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Good afternoon everyone.
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Welcome to the March Ethics Grand Rounds.
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It's a pleasure to welcome Professor Kenneth Iserson
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who is Emeritus Professor at the University of Arizona
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College of Medicine in Tucson.
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Dr. Iserson has had a, what else can I say,
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a truly extraordinary career.
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He was one of the first emergency physicians certified
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as a specialist more years ago than I'll mention.
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He got his MD from the University of Maryland, and his
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qualification in surgery at Mayo Clinic
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and then emergency medicine residency at Cincinnati General.
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Since 1984 he's been basically at the University of Arizona,
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Tucson except for a brief stint
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at the University of Chicago where he got his qualification
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as a senior fellow in bioethics
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and hence the connection here.
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What's been extraordinary about his career
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is his extraordinary academic productivity
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in virtually all areas of emergency medicine,
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ethics and beyond as well as doing extensive tours
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in relief work as a resident or physician in charge
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in various relief efforts, military and otherwise
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literally around the world.
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This morning, for example, we discussed with some detail
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his stint at the Mount Monroe, Murrow, Mount Murrow?
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McMurdo, McMurdo Station.
McMurdo in Antarctica
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where he cared for Antarctic workers over what,
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a month or so?
A year and 1/2.
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Oh wow, that's 18 months so I stand corrected.
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So he has been recipient of numerous awards
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in emergency medicine including
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the President's Volunteer Service Award in 2010
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among many others.
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He's the author of numerous, numerous publications
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as well as for any medical students that are present,
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the 9th edition of a guidebook
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for getting into residency programs titled
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"Getting Into Residency" hence that's available
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from the Galen Press.
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So without further ado from me
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please welcome Professor Iserson.
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(audience applauding)
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Thank you very much, John.
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Thank you very much, John.
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It's a pleasure to be here in Texas again.
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I used to live over in Fort Worth on the military base.
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Carswell for you young ones who never heard of it.
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And really happy to be talking about open-access journals.
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So before we start I'd like to recognize
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two special people, I got a signal from the video guy.
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Oh no, it's set up.
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Oh, okay, okay.
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Two special people, at least two, can you raise your hands?
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Librarians who are here.
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Three, okay, excellent.
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They are your go-to resource after this talk
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about all the material I'm gonna be talking about,
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and they're going to be your biggest help
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in deciphering the confusing area
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that I'm going to be speaking about today.
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And it's Open-Access Medical Journals:
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Promises, Perils and Pitfalls.
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Promise, the best thing since sliced bread.
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The peril, you're gonna fall into a big
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pit of quicksand and the pitfall is
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it's gonna destroy your career.
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Aside from that everything's fine, don't worry about it.
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Okay, so the learning objectives.
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At the end of this talk you'll be able to identify
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the various types of open-access journals in general, okay.
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You're going to be able to use several methods
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to differentiate legitimate versus illegitimate
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open-access journals, and there is a handout.
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Some of you may have gotten it already.
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If not the librarians have it, they've put it together
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with a list and it's very similar
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to the list that I'm going to go through with you
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about how to differentiate legitimate
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and illegitimate open-access journals.
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And I'm gonna describe, and you'll be able to describe
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some of the ethical pitfalls inherent
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in the open-access journals.
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Three big questions, what's the problem,
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why is it important, and how common is it?
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Over the past 15 years since we first started
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using open-access journals, they became available
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the number has increased dramatically.
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And they are constantly publishing
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or saying they're publishing lots and lots of papers.
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There's two groups, well there's actually three groups
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that have to be concerned about this.
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There are the well-funded, well-established
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non-humanities academics.
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Medical, basic science with grants.
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They don't have a lot to worry about
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and I'll tell you why in a second.
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The third group are in developing countries.
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They don't have money, they don't have money
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to do their research, they don't have money
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to do their grants and they definitely don't have money
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to help with publishing costs.
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And then there's the group in the middle.
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They're trying to become established academics.
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They may be in the humanities or semi in the humanities
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or they are clinical or basic science
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and they just don't have grants.
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Each has different problems.
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Now, open-access, what does it mean?
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It means that they put it on the web and you can access it.
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It's very straightforward.
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Okay, and there's lots of this material out there.
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How many of you are clinical?
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Okay, we have some clinical people, good.
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You get procedural and informational videos.
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I wish I had those when I was a resident.
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They would have been awesome, they're very helpful.
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Guidelines from professional organizations
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We see these all the times.
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Free articles that are already on the web,
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and open-access allows easier collaboration worldwide.
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And one of the things we're seeing right now
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is open-access is dramatically helping the whole world
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in its fight against COVID-19.
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When we had SARS we had to wait to have things published
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and people would look at it and then
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they'd start developing the next step.
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That's happening in hours or days now.
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As soon as the COVID was genetically sequenced
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people started using it to say, we can develop a vaccine.
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As soon as they some progress on the vaccine
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people went further than that.
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They're getting epidemiologic data.
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Some of it is reasonable, some of it isn't,
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but it's moving very quickly
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and that's because of open-access.
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But then we have the illegitimate journals.
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They provide a breeding ground
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for unethical publishing practices,
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and I'll talk about some of the ones that exist.
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There's no regulation for open-access journals.
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There is no regulation.
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And so it's like the Wild West of publishing.
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Okay, what are some of the problems?
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The open-access publishers misrepresent what they offer,
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what standards and practices they use.
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For example, we review your paper, no.
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It's gonna be widely disseminated
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through all of these repositories.
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Mm, generally not, okay.
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When you go for promotion or tenure or a new job
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P&T committees now know to look for those kind of journals
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and they'll throw out your application
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or they'll deny you a promotion or tenure.
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It wastes effort, if you spent money and time
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and other people's time doing research
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and you go into one of these open-access publications
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frequently the illegitimate ones, not the legitimate ones,
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you frequently are not gonna ever be able
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to find your paper again, but you've already signed over
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the copyright and so you can't get it back.
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Lack of archived content, that's what we're talking about.
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And then it decreases
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the general confidence of research literature.
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Here a couple things that were published
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about open-access in general.
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And they talked about Wild West of academic publishing.
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Bohannon, and we'll see his name show up
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in just another minute, the players are murky,
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the identity and location of the journals and the editors
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and the financial workings are purposely obscured.
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There's a network of bank accounts
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based mostly in the developing world.
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It's really, really, it's kind of like the drug world.
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It's really subversive
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and not quite illegal but it should be.
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On the other hand Roos wrote, open-access is a good thing.
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And we'll see that it really is, the whole thing
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about the COVID-19 sharing of data, that's a great thing.
