This Week in PLOS Medicine: Brain Drain from Africa to US, Smoking & Venous Thromboembolism, & Translating Reviews

This week PLOS Medicine publishes the following new articles:

Emigration of physicians from Sub-Saharan Africa (SSA) to high income countries is considered a “brain drain” because the countries of origin have often paid for the physicians’ training, and the SSA countries have a very low number of physicians relative to the population. Analyzing the AMA Physician Masterfile and the WHO Global Health Workforce Statistics, Siankam Tankwanchi and colleagues report that the number of physicians trained in SSA now living in the US increased in the last decade, with increases from all studied countries other than South Africa. The number of migrant SSA physicians exceeds the total number of physicians in Ethiopia, Ghana, Liberia, Tanzania, Uganda, Zambia, and Zimbabwe combined (around 10,000 from 2005-2010). These seven countries combined have 0.05 physicians for every 1,000 people, compared to 2.5 physicians per 1,000 people in the US in 2009, a 50-fold difference. In a linked Perspective, Giorgio Cometto and colleagues discuss the steps that destination countries and countries in SSA can take to address this problem.

Venous thromboembolism is a serious diagnosis that includes deep vein thrombosis and pulmonary embolism, where a blood clot in the leg breaks off and travels to the lungs. In a meta-analysis of 32 observational studies involving nearly 4 million participants and roughly 35,000 venous thromboembolism events, Suhua Wu and colleagues find that current, ever, and former smoking is associated with an increased risk of venous thromboembolism (VTE). The more pack-years and cigarettes per day a person smoked, the higher the risk; and when the authors adjust for body mass index (BMI), they find an even larger risk. As high BMI is also a risk factor for VTE, whereas smoking is associated with a smaller BMI, the authors conclude that the true magnitude of the association between smoking and VTE may be even greater.

As part of its 20th anniversary year, the Cochrane Collaboration plans to increase the global reach of its renowned evidence-based reviews (known as systematic reviews) by translating them into other languages. While Cochrane Reviews are published in English, Xavier Bonfill and colleagues present evidence to show that when reviews are translated into Spanish and French there is an increase in global usage.  The authors argue that using new technologies, such as machine translation using learning systems, translation crowd-sourcing, and the use of a controlled language for the original English version, will improve the speed and number of translations.