JerMa88/BMC_Gastroenterology_Peer_Reviews huggingface dataset:
Review for 10.1186/s12876-025-03690-9 (2025)

Title: Systematic Review and Meta-Analysis: No Evidence That Low-dose Non-Steroidal Anti-
Inflammatory Drugs (NSAIDs) Reduce the Risk of Pancreatitis After Endoscopic Retrograde
Cholangiopancreatography (ERCP)
Version: 2 Date: 30 Nov 2024
Reviewer:  Mohamed H. Zidan
Reviewer's report:
Dear Authors,
While the article is well-written, I have concerns regarding the methods, which seem biased.
The article lacks clarity about the exclusion criteria for the 15 articles that were extracted. Could
you specify why these articles were excluded? Additionally, I did not find the PRISMA flow
diagram; perhaps I missed it in Figure 1, as I was unable to open it. I also encountered issues
with assessing the figures in EPS format, as they did not appear on the preview page. I would
appreciate an amendment to provide these figures in .jpg or .png format.
Although I practically agree with the authors' conclusions, I find that there is insufficient
evidence to support them. Please clarify your methods and define your exclusion criteria so that
I can better understand the study.
Best regards.
Review for 10.1186/s12876-025-03690-9 (2025)

Title: Systematic Review and Meta-Analysis: No Evidence That Low-dose Non-Steroidal Anti-
Inflammatory Drugs (NSAIDs) Reduce the Risk of Pancreatitis After Endoscopic Retrograde
Cholangiopancreatography (ERCP)
Version: 2 Date: 02 Dec 2024
Reviewer:  Amira A A Othman
Reviewer's report:
It is a systematic review or meta-analysis, focusing on synthesizing evidence from existing
research to draw meaningful conclusions for improving understanding or treatment strategies in
a clinical setting, potentially within gastroenterology or related medical fields. The paper appears
to involve investigating the relationship between specific interventions, potentially involving
endoscopic retrograde cholangiopancreatography (ERCP), non-steroidal anti-inflammatory
drugs (NSAIDs), and clinical outcomes with advanced statistical techniques such as propensity
score matching to account for potential confounding factors and ensure a robust comparison.
The authors tried to contribute to this field of research with new findings; nevertheless, some
observations require sufficient justification.
1. Title: The title is descriptive but could be more concise. Consider revising the title to make it
more concise and impactful. Focus on capturing the study’s core objectives or outcomes while
maintaining clarity and scientific rigor.
2. Abstract: ensure the abstract succinctly summarizes the study's aims, methods, results, and
implications.
3. Scientific Content: Simplify the structure of the methodology section. While the inclusion
of detailed search terms (e.g., MeSH terms in PubMed) demonstrates thoroughness, it may
overwhelm readers. Summarize these details in the main text and move extensive lists to
supplementary materials for better readability.
4. Language and Flow: Refine the language throughout the manuscript to enhance clarity and
readability. Avoid redundant phrasing, particularly in the methods and results sections, and
ensure smooth transitions between sections for a logical progression of ideas.
5. Statistics: Provide a more detailed explanation of the statistical methods used, particularly
propensity score matching. Highlight why this method was chosen and how it addresses potential
biases. Ensure that results are presented with confidence intervals and p-values to strengthen
the reliability of the findings.
6. Practical Implications: Enhance the discussion section by emphasizing the clinical relevance
of your findings. Highlight how the results could influence practice or inform future research
directions.
7. Supplementary Materials: Consolidate extensive details, such as search term lists, into
appendices or supplementary materials. This will declutter the main text and improve its
readability.
8. Figures and Tables: Review the clarity and effectiveness of all figures and tables. Ensure they
are well-labeled and referenced in the text. Avoid overcrowding with excessive information,
and consider segmenting or simplifying complex visualizations.
Review for 10.1186/s12876-025-03690-9 (2025)

Title: Systematic Review and Meta-Analysis: No Evidence That Low-dose Non-Steroidal Anti-
Inflammatory Drugs (NSAIDs) Reduce the Risk of Pancreatitis After Endoscopic Retrograde
Cholangiopancreatography (ERCP)
Version: 3 Date: 07 Jan 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
The responses are satisfactory.
Review for 10.1186/s12876-025-03690-9 (2025)

Title: Systematic Review and Meta-Analysis: No Evidence That Low-dose Non-Steroidal Anti-
Inflammatory Drugs (NSAIDs) Reduce the Risk of Pancreatitis After Endoscopic Retrograde
Cholangiopancreatography (ERCP)
Version: 3 Date: 09 Jan 2025
Reviewer:  Amira A A Othman
Reviewer's report:
The authors have made a significant effort and responded well to the reviewers' comments,
demonstrating a clear commitment to improving the quality of their manuscript. However, a few
additional adjustments are still needed to achieve the best possible version of the manuscript.
1. Simplify the abstract and make it more structured, emphasizing key findings and clinical
relevance.
2. Avoid repetition in the introduction about the need for prevention strategies and emphasize
NSAID efficacy findings.
3. Specify the variables used in propensity score matching (e.g., age, sex, comorbidities), and
provide detailed exclusion criteria in the methodology section.
4. Statistical findings need better explanation (e.g., odds ratios, significance of low heterogeneity
(I² = 0%), sensitivity analysis ).
5. Provide a critical comparison of your results with other studies in the discussion section
especially lack of significant findings (e.g., low NSAID doses).
6. Table 1 is terrible, please reconstruct it.
Review for 10.1186/s12876-025-03690-9 (2025)

