Robot-assisted gait training in patients with various neurological diseases: A mixed methods feasibility study

Isabella Hotz; Sarah Mildner; Michaela Stampfer-Kountchev; Bianca Slamik; Christoph Blättner; Elisabeth Türtscher; Franziska Kübler; Clemens Höfer; Johanna Panzl; Michael Rücker; Christian Brenneis; Barbara Seebacher

doi:10.1371/journal.pone.0307434

Peer Review History

Original SubmissionOctober 11, 2023
20 Oct 2023 Decision Letter - Dimitrios Sokratis Komaris, Editor PONE-D-23-31858 Robot-assisted gait training in patients with various neurological diseases: a mixed methods feasibility study PLOS ONE Dear Dr. Seebacher, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we have decided that your manuscript does not meet our criteria for publication and must therefore be rejected. I am sorry that we cannot be more positive on this occasion, but hope that you appreciate the reasons for this decision. Kind regards, Dimitrios Sokratis Komaris, Ph.D Academic Editor PLOS ONE Additional Editor Comments: Specifically: I checked the provided protocol, and “5 patients with severe stroke in the subacute phase will be included in this study, … and 2 patients with motoneuron disease” should have been included in this study. Please clearly mention in the manuscript if this was indeed the case in the conducted study (ie, to avoide selective reporting). Additionally, the study sample size is not properly justified, nor is the study a controlled trial as per the CONSORT requirements with appropriate randomisation procedures. Therefore, I cannot consider this submission as a clinical trial. [Note: HTML markup is below. Please do not edit.] [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.] - - - - - For journal use only: PONEDEC3 https://doi.org/10.1371/journal.pone.0307434.r001
Revision 1
8 Jan 2024 Author Response PONE-D-23-31858 Robot-assisted gait training in patients with various neurological diseases: a mixed methods feasibility study Dear Editor, We extend our gratitude for your reconsideration of our manuscript. The dedication to the editorial process thus far is genuinely appreciated. In response to the concerns raised by the Academic Editor, as outlined in your recent communication, we have prepared a comprehensive rebuttal letter, providing a point-by-point response. Unfortunately, as our manuscript has not undergone external peer review, we are currently unable to furnish specific details regarding revisions made since the initial submission. There we cannot provide a manuscript with tracked changes. Since it is a requirement of your editorial manager system to upload a manuscript with tracked changes, we have uploaded the original manuscript twice. Point-by-point response to the Academic Editor's comments Point 1: I checked the provided protocol, and “5 patients with severe stroke in the subacute phase will be included in this study, … and 2 patients with motoneuron disease” should have been included in this study. Please clearly mention in the manuscript if this was indeed the case in the conducted study (ie, to avoid selective reporting). Response: We can confirm that our study included these groups, as indicated in Table 1. Patients in the subacute phase after a stroke had a median (minimum - maximum) Functional Ambulation Categories score of 0 (0-2), with a score of 1 representing a nonfunctional ambulator, and scores of 1-2 indicating an ambulator who is dependent on physical assistance. Patients with motor neuron disease exhibited mild walking impairment. Points 2 and 3: Additionally, the study sample size is not properly justified (Point 2), nor is the study a controlled trial as per the CONSORT requirements with appropriate randomisation procedures. Therefore, I cannot consider this submission as a clinical trial. (Point 3) Response to Point 2: Our study was, in fact, a mixed methods feasibility study. In the materials and methods section, we provided the following rationale for our sample size: “Based on the study design and primary outcome, no formal sample size calculation was carried out. Instead, the decision regarding the number of patients included in the study was influenced by the varying prevalence rates of the investigated diseases, resulting in a total sample size of 28. Considering the study design, methods, and objectives, no additional patients were included to account for an anticipated attrition rate of 10%.” We reviewed other mixed methods feasibility studies published in PLOS ONE, and none of these studies provided a formal sample size calculation or mentioned sample size considerations. Generally, small sample size was acknowledged as a limitation. Our approach to sample size determination aligns with methodological guidance and recommendations [1] that advise considering the full range of possible quantitative and qualitative methods based on what needs to be learned and the study's available resources: “Identify the quantitative and qualitative data sources most appropriate for addressing the study’s questions about feasibility and determining whether benchmarks are met. Consider the full range of possible quantitative and qualitative methods and make decisions based on what needs to be learned and the study resources. Keep in mind that even a small sample or data in the form of observation field notes can provide useful information about feasibility.” Response to Point 3: As for the definition of a clinical trial, we consulted the submission guidelines of PLOS ONE and the relevant links provided for authors. According to the World Health Organization's definition, a clinical trial is any research study that prospectively assigns human participants to health-related interventions to evaluate their effects on health outcomes. Our study, therefore, falls under the definition of a clinical trial. We are more than willing to engage in revisions to further enhance the quality and rigour of our manuscript. We are committed to ensuring that the final version meets the high standards of PLOS ONE. Please find the original cover letter below for your reference. Kind regards, Barbara Seebacher https://doi.org/10.1371/journal.pone.0307434.r002
