Editor-in-Chief Forum: The Past, Present, and Future of Neurosurgery Journal Publishing

This is a preview. Check to see if you have access to the full video. Check access


- Colleagues and friends, thank you for joining us for another session of the Virtual OR. Our guest today is Dr. James Rutka from University of Toronto. He's chairman of surgery there, previous chairman of neurosurgery there. He doesn't require any introduction. He is the chief editor of "Journal of Neurosurgery." He has been in every major leadership position in neurosurgery. His incredible efforts have brought the "Journal of Neurosurgery" to the highest level it's been in its impact factor, approaching above 5.1. It's truly an incredible accomplishment. Jim, the "Journal" has truly thrived in absolutely new heights under your leadership for very good reason. You have been truly a role model, a leader for me and many other neurosurgeons, and your gravitas and executive power in neurosurgery internationally is unparalleled, so with that, I'm very much thankful to you to talk to us today about publishing in the discipline of neurosurgery, pitfalls, pearls, and then, at the end of your discussion, we'll have some also further talk about what's the future of publishing in general, so with that, thank you, Jim, and please go ahead.

- Great, well, Aaron, thank you very much. It's a real pleasure to share the stage with you today and thank you for the invitation. As always, it's wonderful to work with you through so many different initiatives in neurosurgery, including neurosurgical publishing, so you had asked me to say a few words about publishing in general, and so I've entitled my presentation today "The Past, Present, and Future "of Neurosurgery Journal Publishing," and on the left-hand side of this image, what you can see is the very first issue of the "Journal of Neurosurgery," published in 1944. I'll remind all of you that the Cushing Society, the AANS, began in 1933, so 11 years after the formation of the Cushing Society, the "Journal of Neurosurgery" was initiated, interestingly, during the war years, and then, on the right-hand side, you can see an image from our 75th anniversary celebration issue in 2019, and we are the oldest and longest continuously running journal in all of neurosurgery. Hence, we take great pride in the legacy and the history and, I suppose, the importance of the "Journal of Neurosurgery" across the world of neurosurgical publishing. If you look at the previous leaders of the "Journal," over the years, on the left-hand side, you can see a portrait image of the different editors in chief, including such luminaries as Thor Sundt from the Mayo Clinic, Bill Collins from Yale. You have Henry Schwartz, who is from Washington University, John Jane, of course, from University of Virginia, and not the least of whom is Louise Eisenhardt, who's shown there. She was the first editor in chief, and she served for 22 years, the longest-running time that an editor-in-chief has served for the "Journal." On the right-hand side, what you see is strategic planning, and I think very few journals actually run strategic plans, but as I am quite accustomed to running strategic plans, and over the years, I have run several, both in the division of neurosurgery at the University of Toronto, now the Department of Surgery, I thought it would be prudent, when I first became editor in chief, to run a strategic plan. This is our second plan that you see on the screen here on the right. It's entitled "Impactful Publishing: Growing Our Legacy," and I think it's a very strong, robust plan and provides us with a roadmap to know where we are, but more importantly, where we're going in the world of publishing. Well, it may come as no surprise to all of you that neurosurgery is a very visual specialty area, and on the left-hand side, you can see an image from an artist's illustration from the very first issue of the "Journal of Neurosurgery" in 1944, and you can trace articles in the "Journal" all the way back to 1944. They're searchable, you can download the PDFs, and you can see what authors were writing all the way back in time now, well over 75 years, and this is the image of Cushing's crossbow incision that you can see for posterior fossa exposures, as you can see here, and this is very interesting that you can see these exposures like this here and the illustrations that are utilized. Over the years, these illustrations have become increasingly more important, and, Aaron, I would say that you and what you've done with the "Atlas" is absolutely incredible in taking illustrations like these to an all-time new level, so please check the archives of the "Journal of Neurosurgery" all the way back to 1944 up to the present, and you can find illustrations like this throughout and how they've been enhanced in history. The "Journal" uses a number of different icons in its various issues that illustrate, to a degree, what we do in terms of our abilities to highlight different features of the "Journal," so, for example, what you have here are the various linkages to items that are in the Internet world and cyberspace, so "The Rhoton Collection," you can see here, the "Atlas," which is here. We have