AUCTORES
Globalize your Research
Research Article
*Corresponding Author: Nikolay P. Alekseev, Prof., Dr Sci, Department of General Physiology, Faculty of Biology Saint Petersburg State University Russian Federation.
Citation: Alekseev NP, Ilyin VI, Ryumina I.I, (2023), Changes in the Concentration of fat, Protein and Carbohydrates During the Excretion of Milk by Vacuum Breast Pump and Breast Pump with Compression, J. Obstetrics Gynecology and Reproductive Sciences, 8(1) DOI:10.31579/2578-8965/192
Copyright: © 2023, Nikolay P. Alekseev. 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: 15 December 2023 | Accepted: 25 December 2023 | Published: 03 January 2024
Keywords: hormone therapy; menopause; cancer; cryopreservation and ovarian tissue transplantation
Background: The purpose of the work is to investigate the contents of the main nutrients of milk (fat, protein, lactose), as well as the energy value of milk in the process of expression milk using an vacuum electric breast pump and vacuum electric breast pump with compression pulses simultaneously.
Method: Surveys were conducted on 9 women 5-8 weeks of lactation. The analysis was carried out in 10 ml samples of milk, which were continuously expression with breast pump «Laktopuls»: only with vacuum stimuli, and simultaneously with vacuum and compression stimuli. The sampling continuity was ensured by a specially developed procedure. Milk analysis in the samples was performed 1-1.5 hours after gland expression on a Miris AB Uppsala, Sweden, human milk analyzer.
Finding: The largest changes in milk samples were observed in fat concentration. The fat content in milk increased in each subsequent sample and in the latter samples could exceed its content in the initial samples by 3-4 times. The total amount of fat was about 25% more when milk ejected by breast pump with vacuum and compression stimuli than with vacuum stimulus only. When determining the protein concentration in milk samples, an increase in its concentration was also found during milk ejection, but on 10-20%. In contrast to the dynamics of fat and protein concentrations, the carbohydrate concentration did not change in all women during the milk ejection.
Conclusion: A method has been developed that allows analyzing milk nutrients during the continuous removal of milk from the gland. Surveys have shown that ejection of milk with breast pump with vacuum and compression stimuli, increases the amount of fat and protein in breast milk.
Currently, there is no doubt that breast milk has unique nutritional and immune properties for the health and development of the child (American Academy of Pediatrics, 2012). Mother's milk is of particular importance for the health and development of prematurely born children (Fewtrell et al, 2001). At the same time, children born before the 34th week of pregnancy cannot yet feed themselves from the mother's breast (Fewtrell et al, 2001). Pumping milk allows you to feed a sick child who does not have a sucking reflex or who cannot suck out enough milk, and also helps to maintain lactation while the mother or child is ill, prevent milk loss when separated from the child. If it is necessary to express milk for a long time, the question always arises how best to express it – by hand or using special breast pumps. When pumping milk by hand without special devices and breast pumps, it is possible to express milk at any time and in any place, however, in the absence of skill, the mother can injure the breast tissue; the possibility of microorganisms from the hands in violation of hygiene also increases. It is easy to manually express soft breasts and it is much more difficult to express breasts with swelling and lactostasis forming. For more comfortable pumping, it is recommended to use breast pumps with sterile containers, both stationary and individual, electric and manual. The breast pumps must meet a number of requirements: a) effectively stimulate the areola receptors of the mammary gland to form reflexes of milk secretion and excretion in a woman; b) empty the mammary gland accordingly quickly and sufficiently; c) should be easy to operate and not cause painful sensations in a woman, not damage the nipple and the areola of the breast. To date, there are a number of works in the literature in which studies have been conducted to optimize the mechanisms of functioning breast pump aimed at increasing the speed and increasing the amount of milk during pumping (Alekseev and Ilyin ,2016; Alekseev et al, 2020; Ilyin et al, 2019; Mitoulas et al, 2002).
At the same time, it is important to point out that breast pump, along with the optimal speed and amount of milk withdrawn, should ensure a sufficiently high quality of the expressed milk. It is interesting to note here that there are experimental data indicating a connection between the composition of milk and its pumping methods. In particular, the fat content of milk increases with the use of mechanical massage of the mammary glands during pumping by a milk-pumping apparatus, as well as with manual pumping, i.e. when using compression stimuli rather than vacuum stimuli to remove milk (Foda et al, 2004; Mangel et al, 2015).
