A message from the founders of the Public Library of Science The Internet is awash with medical information. Eight hundred million people have direct access to the Internet , and in But something is conspicuously missing. The most reliable medical information on the Internet—the contents of peer-reviewed medical journals—is hidden from the public and most of the world's physicians. Although most medical journals are available online, their publishers limit access to those who choose, and can afford, to pay for access. This should not, and need not, be so.The Lancet,The New England Journal of Medicine, and The Journal of the American Medical Association on cheap paper and selling them to subscribers at a few pennies a copy. For more than a century, printed journals like these were the dominant means of conveying medical knowledge around the world.In the 19th and early 20th centuries independent physicians and small medical societies, interested in making the best new medical knowledge available to doctors, students, and the public, began to publish general medical journals containing case reports, ideas for new treatments, and the results of medical experiments. These pioneers took advantage of the best available technology for disseminating information, printing titles like PLoS Medicine, we are embracing this opportunity.But technology has changed. The Internet is now the most economical and efficient conduit for the delivery of information to most places. Publishers of medical journals realize this—when the Internet took off, they took their journals online. But while they adapted their means of distribution to the 21st century, they left their business model in the 19th century, continuing to charge readers for access just as they had done for their printed journals. This has been good for business—medical publishing has never been more profitable—but it comes at a huge cost. The established medical publishers have turned their back on the opportunity to make the latest and best medical information available to anyone with an Internet connection. With the launch of Everything we publish is immediately, freely available online throughout the world, with no restrictions on distribution, copying, printing, or legitimate use.PLoS Medicine is immediately freely available online throughout the world, with no restrictions on distribution, copying, printing, or legitimate use. Of course, it costs us money to publish this journal, and we must cover our expenses. But the fee-for-access business model that made perfect sense for the printed journal is no longer consistent with the mission of medical publishing because it needlessly limits the reach of the medical literature. And so we have adopted a new model. Instead of charging readers for access to our journal, we ask the authors of accepted research articles to pay a publication fee to cover the costs of peer review, editorial oversight, and production. This “open access” business model ensures our financial health as a publisher while allowing us to convey everything we publish to the widest possible audience.Everything published in could benefit from their research can benefit from it.Of course, we do not expect authors to cover publication costs personally—rather, we expect the government agencies, companies, foundations, research institutions, hospitals, or universities that sponsor the research to pay the fee. These organizations have always considered the wide dissemination of the results of the research they support to be an integral part of their mission. Virtually every leading sponsor of medical research has announced its willingness to pay for open-access publication, the costs of which average less than one percent of the cost of the research itself—a small price to pay to ensure that everyone who We realize that not everyone with something important to convey in a medical journal has access to such funds. To ensure that we don't replace a barrier to access with barriers to publication, we've raised money to cover the publication costs of articles whose authors are unable to pay them. And, for every PLoS journal, an author's ability to pay will never be a consideration in our decision to publish an article.Despite its obvious benefits, open-access publication has met with fierce opposition. Established medical publishers—now businesses more than forces for change—see open-access not as an opportunity to fulfill a mission of public service but as a threat to their lucrative businesses. They contend that their journals still serve the community well, and object that open access threatens their very existence. This is nonsense!It is our responsibility as publishers and members of the medical community not only to give patients access to the medical literature, but to provide them with tools to use it wisely.The Wellcome Trust, the world's largest charitable sponsor of biomedical research, seeking to ensure that the results of the science it funds are “disseminated widely and freely available to all,” recently commissioned a thorough analysis of the scientific and medical publishing industry . It concPLoS Biology, and it is thriving—not only as a destination for the best research in all areas of biology, but also as a resource for students, teachers, and members of the public who have never before had direct access to the product of scientific inquiry (see for yourself at www.plosbiology.org). We are now bringing this success and this spirit to medicine.We know firsthand that the Wellcome Trust is right. In October 2003, we launched our first journal, PLoS Medicine is here to challenge the status quo. We are first and foremost an open-access publisher working to ensure that everyone has access to the latest medical research and expertise. But we aim to be more than just an open-access alternative to established general medical journals. We are determined to make PLoS Medicine the best medical journal in the world by providing outstanding original research and new ideas; thought-provoking, educational, and imaginative features for readers; and the fastest, fairest, and most rigorous peer review for authors.The world of medical journals needs a fresh infusion of idealism. All of today's leading medical journals are more than 70 years old, and As an open-access journal, we see our audience differently than do the conventional medical journals: our audience is composed of medical researchers, physicians, and other health-care providers, patients and their advocates, students, and the public around the world. It will be a great challenge to create a journal that will serve such a diverse audience—we welcome this challenge. We will make it possible for the results of advanced research on infectious diseases to guide treatment in remote clinics thousands of miles away. We will make the results of a clinical trial of a new drug accessible and understandable both to doctors who might prescribe it and to people who might start taking it. We will make research on rare diseases accessible to general practitioners and patients so that they can work together to recognize and treat them.Whereas some would argue that medical journals should not be accessible to patients because patients are unable to use the information effectively, we believe it is our responsibility as publishers and members of the medical community not only to give patients access, but to provide them with tools to use the medical literature wisely. Medical research is a partnership between medical scientists and millions of voluntary human participants, conducted largely with public funds. What better way to acknowledge the public's contribution and ensure their willingness to sponsor and participate in future research than to openly share the product of this research with them?PLoS Medicine and find it useful and provocative. Please share the journal with your colleagues, patients, and friends. Tell us what you want to see, what you like, and what we could do better. Give us your ideas for changes that will make PLoS Medicine a better journal for you and the community. Join us in reinventing the medical journal.We hope that you will enjoy reading


Announcing the next top-tier open-access journal from the Public Library of Science Open access is gaining momentum. Authors are submitting papers in ever-increasing numbers to open-access journals. Several prominent research sponsors, including the Wellcome Trust, the Max Planck Society, the Centre National de la Recherche Scientifique (CNRS), and the Institut National de la Santé et de la Recherche (INSERM), have recently pronounced that open access is the best way for the researchers they support to publish their work. Several established commercial and not-for-profit publishers have announced plans to experiment with open-access models for some or all of their journals.PLoS Medicine this autumn—the next step in our efforts to bring the benefits of open access to the entire scientific and medical community. We aim to make PLoS Medicine a premier journal, providing open access to the best medical research to researchers, to physicians and other caregivers, and to the public.Delighted and encouraged, we gear up for the launch of The case for open access to medical research is even stronger than it is for basic research in biology. There are more interested parties: patients and their advocates; biotechnology and pharmaceutical companies that develop drugs and medical devices; doctors, nurses, and other healthcare providers; and health policy-makers at the national and international levels. The goal of the medical research enterprise is—or should be—scientifically, ethically, and socially responsible medicine, which means research that will benefit patients worldwide.The reality looks somewhat different. Large investments into basic research have not yet lived up to their full potential to save lives and improve their quality. Doctors, patients, and their advocates do not have ready access to the combined peer-reviewed evidence from medical research. The prices for the latest drugs often put them out of reach of patients in poor countries or poor patients in countries without universal healthcare systems. Moreover, research focuses disproportionately on the potentially lucrative treatments for diseases of wealthy societies, shortchanging the poorer countries, which bear the greatest burden of disease.A medical journal by itself cannot change this reality. But with the help of researchers and practicing physicians around the world who recognize the need and opportunity for change, we seek to create a journal that promotes medical research and practice that is both scientifically rigorous and compassionate.all stakeholders free and immediate access to the latest medical research, along with new and more powerful search tools and links between the literature and other relevant information.Open access to this literature will strengthen the medical research community by giving PLoS Medicine will be an international, modern, general medical journal, covering all areas in the medical sciences, from basic studies to large clinical trials and cost-effectiveness analyses. We will concentrate on human studies that enhance our understanding of disease epidemiology, etiology, and physiology; the development of prognostic and diagnostic technologies; and trials that test the efficacy of specific interventions and those that compare different treatments. We will publish original research and commentary that promotes translation both of basic research into clinical investigation and of clinical evidence into practice.PLoS Medicine to promote an integrated understanding of the patient—to make it easy for people to read outside their specialty area. “Doctors are systems biologists,” as one medical researcher put it, and inspiration can often be found in unfamiliar territory.A truly broad medical journal is an ambitious project, but we want PLoS Medicine will be rigorously peer-reviewed. Academic and professional editors, supported by expert peer-reviewers, will select those studies that drive research forward—in this case, toward medical applications and benefits for patients.Articles published in PLoS Biology contains two “human” studies that met our criteria for excellence and originality, a paper by Howard Chang and colleagues  on the microarray analysis of tumors and one by Sarah Rowland-Jones and coworkers  that examines how HIV exhausts the capacity of the immune system. Similar papers submitted in the future will be published in PLoS Medicine, alongside studies that have more direct implications for clinical practice. This issue also contains several articles describing more basic advances with medical implications: a study by Terry van Dyke and colleagues  describing a new mouse model for breast cancer, a report on a novel approach to drug synthesis by Chaitan Khosla and coworkers , and an article by Stephen Dowdy et al.  on targeted modulation of p53 activity. PLoS Biology will continue to solicit and publish such articles, but we will bring them—and similar ones published elsewhere—to the attention of the readers of PLoS Medicine.This issue of PLoS Biology, PLoS Medicine must be a community journal to achieve its goals. If you are a researcher or an individual anywhere in the world who has a stake in medical research and if the goals of PLoS Medicine outlined here resonate with you, please contact us. PLoS Medicine will accept submissions beginning in April 2004, and we are looking for advocates who will help to spread the word about open access and PLoS Medicine in the global medical community and for investigators who will submit excellent research, review submitted articles, and contribute editorials and commentaries. PLoS Medicine is and will stay a work in progress, and we want to consult with as many people as possible, both before the launch and as PLoS Medicine evolves. Sign up to join the PLoS Medicine community at http://www.plos.org/medicine and help us to make the best of medical research and practice accessible to a global audience.Like


