Postmastectomy radiotherapy in pN1 breast cancer: Survival outcomes and prognostic factors from a single-institution cohort

Raksha M. Narasimhan; Aren Singh Saini; Kayla Samimi; Ifeanyichukwu Ogobuiro; Xuesen Zhao; Sunwoo Han; Cristiane Takita; Crystal S. Taswell

doi:10.1371/journal.pone.0341754

Peer Review History

Original SubmissionFebruary 6, 2026
26 Mar 2026 Decision Letter - Satyajeet Rath, Editor -->PONE-D-26-01325-->-->Postmastectomy Radiotherapy in pN1 Breast Cancer: Survival Outcomes and Prognostic Factors From a Single-Institution Cohort-->-->PLOS One Dear Dr. Narasimhan, 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: Major Revision ============================== Please submit your revised manuscript by May 10 2026 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 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. As the corresponding author, your ORCID iD is verified in the submission system and will appear in the published article. PLOS supports the use of ORCID, and we encourage all coauthors to register for an ORCID iD and use it as well. Please encourage your coauthors to verify their ORCID iD within the submission system before final acceptance, as unverified ORCID iDs will not appear in the published article. Only the individual author can complete the verification step; PLOS staff cannot verify ORCID iDs on behalf of authors. We look forward to receiving your revised manuscript. Kind regards, Satyajeet Rath 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. Thank you for stating the following in the Acknowledgments Section of your manuscript: “None” We note that you have provided funding information that is not currently declared in your Funding Statement. However, funding information should not appear in the Acknowledgments section or other areas of your manuscript. We will only publish funding information present in the Funding Statement section of the online submission form. Please remove any funding-related text from the manuscript and let us know how you would like to update your Funding Statement. Currently, your Funding Statement reads as follows: “The author(s) received no specific funding for this work.” Please include your amended statements within your cover letter; we will change the online submission form on your behalf. 3. In the online submission form you indicate that your data is not available for proprietary reasons and have provided a contact point for accessing this data. Please note that your current contact point is a co-author on this manuscript. According to our Data Policy, the contact point must not be an author on the manuscript and must be an institutional contact, ideally not an individual. Please revise your data statement to a non-author institutional point of contact, such as a data access or ethics committee, and send this to us via return email. Please also include contact information for the third party organization, and please include the full citation of where the data can be found. 4. We notice that your supplementary tables are included in the manuscript file. Please remove them and upload them with the file type 'Supporting Information'. Please ensure that each Supporting Information file has a legend listed in the manuscript after the references list. 5. 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 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. --> Reviewer #1: Yes Reviewer #2: Partly Reviewer #3: No ******** -->2. Has the statistical analysis been performed appropriately and rigorously? --> Reviewer #1: Yes Reviewer #2: No Reviewer #3: N/A ****** -->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 Reviewer #3: Yes ****** -->4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.--> Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: Yes ****** -->5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)--> Reviewer #1: This is an automated report for PONE-D-26-01325. This report was solicited by the PLOS One editorial team and provided by ScreenIT. ScreenIT is an independent group of scientists developing automated tools that analyze academic papers. A set of automated tools screened your submitted manuscript and provided the report below. Each tool was created by your academic colleagues with the goal of helping authors. The tools look for factors that are important for transparency, rigor and reproducibility, and we hope that the report might help you to improve reporting in your manuscript. Within the report you will find links to more information about the items that the tools check. These links include helpful papers, websites, or videos that explain why the item is important. While our screening tools aim to improve and maintain quality standards they may, on occasion, miss nuances specific to your study type or flag something incorrectly. Each tool has limitations that are described on the ScreenIT website. The tools screen the main file for the paper; they are not able to screen supplements stored in separate files. Please note that the Academic Editor had access to these comments while making a decision on your manuscript. The Academic Editor may ask that issues flagged in this report be addressed. If you would like to provide feedback on the ScreenIT tool, please email the team at ScreenIt@bih-charite.de. If you have questions or concerns about the review process, please contact the PLOS One office at plosone@plos.org. Reviewer #2: Information in tables of results section should be explained in texts as well. The statistical analysis should be revisited. if only patient with mastectomy between 2016 to 2022 are taken then how the IQR upper range of follow up be 156 months in march 2026? The no. of patients between different demographic