https://orcid.org/0000-0002-6409-577X
Peer Review History
| Original SubmissionAugust 26, 2024 |
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Dear Dr. Do, 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 29 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.
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, Aliasghar Karimi Academic Editor PLOS ONE Journal Requirements: 1. When submitting your revision, we need you to address these additional requirements. 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 2. We noticed you have some minor occurrence of overlapping text with the following previous publication(s), which needs to be addressed: https://bmjopen.bmj.com/content/13/3/e064870.full In your revision ensure you cite all your sources (including your own works), and quote or rephrase any duplicated text outside the methods section. Further consideration is dependent on these concerns being addressed. 3. We noted in your submission details that a portion of your manuscript may have been presented or published elsewhere. This retrospective observational study is the major update of our previously published paper,[1] which collected data on all ARDS patients admitted to the Bach Mai Hospital (BMH) in Hanoi, Vietnam, between August 2015 and August 2017 to elucidate the clinical epidemiology and disease prognosis in ARDS patients in Vietnam. To further investigate the mortality rate and associated factors from ARDS, especially those related to patient transportation, we continued to collect retrospective data on these patients admitted to the BMH between September 2017 and August 2023, following approval from the BMH Scientific and Ethics Committees (08/11/2023). Subsequently, we merged the data sets from the two stages of data collection at this hospital. [1] Chinh LQ, Manabe T, Son DN, Chi NV, Fujikura Y, Binh NG, Co DX, Tuan DQ, Ton MD, Dai KQ, Thach PT, Nagase H, Kudo K, Nguyen DA. Clinical epidemiology and mortality on patients with acute respiratory distress syndrome (ARDS) in Vietnam. PLoS One. 2019 Aug 15;14(8):e0221114. doi: 10.1371/journal.pone.0221114. PMID: 31415662; PMCID: PMC6695190. Please clarify whether this [conference proceeding or publication] was peer-reviewed and formally published. If this work was previously peer-reviewed and published, in the cover letter please provide the reason that this work does not constitute dual publication and should be included in the current manuscript. Additional Editor Comments: The study investigates factors associated with mortality in ARDS patients in a central hospital in Vietnam, analyzing inter-hospital care, clinical characteristics, and treatments that influence outcomes. Key findings include the protective role of endotracheal tube (ET) use during transport and the high mortality rate associated with high SOFA scores. Strengths Provides a crucial analysis of ARDS in a lower middle-income context, filling a gap in ARDS research focused on LMICs. Rigorous data collection and organization, with a comprehensive dataset that captures diverse patient characteristics, comorbidities, and treatment factors. Use of multivariable logistic regression to isolate mortality predictors, enhancing the reliability of findings. Weaknesses Variable Selection Criteria in Regression: The logistic regression method would benefit from more detailed explanation. While significant variables were selected for multivariable regression, a clear justification for each included variable would improve transparency, especially given potential multicollinearity. Data Exclusions: The exclusion of patients with incomplete data could introduce selection bias. It would be beneficial to include an analysis of excluded cases or a sensitivity analysis to assess the impact of these exclusions on outcomes. Inter-hospital Transport Analysis: The manuscript mentions transport categories (EMS, hospital ambulances, private, and public). However, a breakdown of patient outcomes by transport type, adjusted for severity and other covariates, would provide more actionable insights. Sample Size Justification: While the calculation is given, it lacks consideration of covariates in the multivariable analysis. A power analysis that accounts for expected covariate interactions in logistic regression could better support the robustness of findings. Smoking and Comorbidities Analysis: Smoking status is a significant factor in respiratory outcomes, yet its impact on ARDS outcomes in this cohort is not deeply analyzed. Similarly, the Charlson Comorbidity Index (CCI) score is included, but specific comorbidities could be separately analyzed for their mortality impact. Line-Specific Comments Line 67 (Abstract, Background): To increase clarity, consider specifying which "factors associated with acute illness" are commonly associated with ARDS mortality. This would give readers immediate insight into whether these factors pertain to patient demographics, treatment variables, or