JerMa88/BMC_Gastroenterology_Peer_Reviews huggingface dataset:
Review for 10.1186/s12876-024-03212-z (2024)

Title: Prospective, randomized study comparing two different regimens of split-dose
polyethylene glycol and their effect on endoscopic outcomes
Version: 1 Date: 22 Feb 2024
Reviewer's report:
An intriguing question of whether altering the proportion of volume of PEG in a split dose
regimen affects quality of colon cleansing
Introduction
The opening paragraph has a spelling error (endoscopic) and needs references for the last
sentence. The reference for the challenges of colon cleansing (reference 3) isn’t appropriate, as
it is just another RCT and not a review or an overview of the challenges.
I don’t understand why there is a large section on sodium picosulfate when that agent isn’t
studies at all in this paper. PEG-ELS is used by enough people that I don’t think we need a
section talking about a low volume alternative, if that alternative isn’t studied in this paper.
“surfing” the literature is not a scientific term.
Methods:
1) It appears the authors randomized the patients themselves, not an independent research
assistant?
2) Is there a power calculation for sample size?
3) We need a CONSORT diagram for an RCT
4) Were the investigators blinded to treatment assignment, if so, how if they also did the
assigning?
Results:
1) If it was an RCT, why are the final numbers different by 10?
2) The differences in tolerance are interesting, can you give more details on the person
administering the questionnaire?
3) Table one should be split up- patient demographics, then  a table for tolerance, then a table
on procedure results
Review for 10.1186/s12876-024-03212-z (2024)

Title: Prospective, randomized study comparing two different regimens of split-dose
polyethylene glycol and their effect on endoscopic outcomes
Version: 1 Date: 24 Feb 2024
Reviewer's report:
Comments to the author
This is a prospective, randomized study to compare the efficacy and side effect profile of
two different regimens of polyethylene glycol bowel preparation solution: PEG (3+1) vs. PEG
(2+2), and concluded to recommend the use of (2+2) regimen for its superior efficacy in
bowel cleansing. The study is well designed and the result and conclusion is simple and clear
understanding. The text is also carefully described, and slight correction is desired.
Minor comments
1# A change in the order of the items listed in the table 1. is desirable. Please list the “Age” next to
the “Gender”. Order of the primary and secondary outcome is confusing due to the mixed order,
so it would be better to organize them. Specifically, “Presence of adenoma”, “ileal intubation”,
“Boston bowel preparation score”, should be listed at the bottom.
Review for 10.1186/s12876-024-03209-8 (2024)

Title: Dietary inflammatory index in relation to the progression of hepatic steatosis and liver
fibrosis: evaluation by elastography/Fibroscan
Version: 1 Date: 11 Jan 2024
Reviewer's report:
This article revealed the association between the inflammatory possible of the diet and the risk
of progression of hepatic steatosis to fibrosis among patients with NAFLD. There are still the
following problems to be further improved.:
1. Part of the format and the description need to be further adjusted. For example#the unification
of first letters (Page 4 line 92), description on Page 8 line 168#Table 1 T3 group#unit of LS in
Table 3#collection data described in the manuscript were not consistent with the table.
2. The value of liver stiffness to define liver fibrosis needs to be given.
3. Whether the collected dietary data can be analyzed to give further recommendations for
dietary guidance#
Review for 10.1186/s12876-024-03207-w (2024)

Title: London Protocol under water-perfused HRM in a healthy population, towards novel 3D
manometric parameters in an evaluation of anorectal functional disorders
Version: 0 Date: 06 Feb 2024
Reviewer's report:
This is an interesting study showing how much a water-perfused anorectal manometry system
can do.  3D-reconstruction was nice. Results will be useful for a place where the solid-state
catheter is now available.  Here are some questions and comments to consider.
1) Should the upper limit of inclusion "age" be addressed? The lower limit was 18. However,
there was no upper limit.
2) Does the  term "London protocol" in this study refer to the anorectal manometry protocol that
is used in the "London classification"? If this is so, there is no need to find the feasibility because
it is only the description of steps of the procedure.  London classification is not demonstrated
in this study  as the population is normal.
3) 3D-manometric parameters (Endurance complementary parameters: fatigue rate, and
capability to sustain) were interesting. However, these data were derived from calculation  and
clinical relevance are not known. Further study in clinical settings and comparison to the existing
parameter from conventional manometry, such as duration of squeeze and  saline retention would
clarify their role.
4) Included female had vaginal delivery up to 68%. Thus, it was possible that these subjects had
anal sphincter defect to some degree. For this reason, the obtained "normative data" here might
not be normal enough to be a standard comparison to the "diseased patient" who presents with
anal incontinence  or anal sphincter injury.  However, it is understandable that the COVID period
might preclude enrollment of enough number of subjects. Thus, this point should be addressed
in the discussion.
5) From the reason in 4), it could be a reason why  other parameters , e.g. squeeze pressure, and
change during cough, is significantly impaired in female compared to male subjects.
6) Form the reason 4), it could be explained why "asymmetry" was more in female.
7) Table 6: the number of M and F in each study should be addressed only once, may be in
the first row.
7) Under "statistical analysis", t-test ... is more appropriate than T-test.
8) Although, the  water-perfused system is affordable and the authors had demonstrated robusted
information obtained. The "wetness" during procedure, especially a long procedural time with
36-channels water running would lead to discomfort and uncertainty in measurement which
should also be addressed in the discussion.
8) The strenght of this study is the 3D-reconstruction from the 36-channel manometry which
was not frequently showed in the previous literature. Additional description on this point may
elaborate the article.
Review for 10.1186/s12876-024-03207-w (2024)

