JerMa88/BMC_Gastroenterology_Peer_Reviews huggingface dataset:
Review for 10.1186/s12876-024-03446-x (2024)

Title: The prevalence of obesity and underweight in celiac patients at the time of diagnosis: a
systematic review and meta-analysis
Version: 2 Date: 15 Aug 2024
Reviewer:  Stephanie Moleski
Reviewer's report:
I think this is an important topic and it is good to highlight how the classic presentation of
malabsorption in newly diagnosed CD patients is changing and that many patietns will not be
underweight at diagnosis. However it is not as novel as the authors claim.
The article falsely claims that “there is no comprehensive conclusion on the pooled prevalence
of obesity and overweight in celiac patients.”  Barone’s review article published in 2023 does
in fact look at pooled prevalence of patients in different BMI categories at CD diagnosis.  So
this is not as novel data as the authors suggest.
In the first paragraph the last sentence references a recent theory including the compensation
theory.  But the reference is from 1986.  They do mention it is a theory but with such an old
reference I do not think it is appropriate to include in a review.
In the discussion section, there is a paragraph describing the prevalence of underweight CD
patients (page 11). The authors claim that CD is not common in developing countries but also
discuss the presentation of CD patients in India.  The authors should note that the incidence of
CD in India, particularly North India is rising.
Furthermore, the authors discuss (also last paragraph on page 11) that these patients have more
severe intestinal damage due to the delay in diagnosis making it more common that they are
underweight.   However, in the conclusion paragraph the authors state that a delay in diagnosis
is more common in obese individuals.  While this is true, it seems conflicting to their prior
statement.
Review for 10.1186/s12876-024-03446-x (2024)

Title: The prevalence of obesity and underweight in celiac patients at the time of diagnosis: a
systematic review and meta-analysis
Version: 2 Date: 20 Aug 2024
Reviewer's report:
Dear Editor
Thanks for the opportunity to review the manuscript titled, "The prevalence of obesity and
underweight in celiac patients at the time of diagnosis: a systematic review and meta-analysis’’.
The recommended suggestions are applied in this revised manuscript . Overall, the manuscript
well written .
Best wishes,
Review for 10.1186/s12876-024-03446-x (2024)

Title: The prevalence of obesity and underweight in celiac patients at the time of diagnosis: a
systematic review and meta-analysis
Version: 2 Date: 22 Aug 2024
Reviewer's report:
I congratulate the authors on their work and the aim to answer an important question in the field
of celiac disease. I am not a meta analysis methodologist but the search and approach appears
sound.
Suggestions:
-In the eligibility section, formally state that this is an analysis of studies including "adults" with
celiac disease.
-Label abbreviations on the tables/figures.
-When drawing conclusions on the underweight individuals:
---I agree that highlighting that this is decreasing over time, but can you compare the 11% to
that reported in controls? This still may be more than the general population studied/reported.
You did highlight this for India in the discussion.
---Celiac disease should still be considered in those with a malabsorptive phenotype even though
the BMI may be changing.
-I agree with your restrictions to include those at baseline diagnosis, before a gluten free diet.
-While the proportion of obese/overweight celiac patients is increasing, please highlight in the
discussion that you did find that controls an OR of 1.25 for being obese/overweight.
-when referring to continent in the meta-regression, please clarify in the text/figure label if
referring to geography.
-In the discussion, first paragraph, clarify if reported prevalences are percentages (%).
-The discussion should have a  clear  conclusion/highlight that this study shows that it is common
for patients to be overweight/obese at diagnosis, confirming the reported change in phenotype
of celiac disease from that of strictly  malabsorptive/malnourished to now include those  without
clear evidence of malnutrition.  Some CD still presents with the classic phenotype, highlighted
by the 11% seen here.
Paragraph 3 in the discussion is somewhat confusion looking at gender. With your p value of
0.055, I would not ground too much on the female component seen here. I would also phrase
the association with age differently as the verbiage in this paragraph is somewhat unclear. Does
your data suggest that "in celiac patients, there is an association between higher age and being
overweight/obese"?
In paragraph 5 of the discussion,  caution with using the phrase that celiac disease is not common
in developing countries. Consider rephrasing that CD is less frequently diagnosed in developing
countries, and may be more suspect in those with an malnourished phenotype--unless you have
a source to show differences in prevalence of CD in the developing world.
Review for 10.1186/s12876-024-03446-x (2024)

Title: The prevalence of obesity and underweight in celiac patients at the time of diagnosis: a
systematic review and meta-analysis
Version: 4 Date: 07 Sep 2024
Reviewer's report:
1) The authors are advised to utilize the ROBINS-E tool to assess the risk of bias in the included
studies, as the NOS instrument is outdated and has limited reliability.
2) Additional details regarding the heterogeneity estimator employed should be provided in the
statistical section.
3) The GRADE tool should be applied to evaluate the certainty of the study's findings.
4) The authors should address the retrospective registration of their protocol in the limitations
section. In their response to reviewers, they mentioned that their search strategy was updated,
leading to the protocol's retrospective registration. However, this statement is inaccurate.
Retrospective registration diminishes the reliability of the study, as it raises concerns about
potential changes in outcomes or other critical aspects of the systematic review.
Review for 10.1186/s12876-024-03446-x (2024)

