JerMa88/BMC_Gastroenterology_Peer_Reviews huggingface dataset:
Review for 10.1186/s12876-022-02541-1 (2022)

Title: Natural history of decompensated cirrhosis with serum hepatitis B DNA < 2000IU/mL:
a retrospective study
Version: 1 Date: 11 Sep 2022
Reviewer:  Ponsiano Ocama
Reviewer's report:
This is a well written manuscript on an important subject. In most cases patients with LLV if
not cirrhotic are not treated as this may also mean inactive infection especially in those HBeAg
negative and normal liver enzymes. Moreover, occult HBV with negative HBsAg but detected
viraemic may also progress.
This study clearly shows that those alreay with complications, one may find a low level viraemia
but this is still not innocent.
This paper should be published as is
Review for 10.1186/s12876-022-02541-1 (2022)

Title: Natural history of decompensated cirrhosis with serum hepatitis B DNA < 2000IU/mL:
a retrospective study
Version: 1 Date: 20 Sep 2022
Reviewer:  Gibril Ndow
Reviewer's report:
Thank you for sharing your work, which aimed to study the natural history of hepatitis B
related decompensated cirrhosis or hepatocellular carcinoma in patients who have either low
or undetectable HBV viremia and/or hepatitis B surface antigen (HBsAg) seroconversion.
Although several studies have demonstrated the relationship between high HBV DNA viral load
and liver disease progression, the risk of advanced liver disease in patients who have sustained
low HBV viremia and/or cleared HBsAg is not well studied. Therefore, this study could fill
important knowledge gaps.
In my opinion, your study was not appropriately designed to answer these questions, and the
results are presented incoherently and difficult to follow. Clearly defining groups to compare
will present results better and improve quality of study. For example, the study population, all
of whom have advanced liver disease, could be categorised into four groups for analysis:
1. HBsAg negative and undetectable viral load (cleared infection)
2. HBsAg negative and detectable viral load (101-2,000IU/mL)
3. HBsAg positive and undetectable viral load (<100IU/mL)
4. HBsAg positive and detectable viral load (100-2,000IU/mL)
Other minor issues to look into:
1. Please clarify at what time point were viral markers assessed - was this at time of diagnosis
of decompensated cirrhosis/HCC?
2. Please fully write out the meaning of LLV in the abstract where it is first used in the manuscript
(I will suggest completely doing away with this and using universally accepted terminology
rather than LLV. And if used, clearly define LLV and clarify whether it includes patients with
undetectable viral load)
3. Remove reference of the South Korea study (Hang et al) in the results section
Review for 10.1186/s12876-022-02556-8 (2022)

Title: Stereotactic body radiation therapy as an effective local treatment for advanced
hepatocellular carcinoma patients with inferior vena cava and right atrial tumor thrombus
Version: 1 Date: 24 Aug 2022
Reviewer's report:
This is an interesting paper examining the results of SBRT for HCC with tumor in vein involving
the IVC and right atrium. This is a small population of very advanced HCC with few treatment
options and grim prognosis. The authors document in this retrospective analysis that with high
dose SBRT these patients appear to fair better than expected with local control of 80% and a 1-
and 2-year survival rates of 60% and 27% respectively. This is certainly an encouraging signal
of efficacy and I agree with their statement that high-dose radiotherapy should be explored more
in depth in this clinical scenario.
The manuscript requires some linguistic editing.
Figure 2 shows too many images that do not had much important information. It should be
shortened considerably and focused on a message.
There is important information that has not been reported. The authors should provide the
patients performance status at initiation of SBRT, liver function at initiation of SBRT (Child
Pugh score, albi score).
The authors should provide Organs-At-Risk (OAR) constraints for the radiation plans. They
should also provide additional information about the patients who died of upper GI bleeding.
This should include the site of bleeding, and the maximal dose point delivered to the esophagus,
stomach and duodenum.
Review for 10.1186/s12876-022-02556-8 (2022)

Title: Stereotactic body radiation therapy as an effective local treatment for advanced
hepatocellular carcinoma patients with inferior vena cava and right atrial tumor thrombus
Version: 1 Date: 05 Sep 2022
Reviewer's report:
Major and minor comments
1. There are a small number of patients (15).
2. Clarify how grade ¾ or 5 adverse events were attributed to SBRT or not. Presumably many
patients died at some time. How was it determined if events were attributed to treatment?
3. State what the mean dose to the liver was for all patients, and those with liver failure.
4. Specifically comment on any (or lack there of) cardiac complications/ malignant PE, etc.
5. Clarify how these patients were selected, and what the denominator of patients treated with
radiation therapy was during the same time period. How were patients with portal vein and IVC
invasion handled?
6. Clarify how many patients had invasion to the heart versus not, and what the doses to the
heart were.
7. Why were the arms down for radiation therapy? Was any entry dose considered?
8. There appear to be repeat figures, or similar figures. I recommend one figure be more clearly
labelled, with fewer screen shots to demonstrate the imaging, radiation plan and response more
simply.
9. Add page numbers and correct typographical errors (e.g. ‘cana’ to ‘cava’ in discussion.)
Review for 10.1186/s12876-022-02556-8 (2022)

