JerMa88/BMC_Gastroenterology_Peer_Reviews huggingface dataset:
Review for 10.1186/s12876-025-03807-0 (2025)

Title: Optimization of Electrode Position in Electric Field Treatment for Pancreatic Cancer
Version: 2 Date: 25 Feb 2025
Reviewer's report:
Overall Impression:
This manuscript presents an interesting and valuable study on optimizing electrode positions
for electric field treatment in pancreatic cancer. The research is well-conducted, and the results
are presented clearly. The study's findings could significantly contribute to improving treatment
efficacy for pancreatic cancer patients. However, there are a few areas that could be improved
or clarified to enhance the manuscript's quality.
Strengths:
Relevance and Significance: The study addresses a critical issue in cancer treatment, specifically
for pancreatic cancer, which has a poor prognosis. The optimization of electrode positions to
enhance electric field treatment could have a significant impact on clinical practice.
Methodology: The use of a 3D treatment planning system and the creation of multiple treatment
plans by rotating the electrode array in different angles provide a comprehensive evaluation of
the effects of electrode position on treatment efficacy. The inclusion of 13 patients adds to the
robustness of the study.
Clear Presentation of Results: The results are presented in a clear and organized manner, with
tables and figures that effectively illustrate the differences between the reference plan and the
trial plans. The percentage improvements in various indices are easy to understand and interpret.
Weaknesses and Suggestions for Improvement:
Limited Sample Size: The study includes only 13 patients, which may limit the generalizability
of the findings. It would be beneficial to include a larger sample size in future studies to confirm
the results.
Lack of Clinical Outcomes: The study focuses on the optimization of electrode positions based
on electric field intensity, but it does not provide information on the actual clinical outcomes,
such as tumor response or patient survival. It would be valuable to include clinical data in future
research to demonstrate the practical benefits of the optimized treatment plans.
Potential for Further Optimization: The study mentions that other optimization methods, such
as conformal electric field application or intensity-modulated electric field application based on
voltage variation, may be superior. It would be interesting to explore these methods in future
studies to further improve treatment efficacy.
Clarity of Figures and Tables: Some of the figures and tables could be improved for better clarity.
For example, the labels and legends in the figures could be made more prominent, and the table
formatting could be adjusted to make the data easier to read.
Discussion of Limitations: The discussion section briefly mentions the limitations of the study,
but it could be expanded to provide a more in-depth analysis of the potential sources of bias and
the implications of these limitations for the study's conclusions.
Review for 10.1186/s12876-025-03807-0 (2025)

Title: Optimization of Electrode Position in Electric Field Treatment for Pancreatic Cancer
Version: 3 Date: 12 Mar 2025
Reviewer's report:
The research topic selected has more potential in the field of treatment of abdominal cancers. It
has undoubtedly highlighted the use of electrode therapy in fighting this deadly disease.
Review for 10.1186/s12876-025-03807-0 (2025)

Title: Optimization of Electrode Position in Electric Field Treatment for Pancreatic Cancer
Version: 3 Date: 17 Mar 2025
Reviewer's report:
The authors have made essential modifications in response to the questions and suggestions
raised. These changes are necessary and have significantly enhanced the quality of the
manuscript. The methods section now includes more comprehensive experimental details,
the presentation of results is more logical, and the discussion more thoroughly explores the
implications of the findings.
Given the successful incorporation of the requested revisions, I believe the manuscript now
meets the required standards for publication. It presents valuable insights and contributions to
the field.
I recommend that this manuscript be accepted for publication in its current form.
Review for 10.1186/s12876-025-03810-5 (2025)

Title: Analysis of the incidence of post-cholecystectomy diarrhea and its influencing factors in
Hainan Province
Version: 0 Date: 09 Feb 2025
Reviewer's report:
l think it is suitable for this journal in the subject of this study. However, in general it is
insufficient in terms of creativity. Some modification and supplements are as follows. 1.
Abstract  : The results are described in the conclusion of the abstract. Please describe the future
direction, suggestion and etc in it.  2. Method : Please classify in detail in method.  i.e  2. Method
-> 2. Material and Method, 2.1 Material, 2.2 Diagnostic -  3. Reslts :   Due to the lack of table
presented, sufficient research results  were not drawn. 4. Discussion : 1)  Please add a number
to the discussion. 2)  Please add discussion and conclusion or conclusion.
Review for 10.1186/s12876-025-03810-5 (2025)

Title: Analysis of the incidence of post-cholecystectomy diarrhea and its influencing factors in
Hainan Province
Version: 0 Date: 11 Feb 2025
Reviewer's report:
Dear author, Your article has a perfect number of patients. However, it makes me think the
necessary attention has not been paid. It could have been prepared in a more detailed and
informative way. If the required changes are made, it will be an excellent article.
Review for 10.1186/s12876-025-03810-5 (2025)

Title: Analysis of the incidence of post-cholecystectomy diarrhea and its influencing factors in
Hainan Province
Version: 0 Date: 16 Feb 2025
Reviewer:  Said Farhat
Reviewer's report:
Thank you for this interesting  paper.
Although it is a complex  topic, it is well addressed
Review for 10.1186/s12876-025-03810-5 (2025)

Title: Analysis of the incidence of post-cholecystectomy diarrhea and its influencing factors in
Hainan Province
Version: 1 Date: 10 Mar 2025
Reviewer's report:
Dear authors.
The article has reached a more understandable and beautiful content with the changes made.
Congratulations
Review for 10.1186/s12876-025-03802-5 (2025)

