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Instructions for Contributors

Instructions for Contributors

The American Journal of Respiratory and Critical Care Medicine publishes original papers on human biology and disease, as well as animal and in vitro studies, which contribute to the understanding of pathophysiology and treatment of diseases that affect the respiratory system and critically ill patients. Only papers written in English can be considered. Manuscripts should conform to the Uniform Requirements for Manuscripts Submitted to Biomedical Journals (http://www.icmje.org/index.htm). The Journal is published in both print and electronic formats and may be viewed online at http://www.atsjournals.org/ or at http://intl.atsjournals.org/. Articles in Press (articles posted on the Journal's website before the print version) may be viewed online at http://www.ajrccm.atsjournals.org/articlesinpress.shtml.

SUBMISSION OF MANUSCRIPTS
To submit your manuscript, go to http://mc.manuscriptcentral.com/atsjournals. Complete instructions for online submission are located on this website. Technical support is available from Monday through Friday, 9:00 am to 5:00 pm, EST, at 212-315-8638 or by e-mail (fling@thoracic.org). Manuscripts that do not conform to guidelines will be delayed in processing.
All correspondence related to manuscripts should be addressed to:

Dr. Jacob Iasha Sznajder, Editor
American Journal of Respiratory and Critical Care Medicine
ATS Peer Review Office
61 Broadway
New York, NY 10006-2755
Tel: (212) 315-8625/8626
FAX: (212) 315-8613

Manuscripts are acknowledged by ScholarOne upon receipt. Submission, Copyright, and Disclosure of Financial Interest Forms are not acknowledged by the Peer Review Office, but you will be queried if they are not received. When inquiring about a manuscript, please refer to the assigned the manuscript number. Inquiries will be accepted from the designated Corresponding Author only.

Online Submission Form
The Corresponding Author should complete the online Manuscript Submission Form. The Corresponding Author can be a different individual from the contact author on the Title Page of the manuscript.

By virtue of submitting a manuscript to the American Journal of Respiratory and Critical Care Medicine, the authors certify that (a) the material is original, has not been published except in abstract form, and is not being considered for publication elsewhere, including publicly accessible websites or e-print servers, (b) no part of the research presented has been funded by tobacco industry sources, and (c) all authors have read the manuscript and approve its submission, (d) all clinical trials have been registered in a public trial registry. Please view http://www.icmje.org/index.htm#clin_trials for further detail. Any change in authorship following the original submission must be justified and agreed to in writing by the affected author(s). The American Journal of Respiratory and Critical Care Medicine allows the designation of more than a single first author when two authors have made equal contributions to a study.

If any data are derived from subjects or animals of a previous report, this must be stated explicitly in a cover letter in the "Author Comments" area on the ScholarOne website as well as in the manuscript. When some or all of the dataset for a submitted manuscript were also used for the results in another manuscript, this point must be stated explicitly in the "Author Comments" area even when the results presented in the submitted manuscript do not overlap with the results presented in the other manuscript.

Authors may list three to five reviewers (include e-mail address, FAX number, and telephone number) they believe are qualified to review the paper. Suggested reviewers should not have been collaborators or coauthors within the previous three years, nor should they have provided substantial advice or critique of the submitted manuscript. Authors may also request disqualification of up to two reviewers with potential conflict of interest.

Copyright Form
Upon submitting any revised version of a manuscript that has been approved for submission, all Authors must complete the Assignment of Copyright Form and email to forms@thoracic.org. The Assignment of Copyright Form in PDF is available at http://mc.manuscriptcentral.com/societyimages/atsjournals/COPYRIGHTFORM.pdf. When the work is the product of more than one author, each author must complete and send a form.

Public Access Policy
If any of the authors have been supported financially by the NIH to conduct the research that is reported in the article, they should indicate this on the copyright form and provide the grant number and contact name on the title page of the manuscript. The ATS will submit an electronic copy of the final published version on the authors' behalf to the NIH National Library of Medicine's (NLM) and PubMed Central (PMC) at a time in compliance with NIH requirements. If any of the authors of a manuscript have been supported by the Wellcome Trust or other member of the United Kingdom PMC Funders Group, then the ATS will submit an electronic copy of the final published version to the United Kingdom PMC in compliance with requirements.

REVISIONS
Authors should revise their manuscript using a word processor and then resubmit the revised version, ensuring that it is marked R1. Authors need to submit a clean version and a "marked-up" version of their revised manuscript. To create the "marked-up" version, please use a red font instead of a black font to indicate the portions of the manuscript that have been changed.

If supplementary material was initially submitted for consideration for posting in the Online Supplement, the material needs to be included again when a revised manuscript is being submitted.

If a revision of an Original Article is not received within 6 months from the last decision letter of an Associate Editor, the Journal will assume that the authors have withdrawn the manuscript from further consideration. In cases where substantial new data are required, extensions may be granted at the Editors' discretion. The time limit for receipt of revisions of a Featured Article, such as a State-of-the-Art Review Article, Clinical Commentary, Pulmonary Perspective, and Critical Care Perspective, is 3 months.

HANDLING OF MANUSCRIPTS
Manuscripts are accepted for publication on the basis of scientific merit, significance, and suitability for publication devoted to clinical and laboratory studies of respiratory and critical care medicine. Decisions on manuscripts will not be discussed over the phone. On publication, each report indicates the dates that the original manuscript was received at the Peer Review Office and the date that the manuscript was finally accepted.

