JerMa88/BMC_Gastroenterology_Peer_Reviews huggingface dataset:
Review for 10.1186/s12876-025-03838-7 (2025)

Title: Three-to-Six Month Post-POEM Timed Barium Esophagram Can Predict Esophageal
Contents and May Stratify Aspiration Risk on Follow-up EGD
Version: 2 Date: 03 Mar 2025
Reviewer:  Ippei Tanaka
Reviewer's report:
This study aims to determine if timed barium esophagram findings after POEM can predict
esophageal contents at the time of follow-up endoscopy. However, there are several concerns
that the authors should address.
Major Concerns
1, Among the 48 patients, 5 (10.4%) had solid content remaining. However, how much solid
content was present? At the authors' institution, patients are instructed to fast from solid foods for
two days before the procedure, which is generally considered a sufficient fasting period. Under
such conditions, one would typically expect the esophagus to contain no solid or liquid content.
If the fasting protocol at the authors' institution ensures this, would endotracheal intubation even
be necessary in the first place?
If such a pre-procedural protocol is difficult to implement at other institutions, wouldn't it
be more appropriate to conduct this study under the same pre-procedural conditions as those
commonly used at other hospitals? For example, if patients were instructed to fast only on the
day of the procedure, the study could examine whether endotracheal intubation was actually
necessary in those cases.
2, This study aims to reduce the need for endotracheal intubation and concludes that if the 5-
minute barium column height is 7 cm or more, endotracheal intubation should be performed
during EGD.
How many patients had a 5-minute barium column height of 7 cm after POEM? Additionally, if
aspiration did not occur even in the group that did not undergo endotracheal intubation, wouldn't
that suggest that intubation is unnecessary in the first place?
3, In order to elaborate this study, how about grading the amount of remaining solid content?
For example:
Grade 1: Small amount
Grade 2: Moderate amount
Grade 3: Large amount, with a significantly high aspiration risk during endoscopy
Minor Concerns
1, Was there any correlation between barium column height at 3-6 months follow-up esophagram
and post-POEM symptoms?
2, Please describe in the Methods section how the passage of the 13 mm barium tablet was
evaluated in post-POEM esophagram, as well as how cases where the tablet did not pass were
managed.
3, The study states that the median column height at 5 minutes was 0 in post-POEM esophagram.
Please provide additional details on how many patients had specific barium column heights. For
example, how many patients had:
1 cm: X patients
2 cm: Y patients
etc.
Review for 10.1186/s12876-025-03838-7 (2025)

Title: Three-to-Six Month Post-POEM Timed Barium Esophagram Can Predict Esophageal
Contents and May Stratify Aspiration Risk on Follow-up EGD
Version: 2 Date: 04 Mar 2025
Reviewer's report:
I thank the editors for the opportunity to review this interesting article.  In it the authors assessed
the utility of TBE in post-POEM patients to predict the presence of residual food/liquid in the
esophagus on EGD.  I have some comments.
Major points:
1. The authors write that intubation is "typically" (lines 82, 112) or "frequently" (lines 84, 120)
performed for EGDs in patients with achalasia.  What is the evidence for this?  Are there any
studies showing this?  This may be the practice at the authors' institution, but I've never seen
this to be standard of care.  Please support this assertion.  And add it to the limitations that this
may not be applicable in all locales.
2. This study assesses the improvement in TBE findings after achalasia treatment.  This is a
subject that has been extensively written about (and is not novel here), but does not appear to be
cited or discussed in this paper.  Line 123 states that "The timed barium esophagram is useful
in evaluating POEM response." without citing a source, and none of the studies showing how
TBE is useful are discussed.     This should be discussed.
3.  "Esophagram" and "TBE" are not the same.   TBE is a specific type of esophgram so I would
change all uses of the term to timed barium esophagram or TBE, including in the title.
4.  For the conclusion, I think it should be changed to something more on the lines of: This study
adds to our knowledge that TBE findings are a good predictor of esophageal emptying post-
POEM. This may be used to predict which patients may be at risk of having residual esophageal
contents and therefore need intubation.
Smaller points:
1. I would not call POEM "non-invasive" (line 111).  Perhaps change to "minimally invasive"
or "non-surgical"
2.  Some definitions of terms/outcomes are not given.  How was residual food or liquid in the
esophagus on EGD defined?  How much was needed?  If suction was performed?  Was this
defined a priori or retrospectively taken from EGD reports?
3. Line 165 mentions that Eckardt scores significantly improved.  Please provide a p-value.  The
statistical test used should be mentioned in the Methods.
4. Line 166: passed tablets and transiently delayed tablets were combined.  Was this a priori?
How was "transiently" passed defined?
5. Line 170. Some patients were intubated and others were not.  Why?  What factors went into
this decision?
6. Table.  Many rows start with "median Q1 Q3" and then list the variable.  It would be much
easier to read if the variable was always first, then median Q1 Q3.  For example would change
it to: Age at POEM, median, Q1 Q3.  BMI, median, Q1 Q3.
Review for 10.1186/s12876-025-03838-7 (2025)

