describe steps to overcome language barriers to publishing. METHODS Web of Science, Scopus, and Ulrich's Serial Analysis system were searched for neurosurgery journals. The journals were screened for relevance. Language of publication, country and World Health Organization region, World Bank income status and gross domestic product, and citation metrics were extracted. RESULTS Of 867 journals, 74 neurosurgical journals were included. Common publication languages were English (52, 70.3%), Mandarin (5, 6.8%), and Spanish (4, 5.4%). Countries of publication for the greatest number of journals were the United States (23, 31.1%), United Kingdom (8, 10.8%), and China (6, 8.1%). Most journals originated from the Americas region (29, 39.2%), the European region (28, 37.8%), and from high-income countries (n = 54, 73.0%). Median IF was 1.55 (interquartile range [IQR] 0.89-2.40). Journals written in English (1.77 [IQR 1.00-2.87], P = 0.032) and from high-income countries (1.81 [IQR 1.0-2.70], P = 0.046) had highest median IF. When excluding outliers, there was a small but positive correlation between per capita gross domestic product and IF (β = 0.021, P = 0.03, R2 = 0.097). CONCLUSIONS Language concordance represents a substantial barrier to research equity in neurosurgery, limiting dissemination of ideas of merit that currently have inadequate outlets for readership. Initiatives aimed at increasing the accessibility of neurosurgical publishing to underrepresented authors are essential.
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Affiliation(s)
- Nathan A Shlobin
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
| | - Maria A Punchak
- Department of Neurosurgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA
| | - Andre E Boyke
- Department of Neurosurgery, Mount Sinai Icahn School of Medicine, New York, New York, USA
| | - Molly Beestrum
- Galter Health Sciences Library, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Karen Gutzman
- Galter Health Sciences Library, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Gail Rosseau
- Department of Neurological Surgery, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
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22
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Gempeler A, Griswold DP, Rosseau G, Johnson WD, Kaseje N, Kolias A, Hutchinson PJ, Rubiano AM. An Umbrella Review With Meta-Analysis of Chest Computed Tomography for Diagnosis of COVID-19: Considerations for Trauma Patient Management. Front Med (Lausanne) 2022; 9:900721. [PMID: 35957847 PMCID: PMC9360488 DOI: 10.3389/fmed.2022.900721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 06/06/2022] [Indexed: 12/01/2022] Open
Abstract
Background RT-PCR testing is the standard for diagnosis of COVID-19, although it has its suboptimal sensitivity. Chest computed tomography (CT) has been proposed as an additional tool with diagnostic value, and several reports from primary and secondary studies that assessed its diagnostic accuracy are already available. To inform recommendations and practice regarding the use of chest CT in the in the trauma setting, we sought to identify, appraise, and summarize the available evidence on the diagnostic accuracy of chest CT for diagnosis of COVID-19, and its application in emergency trauma surgery patients; overcoming limitations of previous reports regarding chest CT accuracy and discussing important considerations regarding its role in this setting. Methods We conducted an umbrella review using Living Overview of Evidence platform for COVID-19, which performs regular automated searches in MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and more than 30 other sources. The review was conducted following the JBI methodology for systematic reviews. The Grading of Recommendations, Assessment, Development, and Evaluation approach for grading the certainty of the evidence is reported (registered in International Prospective Register of Systematic Reviews, CRD42020198267). Results Thirty studies that fulfilled selection criteria were included; 19 primary studies provided estimates of sensitivity (0.91, 95%CI = [0.88–0.93]) and specificity (0.73, 95%CI = [0.61; 0.82]) of chest CT for COVID-19. No correlation was found between sensitivities and specificities (ρ = 0.22, IC95% [–0.33; 0.66]). Diagnostic odds ratio was estimated at: DOR = 27.5, 95%CI (14.7; 48.5). Evidence for sensitivity estimates was graded as MODERATE, and for specificity estimates it was graded as LOW. Conclusion The value of chest CT appears to be that of an additional screening tool that can easily detect PCR false negatives, which are reportedly highly frequent. Upon the absence of PCR testing and impossibility to perform RT-PCR in trauma patients, chest CT can serve as a substitute with increased value and easy implementation. Systematic Review Registration [www.crd.york.ac.uk/prospero], identifier [CRD42020198267].
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Affiliation(s)
- Andrés Gempeler
- Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali, Colombia
| | - Dylan P. Griswold
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, United Kingdom
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke’s Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Gail Rosseau
- Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington, DC, United States
| | - Walter D. Johnson
- School of Medicine and Public Health, Loma Linda University, Loma Linda, CA, United States
| | | | - Angelos Kolias
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, United Kingdom
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke’s Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Peter J. Hutchinson
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, United Kingdom
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke’s Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Andres M. Rubiano
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, United Kingdom
- Neuroscience Institute, INUB-MEDITECH Research Group, El Bosque University, Bogotá, Colombia
- Neurological Surgery Service, Vallesalud Clinic, Cali, Colombia
- *Correspondence: Andres M. Rubiano,
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23
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Zimmerman K, Salehani A, Shlobin NA, Oates GR, Rosseau G, Rocque BG, Lam S, Blount JP. Community-engaged research: a powerful tool to reduce health disparities and improve outcomes in pediatric neurosurgery. J Neurosurg Pediatr 2022; 30:1-3. [PMID: 35901691 DOI: 10.3171/2022.5.peds22184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Kathrin Zimmerman
- 1Division of Pediatric Neurosurgery, Department of Neurosurgery, University of Alabama at Birmingham
| | - Arsalaan Salehani
- 2Department of Neurosurgery, University of Alabama at Birmingham, Alabama
| | - Nathan A Shlobin
- 3Division of Pediatric Neurosurgery, Ann and Robert H. Lurie Children's Hospital of Chicago
- 4Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Gabriela R Oates
- 5Department of Pediatrics, University of Alabama at Birmingham, Alabama; and
| | - Gail Rosseau
- 6Department of Neurosurgery, The George Washington University, Washington, DC
| | - Brandon G Rocque
- 1Division of Pediatric Neurosurgery, Department of Neurosurgery, University of Alabama at Birmingham
| | - Sandi Lam
- 3Division of Pediatric Neurosurgery, Ann and Robert H. Lurie Children's Hospital of Chicago
- 4Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Jeffrey P Blount
- 1Division of Pediatric Neurosurgery, Department of Neurosurgery, University of Alabama at Birmingham
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24
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Shlobin NA, Radwanski RE, Sandhu MRS, Rosseau G, Dahdaleh NS. Increasing Equity in Medical Student Neurosurgery Education Through Distance Learning. World Neurosurg 2022; 163:187-196.e8. [PMID: 35729820 DOI: 10.1016/j.wneu.2021.09.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 09/06/2021] [Accepted: 09/07/2021] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Addressing equitable opportunities for medical student (MS) education is important for minimizing disparities in neurosurgical care. However, international MSs, particularly from low- and middle-middle income countries (LMICs) may lack access to educational opportunities compared with their contemporaries in high-income countries. We compare the usefulness of virtual neurosurgery training camps (VNTC) between U.S. and international MSs. METHODS A survey assessing demographics, baseline interests, and ratings of usefulness was sent to attendees after the VNTC. Ratings were compared between international and U.S. MSs. RESULTS Thirty-three (27.7%) of 119 attendees were international MSs, of whom 24 (72.7%) were from LMICs. International MSs were more likely to hold an advanced degree (P = 0.0009), more likely to be MS3/MS4s (P = 0.0111) or postdoctoral (P < 0.0001), and less likely to be MS1/MS2s (P = 0.0059). After the VNTC, international MSs reported greater increase in interest in neurosurgery in general (P = 0.0009) and subspecialties of spine (P = 0.0002), peripheral nerve (P = 0.002), vascular (P = 0.0468), functional/epilepsy (P = 0.001), pediatric (P = 0.0285), and trauma/neurocritical care (P = 0.0067). International MSs reported greater post-VNTC willingness to pursue a career in neurosurgery (P = 0.0001), likelihood of taking a year off during medical school (P = 0.0363), and preparedness for subinternships (P = 0.0003). International MSs reported greater increases in awareness of burnout (P = 0.0157) and work-life balance in neurosurgery (P = 0.0249). CONCLUSIONS International MSs experience prolonged periods of education before applying to residency and have unmet informational needs. Distance learning is useful for international MSs. MS neurosurgery education, through online platforms, represents a long-term strategy for addressing disparities in neurosurgical care worldwide.
