COVID-19’s psychological toll on oral health: A cross-sectional study in Iranian adults

Mahsa Karimi; Mohammad Reza Khami; Shabnam Varmazyari; Ahmad Reza Shamshiri; Mahmoud Hormozi; Nourhan M. Aly; Morẹ́nikẹ́ Oluwátóyìn Foláyan

doi:10.1371/journal.pone.0307429

Peer Review History

Original SubmissionMay 9, 2024
29 May 2024 Decision Letter - Hadi Ghasemi, Editor PONE-D-24-17375Psychological toll of the COVID-19 pandemic on oral health: insights from a sample of Iranian adultsPLOS ONE Dear Dr. Shabnam Varmazyari, 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 13 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, Hadi Ghasemi 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. Thank you for stating in your Funding Statement: "This research was supported by Tehran University of Medical Sciences (TUMS), grant number: 1400-2-133-54316." Please provide an amended statement that declares all the funding or sources of support (whether external or internal to your organization) received during this study, as detailed online in our guide for authors at http://journals.plos.org/plosone/s/submit-now. Please also include the statement “There was no additional external funding received for this study.” in your updated Funding Statement. Please include your amended Funding Statement within your cover letter. We will change the online submission form on your behalf. 3. We note that you have indicated that there are restrictions to data sharing for this study. PLOS only allows data to be available upon request if there are legal or ethical restrictions on sharing data publicly. For more information on unacceptable data access restrictions, please see http://journals.plos.org/plosone/s/data-availability#loc-unacceptable-data-access-restrictions. Before we proceed with your manuscript, please address the following prompts: a) If there are ethical or legal restrictions on sharing a de-identified data set, please explain them in detail (e.g., data contain potentially identifying or sensitive patient information, data are owned by a third-party organization, etc.) and who has imposed them (e.g., a Research Ethics Committee or Institutional Review Board, etc.). Please also provide contact information for a data access committee, ethics committee, or other institutional body to which data requests may be sent. b) If there are no restrictions, please upload the minimal anonymized data set necessary to replicate your study findings to a stable, public repository and provide us with the relevant URLs, DOIs, or accession numbers. For a list of recommended repositories, please see https://journals.plos.org/plosone/s/recommended-repositories. You also have the option of uploading the data as Supporting Information files, but we would recommend depositing data directly to a data repository if possible. We will update your Data Availability statement on your behalf to reflect the information you provide. 4. 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. 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 Reviewer #4: Partly ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: Yes Reviewer #4: 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: Yes Reviewer #2: Yes Reviewer #3: Yes Reviewer #4: 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 Reviewer #4: 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: Dear authors, Thanks for sharing your work with us, the following 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 acceptable and of great importance to clinicians and even patients. 3. The manuscript expands our knowledge about COVID-19 and oral health . 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. Four to six keywords representing the main content of the article BUT not mentioned in the title. 7. More paragraphs should be incorporated to introduction about the details of COVID including complications. i.e. suggested references: • Aldelaimi TN, Khalil AA, Alhamdani F. Herpes Zoster Post-COVID-19 Vaccine. Arab Board Medical Journal 2022;23:52-1. • Aldelaimi A A, Aldelaimi T.N.. Mucormycosis in a Diabetic Patient Post COVID-19. Journal of Clinical and Diagnostic Research. 2022 Mar, Vol-16(3): ZJ03, Journal of Clinical and Diagnostic Research. 2022 Mar, Vol-16(3): ZJ03 33. DOI: 10.7860/JCDR/2022/53108.16090 8. The statements in discussion are acceptable but few paragraphs about the justification of your findings and comparison with other recent relevant studies. 9. Up to date references should be kept in your reference list and the old should be omitted. i.e. Suggested reference: Reviewer #2: Comments to the Author/s: - I would like to begin by expressing my appreciation for the effort and dedication that the authors have put into this manuscript. My comments and suggestions to improve clarity and overall quality of the work are as follows. Abstract 1. I prefer to remove the terms (independent variables) and (outcome variables). 2. I prefer not to use abbreviations in the abstract section, such as (MEHEWE). 3. Please type the mean and standard deviation as mean ± SD. 4. Keywords should not exceed five words. Introduction 1. The reference in line 57 needs to be corrected. 