Title: Systematic Review and Meta-Analysis: No Evidence That Low-dose Non-Steroidal Anti-
Inflammatory Drugs (NSAIDs) Reduce the Risk of Pancreatitis After Endoscopic Retrograde
Cholangiopancreatography (ERCP)
Version: 3 Date: 10 Jan 2025
Reviewer's report:
No additional comments
Review for 10.1186/s12876-025-03659-8 (2025)

Title: Potential Predictive Role of Non-HDL to HDL Cholesterol Ratio (NHHR) in MASLD:
Focus on Obese and Type 2 Diabetic Populations
Version: 0 Date: 21 Nov 2024
Reviewer:  Ze-Bin Fang
Reviewer's report:
This manuscript studies the relationship between non-HDL-to-HDL cholesterol ratio (NHHR)
and metabolic function-associated fatty liver disease (MASLD), especially for obese and type 2
diabetic populations, which is innovative and clinically significant. The article has a complete
structure, rigorous data analysis, and clear conclusions. However, there are still some issues that
need to be further supplemented and improved to enhance the scientificity, rigor, and practicality
of the manuscript.
1. The introduction of MASLD and NHHR in the background section is relatively general,
lacking in-depth mechanism discussion.
Can the following content be discussed: How NHHR affects the occurrence and development
of MASLD through mechanisms such as cholesterol metabolism and inflammation? Previous
research results on NHHR and other metabolic-related diseases (such as diabetes and kidney
disease) further highlight the significance of the study.
2. NHANES data have stratified sampling characteristics, but it is not clear whether sample
weights are used for analysis.
3. The NHHR grouping criteria are not explained in detail, which may affect the generalizability
of the results.
4. The literature mentioned in the discussion is insufficiently supported, especially the lack of
research on NHHR in the prediction of MASLD.
5. Some inconsistencies in the results (such as the higher prevalence of MASLD in non-T2D
populations) were not analyzed in depth.
6. The manuscript has important scientific value, but the depth of the background and discussion
sections needs to be supplemented, and the language expression and statistical analysis methods
need to be further optimized.
Review for 10.1186/s12876-025-03659-8 (2025)

Title: Potential Predictive Role of Non-HDL to HDL Cholesterol Ratio (NHHR) in MASLD:
Focus on Obese and Type 2 Diabetic Populations
Version: 0 Date: 08 Jan 2025
Reviewer's report:
This study examines the relationship between the non-HDL to HDL cholesterol ratio
(NHHR) and metabolic function-associated fatty liver disease (MASLD) in obese and diabetic
populations, focusing on clinical implications.
The mechanistic relationship between MASLD and NHHR needs further discussion.
What are the NHHR grouping criteria?
Review for 10.1186/s12876-025-03659-8 (2025)

Title: Potential Predictive Role of Non-HDL to HDL Cholesterol Ratio (NHHR) in MASLD:
Focus on Obese and Type 2 Diabetic Populations
Version: 1 Date: 24 Jan 2025
Reviewer's report:
The authors have thoroughly addressed all comments. No further revisions are needed.
Review for 10.1186/s12876-025-03659-8 (2025)

Title: Potential Predictive Role of Non-HDL to HDL Cholesterol Ratio (NHHR) in MASLD:
Focus on Obese and Type 2 Diabetic Populations
Version: 1 Date: 27 Jan 2025
Reviewer:  Ze-Bin Fang
Reviewer's report:
This study makes a significant contribution to our understanding of metabolic dysfunction-
associated steatotic liver disease (MASLD) by identifying a strong and consistent association
between the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol
ratio (NHHR) and MASLD, particularly in populations with obesity and type 2 diabetes (T2D).
The use of NHANES 2017-2018 data and the rigorous methodology employed, including
multivariable logistic regression and smooth curve fitting, enhances the reliability of the results.
The findings suggest that NHHR could serve as a valuable screening tool for MASLD in high-
risk groups, offering a simple, accessible method for early detection and intervention. This is
particularly important given the rising global prevalence of obesity and T2D, making early
diagnosis of MASLD critical for preventing its progression to more severe liver disease. I
commend the authors for their thorough analysis and the robustness of their findings. This
manuscript has the potential to significantly impact clinical practice by providing a new, cost-
effective tool for identifying at-risk individuals. However, further longitudinal studies would be
valuable to confirm the causality and explore the underlying mechanisms of the NHHR-MASLD
relationship.
Overall, I fully support the conclusions of this study and recognize its important contribution
to the field. I believe this research will pave the way for future investigations and clinical
applications in MASLD screening.
Review for 10.1186/s12876-025-03663-y (2025)

Title: Association between the development of sepsis and the triglyceride-glucose index in acute
pancreatitis patients: a retrospective investigation utilizing the MIMIC-IV database
Version: 1 Date: 30 Sep 2024
Reviewer's report:
1. In the Clinical data collection section, it said "The laboratory parameters included results from
the first day of complete blood analysis, arterial blood gas analysis, and analysis of the first
biochemical profile within 7 days of admission" Please tell us what's time of the triglyceride test
and glucose test which is important to analysis the results.
2. Why the patients who had Diabete or HTG disease did not be excluded? Would it influence
the results?
3. About the combination of the TyG index with clinical indicators model, please tell us what's
those clinical indicators?
Review for 10.1186/s12876-025-03663-y (2025)