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Affiliation(s)
- Nathan A Shlobin
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Medical Student Neurosurgery Training Center, Brain and Spine Group, Inc., Pasadena, California, USA.
| | - Ryan E Radwanski
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Medical Student Neurosurgery Training Center, Brain and Spine Group, Inc., Pasadena, California, USA
| | - Mani Ratnesh S Sandhu
- Department of Laboratory Medicine, Yale University School of Medicine, New Haven, Connecticut, USA; Medical Student Neurosurgery Training Center, Brain and Spine Group, Inc., Pasadena, California, USA
| | - Gail Rosseau
- Department of Neurological Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Nader S Dahdaleh
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Medical Student Neurosurgery Training Center, Brain and Spine Group, Inc., Pasadena, California, USA
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25
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Maleknia P, Shlobin NA, Johnston JM, Rosseau G. Establishing collaborations in global neurosurgery: The role of InterSurgeon. J Clin Neurosci 2022; 100:164-168. [PMID: 35487022 DOI: 10.1016/j.jocn.2022.04.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 04/12/2022] [Accepted: 04/15/2022] [Indexed: 11/28/2022]
Abstract
The global deficiency in surgical care has been highlighted in the past several years, through the publication of the Lancet Commission on Global Surgery in 2015, the passage of WHA Resolution 68.15, and concerted efforts by advocacy organizations such as the G4 Alliance.Approximately 23,300 additional neurosurgeons are estimated to be needed to address the greater than 5 million essential neurosurgical cases that are not performed annually, most in low- and middle-income countries (LMICs). However, increasing recognition of the ease and feasibility of virtual technology prompted a shift towards virtual modes of communication. InterSurgeon (https://www.intersurgeon.org/), an independent, internet-based social network platform, has allowed for formal connection between global surgery advocates who may have complementary needs and resources.This manuscript aims to: 1) characterize the current progress of InterSurgeon, 2) describe lessons learned from the creation and use of InterSurgeon, and 3) discuss future directions for InterSurgeon. Equitable, well-designed collaborations are central to progress in global neurosurgery. InterSurgeon has catalyzed collaborations within global neurosurgery across world regions and country income status. In addition to its role in facilitating traditional in person collaborations, InterSurgeon will become an increasingly important tool for connecting surgeons worldwide as virtual collaboration and augmented reality training paradigms become important components of global surgery capacity building.
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Affiliation(s)
- Pedram Maleknia
- Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Nathan A Shlobin
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - James M Johnston
- Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Gail Rosseau
- Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
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Mediratta S, Lippa L, Venturini S, Demetriades AK, El-Ouahabi A, Gandía-González ML, Harkness W, Hutchinson P, Park KB, Rabiei K, Rosseau G, Schaller K, Servadei F, Lafuente J, Kolias AG. Current state of global neurosurgery activity amongst European neurosurgeons. J Neurosurg Sci 2022:S0390-5616.21.05447-3. [PMID: 35147400 DOI: 10.23736/s0390-5616.21.05447-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The expanding field of global neurosurgery calls for a committed neurosurgical community to advocate for universal access to timely, safe, and affordable neurosurgical care for everyone, everywhere. This study aims to (i) assess the current state of global neurosurgery activity amongst European neurosurgeons and (ii) identify barriers to involvement in global neurosurgery initiatives. METHODS Cross-sectional study through dissemination of a web-based survey, from September 2019 to January 2020, to collect data from European neurosurgeons at various career stages. Descriptive analysis was conducted on respondent data. RESULTS Three hundred and ten neurosurgeons from 40 European countries responded. 53.5% regularly follow global neurosurgery developments. 29.4% had travelled abroad with a global neurosurgery collaborative, with 23.2% planning a future trip. Respondents from high income European countries predominantly travelled to Africa (41.6%) or Asia (34.4%), whereas, respondents from middle income European countries frequently traversed Europe (63.2%) and North America (47.4). Cost implications (66.5%) were the most common barrier to global neurosurgery activity, followed by interference with current practice (45.8%), family duties (35.2%), difficulties obtaining humanitarian leave (27.7%) and lack of international partners (27.4%). 86.8% would incorporate a global neurosurgery period within training programmes. CONCLUSIONS European neurosurgeons are interested in engaging in global neurosurgery partnerships, and several sustainable programmes focused on local capacity building, education and research have been established over the last decade. However, individual and system barriers to engagement persist. We provide insight into these to allow development of tailored mechanisms to overcome such barriers, enabling European neurosurgeons to advocate for the Global Surgery 2030 goals.
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Affiliation(s)
- Saniya Mediratta
- Division of Neurosurgery, Department of Clinical Neurosciences, Cambridge Biomedical Campus, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK -
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK -
| | - Laura Lippa
- Department of Neurosurgery, Ospedali Riuniti, Livorno, Italy
| | - Sara Venturini
- Division of Neurosurgery, Department of Clinical Neurosciences, Cambridge Biomedical Campus, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
| | - Andreas K Demetriades
- Department of Neurosurgery, Royal Infirmary of Edinburgh, Little France, Edinburgh, UK
| | | | - Maria L Gandía-González
- Department of Neurosurgery, Hospital Universitario La Paz, Madrid, Spain
- CranioSPain Research Group, Instituto de Neurociencias y Ciencias del Movimiento (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | | | - Peter Hutchinson
- Division of Neurosurgery, Department of Clinical Neurosciences, Cambridge Biomedical Campus, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
| | - Kee B Park
- Global Neurosurgery Initiative, Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Katrin Rabiei
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg, Sweden
| | - Gail Rosseau
- George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Karl Schaller
- Neurosurgery Division, Department of Clinical Neurosciences, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Franco Servadei
- H umanitas Clinical and Research Center - IRCCS, Rozzano, Milano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milano, Italy
| | - Jesus Lafuente
- Departamento de Neurocirugía, Hospital del Mar, Barcelona, España
| | - Angelos G Kolias
- Division of Neurosurgery, Department of Clinical Neurosciences, Cambridge Biomedical Campus, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
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Hernández-Durán S, Drummond K, Karekezi C, Murphy M, Nejat F, Zanon N, Rosseau G. International Women in Neurosurgery. Adv Tech Stand Neurosurg 2022; 45:1-33. [PMID: 35976446 DOI: 10.1007/978-3-030-99166-1_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The history of women in neurosurgery worldwide has been characterized by adversity and hardships in a male-dominated field, where resilient, tenacious, and ingenious women have nevertheless left their mark. The first women in neurosurgery appeared in Europe at the end of the 1920s, and since then have emerged in all continents in the world. Women neurosurgeons all over the globe have advanced the field in numerous directions, introducing neurosurgical subspecialties to their countries, making scientific and technical advances, and dedicating themselves to humanitarian causes, to name a few. The past 30 years, in particular, have been a period of increasing involvement and responsibility for women in neurosurgery. We must now focus on continual system improvements that will promote a diverse and talented workforce, building a welcoming environment for all aspiring neurosurgeons, in order to advance the specialty in the service of neurosurgical patients.
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Affiliation(s)
- Silvia Hernández-Durán
- Department of Neurological Surgery, Universitätsmedizin Göttingen, Göttingen, Germany.
- European Association of Neurosurgical Societies, Diversity Task Force, Brussels, Belgium.
| | - Katharine Drummond
- Department of Neurosurgery, The Royal Melbourne Hospital, Parkville, VIC, Australia
- Department of Surgery, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Claire Karekezi
- Neurosurgery Unit, Department of Surgery, Rwanda Military Hospital, Kigali, Rwanda
| | - Mary Murphy
- Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, UK
| | - Farideh Nejat
- Tehran University of Medical Science, Children's Medical Center, Tehran, Iran
| | - Nelci Zanon
- Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo, Brazil
- CENEPE Centro de Neurocirurgia pediátrica (Pediatric Neurosurgical Center), São Paulo, Brazil
| | - Gail Rosseau
- Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
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Lambrianou X, Tzerefos C, Janssen IK, Mihaylova S, Aydin AE, Al-Ahmad S, Broekman MLD, Gazioglu N, Duran SH, Ivan DL, Karampouga M, Magnadottir HB, Pajaj E, Rodríguez-Hernández A, Rosseau G, Salokorpi N, Tsianaka E, Vayssiere P, Murphy M, Tasiou A. Gender differences in work-life balance of European neurosurgeons. Brain and Spine 2022; 2:101100. [PMID: 36248165 PMCID: PMC9562249 DOI: 10.1016/j.bas.2022.101100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 08/16/2022] [Accepted: 08/25/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Xanthoula Lambrianou
- Department of Neurosurgery, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Christos Tzerefos
- Department of Neurosurgery, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Insa K. Janssen
- Department of Neurosurgery, Hôpitaux Universitaires de Genève, Geneva, Switzerland
| | - Stiliana Mihaylova
- Clinic of Neurosurgery, Sv. Ivan Rilski University Hospital, Medical University of Sofia, Sofia, Bulgaria
| | | | - Selma Al-Ahmad
- Neurosurgery Department, Sheffield Teaching Hospitals, Sheffield, UK
| | - Marike LD. Broekman
- Department of Neurosurgery, Haaglanden Medical Center and Leiden University Medical Center, Leiden, the Netherlands
| | - Nurperi Gazioglu
- Istinye University, Medical Faculty, Department of Neurosurgery, Istanbul, Turkey
| | | | - Daniela Luminita Ivan
- Department of Neurosurgery, Bucharest Emergency University Hospital, Carol Davila University of Medicine, Bucharest, Romania
| | - Maria Karampouga
- Neurosurgery Department, Nicosia General Hospital, Nicosia, Cyprus
| | | | - Ermira Pajaj
- Department of Neurosurgery, Spitali Rajonal Memorial Fier, Fier, Albania
| | - Ana Rodríguez-Hernández
- Department of Neurological Surgery, Germans Trias i Pujol University Hospital, Universidad Autónoma, Barcelona, Spain
| | - Gail Rosseau
- Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Niina Salokorpi
- Department of Neurosurgery, Oulu University Hospital, Oulu, Finland and Research Unit of Clinical Neuroscience, Medical Research Center, Oulu University, Oulu, Finland
| | - Eleni Tsianaka
- Neurosurgery Department, International Hospital, Salmiya, Kuwait
| | - Pia Vayssiere
- Department of Neurosurgery, Hôpitaux Universitaires de Genève, Geneva, Switzerland
| | - Mary Murphy
- Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Anastasia Tasiou
- Department of Neurosurgery, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
- Corresponding author. Department of Neurosurgery, Building A, 3rd Floor, University Hospital of Larissa, Biopolis, Larissa, 41110, Greece.
