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Manuscripts submitted to TOHM should conform to the "Uniform Requirements for Manuscripts Submitted to Biomedical Journals," which can be found on the ICMJE website.
The following steps outline the process for submitting manuscripts to TOHM.
In step one, you will complete a submission checklist that includes confirming that you have obtained informed consent from any patients used in your research. You will also be required to agree to the terms of the copyright notice. The journal’s privacy statement is listed here. You will have to enter your cover letter into a box during this step.
In step two, you will add author(s) details, set the order of authors and assign the corresponding author. The names of all authors, affiliations, contact details, biography (optional) and the corresponding author details must be completed at this stage.
In step three, you will select a journal section for your submission and enter the abstract and title of the manuscript, submission metadata and any competing interests. In addition, you will have an opportunity to recommend your reviewers and you will be asked to provide information about your supporting agencies.
In step four, you will upload the manuscript file along with any additional files such as figures, videos and supplementary material (click Add Another File). You will be able to replace the manuscript file, if necessary.
In step five, you will review the submission information and officially finish the submission. You will receive an email confirming your submission.
As part of the submission process, authors are required to check off their submission's compliance with all of the following items, and submissions may be returned to authors that do not adhere to these guidelines.
Tremor and Other Hyperkinetic Movements (TOHM) is an online open-access journal that uses an electronic submission system. The system can be accessed at www.tremorjournal.org.
When submitting a manuscript, the author must provide an electronic version of a manuscript, and accompanying figures or videos. The manuscript must be submitted using the online system. Hard copies will not be accepted. In addition to these guidelines, manuscripts submitted to TOHM should conform to "Uniform Requirements for Manuscripts Submitted to Biomedical Journals."
Once a manuscript has successfully been submitted, the review process will begin. All correspondence, including the Editor-in-Chief's decision and request for revisions, will be processed through the system and will reach the corresponding author by email. The author may track the status of a manuscript using the online submission system.
Once the Editor-in-Chief determines that the manuscript is within the scope of the journal, the contribution will be sent to external reviewers to ensure both accuracy and relevance. Even if a manuscript is favorably reviewed, revisions are usually required before the paper is officially accepted. When submitting a revised manuscript, the author must submit (1) a clean manuscript (with the revisions incorporated), (2) a revised manuscript (with the revisions highlighted), and (3) a response to the reviewers’ comments.
The editorial office reserves the right to request that professional scientific editing services be used at the expense of the author in order to improve the quality of the writing in some cases. Use of these services does not guarantee acceptance for publication. See section III below.
The following items must be submitted online:
1. Cover Letter. The cover letter should be added directly in a text box at the first step of the submission form. It should indicate why the paper should be published, why it is especially appropriate for TOHM, and how it adds to the published literature on the topic. In the cover letter, the author must confirm that all authors have read and approved the manuscript; the paper has not been published previously; and it is not under consideration for publication elsewhere.
If authorship is attributed to a group, all members of the group must meet the full criteria and requirements for authorship. The group must designate one or more individuals as authors or members of a writing group who meet full authorship criteria and requirements, and who take responsibility for the group. In this case, the other group members are not listed as authors but may be listed in an acknowledgment at the end of the manuscript. For the criteria to be considered an acceptable research group, please see Flanagin A, Fontanarosa PB, DeAngelis CD. Authorship for research groups. JAMA 2002;288:3166-3168.
If authorship is attributed to a group, the corresponding author must state in the cover letter that the author (1) has full access to the data, (2) has the right to publish all the data, and (3) has had the right to obtain independent statistical analyses of the data.
3. Figures (if applicable). The author should upload each figure as a separate image file, not as part of the manuscript file. See section VIII below.
4. Video (if applicable). See section IX below.
TOHM publishes Full-Length Articles, Brief Reports, Case Reports, Reviews, Viewpoints, Editorials, Letters, and Video Abstracts. All articles in TOHM, including letters, can be accompanied by a video when appropriate. For all manuscripts, the abstract and text word counts must be displayed on the title page of the submission.
Authors for whom English is a second language may choose to have their manuscript professionally edited before submission to improve the English. All such services would be paid for and arranged by the author, and use of one of these services would not guarantee acceptance or preference for publication.
