Peer Review History
Original SubmissionFebruary 17, 2020 |
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PONE-D-20-04059 Consideration of stiffness of wall layers is decisive for patient-specific analysis of carotid artery with atheroma PLOS ONE Dear Dr. Lisický, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. Please submit your revised manuscript by Jul 26 2020 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript:
If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols We look forward to receiving your revised manuscript. Kind regards, Fang-Bao Tian Academic Editor PLOS ONE Journal Requirements: When submitting your revision, we need you to address these additional requirements. 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf 2. We note that you have stated that you will provide repository information for your data at acceptance. Should your manuscript be accepted for publication, we will hold it until you provide the relevant accession numbers or DOIs necessary to access your data. If you wish to make changes to your Data Availability statement, please describe these changes in your cover letter and we will update your Data Availability statement to reflect the information you provide. 3. Please include captions for your Supporting Information files at the end of your manuscript, and update any in-text citations to match accordingly. Please see our Supporting Information guidelines for more information: http://journals.plos.org/plosone/s/supporting-information. Additional Editor Comments (if provided): [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #2: Partly ********** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: I Don't Know Reviewer #2: No ********** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: No Reviewer #2: Yes ********** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes ********** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: The authors have performed a finite element analysis of a carotid atherosclerotic plaque using an endarterectomy specimen. They have assessed the effect of wall thickness, MR imaged slice thickness, lipid and fibrous tissue mechanical properties and media anisotropy. They have found that wall thickness and the MR slice thickness are not so critical as the mechanical properties of the lipid and fibrous tissues when computing the peak stress that might be responsible for plaque rupture. Though it is an interesting exercise, a discussion on plaque characteristics found to be associated with plaque rupture and outcome in current literature is missing and would add critical information and perspective on the impact of their results. It is well known that a thin fibrous cap, a large lipid pool and intraplaque hemorrhage are marks of vulnerable plaque, but this markers are not included, or discussed, here. Other comments: Introduction It is not clear what the author mean with the statement "While 2D histology sections or images of autopsy samples enable us ..... or with samples from endarterectomy where the plaque is resected without media and adventitia". The endarterectomy segments would be analyzed by 2D histology, or where do the 2D histology sections come from? Do the authors need to replace "or" with "of" when they say "While 2D histology sections or images"? The introduction should include a statement indicating how their methodology is going to overcome the listed problems found in current literature. Methods It is unclear whether the authors scanned the endarterectomy specimen prior to histological sectioning, or before, please clarify. Also, they could comment why they did not scan the subject prior to surgery, that would have enable them to have a proper outer wall rendering. The paragraph of the Methods section discussing the use of only one case and how the results can, or cannot, be transferred to other cases, should be moved to the limitations paragraph in the Discussion. Discussion The authors are encouraged to add some discussion on markers for vulnerable plaque, such as the size of the lipid pool, fibrous cap thickness and how their results would be if those were considered, or on how their methodology could accommodate for those markers. In addition, the authors are encouraged to revise their use of English, there are some grammar and spelling errors that, at times, lead to statements that are incorrect, such as "... lead to the stroke in the carotid arteries", when stroke might be due to carotid stenosis but does not occur in those vessels, but in the brain. Reviewer #2: Authors Lisický et al. present a manuscript titled “Consideration of stiffness of wall layers is decisive for patient-specific analysis of carotid artery with atheroma” for possible publication in the PLOS ONE. The authors have employed a Design of Experiment concept with ex vivo imaging data to investigate the effects of various parameters on plaque stress. The authors have also performed a comprehensive analysis on a number of phantom models (50 to be exact) to potentially draw a statistically meaning conclusion. In brief, the authors have highlighted that wall stiffness are more important than wall thickness in predicting plaque stress. Although the study is fundamental sound, the manuscript suffers a few shortfalls. In particular, while the authors have quantified the effects of parameters such as wall thickness, fibrous tissue stiffness, etc., the lack of patient number means that the study is, at best, hypothesis generating. It is unclear how the results would differ even with images from one additional patient. Given the highly doubt reproducibility of the present method clinically, the manuscript cannot be recommended for publication in the PLOS ONE in its current form. Nevertheless, I have provided a list of suggestions/comments for the authors: 1. In the Abstract: “Except for anisotropy, all the other investigated factors are taken as continuous in the range based on published experimental results”. This sentence is difficult to understand. Consider rephrase. 