JerMa88/BMC_Gastroenterology_Peer_Reviews huggingface dataset:
Review for 10.1186/s12876-023-02952-8 (2023)

Title: CLINICAL MANIFESTATION, STAGING AND PROGNOSIS OF
HEPATOCELLULAR CARCINOMA IN GAMBIAN PATIENTS
Version: 2 Date: 12 Jul 2023
Reviewer's report:
The study seeks to assesses the clinical features, stage, and prognostic variables of patients with
HCC in The Gambia. There is a need for observational studies from West Africa on HCC,
however this manuscript in its current state falls below the standard of BMC Gastroenterology
and requires major revision before it can be accepted.
General comments
- The grammar, spelling and editing throughout the manuscript should be improved since there
are several grammatical errors and spelling mistakes.
- Abbreviations should be written out in full on first use
Background
- Background should be strengthened with more up to date references
- The time period/ year for which incidence and prevalence data have been described should be
stated. As much as possible, the authors should provide the most recent published estimates.
Methods
- Study design should be clearly stated in the methods
- What type of medical facility is MRC Fajara. Is it a referral centre? The study setting should
be described.
- What were the inclusion and exclusion criteria. How were patients selected for enrolment, i.e.
what was the sampling strategy.
- Explain how study size was arrived at
- Were medical records reviewed retrospectively or were cases prospectively enrolled? How
was data collected?
- How long were patients followed up for? How was the follow-up done?
- Was information about current/ previous treatment collected? Including hbsag, hcv or hcc
specific therapy?
- How was loss to follow up dealt with?
Results
- Label the survival probability axis on the KM Graph
- Why did the authors choose to combine BCLC ABC in the KS graph? Could they be separated?
- Tables shown appear disjointed, the authors could reformat the table to improve its appearance
and readability.
Discussion
- Start discussion by summarising key findings
- Discuss limitations, potential sources of bias and generalisability of the study.
Review for 10.1186/s12876-023-02952-8 (2023)

Title: CLINICAL MANIFESTATION, STAGING AND PROGNOSIS OF
HEPATOCELLULAR CARCINOMA IN GAMBIAN PATIENTS
Version: 4 Date: 13 Aug 2023
Reviewer's report:
-Authors have responded mostly to the review questions I had in my initial report. I appreciate
the effort that was placed into making these revisions in time.
- I still think cirrhosis's importance must be explicitly stated in the manuscript. As the authors
mentioned that this is a prospective study, it is a bit disappointing that cirrhosis is not considered
when predefining study parameters. It makes me doubt the depth of effort placed into designing
this prospective study during the initial phase. Additionally, since Child-Pugh was being
reported in the manuscript, I would have expected some degree of planning in looking into
cirrhosis.
-The Fibrocan data is quite questionable. The median Kpa is reported as 75, and this is quite
high. I suspect there might be a typographical error, as the 3rd IQR is also reported as 75.
-BCLC D patients are reported to be 41%, but Child's C patients were 14%. I highly doubt the
concordance of these numbers. Furthermore, 41% were reported as Child A, and I doubt this is
unlikely to correlate with the BCLC data.
-Survival is not clearly depicted in the table section.
Review for 10.1186/s12876-023-02952-8 (2023)

Title: CLINICAL MANIFESTATION, STAGING AND PROGNOSIS OF
HEPATOCELLULAR CARCINOMA IN GAMBIAN PATIENTS
Version: 4 Date: 21 Aug 2023
Reviewer's report:
General comments
The authors have done well to revise the manuscript and take into consideration the reviewers'
comments. There are however still some additional revisions that could be made.
There are still some grammatical and editing corrections required in the manuscript, for example:
- This was the only specialist hepatology clinic that received referrals from across the whole
'Gambian' during the study period.
Figure 3: Survival of HCC patients according to child-'purg' class
Background
The authors state: "Sub-Saharan Africa is the most affected region owing to the high prevalence
of chronic hepatitis B virus infection." This statement may not be accurate since GLOBOCAN
data suggests otherwise. I suggest the authors confirm data from other sources such as the
following: https://gco.iarc.fr/today/home
Methods
The authors state that patients were prospectively enrolled and then followed up from time of
enrolment until death. It is appears the study design is therefore a cohort study, rather than a
cross-sectional study.
Results
The tables still require further editing for readability. For example: Table 2 requires further
editing. Which HIV status is shown? What are the Hb, WBC, etc indices shown? Are they
median with range or median with IQR? The abbreviations in the table should either be written
in full, or the abbreviations explained in the footnotes.
Limitations
The limitations of using USG for the diagnosis of HCC, especially early stage HCC should be
noted as a limitation in this study. It is possible that patients with early stage HCC could have
been missed on USG due to several factors including operator skill, which affect the sensitivity
of USG in the HCC diagnosis.
Review for 10.1186/s12876-023-02952-8 (2023)

Title: CLINICAL MANIFESTATION, STAGING AND PROGNOSIS OF
HEPATOCELLULAR CARCINOMA IN GAMBIAN PATIENTS
Version: 5 Date: 06 Sep 2023
Reviewer's report:
Thank you to the authors for responding to the review comments.
I suggest the authors include the limitation regarding pre-planning for cirrhosis evaluation in
the manuscript. I think this needs to be reflected in the final work. Otherwise, I agree with the
revision comments.
Review for 10.1186/s12876-023-02819-y (2023)

