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1.  Reviewing Manuscripts for Biomedical Journals 
The Permanente journal  2010;14(1):32-40.
Writing for publication is a complex task. For many professionals, producing a well-executed manuscript conveying one's research, ideas, or educational wisdom is challenging. Authors have varying emotions related to the process of writing for scientific publication. Although not studied, a relationship between an author's enjoyment of the writing process and the product's outcome is highly likely. As with any skill, practice generally results in improvements. Literature focused on preparing manuscripts for publication and the art of reviewing submissions exists. Most journals guard their reviewers' anonymity with respect to the manuscript review process. This is meant to protect them from direct or indirect author demands, which may occur during the review process or in the future. It is generally accepted that author identities are masked in the peer-review process. However, the concept of anonymity for reviewers has been debated recently; many editors consider it problematic that reviewers are not held accountable to the public for their decisions. The review process is often arduous and underappreciated, one reason why biomedical journals acknowledge editors and frequently recognize reviewers who donate their time and expertise in the name of science. This article describes essential elements of a submitted manuscript, with the hopes of improving scientific writing. It also discusses the review process within the biomedical literature, the importance of reviewers to the scientific process, responsibilities of reviewers, and qualities of a good review and reviewer. In addition, it includes useful insights to individuals who read and interpret the medical literature.
PMCID: PMC2912703  PMID: 20740129
2.  ETHICAL ASPECTS AND DILEMMAS OF PREPARING, WRITING AND PUBLISHING OF THE SCIENTIFIC PAPERS IN THE BIOMEDICAL JOURNALS 
Acta Informatica Medica  2012;20(3):141-148.
Introduction:
In this paper author discussed about preparing and submitting manuscripts - scientific, research, professional papers, reviews and case reports. Author described it from the Editor’s perspective, and specially talked about ethical aspects of authorship, conflict of interest, copyright, plagiarism and duplicate publication from the point of view of his experiences as Editor-in-Chief of several biomedical journals and Chief of Task Force of European Federation of Medical Informatics journals and member of Task Force of European Cardiology Society journals. The scientific process relies on trust and credibility. The scientific community demands high ethical standards to conduct biomedical research and to publish scientific contents. During the last decade, disclosure of conflicts of interest (COI ), (also called competing loyalties, competing interests or dual commitments), has been considered as a key element to guarantee the credibility of the scientific process. Biases in design, analysis and interpretation of studies may arise when authors or sponsors have vested interests. Therefore, COI should be made clear to the readers to facilitate their own judgment and interpretation of their relevance and potential implications.
Results and Discussion:
Authors are responsible to fully disclose potential COI . In October 2009 the ICMJE proposed an electronic “uniform” format for COI disclosure. Four main areas were addressed: authors´ associations with entities that supported the submitted manuscript (indefinite time frame), associations with commercial entities with potential interest in the general area of the manuscript (time frame 36 months), financial association of their spouse and children and, finally, non-financial associations potentially relevant to the submitted manuscript. Consumers of medical scholarship expect a reliable system of disclosure in which journals and authors make disclosures appropriately and consistently. There is a stigma surrounding the reporting of COI that should be progressively overcome. Further actions are required to increase awareness of the importance of COI disclosure and to promote policies aimed to enhance transparency in biomedical research. In this article author discuss about important ethical dilemmas in preparing, writing and publishing of scientific manuscripts in biomedical journals.
doi:10.5455/aim.2012.20.141-148
PMCID: PMC3508847  PMID: 23322969
medical science; biomedical journals; ethics; authorship; acknowledgement; conflict of interest; copyright; plagiarism; duplicate publication.
3.  Manuscript Architect: a Web application for scientific writing in virtual interdisciplinary groups 
Background
Although scientific writing plays a central role in the communication of clinical research findings and consumes a significant amount of time from clinical researchers, few Web applications have been designed to systematically improve the writing process.
This application had as its main objective the separation of the multiple tasks associated with scientific writing into smaller components. It was also aimed at providing a mechanism where sections of the manuscript (text blocks) could be assigned to different specialists. Manuscript Architect was built using Java language in conjunction with the classic lifecycle development method. The interface was designed for simplicity and economy of movements. Manuscripts are divided into multiple text blocks that can be assigned to different co-authors by the first author. Each text block contains notes to guide co-authors regarding the central focus of each text block, previous examples, and an additional field for translation when the initial text is written in a language different from the one used by the target journal. Usability was evaluated using formal usability tests and field observations.
Results
The application presented excellent usability and integration with the regular writing habits of experienced researchers. Workshops were developed to train novice researchers, presenting an accelerated learning curve. The application has been used in over 20 different scientific articles and grant proposals.
Conclusion
The current version of Manuscript Architect has proven to be very useful in the writing of multiple scientific texts, suggesting that virtual writing by interdisciplinary groups is an effective manner of scientific writing when interdisciplinary work is required.
doi:10.1186/1472-6947-5-15
PMCID: PMC1180829  PMID: 15960855
4.  The Relationship of Previous Training and Experience of Journal Peer Reviewers to Subsequent Review Quality 
PLoS Medicine  2007;4(1):e40.
Background
Peer review is considered crucial to the selection and publication of quality science, but very little is known about the previous experiences and training that might identify high-quality peer reviewers. The reviewer selection processes of most journals, and thus the qualifications of their reviewers, are ill defined. More objective selection of peer reviewers might improve the journal peer review process and thus the quality of published science.
Methods and Findings
306 experienced reviewers (71% of all those associated with a specialty journal) completed a survey of past training and experiences postulated to improve peer review skills. Reviewers performed 2,856 reviews of 1,484 separate manuscripts during a four-year study period, all prospectively rated on a standardized quality scale by editors. Multivariable analysis revealed that most variables, including academic rank, formal training in critical appraisal or statistics, or status as principal investigator of a grant, failed to predict performance of higher-quality reviews. The only significant predictors of quality were working in a university-operated hospital versus other teaching environment and relative youth (under ten years of experience after finishing training). Being on an editorial board and doing formal grant (study section) review were each predictors for only one of our two comparisons. However, the predictive power of all variables was weak.
Conclusions
Our study confirms that there are no easily identifiable types of formal training or experience that predict reviewer performance. Skill in scientific peer review may be as ill defined and hard to impart as is “common sense.” Without a better understanding of those skills, it seems unlikely journals and editors will be successful in systematically improving their selection of reviewers. This inability to predict performance makes it imperative that all but the smallest journals implement routine review ratings systems to routinely monitor the quality of their reviews (and thus the quality of the science they publish).
