Open access, China, and the changing geography of publishing in bone science: Lessons from Bone Research.

Open access has widened access to scientific knowledge while shifting much of the cost of publication from readers and libraries to authors and their funders. At the same time, China has rapidly expanded its research output and journal infrastructure, reshaping the geography of scientific publishing. This Commentary examines how these developments intersect in bone science, using Bone Research as a case study. The journal's rise reflects genuine scientific achievement as well as the strategic combination of full open access, international publishing infrastructure, a large research community, authoritative reviews, and strong representation of rapidly expanding interdisciplinary topics. Its high Journal Impact Factor should be understood as a measure of citation performance, not as evidence that every article is more rigorous or clinically consequential than work published elsewhere. These changes matter for osteoporosis research and care because publication costs and citation-oriented editorial priorities may influence which investigators, research questions, and forms of clinical evidence become visible. China did not create these rules; it adapted to them at exceptional scale and speed. A more equitable system should preserve reader access, improve transparency about article processing charges and manuscript transfers, reduce reliance on journal-level metrics, protect editorial independence from publication revenue, and support researchers with limited publication funding.