JerMa88/BMC_Gastroenterology_Peer_Reviews huggingface dataset:
Review for 10.1186/s12876-025-03665-w (2025)

Title: Big Data Analysis of Influenza Vaccination and Liver Cancer Risk in Hypertensive
Patients: Insights from a Nationwide Population-Based Cohort Study
Version: 4 Date: 18 Oct 2024
Reviewer's report:
Thank you for revising your study manuscript to the extent possible.
I understood that it takes you about 1.5 years from the time you apply to use the data to the
time you analyze the data. If so, could you not have applied for use of data until 2022, assuming
you had anticipated this and had applied for use 2 years earlier? I do not understand why you
used the 2001-2012 data. This study may be novel, but I do not think it is of much relevance to
current real-world clinical practice and society. Therefore, you would do well to apply for use
of the new data as soon as possible.
Review for 10.1186/s12876-025-03665-w (2025)

Title: Big Data Analysis of Influenza Vaccination and Liver Cancer Risk in Hypertensive
Patients: Insights from a Nationwide Population-Based Cohort Study
Version: 6 Date: 20 Nov 2024
Reviewer:  Panagiotis Tsibouris
Reviewer's report:
Methods Why have authors limited their study in patients with hypertension? Were there
recordings available for other anti-diabetic medications like GLP1 s or pioglitazone that could
affect steatosis ? Were there any recording for smoking habits a known risk factor for HCC
development or alcohol consumption? Statistics Power of the study should be calculated Results
It might be better to include numerical values and percentages apart from p-values
Review for 10.1186/s12876-025-03665-w (2025)

Title: Big Data Analysis of Influenza Vaccination and Liver Cancer Risk in Hypertensive
Patients: Insights from a Nationwide Population-Based Cohort Study
Version: 6 Date: 02 Dec 2024
Reviewer's report:
If you would add the results shown in Table 4, please describe the specific statistical analysis
in the Methods.
Review for 10.1186/s12876-025-03665-w (2025)

Title: Big Data Analysis of Influenza Vaccination and Liver Cancer Risk in Hypertensive
Patients: Insights from a Nationwide Population-Based Cohort Study
Version: 8 Date: 09 Jan 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
The responses are satisfactory.
Review for 10.1186/s12876-025-03708-2 (2025)

Title: Dose Optimization of Non-Selective Beta Blockers among Esophageal Varices Patients
at University Of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia: A Hospital-
Based Cross-Sectional Study
Version: 3 Date: 11 Nov 2024
Reviewer:  Mohamad Iskandarani
Reviewer's report:
comments in the attached manuscript.
Review for 10.1186/s12876-025-03708-2 (2025)

Title: Dose Optimization of Non-Selective Beta Blockers among Esophageal Varices Patients
at University Of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia: A Hospital-
Based Cross-Sectional Study
Version: 3 Date: 13 Nov 2024
Reviewer:  Haris Alvi
Reviewer's report:
thanks for asking me to review this original article. As it belong to a very common public issue
and help in financial assistance so, I approved the manuscript with little change as to start NSBB
in EV of a cirrhotic patient, then how the study is cross sectional, as the outcome in terms of
hematemesis and hospitalization need the follow-up visit and interaction. The optimum dose is
always  vary from patient to patient.
Review for 10.1186/s12876-025-03708-2 (2025)

Title: Dose Optimization of Non-Selective Beta Blockers among Esophageal Varices Patients
at University Of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia: A Hospital-
Based Cross-Sectional Study
Version: 3 Date: 17 Nov 2024
Reviewer's report:
1. Under the section titled "Clinical and medication-related characteristics", the authors state
thus: "53.3% of esophageal varices were caused by HSS and 45.3% were due to chronic liver
disease (CLD) of different etiologies" and "Identified causes of CLD were HBV (25.58%), HSS
(20.93%), ALD (23.25%), HCV (18.60%), UNKOWN (8.14%), and others (3.49%)". Please,
is HSS a cause of CLD. If it is, please why is it mentioned separately from CLD as a cause of
oesophageal varices?
2.  Please, define CLD and cirrhosis and clarify if they can be used interchangeably.
3. The results state that there were 86 patients with CLD, and 126 patients with ascites (as a
complication of CLD, table 2). Please, clarify this discrepancy in these numbers.
4. For the multivariable logistic regression, some of the independent variables seem to be
correlated with each other, eg BMI & MUAC; cirrhosis & ascites; lasix/spironolactone & ascites.
The use of correlated independent variables in a regression analysis may render the results
inaccurate. Did the authors test for multicollinearity among the independent variables prior to
performing multivariable logistic regression analysis? If yes, this should be stated.
Review for 10.1186/s12876-025-03708-2 (2025)

Title: Dose Optimization of Non-Selective Beta Blockers among Esophageal Varices Patients
at University Of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia: A Hospital-
Based Cross-Sectional Study
Version: 3 Date: 18 Nov 2024
Reviewer:  Ronald Mbiine
Reviewer's report:
Congratulations on the progress made this far.
The manuscript and the topic are interesting to read and explore an area that seems not fully
described with potential to improve patient care.
However there are comments that need to be addressed to make the manuscript better.
These are attached for your review.
Review for 10.1186/s12876-025-03708-2 (2025)

Title: Dose Optimization of Non-Selective Beta Blockers among Esophageal Varices Patients
at University Of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia: A Hospital-
Based Cross-Sectional Study
Version: 3 Date: 23 Nov 2024
Reviewer:  Ahmad Khan
Reviewer's report:
Comments to Authors
1. Background: mentioned latest references.
2. Write keywords in alphabetical order.
3. At the end of the introduction the authors reveal the aim of the work: especially Dose
Optimization of Non-Selective Beta Blockers among Esophageal Varices Patients.
4. Methods. It should be a method. Otherwise, mention the methods in detail in your manuscript.
5. It is suggested to compare the advantages and limitations
of such a topic. The following manuscripts would be useful
for discussion. DOI:10.2174/1871520622666220831124321. DOI:
10.2174/0113892037252820231114045234. DOI:
10.2174/0115734110269897231020065609. DOI:
10.2174/0113892037269589231017055642.
6. Add the impact of current work for future research.
7. The authors need to improve the problem statement in the introduction section deeply.
8. Why and how the said parameters were selected for this work? More specific details needed
to be added with the use of the latest reference.
9. The topic is exciting. Put more of the latest references in the introduction part.
10. In your discussion section, please link your empirical results with a broader and deeper
literature review.
11. Mentioned the Figures in the manuscript.
12. Put an error bar in the Figures.
13. Use EndNote or Mendeley for references.
14. The conclusion is very short make it with more explanation.
15. Cite the following related references.
DOI: 10.1186/s12935-024-03408-z. DOI:10.3390/md22050221. DOI: 10.3390/bioengineering
9(8):406
Review for 10.1186/s12876-025-03708-2 (2025)

Title: Dose Optimization of Non-Selective Beta Blockers among Esophageal Varices Patients
at University Of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia: A Hospital-
Based Cross-Sectional Study
Version: 4 Date: 11 Dec 2024
Reviewer:  Mohamad Iskandarani
Reviewer's report:
Dear Authors,
the previous comments weren't addressed in the revised draft, please consider.
comments such as:
sample size calculations
limitations
results
re attaching old manuscript
Review for 10.1186/s12876-025-03708-2 (2025)

Title: Dose Optimization of Non-Selective Beta Blockers among Esophageal Varices Patients
at University Of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia: A Hospital-
Based Cross-Sectional Study
Version: 4 Date: 12 Dec 2024
Reviewer:  Ahmad Khan
Reviewer's report:
No further comments are required. The current format is accepted
Review for 10.1186/s12876-025-03708-2 (2025)

Title: Dose Optimization of Non-Selective Beta Blockers among Esophageal Varices Patients
at University Of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia: A Hospital-
Based Cross-Sectional Study
Version: 5 Date: 02 Jan 2025
Reviewer:  Mohamad Iskandarani
Reviewer's report:
Dear Authors,
Thank you for your efforts in addressing the comments. Just one comment on the inclusion and
exclusion criteria section (comment in the attached manuscript).
Review for 10.1186/s12876-025-03678-5 (2025)

Title: Reliability Assessment of CT Enhancement Rate and Extracellular Volume in Liver
Fibrosis Prediction
Version: 2 Date: 20 Dec 2024
Reviewer's report:
1.This study mainly focuses on the reliability evaluation of CT Enhancement Rate and
Extracellular Volume in evaluating liver fibrosis. However, the authors did not conduct
reliability analysis of the data.  Test-retest variability and inter-observer agreement are required.
2.Abstract: The description of the abstract part is too redundant and has too many words, please
rewrite it to ensure that the summary is concise and increase readability.
3.Line 60-61 “Results VP-ER and ECV fraction showed significant positive correlations with
fibrosis grade (r#=#0.363, p#=#0.0003; r#=#0.531, p#<#0.0001, respectively)...”this is not correct,
r=0.363/0.531 can only indicate that there is a weak or moderate correlation between the two,
and it does not reach a significant correlation, please correct. And synchronize in the results
section of the text.
4.Line 72-73, it was mentioned that “Incorporating both parameters enhances predictive
accuracy for liver fibrosis,.....” but no corresponding results were presented in the results section.
How did come to this conclusion?  Please explain and correct.
Materials and Methods
1.please provide a diagram to show how to draw ROI for data measurement.
Statistics#
1.To ensure the reliability of data measurements, please include intra-reader and inter-reader
consistency analyses.
2.In correlation analysis, is liver fibrosis staging a binary classification (fibrosis/no) or a graded
classification (F0, 1, 2)?  Please clarify and provide a figure and table to display the results.
Results:
1. Why did the author ignore or exclude patients with F4? Please specify this in the study design
section
2. Results need to be presented in more detail, the number of patients in each group, and basic
information is missing.
3. Line 323-325: “The accuracy of the model and the ROC were obtained to be 72.04% and 0.756
(CI: 0.688-0.863, p<0.0001).”  How was this result concluded? Is it the combination of ECV
and VR-ER to predict the stage of significant liver fibrosis? Please supplement the description
in the Methods and statistics section, and add charts for presentation.
Table : 1.please provide a more detailed explanation of Table 1 to ensure accessibility for non-
specialist readers.
3.Mention the number of excluded cases and reasons for exclusion to give readers a sense of
sample representativeness.
Figures: Ensure all figures and tables are properly cited in the text and include legends that are
standalone and detailed.
Discussion
The discussion section should add the discussion of the biological principles of VP-ER and ECV
related to fibrosis, both of which assess the mechanism of liver fibrosis, etc., and explain how
VP-ER and ECV can be incorporated into routine practice or decision-making to have clinical
impact, rather than simply repeating the description of the results.
Review for 10.1186/s12876-025-03678-5 (2025)