environmental conditions. Line 89 (Abstract, Results): The interpretation of the odds ratio for endotracheal tube (ET) usage is crucial. Since a low OR (0.057) is unusual, clarify its significance by discussing possible mechanisms or logistical practices that could influence this protective effect. Line 112 (Introduction): The phrase "remains associated with high mortality rates" is broad. To strengthen this section, consider including recent global statistics or meta-analysis findings on ARDS mortality to contextualize Vietnam's figures in a broader global health framework. Line 127 (Introduction): The introduction would benefit from a more in-depth explanation of how Vietnam’s healthcare infrastructure specifically impacts ARDS outcomes, particularly regarding referral systems and delays in critical care. Line 168 (Methods, Patient Transport): The categories for patient transport are defined well, but it may improve the study’s applicability if you provide more details on the quality or typical response time associated with each type of transport. This additional detail could help distinguish the types' impact on patient outcomes. Line 201 (Variables): When discussing inter-hospital care data, consider adding any quantitative thresholds or benchmarks (e.g., minimum levels of oxygen saturation that determine MV application). This addition would provide context on how Vietnamese hospitals make critical care decisions during transfers. Line 256 (Outcomes): While hospital mortality is the primary outcome, detailing any standardized discharge criteria could clarify how patients' outcomes are assessed upon transfer or discharge, helping to interpret mortality rates across different levels of care. Line 271 (Statistical Analyses): The analysis methods are detailed, but the selection criteria for variables in the logistic regression model could be more precise. Mentioning any variable selection methods (like stepwise selection or feature importance ranking) would enhance the rigor of this section. Line 315 (Results, Data Exclusions): Excluding cases with missing data may introduce bias, especially if those cases had particularly severe or mild conditions. Discussing potential implications of these exclusions would improve transparency. Line 346 (Results, Smoking Habits): Since smoking is a significant factor for respiratory distress, a breakdown of its impact on ARDS severity or mortality would add depth to the study findings. Consider performing an analysis to examine if there’s an association between smoking status and mortality outcomes. Line 375 (Results, Table 4 - PaO2/FiO2 Ratio): The PaO2/FiO2 ratio is presented in both text and table form. To streamline, a graphical representation of these ratios with survival and mortality outcomes might improve interpretability, as this metric is a core component of the Berlin definition for ARDS severity. Line 403 (Table 7, Multivariable Regression): Given the high odds ratio for SOFA score, it could be beneficial to mention specific SOFA components (e.g., respiratory or cardiovascular factors) that contribute most significantly to this outcome. This would highlight which organ systems might be prioritized in treatment protocols. Minor Comments Line-by-Line Edits: Some minor editorial adjustments for grammar and clarity are needed in the abstract and results sections. Graphs and Tables: Visual aids, such as survival curves stratified by key risk factors (e.g., SOFA scores, PaO2/FiO2 ratios), would improve result interpretability. Statistical Detail: Reporting effect sizes (e.g., odds ratios) with more precise confidence intervals in the abstract would better convey result certainty. [Note: HTML markup is below. Please do not edit.] [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. |
| Revision 1 |
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Dear Dr. Do, 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. ACADEMIC EDITOR: Thank you for submitting the revised manuscript titled Factors related to mortality in patients with acute respiratory distress syndrome (ARDS) in a lower-middle-income country: a retrospective observational study to Plos One. I appreciate the effort you have put into addressing the reviewers' comments, and the manuscript has improved significantly. However, several concerns still need to be addressed before the manuscript can be considered for publication: Key Concerns:
Conclusion: Your study presents valuable insights into the mortality factors for ARDS patients in a resource-limited setting. To move forward with publication, the manuscript requires further clarification regarding the pandemic data analysis, dual publication concerns, and some methodological details. I recommend that you submit a major revision addressing these points. Once these revisions are made, the manuscript will be reconsidered for final publication. Please submit your revised manuscript by Jul 30 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.