Title: The prevalence of obesity and underweight in celiac patients at the time of diagnosis: a
systematic review and meta-analysis
Version: 4 Date: 10 Sep 2024
Reviewer's report:
Dear Editor,
I should first thank for inviting me as potential reviewer to read and comment on paper entitled
‘’The prevalence of obesity and underweight in celiac patients at the time of diagnosis: a
systematic review and meta-analysis’’.
In the current study, the authors aimed to estimate the prevalence of obesity, overweight, and
underweight in celiac disease (CD) at diagnosis before starting the gluten-free diet.
The main title accurately reflects the major topic and content of the study.
The abstract summarizes and reflects the work described in the manuscript. Also, the abstract
presents the significant points related to the background, objectives, materials and methods,
results and conclusions.
The materials and methods sufficiently described for the results and conclusions that are
presented in the preceding sections. The study type and design were defined in the section of
the materials and methods. Inclusion and exclusion criteria are well defined. Figures and tables
are sufficient and well-organized.
The section of the discussion is well organized. The conclusions are drawn appropriately
supported by the literature. The manuscript adequately describes the background, present
status and significance of the study. The manuscript interprets the findings adequately and
appropriately, highlighting the key points clearly.
I think that it will contribute to the literature. I have some minor criticisms.
- The Introduction part of the manuscript appropriately cites the important and authoritative
references but does not cite the recent published articles. Especially at the following sentences,
if the recent published articles about celiac disease and autoimmune disease for example ‘’ Eur
J Rheumatol. 2019 Apr 22;6(3):142-145. Serological screening for celiac disease in children
with systemic lupus erythematosus’’,  ‘’Arab J Gastroenterol. 2019 Jun;20(2):95-98. Serological
screening for coeliac disease in patients with juvenile idiopathic arthritis’’, ‘’Acta Gastroenterol
Belg. 2018 Jan-Mar;81(1):5-8. The frequency of celiac disease in children with autoimmune
thyroiditis’’ are cited, the manuscript would be better.
- Especially at the following sentence, if the recent published articles about that ‘’Clinical
evaluation of children with celiac disease: A single-center experience. Arch Clin Gastroenterol
6(2): 026-030. DOI: https://dx.doi.org/10.17352/2455-2283.000074’’
#s cited, it would be better. In that article conducted in Turkey, underweight was detected in
29 patients (47.5%).
‘’Although the prevalence of underweight among CD patients in developed countries was
approximately less than 10%, in developing countries, overweight and obesity are considered
rare symptoms of CD at the time of diagnosis; for instance, in India, 36%-42% of CD patients
were underweight [5, 32]’’
Review for 10.1186/s12876-024-03446-x (2024)

Title: The prevalence of obesity and underweight in celiac patients at the time of diagnosis: a
systematic review and meta-analysis
Version: 5 Date: 25 Sep 2024
Reviewer's report:
Thanks authors for the study. The authors did  an appropriate point-by-point response.
I think that it will contribute to the literature.
Review for 10.1186/s12876-024-03425-2 (2024)

Title: BODY COMPOSITION AND MUSCLE COMPOSITION PHENOTYPES IN
PATIENTS ON WAITLIST AND SHORTLY AFTER LIVER TRANSPLANT – RESULTS
FROM A PILOT STUDY
Version: 0 Date: 18 May 2024
Reviewer's report:
Forsgren and co-authors report a pilot study of pre- and post-liver transplant body composition
using MRI based analysis in a small single-center patient cohort. I congratulate them on a
clearly written report that will guide design and execution of a potentially practice-changing
investigation of body composition in liver transplantation.
I suggest that the authors consider discussing several issues in the design of their upcoming work:
Can a multi-center vs a single-center design provide enhanced impact and generalizability?
MASLD is becoming a dominant cause of ESLD requiring transplantation. Its components have
predictable impacts on immediate and prolonged muscle, fat, and functional outcomes that set it
apart from other diseases.  I would consider whether limiting the study population to MASLD or
else expanding it to allow a valid subanalysis of the MASLD subpopulation would have merit.
This research team has an opportunity to connect the dots among key outcomes domains that
are usually ignored in overfocused prospective studies.
There should be objective longitudinal measurement of functional physical activity status and
outcomes pre- and post-transplant.  I would give each subject a wearable personal activity
monitor and include steps/day as a tracked baseline parameter and post transplant outcome that
is likely to be superior to LFI or other measurements.
Consider tracking post transplant morbidity (hospital days, actual cost of care) as a key outcome.
Use a standardized QOL metric as a tracked outcome.
Review for 10.1186/s12876-024-03425-2 (2024)

