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Research Article | DOI: https://doi.org/10.31579/2639-4162/324
*Corresponding Author: Jose Luis Turabian, Health Center Santa Maria de Benquerencia Toledo, Spain.
Citation: Jose L. Turabian, (2025), Adaptive Changes of Chromosomal Q-Heterochromatin in The Human Population That Has Been Forced to Live in The Extreme Climatic Conditions, J. General Medicine and Clinical Practice, 9(2); DOI:10.31579/2639-4162/324
Copyright: © 2025, Jose Luis Turabian. 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: 16 December 2025 | Accepted: 20 January 2026 | Published: 27 January 2026
Keywords: human adaptation; high-altitude adaptation; constitutive heterochromatin; chromosomal Q-heterochromatin; ‘excess’ Dna.
Homo sapiens is the only one of the animals that managed to populate the entire Earth while remaining a single tropical biological species. It period is noteworthy that modern man started and implemented this unprecedented biological experience in a very short of time (50,000-70,000 years). There are many hypotheses that try to answer this question: the role of reason, a large brain with neocortex, high physiological plasticity, bipedalism, the peculiarity of the forelimbs and many others. After the completion of the Human Genome Project, the possible role of genes in the adaptation to different ecological zones began to be studied purposefully. Yet many questions remain unanswered, including why exactly did man manage to master of the Earth, if there are no genes in his genome, which in one form or another would be absent in other animals? We believe that a part of the so-called ‘excess’ DNA in the human genome, which represents chromosomal heterochromatin regions (HRs), probably played and continues to play an important role in this process. In particular the chromosomal Q-heterochromatin regions (Q-HRs), which are present in the genome of only three higher primates (Homo sapiens, Pan troglodytes and Gorilla gorilla). The peculiarity of chromosomal Q-HRs is that they show wide heritable variability only in the human populations. We managed to obtain data indicating the adaptive changes in the chromosomal of Q-HRs in the human population, which due to circumstances beyond their control migrate to the territory with extreme climatic conditions.
Homo sapiens is the only one of the animals that managed to populate the entire Earth while remaining a single tropical biological species. It is noteworthy that modern man started and implemented this unprecedented biological experience in a very short period of time (50,000-70,000 years). During this period, humans have managed to populate almost all ecological zones of the Earth's surface, including such extreme areas as the Far North and high-altitudes, which are particularly difficult for the existence of tropical animal species.Among the climatic conditions where man has to live, the most difficult is the high-altitude areas. Therefore, the study of men at highland is important because living at high-altitude has a significant impact on the human body, particularly on physiology, adaptation, health, and disease. To understand the impact of life at high-altitude on humans, it is important to know how many humans live at high-altitude. New research has shown that over 500 million humans live at ≥1,500 m, 219 million at ≥2,000 m, 81.6 million at ≥2,500 m, 25.2 million at ≥3,000 m, 14.4 million at ≥3,500 m, 6.4 million at ≥4,000 m, 2 million at ≥4,500 m), and 0.31 million at ≥5,000 m 1. However, remains not fully known biological mechanisms that allowed man to adapt to such harsh climatic condition. There are many hypotheses that try to answer this question: the role of reason, a large brain with neocortex, high physiological plasticity, bipedalism, the peculiarity of the forelimbs and many others. After the completion of the Human Genome Project, the possible role of genes in the adaptation to different ecological zones began to be studied purposefully. In particular, it has been found that the genome of human populations living permanently in the conditions of Tibet, the Himalayas, the Andes, and the Ethiopian highlands contains genes that are presumably related to human adaptation to high-altitude. However, it turned out that, firstly, these hypothetical genes are not found in all highlanders and, secondly, their frequency(s) are different in different high-altitude populations 2-6. Some authors even believe that there are different genes for adaptation to different mountain provinces7. The problem is further complicated by the well-known circumstance that there are no genes in human genome, which in one form or another would be absent in other animals. Moreover, H. sapiens does not differ significantly from other higher eukaryotes in the number of genes, having about 22,000 in its genome. Nevertheless, it was man who managed to master and populate the entire earth's landmass.
