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Information for Authors

The Lancet is an international general medical journal that will consider any original contribution that advances or illuminates medical science or practice, or that educates or entertains the journal's readers. Whatever you have written, remember that it is the general reader whom you are trying to reach. One way to find out if you have succeeded is to show your draft to colleagues in other specialties. If they do not understand, neither, very probably, will The Lancet's staff or readers. Manuscripts must be solely the work of the author(s) stated, must not have been previously published elsewhere, and must not be under consideration by another journal. For research papers, which will usually be randomised controlled trials, judged to warrant fast dissemination, The Lancet will publish a peer-reviewed manuscript within 4 weeks of receipt (see Fast-track publication). If you wish to discuss your proposed fast-track submission with an editor, please call one of the editorial offices in London (+44 [0] 20 7424 4943), New York (+1 212 633 3667), or Beijing (+86 10 852 08872). The Lancet is a signatory journal to the Uniform Requirements for Manuscripts Submitted to Biomedical Journals, issued by the International Committee for Medical Journal Editors (ICMJE), and to the Committee on Publication Ethics (COPE) code of conduct for editors. We follow COPE's guidelines. If your question is not addressed on these pages then the journal's editorial staff in London (+44 [0] 20 7424 4910), New York (+1 212 633 3810), or Beijing (+86 10 852 08872) will be pleased to help (email [email protected]).

Uniform Requirements for Manuscripts Submitted to Biomedical Journals http://download.thelancet. com/flatcontentassets/authors/ icmje.pdf

How to submit your paper or correspondence

Manuscript submission

Manuscripts (including correspondence letters) should be submitted online via the The Lancet's online submission and peer review website (known as EES) at · SimplylogontoEESandfollowtheonscreeninstructionsfor all submissions · IfyouhavenotusedEESbefore,youwillneedtoregisterfirst. InEES,thecorrespondingauthoristhepersonwhoentersthe manuscriptdetailsanduploadsthesubmissionfiles · Inclusionofillustrations(photographs,graphs,diagramsetc) is a prerequisite for publication. Submission of original and editableartworkfilesisencouraged.Digitalphotographyfiles should have a resolution of at least 300 dpi and be at least 107mmwide · In almost all cases, if you have a finished manuscript, you shouldsubmitit,ratherthancontactingThe Lancet to enquire whetheranunseenmanuscriptislikelytobeaccepted.Unless you have been asked byThe Editor to submit by email, you should use the online system for all types of submission, including Correspondence · Ifyouhaveanytechnicalproblemsorquestions,pleasecontact our dedicated customer support (available 24 hours a day, 365daysayear): FortheAmericas:+18888347287(toll-freeinUSA and Canada) ForAsiaandPacific:+81355615032 ForEuropeandrestoftheworld:+35361709190 Email: [email protected]

· Itishelpfultoindicatewhatcouldshortenyourpaper--thefull paper can be reviewed and a shorter version published; a table orfigure,detailsofaDNAsequence,orfurtherreferences,for example, can be published on our website or made available fromtheauthors. First submissions to The Lancet should include: 1 Covering letter 2 Manuscript including tables and panels 3 Figures 4 Authors'contributionsstatement(seenextsection) 5 Conflictofinterestandsourceoffundingstatements (seenextsection) 6 In-presspapers--onecopyofeachwithacceptanceletters 7 ProtocolsandCONSORTdetailsforrandomisedcontrolled trials (see Articles) 8 Weencouragedisclosureofcorrespondencefromother journalsandreviewers,ifpreviouslysubmitted,andwe mightcontactrelevanteditorsofsuchjournals

COPE Code of Conduct files/u2/New_Code.pdf

Statements, permissions, and signatures

Authors and contributors

· We ask all authors, and all contributors (including medical writersandeditors),tospecifytheirindividualcontributions attheendofthetext · The Lancet will not publish any articles unless we have the signaturesofallauthors · We suggest you use the author statement form and either upload the signed copy with your submission, or fax to+44(0)1865853016 · In addition, please include written consent of any cited individual(s) noted in acknowledgments or personal communications

Author signatures, contributions, and declarations http://download.thelancet. com/flatcontentassets/authors/ tl-author-signatures.pdf

Covering letter

· You should upload your covering letter at the "Enter Comments"stageoftheonlinesubmissionprocess · Use the covering letter to explain whyyour paper should be published in The Lancet--a leading international general medical journal--rather than elsewhere (eg, a specialty journal) November, 2011

