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2.
World Neurosurg ; 157: e198-e206, 2022 01.
Article in English | MEDLINE | ID: covidwho-1458616

ABSTRACT

BACKGROUND: During the COVID-19 pandemic, disruption of surgical hands-on training has hampered the skills acquisition by budding neurosurgeons. Online and virtual classrooms have not been able to substitute the hands-on experience and learning via direct interaction with senior colleagues. To overcome these challenges, we organized a hybrid workshop where simulation-based learning modules, and direct and virtual interaction with surgeons during live surgeries or didactic lectures were utilized to help delegates in understanding the nuances of neurosurgery. METHODS: A 3-day hybrid workshop was held in March 2021, which was attended by 133 delegates. A structured questionnaire was utilized to record their feedback. RESULTS: An overwhelming majority of the respondents (94.1%, n = 64) found hybrid conferences to be better than an online conference. Most of the respondents (88.3%, n = 60) rated the utility of direct face-to-face interaction to be more satisfying as compared with online interaction with faculty during a webinar. Again, many the respondents (86.8%, n = 59) believed that similar hybrid events will be the new normal given the current situation of COVID-19 pandemic. A large majority (88.2%, n = 60) of the respondents reported that they will prefer a hybrid event over an online conference. CONCLUSIONS: In this era of the COVID-19 pandemic, "hybrid" microneurosurgery workshops offer unique opportunities to enhance surgical skills acquisition by hands-on simulation-based learning and observing live surgical demonstrations, apart from 2-way interactions with experts under one roof. This may be a stepping stone for what lies ahead in the future of neurosurgical training.


Subject(s)
COVID-19 , Education, Distance/methods , Education, Medical, Graduate/methods , Neurosurgery/education , Humans , Neurosurgical Procedures/education , SARS-CoV-2
3.
World Neurosurg ; 154: e320-e324, 2021 10.
Article in English | MEDLINE | ID: covidwho-1309404

ABSTRACT

BACKGROUND: Increasing restrictions over trainees' working hours and the recent coronavirus disease 2019 pandemic warrant new educational methods of surgical skills. We assessed a novel video-recording system for neuroendovascular skill education, developed with the installation of a hybrid operating room (OR) at our institution. METHODS: A single-plane angiography unit with a large flat display (FlexVision XL; Philips Medical Systems) was installed in our OR. All media sources in the OR, including live fluoroscopy and ceiling-mounted camcorders, were connected to a video switcher. This video switcher laid up to 8 video images into one big image, which was transferred to the large display and the professional-use Blu-ray recorder. The recording was performed continuously during the procedure. This recording system was evaluated retrospectively with a questionnaire administered to the 5 trainees. RESULTS: Using this system, 68 interventional procedures were recorded. Among the potential merits, the trainees assigned the greatest value to the simultaneous recording of the operator's hand motions and the fluoroscopy images. Among the potential limitations of the system, the prolonged time and the increased volume of the video data bothered the trainees the most. The recorded video looked like a live demonstration. CONCLUSIONS: Our "selfie" video recording system was useful for skill training of neuroendovascular interventions.


Subject(s)
Endovascular Procedures/education , Neurosurgery/education , Neurosurgical Procedures/education , Operating Rooms , Video Recording , Angiography , COVID-19 , Clinical Competence , Education, Medical, Graduate , Fluoroscopy , Humans , Internship and Residency , Pandemics , Retrospective Studies , Surveys and Questionnaires
4.
World Neurosurg ; 151: e68-e77, 2021 07.
Article in English | MEDLINE | ID: covidwho-1164602

ABSTRACT

BACKGROUND: Medical subspecialties including neurosurgery have seen a dramatic shift in operative volume in the wake of the coronavirus disease 2019 (COVID-19) pandemic. The goal of this study was to quantify the effects of the COVID-19 pandemic on operative volume at 2 academic neurosurgery centers in New Orleans, Louisiana, USA from equivalent periods before and during the COVID-19 pandemic. METHODS: A retrospective review was conducted analyzing neurosurgical case records for 2 tertiary academic centers from March to June 2020 and March to June 2019. The records were reviewed for variables including institution and physician coverage, operative volume by month and year, cases per subspecialty, patient demographics, mortality, and morbidity. RESULTS: Comparison of groups showed a 34% reduction in monthly neurosurgical volume per institution during the pandemic compared with earlier time points, including a 77% decrease during April 2020. There was no change in mortality and morbidity across institutions during the pandemic. CONCLUSIONS: The COVID-19 pandemic has had a significant impact on neurosurgical practice and will likely continue to have long-term effects on patients at a time when global gross domestic products decrease and relative health expenditures increase. Clinicians must anticipate and actively prepare for these impacts in the future.