Title: Prolonged time interval from neoadjuvant immunotherapy combined with chemotherapy
to surgery is related to unimproved pathological response and poor survival prognosis for
esophageal squamous cell carcinoma
Version: 1 Date: 10 Dec 2024
Reviewer's report:
I read your research paper focused on time interval form neoadjuvant chemotherapy and found
your conclusion that delayed surgery does not improve survival.
However, I have two suggestions below to strengthen your analysis.
1. I recommend to add sensitivity analyses using 4-week, 5-week, and 7-week cutoff.
2.” A 6-week cutoff was chosen based on clinical trials that typically used this time frame.”
# Addition of the data above, it would be helpful to support your conclusion. “ We observed
similar trends (4-, 5-, 6- and 7- week cutoff),,,,“
I think it would be an even better paper if you mentioned the effectiveness of early surgery.
Review for 10.1186/s12876-025-03802-5 (2025)

Title: Prolonged time interval from neoadjuvant immunotherapy combined with chemotherapy
to surgery is related to unimproved pathological response and poor survival prognosis for
esophageal squamous cell carcinoma
Version: 1 Date: 28 Dec 2024
Reviewer:  Katsushi Takebayashi
Reviewer's report:
Comments to the Author
Thank you for letting me review this interesting article.
This study is conducted by the patients with esophageal squamous cell carcinoma
patients receiving neoadjuvant immunotherapy combined with chemotherapy followed by
esophagectomy. Prolonged time interval from neoadjuvant immunotherapy to surgery was
associated with worse clinical outcome. I also consider esophageal cancer patients should avoid
delaying surgery after neoadjuvant chemotherapy because of local tumor progression. However,
I have some questions around the methodology around your study.
1. What is the reason of prolonged interval from neoadjuvant immunotherapy to surgery? This
matter may affect clinical outcomes. Especially, please show the reason of delaying surgery after
neoadjuvant chemotherapy clearly.
2. The authors set the cut-off point of 6 weeks. They used its point by most clinical trials. I
also feel it may lead to potential bias. Generally, the interval time from neoadjuvant therapy
to surgery is in 4 to 8 weeks. Is it reasonable to divide esophageal cancer patients into groups
of 8 weeks or more, as an analysis? Did the authors consider additional evaluation about time
interval?
Review for 10.1186/s12876-025-03802-5 (2025)

Title: Prolonged time interval from neoadjuvant immunotherapy combined with chemotherapy
to surgery is related to unimproved pathological response and poor survival prognosis for
esophageal squamous cell carcinoma
Version: 1 Date: 26 Feb 2025
Reviewer's report:
The authors retrospectively reviewed the outcomes of patients with esophageal squamous cell
carcinoma who receiving neoadjuvant immunotherapy combined with chemotherapy followed
by esophagectomy. The pathological response, survival outcomes, surgical outcomes, and
postoperative complications were compared between the timely surgery group (time interval
 # 6 weeks) and the delayed surgery group (time interval > 6 weeks). The study topics is quit
interesting. There is still no consensus on the optimal timing of surgery after neoadjuvant therapy
for esophageal squamous cell carcinoma. It is well written and presented and I have some
comments:
1. In the section of "2.1 Study population", the inclusion criteria indicated that patients with
complete clinicopathological and follow-up information was included. How long is the follow-
up period in this study at least ? The median follow-up time of esophageal squamous cell
cercinoma patients was 19 months (range: 2–47 months). Is patient with 2 months follow-up
time after esophagectomy with complete follow-up information ? Also,  patients combing with
other malignancies were excluded. Is that patients with other maligancies means synchronous
or metachronous malignancies ?
2. The indication criteria for adjuvant therapy should be shown.
3. All patients underwent esophagectomy via minimally invasive three-incision McKeown
operation procedures with standard two-field lymphadenectomy. There is 7 (5.3%) patients with
tumor location over cervical region (Table 1) in this study. The treatment strategy for tumors
and the pathophysiology of tumors are different from those of thoracic esophageal squamous
cell carcinoma.
4. In Figure 1,  the horizontal axis (time interval (weeks)) should present as "interval" (e.g. 5<
x # 6 not x # 6).
5. Table 5. Univariate and multivariate Cox regression analyses of overall survival and
progression-free survival for esophageal squamous cell carcinoma patients. Disease-Free
Survival (DFS) was defined as the time interval from the date of surgery to the recurrence of
tumor or death in the materials and methods, not progression-free survival. Please correct it.
6. Significant difference at Kaplan-Meier survival analysis in comparison of overall survival
according to cN stage (cN0 versus cN+). How about comparison of disease-free survival ?
Review for 10.1186/s12876-025-03876-1 (2025)

