AUCTORES
Globalize your Research
Research Article
*Corresponding Author: Vicente Beltrán Campos, Division of Health Sciences and Engineering, Campus Celaya-Salvatierra, University of Guanajuato; Celaya, Guanajuato, Mexico.
Citation: Reyna-Echeveste EI, Beltrán-Campos V, Tolentino Ferrel MR, García Campos ML, Jiménez-García SN, et al. (2021) Acylated Ghrelin increases in young adult with obesity due to lack of sleep. J. Endocrinology and Disorders. 5(4): DOI:10.31579/26401045/079
Copyright: © 2021 Vicente Beltrán Campos, This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 07 July 2021 | Accepted: 13 August 2021 | Published: 18 August 2021
Keywords: acylated ghrelin; obesity; young adult; sleep
Interruption or lack of sleep has been linked to chronic degenerative diseases including obesity, which has tripled its figures worldwide in the last 40 years according to data from the world Health organization (WHO). Obesity associated with lack of sleep affects the Circadian rhythm which is responsible for synchronizing the energy balance during the sleep- wake cycle, hormonal secretion, homeostasis of food/energy, among the others. The aim of the study was to determine plasma levels of acylated ghrelin in obese young adults with sleep deprivation to plasma levels of acylated ghrelin in obese Young Adults. Study was carried out a total of 56 young adults with obesity, one of the groups had the condition of lack of sleep, n = 28 per group, to determine the relationship between hours of sleep levels of acylated ghrelin Spearman's correlation test was applied, a negative correlation of Rho = -0.293 and p = 0.028 was found the results obtained suggest that lack of sleep may be a factor that alters hormonal regulation and promotes obesity.
The interruption or lack of sleep (LS) is associated with the increased neuroendocrine activity of the hypothalamus-pituitary-adrenal axis and the sympathetic system [1]. It affects immunological, metabolic responses, synchronicity of the circadian rhythm and neuroendocrine rhythm, promotes factors that trigger cardiovascular diseases, diabetes, hypertension, dyslipidemias, metabolic syndrome, and obesity [2-4].
Obesity has tripled its figures worldwide in the last 40 years according to data from the World Health Organization (WHO) [5], starting at increasingly early ages and is considered the leading cause of death, due to its comorbidities and complications, which are the first cause of consultation at all levels of care and generate high costs in health services [6].
Obesity associated with lack of sleep affects the Circadian rhythm; which is responsible for synchronizing the energy balance during the sleep-wake cycle, hormonal secretion, body temperature regulation, food/ energy homeostasis [7], cell cycle regulation [8], tissue and organic [9], as well how to ensure maximum activity time both individual, behavioral and physiological cells occur at the right time of day, in addition to governing the time and duration of sleep [10].
During phases I and IV of sleep (non-REM, NREM), endocrine activation [11] is generated, determined by the secretion of growth hormone (GH) [12, 13] and secondarily the secretion of ghrelin which it allows to make a positive feedback allowing to raise the GH levels [14], and the energy expenditure; this promotes the release of hormones that regulate food intake and satiety [15]. However, some studies have shown that LS itself allows the elevation of ghrelin levels (Ghr), which increases food consumption and secondarily to the generation of obesity [16]. Ghr is secreted mainly by endocrine cells of the enteric system type X/A [17, 18], is found in the bloodstream in higher concentrations as desoctanoyl or desacyl-ghrelin or deacylated Gh [19-21], and as Ghr acylated or acyl ghrelin, the latter responsible for the biological effects [22, 23]. Ghr levels promotes activation of the orexigenic hypothalamic axis [24], where r- Agouti protein (AgRP) and neuropeptide Y (NPY)[25] are secreted, both related to higher food consumption [23]. In addition, effects on the Central Nervous System (CNS) [26], on the regulation of adipokines and on immune functions [18, 27] are attributed. At the CNS level, a direct action on hypothalamic neurons activating protein kinase (AMPK)[28,29] has been reported, which establishes and inhibition of acetyl-CoA carboxylase [28], increases mitochondrial metabolism and generation of reactive oxygen species; these events induce the expression of orexigenic neuropeptides [30,31] and intervene in the activation of the mTor cytoplasmic nutrient sensor at the hypothalamic level [32], which maintains orexigenic function, which implies a dependence of the detection of nutrient in the pathway signaling of acyl ghrelin[33].
