JerMa88/BMC_Gastroenterology_Peer_Reviews huggingface dataset:
Review for 10.1186/s12876-025-04089-2 (2025)

Title: Comparison of Efficacy and Safety Between Surgical and Conservative Treatments for
Hemorrhoids: A Meta-Analysis
Version: 0 Date: 13 Apr 2025
Reviewer's report:
This is a systematic review and meta-analysis of surgical and conservative treatments
of haemorrhoids. Authors seem to be proving the effectiveness of surgical treatment for
haemorrhoids. I have some comments and suggestions.
1. There seem to be a contradiction in the results and conclusion section in the abstract. Please
consider revising the results with reference to the conclusion. Short term pain reduction in the
results section and higher risk of post operative pain in the conclusion section. The results section
in the manuscript needs re-writing to clarify the same as in clinical practice postoperative pain is
one of the major issues of haemorrhoidectomy in the short term. Postoperative pain needs more
clarification in the discussion section too.
2. Postoperative urinary retention is a rare complication after surgery. How was this end point
compared with conservative treatment?
3. I suggest including only the 6 RCTs and excluding the cohort study. This will increase the
credibility of this analysis.
4. Furthermore, use Cochrane’s Risk of Bias 2 tool for quality assessment of the RCTs.
5. I2 is not a measure of heterogeneity and may not be quoted in the manuscript. It is Cochrane’s
Q test that determines the heterogeneity along with Tau and Tau squared values.
6. In the results section, authors mention about the discharge comparison between surgical and
conservative treatments. Conservative treatment does not need admission and is carried out as
outpatient. Were patients admitted for conservative treatment? If not this analysis is probably
un necessary.
7. How was the time to recovery measured in the included studies?
8. There is a difference between the actual recurrence and risk of recurrence. How was the risk of
recurrence evaluated? I understand that actual recurrence can be assessed after a certain period
of follow up. What was the follow up in the included studies?
9. Some of the studies included in the analysis reported on the surgical intervention on
thrombosed external haemorrhoids. Did this analysis address emergency or elective treatment
of haemorrhoids?
10. The conclusions drawn from analysis of less than three studies cannot be considered
significant recommendations and may be given in the discussion section. The forest plots of
these results may be excluded.
Review for 10.1186/s12876-025-04089-2 (2025)

Title: Comparison of Efficacy and Safety Between Surgical and Conservative Treatments for
Hemorrhoids: A Meta-Analysis
Version: 3 Date: 09 Jun 2025
Reviewer's report:
The authors have adequately addressed all of my previous comments. The revisions were
implemented clearly and consistently throughout the manuscript, resulting in substantial
improvements in clarity, methodological rigor, and overall organization. I appreciate the careful
attention to the feedback. I have no further comments.
Review for 10.1186/s12876-025-04061-0 (2025)

Title: Unveiling the diagnostic and pro-inflammatory role of Crohn’s disease: insights from
16S-guided discovery and species-specific validation
Version: 1 Date: 14 Feb 2025
Reviewer's report:
The paper investigated the role of Ruminococcus gnavus in Crohn's disease (CD) pathogenesis.
Comments
1. The study used R. gnavus strain ATCC 29149, but it did not address whether this strain was
representative of the strains found in CD patients or if it belonged to a specific clade associated
with disease. Previous studies have shown that R. gnavus exhibits strain-specific effects, with
some strains being pro-inflammatory and others tolerogenic.
2. The study implied a causal role for R. gnavus in CD pathogenesis, but its design
(observational and correlational) cannot establish causality. Previous studies emphasize the need
for experimental validation to determine whether R. gnavus drives disease or is a consequence
of the altered gut environment in CD.
3. The study included 22 patients with active CD, 10 patients with inactive CD, and 32 healthy
controls. This sample size may not be sufficient to capture the full heterogeneity of CD,
especially given the variability in disease presentation and progression.
4. While the random forest model achieved a high AUC (0.938), the authors did not describe
how the model was validated (e.g., cross-validation, independent cohort).
5. The authors focused on R. gnavus but did not discuss the potential roles of other microbial
genera identified. The gut microbiome is generally considered as a complex ecosystem, where
interactions between multiple species may contribute to disease. Furthermore, the study could
not address whether the observed effects of R. gnavus are unique or if other microbes could
compensate for its absence. Functional redundancy in the gut microbiome may exist and disease-
associated microbes may share similar metabolic capabilities.
6. The authors suggest that the identified genera (including R. gnavus) could serve as diagnostic
biomarkers for CD. However, they did not discuss the feasibility of translating these findings
into clinical practice (e.g., sensitivity, specificity, cost-effectiveness).
7. The authors have not investigated whether targeting R. gnavus could be a viable therapeutic
strategy for CD.
Review for 10.1186/s12876-025-04061-0 (2025)

Title: Unveiling the diagnostic and pro-inflammatory role of Crohn’s disease: insights from
16S-guided discovery and species-specific validation
Version: 3 Date: 27 Mar 2025
Reviewer's report:
The authors have addressed all questions and revised the manuscript accordingly. When they
were not able to address a question, they added the concern as a limitation in the discussion
section.
Review for 10.1186/s12876-025-03984-y (2025)

Title: The prognostic significance of desmoplastic reaction, tumor budding, and tumor-
infiltrating lymphocytes in esophageal squamous cell carcinomas
Version: 1 Date: 05 Mar 2025
Reviewer's report:
1. The quality and labelling of the histopathology photos are not great.
2. It is highly unusal that the 3rd author is the corresponding.
3. The manuscript does not contain an abstract.
4. The objectives do not contain any references.
5. Please list the examined parameters (TB, TME, TIL, DR) in the same order as in title and
then later on consequentially.
6. The punctuation of the text has many mistakes.
7. These features are made by the pathologist according to the tumor-node-metastasis (TNM)
classification staging included in the pathology report . - TNM does not include all factors you
mentioned in the previous sentence.
8. In this a consecutive study? Were patients excluded?
9. What was histologically identified as mature DR?
10. The results section is highly unprofessional. Does not include anything about the cohort.
How many males/females? Age? Histotype? TNM? Grade? etc.
11. It is not stated who examined these factors in the study? Was it a pathologist? Was he/she
an expert?
12. The list of abbreviations is not in aphabetical order.
13. Figure legends are highly unprofessional.
Review for 10.1186/s12876-025-03984-y (2025)

Title: The prognostic significance of desmoplastic reaction, tumor budding, and tumor-
infiltrating lymphocytes in esophageal squamous cell carcinomas
Version: 1 Date: 11 Mar 2025
Reviewer:  Sakineh Amoueian
Reviewer's report:
Dear authors
your article was practical and useful for patient,s treatment.I have a  suggestion for you:
your refrencess for Tumor budding (TB) and desmoplastic reaction (DR) is
old(2002-2004) .Please use of 2016 International Tumor Budding Consensus Conference(the
last ones).
Review for 10.1186/s12876-025-03984-y (2025)

Title: The prognostic significance of desmoplastic reaction, tumor budding, and tumor-
infiltrating lymphocytes in esophageal squamous cell carcinomas
Version: 1 Date: 14 Mar 2025
Reviewer's report:
In this manuscript, the authors assessed the efficacy of desmoplastic reaction (DR), tumor
budding, tumor-infiltrating lymphocytes (TIL), and other clinicopathological factors in
predicting the prognosis of esophageal squamous cell carcinoma. It is an original production,
as the majority of published papers on DR are on colorectal cancer and fewer on esophageal
cancer. Since the methods in this manuscript are in part poorly explained, some of the results
seem unreproducible. The conclusions are interesting and consistent with previously published
papers and hypotheses, but overall it does not seem to be well written. No ethical problems are
found in this study. My comments and suggestions are listed below.
Specific points)
1. The abstract is inappropriate. It contains only background and objectives.
2. The information (age, sex, tumor size, grade, etc.) of this cohort of 98 patients should first
be presented in a table.
3. In Materials and Methods. The definition of DR here seems to differ from that of the colon.
In general, DR in colorectal cancer is evaluated at the invasive front outside the muscularis
propria layer. However, this manuscript seems to include cases of early-stage cancer, i.e., pT1-2.
Therefore, it seems necessary to explain in detail how to search for DR.
4. The method of TIL identification is also not specified; a careful explanation is necessary to
keep the subsets of TILs in mind.
5. The Results section is partial and too simplified. Some figures are not explained here.
6. The second paragraph of the Discussion (page 4, lines 8-21): Although the positive data
previously reported were listed, I had the impression that it was difficult to understand what was
the important point.
7. The paragraph #4 of the Discussion (page 4, line 7 from the bottom - page 5, line 7): it would
be easier to understand if they first discuss the data in this study and then describe the differences
from the previous reports.
8. Page 5, line 12; the cited paper #32 is not appropriate. There is a divergence from the intent
of the statement here.
Review for 10.1186/s12876-025-04027-2 (2025)

Title: Timing  and Other Factors Influencing Short#Term Outcomes of Endoscopic
Transpapillary Gallbladder Drainage for Acute Cholecystitis: A Retrospective Study
Version: 1 Date: 20 Mar 2025
Reviewer's report:
This is an interesting paper. In daily clinical practice, we experienced that ETGBD performed
after PTGBD has a higher success rate than ETGBD performed early. The definitions of early
and delayed periods are unclear, so please define them. Please state the number of cases in which
PTGBD or PTGBA was performed before ETGBD in the patient background. Many of the
delayed ETGBDs in this paper had prior PTGBD (or PTGBA), so it is difficult to conclude that
this is an evaluation of delayed ETGBD alone. Please reevaluate the analysis of ETGBD failure
in a multivariate analysis, including a factor that PTGBD (or PTGBA) was not performed. If
prior PTGBD (or PTGBA) can be listed as a factor in ETGBD success, please change the title.
Review for 10.1186/s12876-025-04027-2 (2025)

Title: Timing  and Other Factors Influencing Short#Term Outcomes of Endoscopic
Transpapillary Gallbladder Drainage for Acute Cholecystitis: A Retrospective Study
Version: 1 Date: 23 Mar 2025
Reviewer's report:
The study explores a meaningful topic, but without addressing the fundamental question of
why delayed ETGBD should be performed at all, especially in the absence of recurrence data,
the manuscript lacks clinical justification. Substantial revision and clarification are required to
support the conclusions.
Review for 10.1186/s12876-025-04027-2 (2025)

Title: Timing  and Other Factors Influencing Short#Term Outcomes of Endoscopic
Transpapillary Gallbladder Drainage for Acute Cholecystitis: A Retrospective Study
Version: 2 Date: 01 Apr 2025
Reviewer's report:
If a comparison is required, it may be better to compare early ETGBD with PTGBD. If no
comparison is required, it would be better to state the usefulness of delayed ETGBD after
PTGBD.
Review for 10.1186/s12876-025-04027-2 (2025)