Title: The association between modified cardiometabolic index with non-alcoholic fatty liver
disease and liver fibrosis: A cross-sectional study
Version: 0 Date: 19 Feb 2025
Reviewer's report:
Dear Authors,
Thank you to the authors for their efforts in exploring this important topic. I appreciate their
efforts.
Generally, this paper presents valuable findings. However, it requires revisions to address the
concerns.
1. While the authors excluded and removed heavy drinkers and individuals with hepatitis B and/
or C virus infection, the diagnostic approach described in the manuscript does not fully align with
established guidelines for NAFLD diagnosis. The diagnosis of NAFLD appears to rely solely
on CAP #248 dB/m without addressing other key criteria, such as the exclusion of secondary
causes of liver fat accumulation (e.g., medications). Please clarify whether these exclusions were
performed and how they were handled.
2. To the best of my knowledge, this modified version of the CMI has not been proposed or
validated in any previous studies. While innovation is encouraged, the introduction of a new
metric should ideally build upon existing literature or established methodologies. The absence
of prior evidence or precedent makes it difficult to assess the novelty and appropriateness of
this approach.
3. A major limitation of this study is the lack of separate validation and testing groups to evaluate
the performance of the newly proposed MCMI. Introducing a new metric without proper
validation raises concerns about its reliability and generalizability. Was the modified index
calibrated to ensure it provides reliable predictions across different populations or datasets?
Authors could explain whether: (1) They consider splitting their dataset into training and
validation cohorts to assess the robustness of the MCMI. (2) Alternatively, the MCMI should
be tested on an independent external dataset to confirm its diagnostic accuracy and utility.
To address these concerns, I recommend the following:
1. Provide a detailed diagnostic criteria for subjects with NAFLD.
2. Provide a clear and detailed rationale for the modification of the CMI formula, including
references to prior studies or theoretical frameworks that support this approach.
3. Validate the MCMI using appropriate statistical methods, such as splitting the dataset into
training and validation cohorts or testing it on an independent external dataset.
Review for 10.1186/s12876-025-03876-1 (2025)

Title: The association between modified cardiometabolic index with non-alcoholic fatty liver
disease and liver fibrosis: A cross-sectional study
Version: 0 Date: 03 Mar 2025
Reviewer:  Sang Yi Moon
Reviewer's report:
This study utilizes the 2017–2018 National Health and Nutrition Examination Survey
(NHANES) database to diagnose NAFLD/MASLD and proposes a newly modified CMI as a
formula for distinguishing significant/advanced fibrosis, the most critical prognostic factor.
Given the increasing prevalence of MASLD and the importance of its diagnosis and the
identification of significant/advanced fibrosis in primary care settings, this issue is of significant
clinical relevance.
While the study's content and statistical approach are well-reasoned and appropriate, two
important questions remain.
#1
The study lacks a detailed explanation of the development process of the modified CMI. When
proposing a new formula, it is essential not only to demonstrate its superiority over existing
models but also to clearly describe the rationale and process behind its creation.
#2
The authors assessed the AUROC of MCMI for diagnosing NAFLD and detecting significant/
advanced fibrosis, comparing it with CMI, USFLI, and TyG. However, widely used and well-
validated biomarkers for NAFLD diagnosis include the Fatty Liver Index (FLI), NAFLD Liver
Fat Score (NLFS), and Hepatic Steatosis Index (HSI). Similarly, extensively studied indices
such as the NAFLD Fibrosis Score (NFS) and Fibrosis-4 Index (FIB-4) are commonly used for
identifying significant/advanced fibrosis in NAFLD. A rationale for selecting CMI, USFLI, and
TyG as comparators instead of these well-established biomarkers should be provided.
(Reference: PMID: 34154309, PMID: 39159947)
Review for 10.1186/s12876-025-03876-1 (2025)

Title: The association between modified cardiometabolic index with non-alcoholic fatty liver
disease and liver fibrosis: A cross-sectional study
Version: 1 Date: 01 Apr 2025
Reviewer's report:
Dear Authors,
Thank you for addressing the comments so thoroughly in your revised manuscript. The changes
and clarifications you have made have improved your work. I am pleased to inform you that I
have no further comments.
Reviewer
Review for 10.1186/s12876-025-03876-1 (2025)

Title: The association between modified cardiometabolic index with non-alcoholic fatty liver
disease and liver fibrosis: A cross-sectional study
Version: 1 Date: 04 Apr 2025
Reviewer:  Sang Yi Moon
Reviewer's report:
As a reviewer, I acknowledge the substantial effort the authors have put into revising their
manuscript. The additional analyses have significantly enhanced the depth and rigor of the study.
These revisions have sufficiently strengthened the scientific value of the research, making it a
meaningful contribution to the field and worthy of publication.
Review for 10.1186/s12876-025-03788-0 (2025)

Title: The effectiveness of treatment with probiotics in preventing necrotizing enterocolitis
and related mortality: Results from an umbrella meta-analysis on meta-analyses of randomized
controlled trials
Version: 0 Date: 09 Dec 2024
Reviewer:  Gaohong Wu
Reviewer's report:
The effectiveness of treatment with probiotics in preventing necrotizing Enterocolitis and related
mortality: Results from an umbrella meta-analysis on meta-analyses of randomized controlled
trials
The authors aim to assess the effects of different types of probiotics on NEC and related
mortality.
Good things about the paper
1 The topic of this paper has a strong application value, the collection of literature materials
is detailed, the comprehensive use of the knowledge to solve the problem, there are innovative
insights. In addition, the paper format is correct, the writing is standardized, clear and fluent.
2 In this paper, the literature on all relevant studies were synthesized, which provided a new
basis. The author's thinking is clear, the process of discussion is rigorous, and the analysis is
reasonable. The writing of the paper is standardized and the sentences are smooth.
Major comments
Although this paper has many advantages, there are still some shortcomings.
1 The risk of bias should be evaluated from six perspectives: measurement bias, attrition bias,
reporting bias, choice bias, performance bias, and other biases. I hope the author can make a
clear analysis from these aspects.
2 In “Literature quality assessment”, what software did you use for the evaluation, and what
were the results of the evaluation? It would be better to provide a corresponding summary chart
or table.
The above are my opinions. I hope the author can explain and modify them. If there are any
shortcomings, I hope the author can criticize and correct me.
Review for 10.1186/s12876-025-03788-0 (2025)

