Introduction



Atención Primaria Práctica is a Spanish and English language international journal that publishes articles of interest for health professionals that wish to become familiar with the practical aspects of the discipline. Although it is included in the group of "case report" journals, it is not limited to publishing clinical cases, as it also approaches all those aspects that are of interest in Primary Care practice, such as projects on the improvement of clinical quality, patient safety, patient-centred care, community programs, ethical conflicts, or organisational innovations that improve Primary Care.
Descriptive studies of cases and unique experiences are situated at the bottom of the scientific evidence pyramid, and for this reason they are not usually accepted in journals that publish biomedical research; however, these works provide knowledge that can be very useful for the clinician, the student, and the researcher. They are of interest for identifying rare or new diseases, to evaluate the effects of therapeutics, their adverse effects, or the cost of interventions, as well as contributing to problem-based learning and non-repetition of errors. They serve to encourage the creation of guidelines or clinical practice pathways or to suggest future research projects. They are an important part of medical progress.

Types of article
Any article in this journal involving experiments with human or animal subjects will follow the guidelines in the Human and animal rights described in the Ethics in publishing section of this guide for authors. Authors should clearly indicate in the manuscript that such guidelines have been followed, as well as the statement that informed consent was obtained for experimentation with human subjects.
Any article sent to this journal will follow the guidelines described in the section "Ethics in the publication" of this guide for authors, therefore it is essential to consult it before sending the manuscripts.
In particular, the manuscripts corresponding to the original section the authors must clearly indicate at the end of the section "Material and methods" that such guidelines have been followed, as well as the written and informed consent of the patients has been obtained and has been approved by the corresponding ethics committee.
Likewise, in the manuscripts corresponding to the "Scientific Letters", "Letters to the Editor" and "Medical Images" sections, the authors must clearly indicate in the article's body that the protocols and procedures of the institutional Centre related with the patient's data publication have been followed, as well as the subject privacy and the patient consent for its publication has been obtained.
Any article in this journal involving experiments with human or animal subjects will follow the guidelines in the "Human and animal rights" described in the "Ethics in publishing" section of this guide for authors. Authors should clearly indicate in the manuscript that such guidelines have been followed, as well as the statement that written and informed consent was obtained for experimentation with human subjects.
For any section of this journal, except for Editorials, the three epigraphs:Ethical considerations, Funding and Conflict of interest should be added in the manuscript, before the bibliography.
EDITORIALS
Articles that refer to the most current in Primary Health Care or to any of the articles published in the issue. It is expected that the articles of this section are opinions and reflections of interest in Primary Health Care, that might stimulate debate, or present new perspectives on a topic. Opinions of authors that do not necessarily correspond to those of the publisher or those of the editors should be considered.
The maximum number of authors is 3. The manuscript should include:
- Cover letter (see general guidelines). - First page (see general guidelines)- Text (maximum: 1,000 words. not counting the bibliography).- Tables and Figures (maximum: 1 (See general guidelines).
Each one of the previous parts must be started on a new page.With the aim of helping in its understanding, it is recommended that the text is structured as follows: establishment of the problem, positioning of the author, arguments in favour, arguments against, and conclusions. It is important that the discussion is presented logically and that it cites the type of tests on which the key statements are based (personal or expert opinions, observational studies, clinical trials, systematic reviews).


ORIGINAL ARTICLES
In this section, manuscripts are included that describe an innovative experience such as clinical safety projects, organisational changes in care, implementation of new technologies or quality improvements, as well as community health programs, or a series of clinical cases.The structure of the works must be as follows:
Cover letter (see general guidelines).
First page (See general guidelines). The number of authors should normally be between 4 and 6.
A structured resumen/abstract in Spanish and in English (maximum: 250 words) (There are specific guidelines for each type of original article)
Text: a maximum of 2500 words, not counting Tables, literature references or the resumen /abstract. (There are specific guidelines for each type of original article)
From 3 to 6 key points. Study outline (if applicable, according to the specific guidelines for each type of original)
Tables and Figures: maximum 6 (See general guidelines).
Each one of the previous sections must be started on a new page.
Acknowledgements: To individuals or institutions that, although not having fulfilled the requirements of authorship, may have collaborated in the performing of the work, provided material, technical, or financial help. The type of contribution should be mentioned. They must be included on the first page.
Bibliography: A maximum of 30 literature references is recommended, which must be as recent and relevant as possible, and carefully written in accordance with the Vancouver format.
Key points: All original works must include a Table with the key points to help in the understanding of the work by those readers that do not wish to read the full article. It must include a maximum of 3 short and precise sentences that indicate what is known on the topic before carrying out the study and the need to have carried it out (under the heading "What is known on the topic"), and another maximum of 3 sentences that indicate what this study has contributed to the previous knowledge of the topic (under the heading What this study contributes).

GUIDELINES FOR ORIGINALS ON IMPROVEMENT PROJECTS OR COMMUNITY PROGRAMS
This format is suitable for presenting works on safety, quality, or outcomes of the health services or programs or health policies
- The guidelines for this type of original follow the Revised Standards for Quality Improvement Reporting Excellence (SQUIRE 2.0 ): http://squire-statement.org/index.cfm?fuseaction=Page.ViewPage&pageId=471
Results: It should describe what has been found, mentioning the initial phases of the intervention and any changes. Data on process indicators and results, the contextual elements that have influenced the intervention, as well as the relationship between the contextual aspects, the intervention and the results. The positive unexpected consequences should also be presented, as well as the problems, failures and costs. Also include the details of the missing data. Headings may be used to make the presentation clearer. It is advised to use Tables and Figures without the unnecessary repetition of the data in the text. It is recommended to highlight the Table or Figure that contains the main results of the study, with a description of these in the legend.