editorials, podcasts, letters to the editor, classifications of evidence, and interestingly, an opinion piece area called "Broca's Area," which I'll speak about in a little more detail. When we come to the advances in what we've done with the "Journal," I think no one would argue with the importance of "The Rhoton Collection" in neurosurgical history. Rhoton was a fabulous neurosurgical anatomist, and here is shown some of his cadaveric dissections and illustrations. Probably nothing better in the world to this day than what Rhoton was able to achieve, and thanks to the help and the initiatives to set out "The Rhoton Collection," we can now link various hyperlinks to "Journal" articles directly to "The Rhoton Collection," so we're very pleased to be able to offer this to our colleagues around the world and then, as you know, Aaron, you and I have worked very closely together over the years, and we've really enjoyed our partnership with the "Neurosurgical Atlas" and how we can demonstrate the move into the future of neurosurgical publishing in all of its formats, from these illustrations I mentioned earlier to video presentations to amazing sketches by artists to content to neurosurgical approaches, et cetera. It's truly been remarkable to see how the "Atlas" has advanced and has now become one of the world's leading resources for all of neurosurgery. "Classes of evidence." We believe, in the "Journal," that we like to publish those articles that lend themselves to having a high degree of evidence. I'll just say at the outset that there are very few randomized controlled clinical trials in neurosurgery, but there are a few, and certainly, we've published them in the "Journal of Neurosurgery," and they've been published in other neurosurgical journals as well, but this illustrates for you what these classes of evidence are, and we take great pride in our ability to weigh the evidence, if you will, and to present that to our readership in terms of commentaries and also with the publications that we have put forward over the years. I'll return, just for a moment, to "Broca's Area," and you can see this title here from Leland Albright's work when he was a practicing neurosurgeon in sub-Sahara Africa. Phenomenal work that he did, but we now have an opportunity to allow for these types of opinion pieces because time to time, they don't fit into any specific category or classification of article submission, but they are truly opinion pieces, and I'm very pleased that we can publish these, and if you have something in mind you wish to publish as an opinion piece, please don't hesitate to reach out to me and speak about it further, but these were types of cases that Leland Albright would operate on when he was in sub-Saharan Africa, here, large craniopharyngioma cystic that you can see and a dorsal kyphotic lesion from a baby that was born with a myelomeningocele and so on, so we are very interested in and welcome the submission of various opinion pieces. This particular slide has to do with the presentation of "Neurosurgical Focus," and the editor-in-chief of the first version of "Focus" was Marty Weiss in 1996 to 2016 for that decade, and now he's been, the leadership has been taken over by Bill Couldwell, and, Aaron, you, and, of course, Jason Sheehan, and several others are actively involved in our work with "Neurosurgical Focus," and the topics are, I think, extraordinary, timely, topical, and help us to really move the state of rapid publications forward, and I'll speak a little bit further about that, but a while back, I wrote an editorial on "Focus" and being the first fully online, freely accessible journal in almost the world. There were some scientific journals in chemistry, biochemistry, that were just starting to publish freely online and fully accessible, but "Focus" wasn't far behind, and it was the brainchild, as mentioned, of Marty Weiss and now taken over by Bill Couldwell. So "Impactful publishing," here we are, the "Journal of Neurosurgery," and its diamond anniversary 75 years later. Wonderful to see how far the "Journal" has come over the years and what it's been able to accomplish, and what you're seeing on this image are the print journals that you can see here on the left-hand side, so "JNS," "Spine," "Pediatrics," and on the right-hand side, you can see the online journals, newly developed "Case Lessons" journal and then followed by "Focus" and now "Focus: Video," so each month, "Focus" issues come out, and then, two, sometimes three times a year, we have video-focused issues that come forward and are wonderful, are extremely well viewed around the world, and provide great opportunities for residents and fellows to see neurosurgical approaches prior to getting into the operating room, so I think the world is leaning more towards the online journal approach, as you'll see in the future, for a whole variety of reasons, and not the least of which is the charges that go hand in hand with print publication and printing on paper and then sending, of course, mail-outs to the world. That's becoming increasingly more expensive, so why not? If you have an audience that has a personal device or has a computer, why not concentrate your efforts on online publishing? And