The Ticino Medical Tribune (TMT) applies a zero-tolerance policy toward scientific misconduct and adheres to the recommendations of the
Committee on Publication Ethics (COPE), the World Association of Medical Editors (WAME), and the International Committee of Medical Journal Editors (ICMJE).
All reports or suspicions of misconduct are evaluated case by case, with attention to fairness, confidentiality, and transparency.

Each report must be sent to:
Editorial Manager: tmt@usi.ch

Types of misconduct
Scientific misconduct includes, but is not limited to, the following:

• Data falsification or fabrication: intentional manipulation, omission of contradictory results, or fraudulent alteration of data.
• Plagiarism or redundant publication: use of another person’s text, ideas, or images without proper citation; duplication or republication of the same material in multiple journals.
• Simultaneous submission: submitting the same manuscript to more than one journal at the same time.
• Authorship irregularities: improper inclusion or exclusion of authors, lack of consent from all co-authors.
• Misappropriation of ideas: misuse of information obtained during peer review or grant evaluation processes.
• Deviation from good research practices: inappropriate experimental or statistical manipulation, failure to declare conflicts of interest or funding sources.
• Violation of legal or ethical standards: noncompliance with laws or regulations on research involving humans or animals, or improper use of funds or materials.
• Improper conduct in handling allegations: unfounded or knowingly false accusations, withholding relevant information, or retaliation against whistleblowers or reviewers.
• “Salami publication”: unjustified fragmentation of results from a single study across multiple papers, considered a form of redundant publication.

Articles submitted to TMT must be original, not previously published, and not under consideration elsewhere.

Handling allegations of misconduct
TMT takes every allegation of scientific, editorial, or professional misconduct seriously. Allegations made by whistleblowers will be taken into account and investigated as well.
Suspected cases may be reviewed in collaboration with the journal’s Scientific Committee or with independent experts.
Pending investigation, the Editorial Board may issue an Expression of Concern or adopt other corrective measures.

When necessary, TMT may:
employ automated tools to detect plagiarism or image manipulation;
reject or retract papers suspected of fraudulent activity (e.g., “paper mills”);
cooperate with other publishers or institutions, in line with data protection laws and COPE guidance;
report confirmed cases to appropriate authorities.

Plagiarism detection
TMT may use plagiarism detection services to compare manuscripts against published scientific literature and web content.

Monitoring and follow-up
In cases of prior integrity concerns, TMT may apply enhanced scrutiny to future submissions by the same author or reviewer. Such measures are implemented proportionately and confidentially, with clear justification.

The Ticino Medical Tribune (TMT) follows a strict policy to protect patient privacy and confidentiality, in accordance with the ethical principles of good clinical practice and the recommendations of the
Committee on Publication Ethics (COPE), the General Medical Council (GMC), and the European General Data Protection Regulation (GDPR – EU 2016/679).

Any manuscript containing personal data or identifiable clinical information must comply with TMT’s standards on anonymisation and informed consent for publication.
TMT reserves the right to refuse publication of any paper that fails to meet these requirements.

Patient consent for publication
Any article that includes personal medical information referring to an identifiable living individual requires the patient’s explicit written consent prior to publication.

Consent must be obtained through a specific publication consent form, which:

• is written in a language understandable to the patient;
• confirms that the patient has read and understood the material to be published;
• specifies, if applicable, that consent was given without reviewing the final version of the manuscript, stating clearly what the patient has seen.

The published article must include a statement confirming that informed consent for publication has been obtained.

If the patient cannot be traced, publication is possible only if the information is fully anonymised, so that neither the patient nor any third party could reasonably identify them.
Anonymisation, however, may result in loss of detail or contextual information.

Best practices for obtaining consent
Authors must:

• explain clearly to the patient (or legal representative) the purpose of publication and the potential risks of identification;
• ensure that consent is freely given, informed, and documented;
• keep a copy of the signed consent form and provide it to the Editorial Office if requested.

Deceased patients
The publication of data from deceased patients is possible only with the prior approval of the ethics committee. 