TITLE
Mention that the manuscript refers to an initiative to improve Primary Care (quality, safety, effectiveness, patient-focused care, costs, efficiency, equity, or community programs)STRUCTURED ABSTRACT:
Besides including the title of the work, it should describe the essential aspects of the manuscript and should have the following structure: Context / Local problem/ Methods /Interventions/ Results / Conclusions
TEXT:
It must be adapted to the Introduction/Materials and Methods/Results and Discussion / bibliography structure, following the recommendations set out below:Introduction: It should explain the justification of the project. It must mention the nature and significance of the problem to intervene, a summary of what is known of the problem; include previously conducted studies. The framework, concepts or theories that explain the problem and the reasons that justify the intervention are also presented, as well as the reasons that leads to thinking that the intervention may be effective. This section must contain the aim of the study and of the manuscript that is presented. The introduction must be as brief as possible and be supported in a limited number of key literature references.
Methods: It attempts to explain what has been done. It has to contain aspects such as the contextual elements that explain the intervention, the timeline, the characteristics of the intervention, with sufficient details so that it can be reproduced, as well as the characteristics of the team that performed it. The approach used to assess the impact of the intervention, and to explain that the results are due to the intervention. The methods used to study the process and the result of the intervention, justifying the validity and quality of the data. The quantitative and qualitative methods employed to extract the data, as well as the ethical aspects. The use of headings is recommended to organise the information (study population, interventions, follow-up, statistical analysis). Discussion: It reflects on the significance of the work done. It is recommended to begin with a summary of the key findings, relating them with the main reason for the intervention, as well as the strengths of the intervention. An interpretation of the findings is then presented: the relationship between the results and the intervention, the comparison with other studies, impact of the study on the population or the health.

GUIDELINES FOR ORIGINALS: SYSTEMATIC REVIEWS (META-ANALYSIS)
This section will include all works that present systematic reviews of the literature and other sources of evidence, which are critically evaluated in order to provide an answer to a particular question; therefore, narrative type reviews or knowledge update articles are not included.
ABSTRACT.
It must have the following structure:
Objective: clear identification of the main purpose of the review. If there is more than one, it is advised to point out the primary one and any secondary ones. Design: It study must be identified as a systematic review. Data sources: Data bases consulted, period covered and main characteristics of the search strategy of the individual studies used. Selection of studies: selection criteria of the studies, number of studies included and excluded, main characteristics of the studies included. Data extraction: method for assessing the validity of the studies and data collection, and main variables collected. Results: main quantitative results, identifying the type of measurement used and its corresponding confidence intervals. Where applicable, it should include the level of statistical significance. Where applicable, the results of the sensitivity analysis should be included.


Discussion: It is advised to structure it with the following headings (where relevant): limitations of the review, including suggestions on the effect of a possible publication bias, and comments on the homogeneity of the individual studies and the possible influence of variability on the final results; a comparison with the scientific literature, attempting to explain the differences observed; practical application of the results, performing an evaluation on their clinical relevance; and directions for future research on the topic.Study outline: A Figure will also be included with a diagram that indicates the number of studies selected in each of the stages of the review and the reasons for the exclusions. It is recommended that the outline follows the most up to date PRISMA statement, available at: http://www.prisma-statement.org/

GUIDELINES FOR ORIGINAL QUALITATIVE RESEARCH
Works will be included here that present studies that have used qualitative methodologies for the approach to the topic of the research.
ABSTRACT.
It must be structured, include the title of the work in Spanish and in English and should have the following structure:
Objective: clear identification of the main purpose of the study. If there is more than one, it is advised to point out the primary one and any secondary ones. Design: a description of the qualitative method and the methodological strategies used, as well as its temporal contextualisation. Setting: place where the study was performed and the type and level of health care (Primary Care, hospital, Community ...).Participants and / or contexts: Selection criteria and acquisition process.Method: sample design, description of the information and collection technique/s, mechanisms for ensuring information saturation, strategy and theoretical framework of the analysis.Results: the main findings, interpretations, topics and concepts identified, structure of the segmentation and categories constructed, and relationship within the conceptual framework.Conclusions: the main conclusions arising from the study and their use for the understanding of the problem and for action and change.
TEXT
It must be adapted to the Introduction /Materials and Methods/ Results and Discussion structure, following the recommendations set out below (adapted by: Fernandez de Sanmamed Santos MJ. Adecuacion de las normas de publicacion en revistas cientificas a las investigaciones cualitativas.(Adaptation of the guidelines published in scientific journals to qualitative research) Aten Primaria. 2000;25:502-4): Introduction: The current situation on the knowledge of the topic must be presented, the relevance and the context in which the study is framed, including the formal and informal documental sources, opinions, intuitions and general theoretical and interpretative frameworks, where necessary, all of them in the most concise and brief form as possible, being supported in a reduced number of key literature references. The objective of the study must be clearly defined.Participants and methods: It is recommended to structure this section into the following headings:Design: projected design and methodological strategies, justification for their use, temporal contextualisation, information collection techniques, changes in the design or emerging design, if applicable, etc. Sample and participants and/or contexts: sample design, number and description of participants and/ or contexts, selection criteria of the informants and/or contexts, acquisition process, mechanisms for ensuring information saturation, etc.


Analysis: strategy and theoretical framework of the analysis, description and validation of the analysis, strategies for ensuring the reliability of the results, etc.Results and Discussion: In qualitative research it is difficult to separate the results from the discussion. The results must be presented in a form that makes the analysis method and the structure of the segmentation and categories constructed clear, and associating them within the prior conceptual framework. An exhaustive presentation of the results must be avoided, only showing the most relevant and significant, that may be real contributions to the knowledge of that examined. It is advisable to use narrative fragments or observations to support the analytical synthesis, and to use illustrative matrices and Tables to facilitate the reading and comprehension of the results. It is recommended to highlight the Table or Figure that contains the main results of the study, with a description of these in the legend. Conclusions, usefulness and limitations: The key findings and interpretations of the research must be highlighted, along with their use in the knowledge of the problem and for action or change. The limitations of the study must also be included, as well as proposals for new questions or research lines.

ORIGINALS OF QUANTITATIVE RESEARCH PROJECTS OR CLINICAL CASE SERIES
These include papers presenting clinical and epidemiological research studies that have used quantitative methodology in their design and analysis (for example, prevalence studies, cohort follow-up, case-control studies, randomised clinical trials, etc.).
The specific standards for these papers are as follows:
ABSTRACT

This must have the following structure:
Objective: clear identification of the main purpose of the study. Design: description of the basic study design (randomised clinical trial, case-control study, etc.) and its basic characteristics if relevant (double- blind, multicentre, etc.). If the design does not correspond with a clear design, its main characteristics should be outlined (cross-sectional or longitudinal, prospective or retrospective, observational or interventional, controlled or not controlled, etc.).
Location: place where the study was conducted and healthcare setting or level of care (primary care, hospital, community?.).
Participants: patient characteristics, selection criteria, number of subjects included, and number of non-responses or drop-outs that have occurred.
Interventions(in intervention studies): main characteristics, including administration pattern and duration of the interventions carried out in both the study groups and the comparison groups.
Main measurements: main study variables, particularly the response variable used and its assessment method.
Results: main quantitative findings, identifying the type of measurement used and its confidence interval. When appropriate the level of statistical significance should be included.
Conclusions: main conclusions drawn from the results of the study, including their practical application.


