Dear  Adeniji,

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Opeyemi O Babatunde, Ph.D., MPh., B.Physio

Academic Editor

PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

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

Reviewer #1: No

Reviewer #2: Yes

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

Reviewer #1: Yes

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

Reviewer #1: Yes

Reviewer #2: Yes

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

Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: I generally found that the conclusion sections in both the abstract and main text did not accurately reflect the findings of the analysis outlined in the Results and Discussion section, and at times included statements that appear to be unsubstantiated by the study. I would suggest that these sections are revised. Please find my specific comments below.

1. Weathering the storm of COVID-19 pandemic in UK and Australia First Contact Physiotherapy

Services: A cross-contextual survey investigating the timing and type of rapidly implemented

changes

Could the authors please clarify how they defined “rapidly implemented changes”, and in what way the questionnaire ensured that respondents only focused on these? Note that although one of the main findings of the survey is that the timing of changes implementation was mostly rapid (within 3 months), this does not mean that the survey was investigating rapidly implemented changes.

2. Aim: This study aims to explore the type, and the timing of changes implemented in FCPS during the COVID-19 pandemic in the UK and Australia.

The manuscript frequently references "changes implemented" or "adaptations" in service provision (including in the title). I have two concerns in this regard:

- The changes considered in the survey (Qs 10 to 26) do not differentiate between those formally introduced as policy changes by healthcare providers and unintended changes that may have arisen due to other factors. Such factors include shifts in population needs (e.g., linked to lifestyle changes associated with lockdowns), alterations in healthcare-seeking behaviours, or modifications in healthcare providers’ working patterns that were demand- rather than policy-driven. The authors should clarify throughout the manuscript that the study aimed to document perceived changes in service provision, without implying that these changes were necessarily the result of “adaptations” by healthcare providers. In this particular sentence, I would also clarify that these changes were “self-reported by FCPS providers”.

- The study only considered *initial* changes to FCPS (see point 5). This should be clarified throughout the manuscript.

3. From the questionnaire

“For some, changes occurred in the first three months of the COVID 19 pandemic while it took more months for others.”

One of the main findings of this study appears to be that the initial changes to MSK service delivery were mostly implemented during the first three months of the global pandemic. I therefore find it concerning that the introduction to the questionnaire appears to be highlighting “in the first three months” as a plausible answer to the timing questions Qs 5 and 7. Although “more months” is mentioned in the same sentence, it aggregates all other possible answers to these questions into one category, potentially emphasising the first timeframe more strongly. This is concerning given that respondents are being asked to recall events that occurred three years prior, making their recollections susceptible to suggestion. How do the authors justify the need to include this sentence in the questionnaire’s introduction? This potential source of bias should be acknowledged in the discussion.

4. From the questionnaire “The following set of questions will explore changes to access, mode of delivery, condition managed, interventions provided, patient case load, and administrative duties in your FCP service. The responses you provide should be based on the first changes that occurred in your FCP service delivery for MSK patients during the pandemic”

Participants were asked to describe the “first changes” that occurred in service delivery. This phrasing is ambiguous, as it is unclear:

- Whether these changes should be interpreted as formal policy implementations or simply as observations of shifts in practice (e.g., changes in healthcare-seeking behaviour);

- Which period of time respondents should have considered as representing the “first changes.” Does this refer to any period until another change was introduced (or observed) in service provision? How significant must a subsequent change have been to delineate the timeframe?

- How it relates to previous questions on service suspension;

Given these ambiguities, how confident are the authors that participants would have interpreted these instructions in a consistent manner? And how certain are they that respondents could accurately recall time variations in service provision three years later, particularly considering the likelihood of multiple policy changes throughout the pandemic on timescales of weeks/months?

5. This study aims to explore the type and the timing …

I have two concerns regarding the use of the term “timing” in this context. Firstly, the study focuses exclusively on the initial implementation of changes to service provision and does not account for how these changes may have evolved throughout the pandemic. This limitation means the study cannot determine whether more significant changes occurred at later stages of the pandemic, or how long those initial changes lasted (see point 4). Since the phrase “timing of changes” typically implies not only their onset but also their progression over time, its use here may be misleading. I suggest making it clear that the study concerns only the onset of changes.

