Mechanical and Histological Characteristics of Human Tubular Bones after Hyperthermal Treatment

Round 1

Reviewer 1 Report

 

The paper has a high potential value but the current presentation is messy. Many contents need to be modified for clarity. Abstract does not clearly demonstrate the aim and purpose. the results and discussion section is extremely long with poor logic. 

Consider condensing the whole paper.

Misuse of citations.  Line 64, some of the five are irrelevant. Check others as well.

Other issues, presentation , for example, line 134-139, the whole paragraph seems ineffective; better to use a table instead. 

Fonts of numerical values in tables mismatch the main contents.

Error line 467

 

Author Response

Thank you very much for your interest in our work.
1. The paper has a high potential value but the current presentation is messy. Many contents need to be modified for clarity. Abstract does not clearly demonstrate the aim and purpose. the results and discussion section is extremely long with poor logic. 
Author comments: Some places in the paper were modified.
2. Consider condensing the whole paper.
Author comments: Sorry, but we tried to show all our results which can be interesting. But we made some changes in the paper which can be useful.
3. Misuse of citations.  Line 64, some of the five are irrelevant. Check others as well.
Author comments: All papers in line 64 describe the device which was used in our experiments.
4. Other issues, presentation, for example, line 134-139, the whole paragraph seems ineffective; better to use a table instead. 
Author comments: You are right. It was corrected.
5. Fonts of numerical values in tables mismatch the main contents.
Author comments: You are right. It was corrected.
6. Error line 467
Author comments: You are right. It was corrected.

Author Response File: Author Response.docx

Reviewer 2 Report

I do not have any suggestions

Author Response

Thank you very much for your interest in our work.
We are glad you like our paper.

Reviewer 3 Report

The authors presented an interesting research topic focused on studying changes in strength characteristics and histological patterns of healthy tubular bone tissue depending on the temperature setting of hyperthermal treatment that could culminate in finding the ideal temperature for bone thermoablation. However, there are major mistakes in selecting appropriate statistical tests that would accurately support their hypothesis. Moreover, the manuscript needs to be written in a more appealing way for readers, as extensive editing of the English language and style is required.

Author Response

Thank you very much for your interest in our work.
1. The authors presented an interesting research topic focused on studying changes in strength characteristics and histological patterns of healthy tubular bone tissue depending on the temperature setting of hyperthermal treatment that could culminate in finding the ideal temperature for bone thermoablation. However, there are major mistakes in selecting appropriate statistical tests that would accurately support their hypothesis. 
Author comments: The reasons for using certain statistical tests are given in lines 256-273 (in the new version of the paper).
2. Moreover, the manuscript needs to be written in a more appealing way for readers, as extensive editing of the English language and style is required.
Author comments: The translation was made by qualified translator. But we tried to correct some places to make them better.

Author Response File: Author Response.docx

Reviewer 4 Report

This work is certainly interesting and has important potential consequences. But the manuscript needs the following modifications:

1.      Page 4, Fig. 6: For clarity of presentation, it is recommended to provide more large and clear photographs of the final samples used in the compressive test.

2.      Page 5, Line 159: I think that there is a mistyping error on the word “until” at “sodium acetate unti the condition of the bone …”.

3.      Page 5, Compression experiments: This part is too long and should be summarized and shortened since it presents the well-known information’s about the method of calculation of stress and strain values.

4.      Page 7, Fig. 8: Figure 8 presents an example of a stress/strain graph. It is recommended to mention in the caption of the figure this stress/strain graph for which sample and within which group.

5.      Page 7, Line 247: It is recommended to modify the line as the following: “h is the height of the sample, mm.”, since the description of the parameter must not indicate that they are squared or cubed values.

6.      Conclusion should have one to three sentences described the problem. The main concluded points can be presented in bullets.

7.      References need to be arranged in the same style since there are many references titles mentioned before the authors names. Also, it is recommended to write all of the authors names and do not use the form “xx et al.” (e.g., references 7, 8, 9, …).

