
of important results faster, democratize scientific publishing, and make public criticism
possible, allowing papers to be further vetted by the community instead of a select
group of peer reviewers [10–13]. Skeptics, on the other hand, worry that unvetted
scientific documents released into the public domain risk spreading falsities and push
out niche groups and topics from the greater research enterprise altogether [14–16].
ArXiv, one of the first preprint servers, was launched in 1991 to make the sharing of
high-energy physics manuscripts easier among colleagues [3]. It began as an email server
hosted on a single computer in Los Alamos National Laboratory that sent out
manuscripts to a select mailing list. Within a few years, arXiv was turned into a web
resource. Other fields, like condensed-matter physics, and later computer science and
mathematics, began using arXiv and eventually adopted it as their primary form of
communication. Ginsparg (2011) [3], the founder of arXiv, believes its growth has
helped to democratize science in the fields that have adopted it. Indeed, many of the
previously mentioned fields now use arXiv as their primary source of scholarly
communication [2, 17, 18].
Inspired by arXiv, bioRxiv was launched in 2013 as a preprint server focused
specifically on the biological sciences [6]. The sister server to bioRxiv, medRxiv, was
launched in 2019 [19]. Together, these servers contain over 160,000 biomedical
preprints [20, 21], a number which continues to grow rapidly [6]. This initial growth was
greatly accelerated by the COVID-19 pandemic, where fast dissemination of research
was critical [22] and together, these servers now have over 20,000 COVID-19 related
preprints [23].
Despite the widespread adoption of arXiv in many fields, biology and medicine has
been slow to adopt preprints beyond their use in a pandemic [7, 10,24]. While the utility
of preprints during a pandemic is especially clear, e.g. a quick time to publication,
biomedicine in general tends to still rely on peer reviewed work [25, 26] despite the early
growth of preprint servers in the field. As an example of this hesitancy, the advisory
board behind the conception of PubMedCentral, a free full-text archive for biomedicine,
elected to disallow the posting of non-referried works, despite the knowledge of the
success of an arXiv model, in fear of losing publisher support [3, 27]. More recently,
however, the National Institutes of Health (NIH) allowed researchers to claim preprints
as interim research products in grant applications [28], indicating a level of support for
preprints they have not had in the past. As much of the biomedical research community
relies on the NIH for funding, this is an important step toward greater adoption of
preprints [7]. Another important step is integration of preprints into the primary
database for biomedical research, PubMed. As recently as 2020, NIH has begun a
preprint pilot to index preprints in PubMedCentral and by extension, PubMed [29].
The preliminary nature of preprints offers a unique perspective toward the
development of scientific projects. The relatively lower economic and time barrier to
posting means that work is made available earlier in a project’s development, and may
even be the only public output of a project [30, 31]. The low barrier to entry for
preprints could be particularly powerful for developing countries, where lack of financial
resources for publication and lack of institutional library support makes research,
especially that published in peer-reviewed channels, more difficult [32–34].
It is well known that developing countries are underrepresented in the research
world [35–37], and increasing research output from developing countries may be
beneficial to their economic development [38]. It has been suggested that low research
output stems from high publication costs, lack of institutional support, lack of external
funding, bias, high teaching burden, and language issues [35, 39–46]. The open access
movement promises to overcome some of these issues by making research widely
available to researchers that do not have institutional support [34]. Projects like
SciELO aim to increase visibility of open access works from developing countries [47],
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