JerMa88/BMC_Gastroenterology_Peer_Reviews huggingface dataset:
Review for 10.1186/s12876-025-04166-6 (2025)

Title: Animal Study of Adhesiolysis via Transumbilical Endoscopic Surgery with Gastric
Endoscopy: An Exploration
Version: 0 Date: 12 May 2025
Reviewer's report:
The authors proposed a new method for adhesiolysis with endoscopy in animals. It is interesting,
but many points need to be clarified. After reading this manuscript, as a surgeon and advanced
endoscopist, I still like laparoscopic surgery more than E-NOTES (which should not be called
NOTES because it requires an umbilical incision). My comments are as follows.
Adhesiolysis with a gastroscope will be very difficult because it’s like doing surgery with one
hand. I wish to know how the endoscopist finds the adhesion with only a gastroscope, which
has limited vision and is surrounded by dilated bowel.
-What is the expertise level of the endoscopists in this research?
Can we call it NOTES with an umbilical incision? NOTES should have no visible incision.
-What are the differences between single-port lap and this method? From my point of view,
single-port laparoscopy will be easier than the method you proposed with a similar incision
burden. In addition, the injured bowel could be repaired in case of full-thickness bowel burn
from cauterization.
-Without traction-countertraction, the proposed method sounded dangerous because
cauterization alone without traction could make a full-thickness bowel injury, which needed to
be repaired. At this time, bowel suturing may be impossible and make no sense.
-Did the authors perform water injection before cauterization? In the discussion part, they
mentioned that they inject, but the figure didn’t show this part.
-Only 3 of 8 beagles had vomiting. Could you confirm that all beagles had clinical gut
obstruction? I believe an abdominal radiograph may be more objective in diagnosing it.
-Is this still a viable treatment option for severe bowel obstruction? It may put the patients at
risk of complications. Please comment.
Review for 10.1186/s12876-025-04166-6 (2025)

Title: Animal Study of Adhesiolysis via Transumbilical Endoscopic Surgery with Gastric
Endoscopy: An Exploration
Version: 0 Date: 02 Jun 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Authors, please address the following points below
1. Sample Size and Generalizability
The study's sample size of eight beagles is relatively small, limiting the statistical power and
generalizability of the results. A larger cohort would provide more robust data and allow for
more definitive conclusions regarding the safety and efficacy of the E-NOTES procedure.
2. Duration of Follow-Up
A three-month follow-up period may not be sufficient to assess the long-term outcomes and
potential recurrence of adhesions. Adhesion-related complications can manifest beyond this
timeframe, and longer follow-ups would provide a more comprehensive understanding of the
procedure's durability.
3. Severity and Complexity of Adhesions
The adhesions induced in the beagle models ranged from grade 1 to 3, indicating mild to
moderate severity. This may not fully represent the complexity of adhesions encountered in
human clinical scenarios, where dense and extensive adhesions are common. Further studies
involving more severe adhesion models would better simulate clinical conditions.
4. Lack of Control Group
The absence of a control group undergoing standard laparoscopic or open adhesiolysis
procedures limits the ability to compare the outcomes and advantages of the E-NOTES approach
directly. Including such control groups in future studies would strengthen the comparative
analysis.
5. Technical Challenges and Learning Curve
The study acknowledges the technical challenges associated with the E-NOTES procedure,
particularly the maneuverability and stability of the gastric endoscope within the abdominal
cavity. The reliance on a single access point may also limit instrument triangulation, potentially
complicating the procedure. Addressing these technical limitations and assessing the learning
curve for surgeons are important considerations for clinical adoption.
6. Risk of Adhesion Reformation
While the study reports no new adhesions at the three-month follow-up, the risk of adhesion
reformation remains a concern. Literature indicates that adhesions can reform after adhesiolysis,
with rates varying depending on the surgical technique and patient factors. Long-term studies
are necessary to evaluate the recurrence rates associated with the E-NOTES approach.
7. Translation to Human Clinical Practice
The anatomical and physiological differences between beagle models and humans may affect
the translatability of the findings. Human clinical trials are essential to assess the feasibility,
safety, and efficacy of the E-NOTES procedure in the target patient population.
8. Ethical and Regulatory Considerations
As with any novel surgical technique, ethical considerations regarding patient selection,
informed consent, and regulatory approvals are paramount. Future studies should address these
aspects to ensure responsible clinical implementation.
Review for 10.1186/s12876-025-04166-6 (2025)

Title: Animal Study of Adhesiolysis via Transumbilical Endoscopic Surgery with Gastric
Endoscopy: An Exploration
Version: 1 Date: 18 Jun 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
The responses are satisfactory
Review for 10.1186/s12876-025-04166-6 (2025)

Title: Animal Study of Adhesiolysis via Transumbilical Endoscopic Surgery with Gastric
Endoscopy: An Exploration
Version: 1 Date: 24 Jun 2025
Reviewer's report:
The authors responded well to the comments. This is just a preliminary report on the animal. If
the authors need to explore the role in humans, it will be a very long way to go.
Review for 10.1186/s12876-025-04121-5 (2025)

