JerMa88/BMC_Gastroenterology_Peer_Reviews huggingface dataset:
Review for 10.1186/s12876-021-01911-5 (2021)

Title: Mutation analysis of the ATP7B gene and genotype-phenotype correlation in Chinese
patients with Wilson disease
Version: 4 Date: 10 Feb 2021
Reviewer's report:
The authors performed genetic analysis of ATP7B in a series of 103 southern Chinese patients
with clinical diagnosis of Wilson Disease (WD). Next, they tried to correlate their findings
with those previously reported in a selection of WD clinical series from China by means of a
systematic review. I have some observations in order to improve writing. Also, I have found
some issues to be clarified.
-Variants always should be described following HGVS nomenclature recommendations (i.e:
c.2333G>T (p.Arg778Leu)).
-Variant classification as pathogenic, likely pathogenic, benign etc. should rely on ACMG
standard guidelines for interpretation of variants. In silico predictions are included in this criteria,
but solely are insufficient to determine pathogenicity.
-“hotspot” is well written, “hot spot” not.
-Graphics from Figures 3 and 4 are in Chinese, so it was not possible to revise numeric data
properly.
-Concept of “novel” variant should be revised. A variant is considered “novel” the first time that
it is reported in literature. To call as “novel” variants those reported the first time by another
authors seems confusing.
-In this paper, seven variants are reported as novel. However, in four of them there is no novelty
as they have already been identified in different Chinese clinical series of WD in the last five
years:
c.2075T>C (p.Leu692Pro), published by Yuan et al., 2015; Li et al., 2019
c.3209C>G (Pro1070Arg), Dong et al., 2016
c.3677C>T (p.Thr1226Ile), Hua et al., 2016
c.3793G>T (p.Val1265Leu) Poon et al., 2016
-It is not well explained if authors have performed segregation analysis to confirm biallelic
mutations.
-Discussion line 332: Several studies have demonstrated that mutations in ATOX1 and
COMMD1 are not responsible of the WD phenotype.
Review for 10.1186/s12876-021-01896-1 (2021)

Title: Prognostic nutritional index is an independent prognostic factor for older patients aged
#85 years treated by gastric endoscopic submucosal dissection
Version: 2 Date: 08 May 2021
Reviewer's report:
This study was retrospective study to investigate prognostic factors for survival after ESD in
older patients aged #85 years with EGC.
It is very interesting that high CCI was not found to be a prognostic factor, only low PNI was
an independent prognostic factor associated with OS. However, the authors should address the
following points.
Major#
##It was found that low PNI is an important independent prognostic factor after ESD in EGC,
but are there any data that low PNI was associated with other causes of death (cardiovascular and
pneumonia)?  The authors should add that description. If authors don't have the data, consider
including a reference that can explain them.
##There is a description of selection bias in the limitation section, but it is recommended to add
it in a little more detail. For example, "This study included only patients who were selected by
physicians, and excluded patients who could not undergo ESD because of severe CCI or poor
ECOG PS. ".
Review for 10.1186/s12876-021-01896-1 (2021)

Title: Prognostic nutritional index is an independent prognostic factor for older patients aged
#85 years treated by gastric endoscopic submucosal dissection
Version: 2 Date: 19 May 2021
Reviewer's report:
In this article, the authors analyzed an aged population cohort who underwent gastric ESD for
early gastric cancer. The authors attempted to explore independent prognostic factors for these
patients, and they concluded PNI was the only factor after multivariate analysis.
I have several concerns for this study:
1. While the study is methodologically acceptable, it has no remarkable novelty compared to
other previous studies (Iwai et al, digestive endoscopy 2017, DOI: doi:10.1111/den.13051 and
Sekiguchi et al, GIE 2017, DOI: doi:10.1016/j.gie.2016.10.013). The authors have to think about
more adding value for future clinical practice.
2. Since PNI is determined by albumin and lymphocyte level, I am curious that albumin level
has not been considered as one of the clinical factor in this study (and previous studies!). On
the one hand, PNI may have confounding by albumin level; on the other hand, if albumin level
is predictive for OS, it is much more simpler to use. I strongly recommend the authors should
add this analysis.
3. The authors may have more discussion for the rationale about the predictive value from PNI.
Review for 10.1186/s12876-021-01896-1 (2021)

Title: Prognostic nutritional index is an independent prognostic factor for older patients aged
#85 years treated by gastric endoscopic submucosal dissection
Version: 4 Date: 02 Jun 2021
Reviewer's report:
The questions and comments have been well addressed and replied. I would like to mention that
since albumin level is also predictive in this cohort, further study will be valuable to determine
if PNI can be further simplified. One assumption is that in elderly patient the albumin level will
be more likely to link with underlying disease.
Congratulation to the authors' work.
Review for 10.1186/s12876-021-01910-6 (2021)

Title: Heparin-binding protein is significantly increased in acute pancreatitis
Version: 1 Date: 31 Mar 2021
Reviewer's report:
Congratulations for your nice work. If there is sufficient data, you should try to make subgroups
regarding the time between admission and start of symptoms. Making more mesaurments of
HBP could have been helpful, because the increase in time could correlate better with severity.
Right now I suggest major revision before publication.
Review for 10.1186/s12876-021-01910-6 (2021)