TEXT
It should be adapted to the structure Introduction/Methods/Results and Discussion, following the recommendations below:
Introduction: The current state of knowledge on the subject should be presented and the context in which the study is framed. The objective of the study should be clearly defined. The introduction should be as brief as possible and supported by a small number of key bibliographical references.
Material and methods: This should include the study design, the centre where the research was conducted, the inclusion and exclusion criteria and the mechanism of selection of participants, the interventions carried out (if applicable), the definitions and measurement techniques of the variables, the follow-up of the subjects, and the analysis strategy and statistical tests used. It should be written in sufficient detail so that the study can be repeated. It is recommended to use headings to organise the information (study population, interventions, follow-up, statistical analysis...).
Results: should present, not interpret, the main findings related to the objective of the study. Headings can be used to make the presentation clearer. It is advisable to use tables and figures without unnecessarily repeating data in the text. The main results should include the corresponding confidence intervals, and clearly indicate the type of measurement and statistical tests used, where appropriate. When the degree of statistical significance is less than .20, it is preferable to present its exact value. It is recommended to highlight the table or figure containing the main results of the study, with a description of these in the legend.
Discussion: It is advisable to structure it under the following headings (where relevant): limitations of the design used; comparison with the scientific literature, attempting to explain any discrepancies observed; practical applicability of the results, assessing their clinical relevance; and guidelines for future research on the topic. Study outline: A figure should also be included with the study outline indicating the number of subjects in each of the study stages and the reasons for non-responses, losses and drop-outs that occur. The figure legend should summarise the main features of the study design. If the study is a randomised clinical trial, this figure should follow the outline of the most current CONSORT statement.

CLINICAL CASES
The presentation of the case must follow the CARE guideline (Case Reports Guideline CARE http://www.care-statement.org) (appendix 1)
What cases are published? Cases are published that pose a diagnostic, ethical or management challenge or that have some aspect of teaching interest. In short, they meet one of the following criteria:
  • Recollections of important clinical lessons
  • Errors that provide a lesson
  • Unusual form of presentation of a common disease
  • Myth-busting
  • Rare diseases
  • New diseases
  • New diagnostic tests
  • New treatment
  • Unusual association of diseases
  • Unexpected clinical result
  • Unexpected clinical result
  • New adverse drug effects
  • Ethical dilemmas
  • Cases that may have epidemiological impact
  • Findings that may shed light on the pathogenesis of a disease or on adverse drug effects
  • Cases managed in unusual settings such as refugee centres, telemedicine, or in innovative conditions

-Authors: Normally not more than 4. All of them should have participated in the writing of the manuscript and not only in the clinical care of the case. Those who have cared for the patient may appear in the acknowledgements.
-Patient consent: The author must ensure that he/she has written and signed consent from the patient or relatives when submitting the manuscript for publication.
- Letter of presentation (see general guidelines).
- First page (see general guidelines).
- Text (maximum: 1,000 words, not including bibliography). It should contain the following sections
Title: not include the words "clinical case".
Abstract: 250 words in length, summarising the essential aspects of the manuscript, preferably structured into sections:
context: why the case should be published and is novel; presentation of the case: a short description of the patient's clinical and demographic features, diagnosis, interventions and outcome; conclusions: a summary of the clinical impact or implications of the case, its main insights
Key words: from 3 to 6.
Context: this section should describe the setting of the case, the relevant literature and the objectives justifying its publication.
Presentation of the case: This section should contain aspects such as the description of the patient, his/her family and social context his/her demographic data, medical history, signs and symptoms, differential diagnosis, treatment or interventions, outcomes and any other relevant aspects.
Discussion and conclusions:The case should be discussed in relation to the international literature of similar cases already published, present its limitations as well as the main conclusions stating its relevance for clinical, teaching or research purposes.
Key points: from 3 to 5 points which summarise the lesson that this cases offers References: bibliographic citations numbered and listed in order of appearance according to Vancouver standards (maximum of 15). Figures, tables and other additional documents (e.g. video): up to a maximum of 10 tables and/or figures.
The patient's perspective: Optional but very interesting section providing the patient's point of view and experience.


CLINICAL PRACTICE
This section will publish articles that are of interest to clinicians, such as consensus conferences, continuing education, technical reports or in-depth reviews of a topic, and that do not meet the methodological and structural criteria of the original articles section or systematic reviews. The maximum number of authors is 6.
The manuscript must contain:
  • Cover letter (see general rules).
  • First page (see general rules).
  • Abstract (maximum: 150 words, including the key ideas of the study).
  • Abstract (maximum: 150 words, including the key ideas of the study).
  • Text (maximum: 3,000 words, excluding tables, bibliography and abstract).
  • Tables and figures (maximum: 6) (see general rules).
  • Maximum number of bibliographic references is 24.

Each of the previous sections should be started on a new page.

LETTERS TO THE EDITOR
In this section, letters commenting on articles that have recently appeared in the journal are published preferably and as quickly as possible. The letter will be sent to the authors of the article to which it refers and, if they wish to reply, the letter and its reply will be published simultaneously. Letters to the editor presenting experiences and opinions of interest to primary care that are not descriptions of clinical cases or case series or summaries of research papers will also be accepted. The maximum number of authors will be 4.
The structure of the papers must be as follows:

  • Letter of presentation (see general guidelines).
  • First page (see general guidelines).
  • Text (maximum: 600 words without counting the references or tables).
  • Table and/or figure (maximum: 1) (see general guidelines).

Each of the previous sections must be started on a new page. The maximum number of bibliographic references is 6.
In the case of letters which refer to a published article, one of the references must correspond to this article.


