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Research Article | DOI: https://doi.org/10.31579/2578-8868/389
*Corresponding Author: Julian Lloyd Bruce, Euclid University / Engelhardt School of Global Health and Bioethics, 1101 30th Street NW Suite #500 (Fifth Floor), Washington, D.C. 20007, United States.
Citation: Julian L. Bruce, (2025), Connexus Direct Data Interface: Architectural Design and Translational Performance of a High-Bandwidth Intracortical Brain–Computer Interface, J. Neuroscience and Neurological Surgery, 18(2); DOI:10.31579/2578-8868/389
Copyright: © 2025, Julian Lloyd Bruce. 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: 17 September 2025 | Accepted: 01 October 2025 | Published: 28 October 2025
Keywords: migraine; pathophysiology; prodromal / premonitory phase; ‘pre-prodromal’ phase / ‘pre-premonitory’ phase; migraine with aura (MwA); migraine without aura (MwoA); chronic migraine (CM)
The Connexus Direct Data Interface (DDI) is an implantable brain–computer interface designed to address the limitations of existing intracortical systems by separating cortical sensing from telemetry and computation. This architecture allows for high-bandwidth neural recording, efficient data compression, and secure optical transmission, while reducing heating and improving safety at the brain interface. Connexus incorporates flexible microwire arrays with advanced biocompatible coatings, on-chip signal digitization, and subclavicular transceivers powered by inductive coupling. Decoder pipelines are optimized with transformer-based architectures and streaming strategies to sustain real-time performance. Early results suggest the platform can achieve robust neural decoding in laboratory environments, though long-term durability, chronic biocompatibility, and usability outside of controlled settings remain unresolved. This paper reviews the device’s electrode design, materials and encapsulation, telemetry and powering, decoder performance, surgical workflow, and regulatory considerations. Limitations and directions for future research are highlighted, with emphasis on extending implant longevity, advancing leadless powering methods, and validating performance in at-home clinical trials.
Implantable brain–computer interfaces have progressed significantly in recent years, moving from experimental systems with limited functionality to platforms capable of restoring communication and motor function in humans. However, existing systems often face barriers that limit their translation into long-term clinical use. Chief among these are the trade-offs between channel density and chronic stability, as well as the constraints imposed by bandwidth and powering technologies. Systems that rely on rigid silicon arrays risk high failure rates due to gliosis, while wireless platforms that transmit large volumes of data must contend with heating, interference, and alignment challenges. Addressing these issues requires rethinking both the hardware architecture and the clinical workflows surrounding device implantation and use.
The Connexus Direct Data Interface (DDI) introduces a new approach by partitioning cortical sensing from telemetry and computation. This separation distributes power and thermal loads away from the cortical surface, while enabling high-channel-count recording through integrated digitization and optical uplinks. The system’s flexible microwire arrays and biocompatible coatings aim to mitigate chronic gliosis, while its inductive powering and modular external processors support sustained usability. The purpose of this paper is to examine Connexus’s architecture across its major components, including electrode design, biocompatibility, telemetry and powering, decoding, surgical workflow, and regulatory considerations. By outlining both the opportunities and limitations of this platform, the discussion highlights where further innovation is necessary for Connexus to transition from experimental trials to consistent clinical use.
This paper synthesizes recent peer-reviewed literature, regulatory standards, and manufacturer-reported sources to provide a comprehensive technical analysis of Connexus. Evidence was gathered from PubMed, IEEE Xplore, Web of Science, and arXiv preprints published between 2019 and 2025. Company webpages and university press releases were used only for device-specific details, such as technical specifications and trial announcements, and are identified as manufacturer-reported sources.
The primary search keywords were “minimally invasive brain–computer interface (BCI),” “Paradromics Connexus DDI,” “high-bandwidth data,” “implantable device”, and “neural signals,”. Inclusion criteria required relevance to implantable brain–computer interface hardware or clinical decoding, with quantitative data or reproducible methodology. Review articles were used to establish context, but emphasis was placed on original studies describing electrode materials, telemetry design, decoder performance, and regulatory frameworks. FDA guidance documents and ISO/ASTM standards were included where applicable to demonstrate compliance pathways. All digital object identifiers (DOIs) and regulatory references were verified to ensure accuracy.
