JerMa88/BMC_Gastroenterology_Peer_Reviews huggingface dataset:
Review for 10.1186/1471-230X-12-109 (2012)

Reviewer's report
Title:Longitudinal fluctuations in PD1 and PD-L1 expression in association with
changes in anti-viral immune response in chronic hepatitis B
Version: 5Date:31 July 2012
Reviewer: Christoph Neumann-Haefelin
Reviewer's report:
The authors have now provided a control staining without tetramer as well as
control tetramer stainings from HBV-negative controls. These data are shown in
the supplementary materials.
The validity of these controls is strongly reduced, since the gating procedure is
different from the gating procedure in Figure 1 - using the same gating cut-off for
the PE (tetramer) channel, none of the tests in Figure 1 would be positive.
In conclusion, the validity/ significance of the FACS data is limited. This needs to
be kept in mind when interpreting the data.
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Review for 10.1186/1471-230X-12-110 (2012)

Reviewer's report
Title:Primary Biliary Cirrhosis in a genetically homogeneous population: Disease
associations and familial occurence rates.
Version: 2Date:1 April 2012
Reviewer: Carlo Selmi
Reviewer's report:
In this manuscript, Dr. Mantaka and Colleagues report a very interesting study
based on previous reports of comorbidity and risk factors for PBC. The authors
utilize a series of PBC cases (115/196 currently followed) and first degree
relatives (FDR) plus an equal number of unrelated controls.
Major compulsory revisions.
One cannot avoid to consider the control populations as totally unacceptable for
the proposed aims. First, the unrelated control group is too small and its origin is
unclear. Similarly, FDR are obviously not sex-matched and prone to numerous
types of error. Lastly, the response rate among patients is significantly low.
Minor essential revisions.
The results section is redundant and should be shortened significantly as its
current form is confusing.
A description of the local health system would help.
The authors should justify the choice of a low alcohol intake for the definition of
abuse.
How did the authors determine that 55% of FDR responded to their call.
Discretionary revision.
In the tables I would suggest including only specific variables and not all options
(as in the case of BMI)
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Review for 10.1186/1471-230X-12-110 (2012)

Reviewer's report
Title:Primary Biliary Cirrhosis in a genetically homogeneous population: Disease
associations and familial occurence rates.
Version: 3Date:5 June 2012
Reviewer: Carlo Selmi
Reviewer's report:
All my previous comments have been satisfactorily addressed by the authors and
I believe the study design and manuscript quality are now stronger. In particular,
the better description of the organization leads to a better understanding.
Nevertheless, I would recommend a minor essential revision, i.e. that the
explanation of the potentially low response rate is detailed in the discussion of
the revised manuscript.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Review for 10.1186/1471-230X-12-111 (2012)

Reviewer's report
Title:The I148M PNPLA3 polymorphism influences serum adiponectin in an
association study in patients with fatty liver and healthy controls
Version: 1Date:30 March 2012
Reviewer: Stefano Romeo
Reviewer's report:
The manuscript by Valenti et al. proposes the association of the PNPLA3 I148M
with adiponectin levels in individuals with NAFLD but not with CHC. The study is
well written and it proposes an interesting new association of the PNPLA3 I148M
genetic variants. I think it is an important piece of information in the field and
deserves publications after minor changes.
Specific comments:
1. Adiponectin levels are known to be inversely correlated with the degree of
insulin resistance. I am somewhat surprised by the fact that, despite authors find
an association between lower adiponectin levels and the 148M allele, they do not
see any difference in the insulin sensitivity (assessed by HOMA-IR and fasting
insulin levels). I have noticed that, while adiponectin was log transformed before
entering the analyses, HOMA-IR and fasting insulin were not. These two
variables are highly skewed so they should also be log transformed and showed
as median and interquartile range. I would suggest to carry out the analyses on
HOMA-IR and fasting insulin levels carried out in this way.
2. A recent study found an association of the PNPLA3 148M allele with insulin
resistance (Wang CW, Liver Int. 2011; 31(9):1326-31). The association authors
found in this manuscript may be compatible with this hypothesis. I would be more
careful in drawing conclusions regarding the lack of association with insulin
resistance, tone done the discussion and admit the negative association with
insulin resistance may also be due to a lack of power.
3. Authors do not find any association between the adiponectin levels and the
PNPLA3 genotype in individuals affected by chronic hepatitis. Do they have a
hypothesis on the reasons for this result? Could it be a lack of statistical power
due to a smaller effect size in the latter group due to a different gene
environment interaction? I think this should be discussed.
4. Authors should show a table with clinical characteristics, adiponectin, HOMA
IR also in CHC patients stratified by PNPLA3 I148M genotype.
5. I would not pool in NAFLD, CHC case and control groups and would not
perform a combined analysis. These are too heterogeneous groups.
6. In the mRNA analyses what were the CT values and how the arbitrary units
were calculated?
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Review for 10.1186/1471-230X-12-111 (2012)

