JerMa88/BMC_Gastroenterology_Peer_Reviews huggingface dataset:
Review for 10.1186/s12876-025-03916-w (2025)

Title: Spatiotemporal Trends in Hernia Disease Burden and Health Workforce Correlations in
Aging Populations: A Global Analysis with Projections to 2050
Version: 0 Date: 03 Mar 2025
Reviewer's report:
The authors present a comprehensive analysis of inguinal, femoral, and abdominal wall hernias
in populations aged 45 and above. Drawing on data from the Global Burden of Disease 2021,
they explore incidence, prevalence, mortality, and disability-adjusted life years (DALYs) over
a 31-year period and project future trends up to 2050. They employ a variety of analytical tools,
including average annual percentage change (EAPC), decomposition methods, and age-period-
cohort (APC) analysis. Key findings include:
While age-standardized incidence and mortality rates have declined, the absolute disease burden
has risen due to population growth, aging, and socioeconomic disparities.
Countries with higher SDI report higher incidence but lower mortality, while lower SDI
countries face higher mortality and lower incidence.
The burden remains substantially higher in men than women, with male incidence rates more
than seven times higher.
Although the age-standardized rates are projected to increase only slightly, the absolute number
of new cases and deaths will continue to rise.
Once the following comments are adequately addressed, the manuscript will be even more
compelling and ready for publication:
The introduction would benefit from a deeper synthesis of prior studies to position this work
in the broader scientific context. Please elaborate on existing evidence regarding hernia risk
factors, trends, and management challenges, and clarify how your analysis addresses critical
gaps in the literature.
Maintain consistency in expressing numerical values throughout the text. Decide on a single
standard (e.g., one decimal place vs. two decimal places) and apply that format consistently.
In the Methods and Results sections, some abbreviations are defined multiple times. Provide
definitions only at their first mention, and use the abbreviations consistently afterward.
Your analysis highlights variations by socioeconomic status, age, and sex. Please expand further
on these disparities, explaining why certain populations or regions might face a heavier hernia
burden. This will help readers and policymakers better understand which interventions and
resources may be most beneficial in targeted settings.
Review for 10.1186/s12876-025-03916-w (2025)

Title: Spatiotemporal Trends in Hernia Disease Burden and Health Workforce Correlations in
Aging Populations: A Global Analysis with Projections to 2050
Version: 0 Date: 08 Mar 2025
Reviewer:  Mohammad Amin Khadembashiri
Reviewer's report:
Given that there is a recently published study using the same database with the same title (DOI:
10.1007/s10029-025-03282-2), the only difference being the age group (#45 years) analyzed in
your study, it does not appear to add significant new knowledge to the literature. This lack of
novelty raises concerns about its suitability for publication. Therefore, I do not find this study
appropriate for publication.
Review for 10.1186/s12876-025-03916-w (2025)

Title: Spatiotemporal Trends in Hernia Disease Burden and Health Workforce Correlations in
Aging Populations: A Global Analysis with Projections to 2050
Version: 2 Date: 24 Mar 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
The responses are satisfactory
Review for 10.1186/s12876-025-03930-y (2025)

Title: Association Between Platelet-to-High-Density Lipoprotein Cholesterol Ratio and
Gallstone Prevalence in the American Adult Population: A Cross-Sectional Study Analysis
Version: 1 Date: 30 Dec 2024
Reviewer's report:
1.Is the choice of covariates based on the literature of existing relevant studies or on clinical
experience?
2.Given the strong association between obesity and gallstones, it is recommended that subgroup
analyses of BMI be supplemented to see if there is a robust effect in both obese and non-obese
populations.
3.Given the nonlinear relationship of the smoothed curve-fit plots, it is recommended that the
threshold effects analysis be supplemented to look for potential inflection points.
4.The association between PHR and risk of gallstone development found in this study through
subgroup analyses was strongest among participants aged 20-39 years, women, and individuals
from other racial/ethnic groups. However, the reasons for this phenomenon were not explained
in the discussion section, and additional refinements are recommended.
Review for 10.1186/s12876-025-03930-y (2025)

Title: Association Between Platelet-to-High-Density Lipoprotein Cholesterol Ratio and
Gallstone Prevalence in the American Adult Population: A Cross-Sectional Study Analysis
Version: 4 Date: 17 Mar 2025
Reviewer:  Erfan Arabpour
Reviewer's report:
I would like to thank the authors for addressing the revisions. My minor comments have been
fully addressed, with the exception of Figure 1, which requires a small correction: at the end
of the diagram, "gallbladder" should be replaced with "gallstone." The term "patients without
gallbladder" implies those who have undergone cholecystectomy, which is not accurate in this
context. However, my major concern regarding the clinical implications of the results remains
unresolved, as I believe the conclusions are still overstated. While the authors have addressed
some issues, I maintain that monitoring PHR for detection or risk stratification of patients is not
clinically useful. Additionally, another significant limitation of the study is its reliance on self-
reported data regarding the presence of gallstones. Although this is mentioned in the limitations
section, I recommend that the authors also highlight this issue in the methods section of the
abstract. This would provide readers with a clearer understanding of the study's results and their
potential limitations.
Review for 10.1186/s12876-025-03930-y (2025)

