JerMa88/BMC_Gastroenterology_Peer_Reviews huggingface dataset:
Review for 10.1186/s12876-025-03635-2 (2025)

Title: The Prognostic Value of Systemic Inflammation Response Index in Digestive System
Carcinomas: A Systematic Review and Meta-Analysis
Version: 4 Date: 19 Dec 2024
Reviewer's report:
There are still concerns on heterogeneity, but authors tried their best to address the reviews.
Review for 10.1186/s12876-025-03635-2 (2025)

Title: The Prognostic Value of Systemic Inflammation Response Index in Digestive System
Carcinomas: A Systematic Review and Meta-Analysis
Version: 5 Date: 23 Dec 2024
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
changes are satisfactory, can be accepted for publication.
Review for 10.1186/s12876-025-03628-1 (2025)

Title: Magnitude, Patterns, and Factors Associated with Liver Disease among Clinically
Suspected Clients in Eastern Ethiopia: Hidden Public Health Tragedy
Version: 4 Date: 04 Jul 2024
Reviewer:  Pantong Davwar
Reviewer's report:
1. Few modifications as suggested in track changes in the text.
2. Certain definitions have to be made clear , like cirrhosis  and CLD
Review for 10.1186/s12876-025-03628-1 (2025)

Title: Magnitude, Patterns, and Factors Associated with Liver Disease among Clinically
Suspected Clients in Eastern Ethiopia: Hidden Public Health Tragedy
Version: 7 Date: 27 Dec 2024
Reviewer's report:
PEER REVIEWER ASSESSMENTS:
OBJECTIVE - Full research articles: is there a clear objective that addresses one or several
testable research questions? (Brief or other article types: is there a clear objective?)
Yes - there is a clear objective
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for
the objective?
No - there are minor issues
EXECUTION - Are the experiments and analyses performed with sufficient 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 - 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?
Maybe - with major revisions
PEER REVIEWER COMMENTS:
GENERAL COMMENTS: The authors have responded to most of the comments and concerns
raised in the previous revision. However, there is still a lack of information regarding patient
selection.
REQUESTED REVISIONS:
A major unanswered concern is still the selection of patients, since additional data and flowchart
in figure 1 do not provide enough information to clarify this point. Indeed, figure 1 should be
clarified or removed since it is very unclear how many patients were screened (either outpatient
visitors or clients with one or more signs and symptoms of liver disease), how the number of
388 patients was reached, and why 388 patients instead of 422 were interviewed. This point is
critical because a bias in the selection of patients greatly limits the potential generalization and
application of this manuscript.
In case the authors do not have additional data, apart from clarifying (or removing) figure 1,
they could provide general demographics of outpatient visitors or general population or compare
with other data available from other studies to analyze if their sample is representative of their
population.
Also, in my previous revision I pointed out that “The exclusion of patients with pre-existing liver
disease (n=16) is mentioned in the response document but should be more clearly explained in
the manuscript.” This has not been responded to by mistake.
Review for 10.1186/s12876-025-03628-1 (2025)

Title: Magnitude, Patterns, and Factors Associated with Liver Disease among Clinically
Suspected Clients in Eastern Ethiopia: Hidden Public Health Tragedy
Version: 8 Date: 03 Jan 2025
Reviewer's report:
PEER REVIEWER ASSESSMENTS:
OBJECTIVE - Full research articles: is there a clear objective that addresses one or several
testable research questions? (Brief or other article types: is there a clear objective?)
Yes - there is a clear objective
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for
the objective?
No - there are minor issues
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?
No - there are issues with the statistics 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?
Probably - with minor revisions
PEER REVIEWER COMMENTS:
GENERAL COMMENTS: The authors have adequately addressed the main question raised in
the previous round of comments.
REQUESTED REVISIONS:
The authors have adequately addressed the main question raised in the previous round of
comments.
The only comment is that Figure 1 requires the following amendments:
• Horizontal arrows should point to the right to indicate that patients are "out of" the flow.
• Remove the square containing the text: "Based on the sequence of detection for liver disease
suspect, samples were included every two interval. Detailed interview, laboratory tests, and
imaging were employed."
Review for 10.1186/s12876-025-03628-1 (2025)

Title: Magnitude, Patterns, and Factors Associated with Liver Disease among Clinically
Suspected Clients in Eastern Ethiopia: Hidden Public Health Tragedy
Version: 9 Date: 18 Jan 2025
Reviewer's report:
PEER REVIEWER ASSESSMENTS:
OBJECTIVE - Full research articles: is there a clear objective that addresses one or several
testable research questions? (Brief or other article types: is there a clear objective?)
Yes - there is a clear objective
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for
the objective?
No - there are minor issues
EXECUTION - Are the experiments and analyses performed with sufficient 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 - Has the author addressed your concerns sufficiently
for you to now recommend the work as a technically sound contribution? If not, can further
revisions be made to make the work technically sound?
Yes - current version is technically sound
PEER REVIEWER COMMENTS:
GENERAL COMMENTS: The authors have adequately responded to my concerns and the
manuscript has improved.
REQUESTED REVISIONS:
No further revisions are needed
Review for 10.1186/s12876-025-03614-7 (2025)

