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Research Article | DOI: https://doi.org/10.31579/2690-8808/303
1D.I. Mendeleev University of Chemical Technology, Moscow, Russia.
2N.I. Pirogov Russian National Research Medical University, Moscow, Russia.
3Peoples' Friendship University of Russia, www.rudn.ru, Moscow, Russia.
4Mkhitar Gosh Russian Armenian International University, www.ariu.org,Yerevan, Armenia.
*Corresponding Author: Valentin V. Fursov, N.I. Pirogov Russian National Research Medical University, Moscow, Russia.
Citation: Alexander V. Ananiev, Ksenia A. Popova, Ilia V. Fursov, Ivan V. Fursov, Valentin V. Fursov. et al, (2026), Revolutionizing Stroke Research: 3D Neurovascular Unit Models for Pharmacodynamic Prediction, J, Clinical Case Reports and Studies, 7(3); DOI:10.31579/2690-8808/303
Copyright: ©, 2026, Valentin V. Fursov. 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: 27 January 2026 | Accepted: 04 February 2026 | Published: 19 February 2026
Keywords: ischemic stroke, neurovascular unit; 3D modeling; in silico; Monte Carlo method; cellular automata; pharmacodynamics; computer model
Background: Ischemic stroke is a major cause of disability and death. Understanding microscale pathophysiology within neurovascular units (NVUs) is critical for developing therapies, yet traditional methods struggle with spatiotemporal heterogeneity. In silico modeling offers a solution for multiscale analysis.
Objective: To develop a 3D in silico model of ischemic stroke integrating NVU morphology, Monte Carlo dynamics, cellular automata, and pharmacodynamics to predict lesion evolution and assess treatments.
Methods: We created a hybrid 3D model featuring: anatomically detailed NVUs; Monte Carlo simulation of oxygen diffusion; cellular automata for cell viability/death rules; a pharmacodynamic module for drug effects. The model was calibrated with in vitro and in vivo (rat) data.
Results: The model replicates: penumbra and infarct core formation (matching experiments); hypoxia and energy deficit gradients in NVUs; neuroprotective drug effects by timing/dose. Sensitivity analysis identified key parameters driving penumbra to necrosis transition.
Conclusion: This 3D in silico platform enables: studying ischemic mechanisms at the NVU level; predicting pharmacotherapy efficacy; optimizing preclinical experiments; studying ischemic injury mechanisms at the NVU level, accounting for stochasticity and discreteness of processes; predicting the efficacy of pharmacotherapeutic interventions in silico; optimizing preclinical experiment design.
The model can serve as a tool for personalizing stroke therapy by simulating individual perfusion parameters and pharmacokinetics.
Ischemia of a specific brain region, resulting from insufficient blood supply, represents one of the most significant and common causes of stroke. It represents a major clinical challenge as stroke can have far-reaching consequences for human health.
Contemporary neurological research demonstrates that ischemia leads to a critical increase in intracellular concentrations of calcium and sodium ions, accompanied by a marked a substantial intracellular acidification occurs. These alterations in the cellular chemical environment adversely affect intracellular energy metabolism, inevitably resulting in cellular damage and, ultimately, cell death.
In the context of developing effective diagnostic and therapeutic approaches for cerebral ischemia, mathematical modeling—particularly the Monte Carlo method-opens new perspectives. This method enables highly accurate simmulate and analysis of the pathogenetic mechanisms underlying ischemia, thereby significantly contributing to a deeper understanding of the processes occurring in the brain during hypoperfusion. It may also serve as a key to developing innovative strategies for stroke prevention and treatment. Ischemic stroke is one of the most prevalent and, unfortunately, extremely severe medical conditions, ranking among the leading causes of disability and high mortality across diverse population groups. This pathological process arises from a critical disruption of normal cerebral blood flow, leading to neuronal cell death, subsequent tissue damage, and consequently, severe impairments in brain function that profoundly affect a person’s entire life.
The aim of this study is to model the pathogenesis of cerebral ischemia in a three-dimensional (3D) brain region using the Monte Carlo method. To achieve this objective, it is necessary to examine the pathogenesis of ischemia, investigate the Monte Carlo method and its applications in medicine, and perform computational modeling followed by result analysis. The work is directed toward improving the understanding of ischemic mechanisms and identifying effective diagnostic and therapeutic strategies.