Title: Association between the development of sepsis and the triglyceride-glucose index in acute
pancreatitis patients: a retrospective investigation utilizing the MIMIC-IV database
Version: 1 Date: 11 Jan 2025
Reviewer's report:
I find this manuscript particularly interesting, especially due to its use of the Boruta algorithm for
selecting relevant variables. I recommend accepting the manuscript for publication, contingent
upon the authors addressing minor revisions:
1) In the Introduction, second paragraph, the author states: "Changes in blood glucose and lipid
levels during the pathophysiological process of acute pancreatitis and their impact on patient
outcomes have received widespread attention." While the cited references primarily address the
relationship between diabetes mellitus and pancreatitis, it would strengthen the manuscript to
include additional recent studies exploring the impact of  hypertriglyceridemia by itself on the
outcomes of acute pancreatitis. This is particularly relevant, as patients with dyslipidemia—
despite not being diabetic—have been associated with worse clinical outcomes.
2) What was the optimal cutoff point of the TyG index to predict sepsis in your study, and which
method did you use to determine it?
Review for 10.1186/s12876-025-03669-6 (2025)

Title: Endoscopic Semi-Blunt Dissection Technique is Safe and Effective for Treating Gastric
Submucosal Tumors from The Muscularis Propria
Version: 0 Date: 24 Dec 2024
Reviewer's report:
I have some comment to the authors .
They wrote that the tumors derive from muscularis propria. Is it correct statement that all
tumors derived from muscularis propria? Typically endoscopic submucosal dissection is a metod
allowing to remove tumors from submucosa not muscularis propria. Was ESD combined with
muscle interection?Please clarify
How was the staging before dissection perofmed( EUS?CT?). Was the EUS guided biopsy of
the tumor performed? It might be the factor leading to fibrosis and elongation of the procedure.
Review for 10.1186/s12876-025-03669-6 (2025)

Title: Endoscopic Semi-Blunt Dissection Technique is Safe and Effective for Treating Gastric
Submucosal Tumors from The Muscularis Propria
Version: 2 Date: 15 Jan 2025
Reviewer:  Dimitrios Kehagias
Reviewer's report:
The authors have addressed all of my comments. I have no other amendments or
recommendations to make.
Review for 10.1186/s12876-025-03643-2 (2025)

Title: Expression and prognostic significance of CD93 in blood vessels in colorectal cancer: an
immunohistochemical analysis of 134 cases
Version: 2 Date: 16 Jan 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
The responses are satisfactory.
Review for 10.1186/s12876-025-03682-9 (2025)

Title: Health-Related Quality of Life in Pediatric Patients with Intestinal Failure without
Neurodevelopmental Delay: A Systematic Review and Meta-Analysis
Version: 2 Date: 28 Oct 2024
Reviewer's report:
The authors present a review of health-related quality of life of patients with intestinal failure
(excluding those with neurodevelopmental delay) and a healthy comparator. It was written well
and is easy to understand. Nonetheless, that are a few points that I think are important for the
authors to address in a revised version of their manuscript.
1. In the HRQOL Total Summary section you discuss the differences between self-report and
proxy-report, but there is no information in the main text or Table 1 as to the papers you are
referring to that fell within these two groups. I understand the supplementary data lists the papers
that represent these two groups. However, I believe it would be worth including this is the main
text or Table 1. Please include a column in Table 1 or include the citation of papers that fall
into these groups.
2. Table 1. Please be consistent with how you report the age range and clearly detail the type of
measure used for each study (eg. mean or median).
3. Methodological differences between the studies selected for review was mentioned in your
discussion. Can you please elaborate on these and whether they had an impact upon the findings
etc? For example, age of the child varied across studies reviewed - could this impact upon the
findings? Are older/younger children more likely to have higher/lower HRQoL?
4. In your findings you state agreement of self-report and proxy-report findings. Since a few of
the studies reviewed reported both self-report and proxy-report findings, did these studies report
agreement in their sample?  I think this is important to discuss.
4. The abbreviation list is missing a few terms that were used. Please include all of the
abbreviations used.
5. There were also a few minor typos.
Review for 10.1186/s12876-025-03682-9 (2025)

Title: Health-Related Quality of Life in Pediatric Patients with Intestinal Failure without
Neurodevelopmental Delay: A Systematic Review and Meta-Analysis
Version: 2 Date: 28 Nov 2024
Reviewer's report:
The article "Health-Related Quality of Life in Pediatric Patients with Intestinal Failure without
Neurodevelopmental Delay: A Systematic Review and Meta-Analysis" was extremely well
written. The methodology corresponds to the gold standard of systematic reviews and meta-
analysis.
This is an extremely needed article, as an expert in intestinal failure for the past 20 years, a good
quality  systematic review on quality of life for this population has been missing, as more and
more these patients survive and have to live with the burden of parenteral nutrition at home.
I defer to comment on statistics, as I'm not an expert.
The discussion was very rich and the authors have good points about the heterogeneity of this
population and the difficulties in finding good quality papers.
In conclusion, this is a very needed article, well written and  important for this field.
Review for 10.1186/s12876-025-03682-9 (2025)

