Human Microbiome and Dysbiosis in Clinical Disease

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Our Conference: International Conference on Human Nutrition and Functional Medicine

Our Courses: Functional Inflammology, Dysbiosis, Viral Infections, Fasting and more

Our Journal: International Journal of Human Nutrition and Functional Medicine
Board of Administrators, Factulty, Editors and Reviewers

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Continuing Education Courses 2015


Human Microbiome and Dysbiosis in Clinical Disease

  • Anticipated start: June 2015
  • More information: this page + newsletter linked above
  • Summary and Description: This program is available in two formats 1) self-directed learning via book and videos without CME/CE credits, and 2) an accredited program consisting of 1) book, 2) videos, 3) CME/CE exam and certification. Details and total hours are pending the final "hour count" per reading, videos, review, and examination duration. This information will be posted here as quickly as available.
  • Textbook and Presentation Slides: Available in full-color or discounted black/white/grayscale. Attendees/participants are encouraged to use the full-color version because the text is rich with colors, diagrams, and highlights.
    -- Retail:
    -- Full-Color Version: with Discount Code: Q4QKVJBX. ISBN: 978-0990620419 / 0990620417
    -- Discounted Black/White Printing: with Discount Code: 9BZJ32PJ. ISBN: 978-1512360295 / 1512360295
  • Videos: Videos will be available per 1) the CE/CME website, and/or 2) the ICHNFM video channel:
  • Examinations and CE/CME certificate: Wil be posted here following beta-testing.
  • Conditions: The textbook and printed presentation slides are immediately available and are of superior quality. Other components of the program are pending and subject to change.




International Journal of Human Nutrition and Functional Medicine: ISSN 2378-4881
Open Access: Download Printed book: Purchase at
Publications by ICHNFM and Faculty: IJHNFM publications are currently being (re)organized by Year, Volume, Quarter, and Publication Availability
  • Gonzalez et al. Metabolic Correction, part 1. Puerto Rico Health Science Journal 2015 Mar
  • Miranda-Massari et al. Metabolic Correction, part 2. Puerto Rico Health Science Journal 2015 Mar

Featured IJHNFM and ICHNFM publications 2015:


Featured IJHNFM and ICHNFM publications 2014:

  1. IJHNFM_2014 (v2q1p1): Assessment of the Diagnostic Accuracy of Recently Introduced DNA Stool Screening Test, Gingras, Duncan, Schueller, Schreckenberger
  2. IJHNFM_2014 (v2q2p1): Chronic Diseases as Inborn Errors of Metabolism: The Metabolic Correction Therapy Approach, Gonzalez, Miranda-Massari, Duconge, Arroyo
  3. IJHNFM_2014 (v2q3p1): ISIFMC* Position Paper on the HPS2-THRIVE Study (*International Society of Integrative, Functional and Metabolic Cardiovascular Medicine), PDF, AmazonKindle Houston, Guarneri, Kahn. $3 AmazonKindle
  4. IJHNFM_2014 (v2q4p1): Unifying Antiviral Strategy (English, PDF), AmazonKindle Vasquez. $3 AmazonKindle 

Best of 2014 Compilation
  • Mitochondrial Medicine arrives to Prime Time in Clinical Care, Vasquez
  • Reply to "Role of Western Diet in Inflammatory Autoimmune Diseases" by Manzel et al in Current Allergy Asthma Reports 2014 January, Vasquez

 Publisher prohibits open-access distribution for first 12 months
  • Funtional Inflammology: Volume 1 (see PDF cover)
    • Derivative work: Inflammation Mastery: discounted black & white printing; note that this is the smaller grayscale version of Functional Inflammology
    • Derivative work: Dysbiosis in Human Disease: Pathogenic and Therapeutic Considerations in Diseases of Sustained Inflammation; note that this is a color-printed excerpt from Functional Inflammology
  • Open reply and call for rewrite/withdrawal of Science Magazine's 2014 October article "Pot farmers are poisoning weasel relative" Vasquez A

Submitted publically to Science Magazine 2014 Oct
  • Rebuttals to "Unrestricted Paleolithic Diet is Associated with Unfavorable Changes to Blood Lipids in Healthy Subjects" in International Journal of Exercise Science 2014, Vasquez A, Villalba MF, Picazo O, Névoa V.

Featured IJHNFM and ICHNFM publications 2013:

  • Clinical Monograph: Initial Considerations in Patient Assessment and Management, Vasquez
  • 2013: Mitochondrial Dysfunction and the emerging “Mitochondrial Medicine” and the 2013 International Conference on Human Nutrition and Functional Medicine: Interview with Alex Vasquez D.C., N.D., D.O., F.A.C.N., Vasquez, Gustafson
  • 2013: ICHNFM 2013: Conference Presentation Slides from Dr Alex Vasquez, Vasquez

In preparation:

  • Misadventures and Pitfalls in Chiropractic Academics, Vasquez
  • Polycystic Ovarian Syndrome: Hormones, Mitochondria & Polymorphism, Champion, Haase


Board of Editors and Reviewers: All articles must undergo peer-review and receive approval from at least 3 Editors/Reviewers and are also subject to public posting and review during the peer-review process to increase "openness" of the review process. Any major dissenting views may be published along with the publication. Publication does not imply endorsement by all members of IJHNFM Editorial Review Board.
  • Dr Alex Vasquez (USA, Colombia, Spain)

  • Dr Sergio Abanades (Spain)

  • Dr Jeffrey A. Ruterbusch (USA)

  • Dr Kenneth Cintron (USA & Puerto Rico)

  • Dr Michael Gonzalez (Puerto Rico)

  • Dr Deanna Minich (USA)

  • Dr Ismael Samudio (Colombia & Canada)

  • Dr Annette D'Armata (USA)

  • Dr Steve Hickey (United Kingdom)

  • Dr Jorge R Miranda-Massari (Puerto Rico)

  • Dr Dorothy D. Zeviar (USA)

  • Dr Jill Carnahan (USA)

  • Dr Bruce Milliman, guest reviewer 2014 (USA)

  • Dr Terri Ward (USA)

  • Dr Ryan Bradley (USA)

  • Dr Tariq Shafi (USA and Pakistan and Spain)

  • Dr Joseph Iaccino (USA)

  • Pedro Bastos (Portugal)

  • Maelan Fontes (Spain)

  • Terri Ward (USA)

  • Sayer Ji (USA)

  • Julie Jean (USA)

  • Thomas Easley (USA)

  • Mathieu Bouchard (Canada)


Alex Vasquez DC ND DO FACN, Chief Director and Editor

  • Biographical sketch: Dr Vasquez graduated from University of Western States (Doctor of Chiropractic), Bastyr University (Doctor of Naturopathic Medicine), and University of North Texas Health Science Center (Doctor of Osteopathic Medicine) and has written approximately 100 articles, numerous audios and videos, and more than10 books. Dr Vasquez completed a PreDoctoral Research Fellowship funded by the US National Institutes of Health, National Center for Complementary and Alternative Medicine and has received numerous awards for teaching and leadership in functional/nutritional medicine.

    • Books: Integrative Orthopedics (2005, 2007, 2012), Integrative Rheumatology (2007), Musculoskeletal Pain—Expanded Clinical Strategies (continuing medical education [CME] peer-reviewed monograph published by the Institute for Functional Medicine in 2008), Integrative Medicine and Functional Medicine for Hypertension (2011), Integrative Chiropractic Management of High Blood Pressure and Chronic Hypertension (2010, 2011), Integrative Orthopedics Third Edition (2012), Migraine Headaches, Hypothyroidism, and Fibromyalgia (2012), Chiropractic and Naturopathic Mastery of Clinical Disorders (2009), Functional Immunology and Nutritional Immunomodulation (2012), Fibromyalgia in a Nutshell (2012), Integrative Rheumatology, Nutritional Immunomodulation, and Functional Inflammology (2013).  Complete list of books:

    • More than 100 articles and letters: JAMA—Journal of the American Medical Association, BMJ—British Medical Journal, The, JAOA—Journal of the American Osteopathic Association, Annals of Pharmacotherapy, Journal of Clinical Endocrinology and Metabolism, Alternative Therapies in Health and Medicine, Nutritional Perspectives, Journal of Manipulative and Physiological Therapeutics, The Original Internist, Integrative Medicine, Holistic Primary Care, Nutritional Wellness, Dynamic Chiropractic, Evidence-based Complementary and Alternative Medicine, and Arthritis & Rheumatism: Official Journal of the American College of Rheumatology.

    • Previous Editorial and Reviewer positions: Journal of Naturopathic Medicine (reviewer), Autoimmune Diseases (reviewer), Naturopathy Digest (Editor)

    Dr Vasquez lectures to doctors and healthcare professionals internationally and has taught Pharmacology at University of Western States; he practices in Oregon as a naturopathic physician. Dr Vasquez worked with the Institute for Functional Medicine from 2003-2013, first as Forum Consultant, then as Faculty for the AFMCP (Applying Functional Medicine in Clinical Practice) course; Dr Vasquez formerly taught the Advance Practice Module (APM) "The Many Faces of Immune Dysregulation and Chronic Inflammation: Chronic Infections, Atopy, and Autoimmune Disorders" and now teaches for various groups, especially ICHNFM.

    Languages: English, Spanish (improving), Catalan (pending)

"I choose Editors and Reviewers based on their 1) expertise and experience, 2) quality and depth of reviews, 3) obstinancy, and 4) honesty and courage to present and protect the truth. I don't look for agreement--I look for the truth first, upon which I hope we will agree."

Sergio Abanades MS MD PhD, Research Director

  • Biographical sketch:  new profile in progress--impressive record of work in clinical care, surgery, and research publications.

    • MD--Licentiate in Medicine and Surgery, M.D., School of Medicine, University Complutense of Madrid (certificate issued by the Ministry of Health and Education, Madrid, 1999).

    • PhD in Clinical Pharmacology, School of Medicine, Autonomous University of Barcelona, Barcelona. Thesis, ‘Clinical Pharmacology and abuse potential of Gamma-hydroxybutyric acid (GHB)’.

    • Masters Degree in Toxicology, University of Seville (Spain). Title issued by the University of Seville, Seville, 2007.

    • Publications -- partial listing

      • Shotbolt P, Tziortzi AC, Searle GE, Colasanti A, van der Aart J, Abanades S, Plisson C, Miller SR, Huiban M, Beaver JD, Gunn RN, Laruelle M, Rabiner EA. Within-subject comparison of [(11)C]-(+)-PHNO and [(11)C]raclopride sensitivity to acute amphetamine challenge in healthy humans. J Cereb Blood Flow Metab. 2012 Jan;32(1):127-36. doi: 10.1038/jcbfm.2011.115. Epub 2011 Aug 31.

      • Duran M, Pérez E, Abanades S, Vidal X, Saura C, Majem M, Arriola E, Rabanal M, Pastor A, Farré M, Rams N, Laporte JR, Capellà D. Preliminary efficacy and safety of an oromucosal standardized cannabis extract in chemotherapy-induced nausea and vomiting. Br J Clin Pharmacol. 2010 Nov;70(5):656-63. doi: 10.1111/j.1365-2125.2010.03743.x.

      • Abanades S, van der Aart J, Barletta JA, Marzano C, Searle GE, Salinas CA, Ahmad JJ, Reiley RR, Pampols-Maso S, Zamuner S, Cunningham VJ, Rabiner EA, Laruelle MA, Gunn RN. Prediction of repeat-dose occupancy from single-dose data: characterisation of the relationship between plasma pharmacokinetics and brain target occupancy. J Cereb Blood Flow Metab. 2011 Mar;31(3):944-52.

      • Pichini S, Farré M, Abanades S, Pacifici R, Zuccaro P, Langohr K, de la Torre R.Immunomodulating properties of gamma-hydroxybutyrate (GHB), flunitrazepam and ethanol in'club drugs' users. Addict Biol. 2010 Jul;15(3):336-45. doi: 10.1111/j.1369-1600.2010.00210.x. Epub 2010 Apr 29.

      • O'Mathúna B, Farré M, Rostami-Hodjegan A, Yang J, Cuyàs E, Torrens M, Pardo R, Abanades S, Maluf S, Tucker GT, de la Torre R. The consequences of 3,4-methylenedioxymethamphetamine induced CYP2D6 inhibition in humans. J Clin Psychopharmacol. 2008;28:523-9.

      • Martínez-Rodríguez JE, Munteis E, Carreño M, Blanco Y, Roquer J, Abanades S, Graus F, Saiz Cannabis use in Spanish patients with multiple sclerosis: Fulfilment of patients' expectations?. J Neurol Sci. 2008 ;273:103-7.

      • Farre M, Roset PN, Abanades S, Menoyo E, Alvarez Y, Rovira M, Baena A. Study of paracetamol 1-g oral solution bioavailability. Methods Find Exp Clin Pharmacol. 2008;30:37-41.

      • de Sola LLopis S, Miguelez-Pan M, Peña-Casanova J, Poudevida S, Farré M, Pacifici R, Böhm P, Abanades S, Verdejo-García A, Zuccaro P, de la Torre R. Cognitive performance in recreational Ecstasy polydrug users: a two year follow up study. Journal of Psychopharmacology. 2008;22:498-510.

      • Abanades S, Farré M, Barral D, Torrens M, Closas N, Langohr K, Pastor A and Rafael de la Torre. Relative abuse liability of gamma-hydroxybutyric acid (GHB), flunitrazepam and ethanol in “Club Drug” users. J Clin Psychopharmacol. 2007;27:625-638.

      • Farre M, Abanades S, Roset PN, Peiro A, O’Mahony B, Segura M, de la Torre R. Pharmacological Interaction Between 3,4-Methylenedioxymethamphetamine (MDMA, ecstasy) and Paroxetine: Pharmacological effects and pharmacokinetics. J Pharmacol Exp Ther. 2007;323:954-962.

      • Catafau AM, Bullich S, Danús M, Penengo MM, Cot A, Abanades S, Farré M, Pavía J, Ros D. Test-retest variability and reliability of (123)I-IBZM SPECT measurement of striatal dopamine D(2) receptor availability in healthy volunteers and influence of iterative reconstruction algorithms. Synapse. 2007;62:62-69.

      • Pacifici R, Zuccaro P, Farré M, Poudevida S, Abanades S, Pichini S, Langohr K, Segura S, de la Torre R. Combined Immunomodulating Properties of MDMA and Cannabis in Humans. Addiction. 2007;102:931-6.

      • Abanades S, Farré M, Segura M, Pichini S, Pastor A, Pacifici R, Pellegrini M, de la Torre R. Disposition of gamma-hydroxybutyric acid in conventional and nonconventional biologic fluids after single drug administration: issues in methodology and drug monitoring. Ther Drug Monit. 2007;29:64-70.

      • Abanades S, Pardo-Lozano R, Farré M. New insights on cefepime associated neurotoxicity. Pharmacotherapy 2007; 27: e1-e2.
        Abanades S, Farré M, Segura M, Pichini S, Barral D, Pacifici R, Pellegrini M, Fonseca F, Langohr K, De La Torre R. Gamma-hydroxybutyrate (GHB) in humans: pharmacodynamics and pharmacokinetics. Ann N Y Acad Sci. 2006;1074:559-76.

      • Abanades S, Farré M. Multiple sclerosis and Cannabinoids. electronic response. British Medical Journal. 2006. consulted 22-09-06.

      • Catafau AM, Danus M, Bullich S, Nucci G, Llop J, Abanades S, Cunningham VJ,. Eersels J.L.H, Pavia J, Farre M. Characterization of the SPECT 5-HT2A Receptor Ligand 123I-R91150 in Healthy Volunteers: Part 2—Ketanserin Displacement. J Nucl Med. 2006;47:929-937.

      • Pichini S, Abanades S, Farre M, Pellegrini M, Marchei E, Pacifici R, Torre RD, Zuccaro P. Quantification of the plant-derived hallucinogen Salvinorin A in conventional and non-conventional biological fluids by gas chromatography/mass spectrometry after Salvia divinorum smoking. Rapid Commun Mass Spectrom. 2005;19:1649-1656.

      • Abanades S, Farré M. Out of body experiences: beyond the anatomical basis. electronic response. British Medical Journal. 2004. consulted 14-03-05.

      • Weinbrenner T, Fito M, Torre Rd Rde L, Saez GT, Rijken P, Tormos C, Coolen S, Albaladejo MF, Abanades S, Schroder H, Marrugat J, Covas MI. Olive oils high in phenolic compounds modulate oxidative/antioxidative status in men. J Nutr. 2004;134:2314-2321.

      • de la Torre R, Farre´ M, Roset PN, Pizarro N, Abanades S, Segura M, Segura J, Camı´J. Human Pharmacology of MDMA: Pharmacokinetics, Metabolism, and Disposition. Ther Drug Monit.2004;26:137–144.

      • Abanades S, Nolla J, Rodriguez-Campello A, Pedro C, Valls A, Farre M. Reversible coma secondary to cefepime neurotoxicity. Ann Pharmacother. 2004;38:606-608.

      • Abanades S, Farré M. Guidelines for anecdotes might include more information. BMJ. 2003;327:290.

      • Abanades S, Iglesias ML, Echarte JL, Puig Dou J, Roset PN, Farré M. Gammahydroxibutirate: A novel toxicological emergency. Methods Find Exp Clin Pharmacol. 2001;23:326.

Languages: English, Spanish, Catalan


  • Biographical sketch: Dr. Jeffrey A. Ruterbusch is a retired United States Naval Physician who specializes in "Sports and Exercise Preventive Medicine". Prior to attending medical school, Dr. Ruterbusch was a Naval Aerospace Physiologist where he was an exercise physiologist specializing in exercise science as it pertained to increasing pilots and aircrewman tolerance to G-induced loss-of-consciousness in tactical jet aircraft. He attended medical school on the United States Health Professions Scholarship Program and then did his Internal Medicine internship at the National Naval Medical Center in Bethesda, Maryland. After serving several operational medicine tours with the United States Marine Corps in Okinawa, Japan and the United States Navy as a Naval Flight Surgeon in Pensacola and Jacksonville, Florida, he attended the University of California, San Diego and San Diego State University where he was the Chief Resident in the SEPM program. The last twelve years of his naval career were spent as a sports medicine physician where he practiced primarily physical medicine and rehabilitation. it was during his years as a sports medicine physician that he developed his passion for sports nutrition and orthomolecular/functional medicine. Since his retirement from the military over three years ago he has pursued other post-graduate certifications/credentials in sports and general nutrition, age-management medicine, and physiological regulating medicine. He has acquired Associate Professor status at Central Michigan University, College of Graduate Studies, where he has taught graduate courses in health-services administration. He has also served on a number of special advisory boards for sports supplement companies, strength and fitness associations, and has edited nutrition books for McGraw-Hill Publishing Company. He is a certified functional medicine practitioner, a certified nutrition specialist, and a Diplomate of the American Clinical Board of Nutrition. He has been the Chief Medical Officer at the Clover Medical Center in Al Jabrya, Kuwait in charge of Sports Medicine and Rehabilitation, and Metabolic/Nutritional Medicine. Over the past two years he has been the Medical Director of two Rehabilitation and Wellness Clinics in Jacksonville, and Tallahassee, Florida.. (4/2015)

Languages: English, Spanish

Kenneth Cintron MD

  • Biographical sketch: Dr. Cintron is an active Fellow of the American Academy of Orthopedic Surgeons. He graduated from the University of Puerto Rico School of Medicine in 1990 and completed his training in Orthopaedic Surgery Residency in 1995. He fulfilled a Foot and Ankle Surgery Fellowship at Emory University in Atlanta, Georgia in 1996. Dr. Cintron is Board Certified in Anti-Aging, Preventative, Regenerative and Functional Medicine and an Advanced Fellow of the American Academy of Anti-Aging Medicine. As a former owner an operator of BodylogicMD of Puerto Rico he dedicated his practice to helping women and men overcome health challenges associated with aging, using bioidentical hormone replacement therapy (BHRT) integrated with customized nutrition and fitness programs. He is author and co-author of several published articles related to both Orthopaedic Surgery and Integrative Medicine. During his career he has worked as Team Physician of professional basketball, baseball and volleyball teams as well as in Central American and Panamerican Games and 1996 Olympics. He is past President of the Puerto Rico Orthopaedic State Society and former member of the Board Of Councilors of the American Academy of Orthopaedic Surgeons.