Title: London Protocol under water-perfused HRM in a healthy population, towards novel 3D
manometric parameters in an evaluation of anorectal functional disorders
Version: 4 Date: 03 Mar 2024
Reviewer's report:
Dear Authors,
Congratulations on you revision. It is understandable and informative, and ready for publication.
Review for 10.1186/s12876-024-03211-0 (2024)

Title: Influential Factors on Disease Activity in Crohn's Disease and Their ROC Curve
Evaluation: A Cross-Sectional Study
Version: 3 Date: 21 Dec 2023
Reviewer's report:
The paper focuses on the clinically important issues in Crohn's disease clinical course .
There are  divergent aims of the study  i.eg Clinical Data Collection  (section 2.2.1 )  referes to
the ulcerative colitis  while  the tittle and aims of the study (whole paper ) is concerning  with
factors influencing Crohn's disease course.
There is no explanation why  other disorders except from diabetes  were not taken into
consideration as a factor influencing on CD activity .
Discussion is very deficient - no comparison to known factors i.eg listed in ECCO.  Each result
has to be compaed with known publications.
As for figures - lacking in explanation of abreviations tah makes the picture illegible.
In total the paper needs several revisions.
Review for 10.1186/s12876-024-03211-0 (2024)

Title: Influential Factors on Disease Activity in Crohn's Disease and Their ROC Curve
Evaluation: A Cross-Sectional Study
Version: 3 Date: 25 Jan 2024
Reviewer's report:
The manuscript addresses a pertinent topic regarding factors affecting CD patients. The study
included a substantial number of participants (n=268); however, only clinical evaluation of the
disease was carried out. Therefore, I have some comments and suggestions to make:
1. Abstract section: In the conclusion, the authors repeat the findings presented in the results.
I suggest changing the conclusion.
2. Introduction section: The anti-inflammatory diet is among the various diets suggested for
managing patients with CD. Despite demonstrating certain positive effects, there is no clear
recommendation for selecting a specific diet in the context of CD. Please rephrase the sentence.
3. Please add the diagnostic criteria established by the Chinese Society of Gastroenterology in
the 'Study Population' section.
4. In the' Clinical Data Collection' section, did the authors mean ulcerative colitis or Crohn's
disease?
5. Which instrument for food intake collection was used to calculate the DII? Please add this
information.
6. Why were fecal calprotectin measurements not performed?
7. Which statistical test was employed to assess the normality of the distribution?
8. Please provide the meaning of the acronym 'M' in the 'Statistical Analysis' section.
9. Please verify the names of the biologic agents in Table 1.
10. Why did the authors categorize patients in remission with mild disease rather than comparing
remission versus activity (mild, moderate, and severe)? The difference in the number of patients
in each group was significant - 183 versus 85.
11. Figure legends: Please provide the meanings of all acronyms appearing in the figures.
12. Discussion - The Importance of Physical Activity: I suggest removing the word 'prevention'
from the fourth line.
13. Discussion - Impact of Dietary Inflammatory Index on Disease Activity in CD Patients: I
suggest changing ‘CD patients are encouraged to increase their intake of foods rich in vitamin
C and vitamin D’ to ‘CD patients are encouraged to increase their intake of fruits, vegetables
and omega-3-fatty acids’.
14. Discussion - Impact of Dietary Inflammatory Index on Disease Activity in CD Patients:
Please add and discuss studies on the effects of the DII in CD.
Review for 10.1186/s12876-024-03197-9 (2024)

Title: Safety and efficacy of a low-dose combination of midazolam, alfentanil, and propofol for
deep sedation of elderly patients undergoing ERCP
Version: 1 Date: 24 Nov 2023
Reviewer's report:
PEER REVIEWER ASSESSMENTS:
OBJECTIVE - Full research articles: is there a clear objective that addresses a testable research
question(s) (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?
No - there are minor issues
EXECUTION - Are the experiments and analyses performed with technical rigor to allow
confidence in the results?
No - there are minor issues
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 - Is the current version of this work technically
sound? If not, can revisions be made to make the work technically sound?
Probably - with minor revisions
PEER REVIEWER COMMENTS:
GENERAL COMMENTS: Thank you for the opportunity to review this manuscript.
Overall, I think the study would benefit from a) renaming the study to include midazolam
in the drug combination name (as the authors themselves due in the conclusion), b) to better
establish safety or better inform any sort of dosing changes, I would recommend a middle
aged (maybe 50-65 yr old) comparator group.  It would seem that the authors' intention is to
establish safety of this regimen during ERCP for elderly patients where there is a scant amount of
literature - therefore, you should include a comparison to younger or better studied age groups.
c)  Throughout the paper, the term "elderly" is use - I would establish what the age group is as
early as possible.  Is it generally accepted that "elderly" is > 65 yrs?  Or is it .70, 75, etc?  d)
I would represent the doses in mg/kg propofol, mcg/kg alfentanil, and then include total dose
of midazolam.
Overall, the paper is easy enough to read, but would benefit from a comparator group and some
clarity on doses in order to best replicate what the authors' practice is.
REQUESTED REVISIONS:
Would include a control group of younger patients to better gauge safety of this combination
of drugs in an older patient population.  If no/limited data exist for older patients, comparing a
group of older (65-79) and even older (> 80) patients isn't the right initial approach
Review for 10.1186/s12876-024-03197-9 (2024)

