Changing the way of Auditory Information

Mini Review Article | DOI: https://doi.org/10.31579/2692-9562/067

Changing the way of Auditory Information

  • Jan Myjkowski *

 Poradnia Otolaryngologiczna w Mielcu.

*Corresponding Author: Jan Myjkowski, Poradnia Otolaryngologiczna w Mielcu.

Citation: Jan Myjkowski. (2023). Changing the way of Auditory Information. Journal of Clinical Otorhinolaryngology 5(2); DOI: 10.31579/2692-9562/067

Copyright: © 2023 Jan Myjkowski. 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: 02 January 2023 | Accepted: 20 January 2023 | Published: 30 January 2023

Keywords: inertia; resonance; receptor potential; basal membrane

Abstract

According to the Georg von Bekesy’s theory of traveling wave, announced in 1928, a sound wave from the eardrum travels to the receptor through the middle ear, cochlear fluids, basilemma and bending of the acoustic cell hairs. An analysis of the mechanisms of transmission of information indicates a large number of problems related to the conveyance of a sound signal traveling this way. Experimental studies corroborate some objections which regard as follows:

Disappearance of the sound wave on the way to the receptor. Threshold hearing according to this theory, which is impossible due to wave energy disappearance. Impossible is a resonance of very short audible sounds. Inertia in the ear, which creates problems in the case of high frequencies. Resolution of the lowest frequencies according to the wave length. Calculation of the basilemma’s proper vibrations in line with Bekesy’s theory. Difference in the wave speed in cochlear fluids and the basilemma. Amplification of quiet tones, especially multitones. Time for generating a receptor potential Lack of transmission of high frequencies after stapedotomy. Immobilization of the basilemma in a cochlear implant, which does not affect the hearing. Mechanism of converting the sound wave energy into the receptor potential. In total, those ambiguities related to the traveling wave theory have led to a new theory of hearing under the name ‘Submolecular Theory of Hearing’. The difference consists in acknowledging another signal path to the receptor, accepting the molecular mechanisms of generating receptor potential without tip-links and amplification of quiet sounds through intercellular transformations.

Introduction

The loudest signal ever emitted on the Earth is the explosion of Krakatoa volcano in 1883.The explosion rang within a 4,300 km radius. At a distance of 64 km, the sound wave energy caused tympanic membrane ruptures in seamen.

The receptor’s reaction to a sound depends upon the sound intensity, viz. the sound wave amplitude, signal frequency and its duration time and the receptor’s sensitivity itself. A minimum hearing level for a 1,000 Hz tone, its pressure being 2 x 10 -5 Pascal, in a young person corresponds to a wave whose amplitude amounts to 8 picometres (pm) in the external auditory meatus (‘eam’) =0 dB. There are cases of hyperacusis, where a receptor can receive sounds under 0 dB. Then, there are also creatures receiving considerably quieter sounds with various frequencies. A barn owl has a hearing threshold on a level of 1 pm [1]. It is not possible to generate a traveling wave on the basilemma with an amplitude 130 times smaller than the oxygen atom diameter. The amplitude of a sound wave in the middle ear diminishes, whereas in cochlear fluids its reduction is considerably higher. If a sound of such an amplitude is audible, this means that the sound reaches the receptor on another path, not through cochlear fluids nor the wave traveling on the basilemma. So, the only possible path for the signal to the receptor is the osseous cochlear housing.

Sound wave energy from the space is received through the basilemma. Its purpose is the absorption of sound wave energy and its conveyance to the middle ear ossicles.

