Ethical Principles and Publication Policy

The journal is committed to maintaining high standards of research integrity, publication ethics, patient protection, scientific transparency, and responsible medical and health-science publishing.
Authors, reviewers, editors, editorial board members, and the publisher are expected to comply with applicable ethical, scientific, and publication standards throughout the research, submission, peer-review, editorial, production, and post-publication processes.
The journal follows and supports internationally recognized principles and guidance relevant to medical and health-science publishing, including recommendations and guidance from:
International Committee of Medical Journal Editors (ICMJE)
Committee on Publication Ethics (COPE)
World Association of Medical Editors (WAME)
Council of Science Editors (CSE)
European Association of Science Editors (EASE)
World Medical Association (WMA)
National Library of Medicine (NLM)
EQUATOR Network
The journal applies ethical requirements according to the nature of the research, study design, article type, applicable laws and regulations, institutional requirements, and relevant professional standards.

Research Integrity

Authors are responsible for ensuring that research is conducted and reported honestly, accurately, transparently, and responsibly.
Research findings must not be fabricated, falsified, manipulated, or selectively presented in a manner that misrepresents the research.
Authors should provide sufficient methodological information to permit appropriate scientific assessment of the work.
The journal does not tolerate research or publication practices that compromise the reliability or integrity of the scholarly record.

Research Involving Human Participants

Research involving human participants must comply with applicable ethical principles, institutional requirements, national regulations, and internationally recognized standards.
For medical and health-related research, authors should follow the principles of the Declaration of Helsinki, where applicable.
Where ethical review is required, approval must be obtained from an appropriate research ethics committee, institutional review board, or equivalent competent authority before the research is conducted.
Where applicable, manuscripts should identify:
Name of the ethics committee or institutional review board;
Approval or reference number;
Date of approval or other relevant identifying information;
Ethical approval or exemption status; and
Relevant ethical considerations or limitations.
Where formal ethical approval was not required, authors should provide an appropriate explanation where relevant.
The journal may request supporting ethical-approval documentation when necessary.

Human Participant Protection

Authors must take appropriate measures to protect the rights, safety, dignity, privacy, and confidentiality of research participants.
Manuscripts should provide sufficient information concerning participant selection, eligibility criteria, study procedures, interventions, data collection, and relevant ethical safeguards.
Researchers should minimize unnecessary risks to participants and comply with applicable ethical and regulatory requirements.

Informed Consent

Appropriate informed consent must be obtained where required by applicable ethical standards, institutional requirements, or regulations.
For clinical studies and other research involving human participants, authors should provide information concerning the consent process where appropriate.
For case reports, case series, clinical images, photographs, interviews, or other publications containing potentially identifiable patient information, appropriate consent for publication must be obtained where required.
For minors or individuals unable to provide informed consent, consent should be obtained from an authorized parent, guardian, or legally authorized representative, as applicable.
The manuscript should contain an appropriate statement regarding informed consent where applicable.
The journal may request confirmation or documentation of consent where necessary.

Patient Privacy and Confidentiality

Patient privacy and confidentiality must be protected throughout the research and publication process.
Authors must not publish unnecessary identifying information, including names, addresses, identification numbers, medical record numbers, or other information that could reasonably identify a patient.
Clinical photographs, imaging, case descriptions, videos, genetic information, or other potentially identifiable material must comply with applicable privacy and consent requirements.
Where identifying information is essential for the scientific purpose of the article, appropriate consent for publication must be obtained where required.
Reviewers and editors must also maintain the confidentiality of patient and research information encountered during manuscript handling.

Clinical Trials and Trial Registration

Clinical trials involving human participants should be prospectively registered in a publicly accessible clinical trial registry recognized by the relevant authorities, where registration is applicable.
The manuscript should include:
Name of the clinical trial registry;
Trial registration number; and
Other relevant registration information where appropriate.
Registration information should be consistent with the study described in the manuscript.
Authors should follow appropriate reporting standards for clinical trials, including the CONSORT Statement, where applicable.