Secondly, I am concerned about the use of a “universal” time frame to calibrate the timing of changes. As noted in the manuscript, “Each country responded differently to the COVID-19 pandemic,” and “lockdown measures were implemented across Australian states with varied timing.” Furthermore, the timing and severity of pandemic waves differed significantly between countries, regions, and states. How do the authors justify using the declaration of COVID-19 as a global pandemic (by whom? Please add) as a uniform reference point across the UK and Australia, considering these contextual differences?

6. “An international cross-sectional study was conducted, using an online survey tool. Data were

collected from January-April 2023 from physiotherapists managing MSK patients in PC and ED across the UK and Australia, respectively”.

It should be made clear that the data was collected from physiotherapists who fulfilled the study’s eligibility criteria, which stated that only responses from providers who recalled changes in MSK service delivery would be considered.

7. One hundred and fifty-three participants were included in the analysis with 64.1% based in the UK and 35.9% in Australia

This should be in the methodology, not the results.

8. The main age group were 35-44 years (42.2%), with 59.3% females

The age and gender of the provider was not shown to be significant in any part of the analysis. Why is it included as a main result in the abstract?

9. 75.7% of the changes in the delivery…

The questionnaire only asked participants when the first changes took place, so this sentence should read "75.7% of initial changes" or similar.

10. “75.7% of the changes in the delivery of FCPS mostly occurred during the initial three months

of COVID-19’s declaration as a global pandemic”

What does “mostly” mean in this sentence?

11. The timing and country had a mixed effect on the variables of change.

Please report the most significant results in the abstract.

12. Adaptations in FCPS during the COVID-19 pandemic varied across countries

This study only considered two countries, and therefore does not provide enough statistical evidence to support this statement.

Furthermore, due to the complete overlap between the country and the type of service delivery setting considered (PC settings in the UK and ED settings in Australia), it is impossible to determine whether similar delivery settings in the two countries experienced different or similar changes in FCPS provision. To substantiate such a claim, the authors would need to collect additional data from PC settings in Australia and ED settings in the UK and account for these variables in their analysis.

With regards to the use of the term “adaptations” in this context, please refer to comment 2.

13. This variation underscores the need for timely and context-specific improvement strategies

Variation in observed changes between two different countries in itself doesn’t underscore a) the need for improvements, or b) the need for these improvements to be “context specific” (observing variation does not rule out the possibility that adaptations introduced in country A would have led to better outcomes in country B had they been applied there too). Furthermore, the analysis of the survey data did not investigate the link between the type of changes observed and the quality of service delivered, and therefore cannot provide any conclusions as to what type of changes - context specific or not - led to better outcomes. Please rewrite the conclusions to better reflect the findings reported in the results section.

14. The UK reported 59.2% (n=42) increased use of the triaging process

In this and many other instances where results are reported (e.g. In terms of intervention provided during the pandemic, self-management increased more in the UK 86.8% (n=59), compared to Australia 44.7%) the imprecise phrasing makes the meaning of the sentence open for misinterpretation: As is, the sentence may be incorrectly interpreted as suggesting that the UK reported a 59.2% increase in the triaging process, whereas it should read “Among UK-based respondents, 59.2% observed an increased use of the triaging process”. Please correct this throughout the manuscript, and also in the Tables.

15. The COVID-19 pandemic led to changes in FCPS within the first three months of its declaration as a global pandemic in both the UK and Australia.

The “eligibility criteria” used to select the 153 survey participants considered in this analysis means this sample cannot be used to determine whether any statistically significant changes to MSK service provision occurred during the COVID-19 pandemic in either country. This sentence, therefore, is unsubstantiated unless a reference is provided or further analysis conducted.