3.1 Electrode Array Design
The cortical module of Connexus uses high-density penetrating arrays designed to maximize channel count while preserving long-term recording stability. Traditional Utah arrays, though widely studied, rely on rigid silicon shanks that often provoke gliosis and lead to channel loss over time. Connexus instead employs microwire and polymer-based shanks that bend with cortical tissue, reducing micromotion-induced trauma and improving chronic signal yield. Flexible geometries combined with smaller electrode diameters distribute mechanical stress and lower the risk of vascular disruption.
These arrays are coated with conductive polymers such as PEDOT:PSS, which improve charge transfer capacity and reduce impedance at the electrode–tissue interface [5]. Optimizing shank pitch and penetration depth enables access to both superficial cortical layers important for speech decoding and deeper pyramidal layers critical for motor control. This multimodal reach makes Connexus adaptable across clinical indications, from restoring handwriting to decoding speech. High-channel count platforms like Argo have already demonstrated the feasibility of recording thousands of channels simultaneously [4], and Connexus builds upon these lessons to achieve both scale and stability.
3.2 On-Chip Signal Conditioning and Digitization
The massive data volume generated by thousands of electrodes requires early-stage processing to prevent telemetry bottlenecks. Connexus integrates low-noise amplifiers and digitizers directly on the cortical module, compressing signals before transmission to the subclavicular transceiver. This edge-processing design reduces analog line noise and minimizes susceptibility to interference during lead transmission. Digitization at the source ensures higher fidelity downstream, while efficient compression reduces bandwidth demands on the optical uplink.
Earlier systems such as Utah arrays relied on analog percutaneous connectors, which increased infection risk and noise exposure. Neuralink advanced the field by embedding ASICs under the skull for local digitization and RF transmission [6]. Connexus takes a hybrid approach: digitization occurs at the cortical surface, but higher-power tasks like telemetry and error correction are relegated to the chest-implanted transceiver. This partitioned architecture minimizes heating at the brain interface while sustaining data throughput suitable for real-time decoding.
3.3 Materials and Biocompatibility
Electrode longevity depends on material choice and encapsulation strategy. Connexus employs platinum–iridium electrodes with parylene-C encapsulation, reinforced using atomic layer deposition (ALD) coatings. Long-term studies show that ALD parylene significantly improves moisture resistance compared to conventional coatings, maintaining functional stability beyond one year in immersion testing [7]. Such encapsulation is essential for preventing insulation breakdown and extending implant lifespan.
Conductive coatings such as SIROF (sputtered iridium oxide film) and PEDOT:PSS further reduce impedance and improve charge injection capacity, enhancing both recording sensitivity and stimulation safety [8]. Despite these advances, chronic gliosis and fibrotic encapsulation remain challenges, as even flexible arrays eventually trigger some degree of immune response. Connexus addresses this by optimizing shank geometry to reduce bending stiffness and by distributing arrays to spread local stress across larger cortical regions.
Compliance with ISO 10993 standards for cytotoxicity, sensitization, and irritation remains mandatory, alongside regulatory expectations for chronic histology data in animal models. Emerging materials such as graphene electrodes, bioresorbable insulators, and transparent encapsulants may further reduce gliosis and extend device life [9]. Incorporating these innovations will likely shape the next generation of cortical modules and determine whether Connexus achieves multi-year stability in human use.
4.1 Inductive Powering
Connexus uses inductive coupling to supply continuous power to the implanted subclavicular transceiver. The external wearable coil transmits alternating current at resonance, which is captured by the implanted coil and rectified to direct current for powering amplifiers, digitizers, and telemetry hardware. This architecture eliminates percutaneous leads, lowering infection risk and improving user comfort [10]. However, alignment remains a central challenge: small displacements of the external coil relative to the implant can reduce coupling efficiency and cause power interruptions.
To counteract this, Connexus incorporates adaptive tuning that dynamically adjusts resonance frequency based on coil position. Studies of inductive links in neuromodulation show that closed-loop resonance control improves efficiency by up to 30% during posture changes [10]. In practice, inductive coupling remains the most mature and reliable solution, but emerging alternatives such as ultrasound-based and optical powering have been demonstrated in preclinical systems [11]. These approaches could eventually reduce alignment sensitivity and simplify daily use, but require additional safety validation before translation to humans.