PLoS Medicine Editors set out their vision for the journalWhy does the world need a new medical journal? In this first editorial the  Take monthly, at no cost; reaches six billion Today the possibilities for a medical journal are almost limitless. The first medical journals reflected the needs of a closed group of doctors. But medicine, its place in the world, and the dissemination of information have changed utterly. So in starting afresh, what should a new medical journal retain, and what should it ditch?PLoS Medicine. You can download and distribute articles without restrictions .Most obviously, we should throw out the old way of disseminating information. In today's electronic age, it is no more difficult, and it is only minimally more costly, to provide access to one million people than it is to one person. So the revolutionary idea of anyone being able to read any article is possible. This idea—open access—which completely challenges the old subscription-based publishing model, is the driving force behind the launch of We have also changed the way we involve the academic community in our journal. Our large global editorial board reflects the diversity of medicine today and is intimately involved in what we do. In particular, members of the editorial board are a crucial part of our peer review process. As academic editors they, along with a senior editor at the journal, take research papers through the peer review process in a way that we believe provides the most constructive and fair review. We are delighted that members of our editorial board have also shown their support for our journal by submitting papers to us, even before we launched.What will we publish? The research article on malaria in this issue reflects our priority of publishing papers on diseases that take the greatest toll on health globally. But we will also publish papers reporting a substantial advance in any specialty, whether that advance is in public health, such as the paper on the global burden of disease; drug effects, such as the paper on the effect of HIV drugs on lipids; or the molecular understanding of disease, such as the paper dissecting out the immune responses in lung disease caused by smoking.PLoS Medicine will be devoted to comment, lively debate, and diverse opinions, in particular giving neglected voices and diseases a place in the limelight. In this issue's magazine section you will see articles from five continents that cover a huge range of topics, from basic sciences (such as the pathology of emphysema) to global public health . You will find diverse opinions—for example, on whether President Bush is helping or hindering Africa's progress towards tackling HIV, and on whether health professionals should routinely screen women for domestic violence (tell us what you think by taking our poll at www.plosmedicine.org). And you'll find case-based learning materials on meningitis linked to an online video and an online quiz.A good general medical journal should also be a place where the global medical community can discuss together what matters to them. The magazine section of The revolutionary idea of anyone being able to read any article is possible.PLoS Medicine's professional editors, should provide any health professional with a quick introduction to an article. Patient summaries provide a starting point for patients to assess the relevance to them of a research paper.Interpretation of results is an essential part of a medical journal's job. Although we expect that many of our readers will be doctors, we hope readers will range from patients wanting to learn about the latest research on their illness, to teachers wanting to use an article in the classroom, to policymakers. Hence, we have several levels of comment on original research. Perspectives, written by an expert, are aimed at readers who are already familiar with the topic. Synopses, written by PLoS Medicine will not accept advertisements for pharmaceutical products or medical devices. Our open-access license allows free distribution of articles, so PLoS cannot benefit from exclusive reprint sales. And we consider as the lowest priority for publication papers that are simply aimed at increasing a drug's market share without obvious benefit to patients.We have decided not to be part of the cycle of dependency that has formed between journals and the pharmaceutical industry, an industry that focuses overwhelmingly on the most profitable drugs, thus sidelining many of the world's health problems. Medical journals have allowed their interests to become aligned with those of the pharmaceutical industry by printing advertisements for drugs, publishing trials designed by drug companies' marketing departments, and making profits on reprints used as marketing tools. We will aim to have the highest levels of transparency in our published papers. We require authors to tell us of any possible competing interests; we in turn will tell readers about them.PLoS Medicine is a journal for the global medical community; we invite you to join in.But, information flow should not be just one-way. Our editorial doors (or at least our E-mail boxes) are always open. We want your feedback on the journal: send us an E-mail or submit an eLetter about any article in the journal, take part in our polls, contribute ideas for the magazine section and submit original research.


Journal of Occupational Medicine and Toxicology, a new Open Access, peer-reviewed, online journal published by BioMed Central. Occupational medicine and toxicology belong to the most wide ranging disciplines of all medical specialties. The field is devoted to the diagnosis, prevention, management and scientific analysis of diseases from the fields of occupational and environmental medicine and toxicology. It also covers the promotion of occupational and environmental health. The complexity of modern industrial processes has dramatically changed over the past years and today's areas include effects of atmospheric pollution, carcinogenesis, biological monitoring, ergonomics, epidemiology, product safety and health promotion. We hope that the launch of the Journal of Occupational Medicine and Toxicology will aid in the advance of these important areas of research bringing together multi-disciplinary research findings.This editorial is to announce the  Journal of Occupational Medicine and Toxicology is an Open Access, online journal that publishes research articles, short reports and reviews related to the field of occupational/environmental medicine and toxicology. The first published articles focus on respiratory medicine and infectious diseases [The diseases -5.Occupational medicine and toxicology belongs to the most wide ranging disciplines of all medical specialties. The field is devoted to the diagnosis, prevention, management and scientific analysis of occupational diseases, injuries and disability. It also covers the promotion of health of workers, their families, and communities. In the era of heavy industries occupational medicine was known as "industrial medicine" with a focus on acute medical care for injured employees. The complexity of modern industrial processes changed the field and today's areas covered by occupational medicine include effects of atmospheric pollution, carcinogenesis, biological monitoring, ergonomics, epidemiology, product safety and health promotion.The field of occupational medicine and toxicology is not static and the demand for studies addressing the large variety of current issues continues to grow. In view of this demand and the fact that numerous occupational medicine and toxicology studies are published by journals of related fields such as pulmonary medicine, oncology or allergy, there is a need for a new online journal that also aims to improve communication between basic and clinical science. These features will be combined by an "Open Access model " and a rapid publication process without major space limitations.Journal of Occupational Medicine and Toxicology's Open Access policy changes the way in which articles are published. First, all articles become freely and universally accessible online, and so an author's work can be read by anyone at no cost. Second, the authors hold copyright for their work and grant anyone the right to reproduce and disseminate the article, provided that it is correctly cited and no errors are introduced [Journal of Occupational Medicine and Toxicology's articles are archived in PubMed Central [The troduced . Third,  Central , the US  Central  in Germa Central  in Franc Central , the Nat Central . Second, Central . Third,  Central ).The journal's peer review policy covers is characterized by a "voluntarily open peer review" process. Submitted articles will generally be reviewed by two experts with the aim of reaching a decision as soon as possible. Reviewers should sign their reports according to the voluntarily open peer review policy but are not obliged to do so. They are asked to declare any competing interests.Journal of Occupational Medicine and Toxicology have no financial incentive to accept manuscripts as they are not paid on the basis of the number of manuscripts accepted. In fact, they do not receive any financial remuneration for their involvement with the journal. We insist that decisions about a manuscript are based on the quality of the work, not on whether the authors' can pay the article-processing charge. Authors will be asked to declare any competing interests that they have.The Editors-in-Chief and the Editorial Board of the Journal of Occupational Medicine and Toxicology will aid in the advance of these important areas of research.Bringing together multi-disciplinary research findings of the field, we hope that the launch of the


I am grateful to Rolfe Birch who gave me the opportunity to participate as a board member in a journal dedicated to brachial plexus surgery, as this field concerns my daily clinical and scientific activities over the last ten years.Journal of Brachial Plexus and Peripheral Nerve Injury and was pleased by the idea of such a specific journal, providing open access and facilitating reaching colleagues all over the world, where our traditional and respected journals might not go. I also appreciate the technical opportunity, feasible within this journal, of publishing video documentation, as our operative results might be actually better expressed through this medium.Six months ago, I discovered the online I have to congratulate Dr Nath for his excellent initiative. I propose my input for this journal:- I expect that the journal will fulfill criteria of a scientifically honest, balanced and innovative platform for all interested colleagues;- I believe that an online journal with free access in all countries has large possibilities to share data, high quality photos and videos with critical readers- My goal is to join the Journal and uphold international scientific standards and basic rules when sharing high level medical and scientific expertise.I would like to encourage all colleagues to participate in the discussion by sharing their experience, comments, criticisms, starting with questions, observations, empiric conclusions and scientific contributions.JBP&PNI started as an initiative to be an open-minded platform for an exchange of ideas and techniques in this particular field of clinics and surgery, brachial plexus pathology and related issues in severe peripheral nerve injuries.The Colleagues from all countries who are involved in these treatment plans should feel free to communicate their experience and analysis of the existing literature. Senior colleagues should share their comments about trials and pitfalls, for the benefit of our continued education and thus better serve patients hit by severe nerve injuries, either children or adults.During the past 10 years, I have become aware of how many controversies might exist even between international colleagues sharing one particular medical problem, and this is for many reasons. I believe, however, that we should overcome these differences just by focusing on common, noble targets of scientific education, giving our very best, and respecting established rules that good medical practice has taught us.Jörg Bahm MDFebruary 2007