Reviewer's report
Title:The I148M PNPLA3 polymorphism influences serum adiponectin in an
association study in patients with fatty liver and healthy controls
Version: 1Date:9 July 2012
Reviewer: Maria Antonella Burza
Reviewer's report:
In this manuscript, Valenti et al. examined the effect of PNPLA3 I148M
polymorphism on adiponectin serum levels in individuals with liver diseases and
in healthy controls. They found that PNPLA3 I148M variant is associated with
adiponectin levels both in individuals with non-alcoholic liver disease (NAFLD)
and in healthy controls, but not in individuals with chronic hepatitis C (CHC).
They conclude that PNPLA3 may be a genetic determinant of adiponectin levels
and modulation of its levels may be involved in the development of the entire
spectrum of NAFLD in individuals carrying the 148M allele.
This study is a very interesting and original report offering new perspective on the
possible mechanism underlying the association between NAFLD and PNPLA3
I148M mutation, a genetic variant strongly associated with liver diseases.
Major Compulsory Revisions
-
Minor Essential Revisions
1. Insulin levels and HOMA-IR are usually skewed variables. Were those
variables log-transformed in the analyses performed? Moreover, if they are
skewed variables they should be showed as median and interquartile range.
2. Adiponectin levels are highly related to insulin resistance. In the present work
by Valenti et al found an association between the PNPLA3 I148M polymorphism
and adiponectin levels whereas no association between this genetic variant and
insulin resistance has been found (see Table 4). A recent study by Palmer et al.
(PLoS ONE 2012) showed that PNPLA3 148M allele is associated with insulin
resistance, specifically in obese individuals. Probably both a lack of power and
the non-obese population examined concurred in their contrasting finding as also
suggested by the only marginal significance association between PNPLA3 I148M
polymorphism and ALT levels. Authors should acknowledge this as a limitation of
the study and they should also discuss the differences between their results and
those reported by Palmer et al.
3. It would be good to have at the bottom of the figures or alternatively in the
figure legend the number of individuals per each group.
Discretionary Revisions
1. To make the figure more reader-friendly it would be good to increase the font
size of the Y axis legend in figure 1A.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Review for 10.1186/1471-230X-12-108 (2012)

Reviewer's report
Title:Perception Gaps Between Patients With Ulcerative Colitis and Healthcare
Professionals: an Online Survey
Version: 3Date:10 May 2012
Reviewer: Alexander Moschen
Reviewer's report:
This is a very interesting study presented by Schreiber and co-workers focusing
on the an important issue in daily clinical praxis, namely the discordance
between patients’ and healthcare professionals’ (HCP) perceptions of clinical
symptoms. This is particularly helpful considering the lack of data related to this
topic. The study was carried out as an international, cross-sectional, web-based
questionnaire. 775 patients, 475 physicians, and 50 nurses completed the study.
Patients generally classified their condition as more severe than HCP. Patients
reported a higher estimation in numbers of annual flares and they were more
likely to report significant impact on their quality of life. Interestingly, there has
been a good correlation of specialist IBD nurses and doctors in the UK.
The authors could briefly discuss the frequent problem of IBS-like symptoms that
are very likely to mimic UC-related flares and this is supported by the fact that
stress and diet were reported as likely triggers.
Altogether, these are important findings. The manuscript is well written and the
data clearly presented in its present form.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Review for 10.1186/1471-230X-12-108 (2012)

Reviewer's report
Title:Perception Gaps Between Patients With Ulcerative Colitis and Healthcare
Professionals: an Online Survey
Version: 3Date:25 May 2012
Reviewer: Robert Koch
Reviewer's report:
no Revisions
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Review for 10.1186/1471-230X-12-107 (2012)

