Participants’ perspectives on a multimodal stress management and comprehensive lifestyle modification program for patients with Crohn’s disease—A qualitative interview study

Christoph Schlee; Christine Uecker; Özlem Öznur; Nina Bauer; Jost Langhorst

doi:10.1371/journal.pone.0313127

Peer Review History

Original SubmissionApril 19, 2024
26 Jun 2024 Decision Letter - Mehran Rahimlou, Editor PONE-D-24-13340Participants’ perspectives on a multimodal stress management and comprehensive lifestyle modification program for patients with Crohn’s Disease – a qualitative interview studyPLOS ONE Dear Dr. JLanghorst, 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 Aug 10 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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Additional Editor Comments: Dear Dr. Jost Langhorst based on the comments of the reviewer, the authors are requested to revise their manuscript based on the comments raised and submit it again after correcting it. Many thanks [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: N/A Reviewer #2: I Don't Know Reviewer #3: Yes ****** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: No Reviewer #2: Yes Reviewer #3: Yes ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: Yes ****** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: Clinically relevant qualitative study finding that a multimodal stress reduction and lifestyle modification day clinic appears to be beneficial in the short term as a complementary therapy for CD patients, thereby offering additional options and and helping patients to address individual symptoms and needs, improve their understanding of the disease and their quality of life. Reviewer #2: The authors described that the interviewers completed the interview protocol as field notes to record any idiosyncrasies or problems encountered during the interviews. These results should also be described if any. For individual patient, please describe the number and characteristics of the interviewees and their relationship to the patient, as these may affect the results. The integrated program of stress reduction and lifestyle modification (including, among other things, nutritional therapy and phytotherapy) in the form of a day clinic should be briefly explained also in this manuscript for the readers who would know this intervention for the first time. Reviewer #3: This study by Schlee et al. examined the efficacy of multimodal integrative approach for patients with Crohn’s disease. I have some comments for this study. 1. "Overall, it is evident that IBD patients suffer from a reduced quality of life, due to 2. symptoms, such as abdominal pain, diarrhea, flatulence, as well as psychosocial symptoms." Add references. 3. "The causes and factors influencing CD are not yet clearly understood. However, it is assumed that, in addition to genetic factors, environmental factors, or lifestyle factors such as perceived stress in everyday life play a major role and impact the course of the disease" there are some other reasons that involved in the etiology of CD such as poor dietary patterns and lack of some nutrients (you can read and add this reference for this sentence: 10.1002/ptr.7081, 10.22037/ghfbb.v16i1.2622, 10.1016/j.dsx.2022.102440) 4. "The study was conducted as a mixed methods approach at the Klinikum Bamberg in" add reference. 5. What is the inclusion and exclusion criteria for choosing the participants. 6. "A total of 37 patients diagnosed with CD were enrolled in the randomized controlled trial" what is the approach in sample size calculation. 7. Whether or not the patients were assigned to the intervention and control group in random form. It should be explained in text. 8. ****** 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: 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. https://doi.org/10.1371/journal.pone.0313127.r001
Revision 1
12 Aug 2024 Author Response Response to Reviewers for manuscript Schlee et al. Dear Editor, Dear Reviewers, Thank you very much for your careful attention to our manuscript and the reviews provided. We appreciated the opportunity to revise the manuscript and to respond to the reviews point by point. We have done our best to address all the comments in the best possible way and believe that the paper has benefited from the revisions. We hope that you are satisfied with the changes and find the manuscript appropriate and suitable for publication. Please contact us if you have any questions or concerns. Review Comments to the Author Reviewer #1: Clinically relevant qualitative study finding that a multimodal stress reduction and lifestyle modification day clinic appears to be beneficial in the short term as a complementary therapy for CD patients, thereby offering additional options and and helping patients to address individual symptoms and needs, improve their understanding of the disease and their quality of life. Response from the authors: Thank you very much. Reviewer #2: The authors described that the interviewers completed the interview protocol as field notes to record any idiosyncrasies or problems encountered during the interviews. These results should also be described if any. Response from the authors: Thank you for this comment. There were no problems or peculiarities during the interviews/data collection. We added the sentence: “In this respect, there were no particular incidents or problems that would have affected the quality of the interview” on page 8. For individual patient, please describe the number and characteristics of the interviewees and their relationship to the patient, as these may affect the results. Response