1. Originality and Exclusive Submission

Manuscripts submitted to Health Nexus must present original scholarly work and must not involve plagiarism, unauthorized duplicate publication, misleading reuse of previously published material, or simultaneous consideration by another journal.

Authors must confirm that:

• The manuscript contains an original contribution appropriate to its article type.
• The same or substantially equivalent manuscript is not under simultaneous consideration by another scholarly journal.
• Previously published material is accurately cited, attributed, and distinguished from the present contribution.
• Relevant prior dissemination, related manuscripts, and potentially overlapping publications have been disclosed to the Editorial Office.
• Quoted, paraphrased, translated, and adapted material is appropriately acknowledged.
• Research results are not improperly divided into multiple publications in a way that misrepresents the originality or significance of the findings.
• All necessary permissions have been obtained for the lawful reuse of protected material.

1.1 Preprints and Prior Dissemination

The existence of a preprint, thesis, conference abstract, institutional report, or other form of prior dissemination does not necessarily constitute duplicate publication. Authors must disclose relevant prior versions and provide sufficient information for the Editorial Office to assess originality, rights, overlap, and publication eligibility.

Authors should identify the location, date, and status of relevant prior dissemination, including available DOIs or permanent links. Manuscripts derived from previous research outputs must provide a clearly identifiable scholarly contribution beyond the earlier material.

1.2 Plagiarism and Textual Overlap

Plagiarism, unattributed paraphrasing, misleading appropriation of ideas, and improper reuse of substantial previously published text are prohibited. Reuse of an author's own published material must also comply with relevant attribution, copyright, and publication transparency requirements.

2. Authorship Criteria

All listed authors must make a genuine scholarly contribution and meet the journal's authorship requirements, consistent with the recommendations of the International Committee of Medical Journal Editors (ICMJE).

Each listed author must satisfy all four of the following criteria:

1. Substantial Scholarly Contribution: Make substantial contributions to the conception or design of the work, or to the acquisition, analysis, or interpretation of relevant research data.
2. Manuscript Development: Participate in drafting the manuscript or critically reviewing it for important intellectual content.
3. Final Approval: Approve the version intended for publication.
4. Accountability: Agree to be accountable for the integrity of the work and to ensure that questions concerning accuracy or integrity are appropriately investigated and resolved.

All four criteria are cumulative. Funding acquisition, general supervision, institutional authority, administrative assistance, language editing, or technical support alone does not establish authorship.

2.1 Author Contributions and Acknowledgments

Authors must provide accurate contribution information where required. Individuals who contribute to a study but do not satisfy all applicable authorship criteria should be appropriately acknowledged, subject to relevant consent and attribution requirements.

Gift authorship, ghost authorship, honorary authorship, and the exclusion of eligible contributors are unacceptable.

2.2 Authorship Changes

Requests to add, remove, or reorder authors after submission must be supported by an explanation and documented agreement from all affected and listed authors, including individuals proposed for addition or removal. The Editorial Office may request further documentation or institutional clarification.

Authorship disputes that cannot be resolved through documented agreement may require assessment by the institutions where the research was conducted. Editorial approval is required before an authorized change is incorporated into the official manuscript record.

2.3 Corresponding Author Responsibilities

The corresponding author is responsible for coordinating submission, confirming the agreement of all authors, ensuring the completeness of required declarations, communicating editorial decisions, and providing accurate publication information. This administrative role does not remove the individual accountability of other coauthors.

3. Ethical Approval and Consent

Research involving human participants, animals, clinical records, biological materials, or other ethically sensitive information must comply with applicable ethical oversight, informed consent, welfare, confidentiality, and legal requirements.

3.1 Human Subjects

For research involving human participants, authors must:

• Obtain approval from an appropriate institutional review board, research ethics committee, or other authorized body where required.
• Report the approving institution, approval identifier, and relevant approval date where available and appropriate.
• Obtain informed consent where required, or document an appropriately authorized consent waiver.
• Protect participants' privacy, confidentiality, autonomy, and relevant welfare interests.
• Explain relevant recruitment, sampling, intervention, or data collection procedures sufficiently for ethical and scientific assessment.
• Report material ethical restrictions, risks, and safeguards relevant to the research.

