JerMa88/BMC_Gastroenterology_Peer_Reviews huggingface dataset:
Review for 10.1186/s12876-025-03764-8 (2025)

Title: Association between hematocrit and mortality in critically ill patients with acute
pancreatitis: a retrospective cohort study
Version: 2 Date: 04 Mar 2025
Reviewer's report:
PEER REVIEWER ASSESSMENTS:
OBJECTIVE - Full research articles: is there a clear objective that addresses one or several
testable research questions? (Brief or other article types: is there a clear objective?)
Yes - there is a clear objective
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for
the objective?
Yes - the approach is appropriate
EXECUTION - Are the experiments and analyses performed with sufficient technical rigor to
allow confidence in the results?
Yes - experiments and analyses were performed appropriately
STATISTICS - Is the use of statistics in the manuscript appropriate?
Yes - appropriate statistical analyses have been used in the study
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not
overstated?
Yes - the author's interpretation is reasonable
OVERALL MANUSCRIPT POTENTIAL - Has the author addressed your concerns sufficiently
for you to now recommend the work as a technically sound contribution? If not, can further
revisions be made to make the work technically sound?
Yes - current version is technically sound
PEER REVIEWER COMMENTS:
GENERAL COMMENTS: The authors have addressed my concerns very well. The manuscript
has improved substantially.
Review for 10.1186/s12876-025-03714-4 (2025)

Title: Significance and Clinical Utility of Targeted Metabolomic Analysis of Serum Bile Acid
Profiles for Early Diagnosis of Patients with Acute Pancreatitis
Version: 1 Date: 27 Nov 2024
Reviewer's report:
In this paper, Chunliang Guo, Wen Yong et al. found that some BAs were significantly
dysregulated in acute pancreatitis, and were associated with clinical parameters. The
dysregulation of BAs (TCA, TCDCA, TDCA, GCA) might be useful for the early diagnosis of
acute pancreatitis, especially for MSAP and SAP. It is a simple story, but the following points
should be concerned seriously.
1. In Figure 3, the differences between groups were not labelled.
2. The AUCs shown in Figure 6 were not consistent with the numbers described in the
manuscript.
3. The diagnostic performance of TCA is great, but that of other indicators (TCDCA, TDCA
and GCA) is not as good as TCA.
4. How about the diagnostic performance of AMS, LPS and other clinical parameters? In my
opinion, the diagnostic value of AMS and LPS might be much greater than TCA and other BAs.
5. The number of clinical cases were too small to draw a conclusion.
Review for 10.1186/s12876-025-03714-4 (2025)

Title: Significance and Clinical Utility of Targeted Metabolomic Analysis of Serum Bile Acid
Profiles for Early Diagnosis of Patients with Acute Pancreatitis
Version: 1 Date: 16 Dec 2024
Reviewer's report:
Using metabolomics research methods to search for biomarkers of acute pancreatitis is a valuable
endeavor. However, there are some important issues that the authors need to address.
1.Clinical studies should first consider multicenter, large sample size to ensure the validity of
the results. The author used only 150 clinical samples from one hospital. How reliable are the
study results?
2.More clinical information from the 150 clinical samples should be presented, especially
information such as imaging.
3.Quality control should be included in the study results to indicate the reliability of the results.
4.Figure 2 and Table 1 are the same batch of data and there is no need for a double presentation.
5.Detectors for metabolomics are generally serum, urine, and tissue, etc. Considering that the
goal of this study is to find biomarkers that may provide a scientific reference for non-invasive
diagnosis at a later stage, would it have been better to choose to test urine?
6.Figure quality is too poor, improve the clarity of the figure.
7.The article is crudely written with many formatting issues, while the language should be
revised.
Review for 10.1186/s12876-025-03711-7 (2025)

Title: Leveraging Machine Learning for Precision Medicine: A Predictive Model for Cognitive
Impairment in Cholestasis Patients
Version: 3 Date: 09 Jan 2025
Reviewer:  Dawei Ding
Reviewer's report:
Leveraging Machine Learning for Precision Medicine: A Predictive Model for Cognitive
Impairment in Cholestasis Patients
Comments for Transmission to the Authors
It is a retrospective, monocentric analysis of 353 patients with cholestasis. The statistical analysis
is largely adequate, and the conclusions are supported by the data provided.
Major Points:
1 In the introduction, the author describes that while MoCA has demonstrated utility in patients
with neurodegenerative diseases and cerebrovascular disorders, its application in hepatobiliary
conditions remains underexplored. The authors should demonstrate the legitimacy of MoCA for
assessing cognitive function in cholestatic conditions before using it as an alternative endpoint.
Have any other studies shown this before?
2 Which guidelines were used to diagnose cholestasis?
3 The discussion section may consider highlighting the uniqueness of this study by focusing on
characteristic indicators that predict cognitive function associated with cholestasis conditions
compared to other diseases (neurodegenerative diseases or cerebrovascular disorders).
Minor Points:
1 In the introduction, the author describes that studies focusing on cholestasis have primarily
been descriptive, detailing its association with hepatic encephalopathy or neuroinflammatory
states but lacking targeted tools for stratifying cognitive risk. Furthermore, existing predictive
tools for cognitive impairment often fail to account for the unique biochemical and metabolic
profiles of cholestasis patients, which include elevated bilirubin, altered coagulation parameters,
and systemic inflammation markers such as D-dimer. There was a lack of citations here.
2 Many punctuation marks in the article were in Chinese format, please correct them.
Review for 10.1186/s12876-025-03711-7 (2025)