from the authors: Thank you for this important comment. Two sociologists and one M.Sc. in naturopathy and complementary medicine were involved as interviewers from the research team. The interview was conducted by one interviewer each. All interviewers were specialists in conducting qualitative research and were adequately trained in interviewing. The interviewers did not know the people personally, had no previous contact with the patient, and were not involved in the intervention, in order to ensure the greatest possible openness in conducting the interview and not to influence the interview situation in any other way. We have added this information to the manuscript on pages 8 and 9. The integrated program of stress reduction and lifestyle modification (including, among other things, nutritional therapy and phytotherapy) in the form of a day clinic should be briefly explained also in this manuscript for the readers who would know this intervention for the first time. Response from the authors: Thank you for this hint. The program described in this study is described in more detail on pages 5 and 6. To provide a more complete understanding of the program, we have included additional examples on page 6. Reviewer #3: This study by Schlee et al. examined the efficacy of multimodal integrative approach for patients with Crohn’s disease. I have some comments for this study. 1. "Overall, it is evident that IBD patients suffer from a reduced quality of life, due to 2. symptoms, such as abdominal pain, diarrhea, flatulence, as well as psychosocial symptoms." Add references. Response from the authors: Thank you for this important comment. We added two references Singh et al. 2011 and Barberio et al. 2021 on page 4. 3. "The causes and factors influencing CD are not yet clearly understood. However, it is assumed that, in addition to genetic factors, environmental factors, or lifestyle factors such as perceived stress in everyday life play a major role and impact the course of the disease" there are some other reasons that involved in the etiology of CD such as poor dietary patterns and lack of some nutrients (you can read and add this reference for this sentence: 10.1002/ptr.7081, 10.22037/ghfbb.v16i1.2622, 10.1016/j.dsx.2022.102440) Response from the authors: Thank you for the additional literature suggestions and the hint to include dietary/nutritional factors. We have added the reference Morshedzadeh et al for a very good overview article in this respect on page 4. 4. "The study was conducted as a mixed methods approach at the Klinikum Bamberg in" add reference. Response from the authors: We added "Bamberg, Germany" on page 5 to make clear where the study took place. References to the main study/mixed methods research approach are included in the reference [24,25] at the end of the sentence. Please let us know if you mean another specific reference in this context. Thank you. 5. What is the inclusion and exclusion criteria for choosing the participants. Response from the authors: Thank you very much. We have included more detailed information on this topic in addition to the previously mentioned information on page 7. 6. "A total of 37 patients diagnosed with CD were enrolled in the randomized controlled trial" what is the approach in sample size calculation. Response from the authors: Thank you. As this was a feasibility and pilot study, sample size was not calculated. We included the sentence on page 7: In this respect no sample size calculation was done because this was a feasibility and pilot study 7. Whether or not the patients were assigned to the intervention and control group in random form. It should be explained in text. Response from the authors: Yes, they were randomly assigned to intervention and control group. We included one sentence on this in the manuscript on page 7 to make this clearer. Thank you very much! https://doi.org/10.1371/journal.pone.0313127.r002
11 Sep 2024 Decision Letter - Mehran Rahimlou, Editor PONE-D-24-13340R1Participants’ perspectives on a multimodal stress management and comprehensive lifestyle modification program for patients with Crohn’s Disease – a qualitative interview studyPLOS ONE Dear Dr. Langhorst, 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 Oct 26 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, Mehran Rahimlou, PhD 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. Additional Editor Comments: Authors are requested to revise their manuscript based on the reviewers' comments. [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: All comments have been addressed Reviewer #3: (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: Yes Reviewer #3: Partly ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: N/A Reviewer #2: N/A 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: No ****** 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 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: I am happy with the revisions made to this paper and believe that it is fit to be published in this journal. Reviewer #2: (No Response) Reviewer #3: This study entitled: Participants’ perspectives on a multimodal stress management and comprehensive lifestyle modification program for patients with Crohn’s Disease – a qualitative interview study is interesting. However, I have some comments. 1. Its better to add a IBD definition at the start of introduction 2. "Poor dietary habits and deficiencies in some nutrients are also implicated in the etiology of IBD" add more reference like this reference 10.1002/ptr.7081 3. "In addition, it is suggested that the predominant dietary habits, e.g., highly processed foods, sugar consumption, etc., in modern societies can have a negative influence" add more reference like 10.1016/j.clinthera.2020.12.021 and 10.1016/j.dsx.2015.09.015 4. At the first of the Method section its better to add the design of this study. 5. How do you calculate sample size? 6. In the method section, its better to add primary and secondary outcomes. 7. The quality of figures are so poor and it need to improve. ****** 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 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. https://doi.org/10.1371/journal.pone.0313127.r003