Title: Global Burden, Temporal Trends, and Health Workforce Correlations of Gallbladder and
Biliary Tract Cancer: A Comprehensive Analysis from 1990 to 2021 with Projections to 2046
Version: 0 Date: 09 May 2025
Reviewer's report:
There is much useful information in this article. However, the most serious problem is that the
methodological description is too thin. For readers who are not in this field, many figures and
tables are difficult to understand. After adding more methodological descriptions and placing
unimportant results in the supplementary documents, this article will be very good.
Abstract and keywords:
1. The result section of the abstract should present the key data.
2. Health inequality and prediction analysis were not mentioned in the methods.
3. There are too many key words.
Methods:
4. There are too few methodologies for statistical analysis. The author should introduce the
absolute and relative indicators in health inequality analysis.
5. In the Age-period-cohort model, which indicators were used respectively when describing
age, period and birth cohort effect.
6. If necessary, the relevant references are also required for BAPC model and decomposition
analysis.
Results:
7. “Table 4” should be “Table 2”.
8. The scales in Figure 3 and Figure 5 should not be measured using scientific notation.
9. For readers who do not understand frontier analysis, Table 3 is very difficult to understand.
The author should describe more about the methodological aspects of cutting-edge analysis and
the significance represented by the indicators.
10. Similarly, the methodology (correlation analysis) involved in Figure 4 was not mentioned
by the author in the methods section.
Discussion:
11. The author should present own insights in a separate paragraph, such as how to control the
disease burden of GBTC in the future, including risk factors, health education, and treatment
strategies.
Review for 10.1186/s12876-025-04121-5 (2025)

Title: Global Burden, Temporal Trends, and Health Workforce Correlations of Gallbladder and
Biliary Tract Cancer: A Comprehensive Analysis from 1990 to 2021 with Projections to 2046
Version: 0 Date: 13 May 2025
Reviewer:  Mahsa Heidari-Foroozan
Reviewer's report:
This paper provides a well-structured analysis of the global burden of gallbladder and biliary
tract cancers. With some revisions, it has the potential to be suitable for publication. Below are
specific suggestions to strengthen the manuscript:
Abstract:
The objective should focus on the key burden measures assessed rather than mentioning DALYs
generically.
Please specify which burden metrics (e.g., incidence, mortality, disability-adjusted life years)
were calculated in the Methods section.
The conclusion is currently too broad and could apply to any disease burden study. It should be
revised to highlight unique findings specific to gallbladder and biliary tract cancers.
Methods:
The section on the Global Burden of Disease (GBD) methodology should be expanded to provide
a clearer explanation of the data sources, modeling approaches, and adjustments used.
The decomposition analysis requires a more detailed description, including its purpose,
methodology, and how it contributes to the study’s findings.
Results:
The Results section is well-presented and effectively communicates key data. No major revisions
are needed here.
Discussion:
To strengthen the context, please incorporate more comparisons with prior literature, discussing
how your findings align with or differ from existing studies.
The discussion should also include actionable recommendations for policymakers, addressing
how the study’s results could inform public health strategies.
Review for 10.1186/s12876-025-04121-5 (2025)

Title: Global Burden, Temporal Trends, and Health Workforce Correlations of Gallbladder and
Biliary Tract Cancer: A Comprehensive Analysis from 1990 to 2021 with Projections to 2046
Version: 1 Date: 05 Jun 2025
Reviewer's report:
The author has revised the full manuscript very well. But there are still some sentences that need
to be revised again.
Method Section, Age-Period-Cohort Modeling: What is the meaning of biological aging? Is it
the same as the concept of chronological aging?
Review for 10.1186/s12876-025-04121-5 (2025)

Title: Global Burden, Temporal Trends, and Health Workforce Correlations of Gallbladder and
Biliary Tract Cancer: A Comprehensive Analysis from 1990 to 2021 with Projections to 2046
Version: 2 Date: 26 Jun 2025
Reviewer's report:
I have no questions.
Review for 10.1186/s12876-025-04181-7 (2025)

Title: Evaluation of the association between periodontitis and inflammatory bowel disease: A
Systematic Review and Meta-analysis
Version: 0 Date: 27 Apr 2025
Reviewer:  Vito Annese
Reviewer's report:
I read with interest the systematic review and meta-analysis by Narges Naghsh et al with focus
on the association among periodontitis and IBD. 11 studies have been selected with 1322 IBD
patients and 1031 controls. The main finding  was an increased risk of periodontitis in IBD
(OR=2.3), with an higher risk in UC (OR=3.2) than in CD (OR=2.1). The Authors commented
also in the Discussion some of the possible (hypothetic) shared pathogenetic mechanisms such
as dysbiosisis and abnormal handling of pathogens.
The review is in general well-written and targeting an interesting aspect of the systemic
involvement of IBD.
I have only some minor suggestions:
In the conclusion of the abstract I would suggest that "more  longitudinal studies with larger
sample size are needed to  confirm such association and possibly disclose  the common
pathogenesis" rather than "mechanisms of IBD and treatment strategies".
The ORs of CD and UC are repetitively  reversed in the abstract and discussion. Please correct
11 studies are reported in the results section and table, but only 10 are mentioned in the discussion
In the discussion I would acknowledged the small sample size of the included studies as
limitation of the analysis: only 1 study with over 600 subjects (IBD and controls) and 6 studies
with less than 150!
It would be interesting for the readers to know whether such association was somewhat
correlated with disease activity in IBD or not; provided that such information is available in the
reviewed studies.
Review for 10.1186/s12876-025-04181-7 (2025)

Title: Evaluation of the association between periodontitis and inflammatory bowel disease: A
Systematic Review and Meta-analysis
Version: 0 Date: 13 May 2025
Reviewer's report:
Limited Innovation#
The study design shows significant overlap with previous systematic reviews, such as “A
systematic review and network meta-analysis of the association between periodontitis and
inflammatory bowel diseases” and “Bidirectional association between oral diseases caused by
plaque and the inflammatory bowel disease: A systematic review and meta-analysis” . It lacks
novel hypotheses and methodological improvements. To enhance its scientific value, we suggest
including mechanistic explorations of oral-gut axis interactions, like microbial dysbiosis and
shared immune pathways.
Overinterpretation of Findings#
The conclusion that " patients with UC exhibit a significantly greater propensity for developing
periodontitis than those with CD, as indicated by an OR of 2.313 (95% CI: 1.891–2.828)“,
should be interpreted with caution. Ayati after analyzing 17 studies (n = 9,458), found
similar periodontitis risks between UC and CD patients (OR = 0.96, 95% CI: 0.65 - 1.43).
The discrepancies might be due to Diagnostic Variability and Heterogeneous Confounder
Adjustment.
Review for 10.1186/s12876-025-04181-7 (2025)

Title: Evaluation of the association between periodontitis and inflammatory bowel disease: A
Systematic Review and Meta-analysis
Version: 3 Date: 02 Jul 2025
Reviewer's report:
The authors have clearly improved this new revised version of their manuscript. All suggestions
made by this reviewer have been duly addressed. At this moment, in my opinion, the  manuscript
is acceptable for publication in the journal.
Review for 10.1186/s12876-025-04144-y (2025)

Title: Global Prevalence and Correlation of Intestinal Parasitic Infections in Patients with
Colorectal Cancer: A Systematic Review and Meta-Analysis
Version: 0 Date: 21 May 2025
Reviewer's report:
This study addresses an interesting research question and provides potentially useful findings.
The method used for synthesize data was acceptable. However, there are a few potential issues
that could be improved in terms of clarity. Minor grammatical and stylistic improvements will
significantly improve the readability and scientific quality of the manuscript.  Please see the
highlight in the attached file.
Review for 10.1186/s12876-025-04144-y (2025)

Title: Global Prevalence and Correlation of Intestinal Parasitic Infections in Patients with
Colorectal Cancer: A Systematic Review and Meta-Analysis
Version: 0 Date: 15 Jun 2025
Reviewer's report:
Your study is interesting.
Use the Mesh database for  KeyWords
The introduction is not conclusive; please rewrite it as a problematic concern.
It seems that your search strategy is incomplete, and the keywords used are not complete.
Develop it.
There is a lot of plagiarism in the writing. Please correct it.
It seems like you used a lot of artificial intelligence. Please fix it and mention that you used it.
There are many writing and spelling problems. Please review and correct them.
Because the study was done and completed in the past, verbs should be written in the third person
passive voice, and do not use the present tense.
Review for 10.1186/s12876-025-04140-2 (2025)

Title: Impact of Microplastics on the Human Gut Microbiome: A Systematic Review of
Microbial Composition, Diversity, and Metabolic Disruptions
Version: 3 Date: 04 Jun 2025
Reviewer:  Robert Mkuye
Reviewer's report:
The manuscript titled “Impact of Microplastics on the Human Gut Microbiome: A Systematic
Review of Microbial Composition, Diversity, and Metabolic Disruptions” is a systematic review
focusing on the effects of microplastics (MPs) on the human gut microbiome, particularly on
microbial composition, diversity, and metabolic functions. The revisions made in the manuscript
address reviewers’ observations and suggestions to a satisfactory level. Limitations, particularly
geographic scope and study design heterogeneity, do not diminish the review’s value and
contribution.
Review for 10.1186/s12876-025-04140-2 (2025)

Title: Impact of Microplastics on the Human Gut Microbiome: A Systematic Review of
Microbial Composition, Diversity, and Metabolic Disruptions
Version: 3 Date: 11 Jun 2025
Reviewer's report:
As I go through the authors' response file and the revised draft, I find that the authors have
incorporated all the suggestions. I find their answers to the queries satisfactory. The revised
manuscript looks in good shape to me, and hence, may be accepted in its current form.
Review for 10.1186/s12876-025-04134-0 (2025)

Title: Good performance of monoclonal antibody-based stool H. pylori antigen tests in acute
nonvariceal upper gastrointestinal bleeding patients
Version: 4 Date: 13 May 2025
Reviewer's report:
Introduction
The introduction provides valuable background information on H. pylori testing; however, the
statement of the problem should be more explicit. Specifically, the authors should clearly explain
the rationale for combining the two tests and highlight the significance of this approach in
clinical practice. Providing a stronger justification will enhance the reader’s understanding of
the study’s importance.
Study Methods
Several key methodological details need further clarification:
- The study design should be explicitly stated.
- Information regarding patient age distribution and stratification should be included.
- The authors should explain how the sample size was calculated and provide justification for
the chosen approach.
- The inclusion and exclusion criteria must be clearly outlined to ensure transparency in patient
selection.
Discussion
The discussion should begin with an analysis of the study’s own results before comparing them
to findings from other studies. This will allow for a more structured and logical progression of
argumentation, ensuring the results are contextualized effectively within existing literature.
Review for 10.1186/s12876-025-04134-0 (2025)

Title: Good performance of monoclonal antibody-based stool H. pylori antigen tests in acute
nonvariceal upper gastrointestinal bleeding patients
Version: 5 Date: 09 Jun 2025
Reviewer's report:
PEER REVIEWER ASSESSMENTS:
OBJECTIVE - Full research articles: is there a clear objective that addresses one or several
testable research questions? (Brief or other article types: is there a clear objective?)
Yes - there is a clear objective
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for
the objective?
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: Yes, the authors have responded adequately to each of my concerns
and made pertinent changes in the manuscript. The revised manuscript is much improved and
scientifically sound.
Review for 10.1186/s12876-025-04134-0 (2025)

Title: Good performance of monoclonal antibody-based stool H. pylori antigen tests in acute
nonvariceal upper gastrointestinal bleeding patients
Version: 5 Date: 19 Jun 2025
Reviewer's report:
Thank you for providing the revised version of the manuscript. I have carefully reviewed the
corrections, and I am pleased with the improvements made. I now recommend the manuscript
for publication.
Review for 10.1186/s12876-025-04202-5 (2025)

Title: Development of Nomogram model based on LASSO-Logistic regression for predicting
postoperative undernutrition to complex anorectal malformation: a pilot exploratory study
Version: 2 Date: 16 Jun 2025
Reviewer:  Akihiro Yasui
Reviewer's report:
The significance of developing a predictive model for the nutritional status of patients after
surgery for anorectal malformations—an area that has not received much attention—is well
understood. Furthermore, the good predictive accuracy of the constructed model suggests its
potential for clinical application.
However, there are a few points regarding the model that I would like to clarify.
What is the typical age (in months) of the patients whose postoperative nutritional status
following PSARP is used as explanatory variables? Also, at what time point is the nutritional
status—used as the target variable—being assessed? These aspects were unclear in the current
manuscript, and I recommend revising the text to clarify them.
Review for 10.1186/s12876-025-04202-5 (2025)

Title: Development of Nomogram model based on LASSO-Logistic regression for predicting
postoperative undernutrition to complex anorectal malformation: a pilot exploratory study
Version: 2 Date: 17 Jun 2025
Reviewer's report:
I have to say I do not recognize this problem (undernutrition after correction of ARM) in the
European practice but your study is well designed and well written. I suggest publication, maybe
it will help other countries to consider undernutrition as an important pre-operative aspect of
ARM care.
Here my minor revisions:
Please add how many patients developed postoperative complications like wound infection,
wound dehiscence, intestinal obstruction. Were these factors related to undernutrition? Did you
consider this in your analysis?
Is there any patient who was put on enteral feeding postoperative?  for instance due to intestinal
complications?
Did you have patients who developed major intestinal problems during the follow-up which can
have influenced the nutritional status? if so please specify
Review for 10.1186/s12876-025-04202-5 (2025)

Title: Development of Nomogram model based on LASSO-Logistic regression for predicting
postoperative undernutrition to complex anorectal malformation: a pilot exploratory study
Version: 3 Date: 08 Jul 2025
Reviewer's report:
Dear Authors,
I am used to receiving a reply letter that addresses each of the concerns I raised in my review.
I don’t see that here, so I will ask the Editor for clarification, perhaps it is my fault and I am
simply missing it.
Review for 10.1186/s12876-025-04197-z (2025)

Title: Evaluation of PINK1 Protein Expression as a Predictive Marker for the Efficacy of
Adjuvant Chemotherapy in Colorectal Cancer: A Retrospective Study
Version: 5 Date: 10 Jul 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
The responses are satisfactory
Review for 10.1186/s12876-025-04153-x (2025)

Title: Overexpression of Protein Kinase C iota as a Prognostic Marker and Its Role in Oxaliplatin
Resistance in colorectal Cancer
Version: 3 Date: 25 May 2025
Reviewer's report:
This study investigated the expression of PKC# in colorectal cancer (CRC) and its association
with clinicopathological features, prognosis, and chemotherapy resistance. The research design
is reasonable, the data are substantial, and the conclusions hold certain clinical significance. The
article is well-structured, with detailed methodological descriptions and comprehensive results
analysis. However, some details require further refinement and clarification.
1. Only 42 patients were included, which may affect the statistical power of the results. It is
recommended to mention the limitation of sample size in the Discussion section and suggest
future validation with a larger cohort.
2. In the multivariate analysis, PKC# did not emerge as an independent prognostic factor, yet
the conclusion still emphasizes its importance. It is advisable to discuss this discrepancy more
cautiously or explore how PKC# may indirectly influence prognosis through other factors.
3. Some figures (e.g., Fig. 1) lack detailed explanations in the text. It is recommended to
supplement specific data or descriptions of representative images.
4. The discussion could be deepened by further exploring the specific mechanisms by which
PKC# mediates chemotherapy resistance (e.g., DNA damage repair, apoptosis inhibition, etc.)
to enhance scientific rigor.
5. Full terms should be provided upon first use of abbreviations (e.g., PFS, OS).
Review for 10.1186/s12876-025-04153-x (2025)