Title: High output stoma after surgery for rectal cancer - A risk factor for Low Anterior
Resection Syndrome?
Version: 1 Date: 02 Dec 2024
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Authors , please address the following points below
-The study establishes a significant association between high-output stomas (HOS) and low
anterior resection syndrome (LARS); however, it fails to examine the underlying mechanisms
that contribute to this relationship. For example, inquiries regarding how the altered physiology
associated with a high-output stoma—such as fluid and electrolyte imbalance and modified
motility—causes or exacerbates LARS would enhance the discussion significantly.
-A more thorough investigation into the mechanisms linking HOS to LARS is warranted. Future
research could focus on identifying biomarkers indicative of autonomic dysfunction, intestinal
inflammation, and electrolyte imbalances to support the proposed mechanisms.
-Furthermore, the authors ought to present concrete recommendations for the management of
patients with HOS. This should specifically address the timing of stoma closure and strategies
for electrolyte management, which may assist in reducing the risk of LARS.
-In conclusion, the manuscript offers important insights into the relationship between HOS and
LARS in patients with rectal cancer, highlighting a considerable risk factor for the development
of significant LARS. Nonetheless, limitations such as the retrospective design, small sample
size of HOS patients, and potential confounding variables restrict the generalizability and
conclusiveness of the findings. While the results are encouraging, there is a pressing need
for larger, multicenter, prospective studies to validate these findings and further elucidate the
underlying mechanisms.
Review for 10.1186/s12876-025-03614-7 (2025)

Title: High output stoma after surgery for rectal cancer - A risk factor for Low Anterior
Resection Syndrome?
Version: 1 Date: 05 Dec 2024
Reviewer:  Kil-Yong Lee
Reviewer's report:
1. Major concern in this study is the ambiguous diagnosis of HOS.
1) When is the check time for high output stoma?
2) Please describe whether high output is continued and whether it is well controlled.
3) The authors mentioned that HOS might affect the sympathetic nervous system, but it only
applies to cases with continued high output stoma.
2. Another concern is the anastomosis level. The major cause of major LARS is the lower
level of anastomosis. Please describe the related factors, such as the location of rectal cancer or
anastomotic level from the anal verge.
Review for 10.1186/s12876-025-03614-7 (2025)

Title: High output stoma after surgery for rectal cancer - A risk factor for Low Anterior
Resection Syndrome?
Version: 1 Date: 09 Dec 2024
Reviewer:  Mohamed H. Zidan
Reviewer's report:
Dear Authors,
Re: "High-output stoma after surgery for rectal cancer - A risk factor for Low Anterior Resection
Syndrome?"
This manuscript addresses an important clinical question regarding the relationship between
high-output stoma (HOS) and low anterior resection syndrome (LARS) in patients undergoing
rectal cancer surgery. The study design, focused on subgroup analysis and multivariable
modeling, is appropriate and well-executed. The findings provide valuable insights into the
potential impact of HOS on postoperative quality of life and clinical outcomes.
The introduction effectively sets the stage, detailing the clinical significance of both HOS and
LARS. The methodology is transparent, with clear descriptions of statistical adjustments in
multivariable models. The results are compelling, particularly the robust association between
HOS and LARS, even after adjustment for relevant covariates. Tables and figures are well-
organized and enhance the understanding of your findings.
Strengths:
The association between HOS and LARS is presented with robust statistical support.
Tables and figures are clear, with meaningful visual representation of key relationships.
The study highlights an underexplored area, offering new perspectives on postoperative care in
rectal cancer surgery.
Minor Recommendations:
Consider expanding the discussion on the implications of early intervention strategies for
patients at risk of HOS to reduce LARS incidence.
Provide a brief acknowledgment of the need for prospective validation in future research.
Review for 10.1186/s12876-025-03614-7 (2025)

Title: High output stoma after surgery for rectal cancer - A risk factor for Low Anterior
Resection Syndrome?
Version: 2 Date: 25 Dec 2024
Reviewer:  Mohamed H. Zidan
Reviewer's report:
Dear Authors,
Re: High output stoma after surgery for rectal cancer - A risk factor for Low Anterior Resection
Syndrome?
Thank you for your reply. I believe that you have covered all my recommendations and that the
manuscript has improved accordingly.
Best Regards
Review for 10.1186/s12876-025-03614-7 (2025)

Title: High output stoma after surgery for rectal cancer - A risk factor for Low Anterior
Resection Syndrome?
Version: 2 Date: 26 Dec 2024
Reviewer:  Kil-Yong Lee
Reviewer's report:
This revised manuscript has been thoroughly revised in accordance with the reviewer’s
comments. It is valuable and suitable for acceptance in this journal.
Review for 10.1186/s12876-025-03616-5 (2025)

Title: High serum CA19-9 predicts severe cholecystitis in calculous cholecystitis patients
Version: 3 Date: 18 Dec 2024
Reviewer's report:
This paper discusses the usefulness of CA19-9 for calcified gallbladders.The main contribution
of the paper is the addition of CA19-9 as a preoperative indicator to predict surgical difficulty.
Appropriate corrections have been made to each comment.  I recommend that this paper be
accepted.
Review for 10.1186/s12876-025-03619-2 (2025)

