Submissions

Author Guidelines

General Information

Thank you for considering The Health International (THI) for the publication of your scholarly work. THI is an international, peer-reviewed, open-access medical journal committed to publishing high-quality, original research that advances medicine, healthcare, biomedical sciences, public health, and health professions education.

Authors are expected to ensure that their submissions are scientifically rigorous, ethically conducted, transparently reported, and prepared in accordance with internationally accepted standards of biomedical publishing.

Before submitting a manuscript, authors should carefully read these Instructions for Authors and ensure full compliance with the journal's editorial and ethical requirements. This guide covers:

• Aims and Scope
• Journal Policies
• Article Types
• Manuscript Preparation and Formatting Instructions
• Online Manuscript Submission, Forms, and Licenses
• Article Processing Fee (APC)

These instructions comply with those formulated by the International Committee of Medical Journal Editors (ICMJE). For further details, authors should consult the following article: International Committee of Medical Journal Editors. "Uniform Requirements for Manuscripts Submitted to Biomedical Journals" New Engl J Med 1997, 336:309ΓÇô315. The complete document appears at http://www.icmje.org. Manuscripts that do not comply with these Instructions cannot be considered for publication and will be sent back to the authors.

The Editorial Office is pleased to answer any questions you may have about preparing your manuscript in accordance with our guidelines.

Aims and Scope

The Health International publishes research across the full spectrum of medicine and health sciences, including but not limited to:

Clinical Medicine

• Internal Medicine
• Family Medicine
• Cardiology
• Endocrinology
• Gastroenterology
• Pulmonology
• Nephrology
• Rheumatology
• Infectious Diseases
• Neurology
• Dermatology
• Oncology
• Hematology
• Emergency Medicine
• Critical Care
• Geriatric Medicine
• Palliative Medicine

Surgical Sciences

• General Surgery
• Orthopedic Surgery
• Neurosurgery
• Plastic Surgery
• Urology
• Cardiothoracic Surgery
• Pediatric Surgery
• Vascular Surgery
• Surgical Oncology
• Minimally Invasive Surgery

Women's and Children's Health

• Obstetrics and Gynecology
• Reproductive Medicine
• Pediatrics
• Neonatology
• Adolescent Health

Diagnostic Sciences

• Radiology
• Nuclear Medicine
• Pathology
• Laboratory Medicine
• Clinical Microbiology

Population Health

• Public Health
• Epidemiology
• Occupational Health
• Environmental Health
• Global Health
• Health Promotion

Health Professions Education

• Undergraduate Medical Education
• Graduate Medical Education
• Continuing Professional Development
• Simulation-Based Education
• Curriculum Development
• Assessment and Evaluation
• Faculty Development

Biomedical Sciences

• Molecular Medicine
• Genetics
• Immunology
• Pharmacology
• Physiology
• Biochemistry
• Translational Medicine

Emerging Areas

• Digital Health
• Artificial Intelligence in Medicine
• Precision Medicine
• Telemedicine
• Health Informatics
• Implementation Science
• Quality Improvement
• Patient Safety

Journal Policies

Originality

The Editors require that each manuscript is an original contribution and that it has not been, and will not be, submitted elsewhere while it is under consideration for publication in The Health International. Editors may subject any manuscript submitted for consideration of publication in THI to plagiarism-detection software. Manuscripts dealing with material that has appeared or is in press, in brief or preliminary form in other publications will not be considered unless the prior publication is a meeting abstract reporting only summarized information and does not exceed one printed page. The ICMJE has provided details of what is and what is not duplicate or redundant publication. If you are in doubt (particularly in the case of material that you have posted on a web site), we ask you to proceed with your submission but to include a copy of the relevant previously published work or work under consideration by other journals. Authors must draw attention to any published work that concerns the same patients or subjects as the present paper in a covering letter with their article.

Peer Review Process

All submissions undergo an initial check by our Editorial Office. Following this, Original Research Articles, Systematic Review Articles and Case Series/Reports are subject to external peer review by experts in the relevant field to ensure scientific rigor and accuracy through a double-blind process. Non-research content, such as Correspondence and Editorials, undergo editorial review by the journal's editorial team for clarity, relevance, and adherence to journal standards. Authors submitting manuscripts to the Journal may propose suitable reviewers or oppose reviewers who may have competing interests.