Title: Leveraging Machine Learning for Precision Medicine: A Predictive Model for Cognitive
Impairment in Cholestasis Patients
Version: 3 Date: 19 Jan 2025
Reviewer's report:
The paper addresses a critical gap by creating a machine learning model tailored to predict
cognitive impairment in cholestasis patients. This focus on a high-risk yet understudied
population is commendable and offers potential for significant clinical impact. The authors
employ advanced techniques such as recursive feature elimination, SHAP analysis, and decision
curve analysis (DCA), showcasing a well-rounded and rigorous approach. The use of LightGBM
as the primary model balances performance and interpretability effectively.
The detailed SHAP analysis provides valuable insights into feature importance and interactions,
enhancing the clinical utility of the model. The exploration of non-linear effects and feature
interactions (e.g., age and plasma D-dimer levels) demonstrates a nuanced understanding of the
data.
The paper highlights the robust generalization of the LightGBM model, achieving an AUC of
0.7955 on the testing dataset, which supports its utility in real-world scenarios. The comparison
with other models, including random forest and stacking ensembles, strengthens the credibility
of the findings. However there are many places to improve.
1. While recursive feature elimination is mentioned, the criteria and rationale for final feature
selection could be elaborated. This would help readers understand why certain variables, like
age and plasma D-dimer, emerged as dominant predictors.
2.The paper does not extensively discuss the demographic and clinical diversity of the dataset
from Qingyang People’s Hospital. Providing details on potential biases in the dataset or the
generalizability of the findings to other populations would be beneficial.
3. Although LightGBM demonstrates strong generalization, its AUC in the testing dataset
(0.7955) is significantly lower than in the training dataset (0.8441). Addressing strategies to
further close this gap and avoid potential overfitting could strengthen the conclusions. How
about other classification model? compare them
4. While DCA is mentioned as evidence for clinical utility, the paper does not present
quantitative metrics or visualizations to support this claim. Including such details would
substantiate the model's applicability in clinical decision-making.
5. Expanding validation to external datasets across different clinical settings would enhance
confidence in the model's generalizability.
Review for 10.1186/s12876-025-03711-7 (2025)

Title: Leveraging Machine Learning for Precision Medicine: A Predictive Model for Cognitive
Impairment in Cholestasis Patients
Version: 4 Date: 16 Feb 2025
Reviewer:  Dawei Ding
Reviewer's report:
The authors responded to my questions point by point, and I agreed to accept the manuscript
Review for 10.1186/s12876-025-03755-9 (2025)

Title: The Impact of Inter-Hospital Transfer on Outcomes in Lower Gastrointestinal Bleeding: A
Retrospective Cohort Analysis
Version: 3 Date: 01 Oct 2024
Reviewer's report:
The authors conducted a retrospective analysis via the NIS entitled : The Impact of Inter-
Hospital Transfer on Outcomes in Lower Gastrointestinal Bleeding: A National Inpatient
Sample Analysis
However, I found several parts that may necessitate some changes to improve their study.
1. the authors used the NIS 2020 as part of their study. It is advisable to remove cases with
COVID-19, as that becomes a new demographic of patients that could have LGIB
2. The authors used T tests for categorical variables. The NIS normally follows a non-parametric
nature. The authors can test their data via Kolmogorov-Smirnov Test, and then adopt the Mann-
Whitney U test for continuous variables.
3. The authors used the term Gender. The NIS does not report gender. It reports the sex of the
patients. Please note that there is a difference between gender and sex, and it is wise to use them
with caution, and for the NIS they should use sex.
4. The authors wrote Asian. The NIS does not provide data for only Asian. They merge asian
and pacific islanders together. So it should be Asian/Pacific islanders
5. The authors created a sample of non transferred vs transferred, and used the embedded
variable Trans_IN. However, the nontransferred cohort should also be screened for variables of
Trans_out and those patients should be excluded.
6. In their discussions, the authors mentioned missing and incomplete data as one of the
limitations. Such limitations can be reduced by removing all cases missing data for the variables
included in the tables.
7. In Table 1, how did the authors construct these variables? Did they use Elixhauser codes,
CCSR codes, or icd-10 codes? among the three, the use of ICD-10 codes is best fitted to create
more accurate versions of the variables. the description for that part is missing in the methods
and the supplementary
8. In table 3: "required icu admission". There are no such variables in the NIS nor icd-10 code.
The authors should properly describe what they categorized (ie diagnosis or procedure) as icu
admission
9. What icd-10 code was used for troponin elevation?
10. The discussion section did not adequately talk about the findings in table 1. The authors are
recommended to expand it further.
Review for 10.1186/s12876-025-03755-9 (2025)

