1. Online Submission

All manuscripts must be submitted through the journal's official online submission system. Authors should register an account or sign in using their existing credentials before initiating a new submission.

Authors are responsible for completing the required submission fields, selecting the appropriate article type, supplying accurate manuscript metadata, uploading the necessary files, and confirming the submission through the journal's online submission system.

Email submission is not accepted as the standard submission method unless explicitly authorized by the Editorial Office. Sending a manuscript by email does not establish a formal submission record.

2. Pre-Submission Requirements

Before initiating a submission, authors must ensure that their manuscript meets the journal's scholarly, technical, and ethical requirements.

2.1 Scope and Article Type

• Confirm that the manuscript falls within the journal's Aims & Scope.
• Select the appropriate article type from the journal's recognized submission categories.
• Ensure that the research question, methods, and scholarly contribution are suitable for the selected category.
• Follow applicable word limits, abstract requirements, manuscript structure, and formatting instructions.
• Confirm that the submitted work presents an original scholarly contribution or another permitted form of academic analysis.

2.2 Manuscript Preparation

• Prepare the manuscript in clear academic English.
• Include a title, abstract, keywords, main text, references, and relevant tables or figures, as appropriate to the article type.
• Follow the journal's AMA Citation Style requirements.
• Ensure that in-text citations, references, DOI information, and supporting evidence are accurate and verifiable.
• Prepare an anonymized manuscript and a separate unblinded title page where required for double-blind review.
• Provide relevant reporting checklists, supplementary files, and research documentation where applicable.

2.3 Research Ethics and Integrity

• Confirm that the manuscript is not under simultaneous consideration by another journal.
• Ensure that all listed authors meet applicable authorship criteria and have approved the submission.
• Obtain appropriate ethical approval or documented exemption where required.
• Provide informed consent and consent-for-publication information where applicable.
• Register applicable clinical trials in accordance with the journal's clinical trial registration requirements.
• Disclose relevant funding, competing interests, and the use of AI-assisted technologies.
• Prepare a Data Availability Statement appropriate to the research conducted.
• Obtain necessary permissions for third-party copyrighted material and identifiable clinical information.

Authors should resolve material ethical, methodological, or documentary deficiencies before submission. Failure to provide required information may delay editorial assessment or result in the manuscript being returned or rejected.

3. Submission Materials

Authors must upload the required manuscript files and supporting documents through the journal's online submission system. Files must be identified accurately and prepared according to their intended editorial or review function.

3.1 Anonymized Main Manuscript

The main manuscript intended for external review must be anonymized.

• Include the manuscript title, abstract, keywords, main text, references, and relevant figure or table captions.
• Exclude author names, affiliations, email addresses, acknowledgments, and direct identifying information.
• Remove identifying metadata from document properties and file information.
• Prepare self-citations in a manner that protects anonymity while preserving sufficient scholarly context.
• Avoid unnecessary disclosure of institutional identifiers, identifying repository links, or other information that reveals authorship.

The Editorial Office may request additional anonymization where the manuscript or its supplementary files contain information that could compromise double-blind review.

3.2 Separate Title Page

Authors must provide a separate unblinded title page containing:

• The complete manuscript title.
• The full names and institutional affiliations of all authors.
• Corresponding author contact information.
• ORCID identifiers where available.
• Author contribution information where required.
• Funding declarations and acknowledgments.
• Competing interest statements.
• Other author-identifying declarations or supporting information requested by the Editorial Office.

The title page is retained for editorial administration and must not be included in the anonymized files sent to external reviewers.

3.3 Cover Letter

The cover letter should provide:

• The manuscript title and selected article type.
• A concise explanation of the research question, principal contribution, and scholarly significance.
• An explanation of how the manuscript falls within the journal's Aims & Scope.
• Confirmation of originality and the absence of simultaneous submission.
• Disclosure of relevant prior dissemination, related manuscripts, or potentially overlapping publications.
• Any material ethical, methodological, or administrative issues requiring confidential editorial attention.

The cover letter is intended for editorial assessment and should not be included in files designated for anonymized external review.

3.4 Official Similarity Report

Manuscripts without a compliant official similarity report or an appropriately anonymized main file will be returned during initial screening and will not proceed to external peer review until the relevant submission requirements have been satisfied.

3.5 Supplementary Files and Supporting Documents

Where applicable, supplementary submission materials may include:

• High-resolution figures and editable tables.
• Research protocols and reporting guideline checklists.
• Supplementary methods, analyses, or supporting results.
• Data availability information, repository identifiers, and access documentation.
• Clinical trial registration details.
• Ethics approval documentation, consent information, or relevant exemptions.
• Permissions for copyrighted or identifiable third-party material.
• Other materials requested by the Editorial Office for methodological or ethical assessment.