Title: Safety and efficacy of a low-dose combination of midazolam, alfentanil, and propofol for
deep sedation of elderly patients undergoing ERCP
Version: 2 Date: 21 Jan 2024
Reviewer's report:
PEER REVIEWER ASSESSMENTS:
OBJECTIVE - Full research articles: is there a clear objective that addresses one or several
testable research questions? (Brief or other article types: is there a clear objective?)
Yes - there is a clear objective
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for
the objective?
Yes - the approach is appropriate
EXECUTION - Are the experiments and analyses performed with sufficient technical rigor to
allow confidence in the results?
Yes - experiments and analyses were performed appropriately
STATISTICS - Is the use of statistics in the manuscript appropriate?
Not sure - I am not able to assess the statistics in this 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: Thank you for the thoughtful responses to the original critique of
this manuscript.  The inclusion of a middle-aged comparator group strengthens the authors'
conclusions, although I would ensure to draw attention to the need for lower doses of medications
utilized in the elderly and very elderly group.  This is consistent with known needs for lower
doses in older patients to achieve similar therapeutic effects and minimize adverse reactions.
This should be reflected somewhere in the conclusion and abstract.
My only remaining suggestion is that the discussion is fairly lengthy and meandering, which
loses the main ideas in the amount of data from other studies presented in the text.  I would work
to summarize these studies and background data to make a more cohesive discussion.
REQUESTED REVISIONS:
See prior comments.  I am unable to appropriately evaluate the statistics - the inclusion of
three groups makes the statistical analysis a little more complicated.  An ANOVA test is likely
appropriate, but there may need to be a three way test for categorical data.
ADDITIONAL REQUESTS/SUGGESTIONS:
None as from what have previously been described
Review for 10.1186/s12876-024-03197-9 (2024)

Title: Safety and efficacy of a low-dose combination of midazolam, alfentanil, and propofol for
deep sedation of elderly patients undergoing ERCP
Version: 2 Date: 28 Jan 2024
Reviewer's report:
I am very pleased to review this article edited according to the suggestions given during the peer
review process. I believe that all the reservations raised have been effectively addressed and the
paper is harmonious and ready to be published.
Review for 10.1186/s12876-024-03204-z (2024)

Title: Management of hepatocellular carcinoma, an important cause of death in Japanese
autoimmune hepatitis patients
Version: 3 Date: 11 Feb 2024
Reviewer's report:
The authors investigated the characteristics of hepatocellular carcinoma (HCC) in autoimmune
hepatitis (AIH) patients. They found that HCC could occur as the duration of AIH. Cirrhosis at
the diagnosis of AIH was defined as a risk factor for carcinogenesis. Although the content of
this study is interesting, the following points need to be addressed:
Major
1. The main findings that cirrhosis as the risk for hepatocarcinogenesis is widely accepted. There
must be some additional new findings to define the result as new. Is there any difference between
old cases and recent cases?
2. Since the diagnosis of cirrhosis involves subjective factors, why don’t you consider what
would happen if you did a multivariate analysis using only objective factors?
Review for 10.1186/s12876-024-03204-z (2024)

Title: Management of hepatocellular carcinoma, an important cause of death in Japanese
autoimmune hepatitis patients
Version: 3 Date: 14 Feb 2024
Reviewer's report:
The study retrospectively analyzed the risk factors and prognosis of HCC in patients with AIH.
As already established in the other studies performed in  patients with viral and non viral liver
disease etiology , cirrhotic stage  was significantly associated with the risk of HCC development
in the multivariate analysis (OR 41,  p< 0.0001). The autoimmune etiology made difficult the
therapeutic management as immune checkpoint inhibitors were not used due to autoimmune
etiology and two of the three patients treated with molecular-targeted drugs discontinued the
treatment because of adverse events.
The interest of this study mainly relies on the poorly explored HCC occurrence in AIH patients
so far. However, there are important issues requiring attention.
- HCC cohort patient: of the 131 enrolled patients,  there were 44 patients with AIH/PBC
patients. The authors used the AIH revised score for the diagnosis of AIH and the Paris criteria
for the diagnosis of AIH/PBC overlap syndrome. A pivotal study of Czaja, demonstrated that
the simplified score has greater specificity and predictability for AIH than the revised original
system, and it more commonly excluded the diagnosis in other diseases with concurrent immune
features (DOI: 10.1002/hep.22513).  Importantly, in clinical practice, the simplified AIH score
has been validated in an AIH cohort including  AIH/PBC overlap patients, as previously reported
(doi: 10.1002/hep.22825.). It's therefore of significant importance to report the simplified AIH
scores of AIH and  AIH/PBC patients discussing this clinically relevant point and the validated
use of the simplified criteria in AIH/PBC overlap cases.
- It would be of significant interest to include matched control groups of pure PBC patients and
HCV/HBV patients to compare the rate of HCC occurence and clinical features of the different
etiologies.
-To further evaluate the characteristics of patients developing HCC, it is necessary describing
the treatment as well as treatment response according to established criteria (AASLD guidelines
DOI: 10.1002/hep.31065 ) .
-of the three HCC patients receiving molecular target therapy, one received sorafenib and one
lenvatinib. The third one?
Review for 10.1186/s12876-024-03213-y (2024)