Title: BODY COMPOSITION AND MUSCLE COMPOSITION PHENOTYPES IN
PATIENTS ON WAITLIST AND SHORTLY AFTER LIVER TRANSPLANT – RESULTS
FROM A PILOT STUDY
Version: 0 Date: 09 Jul 2024
Reviewer's report:
PEER REVIEWER ASSESSMENTS:
OBJECTIVE - Full research articles: is there a clear objective that addresses a testable research
question(s) (brief or other article types: is there a clear objective)?
Yes - there is a clear objective
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for
the objective?
Yes - the approach is appropriate
EXECUTION - Are the experiments and analyses performed with technical rigor to allow
confidence in the results?
No - there are minor issues
STATISTICS - Is the use of statistics in the manuscript appropriate?
Yes - appropriate statistical analyses have been used in the study
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not
overstated?
No - there are minor issues
OVERALL MANUSCRIPT POTENTIAL - Is the current version of this work technically
sound? If not, can revisions be made to make the work technically sound?
Probably - with minor revisions
PEER REVIEWER COMMENTS:
GENERAL COMMENTS: This is an interesting study on how body composition changes in
patients with liver failure in transplant waitlist and after liver transplant. The study is well-
performed and has results with the potential of benefiting these patients. Despite the good work,
there are some details still needed to fully understand what was actually done, the manuscript
in its current form has some areas to be improved.
REQUESTED REVISIONS:
The objective is clearly stated and consistent with the work presented. It is not clear why the
so-called functional status was included, it doesnt add information to the work. The authors
state that this is a pilot study, but there is no information on which is the main study, please
add this data. The main issue is about the MRI measurements, it is not clear if there were
only two measurements or more measurements were done. Please clarify and detail hoy these
measurements were done. The discussion lacks a limitations section and the arguments on
cardiovascular diseases is far-fetched.
ADDITIONAL REQUESTS/SUGGESTIONS:
Statistical description is poor. Please review this section and add more details, even discuss
briefly why these models were chosen over other available.
Review for 10.1186/s12876-024-03425-2 (2024)

Title: BODY COMPOSITION AND MUSCLE COMPOSITION PHENOTYPES IN
PATIENTS ON WAITLIST AND SHORTLY AFTER LIVER TRANSPLANT – RESULTS
FROM A PILOT STUDY
Version: 1 Date: 03 Sep 2024
Reviewer's report:
PEER REVIEWER ASSESSMENTS:
OBJECTIVE - Full research articles: is there a clear objective that addresses one or several
testable research questions? (Brief or other article types: is there a clear objective?)
Yes - there is a clear objective
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for
the objective?
Yes - the approach is appropriate
EXECUTION - Are the experiments and analyses performed with sufficient technical rigor to
allow confidence in the results?
Yes - experiments and analyses were performed appropriately
STATISTICS - Is the use of statistics in the manuscript appropriate?
Yes - appropriate statistical analyses have been used in the study
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not
overstated?
Yes - the author's interpretation is reasonable
OVERALL MANUSCRIPT POTENTIAL - Has the author addressed your concerns sufficiently
for you to now recommend the work as a technically sound contribution? If not, can further
revisions be made to make the work technically sound?
Yes - current version is technically sound
PEER REVIEWER COMMENTS:
GENERAL COMMENTS: Authors did address both my suggestions and other suggestions. This
new version of the manuscript has improved. However some typos are all over the text, I would
advise the authors to be more careful. Just in the title there is a typo and this needs to be changed.
ADDITIONAL REQUESTS/SUGGESTIONS:
Please review the manuscript again very carefully to check for some typos in the current version.
For example, phenotypes in the title is misspelled.
Review for 10.1186/s12876-024-03425-2 (2024)

Title: BODY COMPOSITION AND MUSCLE COMPOSITION PHENOTYPES IN
PATIENTS ON WAITLIST AND SHORTLY AFTER LIVER TRANSPLANT – RESULTS
FROM A PILOT STUDY
Version: 1 Date: 07 Sep 2024
Reviewer's report:
Forsgren and co-authors in their revised paper have fully and professionally answered my and
the other reviewers' comments and concerns.
Review for 10.1186/s12876-024-03424-3 (2024)

Title: The Effect of Probiotic Supplementation on Non-Alcoholic Fatty Liver Disease (NAFLD)
Fibrosis Score in Patients Attending a Tertiary Hospital Clinic in Cairo, Egypt
Version: 4 Date: 30 Jun 2024
Reviewer's report:
Good afternoon!
1. I would like to know what the criteria were for choosing the probiotic used;
2. Regarding the request for laboratory tests, I think it is necessary to include ferritin, blood
glucose, glycated hemoglobin, insulin and the HOMA index;
3. Remake the methodology in relation to lifestyle modification. The targeted physical activity
and weekly activity time were not specified and in relation to the diets used in the study, it was
not clear which was followed in both groups;
5.Regarding the diets used, please specify thr percentages of macronutrients;
4. Update the current nomenclature of non-alcoholic fatty liver disease;
5. Most of the bibliographic references are very old, I think it is necessary to use more current
articles, especially those dealing with a relevant topic that is still much discussed.
Thank you very much!
Review for 10.1186/s12876-024-03424-3 (2024)

Title: The Effect of Probiotic Supplementation on Non-Alcoholic Fatty Liver Disease (NAFLD)
Fibrosis Score in Patients Attending a Tertiary Hospital Clinic in Cairo, Egypt
Version: 4 Date: 02 Jul 2024
Reviewer:  Giuseppe Guido Maria Scarlata
Reviewer's report:
The strength of this study is the evaluation of the NAFLD fibrosis score after probiotic
supplementation. However, many points should be clarified:
1. Introduction: "currently, no drug is registered for the treatment of NASH.". However,
FDA approved the use of Resmetirom. Please include this in this section doi: 10.1056/
NEJMoa2309000;
2. It should be clarified how the sample size calculation was done in addition to the software
used;
3. Please revise the abbreviations in the manuscript;
4. What are the limitations of this study?
Review for 10.1186/s12876-024-03445-y (2024)

