conditions for publication form - The Annals of Thoracic Surgery

CONDITIONS FOR PUBLICATION FORM
THE ANNALS OF THORACIC SURGERY
For submissions prior to February 1, 2015: FAX: (215) 614-0416; e-mail: [email protected]
For submissions on or after February 1, 2015: FAX: (312) 268-5263; e-mail: [email protected]
Online manuscript submission website: http://www.atseditorialoffice.org
ATS#:
Authors:
Manuscript Title:
This form MUST be completed, signed by ALL authors, and returned to The Annals of Thoracic Surgery before your
manuscript can be accepted for publication. This form with signatures may be returned by fax or e-mail as noted above.
Individual Conflict of Interest Disclosure:
Each author must indicate below that for the past 12 months either (a) no financial
conflict of interest exists with any commercial entity or competitor whose products are featured, described, reviewed, evaluated or compared
in the manuscript, except for funding supporting the study as disclosed under “Acknowledgments” (see below) or (b) a potential conflict of
interest exists with one or more commercial entities or a competitor whose products are featured, described, reviewed, evaluated or
compared in the manuscript through the existence of one or more of the following relationships: (1) the author is a full- or part-time
employee of a company; (2) the author and/or immediate family members (siblings, parents, children) has an existing or optional equity
interest in a company and/or owns or partly owns patents licensed to a company; (3) the author has an ongoing retainer relationship
(consultant, speaker, etc) with a company for which he/she receives financial remuneration; or (4) the author has received financial
compensation for this publication. Financial compensation includes any amount of cash, securities, gifts, services, or items of value. If “Yes” is
checked, a box on the title page of the published article will read: “Dr X discloses a financial relationship with company Y.”
Acknowledgment of Sources of Funding for This Study: All original scientific articles, editorials, reviews, and new technology
articles must state sources of funding for the work described in the article in “Acknowledgments.” Grants, financial support and
technical or other assistance are acknowledged at the end of the text before references.
Scientific Responsibility: Each author is required to complete this form to certify that he or she has participated sufficiently in the work to
take responsibility for a meaningful share of the content of the manuscript. Each author must specify his or her contributions to the work and
at least one author, usually the corresponding or senior author, must vouch for the accuracy and completeness of all of the data reported in
the manuscript. Except for new technology articles, statements regarding scientific responsibility do not appear in the published manuscript.
Freedom of Investigation: “Freedom of investigation” is defined as freedom from outside interests in controlling the design of the
study, acquisition of data, collection, analysis, and interpretation of data, and having freedom to fully disclose all results. Each author must
indicate whether or not he or she has had full “freedom of investigation” before, during, and after this study. Except for new technology
articles, this statement is signed on the “Conditions for Publication Form” (below) and does not appear in the published manuscript.
Undisclosed Authors: The corresponding author is responsible for identifying names, addresses and affiliations of all undisclosed
writers who have contributed to the submitted manuscript.
Exclusive Publication: Each author must sign this form to certify that none of the material in this manuscript has been published
previously in either print or electronic form, and that none of this material is currently under consideration for publication elsewhere.
This includes symposia, transactions, books, articles published by invitation, posting in electronic format, and preliminary publications
of any kind except an abstract of 400 words or fewer.
Copyright Transfer: Each author must sign this form to certify that, if the manuscript is accepted for publication in The Annals,
copyright (including the right to obtain copyright registration, whether separately or as part of a journal issue or otherwise) in and to the
above article, including original artwork, transfers throughout the world and for the full term and all extensions and renewals thereof to:
THE SOCIETY OF THORACIC SURGEONS (STS)
This transfer includes the right to adapt the article for use in conjunction with computer systems and programs, including reproductions
or publication in machine-readable form and incorporation in retrieval systems.
Rights of authors: The STS hereby licenses the following rights back to the author(s):
(a)
Patent and trademark rights to any process or procedure described in the article.
(b)
The right to photocopy or make single electronic copies of the article for their own personal use, including for their own
classroom use, or for the personal use of colleagues, provided the copies are not offered for sale and are not distributed in a
systematic way outside of their employing institution (e.g., via an e-mail list or public file server). Posting of the article on a
secure network (not accessible to the public) within the author’s institution is permitted.
(c)
The right, subsequent to publication, to use the article or any part thereof free of charge in a printed compilation of works
of their own, such as collected writings or lecture notes.
Note: All copies, paper or electronic, or other use of the information must include an indication of the STS copyright and a full citation
of the journal source. Please refer requests for all uses above, including the authorization of third parties to reproduce or otherwise use all
or part of the article (including figures and tables), to Elsevier’s Global Rights Department, PO Box 800, Oxford OX5 1DX, United
Kingdom; Tel: (+44) 1865 843830 (UK) or (+1) 215 239 3804 (US); Fax: (+44) 1865 853333; Email: [email protected].
Or submit request online at http://www.elsevier.com/permissions.