Reviewer's report
Title:Higher Frequency of cagA EPIYA-C Phosphorylation Sites in H. pylori
Strains from First-degree Relatives of Gastric Cancer Patients
Version: 2Date:24 May 2012
Reviewer: Richard Harry Argent
Reviewer's report:
This study examined the prevalence of H. pylori and associated virulence factors
(VacA, CagA) in relatives of gastric cancer patients from Brazil. The authors
conclude that more virulent strains of H. pylori colonise relatives of gastric cancer
patients.
MAJOR REVISIONS
1) This paper fails to cite, or compare, the article of Argent et al. (2008) Clin
Cancer Res 14, 2227-35, that previously looked at relatives of gastric cancer
patients from Scotland, that also examined whether H. pylori strains from
first-degree relatives of gastric cancer were the same, and whether they had
evolved with vacA and cagA. This article also examined associations with
hypochlorhydria. The penultimate paragraph of the Introduction is therefore
incorrect!
2) Results - all strains of H. pylori possess vacA, so why are the data for 6 strains
missing from Table 3? Did only those strains possessing s2m2 vacA lack cagA?
No i-region typing, particularly of s1m2 vacA was performed. Is the frequency of
vacA mosaicism distribution significant - data would suggest not - a Chi-squared
analysis of data in Table 3 is not significant.
3) Results - the deduced amino acid sequences of the cagA variable regions
should be shown. Additionally, the presence of cagA does not necessarily
indicate the presence of a functional pathogenicity island, so some caution is
required when interpreting the data.
4) Results - Table 4 - how many s1m1 vacA strains also possessed more than
one EPIYA-C motif? How does this alter the significance between groups? I am
unclear how the multivariate analysis was performed, but, from point (2) above I
would expect that the vacA data to be non-significant (as in the univariate
analysis).
MINOR REVISIONS
5) Table 1 seems fairly redundant, and could just be included in the text of the
Methods.
6) Figure 1 - without the corresponding nucleotide sequencing data, the
interpretation of the bands is pure conjecture.
7) Results - final section - the data for these statements should be provided!
8) Introduction - "gram" should be written as "Gram"; "aminoacid" should be
written as "amino acid"; "(MALT)" should be deleted as abbreviation never used
again; paragraph 3, line 7 - don't think "peptides" is correct; paragraph 4, line 4 -
CagA can possess more than 3 EPIYA-C motifs.
9) Methods - vacA and cagA detection - Tx30a possesses a s2m2 VacA, so lines
7-8 are incorrect.
10) Methods - amplification of cagA VR section - pH of Tris used should be
stated, and presumably 1.0 units of Taq were used.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no competing interests
Review for 10.1186/1471-230X-12-107 (2012)

Reviewer's report
Title:Higher Frequency of cagA EPIYA-C Phosphorylation Sites in H. pylori
Strains from First-degree Relatives of Gastric Cancer Patients
Version: 2Date:24 May 2012
Reviewer: Mónica Oleastro
Reviewer's report:
In this study the authors evaluated the frequency of high virulent H. pylori strains
in first-degree relatives of gastric cancer patients, showing that these individuals
harbour more frequently strains with more CagA EPYIA C segments and with the
VacA s1m1 genotype, than individuals from a control group without history of
familiar gastric cancer.
The manuscript is well written, being all sections very clear. It presents
interesting data to those with closely related research interests.
Major Compulsory Revision:
Many studies show the association of more virulent H. pylori strains with
precancerous lesions and gastric cancer, irrespective of being first-degree
relatives of gastric cancer patients or not. Considering the epidemiology of H.
pylori infection, it is likely that first-degree relatives of gastric cancer patients are
infected with more virulent strains. Moreover, their genetic background also
contributes to a higher risk of developing the neoplastic condition. Thus, these
particular patients are likely a target group for an early intervention regarding the
eradication of the infection. All these points are discussed by the authors.
The results of the present study corroborate all these evidences and previous
studies, going a bit further in the characterization of the infecting strains, by the
determination of the CagA EPIYA phosporylation sites. In the light of the
evidences, the results obtained were expectable.
The gap of the study is the lack of information regarding the histological
alterations in the control group, as it would be expected that if those individuals
present preneoplastic alterations, they would probably be infected with more
virulent strains as well. In the same way, if the preneoplastic conditions were
more frequently observed in the relatives group than in the control group, the
conclusion that the relatives of gastric cancer patients are more frequently
colonized that non-relatives looses strength.
So, I strongly recommend including this data and rephrasing the main
conclusions, if necessary.
Minor Essential Revisions:
From page 9 numerate pages correctly.
Page 7, first paragraph: thermal cycler or thermocycler, instead of thermo cycler.
Page 8, first paragraph: delete “the amplified products…” since it is already
described in the previous page.
Page 10, 2nd paragraph: “In all cases with S1…”, lower case of S1.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Review for 10.1186/1471-230X-12-107 (2012)