Title: Stereotactic body radiation therapy as an effective local treatment for advanced
hepatocellular carcinoma patients with inferior vena cava and right atrial tumor thrombus
Version: 2 Date: 05 Oct 2022
Reviewer's report:
Please remove the name "cyberknife" throughout the paper.
Consider reducing the number of response figures.
Review for 10.1186/s12876-022-02556-8 (2022)

Title: Stereotactic body radiation therapy as an effective local treatment for advanced
hepatocellular carcinoma patients with inferior vena cava and right atrial tumor thrombus
Version: 2 Date: 08 Oct 2022
Reviewer's report:
The manuscript is improved and the authors have addresses most of the questions/issues raised.
1. There is a typo in the text of the article where the Child Pugh class distribution is described.
They probably meant that 4 patients had CP B class (rather than A as written)
2. The OAR constraints need to be explicitly provided (I suggest a table or a paragraph dedicated
to detailed description of the constraints
3.  The description of how the authors adjudicated AEs has to be detailed in a paragraph in
the text of the article. It is not sufficient to mention it in the letter of response. This should
include detailed explanation of how the bleeding episodes were ruled out as related to SBRT
and the mean radiation dose to the non involved liver (liver -GTV) in patients who suffered liver
decompensation and died of liver failure.
Review for 10.1186/s12876-022-02556-8 (2022)

Title: Stereotactic body radiation therapy as an effective local treatment for advanced
hepatocellular carcinoma patients with inferior vena cava and right atrial tumor thrombus
Version: 3 Date: 18 Oct 2022
Reviewer's report:
This manuscript is improved.
In regards to the added section on doses to the organs at risk,
1) a table with more dose metrics and summary statistics for the entire group may be helpful,
if available.
2) Include the maximal doses ( or a dose to smaller volume, eg. 0.5 or 1 cc) when describing
the gastric doses
3)  Include the mean liver (minus GTV) dose for the patients that had decline in liver function
4) Remove mention of Charlie Pan, and instead simplify writing to be more concise and add
reference.
Review for 10.1186/s12876-022-02547-9 (2022)

Title: Survival Nomograms for Colorectal Carcinoma Patients with Lung Metastasis and Lung-
Only Metastasis, Based on the SEER Database and a Single-Center External Validation Cohort
Version: 2 Date: 24 Aug 2022
Reviewer's report:
The paper is overall well written but there are some flaws that should be addressed.
1) Like many other SEER papers, the manuscript lacks of granularity and several data are
missing. I acknowledge that this is an intrinsic limitation of this kind of studies but the authors
should clearly address it among the limitations
2) English grammar requires some polishing....
3) The external validation cohort is too limited to get reliable assumptions....
4) It would be interesting to speculate on the potential impact of some inflammatory biomarkers,
for example lymphocyte-monocyte ratio (cite the recent paper  PMID: 27122671)
5) Some comments on the surveillance should be also done either in terms of systemic and local
recurrence (cite the paper PMID: 27005802)
Review for 10.1186/s12876-022-02547-9 (2022)

Title: Survival Nomograms for Colorectal Carcinoma Patients with Lung Metastasis and Lung-
Only Metastasis, Based on the SEER Database and a Single-Center External Validation Cohort
Version: 2 Date: 06 Sep 2022
Reviewer's report:
1.Use the full spelling when the abbreviation first appears in the abstract od manuscript, and
then use the abbreviation in the following.
2.The Introduction of the second paragraph is a little longer. Please divided it into two
paragraphs.
3.The data were downloaded from the SEER database. However, 43 CRC patients of  Shanghai
East Hospital is less as external dataset validation.
4.In Figure 2, “P value or P<0.05 or P>0.05” should be added.
5.In Figure 3-2, some cures were crossed,and the results were not well.
6.The font size of the Figure 4-1 and 4-2 is too small, please check it to meet the requirements
of the journal.
7. The discussion section of the paper should be more in-depth. The author must dig deeper into
the discussion part before the article can be accepted.
8.The results section shows too much, and the authors are suggested to refine some of the
statements. The authors' English writing needs to be greatly improved.
Review for 10.1186/s12876-022-02547-9 (2022)

Title: Survival Nomograms for Colorectal Carcinoma Patients with Lung Metastasis and Lung-
Only Metastasis, Based on the SEER Database and a Single-Center External Validation Cohort
Version: 3 Date: 02 Oct 2022
Reviewer's report:
The revised version is OK. Thank you!
Review for 10.1186/s12876-022-02550-0 (2022)

Title: Association between hepatic steatosis and fibrosis with measures of insulin sensitivity in
patients with severe obesity and type 2 diabetes - a cross-sectional study
Version: 2 Date: 06 Jun 2022
Reviewer's report:
Manuscript represents original contribution of the authors focusing of very important topic.
Methods are clearly defined and the authors chose relevant diagnostic approach to NAFLD
as well as validated indices measured in high risk population. Results implied  important
association of steatosis with hepatic insulin sensitivity, which might be of interest in prediction
of NAFLD progression. Discussion encompasses relevant literature. Flow chart and figures are
informative.
Review for 10.1186/s12876-022-02550-0 (2022)

