JerMa88/BMC_Gastroenterology_Peer_Reviews huggingface dataset:
Review for 10.1186/s12876-024-03465-8 (2024)

Title: Low geriatric nutritional risk index is associated with osteoporosis and fracture risk in
patients with chronic liver disease: a cross-sectional study
Version: 0 Date: 24 Sep 2024
Reviewer's report:
The authors presented a cross-sectional study that investigated relationships between  geriatric
nutritional index (GNRI), osteoporosis and FRAX-derived fracture risk in patients with chronic
liver disease. They found that patients with lower GNRI had higher rates of osteoporosis and
higher risk of fracture. Although  similar results have been  already found in studies that involved
patients with specific comorbidities, this is the first study that involved patients with chronic
liver disease. This paper is of real interest,  because of high risk of fracture in the selected
population, and GNRI is a relatively simple calculation tool to assess the risk for  osteoporosis
and fracture. The presentation of work and data are clean, and the methodology is easy follow
through the text.
However, before publication, several things need to be cleared.
#1: In the clinical trials and in everyday practice,  the CKD EPI formula is usually used to
estimate glomerular filtration rate. However, in this paper another formula is used  to estimate
GFR. Is there any specific reason for that?
#2: Serum creatinine, albumin, bilirubin and prothrombin time  are routine laboratory tests
and need no specification about  laboratory methods that were used for their quantification.
However,  M2BPGi is usually not routinely performed and it needs more specification  about
analytical  methods that were used to it.
#3:  I suggest rephrasing sentence in row 166, which starts with 'The all-risk group', by
eliminating any unnecessary 'ANDs' and replacing them with commas.
Review for 10.1186/s12876-024-03465-8 (2024)

Title: Low geriatric nutritional risk index is associated with osteoporosis and fracture risk in
patients with chronic liver disease: a cross-sectional study
Version: 1 Date: 07 Oct 2024
Reviewer's report:
The authors corrected the previous objections. They also explained why they used a specific
formula to calculate the estimated glomerular filtration rate.
Therefore, if the editor and other reviewer  agree, this article can be accepted.
Review for 10.1186/s12876-024-03460-z (2024)

Title: Risk of Clostridioides difficile infection in inflammatory bowel disease patients
undergoing vedolizumab treatment: a systematic review and meta-analysis
Version: 0 Date: 22 Jun 2024
Reviewer's report:
Authors evaluated the risk of CDI in patients with IBD treated with vedolizumab using
systematic review and meta-analysis. They concluded that the risk of CDI was higher in UC
than in CD. Furthermore, the risk of CDI was not significantly different between vedolizumab
and other medications (anti-TNF# agents, corticosteroids, and 5-ASA).
Evaluating the risk of CDI in patients with IBD is important. However, there are serious concerns
in this study.
Major comment:
The main limitation of this study is the high heterogeneity within included studies. For
example, authors included both clinical trials and real-world observational studies. However, the
characteristics of patients included in clinical trials and real-world settings are quite different.
Furthermore, since the risk of CDI would be different between UC and CD, the results of analysis
comparing the risk of CDI between vedolizumab and other medications would be biased when
studies including both UC and CD patients were  used in the analysis.
Meta-analysis using more severe protocol to include homogenous studies is recommended to
control clinical heterogeneity.
Review for 10.1186/s12876-024-03460-z (2024)

Title: Risk of Clostridioides difficile infection in inflammatory bowel disease patients
undergoing vedolizumab treatment: a systematic review and meta-analysis
Version: 0 Date: 25 Jun 2024
Reviewer's report:
Dr. Chen W and colleagues complied with existing evidence without fail and conducted a meta-
analysis to examine the risk of CDI in patients with inflammatory bowel disease treated with
vedolizumab.
This study was conducted meticulously and appears to have required a great deal of effort. I
would like to extend my sincere gratitude to Dr Chen W and his colleagues.
However, some corrections are required for this paper to be accepted.
Major:
Currently, the term Clostridium difficile is not widely used, and is often written as Clostridioides
difficile. Also, it should be written in italics. I recommend that you rewrite it as above.
Minor
Regarding item "Risk of C. difficile infection in IBD patients in treatment of vedolizumab" in
the Results section, the risk of serious CDI is described as 0.20/100 person-years (95%CI 0.04
to 1.11; I2=92%), but when referring to Figure 2D, it is described as 0.586/100 person-years
(95%CI 0.220 to 1.561; I2=0%), which is inconsistent.
I recommend you check the above items.
Review for 10.1186/s12876-024-03460-z (2024)

Title: Risk of Clostridioides difficile infection in inflammatory bowel disease patients
undergoing vedolizumab treatment: a systematic review and meta-analysis
Version: 1 Date: 14 Jul 2024
Reviewer's report:
The author has responded to the queries with a bibliographic discussion and additional subgroup
analyses. However, the response is rather confusing.
Regarding the inclusion criteria, the content addressed in the response has not been reflected in
the main text, and limitations should also be added to the manuscript. It is difficult for readers
to understand and may lead to misinterpretation of the results.
As the authors have mentioned, in the context of IBD, it is known that the results of clinical
trials can differ from those observed in the real world. Therefore, if the aim is to evaluate the risk
of CDI in the real world, clinical trials should be excluded at the inclusion criteria stage, even
if the results suggest that the impact of clinical trials on the meta-analysis results is minimal.
The consideration that the impact is negligible due to the small number of RCTs collected in
the study is biased and unacceptable. Furthermore, if RCTs are not to be excluded, at the very
least, they should be discussed as a limitation.
The primary outcome is the incidence of CDI in IBD patients, but the results are unclear. It
would be better to understand if the incidence of CDI were reported separately for UC and CD.
Review for 10.1186/s12876-024-03460-z (2024)

