International Collaboration Research Articles

Current smoking is related to severe damage in systemic lupus erythematosus patients

Objective To assess the relationship between smoking exposure and organ damage accrual measured by Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index for Systemic Lupus Erythematosus score (SLICC-SDI) in consecutive patients with systemic lupus erythematosus (SLE) from Argentina. Methods 623 consecutive SLE patients (fulfilling ≥4, 1997 ACR criteria) were included in this cross-sectional study. Sociodemographic and disease related variables including SLICC-SDI score and smoking status were collected. Patients currently smoking were considered “smokers”, and “non-smokers” those who never smoked and former smokers. SLICC-SDI was divided into two categories: <3 and ≥3 was defined as severe damage. Results Six hundred and 23 patients were included in the analysis, 89% women. Eighty-four per cent were non-smokers and 16 % were current smokers 83 percent of patients had SLICC-SDI <3 and 17 % had SLICC-SDI ≥3. Twenty one percent of patients with SLICC-SDI ≥3 and 15% with <3 SLICC-SDI were current smokers ( p 0.081). In the multiple regression analysis, current smoking (OR 1.82, CI 95% 1.01-3.31, p 0.046), older age (OR 1.04, CI 95% 1.00-1.05, p 0.034), disease duration (OR 1.03, CI 95% 1.00-1.07, p 0.021) and cyclophosphamide exposure (OR 2.97, CI 95% 1.49-5.88, p 0.002) were related to SLICC-SDI ≥3. Conclusion In our sample of patients, current smoking, older age, disease duration and cyclophosphamide were related to severe damage (SLICC-SDI ≥3).

A Call to Action for Global Solutions to Air Quality Crisis: Urgent Actions and Innovative Solutions Needed

ABSTRACT Air pollution, specifically smog, has become a prevalent concern worldwide due to its association with various health risks including stroke, heart disease, lung disease, lower respiratory disorders, and cancer. The excessive use of fossil fuels and the rapidly increasing population have led to the rise in air pollution, which also increases the risk of other ailments such as diabetes and negatively impacts cognitive development in children as well as mental health. According to the World Health Organization, almost 7 million people die each year due to air pollution. According to the recent reports by the Swiss organization (IQAir) on October 22nd, 2024, accessed at (https://www.iqair.com) Lahore in Pakistan, Delhi in India, Kinshasa in Democratic Republic of the Congo, Milano in Italy, Belgrade in Serbia, Jakarta in Indonesia and Karachi in Pakistan have been identified as the top seven cities with the highest US Air Quality Index (AQI). The rising levels of air pollution pose significant health risks globally, necessitating immediate action from governments and communities. Implementing effective policies, investing in clean technologies, and fostering international collaboration are essential to mitigate the impacts of air quality deterioration on public health and the environment.

Disease activity at the onset of diagnosis as a predictor of disease outcomes in a cohort of patients with systemic lupus erythematosus: A post hoc retrospective analysis of the COMOSLE-EGYPT study.

Systemic lupus erythematosus (SLE) has a non-uniform course directly reflected in changes in disease activity and anticipation of damage. To determine the impact of disease activity at the onset of disease diagnosis, measured by the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) disease activity score, on different disease parameters and outcomes. This multicentre, retrospective cohort study included 823 SLE patients. Disease damage was measured by the Systemic Lupus International Collaborating Clinics Damage Index (SLICC), and comorbidities were measured by the Charlson Comorbidity Index (CCI). According to the mean SLEDAI at onset of disease diagnosis, patients were classified into two groups: I included patients with a mean SLEDAI ≤ 10 (non-severe disease activity), and II included patients with a mean SLEDAI > 10 (severe disease activity). SLEDAI at onset of disease diagnosis was a predictor of damage and comorbidities. A higher SLEDAI score at onset of disease diagnosis was associated with damage accrual. Patients who are younger at disease onset are more likely to have more severe disease. Severe disease activity at the onset of disease diagnosis was also associated with future comorbidity occurrences, but it was not significantly associated with mortality. SLEDAI at the onset of disease diagnosis could be a prognostic marker predicting the damage, which may help in the identification of patients who are at higher risk of adverse outcomes. Special care should be directed towards patients who are younger at disease onset as they may have a higher disease activity at diagnosis. Key Points • This is a unique study as it is the first to focus on the impact of SLE disease activity at the onset of disease diagnosis measured by SLEDAI disease activity score on different disease parameters and outcomes. • Previous studies, though these are scarce, have highlighted the impact of disease activity throughout the disease course and not specifically at the beginning of the SLE disease.