Title: Association between hepatic steatosis and fibrosis with measures of insulin sensitivity in
patients with severe obesity and type 2 diabetes - a cross-sectional study
Version: 2 Date: 15 Sep 2022
Reviewer's report:
This is a well-conducted observational study with a well-written  report on the association of
liver fat/ fibrosis with insulin sensitivity parameters in a group of patients with type 2 diabetes
and severe obesity. The results are interresting  and the validity of data is clearly demonstrated.
In line with the newer reccommendations, the term morbid obesity should be avoided and
replaced with severe obesity throughout the Abstract and Main text.
Review for 10.1186/s12876-022-02540-2 (2022)

Title: Development of a Novel Immune-Related lncRNA Prognostic Signature for Patients with
Hepatocellular Carcinoma
Version: 3 Date: 22 Jul 2022
Reviewer's report:
Overall, manuscript is well written and analysis is rigorous. I have few concerns that should
address in the manuscript.
1. Abstract, “ Principal basis of relevant deaths” revise this sentence.
2. Do not need to mention the data filtration process in the abstract.
3. The introduction lacks the details on roles of lncRNA in HCC prognosis and diagnosis.
Authors should elaborate on previous literature and method on identification of lncRNA
signatures in HCC prognosis. There are several studies on identifying lncRNAs or genes in
various cancers, authors should describe their approach and advantages over previous methods.
4. Citation is missing for the “the Immport database”
5. “Excluding the patients with survival time less than 30 days, to improve the accuracy of the
study, with 342 patients remaining”. This sentence is repetitive.
6. What is meaning of irregular split?
7. Line 84, elaborate FPKM.
8. Section 2.6, Is lncRNA expression in high and low expression groups significant or not? What
is the p-value?
9. Remove the repetitive sentences in discussion.
10. Be consistent with the wording, HCC or LIHC? carefully check for typos and grammatical
errors throughout the manuscript.
Review for 10.1186/s12876-022-02540-2 (2022)

Title: Development of a Novel Immune-Related lncRNA Prognostic Signature for Patients with
Hepatocellular Carcinoma
Version: 3 Date: 24 Jul 2022
Reviewer's report:
In this manuscript, the authors screened immune-related long non-coding RNAs (IncRNAs) to
evaluate whether to affect the prognosis of the patients with hepatocellular carcinoma. As a
result, they identified the several prognostic biomarkers. The method was simple and has been
well established, and the manuscript is well written. Please consider some concerns with regard
to the following points.
We need the information about the patients in detail because the several prognostic factors have
been identified in addition to age, gender, stage, and grade. Otherwise, the prognostic value of
these IncRNAs as prognostic factors is unclear.
The factors identified in this study are those that influence patient prognosis. Of more interest
is whether they are predictive of response to immunotherapy.
Review for 10.1186/s12876-022-02554-w (2022)

Title: Prognostic nomogram for acute pancreatitis after percutaneous biliary stent insertion in
patients with malignant obstruction
Version: 1 Date: 04 Aug 2022
Reviewer's report:
This is a manuscript developing and varidating the prognostic nomogram for acute pancreatitis
adter percutaneous transhepatic biliary  stent insertion in patients with malignant biliary
obstrustion.
Although this manuscript is likely to be well written, there are some issues to be concerned.
Major
Nowadays, endoscopic biliary drainage is the mainstay  for malignant biliary obstruction.
Nonethless, It is understantable that radiologists still play a role in this topic in some institutions,
regions, or countrires.
However, "BMC Gastroenterology" is the journal of gastroenterology, not of radiology. I
suppose that most readers of this journal  may be more interested in endoscopic drainage than
percutaneous drainage.
Therefore, the pros and cons of PTBS comparing  endoscopic dranaige had better to be discussed
in introduction or discussion section.
Minor
1. Line 51-52
Full spelling of PTBS is expressed as percutaneous biliary insertion. However, I guess that
percutaneous transhepatic biliary insertion is roght. Please confirm it.
2. Line 85-88
Can a 0.035-inch guidewire really pass through a 21-gauge needle?  I think the guidewire  is
too thick.
3. In results section
There should be a table regarding characteristics  of whole patients. Moreover, the  severity of
pancreactitis or period of hospitalization regarding pancreatitis should be contained in the table.
Review for 10.1186/s12876-022-02554-w (2022)

Title: Prognostic nomogram for acute pancreatitis after percutaneous biliary stent insertion in
patients with malignant obstruction
Version: 1 Date: 29 Aug 2022
Reviewer's report:
This article was a study of risk evaluation for pancreatitis after PTBS with a nomogram. And this
study demonstrated the efficacy of the nomogram with internal validation. Although this result is
interesting, this study has some problems in the outcomes, patients enrollment, and uniqueness.
1. This study was performed by retrospective review, and it must have been difficult to obtain
informed consent. For example, if a patient had undergone PTBD for MOJ in July 2016, he or she
might not have been able to agree with the study enrollment, considering the expected survival.
Please clarified the IRB approval number, and the process for obtaining informed consent.
2. The rate of post-procedural pancreatitis is high in this study, comparing the previous studies.
The reason why the rate of pancreatitis was different should be discussed in the Discussion
session.
3. The incidence and risk factors of pancreatitis after percutaneous SEMS placement in patients
with MBO have been evaluated in a previous study (Yang et al., Hepatobiliary Pancreat Dis Int.
2020). Authors developed a new nomogram for post-PTBS pancreatitis, but internal validation
with bootstrap resampling using the study population was not that meaningful. I think it is
mandatory to perform the “external validation” in the independent population, such as different
hospital or nation.
4. According the method in this manuscript, the SEMSs were placed right after percutaneous
puncture. However, although the evidence is insufficient, there is some concern about PTBD
tract injury if the SEMSs were inserted right after puncture. Weren’t there any complications at
the PTBD tract, such as bile leak, bleeding, pneumoperitoneum, or pneumothorax?
Review for 10.1186/s12876-022-02554-w (2022)

Title: Prognostic nomogram for acute pancreatitis after percutaneous biliary stent insertion in
patients with malignant obstruction
Version: 4 Date: 03 Oct 2022
Reviewer's report:
Thank you for  your revision.
The authors revised their manuscript according to reviewers' comments.
I have found one mistake at line 55-56,
"Percutaneous biliary stent insertion (PTBS)" should be revised as "Percutaneous transhepatic
biliary stent insertion (PTBS)".
Review for 10.1186/s12876-022-02539-9 (2022)

Title: Quality assessment of Clinical Practice Guidelines (CPG) for the diagnosis and treatment
of Inflammatory Bowel Disease using the AGREE II instrument: A Systematic Review.
Version: 1 Date: 14 Aug 2022
Reviewer's report:
I congratulate the Authors for their valuable work.
I have minor comments:
- please move the definitions of domains from the Results to the Methods (e.g.  'This domain
evaluates the general objective of the CPG, specific health aspects and the target population.')
- the same would apply ton the sentence 'To visualize and compare the mean AGREE II scores
obtained by the 26 CPGs assessed in this study, we generated a hexagonal radar graph where
each domain is represented on a radial axis centered at 0 and the maximum score of each domain
corresponds to each vertex of the hexagon.'
Review for 10.1186/s12876-022-02539-9 (2022)

Title: Quality assessment of Clinical Practice Guidelines (CPG) for the diagnosis and treatment
of Inflammatory Bowel Disease using the AGREE II instrument: A Systematic Review.
Version: 1 Date: 16 Aug 2022
Reviewer's report:
This review described the quality  of Clinical Practice Guidelines (CPG) on inflammatory bowel
diseases using the AGREE II instrument. Interestingly, the authors also evaluating the change
of CPG quality over time, comparing two periods (2012-2017 to 2018-2022).
There are few important points which should be clarified.
1. no date restriction was applied to the literature search and to the selection of the CPG, as
stated in the methods. However, only CPG published after 2012 were included in the analysis.
Was an effect of the inclusion criteria?
2. inclusion criteria should be better detailed. There are some international guidelines (i.e.
Practical guidelines on endoscopic treatment for Crohn’s disease strictures: a consensus
statement from the Global Interventional Inflammatory Bowel Disease Group, 2020) which
were not selected for the analysis, probably because only  CPG on medical  treatment and
not endoscopic or surgical topics were included.  Also, please, clarify what do you mean with
"conducted their search strategy in at least one database" in the methods. In the PRISMA diagram
there are several CPG excluded because of incomplete methodology or incomplete search
strategy. Please clarify.  What do these exclusion criteria mean exactly? Further guidelines were
not mentioned despite  apparently  in line with the inclusion criteria described in the methods
(i.e.  some  Spanish and Italian guidelines).
Review for 10.1186/s12876-022-02539-9 (2022)

Title: Quality assessment of Clinical Practice Guidelines (CPG) for the diagnosis and treatment
of Inflammatory Bowel Disease using the AGREE II instrument: A Systematic Review.
Version: 1 Date: 28 Aug 2022
Reviewer's report:
i think this is an excellent study overall evaluating IBD guidelines using the AGREE score. The
authors have done an independent review and while the agreement was moderate in terms of
identifying guidelines that are not recommended which should be the most important finding of
such an assessment there was not significant disagreement.
Evaluation of guidelines is an important process and independent evaluation will further enhance
the validity of the guidelines in general
On this basis I have no further additions to be made for this study except for a small typographical
error in line 406 the word easier has been misspelled.
Review for 10.1186/s12876-022-02538-w (2022)

Title: Aberrant cytokeratin 7 expression by hepatocytes can predict the ductopenia grade in
primary biliary cholangitis
Version: 2 Date: 13 Sep 2022
Reviewer:  Amirhossein Hessami
Reviewer's report:
Authors have reported the the relationship of aberrant cytokeratin 7 expression by hepatocytes
with clinical and pathological features of primary biliary cholestasis. The manuscript has good
methodology and novelty. All sections are written well and no significant revisions is bein
required. however there some minor concerns which could be pointed out.
1- Please use suitable references for the 3rd paragraph of the introduction section.
2- It is highly recommended that the manuscript be edited native English editor.
Review for 10.1186/s12876-022-02538-w (2022)

Title: Aberrant cytokeratin 7 expression by hepatocytes can predict the ductopenia grade in
primary biliary cholangitis
Version: 3 Date: 08 Oct 2022
Reviewer:  Amirhossein Hessami
Reviewer's report:
I hereby thank authors for addressing my comments. The manuscript has been revised properly
and it is now suitable for publication.
Review for 10.1186/s12876-022-02549-7 (2022)

Title: Usefulness of discharge standards in outpatients undergoing sedative endoscopy: a
propensity score-matched study of the modified post-anesthetic discharge scoring system and
the modified Aldrete score
Version: 3 Date: 24 Jul 2022
Reviewer's report:
Manuscripts entitled “Usefulness of discharge standards in outpatients undergoing sedative
endoscopy: a propensity score-matched study of the modified post-anesthetic discharge scoring
system and the modified Aldrete score.”
Thank you for allowing me to review this article.
The study aimed to test two anesthetic recovery scores, the modified post-anesthetic discharge
scoring system (MPADSS) and the modified Aldrete score. This study is intriguing and valuable.
However, I have a few comments regarding the article.
- As for theoretical design, data collection design, and statistical analysis, this study greatly
did all the processes. The propensity scores technique for comparing both scores’ results was
also appropriate, and both scores-matched groups had high balanced covariates. In addition,
covariates were suitably chosen.
- All sections in the manuscript were also well-written. All limitations were adequately provided.
- Nevertheless, there is a minor issue regarding the addition of footnotes. In Tables 2 and 3,
similar to the footnote of Table 1 (* Results are presented as the number of patients or mean
± standard deviation), a footnote may be required as there are also some variables presented as
mean ± standard deviation without specification.
In summary, the overall study is well-established regardless of a suggested minor change. I
would like to send my congratulations to the authors.
Review for 10.1186/s12876-022-02549-7 (2022)

Title: Usefulness of discharge standards in outpatients undergoing sedative endoscopy: a
propensity score-matched study of the modified post-anesthetic discharge scoring system and
the modified Aldrete score
Version: 3 Date: 25 Sep 2022
Reviewer's report:
This research revealed that "Patients assessed by the modified Aldrete score were allowed
to discharge earlier than those assessed by the MPADSS. However, a patient’s level of
consciousness should be assessed carefully when using the modified Aldrete score."
This  study is  very meaningful#but there are still several questions remain to to be answered:
(1) Sample size calculation is an essential item. How does the researchers identifie and calculate
the required sample size? Does the current sample size is sufficient to indicate the reliability of
the study's conclusions?
(2)The references are relatively old, and the authoritative literature in the past three years is
rarely cited.
Review for 10.1186/s12876-022-02549-7 (2022)

Title: Usefulness of discharge standards in outpatients undergoing sedative endoscopy: a
propensity score-matched study of the modified post-anesthetic discharge scoring system and
the modified Aldrete score
Version: 4 Date: 12 Oct 2022
Reviewer's report:
Satisfied with overall edits in manuscript & response.
I have no more comments.
Review for 10.1186/s12876-022-02544-y (2022)

Title: A nomogram for predicting cancer-specific survival for elderly patients with gallbladder
cancer
Version: 1 Date: 05 May 2022
Reviewer's report:
Dr. Wen and co-authors present a study of building a nomogram for predicting cancer-specific
survival for elderly patients with gallbladder.
Here I present a few concerns regarding their paper:
1. In SEER database, some patients were based on TNM 6th edition, some were based on TNM
7th edition. The information in 'Derived.AJCC.7.T', 'Derived.AJCC.7.N', 'Derived.AJCC.7.M'
were based on TNM 7th edition. The information in 'Derived.AJCC.T', 'Derived.AJCC.N',
'Derived.AJCC.M' were based on the TNM 6th edition. However, the TNM 8th edition
information were missing in the original data. How to unify the consistency?
2. This study were aimed for elderly GBD patients. Why choose the age 65 for elderly patients?
Is it randomly defined?
3. As for external validation, we usually include the patient cohort from a different affiliation.
However, in this study, the author used the patients in the same cohort from 2016 to 2018
for external validation. There might be bias, since the development of surgery skill and
chemotherapy might improve the overall survival of GBD patients from 2016 to 2018, compared
with patients from 2004 to 2015.
4. The factor of chemotherapy, some patients were identified as "yes", some patients were
identified as "No / Unknown". It was not accurate. The "unknown" patients should be excluded.
Review for 10.1186/s12876-022-02544-y (2022)

Title: A nomogram for predicting cancer-specific survival for elderly patients with gallbladder
cancer
Version: 1 Date: 21 Jul 2022
Reviewer's report:
This is a manuscript that looks into “A nomogram for predicting cancer-specific survival for
elderly patients with gallbladder cancer.” The data was extracted from the SEER database and
a univariate and multivariate Cox proportional hazard regression analysis is used to select the
independent risks factors for elderly GBC patients. Although the topic is of interest to the reader,
there are several key points that should be addressed in the revised manuscript.
1. The authors decided to focus on elderly patient for cancer specific survival in gallbladder
cancer. Age was one of the criterions for improved survival. Does this apply to younger patients
when they present with gallbladder cancer?
2. Histology was one of the risk factors evaluated. Interestingly, there appears to be no difference
between those with adenocarcinoma and non-adenocarcinoma types. What are the subtypes of
the non-adenocarcinomas? Can the authors supply a supplementary figure outlining the types of
the non-adenocarcinoma subtypes of gallbladder cancer?
3. The authors showed that the nomogram showed improved reliability and predictability than
the TNM staging.  How is this helpful in predicting outcome at patient presentation when patients
have not undergone surgery or chemotherapy?
4. IS the nomogram still superior to TNM staging at every stage of the disease or only advanced
stages of the disease?
Minor:
1. Re-word phrases such as “to the best of our knowledge”, and “as far as we know” which are
used repetitively.    There are some grammatical errors in the paper that should be addressed.
Review for 10.1186/s12876-022-02544-y (2022)