Subject(s)
Academic Medical Centers/trends , COVID-19/epidemiology , Internship and Residency/trends , Neurosurgical Procedures/education , Neurosurgical Procedures/trends , Time-to-Treatment/trends , Academic Medical Centers/methods , Adult , Aged , COVID-19/prevention & control , Female , Humans , Internship and Residency/methods , Length of Stay/trends , Male , Middle Aged , Neurosurgery/education , Neurosurgery/methods , Neurosurgery/trends , Neurosurgical Procedures/methods , New Orleans/epidemiology , Pandemics/prevention & control , Retrospective Studies
5.
Neurosurg Focus ; 49(6): E16, 2020 12.
Article in English | MEDLINE | ID: covidwho-954602

ABSTRACT

OBJECTIVE: The COVID-19 pandemic has forced medical professionals throughout the world to adapt to the changing medical scenario. The objective of this survey was to assess the change in neurosurgical training in India following the COVID-19 pandemic. METHODS: Between May 7, 2020, and May 16, 2020, a validated questionnaire was circulated among neurosurgical residents across India by social media, regarding changes in the department's functioning, patient interaction, surgical exposure, changes in academics, and fears and apprehensions associated with the pandemic. The responses were kept anonymous and were analyzed for changes during the COVID-19 pandemic compared to before the pandemic. RESULTS: A total of 118 residents from 29 neurosurgical training programs across 17 states/union territories of the country gave their responses to the survey questionnaire. The survey revealed that the surgical exposure of neurosurgical residents has drastically reduced since the onset of the COVID-19 pandemic, from an average of 39.86 surgeries performed/assisted per month (median 30) to 12.31 per month (median 10), representing a decrease of 67.50%. The number of academic sessions has fallen from a median of 5 per week to 2 per week. The survey uncovered the lack of universal guidelines and homogeneity regarding preoperative COVID-19 testing. The survey also reveals reluctance toward detailed patient examinations since the COVID-19 outbreak. The majority of respondents felt that the COVID-19 pandemic will hamper their operative and clinical skills. Fear of rescheduling or deferring of licensing examinations was significantly higher among those closest to the examination (p = 0.002). CONCLUSIONS: The adverse impact of the pandemic on neurosurgical training needs to be addressed. While ensuring the safety of the residents, institutes and neurosurgical societies/bodies must take it upon themselves to ensure that their residents continue to learn and develop neurosurgical skills during these difficult times.


Subject(s)
COVID-19/epidemiology , Internship and Residency/methods , Neurosurgeons/education , Neurosurgical Procedures/education , Neurosurgical Procedures/methods , Surveys and Questionnaires , COVID-19/surgery , Cross-Sectional Studies , Female , Humans , India/epidemiology , Male
6.
Neurosurg Focus ; 49(6): E18, 2020 12.
Article in English | MEDLINE | ID: covidwho-954494

ABSTRACT

OBJECTIVE: The coronavirus disease 2019 (COVID-19) pandemic has caused dramatic changes in medical education. Social distancing policies have resulted in the rapid adoption of virtual learning (VL) by neurosurgeons as a method to exchange knowledge, but it has been met with variable acceptance. The authors surveyed neurosurgeons from around the world regarding their opinions about VL and how they see the future of neurosurgical conferences. METHODS: The authors conducted a global online survey assessing the experience of neurosurgeons and trainees with VL activities. They also questioned respondents about how they see the future of on-site conferences and scientific meetings. They analyzed responses against demographic data, regions in which the respondents practice, and socioeconomic factors by using frequency histograms and multivariate logistic regression models. RESULTS: Eight hundred ninety-one responses from 96 countries were received. There has been an increase in VL activities since the start of the COVID-19 pandemic. Most respondents perceive this type of learning as positive. Respondents from lower-income nations and regions such as Europe and Central Asia were more receptive to these changes and wanted to see further movement of educational activities (conferences and scientific meetings) into a VL format. The latter desire may be driven by financial savings from not traveling. Most queried neurosurgeons indicated that virtual events are likely to partially replace on-site events. CONCLUSIONS: The pandemic has improved perceptions of VL, and despite its limitations, VL has been well received by the majority of neurosurgeons. Lower-income nations in particular are embracing this technology. VL is still evolving, but its integration with traditional in-person meetings seems inevitable.