IMAGES IN MEDICINE
Images that by themselves allow a visual diagnosis to be made are acceptable. These images must be accompanied by a brief explanatory text, which may be simply a description of what is shown in the image, or a commentary in the form of a brief clinical case. A maximum of 4 authors will be allowed.
The maximum length of the text will be 600 words.
A maximum of 2 figures.
A maximum of 6 bibliographical references.
CLINICAL VIDEOS
Videos are very useful to show how to perform procedures in health care. The materials to be submitted to this journal should not necessarily be novel, but should reflect best practice. These documents are primarily for educational purposes. They should be 2-3 minutes in length and should be accompanied by a 600-word text and a maximum of six bibliographical references. The text should pose a relevant question about the video and answer it. Patients and professionals appearing in the video must give written acceptance and permission for publication. See specific rules for videos below.

SCIENTIFIC LETTERS
This section will accept letters that present short reports on research studies and descriptions of series of clinical cases. In the text of these types of letters, it must mention the aims, design of the study, measurements, results and main conclusions. The maximum number of authors will be 4. The structure of the works must be as follows:
- Cover letter (see general guidelines).
- First page (see general guidelines)
- Text (maximum: 600 words, not counting literature references or Tables).
- Tables and/or Figures (maximum: 1 (See general guidelines).
Each one of the previous parts must be started on a new page. The maximum number of literature references is 6.

SPECIAL ARTICLES
Special Articles are usually commissioned, and will be published under different headings, depending on their contents (consensus conference, continuing education, technical reports, or in-depth reviews of a topic). The Editorial Board may consider non-solicited editorial reviews for publication and submission to the review process, with no obligation of corresponding about them.
The maximum number of authors is 6.The structure of the works must be as follows: Cover letter (see general guidelines); First page (see general guidelines); Abstract (maximum: 150 words that present the key ideas of the study); Text maximum: 3,000 words, not counting Tables, literature references or the Abstract; Tables and Figures (maximum: 6 (See general guidelines).
Each one of the previous parts must be started on a new page. The maximum number of literature references is 24.

Contact details for submission

You can send your manuscript at https://www.editorialmanager.com/appra/

Language
This journal is published in Spanish and in English language.

Submission checklist

You can use this list to carry out a final check of your submission before you send it to the journal for review. Please check the relevant section in this Guide for Authors for more details.

Ensure that the following items are present:

One author has been designated as the corresponding author with contact details:
• E-mail address
• Full postal address

All necessary files have been uploaded:
Manuscript:
• Include keywords
• All figures (include relevant captions)
• All tables (including titles, description, footnotes)
• Ensure all figure and table citations in the text match the files provided
• Indicate clearly if color should be used for any figures in print
Graphical Abstracts / Highlights files (where applicable)
Supplemental files (where applicable)

Further considerations
• Manuscript has been 'spell checked' and 'grammar checked'
• All references mentioned in the Reference List are cited in the text, and vice versa
• Permission has been obtained for use of copyrighted material from other sources (including the Internet)
• A competing interests statement is provided, even if the authors have no competing interests to declare
• Journal policies detailed in this guide have been reviewed
• Referee suggestions and contact details provided, based on journal requirements

For further information, visit our Support Center.

Before you begin

Ethics in publishing

Please see our information on Ethics in publishing.

Studies in humans and animals

If the work involves the use of human subjects, the author should ensure that the work described has been carried out in accordance with The Code of Ethics of the World Medical Association (Declaration of Helsinki) for experiments involving humans. The manuscript should be in line with the Recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals and aim for the inclusion of representative human populations (sex, age and ethnicity) as per those recommendations. The terms sex and gender should be used correctly.

The author should ensure that the manuscript contains a statement that all procedures were performed in compliance with relevant laws and institutional guidelines and have been approved by the appropriate institutional committee(s). This statement should contain the date and reference number of the ethical approval(s) obtained. Authors should also include a statement in the manuscript that informed consent was obtained for experimentation with human subjects. The privacy rights of human subjects must always be observed.

The journal will not accept manuscripts that contain data derived from unethically sourced organs or tissue, including from executed prisoners or prisoners of conscience, consistent with recommendations by Global Rights Compliance on Mitigating Human Rights Risks in Transplantation Medicine. For all studies that use human organs or tissues authors must provide sufficient evidence that they were procured in line with WHO Guiding Principles on Human Cell, Tissue and Organ Transplantation. The source of the organs or tissues used in clinical research must be transparent and traceable. Authors of manuscripts describing organ transplantation must additionally declare within the manuscript:

  1. that autonomous consent free from coercion was obtained from the donor(s) or their next of kin; and
  2. that organs/tissues were not sourced from executed prisoners or prisoners of conscience.

All animal experiments should comply with the ARRIVE guidelines and should be carried out in accordance with the U.K. Animals (Scientific Procedures) Act, 1986 and associated guidelines, EU Directive 2010/63/EU for animal experiments, or the National Research Council's Guide for the Care and Use of Laboratory Animals and the authors should clearly indicate in the manuscript that such guidelines have been followed. The sex of animals must be indicated, and where appropriate, the influence (or association) of sex on the results of the study.

Informed consent and patient details

Studies on patients or volunteers (including organ/tissue donors) require informed consent, which should be documented in the paper. Appropriate consents, permissions and releases must be obtained where an author wishes to include case details or other personal information or images of patients and any other individuals in an Elsevier publication. Written consents must be retained by the author, but copies should not be provided to the journal.

Only if specifically requested by the journal in exceptional circumstances (for example if a legal issue arises) the author must provide copies of the consents or evidence that such consents have been obtained. For more information, please review the Elsevier Policy on the Use of Images or Personal Information of Patients or other Individuals.

Unless the author has written permission from the patient (or, where applicable, the next of kin), the personal details of any patient included in any part of the article and in any supplementary materials (including all illustrations and videos) must be removed before submission.

Declaration of interest

All authors must disclose any financial and personal relationships with other people or organizations that could inappropriately influence (bias) their work. Examples of potential competing interests include employment, consultancies, stock ownership, honoraria, paid expert testimony, patent applications/registrations, and grants or other funding. Authors must disclose any interests in two places: 1. A summary declaration of interest statement in the title page file (if double anonymized) or the manuscript file (if single anonymized). If there are no interests to declare then please state this: 'Declarations of interest: none'. 2. Detailed disclosures as part of a separate Declaration of Interest form, which forms part of the journal's official records. It is important for potential interests to be declared in both places and that the information matches. More information.