Title: The Impact of Inter-Hospital Transfer on Outcomes in Lower Gastrointestinal Bleeding: A
Retrospective Cohort Analysis
Version: 3 Date: 06 Oct 2024
Reviewer's report:
-Are there any previously published studies that have used similar CPT or procedure codes as
used in this study for colonoscopy and interventions?
-Authors have used separate codes for septic shock and vasopressor requirements.  Most patients
in shock are administered pressors based on etiology. Would using both variables duplicate
entries and confound analysis?
-"This trend not only reflects the severity of their conditions but also highlights potential
inefficiencies in other treatments provided pre-transfer" As authors stated, these transfers were
more likely to get IR procedures for uncontrolled LGIB. Were there any data to suggest
inefficiencies prior to transfer- time to colonoscopy ?
-Was propensity scoring method used?
Review for 10.1186/s12876-025-03755-9 (2025)

Title: The Impact of Inter-Hospital Transfer on Outcomes in Lower Gastrointestinal Bleeding: A
Retrospective Cohort Analysis
Version: 3 Date: 18 Oct 2024
Reviewer:  Panagiotis Tsibouris
Reviewer's report:
Methods Could the authors provide data on movement from a secondary hospital to a tertiary
center or in between secondary hospitals? Is there any difference between the grade of
nosocomial services? Could any established score of lower GI bleeding severity be calculated?
For instance Oakland score?At what timepoint mortality was calculated? Is it possible to
calculate 30 days mortality apart from mortality during hospitalization? Results Could the mean
time between initial admission and final intervention be calculated? Was there any difference
in frequency of cardiovascular events? Could difference between CCI difference between
admission and exit could be calculated?
Review for 10.1186/s12876-025-03755-9 (2025)

Title: The Impact of Inter-Hospital Transfer on Outcomes in Lower Gastrointestinal Bleeding: A
Retrospective Cohort Analysis
Version: 4 Date: 18 Jan 2025
Reviewer's report:
The authors addressed several of my concerns adequately.
However, I still have some concerns that have to be properly readjusted.
for point 7, the authors mentioned that they used the ICD-10 code R7989 for troponin elevation.
This is not a specific code for that. As a matter of fact, the NIS quantifies "Other specified
abnormal findings of blood chemistry" under that code. So this is completely erroneous and has
to be removed.
Point 8.
This was not properly addressed. The authors are expected to describe and propose the causes
for the differences and findings in table 1. I believe that this part should also be improved.
Review for 10.1186/s12876-025-03755-9 (2025)

Title: The Impact of Inter-Hospital Transfer on Outcomes in Lower Gastrointestinal Bleeding: A
Retrospective Cohort Analysis
Version: 6 Date: 16 Feb 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
The responses are satisfactory.
Review for 10.1186/s12876-025-03755-9 (2025)

Title: The Impact of Inter-Hospital Transfer on Outcomes in Lower Gastrointestinal Bleeding: A
Retrospective Cohort Analysis
Version: 6 Date: 02 Mar 2025
Reviewer:  Mohamed H. Zidan
Reviewer's report:
Dear Author,
Re: The Impact of Inter-Hospital Transfer on Outcomes in Lower Gastrointestinal Bleeding
Thank you for the opportunity to review your manuscript. Your study addresses an important
issue in gastrointestinal bleeding management by evaluating the impact of interhospital transfer
on patient outcomes.
The authors have satisfactory replied to all the reviewer concerns, and no additional reviews are
needed from my point-of-view
Kind regards
Review for 10.1186/s12876-025-03656-x (2025)

Title: Effectiveness and Safety of Tofacitinib in the Management of Ulcerative Colitis: A
Brazilian Observational Multicentric Study.
Version: 1 Date: 04 Dec 2024
Reviewer:  Ulf Helwig
Reviewer's report:
Dear Authors,
Congratulations to this important real-world study.
You have discussed excellent the  limitations of a retrospective study.
I would recommend to make a comment on the  disproportion of 1year results regarding bio-
naive and bio exposed cohort. Why is the clinical remission different as we  know from other
studies but not the endoscopic response/ mucosal healing?
Regards
Review for 10.1186/s12876-025-03656-x (2025)

Title: Effectiveness and Safety of Tofacitinib in the Management of Ulcerative Colitis: A
Brazilian Observational Multicentric Study.
Version: 1 Date: 10 Dec 2024
Reviewer's report:
This observational, retrospective multicenter study evaluated the long-term real-life
effectiveness and safety of tofacitinib in a large cohort of patients with refractory or difficult-
to-treat UC at 14 IBD centers in Brazil.
The title reflects the main subject/hypothesis of the manuscript. The abstract summarize and
reflect the work described in the manuscript. The key words reflect the focus of the manuscript.
The manuscript describe methods in adequate detail. The research objectives are achieved by
the experiments used in this study. The manuscript is well, concisely and coherently organized
and presented. Conclusions were concise and not speculative.
The study reported relevant information on real-life outcomes of tofacitinib for UC, being the
largest cases series reported till now in Latin America.
I suggest making minimal corrections in the manuscript:
- Maybee acronym of immunosuppressants better IMS or IS (instead of ISS). If you decided to
abbreviate, do so throughout the text.
- If abbreviating Janus kinase as JAK, do so throughout the text.
- It would be convenient to present the adverse effects also as: AE incidence rate (IR) per 100
patients/year (PY). This allows to compare the results with those of other studies and other drugs.
Rewrite AE section in discussion accordingly.
Review for 10.1186/s12876-025-03656-x (2025)