Reviewer's report
Title:Higher Frequency of cagA EPIYA-C Phosphorylation Sites in H. pylori
Strains from First-degree Relatives of Gastric Cancer Patients
Version: 5Date:24 July 2012
Reviewer: Richard Harry Argent
Reviewer's report:
Minor Revisions
1) Figure 1 - please specify what the amino acid is for strain 2 following the
poly-N region (there is an X there).
2) There are a number of typographical errors throughout, including in the
references - please go through your manuscript thoroughly and correct the
errors. Please also correct and non-english writing (e.g. in the figure legend).
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Review for 10.1186/1471-230X-12-107 (2012)

Reviewer's report
Title:Higher Frequency of cagA EPIYA-C Phosphorylation Sites in H. pylori
Strains from First-degree Relatives of Gastric Cancer Patients
Version: 5Date:24 July 2012
Reviewer: Mónica Oleastro
Reviewer's report:
The manuscript was modified according to the suggestions proposed by the
reviewers, thererefore I consider it acceptable for publication in its current form.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Review for 10.1186/1471-230X-12-106 (2012)

Reviewer's report
Title:Goat milk with and without increased concentrations of lysozyme improves
repair of intestinal cells damage induced by enteroaggregative Escherichia coli
Version: 1Date:19 May 2012
Reviewer: Mona Bajaj-Elliott
Reviewer's report:
The paper is well written and clear in its findings. I have two comments that the
author must take into consideration.
1. I accept that the milk +/-LZ comparison is a feasible study and that dilutions
are a fair way forward; however you are not comparing like with like as 200ug/ml
LZ with its positive charge may be binding/interacting with other milk/bacterial
components thus modulating interactions independent of its antimicrobial
function. A good control would have been having denatured lysozyme added to
control milk. I think this aspect should be at least mentioned in the discussion.
2. Please change the y-axis for Figure 5b (upper panel) 5c appropriately.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
no
Review for 10.1186/1471-230X-12-106 (2012)

Reviewer's report
Title:Goat milk with and without increased concentrations of lysozyme improves
repair of intestinal cells damage induced by enteroaggregative Escherichia coli
Version: 1Date:13 June 2012
Reviewer: Paul Kelly
Reviewer's report:
This paper describes experiments which show that several aspects of the
pathophysiology of EAEC infection can be prevented/reversed by goat milk with
or without lysozyme. The paper is well written and original and a significant
contribution to the literature on treatment of diarrhoeal pathogens. The only
significant weakness of the study in my view is that the authors do not dissect out
the antimicrobial activity of the lysozyme in goat milk by using it without milk in
control experiments. However, they do analyse the literature on this point,
pointing out that the incubation is too short for this effect to influence the
adhesion experiments, and acknowledge that this may be a contribution to some
of the other results. The last paragraph of the Discussion on p14 should be more
cautious in this respect.
Minor essential revisions
1 p4 “Goat milk... in the form of meat and milk”. This needs correction.
2 Some verbs need singular/plural to be sorted out, such as “The bacteria was...”
on p6, “the media was removed...” on p7, and “...remain poorly defined” on p12.
3 The legend to Fig 5 does not explain well the 6 panels of this figure.
Level of interest: An article of importance in its field
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I declare that I have no competing interests
Review for 10.1186/1471-230X-12-105 (2012)

Reviewer's report
Title:Effects of patient factors on noninvasive liver stiffness measurement using
acoustic radiation force impulse elastography in patients with chronic hepatitis C
Version: 1Date:16 April 2012
Reviewer: Hirokazu Takahashi
Reviewer's report:
In this article, the association between SWV and necroinflammatory activity is
significant point to be emphasized.
Major Compulsory Revisions
The authors should add the box plot figure and analysis of correlation between
SWV and METAVIR activity . Additionally, the figure of correlation between SWV
and ALT or ALT/ULN grade should be needed.
Level of interest: An article of importance in its field
Quality of written English: Not suitable for publication unless extensively edited
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I declare that I have no competing interests.
Review for 10.1186/1471-230X-12-105 (2012)

Reviewer's report
Title:Effects of patient factors on noninvasive liver stiffness measurement using
acoustic radiation force impulse elastography in patients with chronic hepatitis C
Version: 1Date:29 May 2012
Reviewer: Alina Popescu
Reviewer's report:
This is an interesting paper regarding factors that mai influence the ARFI liver
stiffness measurements in chronic C hepatitis paptients.
The paper needs Major Compulsory Revisions.
The part of the paper addressing the factors that mai influence the liver stiffness
measurements is well presented and documented.
The section regarding the results obtained in different stages of fibrosis on the
other hand need major revision. The results are different from the data already
published. Please comment.
The mean values obtained for liver stiffness for F3 and F4 are much higher that
those published and the cut offs are also different from those from other studies.
Please comment.
Level of interest: An article of importance in its field
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I declare that I have no competing interests
Review for 10.1186/1471-230X-12-105 (2012)