Title: Nomogram Predicts Risk of Perineural Invasion Based on Serum Biomarkers for
Pancreatic Cancer
Version: 0 Date: 24 Feb 2023
Reviewer's report:
Very interesting and well written study.
Did the author try to perform also an internal validation analysis through bootstrapping?
English grammar should be improved.
Did the method for diagnosis of PDAC have a role in the model? IN this regard cite the recent
paper PMID: 27356212
Review for 10.1186/s12876-023-02819-y (2023)

Title: Nomogram Predicts Risk of Perineural Invasion Based on Serum Biomarkers for
Pancreatic Cancer
Version: 0 Date: 03 Apr 2023
Reviewer:  Ragesh B. Thandassery
Reviewer's report:
Well conducted study and the results are pertinent. Predicting perineural invasion in pancreatic
adenocarcinoma is extremely important, and a predictive model is very helpful. A proportion of
tumors do not produce  CA 19-9, and the model is not helpful.
As we know, tumor biology and behavior are very variable, and three parameters identified in
this study (preoperative blood glucose, preoperative total bilirubin, and preoperative CA19-9)
should be validated in larger prospective multicenter cohorts.
In the discussion, please include more related studies for comparison of results of your study.
Review for 10.1186/s12876-023-02910-4 (2023)

Title: Predictive value of lesion morphology in rectal cancer based on MRI before surgery
Version: 2 Date: 06 Jul 2023
Reviewer's report:
This paper investigates the correlation of MRI morphology of primary tumors in rectal cancer
with EMVI, synchronous metastasis, and local recurrence. The paper conducted a series of
experiments and showed some meaningful results. The paper is well organized and presented in
a good style. The claims fully supported by the experimental data.
And I also have a few questions or advice:
1.The first of the exclusion criteria is to exclude mucinous adenocarcinoma of the rectum
because mucinous adenocarcinoma has specific biological behavior. Can you explain the impact
of this particular biological behavior on your current study that led to the exclusion?
2.Please explain why not split the data into test and validation sets which would be more reliable.
3. HRT2WI and CET1WI should be defined at the first time when they first appear in the
manuscript.
4.It would be beneficial to have pathological confirmation for peritoneal reflection invasion.
5.The preoperative evaluation of rectal cancer by MRI includes TN stages, please add the N
stage if possible.
6.This study included a subset of patients with preoperative neoadjuvant therapy, which may
alter the status of the tumor or lymph nodes, which should  be one of the limitations of the study.
Review for 10.1186/s12876-023-02910-4 (2023)

Title: Predictive value of lesion morphology in rectal cancer based on MRI before surgery
Version: 2 Date: 11 Jul 2023
Reviewer's report:
is retrospective study aimed to analyze the MRI morphological characteristics of primary tumors
in rectal cancer and identify significant correlations with several adverse prognostic indicators.
The researchers further developed multiple nomograms based on these findings. Overall, this
paper offers valuable insights and presents important results. One notable strength of this study is
its ability to establish associations between specific MRI findings and histopathological features.
However, it is worth mentioning that several issues still remain unresolved in my opinion:
1.The manuscript extensively employs abbreviations, which presented a considerable challenge
for me to comprehend the content. Remembering and constantly referring back to the definitions
of these abbreviations proved to be quite difficult. Therefore, I recommend reducing the overall
reliance on abbreviations, particularly for those with lower usage frequency.
2.Please provide a clear definition for the abbreviation "HRT2WI" when it first appears.
3.Did the patient undergo any bowel preparation prior to the MRI scan? Please provide this
additional information.
4.In the "2.2. MRI technique" section, I did not see any mention of bowel preparation and
precautions for rectal cancer patients before MRI scans. Please include relevant information.
5.There is a spelling error in the definition of "hEMVI" in the captions below Figure 1 and Table
1. Please correct it.
6.Is the result in Table 3 the multivariable logistic regression analysis results after adjusting for
confounding factors? If it is, please provide an explanation in the statistical analysis section on
how the confounding factors were adjusted.
7.The usage of "a" and "the" throughout the manuscript needs to be accurately reviewed and
corrected. Additionally, some sentences in the discussion section are excessively long and
difficult to understand, and therefore, should be simplified.
8.Although this study primarily utilized oblique axial HRT2WI to observe various MRI
parameters, I believe that oblique coronal and sagittal HRT2WI also hold important value in this
paper. Therefore, I recommend including a description of the parameters and scanning methods
for these two sequences as well.
9.The English tenses in the Figure legends should be consistent.
10.Why was rectal mucinous adenocarcinoma excluded? Please provide an explanation for the
reason.
Review for 10.1186/s12876-023-02910-4 (2023)

Title: Predictive value of lesion morphology in rectal cancer based on MRI before surgery
Version: 4 Date: 31 Jul 2023
Reviewer's report:
1. The study design is appropriate to answer the research question and the conclusions are
supported by the evidence presented.
2. The methods are sufficiently described to allow the study to be repeated.
3. The use of statistics and treatment of uncertainties is appropriate.
4. The presentation of the work is clear.
5. The images in this manuscript are free from apparent manipulation.
Review for 10.1186/s12876-023-02942-w (2023)