18 Mar 2024 Decision Letter - Alessandro de Sire, Editor PONE-D-23-31858R1Robot-assisted gait training in patients with various neurological diseases: a mixed methods feasibility studyPLOS ONE Dear Dr. Seebacher, 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. ============================== ACADEMIC EDITOR: Please insert comments here and delete this placeholder text when finished. Be sure to: Indicate which changes you require for acceptance versus which changes you recommend Address any conflicts between the reviews so that it's clear which advice the authors should follow Provide specific feedback from your evaluation of the manuscript Please ensure that your decision is justified on PLOS ONE’s publication criteria and not, for example, on novelty or perceived impact. For Lab, Study and Registered Report Protocols: These article types are not expected to include results but may include pilot data. ============================== Please submit your revised manuscript by May 02 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, Alessandro de Sire, M.D. Academic Editor PLOS ONE Journal 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 the following financial disclosure: "Funder: Tyromotion GmbH, Graz, Austria A LEXO Gait Trainer was provided for the Clinic for Rehabilitation Münster to be able to conduct the study. No financial or other donations were given to any personnel involved in the study." Please state what role the funders took in the study. If the funders had no role, please state: ""The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript."" If this statement is not correct you must amend it as needed. Please include this amended Role of Funder statement in your cover letter; we will change the online submission form on your behalf. 3. In the online submission form, you indicated that The datasets used and/or analysed during the current study are available from the corresponding authors on reasonable request. All data generated or analysed during this study are included in this published article.. All PLOS journals now require all data underlying the findings described in their manuscript to be freely available to other researchers, either 1. In a public repository, 2. Within the manuscript itself, or 3. Uploaded as supplementary information. This policy applies to all data except where public deposition would breach compliance with the protocol approved by your research ethics board. If your data cannot be made publicly available for ethical or legal reasons (e.g., public availability would compromise patient privacy), please explain your reasons on resubmission and your exemption request will be escalated for approval. 4. We note that the original protocol that you have uploaded as a Supporting Information file contains an institutional logo. As this logo is likely copyrighted, we ask that you please remove it from this file and upload an updated version upon resubmission. 5. We note that Figure S1 in your submission contain copyrighted images. All PLOS content is published under the Creative Commons Attribution License (CC BY 4.0), which means that the manuscript, images, and Supporting Information files will be freely available online, and any third party is permitted to access, download, copy, distribute, and use these materials in any way, even commercially, with proper attribution. For more information, see our copyright guidelines: http://journals.plos.org/plosone/s/licenses-and-copyright. We require you to either (1) present written permission from the copyright holder to publish these figures specifically under the CC BY 4.0 license, or (2) remove the figures from your submission: a. You may seek permission from the original copyright holder of Figure S1 to publish the content specifically under the CC BY 4.0 license. We recommend that you contact the original copyright holder with the Content Permission Form (http://journals.plos.org/plosone/s/file?id=7c09/content-permission-form.pdf) and the following text: “I request permission for the open-access journal PLOS ONE to publish XXX under the Creative Commons Attribution License (CCAL) CC BY 4.0 (http://creativecommons.org/licenses/by/4.0/). Please be aware that this license allows unrestricted use and distribution, even commercially, by third parties. Please reply and provide explicit written permission to publish XXX under a CC BY license and complete the attached form.” Please upload the completed Content Permission Form or other proof of granted permissions as an ""Other"" file with your submission. In the figure caption of the copyrighted figure, please include the following text: “Reprinted from [ref] under a CC BY license, with permission from [name of publisher], original copyright [original copyright year].” b. If you are unable to obtain permission from the original copyright holder to publish these figures under the CC BY 4.0 license or if the copyright holder’s requirements are incompatible with the CC BY 4.0 license, please either i) remove the figure or ii) supply a replacement figure that complies with the CC BY 4.0 license. Please check copyright