Research Involving Animals

Research involving animals must comply with applicable institutional, national, and international requirements for animal welfare and ethical research.
Where required, approval must be obtained from the appropriate institutional animal ethics committee or equivalent authority before the research is conducted.
Manuscripts should provide appropriate information concerning:
The approving ethics committee or authority;
Approval or reference number, where applicable;
Animal welfare procedures; and
Relevant measures taken to minimize pain, suffering, distress, or unnecessary use of animals.
Authors should follow the ARRIVE Guidelines where applicable.

Retrospective, Secondary-Use, and Medical Record Studies

Retrospective studies, secondary analyses, studies using medical records, registries, databases, biobanks, or previously collected human data must comply with applicable ethical, privacy, institutional, and legal requirements.
Where ethical approval or exemption is required, this should be documented in the manuscript.
Where informed consent was not obtained, authors should provide an appropriate ethical justification or exemption where applicable.
Personal or identifiable information must not be disclosed without an appropriate ethical and legal basis.

Human Biological Materials, Tissues, and Organs

Research involving human tissues, biological samples, organs, cells, or other human-derived materials must comply with applicable ethical and regulatory requirements.
Where applicable, authors should provide information regarding:
Ethical approval;
Source of the material;
Consent requirements;
Relevant institutional permissions; and
Appropriate safeguards for donor privacy and confidentiality.
Research involving human organs, tissues, or transplantation should comply with applicable international and national requirements, including relevant WHO Guiding Principles, where applicable.

Authorship and Contributor

Authorship must accurately reflect meaningful contributions to the research and manuscript.
For biomedical and health-related research, authors should follow the authorship recommendations of the International Committee of Medical Journal Editors (ICMJE).
All listed authors should have:
Made a meaningful contribution to the work;
Participated sufficiently to take responsibility for appropriate aspects of the work;
Approved the final version;
Agreed to its submission and publication; and
Accepted responsibility for addressing questions concerning the accuracy or integrity of the work.
Guest, gift, and ghost authorship are not permitted.
Individuals who contributed to the work but do not qualify for authorship may be acknowledged with their permission.

Changes to Authorship

Requests to add, remove, or rearrange authors should normally be made before acceptance.
Such requests should include:
A clear written explanation;
Submission by the corresponding author; and
Appropriate written confirmation from the affected authors and, where applicable, all listed authors.
Requests after acceptance will be considered only in appropriate circumstances and may require additional documentation or publication of a correction.

Conflicts of Interest

Authors, reviewers, editors, and editorial board members must disclose actual, potential, or perceived conflicts of interest that could reasonably affect the research, peer review, interpretation, or editorial decision.
Conflicts may include:
Financial relationships;
Employment;
Consultancies;
Honoraria;
Grants or other financial support;
Stock ownership;
Patents or patent applications;
Institutional relationships;
Personal relationships;
Professional collaborations;
Academic or supervisory relationships;
Competitive relationships; or
Other relevant interests.
Where no relevant conflict exists, authors may state:
“The authors declare that they have no conflict of interest.”
Conflicts must be appropriately managed to protect the independence and integrity of the publication process.

Funding and Financial Support

All sources of financial support for the research or preparation of the manuscript must be disclosed.
Where applicable, authors should describe the role of the funding organization in:
Study design;
Data collection;
Data analysis;
Manuscript preparation; and
The decision to submit or publish the work.
Where no external funding was received, authors may provide an appropriate statement such as:
“No external funding was received for this study.”

Data Availability and Research Transparency

Authors should provide a Data Availability Statement where applicable.
The statement should indicate whether supporting data are:
Publicly available;
Available through a recognized repository;
Available from the corresponding author upon reasonable request; or
Unavailable because of ethical, privacy, legal, confidentiality, or other restrictions.
Authors must not disclose confidential or personally identifiable patient information without appropriate authorization.
Data should be presented accurately and should not be fabricated, falsified, selectively manipulated, or otherwise misrepresented.

Sex and Gender Considerations

Where relevant to the research, authors are encouraged to transparently consider and report sex and gender-related factors.
Authors should distinguish between sex and gender and describe relevant considerations in study design, analysis, interpretation, and reporting where applicable.
For medical and health-science research, authors may refer to the Sex and Gender Equity in Research (SAGER) Guidelines where appropriate.