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, Gurmeet Singh, M.D., Ph.D., Academic Editor PLOS ONE Additional Editor Comments: Dear Dr. Do, Thank you for submitting the revised manuscript titled Factors related to mortality in patients with acute respiratory distress syndrome (ARDS) in a lower-middle-income country: a retrospective observational study to Plos One. I appreciate the effort you have put into addressing the reviewers' comments, and the manuscript has improved significantly. However, several concerns still need to be addressed before the manuscript can be considered for publication: Key Concerns: 1. Duality of Publication: - The manuscript presents an update to your previously published work. Please ensure that you clearly explain why this updated study does not constitute dual publication, both in the cover letter and within the manuscript. This explanation should emphasize that the new data adds significant value and is not a mere repetition of the previous findings. 2. Analysis of the Pandemic Period: - The inclusion of data from the pandemic period (COVID-19) is important but currently lacks analysis of its impact on ARDS outcomes. I recommend performing a comparative analysis between the pre-pandemic and pandemic periods to provide a clearer understanding of how the pandemic may have influenced the results. 3. Methodological Clarifications: - Please provide further clarification on how potential multicollinearity was assessed in the multivariable logistic regression analysis. This would increase confidence in the robustness of your statistical methods. - Consider including a sensitivity analysis or a more in-depth discussion on how the exclusion of patients with incomplete data might have influenced the results, especially regarding selection bias. 4. Inter-hospital Transport Analysis: - A breakdown of patient outcomes by transport type (e.g., EMS, hospital ambulances, private, and public) would provide more actionable insights. While data limitations are acknowledged, please expand on how the lack of detailed transport data impacts the analysis and its conclusions. 5. Cytokine Adsorption Therapy: - Include a brief discussion on the potential impact of cytokine adsorption therapy on outcomes. Even if no formal analysis was done, acknowledging its role and the limitations of this therapy would add valuable context. 6. Minor Language and Formatting Edits: - Please ensure the manuscript is carefully proofread for minor language issues, particularly with the consistency of abbreviations and proper article usage. Conclusion: Your study presents valuable insights into the mortality factors for ARDS patients in a resource-limited setting. To move forward with publication, the manuscript requires further clarification regarding the pandemic data analysis, dual publication concerns, and some methodological details. I recommend that you submit a major revision addressing these points. Once these revisions are made, the manuscript will be reconsidered for final publication. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author Reviewer #1: (No Response) Reviewer #2: All comments have been addressed ********** 2. Is the manuscript technically sound, and do the data support the conclusions??> Reviewer #1: Yes Reviewer #2: Yes ********** 3. Has the statistical analysis been performed appropriately and rigorously? -->?> Reviewer #1: No Reviewer #2: Yes ********** 4. Have the authors made all data underlying the findings in their manuscript fully available??> The PLOS Data policy Reviewer #1: No Reviewer #2: Yes ********** 5. Is the manuscript presented in an intelligible fashion and written in standard English??> Reviewer #1: Yes Reviewer #2: Yes ********** Reviewer #1: I am very concerned about duality of publication however, what I find more concerning is the inclusion of the period of the pandemic without analysis of the period to enrich the manuscript and perhaps make the question of duality even less of an issue. Reviewer #2: This study addresses an important clinical question about ARDS outcomes in a resource-limited setting. The large sample size (353 patients over 8 years) is a notable strength, providing more robust statistical power than many single-center studies. Data collection was thorough – using a standardized case report form and Berlin definition criteria ensures the patient population is well-defined The analysis is rigorous, combining univariate and multivariate methods to identify independent mortality factors. The finding that early airway management during transfer (endotracheal intubation) is associated with improved survival is particularly novel and has practical implications. The manuscript is also well-organized and generally clear, which helps in conveying the findings. Overall, the research appears carefully conducted and fills a knowledge gap regarding pre-hospital care impact on ARDS outcomes in lower-middle-income