In this regard, the purpose of this study was to find out the content of fat, protein, lactose in the process of continuous milk excretion using breast pump in vacuum pumping mode and when using vacuum and compression pulses for pumping milk simultaneously
Breast milk samples obtained from 9 women aged 25-34 years at the 5th-8th week of lactation were examined: 6 women were primiparous, 3 were secondiparous. All the women breastfed their children. The analysis was performed in 10 ml of milk, which were continuously pumped breast pump "Lactopuls" The breast pump « Lactopulse» is approved for use in medical practice by the Ministry of Health of Russia and is produced by Сapella LLC.
Figure 1: The scheme of operation of the breast pump "Lactopulse" when removing milk only by vacuum stimuli (A) and simultaneously by vacuum and compression stimuli (B) and the method of continuous sampling of milk. (C, D, E).
The breast pump "Lactopulse" (fig.1) consists of a control unit with a compressor and a remote cup (3), which is placed on the breast of a woman. It consists of conical and cylindrical parts. However, unlike vacuum breast pumps, the cone shaped cup is made of elastic material, for example, silicone rubber. The cone part is placed on the mammary gland (1). Rigid plates (4) are in contact with the elastic cone from two opposite external sides, which are fixed at the front ends of the levers (5). The rear parts of the levers are connected to the movable membranes (9) of the pneumatic pusher (8), to which pressure pulses are supplied from the control unit through ne the pumatic line (10). The pneumatic pusher is placed in the housing (7), to
which a cylindrical part of the lining is attached from the outside to a special movable protrusion (6).
The breast pump operates in the mode of combined action of vacuum and compression pulses (Fig.1B) as follows. Vacuum and compression stimuli are applied to the remote cup from the control unit in a certain sequence. Just as when milk is excreted by a child (Luther et al, 1974; Mizuno and Ueda ,2001), at the beginning, a vacuum act on the mammary gland, which enters in the cup through a pneumatic duct through a fitting (11) into a milk collector connected to the inside of the elastic cup (3).
The areola of the mammary gland (2) begins to stretch by vacuum, stimulating the skin stretch receptors at the same time, under the influence of vacuum, milk begins to come out of the ducts. After the vacuum inside the elastic cone tube reaches its maximum value, positive pressure stimuli are fed into the pneumatic pusher. The movement of the pneumatic pusher membranes is transmitted to levers (5) and rigid plates (4) produce compression of the conical part and the areolar area of the gland with milk ducts located in it. It is important to note here that, just as in the case of milk excretion by a child, the amplitude of compression and vacuum stimuli can be independently regulated. Compression stimuli additionally more effectively stimulate mechanoreceptors mammary gland areola and, accordingly, contribute to a more effective formation of milk excretion and secretion reflexes, while increasing the output of lactogenic hormones (Alekseev et al, 1998). Milk from the gland enters the cylindrical part of the lining, and then into the milk collector (17).
In the mode of vacuum removal of milk (Figure.1A), only vacuum stimuli act on the gland, which, as in the first case, are transmitted inside the cup via a pneumatic duct through a fitting (11). The continuity of sampling was ensured by a specially developed technique. (Fig.1C, D, E). An elastic cup (Fig.1A, B,3) was placed on the areolar-nipple area (Figure.1A,1) of the woman's breast. The mode of operation of the device was set and the milk began to be excreted from the gland. Milk was supplied to the measuring vessel (17) through a milk outlet (12), an auxiliary container (14) and an elastic silicone tube (15). After 10 ml of milk was collected in the measuring container (Figure.1C), the elastic silicone tube was clamped with a clamp (18), the measuring container was disconnected (Figure.1D), then an empty measuring container similar in volume was attached. At this time, milk excretion did not stop, and it accumulated in an auxiliary container (14). Then the clamp was removed and the milk accumulated in the auxiliary container and the newly withdrawn milk began to flow into the measuring container (Figure.1E). until 10 ml of milk was collected in the measuring container again.
Milk from the disconnected measuring container was poured into a special container for its subsequent analysis. It should be noted that the replacement time of measuring container took no more than 10 seconds. During this time, no more than 5 ml of milk was collected in the auxiliary container at maximum milk output rates from the gland. The same gland was expressed in two different modes of milk excretion: 1) using vacuum only 2) simultaneously by vacuum and squeezing.
Considering that the composition of milk has a circadian character (Paulaviciene et al, 2020) the mammary gland was expressed in both modes at the same time of day. The analysis of milk in the samples was carried out 1-1.5 hours after the pumping of the gland on the analyzer of female milk Miris AB Uppsala, Sweden.
Milk output was measured with accuracy of 0.5 ml and presented of the form histograms.
