Europe’s digital dependence is rising—the US and China pull ahead

Study by the University of Bonn and the Vodafone Institute: Autonomy is particularly low when it comes to digital platforms

University of Bonn

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The majority of DDI countries fall into the medium dependency category (yellow). There are some countries with low dependency (blue) and some with high dependency (purple). 

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Credit: Image: CASSIS/University of Bonn

Dependence on digital technologies in the European Union continues to grow—despite all calls for greater digital sovereignty. Between 2010 and 2023, Europe’s “Digital Dependence Index” (DDI) rose by 0.5 percentage points, while China reduced its dependence by nearly 11 percentage points and the U.S. by 6 percentage points. A major weakness lies in digital platforms, where European countries are almost entirely dependent on foreign providers. This is according to a policy study by the Vodafone Institute and the Center for Advanced Security, Strategic and Integration Studies (CASSIS) at the University of Bonn.

Despite numerous initiatives to strengthen technological autonomy, Europe became more dependent on digital technologies from abroad between 2010 and 2023—according to a new study by the Vodafone Institute and the University of Bonn. The policy study “Getting Strategic Priorities Right – Towards a Framework for Reducing Digital Dependencies” is the result of a year-long collaboration between the Vodafone Institute and the Center for Advanced Security, Strategic and Integration Studies (CASSIS) at the University of Bonn.

The University of Bonn’s “Digital Dependence Index,” on which the study is based, compares 51 countries—including 16 European countries—across four dimensions: trade in information and communication technology (ICT) goods, trade in ICT services, digital platforms, and ICT patents. The study highlights how countries’ dependence on foreign digital technologies changed annually between 2010 and 2023.

Moderate to High Level of Digital Dependence

Europe’s digital dependence increased by about 0.5 percentage points overall during this period. In comparison, China reduced its dependence by nearly 11 percentage points, and the United States by 6 percentage points. Throughout the period under review, European countries consistently exhibited moderate to high levels of digital dependence. Their greatest vulnerability lay in the area of digital platforms, where European countries were almost entirely dependent on foreign providers.

Between 2010 and 2023, the largest percentage point increases in digital dependence were recorded in Finland (13.7), Sweden (7.2), Norway (6.4), Estonia (3.9), and France (3.1). The sharpest declines in Europe were observed in Serbia (−17.3), the Czech Republic (−5.5), Poland (−4.2), and the United Kingdom (−3.5). Europe also remained highly dependent on foreign ICT patents. This limits its ability to capitalize on the economic and strategic benefits of technological innovations.

Joakim Reiter, Vodafone Group Chief External & Corporate Affairs Officer said: “Europe has spent years deliberating on digital sovereignty, but the evidence shows that its underlying dependence remains high. While the United States and China have strengthened their positions, Europe has fallen slightly further in the wrong direction. Europe has significant industrial, research and engineering strengths, but it needs to decide where those strengths can make the greatest difference. That means setting clear priorities, coordinating action across borders and sustaining investment beyond individual political cycles.”

No Uniform Dependency Profile

The study shows that European countries do not have a uniform dependency profile. They exhibit different capabilities and vulnerabilities. Therefore, a uniform Europe-wide policy does not appear advisable. Furthermore, the study shows that previous political efforts to achieve greater technological autonomy were too ambitious.

Maximilian Mayer, Professor for International Relations and Global Politics of Technology at the University of Bonn said: “Although European governments have implemented various policies and measures to foster digital sovereignty, their efforts have not been ambitious enough. One of the key problems is clearly the lack of strategic priorities for increasing digital capabilities and addressing digital dependencies.” Mayer’s CASSIS colleague Dr. Laura Mahrenbach adds: “Setting priorities isn’t enough on its own. To achieve those priorities, Europe needs to be smart in implementing digital resilience measures and engage more with international strategic partners.”

