Peer Review History
Original SubmissionSeptember 24, 2020 |
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PONE-D-20-30168 Stress and anxiety among physicians during the COVID-19 outbreak in the Iraqi Kurdistan Region: An online survey PLOS ONE Dear Dr. Shabila, 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 Feb 19 2021 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:
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: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols We look forward to receiving your revised manuscript. Kind regards, Joseph John Westermeyer 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 2. In your Methods section, please provide a justification for the sample size used in your study, including any relevant power calculations (if applicable). Furthermore, if the questionnaire you developed a questionnaire as part of this study and it is not under a copyright more restrictive than CC-BY, please include a copy, in both the original language and English, as Supporting Information. 3. Please provide additional details regarding participant consent. In the ethics statement in the Methods and online submission information, please ensure that you have specified what type you obtained (for instance, written or verbal, and if verbal, how it was documented and witnessed). If your study included minors, state whether you obtained consent from parents or guardians. If the need for consent was waived by the ethics committee, please include this information. Once you have amended this/these statement(s) in the Methods section of the manuscript, please add the same text to the “Ethics Statement” field of the submission form (via “Edit Submission”). For additional information about PLOS ONE ethical requirements for human subjects research, please refer to http://journals.plos.org/plosone/s/submission-guidelines#loc-human-subjects-research. Editor Comments: Summary. This study from a district of Iraq could be considered representative of many countries facing the Covid-19 Pandemic. At the time of the study there were a limited number of cases identified, and “only a few deaths.” Most cases were asymptomatic; they were tested because of exposure to positive cases or recent international travel. All study participants were physicians, from recent graduates in training to fully trained generalists and specialists. Certain clinical units had been designated as COVID-19 units. Personal protective equipment (PPE) was lacking in units not specified as serving COVID-19 cases. A total of 370 physicians participated in the study and provided “part 1” information (i.e., gender, age, marital status, urban/non-urban practice, working at COVID-19 center versus working elsewhere, and job title). “Part 2,” also completed by 370 people, consisted of the Perceived Stress Scale, a 10-item, 0-4 scale per item reflecting frequency (over last month) of experiencing manifestations of stress (i.e., feeling upset, unable to control own life, nervous and stressed, loss of self-confidence, things going against self, unable to cope, irritable, overwhelmed, etc.), 6 items phrased in the negative and 4 items phrased in the positive, and total possible scores from 0 to 40, validated, widely used self-administered questionnaire. “Part 3,” completed by 201 physicians, consisted of the 7-item Generalized Anxiety Disorder (e.g., feeling nervous/on-edge, worrying, trouble relaxing, irritable, anticipating doom), 0-3 scale indicating frequency over last two weeks, total score from 0 to 28. This scale has also been widely used and validated. The raw demographic data are shown in Tables 1 (demography/professional characteristics for “stress” scale in one column (n = 370) “anxiety” in another column (n = 201). Table 2 shows the distribution of stress items in 370 physicians, and Table 5 shows the distribution of anxiety items in 201 physicians. Table 3 compares the six demographic-professional against three stress levels (low vs. moderate vs. high), to produce Chi Square scores and probabilities. Table 4 compares the demographic-professional variables against two stress levels (low, moderate/high) using the 95% Confidence Interval plus a multivariate analysis probability. Tables 6 and 7 (similar to tables 4 and 5) compare the six demographic-professional against anxiety, using 4 levels of anxiety in Table 6 and two levels of anxiety in Table 7. The authors set the probability level for significance at .05. Their observations included 12 Chi Square comparisons and 12 regression analyses, which showed significant comparisons, of which 2 differences involved male vs. females (more stress and anxiety among women), and 1 regression difference (more anxiety among generalist physicians). Among the 36 95% confidence interval analyses, both COR and AOR were higher for generalist physicians (ORs = 4.12 and 4.16). AOR-only was higher for the COVID-19 center workers (AOR = 2.23). The authors conclude, “A considerable proportion of physicians experience stress and anxiety during the COVID-19 outbreak in Iraqi Kurdistan region. There is a need to establish mechanisms to reduce the risks of stress and anxiety and employ mental health coping interventions. Additional research is required in this field.” Main claims and significance for the discipline. The perceived stressors among physicians, along with their mental health are important areas of research during this Covid-19 Pandemic. The Introduction covers the core issues well, contains an adequate number of relevant citations, and prepares the reader for the subsequent sections. (One exception: most of one paragraph on background in the Discussion should be moved to the Introduction or Methods section; this problem is described below.) Using the entire population of physicians in an entire region provides an appropriate sample. All of the physicians in the sample (n = 370) participated in Parts 1 and 2 of the study. The demographic-professional characteristics of the physicians are salient and might be compared or extrapolated to other national groups of physicians. The instruments used to measure “stress” and the “anxiety symptoms associated with Generalized Anxiety Disorder” have been well studied, validated, and employed in numerous surveys of both patients and “normals” (i.e., clinical and non-clinical samples). The Chi Square and regression statistics were well selected to compare the association between physician characteristics on one hand, and “perceived stress” plus “GAD anxiety experiences” on the other hand. The 95% Confidence Intervals compare the epidemiological rates between the physician characteristics on one hand versus “perceived stress” and “GAD-anxiety experiences” on the other hand. The data collected, as well as the population studied are appropriate for self-administration of an on-line questionnaire. Relatively few demographic-professional variables are associated with stress (mainly generalists and those in COVID-19 centers) or with GAD-anxiety (mainly gender). Potential interventions are considered (primarily mental health), but no data were obtained regarding interventions. The report reads well overall. Claims are properly placed in the context of the previous literature, and the authors treated the literature fairly.
Do the data and analyses fully support the claims? What other evidence is required?
Is the paper considered suitable for publication in its present form?
Are details of the methodology sufficient to allow the experiments to be reproduced? - Does the total population in the region amount to 370 at the time of the study? This information is implied, but not clearly stated. Was this the total number on a single day, or during 2.5 weeks of data collection? For those trying to replicate this study in another setting, such details would be helpful. - How were the authors able to elicit 100% participation in Part 1 and Part 2 data collection, but then lose 46% of participants in Part 3? What might they have done to elicit greater participation in Part 3? How important a limitation is the 46% loss of participants in Part 3? Were any additional data obtained? - It appears that the individual items in the stress and for anxiety instruments tap into severity in the individual items (10 for stress, 7 for anxiety), and the scale scores (0-4 and 0-3 respectively) tap into frequency. If so, such information would be helpful to readers, who are likely to consider that all of these items occur at one time or another in all human beings; but what distinguishes individuals from one another is the severity and frequency of the stress or anxiety experience. - It is not clear how the authors determined what “stressor” or “GAD anxiety” scores would be assigned to various categories (such as “low-moderate-high” for stressors, and “not at all – several days – over half the days – nearly everyday” for GAD anxiety). The distribution of the three stress levels in Table 3 seems to suggest that they employed a normal distribution since “moderate” percentages in the middle tended to contain about 2/3 of participants, whereas most “low” and “high” stressor groups contained about 1/6 of participants. The GAD-anxiety distributions were similar, if “several days” and “over half of days” were merged into a single “middle” variable, which contained about 2/3 of most items. - What are the rationales for grouping selected subgroups into single groups, as was done in Tables 4 and 7 for example? Is the manuscript well organized and written clearly enough to be accessible to non-specialists?
[Note: HTML markup is below. Please do not edit.] Reviewers' comments: [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 |
PONE-D-20-30168R1 Stress and generalized anxiety disorder among physicians during the COVID-19 outbreak in the Iraqi Kurdistan Region: An online survey PLOS ONE Dear Dr. Shabila, 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. The authors have presented findings from their study on some aspects of mental health among the selected physician population of Iraq during the ongoing COVID-19 pandemic. The authors need to address all the comments appended below. The authors should go through their manuscript thoroughly to check for typographic errors and correct them. Please submit your revised manuscript by Jun 03 2021 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:
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: http://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, Arista Lahiri, MBBS, MD Academic Editor PLOS ONE Additional Editor Comments (if provided): The authors have presented a study on the mental health status of the Iraqi participants during the COVID19 pandemic. Apart from the reviewers' comments I have the following comments for the authors: 1. What was the sampling design and technique? Based on this were the obtained results valid? Were the findings generalizable to the target population? How was the sample size calculated? 2. The study tools require elaboration in terms of their validity and reliability measures as observed in the current sample. This is required to understand the validity of the measurements. 3. Since this is an online survey, how did the authors control for response from outside the target population, because random social media share often presents with this difficulty, unless the questionnaire has control questions to restrict the survey among the target population only. 4. What was the response rate? Was response rate accounted when calculating the outcome measures? 5. How was partial/ incomplete response handled in the study? 6. Were the authors able to conclude that those responded and the non-responders were statistically similar in terms of their background characteristics? If yes, then this finding may be incorporated as a supplementary information. However, if not, then authors need to acknowledge this limitation as it again threatens the generalizability of the research. I recommend the authors to follow appropriate reporting guidelines for online survey research and modify accordingly. Optional recommendation: The authors may consider dividing their methods section in some appropriate sub-headings. This will make the article even more comprehensive. [Note: HTML markup is below. Please do not edit.] 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 #1: (No Response) Reviewer #2: All comments have been addressed ********** 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 #1: Yes Reviewer #2: Partly ********** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: No ********** 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 #1: Yes Reviewer #2: 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 #1: Yes Reviewer #2: 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 #1: The article needs following clarifications: 1. It is stated that there are 4 COVID 19 specialized centers. Whether all these centers were covered? Again, how many health centers and hospitals were covered in the study? These selected centers and hospitals constitute what proportion of the entire study settings in Iraqi Kurdistan Region? It has to be specified, since the title conveys physicians among Iraqi Kurdistan Region. 2. Regarding PSS: “The total scores of this measurement were interpreted as follows: 0-13 scores were considered low stress, 14-26 scores were considered moderate stress, and 27-40 scores were considered high perceived stress” – what is the reference? 3. Regarding GAD7: “0-4 scores were considered having no anxiety, 5-9 scores were considered mild anxiety, 10-14 scores were considered moderate anxiety, and 15-21 scores were considered severe anxiety” – what is the reference? 4. “The survey questionnaire included three main parts” – it is mentioned that first part constitutes demographic variables and it is not specified about the second and third part? Are these PSS and GAD 7 respectively? Please specify. 5. Please mention about the - Ethics committee approval statement, reference number and date of approval. 6. “We employed a normal distribution to classify the participants into different categories of stress and anxiety based on their total scores in the two measurements. Stress was classified into three groups, while generalized anxiety disorder was classified into four groups” – on what basis three and four groups were created? Again, what is the reference? 7. “AOR represents the value that has been adjusted for the other covariates, including confounders” – how did you get it from univariate analysis? To my knowledge it will come from multivariable regression analysis. Please clarify. 8. “Normal and mild anxiety groups were combined, and moderate and severe anxiety were ............. with multiple logistics regression analysis” – delete the term multiple from here. Dependent variable was dichotomized only to have logistic regression analysis. Again the term would be ‘logistic’ instead of ‘logistics’. 9. Output of logistic regression is missing. What about model fitness, statistical significance of model, variation of dependent variables that can be explained from the independent variables etc.? 10. How independent variables were chosen in multivariable regression analysis? 11. The term multiple in logistic regression is misnomer. It would have been multivariable logistic regression instead of multiple logistic regression. 12. Table 1: Stress component: Age group & Job title – percentage is not coming to 100%. Please correct. 13. Table 3, 4, 6 & 7: Mention the chi-square statistic along with P value. 14. Table 4, 6, 7: Mention years within parenthesis beside age group. 15. Table 4, 7: Footnote: Correct as ‘Crude odds ratio’ instead of ‘Crudes odds ratio’. 16. Table 5: Item 1 – percentage is not coming to 100%. Also check the other percentages for any corrections. 17. Table 2 & 5: Better to mention the number and percentages as No. (%) format to have smooth look instead of keeping in separate columns. Reviewer #2: Authors here did a study on Stress and anxiety symptoms among physicians during Covid19 in the Iraqi Kurdistan region. The topic is relevant; especially this area is under studied from middle east perspective. However these issues should be addressed first- 1. Applying PSS and GAD in separate google forms and analyzing them together is problematic and lacks validity. 2. While using a scale, referencing a disorder as yes or no according to Normal distribution is not acceptable and flawed. Rather it should be validated first and then to be diagnosed as yes or no according the to the cutoff marks. 3. It was written as 'The level of generalized anxiety disorder was measured based on the 7-item Generalized Anxiety Disorder scale.' GAD7 is a screening tool for GAD and can also be used for measuring Anxiety symptoms. So reframing this sentence(similar sentences are repeated many times in the manuscript) should be done. These things need major update and reanalysis should be done before further proceedings. ********** 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 #1: Yes: Indranil Saha Reviewer #2: Yes: Seshadri Sekhar Chatterjee [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 |
