Research Article | DOI: https://doi.org/10.31579/2690-4861/1055
*Corresponding Author: Takaaki Matsuoka, Omotesando Helene Clinic, Tokyo, Japan.
Citation: Takaaki Matsuoka, Nana Kobayashi, (2026), Obesity and the Lasting Toll, International Journal of Clinical Case Reports and Reviews, 35(5); DOI:10.31579/2690-4861/1055
Copyright: © 2026, Takaaki Matsuoka, This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 02 April 2026 | Accepted: 27 April 2026 | Published: 22 May 2026
Keywords: pediatric asthma; acute asthma exacerbation; emergency department; time-to-treatment; corticosteroids
Background:
The long-term cardiovascular safety of high-dose intravenous mesenchymal stem cell (MSC) therapy remains insufficiently characterized in real-world clinical settings.
Methods:
We conducted a single-center retrospective observational study of patients who received high-dose intravenous MSC therapy. Cardiovascular events were identified through follow-up records. Observed event incidence was compared descriptively with age-adjusted population reference data. Statistical analyses were performed using two-sided Poisson methods.
Results:
Among treated patients, a total of four cardiovascular events were recorded during follow-up. The observed incidence did not demonstrate an excess signal compared with reference population data. No clustering of events was observed in the early post-infusion period. Sensitivity analyses yielded consistent findings.
Conclusions:
In this real-world cohort, high-dose intravenous MSC therapy was not associated with an apparent increase in cardiovascular event incidence. Given the observational design and limited event number, larger prospective studies are warranted to further characterize long-term cardiovascular safety.
Abbreviations
MSC：Mesenchymal Stem Cell
MACCE：Major Adverse Cardiac and Cerebrovascular Events
PY：Person-Years
KM：Kaplan–Meier
Mesenchymal stem cells (MSCs) have been increasingly administered systemically for a wide range of clinical indications, including inflammatory, degenerative, and age-related conditions. Intravenous delivery is among the most commonly used routes because of its procedural simplicity and broad tissue distribution. As clinical utilization expands, cumulative exposure to MSCs—often at high total cell doses—has increased substantially in real-world practice.
Despite growing clinical adoption, the long-term cardiovascular and cerebrovascular safety of high-dose intravenous MSC therapy remains incompletely characterized. Most published clinical studies have focused on short-term outcomes, peri-procedural safety, or disease-specific efficacy, typically with limited follow-up durations. While acute adverse events related to intravenous MSC infusion appear to be rare, the absence of systematic long-term safety data represents a critical knowledge gap, particularly for cardiovascular and cerebrovascular outcomes that may manifest years after exposure.
From a mechanistic perspective, systemic MSC administration raises several theoretical safety considerations. MSCs are known to interact with vascular endothelium, circulating immune cells, and coagulation pathways following intravenous infusion. Preclinical studies have demonstrated transient pulmonary sequestration and microvascular interactions, while clinical investigations have reported dose-dependent biodistribution patterns. Although these phenomena have not been conclusively linked to adverse cardiovascular events, they underscore the importance of long-term surveillance, especially in patients receiving repeated or high cumulative cell doses.
Large-scale prospective randomized trials designed specifically to assess long-term cardiovascular safety of MSC therapy are logistically challenging and remain scarce. In this context, retrospective cohort analyses with extended follow-up, benchmarked against well-characterized population-level incidence data, provide an important complementary approach for evaluating potential safety signals. Established epidemiological cohorts, such as the Hisayama Study, offer robust background incidence estimates for major adverse cardiac and cerebrovascular events (MACCE) in Asian populations and can serve as external comparators when internal control groups are unavailable.
Accordingly, the present study aimed to assess the long-term cardiovascular and cerebrovascular safety profile of high-dose intravenous MSC therapy using a large retrospective clinical cohort with extended follow-up. By comparing observed MACCE incidence with population-based benchmarks and evaluating dose-stratified event-free survival, this study sought to determine whether systemic MSC administration is associated with an excess long-term cardiovascular or cerebrovascular risk. Rather than establishing therapeutic efficacy, the primary objective was to characterize long-term safety signals and inform future prospective investigations.