Title: Potential Alternative and Novel Biomarkers for Paediatric MAFLD: exploratory evidence
from a Chinese cohort
Version: 4 Date: 20 Sep 2024
Reviewer:  Miriam Latorre-Millán
Reviewer's report:
Dear authors,
I believe that your work could be of high interest in the field. However, several major changes
are needed to complete and improve it, so that it can be properly published.
I strongly recommend a revision of the use of the English/American language, with special
attention to the terminology of the field and to improve the communicative effectiveness in
order to reach the reader's standards. For this last point, it is also highly recommended to include
additional information with more quality and detail in several sections to really know the extent
of the findings, and yet it is necessary to be more cautious not to overestimate it.
You can find my detailed comments (section by section) after my review in the attached file.
Yours sincerly,
MIriam Latorre-Millán
Review for 10.1186/s12876-025-03619-2 (2025)

Title: Potential Alternative and Novel Biomarkers for Paediatric MAFLD: exploratory evidence
from a Chinese cohort
Version: 7 Date: 06 Jan 2025
Reviewer's report:
The authors have addressed the comments given in the previous review and they significantly
improved the quality of the article. Therefore, I consider that the actual version of the manuscript
is adequate for being published with minor language corrections.
Review for 10.1186/s12876-025-03597-5 (2025)

Title: The Association Between Oxidative Balance Score with Constipation and Diarrhea in US
Adults: A Cross-sectional Analysis of NHANES 2007–2010
Version: 2 Date: 23 Nov 2024
Reviewer's report:
Congratulations on the development of your research regarding the relationship between diet,
specifically oxidative stress, and intestinal symptoms. Your findings contribute valuable insights
to this important area of study.
I would like to offer a few comments for your consideration. Firstly, it may be beneficial to
include in the limitations section that the medications received by the sample population were
not evaluated. This is particularly relevant for conditions such as depression and diabetes, which
could potentially influence the development of diarrhea and constipation.
Additionally, I suggest clarifying the clinical implications of your findings in the discussion
section. The final statement in the conclusions may lead to some ambiguity. It is challenging to
recommend a specific diet for men to prevent constipation and for women to prevent diarrhea
when we cannot predict which symptom they will develop. This recommendation might only be
applicable in higher-risk situations, such as when associated with certain medications or aimed
at preventing symptom relapses in the context of functional disorders.
In the event that it is not possible to make a specific recommendation, I believe it should be
addressed that there is a limitation in the findings for establishing concrete recommendations
in clinical practice, using a less assertive phrase than the one used in the conclusions: 'The
results indicate that maintaining an antioxidant-rich diet is essential for preventing the risk of
constipation in males and diarrhea in females´.
Thank you for considering these suggestions, and I look forward to seeing how your work
evolves.
Best regards.
Review for 10.1186/s12876-025-03597-5 (2025)

Title: The Association Between Oxidative Balance Score with Constipation and Diarrhea in US
Adults: A Cross-sectional Analysis of NHANES 2007–2010
Version: 3 Date: 14 Dec 2024
Reviewer:  Amira A A Othman
Reviewer's report:
I want to extend my congratulations to all those involved in this work. All the required
amendments have already been made carefully and satisfactorily. I hope that the research will
be presented to science.
Review for 10.1186/s12876-025-03597-5 (2025)

Title: The Association Between Oxidative Balance Score with Constipation and Diarrhea in US
Adults: A Cross-sectional Analysis of NHANES 2007–2010
Version: 3 Date: 14 Dec 2024
Reviewer's report:
CONGRATULATIONS ON TH EGOOD WORK.
SOME MINOR REVISIONS WOULD IMPROVE THE QUALITY.
INTRODUCTION:
1. LINES 50-55 THE DETAILED EPIDEMIOLOGICAL DATA DO NOT ADD IMPORTANT
INFORMATION TO THE READER. THEY COULD BE OMITED OR SHORTENED
2. LINES 57-59 PLEASDE REWRITE TO BE MORE CLEAR
METHODS
3. OBS: IT IS NOT CLEAR HOW YOU CALCULATED OBS FOR ACH PARTICIPANT..
WAS THERE A QUESTIIONNAIRE USED OR ANY LAB TESTS FOR NUTRITIONAL
FACTORS?
4. LINE 145 CONCERNING PHYSICAL ACTIVITY YOU PREVIOUSLY MENTIONED
THAT YOUR DATA DID NOT INCLUDE SPECIFIC INFORMATION FOR ALL
PARTICIPANTS.. YOU COULD INCLUDE AND EXPLAIN THAT IN THAT METHODS
PART.
5.LINES 148-155 REFERENCES FOR THE DIAGNOSTIC CRITERIA YOU USED OF
CHRONIC DISEASES ARE NEEDED
RESULTS
6. LINES  178-179 YOU COULD ADD PERCENTAGES IN PARENTHESES AFTER THE
MENTIONED NUMBER
LINES 181-184 ADD P VALUES
GENERAL COMMENT
ENGLISH LANGUAGE COULD BE IMPROVED
Review for 10.1186/s12876-025-03597-5 (2025)

Title: The Association Between Oxidative Balance Score with Constipation and Diarrhea in US
Adults: A Cross-sectional Analysis of NHANES 2007–2010
Version: 4 Date: 25 Dec 2024
Reviewer:  Amira A A Othman
Reviewer's report:
I want to extend my congratulations to all those involved in this work. All the required
amendments have already been made carefully and satisfactorily. I hope that the research will
be presented to science.
Review for 10.1186/s12876-025-03597-5 (2025)