It is believed that a part of the so-called ‘excess’ DNA in the genome, which represents chromosomal heterochromatin regions (HRs), probably played and continues to play an important role in human adaptation to different climatic-and-geographical conditions, including high-altitude zones. In particular the chromosomal Q-heterochromatin regions (Q-HRs), which are present in the genome of only three higher primates (Homo sapiens, Pan troglodytes and Gorilla gorilla) 8-10. The genome of higher eukaryotes is known to consist of two components: euchromatin and heterochromatin. The first component consists mainly of coding DNA (genes), whereas the second component represents short, repetitive sequences that do not code for specific polypeptides and are known by different names: ‘excess’, ‘redundant’, ‘junk’, ‘selfish’, etc. DNA. In humans, the genic portion makes up about 1.5-2.0% of the DNA of the genome, while the rest is in the form of short, repetitive nucleotides to varying degrees. About 15-20% of the ‘excess’ DNA in the human karyotype is organized in constitutive chromosomal HRs. Two types of constitutive heterochromatin are known: C- and Q-HRs. C-heterochromatin is present in the genome of all higher eukaryotes, whereas Q-heterochromatin is found in the karyotype of only three animals (humans, chimpanzees and gorillas). The peculiarity of chromosomal Q-HRs in the genome of these higher primates is that they show wide heritable variability only in the human population. It was found that human populations differ significantly from each other in the number of chromosomal Q-HRs 11-22. Established that the number of Q-HRs in the genome of a population depends on the climatic-and-geographical peculiarities of the places of their permanent residence, but not on their racial and ethnic features 22. In particular, it was shown that the largest number of chromosomal Q-HRs was found in the genome of indigenous people of Africa 12,19, and the smallest number of Q-heterochromatin materials was found in aborigines of high-altitudes and the Far North 20,21 [see Supplement Materials].

Now for the first time it has been possible to obtain evidence that chromosomal Q-HRs in the genome of a human population can change even over several generations. We managed to obtain data indicating the change in the number of chromosomal Q-HRs in the population, which due to circumstances beyond their control migrate to the territory with extreme climatic conditions. This is what happened to one Kyrgyz population after the Bolshevik Revolution in Russia in 1917. To avoid physical extermination and political persecution one Kyrgyz tribe fled to Afghanistan in the 1920s and appealed to give them asylum. The Afghan government offered them an almost uninhabited and inaccessible high-altitude area in the northeastern Pamirs, which is characterized by an extremely harsh climate [see Supplement Materials]. As the research shows, during more than five generations that the Kyrgyz have lived in complete genetic isolation in the extreme conditions of the Pamir high-altitudes (4200 m and higher above sea level), some changes have occurred at their chromosomes compared to those who continue to live in Kyrgyzstan.
Supplement – 2.

Karyotypes of four human samples stained (Q-staining) with quinacrine mustard. (a) Metaphase of female (46, XX) having no chromosomal Q-HR. (b) Metaphase of human male (46, XY) having one chromosomal Q-HRs. (c) Metaphase of man (46, XY) having three chromosomal Q-HRs. (d) Metaphase of man (46, XY) having four chromosomal Q-HRs.
The material of the study was Kyrgyz sample, who returned to his historic homeland a few years ago by consent of the governments of the two countries due to extremely difficult living conditions at the high-altitude of Afghanistan Pamirs: high morbidity and child mortality, short life expectancy (~35 yrs.), lack of school education, medical services and many others. The sample included 58 repatriates, who moved to live in their historical homeland, which their ancestors left more than 100 years ago (the Alay mountains of Kyrgyzstan). As a control, we used a sample of Kyrgyz (high school students) who are indigenous inhabitants of the Alay highland region (2,600 m and above sea level). For comparison, we studied a sample of students from the North India, who study at Bishkek, Kyrgyzstan. To study the variability of chromosomal Q-HRs, we used a short-term culture of peripheral blood lymphocytes. The sizes and fluorescence intensities of chromosomal Q-bands were evaluated using a 5-point system according to [24]. Q-bands with the 4th and 5th fluorescence intensities were accepted as chromosomal Q-HRs according to the recommendations of [25]. Identification and registration of Q-bands were carried out on the computer screen using a microscope of Carl Zeiss (Germany) model Axio Imager A2 with planapochromatic objective EC ‘Plan-Neofluar’ 100x with numerical aperture 1.40, which is equipped with a special computer system IKAROS (Carl Zeiss, Germany), which automatically analyses and document the entire human karyotype.