Title: Overexpression of Protein Kinase C iota as a Prognostic Marker and Its Role in Oxaliplatin
Resistance in colorectal Cancer
Version: 4 Date: 18 Jun 2025
Reviewer's report:
To enhance the scientific rigor and contextual relevance of the manuscript, the authors are
encouraged to incorporate several recent studies related to colorectal cancer prognosis and
chemotherapy resistance. BEAN1 has been shown to correlate with poor prognosis and
oxaliplatin resistance in rectal adenocarcinoma (PMID: 39276259), supporting the discussion
of PKC#’s role in chemoresistance. Immune-related prognostic markers such as pan-immune-
inflammatory values (PMID: 40046636) and combined NP/LHb indices with monocyte
count (PMID: 40087531) offer additional evidence for the clinical significance of systemic
inflammation in colorectal cancer, which aligns with the manuscript’s findings. Furthermore,
metabolic indicators including serum calcium (PMID: 40162418) have demonstrated prognostic
value and can complement the discussion of body weight and lipid profiles in predicting
progression-free survival. Finally, research on nutritional and inflammatory markers for
anastomotic leakage (PMID: 40291866) can be cited in the Introduction to highlight the
complexity of CRC management and the importance of comprehensive prognostic evaluation.
Incorporating these references will improve the manuscript’s depth, strengthen its discussion,
and situate the findings within the broader landscape of colorectal cancer research.
Review for 10.1186/s12876-025-04153-x (2025)

Title: Overexpression of Protein Kinase C iota as a Prognostic Marker and Its Role in Oxaliplatin
Resistance in colorectal Cancer
Version: 4 Date: 23 Jun 2025
Reviewer's report:
Having carefully reviewed the revised manuscript, I confirm that the authors have adequately
addressed all comments from the reviewers and editors. The revisions have significantly
improved the clarity, rigor, and overall quality of the paper, which now meets the journal’s
publication standards.
Review for 10.1186/s12876-025-04153-x (2025)

Title: Overexpression of Protein Kinase C iota as a Prognostic Marker and Its Role in Oxaliplatin
Resistance in colorectal Cancer
Version: 7 Date: 03 Jul 2025
Reviewer's report:
After careful evaluation of the revised manuscript, I confirm that the study adheres to scholarly
rigor and presents scientifically sound conclusions. I recommend that it be accepted for
publication.
Review for 10.1186/s12876-025-04153-x (2025)

Title: Overexpression of Protein Kinase C iota as a Prognostic Marker and Its Role in Oxaliplatin
Resistance in colorectal Cancer
Version: 7 Date: 04 Jul 2025
Reviewer's report:
Thank you for your thorough revisions and detailed responses to my comments. The authors
have addressed all my concerns thoughtfully and made improvements to the manuscript. The
additional clarifications and data analyses have enhanced the quality and clarity of the work.
Congratulations to the authors on their excellent work.
Review for 10.1186/s12876-025-04160-y (2025)

Title: A GLIM-Defined Malnutrition-Based Model for Predicting Prognosis of Cirrhotic
Patients with Portal Hypertension Following TIPS Procedure
Version: 3 Date: 13 May 2024
Reviewer's report:
Congratulations for the hard work in preparing this original manuscript on a clinically relevant
topic. It is well written and presented.
I have made a few queries which I hope will add value to the manuscript.
Due to the high mortality rate of 20%, it would be better to do the data analysis with Competing
Risk analysis to check if there are any differences compared to Cox Regression analysis.
Review for 10.1186/s12876-025-04160-y (2025)

Title: A GLIM-Defined Malnutrition-Based Model for Predicting Prognosis of Cirrhotic
Patients with Portal Hypertension Following TIPS Procedure
Version: 4 Date: 16 Jul 2024
Reviewer:  Parvez Mantry
Reviewer's report:
Overall, congratulations on this very well done study
I thought it was very relevant, comprehensive, and your modeling is certainly top-notch
I do believe that malnutrition is one of the most important predictors of post tips  HE. What
I would love to see is the impact of nutritional intervention or even the use of medications to
improve  muscle wasting On this condition. Maybe that could be our next study.
Review for 10.1186/s12876-025-04160-y (2025)

Title: A GLIM-Defined Malnutrition-Based Model for Predicting Prognosis of Cirrhotic
Patients with Portal Hypertension Following TIPS Procedure
Version: 5 Date: 13 Sep 2024
Reviewer's report:
Thank you for addressing my concerns. Otherwise, congratulations on the well-written
manuscript.
Review for 10.1186/s12876-025-04160-y (2025)

Title: A GLIM-Defined Malnutrition-Based Model for Predicting Prognosis of Cirrhotic
Patients with Portal Hypertension Following TIPS Procedure
Version: 5 Date: 11 May 2025
Reviewer:  Parvez Mantry
Reviewer's report:
Dear authors, thank you for a very comprehensive and well thought out response to all the
reviewers
As a reviewer, I am content with the explanations and revisions made to the manuscript based
on suggestions
I will recommend that this important work be published
Review for 10.1186/s12876-025-04186-2 (2025)