Title: Reliability Assessment of CT Enhancement Rate and Extracellular Volume in Liver
Fibrosis Prediction
Version: 2 Date: 20 Dec 2024
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Authors, please address the following points below
-The key terms like “fEES” and the calculation methods should be explained more clearly. A
concise definition or a diagram could help make the concepts more digestible.
-Provide more detailed references to specific studies or meta-analyses that directly compare
imaging biomarkers (such as ECV and VP-ER) with liver biopsy results in fibrosis staging. This
could offer a clearer context for the study's novelty and importance.
-Include a power analysis or discuss the rationale behind the chosen sample size, ensuring the
study has adequate power to detect significant relationships.
-Discuss how potential confounders, such as comorbidities or medications, were controlled for
or acknowledged in the study design and analysis.
-Mention the inter-observer or intra-observer reliability of ROI placement to assure readers of
the consistency and accuracy of the imaging measurements.
-Provide more detailed context for the AUC values, explaining their diagnostic relevance in
more clinical terms.
-More critical analysis of why VP-ER had a lower AUC than ECV, and why previous studies
may have found different results, would add depth to the discussion. For example, factors like
the phase of CT imaging or patient characteristics (e.g., comorbidities) may influence diagnostic
performance.
-Provide more details on the inherent limitations of liver biopsy, such as sampling errors or
variability between pathologists, which may affect the comparison between imaging biomarkers
and biopsy findings.
Review for 10.1186/s12876-025-03678-5 (2025)

Title: Reliability Assessment of CT Enhancement Rate and Extracellular Volume in Liver
Fibrosis Prediction
Version: 3 Date: 15 Jan 2025
Reviewer's report:
The biggest problem is that the author confuses the liver fibrosis scoring system.
Please refer to the METAVIR scoring system as follows: no or mild liver fibrosis (no liver
fibrosis or portal fibrosis, no septum, F0-F1), moderate liver fibrosis (portal fibrosis, few septa,
F2), severe liver fibrosis (many septa, no cirrhosis, F3), cirrhosis F4.
I have made some comments and edits, see the attachment.
Please add a correlation figure to improve the readability of the paper.
Review for 10.1186/s12876-024-03585-1 (2025)

Title: Dietary Inflammatory Index and Its Association with Fatty Liver Disease: A Study in
Obese and Non-Obese Populations
Version: 4 Date: 20 Nov 2024
Reviewer:  Giuseppe Guido Maria Scarlata
Reviewer's report:
In the present study the Authors suggest a significant association between the DII score and the
risk of fatty liver disease in a large cohort of patients. I have some suggestions to improve the
manuscript:
1. I suggest to revise the entire manuscript for typos, italics (HP), and references format.
2. Please, check the use of abbreviations in the main text.
3. The recent literature have evaluated the use of several different inflammatory biomarkers
in chronic liver diseases, such as liver cirrhosis (https://doi.org/10.3390/medicina60111854),
or fibrosis (https://doi.org/10.3390/jpm14080798). I suggest to the Authors to cite this papers
adding some lines about this.
4. Please, add a "Conclusion and future perspective" section.
Review for 10.1186/s12876-024-03585-1 (2025)

Title: Dietary Inflammatory Index and Its Association with Fatty Liver Disease: A Study in
Obese and Non-Obese Populations
Version: 6 Date: 12 Dec 2024
Reviewer's report:
- Please include the main obtained results with MASLD in the abstract.
- Keywords: please check "fator".
- Introduction: The current nomenclature is MASLD, not MAFLD. Please modify the
introduction and include details regarding MASLD.
- Results: Please mention the main MASLD results as the primary findings and NAFLD as
secondary findings.
- Conclusions: The conclusions are not correct as the association between DII and fatty liver
was not found in MASLD patients.
Review for 10.1186/s12876-024-03585-1 (2025)

Title: Dietary Inflammatory Index and Its Association with Fatty Liver Disease: A Study in
Obese and Non-Obese Populations
Version: 6 Date: 15 Dec 2024
Reviewer:  Giuseppe Guido Maria Scarlata
Reviewer's report:
After revision the paper is suitable for publication.
Review for 10.1186/s12876-024-03578-0 (2025)