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Okay, but especially in the developing world
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people have all these academic credentials
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and are getting into teaching positions
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and research positions and all their stuff
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is basically illegitimate or unverifiable.
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Okay, so I said we'd see Bohannon's name again, here it is.
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He submitted an article.
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His author was Ocorrafoo Cobange, a biologist
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from the Wassee Institute of Medicine in Asmara, Eritrea.
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Well, no such university exists
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and no such researcher exists.
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The article had obvious serious flaws
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ethically and in research method.
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He submitted it to hundreds of open-access journals.
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98 rejected it, great.
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157 accepted it.
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Now this is one of those real obvious bogus papers.
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Three of the accepted papers
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were from well-known publishers, okay,
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and he published this in "Who's Afraid of Peer Review?"
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That was one of the big reveals
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about illegitimate open-access publishing.
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So why are legitimate researchers affected?
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You do good research, you want to get it published.
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Who's drawn in by these illegitimate OA publishers?
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People who are young and don't know any better.
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They're inexperienced.
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They feel the publish or perish mandate.
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Nobody in here ever felt that, right?
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(audience laughing)
No?
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Yeah, the old guys are sitting there,
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yeah, well, that's a long time ago, I don't have to worry.
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Yes, but if you're young and you're trying
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to make a name for yourself in academia you have that.
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Ego, you're solicited, it comes in your email.
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Did anybody today get a solicitation for?
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Yeah, one, only one?
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Yeah, sure, okay, I counted the ones I got,
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I had on my email when I woke up this morning.
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I had 20 solicitations, okay.
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So okay, frustration, you couldn't get your paper published
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in a couple places where you sent it off to.
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And I'll just go ahead and send it to one
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of those fly-by-night places.
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And lack of guidance, that's why you want your librarian.
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Know who your librarians are.
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They're a great resource.
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I've worked with medical librarians, reference librarians
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my whole career, it's been great.
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So who's harmed by publishing in these,
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this gray, murky area?
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Authors, academic evaluators, people looking to hire you
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or to promote you, potential employers, or grantors,
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clinicians who are reading this and believing it's real,
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media who are generating it to the public,
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and the public who receive this information.
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This is the big promise.
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Easily fulfilling your publish and perish obligation.
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We're gonna publish it right away, don't worry about it.
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So we want your article!
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They give a false impression that it's a legitimate journal.
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They describe conferences or publications that
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they have sponsored or whose results they have published.
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Editorial board invitations.
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Some of you will be getting those.
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Will you be a member of our editorial board?
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Sometimes, will you be the editor of a special edition?
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Yeah, what's your field?
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You looking at me?
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Yeah.
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I'm a medical student.
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You're a medical student.
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Yes, sir.
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Well, would you like to be the special editor
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of the, wait, wait, wait, of the edition
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on engineering of ant farms?
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(students laughing)
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I don't know what that means.
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Yeah, yeah, neither do I,
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but that's the kind of thing you're going to get, right.
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Harassment, you're going to get repeated emails
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from these people, and the more you publish
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the more of these you're going to get.
263
00:16:36.741 --> 00:16:40.450
Okay, here are some of the things in emails
264
00:16:41.500 --> 00:16:46.500
that you can use to spot fake, illegitimate OA publications.
265
00:16:50.418 --> 00:16:52.930
Oh, this is for the conferences, I'm sorry.
266
00:16:52.930 --> 00:16:56.163
I've taken a slight detour because one of the big things
267
00:16:56.163 --> 00:17:01.163
they're doing now is they're sponsoring conferences,
268
00:17:02.720 --> 00:17:05.470
supposedly sponsoring conferences.
269
00:17:05.470 --> 00:17:07.660
You're invited to the conference.
270
00:17:07.660 --> 00:17:10.763
You send us your article, you pay the money,
271
00:17:11.650 --> 00:17:14.810
and by the way you get a continuing education credit
272
00:17:14.810 --> 00:17:17.410
as soon as you pay the money
273
00:17:17.410 --> 00:17:21.010
and we will publish your article for that, yeah.
274
00:17:21.010 --> 00:17:22.720
Of course you never see the article
275
00:17:22.720 --> 00:17:26.620
and your CME credits are usually worthless.
276
00:17:26.620 --> 00:17:28.380
They say you are invited to the conference.
277
00:17:28.380 --> 00:17:31.320
People don't usually invite you
278
00:17:31.320 --> 00:17:32.770
to these kind of conferences.
279
00:17:33.981 --> 00:17:38.644
They use free emails to advertise.
280
00:17:38.644 --> 00:17:40.970
If you see that, forget it.
281
00:17:40.970 --> 00:17:44.520
A Gmail account for example or a Hotmail account.
282
00:17:44.520 --> 00:17:48.350
If you're invited or notified about a legitimate conference
283
00:17:48.350 --> 00:17:50.373
it will come from an organization.
284
00:17:51.950 --> 00:17:55.420
Usually in a fancy tourist destination during high season.
285
00:17:55.420 --> 00:17:58.783
So basically you should know that you're going on vacation.
286
00:17:59.630 --> 00:18:00.463
There's no conference.
287
00:18:00.463 --> 00:18:02.900
Multidisciplinary conference, we are going
288
00:18:02.900 --> 00:18:05.450
to talk about electrical engineering
289
00:18:06.770 --> 00:18:10.853
and genomics and astrophysics.
290
00:18:13.760 --> 00:18:18.760
No I don't think too many people have that kind of diversity
291
00:18:19.040 --> 00:18:21.460
in their knowledge or interest.
292
00:18:21.460 --> 00:18:23.620
Free offers of accommodations occasionally
293
00:18:23.620 --> 00:18:26.370
or meals usually don't pan out.
294
00:18:26.370 --> 00:18:28.573
Key speakers are charged.
295
00:18:31.480 --> 00:18:34.160
If there's a quack review and acceptance process.
296
00:18:34.160 --> 00:18:37.953
Unusual payment method, can't use a credit card.
297
00:18:39.820 --> 00:18:44.820
Can't use a credit card, you've gotta send a bank transfer
298
00:18:45.100 --> 00:18:47.730
usually to a personal bank account
299
00:18:47.730 --> 00:18:50.883
in Upper Mongolia or something similar.
300
00:18:51.960 --> 00:18:55.020
No refund, and there's always a claim
301
00:18:55.020 --> 00:19:00.020
that it'll be indexed in a major index, but that's not true.
302
00:19:02.020 --> 00:19:05.080
So okay, how gullible are you?