Title: Association Between Platelet-to-High-Density Lipoprotein Cholesterol Ratio and
Gallstone Prevalence in the American Adult Population: A Cross-Sectional Study Analysis
Version: 5 Date: 13 Apr 2025
Reviewer:  Erfan Arabpour
Reviewer's report:
My concerns are addressed satisfactorily
Review for 10.1186/s12876-025-03930-y (2025)

Title: Association Between Platelet-to-High-Density Lipoprotein Cholesterol Ratio and
Gallstone Prevalence in the American Adult Population: A Cross-Sectional Study Analysis
Version: 5 Date: 15 Apr 2025
Reviewer's report:
I have not seen a response to my review comments, please confirm.
Review for 10.1186/s12876-025-03904-0 (2025)

Title: Global, Regional, and National Burden of Disease Analysis on Paralytic Ileus and
Intestinal Obstruction in Adults Aged 65 and Over from 1990 to 2021, with Projections for 2030:
A Global Burden of Disease Study 2021 Analysis
Version: 1 Date: 19 Feb 2025
Reviewer's report:
The authors should be commended for a well conducted study. This article contributes to the
global knowledge on a disease area that is less documented and, therefore, warrants publication.
I would like to point out a few areas that need to be included in order to improve the quality
of the work.
1. The possible bias in data capturing from the lower SDI regions needs to be acknowledged in
the discussion. It is well known that data collection and maintenance, which is a high resource-
intensity activity, is less well supported in this region. This needs to be taken into consideration
when interpreting the incidence.
2. The higher incidence of paralytic ileus from the high SDI region may be attributed to the
high use of Opioids in the post-operative periods. It is well recognised that the North Americas,
Australia, and central Europe have a very high rate of post-operative opioid usage compared to
the rest of the world. (Schoenfield et al 2024 & ACoRe survey ; Boutrous et al– preliminary
data ).
3. It would help if you provide a rough breakdown of data contributions  (percentages) from
different regions in the globe. Since there is clearly a difference based on SDI, this information
will be relevant for the readers to get a better perspective.
With these minor corrections the publication can be accepted.
Review for 10.1186/s12876-025-03904-0 (2025)

Title: Global, Regional, and National Burden of Disease Analysis on Paralytic Ileus and
Intestinal Obstruction in Adults Aged 65 and Over from 1990 to 2021, with Projections for 2030:
A Global Burden of Disease Study 2021 Analysis
Version: 2 Date: 10 Mar 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
The responses are satisfactory
Review for 10.1186/s12876-025-03904-0 (2025)

Title: Global, Regional, and National Burden of Disease Analysis on Paralytic Ileus and
Intestinal Obstruction in Adults Aged 65 and Over from 1990 to 2021, with Projections for 2030:
A Global Burden of Disease Study 2021 Analysis
Version: 2 Date: 16 Mar 2025
Reviewer's report:
I am unable to access the .pdf file containing the response to reviewers' queries, as it seems to
be "damaged or corrupted". I have attempted to open it in different computers/browsers.
Please re-upload  for re-assessment in a different format so this can be assessed.
One  fundamental aspect that  is important to consider is the fact that Paralytic Ileus and Intestinal
Obstruction are manifestations of an underlying disease process, and have a multitude of causes
behind them. It would be  important (i.e. if this dataset allows for it in the first place) to see a
broad breakdown of the associated causes behind these cases. This would enable to elicit the
actual culprit  of these cases. If this is within the realm of possibility of this dataset,  it would
certainly enhance the manuscript.
Review for 10.1186/s12876-025-03904-0 (2025)

Title: Global, Regional, and National Burden of Disease Analysis on Paralytic Ileus and
Intestinal Obstruction in Adults Aged 65 and Over from 1990 to 2021, with Projections for 2030:
A Global Burden of Disease Study 2021 Analysis
Version: 5 Date: 25 Mar 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
The responses are satisfactory
Review for 10.1186/s12876-025-03904-0 (2025)

Title: Global, Regional, and National Burden of Disease Analysis on Paralytic Ileus and
Intestinal Obstruction in Adults Aged 65 and Over from 1990 to 2021, with Projections for 2030:
A Global Burden of Disease Study 2021 Analysis
Version: 5 Date: 27 Mar 2025
Reviewer's report:
This reviewer thanks the authors for re-uploading the "Response to Reviewers" file. I was able
to access it and re-review.
All of my queries have been addressed to satisfaction.
Review for 10.1186/s12876-025-03926-8 (2025)

Title: The prognostic value of sarcopenia in acute-on-chronic liver failure: A systematic review
and meta-analysis
Version: 1 Date: 01 Apr 2025
Reviewer's report:
In this meta-analysis, the authors examined whether sarcopenia, a well-known risk factor for
mortality in patients with liver cirrhosis, was a prognostic factor in patients with acute-on-
chronic liver failure (ACLF). The results indicated that sarcopenia was a risk factor for both
short- and long-term mortality in such patients. The Reviewer’s comments are as follows.
There were various causes of ACLF in the studies included in this meta-analysis, which may
influence the results. It is better to perform further analysis according to each cause of ACLF.
Review for 10.1186/s12876-025-03906-y (2025)