The following quantitative characteristics of chromosomal Q-HRs in population were studied:
The obtained data were processed by generally accepted statistical methods using the SPSS Statistics program. The student’s t-test was used to compare the mean numbers of Q-HRs per individual in the population between samples. Empirical distributions were compared using the χ2 criterion.
The aim of the study is finding out whether the number of chromosomal Q-HRs in the genome of a human population may change if it is forced to exist in extreme climatic conditions of the high-altitude for several generations.
Location of Q-HRs | Populations | ||
Kyrgyz repatriates (n = 58) I | Kyrgyz natives (n = 112) II | Indians (n = 97) III | |
| 3 | 50 (43,10) * 44,64** | 68 (30.4) * 21.9** | 93 (50.5) * 23.6** |
| 4 | 7 (6,03) 6,25 | 12 (5.4) 3.9 | 17 (8.2) 4.1 |
| 13 | 31 (26,72) 27,68 | 84 (37.5) 27.1 | 128 (62.3) 30.7 |
| 14 | 8 (6,9) 7,14 | 29 (13.0) 9.3 | 27 (13.9) 6.9 |
| 15 | 6 (5,17) 5,36 | 34 (15.2) 10.9 | 39 (19.6) 9.6 |
| 21 | 3 (2,59) 2,68 | 42 (18.7) 13.5 | 52 (26.8) 13.2 |
| 22 | 7 (6,03) 6,25 | 41 (18.3) 13.2 | 48 (24.2) 11.9 |
| Total Q-HRs | 112 (96,52) 100.0 | 310 (138.5) 99.9 | 404 (203.1) 100.0 |
| Mean number of Q-HRs | 1.9±0.123 | 2.78±0,083 | 4.12±0.149 |
Statistics
| χ2 I, II = 67.3; χ2I, III = 115.2; χ2II, III = 90.56; df = 168; df = 155; df = 207; P = 0.002; P < 0> | ||
* Q-HR frequency of the chromosomes analyzed.
** Q-HR frequency as a percentage of the overall number of chromosomal Q-HRs.
Table 1: Frequency of Q-HRs in seven Q-polymorphic autosomes among Kyrgyz and Indians.
As shown in Table 1, in the studied samples chromosomal Q-HRs were detected on all seven Q-polymorphic autosomes, where Q-heterochromatin can potentially be detected in the human karyotype. The previously established regularity in the distribution of Q-HRs at the population level 11-24 are observed in all samples studied, namely: (a) more than half of Q-HRs
are localized on autosomes 3 and 13, and the rest are more or less evenly distributed on other Q-polymorphic chromosomes; b) the studied samples are statistically significantly different from each other in the distribution of the absolute frequencies of Q-HR on Q polymorphic chromosomes; (c) however, the samples did not differ from each other in terms of the relative frequencies of Q-HRs expressed as a percentage of the total number of chromosomal Q-HRs, i.e. each Q-polymorphic autosome at the population level contains a comparable portion of the total number of Q-heterochromatin irrespective of their places of permanent residence or race-ethnic origin; (d) when the mean number of Q-HRs per individual in the population increases, the absolute frequency of Q-HRs increases simultaneously on all Q-polymorphic chromosomes and vice versa.