Title: The Value of Systemic Inflammatory Response Index in Evaluating the Prognosis of
Postoperative Patients with Stage II Colon Cancer
Version: 2 Date: 12 May 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Authors, please address the following points below
1. Insufficient Control for Confounding Factors
There is no multivariate analysis to adjust for potential confounders (e.g., comorbidities,
nutritional status, exact chemotherapy compliance), which may independently affect prognosis.
Lack of stratification or sensitivity analysis based on high-risk features within stage II (e.g., T4
tumors, perforation, lymphovascular invasion).
2. Definition of Prognostic Groups
The classification of prognosis based solely on 3-year DFS without a detailed follow-up strategy
or verification methodology raises concerns about misclassification bias.
It is unclear whether all deaths were cancer-related or not (cause-specific mortality not
addressed).
3. Incomplete Justification and Discussion of SIRI
While SIRI is the focus, comparison with established inflammatory markers (e.g., PLR, LMR)
is limited.
Mechanistic discussion about how SIRI biologically links to tumor progression in colon cancer
is somewhat superficial and not supported by experimental data.
The cut-off value for high vs. low SIRI is not clearly stated or justified statistically (e.g., using
the ROC-derived Youden index).
4. Data Presentation Gaps
Tables and figures are missing, especially:
ROC curves with AUC values for all biomarkers.
Kaplan-Meier survival curves comparing SIRI groups.
The statistical section mentions ROC and AUC but does not present actual values for CEA,
CA19-9, NLR, etc., for comparison.
5. Language and Clarity
The manuscript contains grammatical issues and awkward phrasing, which can hinder
comprehension.
Redundancies exist in the background and discussion sections, making the narrative less concise.
The introduction lacks a clear research gap to emphasize the novelty of SIRI in stage II colon
cancer.
6. Ethics and Consent
Although informed consent was waived, the authors should mention how data confidentiality
was protected.
The approval number is cited, but it would be more transparent to specify that the waiver applied
to retrospective analysis only.
Review for 10.1186/s12876-025-04186-2 (2025)

Title: The Value of Systemic Inflammatory Response Index in Evaluating the Prognosis of
Postoperative Patients with Stage II Colon Cancer
Version: 3 Date: 25 Jun 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
The responses are satisfactory
Review for 10.1186/s12876-025-04212-3 (2025)

Title: Association of Alpha-1 Acid Glycoprotein with Hepatic Steatosis and Liver Fibrosis
Among Women: A Population-Based Study
Version: 4 Date: 29 Jun 2025
Reviewer's report:
I have reviewed the revised manuscript titled "Association of Alpha-1 Acid Glycoprotein with
Hepatic Steatosis and Liver Fibrosis Among Women: A Population-Based Study" and the
authors’ detailed point-by-point response to reviewers.
The authors have adequately addressed the major comments from the prior review, including:
Explicit incorporation of the non-linear (L-shaped) relationship between AGP and LSM in the
abstract and main text;
Clarification of the study population restriction to women aged 18–49 years;
Careful handling of multicollinearity in the modeling strategy, supported by VIF analysis;
Execution of sensitivity analyses excluding hs-CRP (Tables S1, S2);
Confirmation that NHANES complex survey design (weights, strata, clusters) was applied to all
models, including non-linear and subgroup analyses;
Revision of figure captions and table formatting, and a clearer presentation of covariates.
The revised manuscript demonstrates improved clarity, and the Discussion section provides
a more thoughtful interpretation of the complex non-linear findings. However, a few minor
concerns remain:
Some sections, particularly the Discussion, still contain repetitive or awkward phrasing that
could benefit from additional language editing.
Interpretation of subgroup findings (especially where interaction p-values are marginal or non-
significant) should be presented more cautiously to avoid overstatement.
A few formatting details in Tables 1 and 2 could be further refined for consistency and
readability.
Overall, this is a scientifically sound and clinically relevant study that leverages a large,
nationally representative dataset to explore an under-investigated biomarker in liver health. With
minor revisions to language and presentation, the manuscript would be suitable for publication.
Review for 10.1186/s12876-025-04212-3 (2025)

Title: Association of Alpha-1 Acid Glycoprotein with Hepatic Steatosis and Liver Fibrosis
Among Women: A Population-Based Study
Version: 6 Date: 28 Jul 2025
Reviewer's report:
The authors have satisfactorily addressed all prior reviewer comments, including clarification
of the study population, consistent application of survey design elements, careful handling of
model covariates and multicollinearity, and thorough explanation of the key non-linear finding.
The manuscript has also improved in clarity and structure.
In my opinion, the revised version is scientifically sound, methodologically appropriate, and
clearly presented. I have no further concerns, and I recommend acceptance.
Review for 10.1186/s12876-025-04174-6 (2025)

Title: Elucidating the Role of AC026412.3 in Hepatocellular Carcinoma: A Prognostic
disulfidptosis-related lncRNAs Model Perspective
Version: 2 Date: 14 Jul 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
The responses are satisfactory
Review for 10.1186/s12876-025-04210-5 (2025)

Title: AISI and MASLD: A Nonlinear Association in U.S. Adults (NHANES 2017-2020)
Version: 3 Date: 03 Jul 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
The responses are satisfactory
Review for 10.1186/s12876-025-04210-5 (2025)

