A Dermatology journal issue that might make your skin crawl

A group of authors has found a way to crank up the number of papers on their resumes. The complete “Global Dermatology” September 30, 2019 issue of the Open Access Macedonian Journal of Medical Sciences is filled with papers from the same group of authors, headed by Torello Lotti and Massimo Fioranelli, both from the University of G. Marconi in Rome, Italy.

Some of these papers contain photos of patients without consent, others contain duplicated images, and some papers are full of extraordinary claims without any evidence. Just a bunch of pretty diagrams.

The journal

The Open Access Macedonian Journal of Medical Sciences claims to be a member of the Committee of Publication Ethics (COPE), but it is not listed as a journal member on the COPE website.

This journal has published some papers authored by the Space Dentist and flagged by me (here and here), which were later retracted because the data appeared unbelievable.

The journal’s peer review process is unclear; a page on the journal’s website contains very general text that is found on lots of other sites describing the peer review process.

A special journal issue on Global Dermatology

In September last year, the journal published a complete issue that appears to be full of flawed papers.

The September 30, 2019 issue (Vol. 7, No. 18; archived version) is called “Global Dermatology”. Interestingly, not all papers are about dermatology. Even more interestingly, all papers appear to have been written by the same group of authors, just in slightly different combinations.

The content page lists 39 papers. Of these:

• 37 list Torello Lotti as an author
• 37 list Aleksandra Vojvodic;
• 36 list Uwe Wollina;
• 19 list Petar Vojvodi;
• 19 list Michael Tirant;
• 18 list Massimo Fioranelli;
• 14 list Van Thuong Nguyen;
• 8 list Maria Grazia Rocci;
• 7 list Alireza Sepehri

Some papers in the September issue appear to be suitable for the theme of “Global Dermatology”. There are some review papers about techniques applicable for dermatology and some case reports about patients with skin issues etc. However, those papers appear to have problems with undisclosed conflicts of interest and lack of patient consent.

But the special issue also contains some papers that have nothing to do with Dermatology. These papers, written by the duo Sepehri / Fioranelli, contain extraordinary claims, without providing extraordinary data.

Let’s take a closer look at some of these papers and the concerns I have.

Lack of patient consent

Some papers in this special issue are “case reports”, short papers that describe one patient or a small set of patients with a particular, usually rare, syndrome, and that usually give a short overview of the literature.

It is now becoming accepted practice that patients need to give permission (“consent”) to have their special case be the topic of a paper, in particular when there are photos involved. Even if they might not be recognizable from the photos, their special medical history in combination with the photo and/or some other identifiers, such as their age and gender, might be enough to identify them. You can read discussions about this here, here, and here.

Two papers in the Dermatology issue describe such case reports.

• Rosacea Flare – Up after Photodynamic Therapy (PDT) for Field Cancerization and a Review on Adverse Events with PDT in General – Uwe Wollina et al., Open Access Macedonian Journal of Medical Sciences (2019) – DOI: 10.3889/oamjms.2019.536 – PubPeer
• Eosinophilic Fasciitis – Report of Three Cases and Review of the Literature – Uwe Wollina et al., Open Access Macedonian Journal of Medical Sciences (2019) – DOI: 10.3889/oamjms.2019.296 – PubPeer

Well, none of these papers included wording about patient consent. For a journal that has “Medical Sciences” in the title, one would hope that the Editorial process would involve checking for patient consent. But apparently, these papers were not screened for that. The journal does not even have a policy about patient consent – that is, the word “consent” is included in the title of this page, but there are no policies described.

Animal experiments without approval and image duplication

One of the papers in the special issue raises concerns about a set of duplicated images and the lack of animal ethics approval.

