PONE-D-21-23569

A quantitative microbial risk assessment for touchscreen user interfaces using an asymmetric transfer gradient transmission mode

PLOS ONE

Dear Dr. DiBattista,

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PLOS ONE

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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: Partly

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: N/A

Reviewer #2: Yes

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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

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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

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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 paper PONE-D-21-23569 entitled " A quantitative microbial risk assessment for touchscreen user interfaces using an asymmetric transfer gradient transmission mode" discusses an important issue which is the quantitative microbial risk assessment. In particular, the author wished to know if touchscreens can transmit enough pathogens to a user to cause an infection.

My major concerns regarding the study are the lack of validation of the results obtained. Although it would be difficult to determine the number of infections, it should be at least possible to determine if the results presented in Fig. 6 are close to reality or how they compare with other studies with infection risk in the order of 1-2.5%. Models are important to simulate scenarios but it should be possible to assess how close to reality are the results of each scenario.

One thing that is not clear to the reader is if the risk determined is high or not. How can 1-2.5% infection risk be considered? How can this be compared to other situations?

The author also discusses the use of disinfectants and UV light to decrease the risk of transmission. Could this favour the risk of selecting more resistant strains?

Specific comments are listed below:

- The Methods section should allow the repetition of the study by other colleagues. Information about the software and language used to make the simulations/model should be given here. The author added information about the simulator framework only at the end of the paper, but more information is required in the Methods section.

- The discussion section also contains results that should be presented in the results section (e.g. contamination levels, dose response, etc). A general discussion about what the impact of the different assumptions and choices made is lacking. The author presents the discussion in different sub-sections and states the assumptions made but does not provide what would be the result if another choice was made. With the computational model, the impact of some assumptions could be tested to provide support to the decisions made.

- A general conclusion to the questions presented as aims of the study is not provided.

- English should be checked throughout the text. Examples of phrases that should be improved follow:

+ “A more concerning source of contamination if from a user(s) with unwashed hands, particularly after toilet use.”

+ “All of these methods suffer when administered inappropriately or by insufficiently

trained staff.” (Methods do not suffer..:)

+ “Each simulation results is averaged (…)”

Furthermore, the author should not use the word “we” in the text. Usually scientific studies are written without referring to who did the work. In this particular case, only one author is listed and the use of "we" should be avoided.

- “Another important assumption in this simulation is that people will interact with a TUI using just one finger e.g. index finger of the dominant hand.” – This may be true for older people but younger people use more fingers in touchscreens. In the discussion, decisions such as this should be discussed and their impact assessed.

Reviewer #2: Specific comments:

1. The authors conducted an excellent study and provided an appropriate amount of literature review on the topic.

2. The parameters tested in the QMRA i.e., queueing network, transfer rates-asymmetric gradient model, dynamic equilibrium of surface bioburden and the additional sources of pathogen removal provides a thorough approach validating the simulation.

3. Introducing the coding language C in the methods section and taking a step-by-step approach of explaining how the simulation was performed would be helpful for readers to utilize the simulation model. Excellent idea to provide the link to the code used in the study and the appendix information.

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Reviewer #1: No

Reviewer #2: No

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Attachments

Attachment

Submitted filename: Reviewer comments-PONE-D-21-23569.pdf

A quantitative microbial risk assessment for touchscreen user interfaces using an asymmetric transfer gradient transmission mode

PONE-D-21-23569R1

Dear Dr. DiBattista,

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.

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Kind regards,

Ricardo Santos

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

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

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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: (No Response)

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: (No Response)

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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: (No Response)

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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: (No Response)

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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: The author of manuscript PONE-D-21-23569R1 improved significantly the manuscript following the reviewers’ comments. He answered satisfactorily all questions I raised. In particular, he added a link to the simulation code and added sections discussing risk assessment and model limitations, which were may main concerns I had when reviewing the original submission.

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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