Title: Three-to-Six Month Post-POEM Timed Barium Esophagram Can Predict Esophageal
Contents and May Stratify Aspiration Risk on Follow-up EGD
Version: 2 Date: 09 Mar 2025
Reviewer's report:
1. First, as a method, no details of the protocol for barium esophagography are given. It is unclear
if all contrast agents were administered to the same standard. Please clarify how many milliliters
of barium were administered, what the imaging interval was, and after how many minutes the
examination was completed.
The authors also mention tablet passage, but I could not find this statement in the methods section
either. Please clarify this as well.
2. I think it would be recommended to perform multivariate as well as univariate analysis.
Results considering other confounding factors (e.g., patient age, gender, type of achalasia, etc.)
would also be helpful.
3. I think that changes in IRP values should also be shown, since the authors use HRM to identify
the type of achalasia.
4. The authors mentioned that 23 (47.9%) post-POEM EGD were performed under tracheal
intubation, but considering the present results, how many patients did not require tracheal
intubation?
5. You should describe the methods and software used in the statistics.
Review for 10.1186/s12876-025-03878-z (2025)

Title: Comprehensive analysis of glycometabolism-related genes reveals PLOD2 as a
prognostic biomarker and therapeutic target in gastric cancer
Version: 1 Date: 14 Feb 2025
Reviewer:  Jing-Ping Yuan
Reviewer's report:
The manuscript presents a comprehensive bioinformatics analysis of glycometabolism-related
genes in gastric cancer (GC), identifying PLOD2 as a key prognostic biomarker and therapeutic
target. The study integrates transcriptomic data from multiple databases, functional assays, and
pathway enrichment analyses to elucidate the role of PLOD2 in tumor progression, immune
evasion, and therapeutic resistance. The findings are robust and well-supported by the data.
However, there are a few areas where minor improvements could be made to enhance the clarity
and impact of the manuscript. Therefore, I recommend minor revisions.
1.Expand the discussion to include a critical analysis of the limitations and potential biases in the
study. Discuss potential future directions, including the validation of PLOD2 as a therapeutic
target in clinical trials.
2.Include a more detailed discussion of the potential clinical applications of targeting PLOD2,
particularly in combination with other therapies such as immune checkpoint inhibitors.
3.Update the literature review to include more recent studies on glycometabolism and PLOD2
in GC and other cancers.
4.Simplify some of the figure panels and provide more detailed legends to enhance clarity.
5.Edit the manuscript for conciseness and correct any grammatical errors.
6.Provide a more detailed explanation of the statistical methods used in the bioinformatics
analysis, particularly the machine learning algorithms.
7.Update the literature review to include more recent studies on glycometabolism and PLOD2
in cancer biology.
Review for 10.1186/s12876-025-03878-z (2025)

Title: Comprehensive analysis of glycometabolism-related genes reveals PLOD2 as a
prognostic biomarker and therapeutic target in gastric cancer
Version: 2 Date: 24 Mar 2025
Reviewer:  Jing-Ping Yuan
Reviewer's report:
The authors have satisfactorily addressed all the previously raised concerns. The manuscript
is now in a much improved state. However, there is still room for polishing the language and
careful proofreading. Once these minor revisions are completed, I recommend accepting the
manuscript for publication.
Review for 10.1186/s12876-025-03878-z (2025)

Title: Comprehensive analysis of glycometabolism-related genes reveals PLOD2 as a
prognostic biomarker and therapeutic target in gastric cancer
Version: 2 Date: 03 Apr 2025
Reviewer:  Shuguang Zhou
Reviewer's report:
The author has made meticulous revisions, and at the same time has done a good job of
addressing the issues I raised, which I think meet the requirements for publication
Review for 10.1186/s12876-025-03870-7 (2025)

Title: Correlation between hs-CRP-Triglyceride Glucose Index and NAFLD and Liver Fibrosis
Version: 2 Date: 03 Apr 2025
Reviewer's report:
Dear Authors,
Thank you for thoroughly addressing the editor and reviewers’ comments in your revised
manuscript. The changes and clarifications you’ve incorporated have significantly strengthened
your work. I’m pleased to confirm that I have no further suggestions or revisions to request at
this time.
Reviewer
Review for 10.1186/s12876-025-03853-8 (2025)

Title: Analysis of the distribution characteristics of pathogenic bacteria in the wound tissue of
patients with perianal abscess combined with infection and the influencing factors of wound
healing
Version: 2 Date: 16 Dec 2024
Reviewer:  Reza Ghotaslou
Reviewer's report:
1. "200 patients with perianal abscess combined with infection admitted to our hosp" The number
should be converted into letters, for example, two hundred.
2. The English language has many problems and it is better to be corrected by an expert.
3. gram-negative is not correct.
4. Escherichia coli and Klebsiella pneumoniae must be italicized.
5. The conclusion is not informative.
6. Have all the patients been operated on by one surgeon? If the answer to this question is NO,
the study conditions differ, and the surgeon's expertise is significant.
7. Obligate anaerobic pathogenic bacteria are very important in abscesses, especially in the anus
area. Laboratory conditions show that such bacteria have not been studied. Please clarify why.
8. Many background diseases play a role in this matter, which have not been taken into account.
9. The contamination during sampling is very important, especially in this area. The measures
taken to prevent contamination are not enough.
10.  Delete Table 1.
11. There are three diagrams in photo number one. Please turn it into a diagram.
12. " tumour" what does mean?
13. Delete Fig. 2
14. The relationship between the pathogen and underlying disease has not been determined.
15.  Have the occupations of the patients been studied?
16.  The conditions for entering the study were not the same for everyone, and the conditions of
withdrawal from the study were not written. Inclusion and exclusion criteria.
Review for 10.1186/s12876-025-03853-8 (2025)