Following peer review, every manuscript is assigned to a handling Editor who will make a final decision based on the comments from the reviewers and their own assessment. The comments and suggestions (acceptance / rejection / amendments in manuscript) received from reviewers are conveyed to the corresponding author. If appropriate, the author may be requested to provide a point-by-point response to reviewers' comments and submit a revised version of the manuscript. Manuscripts are accepted on the basis of scientific quality, originality, significance, novelty and interest to the readership of The Health International. All papers must be reported in line with established reporting guidelines where they exist. A paper that has been formally rejected will not be reconsidered for publication in the Journal.

Appeals Policy

Appeals on editorial decisions should be sent to the Editor. Complaints related to how your paper was processed during peer-review and not resolved by the Editor, should be referred to the person named as publisher in "About the Journal" contacts or, if unsatisfied, to COPE (www.publicationethics.org).

Authorship

The Journal expects that each person listed as an author has participated sufficiently in the intellectual content, the analysis of data, and/or the writing of the manuscript to take public responsibility for it. Each author must have reviewed the manuscript, believes it represents valid work, and approves it for submission. Moreover, should the Editors request the data upon which the manuscript is based, the authors shall produce it. We ask all authors to confirm that they have met the criteria for authorship as established by the ICMJE, believe that the paper represents honest work, and are able to verify the validity of the results reported.

All persons designated as authors should qualify for authorship and all those who qualify should be listed. Each author should have participated sufficiently in the work to take public responsibility for appropriate portions of the content. One or more authors should take responsibility for the integrity of the work as a whole, from inception to published article. Authorship credit should be based only on 1) substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data for the work; 2) drafting the work or revising it critically for important intellectual content; 3) final approval of the version to be published; and 4) agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Conditions 1, 2, 3, and 4 must all be met. Acquisition of funding, the collection of data or general supervision of the research group, by themselves, do not justify authorship. All others who contributed to the work who are not authors should be named in the Acknowledgements section in the title page file.

Artificial Intelligence (AI) and AI-assisted Technologies

The journal does not consider Artificial Intelligence (AI) authoring tools to meet the requirements for Authorship as recommended by the ICMJE. Authors who use AI tools in the writing of a manuscript, production of images or graphical elements of the paper, or in the collection and analysis of data, must be transparent in disclosing in the Materials and Methods (or similar section) of the paper how the AI tool was used and which tool was used. Authors are fully responsible for the content of their manuscript, even those parts produced by an AI tool, and are thus liable for any breach of publication ethics.

In addition, authors, reviewers and editors should not upload a submitted, accepted or published manuscript or any part of it into a generative AI tool as this may violate the copyright agreement or licensing terms in effect at the time of acceptance.

Generative AI should not be used by editors or reviewers as the sole mechanism in the evaluation or decision-making process of a manuscript. The editor is responsible and accountable for the editorial process, the final decision, and the communication thereof to the authors.

CRediT (Contributor Roles Taxonomy)

The Journal has integrated CRediT (Contributor Roles Taxonomy) into the editorial workflow. CRediT allows researchers to identify manuscript contribution roles during submission that go beyond just name identification. CRediT enables more transparency to the published work and allows authors to receive credit for individual contributions towards the manuscript.

During submission, when a corresponding author adds additional authors to the author list, they can select each individual author's contribution roles from the list of roles below. More than one contribution can be selected for each author.

Role	Definition
Conceptualization	Ideas; formulation or evolution of overarching research goals and aims.
Data curation	Management activities to annotate (produce metadata), scrub data and maintain research data (including software code, where it is necessary for interpreting the data itself) for initial use and later re-use.
Formal analysis	Application of statistical, mathematical, computational, or other formal techniques to analyse or synthesize study data.
Funding acquisition	Acquisition of the financial support for the project leading to this publication.
Investigation	Conducting a research and investigation process, specifically performing the experiments, or data/evidence collection.
Methodology	Development or design of methodology; creation of models.
Project administration	Management and coordination responsibility for the research activity planning and execution.
Resources	Provision of study materials, reagents, materials, patients, laboratory samples, animals, instrumentation, computing resources, or other analysis tools.
Software	Programming, software development; designing computer programs; implementation of the computer code and supporting algorithms; testing of existing code components.
Supervision	Oversight and leadership responsibility for the research activity planning and execution, including mentorship external to the core team.
Validation	Verification, whether as a part of the activity or separate, of the overall replication/reproducibility of results/experiments and other research outputs.
Visualization	Preparation, creation and/or presentation of the published work, specifically visualization/data presentation.
Writing ΓÇô original draft	Preparation, creation and/or presentation of the published work, specifically writing the initial draft (including substantive translation).
Writing ΓÇô review & editing	Preparation, creation and/or presentation of the published work by those from the original research group, specifically critical review, commentary or revision ΓÇô including pre- or post-publication stages.