Number Of Q-HRs | Populations | ||
Kyrgyz repatriates (n = 58) I | Kyrgyz natives (n = 112) II | Indians (n = 97) III | |
| 0 | 3 | 1 | |
| 1 | 15 | 6 | 1 |
| 2 | 25 | 35 | 7 |
| 3 | 13 | 48 | 25 |
| 4 | 2 | 20 | 32 |
| 5 | 2 | 14 | |
| 6 | 13 | ||
| 7 | 3 | ||
| 8 | 1 | ||
| 9 | 1 | ||
| Total Q-HRs | 112 | 310 | 404 |
Distribution of Q-HRs | χ2 I, II = 34.7; χ2 I, III = 115.2; χ2 II, III = 59.7; df = 169; df = 155; df = 208; P = 0.002; P < 0> | ||
Mean number Of Q-HRs | 1.9±0.123 2.78±0.083 4.12±0.149 t I, II = 6.07; t I, III = 10.38; t II, III = 8.16; df = 169; df = 155; df = 208; P < 0>
| ||
Table 2: The distribution and the mean numbers of chromosomal Q-HRs per individual in Kyrgyz and Indians.
Table 2 shows the distributions of the numbers of Q-HRs in individuals at the population. The studied samples differ significantly from each other both in the distribution of the numbers of Q-HRs and in the mean numbers of Q-HRs. The highest number of Q-HRs is found in the genome of Indians, and the lowest in Kyrgyz repatriates. At the same time, the Kyrgyz repatriates differ with the predominance of individuals with a low number of Q-HRs and a very narrow range of Q-HRs amount variability in the population (from 0 to 4).
The distribution of chromosomal Q-HRs at the level of human populations are known. In particular, it has been established that: a) Q-heterochromatin can be detected only on seven human autosomes (3, 4, 13, 14, 15, 21 and 22) and on the Y chromosome; b) at the population level the distribution of Q-HRs on the seven Q-polymorphic autosomes is uneven, the greatest number of Q-HRs is found on chromosomes 3 and 13 (over 50%), the rest of them
Supplement – 3.
are distributed more or less evenly on the other autosomes. However, populations do not differ from each other in the relative content of Q-HRs on seven autosomes; c) the number of Q-HRs in individuals in a population varies from 0 to 10, although there are 23 loci in the human karyotype where Q-HRs can potentially be detected; d) distribution of the numbers of Q-HRs in individuals of a population is almost normal; e) populations differ from each other in the mean numbers of Q-HRs (from 1.8 to 4.7). These differences proved to be related to features of the climatic-and-geographic conditions of the place of permanent residence, and not to racial and ethnic composition of the population. The highest number of Q-HRs is present in the genome of populations living at low geographical latitudes (from 3.7 to 4.7), and the lowest at high geographical latitudes and high-altitude mountains (from 1.8 to 2.7) [see Supplement Materials]; f) individuals capable of successfully adapting themselves to the extreme high-altitude climate (e.g. mountaineers) and of the Far North (e.g. oil industry workers of polar Eastern Siberia) are characterized by extremely low amounts of Q-HRs in their genome 11-24,31.

The mean number of Q-HRs per individual in the native populations of Eurasia and Africa: a = Chukchi of Chukotsk (n = 132); b = Yakuts of the Yakut ASSR (n = 127); c = Selkups of Eastern Siberia (n = 90); d = Nenets of Eastern Siberia (n = 117); e = Khants of Eastern Siberia (n = 54); f = Mongolians of the MPR (n = 72); g = Chinese of northern China (n = 124); h = Kazakhs of southern Kazakhstan (n = 101); i = Kirghiz of the Pamirs and Tien Shan (n = 603); k = Russians of Bishkek (n = 200); l = Ethiopians of the Ethiopian Highlands (n = 52); m = Negroids of Guinea-Bissau (n = 13); n = Negroids of Mozambique (n = 148); o = Negroids of Zimbabwe (n = 34); p = Negroids of Angola (n = 132); q = Indians of northern India (n = 58) [Ibraimov, 2003; with permission].
Supplement 4.
The lives of Pamir Kyrgyz living at 4,200 m and above sea level in northeastern Afghanistan. There are also dozen videos on You Tube about Kyrgyz living in the Afghan high-altitude Pamirs, filmed by documentary filmmakers.