Title: Health-Related Quality of Life in Pediatric Patients with Intestinal Failure without
Neurodevelopmental Delay: A Systematic Review and Meta-Analysis
Version: 6 Date: 19 Jan 2025
Reviewer's report:
I'm satisfied with the way my comments have been addressed and appreciate the work the author
team put into the edits.
Review for 10.1186/s12876-025-03682-9 (2025)

Title: Health-Related Quality of Life in Pediatric Patients with Intestinal Failure without
Neurodevelopmental Delay: A Systematic Review and Meta-Analysis
Version: 6 Date: 22 Jan 2025
Reviewer's report:
Milo et al present a systematic review with meta-analysis that aimed to evaluate the available
data on health-related quality of life (HRQoL) in pediatric patients with intestinal failure,
excluding those with neurodevelopmental delay, compared with healthy controls. With a
growing population of children with intestinal failure and long-term parenteral nutrition needs,
understanding the impact of this disease on the HRQoL of patients is imperative. The authors
attempted to summarize the available evidence, excluding patients with neurodevelopmental
delay, which could independently affect their HRQOL. The manuscript is clear and easy to
follow, with adequate methodological design.
The authors have adequately addressed previous  comments and suggestions.
Review for 10.1186/s12876-025-03682-9 (2025)

Title: Health-Related Quality of Life in Pediatric Patients with Intestinal Failure without
Neurodevelopmental Delay: A Systematic Review and Meta-Analysis
Version: 6 Date: 25 Jan 2025
Reviewer's report:
As per my first review, the manuscript is well written and the results were accurately reported.
The paper will be  an asset to the centres that have expertise  in intestinal failure.
Review for 10.1186/s12876-025-03652-1 (2025)

Title: Fecal Calprotectin from Ileostomy Output in Patients with Crohn’s Disease
Version: 1 Date: 05 Nov 2024
Reviewer:  Panagiotis Tsibouris
Reviewer's report:
Abstract It would be better if patients with active disease could be subdivided in different
subclassed according to disease activity Moreover it should be defined if acive and inactive
disease was defined according to clinical, endoscopic/radiologic or histologic criteria  The same
comment valids for methods section Statistics Multivariated analysis taking into consideration
diase activity, disease extent and various demographic factors would be better performed Results
disease extent is not know in a large enough group of patients Was disease extent important
determinant of calprotectin levels ? Was disease activity important determinat of calprotectin
levels? If any exceptional cases have been recorded representative pictures can be included in
the text
Review for 10.1186/s12876-025-03652-1 (2025)

Title: Fecal Calprotectin from Ileostomy Output in Patients with Crohn’s Disease
Version: 1 Date: 12 Nov 2024
Reviewer's report:
This is a retrospective cohort study, including CD patients with ileostomy who had undergone
FCal measurment between 2015 and 2022. Patients were divided in two major groups: those
with inflammation (shown by imaging or endoscopy) or those without signs of inflammation.
Patients with active inflammation had higher levels of FCal. The optimal cut off of FCal was
63.3 ug/g by FC-POCT and 40.1 ug/g by FC-ELISA.
Major comments:
• A total of 101 patients with 224 measurements of FCal were included. If I am understanding it
right, this means that each patient underwent FCal measurement in 2 different timepoints. What
was the difference between these 2 timepoints? This may lead to sample duplication? Please
consider explaining when were the FCal measurements performed in each patient.
• Small intestinal inflammation was defined by mural enhancement with wall thickening,
ulcers, perienteric edema/infiltration, pseudo-sacculation of the bowel die to shortening of the
mesenteric border and engorged vasa recta. Could you please clarify if the patients had at least
one of these findings or more than one? Which cut-off was used for bowel wall thickening?
Were the CT/MRE images reviewed by a radiologist or this information was retrieved from
medical charts?
• Only 44 patients underwent endoscopy. Could you please clarify why? Besides, mild
inflammation may not be detected by CT/MRE. How do you address this situation? Consider
adding to the limitations of the study.
• Consider analyzing separately the group of patients that had endoscopy performed and those
that was only based on imaging to see if the values of FCal varied.
• Consider evaluating the value of FCal and the severity of endoscopic or imaging activity.
Minor comments
• Page 9, line 153: fifty-five (should be 55% and not 54%)
Review for 10.1186/s12876-025-03652-1 (2025)

Title: Fecal Calprotectin from Ileostomy Output in Patients with Crohn’s Disease
Version: 2 Date: 16 Dec 2024
Reviewer's report:
Thank you. Most of  the points raised in the 1st version of the manuscript have been addressed by
the authors.  However, I have some concerns about the newly added CT image in the left panel of
Figure 2B. Although the arrow indicates a comb sign, this slice may not be the most suitable for
demonstrating wall thickening. It’s possible that wall thickening could be more clearly observed
in the jejunum or the descending portion of the duodenum. If that is the case, it would be better
to place the arrow there. Could you please provide a cross-sectional image that more clearly
shows the wall thickening?
Review for 10.1186/s12876-025-03652-1 (2025)