HUMAN AND ANIMAL STUDIES
The American Journal of Respiratory and Critical Care Medicine endorses the recommendations concerning human research that are contained in the Declaration of Helsinki. The Editors reserve the right to reject any manuscript containing studies that do not conform to these recommendations. All manuscripts reporting human research must contain a statement in the text that the institutional review board for human studies approved the protocols and written consent was obtained from the subjects or their surrogates if required by the institutional review board.

Use of animals in research should be compliant with all subsequent revisions of the Health Research Extension Act (public law 99-158, 1985 "Animals in Research"). Animal experiments are to be undertaken only with the goal of advancing scientific knowledge and with the explicit approval of the Institutional Animal Care and Use Committee before initiation. In the absence of a global policy on the care and use of laboratory animals, U.S. guidelines must be followed. All animal experiments must conform to the revised Institute of Laboratory Animal Resources, Commission on Life Sciences, National Research Council "Guide for the Care and Use of Laboratory Animals" National Academy Press, Washington, D.C. 1996. These documents can be obtained at: http://grants.nih.gov/grants/olaw/olaw.htm.

Any deviation from the Guide, Public Health Service policy, or the United States Animal Welfare Act must be scientifically justified and approved by the investigators' Institutional Animal Care and Use Committee. Animals used in research and education should receive every consideration for their comfort and care, and discomfort and pain must be minimized. Descriptions of surgical procedures and experiments on animals must include the name, dose, and route of administration of the anesthetic agent. Paralyzing agents are not acceptable alternatives to anesthesia, and should be used only in conjunction with appropriate anesthetic agents. Studies that require the death of an animal must employ the most humane euthanasia method that is consistent with the goal of the study and the recommendations of the "Report of the American Veterinary Medicine Association Panel on Euthanasia" (Journal of the American Veterinary Medicine Association, Vol 218, No. 5, March 1, 2001). The Editors reserve the right to reject any manuscript containing studies that does not conform to these recommendations for the use of animals in research.

CLINICAL TRIAL REGISTRATION
In strict accordance with ICMJE standards, the American Journal of Respiratory and Critical Care Medicine requires that all clinical trials be registered with a database that is readily available to the public Clinical trials are defined by the ICMJE as “any research project that prospectively assigns human subjects to intervention or concurrent comparison or control groups to study the cause-and-effect relationship between a medical intervention and a health outcome. Medical interventions include drugs, surgical procedures, devices, behavioral treatments, process-of-care changes, and the like.”

It is the strong preference of the Editor that clinical trials be registered with http://www.clinicaltrials.gov/. However, other online registries may be acceptable. Acceptable public registries must be free of charge, available to all registrants, and administered through not-for-profit organizations. Information that must be included in the clinical trials registration includes the name of the study, primary and secondary endpoints of the clinical trial, inclusion and exclusion criteria, number of patients expected to be enrolled, and explicit nature of the intervention being tested. Without the necessary registration, papers will not be placed into peer review. Please view http://www.icmje.org/index.htm#clin_trials for further detail.

GENOMICS DATA IN ATS JOURNALS

1. It is the authors’ responsibility to ensure that all data collected and analyzed in their experiments adhere to the Minimal Information About a Microarray Experiment (MIAME) guidelines. The MIAME checklist is available at: http://www.mged.org/Workgroups/MIAME/miame_checklist.html. We require that authors submit all primary microarray data to one of the public repositories (ArrayExpress, GEO, or CIBEX), in a format that complies with the MIAME guidelines, by the time of publication.

2. Nucleic acid or protein sequences should be deposited in EMBL or Genbank databases and accession numbers submitted prior to publication of manuscripts.

AUTHOR DISCLOSURE
Upon submitting an original scientific manuscript, review article, editorial, or letter to the editor that has been approved for submission to the Journal, each and every author and co-author is required to submit a completed American Thoracic Society Disclosure Form online via the following secure ATS website: http://coi.thoracic.org. Journal editors, deputy editors, associate editors and peer reviewers also make disclosures to ATS, according to instructions they receive, at time of appointment.

The ATS Disclosure Form is a “universal ATS disclosure” intended to apply to all ATS activities in which the submitter participates. Individuals are asked explicit questions about relationships with commercial and non-commercial entities relevant to respiratory, critical care and sleep medicine. Examples of information requested include: (a) use of provided dollar ranges to disclose relevant personal financial interests; (b) disclosure of relevant institutional relationships with commercial entities, if known to the author (note: ATS does not require individuals to make specific inquiries of the authorities of their institution); and (c) disclosure of any relationship with the tobacco industry or its affiliates and subsidiaries that benefited the ATS member/non-member or the tobacco industry in its promotion of tobacco products. (Note: the Journal also continues its policy of not accepting research funded by tobacco industry sources.) Disclosure of known involvement of a spouse, life partner, or dependent with relevant entities is also required.

Author disclosures will be considered in relation to the submitted manuscript by the Editor as part of the review process, and summarized within a statement prepared by the Journal that will be published with the manuscript after final approval.

The Journal assumes that all individuals have “competing interests” that may at times cause conflicts of interest. A conflict of interest depends on the situation, and not on the character or actions of the individual. The ATS defines conflict of interest as a “divergence between an individual’s private interests and his or her professional obligations such that an independent observer might reasonably question whether the individual’s professional actions or decisions are motivated by personal gain” and/or a “financial or intellectual relationship that may impact an individual’s ability to approach a scientific question with an open mind.”

After an article has been published, readers sometimes write to a journal because they have reason to believe that authors failed to disclose financial relationships with an entity that has an interest in the subject of the article. The Journal will handle these inquiries according to the recommendation of the American Medical Association. Queries will be forwarded to authors, and authors will be required to provide a written explanation. New disclosures will be published in the correspondence columns of the Journal.

The Journal strongly opposes contractual agreements that deny investigators the right to examine data independently or to submit a manuscript for publication without first obtaining the consent of the sponsor. Researchers should not enter into agreements that interfere with their access to data or their ability to analyze data independently, to prepare manuscripts, and to publish them. Authors should describe the role of the study sponsor(s), if any, in study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the report for publication. If the supporting source had no such involvement, the authors should so state. If a study is funded by an agency with a proprietary or financial interest in the outcome of the study, the corresponding author must include the following statement in the "Author Comments" area of the manuscript submission website, http://mc.manuscriptcentral.com: "I had full access to all of the data in this study and I take complete responsibility for the integrity of the data and the accuracy of the data analysis."


How to Submit Author Disclosure for Peer Review
Step 1: Each and every author must comply with ATS policies for disclosure of competing interests and relationships with the tobacco industry (click here to see the ATS COI and tobacco policies) and submit an up-to-date ATS disclosure form upon submission of a manuscript to the AJRCCM. The form is obtained at: http://coi.thoracic.org.

Step 2: Each author should save his/her completed form as a PDF file, which should be named consistent with the file naming convention defined on the website (e.g. blue200810OC.pdf). Each author should also establish an account at the ATS COI Manager archive, http://coi.thoracic.org, by way of providing basic contact information and determining a user name and password. An electronic copy (PDF file) of the completed form can then be stored on the site in a secure manner (available only to the author and a limited number of authorized ATS administrative staff), to be updated as needed for future Journal submissions or other ATS activities.

Step 3: Each author should also e-mail a second e-copy (PDF file) to the ATS Peer Review Office at forms@thoracic.org. Authors should be sure to include the journal and manuscript number in the subject heading of the email. A limited number of authorized ATS staff will assist the Editor in reviewing disclosures and preparing a statement to be published as a footnote in the official publication.

If you have any questions about submitting disclosures for revised manuscripts, please contact the ATS journal peer review office.

COMPANION PAPERS
The American Journal of Respiratory and Critical Care Medicine strongly discourages the submission of more than one manuscript dealing with related aspects of a single study. In almost every case, a single study is best reported in a single paper.

PRIOR AND FRAGMENTED PUBLICATION
The American Journal of Respiratory and Critical Care Medicine does not publish original contributions that contain a significant portion of material that has been published or submitted for publication elsewhere, with the exception of abstracts containing no more than 400 words. As a general guideline, any material available with PubMed or other accessible electronic sources is considered to be in the public domain and to have been published. The Editors of the Journal reserve the right to determine what constitutes significant duplicate publication.

All manuscripts and data, submitted or in press, which are potentially overlapping, or related to, data presented in the submitted manuscript, must be appended to the online submission. With an online submission of a manuscript, state explicitly in the "Author Comments" area on the website that such material has been uploaded. When the data in the submitted manuscript potentially overlap with, or are related to, data presented in a previously published article or articles, the previously published article(s) need(s) to be listed in the "Author Comments" area on the website.

Some authors may see that two manuscripts overlap, but they consider the overlap insufficient to constitute duplicate publication. At the American Journal of Respiratory and Critical Care Medicine, we wish to make up our own mind as to whether the overlap is significant or not. No matter how small the overlap between two or more manuscripts, authors need to inform the Journal about the related work. If any of the control data in a manuscript are also included among the control data in another manuscript, the Journal must be informed. This requirement applies even when the results presented in the submitted manuscript do not overlap with the results presented in the other manuscript. When authors are in any doubt as to what material to enclose with a submitted manuscript, they should err on the side of including too much rather than too little.

A statement about overlap is best made in the Methods section of a manuscript. Alternatively, a statement can be made in the Online Repository even when no other material is being presented in the Repository. If for some reason neither of these options is suitable, a statement in the "Author Comments" area on the website will also be sufficient. On the Mandatory Submission Form, authors must state whether or not the submitted manuscript overlaps with another manuscript. Authors must also include a cross-reference in a submitted manuscript to potentially overlapping work. When authors develop doubts about possible duplication of publications after a manuscript has been submitted or has already been published, the Journal wants to be informed.

See the section on Redundant or Duplicate Publication in the "Uniform Requirements for Manuscripts Submitted to Biomedical Journals" at (http://www.icmje.org/index.htm). Authors should note the broad nature of expected disclosure. Authors do not need to attach abstracts with their submission when the abstracts are equivalent in length to an abstract submitted to the International Conference of the American Thoracic Society. If some or all of the work in the manuscript has been published or submitted in an abstract that exceeds 400 words, a copy must be attached to the online submission. An explanation of the nature of any possible overlap with the submitted manuscript must be placed in the "Author Comments" area on the website.

If some or all the research contained in a manuscript was previously published as one or more abstracts, irrespective of the number of words in the abstract, this point should be acknowledged in the last sentence of the Introduction. The recommended format is: "Some of the results of these studies have been previously reported in the form of an abstract (s) (References)." In addition, the abstract(s) must be listed in the references.

When authors are submitting a Review Article, the Journal wishes to be informed about other review articles that authors have published on a related topic. Review articles may contain previously published material such as illustrations or tables provided it is appropriately referenced in the legend, as well as in the reference list. It is the responsibility of the author(s) to submit hard copies of appropriate written permission to utilize previously published material that would otherwise violate copyright regulations. Authors who fail to follow the Journal's policy on the requirement for full disclosure of overlapping or related work may be banned from submitting manuscripts to the Journal for a period of time.

