Stefini, Roberto

OBJECTIVE The aim of this study was to examine female authorship in research from collaborations between high-income countries (HICs) and lower-middle-income and low-income countries (LMICs/LICs) across two time periods: 2018–2020 and 2021–2023. METHODS A bibliometric analysis of neurosurgical research articles from the Scopus database, published between 2018 and 2023, was performed to investigate collaboration trends between HICs and LMICs/LICs. Only neurosurgical publications were included, and female authors were identified based on names traditionally associated with female gender identity, verified through online searches and tools such as Genderize.io. Articles with more than 25 authors, commentaries, letters, and news items were excluded to ensure a focus on original research. The selected articles spanned various neurosurgical specialties and were restricted to English-language journals with an impact factor greater than 1. The country affiliations of first, corresponding, and last authors were categorized using the 2018 World Bank classification to understand collaboration patterns across income levels. RESULTS The analysis revealed a steady increase in neurosurgical publications from 2018 to 2023, with a notable rise in the second triennium (2021–2023). Authors from HICs consistently held the majority of first, corresponding, and last authorship positions. Concerning first authorship, authors with affiliations from HICs increased from 66% in the first triennium to 75% in the second. Similarly, corresponding authors from HICs increased from 75% to 82% over the same period. Male authors dominated all key authorship roles, with 127 male-led first authorships compared with 46 female-led first authorships in the second triennium. This male predominance persisted in corresponding and last author roles as well. CONCLUSIONS Global neurosurgical research is growing but significant gender disparities persist, especially in LMICs/LICs, with female researchers underrepresented in key authorship roles, requiring targeted efforts to address systemic barriers and promote gender equity in academic leadership.

Introduction: The spinal rehabilitation process plays a crucial role in SCI patients’ lives, and recent developments in VR have the potential to efficiently engage SCI patients in therapeutic activities and promote neuroplasticity. Objective: The primary objective of this study is to assess a complete review of the extended impacts of VR-assisted training on spine rehabilitation in SCI patients. Methods: This systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) through a single database search in PubMed/Medline between the dates 1 January 2010 and 1 February 2024. MESH terms and keywords were combined in the following search strategy: (Augmented Reality OR VR OR Virtual Reality) AND (Spine OR Spinal) AND Rehabilitation. Included articles were written in English, involved adults with SCI, included an intervention with VR, AR, or any mixed reality system, and assessed changes in outcomes after the intervention. Results: The search produced 257 articles, and 46 of them were allocated for data extraction to evaluate 652 patients. Both when VR training was analyzed and reviewed separately, and when compared to traditional training, the findings exhibited predominantly promising outcomes, reflecting a favorable trend in the study. VR technologies were used in different settings and customizations, and the medium total time of VR training among the studies was 60.46 h per patient. Conclusions: This auspicious outcome of the study further motivates the intervention of VR and AR in the rehabilitation of SCI patients along with ameliorating their overall holistic well-being.