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Research Article | DOI: https://doi.org/10.31579/2692-9562/150
1Department of Otolaryngology, the Second Hospital of Sanming,Sanming, Fujian,China.
2Department of Endocrinology, the Second Hospital of Sanming, Sanming, Fujian, China.
3Department of Otolaryngology-Head and Neck Surgery, National Regional Medical center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fu Zhou, Fujian, China.
4Department of Otolaryngology-Head and Neck Surgery, the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China.
5Allergy Center, the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China.
*Corresponding Author: Wei Lin., Allergy Center, the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China.
Citation: Keliang Zheng, Yingchun Zheng, Yonghong Lei, Jing Lin, Wei Lin, (2025), Modifiable Factors for Tinnitus: A Mendelian Randomization Study Analysis, Journal of Clinical Otorhinolaryngology, 7(4); DOI:10.31579/2692-9562/150
Copyright: © 2025, Wei Lin. 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: 11 September 2025 | Accepted: 12 September 2025 | Published: 19 September 2025
Keywords: joint disorders; disease; blood pressure
Objective:
The topic of tinnitus has received considerable scholarly interest. Contributing factors to the development of tinnitus encompass aging, exposure to loud noises, smoking, and hearing impairment. Nevertheless, the precise risk factors, particularly those that can be modified, remain uncertain. This study aims to explore the potential genetic factors that may be associated with an increased susceptibility to tinnitus.
Methods:
Mendelian randomization analyses were performed using data from the United Kingdom Biobank and FinnGen Biobank data infrastructure. The present study examined the correlation between thirteen prevalent life factors, which were identified as potential risk factors for tinnitus through a comprehensive review of tinnitus risk factors. This investigation employed an inverse-variance weighted (IVW) model to analyze the association. To mitigate database source bias and strengthen the reliability of our findings, the UKB data was utilized for the discovery cohort, while the Finnish database served as the validation cohort. Following this, a meta-analysis was conducted to amalgamate the findings, thereby bolstering the robustness of the results.
Results:
Following a thorough process of MR Quality control and exposure screening, we have identified and chosen 13 risk factors as exposures through careful observation. We discovered significant associations between exposure to the UKB database and the occurrence of tinnitus. Specifically, waist circumference, waist-hip ratio, fasting blood glucose, and fasting insulin were identified as causal factors for tinnitus. Our analysis revealed that waist circumference (IVW, p=0.006, OR=1.37, 95% CI, 1.09-1.71, Cochran Q statistics=13.47, Pheterogeneity=0.2), waist-to-hip ratio (IVW, p=0.005, OR=1.71, 95% CI, 1.17-2.50, Cochran Q statistics=36.5, Pheterogeneity=0.1), fasting blood glucose (IVW, p=0.007, OR=0.7, 95% CI, 0.54-0.9, Cochran Q statistics=34.46, Pheterogeneity=0.59), and fasting insulin(IVW, p=0.03, OR=2.07, 95% CI, 1.07-4.01, Cochran Q statistics=24.95, Pheterogeneity=0.58) all exhibited significant associations with tinnitus.In the validation cohort (Finnish database), our subsequent analysis revealed that smoking exhibited a causal relationship with tinnitus (smoking, IVW, p=0.018, OR=1.20, 95% CI, 1.03-1.40, Cochran Q statistics=52.83, Pheterogeneity=0.86). To analyze these findings, a meta-analysis approach was employed (Waist circumference, p=0.003, OR=1.27, 95% CI, 1.08-1.49,I2=0.00%).
Conclusions:
Our research findings provide evidence supporting a causal association between waist circumference and tinnitus, potentially influenced indirectly by obesity-related indicators. Thereby furnishing substantiation for potential tinnitus prevention measures in subsequent research endeavors.