Changes to Authorship

The Health International considers the final author list to be complete at the time of the first revision submission. Please be sure to check that all authors are properly listed on the revision submission; this includes the spelling of author names, their designated degrees, their affiliations, and the order of authors listed.

The Health International has a strict policy on changes to authorship and will not consider authorship change requests after acceptance of the article.

English Language Assistance

Authors who are not native speakers of English who submit manuscripts to international journals often receive negative comments from referees or editors about the English-language usage in their manuscripts, and these problems can contribute to a decision to reject a paper. To help reduce the possibility of such problems, we encourage such authors to consider using THI Author Services.

THI Author Services offers a unique range of editorial services to help you prepare a submission-ready manuscript:

• Premium Editing: Intensive language and structural editing of academic papers to increase chances of journal acceptance.
• Advanced Editing: A complete language, grammar, and terminology check to give you a publication-ready manuscript.
• Translation with Editing: Write your paper in your native language and THI Author Services will translate it into English, as well as edit it to ensure that it meets international publication standards.
• Plagiarism Check: Helps ensure that your manuscript contains no instances of unintentional plagiarism.
• Artwork Preparation: Save precious time and effort by ensuring that your artwork is viewed favorably by the journal without you having to incur the additional cost of purchasing special graphics software.

Note that the use of such a service is at the author's own expense and risk and does not guarantee that the article will be accepted.

Abbreviations, Nomenclature and Symbols

Abbreviations, nomenclature and symbols should conform to those found in the AMA Manual of Style. Use Standard International (SI) units. Abbreviations should be used sparingly and should be spelled out the first time they are used.

Ethics

All articles dealing with original human or animal data must include a statement on ethics approval at the beginning of the Methods section. This paragraph must contain the following information: the name and address of the ethics committee responsible; the protocol number that was attributed by this ethics committee; and the date of approval by the ethics committee.

The paragraph could read, for example:

Ethical approval for this study (Ethical Committee N┬░ NAC 207) was provided by the Ethical Committee NAC of Geneva University Hospitals, Geneva, Switzerland on 12 February 2015.

Work on human beings that is submitted to The Health International should comply with the principles laid down in the Declaration of Helsinki. The manuscript should contain a statement that the work has been approved by the appropriate ethical committees related to the institution(s) in which it was performed and that you obtained written informed consent from the study participants. Similarly, for experiments involving animals you must state the care of animal and licensing guidelines under which the study was performed and report these in accordance with the ARRIVE (Animals in Research: Reporting In Vivo Experiments) statement. If ethics clearance was not necessary, or if there was any deviation from these standard ethical requests, please state why it was not required. Please note that the editors may ask you to provide evidence of ethical approval. If you have approval from a National Drug Agency (or similar) please state this and provide details, this can be particularly useful when discussing the use of unlicensed drugs.

Informed Consent and Patient Details

The protection of a patient's right to privacy is essential. Studies on patients or volunteers require ethics committee approval and informed consent, which should be documented in the 'Methods' section of your paper. Appropriate consents, permissions and releases must be obtained where an author wishes to include case details or other personal information or images of patients and any other individuals. Written consents must be retained by the author and copies of the consents or evidence that such consents have been obtained must be provided to the Journal on request. Unless you have written permission from the patient (or, where applicable, the next of kin), the personal details of any patient included in any part of the article and in any supplementary materials (including all illustrations and videos) must be removed before submission.

Registration of Studies

Authors submitting manuscripts involving human participants must ensure that their research is registered in a publicly accessible trials registry before the enrolment of the first participant, in accordance with international ethical and editorial standards and the Declaration of Helsinki.

