A cross-sectional study of physicians on fluoride-related beliefs and practices, and experiences with fluoride-hesitant caregivers

Tiffany Bass; Courtney M. Hill; Jennifer L. Cully; Sophie R. Li; Donald L. Chi

doi:10.1371/journal.pone.0307085

Peer Review History

Original SubmissionMay 9, 2024
16 Jun 2024 Decision Letter - Hadi Ghasemi, Editor PONE-D-24-16749A cross-sectional study of pediatric and family medicine providers on fluoride-related beliefs and practices, and experiences with fluoride-hesitant caregiversPLOS ONE Dear Dr. Chi, 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 31 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.<br30june, 2024.="" complete="" if="" more="" need="" revisions="" than="" this="" time="" to="" will="" you="" your=""> Please include the following items when submitting your revised manuscript:</br30june,> 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. 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If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references.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 If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.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. 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 Reviewer #3: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: Yes ****** 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 Reviewer #3: 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 Reviewer #3: 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: As a reviewer, I find several strengths and areas for improvement in the study on fluoride-related beliefs and practices among pediatric and family medicine providers. Strengths: Clear Objectives and Findings Presentation: The study clearly outlines its objectives and presents its findings in a structured manner, making it easy for readers to understand the research aims and outcomes. Relevant and Timely Topic: With increasing concerns about fluoride hesitancy among caregivers, especially mirroring vaccine hesitancy, the study addresses a pertinent issue in pediatric and family medicine practice. Insightful Comparison between Specialties: The comparison between pediatric and family medicine providers provides valuable insights into potential differences in knowledge, beliefs, and practices regarding fluoride recommendations. Identification of Barriers: The study effectively identifies common barriers to incorporating oral health activities into medical practice, particularly the lack of time, which is a practical concern for many healthcare providers. Practical Implications: By highlighting the need to improve medical provider awareness about the benefits of fluoride and addressing fluoride hesitancy among caregivers, the study offers practical implications for enhancing preventive dental care in clinical settings. Areas for Improvement: Sampling Limitations: The use of convenience sampling in two states and the predominantly white physician sample limit the generalizability of the findings. Future studies should strive for more diverse and representative samples to ensure broader applicability of the results, especially considering the disproportionate impact of tooth decay on minority children. Quantitative Data Analysis: While the study provides valuable quantitative data on providers' beliefs and practices, it would benefit from more robust statistical analyses to strengthen the validity and reliability of the findings. Qualitative Insights: Incorporating qualitative methods, such as interviews or focus groups, could provide deeper insights into the reasons behind providers' beliefs, practices, and perceived barriers, enriching the understanding of fluoride-related attitudes in clinical practice. Recommendation Strategies: While the study mentions the need to explore strategies for addressing fluoride hesitancy, it could elaborate further on specific intervention approaches or educational programs that could be implemented in medical settings to improve fluoride-related practices. Addressing these areas for improvement could enhance the rigor and comprehensiveness of the study, thereby strengthening its contribution to the literature on preventive dental care in pediatric and family medicine. Best Regards Reviewer #2: Dear Author Good time It was a pleasure to read the article. It is generally well written and of clinical and public value. However, there are few comments that will enrich the article and increases its academic value. Generally, it is of clinical value at the public level and tackles an important subject. It needs to be presented in a better easy way and use simpler language Title: It is too long and not easy to understand, make it simpler and to the point Abstract: Generally well written and presented with no serious comments. Introduction: it is fine but too long and contains many sentences that need to be in the discussion. 1- lines 55-58 not easy to understand, needs rewriting 2-lines 73-77 do not have references!!! are they your results?? 3- lines 81-85 as above Methodology: overall is acceptable but attention is to be paid for the below points ; 1-instead of the heading : study participants it is better to be: study design, setting and participants 2- Need to make a flow chart for your methodology 3-the grouping is not clear, make them consistent throughout the study, are they two groups or more ? 