Title: Timing  and Other Factors Influencing Short#Term Outcomes of Endoscopic
Transpapillary Gallbladder Drainage for Acute Cholecystitis: A Retrospective Study
Version: 3 Date: 21 Apr 2025
Reviewer's report:
It has been revised and is now easier to understand. The term "delayed or elective" is not
standardized. Please standardize it to one or the other and revise the expression in the text.
Review for 10.1186/s12876-025-04027-2 (2025)

Title: Timing  and Other Factors Influencing Short#Term Outcomes of Endoscopic
Transpapillary Gallbladder Drainage for Acute Cholecystitis: A Retrospective Study
Version: 3 Date: 23 Apr 2025
Reviewer's report:
General Comments to the Authors
Thank you for the opportunity to review your revised manuscript. Your study addresses an
important technical and procedural aspect of endoscopic transpapillary gallbladder drainage
(ETGBD), particularly the influence of timing on short-term outcomes. The data are presented
clearly and the methodology appears sound.
However, I remain concerned that the clinical value of elective ETGBD is overstated in the
absence of any long-term outcome data. While the study shows improved short-term technical
success and fewer adverse events in elective cases, it does not demonstrate whether these
translate into meaningful clinical benefits, such as reduced recurrence, improved quality of life,
or better overall patient outcomes.
This issue was raised in previous reviews, but has not been substantively addressed. The
discussion should be revised to more explicitly acknowledge this limitation. In particular:
Clearly state that no long-term outcomes were evaluated.
Discuss how the prior use of PTGBD in the elective group may confound the results.
Avoid suggesting that elective ETGBD is clinically superior without supporting data.
If follow-up data are available, even limited, please consider including them. Otherwise, the
manuscript should be more cautious in its conclusions.
I believe the manuscript could still offer value if these limitations are properly discussed and
the conclusions appropriately tempered.
Review for 10.1186/s12876-025-04027-2 (2025)

Title: Timing  and Other Factors Influencing Short#Term Outcomes of Endoscopic
Transpapillary Gallbladder Drainage for Acute Cholecystitis: A Retrospective Study
Version: 4 Date: 01 May 2025
Reviewer's report:
Finally, have a native speaker check your paper (including spell checking for upper and lower
case letters).
Review for 10.1186/s12876-025-04027-2 (2025)

Title: Timing  and Other Factors Influencing Short#Term Outcomes of Endoscopic
Transpapillary Gallbladder Drainage for Acute Cholecystitis: A Retrospective Study
Version: 4 Date: 04 May 2025
Reviewer's report:
The authors have adequately addressed the concerns raised in the previous review. The revised
version shows clear improvements in both clarity and content. The explanations are more
precise, the methodology is better motivated, and the results are presented more clearly. I believe
the paper is now in good shape and recommend acceptance.
Review for 10.1186/s12876-025-04086-5 (2025)

Title: Global burden, trends, and risk factors of early-onset and late-onset colorectal cancer from
1990 to 2021, with projections to 2040: A population-based study
Version: 0 Date: 10 Mar 2025
Reviewer's report:
General comments:
This is a very interesting and well-written manuscript containing a lot of important data. The
authors do a very good job summarizing such a large amount of information. Despite the large
number of tables and figures, the manuscript is easy to follow. Specific comments are given
below. One minor general comment is to check for consistent use of abbreviations; for example,
colorectal cancer is sometimes written out and sometimes abbreviated.
Specific comments:
1. Introduction: The text says ‘Currently, most countries have established age 50 as the threshold
for initiating colonoscopy screening2.’ – this is not accurate regarding the age and the modality.
Very few countries use colonoscopy as the main screening tool and I’m not sure that the majority
start at aged 50.
2. Introduction: The text says ‘Additionally, some scholars have suggested that the promotion of
colonoscopy screening in individuals under 50 may lead to an increase in EOCRC incidence due
to earlier detection15’ – which countries are promoting colonoscopy screening in those younger
than 50? This needs to be clearly stated rather than just a reference given.
3. Methods: The text says ‘This study analyzed risk factors with demonstrated causal
relationships with EOCRC, including dietary (low intake of milk, calcium, and fiber, high intake
of red and processed meats), behavioural (alcohol consumption, smoking, and low physical
activity), and metabolic factors (high body mass index and high fasting plasma glucose’ – I don’t
think there is evidence for all of these variables being causally associated with EOCRC?
4. Methods: The text says ‘All methods adhered to relevant guidelines and regulations.’ It is
unclear what the authors are referring to here – should be more specific.
5. Methods: need to be more clear on how the modifiable risk factors were selected.
6. Table S12 – unclear how this table is ordered?
7. Table S12 – unclear what ‘epidemiological changes’ means?
8. Results, Section 3.5: be clear that the statistics in this section refer to 2021 rather than 1990.
9. Results, diet and lifestyle factors: it would help to have a clear explanation of how values for
these variables are determined on a country-wide basis.
10. Discussion: The text says ‘For young individuals, using risk scores to identify high-risk
populations could reduce the burden of colonoscopy,’ – screening does not have to rely on
colonoscopy, the text should reflect this.
11. Discussion: The text says ‘Moreover, the similar risk factors for EOCRC and LOCRC
suggest that unified prevention strategies could be effective’ – I’m not sure this is an evidence-
based statement. There is insufficient data on the aetiology of EOCRC.
12. Discussion: lacks information on why certain countries have the highest or lowest statistic.
Please add some discussion on this.
Review for 10.1186/s12876-025-04086-5 (2025)