So far, the lowest amount of the chromosomal Q-HRs in the genome of human populations was found in the natives of Eastern Siberia, Pamir and Tien-Shan. In the aborigines of the Far North of Eastern Siberia, the mean number of Q-HR in the samples was: Chukchi - 2.2; Nenets - 2.2; Khanty - 1.8; Yakuts - 1.8; Selkups - 1.8 [21,26,31], and in the highlanders of the Pamirs and Tien-Shan (2.7 and 2.1, respectively) [16,21,31]. Among non-indigenous people, such low mean numbers of Q-HRs have been found in mountaineers and oil workers working in polar Eastern Siberia (1.60 and 1.72, respectively). It is noteworthy that in the genome of newcomers, but successfully adapted individuals the number of Q-HRs was lower than in the native populations of the high mountains Pamir and Tien-Shan and the Far North of Siberia [20,21].
The peculiarity of this study is that, for the first time, a decrease in the number of Q-HRs was found in a population that lived for a short time (about 100 years) in extremely harsh climatic conditions at high-altitude. The lower number of Q-HRs in mountaineers is explained by the fact that they have undergone, among other things, strict sports selection. To be enrolled in the section they had to have climbed at least 4,000 m above sea level without compromising their health ]20\. The sample of oil workers were individuals who had worked in the polar conditions of Eastern Siberia for at least 3 years [21]. The point is that despite high salaries, good medical care and social benefits (e.g. early retirement) not all newcomers stay to live and work in this extreme climate. In other words, apparently individuals with very few Q-HRs in their genome could become mountaineers or drillers in the Siberian Arctic Circle, among all those willing to do so. Therefore, the low content of Q-HRs in the genome of the Kyrgyz from the high-altitude Afghanistan Pamirs can more reasonably be explained by the same reasons, i.e. individuals who were born with a smaller number of Q-HRs in their karyotype survived there more often.
The fact of a broad variability in the content of chromosomal Q-HRs in the human genome can be explained within the framework of cell thermoregulation (CT) hypothesis [ 27,28]. The essence of the hypothesis is that chromosomal HRs, as the densest structure around the interphase nucleus, known as condensed chromatin, participate in CT by eliminating of excess metabolic heat from the nucleus into the cytoplasm due to its highest heat conductivity. The phenotypic manifestation of CT on the organism level is human body heat conductivity (BHC), the magnitude of which depends on the number of chromosomal C- and Q-HRs in his genome. Since human populations do not differ significantly from each other in the number of C-HRs [29,30] it is obvious that the differences of individuals in the population at the level of BHC depends on the number of Q-HRs in their genome. It has been shown that the more Q-HRs in the karyotype of an individual, the higher the level of his BHC and vice versa [22,31.]
We do not yet know how the number of Q-HRs in the genome or its physiological phenotype (BHC) affects human adaptation to high-altitude climate. Nevertheless, we consider as highly probable that humans in the struggle with cold and high-altitude hypoxia, in addition to the known morphological and physiological mechanisms use low BHC as a means of defense. Perhaps individuals with low BHC are relatively better at maintaining temperature homeostasis, by more effectively retaining metabolic heat in the body under conditions of permanent high-altitude cold and limited food resources in high altitude regions. Our data support the assumption that: (1) the bodies of individuals in a population differ from each other, among other things, in heat conductivity; (2) apparently, the level of human BHC depends on the density of the peripheral condensed chromatin layer around the interphase nucleus, in the compaction of which the amount of Q-HRs in its genome plays an important role; (3) organ-based physiological thermoregulation, which is the same in all normal people, is realized under different physical conditions because individuals in the population differ in BHC [22,27,31]. The main conclusion of the study is that apparently chromosomal HRs, which represent the higher form of organization of short, highly repetitive DNA, are not ‘excess’ neutral material, but have selective value the amount of which in the human genome is under the control of natural selection [31].
We apologize to those authors whose work is not cited or is cited only through reviews. The reason for this is only the space limitations of the publication.