COMPARATIVE ANALYSIS OF THE COMPETITIVENESS OF UKRAINE'S ICT SECTOR: AN INTERNATIONAL PERSPECTIVE

The purpose of the paper is to examine the international competitiveness of Ukraine's ICT sector through a comparative analysis with 30 countries, identify its strengths and weaknesses, and provide actionable insights for policymakers, industry stakeholders and investors to improve Ukraine's position in the global ICT market. Methodology. The research employs the composite index methodology to assess the international competitiveness of Ukraine's information and communication technology (ICT) sector. The original ITSIC comprises 35 indicators; however, this has been expanded to 58 in order to provide a comprehensive view of the competitive advantages and position of the ICT sector in the global ICT market. Results. The article presents the findings of a comparative study of the ICT sector of Ukraine with global and regional leaders in the global ICT market. In order to identify the factors influencing the formation of competitive advantages, the following groups of factors were taken into account: the state of ICT infrastructure, the availability of qualified and competent IT professionals, the state and favourability of the political and business environment, the innovative potential of the ICT sector and its involvement in international trade and cooperation. The calculations have yielded the ratings for each group of indicators and the composite index as a whole, which identify the leaders in both global and regional dimensions. Specific consideration is given to the positioning of Ukraine's ICT sector within the context of the surveyed countries, with a focus on the identification of its competitive advantages and disadvantages within the global ICT market. Consequently, it has been determined that the international competitiveness of the domestic ICT sector between 2018 and 2022 was most significantly influenced by the extent of its involvement in international trade and collaboration, the availability and proficiency of the talent pool, and the quality of the ICT infrastructure. In conclusion, this study has identified the factors and trends that have the potential to impede Ukraine's ascension as a global leader in the ICT sector. Practical implications. The findings of the study may prove beneficial to a number of parties, including public authorities, ICT companies, investors and venture capitalists, educational and research institutions, international organisations and development agencies, IT entrepreneurs and the general public. The value and originality of the study can be found in its comprehensive, data-driven, and context-specific analysis, which provides actionable insights and strategic recommendations to enhance the international competitiveness of Ukraine's ICT sector.

Celebrating four decades of the Centre de Recerca Matemàtica

Founded in 1984, the Centre de Recerca Matemàtica (CRM) has significantly advanced mathematical research in Catalonia, receiving prestigious awards and international recognition. Created by the Institut d’Estudis Catalans, the CRM promotes international collaboration and advanced training, hosting events and supporting research in both fundamental and applied mathematics to address societal challenges.

Constructing and exploring neuroimaging projects: a survey from clinical practice to scientific research.

Over the past decades, numerous large-scale neuroimaging projects that involved the collection and release of multimodal data have been conducted globally. Distinguished initiatives such as the Human Connectome Project, UK Biobank, and Alzheimer's Disease Neuroimaging Initiative, among others, stand as remarkable international collaborations that have significantly advanced our understanding of the brain. With the advancement of big data technology, changes in healthcare models, and continuous development in biomedical research, various types of large-scale projects are being established and promoted worldwide. For project leaders, there is a need to refer to common principles in project construction and management. Users must also adhere strictly to rules and guidelines, ensuring data safety and privacy protection. Organizations must maintain data integrity, protect individual privacy, and foster stakeholders' trust. Regular updates to legislation and policies are necessary to keep pace with evolving technologies and emerging data-related challenges. CRITICAL RELEVANCE STATEMENT: By reviewing global large-scale neuroimaging projects, we have summarized the standards and norms for establishing and utilizing their data, and provided suggestions and opinions on some ethical issues, aiming to promote higher-quality neuroimaging data development. KEY POINTS: Global neuroimaging projects are increasingly advancing but still face challenges. Constructing and utilizing neuroimaging projects should follow set rules and guidelines. Effective data management and governance should be developed to support neuroimaging projects.