The basilemma’s structure in various quadrants is diversified, which influences the reception and transmission of energy. Diversified is also the tympanic membrane’s position towards the wave incidence. Examined was the speed and translocation of the tympanic membrane in various places. It was noted that for the same wave, the amplitude of vibrations of the posterior quadrants was higher than in the case of the anterior ones. The difference in the displacement on both the sides of the malleus causes its swinging (rocking) rotary motion which is conveyed to the incus and a spherical incudostapedial joint. The rotary motion of the malleus depends on the wave energy and sound wave frequency is converted into the rocking motion of the stapes. [2]. As the sound intensity and frequency increase, so reduced is the piston-like motion; instead, increased is the movement of the stapes lamella, respectively, in the horizontal axis, and in the longitudinal axis in the case of higher frequencies. In the case of rocking movements of the stapes, the full range of frequencies will reach the receptor. It is proved by our hearing up to 20 kHz, whereas other mammals can hear up to 100 or even 200 kHz. Stapedotomy does not ensure rocking actions of the stapes; only the transmission of low frequencies of the mechanism of the stapes piston. High frequency signals will not reach the receptor on a path where vibrating elements on this path are subject to the inertia law.

The sound wave energy from the basilemma is conveyed to cochlear fluids through the middle ear ossicles. In amphibians, reptiles and birds there is one middle ear ossicle formed into a small column which connects the basilemma with the oval window. Instead, in mammals there are three ossicles, which has double importance. Firstly, the weight of the ossicles is important in the inertia of the vibrating parts in the middle ear. Inertia in the wave motion is calculated from the formula: (2 π x frequency)2 x amplitude x mass g x mm/s2. Secondly, the length difference between the malleus and the long limb of the incus constitute the lever mechanism [leverage], crucial mainly for low frequencies. The ratio of the arms of the malleus: incus is 1.3 : 1. That is why the wave amplitude conducted through the ossicles is reduced at a ratio 1.3 : 1. If a sound wave under testing in the auditory meatus amounts to 90 dB, so after conversion into the wave amplitude the wave will be 500 nm.

The 0 dB threshold wave in the auditory meatus has an amplitude of 8 picometres (Resnick, Halliday). In the first case the stapes is subject to a wave with an amplitude of 384.6 nm. Instead, in the vase of the threshold tone the value is 6.15 picometres (pm).

Observations of vibrations of the stapes with a doppler laser vibrometer have proved that (Asai 1999, Huber 2003, Kwacz 2013) the values of vibrations of the stapes depends upon the intensity and frequency, too. It diminishes pro rata to the increase in the sound frequency [3]. For low frequencies - under 1,25 kHz (90 dB), the amplitude of stapes’ vibrations amounts to 8.53 x 10-9 m. For a frequency of 4 kHz ,the amplitude is 7.53 x 10-10 m. Eventually, for 10 kHz, the amplitude is 1.17x10-10 m (Kwacz, Gambin). According to the results available from several research establishments, for a sound wave amplitude in the external auditory meatus - 90 dB = 500 nm, examined upon the stapes the value is [4]: 

For a frequency of 1250 Hz 8.53 nm, and will diminish 58.5 times from the external auditory meatus. 

For a frequency of 4,000 Hz , it amounts to 0,75 nm and is reduced 666 times. For a frequency of 10 kHz, it amounts to 0,11 nm and is reduced 4,300 times. 

It is hardly believed that an acoustic signal might be transmitted to the receptor this way. 

In line with Bekesy’s traveling wave theory, the sound wave energy is transmitted to cochlear fluids. According to the methodology given by the author of the traveling wave theory calculated was the wave amplitude at the beginning of the vestibular meatus and nearby the cupula (Gambin).

For a wave of 1,250 Hz, the 90 dB wave amplitude is 0.179 nm. For a the 90 dB wave amplitude, the value nearby the cupula is 0.372 nm.

For a 4,000 Hz wave, the 90 dB wave amplitude at the beginning of the meatus is 0.088 nm. For a 4,000 Hz wave, the 90 dB wave amplitude nearby the cupula is 0.018 nm.

For a 10 kHz wave, the 90 dB wave amplitude at the beginning of the meatus is 0.000874 nm. For the 90 a 10 kHz wave, the 90 dB wave amplitude nearby the cupula is 0.00181 nm.