Title: The Association Between Oxidative Balance Score with Constipation and Diarrhea in US
Adults: A Cross-sectional Analysis of NHANES 2007–2010
Version: 4 Date: 26 Dec 2024
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Authors, please address the following points below
-While oxidative stress is suggested to contribute to gastrointestinal dysfunction, the study
does not establish the temporal sequence of these events, which is crucial for drawing causal
conclusions.
-The reliance on self-reported bowel health data from the Bowel Health Questionnaire, while
standard in epidemiological studies, could introduce recall bias or misclassification. It may be
beneficial to mention how this limitation compares to other studies or clinical assessments, as
stool frequency and type can vary based on factors such as stress, diet, or medication use.
-The definitions of constipation and diarrhea based on stool frequency and type are clearly
outlined, but the threshold for defining these conditions could be better justified. For example,
why were individuals with fewer than two bowel movements per week classified as constipated,
rather than using more widely accepted criteria, such as the Rome criteria for functional
constipation?
-The authors propose that oxidative stress leads to gastrointestinal dysfunction, yet the
manuscript lacks an in-depth exploration of the biological mechanisms linking oxidative stress to
constipation and diarrhea. Adding more detailed mechanistic insights, such as how antioxidants
or pro-oxidants might specifically affect gut motility, epithelial function, or the gut microbiota,
would strengthen the paper’s contribution to understanding the pathophysiology of these
disorders.
-Although the study stratifies the analyses by sex, a more detailed discussion of the biological,
hormonal, or behavioral factors that might explain the observed differences in the OBS-
gastrointestinal health relationship would be helpful. For example, could estrogen or other sex
hormones modulate the antioxidant defense system, influencing oxidative stress and gut function
differently in men and women?
-More context around the specific cut-off values for OBS quartiles would be helpful for
replicability and understanding.
-The discussion could benefit from a deeper exploration of the biological mechanisms,
particularly regarding the interaction between oxidative stress, gut microbiota, and sex
differences.
-The subgroup analyses are insightful, but further detail on how these factors (e.g., PIR,
depression) influence the relationship between OBS and bowel health could provide more
nuanced insights.
Review for 10.1186/s12876-025-03597-5 (2025)

Title: The Association Between Oxidative Balance Score with Constipation and Diarrhea in US
Adults: A Cross-sectional Analysis of NHANES 2007–2010
Version: 5 Date: 06 Jan 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
The responses are satisfactory.
Review for 10.1186/s12876-025-03626-3 (2025)

Title: The Role of Exercise-based Prehabilitation in Enhancing Surgical Outcomes for Patients
with Digestive System Cancers: A Meta-Analysis
Version: 1 Date: 12 Nov 2024
Reviewer's report:
This meta-analysis addresses an important part of peri-operative care and ERAS pathways by
assessing the impact of pre-habilitation on post-operative outcomes in GI surgery.
Overall, the meta-analysis demonstrates what has been shown consistently in the literature –
improvement in peri-operative care. I am not clear what this meta-analysis provides in terms of
new information given the available literature in the area. Refer to Nature 2024 “Multimodal
prehabilitation and postoperative outcomes in abdominal surgery: a systematic review and meta-
analysis” as an example.
Additional feedback:
The introduction is very dense with two long paragraphs with minimal flow within. I would
suggest making it more concise illustrating the epidemiology of digestive malignancies, impacts
of surgery in these patients and potential importance of pre-habilitation. Lastly, statement of
objectives of the meta-analysis needs to be made more clear. The authors could also discuss how
their planned meta-analysis would be unique as quite a lot of research has been done in ERAS
programs which includes pre-habilitation.
In the methods the authors should be more specific with MeSH terms used in their systematic
literature search. Which authors were involved in identification of papers and the 3rd
adjudicating author should be highlighted.
Could the authors described in more detail how their data was stored? Is stated “in standardized
format” but I think needs to be more explicitly (e.g. excel spreadsheet, RedCaps)
Review for 10.1186/s12876-025-03626-3 (2025)

Title: The Role of Exercise-based Prehabilitation in Enhancing Surgical Outcomes for Patients
with Digestive System Cancers: A Meta-Analysis
Version: 1 Date: 15 Nov 2024
Reviewer's report:
Prehabilitation is a major item in gastrointestinal surgery. This meta-analysis is based on 13
RCT, especially analysing the effects of rehabilitation on postoperative complications, LOS and
pre surgical optimaziation of patients.
Although the manuscript is well written, there are some  shortcomings
Surgical interventions are not really comparable. Although the majority of RCT reports
colorectal surgery, there are also reports of pancreatectomy, esophagogastric surgery and
heterogenous GI tumors. This heterogeneity of patients included is not addressed, although there
is a clear imbalance;ance in the risk of postoperative complications.
Also a striking item is, that rehabilitation decreases postoperative complications over all, but
not severe complications (DC 3 or higher). Data on overall and major complications should be
presented more detailed. It has to be addressed in the discussion and conclusion, that no effect
was seen in major complications
other items:
line 195: Six studies are mentioned, but only 5 cited
line 209: it should be Egger
Review for 10.1186/s12876-025-03626-3 (2025)