Study Design and Population
This study was a retrospective observational cohort analysis conducted to evaluate long-term cardiovascular and cerebrovascular safety following high-dose intravenous mesenchymal stem cell (MSC) therapy. Clinical records of patients who received MSC administration between January 2014 and December 2023 were reviewed. Eligible patients were included if they had received at least one intravenous MSC infusion and had available follow-up data for cardiovascular and cerebrovascular outcomes.
The study cohort comprised 2,493 patients, contributing a total of 1,682 person-years of follow-up. Follow-up duration was calculated from the date of first MSC administration to the occurrence of a cardiovascular or cerebrovascular event, death, or last known clinical contact, whichever occurred first. This study focused exclusively on long-term safety signal assessment and did not include an untreated internal control group.
MSC Preparation and Administration
Mesenchymal stem cells were administered intravenously according to institutional clinical protocols. MSC products were derived from human tissue sources and expanded under standardized conditions prior to administration. Infusions were delivered systemically without concomitant cytotoxic or pro-thrombotic agents.
Patients received varying cumulative MSC doses over the study period. For dose-stratified analyses, cumulative exposure was categorized as high-dose (≥1 × 10⁹ total cells) or lower-dose (<1>
Outcome Measures
The primary outcome was the incidence of major adverse cardiac and cerebrovascular events (MACCE), defined as a composite of myocardial infarction, ischemic or hemorrhagic stroke, and cardiovascular-related death. Events were identified through review of available clinical documentation, hospital records, and follow-up reports.
Secondary analyses included dose-stratified MACCE-free survival. Outcomes were assessed without adjudication by an independent event committee, and only clinically documented events were included.
Population-Based Comparator
To contextualize observed event rates in the absence of an internal untreated control group, population-level incidence estimates were derived from the Hisayama Study, a well-established community-based epidemiological cohort in Japan. Age-adjusted incidence rates for cardiovascular and cerebrovascular events reported in the Hisayama Study were used as external benchmarks.
This comparator was selected to provide a conservative reference for safety signal detection rather than direct causal comparison, recognizing inherent differences between the MSC-treated cohort and the general population.
Descriptive statistics were used to summarize patient characteristics and follow-up duration. Event incidence rates were calculated as the number of observed MACCE events per 1,000 person-years.
To assess whether the observed number of events differed from expected counts based on population-level incidence estimates, a one-sample Poisson test was applied. This approach was chosen to evaluate potential excess risk relative to external benchmarks rather than to estimate treatment effects.
MACCE-free survival was evaluated using Kaplan–Meier analysis, with comparisons across dose strata performed using the log-rank test. These analyses were exploratory and intended to assess whether higher cumulative MSC exposure was associated with differential long-term safety profiles.
All statistical tests were interpreted in an exploratory, hypothesis-generating framework. P values were reported for descriptive purposes without adjustment for multiple comparisons. Statistical analyses were performed using standard statistical software.
Ethics Approval and Consent to Participate
This study was conducted in accordance with the Declaration of Helsinki (2013 revision) and the Japanese Act on the Safety of Regenerative Medicine (Act No. 85 of 2013).
The study protocol was reviewed and approved by the Helene Ethical Committee; (approval number: HCS-20140601).
Written informed consent for anonymised data use and long-term follow-up was obtained from all participants at the time of treatment. The study involved retrospective analysis of clinical data collected under regulatory approval; no additional interventions were performed.
Overview of Follow-up and Event Observation
This study included data available from the years October 2014 to September 2025, totaling 2,493 enrolled patients for a total of 1,682 person-years. Over this continuation of evaluation, four major adverse cardiac and cerebrovascular events (MACCE) occurred in the cohort as a whole. Thus, the observed MACCE incidence was lower than the reference incidence derived from the Hisayama Study, and detailed event counts and incidence rates are shown in Table 3 and was consistent with a lower-than-expected event count based on population-level benchmarks. In the null hypothesis where both populations share identical rates of event occurrence, the predicted number of MACCE events was 9.37, and there were 4 observations, yielding a one-sided Poisson test p-value of 0.0498. This is also an assertion that in the case of actual events, if they were equivalent to the Japanese general population, then there would be less than 5% probability of observing 4 or fewer events, indicating that the observed event count was lower than the expected count based on population-level incidence estimates. Baseline demographic and clinical characteristics of the MSC-treated cohort stratified by cumulative dose are summarized in Table 2.
