1. Submission and Initial Screening

Manuscripts must be submitted through the journal's official online submission system. Following submission, the Editorial Office conducts an initial screening to determine whether the manuscript satisfies the requirements for further editorial consideration.

Initial screening normally addresses:

• Scope and Article Type: Relevance to the journal's aims and scope and suitability for the selected manuscript category.
• Manuscript Completeness: Availability of the required manuscript files, submission metadata, statements, and supporting documentation.
• Double-Blind Preparation: Submission of a separate unblinded Title Page and an appropriately anonymized main manuscript.
• Originality Screening: Verification of the required official similarity report and preliminary evaluation of potential plagiarism or inappropriate textual overlap.
• Research Ethics: Applicable ethics approval, informed consent, clinical trial registration, competing interests, funding, and AI-use declarations.
• Data Transparency: Inclusion of an appropriate mandatory Data Availability Statement and relevant information concerning research data access.
• Methodological Adequacy: Preliminary consideration of the research design, supporting evidence, analytical methods, and scientific or scholarly contribution.
• Academic Presentation: Compliance with relevant manuscript preparation, reporting, language, and citation requirements.

Possible Screening Outcomes

The journal requires a complete official similarity report in PDF format, with an overall similarity index strictly below 15%, as specified in its published submission notice. Compliance with this threshold does not automatically establish originality or guarantee external review.

2. Assignment to Handling Editor

Manuscripts passing initial screening are assigned to the Editor-in-Chief, an Academic Editor, or a designated Handling Editor with appropriate disciplinary and methodological expertise.

The Handling Editor is responsible for coordinating the scholarly assessment of the manuscript, including:

• Confirming the manuscript's suitability for external review.
• Identifying the expertise required for a fair and technically competent assessment.
• Selecting and inviting appropriate independent reviewers.
• Assessing relevant conflicts of interest and maintaining confidentiality.
• Monitoring review progress and the adequacy of returned reports.
• Considering any necessary additional methodological or specialist evaluation.
• Providing an appropriate recommendation or exercising delegated editorial authority where formally authorized.

Editorial assignments are made according to the nature of the manuscript. A study conducted entirely within conventional medicine, TCM, public health, or another eligible discipline should be assessed by individuals competent in its relevant subject matter and methodology.

Editors must disclose relevant competing interests and recuse themselves from handling manuscripts when impartial evaluation cannot be reasonably assured. In such circumstances, the manuscript should be reassigned to an appropriate independent editor.

3. Reviewer Invitation

Research manuscripts selected for external peer review are normally evaluated by at least two qualified and independent expert reviewers. Additional reviewers may be invited when the manuscript requires specialist expertise or when the initial reports are insufficient for a reliable editorial assessment.

Reviewers are selected according to:

• Subject Expertise: Knowledge of the manuscript's principal research discipline and scholarly context.
• Methodological Competence: Experience with the relevant study design, analytical procedures, clinical methods, or theoretical approach.
• Research Experience: Appropriate scholarly qualifications, professional expertise, and relevant research or publication experience.
• Independence: Absence of relationships or competing interests that would compromise impartiality.
• Availability: Ability to provide a thorough and timely review within the agreed period.

Reviewer Responsibilities Before Acceptance

Invited reviewers must consider whether they have sufficient expertise, time, and independence to undertake the assignment. Potential conflicts of interest must be disclosed before accepting the invitation.

A reviewer who cannot provide an appropriate assessment should decline promptly. Reviewers must not independently delegate an accepted assignment or disclose confidential manuscript materials to colleagues or trainees without prior editorial authorization.

Reviewers are expected to follow the journal's Reviewer Guidelines.

4. Double-Blind Peer Review

Authors must submit an unblinded Title Page separately from the anonymized main manuscript. Materials transmitted to external reviewers must be prepared to minimize the possibility of identifying the authors.

Reviewers must not deliberately attempt to identify authors, contact authors directly, disclose their own identities in review reports, or distribute confidential research materials.

Double-blind procedures reduce the risk of bias but cannot guarantee that authors will never be identifiable from public preprints, specialized research subjects, or other contextual information. Any resulting conflict of interest must be disclosed to the Handling Editor.

Scope of Scholarly Evaluation

Reviewers assess manuscripts according to relevant criteria, including:

• Originality and contribution to knowledge.
• Scientific validity and methodological rigor.
• Appropriateness of data, source materials, analytical procedures, or theoretical reasoning.
• Reliability and interpretation of findings.
• Clinical, scientific, methodological, theoretical, or public health relevance.
• Compliance with applicable ethics and reporting standards.
• Clarity of presentation, limitations, and proportionality of conclusions.