Title: Predictive Model for Identification of Gangrenous or Perforated Appendicitis in Adults:
A Multicenter Retrospective Study
Version: 4 Date: 14 Jul 2024
Reviewer:  Sushila Kumar Pattanaik
Reviewer's report:
Good observation and optimal analysis. Minor revision will make it more impressive.
1. It would be better if the title is changed to 'Predictive model for identification of gangrenous
or perforated appendicitis in adults: a multicenter retrospective study',  because gangrene and
perforation are different complications.
2. In 'abstract' section, similarly, you can change 'gangrene and perforation are serious
complications of acute appendicitis having a higher mortality....'
3. In the 'background' section, please ignore and omit the sentence 'Evidence suggests
that......undergoing appendectomy' as it is the result for operated group and not for those treated
with antibiotics alone under Reference no 6.
4. The purpose of training group and testing group may be explained in the first instance. The
cases and controls may be defined mentioning the study design.
5. In 'study variables' section, please explain why CRP was not taken as a study variable although
it was taken in reviewed literature  (e.g. Ref 16,18,19,21,22).
6. In 'discussion' section, Ref no 23 may be deleted as the variables do not differentiate  between
complicated and uncomplicated appendicitis and rest are to be cited correctly. Also please
explain which variables lost significance in different levels of analysis (e.g. NLR, Fg, PCT, Tbil)
although it is mentioned under results.
Review for 10.1186/s12876-024-03445-y (2024)

Title: Predictive Model for Identification of Gangrenous or Perforated Appendicitis in Adults:
A Multicenter Retrospective Study
Version: 4 Date: 17 Jul 2024
Reviewer:  Florin Iordache
Reviewer's report:
Thank you for the opportunity to review the paper “Predictive Model for Gangrenous/Perforated
Appendicitis Identification in Adults: A Multicenter Retrospective Study” by Yun Liang et
al. This retrospective study has the merit of addressing the  issue of discriminating between
complicated/non-complicated appendectomy. The study has a significant study group, and the
statistics are properly done, but I have the following concerns:
1. Why exclude patients aged over 65? In some studies, it is a risk factor for complicated
appendicitis. Furthermore, the study of Eddama et al. (cited by the authors - ref. 13)validates
age. In the reviewed paper there were 13 patients excluded. This is an important study bias -
please address it.
2. Today, CT scan has more value than visualizing the fecalith and measuring the diameter. There
is good literature showing that fat stranding and fluid presence are correlated with complicated
appendicitis. In the study of Kim et al. (Abdominal Radiology 2021 vol 46) a diagnostic model
discriminating between the type of appendicitis their model showed an AUC of 0.81. In another
study (Cai JH et al. Helyon 2023) similar and some different parameters were used for prediction
with an AUC 0,87. The authors should compare their predictive model with those already
published.
3. There is no avoiding unnecessary surgeries as the authors stated in the second paragraph in
the discussion chapter, more likely urgent surgery, because even late results of CODA trial (ref
8 – which is a non-inferiority trial!), showed that almost 46% of those treated conservatively
needed appendectomy in a 2-year interval. The authors should comment accordingly.
Review for 10.1186/s12876-024-03445-y (2024)

Title: Predictive Model for Identification of Gangrenous or Perforated Appendicitis in Adults:
A Multicenter Retrospective Study
Version: 6 Date: 01 Aug 2024
Reviewer:  Sushila Kumar Pattanaik
Reviewer's report:
Thank you for appreciating the comments and making necessary corrections.
1. It would be better to add the last paragraph (parameters such as fibrinogen.......in the
multivariate analysis) in response to comment 6 in the paragraph 8 under discussion section for
clarity of the parameters excluded.
2. The newly added sentence under discussion (the high cost and radiation exposure associated
with CT) may be changed to 'the high cost and radiation exposure associated with enhanced CT',
because in your nomogram CT is also required to be done.
Best wishes
Review for 10.1186/s12876-024-03445-y (2024)

Title: Predictive Model for Identification of Gangrenous or Perforated Appendicitis in Adults:
A Multicenter Retrospective Study
Version: 6 Date: 02 Aug 2024
Reviewer:  Florin Iordache
Reviewer's report:
I welcome the prompt response from the authors addressing most of the issues I have pointed
out before. Still, I have not understood why patients aged over 65 years old were excluded as
they tend to have some additional risks for complicated appendicitis (please clarify).
And a minor issue: I think the present tense would be preferable in the method chapter because
the study was already performed.
Review for 10.1186/s12876-024-03445-y (2024)

Title: Predictive Model for Identification of Gangrenous or Perforated Appendicitis in Adults:
A Multicenter Retrospective Study
Version: 6 Date: 03 Aug 2024
Reviewer:  Heng-Fu Lin
Reviewer's report:
All the  comments have been well adressed and the manuscript was revised accordingly. I have
no more comments.
Review for 10.1186/s12876-024-03445-y (2024)