Title: A nomogram for predicting cancer-specific survival for elderly patients with gallbladder
cancer
Version: 2 Date: 01 Oct 2022
Reviewer's report:
This is a manuscript that looks into “A nomogram for predicting cancer-specific survival for
elderly patients with gallbladder cancer.  It is a revised manuscript which addressed some of
the key concerns that were raised earlier. It is a subject of interest to relevant clinician. One
limitation remains in that it is a nomogram only for elderly patients (>65).  Another limitation
is that it is based on the SEER database which includes incomplete data as some patients with
chemotherapy (yes/no/unknown) are unable to be excluded due to the incomplete data set.
Review for 10.1186/s12876-022-02509-1 (2022)

Title: Gamma-glutamyl transpeptidase to platelet and gamma-glutamyl transpeptidase to
lymphocyte ratio in a sample of Chinese Han population
Version: 3 Date: 14 May 2022
Reviewer:  Serdar Durak
Reviewer's report:
All patients in the study were considered healthy, but no information was given about how
healthy they were. Chronic diseases, drugs used, body mass index, etc. no information provided.
The analysis in Table 2 should be separate between sex and age groups. Rows and columns
made with different groups. Age groups were made incompletely in the ones made according to
age. For example, the analysis of the 20-29 age group was made with the 40-69 age group, why
was the 30-39 age group not included in the analysis?
"The male had a higher GPR at age 20#49 than the female while the GPR at age 60#79 was
higher in female than in male". Where is the 50-59 age group in this analysis?
It is very difficult to determine the reference range with this study design.
Review for 10.1186/s12876-022-02509-1 (2022)

Title: Gamma-glutamyl transpeptidase to platelet and gamma-glutamyl transpeptidase to
lymphocyte ratio in a sample of Chinese Han population
Version: 3 Date: 11 Jul 2022
Reviewer's report:
The authors reported the results of an observational study that aimed to examine the
the reference range of Gamma-glutamyl transpeptidase to platelet ratio (GPR) and gamma-
glutamyl transpeptidase to lymphocyte ratio (GLR) in the Chinese Han population in the
Chaoshan region in South China. By analyzing the data of healthy patients admitted to a hospital
in South China, the authors showed the referenced ranges of GPR and GLR in different sex
and age groups. Significant differences in GPR and GLR between different sex and age groups
were found.
There are some comments.
Comments:
1. Title: This study analyzed data of patients admitted to a hospital. Whether this sample
resembles the Chinese Han population is questionable. I would suggest revising the title.
An example would be “Gamma-glutamyl transpeptidase to platelet and gamma-glutamyl
transpeptidase to lymphocyte ratio in a sample of Chinese Han population.”
2. Methods: “Healthy persons aged 20-79 years were reviewed-.” How was “healthy” defined?
How many patients were screened for eligibility? How many screened patients were noted to be
“healthy”? How many screened patients did not fulfill the “healthy” criteria and were excluded?
Please clarify these issues in more detail.
3. Methods: “The subjects with serious hepatic insufficiency were excluded-.” How was “hepatic
insufficiency” defined? Was it based on a doctor’s diagnosis in ICD codes or laboratory tests?
What were the ICD codes or laboratory tests? Please clarify in more detail.
4. Methods: “Platelet and lymphocyte counts were determined by the Coulter method. GGT
was determined by the rate method.” Please provide more details regarding the measurement
methods (for instance, the name and manufacturer of the machine and the quality control
measures (such as coefficients of variation)).
5. Results (Table 1): It is long known that GGT levels are affected by excessive weight, alcohol,
and drugs (even herbal supplements) intake. A presentation of body mass index (or body weight),
alcohol, and drugs (including herbal supplements) intake information in this table is suggested.
6. Results (Tables 2 and 3): GGT levels are sensitive to multiple factors (for instance, excessive
weight, alcohol, and drugs, among others) in addition to demographic factors. It is unclear how
the authors considered these factors when establishing the reference ranges of GPR and GLR,
as presented in these tables. A strategy would be to exclude those with obesity and those who
drank alcohol or took high-risk medications.
Review for 10.1186/s12876-022-02509-1 (2022)

Title: Gamma-glutamyl transpeptidase to platelet and gamma-glutamyl transpeptidase to
lymphocyte ratio in a sample of Chinese Han population
Version: 5 Date: 12 Sep 2022
Reviewer:  Serdar Durak
Reviewer's report:
Thanks for the edits based on the suggestions
Review for 10.1186/s12876-022-02536-y (2022)

Title: Establishment and evaluation of a prediction model for acute gastrointestinal injury in
patients with prolonged disorder of consciousness
Version: 2 Date: 05 Jul 2022
Reviewer's report:
The authors established a prediction model for acute gastrointestinal injury in prolonged
disorder of consciousness which included 165 patients. It is well written and has the potential
to accurately predict the incidence of AGI in pDOC patients. I have several comments for
improvement.
Major
#How were the covariates for multivariate regression analysis selected? This should be explicitly
stated.
#Result: Is there some information about the causative disease of pDOC such as TBI, stroke,
neurosurgery, etc?
#Although the definition and diagnostic criteria of AGI is stated in the method section, I could
not find AGI grade of the included patients. High grade of AGI should be clinically important,
and thus that should be stated in results. If the grade of AGI is available, is there any association
between the present prediction model and the grade of AGI ?
#More patients received broad-spectrum antibiotics in AGI group than in N-AGI group, which
could increase acute gastrointestinal injury such as diarrhea. Did you adjust this factor?
#This prediction model showed high accuracy to predict the incidence of AGI patients. Please
state the usefulness of the model in clinical settings in the discussion. If the score is high and
has potential to develop AGI, what treatment or intervention will be considered?
Minor
#Method:
“After exclusion according to the exclusion criteria, a total of 165 patients were included.” in
clinical data on material and methods – this sentence should be stated in the results section.
#Most patients with pDOC receive antiulcer agents. Was the information collected in the study?
Review for 10.1186/s12876-022-02536-y (2022)

Title: Establishment and evaluation of a prediction model for acute gastrointestinal injury in
patients with prolonged disorder of consciousness
Version: 2 Date: 19 Jul 2022
Reviewer's report:
The aim of the paper is to develop a tool to predict acute gastrointestinal injury in prolonged
DOC patients. The authors employed logistic regression analysis using pre-selected  risk factors
and  demonstrated good characterics of the model. However, the selection of variables raises an
issue. The level of consciousness is considered to be an important clinical variable that affects
prognosis in pDOC patients [Giacino et al., 2018]. The authors included in their analysis only
GCS score as a covariate indicating clinical patient status; however, in pDOC patients GCS is
not a valid tool for the assessment of the level of consciousness [ACRM, BI-ISIG, DOC Task
Force, 2010; Royal College of Physicians National Clinical Guidelines for pDOC, 2020]. More
reliable instruments, such as CRS-R, or SMART, WNSSP etc., should be used to assess DOC
in this setting. A nominal variable indicating level of consciousness (UWS vs. MCS) might be
also included in the analysis.
Several minor issues to be addressed:
“chronic disturbance of consciousness” should be replaced with “chronic disorder of
consciousness”, as stated in recent guidelines [Kondziella et al., 2020; Giacino et al., 2018].
List of abbreviations should be arranged in alphabetical order.
Language proof reading might be useful to improve the text.
Review for 10.1186/s12876-022-02536-y (2022)

Title: Establishment and evaluation of a prediction model for acute gastrointestinal injury in
patients with prolonged disorder of consciousness
Version: 3 Date: 24 Sep 2022
Reviewer's report:
The authors improved the results of the analysis and the manuscript by including crucial
predictive variables. It may be published without further revision, after English proof-reading.
NB, "Consciousness Disorders Working Group of the American Association of Rehabilitation
Medicine" from Ref. 12 is correctly titled as "Brain Injury-Interdisciplinary Special Interest
Group, Disorders of Consciousness Task Force".
Review for 10.1186/s12876-022-02534-0 (2022)

Title: An extended 36-week oral esomeprazole improved long-term recurrent peptic ulcer
bleeding in patients at high risk of rebleeding
Version: 2 Date: 15 Aug 2022
Reviewer:  Tianyu Chi
Reviewer's report:
Comments to the Author
I reviewed with great interest the manuscript entitled “An extended 36-week oral esomeprazole
improved long-term recurrent peptic ulcer bleeding in patients at high risk of rebleeding” in
BMC Gastroenterology.
The aim of this study is important. However, I found various issues, which are described below.
Major points:
1. A large part of the references in this paper are from before 2013. It is suggested to add
references in recent 5 years to understand the latest progress of relevant research and improve
the scientific nature of this paper. DOI number should be added to each reference.
2. In subgroup analysis of secondary outcomes in this paper, the sample size of one subgroup is
not enough to meet the needs of statistical analysis, so it is suggested to explain in the limitation
to improve the reliability of this paper.
3. The efficacy of PPI is related to CYP2C19. Was Esomeprazole used according to the test
results of CYP2C19 before enrollment in this study? If not, how to ensure that PPI efficacy is
consistent in each group?
4. Whether esomeprazole was used at the same time as other gastric mucosal protective agents
during follow-up is one of the key factors affecting the primary and secondary outcomes. Please
include an analysis and discussion of whether to use gastric mucosal protective agents.
5. H.pylori infection are important issues in peptic ulcer bleeding. Are the results influenced by
H.pylori infection during follow-up? Please elaborate in the discussion.
6. During the follow-up, was the bleeding site of the patients with rebleeding the original
bleeding site, or were there other new bleeding sites?
Minor points
1. On page 15, line 13 of the DISCUSSION, “However, because of the small sample size,
this study did not show a significant difference in terms of risk reduction between twice- and
once-daily esomeprazole.” Please consider whether the theoretical basis for this conclusion is
sufficient in this paper according to your analysis.
2. On page 17, line 11 of the CONCLUSIONS, “However, the protective effect of reducing
recurrent peptic ulcer bleeding was diminished after shifting to on-demand or discontinuing the
use of PPIs.” Please consider whether the theoretical basis for this conclusion is sufficient in
this paper according to your analysis.
Review for 10.1186/s12876-022-02534-0 (2022)