Title: The Role of Exercise-based Prehabilitation in Enhancing Surgical Outcomes for Patients
with Digestive System Cancers: A Meta-Analysis
Version: 3 Date: 01 Jan 2025
Reviewer:  Matthias W. Wichmann
Reviewer's report:
Dear authors - thank you for the opportunity to review your revised manuscript. You have made
a significant effort to improve the manuscript, and I commend you for your work.
I will suggest accepting the paper for publication.
Kind regards, Matthias Wichmann
Review for 10.1186/s12876-025-03623-6 (2025)

Title: Structural Equation Modeling of the Impact of Disease Activity on Inflammatory Bowel
Disease Control: The Mediating Roles of Self- Efficacy and Self-Management Behaviors
Version: 1 Date: 17 Dec 2024
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Authors, please address the following points below
-While the measures are well-explained, further clarification on how each of the key constructs
(disease activity, disease control, self-efficacy, self-management behaviors) will be modeled
in SEM could be useful. Specifically, how the variables will be treated as latent or observed
variables in the analysis could be explained more explicitly. For instance, is IBD-Control-8
treated as a latent variable or summed up as a single score? Clearer details about the measurement
model would improve the reader's understanding.
-While the statistical significance of the relationships is reported (e.g., disease activity’s direct
effect on disease control, # = -0.715, P = 0.001), effect sizes could be discussed more explicitly to
underscore the practical significance of the results. For instance, how much variance in disease
control can be explained by disease activity, self-efficacy, and self-management behaviors
combined? This would help contextualize the magnitude of the effects in practical terms and
might influence clinical recommendations.
-While the discussion references multiple studies, it could better highlight how this study's
findings advance the field or offer new perspectives. For example, while it confirms previous
findings regarding self-efficacy and disease activity, it would be helpful to emphasize how the
study's findings fill gaps or offer novel contributions, especially regarding the non-significant
effects found (e.g., disease activity on self-management behaviors). Providing a clearer contrast
between this study's findings and those of prior research would help situate it more definitively
within the literature.
-The discussion mentions that disease activity did not significantly impact self-management
behaviors and that the effect was borderline significant when combined with self-efficacy.
While this is noted, further exploration of why disease activity does not directly influence self-
management behaviors in this study would strengthen the interpretation. For instance, might
other factors, such as patient beliefs, healthcare access, or support networks, explain the lack
of a direct relationship? Delving deeper into potential explanations for this finding could offer
more nuanced insights.
Review for 10.1186/s12876-025-03623-6 (2025)

Title: Structural Equation Modeling of the Impact of Disease Activity on Inflammatory Bowel
Disease Control: The Mediating Roles of Self- Efficacy and Self-Management Behaviors
Version: 1 Date: 26 Dec 2024
Reviewer:  Peeyush Kumar
Reviewer's report:
This study is a commendable effort by the authors to investigate the impact of disease activity
on inflammatory bowel disease control using Structural Equation Modeling. It focuses on
evaluating and managing interventions that target disease activity, self-efficacy, and self-
management behaviors.
However, if the authors could address a few queries, it would enhance the quality of the paper.
• The sample is geographically limited to Chongqing, potentially restricting the applicability
of findings to other populations, authors can state this limitation and propose studies in varied
settings to enhance generalizability.
• If possible add more diagrams to illustrate complex relationships and key results, particularly
for the structural equation model.
• The paper identifies self-efficacy as an important factor but doesn’t suggest how to improve it
in practice. It would be better to add measures such as patient education programs or counseling.
• The study relies heavily on self-reported data, which can be biased. Suggest acknowledging
this limitation more clearly and proposing ways to reduce bias in future studies.
• The study captures self-efficacy, self-management behaviours, and disease control at a single
point in time. For instance, self-efficacy is measured through a snapshot questionnaire, but no
follow-up data shows whether it improves or declines over time. A longitudinal design could
track changes in self-efficacy and disease control after an intervention, such as a structured self-
management program. Authors can add this in limitations.
• Self-management behaviors are aggregated into broad categories like “medication
management” and “dietary management.” However, detailed behaviors within these categories,
such as specific adherence patterns (timing, dosage) or diet types (low FODMAP, anti-
inflammatory diets), are not examined.  It would be better to Collect data on specific self-
management practices to identify which ones most influence disease control, such as daily
tracking of food triggers or adherence to exercise routines. This is also a short coming in study
which can be specified in limitations and if possible addressed upon.
• The study combines Crohn’s disease (CD) and ulcerative colitis (UC) into one IBD category but
does not analyze how self-efficacy or disease activity might differ between the two. For instance,
patients with CD might face more fistulas, which could impact self-management behaviors
differently than UC. Conduct subgroup analyses to see if the pathways from disease activity to
disease control vary between CD and UC.
Review for 10.1186/s12876-025-03623-6 (2025)

Title: Structural Equation Modeling of the Impact of Disease Activity on Inflammatory Bowel
Disease Control: The Mediating Roles of Self- Efficacy and Self-Management Behaviors
Version: 3 Date: 04 Jan 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
The responses are satisfactory.
Review for 10.1186/s12876-025-03623-6 (2025)