A survey of experienced reviewers, asked about training they had received in peer review, found there are no easily identifiable types of formal training and experience that predict reviewer performance.
Editors' Summary
Background.
When medical researchers have concluded their research and written it up, the next step is to get it published as an article in a journal, so that the findings can be circulated widely. These published findings help determine subsequent research and clinical use. The editors of reputable journals, including PLoS Medicine, have to decide whether the articles sent to them are of good quality and accurate and whether they will be of interest to the readers of their journal. To do this they need to obtain specialist advice, so they contact experts in the topic of the research article and ask them to write reports. This is the process of scientific peer review, and the experts who write such reports are known as “peer reviewers.” Although the editors make the final decision, the advice and criticism of these peer reviewers to the editors is essential in making decisions on publication, and usually in requiring authors to make changes to their manuscript. The contribution that peer reviewers have made to the article by the time it is finally published may, therefore, be quite considerable.
Although peer review is accepted as a key part of the process for the publishing of medical research, many people have argued that there are flaws in the system. For example, there may be an element of luck involved; one author might find their paper being reviewed by a reviewer who is biased against the approach they have adopted or who is a very critical person by nature, and another author may have the good fortune to have their work considered by someone who is much more favorably disposed toward their work. Some reviewers are more knowledgeable and thorough in their work than others. The editors of medical journals try to take in account such biases and quality factors in their choice of peer reviewers or when assessing the reviews. Some journals have run training courses for experts who review for them regularly to try to make the standard of peer review as high as possible.
Why Was This Study Done?
It is hard for journal editors to know who will make a good peer reviewer, and there is no proven system for choosing them. The authors of this study wanted to identify the previous experiences and training that make up the background of good peer reviewers and compare them with the quality of the reviews provided. This would help journal editors select good people for the task in future, and as a result will affect the quality of science they publish for readers, including other researchers.
What Did the Researchers Do and Find?
The authors contacted all the regular reviewers from one specialist journal (Annals of Emergency Medicine). A total of 306 of these experienced reviewers (71% of all those associated with the journal) completed a survey of past training and experiences that might be expected to improve peer review skills. These reviewers had done 2,856 reviews of 1,484 separate manuscripts during a four-year study period, and during this time the quality of the reviews had been rated by the journal's editors. Surprisingly, most variables, including academic rank, formal training in critical appraisal or statistics, or status as principal investigator of a grant, failed to predict performance of higher-quality reviews. The only significant predictors of quality were working in a university-operated hospital versus other teaching environment and relative youth (under ten years of experience after finishing training), and even these were only weak predictors.
What Do These Findings Mean?
This study suggest that there are no easily identifiable types of formal training or experience that predict peer reviewer performance, although it is clear that some reviewers (and reviews) are better than others. The authors suggest that it is essential therefore that journals routinely monitor the quality of reviews submitted to them to ensure they are getting good advice (a practice that is not universal).
Additional Information.
Please access these Web sites via the online version of this summary at http://dx.doi.org/doi:10.1371/journal.pmed.0040040
• WAME is an association of editors from many countries who seek to foster international cooperation among editors of peer-reviewed medical journals
• The Fifth International Congress on Peer Review and Biomedical Publication is one of a series of conferences on peer review
• The PLoS Medicine guidelines for reviewers outline what we look for in a review
• The Council of Science Editors promotes ethical scientific publishing practices
• An editorial also published in this issue of PLoS Medicine discusses the peer review process further
doi:10.1371/journal.pmed.0040040
PMCID: PMC1796627  PMID: 17411314
5.  The Writing Retreat: A High-Yield Clinical Faculty Development Opportunity in Academic Writing 
Background
The need for consistent academic productivity challenges junior clinician-scholars, who often lack the aptitude to ensure efficient production of manuscripts.
Intervention
To solve this problem, an academic division of a major medical center developed an off-site writing retreat. The purpose of the retreat was not to teach writing skills, but to offer senior mentor assistance with a focus on the elements of manuscript writing.
Methods
The retreat paired senior faculty members with junior staff. Senior faculty identified manuscript topics and provided real-time writing and editing supervision. Team-building exercises, midcourse corrections, and debriefing interviews were built into the retreat. The number of manuscripts and grant proposals generated during the 2008–2011 retreats was recorded, and the program was evaluated by using unstructured debriefing interviews.
Results
An average of 6 to 7 faculty members and fellows participated in each retreat. During the past 4 years, participants produced an average of 3 grant proposals and 7 manuscripts per retreat. After the writing retreat, each fellow and junior faculty member produced an average of 4 scholarly products per year, compared to fewer than 2 for prior years' retreats. Participant feedback indicated the success of the retreat resulted from protected time, direct mentorship by the scholars involved, and pairing of authors, which allows for rapid production of manuscripts and accelerated the editing process. More than 80% of mentors returned each year to participate.
Conclusions
The writing retreat is a feasible, effective strategy to increase scholarship among faculty, acceptable to mentees and mentors, and sustainable over time.
doi:10.4300/JGME-D-12-00159.1
PMCID: PMC3693698  PMID: 24404277
6.  Hiring a professional medical writer: is it equivalent to ghostwriting? 
Biochemia Medica  2014;24(1):19-24.
Authors of articles published in medical journals are often busy researchers who cannot afford time devoted to writing. Though they are experts in their own therapeutic area, more often than not, researchers find it difficult to actually write and publish their research. Professional medical writers with their expertise in writing clear, concise, comprehensible, and coherent content are often a great support to researchers. Their contribution to the manuscript is usually focused on getting a manuscript ready for publication. They are not authors unless they make substantial contribution to the study according to the guidelines of the International Committee of Medical Journal Editors (ICMJE). However, medical writing is not the same as ghostwriting. Ghostwriting is unethical. Medical writers can be legitimate contributors to the medical manuscript. Several international guidelines including the ICMJE guidelines require authors to acknowledge the contribution of medical writers in the published article. Medical writers whose name is publicly associated with the article in turn make an extra effort to ensure that all applicable publication ethics and style guidelines are adhered to. This article discusses the current international guidelines about the acknowledgement of writing assistance. It also emphasizes on how acknowledging medical writing support can go a long way in curbing the menace of scientific misconduct including ghostwriting.
doi:10.11613/BM.2014.004
PMCID: PMC3936972  PMID: 24627711
medical writer; ghostwriter; authorship; ethics in publishing; acknowledgement
7.  Appropriate Roles for the Subscriber, Publisher, Editor, Author, and Reviewer in the Archives of Plastic Surgery 
Archives of Plastic Surgery  2013;40(6):663-665.