4.2 Thermal Management
The delivery of wireless power unavoidably produces tissue heating through resistive and dielectric losses. Even small increases in temperature can trigger gliosis or accelerate material degradation. ISO 14708 and IEC 60601 standards restrict temperature rise at the tissue interface to less than 2 °C during maximum power transfer. Connexus reduces cortical heating by locating its high-power components, such as telemetry drivers and modulators, in the chest pocket rather than in the cranial implant. This architectural partitioning ensures that the cortical module is limited to low-power digitizers and amplifiers, lowering thermal load at the neural interface.
Thermal modeling and gel phantom studies confirm that coil design strongly influences tissue heating [9]. Connexus adopts litz-wire coils and optimized ferrite shielding to distribute electromagnetic fields more evenly and reduce hotspots. Additional safety mechanisms, such as dynamic power throttling during extended operation, help maintain safe operating temperatures under worst-case load conditions. These strategies are essential for meeting FDA requirements and ensuring clinical safety.
4.3 Optical Telemetry
After digitization, neural data is transmitted from the implanted transceiver to the wearable relay using optical carriers. Optical telemetry provides higher bandwidth, lower latency, and improved security compared to RF telemetry [12]. Multiplexing strategies, such as wavelength-division multiplexing, allow simultaneous transmission of multiple data streams, enabling Connexus to sustain data rates of hundreds of megabits per second. This capacity supports real-time streaming from thousands of channels without saturating the link.
The main limitations of optical systems are alignment stability and tissue encapsulation. Fibrotic tissue can scatter or attenuate optical signals, increasing error rates. Connexus reduces these risks by applying encapsulation-resistant coatings to optical ports and by integrating redundant photodiodes that adjust sensitivity in real time. Near-infrared wavelengths are chosen to maximize tissue penetration while minimizing photothermal effects [13]. By placing optical drivers in the chest transceiver rather than the cranial module, Connexus avoids placing heat-intensive components near the brain.
4.4 Reliability and Error Correction
High-throughput telemetry systems must balance bandwidth with robustness. Neural decoding pipelines are vulnerable to packet loss, which can cause errors in downstream translation. Connexus addresses this with forward error correction and packet redundancy protocols modeled on those used in optical communication networks [12]. These measures allow the system to sustain acceptable error rates even under partial misalignment or transient interference.
Long-term reliability also depends on usability. Daily wearable placement introduces inevitable variability, which Connexus mitigates through self-calibration routines and automated diagnostics. Users receive real-time status feedback, reducing downtime and supporting independent operation. Clinical experience with neuromodulation devices shows that patients only tolerate systems that maintain uptime greater than 95% [10]. Connexus is therefore designed to meet or exceed this benchmark, ensuring reliability in both laboratory and at-home use.
5.1 Decoder Architecture and Algorithms
The decoding pipeline of Connexus is designed around modern deep learning architectures that can capture both the spatial and temporal structure of neural signals. Transformer-based decoders trained on overt ECoG data have recently been extended to covert speech, demonstrating low token error rates and robust cross-task generalization [3]. These models leverage attention mechanisms that dynamically weight contributions from different channels, which is particularly useful in high-density intracortical systems where some electrodes may intermittently fail. Hybrid networks that combine convolutional layers for feature extraction with recurrent layers for temporal integration, such as the Brain2Char framework, have further improved decoding accuracy [17]. By combining these approaches with language model rescoring, Connexus can achieve resilience to channel loss and noise, while also producing outputs that are contextually coherent.
Adaptation over time is essential. Neural signals shift due to gliosis, impedance changes, and user variability, which can degrade decoder performance. Traditional decoders required recalibration sessions, but recent advances in domain adaptation and self-supervised learning allow models to update weights continuously in the background [14]. For Connexus, this means that the user can interact with the system daily without frequent disruptive retraining. The system architecture is modular, allowing new decoder models to be distributed as software updates. This future-proofs the platform by permitting continuous improvement as more data is collected and as machine learning methods evolve.
5.2 Latency and Real-Time Constraints
Low latency is critical for naturalistic communication. In human-computer interaction, delays greater than 150 ms become noticeable and disruptive, particularly in speech and handwriting applications [17]. Connexus must therefore minimize lag across the full processing pipeline: signal acquisition, digitization, transmission, feature extraction, decoding, and rendering. Hardware acceleration through GPUs or FPGAs, smaller telemetry packet sizes, and parallelized data processing are key strategies to achieve this.