Title: Effectiveness and Safety of Tofacitinib in the Management of Ulcerative Colitis: A
Brazilian Observational Multicentric Study.
Version: 1 Date: 16 Dec 2024
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Authors, please address the following points below
-The introduction could expand a little more on the specific mechanisms of action of JAK
inhibitors like tofacitinib to better explain why this class of drugs is relevant to UC treatment.
-While it is clear that tofacitinib has been studied in international real-world settings, a brief
mention of the limitations or gaps in those studies could provide a more balanced view of the
existing literature before emphasizing the importance of this current study.
-While the study design is solid, it would benefit from a clearer description of how potential
confounders (e.g., comorbidities, prior treatments) were controlled for in the analysis. Although
there is mention of baseline characteristics, a more detailed explanation of how these factors
were adjusted for in the statistical analysis would strengthen the methodology.
-The exclusion of patients with severe disease or those who had undergone colectomy may limit
the generalizability of the findings to the most severe UC cases, as these patients are often the
ones who would benefit most from advanced therapies like tofacitinib.
-While the authors mention limitations such as the retrospective nature of the study and potential
selection biases, there is room for further discussion on how these issues might specifically
impact the interpretation of the results. For instance, more details on how differences in treatment
protocols across centers (e.g., steroid reduction strategies) might have influenced outcomes
would provide a fuller understanding of the study’s limitations.
-The authors report no significant difference in clinical remission rates between biologic-naïve
and biologic-exposed patients in the short term (12–16 weeks and 6 months), but they do find
a significant difference at 1 year. This finding is important but could be further explained. For
example, why might biologic-naïve patients experience more sustained remission at 1 year, and
what does this suggest about the role of tofacitinib in these populations?
Review for 10.1186/s12876-025-03656-x (2025)

Title: Effectiveness and Safety of Tofacitinib in the Management of Ulcerative Colitis: A
Brazilian Observational Multicentric Study.
Version: 4 Date: 15 Jan 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
The responses are satisfactory.
Review for 10.1186/s12876-025-03656-x (2025)

Title: Effectiveness and Safety of Tofacitinib in the Management of Ulcerative Colitis: A
Brazilian Observational Multicentric Study.
Version: 4 Date: 17 Jan 2025
Reviewer:  Mohamed H. Zidan
Reviewer's report:
Dear Authors,
The manuscript is a well-designed and valuable observational study evaluating the long-term
effectiveness and safety of tofacitinib in managing moderate-to-severe ulcerative colitis in a
Brazilian cohort. The multicenter design, inclusion of 127 patients, and extensive follow-up
of 30 months provide robust and clinically relevant real-world data. The clear stratification of
biologic-naïve and biologic-exposed groups, alongside rigorous statistical methods, strengthens
the reliability of the findings, while the safety outcomes align well with international reports.
This study successfully addresses a significant gap in real-world evidence from Latin America,
offering insights that bridge the gap between clinical trials and practical applications. We thank
the authors for their important contribution to advancing the understanding and management of
ulcerative colitis.
Review for 10.1186/s12876-025-03747-9 (2025)

Title: Association between vitamin C, D, and K intake and inflammatory bowel disease risk:
findings from 2009-2010 NHANES
Version: 0 Date: 29 Jan 2025
Reviewer's report:
Only three vitamins are investigated; however, the title refers to "dietary trace elements." This
title is overly general and comprehensive and should be revised for accuracy. I recommend
including vitamin E in the analysis and focusing specifically on fat-soluble vitamins.
Additionally, it is unclear why patients with CVD were excluded from the study, particularly
since CVD is considered a confounding factor in the analysis.
Furthermore, the use of self-reported IBD introduces potential bias into the findings.
Review for 10.1186/s12876-025-03747-9 (2025)

Title: Association between vitamin C, D, and K intake and inflammatory bowel disease risk:
findings from 2009-2010 NHANES
Version: 0 Date: 31 Jan 2025
Reviewer's report:
Thank you inviting me to peer-review this interesting article.
Abstract:
1. "inflammatory bowel disease (IBD) remains unclear." -> ? development, ? exacerbation.
Please define.
2. "nonsmokers" -> non-smokers.
Introduction:
1. "Research highlighted that" sentence -> Change tense to present as opposed to past.
2. "Emerging evidence suggested that" sentence -> Change tense to present.
Methods:
1. MEC needs to be defined.
2. Who are the trained professionals (?dietitians).
3. Is it possible to flesh out how vitamin intake was calculated/determined? (becomes relevant
later on when discussing how increase in intake is associated with lower IBD risk).
Results:
1. "Table 2 and Figure 3presents" -> Missing space.
2. I'm not sure you need to re-define what confounders are considered in Model 4 as it was
defined in Methods.
Discussion:
1. "which supports vitamin D's protective role" -> which supports the protective role of vitamin
D.
2. "Additionally, vitamin D may improve gut health and reduce IBD risk by positively
influencing gut microbiota composition." -> ?Source.
3. "vitamin K helped prevent" -> Change tense. This is a general comment to review tense as it
flips back and forth but makes most sense to use present tense (e.g. vitamin K helps prevent...).
Please review the paper overall for consistent tense.
4. I want to better understand how the study findings contribute to our understanding of IBD
and how we can manage it. What are the implications of the findings? How can we use these
results to our advantage in detection and management?
Review for 10.1186/s12876-025-03747-9 (2025)