that's, I think, going to be a wave of the future, as many of you know, but one of the things we've been able to do with the "Journal of Neurosurgery" is respond to online, to world events in a manner that is very quick, timely, and allows us to produce papers that can give information regarding such things like the pandemic, and you may recall that we published a series of editorials on the COVID-19 pandemic and its impact on the practice of neurosurgery, and this was, I thought, timely almost two years ago now, and what we found out is that while the pandemic was raging initially, neurosurgeons, who weren't allowed to come into their hospitals, let's say, to do all their scheduled or elective cases were busy in their home environments or on their computer producing manuscripts, and it was a busy time, I can tell you, for the editorial office. This shows for you the submission of manuscripts over time when the pandemic first struck in March, and then, look at the numbers of manuscripts that are submitted in the subsequent months. It did tail off, no question, but this huge bolus of manuscripts was really felt by the office, the office staff, by the editorial boards, and by the editor-in-chief, and so we were drowning in manuscripts that you can see here, but it was all good because it really meant that neurosurgeons were being very assiduous about putting their time and skills to good use at a time of the pandemic, when, let's face it, neurosurgical activities were curtailed to a degree. We also published a specific "Focus" issue on preparedness for the pandemic, and a number of key articles came out of this particular publication. Again, rapid response to world events, and this is something that we can do with the "Journal" with a vehicle like "Neurosurgical Focus." And what you can see, if you do a quick literature search, is just going back a few months. Unbelievable that in PubMed over 180,000 articles in less than two years, like, in a year and a half, and COVID and neurosurgery, a PubMed search is well over 2,000 articles now. I don't think there's been another event in our history that has led to such a rapid increase in numbers of publications in a given field as we've seen with this particular pandemic. Well, now we're gonna be moving into the future of publishing with some of these concepts I'll be sharing with you. One here is multimedia platforms, and, of course, here with linkages that we have with the "Neurosurgical Atlas," "Rhoton Collection," other things. We are spotlighting various approaches within the website of the "Journal." We have the "Neurosurgical Atlas," as mentioned. We have "Virtual and Augmented Reality," so all of these things are extremely important for us as we move forward into the future on what journals are gonna look like, but they're definitely going to include online linkages, multimedia, lots of video content, and our ability to move forward with rapid dissemination of information unlike ever before. Something that we've latched onto with respect to the "Journal of Neurosurgery" is our interest in promulgating our work via social media, and we were very fortunate, years ago, to have a maven for social media who was helping us with this particular effort, and we were also very pleased that over time we've built a social media team, essentially, of young neurosurgery residents, some medical students who have become increasingly more involved with our efforts to promote and support social media across neurosurgery, so we have active pages on Facebook on Instagram and on Twitter, so you can, and I would encourage all of you to see where we are with these various entities in the social media space, and this is how you can pick up information just by the click of a button, and I would encourage you to do that. You know, it raises the question, however, what are the next platforms? What are we going to see next in social media that's gonna make a real difference? And you can bet with young, engaged, and active minds like our social media team, we won't be left far behind when it comes to the "Journal of Neurosurgery," thankfully. I would like to draw attention to our social media team, as shown here, so Faith Robertson is the director or chair of our social media team, and she's at the Mass General Hospital in Boston, and the other very talented young neurosurgeons and residents who are involved in helping us distribute our information around the world. Big thanks to our social media team, and you know what? I think across all of publishing in the world, but particularly, in medical, surgical, and in particular, neurosurgery publishing, the advent of social media will only be extremely important and advantageous to us as we try to get information at the drop of a hat. Well, something you may not be so familiar with is the concept of a preprint server, so what is a preprint server? Preprint server is an opportunity to publish your work prior to formal peer review, and there are a number of these preprint servers now that are available for various topic areas in science, and they all end with the term Rxiv, so I'll just illustrate, so here's one that's called arXiv. Here's one that's called ChemRxiv. Here's one that's medRxiv to deal with