Title: A retrospective, observational study to examine the effect of early tumor necrosis factor
inhibitor use on rates of surgery for Crohn’s disease in Japan
Version: 2 Date: 26 Jul 2024
Reviewer:  Milan Lukas
Reviewer's report:
I have read this manuscript entitled: „A retrospective, observational study to examine the effect
of early tumor necrosis factor inhibitor use of rates of surgery for Crohn´s disease in Japan“
with great interest. In the literature we have  convincing data, that biological anti-TNF therapy
is associated with lower risk of surgery comparing the standard (conventional) therapy in
patients with Crohn´s  disease. We also have  some data showing  that early therapy which is
introduced in Crohn´s disease patients shortly after diagnosis (less two years) is more effective
than biological therapy  in patients with long-term  duration of Crohn´ s disease (more than five
years period). This manuscript summarize the results of the first study from Japan. Results of
these retrospective analysis  support these evidence. Authors retrospectively compared patients
with Crohn´s disease those have been exposed to  infliximab or adalimumab (86 patients) with
patients wihout exposition to biological therapy.  Results retrospective analysis clearly showed
that  significantly lower proportion of patients on biological therapy required surgery (3/86)
compaing with cohort of patients on conventional therapy (17/38);  the cummulative surgery
free survival time was significantly higher on biological cohort comparing with patients on
conventional therapy; median time to surgery was significantly longer in those patients exposed
to biologicals comparing with non-biological cohort.
Interesting study where two minor drawbaks seems to me:
• Very low number of patients  those underwent surgery (3/86) precluding efficacy comparison
between infliximab (1) and adalimumab (2) and this part should be be removed
• Different median of observational time in those patients exposed and unexposed to biologicals
(4.62 years  vs 8.13 years) have had impact on higher proportion of patients underwent surgery
with longer observational period. This topic should be mentioned in discussion.
Review for 10.1186/s12876-024-03578-0 (2025)

Title: A retrospective, observational study to examine the effect of early tumor necrosis factor
inhibitor use on rates of surgery for Crohn’s disease in Japan
Version: 3 Date: 05 Dec 2024
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 author(s) have written a very nice rebuttal that helped me to
navigate through the comments easily. The point to point reply is in fact one of the better
compared to those that I have been seen lately
ADDITIONAL REQUESTS/SUGGESTIONS:
The authors state that their data are  of value to determine the effect (size sic)  in the clinical
setting. The argument that I would like to make (banking on this argument ) is that there are
prospective registries and/or clinical trials that have collected a wealth of data. The novelty lies in
the safety / efficacy assessment in their setting and perhaps the comparison between adalumimab
and infliximab (see reviewer #1)
The authors rightfully acknowledge the limitations of a retrospective study, and this
methodology comes with real drawbacks as the authors are unable to retrospectively classify the
patients according to the Montreal classification.
The matched analysis is a fine addition to the manuscript and bolsters the case made by the
authors    .
Last but not least , the observational period (with follow up) is long, and this comes with
advantages. I appreciate the fact that the authors have performed a restricted analysis to patients
diagnosed after 2002 and followed at least 5 years. This in essence bolsters their results.
Given the advent of the new small molecules for inflammatory bowel disease it is to be expected
that its  management will expand beyond that of TNF inhibitors. While it is unsure whether that
will impact surgery rates, the current analysis is helpful.
Review for 10.1186/s12876-025-03671-y (2025)

Title: Casual Effect of Ulcerative Colitis on Chronic Heart Failure: Results from a Bidirectional
Mendelian Randomization Study
Version: 0 Date: 21 Nov 2024
Reviewer's report:
I don't think this work can be considered as a 'study' or 'research '. To be precise, it is more like
a big assignment without obvious characteristics or innovation.
1. The "Samle size" in Table 1 may be a typo in "Sample size".
2. The writing needs to be greatly improved.
Review for 10.1186/s12876-025-03671-y (2025)

Title: Casual Effect of Ulcerative Colitis on Chronic Heart Failure: Results from a Bidirectional
Mendelian Randomization Study
Version: 0 Date: 25 Nov 2024
Reviewer's report:
1. Data Selection Criteria and Dataset Description
The manuscript lacks a clear explanation of data selection criteria and a comprehensive dataset
description. Including a preliminary table summarizing the dataset characteristics, such as the
age range, gender ratio, and any other relevant demographic or clinical variables, would enhance
transparency and provide readers with a better understanding of the study population.
2. Results Section
The results section would benefit from additional interpretation.
3. Section 3.4 – Definition of "Solid"
The term "solid" in Section 3.4 needs further clarification. For example, are you referring to a
specific level of data quality, robustness of the statistical association, or another characteristic?
4. Conclusion Section – Defining Significant Causal Association
Like the previous comment, the phrase "significant causal association" in the conclusion requires
a more precise definition. Are you referring to statistical significance (e.g., p-value thresholds),
effect size, or practical significance in a real-world context?
Review for 10.1186/s12876-025-03671-y (2025)

Title: Casual Effect of Ulcerative Colitis on Chronic Heart Failure: Results from a Bidirectional
Mendelian Randomization Study
Version: 1 Date: 29 Dec 2024
Reviewer's report:
The following writing needs further improvement:
1. On the third to last line of page 4, the "." in "2)." should be redundant.
2. It is recommended to use standard mathematical notation for all variable (not IVs) names
and formulas.
3. What is the source of the formula F=((N-K-1)/K) * ((R2)/1-R2) on page 5? If it is customized
by the authors, please explain why it is defined in this way. Otherwise, please list the reference(s).
4. What is the "Figure" in the sentence "These results are shown in Figure" in Section 3.2?
Review for 10.1186/s12876-025-03676-7 (2025)