Interdisciplinary integration is assessed where it forms part of the manuscript's objectives or stated contribution. Independent disciplinary research is not disadvantaged solely because it does not combine Western medicine and TCM.

5. Reviewer Reports and Recommendations

Reviewers provide structured reports intended to assist authors in understanding scientific and scholarly concerns and to support evidence-based editorial decision-making.

Report Components

An appropriate review report should include:

• Manuscript Summary: A concise account of the research objectives, principal methods, findings, and contribution.
• Overall Assessment: Identification of the manuscript's principal strengths, limitations, and suitability for publication.
• Major Comments: Substantive concerns affecting validity, methodology, interpretation, ethical compliance, or scientific reliability.
• Minor Comments: Clarifications and improvements concerning presentation, language, references, figures, tables, and non-fundamental reporting issues.
• Confidential Comments: Relevant information intended for the editor, including potential conflicts, ethical concerns, or limitations of reviewer expertise.
• Recommendation: A reasoned recommendation concerning the appropriate editorial outcome.

Review Recommendations

Reviewer recommendations are advisory. Reviewers should explain the scientific basis for their assessment and distinguish problems that could be resolved through revision from limitations that fundamentally compromise the work.

Reviewers must provide professional, specific, constructive, and proportionate feedback. Requests for additional analyses, experiments, citations, or manuscript expansion should have a clear scholarly justification.

6. Editorial Decision

After receiving the available reviewer reports, the Handling Editor evaluates their substance, considers the manuscript's scholarly merits, and identifies any unresolved methodological or ethical issues.

The Handling Editor may recommend acceptance, revision, or rejection. Where necessary, additional specialist reviews or clarifications may be obtained before a formal decision is made.

Formal decision correspondence normally includes:

• The editorial decision or current manuscript status.
• Relevant reviewer comments designated for author communication.
• The principal grounds for revision or rejection where appropriate.
• Instructions concerning revision and supporting documentation, where applicable.
• The applicable revision deadline or further editorial instructions.

Confidential reviewer information, protected editorial correspondence, and sensitive research integrity concerns are communicated in accordance with the journal's applicable confidentiality and publication ethics procedures.

7. Revision Process

Authors invited to revise a manuscript must respond to relevant editorial and reviewer comments and submit the revised materials within the timeframe communicated by the Editorial Office.

Revised submissions should include:

• Point-by-Point Response: An organized response addressing each substantive reviewer and editorial comment.
• Revised Manuscript: A complete revised version incorporating the appropriate changes.
• Clearly Identified Changes: Tracked changes, highlighted text, or another revision identification method required by the Editorial Office.
• Supporting Documentation: Updated analyses, tables, figures, reporting checklists, data statements, or additional documents where required.
• Reasoned Explanations: Scientific or methodological justification when authors do not adopt a particular reviewer suggestion.
• Continued Anonymization: Proper protection of author identities in materials intended for further external review.

Reassessment of Revised Manuscripts

Revised manuscripts may be:

• Reassessed directly by the Handling Editor.
• Returned to one or more original reviewers.
• Evaluated by additional reviewers when specialist assessment is required.
• Returned for further revision if material concerns remain unresolved.

Reviewers and editors should evaluate the adequacy of the revisions and determine whether remaining concerns materially affect publication suitability. Additional review rounds are arranged according to scholarly need rather than a predetermined minimum number of revision cycles.

An invitation to revise does not guarantee acceptance. A manuscript may be rejected after revision if substantive scientific, methodological, reporting, or ethical concerns remain unresolved.

8. Final Decision and Acceptance

A manuscript may be formally accepted when the responsible editor determines that it meets the journal's applicable standards of scholarly quality, methodological adequacy, ethical compliance, and publication suitability.

Final editorial consideration includes:

• The scientific or scholarly significance of the manuscript.
• The adequacy of the research design, analytical procedures, or theoretical argumentation.
• The reliability of the findings and their interpretation.
• The substance of relevant reviewer reports and author responses.
• Compliance with the journal's publication ethics and reporting requirements.
• Resolution of material scientific or ethical concerns.
• Overall suitability for publication in Health Nexus.

Acceptance and Continuing Responsibilities

Formal acceptance confirms the journal's editorial decision to proceed toward publication. It does not eliminate the authors' continuing responsibility for the accuracy of their research or the completeness of relevant declarations.

