PONE-D-24-12886Personality traits and other factors associated with psychotropic medication non-adherence at two hospitals in Uganda. A cross-sectional study.PLOS ONE

Dear Dr. Niyokwizera,

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 Aug 18 2024 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:

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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: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols.

We look forward to receiving your revised manuscript.

Kind regards,

Roberto Scendoni

Academic Editor

PLOS ONE

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2. Thank you for submitting the above manuscript to PLOS ONE. During our internal evaluation of the manuscript, we found significant text overlap between your submission and previous work in the [introduction, conclusion, etc.].

We would like to make you aware that copying extracts from previous publications, especially outside the methods section, word-for-word is unacceptable. In addition, the reproduction of text from published reports has implications for the copyright that may apply to the publications.

Please revise the manuscript to rephrase the duplicated text, cite your sources, and provide details as to how the current manuscript advances on previous work. Please note that further consideration is dependent on the submission of a manuscript that addresses these concerns about the overlap in text with published work.

[If the overlap is with the authors’ own works: Moreover, upon submission, authors must confirm that the manuscript, or any related manuscript, is not currently under consideration or accepted elsewhere. If related work has been submitted to PLOS ONE or elsewhere, authors must include a copy with the submitted article. Reviewers will be asked to comment on the overlap between related submissions (http://journals.plos.org/plosone/s/submission-guidelines#loc-related-manuscripts).]

We will carefully review your manuscript upon resubmission and further consideration of the manuscript is dependent on the text overlap being addressed in full. Please ensure that your revision is thorough as failure to address the concerns to our satisfaction may result in your submission not being considered further.

3. We noted in your submission details that a portion of your manuscript may have been presented or published elsewhere. [No, except a preprint available on research square "Psychotropic medication adherence and associated personality traits in Uganda: a hospital-based cross-sectional study" but it is not under review in any journal and I have updated the article now with important changes before I submit the article to this journal.] Please clarify whether this [conference proceeding or publication] was peer-reviewed and formally published. If this work was previously peer-reviewed and published, in the cover letter please provide the reason that this work does not constitute dual publication and should be included in the current manuscript.

4. Your ethics statement should only appear in the Methods section of your manuscript. If your ethics statement is written in any section besides the Methods, please delete it from any other section. 

5. 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. 

6. We are unable to open your Supporting Information file [Emma Data 10th November.sa]. Please kindly revise as necessary and re-upload.

Additional Editor Comments:

Have you encountered any limitations on the impossibility of administering the questionnaire? in what situations? Please indicate this within the limits by expanding this section.

Please add further conclusive starting points, such as the involvement of tutors or trustees to reduce the phenomenon of non-adherence to medication.

Rewrite the abstract based on the indications provided by the reviewers.

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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

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

Reviewer #1: Yes

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: Yes

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 article addresses a current topic; however, there are suggestions that authors should follow to improve the quality of the manuscript.

-The psychosocial aspects of medication nonadherence have been little addressed. Are there any prejudices? What are the main factors that can aggravate or weaken a state of mental lability? Poverty? The fragility of an elderly person? The state of abandonment? An unexpected pregnancy? Please expand this discussion by adding further references (e.g: https://doi.org/10.1016/j.rcsop.2022.100178; https://doi.org/10.3390/healthcare11030328; https://doi.org/10.1111/bcp.14075).

-The conclusions are too limited and one topic that is poorly explored is that of the ethical question. For example, is imparting enhanced psychoeducation always correct or could it raise ethical issues, such as the lack of the principle of self-determination and informed consent? Please argue these aspects by referring to further literature (e.g: https://doi.org/10.3389/fpsyg.2022.935702; https://doi.org/10.3390/philosophies9030061; https://doi.org/10.1080/17522439.2023.2285967)

Reviewer #2: Overall, the study provides useful information that highlights non-adherence to antipsychotic medications in Uganda. The study methods and results generally provide adequate context. The focus on the level of psychotropic medication non-adherence and associated personality traits is a strength of the study. However, the authors should consider the following to strengthen it:

BACKGROUND:

The following statement seems problematic: "In Sub-Saharan African, by 2050, the burden due to psychiatric disorders and substances use disorders is estimated to increase globally by 130% and specifically by 139% in Eastern Africa

if there is no change in the prevalence and management of these disorders (2)." If Sub-Saharan Africa is the focus, is globally needed?" (page 2)

"Patients with psychiatric disorders are more likely to be non-adherent to treatment than those with

medical diseases (5)." (page 3). This statement makes it look like psychiatric disorders are not "medical diseases". Consider adding "other" before just "diseases".

The manuscript cites studies in India and Italy about how some personality traits affect non-adherence but similar studies in Africa were not cited. Did the authors not find a single study on antipsychotic medication non-adherence and personality traits in Africa to cite? If no such study exists, then the authors should consider indicating that as a gap in research for which their study aims to partly address. If there are similar studies in Africa too, the authors should consider citing them.

METHODS

The authors should consider indicating whether the survey was pilot-tested, and whether patients completed the questionnaire themselves (self-administered). If not self-administered, the authors should indicate whether those who administered received any training to minimise potential bias. How many people administered the questionnaires?

RESULTS

Repetition of "during the study period" in first sentence.

Table 1A: How is "Born Again" considered a religion? Did you mean "Pentecostal churches" or similar Charismatic churches?