Subject(s)
COVID-19/epidemiology , Education, Distance/methods , Neurosurgeons/education , Neurosurgical Procedures/education , Neurosurgical Procedures/methods , Surveys and Questionnaires , Education, Distance/trends , Humans , Internationality , Neurosurgeons/trends , Neurosurgical Procedures/trends , Telecommunications/trends
7.
Neurosurg Focus ; 49(6): E17, 2020 12.
Article in English | MEDLINE | ID: covidwho-954005

ABSTRACT

OBJECTIVE: Neurosurgical education in the US has changed significantly as a consequence of the novel coronavirus (COVID-19) pandemic. Institutional social distancing requirements have resulted in many neurosurgical programs utilizing video conferencing for educational activities. However, it is unclear how or if these practices should continue after the pandemic. The objective of this study was to characterize virtual education in neurosurgery and understand how it should be utilized after COVID-19. METHODS: A 24-question, 3-part online survey was administered anonymously to all 117 US neurosurgical residency programs from May 15, 2020, to June 15, 2020. Questions pertained to the current use of virtual conferencing, preferences over traditional conferences, and future inclinations. The Likert scale (1 = strongly disagree, 3 = neutral, 5 = strongly agree) was used. Comparisons were calculated using the Mann-Whitney U-test. Statistical significance was set at 0.05. RESULTS: One-hundred eight responses were recorded. Overall, 38 respondents (35.2%) were attendings and 70 (64.8%) were trainees. Forty-one respondents (38.0%) indicated attending 5-6 conferences per week and 70 (64.8%) attend national virtual conferences. When considering different conference types, there was no overall preference (scores < 3) for virtual conferences over traditional conferences. In regard to future use, respondents strongly agreed that they would continue the practice at some capacity after the pandemic (median score 5). Overall, respondents agreed that virtual conferences would partially replace traditional conferences (median score 4), whereas they strongly disagreed with the complete replacement of traditional conferences (median score 1). The most common choices for the partial replacement of tradition conferences were case conferences (59/108, 55%) and board preparation (64/108, 59%). Lastly, there was a significant difference in scores for continued use of virtual conferencing in those who attend nationally sponsored conferences (median score 5, n = 70) and those who do not (median score 4, n = 38; U = 1762.50, z = 2.97, r = 0.29, p = 0.003). CONCLUSIONS: Virtual conferences will likely remain an integral part of neurosurgical education after the COVID-19 pandemic has abated. Across the country, residents and faculty report a preference for continued use of virtual conferencing, especially virtual case conferences and board preparation. Some traditional conferences may even be replaced with virtual conferences, in particular those that are more didactic. Furthermore, nationally sponsored virtual conferences have a positive effect on the preferences for continued use of virtual conferences.


Subject(s)
COVID-19/epidemiology , Education, Distance/standards , Internship and Residency/standards , Neurosurgical Procedures/education , Surveys and Questionnaires , Telecommunications/standards , Adult , Aged , Education, Distance/methods , Female , Humans , Internship and Residency/methods , Male , Middle Aged , Neurosurgical Procedures/methods , Neurosurgical Procedures/standards
8.
Neurosurg Focus ; 49(6): E5, 2020 12.
Article in English | MEDLINE | ID: covidwho-953187