Studies That Require Registration. You must register your study if it meets the definition of a clinical trial established by the International Committee of Medical Journal Editors (ICMJE), the World Health Organization (WHO), the U.S. Food and Drug Administration (FDA), and the National Institutes of Health (NIH).

A clinical trial is defined as any research project that prospectively assigns human participants to one or more interventions to evaluate their effects on health-related outcomes. Interventions may include drugs, biologics, medical devices, surgical procedures, behavioural programs, educational interventions, dietary changes, or other health-related actions.

Where to Register. The editors of The Health International do not advocate one particular registry but require that the registry utilized is publicly accessible and searchable. Options include:

• ClinicalTrials.gov ΓÇô WHO and ICMJE approved ΓÇô for all human studies ΓÇô free
• Chinese Clinical Trial Registry (chictr.org.cn) ΓÇô for all human studies ΓÇô free
• ISRCTN.com ΓÇô WHO and ICMJE approved ΓÇô for all human studies ΓÇô charge
• PROSPERO ΓÇô for systematic reviews only ΓÇô free

Studies That Do Not Require Registration. Registration is not required for the following article types:

• Non-interventional observational studies (unless required by your funder)
• Laboratory or animal studies
• Retrospective analyses
• Case reports and case series
• Reviews, systematic reviews, or meta-analyses

Authors may voluntarily register observational studies, though this is optional.

Reporting Guidelines

Compliance with the relevant reporting guideline is mandatory for submission. Authors must submit a completed checklist, indicating the page numbers where compliance was achieved, and mention in the methods section that the research is being reported in line with the relevant named guideline.

Case Reports and Studies: All surgical case reports should follow the SCARE guidelines, and all medical case reports should follow the CARE guidelines. Authors must submit a completed SCARE/CARE checklist as supplemental material. See the SCARE statement and CARE guidelines.

Case Series: All case series should follow the PROCESS or STROBE guidelines ΓÇô whichever is most relevant to the work. A completed checklist must be uploaded as supplemental material. See PROCESS and STROBE.

Randomised Controlled Trials: Must include a completed CONSORT flow chart and checklist as supplemental material. See CONSORT.

Systematic Reviews: Should be reported in accordance with the PRISMA guidelines and must include the flow diagram as a figure and the checklist as supplemental material. See PRISMA.

Cohort, Case-Control, and Cross-sectional Studies: Should be compliant with either STROBE or STROCSS ΓÇô whichever is most relevant. See STROBE and STROCSS.

Diagnostic, Quality Improvement and Qualitative Studies: Diagnostic accuracy studies should follow STARD (with flow diagram and checklist); quality improvement studies should comply with SQUIRE; qualitative studies require the COREQ checklist.

Health Economic Evaluation: Should conform to the CHEERS statement.

Tumour Marker Prognostic Study: Should be reported in accordance with the REMARK criteria.

Experimental Animal Studies: Must be reported in accordance with the ARRIVE guidelines and must include the checklist as supplemental material. The institutional protocol number should be included at the end of the abstract.

Financial Support and Competing Interests

All authors must disclose any financial and personal relationships with other people or organizations that could inappropriately influence (bias) their work. A financial disclosure questionnaire must be completed by the corresponding author on behalf of all co-authors at initial submission. In addition to monetary interests, a potential for conflict of interest can exist whether or not an individual believes that a relationship (such as dual commitments, competing interests, or competing loyalties) affects his or her scientific judgment. Please review the ICMJE Uniform Requirements on conflicts of interest.

Authors must include all relevant conflicts of interest in their Cover Letter (for identifiable information) or in their Manuscript (for non-identifiable information). If any of the disclosures are not relevant to your manuscript, please state so underneath the heading.

