Ebola Wars

What’s it like right now to be on the front lines of treating Ebola victims in West Africa, or in the past few weeks, even here in the US? Given that this battle might be waged in my community tomorrow, it would be nice to know that we healthcare providers are getting smarter in humanity’s tectonic battle. The traditional peer-reviewed journals do a credible job of publishing the major studies for a disease like Ebola, even on an accelerated basis; in fact when it comes to hot subjects like Ebola, such journals cannot publish fast enough. It may well be, however, that this disease is not defeated by a big scientific breakthroughs or insights, but rather myriad little things. In fact that is the kind of stuff I want to learn about; which detailed little steps in terms of containment, infection control, tracing of contacts etc. seem to be working against this disease and which are not?

Clearly something wasn’t working correctly when two nurses caring for the first Ebola patient in the U.S. contracted the disease! Over the past week I have certainly received my daily dose of The New York Times and NBC TV reporting about what went wrong, however, I would like to read about the subject after it has been vetted by medical professionals via the peer review process. What, if anything, did the infectious disease unit, ICU or any other staff at Dallas Presbyterian learn in the past 2 weeks? It seems impossible to believe that absolutely nothing has been learned. Even if expert analysis of the problem is incomplete, they probably have some working hypotheses. Is training an issue? Are the wrong gowns being used? What about facial splash shields? There are dozens and dozens of small things being practiced by the medical teams caring for Ebola patients, some of which worked and some which might not have, yet for most of us, the best source of info is, frustratingly enough, the news media.

Clearly my “ask” will find its share of critics. It is rightfully argued that incomplete knowledge is misleading and potentially dangerous if misinterpreted. If the physicians on the front lines of the Ebola fight arrive at incorrect conclusions as a result of a rushed analysis and this information is passed on to the medical community via journals, patients could die. But such a paternalistic critique assumes that the physicians and nurses reading the early lessons of this war are incapable of understanding that such observations are preliminary. How can it not be better to learn from experienced healthcare providers via medical journals than it is to rely on mass media or alternatively, know nothing?

The current approach to disseminating knowledge about the Ebola fight seems to be through panels of “experts” like the CDC or Doctors without Borders or other Federal and State government organizations. This method of establishing protocols is, in an emergency, clearly necessary and needs to be done. Anyone who has ever participated on such committees, however, will tell you that political considerations invariably color recommendations, especially when quality information is scant. For this reason I believe that rapid communication via the peer-reviewed publication process can supplement expert guidelines and keep the “expert” community from straying into all too common political minefields. Moreover, even experts can wrongly interpret some procedure as being inconsequential when in fact it is the key to success. When it comes to publishing seemingly trivial information about a scary and fast moving disease like Ebola, I say simply, “bring it on.”

What if the secret to controlling Ebola is a specific technique for cleaning bedpans? And what if some low ranking nurse has stumbled upon the answer about how to do it right? What if, unsurprisingly, the big government experts are oblivious to this nurse’s unique insight? It might well take 100 years before such unglamorous information was to make it into Lancet or NEJM; there are just so many barriers to vetting and communicating this type of idea in the conventional medical journal world. It is into this void that Cureus would like to boldly step. In the Cureus world of publishing no medical idea submitted in scientific good faith is too humble to be vetted and rapidly and widely communicated through the peer review process. So I say, if clean bedpans could be the answer to eradicating Ebola, let’s hear your story. And once it is published, I trust the wider court of medical expertise will be there to either vet or discredit your idea through Cureus’ SIQ process. A great idea, no matter how humble the origins, is a terrible thing to waste during an epidemic like Ebola.

Although I am far away from the front lines of Ebola, I have been in the trenches of publishing in peer-reviewed medical journals for almost 30 years and I am doubtful that all important information is being documented at the rate at which it’s learned. Nevertheless, since I am not an infectious disease expert nor on the front lines of the current epidemic, I’d love to hear what experienced (with Ebola) physicians think about the hypothesis I have put forward here.

Cureus Advisor Dr. George Lundberg Wins 2014 ASCP Ward Burdick Award for Distinguished Service to Pathology

Cureus is thrilled to share the news that Dr. George Lundberg, special advisor to Cureus, was recently bestowed the 2014 ASCP Ward Burick Award for Distinguished Service to Pathology. Awarded annually by the Board of Directors of the American Society for Clinical Pathology (ASCP), the ASCP Ward Burick Award was presented to Dr. Lundberg during the ASCP Annual Meeting in Tampa, Florida on October 9.

Citing Dr. Lundberg’s illustrious career and extensive history as both educator and editor, the ASCP stated, “Dr. Lundberg has advocated for pathologists to play the critical role as the ‘interpreter’ who guides clinicians to select the appropriate diagnostic test and encourages medical laboratories to focus on the quality outcomes of diagnostic testing, rather than the volume of testing they perform.”