Where ethics review is not required or an exemption applies, authors must provide an accurate explanation of the legal, institutional, or ethical basis for that determination. The Editorial Office may request supporting documentation.

3.2 Animal Studies

Animal experiments must comply with applicable institutional and national animal welfare requirements.

• Obtain approval from the appropriate animal ethics or welfare body where required.
• Describe the species, relevant study conditions, procedures, and welfare safeguards.
• Apply appropriate measures to minimize unnecessary suffering and distress.
• Describe humane endpoints, monitoring, and relevant experimental procedures where applicable.
• Follow relevant ARRIVE reporting guidelines and other applicable standards.

3.3 Clinical Records, Biological Materials, and Secondary Data

Research using patient records, archived specimens, clinical registries, institutional databases, or previously collected human data must comply with applicable ethics review, data protection, consent, and secondary-use requirements.

Public availability of a dataset does not automatically eliminate all ethical or contractual responsibilities associated with its use. Authors must respect lawful access conditions and properly acknowledge the original data sources.

3.4 Consent for Publication

Identifiable clinical information, patient photographs, medical images, detailed case histories, or other materials that could reveal an individual's identity must not be published without an appropriate legal and ethical basis and the required consent or authorization.

Research participation consent and consent for publication are separate considerations. Authors must ensure that the applicable publication requirements are satisfied.

3.5 Traditional and Integrative Medical Research

Clinical investigations involving TCM, herbal products, acupuncture, traditional interventions, or integrative treatment approaches are subject to appropriate ethical approval, safety monitoring, consent, and study reporting standards. Historical, textual, and theoretical studies are assessed according to their actual research methods; such studies do not automatically require clinical ethics approval when no human or animal research is conducted.

4. Clinical Trial Registration

Health Nexus requires prospective registration of applicable clinical trials in a publicly accessible and appropriate clinical trial registry.

A clinical trial generally includes research that prospectively assigns individuals or groups to health-related interventions to evaluate their effects on health outcomes. This may include pharmaceutical, surgical, behavioral, educational, traditional medical, or other healthcare interventions.

4.1 Registration Requirements

• Register the trial at or before the first participant's consent for enrollment, consistent with applicable ICMJE registration requirements.
• Use an appropriate publicly accessible registry, such as ClinicalTrials.gov or an eligible WHO International Clinical Trials Registry Platform primary registry.
• Provide the registry name, registration identifier, and date of registration in the manuscript.
• Describe relevant changes to registered interventions, primary outcomes, study design, or other material protocol information.
• Ensure that the registration record accurately represents the trial and its relevant data sharing arrangements.

4.2 Retrospective Registration

Retrospective registration does not automatically satisfy the journal's requirement for prospective registration. Authors must explain the circumstances, provide the relevant dates, and disclose the registration history. Exceptions may be considered only in unusual and justified circumstances at the journal's editorial discretion, consistent with applicable standards.

4.3 Clinical Trial Data Sharing

Manuscripts reporting clinical trial results must include an appropriate data sharing statement. Trials beginning participant enrollment on or after January 1, 2019, must also include a data sharing plan in the trial registration record, consistent with ICMJE recommendations. These requirements do not authorize unrestricted public release of protected individual participant data.

5. Data Integrity and Availability

Authors must ensure the integrity, reliability, and appropriate documentation of the data and research materials supporting their manuscripts.

Authors are responsible for:

• Accurate recording and reporting of research observations, measurements, and analytical results.
• Avoiding fabrication, falsification, misleading omissions, and inappropriate alteration of evidence.
• Documenting relevant sampling, exclusion, preprocessing, data transformation, and analytical procedures.
• Reporting missing data, methodological limitations, uncertainty, and material deviations from research protocols where applicable.
• Maintaining supporting records in accordance with applicable institutional, funder, ethical, and legal retention requirements.
• Providing appropriate information to support scholarly scrutiny and research verification.