Languages: English, Spanish

Michael J. Gonzalez MS MHSN DSc PhD FACN

  • Biographical sketch: Dr. Michael J. Gonzalez is Professor at the Nutrition Program, School of Public Health in the Medical Sciences Campus, University of Puerto Rico. He earned a Bachelor Degree in Biology and Chemistry (Catholic University), a Masters in Cellular Biology and Biophysics (Nova University), and another Masters in Nutrition and Public Health (University of P.R.). He has a Doctorate in Nutritional Medicine (John F. Kennedy University). He also has a Doctorate in Health Sciences (Lafayette University), and another Doctorate in Nutritional Biochemistry and Cancer Biology (Michigan State University). He completed a Post-Doctoral Fellowship in Geriatrics at the School of Medicine, University of Puerto Rico. Dr. Gonzalez is a Fellow of the American College of Nutrition, and has authored over 150 scientific publications. He has serve as a member on several scientific journal Editorial Boards, such as Biomedicina, the Journal of Orthomolecular Medicine, and Alternative Medicine Reviews. As a consultant for several companies, he has been responsible for designing formulations of nutritional supplements and pharmaceutical products. He has been a consultant for The Center for the Improvement of Human Functioning (now Riordan Clinic), in Wichita, Kansas. He has obtained several research awards for his work on Nutrition and Cancer. He is currently Co- Director of RECNAC II project, and Research Director of the InBioMed Project Initiative. Dr. Gonzalez also serves as a nutrition consultant to the Puerto Rican Basketball National Team and is part of the Medical Commission of the Puerto Rican Basketball Federation. Doctor González and Dr. Jorge Miranda-Massari, founders of InBioMed, are leaders in the development of non-toxic chemotherapy treatments for cancer. The findings of their work with Intravenous Vitamin C as an anti-cancer agent, published in 2002, were confirmed by the NIH in 2005. They published the first Phase-I clinical study utilizing Intravenous Vitamin C for treatment of terminal cancer patients in 2005, and also published in 2005 the most comprehensive review on Vitamin C and Cancer, as a follow-up on the work of two times Nobel Laureate, Dr. Linus C. Pauling. They have brought many new concepts into the field, such as the Bioenergetic theory of carcinogenesis, the systemic saturation phenomenon of intravenous vitamin C, the metabolic correction concept for disease treatment and prevention. in 2015, Dr Gonzalez was appointed to the North American Dietary Supplements Advisory Board.

    • Book: Drs Gonzalez, Miranda-Massari, Saul’s. I Have Cancer What Should I Do: The Orthomolecular Guide to Cancer Management provides evidence-based recommendations for an integrative approach for those dealing with cancer and seeking to improve quality of life and survival.

    • 2012 landmark publication: Gonzalez MJ, et al. The bio-energetic theory of carcinogenesis. Med Hypotheses. 2012 Oct;79(4):433-9 The altered energy metabolism of tumor cells provides a viable target for a non toxic chemotherapeutic approach. An increased glucose consumption rate has been observed in malignant cells. Warburg (Nobel Laureate in medicine) postulated that the respiratory process of malignant cells was impaired and that the transformation of a normal cell to malignant was due to defects in the aerobic respiratory pathways. Szent-Györgyi (Nobel Laureate in medicine) also viewed cancer as originating from insufficient availability of oxygen. Oxygen by itself has an inhibitory action on malignant cell proliferation by interfering with anaerobic respiration (fermentation and lactic acid production). Interestingly, during cell differentiation (where cell energy level is high) there is an increased cellular production of oxidants that appear to provide one type of physiological stimulation for changes in gene expression that may lead to a terminal differentiated state. The failure to maintain high ATP production (high cell energy levels) may be a consequence of inactivation of key enzymes, especially those related to the Krebs cycle and the electron transport system. A distorted mitochondrial function (transmembrane potential) may result. This aspect could be suggestive of an important mitochondrial involvement in the carcinogenic process in addition to presenting it as a possible therapeutic target for cancer. Intermediate metabolic correction of the mitochondria is postulated as a possible non-toxic therapeutic approach for cancer.

    Languages: English, Spanish



Deanna Minich PhD FACN CNS

  • Biographical sketch: Dr. Minich has a unique approach to clinical medicine based in a combination of physiology and psychology. She has trained in functional medicine for the past decade with the “father of functional medicine,” Dr. Jeffrey Bland, as her mentor, and has served on the Nutrition Advisory Board for the Institute of Functional Medicine. Her academic background is in nutritional science, including a Master’s Degree in Human Nutrition and Dietetics from the University of Illinois at Chicago (1995), and a Ph.D. in Medical Sciences (Nutrition) from the University of Groningen in The Netherlands (1999). In conjunction with her academic degrees and extensive teaching experience at the university level, she is both a Fellow (F.A.C.N.) and a Certified Nutrition Specialist (C.N.S.) through the American College of Nutrition and has received education in functional medicine through the Institute of Functional Medicine. Dr. Minich has over ten years of experience working in both the food and dietary supplement industries with her last position as Vice President of Scientific Affairs at Metagenics, Inc., in which she was responsible for global product launches in addition to serving as a teaching clinician for international audiences of healthcare practitioners. She currently leads educational outreach as Vice President of Education at the Personalized Lifestyle Medicine Institute, which involves coordination of cutting-edge information and collaboration with opinion leaders in the personalized lifestyle medicine field, along with her role as adjunct faculty at the University of Western States, Bastyr University, Institute for Functional Medicine, and the Maryland University of Integrative Health. She is the author of five books on nutrition, wellness, and psychology, and is passionate in helping others to live well using therapeutic lifestyle changes.

    • Books: Essential Fatty Acid Absorption and Metabolism (1999); Chakra Foods for Optimum Health: A Guide to the Foods that can Improve Your Energy, Inspire Creative Changes, Open Your Heart, and Heal Body, Mind, and Spirit (Conari Press, 2009); An A-Z Guide to Food Additives (Conari Press, 2009); Quantum Supplements: A Total Health and Wellness Makeover with Vitamins, Minerals, and Herbs (Conari Press, 2010); The Complete Handbook of Quantum Healing: An A-Z Self-Healing Guide for Over 100 Common Ailments (Conari Press, 2011).

    • More than 20 scientific publications: Journal of Lipid Research; American Journal of Clinical Research; Nutrition Reviews; Journal of Clinical Lipidology; Biochimica Biophysica Acta; Gastroenterology; American Journal of Physiology - Gastrointestinal and Liver Physiology; Pediatric Research; Canadian Journal of Physiology and Pharmacology; Metabolic Syndrome and Related Disorders; Journal of Bone and Mineral Metabolism; Journal of Medicinal Food.

Languages: English


Ryan Bradley ND MPH

  • Biographical sketchBiographical sketch: Dr. Ryan Bradley is a practicing naturopathic doctor, clinical researcher and cardiovascular epidemiologist. He is currently an Associate Professor at the National College of Natural Medicine in Portland, OR and an Affiliate Associate Professor in the Department of Pharmaceutics in the School of Pharmacy at the University of Washington in Seattle, WA. He also practices at Guarneri Integrative Health in La Jolla, CA, where he specializes in integrative approaches to treating type 2 diabetes, chronic kidney disease, and cardiovascular disease. Prior to entering private practice, he served as Core Clinical Faculty, Research Faculty and the Director of the Bastyr Center for Diabetes & Cardiovascular Wellness from 2005-13. Dr. Bradley has published his research in leading peer-reviewed medical journals including: Atherosclerosis, the Canadian Medical Association Journal (CMAJ) and Diabetes Care. He is a frequently invited speaker for naturopathic and integrative medicine organizations and he has presented on the benefits of integrative care for diabetes and heart disease at American Diabetes Association, the European Association for the Study of Diabetes, and the International Diabetes Federation. In addition to research publications, Dr. Bradley co-authored the Food User Manual, a patient guide to heart-healthy diet choices. He currently serves on the Diabetes Advisory Board for Prevention Magazine.

Languages: English


Jill Carnahan MD

  • Biographical sketch: Dr. Carnahan completed her residency at the University of Illinois Program in Family Medicine at Methodist Medical Center. In 2006 she was voted by faculty to receive the Resident Teacher of the Year award and elected to Central Illinois 40 Leaders Under 40. She received her medical degree from Loyola University Stritch School of Medicine in Chicago and her Bachelor of Science degree in Bio-Engineering at the University of Illinois in Champaign-Urbana. She is dually board-certified in Family Medicine (ABFM) and Integrative Holistic Medicine (ABIHM). She was also part of the first 100 health-care practitioners to be certified in Functional Medicine through the Institute of Functional Medicine (IFMCP). In 2008, Dr. Carnahan’s vision for health and healing resulted in the creation of Methodist Center for Integrative Medicine in Peoria, IL where she served as the Medical Director for 2 years. In 2010, she founded Flatiron Functional Medicine in Boulder, Colorado where she practices functional medicine with medical partner, Dr. Robert Rountree. Dr. Carnahan is also 13-year survivor of breast cancer and Crohn’s disease and passionate about teaching patients how to “live well” and thrive in the midst of complex and chronic illness. She is also committed to teaching other physicians how to address underlying cause of illness rather than just treating symptoms through the principles of functional medicine. She is a prolific writer, speaker, and loves to infuse others with her passion for health and healing!

Languages: English, Spanish


David H Haase MD

  • Biographical sketch: Dr. Haase graduated from Calvin College (BS Biology), Vanderbilt University School of Medicine (MD) subsequently training and practicing at the Mayo Clinic becoming board certified in both Family and Integrative Holistic Medicine. He is the founder of the MaxWell Clinic for Proactive Medicine, CMO of the LifeStrive Group and CMO of Evoke Neuroscience. He holds certifications in Health Coaching, Nutrition, and Neurofeedback. Dr. Haase is faculty for the University of South Florida Medical School’s Master’s program in Nutritional and Metabolic Medicine and for Western States University’s Master’s program for Functional and Nutritional Medicine with the area of emphasis for each being Functional Neurophysiology. He is a reviewer for the Textbook of Functional Medicine and a reviewer for Alternative Medicine Reviews. Dr. Haase is a co-founder of the non-profit "" where high-school youth learn to live health-response-able and world-response-able lives via a curriculum of small-group learning, organic gardening, and community service.

