This journal publishes in accordance with Cambridge University Press’s research publishing ethics guidelines, which apply to authors, peer reviewers, the editorial office and the journal as a whole. Further details as applicable to this journal can be found below. Anyone who believes that these guidelines have not been followed should raise their concern with the editor or email [email protected].

Disclosure of interests and funding

Competing interests are situations that could be perceived to exert an undue influence on the presentation, review or publication of a piece of work. These may be financial, non-financial, professional, contractual or personal in nature. Conflicts of Interest do not necessarily mean that an author’s work has been compromised. All authors must include a competing interest declaration in accordance with this journal's author instructions. This declaration will be subject to editorial review and may be published in the article.

Peer reviewers are expected to declare any competing interests arising at any point during the peer review process. The editor will review the competing interest and work with the reviewer to mitigate the competing interest. Where a reviewer’s competing interest is too significant to mitigate, the reviewer should recuse themselves from reviewing. See Ethics in Peer Review for further information.

Editors are responsible for declaring any competing interests, whether they apply to individual articles or to their position as an editor of this journal, and recusing themselves as appropriate.

Anyone who suspects an undisclosed competing interest regarding a work published or under consideration in this journal should inform the relevant editor or email [email protected].

Research Ethics: Human participants, tissue, or data

Research involving human participants, tissue or data should be approved by relevant institutional ethics committee(s) and should conform to relevant international ethical and legal standards for research (for example, the Declaration of Helsinki and the Belmont Report).

Ethics committee approval

The name of the ethics committee that approved the research, the ethics committee approval number and the types of consent obtained should be included according to this journal's author instructions. In cases where the need for formal ethics committee approval was waived, the name of the ethics committee that granted the waiver should be included in the methods section of the manuscript. 

Consent to publish

This journal expects authors to respect human participants’ right to privacy, and to gain written consent to publish individual identifying data when relevant before submitting to us. 

Authors should obtain consent to publish from individual participants if their manuscript includes any data that might identify them. For example, this includes photographs, videos, individual clinical data, quotes, demographic details and any other details that might identify the participant. For children (under 18yrs) consent should also be obtained from the child’s parent of legal guardian.

Consent to participate

Consent to participate should not be confused with consent to publish. In the conduct of their research, authors should prospectively obtain consent from the individuals involved to participate in their research and/or for their tissues or data to be used. The need for consent and method of obtaining consent should be determined by the authors’ institutional ethics committee. Details of consent to participate should be included in manuscripts. Where consent for participation was not obtained (for example, in cases where the participants were not capable of providing consent) the editor may ask to see evidence that the need for consent was waived by an ethics committee.

Health-related research

Reporting guidelines

Authors should follow the Enhancing QUAlity and Transparency Of health Research (EQUATOR) guidelines when reporting health related research. Manuscripts reporting the results of randomised controlled trials should follow the CONSORT reporting guidelines and provide a flow diagram to illustrate the progress of all patients in the study.

Authorship

This journal follows the ICMJE definition of authorship and expects anyone listed as an author on any article submitted to this journal to fulfil the criteria listed and that no authors who would reasonably be considered an author have been excluded. In the event of a dispute or change request, at any stage of the publishing process, this journal will be guided by the relevant COPE flowchart in deciding the appropriate action(s). 

Eligibility for authorship should be based on these four criteria (ICMJE recommendations):

1. Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; and/or 
2. Drafting the work or revising it critically for important intellectual content; and 
3. Final approval of the version to be published; and 
4. Agreement to be accountable for all aspects of the work and to ensure that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. 

Note that, regardless of individual contribution, authorship of a manuscript confers a joint responsibility on all authors for the integrity of the work.

The corresponding author is responsible for communicating with co-authors. Anyone who does not meet these criteria should be listed in the Acknowledgement section with their permission.