2. On page 6: “Since the individual vessel wall layers cannot be distinguished in the in vivo MRI scans and the sample harvested at endarterectomy cannot include the media and adventitia layers of the wall, the outer surface of the obtained geometry was used to create the wall volume… equidistantly offset by 0.5 mm… the assumption of constant wall thickness (WT) was adopted here as an appropriate simplification and the thickness was included into DoE as one of the investigated parameters”. While the authors have provided suitable reference for the 0.5 mm offset. It is clear from the Results that the wall thickness can have a major effect on the plaque stress. Further justifications are therefore needed for this assumption, otherwise the present study is just another engineering exercise without real meaning. 3. On page 7: “As the applied FE software Ansys does not offer this material option, the model was implemented via a user material subroutine”. Since this is a user-defined function, it is the authors’ responsibility to thoroughly test and validation its accuracy. Please provide evidences of both validation and verification of this user-defined function as an appendix to the manuscript. 4. On page 10: “To compare models of more patients, a completely different methodology and a statistically significant number of patients would be necessary which is out of scope of this paper.” This is a major concern to the material presented. To provide confidence to the reader, the authors may at least include one or more patient results in the analysis. By varying the input parameters for 1 patient, this study results could be bias. 5. On page 11: “In the DoE methodology, a 2-factorial design was performed and therefore axial points were included (face-centres).” Please explain what axial points (face-centres) is in layman’s terms for wider audience. 6. On page 11: “The first principal stresses were adopted as stress response indicators, especially PPS and PCS; for all the 3D models analysed, they were evaluated in cross sections with a 0.2 mm span” a. Which is the first principal stress? b. Why evaluated in cross-sections with a 0.2 mm span? E.g, why not 0.1 mm or 0.3 mm? Please elaborate. 7. On page 12: “Therefore, ex vivo MRI was used for the 3D reconstruction in this study” Not sure the benefit of ex vivo MRI here. It seems like a random variable to increase the complexity of the study with no relevant clinical input. 8. On page 13: “Results near the boundary conditions and the bifurcation are not considered since they cause non-realistic artefacts (stress concentrations due to boundary conditions)”. While artefects near the boundary conditions are acceptable, the effect of bifurcation cannot be ignored. Specifically, plaques are often developed at the bifurcation. The authors might want to explain this in a bit more details. 9. On page 14: Figures 7 and 8 are very difficult to interpret at first sight. Consider redrawing the figures or providing clearer captions. 10. On page 16, Table 3: It is not clear whether there is any clinical meaning to the statistics provided here given it is a single study with only 1 patient. Further, this should be in the Results section. ********** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No Reviewer #2: No [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. |
Revision 1 |
PONE-D-20-04059R1 Consideration of stiffness of wall layers is decisive for patient-specific analysis of carotid artery with atheroma PLOS ONE Dear Dr. Lisický, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. Please submit your revised manuscript by Oct 03 2020 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript:
If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols We look forward to receiving your revised manuscript. Kind regards, Fang-Bao Tian Academic Editor PLOS ONE [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #1: All comments have been addressed Reviewer #2: (No Response) ********** 2. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #2: Yes ********** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: I Don't Know Reviewer #2: No ********** 4. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: Yes ********** 5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: No ********** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: (No Response) Reviewer #2: The authors have addressed most of my suggestions and the quality of the manuscript has improved. There are still a few minor concerns and I would truly appreciate if the authors can briefly address these issues: 1) A statement or two explaining the limitation of using ex vivo data in the present analysis. In particular, briefly explain how ex vivo data may be different from in vivo data once the artery/tissue leaves the human body. 2) While it is assuring that the second patient's results are within the predicted ballpark, I remain concern the term "statistical significant" in the analysis. I suggest refining this statement. "Despite this limitation, comparable statistical significance of all results was achieved except for MRI slice thickness factor which is strongly related to the complexity of geometry and its inter-patient variability." 3) The authors may want to carefully proof read the manuscript. Here is a non exclusive list of typos/grammatical errors: line 83; lines 154-155; line 263: define ANOVA; lines 295-296; line 362 (58 divided by 147 kPa?); line 422; line 468, etc. ********** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No Reviewer #2: No [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. |
Revision 2 |
Consideration of stiffness of wall layers is decisive for patient-specific analysis of carotid artery with atheroma PONE-D-20-04059R2 Dear Dr. Lisický, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Fang-Bao Tian Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: |
Formally Accepted |
PONE-D-20-04059R2 Consideration of stiffness of wall layers is decisive for patient-specific analysis of carotid artery with atheroma Dear Dr. Lisický: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Fang-Bao Tian Academic Editor PLOS ONE |
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