Speaker 1: You have submitted your paper to the journal, and here's what happens next. The Editorial Office performs a technical check on your manuscript before assigning it to the Editor-in-Chief or an Associate Editor for further handling. Journals usually have multiple Associate Editors, who are each experts in a particular niche within the broader subject area. Your manuscript will be handled by the Associate Editor, who has the highest level of understanding and experience with your paper's research topic. The status remains With Editor until the Editor invites reviewers. The Editor conducts an initial screening of your paper and assesses it against several criteria such as novelty, priority, and scope. If your paper is a better match for another journal, you may be offered a manuscript transfer. Also, it's possible that your paper does not meet some of the assessment criteria, and then the Editor will reject it before going into peer review. We understand that this is a disappointment, but the Editor tries to make this initial evaluation quickly so you can submit your paper elsewhere and not lose time. If the Editor decides that your paper is a good match for their journal, they will identify two or three independent reviewers and send them an invitation to review your manuscript. Once reviewers have been invited, the peer review process is underway. Several factors may influence the time taken to review your paper. For instance, it may be challenging to find reviewers with the right expertise in your subject area. Also, as you can imagine, reviewers are often busy scientists or medical doctors with responsibilities in the clinic, which limits their availability for reviewing papers. We are committed to the highest quality in the review process, and we seek the best experts in each field globally. Please bear in mind that peer review times vary per manuscript and per journal. Once the number of required reviews has been received, the Handling Editor carefully studies the review reports. It can happen that the referee reports are conflicting, in which case the Editor needs to find one or more new reviewers and seek their advice on your paper. When this happens, your submission returns to Under Review status. When the Editor has received enough high-quality feedback from the reviewers, they will begin the decision-making process and move the status to Decision in Process. The Editors have begun a decision in the system. Decision may need to be confirmed by multiple Editors in some journals. When the decision is finalized, you will receive a direct email with the overall Editorial Decision, Editor and or Reviewer comments, and further instructions. There are four possible decision options for the Editor. Revise. The Editor has requested that you revise the submission. You will find the details of changes required and the deadline for your revision in the Decision Letter. Accept and Reject. The submission process has completed with either an Accept or Reject decision. In the case of an Accept decision, the manuscript will begin its production process and you will receive further information. Transfer. The Editor has recommended the submission be transferred to another journal via our automatic article transfer service, and you are offered a transfer. We will await your response before proceeding. Thank you for your interest in publishing with Elsevier. We wish you every success with your paper.