Conflicts of interest: none.
Funding has not been received for the study.
Statement of Consent/Ethical approval: Not required.
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Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.
Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."
I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.
To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.
"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".
I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.
Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.
We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.
My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.
To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina
Dear Jessica, and the super professional team of the ‘Clinical Cardiology and Cardiovascular Interventions’ I am sincerely grateful to the coordinated work of the journal team for the no problem with the submission of my manuscript: “Cardiometabolic Disorders in A Pregnant Woman with Severe Preeclampsia on the Background of Morbid Obesity (Case Report).” The review process by 5 experts was fast, and the comments were professional, which made it more specific and academic, and the process of publication and presentation of the article was excellent. I recommend that my colleagues publish articles in this journal, and I am interested in further scientific cooperation. Sincerely and best wishes, Dr. Oleg Golyanovskiy.
Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. I appreciate the journal (JCCI) editorial office support, the entire team leads were always ready to help, not only on technical front but also on thorough process. Also, I should thank dear reviewers’ attention to detail and creative approach to teach me and bring new insights by their comments. Surely, more discussions and introduction of other hemodynamic devices would provide better prevention and management of shock states. Your efforts and dedication in presenting educational materials in this journal are commendable. Best wishes from, Farahnaz Fallahian.
Dear Maria Emerson, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. I am delighted to have published our manuscript, "Acute Colonic Pseudo-Obstruction (ACPO): A rare but serious complication following caesarean section." I want to thank the editorial team, especially Maria Emerson, for their prompt review of the manuscript, quick responses to queries, and overall support. Yours sincerely Dr. Victor Olagundoye.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. Many thanks for publishing this manuscript after I lost confidence the editors were most helpful, more than other journals Best wishes from, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Agrippa Hilda, Editorial Coordinator, Journal of Neuroscience and Neurological Surgery. The entire process including article submission, review, revision, and publication was extremely easy. The journal editor was prompt and helpful, and the reviewers contributed to the quality of the paper. Thank you so much! Eric Nussbaum, MD
Dr Hala Al Shaikh This is to acknowledge that the peer review process for the article ’ A Novel Gnrh1 Gene Mutation in Four Omani Male Siblings, Presentation and Management ’ sent to the International Journal of Clinical Case Reports and Reviews was quick and smooth. The editorial office was prompt with easy communication.
Dear Erin Aust, Editorial Coordinator, Journal of General Medicine and Clinical Practice. We are pleased to share our experience with the “Journal of General Medicine and Clinical Practice”, following the successful publication of our article. The peer review process was thorough and constructive, helping to improve the clarity and quality of the manuscript. We are especially thankful to Ms. Erin Aust, the Editorial Coordinator, for her prompt communication and continuous support throughout the process. Her professionalism ensured a smooth and efficient publication experience. The journal upholds high editorial standards, and we highly recommend it to fellow researchers seeking a credible platform for their work. Best wishes By, Dr. Rakhi Mishra.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. The peer review process of the journal of Clinical Cardiology and Cardiovascular Interventions was excellent and fast, as was the support of the editorial office and the quality of the journal. Kind regards Walter F. Riesen Prof. Dr. Dr. h.c. Walter F. Riesen.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. Thank you for publishing our article, Exploring Clozapine's Efficacy in Managing Aggression: A Multiple Single-Case Study in Forensic Psychiatry in the international journal of clinical case reports and reviews. We found the peer review process very professional and efficient. The comments were constructive, and the whole process was efficient. On behalf of the co-authors, I would like to thank you for publishing this article. With regards, Dr. Jelle R. Lettinga.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, I would like to express my deep admiration for the exceptional professionalism demonstrated by your journal. I am thoroughly impressed by the speed of the editorial process, the substantive and insightful reviews, and the meticulous preparation of the manuscript for publication. Additionally, I greatly appreciate the courteous and immediate responses from your editorial office to all my inquiries. Best Regards, Dariusz Ziora
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation, Auctores Publishing LLC, We would like to thank the editorial team for the smooth and high-quality communication leading up to the publication of our article in the Journal of Neurodegeneration and Neurorehabilitation. The reviewers have extensive knowledge in the field, and their relevant questions helped to add value to our publication. Kind regards, Dr. Ravi Shrivastava.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, Auctores Publishing LLC, USA Office: +1-(302)-520-2644. I would like to express my sincere appreciation for the efficient and professional handling of my case report by the ‘Journal of Clinical Case Reports and Studies’. The peer review process was not only fast but also highly constructive—the reviewers’ comments were clear, relevant, and greatly helped me improve the quality and clarity of my manuscript. I also received excellent support from the editorial office throughout the process. Communication was smooth and timely, and I felt well guided at every stage, from submission to publication. The overall quality and rigor of the journal are truly commendable. I am pleased to have published my work with Journal of Clinical Case Reports and Studies, and I look forward to future opportunities for collaboration. Sincerely, Aline Tollet, UCLouvain.