Conflict of interest

A conflicts of interest exists if authors or their institutions have financialorpersonalrelationshipswithotherpeopleororganisations that could inappropriately influence (bias) their actions. Financial

Information for Authors

The Lancet patient consent form http://download.thelancet. com/flatcontentassets/ authors/lancet-consentform.pdf

relationships are easily identifiable, but conflicts can also occur because of personal relationships, academic competition, or intellectual passion. A conflict can be actual or potential, and full disclosure to The Editor is the safest course. Failure to disclose conflicts might lead to publication of a statement in our Department of Error or even to retraction. All submissions to The Lancetmustincludedisclosureofallrelationshipsthatcouldbe viewed as presenting a potential conflict of interest (see Lancet2001;358:854­56 and Lancet 2003; 361: 8­9).TheEditor mayusesuchinformationasabasisforeditorialdecisions,andwill publish such disclosures if they are believed to be important to readers in judging the manuscript. · Attheendofthetext,underasubheading"Conflictsofinterest", all authors must disclose any financial and personal relationships with other people or organisations that could inappropriately influence (bias) their work. Examples of financial conflicts include employment, consultancies, stock ownership,honoraria,paidexperttestimony,patentsorpatent applications,andtravelgrants,allwithin3yearsofbeginning theworksubmitted.Iftherearenoconflictsofinterest,authors should state that · Allauthorsarerequiredtoprovideasignedstatementoftheir conflictsofinterestaspartoftheauthorstatementform. · For Comment, Seminars, Reviews, and Series, The Lancet will not publish if an author, within the past 3 years, and with a relevant company or competitor, has any stocks or shares, equity, a contract of employment, or a named position on a companyboard;orhasbeenaskedbyanyorganisationother than The Lancettowrite,benamedon,ortosubmitthepaper (see Lancet2004;363:2­3)

Patients' consent and permission to publish

· Studiesonpatientsorvolunteersneedapprovalfromanethics committee and informed consent from participants. These shouldbedocumentedinyourpaper · Ifthereisanunavoidableriskofbreachofprivacy--eg,inaclinical photograph or in case details--the patient's written consent to publication,orthatofthenextofkin,mustbeobtained · To respect your patient's privacy, please do not send the consentformtous.Instead,werequireyoutosendastatement signedbyyourselfconfirmingthatyouhaveobtainedconsent fromthepatientusingThe Lancetpatientconsentform · USauthorsshouldensureHIPAAcompliance · ConsentmustbeobtainedforallCaseReports,ClinicalPictures, andAdverseDrugReactions


At the external peer review stage you will need to send signed copiesofthefollowingstatements: · Authors'contributions · Conflictsofintereststatements · Statementsofrole,ifany,ofmedicalwriteroreditor · Acknowledgments--writtenconsentofcitedindividual · Personalcommunications--writtenconsentofcitedindividual · Use of copyright-protected material--signed permission statementsfromauthorandpublisher These statements can be scanned and submitted electronically to [email protected] To minimise delays, we strongly advisethatyoupreparesignedcopiesofthesestatementsbefore yousubmityourmanuscript.

Types of article and manuscript requirements

PleaseensurethatanythingyousubmittoThe Lancetfollowsthe guidelinesprovidedforeacharticletype.Forinstructiononhow toformatthetextofyourpaper,includingtables,figures,panels, andreferences,pleaseseeourFormatting guidelines

Role of the funding source

· All sources of funding should be declared as an acknowledgmentattheendofthetext · AttheendoftheMethodssection,underasubheading"Roleof thefundingsource",authorsmustdescribetheroleofthestudy sponsor(s),ifany,instudydesign;inthecollection,analysis,and interpretation of data; inthe writing ofthe report; and inthe decisiontosubmitthepaperforpublication · IfthereisnoMethodssection,theroleofthefundingsource shouldbestatedasanacknowledgment.Ifthefundingsource hadnosuchinvolvement,theauthorsshouldsostate · Thecorrespondingauthorshouldconfirmthatheorshehadfull accesstoallthedatainthestudyandhadfinalresponsibilityfor thedecisiontosubmitforpublication

Red section (Articles and Clinical pictures)


