Integrated Salmonella control in Turkey Production

Case Report | DOI: https://doi.org/DOI:10.31579/2690-1919/145

Integrated Salmonella control in Turkey Production

  • Kilroy S 1*
  • Zwaenepoel P 2
  • Vangroenweghe F 3

1 Elanco Benelux, BU Food Animals, Plantijn en Moretuslei 1 – 3rd floor, 2018 Antwerpen, Belgium

2 Provet, Talpestraat 2, 8610 Kortemark, Belgium

3 Ghent University, Faculty of Veterinary Medicine, Dept. Reproduction-Obstretics-Herd Health, Salisburylaan 122, 9820 Merelbeke, Belgium

*Corresponding Author: Kilroy S, Elanco Benelux, BU Food Animals, Plantijn en Moretuslei 1 – 3rd floor, 2018 Antwerpen, Belgium

Citation: Kilroy S., Zwaenepoel P., Vangroenweghe F, (2021) Integrated Salmonella control in Turkey Production. Journal of Clinical Research and Reports, 7(2); DOI:10.31579/2690-1919/145

Copyright: © 2021 Kilroy S, This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received: 11 February 2021 | Accepted: 11 March 2021 | Published: 24 March 2021

Keywords: salmonella; turkeys; biosecurity; vaccines; risk management

Abstract

 In recent years, an increase of fattening turkey flocks positive for Salmonella spp. was noted in the European Union. Considering these latest trends, there is a high need to increase knowledge on specific risk factors for fattening turkey flocks in conjunction with successful control measures to combat Salmonella infections on farm. Here, we report a commercial turkey fattening farm that was found positive for Salmonella enterica serovar Typhimurium for two consecutive batches. By means of the Food Safety Program, a risk assessment developed by Elanco (Antwerpen, Belgium) and a farm walk, a Food Safety Index was generated, highlighting specific risk factors. Consequently, an action plan was set up, leading to a favorable increase in the Food Safety Index from 45% to 67%. Among others, vaccinating fattening turkeys was an important control measure. Monitoring of the Salmonella status of the batches was performed by sampling paper coming from the transport boxes at day of arrival and boot sock samples at the age of 14 weeks. Finally neck skin samples were taken at the slaughterhouse. Uptake of the vaccine was evaluated by sampling of the caeca and taking cloacal swabs 24 hours after first and second vaccination, respectively. Results coming from the analysis of the caeca indicate that vaccination at day one was efficient. Analysis of the cloacal swabs taken after second vaccination was inconclusive. Cooperatively, these actions improved the overall biosecurity of the farm as shown by the negative Salmonella stat us of the boot sock and neck skin samples in the third batch.

Introduction

Salmonella spp.are one of the major food-borne pathogens and have an importance as a leading cause of food-borne bacterial diseases in humans throughout the world [1]. Different studies indicate that, turkey meat and products are attributed to be important sources of food-borne salmonellosis [2]. The approach against Salmonella spp. in turkey started more than a decade ago. October 2006 marked the start of a European Union (EU)-wide baseline survey over a one-year period, to determine the prevalence of Salmonella spp. in breeding and fattening turkey (Meleagris galapavo) flocks [3]. A decreasing trend in the prevalence of Salmonella-positive flocks was observed in different poultry categories during the period 2007–2018. This decreasing trend however has stabilized over the last 5 years except in breeding turkey flocks, in which the prevalence of Salmonella spp. fluctuated over time [4]. For fattening turkey flocks, in 2019 a total of 6.37% of flocks were found Salmonella spp. positive in the EU, compared with 5.95% in 2017 [4]. Based on the results from the latest EU Zoonosis report, it is mandatory to take action in order to decrease Salmonella spp. prevalence in turkeys. Some studies looked at the role processing plays to increase the contamination rate of Salmonella spp. in turkey meat [5,6]. Scalding, de-feathering, evisceration and cooling steps in slaughtering are the critical points in carcass contamination [5,6]. Few studies have looked at the risk factors in turkey flocks specifically, which differ from chicken broiler flocks in their seasonality of production and longer growing period. Arsenault et al. reported that turkey flocks were more likely to be infected if they originated from a particular hatchery or were raised in houses where two or more persons had access to [7]. They did not detect association between Salmonella spp. infection at flock level and variables related to pest control, downtime period, manure disposal, and poultry-house cleaning and disinfection practices. Here, we report a commercial fattening turkey farm located in West-Flanders (Belgium) that was found positive for S.enterica serovar Typhimurium for two consecutive batches and the methodology used to obtain a negative Salmonella spp. status of the farm.