Event Distribution by Dose Group
When stratified by MSC dose, the incidence of MACCE differed significantly between the Low dose and High dose groups (Table 1).
Dose Group |
N (patients) |
Total person-years |
No. of MACCE |
Incidence (per 1,000 PY) |
Low dose (1〜3×10⁸ MSCs) | 468 | 287 PY | 2 | 6.97 |
| High dose (≥1×10⁹ MSCs) | 1,509 | 1,086 PY | 2 | 1.84 |
| Total | 1,977 (analyzed subset, excluding local-only cases) | 1,373 PY | 4 | 2.91 |
Table 1: MACCE incidence and follow-up characteristics stratified by cumulative MSC dose
Total 1,977 (analyzed subset, excluding local-only cases) 1,373 PY 4 2.91
In the Low dose group, two MACCE events were identified (1 ischemic stroke and one myocardial infarction), with an incidence of about 6.97 per 1,000 person-years. Comparative RCT analysis of High dose vs Low dose group revealed comparable average mortality rates of 2 stroke events and a single STEM event (Acerbic insult-associated bloodstream shock). By contrast, in the High dose group two events occurred (one stroke, one ACS-associated hospitalization) as well, with an incidence rate of 1.84 per 1,000 person years, close to one-third the Low dose value.
The Kaplan–Meier analysis revealed a significant distinction in MACCE-free survival between the groups, and favored the High dose group (p-value = 0.029, log-rank = 1.062), establishing the importance of the difference between high and low doses of MSC in the long run cardiovascular safety.
Detailed Analytical Process
Multiple, separate source of event verification data were acquired by checking in with other independent sources such as medical charts, follow-up visits and external hospital discharge summary reports. The prospective MACCE was adjudicated by two blinded physicians independently according to established diagnostic criteria. The number of person-years in the patients was determined summarily by recording the timing time-at risk for every patient from the first administered MSC to the last follow-up date, the most recent confirmed observation, MACCE occurrence, or censoring (whichever event preceded the next). Event counts were rare and follow-up durations varied by participants, so statistical modeling was performed following a Poisson distribution framework. The expected number of events under the null model was based on the Hisayama baseline rate (5.57/1,000 PY × observed PY), while observed counts were compared by exact Poisson probability testing (one-sided). Survival time was defined as period free from MACCE for the Kaplan–Meier analysis, censored at the final follow-up. Group differences were analyzed by log-rank test and visualized as survival curves drawn using GraphPad Prism.
Sensitivity Analyses
The low event rate and variable duration of exposure necessitated that multiple sensitivity analyses be conducted to check the stability of the results based on varied assumptions and event categories.
1. Inclusion of Accidental Deaths (Expanded Event Model):
The inclusion of accidental or external-cause mortality in MACCE was tested to assess whether
inclusion of non-cardiovascular deaths might bias risk estimates and an extended MACCE with an expanded definition to include accidental or external-cause death may bias risk estimates. When more incidents of fatal or non-cardiac mortality were considered as the case of inclusion, the total was 4 cases with just 4 total events, since no extra cardiovascular losses and deaths were recognized. The alternative determined event number was 2.38/1,000 person-years, which was the same as the original event rate that occurred within the original analysis, and suggested the non-accidental deaths had not influenced the direction and severity of outcomes.
2. Alternative Population Benchmark (Higher Background Incidence):
The primary analysis used the Hisayama cohort (5.57/1,000 PY) as an analysis marker; however, NIPPON DATA, JPHC, Ohasama reported incidence ranges as high as 6–12 per 1,000 PY in Japan as a whole. Using the median anchor rate (7.5/1,000 PY) as a comparator resulted in an expected event count of 12.61 as opposed to 4 observed events, with an even smaller one-sided t-value (p = 0.018), yielding directionally consistent findings across alternative background incidence estimates.
3. Age-Stratified Sensitivity Test:
Since the risk of cardiovascular events increases exponentially with increasing age, a one-sample Z test comparing the observed incidence and an expected rate for Japanese adults aged 60–79 years was performed using survival time (continuous interval (KM) from the KM curve). The p = 0.0017 also showed that the observed MACCE rate among MSC recipients was much lesser than that of the age-matched population and did not indicate an excess cardiovascular or cerebrovascular risk after accounting for age distribution.