Title: SASE, Success and Adverse Event Score in Endoscopic Retrograde
Cholangiopancreatography. A Novel Grading System
Version: 3 Date: 16 May 2023
Reviewer's report:
Very interesting study with a huge sample size. I really don't have major comments.
I suggest to comment on the impact of difficult cannulation of ERCP adverse events and on the
impact on different devices used during ERCP on the same outcome (in these regard cite the
recent NMAs  PMID: 34666153  and  PMID: 34543649)
Review for 10.1186/s12876-023-02942-w (2023)

Title: SASE, Success and Adverse Event Score in Endoscopic Retrograde
Cholangiopancreatography. A Novel Grading System
Version: 3 Date: 28 May 2023
Reviewer's report:
Congratulations to the authors on this multi centre prospective cohort study which consisted of
an impressive sample size of 16327 ERCP procedures. The ASGE grading system has indeed
been developed some years ago and needs frequent evaluation and updating.
In this cohort study, the authors used this database to validate the ASGE grading system and
noted discrepancies and inaccuracies in the system. The authors also suggested a novel grading
score SASE with a correct prediction of cannulation at 92.6%, AEE at 96.5% and bleeding at
96.3%.
suggestions:
1. in general when testing a new screening tool, an ROC curve is generated to show the sensitivity
and specificities. In the validation cohort section of results, perhaps more robust statistical data
needs to be shown.
2. table 2 and table 3 are very long and takes up a lot of space. perhaps it can be shortened, or
put into the appendix section.
Review for 10.1186/s12876-023-02943-9 (2023)

Title: Dietary Inflammatory Index and Risk of Gallstone Disease in Iranian Women: A Case-
Control Study
Version: 2 Date: 03 Jun 2023
Reviewer:  Kimia Leilami
Reviewer's report:
Thanks for your submission,
1-You must mention in the title that the study was done on the population of Iranian women.
2-Your abstract is too long and more that 250 words, actually it is not necessary to talk about
your crude analysis in the results of the abstract.
3-Why did you talk about the relationship between inflammatory biomarkers and DII score? It
wasn’t in the scope of your investigation.
4-You have to report the more recent prevalence of GD in Iran (first paragraph of introduction).
You can use these links:
https://ccsenet.org/journal/index.php/gjhs/article/view/48440
https://ejhm.journals.ekb.eg/article_11952_8a7d8835b02597ad9a86aa788e6213ae.pdf
5-The font and size of text are not the same in different parts, it needs to review and pay more
attention to details.
Review for 10.1186/s12876-023-02951-9 (2023)

Title: Relation between triglycerides and the severity of acute pancreatitis combined with
nonalcoholic fatty liver disease: a retrospective study
Version: 1 Date: 14 May 2023
Reviewer's report:
I am pleased to review the manuscript entitled " Effect of triglycerides on the severity of
acute pancreatitis combined with nonalcoholic fatty liver disease: a retrospective study" by Lei
Zhu et al. The investigation regarding the relationship between high triglycerides and acute
pancreatitis within the context of non-alcoholic fatty liver disease (NAFLD) is both intriguing
and of significant importance. Nevertheless, several concerns surround the analysis in this paper,
warranting substantial revisions to its content.
Major
1. The presence of eight individuals with alcohol in Table 1 raises questions regarding the
premise of this cohort being solely based on NAFLD. This assumption appears to be incorrect,
and thus, it is necessary to exclude these eight individuals from the analysis and reevaluate the
data accordingly.
2. In Table 1, it appears that there are two cases of hypertriglyceridemia (HTG) included in the
non-hypertriglyceridemia (NHTG) group. This raises concern as, by definition, individuals with
HTG should be excluded from the NHTG group. It is imperative to perform a revised analysis
to ensure accurate results and proper grouping of patients.
Minor
1. In 3.2, “ 2012 revision of Atlanta” should be “2012 revision of the Atlanta Classification of
AP” and please add the reference. (Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD,
Sarr MG, Tsiotos GG, Vege SS; Acute Pancreatitis Classification Working Group. Classification
of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international
consensus. Gut. 2013 ;62:102-11. doi: 10.1136/gutjnl-2012-302779.)
2. MAP, MSAP, and SAP should be spelled out.
3. Why did the authors classify AP severity into 3 groups (MAP, MSAP, and SAP) but only
compare MSAP and SAP? Wu et al. [4]reported that the incidence of mild AP, moderately severe
AP, and severe AP was 77.30%, 18.3%, and 4.3% in the non-NAFLD group and 58.2%, 33.9%,
and 7.9% in the NAFLD group, respectively. In this manuscript, MSAP was higher than their
cohort. What do authors think about it? Please discuss it.
4. The authors should discuss the related articles as follows: “Xu C., Qiao Z., Lu Y., et al.
Influence of fatty liver on the severity and clinical outcome in acute pancreatitis. PLoS ONE.
2015;10(11)” and “Qi X., Hou Y., Guo X. Severe fatty liver disease and acute pancreatitis: is
there a correlation between them. Clinical and Experimental Hepatology. 2016;1(4):127–130.”
5. In Figure 1, in addition to mentioning "compare," please add boxes for each comparison and
add the number of the selected case to each box.
6. In Table 1, comparisons should be performed between each etiology.
Review for 10.1186/s12876-023-02951-9 (2023)

Title: Relation between triglycerides and the severity of acute pancreatitis combined with
nonalcoholic fatty liver disease: a retrospective study
Version: 1 Date: 12 Jun 2023
Reviewer's report:
To Authors
I congratulate the authors for Effect of triglycerides on the severity of acute
pancreatitis combined with nonalcoholic fatty liver disease: a retrospective study name’s
article.
Best regards
Review for 10.1186/s12876-023-02951-9 (2023)