Title: Predictive Model for Identification of Gangrenous or Perforated Appendicitis in Adults:
A Multicenter Retrospective Study
Version: 6 Date: 03 Aug 2024
Reviewer's report:
Dear authors
thank you for revising this manuscript. I think it has been quite improved by the revisions and
particular the discussion is more sound and put better in the context of existing literature.
Most of my comments have been implemented to my satisfaction. I strongly disagree with
your response to the CRP given that CRP by itself has an AUC of around 0.80 to discriminate
complicated from uncomplicated appendicitis and I suspect you just did not have CRP available
because it was not routinely done. At the same time PCT is an excellent marker for blood
stream infections and presence of bacterial debris in the blood stream and not at all validated
for Appendicitis but given that this was not significant in your model anyway I don't think we
need to go into further discussion about it.
In your response you say you used unenhanced CT. I presume this means non-contrast and
should thus be also in the manuscript. Most people use a contrast scan with a low dose protocol
for younger adults nowadays so I just need you to mention this precisely.
You have also revised your methods and it has become clearer now what you have done. In
order to properly describe your model however, you should explain what kind of regression was
done, I presume its binominal logistic stepwise? please report chi 2 and omnibus p value for the
overall model and give a nagelkerke / cox and snell R2 in percentage.
Further to this there is still no explanation how the nomogram was created and how it is applied.
These two things are an absolute must for this to be published and you must have this data thus
I wonder why it is not reported here.
Thank you for revising this manuscript and for including the statistical limitations. I do think
this is a valuable study and only a few more things need to be done for this to be publishable. I
also think Figures 4  and 5 are unnecessary and could be moved to supplementary materials
Review for 10.1186/s12876-024-03445-y (2024)

Title: Predictive Model for Identification of Gangrenous or Perforated Appendicitis in Adults:
A Multicenter Retrospective Study
Version: 7 Date: 21 Aug 2024
Reviewer:  Florin Iordache
Reviewer's report:
Dear authors,
You did a good job revising the manuscript but you did not answer /explain the following:
Why exclude patients aged over 65? In some studies, it is a risk factor for complicated
appendicitis. Furthermore, the study of Eddama et al. (cited by the authors - ref. 13) validates
age. In the reviewed paper there were 13 patients excluded. This is an important study bias -
please address it.
Review for 10.1186/s12876-024-03445-y (2024)

Title: Predictive Model for Identification of Gangrenous or Perforated Appendicitis in Adults:
A Multicenter Retrospective Study
Version: 7 Date: 21 Aug 2024
Reviewer:  Sushila Kumar Pattanaik
Reviewer's report:
Thanks for the response.
I could not find the detailed explanation of the reasons why parameters like NLR, fibrinogen,
PCT, total bilirubin were excluded from statistical analysis in page 19, lines 6-9. After analysis of
clinical characteristics, the text shifts to incorporation of seven variables only. Your explanation
to the reviewer in the response to reviewers during revision 1 was correct, which goes like this,
"parameters such as fibrinogen (Fg) were excluded due to their lack of statistical significance
in the univariate analysis. Similarly, factors like neutrophil-to-lymphocyte ratio (NLR) and
procalcitonin (PCT) were not included in the final model due to their lack of statistical
significance in the multivariate analysis." This concept may be added under discussion section,
after analysis of clinical characteristics, for a clarity to the readers. Rest are fine.
Review for 10.1186/s12876-024-03445-y (2024)

Title: Predictive Model for Identification of Gangrenous or Perforated Appendicitis in Adults:
A Multicenter Retrospective Study
Version: 7 Date: 22 Aug 2024
Reviewer:  Heng-Fu Lin
Reviewer's report:
Thank you for the responses. All the mentioned issueds have been well-addressed and I have
no more comments.
Review for 10.1186/s12876-024-03445-y (2024)

Title: Predictive Model for Identification of Gangrenous or Perforated Appendicitis in Adults:
A Multicenter Retrospective Study
Version: 7 Date: 26 Aug 2024
Reviewer's report:
The authors developed model for predicting complicated appendicitis, which showed acceptable
performance in the external validation set, as well as in the development dataset.
It would be ideal to compare the model's performance with radiologists' assessments made
without the use of clinical variables. Or, it would be ideal if it could compared with previous
models such as that by Avansov's or Kim's (https://pubmed.ncbi.nlm.nih.gov/32914350/).
Could CT reports be retrospectively analyzed to evaluate how well radiologists differentiate
between complicated and uncomplicated appendicitis? Or at least add in discussion, the reported
performance in the literature.
One limitation of this model is the inclusion of D-dimer, which is not always routinely measured
in the emergency department.
For this model to have clinical utility, it must serve a specific purpose—in this
case, sensitively identifying patients with complicated appendicitis so they can receive
appendectomy rather than conservative treatment. For example,  a previous study (https://
pubmed.ncbi.nlm.nih.gov/32914350/) has shown a model with high sensitivity of over 90%.
In discussion "External validation using patient data from the Fifth Affiliated Hospital of Sun
Yat-sen University showed no significant variations in baseline characteristics between the
training and testing sets, confirming their suitability as training and validation sets. " why should
there be no significant variations between the training and the testing sets? what's the point of
external validation if the patient characteristics are the same between the two datasets? The point
of external validation is to test the model in another patient sample and see if the results from
the development dataset can be generalized to other patient samples.
Review for 10.1186/s12876-024-03445-y (2024)