Title: Predictive value of the FIB-4 index, APRI, ALBI score, and GPR for overall survival in
treatment-naïve metastatic colorectal cancer patients
Version: 3 Date: 06 Dec 2024
Reviewer:  Eleonora Lai
Reviewer's report:
"Predictive value of the FIB-4 index, APRI, ALBI score, and GPR for overall survival in
treatment-naïve metastatic colorectal cancer patients" is a well written manuscript assessing the
role of some easy-to-assess parameters in predicting survival in untreated metastatic colorectal
cancer patients. The authors provided a consistent background and clearly explained their
methods. Results are well presented and critically discussed in the appropriate section. The study
has its limitations, especially the retrospective nature. Moreover, a specific research might be
performed in the subgroup of liver-only disease patients. However, it has a good point as a
starting idea for further prospective studies to validate the prognostic value of the parameters
assessed
Review for 10.1186/s12876-025-03676-7 (2025)

Title: Predictive value of the FIB-4 index, APRI, ALBI score, and GPR for overall survival in
treatment-naïve metastatic colorectal cancer patients
Version: 3 Date: 04 Jan 2025
Reviewer:  Masahiro Hatori
Reviewer's report:
The main objective of this study was to reveal that determining whether the FIB-4 index, ALBI
score, APRI, and GPR were significant as the prognostic factors in colorectal cancer (CRC)
patients with liver metastasis who had not previously received any systemic chemotherapy or
local ablative therapy or who had undergone surgery.
In the clinical practice, physicians need the noninvasive parameter/biomarker when they had
to evaluate simply the prognosis in patients with CRC. The suggested prognostic factors were
simple, and no need to add blood test. I have regarded this manuscript important one because
there was no report which various factors were analyzed all at once in CRC patients.
I would like to make some comments on the study to develop one:
-Major points,
(1) How many cutoffs of parameter did you analyze? It is very important to consider
reproducibility to conduct other study.
(2) Please clarify how alive or dead of patients are divided into two groups and demonstrate the
follow up time to verify alive or dead.
(3) Please clarify whether the multicollinearity of parameters was or not when you conducted
multivariate analysis. If there was the multicollinearity, you could not conduct multivariate
analysis.
(4) Why did not you add the other prognostic independent variable but these parameters? When
you did not add the previous reported prognosis factors (e.g., performance status, LDH, and
BMI), the impact level of these parameters was possibly unclear.
(5) It is very important to examine content of chemotherapy or surgery when you analyzed
overall survival. Please demonstrate the content of chemotherapy and surgery performed from
recruitment and add them as the independent variable.
Review for 10.1186/s12876-025-03676-7 (2025)

Title: Predictive value of the FIB-4 index, APRI, ALBI score, and GPR for overall survival in
treatment-naïve metastatic colorectal cancer patients
Version: 8 Date: 24 Jan 2025
Reviewer:  Masahiro Hatori
Reviewer's report:
I recommend this manuscript can be accepted your journal because authors appropriately answer
to comments from editor and reviewers point by point.
Review for 10.1186/s12876-025-03673-w (2025)

Title: Impact of duration to endoscopy in patients with non-variceal upper gastrointestinal
bleeding: Propensity score matching analysis of real-world data from Thailand
Version: 3 Date: 10 Sep 2024
Reviewer's report:
I have read with great interest the work done by authors for an very pertinent topic However i
have a few comments regarding the study-
Methodology/Definitions-
1.The authors define endoscopy within 24 hours vs after 24 hours. Multiple studies including
Lau et al (NEJM 2020) have not any benefit over urgent (6-24 HOURS) as compared to 24 hours.
Also is the time to endoscopy 24 hours or above or is it the duration of malena/hemetemesis
with which the patients presents with ?Needs more clarity
However delaying endoscopy further does not seem to have any rationale.This seems to be a
major drawback of the study
2.Further the authors in the exclusion criteria mention -unstable medical condition or designated
palliative that precluded definitive intervention.
However in the methods section it is written-"Regarding our center’s protocol, after
hemodynamic stabilization"
The authors need to explain this statement what criteria was used for hemodynamic stability
3.What was time taken for Hemodynamic resuscitation ?Did inadequate resuscitation in the late
group lead to lower rates of hemostatsis?
4.The authors need to carry out analysis including time dependent bleeding rates
5.By delaying endoscopy(>24 hours) it is obvious the patients will require more transfusion so
the comparison may be flawed
Review for 10.1186/s12876-025-03673-w (2025)

Title: Impact of duration to endoscopy in patients with non-variceal upper gastrointestinal
bleeding: Propensity score matching analysis of real-world data from Thailand
Version: 3 Date: 11 Sep 2024
Reviewer's report:
Comments
Chang et al. present a paper regarding the impact of timing of upper gastrointestinal endoscopy
(UGIE) in patients with nonvariceal UGI bleed. It is a propensity score matched analysis of
large number of patients divided into two groups i.e., early (UGIE within 24 hrs of presentation)
vs. late (after 24 hrs). The authors found that after adjusting for potential confounders, early
UGIE was associated with finding high risk stigmata and requirement of hemostatic procedures
and was negatively associated with need for PRBCs transfusion and duration of hospital
stay. However, hard endpoints such as in-hospital mortality, rebleeding, requirement of rescue
surgery or radiological procedures and the admission cost was not different between the two
groups.
Pro - This is a propensity score matched (PSM) study (rightly stating that RCTs would be
unethical considering the varying severity of presentation of this potentially life-threatening
condition). The sample size is also large. Conclusions have been drawned after adjusting for
confounders.
Cons –
Major issue - Smoking is an important cause of ulcer bleed. There is no mention whether it was
equally distributed in the two groups.
Minor issues -
1. Caliper distance for PSM is not mentioned.
2. Page 6 line 188 – In the endoscopic diagnosis and outcome of results section, admission cost
of the late endoscopy group is not in line with what is mentioned in the Table 2.
3. In the conclusion section of the abstract, making a strong statement for early endoscopy as
“recommended” will be too much as I consider the hard endpoints as mentioned by me above
more important. It can be changed to “suggestion” or “supports” as mentioned in the conclusion
at the end of the paper.
Review for 10.1186/s12876-025-03673-w (2025)