Title: Prevalence and Patterns of Peptic Ulcer Disease in Africa: a systematic review and meta-
analysis
Version: 2 Date: 12 Mar 2025
Reviewer's report:
I must begin by congratulating the authors of this paper, as they looked at a subject that has
received very limited attention in the African context.
My general comment is that they should have mentioned if any of these studies were population
or comminty based. Being either prosepctive or retrospective does not matter as much as
knowing if the individauls being sampled were symptomatic.
Secondly, the results on H. pylori need to be clarified. Was this serological diagnosis or by other
means? This matters because, serological prevelence would be higher than modalities looking
at active disease such as UBT, SAT or urease testing. The analysis should therefore take this
into consideration before drawing any conclusions.
Otherwise this is a good paper.
Review for 10.1186/s12876-025-03906-y (2025)

Title: Prevalence and Patterns of Peptic Ulcer Disease in Africa: a systematic review and meta-
analysis
Version: 2 Date: 18 Mar 2025
Reviewer's report:
Thank you , this is  a very interesting subject .  It's well written in detail and keeping in line
with the objectives.
Minor - Under analysis for prevalence  and pattern of PUD in Africa . First paragraph  please
correct  the "font" of  the sentences.
Review for 10.1186/s12876-025-03906-y (2025)

Title: Prevalence and Patterns of Peptic Ulcer Disease in Africa: a systematic review and meta-
analysis
Version: 2 Date: 22 Mar 2025
Reviewer:  Hsi-Lan Huang
Reviewer's report:
The authors estimated prevalence and patterns of peptic ulcer disease in Africa using systematic
review and meta-analysis. The topic is of importance, but I have some comments below:
Abstract, PUD should be spelled out in its first appearance, even in abstract.
Table1,  I noticed the publish year ranged from 2000 to 2023, which means the authors
pooled prevalence from different time points. This poses a major concern of the validity of the
pooled results. Could the authors specify the calendar year(s) corresponding to the estimated
prevalence? The authors may pooled the prevalence according to the year of the data collected
rather than the year of publication.
The authors may clarify in the Method section if there is any overlapping of data collected
from the same location/ registry. Overlapping data should be dropped according to pre-specified
criteria.
Table1, what are the I2 for pooled GU and DU?
Table1, please add footnotes. Its difficult to understand what are those * ** *** stand for?
Table 2, significant heterogeneity persisted even after subgroup analysis. Can the authors explore
additional subgroup analysis besides the current variables?
Line-157-158, the author wrote “while the retrospective cross-sectional study design yielded an
I2 of 18% (95%CI: 15 to 21) and 99.26%.” This is not consistent with the results in Table 2.
Discussion, could the authors further elaborate on why Africa had a higher prevalence rate of
peptic ulcer disease in addition to the current explanation?
Review for 10.1186/s12876-025-03906-y (2025)

Title: Prevalence and Patterns of Peptic Ulcer Disease in Africa: a systematic review and meta-
analysis
Version: 3 Date: 10 Apr 2025
Reviewer's report:
Thank you  authors  for including most of the suggestions provided  in the revised manuscript,
its much improved .
Minor - the manuscript still has typo errors , i suggest you run the whole your manuscript
through grammar  check  to improve on the grammar and   sentence expressions on what you
are communicating  in this important subject.
E.g   Among others, defining what you mean by  pattern of PUD  in  sentence 94-96 then 100-101.
Please check the grammar and wording of your sentences for easy flow of the manuscript.
Review for 10.1186/s12876-025-03868-1 (2025)

Title: Emergency Pancreatoduodenectomy for Non-Traumatic Conditions: A Case Series
Analysis
Version: 3 Date: 06 Mar 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Authors, please address the following points below
-Although 12 patients underwent emergency surgery, the small sample size of non-traumatic
EPD (9 patients) is a limitation. A larger sample size would allow for more robust conclusions,
particularly when considering complications and mortality rates. The findings may not be
generalizable to a larger population due to this small cohort.
-The manuscript does not include a control group for comparison. A comparison between
patients undergoing non-traumatic EPD and those undergoing elective PD would provide deeper
insights into the effectiveness of emergency surgery compared to scheduled procedures.
-While the paper presents descriptive statistics (age, gender, mortality rates, etc.), more advanced
statistical analysis could strengthen the results. Comparative statistics on complications and
survival rates between non-traumatic and trauma-related EPD would offer more evidence of the
outcomes.
-There is no mention of the long-term follow-up of patients after surgery. Long-term survival
rates, quality of life post-EPD, and potential chronic issues after surgery should be included to
provide a more complete picture of outcomes.
-The paper does not discuss the experience or qualifications of the surgical team. As the
procedure is highly complex, patient outcomes may be influenced by the level of expertise, and
including this information would add context to the findings.
-Although the paper briefly discusses the importance of postoperative management, it could
delve deeper into preoperative resuscitation protocols, especially for patients in shock or with
severe hemorrhage. A better understanding of resuscitative measures before and after surgery
would help readers gauge the overall success of EPD.
-The study focuses on a single institution, which raises concerns about how applicable
the findings are to other medical centers with different resources, expertise, and patient
demographics.
Review for 10.1186/s12876-025-03847-6 (2025)