In some instances, during the review of a manuscript, the editorial office will request that the authors use one of these professional services in order to improve the quality of the English in their revised manuscript. All such services would be paid for and arranged by the author. Failure to comply with this request could result in the rejection of the revised manuscript.
Here we list several scientific editing services:
The following table displays the types of papers that we accept and their associated formatting rules and fees. This information is also presented in text below the table.
|Section||Description||Abstract||Text Word Count||Figures/Tables||References||Fee*|
|Full-Length Articles||Present new data in any field related to tremors or other hyperkinetic movement disorders.||May be up to 250 words and should contain the following sections: Background, Methods, Results, and Discussion.||Up to 5,000 words.**||Up to 4 tables and up to 6 figures.***||Up to 125 references.||$800|
|Brief Reports||Shorter articles that present new data.||May be up to 200 words, and should be organized in this way: Background, Methods, Results, Discussion.||Up to 2750 words.**||Up to 4 figures and/or tables.***||Up to 50 references.||$740|
|Case Reports||Restricted to one or a small series of cases that make a unique point and add to the literature on a topic.||May be up to 100 words and should consist of 3 sections: Background, Case Report, and Discussion.||Up to 1750 words.**||Up to 3 tables and/or figures.||Up to 40 references.||$725|
|Video Abstracts||Video abstracts include short videos that visually illustrate a single interesting phenomenon. The video should have educational value for students or practicing physicians. The emphasis should be on an examination finding (either classic or rarely seen) rather than a full presentation of a new and previously unreported type of case. The latter is more appropriately written up and submitted as a case report.||Should consist of 3 sentences: Background (one sentence), Phenomenology Shown (one sentence), Educational Value (one sentence).||Up to 400 words.**||Generally no tables or figures are allowed unless they provide vital scientific information that cannot be presented in any other format. We allow one video file of no more than 3 minutes. File specifications: .mp4, H.264 encoding, 5000 kbps or 1000 kbps.||Up to 3 references.||$300|
|Teaching NeuroImages||This section features patient photographs, radiologic images, or other pictorial material that illustrate interesting or rare movement disorder phenomenology.||Should consist of 3 sentences: Background (one sentence), Phenomenology Shown (one sentence), Educational Value (one sentence).||Up to 400 words.**||Up to 2 images. See section VIII for details.||Up to 3 references.||$300|
|New Observations Letters||Letters that report interesting new observations. This section is also the appropriate venue for brief reports or case histories with or without videos.||No abstract needed.||Up to 1000 words.**†||Up to two tables and/or figures.||Up to 15 references.||$720|
|Response Letters: |
|Letters related to previously published articles and other materials (Case Reports, Brief Reports, etc.), excluding Letters.||No abstract needed.||Up to 1000 words.**†||Up to 2 tables and/or figures.||Up to 15 references.||No charge|
|A letter related to published materials may be submitted up to 16 weeks after the paper to which it refers was published online.||No abstract needed.||Up to 500 words.**†||Up to 2 tables and/or figures.||Up to 10 references.||No charge|
|Response Letters: Author Replies||Letters written by authors in response to a Letter written about an article they've published.||No abstract needed.||Up to 500 words.**†||Up to 2 tables and/or figures.||Up to 10 references.||No charge|
|Reviews||Clinical and basic science reviews that provide a summary are generally published upon request or after agreement with the Editor-in-Chief. Authors interested in writing Reviews may contact the Editor-in-Chief, but unsolicited Reviews will also be considered for publication.||May be up to 250 words and should consist of the following sections: Background, Methods, Results, Discussion.||Up to 5,000 words.**||Up to 6 tables and/or figures.||Up to 150 references.||No charge|
|Viewpoints||Povide a position statement or that challenge conventional ideas are generally published upon request or after agreement with the Editor-in-Chief. Authors interested in writing Viewpoints may contact the respective Editor-in-Chief, but unsolicited Viewpoints will also be considered for publication.||The abstract may be up to 250 words and there is no set structure.||Up to 2,500 words.**||Up to 3 tables and/or figures.||Up to 125 references.||No charge|
|Editorials||Provide a succinct commentary linked to a specific article, highlighting one or more broader points that emerge from the work. Editorials are generally solicited by the editors and they accompany the specific article. They are not expected to present new or original data or serve as a formal rebuttal of a published letter.||No abstract needed.||Up to 1250 words.**†||1 table or figure.||Up to 15 references.||No charge|
|Deep Brain Stimulation (DBS) Case Files||A quarterly series that identifies clinical dilemmas and gaps in knowledge in the use of DBS surgery to treat tremor and other hyperkinetic movement disorders. Each piece is commissioned by the journal editor and is centered around a clinical vignette, outlining a perplexing clinical question and reviewing the current state of published evidence available to guide clinicians. |
Please note: the journal does not accept unsolicited submissions for this section.