303
00:19:05.080 --> 00:19:09.490
I'm an African prince and I have this bank account
304
00:19:09.490 --> 00:19:14.000
that's really in your name and just send me $50,000
305
00:19:14.000 --> 00:19:18.183
or something, okay, or, and I got one of these just,
306
00:19:19.157 --> 00:19:21.033
it was a phone call.
307
00:19:21.910 --> 00:19:26.910
Your grandson is in jail and he needs money to bail him out.
308
00:19:28.410 --> 00:19:33.153
Well I don't have a grandson so that wasn't a problem, okay.
309
00:19:35.210 --> 00:19:37.230
This is a real solicitation I got
310
00:19:37.230 --> 00:19:42.140
and it has most of the red flags,
311
00:19:42.140 --> 00:19:44.273
and that's what you're gonna be looking for.
312
00:19:45.560 --> 00:19:48.810
I hope all is well and trust you are doing splendidly.
313
00:19:48.810 --> 00:19:51.270
Almost every first line is like that,
314
00:19:51.270 --> 00:19:54.023
and this is better English than most of them.
315
00:19:55.340 --> 00:19:57.133
You're an expert in blah, blah.
316
00:19:57.133 --> 00:20:01.743
We'd like your article, your next article.
317
00:20:04.310 --> 00:20:07.970
And if there's a journal once in a while
318
00:20:07.970 --> 00:20:12.670
they will actually give you a URL for a journal website.
319
00:20:12.670 --> 00:20:17.670
If you go to it luckily now Google puts up at the top
320
00:20:20.350 --> 00:20:23.100
illegitimate journal comments
321
00:20:23.100 --> 00:20:26.938
about how it is an illegitimate journal but you have to go.
322
00:20:26.938 --> 00:20:31.250
Notice, "The New American Journal of Medicine."
323
00:20:31.250 --> 00:20:33.053
Anybody an internist here?
324
00:20:33.900 --> 00:20:36.677
Okay, you are, there's a journal,
325
00:20:36.677 --> 00:20:38.630
"American Journal of Medicine."
326
00:20:38.630 --> 00:20:40.500
It's a respected journal,
327
00:20:40.500 --> 00:20:43.600
but there's no "New American Journal"
328
00:20:43.600 --> 00:20:45.593
so that's one of the things, okay.
329
00:20:47.290 --> 00:20:51.140
Okay, how common are the solicitations?
330
00:20:51.140 --> 00:20:52.550
I told you how many I had gotten.
331
00:20:52.550 --> 00:20:57.550
Here are a couple, 48 hours, these were the most egregious.
332
00:20:58.736 --> 00:21:02.210
"Drug Target Insights," we're interested
333
00:21:02.210 --> 00:21:04.323
in publishing your research.
334
00:21:05.240 --> 00:21:06.840
They said there is a publishing charge.
335
00:21:06.840 --> 00:21:08.860
They usually don't say that up front,
336
00:21:08.860 --> 00:21:10.780
but they didn't specify the amount.
337
00:21:10.780 --> 00:21:14.567
The "Integrative Journal of Ortho and Traumatology."
338
00:21:15.500 --> 00:21:19.820
Final call, we've notified you and we need one more paper.
339
00:21:19.820 --> 00:21:21.920
We need one more paper to complete our journal.
340
00:21:21.920 --> 00:21:25.160
As soon as you send it in, accepted.
341
00:21:25.160 --> 00:21:28.640
Okay, that's okay, and then of course
342
00:21:28.640 --> 00:21:32.520
the conference invitation, nobody's going to China right now
343
00:21:32.520 --> 00:21:35.870
so you don't have to worry about that, okay.
344
00:21:35.870 --> 00:21:38.253
Now, there are legitimate
345
00:21:38.253 --> 00:21:42.410
and respected open-access journals.
346
00:21:42.410 --> 00:21:45.790
They are legitimate, they are respected.
347
00:21:45.790 --> 00:21:48.603
Legitimate researchers publish in them,
348
00:21:48.603 --> 00:21:51.973
and these are just some of them, okay.
349
00:21:54.140 --> 00:21:59.140
But there are illegitimate journals that have similar names.
350
00:21:59.569 --> 00:22:00.870
The legitimate ones,
351
00:22:00.870 --> 00:22:04.147
the "Journal of Cancer Science & Therapy."
352
00:22:05.230 --> 00:22:06.460
The illegitimate one,
353
00:22:06.460 --> 00:22:10.177
the "Journal of Cancer Science & Therapeutics."
354
00:22:11.670 --> 00:22:13.963
Very close, you have to be very careful.
355
00:22:14.960 --> 00:22:15.793
Believe or not the
356
00:22:15.793 --> 00:22:17.980
"Journal of Sports Medicine & Doping Studies"
357
00:22:17.980 --> 00:22:22.980
is a real journal, okay, be careful, okay.
358
00:22:24.460 --> 00:22:26.940
Opportunities and barriers
359
00:22:26.940 --> 00:22:31.370
with legitimate open-access publishing.
360
00:22:31.370 --> 00:22:32.410
We have to talk about that
361
00:22:32.410 --> 00:22:33.790
because you're going to be involved,
362
00:22:33.790 --> 00:22:37.390
if you do any publishing, you're going to be involved
363
00:22:37.390 --> 00:22:40.413
with legitimate open-access publishers.
364
00:22:41.400 --> 00:22:44.860
The basic underlying thing you have to remember
365
00:22:44.860 --> 00:22:47.785
is someone has to pay.
366
00:22:47.785 --> 00:22:52.553
It doesn't suddenly appear without processing.
367
00:22:54.824 --> 00:22:58.470
You know, we're not talking about printing
368
00:22:58.470 --> 00:23:00.290
but there's an editorial process,
369
00:23:00.290 --> 00:23:02.151
there's a formatting process.
370
00:23:02.151 --> 00:23:05.300
Someone has to pay for all of this.
371
00:23:05.300 --> 00:23:10.290
Maintaining the website, someone has to pay, okay.
372
00:23:10.290 --> 00:23:12.720
Business support, there is a business support
373
00:23:13.569 --> 00:23:18.100
and archiving, just getting it into the appropriate archives
374
00:23:18.100 --> 00:23:22.760
and notifying people so you have to remember that people
375
00:23:22.760 --> 00:23:27.268
have to pay anywhere along the line for these things.
376
00:23:27.268 --> 00:23:32.268
Now these are the four general types of open-access journals
377
00:23:34.040 --> 00:23:36.500
and I'm gonna talk about each one.