• New System Delivering Microwaves Energy for Inducing Subcutaneous Fat Reduction: In – Vivo Histological and Ultrastructural Evidence – Nicola Zerbinati et al., Open Access Macedonian Journal of Medical Sciences (2019) – DOI: 10.3889/oamjms.2019.778 – PubPeer

In this paper, a Vietnamese pig was treated with a device to melt away fat. The authors write that “this study on the animal model was carried out in full compliance with international guidelines for safety and compliance with their use” but there is no word on Animal Ethics Committee approval. Yet, they opened up the skin of the animal and took several 1.5 cm long biopsies to study (see Figure 1 below). That is a pretty deep wound to do without Ethics approval. It is not clear if the animal was given anesthesia or if the wound was sutured.

In addition, two of the photos that represent the fat layer of the pig at the start of the experiment (T=0) and 2 months later (T=4) appear to overlap with each other. Here are the individual photos:

And here is a collage with the two images on top of each other to show the overlap:

Extraordinary claims without extraordinary evidence

Part of the special issue on dermatology is filled by papers by the fantastical duo Massimo Fioranelli and Alireza Sepehri, together with other pseudoscientists such as Torello Lotti. I wrote about them before in blog posts called An astrophysicist who decapitates birds and wants to infect pregnant women with viruses and Worst paper of 2020? 5G and Coronavirus induction. The great Sylvie Coyaud also devoted an article to them.

Here, Fioranelli and Sepehri have ‘enriched’ the Dermatology Special issue with papers that have nothing to do with skin science, but that will make your skin craw. Some examples:

• DNA Waves and Their Applications in Biology – Massimo Fioranelli et al. – Open Access Macedonian Journal of Medical Sciences (2019) – DOI: 10.3889/oamjms.2019.767 – PubPeer
• Recovery of Brain in Chick Embryos by Growing Second Heart and Brain – Massimo Fioranelli et al. – Open Access Macedonian Journal of Medical Sciences (2019) – DOI: 10.3889/oamjms.2019.777 – PubPeer
• A Mathematical Model for the Signal of Death and Emergence of Mind Out of Brain in Izhikevich Neuron Model – Massimo Fioranelli et al. – Open Access Macedonian Journal of Medical Sciences (2019) – DOI: 10.3889/oamjms.2019.774 – PubPeer
• A Black Hole at the Center of Earth Plays the Role of the Biggest System of Telecommunication for Connecting DNAs, Dark DNAs and Molecules of Water on 4+N- Dimensional Manifold – Massimo Fioranelli et al. – Open Access Macedonian Journal of Medical Sciences (2019) – DOI: 10.3889/oamjms.2019.776 – PubPeer

In these articles, the authors present incoherent stories about DNA sending out signals called “waves”, that the DNA of males and females sends out different waves that cancel each other out, that new brains can be grown out of chicken embryos or women implanted with some cells from a brain dead person into their uterus, that birds without a head can keep on “minding” and use visual inputs, and that the core of the earth has a ginormous piece of DNA that serves as an antenna to create new life. Or something like that. It is hard to repeat the fantastical claims they make in their papers.

As I always say: Extraordinary claims need to come with extraordinary evidence. But there is no actual data in these papers. No measurements. No proof. As with many other papers by these authors, these papers are illustrated with little diagrams and impressive-sounding-but-nonsensical phrases and formulas that do not prove anything.

What is next?

No peer reviewer should have accepted any of these papers without asking some critical questions. In fact, one can wonder if these papers have been peer-reviewed at all. Just the fact that this special issue contains 39 papers by more or less the same group of authors should have raised some red flags with the Editors, but apparently they were fine with this.

Still, I will write to the Editors of the journal with my concerns. I also invite everyone to join the discussion in the comments below (I will moderate comments that include offensive language), or on PubPeer at the links given above.

I would also like to ask NCBI / PubMed to reconsider including this journal in their database. If you know the best way to contact someone at PubMed who has some authority, please let me know.

Not that I think that anything might happen soon. All of the papers by Alireza Sepehri I flagged last year have not been touched. It seems there are very few people who share my concerns.