Title: Global burden, trends, and risk factors of early-onset and late-onset colorectal cancer from
1990 to 2021, with projections to 2040: A population-based study
Version: 0 Date: 25 Mar 2025
Reviewer's report:
Many thanks for great efforts to this comprehensive study.
Results of the present study provides a huge body of information but target population is not
clear  and how this information may help policy makers to promote health status of population.
Please provide some suggestions to address population health promotion using findings of the
study
Review for 10.1186/s12876-025-04086-5 (2025)

Title: Global burden, trends, and risk factors of early-onset and late-onset colorectal cancer from
1990 to 2021, with projections to 2040: A population-based study
Version: 0 Date: 28 Mar 2025
Reviewer:  Zelalem Asefa
Reviewer's report:
Global burden, trends, and risk factors of early-onset and late-onset colorectal cancer from 1990
to 2021, with projections to 2040: A population-based study
Comments:
1. General comment: The study was conducted to compare the global burden of early onset
colorectal cancer (EOCRC) with late onset colorectal cancer (LOCRC). The authors also tried
to assess the association of national development status, risk factors and the future burden of
EOCRC and LOCRC. The study seems the first of its kind to answer research questions with
those respects.
- The results were accurately reported except for minor corrections as suggested below in the
specific comments.
-The authors documented the limitations of their study and the conclusions and the
recommendations suggested are according to their study results.
2. Specific comments on the manuscript: The specific comments were given referring to the
topic in the text and mentioning the line at which correction has to be considered.
2. Methods
2.1 Data Resource
It is better to change Data Resource to Data Sources
2.2  Definition of EOCRC/LOCRC
-2.3 Definition of Sociodemographic Index
Line 2: SDI which was written after full stop is better written in extended form as The
Sociodemographic Index values range…
2.5 Statistical Analysis
- Line 4: AAPCs which was written after full stop is better written in extended form as Average
annual percentage changes…
3. Results
3.1 Global Burden of EOCRC and LOCRC
- Line 4: It is good to put Table 1 in parenthesis as (Table 1). The same suggestions for Table
S1, Table S2 and Table S3
- The headings of the tables are better placed at the top of the table
Sincerely Yours,
Dr Zelalem Asefa
General and Colorectal Surgeon
Addis Ababa University
College of Health Sciences
Review for 10.1186/s12876-025-04086-5 (2025)

Title: Global burden, trends, and risk factors of early-onset and late-onset colorectal cancer from
1990 to 2021, with projections to 2040: A population-based study
Version: 2 Date: 05 Jun 2025
Reviewer's report:
The authors have responded to all of the reviewers queries.
Review for 10.1186/s12876-025-04069-6 (2025)

Title: Effect of Allostatic Load on hepatic steatosis and Fatty Liver-Associated Liver Fibrosis
Version: 3 Date: 25 Apr 2025
Reviewer's report:
Thank you for the opportunity to review the manuscript titled "Effect of Allostatic Load on
Hepatic Steatosis and Hepatic Fibrosis." While the topic of the association between allostatic
load and liver disease is of clinical interest, this manuscript has several major flaws that, in my
view, preclude publication in its current form.
Major Comments:
1. Lack of Novelty:
The study largely replicates existing findings, particularly a recent study (Dai & Zhou, BMC
Public Health, 2024) , which the authors themselves cite. The manuscript does not sufficiently
differentiate its results or approach from prior work, nor does it provide new mechanistic insights
or robust new hypotheses.
2. Methodological Concerns:
The use of NHANES data is appropriate, but the operationalization of allostatic load (ALI)
is inconsistent and problematic. Triglycerides were excluded without a fully convincing
justification, and the ALI scoring system differs from validated methods without clear validation
or sensitivity analyses to support the adaptation.
The study design is entirely cross-sectional, which the authors acknowledge, yet mediation
analyses are performed. Causal mediation analysis is inappropriate in a purely cross-sectional
design without temporal ordering.
The stratified analyses are extensive but lack clear hypothesis-driven focus, leading to the risk
of multiple testing without correction.
3. Statistical Issues:
Confidence intervals are very wide and often cross critical values, suggesting instability of
results.
Sensitivity analyses with APRI and FIB-4 fail to support the main findings, severely
undermining the robustness of the reported associations.
The adjustment models do not appear sufficient to control for residual confounding, particularly
from metabolic syndrome components closely tied to both ALI and fatty liver outcomes.
4. Language and Writing Quality:
The manuscript is difficult to read due to poor English grammar, awkward phrasing, and frequent
typographical errors (e.g., "unstable load" instead of "allostatic load" repeatedly). A major
language revision would be necessary even if the science were sound.
5. Overinterpretation of Results:
The discussion overstates the implications of the findings. For example, the claim that
"managing stress may reduce fatty liver and liver fibrosis" is speculative and unsupported by
the data presented, given the observational and cross-sectional nature of the study.
Minor Comments:
Figures and tables are not professionally formatted.
References are inconsistently formatted and include typographical errors.
Review for 10.1186/s12876-025-04069-6 (2025)

Title: Effect of Allostatic Load on hepatic steatosis and Fatty Liver-Associated Liver Fibrosis
Version: 6 Date: 02 Jun 2025
Reviewer's report:
The reviewers provided constructive and largely favorable feedback. All suggestions have
been thoughtfully addressed through appropriate revisions. I approve this revised version for
resubmission.
Review for 10.1186/s12876-025-04091-8 (2025)