378
00:23:36.500 --> 00:23:41.500
Okay the green, the gold, the platinum also called silver,
379
00:23:45.340 --> 00:23:49.125
platinum or silver, and the hybrid which is combination
380
00:23:49.125 --> 00:23:53.283
kind of like your Prius, okay.
381
00:23:58.010 --> 00:24:02.140
Green, some people call that second-class publishing.
382
00:24:02.140 --> 00:24:07.140
It really isn't, and there's all kinds of green publishing,
383
00:24:08.330 --> 00:24:10.900
but basically they accept preprints
384
00:24:10.900 --> 00:24:13.503
which means before it goes to peer review.
385
00:24:14.950 --> 00:24:18.020
They take postprints after there's layout
386
00:24:19.400 --> 00:24:22.588
from a other journal.
387
00:24:22.588 --> 00:24:25.490
You can send it to a repository.
388
00:24:25.490 --> 00:24:29.760
Some of you know about ResearchGate, okay.
389
00:24:29.760 --> 00:24:33.530
They'll take these, and there's others.
390
00:24:33.530 --> 00:24:36.420
Your university may have a repository.
391
00:24:36.420 --> 00:24:39.283
The library, does the library have a repository here?
392
00:24:40.630 --> 00:24:42.595
An open-access repository?
393
00:24:42.595 --> 00:24:43.450
Yes.
394
00:24:43.450 --> 00:24:45.440
Yes, we do, okay.
395
00:24:45.440 --> 00:24:49.424
And sometimes my library gets annoying.
396
00:24:49.424 --> 00:24:51.454
Send us a copy of, you know.
397
00:24:51.454 --> 00:24:55.100
Okay, okay, relax, calm down.
398
00:24:55.100 --> 00:24:59.160
But you can publish them and then they're available online
399
00:24:59.160 --> 00:25:01.743
for free, it costs you nothing.
400
00:25:03.400 --> 00:25:08.400
And these have not been accepted in a journal yet.
401
00:25:10.237 --> 00:25:14.630
There are some that are higher level repositories
402
00:25:14.630 --> 00:25:16.480
and some just for specific things.
403
00:25:16.480 --> 00:25:21.480
For example the Cold Harbor Repository is for basic science
404
00:25:25.070 --> 00:25:27.470
more or less, basic biological science
405
00:25:27.470 --> 00:25:30.690
and then they have some for not biological science.
406
00:25:30.690 --> 00:25:32.990
You can put things in there and they will replace it
407
00:25:32.990 --> 00:25:36.300
with a published article once you get it done
408
00:25:36.300 --> 00:25:40.910
and it's for scientists to look at their colleagues' work
409
00:25:40.910 --> 00:25:41.983
and comment on it.
410
00:25:44.010 --> 00:25:47.490
It's discipline-specific unless it's from the university.
411
00:25:47.490 --> 00:25:51.210
And if it's from your university or ResearchGate
412
00:25:51.210 --> 00:25:55.470
it's funded from outside, and I have no idea
413
00:25:55.470 --> 00:25:58.363
how ResearchGate is funded, okay.
414
00:26:02.760 --> 00:26:06.760
All right, there's the Web of Science.
415
00:26:06.760 --> 00:26:10.930
Now that, there's a subscription charge to access that,
416
00:26:10.930 --> 00:26:14.593
but for you to see the articles,
417
00:26:15.430 --> 00:26:19.830
and I suspect that your library has a, yes it does.
418
00:26:19.830 --> 00:26:21.570
It has a subscription to Web of Science
419
00:26:21.570 --> 00:26:24.900
so you can go on it and look, but to put your article
420
00:26:24.900 --> 00:26:29.633
on Web of Science is free, it's open-access, okay.
421
00:26:30.810 --> 00:26:35.810
So sometimes it's also called the gray literature,
422
00:26:35.900 --> 00:26:38.440
but gray literature is another term.
423
00:26:38.440 --> 00:26:42.660
When you go to Wikipedia, please don't plagiarize Wikipedia.
424
00:26:42.660 --> 00:26:44.480
That's so easy to discover.
425
00:26:44.480 --> 00:26:45.580
That's just a sidebar.
426
00:26:47.492 --> 00:26:49.950
But Wikipedia is gray literature.
427
00:26:49.950 --> 00:26:53.360
It's not peer reviewed, it's just out there
428
00:26:53.360 --> 00:26:57.340
and it's available, okay, but it can be very important.
429
00:26:57.340 --> 00:27:01.570
It can also be government documents which are important
430
00:27:01.570 --> 00:27:05.223
and you may have to cite in some of your things.
431
00:27:06.950 --> 00:27:09.283
Okay, so that is free.
432
00:27:10.290 --> 00:27:15.290
Green is free, green is easy, green is not published
433
00:27:17.670 --> 00:27:22.250
as you think if it's in a journal as being published,
434
00:27:22.250 --> 00:27:23.993
but you can cite it, okay.
435
00:27:25.290 --> 00:27:29.040
Gold, and there's all kinds of gold.
436
00:27:29.040 --> 00:27:33.850
There is 14 karat gold, there is fool's gold.
437
00:27:33.850 --> 00:27:35.190
I mean, all kinds of gold.
438
00:27:35.190 --> 00:27:39.743
So we're talking about a gigantic group, it's pay to play.
439
00:27:41.490 --> 00:27:45.800
You pay a fee and we will publish your article
440
00:27:45.800 --> 00:27:49.953
in a legitimate open-access journal, okay.
441
00:27:52.400 --> 00:27:54.530
This is where we get into trouble
442
00:27:54.530 --> 00:27:58.230
because the illegitimate open-access journals
443
00:27:58.230 --> 00:28:03.230
say the same thing, and we'll look at the difference.
444
00:28:03.790 --> 00:28:07.060
How can you tell a legitimate gold access
445
00:28:07.060 --> 00:28:09.223
from an illegitimate gold access?
446
00:28:10.082 --> 00:28:12.430
Okay, but they're pay to play.
447
00:28:12.430 --> 00:28:15.980
You pay, they'll do it.
448
00:28:15.980 --> 00:28:19.860
One of the big ones is, with the legitimate is,
449
00:28:19.860 --> 00:28:23.710
I'm sending you the article, please review it
450
00:28:23.710 --> 00:28:28.703
for your legitimate open-access journal, okay.
451
00:28:29.550 --> 00:28:31.400
It goes through a review process.
452
00:28:31.400 --> 00:28:34.319
They say, okay, we want these changes
453
00:28:34.319 --> 00:28:38.602
and then we'll do it but to publish it
454
00:28:38.602 --> 00:28:43.602
it's going to cost you this much money, how much money?