· The Lancetprioritisesreportsoforiginalresearchthatarelikely to change clinical practice or thinking about a disease (Lancet2000;356:2­4) · Weofferfast-trackpeerreviewandpublicationofrandomised controlled trials that we judge of importance to practice or research (see Fast-track publication) · Weinvitesubmissionofallclinicaltrials,whetherphase1,2,3,or4 (see Lancet2006;368:827­28).Forphase1trials,weespecially encouragethoseofanovelsubstanceforanovelindication,if thereisastrongorunexpectedbeneficialoradverseresponse,or anovelmechanismofaction · We encourage researchers to enrol women and ethnic groups intoclinicaltrialsofallphases,andtoplantoanalysedatabysex andbyrace · Systematicreviewsofrandomisedtrialsaboutdiseasesthathave amajoreffectonhumanhealthalsomightwarrantrapidpeer review and publication · Globalpublic-healthand health-policyresearch areother areas ofinteresttoThe Lancet November, 2011

Role of medical writer or editor

· Ifamedicalwriteroreditorwasinvolvedinthecreationofyour manuscript, we need a signed statement from the correspondingauthortoincludetheirnameandinformation aboutfundingofthisperson · This information should be added to the Acknowledgments and/or Contributors section · Werequiresignedstatementsfromanymedicalwritersoreditors declaring that they have given permission to be named as an author,asacontributor,orintheAcknowledgmentssection

Information for Authors

· Weencouragetheregistrationofallinterventionaltrials,whether early or late phase, in a primary register that participates in WHO's InternationalClinicalTrial Registry Platform (see Lancet 2007;369:1909­11).Wealsoencouragefullpublicdisclosureof the minimum 20-itemtrial registration dataset atthetime of registrationandbeforerecruitmentofthefirstparticipant(see Lancet2006;367:1631­35).Theregistrymustbeindependent offor-profitinterest · Reports of randomised trials must conform to CONSORT 2010 guidelines, and should be submitted with their protocols · Allreportsofrandomisedtrialsshouldincludeasectionentitled Randomisationandmasking,withintheMethodssection · Cluster-randomised trials must be reported according to CONSORTextendedguidelines · Randomisedtrialsthatreportharmsmustbedescribedaccording to extendedCONSORTguidelines · Studies of diagnostic accuracy must be reported according to STARDguidelines · Observational studies (cohort, case­control, or cross-sectional designs) must be reported according to the STROBEstatement, and should be submitted with their protocols · Weencouragetheregistrationofallobservationalstudiesona WHO-compliantregistry(seeLancet2010;375:348) · Genetic association studies must be reported according to STREGAguidelines · Systematic reviews and meta-analyses must be reported according to PRISMAguidelines · Tofindreportingguidelinessee:

· Include any necessary additional data as part of your EES submission · All accepted Articles should include a link to the full study protocol published on the authors' institutional website (see Lancet2009;373:992 and Lancet2010;375:348)

WHO's International Clinical Trial Registry Platform network/trds/en/index.html

Putting research into context

· FromAugust1,2010,authorsareinvitedtosubmittheirresearch paperswithasectionintheDiscussionthatputstheresultsinto context with previous work (see Lancet 2010; 376: 10­11). Authors should provide a Panel explaining in brief how they arrived at their bottom line message · The Discussion section should contain a full description and discussion of the context. Authors are also invited to either reporttheirown,up-to-datesystematicrevieworcitearecent systematicreviewofothertrials,puttingtheirtrialintocontext ofthereview

CONSORT 2010 guidelines http://www.consort-statement. org/consort-statement/ overview0/

CONSORT extended guidelines http://www.consort-statement. org/extensions/extensions/

Research in context

Systematic review Thissectionshouldincludeadescriptionofhowauthors searchedforalltheevidence.Authorsshouldalsosayhowthey assessedthequalityofthatevidence--ie,howtheyselectedand howtheycombinedtheevidence. Interpretation Authorsshouldstateherewhattheirstudyaddstothetotalityof evidencewhentheirstudyisaddedtopreviouswork.

STARD guidelines http://www.stard-statement. org/

STREGA guidelines http://www.medicine.uottawa. ca/public-health-genomics/ web/eng/strega.html PRISMA guidelines http://www.prisma-statement. org/ To find reporting guidelines, see http://www.equator-network. org. Case Report and Clinical Pictures Consent form Aconsentformisavailable (at http://download.thelancet. com/flatcontentassets/authors/ lancet-consent-form.pdf).