Minors
For patients under 18 years of age, written consent from parents or legal guardians is required.
If the child has adequate understanding of the consent process, the child must also sign the consent form.
Authors should consider that the individual may, in the future, not wish identifiable information to remain public.
The final decision to publish material involving minors rests with the Editor-in-Chief, who may seek advice from the Editorial Ethics Committee for complex or sensitive cases.

Patients lacking capacity
When a patient lacks mental capacity to make decisions, generally no one can give consent on their behalf, unless a legally recognized representative (e.g., under a health or welfare power of attorney) is authorized to do so in the patient’s best interests.
In the absence of clear benefit to the patient, TMT will publish only fully anonymized information.

Images and multimedia content
If there is any possibility that a patient could be identified from a photograph, video, or accompanying text, written consent for publication is required.
No consent is required for non-identifiable medical images (such as radiographs, ultrasound scans, pathology slides, or images of non-distinctive body parts) provided they are anonymised and not accompanied by text that could reveal identity.
TMT does not accept photographs altered with blurring or black bars over the eyes, as these methods do not ensure true anonymity and may suggest that consent was not obtained.
Images should be cropped appropriately to preserve patient dignity and privacy.
Images must be provided in a flattened format (TIFF or JPEG) with all editable layers removed, ensuring that deleted portions cannot be restored and protecting the patient’s confidentiality.

Standard for anonymisation
TMT acknowledges that complete anonymisation can never be guaranteed, particularly given the increasing availability of personal data in the public domain and on social media.
The aim of this policy is to strike a balance between:

• protecting the privacy and dignity of patients, and
• enabling the responsible distribution of clinically relevant information.

An article is considered sufficiently anonymised when:

• it contains no direct identifiers, and
• no more than two indirect identifiers (such as precise age, location, or unique clinical features).

Authors must ensure that the removal or generalisation of identifiers does not compromise scientific accuracy or understanding.

Patient consent form
The authors must have obtained informed consent for publication in TMT for any material (text, image, audio, or video) that requires patient authorization.

The informed consent must be:

• completed and signed by the patient or legal representative (and, where appropriate, by the author/physician);
• written in a language the signatory can fully understand.

TMT may request a copy of the consent from the author.

The Ticino Medical Tribune (TMT) recognizes that only those who have made a substantial intellectual contribution to a scientific work should be credited as authors.
This policy ensures that all contributors understand their role, take responsibility and accountability for the published content, and receive appropriate recognition.

TMT distinguishes between:

• Authors: individuals who meet all four ICMJE authorship criteria;
• Non-author contributors: individuals who contributed substantially but do not meet all criteria for authorship.

Each article must include:

• an author list, published on the first page;
• a contributorship statement, at the end of the article, specifying who did what in the conception, execution, and reporting of the work;
• an optional acknowledgements section, listing those who assisted but do not qualify as contributors.

Authorship criteria
To qualify as an author, an individual must meet all four of the following criteria established by the International Committee of Medical Journal Editors (ICMJE, 2019):
Substantial contributions to the conception or design of the study, or to the acquisition, analysis, or interpretation of data;
Drafting the manuscript or revising it critically for important intellectual content;
Final approval of the version to be published;
Agreement to be accountable for all aspects of the work, ensuring that questions related to accuracy or integrity are appropriately investigated and resolved.
Only natural persons can be recognized as authors.
Anyone who meets the criteria must be listed as an author; those who do not meet them cannot be credited.
Each author should know the contributions of their co-authors and be able to take responsibility for their own work.

Specific roles

1. Submitting and corresponding author
   The submitting author is responsible for submitting the manuscript to the journal, communicating with the editorial office, and ensuring that all administrative and ethical requirements are met (authorship details, ethics approvals, trial registration, conflict-of-interest forms, etc.).
   The corresponding author maintains contact with the journal and readers after publication. The same person may serve in both roles.

2. Joint first authorship
   When two or more authors have contributed equally, this may be indicated in the contributorship statement with the phrase: “Authors X and Y contributed equally to this work.”.

3. Group authorship or collaborators
   For research groups, consortia, or multicentre studies, all members listed as authors must meet the four ICMJE criteria.
   The group name should appear in the author list, and individual members may be listed in a collaborator statement or appendix.