Languages: English

Steve Hickey PhD

  • Biographical sketchBiographical sketch: Dr Steve Hickey holds a PhD in Medical Biophysics from the University of Manchester, England; he is a Chartered Biologist and a Member of the Society of Biology and has a degree in science from the Open University. His PhD was on the development, aging, function and failure of the intervertebral disk with Professor DWL Hukins. His first year of research was acknowledged by the Volvo Award by the International Society for the Study of the Lumbar Spine. Following his PhD, he worked on the function of the urethra and invented the conformable catheter with Professor John Broklehurst. With Professor Ian Isherwood he carried out research in super-resolution CT scanning and quantitative imaging on the first clinical MR scanner in Europe. During this period he gained the Annual Award and Medal of the Back Pain Society. Switching to Artificial Intelligence he did research with Professor Enid Mumford on stock market prediction. His later research included pattern recognition, computer science, and decision science. He has published hundreds of scientific articles in a variety of disciplines. Dr Hickey is the author of books on science, health, vitamins, and cancer many co-authored with Dr Hilary Roberts including Tarnished Gold: The Sickness of Evidence Based Medicine, The Vitamin Cure for Heart Disease, Ascorbate: The Science of Vitamin C, Cancer Nutrition and Survival, and The Cancer Breakthrough. He worked with Dr Robert F. Cathcart 3rd on the dynamic flow of vitamin C. Hickey’s other books include Vitamin C: The Real Story (with Andrew Saul), Hospitals and Health (with Abram Hoffer and Andrew Saul), and The Vitamin Cure for Migraines.

Languages: English


Jorge R Miranda-Massari DrPh

  • Biographical sketch: Professor at the School of Pharmacy in the Medical Sciences Campus, University of Puerto Rico, and a Registered Pharmacist. He earned two bachelor degrees at the University of Puerto Rico, one in Science and another in Pharmacy. After earning a Doctorate Degree in Pharmacy at the Philadelphia College of Pharmacy and Science, he completed a Post-Doctoral Fellowship in Clinical Pharmacokinetics at the University of North Carolina. He obtained Post-Doctoral training in Pharmaceutical Care in Nephrology from the University of Pittsburgh, and another one in Clinical Anti-Coagulation from the Medical College of Virginia. Author of numerous scientific publications including editorials, reviews and research data in peer review journals, Dr. Miranda-Massari is a consultant for the prestigious Center for the Improvement for the Human Functioning, in Wichita, Kansas.. Welcome aboard, Dr Miranda-Massari: biography update in progress!

Languages: English, Spanish


Annette J. D'Armata NMD

  • Biographical sketch: Dr. D'Armata earned a B.A. in Communication from the University of St. Thomas, studied graduate Sociology at the University of Houston, and earned a Doctorate of Naturopathic Medicine with honors from Southwest College of Naturopathic Medicine & Health Sciences. While at SCNM, she obtained additional clinical training in the integrative treatment of mental illness under Katherine Raymer, MD, ND, was asked to teach neuroanatomy as assistant to Thomas Richards, PhD, and was honored with an Outstanding Leadership award by her faculty and colleagues. Fluent in Spanish, Dr. D'Armata volunteered to intern with Adelfo Yescas, M.D. (Internal Medicine), on rotation at Hospital San Martin in Oaxaca and at General Regional Hospital No. 25 in Mexico City, working with patients with rheumatoid arthritis, diabetes, infectious disease and advanced cancers. She was offered a post-doctoral residency in naturopathic internal medicine in Fairbanks, Alaska and, upon completion, went on to open and run a successful, multi-practitioner clinic serving that community for three years. She is the author of "Dr. D'Armata's Top Ten Tips for Immediately Improving Your Health," a practical health primer for adults. Dr. D'Armata has been a frequent guest lecturer on radio, in health facilities and in the community, presenting: "Integrative Approaches to Autoimmune Conditions," "Inflammatory Breast Cancer: An Integrative Case Report," "Clinically Effective Natural Treatment of Infectious Diseases," "Neuropsychiatric Effects of Gluten Sensitivity," "Naturopathic Care of Older Adults," "Integrative First Aid" and "Natural Treatment of Obsessive-Compulsive Disorder." Additionally, she has provided medical review and editing for various texts by Dr. Alex Vasquez. Dr. D'Armata is in private practice in Tempe, Arizona, specializing in psychoneuroimmunology. She has proposed original research on obsessive compulsive disorder using Quantitative EEG and Low Resolution Brain Tomography (LORETA). Dr. D'Armata is an active member of the American Association of Naturopathic Physicians (AANP) and the Oncology Association of Naturopathic Physicians. (OncANP).

Languages: English, Spanish


Ismael Samudio PhD

  • Biographical sketch: After several years of research at the world-famous MD Anderson Cancer Center in Houston Texas, Dr Samudio is currently Associate Professor Department of Nutrition and Biochemistry, School of Sciences, Pontificia Universidad Javeriana – Bogotá, Colombia.  Attending the same high school in Georgia with Dr Vasquez, Dr Samudio graduated in 1991 from Riverside Military Academy, then earned his B.S. in Biochemistry and Genetics – Texas A&M University and his Ph.D. in Genetics – Texas A&M University. He is trained in biochemistry, molecular genetics, cytometry, microscopy, immunohistochemistry, Western blotting, mammalian tissue culture, and organic chemistry. Isolation, culture and characterization of adult stem cells. His main interests include: Apoptosis, metabolism, signal transduction, and gene regulation. Metabolic alterations in cancer cells and cancer initiating (stem, progenitor) cells, and how these alterations contribute to disease recurrence and progression. Development/identification of chemical  sstructures as novel chemotherapeutic agents. Development of in vitro systems that mimic the bone marrow microenvironment. Physiology of the normal and leukemic bone marrow. Cellular therapy and regenerative medicine. Adult Stem cells.

Languages: English, Spanish


Tim Jackson DPT CNS

  • Biographical sketch: Dr. Tim Jackson received his undergraduate degree in Health science and chemistry from Wake Forest University in 2003. He completed his Doctorate in Physical Therapy (DPT) from the Medical University of SC in 2009. He is certified in the Spine portion of Active Release Technique. Realizing that manual therapy and orthopedic care helped only some of his patients, he began studying functional and environmental medicine, as well as digestive health, in an effort to help others achieve wellness. He is working to complete his Certified Nutritional Specialist(CNS) Certification. Tim incorporates many areas of health into his work, especially epigenetics, functional endocrinology, and biotoxin-related illnesses. .

Languages: English

Tariq Shafi MD

  • Biographical sketch: A medical doctor in integrative practice for many years, Dr Shafi has administered tens of thousands of patient encounters and therapeutic interventions ranging from diet advice to intravenous nutrient therapy. Dr Shafi and Dr Vasquez worked together in the same health center for 6 years. Dr Shafi also speaks four languages (English, Spanish, Urdu, Punjabi) and has helped with the international translation of Dr Vasquez's books.

Languages: English, Spanish, Urdu, Punjabi


Joseph Iaccino DC (MSc candidate)

  • Biographical sketch: Joseph Iaccino is a Doctor of Chiropractic and a nutritional consultant. He is currently finishing an additional masters degree in Human Nutrition and Functional Medicine. He is also working on a coaching certification through USA Cycling. Dr. Iaccino is detail-oriented and has a strong focus on reviewing and editing articles.

Languages: English


Dorothy D. Zeviar EdD LAc MPH CPH (MSc candidate)

  • Biographical sketch: Improve people’s quality-of-life, and help reduce the financial, physiologic and emotional burdens of health, safety and preparedness. Welcome aboard, Dr Z: biography update in progress!

Languages: English


Pedro Carrera Bastos MA MS (PhD candidate in Medical Sciences at Lund University, Sweden)

  • Biographical sketch: Pedro Bastos is a Portuguese Nutrition researcher and PhD candidate in Medical Sciences, holding an MSc in Human Nutrition and three Post-graduate Diplomas (Clinical Nutrition; Functional Nutrition and Orthomolecular Medicine; Health & Exercise Science). He lectures extensively to health professionals on topics related to Nutrition across Europe, USA and Latin America and has authored and co-authored 12 scientific papers. Best known for being an expert in milk and milk-associated immune dysfunction and allergy.

Languages: English, Spanish, Portuques


Maelan Fontes MS (PhD candidate in Medical Sciences at Lund University, Sweden)

  • Biographical sketch: Physical Therapist, Master in Science in Human Nutrition and Food Quality, PhD scandidate in Medical Sciences, Researcher at the Center for Primary Health Care Research, Lund University, Sweden. Lecturer in several postgraduate courses in Spain and Portugal, Author of peer-reviewed papers on evolutionary nutrition. Focused on Food and Western Disease from an evolutionary perspective.

Languages: English, Spanish



Oscar Picazo MSc (PhD candidate in Human Nutrition at the Universidad Complutense de Madrid)

  • Biographical sketch: Oscar Picazo obtained an MSc in Chemistry at the Universidad de Alcala (Spain),a Certi-ficate in Chemistry at the University of Sussex at Brighton (UK), an MSc in Computatio-nal Chemistry (Universidad Autonoma de Madrid), and MSc in Occupational Health (Uni-versidad de Valladolid). After several year of research experience in organic chemistry, nanotechnology and medicinal chemistry, and working as an occupational health consul-tant, he become interested in nutrition and biochemistry. He is now PhD candidate in Human Nutrition at the Universidad Complutense de Madrid, and taking the degree to become certified nutritionist. He has published several papers in peer reviewed journals and lectures in postgraduates courses in nutrition. Topics of interest are the nutrition-autoimmune disease link, gut flora and endotoxemia, and the evolutionary approach to nutrition.

Languages: English, Spanish

Terri Ward CPA (MS candidate)

  • Biographical sketch: Terri Ward is a certified Nutritional Therapy Practitioner, Certified Public Accountant and student in the Masters of Science in Human Nutrition and Functional Medicine program at the University of Western States. Terri has an excellent eye for detail and is a very excellent reviewer.

