Use of a Novel Mathematical Model to Assess the Effectiveness of Skin-to-Skin Care for the Prevention of Hypothermia in Low-Birth-Weight Neonates
Round 1
Reviewer 1 Report
GENERAL COMMENTS
Thank you for the opportunity to review your paper. The topic of the paper is interesting and fits the scope of the journal. The text itself is well written and composed. However, there are some methodological issues that need to be clarified.
SPECIFIC COMMENTS
L 21: Since this is a mathematical model and not an observational study involving actual neonates I would suggest changing "observe" to "estimate" throughout the manuscript.
L 33: Please consider rephrasing to improve clarity. "Thermal regulation of .... is less effective". Also, I would suggest citing relevant literature to strengthen the validity of this sentence.
L 54-56: It is not clear to the reader how this sentence is connected to the previous ones.
L 138: Please consider changing "radiative heat loss" to "radiative heat loss/gain" to be in line with the equation above.
L 140: K (conductivity) also reflects the transfer of thermal energy from the mother’s body to neonate by means of contact.
L 141: "Evaporative water loss" should be changed to "evaporative heat loss".
L 160: Authors have previously abbreviated metabolic heat production (metabolism - work) with "M", but in this equation they use "M" to indicate metabolism which is a different thing. Also, please clarify if the reported metabolic rate considers non-shivering thermogenesis by means of brown adipose tissue.
L 239: The ambient temperatures presented in the abstract are different compared to what the authors report in this paragraph.
L 247: It is not clear to the reader where this 24 °C came from. The abstract says 25.9 °C, the above paragraph reports 25 °C, here it says 24 °C. Please consider rephrasing to improve clarity.
L 265-269: It is not clear to the reader why Mann-Whitney test (assuming homoscedasticity) was used in this modelling study. Since the study did not involve monitoring actual neonates, and therefore there is not variance in the results, I would suggest providing more information here to enhance clarity.
L 302: Please consider rephrasing to improve clarity.
Author Response
Dear,
Please find enclosed the revised version of the article” Use of a novel mathematical model to assess the effectiveness of skin-to-skin care for the prevention of hypothermia in low-birth-weight neonates”
All the suggestions and comments of the two reviewers have been taken into account (see attached documents). The authors thank the reviewers for their time and their constructive criticism and helpful comments.
Thanks and regards
Delanaud Stéphane
Author Response File: 
Author Response.docx
Reviewer 2 Report
The authors have set up a model for the heat losses in order to calculate the temperature development as a function of time with respect of the skin-to-skin care situation of neonates. The model is experimentally verified by a thermal mannequin equipped with temperature sensors.
The approach is described well and largely with enough detail.
Some questions:
1. In the experiment, is the metabolic heat production M realized by some heat source in the mannequin? This was not clear to me.
2. In particular the cotton sheet cover my adsorb some moisture over time, which then might change its effective thermal conduction. Is this something to be discussed?
The manuscript can be published with some comments referring to these points.
Author Response
Dear,
Please find enclosed the revised version of the article” Use of a novel mathematical model to assess the effectiveness of skin-to-skin care for the prevention of hypothermia in low-birth-weight neonates”
All the suggestions and comments of the two reviewers have been taken into account (see attached documents). The authors thank the reviewers for their time and their constructive criticism and helpful comments.
Thanks and regards
Delanaud Stéphane
Author Response File: Author Response.docx
Round 2
Reviewer 1 Report
Thank you for considering my suggestions and congratulations on presenting an excellent study!
