Surgical science publishes: “σωζειν τα ϕαινομενα”

Dear reader,

Ask yourself and you will agree: whatever you do with love in your eyes turns out to be fun, enjoyment, happiness and mostly provides success (Fundo). As such, motivation is the most important energy for a productive and satisfied life. Positive vibrations may indeed translate into scientific publication and there is no need to waste time and space reasoning about a work/life balance, since such motivated work fosters joy and balance.

This issue of European Surgery spans out a brilliant and knowledge-fostering spectrum of publications dealing with minimally invasive, colorectal, experimental, transplant, and vascular surgery. The authors are to be congratulated on communicating their work to the readers of European Surgery. May this motivate others to do the same. May the readers find the works to contribute to improvement of their surgical quality and expertise. Here comes the matter of fact approach.

Some are checking out for the verily truth and the far distant stars much too early. As such, we are repeatedly taught about our finite existence. This highly essential knowledge should be turned and translated into wisdom for the future generations. Beyond that, the fruitful stream of mood orchestrates the royalty of silence, the gratitude of limos, interrupted by the lights of perception (limos, Greek = lack, deficit).

Introduction

Disease impairs life quality, productivity and wellbeing of the patients (Latein patients = suffering). Conceptually surgical basic and clinical science aim to reveal the essence of a disease in order to tailor an effective diagnosis and therapy, to re-establish life quality and productivity of those affected (= the patients). Disease expresses in the form of signs. This fact was well perceived by the ancient Greek thinker Heraclitus when he considered the essence of the god Apollo: he does not speak, he does not hide, he simply gives signs. Thus, surgical science assesses, defines and analyses the meaning of symptoms in order to model the cause and reason for a disease, i. e. a condition, which impairs the life quality, productivity and wellbeing of an individual. In addition to the taking of patient history, modern technologies profoundly support the process of diagnosis, i. e. unravelling the manifestations of a disease by searching for morphological, functional and psychological aspects and alterations underlying benign or malignant disorders. The disorder itself tunes the sick being of the patient. Interpretation of the diagnosis allows the design of therapy. Taken together, surgical science works with the interpretation of signs and tries to assess reproducible manifestations of an underlying cause. Thus, medicine translates symptoms and signs into therapy.

Technology and machines aid to amplify signs and make them perceivable, decodable, manageable and readable for our interpretation. Science applies the experimental and clinical study approach to monitor, compare and assess the effectiveness of diagnostic and therapeutic modalities. In addition to oral communication, publication (papers, videos etc.) aims to offer a platform for data sharing within the scientific community. Based on novel technological developments, modern data sharing happens in the form of World Wide Web-based communication tools. It remains to be questioned “why publish at all?”

Why publish?

Science describes phenomena. According to the ancient Greeks (i. e. Platon, Aristotle), the term phenomenon describes the underlying idea behind a given perception: the ground, on which itself unhides the perception, what swings through the perceivable things, world and universe. In line with this legacy, the ancient Indian writings of the Upanishads coined the term: Tat vam Asi, “this is you”, meaning that all perceptions are perceived by the observer and thus mirror the I and the self of the observer (i. e. the real meaning of “selfie”; Fig. 1). As a consequence, all you see is you! It is all about you! Language transforms perceptions into a process of communication. Writing aims to store knowledge for repeated data sharing. Here, the ancient Greeks spoke and wrote about a profound characteristic responsibility, the prerequisite, meaning, necessity of human civilization, which is the basic driving force for any publication: σωζειν τα ϕαινομενα; sozein ta pheinomena = save, recover, record, salvage phenomena. Thus, scientific writing aims to save knowledge for others and those coming after us (Fig. 1). During the time of Heraclitus and Parmenides, being and thinking of the being were considered the same. Thereafter, the tree of knowledge continued to prosper and gave life to beautiful branches, blossoms and leaves. Since Plato and Aristotle, academics happened upon the forms of physics (explains movement, force/power and dynamics as forms/manifestations of energy), ethics (explains the moral justification of perception and behaviour) and logics (deduces the “correct” order of reasoning). The subsequent development of numerous specialities contributed to the formation of the multidisciplinary spectrum of our present academy. In addition to the transmission of knowledge, publications offer the possibility to make observations reproducible, comparable and durable. Examinations are conducted in the form of experimental and clinical studies. Any pure and essential science harbours the responsibility to report the outcome of studies for education and research. Taken together, scientific writing reflects fulfilment of the responsibility to patients, colleagues and research. It remains to be questioned “how to publish?”