In studies conducted in animal models, the presence of Ghr immunoreactive cells has been demonstrated through immunohistochemical techniques, distributed in different areas of the hypothalamus such as the paraventricular, ventromedial, arcuate, dorsomedial, and lateral hypothalamus nuclei, proposing their participation in the regulation homeostatic, endocrine and autonomic [34,35]. Other studies in laboratory animals, which were administered Ghr in the paraventricular and lateral hypothalamic nuclei, showed that its administration allows these animals to stay awake., reducing the sleep of slow wave so non- REM (NREM) fast wave sleep or REM sleep, accompanied by increased need for food consumption [36,37]. In addition, when subjecting laboratory mice to a lack of sleep of 5 hours, an increase in the content of the hypothalamic Ghr was observed during the first hour of the lack of sleep, as well as; an increase in corticosterone (CORT) [38], and an increased in food consumption that is related to the increase in Ghr [15]. In addition, it has been shown that the secretion of this hormone occurs after the secretion of growth hormone during the NREM phase and before starting the REM phase of physiological sleep [14]. So, blood levels of this hormone exhibit a circadian fluctuation that aligns with meals, with preprandial elevation followed by rapid postprandial reductions [39]. Ghr contributes to the regulation of body weight that could be involved in the modification of somatometric parameters such as body mass index (BMI). On the other hand, in a study conducted by Broussard et.al., where plasma levels of total ghrelin were measured in 19 men with normal BMI, to see their eating behavior, it was shown that lack of sleep raises ghrelin levels compared to men with sleep restriction; finding a correlation of lack of sleep with higher calorie intake [40]. These authors recommend studies that assess the hormonal homeostatic factor.
Chapman et. al., in another study whose objective was demonstrate whether acute sleep deprivation affects food purchase options in a simulated supermarket, where 14 men with normal BMI were subjected to lack of total sleep. They find that there is a positive relationship between lack of sleep and the purchase of a greater number of high- calorie foods compared to purchases made after a normal 8 hour sleep night. In addition, no relationship was found with total Ghr levels [41]. Andarini et. al., in an experimental study, whose objective was to compare acylated ghrelin levels and appetite ranges at different times, in two groups of 16 subjects, one with obesity and normal BMI, it was shown that the levels of acylated ghrelin were higher in participants with normal BMI compared to the obesity group. There are no differences in appetite ranges between groups at different measurement times, nor was a correlation found between acylated Ghr levels and appetite ranges [42]. There are still controversies between the different studies on the relationship between lack of sleep, obesity and acylated ghrelin levels, which allows us to determine if the variations of this hormone have a direct influence on food consumption. This article aims to identify the relationship between lack of sleep and acylated ghrelin levels in young Adults with obesity.
Study was conducted with 56 young adults with obesity from the city of Celaya, Guanajuato, Mexico; divided into 2 groups. Control group with 28 young people with obesity without lack of sleep; group cases with 28 young people with obesity and lack of sleep. For the exclusion criteria, the diagnosis of chronic degenerative diseases such as hypertension, diabetes, sleep disorders, Prader Willis syndrome, who were under medical treatment to fall asleep, as well as the use of psychoactive substances.
The information of sociodemographic data was obtained through the self-application of data card; prior authorization and signed informed consent.
The weight and height measurement were performed for the calculation of the body mass index, subsequently the blood was collected in a tube with EDTA and Pierce 88265 protease inhibitor by venous puncture. The blood was centrifuged at 3500 rpm at 4° C, the plasma was separated for storage at -20° C until the level of acylated ghrelin levels was determined, using the ELISA technique.
Determination of Acylated Ghrelin Levels
For the determination of plasma acylated ghrelin hormone levels, using the ELISA technique, the Acylated ghrelin (human) express enzyme immunoassay kit# A05106.96 wells kit, Bertin pharma Brand, was used according to the manufacturer´s specifications.
Data analysis
The analysis of the results was carried out through the statistical package SPSS 24.
Descriptive statistics were applied for sociodemographic variables; for the numerical ones, central tendency measures were applied and for the categorical ones, frequencies (f) and percentages (%) were determined. For the analysis of the differences of means between the groups in the values of weight, height and BMI, the Student t test was applied for independent samples. After the analysis with the Levene test, the Mann Whitney U test was applied to obtain the mean difference; as well as Spearman´s correlation coefficient to determine the relationship between lack of sleep and elevated ghrelin levels, with an error value of 0.05.
Ethical and legal considerations
All subjects gave their informed consent for inclusion before they participated in the study. The study was conducted in accordance with the Declaration of Helsinki.
The research project was approved by the Research Committee and the Bioethics Committee of the Celaya-Salvatierra Campus of the University of Guanajuato, with registration numbers CIDSC-3532910 and CBCCS-01626112018 respectively.
Sociodemographic data
The sociodemographic data collected through a questionnaire, applied to a total of 56 participants(n=56), distributed in 2 groups, control group (CG) and case group (CaG) with a total of 28 participants each, showed that the average age of the participants in the GC is 22.11± 1.72 years and for the CaG 21.36± 2.34, a predominant degree level of studies was found with 3.6% of the GC and 14.3% of the CAG study and work, the most common religion was the catholic with 89.3% in the GC and 71.4 in the CaG (Table 1).
Anthropometric data
The analysis of the results obtained by Student´s t test for weight measurements, showed that there is no statically significant difference with a t(1,54) = -0.783; for measurement of body height t(1,54) = 0.192, and for BMI t(1.54) = -0.695 when comparing the CG against the CaG (Table 2).
Hours of sleep and levels of acylated ghrelin
For the analysis of the values obtained from the total hours of sleep and levels of acylated ghrelin, the Mann Whitney U test was applied, where it was shown that there are statistically significant differences with respect to the total hours of sleep when comparing both groups with a U= 0.0001, mid-range for the CG= 42,500 and for the CaG= 14,500.
With respect to the results obtained from ghrelin levels, it showed that there are statistically significant differences when comparing both groups with a U= 234, p= 0.0096, and mid-range for the CG=22.857 and for the CaG= 34.143 (Table 3).
Association between sleep hours and Acylated ghrelin plasma levels
To determine the relationship between sleep hours and acylated ghrelin levels, the Spearman correlation test was applied, showing a negative correlation Rho= -0.293 and p= 0.028, indicating a moderate correlation, implying that at a lower correlation hour of sleep there are higher levels of acylated ghrelin.
The results obtained in this research we can propose the existence of an inverse relationship between lack of sleep and plasma levels of acylated ghrelin in young people with obesity, which implies that shorth-term sleep or lack of sleep may be a factor that alters hormonal regulation and is associated with a greater probability of promoting obesity and increased adiposity [43, 44].
This lack of sleep permeates a dysregulation of the neuroendocrine system, allows the elevation of orexigenic hormones such as ghrelin; that, together with ghrelin, leptin and dopamine; they are involved in the increase in the need for energy consumption and the maintenance of food reward systems, so they are perceived as appetite regulators [42, 45, 46]. As ghrelin is one of the main hormones related to preference of high palatability and high calorie food regardless of metabolic requirements [47, 48]; high concentrations of this could be a cause in the increase and /or difficulty for weight loss [49]. Therefore, its regulation should be proposed in the diagnosis and comprehensive treatment plans of the patient with obesity.
Important coincidence of the results of this study with those obtained by DelParigi et al., where it reports an increase in ghrelin hormone in patients with Prader Willi syndrome, points to ghrelin as the main factor of hyperphagia [50]. In addition, Kweh et al., propose that the increase in ghrelin during childhood is a predictor of obesity [51].
Another study conducted through functional magnetic resonance imaging in obese and non- obese subjects, showed that the activation of various brain areas such as the ventral striatum, the ventromedial prefrontal cortex, and the extra striated visual cortex, related to reward phenomenon. On the other hand, greater activations related to reward in the dorsolateral prefrontal cortex and posterior precuneus cluster of obese subjects were observed; compared to non-obese [52]. Consistent with this, obese subjects exhibited longer election times after repeated rewards and circulating ghrelin levels lower than lean controls. Reduced ghrelin levels significantly predicted slower post- rewards and circulating ghrelin levels lower than lean controls. Reduced ghrelin levels significantly predicted slower post- reward choices and reward- related hyperactivity in the dorsolateral prefrontal cortices in obese subjects [52].
Perhaps ghrelin signaling on the posterior hippocampus- hypothalamus- brain pathway is affects, by counteracting satiety signals at the intestinal level, allowing the increase in the amount of food ingested. Ghrelin and orexin interact to increase the need for energy consumption through a downward signaling pathway from the hippocampus to the hindbrain [53]. On the other hand, Andarini et, al., relate the subtype of acylated ghrelin with the qualification of self- reported appetite in obese subjects with normal body index, when determining acylated ghrelin before food consumption and 30, 60 and 120 minutes after food consumption showed that acylated ghrelin levels remained increased in obese subjects compared to the control group [42]. Thus, ours results of the correlation between obesity and plasma ghrelin levels support the results of this study.
Contrary to the data shown by Quian et. al., point out that circadian misalignment increases appetite for calorie- rich foods, in addition to raising postprandial levels of acylated ghrelin [54]. Likewise, Aly et. al., reported that ghrelin levels are lower in children with obesity [55]. Another study in laboratory animals showed that increase in ghrelin does not favor the reward system and orexigenic effects, proposed a mechanism that favors resistance to ghrelin, whose function is to prevent starvation and not promote obesity [56]. So, so far, the data referring to this relationship remain controversial.
The present study yielded results that allow us to support the obesity approach from the neuroendocrine point of view and the factors involved in it through new mechanisms. Because lack of sleep is a new health problem that leads to appearance of chronic diseases, it is a suggested to intervene early in the diagnosis and treatment of sleep disorders and obesity.
It is recommended to carry out new studies that support this relationship, which will determine a causal relationship (Randomized Controlled Studies, RTC) and double blind, to achieve control of the intervening variables; it is also suggested to contrast the studies found with subjects of normal weight, to enrich the results found in this research.
The authors REEI and BCV, worked equally in the experimental development and in the writing of the article, these authors have contributed equally to this work and share first authorship. The author TFMR participated in the data collection, CGML and JGSN participated in the review of the article and the experimental design, RGXS and BFE in the search for references, all authors reviewed the final version of the article.
The University of Guanajuato supports the financing of laboratory reagents and the publication of this article.
The authors thanks Francisco Corona Palmerin and Miriam Cervantes Tolentino, students of the Degree in Nutrition, María Guadalupe Botello Jacuinde student of the Master´s degree in Nursing Sciences of the University of Guanajuato Campus Celaya- Salvatierra.
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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.
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.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical 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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear 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.
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.
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.
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.
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!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I 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