Case Description

Descriptive case information

Day-of-hatch male and female fattening turkey poults were imported from a French hatchery into Belgium for three consecutive batches. Data regarding the Salmonella status were collected for every batch. The poults were housed on a commercial fattening turkey farm located in West-Flanders (Belgium) comprising 6 houses. Salmonella spp. status of the day-old turkeys was analyzed by collecting paper from the transport boxes as described below. In the third batch, 29 000 turkeys were vaccinated on day one (D1) by off-label coarse spray with the commercially available AviPro® Salmonella Duo (Elanco, Cuxhaven-Germany) [8]. Turkey poults were kept in the transport boxes for 15 min after vaccination to increase contact opportunity. A second vaccination was performed at D47 through drinking water. The poults showed no clinical signs nor any adverse events following both vaccination moments.

Sample collection

Samples were collected on a commercial fattening turkey farm with 6 houses located in West-Flanders (Belgium) according to regulation (EC) No 2160/2003; Annex II. For three consecutive batches, 3 papers present in the transport boxes of the day-old poults were analyzed to determine the Salmonella spp. status. Secondary, a pair of boot socks from each house were taken at week 14 to monitor the Salmonella spp. status of the poults.  The farm was considered positive when Salmonella spp. were detected in at least one sample. In the third batch, 21 turkeys were randomly selected and euthanized by cervical dislocation 24 hours after spray vaccination to detect the vaccine strains and evaluate the vaccine uptake. The caeca were collected aseptically for vaccine recovery as described below. An additional screening for the Salmonella spp. status of the third batch was performed at the age of 4 weeks by taking 50 cloacal swabs (25 males and 25 females). Twenty-four hours after the second vaccination, 25 cloacal swabs (10 males and 15 females) were collected to detect the vaccine strain. Neck skin samples were collected at the slaughterhouse at the age of 16 weeks for the females and 17 weeks for the males.

Bacterial examination of the samples

Paper present in the transport boxes and boot sock samples were analyzed for Salmonella spp. according to the International Organization for Standardization (ISO 6579-1). Caeca were collected and incubated in Buffered Peptone Water (BPW) for 18 hours (± 2 hours) at 37°C. Samples were plated directly on Brilliant Green Agar (BGA) plates supplemented with 100 µg/ml rifampicine to detect the vaccine strain. Negative samples were enriched in tetrathionate brilliant green broth by overnight incubation at 37°C. After incubation, a loopful of the tetrathionate brilliant green broth was plated on BGA supplemented with 100 µg/ml rifampicine. Cloacal swabs taken at week 4 of age were pooled in groups of 5 and analyzed for presence of the Salmonella wild type strains according to the ISO (ISO 6579-1). Cloacal swabs taken 24 hours after second vaccination were pre-enriched in BPW for 18 hours (± 2 hours) at 37°C and plated directly on BGA supplemented with 100 µg/ml rifampicine to detect the vaccine strain. Negative samples were enriched in tetrathionate brilliant green broth by overnight incubation at 37°C. After incubation, a loopful of the tetrathionate brilliant green broth was plated on BGA supplemented with 100 µg/ml rifampicine.