455
00:28:43.610 --> 00:28:48.610
It varies, it can be as little as a few hundred dollars.
456
00:28:48.680 --> 00:28:53.680
It can be $5,000, depends on the nature of the journal.
457
00:28:53.940 --> 00:28:58.740
And this is legitimate and if you have big grants who cares?
458
00:28:58.740 --> 00:29:02.640
If you're in the humanities or in a third-world country
459
00:29:02.640 --> 00:29:04.303
not so good, okay.
460
00:29:05.330 --> 00:29:09.513
The illegitimate ones it's, you wanna submit your article?
461
00:29:09.513 --> 00:29:14.513
Okay, now that you submitted it, please forward $500 to us.
462
00:29:15.166 --> 00:29:17.463
As soon as you do it'll be published.
463
00:29:18.870 --> 00:29:20.600
Eh, not so good, okay.
464
00:29:20.600 --> 00:29:24.250
Platinum or diamond, that is, okay,
465
00:29:24.250 --> 00:29:28.190
some of you are wearing platinum or diamond rings, right?
466
00:29:28.190 --> 00:29:30.563
They were given to you, it's a gift.
467
00:29:31.600 --> 00:29:35.063
Oh well, if it's related to marriage, you know.
468
00:29:36.010 --> 00:29:39.840
But okay, but we'll presume that it's a gift, okay,
469
00:29:39.840 --> 00:29:41.130
and that's what this is.
470
00:29:41.130 --> 00:29:45.760
Platinum and diamond group of open-access journals,
471
00:29:45.760 --> 00:29:48.499
we will look at your article and if we publish it
472
00:29:48.499 --> 00:29:53.030
it will get open-access immediately and it's free
473
00:29:53.030 --> 00:29:54.363
and you don't pay.
474
00:29:55.920 --> 00:30:00.820
At the bottom here are some legitimate open-access
475
00:30:00.820 --> 00:30:05.540
platinum journals that anybody can submit to
476
00:30:05.540 --> 00:30:09.610
and if they accept your article it is published immediately
477
00:30:09.610 --> 00:30:14.610
or after the revisions they ask for and it is free to you
478
00:30:17.090 --> 00:30:19.832
and to people who want to read it.
479
00:30:19.832 --> 00:30:23.200
In ethics, since this is an ethics conference
480
00:30:23.200 --> 00:30:25.620
the "American Medical Association Journal of Ethics"
481
00:30:25.620 --> 00:30:26.933
is the best known.
482
00:30:27.900 --> 00:30:31.710
BMC, the "British Medical Ethics" is another one,
483
00:30:35.790 --> 00:30:39.760
and the "Canadian Journal of Bioethics" is another one.
484
00:30:39.760 --> 00:30:41.160
And who pays for that?
485
00:30:41.160 --> 00:30:44.673
For the AMA journal, it's the AMA, they pay all the costs.
486
00:30:45.730 --> 00:30:50.730
British Medical pays them, Canadian Medical Association
487
00:30:50.910 --> 00:30:55.910
pays 'em, "Journal of the American Heart Association,"
488
00:30:56.800 --> 00:31:00.180
they pay for their articles.
489
00:31:00.180 --> 00:31:04.280
That's platinum, there are very, very, very few platinum
490
00:31:05.160 --> 00:31:07.283
journals available now.
491
00:31:08.220 --> 00:31:09.440
Things may change.
492
00:31:09.440 --> 00:31:12.123
This is rapidly changing area.
493
00:31:13.430 --> 00:31:15.680
And then there's the hybrid journals.
494
00:31:15.680 --> 00:31:18.304
You submitted an article to
495
00:31:18.304 --> 00:31:21.377
the "American Journal of Medicine."
496
00:31:22.720 --> 00:31:27.353
They say, fine, we like your article, we'll publish it.
497
00:31:28.680 --> 00:31:33.620
Would you like to publish it open-access?
498
00:31:33.620 --> 00:31:36.085
'Cause that's an option in our journal.
499
00:31:36.085 --> 00:31:38.070
You know, we have the hard copy
500
00:31:38.070 --> 00:31:40.393
and then we have the ones e-only,
501
00:31:43.440 --> 00:31:47.750
or both print and open-access.
502
00:31:47.750 --> 00:31:50.070
Yes, I'd like to do both.
503
00:31:50.070 --> 00:31:52.453
All right, that'll be $1,000.
504
00:31:53.394 --> 00:31:56.830
Or, they've accepted it.
505
00:31:56.830 --> 00:31:59.690
No, I'd rather it just be in print.
506
00:31:59.690 --> 00:32:03.850
Fine, then it's only available to subscribers,
507
00:32:03.850 --> 00:32:05.270
people who have subscribed
508
00:32:05.270 --> 00:32:07.620
to the "American Journal of Medicine."
509
00:32:07.620 --> 00:32:10.150
And that's happening more and more and more.
510
00:32:10.150 --> 00:32:12.670
There's another tricky thing
511
00:32:12.670 --> 00:32:14.980
that some of these publishers are doing.
512
00:32:14.980 --> 00:32:19.980
You send something in to the "Journal of Pathology," okay.
513
00:32:21.650 --> 00:32:25.416
I don't know why, but okay, but you did and it was accepted.
514
00:32:25.416 --> 00:32:27.580
No, I'm sorry, it wasn't.
515
00:32:27.580 --> 00:32:28.990
Well, we didn't quite like it.
516
00:32:28.990 --> 00:32:33.823
We've had another similar article so we can't publish it.
517
00:32:34.830 --> 00:32:39.830
But here's a link to our sister journal that's open-access
518
00:32:41.970 --> 00:32:43.260
and you can submit it there,
519
00:32:43.260 --> 00:32:45.333
and I'm sure it will be published,
520
00:32:46.676 --> 00:32:50.643
but if it is you'll probably have to pay $1,500.
521
00:32:51.700 --> 00:32:55.680
Very unethical behavior by a lot of publishers now,
522
00:32:55.680 --> 00:32:59.903
and if you're submitting papers you'll see that, okay.
523
00:33:03.280 --> 00:33:06.791
Okay, Plan S, we're not gonna go deeply into Plan S
524
00:33:06.791 --> 00:33:11.791
because it's changing day to day also,
525
00:33:12.090 --> 00:33:15.500
but it's coming mainly out of the European Union,
526
00:33:15.500 --> 00:33:20.500
what's left of the European Union and some funders
527
00:33:20.788 --> 00:33:25.788
like the Gates Foundation, they are basically saying
528
00:33:26.770 --> 00:33:29.133
that there can't be an embargo on the papers.