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Saraceno G, Servadei F, Terzi DI Bergamo L, Iaccarino C, Rubiano AM, Zoia C, Raffa G, Hawryluk G, Grotenhuis A, Demetriades AK, Sala F, Belotti F, Zanin L, Doglietto F, Panciani PP, Biroli A, Agosti E, Serioli S, Rasulic L, Bruneau M, Germano IM, Bosnjak R, Thomé C, Regli L, Vukic M, Tessitore E, Schaller K, Chaurasia B, El-Ghandour NMF, DI Ieva A, Bongetta D, Borghesi I, Fazio M, Esene IN, Rosseau G, El Abbadi N, Baccanelli M, Vajkoczy P, Fontanella MM. Do neurosurgeons follow the guidelines? A world-based survey on severe traumatic brain injury. J Neurosurg Sci 2021; 65:465-473. [PMID: 34814649 DOI: 10.23736/s0390-5616.21.05475-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Traumatic brain injury (TBI) is going to be the third-leading cause of death worldwide, according to the WHO. Two European surveys suggested that adherence to brain trauma guidelines is poor. No study has compared compliance between low- (LMICs) and high-income (UHICs) countries. Hence, this study aimed to investigate differences in the management of severe TBI patients, comparing low- and high-income, and adherence to the BTF guidelines. METHODS A web-based survey was spread through the Global Neuro Foundation, different neurosurgical societies, and social media. RESULTS A total of 803 neurosurgeons participated: 70.4 from UHICs and 29.6% from LMICs. Hypertonic was administered as an early measure by the 73% and 65% of the responders in LMICs and UHICs, respectively (P=0.016). An invasive intracranial pressure monitoring was recommended by the 66% and 58% of the neurosurgeons in LMICs and UHICs, respectively (P<0.001). Antiseizure drugs (P<0.001) were given most frequently in LMICs as, against recommendations, steroids (87% vs. 61% and 86% vs. 81%, respectively). In the LMICs both the evacuation of the contusion and decompressive craniectomy were performed earlier than in UHICs (30% vs. 17% with P<0.001 and 44% vs. 28% with P=0.006, respectively). In the LMICs, the head CT control was performed mostly between 12 and 24 hours from the first imaging (38% vs. 23%, P<0.001). CONCLUSIONS The current Guidelines on TBI do not always fit to both the resources and circumstances in different countries. Future research and clinical practice guidelines should reflect the greater relevance of TBI in low resource settings.
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Affiliation(s)
- Giorgio Saraceno
- Unit of Neurosurgery, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Franco Servadei
- Humanitas Reasearch Hospital-IRCCS and Humanitas University, Rozzano, Milan, Italy
| | | | - Corrado Iaccarino
- Division of Neurosurgery, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, University Hospital of Modena, Modena, Italy
| | - Andrés M Rubiano
- Neuroscience Institute, El Bosque University, Bogotà, Colombia.,Meditech Foundation, Cali, Colombia
| | - Cesare Zoia
- Department of Neurosurgery, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Giovanni Raffa
- Department of Neurosurgery, Messina University Hospital, Messina, Italy
| | - Gregory Hawryluk
- Section of Neurosurgery Winnipeg Health Sciences Center, University of Manitoba, Winnipeg, MB, Canada
| | - André Grotenhuis
- Department of Neurosurgery, Radboud University, Nijmegen, the Netherlands
| | | | - Francesco Sala
- Section of Neurosurgery, Department of Neurosciences, Biomedicine and Movement Sciences, Verona University Hospital, Verona, Italy
| | - Francesco Belotti
- Unit of Neurosurgery, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy -
| | - Luca Zanin
- Unit of Neurosurgery, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Francesco Doglietto
- Unit of Neurosurgery, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Pier Paolo Panciani
- Unit of Neurosurgery, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Antonio Biroli
- Unit of Neurosurgery, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Edoardo Agosti
- Unit of Neurosurgery, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Simona Serioli
- Unit of Neurosurgery, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Lukas Rasulic
- Clinic for Neurosurgery, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Michaël Bruneau
- Department of Neurosurgery, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Isabelle M Germano
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Roman Bosnjak
- Department of Neurosurgery, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Claudius Thomé
- Department of Neurosurgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Luca Regli
- Department of Neurosurgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Miroslav Vukic
- Department of Neurosurgery, University Hospital Center Zagreb, Zagreb, Croatia
| | - Enrico Tessitore
- Unit of Neurosurgery, Faculty of Medicine, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
| | - Karl Schaller
- Unit of Neurosurgery, Faculty of Medicine, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
| | - Bipin Chaurasia
- Department of Neurosurgery, Bhawani Hospital and Research Center, Saraiyaganj, Muzaffarpur, Birgunj, Nepal
| | | | - Antonio DI Ieva
- Department of Clinical Medicine, Faculty of Medicine, Human and Health Sciences, Macquarie University, Sydney, Australia
| | - Daniele Bongetta
- Department of Neurosurgery, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Ignazio Borghesi
- Department of Neurosurgery, GVM Care and Research, Maria Cecilia Hospital, Cotignola, Ravenna, Italy
| | - Marco Fazio
- Department of Neurosurgery, GVM Care and Research, Maria Cecilia Hospital, Cotignola, Ravenna, Italy
| | - Ignatius N Esene
- Division of Neurosurgery, Faculty of Health Sciences, University of Bamenda, Bambili, Cameroon
| | - Gail Rosseau
- Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington DC, USA
| | - Najia El Abbadi
- Department of Neurosurgery, International Cheikh Zaid Hospital, Abulcassis University of Health Sciences, Rabat, Morocco
| | - Matteo Baccanelli
- Department of Neurosurgery, Buenos Aires Italian Hospital, Buenos Aires, Argentina
| | - Peter Vajkoczy
- Department of Neurosurgery, Charité Medical University, Berlin, Germany
| | - Marco M Fontanella
- Unit of Neurosurgery, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
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Shlobin NA, Kedda J, Wishart D, Garcia RM, Rosseau G. Surgical Management of Chronic Subdural Hematoma in Older Adults: A Systematic Review. J Gerontol A Biol Sci Med Sci 2021; 76:1454-1462. [PMID: 33220683 DOI: 10.1093/gerona/glaa293] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Chronic subdural hematoma (cSDH) is a form of intracranial hemorrhage common in older adults. Optimal treatment remains controversial. We conducted a systematic review to identify surgical thresholds, characterize outcomes, and delineate critical considerations in the surgical management of older adults in order to summarize the evidence supporting the best contemporary management of cSDH. METHODS A systematic review exploring surgical management of cSDH among individuals aged 65 years and older was conducting by searching the PubMed, Embase, and Scopus databases for articles in English. Abstracts from articles were read and selected for full-text review according to a priori criteria. Relevant full-text articles were analyzed for bibliographic data, aim, study design, population, interventions, and outcomes. RESULTS Of 1473 resultant articles, 21 were included. Surgery rationale was case-by-case for symptomatic patients with cSDH. Surgery was superior to conservative management and promoted equivalent neurologic outcomes and rates of complications. Recurrence and reoperation rates in older adults were similar to younger individuals. Some studies reported higher mortality rates for older adults, while others reported no difference. Anticoagulation or antiplatelet agent use did not seem to be associated with poorer outcomes in older adults. CONCLUSIONS Surgery for cSDH in older adults leads to favorable neurologic outcomes without increased risk of overall complications, recurrence, or reoperation compared to younger patients. However, older adults may be at increased risk for mortality after surgery. It is important to determine use of anticoagulant or antiplatelet agents in older adults to optimally manage patients with cSDH.