Fugh-Berman and colleagues surveyed medical journals' policies and practices on advertising. Pharmaceutical products, they say, dominate journals' advertising pages, creating conflicts of interests. Peer-reviewed medical journals are generally considered to be a source of unbiased and reliable information about drugs. But at the same time, most medical journals contain advertisements, almost all of which are for drugs, and which are, by their very nature, biased toward promoting sales of that drug. In this article, we address the purpose and effects of journal advertising, the possible reasons for pharmaceutical product domination of advertising pages, and the current policies and practices of representative journals. We also make recommendations for change.Advertisements are intended to increase or maintain market share for targeted products. Pharmaceutical companies value print advertisements because they increase sales effectively . In a suhttp://www.rxpromoroi.org/rapp/index.html). Another industry study of 45 advertising campaigns found that journal advertising returned US$3.05 for advertising of unique products and US$2.46 for advertising of competitive established products   campaign.” He suggests: “Let professional messages complement consumer messages. The copy platform and graphics should work together for all those times the patient will not remember the brand name but might remember the art or headline” . The autIt is clear why drug companies advertise in medical journals, but why do they dominate display advertising pages? In other words, why do journals appear to publish advertisements for drugs much more frequently than for cars, computers, vacations, or other products of potential interest to doctors?New England Journal of Medicine (NEJM), theJournal of the American Medical Association (JAMA), Annals of Internal Medicine , PLoS Medicine, American Family Physician, theLancet, theBMJ, theCanadian Medical Association Journal, and theMedical Journal of Australia. Multispecialty journals were chosen because they receive the most advertising revenue. According to PERQ/HCI, in 2002, US$220,982,000 was spent on advertising in multispecialty journals, almost ten times the amount spent on the runner-up, internal medicine journals   products” through a special, addense version ofJAMA that contains an average of “64 ad pages and 102 editorial pages”  were aware that their subscription toThe Lancet was sponsored by a pharmaceutical company. Moreover, one half also recalled, on anunaided [bold text in the original quotation] basis, the name of the sponsoring company”  delivers your product with your distinct message to thousands of physicians a week” . TheNEJM also offers to “conduct complimentary research for you among sponsored subscribers to validate the success of your program” .Theompany” . “Arm yoJAMA, theArchives journals, andAmerican Medical News), more than twice the US$17.5 million received from subscriptions [Journal advertisements generate profits not only for pharmaceutical companies and medical journals, but also for the physician organizations that publish the journals. In 1996, five of six physician organizations raised 10% or more of their total annual revenue from pharmaceutical company advertising in affiliated medical journals; the proportion of total revenues ranged from 2.1% to 31.3% . The AMAiptions .By accepting only advertisements for drugs and medical devices, medical journals have accepted an exclusive and dependent relationship with corporations. Perhaps the distance between the prescribing physician and the purchase of the advertised product contributes to the perception that drug advertisements in journals are somehow more professional than advertisements for goods hawked directly to the consumer. However, all advertising campaigns are designed to create positive feelings about a brand, to saturate a targeted population's environment with a brand name, and to sell the product.In consumer magazines, article content often caters to, or is ordered by, advertisers, and publishing articles that displease advertisers can financially jeopardize the publication. Medical journals are similarly prone to leash-yanking by advertisers.Annals criticized the accuracy of advertisements in journals [A 1995 survey of North American journal editors found that 12% noted conflicts between advertisers' wishes and editorial decisions, and 21% reported that they had no control over advertisements . In 1992ournals . Severalournals , costingournals . Ensuingournals .At times, advertising departments appear to influence editorial decisions.Annals expressed concern about a planned editorial on high drug costs. These concerns were allayed when the editor invited a commentary from the Pharmaceutical Research and Manufacturers Association , which commissioned a piece from a conservative thinktank, the American Enterprise Institute for Public Policy Research  [Dialysis and Transplantation explained to an author that although the author's article had passed both editorial and peer review, the marketing department had rejected it [At times, advertising departments appear to influence editorial decisions. In 2001, the advertising department ofmerica) . In 2004cted it . The joucted it .Several authors have suggested that dependence on drug advertising endangers the independence of medical journals  and haveBMJ USA has folded because “it has fallen victim to the widespread downturn in US pharmaceutical advertising and has become financially unsustainable for the BMJ Publishing Group” [Dependence on a single industry can be financially disastrous for a journal that displeases its corporate funders. Dependence on prescription drug advertising is also financially risky, as the journal risks closure if it can't attract sufficient revenue—indeed, Group” . AcceptiPLoS Medicine, for example, uses a business model that includes support from foundations, from institutional memberships, and from asking research funders to pay a publication charge for accepted research papers (http://www.plos.org/support/index.html).Another option is to eschew journal advertising altogether. Some journals refuse to advertise drugs or devices, depending instead on other sources of income. The non-profit journalClinicians rely on medical journals for scholarly articles and the latest information on drugs and devices. Advertisements in these journals are unreliable sources of information, since they “educate” physicians to prescribe the newest, most expensive drugs .The scholarly nature of journals confers credibility on both articles and advertisements within their pages. By exclusively featuring advertisements for drugs and devices, medical journals implicitly endorse corporate promotion of the most profitable products. Advertisements and other financial arrangements with pharmaceutical companies compromise the objectivity of journals.The primary obligation of industry is to make money for its stockholders. The primary obligation of journals should be to physicians and their patients, who depend on the accuracy of information within these publications. Medical journals should not accept advertisements from pharmaceutical companies, medical device companies, or other industries “relevant to medicine.”Journal of the American Medical Association:http://pubs.ama-assn.org/misc/jamarates.pdfThe New England Journal of Medicine:http://nejmadsales.org/media/pdfs06/06USRateCard.pdf;http://nejmadsales.org/incentives/advertisingopportunities/minidemo.html;http://nejmadsales.org/incentives/research.html#journal;http://nejmadsales.org/faq/index.htmlMedical Journal of Australia:http://www.mja.com.au/classifieds/Advtg_index.htmlBMJ:http://www.bmjpg.com/advertisingCanadian Medical Association Journal:http://www.cmaj.ca/pdfs/cmaj.pdfLancet:Thehttp://www.elsmediakits.com/ratecards/LANCET_display06.pdfAmerican Family Physician:http://www.aafp.org/PreBuilt/afp_ratecard_2006.pdfAnnals of Internal Medicine:http://www.acponline.org/journals/advert/annals_rates06.pdfPLoS:http://www.plos.org/support/index.htmlMedical Marketing and Media:http://www.mmm-online.com/content/fileadmin/files/mediainfo/onesheet.pdfForbes:http://www.forbesmedia.com/forbes/forbrates.phpVogue:http://www.srds.com/listinglink/advertisinginfo/vogueArchitectural Digest:http://www.condenastmediakit.com/ad/genrates.cfmTravel and Leisure:http://www.tlmediakit.com/nat_rates06.cfmBusiness Week:http://mediakit.businessweek.com/PDFNew England Journal of Medicine:http://nejmadsales.org/media/pdfs06/06USRateCard.pdf;http://nejmadsales.org/incentives/sponsorship.htmlMedical Journal of Australia:http://www.mja.com.au/classifieds/Advtg_index.htmlCanadian Medical Association Journal:http://www.cmaj.ca/misc/advertising.shtml;http://www.cma.ca/index.cfm/ci_id/25274/la_id/1.htm#restrictionsPLoS Medicine:http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0010022;http://www.plos.org/support/index.htmlAnnals of Internal Medicine:http://www.acponline.org/journals/advert/annals_rates06.pdf;http://www.acponline.org/journals/advert/pharm/start_acp.pdfAmerican Medical Association:http://pubs.ama-assn.org/misc/adprinciples.pdfBMJ:http://www.bmjpg.com/advertisingLancet:Thehttp://www.elsmediakits.com/ratecards/LANCET_display06.pdfAmerican Family Physician:http://www.aafp.org/PreBuilt/afp_ratecard_2006.pdfAll Web sites accessed between 2005 December 23 and 2006 January 3.