In the Cover Letter:

• Research registration unique identifying number
• Data availability statement
• Author contribution

In the Manuscript:

• Ethical approval
• Patient or volunteer consent
• Sources of funding
• Conflict of interest disclosure

Ownership/Permissions

All figures submitted must be owned solely by the author(s). For figures not meeting this requirement, authors must obtain permission for the use of the figure by The Health International. Obtaining this permission is the sole responsibility of the author(s). Credit must be included in the figure legend for all figures being printed with permission. These requirements apply to:

• Previously published materials such as figures and adapted tables or direct quotations of more than 50 words ΓÇô require permission from the copyright holder (usually the original publisher).
• Unpublished data (e.g. from a personal conversation or a manuscript in preparation) ΓÇô require permission from the appropriate investigator.
• Photographs revealing unmasked faces ΓÇô require permission from the subject(s) of the photograph. If subject or patient consent cannot be reached, photographs must be unidentifiable.

Product Information

Medications, materials, and devices must be identified by full non-proprietary name as well as brand name if appropriate and the manufacturer's name. Place this information in parentheses in the text, not in a footnote.

Retractions

The Health International is a member of the Committee on Publication Ethics (COPE), and also refers to the ICMJE advice on Scientific Misconduct, Expressions of Concern, and Retraction, as well as on Overlapping Publications.

Disclaimer

The information and opinions presented in the Journal reflect the views of the authors and not of the Journal or its Editorial Board or the Publisher. Publication does not constitute endorsement by the journal. Neither The Health International nor its publishers nor anyone else involved in creating, producing or delivering The Health International or the materials contained therein, assumes any liability or responsibility for the accuracy, completeness, or usefulness of any information provided in The Health International, nor shall they be liable for any direct, indirect, incidental, special, consequential or punitive damages arising out of the use of The Health International. The Health International, nor its publishers, nor any other party involved in the preparation of material contained in The Health International represents or warrants that the information contained herein is in every respect accurate or complete, and they are not responsible for any errors or omissions or for the results obtained from the use of such material. Readers are encouraged to confirm the information contained herein with other sources.

Article Types

Original Research Article: Full-length reports of completed basic, clinical and experimental research reported in accordance with the Reporting Guidelines stated above. The manuscript must be no more than 2,500 words (excluding references) and contain the following: a structured Abstract, Introduction, Methods, Results, Discussion, Acknowledgements, and References. Original articles can have up to six figures/tables. Authors are encouraged to publish additional material (for instance, large tables, figures with forest plots, data from subgroup analyses etc.) as Supplemental Digital Content.

Review Article: These are conventional, non-systematic reviews and should be no more than 3,500 words (excluding references). Reviews should provide a clear introducing and concluding section. Please provide an unstructured abstract (250 words) as well as an Acknowledgement statement. Review articles can have up to six figures/tables.

Experimental Research: Full-length reports of completed basic or cadaveric research reported in accordance with the Reporting Guidelines stated above. The manuscript must be no more than 4,000 words (excluding references) and contain the following: a structured Abstract, Introduction, Methods, Theory/Calculation, Discussion, Conclusion, Appendices, Acknowledgements, and References. Authors are encouraged to publish additional material as Supplemental Digital Content.

Quality Improvement Research Articles: The following structure is recommended: (1) The context; (2) Outline of problem (patient centered); (3) Key measures of improvement; (4) Institutional setting; (5) Process of gathering info about the problem; (6) Analysis and interpretation; (7) Strategy for change and implementation; (8) Effects of change ΓÇô reassessment (PDSA cycles); (9) Lessons learnt, message for others and next steps. The manuscript must be no more than 2,500 words (excluding references), must contain a structured abstract, and can have up to six figures/tables.

Cohort, Case-Control and Cross-sectional Studies: No more than 3,000 words (excluding references), including a structured abstract, and can have up to six figures/tables.

Case Report: Articles reporting rare medical conditions or occurrences, or cases where a lesson can be communicated. Case Reports should increase awareness of a condition, suggest a reasonable diagnostic strategy, or demonstrate a more cost-effective approach to management, and must adhere to the journal's Ethics and Patient's Privacy requirements. The manuscript must be no more than 1,500 words (excluding references) and contain: a structured Abstract, Introduction, Presentation of Case, Discussion, Conclusion, Acknowledgements, and References. Case Reports should have no more than three figures/tables.

Tumour Marker Prognostication Study: Should include the following subsections: Introduction, Materials and Methods (Patients, Specimen characteristics, Assay methods, Study design, Statistical Analysis), Results, and Discussion. No more than 3,000 words (excluding references), including an abstract (300 words) and up to six figures/tables.