Revision 2
10 Oct 2024 Author Response Response to Reviewers for manuscript Schlee et al. Dear Editor, Dear Reviewers, Thank you very much for your careful attention to our manuscript and the reviews provided. We appreciated the opportunity to revise again the manuscript and to respond to the reviewers’ comments. We have done our best to address all the comments to the best of our ability and believe that the paper has again benefited from the revisions. We hope that you are satisfied with the changes and find the manuscript appropriate and suitable for publication. Please contact us if you have any questions or concerns. Sincerely yours, Prof. Dr. Jost Langhorst Review Comments to the Author Reviewer #1: All comments have been addressed. I am happy with the revisions made to this paper and believe that it is fit to be published in this journal. Response from the authors: Thank you very much. Reviewer #2: All comments have been addressed. Response from the authors: Thank you very much. Reviewer #3: This study entitled: Participants’ perspectives on a multimodal stress management and comprehensive lifestyle modification program for patients with Crohn’s Disease – a qualitative interview study is interesting. However, I have some comments. 1. Its better to add a IBD definition at the start of introduction Response from the authors: Thank you. We added a definition on page 4. 2. "Poor dietary habits and deficiencies in some nutrients are also implicated in the etiology of IBD" add more reference like this reference 10.1002/ptr.7081 Response from the authors: Thank you. We added additional references on page 4. 3. "In addition, it is suggested that the predominant dietary habits, e.g., highly processed foods, sugar consumption, etc., in modern societies can have a negative influence" add more reference like 10.1016/j.clinthera.2020.12.021 and 10.1016/j.dsx.2015.09.015 Response from the authors: Thank you. We added further references on page 4. 4. At the first of the Method section its better to add the design of this study. Response from the authors: Thank you for your comment. The study design is described at the beginning of the methods section. In order to make the design more comprehensive and provide the overview earlier (at the beginning of the section), we have moved the first reference to Figure 1 there (see page 5). 5. How do you calculate sample size? Response from the authors: Thank you. We have answered this question during the previous revision and already made changes in the manuscript, see manuscript and previous response. As this was a feasibility and pilot study, sample size was not calculated. We included the sentence on page 7 during the last revision: In this respect no sample size calculation was done because this was a feasibility and pilot study (see page 7). 6. In the method section, its better to add primary and secondary outcomes. Response from the authors: As this paper based on a qualitative study designed to complement the quantitative investigations and objectives, there were no defined primary and secondary outcomes. To make the research interest clearer, we added the following sentence in the manuscript on page 6: More specifically, the following topics were examined: experience of disease in daily life, reasons for participating in the day clinic program, experiences with the program, perceived changes due to the intervention, and integration of program elements in daily life. Thank you. 7. The quality of figures are so poor and it need to improve. Response from the authors: Thank you very much for this hint. We have improved the figures. Attachments Attachment Submitted filename: Response to Reviewers_Schlee et al.docx https://doi.org/10.1371/journal.pone.0313127.r004
21 Oct 2024 Decision Letter - Mehran Rahimlou, Editor Participants’ perspectives on a multimodal stress management and comprehensive lifestyle modification program for patients with Crohn’s disease – a qualitative interview study PONE-D-24-13340R2 Dear Dr. Jost Langhorst, 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, Mehran Rahimlou, PhD 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 #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 #3: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? 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 #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 #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 #3: The authors have made all the necessary changes based on the reviewers' comments. Based on the changes made in the new version of the manuscript, this manuscript meets the necessary conditions for acceptance. ****** 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 #3: No ******** https://doi.org/10.1371/journal.pone.0313127.r005
Formally Accepted
4 Nov 2024 Acceptance Letter - Mehran Rahimlou, Editor PONE-D-24-13340R2 PLOS ONE Dear Dr. Langhorst, 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. Mehran Rahimlou Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0313127.r006

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