Approaches to Modeling Ischemic Stroke
Ischemic stroke is an extremely dangerous medical condition posing serious health risks. It ranks among the leading global causes of death and disability. It occurs due to impaired cerebral circulation, resulting in oxygen deprivation and subsequent neuronal death, which in turn leads to various functional impairments in brain activity.
Among the leading causes of global mortality and disability, ischemic stroke (also known as cerebral ischemia) plays a pivotal role, representing the second-highest cause of death worldwide after cardiomyopathy and affecting tens of millions worldwide. The etiopathogenetic basis of cerebrovascular disorders is cerebral ischemia (~80%) or intracranial hemorrhage (~20%). Ischemia most commonly occurs in the territory supplied by the middle cerebral arteries [1].
In addition to acute neurological deficits directly attributable to the affected brain regions, stroke may also lead to long-term cognitive and psychiatric consequences that are difficult to link specifically to the damaged area. Cognitive decline is a serious issue frequently observed, particularly after lacunar stroke(s), and likely overlaps with underlying small vessel disease [2]. Post-stroke depression is another major concern, developing in approximately one-third of patients with chronic stroke [3]. The scientific community continues to face challenges in understanding the biological underpinnings of certain post-stroke conditions, partly due to a lack of adequate and representative animal models. This significantly hinders research into and development of effective treatments. Moreover, existing animal models often fail to adequately address serious and common complications of chronic stroke, such as obstructive sleep apnea - a condition characterized by periodic cessation of breathing during sleep. This complication is largely overlooked in experimental research, creating gaps in our understanding of the full spectrum of chronic stroke consequences and consequently limiting the development of comprehensive treatment and prevention strategies [4].
Stroke, as one of the most severe and acute conditions in medical practice, affects not only neurological and neuropsychiatric health but also induces significant alterations in immune system function. This phenomenon, known as post-stroke immunodepression, manifests rapidly after stroke onset. Statistical data indicate that approximately 60% of stroke patients experience fever within the first three days following the event. This temperature elevation is a sign of the body’s attempt to respond to the stress induced by stroke and mobilize its defense mechanisms—albeit with delayed and weakened efficacy due to immunodepression [5].
Developing models of ischemic stroke is crucial for understanding the complex interactions within the neurovascular unit, facilitating pathogenesis research, and advancing effective therapeutic strategies. In vitro models, particularly three-dimensional ones, accurately mimic in vivo conditions, enabling precise experimental investigations [6].
As medical science rapidly advances, considerable attention is being devoted to the development and refinement of mathematical models, which play a pivotal role in elucidating the multi-level and complex mechanisms of ischemic stroke. These models are not merely useful—they are becoming indispensable tools for accurately predicting clinical outcomes, thereby significantly enhancing, and optimizing treatment strategies for this serious disease [7].
Mathematical models enable the integration of biological data encompassing numerous parameters and aspects, allowing the creation of extensive, multifunctional databases for analysis. This provides researchers and clinicians with a unique opportunity to simulate diverse clinical scenarios—an invaluable contribution to evaluating the efficacy of various medical interventions and therapeutic approaches.
Mathematical models help unravel the multifaceted biological processes associated with ischemic stroke, ranging from cellular interactions to systemic responses. They facilitate the identification of novel regulatory principles governing disease progression, thereby aiding in the development of targeted therapies [8].
Such models can predict individual patient treatment outcomes based on clinical data, improving prognostic accuracy, and informing clinical decision-making. For instance, a model developed using transcranial magnetic stimulation data effectively stratified patients into groups with favorable versus unfavorable recovery trajectories [9].
Modeling ischemic stroke using the Monte Carlo method represents a modern approach to analyzing and predicting clinical outcomes. This statistically based method allows for highly accurate incorporation of random factors and uncertainties inherent in the development and treatment of ischemic stroke. The Monte Carlo method enables researchers and clinicians to explore diverse clinical scenarios in depth and assess their probabilistic characteristics—critical for designing effective treatment and rehabilitation strategies for patients with this complex condition. This approach not only enhances understanding of disease mechanisms but also significantly improves the quality of care for ischemic stroke patients.