Title: Risk of Clostridioides difficile infection in inflammatory bowel disease patients
undergoing vedolizumab treatment: a systematic review and meta-analysis
Version: 1 Date: 17 Jul 2024
Reviewer's report:
This is a meta-analysis of the incidence of Clostridioides difficile in patients with inflammatory
bowel disease being treated with vedolizumab. This is an important question however there are
concerns with this study in its current form.
1) The authors need to update the title to reflect the updated nomenclature.
2)  Under results in the abstract, the authors need to indicate what the range indicates. This is
assumed to be a 95% confidence interval, however this should be labeled.
3) In the background section, the authors indicate that "vedolizumab posed an increased risk
of gastrointestinal infections compared to the placebo group" however the cited article findings
state: "the exposure-adjusted incidence rates of any infection were lower among patients
receiving vedolizumab (63.5/100 PYs; 95% CI 59.6 to 67.3) than placebo (82.9/100 PYs; 95%
CI 68.3 to 97.5)" and  "The exposure-adjusted incidence rates of serious infections were similar
for vedolizumab and placebo ". Therefore, the authors' statement is incorrect.
4)  The authors included low quality studies in this analysis, such as case series and included
studies that were only published in abstract form. Using low quality studies decreases the
strength of the findings.  Further, it appears that the authors included at least 1 cohort twice
(Kochar - once in abstract form and once full publication).
5) Many of the results either showed a 95% CI that crosses 1 or have a very high i2 score
supporting a finding of a high level of heterogeneity between the studies.  Despite these results,
the authors report a "potentially lower risk of c. difficile infection with vedolizumab" however
this cannot be concluded when the 95% CI crosses 1.
Review for 10.1186/s12876-024-03460-z (2024)

Title: Risk of Clostridioides difficile infection in inflammatory bowel disease patients
undergoing vedolizumab treatment: a systematic review and meta-analysis
Version: 1 Date: 19 Jul 2024
Reviewer's report:
The author has taken my suggestions into account and made appropriate revisions to the paper.
This paper deserves to be accepted.
However, please correct "Clostridium difficile" in the title to "Clostridioides difficile."
Review for 10.1186/s12876-024-03460-z (2024)

Title: Risk of Clostridioides difficile infection in inflammatory bowel disease patients
undergoing vedolizumab treatment: a systematic review and meta-analysis
Version: 1 Date: 26 Jul 2024
Reviewer's report:
Review of the manuscript:
Risk of clostridium difficile infection in inflammatory bowel Disease patients undergoing
vedolizumab treatment: a systematic review and meta-analysis
Thank you for the kind invitation.
This is a systemic review and meta-analysis about a common problem among IBD patients. Due
to its gut-selectivity, vedolizumab has been linked to Clostridium Difficile (C Diff) infection.
The risk of C Diff infection for IBD patients on vedolizumab, was found to be rather low.
Although no statistical significance was reached, vedolizumab was related to less infections
compared to anti-TNFs and more, compared to steroids and 5-ASA.
The data are weak mainly due to the high heterogeneity of included studies and this is pointed
out by the authors. Evidence in patients with IBD is mostly indirect, since C Diff infection is
usually reported as a secondary outcome.
Among the strengths of the study are its subject of high importance for every day clinical
practice, as well as the large number of patients.  A few spelling mistakes need the authors’
attention.
Additionally, I would kindly ask the authors to comment on the following points:
1. Why were patients with pouchitis and postoperative Crohn’s excluded?
2. Are there any data about subcutaneous vedolizumab regarding C Diff infection?
3. Do the duration and dose of vedolizumab affect the risk of the infection?
4. Given that the incidence of C Diff infection is increased in IBD patients, does activity of the
disease play the most important role? Did any associations with activity and/or age emerge from
the included studies?
5. The incidence of C Diff infection among UC patients on vedolizumab, was shown to be higher
than in the CD population. Colonic involvement in UC partly accounts for this.  Vedolizumab
is possibly offered in milder CD cases, whereas it is one of the recommended first -line options
in moderate UC.  Please comment.
6. No difference was found between vedolizumab and anti-TNFs regarding C Diff infection.
However, CD patients under vedolizumab experienced higher risk of C Diff infection compared
to their anti-TNF counterparts. Again, inadequate control of the inflammation may have
accounted for the increased risk.  Please comment.
Unless prospective studies are performed, considering all the possible confounding factors, no
safe conclusions can be drawn. However, data collection and analysis are always appreciated
and are rather reassuring according to the present study. I would like for the authors to expand
on the manuscript’s discussion, taking into account the above-mentioned points.
Review for 10.1186/s12876-024-03460-z (2024)

Title: Risk of Clostridioides difficile infection in inflammatory bowel disease patients
undergoing vedolizumab treatment: a systematic review and meta-analysis
Version: 3 Date: 15 Aug 2024
Reviewer's report:
Please discuss if there was any effect if vedolizumab was used as first, second or even third
line treatment.
Please discuss other co-existing risk factors for CDI infection.
Review for 10.1186/s12876-024-03460-z (2024)