Supporting files containing personal, institutional, or confidential information must be designated appropriately and must not be made available to external reviewers without suitable anonymization or authorization.

4. Initial Editorial Check

After a submission is received, the Editorial Office conducts an initial administrative and scholarly assessment before determining whether the manuscript is suitable for external peer review.

Initial screening examines:

• Scope Alignment: Relevance to the journal's Aims & Scope and the selected article category.
• Manuscript Completeness: Submission of the required article files, metadata, declarations, and supporting documentation.
• Double-Blind Preparation: Compliance with anonymization requirements and separation of the Title Page from the main manuscript.
• Similarity and Originality: Availability and suitability of the required similarity report and preliminary assessment of possible textual overlap.
• Research Ethics: Relevant ethical approval, informed consent, clinical trial registration, confidentiality, and disclosure requirements.
• Methodological Adequacy: Basic suitability of the research design, analytical approach, and supporting evidence.
• Academic Presentation: Compliance with reporting standards, manuscript structure, citation style, and language requirements.

Possible Outcomes of Initial Screening

• Return for Technical Correction: The submission requires correction of missing files, formatting deficiencies, anonymization problems, or other administrative matters.
• Editorial Rejection: The manuscript is outside the journal's scope or does not meet the minimum scholarly, methodological, or ethical requirements for further consideration.
• Proceed to Editorial Assignment: The submission is considered potentially suitable for further scholarly assessment and possible external peer review.

Completion of administrative screening does not guarantee external review, acceptance, or publication. Technical corrections and editorial decisions are communicated through the journal's official submission workflow.

5. Peer Review Process

Research manuscripts selected for external evaluation undergo the journal's double-blind peer review process. The assessment is coordinated by the Editor-in-Chief, a designated Academic Editor, or an authorized Handling Editor.

The review process generally includes:

• Editorial Assignment: Allocation of the manuscript to an editor with appropriate subject and methodological expertise.
• Reviewer Selection: Invitation of at least two qualified and independent experts for externally reviewed research manuscripts.
• Double-Blind Assessment: Author-identifying information is withheld from reviewers, and reviewer identities are not disclosed to authors during the review process.
• Scholarly Evaluation: Assessment of originality, research design, methodological rigor, data interpretation, ethical compliance, and scientific or scholarly contribution.
• Editorial Consideration: Critical assessment of reviewer reports and preparation of an appropriate editorial recommendation or decision.
• Additional Review: Further specialist assessment may be requested when reviewer opinions conflict or additional expertise is required.

Reviewers are selected according to the research subject and methodology. Manuscripts conducted entirely within conventional medicine, TCM, or another eligible discipline are not required to demonstrate interdisciplinary integration.

Editorials and Commentaries are generally subject to appropriate editorial assessment and may undergo additional expert review at the Editorial Office's discretion.

Further information is provided in the Peer Review Process.

6. Editorial Decision

Editorial decisions are based on the scientific and scholarly merits of the manuscript, the adequacy of its methods and evidence, applicable ethical standards, and the substance of relevant reviewer reports.

Possible editorial outcomes include:

• Accept: The manuscript meets the journal's publication requirements and may proceed to post-acceptance checks and production.
• Minor Revision: The manuscript requires limited corrections, clarification, or improvement before reconsideration.
• Major Revision: Substantial changes are necessary to address significant scholarly, methodological, analytical, or reporting concerns.
• Reject: The manuscript does not meet the journal's publication standards or cannot be satisfactorily resolved through revision.

The Handling Editor may provide a recommendation based on the available evidence and reviewer comments. The final editorial decision is made by the Editor-in-Chief or an authorized delegated editor.

Reviewer recommendations are advisory and do not automatically determine the outcome. Acceptance decisions are made independently of article processing charges, funding arrangements, or authors' financial circumstances.

7. Revision and Resubmission

Authors invited to revise a manuscript must address the substantive comments and requirements identified by reviewers and editors.

A revised submission should include:

• Point-by-Point Response: A structured response addressing each reviewer and editorial comment.
• Revised Manuscript: A complete updated manuscript incorporating the necessary revisions.
• Identification of Changes: Tracked changes, highlighted revisions, or another method specified by the Editorial Office.
• Supporting Evidence: Updated analyses, relevant citations, supplementary documentation, reporting checklists, or additional materials where requested.
• Reasoned Disagreement: A clear scientific or methodological explanation where the authors do not adopt a reviewer recommendation.
• Timely Resubmission: Submission within the deadline specified by the Editorial Office or a justified request for an extension.