All Articles should, as relevant:

· Beupto3000wordswith30references · Include an abstract (semistructured summary), with fiveparagraphs(Background,Methods,Findings,Interpretation, and Funding), not exceeding 300 words. Our electronic submissionsystemwillaskyoutocopyandpastethissectionat the"SubmitAbstract"stage · For randomised trials, the abstract should adhere to CONSORT extensions:abstracts(see Lancet2008;371:281­83) · For intervention studies, the abstract should include the primaryoutcomeexpressedasthedifferencebetweengroups with a confidence interval on that difference (absolute differences are more useful than relative ones). Important secondaryoutcomescanbeincludedaslongastheyareclearly markedassecondary · UsetheSIsystemofunitsandtherecommendedinternational non-proprietaryname(rINN)fordrugnames.Ensurethatthe dose,route,andfrequencyofadministrationofanydrugyou mention are correct · Use gene names approved bythe HumanGeneOrganisation. Novelgenesequencesshouldbedepositedinapublicdatabase (GenBank,EMBL,orDDBJ),andtheaccessionnumberprovided. Authorsofmicroarraypapersshouldincludeintheirsubmission the information recommended by the MIAME guidelines. Authorsshouldalsosubmittheirexperimentaldetailstooneof thepubliclyavailabledatabases:ArrayExpress or GEO November, 2011

Clinical Pictures

· · · We will consider clear and interesting Clinical Pictures submittedwithadescriptiveparagraphof150words Authors must obtain signed informed consent from the patient (see Patients' consent and permission to publish) Currently,clinicalpictureswillbeacceptedasexclusiveonline only material, of which a random selection will go into the printjournalasfillerswhenrequired.Picturesthatareonline only aswell asthosethat are later published in printwill be given a DOI and be submitted to the National Library of MedicineforPubMedlisting

Blue section (Comment, World Report, Perspectives, Correspondence, etc)


EditorialsarethevoiceofThe Lancet,andarewrittenin-housebythe journal'seditorial-writingteamandsigned"TheLancet"


· MostCommentsarecommissioned,butspontaneousComments are welcome on a paper or other report or event within the past monthorso,orinthenearfuture · Commentsshouldbeabout700wordsandtenreferences · Theplacetorespondtosomethingwehavepublishedisinour Correspondence section · SeeConflict of Interest guidelinesforComments

Human Gene Organisation MIAME guidelines http://www.mged. org/Workgroups/MIAME/ miame_checklist.html Array and GEO microarray-as/ae/ http://www.ncbi.nlm.nih. gov/geo

Information for Authors

World Report

· The Lancet has a function as an international newspaper covering news about science, medicine, policy issues, and people · Most of the writers of World Report articles are professional journalists,butanimportanteventinyourcountrythatmight beofwiderinterestcanbebroughttotheattentionofourWorld [email protected]

Green section (Seminars, Reviews, Series, Viewpoints, etc)

Commissioned Seminars, Reviews, and Series

· Seminars are disease-oriented clinically focused overviews for the generalist, covering epidemiology, pathophysiology, diagnosis,management,andprevention;whereasReviewshave a narrower remit for a more specialised audience. We aim to provide comprehensive balanced Review papers for clinicians and researchers on topics that we judge to be of widespread interest · Completetransparencyaboutthechoiceofmaterialincludedis important to any Review paper. Therefore, all Seminars and Reviews,andsomeSeries,shouldincludeabriefsectionentitled "Search strategy and selection criteria" stating the sources (includingdatabases,MeSHandfreetextsearchtermsandfilters, and reference lists from journals or books) of the material covered, and the criteria used to include or exclude studies. Citationstopaperspublishedinnon-peer-reviewedsupplements are discouraged. Sincethese papers should be comprehensive, weencouragecitationofpublicationsinnon-Englishlanguages. Anexampleisshownbelow:


· Reviewsofbooksandothermedia,Lifelines,andartofmedicine piecesareoftencommissioned,butsuggestionsforcontributions are welcome via [email protected]


· Obituaries are written by our team of professional journalists, but we invite suggestions from readers for people whom we shouldfeature--remarkableindividualswhoareinternationally renownedfortheircontributionstomedicine · Pleasesubmitsuchsuggestionswithin3weeksofanindividual's death via [email protected]