ABSTRACT

OBJECTIVE: Global outbreak of the novel coronavirus disease 2019 (COVID-19) has forced healthcare systems worldwide to reshape their facilities and protocols. Although not considered the frontline specialty in managing COVID-19 patients, neurosurgical service and training were also significantly affected. This article focuses on the impact of the COVID-19 outbreak at a low- and/or middle-income country (LMIC) academic tertiary referral hospital, the university and hospital policies and actions for the neurosurgical service and training program during the outbreak, and the contingency plan for future reference on preparedness for service and education. METHODS: The authors collected data from several official databases, including the Indonesian Ministry of Health database, East Java provincial government database, hospital database, and neurosurgery operative case log. Policies and regulations information was obtained from stakeholders, including the Indonesian Society of Neurological Surgeons, the hospital board of directors, and the dean's office. RESULTS: The curve of confirmed COVID-19 cases in Indonesia had not flattened by the 2nd week of June 2020. Surabaya, the second-largest city in Indonesia, became the epicenter of the COVID-19 outbreak in Indonesia. The neurosurgical service experienced a significant drop in cases (50% of cases from normal days) along all lines (outpatient clinic, emergency room, and surgical ward). Despite a strict preadmission screening, postoperative COVID-19 infection cases were detected during the treatment course of neurosurgical patients, and those with a positive COVID-19 infection had a high mortality rate. The reduction in the overall number of cases treated in the neurosurgical service had an impact on the educational and training program. The digital environment found popularity in the educational term; however, digital resources could not replace direct exposure to real patients. The education stakeholders adjusted the undergraduate students' clinical postings and residents' working schemes for safety reasons. CONCLUSIONS: The neurosurgery service at an academic tertiary referral hospital in an LMIC experienced a significant reduction in cases. The university and program directors had to adapt to an off-campus and off-hospital policy for neurosurgical residents and undergraduate students. The hospital instituted a reorganization of residents for service. The digital environment found popularity during the outbreak to support the educational process.


Subject(s)
Academic Medical Centers/trends , COVID-19/epidemiology , Internship and Residency/trends , Neurosurgical Procedures/education , Neurosurgical Procedures/trends , Tertiary Care Centers/trends , Academic Medical Centers/standards , Adult , COVID-19/prevention & control , Female , Humans , Indonesia/epidemiology , Internship and Residency/standards , Male , Middle Aged , Neurosurgical Procedures/standards , Tertiary Care Centers/standards
9.
World Neurosurg ; 144: e926-e933, 2020 12.
Article in English | MEDLINE | ID: covidwho-936011

ABSTRACT

BACKGROUND: The coronavirus disease 2019 pandemic has led to sweeping changes in residency programs across the world, including cancellation of elective cases. The effects of safety measures on neurosurgical training remain unclear. To understand how neurosurgical residents have been affected, we analyzed the operative experience in the months leading up to and during the pandemic. METHODS: The resident and institutional case totals were tallied for a single residency program in Miami-Dade County from January 1, 2019 to June 30, 2020. A matched cohort analysis was performed before and during the pandemic to assess the effects on resident surgical training. RESULTS: The case totals for all levels of training were lower when restrictions were placed on elective surgeries. An average of 11 cases was logged in April 2020, a decrease from 26 cases in April 2019 (95% confidence interval, 8.7-22; P < 0.01). An average of 20 cases was logged in May 2020, a decrease from 25 cases in May 2019 (95% confidence interval, 1.2-8.8; P = 0.01). In April and May 2020, 299 (66%) and 148 (50%) fewer cases had been performed at our institution compared with April and May 2109. CONCLUSIONS: Operative experience was reduced for residents during the months when the performance of elective cases was restricted. Our data suggest experience in some areas of neurosurgery were more affected than were others, and residents at different levels of training were also affected differently. However, the extent of the coronavirus disease 2019 pandemic on neurosurgical training is unlikely to be understood in the short term.


Subject(s)
Academic Medical Centers , COVID-19/epidemiology , Education, Medical, Graduate/statistics & numerical data , Elective Surgical Procedures/statistics & numerical data , Neurosurgery/education , Neurosurgical Procedures/statistics & numerical data , Education, Medical, Graduate/organization & administration , Florida/epidemiology , Humans , Internship and Residency , Neurosurgery/organization & administration , Neurosurgical Procedures/education , Personnel Staffing and Scheduling/organization & administration , United States/epidemiology
10.
Childs Nerv Syst ; 37(4): 1313-1317, 2021 04.
Article in English | MEDLINE | ID: covidwho-898010

ABSTRACT

PURPOSE: COVID-19 pandemic has influenced all aspects of societies, with the healthcare being the most affected field. All specialties including neurosurgery are involved, and due to resource limitations, the number of elective surgeries in subspecialized filed has substantially decreased. Herein, we report our practice experience in pediatric neurosurgery in a tertiary hospital during pandemic, and the effects of pandemic on educational issues. METHODS: All the patients on whom any kind of neurosurgical operation was performed from March to June 2020 were retrospectively collected, and also from the same period in the previous year. RESULTS: A total of 111 patients underwent surgery in this period. This figure was 159 patients during the same period in 2019. The total number of surgical cases reduced by 31% compared to the last year. While ventriculoperitoneal shunts and supratentorial tumor were more frequent, there was a considerable reduction in subspecialized educational surgeries like neural tube defects and craniosynostoses. CONCLUSION: CVID-19 pandemic changed all scopes of medical practice and training. Considering the limitation in the available resources, the number of educational cases may decrease in subspecialized disciplines like pediatric neurosurgery. If pandemic continues, alternative measures should be taken to compensate for the shortcoming in technical and practical training.