Tinnitus is defined as the perception of non-speech sound in the absence of an external acoustic stimulus [1]. Tinnitus pathophysiology is not limited to the auditory system alone [2]. Some models of tinnitus pathophysiology suggest that networks associated with attention, memory, distress and multisensory experience are involved in tinnitus perception [3]. Tinnitus is an extremely prevalent condition that impinges on the lives of sufferers to varying degrees. A meta-analysis shows that the prevalence of tinnitus ranges from 11.9 to 30.3% using the same definition of tinnitus[4]. Suffering from tinnitus causes mental distress in most patients [5]. In some people, it is a fairly minor irritation but, for many, the tinnitus intrudes to such a degree that it affects their ability to lead a normal life, and in some very extreme cases has resulted in suicide [6]. It is a very common medical symptom, and some studies show that 5 to 15% of adults had tinnitus in life. It is a condition that could be chronic and for some patients could be very debilitating [7]. A large cross-sectional study involving children and adults who were referred to a regional otolaryngology hospital showed that 97% of those who reported tinnitus had concomitant hearing loss detected by routine audiometry [8]. In addition, tinnitus impact was found to predict increased depression, anxiety sensitivity, and reduced quality of life [9]. At presentation, the possibilities of otological disease, anxiety, and depression should be considered. No effective drug treatments are available, although much research is underway into mechanisms and possible treatments [10]. The causes of tinnitus are varied, but remain unclear in most individual cases [10,11]. However, in some situations, a single hypothesis cannot accurately explain the cause of tinnitus [12]. The objective of our study was to investigate the genetic predisposing factors associated with tinnitus. The numerous etiologies, such as aging (presbycusis), noise exposure, stress, hypertension, diabetes, ototoxic medications, temporomandibular joint disorders, traumatic or ischemic damage, vascular problems, middle-ear problems, and the complex pathophysiology involving peripheral and central auditory and non-auditory structures, have led to the belief that tinnitus is a consequence of some other disease [13].Evidence was also found for a number of non-otological risk factors including temporo-mandibular joint disorder, depression, chronic obstructive pulmonary disease, and hyperlipidemia. Negative associations indicating preventative effects were found for diabetes and high alcohol consumption [14]. Multiple associated factors have been identified, including cardiovascular, psychological, neurological, musculoskeletal and dietary factors [15]. Hypertension and former smoking were associated with an increase in odds of frequent tinnitus [16]. Loud leisure-time, firearm, and occupational noise exposure also were associated with increased odds of frequent tinnitus (16). The tinnitus prevalence increased with age (adjusted odds ratio [AOR], 1.087). Female gender (AOR, 1.401), sleeping less than 9 hours (sleep 7 or 8 h: AOR, 1.437; sleep 6 h or less: AOR, 1.737), noise exposure in other places (AOR, 6.395), and momentary noise exposure (AOR, 5.504) increased the risk of tinnitus [17]. These studies are observational studies, which are susceptible to subjectivity, operational errors, and so on. That makes these studies unreliable. Mendelian randomization uses genetic variants to determine whether an observational association between a risk factor and an outcome is consistent with a causal effect. Mendelian randomization relies on the natural, random assortment of genetic variants during meiosis yielding a random distribution of genetic variants in a population [18]. Mendelian randomization (MR) is one approach to overcome confounding [19]. Mendelian randomization (MR), by using genetic variants randomly allocated at conception as instrumental variables, is less susceptible to confounding than conventional observational studies [20]. The employment of Mendelian randomization (MR) techniques has experienced a noticeable surge in recent years in order to estimate the causal influence of risk factors (exposures) on diseases (outcomes). Consequently, we employed MR methodology to investigate the risk factors associated with tinnitus. This study offers a foundation for both prevention and treatment approaches.
2.1 MR produce
In this particular investigation, a mendelian randomization three assumptions was employed, as depicted in Figure 1. The single nucleotide polymorphisms (SNPs) were found to have a direct association with the exposure to modifiable risk factors. Furthermore, it was determined that these SNPs were not influenced by any confounding factors. Lastly, the SNPs were observed to solely impact the occurrence of tinnitus through their effect on the exposure to modifiable risk factors.
Figure 1: Mendelian randomization three assumptions.
2.2 The summary statistic of modefiable risk factors:
We obtained measurements of Body mass index (BMI), waist circumference, hip circumference, and waist-to-hip ratio from the GIANT (Genetic Investigation of A Nthropometric Traits) consortium. The covariates considered in our analysis included sex, age, age squared, and principal components. In the body mass index (BMI) genome-wide association study (GWAS), a total of 681,275 European individuals and 2,336,260 single nucleotide polymorphisms (SNPs) were included. In the waist circumference GWAS, 60,586 European individuals and 2,744,366 SNPs were included. For the hip circumference GWAS, 225,487 individuals of mixed ancestry and 2,542,663 SNPs were included. Lastly, in the waist-to-hip ratio GWAS, 99,076 individuals of mixed ancestry and 2,146,958 SNPs were included. We obtained measurements of total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides from the Global Lipids Genetics Consortium (GLGC). The variables included in the analysis as covariates were sex, age, age squared, and principal components. The GWAS for total cholesterol involved a sample size of 187,365 individuals of mixed ancestry and analyzed 2,446,982 single nucleotide polymorphisms (SNPs). Similarly, the GWAS for HDL-C included 187,167 mixed individuals and examined 2,447,442 SNPs. The GWAS for LDL-C encompassed 173,082 mixed individuals and investigated 2,437,752 SNPs. Lastly, the GWAS for triglycerides involved 177,861 individuals of mixed ancestry and analyzed 2,439,433 SNPs. Fasting glucose and fasting insulin were obtained from the MAGIC (Meta-Analyses of Glucose and Insulin-related traits Consortium), while the covariates considered in the analysis included sex, age, age squared, and principal components. In the GWAS analysis of fasting glucose, a total of 133,010 European individuals and 64,432 single nucleotide polymorphisms (SNPs) were included. Similarly, for the GWAS analysis of fasting insulin, a cohort of 108,557 European individuals and 64,421 SNPs were incorporated. We obtained data on smoking and drinking habits from the GWAS and Sequencing Consortium of Alcohol and Nicotine use, while controlling for covariates such as sex, age, age squared, and principal components. The GWAS analysis for smoking encompassed a sample size of 337,334 European individuals and 11,913,712 single nucleotide polymorphisms (SNPs). Similarly, the GWAS analysis for drinking involved 335,394 European individuals and 11,887,865 SNPs. The Type 2 diabetes mellitus (T2DM) data was obtained from the DIAGRAM database, with the covariates consisting of sex, age, age squared, and principal components. The T2DM genome-wide association study (GWAS) included a total of 110,452 individuals of mixed ancestry and analyzed 2,915,012 single nucleotide polymorphisms (SNPs).