Title: Risk of Clostridioides difficile infection in inflammatory bowel disease patients
undergoing vedolizumab treatment: a systematic review and meta-analysis
Version: 3 Date: 26 Aug 2024
Reviewer's report:
Review of the manuscript:
Risk of clostridium difficile infection in inflammatory bowel Disease patients undergoing
vedolizumab treatment: a systematic review and meta-analysis
Thank you again for the kind invitation.
I have read the detailed response of the authors to the comments of all reviewers. I am pretty
happy with their response on my part. I therefore agree for this manuscript to be published in
its revised version.
Review for 10.1186/s12876-024-03460-z (2024)

Title: Risk of Clostridioides difficile infection in inflammatory bowel disease patients
undergoing vedolizumab treatment: a systematic review and meta-analysis
Version: 4 Date: 14 Sep 2024
Reviewer's report:
Please provide an algorithm of diagnosis and treatment of IBD  patients  with diarrhea  and
suspected CDiff infection
Review for 10.1186/s12876-024-03460-z (2024)

Title: Risk of Clostridioides difficile infection in inflammatory bowel disease patients
undergoing vedolizumab treatment: a systematic review and meta-analysis
Version: 4 Date: 19 Sep 2024
Reviewer's report:
Review of the manuscript:
Risk of clostridium difficile infection in inflammatory bowel Disease patients undergoing
vedolizumab treatment: a systematic review and meta-analysis
Thank you again for the kind invitation.
After the revision of the manuscript by  the authors and as I already mentioned in our previous
contact, I believe that the manuscript may be published in the recently submitted form.
Review for 10.1186/s12876-024-03466-7 (2024)

Title: Effectiveness of Endoscopic Papillectomy with Stent Placement in Pancreatic and Bile
Ducts for Treating Duodenal Papillary Adenoma: A Retrospective Study
Version: 1 Date: 29 Jul 2024
Reviewer's report:
I read with great interest the article titled “Effectiveness of Endoscopic Papillectomy with
Stent Placement in Pancreatic and Bile Ducts for Treating Duodenal Papillary Adenoma: A
Retrospective Study” by Jiani et al.
This retrospective study describes the role of pancreatic and biliary stenting in management of
duodenal papillary adenomas. I have the following comments to be made for this study:
1. Abstract: please mention primary and secondary outcomes of the study in methods section.
Moreover, also mention percentages (values) in results section, wherever it can be done.
2. Section of “endoscopic procedures”:
a. specify and give reference of which guideline that was followed for anti-coagulation/anti-
platelet stoppage
b. Please provide the detailed technique of performing endoscopic papillectomy in a
supplementary table: discussing various nuances practiced at author’s center and devices used
for the same.
c. What was the “indication” as to which case will receive biliary or pancreatic stenting or both
or no stent at all ? please specify in the methodology. The guidelines clearly suggest to place
PD stent (ASGE) to prevent PEP rates.
d. Please specify whether adverse events were recorded as per ASGE lexicon and AGREE
classification ? if not, please do the same and mention in the manuscript.
e. What criteria was followed for assessing which cases will need stent removal ?
f. Please mention what all was done on follow-up ? as per manuscript, all cases underwent biopsy
of the resected area ?
3. Definitions: please specify the references of articles which authors have used for their
definitions.
4. Put the follow up part in methodology and remove from section of definitions.
5. Results: section of population characteristics: As per Figure 1, the cases of non-pancreatic
stenting includes cases with biliary stenting also; similarly the case is true vice cersa for non-
biliary stented cases which includes pancreatic stenting. Ideally, if the authors have made 4
groups, the comparison of each should be made with those cases which have no-stent (both
biliary and pancreatic) to show whether a single or combination of stents has any role to play in
adverse events and post-resection outcomes on recurrence of adenoma.
6. please modify the results and discussion of the manuscript accordingly as per suggestions
given above.
Review for 10.1186/s12876-024-03466-7 (2024)

Title: Effectiveness of Endoscopic Papillectomy with Stent Placement in Pancreatic and Bile
Ducts for Treating Duodenal Papillary Adenoma: A Retrospective Study
Version: 2 Date: 15 Sep 2024
Reviewer's report:
The authors have answered all my comments. Congratulations to them for this manuscript.
Review for 10.1186/s12876-024-03466-7 (2024)

Title: Effectiveness of Endoscopic Papillectomy with Stent Placement in Pancreatic and Bile
Ducts for Treating Duodenal Papillary Adenoma: A Retrospective Study
Version: 2 Date: 15 Sep 2024
Reviewer's report:
The manuscript is now more suitable for publication, more detailed and clear.
Review for 10.1186/s12876-024-03472-9 (2024)

Title: Association of Oral Manifestations with Severity of the Disease in Ulcerative Colitis
Patients
Version: 2 Date: 26 Jun 2024
Reviewer:  Matiar Madanchi
Reviewer's report:
Thank you very much for giving me the opportunity to review this manuscript. It is a very
interesting and unique manuscript. The authors have expressed their point of view and the
interpretation of the data very well. Additionally, the authors have responded acceptably to the
point-by-point answer. I believe that the manuscript is suitable for the journal and do not think
any further changes to the manuscript are necessary.
Best regards,
Dr. Matiar Madanchi
Review for 10.1186/s12876-024-03472-9 (2024)

