Windsor University School of Medicine

Early-career neurosurgeon training has not yet fully recovered from the decrease in operative exposure that began during the early COVID era. Elective case cancellations, redeployment, and limited staff access to operating rooms reduced the chances of graduated responsibility across a variety of settings and widened existing gaps in the global workforce. Much of this was addressed by numerous programs that reinforced the application of simulation using inexpensive models and virtual environments, helping keep skills developing in the absence of practical experience. It was reported that simulator hours and trainee confidence improved, although practical surgery was needed to consolidate them. Online instruction, video-conferencing dissections, and organized mentoring also assisted learning, particularly in areas where training facilities are not evenly distributed. New interest in digital tools and early uses of artificial intelligence were indicative of a larger project to create flexible training systems. Developing a systematic roadmap that brings together case-log surveillance, simulation, video assessment, stratified mentorship, and partners in networks can help stabilize and modernize early career neurosurgical education.

Introduction: Vitamin D is a fat-soluble vitamin present in two isoforms: vitamin D3 and D2. Along with many essential functions, it also acts as a neurosteroid that plays a vital role in brain development and functioning. Vitamin D deficiency (VDD) is globally seen as associated with risk factors resulting in multiorgan dysfunctions and disorders. The need and demand for nutrition increases during pregnancy and lactation, and a lack of it hampers fetal growth. This review aims to investigate the association between maternal vitamin D levels and the neurodevelopmental health of the offspring. Materials and methods: This review utilised articles published in PubMed and Scopus from 2010 onwards, using specific keywords: maternal, vitamin D deficiency, and neurodevelopment. Systematic reviews, meta-analyses and non-English literature were excluded. A total of 98 articles were retrieved for the review. Discussion: Varying rates of vitamin D deficiency during pregnancy were noticed globally based on geography, race, income, and education. The impact of vitamin D deficiency leading to cognitive disorders such as Schizophrenia, specifically found to be associated with a decrease in GABAergic interneurons, was also reported by various authors. Cortical thickening, decreased surface area of the brain, and decreased expression of GAD proteins associated with VDD have also been reported recently. Conclusion: Vitamin D deficiency has been linked to a host of various neurodevelopmental disorders, including autism spectrum disorder, attention deficit hyperactivity disorder, and schizophrenia. This necessitates the importance of ensuring adequate maternal vitamin D levels to support offspring's cognitive and psychological well-being, thereby fostering healthier communities.

BackgroundDepression and anxiety are highly prevalent in the U.S. and can hinder engagement in preventive health services. Individuals affected by these conditions may have reduced motivation and lower health literacy, increasing their vulnerability to missed preventive-care opportunities such as vaccination. Awareness of human papillomavirus (HPV) and the HPV vaccine is crucial for cancer prevention but remains underexplored among adults with mental-health conditions.MethodsWe analyzed data from the Health Information National Trends Survey (HINTS) 5, Cycles 1-4 (2017-2020), to assess HPV and HPV-vaccine awareness among U.S. adults aged 18-44 with self-reported depression and/or anxiety. Weighted descriptive statistics, chi-square (χ²) tests, and multivariable logistic-regression models were used to assess awareness and associated sociodemographic and health-related factors. The primary aim was to estimate the prevalence of HPV and HPV-vaccine awareness, while the secondary aim was to identify associated sociodemographic and health-related predictors. Awareness was defined using binary (“yes”/“no”) responses to HINTS items, and mental-health exposure was defined as self-reported physician-diagnosed depression and/or anxiety.ResultsThe analytic sample included 1,105 adults, most of whom were female (n = 709; 64.1%), aged 18-34 years (n = 623; 56.4%), White (n = 753; 68.2%), and urban residents (n = 956; 86.5%). Approximately one-third (n = 372; 33.5%) held a college degree, and n = 384 (34.8%) reported annual income ≥ $75,000. Overall, 944 (85.4%) were aware of HPV, and 839 (75.9%) were aware of the HPV vaccine. Higher educational attainment (χ² = 46.7, p < 0.001) and female sex (χ² = 6.88, p = 0.009) were associated with greater awareness, whereas Hispanic ethnicity (χ² = 9.4, p = 0.024) and male sex were linked to lower awareness. Participants with two or more comorbidities showed higher HPV awareness (χ² = 6.11, p = 0.047) but not vaccine awareness (χ² = 2.34, p = 0.311).ConclusionsWhile overall awareness of HPV is high, disparities persist by sex, education, and ethnicity among adults with depression and/or anxiety. Integrating culturally tailored and literacy-appropriate HPV education into mental-health and primary-care settings may promote equitable vaccine awareness and uptake.