Fig. 1

The image mirrors the idea of the author, that record and publishing aim to save the translation of perceptions for future generations. Thus, the nature itself may serve as the mirror of a profound and essential legacy. There is something that we cannot entirely rule out: as you watch the tree, the tree may also look at you. Watch out! The rear depicts the upper Austrian chain of the Alps

How to publish?

A scientific publication aims to translate observations into reproducible and uniformly understandable terms. Expression takes place in the form of text, tables, figures and videos. Every paper is motivated with an underlying idea, which defines the area of interest and the focus of the investigation. Most importantly, the idea should be new, current and of scientific relevance. Therefore, check the published literature before starting your work. The next step defines the methods for addressing the body of research, including statistics, in order to address the topic, prove the thesis and gain an answer to the questions, i. e. primary and secondary endpoints of the study. Finally, based on the data, a conclusion is drawn and an outlook for future studies may be offered.

Keeping in line with the above characteristics of scientific reasoning, the paper is to be structured according to the Instructions for Authors. Before submitting a paper to a journal, one has to check if the topic of the paper is in line with the scope, topic and focus of the respective journal. Usually, journals publish original papers (experimental, clinical research), reviews, case reports and letters to the editor. The structure of original papers and reviews includes a brief summary (background, methods, results, conclusion), keywords, body of the paper (introduction, methods, results, discussion), references, tables, figure legends, figures, acknowledgements and a conflict of interest statement (i. e. grant information). We now come to the body of the paper:

The introduction leads into the topic and explains why the study has been designed. “Methods” describes the study design and approval by the local ethics commission. Results contains data presentation in the form of text, tables, figures and images (graphs, intra OP photos, laparoscopic, endoscopic pictures, CT scans etc.). Avoid double information, thus data should be presented either as text, tables, figures or images. Use terms like: as presented in Tab. 1, Fig. 1, study group A showed better outcome vs. group B (p < 0.001). Avoidance of double information in text, figures and tables saves space and strengthens the paper. Keep in mind that tables are headed by a title and may include notes listed below the table. Fig. (intra OP images, cartoon on mechanisms, technologies and procedures, histopathology, anatomy, column bar graphs) are published with legends. Both tables and figures plus title, notes and legends, should be self-explanatory, without knowing the information described in the body of the paper. For example, a figure legend includes the information: image (line, column graph) shows the superiority of group A vs. B, data were obtained as described in “Methods”. Use arrows to indicate respective structures and details, and refer to the arrows in the figure legends. Legends of figures showing laparoscopic, endoscopic and histopathological images should provide information on the technology and sources, i. e. endoscopic images were obtained using company XY technology; histopathology was conducted using H&E stain or immunohistochemistry, as described in “Methods”. The notes below the tables explain methodological aspects. Both figure legends and table titles and notes explain abbreviations, if present. Thus, a paper improves readability, focus and becomes a straightforward piece of work. This, in turn, motivates a colleague to read the paper and helps the author to spread his ideas. Taken together, well-written and structured papers providing novelties and current topics of relevance have a great chance of getting accepted for publication.

Conclusion

Taken together, we hope that the above suggestions may be a stimulus for surgeons to live what we owe to the legacy of our ancestors: share with others the outstanding fascinations underlying our perceptions: σωζειν τα ϕαινομενα. It remains to be addressed how the above ideas are to be orchestrated to enable a perfect balance between surgical education, routine and science. Here starts the challenge and responsibility of the heads of academic institutions to establish the infrastructure, platform and working time slots for surgical science. In contrast, young academics may balance out their so-called work/life interests to meet the demands. Change is, focus counts, success motivates, silence tempers the sound, enjoy being an expert, stay tuned.

Martin Riegler

Conflict of interest

F. M. Riegler states that there are no conflicts of interest.