Title: Relation between triglycerides and the severity of acute pancreatitis combined with
nonalcoholic fatty liver disease: a retrospective study
Version: 4 Date: 06 Sep 2023
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: -Author perform most of the requested comments
Author: checked the clinical data in table 1 and made the requested changes in the manuscript
- Also they have added the relevant reference as suggested by reviewer
- authors responded adequately to each of the concerns we raised in our comments
-Author have done study design, important goal to relate AP with NAFLD and TG.
- the experiments and analyses performed with technical rigor to allow confidence in the results
- Methods , results and interpretation/discussion of the data reasonable for the study
-Collect Clinical features of the different groups, select patient process.
-Compare the different markers related to the study.
- Revised manuscript become appropriate for publication and we recommend the work for
publication
Review for 10.1186/s12876-023-02916-y (2023)

Title: Construction of a novel signature based on immune-related lncRNA to identify high and
low risk pancreatic adenocarcinoma patients
Version: 1 Date: 29 Apr 2023
Reviewer's report:
Very interesting and well conducted study. I don't have major concerns.
My only comments is on the need of a stronger validation of these results. How the authors think
to confirm their results through a validation approach?
The authors should comment in the Discussion on the need of good quality samples in the clinical
practice of these patients, for example by means of Endoscopic ultrasound FNB (in this regard
cite the recent papers PMID: 35124072  and PMID: 35915956)
Review for 10.1186/s12876-023-02916-y (2023)

Title: Construction of a novel signature based on immune-related lncRNA to identify high and
low risk pancreatic adenocarcinoma patients
Version: 1 Date: 07 May 2023
Reviewer's report:
This article has great bias. I don't think revision can solve the problem with the article. Firstly,
there have been a large number of similar studies published. Secondly, the author cannot prove
whether the model constructed can be applied to other single center queues.
Review for 10.1186/s12876-023-02916-y (2023)

Title: Construction of a novel signature based on immune-related lncRNA to identify high and
low risk pancreatic adenocarcinoma patients
Version: 1 Date: 25 May 2023
Reviewer's report:
Thank you for the opportunity to review this manuscript. The authors developed the immune-
related lncRNA signature for pancreatic adenocarcinoma using TCGA data. The manuscript is
interesting, however, there are several issues to address.
1) The results should be validated in independent cohorts. Considering the previous article, there
is an independent cohort (GSE21501).
2) The Lasso regression is good to shrink variables in high-dimensional data, however, there
are several variable selection methods (Pak K et al., JMIR, 2020). The authors should compare
the results from other methods and describe the reasons why they used the lasso with proper
citations.
3) The quality of the figures should be improved. I cannot read them clearly.
Without accurate external validations, the evidence level is not high.
Review for 10.1186/s12876-023-02916-y (2023)

Title: Construction of a novel signature based on immune-related lncRNA to identify high and
low risk pancreatic adenocarcinoma patients
Version: 2 Date: 19 Jun 2023
Reviewer's report:
The author's revisions to other reviewers have improved the quality of this article, making it
possible to meet publication requirements. Some key issues need to be clarified.
1. However, I noticed that some of the figures have a low resolution which makes them hard
to read. I would suggest that the authors increase the resolution of these figures, which would
make them easier to read and understand. This would also make it easier for readers to fully
understand the results and make use of it. I believe that increasing the resolution of these figures
would greatly improve the manuscript.
2. This study was conducted based on open-accessed data. Some previous studies have
used similar bioinformatics or statistical methods. Although it will lose some innovation,
I think it will benefit the reader if the authors could include the following references,
which would provide readers with a more complete understanding of the whole study: doi:
10.1177/10732748221129451; doi: 10.3389/fgene.2021.627508; doi: 10.18632/aging.202558;
doi: 10.3389/fgene.2022.844709.
3. Detailed description of all method section is required.
4. State the * and statistic value in the method section or otherwise mention in every figure
legend. e.g., *p>0.05.
5. Check the reference style and abbreviation of journals.
6. Some typos are there; rectify those (Minor).
7. The relationship between immune cell infiltration and specific pathways should be well
discussed in the relevant section.
Review for 10.1186/s12876-023-02864-7 (2023)

Title: Analysis of the association between dietary patterns and nonalcoholic fatty liver disease
in a county in Guangxi
Version: 2 Date: 03 Apr 2023
Reviewer's report:
In this manuscript, the authors evaluated the association between dietary patterns and
nonalcoholic fatty liver disease through a FFQ survey. The divided all participants into three
groups according to their dietary patterns, traditional Chinese, Western, and cereal-potato dietary
patterns, and found that the dietary patterns are correlated with the risk of NAFLD. The
followings are my concerns:
1. The association between dietary pattern and risk of NAFLD had been extensively studied,
therefore, the author should highlight the novelty of this study.
2. It is good if the author could give the suggestions for daily diet to reduce the risk of NAFLD.
3. Page 2, Line 67, “Therefore” is illogical.
4. Page 5, Table 1, and Page 6, Line 219, “read meet”, the author may mean “red meet”.
5.  In the entire manuscript, the author sometimes use upper case of “P”, sometimes they use
lower case, please make it consistent. The “p” value usually is lower case and italic.
6. Page 5, Line 186, please delete the comments.
7. Page 6, Line 200, “They had plenty of physical exercise”, is that possible for the author to
explain the criteria for “plenty”?
8. Please correct the content Tables 2, 3 and 4, such as “NAFLD, n (%)” is the header of Table
3, but the data is not show this way, same thing happened in Table 4. The author should indicate
how they calculate the percentage in these tables clearly.
9.  It seems the author mention model 1 of Table 6 in the text, not model 2. Please explain why
the author list the model 2 here.
Review for 10.1186/s12876-023-02864-7 (2023)