Four Policy Pathways

The researchers identify four evidence-based policy pathways, some of which can be combined:

• Building indispensable positions in the supply chain: Strengthening Europe’s existing industrial and technological capacities.
• Creating a European technology powerhouse: Making substantial investments in a competitive European approach, including platforms, infrastructure, patents, and homegrown technology companies.
• Addressing the most serious vulnerabilities: Identifying and eliminating critical technological bottlenecks, particularly where security and essential government functions are at stake.
• Diversification: Reducing excessive dependence on a small number of foreign suppliers by expanding European capabilities and forging new international technology partnerships.

The study recommends that European policymakers agree on common strategic priorities as soon as possible. They should also coordinate regulation, innovation, investment, and procurement across national borders and align short-, medium-, and long-term measures. It is also crucial to launch a long-term public debate on the benefits of greater digital resilience.

Website for the “Digital Dependence Index”

In addition to the study, an interactive website for the “Digital Dependence Index” – https://digitaldependence.eu/ – allows users to track changes in digital dependencies in detail. Policy makers, researchers, businesses, and the general public can use it to compare countries and regions, examine changes in country profiles over time, and view the underlying data. It also includes an AI-powered tool designed to help users navigate the dataset and understand its political context.

Study: https://www.vodafone-institut.de/wp-content/uploads/2026/10/digital-dependencies.pdf

DDI-Website: https://digitaldependence.eu/

Vodafone Institute: https://www.vodafone-institut.de/en/publication/digital-dependencies/


Media Contact:

Dr. Maximilian Mayer
Junior Professor of International Relations and Global Politics of Technology
Center for Advanced Security, Strategic and Integration Studies (CASSIS)
University of Bonn
Tel. +49 (0)228/73 5640
Email: maximilian.mayer@uni-bonn.de

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Method of Research

Data/statistical analysis

Subject of Research

Not applicable

Article Title

Getting Strategic Priorities Right – Towards a Framework for Reducing Digital Dependencies

Article Publication Date

28-Oct-2026

 

Francis Peyton Rous: The discovery that laid the foundations of viral oncology

“Rous is credited for identifying a transmissible agent responsible for sarcoma in chickens, a discovery that laid the foundation for the field of viral oncology”

Impact Journals LLC

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Figure 1. Portrait of Dr. Francis Peyton Rous (Courtesy of National Library of Medicine).

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Credit: Copyright: © 2026 Irudayaraj et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

BUFFALO, NY- October 28, 2026 – A new review was published in Volume 17 of Genes & Cancer on October 23, 2026, titled “The life and legacy of Francis Peyton Rous: The birth of viral oncology.”

The review explores the life and scientific achievements of Francis Peyton Rous, whose pioneering experiments demonstrated that a cancer-causing agent could be transmitted between chickens. His discovery challenged established ideas about cancer and helped lay the foundation for viral oncology, oncogene research and the modern understanding of cancer as a genetic disease. The article also examines his contributions to blood preservation, experimental carcinogenesis and scientific publishing.

The review was led by first author Pratiba Irudayaraj, affiliated with the University of Arkansas at Little Rock. Corresponding authors Nawab Ali and Krishnaswamy Kannan are affiliated with the University of Arkansas at Little Rock and Biomolecular Integrations Inc., Little Rock, Arkansas, respectively.

Today, scientists recognize that certain viruses can contribute to cancer development by altering cellular signaling, interfering with tumor-suppressor pathways or promoting chronic inflammation. However, at the beginning of the twentieth century, cancer was largely considered a disease arising from abnormalities within cells rather than infectious agents. Rous's research helped transform this understanding by demonstrating that an external biological agent could initiate malignant tumor formation.

Born in Baltimore, Maryland, in 1879, Rous developed an early interest in natural history and scientific observation. He studied at Johns Hopkins University, earning his medical degree in 1905, and later pursued pathology research at the University of Michigan and further training in Germany. His scientific approach was shaped by mentors who emphasized careful observation, accurate diagnosis and experimental rigor.

In 1909, Rous joined the Rockefeller Institute for Medical Research, where he was asked to investigate cancer. That same year, a poultry farmer brought him a Barred Plymouth Rock hen with a breast tumor. Rous examined the growth and identified it as a spindle-cell sarcoma, an aggressive malignancy arising from connective tissue.