2.3 The summary statistic of tinnitus:
The genome-wide association studies (GWAS) conducted on tinnitus involved the utilization of the UK Biobank (UKB) biobank(https://www.ukbiobank.ac.uk), which encompassed a sample size of 3,625 individuals of African American or Afro-Caribbean descent and 15,538,145 single nucleotide polymorphisms (SNPs). Additionally, the FinnGen consortium (https://www.finngen.fi/en) was also involved in the GWAS, employing a sample size of 3,502 European individuals with tinnitus, 196,592 control individuals, and 16,380,426 SNPs. Figure 2 provides an overview of the study design employed in this research. A manual search was conducted in the PubMed database to identify modifiable risk factors related to disease, diet and lifestyle, metabolism, and infection. The outcome datasets consisted of summary statistics for SNPs associated with these risk factors, with a significance threshold of p < 5 KB=10000, r2=0.001.>
Figure 2: Analysis framework of the article
The Cochran's Q-test was employed to evaluate the heterogeneity of causal estimates across single nucleotide polymorphisms (SNPs) using the IVW method. The results of this study did not indicate any significant heterogeneity for the exposures examined (P > 0.05). Furthermore, the MR-PRESSO test was utilized to identify potential outliers with horizontal pleiotropy, and no outliers were detected (P > 0.05).
2.4 statistical analysis.
The statistical analyses were conducted utilizing the Two SampleMR package in R statistical software, version 4.1.2, provided by the R Foundation in Vienna, Austria. A two-tailed p-value of less than 0.05 was deemed to be statistically significant.
3.1 Validation results of tinnitus in the UKB consortium
In an exploratory analysis utilizing data from the UKB outcome source, a significant causal relationship was observed between waist circumference (odds ratio [OR], 1.37; 95% confidence interval [CI], 1.09–1.71; p = 0.006), waist-to-hip ratio (odds ratio [OR], 1.71; 95% confidence interval [CI], 1.17–2.50; p = 0.005), fasting glucose (odds ratio [OR], 0.7; 95% confidence interval [CI], 0.54–0.90; p = 0.007), fasting insulin (odds ratio [OR], 2.07; 95% confidence interval [CI], 1.07–4.01; p = 0.03), and tinnitus using the IVW method (Figure 3).The four aforementioned results did not exhibit any heterogeneity or horizontal pleiotropy, as indicated by the statistical tests(Pheterogeneity>0.05 and Ppleiotropy>0.05).
Figure 3: Forest plot of Mendelian randomization results from UKB.
3.2 Validation results of tinnitus in the FinnGen consortium
In a preliminary investigation utilizing the FinnGen Biobank as the source of outcome data, a statistically significant association was identified between smoking and tinnitus using the inverse variance weighted (IVW) method (odds ratio [OR], 1.20; 95% confidence interval [CI], 1.03–1.40; p = 0.018) (Figure 4). Furthermore, no evidence of heterogeneity or horizontal pleiotropy was found (Pheterogeneity > 0.05 and Ppleiotropy > 0.05).
Figure 4: Forest plot of Mendelian randomization results from FinnGen consortium.
3.3 Combined result of cholelithiasis from
In order to enhance the robustness and reliability of the findings, a post-MR meta-merge was conducted, incorporating tinnitus data from both Finland and UKB. Meta-analysisIn shouw that were combined for Meta-analysis, revealing that only waist circumference (odds ratio [OR], 1.27; 95% confidence interval [CI], 1.08–1.49; p = 0.003) remained significantly associated with the outcome. The selection of the model type was based on heterogeneity (I²) and a random effects model was chosen. (Figure5)
Figure 5: Forest plot of Mendelian randomization results from meta-analysis.