countries. Suggestions for Improvement: Clarify the multivariable model building: Please add a brief description of how variables were chosen for the multivariate logistic regression (e.g. based on p-value cutoff or clinical importance). This will assure readers that the model was constructed without bias. If not already done, confirm that you checked for multicollinearity between predictors and that the events-per-variable ratio was sufficient for a reliable model. Citing a sample size rule (e.g., requiring ~50 events per variable) could reinforce that the analysis is well-powered In the Discussion, consider highlighting how your results align with prior studies. For example, earlier research has shown that delayed intubation in ARDS leads to higher mortality (56% vs 36% when intubation is early) This supports your finding that patients intubated during transfer had better outcomes. Drawing this parallel and citing such studies will strengthen the rationale for your recommendation on early intubation. Likewise, the classic risk factors you identified (age, severity scores, shock) are well known in ARDS nature, acknowledging this shows that your data are consistent with existing knowledge. The observed in-hospital mortality of 61.5% is quite high. It would be valuable to discuss possible reasons and compare with international figures. For instance, a large international ARDS study reported ~40% mortality; the substantially higher rate in your cohort may reflect the severity of cases referred to your center or resource limitations (e.g., fewer ICU interventions like ECMO). Emphasize how this finding underlines the urgency of improving critical care capacity. You might suggest specific strategies, such as better training for pre-hospital emergency teams in airway management or ensuring ventilators and skilled personnel are available during transport, to reduce delays in optimal care. Since you report that 36.7% of patients underwent cytokine adsorption therapy, readers may wonder if this intervention had any impact on outcomes. If data permit, consider commenting on whether therapies like cytokine adsorption (or others such as prone positioning, ECMO if applicable) were associated with improved outcomes or not. Even if a formal analysis wasn’t done, a short note acknowledging this point would be useful – for example, clarifying that cytokine adsorption was a rescue therapy used in the sickest patients (hence its effect is hard to discern) or that its benefit could not be confirmed in this study. This would address a potential question in readers’ minds about the role of such treatments. Before final publication, a careful read-through for minor language edits would be helpful. The manuscript is generally well-written, so only small tweaks are needed – e.g., adding missing words (“were”) or articles, and maintaining consistent tense. Ensuring each abbreviation is defined at first use and used consistently (for example, using either “ET” or “endotracheal tube” uniformly after definition) will avoid any confusion. These changes are minor but will polish the text and improve readability for a broad audience. By addressing the above points, the manuscript’s clarity and impact will be further enhanced. The core content and conclusions are strong; these suggestions are intended to refine the presentation and provide additional context for readers. ********** 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: Sagar Bathija ********** [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. |
| Revision 2 |
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Dear Dr. Do, 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 submitting the revised version of your manuscript entitled Factors related to mortality in patients with acute respiratory distress syndrome (ARDS) in a lower middle-income country: a retrospective observational study to PLOS ONE . We appreciate the substantial effort you have made to address the previous reviewer and editorial comments. Both reviewers acknowledge that the manuscript has improved considerably, with clearer presentation, stronger methodology, and an extended dataset that enhances the study’s relevance. The focus on inter-hospital transport and pre-hospital care adds an important dimension that is often underrepresented in the ARDS literature, particularly in resource-limited settings. After careful consideration of the reviewers’ feedback, the editorial decision is: Minor Revision . While the manuscript is close to being suitable for publication, several refinements are still recommended to strengthen the clarity and impact of your work:
Please revise the manuscript accordingly and submit the revised version together with a detailed response letter indicating how each point has been addressed. ============================== Please submit your revised manuscript by Nov 14 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.