|May be up to 150 words and should consist of 4 sections: Clinical Vignette, Clinical Dilemma, Clinical Solution, Gap in Knowledge.||Up to 1750 words.**||Up to 3 tables and/or figures.||Up to 40 references.||No charge|
* Authors may apply for fee waivers. Please see Section IV for more information.
** Excluding references, tables, figure legends, video legends, title page, and abstract.
*** Additional tables or very lengthy tables with individual level data can also be considered as supplementary tables to the manuscript.
† There is no set structure for the body of the manuscript.
Guidelines for applying for fee waivers
For journal-eligible manuscripts, TOHM offers article-processing fee waivers. TOHM fee waivers are available only to authors who have no other sources of funding for their work. No more than two waivers per author group will be granted annually.
To apply for a fee waiver:
1. Download a copy of our Verification Form. Have this form filled and signed by a direct supervisor or program director.
2. Fill out our Fee Waiver Application.
3. Authors with valid applications will not be charged if their articles are selected for publication.
Note: No editors have access to information concerning requests for waivers and such requests will in no way influence the editorial decision.
On Funding Sources
Many universities offer assistance for those publishing in an open-access journal such as TOHM. If you are employed by one of the following institutions, you may be eligible to apply to your institution’s open-access publication fund.
A complete list can be obtained from the Open Access Directory: http://oad.simmons.edu/oadwiki/OA_journal_funds. New funds are created all the time, so please check with your institution’s library to inquire as to your own institution’s policy.
The text of the manuscript should be double-spaced, and should have numbered lines, beginning with the abstract. To number lines of text in Microsoft Word, go to the layout tab, and click on the icon for numbered lines (under the Text Layout heading), selecting "continuous" as the number format.
The text should be presented in the following sequence: (1) Title page (2) Structured Abstract, (3) Introduction, (4) Methods, (5) Results, (6) Discussion, (7) Acknowledgments, (8) Financial Disclosures, (9) Ethics Statement, (10) References, (11) Tables, (12) Figure Legends, (13) Video Legend. Pages should be numbered in succession, with the title page being page number one.
Case reports substitute a case description for the Methods and Results sections.
Reviews may wish to combine the Results and Discussion sections (For additional details about the structure of Reviews, please see Section VI).
Viewpoints may wish to remove the Methods and Results sections.
Letters do not require an abstract, a Methods section or a Results section. There is no set structure for the text.
All manuscripts (except for Letters) must include a summary (50 words or less) highlighting the paper's importance and main findings. This summary (labeled "Highlights") should appear as a separate page after the title page. It will be utilized if the submission is selected for inclusion in the quarterly "Editor's Picks" email.
1. Title Page. The title page should include each of the following elements: (1) Title. This should not exceed 150 characters (including spaces and punctuation). Do not use abbreviations or acronyms in the title. (2) Authors’ first names, middle initial(s), and last names, degrees and institutional affiliations (indicate the specific affiliation of each author by superscript, Arabic numerals). (3) Key Words. List up to six key words, separating each by a semicolon. (4) Abstract word count and text word count. (5) Reference count. (6) Table and figure count. (7) Running title not exceeding 45 letters and spaces. (8) Name, address, telephone and fax numbers and email address of the person to whom proofs should be addressed.
2. Structured Abstract. The page following the title page should include a structured abstract (for word counts, see Section III). For Articles, Brief Reports, and Reviews, the abstract should include sections entitled Background, Methods, Results, and Discussion. For Case Reports the structured abstract should be organized as follows: Background, Case Report, Discussion. Video Abstracts should have abstracts with three sentences in this structure: Background (one sentence), Phenomenology Shown (one sentence), Educational Value (One sentence). Editorials, Viewpoints, and Letters should not have structured abstracts but all other submissions do require an abstract. Abbreviations and acronyms must be spelled out.