Bibliometric Analysis of Herbal Treatments for Male Infertility: Trends, Efficacy, and Future Directions

Male infertility, which affects approximately 7% of men worldwide, contributes significantly to overall infertility rates. This condition stems from complex genetic, hormonal, and environmental factors. Conventional treatments, including pharmacological and surgical options, often have limited efficacy and can cause adverse side effects, prompting growing interest in alternative treatments, particularly herbal medicine. This bibliometric analysis investigates trends, efficacy, safety, and future directions in the use of herbal treatments for male infertility. Using Scopus data and Biblioshiny for network visualization, the analysis evaluates publication trends, geographical and institutional contributions, funding sources, and the primary themes addressed in the field up to 2024. Findings indicate increasing research interest, particularly in China, Iran, and India, where traditional medicine systems like Traditional Chinese Medicine and Ayurveda are culturally significant. Despite promising results, especially from herbs such as Withania somnifera and Tribulus terrestris, the field lacks standardized formulations and rigorous clinical trials that confirm these remedies’ efficacy and safety. This study highlights the need for standardized methodologies and expanded international collaborations to ensure the global applicability of findings. Further research is essential to integrate these herbal treatments effectively into mainstream medical practices, offering culturally sensitive and scientifically validated treatment options.

EXPLORING INTELLECTUAL AND EDUCATIONAL MIGRATION IN KAZAKHSTAN: DOCUMENTARY ANALYSIS

Background: Addressing brain drain and fostering human capital development are critical for sustaining a nation's long-term economic growth, innovation capacity, and global competitiveness. Kazakhstan has faced significant brain drain, particularly following the dissolution of the Soviet Union, as many skilled professionals sought better opportunities abroad. Despite government efforts to retain talent, the country continues to experience a negative migration balance, with a substantial portion of emigrants being highly educated and skilled. This study examines the challenges posed by brain drain and evaluates Kazakhstan's current policy initiatives aimed at addressing intellectual migration and fostering human capital development. Methods: The study employs a qualitative research approach using documentary analysis to explore intellectual and educational migration in Kazakhstan. The methodology involves systematically reviewing key government policy documents and reports, such as the Concept of Migration Policy of the Republic of Kazakhstan for 2023-2027. Documentary analysis was selected for its ability to provide in-depth insights into government initiatives and policy frameworks, enabling an assessment of their long-term effectiveness. Content analysis was applied to identify recurring themes and policy shifts related to human capital development and brain drain. Results and conclusions: The findings highlight the government’s efforts to attract skilled professionals, retain domestic talent, and foster international collaboration through streamlined visa processes, academic partnerships, and the establishment of international branch campuses. The analysis highlights educational immigration as a core component of Kazakhstan's migration strategy, shaped by regional factors and geopolitical considerations. Despite these efforts, the study identifies ongoing challenges in creating attractive domestic career opportunities and competitive research environments, which are crucial for the longterm retention of talent. By leveraging international best practices and fostering collaboration between the government, academia, and industry, Kazakhstan can enhance its position in the global knowledge economy while addressing demographic and economic challenges. The paper concludes by discussing the potential policy implications and recommendations for sustaining Kazakhstan’s human capital development in the context of global intellectual migration trends.

Advancing Global Pharmacoequity in Oncology.

Limited availability and affordability of cancer drugs contribute to staggering disparities in cancer survival between high-income and low- and middle-income countries (LMICs). As infrastructure for cancer care rapidly develops, there is an urgent need to reduce prices and improve access to cancer medicines in LMICs to advance pharmacoequity globally. Prior strategies to expand access to cancer medicines in LMICs have primarily relied on charity or differential pricing and have yielded limited results. Policymakers at the World Health Assembly recently proposed several strategies to increase global access to cancer drugs. Reviewing empirical data and lessons learned from medication access programs for HIV, COVID-19, and other infectious diseases, 3 strategies that multilateral organizations can use to reduce prices of cancer drugs in LMICs are discussed herein. These include (1) building regional technology transfer and manufacturing hubs, (2) expanding and streamlining use of compulsory licenses, and (3) implementing global standards for drug price transparency. Counterpoints to the critiques of these policies are critiqued and how programs can use these strategies to build on existing disease-centered initiatives is discussed. Lessons learned from the global response to HIV and COVID-19 show that international collaboration and support from the World Health and Trade Organizations can ensure a unified, coordinated agenda for advancing access to care in LMICs. Building on these lessons and implementing similar approaches for cancer drugs can play a critical role in expanding accessibility and affordability of cancer medicines in LMICs. With a growing burden of cancer morbidity and mortality in LMICs, redoubled efforts to deliver essential cancer medications to LMICs would have an immense impact on global cancer control and achieving the United Nations Sustainable Development Goals.