While deep transformers provide excellent decoding accuracy, their long context windows can introduce delays [3]. Connexus addresses this by using streaming transformer architectures that update predictions continuously rather than in large batches. This approach allows the decoder to trade a small decrease in accuracy for much faster responsiveness. Latency is further reduced through predictive output strategies that incorporate early stopping rules, where partial but confident predictions are released without waiting for complete context evaluation. These techniques ensure that Connexus remains suitable for conversational speeds in real-world use.
5.3 Output Modalities and Clinical Translation
Connexus supports multiple output modalities to maximize usability across patient needs. Text output remains the most straightforward and has been demonstrated at rates of 40–60 words per minute in high-performance handwriting BCIs [1]. Speech neuroprostheses have shown intelligible, contextually appropriate synthetic speech from cortical signals [2], and Connexus aims to integrate similar pipelines for direct voice generation. Cursor control remains another important modality, enabling navigation of assistive communication devices and integration with consumer electronics.
The real challenge lies in sustaining this performance outside of controlled laboratory environments. At-home use introduces variable signal quality, interruptions in telemetry, and greater diversity in patient posture and behavior. Connexus addresses these challenges through automated calibration routines, real-time error correction, and flexible switching between modalities depending on user needs. By integrating with existing communication software, tablets, and mobile devices, Connexus enhances accessibility. Ultimately, the goal is not only to achieve laboratory benchmarks but also to demonstrate consistent, long-term improvements in quality of life for patients with severe communication impairments.
6.1 Implantation Strategy
The implantation of Connexus arrays requires balancing invasiveness, stability, and chronic usability. Placement begins with a small craniotomy, after which electrodes are stereotactically guided into the cortical target. The flexibility of Connexus’s microwire and polymer shanks provides a significant advantage over rigid Utah arrays by reducing cortical dimpling and vascular trauma. Recent advances in robotic insertion platforms have enabled micron-scale accuracy in electrode delivery, lowering the risks of hemorrhage and ensuring consistent penetration depth [2]. The surgical workflow also includes tunneling of the lead to the chest cavity, where the subclavicular transceiver is implanted. This tunneling process must account for lead strain and insulation wear, as failures in this pathway are among the most common causes of revision in neuromodulation systems [3].
An important consideration for Connexus is surgical duration and complexity. Compared to surface ECoG or endovascular approaches such as Synchron’s Stentrode, Connexus requires a more invasive workflow, which may limit patient acceptance. To counter this, surgical teams are developing streamlined protocols modeled after those used for deep brain stimulation, with standardized incision placement, lead routing, and hardware anchoring. These procedural refinements aim to make Connexus implantation more reproducible and predictable across surgical centers.
6.2 Intraoperative Verification
Ensuring device functionality at the time of surgery is critical for both safety and performance. Impedance testing is performed immediately after electrode placement to confirm the integrity of individual channels. Elevated impedance values may indicate poor seating or tissue damage, prompting intraoperative repositioning. Some centers have also introduced wireless verification using temporary receivers to confirm that digitized packets transmit successfully before the cranial incision is closed [4]. This extra step reduces the risk of early post-operative failures and provides reassurance that downstream decoding will be viable.
Intraoperative neural recording can also be performed to verify that electrodes capture physiologically meaningful signals. For motor cortex arrays, the patient may be asked to attempt hand or speech movements while signals are recorded and analyzed in real time. These procedures, though not always required, can help guide final electrode placement and improve long-term yield. Emerging imaging modalities such as optical coherence tomography and photoacoustic imaging are under investigation for electrode visualization, though these remain experimental and are not yet part of routine workflows.
6.3 Revision and Maintenance
Long-term success of Connexus will depend on the ease of revision and maintenance. Experience with DBS systems shows that hardware revisions are common, often occurring within 3–5 years due to lead fracture, insulation breakdown, or infection [5]. Connexus mitigates this by concentrating complex hardware in the subclavicular transceiver, which can be replaced independently of the cortical array. This modularity allows revision procedures to remain less invasive than full re-implantation.