Title: Heparin-binding protein is significantly increased in acute pancreatitis
Version: 1 Date: 10 May 2021
Reviewer's report:
This is a valid point to explore new biomarkers and their association with the clinical course of
AP. However, there are a few issues that need to be addressed:
1- The rationale behind HBP is not well explained in this manuscript. The paper will benefit
from adding an IV fluid treatment variable in the multivariable analysis: The cumulative amount
of IV fluid and the type of IV fluid (Lactated ringer, Normal saline, etc) within the golden time
of intervention (the first 6 hours of hospital care) will be essential to understand the HBP in
the vascular leak.
2- The paper will benefit from an extensive linguistic review. There are a number of grammatical
errors throughout the paper. For example, in the last paragraph of results, the authors say "When
only those patients who did not received diuretics were analyzed there were still no correlation
between HBP concentration and fluid balance." the verb should change to "When only those
patients who did not receive diuretics were analyzed there were still no correlation between HBP
concentration and fluid balance."
Review for 10.1186/s12876-021-01897-0 (2021)

Title: Emergency gastrointestinal surgery in patients undergoing  antithrombotic therapy in a
single general hospital: A propensity  score-matched analysis
Version: 3 Date: 10 May 2021
Reviewer's report:
Thank you for the opportunity to review this manuscript entitled: " Emergency gastrointestinal
surgery in patients undergoing antithrombotic therapy in a single general hospital: A propensity
score-matched analysis” by Abe S et al.
The authors’ aim in this study is evaluate the risk of bleeding in patient on AT underwent
emergency surgical procedure
The authors conclude that intraoperative blood loss and postoperative complications related to
emergency gastrointestinal surgery were not significantly affected by antithrombotic therapy.
Major comments:
From several years and in different studies it is shown that it is not necessary to suspend the
therapy with antiplatelet drugs  such as acetylsalicylic acid before surgeries both in urgency and
in emergency setting
The problem arises in patients on anticoagulant therapy and not in prophylaxis for the risk of
thrombosis and especially in patients with bleeding at the time of access to the emergency room.
In fact, if the surgical procedure is quod vitam it is not necessary to consider the use of such
drugs, otherwise various protocols have been developed for the suspension and normalization
of coagulant funzinalite in patients needing a surgical intervention under deferred urgency.
I would have expected from the authors a differentiation of patients according to the type of
urgency and especially in the light of the results the development of a protocol or an algorithm
to be adopted according to the drugs taken by the patient.
Moreover, more then 50% of the procedure were appendectomy, therefore an intervention of
itself at low risk of bleeding.
No data among energy device used
how do the authors explain an average operating time of 36 and 53 minutes? in an emergency
setting with a range starting from 10 minutes?
Review for 10.1186/s12876-021-01897-0 (2021)

Title: Emergency gastrointestinal surgery in patients undergoing  antithrombotic therapy in a
single general hospital: A propensity  score-matched analysis
Version: 3 Date: 11 May 2021
Reviewer:  Gianluca Costa
Reviewer's report:
The paper is well done and the statistical analysis was properly carried out. I agree with the use
of PSM above all when facing emergency surgery. I would like to congratulate with authors. I
have only one minor comment: what do you think about the rate of antithrombotic patients (less
than 10%), the age, and CACI? I think that a study entailing patients with more advanced age
and higher CACI could be more interesting.
Review for 10.1186/s12876-021-01912-4 (2021)

Title: Transcriptome sequencing reveals high-salt diet-induced abnormal liver metabolic
pathways in mice
Version: 1 Date: 01 Mar 2021
Reviewer's report:
In this study, the authors aim to investigate the role and mechanism of a high salt diet in liver
function. They claimed that a high-salt diet could induce a serious abnormal liver metabolic
pathway in mice, although substantial damage has not yet been shown. This study is the first to
reveal the impact of a high-salt diet on the liver at the omics level and provides theoretical support
for potential clinical risk evaluation, pathogenic mechanisms, and drug design for combating
liver dysfunction, and this study also provides a serious candidate direction for further research
on the physiological impacts of high-salt diets. However, this study lack of clear endpoint, and
the mechanism can not support their conclusion.
Review for 10.1186/s12876-021-01912-4 (2021)

Title: Transcriptome sequencing reveals high-salt diet-induced abnormal liver metabolic
pathways in mice
Version: 1 Date: 01 Jun 2021
Reviewer's report:
The study presented is interesting and add novelties to the scientific literature regarding the salt
effects in the metabolism. The paper is well presented and requires only a few observations to
be further improved.
Methods.
1. Why did the authors include female mice in the study? We know that in metabolic-related
studies the use of male mice is preferrable as females have a more accentuated hormone
interference. I suggest to include this justification and limitation in the discussion section.
2. Please provide the diets composition details.
3. I suggest the inclusion of the tissues thickness used for this staining procedure.
4. The biochemical procedure to assess hepatic enzymes activities should be reported and
detailed in the methods section, including the methodology protocol and reagents used.
Results
1. In figure 3, the green indicates up-regulated? In the figure legend it appears to be the opposite.
Green for down-regulated and red for up-regulated. Please clarify.
Conclusions
1. In the conclusion the authors used the term long-term high-salt diet. Please correct this
affirmation. The study presented a short-term treatment, not a long-term high-salt intervention.
In fact, it is an important study that shows early signs of metabolic damage, even after a
short-term intervention, which must be acknowledged, however, further studies are needed to
clarify how these pathways will behave on a long-term high-salt diet. Please comment these
observations, either in the conclusion or discussion sections.
Abbreviations
1. There are abbreviations missing from this list.
Review for 10.1186/s12876-021-01909-z (2021)

