JerMa88/BMC_Gastroenterology_Peer_Reviews huggingface dataset:
Review for 10.1186/s12876-024-03196-w (2024)

Title: Feasibility and repeatability of ultrasound-guided surface electroenterography to measure
colonic slow wave motility in healthy adults
Version: 1 Date: 12 Dec 2023
Reviewer's report:
Dear authors
This paper describes a technique for recording human colonic slow waves with surface
electrodes. The electrodes were positioned using ultrasound. You have also tested the
repeatability of the technique. It is a nice procedure.
I have a few questions.
1. One of the key aspects of your paper is to assess the repeatability of the results. The electrodes
were placed using ultrasound the first time and then ~2 weeks later the test was repeated with
the electrodes placed in the same location as in the first recording. To ensure the electrodes were
on the colon in all locations, why wasn’t the ultra sound used for the second recording? Long
lengths of the colon are not fixed,  the second electrode placement may have been just off or
completely off the colon. By not using the same placement protocol for the 2 recordings can you
really say you have assessed the repeatability of the recordings? Had you used the ultrasound
the second time, you would have been able to address whether or not the regions of the colon
where in the same anatomical location within in the body. Given the electrodes must be close to
colon to get an accurate recording, reasonably precise placement is essential isn’t it?
2. The transverse colon and sigmoid colon often overlay part of the descending colon. In adults
and children with constipation, the sigmoid colon can sit behind or over the ascending, transverse
or sigmoid colon. How does ultrasound distinguish between these overlapping regions?
3. While the reproducibility of the results was statistically poor, it appears the results diffed
by only 0.5cpm. As you have stated in the paper the colonic slow wave frequency is between
2-6cpm. Therefore is there any clinical relevance at all in a difference of 0.5cpm. Both the first
and second recordings  appear to fall well within the normal range.
4. Based upon this slight difference in repeatability findings you also suggest, at line 210-11,
that “the low repeatability limits the usability of the studied measurement protocol for adequate
assessment of colonic motility”. Why do you say this? Again do you have any evidence to
suggest that a difference of 0.5cpm makes any difference to the measurements of colonic
motility? I would suggest the differences fall well within an acceptable margin of error.
5. Manometric studies, show that nearly all patient groups display dominant 2-6cpm activity
in the colon and that this activity increases after a meal. Therefore I wonder how you see this
technique being used in a clinical setting? If it can only detect the presence of slow wave
activity, what can it add to the diagnosis? Using your system, a healthy adult would likely have
a recordings very similar to a patient with IBS. Some discussion of what this technique could
add to diagnostics could be added.
Review for 10.1186/s12876-024-03196-w (2024)

Title: Feasibility and repeatability of ultrasound-guided surface electroenterography to measure
colonic slow wave motility in healthy adults
Version: 1 Date: 16 Dec 2023
Reviewer's report:
The study investigated the efficacy of body-surface colonic recordings in ten human subjects.
Metrics derived from the frequency domain were compared between pre and postprandial states,
as well as between regions of the colon. Furthermore, a repeatability test was conducted in a
second session for each subject with the same protocols as the first session.  The main finding
was changes in metrics were observed depending on the meal state as well as region of the colon.
Reproducibility of the test was poor. I have made the following comments and suggestions for
the authors to consider in order to improve the manuscript.
Major
Line 100-13 Given the typical frequency of colonic slow wave activity is 2-6 cpm, a 20 min
recording would only contain between 40-120 cycles of events (likely towards the lower end), it
is questionable whether the duration is sufficient in capturing the pre and postprandial changes
of colonic slow waves. Furthermore, it is possible that the anticipation of meal and distention of
the stomach triggers neurohumoral pathways that affect the distal gut, the role of which should
be further discussed.
Line 145 – Would be more appropriate to consider a 2-way test (e.g., 2 way ANOVA) of
each sEEnG metric with meal-state (i.e., pre -and postprandial) as one factor and the region of
recording as the other factor? The problem of doing any one-way measures (e.g., Friendman
test) is it potentially misses the interaction between the two factors.
Line 190 – In addition to LCCC, it might be good to report the actual values of the different
metrics from the segment session to get an idea the magnitude of differences between the two
sessions. Also it could be more meaningful to consider comparing the normalized values of
metrics (e.g., frequency ratio between pre- and postprandial states) instead of the absolute values.
Line 307 – It is a bit unclear how the conclusion of the improved accuracy with ultrasound
guide was derived. Did the investigators specifically compare between guided and unguided
protocols? I would not consider the second session as ‘unguided’ since the anatomical locations
were documented based on ultrasound information in the first session. To be clear, I am not
questioning that improvement is made by ultrasound guided placement, just that it was not tested
in the present study.
Minor
Line 64 - ‘Colonic slow wave muscle activity’ should be just colonic slow wave activity, or the
authors may wish to specify whether it is the pacemaker or the muscle that is the origin of the
surface activity recorded.
Line 135 – A minor issue of taking the area average of power of 2 cpm centered around the
dominant frequency is when the dominant frequency is lower than 3.5 cpm, then the lower band
could go lower than the cutoff of 1.5 cpm. Similar could be applied to dominant frequencies
higher than 8 cpm, although it would be unlikely.
Review for 10.1186/s12876-024-03196-w (2024)