EMBARGO POLICY

An article published in the American Journal of Respiratory and Critical Care Medicine may not be discussed by journalists or presented in other public media, such as websites, before the article is posted on the Journal's Articles in Press website. It is permissible to present the material contained in the article at a scientific meeting. The ATS may refuse to publish a manuscript, despite acceptance for publication by an editor, if the contained information has been disseminated prematurely in the media. Unless otherwise noted, Articles in Press are not under media embargo once they appear online.  Please refer any questions to Keely Savoie, ksavoie@thoracic.org (or call 212-315-8620).

PROOFS
One set of paged galley proofs is e-mailed before publication of each paper and must be returned within 48 hours of receipt. Alterations are to be kept to a minimum and may be made only on the paged galley proof. Please note that changes of content and insertions of missing information will be billed to the author. An offprint order form is e-mailed with the paged galleys.

SUBMISSION FEES (before acceptance)
Authors are billed for submission fees at the time of the submission of a manuscript. These fees vary according to ATS membership status. Nonmembers are billed $100; full members (US and all international levels) are billed $50, U.S. affiliate members are billed $65, and U.S. and international trainee members are billed $40.  Submission fees are not refundable. Please write to the Publisher if there is a hardship or special circumstances.

PAGE CHARGES (after acceptance)
Authors are billed for page charges at different rates depending on their ATS membership status. Nonmembers are billed at the rate of $100 per printed page. Full U.S. ATS members and international Level A members are billed $70,  U.S. affiliate members are billed $80, U.S. and international trainee members are billed $40, international Level B members are billed $45, and international Level C members are billed $20 per printed page. Member discounts are based solely on the corresponding author’s membership status in the Society. Level B and C memberships comprise countries with limited resources. (If you are not a member of the ATS and would like to join, please visit the “Become a Member” page, or contact membership@thoracic.org or 212-315-8685.) 

CONTRIBUTORSHIP

For original research manuscripts, the contributions of each person named in the author line and their participation in the study must be listed on the title page of the manuscript. Please see the ICMJE Uniform Requirements for more information.

CRITERIA FOR AUTHORSHIP
Each author should have participated sufficiently in the work, the data analysis, and the preparation of the manuscript, and have reviewed and approve the manuscript as submitted to take public responsibility for it. This would include substantial participation in some or all of the following aspects of the work relating to the manuscript:

  • involvement in the conception, hypotheses delineation, and design of the study
  • acquisition of the data or the analysis and interpretation of such information
  • writing the article or substantial involvement in its revision prior to submission


MANUSCRIPT PREPARATION
Manuscripts should be typed in 12-point type with margins of 2.5 centimeters (1 inch). Double spacing should be used throughout. All papers should be organized to include: title page, abstract, text, acknowledgments, references, figure legends, footnotes, tables, and figures. Each of the preceding elements should begin on a separate page. While the Introduction should begin on a separate page, it is not necessary for the Methods, Results, and Discussion section to begin on a separate page; instead, they should follow after the Introduction, with two spaces separating each section. Pages should be numbered consecutively, beginning with the abstract.

Abbreviations and Acronyms

The American Journal of Respiratory and Critical Care Medicine discourages the use of abbreviations and acronyms, and requires authors to avoid them completely in the abstract. Abbreviations impose a burden on a reader because the reader must first decipher the writer's code. This task distracts the reader from concentrating on the science in an article. A reader should not need a glossary to understand an article. If a reader is already familiar with an abbreviation and the writer uses it skillfully, it can ease communication. It is acceptable to substitute a standard abbreviation for an unwieldy word or phrase appearing more than five times in a manuscript. An abbreviation should never replace one short word: for example, do not use ETX for endotoxin or AR for arousal, whereas LAM for lymphangioleiomyomatosis is acceptable. A simple way of avoiding abbreviations is to use a substitute word. Instead of writing "IRL" for "inspiratory resistive load", simply write "load" after first stating what type.

If an abbreviation is used, the term should always be first written in full with the abbreviation in parentheses immediately after it. Do not invent new abbreviations where pre-existing ones exist. If you use an abbreviation, make it a sensible one, such as three capital letters without periods. Avoid using terms like Group 1 or Group A; readers should not have to remember what Group 1 or Group A stands for. Instead, write the "treated patients" or the "control group."

Specialized jargon should also be avoided.

Title Page

The title page should include a concise and descriptive title (limited to 100 characters, including spaces); the first name, middle initial, and last name of each author; the departmental and institutional affiliation of each author; and the telephone and fax numbers as well as the e-mail address of the corresponding author. (The corresponding author listed on the title page does not have to be the same person listed as the corresponding author for Peer Review in the ScholarOne system.) A running title of no more than 50 characters (including characters and spaces) should be included. Please note that the title that appears on the manuscript itself must be identical to the manuscript title entered into the ScholarOne site. Authors should state in 2-3 sentences what impact this research will have on clinical medicine and basic science and how the research adds to our knowledge base of the disease process and include this on the title page of the manuscript.
List all of the following items.


1. Title, which should be limited to 100 characters (count letters and spaces, use no abbreviations)

2. First name, middle initial, and last name of each author

3. Name of department(s) and institution(s) to which the work should be attributed linked to each author with a corresponding number

4. Name and address of the author to whom requests for reprints should be addressed

5. Corresponding Author's e-mail address, FAX number, and phone number (this can be a different Corresponding Author than the Corresponding Author listed in ScholarOne)

6. All source(s) of support in the form of grants, gifts, equipment, and/or drugs

7. A short running head of no more than 50 characters (count letters and spaces)

8. List ONE descriptor number that best classifies the subject of your manuscript, using the Subject Category List for Authors
(http://www.thoracic.org/journals/ajrccm/subject-code-list-for-classification-of-articles-submitted.html)

9. State the word count for the body of the manuscript, excluding abstract, references and online supplementary information for the Online Repository; state the word count for the Abstract on the Abstract page (numbered page 1)

10. Include an “At a Glance Commentary” which addresses the following two issues: Scientific Knowledge on the Subject, and What This Study Adds to the Field. Please note that this same text should be included at the end of your Manuscript Details in the appropriate boxes when submitting your paper online.

