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Nguembu S, Kenfack YJ, Sadler S, Zolo Y, Figuim B, Sebopelo LA, Tétinou F, Kanmounye US. Factors Associated with Adverse Outcomes in Cameroonian Patients with Traumatic Brain Injury: A Cross-Sectional Study. World Neurosurg 2023; 172:e62-e67. [PMID: 36481439 DOI: 10.1016/j.wneu.2022.11.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND The burden of traumatic brain injury (TBI) disproportionately affects low- and middle-income countries. In Cameroon, the estimated annual incidence rate is 572 cases per 100,000 people. This study investigated factors associated with adverse outcomes in the management of Cameroonian patients with TBI. METHODS This cross-sectional study included all patients with TBI treated between January 1 and December 31, 2018, at 2 Cameroonian referral hospitals. Sociodemographic and clinical data were extracted from patient charts and admission registries and analyzed with SPSS v.26. Independent t tests, odds ratios, and cumulative mortality hazard rates were computed. A P-value <0.05 was considered statistically significant. Also, binomial regression analyses were calculated. RESULTS One hundred seventy-one patients aged 38.63 ± 20.46 years old received treatment for TBI. Most patients were male (78.9%), Cameroonian (98.2%), from urban areas (75.4%), and uninsured (88.8%). The average admission length was 11.23 ± 10.71 days, during which 27.5% of patients received surgical treatment while 72.5% received non-surgical (conservative) management. From postdischarge day 12 onwards, surgically-treated patients had a greater cumulative mortality hazard rate than conservatively-treated patients. By 28 days postdischarge, 66.1% of patients had recovered completely [Glasgow Outcome Scale (GOS) = 5], 23.4% had a disability (GOS = 2-4), and 10.5% expired (GOS = 1). Complete recovery was associated with the absence of severe TBI (B = -1.42, standard error [SE] = 0.52, P = 0.006), disability was associated with increased injury-to-admission delay (B = -1.27, SE = 0.48, P = 0.009), and death was associated with severe TBI (B = 3.16, SE = 0.73, P < 0.001). CONCLUSIONS We identified factors associated with unfavorable outcomes among Cameroonian patients with TBI. These results can inform triage and referral practices and aid policymakers in developing context-specific prehospital guidelines.
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Affiliation(s)
- Stéphane Nguembu
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon
| | - Yves Jordan Kenfack
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon; University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | | | - Yvan Zolo
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon
| | - Bello Figuim
- Department of Surgery, Neurosurgery Unit, Yaounde Central Hospital, Yaounde, Cameroon
| | | | - Francklin Tétinou
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon
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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] [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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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] [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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Kanmounye US, Zolo Y, Nguembu S, Tétinou F, Sebopelo LA, Endalle G, Sichimba D, Takoukam R, Ghomsi N, Jumbam DT. Training the Next Generation of Academic Global Neurosurgeons: Experience of the Association of Future African Neurosurgeons. Front Surg 2021; 8:631912. [PMID: 34124130 PMCID: PMC8193051 DOI: 10.3389/fsurg.2021.631912] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 04/28/2021] [Indexed: 11/24/2022] Open
Abstract
Introduction: Although the past decade has seen a substantial increase in African neurosurgeons' academic productivity, productivity remains low compared to their colleagues from other regions. Aspiring neurosurgeons can contribute to the academic neurosurgery workforce by taking care of less technical and time-consuming research tasks. Fortunately, global neurosurgery institutions have also made efforts to increase research exposure and scholarly output in academic global neurosurgery. The Association of Future African Neurosurgeons (AFAN) created a research incubator for aspiring academic global neurosurgeons in Africa to provide enrollees with mentorship, skills, and experience. This study assesses and reports the activities and results of the research incubator. Methods: Aspiring academic global neurosurgeons were enrolled in the AFAN Research Incubator Program (ARIP), whose primary objective was to provide enrollees with foundational skills in all aspects of the research cycle. ARIP enrollees participated in didactic and practical activities with the aim of publishing ≥1 article and presenting ≥1 abstracts at international conferences in one year. Results: Fifteen AFAN members aged 25.0 ± 3.0 years enrolled in ARIP: 7 (46.7%) medical students, 4 (26.7%) general practitioners, and 4 (26.7%) residents. Eleven (73.3%) were male, 6 (40.0%) were from Cameroon and 6 (40.0%) had no previous research experience. Two (13.3%) enrollees dropped out. ARIP enrollees published a total of 28 articles, and enrollees published a median of 1.0 (IQR = 2) first-author articles on neurosurgical system strengthening. Additionally, ARIP enrollees presented 20 abstracts with a median of one abstract (IQR = 3.0). Conclusion: South-South research collaborations like ARIP can contribute to improving global neurosurgery research capacity and output. These collaborations can set up the foundations for robust research in low- and middle-income countries.