Title: Risk prediction and effect evaluation of complicated appendicitis based on XGBoost
modeling
Version: 0 Date: 24 Feb 2025
Reviewer's report:
I have reviewed your manuscript. My suggestions are as follows.
Ensure consistent use of terms throughout the section. For example, "Xgboost" should always
be written as "XGBoost," and "Svm" should be "SVM."
In scientific writing, it is generally recommended to spell out numbers less than ten (e.g., "five
to six percent" instead of "5–6%"). This maintains a formal tone.
The final sentence could be stronger. Instead of just stating the aim of the study, consider briefly
outlining the significance of this research and how it addresses the identified gap in current
diagnostic practices.
The exclusion criteria could be more explicitly stated. For example, clarify what constitutes
"significant outliers" and how "missing data" was handled.
While you provide hyperparameters for the models, consider adding a brief rationale for why
those specific values were chosen. For example, how were these values determined (e.g., grid
search, prior studies)?
Clarify that "SVM" stands for Support Vector Machine when first mentioned. Additionally,
explain what "cost" and "gamma" mean in practical terms for the model's performance.
When discussing sensitivity, specificity, and precision, briefly explain what these metrics mean
in the context of clinical decision-making.
When discussing the performance of other models (e.g., ANN, CatBoost), provide a brief
explanation of why your approach (without radiological imaging) is advantageous.
Review for 10.1186/s12876-025-03847-6 (2025)

Title: Risk prediction and effect evaluation of complicated appendicitis based on XGBoost
modeling
Version: 0 Date: 01 Mar 2025
Reviewer:  Miguel Puga-Tejada
Reviewer's report:
Contratulations. This is a great research. The study presents an innovative application of
machine learning to differentiate complicated from uncomplicated appendicitis, with notable
performance of the proposed model. The manuscript is well written and illustrated.
Review for 10.1186/s12876-025-03847-6 (2025)

Title: Risk prediction and effect evaluation of complicated appendicitis based on XGBoost
modeling
Version: 0 Date: 04 Mar 2025
Reviewer's report:
• The primary output/endpoint variable(s)/measurement(s) of the study should be defined.
• How was the sample size determined? This information should be explained in the Materials
and Methods section.
• Which sampling (probable or non-probable, etc.) method was used in the study?
• Statistical tests for hypothesis testing and their assumptions should be specified in the study's
statistical analysis in the Materials and Methods section.
• The details (version, license number, etc.) of the statistical package(s) or program(s) should be
given in the sub-section of "Data Analysis or Statistical Analysis".
• It should be explained how the qualitative and quantitative data are summarized under the sub-
heading of Statistical Analyses in the Materials and Methods section of the study.
• The exact P values should be added to the table(s) (e.g., p=0.25; p=0.03).
• Which methods are used to model relationships between variables?
• The descriptions and other descriptive values/data should be defined on the tables and shapes.
• Are the data subjected to pre-processing?
• How were extreme/outlier values in the data determined and resolved?
• What approaches were used to test the validity of the models?
• Which metrics were used in the performance evaluation of the estimates of models/algorithms?
• How were the predictive models selected in this study?
• Which method(s) was/were used to optimize the hyperparameters of models/algorithms?
Review for 10.1186/s12876-025-03847-6 (2025)

Title: Risk prediction and effect evaluation of complicated appendicitis based on XGBoost
modeling
Version: 0 Date: 10 Mar 2025
Reviewer's report:
Dear Author
First of all, thank you for your work. You are expected to make some necessary revisions.
Revision requests are as follows:
1. Classical statistical models could have been explained in addition to machine learning, but
it is not necessary.
2. It is not fully understood how to use model estimates in clinical practice. Can you explain
it clearly?
3. Different methods can be tried in variable selection for the model, and their compatibility
with each other can be evaluated.
4. Positive and negative predictive values should also be included in the results. In addition,
logistic regression values should be included in the manuscript.
Best regards,
Review for 10.1186/s12876-025-03847-6 (2025)

Title: Risk prediction and effect evaluation of complicated appendicitis based on XGBoost
modeling
Version: 1 Date: 27 Mar 2025
Reviewer's report:
I honored to have been assigned to review this article, I believe your manuscript titled "Risk
prediction and effect evaluation of complicated appendicitis based on XGBoost modeling" is
acceptable.
Review for 10.1186/s12876-025-03847-6 (2025)

Title: Risk prediction and effect evaluation of complicated appendicitis based on XGBoost
modeling
Version: 1 Date: 28 Mar 2025
Reviewer's report:
Thank you very much for the submission of a revised version of your paper. I have gone through
the revised, track-changes manuscript and rebuttal letter, and see that the authors addressed the
reviewers' concerns and substantially improved the content of the manuscript. So, based on my
own assessment as a reviewer, the manuscript may be now accepted for publication.
Review for 10.1186/s12876-025-03890-3 (2025)