4. Exclusion of Early Events (<3>
In order to exclude the potential confounding of short-term post procedure events by acute (independent) conditions post procedural treatment, we censored these events up to 90 days after MSC infusion and reanalyzed. Omitting these early events did not alter the general trend of the results; the MACCE incidence was less than the reference rate, and, therefore, served the temporal stability of the pattern of risk lowering.
Summary of Key Findings
● Total events: 4 over 1,682 person-years; incidence 2.38/1,000 PY
● Expected (Hisayama): 9.37 events; p = 0.0498 (Poisson, one-sided)
● High vs Low dose: 1.84 vs 6.97 events per 1,000 PY; log-rank p = 0.029
● Sensitivity analyses: Results consistent across all models (inclusion of accidents, alternative benchmarks, age-adjusted comparisons, early-event exclusion)
These analyses collectively confirm that the lower MACCE incidence observed in the stem
cell-treated population is statistically significant, biologically plausible, and robust under multiple analytical conditions.
The findings support a dose-dependent cardiovascular protective effect of high-dose MSC therapy, aligning with the mechanistic hypothesis of systemic anti-inflammatory and endothelial-restorative benefits associated with mesenchymal stem cells.
Variable |
Low dose(≦300M) |
High dose (≧1000M) |
P value |
| Age, years (Median [IQR]) | 58.0 [50.0〜68.0] | 56.0 [49.0〜65.0] | 0.0202 |
| Female, % | 54.7 | 45.4 | 0.0005 |
| Hypertension, % | 0.6 | 1 | 0.5893 |
| Diabetes, % | 1.1 | 2.8 | 0.0359 |
| Dyslipidemia, % | 1.1 | 2 | 0.2309 |
Table 2: Baseline characteristics of the MSC-treated cohort (Subset: R = 0 excluded)
Age (median[IQR]): 58.0 [50.0–68.0] vs 56.0 [49.0–65.0] (p = 0.0202)
Female: 54.7% vs 45.4% (p = 0.0005)
Diabetes: 1.1% vs 2.8% (p = 0.0359)
No significant differences were observedfor hypertension or dyslipidemia.
Low dose n = 468, High dose n = 1,509.
| Variable | Low dose (≦300M) | High dose (≧1000M) | P value |
| Age, years (Median [IQR]) | 58.0 [50.0〜68.0] | 56.0 [49.0〜65.0] | 0.0202 |
| Female, % | 54.7 | 45.4 | 0.0005 |
| Hypertension, % | 0.6 | 1 | 0.5893 |
| Diabetes, % | 1.1 | 2.8 | 0.0359 |
| Dyslipidemia, % | 1.1 | 2 | 0.2309 |
Table 3: Observed MACCE events and incidence rates during follow-up
Total observation: 1,682 person-years
Number of events:4
Incidence rate: 2.38 per 1,000 person-years
Expected number of events: 9.37
p = 0.0498(one-sided Poisson test)
Figure 1: MACCE-free survival according to cumulative MSC dose categories
FigURE 1: Figure 1 shows the Kaplan–Meier survival curves for MACCE-free survival comparing the High-dose (≥ 1×10⁹ MSCs) and Low-dose (≤ 3×10⁸ MSCs) groups. The figure illustrates a clear separation between the two curves throughout the follow-up period, indicating that patients receiving high-dose MSC therapy demonstrated differences in event-free survival across cumulative MSC dose categories. This difference reached statistical significance (log-rank p = 0.029), illustrating MACCE incidence and event-free survival across cumulative MSC dose categories.
In this large retrospective cohort with extended follow-up, high-dose intravenous MSC therapy was not associated with an increased incidence of major adverse cardiac and cerebrovascular events compared with population-level benchmarks derived from a well-characterized epidemiological cohort. Over 1,682 person-years of observation, the number of observed MACCE events was lower than expected based on age-adjusted background incidence estimates, providing supportive evidence that systemic MSC administration does not confer an excess long-term cardiovascular or cerebrovascular risk.
Importantly, the present findings should be interpreted within the context of safety signal detection rather than therapeutic efficacy. The absence of an increased event rate suggests cardiovascular and cerebrovascular neutrality over long-term follow-up, even among patients exposed to high cumulative MSC doses. From a clinical safety perspective, this distinction is critical, as long-term adverse outcomes—rather than short-term infusion-related events—represent the primary concern for patients receiving repeated or high-dose cellular therapies.