Reviewer's report
Title:Effects of patient factors on noninvasive liver stiffness measurement using
acoustic radiation force impulse elastography in patients with chronic hepatitis C
Version: 2Date:3 July 2012
Reviewer: Hirokazu Takahashi
Reviewer's report:
The manuscript was well revised and could be accepted.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I have no relating or competing interests to this manuscript.
Review for 10.1186/1471-230X-12-104 (2012)

Reviewer's report
Title:The impact of Irritable Bowel Syndrome on health-related quality of life: A
Singapore perspective.
Version: 1Date:29 March 2012
Reviewer: Oliver Schwandner
Reviewer's report:
Very interesting manuscript containing a very important topic in gastroenterology.
No revisions from my side.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
No competing interests
Review for 10.1186/1471-230X-12-104 (2012)

Reviewer's report
Title:The impact of Irritable Bowel Syndrome on health-related quality of life: A
Singapore perspective.
Version: 1Date:28 May 2012
Reviewer: Yuka Endo
Reviewer's report:
Major Compulsory Revisions
1. You described "The factors associated with IBS were younger age", but what
is the definition of young people? Are 50 year-olds classified as young or old?
How did you calculate odds ratio?
Minor Essential Revisions
1. I can't understand the meaning of each five domains of EQ-5D clearly,
especially mobility and self-care. You had better explain these domains in detail.
2. It is also difficult to grasp the meaning of these sentences-"Ratings for each
dimension can be combined into a 5-digit number that describes the
respondent’s health state. This 5 digit EQ-5D health state was converted into a
single summary index score by imputing the 5 digit number into the EQ-5D index
calculator available from the EuroQol Group.
3. How did you analyze the data of visual analogue scales?
4. I found several mistakes in grammar and in using capital and small letters. And
some commas and periods were missing. I recommend your paper to be
checked by a person whose native language is English.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I declare that I have no competing interests.
Review for 10.1186/1471-230X-12-104 (2012)

Reviewer's report
Title:The impact of Irritable Bowel Syndrome on health-related quality of life: A
Singapore perspective.
Version: 1Date:31 May 2012
Reviewer: Marco DiBonaventura
Reviewer's report:
The objective of this study was to examine the relationship between IBS and
health-related quality of life in Singapore. Although the topic is of interest, as data
on IBS in very limited in Asia, I have several concerns with this study as
summarized below.
Major compulsory revisions
1) I found the writing in need of improvement; typos and awkward sentences
made it the paper difficult to follow at times. I would strongly recommend an
editorial review by a member outside the research team prior to a resubmission.
2) The biggest concern I have is the lack of external validity. The study sample
was participants from the National Foundation for Digestive Diseases
Symposium. Although the authors acknowledge this threat to external validity, I
think this seriously compromises the interpretability of the findings. It can’t be
assumed that relationships between IBS and health-related quality of life would
be identical between the present sample of actively engaged patients attending a
digestive disease symposium and the general population.
3) I found the backwards stepwise method a curious choice. Any reason a
standard multiple regression model (using an enter method) was not used?
Given the criticisms of both backward and forward selection methods, I think
more detail on this decision is warranted.
4) The description of some of the results is odd (page 6, paragraph 4). It reads as
if health-related quality of life is a predictor of IBS (“The adjusted odds of having
IBS were 2.38 times greater for a person having some mobility problems as
opposed to a person having no mobility problems…”). I don’t believe the authors
are suggesting that mobility problems cause the appearance of IBS. Instead, I
think the authors are suggesting that IBS is associated with increased mobility
problems. As a result, I think the regressions are conducted incorrectly (or just
reported incorrectly).
Minor essential revisions
5) IBS has previously been linked to a number of comorbidities. More clarify
about how “significant illnesses” were assessed would be helpful. If it was merely
the presence versus absence of a “significant illness”, there may be an
overestimate in the health-related quality of life burden as a full range of
comorbidities was not assessed (using a Charlson comorbidity index or
something similar).
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Review for 10.1186/1471-230X-12-103 (2012)