Title: Association of Oral Manifestations with Severity of the Disease in Ulcerative Colitis
Patients
Version: 2 Date: 16 Jul 2024
Reviewer:  Bhaskar Kante
Reviewer's report:
Dear Authors, Congratulations to the team for the commendable work on prevalence of oral
manifestations and its correlation with disease activity. The manuscript was well written and I
have few comments for the manucscript highlighted below
1. Abstract needs to be rewritten
2. In the introduction, you can talk about various oral manifestations associated with UC as
shown in other studies
3. In methodology, clinical signs and symptoms such as dysphagia, burning sensation, nausea ,
vomitings symptoms should  not be considered as oral manifestations, before planning the study
why did choose only certain symptoms ?
4. Did you look for common oral manifestations associated with UC such apthous stomatitis,
pyostomatitis vegans, periodonititis, orofacial granulomatosis . It would have been better as per
Dentist assessment, pathology could have taken into consideration
5. In the methodology, it was unclear that why controls were used, did you assess the difference
prevalence of oral symptoms among patients of UC and controls. It was also unclear, did you
take consecutive patients of UC to look for oral symptoms prevalence
6. Did you assess the extent of disease among patients of UC. It would be better to compare the
severity of disease with extent with the oral symptoms
7. What could be possible cause of dysphagia prevalence among the patients of UC. Did you
perform endoscopy to know the cause
8. What are the categories of drugs used by patients in the study, any information on antibiotic
usage,
9. In the discussion, discuss in detail the possible explanation of oral symptoms with UC disease
pathogenesis and its impact on patient of UC
Review for 10.1186/s12876-024-03472-9 (2024)

Title: Association of Oral Manifestations with Severity of the Disease in Ulcerative Colitis
Patients
Version: 3 Date: 07 Aug 2024
Reviewer:  Matiar Madanchi
Reviewer's report:
The manuscript is very interesting. The authors have responded in detail to the questions/
comments of reviewer 2, and therefore, I believe the text is fit for publication.
Best regards,
Dr. Matiar Madanchi
Review for 10.1186/s12876-024-03468-5 (2024)

Title: Endoscopic management of post-cholecystectomy complications at a Nigerian tertiary
health facility
Version: 2 Date: 21 Aug 2024
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Authors, please make sure to address the following points in your manuscript:
1. Clarify how you calculated your sample size.
2. Include the different classifications of biliary injuries (Bismuth, Strasberg, and Amsterdam)
in your introduction.
3. Specify if there were refractory leaks in your patients.
4. Indicate the site of the bile leak - whether it was a high or low flow.
5. Discuss the complications of endoscopic management.
6. Divide the table in your results, as all the information in one table makes it less clear to readers.
7. Add your conclusion at the end.
8. Ensure that your manuscript undergoes grammar and language editing.
Review for 10.1186/s12876-024-03468-5 (2024)

Title: Endoscopic management of post-cholecystectomy complications at a Nigerian tertiary
health facility
Version: 2 Date: 27 Aug 2024
Reviewer's report:
This is a well written manuscript on post cholecystectomy ERCPs in a hospital setting. Please
see comments in the attached manuscript.
Given that most procedures are paid out of pocket in your setting, how much would it cost to
get an ERCP?
Review for 10.1186/s12876-024-03468-5 (2024)

Title: Endoscopic management of post-cholecystectomy complications at a Nigerian tertiary
health facility
Version: 4 Date: 04 Oct 2024
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear authors,
The changes made to the manuscript are positive. Please just revise some spelling mistakes.
Review for 10.1186/s12876-024-03463-w (2024)

Title: Lipid Levels and Insulin Resistance Markers in Gastric Cancer Patients: Diagnostic and
Prognostic Significance
Version: 2 Date: 22 Aug 2024
Reviewer's report:
Lipid Levels and Insulin Resistance Markers in Gastric Cancer Patients: Diagnostic and
Prognostic Significance
In this study to investigate the clinical significance of serum lipid profiles, insulin resistance
markers including the triglyceride-glucose (TyG) index and the atherosclerotic index (AI), in
GC patients. Preoperative lipid profiles in the serum show a strong correlation with patients
diagnosed with GC. Evaluating a combination of various serum lipids and cancer markers
significantly improves diagnostic precision for GC and the ability to predict chemotherapy side
effects. Overall, this manuscript is well designed and studied. Some suggestions for this paper
are as follows:
Detailed comments to the author
1. The limitations of the paper and its interpretation are not discussed by using serum lipid
profiles, insulin resistance markers including the triglyceride-glucose (TyG) index and the
atherosclerotic index (AI), database collections.
2. In the discussion part, the author could discuss the possibility mechanism of chemotherapy
side effects.
Review for 10.1186/s12876-024-03463-w (2024)