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Affiliation(s)
- Nathan A Shlobin
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Jayanidhi Kedda
- Department of Neurosurgery, George Washington University School of Medicine & Health Sciences, Washington, District of Columbia
| | - Danielle Wishart
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Roxanna M Garcia
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Gail Rosseau
- Department of Neurosurgery, George Washington University School of Medicine & Health Sciences, Washington, District of Columbia
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Lepard JR, Spagiari R, Corley J, Barthélemy EJ, Kim E, Patterson R, Venturini S, Still MEH, Lo YT, Rosseau G, Mekary RA, Park KB. Differences in outcomes of mandatory motorcycle helmet legislation by country income level: A systematic review and meta-analysis. PLoS Med 2021; 18:e1003795. [PMID: 34534215 PMCID: PMC8486090 DOI: 10.1371/journal.pmed.1003795] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 10/01/2021] [Accepted: 09/03/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The recent Lancet Commission on Legal Determinants of Global Health argues that governance can provide the framework for achieving sustainable development goals. Even though over 90% of fatal road traffic injuries occur in low- and middle-income countries (LMICs) primarily affecting motorcyclists, the utility of helmet laws outside of high-income settings has not been well characterized. We sought to evaluate the differences in outcomes of mandatory motorcycle helmet legislation and determine whether these varied across country income levels. METHODS AND FINDINGS A systematic review and meta-analysis were completed using the PRISMA checklist. A search for relevant articles was conducted using the PubMed, Embase, and Web of Science databases from January 1, 1990 to August 8, 2021. Studies were included if they evaluated helmet usage, mortality from motorcycle crash, or traumatic brain injury (TBI) incidence, with and without enactment of a mandatory helmet law as the intervention. The Newcastle-Ottawa Scale (NOS) was used to rate study quality and funnel plots, and Begg's and Egger's tests were used to assess for small study bias. Pooled odds ratios (ORs) and their 95% confidence intervals (CIs) were stratified by high-income countries (HICs) versus LMICs using the random-effects model. Twenty-five articles were included in the final analysis encompassing a total study population of 31,949,418 people. There were 17 retrospective cohort studies, 2 prospective cohort studies, 1 case-control study, and 5 pre-post design studies. There were 16 studies from HICs and 9 from LMICs. The median NOS score was 6 with a range of 4 to 9. All studies demonstrated higher odds of helmet usage after implementation of helmet law; however, the results were statistically significantly greater in HICs (OR: 53.5; 95% CI: 28.4; 100.7) than in LMICs (OR: 4.82; 95% CI: 3.58; 6.49), p-value comparing both strata < 0.0001. There were significantly lower odds of motorcycle fatalities after enactment of helmet legislation (OR: 0.71; 95% CI: 0.61; 0.83) with no significant difference by income classification, p-value: 0.27. Odds of TBI were statistically significantly lower in HICs (OR: 0.61, 95% CI 0.54 to 0.69) than in LMICs (0.79, 95% CI 0.72 to 0.86) after enactment of law (p-value: 0.0001). Limitations of this study include variability in the methodologies and data sources in the studies included in the meta-analysis as well as the lack of available literature from the lowest income countries or from the African WHO region, in which helmet laws are least commonly present. CONCLUSIONS In this study, we observed that mandatory helmet laws had substantial public health benefits in all income contexts, but some outcomes were diminished in LMIC settings where additional measures such as public education and law enforcement might play critical roles.
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Affiliation(s)
- Jacob R. Lepard
- Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
- * E-mail:
| | | | - Jacquelyn Corley
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Ernest J. Barthélemy
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Neurosurgery, Mount Sinai Health System, New York, New York, United States of America
| | - Eliana Kim
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
- University of California-San Francisco School of Medicine, San Francisco, California, United States of America
| | - Rolvix Patterson
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
- Tufts University School of Medicine, Boston, Massachusetts, United States of America
| | - Sara Venturini
- Aberdeen Royal Infirmary, Aberdeen, Scotland, United Kingdom
| | - Megan E. H. Still
- Department of Neurosurgery, University of Florida, Gainesville, Florida, United States of America
| | - Yu Tung Lo
- Department of Neurosurgery, National Neuroscience Institute, Singapore
- Computational Neuroscience Outcomes Center, Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Gail Rosseau
- Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington, DC, United States of America
| | - Rania A. Mekary
- Computational Neuroscience Outcomes Center, Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- School of Pharmacy, MCPHS University, Boston, Massachusetts, United States of America
| | - Kee B. Park
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
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Shlobin NA, Kanmounye US, Ozair A, de Koning R, Zolo Y, Zivkovic I, Niquen-Jimenez M, Affana CK, Jogo L, Abongha GB, Garba DL, Rosseau G. Educating the Next Generation of Global Neurosurgeons: Competencies, Skills, and Resources for Medical Students Interested in Global Neurosurgery. World Neurosurg 2021; 155:150-159. [PMID: 34464771 DOI: 10.1016/j.wneu.2021.08.091] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 08/20/2021] [Accepted: 08/21/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Global neurosurgery operates at the intersection of neurosurgery and public health. Although most global neurosurgery initiatives have targeted neurosurgeons and trainees, medical students represent the future of global neurosurgery. METHODS A narrative review of the literature regarding research methodology, education, economics, health policy, health advocacy, relevant to global neurosurgery was conducted. RESULTS We summarize pearls that all medical students interested in global neurosurgery should know. DISCUSSION To become effective agents of change within global neurosurgery, medical students must master competencies of motivation, organization, collaborativeness, dependability, flexibility, resilience, creative problem-solving, ethical thinking, cultural humility, and global awareness and gain knowledge and skills regarding research, education, policy making, and advocacy. Discussions with neurosurgeons and trainees, neurosurgery interest groups, conferences, university global neurosurgery initiatives, and student organizations represent opportunities for learning and becoming involved in global neurosurgery.
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Affiliation(s)
- Nathan A Shlobin
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; World Federation of Neurosurgical Societies Global Neurosurgery Committee, Nyon, Vaud, Switzerland; Foundation for International Education in Neurological Surgery; G4 Alliance, Chicago, Illinois, USA.
| | - Ulrick Sidney Kanmounye
- World Federation of Neurosurgical Societies Global Neurosurgery Committee, Nyon, Vaud, Switzerland; Foundation for International Education in Neurological Surgery; Research Department, Association of Future African Neurosurgeons, Cameroon; Department of Neurosurgery, University of Kinsasha Faculty of Medicine, Kinsasha, Democratic Republic of the Congo
| | - Ahmad Ozair
- Faculty of Medicine, King George's Medical University, Lucknow, India
| | | | - Yvan Zolo
- World Federation of Neurosurgical Societies Global Neurosurgery Committee, Nyon, Vaud, Switzerland; Department of Neurosurgery, University of Kinsasha Faculty of Medicine, Kinsasha, Democratic Republic of the Congo; Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | - Irena Zivkovic
- School of Medicine, University of British Columbia Faculty of Medicine, Vancouver, Canada
| | - Milagros Niquen-Jimenez
- World Federation of Neurosurgical Societies Global Neurosurgery Committee, Nyon, Vaud, Switzerland; Facultad de Medicina Humana Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - Leslie Jogo
- Faculty of Medicine and Biomedical Sciences, University of Ngaoundéré, Garoua, Cameroon
| | | | - Deen L Garba
- World Federation of Neurosurgical Societies Global Neurosurgery Committee, Nyon, Vaud, Switzerland; Department of Neurosurgery, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Gail Rosseau
- World Federation of Neurosurgical Societies Global Neurosurgery Committee, Nyon, Vaud, Switzerland; Foundation for International Education in Neurological Surgery; G4 Alliance, Chicago, Illinois, USA; Department of Neurological Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
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Rosseau G, Kim EE, Barthélemy EJ, Yusuf M, Dahir SM, Tolessa CS, Yusuuf MA, Carter A, Vryhof D, Geelhoed GW, Shlobin NA. The Current State of Neurosurgery in Somaliland. World Neurosurg 2021; 153:44-51. [PMID: 34229101 DOI: 10.1016/j.wneu.2021.06.136] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/26/2021] [Accepted: 06/28/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Surgical conditions account for as much as one third of the global burden of disease, yet 5 billion people worldwide do not have access to timely, affordable surgical care. These disparities in access to timely surgical care are most pronounced in low- and middle-income countries, where the availability of specialty surgical services such as neurosurgery are severely limited or completely absent. The African autonomous region of Somaliland, in the Horn of Africa, is one such region. METHODS Discussions were conducted with key individuals in Somaliland to ascertain the current state of neurosurgery in Somaliland. RESULTS The current state of neurosurgery in Somaliland was characterized. First, a background on the recent history of the republic and the surrounding region was furnished, which provides context for the challenging socioeconomic conditions in Somaliland. Brief biographical sketches were presented of local leaders and general surgeons who are actively working to improve economic and health conditions and who welcome opportunities to improve all health services, including neurosurgery. In addition, an overview was presented of new initiatives in capacity building in neurosurgery and sources of directed training and care in neurosurgery. CONCLUSIONS This article provides the first-ever assessment of current neurosurgery-related activity in Somaliland. The article provides recommendations to guide the international neurosurgery community in future contributions.