Authors, editors and reviewers, publishers, and subscribers all play their role in scientific journals. These 5 stakeholders are essential to journals. In this paper, firstly, I briefly summarize the role of each journal stakeholder and their respective goals. Secondly, the status of each participant in the Archives of Plastic Surgery is described. Finally, I propose an appropriate role and plan for each of them. Specific roles and responsibilities include the following: subscribers should welcome and submit the critiques of published papers in letters to the editor. Publishers should trust editors and provide them with adequate financial support for ongoing quality improvement of the journal. The editor-in-chief should be given a sufficient period of time-several years-to build up journal quality and train the incoming editor. The editors, including section editors, are also responsible for increasing the author pool. One editor might be designated a 'devil's referee', that is, a kind of devil's advocate with the responsibility of examining the originality of the manuscript, taking a skeptical view of the manuscript, and looking for holes in the methods and results of reported experiments. Authors' responsibilities include submitting manuscripts with scientific integrity and being ready to take responsibility for their articles even long after publication. Finally, reviewers' responsibilities include identifying similar articles not cited. Reviewers are also welcome to write a discussion on the article they review.
doi:10.5999/aps.2013.40.6.663
PMCID: PMC3840171  PMID: 24286037
Journal article; Publishing; Role; Editorial policies
8.  Practical recommendations for statistical analysis and data presentation in Biochemia Medica journal 
Biochemia Medica  2012;22(1):15-23.
The aim of this article is to highlight practical recommendations based on our experience as reviewers and journal editors and refer to some most common mistakes in manuscripts submitted to Biochemia Medica. One of the most important parts of the article is the Abstract. Authors quite often forget that Abstract is sometimes the first (and only) part of the article read by the readers. The article Abstract must therefore be comprehensive and provide key results of your work. Problematic part of the article, also often neglected by authors is the subheading Statistical analysis, within Materials and methods, where authors must explain which statistical tests were used in their data analysis and the rationale for using those tests. They also need to make sure that all tests used are listed under Statistical analysis section, as well as that all tests listed are indeed used in the study. When writing Results section there are several key points to keep in mind, such as: are results presented with adequate precision and accurately; is descriptive analysis appropriate; is the measure of confidence provided for all estimates; if necessary and applicable, are correct statistical tests used for analysis; is P value provided for all tests, etc. Especially important is not to make any conclusions on the causal relationship unless the study is an experiment or clinical trial. We believe that the use of the proposed checklist might increase the quality of the submitted work and speed up the peer-review and publication process for published articles.
PMCID: PMC4062332  PMID: 22384516
biostatistics; errors; data analysis; research ethics
9.  Ghost Authorship in Industry-Initiated Randomised Trials 
PLoS Medicine  2007;4(1):e19.
Background
Ghost authorship, the failure to name, as an author, an individual who has made substantial contributions to an article, may result in lack of accountability. The prevalence and nature of ghost authorship in industry-initiated randomised trials is not known.
Methods and Findings
We conducted a cohort study comparing protocols and corresponding publications for industry-initiated trials approved by the Scientific-Ethical Committees for Copenhagen and Frederiksberg in 1994–1995. We defined ghost authorship as present if individuals who wrote the trial protocol, performed the statistical analyses, or wrote the manuscript, were not listed as authors of the publication, or as members of a study group or writing committee, or in an acknowledgment. We identified 44 industry-initiated trials. We did not find any trial protocol or publication that stated explicitly that the clinical study report or the manuscript was to be written or was written by the clinical investigators, and none of the protocols stated that clinical investigators were to be involved with data analysis. We found evidence of ghost authorship for 33 trials (75%; 95% confidence interval 60%–87%). The prevalence of ghost authorship was increased to 91% (40 of 44 articles; 95% confidence interval 78%–98%) when we included cases where a person qualifying for authorship was acknowledged rather than appearing as an author. In 31 trials, the ghost authors we identified were statisticians. It is likely that we have overlooked some ghost authors, as we had very limited information to identify the possible omission of other individuals who would have qualified as authors.
Conclusions
Ghost authorship in industry-initiated trials is very common. Its prevalence could be considerably reduced, and transparency improved, if existing guidelines were followed, and if protocols were publicly available.
Of 44 industry-initiated trials, there was evidence of ghost authorship in 33, increasing to 40 when a person qualifying for authorship was acknowledged rather than appearing as an author.
Editors' Summary
Background.
Original scientific findings are usually published in the form of a “paper”, whether it is actually distributed on paper, or circulated via the internet, as this one is. Papers are normally prepared by a group of researchers who did the research and are then listed at the top of the article. These authors therefore take responsibility for the integrity of the results and interpretation of them. However, many people are worried that sometimes the author list on the paper does not tell the true story of who was involved. In particular, for clinical research, case histories and previous research has suggested that “ghost authorship” is commonplace. Ghost authors are people who were involved in some way in the research study, or writing the paper, but who have been left off the final author list. This might happen because the study “looks” more credible if the true authors (for example, company employees or freelance medical writers) are not revealed. This practice might hide competing interests that readers should be aware of, and has therefore been condemned by academics, groups of editors, and some pharmaceutical companies.
Why Was This Study Done?
This group of researchers wanted to get an idea of how often ghost authorship happened in medical research done by companies. Previous studies looking into this used surveys, whereby the researchers would write to one author on each of a group of papers to ask whether anyone else had been involved in the work but who was not listed on the paper. These sorts of studies typically underestimate the rate of ghost authorship, because the main author might not want to admit what had been going on. However, the researchers here managed to get access to trial protocols (documents setting out the plans for future research studies), which gave them a way to investigate ghost authorship.
What Did the Researchers Do and Find?
In order to investigate the frequency and type of ghost authorship, these researchers identified every trial which was approved between 1994 and 1995 by the ethics committees of Copenhagen and Frederiksberg in Denmark. Then they winnowed this group down to include only the trials that were sponsored by industry (pharmaceutical companies and others), and only those trials that were finished and published. The protocols for each trial were obtained from the ethics committees and the researchers then matched up each protocol with its corresponding paper. Then, they compared names which appeared in the protocol against names appearing on the eventual paper, either on the author list or acknowledged elsewhere in the paper as being involved. The researchers ended up studying 44 trials. For 31 of these (75% of them) they found some evidence of ghost authorship, in that people were identified as having written the protocol or who had been involved in doing statistical analyses or writing the manuscript, but did not end up listed in the manuscript. If the definition of authorship was made narrower, and “ghost authorship” included people qualifying for authorship who were mentioned in the acknowledgements but not the author list, the researchers' estimate went up to 91%, that is 40 of the 44 trials. For most of the trials with missing authors, the ghost was a statistician (the person who analyzes the trial data).
What Do These Findings Mean?
In this study, the researchers found that ghost authorship was very common in papers published in medical journals (this study covered a broad range of peer-reviewed journals in many medical disciplines). The method used in this paper seems more reliable than using surveys to work out how often ghost authorship happens. The researchers aimed to define authorship using the policies set out by a group called the International Committee of Medical Journal Editors (ICMJE), and the findings here suggest that the ICMJE's standards for authorship are very often ignored. This means that people who read the published paper cannot always accurately judge or trust the information presented within it, and competing interests may be hidden. The researchers here suggest that protocols should be made publicly available so that everyone can see what trials are planned and who is involved in conducting them. The findings also suggest that journals should not only list the authors of each paper but describe what each author has done, so that the published information accurately reflects what has been carried out.
Additional Information.
Please access these Web sites via the online version of this summary at http://dx.doi.org/10.1371/journal.pmed.0040019.
Read the Perspective by Liz Wager, which discusses these findings in more depth
The International Committee of Medical Journal Editors (ICMJE) is a group of general medical journal editors who have produced general guidelines for biomedical manuscripts; their definition of authorship is also described
The Committee on Publication Ethics is a forum for editors of peer-reviewed journals to discuss issues related to the integrity of the scientific record; the Web site lists anonymized problems and the committee's advice, not just regarding authorship, but other types of problems as well
Good Publication Practice for Pharmaceutical Companies outlines common standards for publication of industry-sponsored medical research, and some pharmaceutical companies have agreed to these
doi:10.1371/journal.pmed.0040019
PMCID: PMC1769411  PMID: 17227134
10.  Structure of a Scholarly Manuscript: 66 Tips for What Goes Where 
Journal of Athletic Training  1996;31(3):201-206.
Objective:
To share with potential authors tips for constructing a scholarly manuscript and for organizing information in various types of scholarly manuscripts: experimental reports, literature reviews, case reports, and clinical techniques.
Description:
The goal of writing a scientific/technical/ medical article is to communicate new information that hopefully has clinical relevance and will improve health care. This information must be organized and presented clearly and logically. We present 66 tips for organizing a scholarly manuscript. We tell not only what goes where in the manuscript but also how to construct each of the elements so as to logically communicate the author's message. The tips are numbered to facilitate referencing.
Conclusion:
By becoming familiar with these tips, potential authors can avoid making mistakes that may hinder publication of their manuscripts.
PMCID: PMC1318504  PMID: 16558399
11.  It's Money! Real-World Grant Experience through a Student-Run, Peer-Reviewed Program 
CBE Life Sciences Education  2013;12(3):419-428.
Grantsmanship is an integral component of surviving and thriving in academic science, especially in the current funding climate. Therefore, any additional opportunities to write, read, and review grants during graduate school may have lasting benefits on one's career. We present here our experience with a small, student-run grant program at Georgetown University Medical Center. Founded in 2010, this program has several goals: 1) to give graduate students an opportunity to conduct small, independent research projects; 2) to encourage graduate students to write grants early and often; and 3) to give graduate students an opportunity to review grants. In the 3 yr since the program's start, 28 applications have been submitted, 13 of which were funded for a total of $40,000. From funded grants, students have produced abstracts and manuscripts, generated data to support subsequent grant proposals, and made new professional contacts with collaborators. Above and beyond financial support, this program provided both applicants and reviewers an opportunity to improve their writing skills, professional development, and understanding of the grants process, as reflected in the outcome measures presented. With a small commitment of time and funding, other institutions could implement a program like this to the benefit of their graduate students.
The authors describe a student-run, peer-reviewed grant program. The program aimed to give graduate students an opportunity to conduct small research projects, to encourage them to write grants, and to give them an opportunity to review grants. Participants showed improved grant-writing skills and an increased understanding of the grants process.
doi:10.1187/cbe.12-05-0058
PMCID: PMC3763010  PMID: 24006391
12.  Magazine or journal—what is the difference? The role of the monitoring editor 
Molecular Biology of the Cell  2013;24(7):887-889.
Scientific communication, career advancement, and funding decisions are all dependent on research publications. The way manuscripts are handled by high-visibility, professionally edited magazines differs from the way academic journals evaluate manuscripts, using active scientists as monitoring editors. In this essay, I discuss the benefits that come with the involvement of active scientists. I enumerate the decisions a monitoring editor has to make, and how he or she goes about making them. Finally, I indicate ways in which authors can help to make the process a smoother and more positive experience.
doi:10.1091/mbc.E12-12-0899
PMCID: PMC3608498  PMID: 23533210
13.  Reporting Guidelines: Optimal Use in Preventive Medicine and Public Health 
Numerous reporting guidelines are available to help authors write higher quality manuscripts more efficiently. Almost 200 are listed on the EQUATOR (Enhancing the Quality and Transparency of Health Research) Network’s website and they vary in authority, usability, and breadth, making it difficult to decide which one(s) to use. This paper provides consistent information about guidelines for preventive medicine and public health and a framework and sequential approach for selecting them.
EQUATOR guidelines were reviewed for relevance to target audiences; selected guidelines were classified as “core” (frequently recommended) or specialized, and the latter were grouped by their focus. Core and specialized guidelines were coded for indicators of authority (simultaneous publication in multiple journals, rationale, scientific background supporting each element, expertise of designers, permanent website/named group), usability (presence of checklists and examples of good reporting), and breadth (manuscript sections covered). Discrepancies were resolved by consensus. Selected guidelines are presented in four tables arranged to facilitate selection: core guidelines, all of which pertain to major research designs; guidelines for additional study designs, topical guidelines, and guidelines for particular manuscript sections. A flow diagram provides an overview. The framework and sequential approach will enable authors as well as editors, peer reviewers, researchers, and systematic reviewers to make optimal use of available guidelines to improve the transparency, clarity, and rigor of manuscripts and research protocols and the efficiency of conducing systematic reviews and meta-analyses.
doi:10.1016/j.amepre.2012.06.031
PMCID: PMC3475417  PMID: 22992369
14.  Vascular Contributions to Cognitive Impairment and Dementia 
Background and Purpose
This scientific statement provides an overview of the evidence on vascular contributions to cognitive impairment and dementia. Vascular contributions to cognitive impairment and dementia of later life are common. Definitions of vascular cognitive impairment (VCI), neuropathology, basic science and pathophysiological aspects, role of neuroimaging and vascular and other associated risk factors, and potential opportunities for prevention and treatment are reviewed. This statement serves as an overall guide for practitioners to gain a better understanding of VCI and dementia, prevention, and treatment.