Title: Lipid Levels and Insulin Resistance Markers in Gastric Cancer Patients: Diagnostic and
Prognostic Significance
Version: 2 Date: 12 Sep 2024
Reviewer's report:
Dear fellow scientist,
Thank you for conducting this study. It is a well-executed and solid piece of research, with
relevant sections that are clearly described in the results.
However, the Methods section could benefit from more structure. It would help to start
by outlining the endpoints and hypothesis and creating clear subsections. Currently, it feels
somewhat disorganized, and it's difficult to follow exactly what you did and how.
I recommend providing more detailed descriptions for each step in the Methods section to make
the process clearer.
Regarding the Discussion, it’s not quite optimal yet. While you offer a lot of theory and
explanations of how certain concepts work or why they were used, I miss a true discussion. What
are your own conclusions? What do other studies say, and how can we apply these findings in
practice?
The study is particularly strong because of the control group, which underwent propensity score
matching (PSM). So, my compliments for that. Make sure to use that data and critically reflect
on what could have been done better.
Also, why is "The identification of cost-effective..." mentioned at the start of the Discussion
when the article doesn’t address this topic? Begin the discussion by focusing on the study design,
what you found, and then delve into the deeper implications. This is currently missing.
Finally, how did you arrive at the sample sizes of 215 and 827 patients? This needs to be
explained.
Other than that, I have no further comments. I thoroughly enjoyed reading your study and would
like to offer my compliments.
Review for 10.1186/s12876-024-03463-w (2024)

Title: Lipid Levels and Insulin Resistance Markers in Gastric Cancer Patients: Diagnostic and
Prognostic Significance
Version: 3 Date: 10 Oct 2024
Reviewer:  Xiuming Li
Reviewer's report:
This is a meaningful study, preoperative lipid profiles in the serum show a correlation
with patients diagnosed with GC. Evaluating a combination of various serum lipids and
cancer markers significantly improves diagnostic precision for GC and the ability to predict
chemotherapy side effects.
Review for 10.1186/s12876-024-03456-9 (2024)

Title: Host cytokine genetic polymorphisms in a selected population of persons living with
hepatitis B virus infection in the Central Region of Ghana
Version: 2 Date: 15 Jul 2024
Reviewer's report:
Report on Host cytokine genetic polymorphisms in a selected population of persons living with
hepatitis B virus infection in the Central Region of Ghana
introduction
What is the difference between liver disease and liver cancer
Too  many unnecessary repetitions: infection is a public health concern in sub-Sahara Africa
(SSA); infections occur in Eastern and Sub-Saharan Africa; occur in the African region ?????.
Where is realy HBV?
Cytokines were already talked off in the first paragraph of the introduction. Why come now
to reintroduce cytokines afresh in the next paragraph? The introduction looks like pieces of
information cut and pasted without any coherence and a lot of repetition.
Materials and methods: OK
Results:
Tables 1& 2  talk of many parameters that were not announced in the introduction  It’s not
understood their role in the work. Does marital status, BMI, Alcohol,  education etc affect the
development of hepatitis B?. If yes, Please indicate in the introduction how these numerous
parameters in tables 1 &2 have been found to  affect HBV infection. The title of the work is
genetic polymorphisms and the work should be focused on this
Table 2 talks of clinical & anthropometric factors: Which are the anthropometric data in the
table?. I do not see.
Various ethnic groups were considered in this work. What is the frequency distribution of
cytokine genotypes in various ethnic groups in the country?
Table 5:  Comparison of variant allele frequency with other populations: Where are the values
from? Did authors work with Asians, Americans?
Review for 10.1186/s12876-024-03456-9 (2024)

Title: Host cytokine genetic polymorphisms in a selected population of persons living with
hepatitis B virus infection in the Central Region of Ghana
Version: 2 Date: 19 Jul 2024
Reviewer:  Juliet A. Shenge
Reviewer's report:
1.  Authors should make the necessary corrections in the tracked manuscript.  A clean copy must
be accompanied by the tracked manuscript when resubmitting.
2.  Submit a rebuttal showing responses to the queries raised in the manuscript.
3.  The data especially the genotyping results must be deposited in GenBank or any other
repository.  and accession numbers obtained
4. Check each citation and accompanying reference for it.
Review for 10.1186/s12876-024-03456-9 (2024)

Title: Host cytokine genetic polymorphisms in a selected population of persons living with
hepatitis B virus infection in the Central Region of Ghana
Version: 2 Date: 23 Jul 2024
Reviewer:  Kingsley Andrew Egbe
Reviewer's report:
The article presents intriguing insights that will significantly contribute to our understanding of
“Host cytokine genetic polymorphisms in a selected population of persons living with hepatitis
B virus infection in the Central Region of Ghana.”
However, several observations have been noted. The authors should review the manuscript for
grammatical accuracy and correct the identified errors, such as:
Abstract.
Under the background section of the abstract, the 4th line reads,  The outcome of HBV infection
is influenced by viral and hots factors including genetic. It should be viral host factors, including
genetics.
Under the result section of the abstract, the starting: There 20–39-year-old group formed
majority of the HBV infected  participants. The authors should consider rewording the sentence
accordingly for grammatical accuracy.
Methods
The authors should indicate when the sampling was done
Ethical consideration
The authors should consider checking for grammatical accuracy.
After the reference number it should read…..Participants who met the inclusion criteria were
approached at the clinic during their visit and informed of the study, and those who were willing
were enrolled.
Laboratory management
The authors should include the instrument for blood collection and how the plasma was
processed as indicated in the manuscript.
HBV antigen profile test
The authors should confirm whether it is Wondo or Wondfo and maintain consistency.
DNA Extraction and cytokine genotyping
The reverse primer sequence for TNF-# should be in capital letters.
Statistical Analysis
The authors should consider including the type of data collected using KoBo.
Results
Table 2
The explanation for table 2 should be checked for grammatical accuracy.
Figure 3:
The pair-wise LD association between three SNPs and the corresponding D’ and R’ values. The
colour gradient from red to white reveals higher?
Discussion
Line 16 reads: In a study that looked inactive HBV inactive carriers, it was discovered that 92%
of patients were inactive carriers which was much higher than our cases, although they have a
reduced sample size of 52 (38). It should be properly stated.
The authors should consider including and stressing the relevance of the study to global
discourse. For example, what specific target (not just to mention Goal 1, Goal 2, etc.)  in the
SDGs or AU Agenda 2063 does the findings of this study contribute to?
Review for 10.1186/s12876-024-03456-9 (2024)