Health Economic Evaluation: Should include: Title and abstract (300 words), Introduction (Background and objectives), Methods (target population, setting, perspective, comparators, timeframe, measurement of effectiveness, estimations of resources, costs and analytic method), Results (Parameters, costs, outcomes), Discussion (findings, limitations, generalizability), and Other (Source of funding, Conflict of interests). Word limit is 3,000 words (excluding references), with up to five figures/tables.

Editorial: Discuss issues that are not directly related to published material and are usually invited. Up to 2,000 words with no more than 15 references and no more than three figures/tables, with a clear introducing and concluding section. Please include a title page giving all authors' names, addresses, email addresses, phone numbers, and an Acknowledgement statement.

Correspondence: A letter to the Editor raising issues of importance regarding an article recently published in the journal. If accepted, the letter is sent to the authors of the article for a response. No more than 1,000 words, no abstract or sub-titles, and no more than three figures/tables. The title should reflect the content of the letter and not repeat the title of the targeted article. Please include a title page giving the author's name, address, email address, phone number, and an Acknowledgement statement.

Manuscript Preparation and Formatting Instructions

Manuscripts must be written in clear, grammatical English (see English Language Assistance above). Manuscripts not conforming to journal format will be returned to authors for modification.

• Text should be 1.5-spaced.
• Body text size should be no smaller than 10 pt and no larger than 12 pt.
• Do not add line numbers, as the system will generate those when the PDF is built.
• Authors should avoid repeating the same information in the Abstract, Introduction, and Discussion.

Footnotes, abbreviations, and abstract pages must be included in the main body file; please do not upload separate copies of these documents. Please ensure the Title Page is uploaded separately from the main body file, to comply with our double-blind peer review process ΓÇô the main body file should not include any identifiable author information.

Acceptable document file types for text and tables include .DOC and .DOCX; do not submit a PDF.

Title Page

The following elements are required for every submission:

Title. Include a concise, descriptive and informative title. Titles are often used in information-retrieval systems. Avoid abbreviations and formulae where possible. The title should not be a sentence. No proprietary or brand names for drugs or agents may be used in article titles.

Authors. Author names should be listed in the following order: the full first name, middle initials, last name of each author, medical and/or highest academic degrees, followed by the name(s) of the department(s) and institution(s) to which the work should be attributed. When a large group or center has conducted the work, the author list should include the individuals whose contributions meet the authorship criteria defined above, as well as the group name. If the article has been submitted on behalf of a consortium, all author names and affiliations should be listed in the Acknowledgements section.

Address for Correspondence. One author should be designated as the corresponding author. A current email and full mailing address for the corresponding author must be provided.

Acknowledgements statement. This section should contain the following distinct statements in separate paragraphs:

• Assistance with the study. Acknowledgements should be made only to those who have made a substantial contribution to the study. Authors are responsible for obtaining written permission from people acknowledged by name. If there was no assistance, state: "Assistance with the study: none."
• Financial support and sponsorship. Reference all relevant sources of funding concerning this article. If there were none, state: "Financial support and sponsorship: none."
• Conflicts of interest. Reference all relevant conflicts of interest concerning this article, including financial, consultant, institutional and other relationships. If there are none, state: "Conflicts of interest: none."
• Presentation (for original articles only). Presentations of preliminary data at, for example, international meetings should be acknowledged separately. If not previously presented, state: "Presentation: none."

Abstract

A concise and factual abstract is required. The abstract should briefly describe the purpose of the research, the principal results and major conclusions.

A structured abstract should be a maximum of 300 words. For all original research articles, the abstract should be structured using the following headings: Background; Materials and Methods; Results; Conclusion.

Conventional non-systematic reviews should include an unstructured abstract of no more than 250 words.

Graphical Abstract

Although a graphical abstract is optional, its use is encouraged as it draws more attention to the online article. The graphical abstract should summarize the contents of the article in a concise, pictorial form. Graphical abstracts should be submitted as a separate file. Preferred file types: TIFF, JPEG, EPS or MS Office files.

Highlights

Highlights are concise bullet points that convey the core findings and provide readers with a quick textual overview of the article. Highlights are mandatory for all original research articles.