Title: Analysis of the distribution characteristics of pathogenic bacteria in the wound tissue of
patients with perianal abscess combined with infection and the influencing factors of wound
healing
Version: 2 Date: 18 Dec 2024
Reviewer's report:
Enhance Objective Clarity: Revise the objective to include the significance of this research in
clinical contexts.
Define Healing Criteria: Clearly define what constitutes "good" and "poor" healing in the
methods section.
Detail Statistical Analyses: Include specific statistical tests used in both univariate and
multifactorial analyses.
Clarify Results Presentation: Rephrase results to avoid ambiguity regarding the detection of
bacterial strains.
Organize Results Effectively: Consider using tables or bullet points to present key findings
clearly.
Strengthen Conclusion: Revise the conclusion to highlight practical implications and future
research directions based on study outcomes.
Review for 10.1186/s12876-025-03853-8 (2025)

Title: Analysis of the distribution characteristics of pathogenic bacteria in the wound tissue of
patients with perianal abscess combined with infection and the influencing factors of wound
healing
Version: 2 Date: 18 Dec 2024
Reviewer:  Ramazan Gozukucuk
Reviewer's report:
First of all, it is a very nice work and very well written, I was very impressed, congratulations.
I have some small suggestions;
My suggestions;
1-In the general information section, line 5 reads "# The number of incisions is 3 or more; #
Complete clinical data." These sentences are repeated.
2-In Table 1, the first letter of Pseudomonas aeruginosa should be capitalized, i.e. Pseudomonas
aeruginosa, and the microorganism names should be written in italics.
3-Again, microorganism names should be written in italics throughout the text.
Review for 10.1186/s12876-025-03853-8 (2025)

Title: Analysis of the distribution characteristics of pathogenic bacteria in the wound tissue of
patients with perianal abscess combined with infection and the influencing factors of wound
healing
Version: 2 Date: 28 Dec 2024
Reviewer:  Yalda Malekzadegan
Reviewer's report:
In this manuscript the authors present data on the analysis of the distribution characteristics of
pathogenic bacteria in the wound tissue of patients with perianal abscess combined with infection
and the influencing factors of wound healing. However, there are several scientific writing,
methodological, analysis and interpretation problems with the study which must be corrected,
(see specific points below).
1. Some sentence is very long. It is better to write them shorter.
2. In introduction, explain more about the types of microbes isolated from perianal abscess
combined with infection.
3. The type of study not mentioned.
4. For bacterial detection, the author must provide references or explain the method.
5. How were the samples protected from contamination during transport?
6. Please keep correct scientific writing for bacterial and fungal name in entire manuscript, e.g.
Klebsiella pneumonia must be corrected as Klebsiella pneumoniae; gram-negative bacilli must
be corrected as Gram-negative bacilli and so on…
7. The title mentions isolated bacteria, but the table also lists the names of isolated fungi. If
fungus is also considered, the title should be changed to microbe and title of table 1 and figue1
must be changed.
8. Please enter references correct with endnote format.
Review for 10.1186/s12876-025-03853-8 (2025)

Title: Analysis of the distribution characteristics of pathogenic bacteria in the wound tissue of
patients with perianal abscess combined with infection and the influencing factors of wound
healing
Version: 2 Date: 30 Dec 2024
Reviewer's report:
The responses to the referees' questions were satisfactory and convincing, and the required
corrections have been made to the text.
Review for 10.1186/s12876-025-03853-8 (2025)

Title: Analysis of the distribution characteristics of pathogenic bacteria in the wound tissue of
patients with perianal abscess combined with infection and the influencing factors of wound
healing
Version: 2 Date: 30 Dec 2024
Reviewer's report:
Based on the provided documents, the authors appear to have addressed the reviewers' comments
thoroughly and professionally.
The authors have added the required "Declarations" section with all necessary subsections, such
as Ethics approval, Consent to participate, data availability, Competing interests, and Funding.
They provided detailed information about the Ethics Committee that approved the study.
The statement regarding informed consent was clarified and included in the "Ethics approval
and consent to participate" section.
Discrepancies in the data availability statement between the manuscript and the submission
system were resolved.
Scientific Revisions:
They revised the conclusions and explicitly addressed the study’s limitations, such as the small
sample size, geographical and demographic influences, and evolving antibiotic resistance.
Review for 10.1186/s12876-025-03853-8 (2025)

Title: Analysis of the distribution characteristics of pathogenic bacteria in the wound tissue of
patients with perianal abscess combined with infection and the influencing factors of wound
healing
Version: 3 Date: 15 Jan 2025
Reviewer:  Reza Ghotaslou
Reviewer's report:
All the problems and defects of the article have been corrected.
Review for 10.1186/s12876-025-03853-8 (2025)

Title: Analysis of the distribution characteristics of pathogenic bacteria in the wound tissue of
patients with perianal abscess combined with infection and the influencing factors of wound
healing
Version: 3 Date: 15 Jan 2025
Reviewer:  Yalda Malekzadegan
Reviewer's report:
Dera author
I hope you are well.
Thank you for responding to the comments.
Best Wishes.
Review for 10.1186/s12876-025-03853-8 (2025)