Title: Impact of Occupation on Survival of Esophageal Squamous Cell Carcinoma Patients
Following Esophagectomy : A Long-term Survival Analysis
Version: 2 Date: 10 Mar 2025
Reviewer's report:
This study examines the impact of occupational background on the long-term survival of ESCC
patients following esophagectomy. However, several issues need to be addressed:
Formatting Issues: The manuscript does not adhere to the required formatting guidelines.
Line spacing is inconsistent, numbers should be formatted with commas every three digits,
and spacing errors (e.g., on page 6) need correction. Additionally, tables extend beyond page
boundaries.
Missing Key Clinical Variables: The study does not account for crucial prognostic factors such
as smoking and alcohol consumption, which significantly influence cancer outcomes. Their
omission weakens the validity of the analysis.
Multivariate Analysis Details: The manuscript does not specify which variables were adjusted
for in the multivariate analysis. Clearly stating these variables is essential for assessing the
robustness of the findings.
Selection of Occupational Categories: The study includes only four occupational groups—
Farmer, Civil Servant, Teacher, and Factory Worker. However, the rationale for selecting these
specific occupations is unclear. The lack of justification raises concerns about the study's novelty
and generalizability.
Logical Inconsistency in Occupational Stress and Survival: The assumption that civil servants
experience more stress than farmers, leading to differences in cancer survival, appears to be a
logical overreach. The reasoning needs stronger evidence and theoretical support.
Given these significant concerns, I recommend rejecting the manuscript in its current form.
Review for 10.1186/s12876-025-03890-3 (2025)

Title: Impact of Occupation on Survival of Esophageal Squamous Cell Carcinoma Patients
Following Esophagectomy : A Long-term Survival Analysis
Version: 2 Date: 17 Mar 2025
Reviewer's report:
This is a longitudinal study aimed to  explore the long-term overall survival (OS) of patients with
differing occupational backgrounds who undergo esophagectomy. The findings are interesting.
However, I had some concerns for this study.
1-The relevant review or meta analysis should be added in the introduction section.
2-Which package was adopted in R for statistical analysis? The authors should clarify this
concern.
3-Statistical analysis is well written. Does univariate analysis show significance among
important variables?
4-The sample size is large. But, I still suggest the authors should clarify the normal assumption
for variables in this study.
5-Subgroup analysis of various work groups is usually used to identify interaction effects. Does
any interaction effect show significance among subgroup variables?
6-Please add RCS of hazard ratio (HR). I mean the clinical merit of nodes of RCS for HR should
be discussed.
7-Please add DCA analysis in this study.
8-Please check the typos before re-submission.
Review for 10.1186/s12876-025-03890-3 (2025)

Title: Impact of Occupation on Survival of Esophageal Squamous Cell Carcinoma Patients
Following Esophagectomy : A Long-term Survival Analysis
Version: 2 Date: 20 Mar 2025
Reviewer's report:
1.Previous studies have shown that lifestyle habits, such as smoking, alcohol consumption and
consumption of pickled food, were risk factors for the prognosis of patients with esophageal
cancer,  these data should be included in the analysis of this study.
2.Gender may have an impact on the choice of occupation. It is recommended to separate male
and female patients in the survival analysis.
3.The article occupation classification is too simple, which can refer to the International Standard
Classification of Occupations.
4.In the group of factory workers, whether there is a history of occupational exposure to harmful
substances, such as asbestos, benzene and so on. It is suggested that the occupations of factory
workers be classified in detail.
5.Why is the horizontal coordinate of the dotted line of the forest map 0 instead of 1.
6.The discussion section is too simple and needs to be further explored in depth.
Review for 10.1186/s12876-025-03839-6 (2025)

Title: Transient and Persistent Small-Bowel Intussusception in Children: A Diagnostic Tree
Analysis Model Based on Ultrasound and Clinical Findings
Version: 8 Date: 18 Feb 2025
Reviewer:  Einar Arnbjörnsson
Reviewer's report:
This paper on intussusception is of great interest to pediatric surgeons globally. The data reported
here supports findings well-known in the literature and among practicing pediatric surgeons.
The strength of this report lies in the analysis of the collected data and the construction of the
diagrams.  While reading the manuscript, I had the following thoughts:
I would appreciate the authors' comments on potential biases in their research.
I suggest the authors include the name of the statistical method used in each table.
Linguistic revision would improve the text.
Do the authors have any insight into whether some transient intussusceptions might be missed
due to spontaneous resolution?
I suggest the authors avoid repeating data from the tables and figures within the text. The text
should only comment on the data.
Review for 10.1186/s12876-025-03839-6 (2025)

Title: Transient and Persistent Small-Bowel Intussusception in Children: A Diagnostic Tree
Analysis Model Based on Ultrasound and Clinical Findings
Version: 9 Date: 17 Mar 2025
Reviewer:  Einar Arnbjörnsson
Reviewer's report:
The authors have addressed all editor and reviewer queries, revised the manuscript, and
significantly enhanced its presentation.
Review for 10.1186/s12876-025-03839-6 (2025)

Title: Transient and Persistent Small-Bowel Intussusception in Children: A Diagnostic Tree
Analysis Model Based on Ultrasound and Clinical Findings
Version: 9 Date: 18 Mar 2025
Reviewer's report:
I have reviewed the revised version of the manuscript and confirmed that the necessary revisions
have been made.
Review for 10.1186/s12876-025-03833-y (2025)