Submission declaration and verification

Submission of an article implies that the work described has not been published previously (except in the form of an abstract, a published lecture or academic thesis, see 'Multiple, redundant or concurrent publication' for more information), that it is not under consideration for publication elsewhere, that its publication is approved by all authors and tacitly or explicitly by the responsible authorities where the work was carried out, and that, if accepted, it will not be published elsewhere in the same form, in English or in any other language, including electronically without the written consent of the copyright-holder. To verify compliance, your article may be checked by Crossref Similarity Check and other originality or duplicate checking software.

Preprints
Please note that preprints can be shared anywhere at any time, in line with Elsevier's sharing policy. Sharing your preprints e.g. on a preprint server will not count as prior publication (see 'Multiple, redundant or concurrent publication' for more information).

Author contributions

For transparency, we encourage corresponding authors to provide co-author contributions to the manuscript using the relevant CRediT roles. The CRediT taxonomy includes 14 different roles describing each contributor’s specific contribution to the scholarly output. The roles are: Conceptualization; Data curation; Formal analysis; Funding acquisition; Investigation; Methodology; Project administration; Resources; Software; Supervision; Validation; Visualization; Roles/Writing - original draft; and Writing - review & editing. Note that not all roles may apply to every manuscript, and authors may have contributed through multiple roles. More details and an example.

Authorship

All authors should have made substantial contributions to all of the following: (1) the conception and design of the study, or acquisition of data, or analysis and interpretation of data, (2) drafting the article or revising it critically for important intellectual content, (3) final approval of the version to be submitted.

Changes to authorship

Authors are expected to consider carefully the list and order of authors before submitting their manuscript and provide the definitive list of authors at the time of the original submission. Any addition, deletion or rearrangement of author names in the authorship list should be made only before the manuscript has been accepted and only if approved by the journal Editor. To request such a change, the Editor must receive the following from the corresponding author: (a) the reason for the change in author list and (b) written confirmation (e-mail, letter) from all authors that they agree with the addition, removal or rearrangement. In the case of addition or removal of authors, this includes confirmation from the author being added or removed.
Only in exceptional circumstances will the Editor consider the addition, deletion or rearrangement of authors after the manuscript has been accepted. While the Editor considers the request, publication of the manuscript will be suspended. If the manuscript has already been published in an online issue, any requests approved by the Editor will result in a corrigendum.

Clinical trial results

In line with the position of the International Committee of Medical Journal Editors, the journal will not consider results posted in the same clinical trials registry in which primary registration resides to be prior publication if the results posted are presented in the form of a brief structured (less than 500 words) abstract or table. However, divulging results in other circumstances (e.g., investors' meetings) is discouraged and may jeopardise consideration of the manuscript. Authors should fully disclose all posting in registries of results of the same or closely related work.

Reporting clinical trials
Randomized controlled trials should be presented according to the CONSORT guidelines. At manuscript submission, authors must provide the CONSORT checklist accompanied by a flow diagram that illustrates the progress of patients through the trial, including recruitment, enrollment, randomization, withdrawal and completion, and a detailed description of the randomization procedure. The CONSORT checklist and template flow diagram are available online.

Registration of clinical trials
Registration in a public trials registry is a condition for publication of clinical trials in this journal in accordance with International Committee of Medical Journal Editors recommendations. Trials must register at or before the onset of patient enrolment. The clinical trial registration number should be included at the end of the abstract of the article. A clinical trial is defined as any research study that prospectively assigns human participants or groups of humans to one or more health-related interventions to evaluate the effects of health outcomes. Health-related interventions include any intervention used to modify a biomedical or health-related outcome (for example drugs, surgical procedures, devices, behavioural treatments, dietary interventions, and process-of-care changes). Health outcomes include any biomedical or health-related measures obtained in patients or participants, including pharmacokinetic measures and adverse events. Purely observational studies (those in which the assignment of the medical intervention is not at the discretion of the investigator) will not require registration.

Article transfer service
This journal uses the Elsevier Article Transfer Service to find the best home for your manuscript. This means that if an editor feels your manuscript is more suitable for an alternative journal, you might be asked to consider transferring the manuscript to such a journal. The recommendation might be provided by a Journal Editor, a dedicated Scientific Managing Editor, a tool assisted recommendation, or a combination.
If you agree, your manuscript will be transferred, though you will have the opportunity to make changes to the manuscript before the submission is complete. Please note that your manuscript will be independently reviewed by the new journal. More information.

Copyright

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Role of the funding source

You are requested to identify who provided financial support for the conduct of the research and/or preparation of the article and to briefly describe the role of the 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 article for publication. If the funding source(s) had no such involvement, it is recommended to state this.

Open access

Please visit our Open Access page for more information about open access publishing in this journal.

Elsevier Researcher Academy
Researcher Academy is a free e-learning platform designed to support early and mid-career researchers throughout their research journey. The "Learn" environment at Researcher Academy offers several interactive modules, webinars, downloadable guides and resources to guide you through the process of writing for research and going through peer review. Feel free to use these free resources to improve your submission and navigate the publication process with ease.

Language (usage and editing services)
Please write your text in good English (American or British usage is accepted, but not a mixture of these). Authors who feel their English language manuscript may require editing to eliminate possible grammatical or spelling errors and to conform to correct scientific English may wish to use the Language Editing service available from Elsevier's Language Services.

Submission

Our online submission system guides you stepwise through the process of entering your article details and uploading your files. The system converts your article files to a single PDF file used in the peer-review process. Editable files (e.g., Word, LaTeX) are required to typeset your article for final publication. All correspondence, including notification of the Editor's decision and requests for revision, is sent by e-mail.

Submit your article
Please submit your article via https://www.editorialmanager.com/APPRA/default.aspx.

Suggesting reviewers
Please submit the names and institutional e-mail addresses of several potential reviewers.