529
00:33:30.410 --> 00:33:31.801
Things can be used that are published.
530
00:33:31.801 --> 00:33:33.743
It's gonna be open-access.
531
00:33:37.240 --> 00:33:42.240
It's the idea that we first had about open-access journals
532
00:33:42.540 --> 00:33:45.040
is they'll be legitimate, they will publish,
533
00:33:45.040 --> 00:33:48.360
they won't charge you exorbitant fees,
534
00:33:48.360 --> 00:33:52.170
and everybody will have access to 'em.
535
00:33:52.170 --> 00:33:53.383
We'll see what happens.
536
00:33:55.130 --> 00:33:58.070
It's supposed to go into full effect in 2024
537
00:33:58.070 --> 00:34:00.143
but don't hold your breath.
538
00:34:02.120 --> 00:34:04.180
Oh, here, here's one thing that you need to know
539
00:34:04.180 --> 00:34:09.180
just in general, the CC-BY, the Creative Commons License.
540
00:34:09.340 --> 00:34:11.661
For those of you who are publishing or using things
541
00:34:11.661 --> 00:34:14.457
off the web and especially images,
542
00:34:14.457 --> 00:34:19.457
if you look for Creative Commons License,
543
00:34:19.920 --> 00:34:21.490
and it'll be right there on the page
544
00:34:21.490 --> 00:34:24.960
or associated with the illustration.
545
00:34:24.960 --> 00:34:29.050
If you have that and you can take that image,
546
00:34:29.050 --> 00:34:31.500
you can put it in the article you want to publish.
547
00:34:31.500 --> 00:34:36.500
You just have to put the Creative Commons citation down
548
00:34:36.610 --> 00:34:38.670
and publishers will publish it,
549
00:34:38.670 --> 00:34:43.370
and I've used that many times, and it's very useful.
550
00:34:43.370 --> 00:34:46.860
Okay, so it's often very difficult
551
00:34:46.860 --> 00:34:49.955
to distinguish between the two types of gold journals,
552
00:34:49.955 --> 00:34:51.950
the legitimate and illegitimate.
553
00:34:51.950 --> 00:34:54.990
We're gonna talk about how to identify questionable journals
554
00:34:56.560 --> 00:35:00.440
just knowing, as you'll see, that it's not that simple.
555
00:35:00.440 --> 00:35:03.633
But you've got the list from your library,
556
00:35:04.530 --> 00:35:06.897
and these are gonna go over some of those things
557
00:35:06.897 --> 00:35:09.510
and some others, here are some of the questions
558
00:35:09.510 --> 00:35:14.510
you have to ask, okay, and this is from an article we had
559
00:35:14.564 --> 00:35:19.560
in "Academic Medicine" last year.
560
00:35:19.560 --> 00:35:24.560
We're gonna go, okay, journal familiarity.
561
00:35:25.070 --> 00:35:26.729
Have you heard about the journal?
562
00:35:26.729 --> 00:35:29.370
Have your colleagues heard about the journal?
563
00:35:29.370 --> 00:35:31.620
Have your librarians heard about the journal?
564
00:35:33.700 --> 00:35:34.533
Okay.
565
00:35:37.190 --> 00:35:41.830
Is it sponsored by a legitimate organization?
566
00:35:41.830 --> 00:35:46.220
You belong to the American Society of Anesthesiologists.
567
00:35:46.220 --> 00:35:49.640
Is it their journal, is it an offshoot of their journal?
568
00:35:49.640 --> 00:35:51.720
Is that what it says?
569
00:35:51.720 --> 00:35:53.340
Have you read the journal before?
570
00:35:53.340 --> 00:35:56.253
Have you seen an article cited from that journal?
571
00:35:58.560 --> 00:36:03.560
Does the journal's name have something strange in it
572
00:36:03.810 --> 00:36:08.783
like it says "American Journal of Dermatology"
573
00:36:09.890 --> 00:36:14.890
but the English that you're reading isn't American English.
574
00:36:15.530 --> 00:36:19.183
In fact, it's nobody's English, that's pretty common.
575
00:36:21.822 --> 00:36:26.822
Okay, does it look like it's coming addressed
576
00:36:26.890 --> 00:36:29.663
to multiple different audiences simultaneously?
577
00:36:31.030 --> 00:36:36.030
The "Engineering Journal of Biological Physics
578
00:36:38.687 --> 00:36:41.037
"and Skin Disorders."
579
00:36:43.253 --> 00:36:45.600
Certainly I'd go for that.
580
00:36:45.600 --> 00:36:48.050
Solicitations, this is your email.
581
00:36:48.050 --> 00:36:51.550
Did the publisher send you an unsolicited email?
582
00:36:51.550 --> 00:36:54.760
Direct marketing, okay, if it's no
583
00:36:54.760 --> 00:36:57.851
it suggests, the answers I'm giving
584
00:36:57.851 --> 00:37:01.320
suggest that it's a legitimate journal.
585
00:37:01.320 --> 00:37:02.897
So no, they didn't do that.
586
00:37:02.897 --> 00:37:06.290
Did they promise an unusually short submission
587
00:37:06.290 --> 00:37:10.533
to publication time such as a few weeks or a month?
588
00:37:11.500 --> 00:37:14.460
No, although I can tell you that legitimate journals,
589
00:37:14.460 --> 00:37:17.650
especially legitimate medical journals now
590
00:37:17.650 --> 00:37:20.363
are offering to give you an answer,
591
00:37:21.410 --> 00:37:24.790
especially if it's rejected, within a couple weeks.
592
00:37:24.790 --> 00:37:26.678
That's new because there's so much competition
593
00:37:26.678 --> 00:37:31.203
among the legitimate hard copy medical journals.
594
00:37:33.220 --> 00:37:35.850
Can you easily locate the journal's website?
595
00:37:35.850 --> 00:37:40.850
And like I said, and it doesn't have notations saying,
596
00:37:41.170 --> 00:37:43.490
I think this is an illegitimate journal
597
00:37:44.380 --> 00:37:47.450
especially if you're looking through Google.
598
00:37:47.450 --> 00:37:49.853
Does the website appear professional?
599
00:37:51.070 --> 00:37:54.483
Or did some elementary school student put it together?
600
00:37:56.550 --> 00:37:58.360
Are there advertisements?
601
00:37:58.360 --> 00:38:03.110
If they offer you a view at an issue,
602
00:38:03.110 --> 00:38:06.073
are there advertisements from unrelated sources?