Title: Impact of duration to endoscopy in patients with non-variceal upper gastrointestinal
bleeding: Propensity score matching analysis of real-world data from Thailand
Version: 4 Date: 17 Oct 2024
Reviewer's report:
All comments have been answered .The limitations of the study are immense and must
be mentioned very clearly in a seperate section.Point wise all the limitations must be
mentioned .These are important so that further studies are designed to answer  the limitations
for this very important topic
Review for 10.1186/s12876-025-03680-x (2025)

Title: A prospective, quasi-experimental study on the efficacy of a novel double-headed
endoscope cleaning brush for cleaning flexible endoscopes
Version: 0 Date: 12 Sep 2024
Reviewer's report:
This paper is a very meaningful description of how to clean endoscopes using new instruments.
In recent years, the demand for endoscopes has been increasing, and we believe that this method
is groundbreaking amid concerns about the risk of infection spread due to inadequate cleaning.
Therefore, I believe that this paper should be published and disseminated to the world.
Review for 10.1186/s12876-025-03680-x (2025)

Title: A prospective, quasi-experimental study on the efficacy of a novel double-headed
endoscope cleaning brush for cleaning flexible endoscopes
Version: 0 Date: 13 Nov 2024
Reviewer:  Panagiotis Tsibouris
Reviewer's report:
Abstract Number of cases belongs in the result section Numerical and p-values should be given
in the results section Linguistic modifications are mandatory Methods Patients demographics
might be better to be recorded and included in inclusion-exclusion criteria It should be mentioned
that apart from using different brushes the rest of disinfection procedure was the same for both
groups Was staff responsible for endoscopes disinfection   interchangeable between the two
groups of endoscopes The way of quantification of ATP fluorescence should be defined Does
the indication of endoscopy affect the outcome?   Pictures of brushes and fluorescence results
could be included
Review for 10.1186/s12876-025-03680-x (2025)

Title: A prospective, quasi-experimental study on the efficacy of a novel double-headed
endoscope cleaning brush for cleaning flexible endoscopes
Version: 2 Date: 29 Jan 2025
Reviewer's report:
This paper compares the cleaning method of the gastrointestinal endoscope with the
conventional method and the method of double-headed endoscope cleaning brush. I believe that
this content deserves to be published in order to contribute to the prevention of endoscopic-
related infections.
Review for 10.1186/s12876-025-03695-4 (2025)

Title: Unveiling the Superior Diagnostic Efficacy of Double-Balloon Endoscopy Compared to
Small Intestine Dual-Energy CT Enterography in Small Bowel Crohn's Disease
Version: 2 Date: 11 Jan 2025
Reviewer's report:
Your revisions address reviewers concerns comprehensively, suggesting that the paper should
be accepted.
Review for 10.1186/s12876-025-03595-7 (2025)

Title: Understanding the Adult and Adolescent Patient Experience with Cyclic Vomiting
Syndrome: A Concept Elicitation Study
Version: 1 Date: 04 Aug 2024
Reviewer's report:
I have reviewed the manuscript " Understanding the Adult and Adolescent Patient Experience
with Cyclic Vomiting Syndrome: A Concept Elicitation Study" submitted for publication in
BMC Gastroenterology.
The study reports on the experiences of patients (adults and adolescents) with CVS, identify
CVS symptoms and impacts on adults, adolescents, and caregivers.
Question to the authors: why was exclusion criterion CVS prodrome phase of > 4 h duration
before CVS emetic events?
They also refer to tables 3 and 4 in the text, which are not in the supplementary.
In conclusion, this is an interesting report, which records symptoms and socioeconomic
characteristics of patients with CVS.
Review for 10.1186/s12876-025-03595-7 (2025)

Title: Understanding the Adult and Adolescent Patient Experience with Cyclic Vomiting
Syndrome: A Concept Elicitation Study
Version: 2 Date: 09 Sep 2024
Reviewer's report:
The authors' report of anxiety being a prevalent comorbidity in pediatric CVS is supported by
references 33,34 as cited. However, neither of these papers provides evidence of the association
between anxiety and difficulty paying attention in class and keeping up with schoolwork and
therefore this example provided should be deleted.  (See text below)
"Anxiety is a prevalent comorbidity among the CVS population, including school-aged children,
and studies have identified anxiety symptoms as a predictor of higher impact of the child’s
illness on themselves and their families, e.g., inability to pay attention in class or keep up with
schoolwork (33, 34). "
Review for 10.1186/s12876-025-03595-7 (2025)