Title: Prognostic Role of Preoperative Inflammatory Markers in Postoperative Lung Metastasis
of Colorectal Cancer: A Retrospective Study
Version: 1 Date: 25 Dec 2024
Reviewer's report:
There is a lack of detailed discussion on why lung metastasis was studied independently rather
than liver metastasis. It is recommended to elaborate on the unique prognostic or biological
mechanisms of lung metastasis, even though its prognosis may be better than that of liver
metastasis.
The rationale for selecting the inflammatory markers (e.g., NLR, PLR, CALLY) needs further
explanation. For instance, how do these markers address gaps in existing research?
Explain why patients with pre-existing inflammation or other malignancies were excluded from
the study.
Provide a biological or clinical explanation for the chosen cutoff values of the inflammatory
markers and clarify whether these cutoff values have been externally
How were missing data handled in the analysis?
Explain why logistic regression was used for baseline characteristic analysis, while Cox
regression was applied for outcome analysis, ensuring consistency in model selection and result
interpretation.
Further clarify why certain markers (e.g., SIRI, PLR) were significant in univariate analysis but
lost statistical significance in the multivariate model.
It is recommended to add more descriptive figure legends to the Kaplan-Meier curves to help
readers unfamiliar with specific markers quickly understand the results.
The discussion focuses heavily on positive findings (e.g., PNI and CALLY) but insufficiently
addresses negative results (e.g., LMR not being an independent predictor). It is suggested to
analyze the potential reasons for these findings.
Supplement the discussion with the biological mechanisms linking CALLY and PNI to
lung metastasis. For example, how do albumin and CRP levels influence the progression of
metastasis?
Review for 10.1186/s12876-025-04091-8 (2025)

Title: Prognostic Role of Preoperative Inflammatory Markers in Postoperative Lung Metastasis
of Colorectal Cancer: A Retrospective Study
Version: 1 Date: 26 Dec 2024
Reviewer:  Shi-Yan Zhang
Reviewer's report:
Reviewer comments
The paper examines the prognostic significance of inflammatory markers for lung metastasis in
colorectal cancer (CRC). Below are specific suggestions for improvement:
Introduction:
1.Phrases such as "is one of the most common malignancies globally" and "a leading cause of
cancer-related deaths" can be condensed. The distinction between liver and lung metastasis is
repeated unnecessarily and should be streamlined.
2.The statement "a lack of reports on lung metastasis" is vague. Specify the absence of data on
inflammatory markers in relation to lung metastasis.
3.While many markers are introduced, their specific relevance to lung metastasis is not clearly
explained. Include a brief rationale for selecting these markers to strengthen the argument.
Materials and methods:
1."Patents underwent" should be "Patients underwent"
2.Some technical terms (e.g., "Youden index") could include a brief explanation for readers
unfamiliar with them.
3.The formulas section is incomplete ("The formulas for the relevant indices in this study are as
follows: ; ; ;; ;"). Ensure all formulas are provided and described.
4.Use bulleted or numbered lists for inclusion/exclusion criteria and follow-up procedures to
enhance readability.
5.Avoid redundancy by consolidating details about survival data that appear in multiple sections.
Results:
1.Some sentences are lengthy and could be broken down for readability. For example,
descriptions of statistical results and comparisons (e.g., Kaplan-Meier survival outcomes) could
be simplified.
2.Avoid repeating similar findings, such as PNI and CALLY being risk factors, in multiple
instances.
3.Improve transitions between baseline characteristics, PFS, and metastasis outcomes by
explicitly linking findings to patient outcomes.
While the results are well-presented, include brief interpretations to explain why certain markers
are significant and their implications for clinical practice
Discussion:
1.Reduce verbosity and avoid redundant mentions of findings, such as repeated references to
PNI and CALLY.
2.Ensure a logical progression between specific markers and general findings to maintain
coherence.
3.Limitations: Although limitations are mentioned, expand on them with specific suggestions
for future research to address these gaps.
Figures:
The y-axis labels should be made more visible and detailed with clearer descriptions such as
'Survival Probability' or 'Probability of Survival Over Time.' Legends for each panel should
clearly specify the groups being compared, using more descriptive terms (e.g., 'High vs. Low
CALLY' or 'High PNI vs. Low PNI') to enhance clarity and comprehension.
Review for 10.1186/s12876-025-04091-8 (2025)

Title: Prognostic Role of Preoperative Inflammatory Markers in Postoperative Lung Metastasis
of Colorectal Cancer: A Retrospective Study
Version: 3 Date: 11 May 2025
Reviewer's report:
Thank you for the revised manuscript. I understand that your study aims to identify novel
prognostic factors that may help better stratify high-risk patients with pulmonary metastases.
If the purpose is to evaluate the predictive significance of inflammatory markers for lung-specific
metastasis, I believe it would be important to compare patients with pulmonary metastases to
those with other types of distant metastases. This would help clarify whether the identified
markers are specific to lung metastases or reflect a general metastatic tendency.
Additionally, could you clarify whether patients with pulmonary metastases who also had other
distant metastases were included or excluded from the analysis?
Including a detailed breakdown of metastatic patterns (e.g., lung only, liver only, peritoneum,
or multiple sites) in the table of baseline clinicopathological characteristics would also enhance
interpretability.
Review for 10.1186/s12876-025-04091-8 (2025)