Title: Impact of severe postoperative complications on the prognosis of older patients with
colorectal cancer: A two#center retrospective study
Version: 1 Date: 21 Aug 2023
Reviewer's report:
First of all, I'd like to salute the authors for their fine work. The writing is good and clear, but
my judgment is limited as a non-English speaker.   The article is acceptable, with one minor
remark to clarify.
Was the type of chirurige different between the groups? Right colectomy versus left colectomy,
number of temporary / definitive stomas, proportion of cancer in occulsion?
Review for 10.1186/s12876-024-03213-y (2024)

Title: Impact of severe postoperative complications on the prognosis of older patients with
colorectal cancer: A two#center retrospective study
Version: 1 Date: 11 Oct 2023
Reviewer's report:
I congratulate with authors for the correct methodology of the study  and the adherence  of
the data to major scientific Society.However,as declared by Authors,the study shows important
limitations  and  the  results are not particularly significant compared to previous  studies about
the topic.Despite  it all  the acceptance for publication could be considered  into account  the
frequent  current colorectal surgery  in over 80 yrs patients.
Review for 10.1186/s12876-024-03213-y (2024)

Title: Impact of severe postoperative complications on the prognosis of older patients with
colorectal cancer: A two#center retrospective study
Version: 1 Date: 24 Oct 2023
Reviewer's report:
Dear author thank you for your submission to BMC. The paper you wrote is interesting and
actual, however there some point I need to fix. The population is wide, but the two cohort are not
well balanced, so I suggest to perform a propensity score matched analysis and then re-evaluate
results and resubmit the paper.
Review for 10.1186/s12876-024-03213-y (2024)

Title: Impact of severe postoperative complications on the prognosis of older patients with
colorectal cancer: A two#center retrospective study
Version: 4 Date: 06 Jan 2024
Reviewer:  Giovanni Tomasicchio
Reviewer's report:
In this retrospective, bi-centre study the authors aimed to investigate the impact of severe
postoperative complications on the oncological outcomes of older and non-older patients with
CRC. The study shows important limitations and there is not particularly novelty in the
results compared to previous studies. However, the authors used the correct methodology and
propensity score matching analysis to control possible cofounders.
I have several questions/comments for the authors:
- In your analysis, you considered only adjuvant chemotherapy, but any patients underwent to
neoadjuvant chemo-radiotherapy for colorectal cancer?
- Moreover, precise if patients were treated in elective or in urgency setting and compare it
between groups.
- In your discussion you need to compare your results with those already present in literature.
Your hypothesis about the post-operative inflammation status of older patients needs more data,
moreover you did not evaluate inflammation post-operative marker in your study.
Review for 10.1186/s12876-024-03213-y (2024)

Title: Impact of severe postoperative complications on the prognosis of older patients with
colorectal cancer: A two#center retrospective study
Version: 4 Date: 10 Jan 2024
Reviewer's report:
The authors have responded appropriately to the reviwers' comments, providing additional data.
i do not have any substantial amendments to suggest.
Review for 10.1186/s12876-024-03213-y (2024)

Title: Impact of severe postoperative complications on the prognosis of older patients with
colorectal cancer: A two#center retrospective study
Version: 6 Date: 09 Feb 2024
Reviewer:  Giovanni Tomasicchio
Reviewer's report:
Dear Author, after revisions the paper as been improved and it is suitable for publication
Review for 10.1186/s12876-024-03187-x (2024)

Title: Endoscopic diagnosis of gastric and oesophageal cancer in Lusaka, Zambia: A
retrospective analysis
Version: 1 Date: 25 Oct 2023
Reviewer's report:
The article submitted is worthy of publication. It adds important data  to the  the knowledge
base regarding gastroenterology and upper GI malignancy in sub Saharan Africa . The authors
have extrapolated the findings from ne academic endoscopy centre in Zambia to the whole of
Zambia. As we are not presented with demographic data it is not possible to ascertain whether
these data represent an urban population of Lusaka or the general population of Zambia. Is the
Lusak aendoscopy still the only endoscopy centre in Zambia.
Is Helicobacter pylori status routinely checked at endoscopy are tese data available?
Review for 10.1186/s12876-024-03187-x (2024)

Title: Endoscopic diagnosis of gastric and oesophageal cancer in Lusaka, Zambia: A
retrospective analysis
Version: 3 Date: 21 Feb 2024
Reviewer's report:
This is an important body of work. The authors have adequately addressed all the comments,
and when this was not possible, provided reasonable justification.
Review for 10.1186/s12876-024-03163-5 (2024)