Title: The effectiveness of treatment with probiotics in preventing necrotizing enterocolitis
and related mortality: Results from an umbrella meta-analysis on meta-analyses of randomized
controlled trials
Version: 0 Date: 12 Dec 2024
Reviewer's report:
Thank you for giving me the opportunity to review the manuscript entitled: The effectiveness of
treatment with probiotics in preventing necrotizing enterocolitis and related mortality: Results
from an umbrella meta-analysis on meta-analyses of randomized controlled trials. I find the work
very interesting and it provides new evidence on the usefulness of probiotics in Neonatal Units.
However, I see some inconsistencies in the methodological material section that I present below:
- I do not understand the selection criteria and it deviates from the objective of the study. I can
understand that the participants are newborns weighing less than 1500g, but not that they refer
to children with Helicobacter pylori eradication treatment.
- I also do not understand that the selection criteria are patients aged 18 years or older, a criterion
that should be directed to a population of premature newborns with very low birth weight.
The other aspects of the manuscript seem adequate to me.
Review for 10.1186/s12876-025-03788-0 (2025)

Title: The effectiveness of treatment with probiotics in preventing necrotizing enterocolitis
and related mortality: Results from an umbrella meta-analysis on meta-analyses of randomized
controlled trials
Version: 2 Date: 18 Feb 2025
Reviewer:  Gaohong Wu
Reviewer's report:
The author has revised the paper in detail according to the reviewer's comments.
Review for 10.1186/s12876-025-03788-0 (2025)

Title: The effectiveness of treatment with probiotics in preventing necrotizing enterocolitis
and related mortality: Results from an umbrella meta-analysis on meta-analyses of randomized
controlled trials
Version: 3 Date: 07 Mar 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
The responses are satisfactory
Review for 10.1186/s12876-025-03812-3 (2025)

Title: The Role of Seladelpar in Primary Biliary Cholangitis: A Systematic Review and Meta-
Analysis
Version: 0 Date: 06 Feb 2025
Reviewer's report:
This article systematically evaluated the efficacy and safety of Seladelpar, a selective PPAR-
# agonist, for the treatment of primary biliary cholangitis (PBC). To address the conflicting
efficacy conclusions and insufficient long-term safety evidence in existing studies, the authors
integrated clinical trial data to clarify the clinical value of Seladelpar through a systematic review
and meta-analysis, and explored future research directions, aiming to provide an evidence-based
rationale for optimising therapeutic strategies for PBC.However, some drawbacks in the paper
necessitate revisions prior to publication.
1.There are some typos errors and grammatical issues through the manuscrip.
2.The authors retrieved studies up to March 2024, which is almost a year ago now, so please
retrieve any new studies that have been done in that time and add to them.
3.Due to limited studies, only two results in the 10mg group were available for combining, other
doses were not applicable, please check that the methodology of the subgroup analyses is correct.
Review for 10.1186/s12876-025-03812-3 (2025)

Title: The Role of Seladelpar in Primary Biliary Cholangitis: A Systematic Review and Meta-
Analysis
Version: 0 Date: 07 Feb 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Authors, please address the following points below
-Although non-English studies were excluded, including them could enhance the
comprehensiveness of the review. If language bias is a concern, the authors could consider
including a method for handling studies in different languages (e.g., translation or summarizing
results).
-It’s great that grey literature sources were searched, but more details about how this was
done (e.g., specific databases or platforms) would be useful. Additionally, the authors should
comment on any challenges faced in identifying or evaluating grey literature.
-The inclusion of various adverse events, such as pruritus and abdominal pain, is a strong point.
However, a more detailed breakdown of the severity and frequency of these events, along with
their impact on treatment adherence, could further enrich the analysis.
-Although the authors mention heterogeneity across studies, the discussion could provide more
details on the potential causes of the heterogeneity. For example, it would be helpful to delve
deeper into the specific dosages and disease severities in the studies included, as these factors
may influence outcomes significantly. Additionally, more specific data on the random-effects
model and its implications could further support the analysis.
-While the long-term safety concerns of Seladelpar are mentioned, it would be useful to provide
a more detailed examination of these issues. For instance, what were the specific adverse events
that occurred after long-term usage? How do these compare to other treatments over an extended
period? This would help in weighing the risk-benefit profile of Seladelpar for chronic use.
-The absence of immunohistochemistry evaluation in the included studies is a limitation that
could be more thoroughly addressed. Understanding Seladelpar’s mechanistic effects on the
liver, such as its anti-fibrotic and anti-inflammatory properties, would significantly enhance the
understanding of its potential benefits. Providing suggestions for how future studies could better
explore these mechanisms would be helpful.
-The discussion briefly touches on adverse effects such as abdominal pain, headache, and
gastrointestinal upset. However, more details about the severity of these side effects, their
impact on treatment adherence, and how Seladelpar compares with other treatments in terms
of tolerability would add depth to the safety analysis. Additionally, the impact of comorbidities
(e.g., cardiovascular conditions) on Seladelpar's safety profile could be explored further.
-The authors mention comparing Seladelpar with other emerging medications, but this
comparison could be more detailed. How does Seladelpar compare with other PPAR agonists
or novel treatments for PBC in terms of efficacy, safety, and long-term benefits?
Review for 10.1186/s12876-025-03774-6 (2025)