Title: Metabolic Score for Visceral Fat is Correlated with All-Cause and Cardiovascular
Mortality among Individuals with Non-Alcoholic Fatty Liver Disease
Version: 0 Date: 03 Feb 2025
Reviewer's report:
This study aims to explore the correlation between METS-VF and both all-cause mortality
and cardiovascular disease (CVD)-related mortality among individuals with NAFLD. For this
purpose, the authors analyzed data from a cohort of 6,759 subjects from the US NHANES during
the period from 1999 to 2018 diagnosed with NAFLD. They found that elevated METS-VF
independently associates with an increased risk of all-cause and CVD mortality in individuals
with NAFLD.
Comments:
1. Introduction: The authors should use the new definition MASLD (PMID: 37363821) instead
of NAFLD or at least discuss this aspect.
2. Introduction: When the authors discuss that the incidence of cardiovascular adverse events is
higher in individuals with NAFLD, they should also highlight that this is not always the case and
briefly address the heterogeneity in the CVD risk in people with MASLD (PMID: 39681121).
3. Results: In the table 1 the data shown for waist circumference in cm appear not to be correct.
4. Results: For the calculation of the METS-VF height is being used and, for example, height is
not used for the calculation of the VAI or other presented indices of CVD-mortality risk. Because
height impacts on the estimation of total fat mass and the BMI-associated risk of diabetes
(PMID: 38968941) the authors should also perform their analyses in people with different height
categories (e.g. in sex-specific height tertiles).
5. Discussion: It cannot be excluded that increased METS-VF also strongly represents increased
liver fat content which, often, independently of visceral obesity contributes to insulin resistance
and the risk of CVD (PMID: 36754018). The authors should address this point.
6. Discussion: It is not clear to what extent the present findings help to improve the prediction of
total and CVD-mortality. It would also have been important that the authors test the relationship
of the METS-VF with mortality in people without MASLD and compare the predictive results in
people with and without MASLD. Furthermore, at this stage of research much interest exists in
the scientific community in the stratification of the cardiometabolic risk based on BMI, presence
or absence of metabolic health and prediabetes and clusters of people at risk for diabetes or
with diabetes (e.g. see PMID: 37156256). The authors should perform such analyses or at least
discuss this important point.
Review for 10.1186/s12876-025-03833-y (2025)

Title: Metabolic Score for Visceral Fat is Correlated with All-Cause and Cardiovascular
Mortality among Individuals with Non-Alcoholic Fatty Liver Disease
Version: 0 Date: 03 Feb 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Authors, please address the following points below
-While METS-VF is introduced and its components are explained, there could be more emphasis
on how METS-VF compares to other similar indices, like the visceral adiposity index (VAI)
and the TyG index. How does METS-VF outperform or complement these other markers in
predicting mortality outcomes in NAFLD? Providing a brief comparison could strengthen the
argument for using METS-VF in this population.
-The study mentions that METS-VF is related to visceral fat but doesn’t fully explain what
visceral fat is or why it is particularly relevant in the context of NAFLD. A bit more on the
biology of visceral fat and why its accumulation is dangerous for those with NAFLD (e.g.,
through insulin resistance, and inflammation) could enhance the reader’s understanding of the
significance of the findings.
-The exclusion criteria are well-defined, but there is no explanation for why some groups (e.g.,
pregnant women, and heavy alcohol users) were excluded. While it's understandable that these
factors could confound results, it would be beneficial to explicitly address how their inclusion
or exclusion may influence the study's generalizability.
-The exclusion of subjects with missing METS-VF or FLI data (34,913 and 78, respectively)
might seem high. A brief mention of how the excluded subjects differed from those included in
terms of baseline characteristics would be useful in assessing the risk of selection bias.
-The definitions of CVD and all-cause mortality are well-established through ICD-10 codes,
but it would be helpful to discuss any potential misclassification biases, especially when
relying on administrative coding data. For example, could there be a risk of underreporting or
misclassifying some deaths as "all-cause" rather than "CVD-related"?
-Although the authors advocate for METS-VF as a superior predictor of mortality, further
discussion of how METS-VF could be practically integrated into clinical practice would be
valuable. For example, can METS-VF be routinely measured in primary care settings or liver
clinics? How might it be incorporated alongside other diagnostic tools for assessing metabolic
risk in individuals with NAFLD?
-The non-linear correlation with an inflection point at 7.436 is intriguing but would benefit from
more clarification. The authors might consider elaborating on the significance of this threshold
and how it could be used clinically. Does this inflection point indicate a critical level of visceral
fat, beyond which the risk of mortality sharply increases?
Review for 10.1186/s12876-025-03833-y (2025)

Title: Metabolic Score for Visceral Fat is Correlated with All-Cause and Cardiovascular
Mortality among Individuals with Non-Alcoholic Fatty Liver Disease
Version: 1 Date: 28 Mar 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
The responses are satisfactory
Review for 10.1186/s12876-025-03894-z (2025)