Title: Mixed adenoneuroendocrine carcinomas of stomach and ampulla of vater after curative-
intent resection: a single center cases series
Version: 1 Date: 08 Jun 2021
Reviewer's report:
Few issues might be addressed before accept for publication as follows:
1) The English language grammar need to be polished, 2) Figures need to be revised delicately,
3) The last sentence in "follow-up" paragraph should be revised to provide the clear intention, 4)
As authors' opinion, the grade of the adenocarcinoma component  was an independent predictor
of OS. Therefore, authors had better provide the OS of adenocarcinoma of stomach and Vaters
ampullar.
Review for 10.1186/s12876-021-01909-z (2021)

Title: Mixed adenoneuroendocrine carcinomas of stomach and ampulla of vater after curative-
intent resection: a single center cases series
Version: 1 Date: 12 Jun 2021
Reviewer's report:
I would recommend res ubmitting with minor language edits, as well as revising the figures - it
seemes that figures 2 and 3 are identical for example.
Review for 10.1186/s12876-021-01907-1 (2021)

Title: Glucocorticoids in Acute Pancreatitis: A Propensity Score Matching Analysis
Version: 2 Date: 20 Apr 2021
Reviewer's report:
This is a well-written study evaluating the effects of evaluating the effect of glucocorticoids in
the treatment of acute pancreatitis. The aim mentions reevaluation, better to say evaluate only.
The severity of pancreatitis needs to defined better throughout the manuscript.
Review for 10.1186/s12876-021-01907-1 (2021)

Title: Glucocorticoids in Acute Pancreatitis: A Propensity Score Matching Analysis
Version: 2 Date: 03 May 2021
Reviewer's report:
This is a report regarding whether clinicians should use glucocorticoid in routine treatment
against acute pancreatitis. Though the subject of current study is quite pratical, I have certain
concerns for this work.
First, lots of previous reports, including RCTs and meta-analysis have been conducted for this
field. I noticed that few publications within the last 5 years have been listed in the reference part
of this paper. I wonder if this study, which is an observational one, could be more convincing
than previous studies.
Second, the authors used PSM to circumvent bias of age, gender, APACHE II and SOFA. What
about other parameters, e.g., marshall score, BISAP, SIRS, etc?
Third, I care about the impact of glucocorticoid on infection rate of AP patients, as use of
antibiotics is significantly involved in pancreas infection, the authors should address antibiotics
use in their study.
Review for 10.1186/s12876-021-01907-1 (2021)

Title: Glucocorticoids in Acute Pancreatitis: A Propensity Score Matching Analysis
Version: 4 Date: 31 May 2021
Reviewer's report:
The authors well answered the questions of preivious reviewers. But we need to know the
defination of GC usage, by the type, dose and duration.
Review for 10.1186/s12876-021-01907-1 (2021)

Title: Glucocorticoids in Acute Pancreatitis: A Propensity Score Matching Analysis
Version: 4 Date: 07 Jun 2021
Reviewer's report:
The writting should be further improved.
In the Result part of Abstract section, the abbreviation "APACHE II" should be followed by the
full name "Acute Physiology and Chronic Health Evaluation II".
In the Result part of Abstract section, the authors said “The incidence of multi-organ failure”.
However, the authors said “prevalence of multiple organ dysfunction” in line 222 of the
manuscript. The manuscript should be carefully checked.
In the background section, the research progress of glucocorticoids in the treatment of acute
pancreatitis with hypertriglyceridemia should be provided. This can support your study results.
The Ethics number should be provided in Methods section.
Subheading titles should be given in the Results section.
In the Result section, the authors said “After matching, patients in the GC group had a lower
heart rate than those in the NGC group (110.9 ± 10.7 vs. 119.4 ± 12.7, P = 0.374)”. should be
revised as “After matching, the heart rate was no significant difference between the two groups
(110.9 ± 10.7 vs. 119.4 ± 12.7, P = 0.374)”.
Figure 1 is represented by a line chart, the results of the study may be clearer.
marshall score, BISAP should be explored in the results section.
Review for 10.1186/s12876-021-01906-2 (2021)

Title: The global, regional, and national burden of acute pancreatitis in 204 countries and
territories, 1990– 2019
Version: 0 Date: 04 Jun 2021
Reviewer:  Era Upadhyay
Reviewer's report:
Your review should be constructive and thorough to allow the authors to prepare a revision ready
for acceptance.
Review for 10.1186/s12876-021-01908-0 (2021)