Title: Clinical Practice Guidelines for the Diagnosis of Constipation-predominant Irritable
Bowel Syndrome and Functional Constipation in Adults: A Scoping Review
Version: 1 Date: 30 Jan 2025
Reviewer's report:
Thank you for an interesting scoping review on the differences between clinical practice
guidelines (CPGs) for Irritable Bowel Syndrome with predominant constipation (IBS-C) and
Functional Constipation (FC) in different countries over time. Here are my suggestions for
clarifying your manuscript even further.
An overall comment: I lack discussion around that and why the CPGs do not follow the existing
Rome criteria (in this case Rome III and IV) as these criteria are used and accepted worldwide.
Please adjust reference 2, as this reference is from the year 1990, and thus cannot include either
of Rome III or Rome IV criteria.
The numbers are mixed up in row 96. The prevalence for FC is 11.7% and for IBS-D 1.3%.
The sentence in row 109-110 is not complete.
Please consider rephrasing rows 117-118.
I would suggest to move the sentence in rows 217-218 to the discussion part.
Please consider moving the sentence in rows 318-321 to the part on serotonin later on in the
discussion.
Please elucidate on “changing is lack of evidence” in row 340.
I miss references to the questionnaires mentioned in rows 349-351. Also, row 351 is the only
part where quality of life is mentioned in the manuscript. Please consider removing it, as the
other parts of the discussion are more focused on biometrics.
The study described in rows 419-424 is interesting, but I lack a description with which patient
group or healthy the oleamide levels in FC was compared. This is interesting to know, especially
if the comparison group was IBS-C.
For the figures and tables, please consider following: Remove Figure 2 and replace it with
Supplementary Figure 5a-c. Remove Figure 3 and use Supplementary Figure 5d-f instead, with
specifying which variable was mentioned for IBS and which for FC. Remove Supplementary
File 6a-b from the supplementary material and merge them into one regular table. Please adjust
Figure numbers, as Figure 4 is missing.
Review for 10.1186/s12876-025-03774-6 (2025)

Title: Clinical Practice Guidelines for the Diagnosis of Constipation-predominant Irritable
Bowel Syndrome and Functional Constipation in Adults: A Scoping Review
Version: 1 Date: 07 Feb 2025
Reviewer's report:
The authors present a scoping review on clinical practice guidelines of constipation predominant
irritable bowel syndrome (IBS-C) and functional constipation (FC). This area is of great interest
as the authors correctly mention: currently used approaches and clinical diagnostic criteria do
not assess bowel habits (frequency of spontaneous bowel movements, presence of straining and
incomplete evacuation) in IBS-C and do not assess pain (frequency, intensity) granularly enough
in patients with FC - this makes diagnosing these conditions difficult, especially as they might
overlap in the same individual over time.
Unfortunately, the manuscript falls short in several domains:
Major:
1) The manuscript requires linguistic overhaul: currently, past and present tenses are mixed and
not consistently used
2) Statements are not consistently referenced (e.g. some statements regarding guidelines do not
include a reference to the respective reference).
3) The authors present overviews on whether guidelines various disease characteristics
(abdominal pain frequency etc.). This information would be of much greater value if presented
in a more detailed way: e.g. what was the pain frequency threshold to diagnose IBS-C (mean
and range of guidelines). This would paint a much more detailed picture of clinical guidelines
than merely show a figure of whether it was mentioned or not. I would encourage the authors
to show for all aspects shown in Figure 2 what the thresholds or recommendations were in the
guidelines that mentioned it.
4) The discussion is not concise and includes highly speculative aspects on microbiota etc. not
at all related to the present work.
Review for 10.1186/s12876-025-03774-6 (2025)

Title: Clinical Practice Guidelines for the Diagnosis of Constipation-predominant Irritable
Bowel Syndrome and Functional Constipation in Adults: A Scoping Review
Version: 1 Date: 09 Feb 2025
Reviewer's report:
Thanks for submitting this manuscript. It’s a well-executed scoping review with a solid
methodology,
• The authors focus only on diagnostic criteria in CPGs but don’t provide a rationale for
excluding treatment recommendations. Given that diagnosis and management often go hand in
hand, it would strengthen the paper to justify why treatment guidelines were excluded.
• The Rome IV criteria are subjective and symptom-based, so why prioritize this narrow focus?
A broader review considering treatment pathways in CPGs would give a more complete picture.
If this focus is intentional, the reasoning should be explicitly stated.
• Not all CPGs are created equal—some are based on systematic reviews, while others are expert
consensus-based. Without evaluating guideline rigor, the review treats all CPGs as if they hold
equal weight, which is problematic.
• There is extensive commentary on microbiome research, omics, and biomarker development,
but this feels disconnected from the manuscript’s core focus. While it’s fair to discuss
pathophysiology briefly, this review is about CPGs.
• Are the authors suggesting these biomarkers should be incorporated into current or future
guidelines? If so, that argument needs much more development. If not, this section should be
trimmed down significantly or reframed.
• Regional differences are discussed descriptively, but without any statistical tests, it’s hard to tell
whether these differences are meaningful. Even a basic chi-square test would add much-needed
rigor. If statistical analysis isn’t possible, this limitation should be explicitly acknowledged.
Review for 10.1186/s12876-025-03774-6 (2025)