Title: Assessment of the Impact of Power Business Intelligence on Adenoma Detection Rate:
A Prospective Observational Trial
Version: 2 Date: 28 Feb 2025
Reviewer's report:
The study presents the analysis of the impact of Power BI on adenoma detection rates (ADR),
but although multivariate analysis was performed, the paper does not thoroughly explore why
Power BI did not significantly improve ADR. I recommend further clarification of the specific
situations where Power BI might or might not be effective, supported by additional empirical
data.
The discussion mentions that information overload and excessive feedback could influence the
results. It would be beneficial to further elaborate on these hypotheses and explore how the
feedback mechanism can be optimized to prevent overload and increase usability.Although
multivariate regression was conducted, the study does not fully explore other potential factors
affecting ADR. It would be important to investigate additional variables directly related to the
Power BI feedback mechanism, such as the method of information presentation and feedback
timing, to better understand the tool's actual impact.
The conclusion notes that Power BI has limited impact in high baseline ADR hospitals. I
recommend the authors expand this conclusion to focus more on how feedback tools can benefit
individual low-performing endoscopists, emphasizing the potential for improvement in these
cases.
Review for 10.1186/s12876-025-03894-z (2025)

Title: Assessment of the Impact of Power Business Intelligence on Adenoma Detection Rate:
A Prospective Observational Trial
Version: 2 Date: 02 Mar 2025
Reviewer's report:
I would like to congratulate authors for the well planned study. I have several comments:
Major
1. It is not precisely written if operators received institutional data or individual performance.
It needs to be clarified.
2. The operators have access to the data or it was presented to them on the meetings? Were there
able to see data presented on figure 1 or all mentioned in methods section? Precise intervention
information (ability to see some data vs standardized feedback continuously presented/ ADR
data vs all metrics data) must be included in the methods section.
3. In the results section BBPS threshold was presented as “>6” – how it was selected? The
usually used threshold is equal or higher that 6.
4. Same with the BMI it is mentioned that at least of 25 it is overweight but then 24 as threshold
is used in the regression analysis.
5. The improved ADR of worst performing operator is one of crucial information. It I demanded
to achieve improvement of operators who have ADR <26% [1] - it should be discussed.
1.Pilonis ND, Spychalski P, Kalager M, Løberg M, Wieszczy P, Didkowska J, Wojciechowska
U, Kobiela J, Regula J, Rösch T, Bretthauer M, Kaminski MF. Adenoma Detection Rates by
Physicians and Subsequent Colorectal Cancer Risk. JAMA. 2025 Feb 4;333(5):400-407. doi:
10.1001/jama.2024.22975. PMID: 39680377; PMCID: PMC11795324.
Minor.
1. In introduction term „interval cancer” was used, it should be changed for “post-colonoscopy
colorectal cancer” with adequate definitions and references.
2.  Introduction “techniques, and endosocpi devices” – misspelling.
3. How withdrawal time was measured and assessed? It needs to be defined in methods section.
4. „After adjusting for confounding factors, multivariate analysis revealed no association
between Power BI usage and adeoma detections. Adeoma detections” – misspelling.
5. „These outcomes illustrate the challenges of feedabck from generalized reporting systems in
driving performance improvements.” – misspelling.
6. „This could mean that either the quality of endoscopy was already high, or the Powe BI can’t
change the behabior.” – misspelling.
7. „In contrast to the above patient factos, the modiferable technique facts were more imporatnat
because it could provide by the health care give” – misspelling.
8. „Adequate withdrawal time allows colonoscopists to perform careful and detailed inspection
of the colon” – misspelling.
Review for 10.1186/s12876-025-03894-z (2025)

Title: Assessment of the Impact of Power Business Intelligence on Adenoma Detection Rate:
A Prospective Observational Trial
Version: 3 Date: 25 Mar 2025
Reviewer's report:
The authors have adequately addressed the concerns raised in the review, providing clear
explanations and incorporating relevant revisions. The discussion on Power BI’s limitations and
its impact on different groups of endoscopists has been strengthened, and the conclusions now
better reflect the observational nature of the study. The manuscript is now sufficiently revised
and meets the standards for publication.
Review for 10.1186/s12876-025-03894-z (2025)

Title: Assessment of the Impact of Power Business Intelligence on Adenoma Detection Rate:
A Prospective Observational Trial
Version: 3 Date: 27 Mar 2025
Reviewer's report:
Congratulations on authors' effort.
I have no further commends. The selection of PCCRC definition proposed by  WEO is accurate.
Review for 10.1186/s12876-025-03820-3 (2025)

Title: Remimazolam alleviates hepatic ischemia-reperfusion injury by activating FOXO1/3
signaling
Version: 2 Date: 19 Feb 2025
Reviewer's report:
In this study, a liver ischemia-reperfusion injury model was established through animal
experiments, and a cell hypoxia-reperfusion injury model was established by subjecting cells to
hypoxia and then reoxygenation. It was explored that remimazolam alleviates liver ischemia-
reperfusion injury by activating the FOXO1/3 signaling pathway. The overall design of the full
text is reasonable, and the experimental results can effectively support the research objectives.
However, there are still some related issues:
1.When establishing the animal model, the mice were not placed on a thermostatic plate, which
shows a lack of awareness of animal protection in terms of ethics. At the same time, it may have
an impact on the data.
2.The model of ischemia-reperfusion injury was established by clamping the left and middle
hepatic arteries. However, it is not described in the later part which specimens were taken from
the left lobe and the middle lobe of the liver. Please provide a detailed description, author.
3.The time for establishing liver ischemia in mice was 60 minutes, and the reperfusion time was
6 hours. What is the basis for determining these two time periods? Were any preliminary animal
experiments conducted to determine them? Please provide a detailed description.
4.In the RMZL group, the mice received an intraperitoneal injection of RMZL at a dose of 20 mg/
kg. Where does the basis for determining this concentration come from? Were any concentration
gradient preliminary experiments conducted? Please provide a detailed description.
5.In the experimental grouping, the RMZL group has no comparative significance throughout
the entire experimental process, and there is no need to set up this group.
Review for 10.1186/s12876-025-03820-3 (2025)