Title: AISI and MASLD: A Nonlinear Association in U.S. Adults (NHANES 2017-2020)
Version: 3 Date: 05 Jul 2025
Reviewer:  Amira A. A. Othman
Reviewer's report:
Authors should be appreciated for their efforts in giving exhaustive explanations about every
point raised by the reviewers, mainly concerning methods and statistics. They extensively and
correctly answered all the comments, opportunely modifying the content of the manuscript.
The authors tried to contribute to this field of research with new findings, nevertheless, there is
an observation for which sufficient justification must be obtained.
Non-alcoholic fatty liver disease (NAFLD) is recognized as the most prevalent chronic liver
disease, impacting about 30% of global individuals, with the potential to progress to advanced
hepatic fibrosis and end-stage liver diseases eventually [*]. In June 2023, a multi-society
committee of international experts was gathered, and new terminology was adopted to reduce
stigma and increase disease awareness [**]. A new terminology, Steatotic liver disease (SLD),
replaces “fatty liver disease” as the umbrella term. Under subgroups of SLD, NAFLD has been
renamed as metabolic dysfunction-associated Steatotic liver disease (MASLD) [**]. NAFLD/
MASLD is closely related to metabolic syndrome (MetS) and its associated components of
hypertension, type 2 diabetes mellitus, dyslipidemia, and obesity[***].
(*:doi: 10.1097/HEP.0000000000000004, **: doi: 10.1016/j.jhep.2023.06.003, ***  doi:
10.1111/apt.17308).
1. MAFLD must replace NAFLD:
“In contrast to NAFLD, MAFLD does not necessitate ruling out other liver disease causes, such
as viral hepatitis or heavy alcohol use*. The new name chosen to replace NAFLD reflected the
disease etiology better and conveyed a more practical approach in daily clinical practice than
NAFLD, considering its close association with metabolic syndrome**. Please discuss the new
nomenclature in more detail.
(*: Doi: 10.1016/j.jhep.2020.03.039, **: doi: 10.1097/HEP.0000000000000520)
Review for 10.1186/s12876-025-04210-5 (2025)

Title: AISI and MASLD: A Nonlinear Association in U.S. Adults (NHANES 2017-2020)
Version: 5 Date: 21 Jul 2025
Reviewer:  Amira A. A. Othman
Reviewer's report:
I want to extend my congratulations to all those involved in this work. All the required
amendments have already been made carefully and satisfactorily. I hope that the research will
be presented to science.
Review for 10.1186/s12876-025-04179-1 (2025)

Title: Association Between International Normalized Ratio-to-Albumin Ratio and Mortality
in Critically Ill Patients with Gastrointestinal Bleeding: A Retrospective MIMIC-IV Database
Study
Version: 0 Date: 11 Jun 2025
Reviewer's report:
Major comments:
1.Ensure consistency in formatting throughout the manuscript, adhering to the journal’s
guidelines.
2.Why you involved sepsis, diabetes, cirrhosis, HF, MI, IHD, and CRRT in the Subgroup
analysis
Minor comments:
1. Proofread the manuscript thoroughly to ensure it is free from grammatical and typographical
errors.
2.Provide more detailed explanations of the inclusion and exclusion criteria used for study,
which will enhance the transparency of the manuscript. Excluding multiple ICU admissions may
result in the omission of critically ill patients.
3.Ensure that the citation image format is consistent: Line 121/Fig. 1
4.The MSTATA platform (https://www.mstata.com) is also based on R
Review for 10.1186/s12876-025-04179-1 (2025)

Title: Association Between International Normalized Ratio-to-Albumin Ratio and Mortality
in Critically Ill Patients with Gastrointestinal Bleeding: A Retrospective MIMIC-IV Database
Study
Version: 0 Date: 12 Jun 2025
Reviewer's report:
I have some suggestions:
1. The format of Tables is not correct, please change to correct format.
2. I suggest to delete abbreviation in Table, and add explain in the main text or List of
abbreviations.
Review for 10.1186/s12876-025-04179-1 (2025)

Title: Association Between International Normalized Ratio-to-Albumin Ratio and Mortality
in Critically Ill Patients with Gastrointestinal Bleeding: A Retrospective MIMIC-IV Database
Study
Version: 0 Date: 24 Jun 2025
Reviewer's report:
Thank you for the opportunity to review this manuscript. While the study addresses an important
clinical question, I have a major concern regarding the central conclusion. The data presented
do not convincingly demonstrate that the proposed PTAR score offers a meaningful advantage
over using the INR value alone for prognosis.
My primary points are as follows:
Lack of Superior Predictive Performance: The core issue is that the newly established PTAR
marker does not outperform the standalone INR. The AUC for PTAR at 28 days is 0.691, which
is only negligibly higher than the 0.683 for INR. More importantly, the 95% confidence intervals
show substantial overlap (PTAR: 0.658–0.724 vs. INR: 0.650–0.717). This strongly suggests
that the difference between the two models is not statistically significant. I would recommend
the authors perform a DeLong test to formally compare the AUCs, as it is highly probable the
p-value will be greater than 0.05.
Redundancy of the Marker: PTAR is a composite marker derived from both INR and albumin. A
new marker that adds a layer of complexity (i.e., requiring an additional variable and calculation)
should offer a clear and significant improvement in performance to justify its clinical use. As the
predictive accuracy is virtually identical to that of INR alone, PTAR appears to be a redundant
indicator.
Given these points, I am not convinced that the findings of this manuscript provide significant
clinical value. The introduction of a more complex prognostic score without a demonstrable
improvement in accuracy is unlikely to change clinical practice.
Review for 10.1186/s12876-025-04179-1 (2025)