Title: Structural Equation Modeling of the Impact of Disease Activity on Inflammatory Bowel
Disease Control: The Mediating Roles of Self- Efficacy and Self-Management Behaviors
Version: 3 Date: 12 Jan 2025
Reviewer:  Mohammad Reza Hatamnejad
Reviewer's report:
The authors have revised and addressed my concerns appropriately. Manuscript can be accepted.
Review for 10.1186/s12876-025-03623-6 (2025)

Title: Structural Equation Modeling of the Impact of Disease Activity on Inflammatory Bowel
Disease Control: The Mediating Roles of Self- Efficacy and Self-Management Behaviors
Version: 3 Date: 12 Jan 2025
Reviewer:  Peeyush Kumar
Reviewer's report:
The Authors have done a wonderful job, clarifying all the details.
Review for 10.1186/s12876-025-03613-8 (2025)

Title: The clinical value of serum sirtuin-1 concentration in the diagnosis of metabolic
dysfunction-associated steatotic liver disease
Version: 0 Date: 29 Oct 2024
Reviewer:  Marwan S.M. al-Nimer
Reviewer's report:
Dear authors
The manuscript was not well-prepared. The diagnostic criteria of MDASLD were not followed
when collecting the data. The statistical analysis should be so precise.
Review for 10.1186/s12876-025-03613-8 (2025)

Title: The clinical value of serum sirtuin-1 concentration in the diagnosis of metabolic
dysfunction-associated steatotic liver disease
Version: 0 Date: 11 Nov 2024
Reviewer's report:
The clinical value of serum sirtuin-1 concentration in the diagnosis of metabolic dysfunction-
associated steatotic liver disease: a pilot study This study is not considered as  a pilot study, it
is an observetional study
For the diagnosis of  MASLD : serologic tests that rule out hepatitis B and C ( hepatitis B surface
antigen and hepatitis C virus antibody should be negative)
Recent studies propose increasing the activity of Sirtuin enzymes by decreasing calorie intake
[10]. this reference at 2015 whish not considered as recent studies
Review for 10.1186/s12876-025-03613-8 (2025)

Title: The clinical value of serum sirtuin-1 concentration in the diagnosis of metabolic
dysfunction-associated steatotic liver disease
Version: 0 Date: 15 Nov 2024
Reviewer's report:
The study showed that serum Sirt-1 levels were lower in patients with MASLD which could
assist in detecting patients with MASLD.
In the abstract section, please add the missing abbreviation (ROC). Additionally, add the missing
abbreviations in whole manuscript such as SREBP-1c, ACC, FAS, HCC, and ER.
In the background section, correct the abbreviation metabolic-dysfunction associated
steatohepatitis (MSH) to be (MASH).
In the background section, you stated that "on the other hand, the decreased expression of
the Cyrtuin1 gene and its serum levels were associated with an increase in the expression of
lipogenic genes, obesity, insulin resistance, lipid and cholesterol levels, as well as inflammation
and oxidative stress [15]". Correct Cyrtuin1 gene to be Sirtuin1 gene.
In the background section, you mentioned previous study that had been reported a decrease in
the expression of Sirt-1 and reduced plasma levels in people with MASLD, and its association
with an increased degree of hepatic steatosis. Please explain the novelty of this study in the aim
of your study.
In the results section, Table 2: Correlations between serum Sirtuin-1 levels and biochemical
parameters in the whole study samples (n=90). Correct the study samples number (n=90) into
(n=190).
In the results section (Tables), correct the unit (mg/dl) to be (mg/dL).
In the results section, Table 3 was showed the sensitivity and specificity for the diagnostic values
of serum sirtuin-1 levels in prediction of MASLD. Please add the accuracy for the diagnostic
values of serum sirtuin-1 levels in prediction of MASLD in table 3.
In the results section, Table 4: Association and agreement between serum Sirtuin-1 cutoff levels
and the presence of MASLD. Please explain what the p-value (p=< 0.001*) represent and also
Kappa agreement.
Review for 10.1186/s12876-025-03613-8 (2025)

Title: The clinical value of serum sirtuin-1 concentration in the diagnosis of metabolic
dysfunction-associated steatotic liver disease
Version: 0 Date: 19 Nov 2024
Reviewer:  Mohsen Korani
Reviewer's report:
This study is well-designed, executed, and written. Considering that this study has tried to
introduce sirtuin-1 as a biomarker for diagnosing  MASLD, it is precious, and in my opinion,
it is acceptable with a minor revision.
1-Write introduction instead of background.
2- In the introduction section, write the full name of SREBP-1c, ACC, and FAS.
3- In the introduction section, write sirtuin-1 instead of Cyrtuin1.
4- In the second line of the results section, write the percentage of women and men and the units
of age and BMI.
5-In the limitations of the study section, it is written that” Additionally, we did not investigate
the relationship between Sirt-1 and the degree of hepatic steatosis”. Considering that you know
the amount of sirtuin-1 and the number of patients in each grade, you shouldn’t have  mentioned
it as a limitation of your study
Review for 10.1186/s12876-025-03613-8 (2025)

Title: The clinical value of serum sirtuin-1 concentration in the diagnosis of metabolic
dysfunction-associated steatotic liver disease
Version: 1 Date: 01 Jan 2025
Reviewer:  Mohsen Korani
Reviewer's report:
The authors have considered the comments that I made on the article and it is acceptable to be
published in the journal
Review for 10.1186/s12876-025-03613-8 (2025)