Title: Analysis of the distribution characteristics of pathogenic bacteria in the wound tissue of
patients with perianal abscess combined with infection and the influencing factors of wound
healing
Version: 3 Date: 20 Jan 2025
Reviewer:  Payam Behzadi
Reviewer's report:
Dear Author
Unfortunately, there are many cases which have not been revised.
1. The application of the terms should be unified: e.g., Gram-negative or
gram-negative not Gram-negative and gram-negative. There are several terms that
have been used the same throughout the manuscript. Please do revise all of them.
2. In abstract section: The authors have claimed "The results of multifactorial logistic
regression analysis showed that body mass index, diabetes mellitus, concurrent infections and
stool traits were independent risk factors influencing the poor quality of
wound healing (P < 0.05)." What does P < 0.05 mean?
Dear author, please do add in brief to the abstract.
3.  The keywords should be revised according to the MeSH terms. Please do revise
them.
4. The Methodology section still suffers from the lack of effective references. Please do  add
the related references for the used protocols.
5. Table 1 can be very effective if the current data presented by other items like
gender and the age range of the patients.
6.  Figure 1 can be very effective if the current data presented by other items like
gender and the age range of the patients. Please do read the following paper which can
be very useful reference for the current manuscript:
Distribution of chaperone-usher fimbriae and curli fimbriae among uropathogenic
Escherichia coli. BMC Microbiol. 2024 Sep 14;24(1):344. doi:
10.1186/s12866-024-03472-5. PMID: 39271999; PMCID: PMC11401301.
7. Please do interpret the results of the statistical analyses in Discussion section, in
details.
8. Discussion section has not been deeply revised.
9. Please do highlight the revised sections with yellow color.
Review for 10.1186/s12876-025-03853-8 (2025)

Title: Analysis of the distribution characteristics of pathogenic bacteria in the wound tissue of
patients with perianal abscess combined with infection and the influencing factors of wound
healing
Version: 3 Date: 26 Jan 2025
Reviewer's report:
In introduction:
Some points are repeated, such as the mention of bacterial infections and specific pathogens like
E. coli and K. pneumoniae. These could be consolidated to avoid redundancy
while the study's purpose is mentioned, the specific gap in the current literature that this study
aims to fill is not clear.
There are minor typographical and grammatical errors, such as inconsistent use of spaces
before and after parentheses (e.g., Escherichia coli(E. coli) and Klebsiella pneumoniae(K.
pneumoniae)).
Method:
Factors like smoking, alcohol use, and personal hygiene are not included in the data collection
but could significantly affect infection rates and wound healing. These lifestyle factors could be
important to identify as risk factors. If there are this data, please consider it.
Discussion:
the mechanisms through which diabetes impacts wound healing are well-detailed, please
describe the causal relationship between diabetes and wound healing in perianal abscesses could
be more clearly established.
In conclusion: Given the prevalence of Gram-negative bacteria and the potential for
antimicrobial resistance (especially in the context of E. coli and K. pneumoniae), it would be
important to mention the implications of antibiotic resistance.
Review for 10.1186/s12876-025-03853-8 (2025)

Title: Analysis of the distribution characteristics of pathogenic bacteria in the wound tissue of
patients with perianal abscess combined with infection and the influencing factors of wound
healing
Version: 5 Date: 24 Mar 2025
Reviewer:  Payam Behzadi
Reviewer's report:
Dear Author
Thank you for your partly revision. Please do revise the following items, too:
1.  The keywords should be revised according to the MeSH terms. Please do revise
them.
2. In Methodology section: The related references should be added to the main text not to the
subtitles. Please do revise it.
3.  Figure 1 can be very effective if the current data presented by other items like
gender and the age range of the patients.
4. Please do revise the Discussion section in accordance with comment #3.
5. Please do highlight the revised sections with yellow color.
Review for 10.1186/s12876-025-03853-8 (2025)

Title: Analysis of the distribution characteristics of pathogenic bacteria in the wound tissue of
patients with perianal abscess combined with infection and the influencing factors of wound
healing
Version: 6 Date: 03 Apr 2025
Reviewer:  Payam Behzadi
Reviewer's report:
Dear Author
Thank you for your effective revision.
Review for 10.1186/s12876-025-03811-4 (2025)

Title: "Evaluation of Hepatobiliary Disorders Using Magnetic Resonance
Cholangiopancreatography in a Low-Resource Setting in Kano,Nigeria: A Retrospective Study"
Version: 2 Date: 11 Jan 2025
Reviewer's report:
The paper is well written with minor changes
1. please review 'The confidentiality and anonymity of patients will be observed strictly. All
detected abnormalities on the MRCP exam were adequately communicated promptly to the
requesting physician for appropriate treatment/intervention'.
2. Some of the images are degraded. If High resolution images are available, they should be
added.
3. Discussion - Paragraph 2, patients instead of 'patents'
4. This statement is disjointed 'This study highlights how MRCP's strengths—such as its
nonreliance on ionizing radiation and its capacity for detailed ductal imaging—are particularly
impactful in regions like Kano, where healthcare infrastructure may face constraints.'
5. The methodology states retrospective study, how did you manage to get patients to sign the
consent form at the time of the MRCP?
Review for 10.1186/s12876-025-03811-4 (2025)