Title: Comparative efficacy and safety of subcutaneous infliximab and vedolizumab in patients
with Crohn’s disease and ulcerative colitis included in randomised controlled trials
Version: 2 Date: 01 Jun 2023
Reviewer's report:
The paper by Peyrin-Biroulet et al compared indirectly the efficacy and safety of sc infliximab
vs i.v. vedolizumab in Crohn's and of sc infliximab vs iv/sc Vedolizumab in UC using former
RCTs.
It is not clear to me why RCTs with only iv VEDO were included (on page 11, line the authors
stated that IFX i.v. studies included in a meta-analysis published in BMC Gastro in 2022 did
not met the eligibility criteria, why? before 2010?); or better why was Visible 2 not included?
(it has been published on January 2022.
Crohn's analysis: 1 study with IFX s.c. and 2 studies with Vedo i.v
UC analysis: 1 study with IFX s.c., 2 studies with Vedo i.v., 1 study with vedo sc after iv
induction
Study characteristics: the authors refer to their previous paper BMC Gastro 2022
Title: should include that the comparison is carried out on RCTs  + data from the manufacturer
of CTP13 sc
I think that the paper is importantly hampered by the exclusion  of the Visible 2 study
In the previous paper (ref 9 BMC Gastro 2022) visible 1 and CTP13 s.c. were already included
Conclusions are similar to that in the previous paper; besides the inclusion of a minor number
of RCTs in the present paper, the differences should be better explained at least in Discussion
Review for 10.1186/s12876-024-03163-5 (2024)

Title: Comparative efficacy and safety of subcutaneous infliximab and vedolizumab in patients
with Crohn’s disease and ulcerative colitis included in randomised controlled trials
Version: 2 Date: 08 Jun 2023
Reviewer's report:
Although the Title may appear appealing interesting for audience  who mostly go through the
abstract of the study .I have certain reservations which are enumerated below
1. The basic concept of the study where a SC bio similar(CT-P13) is being compared to originator
IV or SC VDZ. Abstract does not mention the point pertaining to bio similar anywhere which
might be misleading to readers.
2. The numbers are too small in SC bio similar group as compared to VDZ and also Pharma
sponsored  additional data was added to biosimilar group, which is still unpublished. As per my
understanding 2-3 RCTS with generally comparative numbers in each group would be ideal for
comparative Analysis
3. The comparison lacks numbers and has very heterogenous population (TNFi exposure) which
limits drawing such simplified conclusions as projected by authors
Review for 10.1186/s12876-024-03163-5 (2024)

Title: Comparative efficacy and safety of subcutaneous infliximab and vedolizumab in patients
with Crohn’s disease and ulcerative colitis included in randomised controlled trials
Version: 3 Date: 15 Oct 2023
Reviewer's report:
i have read the author's response thoroughly and find the revisions don't address the comments
satisfactorily. In my opinion, the comparison is not updated despite the published available data.
skewed data and heterogeneous populations from very limited numbers may provide data that
may not be true.
Review for 10.1186/s12876-024-03163-5 (2024)

Title: Comparative efficacy and safety of subcutaneous infliximab and vedolizumab in patients
with Crohn’s disease and ulcerative colitis included in randomised controlled trials
Version: 3 Date: 18 Oct 2023
Reviewer's report:
the authors addressed  all questions I'd raised
unfortunately Visible 2 remaines excluded
Review for 10.1186/s12876-024-03208-9 (2024)

Title: Patients with chronic hepatitis B who have persistently normal alanine aminotransferase
or aged < 30 years may exhibit significant histologic damage
Version: 0 Date: 04 Jan 2024
Reviewer's report:
A. General Comments:
1. English language of the text needs considerable polishing. Correct some typing errors.
2. It is advisable that authors compare their histological findings to those of patients with an
ALT cutoff at 30 U/L for males and 19 U/L for females (Hepatology 2010; 51:1577, Hepatology
2012; 55:447) and also to the group of patients with ALT #40 IU/L and HBV DNA <2000 IU/
mL. Report any respective group differences of the corresponding stage and grade.
B. Major Comments:
1. (Line 2): Consider “may exhibit”.
2.  (Line 25): Authors should clarify whether “normal ALT” values were those at presentation
(baseline) only, or “persistently normal” ALT levels, observed over a defined time period.
3. (Line 25): The histological scoring system must appear at this point.
4. (Line 49-51): Please consider a change in this sentence. HBV DNA non detectability is the
expected outcome of nucleos(t)ide analog treatment for all patients. What is infrequent is the
elimination or seroconversion of HBsAg.
5. (Line 58): Authors must be aware that the term “inactive HBV carriers” (Hepatology
2018;67;1560) or “HBeAg-negative chronic HBV infection” (J Hepatol 2017;67:370), or “low
replicative chronic HBV infection” (Hepatol Int 2016;10:1), includes HBeAg-negative patients
with persistently normal serum ALT, HBV DNA #2000 IU/mL (and HBsAg #1000 IU/mL) and
not only HBeAg-negative patients with normal serum ALT.
6. (Line 89): Please mention whether the HBV DNA examination was made by qualitative or
quantitative PCR.
7. (Line 89): What percentage of HBsAg-positive patients, conforming with criteria 1 & 2,
underwent a liver biopsy? What was the total number of patients with HBV infection and co-
infection seen between 1999 and 2003 in the authors’ Center?
8. (Line 109): Please report of any major side effects of the liver biopsy procedure.
9. (Table 1, Line 3): In the footnote, the authors must indicate the upper limit of normal of AST,
ALT and GGT.
10. (Table 1, Male sex): Please discuss whether the great preponderance of males in your cohort
was due to limited hospital access of females or to other reasons.
11. (Table 1, Footnote): The number (and percentage) of HBeAg-positive and -negative patients
should appear in the Table.
12. (Table 2):  Tables 1 & 2 can be combined.
C. Minor Comment:
(Line 460): “Two subgroups”. Please correct and elsewhere.
Review for 10.1186/s12876-024-03208-9 (2024)