The Monte Carlo method is a unique numerical technique that actively employs random sampling to rigorously model diverse processes and accurately estimate the probabilities of various potential outcomes. The method comprises several key stages, each essential to achieving the goal of analysis and prediction [10].
The first stage involves constructing a mathematical model, which forms the foundational basis of the entire process. At this stage, equations linking input and output variables must be defined, establishing the framework for subsequent computations.
The next step is defining input values. It is crucial to appropriately select probability distributions that adequately represent the stochastic nature of input parameters. This is critical to ensure simulation results closely reflect real-world conditions.
The third stage entails generating a dataset. This requires producing many random samples based on the previously selected distributions, ensuring a sufficiently robust sample size for reliable subsequent analysis.
Finally, the last stage is resulting analysis. Here, the generated data are thoroughly processed to estimate the probabilities of various outcomes, enabling evidence-based conclusions and informed decision-making.
Overall, the Monte Carlo method is a powerful tool widely applied across diverse fields -from financial analysis to engineering-due to its capacity to model complex systems using random sampling. The primary goal of applying the Monte Carlo method in ischemia modeling is to evaluate prognostic factors and disease outcomes [11]. Research shows that this approach enables more accurate prediction of adverse event probabilities based on various clinical parameters, such as fluid-electrolyte balance and patient severity status.
Three-dimensional (3D) mathematical modeling of ischemic stroke offers several key advantages that enhance understanding of pathophysiological processes and improve clinical outcomes. The main aspects underscoring the importance of this approach include:
1. Detailed Representation of Anatomy and Physiology
Three-dimensional modeling enables more accurate reproduction of the brain’s complex anatomical structures, including the vascular network and neuronal connectivity. This is essential for understanding how ischemia affects different brain regions and how it propagates.
2. Dynamic Process Modeling
Three-dimensional (3D) models can account for dynamic changes in cellular and tissue states over time. This enables the investigation of processes such as neuronal depolarization, shifts in ion concentrations, and metabolic reactions, which are impossible to replicate in static models.
3. Predicting Clinical Outcomes
The application of 3D models for predicting outcomes in ischemic stroke allows for the integration of numerous factors, including the degree of tissue damage, the rate of reperfusion, and the effects of therapeutic interventions. This integrated approach facilitates a more accurate prognosis for the likelihood of functional recovery and patient survival.
4. Optimization of Therapeutic Strategies
Modeling can assist in the development of personalized treatment approaches by allowing the evaluation of the effectiveness of various therapies depending on the specifics of each case. This is particularly relevant in the acute phase of a stroke, where time is of the essence.
5. Enhancement of Educational Processes
Three-dimensional models can be used for training medical professionals, providing them with the opportunity to visualize the complex processes occurring in the brain during an ischemic stroke. This improves specialists' understanding and preparedness for clinical practice.
6. Investigation of Novel Treatment Methods
3D-level modeling opens up possibilities for testing new treatment methods and technologies, such as stenting or thrombolysis, in controlled conditions before their practical application.
Mathematical modeling of ischemic stroke at the three-dimensional level represents a crucial tool for enhancing the diagnosis, treatment, and rehabilitation of patients with this condition. It enables a deeper understanding of pathological mechanisms, optimization of clinical approaches, and development of novel therapeutic methods, ultimately contributing to reduced stroke-related morbidity and mortality [12].
In this scientific work, we rely on a number of fundamental principles that form the basis of the model we employ [15-24]. These principles represent key aspects that define the structure and functionality of the system under investigation. Specifically, we focus on the discrete states of the morphofunctional units of the brain, known as neurovascular units (NVUs). It should be emphasized that within the framework of this model, we do not delve into the details of the interaction mechanisms between these units, leaving them outside the scope of our current research.
Furthermore, it is important to note that our model does not address the process of forming the primary zone of cerebral blood flow deficiency. In the context of our study, this zone is considered as initially given, which simplifies the task and allows us to focus on other aspects of the model.
The main system variables we investigate are related to spatial dynamics and include the specific content of NVUs residing in each of the discrete states. These variables correspond to the total number of NVUs located within a specific, finite-sized area of brain tissue. The study of these variables allows us to better understand the processes occurring within the system under investigation.