Title: Fecal Calprotectin from Ileostomy Output in Patients with Crohn’s Disease
Version: 2 Date: 16 Dec 2024
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Auhtors, please address the following points below
-The introduction refers to the use of imaging techniques like CT enterography (CTE) and MRI
enterography (MRE) as part of clinical practice. Still, there is little mention of their accuracy or
how they compare to endoscopy. More details on the current gold standard for detecting small
bowel inflammation in postoperative CD patients would help further justify the study’s approach
and the role of FC in this context.
-The methods section mentions collecting demographic and laboratory data but does not
specifically address whether patients were on immunosuppressive therapy (e.g., biologics or
steroids). Since medication can significantly impact inflammation and FC levels, this is an
important consideration, and the authors should clarify whether therapy was accounted for in
the analysis.
-The median interval between FC testing and imaging/ileoscopy is mentioned as 3 days, but a
wider range is provided (IQR 0-21 days). The authors should address whether this variability in
timing could influence the accuracy of FC in predicting inflammation and whether a shorter or
longer interval would be more optimal for clinical monitoring.
-While the discussion mentions that FC can "potentially replace the need for frequent imaging
and/or endoscopic evaluations," this assertion could benefit from further elaboration. The
authors could explain more clearly in what clinical scenarios FC testing would be preferable to
imaging or endoscopy, or how often FC tests would need to be performed to effectively monitor
disease activity. This would strengthen the real-world applicability of the findings.
-The study does not delve into whether FC levels might vary depending on patient subgroups
(e.g., age, disease phenotype, prior surgeries). A discussion of how FC might perform differently
across these subgroups could make the findings more nuanced and would provide insights into
the potential limitations of FC testing in certain groups of patients.
Review for 10.1186/s12876-025-03652-1 (2025)

Title: Fecal Calprotectin from Ileostomy Output in Patients with Crohn’s Disease
Version: 3 Date: 02 Jan 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Authors response are satisfactory, can be accepted for publication.
Review for 10.1186/s12876-025-03661-0 (2025)

Title: Impact of Steatotic Liver Disease Subtypes, Sarcopenia, and Fibrosis on All-cause and
Cause-specific Mortality: A 15.7-year Cohort Study
Version: 0 Date: 12 Dec 2024
Reviewer's report:
The paper from Liang et al evaluated the association between SLD and sarcopenia with mortality
in the NHANES data set.  There were some limitations as US and BIA were not available in the
same NHANES data sets.  This led to the utilization of a model to estimate the prevalence of
steatosis (FLI).  I would consider addressing the following issues
1.  I would remove data regarding "MAFLD/NAFLD".  It is confusing and does not align with
updated definitions.
2. The FLI mostly would account for what would be considered as MASLD given its reliance
on factors- TG, BMI, GGT and WC.  This is a limitation as much of SLD (alcohol and other)
may be missed by utilizing this model. This should be acknowledged as a limitation
3. why did the authors choose  that model for defining sarcopenia when others have been already
used for the US population in NHANES (Euro J gastro and hep 2019;31:1121-1128)
4. I believe it stated so in the methods, but could the authors clarify that appropriate sampling
waiting was done per NHANES guidelines?
Review for 10.1186/s12876-025-03661-0 (2025)

Title: Impact of Steatotic Liver Disease Subtypes, Sarcopenia, and Fibrosis on All-cause and
Cause-specific Mortality: A 15.7-year Cohort Study
Version: 0 Date: 29 Dec 2024
Reviewer:  Valeria Fernandez
Reviewer's report:
This manuscript reviews all cause-mortality and cause-specific mortality across different SLD
categories (MASLD, MetALD, and other etiology SLD), as well as the previous definition
“MAFLD” and sarcopenia. I enjoyed reading your manuscript and believe your research
provides value to the field. I also consider your article within the journal’s scope. However, in
light of strengthening your manuscript, these are my comments and suggestions:
* I suggest a study flow chart to provide a visual overview about how many subjects were
identified, excluded, and included in the final analysis.
* I appreciate the recognition of using two non-invasive indices (and not biopsy or FibroScan)
as an important limitation when defining advanced liver fibrosis.
* I would suggest clarifying the term “unfavorable metabolic profiles”, how many of these
patients were also diabetic? Since diabetes is associated with  liver and non-liver related adverse
outcomes (including mortality), I would suggest including this diagnosis in table 1.
* What percentage of your study sample were using glucose-lowering or cardiovascular
medications?
* You mentioned that the Fatty Liver Index (FLI) was used to identify subjects with steatotic
liver disease. There is evidence that the Fatty Liver Index (FLI) indicates future development
of cardiovascular disease, which means that patients with higher FLI values could potentially
experience worse outcomes.
Review for 10.1186/s12876-025-03661-0 (2025)

Title: Impact of Steatotic Liver Disease Subtypes, Sarcopenia, and Fibrosis on All-cause and
Cause-specific Mortality: A 15.7-year Cohort Study
Version: 1 Date: 15 Jan 2025
Reviewer's report:
authors have addressed queries from reviewers adequately
Review for 10.1186/s12876-025-03661-0 (2025)

Title: Impact of Steatotic Liver Disease Subtypes, Sarcopenia, and Fibrosis on All-cause and
Cause-specific Mortality: A 15.7-year Cohort Study
Version: 1 Date: 27 Jan 2025
Reviewer:  Valeria Fernandez
Reviewer's report:
The authors have addressed all my concerns and suggestions. I have no further comments. Thank
you for inviting me to review this article.
Review for 10.1186/s12876-025-03672-x (2025)