Title: Host cytokine genetic polymorphisms in a selected population of persons living with
hepatitis B virus infection in the Central Region of Ghana
Version: 6 Date: 22 Aug 2024
Reviewer's report:
The second version of the manuscript “Report on Host cytokine genetic polymorphisms in a
selected population of persons living with hepatitis B virus infection in the Central Region of
Ghana” is improved but still needs improvement.
Abstract
• Line 50 and 51 combine as “Over the past decades, it has been noted that the natural course
of HBV in persons infected is taking a worse turn, leading to liver conditions such as cirrhosis
and cancer. “
• Under methods section, mention study design and period
• Under result section, state main findings those statistically significant (p<0.05)
Introduction
• Line 96, the word “in Eastern”, as Eastern is also part of Sub-Saharan
Methods
• The sample size calculation still needs revision. Using Raosoft software, with an average
patient population of 1000, a confidence interval of 95%, 5% margin of error and a 5% provision
for contingency the sample size is 278 not 166. Even with 5% contingency it is 174 not 207.
• The authors argue that this is not a protocol paper; however, in scientific articles the method is
the most important parts that show the research integrity. Hence, I suggest the authors to revise
the laboratory analysis. How did you do the RT-PCR? Which region of the HBV genome do
the Cobas TaqMan (CAP/CTM) HBV test kits target? The RT-PCR amplification profile? The
controls (positive, negative, and internal) were used in the experiment. For cytokine genotyping,
show the agarose gels with the different genotype bands.
Results
• A p-value less than 0.05 are typically considered to be statistically significant, depending on
the parameters you want to test. Accordingly, the interpretation of results in Table 1-4 with p
value < 0.05 should be describe in statement in body of the manuscript. For instance, male is
significantly predisposed to HBV infection than female (P <0.001), and so on. If the significance
of the p values is not meaningful, dealt from the tables.
• In the multivariate analysis, age group of 40-59 is risk factors for HBV DNA levels and FIB-4
score? If so, elaborate it.
Discussion
Line 363, replace the word “outcome” with “objective”
Line 368-369, delete the sentence “The total sample size for the study was 227 out of which 176
was selected for genotyping based on HBV DNA levels, AST/ALT levels and FIB score.”
Line 375, Table 5 is not presenting about Variant allele, consider other reference.
Review for 10.1186/s12876-024-03456-9 (2024)

Title: Host cytokine genetic polymorphisms in a selected population of persons living with
hepatitis B virus infection in the Central Region of Ghana
Version: 7 Date: 02 Sep 2024
Reviewer's report:
The 3rd version of the manuscript “Report on Host cytokine genetic polymorphisms in a selected
population of persons living with hepatitis B virus infection in the Central Region of Ghana”
is much improved, and I recommend publication. However, prior to publication, the following
points should be addressed:
• Typo error, punctuations, font type and size should be edited throughout the manuscript
• Table 1. Merge the two rows into one (single) row : Parameter; Total population n (%); Acute
HBV n (%); Chronic HBV n (%); Controls n (%); p-value .
• Table 2. Delete the n (%) in the Immune Phase row and correct as, Acute HBV n (%); Chronic
HBV n (%); Controls n (%)
• Table 3. Merge  the two rows into one (single) row: Parameter; Total participant n (%); Acute
HBV Median (IQR); Chronic HBV Median (IQR); Controls Median (IQR); p-value .
• Line 371-373 correct as, The objective of this study was to evaluate cytokine polymorphism,
viral survival strategies, and pathogenesis.
Review for 10.1186/s12876-024-03456-9 (2024)