3. Introduction. The author should provide a brief description of the background and rationale for the scientific contribution. The author is encouraged to test specific hypotheses. This section should indicate how the work contributes to the currently available literature.
4. Methods. The author is encouraged to provide a separate “data analysis” section and a separate “sample size calculation” section toward the end of the Methods section. If multivariate modeling was performed, a specific statement as to how confounding factors were considered and entered into the models should be included.
For experimental investigation of human subjects, the author must state in this section that an appropriate institutional review board approved the project. For those investigators who do not have formal ethics review committees, the principles outlined in the “Declaration of Helsinki” should be followed. The author should state in this section the manner in which informed consent was obtained from the subjects. A letter of consent must accompany all photographs, patient descriptions, and pedigrees in which a possibility of identification exists; this letter should be kept on file with the patient's case notes. The author is responsible for proper anonymization of patients.
TOHM also requires authors to register all clinical trials in a public registry at or before the time of first patient enrollment. Clinical trials may be registered in any public registry, though TOHM suggests utilizing those recommended by the International Committee of Medical Journal Editors (ICMJE). The ICMJE recommends registering with any of the primary registries listed within the WHO International Clinical Trials Registry Platform (ICTRP), or via ClinicalTrials.gov, a registry provided by the U.S. National Institutes of Health. Authors must include the trial registration number within manuscripts submitted to the journal. Registration numbers should be referenced (1) within the Methods section and (2) the first time an acronym is used to refer to the trial within the body of the manuscript. More information can be found on the ICMJE's Clinical Trial Registration page.
All animal experiments should be carried out in accordance with the U.K. Animals (Scientific Procedures) Act of 1986 and associated guidelines, the European Communities Council Directive of 24 November 1986 (86/609/EEC) or National Institute of Health’s Guide for the Care and Use of Laboratory Animals (NIH Publications No. 80-23, revised 1978). Papers should be accompanied by a statement in the methods section that all efforts were made to minimize animal suffering, to reduce the number of animals used and to utilize alternatives to in vivo techniques, if available. Authors must also include the name of the ethics committee that approved their study.
5. Results. For all statistical tests, the author should provide the test name, result, and p value (e.g., “t test = 4.57, p = 0.02”). For odds ratios and relative risks, provide both a 95% confidence interval and a p value. All figures to be included with the paper should not be in the text. They should be uploaded separately, with callouts in the text referencing each figure.
6. Discussion. Toward the end of the Discussion, the author is encouraged to provide a section on the limitations and strengths of his or her work. Also, authors are encouraged to highlight the clinical applicability, if any, of their findings.
7. Acknowledgments. The author must receive the approval of any person listed in the acknowledgements section.
8. Financial Disclosures.
9. Ethics Statement.
10. References. TOHM complies with the Vancouver reference style given in “Uniform Requirements for Manuscripts Submitted to Biomedical Journals.” These guidelines are available online at http://www.icmje.org/.
If using a reference manager (such as EndNote) the author may select "Vancouver" from the list of citation styles in order to format all references in the style of the journal.
References are to be cited in the text by superscript number (following punctuation), and in the list of references they are to be numbered in the order in which they are cited. The reference section should be double-spaced at the end of the text, following the sample formats given below. When there are fewer than seven authors’ names, the author should provide them. When there are seven or more, the author should list the first six and add et al. Provide article titles and inclusive pages. Accuracy of reference data is the responsibility of the author. For abbreviations of journal names, the author should refer to the National Library of Medicine’s list of journals included in their databases (http://www.ncbi.nlm.nih.gov/nlmcatalog?term=currentlyindexed[All]).
Sample References (in the Vancouver Style)
1. Horgan JH, O'Callaghan WG, Teo KK. Therapy of angina pectoris with low-dose perhexiline. J Cardiovasc Pharmacol. 1981;3:566–572.
2. Vanhoutte PM, Leusen I, editors. Vasodilatation. New York: Raven Press; 1981. 96 p.
Chapter in a Book:
3. Patrono C, Ciabattoni G, Pugliese F, Meltzer PS, Kallioniemi A, Trent JM, et al. Effect of dietary variation in linoleic acid content on platelet aggregation and the major urinary metabolites of the E prostaglandins and (PGE-M) in infants. In: Hegyeli RJ, editor. Prostaglandins and cardiovascular disease. New York: Raven Press; 1981. p 111–122. (Atherosclerosis reviews; vol. 8).