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Affiliation(s)
- Gail Rosseau
- Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington, D.C., USA.
| | - Eliana E Kim
- University of California San Francisco School of Medicine, San Francisco, California, USA
| | - Ernest J Barthélemy
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Musa Yusuf
- Department of Emergency Medicine, Hargeisa Group Hospital, Hargeisa, Somaliland
| | | | | | | | - Ashley Carter
- Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Daniel Vryhof
- Department of Emergency Medicine, Yale University, New Haven, Connecticut, USA
| | - Glenn W Geelhoed
- Office of the Dean, George Washington University Medical Center, Washington, D.C., USA
| | - Nathan A Shlobin
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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Shlobin NA, Rosseau G. Erratum to: A Call for Studies Examining the Management of Chronic Subdural Hematoma in Older Adult Cohorts. J Gerontol A Biol Sci Med Sci 2021; 77:e110. [PMID: 34184739 DOI: 10.1093/gerona/glab129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Nathan A Shlobin
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, US
| | - Gail Rosseau
- Department of Neurosurgery, George Washington University School of Medicine & Health Sciences, Washington, District of Columbia, US
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Griswold D, Gempeler A, Rosseau G, Kaseje N, Johnson WD, Kolias A, Hutchinson PJ, Rubiano AM. Chest Computed Tomography for the Diagnosis of COVID-19 in Emergency Trauma Surgery Patients Who Require Urgent Care During the Pandemic: Protocol for an Umbrella Review. JMIR Res Protoc 2021; 10:e25207. [PMID: 33878019 PMCID: PMC8104001 DOI: 10.2196/25207] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 12/01/2020] [Accepted: 03/17/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Many health care facilities in low- and middle-income countries are inadequately resourced. COVID-19 has the potential to decimate surgical health care services unless health systems take stringent measures to protect health care workers from viral exposure and ensure the continuity of specialized care for patients. Among these measures, the timely diagnosis of COVID-19 is paramount to ensure the use of protective measures and isolation of patients to prevent transmission to health care personnel caring for patients with an unknown COVID-19 status or contact during the pandemic. Besides molecular and antibody tests, chest computed tomography (CT) has been assessed as a potential tool to aid in the screening or diagnosis of COVID-19 and could be valuable in the emergency care setting. OBJECTIVE This paper presents the protocol for an umbrella review that aims to identify and summarize the available literature on the diagnostic accuracy of chest CT for COVID-19 in trauma surgery patients requiring urgent care. The objective is to inform future recommendations on emergency care for this category of patients. METHODS We will conduct several searches in the L·OVE (Living Overview of Evidence) platform for COVID-19, a system that performs automated regular searches in PubMed, Embase, Cochrane Central Register of Controlled Trials, and over 30 other sources. The search results will be presented according to PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis). This review will preferentially consider systematic reviews of diagnostic test accuracy studies, as well as individual studies of such design, if not included in the systematic reviews, that assessed the sensitivity and specificity of chest CT in emergency trauma surgery patients. Critical appraisal of the included studies for risk of bias will be conducted. Data will be extracted using a standardized data extraction tool. Findings will be summarized narratively, and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach will be used to grade the certainty of evidence. RESULTS Ethics approval is not required for this systematic review, as there will be no patient involvement. The search for this systematic review commenced in October 2020, and we expect to publish the findings in early 2021. The plan for dissemination is to publish the findings in a peer-reviewed journal and present our results at conferences that engage the most pertinent stakeholders. CONCLUSIONS During the COVID-19 pandemic, protecting health care workers from infection is essential. Up-to-date information on the efficacy of diagnostic tests for detecting COVID-19 is essential. This review will serve an important role as a thorough summary to inform evidence-based recommendations on establishing effective policy and clinical guideline recommendations. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42020198267; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=198267. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/25207.
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Affiliation(s)
- Dylan Griswold
- National Institute of Health Research Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, United Kingdom.,Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Andrés Gempeler
- Clinical Research Center, Fundación Valle del Lili, Cali, Colombia
| | - Gail Rosseau
- Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington, DC, United States
| | | | - Walter D Johnson
- Schools of Medicine and Public Health, Loma Linda University, Loma Linda, CA, United States
| | - Angelos Kolias
- National Institute of Health Research Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, United Kingdom.,Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Peter J Hutchinson
- National Institute of Health Research Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, United Kingdom.,Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Andres M Rubiano
- National Institute of Health Research Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, United Kingdom.,Neuroscience Institute, INUB-MEDITECH Research Group, El Bosque University, Bogota, Colombia
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Habibi Z, Hadi NA, Kim EE, Alkhataybeh RAM, Sbeih A, Abou-Hamden A, Abdulsalam HKA, Shehhi NA, Al-Azzani R, Garozzo D, Hasan A, Namer T, Quadamkhear H, Zabihyan S, Nejat F, Rosseau G. Progress in neurosurgery: Contributions of women neurosurgeons in the Middle East. J Clin Neurosci 2021; 86:337-346. [PMID: 33653667 DOI: 10.1016/j.jocn.2021.01.055] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 01/29/2021] [Accepted: 01/31/2021] [Indexed: 11/15/2022]
Abstract
The Middle East is known for its complex history and rich environment and culture. The region is home to a wide variety of traditions, cultures and religions, which have made the area vulnerable to political conflicts. Despite these difficulties, science and medicine have always thrived in the region, with many medical practices and principles established by physicians and scholars living in the Middle East. The first academic neurosurgical activity in the region started in the 1950s. The first women neurosurgeons in the Middle East started training in the 1970s, and were from Iran, Palestine, followed by Saudi Arabia in the 1970s. These pioneers have encountered serious challenges, yet have become role models for the next generation. These women have paved the way and facilitated neurosurgical training and practice for more women surgeons. The gradual increase in the number of women neurosurgical residents in the region leads to the expectation that women will play a more prominent role in the future as leaders in neurosurgery in the Middle East. This collaborative study, which identifies the known women neurosurgeons in the Middle East for the first time, may serve to provide background and context for further contributions of women neurosurgeons for our profession and our patients.
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Affiliation(s)
- Zohreh Habibi
- Tehran University of Medical Science, Children's Medical Center, No 63, Gharib Ave, Keshavarz Blv, Tehran, Iran
| | - Nada Ayedh Hadi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Rimayah, Al Hars Al Watani, Riyadh, Saudi Arabia
| | - Eliana E Kim
- University of California-San Francisco School of Medicine, 513 Parnassus Ave. Suite S-245, San Francisco, CA 94143-0454, United States; Gender Equity Initiative in Global Surgery, 641 Huntington Avenue, Boston, MA, United States.
| | | | - Aseel Sbeih
- Department of Neurosurgery, Jordanian Royal Medical Services, PO Box 855122, Amman, Jordan
| | - Amal Abou-Hamden
- Department of Neurosurgery, Royal Adelaide Hospital, University of Adelaide, 1 Port Road, Adelaide 5000, Australia.
| | - Hissah K Al Abdulsalam
- Division of Neurosurgery, King Saud University, P.O.Box: 266, Riyadh 11362, Saudi Arabia
| | - Noora Al Shehhi
- Tawam Hospital, Maqam Street, Al Ain, Abu Dhabi, United Arab Emirates.
| | - Roqia Al-Azzani
- Department of Neurosurgery, Al-Thwra Modern General Hospital, Sana'a, Yemen
| | - Debora Garozzo
- Mediclinic Parkview Hospital, Umm Suquim, Al Barsha South 3 PO BOX 51122, Dubai, United Arab Emirates.
| | - Alya Hasan
- Neurosurgery Department, Ibn Sina Hospital, Jamal Abdel Nasser Street, PO Box 5, 13001, Kuwait
| | - Thana Namer
- Division of Neurosurgery, King AbdulAziz Medical City, Ministry of National Guard Health Affairs, Prince Mutib Ibn Abdullah Ibn Abdulaziz Rd, Ar Rimayah, Riyadh, Saudi Arabia.
| | - Hama Quadamkhear
- Department of Neurosurgery, Rozhawa Hospital, 100 Meter Street, Erbil 44001, Iraq
| | - Samira Zabihyan
- Department of Neurosurgery, Ghaem Hospital, Mashhad University of Medical Sciences, Ahmadabad Blvd., Mashhad, Iran
| | - Farideh Nejat
- Tehran University of Medical Science, Children's Medical Center, No 63, Gharib Ave, Keshavarz Blv, Tehran, Iran.
| | - Gail Rosseau
- Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Avenue, NW Washington, DC 20037, United States
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Zanon N, Niquen-Jimenez M, Kim EE, Zegarra AB, Ramírez-Reyes AG, Quiroga DP, Miller Molina EI, Santana NV, Garcia RM, Rosseau G. Progress in neurosurgery: Contributions of women neurosurgeons in Latin America. J Clin Neurosci 2021; 86:347-356. [PMID: 33653668 DOI: 10.1016/j.jocn.2021.01.054] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 01/29/2021] [Accepted: 01/31/2021] [Indexed: 11/25/2022]
Abstract
Nearly 75 years after the first woman neurosurgeon was trained in Latin America, the field of neurosurgery is changing and the prominence of women neurosurgeons within the specialty is increasing. By researching the histories of individual physicians and neurosurgeons, as well as neurosurgical departments and societies, we present, for the first time, the history of the women in neurosurgery in Latin America. Women neurosurgeons in the region have made notable progress, inspiring subsequent generations and actively participating in organized neurosurgery, medical leadership outside neurosurgery, academic neurosurgery, and leadership in contemporary society. The establishment of "Women in Neurosurgery" networks and organizations has been important to the success of many of these efforts. This collaborative study, which identifies the known women neurosurgeons in Latin America for the first time, may serve to provide background and context for further contributions of women neurosurgeons for our profession and our patients.