What began as the examination of an unusual chicken tumor developed into experiments that would change cancer biology. Rous initially transplanted tumor tissue into other chickens, observing successful growth in genetically related birds but not in unrelated animals. These findings highlighted the importance of host compatibility and encouraged further investigation into how the tumor could spread.

The decisive breakthrough came when Rous tested whether tumor transmission required living cancer cells. He ground tumor tissue in solution, separated the liquid component and passed it through a Berkefeld filter designed to retain bacteria and intact cells. When the resulting cell-free filtrate was injected into healthy chickens of a closely related strain, new tumors developed.

These experiments, reported in 1910–1911, demonstrated that a filterable agent could transmit malignant disease without transferring intact tumor cells. The agent was later identified as Rous sarcoma virus (RSV), an avian retrovirus capable of transforming infected cells into cancer cells.

The discovery challenged prevailing assumptions about cancer. Although Rous could not identify the virus using modern molecular techniques, his experiments established a new explanation for how certain malignancies could arise.

Despite the significance of his findings, many scientists remained skeptical. No human cancer had yet been conclusively linked to a virus, and researchers questioned whether observations in chickens were relevant to human disease. Limited experimental technologies also made it difficult to explain how the agent caused tumors. Rous nevertheless maintained confidence in his observations, supported by careful documentation and reproducible evidence.

During the years when his cancer research received limited recognition, Rous expanded his investigations into other medical fields. Working with J. R. Turner during 1915–1916, he developed the Rous–Turner solution, a citrate-sugar preparation that allowed red blood cells to be preserved for extended periods.

This innovation contributed to the development of blood storage and transfusion practices, including early wartime blood banks. Although the original formulation was later replaced, its principles of citrate anticoagulation and glucose-supported red blood cell preservation remain important in modern transfusion medicine.

Rous also returned to cancer research through studies of rabbit papillomaviruses and chemical carcinogenesis. His investigations examined how viral infection and chemical agents could interact during tumor development. In work with William F. Friedewald in 1944, he helped clarify the distinction between tumor initiation and promotion, contributing to the understanding that cancer develops through multiple biological stages.

Meanwhile, advances in cell culture and molecular biology began revealing the broader significance of RSV. In the 1950s, Howard Temin and Harry Rubin developed experimental assays that allowed researchers to measure virus-induced cellular transformation in culture. These methods moved tumor virology beyond animal experiments and made the underlying mechanisms easier to investigate.

Another breakthrough came with the discovery of reverse transcriptase by Temin and David Baltimore in 1970. This enzyme allows retroviruses to convert RNA into DNA, which can then integrate into the host genome. The finding explained a fundamental step in retroviral replication and helped researchers understand how viral genetic information could persist within infected cells.

Subsequent research identified the v-src gene as the transforming oncogene carried by RSV. Scientists later discovered that this viral gene was related to c-src, a normal cellular gene involved in regulating growth and signaling. This established a fundamental principle of cancer biology: genes that normally regulate cellular functions can become oncogenic when altered or improperly controlled.

Further investigations demonstrated that Src functions as a tyrosine kinase, an enzyme involved in transmitting signals that regulate cell growth, survival and other activities. These discoveries helped establish the importance of oncogenes, proto-oncogenes and abnormal signaling pathways in cancer development, providing a foundation for later advances in molecular oncology.

The review also traces how tumor virology contributed to understanding human cancers associated with infectious agents. Subsequent research identified cancer-related viruses, including human papillomavirus (HPV), hepatitis B virus (HBV), Epstein–Barr virus (EBV), human T-lymphotropic virus type 1 (HTLV-1) and Kaposi's sarcoma-associated herpesvirus (KSHV).

These discoveries contributed to cancer prevention and treatment strategies, particularly vaccination against HPV and HBV, which can prevent infections responsible for certain malignancies. However, the review presents Rous's contribution as foundational rather than suggesting that his original experiments directly produced modern therapies.

Recognition of Rous's achievement came decades after his initial discovery. In 1966, at the age of 87, he received the Nobel Prize in Physiology or Medicine for demonstrating that a filterable agent could induce malignant tumors in chickens. He shared the award with Charles Huggins, whose work established the hormonal responsiveness of prostate cancer.