For more sample references, see here: http://www.nlm.nih.gov/bsd/uniform_requirements.html.
11. Tables. Tables should be included in the manuscript. They must be created using a word processor's table function, not tabbed text. They should be typed neatly, each on a separate page. All abbreviations should be explained.
The final layout will place the tables as close to their first citation as possible. All tables must be cited within the main text, and numbered with Arabic numerals in consecutive order (e.g. Table 1, Table 2, etc.).
Each table must have an accompanying descriptive title. This should clearly and concisely summarise the content and/or use of the table. A short additional table legend is optional to offer a further description of the table. The table title and legend should be placed underneath the table.
Tables should not include: Rotated text, colour to denote meaning (it will not display the same on all devices), images, vertical or diagonal lines, multiple parts (e.g. ‘Table 1a’ and ‘Table 1b’). These should either be merged into one table, or separated into ‘Table 1’ and ‘Table 2’.
NOTE: If there are more columns than can fit on a single page, then the table will be placed horizontally on the page. If it still can't fit horizontally on a page, the table will be broken into two.
12. Figure Legends. Double-space figure legends and include a title and a descriptor. Figures should not be imported into the manuscript but should be uploaded as separate files. For photomicrographs, the author should include the type of specimen, original magnification, and stain type.
Sample figure legend:
Figure 1. Photographs of Three Subjects with Blepharospasm and Anterocollis. Frontal, lateral, and posterior views of subjects #1 (A–C) and #2 (D–F). Subject #5 before (H) and after ([I] 1 month; [J] 2 months) bilateral GPi DBS.
13. Video Legends. If there is a video, then the author must also supply a video legend, which describes the content of the video clip. If the video is comprised of several different clips, then the legend should describe the content of each clip in order. Legends should include a title and a descriptor.
Sample video legend:
Video Segment 1B. The Patient from Segment 1 at Initial Follow-up. Movements are markedly diminished in amplitude and intensity. Subsequent examinations showed no movements.
It is important for all authors of review articles to acquaint themselves with the guidelines for preparing a review article. If you'd like to download a PDF copy of these review guidelines please click here.
A brief guide to preparation of a review article:
Methods section requirements:
It is required that you include, at a minimum, each of the following elements in your Methods Section:
A table and/or flow diagram figure of this search strategy is preferred. For an excellent example of the methods section please see here. For an excellent example of a table, please see here. For an excellent example of a flow diagram, please see here.
Common Problems to Avoid When Preparing Your Review:
Units of measure: Conventional units of measure according to the Systeme International (SI) are preferred.
Drug Names: Only generic names should be used in referring to drugs.
Abbreviations: The author should follow the list of abbreviations given in "Uniform Requirements for Manuscripts Submitted to Biomedical Journals" (see section on References). For additional abbreviations, consult the CBE Style Manual (available from the Council of Biology Editors, 9650 Rockville Pike, Bethesda, Maryland 20814, USA) or other standard sources.
Spelling: American spelling is used throughout the Journal.
Avoid statements such as "Walker et al. found xxxxx", "Louis et al. reported yyyyyyy"; emphasis should be upon the conclusions of these articles and the interpretations of their results in the context of the current review (rather than upon the authors).
For best reproduction, electronic artwork files must be in TIFF or JPG format, at a resolution of 300 dpi for black and white or color images, or 600 dpi or higher for lined art, flow charts, and spiral images, sized to print. The figures should not be imported into the text. They will be uploaded separately.
For Teaching NeuroImages: each image may have more than one panel, but they should be clear and legible, and of sufficient size. Images may take up 2 full columns and half a page in PDF format, or two images that take up one column each.
Each file should not be more than 20MB. Standard formats accepted are: JPG, TIFF, GIF, PNG, EPS. For line drawings, please provide the original vector file (e.g. .ai, or .eps).
The video must be in a digital format (.mp4, H.264 encoding, 5000 kbps or 1000 kbps). The video clip must be limited to 120 seconds unless specific approval is obtained from the editorial office. As part of the manuscript, the author must also supply a video legend, at the end of the article, which describes the content of the video clip. If the video is comprised of several different clips, then the legend should describe the content of each clip in order.