Title: "Evaluation of Hepatobiliary Disorders Using Magnetic Resonance
Cholangiopancreatography in a Low-Resource Setting in Kano,Nigeria: A Retrospective Study"
Version: 2 Date: 24 Jan 2025
Reviewer's report:
• Please define abbreviations upon their first use (e.g., MPD, AKTH) in the abstract.
• The diagnostic value of MRCP in hepatobiliary pathology is well-established in existing
literature. What additional insights does this study provide?
• Kindly remove the subheadings in the Materials and Methods section.
• Please include the exclusion criteria for the study.
• Who was responsible for analyzing the images for the presence of pancreatic mass,
cholangiocarcinoma, and hepatic mass? What was the interobserver agreement?
• What potential biases were present in the study, and how were they addressed?
• In the Results section, the same information is presented both in text and table format. Please
revise to avoid repetition.
• Reduce the number of images; only include a few representative ones.
• Please make the Results section more concise, focusing on the most relevant information.
• Please revise the Conclusion to be more concise, summarizing only the key findings of the
manuscript. Avoid restating the results.
Review for 10.1186/s12876-025-03811-4 (2025)

Title: "Evaluation of Hepatobiliary Disorders Using Magnetic Resonance
Cholangiopancreatography in a Low-Resource Setting in Kano,Nigeria: A Retrospective Study"
Version: 2 Date: 27 Jan 2025
Reviewer's report:
The manuscript contains good findings, however, it is poorly written and badly presented.
Here are the comments to improve the manuscript:
1-To  prove the role of MRCP, you should compare the findings of MRCP with another modality
such as ERCP or postoperative findings. The most accurate suggested title is "  Descriptive
study of hepatobiliary disorders using magnetic resonance cholangiopancreatography in kano
in Nigeria: A retrospective study" to describe the findings of MRCP in Kano in Nigeria.
2-Abstract, MRCP is not a managing tool, 2-It is better to add the period of study.
3-Results, unsuitable analytic tests and incorrect correlations were done such as:
-In age, It is better to divide participants into 4 groups to assure more than 10 participants in each
group such as: 1-less than 20 years, 2-from 21 to 40, 3-from 41 to 60, and 4-More than 60 years.
-The comparison and correlations in CBD and pancreatic diameters between the participants is
not correct because these are pathologic cases with diversity in diameters due to pathologies.
4-Discussion, should be concentrated on the hepatobiliary disorders instead of the role of MRCP.
5- Figures should be preserved in their normal width and height.
6-Language editing is necessary to improve writing.
Best regards
Review for 10.1186/s12876-025-03811-4 (2025)

Title: "Evaluation of Hepatobiliary Disorders Using Magnetic Resonance
Cholangiopancreatography in a Low-Resource Setting in Kano,Nigeria: A Retrospective Study"
Version: 3 Date: 13 Feb 2025
Reviewer:  Alaa Ismail
Reviewer's report:
I am pleased to inform you that the second revised version of the manuscript "Magnetic
Resonance Cholangiopancreatography in the Evaluation of Hepatobiliary Disorders in a Low-
Resource Setting: A Retrospective Study from Kano, Nigeria" has addressed all the concerns
raised in the previous review exceptionally well.
Review for 10.1186/s12876-025-03811-4 (2025)

Title: "Evaluation of Hepatobiliary Disorders Using Magnetic Resonance
Cholangiopancreatography in a Low-Resource Setting in Kano,Nigeria: A Retrospective Study"
Version: 3 Date: 21 Feb 2025
Reviewer's report:
1-The manuscript describes the hepatobiliary disorders so that the title should be " Evaluation
of Hepatobiliary Disorders Using Magnetic Resonance Cholangiopancreatography  in a Low-
Resource Setting in Kano in Nigeria: A Retrospective"
2-SPSS means "Statistical Package for Social Sciences" so that you should correct the name in
your manuscript.
3-It is better to paraphrase the conclusion without numbers either in abstract or at the end.
4-In your introduction, you should extract the gap and explain the purpose and importance of
the study.
5-In Figures, you MUST remove any information related to patient's identity.
6-In table-4, you should add the association in different age groups and compare the results with
other studies to confirm your results.
7-The opening of discussion should be about  hepatobiliary disorders instead of MRCP.
8-Language editing is needed.
Best regards
Review for 10.1186/s12876-025-03811-4 (2025)

Title: "Evaluation of Hepatobiliary Disorders Using Magnetic Resonance
Cholangiopancreatography in a Low-Resource Setting in Kano,Nigeria: A Retrospective Study"
Version: 3 Date: 23 Feb 2025
Reviewer's report:
I would like to commend the authors for revising the manuscript in accordance with the
suggestions, making it significantly more valuable.
Review for 10.1186/s12876-025-03811-4 (2025)

Title: "Evaluation of Hepatobiliary Disorders Using Magnetic Resonance
Cholangiopancreatography in a Low-Resource Setting in Kano,Nigeria: A Retrospective Study"
Version: 5 Date: 12 Mar 2025
Reviewer's report:
The MRCP images should be in their normal dimensions.  Please, do not increase only the width
of the image and destruct the image.
Review for 10.1186/s12876-025-03863-6 (2025)