Dr. George LundbergWhen asked for his reactions to winning the ASCP Ward Burick Award, Dr. George Lundberg stated, “I have always, or at least since about 1969, believed that a laboratory test is a loop that begins when an individual decides to obtain a laboratory test, proceeds through a series of some 9 steps such as ordering, specimen collection, transportation, analysis, reporting and interpretation and ends with an action. Like a chain being only as strong as its weakest link, the test is only valid if all steps are completed correctly. In 2014, in AJCP, I proposed that we should add a 10th step…outcome….as a routine in what has come to be known as the ‘Brain to Brain Loop in Laboratory Testing.'”

Join us in congratulating Dr. Lundberg on his achievement – we are thrilled that he is part of the Cureus team!

SBMT and Cureus Team Up To Accelerate the Publication of Leading Edge Neuroscience

One challenge of the twenty-first century is to catalyze the development of medical advances from basic science. To help accelerate diagnostic and therapeutic discoveries, one of the leading multispecialty and multidisciplinary associations, Society for Brain Mapping and Therapeutics, has teamed with Cureus, an innovative online open-access medical journal, to bring together clinicians, scientists, engineers and policy makers from multiple disciplines who share this aspiration of improving patient care. The two cutting edge organizations believe their partnership is essential to bring about advances in neurosurgery, radiology, neurology, stem cell research, nanotechnology and psychiatry.

“Cureus is a free, open access, peer-reviewed journal that rapidly publishes a broad range of medical science including all types of articles, posters and meeting abstracts,” said John Adler, Professor of Neurosurgery at Stanford University and Cureus Founder.

Cureus’ browser based tools enable well written articles to be routinely peer reviewed and published in less than one week. The journal is the first and only journal employing “crowd sourcing” to ascertain the scientific quality of published peer-reviewed articles. While accepting a broad range of medical science, Cureus focuses on advanced technology and innovative medical procedures. Additionally, case reports are enthusiastically welcomed and routinely published.

“Cureus seeks to find the broadest possible audience for every paper, including curious patients, and uniquely offers a “Patient Reported Outcome” section that runs in parallel with articles reporting clinical outcomes,” stated John Adler.

Cureus also uniquely supports the solicitation of charitable gifts to an author’s not-for-profit research fund; this could be a great tool for SBMT, which is a non-profit organization that encourages scientists in areas of brain mapping, engineering, stem cells, nanotechnology, imaging, and medical devices to improve the diagnosis, treatment and rehabilitation of patients with neurological disorders.

“We believe this collaboration will provide an additional tool for our colleagues and members who are thinking out of the box and taking a multidisciplinary approach to solving complex neurological disorders,” said Dr. Ramin Rak, SBMT board member and neurosurgeon at Winthrop University.

Cureus and SBMT will be exhibiting their vision at the Congress of Neurological Surgeons in Boston, MA next week from October 20-22 at booth 660 in the exhibit hall of the Boston Convention Center.

To learn more about SBMT, visit http://www.worldbrainmapping.org

ZEISS/Cureus Competition Spotlight: 1st & 2nd Place Articles

ZEISS recently partnered with Cureus to host a publishing competition focused on microscope-integrated intraoperative fluorescence. The competition attracted articles submitted from all over the world, with the final field of published articles standing at 10. While prizes have already been awarded, we wanted to take some time to recognize a few of the highest-scoring articles.

The articles featured today finished the competition in 1st and 2nd place, respectively.

With a final SIQ score of 7.5, the winner of the Grand Prize for Scientific Acclaim, A Bioengineered Peptide that Localizes to and Illuminates Medulloblastoma: A New Tool with Potential for Fluorescence-Guided Surgical Resection was submitted by Shelley Ackerman, Christy Wilson, Suzana Kahn, James Kintzing, Darren Jindal, Samuel Cheshier, Gerald Grant & Jennifer Cochran.

Cureus Co-Editor-in-Chief Dr. Alexander Muacevic had this to say about the winning article, “It’s all about finding ways to better illuminate brain tumors for complete tumor resection – something I feel this article certainly accomplished.”

The 2nd place article, recieving an SIQ score of 7.0, was Fluorescence-Guided Tumor Visualization Using the Tumor Paint BLZ-100, and was submitted by David Kittle, Adam Mamelak, Julia Parrish-Novak, Stacey Hansen, Rameshwar Patil, Pallavi Gangalum, Julia Ljubimova, Keith Black and Pramod Butte.

Dr. Muacevic, again with his thoughts: “This is an interesting new innovation and I congratulate the authors for their work. They developed an imaging system for in-vivo imaging of the tumor ligand BLZ-100 for use in surgical resections of gliomas. Next step is to prove the clinical application. Ultimately the question remains if a clinical benefit in terms of prolonged survival can be demonstrated using this new innovation.”

Meanwhile, Cureus Founder and Co-Editor-in-Chief, Dr. John Adler chipped in with his reaction: “Both of these gorgeous articles are examples of cutting edge science which will enable futuristic intraoperative fluorescence techniques to do ever better tumor resections.”