As noted above, the video should be less than 120 seconds total, except for very special instances, which must be cleared beforehand with the editorial office. The video should be high quality and the author is expected to edit it before submission in order to ensure that is makes a specific point with maximal efficiency. The use of text between video clips or subtitles is possible.
The corresponding author must confirm in writing that he or she has received a signed release form from each patient videotaped authorizing the online distribution of this video material. Videos will not be sent out for review until this documentation is received.
The Editors reserve the right to request additional video editing by the authors and to edit video submissions prior to posting and/or distribution.
The video is uploaded as a separate file from the manuscript and figures.
Papers that are submitted to TOHM generally undergo more than one rounds of peer review. After the initial round, authors will be asked to revise their paper based on reviewer comments. These materials should be uploaded onto the journal website when they are ready: (1) A clean copy of the revised paper, (2) a copy of the revised paper that clearly highlights all changes, (3) a detailed letter that both reproduces these changes and clearly notes the exact lines in which they appear in the highlighted version of the revised paper. During the revision process, the authors may need to add additional text in order to address reviewer comments. In this case, the word restrictions will be relaxed by the editor, who will allow up to a 20% increase in word count to accommodate changes.
Proof corrections must be made within two days of receipt; late return may cause a delay in publication of an article. The author must check text, tables, legends, and references carefully. To expedite publication, page proofs rather than galleys will be sent electronically to the authors, and it may be necessary to charge for alterations other than correction of typesetting errors.
As part of the submission process, authors are required to check off their submission's compliance with all of the following items, and submissions may be returned to authors that do not adhere to these guidelines.
Authors who publish with this journal agree to the following terms. If a submission is rejected or withdrawn prior to publication, all rights return to the author(s):
Submitting to the journal implicitly confirms that all named authors and rights holders have agreed to the above terms of publication. It is the submitting author's responsibility to ensure all authors and relevant institutional bodies have given their agreement at the point of submission.
Note: some institutions require authors to seek written approval in relation to the terms of publication. Should this be required, authors can request a separate licence agreement document from the editorial team (e.g. authors who are Crown employees).
|Deep Brain Stimulation Case Files||0.00$|
|New Observations Letters||720.00$|
|Response Letters: Type 1||0.00$|
|Response Letters: Type 2||0.00$|
|Response Letters: Author Replies||0.00$|
Tremor and Other Hyperkinetic Movements (TOHM) is committed to making a sustainable contribution to the field of movement disorders neurology by providing cutting-edge content to as many readers as possible. As an open-access journal, TOHM’s content is available to everyone — clinicians, practitioners, scientists, patients, the lay public — without the prohibitive onus of subscription fees. Open access ensures constant availability to the material regardless of institutional affiliation. Therefore there is immediate, worldwide, barrier-free access to the full-text of all of our published articles. In this manner, open access allows any interested reader to view, download, print, and redistribute any article, thereby enabling far greater distribution of an author's work than the traditional subscription-based publishing model.
In an open access model, the article’s publication costs are paid from an author's research budget, or by their supporting institution, in the form of Article Processing Charges (APCs). Like TOHM, other open access medical journals often require APCs to enable research articles to be made freely available to all. For example, The British Medical Journal, one of the top-ranked journals in the world, charges a $4000 APC to grant-funded authors. Another top-ranked journal, PLoS Medicine, which is fully open access, charges $3000 per article, and BMC Medicine, also ranked among the top journals, charges $3490. PLoS ONE, now the largest journal in the world, charges an APC of $1595. Other movement disorders journals that use an open access model charge more than TOHM (e.g., Journal of Clinical Movement Disorders = $2,170, Frontiers in Movement Disorders = $1,900, and Parkinson’s Disease = $1,450).
TOHM has kept its APC very low, and only charges fees to cover the cost of operation to ensure the quality and the persistent availability of its content.
Tremor and other Hyperkinetic Movements relies on fees to support its publishing. Author Processing Charges (APCs) pay for professional copyediting and typesetting services as well as XML encoding that allows our journal to be indexed in medical databases and provides a professional setting for our published research articles.
Waivers are available for students and clinicians without access to institutional or grant funding for their research. Please note that waiver applicants must be the first author of the article under consideration.
Please, follow our detailed instructions in the Submissions page. Should your article be accepted for publication, authors with complete waiver applications will not be charged for publication.
Editorial decisions are made independently from the ability to pay the APC.