Author Form All British Columbia Medical Journal (BCMJ) authors must read and complete sections (1) authorship, (2) copyright, (3) disclosure of financial and other interests, and (4) artificial intelligence (AI)–assisted technology and agree to the statement at the end of this form. If the manuscript is of a clinical/scientific nature, authors must also complete section (5) checklists. If the manuscript is a case report or if an individual patient is described, written patient consent must also be obtained on the Patient Consent Form. I am submitting a * Clinical Case Report Clinical Image Original Research Article Review Article Other (please specify) Other * Proposed manuscript title * Your Name Prefix * TitleDrMsMrMx Given Name * Family Name * Telephone * Email * Corresponding author’s name Prefix * TitleDrMsMrMx Given Name * Family Name * If you are the corresponding author, would you like your email to be published with the article? Yes No N/A 1. Certification of authorship All persons who qualify for authorship must complete this section. An author, according to the International Committee of Medical Journal Editors, is someone who has made substantive intellectual contributions to a manuscript. To be listed as an author in the BCMJ, the following four conditions must be met: Substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; and Drafting the manuscript or reviewing it critically for important intellectual content; and Final approval of the version to be published; and Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Each author must have participated sufficiently in the work to take public responsibility for appropriate portions of the content. Individuals who do not meet all the criteria should be listed in an acknowledgments section in the manuscript as contributors. Acquisition of funding, collection of data, or general supervision of the research group alone does not constitute authorship. All contributors must complete a Permission to appear in acknowledgments form. I certify that I meet the four conditions listed above. * I certify that I meet the four conditions listed above. 2. Copyright The copyright for manuscripts published in the BCMJ from January 2022 onward is held by the manuscript’s author(s) and/or their institution. Authors agree that their manuscript will be published in the BCMJ in accordance with the Creative Commons Attribution Non-Commercial No Derivatives (CC BY-NC-ND 4.0) license. This means that authors and any noncommercial users may share, copy, and redistribute the material in any format as long as they adhere to the following criteria: Attribution: You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. Noncommercial: You may not use the material for commercial purposes. No derivatives: If you remix, transform, or build upon the material, you may not distribute the modified material. No additional restrictions: You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits. Any use of materials from the BCMJ must include full bibliographic citations, including journal name, author(s), article title, year, volume, page numbers. I warrant that * The manuscript is an original work not published elsewhere in whole or in part, except in abstract form, and that the manuscript contains no matter libelous or otherwise unlawful or which invades the right of privacy. The manuscript has not been previously published and that if portions have been previously published, permission has been obtained for publication in the BC Medical Journal, and the author will submit a copy of the permission release and copy for credit lines with the manuscript. 3. Disclosure of financial and other interests In the past 36 months, have you accepted any of the following related to the content of your manuscript? “Related” means any relation with for-profit or not-for-profit third parties whose interests may be affected by the content of the manuscript. Disclosure represents a commitment to transparency and does not necessarily indicate a bias. If you are in doubt about whether to list a relationship/activity/interest, it is preferable that you do so. Please give details in the space provided. Honoraria Fees for speaking Fees for consultancy Fees for organizing education Grants Support for attending meetings and/or travel Payment for expert testimony Patents issued or pending Receipt of equipment, materials, drugs, medical writing, gifts, or other services Royalties or licenses If you ticked any boxes, please provide details Do you own stock, stock options, or have an affiliation with an organization whose interests, financial or otherwise, may be affected by the publication of your manuscript? * Yes No If you answered “yes,” please provide details In the past 36 months, have you been employed by or volunteered for an organization, including companies, boards, societies, committees, or advocacy groups, whose interests, financial or otherwise, may be affected by the publication of your manuscript? * Yes No If you answered “yes,” please provide details If you have no competing interests, please also check the box below and we will publish: “Competing interests: None declared.” I have no competing interests to declare. 4. Artificial Intelligence (AI)–Assisted Technology Did you use artificial intelligence (AI)–assisted technologies (e.g., large language models, chatbots, or image creators) in the production of the manuscript? * Yes No If yes: Please describe how in the acknowledgment section of the manuscript. 5. Checklists When submitting a clinical/scientific manuscript, authors must attest that they have followed and completed the applicable checklist of information to include. Links to checklists are provided below. I certify that I have followed and completed the checklist applicable to the article type I am submitting Case report: CARE checklist Clinical practice guidelines: AGREE reporting checklist Observational studies (choose the applicable STROBE checklist): STROBE checklist: combined STROBE checklist: cohort studies STROBE checklist: case-control studies STROBE checklist: cross-sectional studies Qualitative research SRQR: I have followed the Standards for Reporting Qualitative Research Quality improvement studies: SQUIRE 2.0 checklist (2015 update) Randomized trials: CONSORT checklist (Word file is downloaded) Systematic reviews: PRISMA 2020 checklist None of the checklists apply to my manuscript. I agree to the statements made in sections 1, 2, and 3. * I agree to the statements made in sections 1, 2, 3, and 4. Date: November 24, 2024 Leave this field blank
