Within 5 working days of submission, the Editor-in-Chief and relevant Associate Editor assess each manuscript for scope fit, originality, ethical compliance and methodological soundness. Manuscripts that fall outside the journal's scope or do not meet minimum standards are returned to the authors with feedback at this stage.

Manuscripts that pass triage are sent to at least two independent external reviewers with relevant subject expertise. Reviewers evaluate the work against the following criteria:

• Scientific accuracy and methodological rigour
• Originality and contribution to the field
• Clinical applicability and educational value
• Clarity, structure and reporting transparency
• Ethical compliance and patient-safety alignment

Typical first-decision turnaround is six weeks from submission.

The journal uses AI tools to support — but never replace — editorial judgement. AI may be used to assist with:

• Reference verification and citation formatting
• Plagiarism and duplication screening
• Language polishing and readability checks
• Structural consistency across the manuscript

No AI tool is permitted to make editorial decisions, write reviewer reports, or generate scientific content on behalf of authors, reviewers or editors.

One of four decisions is issued by the handling editor:

• Accept — manuscript accepted in current form.
• Minor Revisions — accepted subject to specific revisions.
• Major Revisions — significant revisions required, followed by re-review.
• Reject — manuscript not suitable for publication.

Authors must disclose any use of AI tools (including large language models) in manuscript preparation, in the Methods or Acknowledgements section. The named human author(s) retain full responsibility for the accuracy, integrity and editorial content of all published work.

Reviewers and editors must declare any conflicts of interest. Editorial board members are independent of the publisher and serve in a voluntary advisory capacity. The journal adheres to COPE-aligned principles of editorial independence and ethical publishing.

Authors may appeal an editorial decision in writing to the Editor-in-Chief within 30 days. Post-publication corrections, expressions of concern and retractions follow COPE guidelines and are linked to the original article record.