We’re thrilled that these excellent articles were submitted and published as part of the competition and we’re looking forward to publishing many more as our competitions continue! Stay tuned for a look at the 3rd place article!

Cureus in the Field: A Visit to Carl Zeiss Meditec

ZEISS 1 A few members of the Cureus team recently took some time out of their day to visit the folks over at Carl Zeiss Meditec in warm, sunny Dublin, California. (Weather that is, sadly, all too rare here in San Francisco.) The purpose of our visit was to provide a wrap-up of the recently concluded ZEISS/Cureus Intraoperative Fluorescence Publishing Competition.

We delivered the final competition statistics and took a look at all of the great articles submitted as part of the competition. We can’t thank ZEISS enough for taking a chance on this original and exciting marketing opportunity, an opportunity that both parties can now comfortably label a success!

Stay tuned for more information on future Cureus publishing competitions and feel free to reach out to us at info@cureus.com if your organization is interested in learning more about this exciting opportunity!

IMG_2094

IMG_2095

ZEISS & Cureus Intraoperative Fluorescence Competition Results

Five months, ten published articles and countless article views later, we’ve finally arrived at the finish line. Cureus would like to thank all of the submitting authors for their excellent work, the reviewer panel for their tireless efforts and the Cureus community for pitching in to read and score the articles. By publishing ten articles on the topic of microscope-integrated intraoperative fluorescence, we’ve managed to increase the world literature on the topic by roughly 27%!

Additionally, the competition has thus far generated 19,617 article views and 377 article scorings – we’re beyond excited that our authors’ work has generated such a fevered response.

As a reminder, prizes are awarded to three articles: The Grand Prize for Scientific Acclaim ($3,000) is awarded to the article with the highest SIQ score. Educator Awards ($1,000 each) are awarded to two articles: the most viewed article and the article receiving the most audience engagement (SIQ scorings + comments).

Without further ado, we’re pleased to announce the winning articles of the ZEISS/Cureus Intraoperative Fluorescence Publishing Competition:

Grand Prize for Scientific Acclaim (7.5 SIQ): “A Bioengineered Peptide that Localizes to and Illuminates Medulloblastoma: A New Tool with Potential for Fluorescence-Guided Surgical Resection” by Ackerman, Wilson, Kahn, Kintzing, Jindal, Cheshier, Grant & Cochran

Educator Award (6,713 article views): “The Use of 5-ALA in Glioblastoma Resection: Two Cases with Long-Term Progression-Free Survival” by Awad & Sloan

Educator Award (92 audience actions): “Intraoperative Photodynamic Surgery (iPDS) with Acridine Orange for Musculoskeletal Sarcomas​” by Kusuzaki, Matsubara, Satonaka, Matsumine, Nakamura, Sudo, Murata, Hosogi & Baldini

Winning submitting authors will be contacted with additional instructions for claiming their prizes.

Complete competition statistics:

  • 19,617 article views
  • 377 SIQ scorings
  • 80 author and audience article shares
  • 670 clicks resulting from these shares
  • 8 minutes – the average engagement time per user

Thanks again to all of the competition authors, reviewers and community members for helping determine our winners. Please feel free to contact us at info@cureus.com if you’d like to learn more about our publishing competitions.

Introducing Patient Reported Outcomes: Telling Both Sides of the Story

We’re excited to announce the addition of Patient Reported Outcomes to Cureus! Cureus articles are written by practicing physicians or medical researchers with an audience consisting of largely the same population. With Patient Reported Outcomes (PROs), Cureus is adding a new wrinkle to this tried-and-true system by allowing patients studied within Cureus articles to share the spotlight with the physicians and researchers.

With a PRO, a patient gets to share his or her experience from the other side of the knife, so to speak. From consultation to procedure to post-op, our readers can get a layman’s perspective while also learning what it would be like to undergo such a procedure themselves. Not only are PROs beneficial to potential patients, but to doctors as well. The inclusion of a Patient Reported Outcome with your published article can provide relevant, easily digestible evidence when recommending certain procedures to your current patients – just direct them to the PRO as a way of educating them about a potential course of action.

A recently published PROEach submitted PRO receives editing for spelling and grammatical errors by Cureus staff, but all PROs are otherwise published as is, with no interference from the article authors or the Cureus editorial team. PRO authors can also include supplemental images to be published alongside their words.

Check out our first published PROs below! Just click on the link and then click the purple “PRO” tab near the top of the article to read the patient reported outcomes for the following articles:

Transient Tumor Volume Increase in Vestibular Schwannomas after Radiotherapy

CyberKnife Ablation for Intramedullary Spinal Cord Arteriovenous Malformations (AVMs): A Promising New Therapeutic Approach

Would you like to add a PRO to one of your published articles? Contact your patient today – once patient consent has been obtained, we’ll gladly start a dialogue with the patient author!