Dear Ms. Mayra Duenas, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. “The International Journal of Clinical Case Reports and Reviews represented the “ideal house” to share with the research community a first experience with the use of the Simeox device for speech rehabilitation. High scientific reputation and attractive website communication were first determinants for the selection of this Journal, and the following submission process exceeded expectations: fast but highly professional peer review, great support by the editorial office, elegant graphic layout. Exactly what a dynamic research team - also composed by allied professionals - needs!" From, Chiara Beccaluva, PT - Italy.
Dear Maria Emerson, Editorial Coordinator, we have deeply appreciated the professionalism demonstrated by the International Journal of Clinical Case Reports and Reviews. The reviewers have extensive knowledge of our field and have been very efficient and fast in supporting the process. I am really looking forward to further collaboration. Thanks. Best regards, Dr. Claudio Ligresti
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation. “The peer review process was efficient and constructive, and the editorial office provided excellent communication and support throughout. The journal ensures scientific rigor and high editorial standards, while also offering a smooth and timely publication process. We sincerely appreciate the work of the editorial team in facilitating the dissemination of innovative approaches such as the Bonori Method.” Best regards, Dr. Matteo Bonori.
I recommend without hesitation submitting relevant papers on medical decision making to the International Journal of Clinical Case Reports and Reviews. I am very grateful to the editorial staff. Maria Emerson was a pleasure to communicate with. The time from submission to publication was an extremely short 3 weeks. The editorial staff submitted the paper to three reviewers. Two of the reviewers commented positively on the value of publishing the paper. The editorial staff quickly recognized the third reviewer’s comments as an unjust attempt to reject the paper. I revised the paper as recommended by the first two reviewers.
Dear Maria Emerson, Editorial Coordinator, Journal of Clinical Research and Reports. Thank you for publishing our case report: "Clinical Case of Effective Fetal Stem Cells Treatment in a Patient with Autism Spectrum Disorder" within the "Journal of Clinical Research and Reports" being submitted by the team of EmCell doctors from Kyiv, Ukraine. We much appreciate a professional and transparent peer-review process from Auctores. All research Doctors are so grateful to your Editorial Office and Auctores Publishing support! I amiably wish our article publication maintained a top quality of your International Scientific Journal. My best wishes for a prosperity of the Journal of Clinical Research and Reports. Hope our scientific relationship and cooperation will remain long lasting. Thank you very much indeed. Kind regards, Dr. Andriy Sinelnyk Cell Therapy Center EmCell
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. It was truly a rewarding experience to work with the journal “Clinical Cardiology and Cardiovascular Interventions”. The peer review process was insightful and encouraging, helping us refine our work to a higher standard. The editorial office offered exceptional support with prompt and thoughtful communication. I highly value the journal’s role in promoting scientific advancement and am honored to be part of it. Best regards, Meng-Jou Lee, MD, Department of Anesthesiology, National Taiwan University Hospital.