Title: The Influence of a Gluten-free Diet on Health-related Quality of Life in Individuals with
Celiac Disease
Version: 1 Date: 09 May 2021
Reviewer's report:
1) Please check the format for your references. They are not in consistent complete form and
frequently don’t include the year of publication. Please correct.
2) I suggest using a different first reference since you are discussing the definition of celiac
disease the first reference is less appropriate.  I suggest using a reference such as Celiac Disease,
New England Journal of medicine 2007; 357: 1731-43 by Green , and Cellier, or any other
similar paper describing overview of celiac disease.
3) Your second reference is a paper on HLA associated with Celiac disease and if citing this
it would be better if you mention the permissive HLA associated with celiac disease in your
description of celiac disease.
4) Do you have the range of time on a gluten free diet 6months-? Years. Your sample size is
small but it would be interesting to see if time on a gluten free diet was an important factor
5) Line 168 Reference 19, the Biagi GFD questionnaire consists of 4 questions.
6) Line 223 Comment- It is also notable that 43% of participants were overweight.
7) Lines 316-320 it is confusing what the 3 categories of scores are for. It would help to indicate
it is for the 3 levels of income at the beginning of the score comparisons for income.
8) Overall 62% were FI, of these 35% Nonadherent and 65% adherent, Most nonadherent were
FI. It is interesting that the overall rate is that high.  Is there data on FI in the general population
in Saudi Arabia – it would be interesting to compare.
9) Line 413 A significant limitation of the study is that most of your study group (75%) only
had a serology test for diagnosis. This means you could have included people without celiac
disease. Do you have other supportive info you could include such as a medical diagnosis or
recommendation by a physician to follow a lifelong gluten free diet in these pts? Some of the
studies you site such as reference #18, only 11% were serology only, others such as in the
Canadian study reference they  only included biopsy proven celiac disease or DH. Your first
reference #1, was conducted in Saudi Arabia and that study was vague as to the criteria for
inclusion for celiac disease. It is stronger data if the study can identify adult celiac disease
patients with biopsy and serology.
Congratulations on your interest and work on this important aspect in celiac disease treatment
and how it affects the lives of celiac patients around the world.
Review for 10.1186/s12876-021-01908-0 (2021)

Title: The Influence of a Gluten-free Diet on Health-related Quality of Life in Individuals with
Celiac Disease
Version: 1 Date: 18 May 2021
Reviewer's report:
The study by Al-Sunaid et al. investigates the influence of a gluten-free diet on health-related
quality of life in individuals with CD. This is an important topic, and more studies on this issue
are certainly welcomed. This manuscript has several important findings and, in my opinion,
could be acceptable for publication, but it will need a major revision before that.
1. Major limitation of the study is a lack of adequate control group. This should be further
emphasized in the discussion.
2. Abstract: Many mean HRQOL values are given, but these points do not tell much for the
readers as such. Please clarify.
3. The authors have missed several relevant papers relevant papers for their study, which could
be added both to the Introduction and Discussion, see eg. Digestion. 2012;86:309-14; Nutrients
2019;11:1718; United European Gastroenterol J 2020;8:157-166
4. How was CD diagnosed? This is briefly mentioned in the discussion, but should be clarified
in the M&M
5. Was the use of What´s up really accepted by the ethical committee? I do not think it is safe/
personal information is inadequately protected, please clarify.
6. It is said that “participants with any other conditions that can affect HRQOL were excluded”.
How many cases were actually excluded? A flowchart might be helpful. Then later in the results
it is said that “only 24 participants had CD and other diseases.” This is confusing, so not all
patients with other conditions were excluded? Which were these conditions? T1D and allergies?
Certainly e.g T1D can affect to the HRQOL and even the allergies. Please clarify and discuss
further.
7. There are several misspellings/grammatical errors in the text, please check each sentence
carefully.
8. The result text repeats unnecessary a lot of data which are given in the relevant figure/table
just below (numbers, percentages etc.). The text should be more concise.
9. Fig. 1 can be removed.
10. Figures are unclear and of poor quality; they should be improved.
11. “…exhibited significant inverse correlations with…” etc. The actual correlation coefficients
are small = the correlation is weak although significant. P value is less important here. Please
discuss.
Review for 10.1186/s12876-021-01908-0 (2021)

Title: The Influence of a Gluten-free Diet on Health-related Quality of Life in Individuals with
Celiac Disease
Version: 3 Date: 07 Jul 2021
Reviewer's report:
To readdress the subject of diagnosis. The ESPGHAN criteria for non biopsy diagnosis of celiac
disease applies to the pediatric population only and it is not accepted world wide yet. Your study
is in adult patients so it is not applicable as a definite diagnosis for celiac disease. Serology assays
differ and are not 100% sensitive or specific and  you do  not specify what serology was used
(TTG IGA, EMA, DGP) or what values were accepted as a positive celiac diagnosis ( TTG IGA
>10 x ULN per ESPGHAN pediatric guidelines). This is a limitation of the study and should
be noted as such.  You can include the information that patients had a letter from a physician
confirming diagnosis based on either serology or serology with biopsy.  You note there is no
control group but Line 369-370 explaining why there is no control group is confusing. A control
group could be those following a gluten free diet without celiac disease but this group may be
difficult to identify though certainly exists. Please adjust the discussion.
Review for 10.1186/s12876-021-01889-0 (2021)

Title: Fecal calprotectin is a useful biomarker for predicting the clinical outcome of granulocyte
and monocyte adsorptive apheresis in ulcerative colitis patients: a prospective observation study.
Version: 2 Date: 02 Apr 2021
Reviewer's report:
Dear authors
I am interested in this manuscript. Although the eligible patients were a few, you indicated and
demonstrated that fecal calprotectine (FC) the predictive biomarker of good clinical response to
GMA and improvement of mucosal inflammation after GMA treatment. Recently it is not easy
to undergo colonoscopy  for patients, because the spread of COVID19 is getting to be pretty
serious. So we suggested that the utility of FC will be enhanced. We think that this report are
very useful for treatment of ulcerative colitis.
Review for 10.1186/s12876-021-01889-0 (2021)