Methods
Writing group members were nominated by the writing group co-chairs on the basis of their previous work in relevant topic areas and were approved by the American Heart Association Stroke Council Scientific Statement Oversight Committee, the Council on Epidemiology and Prevention, and the Manuscript Oversight Committee. The writing group used systematic literature reviews (primarily covering publications from 1990 to May 1, 2010), previously published guidelines, personal files, and expert opinion to summarize existing evidence, indicate gaps in current knowledge, and, when appropriate, formulate recommendations using standard American Heart Association criteria. All members of the writing group had the opportunity to comment on the recommendations and approved the final version of this document. After peer review by the American Heart Association, as well as review by the Stroke Council leadership, Council on Epidemiology and Prevention Council, and Scientific Statements Oversight Committee, the statement was approved by the American Heart Association Science Advisory and Coordinating Committee.
Results
The construct of VCI has been introduced to capture the entire spectrum of cognitive disorders associated with all forms of cerebral vascular brain injury—not solely stroke—ranging from mild cognitive impairment through fully developed dementia. Dysfunction of the neurovascular unit and mechanisms regulating cerebral blood flow are likely to be important components of the pathophysiological processes underlying VCI. Cerebral amyloid angiopathy is emerging as an important marker of risk for Alzheimer disease, microinfarction, microhemorrhage and macrohemorrhage of the brain, and VCI. The neuropathology of cognitive impairment in later life is often a mixture of Alzheimer disease and microvascular brain damage, which may overlap and synergize to heighten the risk of cognitive impairment. In this regard, magnetic resonance imaging and other neuroimaging techniques play an important role in the definition and detection of VCI and provide evidence that subcortical forms of VCI with white matter hyperintensities and small deep infarcts are common. In many cases, risk markers for VCI are the same as traditional risk factors for stroke. These risks may include but are not limited to atrial fibrillation, hypertension, diabetes mellitus, and hypercholesterolemia. Furthermore, these same vascular risk factors may be risk markers for Alzheimer disease. Carotid intimal-medial thickness and arterial stiffness are emerging as markers of arterial aging and may serve as risk markers for VCI. Currently, no specific treatments for VCI have been approved by the US Food and Drug Administration. However, detection and control of the traditional risk factors for stroke and cardiovascular disease may be effective in the prevention of VCI, even in older people.
Conclusions
Vascular contributions to cognitive impairment and dementia are important. Understanding of VCI has evolved substantially in recent years, based on preclinical, neuropathologic, neuroimaging, physiological, and epidemiological studies. Transdisciplinary, translational, and transactional approaches are recommended to further our understanding of this entity and to better characterize its neuropsychological profile. There is a need for prospective, quantitative, clinical-pathological-neuroimaging studies to improve knowledge of the pathological basis of neuroimaging change and the complex interplay between vascular and Alzheimer disease pathologies in the evolution of clinical VCI and Alzheimer disease. Long-term vascular risk marker interventional studies beginning as early as midlife may be required to prevent or postpone the onset of VCI and Alzheimer disease. Studies of intensive reduction of vascular risk factors in high-risk groups are another important avenue of research.
doi:10.1161/STR.0b013e3182299496
PMCID: PMC3778669  PMID: 21778438
AHA Scientific Statements; vascular dementia; Alzheimer disease; risk factors; prevention; treatment
15.  Biochemia Medica appoints Research integrity editor 
Biochemia Medica  2012;22(3):271.
Biochemia Medica has just established the Research integrity editor who will act as the Editorial team member responsible for all matters related to the various aspects of scientific misconduct. The major reason for this is the increasing number of various types of scientific misconduct in manuscripts submitted to our Journal. Research integrity editor will: a) strive to continuously raise awareness for research and publication integrity issues; b) educate our authors, reviewers and readers, by providing educational articles on various topics related to responsible research and writing; c) aim to prevent unethical research and publication practices; and d) responsibly deal with research and publication misconduct attempts in accordance with internationally accepted policies and recommendations. This initiative provides firm evidence of our commitment and respect for publishing ethical and responsible research. By this we hope to further increase the scientific quality of the journal content as well as the quality of the editorial work.
PMCID: PMC3900055  PMID: 23092057
scientific misconduct; plagiarism; editorial policies
16.  Content and communication: How can peer review provide helpful feedback about the writing? 
Background
Peer review is assumed to improve the quality of research reports as tools for scientific communication, yet strong evidence that this outcome is obtained consistently has been elusive. Failure to distinguish between aspects of discipline-specific content and aspects of the writing or use of language may account for some deficiencies in current peer review processes.
Discussion
The process and outcomes of peer review may be analyzed along two dimensions: 1) identifying scientific or technical content that is useful to other researchers (i.e., its "screening" function), and 2) improving research articles as tools for communication (i.e., its "improving" function). However, editors and reviewers do not always distinguish clearly between content criteria and writing criteria. When peer reviewers confuse content and writing, their feedback can be misunderstood by authors, who may modify texts in ways that do not make the readers' job easier. When researchers in peer review confuse the two dimensions, this can lead to content validity problems that foil attempts to define informative variables and outcome measures, and thus prevent clear trends from emerging. Research on writing, revising and editing suggests some reasons why peer review is not always as effective as it might be in improving what is written.
Summary
Peer review could be improved if stakeholders were more aware of variations in gatekeepers' (reviewers' and editors') ability to provide feedback about the content or the writing. Gatekeepers, academic literacy researchers, and wordface professionals (author's editors, medical writers and translators) could work together to discover the types of feedback authors find most useful. I offer suggestions to help editologists design better studies of peer review which could make the process an even stronger tool for manuscript improvement than it is now.
doi:10.1186/1471-2288-8-3
PMCID: PMC2268697  PMID: 18237378
17.  Editorial Peer Reviewers' Recommendations at a General Medical Journal: Are They Reliable and Do Editors Care? 
PLoS ONE  2010;5(4):e10072.
Background
Editorial peer review is universally used but little studied. We examined the relationship between external reviewers' recommendations and the editorial outcome of manuscripts undergoing external peer-review at the Journal of General Internal Medicine (JGIM).
