Knowledge, attitude, and practice towards enhanced recovery after surgery among patients underwent thoracoscopy surgery

Yinping Huang; Xingbang Wang; Jiajia Li; Qing He; Rui Wang

doi:10.1371/journal.pone.0309821

Peer Review History

Original SubmissionDecember 18, 2023
13 Mar 2024 Decision Letter - Francesco Guerrera, Editor PONE-D-23-41704Knowledge, Attitude, and Practice towards Enhanced Recovery after Surgery among Patients Underwent Thoracoscopy SurgeryPLOS ONE Dear Dr. Huang, 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 Apr 27 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. 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Please include captions for your Supporting Information files at the end of your manuscript, and update any in-text citations to match accordingly. Please see our Supporting Information guidelines for more information: http://journals.plos.org/plosone/s/supporting-information. Additional Editor Comments: Dear Authors, I read your manuscript with great interest, Nevertheless, some improvement must be accomplished, and several points must be addressed in order to consider it for publication. In particular, as the reviewers pointed out, the indication of surgical procedures and the practical implication of your results should be elucidated. Good luck with your paper, and thank you for submitting it. [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: Partly Reviewer #2: Partly ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: 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 ****** 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 ****** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: The authors reported an interesting paper on the knowledge of patients regarding ERAS. The manuscript is of potential interest, but I have some comments: - Did the authors analyze the impact of knowledge on early postoperative outcomes - Did the authors analyze the influence of a previous surgerical procedure (even of not thoracic) on the knowledge of patients? - When the questionnaire was administered? - Based on the results, did you change your clinical practice? Reviewer #2: Congratulations to the authors for their contribution in the topic of ERAS. I appreciated the patient centered analysis. The methodology is clear, and the questionnaire employed is appropriate. The paper has a transverse interest, all the medical workers (surgeons, nurses and physiotherapist) are involved in ERAS strategy. Like in surgery, an deep understanding of the theoretics basis could translate in a perfect practice. although I suggest few improvements before to publish the paper. I hope that this review will make a good contribution to your work. Major Revisions - Provide the aim of thoracoscopy in the clinical parameters. VATS for pleural biopsy benign/malign, empyema, pneumothorax, lung resections? The type of surgery can influence in the clinical outcome. - Other clinical parameters important for the analysis are: smoking status and nutritional status (obese/cachexia). - Did KAP affected the duration of pleural drainage? Minor Revisions - The length of hospital stay is long. Can you explain that? - Line 193. Medical “professor”. Do you mind professionist? - Discussion. Did you suggest any strategies to improve KAP? - Discussion. The results shown moderate knowledge parameter. Any suggestions to improve it? ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No Reviewer #2: Yes: Giovanni Bocchialini ******** [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/. 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Revision 1
17 Apr 2024 Author Response Title: Knowledge, Attitude, and Practice towards Enhanced Recovery after Surgery among Patients Underwent Thoracoscopy Surgery Journal: PLoS One Response to Reviewers' comments Dear Editor, We thank you for your careful consideration of our manuscript. We appreciate your response and overall positive initial feedback and made modifications to improve the manuscript. After carefully reviewing the comments made by the Reviewers, we have reorganized the literature data, modified the manuscript to improve the presentation of our results and their discussion, therefore providing a complete context for the research that may be of interest to your readers. We hope that you will find the revised paper suitable for publication, and we look forward to contributing to your journal. Please do not hesitate to contact us with other questions or concerns regarding the manuscript. Best regards, Additional Editor Comments: Dear Authors, I read your manuscript with great interest, Nevertheless, some improvement must be accomplished, and several points must be addressed in order to consider it for publication. In particular, as the reviewers pointed out, the indication of surgical procedures and the practical implication of your results should be elucidated. Response: Thanks for the valuable comments. We added information and analysis about surgical types, and added limitations about lack of collection for outcomes and variables such as previous surgical procedure, nutritional status and duration of pleural drainage. Thirdly, the limited items of early postoperative outcomes (postoperative complications, postoperative bed rest time and duration of hospital stay) were collected, which cannot comprehensively grasp the relationships between KAP and early postoperative outcomes. Therefore, the observed findings should be taken with caution. Fourthly, several variables, such as previous surgical procedure, nutritional status and duration of pleural drainage, were not included in the questionnaire. The missing information can impede the investigation into the determinants of clinical outcomes, highlighting the need for future studies involving a larger cohort of phenotyped individuals. The practical implications were added to Conclusion in brief. “In conclusion, patients underwent thoracoscopy surgery showed moderate knowledge, positive attitudes, and appropriate practice towards ERAS. Based on the identified gaps in KAP items, we recommend further development of preoperative education, personalized counseling, peer support groups, and follow-up care to enhance the prognosis and quality of life for individuals undergoing thoracoscopy.” 