Subject(s)
COVID-19 , Neurosurgery/statistics & numerical data , Neurosurgical Procedures/statistics & numerical data , Pediatrics/statistics & numerical data , Developing Countries , Humans , Iran , Neurosurgery/education , Neurosurgical Procedures/education , Pediatrics/education , SARS-CoV-2
12.
World Neurosurg ; 144: e164-e177, 2020 12.
Article in English | MEDLINE | ID: covidwho-800041

ABSTRACT

OBJECTIVE: Neurosurgery departments worldwide have been forced to restructure their training programs because of the coronavirus disease 2019 (COVID-19) pandemic. In this study, we describe the impact of COVID-19 on neurosurgical training in Southeast Asia. METHODS: We conducted an online survey among neurosurgery residents in Indonesia, Malaysia, Philippines, Singapore, and Thailand from May 22 to 31, 2020 using Google Forms. The 33-item questionnaire collected data on elective and emergency neurosurgical operations, ongoing learning activities, and health worker safety. RESULTS: A total of 298 of 470 neurosurgery residents completed the survey, equivalent to a 63% response rate. The decrease in elective neurosurgical operations in Indonesia and in the Philippines (median, 100% for both) was significantly greater compared with other countries (P < 0.001). For emergency operations, trainees in Indonesia and Malaysia had a significantly greater reduction in their caseload (median, 80% and 70%, respectively) compared with trainees in Singapore and Thailand (median, 20% and 50%, respectively; P < 0.001). Neurosurgery residents were most concerned about the decrease in their hands-on surgical experience, uncertainty in their career advancement, and occupational safety in the workplace. Most of the residents (n = 221, 74%) believed that the COVID-19 crisis will have a negative impact on their neurosurgical training overall. CONCLUSIONS: An effective national strategy to control COVID-19 is crucial to sustain neurosurgical training and to provide essential neurosurgical services. Training programs in Southeast Asia should consider developing online learning modules and setting up simulation laboratories to allow trainees to systematically acquire knowledge and develop practical skills during these challenging times.


Subject(s)
COVID-19/prevention & control , Education, Distance/statistics & numerical data , Education, Medical, Graduate/statistics & numerical data , Elective Surgical Procedures/statistics & numerical data , Neurosurgery/education , Neurosurgical Procedures/statistics & numerical data , Occupational Health , Asia, Southeastern/epidemiology , Attitude of Health Personnel , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19 Testing/statistics & numerical data , Emergencies , Humans , Indonesia/epidemiology , Internship and Residency , Malaysia/epidemiology , Neurosurgical Procedures/education , Personal Protective Equipment/supply & distribution , Philippines/epidemiology , Research/statistics & numerical data , Singapore/epidemiology , Surveys and Questionnaires , Telemedicine/statistics & numerical data , Thailand/epidemiology
13.
World Neurosurg ; 143: 557-563.e1, 2020 11.
Article in English | MEDLINE | ID: covidwho-728881

ABSTRACT

BACKGROUND: During the current global crisis unleashed by the severe acute respiratory syndrome coronavirus 2 outbreak, surgical departments have considerably reduced the amount of elective surgeries. This decrease leads to less time in the surgical room to develop and improve the surgical skills of residents. In this study, we developed a training program to obtain and maintain microsurgical skills at home, using a smartphone camera and low-cost materials, affordable for everyone. METHODS: Using a smartphone camera as a magnification device, 6 participants performed 5 exercises (coloring grids, grouping colors, unraveling of a gauze, knots with suture threads, and tower of Hanoi), both with the dominant and with the nondominant hand, for 4 weeks. We compared performance at the beginning and at the end of the training process. Each participant filled out an anonymous survey. RESULTS: When we compared the performance at the beginning and at the end of the training process, we found significant improvements (P = 0.05) with the dominant as well as the nondominant hand in all the exercises. All participants were satisfied or very satisfied with the definition of the objectives of the training process, material availability, the exercises performed, the choice of the time to train, and general satisfaction with the training program. CONCLUSIONS: We developed a microsurgical skills training program to be performed at home, which can be easily reproduced. It allows residents to improve manual coordination skills and is regarded as a feasible adjunct for ongoing training for surgical residents.