Medical researchers—and scientists in general—place a high value on their ability to make independent judgments. Yet the same group often seeks metrics to validate their subjective opinions. One could argue that as rationalists, scientists should have little use for subjectivity, opinions should be supported by verifiable data, and the subjective view of a paper's worth should not be a consideration in editorial decisions about which papers to publish. In reality, however, given the sheer volume of papers published each day, the subjective value of a paper's “worth” is an accepted criterion in scientific publication as no individual could possibly read all papers published in their own field without some guidance as to their likely importance.PLoS Medicine have ultimately to make subjective decisions about which papers we accept. As an indication of how far we have come in establishing a “top-tier” open-access medical journal, PLoS Medicine now has a rejection rate of greater than 80 percent. We feel that the unwanted side-effect of this rejection rate—and the authors of rejected papers would agree—is that we are turning away many valuable contributions. Some of the papers we reject are clearly not suitable for a general medical journal, but for others that decision is less clear-cut, and most of the submitted manuscripts contain valuable data, even if they sometimes fall short of supporting more ambitious conclusions.So, like other journals presented with many objectively sound submissions, the editors at As an organization whose vision is a world of scientific publishing where there is an open-access journal for every paper worth publishing, it is essential that PLoS continues to create additional open-access venues to help reach this goal. Two recent developments take us closer.PLoS Clinical Trials  was launched five months ago and has already started to broaden the scope of clinical trials reporting by publishing the results of randomized clinical trials from all medical and public health disciplines without regard to the direction of the results, a trial's size, or its “importance.”PLoS ONE (http://www.plosone.org) will be an open-access venue for research from every discipline, including all areas of medicine and public health, and will use the capabilities of the Internet to allow readers to participate directly in the publishing process. The growing availability of online tools that allow users to share, filter, link, and annotate online information makes it much easier for readers to find the information that is of most interest to them, and to add value to it. By making use of these advances, we hope that PLoS ONE will lead the way towards a new form of scientific discourse that maintains those elements of conventional journals that benefit the scientific and medical community but which also embraces the potential of the Internet to create a more interactive, community-driven literature that invites participation from anyone who has a valuable contribution to make.Broadening the range of open-access options further, PLoS has recently announced the forthcoming launch of a new and very different publishing project. PLoS ONEWe hope that PLoS ONE will lead the way towards a new form of scientific discourse.PLoS ONE will be held to rigorous standards of scientific quality. Experts will assess whether the results are valid and presented in sufficient detail to allow critical evaluation by readers, and whether the conclusions are fully supported. Speculation is encouraged, but must be clearly marked as such. However, subjective considerations such as “likely impact,” “degree of advance,” or “interest to a general reader” will not play a role in deciding whether an article should be published. Hence, PLoS ONE will be able to publish a much wider range of papers than PLoS Medicine, for example, can now accommodate. Editorial decisions will be reached rapidly by an extensive editorial board, and accepted articles will be published (in PDF and fully tagged XML formats) in as little as two weeks after acceptance.Papers published by PLoS ONE will empower researchers and consumers of research to engage in an open discussion on published articles. The goal is to capture the varied and extremely valuable assessment of papers that occurs after publication in a way that is not possible within the limits of conventional Correspondence or Letters sections. It is our hope that such post-publication activity will have many benefits: papers that emerge as influential for a particular field will attract significant annotation and comment, benefiting the authors as well as the readers; discussion will help to link previously unconnected groups or even communities of researchers; free access to this content and interaction will help to level out some of the inequalities between researchers in privileged settings with easy access to information and those who are less well connected. No doubt, there will be some surprises too.And, crucially, published papers will be exposed to post-publication peer review. Readers will have the tools to add comments, questions, related data, and ratings to each article, and authors will be able to update, clarify, and further discuss their findings. PLoS ONE will have publication charges.  Annotation, on the other hand, carries no charge; all contributions that are deemed valuable will be posted rapidly and are citable.Like the other PLoS journals, PLoS ONE will be our prototype, but the open-source software that allows this level of online interaction will be added to PLoS Medicine shortly after the launch of PLoS ONE later this year. What this means is that although we will maintain “subjective” editorial criteria for PLoS Medicine, this assessment itself will be open to broader community opinion. We are excited that we will be able to accommodate a much larger number of contributors—authors and annotators—to all PLoS publications and invite you to participate.


Journal of Orthopaedic Surgery and Research shortly after submitting the article to European Spine Journal. European Spine Journal accepted the article [Journal of Orthopaedic Surgery and Research in November 2006. Since it has been brought to the attention of all authors that duplicate submission and publication have taken place the decision has been made to retract the article published in Journal of Orthopaedic Surgery and Research. Dr Wenbao Wang accepts full responsibility for this unfortunate situation and is deeply sorry for any inconvenience this may have caused to the editorial staff of Journal of Orthopaedic Surgery and Research and its readers.The corresponding author, Dr Wenbao Wang, submitted this article  to Journ article  in Septe


Creating an Internet based community requires a supporting software and hardware infrastructure that enables community members and community organisers to easily enter and update information, apart from other aspects such as discussion organisation and virtual meeting places. Here we describe a software system, "Virtual Magazine Publisher" (VMP) for managing magazines, newsletters, journals, member profile pages and project description pages. Its application for "Virtual Medical Worlds Community", a group of organisations involved in telemedicine and underlying advanced technologies is described.The VMP software (http://www.hoise.com/vmp) was designed, with the following criteria in mind:It must be suited for almost any magazine and newsletterAuthors and editors should be able to access it from anywhere-Authors should be guided with entry of their contributionEditors should be given enough tools to manage their publication in much the same way they are used toThe content should be separated from the lay-out-Information should be entered once: no need for hand conversions.When analysing magazines we found that most have a simple structure, apart from glossy magazines and a number of scientific journals, being subdivided in sections, and each section is subdivided in articles or items. The lay-out of the articles in the section follow the same rules. Each issue has the same look and feel. Information from an article is used in the contents of the magazine. The structure is captured in an SGML definition (DTD) with two types of elements:for the general structure: title, subtitle, several lead parts, main text, and reference sectionfor meta information: author, editors, issues, attached filesThe issues can be constructed automatically from the information contained in each article using templates. Multimedia files that belong to an articles can identified by an "attach" element. The publishing software can help the editor with an overview of everything that belongs to an article or an issue.The system is used for a number of magazines and communities. The most elaborate is the "Virtual Medical Worlds Community", a group of organisations involved in telemedicine and underlying advanced technologies (http://www.hoise.com/vmw/vmwc). The main parts of this community are:A news magazine called Virtual Medical Worlds Magazine: an extended table of contents is send by e-mail. The full magazine is available on the Web.ITIS letters: a journal for publishing fast refereed results from telemedicine research.Member profiles with activities, projects, products etc.Calendar.The current system is implemented using an article description based on an HTML-extension. The system is written mainly in PERL, Javascript, and a Java application. The fast take-up of XML allows to revert this situation: a new design will use XML to implement the article structure.


PLoS Medicine [We regret that in our paper in the January issue of Medicine , we failMedicine  that val


Studying the contribution of individual countries to leading journals in a specific discipline can highlight which countries have the most impact on that discipline and whether a geographic bias exists. This article aims to examine the international distribution of publications in the field of bioethics.Bioethics, Cambridge Quarterly of Healthcare Ethics, Hastings Center Report, Journal of Clinical Ethics, Journal of Medical Ethics, Kennedy Institute of Ethics Journal, Nursing Ethics, Christian Bioethics, and Theoretical Medicine and Bioethics).Retrospective quantitative study of nine peer reviewed journals in the field of bioethics and medical ethics , the United Kingdom , Canada  and Australia  had the highest number of publications in terms of absolute number of publications. When normalized to population size, smaller affluent countries, such as New Zealand, Finland and Sweden were more productive than the United States. The number of studies originating from the USA was decreasing in the period between 1990 and 2003.While a lot of peer reviewed journals in the field of bioethics profile themselves as international journals, they certainly do not live up to what one would expect from an "international" journal. The fact that English speaking countries, and to a larger extent American authors, dominate the international journals in the field of bioethics is a clear geographic bias towards the bioethical discussions that are going on in these journals. Journal of Medical Ethics aims to be a "leading international journal that reflects the whole field of medical ethics", the Cambridge Quarterly of Healthcare Ethics aims to be "an international journal that explores both broad issues in healthcare and society and organizational concerns that arise in institutions where ethics committees work", Bioethics is the official journal of the International Association of Bioethics that wants to be "truly international". However, there are no widely accepted standards for what it means to be international.Journals frequently lay claim to international status. The In many disciplines research has been executed by the curiosity to ascertain each country's contribution to the growth of scientific knowledge. Recently research has been done in the fields of anesthesiology , cardiolThe objective of our research is to analyse how international the discipline of bioethics is by investigating which countries contribute to international journals in the field. Therefore a study of the geographical distribution of publications in nine leading journals in the field of medical ethics and bioethics has been carried out. On the same dataset, we studied earlier authorship trends in bioethics , the metBioethics, Cambridge Quarterly of Healthcare Ethics, Hastings Center Report, Journal of Clinical Ethics, Journal of Medical Ethics, Kennedy Institute of Ethics Journal, Nursing Ethics, Christian Bioethics, and Theoretical Medicine and Bioethics . Pubmed was used to obtain all electronic citations of the articles published in these journals. To verify their reliability, all journals were searched by hand and compared to the electronic dataset. Microsoft Access was used to create a template for data collection and coding. Articles were coded for the following criteria: number of authors, present occupation of author(s), countries of author(s), funding, research design, research subject, and research topic . To guarantee reliability of data collection, the coding scheme was pilot-tested by two independent researchers. Following a discussion to resolve inconsistencies, the coding scheme was refined and then used for our review of the entire dataset. Countries were classified on the basis of the World Bank classification in high income economies and developing economies (low income and middle-income economies). The first author's affiliation was used to assign the publication's origin. The country of the institution to which the author was connected was used as a yardstick, not his personal nationality or country of origin. Population indexes (2003) were used from the World Development Indicators Database from the World Bank. Data was analysed in SAS 9.1.2 using the non-parametric chi square test for independent samples.Our research focuses on a set of peer reviewed journals (dating from 1990 to 2003) that are explicitly dedicated to ethical issues in the context of health care and biomedicine and that are still active in 2003. The journals were selected after comparing the lists of journals indexed by Pubmed, Fangerau [From 1990 to 2003, 4029 articles were retrieved in the nine peer reviewed international journals under study. The articles originated from 59 different countries. The United States , the United Kingdom , Canada  and Australia  had the highest number of publications in terms of absolute number of publications. These four nations account together for 80.6% of the production of articles in the bioethical journals under study. Table Journal of Clinical Ethics (93.9%), the Kennedy Institute of Ethics Journal (89.6%) and the Hastings Center Report (89.1%) and Christian Bioethics (82.2%) have more than 80% of publications coming from the United States. The Journal of Medical Ethics and Nursing Ethics are the only journals with a European country that is leading the list. In both cases this is the United Kingdom. If the number of different countries is considered, the Journal of Medical Ethics, Bioethics, and Nursing Ethics are the most international journals with respectively 40, 34 and 33 different countries involved.In 7 of the 9 analysed journals the United States are the most active contributors Table . The Jou2 = 90, p < .0001) than in the period 1990–1996. While in the period 1990–1996 67.5% of the publications came from the USA, in the period 1997–2003 this had diminished to 52.7%. The introduction of Nursing Ethics, whose contributors are mainly European, explains only partly this tendency. The results of the chi square test without Nursing Ethics presents still a significant lower number of articles originating from the USA  in the period 1997–2003 than in the period 1990–1996. As we described earlier [2 = 2.7, p = .10). Most publications from developing economies came from China , Turkey , South Africa , Hungary  and the Philippines . Meanwhile 51.1% (28/54) of the High Income contries indexed by the World Bank have contributed in the nine bioethical journals under study, only 20,1% (31/154) of the developing economies did so.In table  earlier , developWhen talking about research collaboration in the field of bioethics, it should be clear that 71.51% of all articles in our dataset are written by a single author. Two-author articles account for 16.88%  and articles with two or more authors for 11.61%. At the level of research collaboration we observed that the group of articles with more than one author (n = 1148) has in 91.5% only 1 country of origin. In 7% (n = 81) of the cases, the contributors came from two different countries. Only exceptionally more than two countries were involved. Research collaborations were mostly combined efforts between different European countries. Only exceptionally research collaborations between U.S. and Europe or U.S. and Asia were observed.In this investigation, the geographical distribution of publications in nine leading bioethical journals has been studied. Authors from 59 different countries published in these journals, but they were clearly dominated by English-speaking countries. The United States of America, the United Kingdom, Canada and Australia are the most productive countries in terms of absolute number of publications. The calculation of publications in relation to the number of inhabitants resulted in a high publication output for relatively small countries such as Finland and Sweden, but English-speaking countries as New Zealand, the UK and the USA complete the list of most productive countries. Our research reported also a low proportion of articles from authors from developing countries in the scientific literature in the field of bioethics. This corresponds with similar studies in leading medical journals  and manylingua franca of scientific communication offers a huge advantage to English native speakers [It is apparent that despite efforts to enhance cross-cultural and international perspectives on bioethics -18, the speakers . Althougspeakers The decline in the dominance of US researchers in publications in leading peer reviewed bioethical journal, is not unique to the field of bioethics. Such a trend has been observed for example in the field of anesthesiology , reproduThe fact that mainly English speaking authors participate in international bioethical journals is a clear geographic bias towards the bioethical discussions that are going on. Although we cannot assume that authors from developed (respectively developing) countries will only write about ethical problems that affect developed (respectively developing) countries, this might affect the agenda of bioethics. Turner already pointed that bioethics is biased towards ethical problems that affect wealthy developed countries and only rarely to address ethical discussions that affect developing countries such as globalisation and international inequity in access to basic goods such as food, clean water, and shelter.  EmbryoniResearch in bioethics of course depends on substantial economic inputs. Most of the differences observed between the countries depend on the amount of funding. Nonetheless smaller initiatives may also contribute to enlarge the scope of bioethics and make bioethics more international such as the inclusion of internationally representative members in editorial boards, partnerships between high income countries and developing countries, and twinning arrangements.  MultilatAmerican Journal of Bioethics, the Journal of Medicine and Philosophy, Developing World Bioethics, Ethics and Medicine, Medicine Health Care and Philosophy did not fit our selection criteria and were excluded from analysis. Although we did not intentionally limit our research to English language journals, journals as Ethik in der Medizin and other non English language journals could not be included for the same reason. A larger study including other bioethical journals and other medical journals should be realized to confirm the results of this study.The geographical distribution of publications in nine leading peer reviewed journals from the field of bioethics and medical ethics was investigated. Our study has, however, several limitations in the collection and interpretation of data. First, we have to remind us that publications about bioethics are not only found in journals dedicated to bioethical issues, but also in other journals such as general medical journals or speciality medical journals. Second, important journals as the In summary, we investigated the geographical differences in research productivity in the field of bioethics on the basis of nine leading bioethical journals for the period 1990–2003. The bioethical journals are clearly dominated by English speaking countries, and especially by the USA. Nevertheless, our study showed that the contribution of West European countries is increasing. The participation of important countries as France, Germany and Italy, however, remains very modest. Major efforts will be necessary to make bioethics a real "international" discipline, as far as this is achievable as goal.The author(s) declare that they have no competing interests.Pascal Borry and Kris Dierickx designed the study. After data collection by Eveline Devos and Pascal Borry, Pascal Borry performed statistical analysis. He wrote also a first draft of the article that was critically discussed by Paul Schotsmans and Kris Dierickx. Kris Dierickx coordinated the study.The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1472-6939/7/1/prepub


We are very excited and proud to announce that in July 2001 the Journal of Medical Internet Research (JMIR) has been selected by the National Library of Medicine (NLM) to be indexed in Medline/Index Medicus, the world's most important biomedical bibliographical database. NLM uses an advisory committee, the Literature Selection Technical Review Committee, composed of authorities knowledgeable in the field of biomedicine, such as physicians, researchers, educators, editors, health science librarians, and historians, to review and recommend the journal titles NLM should index. Only 15-20% of medical journals are selected at each session for inclusion in Medline, and only very few pure electronic journals have been selected for indexing so far. The Committee recently completed a review of journals for possible inclusion in the National Library of Medicine's database systems and decided to select the "Journal of Medical Internet Research" for indexing and inclusion in Index Medicus and Medline. This will include not only articles which will be published in the future, but also retrospectively all articles which have been published in the Journal in the past 3 years, back to the first issue.An electronic journal with no print equivalent must meet certain additional criteria to be selected for indexing. First, no restrictions on viewing the journal may exist (other than it might be fee-based). Secondly, NLM should be allowed to make copies of the content to preserve articles for posterity. Thirdly, publishers must provide XML/SGML-tagged data.The Journal of Medical Internet Research is currently working on the required XML files to make these citations available to NLM. As soon as this process is finished, all articles published in the Journal of Medical Internet Research will be searchable via PubMed and other MEDLINE systems. We will then join the ranks of more than 150 publishers of nearly 1,000 MEDLINE journals (40% of MEDLINE's current citations) who are sending electronic XML data for citations and abstracts for quick inclusion in PREMEDLINE. PubMed will also offer links back to the respective article on the JMIR Web site. In addition, the Journal is working towards inclusion of its full-text articles into PubMed Central.To date, only 20 pure electronic journals have been chosen for indexing by the National Library of Medicine, plus the BiomedCentral (BMC) specialty journals and the Cochrane database of systematic reviews. The editorial board of the Journal of Medical Internet research is proud to be among the pioneers of successful and sustainable online journals and thanks everybody who has contributed to this success, most of all our authors, our peer-reviewers and our readers, who continue to give us useful feedback.Gunther Eysenbach                            Editor,                            Journal of Medical Internet Research


