Peer Review History

Original SubmissionApril 14, 2024
Decision Letter - Muhammad Iqhrammullah, Editor

PONE-D-24-11405Application of Attenuated Total Reflection–Fourier Transform Infrared spectroscopy in semi-quantification of blood lipids and characterization of the metabolic syndromePLOS ONE

Dear Dr. Lee,

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.

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Please improve the novelty statement and sampling handling explanation.

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We look forward to receiving your revised manuscript.

Kind regards,

Muhammad Iqhrammullah, Ph.D

Academic Editor

PLOS ONE

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Additional Editor Comments:

Please improve the novelty statement and sampling handling explanation.

[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: 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: Yes

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: 1. After carefully reviewing the introduction section, I did not find a clear and explicit statement highlighting the novelty or newness of the study. The authors do not appear to directly state what makes their work novel compared to previous research in the field.

2. The authors emphasize the advantages of their ATR-FTIR method, such as rapid assay times and the need for small blood samples (0.5 μL). These benefits make the method potentially better for frequent monitoring and clinical applications compared to established techniques. Unfortunately, the authors lack a comprehensive comparison of the accuracy, sensitivity, and specificity of their approach against established methods. A deeper analysis of the performance metrics and potential limitations of their technique, in relation to existing gold standards, would better support their case for the usefulness and innovation of their method.

3. The conclusion should explicitly reiterate the potential impact of early detection and management of MetS on improving patient outcomes and quality of life, as highlighted in the introduction.

4. What do you mean by the brackets in table 2 as standard deviation (SD)?

5. However, there are a few minor points that could be improved in the reporting of the SHAP analysis: The authors could provide more details on how exactly the SHAP values were calculated (e.g., using the TreeExplainer for tree-based models like GBT) and what they represent (e.g., the contribution of each wavelength to the model's output relative to the average prediction). They could also discuss any potential limitations or caveats of using SHAP for model interpretation in this specific context.

6. From a purely statistical perspective, an R2 value of 0.419 indicates that only 41.9% of the variance in LDL-C levels can be explained by the ATR-FTIR spectral data using the HGBT model. This suggests that the model's predictions for LDL-C are not as accurate as those for other lipid parameters like TG (R2 = 0.854) or HDL-C (R2 = 0.758). In many scientific contexts, an R2 value below 0.5 would be considered poor model performance. I'm uncertain about the authors' argument, which claims that despite the low R² value, the mean absolute error (MAE) for LDL-C prediction was between 9 and 12 mg/dL.

Reviewer #2: Interesting work that discusses the application of ATR-FTIR in biological samples. The study is needed and the use of AI algorithms added value. Just some comments are needed to clarify:

-How were the samples stored?

-How did the authors ensure stability of samples?

-Was any heating of the sample applied prior to measurement? To prevent water interference?

-Comment on transferability of the models to other matrices in the discussion

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Reviewer #1: No

Reviewer #2: No

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Revision 1

28-July-2024

Editor-in-Chief

PLOS ONE

Dear Editors:

We would like to thank all the reviewers and editors for their comments on the manuscript (PONE-D-24-11405) entitled “Application of attenuated total reflection–Fourier transform Infrared spectroscopy in semi-quantification of blood lipids and characterization of metabolic syndrome”.

Following the reviewers’ comments, we revised the manuscript and provided responses to describe the manuscript amendments. Point-to-point responses have been included in this submission.

We apologize that the grant information we provided in the ‘Funding Information’ and ‘Financial Disclosure’ sections do not match. One of our authors forgot to add a Financial Disclosure Statement before the primary submission. We received funding to support this study and updated the Funding Information on the Submission page as follows: National Health Research Institutes (NHRI-EX107-10724SC, NHRI-EX108-10724SC, NHRI-EX109-10724SC, and NHRI-EX110-10724SC), Kaohsiung Medical University Hospital (KMUH111-1R07 and KMUH110-0R11), Taiwan Ministry of Science and Technology/National Sciences, and Technology Council Grants (MOST 109-2314-B-037-111-MY3) NSTC 112-2314-B037-069. Please change the online submission form on our behalf. Thank you.

Regarding raw data sharing, all authors have decided on a data-sharing plan, and our entire data will be made freely accessible if our manuscript is accepted for publication. We will adhere to your open-data policy. To meet your requirement that all data presented in the study be made publicly available at or before the time of acceptance, the file named “encoded_data” is uploaded to the Submission System as a Supporting Information.

