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Image processing software, such as Adobe Photoshop, has made it relatively easy for authors to manipulate images to highlight a specific outcome or feature by cropping or by adjusting color, brightness, or contrast. These same applications can be used by journal staff to screen digital images for evidence of inappropriate manipulation and fraudulent manipulation., Some enhancements to figures, such as cropping or adjusting color of the entire image, may be appropriate if such manipulations do not alter the interpretation of the original data or omit or obscure important data. However, any manipulation that results in a change in how the Less