Title: Comparative Analysis of #-Estradiol and Testosterone on Lipid Droplet Accumulation,
and Regulatory Protein Expression in Palmitate/Oleate-Induced Fatty HepG2 Cells
Version: 0 Date: 19 Feb 2025
Reviewer:  Dolores Njoku
Reviewer's report:
In this  study, the authors compared the effects of sex hormones on lipid droplet (LD)
accumulation in palmitate/ oleate-treated HepG2 cells in vitro. The authors utilized MTT method
to determine effective doses of palmitic and oleic acids in HepG2 cells, followed by a combined
dose for inducing LD formation.  The authors evaluated cells in vitro using light microscopy.
The authors measured the effect of beta estradiol and testosterone on lipid droplet formation.
1. My overall assessment of the paper is that the idea is interesting, but I have methodological
concerns that may have skewed the results.
a.  The LD50 does not seem to produce significant differences in measured endpoints.  This
could be because there are no differences or because the dose may still be too high or even
too low.  Extremes of dosing would help clarify whether or not the findings are a dose-related
effect.  Alternatively, the authors could provide guidance regarding a clinically relevant dose of
the saturated and unsaturated fats that would help guide the interpretation.
b. Clinical relevance regarding the doses of estradiol and testosterone would help to comprehend
the result.  In my opinion, they appear high.  Are these the doses that are routinely utilized in this
type of  in vitro study?  As an example, clinical doses of beta estradiol are 30 - 400 picograms/
ml testosterone levels can vary widely.
c. Visually, the oil Red O staining seems equivocal . Suggest photographs that are more
representative of the data analyses that was demonstrated.
2. In the discussion, the following statement was made:  “Although no studies were found
that show the relationship between sex hormones and PPAR#…”   However, a recent study
demonstrated sex differences in hepatic PPARalpha in a mouse model of MASH. (Front Med
(Lausanne). 2024 Aug 20;11:1425528. PMID: 39228797)
3. Minor comment:  In the introductory paragraph, kindly revise “premenopause” to
“premenopausal”.
Review for 10.1186/s12876-025-03863-6 (2025)

Title: Comparative Analysis of #-Estradiol and Testosterone on Lipid Droplet Accumulation,
and Regulatory Protein Expression in Palmitate/Oleate-Induced Fatty HepG2 Cells
Version: 1 Date: 26 Mar 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
The responses are satisfactory
Review for 10.1186/s12876-025-03863-6 (2025)

Title: Comparative Analysis of #-Estradiol and Testosterone on Lipid Droplet Accumulation,
and Regulatory Protein Expression in Palmitate/Oleate-Induced Fatty HepG2 Cells
Version: 1 Date: 31 Mar 2025
Reviewer's report:
The authors have addressed all the raised comments. My recommendation is to accept for
publication.
Review for 10.1186/s12876-025-03823-0 (2025)

Title: A nomogram for the prediction of overall survival and Prognostic significance of different
treatment modalities for elderly Hepatocellular carcinoma
Version: 3 Date: 16 Jul 2024
Reviewer:  Antonia Federica Sacco
Reviewer's report:
First of all, I found the title not really consistent with the content of the manuscript, it would
be better "A NOMOGRAM FOR PROGNOSTIC PREDICTION AND FOR THERAPEUTIC
DECISION MAKING OF ELDERY HCC PATIENTS".
The reason why it was decided to focus the study on the elderly population could be included in
the introduction (which is instead only explained at the end in the discussion section).
Furthermore, the introduction does not address the limitations of the topic, it is not clear where
the study was carried out (it is generally referred to as "United States" and the study was not
carried out according to the Helsinki declarations.
In paragraph 2.1 ("patients cohort") it would be better to explain the inclusion criteria rather than
the exclusion criteria, which could be mentioned quickly afterwards. However, this part could
also be summarized as it is information already reported in the flowchart.
In paragraph 3.1 ("demographic and clinical characteristics"), play attention because there is an
error in the number of male patients (2261-29.4%, and not 3265-42.4%).
Also there is the table, it is not necessary to describe all the data in the paragraph. However, in
table 1, pay attention as there is no degree of tumor differentiation, which is instead reported
in the paragraph.
Still in the results, in paragraph 3.2 ("selection of prognostic factors"), the data reported are quite
obvious, they do not bring anything new to the scientific community compared to the TNM
system. On the contrary, the data reported in the following paragraphs 3.3 and 3.4 are interesting.
The paper is based on an interesting focus, but the use of the nomogram is not straightforward.
A nomogram should be rewritable in the form of a simple equation, and it does not naturallu
come out of the paper.
The discussion section is too long and distracting, please change the excessively long and
interminable sentences with quicker and clearer concepts.
Finally, please play attention to some mistakes I found: in the paragraph 1 (introduction) on
the 10th line “recent years” it would be better “IN MORE recent years” and the sentence
“some studies have also proved portal vein tumor thrombus, an early phenomenon of vascular
invasion in hepatocellular carcinoma (…)” is repeated twice with two different references. In
the paragraph 3.4 on the 2th line there is no need for the dot between “patients” and “we
estabilished”.
Review for 10.1186/s12876-025-03823-0 (2025)

Title: A nomogram for the prediction of overall survival and Prognostic significance of different
treatment modalities for elderly Hepatocellular carcinoma
Version: 4 Date: 25 Feb 2025
Reviewer's report:
PEER REVIEWER ASSESSMENTS:
OBJECTIVE - Full research articles: is there a clear objective that addresses one or several
testable research questions? (Brief or other article types: is there a clear objective?)
Yes - there is a clear objective
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for
the objective?
Yes - the approach is appropriate
EXECUTION - Are the experiments and analyses performed with sufficient technical rigor to
allow confidence in the results?
Yes - experiments and analyses were performed appropriately
STATISTICS - Is the use of statistics in the manuscript appropriate?
Yes - appropriate statistical analyses have been used in the study
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not
overstated?
Yes - the author's interpretation is reasonable
OVERALL MANUSCRIPT POTENTIAL - Has the author addressed your concerns sufficiently
for you to now recommend the work as a technically sound contribution? If not, can further
revisions be made to make the work technically sound?
Yes - current version is technically sound
PEER REVIEWER COMMENTS:
GENERAL COMMENTS: In their present revised version, authors have addressed my previous
comments with appropriate changes made in their manuscript. I have no further major issues
to report.
Review for 10.1186/s12876-025-03819-w (2025)

