This is a really tough problem to solve. Getting research into the public's hands isn't very difficult because you can just put pre-prints into biorxiv or medrxiv. Doesn't really matter what the content is as long as it follows the formatting guideline. I think the bigger problem with those platforms is the limited functionality to interact with the content. It's basically no different from just reading printed paper. What currently gives the research weight is the peer review process and the "scarcity" perception of the publishing outlet. Peer review is already highly skilled unpaid work because journals maintain their monopoly over the process, and the journals themselves manufacture scarcity by publishing only what they think brings them more money. By extension, funding typically goes to researchers that publish in those artificially scarce journals. That creates a lot of intertia in the system.

Getting citations on published work is also validation that the research is valuable because it implies others are building on top of it, or adjacent to it, or at least recognized in some way. If works published through medschlr start getting cited through other various channels then that could boost its legitimacy. There's still the peer review problem to deal with though.

Totally @smallworlnd. Many issues to ponder especially while building a decentralized censorship resistant publishing platform like MedSchlr. Thinking about the point around the limited ability to interact with pre-print content of such kind, a gap that MedSchlr could fill since it is a Nostr native social networking knowledge commons that integrates @GitCitadel Alexandria library is infrastructure for engagement and learning that traditional platforms are without. It could be a viable tool that: 1) encourages individual learning in a novel way. In a user’s MedSchlr instance they could create lists, publish new content, remix other content with attribution, reference external links to articles using doi’s; 2) allows users to follow, comment, and synthesize related content of people they follow; 3) be a network of discovery and organic community formation not just for healthcare professionals and researchers but other users interested in medicine and health. The features and health related content are somewhat starting to take shape now, and that’s why we are building a landing page to help guide interested users. There are many things to consider like relays and quality standards. If users aren’t using the same relay how would they be able to see others content and discover new? And also how is quality determined of academic works, web-of-trust? For ‘academic’ quality publication is it enough to have a charter that notes the rules of the community and for different study publication types ensure publication guidelines with checklists like CONSORT for randomized controlled trials as an example? There may need to be a degree of centralization for certain user groups but the decentralization could help to further reach and transparency. Another aspect where MedSchlr could shine is content types. There could be transcriptions of videos, podcasts, etc. of medical and heath sciences information. This is already possible using #Alexandria. This would greatly expand what pre-print sites allow. On the note of the publishing inertia, zaps, might potentially be a way to incentivize people to publish papers on Nostr and could be indexed in MedSchlr. Professional communities could form and could create new peer-review processes using the new value incentive structure. These are all preliminary ideas to see how to leverage the MedSchlr-Alexandria-nostr ecosystem to better medical and health sciences publishing. Additional thoughts are always welcome.

Excellent point re: citations.

@liminal 🦠 great discussion here by @smallworlnd

I'd say Alexandria is less a place for scientific publications and more a place to facilitate discussions. The things that happen before a final publication. For the medical health sciences, MedSchlr can be a place to break down studies for different audiences or even collaborating with someone else's interesting notes.

I like the ideas for novel ways of interacting with research you mentioned here. It's all very compelling from a user perspective, but maybe even more so is the potential for organic growth beyond what we might imagine currently. It could be something that lowers the barrier to entry for "non experts" to learn and engage, and maybe even to contribute to experiments and validation but that won't be the case for most experiments. Equipment and materials are expensive in many fields of research. Either way, making research more accessible, and open to both interaction and discussion is a great way to build trust. As for attracting research to Nostr, I'm ambivalent about zaps as an incentive. The problem is that it's an incentive that may or may not align with the vision of making research more open and accessible and, more importantly, building trust. Contrary to some narratives out there, I know plenty of people that are die-hard scientists with a genuine curiosity about the world. Money is just another necessary tool to keep the research going, and they honestly couldn't care less about it. That said, the current paradigm of "publish or perish" is not so different from zapping in that it, too, is just an incentive that may or may not align with good science. The same ambivalence I have about zaps to attract content applies to the peer review process. Currently peer review is unpaid work, which is actually criminal, but introducing zaps from anyone to anyone for peer review can also have a corrupting effect. I honestly don't have a good solution that applies universally, and I'm not sure there is one, but good solutions may evolve organically depending on unique sets of conditions.

What you’ve said about zaps makes sense. It could be a negative incentive in some cases but signal for blog style and emergent pieces of scholarship possibly. Organic growth will be critical to help identify use cases among different stakeholder groups.

Great discussion all around. My hope for MedSchlr is to have discussions around emerging solutions to chronic disease. As an example, suppose a low-risk intervention on a disease. Suppose that low-risk intervention is not widely supported, for any number of reasons. Suppose one main reason: the low-risk intervention in question uses non-patented natural medicines, or pharmaceuticals with expired patents, or both, and suppose that if the intervention is found to be helpful against one or more chronic disease, that it will represent a real threat to pharma profits and reduce the need for expensive surgical procedures. Now suppose there are regular people, some with chronic diseases, who like to try stuff and read scientific developments on health topics (enter biohackers). Suppose that some of them are trying some emerging protocols already and suppose we just suggest to them a template for documenting their results as a case study. And suppose those who get on board start publishing their case studies individually. Could be on MedSchlr for discussion. The example I'm writing of is real world for me. Dr. Makis' protocol using ivermectin and fenbendazol has been reported to help cancer patients shrink their tumours. So if it's good for shrinking tumours, what about shrinking non-cancerous growths like endometriosis or fibroids? As a biohacker I tried most of this protocol (I didn't use the vitamin C or the HBOT, but did use pretty much everything else). I did it for 12 weeks. An endometrioma cyst that used to be visible by ultrasound for years on my left ovary was gone after 12 weeks of this protocol. Wrt fibroids, the results were less conclusive. Two fibroids grew and two shrank. Overall total volume of fibroids grew, but at a slower rate than recorded from prior ultrasounds. Symptoms related to the fibroids disappeared for the duration of the protocol. I would love to try another 12 weeks with more rigorous controls and documentation and publish it on MedSchlr or wherever people could access it to discuss constructively. Here's the protocol: https://isom.ca/wp-content/uploads/2024/09/Targeting-the-Mitochondrial-Stem-Cell-Connection-in-Cancer-Treatment-JOM-39.3.pdf

Thank you for your thoughtful feedback and input. MedSchlr strives to be a place where experience and information can flow for learning purposes around chronic diseases and other health and medical sciences topics. Based on your feedback, we are currently drafting and contemplating use of a content/publishing guideline for general content, personal experience reports, and self-documented case studies. Potentially if interest increases there could be additional guidelines for other major content types that aim to be ‘peer-reviewed’ literature etc. What you describe for your particular use case sounds like a self-documented case study. We’ll appreciate your feedback once the guideline is published and see how it can work for your needs and more broadly for others interested in this type of content publication. Additional thoughts are always welcome in this early development phase of MedSchlr.