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: Partly Reviewer #2: Partly ________________________________________ 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: 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 ________________________________________ 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 ________________________________________ 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: The authors reported an interesting paper on the knowledge of patients regarding ERAS. The manuscript is of potential interest, but I have some comments: Comments1- Did the authors analyze the impact of knowledge on early postoperative outcomes Response: Thanks for the valuable comments. Univariate and multivariate logistic and linear regressions were conducted to explore the association between KAP and prognosis. The associations of KAP scores with postoperative complications, postoperative bed rest time and duration of hospital stay were detailed in Supplementary Tables 5-7. However, no significant associations between KAP scores and early postoperative outcomes were observed. The possible explanation has been added in the Discussion. Besides, the lack of significant associations between KAP scores and clinical outcomes was found. One plausible explanation was that the effectiveness of ERAS might not be contingent upon the patients' KAP. Instead, it might rely more heavily on the implementation of ERAS by healthcare providers, such as optimized anesthesia, minimal incision techniques, and early mobilization. This underscored the multifaceted nature of clinical outcomes, suggesting that KAP scores might not be the determinant. Since we only collected limited information of early postoperative outcomes, it is possible that the findings could be biased. The contents have been added to limitation. Thirdly, the limited items of early postoperative outcomes (postoperative complications, postoperative bed rest time and duration of hospital stay) were collected, which cannot comprehensively grasp the relationships between KAP and early postoperative outcomes. Therefore, the observed findings should be taken with caution. Comments 2- Did the authors analyze the influence of a previous surgical procedure (even of not thoracic) on the knowledge of patients? Response: Thanks for the valuable comments. Due to not collecting information on previous surgical procedures of participants, we did not analyze their influence on KAP scores. We acknowledge that this is one of limitations of our study, and the related contents has been added to the limitations section. Fourthly, several variables, such as previous surgical procedure, nutritional status and duration of pleural drainage, were not included in the questionnaire. The missing information can impede the investigation into the determinants of clinical outcomes, highlighting the need for future studies involving a larger cohort of phenotyped individuals. Comments 3- When the questionnaire was administered? Response: Thanks for the valuable comments. The detailed procedure was added in the Methods The electronic questionnaire was generated by the “Sojump” platform (www.wjx.cn), and were distributed via QR codes. The questionnaires were disseminated to patients when they had received ERAS education before thoracoscopy surgery. In instances where elderly patients lacked smartphones, access to paper-based surveys or assistance from family members using smartphones was facilitated. During the survey, research aides were present to aid participants grappling with comprehension. For individuals encountering difficulties with responses, staff members facilitated question presentation and response recording. Comment4- Based on the results, did you change your clinical practice? Response: Thanks for the valuable comments. The clinical practice has not changed yet, but we have incorporated additional clinical practice implications based on the survey results in discussion section. “Targeted patient education should be developed to provide training on ERAS protocols and address related misunderstandings through doctor-patient communications.” “This underscored the importance of integrating ERAS education into preoperative care for patients undergoing thoracic surgery and similar surgeries. Standardization of ERAS education may also facilitate comparisons across different patient populations, enabling researchers to evaluate the impact of education on patient outcomes more rigorously in future studies.” We believe that implementing these measures in future clinical practice would be helpful in improving patients’ KAP on ERAS. In addition, we have included practical implications in the Conclusion. “In conclusion, patients underwent thoracoscopy surgery showed moderate knowledge, positive attitudes, and appropriate practice towards ERAS. Based on the identified gaps in KAP items, we recommend further development of preoperative education, personalized counseling, peer support groups, and follow-up care to enhance the prognosis and quality of life for individuals undergoing thoracoscopy.” Reviewer #2: Congratulations to the authors for their contribution in the topic of ERAS. I appreciated the patient centered analysis. The methodology is clear, and the questionnaire employed is appropriate. The paper has a transverse interest, all the medical workers (surgeons, nurses and physiotherapist) are involved in ERAS strategy. Like in surgery, an deep