medical issues. Here's agriRxiv to do with agriculture, for example, and so on, and bioRxiv is another major archive preprint server. Yeah, so you have a work. You want to publish it online instantaneously. You can do that on these preprint servers, and does that preclude you, then, from publishing in a journal like the "Journal of Neurosurgery"? The answer to that is no because once you publish in a preprint server, you do get a a number, what's called a DOI, a digital index number that allows you, then, to know that your paper has been published in this archival manner on a preprint server, and when you go to publish your work in a journal like the "Journal of Neurosurgery," you just translate that DOI to the "Journal of Neurosurgery." You let us know that you have already published it on a preprint server, and we can send your article that's already been published online out for formal peer review and then get it published within the "Journal of Neurosurgery," so I hope that that's clear to you, and I think that this is going to lead to very rapid accessibility of information that has never been really done before, and I'm seeing more and more publications now, mostly along the lines of, or realm of science articles in neurosurgery that are being published first on these preprint servers, so here's bioRxiv, and you can see that the numbers of papers on COVID in bioRxiv as a preprint server here is over 20,000, so yeah, a lot of folks are planning to publish their work first, and why do you do this? I think the reason is what's called primacy, which is that if you've published something online on a preprint server, you get a date of that particular digital imprint, and then, if somebody else publishes it subsequent to that, you can always claim that you were the first, let's say, to have the notion and the concept, even though it wasn't formally peer reviewed. You can make that claim with a DOI and publishing on a preprint server, and that's why a lot of scientists in research groups put their work up on preprint servers. Okay, we're moving even further ahead now into the future of what publishing looks like, and this is Octopus. Well, what is Octopus? It's claimed here to be the primary research record, but essentially, it's kind of a new way to publish your research that's fast, free, and fair. That's what it says there, and this is open by design, free to everybody. You can publish it. It could be scientific article. Could be a peer review-based article. Could be a review article, meta-analysis, you name it. You can put it on Octopus in the future, so all of these statements here relate to how Octopus is entering the field. It's not exactly a done deal yet. By that, I mean that it's not clear that Octopus will have the arms, you know, to take over the future of scientific publishing, but this is just an example of a platform that's out there that is attracting attention amongst our scientists because they wanna get their work out there as soon as possible, get primacy for the work, get credit for it before going through the somewhat more arduous process of peer review. Okay, another very important concept is open science, and, you know, we talked previously about "Neurosurgical Focus" being freely accessible online, available, et cetera. Well, open science allows research groups to deposit their data into this particular center, Center for Open Science, where other research teams can review it, can examine it, can make comments to it, can learn the methodologies that are involved with the research work that's being deposited in this particular repository, and then, you can add to it all the time and have it as a freely open accessible available for the world. Huge library, if you will, of open science, and this is is going to be, I think, an extremely important concept and wave of the future for publishing. If we step back to the journals that undergo peer review, articles that are sent out and where comments are received back for the authors, peer review is probably the best system that we have for adjudicating over the way in which articles are imagined, are improved upon, and then are published that we have. Is it a perfect system? No. Clearly, there are faults with any kind of review system, and so the peer review process is something that we're always trying to improve upon and always trying to get to a level that others will find is fair, equitable, and provides, you know, information that will only help the authors more in terms of getting their paper published in the best form possible, so one solution to peer review is an entity like this one, which is called Publons, so that's here, and already, some 3 million researchers are involved in Publons, and it essentially tracks your publications, your metrics, what you've already done in the peer review world, how you've been involved in journal editing in the past, and it will organize for you and establish or create a very important dashboard that can then be reviewed by editors in chief, like myself, so if I'm looking for an individual to review, let's say, the topic of trigeminal neuralgia and the use of MRI scanning to look at the fifth cranial nerve and what the importance is after decompression, I can