PONE-D-20-30168R2 Stress and anxiety among physicians during the COVID-19 outbreak in the Iraqi Kurdistan Region: An online survey PLOS ONE Dear Dr. Shabila, 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. ============================== Authors must address all comments by reviewer 1. They must also provide clarification to comments 1,2,3,6, and 7 provided by reviewer 2. ============================== Please submit your revised manuscript by Jul 09 2021 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:
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: http://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, Arista Lahiri, MBBS, MD Academic Editor PLOS ONE Journal Requirements: Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. Additional Editor Comments (if provided): Authors must address all comments by reviewer 1. They must also provide clarification to comments 1,2,3,6, and 7 by reviewer 2. Authors should consider discussing about their study's overall response rate in their discussion section. [Note: HTML markup is below. Please do not edit.] 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 #1: All comments have been addressed Reviewer #2: (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 #1: Yes Reviewer #2: No ********** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: No ********** 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 #1: Yes Reviewer #2: 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 #1: Yes Reviewer #2: 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 #1: The article needs following clarifications: The term ‘Multivariate’ should better be replaced by ‘Multivariable’. Table 1: Two digits after decimals are not desirable while showing distribution of the study subjects. Again the uniformity will not be maintained. Thus please keep single digit after decimal and modify accordingly. Reviewer #2: 1. Clarify the sample size calculation and precision level. Why chosen 3.5% as precision, though conventionally we take 5% as precsion. Non response rate how much to be taken here? 2. Translation of the questionnaire is important. Back translation and validation is required even for English speaking persons. Eventhough questions are having medical terminologies that just not justify the reasons of non medical persons not responding this question. Moreover PSS scale and GAD scale is used for Common people also. Restriction of response strictly for medical persons must be maintained 3. Exclusion criteria of study participants must be mentioned. Otherwise reasons of covid related stress and anxiety can never be established 4. Better to use the term univariate analysis because logistic regression is strictly for dichotomous outcome controlling confounding factors 5. Response rate 44% is unacceptable in generalised Anxiety disorder 6. In discussion part, writing justification of intervention should be modified. Counselling can be given..and covid protocol guidelines to be followed. 7. There are many lines in the discussion which are not related with the topic of interest, hence commenting these lines is absolute unnecessary and not acceptable. For example: a. If mental health services are warranted, it 384 would be for the physicians showing a reverse correlation between stress and anxiety [37]. For 385 example, physicians with alexithymia in need of treatment might have high stress with low 386 anxiety. Those whose anxiety disorder has been tripped off by minimal stress may be 387 characterized by low stress and high anxiety. b. The findings of the current study do not justify mental health interventions such as 352 counseling and the use of anxiolytic treatment or pharmacotherapy at this stage. - How authors came to this conclusion, please explain. ********** 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 #1: Yes: Indranil Saha Reviewer #2: 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. Please note that Supporting Information files do not need this step. |
Revision 3 |
Stress and anxiety among physicians during the COVID-19 outbreak in the Iraqi Kurdistan Region: An online survey PONE-D-20-30168R3 Dear Dr. Shabila, 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 for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. 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, Arista Lahiri Academic Editor PLOS ONE Additional Editor Comments (optional): The revised version of the manuscript is now scientifically acceptable. 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 #1: All comments have been addressed Reviewer #2: All comments have been addressed ********** 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 #1: Yes Reviewer #2: Yes ********** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: Yes ********** 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 #1: Yes Reviewer #2: 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 #1: Yes Reviewer #2: 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 #1: All my comments are adequately addressed. Accepted from my part. All things are adequately met from the authors' side Reviewer #2: Authors addressed all the queries asked by me. Redundant lines in discussion sectioned pruned, Now it can be accepted. ********** 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 #1: Yes: Indranil Saha Reviewer #2: Yes: Seshadri Sekhar Chatterjee |
Formally Accepted |
PONE-D-20-30168R3 Stress and anxiety among physicians during the COVID-19 outbreak in the Iraqi Kurdistan Region: An online survey Dear Dr. Shabila: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. 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. If we can help with anything else, please email us at plosone@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. Arista Lahiri Academic Editor PLOS ONE |
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 .