8.      Reference 27 does not cited within the manuscript text.

Author Response

Thank you very much for your interest in our work.
This work is certainly interesting and has important potential consequences. But the manuscript needs the following modifications:
1. Page 4, Fig. 6: For clarity of presentation, it is recommended to provide more large and clear photographs of the final samples used in the compressive test.
Author comments: Sorry, but we haven’t another photo.
2. Page 5, Line 159: I think that there is a mistyping error on the word “until” at “sodium acetate unti the condition of the bone …”.
Author comments: You are right. It was corrected.
3. Page 5, Compression experiments: This part is too long and should be summarized and shortened since it presents the well-known information’s about the method of calculation of stress and strain values.
Author comments: This part was described in detail, since when we prepared an article with compression experiments with pig bones (reference 21 in this paper), the reviewer suggested that all calculation methods be described in more detail.
4. Page 7, Fig. 8: Figure 8 presents an example of a stress/strain graph. It is recommended to mention in the caption of the figure this stress/strain graph for which sample and within which group.
Author comments: This is a conditional figure, not associated with specific measurements. It is provided to explain all the terms that are used in this article.
5. Page 7, Line 247: It is recommended to modify the line as the following: “h is the height of the sample, mm.”, since the description of the parameter must not indicate that they are squared or cubed values.
Author comments: You are right. It was corrected.
6. Conclusion should have one to three sentences described the problem. The main concluded points can be presented in bullets.
Author comments: You are right. The conclusion was was redone in accordance with your recommendations.
7. References need to be arranged in the same style since there are many references titles mentioned before the authors names. Also, it is recommended to write all of the authors names and do not use the form “xx et al.” (e.g., references 7, 8, 9, …).
Author comments: You are right. It was corrected.
8. Reference 27 does not cited within the manuscript text.
Author comments: You are right. It was corrected.

Author Response File: Author Response.docx

Reviewer 5 Report

The given study is focused on the effect of hyperthermal treatment on the compression and bending properties of bone along with the histological pattern. The materials and method section is well explained. Significant efforts are applied to prepare samples from different length locations of the diaphysis along with the experimental procedure. The results of the manuscript are interesting. However, I have noticed some errors in the calculation of mechanical properties. I have following suggestions, questions and recommendations to the authors;

1. Bone is a highly heterogeneous tissue and its mechanical properties may vary significantly along its diaphysis. Did authors considered and analyzed this factor before comparing the results obtained?

2. Line 41: Plastic materials... I think it should be biomaterials.

3. Line 222: This is not pure plastic deformation. It should be called elastic-plastic deformation.

4. Equation 3: Can authors briefly describe about the equation used to calculate the failure strength under bending.

5. Figure 8: Plastic strain (epsilon pl in the figure) is wrongly defined. For more understanding authors may refer to;  https://doi.org/10.4028/www.scientific.net/AMM.232.157

 6. The authors compared the compressive strength of bone analyzed in the given study with the one from literature conducted on pig cadaver (line: 262-265). Can the authors explain why this comparison is performed as both the bones should be totally different in terms of microstructure and composition. 

7. The connection described between hardening and plastic deformation is incorrect (line: 332-334). Fig. 8 shows isotropic hardening of the material. 

8. Table 3: elastic deformation (strain) can not be in MPa. It should be either mm/mm or % strain. Same comment for Table 7 to 9. 

9. Table 4: Plastic deformation should not be in MPa. Further the plastic deformation which is actually plastic strain is calculated inaccurately. This table need to be revised accordingly.  

10. Table 9: again plastic strain is inaccurately calculated. 

11. In the manuscript elastic/plastic/failure deformation should be written as elastic/plastic/failure strain. 

12. Table 1 to 10 may be replaced by the bar charts for more clarity and effective representation. instead of reporting the p values, authors may use * or # in the bar chart to show the statistical difference. Authors can also fix the value of p say 0.5.   

Author Response

Thank you very much for your interest in our work.

The given study is focused on the effect of hyperthermal treatment on the compression and bending properties of bone along with the histological pattern. The materials and method section is well explained. Significant efforts are applied to prepare samples from different length locations of the diaphysis along with the experimental procedure. The results of the manuscript are interesting. However, I have noticed some errors in the calculation of mechanical properties. I have following suggestions, questions and recommendations to the authors;

1. Bone is a highly heterogeneous tissue and its mechanical properties may vary significantly along its diaphysis. Did authors considered and analyzed this factor before comparing the results obtained?

Author response: According to the results of Cristofolini et al. (2013), mechanical properties of human tibia are quite homogeneous. We added our comment in section 2 of the manuscript by green insertion as follows:

“The strain distribution is remarkably uniform along the human tibia under quasi-constant-bending in the sagittal and frontal planes, under torsional and an axial loading [Cristofolini L, Angeli E, Juszczyk JM, Juszczyk MM. Shape and function of the diaphysis of the human tibia. J Biomech. 2013 Jul 26;46(11):1882-92. doi: 10.1016/j.jbiomech.2013.04.026]. Therefore, a comparison of mechanical features of different parts of tibia diaphysis after hyperthermal treatment (Fig.1) was justified”.

2. Line 41: Plastic materials... I think it should be biomaterials.

Author comments: You are right. It was corrected.