2. Please clarify the following statement in line 66: "They might also initiate hormonal responses that weaken the immune system and thus, lead to the development of oral ulcers. Materials 1. The date of approval needs to be written. 2. The required sample size is preferred to be written. 3. Authors sometimes use the term (sex) and at other times use the term (gender). Please use one of them consistently. Discussion 1. The references in line 203 need to be corrected. Reviewer #3: I respect the limitations of your research, but the importance of this topic, the size of your country, the population, and the different methods used to share it on social media platforms cannot be reflected in your small sample size. Therefore, this cannot be considered a representative Iranian sample. Secondly, you use the term "mouth ulcer" in your outcome variables, which is considered jargon. It would be more appropriate to use "mouth lesion" instead. Thirdly, you did not compare the negative and positive coronavirus subjects for outcome variables. Finally, in the discussion on line 176, you stated that “being male and having changed sleeping patterns increased the chance of reduced tooth brushing frequency.” This is not accurate because the number of males in this study is much smaller than the number of females, so it does not accurately reflect the data. Reviewer #4: 1-The survey has insufficient number of participants. 2-The discussion of this manuscript is insufficient. 3-The number of questions in the survey could have been more. Thus, it would have been a more comprehensive research. 4-There are no concerns about research ethics or publication ethics. ****** 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: Tahrir Aldelaimi Reviewer #2: No Reviewer #3: No Reviewer #4: 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. https://doi.org/10.1371/journal.pone.0307429.r001
Revision 1
25 Jun 2024 Author Response Journal: PLOS ONE Manuscript no: PONE-D-24-17375 Revised manuscript title: COVID-19's psychological toll on oral health: a cross-sectional study in Iranian adults Date of revision: June 2024 The team of authors would like to thank the reviewers for their painstaking efforts, we found your comments extremely useful. Provided below is a point-by-point response to the reviewers’ comments. In addition, we conducted an extensive grammar check. All revisions were carried out with “track changes on”. In response to the journal’s comments: 1. The manuscript was evaluated to ensure compliance with PLOS ONE style requirements, especially with regards to file names. 2. Amended funding statement was included in the cover letter. 3. The minimum anonymized dataset was attached as a supporting information file. 4. References were thoroughly checked, and no retracted articles are included to the best of our knowledge. Reviewer #1: Thanks for sharing your work with us, the following points should be kept in consideration: The manuscript within the scope of the journal. Both the quality and data presentation of this manuscript are acceptable and of great importance to clinicians and even patients. The manuscript expands our knowledge about COVID-19 and oral health. RESPONSE: We thank the reviewer for this positive constructive feedback. 4. The title should be revised and reduced its characters (precise & and informative) RESPONSE: Title was revised to be more concise, precise, and informative in line with the requirement of the STROBE guidelines. It now reads as: “COVID-19's psychological toll on oral health: a cross-sectional study in Iranian adults” 5. The abstract should reflect the content of the article and must be with range of 250-300 words. RESPONSE: All sections of the abstract especially the conclusion, were revised to ensure accurate reflection of the article. It is within the <300 word-limit range. 6. Four to six keywords representing the main content of the article BUT not mentioned in the title. RESPONSE: The keywords were limited to five representative ones that did not overlap with the title terms. 7. More paragraphs should be incorporated to introduction about the details of COVID including complications. i.e. suggested references: • Aldelaimi TN, Khalil AA, Alhamdani F. Herpes Zoster Post-COVID-19 Vaccine. Arab Board Medical Journal 2022;23:52-1. • Aldelaimi A A, Aldelaimi T.N.. Mucormycosis in a Diabetic Patient Post COVID-19. Journal of Clinical and Diagnostic Research. 2022 Mar, Vol-16(3): ZJ03, Journal of Clinical and Diagnostic Research. 2022 Mar, Vol-16(3): ZJ03 33. DOI: 10.7860/JCDR/2022/53108.16090 RES RESPONSE: Additional paragraphs were incorporated into the introduction to elaborate on the effects of COVID-19 on oral health, particularly in terms of impacting oral hygiene behaviors and oral mucosa. The underlying mechanisms behind these impacts were also discussed in greater detail. While one of the suggested references was included, we regret that the other reference could not be included as it did not directly address COVID-19-related oral ulcers. Specific changes related to this comment can be found in lines 62-69 and 78-83. To maintain coherence and flow, the entire Introduction section underwent revisions for grammar and clarity. Furthermore, the paragraph outlining the research gap (lines 75-91) was expanded to align with the aforementioned expansions in the Introduction and provide a more thorough explanation of the identified gap. 8. The statements in discussion are acceptable but few paragraphs about the justification of your findings and comparison with other recent relevant studies. RESPONSE: We tried to improve the robustness of the discussion by elaborating the explanations, comparisons, and justifications for each of the 4 main findings and also utilized more recent relevant studies. Since these changes resulted in notable expansion of Discussion, the practical implications of findings were summarized slightly and combined. You’ll find these changes in each paragraph of Discussion. As a result of changes to Discussion, slight changes also had to be made to Conclusion section and Abstract conclusion subsection. 