Title: Understanding the Adult and Adolescent Patient Experience with Cyclic Vomiting
Syndrome: A Concept Elicitation Study
Version: 2 Date: 04 Oct 2024
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
The responses have been found to be satisfactory, and it is determined that the manuscript can
be published in its current form.
Review for 10.1186/s12876-025-03595-7 (2025)

Title: Understanding the Adult and Adolescent Patient Experience with Cyclic Vomiting
Syndrome: A Concept Elicitation Study
Version: 3 Date: 11 Oct 2024
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
The manuscript can be accepted in its current form
Review for 10.1186/s12876-025-03595-7 (2025)

Title: Understanding the Adult and Adolescent Patient Experience with Cyclic Vomiting
Syndrome: A Concept Elicitation Study
Version: 3 Date: 14 Oct 2024
Reviewer:  Panagiotis Tsibouris
Reviewer's report:
Abstract Which was the time distance between episode of CVS and completion of the
questionnaire ? Authors should reported mean duration of each phase Did adolescence receive
any antiemetics? Conditions could be preferably used for anxiety, missing school and suffering
Methods Cannabis would be better to be excluded at all  Vomiting related to drugs should be
excluded when there is a time proximity to emetogenic medication Other causes of vomiting
Objective criteria should be reported in sample size calculation Patient demographics and
clinical characteristics should be described Were all patients consecutive? What happened
with non-English speaking subjects? In what way stressful events and anxiety/depression were
measured? Did authors use a particular scale? Impact in life would be better measured using
a quality of life scale Statistical methods should be described as well as size of the study
calculation Results Because only one adolescent was evaluated back to back it would be
preferable to be excluded Could smoking and alcohol consumption habit data be provided? Did
patients report hyperosmia ( increased irritability in smells) before the episodes?Have authors
divided day to define a part when particularly events happened or do they suggest that episodes
happened around the same time-point each time Do they imply that light might have some
correlation? Perhaps because the size of the document is quite large this part could be omitted
Possibly anxiety and depression should be better categorized as precipitating factors rather than
prodromal symptoms Does lightheadedness mean hyperpnea?
Review for 10.1186/s12876-025-03595-7 (2025)

Title: Understanding the Adult and Adolescent Patient Experience with Cyclic Vomiting
Syndrome: A Concept Elicitation Study
Version: 4 Date: 29 Oct 2024
Reviewer:  Panagiotis Tsibouris
Reviewer's report:
Authors should define in which way use of cannabinoids was defined Statistical methods used
should be provided Results Study population is too small to request any additional analysis eg
according to race
Review for 10.1186/s12876-025-03595-7 (2025)

Title: Understanding the Adult and Adolescent Patient Experience with Cyclic Vomiting
Syndrome: A Concept Elicitation Study
Version: 5 Date: 21 Nov 2024
Reviewer:  Panagiotis Tsibouris
Reviewer's report:
Power of the study would be better estimated in a more rigorous way rather than authors
experience Methods  In which way cannabinoid hyperemesis syndrome since cannabinoids were
allowed at least twice weekly? Because questionnaires were in English non English speeking
population was excluded and that should be report in exclusion criteria In what way have
questionnaires been validated? Were they standard validated one or had they been constructed
by authors? In the latter case they should be validated before the study
Review for 10.1186/s12876-025-03595-7 (2025)

Title: Understanding the Adult and Adolescent Patient Experience with Cyclic Vomiting
Syndrome: A Concept Elicitation Study
Version: 6 Date: 07 Dec 2024
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
changes are done, accepted for publication
Review for 10.1186/s12876-025-03595-7 (2025)

Title: Understanding the Adult and Adolescent Patient Experience with Cyclic Vomiting
Syndrome: A Concept Elicitation Study
Version: 6 Date: 24 Dec 2024
Reviewer:  Mohamed H. Zidan
Reviewer's report:
Dear Authors,
Re: "Understanding the Adult and Adolescent Patient Experience with Cyclic Vomiting
Syndrome: A Concept Elicitation Study"
Thank you for the opportunity to review this insightful and well-executed manuscript.
I find the manuscript satisfactory in its current form and recommend it for acceptance
Best Regards,
Review for 10.1186/s12876-025-03674-9 (2025)

Title: Relationship between Sarcopenia and Minimal Hepatic Encephalopathy in Patients with
Cirrhosis: A Prospective Observational Study
Version: 0 Date: 16 Dec 2024
Reviewer's report:
Comments to Authors:
1.There are numerous studies on the role of sarcopenia in predicting minimal hepatic
encephalopathy in cirrhotic patients, scientific novelty of this study is limited in my view.
2.Please mention ethical committee registration number
3.The authors have assessed muscle mass by using bioelectrical impedance analysis, more
objective and quantitative assessment of muscle mass by CT could have been done in these
patients.
4.Authors have not assessed the serum ammonia and Serum BCAA levels which might be
confounding factor for minimal hepatic encephalopathy.
5.Authors have excluded ascites in their study population,then why 6.7 % patients were taking
diuretics,please clarify.
6. Although majority of patients were CTP A, the prevalence of minimal hepatic encephalopathy
is substantially low as compared to previous studies, few studies had recorded the prevalence
of MHE in more than 50% of their study population.
7.Authors had not incuded CTP score and MELD score in logistic regression analysis for
predicting minimal hepatic encephalopathy. Numerous studies have shown CTP score was a
significant independent predictor of MHE.
8.There are lots of typographical errors,which needs to be corrected.
Review for 10.1186/s12876-025-03674-9 (2025)