Maintenance also includes ongoing monitoring. Connexus integrates impedance trending and telemetry diagnostics to detect early signs of hardware degradation. These features allow clinicians to intervene proactively, scheduling elective revisions rather than waiting for catastrophic failures. Remote monitoring capabilities further extend this model, enabling at-home data uploads for clinical review. Ultimately, surgical workflows for Connexus must be designed not only for the index procedure but also for long-term maintenance, ensuring that patients remain safely and effectively supported throughout years of device use.
7.1 ISO/FDA Biocompatibility Standards
For an intracortical device such as Connexus, biocompatibility testing represents the first major regulatory hurdle. All electrode and encapsulation materials must comply with ISO 10993 standards, which assess cytotoxicity, irritation, sensitization, and systemic toxicity. In practice, this means Connexus must provide bench testing data for its parylene and ALD coatings, as well as chronic in vivo histology demonstrating minimal gliotic response. Long-term studies show that ALD parylene encapsulation improves resistance to water ingress and extends insulation stability [7]. These results are promising but regulators will require confirmatory chronic implantation data before approving large-scale trials. Importantly, the FDA expects both ISO-compliant testing and histopathological analysis in animals as part of any Investigational Device Exemption submission, mirroring requirements used in cochlear and DBS implants [9].
Electrode coatings further complicate the biocompatibility picture. PEDOT:PSS and SIROF have demonstrated improved charge injection capacity and reduced impedance [8], but their long-term stability in human cortex remains under review. The FDA will require clear evidence that electrode coatings do not degrade into harmful byproducts over time. This places material science innovations under the same regulatory scrutiny as the electronics, emphasizing that device approval rests as much on chronic safety as on decoding performance.
7.2 MRI Safety Testing
Given the likelihood that patients with Connexus implants will require MRI scans during their lifetime, safety in magnetic resonance environments is another regulatory priority. ASTM F2182 defines protocols for measuring RF-induced heating of implants, while additional tests assess magnetically induced displacement, torque, and image artifact [14]. The implant’s metallic components and leads must be shown to remain stable and safe under standard clinical MRI conditions. Even if Connexus receives only “MR-conditional” labeling, such designation must be specific about allowable scanner strengths, coil geometries, and SAR limits.
The complexity of Connexus’s architecture, which includes cranial electrodes, a tunneled lead, and a chest transceiver, necessitates testing the entire system under MRI conditions. For regulators, this testing is mandatory; incomplete data could lead to patients being denied MRI access entirely. Securing MR-conditional status early is therefore essential not only for safety but also for successful patient recruitment into trials, as MRI exclusion often poses a barrier to enrollment.
7.3 Regulatory Pathways
The regulatory pathway for Connexus will almost certainly begin with an Investigational Device Exemption (IDE) allowing feasibility trials in humans. If safety and efficacy are demonstrated, the system would advance to a Premarket Approval (PMA) application. Unlike some neuromodulation devices cleared via the 510(k) process, BCIs such as Connexus represent novel risk profiles, requiring a higher evidentiary standard. The FDA’s Total Product Life Cycle Advisory Program (TAP) provides a structured pathway for frequent feedback on endpoints, cybersecurity, and clinical trial design, and participation in TAP could accelerate Connexus’s review.
Cybersecurity is now considered a fundamental element of medical device safety. FDA guidance specifies requirements for encryption of data streams, patch management for external software, and continuous vulnerability monitoring [15]. Since Connexus relies on external wearables and computing devices, ensuring end-to-end cybersecurity will be non-negotiable for regulatory approval. Failure to provide a robust cybersecurity strategy has already delayed or blocked other neuromodulation devices. By proactively addressing these standards, Connexus not only reduces regulatory risk but also increases patient trust in the system.
8.1 Current Limitations
Despite its architectural advances, Connexus still faces important limitations that will determine its translational trajectory. The first challenge is biological: chronic gliosis and fibrotic encapsulation remain unavoidable to some degree, even with flexible microwire shanks and advanced coatings. Over time, this response can increase impedance and reduce the quality of recorded signals, requiring recalibration or partial channel abandonment. While adaptive decoders can partially compensate, hardware longevity remains a central concern.
Another limitation lies in the power and telemetry subsystem. Inductive coupling, though robust, is inherently sensitive to alignment, meaning that patient comfort and day-to-day usability may suffer in non-laboratory environments. Optical telemetry also introduces risks of tissue scattering and port encapsulation, which may degrade performance over months or years. Although Connexus mitigates these issues with redundant photodiodes and adaptive resonance tuning, these strategies have not yet been validated in long-term human trials. In addition, surgical complexity remains greater than competing endovascular or ECoG systems, potentially limiting adoption outside of major neurosurgical centers.