· WewelcomecorrespondenceoncontentpublishedinThe Lancet oronothertopicsofinteresttoourreaders · Lettersforpublicationintheprintjournalmustreachuswithin ksofpublicationoftheoriginalitemandshouldbenolonger than250words · Letters of general interest, unlinked to items published in the journal,canbeupto400wordslong · Correspondencelettersarenotusuallypeerreviewed(werarely publishoriginalresearchorCaseReportsinthissection),butthe journal might invite replies from the authors of the original publication,orpassonletterstotheseauthors · Only one table or figure is permitted, and there should be no morethanfivereferencesandfiveauthors · All accepted letters are edited, and proofs will be sent out to authorsbeforepublication · Somelettersmightbechosenforonline-onlypublication

Search strategy and selection criteria

DataforthisReviewwereidentifiedbysearchesofMEDLINE, CurrentContents,PubMed,andreferencesfromrelevant articlesusingthesearchterms"sentinelnode","breast cancer",and"axilla".Abstractsandreportsfrommeetings wereincludedonlywhentheyrelateddirectlytopreviously publishedwork.OnlyarticlespublishedinEnglishbetween 1980and2006wereincluded. · Seminarsshouldbenomorethan5000wordswithamaximum of 140 references, and Reviews should be no more than 4500 words, with a maximum of 100 references. A 150-word unstructuredsummaryshouldbeincluded.Thesepapersshould includeaboutfiveillustrationstoaidthereader


· Ahypothesispaperdescribesasubstantialjumpinthinkingthat istestablebutnotsoeasilytestablethatreaderswillwonderwhy you have not already done it. New data are not part of a hypothesis, but you must include a section on howtotestyouridea · Sharinganewideatakescourageandconcision.Ifyoucannot expressyourlineofthoughtin1500words,20references,anda 150-wordunstructuredsummary,itisnotahypothesis

Adverse drug reactions

· Reportsofadversedrugreactionsarepeerreviewedandthose we accept are published in the Correspondence section · Length must not exceed 800 words, with only one table or figure, and no more than five references. No more than five authors are permitted

Department of Error

· AnysubstantialerrorinanyarticlepublishedinThe Lancet should becorrectedassoonaspossible.Blameisnotapportioned;the important thing is to set the record straight · The Lancet journals have a policyfortypesoferrorsthatwedo anddonotcorrect.Wewillalwayscorrectanyerroraffecting a non-proprietary drug name, dose, or unit, any numerical error in the results, or any factual error in interpretation of results

Other departments

· Much of The Lancet's role in encouraging debate and opinion takesplaceinsectionssuchasPublicHealth,Viewpoint,Essay, Reportage, and the Departments of Medical History, Ethics, MedicineandArt,andLiteratureandMedicine.1500wordsand 20 references are our general guidelines for papers in these sections

For The Lancet journals' policy on correction of errors see http://download.thelancet. com/flatcontentassets/ authors/correction-policy.pdf November, 2011

Information for Authors

Case Reports

· Case reports are intended to inform, entertain, and inspire. Presentadiagnosticconundrum,andexplainhowyousolved it. Tell us about the presentation, history, examination, investigations,management,andoutcome.Inyourdiscussion, educate the reader · Casereportsshouldtellreadersaboutaconditionorpresentation that they might encounter--so novelty, rarity, and overspecialisation are not what we are looking for.Aim atthe generalist: the family doctor, junior psychiatrist, surgeon in training,orthewellinformedmedicalstudent · Usenomorethan600wordsand5references.Explanatoryand graphicpictures(uptoamaximumoftwo)canbehelpful · Consentforpublicationinprintandelectronicallymustbeobtained fromthepatientor,ifthisisnotpossible,thenextofkinbefore submission. See Patients' consent and permission to publish

· Give any subpart to the title of the article. Journal names are abbreviatedintheirstandardformasinIndexMedicus · Iftherearesixauthorsorfewer,giveallsixintheform: surname space initials comma · Iftherearesevenormoregivethefirstthreeinthesameway, followedbyetal · For a book, give any editors and the publisher, the city of publication,andyearofpublication · Forachapterorsectionofabook,alsogivetheauthorsandtitle ofthesection,andthepagenumbers · Foronlinematerial,pleasecitetheURL,togetherwiththedate youaccessedthewebsite · OnlinejournalarticlescanbecitedusingtheDOInumber · DonotputreferencesintheSummary

Index Medicus

Formatting guidelines

Title page

A brief title, author name(s), preferred degree (one only), affiliation(s),andfulladdress(es)oftheauthorsmustbeincluded. The name and address of the corresponding author should be separatelyandclearlyindicatedwithemailandtelephonedetails.

Guidelines for web extra material

AllmaterialshouldbesubmittedasonePDF(withnumberedpages) with the paper and will be peer reviewed. Material will be published atthediscretionofThe Lancet journals' editors. All material should be provided in English.

The Lancet patient consent form http://download.thelancet. com/flatcontentassets/ authors/lancet-consentform.pdf

Formatting of text

· · · · Typeasinglespaceattheendofeachsentence Donotuseboldfaceforemphasiswithintext Weuseacommabeforethefinal"and"or"or"inalistofitems Type decimal points midline (ie, 23·4, not 23.4). To create a midlinedecimalonaPC:holddownALTkeyandtype0183on thenumberpad,oronaMac:ALTshift9 · Numbersonetotenarewrittenoutinwordsunlesstheyareused asaunitofmeasurement,exceptinfiguresandtables · Usesinglehard-returnstoseparateparagraphs.Donotusetabs or indents to start a paragraph · Do not use the automated features of your software, such as hyphenation, endnotes, headers, or footers (especially for references).Youcanusepagenumbering


· Mainheadingforthewebextramaterialshouldbein12point TimesNewRomanfontBOLD · Text should be in 10 point Times New Roman font, single spaced · Headingsshouldbein10pointBOLD

Formatting guidelines for revised manuscripts Guidelinesonformatfortextand figurescanbefoundat http://download.thelancet. com/flatcontentassets/authors/ artwork-guidelines.pdf


· Main table heading should be in 10 pointTimes New Roman fontBOLD · Legendsshouldbein10point,singlespaced · Tables should be in 8 point Times New Roman font, single spaced · Headingswithintablesshouldbein8pointBOLD


· Cite references in the text sequentially in the Vancouver numberingstyle,asasuperscriptednumberafteranypunctuation mark.Forexample: ...asreportedbySaitoandcolleagues.15 · Tworeferencesarecitedseparatedbyacomma,withnospace. Threeormoreconsecutivereferencesaregivenasarangewith anenrule.TocreateanenruleonaPC:holddownCTRLkeyand minussignonthenumberpad,oronaMac:ALThyphen · Referencesintables,figures,andpanelsshouldbeinnumerical orderaccordingtowheretheitemiscitedinthetext · Hereisanexampleforajournalreference(notetheuseoftab, bold,italic,andtheenruleor"long"hyphen): ...15[tab]SaitoN,EbaraS,OhotsukaK,KumetaJ,Takaoka K.Naturalhistoryofscoliosisinspasticcerebralpalsy. Lancet1998; 351:1687­[enrule]92. November, 2011


· SIunitsarerequired · Numbers in text and tables should always be provided if % is shown · MeansshouldbeaccompaniedbySDs,andmediansbyIQR · Exactpvaluesshouldbeprovided,unlessp<0·0001

Drug names

· Recommended international non-proprietary name (rINN) is required


· Vancouverstyle--eg, --Smith A, Jones, B, Clements S. Clinical transplantation of tissue-engineered airway. Lancet2008;372:1201­09.

Information for Authors

--Hourigan P.Ankle injuries. In:Chan D, ed. Sports medicine.London:Elsevier,2008:230­47. · NumberedinorderofmentioninWebappendixandnumbered separatelyfromreferencesinthefullpaper


· All images must have a minimum resolution of 300 dpi, width107mm · Main figure heading should be in 10 pointTimes New Roman fontBOLD · Legendsshouldbein10point,singlespaced

trials, The Lancet will publish a peer-reviewed manuscript within4weeksofreceipt · Systematic reviews of randomised trials about diseases that haveamajoreffectonhumanhealthalsomightwarrantrapid peer review and publication · If you wish to discuss your proposed submission with an editor, please call one of the editorial offices in London(+44[0]2074244943),NewYork(+12126333667), orBeijing(+861085208872) · SeeArticlessectionformanuscriptrequirements

Online First publication

· The Lancet increasingly publishes articles online ahead of print publication.Youwillbeinformedatleastaweekinadvanceofthe OnlineFirstpublicationdate · Theonlinearticleisidenticaltotheversionsubsequentlypublished inthe print journal, and is citable bythedigitalobject identifier (DOI)assignedatthetimeofonlinepublication

Audio/video material

· The paper to which the audio or video clip relates should be mentioned in the recording · Audioclipandvideofilesshouldbeaccompaniedwithbrieftext explaining the content of the audio, names of interviewers/ interviewees, date of recording, and place of recording if relevant · Writtenconsentfromallpartiesmustbesuppliedatsubmission