9. Up to date references should be kept in your reference list and the old should be omitted. i.e. Suggested reference: RESPONSE: Newer references, particularly those published during and in the context of the pandemic, have been strongly prioritized. An effort was made to limit references to studies from after 2016 as much as possible and studies prior to this date were only included when absolutely necessary, for instance in the sample size determination subsection. Reviewer #2: I would like to begin by expressing my appreciation for the effort and dedication that the authors have put into this manuscript. My comments and suggestions to improve clarity and overall quality of the work are as follows. RESPONSE: We thank the reviewer for their constructive feedback. Abstract: I prefer to remove the terms (independent variables) and (outcome variables). I prefer not to use abbreviations in the abstract section, such as (MEHEWE). Please type the mean and standard deviation as mean ± SD. Keywords should not exceed five words. RESPONSE: Outcome and independent variable terms were omitted from the abstract. The abbreviations MEHEWE and COVID were also omitted and replaced. The mean and standard deviation were referred to as mean ± SD. Five keywords were retained. Introduction: The reference in line 57 needs to be corrected. RESPONSE: Thanks for identifying this error. That reference is now corrected. Please clarify the following statement in line 66: "They might also initiate hormonal responses that weaken the immune system and thus, lead to the development of oral ulcers. RESPONSE: The sentence has been re-written in the process of the revisions outlined in response to reviewer 1. It now reads as: Additionally, their subsequent oral ulcers arise from changes in immune cell numbers and functions, as well as elevated oxidative stress and inflammatory markers in both saliva and serum. Methods: 1. The date of approval needs to be written. RESPONSE: Ethics approval date was included: on August 29th, 2021 ,… 2. The required sample size is preferred to be written. RESPONSE: Thanks for raising this point. We included in the methods section: Using the sample-to-item ratio guide of 5-to-1 [33-35] the minimum pre-survey sample size required for this study was determined to be 135 valid responses for its 27 independent study variables. This sample size would allow for conducting regression tests with up to eight predictors, maintaining a minimum probability level (p-value) of 0.05. 3. Authors sometimes use the term (sex) and at other times use the term (gender). Please use one of them consistently. RESPONSE: Thanks for raising this point. The term “gender” has now been used consistently throughout the paper. Discussion: The references in line 203 need to be corrected. RESPONSE: These references are now replaced due to the substantial revisions made to the discussion section per the requests of reviewers 1 and 4. Reviewer #3: I respect the limitations of your research, but the importance of this topic, the size of your country, the population, and the different methods used to share it on social media platforms cannot be reflected in your small sample size. Therefore, this cannot be considered a representative Iranian sample RESPONSE: We are grateful for your understanding. To address this comment, we included details about sample size determination in the Methods section and revised the Limitations’ subsection in Discussion comprehensively to outline the reasons for this shortcoming, explain the efforts made to mitigate it, and highlight the fact that present findings, although valuable, are not generalizable to the Iranian population. Secondly, you use the term "mouth ulcer" in your outcome variables, which is considered jargon. It would be more appropriate to use "mouth lesion" instead RESPONSE: We thank the reviewer for suggesting. We opted for the term “oral ulcer” because it was used more conventionally in global studies such as the one conducted by Folayan MO, et al. (Hygiene. 2023; 3(2):85-92. https://doi.org/10.3390/hygiene3020009) and Folayan MO, et al. (Int J Environ Res Public Health. 