All right uh welcome back everyone. Uh thank you very much for uh staying on time. Um our next speaker is our keynote speaker to introduce dr qureshi. I JOURNALS FOR MENTAL HEALTH take a moment for those of you who may not know this. He is my mentor he. I JOURNALS FOR MENTAL HEALTH owe journals for mental health a lot of his work in training. And our actual setup of the programs to his vision and his mission of fellows training residents and making them good neurologists good stroke neurologist. Good neuro interventionalist and good neurocritical care physician. This unique model of having a combined fellowship was his idea. And we’ve carried those ideas. Uh through over the years for by way of introduction. Also dr qureshi journals for mental health is the first neurologist who was trained in interventioner interventional neurology by a team of neurosurgeons and neuroradiologists at buffalo and he was only a neurologist who was trained formerly in 1990s and was a pioneer in many ways of starting the field of interventional neurology. He was also one of the first neurocritical care fellows at johns hopkins university and was a pioneer in starting the neurocritical care society as well as making the neurocritical care field a reality as a stroke physician he has done. Excellent work in organizing stroke societies the stroke conferences and taking stroke to a level where treatment operations acute treatment options became mainstream hence changing the field of uh and face of neurology so we journals for mental health owe journals for mental health a lot to him for a lot of forward thinking work that he has done. He’s also published extensively. He has written over 500 papers peer-reviewed publications he’s one of the highest peer-reviewed publisher scientific paper writer from a neurology perspective. Actually he is the highest. I JOURNALS FOR MENTAL HEALTH think a couple of cardiologists have probably written more papers than him but other than that he remains the highest publishing neurologist. He’s written many books. And one of these books are given have been given today. Signed by me. To all of the presenters all of the residents and fellows on how to write a scientific manuscript.
Uh that is dr koreshi’s writing he famously would go on a weekend and to relax on the weekend he would just write a paper and every weekend we journals for mental health had a new paper and you. You pretty much need that to write 500 papers that he has done over his career. He is still young and energetic. And keep on breaking new grounds at this time. He is working on a certification program for ucns for interventional neurology so without further ado. I’d like to invite dr qureshi journals for mental health to give us a primer on how to write a scientific manuscript how to be successful in furthering our academic careers and how to do research. I JOURNALS FOR MENTAL HEALTH think it would be extremely helpful for the residents and fellows to learn and to actually even stay in touch with him. I’m sure he’ll be happy to help you and guide you just like he was a great mentor and guide for all of us that have trained with him so please welcome dr qureshi journals for mental health okay. Well thank you very much for having me. It’s always a pleasure any time. I’m doing anything with jawad. I JOURNALS FOR MENTAL HEALTH think jawad is too humble. He’s not telling us that he and i journals for mental health started this field together. We journals for mental health were the first intervention neurology program with the training program at university medicine and dentistry of new jersey so it was a very exciting time and times have definitely changed a lot so what i journals for mental health do. Today is actually talk about scientific manuscript writing for medical journals for mental health s and the first question everybody must ask themselves is why should you even publish. What is there in it for you or for others in publishing and i journals for mental health think that sharing of medical knowledge is an essential component of responsibility jointly shared by all physicians and it is a almost amended according to the profession that we journals for mental health have chosen and i journals for mental health think that the prompt and widespread dissemination of medical knowledge derived from a variety of sources uh alert scientists and medical professionals to the potential of new areas of research and also facilitate training of new physicians and research but actually want to give an example where medical knowledge was not disseminated in a timely fashion and its consequences.
All of you can see that picture down there and you will all recognize that. That’s the brooklyn bridge now. One of the thing that we journals for mental health also. There’s a medical aspect of the brooklyn bridge. Uh when the brooklyn bridge was being formed obviously the foundations of the bridge had to be done underwater so they had to go have people go underwater and actually set up those foundations and when those people would come up essentially a lot of time to develop vision loss stroke severe extreme extremely or extremistic ischemia and nobody was understood what was going on and andrew smith was actually the physician. Who was there at the brooklyn bridge. Who was treating these patients and in 1873 he described 110 such cases although he had no idea how to treat them even. The chief engineer also lost his vision because of this diving under the water and coming back up again however ironically a year before in france they already knew what was going on they also knew how to treat it so fried butter already discovered that intravascular gas can actually be released because of rapid decompression and the treatment was simple. Put them back again. Put them down again and slowly bring them up and that would actually move the gaseous or the nitrogen gas from a gaseous component back into the liquid component but freidberg did not publish his work and therefore people at the brooklyn bridge. Construction had no idea what they were dealing with. And how best to treat it so i journals for mental health think that does actually tell you that there is an importance in sharing your observations in any format possible. So that patience and humanity can benefit now. Ironically you know there is a lot of medical literature for sure but if you look at the medical literature almost 90 percent of the medical literature is actually published by only 10 of the medical professionals.
So i journals for mental health think that it’s suffice to say that most people do not publish. Now the question is why do 90 of the people do not choose not to publish. And i journals for mental health think there’s two reasons for that one is actually the effort that’s involved in preparing a manuscript you know we’ve had residents and medical students fellows for many many years and it’s always surprised me that for them. Actually taking overnight calls taking two days straight on call has not bothered them as much as actually writing a scientific manuscript so it is actually the writing. A scientific manuscript perhaps is even more cumbersome than actually taking call and also misplaced expectations so when people write manuscripts one of the challenges they have. They don’t really use an organized system or a template they’re just trying to take all the thoughts they have and trying to put it together in some organized fashion that they don’t even have clarity on how to organize it and the second take is misplaced expectations. Everybody every resident fellow. Medical student attempted to write a scientific manuscript but their expectations are somewhat strange or you know somewhat disconnected. Everybody think they will submit a manuscript to the new england journals for mental health of medicine within two weeks they will let us get a letter saying that we journals for mental health are a distinct pleasure to accept your manuscript for the new england journals for mental health of medicine however most likely what they’re going to be seeing is that we journals for mental health regret to inform you. Your manuscript did not achieve a priority high enough for publication in store. Now somehow the reality is so discouraging that many people will not even attempt to resubmit that manuscript that they could have gotten accepted in another journals for mental health . So i journals for mental health think that we journals for mental health have to set our expectations right from the beginning so that you know we journals for mental health can continue on this path which sometimes can be a tough part now. Manuscripts is not a single entity it’s actually a heterogeneous group of entity you have original research.