Title: Association between vitamin C, D, and K intake and inflammatory bowel disease risk:
findings from 2009-2010 NHANES
Version: 0 Date: 31 Jan 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Authors, please address the following points below
-While the introduction discusses the potential roles of vitamins C, D, and K, it would be useful to
briefly highlight the gaps or controversies in the existing literature more explicitly. For example,
some studies suggest vitamin D may help with IBD, while others show mixed results. A clearer
explanation of why the role of vitamins C and K remains ambiguous would help underscore the
necessity of your study.
-Although the introduction mentions the potential roles of these vitamins in immune modulation
and anti-inflammatory effects, it could benefit from further explanation of the underlying
mechanisms, particularly for vitamin K. Since vitamin K's impact on IBD is less studied,
expanding on the potential mechanisms (e.g., microbiota modulation or matrix GLA protein
regulation) could strengthen the rationale for its inclusion in the study.
-While the AMPM method used to assess dietary intake is a robust tool, it’s worth
acknowledging its limitations, particularly in terms of recall bias. It may be worth including
a sentence or two discussing the potential for underreporting or misreporting of certain foods,
especially given that the study relies on 24-hour dietary recall.
-When discussing covariates, the impact of including specific factors such as income-to-poverty
ratio or BMI could be highlighted. These variables can be significant confounders in nutritional
epidemiology studies and could be mentioned explicitly in the context of their relevance to IBD.
-While the authors mention that vitamin K may reduce inflammation and regulate the gut
microbiota, the mechanisms through which this happens could be elaborated further. For
instance, specific vitamin K-dependent proteins involved in anti-inflammatory pathways (e.g.,
Gas6, osteocalcin) could be discussed in more detail. Providing more information on these
specific mechanisms would add depth to the explanation and support the hypothesis that vitamin
K may have a protective effect on IBD.
-The potential paradoxical relationship between vitamin C and IBD risk is intriguing but
could benefit from more exploration. The authors mention that vitamin C may exacerbate
inflammation by stimulating immune cell activity, but it would be useful to cite more evidence
or specific studies supporting this idea. Additionally, it may be worth discussing the possibility
that vitamin C’s effect could vary based on its dosage or the context of the existing immune
dysregulation in IBD.
Review for 10.1186/s12876-025-03747-9 (2025)

Title: Association between vitamin C, D, and K intake and inflammatory bowel disease risk:
findings from 2009-2010 NHANES
Version: 1 Date: 17 Feb 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
The responses are satisfactory.
Review for 10.1186/s12876-025-03747-9 (2025)

Title: Association between vitamin C, D, and K intake and inflammatory bowel disease risk:
findings from 2009-2010 NHANES
Version: 1 Date: 20 Feb 2025
Reviewer's report:
Please correct this sentence: Finally, our study was focused on three vitamins, C, D, and K,
which may not fully capture the role of dietary trace elements, especially fat-soluble vitamin
(vitamin K), in the risk of IBD, which will be our next research step.
In the parentheses, it should be vitamin E, not K.
Review for 10.1186/s12876-025-03766-6 (2025)

Title: Using a nomogram based on the controlling nutritional status score to predict prognosis
after surgery in patients with resectable gastric cancer
Version: 0 Date: 12 Sep 2023
Reviewer's report:
In this study, researchers set out to develop a prognostic tool for predicting the overall survival
(OS) of patients with resectable gastric cancer (GC), utilizing the controlling nutritional status
(CONUT) score. The study involved a retrospective analysis of data from 404 patients who
underwent radical gastrectomy, seeking to identify significant prognostic factors for GC patients
through statistical analyses. They found that among various indicators, the CONUT score, type
of gastrectomy, pTNM stage, and nerve invasion emerged as independent risk factors for OS
following multivariate Cox regression analysis. They then constructed a nomogram based on
these factors, which exhibited a higher predictive performance (C-index of 0.76) compared
to the AJCC-8 staging system. This nomogram is poised to play a pivotal role in tailoring
postoperative therapy regimens for GC patients, offering valuable insights into their survival
outcomes. Anyway, since it is an interesting topic, I do not agree with the latest point of
methodological sequence: the CONUT does not include the history of cancer disease as well as
disease burden, so I recommend to delete the comparison between the CONUT and TNM since
they are based on completely different hypotheses. Furthermore, CONUT could empower TNM
in defining prognosis, but of course it will be described in an alternative way.
Review for 10.1186/s12876-025-03766-6 (2025)