information on all replacement figures and update the figure caption with source information. If applicable, please specify in the figure caption text when a figure is similar but not identical to the original image and is therefore for illustrative purposes only. 6. We note that Figure S1 includes an image of a participant in the sudy. As per the PLOS ONE policy (http://journals.plos.org/plosone/s/submission-guidelines#loc-human-subjects-research) on papers that include identifying, or potentially identifying, information, the individual(s) or parent(s)/guardian(s) must be informed of the terms of the PLOS open-access (CC-BY) license and provide specific permission for publication of these details under the terms of this license. Please download the Consent Form for Publication in a PLOS Journal (http://journals.plos.org/plosone/s/file?id=8ce6/plos-consent-form-english.pdf). The signed consent form should not be submitted with the manuscript, but should be securely filed in the individual's case notes. Please amend the methods section and ethics statement of the manuscript to explicitly state that the patient/participant has provided consent for publication: “The individual in this manuscript has given written informed consent (as outlined in PLOS consent form) to publish these case details”. If you are unable to obtain consent from the subject of the photograph, you will need to remove the figure and any other textual identifying information or case descriptions for this individual. 7. When completing the data availability statement of the submission form, you indicated that you will make your data available on acceptance. We strongly recommend all authors decide on a data sharing plan before acceptance, as the process can be lengthy and hold up publication timelines. Please note that, though access restrictions are acceptable now, your entire data will need to be made freely accessible if your manuscript is accepted for publication. This policy applies to all data except where public deposition would breach compliance with the protocol approved by your research ethics board. If you are unable to adhere to our open data policy, please kindly revise your statement to explain your reasoning and we will seek the editor's input on an exemption. Please be assured that, once you have provided your new statement, the assessment of your exemption will not hold up the peer review process. Additional Editor Comments (if provided): The paper could be accepted after major revisions. [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) ******** 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: (No Response) ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: (No Response) ****** 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 Response) ****** 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: Dear Authors, Thank you for answering to the previous reviwer’s comments. I think you analized a cutting-edge topic, in my opinion the paper is well written. Reviewer #2: The authors intended to explore the feasibility, acceptability, goal attainment, and preliminary effects of RAGT in patients with common and rare neurological diseases. They recruited 28 inpatients after stroke who will receive the planned intervention. Among 26 patients, RAGT was considered highly feasible. The manuscript was well prepared for the proof of the concept purpose. Only minor comments were listed below. 1. The authors argued no sample size calculation is needed due to the feasibility analysis, which is fine. But also argued “to account for an anticipated attrition rate of 10%”, which somewhat has sample size in mind. Please clarify. 2. Line 253. Effect sizes were calculated as correlation coefficients. Please clarify which two variables’ correlation do you refer to and how to interpret in this content. 3. In the abstract, authors specifically pointed out the count for different diseases but nothing related was discussed later. What will be the main point to talk about in the abstract? 4. As the sample size is extremely small, whether the significant results are replicable is uncertain. So the tone of the results or conclusion should be softened and focus on the feasibility of the study. ****** 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. https://doi.org/10.1371/journal.pone.0307434.r003
Revision 2
7 Apr 2024 Author Response PONE-D-23-31858R1 Robot-assisted gait training in patients with various neurological diseases: a mixed methods feasibility study PLOS ONE Dear Academic Editor, Dear Dr. de Sire, Dear Reviewers, We thank the Editor and Reviewers for their valuable comments and feedback and for giving us a chance to submit a revised manuscript. Please find below our point-by-point responses. The main manuscript and figure S1 caption have been amended accordingly, with any changes highlighted to allow the Editor and Reviewers to check the adaptations made. We thank the Editor and Reviewers for their time and effort and hope we have sufficiently responded to the Editor’s and Reviewers’ requests. With kind regards, Barbara Seebacher, on behalf of all the authors Comments to the Author Reviewer #1: Dear Authors, Thank you for answering to the previous reviewer’s comments. I think you analized a cutting-edge topic, in my opinion the paper is well written. Dear Reviewer #1, Thank you very much for reviewing our manuscript and acknowledging its value. Reviewer #2: The authors intended to explore the feasibility, acceptability, goal attainment, and preliminary effects of RAGT in patients with common and rare neurological diseases. They recruited 28 inpatients after stroke who will receive the planned intervention. Among 26 patients, RAGT was considered highly feasible. The manuscript was well prepared for the proof of the concept purpose. Only minor comments were listed below. Dear Reviewer #2, Thank you for reviewing our manuscript, acknowledging its value, and for offering your suggestions to enhance the quality of our manuscript. Please find our point-by-point response as follows. 