Head & Face Medicine therefore as a thematically broad ranged journal, including all disciplines involved in the head and neck area. We hope this journal will attract basic researchers and clinicians who are involved in investigating and applying complex themes (examplified by tissue engineering) in the head and face region and will contribute to a gain in scientific information, communication, and collaboration in order to improve the outcome of patient treatments.During the last years, tissue engineering-based therapies have been introduced in clinical practice in the head and face area. The regeneration of complex tissue structures for all sites of the body is envisioned for the future. In the present situation, specialists of the different fields publish excellent research papers in specialised journals. As a result, the scientific community, seperated towards distinct sub-specialities, has difficulties in communication. To overcome this problem, the demanding, complex and interdisciplinary aspects of tissue engineering has to be approached from new ways. We have conceptualised  Tissue engineering is a new and fast growing branch of medicine that has now been introduced in clinical practice. The regeneration of various tissues for all sites of the body is envisioned for the future. The artificial generation of hard and soft tissues offers clinicians new tools in the treatment of various diseases of the head and face region. On the other hand, tissue engineering poses significant challenges, which needed to be overcome before this treatment option can be routinely performed.Head & Face Medicine. There were two reasons for this decision: during the phase of establishment of tissue engineering in our clinics on an experimental and clinical level, we observed that many specialists of the different fields involved in approaching tissue engineering, had difficulties in overviewing the complexity of the field. Secondly, as tissue engineering forces basic researchers, mainly having a biological, biophysical or material science oriented background, to closely collaborate with clinically oriented physicians, we found that they had difficulties in communication. The basis for the problems in 'intra-interdisciplinary' [One of the reasons for the fast growth of tissue engineering is the high number of excellent research papers, published in a wide array of  journals, covering all aspects of basic research, preclinical testing and clinical application. Additionally, numerous high quality books are available describing in detail the different aspects of tissue engineering. Despite the fact that various journals publish excellent research papers focusing on specialised areas of tissue engineering, we decided to also include papers on such specialties in our journal, plinary'  researchHead & Face Medicine therefore as a thematically broad ranged journal, including all disciplines involved in the head and neck area. By publishing the various aspects of, for example tissue engineering in one journal the reader can gain an overview of the whole field. Research papers are intended to provide extended information for the specialist. On the other hand, we think that interested readers from other disciplines will be able to extract the data to an extent, that enable them to understand the most relevant informations.We have conceptualised Head & Face Medicine. We hope this journal will attract basic researchers and clinicians who are involved in investigating and applying tissue engineering in the head and face region and will contribute to a gain in scientific information, communication, and collaboration in order to improve the outcome of patient treatments.To induce a learning curve from the acquisition of fragmented, but detailed information, to the ability to critically overview over the complex field of tissue engineering is a vision of


PLoS Medicine, vol 2, issue 2, DOI: 10.1371/journal.pmed.0020036In David D. Ho states that he should have declared as a competing interest that two members of his research team and Ho himself are co-inventors on two candidate vaccines that are in clinical development. For this effort, they also receive funding from the International AIDS Vaccine Initiative.


Nonlinear Biomedical Physics are: firstly to show how nonlinear methods can shed new light on biological phenomena and medical applications and secondly to bridge the technical, mathematical, and cultural divides between the physical disciplines where these methods are being developed and the audience for their use in the biological and medical sciences.The two goals of  Nonlinear biomedical physics lies at the crossroads of frontier research in physics, engineering, medicine, and biology, since current medical research studies of different biochemical and biophysical mechanisms must deal with mathematical modeling. The main aim of establishing Nonlinear Biomedical Physics (NBP) is to create a home for widely dispersed articles that concern extensive research in this field of great interdisciplinary relevance. NBP will deal with problems applicable to both the medical science and practice. Since the best definition of basic research is 'research that has not yet been applied', the basic research in the field of nonlinear biomedical physics is extremely important for near-future applications in clinical, environmental, and occupational medicine.Systems and processes studied in biophysics and medical physics are Linear methods are not 'just approximations' of nonlinear ones. For instance, correlations of dose and effect are rarely linear. Often, in a phenomenon known as hormesis, the effects of small doses are opposite to those caused by large ones. Any process that shows a threshold, for example the generation of a neural spike, is inherently nonlinear. Because of a long tradition, linear models and methods are still widely used in science and technology and one often forgets that these methods may neither adequately analyse nor predict phenomena sometimes of the highest importance.Our new knowledge from the theory of complex systems gives us the opportunity to develop new approaches that are needed to understand and control the complex systems in biology and medicine. Nonlinear, fast and reliable methods for analyzing noisy and non-stationary signals and images are required for proper analysis and interpretation of vast amounts of data to support accurate prediction of the onset and progression of major diseases, their diagnosis, treatment and prognosis. Currently work dealing with these problems is dispersed throughout specialized journals, and so outcomes of excellent work remains often unknown to specialists in other fields and are not finding their way into clinical practice and application (drug production).Another current problem is storing and transmitting medical data. Researchers can accumulate huge amounts of data, especially in form of digital images. This data has to be stored at an adequate security level and transmitted safely and quickly. Sometimes such procedures require the application of extra cryptographic methods. Data transmission is a subject of the fast developing telemedicine. These are the teleconsultation of images , monitoring of ECG signal and treating of cardiac dysrithmias. Another important topic is the way teleconferences for patient consultations and treatments can be arranged as well as exchanging ideas for medical education. This creates needs for new and improved nonlinear image and signal compression and processing algorithms.Medical doctors and biologists rarely read highly rated physical journals because the articles published there contain rather 'heavy' mathematics; what they usually rely on are more accessible papers, containing more extensive clinical data, high-resolution colour images, and user-friendly computer interfaces. On the other hand, physicists and biomedical engineers tend not to read biological and medical journals because articles there are mostly descriptive.NBP will be the place where both groups meet, with each group getting from the same open access articles the information they need most. The articles in NBP will be written and read by both physicists and biomedical engineers as well as by medical doctors and biologists. The main body of articles published by NBP should be sufficiently simple so that those with only a limited professional interest in and knowledge of physics or mathematics can understand and benefit from explanations. At the same time, the articles will contain  sufficient technical and mathematical detail for an expert reader to assess the methods used, and also sufficient experimental data so that the calculations might be repeated and the results verified. 'Classical' journals usually print articles of restricted length and charge for colour figures and additional material. As an open access, online journal, NBP encourages authors to take full advantage of the electronic medium to include colour, video, audio or other innovative presentation formats and links to more extensive tutorial information or data. This will help all the stakeholders since application of physics to medicine and biology requires diverse backgrounds to tackle problems with a broad range of competence and methodology. To cover the cost of open access publication the journal will levy an article-processing charge on each accepted article.Editorial Board [The active al Board  consistsNBP intends to be comprehensive, covering a broad range of basic research in the multidisciplinary and dynamic field of nonlinear biomedical physics. Equally important will be coverage of applied aspects of biomedical physics, such as biosensors, quantitative biosignal analysis and medical imaging, as well as assistance in medical diagnosis and therapy assessment.Journal articles will cover (but will not be limited to) the following current topics in nonlinear biomedical physics:• achieving a better understanding of the physiological origin of complex nonlinear dynamics of living systems• calculation of quantitative measures of complex spatial and temporal behaviour and classification of different physiological and pathological states through nonlinear analysis of biosignals • studies of feasibility of applying complexity measures as diagnostic tools in medicine to characterize changes induced by pathologies, administered drugs, photo-therapy, anaesthesia, etc. by comparing experimentally observed behaviour with predictions and computer simulations based on mathematical models• nonlinear methods of data  processing, compression, and teletransmission• collective phenomena, self-organized ordering and synchronisation in biological systems• bioelectromagnetic phenomena and biomedical devices such as biosensors and pacemakers• nonlinear, non-Newtonian fluids in the body – respiration, blood circulation, CSF, lymphNBP will consider publication of 'suggesting articles', containing only description of the methods, detailed results , and qualitative biomedical explanation of obtained results. At the same time the journal will invite readers with a theoretical background to use these data in a follow up article to be published in NBP as the input for nonlinear quantitative analysis and/or for building up a nonlinear model. Such 'suggesting-inviting' articles combination will positively contribute towards multidisciplinary international cooperation and help foster an interactive journal for the research community.To encourage medical doctors and biologists, NBP also intends to publish research, invited articles, reviews, conference proceedings and book reports.Nonlinear Biomedical Physics into the leading scientific journal in its field by publishing articles of outstanding scientific quality that merit the attention and interest of the journal's broad readership.Together with the Editorial Board and staff we are committed to build Editors-in-ChiefZbigniew Czernicki,  Wlodzimierz Klonowski, and  Larry Liebovitch


BioPsychoSocial Medicine [We are pleased to announce the launch of Medicine , an openJapanese Journal of Psychosomatic Medicine [BioPsychoSocial Medicine is the official journal of The Japanese Society of Psychosomatic Medicine , which wMedicine , the latBioPsychoSocial Medicine.With the support of psychiatrists, Japanese psychosomatic medicine specialists have aspired to promote the development of clinical medicine, education, and research into biopsychosocial medical science targeting the physical disorders of each branch. Our members' wishes to transmit their results to the world have been realized through the publication of an English language journal, BioPsychoSocial Medicine will become an important journal in its field. We look forward to receiving your submissions.We welcome the contributions of psychosomatic medicine scientists from around the world, as well as from those in Japan, and have high expectations that by publishing high-quality research papers on biopsychosocial medical science and by providing opportunities for communication among the psychosomatic medicine scientists of the world, BioPsychoSocial Medicine and President of the Japanese Society of Psychosomatic Medicine.Yoshihide Nakai is an Advisory Board member of


I agree with Richard Smith  that somBMJ [Of his eight ways of massaging data, the last five are dealt with by the International Conference on Harmonisation guidelines covering statistical principles for clinical trials (ICH E9) that reqBMJ  was doinBMJ  that covNew England Journal of Medicine published in January 2002 a paper claiming that voriconazole is a suitable alternative to amphotericin B preparations for empirical antifungal therapy in patients with neutropenia and persistent fever [New England Journal of Medicine owe readers some sort of explanation.The problems are inherent to publication not drug regulation. An instance: the nt fever . Howevernt fever  pointed Do the editors agree with Richard Smith (and me) that a published paper, whatever else it covers, should always identify the results of prespecified analysis, and if so, how do they check that this is so?Thus, I agree with Richard Smith that much is wrong with the publication of clinical trials sponsored by the pharmaceutical industry. I disagree that it is a particular problem for industry trials. It is the publication process that is in need of reform, and in particular we need to scrutinize carefully the motives of authors in publishing and the standards that editors apply in deciding what gets published.


