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Since When is “Fast and Efficient” a Shortcoming?


Read the latest blog post from Cureus Editor-in-Chief, John R. Adler, Jr., M.D. This past winter, I was notified in a short email that a scientific journal directory intended to drop Cureus from its list of preferred Open Access journals. No matter how specious any claim to exclusivity might be, who doesn’t crave getting past the big burly doorman guarding “The Club”? I reached out to this burly “Editor-in-Chief” of a “fraternity of journals” asking him how and why he arrived at his decision. After six email requests over nearly five months, I finally received a terse three-sentence 72-word response. In the eyes of the “Editor-in-Chief”, Cureus’ primary shortcoming was “submission to publication times are extremely short and you advertise your speed.” Basically, as I interpret this email rejection, Cureus’ sin is that it’s just too damn fast and efficient. Ahh… yeah, I guess Cureus is guilty as charged. What am I, or any of us here to make of this criticism? Totally dumfounded, I sent my parting shot to the doorman: “I find it more than ironic that the unique attributes of Cureus which we the journal editors most celebrate as virtues, are antithetically interpreted as shortcomings.” Ultimately, the issue at hand here is not really just about an indexing service and its gatekeeper. For me, what’s really at stake is a common understanding of the role medical knowledge plays in our modern world and, most importantly, does the existing journal paradigm serve this function? Unfortunately, I suggest not. In fact, the obliviousness with which the doorman dismissed efficient journal peer review and publication is emblematic of what happens today at nearly all journals. All too typically the journal industry is run by a self-righteous professional editorial class which seeks to reinforce tradition and aristocracy at the expense of efficiency and low costs, while laughing all the way to the bank. A quick search of PubMed and Google revealed that our critic had published a modest collection of basic science articles and nearly all published in the past decade were about scholarly publishing itself. Yet even more telling, he had zero obvious experience in clinical medicine. Somehow this guy deemed himself anointed by some unknown entity to judge how we physicians generate, curate and disseminate potentially life-saving medical knowledge amongst ourselves. What entitles him to be such a judge? Sure, it is always nice to be part of “The Club”, but ultimately, I would much rather be appreciated as THE peer-reviewed journal that offers fast and cost-efficient service to our community of hardworking clinically-oriented authors. If Cureus is to be judged, I want it to be our user community that gets the last word. In the meantime, I intend Cureus’ technology and processes to improve relentlessly thereby making the process of peer review and publication in Cureus even faster. Hopefully you can bank on that, Mr. Doorman!

Aug 11, 2020

Wear a Damn Mask, PLEASE!


Read the latest blog post from Cureus Editor-in-Chief, John R. Adler, Jr., M.D. When Covid first appeared in the US, several Asian physician friends had simple advice for me, “Wear a mask.” Having dealt with various coronaviruses for over a decade, this was the fundamental lesson taken from dealing with and controlling these respiratory viruses. Now, I may only be a dumb neurosurgeon, (said with humility, irony and in jest), but I know a thing or two about masks, having spent 30 years of life wearing them, sometimes for 12 or more hours at a time. There is nothing pleasurable about wearing a mask, but I have experienced first-hand how masks can protect patients and physicians from illness. More broadly I have seen how masks can protect healthcare workers from the worst of infectious diseases, even giving them supernatural-like protection when they must enter the belly of the beast while caring for highly contagious and fatal illnesses like Ebola. Meanwhile, each and every day, healthcare workers all over the world, including my own family members are able to avoid infection while caring for hospitalized Covid patients who are often spewing the virus everywhere. It’s incontrovertible - masks truly work!; they prevent Covid infections. So why is it that some people contest the efficacy of masks and refuse to wear them? Perhaps they’ve heard claims that wearing a mask poses a health risk such as hypoxia (when the body is deprived of oxygen) or hypercapnia (excessive carbon dioxide in the bloodstream). A plastic bag might do such a thing but certainly never a cloth mask, the preferred personal protection equipment (PPE) for the public. More sophisticated surgical masks and N95 respirators tend to fit more tightly than a cloth mask but they never result in hypoxia or hypercapnia. Meanwhile these more sophisticated tight fitting masks are generally reserved for healthcare professionals who sometimes can be literally engulfed in a cloud of airborne Covid-19 particles when dealing with very sick patients. No matter, masks trap only a tiny bit of carbon dioxide which is why as a surgeon I could wear one all day while performing very demanding surgeries. Even most patients with asthma and chronic obstructive pulmonary disease, or COPD, can AND SHOULD wear masks unless they are in the middle of an extreme exacerbation of their disease. So damn it, why can’t y’all just wear masks when in public? Deep down I am a lifelong libertarian, and truly cherish freedom as much as any, but to equate wearing a mask with subjugation is just plain stupid. Neither is going maskless some expression of courage! I am asking you to wear a mask not to protect yourself, but so that you might protect other people, especially truly vulnerable individuals. OK, maybe you don’t give a sh*t about yourself or others; then wear a mask because you don’t want to be poor. Rampant Covid infections are interfering with US domestic economic activity but especially between the US and the rest of the world. If you haven’t heard, or experienced first-hand, Covid is really REALLY bad for the US economy. So what is it? What is your excuse for not wearing a mask when you are in public? Damn it, you are out of excuses. Covid-19 may be one badass virus, but it turns out it is no match for masks. So please, please, please wear a mask… and by the way, wash your hands too!

Jul 06, 2020