603
00:38:06.960 --> 00:38:07.793
You know, like,
604
00:38:11.450 --> 00:38:16.060
I don't know, underwear models in the,
605
00:38:16.060 --> 00:38:18.533
I don't know, AMA does that, well, who knows.
606
00:38:20.690 --> 00:38:23.303
Does the website contain misleading information?
607
00:38:24.830 --> 00:38:26.670
Or many language errors?
608
00:38:26.670 --> 00:38:28.950
Language errors in emails and on the website
609
00:38:28.950 --> 00:38:31.670
are one of the big, big things.
610
00:38:31.670 --> 00:38:35.700
Remember, these are publishers, these are publishers.
611
00:38:35.700 --> 00:38:38.521
They should have vetted their website really well.
612
00:38:38.521 --> 00:38:41.190
Is there full contact information
613
00:38:43.120 --> 00:38:46.140
or just a place to send your money?
614
00:38:46.140 --> 00:38:48.950
Okay, do they talk about the ownership
615
00:38:48.950 --> 00:38:50.513
and management of the journal?
616
00:38:52.310 --> 00:38:54.033
Illegitimate, no.
617
00:38:55.670 --> 00:39:00.670
Business model, we'll go on to editorial board.
618
00:39:00.800 --> 00:39:04.550
Can you recognize the names of the editorial board?
619
00:39:04.550 --> 00:39:06.420
Are they in your specialty, in your area?
620
00:39:06.420 --> 00:39:10.950
One danger, sometimes they'll put names down
621
00:39:10.950 --> 00:39:13.690
that are well known in the field
622
00:39:13.690 --> 00:39:14.930
just on their editorial board.
623
00:39:14.930 --> 00:39:16.900
Have they asked the people?
624
00:39:16.900 --> 00:39:20.240
No, can you get them off of there?
625
00:39:20.240 --> 00:39:23.443
No, people have filed lawsuits to get their names
626
00:39:23.443 --> 00:39:27.400
off of some of these editorial board lists
627
00:39:27.400 --> 00:39:29.650
and they've been unsuccessful
628
00:39:29.650 --> 00:39:31.870
basically because they can't find them
629
00:39:31.870 --> 00:39:34.680
or they're in countries that don't recognize
630
00:39:35.744 --> 00:39:37.953
US, British, Canadian law.
631
00:39:41.540 --> 00:39:45.580
Okay, can you find the journal's latest papers?
632
00:39:45.580 --> 00:39:48.350
I find that very, very useful.
633
00:39:48.350 --> 00:39:53.350
Go to ResearchGate and or Google or something similar
634
00:39:54.040 --> 00:39:56.680
and look for the name of the journal
635
00:39:56.680 --> 00:39:59.390
if you really think you're not sure
636
00:39:59.390 --> 00:40:02.203
and see if there's some recent articles listed.
637
00:40:03.330 --> 00:40:06.960
Okay, are those articles of good quality?
638
00:40:06.960 --> 00:40:11.253
Okay, do they contain the contact information
639
00:40:11.253 --> 00:40:15.593
for the author, if so, contact the authors and see.
640
00:40:16.830 --> 00:40:20.260
Does the journal have the same authors repeatedly
641
00:40:20.260 --> 00:40:22.180
on their articles?
642
00:40:22.180 --> 00:40:25.583
And all you need is a table of contents for that, okay.
643
00:40:28.700 --> 00:40:29.878
Do they have author instructions
644
00:40:29.878 --> 00:40:32.290
or can you submit anything you want?
645
00:40:32.290 --> 00:40:36.381
Big red flag, do they have an external review process
646
00:40:36.381 --> 00:40:37.963
and do they describe it?
647
00:40:40.200 --> 00:40:44.440
Submission fee, now this is where the rubber meets the road.
648
00:40:44.440 --> 00:40:48.060
Do they tell you about submission fees on their website?
649
00:40:48.060 --> 00:40:52.913
Author instructions, a legitimate gold journal will say
650
00:40:54.080 --> 00:40:59.080
if it's accepted we will charge a fee.
651
00:41:00.490 --> 00:41:02.180
And they can have various fees
652
00:41:02.180 --> 00:41:04.880
and they can have graduated fees, all different things
653
00:41:04.880 --> 00:41:06.680
and they can even say, if you're coming
654
00:41:06.680 --> 00:41:09.650
from a developing country we can waive the fee.
655
00:41:09.650 --> 00:41:13.130
And that's all legit, but they don't say anything
656
00:41:13.130 --> 00:41:17.730
about the fee until they accept your paper the next day
657
00:41:17.730 --> 00:41:19.453
that's a problem, okay.
658
00:41:24.120 --> 00:41:29.120
Here are some sites you can go to and these links,
659
00:41:30.466 --> 00:41:35.466
or actually some of these sites are on your library site.
660
00:41:37.556 --> 00:41:41.040
If you go to your library site you can have access
661
00:41:41.040 --> 00:41:43.140
to some of this information.
662
00:41:43.140 --> 00:41:46.161
Whether they are listed on the do not publish
663
00:41:46.161 --> 00:41:50.323
essentially site or on the legitimate site.
664
00:41:52.700 --> 00:41:54.810
Okay, here's one of the big ones,
665
00:41:54.810 --> 00:41:57.789
Beall's List of Predatory Journals
666
00:41:57.789 --> 00:42:00.380
and Publishers and Updates.
667
00:42:00.380 --> 00:42:03.080
And here's the link and that's the one you guys
668
00:42:03.080 --> 00:42:05.590
have a subscription to?
669
00:42:05.590 --> 00:42:08.910
Yes, okay, it's the simplest way--
670
00:42:08.910 --> 00:42:10.013
Cabell's.
I'm sorry?
671
00:42:10.013 --> 00:42:12.688
Cabell's, Cabell's, we have Cabell's blacklist.
672
00:42:12.688 --> 00:42:14.610
Cabell's, okay, they have a different one.
673
00:42:14.610 --> 00:42:16.970
Okay, but that's the easiest way.
674
00:42:16.970 --> 00:42:20.370
Just go down the list, if it's on the list of do not publish
675
00:42:20.370 --> 00:42:25.370
then you don't and if it's on the good one then go for it.
676
00:42:25.650 --> 00:42:28.300
Copyright and embargo, you want to be able
677
00:42:28.300 --> 00:42:32.830
to use your paper, send it around, post it on wherever,
678
00:42:32.830 --> 00:42:34.803
and you need to be able to do that.
679
00:42:37.760 --> 00:42:42.460
If you publish in some of these illegitimate journals
680
00:42:42.460 --> 00:42:43.770
you're not gonna have access
681
00:42:43.770 --> 00:42:46.523
to your publication for other use.