Authorship:
If copyright is held by the employer, the employer or an authorized representative of the employer must sign in
addition to the author(s).
If the author is a U.S. Government employee and this work was done in that capacity, the copyright transfer applies only to the extent
allowed by U.S. law and the author should sign this form. Please confirm by checking the appropriate space in the signature area at the end
of this form. Any other author who is not a U.S. Government employee should also sign the Conditions for Publication Form.
Warranties: The author(s) warrant that the article is the author’s original work and has not been published before. The author(s) warrant that
the article contains no libelous or other unlawful statements, and does not infringe on the rights of others. If excerpts from copyrighted works are
included, the author(s) has (have) obtained written permission from the copyright owners and will credit the sources in the article.
Preprints: The author(s) warrant(s) that if a prior version of this work (normally a preprint) has been posted to an electronic server,
such version was accessible to only a small group of individuals and the author(s) will cause its prompt removal from such server.
CONDITIONS FOR PUBLICATION FORM
I agree with the preceding conditions and provide the appropriate signatures and information below accordingly:
CORRESPONDING AUTHOR SECTION (If corresponding author and senior author are the same person, that author should fill out this section only):
Corresponding Author’s Name:
Signature:
Date:
Author’s employer’s signature, if appropriate:
U.S. Government employee:
Yes
No
Conflict of interest:
Yes
No
If yes, with which entity:
Did you have freedom of investigation in all aspects of this work?
Yes
No
Undisclosed writers have contributed to this paper:
Yes
No
If yes, provide the writer’s full name, address and affiliation in separate correspondence.
My contribution to this study included (check applicable items):
study design;
development of methodology;
collection of data;
analysis
and/or interpretation of data;
writing (not revising) all or sections of the manuscript;
supervision;
other, please specify
I vouch for the accuracy and completeness of all of the data reported in the manuscript:
Yes
No
SENIOR AUTHOR SECTION (If different person from corresponding author):
Senior Author’s Name:
Signature:
Author’s employer’s signature, if appropriate:
U.S. Government employee:
Yes
No
Conflict of interest:
Yes
No
If yes, with which entity:
Did you have freedom of investigation in all aspects of this work?
Yes
No
My contribution to this study included (check applicable items):
study design;
development of methodology;
and/or interpretation of data;
writing (not revising) all or sections of the manuscript;
supervision;
other, please specify
I vouch for the accuracy and completeness of all of the data reported in the manuscript:
Yes
No
OTHER AUTHORS:
Author’s Name:
Signature:
Author’s employer’s signature, if appropriate:
U.S. Government employee:
Yes
No
Conflict of interest:
Yes
No
If yes, with which entity:
Did you have freedom of investigation in all aspects of this work?
Yes
No
My contribution to this study included (check applicable items):
study design;
development of methodology;
and/or interpretation of data;
writing (not revising) all or sections of the manuscript;
supervision;
other, please specify
Date:
collection of data;
analysis
Date:
collection of data;
Author’s Name:
Signature:
Author’s employer’s signature, if appropriate:
U.S. Government employee:
Yes
No
Conflict of interest:
Yes
No
If yes, with which entity:
Did you have freedom of investigation in all aspects of this work?
Yes
No
My contribution to this study included (check applicable items):
study design;
development of methodology;
and/or interpretation of data;
writing (not revising) all or sections of the manuscript;
supervision;
other, please specify
Date:
Author’s Name:
Signature:
Author’s employer’s signature, if appropriate:
U.S. Government employee:
Yes
No
Conflict of interest:
Yes
No
If yes, with which entity:
Did you have freedom of investigation in all aspects of this work?
Yes
No
My contribution to this study included (check applicable items):
study design;
development of methodology;
and/or interpretation of data;
writing (not revising) all or sections of the manuscript;
supervision;
other, please specify
Date:
Author’s Name:
Signature:
Author’s employer’s signature, if appropriate:
U.S. Government employee:
Yes
No
Conflict of interest:
Yes
No
If yes, with which entity:
Did you have freedom of investigation in all aspects of this work?
Yes
No
My contribution to this study included (check applicable items):
study design;
development of methodology;
and/or interpretation of data;
writing (not revising) all or sections of the manuscript;
supervision;
other, please specify
Date:
Author’s Name:
Signature:
Author’s employer’s signature, if appropriate:
U.S. Government employee:
Yes
No
Conflict of interest:
Yes
No
If yes, with which entity:
Did you have freedom of investigation in all aspects of this work?
Yes
No
My contribution to this study included (check applicable items):
study design;
development of methodology;
and/or interpretation of data;
writing (not revising) all or sections of the manuscript;
supervision;
other, please specify
Date:
collection of data;
collection of data;
collection of data;
collection of data;
analysis
analysis
analysis
analysis
analysis
If there are additional authors on the article, please photocopy this form and attach additional sheets as need be with appropriate information and
signatures affixed.