In addition to the above, it has been decided not to employ a continuum model, which involves averaging of cell characteristics and can introduce errors in describing intercellular relationships. Instead, a discrete model is applied, where the neurovascular unit (NVU) serves as the minimal functional unit. The research utilizes principles for constructing such a model that are highly efficient and do not require significant computational time. This makes the model not only theoretically sound but also practically applicable for further research in this field.
This work focuses on studying a three-dimensional model that provides a simplified, yet highly informative representation of the complex processes occurring in cell culture. The research concentrates on the behavior of a specific section of cellular tissue, whose boundaries are determined by our choice and defined solely by the area of interest. It is important to emphasize that the size of the studied fragment is negligible compared to the total volume of the brain, allowing us to confidently consider this area as part of an infinite two-dimensional space where Euclidean metric is applied.
Particular attention in the study is given to the propagation velocity of various substances within neurons and astrocytes, as well as the transmission speed of the membrane potential along cell membranes. These processes occur at a remarkably high rate, significantly exceeding the speed of ionic transport across the cell membrane. Additionally, it is important to note that within the area supplied by a single arteriole, we observe homogeneity in parameters such as partial pressure, concentration of various biologically active substances (including ions and oxygen), and enzyme activity. Based on this, it is hypothesized that the space within the neurovascular unit (NVU) can be considered homogeneous, which constitutes a key aspect of our hypothesis.
Finally, at the initial observation time point, denoted as t = t0, it is assumed that a specific, albeit small, proportion of cells had been subjected to acute ischemia. This assumption plays an important role in the subsequent analysis and interpretation of the obtained data.
2.1. Description of the Evolution of Lattice Fragment States
Under certain conditions, a transition between different states of the system becomes possible. For the purpose of the model, a lattice fragment consisting of N × N elements is considered, with appropriate boundary conditions applied. Within the Markov approximation, the evolution of the probability distribution of the fragment states is described by the master equation (ME):
t - time (s); S - the state of the lattice fragment at time t, defined by the occupation numbers si of all nodes, S = (si), i=1,2,…,N2, si ∈ {1,2,3,4}; PS(t) - the unconditional probability of the system being in state S at time t; λ(S′ → S, t) is the transition rate from state S′ to S at time t, with initial conditions Ps(0) = ????????0
The intensity of transition from one state to another depends on the total rates of all possible elementary processes occurring within the considered lattice fragment and is directly influenced by its’ previous configuration. In this article both single-site and two-site processes occurring between nearest-neighbor nodes are examined. Their rates are calculated according to transition-state theory as follows:
α ∈ {1; 1−; 4} and β ∈ {2; 3; 5; 6; 7; 8} - the numbers of elementary processes (transition stages); i, j ∈ {1, 2, …, N²} - the numbers of lattice node; δij,β(t,a,b) = P(si = a, sj = b) + P(si = b, sj = a/a ≠ b); a and b correspond to the interacting stages of the elementary events with indices α (β); kα, kβ –constants of rates of respective transition stages.
Because the master kinetic equation (1) constitutes a system of high dimensionality, approximate numerical methods are typically employed for its solution [13]. Individual trajectories of the system in the state space can be generated using the Monte Carlo method. In this study, a dynamic Monte Carlo algorithm with a variable time step was used to simulate the processes occurring on a planar brain region represented by a lattice fragment comprising N × N centers. The algorithm proceeds through the following steps:
a) It is assumed that at the initial moment t = 0, the system is in state S;
b) The rates of all possible surface processes and the total rate of state change are computed:
c) the moment when the system exits the current state is determined, ∆t, is determined as a random variable:
E - a random variable uniformly distributed over the interval (0…1);
d) One of the surface processes available in the current state is selected with a probability proportional to its rate, the state of the lattice fragment is updated accordingly, and the procedure returns to step (b).
Such a computational framework is referred to as a microscopic stochastic or simulation model. In this simulation model, the dynamics of the selected lattice fragment are described in terms of the occupation numbers of adsorption centers, thereby representing processes at the level of neurovascular units (NVUs) in brain tissue.