Title: Analysis of the association between dietary patterns and nonalcoholic fatty liver disease
in a county in Guangxi
Version: 2 Date: 27 May 2023
Reviewer's report:
In the present manuscript the Authors report the results of a cross-sectional study investigating
the association between dietary pattern and presence of NAFLD in Chinese individuals. The
topic is of some interest given the prevalence of NAFLD in the general population, as well as
the importance of dietary factor on its development and progression.
I have the following comments:
1. Please make it clear that NAFLD was diagnosed based on ultrasound in the abstract as the
readers should be able to know that from the beginning.
2. Please better describe the exclusion criteria (e.g. serious medical condition) and provide a
flowchart to show how many participants were excluded and for what reasons.
3. There is no mention of exclusion of participants based on viral hepatitis. Did you perform
serology? Did you exclude all participants with viral hepatitis? If not please include this aspect
as a limitation of the study in the discussion section,
4. I suggest reporting the features described in the Additional File 1 in Table 2 as part of the
main manuscript.
5. I suggest looking at biomarkers of fibrosis as well (such as FIB-4 or NALFD fibrosis score)
to evaluate whether dietary patterns impacts not only steatosis but also fibrosis, which is more
important as a predictor of poor liver outcomes. If you do not have the data to calculate these
indexes this should be included as a limitation of the current study in the discussion section.
6. I suggest mentioning a recent study investigating the importance not only of BMI but also of
fat distribution in the development of NAFLD and fibrosis (10.1093/ajcn/nqac059)
Review for 10.1186/s12876-023-02864-7 (2023)

Title: Analysis of the association between dietary patterns and nonalcoholic fatty liver disease
in a county in Guangxi
Version: 4 Date: 18 Jun 2023
Reviewer's report:
I congratulate the Authors for a thorogu revision, in which they addressed all the points I had
previously raised.  I have no further comments.
Review for 10.1186/s12876-023-02949-3 (2023)

Title: Clinical Data Based XGBoost Algorithm for Infection Risk Prediction of Patients
with Decompensated Cirrhosis: A 10-year (2012-2021) Multicenter Retrospective Case-control
Study
Version: 2 Date: 04 Jul 2023
Reviewer's report:
In this study, the authors propose to appraise effective predictors for infection in patients with
decompensated cirrhosis (DC) by using the XGBoost algorithm in a retrospective case-control
study of 6,648 patients. This study may be interesting for researchers who are mainly interested
in decompensated cirrhosis. However, the paper needs additional work, and some minor changes
are recommended before considering the paper for publication.
• Before using nonparametric methods for statistical analysis, whether the data are normally
distributed should be checked. It should be stated with which statistical test was used to check
if the normality assumption of the data was not met.
• Please provide the details of the solutions for the preprocessing problems of the data (missing
data, imbalanced data, etc.)
• Which correlation method (Spearman or Pearson) was used in the data analysis? Which method
was used in the univariate analysis? Please provide the name of all the statistical tests in the
statistical methods section. Additionally, please give the formula details of the performance
criteria (AUC, PPV etc.)
Review for 10.1186/s12876-023-02949-3 (2023)

Title: Clinical Data Based XGBoost Algorithm for Infection Risk Prediction of Patients
with Decompensated Cirrhosis: A 10-year (2012-2021) Multicenter Retrospective Case-control
Study
Version: 2 Date: 20 Jul 2023
Reviewer's report:
1. Without page numbers, the reviewer's comments are difficult to indicate.
2. On page 8, “In training set, the simple-tree XGBoost model with 6 selected features revealed
superior performance compared to the LR with all 11 features (AUROC: 0.971 vs 0.869,
P<0.001) or 6 features (AUROC: 0.971 vs 0.864, P<0.001) (Figure 4)." The results suggest that
5 out of 11 features do not add more predictive ability since the AUROC is 0.971 in both models.
The authors did not discuss in detail the five useless features."
3. In Table 3: the sensitivity of logistic-6 is higher than logistic-11. Why do more predictors
reduce sensitivity?
4. What is the simple-tree XGBoost? What does it look like? I did not see a reference for such
method. This particular name is rare since XGBoosting machine has numerous trees, not just
one.
5. It is a retrospective study, and the study lasts ten years. What is the time between the
predictors measured in Table 1? Do all patients use these measures simultaneously and then
predict infection outcomes after ten years? This study did reveal such temporal information.
Thus, the analyses and results raise concerns regarding validity.
6. The reference for the XGBoosting machine is “21. Hou N, Li M, He L, Xie B, Wang L,
Zhang R, et al. Predicting 30-days mortality for MIMIC-III patients with sepsis-3: a machine
learning approach using XGboost. Journal of Translational Medicine. 2020;18(1):462. It is not
a common way to cite the XGBoosting machine. The authors are not familiar with machine
learning models.
7. Do patients present identical characteristics and the distribution of the outcome? The authors
did not examine the center by predictor interactions. In addition, the cluster effect due to different
centers is likely and should be appropriately handled.
8. What does the p-value stand for in Table 2? Does it mean the comparison between the three
columns or just the last two columns?
9. The 11 features are GIB, HF, TP, TB, hemoglobin, Na, ALB, PTA, BUN, WBC count, and
NLR (Figure 1). However, the sex variable was excluded from the list. It raises critical concerns
regarding the analysis and results since sex is a highly significant predictor for infection in Table
2.
Review for 10.1186/s12876-023-02949-3 (2023)