Keywords

Immediately after the abstract, provide a maximum of 6 keywords, avoiding general and plural terms and multiple concepts. Be sparing with abbreviations: only abbreviations firmly established in the field may be eligible. These keywords will be used for indexing purposes.

Main Body

Introduction. Contains a statement of the purpose of the work, the problem that stimulated it, and a brief summary of relevant published investigations.

Methods. Provide sufficient detail to allow the work to be reproduced. Methods already published should be indicated by a reference; only relevant modifications should be described. Include appropriate ethical and statistical information.

Results. Should be concise, avoiding redundant tables and figures illustrating the same data.

Discussion. Should explore the significance of the results of the work, not repeat them. A combined Results and Discussion section is often appropriate. Avoid extensive citations and discussion of published literature.

References

The style of references should conform to the guidelines set forth by the AMA Manual of Style (see amamanualofstyle.com). Authors using reference management software should use JAMA style.

• All references cited in the text must be both listed and cited by the reference number (footnotes are not accepted).
• Each reference should be cited in the text, tables, or figures in consecutive numerical order by means of superscript Arabic numerals. Use superscript numerals outside periods and commas, inside colons and semicolons.
• References should be numbered consecutively in the order in which they are cited in the text.
• References in tables and figure legends must appear in the reference list.
• In listed references, use the author's surname followed by initials without periods (e.g., Doe JF).
• For references with 6 or fewer authors, list all authors. For references with more than 6 authors, list the first 3 authors followed by "et al."

Examples:

• 1 author: Doe JF.
• 2 authors: Doe JF, Roe JP III.
• 6 authors: Doe JF, Roe JP III, Coe RT Jr, Loe JT Sr, Poe EA, van Voe AE.
• >6 authors: Doe JF, Roe JP III, Coe RT Jr, et al.

Full-page ranges should be given in expanded form (e.g., 426-429, not 426-9). If non-English-language titles are translated into English, a bracketed indication of the original language should follow the title. Abbreviate and italicize names of journals according to the style in PubMed; refer to the National Library of Medicine (NLM) Journals Database if needed.

1. Author(s). Article Title. Journal Name. Month Year: inclusive pages.
2. Author(s). Article Title. Journal Name. Year;(Issue No.): inclusive pages.
3. Author(s). Article Title. Journal Name. Year; vol: inclusive pages.

Papers "submitted for publication" but not yet accepted, and citations such as "personal communication" or "unpublished data," are not acceptable as listed references and instead should be included parenthetically in the text (e.g., "J. F. Doe, MD, unpublished data, January 2010"). Papers denoted "in press" (accepted for publication) should appear in the references. Authors are responsible for the accuracy and completeness of the references.

Tables

References to tables should be made in order of appearance in the text and should be in Arabic numerals in parentheses, e.g. (Table 1). Each table should be typed on a separate word processing document in 1.5 spacing and uploaded individually. Tables should not be submitted as photographs. Do not embed tables within the manuscript file; tables are text-only, and images must not be embedded within a table file. Each table should have a brief title as a heading, appropriate column heads, and any legends. Vertical rules should not be used. Place explanatory matter in a footnote, not in the heading. Abbreviations are not permitted in table titles; any abbreviation(s) used in the body of the table must be defined in the footnotes, listed in reading order. Be sure that each table is cited in the text. If you use data from another published or unpublished source, obtain permission and acknowledge the source fully. Authors are encouraged to submit non-essential tables as Supplemental Digital Content for online-only publication. For further information, see the AMA Manual of Style.