Languages: English

Sayer Ji BA

  • Biographical sketch: Sayer Ji is a widely recognized researcher, author, and presenter, Steering Committee Member of the Global GMO Free Coalition (GGFC), an advisory board member of the National Health Federation, and Fearless Parent, and the founder of the world's most widely referenced, evidence-based natural health resource of its kind. He founded in 2008 in order to provide the world an open access, evidence-based resource supporting natural and integrative modalities. Sayer's work has been published in various online and print publications, including Truthout, The Wellbeing Journal, Pathways Connect,, The Journal of Gluten Sensitivity. Sayer attended Rutgers University, where he studied under the American philosopher Dr. Bruce W. Wilshire, with a focus on the philosophy of science, receiving a BA degree in Philosophy in 1995. In 1996, following residency at the Zen Mountain Monastery in upstate New York, he embarked on a 5 year journey of service as a counselor-teacher and wilderness therapy specialist for various organizations serving underprivileged and/or adjudicated populations, from the Princeton-Blairstown Center (NJ), the Mayhew Foundation (NH) and Eckerd Youth Alternatives (FL). Since 2003, Sayer has served as a patient advocate and an educator and consultant for the natural products industry and health and wellness field.

Languages: English


Julie Jean BS BSN RN

  • Biographical sketch: Julie's nursing background is in functional medicine, ER, post-anesthesia care, wound care, and cardiac stepdown. She is studying the application of botanicals in functional medicine and has a keen interest in helping to make FM accessible to the wider population. Julie has bachelor degrees in Nursing and Geology from Michigan State University. She is working on attaining her Master of Science in Nursing degree from the family nurse practitioner track at Texas Tech University Health Sciences Center.

Languages: English

Thomas Easley, Registered Herbalist (American Herbalist Guild)

  • Biographical sketch: Thomas Easley is a Registered Herbalist with the American Herbalist Guild, author and teacher. Thomas integrates modern science and Traditional Western Herbalism into a unified and systematic approach to health and healing. He utilizes herbs from all over the world, including Ayuveda and Traditional Chinese Medicine, but focuses on the deep and rich tradition of Western Herbalism. Thomas emphasizes using foods as primary medicine and uses intensive diets as well as stress reduction techniques, nutritional supplements, and exercise to help people achieve their health goals. Thomas believes that herbal medicine has the potential to change the world. Unfortunately, much of what is taught about herbs and nutritional supplements is driven by marketing and is not based in tradition or science. Thomas’s approach draws on his extensive clinical experience, which spans 14 years of full-time practice and over 10,000 clients.

Languages: English

Mathieu Bouchard, independent researcher and traditional naturopath practicing in Canada

  • Biographical sketch: After starting his adventure in the fitness industry, Mr. Bouchard is now working at is own Naturopathic Clinic in Montréal, Québec. He is also the founder of Institut AAT, a continuing education institute to help trainers, naturopaths or any health related profession in having a better understanding of the holistic approach. His journey in functional medicine started in 2013 and the creation of his first seminar on how to understand and address "adrenal fatigue". Seeing that the body has a lot of mixed patterns, he then registered at the Functional Medicine University to start his education in the functional approach of medicine. Now more familiar with the medical part of the holistic approach, Mr. Bouchard works with his colleagues at improving natural healthcare. Mathieu helps IJHNFM with the French translations of our publications.

Languages: English, French

Our Journals and publication platforms: International College of Human Nutrition of Functional Medicine (, [main]) holds several different publication platforms; this document will describe the various journal platforms held by We have journals formatted and delivered either in paper print and/or as digital publications.

  • Submitted articles: Submissions to the journal imply permission to edit, publish, and distribute.
  • Board of Reviewers: Acknowledgement here does not imply that the reviewer fully agrees with or endorses the material in this text but rather that they were willing to review specific sections of the book for clinical applicability and clarity and to make suggestions to their own level of satisfaction. Credit for improvements and refinements to this text are due in part to these reviewers; responsibility for oversights remains that of the author(s) and Editor.

International Journal of Human Nutrition Functional Medicine ® © is the college's flagship journal, established/copyrighted/trademarked in 2013 and globally launched in2014 with three issues followed by consistent periodic publishing thereafter. This journal is printed and distributed by major publisher, therefore it's glossy, contains limited advertising on an exclusive basis. Indexed on Medline may be pursued, but more important than this is the Journal's internal quality; Medline indexing is increasingly irrelevant in a world of international immediate access via open-assess web-based platforms. In sum, this is the journal for our best publications. Given that English is the official language of scientific discipline, English articles are preferred but certainly not on an exclusive basis; when articles are submitted in other languages, we will try to provide an abstract or complete translation in English. Topics in this journal can focus on anything from case reports, to hypotheses, to detailed exegesis on various topics relevant to human attrition and the clinical practice of functional medicine. A strong preference for preferred articles includes their description of molecular mechanisms of disease and clinical applications of applicable therapeutics. Better articles will also contain a blend of philosophy and social perspective along with the science.

European Journal of Human Nutrition and Functional Medicine © publishes articles and virtually any language, with topical preferences specific to the region of Europe, the UK Africa and Eurasia/Asia. Any articles published in a language other than English will be accompanied by either an abstract and English or a complete translation of the article.

North American Journal of Human Nutrition and Functional Medicine © contains articles written in the English language with topics particularly relevant to – of course – North America, including United States, Canada, Mexico and other neighboring territories and countries. USA-specific examples from recent news:

  • Medical bankrupties vs personal finances: "the average $166,750 medical school debt takes 30 years to repay at 7.5 percent interest: a total cost of $419,738."
  • Genetically modified foods: The U.S. Department of Agriculture estimates 70 percent of the products sold in American supermarkets contain genetically modified ingredients. The Food and Drug Administration regulates genetically modified foods, but regulators have left testing to the industry that is producing them.
  • Healthcare politics and controversies: "Influenza and pneumonia” took 62,034 lives in 2001–61,777 of which were attributable to pneumonia and 257 to flu, and in **only 18 cases was the flu virus positively identified.** In other words, the influenza virus was actually present in only 18 of 62,034 deaths attributed to both influenza and pneumonia. Doshi research published more recently in the BMJ found that in the hundreds of thousands of respiratory samples taken each year from flu patients in the United States and tested in labs, only 16 percent test positive for the influenza virus. It turns out that most flu cases are actually caused by bacteria or fungus or any of a number of other things except the influenza virus being blamed. "But perhaps the cleverest aspect of the influenza marketing strategy surrounds the claim that “flu” and “influenza” are the same. The distinction seems subtle, and purely semantic. But general lack of awareness of the difference might be the primary reason few people realize that even the ideal influenza vaccine, matched perfectly to circulating strains of wild influenza and capable of stopping all influenza viruses, can only deal with a small part of the “flu” problem because most “flu” appears to have nothing to do with influenza. Every year, hundreds of thousands of respiratory specimens are tested across the US. Of those tested, on average 16% are found to be influenza positive."
  • Chemtrails: Essay by Russel Blaylock MD (neurology): The Internet is littered with stories of “chemtrails” and geoengineering to combat “global warming” and until recently I took these stories with a grain of salt. One of the main reasons for my skepticism was that I rarely saw what they were describing in the skies. But over the past several years I have notice a great number of these trails and I have to admit they are not like the contrails I grew up seeing in the skies. They are extensive, quite broad, are laid in a definite pattern and slowly evolve into artificial clouds. Of particular concern is that there are now so many ­dozens every day are littering the skies. My major concern is that there is evidence that they are spraying tons of nanosized aluminum compounds. It has been demonstrated in the scientific and medical literature that nanosized particles are infinitely more reactive and induce intense inflammation in a number of tissues. Of special concern is the effect of these nanoparticles on the brain and spinal cord, as a growing list of neurodegenerative diseases, including Alzheimer’s dementia, Parkinson’s disease and Lou Gehrig’s disease (ALS) are strongly related to exposure to environmental aluminum. Nanoparticles of aluminum are not only infinitely more inflammatory, they also easily penetrate the brain by a number of routes, including the blood and olfactory nerves (the smell nerves in the nose). Studies have shown that these particles pass along the olfactory neural tracts, which connect directly to the area of the brain that is not only most effected by Alzheimer’s disease, but also the earliest affected in the course of the disease. It also has the highest level of brain aluminum in Alzheimer’s cases. The intranasal route of exposure makes spraying of massive amounts of nanoaluminum into the skies especially hazardous, as it will be inhaled by people of all ages, including babies and small children for many hours.
  • Medical bankruptcy: "Bankruptcies resulting from unpaid medical bills will affect nearly 2 million people this year—making health care the No. 1 cause of such filings, and outpacing bankruptcies due to credit-card bills or unpaid mortgages, according to new data. And even having health insurance doesn't buffer consumers against financial hardship." and
  • Digital distribution, free open-access
  • View/purchase sample (first edition) at


Quick Guide to Citation Formatting modified slightly from

International Committee of Medical Journal Editors (ICMJE) Recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals: Sample References

The International Committee of Medical Journal Editors offers guidance to authors in its publication Recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals (ICMJE Recommendations), which was formerly the Uniform Requirements for Manuscripts. The recommended style for references is based on the National Information Standards Organization NISO Z39.29-2005 (R2010) Bibliographic References as adapted by the National Library of Medicine for its databases. Details are in Citing Medicine. (Note Appendix F which covers how citations in MEDLINE/PubMed differ from the advice in Citing Medicine.) Sample references typically used by authors of journal articles are provided below.

Articles in Journals (see also #36. Journal article on the Internet)

1. Standard journal article

List the first six authors followed by et al. (Note: NLM now lists all authors.) JournalInItalics year month COLON volume SEMICOLON pages

Halpern SD, Ubel PA, Caplan AL. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002 Jul 25;347(4):284-7

As an option, if a journal carries continuous pagination throughout a volume (as many medical journals do) the month and issue number may be omitted.

Halpern SD, Ubel PA, Caplan AL. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

More than six authors:

Rose ME, Huerbin MB, Melick J, Marion DW, Palmer AM, Schiding JK, et al. Regulation of interstitial excitatory amino acid concentrations after cortical contusion injury. Brain Res. 2002;935(1-2):40-6.