Methodology/Principal Findings
We examined reviewer recommendations and editors' decisions at JGIM between 2004 and 2008. For manuscripts undergoing peer review, we calculated chance-corrected agreement among reviewers on recommendations to reject versus accept or revise. Using mixed effects logistic regression models, we estimated intra-class correlation coefficients (ICC) at the reviewer and manuscript level. Finally, we examined the probability of rejection in relation to reviewer agreement and disagreement. The 2264 manuscripts sent for external review during the study period received 5881 reviews provided by 2916 reviewers; 28% of reviews recommended rejection. Chance corrected agreement (kappa statistic) on rejection among reviewers was 0.11 (p<.01). In mixed effects models adjusting for study year and manuscript type, the reviewer-level ICC was 0.23 (95% confidence interval [CI], 0.19–0.29) and the manuscript-level ICC was 0.17 (95% CI, 0.12–0.22). The editors' overall rejection rate was 48%: 88% when all reviewers for a manuscript agreed on rejection (7% of manuscripts) and 20% when all reviewers agreed that the manuscript should not be rejected (48% of manuscripts) (p<0.01).
Conclusions/Significance
Reviewers at JGIM agreed on recommendations to reject vs. accept/revise at levels barely beyond chance, yet editors placed considerable weight on reviewers' recommendations. Efforts are needed to improve the reliability of the peer-review process while helping editors understand the limitations of reviewers' recommendations.
doi:10.1371/journal.pone.0010072
PMCID: PMC2851650  PMID: 20386704
18.  Promotional Tone in Reviews of Menopausal Hormone Therapy After the Women's Health Initiative: An Analysis of Published Articles 
PLoS Medicine  2011;8(3):e1000425.
Adriane Fugh-Berman and colleagues analyzed a selection of published opinion pieces on hormone therapy and show that there may be a connection between receiving industry funding for speaking, consulting, or research and the tone of such opinion pieces.
Background
Even after the Women's Health Initiative (WHI) found that the risks of menopausal hormone therapy (hormone therapy) outweighed benefit for asymptomatic women, about half of gynecologists in the United States continued to believe that hormones benefited women's health. The pharmaceutical industry has supported publication of articles in medical journals for marketing purposes. It is unknown whether author relationships with industry affect promotional tone in articles on hormone therapy. The goal of this study was to determine whether promotional tone could be identified in narrative review articles regarding menopausal hormone therapy and whether articles identified as promotional were more likely to have been authored by those with conflicts of interest with manufacturers of menopausal hormone therapy.
Methods and Findings
We analyzed tone in opinion pieces on hormone therapy published in the four years after the estrogen-progestin arm of the WHI was stopped. First, we identified the ten authors with four or more MEDLINE-indexed reviews, editorials, comments, or letters on hormone replacement therapy or menopausal hormone therapy published between July 2002 and June 2006. Next, we conducted an additional search using the names of these authors to identify other relevant articles. Finally, after author names and affiliations were removed, 50 articles were evaluated by three readers for scientific accuracy and for tone. Scientific accuracy was assessed based on whether or not the findings of the WHI were accurately reported using two criteria: (1) Acknowledgment or lack of denial of the risk of breast cancer diagnosis associated with hormone therapy, and (2) acknowledgment that hormone therapy did not benefit cardiovascular disease endpoints. Determination of promotional tone was based on the assessment by each reader of whether the article appeared to promote hormone therapy. Analysis of inter-rater consistency found moderate agreement for scientific accuracy (κ = 0.57) and substantial agreement for promotional tone (κ = 0.65). After discussion, readers found 86% of the articles to be scientifically accurate and 64% to be promotional in tone. Themes that were common in articles considered promotional included attacks on the methodology of the WHI, arguments that clinical trial results should not guide treatment for individuals, and arguments that observational studies are as good as or better than randomized clinical trials for guiding clinical decisions. The promotional articles we identified also implied that the risks associated with hormone therapy have been exaggerated and that the benefits of hormone therapy have been or will be proven. Of the ten authors studied, eight were found to have declared payment for speaking or consulting on behalf of menopausal hormone manufacturers or for research support (seven of these eight were speakers or consultants). Thirty of 32 articles (90%) evaluated as promoting hormone therapy were authored by those with potential financial conflicts of interest, compared to 11 of 18 articles (61%) by those without such conflicts (p = 0.0025). Articles promoting the use of menopausal hormone therapy were 2.41 times (95% confidence interval 1.49–4.93) as likely to have been authored by authors with conflicts of interest as by authors without conflicts of interest. In articles from three authors with conflicts of interest some of the same text was repeated word-for-word in different articles.
Conclusion
There may be a connection between receiving industry funding for speaking, consulting, or research and the publication of promotional opinion pieces on menopausal hormone therapy.
Please see later in the article for the Editors' Summary
Editors' Summary
Background
Over the past three decades, menopausal hormones have been heavily promoted for preventing disease in women. However, the Women's Health Initiative (WHI) study—which enrolled more than 26,000 women in the US and which was published in 2004—found that estrogen-progestin and estrogen-only formulations (often prescribed to women around the age of menopause) increased the risk of stroke, deep vein thrombosis, dementia, and incontinence. Furthermore, this study found that the estrogen-progestin therapy increased rates of breast cancer. In fact, the estrogen-progestin arm of the WHI study was stopped in 2002 due to harmful findings, and the estrogen-only arm was stopped in 2004, also because of harmful findings. In addition, the study also found that neither therapy reduced cardiovascular risk or markedly benefited health-related quality of life measures.
Despite these results, two years after the results of WHI study were published, a survey of over 700 practicing gynecologists—the specialists who prescribe the majority of menopausal hormone therapies—in the US found that almost half did not find the findings of the WHI study convincing and that 48% disagreed with the decision to stop the trial early. Furthermore, follow-up surveys found similar results.
Why Was This Study Done?
It is unclear why gynecologists and other physicians continue to prescribe menopausal hormone therapies despite the results of the WHI. Some academics argue that published industry-funded reviews and commentaries may be designed to convey specific, but subtle, marketing messages and several academic analyses have used internal industry documents disclosed in litigation cases. So this study was conducted to investigate whether hormone therapy–promoting tone could be identified in narrative review articles and if so, whether these articles were more likely to have been authored by people who had accepted funding from hormone manufacturers.
What Did the Researchers Do and Find?