Title: Clinical Data Based XGBoost Algorithm for Infection Risk Prediction of Patients
with Decompensated Cirrhosis: A 10-year (2012-2021) Multicenter Retrospective Case-control
Study
Version: 2 Date: 22 Jul 2023
Reviewer's report:
The main goal of this study was to appraise effective predictors for infection in patients with
decompensated cirrhosis (DC) by using XGBoost algorithm in a retrospective case-control
study. The results showed that the simple-tree XGBoost predictive model developed based on
a minimal amount of clinical data available to DC patients with restricted medical resources
could help primary healthcare practitioners promptly identify potential infection. The whole
methodology and research framework were complete and specific. But certain aspects are still
worthy of further discussion.
The following advices for amendments were listed below.
1. This study uses the correlation analysis based on the cases with confirmed diagnoses. It is
a good choice to analyze the confirmed diagnosis groups, but there may be selection errors.
This result only shows that the six indicators obtained have excellent predictions, but it does not
explain these values. Clinically, they may go on different time axes, and there will be different
data. The authors did not explain that the figures he chose were obtained during the period of
the case, so this study may have an overly idealized analysis and induction.
2. Relevant research results can only prove that the XGBoost method used may be better than
the current linear regression analysis. In clinical practice, there may be more verification of big
data and do not use it for verification on selected cases. Maybe better analysis results can be
obtained. At present, it can only be regarded as a pilot study.
3. This study does not address the level of hospital chosen and whether they compare differently
in terms of diagnostic agreement and prognosis for this disease.
4. In the discussion part of this study, there is no comparison of relevant clinical indicators
and multiple related indicators presented in many literatures. It only shows the difference
between different analysis methods. In this way, in many simulation studies, relevant analysis
and comparison can be carried out. Therefore, the overall practical value of this study is not high
at present. However, if you really use large community screening in the future, if you can get
reliable data, you may consider using it.
5. Please explains the limitations of this study in the discussion. and the future work.
Review for 10.1186/s12876-023-02949-3 (2023)

Title: Clinical Data Based XGBoost Algorithm for Infection Risk Prediction of Patients
with Decompensated Cirrhosis: A 10-year (2012-2021) Multicenter Retrospective Case-control
Study
Version: 3 Date: 24 Aug 2023
Reviewer's report:
I thank to authors for revision of the manuscript. The authors have satisfactorily addressed my
concerns.
Review for 10.1186/s12876-023-02949-3 (2023)

Title: Clinical Data Based XGBoost Algorithm for Infection Risk Prediction of Patients
with Decompensated Cirrhosis: A 10-year (2012-2021) Multicenter Retrospective Case-control
Study
Version: 3 Date: 31 Aug 2023
Reviewer's report:
I do not think six features could outperform 11 since they were selected due to significant
association. The results are contradictory.
The revision is not revised according to these comments.
Review for 10.1186/s12876-023-02949-3 (2023)

Title: Clinical Data Based XGBoost Algorithm for Infection Risk Prediction of Patients
with Decompensated Cirrhosis: A 10-year (2012-2021) Multicenter Retrospective Case-control
Study
Version: 3 Date: 31 Aug 2023
Reviewer's report:
The authors have worked hard to answer my questions and suggestions.
This article deserves to be published.
Review for 10.1186/s12876-023-02922-0 (2023)

Title: A radiomics model fusing clinical features to predict microsatellite status preoperatively
in colorectal cancer liver metastasis
Version: 3 Date: 01 Feb 2023
Reviewer's report:
Dear Author,
in the era of precision medicine the theme treated appears really interesting. Matherial and
Methods are explained clearly and the model building appears reproducible.
As MSI mutation rapresent a small part of rectal cancer, the sample of mutation patients is small.
Please give the readers suggestion to make the AI model reliable and compare the nomogram
to formal methods applied to colorectal liver metastases.
In the discussion, please explain also the impact of the early diagnosis of MSI in the choice
of treatment strategy  especially in synchronous patients. (Rocca, A., Cipriani, F., Belli, G.
et al. The Italian Consensus on minimally invasive simultaneous resections for synchronous
liver metastasis and primary colorectal cancer: A Delphi methodology. Updates Surg 73,
1247–1265 (2021). https://doi.org/10.1007/s13304-021-01100-9;) ; or the impact of the most
appropriate timing of surgical treatment considering the advantages of minimally invasive
surgery (Ceccarelli G, Andolfi E, Fontani A, Calise F, Rocca A, Giuliani A. Robot-assisted liver
surgery in a general surgery unit with a "Referral Centre Hub&Spoke Learning Program". Early
outcomes after our first 70 consecutive patients. Minerva Chir. 2018 Oct;73(5):460-468. doi:
10.23736/S0026-4733.18.07651-4. Epub 2018 May 24. PMID: 29795060.)
Figure 3 is described as "The (A) shows the ROC curves of three models in original data
validation sets, and the (B) shows the ROC curves of three models in original data validation
sets”. Which is the difference between A and B?
In Table 2 you could also explain the abbreviation.
You can also consider to extend also the text with the results shown in figures and table.
Review for 10.1186/s12876-023-02922-0 (2023)

