Ankara Üniversitesi Tıp Fakültesi Mecmuası

The Journal of Ankara University Faculty Medicine is published quarterly (March, June, September, December). It aims to publish research articles, invited reviews and case reports on Basic, Medical and Surgical sciences.

The abbreviation of the Journal of Ankara University Faculty Medicine is J Ankara Univ Fac Med.

The Journal of Ankara University Faculty Medicine does not charge any article submission, processing or publication fees.

The editorial and publication process of the Journal of Ankara University Faculty Medicine are shaped in accordance with the guidelines of the International Committee of Medical Journal Editors (ICMJE), World Association of Medical Editors (WAME), Council of Science Editors (CSE), Committee on Publication Ethics (COPE), European Association of Science Editors (EASE), and National Information Standards Organization (NISO). The journal is in conformity with the Principles of Transparency and Best Practice in Scholarly Publishing.

The Journal of Ankara University Faculty Medicine is an independent journal based on double-blind peer-review principles. The manuscript is assigned to the members of the editorial board, who reviews the manuscript and makes an initial decision based on manuscript quality and editorial priorities. Manuscripts that pass initial evaluation are assigned to two external reviewers. The reviewers must review the manuscript within 21 days. The Associate Editor recommends a decision, based on the reviewers’ recommendations and sends the manuscript to the Editor-in-Chief. The Editor-in-Chief makes a final decision based on editorial priorities, manuscript quality, and Associate Editor’s and reviewers’ recommendations.

All manuscripts submitted are screened for plagiarism using Crossref Similarity Check powered by “iThenticate” or Turnitin software. Reports obtained through any other programs will not be considered. Results indicating plagiarism may cause manuscripts being to be returned or rejected.

Experimental, clinical and drug studies requiring approval by an ethics committee must be submitted to the Journal of Ankara University Faculty Medicine with an ethics committee approval report confirming that the study was conducted in accordance with international agreements and the Declaration of Helsinki. The approval of the ethics committee and the fact that informed consent was given by the patients should be indicated in the Patients and Methods section. In experimental animal studies, the authors should indicate that the procedures followed were in accordance with animal rights as per the Guide for the Care and Use of Laboratory Animals, and they should obtain animal ethics committee approval.
 

The presentation of the article types must be designed in accordance with trial reporting guidelines:

Human research: Helsinki Declaration as revised in 2024

Systematic reviews and meta-analyses: PRISMA guidelines, Systematic Reviews and Meta-Analyses Guidelines

Observational Studies: Observational Studies Guidelines

Case reports: the CARE case report guidelines

Clinical trials: CONSORT

Animal studies: ARRIVE and Guide for the Care and Use of Laboratory Animals
 

A copyright form should accompany the manuscript. 

Authors must provide disclosure/acknowledgement of financial or material support, if any was received, for the current study.

If the article includes any direct or indirect commercial links or if any institution provided material support to the study, authors must state in the cover letter that they have no relationship with the commercial product, drug, pharmaceutical company, etc. concerned; or specify the type of relationship (consultant, other agreements), if any.

Authors must provide a statement on the presence or absence of conflicts of interest among the authors and provide authorship contributions.

In case of any suspicion or claim regarding scientific shortcomings or ethical infringement, the journal reserves the right to submit the manuscript to the supporting institutions or other authorities for investigation. The journal accepts the responsibility of initiating action but does not undertake any responsibility for an actual investigation or any power of decision.

Guidelines:
1- Manuscripts can only be submitted electronically through the DergiPark website after creating an account.
2- Format: Manuscripts should be prepared using Microsoft Word, size A4 with 2.5 cm margins on all sides, 12 pt Arial font and 1.5 line spacing.
3- Abbreviations: Abbreviations should be defined at first mention and used consistently thereafter. Internationally accepted abbreviations should be used; refer to scientific writing guides as necessary.
4- Cover letter: The cover letter should include statements about the manuscript type, single-journal submission affirmation, conflict of interest statement, sources of outside funding, equipment (if applicable), approval of language for articles in English and approval of statistical analysis for original research articles.