Optional addition of a database's unique identifier for the citation: [Edited 12 May 2009]

Halpern SD, Ubel PA, Caplan AL. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002 Jul 25;347(4):284-7. PubMed PMID: 12140307.

Forooghian F, Yeh S, Faia LJ, Nussenblatt RB. Uveitic foveal atrophy: clinical features and associations. Arch Ophthalmol. 2009 Feb;127(2):179-86. PubMed PMID: 19204236; PubMed Central PMCID: PMC2653214.

Optional addition of a clinical trial registration number: [Added 12 May 2009]

Trachtenberg F, Maserejian NN, Soncini JA, Hayes C, Tavares M. Does fluoride in compomers prevent future caries in children? J Dent Res. 2009 Mar;88(3):276-9. PubMed PMID: 19329464. registration number: NCT00065988.

2. Organization as author

Diabetes Prevention Program Research Group. Hypertension, insulin, and proinsulin in participants with impaired glucose tolerance. Hypertension. 2002;40(5):679-86.

3. Both personal authors and organization as author (List all as they appear in the byline.) [Edited 12 May 2009]

Vallancien G, Emberton M, Harving N, van Moorselaar RJ; Alf-One Study Group. Sexual dysfunction in 1,274 European men suffering from lower urinary tract symptoms. J Urol. 2003;169(6):2257-61.

Margulies EH, Blanchette M; NISC Comparative Sequencing Program, Haussler D, Green ED. Identification and characterization of multi-species conserved sequences. Genome Res. 2003 Dec;13(12):2507-18.

4. No author given

21st century heart solution may have a sting in the tail. BMJ. 2002;325(7357):184.

5. Article not in English [Edited 12 May 2009]

Ellingsen AE, Wilhelmsen I. Sykdomsangst blant medisin- og jusstudenter. Tidsskr Nor Laegeforen. 2002;122(8):785-7. Norwegian.

Optional translation of article title (MEDLINE/PubMed practice):

Ellingsen AE, Wilhelmsen I. [Disease anxiety among medical students and law students]. Tidsskr Nor Laegeforen. 2002 Mar 20;122(8):785-7. Norwegian.

6. Volume with supplement

Geraud G, Spierings EL, Keywood C. Tolerability and safety of frovatriptan with short- and long-term use for treatment of migraine and in comparison with sumatriptan. Headache. 2002;42 Suppl 2:S93-9.

7. Issue with supplement

Glauser TA. Integrating clinical trial data into clinical practice. Neurology. 2002;58(12 Suppl 7):S6-12.

8. Volume with part

Abend SM, Kulish N. The psychoanalytic method from an epistemological viewpoint. Int J Psychoanal. 2002;83(Pt 2):491-5.

9. Issue with part

Ahrar K, Madoff DC, Gupta S, Wallace MJ, Price RE, Wright KC. Development of a large animal model for lung tumors. J Vasc Interv Radiol. 2002;13(9 Pt 1):923-8.

10. Issue with no volume

Banit DM, Kaufer H, Hartford JM. Intraoperative frozen section analysis in revision total joint arthroplasty. Clin Orthop. 2002;(401):230-8.

11. No volume or issue

Outreach: bringing HIV-positive individuals into care. HRSA Careaction. 2002 Jun:1-6.

12. Pagination in roman numerals

Chadwick R, Schuklenk U. The politics of ethical consensus finding. Bioethics. 2002;16(2):iii-v.

13. Type of article indicated as needed

Tor M, Turker H. International approaches to the prescription of long-term oxygen therapy [letter]. Eur Respir J. 2002;20(1):242.

Lofwall MR, Strain EC, Brooner RK, Kindbom KA, Bigelow GE. Characteristics of older methadone maintenance (MM) patients [abstract]. Drug Alcohol Depend. 2002;66 Suppl 1:S105.

14. Article containing retraction

Feifel D, Moutier CY, Perry W. Safety and tolerability of a rapidly escalating dose-loading regimen for risperidone. J Clin Psychiatry. 2002;63(2):169. Retraction of: Feifel D, Moutier CY, Perry W. J Clin Psychiatry. 2000;61(12):909-11.

Article containing a partial retraction: [Added 12 May 2009]

Starkman JS, Wolder CE, Gomelsky A, Scarpero HM, Dmochowski RR. Voiding dysfunction after removal of eroded slings. J Urol. 2006 Dec;176(6 Pt 1):2749. Partial retraction of: Starkman JS, Wolter C, Gomelsky A, Scarpero HM, Dmochowski RR. J Urol. 2006 Sep;176(3):1040-4.

15. Article retracted

Feifel D, Moutier CY, Perry W. Safety and tolerability of a rapidly escalating dose-loading regimen for risperidone. J Clin Psychiatry. 2000;61(12):909-11. Retraction in: Feifel D, Moutier CY, Perry W. J Clin Psychiatry. 2002;63(2):169.

Article partially retracted: [Added 12 May 2009]

Starkman JS, Wolter C, Gomelsky A, Scarpero HM, Dmochowski RR. Voiding dysfunction following removal of eroded synthetic mid urethral slings. J Urol. 2006 Sep;176(3):1040-4. Partial retraction in: Starkman JS, Wolder CE, Gomelsky A, Scarpero HM, Dmochowski RR. J Urol. 2006 Dec;176(6 Pt 1):2749.

16. Article republished with corrections

Mansharamani M, Chilton BS. The reproductive importance of P-type ATPases. Mol Cell Endocrinol. 2002;188(1-2):22-5. Corrected and republished from: Mol Cell Endocrinol. 2001;183(1-2):123-6.

17. Article with published erratum

Malinowski JM, Bolesta S. Rosiglitazone in the treatment of type 2 diabetes mellitus: a critical review. Clin Ther. 2000;22(10):1151-68; discussion 1149-50. Erratum in: Clin Ther. 2001;23(2):309.

18. Article published electronically ahead of the print version

Yu WM, Hawley TS, Hawley RG, Qu CK. Immortalization of yolk sac-derived precursor cells. Blood. 2002 Nov 15;100(10):3828-31. Epub 2002 Jul 5.

Books and Other Monographs: Authors. Title. City COLON publisher SEMICOLON year COMMA pages

19. Personal author(s)

Murray PR, Rosenthal KS, Kobayashi GS, Pfaller MA. Medical microbiology. 4th ed. St. Louis: Mosby; 2002.

20. Editor(s), compiler(s) as author

Gilstrap LC 3rd, Cunningham FG, VanDorsten JP, editors. Operative obstetrics. 2nd ed. New York: McGraw-Hill; 2002.

21. Author(s) and editor(s)

Breedlove GK, Schorfheide AM. Adolescent pregnancy. 2nd ed. Wieczorek RR, editor. White Plains (NY): March of Dimes Education Services; 2001.

22. Organization(s) as author [Edited 12 May 2009]

Advanced Life Support Group. Acute medical emergencies: the practical approach. London: BMJ Books; 2001. 454 p.

American Occupational Therapy Association, Ad Hoc Committee on Occupational Therapy Manpower. Occupational therapy manpower: a plan for progress. Rockville (MD): The Association; 1985 Apr. 84 p.

National Lawyer's Guild AIDs Network (US); National Gay Rights Advocates (US). AIDS practice manual: a legal and educational guide. 2nd ed. San Francisco: The Network; 1988.

23. Chapter in a book

Meltzer PS, Kallioniemi A, Trent JM. Chromosome alterations in human solid tumors. In: Vogelstein B, Kinzler KW, editors. The genetic basis of human cancer. New York: McGraw-Hill; 2002. p. 93-113.

24. Conference proceedings

Harnden P, Joffe JK, Jones WG, editors. Germ cell tumours V. Proceedings of the 5th Germ Cell Tumour Conference; 2001 Sep 13-15; Leeds, UK. New York: Springer; 2002.

25. Conference paper

Christensen S, Oppacher F. An analysis of Koza's computational effort statistic for genetic programming. In: Foster JA, Lutton E, Miller J, Ryan C, Tettamanzi AG, editors. Genetic programming. EuroGP 2002: Proceedings of the 5th European Conference on Genetic Programming; 2002 Apr 3-5; Kinsdale, Ireland. Berlin: Springer; 2002. p. 182-91.

26. Scientific or technical report

Issued by funding/sponsoring agency:

Yen GG (Oklahoma State University, School of Electrical and Computer Engineering, Stillwater, OK). Health monitoring on vibration signatures. Final report. Arlington (VA): Air Force Office of Scientific Research (US), Air Force Research Laboratory; 2002 Feb. Report No.: AFRLSRBLTR020123. Contract No.: F496209810049.

Issued by performing agency:

Russell ML, Goth-Goldstein R, Apte MG, Fisk WJ. Method for measuring the size distribution of airborne Rhinovirus. Berkeley (CA): Lawrence Berkeley National Laboratory, Environmental Energy Technologies Division; 2002 Jan. Report No.: LBNL49574. Contract No.: DEAC0376SF00098. Sponsored by the Department of Energy.

27. Dissertation

Borkowski MM. Infant sleep and feeding: a telephone survey of Hispanic Americans [dissertation]. Mount Pleasant (MI): Central Michigan University; 2002.

28. Patent

Pagedas AC, inventor; Ancel Surgical R&D Inc., assignee. Flexible endoscopic grasping and cutting device and positioning tool assembly. United States patent US 20020103498. 2002 Aug 1.

Other Published Material

29. Newspaper article

Tynan T. Medical improvements lower homicide rate: study sees drop in assault rate. The Washington Post. 2002 Aug 12;Sect. A:2 (col. 4).

30. Audiovisual material

Chason KW, Sallustio S. Hospital preparedness for bioterrorism [videocassette]. Secaucus (NJ): Network for Continuing Medical Education; 2002.

31. Legal Material

Public law:
Veterans Hearing Loss Compensation Act of 2002, Pub. L. No. 107-9, 115 Stat. 11 (May 24, 2001).

Unenacted bill:
Healthy Children Learn Act, S. 1012, 107th Cong., 1st Sess. (2001).

Code of Federal Regulations:
Cardiopulmonary Bypass Intracardiac Suction Control, 21 C.F.R. Sect. 870.4430 (2002).