parameters are different. This needs explanation. e.g. - cancer type N=49, No of positive nodes N=51.and similarly there are different event rates for different parameters as well. This needs explanation. in line 190-191 it is inappropriate to say tending to wards significant with wide CI & P=0.263. Such loose inferences are there in other places in results section as well. in a study where patients included are patients with mastectomy in 2016 to 2022 the graphs of Kaplan Meier are reaching upto 288 months of follow up. in 2026 maximum time can be around 120 months. Overall the data needs to be reverified and statistical analysis needs to be revisited with complete overhauling of the results section of the manuscript. Reviewer #3: I extend my sincere appreciation to the Editor for the opportunity to review this manuscript and to the authors for their thoughtful submission. The study presents a descriptive, retrospective evaluation of two cohorts of breast cancer patients treated with mastectomy and axillary surgery at a single center—one cohort receiving post-mastectomy radiotherapy (PMRT) and the other not. The primary objective was to compare survival outcomes between cohorts. The authors provide a comprehensive characterization of the study population, encompassing clinical and pathological features, and investigate associations between clinical/therapeutic variables and survival. Their detailed survival analyses for both cohorts highlight select clinical characteristics and reveal no significant differences. These findings may inform institutional understanding of the studied population and guide adaptations to local management protocols. Nevertheless, the retrospective, descriptive methodology, coupled with modest sample sizes in each cohort, limits the generalizability of findings to diverse populations, thereby diminishing their wider applicability. Moreover, the manuscript recapitulates well-established prognostic factors without introducing “novel” insights or contributions specific to this population. In light of these major constraints, I cannot recommend acceptance for publication in this journal. ****** -->6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.--> Reviewer #1: No Reviewer #2: No Reviewer #3: No ******** [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] To ensure your figures meet our technical requirements, please review our figure guidelines: https://journals.plos.org/plosone/s/figures You may also use PLOS’s free figure tool, NAAS, to help you prepare publication quality figures: https://journals.plos.org/plosone/s/figures#loc-tools-for-figure-preparation. NAAS will assess whether your figures meet our technical requirements by comparing each figure against our figure specifications. Attachments Attachment Submitted filename: report_10.64898+2026.02.13.26346274.pdf https://doi.org/10.1371/journal.pone.0341754.r001
Revision 1
14 Apr 2026 Author Response Response to Reviewers: Postmastectomy Radiotherapy in pN1 Breast Cancer: Survival Outcomes and Prognostic Factors From a Single-Institution Cohort Journal Requirements: 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. Response: The manuscript has been revised to meet PLOS ONE’s style requirements. 2. Please remove any funding-related text from the manuscript and let us know how you would like to update your Funding Statement. Currently, your Funding Statement reads as follows: “The author(s) received no specific funding for this work.” Please include your amended statements within your cover letter; we will change the online submission form on your behalf. Response: All funding-related text has been removed from the manuscript. The amended funding statement is included in our revised cover letter. 3. Please revise your data statement to a non-author institutional point of contact, such as a data access or ethics committee, and send this to us via return email. Please also include contact information for the third-party organization, and please include the full citation of where the data can be found. Response: We changed the contact point in the submission form to the following: “Data supporting the findings of this study are not publicly available due to institutional and ethical restrictions related to patient confidentiality. The data are available upon reasonable request from the University of Miami Human Subjects Research Office, which serves as the institutional oversight body for this study. Requests for data access may be sent to: Human Subjects Research Office University of Miami Email: hsro@miami.edu Phone: 305-243-3195 Website: www.hsro.miami.edu Study reference: HSRO Study Number: 20090856 Study Title: Collection of Characteristics and Outcome of Patients Treated for Breast Cancer by Physicians in the Department of Radiation Oncology IRB Approval Date: December 1, 2009 Data access is subject to institutional review and approval and may require a data use agreement in accordance with University of Miami policies.” 4. We notice that your supplementary tables are included in the manuscript file. Please remove them and upload them with the file type 'Supporting Information'. Please ensure that each Supporting Information file has a legend listed in the manuscript after the references list. Response: The requested changes have been made. 5. 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. Response: Not applicable. Comments to the Author: We thank the reviewers and editorial team for their careful evaluation of our manuscript. We have addressed the concerns raised and outline our responses below. 