Title: A radiomics model fusing clinical features to predict microsatellite status preoperatively
in colorectal cancer liver metastasis
Version: 3 Date: 09 Feb 2023
Reviewer's report:
In this manuscript, “A radiomics model fusing clinical features to predict microsatellite status
preoperatively in colorectal cancer liver metastasis,” the authors aimed to use enhanced CT
images for preoperative noninvasive prediction of microsatellite status in patients with liver
metastasis from colorectal cancer. The structure of the manuscript was not easy to understand. In
addition, although the authors attempted to present more measurements to describe the models,
it may make the readers some confusion about the study aim due to the un-clear description. I
have some concerns as below,
1. The section of introduction was too long, the authors should make the structure simplify to
present your research background and questions.
2. The authors should describe the sample sizes and statistical power in this study. Due to the
sample sizes is less, how could the authors establish the reasonable model?
3. How about the missing data in all interested variables? In Table1, we could find there is
missing data in the training group.
4. Could the authors explain the distribution of Tumor Location presented the difference? I think
it may affect the model building.
5. In Figure3, the authors should indicate the difference between three models.
6. Although the authors stated the limitation of this study, they did not offer any approach to
improve these limitation. Thus, I do not think the model from this study could assist in clinical
decision-making by providing personalized treatment plans for patients with liver metastasis
from colorectal cancer.
7. The approval number for the Ethics committee should be offered.
Review for 10.1186/s12876-023-02922-0 (2023)

Title: A radiomics model fusing clinical features to predict microsatellite status preoperatively
in colorectal cancer liver metastasis
Version: 3 Date: 13 Mar 2023
Reviewer's report:
Dear Author,
Did you find any difference in results segmenting half-tumor or the entire tumor with MSI
mutation?
Because your patient dataset included patients with liver metastases, please discuss the
different treatment strategies available for the patients with MSI-H, whenever the medical
therapy could be useless.  (Rocca A, Cipriani F, et al. The Italian Consensus on minimally
invasive simultaneous resections for synchronous liver metastasis and primary colorectal
cancer: A Delphi methodology. Updates Surg. 2021 Aug;73(4):1247-1265. doi: 10.1007/
s13304-021-01100-9. Epub 2021 Jun 5. PMID: 34089501.)
(Ceccarelli G, Rocca A, De Rosa M, Fontani A, Ermili F, Andolfi E, Bugiantella W,
Levi Sandri GB. Minimally invasive robotic-assisted combined colorectal and liver excision
surgery: feasibility, safety and surgical technique in a pilot series. Updates Surg. 2021
Jun;73(3):1015-1022. doi: 10.1007/s13304-021-01009-3. Epub 2021 Apr 8. Erratum in:
Updates Surg. 2021 May 10;: PMID: 33830484.)
Explain also the work time the manual segmentation requested, in spite of the accuracy achieved.
The AI method proposed is not so performing with a small sample of patients, discuss the
difference with Radiomics - Formal- Methods
(Rocca A, Brunese MC, Santone A, Avella P, Bianco P, Scacchi A, Scaglione M, Bellifemine
F, Danzi R, Varriano G, Vallone G, Calise F, Brunese L. Early Diagnosis of Liver Metastases
from Colorectal Cancer through CT Radiomics and Formal Methods: A Pilot Study. J Clin Med.
2021 Dec 22;11(1):31. doi: 10.3390/jcm11010031. PMID: 35011771; PMCID: PMC8745238)
Brunese L, Martinelli F, Mercaldo F, Santone A. Machine learning for coronavirus covid-19
detection from chest x-rays. Procedia Comput Sci. 2020;176:2212-2221. doi: 10.1016/
j.procs.2020.09.258. Epub 2020 Oct 2. PMID: 33042308; PMCID: PMC7531990.
Review for 10.1186/s12876-023-02922-0 (2023)

Title: A radiomics model fusing clinical features to predict microsatellite status preoperatively
in colorectal cancer liver metastasis
Version: 6 Date: 26 Apr 2023
Reviewer's report:
While the authors did acknowledge and address some of my concerns, I still have reservations
about the study's sample size. The sample sizes were relatively small, which could potentially
limit the statistical power and the ability to establish a suitable model. In addition, the authors
still not indicated the potential study limitation in the manuscript.
Review for 10.1186/s12876-023-02922-0 (2023)

Title: A radiomics model fusing clinical features to predict microsatellite status preoperatively
in colorectal cancer liver metastasis
Version: 6 Date: 10 Jun 2023
Reviewer's report:
Congratulations to the authors for this interesting manuscript which highlights how the use of
radiomics has now become a very useful diagnostic tool in the various aspects of oncological
surgery and therefore also in liver surgery, highlighting a fundamental aspect in the treatment of
liver metastatic disease from colorectal cancer which is to identify subjects with MSI mutations
that would benefit from a preoperative immunotherapy treatment.
The authors performed the revisions of all the points indicated by the reviewers however :
1) The authors must review the bibliography as in the report the various numbers do not match
with the various citations eg  Aldo Rocca et al. helped physicians to predict the presence of liver
metastases by analyzing CT radiological features[18]... instead of [26]
2) In the validation model, the authors do not mention the right colon and the left colon among
the clinical characteristics of the primary tumor, which instead are present in Table I. Explain
the reason.
Review for 10.1186/s12876-023-02922-0 (2023)

Title: A radiomics model fusing clinical features to predict microsatellite status preoperatively
in colorectal cancer liver metastasis
Version: 6 Date: 18 Jun 2023
Reviewer:  Fabio Melandro
Reviewer's report:
I read with interest the paper of Whang et al. on the role of  radiomics model to predict
microsatellite status before surgery in CRLM.
The paper is interesting, the model is well built, and the recent literature is covered.
Omics is a new argument in the field of CRLM and the authors added intriguing data tu to the
existing literature.
I completely agree with reviewer 1 and 2 about the criticism and suggestions, in particular the
introduction is too long compared to subsequent paragraphs.
In my opinion the paper could be valued for the pubblication after the revision of the reviewer
1 and 2' queries.
Review for 10.1186/s12876-023-02922-0 (2023)

Title: A radiomics model fusing clinical features to predict microsatellite status preoperatively
in colorectal cancer liver metastasis
Version: 8 Date: 31 Jul 2023
Reviewer's report:
Dear Author,
the paper has been improved after revision. It is acceptable for publication
Best Regards
Aldo Rocca
Review for 10.1186/s12876-023-02940-y (2023)

Title: High prevalence of de novo metabolic dysfunction-associated fatty liver disease after liver
transplantation and the role of controlled attenuation parameter
Version: 1 Date: 20 Apr 2023
Reviewer's report:
Dear authors
Comments to authors:
In this study, Mak et al address that High prevalence of de novo metabolic dysfunction-
associated fatty liver disease after liver transplantation. This study aimed to determine the
prevalence of de novo steatosis and metabolic dysfunction-associated fatty liver disease
(MAFLD) after LT. Controlled attenuation parameter (CAP) was compared with implant liver
biopsy, and also validated in 42 patients with post-LT liver biopsy. The optimal cut-off level
of CAP for diagnosing at least mild (#S1) and moderate-to-severe steatosis (#S2/3) was 266
and 293 dB/m respectively, with AUROC of 0.740 and 0.954 respectively. Using this newly
derived cut-off, 28.9% patients have de novo NAFLD, of which 95.6% fulfilled the criteria
for MAFLD. After multivariate analysis, BMI (HR 1.34), DM (HR 2.01), hypertension (HR
2.03), HDL-cholesterol (HR 0.25), LDL-cholesterol (HR 1.5) and cryptogenic cirrhosis (HR
4.85) were associated with the development of S2/3 graft steatosis. There was no significant
difference in the median liver stiffness between those with S2/3 and S0/1 steatosis (5.4 kPa vs
4.9 kPa, p=0.091). In conclusion, although NAFLD remains an uncommon primary liver disease
indication for LT in Chinese patients, post-transplant de novo graft steatosis is common and
the majority is classified as MAFLD. Development of graft steatosis is not associated with an
increase in graft dysfunction or fibrosis.
COMMENTS
The study is interest and there is some space for improvement. In particular, as presented the
study looks too descriptive in nature with some insights for the observations made.
1. The optimal cut-off level of CAP for diagnosing at least mild (#S1) was 266 dB/m, with
AUROC of 0.740. The AUROC of 0.740 is not good. Do you have a higher AUROC for at
least mild (#S1)?
2. A total of 879 patients underwent LT is a large series for LT and 571 had transient elastography
performed. Why were only 42 patients undergoing biopsy?
3. After LT, 192, 389, and 164 patients developed new onset DM, hypertension, and
dyslipidemia with cumulative rate of 17.9%, 23.8%, and 2.5%, respectively at 1 years. 28.9%
patients have de novo NAFLD. Why was the high perveance for de novo NAFLD, DM,
hypertension, and dyslipidemia?
4. 42 patients with post-LT liver biopsy were done and Correlation of CAP with liver biopsy
after liver transplantation. Do you have CAP data or pathology reports of donor liver before LT
in 42 patients with post-LT liver biopsy?
5. Development of graft steatosis is not associated with an increase in graft dysfunction or
fibrosis. Why is graft steatosis not associated with an increase in graft dysfunction or fibrosis?
Review for 10.1186/s12876-023-02940-y (2023)

Title: High prevalence of de novo metabolic dysfunction-associated fatty liver disease after liver
transplantation and the role of controlled attenuation parameter
Version: 1 Date: 26 Apr 2023
Reviewer's report:
This study validated the use of CAP measurement in post-transplant graft steatosis and the
prevalence of de novo graft steatosis and MAFLD after LT in Chinese patients was determined.
The method used in the study is reliable and the results have certain clinical practical value. I
have several suggestions or concerns as follows.
1. The title doesn’t accurately represent the main content of the study. CAP should be involved
in the title.
2. A detailed structured Inclusion and Exclusion Criteria should be provided.
3. Continuous variables should be tested for normality first, and then the appropriate presentation
and statistical method should be selected based on the results.
4. Whether the P-value is a one-sided or two-sided test needs to be specified.
5. Can the combination of CAP with other MAFLD indicators enhance the ability to predict
fatty liver after liver transplantation.
6. Whether CAP results can facilitate effective clinical interventions needs to be discussed.