Protocol review

· The Lancet will assess protocols of randomised trials and systematicreviewsandwillpublishonourwebsitesummaries ofthoseprotocolsthatsurvivereview · Itisbesttosubmityourprotocolbeforethestartofthetrial;all trials should be registered · Wealsomakeacommitmenttoseekpeerreviewofanypaper thatreportstheprimaryclinicaldataofaprotocolthatwehave published (see Lancet 2008; 372: 189­190 and Lancet 2001; 357: 1819­20), and therefore encourage submissionofsuchpaperstoThe Lancet


· · Audio material submitted as an mp3 file, no larger than 50Mb Yourpapermaybeselectedforapodcast.Ifso,theWebEditor willcontactyoutoarrangeapre-recordedinterviewtodiscuss yourpaper.Formoreinformation,seeAudio


· Video material should preferably be submitted in .mpg (or .mov,.avi,or.gif)formatwithaspectratioof16:9,nolarger than50Mb Wewelcomeyourvideosandinviteyoutosubmitanyvideo material(reports,interviews,scans,imaging)forconsideration intheonlinejournal.Pleaseensurethatallthosefeaturedin the video have given permission for publication (see also the above section on Patients' consent and permission to publish) AllvideofilescanbesubmittedalongsideyourarticleinEES

How The Lancet handles your paper


· Receipt of your paper will be acknowledged by an email containing a reference number, which should be used in all futurecommunications


Checking for plagiarism, duplicate publication, and text recycling

· All Seminars, Series, Reviews, and other non-research material thatwe are interested in publishingwill be checked by editors using CrossCheck (see Lancet 2011; 377: 281­82). We expect that such papers arewritten in awaythatoffers newthinking withoutrecyclingpreviouslypublishedtext


Disclosure of results before publication

· Presentation of data at a scientific meeting, as a poster, abstract,orally,onaCD,orasanabstractonthewebdoesnot conflict with submission to The Lancet · AsamemberjournaloftheInternationalCommitteeforMedical JournalEditors,The Lancet does not regard results that are posted inthesameclinicaltrialsregistryinwhichprimaryregistration resides as prior publication, if the results are presented in the form of a brief structured abstract or table (<500 words; see Lancet2007;369:1909­11).However,presentationofresultsin othercircumstances(eg,investors'meetings)isdiscouragedand couldjeopardiseconsiderationofthemanuscript

Peer review

· Every Article, Case Report, Hypothesis, Seminar, and Review published in The Lancet has been peer reviewed. Occasional contributions(eg,Essays)areacceptedwithoutpeerreview · OnsubmissiontoThe Lancet,yourreportwillfirstbereadbyoneor moreofthejournal'sstaffofphysiciansandscientists.Ouracceptance rateoverallisabout5%anditisanimportantfeatureofourselection processthatmanypapersareturnedawayonthebasisofin-house assessmentalone.Thatdecisionwillbecommunicatedquickly · Research papers and most other types of paper that receive positivein-housereviewsarefollowedbypeerreviewbyatleast three reviewers.Youwill receive notificationofwhich editor is November, 2011

Fast-track publication

· For research papers that are judged to warrant fast dissemination, which will usually be randomised controlled

Information for Authors

handlingthepeerreviewofyourpaper.Ifreviewsareencouraging, and the editorial consensus is also favourable, then we seek statistical advice where appropriate

What happens after publication?

Press release

PressreleasesareissuedforsomeofThe Lancet'scontent,including almostallArticles.Youwillbeadvisedwellinadvanceifyourpaper has been selected for press release. The Lancet's Press Officer will contactyouwithdetailedinstructionsabouttheembargoattached to your paper, and will provide a draft press release for your commentsaheadofthepublicationdate.

Press release Forfurtherdetailson The Lancet's press release see press-room


· Submissions that survive in-house and peer review might be referred back to authors for revision. This is an invitation to presentthebestpossiblepaperforfurtherscrutinybythejournal; it is not an acceptance · Authors should give priority to such revisions; the journal will reciprocatebymakingafinaldecisionquickly · Two copies of the revised version should be sent back, one of which should be highlighted to show where changes have been made.Detailedresponsestoreviewers'comments,inacovering letter,arealsonecessary

Author interview

Yourpapermaybeselectedforapodcast.Ifso,theWebEditorwill contactyoutoarrangeapre-recordedinterviewtodiscussyour paper.Formoreinformation,seeAudio