Reporting Guidelines

Authors should follow recognized reporting standards appropriate to the study design and article type.
Examples include:
CONSORT – Randomized Controlled Trials
STROBE – Observational Studies
PRISMA – Systematic Reviews and Meta-Analyses
CARE – Case Reports
STARD – Diagnostic Accuracy Studies
ARRIVE – Animal Research
EQUATOR Network
Authors may consult the EQUATOR Network to identify appropriate reporting guidelines.
Where applicable, completed reporting checklists should be submitted as supplementary material.

Plagiarism and Text Reuse

The journal does not tolerate plagiarism, inappropriate text reuse, fabrication, falsification, duplicate publication, or other forms of research or publication misconduct.
Submitted manuscripts may be screened using similarity-detection or other appropriate verification tools.
A similarity report is an editorial screening tool and does not by itself establish plagiarism. Editors should consider the nature, location, extent, and context of identified similarities, including legitimate quotations, references, standard terminology, and methodological descriptions.
The journal does not apply an automatic fixed similarity-percentage threshold for determining plagiarism.

Duplicate and Redundant Publication

Manuscripts must not be submitted simultaneously to more than one journal.
Authors should disclose relevant prior dissemination, including:
Preprints;
Conference presentations;
Conference proceedings;
Theses or dissertations;
Datasets;
Previously published related articles; and
Other relevant forms of prior dissemination.
Substantial overlap with previously published or submitted material should be disclosed to the editorial office.

Image and Clinical Image Integrity

Clinical photographs, radiographs, microscopy images, pathology images, figures, charts, and other visual materials must accurately represent the underlying clinical or research information.
Authors must not manipulate images in a manner that misrepresents the original information.
Any permitted image processing should be applied consistently and disclosed where appropriate.
Identifiable patient images must comply with applicable consent and privacy requirements.

Peer-Review Ethics

The journal follows a single-anonymous (single-blind) peer-review process, unless otherwise stated by the individual journal.
Reviewers must maintain confidentiality and provide independent, objective, constructive, and evidence-based assessments.
Reviewers should:
Evaluate the manuscript objectively;
Disclose relevant conflicts of interest;
Protect confidential manuscript information;
Avoid personal criticism of authors;
Not use unpublished information for personal or professional advantage;
Identify ethical or research-integrity concerns confidentially to the editor; and
Provide comments supported by appropriate scientific reasoning.
Reviewer recommendations are advisory and do not constitute the final publication decision.
The final editorial decision is made by the Editor-in-Chief or by a Senior Editor, Associate Editor, or another formally designated editor acting under authority delegated by the Editor-in-Chief.

Editorial Ethics and Independence

The Editor-in-Chief has overall responsibility for the journal's editorial and publication-ethics standards.
The Editor-in-Chief may delegate manuscript handling, peer-review management, and editorial decision-making to a Senior Editor, Associate Editor, or another formally designated editor with appropriate subject expertise.
Editors must:
Maintain confidentiality;
Manage conflicts of interest;
Apply editorial policies consistently;
Maintain editorial independence;
Ensure appropriate peer review; and
Base editorial decisions on scholarly, scientific, ethical, and editorial considerations.
Editorial decisions must not be improperly influenced by commercial interests, advertisers, sponsors, authors, reviewers, publishers, or other external parties.

Confidentiality

Manuscripts, unpublished research data, peer-review reports, editorial correspondence, patient information, and other information obtained during the editorial process must be treated as confidential.
Authors, reviewers, editors, and publisher representatives must not disclose confidential information to unauthorized persons.
Unpublished information obtained through manuscript handling must not be used for personal, professional, academic, or commercial advantage without appropriate authorization.