Title: Fecal calprotectin is a useful biomarker for predicting the clinical outcome of granulocyte
and monocyte adsorptive apheresis in ulcerative colitis patients: a prospective observation study.
Version: 2 Date: 23 May 2021
Reviewer:  Naveen Sharma
Reviewer's report:
Overall I think this is an interesting study in that the group assesses the use of FC as a biomarker
to assess endoscopic and clinical remission in active UC treated with apheresis. Particularly as
this treatment causes a depletion in neutrophils in the circulation and colonic mucosa which
would be the main source of stool FC.
The study appears well designed with appropriate analysis and statistical methods. The findings
suggest FC could be a useful biomarker to predict early response to apheresis therapy and also
mucosal healing after successful clinical remission.
This is a small study and the authors recognise this and in itself would be best regarded as pilot
study requiring further larger studies.
Minor point: Line 156 the word Adacolumn is misspelt.
Review for 10.1186/s12876-021-01893-4 (2021)

Title: Obesity and metabolic abnormalities as risks of alcoholic fatty liver in men: NAGALA
study
Version: 1 Date: 16 May 2021
Reviewer:  Vik Meadows
Reviewer's report:
The authors present interesting evidence to metabolic factors that influence AFLD development.
This manuscript will help advance understanding of ALD in the authors geographic region and
population included in this manuscript.
1. The data from this manuscript is acquired from a cohort of healthy individuals who consume
at least 420g EtOH/week. This manuscript would benefit from inclusion and data analysis
comparing metabolic parameters used in this study including hepatic steatosis between >420g/
week to <420g/week and 0g/week (if there are individuals who meet these two criters- otherwise
<420g/week would suffice).
2. The authors finding that "The volume of habitual alcohol consumption at baseline does not
predict incident AFLD." should be compared to other retrospective studies. This is interesting
and important for the advancement of ALD studies so it should be emphasized and expanded
upon in the discussion. Similarly, if there are contradicting studies those should be addressed
and differences between the two studies highlighted.
3. The statistical analysis of the data acquired in this manuscript is unclear and should be
rewritten to allow for reader understanding, as in continuous and categorical variables should
be clearly defined in the methods.
4. Additionally, authors may consider changing data presentation from persons-year to persons
per year for clarity.
Review for 10.1186/s12876-021-01893-4 (2021)

Title: Obesity and metabolic abnormalities as risks of alcoholic fatty liver in men: NAGALA
study
Version: 1 Date: 18 May 2021
Reviewer's report:
1. The study is not novel and doesn’t bring any significant new information to the knowledge
of the fatty liver disease. it is a retrospective longitudinal study. Interestingly, in all probability,
this same data was used in the publication of another manuscript earlier by the same authors
which highlighted the role of hyperglycemia being associated with AFLD. However, in this
manuscript, while citing the same reference (19), they mention that it was unclear whether AFLD
was a phenotype in metabolic syndrome. These two things appear contradictory and need to be
elaborated more.
2. The authors use ARLD and AFLD at the beginning of the manuscript. However, from the
definition of AFLD provide, it seems that both the acronyms are similar. Thus authors are
requested to explain if these two acronyms are different and are also suggested to stick to one
if not.
3. The authors, in the discussion section, mention that their data indicates overnutrition being an
important trigger for the development of liver steatosis in subjects consuming alcohol habitually.
However, in the baseline characteristics of the study population, the authors do not present any
parameter where they have monitored the nutrition/diet of these subjects over the period of the
study. Hence the claim about overnutrition pertaining to this study appears to be overanalyzing.
4. The discussion section is drafted well while the authors tried to provide a rational direction
to the outcome of this retrospective study. The authors are advised to include a working model
diagram/ infographic to summarize the metabolic pathways they talk about in the discussion.
Review for 10.1186/s12876-021-01893-4 (2021)

Title: Obesity and metabolic abnormalities as risks of alcoholic fatty liver in men: NAGALA
study
Version: 2 Date: 07 Jul 2021
Reviewer's report:
The suggestions provided have been incorporated in the revised manuscript.  However, the
supplementary figures, at least the infographic should be part of the main manuscript.
Review for 10.1186/s12876-021-01893-4 (2021)

Title: Obesity and metabolic abnormalities as risks of alcoholic fatty liver in men: NAGALA
study
Version: 2 Date: 12 Jul 2021
Reviewer:  Vik Meadows
Reviewer's report:
The authors addressed all concerns and comments from this reviewer. This manuscript is a great
addition to the field of alcohol liver research.
Review for 10.1186/s12876-021-01895-2 (2021)

Title: Prognosis of hypoglycemia episode in cirrhotic patients during hospitalization
Version: 2 Date: 04 Mar 2021
Reviewer's report:
Dr. Hong et al. presented an interesting draft about the topic that hypoglycemia in liver cirrhosis
may affect short term mortality, the study question is answerable by nationwide population
database. However, several items are needed to be addressed before accepting this manuscript.
1. Please provide flow-chart of your population
2.Please improve the methodology by using case-mix adjustment and sensitivity test concerning
the important confounding factors such as malnutrition and cancer.
3. Please list more characteristics in table 1, suggest hypertension, type 2 DM...
4. Please improve the language fluent by professional native English speaker.
Review for 10.1186/s12876-021-01895-2 (2021)