The researchers conducted a comprehensive literature search that identified 340 relevant articles published between July 2002 and June 2006—the four years following the cessation of the estrogen-progestin arm of the women's health initiative study. Ten authors had published four to six articles, 47 authored two or three articles, and 371 authored one article each. The researchers focused on authors who had published four or more articles in the four-year period under study and, after author names and affiliations were removed, 50 articles were evaluated by three readers for scientific accuracy and for tone. After individually analyzing a batch of articles, the readers met to provide their initial assessments, to discuss them, and to reach consensus on tone and scientific accuracy. Then after the papers were evaluated, each author was identified and the researchers searched for authors' potential financial conflicts of interest, defined as publicly disclosed information that the authors had received payment for research, speaking, or consulting on behalf of a manufacturer of menopausal hormone therapy.
Common themes in the 50 articles included arguments that clinical trial results should not guide treatment for individuals and suggestions that the risks associated with hormone therapy have been exaggerated and that the benefits of hormone therapy have been or will be proven. Furthermore, of the ten authors studied, eight were found to have received payment for research, speaking or consulting on behalf of menopause hormone manufacturers, and 30 of 32 articles evaluated as promoting hormone therapy were authored by those with potential financial conflicts of interest. Articles promoting the use of menopausal hormone therapy were more than twice as likely to have been written by authors with conflicts of interest as by authors without conflicts of interest. Furthermore, Three authors who were identified as having financial conflicts of interest were authors on articles where sections of their previously published articles were repeated word-for-word without citation.
What Do These Findings Mean?
The findings of this study suggest that there may be a link between receiving industry funding for speaking, consulting, or research and the publication of apparently promotional opinion pieces on menopausal hormone therapy. Furthermore, such publications may encourage physicians to continue prescribing these therapies to women of menopausal age. Therefore, physicians and other health care providers should interpret the content of review articles with caution. In addition, medical journals should follow the International Committee of Medical Journal Editors Uniform Requirements for Manuscripts, which require that all authors submit signed statements of their participation in authorship and full disclosure of any conflicts of interest.
Additional Information
Please access these Web sites via the online version of this summary at http://dx.doi.org/10.1371/journal.pmed.1000425.
The US National Heart, Lung, and Blood Institute has more information on the Womens Health Initiative
The US National Institutes of Health provide more information about the effects of menopausal hormone replacement therapy
The Office of Women's Health, U.S. Department of Health and Human Services provides information on menopausal hormone therapy
The International Committee of Medical Journal Editors Uniform Requirements for Manuscripts presents Uniform Requirements for Manuscripts published in biomedical journals
The National Womens Health Network, a consumer advocacy group that takes no industry money, has factsheets and articles about menopausal hormone therapy
PharmedOut, a Georgetown University Medical Center project, has many resources on pharmaceutical marketing practices
doi:10.1371/journal.pmed.1000425
PMCID: PMC3058057  PMID: 21423581
19.  Common Errors in Manuscripts Submitted to Medical Science Journals 
Background:
Many manuscripts submitted to biomedical journals are rejected for reasons that include low-quality of the manuscripts.
Aim:
The aim of this study is to identify and characterize the common errors in manuscripts submitted to medical journals based in Africa and Asia.
Materials and Methods:
Reviewers’ reports on 42 manuscripts were analyzed qualitatively using deductive coding, and quantitatively to determine the errors by sections of the manuscripts. The study included only reviews on full length original research articles.
Results:
Results showed that 66.7% (28/42) of the manuscripts had flaws in the introduction, 85.7% (36/42) in materials and methods, 66.7% (28/42) in the results, 71.4% (30/42) in discussion, 69.0% (29/42) in references, and 81.1% (34/42) in the general sections. Qualitative analysis of the reviews revealed 22 themes. Most common flaws identified were improper review of literature, provision of insufficient detailed methodology, unsystematic or illogical presentation of results, and unsupported conclusions. Others were inconsistent or nonconforming citations, and lack of good grammatical writing.
Conclusions:
The results show that many of the manuscripts had remarkable errors and demonstrate the need for attention to detail in study design and manuscript preparation and for further training of medical scientists in the techniques of manuscript writing for journal publication.
doi:10.4103/2141-9248.117957
PMCID: PMC3793443  PMID: 24116317
Academic writing; Africa; Asia; Manuscript preparation; Peer review
20.  PUBLISHING YOUR WORK IN A JOURNAL: UNDERSTANDING THE PEER REVIEW PROCESS 
Manuscripts have been subjected to the peer review process prior to publication for over 300 years. Currently, the peer review process is used by almost all scientific journals, and The International Journal of Sports Physical Therapy is no exception. Scholarly publication is the means by which new work is communicated and peer review is an important part of this process. Peer review is a vital part of the quality control mechanism that is used to determine what is published, and what is not. The purpose of this commentary is to provide a description of the peer review process, both generally, and as utilized by The International Journal of Sports Physical Therapy. It is the hope of the authors that this will assist those who submit scholarly works to understand the purpose of the peer review process, as well as to appreciate the length of time required for a manuscript to complete the process and move toward publication.
PMCID: PMC3474310  PMID: 23091777
Peer review; quality control; research publication
21.  How to write an article: Preparing a publishable manuscript! 
CytoJournal  2012;9:1.
Most of the scientific work presented as abstracts (platforms and posters) at various conferences have the potential to be published as articles in peer-reviewed journals. This DIY (Do It Yourself) article on how to achieve that goal is an extension of the symposium presented at the 36th European Congress of Cytology, Istanbul, Turkey (presentation available on net at http://alturl.com/q6bfp). The criteria for manuscript authorship should be based on the ICMJE (International Committee of Medical Journal Editors) Uniform Requirements for Manuscripts. The next step is to choose the appropriate journal to submit the manuscript and review the ‘Instructions to the authors’ for that journal. Although initially it may appear to be an insurmountable task, diligent organizational discipline with a little patience and perseverance with input from mentors should lead to the preparation of a nearly perfect publishable manuscript even by a novice. Ultimately, the published article is an excellent track record of academic productivity with contribution to the general public good by encouraging the exchange of experience and innovation. It is a highly rewarding conduit to the personal success and growth leading to the collective achievement of continued scientific progress. Recent emergences of journals and publishers offering the platform and opportunity to publish under an open access charter provides the opportunity for authors to protect their copyright from being lost to conventional publishers. Publishing your work on this open platform is the most rewarding mission and is the recommended option in the current modern era.