Reviewer's report
Title:Endoscopic stenting for hilar cholangiocarcinoma: Efficacy of unilateral and
bilateral placement of plastic and metal stents in a retrospective review of 480
patients
Version: 1Date:28 April 2012
Reviewer: Itaru Naitoh
Reviewer's report:
Overview
The authors described the outcomes of endoscopic biliary drainage for hilar
cholamgiocarcinoma retrospectively. This study consists of large sample
including two kinds of stent (PS and SEMS) and two kinds of drainage area
(unilateral or bilateral). They concluded that SEMS was significant better
outcomes in respect of technical and clinical success, complication rate and
cumulative stent patency. Furthermore, they concluded that the cumulative stent
patency of bilateral SEMS or PS was significantly better than that of unilateral in
Bismuth II patients. These results are very important points about hilar biliary
drainage that we would like to know. These results are convincing for us because
of large sample size.
Major Compulsory Revisions
1. Unilateral or bilateral drainage was performed in the patients with Bismuth type
2 (Group 2). The authors should indicate the criteria which drainage method was
selected.
2. PS or SEMS was used in this study. The authors should indicate the criteria
which stent was selected. There is a possibility that selection bias might affect
the outcomes.
3. The rates of unilateral and bilateral drainage in Bismuth Type 1 (Group1) and
Type3,4 (Group3) were not mentioned. The authors should describe these rates.
4. The authors should describe the rate of stent-within-stent and side-by-side
methods in bilateral SEMS. There is the possibility that the method affect the
outocomes.
5. The results of this study were all univariate analysis. However, this study
includes many sample size. The authors should indicate multivariate analysis
assessing cumulative stent patency in respect of such as kinds of stent and stent
deployment. Multivariate analysis is more convincing in this study.
6. The authors should indicate the number of re-intervention for stent occlusion
between PS and SEMS. We consider that this result is important for superiority of
SEMS to PS.
7. The discussion section is very long. The authors should describe more
intelligibly and briefly.
8. There are a lot of Figures and Tables. The author should delete the Tables
and Figures which are not important (Table2, Figure9).
9. Table1 and 2 are confusing and difficult to understand. The authors should
revise these tables more intelligibly.
Minor Essential Revisions
Discretionary Revisions
1. In patients and study section, the authors should describe the diagnostic rate
that was confirmed histopathologically.
2. In patients and study section, the authors should describe the rate of
unresectable reason (the rate of medical fitness or disease extent).
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
'I declare that I have no competing interests'
Review for 10.1186/1471-230X-12-103 (2012)

Reviewer's report
Title:Endoscopic stenting for hilar cholangiocarcinoma: Efficacy of unilateral and
bilateral placement of plastic and metal stents in a retrospective review of 480
patients
Version: 1Date:13 June 2012
Reviewer: Nicholas church
Reviewer's report:
General
This is a well written and presented paper documenting impressive outcomes for
endoscopic stenting of hilar tumours. The background and aims are clearly
stated, the methods and techniques well described, and the conclusions
supported by the data presented. The authors acknowledge that the
retrospective nature of the study over a 15 year period with a resultant variability
in materials and techniques is the major limitation of the work. I would agree that
prospective randomised controlled trials are needed in this area and that this
study would support the performance of such trials.
Major compulsory revisions
None
Minor essential revisions
The legend relating to the figures corresponds with the text. However, the
labelling on the images themselves does not correspond with the legend.
Discretionary revisions
1. A recent randomised controlled trial comparing outcomes of plastic and metal
stents in complex hilar strictures is in press (Sangchan A, Kongkasame W,
Pugkhem A, Jenwitheesuk K, Mairiang P. Efficacy of metal and plastic stents in
unresectable complex hilar cholangiocarcinoma: a randomized controlled trial.
Gastrointest Endosc. 2012 May 15. [Epub ahead of print]) The discussion would
benefit from the inclusion of the results of this trial, which demonstrated superior
outcomes in patients treated with metal stents both in terms of success of
drainage and survival.
2. Although this study demonstrated improvements in technical and clinical
success rates of biliary drainage for SEMS along with lower complication rates
and longer cumulative stent patency, this did not translate into a survival benefit.
The paper would be strengthened by a more comprehensive discussion of this
aspect. Were there any data available regarding quality of life in the different
groups? In addition it would be useful to consider or suggest a cost/benefit
analysis, taking into account length of hospital stay, re-admission and
re-intervention rates for the two stenting methods.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Review for 10.1186/1471-230X-12-102 (2012)