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Affiliation(s)
- Nelci Zanon
- Department of Neurology and Neurosurgery, Federal University of São Paulo, R. Sena Madureira, 1500 - Vila Clementino, São Paulo, SP 04021-001, Brazil; CENEPE Centro de Neurocirurgia pediátrica (Pediatric Neurosurgical Center), Rua Doutor Veiga Filho, 350, Higienópolis, São Paulo, Brazil
| | - Milagros Niquen-Jimenez
- Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martín de Porres 15102, Lima, Peru; Gender Equity Initiative in Global Surgery, 641 Huntington Ave., Boston, MA, USA
| | - Eliana E Kim
- Gender Equity Initiative in Global Surgery, 641 Huntington Ave., Boston, MA, USA; University of California-San Francisco School of Medicine, 513 Parnassus Ave. Suite S-245, San Francisco, CA, USA.
| | - Alicia Becerra Zegarra
- Department of Neurosurgery, Hospital Nacional Edgardo Rebagliati Martins, Av Edgardo Rebagliati 490, Jesús María 15072, Lima, Peru; Department of Neurosurgery, Universidad Nacional Mayor de San Marcos, Av. Miguel Grau 755, Cercado de Lima 15001, Peru
| | - Alma Griselda Ramírez-Reyes
- Unidad Médica de Alta Especialidad, Hospital de Pediatría Dr. Silvestre Frenk Freund Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Av. Cuauhtémoc 330 Col.Doctores C.P.06720 Alcaldía Cuauhtémoc de la Ciudad de México, Mexico; Faculty of Medicine, Universidad Nacional Autónoma de Mexico, Circuto Escolar 411A, Copilco Universidad, Coyoacán, 04360 Ciudad de México, Mexico
| | - Dunia Patricia Quiroga
- Department of Neurosurgery, Fundación Clínica Infantil Club Noel Clinica, Cali, Calle 5 #22-76, Cali, Valle del Cauca, Colombia
| | - Ena I Miller Molina
- Hospital Centro Medico Sampedrano, Col. Altamira, 21 Calle Bulevar del Sur, San Pedro Sula, Honduras
| | - Nujerling Vargas Santana
- Department of Neurosurgery, Hospital Ana Francisca Perez de Leon II, Avenida Francisco de Miranda, Caracas 1073, Caracas, Venezuela
| | - Roxanna M Garcia
- Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, 676 North St. Clair Street, Suite 2210, Chicago, IL 60611, USA
| | - Gail Rosseau
- Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Avenue, NW, Suite 7-420, Washington, D.C. 20037, USA
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Shlobin NA, Rosseau G. A Call for Studies Examining the Management of Chronic Subdural Hematoma in Older Adult Cohorts. J Gerontol A Biol Sci Med Sci 2021; 76:e158. [PMID: 33626139 DOI: 10.1093/gerona/glab053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Nathan A Shlobin
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, US
| | - Gail Rosseau
- Department of Neurosurgery, George Washington University School of Medicine & Health Sciences, Washington, District of Columbia, US
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Affiliation(s)
- Katharine J Drummond
- Department of Neurosurgery, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia.
| | - Gail Rosseau
- Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
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Murphy M, Hernández-Durán S, Kim E, Al-Shehhi N, Broekman M, de Praeter M, Dubuisson A, Emery É, Gazioglu N, Grossman R, Janssen IK, Karampouga M, Khorbaladze L, Lambrianou X, Lippa L, Magnadottir H, Mihaylova S, Pajaj E, Rabiei K, Rodríguez-Hernández A, Tasiou A, Vayssiere P, Rosseau G. European women in neurosurgery: II - Historical characters and living legends. J Clin Neurosci 2021; 86:324-331. [PMID: 33558184 DOI: 10.1016/j.jocn.2021.01.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 01/14/2021] [Accepted: 01/16/2021] [Indexed: 10/22/2022]
Abstract
A collaborative global working group of women neurosurgeons in multiple countries at different stages of their neurosurgical careers undertook the task of researching the history of European women in neurosurgery. While doing so, we happened upon many remarkable female neurosurgeons who overcame great adversity, made tremendous contributions to society and institutional neurosurgery, and displayed numerous talents beyond the operating room. In the first part of this paper, we recounted a chronology of female neurosurgeons in Europe, highlighting the most remarkable achievements of women in every decade, from the 1920's to 2020. In this paper, we honor fascinating women in European neurosurgery, both historical characters and living legends. These women have overcome great adversity and have also excelled in a huge variety of pursuits. While some were themselves refugees, we also have uncovered noteworthy examples of women who immersed themselves in humanitarian missions and who tried to better the world through political action. There are stories of women beating the odds, taking on biased institutions and proving their worth, in spite of the prevailing system. Most inspirational, we have discovered through our comprehensive research on the history of women in European neurosurgery that the future is increasingly female.
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Affiliation(s)
- Mary Murphy
- Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom
| | - Silvia Hernández-Durán
- Department of Neurosurgery, Universitätsmedizin Göttingen, Göttingen, Germany; European Association of Neurosurgical Societies, Diversity in Neurosurgery Task Force, Brussels, Belgium.
| | - Eliana Kim
- University of California-San Francisco School of Medicine, San Francisco, CA, United States
| | | | - Marike Broekman
- Department of Neurosurgery, Haaglanden Medical Center, The Hague, Zuid-Holland, the Netherlands; Department of Neurosurgery, Leiden University Medical Center, Leiden, Zuid-Holland, the Netherlands; Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Mania de Praeter
- Department of Neurosurgery, Universitair Ziekenhuis Antwerpen, Edegem, Belgium
| | - Annie Dubuisson
- Department of Neurosurgery, Centre Hospitalier Universitaire Liège, Liège, Belgium
| | - Évelyne Emery
- Department of Neurosurgery, University Hospital of Caen, Caen Normandie University, Caen, France
| | - Nurperi Gazioglu
- Department of Neurosurgery, Demiroglu Bilim University - Medical School, İstanbul, Turkey
| | - Rachel Grossman
- Department of Neurosurgery, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | | | - Maria Karampouga
- Department of Neurosurgery, Nicosia General Hospital, Nicosia, Cyprus
| | - Lika Khorbaladze
- Neuroscience Department, JSC Evex, M.Iashvili Children''s Central Hospital, Tbilisi, Georgia
| | | | - Laura Lippa
- Department of Neurosurgery, Ospedali Riuniti di Livorno, Livorno, Italy
| | | | - Stiliana Mihaylova
- Department of Neurosurgery, University Hospital "St. Ivan Rilski" Sofia, Bulgaria
| | - Ermira Pajaj
- Department of Neuroscience, University Hospital "Mother Theresa", Tirana, Albania
| | - Katrin Rabiei
- European Association of Neurosurgical Societies, Diversity in Neurosurgery Task Force, Brussels, Belgium; Institution of Neuroscience & Physiology, Sahlgrenska Academy, Gothenberg, Sweden
| | - Ana Rodríguez-Hernández
- Department of Neurological Surgery, Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - Anastasia Tasiou
- Department of Neurosurgery, University Hospital of Larissa, Thessaly, Greece
| | - Pia Vayssiere
- European Association of Neurosurgical Societies, Diversity in Neurosurgery Task Force, Brussels, Belgium; Department of Neurosurgery, University Hospital Geneva, Geneva, Switzerland
| | - Gail Rosseau
- Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington, DC, United States
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Hernández-Durán S, Kim E, Ivan D, Rosseau G, Murphy M. Four Athenas - Europe's first female neurosurgeons. J Clin Neurosci 2021; 86:332-336. [PMID: 33558183 DOI: 10.1016/j.jocn.2021.01.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 01/20/2021] [Indexed: 10/22/2022]
Abstract
In the early 20th century, a tumultuous era was yielding geopolitical and social change. Europe at large was undergoing redefinition of borders, political structures, and economies, while rebuilding societies after World War I. At the same time, neurosurgery was emerging as a new specialty, and women were allowed to study medicine for the first time in many European countries. These factors created a synergy, setting the stage for Europe's four first female neurosurgeons to emerge. In 1924, Germany's Alice Rosenstein began her neurosurgical career and contributed to the refinement of pneumoencephalography. Due to her Jewish background, she was forced to flee Europe, emigrating to the United States, where she did not continue to practice neurosurgery. In 1929, Russia's Serafima Bryusova began her neurosurgical training. She studied intracranial pressure in trephined patients and wrote the first Russian monograph on cerebral angiography before she was immobilized by severe arthritis. England's Diana Beck began her neurosurgical career in 1939. She contributed to the surgical treatment of intracerebral hemorrhage and researched idiopathic intracranial hypertension, even though many believed she could not be a successful surgeon due to her myasthenia gravis. In 1943, Romania's Sofia Ionescu started a prolific academic neurosurgical career. She developed a minimally-invasive technique to treat intracerebral hematomas and worked tirelessly to bring neurosurgery to all corners of her country. Europe's first women in neurosurgery were marked by war and adversity. Their stories carry within them a spirit of resilience, fortitude, and tenacity that continues to characterize women in neurosurgery today.