Title: Prognosis of hypoglycemia episode in cirrhotic patients during hospitalization
Version: 2 Date: 12 Mar 2021
Reviewer's report:
1. If possible, I will suggest the authors to show the follow-up period (person-year) and 30-day
mortality "rate" of the hypoglycemia group and the non-hypoglycemia group.
Review for 10.1186/s12876-021-01895-2 (2021)

Title: Prognosis of hypoglycemia episode in cirrhotic patients during hospitalization
Version: 4 Date: 23 May 2021
Reviewer's report:
There are some minor points need attention and to be further clarified.
1.  Please provide the codes for variceal bleeding, ascites and hypoalbuminemia (Page 6 & 9)
2. Please correct the typo? "socioeconomic stat (SES)" (Page 7)
3. For Figure 1, what the numbers listed in brackets (cachexia, cancer, CCI....) mean? the subjects
included or excluded?...
Review for 10.1186/s12876-021-01892-5 (2021)

Title: Prevalence of sero-markers and non-invasive assessment of liver cirrhosis in patients with
Hepatitis B virus infection in Freetown, Sierra Leone: A cross-sectional study
Version: 2 Date: 21 Apr 2021
Reviewer's report:
The authors discussed the situation of HBV in Sierra Leone. They made an overview of HBV
clinical presentation, laboratory changes and non invasive fibrosis markers. the manuscript is
well written however there are few comments on the manuscript
1- The manuscript lacks novelty and it's results didn't add new to the existing knowledge.
2- Number of patients is low in a country with high prevalence of HBV
3- Many data are missing such as US data which is mandatory for assessment of any HBV patient
and it may change the overall picture of patients.
4. AFP Data are missing which is important in HBV assessment
4- Additional comments in the manuscript
A. Methodology: Kindly add a reference to the following sentence "patients were assessed in
accordance with the recommendations of the Sierra Leone National Treatment Guidelines for
Viral Hepatitis B and C"
B. Describe in details "comprehensive metabolic panel"
C. It's recommended to use the new terminology of HBV stages instead of  immune
clearance phase, immune tolerant phase,  etc...  (https://www.journal-of-hepatology.eu/article/
S0168-8278(17)30185-X/fulltext)
D. Results numbers and percentage needs be unified in presentation (n, %)
Review for 10.1186/s12876-021-01892-5 (2021)

Title: Prevalence of sero-markers and non-invasive assessment of liver cirrhosis in patients with
Hepatitis B virus infection in Freetown, Sierra Leone: A cross-sectional study
Version: 2 Date: 28 Apr 2021
Reviewer's report:
This study tackles an important issue related to HBV which evaluates the clinical presentation
and patterns of HBV serum markers in asymptomatic patients. However, the sample size was
small.
My comments are:
1. The following statement all through the manuscript very confusing "the presence of any
symptom strongly predicted the presence of significant liver fibrosis" however regression
analysis in the study predict liver cirrhosis (cutoff of APRI above 2 and FIB-4 above 3.25), not
significant fibrosis. Please clarify and correct all through the manuscript.
2. Mention inclusion and exclusion criteria of the study.
3. The five patients with HIV/HBV co-infection and the one patient with HCV/HBV co-
infection. I think they should be excluded from the study to ensure homogeneity of the study
population as co-infection affects the natural history of disease and it is difficult to compare
them with patients with HBV mono-infection due to their relatively small number.
4. The author mentioned 4 patients had features suggestive of a hepatoma. Data of confirmation
of HCC as AFP and CT should be added as HBV is an established hepatocarcinogen.  Also,
these patients had HBV mono-infection or co-infection.
5. The following statement needs a good and clear interpretation in the result section " Although
most of the patients were asymptomatic, where any symptom was present, the patient was
already more likely to have a non-invasive marker likelihood of liver fibrosis based on APRI
scores"
Review for 10.1186/s12876-021-01892-5 (2021)

Title: Prevalence of sero-markers and non-invasive assessment of liver cirrhosis in patients with
Hepatitis B virus infection in Freetown, Sierra Leone: A cross-sectional study
Version: 3 Date: 17 Jun 2021
Reviewer's report:
Thank you for clarifying and answering the required comments.
Review for 10.1186/s12876-021-01892-5 (2021)

Title: Prevalence of sero-markers and non-invasive assessment of liver cirrhosis in patients with
Hepatitis B virus infection in Freetown, Sierra Leone: A cross-sectional study
Version: 3 Date: 26 Jun 2021
Reviewer's report:
Thank you for addressing all comments, I agree on publishing this manuscript
Review for 10.1186/s12876-021-01887-2 (2021)

Title: Supplemental bifid triple viable capsule treatment improves inflammatory response and
T cell frequency in ulcerative colitis patients
Version: 0 Date: 03 Feb 2021
Reviewer's report:
Overall the manuscript addresses an important topic and investigates new options to cure
ulcerative colitis.
There are major concerns that need to be addressed to re-write the manuscript for consideration.
Therefore, I am not able to accept this manuscript.
The introduction needs that evidence for the use of somatostatin are detailed.
Efficacy of treatment should be addressed with colonoscopy to answer whether the patient is in
endoscopic remission or not. Mucosal healing is the treatment target for UC.
English is too poor.
Review for 10.1186/s12876-021-01887-2 (2021)