Title: Enhancing Liver Fibrosis Detection: A Novel PIGR-Utilizing Approach in Chronic
Hepatitis B Injury Assessment
Version: 0 Date: 07 Dec 2024
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Authors, please address the following points below
-The introduction indicates that PIGR is involved in inflammation and immune cell infiltration;
however, a more comprehensive discussion of PIGR's role in fibrosis at the cellular and
molecular levels would enhance the argument for its use as a biomarker.
-Furthermore, it is essential to highlight how liver fibrosis specifically contributes to the
progression toward cirrhosis and cancer, along with the importance of early detection of fibrosis
in improving patient outcomes.
-Although the introduction briefly acknowledges the limitations of liver biopsy and non-invasive
methods, a more thorough comparison of existing biomarkers—including ELF score, liver
stiffness measurements, and other serum markers—against PIGR would present a stronger
rationale for PIGR as a novel and potentially valuable addition to the current diagnostic arsenal.
-The authors ought to clarify the criteria by which the 150 patients were selected from the larger
cohort of patients with chronic hepatitis B (CHB). Were these patients selected randomly, or
was there a specific rationale for including certain individuals (e.g., based on the availability
of biopsy data)? Providing further details regarding the selection process would enhance
transparency and mitigate potential bias.
-Additionally, it is necessary to determine whether patients were classified according to specific
fibrosis stages, such as the METAVIR score or Scheuer classification.
-A more in-depth explanation of how PIGR interacts with hepatic stellate cells and other
fibrogenic pathways would contextualize the findings within the broader literature.
-Moreover, a comparison of PIGR with traditional biomarkers such as hyaluronic acid (HA),
procollagen type III amino-terminal propeptide (PCIII), and collagen type IV (CIV) in terms of
diagnostic accuracy and clinical utility would aid in positioning PIGR as a potential alternative
or complementary biomarker in clinical practice.
In conclusion, the manuscript presents compelling evidence supporting the potential role of
PIGR as a biomarker for liver fibrosis in patients with CHB. Incorporating these revisions would
render the manuscript more robust and provide clearer insights into the clinical applicability of
PIGR for liver fibrosis detection.
Review for 10.1186/s12876-025-03672-x (2025)

Title: Enhancing Liver Fibrosis Detection: A Novel PIGR-Utilizing Approach in Chronic
Hepatitis B Injury Assessment
Version: 1 Date: 13 Jan 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
The responses are satisfactory.
Review for 10.1186/s12876-025-03672-x (2025)

Title: Enhancing Liver Fibrosis Detection: A Novel PIGR-Utilizing Approach in Chronic
Hepatitis B Injury Assessment
Version: 1 Date: 17 Jan 2025
Reviewer's report:
I found the manuscript is a revised version and has made significant improvements according
to the comments by the two original reviewers. I have no further comments and would like to
suggest "accept for publication in the current version".
Review for 10.1186/s12876-025-03654-z (2025)

Title: Stent as A Bridge to Surgery for Malignant Colonic Obstruction: a retrospective study
on survival and outcomes
Version: 0 Date: 12 Nov 2024
Reviewer's report:
Congratulations on reporting findings on this topic within the context of a developing country.
I have a few comments for your consideration:
Background
• The phrase, “More importantly, it is the only malignancy with an increased incidence in
Thailand,” is unclear and would benefit from rephrasing for clarity.
• Beyond colonic ischemia, the primary concern in cases of colonic obstruction is bowel
perforation.
Methods
• The primary outcome is described as “overall survival (OS) between the STBS and the ES
groups,” while secondary outcomes include “5-year OS.” Could you clarify the distinction
between these two measures?
Results
• Could you explain how a technical success rate of stent placement of 96.6% aligns with a
bowel perforation rate of 17.2%?
• What accounts for the observed differences in surgical methods between groups?
Additionally, I would suggest a thorough English language revision for improved readability
and precision.
Review for 10.1186/s12876-025-03609-4 (2025)

Title: Clinical Risk Factors for Sarcopenia in Acute and Chronic Pancreatitis
Version: 3 Date: 02 Dec 2024
Reviewer:  Amira A A Othman
Reviewer's report:
The manuscript addresses an important and underexplored clinical topic—sarcopenia in
acute and chronic pancreatitis—with significant implications for patient management. Its
robust methodology, utilizing CT imaging for skeletal muscle index (SMI) quantification
and multivariate logistic regression analysis, ensures scientific rigor. The data are presented
clearly through well-organized tables and figures, effectively illustrating key findings such as
sarcopenia prevalence differences between AP and CP. Additionally, the discussion thoughtfully
contextualizes results within the broader literature and identifies critical areas for future research,
particularly regarding mechanisms and potential interventions for sarcopenia in pancreatitis.
The authors tried to contribute to this field of research with new findings; nevertheless, some
observations require sufficient justification.
1. With only 103 subjects, the sample size may reduce the power of some subgroup analyses,
particularly within the CP-only cohort.
2. The limitations note that reliance on muscle mass without functional measures may
overestimate the prevalence of sarcopenia.
3. The cross-sectional design limits insights into causal relationships and temporal changes in
sarcopenia.
4. Critical confounders like dietary intake and activity levels are missing, which may affect the
interpretation of sarcopenia’s determinants.
5. Provide more detail about the methodology, including the criteria used for selecting subjects
and how imaging quality was evaluated. Additionally, explain the steps taken to minimize
variability between reviewers during CT analysis.
6. Suggest incorporating functional assessments like grip strength or gait speed in future studies
to align more closely with contemporary definitions of sarcopenia.
7. Address whether the study population reflects the broader pancreatitis demographic,
particularly in terms of racial and socioeconomic diversity.
8. Consider discussing practical interventions informed by the study’s findings, such as tailored
nutritional plans or exercise programs, to improve clinical outcomes.
9. Offer a more detailed explanation of the statistical approach, particularly the rationale behind
using logistic regression and the forward selection method.
10. Propose specific areas for future research, such as examining the role of cytokines in the
development of sarcopenia or tracking body composition changes over time in pancreatitis
patients.
Review for 10.1186/s12876-025-03657-w (2025)