Title: Patients with chronic hepatitis B who have persistently normal alanine aminotransferase
or aged < 30 years may exhibit significant histologic damage
Version: 2 Date: 06 Feb 2024
Reviewer:  Leon Louis Seifert
Reviewer's report:
As pointed out in my first review report, the findings presented by Wei et al. are very interesting
especially with regard to ongoing discussions concerning the questions when and in whom to
start antiviral therapy in HBV infected individuals. Very commonly it is recommended not to
start antiviral therapy in patients <30. This manuscript shows that even in patients <30 and
even in patients without ALT elevation, significant fibrosis can be observed. These findings
can potentially contribute to current discussions which may result in lowering the threshold to
antiviral therapy in these particular groups of patients. The large cohort size reported in this
manuscript promises that these findings are potentially generalizable. It has to be kept in mind
though, that important HBV patient parameters differ among regions (HBV genotypes, life-
style, way of transmission etc.). Most of these are nicely discussed by the authors.
The authors have addressed most of the points I have raised in my initial review report. I
understand that due to retrospective character of this study, many parameters cannot be reported.
Given the fact that a large amount of this data has been extracted from non-electronic patient
files in times when a lot of HBV parameters I requested were not routinely available, I accept
that this data cannot be provided by the authors.
Nonetheless I believe that the results of this study are exciting and well presented and I therefor
recommend to accept this manuscript for publication.
I recommend though to add minor changes to the results part 3.3 Factors associated with
significant liver histological damage. In addition to the p-values, the OR should be provided
in the text.
Review for 10.1186/s12876-024-03208-9 (2024)

Title: Patients with chronic hepatitis B who have persistently normal alanine aminotransferase
or aged < 30 years may exhibit significant histologic damage
Version: 2 Date: 10 Feb 2024
Reviewer:  Emanuel K. Manesis
Reviewer's report:
1. (Line 1): The authors should replace everywhere in the text the phrase “normal ALT” with
“persistently normal ALT”.
2.  Line 112-113): Authors should mention the number of patients tested with the “pre-2002
Digene test” and the current Cobas-Monitor test. They must, also,  define the commercial source
of both tests and their respective lower level of detectability.
3. (Line 124, Statistical analysis): The authors are advised to compare patients with undetectable
HBV DNA by the Digene method to those with # 2000 IU/mL by Cobas-Monitor. There is a
strong possibility that finding high percentages of advanced fibrosis and necroinflammation in
their cohort of naïve HBV-infected patients with persistently normal ALT is due to inadverted
inclusion of chronic hepatitis B patients with high HBV DNA in the older sample.
Review for 10.1186/s12876-024-03208-9 (2024)

Title: Patients with chronic hepatitis B who have persistently normal alanine aminotransferase
or aged < 30 years may exhibit significant histologic damage
Version: 4 Date: 14 Mar 2024
Reviewer:  Leon Louis Seifert
Reviewer's report:
I have no further comments and would like to congratulate the authors for conducting this
interesting retrospective study.
Review for 10.1186/s12876-024-03205-y (2024)

Title: Evaluating the Efficacy of Different Volume Resuscitation Strategies in Acute
Pancreatitis Patients: A Systematic Review and Meta-Analysis
Version: 1 Date: 21 Jan 2024
Reviewer's report:
You have processed through a meta-analysis the majority of studies regarding volume
resuscitation in severe acute pancreatitits. That what I would emphasize is the comparison
between early and late fluid resuscitation.
You also mentioned the type of infused crystalloids, but I didn't find anything on balanced
crystalloids.
The meta-analysis was detailed and in your Conclusion you emphasize "the lack of robustness of
studies that vividly and analytically provided a uniform comparison between low vs. moderate
vs. high fluid therapy, this study recommends further research, including recent studies with
high methodological quality, to validate the findings of this study". I deffinitely agree with that.
Review for 10.1186/s12876-024-03205-y (2024)

Title: Evaluating the Efficacy of Different Volume Resuscitation Strategies in Acute
Pancreatitis Patients: A Systematic Review and Meta-Analysis
Version: 1 Date: 28 Jan 2024
Reviewer:  Kamil Safiejko
Reviewer's report:
This thesis delves into the critical issue of fluid resuscitation in acute pancreatitis, presenting
a logical and concise introduction that seamlessly guides the reader into the heart of the
research problem. A meticulous analysis of 38 contemporary studies, including both randomized
controlled trials and retrospective analyses, underscores the comprehensive nature of our
literature review.
Central to this thesis is a meta-analysis of 12 selected studies, encompassing a cohort of 4,667
patients—a sizeable sample for such research in this domain. The clarity and precision of our
visual aids—figures, tables, and graphs—complement the textual narrative, free from significant
substantive errors.
Statistical rigor is maintained through the use of meta-analysis techniques, a standard in
data synthesis across multiple studies. We employ odds ratios and confidence intervals for
assessment, ensuring robustness in our findings. Moreover, the consideration of heterogeneity
among studies enhances the reliability of our conclusions.
While the thesis effectively proposes further research in the field, it could be enriched by a more
detailed exploration of the clinical implications of these findings in the broader context of acute
pancreatitis treatment. A clearer articulation of specific future research directions would further
strengthen this work's contribution to the field.
Future Research Directions: Provide more detailed suggestions for future research, perhaps
including potential study designs or specific areas of inquiry?
Statistical Analysis Discussion: Elaborate on the choice of statistical methods, explaining their
suitability and potential limitations in the context of this study?
Review for 10.1186/s12876-024-03201-2 (2024)