5.1 Mandatory Data Availability Statement

Responsible sharing of supporting data is encouraged wherever ethically appropriate, legally permissible, and technically feasible. The journal does not require public disclosure of identifiable patient information, protected clinical datasets, confidential research records, or other restricted materials.

5.2 Research Verification

The Editorial Office may request supporting data, original research records, analytical code, protocols, images, or other relevant documentation during manuscript assessment or after publication where reasonably necessary to verify findings or investigate a material concern.

Where legal or ethical restrictions prevent direct transfer of records, authors should explain the restrictions and cooperate with an appropriate alternative verification procedure where possible. Further provisions are set out in the Data Policy.

6. Conflict of Interest Disclosure

All authors must disclose relationships, affiliations, or interests that could reasonably be perceived as influencing the conduct, interpretation, or reporting of their research.

Relevant competing interests may include:

• Financial Interests: Employment, consulting fees, honoraria, equity, royalties, patents, stock options, or other financial relationships.
• Institutional Interests: Organizational appointments, professional roles, contractual relationships, or affiliations relevant to the research.
• Personal and Professional Relationships: Relationships that may materially affect, or appear to affect, independent scholarly judgment.
• Intellectual and Academic Interests: Relevant professional commitments, competing scholarly positions, or interests affecting the interpretation of evidence.
• Other Relevant Interests: Relationships with commercial, governmental, clinical, or other organizations that may reasonably be relevant to the submitted work.

6.1 Declaration Requirements

Authors must provide a complete Competing Interests Statement. Where no relevant competing interests exist, an explicit declaration to that effect is required.

The existence of a competing interest does not automatically disqualify a manuscript from publication. Editors assess whether the interest has been disclosed adequately and whether it creates an unacceptable risk to the independence or integrity of the research.

6.2 Double-Blind Review

Complete author-identifying declarations must be available to the Editorial Office. Identifying information must be excluded or appropriately anonymized in files designated for external double-blind review and restored accurately before publication.

7. Funding Transparency

Authors must disclose all relevant sources of financial support for their research and identify the role of funding organizations or sponsors where applicable.

A Funding Statement should include:

• The official name of each funding organization.
• Relevant grant numbers or funding identifiers where available.
• The recipients of relevant grants or financial support where necessary for transparency.
• The role of sponsors in study design, participant recruitment, data collection, analysis, interpretation, and manuscript preparation.
• Any sponsor involvement in decisions concerning submission or publication.
• An explicit declaration where no specific external funding was received.

Authors must describe any material contractual restrictions affecting access to research data, independent analysis, or the publication of findings.

Funding disclosure is separate from the Competing Interests Statement. Both must be completed where required, even when the same organization is relevant to each declaration.

8. Use of Artificial Intelligence (AI)

Health Nexus permits responsible use of artificial intelligence and AI-assisted technologies for appropriate scholarly activities, subject to transparent disclosure, human verification, research integrity, and relevant confidentiality and ethical safeguards.

8.1 Permitted AI Assistance

Permitted uses may include:

• Language editing, translation, grammar correction, and improvement of manuscript readability.
• Literature organization and research information processing.
• Coding assistance, debugging, and computational workflow support.
• AI-assisted data analysis, classification, modelling, and image processing when scientifically appropriate.
• Development or evaluation of AI systems as the subject of legitimate research.
• Creation of clearly identified synthetic data, simulations, or illustrative materials for lawful and scientifically justified purposes.

8.2 Disclosure and Human Responsibility

• Authors must disclose relevant generative AI use in writing, translation, analysis, coding, or scientific content preparation.
• Material AI-assisted research procedures must be described in the Methods section or other appropriate location.
• Authors must independently evaluate AI-generated or AI-assisted scientific claims, results, interpretations, and references.
• All authors remain accountable for the final manuscript and the integrity of the reported research.
• AI tools and automated systems must not be listed as authors.