Title: An extended 36-week oral esomeprazole improved long-term recurrent peptic ulcer
bleeding in patients at high risk of rebleeding
Version: 2 Date: 02 Sep 2022
Reviewer's report:
This is an interesting study and it provides some important clinical information. However, I have
several comments about this article.
1. The competing risks regression model was used in this study. Please explain the reason
using this model in this article. Can you provide the results without performing competing risks
regression model?
2.  (I think this point is not very important.) It seems need another statistical packages for
performing competing risks regression. If you also used another software or statistical packages
(besides SPSS Statistics “20.0”) to perform competing risks regression, please listed that in the
article.
3. It is better to briefly describe the Rockall scores and ASA classification in the article. I think
many readers cannot understand the meaning or importance of this score or classification.
Review for 10.1186/s12876-022-02534-0 (2022)

Title: An extended 36-week oral esomeprazole improved long-term recurrent peptic ulcer
bleeding in patients at high risk of rebleeding
Version: 4 Date: 22 Sep 2022
Reviewer:  Tianyu Chi
Reviewer's report:
The authors have made careful revisions in the paper based on all the comments. The revised
paper is more appropriate in expression and more detailed in content. I recommend accepting
the paper.
Review for 10.1186/s12876-022-02507-3 (2022)

Title: New-onset and relapsed liver diseases following COVID-19 vaccination: A systematic
review
Version: 1 Date: 15 Aug 2022
Reviewer:  Amirhossein Hessami
Reviewer's report:
Authors have reported the occurrence of liver diseases following COVID-19 vaccination using
a systematic review and meta-analysis. This study is comprehensive and provides a good
viewpoint of adverse effects of vaccination on liver observed around the world. The data could
be used by clinicians and policy makers around world in order to develop guidelines and increase
the knowledge regarding COVID-19 vaccines. However there are some points which needs to
be addressed.
1- The study title mentioned "meta-analysis", but there were no meta-analysis performed in
the study. Forest plots, funnel plots, pooled prevalence etc. was not included in the study.
As in my opinion this is a systematic review only but not meta-analysis since there were no
pooled estimated or P-values for assessing a hypothesis. Authors needs to correct the article and
reconsider the use of the word meta-analysis in this article.
2- Authors have mentioned that all statistical analysis was done using Microsoft Excel software.
This software is not generally being considered as a statistical analysis or meta-analysis tool.
In case authors have performed a meta-analysis, it needs to be done using other meta-analysis
package software including Comprehensive Meta-analysis, STATA, RevMan etc. All meta-
analyses should be presented using a forest-plot.
3-  Authors have mentioned that data was shown as mean and standard deviation. There were no
means or standard deviations reported through the study. Please correct the mentioned statement.
Review for 10.1186/s12876-022-02507-3 (2022)

Title: New-onset and relapsed liver diseases following COVID-19 vaccination: A systematic
review
Version: 3 Date: 27 Aug 2022
Reviewer:  Amirhossein Hessami
Reviewer's report:
The authors have addressed the raised issues during the last review.  The manuscript is more
precise and insightful. Therefore, I suggest accepting the manuscript for publication.
Review for 10.1186/s12876-022-02507-3 (2022)

Title: New-onset and relapsed liver diseases following COVID-19 vaccination: A systematic
review
Version: 3 Date: 27 Aug 2022
Reviewer's report:
Thank you for addressing some of my previous comments. However, there are still some
major issues which haven't been resolved with the current version of revised manuscript. My
major concern is still regarding the Methodological quality of this manuscript which should be
improved. My detailed comments regarding this manuscript can be seen below:
1) Consistent with my previous comments, I think the background haven't been clear enough to
provide the rationale or reasons to conduct this systematic review. Systematic review (with or
without meta-analysis) is usually performed when there were inconsistencies among the results
from various studies. Systematic review may give light in solving those inconsistencies. How
about this study? Why systematic review is so important for this topic?
2) Registration of research protocol is one of the requirements in the PRISMA checklist.
PROSPERO is one of the international registries which can be used to register our research
protocol. Moreover, if the topic is related to Covid-19, PROSPERO usually can provide
registration number in just few days. Why do the authors not register their research protocol?
3) Methods: Please mention the period for literature searching.
4) Methods: The description of keywords used for literature searching may be benefited with the
use of "()", such as ("SARS-CoV-2" OR "Covid-19" OR "coronavirus") AND ("vaccination"
OR "vaccine") etc...
5) Methods: The inclusion criteria number 1 and 2 seems overlapping. Please revise.
6) Methods: The exclusion criteria number 1 and 2 seems overlapping too. Please revise.
7) Methods: The process for study selection haven't been mentioned in the Methods.
8) Methods: Regarding the use of NOS for case report/case-series, the authors have cited study
by Murad MH et al. 2017 (ref no 22) for references. In the original study by Murad MH et al.
there were 8 items of questions from modified NOS scale, but in the current study the authors
only mention 5 items. Why there is difference in this matter? Moreover, the original study by
Murad MH et al. did not mention about the cut-off for classifying studies into good, moderate or
poor quality. From what studies do the authors use this interpretation of results? Please explain
and provide.
9) Methods: The authors have removed "meta-analysis" from the title, but why I still see sub-
section "Data-Analysis" in the Methods? Moreover, the authors still mention about Microsoft
Excel for statistical analysis. This is substantially wrong because Microsoft Excel cannot be
used for statistical analysis. Do the authors understand the essential of systematic review study?
I suggest the authors to read again Cochrane manual handbook for conducting systematic review
and revise their manuscript accordingly.