Subject(s)
COVID-19/surgery , Microsurgery/education , Neurosurgical Procedures/education , SARS-CoV-2/pathogenicity , COVID-19/virology , Clinical Competence/statistics & numerical data , Disease Outbreaks , Female , Humans , Internship and Residency , Suture Techniques , Sutures
14.
World Neurosurg ; 144: e204-e209, 2020 12.
Article in English | MEDLINE | ID: covidwho-720739

ABSTRACT

BACKGROUND: The 2019 novel coronavirus disease (COVID-19) pandemic has directly and indirectly impacted health care systems, including residency programs. Social distancing, cancellation of elective cases, and staff re-deployment have compromised clinical and academic teaching. We describe the neurosurgical experience at Emory University during the COVID-19 pandemic and the impact of COVID-19-related policies on resident experience. METHODS: We retrospectively reviewed all neurosurgical cases performed at Emory University Hospital between March 16, the day cancellation of elective cases was effective, and April 15, 2020, and the same period in the preceding 3 years. For the study period, we collected the number of cases and their distribution by subspecialty along with total hospital charges. RESULTS: Compared with an average of 606 cases performed during the study period over the past 3 years, only 145 neurosurgical cases were performed between March 16 and April 15, 2020, which corresponds to an 80% reduction in case volume and 66% decrease in hospital revenue in 2020. When divided by subspecialty, the most significant reduction was observed in functional (84%; P < 0.01) followed by spine (78%; P < 0.01) surgery, although all subspecialties were significantly impacted. Assessing junior resident experience, we observed a significant reduction in number of neurosurgical admissions (47%; P < 0.01) and bedside procedures (59%; P < 0.01) in the study period in 2020 compared with the past 3 years, with no significant reduction in number of consultations (17%; P > 0.1). CONCLUSIONS: Even at academic centers that were not hugely impacted by the COVID-19 pandemic, prophylactic and preparedness measures still exhibited an unprecedented toll on neurosurgical resident and fellow experience.


Subject(s)
COVID-19 , Education, Medical, Graduate/statistics & numerical data , Elective Surgical Procedures/statistics & numerical data , Hospitalization/statistics & numerical data , Neurosurgery/education , Neurosurgical Procedures/statistics & numerical data , Vascular Surgical Procedures/statistics & numerical data , Georgia , Hospital Charges/statistics & numerical data , Hospitals, University/statistics & numerical data , Humans , Neuroendoscopy/education , Neuroendoscopy/statistics & numerical data , Neurosurgical Procedures/education , Personnel Staffing and Scheduling , Referral and Consultation/statistics & numerical data , Retrospective Studies , Vascular Surgical Procedures/education
16.
World Neurosurg ; 139: 732-733, 2020 07.
Article in English | MEDLINE | ID: covidwho-617260

ABSTRACT

Never in history has the fabric of African neurosurgery been challenged as it is today with the advent of the novel coronavirus identified in 2019 (COVID-19). Even the most robust and resilient neurosurgical educational systems in the continent have been brought to their knees with neurosurgical trainees and young neurosurgeons bearing the brunt. In the face of this new reality, and in order to limit the impact of the current COVID-19 pandemic, multiple programs have implemented physical distancing to reduce in-person interactions. In some cases, residents have been asked to stay home at least until they are instructed otherwise. This unfortunate event presents an innovative opportunity for neurosurgical education in Africa. Herein, we detail the framework of an online neurosurgical education initiative to advance the education of African residents and young neurosurgeons during and after the COVID-19 pandemic.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Neurosurgeons/education , Neurosurgical Procedures/education , Pneumonia, Viral/epidemiology , Africa/epidemiology , COVID-19 , Coronavirus Infections/surgery , Humans , Neurosurgeons/trends , Neurosurgical Procedures/trends , Pandemics , Pneumonia, Viral/surgery , SARS-CoV-2 , Surveys and Questionnaires
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