The growth and acceptance of osteopathic physicians as conventional medical practitioners in the United States has also raised questions about the distinctive aspects of osteopathic medicine. Although the use of osteopathic manipulative treatment (OMT) and a focus on primary care are most often cited as rationales for the uniqueness of osteopathic medicine, an osteopathic professional identity remains enigmatic.omtology" and its derivative terms are recommended in referring to the study of OMT.The fledgling basic osteopathic research efforts of the early and mid-twentieth century have not been sustained and expanded over time. Thus, there is presently a scarcity of basic mechanistic and translational research that can be considered to be uniquely osteopathic. To be sure, there have been advances in osteopathic clinical trials, particularly those involving OMT for low back pain. Meta-analysis of these low back pain trials has provided evidence that: (1) OMT affords greater pain reduction than active or placebo control treatments; (2) the effects of OMT are comparable regardless of whether treatment is provided by fully-licensed osteopathic physicians in the United States or by osteopaths in the United Kingdom; and (3) the effects of OMT increase over time. However, much more clinical research remains to be done. The planning and implementation of a large longitudinal study of the natural history and epidemiology of somatic dysfunction, including an OMT component, represents a much-needed step forward. Osteopathic medicine's use of OMT and its focus on primary care are not mutually exclusive aspects of its uniqueness. The intersection of these fundamental aspects of osteopathic medicine suggests that the profession may successfully adopt a generic strategy of "focused differentiation" to attain a competitive advantage in the health care arena. While there are both requisite demands and risks for the osteopathic profession in adopting such a strategy, these are reasonable in relation to the potential rewards to be attained. To help promote an osteopathic identity, "The osteopathic profession should adopt a coherent strategy for developing and promoting its identity. Failure to do so will likely ensure that osteopathic medicine remains "stuck in the middle." Osteopathy experienced substantial evolution and growth during the twentieth century. The emergence and acceptance of osteopathic medicine as a "mainstream" or "conventional" medical system appears to afford unparalleled opportunities for the next generation of osteopathic physicians. Upon closer inspection, however, the triumphs of osteopathic medicine and its position on the American medical landscape may also herald a new challenge – that for its long-term survival. Increasingly, osteopathic physicians (DOs) are asked what makes them distinctive . Inevitably the responses focus on two rationales – the use of osteopathic manipulative treatment (OMT) and an emphasis on primary care. The objective of this commentary is to review the history and current state of osteopathic research, within the overarching framework of contemporary medical practice with its emphasis on evidence-based medicine and the "business" of medicine, and to offer some suggestions on future directions for the osteopathic profession.de facto justification for OMT's place in their clinical armamentarium prior to the emergence of rigorous clinical trial methodologies.A.T. Still established the osteopathic philosophy based on anatomical and physiological principles. Prior to the rise of the pharmaceuticals industry, the growth of osteopathy was largely attributed to OMT and its presumed therapeutic benefits. The licensure of osteopathic physicians in the United States was However, several factors during the latter half of the twentieth century altered this paradigm. First, the growth of the pharmaceuticals industry and the regulatory need for demonstrating the safety and efficacy of new drugs led to the development of and reliance on randomized controlled trials. Second, traditional epidemiologic research methods developed for public health began to be applied to clinical populations. Hastened by the growing power and availability of computers, supporting software applications, and health-related databases, the field of clinical epidemiology blossomed and subsequently refined the tools for contemporary evidence-based medicine. Third, with the requisite methodologies and resources to collect and analyze clinical data widely available, government and other third-party payers increasingly demanded evidence not only of the safety and efficacy of clinical interventions, but also of their cost-effectiveness. Consequently, in response to these phenomena, there is a present need to demonstrate the safety, efficacy, and cost-effectiveness of OMT.Somatic dysfunction is defined as impaired or altered function of related components of the somatic (body framework) system: skeletal, arthrodial, and myofascial structures, and related vascular, lymphatic, and neural elements . Given tsufficient to cause a particular disease? Is somatic dysfunction necessary to cause a particular disease? The most likely and complex scenario occurs when the response to each of the previous questions is negative. For example, when considering low back pain as the "disease," this scenario leads to the 2 × 2 table presented in Figure The concept of somatic dysfunction raises some fundamental questions regarding its causal relationship to disease states and its responsiveness to OMT . Is somaThe foregoing discussion highlights the need for research on the natural history and epidemiology of somatic dysfunction. Relatively little research has been performed on this integral aspect of osteopathic theory and practice. A retrospective analysis of family medicine patients attending university-based clinics was recently performed to begin addressing this issue . This stA large, long-term longitudinal study is urgently needed to extend our knowledge in this fundamental area. Such a study could not only address the natural history and epidemiology of somatic dysfunction, but also its response to OMT. Following a baseline osteopathic examination, the study would be facilitated by including a cohort of subjects followed by osteopathic physicians and another cohort followed by allopathic physicians. Because the latter do not diagnose or treat somatic dysfunction, the natural history of somatic dysfunction in the absence of OMT could be ethically and validly studied. Additionally, elegant case-control studies could be nested within this longitudinal design. The importance of this study to the osteopathic profession would not be overstated by referring to it as the "Osteopathic Framingham Study."Some observers of osteopathic medicine criticize its continued promotion of OMT because of a perceived lack of evidence regarding its efficacy. One point of view is that belief in the efficacy of OMT is based more on faith than on evidence . CertainImportant osteopathic clinical trials are being conducted and planned. Sponsors of these clinical trials include the National Institutes of Health, the Osteopathic Heritage Foundations, and other organizations. For example, the Osteopathic Research Center coordinates two major trials: the Multi-Center Osteopathic Pneumonia Study in the Elderly (MOPSE)  and a large clinical trial of OMT for chronic low back pain . The Osteopathic Research Center hopes to soon begin enrolling subjects in two other clinical trials. One trial involves the use of OMT for low back pain in active duty military personnel, while the other entails OMT to treat carpal tunnel syndrome. The Multi-center Osteopathic Otitis Media Study (MOMS), which will assess the efficacy of OMT for otitis media in children, is presently at an advanced developmental stage.Not surprisingly, because of the historical preponderance of low back pain as a reason for visiting osteopathic physicians, osteopathic clinical trials have addressed low back pain more often than any other condition . Thus, lThe New England Journal of Medicine [The Lancet [Journal of the American Medical Association [Spine [The clinical trials involving OMT for low back pain have been published in such high-impact journals as Medicine , The Lane Lancet , the Jouociation , and Spin [Spine . The thrn [Spine . The oven [Spine  are showSeveral important implications derive from these findings. The pain-reducing effects of OMT are significantly greater than those of a placebo or sham treatment. In fact, by comparison with published data, the pain reduction afforded by OMT is comparable to that of non-steroidal anti-inflammatory drugs, including cyclo-oxygenase-2 inhibitors , and mayin-utero exposures among the cancer cases. A case-control study then implicated maternal diethylstilbestrol (DES) as the causal factor in subsequent development of vaginal adenocarcinoma in the exposed daughters [Webster's Thesaurus lists the following synonyms for the term "enigma": puzzle, riddle, question, perplexity, conundrum, mystery, secret, and hidden meaning. A cluster of vaginal adenocarcinoma cases among young women at a Boston hospital between 1966 and 1969 represented an enigma, as this type of cancer was rare and unusual in young women . No obviaughters . SometimOsteopathic medicine has its enigmas as well. An enigma integral to osteopathic principles involves the complex inter-relationships among the spinal cord, autonomic nervous system, and viscera. Louisa Burns performed animal research in this area in the early 1900s and was the first osteopathic investigator to establish and carry on a long-term research program . J. StedOsteopathic medicine faces another enigma at a different level – establishing a professional identity that is compatible with the demands and expectations of contemporary medical practice. In this regard, the osteopathic profession may do well to adopt a generic strategy aimed at achieving osteopathic "competitive advantage." As shown in Figure Some considerations in making conventional business decisions involving the dimension of strategic advantage may not apply directly to the health care market in the United States. For example, the cost  for a health care service may be largely constrained by third-party payers who negotiate fixed fees. In such an environment, low cost leadership may not represent a viable strategy. Even in the classical market situation, in which costs are free to vary according to such factors as demand, cost leadership does not represent a strategy to be embraced by osteopathic physicians. Cost leadership implies large economies of scale that are generally not seen in osteopathic medical facilities and an "assembly-line" mentality that is incompatible with the osteopathic "hands-on" approach to patient care. Thus, it is clear that osteopathic medicine must adopt perceived uniqueness as its mechanism for strategic advantage.Based on osteopathic principles and current specialty practice patterns, few would argue against focusing on primary care as the appropriate strategic target market segment for osteopathic physicians. The relatively small number of osteopathic physicians in non-primary care specialties  effectivImplementing a focused differentiation strategy will entail some challenges and potential risks for osteopathic medicine. From an osteopathic professional perspective, there are four basic requirements for implementing a focused differentiation strategy : (1) a lomtology" to refer to OMT-related research and scholarly activity. Similarly, derivative terms such as "omtoepidemiology," "omtogenetics," and "omtovigilance" may be used to refer to specific fields of research within the realm of OMT.There are two potential risks for osteopathic medicine in implementing a focused differentiation strategy : (1) difThe question of OMT efficacy is not the elephant in the room. While much osteopathic research – mechanistic, translational, and clinical – remains to be performed, the clinical trials involving low back pain, taken together in a meta-analysis, have provided evidence of OMT efficacy. More importantly, the role of OMT and the emphasis on primary care have not been adequately reconciled in developing a professional identity for osteopathic medicine. A focused differentiation strategy that entails both of these aspects should be adopted by osteopathic medicine to help develop and promote its professional identity.Osteopathic Medicine and Primary Care. He was not involved in the review of this manuscript or in the editorial decision with respect to its suitability for publication.JCL is Editor-in-Chief of