understanding of the theoretics basis could translate in a perfect practice. although I suggest few improvements before to publish the paper. I hope that this review will make a good contribution to your work. Major Revisions Comments 1- Provide the aim of thoracoscopy in the clinical parameters. VATS for pleural biopsy benign/malign, empyema, pneumothorax, lung resections? The type of surgery can influence in the clinical outcome. Response: Thanks for the valuable comments. The majority of patients underwent pulmonary lobectomy, while a minority underwent procedures such as fracture fixation, exploratory thoracotomy, and drainage. Due to the relatively low frequency of these alternative surgical interventions, our analysis categorized the data as "pulmonary lobectomy vs. other procedures". The associations between type of surgery and clinical outcomes were added in the Supplementary Table 5-7. The KAP scores were compared between different surgeries, but no significant differences were observed. The related contents were added. Surgery type was categorized into pulmonary lobectomy and others (including fracture fixation, exploratory thoracotomy, and drainage). However, the multivariate logistic and linear regression revealed that the KAP were not associated with postoperative bed rest time, hospital stay, or complications after adjusted for factors including alcohol consumption, ASA classification, surgery duration, and surgery types (Supplementary Tables 5-7). Table The comparisons of KAP scores Knowledge Attitude Practice N(%) n±mean P n±mean P n±mean P Surgery 0.850 0.626 0.659 pulmonary lobectomy 235 (76.05) 28.93±7.35 53.48±6.81 43.49±5.64 Others* 74 (23.95) 28.88±6.80 53.97±6.51 43.34±5.07 : including fracture fixation, exploratory thoracotomy, and drainage Comments 2- Other clinical parameters important for the analysis are: smoking status and nutritional status (obese/cachexia). Response: Thanks for the valuable comments. The association of demographic data and clinical parameters with postoperative outcomes were detailed in Supplementary Table 5-7. For example, smoking status was not significantly associated with postoperative outcomes (OR=0.053-1.452, all P>0.05). However, considering the studying feasibility, only variables deemed to have perceived impacts on outcomes by experts were included in the questionnaire. Accordingly, nutritional status and other parameters were not collected, which was a limitation of our study. The related contents were added in the limitation section. Fourthly, several variables, such as previous surgical procedure, nutritional status and duration of pleural drainage, were not included in the questionnaire. The missing information can impede the investigation into the determinants of clinical outcomes, highlighting the need for future studies involving a larger cohort of phenotyped individuals. Comments 3- Did KAP affected the duration of pleural drainage? Response: Thanks for the valuable comments. The duration of pleural drainage was not collected during the design of questionnaire. The impacts KAP on the duration were thus not explored. The related contents were added in the limitation section. Fourthly, several variables, such as previous surgical procedure, nutritional status and duration of pleural drainage, were not included in the questionnaire. The missing information can impede the investigation into the determinants of clinical outcomes, highlighting the need for future studies involving a larger cohort of phenotyped individuals. Minor Revisions Comments 1- The length of hospital stay is long. Can you explain that? Response: Thanks for the valuable comments. The postoperative hospital stay of thoracoscopy surgery is 9.15±0.33. Possible reasons for the extended hospital stay may include the need for close postoperative monitoring, and the management of potential complications, including lung infection, pneumothorax and hypoproteinemia (Supplementary Table 4). Besides, the majority underwent pulmonary lobectomy, which is a treatment modality for severe lung diseases. The contents were added. In contrast to a prior study where patients undergoing thoracoscopic surgery lobectomy were discharged within 4 days, patients in our study experienced a longer postoperative hospital stay (9.15±0.33 days). Several factors may contribute to this extended duration. Firstly, a majority of patients underwent pulmonary lobectomy, which is a treatment modality for severe lung diseases. Additionally, the management of potential complications such as lung infection, pneumothorax, and hypoproteinemia could have prolonged hospitalization. However, direct comparisons of hospital stay lengths are challenging due to variations in discharge criteria among studies. Comments 2- Line 193. Medical “professor”. Do you mind professionist? Response: Thanks for the valuable comments. The phrase was corrected into “medical professionists”. Comments 3- Discussion. Did you suggest any strategies to improve KAP? Response: Thanks for the valuable comments. The contents were added in the Discussion. This underscored the importance of integrating ERAS education into preoperative care for patients undergoing thoracic surgery and similar surgeries. Based on the gaps in KAP items, preoperative education, personalized counseling, peer support groups and follow-up care can be further developed to facilitate prognosis and life quality of individuals undergoing thoracoscopy. Comments 4- Discussion. The results shown moderate knowledge parameter. Any suggestions to improve it? Response: Thanks for the valuable comments. The contents were added in the Discussion. Targeted patient education should be developed to provide training on ERAS protocols and address related misunderstandings through doctor-patient communications. ________________________________________ Attachments Attachment Submitted filename: Response letter-R1.docx* https://doi.org/10.1371/journal.pone.0309821.r002
