Academic publishing is central to scholarly knowledge validation and dissemination, yet persistent issues such as editorial gatekeeping, prestige-driven evaluation metrics, and global inequities in knowledge access continue to shape the field. These challenges have significant implications for research integrity, inclusivity, and the equitable dissemination of educational scholarship. The conversation around these topics is on-going, but little is known about how these discussions have evolved within the scholarly literature. This study presents a three-fold bibliometric analysis of scholarly literature on academic publishing reform published between 2000 and 2025. The analysis examines the literature landscape on the topics of (1) Gatekeeping and Editorial Bias, (2) Prestige-driven Metrics and Research Assessment, and (3) Barrier and Equity Issues in Research Accessibility. Using structured searches in Scopus and bibliometric analysis techniques (i.e., performance and conceptual analysis), this study identifies key publication trends and thematic patterns within each area. Time-sliced analyses further explore how discourse has shifted in response to major milestones such as the San Francisco Declaration on research assessment and the rise of the sci-hub shadow library. By providing a comprehensive overview of how these critical conversations have evolved across global scholarship, this study contributes to a deeper understanding of the dynamics, thereby shaping the future of scholarly communication and offering insights to inform ongoing reform efforts for educators, researchers, and policymakers to foster a more inclusive, transparent, and equitable academic publishing landscape.

Sahasthara (SHT), a traditional Thai herbal remedy used for anti-inflammatory and musculoskeletal disorders, lacks clinical evaluation as a topical formulation employing microemulsion (ME) technology. This study aimed to assess the efficacy and safety of a Sahasthara microemulsion (SHT-ME) compared with a diclofenac microemulsion (DF-ME) in patients with primary knee osteoarthritis (OA). Eighty-four patients aged 40–70 years were randomized to receive either 1% SHT-ME or 2% DF-ME, applied three times daily for 28 days. Efficacy was evaluated using the pain visual analogue scale (VAS), 100-m walking time, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, and global assessments. Safety assessments included physical examinations, laboratory tests, and adverse-event monitoring. Both formulations significantly reduced VAS pain scores, improved walking time, and decreased WOMAC scores at days 14 and 28 compared with baseline (P < 0.05). No significant efficacy differences were observed between groups (P > 0.05). Liver and renal function, blood pressure, and biochemical parameters remained within normal ranges, and no severe or skin-related adverse events occurred in either group. SHT-ME provided efficacy comparable to DF-ME in relieving pain and improving mobility in knee OA. Both treatments were well tolerated and safe. These findings suggest that SHT-ME, a natural herbal alternative, and DF-ME, a synthetic drug formulation, are equally effective topical microemulsions for knee osteoarthritis management.