just type in a few words. I can see a dashboard on a number of reviewers who have published in this space who might have tremendous expertise, and I can reach out to them, and they become, instantaneously, a huge database for reviewers and hopefully, reviewers that won't have bias or will be fair in the process of peer review, so what are some of the solutions to peer review in the future? Well, no doubt, this concept, artificial intelligence that you see here. Yeah, everybody is talking about artificial intelligence when it comes to the way that we use neurosurgical applications in the operating room and the way that we look at imaging, the way that pathologists now are looking at slides and so on. All of these things are being the territory of artificial intelligence, but maybe we can find reviewers without bias using AI algorithms. We probably really need to talk about this in detail, which is the diversity of the editorial board members, and I'll be the first to admit that, you know, when I took over the "Journal" some eight years ago, that our editorial board was fairly lean when it came to diverse members on the board. That said, we've made a very concerted effort to change the editorial board to include members that demonstrate a whole variety of diversity, whether it's diversity of standing, age, culture, race. We're doing all of that now to truly improve the way that a diverse group of minds and individuals will review the articles that are sent to them for the purpose of peer review. We have to improve systems for scientific misconduct detection. This is the boon, I would say, of the future. It's also the bane of our existence as editors in chief because time to time, we get notice that, after something's been published, that an article has been subject to some form of scientific misconduct, which leads to an investigation, and subsequent to that, can lead to either a note of correction within the "Journal" or even a retraction of an article. That happens rarely, thankfully, in the "Journal of Neurosurgery," but it can happen and we have to be clearly professional and earnest about identifying misconduct and treating it and dealing with it, but I could go on for hours talking about the ways in which misconduct items have come directly to me and how we've had to deal with them. We have somebody particularly assigned to investigating these within the office, with whom I work very closely, and it requires literally hours of time to investigate, to reach out to the institutions, the authors involved, et cetera, to put these issues to rest. Another item is a lot of peer review is done what's called pro bono. That means for the greater good, so how can we actually thank and appreciate our editors on the editorial board, our reviewers, and I think this is extremely important. We try to do this within the "Journal." We have lots of ways that we acknowledge them, and we try to encourage them to use the fact that they've been on the editorial board towards their promotion at their institutions, for example. We have items that we distribute to the editorial board members throughout the year as a small token of our thanks, and I frequently write to my own editorial board members just to thank them for their excellent reviews. Obviously, I can't do that daily, but I do that, particularly when I see an amazing review, which there's an abundance of within the "Journal," and so very happy to acknowledge, recognize, and support editorial board members in that fashion. There's post-publication peer review and early statistical methods review, so journals would be really fortunate if they had a stable of statisticians who could look at the statistics very quickly for the manuscripts and determine whether the statistics, the tools that were used make sense or whether they're flawed, and if they're flawed, then perhaps that article should not, from the outset, be sent out for peer review. Unfortunately, that's an expensive undertaking. Perhaps only the largest publishing groups are able to afford such a luxury of statistical methods review before peer review. I would think that, you know, really prominent journals like "The New England Journal of Medicine," maybe "Nature" or "Science," would have these statisticians available to query the stats that are used before sending out for peer review, but we don't, but thankfully, we have a lot of our editorial board members who are experts at statistics, and importantly, if I have a question about statistics when the reviews come back, I also can call on other members that are ad hoc reviewers for the "Journal" that can perform statistical methods review for us. This is a Latin phrase here, quis custodiet ipsos custodes, which basically means who guards the guards? And by this, who watches over whether articles that are published are true, real, informative, absent of bias, and are not ones that have false data within them that would lead to, let's say, a retraction, so there is an entity, a vehicle that's called Retraction Watch, and here's an example. This is the number-one most highly cited retracted paper. It was published in "The New England Journal." 