30 Jul 2024 Decision Letter - Sirwan Khalid Ahmed, Editor PONE-D-23-41704R1Knowledge, Attitude, and Practice towards Enhanced Recovery after Surgery among Patients Underwent Thoracoscopy SurgeryPLOS ONE Dear Dr. Huang, 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 Sep 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. 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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, Sirwan Khalid Ahmed Academic Editor PLOS ONE Journal Requirements: Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. 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Lastly, please submit the English version of the questionnaires and raw data (Excel) as a supplemental file. [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 ******** 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 ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: 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 ****** 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 ****** 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: Tha authors replied to all the points that have been raised. I think the paper is now more clear. I have no further comments. ****** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). 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Revision 2
10 Aug 2024 Author Response Title: Knowledge, Attitude, and Practice towards Enhanced Recovery after Surgery among Patients Underwent Thoracoscopy Surgery Journal: PLoS One Response to Reviewers' comments Dear Editor, We thank you for your careful consideration of our manuscript. We appreciate your response and overall positive initial feedback and made modifications to improve the manuscript. After carefully reviewing the comments, we have modified the manuscript, therefore providing a complete context for the research that may be of interest to your readers. We hope that you will find the revised paper suitable for publication, and we look forward to contributing to your journal. Please do not hesitate to contact us with other questions or concerns regarding the manuscript. Best regards, Journal Requirements: Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. Response: We thank the requirement. We have meticulously checked our reference list to ensure it is both complete and correct. All references have been cross-verified for accuracy, and we have updated any incomplete information. We also have conducted a thorough review of all references to ensure their relevance and timeliness, making sure that our manuscript is supported by the most current and authoritative sources. Besides, each citation now includes the DOI for easy access. Additional Editor Comments: Dear Esteemed Authors, We appreciate your diligent efforts in editing the manuscript. However, it is necessary to restructure the entire paper to adhere to the STROBE checklist guidelines. Please complete the checklist and submit it as a supplementary file. Response: We thank the Editor. We have thoroughly checked the manuscript to align with the STROBE checklist and Journal guideline. Each section and subheading in the text now corresponds to those specified in the STROBE checklist. The completed STROBE checklist is included as a supplementary file with our revised submission. Please ensure that all subheadings in the text precisely align with those specified in the STROBE checklist. Additionally, carefully review the journal's guidelines to accurately revise references and include the DOI for each citation. Response: We thank the Editor. We have carefully reviewed all subheadings in the manuscript to ensure they match the STROBE checklist guidelines. This ensures clarity and consistency throughout the paper. In accordance with the journal’s guidelines, we have meticulously reviewed all references for accuracy and completeness. We have revised the reference list to ensure that it adheres to the journal’s formatting requirements. Each citation now includes the DOI. It is also vital to address all reviewer remarks from the previous round comprehensively. Response: Thank you for your detailed feedback and for the opportunity to further improve our manuscript. We are pleased to note that Reviewer #1 acknowledged that all comments have been addressed in the previous round. In the first round of revision, we comprehensively addressed all comments from Reviewer #2. Specifically, we clarified methodological details, expanded on the discussion points, and provided additional references as requested. Lastly, please submit the English version of the questionnaires and raw data (Excel) as a supplemental file. Response: We thank the Editor. As requested, we have prepared the English version of the questionnaires used in our study. These are submitted as a supplemental file. Additionally, we have compiled and submitted the raw data in Excel format as a supplemental file, ensuring transparency and reproducibility of our findings. Attachments Attachment Submitted filename: Response letter-R2.docx https://doi.org/10.1371/journal.pone.0309821.r004
20 Aug 2024 Decision Letter - Sirwan Khalid Ahmed, Editor Knowledge, Attitude, and Practice towards Enhanced Recovery after Surgery among Patients Underwent Thoracoscopy Surgery PONE-D-23-41704R2 Dear Dr. Yinping Huang, 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, Sirwan Khalid Ahmed Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: https://doi.org/10.1371/journal.pone.0309821.r005
Formally Accepted
23 Aug 2024 Acceptance Letter - Sirwan Khalid Ahmed, Editor PONE-D-23-41704R2 PLOS ONE Dear Dr. Huang, 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. Sirwan Khalid Ahmed Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0309821.r006

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