Non-A Non-B Acute Aortic Dissection: Is There Some Confusion in the Radiologist’s Mind?

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Comments for author File: Comments.pdf

Comments on the Quality of English Language

See attached reviewer comments. It is included here.

Author Response

Response to Reviewer 1 Comments
1. Summary
Thank you very much for taking the time to review this manuscript. Please find the detailed responses below and the corresponding revisions/corrections highlighted/in track changes in the re-submitted files.
2. Point-by-point response to Comments and Suggestions for Authors
Comments 1: It appears that the composing author is not of a native English-speaking background and prior to any resubmission it would be beneficial if the grammar, phrasing and general flow of the manuscript is read and edited by a native English speaker.
Response 1: Thank you for pointing this out. We agree with this comment. Therefore, we have subjected the work to grammatical English correction and several sentences have been modified in the text
Comments 2:  The utility and merit of this study should be made more clear in the manuscript. What is the novelty? What has been newly discovered? How does the paper add to our understanding of non A non B aortic dissection?
Response 2: Agree. We have modified discussion section to emphasize this point.

Comments 3 and 4 No statistical analyses have been performed. As a result the paper lacks robust interrogation. This could be added. For example the categorized variables presented

in Table 2 could be tested for their statistical significance which could allow the

authors to make some sort of assessment about the frequency and outcomes of the

different non A non B aortic dissection types. As the authors point out in their introduction non A and non B are described according to their anatomical configuration but this lacks any link to outcomes. It would be relevant to know if Configuration 1 for example is associated with a worse prognosis (surgery, malperfusion, stroke, mortality etc.) than the other configurations. This would give the paper scientific merit and add to the literature but requires statistical testing.

Response 3 and 4 Agree. a statistical analysis would give more strength to our results, we added it in the discussion as a major weakness of our study, requiring further evaluation. About configuration 1 in discussion section and in results we have stated “In our patients, primary ET in the arch worsened outcome, and this must be considered as a sign of advanced dissection instability, needing to be more aggressively treated”.

 

Comments 5 The introduction, results and discussion fail to present as a cohesive document. The

link between the introduction and discussion in relation to the data obtained for this

study and reason for why it was performed needs to be made clearer. The proposed

aim of the study was to define the rate, anatomy and outcomes associated with non A

and non B aortic dissection, though this may have been performed the reasons for

doing so in the introduction are not communicated strongly and the discussion mainly

describes the literature rather than linking the findings of the study to the literature to

advance the field.

 

Response 5 Thank you for pointing this out. We agree with this comment. Therefore, we have added these concepts in the discussion section.

 

Minor comments

Comment 1: The term “Group” and “Configuration” is used interchangeably in abstract and text. This is confusing. Use only one term.

Response 1: We have eliminated the term Group.

 

Comment 2: Table 1 is brief and provides no advantage being presented this way. It would be best described in text.

Response 2: We have eliminated Table 1 and described it in the text

 

Comment 3: Table 2 is confusing and needs to be reworked.

1. This table has abbreviations and lacks a legend. This should be added.
2. Present age as mean and range as in the “All” column.
3. Present sex as a number and percentage using a single sex i.e. Sex (male):

All = 26 (72%), DTA-entry = 18 (72%) etc.

1. Once the frequency of the AD type has been describe (first row) it does not

need to be repeated in the Primary ET diagnosis, Primary ET location etc.

rows as this is redundant. I.e. Primary ET diagnosis row for Configuration 1

should read 24 (96%) not 24/25 (96%).

1. Round decimals of percentages. This should be done throughout the

manuscript.

1. In aortic diameter row the unit of measurement has already been described

(mean, mm). mm therefore does not need to be repeated in each column.

1. Add percentages for all Treatment column data.

Response 3: We have made all the changes required in table 2 and in the text.

 

Comment 4: Avoid using terms “In our series” in the result. This is redundant. Of course you are speaking of your series, this is the Results section of your study.

Response 4: We have avoided the term “our series” in the results section.

 

Comment 5 and 6: The discussion should include an opening paragraph which rehashes the aims and principal findings of the paper. There are a couple of 1 line paragraphs. These should be incorporated into neighboring paragraphs.

Response 5 and 6: we have added sentences about the aim of the study in the discussion section. We have eliminated the redundant line 1 paragraph.

Reviewer 2 Report

Comments and Suggestions for Authors

 

Within this scholarly work, the authors have undertaken a comprehensive examination of Non-A Non-B acute aortic dissection, drawing upon patient data. This investigation culminated in the meticulous categorization of patients' symptoms, treatment modalities, and prognostic outcomes into three distinct configurations. Such an approach serves to effectively address certain knowledge lacunae that previously existed in the understanding of this medical condition. While the outcomes of this inquiry have yielded satisfactory results, it is worth acknowledging the presence of certain unresolved issues warranting further consideration.

 

 

Major issues:

1. Evident anomalies in the layout and formatting, notably within Lines 69, 70, 105, 106, and certain figures, have been identified. It is strongly recommended that a meticulous review of the manuscript be conducted to ensure compliance with formatting and structural prerequisites.
2. Within the results section, the author has made reference to a notably high incidence rate among males, specifically at 72.2%. However, there is an absence of discourse regarding gender-based variations, warranting further exploration.

Minor issues:

1.     Page 5, line 162, 163, there is an issue with the number format, such as: 9,3% and 72,2%.

2.     Page 6, line 190, check the spelling of “blu”. 

Comments on the Quality of English Language

 

Major issues:

1. Evident anomalies in the layout and formatting, notably within Lines 69, 70, 105, 106, and certain figures, have been identified. It is strongly recommended that a meticulous review of the manuscript be conducted to ensure compliance with formatting and structural prerequisites.
2. Within the results section, the author has made reference to a notably high incidence rate among males, specifically at 72.2%. However, there is an absence of discourse regarding gender-based variations, warranting further exploration.

Minor issues:

1.     Page 5, line 162, 163, there is an issue with the number format, such as: 9,3% and 72,2%.

2.     Page 6, line 190, check the spelling of “blu”.  

Author Response

 

Response to Reviewer 2 Comments
1. Summary
Thank you very much for taking the time to review this manuscript. Please find the detailed responses below and the corresponding revisions/corrections highlighted/in track changes in the re-submitted files
2. Point-by-point response to Comments and Suggestions for Authors
Comments 1:   Evident anomalies in the layout and formatting, notably within Lines 69, 70, 105, 106, and certain figures, have been identified. It is strongly recommended that a meticulous review of the manuscript be conducted to ensure compliance with formatting and structural prerequisites. Response 1: Thanks. We have corrected the format.   Comments 2: Within the results section, the author has made reference to a notably high incidence rate among males specifically at 72.2%. However, there is an absence of discourse regarding gender-based variations, warranting further exploration. Response 2: We have emphasized this point in the discussion section.   Minor issues:   1. Page 5, line 162, 163, there is an issue with the number format, such as: 9,3% and 72,2%.   2. Page 6, line 190, check the spelling of “blue”.
Response minor issues: we have corrected the format and the spelling in the text.

 

 

 

 

 

 

 

 

 

 

 

 

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

Still some minor grammatical errors but overall improved. Some percentages still contain a decimal rather than rounding.

Author Response

We thank reviewer 1 for the timely and correct clarification.

"Still some minor grammatical errors but overall improved. Some percentages still contain a decimal rather than rounding."

Thanks for the detailed revision of the text. We have rounded the decimal in the results section, but left it in the discussion section where we report literature data.