PONE-D-22-13178Biomarkers for prediction of neurological complications after acute Stanford type A aortic dissection： a systematic review and meta-analysisPLOS ONE

Dear Dr. Li,

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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: Yes

Reviewer #2: Partly

Reviewer #3: Yes

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

Reviewer #1: Yes

Reviewer #2: N/A

Reviewer #3: 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: Yes

Reviewer #2: No

Reviewer #3: 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: No

Reviewer #2: Yes

Reviewer #3: 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: I have read with great interest regarding the biochemical prognostic markers of type 1 aortic dissection, which may help with management of this highly morbid condition. Below are my suggestions:

1) In the abstract, ". In addition, NFL, IL-6, DD and coagulation factor R are expected to be biomarkers for postoperative neurological complications in patients with AAAD." - the main text only mentions NSE and S100B as significant prognostic markers. I would revise or remove this phrase to avoid any confusions.

2) In the Introduction the authors mention: "The mortality of patients without surgical treatment is 90% in the first 24 hours and 50% in 48 hours". The cited article mentions overall mortality in medically managed AAAD to be around 50%, and it would be paradoxical to have 24hr mortality to be higher than 50%.

3) I would recommend expanding on the biologic role of NSE and S100B and its clinical significance on the Introduction rather than the Discussion.

4) Aside from above, the manuscript suffers from many small grammatical errors which sometimes hinder with legibility. I would recommend repeat proofreading to address these prior to publication.

Reviewer #2: Dear Authors, thank you for submitting your paper about this important topic.

I have the following questions:

- the majority of studies included in the paper come from China; to broaden the spectrum of disease, treatment and molecular assay, please include also the valuable contribution from other countries.

- In the plots experimental and control group are difficult for the reader to understand which group is; please change the labels accordingly

- some outputs are directly computer generated and are not easy to understand; please summarise the findings in one table.

Reviewer #3: Dear the authors of the manuscript entitled "Biomarkers for prediction of neurological complications after acute Stanford type A aortic dissection: a systematic review and meta-analysis"

Thank you for writing this systemic review and meta-analysis which highlighted an important subject in the field of aortic surgery

As youy explained, neurological complications are serious issues after aortic replacements and carry poor prognosis once happened

I can understand the limitations that were mentioned, but i do recommend the following points to be considered:

1. Please run an intense English language spell check through the whole manuscript

2. Please check the accuracy of the following written sentences in the introduction section:

A."The mortality of patients without surgical treatment is 90% in the first 24 hours and 50% in 48 hours". I guess the percentages need to reversed

B."Total aortic arch replacement is the first choice for saving patients' lives". I think the minority of the patients need total aortic arch replacements for Type AAAD

Thank you

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Reviewer #1: No

Reviewer #2: No

Reviewer #3: Yes: Salah Eldien Altarabsheh

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Biomarkers for prediction of neurological complications after acute Stanford type A aortic dissection： a systematic review and meta-analysis

PONE-D-22-13178R1

Dear Dr. Li,

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,

Eyüp Serhat Çalık

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 #3: 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 #3: Yes

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

Reviewer #3: Yes

**********

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 #3: Yes

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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 #3: Yes

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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 #3: Dear the authors

Thank you for taking in consideration the reviewers comments

I have no concerns about the manuscript

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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 #3: Yes: salah Eldien Altarabsheh

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