You should not suggest reviewers who are colleagues, or who have co-authored or collaborated with you during the last three years. Editors do not invite reviewers who have potential competing interests with the authors. Further, in order to provide a broad and balanced assessment of the work, and ensure scientific rigor, please suggest diverse candidate reviewers who are located in different countries/regions from the author group. Also consider other diversity attributes e.g. gender, race and ethnicity, career stage, etc. Finally, you should not include existing members of the journal's editorial team, of whom the journal are already aware.

Note: the editor decides whether or not to invite your suggested reviewers.

Preparation

Peer review

This journal operates a double anonymized review process. All contributions will be initially assessed by the editor for suitability for the journal. Papers deemed suitable are then typically sent to a minimum of two independent expert reviewers to assess the scientific quality of the paper. The Editor is responsible for the final decision regarding acceptance or rejection of articles. The Editor's decision is final. Editors are not involved in decisions about papers which they have written themselves or have been written by family members or colleagues or which relate to products or services in which the editor has an interest. Any such submission is subject to all of the journal's usual procedures, with peer review handled independently of the relevant editor and their research groups. More information on types of peer review.

Double anonymized review

This journal uses double anonymized review, which means the identities of the authors are concealed from the reviewers, and vice versa. More information is available on our website. To facilitate this, please include the following separately:
Title page (with author details): This should include the title, authors' names, affiliations, acknowledgements and any Declaration of Interest statement, and a complete address for the corresponding author including an e-mail address.
Anonymized manuscript (no author details): The main body of the paper (including the references, figures, tables and any acknowledgements) should not include any identifying information, such as the authors' names or affiliations.

Use of word processing software
It is important that the file be saved in the native format of the word processor used. The text should be in single-column format. Keep the layout of the text as simple as possible. Most formatting codes will be removed and replaced on processing the article. In particular, do not use the word processor's options to justify text or to hyphenate words. However, do use bold face, italics, subscripts, superscripts etc. When preparing tables, if you are using a table grid, use only one grid for each individual table and not a grid for each row. If no grid is used, use tabs, not spaces, to align columns. The electronic text should be prepared in a way very similar to that of conventional manuscripts (see also the Guide to Publishing with Elsevier). Note that source files of figures, tables and text graphics will be required whether or not you embed your figures in the text. See also the section on Electronic artwork.
To avoid unnecessary errors you are strongly advised to use the 'spell-check' and 'grammar-check' functions of your word processor.

Article structure

Subdivision - unnumbered sections
Divide your article into clearly defined sections. Each subsection is given a brief heading. Each heading should appear on its own separate line. Subsections should be used as much as possible when cross-referencing text: refer to the subsection by heading as opposed to simply 'the text'.

Introduction
State the objectives of the work and provide an adequate background, avoiding a detailed literature survey or a summary of the results.

Material and methods
Provide sufficient details to allow the work to be reproduced by an independent researcher. Methods that are already published should be summarized, and indicated by a reference. If quoting directly from a previously published method, use quotation marks and also cite the source. Any modifications to existing methods should also be described.

Results
Results should be clear and concise.

Discussion
This should explore the significance of the results of the work, not repeat them. A combined Results and Discussion section is often appropriate. Avoid extensive citations and discussion of published literature.

Conclusions
The main conclusions of the study may be presented in a short Conclusions section, which may stand alone or form a subsection of a Discussion or Results and Discussion section.

Appendices
If there is more than one appendix, they should be identified as A, B, etc. Formulae and equations in appendices should be given separate numbering: Eq. (A.1), Eq. (A.2), etc.; in a subsequent appendix, Eq. (B.1) and so on. Similarly for tables and figures: Table A.1; Fig. A.1, etc.

Essential title page information

Title. Concise and informative. Titles are often used in information-retrieval systems. Avoid abbreviations and formulae where possible.
Author names and affiliations. Please clearly indicate the given name(s) and family name(s) of each author and check that all names are accurately spelled. You can add your name between parentheses in your own script behind the English transliteration. Present the authors' affiliation addresses (where the actual work was done) below the names. Indicate all affiliations with a lower-case superscript letter immediately after the author's name and in front of the appropriate address. Provide the full postal address of each affiliation, including the country name and, if available, the e-mail address of each author.
Corresponding author. Clearly indicate who will handle correspondence at all stages of refereeing and publication, also post-publication. This responsibility includes answering any future queries about Methodology and Materials. Ensure that the e-mail address is given and that contact details are kept up to date by the corresponding author.
Present/permanent address. If an author has moved since the work described in the article was done, or was visiting at the time, a 'Present address' (or 'Permanent address') may be indicated as a footnote to that author's name. The address at which the author actually did the work must be retained as the main, affiliation address. Superscript Arabic numerals are used for such footnotes.

Highlights

Highlights are optional yet highly encouraged for this journal, as they increase the discoverability of your article via search engines. They consist of a short collection of bullet points that capture the novel results of your research as well as new methods that were used during the study (if any). Please have a look at the example Highlights.

Highlights should be submitted in a separate editable file in the online submission system. Please use 'Highlights' in the file name and include 3 to 5 bullet points (maximum 85 characters, including spaces, per bullet point).

Abstract

The headings will consist of: «Introduction and Objectives», «Patients or Materials and Methods», «Results» y «Conclusions».

Graphical abstract
Although a graphical abstract is optional, its use is encouraged as it draws more attention to the online article. The graphical abstract should summarize the contents of the article in a concise, pictorial form designed to capture the attention of a wide readership. Graphical abstracts should be submitted as a separate file in the online submission system. Image size: Please provide an image with a minimum of 531 × 1328 pixels (h × w) or proportionally more. The image should be readable at a size of 5 × 13 cm using a regular screen resolution of 96 dpi. Preferred file types: TIFF, EPS, PDF or MS Office files. You can view Example Graphical Abstracts on our information site.

Keywords

Immediately after the abstract, provide a maximum of 6 keywords, using American spelling and avoiding general and plural terms and multiple concepts (avoid, for example, 'and', 'of'). Be sparing with abbreviations: only abbreviations firmly established in the field may be eligible. These keywords will be used for indexing purposes.

Abbreviations
Define abbreviations that are not standard in this field in a footnote to be placed on the first page of the article. Such abbreviations that are unavoidable in the abstract must be defined at their first mention there, as well as in the footnote. Ensure consistency of abbreviations throughout the article.