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Affiliation(s)
- Silvia Hernández-Durán
- Department of Neurosurgery, Universitätsmedizin Göttingen, Göttingen, Germany; European Association of Neurosurgical Societies, Diversity in Neurosurgery Task Force, Brussels, Belgium.
| | - Eliana Kim
- University of California-San Francisco School of Medicine, San Francisco, CA, United States
| | - Daniela Ivan
- Carol Davila University of Medicine, Bucharest, Romania
| | - Gail Rosseau
- Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington, DC, United States
| | - Mary Murphy
- Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom
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Abstract
Over the past century, the field of neurosurgery has evolved and expanded in various directions. Neurosurgeons have continuously pushed the boundaries of the specialty with scientific discovery and innovation. A diverse array of neurosurgical techniques, treatments, and new areas of study have emerged within the field. Meanwhile, the neurosurgical workforce has stayed demographically homogeneous throughout time. Certain groups remain underrepresented owing to systemic barriers based on social identities and categorizations, including gender, race, ability status, and others. In this article, we highlight some of the underrepresented groups in neurosurgery and chronicle the important contributions and achievements that individuals from these groups have made in the field despite structural barriers and discrimination. We present evidence from the basic sciences, economics, business, and other disciplines that illustrate that diversity is not only just but also the most rational pursuit for positive growth and advancement. Diversity is needed to enrich the specialty and augment its capacity to serve the heterogeneous population of patients that reflect our society. To promote equity and diversity in the field, ongoing deliberate, organized, and systematic efforts to change the status quo and make the field more inclusive are needed.
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Affiliation(s)
- Eliana E Kim
- Gender Equity Initiative in Global Surgery, Boston, Massachusetts, USA; University of California, San Francisco, School of Medicine, San Francisco, California, USA.
| | - Andrea L Klein
- George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Jean W Lartigue
- Gender Equity Initiative in Global Surgery, Boston, Massachusetts, USA; Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Shawn L Hervey-Jumper
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Gail Rosseau
- Gender Equity Initiative in Global Surgery, Boston, Massachusetts, USA; Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
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Niquen-Jimenez M, Wishart D, Garcia RM, Shlobin NA, Steinle J, Weiss H, Reynolds RA, Lam S, Rosseau G. A Bibliographic Analysis of the Most Cited Articles in Global Neurosurgery. World Neurosurg 2020; 144:e195-e203. [PMID: 32829020 PMCID: PMC7895493 DOI: 10.1016/j.wneu.2020.08.084] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 08/10/2020] [Accepted: 08/12/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Global neurosurgery is the practice of neurosurgery with the primary purpose of delivering timely, safe, and affordable neurosurgical care to all who need it. The aim of this study is to identify the most frequently cited articles in global neurosurgery through a bibliographic review to characterize articles and trends around this growing topic. METHODS The top most-cited articles in global neurosurgery were determined by searching the Web of Science database using a priori search terms. Articles with at least 5 citations were selected, and there were no time period or language restrictions. The data were extracted from each included article and all characteristics were summarized. RESULTS A total of 932 articles were identified using the search terms; 69 articles fulfilled inclusion criteria and 17 articles were selected that had more than 5 citations. The articles' number of citations ranged from 6 to 98 for the most-cited article. Authors from, or affiliated with, 14 countries contributed to the 17 articles, and the country that had the greatest representation was the United States. The main topic discussed was surgical capacity, the second topic was the treatment of different neurosurgical conditions, and volunteerism was the third topic. CONCLUSIONS There is currently a deficit in both the amount of literature surrounding the topic of global neurosurgery and how much that literature is cited. Developing innovative ways to increase academic productivity within, or in collaboration with, low-middle income countries is essential to contribute to global neurosurgery.
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Affiliation(s)
- Milagros Niquen-Jimenez
- Facultad de Medicina Humana Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Danielle Wishart
- Northwestern Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Roxanna M Garcia
- Northwestern Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA; Department of Neurological Surgery, Northwestern Medicine, Chicago, Illinois, USA; Institute for Global Health, Center for Healthcare Studies, Northwestern University, Chicago, Illinois, USA.
| | - Nathan A Shlobin
- Northwestern Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Julia Steinle
- Faculty of Medicine, University of Münster, Münster, Germany
| | - Hannah Weiss
- Northwestern Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Rebecca A Reynolds
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Sandi Lam
- Northwestern Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA; Department of Neurological Surgery, Northwestern Medicine, Chicago, Illinois, USA; Division of Neurosurgery, Ann and Robert H. Lurie Children's Hospital, Chicago, Illinois, USA
| | - Gail Rosseau
- Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
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Garcia RM, Reynolds RA, Weiss HK, Chambless LB, Lam S, Dahdaleh NS, Rosseau G. Letter: Preliminary National Survey Results Evaluating the Impact of COVID-19 Pandemic on Medical Students Pursuing Careers in Neurosurgery. Neurosurgery 2020; 87:E258-E259. [PMID: 32385510 PMCID: PMC7239099 DOI: 10.1093/neuros/nyaa214] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Roxanna M Garcia
- Department of Neurological Surgery Northwestern Chicago, Illinois
- Northwestern Feinberg School of Medicine Chicago, Illinois
| | - Rebecca A Reynolds
- Department of Neurosurgery Vanderbilt University Medical Center Nashville, Tennessee
| | - Hannah K Weiss
- Department of Neurological Surgery Northwestern Chicago, Illinois
- Northwestern Feinberg School of Medicine Chicago, Illinois
| | - Lola B Chambless
- Department of Neurosurgery Vanderbilt University Medical Center Nashville, Tennessee
| | - Sandi Lam
- Department of Neurological Surgery Northwestern Chicago, Illinois
- Northwestern Feinberg School of Medicine Chicago, Illinois
- Ann and Robert H. Lurie Children's Hospital Chicago, Illinois
| | - Nader S Dahdaleh
- Department of Neurological Surgery Northwestern Chicago, Illinois
- Northwestern Feinberg School of Medicine Chicago, Illinois
| | - Gail Rosseau
- Department of Neurosurgery George Washington University School of Medicine and Health Sciences Washington, District of Columbia
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Ganguli S, Yibrehu B, Shah A, Rosseau N, Niba V, Rosseau G. Global surgery in the time of COVID-19: A trainee perspective. Am J Surg 2020; 220:1534-1535. [PMID: 32684291 PMCID: PMC7351067 DOI: 10.1016/j.amjsurg.2020.07.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 07/07/2020] [Accepted: 07/08/2020] [Indexed: 11/18/2022]
Affiliation(s)
- Sangrag Ganguli
- The George Washington University School of Medicine and Health Sciences, 2300 I St NW, Washington, DC, 20052 USA.
| | | | - Aribah Shah
- The George Washington University School of Medicine and Health Sciences, 2300 I St NW, Washington, DC, 20052 USA
| | - Natalie Rosseau
- The George Washington University School of Medicine and Health Sciences, 2300 I St NW, Washington, DC, 20052 USA
| | - Vanessa Niba
- University of Michigan Department of Surgery, USA
| | - Gail Rosseau
- The George Washington University School of Medicine and Health Sciences, 2300 I St NW, Washington, DC, 20052 USA
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Robertson FC, Esene IN, Kolias AG, Khan T, Rosseau G, Gormley WB, Park KB, Broekman ML. Global Perspectives on Task Shifting and Task Sharing in Neurosurgery. World Neurosurg X 2020; 6:100060. [PMID: 32309801 PMCID: PMC7154229 DOI: 10.1016/j.wnsx.2019.100060] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 08/28/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Neurosurgical task shifting and task sharing (TS/S), delegating clinical care to non-neurosurgeons, is ongoing in many hospital systems in which neurosurgeons are scarce. Although TS/S can increase access to treatment, it remains highly controversial. This survey investigated perceptions of neurosurgical TS/S to elucidate whether it is a permissible temporary solution to the global workforce deficit. METHODS The survey was distributed to a convenience sample of individuals providing neurosurgical care. A digital survey link was distributed through electronic mailing lists of continental neurosurgical societies and various collectives, conference announcements, and social media platforms (July 2018-January 2019). Data were analyzed by descriptive statistics and univariate regression of Likert Scale scores. RESULTS Survey respondents represented 105 of 194 World Health Organization member countries (54.1%; 391 respondents, 162 from high-income countries and 229 from low- and middle-income countries [LMICs]). The most agreed on statement was that task sharing is preferred to task shifting. There was broad consensus that both task shifting and task sharing should require competency-based evaluation, standardized training endorsed by governing organizations, and maintenance of certification. When perspectives were stratified by income class, LMICs were significantly more likely to agree that task shifting is professionally disruptive to traditional training, task sharing should be a priority where human resources are scarce, and to call for additional TS/S regulation, such as certification and formal consultation with a neurosurgeon (in person or electronic/telemedicine). CONCLUSIONS Both LMIC and high-income countries agreed that task sharing should be prioritized over task shifting and that additional recommendations and regulations could enhance care. These data invite future discussions on policy and training programs.
