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Ethical and Legal Policies

Critical Care Explorations adheres to the ethical policies put forth by the Committee on Publication Ethics (COPE) and the International Committee on Medical Journal Editors (ICMJE).


According to the International Committee on Medical Journal Editors (ICMJE), an author is defined as one who has made substantive intellectual contribution to the development of a manuscript. The ICMJE guidelines state that "authorship credit should be based on 1) substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; and 2) drafting the article 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 in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Authors should meet conditions 1, 2, 3, and 4. If more than 10 authors are listed for any given manuscript, it will be sent back to the corresponding author. Overage should be relocated to the Acknowledgment section of the manuscript; authors may write on behalf of "working groups;" all members of working groups are to be listed in the Acknowledgement section. Special exceptions to this rule may be sought via special request: The Editor-in-Chief will consider your request after you have completed a form in which all authors attest and sign that they have fulfilled all four conditions of authorship After the initial submission of a manuscript, any changes whatsoever in authorship (adding author(s), deleting author(s), or re-arranging the order of authors) must be explained by a letter to the Editor from the authors concerned. This letter must be signed by all authors on the paper. Copyright assignment must be completed by every author.

Ghostwriting is not permitted by the journal.  Manuscripts are received with the understanding that they have not been written by unacknowledged freelance writers. Guest authorship and "gift" authorship are also prohibited.

Professional writers and medical writers who contribute substantially to the writing or editing of a manuscript should be acknowledged with their permission or credited in the author list. The financial nature of their contract must be disclosed.

Each author must disclose at the time of submission any commercial associations or financial disclosures that might pose or create a conflict of interest with information presented in any submitted manuscript. Such associations include consultancies, stock ownership, or other equity interests, patent licensing arrangements, and payments for conducting or publicizing a study described in the manuscript.

Duplicate Publication

Manuscripts containing original material are accepted for consideration when neither the article nor any part of its essential substance, tables, or figures has been or will be published or submitted elsewhere before appearing in the journal (in part or in full, in other words or in the same words, in English or in another language), and will not be submitted elsewhere unless rejected by the journal or withdrawn by the author. Simultaneous submissions of the same article to multiple journals are prohibited. If an author violates this requirement or engages in similar misconduct, the Journal's Editorial Board may reject the manuscript or impose a moratorium on acceptance of new manuscripts from the author. If it deems the misconduct sufficiently serious, the Editorial Board can refer the matter for investigation to the author's academic institution or hospital, to the appropriate state or local disciplinary body, and/or other appropriate bodies.

A letter of permission is required for any and all material that has been published previously or is "in press" by another journal. It is the responsibility of the author to request permission from the publisher for any material that is being reproduced. This requirement applies to text, illustrations, and tables. These permissions must be supplied to the Journal upon submission of the article, along with ample acknowledgment of the original source of the materials in the legend and/or text.

To reiterate, any previously published material (including material published in foreign-language, open access, or e-journals) that is included in a submission to Critical Care Explorations must:

a) Clearly reference the original publication of the previously published material.

b) Be accompanied by a letter of permission from the copyright holder of the material. Any fee associated with permission to reuse previously published material is the responsibility of the author of the manuscript.

 If an author submits an article to Critical Care Explorations that contains material to which he or she holds the copyright (figures, material from articles published on open-access or e-journals, and so on), he or she needs to indicate clearly that he or she holds the copyright and provide Critical Care Explorations  with written permission to use the copyrighted material.

The Journal's online submission system, Editorial Manager, employs an automated plagiarism/duplicate publication program called "CrossCheck." As such, we use this program strategically to help us discover instances of misconduct at the earliest stages of manuscript submission.

Plagiarism and Fabrication

Plagiarism is when an author passes off the work of someone else as his or her own. This can also include self-plagiarism, which happens when an author reuses portions of his or her previously published work without the proper references. Manuscripts containing plagiarized content will not be considered for publication in the Journal.

All authors must take responsibility for their manuscripts. If your name is on a manuscript, make sure all of the material in the paper either is original or is properly cited and has proper permission to be reproduced. If you have a question about the originality of any part of a manuscript, verify it with your coauthors. Senior authors should pay special attention to what the junior authors are doing and where they are sending their manuscripts.

If you realize you have made an error of dual publication or plagiarism inadvertently, proactively contact the editorial office. It is much better to come forward of your own volition than to have an accusation made against you.

If the Journal learns of a case of plagiarism after publication, the Journal will conduct an investigation. If plagiarism is found, the author, the author's institution and funding agencies, and the original publication will be notified. A statement noting the plagiarism, providing a reference to the plagiarized material, and linking to the original to the original paper may follow. Depending on the extent of the plagiarism, the paper may also be formally retracted.

Image Integrity

Illustrations should be labeled clearly. Illustrations should be arranged symmetrically, in either "portrait" or "landscape" orientation. Before-and-after photographs should be identical in terms of size, position, and lighting. All illustrations must be accompanied by figure legends, to be attached at the end of the manuscript.

No photographs, digital or otherwise, should be substantively modified.

Graphics-altering programs can be used to assemble multi-panel images, clean up dust specks from scanning in originals, and cropping. However, these programs should not be used improperly to attempt to modify results. Tools such as "clone stamping" can often be detected due to a trail of "smudged" skin tone. There is zero tolerance for abusing digital photo editing software to change the appearance of clinical results.

Photographs must be taken with appropriate lighting and must be clearly in focus.

Patient Consent for Identification in Photos, Videos, etc.

If patients in photographs or videos are identifiable, authors must obtain and provide to the Journal at the time of submission written consent from the patients. 

Permission to use photographs for all types of media should include but are not limited to the following: print, visual, electronic, or broadcast media. Also, details in text that might identify patients, including but not limited to names, initials, and hospital numbers, must not be used unless essential for scientific purposes.  If identification of patients is unavoidable, informed consents from the patients must be obtained.

  • Patient authorization and permission is needed to reproduce any photograph of a patient's face or identifiable body part. An identifiable tattoo on an otherwise unidentifiable body part effectively identifies the patient; patient permissions are required for these images, too. Photographs with bars placed over the eyes of patients are not allowed in place of patient authorization and permission.
  • If "deidentification" by sufficient cropping of a patient's features is not possible, the authors need to obtain authorization and consent from the patient. If the patient cannot be located or refused to provide consent and authorization, the photograph must not be included in the manuscript submission.
  • In the event that the patient cannot provide consent due to death or legal incompetency (this includes photographs of corpses), permission from the power of attorney is needed as well as proof of power of attorney.

Correction and Retraction Policy

Critical Care Explorations takes full responsibility to correct errors as they occur. Content that is published online or in an issue is considered the final published record and must be preserved; therefore, all changes to articles must be made as a formal correction. Corrections will be published online and in the next available issue and will be bi-directionally linked to the original article.  These corrections will then be picked up by Ovid and transmitted to PubMed and other aggregating databases.

Corrections will be reviewed and considered if they affect the publication record, the scientific integrity of the paper, or the reputation of the authors, or of the Journal.  Corrections that do not significantly affect the paper may not be approved (i.e. a spelling error).

Retractions will be considered if results are invalid or ethical guidelines have been violated (e.g. applicable cases of plagiarism or ghostwriting). All coauthors must sign a retraction detailing the error and how the conclusions were affected.

All decisions about corrections or retractions are made by the editor. Author consultation may be required. In situations in which coauthors disagree about a correction, the editors will consult with independent peer-reviewers before applying the appropriate correction. The dissenting author(s) position will be noted on the correction.


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