Title: The clinical value of serum sirtuin-1 concentration in the diagnosis of metabolic
dysfunction-associated steatotic liver disease
Version: 1 Date: 04 Jan 2025
Reviewer's report:
This study is well-designed, executed, and written. The authors addressed the majority of the
points raised in the  first review recommendation, and in my opinion, it is acceptable.
Review for 10.1186/s12876-025-03613-8 (2025)

Title: The clinical value of serum sirtuin-1 concentration in the diagnosis of metabolic
dysfunction-associated steatotic liver disease
Version: 1 Date: 04 Jan 2025
Reviewer:  Marwan S.M. al-Nimer
Reviewer's report:
It is an interesting article with new information, but it requires a specific attention to the typing
of the references and the list of abbreviations.
Review for 10.1186/s12876-025-03613-8 (2025)

Title: The clinical value of serum sirtuin-1 concentration in the diagnosis of metabolic
dysfunction-associated steatotic liver disease
Version: 2 Date: 09 Jan 2025
Reviewer:  Marwan S.M. al-Nimer
Reviewer's report:
Please correct reference No.7: the reference's title was capitalised for each word. Please use
sentence letter
Review for 10.1186/s12876-024-03575-3 (2025)

Title: Association of Anxiety Status and Anxiety Duration with Constipation in Adult
Americans: A Cross-sectional Study Using Data from the NHANES 2007-2010
Version: 1 Date: 23 Nov 2024
Reviewer's report:
I would like to congratulate you on the development of your research and the high quality of
your article. The findings you have presented are significant, particularly in addressing the long-
standing question of whether anxiety is a cause or a consequence of constipation. Your study
clearly demonstrates that the duration of anxiety plays a crucial role in the development of
constipation.
I would like to suggest adding a limitation regarding the exclusion of pharmacological factors in
your study. While it is understandable that this may not be feasible in a population-based study
of this nature, it could potentially limit the conclusions drawn from your findings.
Overall, your conclusions are well-articulated and effectively discuss their applicability in
clinical practice.
I trust that your research will continue to shed light on some epidemiological issues related to
intestinal disorders.
Best regards
Review for 10.1186/s12876-024-03575-3 (2025)

Title: Association of Anxiety Status and Anxiety Duration with Constipation in Adult
Americans: A Cross-sectional Study Using Data from the NHANES 2007-2010
Version: 1 Date: 27 Nov 2024
Reviewer:  Panagiotis Tsibouris
Reviewer's report:
Actually authors don't study the relation of anxiety duration and constipation but relation to
anxiety symptoms persisting for 10 days which could be seen rather as a parameter of anxiety
presentation Abstract Confounding factors would be better to be presented in methods section
More data could be included and data certifying interconnection could be left  for the main
text Methods Numerical description of patients included belong in results section Were any
data available for for straining Should short duration anxiety episodes  taken into consideration
when diagnosing anxiety disorder Diagnostic criteria for anxiety disorder should be provided
and applied in the study Statistics Power of the study should be calculated Results It seems
that anxiety is not related to constipation Authors tried various manipulations to uncover such a
relationship Thus at least some doubts are mandatory At least in the title
Review for 10.1186/s12876-024-03575-3 (2025)

Title: Association of Anxiety Status and Anxiety Duration with Constipation in Adult
Americans: A Cross-sectional Study Using Data from the NHANES 2007-2010
Version: 2 Date: 14 Dec 2024
Reviewer:  Amira A A Othman
Reviewer's report:
I want to extend my congratulations to all those involved in this work. All the required
amendments have already been made carefully and satisfactorily. I hope that the research will
be presented to science.
Review for 10.1186/s12876-024-03575-3 (2025)

Title: Association of Anxiety Status and Anxiety Duration with Constipation in Adult
Americans: A Cross-sectional Study Using Data from the NHANES 2007-2010
Version: 2 Date: 17 Dec 2024
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
responses are satisfactory, can be accepted for publication.
Review for 10.1186/s12876-025-03610-x (2025)

Title: Association between non-insulin-based insulin resistance surrogate makers and
Helicobacter pylori infection: a population-based study
Version: 0 Date: 01 Dec 2024
Reviewer's report:
In this study, Jiayu Qiu et al reported the associations between three non-insulin-based markers
(TG glucose index, TG/HDL ratio, MetS-IR) and H pylori infection. They used the National
Health and Nutrition Examination Survey (NHANES) 1999-2000 data and logistic regression
model, restricted cubic spline (RCS) curve and subgroup analysis to perform the analyses. They
found all the three non-insulin-based IR surrogate markers were all positively associated with H.
pylori infection in US populations. This is an interesting study. However, I have some questions:
1. The associations between H pylori infection and insulin resistance (IR), cardiovascular
diseases have been reported in many previous studies. The current study found the same
association between IR and H pylori infection by using the non-insulin-based surrogate markers.
The novelty or clinical significance is not high.
2. As the authors mentioned in the limitation section, patients with a positive finding of serum
antibody IgG of H pylori may have current or past infections of H pylori infection. Some of the
patients might receive H pylori eradication therapy. The association between IR and H pylori
infection effects is unsure (from current or past inflammation or immune status ? )
3. This cross-section study used data form NHANES 1999-2000. The authors used good
statistical methods to perform the analyses. But the data was from 24 years ago. For such a
long period, a longitudinal follow up could find the incidence or prevalence of IR, DM or
cardiovascular events in those with or without H pylori infection.
4. Serum fasting insulin and glucose values were available in this study (table 1). Could authors
give the correlations between HOMA-IR and these three non-insulin-based surrogate markers?
5. In discussion section, after the reference 48, authors reported “ In our study, we found the
high level of IR surrogate markers might be significantly induce an increased risk of H. pylori
infection based on large sample of US populations, which firstly contribute to provide evidence
for the effects of IR on H. pylori infection.” Do authors mean a higher level of IR surrogate
markers induce an increased risk of H. pylori infection? In fact, most patients got H. pylori
infection before young adult (teenage period) and kept the infection status for a long time.
Patients with higher non-insulin-based markers may have a lower immunity and be easy to get
infections, such as H pylori. But the current study could not give solid evidence for “higher non-
insulin-based surrogate markers increase a risk of H pylori infection”.
Review for 10.1186/s12876-025-03610-x (2025)