PLoS Medicine by Deborah Hayden, entitled “Alas, Poor Yorick: Digging Up the Dead to Make Medical Diagnoses” [Science piece with Lori B. Andrews that Hayden references, I am troubled by her comment on our article. Nowhere in that article, “Ethics. Constructing Ethical Guidelines for Biohistory” [I am writing in response to an essay published in the most recent issue of agnoses” . As a cohistory” , do we s


Editors of medical journals accept that published research should be open to comment and correction in published correspondence ; Box 1)..Box 1). “Publishing corrections, retractions, and letters critical of articles published in their own journal.“Playing an active role in investigating and preventing fraud.“Taking responsibility for improving the level of scientific investigation and medical writing in the larger community of potential authors.“Giving authors an opportunity to review and approve edited manuscripts before they are published.“Participating in efforts to detect and prevent publication bias—for example, by collaborating with registries of controlled trials and publishing protocols.”Source: .I previously criticised the effective “statute of limitations” in several leading general medical journals “whereby authors of papers are immune to disclosure of methodological weaknesses once some arbitrary (short) period has elapsed” . Such a The Lancet and a 175-word limit by the New England Journal of Medicine.Subsequently, three of the six journals did revise their instructions , but eacEditors are seemingly falling over themselves to speed up and shorten letters, but this behaviour is inappropriate for a scientific journal. The key characteristic of science is not its infallibility, a quality it clearly does not and cannot have, but its self-correcting ability. The decision by medical editors to stifle debate is misguided ,6. A timPLoS Medicine has imposed a time limit of four weeks on correspondence. As explained above, I believe that such a limit is mistaken. The word limit of 750 words is generous by comparison to established general medical journals, but even this should be open to flexibility should the circumstances merit it.I am disappointed that In this world of Web-based journals and Web pages for print journals there is no real cost to permitting longer and later letters on the web while keeping the print version timely and terse.


EHealth has developed largely from an interdisciplinary framework and, as such, does not have a “home” discipline. The absence of this home discipline has allowed eHealth research to be published widely in journals ranging from the medical sciences, to engineering, to social science or to business and policy studies. The result of this fragmented, decentralized literature base is that researchers are not always aware of important papers published in other areas and journals. With this issue the Journal of Medical Internet Research is inaugurating a new article category which we call “CATCH-IT Reports” . We hope these reports will draw attention to important work published in other (sometimes obscure) journals, provide a platform for discussion around results and methodological issues in eHealth research, and help to develop a framework for evidence-based eHealth. CATCH-IT Reports arise from “journal club” - like sessions founded in February 2003 at the Centre for Global eHealth Innovation. We invite other research institutions to create similar journal clubs and to write up and submit to this journal critiques in the form of CATCH-IT Reports. Internet Healthcare Strategies as this journal does not publish original papers).While health informatics is widely seen as a discipline with the potential for making health care more effective by advancing the introduction of medical evidence into clinical practice, information professionals are not always known for their optimal utilization of research findings in their own area of specialization. One of the barriers for keeping on top of research findings in health informatics is that even for information professionals trained in retrieving, organizing, and filtering information, it is difficult to keep pace with the scattered literature in this rapidly expanding field. With information technology having penetrated virtually every field of medicine, pertinent papers appear scattered in many different journals. in particular if we consider the broad definition of medical informatics as “the field that deals with the storage, retrieval, and optimal use of biomedical information, data, and knowledge for problem solving and decision making or in information delivery” [1], or the even broader definition of “eHealth”, which would also include for example papers dealing with the role of the Internet for information dissemination, data collection, and decision making for health professionals and consumers, and impact of the Internet on health behavior and well-being of people with a public health focus . In a search conducted on December 30, 2004 for journal articles published in 2003/2004 with “Internet” as a major MeSH keyword, we identified 1702 papers.  as well as the two proceedings volumes from major medical informatics conferences  would keep readers informed of approximately 10% of the work published in this area.  One would have to read papers in 36 different journals to cover 33% of the articles, 92 different journals to cover 50%, 190 journals to cover 66%, and 344 journals to cover 80% of all articles  . While such a distribution, where a small group of core journals would provide 1/3 of the articles on that subject, a medium number of less-core journals would provide another 1/3 of the articles on that subject, and a large number peripheral journals would provide the final 1/3 of the articles on that subject, is typical (known as “Law of Scatter” or “Bradford's Distribution”), the extent of scatter in the field of eHealth is extreme, with a very long tail. While the Journal of Medical Internet Research ranks as the top journal which published more papers related to the Internet in medicine than any other journal, it still “only” publishes about 3% of the total number of papers in this field .The 1702 papers were scattered across 685 different journals . The absence of this home discipline has allowed eHealth research to be published widely in journals ranging from the medical sciences to engineering, to social sciences and to business and policy studies. The aforementioned analysis does not even take into account articles published in journals which are not indexed in Medline. The result of this fragmented, decentralized literature base is that researchers are not always aware of important papers published in other disciplines and journals.Journal of Medical Internet Research is inaugurating a new article category which we call “CATCH-IT Reports” . With this new article series we hope to draw attention to important work published in other (sometimes obscure) journals, and provide a platform for discussion around methodological issues in eHealth research.With this issue, the The reports arise from “journal club” - like CATCH-IT sessions founded in February 2003 at the Centre for Global eHealth Innovation by Gunther Eysenbach with the goal of bringing together researchers, students, faculty, researchers, and health professionals interested in furthering understanding of eHealth through the process of critically appraising and discussing current eHealth research. The objectives of these bi-weekly sessions and the CATCH-IT Reports areTo train researchers, students, and faculty in critical appraisal skills and to encourage an evidence-based approach to the medical informatics literatureTo bring to the attention of the eHealth community important and timely issues and publications concerning evidence and issues in the fieldTo provide, in a systematic fashion, critical analyses of publications and eHealth trialsTo identify pressing research issues and to stimulate thinking about methodological issues in eHealth.The CATCH-IT review group at the Centre for Global eHealth Innovation comprises individuals who all have experience in developing, deploying and evaluating eHealth interventions. What we lack in terms of length of experience  we make up for in breadth of experience. Our group consists of researchers and practitioners from many different disciplines, cultures, ages, and roles. We are scientists, practitioners, professors, and students. All of us are consumers. Some of us are new to the process of critical appraisal of research while others have been at the forefront of developing methods for evidence-based medicine since the term was first coined. In short, we represent a diverse cross section of eHealth consumers.Each session is prepared by one of the participants taking on the role of facilitator. The facilitator selects a recent paper from the current body of literature  and circulates the paper to all participants at least 1 week before the CATCH-IT session.Selection criteria for papers discussed in a CATCH-IT report include one or more of the following:or                    High quality papers with great potential impact on one or more groups of decision makers in the health system Papers illustrating methodological flaws worth discussing (seeking to prevent them in future studies)Papers providing an elegant solution to a  problem or otherwise addressing timely methodological issues or problemsIllustration of new ideas or concepts that could represent food for reflection and discussionDirect impact on ongoing research (of the facilitator or elsewhere).At the session, the facilitator first presents the paper, which is then critically discussed in the group under aspects such as validity and importance of the paper. Often, new research ideas are generated in the process, or methodological problems are unearthed. Almost always questions remain open as articles are often incompletely reported. We often ask ourselves the question, “How could the peer reviewer/editor miss this?”Minutes of the discussions are kept, and the facilitator writes up a short report, typically 1000 to 1500 words in length. In the future, we will publish the best of these reports in this journal. The reports will be sent to the author of the original paper and he will be invited to respond to the report. A general template for CATCH-IT Reports will be developed during the project, but generally each published CATCH-IT Report will address the following questions:Why is the paper interesting, why was it picked?For whom is this paper interesting, and why?What were the intervention, setting, outcome measures, results, and conclusions of the authors?Background information – what's not written in the paper is… What are the methodological issues, and is the result valid?What can health professionals learn from this study?What can consumers learn from this study?What can policy makers learn from this study?What can researchers learn from this study?What further research is required?What questions for the author arise?One of our goals is to produce reports based on our discussions and reviews in order to promote better research and to foster further debate and discussion on ways to create the best evidence for the use of eHealth. The focus of the first report, published in this issue , is on tWhile forthcoming CATCH-IT papers will be primarily produced by graduate students and faculty at the Centre for Global eHealth Innovation, we invite other research institutions to create similar journal clubs and to write up and submit critiques and discussion pieces of the current eHealth literature in the form of CATCH-IT Reports.