[This open access article can be linked (copy-paste link from HTML version of this article) or reproduced FREELY if original reference details are prominently identifiable].
doi:10.4103/1742-6413.92545
PMCID: PMC3280045  PMID: 22363390
Author; cytopathology; manuscript; publish; research; reviewer
22.  How to write an original article for the Journal of Orthopaedics and Traumatology 
The abstract is the precise summary of the article, not a preface. As Baue wrote in a popular editorial of the Archives of Surgery in 1979, “writing a good abstract is not abstract writing” [6]. The main data have to be represented, as they allow readers to understand contents clearly. Sentences like “The paper reports...” or “The authors describe...” have to be avoided as well as any generic statements.
In order to help writers avoid generalities, the recently revised version of this journal’s “instructions to authors” [4] requires the abstract to be no longer than 300 words and structured in 4 paragraphs: the Background declares the hypothesis, the Materials and methods impart the study design and quote the relevant numerical features of the samples, the Results report the main data and their statistical significance, the Conclusions state whether the hypothesis is verified or not. One or two sentences per paragraph are usually sufficient.
The abstract is frequently recommended to be written after the text, as “the process of writing changes thought and perhaps even purpose” [7]. Nonetheless, in my view, preparing the abstract first is a useful exercise that forces the authors to organize their thoughts and guides the organization of the article. However, the abstract should be always revised after the manuscript has been completed.
doi:10.1007/s10195-008-0096-1
PMCID: PMC2656977  PMID: 19384473
23.  Scientific Value of Systematic Reviews: Survey of Editors of Core Clinical Journals 
PLoS ONE  2012;7(5):e35732.
Background
Synthesizing research evidence using systematic and rigorous methods has become a key feature of evidence-based medicine and knowledge translation. Systematic reviews (SRs) may or may not include a meta-analysis depending on the suitability of available data. They are often being criticised as ‘secondary research’ and denied the status of original research. Scientific journals play an important role in the publication process. How they appraise a given type of research influences the status of that research in the scientific community. We investigated the attitudes of editors of core clinical journals towards SRs and their value for publication.
Methods
We identified the 118 journals labelled as “core clinical journals” by the National Library of Medicine, USA in April 2009. The journals’ editors were surveyed by email in 2009 and asked whether they considered SRs as original research projects; whether they published SRs; and for which section of the journal they would consider a SR manuscript.
Results
The editors of 65 journals (55%) responded. Most respondents considered SRs to be original research (71%) and almost all journals (93%) published SRs. Several editors regarded the use of Cochrane methodology or a meta-analysis as quality criteria; for some respondents these criteria were premises for the consideration of SRs as original research. Journals placed SRs in various sections such as “Review” or “Feature article”. Characterization of non-responding journals showed that about two thirds do publish systematic reviews.
Discussion
Currently, the editors of most core clinical journals consider SRs original research. Our findings are limited by a non-responder rate of 45%. Individual comments suggest that this is a grey area and attitudes differ widely. A debate about the definition of ‘original research’ in the context of SRs is warranted.
doi:10.1371/journal.pone.0035732
PMCID: PMC3341385  PMID: 22563469
24.  Enhancing the reporting and transparency of rheumatology research: a guide to reporting guidelines 
Manuscripts and abstracts from biomedical journals frequently do not contain proper information for meeting required standards and serving the multiple needs of their end users. Reporting guidelines and checklists help researchers to meet those standards by providing rules or principles for specific research areas. Rheumatology research includes a broad range of heterogeneous research areas, each with its own requirements, producing several distinct categories of articles. Our objectives with this article are to raise awareness of the existence and importance of reporting guidelines, to present a structured overview of reporting guidelines that rheumatology journals could apply, and to encourage their use by journal authors, editors, and reviewers, including those of Arthritis Research & Therapy. Internationally recognized reporting guidelines exist for a diversity of research areas. We encourage colleagues to consult the 'Enhancing the QUAlity and Transparency Of health Research' (EQUATOR) network when writing scientific papers. EQUATOR is an international initiative that seeks to improve the reliability and value of biomedical research literature by promoting transparent and accurate reporting of studies. We propose specific reporting guidelines for a number of study designs: animal research, randomized trials, reliability and agreement studies, systematic reviews with and without meta-analyses, diagnostic test accuracy studies, and also observational research including cross-sectional, cohort, and case-control studies. We encourage authors, editors, and reviewers to adhere to and enforce the use of the appropriate guidelines when writing, reading, and reviewing scientific papers.
doi:10.1186/ar4145
PMCID: PMC3672749  PMID: 23448311
25.  Our silent enemy: ashes in our libraries 
Scholars, scientists, physicians, other health professionals, and librarians face a crucial decision today: shall we nourish the biomedical archives as a viable and indispensable source of information, or shall we bury their ashes and lose a century or more of consequential scientific history? Biomedical books and journals published since the 1850s on self-destructing acidic paper are silently and insidiously scorching on our shelves. The associated risks for scientists and physicians are serious—incomplete assessment of past knowledge; unnecessary repetition of studies that have already led to conclusive results; delay in scientific advances when important concepts, techniques, instruments, and procedures are overlooked; faulty comparative analyses; or improper assignment of priority.
The archives also disclose the nature of biomedical research, which builds on past knowledge, advances incrementally, and is strewn with missteps, frustrations, detours, inconsistencies, enigmas, and contradictions. The public's familiarity with the scientific process will avoid unrealistic expectations and will encourage support for research in health. But a proper historical perspective requires access to the biomedical archives. Since journals will apparently continue to be published on paper, it is folly to persist in the use of acidic paper and thus magnify for future librarians and preservationists the already Sisyphean and costly task of deacidifying their collections.
Our plea for conversion to acid-free paper is accompanied by an equally strong appeal for more rigorous criteria for journal publication. The glut of journal articles—many superficial, redundant, mediocre, or otherwise flawed and some even fraudulent—has overloaded our databases, complicated bibliographic research, and exacerbated the preservation problem. Before accepting articles, journal editors should ask: If it is not worth preserving, is it worth publishing?
It is our responsibility to protect the integrity of our biomedical records against all threats. Authors should consider submitting manuscripts to journals that use acid-free paper, especially if they think, as most authors do, that they are writing for posterity. Librarians can refuse to purchase journals published on acidic paper, which they know will need restoration within a few decades and will thus help deplete their budgets. All of us can urge our government to devise a coordinated national conservation policy that will halt the destruction of a century of our historical record. The battle will not be easy, but the challenge beckons urgently. The choice is ours: we can answer the call, or we can deny scientists, physicians, and historians the records they need to expand human knowledge and improve health care.
PMCID: PMC227429  PMID: 2758179

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