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Affiliation(s)
| | - Yvan Zolo
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon.,Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | - Stéphane Nguembu
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon.,Faculty of Medicine, Higher Institute of Health Sciences, Université des Montagnes, Bangangté, Cameroon
| | - Francklin Tétinou
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon.,Faculty of Medicine, Higher Institute of Health Sciences, Université des Montagnes, Bangangté, Cameroon
| | - Lorraine Arabang Sebopelo
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon.,Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | - Geneviève Endalle
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon.,Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | - Dawin Sichimba
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon.,School of Medicine, Copperbelt University, Ndola, Zambia
| | - Régis Takoukam
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon.,Department of Neurosurgery, Felix-Houphouet Boigny University, Abidjan, Côte d'Ivoire
| | - Nathalie Ghomsi
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon.,Department of Neurosurgery, Felix-Houphouet Boigny University, Abidjan, Côte d'Ivoire
| | - Desmond T Jumbam
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon.,Operation Smile Ghana, Accra, Ghana
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Higginbotham G. Virtual Connections: Improving Global Neurosurgery Through Immersive Technologies. Front Surg 2021; 8:629963. [PMID: 33681283 PMCID: PMC7933682 DOI: 10.3389/fsurg.2021.629963] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 01/28/2021] [Indexed: 12/18/2022] Open
Abstract
The field of neurosurgery has always been propelled by the adoption of novel technologies to improve practice. Although advancements have occurred in the diagnosis, treatment, and long-term outcomes of patients, these have not translated to global patient benefit. Up to five million people each year do not have access to safe and affordable neurosurgical interventions, and those in low- and middle-income countries (LMICs) are disproportionately affected. Current approaches to increase neurosurgical capacity are unlikely to meet the UN Sustainable Development Goals target by 2030, and many of the most successful programs have been disrupted by the travel restrictions of the COVID-19 pandemic. There is therefore a pressing need for creative virtual solutions. An area of growing relevance is the use of immersive technologies: virtual reality (VR) and augmented reality (AR). AR allows additional information to be superimposed onto the surgeon's visual field, thus enhancing intra-operative visualization. This can be used for remote tele-proctoring, whereby an experienced surgeon can virtually assist with a procedure regardless of geographical location. Expert guidance can therefore be given to both neurosurgical trainees and non-neurosurgical practitioners, further facilitating the growing practice of neurosurgical task-shifting in LMICs. VR simulation is another useful tool in remote neurosurgical training, with the potential to reduce the learning curve of complex procedures whilst conserving supplies in low-resource settings. The adoption of immersive technologies into practice is therefore a promising approach for achieving global neurosurgical equity, whilst adapting to the long-term disruptions of the pandemic.
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Shlobin NA, Hoffman SC, Clark JR, Hopkins BS, Kesavabhotla K, Dahdaleh NS. Social Media in Neurosurgery: A Systematic Review. World Neurosurg 2021; 149:38-50. [PMID: 33556595 DOI: 10.1016/j.wneu.2021.01.135] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 01/25/2021] [Accepted: 01/26/2021] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Social media has been used increasingly in neurosurgery by individuals. We aimed to identify demographics and preferences of social media use, describe the scope of social media use, and characterize its utility. METHODS A systematic review was conducted using PubMed, Embase, and Scopus databases. Titles and abstracts from articles identified in the search were read and selected for full-text review. Studies meeting prespecified inclusion criteria were reviewed in full and analyzed for relevant data. RESULTS Of 431 resultant articles, 29 were included. Patients and caregivers most commonly used Facebook and Twitter, whereas nearly 50% of neurosurgeons used LinkedIn and Doximity. Patient and caregiver users of social media tended to be <35 years old. Content of posts varied from requesting/providing information (∼40%) to seeking emotional support/forming connections (∼30%). A total of 20.6% of videos were irrelevant to clinical neurosurgery. Factual accuracy of most videos was poor to inadequate. Social media use was associated with greater academic impact for neurosurgical departments and journals. Posts with photos and videos and weekend posts generated 1.2-2 times greater engagement. CONCLUSIONS Patients and caregivers who use social media are typically younger than 35 years old and commonly use Facebook or Twitter. Neurosurgeons prefer Doximity and LinkedIn. Social media yields information regarding common symptoms and uncovers novel symptoms. Videos are poor-to-inadequate quality and often irrelevant to clinical neurosurgery. Optimizing social media use will augment the exchange of ideas regarding clinical practice and research and empower patients and caregivers.
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Affiliation(s)
- Nathan A Shlobin
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Steven C Hoffman
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Jeffrey R Clark
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Benjamin S Hopkins
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Kartik Kesavabhotla
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Nader S Dahdaleh
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
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