African Women in Neurosurgery: An Exploration of Historical Perspectives, Current Realities, and Future Prospects.

BACKGROUND: Gender disparities remain a significant issue, particularly impacting African women in the field of neurosurgery. METHODS: Databases, articles, and perspectives were reviewed to identify challenges faced by African Women in Neurosurgery (AWIN), and explore solutions for recruitment, retention, and career advancement of AWIN. RESULTS: In 1982, Africa saw its first female neurosurgeon, with the first female president of the World Federation of Neurosurgical Societies appointed four decades later. Presently, the continent hosts 245 female neurosurgeons, with North Africa comprising the majority at 76.3%, with Algeria notably contributing 72.2% of this total. Southern Africa contributes 7.8%, while West Africa, East Africa, and Central Africa contribute 6.5%, 6.1%, and 3.3%, respectively. Thirteen countries lack neurosurgeons entirely, and 30 out of the 54 African nations face shortages of female neurosurgeons, with distributions as follows: North Africa (1-country), Southern Africa (6-countries), West Africa (8-countries), East Africa (9-countries), and Central Africa (6-countries). Our analysis mapped the distribution of 245 AWIN across the African regions and examined the professional trajectories and achievements of 17 pioneering AWIN. Additionally, we compiled registries for: 1) 76 neurosurgical training programs across 26 African countries, 2) organizations tackling gender disparities in neurosurgery, and 3) recommendations to promote AWIN across governmental, community, and academic spheres. CONCLUSION: To boost AWIN representation in neurosurgery, concerted and comprehensive efforts are vital. Collaboration among medical schools, training programs, and governments is key to fostering diversity and inclusivity in African neurosurgical settings.

The Effectiveness of Common Interventions in the Management of Sickle Cell Disease in Primary Care Settings: A Review.

Sickle cell disease (SCD), a chronic condition that affects men and women equally, continues to present a public health burden in the United States due to its associated morbidity and complications. Despite advances in medical knowledge and the design of novel therapies for managing the disease, its burden remains compounded because of increasing rates of immigration arising from global displacements and economic unrest in many countries. We thus conducted a comprehensive literature review of publications from 2000 to 2022 to gather guidelines on managing SCD, with a search through four databases, PubMed, Embase, Google Scholar, and Cochrane; 42 articles met the final inclusion criteria after the full-text article screening process. In the United States healthcare system, primary care physicians (PCPs) are generally providers who cater to the lifelong management of chronic medical conditions, SCD not being an exception. While more SCD patients now present to primary care clinics, many PCPs still lack the confidence and adequate experience necessary to manage the condition effectively. The gap created by the shortage of PCPs extensively equipped to provide comprehensive SCD care leads to poor health outcomes for patients. It is imperative now more than ever to continue to raise awareness about this condition at the provider level, to ensure that patients receive well-rounded care to improve their quality of life and clinical outcomes. Providing up-to-date knowledge about existing and novel therapies and/or modalities of SCD treatment would undoubtedly equip the PCPs with self-assurance to manage the condition adeptly. Thus, we explore various public health interventions such as hydroxyurea therapy, pneumococcal vaccination, penicillin therapy, iron chelation therapy, and clinical decision support tools that have been implemented in primary healthcare settings and shown to be effective in improving SCD care. We also discuss recent advancements that can lead to improved outcomes for SCD patients in the future.

Challenges and Perspectives for Future Considerations in the Bioengineering of a Bioartificial Pancreas.

There is an unrelenting interest in the development of a reliable bioartificial pancreas construct since the first description of this technology of encapsulated islets by Lim and Sun in 1980 because it promised to be a curative treatment for Type 1 Diabetes Mellitus (T1DM). Despite the promise of the concept of encapsulated islets, there are still some challenges that impede the full realization of the clinical potential of the technology. In this review, we will first present the justification for continued research and development of this technology. Next, we will review key barriers that impede progress in this field and discuss strategies that can be used to design a reliable construct capable of effective long-term performance after transplantation in diabetic patients. Finally, we will share our perspectives on areas of additional work for future research and development of the technology.

Islet cell encapsulation - Application in diabetes treatment.

In this minireview, we briefly outline the hallmarks of diabetes, the distinction between type 1 and type 2 diabetes, the global incidence of diabetes, and its associated comorbidities. The main goal of the review is to highlight the great potential of encapsulated pancreatic islet transplantation to provide a cure for type 1 diabetes. Following a short overview of the different approaches to islet encapsulation, we provide a summary of the merits and demerits of each approach of the encapsulation technology. We then discuss various attempts to clinical translation with each model of encapsulation as well as the factors that have mitigated the full clinical realization of the promise of the encapsulation technology, the progress that has been made and the challenges that remain to be overcome. In particular, we pay significant attention to the emerging strategies to overcome these challenges. We believe that these strategies to enhance the performance of the encapsulated islet constructs discussed herein provide good platforms for additional work to achieve successful clinical translation of the encapsulated islet technology.