Arsenic in Drinking Water: An Update on the Science, Benefits and Cost: Hearing Before the Subcomm. on Environment, Technology and Standards of the House Comm. on Science, 107th Cong., 1st Sess. (Oct. 4, 2001).

32. Map

Pratt B, Flick P, Vynne C, cartographers. Biodiversity hotspots [map]. Washington: Conservation International; 2000.

33. Dictionary and similar references

Dorland's illustrated medical dictionary. 29th ed. Philadelphia: W.B. Saunders; 2000. Filamin; p. 675.

Unpublished Material

34. In press or Forthcoming [Edited 12 May 2009]

(Note: NLM prefers "Forthcoming" rather than "In press" because not all items will be printed.)

Tian D, Araki H, Stahl E, Bergelson J, Kreitman M. Signature of balancing selection in Arabidopsis. Proc Natl Acad Sci U S A. Forthcoming 2002.

Electronic Material

35. CD-ROM

Anderson SC, Poulsen KB. Anderson's electronic atlas of hematology [CD-ROM]. Philadelphia: Lippincott Williams & Wilkins; 2002.

36. Journal article on the Internet [Edited 12 May 2009]

Abood S. Quality improvement initiative in nursing homes: the ANA acts in an advisory role. Am J Nurs [Internet]. 2002 Jun [cited 2002 Aug 12];102(6):[about 1 p.]. Available from:

Optional presentation (omits bracketed phrase that qualifies the journal title abbreviation):

Abood S. Quality improvement initiative in nursing homes: the ANA acts in an advisory role. Am J Nurs. 2002 Jun [cited 2002 Aug 12];102(6):[about 1 p.]. Available from:

Article published on the Internet ahead of the print version:
See # 18.

Optional formats used by NLM in MEDLINE/PubMed:

Article with document number in place of traditional pagination:

Williams JS, Brown SM, Conlin PR. Videos in clinical medicine. Blood-pressure measurement. N Engl J Med. 2009 Jan 29;360(5):e6. PubMed PMID: 19179309.

Article with a Digital Object Identifier (DOI):

Zhang M, Holman CD, Price SD, Sanfilippo FM, Preen DB, Bulsara MK. Comorbidity and repeat admission to hospital for adverse drug reactions in older adults: retrospective cohort study. BMJ. 2009 Jan 7;338:a2752. doi: 10.1136/bmj.a2752. PubMed PMID: 19129307; PubMed Central PMCID: PMC2615549.

Article with unique publisher item identifier (pii) in place of traditional pagination or DOI:

Tegnell A, Dillner J, Andrae B. Introduction of human papillomavirus (HPV) vaccination in Sweden. Euro Surveill. 2009 Feb 12;14(6). pii: 19119. PubMed PMID: 19215721.

37. Monograph on the Internet [Edited 12 May 2009]

Foley KM, Gelband H, editors. Improving palliative care for cancer [Internet]. Washington: National Academy Press; 2001 [cited 2002 Jul 9]. Available from:

38. Homepage/Web site [Edited 12 May 2009] [Internet]. New York: Association of Cancer Online Resources, Inc.; c2000-01 [updated 2002 May 16; cited 2002 Jul 9]. Available from:

39. Part of a homepage/Web site [Edited 12 May 2009]

American Medical Association [Internet]. Chicago: The Association; c1995-2002 [updated 2001 Aug 23; cited 2002 Aug 12]. AMA Office of Group Practice Liaison; [about 2 screens]. Available from:

40. Database on the Internet [Edited 12 May 2009]

Open database:
Who's Certified [Internet]. Evanston (IL): The American Board of Medical Specialists. c2000 -   [cited 2001 Mar 8]. Available from:

Closed database:
Jablonski S. Online Multiple Congenital Anomaly/Mental Retardation (MCA/MR) Syndromes [Internet]. Bethesda (MD): National Library of Medicine (US); c1999 [updated 2001 Nov 20; cited 2002 Aug 12]. Available from:

41. Part of a database on the Internet [Edited 12 May 2009]

MeSH Browser [Internet]. Bethesda (MD): National Library of Medicine (US); 2002 -   . Meta-analysis [cited 2008 Jul 24]; [about 2 p.]. Available from: MeSH Unique ID: D017418.

42. Blogs [Added 12 May 2009]

Holt M. The Health Care Blog [Internet]. San Francisco: Matthew Holt. 2003 Oct -   [cited 2009 Feb 13]. Available from: [Internet]. New York: KidneyNotes. c2006 -   [cited 2009 Feb 13]. Available from:

Wall Street Journal. HEALTH BLOG: WSJ's blog on health and the business of health [Internet]. Hensley S, editor. New York: Dow Jones & Company, Inc. c2007 -   [cited 2009 Feb 13]. Available from:

Contribution to a blog:

Mantone J. Head trauma haunts many, researchers say. 2008 Jan 29 [cited 2009 Feb 13]. In: Wall Street Journal. HEALTH BLOG [Internet]. New York: Dow Jones & Company, Inc. c2008 -   . [about 1 screen]. Available from:

Campbell A. Diabetes and alcohol: do the two mix? (Part 2). 2008 Jan 28 [cited 2009 Feb 13]. In: Diabetes Self-Management Blog [Internet]. New York: Diabetes Self-Management. [2006 Aug 14] -   . 2 p. Available from:

Reider J. Docnotes: Health, Technology, Family Medicine and other observations [Internet]. [place unknown]: Jacob Reider. 1999 -   . CRP again ...; 2004 Apr 2 [cited 2009 Feb 13]; [about 1 screen]. Available from:

International Committee of Medical Journal Editors site

Preparing a Manuscript for Submission to a Medical Journal

Journal submissions should follow standard guidelines ( and be submitted to our email address ICHNFM @ gmail as linked above.  Additional details follow, sourced 2014Feb from:


1. General Principles

The text of articles reporting original research is usually divided into Introduction, Methods, Results, and Discussion sections. This so-called “IMRAD” structure is not an arbitrary publication format but a reflection of the process of scientific discovery. Articles often need subheadings within these sections to further organize their content. Other types of articles, such as meta-analyses, may require different formats, while case reports, narrative reviews, and editorials may have less structured or unstructured formats.

Electronic formats have created opportunities for adding details or sections, layering information, cross-linking, or extracting portions of articles in electronic versions. Supplementary electronic-only material should be submitted and sent for peer review simultaneously with the primary manuscript.

2. Reporting Guidelines

Reporting guidelines have been developed for different study designs; examples include CONSORT for randomized trials, STROBE for observational studies, PRISMA for systematic reviews and meta-analyses, and STARD for studies of diagnostic accuracy. Journals are encouraged to ask authors to follow these guidelines because they help authors describe the study in enough detail for it to be evaluated by editors, reviewers, readers, and other researchers evaluating the medical literature. Authors of review manuscripts are encouraged to describe the methods used for locating, select¬ing, extracting, and synthesizing data; this is mandatory for systematic reviews. Good sources for reporting guidelines are the EQUATOR Network and the NLM’s Research Reporting Guidelines and Initiatives.

3. Manuscript Sections

The following are general requirements for reporting within sections of all study designs and manuscript formats.

a. Title Page

General information about an article and its authors is presented on a manuscript title page and usually includes the article title, author information, any disclaimers, sources of support, word count, and sometimes the number of tables and figures.

Article title. The title provides a distilled description of the complete article and should include information that, along with the Abstract, will make electronic retrieval of the article sensitive and specific. Reporting guidelines recommend and some journals require that information about the study design be a part of the title (particularly important for randomized trials and systematic reviews and meta-analyses). Some journals require a short title, usually no more than 40 characters (including letters and spaces) on the title page or as a separate entry in an electronic submission system. Electronic submission systems may restrict the number of characters in the title.

Author information: Each author’s highest academic degrees should be listed, although some journals do not publish these. The name of the department(s) and institution(s) or organizations where the work should be attributed should be specified. Most electronic submission systems require that authors provide full contact information, including land mail and e-mail addresses, but the title page should list the corresponding authors’ telephone and fax numbers and e-mail address.

Disclaimers. An example of a disclaimer is an author’s statement that the views expressed in the submitted article are his or her own and not an official position of the institution or funder.

Source(s) of support. These include grants, equipment, drugs, and/or other support that facilitated conduct of the work described in the article or the writing of the article itself.

Word count. A word count for the paper’s text, excluding its abstract, acknowledgments, tables, figure legends, and references, allows editors and reviewers to assess whether the information contained in the paper warrants the paper’s length, and whether the submitted manuscript fits within the journal’s formats and word limits. A separate word count for the Abstract is useful for the same reason.

Number of figures and tables. Some submission systems require specification of the number of Figures and Tables before uploading the relevant files. These numbers allow editorial staff and reviewers to confirm that all figures and tables were actually included with the manuscript and, because Tables and Figures occupy space, to assess if the information provided by the figures and tables warrants the paper’s length and if the manuscript fits within the journal’s space limits.

Conflict of Interest declaration. Conflict of interest information for each author needs to be part of the manuscript; each journal should develop standards with regard to the form the information should take and where it will be posted. The ICMJE has developed a uniform conflict of interest disclosure form for use by ICMJE member journals and the ICMJE encourages other journals to adopt it. Despite availability of the form, editors may require conflict of interest declarations on the manuscript title page to save the work of collecting forms from each author prior to making an editorial decision or to save reviewers and readers the work of reading each author’s form.

b. Abstract

Original research, systematic reviews, and meta-analyses require structured abstracts. The abstract should provide the context or background for the study and should state the study’s purpose, basic procedures (selection of study participants, settings, measurements, analytical methods), main findings (giving specific effect sizes and their statistical and clinical significance, if possible), and principal conclusions. It should emphasize new and important aspects of the study or observations, note important limitations, and not overinterpret findings. Clinical trial abstracts should include items that the CONSORT group has identified as essential. Funding sources should be listed separately after the Abstract to facilitate proper display and indexing for search retrieval by MEDLINE.

Because abstracts are the only substantive portion of the article indexed in many electronic databases, and the only portion many readers read, authors need to ensure that they accurately reflect the content of the article. Unfortunately, information in abstracts often differs from that in the text. Authors and editors should work in the process of revision and review to ensure that information is consistent in both places. The format required for structured abstracts differs from journal to journal, and some journals use more than one format; authors need to prepare their abstracts in the format specified by the journal they have chosen.