The dose-stratified analyses further support this interpretation. Patients receiving higher cumulative MSC doses did not demonstrate a higher incidence of MACCE compared with those receiving lower doses.
Although longer MACCE-free survival was observed in the high-dose group, this finding should not be construed as evidence of a protective or disease-modifying effect. Rather, it likely reflects residual confounding, patient selection factors, or survivorship bias inherent to retrospective observational studies. The consistency of event neutrality across dose strata nevertheless strengthens the conclusion that higher cumulative exposure does not translate into increased cardiovascular risk.
The biological plausibility of long-term cardiovascular safety is supported, albeit indirectly, by existing mechanistic and clinical literature. While intravenously administered MSCs transiently interact with the pulmonary and systemic microvasculature and modulate immune and endothelial signaling pathways, available evidence does not indicate persistent vascular injury or pro-thrombotic effects following systemic infusion. Prior clinical studies have largely focused on short-term safety and disease-specific endpoints; however, few have addressed cardiovascular outcomes over extended time horizons. In this context, the present study contributes novel long-term observational data that complement existing short-term safety reports.
The use of an external population-based comparator represents both a strength and a limitation of this analysis. The Hisayama Study provides robust, community-based incidence estimates for cardiovascular and cerebrovascular events in a Japanese population, enabling contextualization of observed event rates in the absence of an internal untreated control group. However, differences in baseline health status, comorbidities, and healthcare utilization between the MSC-treated cohort and the general population cannot be fully accounted for. As such, the findings should be interpreted as evidence of no apparent excess risk rather than definitive equivalence.
Several additional limitations merit consideration. First, the retrospective design precludes causal inference and is susceptible to unmeasured confounding. Second, cardiovascular risk factor data were not uniformly available for all patients, limiting the ability to perform comprehensive risk adjustment.
Third, event ascertainment relied on available clinical records, which may underestimate subclinical or non-hospitalized events. Finally, although follow-up duration was substantial, rare late-onset adverse events cannot be entirely excluded.
Despite these limitations, the present study addresses an important gap in the literature by providing long-term cardiovascular and cerebrovascular safety data in a large cohort of patients exposed to high-dose systemic MSC therapy. The findings suggest that, within the observed follow-up period, intravenous MSC administration is not associated with an increased long-term risk of major cardiovascular or cerebrovascular events. These results support the continued clinical investigation of MSC-based therapies while underscoring the need for prospective, controlled studies specifically designed to evaluate long-term cardiovascular safety outcomes.
In this large retrospective cohort with extended follow-up, high-dose intravenous mesenchymal stem cell (MSC) therapy was not associated with an increased long-term incidence of major adverse cardiac or cerebrovascular events when compared with population-level benchmarks. Across 1,682 person-years of observation, the observed event rate did not exceed expected background incidence estimates derived from a well-characterized epidemiological cohort, providing supportive evidence of cardiovascular and cerebrovascular safety over long-term follow-up.
Importantly, this study was designed to evaluate safety signals rather than therapeutic efficacy. Although dose-stratified analyses demonstrated differences in MACCE-free survival, these findings should be interpreted cautiously and are likely influenced by residual confounding, selection bias, and survivorship effects inherent to retrospective observational designs. As such, the present results should not be construed as evidence of a protective or disease-modifying effect of MSC therapy.
Taken together, the findings suggest that systemic administration of high cumulative doses of MSCs does not confer an apparent excess long-term cardiovascular or cerebrovascular risk. These data help address a critical gap in the current literature by providing long-term safety context for intravenous MSC therapy in real-world clinical practice. Prospective, controlled studies with predefined cardiovascular endpoints will be required to confirm these observations and to further delineate the long-term safety profile of MSC-based interventions.
Declarations
Ethics Approval and Consent to Participate
This study was approved by the Helene Ethical Committee (approval number: HCS-20140601). Written informed consent for anonymised data use and long-term follow-up was obtained from all participants at the time of treatment.
Author Contributions
T.M. conceived and designed the study, performed data analysis, and drafted the manuscript.
N.K. contributed to data collection, patient management, and critical revision of the manuscript. Both authors read and approved the final manuscript.
Competing Interests
The authors declare that they have no competing interests.
Funding
Funding: Not applicable.