Revised files intended for external review must retain appropriate anonymization. Author-identifying information should remain in the separate unblinded submission materials.

The editor may assess revisions directly, return the manuscript to previous reviewers, or seek additional expertise. Further rounds of revision or review may be required.

An invitation to revise does not guarantee acceptance. Inadequate responses, unresolved methodological concerns, or failure to meet applicable requirements may result in rejection.

8. Acceptance and Production

After formal editorial acceptance, the manuscript enters the journal's production workflow. Acceptance is subject to the completion of applicable administrative, publication ethics, licensing, and production requirements.

The production process normally includes:

• Final Documentation: Verification of author information, declarations, publication permissions, and other required documents.
• Copyediting: Editorial preparation for clarity, accuracy, consistent terminology, and journal style.
• Typesetting and Formatting: Preparation of publication-ready article files.
• Author Proofreading: Review of proofs and correction of production errors.
• Metadata Verification: Checking article titles, author affiliations, abstracts, references, publication information, and identifiers.
• Online Publication: Formal publication of the Version of Record through the journal's official website.

Published articles are made freely accessible under the journal's applicable open-access and copyright arrangements. The journal supports digital preservation and scholarly dissemination through its published policies and preservation infrastructure.

Substantive scientific or authorship changes requested after acceptance may require additional editorial review. Post-publication corrections and research integrity matters are handled under the relevant journal policies.

9. Ethical Compliance Check

Before publication, accepted manuscripts are subject to final editorial and research integrity checks appropriate to the article type and study design.

These checks may include:

• Ethics Approval: Verification of approval, exemption, or other appropriate ethical oversight documentation where required.
• Informed Consent: Appropriate documentation relating to participant consent, publication consent, and privacy protection where applicable.
• Trial Registration: Confirmation of relevant registration information for applicable clinical trials.
• Competing Interests: Verification of financial and non-financial disclosures.
• Funding Transparency: Accurate identification of funding sources and the role of relevant sponsors.
• Data Availability: Inclusion of an appropriate Data Availability Statement and any necessary access restrictions.
• AI-Use Disclosure: Relevant declarations concerning AI-assisted research, analysis, or manuscript preparation.
• Copyright and Permissions: Appropriate authorization for third-party materials and compliance with the journal's open-access licensing requirements.
• Research Integrity: Resolution of outstanding concerns involving originality, data reliability, authorship, or other material publication ethics issues.

If a material ethical or scientific concern arises after acceptance but before publication, the journal may suspend production while the matter is assessed. Formal acceptance does not prevent necessary research integrity review or proportionate editorial action.

10. Article Processing Charges (APC)

Health Nexus is a fully open-access scholarly journal. It has announced a transition from Diamond Open Access to an APC-supported publishing model beginning in 2027, with transitional exemptions for eligible earlier submissions.

Full or partial waivers may be available under the journal's published eligibility criteria. Authors seeking a discretionary waiver should submit the request at the time of manuscript submission, in accordance with the applicable APC & Waiver Policy.

The journal separately identifies certain optional, author-requested administrative services that may incur charges after acceptance or publication. Such charges are not submission or peer review fees and do not apply to required research integrity corrections, complaints, or appeals.

For fee conditions, transitional exemptions, waiver applications, and invoicing arrangements, consult the APC & Waiver Policy and the 2027 Publishing Model Transition Announcement.

11. Communication

Official manuscript-related correspondence is conducted through the journal's online submission system and the registered email address of the corresponding author.

Communications may include:

• Submission Confirmation: Notification concerning the submission record and relevant administrative details.
• Technical Queries: Requests for missing files, anonymization corrections, declarations, or additional documentation.
• Editorial Decisions: Formal decisions and relevant reviewer feedback.
• Revision Requests: Instructions concerning necessary manuscript changes, supporting materials, and revision deadlines.
• Production Correspondence: Queries concerning copyediting, proofs, article metadata, and publication requirements.
• Publication Notification: Communication concerning the final published article and its official publication link.

Corresponding authors are responsible for maintaining an accessible and accurate registered email address, monitoring notifications from the journal, and communicating relevant editorial information to their coauthors.

Authors should not send confidential patient information, unnecessary personal records, account passwords, or sensitive research data through unsecured correspondence. Where confidential documentation is required, the Editorial Office will provide appropriate submission or communication instructions.