Title: Prognostic Role of Preoperative Inflammatory Markers in Postoperative Lung Metastasis
of Colorectal Cancer: A Retrospective Study
Version: 5 Date: 13 Jun 2025
Reviewer's report:
Thank you for your thorough revision. The manuscript has been substantially improved and
addresses  the reviewers’ comments appropriately.
Review for 10.1186/s12876-025-04066-9 (2025)

Title: Prophylactic endotracheal intubation prior to emergency endoscopy for acute
esophagogastric variceal hemorrhage: A retrospective single center study
Version: 1 Date: 14 May 2025
Reviewer's report:
Great idea for a study.
I have few comments:
1.  You showed that active bleed was associated with higher cardiopulm complication. PEI
groups has more patient requiring higher transfusion, which should be sign of active bleed. Is it
possible pna/pulm edema/taco were related to aspiration prior to the intubation due to high rate of
bleed and pulm edema was related to taco rather than mechanical ventilation, which should help
with edema and not cause it, especially when exercising positive pressure ventilation. Would
check for this cofounding.
2. Stats calculation seems to be little off. How can you meaningfully calculate p value in low N
of 97 with rare event of death with intubation ? lines: 195-198
3.Why are you excluding 3 cases of massive aspiration from non PEI group? It was decision
not to intubate initially and not rescue intubation which resulted in many cardiopulmonary
complication and ultimately cause certain LOS
4. Please check syntax, flow of text and wording. For example: line 226: i think you wanted
to say:
" patients intubated for more than 24 hrs" and not extubated. Some of the sentences  discussing
extubation within 24 hrs and after 24 hrs are confusing.
5. Finally, conclusion, recommendation may be little overstated. I think more correct statement
is that study does not allow you to recommend PEI before emergency endoscopy for patients
with AEVB to be performed routinely and decision to prophylactically intubate should stay on
case by case basis till more information is collected.
Probably the most robust data support statement that extubation within 24 hrs results in lesser
cardiopulmonary complication and shorter LOS .
Review for 10.1186/s12876-025-04066-9 (2025)

Title: Prophylactic endotracheal intubation prior to emergency endoscopy for acute
esophagogastric variceal hemorrhage: A retrospective single center study
Version: 1 Date: 18 May 2025
Reviewer's report:
#1.The usual considerations by the physicians to choose PEI while performing endoscopy are
unstable hemodynamics, acute respiratory distress, bleeding needing massive blood  transfusion.
It seems not to be shown in the table for comparison.
#2.Would you try to do the study with propensity score matching reduced bias in these two
groups.
#3.The study give no new knowledge about the use of PEI for acute UGI  bleeding. The point
of early extubation within 24 hours if doing PEI had less complications. Would you to rewrite
the title for more concise to this finding?
Review for 10.1186/s12876-025-04066-9 (2025)

Title: Prophylactic endotracheal intubation prior to emergency endoscopy for acute
esophagogastric variceal hemorrhage: A retrospective single center study
Version: 2 Date: 28 May 2025
Reviewer:  Mehmet Turan Inal
Reviewer's report:
Good work
Review for 10.1186/s12876-025-04066-9 (2025)

Title: Prophylactic endotracheal intubation prior to emergency endoscopy for acute
esophagogastric variceal hemorrhage: A retrospective single center study
Version: 2 Date: 29 May 2025
Reviewer:  #ahin Temel
Reviewer's report:
Thank you for your detailed responses and careful revisions. I have re-reviewed your manuscript,
the revised supplementary material, and your point-by-point response. The revised manuscript
is significantly improved and scientifically sound. I recommend acceptance pending minor
language edits. The authors are commended for their responsiveness and the clinical relevance
of their findings regarding PEI and early extubation in patients with acute upper GI bleeding
and cirrhosis.
Review for 10.1186/s12876-025-04080-x (2025)

Title: Global burden of early-onset gallbladder and biliary tract cancer from 1990 to 2021
Version: 1 Date: 25 Apr 2025
Reviewer's report:
The manuscript by Liu et. al. described the global burden of gallbladder and biliary tract cancers
in younger individuals (EOGBTC patients). The data are well presented, and their findings are
relevant for EOGBTC research. A few minor revisions could further strengthen the manuscript.
The discussion is very well written, and the limitations of the study are clearly presented, which
helps to contextualize the findings and makes the interpretation of the results much easier to
follow. It would be interesting to explore why ASIR and ASPR are increasing and ASMR and
ASDR showed downward trends in these patients. Adding some potential explanations (such as
changes in lifestyle, screening practices, or access to healthcare) could provide valuable context
for these trends.
The color scheme of figure 4 is difficult to interpret, as similar color tones are used for countries
within the same region, making it hard to distinguish between them, combining color with shape
or pattern could improve clarity. Also, the text within the plots of figures 4 and 5 are quite small
and difficult to read. Increasing the font size would really help improve the figure's readability.
Review for 10.1186/s12876-025-04080-x (2025)

Title: Global burden of early-onset gallbladder and biliary tract cancer from 1990 to 2021
Version: 1 Date: 27 Apr 2025
Reviewer's report:
This manuscript presents an epidemiological study assessing the burden of early-onset
gallbladder and biliary tract cancer (EOGBTC) among individuals under 50 years old from 1990
to 2021, using data sourced from the Global Burden of Disease Study 2021. The authors calculate
average annual percentage changes (AAPCs) and age-standardized rates (ASRs) to analyze
trends in incidence, prevalence, and mortality. Findings indicate a notable rise in prevalence
and incidence, with a significant burden concentrated in East Asia and South Asia, particularly
in regions classified as having middle, low-middle, and low socio-demographic indices (SDI).
Decomposition analysis identifies population growth as a critical factor influencing the disease
burden, while health inequalities have shown improvement over the study period. Projections
indicate an anticipated increase in global EOGBTC incidence and prevalence by 2040, despite
a downward trend in mortality and disability-adjusted life years (DALYs).
comments:
Please provide comprehensive details regarding the classifications of GBD super regions used in
this analysis. Understanding these classifications is important for contextualizing the geographic
disparities.
A more thorough explanation of the methodologies used for calculating confidence intervals
(CIs) is needed. Additionally, please improve the interpretation of these intervals in relation to
the study's findings to clarify their significance.
The authors should expand upon the public health implications of their findings. A discussion on
how this research can inform policy development, healthcare strategies, and resource allocation
would enhance the manuscript.
Additional context regarding the GBD modeling framework utilized would strengthen the
manuscript. Information on the assumptions, limitations, and analytical approaches in the GBD
framework would be valuable.
Please clarify how uncertainty intervals (UIs) were calculated in this study. Providing this
information will help the reader understand the reliability of the reported data.
The rationale for the study could be further developed. I recommend integrating more recent
literature to provide a stronger basis for the significance of investigating EOGBTC trends and
epidemiology.
The manuscript should maintain consistency in decimal representation throughout the text. It
would be helpful to standardize either one decimal place (e.g., 0.0) or two decimal places (e.g.,
0.00) to enhance professionalism and readability.
The manuscript includes some outdated references. I encourage the authors to incorporate more
recent literature to present updated estimates and insights on EOGBTC.
Sincerely,
Review for 10.1186/s12876-025-04080-x (2025)

Title: Global burden of early-onset gallbladder and biliary tract cancer from 1990 to 2021
Version: 2 Date: 28 May 2025
Reviewer's report:
This manuscript assesses the global burden of early-onset gallbladder and biliary tract cancer
(EOGBTC) from 1990 to 2021, particularly among individuals under 50 years old. By utilizing
data from the Global Burden of Disease Study 2021, the authors calculate average annual
percentage changes (AAPCs) and age-standardized rates (ASRs) to analyze trends in prevalence,
incidence, mortality, and disability-adjusted life years (DALYs) associated with EOGBTC.
The findings reveal over 24,555 prevalent cases, 13,611 new cases, and approximately 8,777
deaths due to EOGBTC in 2021. Notably, East Asia and South Asia exhibit the highest disease
burdens, predominantly affecting populations in regions with middle, low-middle, and low
Sociodemographic Index (SDI). The study indicates that although the incidence and prevalence
rates are increasing, mortality and DALY rates show a declining trend. The authors utilize
statistical models, including decomposition analysis and health inequality assessments, to
elucidate the findings and forecast future trends, emphasizing the need for innovative healthcare
strategies to address this significant health challenge.
Review for 10.1186/s12876-025-04057-w (2025)

Title: Association of serum lactate dehydrogenase levels with non-alcoholic fatty liver disease
and advanced hepatic fibrosis in the United States: a cross-sectional study using NHANES data
from 2007 to 2018
Version: 1 Date: 14 Feb 2025
Reviewer's report:
Thank you for the opportunity to review this work.
This is an interesting and novel study, and I believe some minor revisions and clarifications are
needed in order for future publication.
Specific Comments:
Lines 125-127: You mention that LDH was separated into tertiles, but then describe “quartile”
1,2,3. This should be changed to “tertile” 1,2,3.
Furthermore, what is the justification for turning LDH into a categorical variable? This is
naturally a continuous variable, and you are sacrificing information by categorizing it.
Lines 143-144, 150-153: Again, what is the reason for turning age, BMI, PIR into categories?
These are continuous variables.
Lines 206-208: What is the meaning of “#: 20.977, 95% CI: 15.757-26.197, P < 0.0001.” If LDH
is separated into tertiles, what is this coefficient telling us? I have the same question for the OR
for NAFLD: “OR: 2.717, 95% CI: 2.001-3.688.”
Line 226: Can you explain the nature of this non-linear relationship more? It’s unclear from
just the plot.
Review for 10.1186/s12876-025-04057-w (2025)

Title: Association of serum lactate dehydrogenase levels with non-alcoholic fatty liver disease
and advanced hepatic fibrosis in the United States: a cross-sectional study using NHANES data
from 2007 to 2018
Version: 1 Date: 15 Feb 2025
Reviewer's report:
Dear Authors,
Thank you for your submission. I have reviewed the manuscript thoroughly and provided
several comments aimed at enhancing the credibility of the study. These suggestions cover
various aspects, including statistical analysis, clarity in terminology, and the discussion of key
limitations. I believe that addressing these comments will strengthen the manuscript and improve
its overall quality.
I look forward to your revised version and am confident that these revisions will further enrich
the study.
Best regards,
Review for 10.1186/s12876-025-04057-w (2025)

Title: Association of serum lactate dehydrogenase levels with non-alcoholic fatty liver disease
and advanced hepatic fibrosis in the United States: a cross-sectional study using NHANES data
from 2007 to 2018
Version: 2 Date: 20 May 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
The responses are satisfactory
Review for 10.1186/s12876-025-04057-w (2025)

Title: Association of serum lactate dehydrogenase levels with non-alcoholic fatty liver disease
and advanced hepatic fibrosis in the United States: a cross-sectional study using NHANES data
from 2007 to 2018
Version: 2 Date: 20 May 2025
Reviewer's report:
The authors have adequately addressed  my original comments - I have no further suggestions.
Review for 10.1186/s12876-025-04078-5 (2025)

Title: Neuroendocrine Carcinoma of Esophagus: Systematic Review and Meta-analysis of Case
Series
Version: 1 Date: 03 Mar 2025
Reviewer's report:
The authors conducted a systematic review and meta-analysis of ENEC, but several areas require
further refinement:
1.How did the authors address missing data in their analysis?
2.Could the authors perform stratified analyses to investigate prognostic differences between
different pathological types of ENEC?
3.Please analyze and discuss the high heterogeneity observed in some of the results.
4.Further discussion of combined treatment strategies, particularly in locally advanced cases,
would be beneficial.
Review for 10.1186/s12876-025-04078-5 (2025)

Title: Neuroendocrine Carcinoma of Esophagus: Systematic Review and Meta-analysis of Case
Series
Version: 1 Date: 19 Apr 2025
Reviewer:  Zixian Jin
Reviewer's report:
This is a systematic review and meta-analysis on esophageal neuroendocrine carcinoma that has
yielded several valuable conclusions. However, I would like to raise a few questions that require
clarification from the authors.
The study primarily relies on retrospective data from China, Japan, and the United States, with
some studies having very small sample sizes. It remains unclear whether there was any patient
overlap across these studies, which requires further clarification from the authors.
Significant heterogeneity was observed in several subgroup analyses. Although a random-effects
model was employed for all patient analyses, this high heterogeneity needs to be properly
addressed - either through additional explanation or sensitivity analyses - otherwise the findings
may lack sufficient persuasiveness.
In the background section, the authors mentioned: "The NANETS guidelines advise resection of
a primary regional gastroenteropancreatic (GEP) NEC only in carefully selected cases, whereas
the ENETS guidelines generally recommend surgery of the primary tumor, except for stage III
esophageal NEC . There are studies reporting surgical resection may not affect the prognosis,
particularly in metastatic cases; however, chemoradiation alone or as adjuvant systemic therapy
has been beneficial and improved survival." For the studies included in this meta-analysis,
more detailed information should be provided regarding the specific surgical approaches and
chemoradiotherapy regimens employed.
Review for 10.1186/s12876-025-04078-5 (2025)

Title: Neuroendocrine Carcinoma of Esophagus: Systematic Review and Meta-analysis of Case
Series
Version: 3 Date: 25 May 2025
Reviewer's report:
Thank you for the author's response. I am quite satisfied with the revised manuscript and believe
it is ready for publication.
Review for 10.1186/s12876-025-04072-x (2025)

Title: Hospital-based prevalence and predictors of upper gastrointestinal bleeding in Northern
Uganda: A retrospective cross-sectional study
Version: 0 Date: 09 Mar 2025
Reviewer's report:
This was a well written article with significant relevance to the field.
However the following issues have to be addressed
firstly, although  acknowledged  by the author as a limitation , NSAIDS was not clearly stated as
one of the causes , this is a significant limitation as we know that it constitutes one of the major
causes of bleeding worldwide. Its inclusion would have impacted the study greatly.
Secondly ,inclusion criteria should be clearer , were the subjects 18 years or had to be 18 and
above.
UGIB can occur from liver cirrhosis  caused by schistosomiasis  and alcohol , yet you had another
group represented under liver cirrhosis, what were the underlying causes of liver cirrhosis in
your study ?
Overall the data was well represented and analysed
The study could contribute to the existing knowledge but it could be improved by further
addressing the above issues
Review for 10.1186/s12876-025-04072-x (2025)

Title: Hospital-based prevalence and predictors of upper gastrointestinal bleeding in Northern
Uganda: A retrospective cross-sectional study
Version: 2 Date: 25 Apr 2025
Reviewer:  Amsalu Feleke
Reviewer's report:
Kindly refer to the uploaded document for detailed comments and suggestions.
Review for 10.1186/s12876-025-04072-x (2025)

Title: Hospital-based prevalence and predictors of upper gastrointestinal bleeding in Northern
Uganda: A retrospective cross-sectional study
Version: 2 Date: 27 Apr 2025
Reviewer's report:
The issues raised have been addressed to an acceptable level.
The writer  has tried to correct and include all the comments raised by me .
Firstly they included  that not identifying NSAIDS as a major cause was a major limitation.
Secondly they  made clearer the age group of the subjects for this study.
Thirdly, those affected by liver cirrhosis have correctly grouped .
This article can be considered for publication if other reviewers are satisfied.
Review for 10.1186/s12876-025-04017-4 (2025)

Title: The Diagnostic Value of MRI-PDFF in Hepatic Steatosis of Patients with metabolic
dysfunction-associated steatotic liver disease: A Systematic Review and Meta-Analysis
Version: 1 Date: 11 Mar 2025
Reviewer:  Ioan Sporea
Reviewer's report:
This is an important meta-analysis with implication for practice. Despite in this moment we
have many methods for ultrasound based fatty quantification, in some geographical areas, like
USA, MRI-PDFF is used in many patients (this maybe in connection with high grade obesity
of the patients). This meta-analysis is well made, with quite a good number of subjects. The
only concern is about the terminology: from 2023 (Rinella paper) we use the term of MASLD
that replaced NAFLD. Despite the papers that you used in this meta-analysis come from the era
when the term of NAFLD (and NASH) was used, you must discuss about the new nomenclature
in the paper, to have a modern paper!