11. If material is being submitted for the Online Data Supplement, please include the following statement on the title page of the main manuscript, "This article has an online data supplement, which is accessible from this issue's table of content online at www.atsjournals.org"

Abstract

The second page (numbered page 1) should carry an abstract of not more than 250 words and labeled Abstract. The American Journal of Respiratory and Critical Care Medicine requires that the abstract be written in a structured format for original research articles. An abstract is required for State of the Art, Workshop reports, Clinical Commentaries, Critical Care Perspectives, and Pulmonary Perspectives, but need not be structured. An abstract is not required for manuscripts of the types Occasional Essay and Pro and Con.

A structured abstract must include the following headings: Rationale, Objectives, Methods, Measurements and Main Results, and Conclusions. Avoid a long introductory section. A clear conclusion is imperative, and all speculation should be avoided. The abstract should be written in a format that can be understood by both researchers and clinicians.

Do not use abbreviations, acronyms, footnotes or references in the abstract.

At the bottom of the page, state the number of words in the abstract and list 3 to 5 key words for use as indexing terms. These terms should not include words in the title of the manuscript. Key words are best expressed as MeSH (Medical Subject Headings) terms, the controlled vocabulary used by Pub Med. The MeSH browser available at (http://www.nlm.nih.gov/mesh/MBrowser.html) provides an online guide to the selection of key words.

Text
The text of articles should usually, but not necessarily, be divided into the following sections: Introduction, Methods, Results, and Discussion. Long articles may require subheadings within some sections to clarify the contents, especially the Results and Discussion sections. There should not be more than two levels of subheadings. Subheadings must never be used in the Introduction section.

Manuscripts should be concise. Verbose reports containing excessive redundancy and repetition are less likely to be accepted.

The Introduction should contain background material, and, most importantly, a clear rationale and hypothesis or central question. With rare exceptions, the introduction should contain less than 450 words (one and a half typed pages).

Statements referring to work in progress that implies future publication, in the Journal or elsewhere, should not be used. Unpublished work should not be cited in References, but may be cited in full parenthetically within the text. Written permission from the author for citation of unpublished work should be mailed to the Peer Review Office.

All cases of tuberculosis and all designators of mycobacteria should be classified according to the 1990 edition of Diagnostic Standards and Classification of Tuberculosis, published by the American Lung Association.

Generic names of drugs should be used instead of trade names. The location (city, state, country) of a manufacturer listed in the text should be provided after the first reference to the manufacturer.

Units of measurement should conform to current scientific usage and can be abbreviated when they follow a number (e.g., cm, nm, ml, g, mg, nmol) but not otherwise. Unusual units should be defined.

Statistical methods must be described and the program used for data analysis, and its source, should be stated. Summary statistics should define whether standard deviation (± SD), variability of the sample, or standard error of the mean (± SEM), uncertainty about the average, is being used.

Clinical trials must follow the CONSORT guidelines. The authors should ensure that their manuscript complies with the 25-item CONSORT checklist and flow diagram. The first figure in a report of a clinical trial must contain information regarding progress through the phases of the trial, including enrollment, patient allocation, follow-up, and analysis.

Methods in the Print Version
Materials and Methods should be limited to essential new information. Information that is available in previous publications should be cited rather than repeated. A limit of 500 words is recommended. Authors are encouraged to submit additional detail on Methods as a supplement for the Journal's Online Repository. Exceptions to the 500-word limitation for Methods in the print version of the paper will be granted if authors make a convincing case in a letter in the "Author Comments" area on the website that the use of novel methodologies is central to the main point of the article. The availability of the Online Repository makes it possible for authors to describe their Methods in greater detail than was ever possible in the past. Many manuscripts are declined for publication because authors fail to describe their methods in sufficient detail. To indicate the presence of supplementary material being submitted for the Online Repository, authors should include sentences at appropriate points in the main manuscript to alert the reader; for example, "additional detail on the method for making these measurements is provided in an online data supplement."

Online Data Supplement
Authors may submit materials supporting the manuscript for posting in the Online Data Supplement of the American Journal of Respiratory and Critical Care Medicine.

Additional text, tables (and supporting information), figures (and supporting information), and video and soundtrack files can be included in this section. Whenever possible, large video files should be broken down into separate files of five megabytes or less.

The supplementary material must be submitted simultaneously with the rest of the manuscript and will undergo peer review and be judged by the same criteria as the rest of the manuscript. The supplementary material (text, figures, tables) must be appended to the main manuscript being submitted for consideration in the print journal. The cover sheet of material being submitted for the Online Data Supplement should give only the manuscript title, list the authors (not affiliations), and include the statement "Online Data Supplement."

Material in the Online Data Supplement is independent from the manuscript and will appear online only. In contrast, material in the main manuscript will appear in both the print version and the online version of the Journal.

When writing material for the Online Data Supplement, authors are allowed to repeat sentences included in the manuscript submitted for the print journal if this will make comprehension easier. The figures and tables in the Online Data Supplement should be labeled Figure E1, Table E1, and so on. To indicate the presence of these items, the author must make a statement in the main manuscript, such as "see Figure E1 in the online data supplement."