Artificial Intelligence and Generative AI

The use of artificial intelligence and AI-assisted technologies must be transparent and responsible.
Authors remain responsible for the accuracy, originality, integrity, citations, interpretation, and ethical compliance of their manuscripts.
AI tools must not be listed as authors.
AI tools must not be used to fabricate or falsify data, results, references, citations, images, patient information, or other scholarly content.
Where substantial AI assistance has been used in manuscript preparation, authors should disclose the tool used and the general nature or purpose of the assistance in accordance with the journal's applicable guidelines.
Editors and reviewers must protect confidential manuscript information and should not upload confidential manuscripts, unpublished data, patient information, reviewer reports, or other protected editorial materials to external AI systems where confidentiality or intellectual property could be compromised.

Research and Publication Misconduct

Potential misconduct includes, but is not limited to:
Fabrication of data;
Falsification of data or results;
Plagiarism or inappropriate text reuse;
Duplicate or redundant publication;
Inappropriate image manipulation;
Unethical research practices;
Falsified or inappropriate ethics approvals;
Improper authorship practices;
Undisclosed conflicts of interest;
Manipulation or fabrication of peer review; and
Other forms of research or publication misconduct. Suspected misconduct will be assessed and investigated in accordance with applicable journal procedures and relevant publication-ethics guidance, including COPE guidance where appropriate.
The journal may request clarification or supporting documentation from authors, institutions, ethics committees, reviewers, or other relevant parties.
Authors will be provided an appropriate opportunity to respond to substantive allegations where applicable.

Handling of Research Misconduct

Depending on the nature and seriousness of the concern and the available evidence, the journal may:
Reject a manuscript;
Suspend editorial processing;
Request additional information or documentation;
Refer concerns to an appropriate institution or authority;
Publish a correction;
Publish an Expression of Concern;
Retract a published article; or
Take another appropriate editorial action.
The journal will seek to protect the integrity of the scholarly record while maintaining appropriate confidentiality and procedural fairness.

Corrections, Retractions, and Expressions of Concern

The journal recognizes that different types of post-publication problems require different editorial responses.

Corrections

A correction may be issued when a published article contains an error that affects accuracy or clarity but does not invalidate the overall scholarly record.

Retractions

An article may be considered for retraction where reliable evidence indicates that the published work is substantially unreliable or involves serious research or publication misconduct.
Possible grounds may include:
Major errors that invalidate the findings;
Fabrication or falsification;
Plagiarism or substantial inappropriate text reuse;
Duplicate or redundant publication;
Serious ethical violations;
Unreliable or manipulated data;
Serious authorship or publication misconduct; or
Other circumstances that materially compromise the integrity of the published record.
A retracted article will normally remain part of the scholarly record with a clear retraction notice explaining the reason for retraction.

Expressions of Concern

Where a significant concern exists but available evidence is insufficient to reach a final conclusion, the journal may publish an Expression of Concern while further investigation is undertaken.

Post-Publication Concerns

Concerns regarding published articles should be submitted to the editorial office with sufficient information and supporting evidence to allow appropriate assessment.
The editorial team may investigate concerns relating to:
Research integrity;
Ethical approval;
Patient consent or confidentiality;
Authorship;
Data integrity;
Image integrity;
Peer-review processes;
Conflicts of interest; or
Other publication-ethics matters.
Where appropriate, the journal may consult authors, reviewers, institutions, ethics committees, or other relevant authorities.

Editorial Accountability

The Editor-in-Chief has overall responsibility for maintaining the journal's editorial and publication-ethics standards.
Editors handling manuscripts under delegated authority are responsible for manuscripts assigned to them and must exercise their editorial responsibilities fairly, independently, confidentially, and in accordance with the journal's policies.
Reviewers are responsible for providing confidential, objective, and constructive assessments.
Authors are responsible for the accuracy, originality, ethical conduct, and integrity of their research and manuscript.
The publisher is responsible for maintaining an appropriate publication framework and supporting the integrity of the scholarly record.

Commitment to Publication Ethics

The journal is committed to maintaining reliable, transparent, ethical, and responsible medical and health-science publishing.
The editorial team will continue to review and update its policies where necessary to reflect developments in research ethics, publication ethics, peer review, reporting standards, research integrity, patient protection, and scholarly communication.
The journal will apply appropriate internationally recognized ethical and publication standards according to the nature of each manuscript and its research context.