Title: Supplemental bifid triple viable capsule treatment improves inflammatory response and
T cell frequency in ulcerative colitis patients
Version: 2 Date: 23 Apr 2021
Reviewer's report:
Although the authors have met many of the concerns raised during the review I am not able to
accept this manuscript. My primary major comment, where I asked the authors to compare the
changes between baseline and end of treatment for the two treatment groups, has not at all been
addressed. Unfortunately, none of the tables have been changed in relation to this. In addition
to this, many parts of the sections in the introduction and discussion are missing references,
meaning that statements are being made with no background. Even though the discussion has
improved, it is still not acceptable in its present form. Finally, as stated by reviewer no 1, the
English is too poor.
Review for 10.1186/s12876-021-01887-2 (2021)

Title: Supplemental bifid triple viable capsule treatment improves inflammatory response and
T cell frequency in ulcerative colitis patients
Version: 4 Date: 25 May 2021
Reviewer's report:
The authors have now added the analyses which compare the change between the two groups
and show the results in Table 2-5. It was nice to see that there were also differences detected
between the changes. The manuscript has also been edited for English language and now reads
fine. In addition, references have been added at key positions. I have no further comments.
Review for 10.1186/s12876-021-01888-1 (2021)

Title: Long-term outcomes of endoscopic submucosal dissection for superficial esophageal
squamous cell carcinoma in Taiwan
Version: 3 Date: 03 May 2021
Reviewer's report:
This is a retrospective study to assess the long-term outcomes of endoscopic submucosal
dissection (ESD) for esophageal squamous cell carcinoma (SCC) in Taiwan. The clinical
question is important. However, this study has some limitations. My main issues are as follows.
Please show not only disease specific survival but also overall survival of patients, because other
organ cancer is very important for patients with esophageal SCC.
In this study, 17.4% of cancers were invading into the submucosa. Please show additional
treatments for patients with non-curative resection.
Please summarize breakdown of metastatic recurrence.
Please also summarize stage of metachronous esophageal SCC and their treatment.
In this study, approximately 60% of patients had head and neck cancers. What are the risk factors
for head and neck cancers in this study (drinking, multiple LVLs, or betel nuts)?
Minor point.
In the result, there is a description as follows “The mean tumor size was 32.8 ± 16.9 cm”.
However, it should be “The mean tumor size was 32.8 ± 16.9 mm”.
Review for 10.1186/s12876-021-01888-1 (2021)

Title: Long-term outcomes of endoscopic submucosal dissection for superficial esophageal
squamous cell carcinoma in Taiwan
Version: 3 Date: 09 May 2021
Reviewer's report:
The study reported the Long-term outcomes of endoscopic submucosal dissection for superficial
esophageal squamous cell carcinoma in Taiwan. A total of 229 lesions were enrolled in 10 years.
The relationship between Lugol staining background pattern and the risk of recurrence were
analyzed. But many similar articles about it have been reported in recent years.
Review for 10.1186/s12876-021-01888-1 (2021)

Title: Long-term outcomes of endoscopic submucosal dissection for superficial esophageal
squamous cell carcinoma in Taiwan
Version: 3 Date: 24 May 2021
Reviewer:  Noboru Hanaoka
Reviewer's report:
Thank you for giving me an opportunity to review this article. This is a retrospective analysis of
the outcome of the patients who underwent esophageal ESD in Taiwan. This manuscripts was
well written and would help the readers to manage esophageal cancer.
I have some comments as below.
##There is a consensus on the course of tumors with shallow depths, and many cases have
been proven to be curable with ESD resection. However, tumors deeper than SM1 require
some additional treatment, and no consensus has been reached. In this case, you mentioned that
additional surgical treatment or CRT was chosen for cases deeper than SM1, and you should
present and detail the clinical course of these cases.
2#It details the use of endoscopy for follow-up to detect local recurrence and metachronous
lesions. However, specific methods and examination intervals for detecting lymph node
metastases and distant metastases are not described. I don't think there is a uniform method for
all eligible patients because this is a retrospective analysis, but this can be a limitation.
3#I don't think there is much difference from the reports from Japan, what do you think is the
reason for that?
4.The authors should clarify the definition of adverse events. Mediastinal emphysema was
defined as the presence of air in the mediastinal space.  How did the authors confirm the air in
the mediastinal space? Computed tomography?
5. Esophageal stricture was defined as narrowing with dysphagia that required endoscopic
treatment. How did the authors confirm the stricture? Esophagogastroduodenoscopy?
Review for 10.1186/s12876-021-01888-1 (2021)

Title: Long-term outcomes of endoscopic submucosal dissection for superficial esophageal
squamous cell carcinoma in Taiwan
Version: 4 Date: 11 Jul 2021
Reviewer:  Noboru Hanaoka
Reviewer's report:
Dear authors
The content has been brushed up and improved. There are no particular questions or corrections.
Review for 10.1186/s12876-021-01864-9 (2021)

Title: Prognostic role and clinicopathological features of SMAD4 gene mutation in colorectal
cancer: a systematic review and meta-analysis
Version: 0 Date: 27 Apr 2021
Reviewer's report:
The manuscript addresses a clear hypothesis and it would provide valuable data if the text was
better written. There are many typographical errors and incomprehensible parts of the text that
should be rewritten.
Major issues:
The term "mutation" used throughout the manuscript is confusing for readers. If this term refers
to any change in sequence, then their consequences should be considered by the authors in the
context of results interpretation. If the term refers to pathogenic variants only, then it should be
clarified throughout the manuscript.
The term "activating mutations" is not suitable for a tumor suppressor gene that is inactivated
in cancer (page 2 line 2).
The abstract states that 10 studies were included, while the text of the manuscript indicates 9?
The figures are mislabeled (1-7 or 1-4?).
There are typographical errors (page 3 line 1 and page 9 line 2).
I would suggest English proofreading.
Review for 10.1186/s12876-021-01871-w (2021)