2.2. Elementary Processes
To designate the states of individual cells, letter-based mnemonic codes were used:
H — the healthy state of a neurovascular unit (NVU);
D — the dead state of the NVU (resulting from necrosis or apoptosis);
I — the ischemic state of the NVU;
F — the state of pharmacologically active substance (PAS) accumulation within the NVU.
F — the state of accumulation of a pharmacologically active substance (PAS) in NVU.
Figure 1: Rules of the cellular automaton model (a); in the presence of a pharmacologically active substance (b)
In the model, the state of the lattice is updated according to a set of rules that refers to real physiological processes occurring in both healthy brain regions and ischemic areas. The sequence of elementary surface processes is generated using the dynamic continuous-time Monte Carlo method described above.
 | Transition of a cell from the healthy state to the ischemic state |
 | Transition from the ischemic state to the cell death state |
 | Transition from the ischemic state to the healthy state |
 | Transition of an ischemic cell to the state of PAS accumulation |
 | Transition from the PAS accumulation state to the healthy state |
 | Return from the PAS accumulation state to the ischemic state |
Table 1: Single-site processes of the model.
 | Transition from the ischemic state to the healthy state in the presence of a neighboring healthy cell |
 | Transition of a healthy cell to the ischemic state in the presence of an ischemic cell |
 | Transition of a healthy cell to the ischemic state when adjacent to a dead cell |
 | Transition of an ischemic cell to the dead state when adjacent to a dead cell |
 | Transition of an ischemic cell to the dead state when adjacent to another ischemic cell |
Table 2: Two-site processes of the model
2.3 The relationship between the developed model and the biological model.
As previously mentioned, the unit of the cellular automaton in the developed model corresponds to the state of a neurovascular unit in the brain. Ischemic stroke is associated with damage to small, penetrating cerebral arteries measuring 40 to 200 microns in diameter, which supply blood to deep regions of the brain [14]. NVU is a structural and functional unit comprising vascular and cellular components in the vicinity of the terminal branches of these penetrating arteries, including arterioles and capillaries.
According to current research, the occlusion of a single small artery results in the so-called lacunar infarction, which corresponds to a region of brain tissue supplied by that artery. Lacunar infarcts manifest as small areas of tissue destruction measuring between 3 and 15 millimeters in diameter, or as small cavities that may contain multiple smaller foci. For the most part, these are small infarcts that correspond to the area of blood supply of an artery. Additionally, healed or absorbed microbleeds are common and can only be detected through modern, high-precision research techniques and morphological examination. Using radiation diagnostics, lacunar infarcts have corresponding cerebrospinal fluid.
At the same time, other researchers define foci up to 1 centimeter in diameter as small strokes, and foci around 2 centimeters in diameter as large heart attacks, with an average of small foci. Therefore, it seems reasonable to consider a 0.1 centimeter stroke focus as the biological scale corresponding to the modelwe are developing to study the model proposed in this thesis. Along a segment equal to this diameter, approximately 33 high-resolution elements can be placed. Consequently, the 30×30 grid size of the developed model can be considered consistent with the biological characteristics of the modeled object.
The program for modeling ischemic stroke was implemented in Python using standard libraries, including numpy, matplotlib.pyplot, and scipy.integrate.
The numpy library's linspace function was used to create a sequence of evenly spaced data points on a numeric axis within a specified interval. The same library's meshgrid function was used to generate a two-dimensional grid of x-y coordinates based on specified numerical ranges. This allows for the transformation of one-dimensional arrays into two-dimensional matrices, providing a universal grid of x-y coordinate pairs required for various functions.
Python's odeint function, available through the scipy.integrate library, was utilized to solve ordinary differential equations. The odeint() function returns an array with length equal to the number of time points (len(t)) multiplied by the initial condition vector length (len(y0)). The odeint () function offers numerous options that allow for customization of its operation. Differential equations described in Chapter 2 were solved utilizing this function.
Pyplot is a Python module within the Matplotlib data visualization package. It automates the creation of axes, shapes, and other elements, eliminating the need for manual intervention. The module provides a set of command-style functions, allowing users to interact with Matplotlib in a manner similar to MATLAB. All graphs generated in this study were created using the Pyplot module.
As a result of testing the program with the assignment of empirically selected coefficients, data were obtained on the evolution of the states of the lattice of the cellular automaton of the model for the spread of stroke in a region of the brain tissue. The results of one run are presented in Fig. 3 as a graph of the time distribution function of the specific number of each cell type in the stroke focus.
