PONE-D-24-05546Patterns of Diabetes Mellitus by Age, Sex, and Province among Iranian Hajj Pilgrims and Health Care Delivery during 2012-2022: A Retrospective Study of 469,581 ParticipantsPLOS ONE

Dear Dr. Azari,

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We look forward to receiving your revised manuscript.

Kind regards,

Harunor Rashid, MD

Academic Editor

PLOS ONE

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Reviewers' comments:

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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: No

Reviewer #2: Yes

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

Reviewer #1: No

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: No

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Major revisions are required. contradictions in results. the study lacks depth in methodology, and lacks many details. Should be meticulously revised before submitting. In this stage the manuscript is not suitable for acceptance and will affect the reputation of journal.

Reviewer #2: There is good data in this study. Some comments:

1. Indicate why 2020/2021 data is not available (we know its due to COVID-19)

2. Is there any indication of %age pilgrims who used insulin?

3. If insulin usage is known was the pathology/morbidity increased in that group?

4. Any indication of knowledge of insulin storage/handling during travel? (there was a recent study by Yezli on it).

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Reviewer #1: No

Reviewer #2: No

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Attachments

Attachment

Submitted filename: PONE-D-24-05546.docx

Attachment

Submitted filename: PONE-D-24-05546_reviewer comments.pdf

PONE-D-24-05546R1Patterns of Diabetes Mellitus by Age, Sex, and Province among Iranian Hajj Pilgrims and Health Care Delivery during 2012-2022: A Retrospective Study of 469,581 ParticipantsPLOS ONE

Dear Dr. Azari,

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.

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

Thank you for revising the manuscript. Reviewers' comments are more favorable now, but in places there are some factual and syntactical errors, once addressed those we would be happy to reconsider the manuscript for publication.

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

Please submit your revised manuscript by Oct 04 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,

Harunor Rashid, MD

Academic Editor

PLOS ONE

Journal Requirements:

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

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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: (No Response)

Reviewer #3: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #2: Yes

Reviewer #3: Yes

**********

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

Reviewer #2: Yes

Reviewer #3: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #2: Yes

Reviewer #3: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #2: Yes

Reviewer #3: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #2: The minor comments in the initial draft were NOT addressed. I have put it in word format in the attached document.

Some of these include:

1. The word 'ceremony' should be deleted.

2. India is NOT a Muslim majority country.

3. Hajj WAS held in 2015, 2020 and 2021. Please correct that.

4. Iranian pilgrims DID attend 2015 Hajj. I met a number of them.

5. Iranian pilgrims did not attend the 2016 Hajj.

6. The paragraph below is not clear. Your study was till 2022, yet you include 2023. Does the below paragraph refer only to Iranians and only dialysis and why the massive difference for 2023?

Reviewer #3: Overall, the is article is so unique and has an important outcome that worth to be published. Minor modification could enrich the results and strengthens the findings of the study.

- Introduction:

o Hajj is attracting about 2.5 million Hajj pilgrims. NOT 3.5.

- Methodology:

o More information about the database is required:

� Were the data was available for all Iranian pilgrims?

� What are the medical data?

� There was a mention about FBS in the results. More information is required about such data and how and when was collected?

� What other information in database related to health records available can be added to this analysis?"

- Results:

o Were there any data about the compliance of diabetic pilgrims to treatment?

o When mentioning the rate of receiving DM services, provide the following:

� percentage out of the total provided services NOT numbers each year.

� percentage of dietetic pilgrims required services out of all dietetic pilgrims.

� Detailed information about the medical services attained by diabetic patients would be very helpful? Incidence of specific complications, Acquiring extra medications, modification of treatment?"

- Table 5:

o Detailed information need to be added about the acquisition of FBS. Was it collected from all pilgrims? Was it collected once? and when that was? Is there any follow-up data?"

- Discussion:

o It is better to emphasize the main finding of the study briefly in the first paragraph, then discuss the findings in following paragraphs.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #2: No

Reviewer #3: 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.

Attachments

Attachment

Submitted filename: DM Manuscript clean revise Reviewer comments.docx

Attachment

Submitted filename: Review.docx

Patterns of Diabetes Mellitus by Age, Sex, and Province among Iranian Hajj Pilgrims and Health Care Delivery during 2012-2022: A Retrospective Study of 469,581 Participants

PONE-D-24-05546R2

Dear Dr. Azari,

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.

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Kind regards,

Harunor Rashid, MD

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments: