JerMa88/BMC_Gastroenterology_Peer_Reviews huggingface dataset:
Review for 10.1186/s12876-025-03668-7 (2025)

Title: Machine Learning for Temporary Stoma After Intestinal Resection in Surgical Decision-
Making of Crohn's Disease
Version: 2 Date: 18 Jan 2025
Reviewer:  Michele Cricri’
Reviewer's report:
I was pleased to review the article entitled "Machine Learning for Temporary Stoma After
Intestinal Resection in Surgical Decision-Making of Crohn's Disease" by Fang-Tao Wang and
colleagues.
The article is technical, nevertheless clear and well written.
I appreciate the use of LASSO technique for variable screening and cross-validation in the
revised manuscript.
I think this article is of particular  interest for IBD specialists.
Review for 10.1186/s12876-024-03586-0 (2025)

Title: A validation Study of Three Early Warning Scores in Early Identification of Gastric
Cancer Patients with Deteriorating Condition after Gastrectomy
Version: 2 Date: 29 Aug 2024
Reviewer's report:
Retrospective study examining the application of early warning Scores.  With the SEWS the
stronger indicator for gastrectomy complications.
Areas to be addressed
1. Abstract uses acronym SEWS as surgical early warning score.  Later in the paper SEWS is
referred to as Standardised early warning score.
2. Grammar errors
- "Patients admitted to general wards who were not included# and patients who required
immediate ICU transfer for advanced life support due to critical condition after surgery "
3. Referencing errors
- Calibration ability is assessed using the Hosmer-Lemeshow goodness-of-fit test[26]  ( 25 in
the references)
4. For the Calibration Model, please add an appendix on the calculations (what was the input data
to achieve the chi-square values).  With calibration models the paper referenced also suggests
to use in conjunction with the pearson chi-square statistic and the Stukel's test (pg 152)
Review for 10.1186/s12876-024-03586-0 (2025)

Title: A validation Study of Three Early Warning Scores in Early Identification of Gastric
Cancer Patients with Deteriorating Condition after Gastrectomy
Version: 2 Date: 02 Sep 2024
Reviewer:  Chikashi Shibata
Reviewer's report:
This study investigated postoperative complications in patients undergoing gastrectomy for
gastric cancer. The authors compared three scoring systems (MEWS, SEWS, NEWS) in terms
of model discrimination, model calibration, and decision curve analysis, and  found that SEWS
is the most recommended method.
I have following suggestions.
1. The authors need to state limitation of this study.
2. The conclusion at the end of the text is too long and too repetitious. It should be short.
Review for 10.1186/s12876-024-03586-0 (2025)

Title: A validation Study of Three Early Warning Scores in Early Identification of Gastric
Cancer Patients with Deteriorating Condition after Gastrectomy
Version: 6 Date: 27 Dec 2024
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Changes are done, accepted for publication.
Review for 10.1186/s12876-025-03704-6 (2025)

Title: Factors influencing the cure of pseudolithiasis: A retrospective study of 264 patients
Version: 2 Date: 24 Dec 2024
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Authors, please address the following points below
-The introduction primarily focuses on research conducted in specific populations, emphasizing
children and the elderly. Including a brief mention of how pseudolithiasis is managed across
different geographical regions or healthcare settings could enhance the generalizability of the
findings and highlight the global relevance of the issue.
-While the introduction establishes the need for the study, the primary objective could be
stated more clearly upfront. It would benefit the reader to know early on that the study
aims to identify independent predictors of complete resolution in pseudolithiasis and evaluate
therapeutic strategies. This would make the focus of the survey immediately apparent.
-The CT imaging criteria could be described in more detail, particularly regarding how "new-
onset pseudolithiasis" is distinguished from other types of biliary abnormalities (e.g., biliary
sludge or other gallbladder precipitates). While it’s mentioned that CT scans were used to
confirm the diagnosis, a more explicit definition of the imaging characteristics would enhance
the reproducibility of the study.
-While a comprehensive list of laboratory parameters is provided, it would be helpful to explain
why specific markers were chosen and how they are expected to correlate with pseudolithiasis
resolution. For instance, how do AST/ALT ratios, white blood cell counts, or CRP levels tie into
the pathophysiology of pseudolithiasis? A brief rationale for each marker’s inclusion would add
clarity and strengthen the reader’s understanding of the data analysis.
-The significance of the gender difference (P = 0.03) and the higher average age in the complete
resolution group (P = 0.03) is noted, but a more nuanced discussion of how these factors may
relate to pseudolithiasis progression could be helpful. For example, the reasons behind the higher
prevalence of cholecystitis in the complete resolution group could be explored further, as it may
suggest an interplay of inflammatory processes and resolution.
-In the section describing differences in conditions such as viral hepatitis, decompensated liver
cirrhosis, and laboratory markers (e.g., fasting glucose), it would be helpful to discuss why
some variables showed no significant differences (e.g., P > 0.05). Understanding the lack of
association between these factors and pseudolithiasis could provide valuable insight into the
disease's pathophysiology.
-Although the study does not show a significant association between ceftriaxone use and
pseudolithiasis resolution, a brief exploration of why this might be (e.g., shorter treatment
duration or lower cumulative dose) could be beneficial. This might help explain the lack of
association with the typical risk factor for pseudolithiasis.
Review for 10.1186/s12876-025-03704-6 (2025)

Title: Factors influencing the cure of pseudolithiasis: A retrospective study of 264 patients
Version: 3 Date: 14 Jan 2025
Reviewer:  Shi-Yan Zhang
Reviewer's report:
1. Title: Consider adding a colon or em dash to separate the main title from the subtitle for better
readability. Additionally, the title should not end with punctuation such as period. Suggested
title : “Factors influencing the cure of pseudolithiasis: A retrospective study of 264 patients.”
2. Ensure uniform capitalization for the institution's name.
3. Minor Typographical Error in Abstract: Add a space between "Among264."
4. The manuscript mentions using the Shapiro-Wilk test in the statistical analysis section but
does not include the test results in the results section.
5. Tables:
(1). Units and Abbreviations: Define all units and abbreviations in the table footnotes. For
instance, in Table 1, "Age (years)*" should have an asterisk explained in a footnote.  AST, ALT,
WBC...
(2). Table headers could be more descriptive for standalone clarity (e.g., "Table 1" should
explicitly mention it compares characteristics between groups).
(4). Duplicate Titles: Both Table 2 and Table 3 are titled "Multifactorial Logistic Regression
Analysis of Prognosis in Pseudolithiasis." , differentiate them.
(5). Decimal Places: Maintain consistent decimal places across similar variables. For example,
"Age (years)*" in Table 1 shows two or three decimal places, while other variables like "WBC
count" show three. Spacing and Alignment: Ensure uniform spacing around symbols (e.g., #²)
and proper alignment of numerical data for readability. Years retaining three decimal places is
scientifically unnecessary.
Review for 10.1186/s12876-025-03704-6 (2025)

Title: Factors influencing the cure of pseudolithiasis: A retrospective study of 264 patients
Version: 5 Date: 01 Feb 2025
Reviewer:  Shi-Yan Zhang
Reviewer's report:
The authors have thoroughly addressed the reviewers' comments and made corresponding
revisions, which have significantly improved the quality of the manuscript. However, while
the authors mentioned in their response to reviewers that histograms were used to confirm the
normality of data distribution, this information is not explicitly described in the manuscript itself.
Specifically, the "Statistical Analysis" section does not detail how the normality of the data was
assessed. To enhance the rigor and transparency of the statistical analysis, it is recommended
to include a brief description of the methods used to evaluate normality (e.g., histograms or Q-
Q plots) in the "Statistical Analysis" section. Additionally, providing histograms or Q-Q plots
as supplementary material would further strengthen the manuscript and provide visual evidence
supporting the assumption of normality.
Review for 10.1186/s12876-025-03704-6 (2025)

Title: Factors influencing the cure of pseudolithiasis: A retrospective study of 264 patients
Version: 6 Date: 10 Feb 2025
Reviewer:  Shi-Yan Zhang
Reviewer's report:
The authors have made the required revisions to the manuscript. However, the description of
statistical methods should be included in the Methods section, while the results of statistical
analyses should be reported separately in the Results section.
Review for 10.1186/s12876-025-03698-1 (2025)

Title: Imaging features of epidermoid cysts in intrapancreatic spleen: A single center study of
24 patients
Version: 3 Date: 14 Aug 2024
Reviewer's report:
Please consider language correction is some parts, for better understanding.
Image acquisition
Please explain why MRCP only was performed and not contrast enhanced MRI. DWI technique
could also be beneficial for the differential diagnosis.
Results
Regarding the diagnoses, please clarify if the results refer to the first diagnosis before surgery,
or to the diagnosis of the two radiologists during the retrospective analysis.
Concerning the cases diagnosed as benign cystic lesion, or serous cystadenoma, please explain
why surgery was performed?
Concerning MRCP findings as none of the lesions communicated with the pancreatic dust, how
the diagnosis of IPMN was proposed in one patient?
Discussion-Image analysis
Please change the following “The lesions of ECIPAS show no marked reinforcement in arterial
phase: to “The lesions of ECIPAS show no marked enhancement in arterial phase
Figures
1.Please change “(c) The lesion shows strip-like enhancement in the veneous phase” to “(c) The
lesion shows strip-like enhancement in the venous phase”.
2.Please change “the multilocular mass shows slightly uneven enhancement” to “the
multilocular mass shows slightly heterogenous enhancement”
4.Please change “(a) The mass shows slightly iso-, hyperdense with ill-fined border” to “(a) The
mass shows slightly iso-, hyperdense with ill-defined border”
5.Please change “(d) Coronal T2WI imaging shows a round homogeneous mass with
hyperintense in the tail of the pancreas” to “(d) Coronal T2WI imaging shows a round
homogeneous hyperintense mass in the tail of the pancreas”.
Review for 10.1186/s12876-025-03698-1 (2025)

Title: Imaging features of epidermoid cysts in intrapancreatic spleen: A single center study of
24 patients
Version: 3 Date: 01 Sep 2024
Reviewer's report:
‘Imaging features of epidermoid cysts in intrapancreatic spleen: A single center study of 24
patients’
It is an interesting topic despite small sample size because of rarity.
The corrections which were wanted before, had been done.
There are a lot of grammatical errors which should be corrected such as:
In abstract T2WI------ T2-weighted imaging (T2WI)
Capital and small letters
CT image acquisition
The abdominal plain and contrast-enhanced CT scan--------- The pre-contrast and contrast-
enhanced CT scans
800-1,000 ml warm----800-1.000 ml warm
Fig. 3 Irregular mass in pancreatic tail. A patient with a occupying lesion---- a space occupying
lesion, etc …
Figures are demonstrative and informative.
In my opinion, it is more likely as a pictorial essay or case series. It is better to rewrite as a
pictorial essay or case series, or statistically compare with some other pancreatic cystic lesions'
imaging findings for research article.
Rejection, resubmit as a new article after rewriting with revisions
Review for 10.1186/s12876-025-03698-1 (2025)

Title: Imaging features of epidermoid cysts in intrapancreatic spleen: A single center study of
24 patients
Version: 4 Date: 06 Jan 2025
Reviewer's report:
I think this is a very informative article that summarizes the imaging and pathology of pancreatic
epidermoid cysts and is well organized.
Major: To make this article even more educational, how about the following? In other words,
I would like to know what the 24 cases looked like on CT/MRI that led to that preoperative
diagnosis, so it would be good to have a table (as in supple 1) summarizing the imaging
characteristics of the 24 cases. Please summarize the imaging findings together with the
preoperative diagnosis as SUPPLEMENT 2.
Minor:
(bottom of page 4, in Image acquisition)
Is taking 800-1000 ml of warm water a commonly done imaging method? Please cite any articles.
Review for 10.1186/s12876-025-03698-1 (2025)

Title: Imaging features of epidermoid cysts in intrapancreatic spleen: A single center study of
24 patients
Version: 5 Date: 23 Jan 2025
Reviewer's report:
Thank you for your response.
As for the supplementary 2 table, the request has been met.
Regarding your reference to the article I pointed out last time regarding drinking warm water,
please cite the paper presented in the text.
Review for 10.1186/s12876-025-03599-3 (2025)

Title: The prognostic nutritional index is an effective prognostic and nutritional status indicator
for cirrhosis
Version: 0 Date: 06 Nov 2024
Reviewer's report:
In this manuscript entitled “Prognostic nutritional index: a validated biomarker to predict
prognosis in cirrhotic patients”, the authors validated the ability of prognostic nutritional index
(PNI) in stratification of cirrhosis and mortality. While the association between nutritional status
and cirrhosis is important, there are some concerns which should be clarified.
Major comments
1. The new consensus of nutritional assessment is the Global Leadership Initiative on
Malnutrition criteria. The authors should modify the introduction using this study (PMID:
35861232).
2. The authors assessed mortality in this study. However, mortality should be analyzed using
the cox proportional hazards model.
3. In the statistical analysis section, details on how covariates were selected for logistic
regression are missing.
4. Some abbreviations, such as INR, CTP, MELD, and AUC in the abstract and CONUT, TG/
HDL-C, LDL-C, ApoA, ApoB, OR, and CI in the manuscript, appear without initial definitions,
which may be confusing for readers unfamiliar with these terms. Ensuring all abbreviations are
clearly defined at their first occurrence would improve clarity.
5. There are many typographical errors throughout the text, such as inconsistent spacing and
occasional grammatical mistakes throughout the paper. I would suggest using the language
editing service to improve the readability of the manuscript.
Minor comments
1. The authors must reconsider the title of the paper because the current title is very similar to
a previous report (PMID: 36687701).
2. Cirrhotic patients and alcoholic cirrhosis are inappropriate explanations. This should be
“patients with cirrhosis” and “alcohol-related/associated cirrhosis”.
Review for 10.1186/s12876-025-03599-3 (2025)

Title: The prognostic nutritional index is an effective prognostic and nutritional status indicator
for cirrhosis
Version: 0 Date: 20 Nov 2024
Reviewer:  Panagiotis Tsibouris
Reviewer's report:
Abstract Presentation of the study population belongs in the results Only general characteristics
and definition of inclusion and exclusion criteria belongs in methods OR and p-values should
be included for statistical significant factors Methods definition of cardiovascular, pulmonary
and renal comorbidities should be better defined since liver cirrhosis could be complicated
with renal, pulmonary and cardiovascular imbalance To what extend were those complications
accepted? Lactation should be also be exclusion criterion Was it not been better to provide one or
more test validating nutritional status Statistics Power of the study should be calculated Results
Numerical and p-values should be included for every significant risk factor Apart from  OR p-
values should be included PNI might be useful to be compared with MELD score or CPT as
markers of disease cirrhosis severity
Review for 10.1186/s12876-025-03688-3 (2025)

Title: PD-1 inhibitors combined with chemotherapy or lenvatinib in advanced gallbladder
cancer: A retrospective comparative study
Version: 3 Date: 08 Sep 2024
Reviewer:  Hiroki Ueda
Reviewer's report:
This study was a single-center trial based on clinical practice. The combination of tislelizumab
and GS chemotherapy is a safe and more effective treatment option for patients with advanced
GBC. This paper is significant in demonstrating the safety and efficacy of combining
tislelizumab and GS and was well-understood. However, I believe some revisions are needed
for publication. Below are the points that require correction:
1. This study demonstrated that the combination of tislelizumab and GS chemotherapy showed
better therapeutic efficacy for advanced GBC compared to the combination of tislelizumab and
Lenvatinib. However, it seems that the underlying reasons for this difference have not been
sufficiently discussed. Further discussion is needed on the improvement in therapeutic effect of
tislelizumab and GS chemotherapy.
2. In this study, both the combination therapy of tislelizumab with GS and the combination of
tislelizumab with Lenvatinib were administered, but was this conducted as first-line therapy for
advanced GBC? If so, it would be important to include details about any differences between
the two groups in terms of second-line therapies and beyond.
Review for 10.1186/s12876-025-03688-3 (2025)

Title: PD-1 inhibitors combined with chemotherapy or lenvatinib in advanced gallbladder
cancer: A retrospective comparative study
Version: 3 Date: 10 Oct 2024
Reviewer:  Hasan Cagri Yildirim
Reviewer's report:
Biliary tract cancers are a very heterogeneous group, and gallbladder cancers and intra- and
extrahepatic cholangiocarcinoma have quite different courses. I would like to thank the authors
for their extensive studies including gallbladder cancers.
My suggestions regarding the article are as follows.
In the method section, it is stated that the study is retrospective, but it contradicts the statement
‘Twelve patients withdrew consent before treatment, and 10 patients were lost to follow-up after
one course of treatment (Fig. 1).’ Was it prospectively followed and written retrospectively?
Figure 2 is not fully understood, were OS and PSF analysis performed as multivariate COX
regression analysis including all patients? Why weren’t univariate analysis performed first and
then the factors that were significant in univariate analysis evaluated with multivariate analysis?
If this patient group specified in Figure 2 is all patients, express it as all patients.
How was it understood from the analysis in Figure 2 that there was no difference in pre-treatment
conditions between the two groups of patients?
‘Measured according to RECIST 1.1, the tumors shrunk by over 30%, reaching a partial reaction
degree.’ You can specify the sentence as partial response was achieved in 30% of patients
Correct the CA199 expression in Table 3 to CA19-9
There are currently two different IO-chemotherapy combinations recommended in international
guidelines for the treatment of biliary tract cancer, and it is recommended that authors include
these articles in the discussion section.
In the article evaluating the medical treatment of advanced gallbladder cancer, it is not
understood why the medical oncology specialists who actually apply these treatments are not
the authors (according to the affiliations on the title page)
Best regards
Review for 10.1186/s12876-025-03686-5 (2025)

Title: Association between lactate-to-albumin ratio and all-cause mortality in critically
ill cirrhotic patients with sepsis: A retrospective analysis of the MIMIC-IV database
Version: 1 Date: 29 Nov 2024
Reviewer's report:
Overall, this is a well-designed study on a pertinent topic. The authors adequately controlled
for confounding variables and managed missing data effectively. However, I would like to see
a more detailed explanation of the inclusion criteria, particularly regarding how infection was
defined (e.g., using ICD codes, positive microbiology results, imaging, etc.).
Additionally, it would be helpful to specify whether a defined timeframe was considered for
identifying the "first value after ICU admission" when collecting the data.
Review for 10.1186/s12876-025-03686-5 (2025)

Title: Association between lactate-to-albumin ratio and all-cause mortality in critically
ill cirrhotic patients with sepsis: A retrospective analysis of the MIMIC-IV database
Version: 1 Date: 11 Dec 2024
Reviewer's report:
Thank you for the opportunity to review this interesting work.
I believe that this work is suitable for publication, but some clarifications and minor
improvements would help enhance the quality of this work.
Specific Comments:
Lines 137-139 : Please add a reference for Multiple Imputation here. What type of multiple
imputation was used? How many iterations? And, did you only use one dataset, or were multiple
datasets imputed and then combined for analysis? I would like to see some more detail here.
Lines 142-145 : If a patient died at day 45, would they be censored for the analysis of the 30-
day death, but then included in the analysis of 90 & 180-day death? If so, then it may be more
simple to just analyze survival up to 180-days. You could still calculate mortality rates at 30,
90, and 180 days, this would just be less redundant.
Lines 153-154 : Did you assess proportional hazards assumption for Cox model? Also, liver
transplant could be a competing risk to mortality here – did you look at LT rates between the
quantiles of LAR?
Line 169 : Can you add more detail on this “recursive algorithm?”
Other General Comments:
-In all instances, change the word “multivariate” to “multivariable.”
-Lines 143, 144, 184, 276 : The word “enrolled” is not correct here – this was a retrospective
cohort study where you pulled info from a database – “enrolled” would be more suitable for a
prospective study or clinical trial where you were able to screen each patient before entering
them into the study.
-Figure 3 needs more clarification, it is somewhat confusing as-is. What do the red lines in the
top three panels represent?
-I think it would be interesting to see how LAR compares to lactate alone or albumin alone in
this cohort. Can you see if replacing LAR with lactate/albumin individually provides a better
fit? Or – even better, if you have access to an independent cohort (or even the same database
at a different time period than that used in your main analysis), you could compare the AUCs
and predictive performance.
If not, this is fine, but this analysis would help strengthen the argument that LAR is a superior
predictor.
Review for 10.1186/s12876-025-03686-5 (2025)

Title: Association between lactate-to-albumin ratio and all-cause mortality in critically
ill cirrhotic patients with sepsis: A retrospective analysis of the MIMIC-IV database
Version: 2 Date: 24 Dec 2024
Reviewer's report:
Thank you for addressing the initial review comments.
I am satisfied by the authors' responses and changes made.
No further revisions are necessary.
Review for 10.1186/s12876-025-03686-5 (2025)

Title: Association between lactate-to-albumin ratio and all-cause mortality in critically
ill cirrhotic patients with sepsis: A retrospective analysis of the MIMIC-IV database
Version: 2 Date: 11 Jan 2025
Reviewer's report:
There is no problem in publishing this article which was found that LAR  had a significant effect
on mortality at 30, 90 and 180 days in cirrhotic patients with sepsis from MIMIC-IV data and
which was sent to me after revision. I do not have any additional suggestions or contributions in
this article which was revised in line with the suggestions of previous referees. It is an appropriate
article in terms of content and scientific contribution to be published in your journal.
Review for 10.1186/s12876-025-03686-5 (2025)

Title: Association between lactate-to-albumin ratio and all-cause mortality in critically
ill cirrhotic patients with sepsis: A retrospective analysis of the MIMIC-IV database
Version: 2 Date: 11 Jan 2025
Reviewer's report:
I have reviewed with interest the manuscript by Ma et al. investigating lactate-to-albumin
ratio (LAR) in critically ill cirrhotic patients with sepsis. The authors present a well-conducted
retrospective analysis of the MIMIC-IV database, examining whether this simple ratio of two
routine laboratory values can predict mortality in this high-risk patient population. Their work
is methodologically sound, using appropriate statistical methods including multiple regression
models and careful adjustment for confounding factors. The large sample size of almost 2,000
patients provides adequate power, and the clinical question is certainly relevant, as better
prognostic tools for patients with both cirrhosis and sepsis are urgently needed. The authors
demonstrate that a LAR above 1.05 is associated with increased mortality and that adding
LAR to existing scoring systems modestly improves their predictive accuracy. However, I must
point out that there are already multiple published papers evaluating LAR in various patient
populations using the MIMIC database, including works by Gharipour et al. and others. While
this manuscript is well-written and methodologically sound, I do not believe it adds substantially
new insights to the existing literature. Therefore, I would suggest that the authors consider
reformatting their findings as a brief letter to the editor, focusing on the specific aspects unique
to the cirrhosis population, rather than a full original research article.
e.g.: https://pubmed.ncbi.nlm.nih.gov/36591285/ and https://
pubmed.ncbi.nlm.nih.gov/39624213/ and https://www.frontiersin.org/journals/cardiovascular-
medicine/articles/10.3389/fcvm.2024.1486697/full and many many more!
Review for 10.1186/s12876-024-03544-w (2025)

Title: Advanced Lung Cancer Inflammation Index  A Key Predictor of Hepatic Steatosis and
Fibrosis Severity
Version: 2 Date: 22 Sep 2024
Reviewer:  Tadashi Namisaki
Reviewer's report:
The present study, being cross-sectional, can only explore the association of risk between ALI
and hepatic steatosis and fibrosis without establishing causality; therefore, future research should
focus on larger prospective cohort studies.
The authors shouled specficaly show how to do it.
Review for 10.1186/s12876-024-03544-w (2025)

Title: Advanced Lung Cancer Inflammation Index  A Key Predictor of Hepatic Steatosis and
Fibrosis Severity
Version: 2 Date: 06 Oct 2024
Reviewer:  Masatsugu Ohara
Reviewer's report:
Comment
In this manuscript, the authors demonstrated a positive association between elevated ALI levels
and both CAP and LSM levels, highlighting the importance of inflammation and nutritional
status in diagnosing hepatic steatosis and fibrosis. This is the first report on the utility of ALI
in relation to CAP and LSM.
However, the current findings provide limited evidence to support the use of ALI as a necessary
tool for evaluating CAP and LSM in fatty liver disease. There are several issues that need to
be addressed.
Major comments
1. To validate the utility of ALI, it is essential to compare it with established markers of fibrosis
and nutrition, such as the FIB-4 index, GNRI, and GLIM, which have been reported in relation
to liver disease.
2. In Table 2, the authors compare AHF (advanced hepatic fibrosis) with non-AHF. However, it
may be more appropriate to evaluate these cases within the context of NAFLD (AHF vs non AHF
in NAFLD), as there is already a difference in ALI between non-NAFLD and NAFLD patients.
Minor comment
In addition to the figure titles, legends may also be necessary for clarity. Furthermore, the graph's
X-axis and Y-axis lack unit labels; please consider adding these.
Review for 10.1186/s12876-024-03544-w (2025)

Title: Advanced Lung Cancer Inflammation Index  A Key Predictor of Hepatic Steatosis and
Fibrosis Severity
Version: 2 Date: 07 Oct 2024
Reviewer:  Panagiotis Tsibouris
Reviewer's report:
Methods Age limitations should be stressed Comorbidities should be defined and anyone of
them ending up in patient exclusion from the study should be reported Moreover all chronic
liver diseases apart from MASLD should be an exclusion criterion Alcohol consumption should
be defined and MASLD should be differentiated from MetSLD Number of patients in the study
belong to the results as well as those excluded for various reasons Any condition leading in liver
congestion like clinically significant heart failure should be taken into consideration Evaluation
in the three discrimination margins for F2,F3 and F4 could be more informative Results could
include changes according to LSM stratification in F2, F3 and F4 patients
Review for 10.1186/s12876-024-03544-w (2025)

Title: Advanced Lung Cancer Inflammation Index  A Key Predictor of Hepatic Steatosis and
Fibrosis Severity
Version: 3 Date: 18 Nov 2024
Reviewer:  Panagiotis Tsibouris
Reviewer's report:
Abstract Numerical and p-values should be provided for statistical significant factors Methods
Apart from hepatatitis all patients with other concurrent liver diseases should be excluded
Statistics Power of the study should be calculated
Review for 10.1186/s12876-024-03544-w (2025)

Title: Advanced Lung Cancer Inflammation Index  A Key Predictor of Hepatic Steatosis and
Fibrosis Severity
Version: 3 Date: 18 Nov 2024
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/s12876-024-03544-w (2025)

Title: Advanced Lung Cancer Inflammation Index  A Key Predictor of Hepatic Steatosis and
Fibrosis Severity
Version: 4 Date: 27 Nov 2024
Reviewer:  Panagiotis Tsibouris
Reviewer's report:
I think that the authors have applied all changes requested Thus the document could be approved
Review for 10.1186/s12876-025-03703-7 (2025)

Title: Clinical application of the Intersphincteric Approach with Internal incision combined with
Counter- Drainage for Deep Perianal Abscess
Version: 3 Date: 11 Sep 2024
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Authors, please address the following points below:
-Could you please provide an overview of the univariate analysis and multivariate logistic
regression analysis for predicting the prognosis of perianal abscess after surgery?
-Also, what was the dropout rate for the study?
- It's important to note that the small sample size is a significant limitation of the study.
Review for 10.1186/s12876-025-03703-7 (2025)

Title: Clinical application of the Intersphincteric Approach with Internal incision combined with
Counter- Drainage for Deep Perianal Abscess
Version: 3 Date: 31 Oct 2024
Reviewer's report:
Thank you for giving me the chance for reviewing this paper. Interesting subject and a reflection
of the daily practice. Although the study is retrospective with not large sample (questionable
power?) but still an important knowledge addition to the subject. A good abscess treatment is
necessary to avoid recurrence and fistula.
I have the following comments for the authors:
1. it is unclear for me who and how the patients were selected for the treatment type. It is very
important to clarify in details.
2.It is not clear if there were patients with observed internal opening in the control group that
might be the reason for lower healing rate.
3. the authors should cleary specify the number of patients with observed internal opening in
both groups.
4. It is also relevant to inform the reader about the qualification of the surgeon doing the
procedure in both groups.
5. Who performed the follow-up evaluation?
6. Consider revision of table 1 for better lay-out.
7. Consider revision of the method description of the treatment group, it is some how unclear
and difficult to understand.
8. How come the postoperative treatment includes routine antibiotics? There is no solid evidence
for this practice apart for immunosupression and weak patients. Please advocate for this practice.
Review for 10.1186/s12876-025-03703-7 (2025)

Title: Clinical application of the Intersphincteric Approach with Internal incision combined with
Counter- Drainage for Deep Perianal Abscess
Version: 4 Date: 13 Jan 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
The responses are satisfactory
Review for 10.1186/s12876-025-03703-7 (2025)

Title: Clinical application of the Intersphincteric Approach with Internal incision combined with
Counter- Drainage for Deep Perianal Abscess
Version: 4 Date: 23 Jan 2025
Reviewer's report:
The authors have made changes in the manuscript as I can see. However, I still need to have
some points clarified in this manuscript.
1. it is still unclear for me who and how the patients were selected for the treatment type. It is
very important to clarify in details. As I read in the text it is stated that the study is conducted
as retrospective analysis on patients who enrolled and randomized into two groups.
2.It is not clear if there were patients fistulas after treatment. The internal opening were excided
and drain was applied. As we know from the available evidence fistula formation is high aftaer
Seton drainage.
3. the authors have tried revision of the method description of the treatment group, it is some
how still unclear and difficult to understand.
4. the authors stated that antiotics were prescribed according to blood test results, which is
questionable practice.
5. The authors responded to the question about the difference in the number of patients who had
internal opening identified. It is stated that around 72% of the patients enrolled had an internal
opening with no difference between the groups. In the control group only incision drainage was
done. In the treatment group the internal opening was excised and a rubber drain was applied
through the internal opening to the nearest counter drainage. It seems to me as a significant
difference in the method which can clarify the results in term of cure rate as the internal opening
was not managed in the control group. One can not expect a high healing rate in deep anal
abscess where 73% of the cases with identifiable internal opening by merely incision drainage.
The method of comparing the two treatments has a serious breach.
6. Table 1 needs still a revision.
Review for 10.1186/s12876-025-03703-7 (2025)

Title: Clinical application of the Intersphincteric Approach with Internal incision combined with
Counter- Drainage for Deep Perianal Abscess
Version: 5 Date: 14 Feb 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
the responses are satisfactory
Review for 10.1186/s12876-025-03687-4 (2025)

Title: Metabolic Outcomes in Non-Alcoholic and Alcoholic Steatotic Liver Disease among
Korean and American Adults
Version: 0 Date: 05 Dec 2024
Reviewer's report:
In this manuscript entitled “Metabolic Outcomes in Non-Alcoholic and Alcoholic Steatotic
Liver Disease among Korean and American Adults”, the authors examined the association
between steatotic liver disease and metabolic disorders. While this is an interesting study, there
are some concerns which should be clarified.
Major comments
1. The introduction explaining NAFLD can be deleted because this study did not evaluate
NAFLD and the readers of the manuscript are hepatologists who understand the renaming. In
addition, NAFLD in page 11, line 277 can be changed to MASLD. Furthermore, the authors
should change the term “fatty liver” to “steatotic liver” throughout the paper.
2. In the introduction, the authors should explain the epidemiology of MASLD in general
population. (PMID: 38398471).
3. Cardiometabolic criteria is required for the diagnosis of MASLD and MetALD. The authors
should precisely explain in the method section.
4. The rationale for choosing different HSI thresholds for Korean and American cohorts (36 and
41, respectively) needs further justification. Especially, previous studies suggest lower cutoff
values for HSI in Asian cohort (PMID: 38895100, PMID: 33467114).
5. Sex difference of body composition may also influence MASLD and cardiometabolic diseases
The authors should make a discussion in this point (PMID: 37143429).
6. While the study emphasizes the need for integrated management of liver health and metabolic
risk factors, specific actionable recommendations for clinicians or policymakers are lacking.
Minor comments
1. “HIS” in line 119 should be “HSI”. The authors should check throughout the paper.
2. “MASDL” in line 264 should be “MASLD”.
Review for 10.1186/s12876-025-03687-4 (2025)