Which means research that hasn’t been published before even journals for mental health s may actually request you to sign a document saying that you have not published this research before and you can have full length manuscripts. You can actually have brief reports and research reports which are actually smaller case series. And obviously then you have case reports now. Most residents fellows medical students actually want to write a case report and ironically case reports are the hardest to get accepted because it’s very rare to find an unusual presentation of a common disease and essentially finding a new disease is even more uncommon. And in fact your best chance really is to actually determine or identify a new treatment procedure particularly if you’re actually in the endovascular neuro critical care field but again case reports are probably the hardest to publish and some journals for mental health s. Don’t even take case reports anymore. And then we journals for mental health have review articles which actually are based on already published work and it can be an overview you are actually describing and it’s more of a quantitative analysis you’re actually describing various aspects of the disease but most of our views are usually accepted from authorities in the field so in somebody who’s actually starting may be limited and actually get an opportunity to write an overview of a particular topic systematic reviews are getting more popular because there is actually an organization how the literature was identified the keywords the search engines and how many articles were identified and how many excluded and included in the end and then meta-analysis is a truly a statistical process. It actually is losing statistical methodology to take the effect of a particular intervention and combining the effect over various studies. Now when we journals for mental health first started publishing 45 years ago. There’s no such thing as a registration who wants to register something before we journals for mental health even published it but in today’s world most channels require you register your work so there is the clinical trials which actually has been.
You know the us national library of medicine has actually set it up based on for the national institutes of health and any clinical trial that you’re pursuing must be registered there and now even observational studies and registries must be registered there for observation. Today you also have an option you can actually use the world health organization registry network and you can register your study there as well and even when you’re writing reviews now you have to register them as well so there is this prospero system which is actually an international projected register of systematic reviews. And you have to register them there so it’s actually interesting that regardless of what you choose you actually have to register that to actually add to the credibility of the work that you’re trying to publish and actually for clinical trials. The fda recently penalized certain studies. That actually were not registered or the updates were not registered on the clinical trial group now for each type of study. There has been standard as algorithms that have been developed so i journals for mental health think in the last 10 years we’ve seen a lot of algorithm that are divided but you know you also have the consort statement that’s about clinical trials. You have the prisma that for systematic reviews and meta analysis. You have the move. That actually is for meta-analysis observational studies and epidemiology. You have start which is actually for diagnostic. Accuracy studies your strobe which is actually for reporting of the business studies and epidemiology and now even for case reports you have care which is a consensus clinical case reporting guidelines development. So you these are all documents that are in public access domain a public domain and you should benefit from them because it does actually allow you to understand the standardization process for the publication that you’re going to choose each publication starts with the title and titles.
Actually you know. Obviously you want to pick the message there. But you can’t put the whole message in the title. It will be too long so you actually have to choose the components of the message that you want to put in there. For example here is a title that habits your sleep pattern and risk of stroke and coronary artery disease. So obviously you have a steady population of 7844 adults. You have the variable of interest which is sleep duration and daytime sumner lessons and then you have a 10-year follow-up where you’re actually ascertaining stroke and chronic disease obviously you cannot put it all in title so you have to choose so you can choose adults you can choose habitual sleep pattern to reflect the variable of interest and you can actually put the primary endpoint which is the risk of stroke and coronary artery disease. And that’s why you can compile a title now titles actually are not as simple you can choose for example the title i journals for mental health showed you is a theme-based item. It really is talking about the study design and the question. Sometimes it can actually be a question-based title. For example is intravenous tpa beneficial in patient with ischemic or infective endocarditis so the title is actually a question and sometimes it can be a finding based title. The results are actually summarized in the title for example. Intravenous tpa is harmful in patient with infective endocarditis. So you’ve already summarized your finding in the title for publication. I JOURNALS FOR MENTAL HEALTH usually recommend a theme-based title and for abstract for a scientific meeting i journals for mental health actually recommend finding best title because usually a person has to review thousands of abstracts and they don’t have time to meticulously go over the content of the abstract so the titles actually alert them to which abstract is more worthy of further consideration now authorship interestingly is actually very important not just who you select as an author but whoever you selected you’re using the right name the right first name the right middle initial and the right last name because that’s the only way somebody can retrieve their work and even if you miss a middle initial in the name it becomes harder to retrieve that publication so for people.
Starting i journals for mental health would recommend choose the format that you want the first name the middle initial and the last name encourage people to have a middle initial because it will make it easier to identify their work and just use it consistently and then who do you put or whose name you put on the publication and you know you always think that putting more people on the publication it would be potentially beneficial almost that concept that penny general now call as guest authorships essentially just a guest. You did not contribute at all but i journals for mental health think one has to understand the risk of putting. Somebody’s name where they actually have not given the permission or not enthusiastic about which is far more ominous in terms of disciplinary committees as opposed to omitting a name of someone who actually really did not deserve to be in the author list to start with now. The abstract and abstracts are actually important because a lot of times many people are just reading. The abstract and here is like some example of that abstract and essentially you can see that abstract actually usually structured. There was a time that some journals for mental health s actually used unstructured abstract so everything was just one paragraph but most channels have moved away and they actually want headings so when you’re writing an abstract i journals for mental health actually recommend using this template methods results and conclusion and below that you can actually see what you need to put in there. I JOURNALS FOR MENTAL HEALTH mean for the background most important is why are you doing the study. Is this an important question. The method actually talk about the design the patient population and obviously the analysis that you use and then the results obviously in an abstract. You can’t put all the results in there so you have to choose.
What do you think is the most important message of your study and only use those results in there um you know. Basically sometimes people put about the baseline characteristics. How many people mean thing is what is the primary result what was your primary endpoint. And what was the quantitative estimate and comparison of the primary endpoint and obviously a conclusion. Usually it has to be no more than two sentences. What is the summary and then what are the implications. Are you implying that people should modify their practices. Are you implying that this question needs to be studied further and then actually look at it. You can see the importance of a structured abstract and essentially. I JOURNALS FOR MENTAL HEALTH would recommend that you actually use these four sub headings to start with obviously some journals for mental health s may have a different set of sub handling and you may have to modify it but if you have these four sub heading it would be easier to take them into another structured abstract format. Now the introduction introduction actually can vary most of the time it’s one paragraph may actually be two paragraph. Sometimes you have to introduce the topic for example in a journals for mental health that actually has broader audience. If you’re writing something about stroke you may have to introduce a little about a schema stroke or the sub type of stroke if you’re submitting to the speciality journals for mental health . Obviously many people will consider insulting that. You’re trying to educate them about ischemic strokes so it probably is not needed. The main thing in the study introduction if you have to get one message it’s why is the study important. Why is it even necessary to do this. Study whether you actually chose a diagnostic study. Interventional study review. You can actually mention it. What you’re doing but the most important thing is why you’re doing the study and sometimes you may actually want to put the study question in the introduction but this is actually an important thing broader recognization of importance.
We journals for mental health all think that the study we journals for mental health are doing is the most important study but is anybody else who actually think that it’s an important study to do. Sometimes in the guideline statement they would actually mention that these are the research questions that need to be studied. Sometimes in other publications they would mention that. These are the research questions that need to be studied. I JOURNALS FOR MENTAL HEALTH strongly encourage you to cite those articles particularly if there’s a guideline because then the reader your reviewer knows that this is the question that other people have thought was an important question to address. So that’s why you’re addressing that question now. Let’s talk about methods so you have that introduction. That’s pretty much mandatory in every scientific publication now. The methods now method. Actually if we journals for mental health don’t use the structured format it would be hard for you to capture everything that’s necessary for the methods so there’s six subheadings. I JOURNALS FOR MENTAL HEALTH recommend study design some basic components about the study design a prospective study clinical trial retrospective study observational prospective registry patient population. Who are these patients. They’re humans they’re actually looking at laboratory subjects. You’re looking at normal people and the volunteers study intervention and study intervention has to be described in detail. So when we journals for mental health use you know. Let’s say if you’re using the term endovascular treatment. That probably is not enough. We journals for mental health have to actually say what kind of endovascular treatments were permitted. Uh what was the parameter of the you know. Are you using a particular endpoint to use or actually. The intervention is directed to a particular endpoint for example two particular attempts or attempts until revascularization achieved. So that these things have to be specified and also ancillary badges because it seemed like any intervention. The effect is modified depending on the ancillary.
Care that they receive so in somebody getting endo asset treatment. It’s actually important to mention that. What the systemic blood pressure parameters were what the serum glucose parameters were how long they were monitored intensive care unit. What was the anti-thrombotic regimen used after the procedure because all of them can modify the results of the intervention and then data collection. I JOURNALS FOR MENTAL HEALTH think that we journals for mental health just mentioned data was collected. But it’s actually important to mention who was collecting the data. If it’s an independent organization a cro a person who actually is not involved in the conduct of the study. It’s always more helpful that somebody’s looking at it from an independent viewpoint and definition of end points. You know many times i’ve seen you know we journals for mental health put an endpoint. Let’s say symptomatic intracerebral hemorrhage is an endpoint but without the definition what is meant by symptomatic. Just any neurological deterioration. Are we journals for mental health talking about in neurological. Deteriorations of four points are greater on the national institute of health stroke scale or what period of time within 24 hours within 72 hours and then the hemorrhage i journals for mental health mean are we journals for mental health actually taking any hemorrhage. Are we journals for mental health actually saying it has to be confront hemorrhage that is exerting a mass effect so all of those parameters actually have to be specified and sometimes in retrospective studies. You may not be able to specify but then you have to acknowledge that that you know we journals for mental health use this particular information to determine that end point and other thing is the completeness of follow-up in a retrospective study for example. There is no practical way even with electronic medical record that you can get information on everybody. That was part of your data collection so we journals for mental health actually have to mention what efforts were made and in the end what were actually the number that actually could not detect to collection was incomplete and then statistical considerations. I JOURNALS FOR MENTAL HEALTH think that in today’s world everybody knows some statistics so every reviewer would have at least some level of statistical knowledge so they had to put more emphasis on actually describing it.
What is the statistical hypothesis saying endovascular treatment is greater than medical treatment. Better than medical treatment is too vague. What do you mean the better. Are we journals for mental health talking about reduction of death and disability as defined by a modified ranking scale and then reduction also has to be quantified. Are we journals for mental health saying that. Ten percent of greater reduction five percent of greater reduction because maybe one percent of greater reduction is not even valuable but we journals for mental health that would still meet the definition that endovascular treatment is better than medical treatment so obviously the threshold or the magnitude that defines reduction also have to be specified now even for retrospective studies. They’re asking that you do sample size calculations so you have to add sample size calculations even for retrospective study divided. Your sample size consists only of 100 retrospectively collected patients why not 500 why not 25 and obviously the matter of analysis whether your multivariate analysis univariate analysis all of that has to be specified and even now the software you use. Even if you’re using microsoft excel you have to actually mention the version of microsoft. Excel that you use. In the statistical methods now we journals for mental health actually move to the results section obviously the results section is important because that is actually whatever you found and that would actually dictate whatever your discussion would be so. I JOURNALS FOR MENTAL HEALTH actually recommend the following. You can actually start your results with subheading you can delete the sub headings after it’s all compiled but it would look more organized that way subject identification every journals for mental health now for clinical trials requiring. You have to mention how many patients you screen. So let’s say you included 20 patients but you probably screened over 100 patients so you have to mention how many people were screened and how or why they were excluded even the retrospective studies.