Title: Antimicrobial resistance in patients with decompensated liver cirrhosis and bacterial
infections in a tertiary center in Northern Germany
Version: 1 Date: 30 Apr 2021
Reviewer's report:
This is an interesting and important article about cirrhotic patients with bacterial infections.
However, I have some questions and suggestions to this study:
1) Because all of the enrolled cirrhotic patients have ascites, the world “ascites” should be listed
in the title of this article.
2) What is “BSI”? blood stream infection? It should be listed in the Abbreviations sections or
in the article.
3) In this study, the definition of SBP was “ # 500 nucleus containing cells/µl ascites fluid”.
Please provide the guidelines or articles as reference about this definition.
4) Pneumonia is also an important infection in cirrhotic patients. It is better to explain why
pneumonia was not analyzed in this study.
5) Using regression analysis method may provide more information in this study.
6) What is the mortality of the patients in the study  Infections are important issues in patients
with liver cirrhosis because of the high mortality. Could you provide this data in the article? If
not possible, please also mentioned that in the limitation part of the article.
Thanks!
Review for 10.1186/s12876-021-01871-w (2021)

Title: Antimicrobial resistance in patients with decompensated liver cirrhosis and bacterial
infections in a tertiary center in Northern Germany
Version: 2 Date: 21 May 2021
Reviewer's report:
Thank you for answering my questions. I commented some points below.
1, Regarding the discussion, the tenses are all scattered, so please unify them.
2, In the discussion, PPI use and alcohol consumption are considered to be involved in the
increase of gram-positive cocci, but were the two factors related in the patients who had gram-
positive cocci infections and those who did not in this study?
3, Please describe the findings that can be generalized from this study in conclusion.
Review for 10.1186/s12876-021-01867-6 (2021)

Title: Return on Investment of Internet Delivered Exposure Therapy for Irritable Bowel
Syndrome: A Randomized Controlled Trial
Version: 3 Date: 15 Apr 2021
Reviewer:  Daniel Keszthelyi
Reviewer's report:
The paper by Wallen et al. is a timely, well-written piece of work describing the cost-
effectiveness of the exposure-element to CBT in IBS. The findings support the notion that
the exposure element is a worthwhile addition to CBT. The authors are to be congratulated
on the soundness of the data collection (digital systems, incl. well-establish Trimbos/iMTA
questionnaire) and analysis.
I only have some minor comments.
1. The manuscript is structured in a somewhat unconventional way: the introduction is quite
long, whereas the discussion is rather brief (in fact, shorter than the introduction). Please consider
restructuring.
2. Something that struck me was the costs for GP consultation (over 380 USD), even more
expensive than consultation with a medical specialist. Could you please elaborate?
3. Along the same line, it should me mentioned as a limitation that the current analysis may only
be applicable to the Swedish situation as healthcare financing (and in particular psychological
care) differs across countries, even within Europe.
4. Do the authors have any data as to the satisfaction of the healthcare provider regarding this
type of delivery of healthcare?
Review for 10.1186/s12876-021-01867-6 (2021)

Title: Return on Investment of Internet Delivered Exposure Therapy for Irritable Bowel
Syndrome: A Randomized Controlled Trial
Version: 3 Date: 02 May 2021
Reviewer:  Zlatan Mujagic
Reviewer's report:
Overall a well conducted and well analyzed study. The conclusion adds value to the available
literature.
A few remarks / suggestions for revisions:
1) The authors indicate that not all patients completed the treatment and treatment completion
was not taken into account in the present study. Why was this point not taken into account as
it could have an effect on the final conclusion? Could the authors provide more information or
consider taking the completion of the study into account in their analysis?
2) The authors indicate that the small number of missing data (maximum of 13.7% at 6 months
FU), probably has no effect on the final conclusion. While this is probably true, depending on
which patients had missing data, it may have an effect on the conclusion. As there could be some
unreported bias. The authors could provide some more data on this point by describing whether
the patient group with missing data does or does not differ from the rest of the study population.
3) One minor remark: the abbreviation ICBT-WE spelled out as full term, and throughout the
manuscript is it written as ICBT-we and ICBT-WE.
Review for 10.1186/s12876-021-01867-6 (2021)

Title: Return on Investment of Internet Delivered Exposure Therapy for Irritable Bowel
Syndrome: A Randomized Controlled Trial
Version: 5 Date: 03 Jun 2021
Reviewer:  Zlatan Mujagic
Reviewer's report:
The authors have provided clear answers to the comments and have revised the manuscript
accordingly.
Review for 10.1186/s12876-021-01867-6 (2021)

Title: Return on Investment of Internet Delivered Exposure Therapy for Irritable Bowel
Syndrome: A Randomized Controlled Trial
Version: 5 Date: 05 Jun 2021
Reviewer:  Daniel Keszthelyi
Reviewer's report:
Thank you for revising the manuscript. I have no additional comments.