682
00:42:48.600 --> 00:42:51.882
Again, your P&T committees and potential employers
683
00:42:51.882 --> 00:42:56.020
are not going to recognize it or if they do recognize it
684
00:42:56.020 --> 00:42:58.650
are not gonna think highly of you,
685
00:42:58.650 --> 00:43:02.030
and generally they're not accepted for promotion and tenure.
686
00:43:02.030 --> 00:43:07.030
Now ethical issues in general in open-access publishing.
687
00:43:10.452 --> 00:43:13.240
Promotion and tenure committees are looking
688
00:43:13.240 --> 00:43:18.240
at the article processing charges as a measure
689
00:43:18.240 --> 00:43:20.884
of how important the journal is
690
00:43:20.884 --> 00:43:23.303
and how important your paper was.
691
00:43:24.510 --> 00:43:29.250
It may restrict academic freedom if you don't have the money
692
00:43:30.850 --> 00:43:33.063
especially from poorer countries,
693
00:43:34.900 --> 00:43:39.350
and the hybrid journals which are increasing all the time
694
00:43:39.350 --> 00:43:44.350
where they have subscriptions, print publications,
695
00:43:45.180 --> 00:43:48.846
and then they also charge authors fees for open-access.
696
00:43:48.846 --> 00:43:51.230
It's called double-dipping, they're getting money
697
00:43:51.230 --> 00:43:53.450
from everybody at the same time,
698
00:43:53.450 --> 00:43:56.573
and that poses some ethical dilemmas.
699
00:43:57.640 --> 00:43:59.920
Okay, other fake news.
700
00:43:59.920 --> 00:44:02.070
You never heard of fake news before I know.
701
00:44:03.835 --> 00:44:05.968
You haven't heard of fake news?
702
00:44:05.968 --> 00:44:07.083
No.
703
00:44:08.780 --> 00:44:11.380
Well fake news, it comes out in open-access.
704
00:44:11.380 --> 00:44:16.380
The Fox News puts it as a lead and then millions of people
705
00:44:17.190 --> 00:44:21.693
are affected by bad information, ghostwritten research.
706
00:44:25.940 --> 00:44:28.650
Okay, now here's from the Federal Trade Commission,
707
00:44:28.650 --> 00:44:30.840
and this was an official document
708
00:44:31.960 --> 00:44:36.800
published in 2017 about these journals.
709
00:44:36.800 --> 00:44:41.800
They deceptively claim that their journals provide authors
710
00:44:42.280 --> 00:44:45.470
with rigorous peer review and have editorial boards.
711
00:44:45.470 --> 00:44:46.653
In fact they don't.
712
00:44:47.840 --> 00:44:50.570
Editors have not agreed to be affiliated,
713
00:44:50.570 --> 00:44:54.780
and they charge significant fees and do not allow authors
714
00:44:54.780 --> 00:44:57.580
to withdraw their publications once they're sent in.
715
00:44:57.580 --> 00:45:02.015
Who's responsible for guiding you to the right places?
716
00:45:02.015 --> 00:45:05.360
And I've mentioned the librarians multiple times,
717
00:45:05.360 --> 00:45:09.470
but your bioethics committee or your IRBs
718
00:45:09.470 --> 00:45:12.730
should have a role if you go to them.
719
00:45:12.730 --> 00:45:17.710
Colleagues, mentors, other authors in your field,
720
00:45:17.710 --> 00:45:20.470
and your professional organizations.
721
00:45:20.470 --> 00:45:23.350
So everybody has a piece of the pie
722
00:45:23.350 --> 00:45:27.043
to help guide you to the right place, now what?
723
00:45:27.920 --> 00:45:29.270
What are you gonna do?
724
00:45:29.270 --> 00:45:31.250
You have something sitting on your computer.
725
00:45:31.250 --> 00:45:34.170
It's almost ready or it's ready to be sent in.
726
00:45:34.170 --> 00:45:35.420
What are you going to do?
727
00:45:36.910 --> 00:45:41.910
Well, that's up to you and your institution.
728
00:45:42.160 --> 00:45:43.980
They have to help you.
729
00:45:43.980 --> 00:45:48.433
And I hope the resources are there.
730
00:45:50.170 --> 00:45:54.393
Okay, I have no idea, we're stuck, but okay.
731
00:45:56.327 --> 00:45:59.150
Okay, so we'll take questions
732
00:45:59.150 --> 00:46:02.070
and I'm supposed to ask for outsiders to call in
733
00:46:02.070 --> 00:46:04.440
if they would like to.
734
00:46:04.440 --> 00:46:07.503
I promise not to charge you an article processing fee.
735
00:46:09.536 --> 00:46:12.703
(audience applauding)
736
00:46:15.727 --> 00:46:17.687
You're very kind.
737
00:46:17.687 --> 00:46:20.740
One, two, three, okay, yes, sir.
738
00:46:20.740 --> 00:46:25.090
Yeah, so do you think pharmaceutical companies
739
00:46:25.950 --> 00:46:29.435
make high use of these illegitimate journals
740
00:46:29.435 --> 00:46:31.073
to increase profits?
741
00:46:32.070 --> 00:46:35.120
Do pharmaceutical companies
742
00:46:35.120 --> 00:46:40.120
use these open-access journals to increase profits?
743
00:46:40.930 --> 00:46:43.063
They have so many other ways to increase profits
744
00:46:43.063 --> 00:46:48.063
and screw the profession and the public,
745
00:46:49.900 --> 00:46:51.880
they don't make a lot of use of it.
746
00:46:51.880 --> 00:46:56.640
They will publish, get their people to publish in some
747
00:46:56.640 --> 00:47:01.150
of these journals just so they can show the clinicians,
748
00:47:01.150 --> 00:47:04.680
the gullible clinicians, see, we had good results
749
00:47:04.680 --> 00:47:09.330
from our sketchy drug,
750
00:47:09.330 --> 00:47:14.260
but they have lots of other ways of doing it.
751
00:47:14.260 --> 00:47:17.170
Have you seen the commercials on television?
752
00:47:17.170 --> 00:47:21.020
Make your patients demand that they get the drug.
753
00:47:21.020 --> 00:47:23.513
That's a lot better, other questions?
754
00:47:26.610 --> 00:47:28.703
Okay, again, we're good?
755
00:47:30.640 --> 00:47:31.790
Good, good, good, good?
756
00:47:32.660 --> 00:47:36.495
Okay, good luck in your careers, thank you very much.
757
00:47:36.495 --> 00:47:39.662
(audience applauding)