Title: Remimazolam alleviates hepatic ischemia-reperfusion injury by activating FOXO1/3
signaling
Version: 3 Date: 11 Mar 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
The responses are satisfactory
Review for 10.1186/s12876-025-03879-y (2025)

Title: Effect of Saccharomyces boulardii supplementation to bismuth quadruple therapy on
Helicobacter pylori eradication
Version: 2 Date: 08 Jan 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Authors, please address the following points below
-While S. boulardii is described as resistant to antibiotics and gastric acid, its role in enhancing
eradication rates and reducing adverse effects could be explained briefly (e.g., modulation of
gut microbiota or anti-inflammatory properties).
-Clarify why earlier meta-analyses were insufficient (e.g., outdated protocols, limited subgroup
analysis) to better justify this study's necessity.
-Consider adding a brief justification for excluding multi-strain probiotics to preempt questions
about their potential effects on the outcomes.
-The process is well-described, but including examples of diagnostic methods for H. pylori (e.g.,
urea breath test, stool antigen test) would enhance clarity.
-Provide more detail on how heterogeneity was managed beyond switching between fixed
and random-effects models. Were subgroup analyses or meta-regression conducted to explore
potential sources of heterogeneity?
-Clarify how inter-rater reliability for quality assessment was managed (e.g., kappa statistic) to
ensure transparency in the review process.
-The quality assessment description is clear but can benefit from added context. For example:
Discuss the implications of having moderate-quality evidence based on the GRADE assessment.
Address how unclear the risk of bias in some studies might influence the results.
-Provide more context for the mechanisms of S. boulardii and their clinical implications.
-The discrepancy between the findings of this study and those of Zhou et al.[10] is noted.
Consider discussing other factors (e.g., differences in patient populations, eradication regimens,
or methodologies) that could explain the variability.
-Since all included studies were conducted in China, address how these findings may translate to
other regions with different dietary habits, healthcare practices, or antibiotic resistance profiles.
Review for 10.1186/s12876-025-03879-y (2025)

Title: Effect of Saccharomyces boulardii supplementation to bismuth quadruple therapy on
Helicobacter pylori eradication
Version: 2 Date: 21 Feb 2025
Reviewer:  Mohsen Rajabnia
Reviewer's report:
TheThank you for submitting the article to our journal
Considering the clinical application of the results of this study, it seems that the publication of
this article is valuable for the readers. results are practical.
Review for 10.1186/s12876-025-03866-3 (2025)

Title: Effect of Biliopancreatic Tree Anatomy on Development of Acute Gallstone Pancreatitis
Version: 1 Date: 08 Nov 2024
Reviewer's report:
This manuscript examines the influence of the anatomy of the pancreaticobiliary tract on the
development of biliary pancreatitis. This is a retrospective analysis.
Apart from some minor superficialities, the work has significant shortcomings.
Minor points:
• The literature is not always very carefully cited. In the introduction, reviews are cited to support
hypotheses that should actually be based on original data.
Major points
• There are also relevant disadvantages in the definition of the patient population. Patients with
acute pancreatitis were included retrospectively. How the diagnosis was made and whether the
correctness of the diagnosis was verified is not defined.
• There is also no clear definition of ‘gallstone-associated pancreatitis’.
• The control group consists of patients with elevated liver function tests. This should be more
specified in order to exclude possible selection bias for investigations of anatomical variants of
the bile ducts.
• It is also not clear why only patients with ‘normal’ anatomy of the biliary tract and pancreatic
duct system were included in the control group and what the definition of ‘normal’ is.
• The high proportion of MRCP examinations in the patient group in which the diagnosis of
biliary pancreatitis could obviously not be made sonographically is striking. This could also
represent a selection bias, as it is possible that sonographic visualisation of the entire DHC is
differently difficult in patients with certain anatomical variants.
• Were the criteria used to categorise anatomical variants chosen arbitrarily or is there evidence
in the literature to justify this choice?
Overall, the selection of study patients and control group appears unsuitable for answering the
question of whether anatomical variants of the ductal system represent a predisposition to biliary
pancreatitis. It would be better to compare patients with gallstone disease and acute pancreatitis
with patients with gallstone disease and no history of pancreatitis.
Review for 10.1186/s12876-025-03866-3 (2025)

Title: Effect of Biliopancreatic Tree Anatomy on Development of Acute Gallstone Pancreatitis
Version: 1 Date: 10 Nov 2024
Reviewer's report:
It is important to provide information on MRCP protocol and parameters used.
Please present numbers on the distribution of different types of cystic duct course in the control
group.
As this is a retrospective study it is important to know what was the reason for MRCP studies
done during the course of acute pancreatitis, and on which day was MRCP performed?
Did you have cases with acute cholecystis too? Were these patients excluded from the study?
Please define.
Were cases of other ductal variations (eg pancreas divisum) included in the study?