If a material scientific or ethical issue is identified after acceptance but before publication, production may be suspended while the matter is assessed. Appropriate editorial action may be taken in accordance with the journal's Publication Ethics Policy.

Editorial acceptance is independent of Article Processing Charges, waiver eligibility, funding arrangements, and other financial considerations. Applicable billing and transitional exemption arrangements are administered separately from academic evaluation.

9. Production and Publication

After formal acceptance, manuscripts enter the journal's production workflow, subject to completion of the required publication documentation and applicable editorial or administrative checks.

The process normally includes:

• Final Documentation: Verification of author details, funding and competing interest statements, Data Availability Statements, ethics declarations, AI disclosures, and relevant permissions.
• Copyediting: Editorial preparation to improve language consistency, clarity, citation presentation, and journal style.
• Typesetting: Preparation of the article in the journal's supported publication formats.
• Author Proofreading: Review of publication proofs to identify production errors and ensure that the final text accurately represents the accepted manuscript.
• Metadata and DOI: Verification of bibliographic metadata and registration of the appropriate DOI where applicable.
• Online Publication: Publication of the final Version of Record on the official journal website.

Open Access and Preservation

Articles are made freely available to readers under the journal's applicable open-access arrangements, normally through the Creative Commons Attribution 4.0 International Licence (CC BY 4.0).

Health Nexus participates in LOCKSS, CLOCKSS, and the PKP Preservation Network as part of its long-term digital preservation framework. Actual archival coverage of individual articles and issues is subject to the relevant deposit and preservation records.

Post-publication corrections, retractions, expressions of concern, and related research integrity matters are addressed in accordance with the journal's publication ethics and preservation policies.

10. Timeline (Indicative)

Health Nexus aims to maintain an efficient review process while allowing sufficient time for independent expert assessment and responsible editorial judgment. The following periods are indicative targets and do not constitute guaranteed processing times.

The journal prioritizes scientific rigor, fair review, and the reliability of editorial decisions over strict adherence to administrative timelines. The Editorial Office may communicate delays or updated deadlines where appropriate.

11. Ethical Oversight

All participants in the review process must comply with the journal's research integrity, confidentiality, competing interest, data protection, and responsible AI requirements.

Reviewers

• Maintain confidentiality and protect unpublished manuscript materials.
• Disclose relevant competing interests and decline assignments when impartiality cannot be maintained.
• Provide independent, professional, and evidence-based assessments.
• Report specific and substantiated ethical concerns confidentially to the Handling Editor.
• Seek prior written editorial authorization before using AI to assist with manuscript review, and comply with all applicable confidentiality requirements.

Editors

• Select qualified and independent reviewers.
• Manage relevant conflicts of interest and reassign manuscripts where necessary.
• Protect confidential submission and review information.
• Assess reviewer comments and manuscript evidence independently.
• Maintain appropriate human oversight of any authorized AI-assisted editorial activity.
• Respond proportionately to scientific and ethical concerns in accordance with the journal's published procedures.

Research Integrity Concerns

Potential plagiarism, fabrication, falsification, image manipulation, deficient research approval, inappropriate authorship, undisclosed competing interests, or other material concerns may require additional assessment.

Allegations are examined according to the available evidence and applicable editorial procedures. An automated similarity or AI-detection score does not independently establish research misconduct.

Where appropriate, affected authors may be asked to explain the circumstances and provide relevant supporting materials. Additional independent expertise or institutional clarification may be sought when justified.

Appeals and Complaints

Authors may submit a reasoned appeal concerning a formal editorial decision or raise a complaint about procedural fairness through the journal's established channels. Appeals should identify specific scientific, methodological, factual, or procedural grounds and provide relevant supporting information.

Appeals and complaints are handled under the Complaints & Appeals Policy. Where necessary, the matter may be assigned to an appropriate editor or independent assessor who was not materially involved in the original decision.

12. Editorial Independence

Health Nexus maintains editorial independence to ensure that manuscript decisions are based on scholarly merit, scientific validity, ethical compliance, and suitability for publication.

Panorama Scholarly Group, as the publisher, provides administrative, technical, and publishing support while respecting the academic independence of the Editor-in-Chief and authorized editors.

Editorial independence does not eliminate the publisher's responsibility to support lawful publishing operations, publication ethics procedures, research integrity investigations, or necessary corrective actions.

The final decision concerning manuscript suitability rests with the Editor-in-Chief or an appropriately delegated editor. External peer review, editorial screening, and the handling of revisions must remain consistent with the journal's published policies.