The survey collected raw data (which was excluded from the sample of data analysed) from respondents who reported observing no changes in service provision during the pandemic (20.3% overall). If analysed, this data could provide some evidence in support of this statement. However, the title of the survey itself (“Exploring changes to first contact physiotherapy services for musculoskeletal patients during COVID-19 Pandemic”) and stated objectives is very likely to have introduced a bias in the collection of responders, favouring participation from individuals who indeed observed changes in service provision. The authors should either a) conduct an analysis on the statistical significance of the claim that the COVID19 pandemic led to changes in FCPS from their complete raw data sample while providing a satisfactory explanation for why the above-mentioned bias is not a cause for concern, b) provide a reference for this sentence, or c) remove this sentence.

16. These changes varied depending on contextual factors influenced by policies, needs, supply and demands during the pandemic

This study did not consider the role of policy implementation, nor collect statistics on the needs in the local population, or on the “demand” during the pandemic. This statement therefore is not substantiated by the study.

17. For instance, patients continued to have access to the FCPS due to the availability of telehealth in the PC setting, while the ED saw a significant reduction in MSK patient presentations, as it primarily continued with traditional face-to-face services based on the need for hands-on acute care.

This statement seems to be in direct contradiction with the earlier statement that “Among UK respondents, 60.0% (n=53) reported suspensions, compared to only 9.3% (n=5) of respondents from Australia”. How do you reconcile the two statements?

18. This underscores the necessity for the development of context tailored implementation

Since the relationship between observed changes (some of which may have been beyond the control of providers and therefore fall beyond the scope of ‘implementation’), “context” (how is context defined?), and outcomes haven't been investigated in this analysis, this statement is unsubstantiated by this study.

Reviewer #2: This is an interesting topic and author write it well but still need some gramatical corrections. Valid stat analysis is done. authors has makrked all the valuable points in manuscript. Despite some corrections are required which are mention below:

introduction need to be deined more explaining about the topic

discussion also need some minor corrections

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Reviewer #1: Yes:  Margherita Molaro

Reviewer #2: No

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Dear Dr. Adeniji,

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.

publication criteria  and not, for example, on novelty or perceived impact.

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

Please submit your revised manuscript by Aug 15 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.

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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,

Opeyemi O Babatunde, Ph.D., MPh., B.Physio

Academic Editor

PLOS ONE

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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:

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

Reviewer #1:

Reviewer #3: (No Response)

Reviewer #4: All comments have been addressed

Reviewer #5: (No Response)

Reviewer #6: (No Response)

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

Reviewer #1: No

Reviewer #3: Partly

Reviewer #4: Yes

Reviewer #5: Partly

Reviewer #6: Yes

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

Reviewer #1: Yes

Reviewer #3: Yes

Reviewer #4: Yes

Reviewer #5: (No Response)

Reviewer #6: Yes

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

The PLOS Data policy

Reviewer #1: Yes

Reviewer #3: No

Reviewer #4: Yes

Reviewer #5: Yes

Reviewer #6: Yes

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

Reviewer #1: Yes

Reviewer #3: No

Reviewer #4: Yes

Reviewer #5: Yes

Reviewer #6: Yes

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Reviewer #1: The authors have comprehensively addressed the points raised in my first review. I believe currently there is only one major outstanding issue that should be addressed by the authors. I also include a few minor comments.

Major comment:

The manuscript repeatedly states (in the abstract, results, and conclusions section) that “both [countries] demonstrated similar levels of inadequate readiness for rapid changes in service delivery and moderate levels of responsiveness to the healthcare needs of MSK patients”. I believe at present the analysis has not sufficiently demonstrated either claim.

With regards to the claim of “moderate levels of responsiveness”: The study should more clearly define the use of the term “moderate”. In the text, however, this is discussed as being indicative of an issue with responsiveness (e.g. “The moderate level of FCPS responsiveness could be attributed to *inadequate* readiness”, “the changes reported in FCPS in the UK and Australia during the pandemic generally reflect the experiences of changes reported in healthcare service [..] exposed the fragility of the current health systems and their unpreparedness to deal with the turbulence of the unexpected”).

However, from what I can see from Fig. 1B, in the UK only in the case of “Choice (in person or virtual)” did a majority of respondents disagree with the statement “I believe my FCP services met the patient's expectations and needs”. In the case of Australia, in none of the criteria a majority of respondents disagreed with that statement.