Title: Using a nomogram based on the controlling nutritional status score to predict prognosis
after surgery in patients with resectable gastric cancer
Version: 0 Date: 21 Jan 2024
Reviewer's report:
The authors reported “using a nomogram based on the controlling nutritional status score to
predict prognosis after surgery in patients with resectable gastric cancer”. The authors concluded
that the nomogram model based on the CONUT score is a credible model for predicting the
postoperative survival of GC patients and provides a crucial foundation for developing tailored
postoperative therapy regimens..
However, there are many problems in this paper, I think.
1. In the first place, it is doubtful whether it is possible to create an excellent predictive model
with a combination of about only 4 factors.
2. I believe that both count score and nerve invasion are not factors that are used in daily clinical
practice and lack simplicity. The bigger drawback is that it takes time and effort unless the
predictive ability of this model is very good.
3. The authors should present the Kaplan-Meier survival curves based upon AJCC (UICC)
staging with number at risk.
4. There are many studies regarding to nomogram. It would be of little value to publish unless
the authors describe in detail how this model changes daily clinical practice.
5. Why did the authors include AJCC (UICC) staging as a factor to construct the nomogram?
AJCC Staging is made up of a combination of T and N. Most researchers usually create a model
with T and N as separate and independent factors to improve predictive ability.
6. I find it a little strange that treatment factors (type of gastrectomy) and prognostic factors are
treated as prognostic factors of the same dimension.
7. The authors categorized COUNT score (originally continuous variable). Harrell’s guideline
(Harrell FE. Regression Modeling Strategies: With Applications to Linear Models, Logistic
Regression, and Survival Analysis. 2nd edition. New York: Springer; 2015) emphasized
avoiding the categorization of continuous variables because some categorical variables are
subjective and hard to standardize and do not contain the same amount of statistical information
as continuous variables.
Review for 10.1186/s12876-025-03766-6 (2025)

Title: Using a nomogram based on the controlling nutritional status score to predict prognosis
after surgery in patients with resectable gastric cancer
Version: 1 Date: 01 May 2024
Reviewer's report:
I am pleased to report that the authors have diligently addressed all of the concerns raised
during the previous review cycle. Their efforts have resulted in a significantly improved paper
that now meets the expectations outlined by the reviewers. The authors have demonstrated a
thorough understanding of the feedback provided, and they have made substantial revisions
to the manuscript accordingly. They have clarified their methodology, strengthened their
arguments, and provided additional evidence where necessary. Moreover, they have addressed
any ambiguities in their findings and conclusions, ensuring the coherence and robustness of their
work. Overall, the revisions have notably enhanced the quality and impact of the paper. It now
presents a comprehensive and compelling contribution to the field, deserving of publication in
BMC Gastroenterology. Therefore, I fully recommend the publication of this manuscript.
Review for 10.1186/s12876-025-03754-w (2025)

Title: Efficacy and Safety of Pembrolizumab in Advanced Gastric and Gastroesophageal
Junction Cancer: A Systematic Review and Meta-Analysis
Version: 3 Date: 30 Jan 2025
Reviewer's report:
Dear Editor, thank you so much for inviting me to revise this manuscript.
This study addresses a current topic.
The manuscript is quite well written and organized. English could be improved.
Figures and tables are comprehensive and clear.
The introduction explains in a clear and coherent manner the background of this study.
We suggest the following modifications:
• Introduction section: although the authors correctly included important papers in this setting,
we believe the evolving systemic treatment scenario for GI tumors - especially in terms of
IO and IO-based combos -  should be further discussed and some recent papers added within
the introduction (PMID: 33508962; PMID: 37819422; PMID: 38791914 ;  PMID: 33916206 ;
PMID: 35029519), only for a matter of consistency. We think it might be useful to introduce
the topic of this interesting study.
• Methods and Statistical Analysis: nothing to add.
• Discussion section: Very interesting and timely discussion. Of note, the authors should expand
the Discussion section, including a more personal perspective to reflect on. For example, they
could answer the following questions – in order to facilitate the understanding of this complex
topic to readers: what potential does this study hold? What are the knowledge gaps and how do
researchers tackle them? How do you see this area unfolding in the next 5 years? We think it
would be extremely interesting for the readers.
However, we think the authors should be acknowledged for their work. In fact, they correctly
addressed an important topic, the methods sound good and their discussion is well balanced.
One additional little flaw: the authors could better explain the limitations of their work, in the
last part of the Discussion.
We believe this article is suitable for publication in the journal although major revisions are
needed. The main strengths of this paper are that it addresses an interesting and very timely
question and provides a clear answer, with some limitations.
We suggest a linguistic revision and the addition of some references for a matter of consistency.
Moreover, the authors should better clarify some points. e authors should better clarify some
points.
Review for 10.1186/s12876-025-03754-w (2025)

Title: Efficacy and Safety of Pembrolizumab in Advanced Gastric and Gastroesophageal
Junction Cancer: A Systematic Review and Meta-Analysis
Version: 3 Date: 03 Feb 2025
Reviewer's report:
I'm truly grateful to the editor for inviting me to review this manuscript. I read it with great
interest and have some questions that need to be clarified by the author.
1. For this pre-registered systematic review and meta-analysis, could you provide the registration
number?
2. The authors need to add search terms in the "search strategy section" to facilitate readers'
understanding.
3. My suggestion is to adopt the Cochrane Risk of Bias Assessment Tool to evaluate the included
RCT studies, and use the more preferred ROBINS-I to assess non-randomized studies.
4. In the inclusion criteria section of the text, item "e" indicates that retrospective literature can
be included. Does this conflict with the title?
5. I don't understand why the 26th citation is an "INVALID CITATION".
6. When describing the forest plot, in addition to listing the effect size and confidence interval,
the author should further indicate whether the results of each study in the forest plot are
significant, and describe the manifestation of heterogeneity, etc., to help readers understand
better.
7. In the "introduction section", the author has described the disease burden of advanced gastric
cancer and gastroesophageal junction cancer, the limitations of existing treatment strategies, the
rise of immunotherapy, and the mechanism of action of pembrolizumab. However, the current
research status of meta-analysis in this field has not been mentioned. It is recommended to
supplement relevant content to highlight the necessity and innovation of this study.
8. When discussing the limitations, regarding the impact of potential publication bias, in addition
to mentioning the publication tendency of research results, it is advisable to further analyze the
possible affected results and their extent in combination with the specific circumstances of this
study, so as to make the discussion more targeted.
Review for 10.1186/s12876-025-03754-w (2025)