Acknowledgements
Collate acknowledgements in a separate section at the end of the article before the references and do not, therefore, include them on the title page, as a footnote to the title or otherwise. List here those individuals who provided help during the research (e.g., providing language help, writing assistance or proof reading the article, etc.).

Formatting of funding sources
List funding sources in this standard way to facilitate compliance to funder's requirements:

Funding: This work was supported by the National Institutes of Health [grant numbers xxxx, yyyy]; the Bill & Melinda Gates Foundation, Seattle, WA [grant number zzzz]; and the United States Institutes of Peace [grant number aaaa].

It is not necessary to include detailed descriptions on the program or type of grants and awards. When funding is from a block grant or other resources available to a university, college, or other research institution, submit the name of the institute or organization that provided the funding.

If no funding has been provided for the research, it is recommended to include the following sentence:

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Units
Follow internationally accepted rules and conventions: use the international system of units (SI). If other units are mentioned, please give their equivalent in SI.

Artwork

Electronic artwork
General points
• Make sure you use uniform lettering and sizing of your original artwork.
• Embed the used fonts if the application provides that option.
• Aim to use the following fonts in your illustrations: Arial, Courier, Times New Roman, Symbol, or use fonts that look similar.
• Number the illustrations according to their sequence in the text.
• Use a logical naming convention for your artwork files.
• Provide captions to illustrations separately.
• Size the illustrations close to the desired dimensions of the published version.
• Submit each illustration as a separate file.
• Ensure that color images are accessible to all, including those with impaired color vision.

A detailed guide on electronic artwork is available.
You are urged to visit this site; some excerpts from the detailed information are given here.
Formats
If your electronic artwork is created in a Microsoft Office application (Word, PowerPoint, Excel) then please supply 'as is' in the native document format.
Regardless of the application used other than Microsoft Office, when your electronic artwork is finalized, please 'Save as' or convert the images to one of the following formats (note the resolution requirements for line drawings, halftones, and line/halftone combinations given below):
EPS (or PDF): Vector drawings, embed all used fonts.
TIFF (or JPEG): Color or grayscale photographs (halftones), keep to a minimum of 300 dpi.
TIFF (or JPEG): Bitmapped (pure black & white pixels) line drawings, keep to a minimum of 1000 dpi.
TIFF (or JPEG): Combinations bitmapped line/half-tone (color or grayscale), keep to a minimum of 500 dpi.
Please do not:
• Supply files that are optimized for screen use (e.g., GIF, BMP, PICT, WPG); these typically have a low number of pixels and limited set of colors;
• Supply files that are too low in resolution;
• Submit graphics that are disproportionately large for the content.

Color artwork
Please make sure that artwork files are in an acceptable format (TIFF (or JPEG), EPS (or PDF) or MS Office files) and with the correct resolution. If, together with your accepted article, you submit usable color figures then Elsevier will ensure, at no additional charge, that these figures will appear in color online (e.g., ScienceDirect and other sites). Further information on the preparation of electronic artwork.

Figure captions
Ensure that each illustration has a caption. Supply captions separately, not attached to the figure. A caption should comprise a brief title (not on the figure itself) and a description of the illustration. Keep text in the illustrations themselves to a minimum but explain all symbols and abbreviations used.

Tables

Please submit tables as editable text and not as images. Tables can be placed either next to the relevant text in the article, or on separate page(s) at the end. Number tables consecutively in accordance with their appearance in the text and place any table notes below the table body. Be sparing in the use of tables and ensure that the data presented in them do not duplicate results described elsewhere in the article. Please avoid using vertical rules and shading in table cells.

References

Citation in text
Please ensure that every reference cited in the text is also present in the reference list (and vice versa). Any references cited in the abstract must be given in full. Unpublished results and personal communications are not recommended in the reference list, but may be mentioned in the text. If these references are included in the reference list they should follow the standard reference style of the journal and should include a substitution of the publication date with either 'Unpublished results' or 'Personal communication'. Citation of a reference as 'in press' implies that the item has been accepted for publication.

Reference links
Increased discoverability of research and high quality peer review are ensured by online links to the sources cited. In order to allow us to create links to abstracting and indexing services, such as Scopus, Crossref and PubMed, please ensure that data provided in the references are correct. Please note that incorrect surnames, journal/book titles, publication year and pagination may prevent link creation. When copying references, please be careful as they may already contain errors. Use of the DOI is highly encouraged.

A DOI is guaranteed never to change, so you can use it as a permanent link to any electronic article. An example of a citation using DOI for an article not yet in an issue is: VanDecar J.C., Russo R.M., James D.E., Ambeh W.B., Franke M. (2003). Aseismic continuation of the Lesser Antilles slab beneath northeastern Venezuela. Journal of Geophysical Research, https://doi.org/10.1029/2001JB000884. Please note the format of such citations should be in the same style as all other references in the paper.

Web references
As a minimum, the full URL should be given and the date when the reference was last accessed. Any further information, if known (DOI, author names, dates, reference to a source publication, etc.), should also be given. Web references can be listed separately (e.g., after the reference list) under a different heading if desired, or can be included in the reference list.

Data references
This journal encourages you to cite underlying or relevant datasets in your manuscript by citing them in your text and including a data reference in your Reference List. Data references should include the following elements: author name(s), dataset title, data repository, version (where available), year, and global persistent identifier. Add [dataset] immediately before the reference so we can properly identify it as a data reference. The [dataset] identifier will not appear in your published article.

Preprint references
Where a preprint has subsequently become available as a peer-reviewed publication, the formal publication should be used as the reference. If there are preprints that are central to your work or that cover crucial developments in the topic, but are not yet formally published, these may be referenced. Preprints should be clearly marked as such, for example by including the word preprint, or the name of the preprint server, as part of the reference. The preprint DOI should also be provided.

References in a special issue
Please ensure that the words 'this issue' are added to any references in the list (and any citations in the text) to other articles in the same Special Issue.

If you manage your research with Mendeley Desktop, you can easily install the reference style for this journal by clicking the link below:
When preparing your manuscript, you will then be able to select this style using the Mendeley plug-ins for Microsoft Word or LibreOffice. For more information about the Citation Style Language, visit http://citationstyles.org.