Title: Host cytokine genetic polymorphisms in a selected population of persons living with
hepatitis B virus infection in the Central Region of Ghana
Version: 7 Date: 09 Sep 2024
Reviewer's report:
This version of the draft is improved, however minor comments remain.
1. Study design
The aim of the study is no longer to be mentioned here (line 149-150).
I suggest this sentence: The study is a single-centre cross-sectional study carried out at the
hepatitis clinic at the Cape Coast Teaching Hospital, Cape Coast, Ghana.
2. Genotyping
Clearly describe Iplex GOLD SNP genotyping protocol and classical PCR protocol (reaction
volume, PCR program, etc.)
3. It should be better to combine tables 2 and 3 into a single table named clinico-biological
characteristics.
4. The presentation of the results of the univariate and multivariate analysis remains to be
reviewed in the abstract (line 71-74) and the main document (line 318-327). For TNF-#
rs1800629, the odds ratios are less than 1 which tends towards protection, therefore a lower
susceptibility. This was even well mentioned in your discussion.
I suggest these sentences: The results of univariate (OR=0.08, 0.01-0.93; p= 0.043) and
multivariate (OR= 0.02, 0.00-0.67; p= 0.029) analysis, showed that carrying TNF-# rs1800629
AA genotype reduce susceptibility to high FIB score compared with GG genotypes. In univariate
analysis, subjects aged 20-39 years (OR=5.00, 1.13-6.10; p= 0.034) and 40-59 years (OR=
41.99, 3.74-47.21; p= 0.0002) were more susceptible to high FIB score compared to subjects
aged 1-19 years. Being female (OR= 2.42, 1.03-5.71; p=0.043) in the univariate models showed
higher odds of having high levels of HBV DNA in the multivariate model. There was a reduced
likelihood of herbal medicine usage influencing HBV DNA levels significantly (OR= 0.29,
0.10-0.86; p= 0.025).
5. Concerning figure 1, did you do a statistical comparison of the HBV DNA means between
the different genotypes? If not, it would be interesting to do it to confirm the differences.
6. For figure 2, I suggest the following title and legend: Figure 2: Linkage disequilibrium (L.D)
plot of IFN-#R1 rs11914, IFN-# rs121913163, IFN-#R1 rs1887415, IFN-# rs2069722 and IFN-
# rs2069723.
Legends: For the pair-wise LD association between five SNPs and the corresponding D’and R’
values, the color gradient from red to white reveals higher to lower LD (D’ 1-0; R’ 1-0).
Review for 10.1186/s12876-024-03456-9 (2024)

Title: Host cytokine genetic polymorphisms in a selected population of persons living with
hepatitis B virus infection in the Central Region of Ghana
Version: 7 Date: 10 Sep 2024
Reviewer's report:
There are many run on sentences, with convoluted meaning. These need to be recast.
There are many grammatical errors that may be identified and sorted out with the help of
professional editing service.
My main concern is that the frequency of cytokine variations do not show a causative effect;
rather an association may be recognised.
In the same way adducing a protective effect to any cytokine variant with this study design can
only be an educated guess and should be reported as such.
Review for 10.1186/s12876-024-03456-9 (2024)

Title: Host cytokine genetic polymorphisms in a selected population of persons living with
hepatitis B virus infection in the Central Region of Ghana
Version: 8 Date: 28 Sep 2024
Reviewer's report:
Issues of grammar pointed out in the last review were not attended to.
There are still many cases of poor grammar, tenses not agreeing etc.
There was no reaction to the  comment about the title of fig 1 and its conclusions
Review for 10.1186/s12876-024-03456-9 (2024)

Title: Host cytokine genetic polymorphisms in a selected population of persons living with
hepatitis B virus infection in the Central Region of Ghana
Version: 8 Date: 30 Sep 2024
Reviewer's report:
This version of the manuscript is fairly well written but some effort is still needed in writing
the discussion.
Major comments
1. I propose a two-part discussion:
First, the authors will discuss their results on the impact of the studied polymorphisms on HBV
DNA level. At this level, it is important to present in the results section a comparison of the viral
load means between the genotypes for figure 1, especially since the univariate and multivariate
analysis do not confirm your deductions on this figure.
In a second step, you will discuss your results on the association of polymorphisms with the
FIB score.
2.  I wanted to challenge the authors on the need to take into account the genotypes considered
in previous studies when making comparisons, because the association may be obvious but the
risk or protection will depend on the genotypes considered in each study.
Minor comments
1. Line 374-375: I propose to start the discussion with the objective which should be clearly
formulated. Proposed reformulation: The objective of this work was to study the association
of polymorphisms of genes coding for cytokines IL-2, IL-10, IL-18, INF-#, and TNF-# with
plasma HBV DNA level and FIB score in patients with HBV infection in Ghana.
2. Line 399-402 (This finding…hepatocellular carcinoma): this sentence is confusing even if
your results are indeed comparable. Your results show “protection or reduce likehood” and Jeng
et al. find risk factor.
3. Lines 403-413: there is no reference in this section.
4. When using an abbreviation for the first time, it is important to define it: Sustainable
Development Goals (SDG).
Review for 10.1186/s12876-024-03464-9 (2024)

Title: The independent prognostic value of perioperative hepatic venous pressure gradient
measurements in patients with portal hypertension who underwent laparoscopic splenectomy
plus esophagogastric devascularization
Version: 2 Date: 04 Sep 2024
Reviewer's report:
This is a retrospective study to evaluate the efficacy of laparoscopic splenectomy plus
esophagogastric devascularization (LSED) for treating portal hypertension (PHT). The authors
showed a significant decreased hepatic venous pressure gradient (HVPG), and patients with
postoperative HVPG decreased > 20% obtained better upper gastrointestinal bleeding (UGIB)-
free survival. However, the following concerns need to be addressed:
Major comments
1. On line 2 in Page 4, 135 patients were finally included into the study. Could the authors show
how many patients underwent LSED during the study period in total? It would be better to add
the consort diagram for the retrospective study.
2. On lines 20-21 in Page 4, the authors described that the spleen was transected with an Endo
GIA stapler. Precisely saying, “spleen” should be replaced with “splenic hilum”.
3. On lines 5-8 in Page 10 and Table 5, the authors analyzed the prognostic factor for
postoperative UGIB. However, the model was unstable and the range of CI was too large,
since the UGIB events had occurred in only 9 of 57 patients.  It would be better to delete the
multivariate analysis.
4. As for the analysis of UGIB-free survival in Figure 5, was the death of the patient included into
the event? For this type of analysis, the event of death can be a competing risk. In Figure 5, what
did the spot in the graph mean? Could the authors please add patients at risk under the graph?
Minor comment
5. On line 18 in Page 2, the word “always” should be replaced.
6. On line 14 in Table 3, the font type of “6.21” was not consistent to the other parts.
Review for 10.1186/s12876-024-03464-9 (2024)