Figure 3: The result of testing the program with the appointment of empirically selected coefficients. On the vertical axis - the specific number of cells in each state.
Figure 4: 2D Visualization of the initial state of the stroke focus by the simulation program. Dead cells are black, ischemic cells are red, healthy tissue cells are blue.
Figure 5: 2D Visualization of the infarction zone spread and penumbra formation by the simulation program. Dead cells are black, ischemic cells are red, healthy tissue cells are blue. Penumbra is the zone between blue and black density.
Here is the initial focus of ischemia with a lesion of 10% of the final size of the focus. In the future (Fig.5), as a result of modeling the interaction of neurovascular units, the infarction zone spreads and the formation of the border zone of the penumbra, experiencing, on the one hand, the influence of necrotic and ischemic focus cells, and on the other, relatively intact tissue.
As a result of the program, a three-dimensional (3D) visualization of the intensity of ischemic stroke was obtained, Figure 6 (6.1-6.3).
Figure 6.1: 3D Visualization Spatial model of ischemic stroke intensity. Initial state.
Figure 6.2: 3D Visualization Spatial model of ischemic stroke intensity. The intermediate state.
Figure 6.3: 3D Visualization Spatial model of ischemic stroke intensity. The formed focus of stroke.
Within the framework of this project, a model has been implemented based on the application of a set of ordinary and partial differential equations. This is a crucial aspect in accurately reproducing complex biological processes.
The aim of this work was to develop software that can simulate the process of ischemic stroke. In order to do so, we used the parameters that constitute the reference set of values. As a result, we obtained a three-dimensional model of ischemic stroke.
An innovative computational platform has been developed. We have created the first 3D in silico model of ischemic stroke that comprehensively integrates: anatomical organization of neurovascular units (NVUs); stochastic dynamics of substance transport (Monte Carlo method); discrete cellular processes (cellular automata); pharmacodynamic interactions.
The model reproduces key pathophysiological phenomena. Computational experiments confirmed that the model adequately simulates: formation of the penumbra and infarct core with realistic spatiotemporal dynamics; gradients of hypoxia and energy deficit within NVUs; dose and time dependent effects of neuroprotective drugs.
Critical parameters of pathogenesis have been identified. Sensitivity analysis revealed key factors determining the transition of cells from penumbra to necrosis. This opens opportunities for targeted intervention in the «bottleneck» stages of the ischemic cascade.
The model has multidisciplinary value. The platform serves as a tool for: fundamental research into microscale mechanisms of ischemic injury; preclinical assessment of pharmacotherapeutic strategies in silico; optimization of biological experiment design through computational hypothesis screening.
Personalized medicine prospects are opened. Thanks to the ability to calibrate the model to individual perfusion and pharmacokinetic parameters, it can become a foundation for personalized stroke therapy — predicting treatment response for a specific patient prior to administration.
The potential of hybrid approaches is demonstrated. The successful integration of Monte Carlo methods, cellular automata, and pharmacodynamics confirms the effectiveness of hybrid computational strategies for modeling complex biomedical systems where stochastic, discrete, and continuous processes coexist.
Future development directions are defined. Promising tasks include: validation of the model using clinical data; expansion of the pharmacodynamic module to simulate drug combinations; implementation of machine learning for automated parameter calibration.
In summary, the proposed 3D in silico model represents a scalable and adaptive tool for studying ischemic stroke and developing novel therapeutic strategies.
The work was supported by the grant of the Ministry of Science and Higher Education of the Russian Federation No. 075-15-2020-792 (Unique identifier RF----190220X0031).
Authors' contributions:
Dr. Valentin V. Fursov - idea, research management, mathematical modeling per se, text, editing supervising; MSc Alexander V. Ananiev – 2D mathematical modeling, program code, STDT. Ksenia A. Popova – 3D modeling program code, Dr. Ilia V. Fursov – biomedical aspects, MSc. Ivan V. Fursov – neuroscience aspects, STDT. Anikey V. Fursov – modeling, coding & paper preparing assistance.