The Nobel Prize came approximately 55 years after Rous's landmark experiments, reflecting the prolonged skepticism surrounding viral carcinogenesis. By then, RSV had become an important experimental model for cancer research, while later discoveries involving reverse transcriptase and the src oncogene further clarified the molecular mechanisms of cancer.

Beyond his laboratory research, Rous influenced biomedical publishing through his work at the Journal of Experimental Medicine. Beginning as co-editor in 1921, he later served as editor and remained involved until 1970. His commitment to clear scientific communication, experimental rigor and accurate attribution helped shape the journal and influence generations of researchers.

“What began with the investigation of a tumor-bearing chicken at the Rockefeller Institute therefore contributed to a chain of discoveries that profoundly changed our understanding of cancer biology and its molecular basis.”

The review highlights broader lessons from Rous's career, including the importance of scientific preparedness, meticulous recordkeeping, intellectual flexibility and persistence. His willingness to investigate an unexpected observation, despite limited technology and professional skepticism, demonstrates how careful experimentation can challenge established assumptions and open new research directions.

As a historical and scientific review, the article synthesizes historical accounts and subsequent research developments rather than presenting new experimental findings. The authors emphasize that Rous's original discovery became the starting point for a broader scientific effort involving many investigators who helped establish the molecular basis of cancer.

Overall, the review presents Francis Peyton Rous as a pioneering scientist whose curiosity, persistence and experimental rigor transformed cancer research. His demonstration that a filterable agent could cause malignant tumors established a foundation for viral oncology and the discovery of cellular oncogenes. More than a century later, his legacy continues to influence research into cancer mechanisms, prevention and molecularly targeted therapies.

Paper DOI: https://doi.org/10.18632/genesandcancer.245                 

Corresponding authors: Nawab Ali - nali@ualr.edu, Krishnaswamy Kannan krishna.kannan9900@gmail.com, (ORCID 0009-0008-7731-0572)  

Abstract video: https://www.youtube.com/watch?v=hfqgKkYp64k

Keywords: Francis Peyton Rous, Rous sarcoma virus, retrovirus, oncogenes, viral oncology

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Journal

Genes & Cancer

DOI

10.18632/genesandcancer.245

Method of Research

Literature review

Subject of Research

People

Article Title

The life and legacy of Francis Peyton Rous: The birth of viral oncology

Article Publication Date

23-Oct-2026

COI Statement

 

Researchers identify an energy boundary that could guide the design of more efficient organic solar cells

The study identifies the conditions for photocurrent generation and links more rigid donor molecules to lower radiative voltage losses

Chiba University

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Photocurrent can be sustained when the donor optical gap approaches the free-carrier energy (Eg, Dopt≈ ECS ). Rigid donor molecules can further reduce CT-state relaxation and effective CT binding, helping to suppress voltage losses near this thermodynamic boundary.

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Credit: Hirohiko Fukagawa, Taku Oono, Yusuke Aoki, Tsubasa Sasaki, Haruto Shoji, Manato Tateno, Seita Kyogoku, Shintaro Mitsui, Hisao Ishii, Feiran Liu, Takuji Hatakeyama, and Takahisa Shimizu. A Unified Thermodynamic Framework for Photocurrent Generation and Voltage Losses in Organic Photovoltaics. Advanced Materials. 2026. © Copyright 2026 Wiley-VCH GmbH or related companies. All rights reserved, including rights for text and data mining and training of artificial intelligence technologies or similar technologies. This permission does not include the right to grant others permission to photocopy or otherwise reproduce this material except for accessible versions made by non-profit organizations serving the blind, visually impaired and other persons with print disabilities (VIPs). Image source link: https://advanced.onlinelibrary.wiley.com/doi/10.1002/adma.75304

Reducing voltage losses while maintaining efficient charge generation is a key challenge in developing efficient organic solar cells. Researchers from Chiba University, Japan, investigated how the energy levels of different donor–acceptor combinations affect solar cell performance. They identified a thermodynamic boundary for photocurrent generation and found that more rigid donor molecules were associated with lower radiative voltage losses. These findings could guide the design of more efficient organic solar cells.