We believe that, after incorporating the valuable reviewers’ and editors’ opinions, the manuscript is worthy of consideration for publication in PLOS ONE.

Thank you for your consideration.

Sincerely yours,

Hsiang-Chun Lee, MD, PhD

Professor, College of Medicine, Kaohsiung Medical University

Attending Physician, Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital

100 Tzyou 1st Rd, Kaohsiung 807, Taiwan

Tel.: +886-7-3121101#7741 Fax: +886-7-3234845

E-mail: hclee@kmu.edu.tw

Attachments
Attachment
Submitted filename: Specific Responses to Reviewers.docx
Decision Letter - Rajesh Kumar Singh, Editor

PONE-D-24-11405R1Application of attenuated total reflection–Fourier transform Infrared spectroscopy in semi-quantification of blood lipids and characterization of metabolic syndromePLOS ONE

Dear Dr. Lee,

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 Dec 20 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,

Rajesh Kumar Singh, Ph.D.

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.

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

Reviewer #4: 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 #3: Yes

Reviewer #4: (No Response)

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

Reviewer #3: Yes

Reviewer #4: Yes

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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

Reviewer #4: Yes

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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

Reviewer #4: Yes

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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 study based on Application of attenuated total reflection–Fourier transform Infrared spectroscopy in

semi-quantification of blood lipids and characterization of metabolic syndrome is highly significant. However I would suggest to authors please expand this study by using molecular methods.

Reviewer #4: • Provide additional context on ATR-FTIR: Add a brief explanation about how ATR-FTIR spectroscopy works, specifically for readers less familiar with the technique. This could improve the accessibility of the study’s technical approach.

• Add a visual comparison: Consider adding a figure that visually compares the ATR-FTIR spectrum with traditional spectra of individual lipid classes or a figure showing predicted vs. actual lipid levels for better visual interpretation.

**********

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

Reviewer #4: No

**********

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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.

Revision 2

PONE-D-24-11405R1

Application of attenuated total reflection–Fourier transform Infrared spectroscopy in semi-quantification of blood lipids and characterization of metabolic syndrome

PLOS ONE

Comments to the Author

Reviewer #3: The study based on Application of attenuated total reflection–Fourier transform Infrared spectroscopy in semi-quantification of blood lipids and characterization of metabolic syndrome is highly significant. However I would suggest to authors please expand this study by using molecular methods.

Response:

Thank you for your comments. We agree that molecular methods are also very important for applying non-destructive ATR-FTIR spectrometry in serum analysis, particularly for lipids. The following studies demonstrate the use of ATR-FTIR spectrometry to analyze blood samples. Bel’skaya et al. published their work on using model solutions in applying FTIR spectroscopy for the quantitative analysis of blood serum.[32] Portaccio et al. published their study results on ATR-FTIR spectra of commercial lipid samples and demonstrated specific fingerprint regions in ATR-FTIR spectra for phospholipids (phosphatidylcholine, phosphatidylethanolamine, phosphatidylserine, and phosphatidylinositol) from 3500 to 2800 cm−1 and 1800 to 600 cm−1), sphingolipids (ceramide, sphingosine 1-phosphate, ceramide 1-phosphate, and sphingomyelin) from 3500 to 2800 cm−1 and 1800 to 600 cm−1), and cholesterol (3150–2800 cm−1) [33]. Their study proved the usefulness of FTIR spectra for analyzing complex lipids, and this application can ultimately contribute to lipid research and its implications for human health. (Line 319-328)

Based on the known advantage of FTIR spectra in quantitative analysis and sensitivity to differentiate various lipids, our study approach was directed toward linkage to clinical application. Consistent with the aforementioned literature, our results revealed the reliability of ATR-FTIR for semi-quantitative lipid analysis of human serum samples.

Unlike those publications, our study emphasizes the predictive capability of machine learning models. The core concept is to uncover the correlations between FTIR spectra, clinically derived lipid values, and diagnostic classifications.

Since this approach centers on data-driven correlations rather than direct molecular causation, it inherently lacks molecular specificity, which remains a limitation of ML-based predictions.

In future work, we may explore causation-focused models to investigate molecular associations further and validate these predictions. However, given the study’s current scope, our ML approach offers valuable insights into broad lipid level trends without requiring the extensive molecular characterization that lies beyond this study’s objectives. (Line 380-384)

Two new citations have been added.