Title: Predictive Model for Identification of Gangrenous or Perforated Appendicitis in Adults:
A Multicenter Retrospective Study
Version: 7 Date: 30 Aug 2024
Reviewer's report:
Thank you for implementing my comments into your manuscript. I am now content with the
revisions.
Thank you also for explaining the nomogram. I still don't quite understand how you get from
"total points" to "linear predictor" to "predicted value".
I also think, looking at the nomogram now that some "predictors" seem to be much more relevant
i.E. WBC, lymphocyte and D-Dimer and feacalith gives you so little points it coul have probably
been left out without changing the model in a relevant way while also reducing a little bit of
subjectivity given that not calcified faecaliths can be missed.
As a final suggestion for editing I think figure 2 should have the words spelled out and without
_. Just call it White Cell Count, D-Dimer ... since Presence of fecalith is so long anyway there
is no point in abbreviating the rest.
I think this manuscript could now be published.
Review for 10.1186/s12876-024-03445-y (2024)

Title: Predictive Model for Identification of Gangrenous or Perforated Appendicitis in Adults:
A Multicenter Retrospective Study
Version: 8 Date: 14 Sep 2024
Reviewer:  Sushila Kumar Pattanaik
Reviewer's report:
Thank you for respecting the comments. My points have been taken care of. In my view, the
manuscript appears complete. Best wishes.
Review for 10.1186/s12876-024-03445-y (2024)

Title: Predictive Model for Identification of Gangrenous or Perforated Appendicitis in Adults:
A Multicenter Retrospective Study
Version: 8 Date: 15 Sep 2024
Reviewer:  Florin Iordache
Reviewer's report:
Dear authors,
You have addressed the issues I mentioned accordingly. Good work.
Review for 10.1186/s12876-024-03341-5 (2024)

Title: Real-World Evidence on the Effectiveness and Safety of Tofacitinib in Patients with
Ulcerative Colitis in Lebanon
Version: 3 Date: 26 Jan 2024
Reviewer's report:
The language is simple and well-formed.
The introduction is informative and well-referenced.
Such a study is informative and valuable, especially in the Middle East. However, the sample
size is small, and a larger sample is needed to evaluate the effectiveness of this therapy and to
make a comparison to the larger meta-analysis more justified and logical.
Even if a consent form is not needed in the study, I think that this study needs ethical approval.
I recommend that there should be a scale about the degree of satisfaction patients have with
their experience and, if applicable, a sentence about the cost of therapy and comparison to other
modalities, as this is very important in an area like the Middle East.
Review for 10.1186/s12876-024-03341-5 (2024)

Title: Real-World Evidence on the Effectiveness and Safety of Tofacitinib in Patients with
Ulcerative Colitis in Lebanon
Version: 3 Date: 14 Apr 2024
Reviewer's report:
The retrospective cross-cestional study from Lebanon aimed to evaulate the effectiveness and
safety of tofacitinib in patients with UC in clinical practice. However the study has not presented
new results about tofacitinib, this is the first report from the Middle East and North Africa region.
The study is well designed and interpreted. I consider it is suitable for publication with minor
revision.
I have the following questions regarding the paper:
1. There are different methods of dispensation of tofacitinib in the study population. Could this
cause selection bias in the study? Self-payer patients had similar severity and disease duration
than the other patients? What does „NSSF” mean among the dispensation categories at Table 1.?
2. The main result is  that endoscopic remission was achieved in 46.7% of patients at 24 weeks.
Most of these patients were steroid free at that point. Could you indicate the corticosteroid-free
clinical and endoscopic remission, too?
3. HZV-test results were positive at 81.5% of patient. Were they previously suffered from HZV
in childhood, or vaccinated against varicella? What is your clinical practice with patients naive
to HZV? Do you vaccinate them?
Thank you for your answers!
Review for 10.1186/s12876-024-03341-5 (2024)

Title: Real-World Evidence on the Effectiveness and Safety of Tofacitinib in Patients with
Ulcerative Colitis in Lebanon
Version: 4 Date: 30 Jun 2024
Reviewer:  Zsuzsanna Kurti
Reviewer's report:
The study is well designed and interpreted. I think this paper progressed a lot since the latest
revision. I consider it is suitable for publication. Congratulations for the authors!
Review for 10.1186/s12876-024-03442-1 (2024)