Finally, the decoding pipeline, while advanced, is still dependent on large-scale data collection for training and validation. Many current results in speech and handwriting decoding are derived from small patient cohorts in tightly controlled research settings [1,2,17]. Translating these gains to broader patient populations, with diverse neural architectures and clinical conditions, remains a major hurdle. Until datasets scale and adaptive algorithms mature further, Connexus may struggle to deliver uniform performance across heterogeneous users.
8.2 Future Work
Connexus shows promising engineering strategies to reduce tissue reaction and extend functional lifetime, but multi‑year stability in human cortex remains unproven. Preclinical immersion and short‑term chronic studies indicate improved moisture resistance and reduced impedance drift, yet chronic histology and multi‑year in vivo electrophysiology are required to confirm sustained channel yield and functional decoding performance. Statements about long‑term durability should therefore be framed as conditional on forthcoming chronic implantation data and post‑market surveillance, and planned clinical protocols should specify the histological, electrophysiological, and usability endpoints that will be used to demonstrate multi‑year stability.
Future work should prioritize extending implant longevity and reducing biological reactivity. Research into graphene electrodes, bioresorbable encapsulants, and transparent polymer coatings has shown promise in reducing gliosis and maintaining stable impedance [9]. Incorporating these materials into Connexus’s electrode design could extend device lifespan and reduce the frequency of revision surgeries. Long-term preclinical trials will be essential for validating these approaches before human deployment.
Another area for advancement is powering and telemetry. Leadless energy transfer methods, such as ultrasound-based powering, have demonstrated feasibility in preclinical cortical and endovascular systems [11]. Similarly, advances in infrared and terahertz-band telemetry may eventually replace optical carriers, offering greater tissue penetration and resilience to encapsulation. These modalities remain experimental, but incorporating modularity into Connexus’s transceiver will allow integration of such technologies once proven safe.
On the computational side, future work must also focus on personalization and scalability. Decoders should not only adapt to individual neural shifts over time but also generalize across different tasks and user populations. Integrating federated learning approaches, in which decoders are updated across distributed patient cohorts without compromising privacy, could accelerate performance gains while satisfying regulatory requirements for data security [15]. Finally, clinical trials must move beyond laboratory demonstration to multi-year, at-home use, ensuring that Connexus delivers consistent improvements in communication and independence for patients living with severe motor and speech impairments.
The Connexus Direct Data Interface represents a significant advancement in the evolution of implantable brain–computer interfaces. Its design philosophy, which partitions cortical sensing from telemetry and compute, addresses longstanding bottlenecks in bandwidth, thermal management, and device modularity. By integrating flexible electrode arrays, on-chip digitization, and optical telemetry, Connexus establishes an architecture capable of supporting high-channel-count recording at latencies suitable for real-time communication. These features position Connexus as one of the first platforms that can realistically bridge the gap between laboratory demonstrations and sustained clinical use.
At the same time, the system faces limitations that cannot be overlooked. Biocompatibility challenges, the dependency on precise inductive alignment, and the complexity of implantation all introduce barriers to widespread adoption. Yet these limitations also define a clear agenda for future innovation, including more durable biomaterials, leadless power transfer, scalable decoding algorithms, and regulatory pathways that prioritize both safety and usability. If these developments are realized, Connexus has the potential to redefine not only how neural interfaces are engineered but also how they are translated into clinical practice. The trajectory of Connexus therefore embodies both the promise and the challenge of modern BCI development, a field moving steadily from experimental systems toward practical, long-term neuroprosthetic solutions.
All journal policies and submission guidelines were carefully reviewed to ensure full compliance, and the manuscript has not been previously published or submitted elsewhere. The author declares no conflicts of interest. No human, animal, or plant subjects were involved in this literature review, so ethics approval, participant consent, and studies involving plants are not applicable. Additionally, no personal details, images, or videos of individuals are included, which makes publication consent unnecessary. The research did not receive external funding, and no data or supplementary materials are associated with the manuscript. Grammarly AI was used solely to refine grammar, syntax, and paragraph structure. It did not generate ideas or content, thereby preserving the originality of the work.
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I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
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.