Title: Manuscript Title: Comparative study on different endoscopic submucosal dissection
techniques for the treatment of superficial esophageal cancer and precancerous lesions
Version: 2 Date: 08 Dec 2024
Reviewer's report:
This study retrospectively evaluates the efficacy and safety of three endoscopic techniques—
endoscopic submucosal dissection (ESD), endoscopic submucosal tunneling dissection (ESTD),
and endoscopic submucosal dissection with C-shaped incision (ESD-C)—for the treatment of
superficial esophageal tumors. The findings suggest that ESD-C is a superior resection technique
compared to ESD and ESTD. This study is potentially novel, given the limited number of
prior publications directly comparing these three approaches. However, significant revisions are
required for this manuscript to meet the standards for publication in this journal.
1. Comparison Methodology:
The manuscript compares the outcomes of ESD, ESTD, and ESD-C in approximately 100
cases for each technique. To provide a robust comparison of their efficacy, a comprehensive
analysis of patient and lesion backgrounds across the three groups is essential. A propensity score
matching approach is recommended to adjust for potential confounding factors. For this purpose,
propensity scores can either be calculated and compared between two groups or generalized
propensity scores may be utilized to facilitate comparisons across all three groups.
2. Chronological Considerations:
The manuscript should clarify whether ESD, ESTD, and ESD-C were performed sequentially
or concurrently. Surgical expertise typically improves over time, and if ESD-C was performed
more recently, outcomes may reflect advances in procedural skill rather than intrinsic superiority
of the technique.
3. Terminology of Resection Outcomes:
The term "complete resection" is preferred over "curative resection" when referring to
procedures achieving negative resection margins, as it more accurately describes the technical
outcome of the resection.
Review for 10.1186/s12876-025-03657-w (2025)

Title: Manuscript Title: Comparative study on different endoscopic submucosal dissection
techniques for the treatment of superficial esophageal cancer and precancerous lesions
Version: 2 Date: 19 Dec 2024
Reviewer's report:
The manuscript provides some evidences about endoscopic submucosal dissection techniques
for superficial esophageal neoplasms. The authors could demonstrate that ESD-C has advantages
over ESTD and ESD in terms of operative time and resection speed. While I agree with
usefulness of the ESD-C technique in esophageal ESD, there are some concerns which are
described below. I hope that my comments are useful for the improvement of the article. 
Specific Comments
1. How did the endoscopists choose each ESD technique? The authors described “the selection of
endoscopic treatment modalities influenced by the procedural habits of the operating physicians
and the characteristics of the lesions” in Discussion section. Please add the detailed description
of the indication of each technique, especially about the characteristics of the lesions.
2. Each technique was used in the different periods? If so, is there any impact of learning curve
for study outcomes?
3. This is related to the previous query. As the authors described in Discussion section, there is
a selection vias which has some impact for study results. Please add the multivariate analysis
about operative time, and resection speed.
4. Did the operators use no traction method such as clip with line technique?
5. Please add the description about lesion size and morphology in Table 2.
6. Was the study aim to evaluate and compare the usefulness of different ESD techniques? Why
didn’t the multivariate analysis shown in Table 9 include ESD methodologies (ESD/ESTD/ESD-
C) as an explanatory variable?
Review for 10.1186/s12876-025-03657-w (2025)

Title: Manuscript Title: Comparative study on different endoscopic submucosal dissection
techniques for the treatment of superficial esophageal cancer and precancerous lesions
Version: 2 Date: 23 Dec 2024
Reviewer's report:
The authors conducted a retrospective study to investigate the efficacy of several ESD techniques
for esophageal ESD. The manuscript is comprehensive; however, some concerns should be
addressed.
Major
Abstract. The conclusion seems lengthy. Please shorten it.
Methods. Didn’t the authors use the counter traction methods such as clip and line methods that
are commonly used in esophageal ESD?
Methods. Is there any information regarding the periods in which each ESD methods are
performed? I mean if the authors start with conventional ESD, and then move onto ESTD or
ESD-C, there may be the effect of a learning curve.
Results. Since the main purpose of this research is to investigate the better ESD technique
for esophageal ESD, the analysis regarding esophageal stricture seems irrelevant. It made the
contents lengthy. At the very least, the association between esophageal strictures and ESD
methods should be investigated and discussed.
Review for 10.1186/s12876-025-03637-0 (2025)