4- PLEASE USE SIMPLE CLEAR LANGUAGE THAT DELIVERS THE MEANING Results: Not easy to understand so PLEASE MAKE IT EASY 1- Lines 231-233 not clear 2- Table 1: regarding age I am not sure if the mean of the age has percentage !!! 3- Table 1: Why Hispanic is not part of the race and is a separate entity??? Discussion : acceptable with logical flow of the section but it seems to be slightly long Conclusion: reasonable and not extravagant Reviewer #3: Dear authors, Thanks for sharing your work with us, some points should be kept in consideration: 1.The manuscript within the scope of the journal. 2.Both the quality and data presentation of this manuscript are good and of great importance to dentists, physicians and even patients. 3.The manuscript expands our knowledge about fluoride-related beliefs and practices 4.The title should be revised and reduced its characters ( precise & and informative) 5.The abstract should reflect the content of the article and must be with range of 250-300 words. 6.more paragraphs should be incorporated to introduction and discussion about the justification of your findings and comparison with other recent relevant studies. 7.Up to date references should be kept in your reference list and the old should be omitted. Good Luck ****** 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: Yes: Bassam Alsheekhly Reviewer #2: No Reviewer #3: Yes: Tahrir Aldelaimi ******** [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. Attachments Attachment Submitted filename: PONE-D-24-16749_reviewer.docx https://doi.org/10.1371/journal.pone.0307085.r001
Revision 1
17 Jun 2024 Author Response Dear Dr. Ghasemi, We are pleased to submit our revised paper. Below we provide detailed responses to each of the reviewer’s comments. Responses are indicated below. Thank you very much. Sincerely, Donald Chi I thank the editor for providing this opportunity to participate in the manuscript review As a reviewer, I find several strengths and areas for improvement in the study on fluoride-related beliefs and practices among pediatric and family medicine providers. Thank you very much. Strengths: Clear Objectives and Findings Presentation: The study clearly outlines its objectives and presents its findings in a structured manner, making it easy for readers to understand the research aims and outcomes. Thank you. Relevant and Timely Topic: With increasing concerns about fluoride hesitancy among caregivers, especially mirroring vaccine hesitancy, the study addresses a pertinent issue in pediatric and family medicine practice. We agree. Insightful Comparison between Specialties: The comparison between pediatric and family medicine providers provides valuable insights into potential differences in knowledge, beliefs, and practices regarding fluoride recommendations. Thank you. Identification of Barriers: The study effectively identifies common barriers to incorporating oral health activities into medical practice, particularly the lack of time, which is a practical concern for many healthcare providers. Thank you. Practical Implications: By highlighting the need to improve medical provider awareness about the benefits of fluoride and addressing fluoride hesitancy among caregivers, the study offers practical implications for enhancing preventive dental care in clinical settings. Thank you. Areas for Improvement: Sampling Limitations: The use of convenience sampling in two states and the predominantly white physician sample limit the generalizability of the findings. Future studies should strive for more diverse and representative samples to ensure broader applicability of the results, especially considering the disproportionate impact of tooth decay on minority children. We agree. These are noted as the two main limitations in the Discussion section. Quantitative Data Analysis: While the study provides valuable quantitative data on providers' beliefs and practices, it would benefit from more robust statistical analyses to strengthen the validity and reliability of the findings. This was a descriptive study to evaluate physicians’ views on fluoride hesitancy. Since it is the first such study, our goal was to describe their views and see if there are potential differences by medical provide type. The statistical methods employed were sufficient for these goals. We look forward to using more complex statistical methods in the future to answer more complex study hypotheses. Qualitative Insights: Incorporating qualitative methods, such as interviews or focus groups, could provide deeper insights into the reasons behind providers' beliefs, practices, and perceived barriers, enriching the understanding of fluoride-related attitudes in clinical practice. We agree. We hope to incorporate qualitative methods into future investigations. Recommendation Strategies: While the study mentions the need to explore strategies for addressing fluoride hesitancy, it could elaborate further on specific intervention approaches or educational programs that could be implemented in medical settings to improve fluoride-related practices. We do not currently have evidence-based strategies to address fluoride hesitancy in dental settings, which precludes our team from recommending strategies for use in medical settings. We do discuss the