The New Paradigm of Russia’s International Financial Relations

The objective of this study is to explore the fundamental features of the emerging international financial framework in Russia, to pinpoint potential risks and central issues in its development. The distinctive characteristics of Russian companies’ international trade activities are explored through a comparative and economic-statistical analysis. The identification of risks was done by creating checklists using logical and analytical methods to organize information about the research topic. The risk analysis was based on the Ishikawa method (“fish bone”). The framework of Russia’s international financial interactions from 1991 to 2014 was centred on the goal of swiftly integrating the country into the global monetary and financial framework, fully embracing the standards set by the global power, while also acknowledging the increasing reliance on the collective West, which could potentially compromise national interests. The New Paradigm envisions a balanced integration of diverse subsystems and individual components — nations and groups of nations — within a cohesive geographical context. This framework envisions the enhancement of mutually beneficial international collaboration with allied nations and the development of novel settlement and payment systems, which are based on the utilization of national currencies and/or cutting-edge digital instruments.

Clinical Presentation, Care Pathways, and Delays in Access to Specialized Care in Patients With Systemic Lupus Erythematosus: A Study From Lupus Midwest Network (LUMEN).

We aimed to characterize presentation and care pathways of patients with systemic lupus erythematosus (SLE), and delays in access to SLE-specialized care. We included patients with incident SLE from the Lupus Midwest Network registry. Time from the first medical encounter for SLE clinical manifestation to access to SLE-specialized care, physician diagnosis, and treatment was estimated. Delays were defined as ≥6 months to access specialized care. We compared SLE manifestations, disease activity, and Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage indexes (SDI) between patients with and without delays. Logistic regression models assessed associations with delays. The study included 373 patients with SLE. The median time to access SLE-specialized care was 1.1 (95% confidence interval [CI] 0.9-1.5) months, time to diagnosis was 30.6 (95% CI 18.9-48.1) months, and time to treatment initiation was 4.7 (95% CI 3.9-8.4) months. Approximately 25% of patients (93 out of 373) experienced delays accessing specialized care, which were associated with fewer SLE manifestations at first SLE-related encounter (fewer than two SLE domains; 92% vs 72%, P < 0.001). Patients with mucocutaneous or musculoskeletal manifestations were less likely to experience delays, whereas hematologic (odds ratio [OR] 1.71, 95% CI 1.03-2.84) or antiphospholipid antibodies domains (OR 6.05, 95% CI 2.46-14.88) were associated with delays. Delays were associated with damage at first access to SLE-specialized care (SDI ≥1; 30% vs 7%, P < 0.001). Patients follow a heterogeneous pathway to receive care. One-fourth of patients experienced delays accessing SLE-specialized care, which was associated with disease-related damage. Fewer manifestations, hematologic manifestations, or antiphospholipidantibodies were associated with delays.

The Influence of Facial Injury during the First World War on the Development of Plastic and Reconstructive Surgery in Britain and Germany.

In the First World War (WW1), different types of injuries became both political and economic factors for the main belligerent countries. This work illustrates the special role facial injuries played during and after the war and the profound impact they had on the field of Plastic Surgery in Britain and Germany.This is a historical work based on primary and secondary sources. English and German material was used to compile an overview of the development of Plastic and Reconstructive Surgery as a specialty during WW1 and up to the Second World War (WW2).Plastic and Reconstructive Surgery had the task of reconstructing male beauty and personalities, restoring the most intense, disfigured reminders of a terrible war in homes and the public. Looking at the significant role the specialty played during the war, remarkably, most of the contributors struggled to find financial support to develop designated specialized departments in the inter-war period. The specialty's connection to the emotional subject of facial disfigurement did not work in its favor at a time when people wanted to forget the horrors of the war.The developments in Britain and Germany during the WW1 were less isolated than often described and the inter-war period saw much effort for international collaboration. The different developments of WW2 further illustrate how essential the efforts of a strong group of individuals and support from authorities were for the evolution of Plastic Surgery as a specialty.

Emerging trends and key themes in public financial management: A bibliometric analysis from 1977 to 2024

This study presents a comprehensive bibliometric analysis of the literature on public financial management (PFM), aiming to identify key trends, influential publications, and emerging themes. Using data from Web of Science and Scopus, the study examines the evolution of PFM research from 1977 to 2024. The findings reveal a significant increase in PFM research output, particularly after 2010, with countries like the United States, the United Kingdom, and China contributing the most publications. Central themes such as financial management, transparency, and accountability remain prominent while emerging topics like gender budgeting, health insurance, and blockchain technology reflect shifting priorities in the field. The study employed performance analysis and science mapping techniques to assess the structure and dynamics of PFM research. The analysis highlights key focus areas, including fiscal decentralization and sector-specific management, and identifies gaps in the existing literature, particularly regarding interdisciplinary and international collaboration. The results suggest that while PFM remains rooted in traditional governance and financial control, there is a growing emphasis on modern, innovative solutions to address contemporary challenges. This study’s insights provide a roadmap for future research, emphasizing the importance of transparency, technological integration, and inclusive financial policies. In conclusion, this bibliometric analysis contributes to understanding PFM’s evolving landscape, offering scholars and policymakers a clearer perspective on current trends and future directions in the field. Future research should focus on expanding interdisciplinary approaches and exploring the practical impacts of emerging PFM trends across different regions.

