"Publish or perish" is a maxim that demonstrates that publishing "attracts" attention towards the author; “favours” individual progress; can be seen as a measure of "competence", assisting access to academic positions, and which could be introduced as a criterion for appointment or allocating funds for collegiate projects.1 It is not surprising, then, that frequent publication can be a powerful weapon to argue in favour of potential "academic talent" and that this situation creates immense pressure to publish, along with its associated consequences.2
The pressure to publish is not a minor issue, the most recent data that has come from the National Science Board (NSB) in the US3 indicates a progressive increase in the number of publications in science and engineering.3 Of all the publications analysed by the NSB, 37.4% correspond to publications in the field of health sciences and 14.1% to biological-biomedical sciences.3
The pressure to publish is the result of the interaction of three different groups of players: publishing companies, authors and funders.4 Publishers compete with each other and in recent years the vast majority have experienced a continuous increase in the number of articles published.4 The Open Access model is an editorial feature used increasingly frequently and has reshaped the way in which biomedical literature has been disseminated and accessed over this decade, with the findings and efforts of authors being freely shared with others.5 Authors also compete with each other, and the more publications they obtain in high impact "prestigious" journals, the more positively they are considered, This can have a favourable impact on their job, promotion, access to university and potential funding for research projects.6 Funders, with few exceptions, will use publication in a scientific journal as a marker of quality (for universities and scientific societies, etc.). with the potential biases that this may give rise to.7 Economic factors also work as a feedback loop to all three groups of players.
The pressure to publish is not without threats and risks: the first concerns peer review. Peer review is an essential step in the process of publication and can be defined as the process of subjecting an author's academic work, research, or ideas to the scrutiny of other experts in the same field, before the manuscript describing that study is published. All genuine academic journals that publish research papers rely on peer review to ensure the quality of the articles they publish. It is, however, difficult to define the characteristics of a good reviewer with objective and measurable attributes. A positive quality may be to be in possession of a medical degree, simply because a medical degree is associated, a priori, with explicit proof of knowledge of the scientific method. However, some data shows that the progressive growth in publications in recent years does not correspond with the same growth in the number of researchers with a doctorate degree, at least in the countries within the Organization for Economic Cooperation and Development (OECD).4 Of course, it would be very risky to say that the peer review practised in many journals may not be optimal, solely for the previous reasons, although there is currently a clear awareness that it can and should be improved.8 However, what does appear to be a proven fact is that the number of disruptive publications has progressively decreased over recent decades9; that between 40% and 60% of what is published will never be cited1 and that 85% of biomedical research efforts may be wasted.10 The pressure to publish and the exponential increase in the number of journals may be related to other threats: the verification of Goodhart's law: when a measure [i.e. number of publications, an impact factor, etc.] becomes a target, it ceases to be a good measure”; the practice of "salami slicing": dividing the results of a research into several different publications, each of which presents a small part of the results of a larger study; plagiarism; double publication; fraudulent data in the publication; ghost-writing: (attributing authorship to those who are not involved in the drafting of the publication; or hyper-prolific authors. Other dangers related to the pressure to publish and which may be absolutely "organisations" are: predator journals, which claim to be legitimate academic journals but may distort their editorial practices; "article factories" (i.e. paper mills), as set-ups that produce fake articles with copied or invented data that simulate legitimate, genuine research work and whose business model involves selling production, publication and authorship; the "citation cartels" that lead some journals to artificially increase the impact factor through the coordinated effort of a quotes cartel of journals. Finally, another potential emerging danger is the development of artificial intelligence (AI), especially in manuscript production, and the phasing out of human involvement in the roles of editor and reviewer.
In this environment we have described, it would appear absolutely necessary that the pressure to publish be correctly modulated with sufficient academic integrity, applying: honesty i.e. being truthful, giving credit and providing correct data; trust, that is, transparency and credibility; fairness: consistent rules, equitable interactions, acceptance of responsibility; respect: accepting the opinions of others by acknowledging the impact of our words and actions; accountability: respecting institutional norms and codes of conduct, participating in difficult decisions and setting an example); and lastly, courage: standing up for integrity and enduring discomfort over something in which we believe. However, despite the good wishes of the practice of adequate academic integrity, everything described in the previous paragraphs could lead us to reflect on whether or not the term "scientific publication" is being devalued and whether the title of this document should be altered to "How can scientific publication be maintained as a benchmark for recognition". The challenge is difficult because of the complexity of all the different factors and players that fuel the pressure to publish. In our opinion, a benchmark of recognition is one that favours authority, understanding by this the prestige and credit that is recognised as given to a person or institution for their legitimacy or for their quality and competence in some matter. A benchmark for recognition is not one that favours visibility, understood as reputation or fame. A high level of integrity, self-awareness and personal discipline is required to try to avoid, or at least control, all conflicts of interest involved in research and the publication of its results, since ensuring authority means maintaining the primary interest in the foreground and moving away from any impulse towards renown that may be associated with the professional field. On the other hand, in order to maintain scientific publication as a benchmark for recognition, the three players involved must collaborate with each other. Thus, publishers should influence the clarity of allocating metrics in journals (i.e. the impact factor), promoting the maximum independence of editorial teams, the transparency of benefits and costs - or promoting quality instead of quantity. Funders should also influence the promotion of quality instead of quantity, protect absolute transparency in promoting and financing models, and further education in academic integrity. Authors should improve their education in the field of editorial work (i.e., peer review, manuscript writing, and the use of causal language), advocating quality rather than quantity, and keeping in mind a clearly understood culture of authority rather than renown.
The current academic system promotes quantity over quality, rewards high-speed science, and may ostracise scientists who do not fit this profile.11 We want to remember that we require time to think and digest; we cannot continuously "reinvent the wheel". We need slow science to develop a truthful and sustainable academic ecosystem.12 Perhaps only in this way can we prevent the aphorism "publish or perish" from being transformed into "publish and perish".