5- Use of Large Language Models and Generative AI Tools: “AI tools cannot meet the requirements for authorship as they cannot take responsibility for the submitted work. As non-legal entities, they cannot assert the presence or absence of conflicts of interest nor manage copyright and license agreements. Authors who use AI tools in the writing of a manuscript, production of images or graphical elements of the paper, or in the collection and analysis of data, must be transparent how the AI tool was used and which tool was used. Authors are fully responsible for the content of their manuscript, even those parts produced by an AI tool, and are thus liable for any breach of publication ethics.” COPE Position Statement on Authorship and AI tools. Detailed information about the statement can be accessed at https://publicationethics.org/cope-position-statements/ai-author
After reviewing the COPE statement, the editors of the Journal of Ankara University Faculty Medicine have decided that papers should include a statement in a section called “Declaration Regarding the Use of AI and AI-Assisted Technologies” to let readers know if AI or AI-assisted tools were used in the writing process. It's important to remember that all authors are responsible for the content of their work. This declaration does not apply to the use of basic tools for checking grammar, spelling, or references (such as Mendeley, EndNote, Zotero, and others). If there is nothing to declare, there is no need to add a statement.

It is suggested that authors follow this format when preparing their statement:

During the preparation of this work, the author(s) utilized [NAME OF TOOL(S) USED] to [DESCRIPTION OF HOW THE TOOL(S) WERE UTILIZED AND HOW THE VALIDITY OF THE OUTPUTS WAS EVALUATED]. After carefully reviewing and editing the content as necessary, full responsibility for the publication's content is taken by the author(s). This incorporation of AI tool usage primarily impacted [SPECIFY WHICH ASPECTS OF THE STUDY, ARTICLE CONTENTS, DATA, OR SUPPORTING FILES WERE AFFECTED/GENERATED].

Example:
During the preparation of this work, the author(s) utilized OpenAI's ChatGPT to generate summaries of research articles related to the topic. These summaries were evaluated by comparing them to manually written summaries by experts in the field. Upon confirming the accuracy and relevance of the generated summaries, they were integrated into the literature review section of the manuscript. After carefully reviewing and editing the content as necessary, full responsibility for the publication's content is taken by the author(s). This incorporation of AI tool usage primarily impacted the efficiency of literature review process and the comprehensiveness of the gathered research insights.

6-Submitted articles must be accompanied by the following files depending on their types:

Title Page: All articles submitted should be accompanied by a title page ( 📝 TITLE PAGE.docx ). This page should include the title of the manuscript, short title, name(s) of the authors and author information. The following descriptions should be stated in the given order:
• Title of the manuscript, as concise and explanatory as possible, including no abbreviations, up to 12 words
• Short title, up to 60 characters
• Name(s) and surname(s) of the author(s) (without abbreviations and academic titles), their ORCID ID's and affiliations. The individuals who do not meet the criteria for authorship but have contributed to the article should be acknowledged under the 'Acknowledgments' section at the end of the article.

• Name, institutional address, e-mail, phone and fax number of the corresponding author
• The place and date of the scientific meeting in which the manuscript was presented and its abstract published in the abstract book, if applicable
 

Manuscript: The manuscripts should be structured and include following sections depending on the type of the article besides a structured abstract: 

Abstract: A summary of the manuscript should be written both in English and Turkish. The abstract should not exceed 250 words. References should not be cited in the abstract. The use of abbreviations should be avoided as much as possible; if any abbreviations are used, they must be taken into consideration independently of the abbreviations used in the text.
For original articles, the structured abstract should include the following sub-headings:
Objectives: The aim of the study should be clearly stated.
Materials and Methods: The study and standard criteria used should be defined; it should also be indicated whether the study is randomized or not, whether it is retrospective or prospective, and the statistical methods applied should be indicated, if applicable.
Results: The detailed results of the study should be given, and the statistical significance level should be indicated.
Conclusion: Should summarize the results of the study, the clinical applicability of the results should be defined, and the favorable and unfavorable aspects should be declared.
Keywords: A list of minimum 3, but no more than 5 keywords must follow the abstract. Keywords in English should be consistent with “Medical Subject Headings” (MESH). Turkish keywords should be direct translations of the terms in MESH.