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, Gurmeet Singh, M.D., Ph.D., Academic Editor PLOS ONE Journal Requirements: 1. 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. 2. 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 Authors, Thank you for submitting the revised version of your manuscript entitled "Factors related to mortality in patients with acute respiratory distress syndrome (ARDS) in a lower middle-income country: a retrospective observational study" to Plos One. We appreciate the substantial effort you have made to address the previous reviewer and editorial comments. Both reviewers acknowledge that the manuscript has improved considerably, with clearer presentation, stronger methodology, and an extended dataset that enhances the study’s relevance. The focus on inter-hospital transport and pre-hospital care adds an important dimension that is often underrepresented in the ARDS literature, particularly in resource-limited settings. After careful consideration of the reviewers’ feedback, the editorial decision is: Minor Revision. While the manuscript is close to being suitable for publication, several refinements are still recommended to strengthen the clarity and impact of your work: Mortality Rate Contextualization Please provide a deeper discussion of the high observed mortality rate (61.5%), particularly in relation to referral bias, resource limitations, and the availability of advanced therapies. COVID-19 Subgroup Analysis Expand the discussion to more explicitly address how the pandemic may have shaped ARDS case-mix, transport practices, and access to ventilatory support. Transport Data Limitations Highlight the limitations of the transport-related data more clearly, and if possible, provide a conceptual framework to guide interpretation of these findings. Adjunctive Therapies A brief discussion on adjunctive therapies (e.g., prone positioning, ECMO, HFNC, cytokine adsorption) would strengthen completeness, even if data remain limited. Language and Style We encourage further polishing of the language, including shortening long sentences, ensuring abbreviation consistency, and improving overall readability. Please revise the manuscript accordingly and submit the revised version together with a detailed response letter indicating how each point has been addressed. We look forward to receiving your revised manuscript soon. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author Reviewer #2: All comments have been addressed Reviewer #3: All comments have been addressed ********** 2. Is the manuscript technically sound, and do the data support the conclusions??> 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 Reviewer #2: Yes Reviewer #3: Yes ********** 5. Is the manuscript presented in an intelligible fashion and written in standard English??> Reviewer #2: Yes Reviewer #3: Yes ********** Reviewer #2: You guys did a solid job with the revisions. The paper is clearer, more rigorous, and adds useful insights into ARDS outcomes in a resource-limited setting. The focus on transport and pre-hospital care makes it stand out, since most ARDS studies focus only on ICU interventions. Main Points: They addressed all prior reviewer/editor concerns. The issue of “dual publication” is clarified—this is an updated dataset with a new focus, not a duplicate. You added a COVID vs. pre-COVID analysis, which showed no major difference in mortality but gives extra context. The stats section is much stronger now. You explained how they built the model, checked for multicollinearity (all fine), and discussed missing data honestly. Key result: intubation during transport strongly predicts survival. The effect size is big, but given the wide confidence intervals, I’d interpret it cautiously. Still, it’s a meaningful and practice-relevant finding. You added discussion of cytokine adsorption therapy—helpful for context, while noting it was used mainly in very sick patients. Reviewer #3: The manuscript has been substantially improved compared to the earlier version, and the authors have clearly made an effort to address the reviewers’ and editor’s concerns. The extended dataset, inclusion of the pandemic period, and focus on inter-hospital transport strengthen the study and add relevance. The finding regarding endotracheal intubation during transfer remains a novel and clinically meaningful contribution. Some areas would still benefit from refinement: - The high mortality rate (61.5%) needs deeper contextualization, particularly in relation to referral bias, resource limitations, and lack of advanced therapies. - The COVID-19 subgroup analysis is useful, but the discussion could emphasize more explicitly how the pandemic may have shaped ARDS case-mix, transport practices, and access to ventilatory support. - The limitations regarding transport data should be highlighted further; if possible, provide a conceptual framework to guide interpretation. - A short discussion on adjunctive therapies (cytokine adsorption, prone positioning, ECMO, HFNC) would strengthen the completeness of the discussion, even if data are limited. - Minor polishing of language (shorter sentences, abbreviation consistency) would improve readability. Overall, this revision represents a meaningful contribution to the ARDS literature in resource-limited settings. With the suggested refinements, it should be suitable for publication. ********** 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: Yes: Sagar Bathija 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 |
| Revision 3 |
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Factors related to mortality in patients with acute respiratory distress syndrome (ARDS) in a lower middle-income country: a retrospective observational study PONE-D-24-35750R3 Dear Dr. Do, 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. For questions related to billing, please contact billing support . 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, Gurmeet Singh, M.D., Ph.D., Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: |
| Formally Accepted |
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PONE-D-24-35750R3 PLOS ONE Dear Dr. Do, 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 You will receive further instructions from the production team, including instructions on how to review your proof when it is ready. Please keep in mind that we are working through a large volume of accepted articles, so please give us a few days 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. You will receive an invoice from PLOS for your publication fee after your manuscript has reached the completed accept phase. If you receive an email requesting payment before acceptance or for any other service, this may be a phishing scheme. Learn how to identify phishing emails and protect your accounts at https://explore.plos.org/phishing. 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. Gurmeet Singh Academic Editor PLOS ONE |
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