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Affiliation(s)
- Faith C. Robertson
- Harvard Medical School, Boston, Massachusetts, USA
- Computational Neuroscience Outcomes Center, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Ignatius N. Esene
- Neurosurgery Division, Department of Surgery, University of Bamenda, Bamenda, Cameroon
| | - Angelos G. Kolias
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge and Addenbrooke's Hospital, Cambridge, United Kingdom
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, United Kingdom
| | - Tariq Khan
- Department of Biotechnology, University of Malakand, Chakdara Dir Lower, Pakistan
| | - Gail Rosseau
- Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - William B. Gormley
- Harvard Medical School, Boston, Massachusetts, USA
- Computational Neuroscience Outcomes Center, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Department of Neurological Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Kee B. Park
- Global Neurosurgery Initiative, Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Marike L.D. Broekman
- Leiden University Medical Center, Neurosurgery, Leiden, the Netherlands
- Department of Neurosurgery, Haaglanden Medical Center, The Hague, the Netherlands
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Corley J, Kim E, Philips CA, Stippler M, Parr AM, Sweet J, Rosseau G. One hundred years of neurosurgery: contributions of American women. J Neurosurg 2020:1-6. [PMID: 32059180 DOI: 10.3171/2019.12.jns192878] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 12/03/2019] [Indexed: 11/06/2022]
Abstract
The end of the first 100 years of any endeavor is an appropriate time to look back and peer forward. As neurosurgery celebrates its 1st century as a specialty, the increasing role of women neurosurgeons is a major theme. This article documents the early women pioneers in neurosurgery. The contributions of these trailblazers to the origins, academics, and professional organizations of neurosurgery are highlighted. The formation of Women in Neurosurgery in 1989 is described, as is the important role this organization has played in introducing and promoting talented women in the profession. Contributions of women neurosurgeons to academic medicine and society as a whole are briefly highlighted. Contemporary efforts and initiatives indicate future directions in which women may lead neurosurgery in its 2nd century.
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Affiliation(s)
- Jacquelyn Corley
- 1Gender Equity Initiative in Global Surgery, Boston, Massachusetts.,2Department of Neurological Surgery, Duke University Hospital, Durham, North Carolina
| | - Eliana Kim
- 1Gender Equity Initiative in Global Surgery, Boston, Massachusetts.,3University of California, San Francisco School of Medicine, San Francisco, California
| | - Chris Ann Philips
- 4American Association of Neurological Surgeons, Rolling Meadows, Illinois
| | - Martina Stippler
- 5Department of Neurosurgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Ann M Parr
- 6Department of Neurosurgery, University of Minnesota, Minneapolis, Minnesota
| | - Jennifer Sweet
- 7Department of Neurosurgery, Case Western Reserve University, Cleveland, Ohio; and
| | - Gail Rosseau
- 1Gender Equity Initiative in Global Surgery, Boston, Massachusetts.,8Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington, DC
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Rosseau G, Johnson WD, Park KB, Hutchinson PJ, Lippa L, Andrews R, Servadei F, Garcia RM. Global neurosurgery: continued momentum at the 72nd World Health Assembly. J Neurosurg 2020; 132:1256-1260. [PMID: 31952031 DOI: 10.3171/2019.11.jns191823] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 11/15/2019] [Indexed: 01/15/2023]
Abstract
Global neurosurgery is the practice of neurosurgery with the primary purpose of delivering timely, safe, and affordable neurosurgical care to all who need it. This field is led by neurosurgeons, and global neurosurgery sessions are now part of every major international neurosurgical meeting. The World Federation of Neurosurgical Societies (WFNS) is working to coordinate activities and align all related activities for greater impact. This report updates the contributions made by the WFNS-WHO Liaison Committee at the most recent World Health Assembly (WHA) in 2019. The WHA is a decision-making body of the World Health Organization (WHO), attended by its 194 Member States. The WFNS has maintained official relations as a nongovernmental organization with the WHO for over 30 years, and this year 15 neurosurgical delegates attended events during the WHA. Participation by neurosurgeons continues to grow as many WHA events focused on global surgery have intrinsically involved neurosurgical leadership and participation. This year, resolution WHA72.31, entitled "Emergency and trauma care, Emergency care systems for universal health coverage: ensuring timely care for the acutely ill and injured," was passed. This resolution provides further opportunities for neurosurgical advocacy as the landscape of global surgery gains recognition and momentum.
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Affiliation(s)
- Gail Rosseau
- 1Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Walter D Johnson
- 2Emergency and Essential Surgical Care Programme, World Health Organization, Geneva, Switzerland
| | - Kee B Park
- 3Global Neurosurgery Initiative, Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts
| | | | - Laura Lippa
- 5Department of Neurosurgery, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Russell Andrews
- 6Nanotechnology and Smart Systems, NASA Ames Research Center, Mountain View, California
| | - Franco Servadei
- 7Department of Neurosurgery, Humanitas University, Milan, Italy; and
| | - Roxanna M Garcia
- 8Department of Neurosurgery, McGaw School of Medicine, Northwestern University, Chicago, Illinois
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Weiss HK, Garcia RM, Omiye JA, Vervoort D, Riestenberg R, Yerneni K, Murthy N, Wescott AB, Hutchinson P, Rosseau G. A Systematic Review of Neurosurgical Care in Low-Income Countries. World Neurosurg X 2020; 5:100068. [PMID: 31956859 PMCID: PMC6957821 DOI: 10.1016/j.wnsx.2019.100068] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 11/29/2019] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE More than 5 billion individuals lack access to essential surgical care. Neurosurgical care is especially limited in low-income countries (LICs). Studies describing neurosurgical care in LICs are critical for understanding global disparities in access to neurosurgical procedures. To better understand these disparities, we conducted a systematic review of the literature identifying neurosurgical patients in LICs. METHODS MEDLINE (PubMed), Embase (embase.com), and Cochrane Library (Wiley) databases were systematically searched to retrieve studies describing neurosurgical care in LICs as defined by the World Bank Country and Lending Groups income classification. All databases were searched from their inception; no date or language limits were applied. All the articles were blindly reviewed by 2 individuals. Data from eligible studies were extracted and summarized. RESULTS Of the 4377 citations screened, 154 studies met inclusion criteria. The number of publications substantially increased over the study period, with 49% (n = 76) of studies published in the last 5 years. Twenty-six percent (n = 40) of studies had a first author, and 30% (n = 46) had a senior author, affiliated with a country different from the LIC of study. The most common neurosurgical diagnosis was traumatic brain injury (24%, n = 37), followed by hydrocephalus (26%, n = 40), and neoplastic intracranial mass (10%, n = 16). Of LICs, 43% (n = 15/35) had no published neurosurgical literature. CONCLUSIONS There is a significant deficit in the literature on neurosurgical care in LICs. Efforts must focus on supporting research initiatives in LICs to improve publication bias and understand disparities in access to neurosurgical care in the lowest-resource countries.
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Affiliation(s)
- Hannah K. Weiss
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
- Department of Neurosurgery, Northwestern University, Chicago, Illinois, USA
| | - Roxanna M. Garcia
- Department of Neurosurgery, Northwestern University, Chicago, Illinois, USA
- Institute for Public Health and Medicine (IPHAM), Center for Healthcare Studies, Northwestern University, Chicago, Illinois, USA
| | | | - Dominique Vervoort
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA
| | - Robert Riestenberg
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
- Department of Neurosurgery, Northwestern University, Chicago, Illinois, USA
| | - Ketan Yerneni
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
- Department of Neurosurgery, Northwestern University, Chicago, Illinois, USA
| | - Nikhil Murthy
- Department of Neurosurgery, Northwestern University, Chicago, Illinois, USA
| | - Annie B. Wescott
- Galter Health Sciences Library & Learning Center, Northwestern University, Chicago, Illinois, USA
| | - Peter Hutchinson
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke’s Hospital and University of Cambridge, Cambridge, United Kingdom
| | - Gail Rosseau
- Midwest Neurosurgical Associates, Oak Brook, Illinois, USA
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50
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Rosseau G, Johnson WD, Park KB, Arráez Sánchez M, Servadei F, Vaughan KA. Global neurosurgery: current and potential impact of neurosurgeons at the World Health Organization and the World Health Assembly. Executive summary of the World Federation of Neurosurgical Societies-World Health Organization Liaison Committee at the 71st World Health Assembly. Neurosurg Focus 2019; 45:E18. [PMID: 30269578 DOI: 10.3171/2018.7.focus18295] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Since the creation of the World Health Organization (WHO) in 1948, the annual World Health Assembly (WHA) has been the major forum for discussion, debate, and approval of the global health agenda. As such, it informs the framework for the policies and budgets of many of its Member States. For most of its history, a significant portion of the attention of health ministers and Member States has been given to issues of clean water, vaccination, and communicable diseases. For neurosurgeons, the adoption of WHA Resolution 68.15 changed the global health landscape because the importance of surgical care for universal health coverage was highlighted in the document. This resolution was adopted in 2015, shortly after the publication of The Lancet Commission on Global Surgery Report titled "Global Surgery 2030: evidence and solutions for achieving health, welfare and economic development." Mandating global strengthening of emergency and essential surgical care and anesthesia, this resolution has led to the formation of surgical and anesthesia collaborations that center on WHO and can be facilitated via the WHA. Participation by neurosurgeons has grown dramatically, in part due to the official relations between WHO and the World Federation of Neurosurgical Societies, with the result that global neurosurgery is gaining momentum.
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Affiliation(s)
- Gail Rosseau
- 1Midwest Neurosurgical Associates, Oak Brook, Illinois
| | - Walter D Johnson
- 2Emergency and Essential Surgical Care Programme, World Health Organization, Geneva, Switzerland
| | - Kee B Park
- 3Global Neurosurgery Initiative, Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts
| | | | - Franco Servadei
- 5Department of Neurosurgery, Humanitas University, Milan, Italy; and
| | - Kerry A Vaughan
- 3Global Neurosurgery Initiative, Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts.,6Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
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