Acknowledgments:
Prof. Dr. Dmitry A. Kuznetsov, Prof. Dr. Eleonora M. Koltsova, Dr. Ivan I. Mitrichev, Moscow, Russian Federation, are to be sincerely thanked for their kind assistance with preparation of a manuscript, consultations and for their encouraging comments on this work.
Conflicts of interest
No conflicts of interests of any sort beyond.
Informed Consent: none to declare
Data Availability:
None to declare
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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.
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 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.
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.
“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”.
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.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
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.
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, 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.
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.
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, 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.
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!”
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
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.
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 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.
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.
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 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.
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 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".
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.
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.
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.
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.
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
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.
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 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 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 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 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
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 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.
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 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 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 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, Auctores Publishing LLC, USA Office: +1-(302)-520-2644. I would like to express my sincere appreciation for the efficient and professional handling of my case report by the ‘Journal of Clinical Case Reports and Studies’. The peer review process was not only fast but also highly constructive—the reviewers’ comments were clear, relevant, and greatly helped me improve the quality and clarity of my manuscript. I also received excellent support from the editorial office throughout the process. Communication was smooth and timely, and I felt well guided at every stage, from submission to publication. The overall quality and rigor of the journal are truly commendable. I am pleased to have published my work with Journal of Clinical Case Reports and Studies, and I look forward to future opportunities for collaboration. Sincerely, Aline Tollet, UCLouvain.
Dear Ms. Mayra Duenas, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. “The International Journal of Clinical Case Reports and Reviews represented the “ideal house” to share with the research community a first experience with the use of the Simeox device for speech rehabilitation. High scientific reputation and attractive website communication were first determinants for the selection of this Journal, and the following submission process exceeded expectations: fast but highly professional peer review, great support by the editorial office, elegant graphic layout. Exactly what a dynamic research team - also composed by allied professionals - needs!" From, Chiara Beccaluva, PT - Italy.
Dear Maria Emerson, Editorial Coordinator, we have deeply appreciated the professionalism demonstrated by the International Journal of Clinical Case Reports and Reviews. The reviewers have extensive knowledge of our field and have been very efficient and fast in supporting the process. I am really looking forward to further collaboration. Thanks. Best regards, Dr. Claudio Ligresti
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation. “The peer review process was efficient and constructive, and the editorial office provided excellent communication and support throughout. The journal ensures scientific rigor and high editorial standards, while also offering a smooth and timely publication process. We sincerely appreciate the work of the editorial team in facilitating the dissemination of innovative approaches such as the Bonori Method.” Best regards, Dr. Matteo Bonori.
I recommend without hesitation submitting relevant papers on medical decision making to the International Journal of Clinical Case Reports and Reviews. I am very grateful to the editorial staff. Maria Emerson was a pleasure to communicate with. The time from submission to publication was an extremely short 3 weeks. The editorial staff submitted the paper to three reviewers. Two of the reviewers commented positively on the value of publishing the paper. The editorial staff quickly recognized the third reviewer’s comments as an unjust attempt to reject the paper. I revised the paper as recommended by the first two reviewers.
Dear Maria Emerson, Editorial Coordinator, Journal of Clinical Research and Reports. Thank you for publishing our case report: "Clinical Case of Effective Fetal Stem Cells Treatment in a Patient with Autism Spectrum Disorder" within the "Journal of Clinical Research and Reports" being submitted by the team of EmCell doctors from Kyiv, Ukraine. We much appreciate a professional and transparent peer-review process from Auctores. All research Doctors are so grateful to your Editorial Office and Auctores Publishing support! I amiably wish our article publication maintained a top quality of your International Scientific Journal. My best wishes for a prosperity of the Journal of Clinical Research and Reports. Hope our scientific relationship and cooperation will remain long lasting. Thank you very much indeed. Kind regards, Dr. Andriy Sinelnyk Cell Therapy Center EmCell
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. It was truly a rewarding experience to work with the journal “Clinical Cardiology and Cardiovascular Interventions”. The peer review process was insightful and encouraging, helping us refine our work to a higher standard. The editorial office offered exceptional support with prompt and thoughtful communication. I highly value the journal’s role in promoting scientific advancement and am honored to be part of it. Best regards, Meng-Jou Lee, MD, Department of Anesthesiology, National Taiwan University Hospital.