Title: Analyzing Risk Factors and Constructing a Predictive Model for Superficial Esophageal
Carcinoma with Submucosal Infiltration Exceeding 200 Micrometers.
Version: 3 Date: 31 Aug 2024
Reviewer:  Panagiotis Tsibouris
Reviewer's report:
Abstract: OR and p values couls be introduced in the abstract Words cab be gained on
behalf of  reduction of objectives and rephrasing. Methods Criteria for possible lymph node
involvement and catalogue of excluded comorbidities should be given Prior chemoradiotherapy
is presupposed by excluding previous malignancies Some study variables need futher definition
Like: heart disease,  kidney disease, EUS and EOM findings and family history For parameters
expressed in numerical values it should be defined if continues values or dichotomised
expression was selected For the later dichotomising value should be given Lifestyle assessment
should be further explained Number of cases should be moved to results Results Variable
transformation should be moved to methodsThe same for risk factor identification Results
should be initiated with number of patients in each cohort and patient demographics Analysis
of significant risk factors should follow and construction of final model should come after.
Discribing of method construction also belongs to the methods Significant parameters should
be presented in the text, as well as OR and p values Prediction model formula should also be
in the text so that it can be easily found for future evaluations of the model Finaly AUC and
sensitivity specificity NPV and PPV for the model should be given in the text Discussion should
be adapted accordingly
Review for 10.1186/s12876-024-03442-1 (2024)

Title: Analyzing Risk Factors and Constructing a Predictive Model for Superficial Esophageal
Carcinoma with Submucosal Infiltration Exceeding 200 Micrometers.
Version: 3 Date: 14 Sep 2024
Reviewer:  Dimitrios Christodoulou
Reviewer's report:
This is an interesting manuscript aiming to analyze risk factors and to constructing a predictive
model for superficial esophageal carcinoma with submucosal infiltration exceeding 200
micrometers.
The manuscript is well written elucidating a hot topic in endoscopic submucosal endoscopy.
Review for 10.1186/s12876-024-03442-1 (2024)

Title: Analyzing Risk Factors and Constructing a Predictive Model for Superficial Esophageal
Carcinoma with Submucosal Infiltration Exceeding 200 Micrometers.
Version: 4 Date: 24 Sep 2024
Reviewer:  Panagiotis Tsibouris
Reviewer's report:
Document is much improved Small details should be ajusted before it would be ready
for approval Abstract Results significant factors in ultrasonography should be defined If
a nomogram or model used it should be descibed Numerical values could be introduced
Available space could be produced by reduced the introduction Methods who was eligible for
ESD? Exclusion criteria should better describe those excluded A reference might be provided
Commorbidities and demographic data definitions should be provide For instance definition of
DM or smoking habits ( duration -long term is a vague term)  Model creation belongs to methods
and should be removed for the results
Review for 10.1186/s12876-024-03442-1 (2024)

Title: Analyzing Risk Factors and Constructing a Predictive Model for Superficial Esophageal
Carcinoma with Submucosal Infiltration Exceeding 200 Micrometers.
Version: 5 Date: 26 Sep 2024
Reviewer:  Panagiotis Tsibouris
Reviewer's report:
There are no more changes requested I congratulate the authors and suggest acceptance
Review for 10.1186/s12876-024-03444-z (2024)

Title: Nucleated red blood cell distribution in critically ill patients with acute pancreatitis: a
retrospective cohort study
Version: 0 Date: 17 Aug 2024
Reviewer's report:
I want to congratulate the authors for their work on a topic of great importance: the prediction
of the evolutionary course of acute pancreatitis cases, when it is in the early hours.
The sample size is sufficient, the methodology correct, with a complete statistical analysis that
demonstrates the correlation between nucleated red blood cell and mortality in patients admitted
to intensive care for acute pancreatitis.
I suggest two changes to the authors in order to improve the article. On the one hand, describe
in the general series the intra-ICU mortality and the overall 90-day mortality.
On the other hand, and more importantly, give a practical approach to work. Differences in the
distribution of nucleated red blood cell distribution between deceased and survivors have been
established, but no cutoff points have been established. Cutoff points to predict mortality, in three
categories, for example, would be appreciated. Each category should have its own sensitivity
and specificity, which would be of great use to clinicians.
Review for 10.1186/s12876-024-03444-z (2024)

Title: Nucleated red blood cell distribution in critically ill patients with acute pancreatitis: a
retrospective cohort study
Version: 1 Date: 28 Aug 2024
Reviewer:  Ioannis Andrianopoulos
Reviewer's report:
Thank you for your reply and your extensive revision, this does show commitment from the
authors to improve quality of their work rather than please the reviewers/editors.
I have three more comments:
a) Lines 159-160 state: “  The predictive model we generated assigned risk scores based on
NRBC levels and categorized patients into high and medium-low risk groups using tertiles” and
lines 276-277 “Based on the risk scores classified as high, medium, and low, survival curves
illustrated notable discrepancies among the different risk subgroups”. Was the survival curve
analysis based on the three NRBC level categories described in figure 2d-f or was it based on
three different tertiles derived from the 9 variable prognostic model? Please clarify that in figure
4e and in the main text.
b) Figure 4 legend needs more explanation eg: a) and B) they show ROC and PR curves of 4
different machine learning models. E) survival analysis in subgroups with different risk scores
based on  (see my comment a)
c) Minor comment: table 3 needs a full description of the abbreviated parameters in the footnote.
Review for 10.1186/s12876-024-03444-z (2024)