The international nucleotide sequence database collaboration (INSDC): enhancing global participation.

The members of the International Nucleotide Sequence Database Collaboration (INSDC; https://insdc.org) have built systems to collect, archive and disseminate sequence data for more than four decades. The three collaborating organizations, the National Library of Medicine, National Center for Biotechnology Information (NLM-NCBI) in the UnitedStates, Research Organization of Information and Systems, National Institute of Genetics (ROIS-NIG) in Japan; and the European Molecular Biology Laboratory-European Bioinformatics Institute (EMBL-EBI) formalized their relationship through the adoption of an arrangement which documents their commitment to free and open access to genomic sequences. The INSDC is committed to expand the collaboration to be more representative of the global community of sequences and users. Diversifying participation through new membership will advance open science and data sharing and, in turn, drive innovation. This expansion will additionally benefit the INSDC and its broad user base by providing additional diverse perspectives as it explores emerging areas of data management, including federation, attribution and management.

Red cell specifications for blood group matching in patients with haemoglobinopathies: An updated systematic review and clinical practice guideline from the International Collaboration for Transfusion Medicine Guidelines.

Red blood cell (RBC) antigen matching beyond ABO and RhD is commonly recommended for patients with sickle cell disease (SCD) and thalassaemia. We present an updated systematic literature review to inform evidence-based guidelines on RBC matching. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) tool was used to develop recommendations. Six new observational studies (4 prospective, 2 retrospective) were identified. The six studies reported on 583 patients in total, including cross-over designs, with sample sizes from 10 to 343. Studies were heterogeneous, utilising varying degrees of RBC matching and different definitions for 'extended' matching. All reported on alloimmunisation. One study reported on molecular matching. The reported prevalence of alloimmunisation using limited matching was 0%-50% and with extended matching was 0%-24%. Eighty-two patients were alloimmunised before study entry. The risk of bias across studies was moderate to critical. The guideline panel recommends that ABO, RhDCcEe, and K-compatible RBCs are selected for individuals with SCD and thalassaemia, even in the absence of alloantibodies, and that RBCs which are antigen-negative to already existing clinically significant antibodies are chosen. There is a need for comparative research to define the benefit, impact, cost-effectiveness, and feasibility of extended RBC matching strategies to prevent alloimmunisation.

OGC O01 - Stomach Cancer Elective Surgery Morbidity and Mortality at 90-Days (HOLD Study): A Prospective, International Collaborative Cohort Study

Abstract Background Data on multinational 90-day mortality and morbidity rates after surgery for gastric cancer is limited in the literature. This study aimed to understand the 90-day mortality and morbidity outcomes according to GASTRODATA Registry for elective gastric cancer surgery patients and identify risk factors. Method We conducted an international prospective study on ≥18 years patients undergoing elective surgery for gastric cancer with curative intent from 01 April 2022 to 30 September 2022. Known metastatic disease, concurrent secondary cancers, gastrointestinal stromal tumour (GIST) and Siewert type I/II oesophagogastric junction malignancies were excluded. Univariate and multivariate logistic regression was used to identify variables associated to 90-day outcome. Results 380 collaborators from 47 countries submitted data on 1538 patients. Mean age was 64.2 years and 58.5% were males. 90-day morbidity rate was 38.2% (n=587) and mortality rate was 2.9% (n=45). Pre-operative higher CCI or ASA score, pre-operative weight loss &amp;gt;10%, and surgical determinants such as type of gastric resection, positive specimen margin, number of harvested lymph nodes, longer surgery duration and post operative pathological IV staging (p value&amp;lt;0.05) were identified as predictors of postoperative severe complications and mortality. Conclusion Elective gastric cancer surgery has a 90-day morbidity of 38.2% and 90-day mortality of 2.9%, globally. This study identified several factors associated with higher morbidity and exemplified the importance of a unified language on surgical morbidity, pre-habilitation and ongoing audits to enhance patient outcomes.