2018. You can see prior to its retraction, it already had 1,900 citations, and then, even after its retraction, it had a lot of citations, so it's interesting that, you know, prior to retraction, people were latching onto this number, and, you know, thinking that this was really good science, but then, after the retraction, you could imagine that people thought a lot differently about this particular manuscript. Okay, there's another area that's extremely important now, and that's about publication ethics, and in the future of publishing, so yeah, we have to be filled with integrity when we publish our work in scholarly journals like the neurosurgical journals, and there's a committee on publication ethics, or COPE, and you can see what they do: misconduct, authorship, complaints, appeals, conflicts of interest, data, ethical oversight, intellectual property, peer review processes, et cetera. All of these things are really important for the purpose of maintaining the integrity of a journal, and so there's a committee specifically devoted to maintaining these ethical standards within journal publishing. Yeah, so Aaron, we're just about to wrap up, and I really want to thank you again for allowing me to say a few words about the future of publishing. This is the office staff for the "Journal." None of the work that I talked about today, at least for the "Journal of Neurosurgery," could be done without a cohort of very dedicated individuals such as I'm showing you here, and this is upon one of my visits to the "Journal" office, which is in Charlottesville, Virginia. Over the past eight years, I had traveled frequently to Charlottesville to meet with the staff and to discuss areas of interest to promote our strategic plan that I mentioned at the beginning and to stay in touch with what's new, what's current, what's in the future of publishing. The office building is also shown there that you can see, and we were very happy that, on this particular occasion, we could be visited by several of the dignitaries of the AANS head office such as the, at that time, president of the AANS, who's Shelly Timmons, and also, Kathleen Craig, who's the CEO of the AANS, so that's... It was great, and we have this very good relationship between the AANS and the "Journal of Neurosurgery" office, and it's great that the AANS executive team, the executive director and presidents, would come and visit us and see what the "Journal" is all about. The "Journal of Neurosurgery" is, essentially, what's called self-published, which means that we're the master of our own destiny, unlike many other journals that are commercially published. We may want to talk a little bit about that, the pros and cons in the discussion period. I believe that having self-publication abilities makes you a bit more nimble. Ability to react to the environment also allows you to do things your own way without having barriers or borders put around you that are imposed, at times, by the various large publishing firms. The downside, of course, is that you have to manage the finances, and so these are things that we're always weighing in balance as we're talking about annual year-ends and financials of the "Journal of Neurosurgery." All right, as we're wrapping up, the scholarly publishing trends to watch include, as I mentioned before, machine learning and artificial intelligence, interoperable metadata, new open access publishing models and standards, advancement in alternate research methods, increased use of preprint servers, which I had talked about earlier, open science formats. We talked about the preprint servers and how those can be used at first prior to your own publication in a peer review journal such as the "Journal of Neurosurgery." I think in the future you'll be able to interact with authors in real time. In other words, they'll publish an article. You click on a link, and that'll take you to the office or the home of that author, and you can have a private conversation with the author about their findings and have a dialogue in real time about what they found and how you either support or refute their findings. Previously, I mentioned multiplatform, which will be important, multiformat, hyperlinked, single click. One thing is for sure is, you know, the days of handholding a paper journal are probably coming to a close. I can't predict exactly when that'll be, but I'm guessing within five or 10 years, and everything that we'll be doing, as mentioned there, will be available and here. Hope you can see this is my handheld device, everything with a single click, double click, and, you know, this is the way that the current generation of trainees is trained to learn information is from their personal devices as opposed to going to a computer, as opposed to reading a paper journal and so on, so all available on your personal device. It's gonna be extraordinary, and you watch for the future. It's gonna be very exciting, and I'm certainly very keen to see how this all plays out in the future of scholarly publishing, so with that, I'll conclude. Aaron, wanna thank you again for the invitation to spend some time here with you and also to share some of my thoughts and insights into the past, present, and future of neurosurgical publishing, especially as it relates to the "Journal of Neurosurgery."