Title: Clinical Practice Guidelines for the Diagnosis of Constipation-predominant Irritable
Bowel Syndrome and Functional Constipation in Adults: A Scoping Review
Version: 2 Date: 22 Feb 2025
Reviewer's report:
I appreciate the effort you have put into revising your manuscript. The revised version has
successfully addressed the concerns raised during the review process, and I am satisfied with the
improvements. Your thorough responses and modifications have strengthened the clarity and
quality of the manuscript.
Congratulations on this well-executed revision. I look forward to seeing your work published.
Review for 10.1186/s12876-025-03774-6 (2025)

Title: Clinical Practice Guidelines for the Diagnosis of Constipation-predominant Irritable
Bowel Syndrome and Functional Constipation in Adults: A Scoping Review
Version: 2 Date: 25 Feb 2025
Reviewer's report:
Thank you for a very interesting scooping review manuscript on clinical practice
guidelines (CPGs) for functional constipation and irritable bowel syndrome with constipation
predominance. The manuscript has greatly improved since the first round of review, but still
some issues remain.
I would recommend the authors to revise the use of present or past tense throughout the
manuscript, especially in the Methods and Discussion section. Also, the Lower Endoscopy,
Laboratory Test and Imaging Tests and Assessment for Motility parts needs a minor language
revision, due to long and somewhat unclear sentences.
The manuscript describes the use of Bristol Stool Form Scale (BSFS) type 3 in some CPGs,
but I miss an explanation of the types of BSFS commonly used in the criteria for IBS-C (which
should be BSFS type 1 and 2).
Some minor comments:
Please consider moving the description of the one and only CPG with abdominal pain severity
criteria from the abstract to row 221, as it is a minor, although important, finding of the study.
In row 236, you present that many, but not all CPGs consider abdominal discomfort without
pain as one of the criteria for IBS, but did not mention how many of these were Rome III based
CPGs. In Rome III, either abdominal pain or discomfort were a part of IBS criteria and thus, it
would be natural for these CPGs to include abdominal discomfort as one of their criteria.
Review for 10.1186/s12876-025-03774-6 (2025)

Title: Clinical Practice Guidelines for the Diagnosis of Constipation-predominant Irritable
Bowel Syndrome and Functional Constipation in Adults: A Scoping Review
Version: 3 Date: 06 Mar 2025
Reviewer's report:
I appreciate the effort you have put into revising your manuscript. The revised version
has successfully addressed the concerns raised during the review process, and I am
satisfied with the improvements. Your thorough responses and modifications have
strengthened the clarity and quality of the manuscript.
Congratulations on this well-executed revision. I look forward to seeing your work
published.
Review for 10.1186/s12876-025-03774-6 (2025)

Title: Clinical Practice Guidelines for the Diagnosis of Constipation-predominant Irritable
Bowel Syndrome and Functional Constipation in Adults: A Scoping Review
Version: 3 Date: 06 Mar 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
The responses are satisfactory
Review for 10.1186/s12876-025-03831-0 (2025)

Title: The Fasting Plasma Glucose to High-Density Lipoprotein Cholesterol Ratio: A Novel
Index for Identifying NAFLD
Version: 1 Date: 12 Mar 2025
Reviewer:  Nam Nhat Nguyen
Reviewer's report:
The authors have adequately addressed all of my concerns. The manuscript is now ready for
acceptance in its current form.
Review for 10.1186/s12876-025-03831-0 (2025)

Title: The Fasting Plasma Glucose to High-Density Lipoprotein Cholesterol Ratio: A Novel
Index for Identifying NAFLD
Version: 1 Date: 20 Mar 2025
Reviewer's report:
I have read through the revisions and the rebuttal letter to my previous comments. All issues
have been well addressed, and I have no further comments on this.
Review for 10.1186/s12876-025-03773-7 (2025)

Title: Title: Association of sarcopenia with serum ferritin levels and hepatic indices like NFS
and FIB-4 in NAFLD patients
Version: 2 Date: 22 Aug 2024
Reviewer's report:
The topic is very interesting!
However, I think it could be better explored by including the analysis of iron levels and
separating the results by gender due to the differences in some parameters analyzed in women
and men.
Pay more attention to the writing, some paragraphs are difficult to understand.
I suggest redoing the tables.
Review for 10.1186/s12876-025-03773-7 (2025)

Title: Title: Association of sarcopenia with serum ferritin levels and hepatic indices like NFS
and FIB-4 in NAFLD patients
Version: 2 Date: 06 Sep 2024
Reviewer's report:
Authors are requested to stress a central point that is ...  A limitation in the field of clinical
investigation of sarcopenic patients is the lack of a generally accepted definition coupled with
the difficulty of adopting common diagnostic criteria. This explains the  different prevalence
in various studies, as evident in..Intern Emerg Med. 2023; 18(7): 1887–1895. Published online
2023 Jul 25. doi: 10.1007/s11739-023-03339-z
PMCID: PMC10543607PMID: 37490203
Among confounding factor  (authors should point out all of them and shown the results of various
models) was physical activity evaluated and what ere the results?
in the light that exercise is closely linked to sarcopenia , as evident in...Association of
physical behaviours with sarcopenia in older adults: a systematic review and meta-analysis of
observational studies
Lancet Healthy Longev. 2024; 5:e108-e119.
Also middle aged population can suffer from sarcopenia, as evident in..Association of possible
sarcopenia with major chronic diseases and multimorbidity among middle-aged and older adults:
findings from a national cross-sectional study in China. Geriatr Gerontol Int. 2023;23(12):925–
31. https://doi.org/10.1111/ggi.14720.
Authors should specify the US criteria for diagnosing NAFLD and classify its severity, as well
as the values of cross sectional area of the  rectus femoris for detecting sarcopenia.
Could authors express values with a more precise definition, such as mean+/-SD ,   median (IQ),
percentage and CI of OR  to easy the comprehension of the results in the text and Tables?
Could  authors evidence the serum  Ferritin concentrations in their selected patients and controls?
In the Introduction section, authors are requested to check this sentence and amend it...To
emphasize the importance of metabolic risk factors in the progression of NAFLD an international
panel led by Eslam M.  proposed another term for it, going by metabolic-dysfunction-associated-
fatty-liver-disease (NAFLD)....MAFLD?
In the Discussion section, authors are advised to start summarizing their results and discussing
them, instead of referring to other studies.
There are some  typos that should be amended  in the  text and legend to Table 2
Review for 10.1186/s12876-025-03773-7 (2025)