It is puzzling that according to those investigations, the sound wave amplitude, irrespective of the frequency, will increase by around 100% on the way from the beginning of the vestibule towards the cupula. As perplexing is a fall in the amplitude of a 500 nm wave in the external auditory meatus (1000 Hz) - down to 11.7 nm - vibrations of the stapes’ and 0.275 nm at the beginning of the vestibular duct. This is yet more conspicuous for 10 kHz: external auditory meatus - 500 nm, stapes lamella: 0.117 nm and initial wave in cochlear fluids: 0.000874 nm. For 10 dB and 10 kHz, the wave amplitude in the vestibular duct at the base is 0.0000000874 nm (Gambin). This implies an error in the assumptions of the traveling wave theory. Sounds with intensities of 10 dB and frequencies of 10 kHz are audible to us although the amplitude of this wave on the way through cochlear fluids disappears 230 million times even before reaching the receptor. This is physically impossible, so there must be another signal path without such losses of energy and time as well.

Susceptibility to displacements of the oval window, which is twenty times smaller than that of the round window, in conjunction with the resonance of the traveling wave in cochlear fluids and proper vibrations of the basilemma will generate a traveling wave on the basilemma. There are some objections to the feasibility of the basilemma’s spontaneous vibrations and the calculated proper vibrations since the basilemma is loaded from the top by the organ of Corti and a band of connective tissue on the inferior membrane surface. In addition, the whole is immersed in cochlear fluids. Resonance of the longitudinal sound wave in cochlear fluids with the transverse wave traveling on the basilemma is difficult to occur due to a very big difference in the speed of both the waves [5]. A sound wave can travel in a fluid at a speed of 1,450 m/s, whereas the speed of a traveling wave depends upon the wave frequency, and for 2-3 kHz this value is 1.9-2.4 m/s, while for frequencies 29-40 kHz - the speed of the wave traveling forwards is 9-8 m/s [6]. Therefore, the average speed of a traveling wave is 290 times smaller than the speed of a sound wave traveling in cochlear fluids. Moreover, resonance is actually unlike to occur at low frequencies when the wave length is many times longer than the basilemma’s length. Resonance is unlikely to occur, too, in the case of tones with duration times of tenth parts of ms which are physiologically audible [7]. A signal will reach the receptor, but not through cochlear fluids and resonance [8]. As Bekesy has it, a wave traveling on the basilemma will lead to a reduction and increase of the distance between the basilemma and the covering membrane, whose consequence is a flow of cochlear fluids and bending of acoustic cell hairs [9]. It is not a stationary, laminar flow. If encoded information should be conveyed this way, therefore the motion of fluids must comply with the sound amplitude and frequency, too. Since the organ of Corti vibrates as the basilemma does, it is provided with mass, speed and acceleration, and thus will be subject to the inertia law which limits the conduction of high frequencies. On the inferior pole of OHCs arranged are delicate efferent and afferent synapses, susceptible to continuous vibrations of OHCs with the organ of Corti and the basilemma. In a wave motion, the fluid in the middle ear, set agoing by a traveling wave has a speed, acceleration and mass – so it is subject to inertia. If the amplitude od a 90 dB and 10 kHz wave in the auditory meatus, of an amplitude of 500 nm, diminishes in the initial section of the vestibular duct down to 0.8 pm, a traveling wave and ‘flows of fluids’ bending the hairs of thicker acoustic cells 125,000 times are unlikely to be generated. It should be also noted that the receptor is reached as well by a 0 dB signal whose amplitude is 8 pm in the external auditory meatus which reduces the amplitude on the way through fluids and the basilemma more than 6 million times – in line with the calculations made according to the traveling wave theory. The cause of such calculations may be the straightening of the cochlea up to a straight tube and a connection of the vestibular duct with the cochlear duct so that the wave may travel on both the cochlea’s sides and an incorrect calculation of the cochlea’s proper vibrations by assuming that the basilemma is an independent element vibrating in the air.