Define abbreviations such as JRRH

TABLE 1B: Define BAD and HIV

TABLE 2: Consider defining cOR under "Bivariate Analysis" as has been done for aOR

DISCUSSION

In the first paragraph, the authors wrote: "The high prevalence of medication non-adherence found in our study can also be explained by the false beliefs about mental illness and the use of alternative medicine in Uganda, among others factors." However, the study did not assess use of alternative medicines in Uganda. Authors should consider citing at least a study showing that use of alternative medicine contributes to medication nonadherence otherwise they should consider not blaming alternative medicine for nonadherence.

Authors should consider assessing their in-text citation again. It seems references 19 and 20 in the text should be 20 and 21 in the reference list.

Authors should consider avoiding the terms "non-compliance" (pages 3 and 16) as non-adherence is the preferred term.

Authors claim their study is the first in Uganda and in East Africa on the subject (page 16). This is a bold statement.

As indicated earlier, the authors should consider examining the literature on antipsychotic medication nonadherence and personality traits again to determine similar studies done elsewhere in Africa. The can then discuss their findings in the context of the findings of those studies. If they cannot find any such study in Africa, they should consider adding "the best of our knowledge" to qualify that statement on page 16

The strengths and limitations are written like those of theses. Authors should consider rewriting them without bulleted points.

ALL OTHER SECTIONS

There are several issues with punctuation (eg, missing full stops; page 3 (after adding reference 8); page 7 after below") and inconsistencies that need to be addressed. For example "non adherence" (several pages) and "non-adherence" (page 3).

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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

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[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.

PONE-D-24-12886R1Personality traits and other factors associated with psychotropic medication non-adherence at two hospitals in Uganda. A cross-sectional study.PLOS ONE

Dear Dr. Niyokwizera,

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 follow the reviewers' suggestions to make the article complete, also comparing it with other scientific works on the topic. 

==============================

Please submit your revised manuscript by Oct 12 2024 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:

• A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled '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: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols.

We look forward to receiving your revised manuscript.

Kind regards,

Roberto Scendoni

Academic Editor

PLOS ONE

Journal Requirements:

Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

[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: (No Response)

Reviewer #2: (No Response)

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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: Yes

Reviewer #2: Yes

**********

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

Reviewer #1: Yes

Reviewer #2: 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 #1: Yes

Reviewer #2: (No Response)

**********

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: The authors have considered the issues raised during the review. However, the Conclusions section continues to be sparse. Therefore, they are again urged to expand it by referring to additional literature (e.g., https://doi.org/10.3389/fpsyg.2022.935702; https://doi.org/10.3390/philosophies9030061; https://doi.org/10.1080/17522439.2023.2285967).

Reviewer #2: The authors have to a great extent addressed the issues I raised. However, this manuscript has serious language issues. I am unable to point all of them here.

Just consider the sentence below

"This is similar to the results of a study done in Sweden who found that agreeableness influences positively the adherence behavior [30] and a systematic review done in India, studies showed that Agreeableness was among the personality traits negatively associated with non-adherence for patients with chronic conditions[20]." (See discussion). The use of "who" is a problem, and the subsequent phrase beginning with "studies" is also a problem.

"Sociodemographic informations" appears four times but there should be no "s" after "information".

Even under the Aknowledgements, punctuation is a problem (no full stop after second sentence). Under Authors' contributions, the authors have not used proper tenses. They should consult recently published papers in PLOS to learn how to craft Authors contributions.

Authors should consider getting the help of someone who can adequately address such language issues if the authors cannot address them themselves.

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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

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.

PONE-D-24-12886R2Personality traits and other factors associated with psychotropic medication non-adherence at two hospitals in Uganda. A cross-sectional study.PLOS ONE

Dear Dr. Niyokwizera,

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 Dec 06 2024 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:

• A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled '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: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols.

We look forward to receiving your revised manuscript.

Kind regards,

Roberto Scendoni

Academic Editor

PLOS ONE

Journal Requirements:

Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

[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)

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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)

Reviewer #2: Yes

**********

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

Reviewer #1: (No Response)

Reviewer #2: 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 #1: (No Response)

Reviewer #2: (No Response)

**********

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)

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 slightly improved the manuscript. However, the language issues have not been fully addressed.

I am unable to point all of them here, but the authors should consider the following:

INTRODUCTION

1. "The 2017 report of WHO indicated that globally, 80% of people with mental disorders are living in low- and middle-income countries (LMIC) which include Uganda and, up to 75% of affected persons in many LMIC did not have access to the needed treatment [3]."

SUGGESTION

"are" after "disorders" should be "were", LMIC should be "LMICs", "and, up to" should be ..., and up to" [comma before "and"

"Psycho-social and demographic factors (age, gender, marital status, occupation, family and social support, etc.), substance abuse, beliefs about mental illness are important factors associated with non-adherence related to the patient [5]."

SUGGESTION

Consider adding "and" before "beliefs".

"Illness related factors like side effects of medications, beliefs about the illness, treatments complexity and lack of insight are barriers to medication adherence [16]."

SUGGESTION

"Illness related factors" should be "Illness-related factors [hyphen between illness and related"

The manuscript would need additional editing for issues such as grammar, punctuation and tenses to make its presentation more intelligible.

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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

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.

Personality traits and other factors associated with psychotropic medication non-adherence at two hospitals in Uganda. A cross-sectional study.

PONE-D-24-12886R3

Dear Dr. Niyokwizera,

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 will be generated when your article is formally accepted. Please note, if your institution has a publishing partnership with PLOS and your article meets the relevant criteria, all or part of your publication costs will be covered. Please make sure your user information is up-to-date by logging into Editorial Manager at Editorial Manager® and clicking the ‘Update My Information' link at the top of the page. If you have any questions relating to publication charges, 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,

Roberto Scendoni

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments: