Provide direct references to original research sources whenever possible but avoid extensive lists of references to original work on a topic. Small numbers of references to key original papers will serve as well as more exhaustive lists, since electronic literature searching allows readers to retrieve published literature efficiently. Where available, Digital Object Identifiers (DOIs) or URLs for the references should be provided Avoid using abstracts as references. References to papers accepted but not yet published should be designated as “in press” or “forthcoming”; authors should obtain written permission to cite such papers as well as verification that they have been accepted for publication. Information from manuscripts submitted but not accepted should be cited in the text as “unpublished observations” with written permission from the source.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, authors should obtain written permission and confirmation of accuracy from the source of a personal communication. To minimize citation errors, authors should verify references against original documents. 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 MEDLINE-indexed journals, the ICMJE considers PubMed ( the authoritative source for information about retractions.

References should be cited as follows:

  1. In the text, tables and legends references should be indicated using Arabic numerical superscripts corresponding to their listing at the end of the manuscript. For instance:

    The wound should be irrigated with clean water.5Meara6 advocates debridement with a sponge.

    All non-original material should acknowledge the source reference; direct quotations should be enclosed in quotation marks and cited. Parapharasing does not render material original, and should be avoided.

2. At the end of the manuscript, references should be numbered consecutively in the order in which they are first mentioned in the text.

3. 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.


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