Food Safety Program

A risk assessment focused on live production, Food Safety Program (FSP, Elanco, Antwerpen, Belgium), was used to perform hazard analysis by means of a comprehensive questionnaire and a farm walk. A Food Safety Index (FSI) was created based on the questionnaire, and farm-specific critical control points (CCP) related to the general biosecurity status of the farm were highlighted. The index is presented as a percentage; the higher the percentage, the lower the risk. Following this FSI audit, a report was generated, breaking down all sections and highlighting the CCPs that significantly impacted the risk assessment. The food safety questionnaire and farm visit were performed in January 2020 to establish a baseline FSI. Based on this index, several actions were set up in order to increase the general biosecurity of the farm. The progression and impact of the interventions were evaluated by generating a FSI after control measures were set in place in June 2020. In the frame of the integrated approach, vaccinating fattening turkeys is a critical control measure that is not routinely performed in practice. This study reports the use of a bivalent live attenuated Salmonella vaccine for controlling Salmonella spp. in turkeys.

Results

Analysis of Salmonella spp. wild type strains

In the period between December 2018 until June 2020, S.enterica serovar Typhimurium was present in the boot sock samples in June 2019 (first batch) and December 2019 (second batch; Table 1).

1DOA: Day of arrival
Table 1: Results from different sample media at different sampling time points collected for monitoring of Salmonella spp. at the commercial turkey fattening farm. The numbers indicate the results from batch 1, 2 or 3. Negative results are indicated as ‘-‘, positive results as ‘+’. In case a sampling was not carried out ‘NA’ (not applicable) is marked.

Salmonella spp. were also detected through positive neck skin samples collected at slaughter. Consequently, several actions were taken to avoid subsequent Salmonella spp. contamination of the following flock.

Food Safety Index

Based on the questionnaire and a farm visit, the FSI was set at 45%. The following report highlighted the actions that would lead to a significant increase of the FSI and thus overall biosecurity. The actions are listed in Table 2.

Table 2: Food safety index report highlighting both external and internal biosecurity measures to be improved in order to increase the level of biosecurity for control and prevention of Salmonella spp. at farm level.

After the second batch, litter was removed from the farm immediately after the turkeys were loaded for slaughter. A thorough cleaning with hot water (64°C) was followed by disinfection with a concentrated disinfectant based on quaternary ammonium, glutaraldehyde, and isopropanol (Virocid®; CID Lines, Ieper, Belgium), including the roof top. Additionally, houses were fogged with formaldehyde. The farm premises surrounding the barns were treated with a solution containing 150 g/L NaOCl. An aluminum profile was added to the wall at 0,5 meter avoiding migration of beetles to the isolation. Additionally, a concrete wall was constructed at the inside perimeter of the building to prevent external vectors from entering the farm (Figure 1). 

Figure 1:A. Specific control measure to omit beatles from circulation within the building using a sticky glue band; B. Concrete wall constructed at the inside perimeter of the building to prevent external vectors from entering the farm.

During the third batch, an insecticide containing spinosad (Elektor®; Elanco, Antwerpen, Belgium) was applied as described in the directions for use upon arrival of the turkeys. This procedure was repeated at D28. Secondly, the day of hatch turkeys were vaccinated using the commercially available live vaccine AviPro™ Salmonella Duo (Elanco, Cuxhaven – Germany). The uptake of the vaccine was evaluated by detection of the vaccine strains in the caeca of 21 turkeys, 24 hours after vaccination (Table 3).

Table 3: Analysis results of presence of Salmonella vaccine strains from the commercially applied Salmonella DUO-VAC (Elanco) vaccine in different sample materials and at two different sampling time points to confirm sufficient uptake of the applied vaccine strains. Number of positive samples out of total number of samples collected. If difference exist between male (♂) and female (♀), sampling results are split in results by sex.

A second vaccination was performed at D47. The uptake of the vaccine was evaluated by collection of cloacal swabs from 25 turkeys. After implementation of the recommended corrective actions another FSP was set up to measure the increase in biosecurity by means of the FSI. The new FSI was set at 67%.