8.3 Prohibited AI Practices

Authors must not use AI to fabricate clinical observations, falsify research data, invent references, misrepresent synthetic materials as authentic evidence, or disclose confidential patient information without appropriate authorization.

Conventional non-generative spelling or formatting functions that do not generate substantive content do not ordinarily require separate AI disclosure. The specific declaration requirements are governed by the journal's AI & Research Integrity Policy.

For detailed requirements, consult the AI & Research Integrity Policy.

9. Image and Data Integrity

All research images, figures, tables, datasets, clinical records, and other evidentiary materials must accurately reflect the observations and procedures from which they were derived.

9.1 Scientific Images

Authors must:

• Avoid manipulation that changes or misrepresents the scientific meaning of an image.
• Describe material image-processing methods and relevant adjustments.
• Identify reconstructed, synthetic, AI-generated, or materially altered scientific images where applicable.
• Retain original or appropriately documented source images where available and required.
• Avoid misleading duplication, selective removal, inappropriate compositing, or other practices that falsify visual evidence.
• Protect confidential or identifiable clinical image content.

9.2 Data Processing and Analytical Integrity

Data exclusions, transformations, imputation, normalization, preprocessing, and relevant statistical or computational decisions must be performed using appropriate methods and described sufficiently to permit scholarly evaluation.

Legitimate data transformation and image processing are permitted when they are appropriate to the research design and reported transparently. Fabrication, falsification, and misleading alteration of evidence are prohibited.

9.3 Requests for Original Materials

The Editorial Office may request original images, processing records, relevant code, or other supporting materials where necessary to assess a scientific or ethical concern. Any request must respect applicable privacy, institutional, ethical, and legal restrictions.

10. Permissions and Copyright

Authors must ensure that all materials included in a submitted manuscript are used lawfully and that relevant copyright, licensing, source attribution, and publication permission requirements have been satisfied.

10.1 Third-Party Materials

Authors must appropriately manage rights associated with:

• Previously published figures, tables, photographs, and illustrations.
• Clinical photographs, diagnostic images, and other potentially identifiable materials.
• Copyrighted questionnaires, clinical instruments, diagnostic scales, and research materials.
• Third-party datasets, software, diagrams, maps, and other protected content.
• Materials obtained under contractual, institutional, or repository access conditions.

Permission must be obtained where legally required. Separate permission may be unnecessary where the material is covered by a suitable open licence, falls within the public domain, or is lawfully used under an applicable exception.

10.2 Open-Access Licensing

Health Nexus ordinarily publishes articles under the Creative Commons Attribution 4.0 International Licence (CC BY 4.0), unless otherwise identified in an individual article's rights statement.

Authors ordinarily retain copyright in their original scholarly contributions, subject to applicable lawful ownership arrangements, and grant the publisher non-exclusive publication rights. Authors must ensure that third-party rights do not conflict with the proposed publication and licensing arrangements.

10.3 Research Participants and Privacy

Copyright permission does not replace required patient consent, confidentiality protections, or lawful authorization to publish identifiable clinical information.

For further information, consult the Copyright & Licensing Policy.

11. Reporting Standards

Authors must follow appropriate reporting guidelines for their research design. Reporting guidelines support transparency, completeness, and the reliable interpretation of scholarly findings.

Relevant guidelines include:

• CONSORT: Randomized controlled trials.
• PRISMA: Systematic reviews and meta-analyses.
• STROBE: Observational research.
• CARE: Clinical case reports.
• STRICTA: Acupuncture interventions, where applicable.
• ARRIVE: In vivo animal experiments.
• STARD: Diagnostic accuracy studies.
• TRIPOD+AI: Relevant clinical prediction model studies.
• CONSORT-AI and SPIRIT-AI: Applicable clinical trials involving AI interventions and their study protocols.
• Other Appropriate Guidelines: Relevant standards for qualitative research, health economics, medical imaging, public health, and other specialized methods.