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #2: Partly Reviewer #3: No Response: We appreciate the reviewers’ assessment. In response, we carefully revised the manuscript to ensure that our conclusions are appropriately supported by the data and not overstated. Specifically, we refined the language in the Results and Discussion sections to avoid overinterpretation of non-significant findings and to more clearly align our results with our conclusions. We also strengthened the Discussion to more explicitly acknowledge the limitations of our study, including retrospective single-institution design and modest sample size, which may affect generalizability. We also clarified aspects of the dataset that were previously vague, including handling of missing data and variable-specific sample sizes. We hope these revisions address the concerns raised and reinforce that the study is methodologically sound, with appropriately grounded conclusions. 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: No Reviewer #3: N/A Response: We thank Reviewer #2 for highlighting their concerns about our statistical analysis. We carefully revisited all analyses to ensure accuracy and internal consistency. Of note, we corrected the study timeframe to distinguish between the years of mastectomy (2016-2022) and the full range of diagnosis and follow-up (1999-2023), which resolves the previously noted inconsistencies in follow-up duration and Kaplan-Meier estimates. We also revised the Results section to more clearly describe the statistical findings presented in the tables, ensuring that key results are interpretable within the text and that readers do not have to rely on tables alone to make sense of our findings. In addition, we clarified discrepancies in sample sizes across variables by explicitly noting missing data. We also reported evaluable denominators for different variables. We removed imprecise language such as “trending toward significance” and replaced these phrases with more accurate and specific interpretations of statistical results. We strongly believe these revisions substantially improve the rigor, clarity, and transparency of the statistical analysis. 3. Have the authors made all data underlying the findings in their manuscript fully available? Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: Yes Response: We appreciate the reviewers’ confirmation of our data. As previously noted, we have further clarified our Data Availability Statement to include a non-author institutional point of contact (University of Miami Human Subjects Research Office), along with full contact information and study citation. 4. Is the manuscript presented in an intelligible fashion and written in standard English? Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: Yes Response: We thank the reviewers for their positive assessment. While making revisions, we have further edited the manuscript for clarity and flow, particularly in the Results and Discussion sections. Reviewer Comments to the Author Reviewer #1: This is an automated report for PONE-D-26-01325. This report was solicited by the PLOS One editorial team and provided by ScreenIT. ScreenIT is an independent group of scientists developing automated tools that analyze academic papers. A set of automated tools screened your submitted manuscript and provided the report below. Responses: 1. Rigor a. Randomization: Not applicable (retrospective cohort study) b. Blinding: Not applicable (retrospective cohort study) c. Power Analysis: A formal power/sample size calculation was not performed, as this study was retrospective in design. The sample size was determined by including all eligible patients who met inclusion criteria during the study period. 2. Transparency a. Open Code: No custom code was used for the analysis. Statistical analyses were performed using standard software (SAS version 9.4). b. Open Data: Due to IRB restrictions and patient privacy concerns, the data is not available to the public. Data is stored in a secure institutional repository and may be accessed upon reasonable request to the corresponding author in accordance with institutional policies. Reviewer #2: 1. Information in tables of results section should be explained in texts as well. Response: We have revised the Results section to more explicitly describe and interpret the key findings presented in Tables 1-3. We summarized descriptions of baseline cohort characteristics and highlighted the most clinically relevant associations from the univariable Cox regression analyses to improve clarity and ensure that the reader may understand the main findings from the manuscript itself rather than having to rely on the tables. 2. The statistical analysis should be revisited. If only patient with mastectomy between 2016 to 2022 are taken then how the IQR upper range of follow up be 156 months in March 2026? Response: Thank you for pointing out this error. We fixed this mistake by correcting the date range to 1999-2023, which represents the earliest date of diagnosis to the latest date of follow-up. The 2016-2022 time frame corresponded the range of years during which participants underwent mastectomy. 3. The no. of patients between different demographic parameters are different. This needs explanation. e.g. - cancer type N=49, No of positive nodes N=51 and similarly there are different event rates for different parameters as well. This needs explanation. Response: Thank you for the comment. This observed discrepancy is due to variable-specific missing values. To further clarify this within the manuscript, we added note of "For a variable with missing value, we clarified the evaluable number of participants and events after excluding the missing values." to Tables 2 and 3 as well as Supplemental Table 1 and 2. 