The corresponding author's specific responsibilities include: 

• Manuscript correction and proofreading. Handling the revisions and re-submission of revised manuscripts up to the acceptance of the manuscripts. 
• Agreeing to and signing the Author Publishing Agreement on behalf of relevant co-authors and/or arranging for any third-party copyright owners’ signature. 
• Arranging for payment of an APC (article processing charge) where one is required. The affiliation of the corresponding author is used to determine eligibility for discounted or waived APCs under read and publish agreements. 
• Acting on behalf of all co-authors in responding to queries from all sources post-publication, including questions relating to publishing ethics, reuse of content, or the availability of data, materials, resources etc.

Requests to change the corresponding author after submission will be subject to scrutiny and a formal process, as with any authorship change. This applies to both pre- and post-publication of the article. 

Authorship statements should be transparent about who contributed to the work and in what capacity. 

This journal's author instructions contain further information on submitting your author list with your manuscript.

Plagiarism

This journal adheres to Cambridge University’s definition of plagiarism. Plagiarism is defined as ‘using someone else’s ideas, words, data, or other material produced by them without acknowledgement.’ Plagiarism can occur in respect to all types of sources and media, including: 

• text, illustrations, musical quotations, extended mathematical derivations, computer code, etc. 
• material downloaded from websites or drawn from manuscripts or other media
• published and unpublished material, including lectures, presentations, and grey literature

We do not tolerate plagiarism in any of our publications, and we reserve the right to check all submissions through appropriate plagiarism checking tools. Submissions containing suspected plagiarism, in whole or part, will be rejected. If plagiarism is discovered post-publication, we will follow our guidance outlined in the Retractions, Corrections and Expressions of Concern section of these guidelines. We expect our readers, reviewers, and editors to raise any suspicions of plagiarism, either by contacting the relevant editor or by emailing [email protected].

Peer review

This journal usually requires a minimum of two independent peer reviewers to peer review manuscripts for consideration in the journal.

This journal uses a double-anonymous peer review model. This means that the identities of both the peer reviewers and the authors are kept hidden. Please check the journal's peer review information for full details of this process and any policy exceptions.

Registration of clinical trials

As a condition of consideration for publication, registration of clinical trials in a public trials registry is required. A clinical trial is defined by the International Committee of Medical Journal Editors (in accordance with the definition of the World Health Organisation) as any research project that prospectively assigns human participants or groups of humans to one or more health-related interventions to evaluate the effects on health outcomes. Trials must be registered before the start of patient enrolment. The registry must be accessible to the public at no charge. It must be open to all prospective registrants and managed by a not-for-profit organization. There must be a mechanism to ensure the validity of the registration data, and the registry should be electronically searchable. An acceptable registry must include at minimum a unique trial number, trial registration date, secondary identification information if assigned by sponsors or others, funding source(s), primary and secondary sponsor(s), responsible contact person, research contact person, official scientific title of the study, research ethics review, the medical condition being studied, intervention(s), key inclusion and exclusion criteria, study type, anticipated trial start date, target sample size, recruitment status, primary outcome, and key secondary outcomes. Registration information must be provided at the time of submission in accordance with this journal's author instructions.

Affiliations

Any article affiliations should represent the institution(s) at which the research presented was conducted and/or supported and/or approved. For non-research content, any affiliations should represent the institution(s) with which each author is currently affiliated. Knowingly providing false or fraudulent affiliation information is a form of misconduct, and may lead to article retraction. 

Text recycling

Text recycling, also known as self-plagiarism, is when an author re-uses sections of text from their own previous publications without proper attribution. This is distinct from redundant or duplicate publication which refers to larger scale repeated publication of text or data with at least one author in common. This journal will follow COPE guidelines on text recycling when assessing acceptability of text recycling in a given manuscript. These factors that will be considered are:

• How much text is recycled
• Where in the article the text recycling occurs
• Whether the source of the recycled text has been acknowledged
• Whether the article is a research or non-research article
• Whether there is a breach of copyright
• In some circumstances, cultural norms at the time and place of publication. 

Where text recycling is deemed unacceptable, a submitted manuscript may be rejected. A published article may require a post-publication change as described in the Retractions, Corrections and Expressions of Concern below. 