If only in a minority of cases were issues identified with the level of care received by the patients, why is this indicative of an issue with responsiveness? In what way does it reflect “the fragility of the current health systems and their unpreparedness to deal with the turbulence of the unexpected”?

With regards to the claim of “inadequate readiness”: It is unclear how the authors determined that both settings demonstrated levels of inadequate readiness; in particular:

Based on Fig 1A, respondents were asked to express their opinion on readiness in 15 different areas. However the results section only reports answers to five (access to information, effective leadership, stakeholder buy-in, tech support, and infrastructure); why was only this subset considered? Why were areas as important as “Outputs & Results” not included?

The criteria used to determine whether there is overall agreement with a particular statement are unclear. Based on my understanding, the survey asked respondents whether they “agreed,” “disagreed,” or were “neutral” regarding readiness in various areas. When reporting overall agreement with readiness, the authors appear to use a majority rule—that is, they consider respondents to be in agreement if more than 50% selected “agree”. However, it seems the authors apply a different standard when interpreting disagreement.

Specifically, they appear to treat disagreement with readiness as equivalent to agreement with a lack of readiness (this in itself should be explicitly stated in the text as an assumption), but without requiring a majority for overall interpretation. For example, in support of the statement that “participants agreed there was a lack of readiness for change in terms of infrastructure,” they cite agreement levels of 42.4% (UK) and 39.0% (Australia)—both below the 50% threshold. By contrast, in other areas such as access to information or effective leadership, the authors emphasize whether a majority agreed, suggesting inconsistency in their criteria for interpreting overall agreement levels. I believe their reasoning is that, in the case of the UK, more respondents selected “disagree” than selected “agree” or “neutral” individually. However, this still means that only a minority (<50%) of participants explicitly disagreed with the statement of readiness. Therefore, I do not think the authors can reasonably claim that respondents “agreed that there was lack of readiness for change in terms of infrastructure” based on this result.

In the case of Australia, however, I believe the authors have made a mistake when quoting 39% in disagreement with readiness of infrastructure, based on Fig 1A. Please clarify the discrepancy.

Based on the subset of 5 areas considered, it would appear that only in 2 out of 5 cases a majority of respondents thought that their FCPS was not ready for rapidly implemented changes. In what way does this support the statement of “inadequate readiness for rapid changes in services”?

To establish whether this claim can be supported, authors should 1) use consistent criteria of majority, and 2) summarise all areas investigated in the survey (especially “results and outcomes”) or motivate why only 5/15 are relevant.

Overall, I believe the survey results are more nuanced—and at times contradictory to existing literature—than currently acknowledged. The conclusions should reflect this complexity, not just for the sake of accuracy, but also because it adds to the interest and value of the study.

Minor comments:

- Suggest using “reported changes” in the title

- Fig 1 axes should be number of respondents, not frequency.

- Throughout the manuscript, clarify that when analysing responses as a function of country, this is really a function of country + type of service (ED and PC) because of the degeneracy with which the survey was constructed. Maybe this combination could be redefined as “setting”.

Reviewer #3: Thanks for your effort to cover the comments but In most cases, the answers and edits made did not cover the reviewer's comments.

Reviewer #4: Authors carefully responded to Reviewer 1's remarks by revising the title, abstract, introduction, and discussion for clearer definition of the scope of the study on first, perceived, and self-reported changes early in COVID-19 in First Contact Physiotherapy Services (FCPS). They acknowledged limitations such as recall bias, ambiguity in definitions, and sample representativeness. Technical terms such as "adaptations", "timing" were also clarified to prevent misinterpretation. Findings and tables were rewritten to ensure accuracy and unsubstantiated claims were removed and made more specific. Structural and grammatical suggestions for introduction and discussion were applied. Editorial requests were accommodated, such as ethics clarification, participant consent information, data availability via a DOI, and format changes according to PLOS ONE guidelines. Overall, the authors thoroughly revised with substantive changes that sufficiently resolved the reviewer's and editor's concerns and made the manuscript more transparent, consistent, and scientifically valid. Revisions reflect a strong effort to align the content with journal standards and reviewer expectations.