If citations are made in the Online Data Supplement, this supplement must contain its own independent reference section with the references numbered sequentially, even if some of these references duplicate those in the print version. The references should be numbered E1, E2, and so on.

If supplementary material was initially submitted for consideration for posting in the Online Data Supplement, the material needs to be included again when a revised manuscript is being submitted.

The Editorial Office staff is not responsible for extracting supplementary material from the main manuscript for posting in the Online Data Supplement. All information included in the Online Data Supplement should be carefully reviewed, as it will not be copyedited or proofread by the Journal staff. The Editorial Office staff will create the hypertext link between the Online Data Supplement and the online version of the American Journal of Respiratory and Critical Care Medicine.

Acknowledgments
All acknowledgments should be grouped into one paragraph and placed after the Discussion. Information about grants, funding, financial support, or previous publication of an article as an abstract should not appear in the acknowledgements; it should appear as a footnote on the first page of the article.

References and Supplemental Information
Please ensure that your references include the most current articles and information. References should be limited to 50; exceeding this limit may delay manuscript processing. References should be typed double-spaced beginning on a separate sheet and numbered in the order that they appear in the text. All authors' names (do not use "et al."), complete article titles, and inclusive page numbers should be cited. The titles of journals should be abbreviated according to the style used in Index Medicus. If an article cited in the References is in press, one copy must be attached at the end of the manuscript submitted online. Unpublished observations and personal communications should be referred to as such in the text and not be referred to in the reference list. Submit written permission when citing a personal communication. Manuscripts "submitted for publication" are considered unpublished work and should not be included in the reference list. They should be cited in parentheses in the text as "unpublished data" or "unpublished observations." If overlapping work or supplemental information is discussed within the manuscript text, a labeled copy of the overlapping article or supplemental information should be attached at the end of the submitted manuscript file.

Authors should make every effort to discuss their work in the context of the most recent research in their field of inquiry. Before submitting a manuscript (including a revised manuscript), authors are encouraged to consult the annual Pulmonary and Critical Care Update series in the Journal, as well as the Journal online search engine (http://ajrccm.atsjournals.org/search.dtl), and other literature search engines.

Use abbreviations for the names of all journals as provided in Index Medicus (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi). Spell out the names of journals that are not listed.

A reference for the statistical methods used should be cited.

Examples of References

Journal Articles

Gandevia SC, Gorman RB, McKenzie DK, DeTroyer A. Effects of increased ventilatory drive on motor unit firing rates in human inspiratory muscles. Am J Respir Crit Care Med 1999;160:1598-1603.

In Press
Lakatos E, DeMets DL, Kannel, WB, Sorlie P, MacNamara P. Influence of cigarette smoking on lung function and COPD incidence. Chronic Dis. (In press)

Abstracts
Carr MJ, Undem BJ. Trypsin-induced, neurokinin-mediated contraction of guinea pig isolated bronchus [abstract]. Am J Respir Crit Care Med 2000;161:A466.

Books

Lang TA, Secic M. How to report statistics in medicine. Philadelphia: American College of Physicians; 1997.

Articles in Books
Voyce SJ, Urbach D, Rippe JM. Pulmonary artery catheters. In: Rippe JM, Irwin RS, Alpert JS, Fink MP, editors. Intensive care medicine, 2nd ed. Boston, MA: Little Brown; 1991. p. 48-72.

Government or Association Report
U.S. Public Health Service. Smoking and Health. A Report on the Surgeon General. Washington, DC.: U.S. Government Printing Office; 1979. DHEW Publication No. (PHS)79-50066.

Journal Article in Electronic Format
Manoloff ES, Francioli P, Taffé P, van Melle G, Bille J, Hauser PM. Risk for Pneumocystis carinii transmission among patients with pneumonia: a molecular epidemiology study. Emerg Infect Dis [serial online] 2003 Jan [cited 2004 Jul 14]; vol. 8. Available from: http://www.cdc.gov/ncidod/EID/vol9no1/02-0141.htm

Citation Managers
If you use use a citation manager to organize and style your references, you must make sure that you have downloaded the corrected style. For EndNotes you may go directly to http://www.endnote.com/support/enstyledetail.asp; for Reference Manager, go to http://www.refman.com/ and select “Get the Latest Styles and Filters” in the yellow box on the left.

Tables
Each table should constitute a single unit of communication, completely informative in itself. It should be possible to understand the information in a table without reading the text. The information in a very small table can be presented more economically as one or two sentences of text.

Tables should be configured to fit vertically on the printed page. They will be typeset to fit a width of 3½ inches (9 centimeters) for single column or up to 7¼ inches (18½ centimeters) for double column. Tables that do not fit into this format will be returned for reworking.
With Revisions, each table should be typed double-spaced on a separate sheet. Do not submit tables as photographs or figures. Tables should be numbered consecutively, have a brief title, and be cited in text. Compare the titles of tables with one another, and remove redundant words. Avoid very broad and very narrow tables. All tables should be rotated through 90 degrees to determine the orientation that achieves the best presentation. Do not insert horizontal or vertical lines in a table. Large collections of data in a table are of interest to very few readers. Such tables should be submitted for consideration for the Journal's Online Repository rather than for the print version of the Journal.

Avoid arbitrary labels or classifications, such as groups A and B, when specific descriptors, such as "control" and "hypoxia", can be used.
All non-standard abbreviations used in each table should be explained in footnotes. For footnotes, use the following symbols in this sequence: *, † , ‡ , §, ll, , **, †† , etc.