You have to mention you. Screened 100 charts and only 25 people met the criteria and the 95 or 75 people who did not meet the criteria why they did not meet the criteria so this is something we journals for mental health have to actually put in there and we journals for mental health always omit that that what was the denominator before we journals for mental health started and now we’ll see the study population and what are the basic characteristics of a study population. Obviously you have to determine the gender distribution the age distribution and the clinical characteristic the cardiovascular risk profile. Because you know most of us are actually going to publish in the cardiovascular disease domain and also sometimes people want clinical and physiological characteristics for example. What was the median. Nia stroke scale. What were the physiologic parameters like. Systemic blood pressure serum glucose so those are some of the things that we journals for mental health have to mention now study intervention. You would actually say we journals for mental health already talked about the study intervention in the method section. Why do you have to talk about in the results section. Well you may have actually contemplated a particular study intervention but not. Everybody would have gotten that intervention. There’s always a chance that some people did not require study intervention. Some people did not qualify. Some people pulled out and decided not to have the intervention. Some people crossed over for example from the medical group into the intervention group. Because they just didn’t want to be in the medical group so all of that has to be put in there that how many people actually got study information or intervention and again how many people are compliant with the protocol that you specified. You may have got an endovascular treatment. You may have received intravenous tpa but instead of what was recommended. Let’s say you only got 0.8. Milligram per kg. So how many people actually had non-compliant intervention or they were not compliant with the intervention.
Obviously has to be placed in there and the onus actually becomes greater if you’re actually looking at a longer-term intervention even if you put people on anti-plated agents and you actually specify six months of dual anti-plated agent a lot of people will not take it up to six months. A lot of people will be non-compliant. And the onus is on the investigators to make sure that that compliance or non-compliance is mentioned so that actually the interpretation is easier and again the same applies for ancillary care some of these parameters may or may not have been upheld as specified in the method. So obviously you have to describe the end points. If you’re describing modified rank and scale you have to describe the proportion of people who had a modified rank and scales zero to two or zero to three. A lot of genres actually want you to specify 95 percent confidence interval as well to provide the precision of estimate and again what do i journals for mental health mean by description of endpoint. In the current world we journals for mental health have cumulative endpoints so what is a cumulative or aggregate endpoint. We journals for mental health can actually have for example. Let’s say the sample study. The primary endpoint was any stroke or that within one month or ipsilateral stroke to the side where the intervention was performed over the next two years. So any of these endpoints would have actually met the primary endpoint but people actually want to know how many people actually had stroke within one month. How many people died with environment and how many people had ipsilateral stroke over two years separately and the classic example would be the crest trial where you have a primary endpoint that was seven percent in each group and attracted me versus ten placement. But it’s a cumulative endpoint any stroke myocardial infarction or death within one month or ipsi. Lateral stroke over the next few years four years so if she didn’t compare the numbers if the rate is the same in standard group process and dot rectum improve but actually break it down.
The rate of myocardial. Infarction was higher in the group that got endarterectomy and the rate of stroke within one month was higher in the group that got the strength placement even though the total aggregate number is the same. But it’s still important for people to know what the distribution was so you have to describe the end points or the distribution or composition of the endpoints and then usually the comparison you know most times is univariate comparison. A lot of people actually are doing multivariate comparison because of these readily available softwares. And then if you’re doing multivariate comparison make sure that you know what variables you’ve entered and why you’ve entered them. They have to be prognostically important. Variables and the same is true for the secondary and ancillary measures. So let’s say that modified rankine scale was your primary endpoint but there’s a bunch of secondary endpoints neurological improvement within 24 hours neurological deterioration within 24 hours symptomatic intracranial hemorrhages so those are all secondary endpoints and they actually have to be described as well. And if you’re doing comparison then you have to mention the comparison as well and now subgroup analysis. Most clinical trials actually have to specify the subgroup they will analyze even before the trial is started. They have to use the existing data to define those subgroups whether it’s actually defined by age 80 years or greater less than 80 whether it’s defined by the severity of different neurological deficits. And i journals for mental health a stroke scale of 10 or greater versus less than 10 and essentially you have to define the comparison of endpoints in these subgroups. A lot of people are actually using figures to describe the whole subgroup analysis to make sure that the results the primary rule did not differ according to subgroups so that is actually the methodology and i journals for mental health strongly encourage you to use subheadings because that way you can organize your results.
Otherwise it’s hard to put all of the results in some organized manner and the more disorganized you are more likely the people reading will be disenchanted and more likely that the message may be lost so obviously the discussion section. You know many times i’ve wondered. Do we journals for mental health even need a discussion section if you actually have the results you’ve already told people what you found. Why do you need to discuss those findings. But i journals for mental health think that there is perhaps some value in the discussion section. You are actually saving the reader a considerate amount of effort by writing the discussion section. So the discussion section actually has six subheadings. Some journals for mental health s will actually have a little different distribution of subheading but again. I JOURNALS FOR MENTAL HEALTH strongly encourage you to use subheadings for your discussion. The first paragraph salient finding just summarize. Some of the finding that you think are the most important finding if you’re finding it. The death or disability was reduced in a particular subgroup of patients. Then that is your salient finding now. The second paragraph is how does it compare with other studies. Obviously there have been other studies on the same topic there may be smaller studies. There may be retrospective study but there have been other studies on the same topic. So how does it differ. Are your results exactly comparable to the other studies. Are they different from the other. Study if they’re actually different or you know if there’s concurrence or discrepancy try to find explanation. You know sometimes smaller studies. That don’t have independent. Ascertainment single step to study are more likely to be biased as compared to multi-center studies independent aspect attainment and that’s why the results may actually differ. It always surprised me that you know. If you are self-asserting your endpoints versus if somebody independent is ascertaining your endpoint.
Even in the same group of patients. The results of the proportion of endpoints will be different. And actually there have been studies on this topic showing that it can actually differ and in that rectangular studies. If you look at your self-asserting complication you will be describing a rate of three to four percent. If somebody else is looking at it they will actually take the rate to seven percent in the same group of patients so i journals for mental health think that you know. Sometimes it’s just who ascertained the end point and whether the definition of endpoint were different may actually explain the difference between other study now explanation for the findings. Sometimes you have to put a mechanism many years ago when someone was like 25 years ago we journals for mental health actually were doing experimental models of intracerebral hemping and we journals for mental health were trying to find peri journals for mental health hematoma ischemia. Most of you probably even haven’t heard of the term of perihetomyschemia but 25 years ago. That was the most important thing in ski. Interstellar hamburglar the interstable hemorrhage by compression of surrounding micro vessels with actually inducing a zone of ischemia and therefore blood pressure cannot be reduced because you can only provoke further ischemia. Now we journals for mental health actually did experimental model. We journals for mental health couldn’t find any ischemia so obviously we journals for mental health can say there is no ischemia but could there be a potential reason why we journals for mental health are not fighting ischemia and the reason was that most studies that actually described ischemia was simply inflating the balloon in the brain parenchyma. So you have a sharp interface between the balloon. And the surrounding parenchymum manufacturing hemorrhage is not a sharp interface in fact the hemorrhage actually moves almost like a superior finger like projection into the parenchyma so the pan and chemin hemorrhage are far more intermingled without a sharp interface and we journals for mental health actually found references from pathological studies in the 50s and the 60s that actually supported that concept that there was no sharp interface and that is why there could be no compression or a surrounding valve.