Title: Nucleated red blood cell distribution in critically ill patients with acute pancreatitis: a
retrospective cohort study
Version: 1 Date: 06 Sep 2024
Reviewer's report:
I would like to thank the authors for their work in reviewing and responding to the points raised
by the reviewers, resulting in an article of higher quality.
I raise two points to be corrected in this article.
On the one hand, the penultimate sentence of the introduction should be deleted (lines 72 to 74).
It is a sentence that refers to the methodology, which is worked on later.
On the other hand, and more importantly, the idea of using cut-off points for the prognosis of
cases of acute pancreatitis admitted to intensive care has been developed. From a practical point
of view this is of great importance. With a cut-off point of 1.7, the best point according to the
ROC curves for 90-day mortality, the sensitivity obtained is 0.475, and the specificity 0.711.
With these values, its use as a predictor of severity is not very sensitive, and it has a medium-
low specificity. I believe that this point is very important, and should be added to the discussion.
We need better evolution predictors for patients with AP, and NRBC could complete this gap.
Review for 10.1186/s12876-024-03444-z (2024)

Title: Nucleated red blood cell distribution in critically ill patients with acute pancreatitis: a
retrospective cohort study
Version: 2 Date: 18 Sep 2024
Reviewer's report:
I would like to congratulate the authors for their work. The effort made in data collection,
statistical analysis and preparation of the manuscript has been very good, and subsequently they
have responded well to the reviewers' suggestions. With the changes introduced, I consider that
an excellent work has been obtained, which deserves to be published in a prestigious journal,
as in this case.
Review for 10.1186/s12876-024-03443-0 (2024)

Title: The early biomarker of immature granulocyte count in predicting right-side colonic
complicated acute diverticulitis: A retrospective cohort study
Version: 2 Date: 02 Sep 2024
Reviewer's report:
I appreciate the opportunity to reivew this manuscript.
It's well written and results are interesting.
However, there is one major flaw: Authors evaulate, analyze and discuss about patients with
Rt sided diverticulitis. It is very different from Lt sided diverticulitis. For example (read -
doi.org/10.1111/codi.15328, but there are many more publications). First of all- note in the title
that you are speaking about Rt sided colonic diverticulitis. Second, I believe that most of your
references are studies done on Lt sided diverticulitis (at least most of the patients in each cohort).
The authors should explain why they can extrapolate on their Rt sided diverticulitis cohort or at
least emphasize it as limitation. Third- if in your country there is higher incidence of Rt sided
diverticulitis than in the western world (me myself practicing in the US and was practicing in
another western country and saw very few cases of Rt sided diverticulitis) - please emphasize
it in the text.
Review for 10.1186/s12876-024-03443-0 (2024)

Title: The early biomarker of immature granulocyte count in predicting right-side colonic
complicated acute diverticulitis: A retrospective cohort study
Version: 2 Date: 03 Sep 2024
Reviewer's report:
The authors presents here a series of right-side colonic diverticulitis and searched for relevant
diagnostic biomarkers. They found immature granulocytes (IG) could be one of them. They
included 289 patients (31 complicated diverticulitis vs 258 uncomplicated).
They are several points to review :
- in the abstract, the authors should correct "left-side colonic" by "right-side" as they only
included right-side diverticulitis.
- the statistical analysis description should be reviewed because of some mistakes and missing
data. This manuscript reports diagnostic data about IG. The authors should follow the STARD
guidelines  so they must include likelihood ratio for example. The continue variables should be
presented as median (with interquartile range) or mean +/- standard deviation. The presentation
of binary data should include number (percentage).
Through the text, the decimal number should be less than 2. For the p values, if p = 0.000, you
should write <0.001. Because of these aspects the results are confusing.
For the regression, OR of SII is 1 so it is not a risk factor.
In the text the authors wrote "251 patients" in the uncomplicated group but in the flowchart it is
"258". Because of that, the authors should check their statistics through the text.
Review for 10.1186/s12876-024-03443-0 (2024)

Title: The early biomarker of immature granulocyte count in predicting right-side colonic
complicated acute diverticulitis: A retrospective cohort study
Version: 2 Date: 04 Sep 2024
Reviewer's report:
Thank you for allowing me to review this manuscript. In this study, the authors aim to identify
the importance of immature granulocyte count in the early prediction of complicated acute
diverticulitis, a crucial aspect that could significantly impact clinical practice. The study presents
clear objectives and an adequate methodology. However, I have some questions that I would
like the authors to clarify:
1. For sample selection, were patients with hematological diseases or specific treatment that will
alter the leukocyte count excluded? If so, it is recommended that this be indicated within the
exclusion criteria.
2. Some studies have observed that comorbidities are predictive factors of severe diverticulitis.
What is the association of comorbidities with complicated acute diverticulitis in your study?
3. The authors do not indicate in the study whether the episode of acute diverticulitis analyzed
was the first episode or whether the patient had had previous episodes. Considering that some
studies have observed the first episode of diverticulitis is a predictive factor of severity. Is it
possible to have this variable available and analyze its association with complicated diverticulitis
in the analyzed sample?
4. From the results and Table 2, it is clear that in the univariate analysis, BMI had a significant
correlation with complicated acute diverticulitis and that in the multivariate analysis, the
correlation was not significant. With the data in Table 2, it is confusing to identify whether the
values in the table are from the univariate or multivariate analysis. It is recommended that the
results of the univariate and multivariate analysis be expressed separately for each variable.