Title: Metabolic Outcomes in Non-Alcoholic and Alcoholic Steatotic Liver Disease among
Korean and American Adults
Version: 0 Date: 07 Dec 2024
Reviewer's report:
Thank you for submitting your manuscript titled "Metabolic Outcomes in Non-Alcoholic and
Alcoholic Steatotic Liver Disease among Korean and American Adults" for consideration. After
a thorough review, I have several comments and suggestions that could help improve the quality
and impact of your work.
Title and Abstract:
1. The title is clear and concise, effectively summarizing the focus of the study.
2. The abstract provides a good overview of the study, but it could benefit from a more detailed
description of the methods used.
Introduction:
1. The background section effectively sets the stage for the study, but it could be strengthened
by providing more specific details on the prevalence of steatotic liver disease (SLD) in the study
populations.
Methods:
1.The study population and data sources are well-described. However, it would be beneficial to
have a more detailed explanation of the preprocessing steps taken to merge and clean the data.
2.The use of logistic regression to assess the prevalence of chronic diseases is appropriate, but
the authors should ensure that the models are not overfitted by including too many covariates
relative to the number of events. A rule of thumb is to have at least 10 events per covariate.
3.The authors should also report goodness-of-fit measures for the logistic regression models,
such as the Hosmer-Lemeshow test, to assess the calibration of the models.
4.The use of Cox regression for longitudinal data is appropriate, but the proportional hazards
assumption should be formally tested and reported. Violations of this assumption could lead to
biased estimates of the hazard ratios.
5.While the authors have adjusted for potential confounders, it is unclear how these variables
were selected. The authors should provide a rationale for the inclusion of each covariate and
consider using a more systematic approach, such as directed acyclic graphs (DAGs), to identify
and adjust for confounding.
Results:
1.The results are presented clearly.
Discussion:
1. The discussion of the potential mechanisms underlying the observed associations is lacking.
It would be beneficial to have a more detailed discussion of these mechanisms, particularly in
the context of MetALD.
2. The implications of the findings for clinical practice are not fully explored. It would be helpful
to have a more detailed discussion of how these findings might influence clinical decision-
making.
Conclusion:
1.The conclusion effectively summarizes the key findings of the study. However, it could be
strengthened by a more detailed discussion of the implications of these findings for future
research and clinical practice.
Other Comments:
I recommend that you enhance the introduction and discussion sections by referencing the
following key publication: PMID: 34234521.
Overall, the study addresses an important topic and provides valuable insights into the
relationship between SLD and chronic metabolic diseases.
Review for 10.1186/s12876-025-03687-4 (2025)

Title: Metabolic Outcomes in Non-Alcoholic and Alcoholic Steatotic Liver Disease among
Korean and American Adults
Version: 0 Date: 07 Dec 2024
Reviewer's report:
The manuscript investigates the relationships between different types of steatotic liver disease
(MASLD, MetALD, and ALD) and chronic metabolic diseases using large cohort data from
Korea and the US. The study demonstrates that machine learning models can effectively predict
these relationships and highlights the particular significance of MetALD. The paper is timely
and relevant, especially given the recent reclassification of fatty liver diseases. However there
are still a number of issues that need to be addressed.
1. Include more recent references on MetALD specifically, as this is a key focus.
2. Improve clarity in methods section with shorter, more direct sentences.
Review for 10.1186/s12876-025-03687-4 (2025)

Title: Metabolic Outcomes in Non-Alcoholic and Alcoholic Steatotic Liver Disease among
Korean and American Adults
Version: 0 Date: 07 Dec 2024
Reviewer:  Amira A A Othman
Reviewer's report:
The scientific results of this study are previously published in another journal in September 22,
2024. The word “American” was inadvertently omitted from the title in the previously published
research text, while there is a 100% match in the rest of the research sections.  The Google
Scholar title is identical. I do not see the benefit of re-publishing.
Kim Y, Lee TS, Oh CM. Metabolic Outcomes in Non-Alcoholic and Alcoholic Steatotic
Liver Disease among Korean and American Adults: A Population-Based Multi-Cohort Study.
medRxiv. 2024:2024-09. doi: https://doi.org/10.1101/2024.09.20.24313951
Review for 10.1186/s12876-025-03687-4 (2025)

