 brief overview of what is the life cycle of a manuscript since the time it's published to its printed. Happy to. So manuscripts are submitted to our journal electronically and so when we come into the office on Mondays or any day of the week actually our editorial assistant will look at what we've got and he or she will go through the manuscripts and evaluate them and they're doing an initial screen there to make sure that some major things are taken care of. For instance do we have all the tables and figures that are referenced in the article? Does it have an abstract? Does it have a title page? You know just simple basic things like that. Does it pass that basic screen? If not it will go back to the author but if it does pass that screen then it is assigned to an editor. And then the editor evaluates the paper again just quickly and makes a decision about whether or not to send it out for peer review. A manuscript that goes out for peer review is assigned to one editorial board member and two expert peer reviewers. So the editor or the assistant will identify those people using the manuscript tracking system. The manuscript is sent out for peer review to at least three people. If it's an original research and it comes back and it looks like it's something that might be acceptable we send that to our statistical editor and he takes a look at the statistics. When all of those reviews are back in it goes to the editor for a first decision. Like I mentioned before though our decisions aren't made by one person. So every Thursday at one o'clock we have a phone call between all of four of our editors and they talk about manuscripts that are going to go forward. So this is actually an opportunity for manuscripts that might be rejected to be sort of pulled back and sent out for revision and vice versa. Things that an editor offers for revision may just be rejected at that point. If it is sent out for revision it goes to the authors and we ask them to turn around their revisions in 21 days. So it's quick turn around. Once that revision comes back in our office our manuscript editor looks at it at the point and what she's looking for is does the abstract for instance does the abstract match what's in the paper? Do they have institutional review board approval? If it's a randomized trial have they registered it in clinicaltrials.gov or something similar? So those types of things she's looking very closely at and issues of style and so she'll put in author queries in the manuscript. Then it goes to our production editor who will look at the art and at that point a production editor might start redoing that art for the author and then it goes to the editor for that final look and then we talk about it once again on Thursday and we decide you know is this okay to be accepted and to be sent. If it is acceptable it's sent by our manuscript editor to our publisher. Our publisher runs it through some software that takes care of some minor style issues, references, things like that and then a copy editor at our publisher copy edits the manuscript and then it is sent for type setting. A compositor works on it. Page proofs go to the author and the editorial office at the same time. The editorial office sends back any corrections at the same time the author does. Then the editorial office sees it a second time and then we see it a third time and then it's sent out for publication. So there are good at least two or three people at the publisher who are editing it and working on the page proofs and then the compositor is working on getting that ready for publication, coding it, getting the XML ready and all of that conversion. So a lot of people are touching that manuscript as it moves through the process.