Title: Optimizing LI-RADS: Ancillary features screened from LR-3/4 categories can improve
the diagnosis of HCC on MRI
Version: 1 Date: 09 Jan 2024
Reviewer's report:
This study tried to screen out the favorable AFs to upgrade a LR-3/4 observation, intending to
improve the sensitivity for HCC. This is a good idea because until now, the use of AFs is on
the radiologists' bias and LI-RADS has not clearly illustrate which AFs are more important for
upgrading an observation.
However, there were some problems as follows:
1. Manuscript needs a language revision, a lot of sentences were difficult to understand. auxiliary
should be ancillary.
2. The inclusion and exclusion criteria were not clear. Are all of the patients underwent
MRI? What contrast-enhanced agent was used (extracellular or hepatobilliary contrast-enhanced
agent)? What interval between MRI and pathology can be included/excluded? What is the least
follow-up time can be included/excluded? Can an observation treated before MRI be included?...
3. The upgraded and downgraded argorithm were not clear. Is it allow for a LR-4 observation
upgrade to LR-5? Is it allow for a LR-3 observation upgrade to LR-5? In what situation is a
LR-3  observation upgraded to LR-4, and in what situation it is upgraded to LR-5?
4. The presentation of the manuscript was a bit in chaos. Some parts in the "Reference standard
should move to "Results". Some parts in the "Discussion" should move to "Results".
5. Table 5 is difficult to understand.
Review for 10.1186/s12876-024-03201-2 (2024)

Title: Optimizing LI-RADS: Ancillary features screened from LR-3/4 categories can improve
the diagnosis of HCC on MRI
Version: 6 Date: 25 Feb 2024
Reviewer:  Sidong Xie
Reviewer's report:
1. In the inclusion criteria, "nodules" were still used in Figure 1, while in the Materials and
Methods section,  "nodules" or "lesions" were used. In order to standardization and uniformity,
it is recommended to change to "observations" or "lesions".
2. What does" *" represent in Tables 3 and 4? Please add a note
3. In Figure 2, the measurement of lesion size is not described, and how to use LI-RADS for
classification#What does the mean of this sentence “The nodule was classified into LR-4 in
addition to the major features and based on AF-HCC, especially TP hypointensity, it can be
upgraded. ”
4. A similar problem also appears in Figure 3.
Review for 10.1186/s12876-024-03191-1 (2024)

Title: Perioperative outcomes of the surgical management of achalasia in two tertiary
Cameroonian hospitals: a cohort study
Version: 1 Date: 31 Oct 2023
Reviewer:  Ahmed Elgeidie
Reviewer's report:
I think your work is good enough to be  published. The study design, the scientific writings and
the work outline are satisfactory.
Review for 10.1186/s12876-024-03191-1 (2024)

Title: Perioperative outcomes of the surgical management of achalasia in two tertiary
Cameroonian hospitals: a cohort study
Version: 1 Date: 26 Nov 2023
Reviewer:  Ibrahima Konaté
Reviewer's report:
This article discusses an interesting topic. It could be a good contribution to provide data from
Africa, but there are many concerns with the methodology.
I recommend a major revision and a professional language edition.
The title could be reduced in length
The introduction should be concise and focused on the subject.
The study's objectives need to be clarified.
I am not sure it is  a good option to mix laparoscopic patients and laparotomy patients;
The selection process for patients needs to be clarified.
The data collected in the methodology section differ from those mentioned in the result section.
The surgical management section is confusing.
Please provide intra operative images.
There is potential Figure 2 to be of better quality
The inscriptions in Table 2 are written in both French and English
The discussion section must be rewritten to focus on the main goals and highlight the study's
limitations.
The laparoscopic approach is the best option for surgical treatment of achalasia, and most of
your patients underwent laparotomy procedures, that requires a clear explanation.
Review for 10.1186/s12876-024-03191-1 (2024)

Title: Perioperative outcomes of the surgical management of achalasia in two tertiary
Cameroonian hospitals: a cohort study
Version: 3 Date: 10 Jan 2024
Reviewer:  Ibrahima Konaté
Reviewer's report:
The manuscript has been improved.
Having higher-quality images would be beneficial.
Review for 10.1186/s12876-024-03191-1 (2024)