possibility of incorporating dental hygienists in medical practice settings, which has been shown to be effective in some clinics. Future work will hopefully continue to help clarify what these approaches are. Addressing these areas for improvement could enhance the rigor and comprehensiveness of the study, thereby strengthening its contribution to the literature on preventive dental care in pediatric and family medicine. Thank you again. Best Regards 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: Yes Reviewer #3: Yes ________________________________________ 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: Yes ________________________________________ 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 Reviewer #3: 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 Reviewer #3: 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: As a reviewer, I find several strengths and areas for improvement in the study on fluoride-related beliefs and practices among pediatric and family medicine providers. Strengths: Clear Objectives and Findings Presentation: The study clearly outlines its objectives and presents its findings in a structured manner, making it easy for readers to understand the research aims and outcomes. Thank you. Relevant and Timely Topic: With increasing concerns about fluoride hesitancy among caregivers, especially mirroring vaccine hesitancy, the study addresses a pertinent issue in pediatric and family medicine practice. We agree. Insightful Comparison between Specialties: The comparison between pediatric and family medicine providers provides valuable insights into potential differences in knowledge, beliefs, and practices regarding fluoride recommendations. Thank you. Identification of Barriers: The study effectively identifies common barriers to incorporating oral health activities into medical practice, particularly the lack of time, which is a practical concern for many healthcare providers. Agreed. Practical Implications: By highlighting the need to improve medical provider awareness about the benefits of fluoride and addressing fluoride hesitancy among caregivers, the study offers practical implications for enhancing preventive dental care in clinical settings. Thank you. Areas for Improvement: Sampling Limitations: The use of convenience sampling in two states and the predominantly white physician sample limit the generalizability of the findings. Future studies should strive for more diverse and representative samples to ensure broader applicability of the results, especially considering the disproportionate impact of tooth decay on minority children. We agree. These are noted as the two main limitations in the Discussion section. Quantitative Data Analysis: While the study provides valuable quantitative data on providers' beliefs and practices, it would benefit from more robust statistical analyses to strengthen the validity and reliability of the findings. This was a descriptive study to evaluate physicians’ views on fluoride hesitancy. Since it is the first such study, our goal was to describe their views and see if there are potential differences by medical provide type. The statistical methods employed were sufficient for these goals. We look forward to using more complex statistical methods in the future to answer more complex study hypotheses. Qualitative Insights: Incorporating qualitative methods, such as interviews or focus groups, could provide deeper insights into the reasons behind providers' beliefs, practices, and perceived barriers, enriching the understanding of fluoride-related attitudes in clinical practice. We agree. We hope to incorporate qualitative methods into future investigations. Recommendation Strategies: While the study mentions the need to explore strategies for addressing fluoride hesitancy, it could elaborate further on specific intervention approaches or educational programs that could be implemented in medical settings to improve fluoride-related practices. We do not currently have evidence-based strategies to address fluoride hesitancy in dental settings, which precludes our team from recommending strategies for use in medical settings. We do discuss the possibility of incorporating dental hygienists in medical practice settings, which has been shown to be effective in some clinics. Future work will hopefully continue to help clarify what these approaches are. Addressing these areas for improvement could enhance the rigor and comprehensiveness of the study, thereby strengthening its contribution to the literature on preventive dental care in pediatric and family medicine. Thank you again. Best Regards Reviewer #2: Dear Author Good time It was a pleasure to read the article. It is generally well written and of clinical and public value. However, there are few comments that will enrich the article and increases its academic value. Generally, it is of clinical value at the public level and tackles an important subject. It needs to be presented in a better easy way and use simpler language Title: It is too long and not easy to understand, make it simpler and to the point We shortened the title as suggested. Abstract: Generally well written and presented with no serious comments. Introduction: it is fine but too long and contains many sentences that need to be in the discussion. 