A key goal in solar cell research is to improve efficiency toward the Shockley–Queisser limit, the theoretical maximum efficiency for converting sunlight into electricity under specified conditions. Organic solar cells use carbon-based semiconducting materials and offer advantages such as being lightweight, potentially low-cost, and suitable for flexible applications. Their power conversion efficiencies have approached 20%, but voltage losses remain a major obstacle to further improvements.

In organic solar cells, the donor material absorbs light and creates excited states. An electron can then transfer to the acceptor material, forming a charge-transfer (CT) state in which the electron and hole remain bound to each other. For the cell to generate electricity, these charges must separate into free charges. The energy of the CT state also influences the voltage the cell can deliver, and radiative recombination involving these states contributes to voltage losses.

One challenge is to identify the energy-level relationships that allow efficient charge generation while minimizing voltage losses. In particular, researchers need to understand the conditions under which a solar cell can continue generating photocurrent as the donor's optical energy gap approaches the energy of separated charges.

To investigate this, researchers led by Professor Hirohiko Fukagawa from the Center for Frontier Science, Chiba University, Japan, measured the energy levels of different donor–acceptor combinations to develop a framework for understanding how they influence charge generation and voltage losses.

The study was published online in the journal Advanced Materials on October 7, 2026. The research team included Dr. Takahisa Shimizu and Dr. Taku Oono from NHK Science & Technology Research Laboratories, Japan, and Professor Takuji Hatakeyama from Kyoto University, Japan.

“In this study, we focused not only on whether a CT state can be formed, but also on whether electrons and holes can then reach a free charge state in which they are sufficiently separated,” says Prof. Fukagawa.

To investigate how the energy levels of the two materials relate to charge generation and voltage losses, the researchers built simplified organic solar cells with separate layers of donor and acceptor materials. They designed the cells so that the donor absorbed visible light, while the acceptor remained transparent to sunlight. They tested five donor materials with different molecular structures and degrees of rigidity, pairing them with 15 acceptor materials with varying electron affinities between 2.0 and 3.1 eV.

They measured the materials' ionization energies and electron affinities in the solid state using ultraviolet photoelectron spectroscopy and low-energy inverse photoelectron spectroscopy, capturing energy levels under conditions more representative of those in an actual solar cell.

The researchers found that the difference between the donor's optical energy gap and the energy of separated charges was important for determining whether photocurrent could be maintained. When these energy values approached one another, the researchers identified a practical thermodynamic boundary for photocurrent generation. Power conversion efficiency also tended to increase near this boundary. The findings suggest that this energy relationship could help researchers maintain photocurrent while minimizing voltage losses.

The researchers also found that more rigid donor molecules were associated with reduced relaxation and energy spreading of the CT state. In several systems using rigid donors, the effective CT binding energy was 0.1 eV or less, indicating that the CT-state energy was close to that of the separated charges. These results suggest that controlling the CT state's energy through molecular design could help reduce voltage losses. However, the effective CT binding energy is also influenced by other factors, including charge delocalization, molecular packing, and the electrostatic environment at the donor–acceptor interface.

These findings could provide design guidelines for developing more efficient organic solar cells and help researchers explore the limits of their achievable efficiency.

“If these principles can be incorporated into practical bulk heterojunction materials, they may help researchers develop solar cells that generate current efficiently while losing less energy as voltage. In the longer term, such devices could make solar energy harvesting more practical in lightweight, flexible, and space-limited applications that are difficult for conventional silicon modules,” says Prof. Fukagawa.

To see more news from Chiba University, click here.

About Professor Hirohiko Fukagawa from Chiba University, Japan

Dr. Hirohiko Fukagawa obtained a Ph.D. in Engineering from Chiba University in 2007. After over a decade of research at the Broadcasting Technology Research Institute, Japan Broadcasting Corporation, he joined the Center for Frontier Science at Chiba University in 2024, where he currently serves as a Full-Time Professor. He specializes in organic electronics, surface and interface engineering, and advanced optoelectronics. He has authored over 100 publications and has received numerous awards, including the Achievement Award at the OLED Symposium in 2019.

Funding:

This work was supported by the Japan Science and Technology Agency (JST) CREST (Grant No. JPMJCR22B3). This work was also supported by the Japan Society for the Promotion of Science (JSPS) KAKENHI Grant-in-Aid for Scientific Research (Grant No. 24K23071) and JKA through its promotion funds from the KEIRIN (Grant No. 2025M-340).

Reference:

Authors: Hirohiko Fukagawa1,2,3, Taku Oono4, Yusuke Aoki5, Tsubasa Sasaki4, Haruto Shoji5, Manato Tateno3, Seita Kyogoku3, Shintaro Mitsui3, Hisao Ishii1,2,3, Feiran Liu6, Takuji Hatakeyama6, and Takahisa Shimizu4

Affiliations:

1Center for Frontier Science, Chiba University, Japan

2Molecular Chirality Research Center, Chiba University, Japan

3Graduate School of Science and Engineering, Chiba University, Japan

4Science & Technology Research Laboratories, Japan Broadcasting Corporation (NHK), Japan

5Department of Applied Physics, Tokyo University of Science, Japan

6Department of Chemistry, School of Science, Kyoto University, Japan

DOI: 10.1002/adma.75304

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Journal

Advanced Materials

DOI

10.1002/adma.75304

Method of Research

Experimental study

Subject of Research

Not applicable

Article Title

A Unified Thermodynamic Framework for Photocurrent Generation and Voltage Losses in Organic Photovoltaics

Article Publication Date

7-Oct-2026

Chinese Neurosurgical Journal review explores neurological considerations for gender dysphoria care

Increased awareness about gender dysphoria-related medical and psychological issues can aid neurosurgeons in effectively managing the condition

Chinese Neurosurgical Journal

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Transgender patients may have specific medical and psychosocial needs when undergoing neurosurgery. Understanding the potential effects of hormone therapy, medication interactions, and individual health risks can help healthcare professionals provide safer, more inclusive care.

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Credit: US Army Africa from Openverse Image source link: https://openverse.org/image/41fc6e80-d359-4671-822d-478992ac5a49?q=Surgeons+working&p=46

Gender dysphoria is a psychiatric condition characterized by distress due to a mismatch between the gender assigned at birth (based on external genitalia) and the self-perception of gender. Meanwhile, transgenderism is a generalized term used to describe a similar condition but may or may not involve the distress component. The incidence of gender dysphoria has gradually increased, especially among children and adolescents. Individuals with gender dysphoria seek various treatments, including gender-affirming hormone therapy (GAHT), psychotherapy, and surgery. However, these treatments are associated with several adverse effects. Neurosurgeons have decreased confidence in managing gender dysphoria owing to their limited knowledge and awareness of neurological implications associated with the condition and its treatment.

To improve this awareness, Dr. Rajdeep Brahmachari and Dr. Chandrasekaran Kaliaperumal from the Royal Infirmary of Edinburgh reviewed the literature on the neurological considerations of gender dysphoria. This review was published in Volume 12 of the Chinese Neurosurgical Journal in September 9, 2026. Commenting on the rationale for the study, Dr. Kaliaperumal remarked, “Gender dysphoria and its treatment are associated with several neurological issues. Effective management can be achieved by improving the knowledge of neurosurgeons. Therefore, we reviewed the literature to clarify neuroanatomical variations, neurological and neurosurgical risk factors, and perioperative, neuroanesthetic, and neuropsychiatric considerations, enabling evidence-based holistic neurosurgical care.”

The authors analyzed published articles retrieved from various sources, including public databases. The anatomical features of the brains of transgender individuals resembled the self-identified gender rather than those of the assigned gender, including increased cortical thickness and weak connections in regions involved in processing body perception. Gender-affirming treatment can also lead to physiological changes. For example, GAHT increases gray matter density, volume and the risk of headaches, benign tumors (meningioma and prolactinoma), intracranial hypertension, stroke, and epilepsy.