Reviewer's report
Title:Pancreatic-specific autoantibodies to glycoprotein 2 mirror disease location
and behaviour in younger patients with Crohn's disease
Version: 1Date:24 May 2012
Reviewer: Richard RUssell
Reviewer's report:
The authors have examined the role of the GP2 pancreatic antigen in 271
patients with IBD (169 CD, 102 UC). Phenotypic analysis then describes
association with L3 disease, stricturing and paediatric patients. There are
however a number of outstanding issues:
Major Compulsory Revisions
1. The study would be improved by including serological data on healthy controls
rather than using UC patients as proxy controls
2. The authors should justify why IBDU patients were excluded - it would have
been more interesting and useful to have included them in the study
3. The start of the results section on PAB/ASCA/GP2 results could be clearer
and may be more easily understood in a table rather than text
4. The authors should only use fishers exact test when low numbers of patients
are being analysed in one or more groups otherwise it would be better to use a
chi-square test
5. The authors should justify analysing both IGA and IGG in the sub analysis - it
would be simpler just to analyse positive and negative serology whether IGA or
IGG together
6. When generating p - values the authors should not just show the data of
interest eg the proportion of patient in A1 with positive serology they should also
list the numerator and denominator of the comparative data too
7. In making multiple comparisons the authors should use corrected p-values or
justify why they are not used
8. Given that patient were recruited from 3 centres - per centre analysis should
be done to exclude a difference between serology rates in German cf. UK
patients
9. The effect on age may have nothing to do with CD it may just be younger
patients are more likely to have positive serology - again a suitable control cohort
would address this issue
Minor Essential Revisions
1. All data should be listed in the abstract when p-values are being quoted
2. consistent number of decimal places should be used for p-values - suggested
2
3. Age distribution in the study is likely to have a non-uniform distribution thus a
median with IQR rather than mean should be used
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Review for 10.1186/1471-230X-12-102 (2012)

Reviewer's report
Title:Pancreatic-specific autoantibodies to glycoprotein 2 mirror disease location
and behaviour in younger patients with Crohn's disease
Version: 1Date:7 June 2012
Reviewer: Mária Papp
Reviewer's report:
The authors assessed the prevalence and clinical significance of anti-GP2
antibodies in IBD and reported that patients having these antibodies show
distinct diseases phenotypes. Results might be of interest for clinicians in the
patient stratification. Discussion and conclusions are well balanced supported by
the results.
Minor comments:
Method section is unnecessarily long. Please do not detail the method of a
commercially available ELISA and shorten the method previously reported
elsewhere as well.
Report of data significance is annoying. Please do not use six decimal value.
Instead chose p#0.001 or p#0.01 or three decimal value.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Review for 10.1186/1471-230X-12-102 (2012)

Reviewer's report
Title:Pancreatic-specific autoantibodies to glycoprotein 2 mirror disease location
and behaviour in younger patients with Crohn's disease
Version: 2Date:17 July 2012
Reviewer: Mária Papp
Reviewer's report:
I accept the author's answers and corrections they made in the manuscript.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Review for 10.1186/1471-230X-12-101 (2012)

Reviewer's report
Title:Analysis of etiology and clinical characteristics of Jejunoileum hemorrhage
in China - A multicenter 10-years survey
Version: 3Date:14 March 2012
Reviewer: Oreste PIeramico
Reviewer's report:
This study deals with a multicenter analysis of etiology and clinical pictures of a
total of 72 cases of jejunoileal bleeding in a province of China. I have no major
criticisms on this paper. However, the manuscript needs an extensive revision of
the english text.
Level of interest: An article of importance in its field
Quality of written English: Not suitable for publication unless extensively edited
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Review for 10.1186/1471-230X-12-101 (2012)

Reviewer's report
Title:Analysis of etiology and clinical characteristics of Jejunoileum hemorrhage
in China - A multicenter 10-years survey
Version: 3Date:23 March 2012
Reviewer: Lisheng Wang
Reviewer's report:
In this manuscript, the authors analyzed the data from multiple centers to
highlight the causes and clinical characteristics of jejunoileum hemorrhage. The
authors stated that, in sharp contrast to the results in the previous reports from
the western countries, malignant tumors were found to be the major reason and
the patients presented as bleeding with abdominal pain. The results seem
interesting and might be indicative for the diagnosis and management of the
patients with small intestine bleeding. This reviewer has the following comments.
1. Though English of the manuscript is generally readable, there are too many
grammar errors to be corrected. This reviewer suggests that the authors should
rearrange the manuscript after critical reviewing from a native English speaker.
2. The discusses about the diagnostic means should be more detailed to point
out whether laparotomy is needed in this setting, based on the data here that
indicate that the main cause is malignant tumor.
3. The Y-axis of Fig1 and Fig2 should be labeled.
Level of interest: An article of importance in its field
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no competing interests
Review for 10.1186/1471-230X-12-100 (2012)