Title: The Double-Edged Sword: Impact of Antibiotic Use on Immunotherapy Efficacy in
Advanced Hepatocellular Carcinoma
Version: 3 Date: 18 Mar 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
The responses are satisfactory
Review for 10.1186/s12876-025-03819-w (2025)

Title: The Double-Edged Sword: Impact of Antibiotic Use on Immunotherapy Efficacy in
Advanced Hepatocellular Carcinoma
Version: 3 Date: 23 Mar 2025
Reviewer:  Mohamed H. Zidan
Reviewer's report:
Dear Authors,
Re: Revised manuscript entitled "The Double-Edged Sword: Impact of Antibiotic Use on
Immunotherapy Efficacy in Advanced Hepatocellular Carcinoma"
Thank you for the opportunity to review your revised manuscript. The revised manuscript has
clearly stated all the reviewers' concerns.
Sincerely,
Review for 10.1186/s12876-025-03821-2 (2025)

Title: Efficacy and Safety of PPAR agonists in Primary Biliary Cholangitis: A Systematic
Review and Meta-Analysis of Randomized Controlled Trials
Version: 1 Date: 27 Jan 2025
Reviewer's report:
In this study, Saeedian et al. reviewed the use of PPARs as second-line therapies for PBC. The
study is relevant and well-conducted.
Introduction
Please update the list of medications approved for second-line therapy to include seladelpar and
elafibranor.
Mention that fibrates are used as off-label options in several countries.
Correct the description of bezafibrate: it is a pan-PPAR.
Include information about ciprofibrate and pemafibrate, which have demonstrated efficacy in
small studies.
In Section 3.3, please define "PBS."
Methods
The review reports a large number of outcomes. It is essential to clearly define the primary and
secondary outcomes in the Methods section. What was the definition of pruritus for example?
The combination of different types of PPARs may not be appropriate, as differences exist in
mechanisms of action and outcomes (e.g., safety, ALP reduction rates, and pruritus control).
Are the baseline characteristics comparable between the studies included? Baseline ALP values
strongly impact the effects of lowering and/or normalizing liver tests.
What is the percentage of patients with advanced fibrosis or cirrhosis in the different studies?
This strongly influences the efficacy of second-line therapies and could impact subgroup
analyses.
Is it possible to stratify the analysis by the presence or absence of cirrhosis or advanced fibrosis?
One of the major challenges in PBC meta-analyses is the lack of uniformity in data presentation
across trials, with some reporting lab test results as multiples of the ULN and others as absolute
values. How did the authors address this issue?
Results
Please include baseline liver biochemistry (especially ALP and bilirubin) and the percentage of
patients intolerant to UDCA in Table 1.
Discussion
Since 2015, several meta-analyses on fibrate therapy in PBC have been published. The authors
should compare their findings in depth with these prior studies.
Comment on the potential impact of baseline imbalances (e.g., ALP levels, fibrosis degree,
inclusion criteria) on post-treatment subgroup comparisons.
Minor
There are several typographical errors. Please review and correct them.
Review for 10.1186/s12876-025-03821-2 (2025)

Title: Efficacy and Safety of PPAR agonists in Primary Biliary Cholangitis: A Systematic
Review and Meta-Analysis of Randomized Controlled Trials
Version: 1 Date: 10 Feb 2025
Reviewer's report:
The manuscript by Saeedian et al. presents a systematic review and meta-analysis evaluating the
efficacy and safety of PPAR agonists in patients with PBC. The study aims to determine whether
PPAR agonists, when used in combination with UDCA, can improve biochemical markers and
clinical outcomes in PBC patients who do not adequately respond to UDCA alone. However,
the following issues should be addressed before it can be considered for publication.
1. The study reports significant heterogeneity in the meta-analysis for several outcomes,
including ALP (I² = 82%), GGT (I² = 92%), and total bilirubin (I² = 53%). The authors have
conducted sensitivity analyses and subgroup analyses, but the high heterogeneity suggests
potential variability in study populations, interventions, and outcomes that need to be addressed
more thoroughly.
2. Funnel plots and Egger's tests suggest the presence of publication bias for GGT and total
bilirubin levels. The authors should provide a more detailed discussion on the potential sources
of bias and how they might have affected the results.
3. Some studies included in the meta-analysis had missing data for certain outcomes (e.g., ALT,
AST, pruritus). The authors should provide a more detailed explanation of how they addressed
these missing data and the potential impact on the overall findings.
4. The study includes both open-label and double-blind trials, which can introduce bias. The
authors should discuss the potential impact of this variability on the study outcomes and the
robustness of their findings.
5. The study should provide more detailed information on the safety profile of the different
PPAR agonists, including a summary of adverse events and serious adverse events.
Review for 10.1186/s12876-025-03829-8 (2025)