Title: Title: Association of sarcopenia with serum ferritin levels and hepatic indices like NFS
and FIB-4 in NAFLD patients
Version: 2 Date: 08 Sep 2024
Reviewer's report:
Title: Association of sarcopenia with serum ferritin levels and hepatic indices like NFS and
FIB-4 in NAFLD patients
This is a very interesting study, I got acquainted with the information and results that are of
practical importance with great interest. However, I have a few comments.
1. Sarcopenia was diagnosed by measuring the thickness of the rectus femoris by
ultrasonography.  Muscle strength and physical performance were not determined. There are
no cumulative signs of sarcopenia. Please read and add this consensus to references: https://
doi.org/10.1093/ageing/afy169. It is advisable to rename the article, namely, to indicate not
"Association of sarcopenia with ...", but "Association of ultrasound signs of sarcopenia with ...".
2. The results in the abstract look like this: «According to statistical analysis, there is a significant
association between the level of ferritin in serum and sarcopenia. Besides, there is a significant
association between NFS, Fib4, and sarcopenia». I would like to see more specific formulations
here (what is the positive correlation? what is the prevalence of ultrasound signs of sarcopenia
in the study participants?). The results in the article take up 1 page and 3 tables. The tables
indicate that 82% of patients are overweight. It is not clear how many patients had ultrasound
signs of sarcopenia. A significant positive correlation between sarcopenia and ferritin, NFS and
Fib4 was revealed. And what follows from this? Please describe it in more detail.
3. Discussion: - the Kwon Y. study https://doi.org/10.3390/jcm9103355 - This comparison in
the discussion is not correct, given the difference in the age of patients in the two studies.
4. The authors write that serum ferritin levels are associated with criteria that determine fibrosis.
Perhaps it would be appropriate to write in more detail about ferritin in the «Introduction» or
«Discussion» and explain why it was chosen for this study. It is necessary to explain to the
reader the logic of the authors.
5. In the same part, it is desirable to note about sarcopenic obesity and make analogies with
other studies.
Review for 10.1186/s12876-025-03773-7 (2025)

Title: Title: Association of sarcopenia with serum ferritin levels and hepatic indices like NFS
and FIB-4 in NAFLD patients
Version: 2 Date: 08 Sep 2024
Reviewer's report:
The paper: Association of sarcopenia with serum ferritin levels and hepatic indices like NFS and
FIB-4 in NAFLD patients presents some knowledge on selected parameters of liver function
and relation to sarcopenia.
Major flaws are:
1. Methods are not described properly. The liver steatosis in ultrasound- how was it described?
The most important: how was sarcopenia evaluated with ultrasound- no data on it. Statistical
methods- not described properly. Why were the markers of liver fibrosis (FIB-4) chosen for
evaluations?? The ferritin level is  often elevated in liver injury – why was it chosen??
2. Results- the are no basic results- what was the results of sarcopenia measurements, other lab
tests ??
The English needs corrections,
I can not recommend the paper for publication
Review for 10.1186/s12876-025-03773-7 (2025)

Title: Title: Association of sarcopenia with serum ferritin levels and hepatic indices like NFS
and FIB-4 in NAFLD patients
Version: 3 Date: 16 Jan 2025
Reviewer's report:
Thank you for the work you have done on the article.
I have comments that remain:
1. The phenomenon of “sarcopenic obesity” in patients with this pathology is still not described
2.  There is no comparison group
3. no analysis with inflammatory markers has been performed
I recommend finalizing the manuscript.
Review for 10.1186/s12876-025-03773-7 (2025)

Title: Title: Association of sarcopenia with serum ferritin levels and hepatic indices like NFS
and FIB-4 in NAFLD patients
Version: 4 Date: 05 Mar 2025
Reviewer's report:
Peer Review Report
Manuscript Title: "Association of Ultrasound Signs of Sarcopenia with Serum Ferritin Levels
and Hepatic Indices like NFS and FIB-4 in NAFLD Patients"
Dear Editors and Authors,
I have thoroughly reviewed the revised version of the manuscript titled "Association of
Ultrasound Signs of Sarcopenia with Serum Ferritin Levels and Hepatic Indices like NFS and
FIB-4 in NAFLD Patients". The authors have addressed the reviewers’ comments diligently and
significantly improved the quality of the paper.
The study explores the association between ultrasound-diagnosed sarcopenia, serum ferritin
levels, and non-invasive hepatic indices (NFS, FIB-4) in patients with non-alcoholic fatty liver
disease (NAFLD). The authors have presented a compelling and methodologically sound study
that contributes valuable evidence to the NAFLD field. The revisions have addressed previous
concerns effectively. I recommend acceptance for publication in BMC Gastroenterology.
This work aligns well with the journal’s focus and will interest a broad audience.
Review for 10.1186/s12876-025-03778-2 (2025)