Reviewer's report
Title:Factors associated with consultation behaviour for primary symptoms
potentially indicating colorectal cancer: A cross-sectional study on response to
symptoms.
Version: 1Date:18 March 2012
Reviewer: Maria Ramos
Reviewer's report:
Major Compulsory Revisions
The main variables: rectal bleeding an change in bowel habit are not well
defined. Rectal bleeding could range from some drops in the toilet paper to the
reddening of all the toilet bowl. Change in bowel habit could include a self-limited
diarrhoea due to a gastroenteritis, but also difficulty in evacuation due to a
colonic mass. In this broad sense, “rectal bleeding” and “change in bowel habit”
are very common symptoms, and it is at least doubtful that they have to be
consulted to the doctor as soon as they appear. I’m not sure that the study
results suggest “a pressing need for identification of symptomatic patients in the
primary care setting” (“The need for intervention in the primary care setting”
section in the Discussion).
As the authors recognize, recall bias has probably affected respondents’
reliability, especially regarding the time taken to seek medical advise. Five years
is a long period to ask someone to specify if he/she has gone to the doctor and
when. Objective verification could have been done reviewing primary health care
clinical records.
Therefore, if the main variables are not well defined, and time intervals collected
from the participants memory, validity of results can be questioned.
Minor Essential Revisions
Background
Survival colorectal cancer information is supported with references of articles
about colorectal mortality (first paragraph).
The statement: “it should be concluded that the public health message should be
to engage in screening for CRC” is too general. This message could be different
in each country depending of the existence or not of a universal public health
system and a population-based screening program.
Results
Description of the clinical and psychological characteristics and predictors of
study respondents variables arre not shown.
Discretionary Revisions
Background
Two systematic reviews were performed and published in European Journal of
Cancer in 2007 and 2008 about the relationship between diagnostic delay and
stage and survival of colorectal cancer. Their results could be taken into account
in the Background section.
A qualitative study exploring factors triggering medical consultation for symptoms
of colorectal cancer and perceptions surrounding diagnosis was published in
Europan Journal of Cancer Care in 2009. Their results could be taken into
account in the Background and Discussion sections.
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
'I declare that I have no competing interests'
Review for 10.1186/1471-230X-12-100 (2012)

Reviewer's report
Title:Factors associated with consultation behaviour for primary symptoms
potentially indicating colorectal cancer: A cross-sectional study on response to
symptoms.
Version: 2Date:19 June 2012
Reviewer: Alice Simon
Reviewer's report:
The authors' provide helpful justifications in their response to the review. It has
been especially useful to see the questionnaire. However, many of the responses
to the review do not have a corresponding change in the manuscript - see
response to point 3 (5-year recall), 4 (early-help seeking definitions), and 6 (study
participant exclusions). I understand that there are space limitations, but the
paper would be improved if greater justification for the methodological decisions
were included.
The paper would also benefit from a larger discussion of the methodological
limitations. As both reviewers commented on the problem of 5-year recall, it
would be particularly useful to have this topic explored in more detail in the
discussion. In the authors' response they note that previous studies have used
this cut-off. Which previous studies? This should be made clear in the text. That
this cut-off has been used before gives some support to the method, but it is not
a complete justification. After all, shouldn't we be striving for methodological
improvements?
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Review for 10.1186/1471-230X-12-99 (2012)

Reviewer's report
Title:With the assistance of a "Rusch" intubation stylet for facilitating insertion of
a nasogastric tube in anesthesized patients: a randomized controlled trial
Version: 1Date:6 June 2012
Reviewer: JITHESH APPUKUTTY
Reviewer's report:
Minor Essential Revisions
1. Title - Review the title - Rephrase the tile to make it more appealing to the
reader.
2. Neutral position - elaborate - eg: intubating position
3. Background - 3rd para 2nd line - Spelling correction (polyurethanea)
4. Methods - Interventions - remove Fr. from tube - changed to just Internal
diameter.
5. Methods - Interventions - 2nd para -1st line - change 'to' to 'for'
6. Discussion - 7th para - "Esophageal rupture.... " - did not make any sense.
Discretionary Revisions
1.Methods - participants - exclusion criteria - why CL 3/4 and MP 3/4 were
excluded?
2. Methods -Interventions - 2nd para - 2nd sentence -rephrase
3. Results - Outcome - 3rd para - timing could be limited to one decimal
4. Discussion - reconsider the word 'tender'
5. could consider to emphasize the use in patients with limited mouth opening or
other difficult airways.
6. Reduce the number of references.
Level of interest: An article of limited interest
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no competing interests