Title: Perioperative outcomes of the surgical management of achalasia in two tertiary
Cameroonian hospitals: a cohort study
Version: 6 Date: 23 Feb 2024
Reviewer's report:
PEER REVIEWER ASSESSMENTS:
OBJECTIVE - Full research articles: is there a clear objective that addresses one or several
testable research questions? (Brief or other article types: is there a clear objective?)
Yes - there is a clear objective
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for
the objective?
Yes - the approach is appropriate
EXECUTION - Are the experiments and analyses performed with sufficient technical rigor to
allow confidence in the results?
Yes - experiments and analyses were performed appropriately
STATISTICS - Is the use of statistics in the manuscript appropriate?
Yes - appropriate statistical analyses have been used in the study
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not
overstated?
Yes - the author's interpretation is reasonable
OVERALL MANUSCRIPT POTENTIAL - Has the author addressed your concerns sufficiently
for you to now recommend the work as a technically sound contribution? If not, can further
revisions be made to make the work technically sound?
Yes - current version is technically sound
PEER REVIEWER COMMENTS:
GENERAL COMMENTS: HAVE THE AUTHORS RESPONDED ADEQUATELY TO
EACH OF THE QUESTIONS YOU RAISED IN YOUR COMMENTS
Yes well done authors
HAVE THEY MADE THE APPROPRIATE CHANGES IN THE MANUSCRIPT
Yes well done authors
WHAT IS YOUR OVERALL IMPRESSION OF THE REVISED MANUSCRIPT
This is ready to be published.  The
minor changes I suggest can be delt with by journal editor . Excellent study !
ADDITIONAL REQUESTS/SUGGESTIONS:
ARE THERE ANY ADDITIONAL REVISIONS THE AUTHORS SHOULD MAKE
I have re-read the entire manuscript  all my suggestions are minor and will only to buff it up a
bit.  AUTHORS CONGRATULATIONS THIS IS  A REALLY GOOD SUBMISSION- Well
down you should be proud of this study!
1.line 143 change to “Student’s”
2. Line 167 change to 1.0+\- 1.1
3. Line 192 and 376 change to esophagocardiomyotomy
4.line 199. I would change the word “barium” to “radiographic contrast” I’d really barium
wouldn’t be used because debasement of barium in periesophageal tissues is quite difficult.
Probably a water soluble agents was used d so stick with “radiographic contrast”
5. Line 275. Change gender to “sex” and suggest ending the sentence with “for as yet unknown
reasons”. That will at least acknowledge the presence of a female preponderance in  relation to
other series else where ( not just Africa).
6. Line 377.  The word of dilaceration is used in dentistry and not here change to “myotomy
Review for 10.1186/s12876-024-03193-z (2024)

Title: Characterization of Primary Small Intestinal Lymphoma: A Retrospective Study Based
on Double Balloon Endoscopy
Version: 2 Date: 22 Nov 2023
Reviewer's report:
The authors conducted a retrospective study of primary small intestinal lymphoma
characteristics. Although some interesting points are acknowledged, some severe problems
exist.
Major
1. The authors noted in their results that deep ulcers and aneurysmal dilation were associated
with prognosis, emphasizing the prognosis of primary small intestinal lymphoma.
However, the Introduction is inadequate because it does not include information on the prognosis
of primary small intestinal lymphoma, including previous reports.
2. Need for more description of statistical analysis.
What methods were used to perform a multivariate analysis of factors associated with prognosis?
Was the multivariate analysis using the Cox proportional hazards model, and how were the
factors selected for multivariate analysis?
3. It is disconcerting that factors associated with prognosis in multivariate analysis have odds
ratios less than 1. Does this mean the prognosis is better if there are deep ulcers and aneurysmal
dilation?
Minor
1.  The breakdown of the 30 patients is difficult to understand. I believe it should be stated
as follows "Among them, 30 were diagnosed with SIL, including 10 (33.3%) with diffuse
large B-cell lymphoma (DLBCL), 11 (21.3%) with indolent B cell lymphoma (7 follicular
lymphoma(FL), 4  with mucosa-associated lymphoid tissue lymphoma (MALT)), 9 (27.3%)
with T-cell lymphoma (5 PTCL, 3 NK/T and 1 MEITL)."
Review for 10.1186/s12876-024-03193-z (2024)

Title: Characterization of Primary Small Intestinal Lymphoma: A Retrospective Study Based
on Double Balloon Endoscopy
Version: 2 Date: 14 Dec 2023
Reviewer:  Yuichiro Ikebuchi
Reviewer's report:
Although this is a report of a small number of cases from a single institution, we believe it is an
important contribution, given the scarcity of reports on small intestinal lymphoma.
Below are the issues I noticed:
1. In Table 3, what was the level of soluble IL-2 receptor in the laboratory examination?
2. What is the definition of "Aneurysmal dilation"? If possible, please add a typical image to
Figure 1.
3. Please define "deep ulcers," as in comment 2. If possible, add a typical image to Figure 2.
4. The sentence "Multivariate analysis showed that deep ulcers (p = 0.019, OR 0.028, 95% CI:
0.001-0.555) and aneurysmal dilation (p = 0.035, OR 0.057, 95% CI: 0.004-0.817) had statistical
significance for prognosis" would be more coherent if it were moved to the "Therapy and Clinical
Outcome" section."
Review for 10.1186/s12876-024-03193-z (2024)

Title: Characterization of Primary Small Intestinal Lymphoma: A Retrospective Study Based
on Double Balloon Endoscopy
Version: 5 Date: 04 Jan 2024
Reviewer:  Yuichiro Ikebuchi
Reviewer's report:
The manuscript has been much improved and is in a nice condition now.