3. Line 222: This is not pure plastic deformation. It should be called elastic-plastic deformation.

Author comments: It was corrected to “plastic (elastic-plastic) strain”

4. Equation 3: Can authors briefly describe about the equation used to calculate the failure strength under bending.

Author comments: Sorry, but we can’t understand what description is necessary accept the one which is in lines 239-244 (in the new version of the paper).

5. Figure 8: Plastic strain (epsilon pl in the figure) is wrongly defined. For more understanding authors may refer to; https://doi.org/10.4028/www.scientific.net/AMM.232.157

Author comments: Unfortunately, we do not have access to the specified source. The terms indicated in Figure 8 were agreed with the Institute of Strength Physics and Materials Science of the Russian Academy of Sciences

6. The authors compared the compressive strength of bone analyzed in the given study with the one from literature conducted on pig cadaver (line: 262-265). Can the authors explain why this comparison is performed as both the bones should be totally different in terms of microstructure and composition.

Author response: In this case, the sentence on lines 262-265 is written incorrectly. It was rewritten as follows (lines 259-267 in the new version of the paper): “Besides, statistical differences were calculated using the Mann–Whitney test [30].  The purpose was to discuss the strength characteristics in this investigation with the data obtained at hyperthermia in the previous study, which was also ex vivo conducted on dyaphyses of cadaveric porcine femurs [31]. Of course, the biomechanics of pig bone is not quite similar to human bone [Kieser DC, Kanade S, Waddell NJ, Kieser JA, Theis JC, Swain MV. The deer femur--a morphological and biomechanical animal model of the human femur. Biomed Mater Eng. 2014;24(4):1693-703. doi: 10.3233/BME-140981]. However, porcine bone is often used as a substitute for human bone in trauma studies because some biomechanical parameters are comparable to those reported for adult human bones [Bonney H, Goodman A. Validity of the use of porcine bone in forensic cut mark studies. J Forensic Sci. 2021 Jan;66(1):278-284. doi: 10.1111/1556-4029.14599]. Besides, an understanding of the hyperthermia in humans can be aided by a study of its similarities to porcine model [Jardon OM, Wingard DW, Barak AJ, Connolly JF. Malignant hyperthermia. A potentially fatal syndrome in orthopaedic patients. J Bone Joint Surg Am. 1979 Oct;61(7):1064-70]”.

7. The connection described between hardening and plastic deformation is incorrect (line: 332-334). Fig. 8 shows isotropic hardening of the material.

Author comments: You are right about text in lines 332-334. It was corrected. The terms indicated in Figure 8 were agreed with the Institute of Strength Physics and Materials Science of the Russian Academy of Sciences.

8. Table 3: elastic deformation (strain) can not be in MPa. It should be either mm/mm or % strain. Same comment for Table 7 to 9.

Author comments: You are right. It was corrected.

9. Table 4: Plastic deformation should not be in MPa. Further the plastic deformation which is actually plastic strain is calculated inaccurately. This table need to be revised accordingly.

Author comments: You are right. It was corrected.

10. Table 9: again plastic strain is inaccurately calculated.

Author comments: You are right. It was corrected.

11. In the manuscript elastic/plastic/failure deformation should be written as elastic/plastic/failure strain.

Author comments: You are right. It was corrected.

12. Table 1 to 10 may be replaced by the bar charts for more clarity and effective representation. instead of reporting the p values, authors may use * or # in the bar chart to show the statistical difference. Authors can also fix the value of p say 0.5.

Author comments: You are right. It was corrected.

Author Response File: Author Response.docx

Round 2

Reviewer 1 Report

In this version, some changes were made, however, the most critical part, the length of the paper, remains too long. It seems like a final-year or bachelor project report, not a scientific journal paper. Only key elements are required, not all the things that should appear in a report.

The figures appear one by one, which is unscientific and loose.  Consider integration. 

Also, the changes were not marked in the modified version. I cannot judge where the declaration indicates-"we made some changes in the paper which can be useful" 

Author Response

Thank you very much for your interest in our work.

We once again studied the requirements for articles in the journal Symmetry. It states that the length of the article should be more than 4,000 words, but preferably less than 10,000 words. Our article has 6949 words, that is, more than the minimum required, but almost 1.5 times less than the recommended maximum. Nevertheless, taking into account your recommendations, we moved the figures from the Results and Discussion section to Supplementary Materials. Thanks to this, the size of the article has decreased from 21 to 15 pages.

Reviewer 3 Report

The authors have not adequately addressed the requested modifications in order to qualify their work for publication. 

Author Response

Thank you very much for your interest in our work.

In round 1, we have attached responses to comments on your review, where we tried to take into account your wishes as much as possible. Unfortunately, it is currently not clear to us what specific comments you have on our work now.