Offprints and Reprints

100 offprints of Articles, Case Reports, and most types of review paperswillbeprovidedfreeofcharge.Allrequestsforreprintsshould be addressed to the Reprints Department in the London office: tel: +44 [0]20 7424 4329, fax: +44 [0]20 7424 4433, email [email protected]

The Lancet journals and other Elsevier journals

· IfyourpaperisrejectedbyThe Lancet,wemightjudgeitsuitableto passtotheeditorsofThe Lancet Oncology,The Lancet Neurology,or The Lancet Infectious Diseasesforconsideration · If your paper is rejected by The Lancet, The Lancet Oncology, The Lancet Neurology,andThe Lancet Infectious Diseases,wemightjudge it appropriateto pass onto editors of other journals withinthe Elsevierportfolio

Data storage

Authorsmayberequiredtoprovidetherawdataforresearchpapers when they are under review and up to 10 years after publication in The Lancet.


· Sometimeseditorsmakemistakes.Whenwedo,weliketohear aboutthem.Ifanauthorbelievesthataneditorhasmadean errorindecliningapaper,wewelcomeanappeal.Inyourappeal letter, which should be sent to [email protected], please statewhyyouthinkthedecisionismistaken,andsetoutyour specific responses to any peer reviewers' comments if those seemtohavebeenthemaincauseofrejection · At least two editors will decide whether to invite a revised manuscript and whether re-review, or otherwise (see Lancet2003;361:1926formoredetailsonourappealsprocess) is indicated


Authorswillbeaskedtosignatransferofcopyrightagreement,which recognises the common interest that both journal and author(s) have in the protection of copyright. We accept that some authors (eg, government employees in some countries) are unable to transfer copyright.However,suchopen-accesspoliciesdonotprovideanyone other than The Lancettherighttomakeinanyformfacsimilecopiesof the version printed. All requests to reproduce or make available anything inthe journal--inwholeor in part, in electronicor in any otherform,includingtranslation--mustbesentto: ElsevierGlobalRightsDepartment TheBoulevard, LangfordLane, Kidlington Oxford, OX51GB,UK Tel:+44(0)1865843830 Fax:+44(0)1865853333 Email: [email protected]


· The Lancet employs highly skilled Assistant Editors, and it is likely that your paper will be substantially edited after acceptance to ensure that it is accurate, clear, and understandable to a wide readership · AllfigureswillberedrawnintoThe Lancetstylebyourin-house illustrators · You will receive a proof from an Assistant Editor. That proof should be corrected and returned within 48 hours

Open access

The Lancet is committed to support authors in making their research publiclyandfreelyavailable.Theeditorsencourageauthorstoposta Word-processedversionoftheirpeer-reviewed,accepted,andedited article on their personal or institutional websites any time after publication in print or online.Your document should indicate the article's citation and a link to The Lancet's homepage.

Editorial research

· We are keen to better understand and improve editorial conduct, decision making, and issues relatedto peer review. Therefore, we occasionally take part in or conduct editorial research.Yoursubmittedpapermightbeusedinsuchresearch. Ifyoudonotwantyourpaperenteredintosuchastudy,please letusknowinyourcoveringletter.Yourdecisiontotakepart or not will have no effect on the editorial decision on yourpaper November, 2011

The Lancet's policy on open archiving

Wellcome Trust, Medical Research Council, Cancer Research UK, ArthritisResearchCouncil,BritishHeartFoundation,UKDepartment

Information for Authors

Article Sponsorship Form http://download.thelancet. com/flatcontentassets/authors/ article-sponsorship_form.pdf

of Health, UK Chief Scientist Office, or Austrian Science Fund grantees, who reporttheir funded research in The Lancet Journals, cancomplywiththeirfundingbody'spolicyoragreementonopen archiving. If you have an Article accepted for publication in The Lancet, The Lancet Oncology, The Lancet Neurology, or The Lancet Infectious Diseases, and your funding body's policy or agreement applies, please complete and submit the Article Sponsorship FormforThe Lancet journals. Authors funded by the National Institutes of Health (NIH) can comply with the NIH's public-access policy via the Journal

PublishingAgreement (copyrighttransfer form)which is sentto thecorrespondingauthorofacceptedArticles.AllHowardHughes Medical Institute scientists who are authors of accepted Articles can also have their accepted manuscripts deposited in PubMed Central if they complete the relevant section of the Journal Publishing Agreement. Click hereforElsevier'sagreementswithfundingbodies. November, 2011


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