Individuals with gender dysphoria are hesitant to seek surgical treatment owing to stigma, social isolation, and prejudice. To mitigate this hesitancy, neurosurgeons must utilize inclusive language while communicating and document pre-surgical GAHT duration. Patients must be informed about the benefits and risks of the surgery and encouraged to seek advice from a mental health professional for further clarity. Neurosurgeons can increase patient comfort by recording the preferred gender identity and pronouns along with the details of previous or ongoing GAHT before surgery.

The preoperative risks of neurosurgery include viral and bacterial infections. The increased prevalence of stress, anxiety, and depression among transgender individuals may predispose them to smoking, alcohol consumption, and drug abuse, increasing perioperative risks. Transgender individuals are also predisposed to metabolic disorders, such as diabetes and insulin resistance. Thus, neurosurgeons must account for preoperative and perioperative risks to mitigate adverse events. Sedation during surgery is an important consideration. Anti-seizure medications, corticosteroids, and neuromuscular blockers may exhibit interactions in individuals undergoing hormonal therapy before surgery. Thus, perioperative neuromuscular monitoring is warranted when the neurosurgery involves the use of neuromuscular blocking agents. Intraoperative risks are especially evident in patients with human immunodeficiency virus infection. Antiviral drugs may interact with hypnotics, anxiolytics, and antibiotics. As GAHT can induce hematological changes, intraoperative blood transfusion must be considered. Surgery may also involve respiratory risks for individuals with gender dysphoria, especially in transmen who use breast-binder garments. Meanwhile, intubation is a concern in transwomen who have undergone laryngeal surgery. Special considerations are warranted for urinary catheterization in individuals who have previously undergone gender-affirming surgery.

When preferred, private rooms can enhance patient privacy and comfort after surgery. Healthcare personnel attending the neurosurgical patient can mitigate psychosocial stress by addressing the patient with preferred names and pronouns and effectively managing wounds and scars. The implementation of a multidisciplinary approach for pain management can improve surgical outcomes. Commenting on the importance of this review, Dr. Brahmachari states, “Our review summarizes the medical and psychosocial implications of neurosurgery for individuals with gender dysphoria. Proactive training for neurosurgeons and healthcare personnel can improve the outcomes of neurosurgery in these individuals.”

 

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Reference
Title of original paper: Gender reassignment and neurosurgical implications: a narrative review

Journal: Chinese Neurosurgical Journal

DOI: 10.1186/s41016-026-00447-5

 

About Royal Infirmary of Edinburgh
The Royal Infirmary of Edinburgh (RIE) was established in 1729 and is a major acute-care teaching hospital operated by NHS Lothian in Edinburgh, Scotland. RIE has a longstanding tradition of clinical care, medical education, and research. The hospital relocated to Little France in 2003 and serves as a major trauma center, providing a wide range of specialist medical and surgical services. The clinical departments of RIE include cardiology, neurology-related services, renal medicine, respiratory medicine, general surgery and transplantation. The institution maintains strong academic links with the University of Edinburgh Medical School, supporting clinical training, postgraduate education and medical research.

Website: https://www.med.scot.nhs.uk/hospitals/rie

 

About Dr. Rajdeep Brahmachari from Royal Infirmary of Edinburgh
Dr. Rajdeep Brahmachari is a researcher affiliated with the Department of Clinical Neuroscience at the Royal Infirmary of Edinburgh, Scotland, UK. Dr. Brahmachari is also a medical professional associated with Ruby General Hospital in Kolkata, India. He studied at the West Bengal University of Health Sciences, Kolkata, from 2014 to 2019. His professional profile lists additional training and credentials, including Membership of the Royal College of Surgeons of Edinburgh (MRCS), ECFMG certification, and surgical skills training through the Royal College of Surgeons of England. His experience spans clinical practice and research in neurosurgery.

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Journal

Chinese Neurosurgical Journal

DOI

10.1186/s41016-026-00447-5

Method of Research

Literature review

Subject of Research

People

Article Title

Gender reassignment and neurosurgical implications: a narrative review