1- lines 55-58 not easy to understand, needs rewriting The sentence length has been reduced. 2-lines 73-77 do not have references!!! are they your results?? The sentences without references have been removed. 3- lines 81-85 as above Ditto as above. Methodology: overall is acceptable but attention is to be paid for the below points ; 1-instead of the heading : study participants it is better to be: study design, setting and participants The section has been relabeled. 2- Need to make a flow chart for your methodology We believe the methodology is straightforward and therefore chose not to include a flow chart. 3-the grouping is not clear, make them consistent throughout the study, are they two groups or more ? There are 2 groups. This is clarified in the revised paper. 4- PLEASE USE SIMPLE CLEAR LANGUAGE THAT DELIVERS THE MEANING Results: Not easy to understand so PLEASE MAKE IT EASY 1- Lines 231-233 not clear These are findings directly presented in the table and are self-explanatory. Clarified that Medicaid means publicly-insured. 2- Table 1: regarding age I am not sure if the mean of the age has percentage !!! These are mean (SD) as indicated at the top of the Table. 3- Table 1: Why Hispanic is not part of the race and is a separate entity??? Hispanic ethnicity is a separate variable from race in the U.S. Discussion : acceptable with logical flow of the section but it seems to be slightly long Conclusion: reasonable and not extravagant Reviewer #3: Dear authors, Thanks for sharing your work with us, some points should be kept in consideration: 1.The manuscript within the scope of the journal. Thank you. 2.Both the quality and data presentation of this manuscript are good and of great importance to dentists, physicians and even patients. Thank you very much. 3.The manuscript expands our knowledge about fluoride-related beliefs and practices We agree. 4.The title should be revised and reduced its characters ( precise & and informative) The title has been shortened. 5.The abstract should reflect the content of the article and must be with range of 250-300 words. The abstract length was increased to 253 words. 6.more paragraphs should be incorporated to introduction and discussion about the justification of your findings and comparison with other recent relevant studies. All of the available studies have been cited in both sections, and comparisons are made whenever possible. 7.Up to date references should be kept in your reference list and the old should be omitted. The cited references are the ones that are most up to date and more importantly only relevant references are cited. Good Luck Thank you! ________________________________________ 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: Yes: Bassam Alsheekhly Reviewer #2: No Reviewer #3: Yes: Tahrir Aldelaimi https://doi.org/10.1371/journal.pone.0307085.r002
1 Jul 2024 Decision Letter - Hadi Ghasemi, Editor A cross-sectional study of physicians on fluoride-related beliefs and practices, and experiences with fluoride-hesitant caregivers PONE-D-24-16749R1 Dear Dr. Donald L. Chi, 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, Hadi Ghasemi 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 #2: All comments have been addressed Reviewer #3: All comments have been addressed ******** 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 #2: Yes Reviewer #3: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #2: Yes 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 #2: Yes Reviewer #3: 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 #2: Yes Reviewer #3: Yes ****** 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 #2: Dear Author You addressed my concern. The work is of significant scientific merit Wishing you the best in your academia and clinical work Reviewer #3: Dear authors Thanks for sharing your work with us, the authors have performing all the suggested comments and revisions. Good Luck ****** 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 #2: No Reviewer #3: Yes: Tahrir N Aldelaimi ******** https://doi.org/10.1371/journal.pone.0307085.r003
Formally Accepted
11 Jul 2024 Acceptance Letter - Hadi Ghasemi, Editor PONE-D-24-16749R1 PLOS ONE Dear Dr. Chi, I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now being handed over to our production team. At this stage, our production department will prepare your paper for publication. This includes ensuring the following: * All references, tables, and figures are properly cited * All relevant supporting information is included in the manuscript submission, * There are no issues that prevent the paper from being properly typeset If revisions are needed, the production department will contact you directly to resolve them. If no revisions are needed, you will receive an email when the publication date has been set. At this time, we do not offer pre-publication proofs to authors during production of the accepted work. Please keep in mind that we are working through a large volume of accepted articles, so please give us a few weeks to review your paper and let you know the next and final steps. Lastly, 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 customercare@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. Hadi Ghasemi Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0307085.r004

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