Original Articles
Clinical research should comprise clinical observation, new techniques or laboratory studies. Original research articles should include title, structured abstract, keywords relevant to the content of the article, introduction, patients/materials and methods, results, discussion, references, tables/figures and acknowledgement sections. Title, abstract and keywords should be written in both Turkish and English. The manuscript should be formatted in accordance with the above-mentioned guidelines and should not exceed 3000 words.
Introduction: Should consist of a brief explanation of the topic and indicate the objective of the study, supported by information from the literature.
Materials and Methods: The study plan should be clearly described, indicating whether the study is randomized or not, whether it is retrospective or prospective, the number of trials, the characteristics, and the statistical methods used.
Results: The results of the study should be stated, with tables/figures given in numerical order; the results should be evaluated according to the statistical analysis methods applied.
Discussion: The study results should be discussed in terms of their favorable and unfavorable aspects, and they should be compared with the literature. The conclusion of the study should be highlighted.
Acknowledgements: Any technical or financial support or editorial contributions (statistical analysis, English/Turkish evaluation) towards the study should appear at the end of the article.
References: The number of references should not exceed 40. Authors are responsible for the accuracy of the references. See References Section for details about the usage and formatting required.

Case Reports
Case reports should present cases which are rarely seen, feature novelty in diagnosis and treatment, and contribute to our current knowledge. The first page should include the title in Turkish and English, an unstructured abstract not exceeding 250 words, and keywords. The main text should not exceed 1500 words and consist of introduction, case presentation, discussion and references not exceeding 20.

Review Articles
The journal publishes invited reviews only. Review articles must provide critical analyses of contemporary evidence and provide directions of current or future research. Review articles analyze topics in depth, independently and objectively. The first page should include the title in Turkish and English, an unstructured abstract and keywords. Source of all citations should be indicated and referencess should not exceed 100 in number. The main text should not exceed 5000 words.

7- Presentation of the References
Authors are responsible for the accuracy and completeness of their refences and for correct in-text citation. All references should be in accordance with following rules:
In-text citations: References should be indicated in the parentheses before the full stop of the relevant sentence. If the author(s) of a reference is/are indicated at the beginning of the sentence, this reference should be written in the parentheses immediately after the author’s name. If relevant research has been conducted in Turkey or by Turkish researchers, these studies should be given priority while citing the literature.
References section: References should be numbered consecutively in the order in which they are first mentioned in the text. If there are more than 3 authors, first 3 authors must be listed followed by “et al”. The titles of journals should be abbreviated according to the style used in the Index Medicus.

Reference Format
Journal: Schwarz DS, Blower MD. The endoplasmic reticulum: structure, function and response to cellular signalling. Cell Mol Life Sci. 2016;73:79-94.
Book: Tos M. Cartilage tympanoplasty. 1st ed. Stuttgart-New York: Georg Thieme Verlag; 2009.
Editor(s) compiler as author: Kurt N, editor. Yetişkinlerde ve Çocuklarda Ameliyat Öncesi Değerlendirme. Istanbul: Nobel Tıp Kitapevleri; 2002.
Book Chapter: Rowe JS. Liver. In: Skandalakis JE, Gray SW, Rowe JS, editors. Anatomical Complications in General Surgery. 1st ed. New York: McGraw-Hill Book Co; 1986. p. 103-124.
Conference Paper: Seyhan F. Kalça ekleminde yüzey değiştirme artroplastisinin (Wagner protezi) geç sonuçları. In: Ege R, editor. X. Milli Türk Ortopedi ve Travmatoloji Kongre Kitabı; 17-20 Mayıs, 1987; Mersin, Türkiye. Ankara: Emel; 1989. p. 494-6. (Unpublished conference paper should not be used as a reference).
Webpage: 2017 ÖSYS yüksek öğretim programları ve kontenjanları kılavuzu. [Internet]. [Retrieved on September 13, 2019]. Available from: https://www.osym.gov.tr/TR,13263/2017-osys-yuksekogretim-programlari-ve-kontenjanlari-kilavuzu.html

Computer Software: StatView SE+Graphics [computer program] Version 1.03. Berkley: Abacus Concepts İnc.; 1988.
 