Title: Relationship between Sarcopenia and Minimal Hepatic Encephalopathy in Patients with
Cirrhosis: A Prospective Observational Study
Version: 0 Date: 02 Jan 2025
Reviewer's report:
The current study is an interesting study, and authors explore the association between sarcopenia
and MHE. There are several questions that should be resolved.
1. There were many studies conducted in this questions, authors should indicate the novelty of
the current study.
2. For a prospective study, Did the current study registered on a public website? If so, please
provide the registration number.
3. A Flow Chart of patients’ selection should be provided.
4. Authors excluded the history of decompensation events (e.g., OHE, variceal bleeding,
spontaneous bacterial peritonitis) within the past 3 months, but in table 1, there showed that
approximately 30% of patients had a history of OHE or variceal bleeding. The date frame of
these decompensated events should be provided.
5. For the medications use data, the use of human albumin infusion should be provided, because
of previous evidence showed that it is a potential disease modify agents in patients with liver
cirrhosis and also had a potential benefit for HE.
Review for 10.1186/s12876-025-03662-z (2025)

Title: Relationship Between Gastric Mucosal Atrophy, Cystic Dilatation, and Histopathological
Characteristics
Version: 0 Date: 01 Oct 2024
Reviewer's report:
In this study, the authors investigated the relationship between cystic dilatation of the
gastric mucosa and mucosal atrophy in a good number of endoscopic biopsy samples by
histopathological and immunohistochemical evaluation.
They suggested that this condition originates from gastric mucosal atrophy which may progress
into either simple cystic dilatation or into compound cystic dilatation, both of them having
distinct histological features and risk of carcinogenesis.
Overall the manuscript is well structured and written. The results are clearly presented and the
discussion is comprehensive.
Considering the effect of H. pylori infection on atrophic gastritis and gastric cancer development,
I would like to see the incidence of H. pylori in this sample of specimens and its association
with the findings of the study. However, I understand that this was not included in the planning
of the study.
Some minor points: It would be useful for the readers to give the magnifications used in Figs
2-4. Similarly, the use of arrows to delineate the points of interest in these figures would add
clarity for readers not familiar with histopathology and immunestaining images.
Review for 10.1186/s12876-025-03662-z (2025)

Title: Relationship Between Gastric Mucosal Atrophy, Cystic Dilatation, and Histopathological
Characteristics
Version: 0 Date: 03 Oct 2024
Reviewer:  Panagiotis Tsibouris
Reviewer's report:
Abstract constraction refers to a review article Nevetheless it is an original paper based on
ESD findings Methods should provide details on characteristics of the study population, ESD
performed and biopsy preparation and analysis  Results should provide the findings Numerical
values belong there and not in methods section Methods Gastric biopsies and ESD samples
does not consist a homogeneous sample  Demographic and clinical charasteristics of the
study population should be presented as well as any structural constracted questionnaire used
Approval of the study from a relevant Scientific board and compliance to Helsinki regulations
is mandatory More details should be provided for histological findings stratification Statistical
analysis methods used should be described as well as study power calculation Logistic regression
analysis evaluating the influence of patients characteristics would be useful Results section 2 of
results should be focused in patients findings Discussion belongs to the relevant section  Section
3 Some part of it belongs to methods and some part to the discussion the same is valid for section
4 Authors should provide their findings
Review for 10.1186/s12876-025-03662-z (2025)

Title: Relationship Between Gastric Mucosal Atrophy, Cystic Dilatation, and Histopathological
Characteristics
Version: 1 Date: 07 Nov 2024
Reviewer:  Panagiotis Tsibouris
Reviewer's report:
Abstract Numerical values belong results section Results  should provide numerical values of
each finding as well as percentages Moreover description of the study population should be
given before the histolic findings Outcome of patients in the study population should be descibed
The study is not a review Thus general comments belong in the discussion and/or introduction
Methods Description of the study population belongs in the results section Biopsy protocol  for
patients with cystic dilatation should be presented Description of typical findings of typical
and compound cystic dilatation if it is not a new finding belongs there and not in the results
Results p-values should be given for the comparisons Only statistical significant differences
should be introduced in the text Were any more data (like smoking habits, alcohol consumption
or comorbidities) available? Number and percentages of histological findings should be provided
Review for 10.1186/s12876-025-03662-z (2025)

Title: Relationship Between Gastric Mucosal Atrophy, Cystic Dilatation, and Histopathological
Characteristics
Version: 1 Date: 21 Nov 2024
Reviewer's report:
The authors responded sufficiently to the comments raised by the reviewers and the manuscript
has largely improved.
Some minor comments
Figure 2. It is not clear what are the values in thw y-axis. Do they represent number of cases
or percentages of the cases studied? Please clarify. Similarly add an explanatory comment in
the figure legend.
Figure 3-5. In the figure legends describing the important findings please add “arrow”