4. In line 190-191 it is inappropriate to say tending towards significant with wide CI & P=0.263. Such loose inferences are there in other places in results section as well. Response: We changed the wording to “not significant differences between the PMRT and non-PMRT groups” in line 190-191. This was the only place we encountered such an issue. 5. In a study where patients included are patients with mastectomy in 2016 to 2022 the graphs of Kaplan Meier are reaching up to 288 months of follow up. in 2026 maximum time can be around 120 months. Response: Please see our response to comment #1. With the corrected timeframe of 1999-2023, the maximum follow-up time is consistent with 288 months. Reviewer #3: I extend my sincere appreciation to the Editor for the opportunity to review this manuscript and to the authors for their thoughtful submission. The study presents a descriptive, retrospective evaluation of two cohorts of breast cancer patients treated with mastectomy and axillary surgery at a single center—one cohort receiving post-mastectomy radiotherapy (PMRT) and the other not. The primary objective was to compare survival outcomes between cohorts. The authors provide a comprehensive characterization of the study population, encompassing clinical and pathological features, and investigate associations between clinical/therapeutic variables and survival. Their detailed survival analyses for both cohorts highlight select clinical characteristics and reveal no significant differences. These findings may inform institutional understanding of the studied population and guide adaptations to local management protocols. Nevertheless, the retrospective, descriptive methodology, coupled with modest sample sizes in each cohort, limits the generalizability of findings to diverse populations, thereby diminishing their wider applicability. Moreover, the manuscript recapitulates well-established prognostic factors without introducing “novel” insights or contributions specific to this population. In light of these major constraints, I cannot recommend acceptance for publication in this journal. Response: We sincerely thank the reviewer for their thoughtful and detailed evaluation of our manuscript and for highlighting these important considerations. We agree that the retrospective single-institution design and modest sample size limit generalizability and statistical power. We have revised the Discussion to more explicitly acknowledge these limitations. We have also refined the framing of our study to better contextualize its contribution within the existing literature. While our findings are consistent with previously established prognostic factors and do not introduce novel predictors, we emphasize that they provide contemporary validation in the real-world modern era of systemic therapy, where the absolute benefit of PMRT in pN1 disease remains under ongoing debate. We have also adjusted our limitations and conclusions sections to avoid overinterpretation and jumping to false conclusions. We hope these revisions clarify the value of our study in its contributions to contemporary, individualized decision-making in this clinically heterogeneous population. Attachments Attachment Submitted filename: PLOS Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0341754.r002
12 May 2026 Decision Letter - Satyajeet Rath, Editor Postmastectomy Radiotherapy in pN1 Breast Cancer: Survival Outcomes and Prognostic Factors From a Single-Institution Cohort PONE-D-26-01325R1 Dear Dr. Narasimhan, 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, Satyajeet Rath Academic Editor PLOS One Additional Editor Comments (optional): Reviewers' comments: Reviewer's Responses to Questions -->Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.--> Reviewer #2: All comments have been addressed Reviewer #3: (No Response) ******** -->2. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. --> Reviewer #2: Yes Reviewer #3: No ****** -->3. Has the statistical analysis been performed appropriately and rigorously? --> Reviewer #2: Yes Reviewer #3: N/A ****** -->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 #2: Yes Reviewer #3: Yes ****** -->5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.--> Reviewer #2: Yes Reviewer #3: Yes ****** -->6. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)--> Reviewer #2: Authors have incorporated the changes as suggested and have made the required changes in the manuscript. Reviewer #3: I thank the authors for the review and the revisions made to the manuscript; however, I believe the primary limitation of the manuscript is the sample size of the study, which is insufficiently representative to permit generalization of the conclusions and renders the study's relevance somewhat difficult to accept for publication in this journal ****** -->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 #2: No Reviewer #3: No ******** https://doi.org/10.1371/journal.pone.0341754.r003
Formally Accepted
Acceptance Letter - Satyajeet Rath, Editor PONE-D-26-01325R1 PLOS One Dear Dr. Narasimhan, 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. Satyajeet Rath Academic Editor PLOS One https://doi.org/10.1371/journal.pone.0341754.r004

Open letter on the publication of peer review reports

PLOS recognizes the benefits of transparency in the peer review process. Therefore, we enable the publication of all of the content of peer review and author responses alongside final, published articles. Reviewers remain anonymous, unless they choose to reveal their names.

We encourage other journals to join us in this initiative. We hope that our action inspires the community, including researchers, research funders, and research institutions, to recognize the benefits of published peer review reports for all parts of the research system.

Learn more at ASAPbio .