8- Figures and Tables
All visual materials (pictures, graphs and drawn figures) must be named as “Figure”. All figures and tables must be cited within the main text consecutively. Legends of all figures must be submitted as a separate page of main document. If abbreviations are used in the figures, their explanations should be provided in alphabetical order in the figure captions, separated by semicolons. Each figure must be submitted as a separate file and in “.jpeg” format. All figures shoud be of the possible highest quality and at a minimum resolution of 300 dpi. All figures must be original. Figures previously published by other sources, must be submitted with a copy of written permission of the owner of figure. All permissions must be obtained by authors prior to submission. For figures involved human studies, written informed consent must be taken from patient or his/her parent and uploaded during submission. Otherwise, patient’s names must not be indicated and their eyes must be hided with black lines to prevent any exposure of identity. Used stain and zoom rate must be indicated in microscobic figures.
 

Examples for figure legends:
Figure 1. Anteroposterior (A) and lateral (B) images of the femur after 3D reconstruction of the CT images obtained by Leonardo Dr/Dsa Va30a software (Siemens®, Erlangen, Germany).
Figure 2. Reference angles of the distal femur in the sagittal plane. ACA: Anterior cortical axis; DMA: Distal medullary axis; sMA: Sagittal mechanical axis; the line that connects the center of the femoral head and the midpoint of the epicondylar axis.

All tables should be added to the main document or to the separate file. Tables added within the main document must be placed as each in a separate page after the reference list with descriptive title above the table. Titles of tables added to the separate file must be indicated within the main text on a separate page. If abbreviations are used in the tables, their explanations should be provided in alphabetical order in the table captions, separated by semicolons. When creating tables, the following format should be followed: AMA Manual of Style Committee. 4.1.2. Organizing Information in Tables. AMA Manual of Style: A Guide for Authors and Editors (10th Edition). 2009 April. URL: http://www.amamanualofstyle.com/view/10.1093/jama/9780195176339.001.0001/med-9780195176339-div2-97#
 

Example for a table:
 

9- Clinical Trial Policy
All clinical trials, which are a part of a research project that prospectively assigns individuals or a group of people to an intervention, with or without concurrent comparison or control groups, in order to study the relationship between a health-related intervention and a health outcome, must be registered in a public trials registry acceptable to the International Committee of Medical Journals Editors (ICMJE). Authors of randomized controlled trials must adhere to the CONSORT guidelines , and provide both a CONSORT checklist (for protocols, see the SPIRIT guidance) and flow diagram. We require that you choose the MS Word template at www.consort-statement.org for the flow chart and cite/upload it in the manuscript as a figure. In addition, submitted manuscripts must include the unique registration number in the Abstract as evidence of registration. The Clinical Trial Registration Policy has been implemented in our journal as of September 2023. For more detailed instructions regarding clinical trials, please visit the guideline below:

Clinical Trials Guidelines
You can register for clinical trials by visiting the following link: https://clinicaltrials.gov/ To register the relevant record in the system and learn more about the protocol to be followed, please review the link below: https://classic.clinicaltrials.gov/ct2/manage-recs/how-register The other registries are accepted by ICJME: www.anzctr.org.au www.ISRCTN.org www.umin.ac.jp/ctr/index/htm www.onderzoekmetmensen.nl/en https://eudract.ema.europa.eu/

10- Informed Consent and Ethics
Manuscripts reporting the results of an experimental investigation on human subjects must include a statement in the Patients and Methods section that the institutional review board has approved the study and the informed consent were obtained from patient or parents. Please fill out the Patient Consent Form when necessary and upload it to the system during your submission. The authour(s) should state the accordance to the Declaration of Helsinki and “Regulations in drug research Ministry of Health,Goverment of Turkey, January 29,1993’’.

Experimental studies involving animals must be approved by the ethics commitee for animal use and proper ethics.

Correspondence
Prof. Neriman Defne Altıntaş
Address: Ankara Üniversitesi Tıp Fakültesi, Yayın Komisyonluğu Başkanlığı,

06100 Sıhhıye, Ankara/Turkey

Phone: + 90 312 595 82 07
Fax: + 90 312 310 69 40
E-mail: tipdergi@medicine.ankara.edu.tr

The editorial and publication process of the Journal of Ankara University Faculty of Medicine are shaped in accordance with the guidelines of the International Committee of Medical Journal Editors (ICMJE), World Association of Medical Editors (WAME), Council of Science Editors (CSE), Committee on Publication Ethics (COPE), European Association of Science Editors (EASE), and National Information Standards Organization (NISO). The journal is in conformity with the Principles of Transparency and Best Practice in Scholarly Publishing.

Journal of Ankara University Faculty of Medicine is the scientific, peer-reviewed, open-access journal of Ankara University Faculty of Medicine. The entire submission process for an article is completed online through a descriptive online submission system via the following website: https://jag.journalagent.com/atfm/

Reviewers can access their personal pages with their passwords through the same address.
After preliminary evaluation, the associate editors send the manuscript to at least two external reviewers for evaluation. All articles are scientifically evaluated by a double-blind review process.

Journal of Ankara University Faculty of Medicine requires reviewers to keep articles confidential. The material of the article should not be used or shared in any way until it is published.

When editors suspect any ethical misconduct, they will act in accordance with the relevant international publication ethics guidelines, such as the COPE guidelines, ICMJE Recommendations, CSE's White Paper on Publication Ethics, WAME resources, WMA policies, and ORI. The reviewed articles are then re-evaluated by the Editor-in-Chief and the Editorial Board, and a decision to reject or accept is formed. If any reviewer has a conflict of interest, they must inform the editor before accepting to review the submission.

For all research studies, approval of research protocols by an ethics committee is required in accordance with international agreements such as the WMA Declaration of Helsinki- Ethical Principles for Medical Research Involving Human Subjects (latest update: October 2024, Helsinki, Finland), the Guide for the Care and Use of Laboratory Animals (8th edition, 2011), and/or the International Guiding Principles for Biomedical Research Involving Animals (2012). If the submitted article does not include ethics committee approval, it will be reviewed according to COPE guidelines (Guidelines for Editors: Research, Audit, and Service Evaluations). If it is determined that the study requires ethical approval, authors will be asked to provide it to continue the review process.
If they cannot provide ethical approval, their article will be rejected, and it will be reported to the relevant institutions in their country if necessary, indicating that the study should have had ethics committee approval. If ethical approval is provided, the review of the article will continue. If the study does not require ethics committee approval, after the editorial board's review, authors will be asked to provide either a document obtained from an independent board stating that ethics committee approval is not required according to the research integrity rules of the country where the study was conducted or to provide the ethics committee approval. If the authors provide one of these documents, the review process will continue. If they cannot provide the documents, the article will be rejected.
For articles related to experimental research on humans, a statement should be included showing that informed consent was obtained after detailed information about the procedures the patients and volunteers would undergo was provided. Informed consent must also be obtained for case reports. Written permission must be obtained from the patient to publish recognizable photographs of them. Procedures performed to alleviate any pain, harm, or discomfort in subjects/animals should be clearly stated. Authors must clearly indicate that they have complied with internationally accepted guidelines and the guidelines issued by the relevant authorities in their country. The journal requires a copy of the Ethics Committee Approval obtained from the relevant authority.
Reviewers are expected to check whether the articles comply with the SAGER guidelines and to encourage authors in this regard. Authors should carefully use the terms sex, referring to biological characteristics, and gender, shaped by social and cultural conditions. Article titles and/or abstracts should clearly state which sex(es) the study applies to. Authors should also identify whether sex and/or gender differences were anticipated, report how sex and/or gender were considered in the study design, provide sex- and/or gender-disaggregated data where appropriate, and discuss relevant outcomes.
Reviewers can refer to the 'Instructions to Authors' page if needed. They can also use the following criteria when evaluating articles:

RESEARCH EVALUATION CRITERIA

The following criteria should be considered when evaluating a manuscript: 

1 Has ethics committee approval been obtained for the study?
2 Does the title of the article reflect the study? 
3 Does the English and Turkish abstract clearly and accurately reflect the content of the article? 
4 Are English and Turkish keywords selected appropriately?
5 Is the text divided into appropriate sections according to the type of writing? 
6 Is the purpose of the study and/or the research question and hypotheses if any, clearly stated? 
7 Is the place, time, design (type of study) specified? 
8 Are the population, sample size, sampling method, inclusion and exclusion criteria specified? 
9 Is the study method sufficiently detailed (place, time, type of study, interview conducted, parameters assessed, etc.)? 
10 Are appropriate statistical methods preferred? (see https://www.toraks.org.tr/site/sf/books/pre_migration/ba74d7c39e0eee0e51a40505443342657f589732f18afc9273c4dfb9f0abd8ef.pdf )
11 Are the results written in line with the objectives of the study, including the results of statistical analysis? 
12 Are the figures and tables sufficient and arranged according to the journal rules? 
13 Has the discussion included the current literature?
14 Does the citation of references in the text and the writing of references comply with the journal rules? 
15 Are the strengths and/or limitations of the study and potential sources of bias identified? 
16 Is the study topic original? Does it contribute to science? 
17 Is the written language of the study understandable, does it comply with the rules of spelling? 

Suitability should be marked with one of the following options: "yes", "partially", "no" and "not required".

Reviewer Invitation Process
Reviewers have 3 days to respond to the invitation to review. The period given to reviewers who accept the invitation to make their evaluation is 21 days. The 21-day period for the reviewer to evaluate the publication starts upon acceptance of the invitation. If the reviewer is unable to evaluate the work within the specified period, an additional period of 10 days is given. If the reviewer does not evaluate the article within this period, the reviewer is removed from the evaluation process and a new reviewer is invited by the associate editor. Reviewers are selected among experts in their fields.

Article Evaluation Process
Reviewers are expected to evaluate only studies in their own subject areas in line with the publication principles. It is expected that evaluation criteria should not only be answered with "yes", "no", etc.; negative opinions should be detailed and justifications should be explained. Reviewers who reject the manuscript are expected to write detailed explanations to guide the author. Reviewers can use the "track changes" feature on the manuscript file to elaborate on their views expressed in the evaluation form.
If deemed necessary, the revised article is sent back to the reviewers after the editorial check. The reviewer fills in the evaluation form again at this stage. After the reviewers evaluations are completed, the article is evaluated by the Editorial Board for a final decision.

When you are invited to review an article;
• Please make sure that the article topic is within your area of expertise.
• Please make sure you have enough time to evaluate the article.
• Please make sure that you have no conflict of interest regarding the study.


HOW TO WRITE A REVIEWER EVALUATION REPORT?
Below is a guide to help you review an article and make your recommendations.

Reviewing the Scope of the Journal
Visit the journal homepage of Journal of Ankara University Faculty of Medicine and read the instructions for authors to get an idea of the scope and content of the journal. This will help you determine whether the article you are reviewing is suitable for the journal.

Reading the Article
Get an idea of the originality of the article's topic for the journal's readership, the accuracy and validity of the methodology, and whether the results are presented appropriately. Don't forget to review tables, figures or supplementary files while reading the article.

Writing the Report
Keep in mind that your report has two purposes: "to provide the editor with information to make decisions" and "to provide feedback to the authors to help them improve their work".
It is often useful to start with a brief summary of the main findings as you understand them and a summary of your overall view. Make constructive suggestions, ask for clarification and more details on unclear points. Direct your criticism to the work and avoid comments that may be taken personally by the author.
Here are the points you should pay attention to when writing your report:
• Give your impressions about whether the article is new and interesting, whether it contributes to science and whether it can have sufficient impact.
• Comment on whether the methods were appropriate and whether the study was conducted in accordance with the standards expected in your field.
• Make suggestions on how the author could improve the clarity, conciseness and quality of the presentation.
• Verify whether the topic of the article is interesting enough to justify its length. If you recommend abbreviation, mention the specific areas where you think it is necessary.
• Request the correction of places in the article where the expression is unclear in terms of spelling, grammar, etc.
• If you have plagiarism or other ethical concerns, please communicate your doubts to the editor, providing as much detail as possible.

Providing Detailed Feedback
Comments should be carefully worded so that the author understands what actions he or she needs to take to improve his or her article, rather than simply pointing out what is wrong. Try to write simply and avoid rhetorical flourishes that can lead to misunderstandings. Also, avoid generalized or vague statements, as well as negative comments that are not relevant or constructive.

Peer Review Comment Samples
Below are examples of how you can provide feedback on an author's work.

Examples of positive comments:
• The article is written in an engaging narrative.
• The topic is very important, it is currently a "hot topic" and this study makes an important contribution to the literature.
• I have no hesitation in recommending that it be accepted for publication after a few typos and other minor details have been taken care of.
• The literature review provides a useful overview of current research and the resulting product provides a useful resource for scientists.
• This is a well-written article that fills an important gap.
• Although this study is largely confirmatory, it can still be a contribution to the literature.
• I checked the methods and results and found that the study was well conducted and had no obvious errors.

Examples of constructive feedback:
• The introduction is too long, I suggest that authors shorten this section to retain only the important elements.
• I strongly advise the authors to rewrite the discussion to make it more contextualized.
• The authors used the X approach and therefore I expect to see disclosure of ethical approvals and storage of data in a publicly available database. It is important that the authors provide this information.
• A few important citations, such as the following, should be included in the paper.
• The data shown in table 1 and figure 3 refer to X, while the results section refers to Y. Authors should check carefully.
• This research reveals an interesting finding about ... However, I would have liked to see more discussion about what exactly this finding means and its implications.
• I would like to see more information about ...
• I do not think this article contains enough solid data to prove the statement on lines Y-Z on page X.
• This discussion can be extended to explain ...
• The author can strengthen the article as follows.
• The article could be significantly improved by adding more details about ...
• To make this article publishable, I recommend that authors perform the following additional analyses:

Examples of linguistic correction proposals:
• This article contains many grammatical errors (e.g. agreement of verbs) that make it difficult to follow.
• It may be useful to work with a professional English language editor after the article has been restructured.
• The article should change the way it is written to have a stronger, clearer and more convincing argument.
• There are a few sentences that need to be rephrased for clarity.

Decision on the Article
After reading the article and assessing its quality, you should make one of the following suggestions to the editor to help them make a decision.
• Accept: The article is suitable for publication in its current form.
• Minor revision: The article will be ready for publication after minor revisions. Please list the revisions you would recommend the author to make.
• Major revision: The article requires significant changes, such as expanded data analysis, expansion of the literature review, or rewriting of sections of the text.
• Reject: The manuscript is not suitable for publication in this journal or the revisions required are too extensive for the submission to continue to be considered in its current form. It would be helpful for the editor if you explain (in hidden comments if necessary) whether your suggestion is based on article content or technical flaws.

Revision Process
When authors revise their manuscripts, they are asked to include a list of changes and comments for reviewers. If only minor revisions have been requested, the revised version may be considered by the editor. Or the revised version may be sent to reviewers, who will be asked to confirm that the revisions are satisfactory.