The ICMJE recommends that journals publish the clinical trial registration number at the end of the abstract. The ICMJE also recommends that, when a registration number is available, authors list that number the first time they use a trial acronym to refer to the trial they are reporting or to other trials that they mention in the manuscript.

c. Introduction

Provide a context or background for the study (that is, the nature of the problem and its significance). State the specific purpose or research objective of, or hypothesis tested by, the study or observation. Cite only directly pertinent references, and do not include data or conclusions from the work being reported.

d. Methods

The guiding principle of the Methods section should be clarity about how and why a study was done in a particular way. The section should include only information that was available at the time the plan or protocol for the study was being written; all information obtained during the study belongs in the Results section.

i. Selection and Description of Participants

Clearly describe the selection of observational or experimental participants (healthy individuals or patients, in¬cluding controls), including eligibility and exclusion criteria and a description of the source population. Because the relevance of such variables as age, sex, or ethnicity is not always known at the time of study design, researchers should aim for inclusion of representative populations into all study types and at a minimum provide descriptive data for these and other relevant demographic variables. If the study was done involving an exclusive population, for example in only one sex, authors should justify why, except in obvious cases (e.g., prostate cancer).” Authors should define how they measured race or ethnicity and justify their relevance.

ii. Technical Information

Specify the study’s main and secondary objectives–usually identified as primary and secondary outcomes. Identify methods, equipment (give the manufacturer’s name and address in parentheses), and procedures in sufficient detail to allow others to reproduce the results. Give references to established methods, including statistical methods (see below); provide references and brief descrip¬tions for methods that have been published but are not well-known; describe new or substantially modified methods, give the reasons for using them, and evaluate their limitations. Identify precisely all drugs and chemicals used, including generic name(s), dose(s), and route(s) of administration. Identify appropriate scientific names and gene names.

iii. Statistics

Describe statistical methods with enough detail to enable a knowledgeable reader with access to the original data to judge its appropriateness for the study and to verify the reported results. When possible, quantify findings and present them with appropriate indicators of mea¬surement error or uncertainty (such as confidence intervals). Avoid relying solely on statistical hypothesis testing, such as P values, which fail to convey important information about effect size and precision of estimates. References for the design of the study and statistical methods should be to standard works when possible (with pages stated). Define statistical terms, abbreviations, and most symbols. Specify the statistical software package(s) and versions used. Distinguish prespecified from exploratory analyses, including subgroup analyses.

e. Results

Present your results in logical sequence in the text, tables, and figures, giving the main or most important findings first. Do not repeat all the data in the tables or figures in the text; emphasize or summarize only the most important observations. Provide data on all primary and secondary outcomes identified in the Methods Section. Extra or supplementary materials and technical details can be placed in an appendix where they will be accessible but will not interrupt the flow of the text, or they can be published solely in the electronic version of the journal.

Give numeric results not only as derivatives (for example, percentages) but also as the absolute numbers from which the derivatives were calculated, and specify the statistical significance attached to them, if any. Restrict tables and figures to those needed to explain the argument of the paper and to assess supporting data. Use graphs as an alternative to ta¬bles with many entries; do not duplicate data in graphs and tables. Avoid nontechnical uses of technical terms in statistics, such as “random” (which implies a randomizing device), “normal,” “significant,” “correlations,” and “sample.”

Separate reporting of data by demographic variables, such as age and sex, facilitate pooling of data for subgroups across studies and should be routine, unless there are compelling reasons not to stratify reporting, which should be explained.

f. Discussion

Emphasize the new and important aspects of the study and the conclusions that follow from them in the context of the totality of the best available evidence. Do not repeat in detail data or other information given in other parts of the manuscript, such as in the Introduction or the Results section. For experimental studies, it is useful to begin the discussion by briefly summarizing the main findings, then explore possible mechanisms or explanations for these findings, compare and contrast the results with other relevant studies, state the limitations of the study, and explore the implications of the findings for future research and for clinical practice.

Link the conclusions with the goals of the study but avoid unqualified statements and conclusions not adequately supported by the data. In particular, distinguish between clinical and statistical significance, and avoid making statements on economic benefits and costs unless the manuscript includes the appropriate economic data and analyses. Avoid claiming priority or alluding to work that has not been completed. State new hypotheses when war¬ranted, but label them clearly.

g. References

i. General Considerations Related to References

Authors should provide direct references to original research sources whenever possible. Although references to review articles can be an efficient way to guide readers to a body of literature, review articles do not always reflect original work accurately. On the other hand, extensive lists of references to original work on a topic can use excessive space. Fewer references to key original papers often serve as well as more exhaustive lists, particularly since references can now be added to the electronic version of published papers, and since electronic literature searching allows readers to retrieve published literature efficiently.

Do not use conference abstracts as references: they can be cited in the text, in parentheses, but not as page footnotes. References to papers accepted but not yet published should be designated as “in press” or “forthcoming.” Information from manuscripts submitted but not accepted should be cited in the text as “unpublished observations” with written permission from the source.

Avoid citing a “personal communication” unless it provides essential information not available from a public source, in which case the name of the person and date of communication should be cited in parentheses in the text. For scientific articles, obtain written permission and confirmation of accuracy from the source of a personal communication.

Some but not all journals check the accuracy of all reference citations; thus, citation errors sometimes appear in the published version of articles. To minimize such errors, references should be verified using either an electronic bibliographic source, such as PubMed, or print copies from original sources. Authors are responsible for checking that none of the references cite retracted articles except in the context of referring to the retraction. For articles published in journals indexed in MEDLINE, the ICMJE considers PubMed the authoritative source for information about retractions. Authors can identify retracted articles in MEDLINE by searching PubMed for "Retracted pub¬lication [pt]", where the term "pt" in square brackets stands for publication type, or by going directly to the PubMed’s list of retracted publications.

References should be numbered consecutively in the order in which they are first mentioned in the text. Identify references in text, tables, and legends by Arabic numerals in parentheses.

References cited only in tables or figure legends should be numbered in accordance with the sequence established by the first identification in the text of the particular table or figure. The titles of journals should be abbreviated according to the style used for MEDLINE ( Journals vary on whether they ask authors to cite electronic references within parentheses in the text or in numbered references following the text. Authors should consult with the journal to which they plan to submit their work.

ii. Reference Style and Format

References should follow the standards summarized in the NLM’s International Committee of Medical Journal Editors (ICMJE) Recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals: Sample References webpage and detailed in the NLM’s Citing Medicine, 2nd edition. These resources are regularly updated as new media develop, and currently include guidance for print documents; unpublished material; audio and visual media; material on CD-ROM, DVD, or disk; and material on the Internet.

h. Tables

Tables capture information concisely and display it efficiently; they also provide information at any desired level of detail and precision. Including data in tables rather than text frequently makes it possible to reduce the length of the text.

Prepare tables according to the specific journal’s requirements; to avoid errors it is best if tables can be directly imported into the journal’s publication software. Number tables consecutively in the order of their first citation in the text and supply a title for each. Titles in tables should be short but self-explanatory, containing information that allows readers to understand the table’s content without having to go back to the text. Be sure that each table is cited in the text.

Give each column a short or an abbreviated heading. Authors should place explanatory matter in footnotes, not in the heading. Explain all nonstandard abbreviations in footnotes, and use symbols to explain information if needed. Symbols may vary from journal to journal (alphabet letter or such symbols as *, †, ‡, §), so check each journal’s instructions for authors for required practice. Identify statistical measures of variations, such as standard deviation and standard error of the mean.

If you use data from another published or unpublished source, obtain permission and acknowledge that source fully.

Additional tables containing backup data too extensive to publish in print may be appropriate for publication in the electronic version of the journal, deposited with an archival service, or made available to readers directly by the authors. An appropriate statement should be added to the text to inform readers that this additional information is available and where it is located. Submit such tables for consideration with the paper so that they will be available to the peer reviewers.

i. Illustrations (Figures)

Digital images of manuscript illustrations should be submitted in a suitable format for print publication. Most submission systems have detailed instructions on the quality of images and check them after manuscript upload. For print submissions, figures should be either professionally drawn and photographed, or submitted as photographic-quality digital prints.

For X-ray films, scans, and other diagnostic images, as well as pictures of pathology specimens or photomicrographs, send high-resolution photographic image files. Since blots are used as primary evidence in many scientific articles, editors may require deposition of the original photographs of blots on the journal’s website.

Although some journals redraw figures, many do not. Letters, numbers, and symbols on figures should therefore be clear and consistent throughout, and large enough to remain legible when the figure is reduced for publication. Figures should be made as self-explanatory as possible, since many will be used directly in slide presentations. Titles and detailed explanations belong in the legends—not on the illustrations themselves.

Photomicrographs should have internal scale markers. Symbols, arrows, or letters used in photomicrographs should contrast with the background. Explain the internal scale and identify the method of staining in photomicrographs.

Figures should be numbered consecutively according to the order in which they have been cited in the text. If a figure has been published previously, acknowledge the original source and submit written permission from the copyright holder to reproduce it. Permission is required irrespective of authorship or publisher except for documents in the public domain.

In the manuscript, legends for illustrations should be 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, identify and explain each one clearly in the legend.

j. Units of Measurement

Measurements of length, height, weight, and volume should be reported in metric units (meter, kilogram, or liter) or their decimal multiples.

Temperatures should be in degrees Celsius. Blood pressures should be in millimeters of mercury, unless other units are specifically required by the journal.

Journals vary in the units they use for reporting hematologic, clinical chemistry, and other measurements. Authors must consult the Information for Authors of the particular journal and should report laboratory information in both local and International System of Units (SI).

Editors may request that authors add alternative or non-SI units, since SI units are not universally used. Drug concentrations may be reported in either SI or mass units, but the alternative should be provided in parentheses where appropriate.

k. Abbreviations and Symbols

Use only standard abbreviations; use of nonstandard abbreviations can be confusing to readers. Avoid abbreviations in the title of the manuscript. The spelled-out abbreviation followed by the abbreviation in parenthesis should be used on first mention unless the abbreviation is a standard unit of measurement.





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