Distribution and Implications of Mycobacterium Tuberculosis Genotypes in Animals: A Comprehensive Review

This narrative review discusses the spread of Mycobacterium tuberculosis among animal populations, focusing on M. tuberculosis genotype distribution and frequency across different species. To develop comprehensive tuberculosis control strategies under the One Health approach, it is important to have an understanding of the genotypes of M. tuberculosis in animals. Animal infections are discussed, as well as the pathogenesis and epidemiology of M. tuberculosis. Various genotyping methods, including spoligotyping, MIRU-VNTR, and whole genome sequencing, are discussed in the review, emphasizing their role in understanding strain diversity and transmission dynamics. There are many factors influencing the distribution of M. tuberculosis genotypes in animals, including environmental conditions, host factors, human-animal interactions, and animal trade practices. It is clear from the review that the Euro-American lineage is widely distributed across animal species, with the Beijing genotype becoming increasingly prevalent in regions where it is prevalent in humans. The study highlights the need for more comprehensive genotyping studies as well as the development of better diagnostic tools. This will enhance our understanding of M. tuberculosis in animal populations. A conclusion to the review, emphasizes that standardizing genotyping protocols, utilizing whole genome sequencing, and fostering international collaboration are essential for improving our understanding of M. tuberculosis diversity in animals and developing targeted tuberculosis control strategies. The impact of Mycobacterium tuberculosis genotypes in animals is multi-faceted, affecting both public health and veterinary practices. Addressing these challenges requires a coordinated and comprehensive approach that considers the interconnectedness of human and animal health systems, fosters research, enhances surveillance, and implements effective control strategies.

Fishing Vessel Risk and Safety Analysis: A Bibliometric Analysis, Clusters Review and Future Research Directions

This study conducts a bibliometric analysis to evaluate the current research landscape and identify future directions in fishing vessel safety. Using the Scopus database, 285 relevant documents were collected and analyzed using the Biblioshiny app version 4.1 in the bibliometrix R package and VOSviewer version 1.6.20. The analysis generated an authors’ collaboration network, a three-field plot, and a keyword Thematic map, which were used for citation analysis, while VOSviewer was utilized to build networks between journals, articles, affiliations, countries, and keywords, enabling bibliographic coupling. The results identified four primary research clusters: Accident/Risk Analysis, Human Errors, Stability, and Operation. A detailed review of selected studies within these clusters was conducted, focusing on accident and risk factors, analytical methods, their strengths and weaknesses, and potential improvements. Based on these findings, a discussion was provided on future research directions in fishing vessel safety. The results suggest that future research should prioritize the integration of advanced technologies, enhancement of real-time monitoring capabilities, and promotion of international collaboration to ensure the safety of fishermen in hazardous environments.

OGC O01 - Stomach Cancer Elective Surgery Morbidity and Mortality at 90-Days (HOLD Study): A Prospective, International Collaborative Cohort Study

OGC O01 - Stomach Cancer Elective Surgery Morbidity and Mortality at 90-Days (HOLD Study): A Prospective, International Collaborative Cohort Study

Advanced practice nursing in surgery: A scoping review of roles, responsibilities, and educational programs.

The increasing complexity of the healthcare sector requires an evolution in nursing education to effectively manage care in complex and interdisciplinary contexts. This review aims to analyze the role of advanced practice nurse (APN) in the surgical context within hospital settings, detailing their functions and responsibilities. It also provides an overview of the main degrees and postgraduate training programs for specialization in perioperative management in major Western countries. This scoping review followed the Arksey-O'Malley framework and Joanna Briggs Institute methodology. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was used to ensure rigorous and transparent reporting. Among the 3663 records analyzed, 20 were included in this review. The role of the APN spans across the preoperative, intraoperative, and postoperative phases, encompassing follow-up care as leaders, mentors, and contributors to research. APNs play a pivotal role by offering direct and indirect patient care at each stage of the surgical journey. Acting as liaisons between the healthcare team and patients, APNs enhance healthcare delivery through personalized, coordinated care, while also fostering ongoing education and research in the field. APNs enhance surgical care by providing in-depth clinical assessments, education, and support throughout the treatment process. However, the lack of standardized regulatory frameworks in some countries limits the autonomy of APNs within the healthcare system, compromising their ability to address unmet health needs and engage in international collaboration. The findings underscore the need for standardized educational pathways, roles, responsibilities, and autonomy for APNs, facilitating better international collaboration and contributing to scientific research.