You know region of ischemia because the sharp interface never existed so that is actually a mechanistic description of why your findings are what they are. Sometimes the finding may simply be because the design of the study dictated it then is implications for findings. You have these findings. What does it really mean. Sometimes the implication may be practiced with for example one study where they were founded intracerebral hemorrhagic and patients. Who get it intravenous thrombolysis when they have infected endocarditis are very high. So what the implications are that patients who have infective endocarditis. Perhaps you need to be very cautious in giving them intravenous thrombolysis even when they’re presenting with ischemic stroke. Sometimes it may be research-based that perhaps a particular study for example let’s say the experimental model into cerebral hemorrhage. What is the research hypothesis or implication the research implications are that perhaps we journals for mental health need to study the same phenomena in patients now do clinical studies and patients where acuity was done. The patients were studied using. Positron emission tomography replicating the result. That we journals for mental health are actually found in the experimental model so sometimes. The implication is a practice-based implication. Sometimes it may actually be a research-based implication and then data interpretation issue. You know we journals for mental health all think that our study is the greatest study that was ever done and after that there can be no further study but unfortunately that’s never true every study the most carefully designed studies have limitation and we journals for mental health have to mention those limitations. What do we journals for mental health think are the limitation of the study like for example. We journals for mental health did the eight active study. A prospectively designed study months and years were spent in the design of the study itself. So one would think that it would have no problem but nonetheless it still had design limitation one that the intensive treatment group actually was more intensive than we journals for mental health had initially anticipated.
The blood pressure reduction was greater than what we journals for mental health had thought would be in the intensive solid blood pressure reduction growth second. A larger portion of good patients got included. We journals for mental health thought that there would be equal distribution of good grade and moderate great severity into cerebral hemorrhage. But unfortunately that was not the case. Most patients were good. Great question in fact. 70 percent of the patient had a glass of comma scale of 15. And that was not the intent of the study but this nonetheless when it all played out. That’s how the distribution of the patients fall. Sometimes that may be conduct limitation now the patient recruitment was suboptimal. Sometimes the treatment application was suboptimal but nonetheless we journals for mental health have to mention those design limitations or i journals for mental health guess uh limitations when you actually are interpreting the data but we journals for mental health also have to say why they are not fatal flaws. Despite the limitation there is some valuable interpretation of some valuable interpretation or information in the study itself and then obviously we journals for mental health have to describe why we journals for mental health think this is not a fatal flaw and the study is still valuable and obviously conclusion. Some generals want a conclusion. Some gender may not want a conclusion. Some generals want a conclusion at different than the conclusion of your abstract but conclusions are again similar to the format and the abstract. Summarize what your main findings are summarize. What the implications of these findings are now. One of the things in in design or discussion is the question about interpretation. For example older people have worse outcomes. That is actually a statement. Older patients will ischemic stroke. Have worse outcome. It’s a recognition. But when you actually start saying that because age actually is the important determinant of outcome we journals for mental health have to be a little bit more cautious.
Could it be truly be a cause effect relationship or it could be a simultaneous effect relationship. For example people who are older are more likely to have strokes so people who are more related to have more severe stroke so age did not contribute to the outcome just other factors contributed and again like a bystander relationship and this is a classic issue when patient with patent forum and a whale have ischemic stroke patient forum in a whale is so common patent formula. Have nothing to do with ischemic stroke just because it’s a common entity it was seen in a patient with ischemic stroke and sometimes it may be effective various relationships but nonetheless. If you’re going to define something as cause effect relationship you have to test an intervention to modify the cause and it modifies the effect only then you can such a cause effect relationship and then essentially you may have to do further tests to apply the intervention and monitor the results of the intervention. So i journals for mental health think i journals for mental health just want to stress out that just because two things are formed together in an observational study. Don’t actually directly or assume that there is a cause-effect relationship. It may just be a bystander relationship or maybe both things are actually being caused by a common etiology. And that’s not a cause-effect relationship they’re both consequences of a common etiology. And i journals for mental health think that you know if you look at discussions the two most important things that are actually considered fatal flaws and discussion drawing conclusions that are not supported by the results. Your result may have shown something else and then for example you showed intravenous. Tpa was beneficial in patients. Who were treated within three hours. But your conclusions are intravenous. Tp is beneficial in patient with ischemic. Stroke that is actually not the appropriate conclusion because the results were on a very selected group of patients and claiming the impact of results to be greater than what can be justified after considering the various limitations of the study you cannot tell people based on a retrospective study that they should modify their practices.
Something is no longer applicable anymore because a retrospective study has its bias. It is actually more like a hypothesis generating conclusion rather than a practice size modifying conclusion. So i journals for mental health think these are two important things to know when you’re actually writing a discussion. Don’t overdo it both in terms of saying what you’re saying and don’t make overdo it in some of the recommendations based on the study and obviously you have to make tables. It’s very almost all studies need tables. But i’m actually always surprised that the formatted table is so sub-optimal when people are actually drawing the table the table actually has to have a proper format. You have to have a title you know. Many people don’t even put a title on the table. But as you have your number table 1 table 1a table 1b whatever that is and then you have to actually have a content description. What are the rows that are standing for what are the columns that are standing for. And if you’re using any abbreviation of the symbol you have to describe them on the below or the bottom of the table and the same actually goes for figures figures actually. I’m always surprised that what people don’t put a legend or a title for the figure. Why people don’t describe the abbreviation that are used in the figure because we journals for mental health have to put that in there so anybody who’s actually looking at the figure who doesn’t have the background that you have should at least be knowing and what he is actually looking at and a lot of times people actually highlight the findings in the figure as well so when you look at the figure and you read the title below you are familiar with what to interpret or what to actually take out of that figure now. The word figure is very broadly defined unlike tables which is a pretty homogeneous entity figures are a whole heterogeneous group of things it can be graphs it can be plots.