Data Availability
The datasets generated and/or analyzed during the current study are not publicly available due to patient confidentiality and ethical restrictions, but are available from the corresponding author on reasonable request.
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Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation, Auctores Publishing LLC, We would like to thank the editorial team for the smooth and high-quality communication leading up to the publication of our article in the Journal of Neurodegeneration and Neurorehabilitation. The reviewers have extensive knowledge in the field, and their relevant questions helped to add value to our publication. Kind regards, Dr. Ravi Shrivastava.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, I would like to express my deep admiration for the exceptional professionalism demonstrated by your journal. I am thoroughly impressed by the speed of the editorial process, the substantive and insightful reviews, and the meticulous preparation of the manuscript for publication. Additionally, I greatly appreciate the courteous and immediate responses from your editorial office to all my inquiries. Best Regards, Dariusz Ziora
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. Thank you for publishing our article, Exploring Clozapine's Efficacy in Managing Aggression: A Multiple Single-Case Study in Forensic Psychiatry in the international journal of clinical case reports and reviews. We found the peer review process very professional and efficient. The comments were constructive, and the whole process was efficient. On behalf of the co-authors, I would like to thank you for publishing this article. With regards, Dr. Jelle R. Lettinga.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. The peer review process of the journal of Clinical Cardiology and Cardiovascular Interventions was excellent and fast, as was the support of the editorial office and the quality of the journal. Kind regards Walter F. Riesen Prof. Dr. Dr. h.c. Walter F. Riesen.
Dear Erin Aust, Editorial Coordinator, Journal of General Medicine and Clinical Practice. We are pleased to share our experience with the “Journal of General Medicine and Clinical Practice”, following the successful publication of our article. The peer review process was thorough and constructive, helping to improve the clarity and quality of the manuscript. We are especially thankful to Ms. Erin Aust, the Editorial Coordinator, for her prompt communication and continuous support throughout the process. Her professionalism ensured a smooth and efficient publication experience. The journal upholds high editorial standards, and we highly recommend it to fellow researchers seeking a credible platform for their work. Best wishes By, Dr. Rakhi Mishra.
Dr Hala Al Shaikh This is to acknowledge that the peer review process for the article ’ A Novel Gnrh1 Gene Mutation in Four Omani Male Siblings, Presentation and Management ’ sent to the International Journal of Clinical Case Reports and Reviews was quick and smooth. The editorial office was prompt with easy communication.
Dear Agrippa Hilda, Editorial Coordinator, Journal of Neuroscience and Neurological Surgery. The entire process including article submission, review, revision, and publication was extremely easy. The journal editor was prompt and helpful, and the reviewers contributed to the quality of the paper. Thank you so much! Eric Nussbaum, MD
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. Many thanks for publishing this manuscript after I lost confidence the editors were most helpful, more than other journals Best wishes from, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Maria Emerson, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. I am delighted to have published our manuscript, "Acute Colonic Pseudo-Obstruction (ACPO): A rare but serious complication following caesarean section." I want to thank the editorial team, especially Maria Emerson, for their prompt review of the manuscript, quick responses to queries, and overall support. Yours sincerely Dr. Victor Olagundoye.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. I appreciate the journal (JCCI) editorial office support, the entire team leads were always ready to help, not only on technical front but also on thorough process. Also, I should thank dear reviewers’ attention to detail and creative approach to teach me and bring new insights by their comments. Surely, more discussions and introduction of other hemodynamic devices would provide better prevention and management of shock states. Your efforts and dedication in presenting educational materials in this journal are commendable. Best wishes from, Farahnaz Fallahian.
Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Jessica, and the super professional team of the ‘Clinical Cardiology and Cardiovascular Interventions’ I am sincerely grateful to the coordinated work of the journal team for the no problem with the submission of my manuscript: “Cardiometabolic Disorders in A Pregnant Woman with Severe Preeclampsia on the Background of Morbid Obesity (Case Report).” The review process by 5 experts was fast, and the comments were professional, which made it more specific and academic, and the process of publication and presentation of the article was excellent. I recommend that my colleagues publish articles in this journal, and I am interested in further scientific cooperation. Sincerely and best wishes, Dr. Oleg Golyanovskiy.
To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina
My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.
We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.
Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.
I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.
"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".
To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.
I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.
Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."
I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.
We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.
Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.
Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