- Very well done, Jim. Beautiful vision, obviously. The proof is in the pudding that you have brought the "Journal" to a new level and within the past few years, the "Journal" has entered its highest impact factor ever, and that's just an obvious proof nobody can really argue with, and that's really an incredible accomplishment. You brought up a few very excellent points. The first one that I think is worth discussing is the issue of the self-published versus publisher-publish, and I think the self-publishing puts the destiny in the hands of a neurosurgeon. The sky's the limit. You can really innovate. You can be able to do high-quality work without necessarily be constrained with templates on the website of a publisher who is using economies of scale to be able to gain profit. For them, profit is the goal; for us, it's the science, so the priorities are extremely different, and so I wanted to just maybe have you talk to us a few minutes. How do we manage the issue of the extra cost of a self-publishing versus the advantages? What is the future in terms of all of this? Personally, I feel we will have a much different platform for publishing that we'll discuss right after this, but I wanna just get your thoughts on that first.

- Yeah, thanks, Aaron. Yeah, you know, at times it's really hard to compete with the behemoths of the publishing world, so these are the Elseviers, the Oxford University Press, Lippincott, et cetera. These are large, large publishing firms that have deep pockets, and as you say, they have economy of scales, and they produced hundreds, if not, at times, thousands of different journals. The restrictions, however, are quite notable for commercial publishing, and they include page restrictions, journal restrictions themselves in terms of what types of journals you're enabled to publish, and, you know, you sign things contractually, and you have to stay within that contract. You can't veer outside the contract, by and large, or you run the risk of paying a fee or a fine or a penalty, whatever you wish to call it, but with self-publishing, as mentioned, you have the freedom, to a degree, to do things your own way while watching the financials and to do things that you think are in the best interest along, you know, strategic plan that you have for the "Journal," so a good example of a self-published journal, which is a different category than the "Journal of Neurosurgery" is "The New England Journal of Medicine." You may not have known that "New England Journal" is a self-published entity. Its impact factor is extraordinary. The last time I looked, it was up to like 90 or something. It's way off scale, and they've got a captive audience, and they publish across the whole spectrum of medicine, surgery, lab, everything. They do all sorts of publishing, so they're in a different category, if you will, in self-publishing, but there's an example of a successful self-publishing group that does extremely well, and the "Journal," since its onset, since it was first established, has been self-published, and it is a member-published journal, which means, or a member association journal, which means that, you know, individuals who belong to the AANS have a registration fee, a membership fee, and part of that membership fee goes to support the "Journal," but where the "Journal" actually has most of its revenue is from the institutional licenses that it sells to basically universities around the world, and as the "Journal" is doing extremely well, as you mentioned, there's a lot of interest to have our journals within each of these institutions because we bundle all of our journals, from "JNS," "Peds," "Spine," et cetera, "Focus," all those things are bundled together, and we give a very competitive price to each of the institutions who will purchase a site license for the "Journal of Neurosurgery." As one tangible example, I would say, you know, we saw all these articles coming to the "Journal of Neurosurgery" that had merit. A lot of them were written by residents and fellows. They may have been case reports or case series, but they're valuable experiences, you know, for our trainees to undertake, and we thought that we were rejecting, by and large, 95 to 99% of them and sending the wrong message to this very important group of neurosurgery trainees, so we got together, and with the assistance and the vision of, at the time, my associate editor, Doug Kondziolka, we put together the notion of a journal called "Journal of Neurosurgery Case Lessons," and it has been wonderfully successful, and we didn't have to run it by a publishing company to say, you know, can we do this? And the answer may have been if it was commercial published, yes, you can do it, but here's the cost to you. We were able to do it and include it within our financials, include it within our business model and business plan and then be able to establish a journal within a very short timeframe, and now I can tell you within the first year of the "Journal" being launched, we've had well over 700 submissions, like, it's remarkable, and many of our residents and fellows now and medical students are having papers published within the JNSPG that they're really honored to have and very excited about and gives them a real good learning experience on how to enter the world of scientific and neurosurgery publishing, so that's one example, and then, the other thing I'll mention to you is I think the future, when it comes to self-publishing and being successful at self-publishing, is being able to do what's called monetizing content, all right? So being able to work with vendors in the publishing world, with vendors making, you know, neurosurgical devices and equipment and being able to show them the value of neurosurgical content in the scientific literature and have them help to sponsor pages or works or articles that we are publishing, whether it's online or in print journals, and that's already taking place, of course, in the print journals in terms of advertising, but I think there's way more opportunity now, and you know this from your work with the "Atlas," how this is looking in the future for how we will be engaged to fund and promote and support our digital publications.