2022 Sep 14;19(18):11550. doi: 10.3390/ijerph191811550). Thus, we hope the reviewer will agree with us that this is suitable terminology. Thirdly, you did not compare the negative and positive coronavirus subjects for outcome variables. RESPONSE: The independent variable “positive COVID-19 test results” was included in descriptive analyses and simple logistic regression models, with their results demonstrated in Table 1,2, and 3. The variable was then included in the multiple logistic regression for oral ulcers since its simple logistics regression test produced a p-value of less than 0.2 (p-value=0.06) and excluded from multiple logistic regression for reduced tooth-brushing frequency since its simple logistic regression result did not meet the threshold for inclusion (p-value=0.23). After multiple logistic regression analysis, no significant association was spotted between the reports of oral ulcers and coronavirus test results and thus, this variable was not reported in Table 4 which includes only the variables that ended up being significantly associated with either reduced tooth brushing or oral ulcer reports following multiple logistic regression. The methods (statistical analysis) and Results (Table footnotes) sections were revised to accurately reflect these undertaken steps. Finally, in the discussion on line 176, you stated that “being male and having changed sleeping patterns increased the chance of reduced tooth brushing frequency.” This is not accurate because the number of males in this study is much smaller than the number of females, so it does not accurately reflect the data. RESPONSE: Thank you for raising this point. Unequal sample sizes do not negate finding when simple and multiple logistic regression are used, as these tests automatically adjust for these imbalances through estimating the relationship between variables instead of counting and comparing raw sample counts. These tests then display these adjustments in their calculated p-values and confidence intervals. Reviewer #4: 1-The survey has insufficient number of participants. RESPONSE: Thanks for this observation. We incorporated sample size estimation details into the Methods section and thoroughly addressed this shortcoming in the Discussion section's Limitations subsection by outlining its reasons, explaining the utilized mitigation strategies, and emphasizing the resulting negative implications for study representativeness and generalizability. 2-The discussion of this manuscript is insufficient. RESPONSE: We tried to improve the robustness of the discussion by elaborating the explanations, comparisons, and justifications for each of the 4 main findings and also utilized more recent relevant studies. Since these changes resulted in notable expansion of Discussion, the practical implications of findings were summarized slightly and combined. You’ll find these changes in each paragraph of Discussion. As a result of changes to Discussion, slight changes also had to be made to Conclusions section and Abstract conclusion subsection. 3-The number of questions in the survey could have been more. Thus, it would have been more comprehensive research. RESPONSE: Your comment is valuable. We used a validated instrument for this survey that included the variables needed to address the study objectives originally inspired by the global MEHEWE study. However, the current findings can serve as hypotheses to conceptualize new studies by adding to the items of the questionnaire. 4-There are no concerns about research ethics or publication ethics RESPONSE: Thanks for your valuable feedback. Attachments Attachment Submitted filename: Response to Reviewers-2.docx https://doi.org/10.1371/journal.pone.0307429.r002
5 Jul 2024 Decision Letter - Hadi Ghasemi, Editor COVID-19's psychological toll on oral health: a cross-sectional study in Iranian adults PONE-D-24-17375R1 Dear Dr. Shabnam Varmazyari, 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 #1: All comments have been addressed 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 #1: Yes Reviewer #2: Yes Reviewer #3: Partly ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes 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 #1: Yes 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 #1: Yes 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 #1: Thinks for sharing your work with us and thanks taking in consideration the suggested changes and comments Reviewer #2: (No Response) Reviewer #3: I want to thank the authors for their scholarly response and meticulous editing, which are sufficient to accept the manuscript for publication. ****** 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: Yes: Tahrir N. Aldelaimi Reviewer #2: Yes: Muhanad L. Alshami Reviewer #3: No ******** https://doi.org/10.1371/journal.pone.0307429.r003
Formally Accepted
10 Jul 2024 Acceptance Letter - Hadi Ghasemi, Editor PONE-D-24-17375R1 PLOS ONE Dear Dr. Varmazyari, 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.0307429.r004

Open letter on the publication of peer review reports

PLOS recognizes the benefits of transparency in the peer review process. Therefore, we enable the publication of all of the content of peer review and author responses alongside final, published articles. Reviewers remain anonymous, unless they choose to reveal their names.

We encourage other journals to join us in this initiative. We hope that our action inspires the community, including researchers, research funders, and research institutions, to recognize the benefits of published peer review reports for all parts of the research system.

Learn more at ASAPbio .