Figures and Legends

• Figures should be uploaded in the highest resolution available. Legends should be supplied for all figures, numbered to correspond with the figures and typed double-spaced on a separate page.
• Do not embed figures into the main body file.
• Each figure must be uploaded as a separate file, saved as the appropriate figure number (e.g., Figure 1.tif). Label figures using the Description field in the Attach Files section (e.g., Figure 1, Figure 2). Do not include the author's name in the figure file name.
• Cite figures consecutively in the manuscript and number them in the order in which they are discussed.
• All final digital figures for accepted manuscripts must be submitted in EPS, TIFF, or MS Office (DOC, PPT, XLS).
• Art should be created and scaled to the size intended for publication, with the same orientation as intended for publication.
• Artwork generated from office suite programs such as CorelDRAW, MS Word, MS PowerPoint and artwork downloaded from the Internet (low resolution JPEG or GIF files) cannot be used.
• All figures must be designated GRAYSCALE (black and white) or RGB (colour).
• Diagrams, drawings, graphs, and other line art (purely black and white figures with no shades of grey) should be prepared at a resolution of 1200 DPI.
• Halftone images (black/white or colour) should be prepared at a resolution of at least 300 DPI.
• Combination halftones (images containing both pictures and text labelling) should be prepared at 600 DPI.
• Digital art files should be cropped to remove non-printing borders and should not include embedded "legend" text, figure titles, or figure numbers.
• Composite figures may be submitted as one single print-quality image neatly labelled with uppercase letters using Arial/Helvetica bold font, or as separate panels (without labels), e.g. Figure 1A.tif, Figure 1B.tif, to be combined during production if accepted.
• Legends for all figures should be brief and specific and should appear on a separate page at the end of the manuscript document, following the list of references, correctly numbered.
• All symbols or abbreviations appearing in an illustration must be defined in the legend; arrows appearing in a figure should be mentioned in the legend.
• Legends of composite figures should be formatted as a single legend containing necessary information about each part/panel.
• Your manuscript may be returned to you for correction if the images are of insufficient quality.
• If photographs of people are used, their identities must be obscured or their written consent to use the photograph must have been obtained. The Editors may request copies of consent forms.
• If a figure has been published before, the original source must be acknowledged and written permission from the copyright holder for both print and electronic formats should be submitted with the material.
• Figures may be reduced, cropped, or deleted at the discretion of the editor.
• Carefully review the PDF conversion of your submission files to ensure that the figures uploaded without error and appear as intended.
• Artwork submitted to the journal will be checked for quality. Authors submitting a revised paper will have the opportunity to check the quality of their images and make necessary changes.

Supplemental Digital Content (SDC)

Authors may submit Supplemental Digital Content to supplement the information provided in the manuscript. SDC may include text, tables, figures, references peripheral to the SDC, audio, and video. SDC should be consecutively cited in the Main Body text of the submitted manuscript. SDC files will be available via URL(s) placed at the citation points within the article and are not copyedited by the publisher; they will be presented digitally as submitted. Journal policies for manuscript submission relating to peer review, patient anonymity, ethics, financial disclosure, copyright, and permissions also apply to SDC. Authors should mask patients' eyes and remove patients' names from supplemental digital content unless they obtain written consent from the patients and submit them as supplemental files at the time of manuscript submission.

Format, File Type and Size Requirements: SDC may be presented in any format (PDF is preferred) and should indicate the article title and first author for clarity. Supplemental content should include a sequential number if submitting more than one. Each SDC file should have a visual header in the following name format (e.g., "SDC, Figure 1"; "SDC, Materials and Methods") with a corresponding citation appearing consecutively in the Main Body text. SDC is numbered separately from non-SDC material. When uploading SDC, select "Supplemental Digital Content" as the file designation. For audio and video files, also include the author's name, videographer, participants, length (minutes), and size (MB). Video files should be formatted with a 320x240 pixel minimum screen size, submitted using .wmv, .mov, .flv, .qt, .mpg, .mpeg, or .mp4 formats only, should not exceed 10 minutes of runtime, and must include embedded audio narration in English. For each submission, the SDC file cannot exceed a total size of 10 MB.

Online Manuscript Submission, Forms, and Licenses

New Submissions

Once the manuscript has been created, use the journal's online submission system to upload it. Once the manuscript has been vetted for compliance with the Journal's requirements, a manuscript number will be assigned to the submission. Failure to adhere to these guidelines will result in your manuscript being returned to you for correction. Emailed copies of manuscripts will not be accepted.

Page Proofs / Electronic Proofs

Authors will receive notification via email that the PDF proofs of their article are available. Authors are urged to carefully examine the proofs, correct any inadequacies or inaccuracies, and answer all queries. Only the most critical changes to the accuracy of the content will be made. Changes that are stylistic or a reworking of previously accepted material will be disallowed. Rewriting sections of text, adapting tables and figures, and/or adding/subtracting references are not permitted at this point in the process. Corrections or approval should be sent to the Production Editor within 48 hours.