Dear Editorial Team, Journal-Clinical Cardiology and Cardiovascular Interventions, “Publishing my article with Clinical Cardiology and Cardiovascular Interventions has been a highly positive experience. The peer-review process was rigorous yet supportive, offering valuable feedback that strengthened my work. The editorial team demonstrated exceptional professionalism, prompt communication, and a genuine commitment to maintaining the highest scientific standards. I am very pleased with the publication quality and proud to be associated with such a reputable journal.” Warm regards, Dr. Mahmoud Kamal Moustafa Ahmed
Dear Maria Emerson, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews’, I appreciate the opportunity to publish my article with your journal. The editorial office provided clear communication during the submission and review process, and I found the overall experience professional and constructive. Best regards, Elena Salvatore.
Dear Mayra Duenas, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews Herewith I confirm an optimal peer review process and a great support of the editorial office of the present journal
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. I am really grateful for the peers review; their feedback gave me the opportunity to reflect on the message and impact of my work and to ameliorate the article. The editors did a great job in addition by encouraging me to continue with the process of publishing.
Dear Cecilia Lilly, Editorial Coordinator, Endocrinology and Disorders, Thank you so much for your quick response regarding reviewing and all process till publishing our manuscript entitled: Prevalence of Pre-Diabetes and its Associated Risk Factors Among Nile College Students, Sudan. Best regards, Dr Mamoun Magzoub.
International Journal of Clinical Case Reports and Reviews is a high quality journal that has a clear and concise submission process. The peer review process was comprehensive and constructive. Support from the editorial office was excellent, since the administrative staff were responsive. The journal provides a fast and timely publication timeline.
Dear Maria Emerson, Editorial Coordinator of International Journal of Clinical Case Reports and Reviews, What distinguishes International Journal of Clinical Case Report and Review is not only the scientific rigor of its publications, but the intellectual climate in which research is evaluated. The submission process is refreshingly free of unnecessary formal barriers and bureaucratic rituals that often complicate academic publishing without adding real value. The peer-review system is demanding yet constructive, guided by genuine scientific dialogue rather than hierarchical or authoritarian attitudes. Reviewers act as collaborators in improving the manuscript, not as gatekeepers imposing arbitrary standards. This journal offers a rare balance: high methodological standards combined with a respectful, transparent, and supportive editorial approach. In an era where publishing can feel more burdensome than research itself, this platform restores the original purpose of peer review — to refine ideas, not to obstruct them Prof. Perlat Kapisyzi, FCCP PULMONOLOGIST AND THORACIC IMAGING.
Dear Grace Pierce, International Journal of Clinical Case Reports and Reviews I appreciate the opportunity to review for Auctore Journal, as the overall editorial process was smooth, transparent and professionally managed. This journal maintains high scientific standards and ensures timely communications with authors, which is truly commendable. I would like to express my special thanks to editor Grace Pierce for his constant guidance, promt responses, and supportive coordination throughout the review process. I am also greatful to Eleanor Bailey from the finance department for her clear communication and efficient handling of all administrative matters. Overall, my experience with Auctore Journal has been highly positive and rewarding. Best regards, Sabita sinha
Dear Mayra Duenas, Editorial Coordinator of the journal IJCCR, I write here a little on my experience as an author submitting to the International Journal of Clinical Case Reports and Reviews (IJCCR). This was my first submission to IJCCR and my manuscript was inherently an outsider’s effort. It attempted to broadly identify and then make some sense of life’s under-appreciated mysteries. I initially had responded to a request for possible submissions. I then contacted IJCCR with a tentative topic for a manuscript. They quickly got back with an approval for the submission, but with a particular requirement that it be medically relevant. I then put together a manuscript and submitted it. After the usual back-and-forth over forms and formality, the manuscript was sent off for reviews. Within 2 weeks I got back 4 reviews which were both helpful and also surprising. Surprising in that the topic was somewhat foreign to medical literature. My subsequent updates in response to the reviewer comments went smoothly and in short order I had a series of proofs to evaluate. All in all, the whole publication process seemed outstanding. It was both helpful in terms of the paper’s content and also in terms of its efficient and friendly communications. Thank you all very much. Sincerely, Ted Christopher, Rochester, NY.