32. Bel’skaya LV, Sarf EA, Solomatin DV. Application of FTIR Spectroscopy for Quantitative Analysis of Blood Serum: A Preliminary Study. Diagnostics. 2021;11(12):2391. PubMed PMID: doi:10.3390/diagnostics11122391.

33. Portaccio M, Faramarzi B, Lepore M. Probing Biochemical Differences in Lipid Components of Human Cells by Means of ATR-FTIR Spectroscopy. Biophysica. 2023;3(3):524-38. PubMed PMID: doi:10.3390/biophysica3030035.

 Reviewer #4: • Provide additional context on ATR-FTIR: Add a brief explanation about how ATR-FTIR spectroscopy works, specifically for readers less familiar with the technique. This could improve the accessibility of the study’s technical approach.

Response:

Thank you for your comments. We have added a paragraph to the Introduction and Methods section to briefly explain how ATR-FTIR spectroscopy works. The context is as follows.

ATR-FTIR spectroscopy is a technique for analyzing the chemical composition of materials by detecting their characteristic absorption of mid-infrared light. In ATR-FTIR, molecules absorb mid-infrared light at specific wavenumbers (or frequencies), depending on their chemical bonds and structure. Each type of bond (e.g., C=O and C–H) has a unique absorption pattern, creating a molecular fingerprint. (Line 77-81)

This study applied a small sample volume (0.5 µL to a Ge ATR crystal, as shown in Figure 1(A). A modulated mid-infrared beam was directed into the Ge crystal, generating an evanescent wave at the crystal surface, allowing the light to interact with the sample. The sample absorbs light at characteristic wavenumbers, and the remaining light is detected using a liquid nitrogen-cooled mercury cadmium telluride (MCT) infrared detector. The resulting spectrum shows peaks corresponding to specific molecular bonds, providing a unique chemical profile of the sample. (Line 122-127)

Figure 1(A). The schematic depicts the attenuated total reflection for acquiring the FTIR spectra of a blood sample. The mid-infrared light is modulated using the Michaelson interferometer of an FTIR spectrometer. (Line 142-144)

• Add a visual comparison: Consider adding a figure that visually compares the ATR-FTIR spectrum with traditional spectra of individual lipid classes or a figure showing predicted vs. actual lipid levels for better visual interpretation.

Response:

Thank you for your comments. To illustrate the ability of spectral values to quantify traditionally categorized lipid classes (e.g., cholesterol and triglycerides), we categorized lipid values into five equally divided groups from maximum to minimum to examine potential spectral differences among varying lipid levels (see Figures below). The X-axis represents the input ATR-FTIR wavenumbers, the Y-axis represents the input ATR-FTIR spectral values, and the color group corresponds to the measurement group obtained from conventional biochemical assays. The average ATR-FTIR spectrum for each group is shown as a line, with the shaded regions representing plus one standard deviation. This visualization highlights the trends in spectral differences across lipid groups. However, although these trends suggest potential relationships, they do not allow for direct quantitative conclusions or inferences. Overlapping or minimal differences in FTIR spectral absorption across lipid ranges further suggest that nonlinear associations may exist that are not directly observable in raw spectral data. By applying machine learning models, we can efficiently capture and interpret these complex patterns, offering precise and meaningful lipid-level predictions beyond what is visually discernible. All figures are listed in Appendix 2. Grouped Spectrum with Specified Lipid Value Ranges (Line 211-223)

In response to your suggestion, we have also included Figure 2 to illustrate the comparison of predicted versus actual lipid levels. In this figure, the x-axis represents the lipid values predicted by the model based on the input ATR-FTIR spectral data, whereas the y-axis shows the actual measured lipid values. Additionally, we included a visualization of the distribution of error values to further elucidate the prediction accuracy and deviations of the model.

Attachments
Attachment
Submitted filename: Response to Reviewers.docx
Decision Letter - Rajesh Kumar Singh, Editor

Application of attenuated total reflection–Fourier transform Infrared spectroscopy in semi-quantification of blood lipids and characterization of metabolic syndrome

PONE-D-24-11405R2

Dear Dr. Lee,

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.

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Kind regards,

Rajesh Kumar Singh, Ph.D.

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Formally Accepted
Acceptance Letter - Rajesh Kumar Singh, Editor

PONE-D-24-11405R2

PLOS ONE

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Academic Editor

PLOS ONE

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