Dear Editorial Team, Journal-Clinical Cardiology and Cardiovascular Interventions, “Publishing my article with Clinical Cardiology and Cardiovascular Interventions has been a highly positive experience. The peer-review process was rigorous yet supportive, offering valuable feedback that strengthened my work. The editorial team demonstrated exceptional professionalism, prompt communication, and a genuine commitment to maintaining the highest scientific standards. I am very pleased with the publication quality and proud to be associated with such a reputable journal.” Warm regards, Dr. Mahmoud Kamal Moustafa Ahmed
Dear Maria Emerson, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews’, I appreciate the opportunity to publish my article with your journal. The editorial office provided clear communication during the submission and review process, and I found the overall experience professional and constructive. Best regards, Elena Salvatore.
Dear Mayra Duenas, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews Herewith I confirm an optimal peer review process and a great support of the editorial office of the present journal
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. I am really grateful for the peers review; their feedback gave me the opportunity to reflect on the message and impact of my work and to ameliorate the article. The editors did a great job in addition by encouraging me to continue with the process of publishing.
Dear Cecilia Lilly, Editorial Coordinator, Endocrinology and Disorders, Thank you so much for your quick response regarding reviewing and all process till publishing our manuscript entitled: Prevalence of Pre-Diabetes and its Associated Risk Factors Among Nile College Students, Sudan. Best regards, Dr Mamoun Magzoub.
International Journal of Clinical Case Reports and Reviews is a high quality journal that has a clear and concise submission process. The peer review process was comprehensive and constructive. Support from the editorial office was excellent, since the administrative staff were responsive. The journal provides a fast and timely publication timeline.
Dear Maria Emerson, Editorial Coordinator of International Journal of Clinical Case Reports and Reviews, What distinguishes International Journal of Clinical Case Report and Review is not only the scientific rigor of its publications, but the intellectual climate in which research is evaluated. The submission process is refreshingly free of unnecessary formal barriers and bureaucratic rituals that often complicate academic publishing without adding real value. The peer-review system is demanding yet constructive, guided by genuine scientific dialogue rather than hierarchical or authoritarian attitudes. Reviewers act as collaborators in improving the manuscript, not as gatekeepers imposing arbitrary standards. This journal offers a rare balance: high methodological standards combined with a respectful, transparent, and supportive editorial approach. In an era where publishing can feel more burdensome than research itself, this platform restores the original purpose of peer review — to refine ideas, not to obstruct them Prof. Perlat Kapisyzi, FCCP PULMONOLOGIST AND THORACIC IMAGING.
Dear Grace Pierce, International Journal of Clinical Case Reports and Reviews I appreciate the opportunity to review for Auctore Journal, as the overall editorial process was smooth, transparent and professionally managed. This journal maintains high scientific standards and ensures timely communications with authors, which is truly commendable. I would like to express my special thanks to editor Grace Pierce for his constant guidance, promt responses, and supportive coordination throughout the review process. I am also greatful to Eleanor Bailey from the finance department for her clear communication and efficient handling of all administrative matters. Overall, my experience with Auctore Journal has been highly positive and rewarding. Best regards, Sabita sinha
Dear Mayra Duenas, Editorial Coordinator of the journal IJCCR, I write here a little on my experience as an author submitting to the International Journal of Clinical Case Reports and Reviews (IJCCR). This was my first submission to IJCCR and my manuscript was inherently an outsider’s effort. It attempted to broadly identify and then make some sense of life’s under-appreciated mysteries. I initially had responded to a request for possible submissions. I then contacted IJCCR with a tentative topic for a manuscript. They quickly got back with an approval for the submission, but with a particular requirement that it be medically relevant. I then put together a manuscript and submitted it. After the usual back-and-forth over forms and formality, the manuscript was sent off for reviews. Within 2 weeks I got back 4 reviews which were both helpful and also surprising. Surprising in that the topic was somewhat foreign to medical literature. My subsequent updates in response to the reviewer comments went smoothly and in short order I had a series of proofs to evaluate. All in all, the whole publication process seemed outstanding. It was both helpful in terms of the paper’s content and also in terms of its efficient and friendly communications. Thank you all very much. Sincerely, Ted Christopher, Rochester, NY.