This Mendelian randomization study has successfully established a causal relationship between genetically determined increases in waist circumference and the risk of tinnitus. Moreover, within the tinnitus sample exclusively selected from the UK Biobank, four risk factors have been identified as causally associated with tinnitus. Furthermore, the tinnitus sample obtained from the Finnish database has revealed the presence of only one risk factor, namely smoking, that exhibits a causal association with tinnitus. Discrepancies in findings can be attributed to the failure to account for significant confounding variables in certain studies, as well as variations in the definition of tinnitus, the duration of analysis, and the selection of the study population. Factors such as socioeconomic status and lifestyle, which are frequently encountered in conventional observational studies, have the potential to influence the interpretation of results. With hearing loss, older age, male gender, high BMI, higher deprivation, higher blood pressure, smoking history, as well as numerous comorbidities being associated with higher odds of current tinnitus(20). In a systematic review of studies, For models of tinnitus presence, the most common predictors were age, gender and smoking(21). The utilization of a solitary outcome may introduce a potential bias stemming from the data source. The present body of research has begun to disclose a genetic architecture for tinnitus but there is still much work ahead for the identification of specific variants influencing critical gene expression and gene products in tinnitus pathophysiology(22).An important complicating factor is the heterogeneity in tinnitus causes and types(23–26).In contrast, our analysis encompasses a broader scope, encompassing tinnitus data from both the UK Biobank and Finland. By merging the meta-analysis of these two datasets, our findings exhibit enhanced reliability and robustness. In clinical practice, the primary etiologies of tinnitus are frequently examined. On one hand, it can be attributed to localized lesions within the auditory system, while on the other hand, it can be linked to lifestyle factors, encompassing sleep patterns, tobacco consumption, alcohol intake, and similar habits. Established cardiovascular disease and individual and combined cardiovascular disease risk factors were found to be associated with hearing loss(27). According to relvant reports, cardiovascular disease risk factors were found to be associated with hearing loss. Cardiovascular risk factors were assessed via objective measurements including blood pressure, body mass index, waist circumference, lipid profile and glycated haemoglobin (27).Three factors related to cardiovascular disease and its risk factors were associated with having tinnitus(alcohol consumption, Arthritis, use of NSAID medications)(28). we believe that atherosclerotic carotid artery stenosis should be considered a possible cause of pulsatile tinnitus, particularly in patients with cardiovascular risk factors(24).The results were consistent with the previous research- certain measures of cardiometabolic risk inculding waist circumference are weakly related to both reported tinnitus and level of tinnitus handicap(29).In subsequent research, it is advisable to conduct a more comprehensive examination of the underlying determinants of tinnitus, encompassing anatomical characteristics (e.g., hip bone dimensions, hip joint functionality) and lifestyle factors (e.g., prolonged sitting or standing, preference for supine positioning). In the present study, we have successfully established a causal association between waist circumference and tinnitus, thereby highlighting its potential significance in the prevention of tinnitus. This finding is primarily attributed to the comprehensive nature of our Genome-Wide Association Study (GWAS), encompassing diverse sources of data and exposure variables, and further reinforced by a meticulous meta-analysis. Despite the absence of potential pleiotropy or heterogeneity in the sensitivity analysis conducted in this study, it is important to acknowledge that there may still be unresolved bias due to the utilization of different data sets for exposures and outcomes. While the current Mendelian randomization (MR) Study successfully established a causal association between waist circumference and tinnitus, further investigation is required to determine the precise threshold of waist circumference control necessary for managing tinnitus.
Not applicable.
Authors’ contributions
keliang ZHENG: Formal Analysis, Writing–original draft. Wei LIN: Formal Analysis, Writing–original draft,Supervision, Writing–review and editing.yingchun ZHENG: Writing–original draft.yonghong LEI: Writing–original draft. ,jing LIN: Visualization, Writing–original draft. 5: Visualization, Writing–original draft. 6:
Funding
There was no financial support for the research.
Availability of data and materials
Summary statistics for all neoplasms and HPV are available on the IEU GWAS database (https://gwas.mrcieu.ac.uk/).
Ethics approval and consent to participate
Our study used summary statistics from publicly available GWAS (https://gwas.mrcieu.ac.uk/),which followed the protocol approved by the respective institutional review boards, obtained informed consent from all participating studies, and did not require separate ethical approval.
Consent for publication
Not applicable.
Competing interests
All authors declared that they have no potential conflicts of interest.
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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.