Title: Association Between International Normalized Ratio-to-Albumin Ratio and Mortality
in Critically Ill Patients with Gastrointestinal Bleeding: A Retrospective MIMIC-IV Database
Study
Version: 0 Date: 27 Jun 2025
Reviewer:  Shiyao Zhang
Reviewer's report:
This manuscript reports an interesting study that explores the correlation between the
international normalized ratio and albumin ratio and the mortality rate of critically ill patients
with gastrointestinal bleeding, and develops a nomogram for predicting the risk of death in
critically ill patients with gastrointestinal bleeding.
However, there are still some deficiencies in this study. For example, the verification link of the
nomogram is relatively weak. It is suggested to supplement the calibration curve and decision
curve analysis to further prove the reliability of the nomogram model.
Review for 10.1186/s12876-025-04179-1 (2025)

Title: Association Between International Normalized Ratio-to-Albumin Ratio and Mortality
in Critically Ill Patients with Gastrointestinal Bleeding: A Retrospective MIMIC-IV Database
Study
Version: 1 Date: 08 Jul 2025
Reviewer's report:
I agree to publish this paper.
Review for 10.1186/s12876-025-04163-9 (2025)

Title: Cruciferous Vegetables Intake and Risk of Colon Cancer: A Dose-Response Meta-
Analysis
Version: 2 Date: 14 May 2025
Reviewer:  Ivan Perez Neri
Reviewer's report:
Manuscript entitled "Cruciferous Vegetables Intake and Risk of Colonic Neoplasms:A
Systematic Review and Meta-Analysis" is aimed to "systematically synthesize existing literature
on the association between CV consumption and CC risk".
Major comments
- Search algorithms should be reported exactly as they were run on each consulted database
- It should be clearly justified why the authors limited inclusion for studies to Cohort and case-
control designs (1.2 Inclusion and Exclusion Criteria)
- Using an effect measure (odds ratios (OR) or relative risks (RR)  along with 95% CI, see
1.2 Inclusion and Exclusion Criteria) as an inclusion criterion is uncommon and might not be
recommended. This should be clearly justified
- Authors should elaborate on what exactly "Studies with insufficient data" are (see 1.2 Inclusion
and Exclusion Criteria)
- Authors should justify why no Risk of Bias assessment was applied
- Authors state that "For moderately diverse cases (defined as I2 values between 30% and 60%),
the random-effects model was also employed due to its careful methodology" (see 1.4 Statistical
Analysis), but this was not specified in the review protocol. The rationale for this decision should
be convincingly justified
- Authors must explain what was considered "unnecessary" when saying that "Following the
screening of abstracts and titles, 184 records were removed as unnecessary"
- Authors should provide a full list of excluded studies with reasons for exclusion of each study
Minor comments
- It is stated that MeSH terms were included in the search strategy (see 1.1 Search Strategy)
which works for PubMed, but Emtree terms for Embase are not mentioned although this database
was consulted
Review for 10.1186/s12876-025-04163-9 (2025)

Title: Cruciferous Vegetables Intake and Risk of Colon Cancer: A Dose-Response Meta-
Analysis
Version: 3 Date: 17 Jun 2025
Reviewer's report:
1. If the database search has been updated, please revise the reported date in the manuscript
accordingly. As of now, the Search Strategy section in Materials and Methods still indicates
October 18, 2024, which appears outdated.
2. The full search strategy for each database is not included in the Supplementary Material. To
ensure transparency and reproducibility, please provide the complete search strings used for all
databases in a supplementary appendix.
3. The statement “Due to the low incidence of CC, odds ratios (ORs) from case-control studies
were interpreted as approximating relative risks (RRs)” is methodologically incorrect. The rare
outcome assumption (which allows ORs to approximate RRs) applies only when the prevalence
of the outcome is below 10% in the “studied” population, and more importantly, it is relevant
within individual studies, not at the population level (For instance,  in a case-control study if
the ratio of cases and control are 1:1 the prevalence of outcome (which here is colon cancer) is
50% and if in a study they increase this ratio to 1:3, the prevalence is still 25%. ). Therefore, this
assumption does not apply to case-control studies by design, where RRs cannot be calculated
( OR can be calculated in cohort studies, while RR is more valid effect size for this design). As
previously noted, when combining effect sizes from both cohort and case-control studies, the
summary effect should be reported as an odds ratio (OR).
4. As noted in my previous review comments, reporting the average NOS score is not an
appropriate summary of study quality. Instead, please categorize studies by quality level (e.g.,
low, moderate, high) and provide a brief discussion on the reasons for lower quality scores where
applicable.
5. Line 163: The phrase should be: “an inverse association” (not a inverse).
6. According to my previous recommendation for a subgroup analysis restricted to studies
adjusting for all major confounders: it is acknowledged that studies vary in which confounders
they adjust for. However, a standard and common practice is to use the most adjusted effect
size available in each study, even if the variables included differ. Also, It would be a good idea
to advise future researchers to not only report the crude association, but also report adjusted
effect sizes.
7. Line 287: There appears to be a typographical error in this line. The use of colons (:) seems
redundant.