Any manuscript based on a thesis should be a reworking of the material in the thesis and written to conform to this journal's style guide. When quoting from the thesis or reusing figures, authors should avoid self-plagiarism by citing and referencing any extracts copied or adapted from the thesis appropriately. If a thesis was published by a publisher and is publicly accessible, permission may be required from the thesis publisher before submitting to a journal. The relevant editor should be informed that the manuscript draws on a thesis in the cover letter.

Libel, defamation and freedom of expression

Freedom of expression is critical to us as academic publishers, but we do not support publishing false statements that harm the reputation of individuals, groups, or organisations. Authors should contact the editor if they have concerns about potentially libellous content in their own manuscripts or any publications.

Questionable research practices and research misconduct

Image Manipulation

Where research data are collected or presented as images, modifying these images can sometimes misrepresent the results obtained or their significance. We recognise that there can be legitimate reasons for modifying images, but we expect authors to avoid modifying images where this leads to the falsification, fabrication, or misrepresentation of their results. Any allegation or finding of image manipulation will be investigated and acted on in accordance with COPE guidance, and may lead to a correction, retraction, or other notice being applied to the article.

Fraudulent Research and Research Misconduct 

Where an allegation of research misconduct is made to the journal by an author, reader or peer reviewer, the journal’s first concern is the integrity of content it has published. The editor will work in line with COPE guidance, with Cambridge University Press and appropriate institutions or organisations, to investigate the allegation. Any publication found to include fraudulent or unethical research or research which violates the journal’s policies may be retracted or have an appropriate correction or expression of concern issued. Please see the Retractions, Corrections and Expressions of Concern section of these guidelines for more information.

Occasionally, as part of an investigation into an allegation of data or image manipulation, the editor may ask to see the raw data related to the data or images presented in the authors’ manuscript or publication. In order to support or carry out a misconduct investigation, this journal may also be required to share information about a submission or publication, including peer reviews, with third parties. This journal reserves the right to alert and/or involve an author’s employer, funder, or other responsible body in the event of a misconduct investigation, and to share information such as may be necessary to support an investigation. 

Corrections, Retractions and Expressions of Concern

Corrections 

Minor changes such as those which would likely occur during copyediting, typesetting or proofreading may be made on accepted manuscripts, but will not normally be made to First View or Versions of Record unless they impact the interpretation of the article.

If an author is found to have made an error in a published article, a Corrigendum will be used. If the journal is found to have made an error, an Erratum will be used.

Retractions

This journal will consider retractions in line with COPE’s Retraction Guidelines*. 

Retractions are usually reserved for articles that are so seriously flawed that their findings or conclusions should not be relied upon, or that contain substantial plagiarism or life-endangering content or report unethical research. 

*Note that the list of reasons to retract in COPE’s guidelines is not exclusive. The editor may retract a publication for any reason that irreversibly undermines the article’s validity or integrity.

Expressions of concern

Occasionally, where the reliability or integrity of a publication is of concern, but where an investigation will take an unusually long time, or where an investigation is not possible, the editor may choose to publish an Expression of Concern on the article to alert readers to interpret the article content with caution. 

Permanence of the published record 

Cambridge University Press maintains a record of the existence of everything its journals publish with information (metadata) describing each publication. Where we are obliged to alter the publication record in any way, such as in the case of research misconduct leading to retraction of a publication, we preserve the academic record as far possible.  In exceptional cases an article may be removed from online publication where it is deemed necessary to comply with legal obligations. This includes, without limitation, where there are concerns that the article is defamatory, violates personal privacy or confidentiality laws, is the subject of a court order, or might pose a serious health risk to the general public. In these circumstances, the article may be removed, and a notice published that clearly states why the full article has been removed. 

Supporting evidence

Cambridge University Press aims to provide authors with the ability to connect supporting evidence with their manuscripts, either on our own platform or through third party services.

Please see this journal's research transparency policy for details of any requirements regarding the sharing of supporting evidence.

This journal permits authors to submit and publish supplementary materials that are not essential for inclusion or that cannot be accommodated in the main text, but that would be of benefit to the reader. Data, code and other materials or supplementary files are reviewed in line with this journal’s peer review process and research transparency policy.