Title: Single-cell transcriptomic analysis reveals prognosis-related stromal signatures that
potentiate stratification of patients with extrahepatic cholangiocarcinoma
Version: 0 Date: 05 Jan 2025
Reviewer's report:
The authors proposed that stroma in eCCA can be classified using single cell transcriptome
analysis. The study appears to have been appropriately conducted. However, there are some
concerns with the present manuscript. Following points should be addressed.
Specific comments:
1. Figure legends: Please provide detailed explanations for each figure. Simply listing the title
of each result is insufficient for readers and reviewers.
2. Please provide continuous line numbers in the manuscript to facilitate the review process.
3. CAFs play crucial roles in both chemoresistance and cancer progression. Although the authors
cite one article regarding the link between CAFs and chemoresistance in page 20, this reviewer
recommends citing additional relevant studies. The following articles are suggested for citation.
https://doi.org/10.1038/s41416-024-02717-4
https://doi.org/10.1007/s10120-021-01174-9
4. Identification of epithelial cells and tumor cells: This reviewer cannot understand that how
they differentiate non-tumor epithelial cells and tumor cells since both cells express epithelial
cell markers. Additionally, proliferation markers are not helpful to differentiate them since non-
tumor epithelial cells can express high levels of proliferation markers as well as tumor cells.
5. Figure 7a and d: Are these stromal subgroups? While Group 2 and Group 3 are clear, Group
1 is unclear. What cell types are “proliferative”? The term may not be appropriate. Which cell
types are responsible for the upregulation of MYC in Figure 7d?
6. The association between gene expression profile/subtype in tumors in eCCA and stromal
subgroup: This reviewer thinks that tumors in eCCA also show different profiles/subtypes.
This reviewer suggests investigating the relationship between stromal subgroups (Groups 1-3
in Figure 7) and tumor subtypes. Does each stromal subgroup correspond to a specific tumor
subtype?
7. Figure 7c: Please refrain from showing the same data. Left upper plot show the same data
as the other plots.
8. Previous studies have shown that transcriptomic can identify molecular subtypes in tumors
as well as stromal subtypes. The authors should cite such papers. The following papers are
recommended for citation.
DOI: https://doi.org/10.1038/ng.3398
DOI: 10.1093/carcin/bgae056
Review for 10.1186/s12876-025-03829-8 (2025)

Title: Single-cell transcriptomic analysis reveals prognosis-related stromal signatures that
potentiate stratification of patients with extrahepatic cholangiocarcinoma
Version: 0 Date: 12 Jan 2025
Reviewer:  Y. Huang
Reviewer's report:
The authors in this study profiled the tumor cellular composition and identified prognosis-related
stromal signatures by scRNA-seq in eCCA. The results revealed that the eCCA tumors were
categorized into three classes: proliferative Group 1, inflammatory and fibrotic Group 2, and
neuronal Group 3. Patients in Group 3 had a better prognosis when compared to Group 1 and 2,
reflecting different impact of stromal subtypes on tumor progression.
1. There were some reported researches by analysis the features of eCCA using the scRNA-seq,
What is the most important new findings in this study?
2. As discussed in this study, further studies are needed to determine the differences between
pCCA and dCCA.
3. As per the results in this study, what is the clinical benefit to a patient with eCCA? How do
the result stratify a eCCA patient with good or poor prognosis?
4. More discussion should address the future application prospects.
Review for 10.1186/s12876-025-03829-8 (2025)

Title: Single-cell transcriptomic analysis reveals prognosis-related stromal signatures that
potentiate stratification of patients with extrahepatic cholangiocarcinoma
Version: 1 Date: 30 Jan 2025
Reviewer:  Hong-Yue Lai
Reviewer's report:
This study used single-cell RNA sequencing (scRNA-seq) to profile the tumor
microenvironment of extrahepatic cholangiocarcinoma (eCCA), focusing on stromal cell
heterogeneity and its impact on prognosis. By analyzing 37,498 individual cells from tumor and
adjacent normal tissues, the researchers identified key prognosis-related stromal subpopulations,
including proliferative hematopoietic progenitor-like cells (HPLCs), fibroblasts, Schwann cells,
mast cells, and regulatory T cells. Based on stromal signatures, eCCA tumors were classified
into three groups: (1) Proliferative, (2) Inflammatory and Fibrotic, and (3) Neuronal, with Group
3 showing the best prognosis. These findings highlight the significance of stromal components in
eCCA progression and suggest a new molecular classification system with potential therapeutic
implications.
This study is intriguing; however, several issues still need to be addressed.
Major concerns:
1.  The authors stated that single-cell transcriptomic analysis identified prognosis-related stromal
signatures; however, why were marker gene expression levels in bRNA-seq data used to
correlate stromal cell clusters with survival?
2. The cohort's background, including clinicopathological characteristics, treatment strategies,
and comorbidities that may influence patient survival, should be provided.
3. This study lacks experimental validation.
Review for 10.1186/s12876-025-03829-8 (2025)

Title: Single-cell transcriptomic analysis reveals prognosis-related stromal signatures that
potentiate stratification of patients with extrahepatic cholangiocarcinoma
Version: 1 Date: 07 Feb 2025
Reviewer's report:
I have reviewed the revised manuscript and the authors’ responses to my comments.
I appreciate the authors’ efforts in carefully addressing my concerns and making the necessary
revisions. The responses are clear and satisfactory, and the manuscript has been appropriately
improved.
I have no further issues to raise and consider the manuscript suitable for publication in its current
form.
Best regards,
Review for 10.1186/s12876-025-03829-8 (2025)

Title: Single-cell transcriptomic analysis reveals prognosis-related stromal signatures that
potentiate stratification of patients with extrahepatic cholangiocarcinoma
Version: 1 Date: 08 Feb 2025
Reviewer:  Y. Huang
Reviewer's report:
All the questions had been explained in the revised document.