Title: Metabolic Outcomes in Non-Alcoholic and Alcoholic Steatotic Liver Disease among
Korean and American Adults
Version: 1 Date: 07 Jan 2025
Reviewer:  Amira A A Othman
Reviewer's report:
The authors' efforts to improve the manuscript and address the reviewers' comments are
praiseworthy. In general, their answers are adequate, and the work has been strengthened by
the changes. Nonetheless, there are a few places where the manuscript's quality may be further
improved with further explanation or polish. The study would be even stronger if it addressed
the proportional risks assumption, elaborated on the DAGs, and clarified the topic.
1. To guarantee the validity of longitudinal analysis, test and report the proportional hazards
assumption for Cox regression models.
2. Give further information about Directed Acyclic Graphs (DAGs), such as the methods used
to find confounders and the rationale behind the inclusion of covariates.
3. Explain how missing data was handled; indicate whether imputation techniques or thorough
case analysis were applied and provide justification for the strategy.
4. Describe preprocessing in more detail, including how datasets were normalized and how
alcohol intake was measured.
5. Include Hosmer-Lemeshow test results (e.g., p-values) in the main text or supplementary
material to demonstrate model calibration.
6. Provide specific clinical recommendations tailored to different patient subgroups (e.g., by sex
or disease severity).
7. Propose detailed future research questions, such as investigating molecular mechanisms of
MetALD or developing risk prediction models.
8. Avoid repetition in responses to reviewers’ comments by cross-referencing earlier responses
where applicable.
9. Summarize key supplementary findings in the main text to improve accessibility for readers.
10. Consolidate epidemiological data into one section to avoid redundancy and improve flow.
11. Simplify the discussion to prevent duplication, particularly in the parts on future research
and clinical implications.
12. To improve the discussion of MetALD's causes and clinical relevance, incorporate more
recent research.
Review for 10.1186/s12876-025-03687-4 (2025)

Title: Metabolic Outcomes in Non-Alcoholic and Alcoholic Steatotic Liver Disease among
Korean and American Adults
Version: 2 Date: 05 Feb 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/s12876-025-03665-w (2025)

Title: Big Data Analysis of Influenza Vaccination and Liver Cancer Risk in Hypertensive
Patients: Insights from a Nationwide Population-Based Cohort Study
Version: 1 Date: 22 Jul 2024
Reviewer's report:
This study analyzes data from the Taiwan National Health Insurance Research Database
from 2001 to 2012 and finds that influenza vaccination is linked to a decreased risk of liver
cancer in individuals with hypertension. The writing and statistical analysis in this article are
comprehensive. Still, some questions remain.
The analyzed data only covers the period from 2001 to 2012. Why has more recent data not
been utilized? If updated data is not accessible, the reasons should be clarified in the discussion
section under limitations.
As stated by the author in the abstract, "the protective effect of influenza vaccination against
primary liver cancer in individuals with hypertension remains unclear." Why did the author
choose to investigate the interplay between influenza vaccination, hypertensive patients, and
liver cancer risk, given the lack of strong biological connections?
The research team appears to study cancer risk in chronic disease patients following influenza
vaccination. Their research includes but is not limited to the following papers, all of which
use the same data source, similar statistical analysis methods, and even the same ethical
approval number (approval no. N201804043). I am curious why the author did not undertake a
comprehensive analysis encompassing all chronic diseases (e.g., hypertension, COPD, diabetes)
and all cancers (e.g., lung cancer, liver cancer), instead of dividing it into several smaller studies.
Ref 1. Zheng J Q, Lin C H, Chen C C, et al. Role of annual influenza vaccination against lung
cancer in type 2 diabetic patients from a population-based cohort study[J]. Journal of Clinical
Medicine, 2021, 10(15): 3434.
Ref 2. Chen C C, Wu C H, Lin C H, et al. Influenza vaccination and risk of lung cancer in
patients with chronic kidney disease: a nationwide, population-based cohort study[J]. Cancers,
2022, 14(12): 2926.
Ref 3. Hao W R, Yang T Y, Chen C C, et al. Influenza Vaccination Reduces the Risk of
Liver Cancer in Patients with Chronic Kidney Disease: A Nationwide Population-Based Cohort
Study[J]. Vaccines, 2022, 10(12): 2008.
Ref 4. Jong H C, Zheng J Q, Zheng C M, et al. Effect of Annual Influenza Vaccination on the
Risk of Lung Cancer Among Patients With Hypertension: A Population-Based Cohort Study in
Taiwan[J]. International Journal of Public Health, 2023, 68: 1605370.
Review for 10.1186/s12876-025-03665-w (2025)

Title: Big Data Analysis of Influenza Vaccination and Liver Cancer Risk in Hypertensive
Patients: Insights from a Nationwide Population-Based Cohort Study
Version: 2 Date: 28 Aug 2024
Reviewer's report:
The author has adequately addressed all of my questions, and I have no further comments.
Review for 10.1186/s12876-025-03665-w (2025)

Title: Big Data Analysis of Influenza Vaccination and Liver Cancer Risk in Hypertensive
Patients: Insights from a Nationwide Population-Based Cohort Study
Version: 4 Date: 16 Oct 2024
Reviewer:  Panagiotis Tsibouris
Reviewer's report:
Abstract Uni and multivariated analysis are adequate to unfold relation between influenza
vaccination and HCC Moreover relation of vaccination 10 years post exposure could be
presented Definition of hypertension should be provided Methods Definition of comorbidities
could be provided MAFLD should be included as it could lead in HCC without cirrhosis Time
distance between vaccination and HCC diagnosis should be defined Because at least 10 years
need to develop HCC  such results would be appreciated to be included in the study Instead of
cancer neoplasia would be better definition for exclusion criteria