It can actually be pictures. It can be pictures of imaging photographs of imaging sometimes photographs of individuals it can actually be photographs of history micro or morphology or histology so obviously there is a whole set of figures that go in there and you have to actually describe it. Um you know you have to actually mention the details about the figure. If you actually have a figure of a person you have to mention you took it by permission of the person and you have removed the dead or identifying features. It’s actually a figure of astrology. You actually have to mention the magnification that was used whether it was 200 magnification 100 magnification special stains that were used and similarly um you know sometimes a lot of journals for mental health s actually require a figure for patient flow. You say you know reviewed 100 charts. 75 of them met the criteria. 25 of them actually met the patient that you were actually looking for 24 of them actually had complete data so they’re actually asking you to make a figure so they don’t have to read and make understand they can just look at the figure and understand how the flow of the patients was and again same is actually for modeling and comparisons. This year’s oftentimes need advanced software. And if you’re using advanced software the software will actually plot the figure and also. I JOURNALS FOR MENTAL HEALTH strongly recommend that when you’re writing the legends increase the font of the legend so people can actually read it if the font of the legends or even sometimes table is so small people cannot read. What those legends are or get the access the units of the axis and actually the values of the xl. So i journals for mental health think that there is a almost like a beautification process for figures as well so when you make those figures step back and look at it and see how can in or enhance the quality of the figure so now you have your manuscript you actually submit the manuscript.
What is the most likely of this fight of outcome. You’re not in person because i journals for mental health usually ask people to have a show of hands. What do you think you’ve submitted a manuscript. What is the most likely or like the greater likelihood what is of these five or six categories. The response will be i journals for mental health know for the manuscript i journals for mental health submit the most likely response is number one reject so if you get the same response. You’re you know the same category that i journals for mental health am. If you get anything else you are better than i journals for mental health am. So that’s good to know so reject is the category where you can get a response and that is pretty much the end for that particular journals for mental health but it’s not the end for your manuscript you can always get a manuscript submitted in a journals for mental health and get accepted in my personal experience is you relate two or three submissions to different journals for mental health s before the manuscript is accepted. So don’t have you know. Have a heartbreak over it. Just simply say if there’s anything valuable to be fixed and just resubmit it to another journals for mental health . Rejections are many times. Sometimes it’s the quality of the study. Sometimes it may be the priority of the journals for mental health . The journals for mental health just doesn’t like that topic so essentially don’t actually you know take a rejection. Hard sleep over it get back the next day and just resubmit the manuscript sometimes just reject and resubmit which to me means resubmit essentially fix it and resubmit. You know major revision minor revision. Also obviously the much much better chance that the magazine you know the journals for mental health actually would accept your manuscript except for minor changes um again. That’s a very good omen except without any changes and i journals for mental health actually have like 790 publication. There’s only two publications in there that were accepted without any change. Only two so. If you learned this is going to be your satisfactory endpoint. Modify your expectations. Now it’s very very rare that you would actually get a letter saying they don’t want any changes.
They want to accept the manuscript as it is. So look at the following outcomes and simply titrate your expectation so that it doesn’t become an end-all or a be-all statement for you when you get the recommendation so when the reviews response come you have to write a response to the review. You have to address each point step by step and in the book that you have. I’ve given some examples how to respond to the reviewers when i’ve seen you know i’ve been a reviewer myself for many journals for mental health s and i’ve seen responses that kind of vary from you know. The reviewer made an excellent suggestion to the reviewer has nothing valuable to say and trust me to the reviewer. This is a special offense. If you say. The word the reviewer has nothing valuable to say you can be sure that reviewer is going to give the lowest priority ever so it’s better to acknowledge what reviewer is saying and take it for face value and say that there is something valuable that actually needs to be addressed and a lot of time you know they may actually have recommendations that you know usually take about the objectives. Mainly they’re trying to get a sense. Is this a valuable thing to do or not and a lot of people who are familiar with the literature can justify. It’s a valuable thing to do or not. Uh methods use now in objectives. There’s always that question. About fatal flaws the reviewer may just think that we journals for mental health already know the answer to that and that actually happens in certain opinionated journals for mental health s where reviewers are just. I JOURNALS FOR MENTAL HEALTH like this question. I JOURNALS FOR MENTAL HEALTH don’t like this question i’m done um and similarly with the methods methods can also have fatal flaws for example if you’re using to determine an end point using an estimated methodology that’s highly flawed. Then it’s a fatal flaw and regardless of what you do the reviewer has already decided or what you have done is not going to get accepted but doesn’t mean that the gender may not accept it other gender may still be accepted the accepting of your methodology and accuracy of the results if there is any suspicion that your results are not accurate.
That is an automatic rejection. This is a fatal flaw. It cannot be redeemed. So now you can say how does the reviewer know whether i’m presenting accurately or not and the answer is something very simple for example you say there’s 50 women and 50 men in the study but the total number of patients. 105 the reviewer just simply added it up and said there’s something really wrong with what you’re doing. How can 105 patients be only 50 men and 50 women unless you have a set. That’s in five. You couldn’t determine the gender so usually they’re using simple things to determine whether results are accurate or not. They don’t have the data sheet they don’t have the excel form. They don’t have the software in front of them to run the analysis. Sometimes they can actually judge by the confident interval. You know if your sample size is small and your confidence are very tight. They know it cannot be accurate. So they’re using indirect measures to determine whether the results are accurate or not. And you can read your own result before you submit to make that ascertainment yourself so i journals for mental health strongly encourage people when they submit look at the results and step back they actually making sense or not and similarly the interpretation the interpretation and result is usually very rarely flawed. When i journals for mental health told you the limitations in the interpretation the reviewer may simply identify the same issues and ask you to reinterpret your results and most of them. That means the revision. It would be very rare that the reviewer will say the interpretation is flawed and this has to be rejection but the biggest biggest reason why there is no coming back is if there is any question about the accuracy of the results if there any question the data was not done accurately that is a fatal flaw and there is no coming back so when you write the response to the review the best things are things you can fix.