When conducting surveys among women, noticeable variations were found in the amount of milk excreted and in the concentration of the milk nutrients studied. At the same time, the dynamics of nutrient concentrations in the process of milk excretion was similar in all women (table.1,2). Surveys have shown that the greatest changes in milk samples are observed in the fat concentration. The fat content in milk increased in each subsequent sample and in the last samples could exceed 3-4 times its content in the initial samples (table.1). Figure 2A shows the total amount of fat in milk in all nine examined patients in the first (figure.2A1) and second halves (figure.2A2) of the volume of milk excreted. The total amount of fat in the second half of the volume of milk excreted (Figure.2A,2) exceeded the amount of fat in the first half of the volume (Figure.2A,1). At the same time, when pumping by vacuum with compression, the total amount of fat removed was about 25% more than when pumping only with vacuum.
When determining the protein concentration in milk samples, an increase in its concentration during pumping was also detected, but not by several times as in the case of fat concentration, but by 10-20% (table.1). The protein concentration in the second half of the volume of milk excreted was 13-20% higher than in the volume of the first half (Figure.2.B 1). Just as in the case of fat determination, the protein concentration was higher in samples derived simultaneously by vacuum and compression stimuli (Table. 1).
Table 1 :V - milk ejection only with vacuum stimuli
VC - milk ejection with vacuum and compression stimuli
Table:2 V - milk ejection only with vacuum stimuli
VC - milk ejection with vacuum and compression stimuli
In contrast to the dynamics of fat and protein concentrations, the concentration of carbohydrates practically did not change in all women during milk pumping (Table 2)
The energy value of milk is determined by the content of fat, protein, carbohydrates (Perrin ,1954). Since, in our case, the fat content changed to a
greater extent in the samples during milk excretion, it is not difficult to notice that changes in the energy value of milk (table 2. fig.2 D) have a similarity with the changes in the fat content of milk.
Data on the effect of compression stimuli on the dynamics and concentration of nutrients in milk samples are of great interest. Surveys have shown that in women, compression stimuli increase the concentration of fat, protein and, accordingly, the energy value in milk samples. The experimental data available to date suggest that the increase in fat content is due to more efficient milk excretion due to the formation of milk excretion reflexes (Alekseev et al, 1998) , as well as due to a direct increase in the rate of milk excretion by compression stimuli (Alekseev and Ilyin ,2016). Recall that the intake lactose and proteins of milk into the alveolar cavity is carried out by the process of exocytosis. These nutrients are packed into vesicles in the Golgi apparatus of the secretory cells of the alveoli, and then transported to the apical region, merge with the apical membrane, which is perforated and the contents of the vesicles are removed into the lumen of the alveoli (Shennan and Peaker, 2000) Lipids are synthesized in a smooth plasma reticulum localized in the basal part of the cell from fatty acids and glycerol. Synthesized lipid molecules form lipid droplets, which are covered by a protein shell. When approaching the apical part of the secretory cell, the droplets increase in size, merging with each other. In contact with the apical membrane, fat droplets are enveloped by the cell membrane, form fat globules, and then separated, unlaced from the cell so that the integrity of the cell is not violated. The membrane surrounding the globule prevents the formation of large fat droplets, which can hinder the movement and exit of milk from the alveolar duct system. However, the size of lipid globules is much larger than the size of protein molecules and lactose. Therefore, the diffusion of lipid globules is difficult in the thin ducts (70-80 microns) connecting the cavity of the alveoli with medium and thick ducts, from which it is relatively easy to withdraw milk to a child or an apparatus. In addition, it is assumed that fat globules are additionally absorbed to the membranes of cells forming alveoli and duct (Patton and Fowkes, 1967). All this contributes to the fact that milk with a large amount of fat accumulates in the alveoli and thin ducts. Therefore, according to Whittleston's filtration theory (Whittleston, 1953), milk with fat droplets should be "pushed" into medium and thick ducts. This is done due to neuroendocrine reflexes of milk excretion. In response to stimulation of the receptors of the areolar-nipple complex of the mammary gland, when milk is excreted by a child or a breast pump, oxytocin is released impulsively from the neurohypophysis, which causes a contraction of myoepithelial cells, an increase in milk pressure inside the ducts and the milk is pushed out into wider ducts. The available experimental material indicates that the greater the increase in the concentration of oxytocin during the formation of milk ejection reflexes, the higher the intra-alveolar and intra-current pressure rises and, accordingly, the faster the milk exits into the wide ducts. At the same time, due to the arrival of "fatty" milk from the alveoli and thin ducts, the fat content of milk in the samples increases. The use of compression stimuli in the apparatus enhances the formation of the milk excretion reflex. Small changes in the concentrations of protein or lactose in the samples as milk is excreted could be due to the fact that protein and lactose molecules are distributed relatively quickly in the volume of milk in the ductal system of the gland during the period between milk pumping by diffusion. Therefore, there were no such significant differences in the concentration of protein and lactose in milk samples as for the fat content of milk.
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
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.