Reference style
Text: Indicate references by superscript numbers in the text. The actual authors can be referred to, but the reference number(s) must always be given.
List: Number the references in the list in the order in which they appear in the text.
Examples:
Reference to a journal publication:
1. Van der Geer J, Hanraads JAJ, Lupton RA. The art of writing a scientific article. J Sci Commun 2010;163:51–9. https://doi.org/10.1016/j.Sc.2010.00372.
Reference to a journal publication with an article number:
2. Van der Geer J, Hanraads JAJ, Lupton RA. The art of writing a scientific article. Heliyon. 2018;19:e00205. https://doi.org/j.heliyon.2018.e00205.
Reference to a book:
3. Strunk Jr W, White EB. The elements of style. 4th ed. New York: Longman; 2000.
Reference to a chapter in an edited book:
4. Mettam GR, Adams LB. How to prepare an electronic version of your article. In: Jones BS, Smith RZ, editors. Introduction to the electronic age, New York: E-Publishing Inc; 2009, p. 281–304.
Reference to a website:
5. Cancer Research UK. Cancer statistics reports for the UK, http://www.cancerresearchuk.org/aboutcancer/statistics/cancerstatsreport/; 2003 [accessed 13 March 2003].
Reference to a dataset:
[dataset] 6. Oguro M, Imahiro S, Saito S, Nakashizuka T. Mortality data for Japanese oak wilt disease and surrounding forest compositions, Mendeley Data, v1; 2015. https://doi.org/10.17632/xwj98nb39r.1.
Note shortened form for last page number. e.g., 51–9, and that for more than 6 authors the first 6 should be listed followed by 'et al.' For further details you are referred to 'Uniform Requirements for Manuscripts submitted to Biomedical Journals' (J Am Med Assoc 1997;277:927–34)(see also Samples of Formatted References).

Journal abbreviations source
Journal names should be abbreviated according to the List of Title Word Abbreviations.

Video

Elsevier accepts video material and animation sequences to support and enhance your scientific research. Authors who have video or animation files that they wish to submit with their article are strongly encouraged to include links to these within the body of the article. This can be done in the same way as a figure or table by referring to the video or animation content and noting in the body text where it should be placed. All submitted files should be properly labeled so that they directly relate to the video file's content. In order to ensure that your video or animation material is directly usable, please provide the file in one of our recommended file formats with a preferred maximum size of 150 MB per file, 1 GB in total. Video and animation files supplied will be published online in the electronic version of your article in Elsevier Web products, including ScienceDirect. Please supply 'stills' with your files: you can choose any frame from the video or animation or make a separate image. These will be used instead of standard icons and will personalize the link to your video data. For more detailed instructions please visit our video instruction pages. Note: since video and animation cannot be embedded in the print version of the journal, please provide text for both the electronic and the print version for the portions of the article that refer to this content.

Data visualization

Include interactive data visualizations in your publication and let your readers interact and engage more closely with your research. Follow the instructions here to find out about available data visualization options and how to include them with your article.

Supplementary material

Supplementary material such as applications, images and sound clips, can be published with your article to enhance it. Submitted supplementary items are published exactly as they are received (Excel or PowerPoint files will appear as such online). Please submit your material together with the article and supply a concise, descriptive caption for each supplementary file. If you wish to make changes to supplementary material during any stage of the process, please make sure to provide an updated file. Do not annotate any corrections on a previous version. Please switch off the 'Track Changes' option in Microsoft Office files as these will appear in the published version.

Research data

This journal encourages and enables you to share data that supports your research publication where appropriate, and enables you to interlink the data with your published articles. Research data refers to the results of observations or experimentation that validate research findings, which may also include software, code, models, algorithms, protocols, methods and other useful materials related to the project.

Below are a number of ways in which you can associate data with your article or make a statement about the availability of your data when submitting your manuscript. If you are sharing data in one of these ways, you are encouraged to cite the data in your manuscript and reference list. Please refer to the "References" section for more information about data citation. For more information on depositing, sharing and using research data and other relevant research materials, visit the research data page.

Data linking
If you have made your research data available in a data repository, you can link your article directly to the dataset. Elsevier collaborates with a number of repositories to link articles on ScienceDirect with relevant repositories, giving readers access to underlying data that gives them a better understanding of the research described.

There are different ways to link your datasets to your article. When available, you can directly link your dataset to your article by providing the relevant information in the submission system. For more information, visit the database linking page.

For supported data repositories a repository banner will automatically appear next to your published article on ScienceDirect.

In addition, you can link to relevant data or entities through identifiers within the text of your manuscript, using the following format: Database: xxxx (e.g., TAIR: AT1G01020; CCDC: 734053; PDB: 1XFN).

After acceptance

Proofs

One set of page proofs (as PDF files) will be sent by e-mail to the corresponding author (if we do not have an e-mail address then paper proofs will be sent by post) or a link will be provided in the e-mail so that authors can download the files themselves. To ensure a fast publication process of the article, we kindly ask authors to provide us with their proof corrections within two days. Elsevier now provides authors with PDF proofs which can be annotated; for this you will need to download the free Adobe Reader, version 9 (or higher). Instructions on how to annotate PDF files will accompany the proofs (also given online). The exact system requirements are given at the Adobe site.
If you do not wish to use the PDF annotations function, you may list the corrections (including replies to the Query Form) and return them to Elsevier in an e-mail. Please list your corrections quoting line number. If, for any reason, this is not possible, then mark the corrections and any other comments (including replies to the Query Form) on a printout of your proof and scan the pages and return via e-mail. Please use this proof only for checking the typesetting, editing, completeness and correctness of the text, tables and figures. Significant changes to the article as accepted for publication will only be considered at this stage with permission from the Editor. We will do everything possible to get your article published quickly and accurately. It is important to ensure that all corrections are sent back to us in one communication: please check carefully before replying, as inclusion of any subsequent corrections cannot be guaranteed. Proofreading is solely your responsibility.

Offprints

The corresponding author will be notified and receive a link to the published version of the open access article on ScienceDirect. This link is in the form of an article DOI link which can be shared via email and social networks. For an extra charge, paper offprints can be ordered via the offprint order form which is sent once the article is accepted for publication.

Author inquiries



Visit the Elsevier Support Center to find the answers you need. Here you will find everything from Frequently Asked Questions to ways to get in touch.
You can also check the status of your submitted article or find out when your accepted article will be published.