Title: High sensitivity C-reactive protein Implicates Heterogeneous Metabolic Phenotypes and
Severity in Metabolic Dysfunction Associated-Steatotic Liver Disease
Version: 2 Date: 11 Feb 2025
Reviewer's report:
In this manuscript entitled “High sensitivity C-reactive protein Implicates Heterogeneous
Metabolic Phenotypes and Severity in Metabolic Dysfunction Associated-Steatotic Liver
Disease”, the authors examined the association between MASLD and high sensitivity CRP.
Although this is an interesting topic, there are several points which should be clarified in the
current paper.
1. In the introduction, the authors should explain the epidemiology of MASLD in general and
overweight or obese population (PMID: 38398471).
2. The study examines the role of hs-CRP in MASLD, but its clinical relevance as a diagnostic
or prognostic marker remains unclear. The manuscript states that hs-CRP levels are associated
with liver fat content (LFC) in overweight/obese individuals and liver stiffness in lean MASLD
patients, yet the reported AUC values suggest weak predictive ability (AUC < 0.7).
3. Although the study adjusts for several confounders, it does not clearly discuss the impact of
other key metabolic and inflammatory conditions, such as insulin resistance, chronic infections,
or comorbid conditions like cardiovascular disease. These factors could influence both hs-CRP
levels and MASLD severity.
4. The study validates findings in a biopsy-proven MASLD subgroup, but the results appear
inconsistent. While hs-CRP correlates with steatosis severity in overweight/obese MASLD
patients, it does not seem to predict MASH or fibrosis effectively. This raises concerns about
its utility in histologically confirmed MASLD cases.
5. Body fat accumulation is associated with steatotic liver disease and systemic inflammation.
The authors should make a discussion in this point (PMID: 37143429).
Review for 10.1186/s12876-025-03778-2 (2025)

Title: High sensitivity C-reactive protein Implicates Heterogeneous Metabolic Phenotypes and
Severity in Metabolic Dysfunction Associated-Steatotic Liver Disease
Version: 2 Date: 14 Feb 2025
Reviewer's report:
This manuscript examines the association between hs-CRP and other systemic inflammatory
markers and evaluates the diagnostic performance of hs-CRP in predicting MASLD severity.
The topic holds clinical significance; however, the study lacks sufficient evidence, and the
manuscript structure requires improvement.
1. A substantial amount of essential information is presented in the supplemental materials,
making the main manuscript unclear. Key details such as subgroup definitions and statistical
methods are completely missing from the Methods section. Even if constrained by word limits,
the main manuscript must contain essential methodological details. The authors should consider
condensing other sections to ensure critical information is included within the main text.
2. Lack of background on systemic inflammatory markers: The Introduction does not provide
sufficient context on MHR, NHR, NLR, PLR, and LMR, as well as liver injury indicators.
The authors should explain their physiological roles, relevance to MASLD, and expected
relationships with disease severity.
3. Figure 1 – The figure lacks a clear definition of "overlap"—does it represent the proportion
of participants with elevated biomarkers? If so, what threshold was used? Additionally, are the
elevations statistically significant? These clarifications are necessary for accurate interpretation.
4. Figure 2 – It is unclear which group is represented here, and the total number sums to 401,
which does not align with the stated cohort. The authors should clarify how participants were
selected for this analysis.
5. Figure 3 – Figure 3 is referenced in Section 3.3 (Correlation Analysis), but it does not contain
correlation-related information. It is also cited in Section 3.4 (Validation Analysis), but its
relevance is unclear. The authors should double-check the figure contents and ensure proper
referencing.
6. Table 3 presents correlation analyses with significant p-values, but the correlation
coefficients for independent variables are low, indicating weak associations. The authors should
acknowledge this limitation and discuss its implications for clinical relevance.
Review for 10.1186/s12876-025-03778-2 (2025)

Title: High sensitivity C-reactive protein Implicates Heterogeneous Metabolic Phenotypes and
Severity in Metabolic Dysfunction Associated-Steatotic Liver Disease
Version: 4 Date: 04 Mar 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
The responses are satisfactory
Review for 10.1186/s12876-025-03778-2 (2025)

Title: High sensitivity C-reactive protein Implicates Heterogeneous Metabolic Phenotypes and
Severity in Metabolic Dysfunction Associated-Steatotic Liver Disease
Version: 4 Date: 04 Mar 2025
Reviewer's report:
Thank you for the effort to revise. I have no further comments.
Review for 10.1186/s12876-025-03883-2 (2025)

Title: Dynamic Variations in Peripheral Blood Indices and Their Association with Efficacy
and Adverse Reactions of PD-1 Inhibitor Combined Chemotherapy in Patients with Advanced
Gastric Cancer
Version: 4 Date: 30 Jan 2025
Reviewer:  Mohamed H. Zidan
Reviewer's report:
Dear Authors,
The study titled "Dynamic Variations in Peripheral Blood Indices and Their Association with
Efficacy and Adverse Reactions of PD-1 Inhibitor Combined Chemotherapy in Patients with
Advanced Gastric Cancer" provides an insightful retrospective study on peripheral blood
biomarkers in predicting response and prognosis in gastric cancer patients receiving PD-1
inhibitor-based immunotherapy. The study is methodologically sound, employing statistical
modeling to evaluate associations between inflammatory markers, tumor markers, and clinical
outcomes.
I have no comments