Title: Efficacy and Safety of Pembrolizumab in Advanced Gastric and Gastroesophageal
Junction Cancer: A Systematic Review and Meta-Analysis
Version: 5 Date: 17 Feb 2025
Reviewer's report:
The authors have addressed all my concerns. I have no further comments, and I think this
systematic review and meta-analysis is acceptable.
Review for 10.1186/s12876-025-03748-8 (2025)

Title: Factors associated with lymph node metastasis and survival in T2 colon cancer
Version: 0 Date: 06 Jan 2025
Reviewer's report:
The manuscript "Factors associated with lymph node metastasis and survival in T2 colon cancer"
enrolled a relatively large number of patients and statistically analyzed the effects of common
clinical and pathological features as well as some novel lymph node imaging features on lymph
node metastasis and prognosis of colorectal cancer. The study on the influence of T2 colorectal
cancer and radiological parameters on LNM is relatively novel.
Review for 10.1186/s12876-025-03748-8 (2025)

Title: Factors associated with lymph node metastasis and survival in T2 colon cancer
Version: 0 Date: 09 Jan 2025
Reviewer's report:
The research topic should be more innovative and clinically significant to provide greater value
to the field. Additionally, the writing needs to be more rigorous, particularly in terms of statistical
analysis and data presentation.
Review for 10.1186/s12876-025-03745-x (2025)

Title: Colitis Can Reduce the Cingulate Cortex Neuronal Density in Rats
Version: 2 Date: 07 Nov 2024
Reviewer's report:
The authors have written a manuscript entitled " Colitis Can Reduce the Cingulate Cortex
Neuronal Density in Rats".
-This manuscript still requires careful editing by someone professional in English
- This manuscript still needs to put an anatomical image from the CC and amygdala by injection
colours or something like that to show the proper location of them
- Discussion should focus on the methods that have been used and the results obtained and show
the novelty of the work
- The authors have mentioned in the discussion section (A noteworthy finding of this study was
the insignificant decrease in neuronal density observed in the amygdala of rats with colitis,  as
compared to the control group); however,  Fig 2 shows the significance in neuronal density.
-The results have not been discussed well
Review for 10.1186/s12876-025-03745-x (2025)

Title: Colitis Can Reduce the Cingulate Cortex Neuronal Density in Rats
Version: 2 Date: 12 Jan 2025
Reviewer:  Lubna al#Gailani
Reviewer's report:
1. The text has formatting inconsistencies, such as excessive spacing.
2. Ensure  consistent citation formatting within the manuscript.
3. while the introduction provides a general background it lacks a focused hypothesis research
question.
4. The  figure while visually clear, need descriptive legends and explanations in the text. it is
unclear how the neural density was quantified (eg. stereology, image analysis software).
5. The discussion does not adequately connect the finding to the existing literature or elaborate
on their implication for human health.
Review for 10.1186/s12876-025-03759-5 (2025)

Title: Estimated sdLDL-C as a biomarker of hepatic steatosis severity in MASLD: a
retrospective study
Version: 1 Date: 24 Feb 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
The responses are satisfactory.
Review for 10.1186/s12876-025-03759-5 (2025)

Title: Estimated sdLDL-C as a biomarker of hepatic steatosis severity in MASLD: a
retrospective study
Version: 1 Date: 26 Feb 2025
Reviewer:  Amira A A Othman
Reviewer's report:
I want to extend my congratulations to all those involved in this work. All the required
amendments have already been made carefully and satisfactorily. I hope that the research will
be presented to science.
Review for 10.1186/s12876-025-03758-6 (2025)

Title: Endoscopic treatment for gastroesophageal varices in patients with cirrhosis: a survey
comparing between developed and developing countries
Version: 1 Date: 16 Jul 2024
Reviewer's report:
Gastric varices treatment practices have not been adequately reported, due to their relative
infrequency compared to oesophagal varices. Therefore studies that address these practices are
indeed needed.
Nevertheless, there many questions to be answered with regards to the methodology, results and
conclusions of the study.
Comments
1. There are guidelines in place for primary prevention of gastric varices, both Baveno VII and
ESGE guidelines state (although not that clearly) that beta-blockers should be use for prevention
of decompensation.
2. Please define the language of the questionnaire (probably English)
3. By which metric were the countries characterized as developed or developing?
4. Through which avenue were these endoscopists found and contacted?
5. How many questionnaires were sent and what was the response rate?
6.  Was there any mention of the capabilities of each center in terms of treatment options? Were
there hospitals that did not have access to cyanocrylate or to TIPS/bRTO therapy? If this was
not included in the questions, it should be added as a potential limitation and/or interpretation
of study findings. Also, the availability of these techniques may be a more important predictor
of practices than country.
Review for 10.1186/s12876-025-03758-6 (2025)