- Very well said. A very complex world, but definitely very much also in, you know, flux with the new era and changes talking about in Metaverse and open publishing. I think, you know, the idea of two items that you mentioned, open science platform and Octopus. I think that is gonna gain more traction. In fact, the "Atlas," as we have discussed before, is creating its own platform, which is called AtlasLink, and we'll be able to provide a similar platform, like open science, where people can have a sort of a preprint flavor server, social media platform, ability to crowdsource, almost, your review for the paper, and have an ability to communicate with the authors very much at an easy level. You know, the academic thirst is so important to drive this business. The authors wanna be recognized, and they're willing to go out of their way to discuss their findings at any time, and we gotta sort of harness that kind of power, that sort of academic thirst, and be able to present that in a much more open manner to promote science and also in neurosurgery, so I do agree with you that the future is gonna be different, and it's coming very soon. I think we're gonna have a similar models like Octopus and open science where things are gonna be preprinted, almost. The author are gonna have a much open way of discussing their findings, almost in a, like, a pseudosocial media platform, and then, also be available to discuss it directly with others. I think that model is very feasible, very functional, and it's gonna be something that we're gonna see more of it in the future. Do you have any other thoughts about sort of that kind of cutting-edge publishing model?

- Yeah, thanks, Aaron. You mentioned the term crowdsourcing, which I really like, actually, and the notion that none of us is as smart as all of us, and if you put a concept out there to individuals around the world, let's say, just for the sake of argument, an idea like how would you develop an imaging device that would best make a diagnosis of, let's say, moyamoya disease or something that takes into account, you know, cerebral blood flow, brain activations, functional abilities within the brain, and so on, and putting all of that together into one kind of imaging package and promote that as a competition, like, just say, "We're interested." This is an open access crowdsourcing idea, and the winners with the best idea will be able to fund with a grant, let's say, or some kind of support for them to pursue their goal towards establishing this new device or this new imaging, you know, feature or whatever. I think there's a lot of potential for that, and I really believe that with the brilliant minds that are out there across all disciplines, but particularly in neurosurgery, that these types of interactions and open access having a almost a free-for-all of ideas, but have some kind of goal at the end, a reward, if you will, will draw people in and will help us advance our field even further.

- Great insights. Very much so, Jim. You know, the future is bright, both in neurosurgery and both in publishing. I think "JNS," for sure, has been the leader in just being able to be innovative and also keep its transition and have a transition period just like that's been part of your strategic planning. I wanna thank you for what you have done for academic neurosurgery, Jim. You truly have been the leader for the past decades, and it's really demonstrated in your mentorship, being the chief editor of "Journal," and taking the "Journal" to absolutely new heights, so God bless you for all you have done for neurosurgery. We're very thankful to you and very much looking forward to having you with us in the near future.

- Thanks, Aaron. As always, a pleasure working with you on all these very important concepts, ideas, trends in neurosurgery. Thank you.

- Thank you.

Please login to post a comment.