Illustrations
The size of the symbols and lettering should be in scale with the figure. Lettering on figures should have a sans serif font, such as Helvetica, and be of uniform size. All figures within a manuscript should be the same point size.

Multipart figures should be submitted as single composites, with each panel labeled (e.g., A, B). Labels indicating subparts of a figure (A, B, C, etc.) should be boldface and capitalized, but should not be larger than the type used in the text of the published article (i.e., after the figure is reduced to fit the width of one column, the labels and text in the figure should not be larger than 10 points [3-4 mm in height]).
Do not put a caption above a figure. The title for a figure should be described only in the figure legend, and not appear on the figure. Explanations of symbols should appear only in the figure legend, and not in the actual figure. Labels should be placed within the body of the figure, not outside it. The abscissa and ordinate of each graph should be labeled clearly.

Minimize the number of tick marks on the axes, and do not number each tick. Design figures so that you need the least possible number of letters. Avoid bold lettering, because this looks unpleasantly dark when printed. The style and format of lettering except for indicating subparts of figures should be uniform throughout all the figures in a manuscript. Use lower case rather than capital letters in the labels of a figure. Make letters and numbers of a size that will enable them to appear about 2 to 3 mm high after reduction. Leave adequate space between the lettering and the axis.

The legend and figure form a separate unit and must be fully self-explanatory. By reading the legend, the reader should be able to understand the main findings in an illustration without looking at the text of an article.

Additional figures may be submitted as supplementary information, subject to peer review, for publication in the Online Data Supplement.

Color
The cost of publishing color art in the Journal is partially subsidized by the ATS with a portion of the costs billed to authors. In addition, authors are offered discounts depending on their ATS membership status. Nonmembers are billed $700 (first color page)/$425 (each additional page that contains color).  Full U.S. ATS members are billed $400/$200, U.S. affiliate members are billed $450/$250, and U.S. trainee members are billed $300/$150. International Level A members are billed $400/$200, international Level B members are billed $300/$150, international Level C members are billed $100/$75 and international trainee members are billed $100/$75. Member discounts are based solely on the corresponding author’s membership status in the Society. (If you are not a member of the ATS and would like to join, please visit the “Become a Member” page at www.thoracic.org, or contact membership@thoracic.org or 212-315-8685).

Corresponding authors with manuscripts accepted for publication will be asked to confirm in writing their acceptance and responsibility for payment of this color art billing. If the color quote is not accepted, the author must indicate whether the figure should be printed in black and white or be deleted. There is no charge for having color figures appear in an online data supplement. However, if a figure in the main part of the article appears in color online, it must also appear in color in the printed version of the article.

Legends for Illustrations
Legends for illustrations should convey the findings and be typed double-spaced. The text included in each legend should be sufficient to enable a reader to understand the information in an illustration without reading the body of the text. Start the legends section on a separate page with Arabic numerals corresponding to the illustrations. When symbols, arrows, numbers, or letters are used to identify parts of the illustrations, each one should be identified and explained clearly in the legend. In photomicrographs, explain internal scale and identify the method of staining. Each figure should be cited in numerical order in the text.

IMAGE MANIPULATION
Electronically submitted figures must be accurate representations of actual research images. Specific features within an image should not be enhanced, obscured, moved, deleted, or added. The grouping of images from different parts of the same gel, or from different gels, fields, or exposures must be made explicit by using dividing lines (or other graphic means of demarcation) and must also be stated in the figure legend. Adjustments of brightness, contrast, or color balance are acceptable if applied to the entire image, as long as these techniques do not obscure, eliminate, or misrepresent any information present in the original, including backgrounds (backgrounds should not be faded out to the extent that they are undetectable). Nonlinear adjustments (e.g., changes to gamma settings) as well as other manipulations such as pseudo-coloring must be disclosed in the figure legend. Authors should always have access to their original unprocessed images to provide to the Editor upon request. All figures will undergo image analysis for signs of inappropriate manipulation; if there are any questions about a figure, the Editor may contact the corresponding author at any point, even after the publication of the article.

COVER

Color cover illustrations will be chosen each month from an article appearing in the Journal. The choice of cover art illustration will be made by the Editor. Authors are also encouraged to submit suitable high-quality color figures that do not appear in the actual article for consideration as cover illustrations. These figures should be related to the topic of their article and be accompanied by a short explanatory legend. Color figures will be published on the cover without additional charge; normal plate charges will continue to apply for color figures used within an article. The dimensions of cover illustrations should be 7-1/2 X 10 inches (width X height). These figures should be submitted according to the Submission of Digital Art Guidelines for the American Journal of Respiratory and Critical Care Medicine.

IMAGES IN PULMONARY, CRITICAL CARE, SLEEP MEDICINE AND THE SCIENCES

The AJRCCM now welcomes submissions of images for a newly added feature in the online and/or print versions of the Journal. The images should be related to pulmonary, critical care, or sleep medicine, and/or be scientific images providing advances and/or unusual contributions to our field. In addition to seeking photomicrographs and images of gross pathology, we are also looking for other interesting types of images, including radiographs, CTs, MRIs, polysomnographic tracings, lab setups, etc. Authors are also encouraged to submit accompanying videos. Please compose a few sentences (of approximately 120 words) describing your submitted images and the techniques used to capture them. In addition, include a statement affirming that the images have not been previously published.

Please upload high quality images for consideration to the AJRCCM submission site (http://mc.manuscriptcentral.com/ajrccm) and select the submission type “IM – Images” from the drop-down menu.  You can enter N/A for any questions that do not apply to submission of an image. When you upload the image file, please be sure to upload the original source file. The system will convert the file to a quick-view PDF and the original source file will be available for editors’ evaluation.