Title: The independent prognostic value of perioperative hepatic venous pressure gradient
measurements in patients with portal hypertension who underwent laparoscopic splenectomy
plus esophagogastric devascularization
Version: 2 Date: 05 Sep 2024
Reviewer's report:
I would like to congratulate for your work ragarding this quite difficult to assess clinical
condition. Looks like a dedicated team came through all the invasive steps an that is challenging.
even if this is not the  standard treatment of Portal hypertension presented with UGIB, still
remains an important tool.
As far as my understanding is , HVGP measurement even as the best indicator of HTN is qyite
invasive and laparoscopic approach even so is of high risk of morbidity and mortality. I think it
would be a good opportunity to clarify compications and decompensation rates in you cohort. As
you undestand is paramount to integrate all data since its difficult to standarised such a procedure
as devascularizzation -splenectomy in patients who are potential candidates for liver transplant.
Even if admire your dedication to the approach one could state that is not a step forard when
we try to integrate non invasive methods, scores or non invasive tools to better understand the
degree od PHTN.
Iwould be grateful if you could better clarify- in the discussion -  the absolute or relative
indications for the invasive procedure as you have described in your paper
Review for 10.1186/s12876-024-03464-9 (2024)

Title: The independent prognostic value of perioperative hepatic venous pressure gradient
measurements in patients with portal hypertension who underwent laparoscopic splenectomy
plus esophagogastric devascularization
Version: 3 Date: 21 Sep 2024
Reviewer's report:
Excellent paper. In the era of liver transplantation, aggressive surgery for portal hypertension
is still appreciated. Particularly in countries where donor availability is so limited, laparoscopic
splenectomy with esophagogastric devascularization is definitely an option in order to prevent
or decrease mortality from upper GI bleeding due to PHT. In that setting perioperative  hepatic
venous pressure gradient measurements proved to be of significantly prognostic value.
Well structured. Well documented with statistical power. Satisfying English language.
Merits to be published.
Review for 10.1186/s12876-024-03464-9 (2024)

Title: The independent prognostic value of perioperative hepatic venous pressure gradient
measurements in patients with portal hypertension who underwent laparoscopic splenectomy
plus esophagogastric devascularization
Version: 3 Date: 28 Sep 2024
Reviewer's report:
This is a revised paper of the retrospective study to evaluate the efficacy of laparoscopic
splenectomy plus esophagogastric devascularization (LSED) for treating portal hypertension
(PHT). The authors showed a significant decreased hepatic venous pressure gradient (HVPG),
and patients with postoperative HVPG decreased > 20% obtained better upper gastrointestinal
bleeding (UGIB)-free survival. The paper has appropriately been revised and contained valuable
information.
Review for 10.1186/s12876-024-03457-8 (2024)

Title: Clinical study on conversion therapy of hepatocellular carcinoma - Summary and
comparison of clinical data from a single center of  consecutive four years
Version: 3 Date: 04 Aug 2024
Reviewer's report:
It is a great honor to review your manuscript as a reviewer. Thank you for your excellent work
in related fields, but I have a few suggestions for your consideration before this manuscript is
published.
Review for 10.1186/s12876-024-03457-8 (2024)

Title: Clinical study on conversion therapy of hepatocellular carcinoma - Summary and
comparison of clinical data from a single center of  consecutive four years
Version: 3 Date: 11 Sep 2024
Reviewer's report:
(A)An overview of the manuscript
This preliminary study has been undertaken to investigate the surgical safety and survival
outcomes of patients with initial unresectable hepatocellular carcinoma (uHCC) after conversion
therapy.
It is observed that a small percentage (1.81%) of uHCC patients are likely to be converted to
radical resection. It is suggested that a small percentage (1.81%) of uHCC patients are likely
to be converted to radical
(B) Introduction and discussion:
All relevant previously published studies have been cited
The work's aims, significance, and novelty are clearly outlined in the manuscript.
(C) Materials and methods:
The methods and statistical analyses are appropriate.
The manuscript complies with relevant national or international ethics guidelines.
(D) Results
The data presented is convincing regarding the reliability and validity of the results and figures.
The authors present the relevant controls.
The data support all the conclusions made by the authors.
(E) The level of the English
The manuscript does not require further revisions by a language editing company or a native
English speaker; however, a minor revision is required.
Review for 10.1186/s12876-024-03462-x (2024)

Title: Lymph node ratio is a prognostic indicator for locally advanced gastric cancer after
neoadjuvant immunochemotherapy
Version: 2 Date: 27 Jul 2024
Reviewer's report:
The topic of this study is interesting. The authors verified the lymph node ratio (LNR) as
a prognostic efficacy indicator for patients with locally advanced gastric cancer (LAGC)
after neoadjuvant immunochemotherapy (NICT), and the results demonstrated that LNR had
significant prognostic value for the prognosis of patients with LAGC after NICT.  However, we
can notice insufficient and missing data in this study.