4. Deceased authors
   If an author dies during the preparation of the work, they may be included as an author if they made a substantial contribution and it is likely they would have approved the final version.
   The contributorship statement should describe their contribution and may include a brief dedication.
   Deceased authors cannot serve as corresponding authors or guarantors; these roles must be reassigned to living co-authors.

Use of Artificial Intelligence (AI)
AI technologies cannot be credited as authors.
If AI tools are used, their use must be transparently declared, specifying: which technology was used, for what purpose, and how it was used.
If AI was used during research, the description must appear in the Methods section; if used in writing or editing, it should be included in the Contributors section.

Contributorship statement
Every manuscript must include a detailed contributorship statement, outlining the roles and responsibilities of each author and collaborator — for example:
“Designed the study,” “analyzed the data,” “drafted the manuscript,” “supervised the research.”
The statement must also identify the guarantor of the work — the author who assumes overall responsibility for the study’s integrity, data accuracy, and the decision to publish.
All contributors named in this section must provide permission to be mentioned, as inclusion implies agreement with the data and conclusions.

Acknowledgements
An acknowledgements section may be included at the end of the article to thank individuals or organizations who provided technical, administrative, or logistical assistance but did not contribute scientifically.
Authors must obtain explicit consent from all individuals mentioned, since acknowledgment may imply endorsement of the work.

Changes in authorship
Any change to the author list (addition, removal, or reordering) after submission must be approved by all authors and explained in writing to the editorial office.
TMT reserves the right to contact authors directly to verify their agreement.

The Ticino Medical Tribune (TMT) takes seriously all complaints concerning editorial content, procedures, or policies under its responsibility.
Complaints are considered an opportunity to improve transparency and editorial quality.
TMT is committed to responding promptly, courteously, and constructively, while ensuring fairness and confidentiality for both complainants and those subject to complaints.

Each enquiry appeal or complaint must be sent to: tmt@usi.ch

Definition of a complaint and of an appeal
A complaint is defined as:

• any communication explicitly identified as a complaint by the sender, or
• any issue that goes beyond simple disagreement with an editorial decision and indicates a perceived procedural error or editorial misjudgment.

Complaints must concern matters within the responsibility of the Editorial Board or editorial staff.
Requests to appeal editorial rejection decisions follow a separate appeals procedure.

An appeal is defined as:
a formal request by an author to have an editorial decision reconsidered. It is submitted when the author believes that an error, misunderstanding, or oversight occurred during the review or evaluation process. Appeals must be supported with clear justification and are assessed by editorial staff who were not involved in the original decision.

How to make a complaint/appeal
Complaints/appeals should be submitted by email to Editorial Manager: tmt@usi.ch
with the subject line: Editorial Complaint/Appeal – Ticino Medical Tribune.
All complaints and appeals are handled confidentially and reviewed by the Editorial Board.

Complaint and Appeal Procedure

1. Submission
   Complaints or appeals must be submitted in writing.
   Appeals regarding editorial decisions must be submitted within 30 days of receiving the decision.
   The submission must include a clear and documented explanation of the issue or the aspects of the decision being contested.
   Acknowledgment of receipt: within 4 working days.
2. Receipt and Assessment
   A designated editorial representative reviews the complaint or appeal to determine its relevance and completeness.
3. Assignment
   The case is forwarded to the appropriate responsible person, such as the Editor-in-Chief, an Associate Editor, or a member of the Editorial Board not involved in the original decision.
4. Initial Response
   An initial reply is provided within the standard timeframe.
5. Review Process
   The Editor-in-Chief, possibly in consultation with a senior Editorial Board member, reassesses the case.
   If necessary, a new independent review may be requested. If further investigation is required, an interim reply will be provided within two weeks, followed by updates until resolution.
6. Escalation
   If the author is not satisfied with the initial handling, the case may be escalated to the Editor-in-Chief or the Scientific Committee for an independent evaluation.
7. Final Decision
   The outcome of the complaint or appeal is communicated within 4–6 weeks.
   The decision of the Editor-in-Chief is final within the journal’s internal process.
8. External Appeal
   If the issue concerns an unresolved ethical matter, it may be referred externally in according with Committee on Publication Ethics (COPE) procedures.
   
   TMT reserves the right not to respond individually to frivolous, repetitive, or vexatious complaints/appeals.