The text should start on a separate page. When symbols, arrows, numbers, or letters are used to identify parts of the illustrations, each one should be identified and explained clearly in the legend. In photomicrographs, explain internal scale and identify the method of staining. Please remember to crop all white or otherwise unnecessary space from the figure before uploading.

If a photograph of an identifiable patient is used, the patient must sign a waiver indicating their agreement to be published in the Journal. Any information in photographs that might identify a patient or hospital (including date or city) must be removed or otherwise edited out of the image. Halftones (photographs or continuous tone images with no added labels or graphics) should ideally be submitted as TIFF at a minimum resolution of 300 dots per inch (d.p.i.), or 118 dots per cm (d.p.c.); JPEGs are acceptable if the image was originally captured as a large JPEG file with minimal or no compression. Color figures should be saved as RGB (red/green/blue), not CMYK (cyan/magenta/yellow/black).

If you are adding labels, or combining halftones with other graphics (combo) or with other halftones, this should be done in PhotoShop (.psd files) or Illustrator (.ai files). Please send us the source files (.pds or .ai), although Illustrator EPS files are acceptable. If you only have a TIFF for a combo, it must be between 500–900 d.p.i. (197–354 d.p.c.). If you are adding in labels or combining figures or graphics in a Microsoft program (Word, PowerPoint, etc.)--which is not recommended--then upload the source Word or PowerPoint files; do not create TIFFs in this case because they will be low resolution files if generated directly from the Microsoft program. Line art (graphs and charts with no photographic images) must have a minimum resolution of 1,000 d.p.i. [394 d.p.c.]).

If you are submitting art that you have created in a program or file format that we do not support (i.e., other than Illustrator, PhotoShop, or a Microsoft program), the preferred solution is to send us a PDF that must be configured to “press quality” settings (you must have Acrobat Distiller installed, not just the free reader). To create a high quality PDF in Windows, click “Print,” under “Printer Name” select “Adobe PDF,” click “Preferences,” then select “Press Quality” (remember to change your settings back for regular printing).

For further information on the preparation of digital art see the Submission of Digital Art Guidelines.

Please ensure that all the guidelines in the section on image manipulation are carefully followed.

CONCISE CLINICAL REVIEWS

Concise Clinical Reviews provide a scholarly, authoritative, and evidence-based synthesis of the literature pertaining to topics of fundamental importance to the practice of pulmonary, critical care, and sleep medicine. The reviews should have a clinical focus but may include a discussion of basic science germane to understanding disease pathogenesis or therapeutic approaches. Authors should be recognized experts in the field, with prior publications in the area under discussion, but should avoid simply recapitulating their previous works. The target length is 3,000 to 5,000 words with a combined maximum of 4-6 figures and tables, and 50 to 75 references. Graphic artist support is available for development of original artwork and figures but requests for such support should be discussed with the editors prior to submission of the manuscript. Concise Clinical Reviews require an abstract, written as a single paragraph containing no more than 250 words. It should briefly summarize the main ideas covered in the article. Three to five key words, preferably using MeSH (Medical Subject Headings) terms, should be listed on the cover sheet. Invited reviews will undergo expedited peer review.

While many reviews will be by invitation, unsolicited proposals for review articles are welcome. Potential authors should submit an outline describing the contents of the proposed article to Associate Editors Dr. Robert Kotloff (kotloffr@uphs.upenn.edu) or Dr. Thomas Corbridge (tcc734@northwestern.edu) BEFORE starting to write a Concise Clinical Review. Additionally, authors should compose a paragraph stating the importance of the proposed topic to clinical practice and recent developments and/or novel aspects that will be addressed by the review. Authors should list previously published review articles on the same topic, and explain in what ways the new manuscript will add to rather than reiterate these works. If the authors have previously written review articles or chapters on the same topic, they need to indicate how the new manuscript will differ from their previous reviews. Abbreviated curricula vitae of each co-author, identifying prior publications relevant to the current proposal, should be provided. Authors should state the date they expect to submit the completed manuscript.

All submitted manuscripts undergo peer-review, and even commissioned manuscripts may be declined for publication in American Journal of Respiratory and Critical Care Medicine.

EDITORIALS

Editorials should be submitted online through Manuscript Central, choosing manuscript type “Editorial.” Please make a note in the author comments section if the editorial is a tie-in to another manuscript. For tie-in editorials, please be sure to list the original article to which it is referring in your references (see style for in-press references below).

Editorials should be approximately 800-1000 words and contain no more than 16 references. The title for an editorial should not exceed 85 characters (count letters and spaces). No abbreviations should be included in the title.

CASE REPORTS

A case report describes and discusses an instance of disease in a patient that is unique and provides educational value. An unstructured abstract is required.

LETTERS TO THE EDITOR

Letters to the Editor provide a format to discuss previously published material or other controversies. Presentations of unpublished investigations are not appropriate as Letters. Letters that confirm previously published material without adding significant new information are less likely to be published. Because of space limitations, priorities will be assigned to submitted Letters, and publication will depend on this priority rating.

Letters to the Editor should be no longer than 400 words and cite no more than six references. The title should be brief and reflect the content of the letter. Illustrations and tables are discouraged.

Please upload your Letter to the Editor via ScholarOne (http://mc.manuscriptcentral.com/atsjournals), choosing manuscript type “Letter-to-the-Editor” (LE).

Reprints of instructions regarding Letters to the Editor may also be obtained from the Journal Peer Review or Editorial Office.

Last Update: August 2010