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For most researchers, academic publishing serves two goals that are often misaligned--knowledge dissemination and establishing scientific credentials. While both goals can encourage research with significant depth and scope, the latter can also pressure scholars to maximize publication metrics. Commercial publishing companies have capitalized on the centrality of publishing to the scientific enterprises of knowledge dissemination and academic recognition to extract large profits from academia by leveraging unpaid services from reviewers, creating financial barriers to research dissemination, and imposing substantial fees for open access. We present a set of perspectives exploring alternative models for communicating and disseminating scientific research. Acknowledging that the success of new publishing models depends on their impact on existing approaches for assigning academic credit that often prioritize prestigious publications and metrics such as citations and impact factors, we also provide various viewpoints on reforming academic evaluation. [ABSTRACT FROM AUTHOR]

Objective: Neurosurgical care is difficult to access in many scenarios. Aeromedical evacuation of acutely unwell neurosurgical patients from remote, isolated, or poorly equipped locations can be considered. This article aims to provide a framework of logistical factors that deserve special consideration in the preparation of these patients for transfer., Methods: We searched all relevant medical literature, military reports, and travel industry documents on transfer of neurosurgical patients. This review was combined with a senior author's (M.J.) extensive relevant experience, to present important factors for neurosurgeons to consider during planning of aeromedical evacuation, highlighting potential preventable causes of deterioration en route., Results: Several criteria must be met for a transfer to be considered. The safe transfer of patients with craniospinal pathology requires efficient collaboration between the referring teams, the receiving units/departments, and the medical transfer service. Clear communication, qualified personnel, and appropriate transportation equipment must be available for the transfer. One must consider unique stressors during the air transfer, including the risk of hypoxia on certain types of flights. Vibration, loud noise, acceleration, and changes in barometric pressure en route may negatively affect the patient during transfer. Patient stabilization before transfer is a priority. Medical conditions that can potentially worsen in-flight should be corrected before transfer. The use of a checklist before departure is highly recommended and is included herein. The timing of transfer concerning the postoperative patient deserves special consideration., Conclusions: Although there is little published information, this review provides useful criteria and parameters needed for safe aeromedical evacuation of neurosurgical patients., (Copyright © 2025 The Authors. Published by Elsevier Inc. All rights reserved.)

Objective: We present a case of a patient with an intrathecal pump who experienced an unrecognized partial pocket fill, leading to an atypical opioid withdrawal characterized by akathisia. Case Report: A 57-year-old female with multiple myeloma presented to an emergency department with new-onset akathisia requiring admission. Eight weeks prior, her intrathecal pump was refilled with morphine, bupivacaine, and ziconotide. After a thorough evaluation, her pump reservoir was found to be empty despite an expected residual volume of 10 mL. Furthermore, she reported sedation following her last pump refill, all consistent with an unrecognized partial pocket fill followed by an unusual opioid withdrawal presentation. Conclusions: This case represents an example of both an unrecognized partial pocket fill and an atypical presentation of opioid withdrawal manifesting as akathisia. Furthermore, this patient's case may be considered a medical error given the serious morbidity that can be associated with inadvertent pocket fills.