Title: Pilot feasibility study to determine the utility of direct access and quantitative magnetic
resonance cholangiopancreatography (MRCP) in the assessment of suspected acute biliary or
ductal gallstone presentations.
Version: 2 Date: 10 Nov 2024
Reviewer:  Toshio Tsuyuguchi
Reviewer's report:
This is an interesting paper showing the results of RCT, but the number of cases included is small
and the results of imaging and clinical diagnosis are difficult to understand. The paper advocates
the superiority of the direct MRCP group in terms of cost and time, but the results of imaging
and clinical diagnosis should be clearly presented before proceeding with the discussion.
#1. ALP is preferable to GGT for biochemical testing in suspected cholangitis. Biochemical tests
such as WBC and CRP, which indicate an inflammatory response, are necessary to differentiate
cholecystitis or cholangitis from gallstone colic pain.
#2. In Figure 1, 276 of 305 patients were excluded because they did not meet the inclusion
criteria. In this study, about 90% of the cases were excluded. How many of the 276 cases included
those who required emergency ERCP or surgery or those who were admitted to the ICU, which
are exclusion criteria?
#3. The MRCP shows a diagnosis of gallstones in 8 out of 11 cases, but there is no mention of
common bile duct stones or gallbladder stones. The authors also mention 5 common bile duct
stones out of 27 cases in the discussion, but these are not mentioned in the results.
#4. Due to the small number of cases included, no comparison was made between quantitative
MRCP and traditional MRCP. In general, gallbladder enlargement and bile duct diameter alone
are not sufficient to diagnose cholelithiasis, and authors must provide evidence, historical data,
and citations.
Review for 10.1186/s12876-025-03637-0 (2025)

Title: Pilot feasibility study to determine the utility of direct access and quantitative magnetic
resonance cholangiopancreatography (MRCP) in the assessment of suspected acute biliary or
ductal gallstone presentations.
Version: 3 Date: 11 Dec 2024
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Authors, please address the following points below
-The pandemic severely affected recruitment, and although the study managed to complete data
collection on 27 patients, the interruptions in recruitment limit the representativeness of the
sample. The impact of this limitation on the study's generalizability needs to be considered when
interpreting the results.
-The exclusion of MRCP scans due to reduced image quality highlights a limitation in the current
technology's applicability in an acute setting, where patient conditions or technical constraints
may compromise image acquisition. This could reduce the utility of quantitative MRCP in
certain clinical contexts.
-Although quantitative MRCP measurements (e.g., biliary volume and common bile duct
diameter) were analyzed, the clinical relevance of these parameters in guiding acute management
remains unclear. The study does not assess whether these measurements improve patient
outcomes (e.g., faster resolution of symptoms, fewer complications), which is the ultimate test
of any diagnostic tool's utility.
-The study did not compare the diagnostic accuracy of quantitative MRCP versus traditional
qualitative MRCP, nor did it assess the impact of direct MRCP on clinical decision-making
or patient management. A direct comparison between these approaches would be helpful
in understanding whether quantitative MRCP offers additional diagnostic value beyond the
traditional MRCP interpretation.
-Although the study mentions the possibility of discomfort or failure with MRCP due to
claustrophobia, it does not explore the failure rates associated with the traditional ultrasound
approach (e.g., pain, difficulty obtaining images). Including data on ultrasound-related
challenges would provide a more balanced comparison of the two diagnostic strategies and give
a clearer picture of the strengths and weaknesses of both approaches.
-The study presents promising early findings regarding the potential role of AI-assisted MRCP
in automating and standardizing measurements, but it does not explore the actual clinical utility
of these measurements in guiding management decisions. Further studies are needed to assess
whether these quantitative data truly impact clinical decisions, or if they merely add complexity
without improving patient outcomes.
Review for 10.1186/s12876-025-03637-0 (2025)

Title: Pilot feasibility study to determine the utility of direct access and quantitative magnetic
resonance cholangiopancreatography (MRCP) in the assessment of suspected acute biliary or
ductal gallstone presentations.
Version: 3 Date: 12 Dec 2024
Reviewer:  Toshio Tsuyuguchi
Reviewer's report:
The authors answered each question appropriately. Thank you very much.
Review for 10.1186/s12876-025-03637-0 (2025)

Title: Pilot feasibility study to determine the utility of direct access and quantitative magnetic
resonance cholangiopancreatography (MRCP) in the assessment of suspected acute biliary or
ductal gallstone presentations.
Version: 4 Date: 15 Jan 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
The responses are satisfactory.
Review for 10.1186/s12876-025-03620-9 (2025)

Title: The Serum Hepcidin and the Hepcidin/Ferritin ratio in NAFLD: A Systematic Review
and Meta-Analysis
Version: 3 Date: 17 Nov 2024
Reviewer's report:
1. All the abbreviations used in the abstract should be defined as they can be hard to follow.
2. Report on the inter-rater reliability of the data screening and selection process, ideally using
a kappa statistic to demonstrate agreement between the authors.
3. Why random effect model used to analysis of the results and no fixed effect model?
4.  Results were duplicated in the text and tables/figures. I suggest avoiding any duplication in
order to improve the readability of the manuscript.
5. The authors are advised to perform a GRADE assessment to evaluate the strength of their
evidence.
6. The quality of English needs serious modification by a native speaker. There are some wording
and grammatical errors.
7. Add your full search strategy for each database in the supplementary material. The search was
performed more than 6 months ago so I think authors should update their search
8. Explain more about the strengths and limitations of this study.