Discussion

The serotype identified on the commercial farm rearing fattening turkeys in this case report, S. enterica serovar Typhimurium, belongs to the top-6 serovars of fattening turkeys that contribute most to human cases, among S. enterica ser. Enteritidis, S. enterica ser. Kentucky, S. enterica ser. Newport, S. enterica ser. Virchow and S. enterica ser. Saintpaul [2]. Featherstone et al.[9] concluded that, based on a Salmonella spp. testing program, using tap water as a water source and wax blocks to control rodents were effective to reduce the risk of testing positive for S. enterica serovar Typhimurium. The results coming from this study indicate that Salmonella spp. contamination originated on farm. The European Food Safety Authority (EFSA) however reported that vertical transmission of Salmonellaspp. As well as hatchery acquired Salmonellaspp. contamination originating from breeding stock are very important sources for Salmonella spp. infection in turkeys [2]. In order to eliminate Salmonella spp. from a turkey farm, it is necessary to look at the specific risk factors present on farm. By performing a food safety program (FSP), designed by Elanco, these risk factors were highlighted through a comprehensive questionnaire followed by a farm visit. Based on the FSP, a FSI was created before and after a Salmonella spp. control action plan was set up. It was advised to increase external farm biosecurity due to a pig farm located in close proximity of the turkey farm.  Indeed, it is widely reported that pigs may act as a source of Salmonella spp. infection [10,11]. Increasing the concrete surface of the surroundings and cleaning with a solution containing 150ng/L NaOCl on a timely basis could prevent manifestation of Salmonella spp. on the farm premises. Using farm specific materials, such as clothing and boots, together with improved hand hygiene practices for staff members also improved external as well as internal farm biosecurity. A concrete wall was built to avoid infestation of rodents and other possible vectors entering the houses. The role of mice and other rodents in Salmonella spp. epidemiology on poultry farms is well documented [12, 13].

During the farm visit beetles were detected in the houses. An insecticide containing spinosad (Elektor®; Elanco) as the active ingredient was implemented upon arrival of the day-old turkeys. The treatment was repeated at week 4. Since Salmonella spp. among other pathogens might reside within biofilms, flushing the drinking lines improved water quality. Cleaning silo bins on a timely basis corroborates ingestion of Salmonella spp. free feed. Since no other farms were reported Salmonella positive supplied by the same feed mill, it was assumed the feed was Salmonella free.  Featherstone et al. previously identified additional risk factors for Salmonella spp. infection on fattening turkey units, based on a cross-sectional study [10]. Seasonal flock production had an odds of 0.33 to contract Salmonella spp. as compared to flocks produced in year-round consecutive batches. Indeed, an extended period between batches of birds is optimal for thorough cleaning and disinfection and interrupts the carry-over of infection between consecutive batches. Other studies have identified the hatchery as risk factor for Salmonella spp. in poultry [14]

Systematically, these actions improved the overall biosecurity of the farm. Importantly, the number of beetles was reduced, indicating that the insecticide was efficient at killing the residing beetle population. When biosecurity is at an acceptable level, vaccination with a commercially available live vaccine strain can protect the birds against Salmonella spp. infection. Incontrovertibly, the level of protection generated by vaccination not only depends on the challenge itself (e.g. strain involved, infection dose, route of transmission), but is also influenced by the route of vaccine administration, the vaccine dose, vaccine preparation, water quality, age of the birds and genetics [15]. Therefore, scientific evidence indicates that vaccination will be more efficient in protecting a flock when environmental presence of Salmonella spp. is duly managed by complementary measures reducing the infection pressure over time. Moreover, live Salmonella vaccines generally confer better protection than killed vaccines, because the former stimulate both cell-mediated and humoral immunity [16]. Since infection with Salmonella spp. usually occurs in the first week of life, it is important to vaccinate as soon as possible. This is supported by additional data indicating that infection of very young chicks results in high levels of environmental contamination [17]. In this study, day-old turkeys were vaccinated upon arrival, followed by drinking water vaccination at D47 of age. Opening the vaccine under water and stirring for a few minutes prior to spraying the water solution containing the vaccine improves the homogenic spread of the vaccine in the spray solution. Allowing the day-old turkeys to stay in close contact in the transport boxes for 15 minutes increased ingestion and guaranteed a successful vaccination, as shown by the positive caeca samples of 21 randomly selected turkeys. Although spray vaccination is currently off label, it has been previously demonstrated that spray vaccination of day old chicks is a practical way to ensure ingestion of the vaccine at an early age [8]. A second dose of the vaccine was administered at D47, conferring resistance not only in the immediate post-hatch period but also maintaining longer-term protective effects. Due to the nature of both vaccine strains having a decreased shedding over time, it is less recommended to take cloacal swabs to monitor the uptake of the vaccine strain by the turkeys, as shown under experimental conditions with broilers [8]. Combining increased biosecurity together with bivalent live vaccination, enabling active immunity against target serovars, was successful in protecting turkeys from Salmonella spp. infection. Vaccination is likely to become increasingly important in the control of Salmonella spp. for the foreseeable future, especially in turkeys. Since most Salmonella spp. infections are subclinical, it is recommended to continue monitoring for Salmonella spp. presence on the farm, allowing prompt detection and response to Salmonella spp.infections. A testing program will also help to further develop action plans to avoid spread and persistence of Salmonella spp. infections.

Conclusions

In conclusion, this study describes important practical measures that can be implemented by farmers and veterinarians within the turkey industry to control salmonellosis, although additional risk factors at other turkey farms should be taken into account. Finally, Salmonella spp. bivalent live vaccination should be considered as a critical part of the package of control measures to limit S. enterica serovar Typhimurium infection in turkeys when biosecurity is at an acceptable level.

Acknowledgements

Conceptualization, S.K and P.Z; Methodology, S.K and P.Z; Writing-Original Draft Preparation, S.K, P.Z and F.V.; Writing-Review & Editing, F.V.

References

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.

img

Virginia E. Koenig

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.

img

Delcio G Silva Junior

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.

img

Ziemlé Clément Méda

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.

img

Mina Sherif Soliman Georgy

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.

img

Layla Shojaie

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.

img

Sing-yung Wu

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.

img

Orlando Villarreal

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.

img

Katarzyna Byczkowska

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.

img

Anthony Kodzo-Grey Venyo

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.

img

Pedro Marques Gomes

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.

img

Bernard Terkimbi Utoo

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.

img

Prof Sherif W Mansour

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.

img

Hao Jiang

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.

img

Dr Shiming Tang

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.

img

Raed Mualem

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.

img

Andreas Filippaios

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.

img

Dr Suramya Dhamija

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.

img

Bruno Chauffert

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!

img

Baheci Selen

"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".

img

Jesus Simal-Gandara

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.

img

Douglas Miyazaki

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.

img

Dr Griffith

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.

img

Dr Tong Ming Liu

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.

img

Husain Taha Radhi

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.

img

S Munshi

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.

img

Tania Munoz

“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”.

img

George Varvatsoulias

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.

img

Rui Tao

Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.

img

Khurram Arshad

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.

img

Gomez Barriga Maria Dolores

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.

img

Lin Shaw Chin

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.

img

Maria Dolores Gomez Barriga

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.

img

Dr Maria Dolores Gomez Barriga

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¨.

img

Dr Maria Regina Penchyna Nieto

Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.

img

Dr Marcelo Flavio Gomes Jardim Filho

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!”

img

Zsuzsanna Bene

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

img

Dr Susan Weiner

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.

img

Lin-Show Chin

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.

img

Sonila Qirko

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.

img

Luiz Sellmann