11.1 Reporting Documentation

Authors must provide appropriate reporting checklists, study protocols, flow diagrams, and supporting documentation where required by the article type or Editorial Office.

Reporting should include relevant study design information, methods, results, uncertainty, limitations, and ethically important information necessary for evaluation.

11.2 Theoretical and Historical Scholarship

Manuscripts based on conceptual analysis, history of medicine, traditional medical texts, philosophical interpretation, or theoretical inquiry must apply suitable scholarly methods, accurate source attribution, and transparent reasoning. Clinical reporting checklists are not automatically applicable to research that does not involve the corresponding clinical study design.

12. Misconduct and Ethical Violations

Health Nexus evaluates concerns involving suspected research or publication misconduct according to its Publication Ethics Policy and applicable principles of confidentiality, evidence-based assessment, proportionality, and procedural fairness.

12.1 Potential Ethical Violations

Concerns requiring editorial attention may include:

• Plagiarism, misleading textual reuse, or unauthorized duplicate publication.
• Fabrication, falsification, or material misrepresentation of research data or findings.
• Inappropriate manipulation of scientific or clinical images.
• Serious deficiencies in ethical approval, informed consent, or patient confidentiality.
• Improper authorship, undisclosed contributors, or unauthorized authorship changes.
• Material nondisclosure of competing interests, funding arrangements, or relevant AI use.
• Falsified clinical trial registration, research documentation, or supporting evidence.
• Peer review manipulation, false reviewer identities, or inappropriate interference with editorial processes.
• Other serious violations of the journal's research integrity and publication ethics requirements.

12.2 Editorial Assessment and Investigation

The journal may follow a structured process including:

1. Preliminary examination of the concern and available evidence.
2. Identification of the relevant research integrity or ethical issue.
3. Confidential requests for clarification or supporting documentation.
4. An appropriate opportunity for affected authors to respond to material allegations.
5. Consultation with independent experts, institutions, or appropriate authorities where warranted.
6. A documented and proportionate editorial determination based on the relevant evidence.

A suspected irregularity, automated detection result, or unsupported complaint is not automatically proof of misconduct. The journal distinguishes technical or administrative errors from negligent reporting, unresolved integrity problems, and intentional falsification.

12.3 Possible Editorial Outcomes

Depending on the findings and publication status, the journal may:

• Request clarification, additional documentation, or manuscript revision.
• Suspend assessment or publication while a material concern is examined.
• Reject the manuscript or withdraw formal acceptance where justified.
• Publish an appropriate correction, expression of concern, or retraction.
• Refer relevant matters to an institution, ethics committee, funder, or competent authority where warranted.
• Take other proportionate measures consistent with the journal's published procedures.

12.4 Post-Publication Integrity

Authors must notify the Editorial Office when they identify a material error or ethical concern affecting their published research. Corrections and other necessary publication integrity measures are administered independently of optional administrative service fees.

Authors may raise legitimate concerns or appeal an editorial decision through the Complaints & Appeals Policy.

13. Author Declaration (Required at Submission)

The corresponding author must confirm compliance with the journal's ethical and publication requirements on behalf of the author group when submitting the manuscript.

All authors remain individually accountable for their own contributions, required disclosures, and the integrity of the submitted work.

13.1 Submission Documentation

Required author declarations and identifying information must be provided through the journal's online submission system and appropriate unblinded submission files. Information intended for external double-blind review must be anonymized according to the journal's instructions.

The Editorial Office may request clarification, documentary evidence, or corrected declarations where necessary to verify compliance.

13.2 Continuing Responsibility

Submission declarations form part of the authors' continuing responsibilities throughout peer review, revision, acceptance, production, and post-publication assessment. Authors must inform the Editorial Office of material changes or newly identified circumstances affecting the accuracy of their declarations.