Title: Association between non-insulin-based insulin resistance surrogate makers and
Helicobacter pylori infection: a population-based study
Version: 0 Date: 16 Dec 2024
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Authors, please address the following points below
-While the authors describe the statistical models in detail, they could provide more justification
for their choices. For example, why were three progressive models chosen for adjustment? How
were potential interactions handled in the analysis? A brief rationale for the modeling decisions
would improve the robustness of the methods section.
-The study categorizes the IR markers (TyG index, TG/HDL-C ratio, METS-IR) into quartiles,
which could limit the sensitivity of detecting associations. The authors mention that the IR
markers are analyzed as continuous variables as well, but it would be helpful to emphasize how
the continuous analysis complements the quartile-based approach. Including a discussion on the
advantages and limitations of using quartiles would strengthen this section.
-The discussion presents some contradictions without fully exploring them. For example, the
study mentions that H. pylori infection is associated with higher triglycerides, FBG, and IR
(consistent with the findings of Upala et al. in 2016), but it also notes that another meta-analysis
by Upala et al. in 2017 suggested that H. pylori eradication does not improve IR. The authors
could clarify these contradictions further. How can the eradication of H. pylori not improve IR
when the infection is associated with increased IR? Further discussion of potential reasons for
these conflicting findings would enrich the discussion.
-The study suggests that IR could influence the risk of H. pylori infection, which is an interesting
hypothesis. However, the authors only briefly mention this and do not provide enough evidence
or discussion to substantiate the claim. Since the study does not explore the effects of IR on H.
pylori infection directly, more caution in presenting this as "new evidence" would be prudent.
While this is a valuable hypothesis, it requires more investigation before being presented as a
strong conclusion.
Review for 10.1186/s12876-025-03610-x (2025)

Title: Association between non-insulin-based insulin resistance surrogate makers and
Helicobacter pylori infection: a population-based study
Version: 1 Date: 02 Jan 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
The responses are satisfactory, can be accepted for publication
Review for 10.1186/s12876-025-03610-x (2025)

Title: Association between non-insulin-based insulin resistance surrogate makers and
Helicobacter pylori infection: a population-based study
Version: 1 Date: 07 Jan 2025
Reviewer's report:
The authors have successfully addressed the comments. However,  based on the diagnostic
methods of the acquired dataset, concerns remain regarding the accuracy and reliability of the
results.
Review for 10.1186/s12876-024-03555-7 (2025)

Title: Deep Learning-based CT Radiomics Predicts Prognosis of Unresectable Hepatocellular
Carcinoma Treated with TACE-HAIC combined with PD-1 Inhibitors and Tyrosine Kinase
Inhibitors
Version: 2 Date: 16 Sep 2024
Reviewer's report:
Review for 10.1186/s12876-024-03555-7 (2025)

Title: Deep Learning-based CT Radiomics Predicts Prognosis of Unresectable Hepatocellular
Carcinoma Treated with TACE-HAIC combined with PD-1 Inhibitors and Tyrosine Kinase
Inhibitors
Version: 2 Date: 06 Oct 2024
Reviewer's report:
- Line 48: The term "uHCC" appears twice.
- Line 69: What is the stage of HCC in this study?
- Line 124: Toripalimab does not have an indication for liver cancer treatment, so why is it
included in this study? Additionally, the usual dose for toripalimab is 240 mg.
- Line 126: Is the combination therapy discussed in this study intended for first-line treatment?
Why is a second-line therapy mentioned here?
- Line 183: Why did you construct a nomogram for PFS only and not for OS?
- Lines 138-140: You mention safety evaluation indicators, but there are no related data in the
results section. The authors need to supplement this information.
- Line 215: It is recommended to use either "HCC" or "Liver Cancer" consistently throughout
the paper. Additionally, the total number of participants in this study is 122; does this include
external validation data? Please verify.
- Line 227: If there are 118 people still alive at the last follow-up, this does not match the OS
curve. Please check the data.
- Lines 228-230: Please verify the survival rate data.
- Is the unit for "Largest Tumor Diameter" in Table 1 centimeter? Please confirm.
- The term "tumor thrombus" would be more appropriate for referring to cancer embolus.
- When was the mRECIST standard evaluation conducted post-treatment? Please include this
in the footnotes of Table 1.