Introduction: Dementia is a progressive neurocognitive disorder affecting aging populations worldwide. Understanding its incidence trends is essential for planning preventive strategies and healthcare services, particularly in countries with aging demographics like Canada. This study aimed to examine national trends in the age-standardized incidence rates of newly diagnosed dementia, including Alzheimer's disease, among Canadians aged 65 years or older from 2007 to 2022.Methods: We conducted a retrospective, population-based trend analysis using the Canadian Chronic Disease Surveillance System (CCDSS), administered by the Public Health Agency of Canada (PHAC). The CCDSS aggregates de-identified administrative health data supplied by provincial and territorial health ministries, including physician billing claims, hospital discharge abstracts, and health insurance registry data. Dementia cases were ascertained using validated International Classification of Diseases (ICD)-9/ICD-10 diagnostic codes for Alzheimer’s disease and related dementias applied to physician and hospital records (case definition and code list per CCDSS protocols). The study period covered fiscal years 2007-2008 through 2021-2022, with supplementary data for 2022-2023 where available. Age-standardized incidence rates were calculated using the 2011 Canadian standard population. Data completeness for physician billing and hospital discharge records exceeded 95% in participating jurisdictions; however, some provinces/territories had partial or missing submissions in certain years. All analyses used aggregated, de-identified counts provided by CCDSS; no individual-level records were accessed.Results: In 2022, the crude incidence rate of newly diagnosed dementia among Canadians aged 65 years and older was 1,323 per 100,000 population per year (95%CI: 1315-1331). By sex, females had a higher crude incidence (1,437 per 100,000 population per year; 95%CI: 1425-1449) than males (1,194 per 100,000 population per year; 95%CI: 1183-1206). Incidence increased markedly with advancing age: 610 per 100,000 population per year (95%CI: 604-617) in those aged 65-79, and 3,669 per 100,000 population per year (95%CI: 3640-3697) among individuals aged more than 80. Regional disparities were observed: Nunavut had the highest age-standardized rate (1,700 per 100,000 population per year; 95%CI: 921-2969) while Saskatchewan had the lowest (1,154 per 100,000 population per year; 95%CI: 1108-1203). From 2007 to 2022, the age-standardized incidence declined overall; this pattern may potentially reflect improvements in prevention, risk-factor control, or early detection, although causal attribution cannot be established from these data alone.Conclusion: Although the age-standardized incidence of newly diagnosed dementia in Canada declined modestly between 2007 and 2022, substantial sex, age, and regional disparities remain. The findings emphasize the need for ongoing investment in dementia prevention, equitable diagnostic access, and region-specific interventions. With the aging population, coordinated public health strategies remain essential to sustain progress and reduce the future burden of dementia on individuals, caregivers, and healthcare systems.

Background and aimsMelanoma now presents an average risk of 1 in 50 in the Western world. Talimogene laherparepvec (T-VEC), an FDAapproved oncolytic virus derived from Herpes Simplex Virus type 1 (HSV-1), has proven effective in reducing morbidity and mortality from melanoma but causes adverse effects like chills, fever, exhaustion, and injection site discomfort. Research focuses on combining T-VEC with immune checkpoint inhibitors, such as pembrolizumab, to enhance its efficacy and broaden its application.MethodsA systematic search was conducted using PubMed, Scopus, Web of Science, Google Scholar, and ProMED, adhering to PRISMA guidelines. Results were tabulated and analyzed.ResultsThis review included 15 studies comprising nine cohorts, four case reports, a case series, and a randomized control trial, involving 779 melanoma patients in stages IIIB to IV, 58% of whom were male with a mean age of 65 years. Treatment duration with T-VEC averaged 35.07 weeks, with dosages ranging from 10^6 to 10^8 PFU/ml. The intervention yielded a mean DRR of 41.87% and an ORR of 62.2%. The most common side effect was chills, affecting 21.69% of participants. Pyrexia was reported by 20.41% of participants, followed by influenzalike illness (14.89%).ConclusionT-VEC effectively improves ORR and DRR in melanoma patients. However, further research is needed on combination therapy prospects and its adverse effects.

ObjectivesProblematic smartphone use (PSU) is widespread among medical students and might be associated with visual, musculoskeletal, and neurological complaints. In this study, we investigated the relationship between PSU and oculomotor strain, cervical disability, and the impact of headaches.Materials and MethodsThe present study was conducted through a cross-sectional survey among 498 medical students in Lahore, Pakistan. PSU was assessed using the Smartphone Addiction Scale-Short Version (SAS-SV), oculomotor strain with the Computer Vision Syndrome Questionnaire (CVS-Q), cervical disability with the Neck Disability Index (NDI), and headache impact using the HIT-6. Data were assessed using Pearson's correlations, t-test, ANOVA, and multivariate regression in SPSS v.26.ResultsThe average SAS-SV score was 32.1 ± 4.9. PSU was associated with CVS (r = 0.229), NDI (r = 0.147), and HIT-6 (r = 0.088). Scores for all measures were higher among female students (p < 0.001). The youngest students presented with higher PSU; the CVS was more intense in 21-23 years of age, and older students had a greater cervical disability. Predictors of CVS, cervical disability, and headache impact were PSU, gender (female), younger age, low physical activity status, and comorbidities according to the regression models.ConclusionPSU is associated with increased oculomotor strain, neck disability, and headache burden in medical students, especially for females, younger-aged students, and those having low activity or comorbidities. Preventive strategies that promote digital well-being and healthy behaviours are advised.