Reviewer #5: The definitions of "rapidly implemented changes" and the vagueness of the survey questions could cause respondents to perceive them differently. Concerns around recall bias are further raised by the use of self-reported data. The findings are not well represented in the conclusion, and the authors ought to make a clearer contrast between observed changes in practice and official policy changes. The approach, a cross-sectional survey using physiotherapists' self-reported data, is suitable for documenting perceived changes. However, issues with recall bias and the imprecise definition of "first alterations" could compromise the validity of the results. Overall, even though the goal is pertinent, the method's drawbacks must be carefully considered. Resolving these problems could improve the validity and significance of the study.

Reviewer #6: Thank you for the invitation to review the manuscript titled “Weathering the storm of COVID-19 pandemic: A cross-sectional survey of changes in first contact physiotherapy services in the UK and Australia”

The manuscript is concise and scientifically written using recent literature

I have the following comments to offer in order to improve the quality of the study for use especially during pandemic period to enhance healthcare services in the two regions and globally

Reviewer: Adamu Ahmad Adamu PT PhD

Comments:

1. Authors should give adequate explanation to changes in service delivery

2. Conclusion in the abstract should highlight the effect on changes in service delivery in relation to future pandemic

3. What are the initial changes noticed in UK and Australia during the pandemic?

4. How did the authors ensured the participants were able to recall changes in their practice during the pandemic, was any instrument used to ascertain cognitive function?

5. What is the educational level of the participants?

6. The sample size is a bit low to make conclusion based on the findings

7. Explain the experiences and qualifications of the 12 participants drawn for the pilot test of the study instrument

8. In Table 1, the first column should have a heading like item or domain for clarity

9. Recommendation for future study should be incorporated to address gaps in the existing study

10. Any conflict of interest resolved by the authors?

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what does this mean? ). If published, this will include your full peer review and any attached files.

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Reviewer #1: Yes:  Margherita Molaro

Reviewer #3: No

Reviewer #4: Yes:  Fawaz Alrasheedi

Reviewer #5: Yes:  Ahmed Ibrahim Ahmed Al Kharusi

Reviewer #6: Yes:  Adamu Ahmad Adamu

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Attachments

Attachment

Submitted filename: WEATHERING REVIEWER COMMENTS.docx

Dear Dr. Adeniji,

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 06 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'.

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,

Aamir Ijaz, MD, FCPS, FRCP, MCPS-HPE

Academic Editor

PLOS ONE

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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.

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

Reviewer #1: All comments have been addressed

Reviewer #5: All comments have been addressed

**********

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

Reviewer #1: Yes

Reviewer #5: Yes

**********

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

Reviewer #1: Yes

Reviewer #5: Yes

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

The PLOS Data policy

Reviewer #1: Yes

Reviewer #5: Yes

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

Reviewer #1: Yes

Reviewer #5: Yes

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Reviewer #1: (No Response)

Reviewer #5: Clear scope and title updated to “reported changes.”

Abstract now reflects findings accurately and avoids overclaims.

Methods are appropriate and well justified.

Readiness/responsiveness criteria now consistently use ≥50% cut-off as reviewers requested.

All reviewer concerns appear carefully addressed with detailed responses.

Ethics, consent, data availability, conflicts of interest, and CHERRIES checklist are complete.

Tables and figures are reorganized and clarified (e.g. “frequency” → “number of respondents”).

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what does this mean? ). If published, this will include your full peer review and any attached files.

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Reviewer #1: No

Reviewer #5: Yes:  Ahmed Ibrahim Al Kharusi

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Weathering the storm of COVID-19 pandemic: A cross-sectional survey of reported changes in first contact physiotherapy services in the UK and Australia

PONE-D-24-54679R3

Dear Dr. Adeniji,

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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Academic Editor

PLOS One

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

Reviewer #5: All comments have been addressed

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

Reviewer #5: Yes

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

Reviewer #5: Yes

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

The PLOS Data policy

Reviewer #5: Yes

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

Reviewer #5: Yes

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Reviewer #5: Thank you for addressing all the comments and now the manuscript is very informative and no more changes required

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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 #5: Yes:  AHMED IBRAHIM AL KHARUSI

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