Complaints about advertisements
Complaints regarding advertising content published in the Ticino Medical Tribune should first be directed to the advertiser.
If no response is received, the complainant may contact the editorial office at tmt@usi.ch.

External bodies
If, after completing the internal procedure, the complainant remains dissatisfied, they may contact the following bodies:

• Committee on Publication Ethics (COPE)
  for unresolved ethical issues related to editorial conduct publicationethics.org
• National regulatory authorities
  for complaints related to advertising or professional standards in the medical field

Guiding principles
The complaints/appeals process of the Tribuna Medica Ticinese is based on the following principles:

• Impartiality, ensuring fair consideration for all parties involved;
• Confidentiality, protecting the identity of authors, reviewers, and complainants;
• Transparency, documenting decisions and actions taken;
• Accountability, correcting mistakes and improving editorial processes.

In line with the principles of transparency and scientific integrity, Ticino Medical Tribune requires all authors, reviewers, and editors to declare any financial or non-financial conflicts of interest that could influence — or be perceived as influencing — the content of the work, the interpretation of data, or editorial decisions.

Definition of Conflict of Interest
A conflict of interest is any financial or non-financial interest that may compromise, or appear to compromise, the objectivity, integrity, or scientific value of a publication.

1. Financial Conflicts of Interest
   These may include, but are not limited to:

• funding, grants, or support from entities with an interest in the content of the article;
• recent, current, or anticipated employment with organizations that may benefit or be disadvantaged by the publication;
• equity holdings, honoraria, consultancy fees, patents, or patent applications that could be affected by the study findings.

2. Non-Financial Conflicts of Interest
   These may include:

• unpaid roles in governmental bodies, NGOs, advocacy groups, or companies;
• relevant personal, professional, or academic relationships;
• consultancy, teaching activities, or service as an expert witness.

Authors’ Responsibilities
At submission, the corresponding author must declare in the cover letter the presence or absence of conflicts of interest for each author.
Each published article must include, at the end of the manuscript, a statement indicating whether any conflicts of interest exist.

Reviewers’ Responsibilities
Reviewers must promptly declare any potential conflict of interest that could influence their judgment (e.g., financial ties, collaborations, or personal relationships with the authors).
If a conflict of interest is identified, the reviewer must decline the review assignment.

Editors’ and Editorial Board Members’ Responsibilities
Editors must declare to the journal any interests that could influence editorial decisions.
Editors or editorial board members who are authors of a submitted manuscript, or who have relevant interests, will be excluded from handling that article; it will instead be assigned to an independent editor.

Editorial Independence
Editorial decisions at Ticino Medical Tribune are made autonomously, free from commercial or financial influence.
Any agreements with funders or sponsors that could raise concerns of influence will be publicly disclosed.

Any study involving the collection of original data from human subjects requires prior approval from a research ethics committee. In addition, study participants must provide informed consent to take part in the research. Authors must report the name of the ethics committee and the date of approval within the article.

If the authors believe that ethics committee approval and informed consent are not required, it is their responsibility to request authorisation from the relevant ethics committee to be exempted from these procedures. They must then declare this exemption within the manuscript.

All sources of financial support must be declared under the heading “Funding”, placed at the end of the manuscript (before the references).

Authors are required to specify the role of any funding organisation(s) in:

• the study design,

• the collection, analysis, and interpretation of data,

• the writing of the manuscript,

• the decision to submit the article for publication.

If the funder(s) had no involvement in any of these stages, this must be clearly stated.

If an author is affiliated with an organisation that funded the study, a disclaimer must be included indicating whether that organisation influenced the content of the article.
Example: “The funder had no influence on the results or conclusions of the study despite the author’s affiliation with the funding organisation.”

The journal follows the Committee on Publication Ethics (COPE) recommendations regarding:

• Retractions: in cases of significant errors, research misconduct, or duplicate publication.
• Corrections: for minor errors that do not affect the main findings or conclusions of the study.
• Expressions of concern: when an article is under investigation but conclusive evidence is not yet available.

Readers may send critical comments or concerns about published articles to the following address: tmt@usi.ch
Readers are also welcome to submit letters commenting on published articles.
The Editorial Board will evaluate such letters and decide whether they are suitable for publication in the journal.