Title: Endoscopic treatment for gastroesophageal varices in patients with cirrhosis: a survey
comparing between developed and developing countries
Version: 1 Date: 01 Aug 2024
Reviewer's report:
Dear Authors
your topic is very interesting but there are some issues to be underlined; authors should use
varices' classifications  according to international guidelines  (not acceptable classifications in
mild, medium or large varices); methos of treatment shoul be best described  both in esophageal
and in gastric varices
(if some patients are treated by sclerotherapy or banding this should be described in two separate
groups because results and complications are different)
Review for 10.1186/s12876-025-03758-6 (2025)

Title: Endoscopic treatment for gastroesophageal varices in patients with cirrhosis: a survey
comparing between developed and developing countries
Version: 2 Date: 12 Oct 2024
Reviewer's report:
Comments to the Authors:
I appreciate the authors' efforts in revising the manuscript titled "Endoscopic treatment for
gastroesophageal varices in patients with cirrhosis: a survey comparing between developed and
developing countries." The revisions have addressed most of the concerns raised in the initial
review, and the manuscript has been improved significantly.
1. Abstract: The purpose of the study is now clearly stated, and the emphasis on the sample size
and time frame has been adequately addressed. This provides a clearer context for the reader.
2. Introduction: The addition of more recent statistics and a detailed explanation of the
differences between developed and developing countries has strengthened the rationale for the
study. This section is now more compelling and informative.
3. Methods: The criteria for participant selection and the development process of the survey
have been clarified, which enhances the transparency and reproducibility of the study. However,
additional details regarding the validity and reliability of the survey instrument would further
strengthen this section.
4. Results: The presentation of data in the tables and figures has been improved, making the
results clearer and easier to interpret. However, a more detailed analysis of how the differences
between countries translate into clinical outcomes would still be beneficial.
5. Discussion: The discussion has been enhanced by a deeper analysis of the findings and a more
focused discussion on the clinical implications. The effort to reduce speculative statements is
noted, although there is still room to anchor the conclusions more firmly to the data presented.
Overall, the manuscript has been significantly improved, and most of the major concerns have
been addressed. A few minor revisions remain, particularly in strengthening the methodological
details and further refining the discussion. Therefore, I recommend a minor revision before final
acceptance.
Thank you for your hard work and dedication to improving the manuscript.
Review for 10.1186/s12876-025-03758-6 (2025)

Title: Endoscopic treatment for gastroesophageal varices in patients with cirrhosis: a survey
comparing between developed and developing countries
Version: 3 Date: 27 Jan 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
The responses are satisfactory.
Review for 10.1186/s12876-025-03758-6 (2025)

Title: Endoscopic treatment for gastroesophageal varices in patients with cirrhosis: a survey
comparing between developed and developing countries
Version: 3 Date: 05 Feb 2025
Reviewer:  Pantong Davwar
Reviewer's report:
Great idea to evaluate the practice across countries considered to be developed and those not
developed. However, there are some inconsistencies in the progression of the discussion that
should  be addressed. for instance, it is not clear if the authors are interested in both esophageal
and gastric varices or just gastric varices. This is fundamental to the study and has to be made
clear . The supplementary material appeaers to incomplete since some of the data reported is not
found in the questionnaire sent. Like grading of the varices , was that based on the pictures ?
Review for 10.1186/s12876-025-03758-6 (2025)

Title: Endoscopic treatment for gastroesophageal varices in patients with cirrhosis: a survey
comparing between developed and developing countries
Version: 4 Date: 22 Feb 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
The responses are satisfactory.
Review for 10.1186/s12876-025-03679-4 (2025)

Title: One in Three Adenomas Could Be Missed by White-Light Colonoscopy – Findings from
a Systematic Review and Meta-analysis
Version: 3 Date: 13 Nov 2024
Reviewer:  Panagiotis Tsibouris
Reviewer's report:
Abstract Were all publications extracted in English? Was it better to use for morphology Paris
classification? The same questions are valid for methods section Methods Why studies with
screening colonoscopies have to be excluded? Was the size of adenomas the one extracted from
the colonoscopy report or the one measured in the pathology report? Were any restriction for
ADR of the colonoscopists taking part in the studies selected?  Results Could a subanalysis be
performed for different NCTs?
Review for 10.1186/s12876-025-03679-4 (2025)

Title: One in Three Adenomas Could Be Missed by White-Light Colonoscopy – Findings from
a Systematic Review and Meta-analysis
Version: 4 Date: 06 Feb 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
The responses are satisfactory.
Review for 10.1186/s12876-025-03679-4 (2025)

Title: One in Three Adenomas Could Be Missed by White-Light Colonoscopy – Findings from
a Systematic Review and Meta-analysis
Version: 4 Date: 07 Feb 2025
Reviewer's report:
The points raised by the previous reviewers were valid and the authors have addressed them
satisfactorily. I have no further comments.