Dear Dr. Ryan,

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 02 2025 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.

• 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'.

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We look forward to receiving your revised manuscript.

Kind regards,

Eyob Alemayehu Gebreyohannes, PhD

Academic Editor

PLOS ONE

Journal Requirements:

When submitting your revision, we need you to address these additional requirements.

1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf

2. Please provide a complete Data Availability Statement in the submission form, ensuring you include all necessary access information or a reason for why you are unable to make your data freely accessible. If your research concerns only data provided within your submission, please write "All data are in the manuscript and/or supporting information files" as your Data Availability Statement.

3. 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.

4. If the reviewer comments include a recommendation to cite specific previously published works, please review and evaluate these publications to determine whether they are relevant and should be cited. There is no requirement to cite these works unless the editor has indicated otherwise. 

5. 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 :

Dear Mr Ryan,

Thank you very much for submitting your manuscript, "Factors associated with stroke recurrence and mortality in ischemic and haemorrhagic stroke: protocol for a systematic review and meta-analysis" (Manuscript ID: PONE-D-25-10654), to PLOS One. I also appreciate your patience during what has been an extended review process.

As an Academic Editor, I was unable to secure a second reviewer despite repeated efforts — an outcome that is relatively uncommon but sometimes unavoidable. Nevertheless, after receiving feedback from one expert reviewer and conducting a thorough evaluation by myself, I am confident in moving forward based on the input available.

Following this assessment, I have reached a decision of minor revision. The reviewer’s comments are included below and should guide your revisions. Please provide a point-by-point response to the reviewer’s suggestions, indicating how you have addressed each comment in the revised manuscript.

I look forward to receiving your revised submission.

Kind regards,

Eyob Alemayehu Gebreyohannes (PhD)

Academic Editor

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Does the manuscript provide a valid rationale for the proposed study, with clearly identified and justified research questions?

Reviewer #1: Yes

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2. Is the protocol technically sound and planned in a manner that will lead to a meaningful outcome and allow testing the stated hypotheses??>

Reviewer #1: Yes

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3. Is the methodology feasible and described in sufficient detail to allow the work to be replicable??>

Reviewer #1: Yes

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4. Have the authors described where all data underlying the findings will be made available when the study is complete??>

The PLOS Data policy

Reviewer #1: Yes

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

Reviewer #1: Yes

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Please use the space provided to explain your answers to the questions above and, if applicable, provide comments about issues authors must address before this protocol can be accepted for publication. You may also include additional comments for the author, including concerns about research or publication ethics.

You may also provide optional suggestions and comments to authors that they might find helpful in planning their study.

Reviewer #1: The authors present a well-designed systematic review protocol aimed at identifying clinical and lifestyle risk factors associated with recurrence of hemorrhagic and ischemic stroke. The justification for the future review is well-founded, and the authors have met all the requirements for a systematic review of observational studies. I congratulate the authors on the quality of the manuscript but suggest that they rethink selecting only articles published in English, since more and more technologies, artificial intelligence, and sites such as DeepL Translate make it possible to translate articles published in other languages into English with good quality. Therefore, in order to avoid this limitation put forward in the discussion, I suggest you review and consider including studies published in any language, with the explanation that they will be translated into English with good-quality free technologies available.

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Reviewer #1: Yes:  Ricardo Ney Cobucci

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Factors associated with stroke recurrence and mortality in ischemic and haemorrhagic stroke: protocol for a systematic review and meta-analysis

PONE-D-25-10654R1

Dear Dr. Ryan,

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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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,

Eyob Alemayehu Gebreyohannes, PhD

Academic Editor

PLOS ONE