The time for generating receptor potential is almost indeterminable; nor any latency period is observed (Pruszewicz). This results from the speed of sound transmission through a bone – approx. 4,000 m/s as well as from a short signal path to the receptor. A cochlear implant, in the case of partial deafness, corroborates the thesis that the basilemma does not play the role attributed thereto by the theory of traveling wave. Stapedotomy procedures indicate there is neither any transmission nor amplification of high frequencies when operates only the piston conveying wavs to cochlear fluids [10, 11]. 

Any and all problems related to the path on which information is transmitted to a receptor through cochlear fluids and the basilemma will give a strong foundation to set forth a thesis there is another path conveying a signal to the receptor. This is the signal path from the middle ear through the cochlear osseous housing directly to the receptor. The energy of sound waves arrives at the ear incessantly event at night. It can be either stored nor destroyed. In line with the 1st principle of thermodynamics it can be turned into another form of energy. That is why the information in the form of energy encoded in a sound wave reaches the receptor unchanged; instead, the other part of energy will be subject to degradation while traveling through cochlear fluids when the wave amplitude diminishes millions of times.

Molecular mechanisms are responsible for the reception and processing information in an acoustic cell [12]. When the signal is not received by the receptor, mechanical amplification through pulling at the basilemma by contracting OHCs is not possible. There is a perfect intracellular amplification of the received signal, too weak to reach the center. Such an amplification is present in other sense organs [12].Mechanical amplification causes problems to multitones with both loud and quiet tones and numerous harmonics. A mechanical amplification of quiet tones is time consuming and brings about a separation of information for the center. Unamplified information is sent directly. After amplification, amplified information is sent to the center in a considerable delay with other information pertinent to other waves.

Bearing in mind all problems related to the transmission of auditory information to the receptor through cochlear fluids and the basilemma it is certain there is another signal path to the receptor. In this process involved is the conduction of the cochlear housing bones and the ‘osseous boneless conduction, viz. conduction of sound waves through soft tissues, which, apart from rocking movements of the stapes, ensures direct transmission of sound waves from the middle ear to the housing bone of the labyrinth. A proof for the conduction of sound waves through soft its issues is the hearing of a baby in the mother’s womb from the second half of the gestation. The baby can hear its mother’s voce, remembers the voice after birth, which implies the recognition and remembering the voice timbre. A sound wave does not have any mass, and thus it is not 

References

Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.

img

Virginia E. Koenig

Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.

img

Delcio G Silva Junior

Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.

img

Ziemlé Clément Méda

Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.

img

Mina Sherif Soliman Georgy

We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.

img

Layla Shojaie

The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.

img

Sing-yung Wu

Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.

img

Orlando Villarreal

Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.

img

Katarzyna Byczkowska

Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.

img

Anthony Kodzo-Grey Venyo

Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.

img

Pedro Marques Gomes

Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.

img

Bernard Terkimbi Utoo

This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.

img

Prof Sherif W Mansour

Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.

img

Hao Jiang

As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.

img

Dr Shiming Tang

Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.

img

Raed Mualem

International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.

img

Andreas Filippaios

Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.

img

Dr Suramya Dhamija

Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.

img

Bruno Chauffert

I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!

img

Baheci Selen

"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".

img

Jesus Simal-Gandara

I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.

img

Douglas Miyazaki

We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.

img

Dr Griffith

I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.

img

Dr Tong Ming Liu

I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.

img

Husain Taha Radhi

I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.

img

S Munshi

Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.

img

Tania Munoz

“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.

img

George Varvatsoulias

Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.

img

Rui Tao

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

img

Khurram Arshad

Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.

img

Gomez Barriga Maria Dolores

The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.

img

Lin Shaw Chin

Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.

img

Maria Dolores Gomez Barriga

Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.

img

Dr Maria Dolores Gomez Barriga

Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.

img

Dr Maria Regina Penchyna Nieto

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

img

Dr Marcelo Flavio Gomes Jardim Filho

Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”

img

Zsuzsanna Bene

Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner

img

Dr Susan Weiner

My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.

img

Lin-Show Chin

My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.

img

Sonila Qirko

My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.

img

Luiz Sellmann