1. The authors argued no sample size calculation is needed due to the feasibility analysis, which is fine. But also argued “to account for an anticipated attrition rate of 10%”, which somewhat has sample size in mind. Please clarify. Response: We appreciate your attention to detail in identifying this inconsistency. Previously, we mentioned that 'Given the study design, methods, and objectives, no extra patients were incorporated to accommodate an expected attrition rate of 10%.' Recognising the lack of value in this statement, we have since deleted it. 2. Line 253. Effect sizes were calculated as correlation coefficients. Please clarify which two variables’ correlation do you refer to and how to interpret in this content. Response: Thank you for your valuable feedback. As mentioned, the rank-biserial correlation coefficient (r) is a commonly used effect size measure in the context of the Wilcoxon signed-rank test. This coefficient provides estimates regarding the strength and direction of association between paired samples. To clarify, the paired samples we are referring to in this study are the baseline and post-intervention measures of the respective functional outcomes. In response to your suggestion, we have included the following revised statement in the manuscript: ‘Effect sizes were calculated using the rank-biserial correlation coefficient (r) obtained from the Wilcoxon signed-rank test. This coefficient offers insights into the strength and direction of association between paired samples, specifically the baseline and post-intervention measures.’ 3. In the abstract, authors specifically pointed out the count for different diseases but nothing related was discussed later. What will be the main point to talk about in the abstract? Response: Thank you for bringing this to our attention. Taking your feedback into consideration, we have removed the count for the different diseases from the abstract. 4. As the sample size is extremely small, whether the significant results are replicable is uncertain. So the tone of the results or conclusion should be softened and focus on the feasibility of the study. Response: We sincerely value this feedback. Taking into account your suggestion, we have revised our conclusions, which now read as follows: ‘To our knowledge, there is a gap in the literature regarding the exploration of quantitative RAGT effects alongside patient acceptance and satisfaction using qualitative methods across various neurological conditions. Our study aims to fill this gap by offering valuable insights into understanding patients' needs and identifying necessary adjustments to ensure that RAGT is both enjoyable and maximally effective for patients. The outcomes of our study imply the feasibility of utilising the LEXO® gait trainer for RAGT among patients with various neurological conditions. This is evidenced by robust recruitment, retention, and adherence rates. Furthermore, the findings underscore the safety of this approach, as indicated by the occurrence of anticipated mild and transient adverse events, alongside its initial effectiveness in enhancing RAGT outcomes among patients with diverse neurological conditions. Moreover, the majority of patients experienced the training positively and expressed satisfaction with their performance and outcomes. While our findings are promising, it is essential to conduct subsequent adequately powered RCTs to validate our results regarding the safety and efficacy of end-effector-based RAGT in patients with MND and SCA. Additionally, further mixed-methods studies are warranted to provide more nuanced insights into patients' perceptions of RAGT with end-effector devices and the influence of the therapeutic relationship on RAGT outcomes.’ Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0307434.r004
5 Jul 2024 Decision Letter - Domiziano Tarantino, Editor Robot-assisted gait training in patients with various neurological diseases: a mixed methods feasibility study PONE-D-23-31858R2 Dear Dr. Seebacher, 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, Domiziano Tarantino, MD Academic Editor PLOS ONE Additional Editor Comments (optional): Dear Authors, I am pleased to announce you that the final version of the manuscript has been accepted for publication. Best regards 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 ******** 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: (No Response) ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #2: (No Response) ****** 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: (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 #2: (No Response) ****** 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: All the raised comments have been successfully addressed. This reviewer has no further comments on this manuscript. ****** 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 ******** https://doi.org/10.1371/journal.pone.0307434.r005
Formally Accepted
15 Jul 2024 Acceptance Letter - Domiziano Tarantino, Editor PONE-D-23-31858R2 PLOS ONE Dear Dr. Seebacher, 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. Domiziano Tarantino Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0307434.r006

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 .