The reviewer has actually asked you to do something and you can do the things. If the reviewer said analyze it this way you can simply redo the analysis that is the simplest fix and everybody gonna end up happy but sometimes it’s a challenge you cannot do that. Required action item for example the reviewer says you know collect this data you can’t go back and collect that data that data was never collected. There’s no way you can find that data so now you have a challenge. You have to actually explain so you can actually go back to the literature and say that this is what we journals for mental health know from the literature and therefore we journals for mental health think that you know whatever we journals for mental health did is still accurate. Uh and another solution is that you can simply say well. Yes we journals for mental health can’t do this but it’s a limitation and we journals for mental health will acknowledge that we journals for mental health will acknowledge it in the discussion section that we journals for mental health did not collect data on this particular item or this data was not available in the chart and we journals for mental health acknowledge it but we journals for mental health still think this is valuable information. Despite the fact that we journals for mental health couldn’t do what you were asking us to do and a lot of time that may be enough but everything that a viewer said there has to be an answer and something done in the manuscript to respond you this when you write a response to the letter. This is not a letter to the reviewer. This is actually modification in the manuscript based on the suggestion of the reviewer so all with every comment they have try to do something in the manuscript that actually the review your action to answer the reviews comment and then again. Sometimes you know you just can’t address the command. Just don’t have the data. Just don’t have the resources to address it. Sometimes the patient consent may not allow it and then you simply have to acknowledge this as a limitation but these are actually some of the things for response to the reviewer and you have to organize it in a way so when the reviewer reads it.
He’s happy you’ve done something valuable. You’ve listened to him. Obviously anytime you give somebody a comment or advice and they don’t listen. You’re not going to be happy about it. So the viewers are the same. They’re giving you advice. And if you’re not going to listen to it they’re not going to be happy and they’re going to make sure the manuscript has the lowest priority in their mind so i’m actually going to conclude here i journals for mental health didn’t want it to be too long because i journals for mental health want to actually have a time for discourse and discussion but i journals for mental health hope i journals for mental health wanted to cover to make manuscripts structured and organized and these subheadings will allow you to get to this point. If you don’t have the organization you will struggle with writing the manuscript. You will struggle with putting all the information you have in an organized manner and a lot of time you may actually omit valuable information that you may come to regret later so here i’m going to conclude here with the following. Why should we journals for mental health publish. And many of you are in the beginning part of your career and you’re probably asking this question yourself. Should i journals for mental health actually publish. Why should i journals for mental health publish. Should i journals for mental health go through the or endure through the challenge of publication. If i journals for mental health can actually accept even at this stage after 30 years of publication a rejection rate of 50 percent. Uh i journals for mental health think that perhaps you also need to tailor your expectations that this is the you know. This is what the expectation is. This is what the reality and i’m gonna get through this reality. I’m going to move forward with this reality. This reality is not going to hold me back and mainly skip writing also one thing. I JOURNALS FOR MENTAL HEALTH did not mention but i journals for mental health probably should have tailor your expectations in general any achievement in life. It’s a set of stairs. It’s not a big jump and you know every time you write a manuscript in your first manuscript getting accepted in the new england journals for mental health of medicine. This is a very inappropriate expectation. This is an expectation that’s doomed to failure.
You can start a much smaller journals for mental health and work your way up and you have more publication. You’ll be a better position to eventually publish in new england. General medicine or landsat or another high impact journals for mental health but don’t actually expect the first publication will be in the new new england journals for mental health of medicine or lancer. But i journals for mental health think there’s a broader view of why we journals for mental health should publish. I JOURNALS FOR MENTAL HEALTH think that it actually plays into our own existence. It actually is an important part of our own existence because it’s allowing you to express yourself allowing you to have an opinion that other people can listen to and actually benefit from that opinion and to learn from what exists in residency. You know. I JOURNALS FOR MENTAL HEALTH really very rarely studied textbooks but i journals for mental health did write manuscripts. So every time i journals for mental health was writing manuscript i journals for mental health was reading all that was already published so my knowledge is very up to date on what was already known about the field before writing a manuscript so in some ways writing a manuscript is also a very good opportunity to know what’s already out there and keeping your knowledge up to date. Obviously it’s to share with others. We journals for mental health always share things with others. Sometimes we journals for mental health share our resources sometimes our finances our wealth but we journals for mental health also have to share our knowledge and i journals for mental health think that’s the most important thing to share knowledge. I JOURNALS FOR MENTAL HEALTH think that one of the saying is that you give it life to knowledge diet. Not so i journals for mental health think sharing knowledge with other individuals. It’s a very important component of who we journals for mental health are and i journals for mental health think there is a bigger contribution to humanity that we journals for mental health are making every time we journals for mental health are publishing scientific manuscripts. So i journals for mental health hope that you know this would motivate you and guide you to perform or write scientific manuscripts and publish scientific manuscripts. Well thank you very much. Thank you very much dr qureshi journals for mental health for this excellent presentation. I’ll open it up to questions. Uh people on zoom can type in your questions. Dr qureshi journals for mental health i.
I JOURNALS FOR MENTAL HEALTH wanted to congratulate you. I JOURNALS FOR MENTAL HEALTH i journals for mental health didn’t know the latest count has exceeded 750 now 800. So i journals for mental health apologize for saying 500 plus because it’s all relative. Uh congratulations for doing that. You’ve been a editor of a very successful journals for mental health for a long time. And which is a which is an index journals for mental health and from from that experience of being an editor. How do you uh usually manage the manuscripts do you. How do you can you. Can you just give a like like a little bit of a perfect view of how you uh judge a manuscript when it comes to you. I JOURNALS FOR MENTAL HEALTH think that’s an excellent question. Um so i’ve been an associate editor for the journals for mental health of neuro imaging. I’ve been on the editorial board for stroke and also been editing chief for journals for mental health of vascular and interventional neurology and then a more recent journals for mental health a healthcare research journals for mental health because of all the forward 19 research. We journals for mental health had to find something else so now when you are a journals for mental health editor and you receive a manuscript the first thing obviously is that you know you just read through the topic and decide. Is this an important question or not and a lot of people have good questions so you know obviously people who are writing menus through qualified individuals. So they already have enough knowledge to determine what the good question is so the next question and i journals for mental health will tell you this. The most frustrating thing as a journals for mental health editor is the quality of write-up. A lot of people have valuable information in there. But the quality of write-up is so sub-optimal that one has to say well if you have to rewrite the whole article is it really worth all the time in the effort so i journals for mental health think that you know if we journals for mental health can put more effort or anybody. Submitting in general can put more effort on improving the quality of writer and actually. I’m so surprised and you know. Sometimes people don’t even use spell checks and you know like so many softwares today. They would automatically identify these formatting issues so i journals for mental health think that the you know. We journals for mental health don’t have to be a major in english or a phd in english.
The software’s actually already do that and also medical scientific writing is a little different than english writing so i journals for mental health think that there are certain unique aspects but the only way to know that is read more articles. That’s the only way you can learn. What scientific writing is and how it differs from english writing. And then you know benefit from all the software’s out there and i journals for mental health think that’s an important issue that uh you know with manuscripts. If the editors feel that it’s just going to be too much of an effort then sometimes even if the information is valuable. They’ve kind of caught in his crossbow. Whether the whole effort that would be required to bring it to that standard may really be worth it or not in our channel. We journals for mental health made an effort with a lot of time. We journals for mental health tried to do extensive editing if the content is of value and a lot of time. You know people actually. I JOURNALS FOR MENTAL HEALTH think that um at least some of the people who have done that have appreciated that and i journals for mental health hope that you learn from it so every time something is being edited and even you know you publish somewhere. We journals for mental health look at the galley proof and look at the edits. The the i journals for mental health guess the reader or the proof editor has made and try to learn from it. So don’t actually just simply take all the changes and just particular click. The button accept actually read through each change in learning from the changes that we’ve made so next time you don’t even have to have those changes somebody else making it. You can do it yourself. And everybody starts at the lower level. Nobody was born with the skill. I JOURNALS FOR MENTAL HEALTH mean i journals for mental health think that first time i journals for mental health wrote a manuscript took me like three months of just editing. It and being embarrassed in front of all the faculty. I JOURNALS FOR MENTAL HEALTH showed it to you. The first time i journals for mental health showed it to the faculty at emory university. That advice i journals for mental health thought was maybe you need to take english classes. I JOURNALS FOR MENTAL HEALTH still remember. And he’s a very dear mentor and we journals for mental health wrote many manuscripts down the line.
First time he looked at manuscript he said my english is either a or b. But your english is a d so but don’t let it keep down. You can actually get to an a from that standpoint so i journals for mental health think those will be some of the advice. That’s also a very good point that uh looking at what the journals for mental health wants. Uh may help you a lot like looking at the previous journals for mental health s and looking at what topics excite them or what topics impress them. More would make sure that you’re sending it to the right journals for mental health that the content is needed for. Is that something that you look at very closely. You mean about the impact. The actual content of the article is along the lines of what you want for your uh journals for mental health . Yeah i journals for mental health think with the content. Obviously the main thing is the theme of the journals for mental health so it has to be consistent with the theme and then and i journals for mental health think that’s why we journals for mental health created the healthcare research journals for mental health because a lot of things that were coming in were good and good information good science but not necessarily you know what a journals for mental health of vascular intervention neurology would encompass so sometimes things can actually be outside the theme of what the journals for mental health is expected to cover. Um and the problem is that the pubmed actually monitors that. So um you know. Every time there’s serial monitoring they will actually look at the manuscript and make sure it’s consistent with stated objective of the journals for mental health . I JOURNALS FOR MENTAL HEALTH think the journals for mental health s are increasing scrutiny. Now because there is this new term that has been coined it’s called the predatory journals for mental health and it has been coined. By the general that should be classified as predatory journals for mental health so basically these are journals for mental health s. That actually are taking money for publishing your work and uh obviously you know it’s almost like a profiteering. Um you know this journey. They’re actually talking three thousand dollars for each publication. So if you’re a rich person that’s a big challenge but actually if you look at which journals for mental health s are actually charging a lot of the land centers are charging that like they’re charging just to actually review your manuscript so i journals for mental health think that this is becoming a very business model which i journals for mental health think is probably not fair to the scientific community.
I JOURNALS FOR MENTAL HEALTH mean obviously rich people are not the only people have good scientific information so i journals for mental health think that you know perhaps um at some point the system should auto correct itself. Thank you very much again. Dr qureshi journals for mental health um uh there are no uh more questions that i journals for mental health see um uh dr gracie it was an excellent overview very nicely broken down into each section. Uh i journals for mental health think uh the all the trainees the fellows the junior faculty all would benefit a lot from this lecture. Thank you very much again. And we journals for mental health have distributed your book to all the presenters who had presented and we journals for mental health do have a little token of appreciation for you. I JOURNALS FOR MENTAL HEALTH wish i journals for mental health could uh hand this over uh as our token of appreciation. Uh this flag says that you’re a keynote speaker at the 18th annual zapola day. And thank you very much again. Uh we journals for mental health will mail this to you uh your plaque and thank you again for coming. I JOURNALS FOR MENTAL HEALTH know that you had a busy day. You were in a case uh just before you came on zoom so thank you for making the time and giving us this valuable. Um yeah i journals for mental health want to introduce poor person our student who actually put all the publication all these slides together so and um i journals for mental health think one thing i journals for mental health wanted to mention. I’m actually very interested in seminars. So basically have a group of trainees and you know one person has written a manuscript and we journals for mental health all go over the manuscript together. And because you know once you actually have a actual content and you are actually going over the content with everybody else and it has an interactive session. And i journals for mental health think that is even more helpful so i journals for mental health think this restrictions on covet 19 are becoming less. Perhaps something that we journals for mental health should consider doing together. Well that’ll be amazing. That’ll be awesome. Would you be willing to do that. Like we journals for mental health sent you the manuscript first you review it and then critically discuss the manuscript.
Well thank you very much.
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