Title: Feasibility and repeatability of ultrasound-guided surface electroenterography to measure
colonic slow wave motility in healthy adults
Version: 1 Date: 18 Dec 2023
Reviewer's report:
In this study the authors have conducted ultrasound-guided electroenterography measurements
to measure colonic slow-wave muscle activity within 10 healthy adults. This study is within the
scope of the journal and the manuscript is well written. However it needs several clarifications/
changes before further assessment.
1) The novelty of this study lies in the use of ultrasound to guide electrode placement. But details
on this methodology are lacking i.e the single Figure 1 does not accurately show the link between
ultrasound and electrode placement.
2) One of the major limitations of the current methodology is the fact that the stomach's electrical
activity was not taken into account during the data processing, and this is justified by: "However,
it is not plausible that all measured activity originated in the stomach, because the largest
relative postprandial motility increase was not observed in the middle colon, which included
the electrodes closest to the stomach. " This statement is contradictory to that in Lines 185-176:
"Nevertheless, note that the median postprandial MPD is nearly twice as high as in the middle
colon compared to the proximal and distal colon."
There needs to be more justification as to why the stomach's electrical activity is not being
captured by the current data analysis.
Review for 10.1186/s12876-024-03196-w (2024)

Title: Feasibility and repeatability of ultrasound-guided surface electroenterography to measure
colonic slow wave motility in healthy adults
Version: 5 Date: 12 Feb 2024
Reviewer:  Phil G. Dinning
Reviewer's report:
Dear Authors
I am satisfied with your responses to my questions. No further questions
Review for 10.1186/s12876-024-03196-w (2024)

Title: Feasibility and repeatability of ultrasound-guided surface electroenterography to measure
colonic slow wave motility in healthy adults
Version: 5 Date: 20 Feb 2024
Reviewer's report:
The authors have addressed all of the comments raised previously by the reviewers, and therefore
this version of the manuscript is acceptable for publication.
Review for 10.1186/s12876-024-03202-1 (2024)

Title: Poly-#-caprolactone scaffold as staple-line reinforcement of rectal anastomosis: An
experimental piglet study
Version: 1 Date: 06 Dec 2023
Reviewer's report:
PEER REVIEWER ASSESSMENTS:
OBJECTIVE - Full research articles: is there a clear objective that addresses a testable research
question(s) (brief or other article types: is there a clear objective)?
Yes - there is a clear objective
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for
the objective?
Yes - the approach is appropriate
EXECUTION - Are the experiments and analyses performed with technical rigor to allow
confidence in the results?
Yes - experiments and analyses were performed appropriately
STATISTICS - Is the use of statistics in the manuscript appropriate?
Yes - appropriate statistical analyses have been used in the study
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not
overstated?
Yes - the author's interpretation is reasonable
OVERALL MANUSCRIPT POTENTIAL - Is the current version of this work technically
sound? If not, can revisions be made to make the work technically sound?
Yes - current version is technically sound
PEER REVIEWER COMMENTS:
GENERAL COMMENTS: The authors present a very interesting research study using a scaffold
in order to improve the quality of the anastomosis in colorectal surgery. They present a case
series in animal model of the proposed scaffold. The study is correctly conduced respecting
ethical principles about animal wellness. The results are presented very well with completeness.
The findings are about the usefulness of a scaffold in order to improve the quality of colorectal
anastomosis. They experimented that the histologic findings prove that the quality of the
anastomosis is improved because of it impacts in the quality of the scar tissue around the
anastomosis itself that is quite reasonable due to the use of the scaffold. It is not usual to imagine
to use devices to improve anastomosis despite anastomosis leakage remains a major problem
in this surgical field. The results should be an important starting point for further studies and
evaluations.
Review for 10.1186/s12876-024-03202-1 (2024)

Title: Poly-#-caprolactone scaffold as staple-line reinforcement of rectal anastomosis: An
experimental piglet study
Version: 1 Date: 10 Dec 2023
Reviewer:  Akira Umemura
Reviewer's report:
The authors could not demonstrate the speriority of PCL scaffold in rectal anastomosis. These
results can not be lead to the conclusion of sfae use of scaffold...Usual rectal anastomosis is
perfomed under severe edematous and inflammatory condition; therefore, you should duplicate
the same condition as usual clinical practice.
Review for 10.1186/s12876-024-03202-1 (2024)

Title: Poly-#-caprolactone scaffold as staple-line reinforcement of rectal anastomosis: An
experimental piglet study
Version: 1 Date: 18 Dec 2023
Reviewer's report:
First of all, I would like to congratulate you for the work you have done. I would like to say
that it is a very nice work. The fact that the article is written in a very fluent language really
deserves appreciation.
I would like to add a few criticisms
1- It would be better to consider adding another group whose effectiveness has been shown in
previous studies. for example stem cells.
2- When I examined the reference section, I saw only 3 reference articles published in the last
5 years. I believe the references definitely need to be updated.
Review for 10.1186/s12876-024-03202-1 (2024)

Title: Poly-#-caprolactone scaffold as staple-line reinforcement of rectal anastomosis: An
experimental piglet study
Version: 4 Date: 11 Jan 2024
Reviewer:  Akira Umemura
Reviewer's report:
Please write reply letter by using point-by-point answer. I could not evaluate the accuracy of your
revision from your reply. Please provide more concise letter. If all the authors have provided
few comments,  please desribe so.
Review for 10.1186/s12876-024-03202-1 (2024)

Title: Poly-#-caprolactone scaffold as staple-line reinforcement of rectal anastomosis: An
experimental piglet study
Version: 4 Date: 16 Jan 2024
Reviewer's report:
First of all, I would like to thank you for this meticulously carried out work. I reviewed the
revised version of the article. I see that the references are still not up to date. While there are
many beautiful works that have been done, it is not appropriate not to mention them at all. I
do not find it appropriate to complete the study based on very old references. Also, we cannot
say that the method used is usable. We cannot say that it is useful. There is nothing proven in
the article. The study does not improve a previously known method. I think this article should
not be accepted.
Review for 10.1186/s12876-024-03202-1 (2024)

Title: Poly-#-caprolactone scaffold as staple-line reinforcement of rectal anastomosis: An
experimental piglet study
Version: 4 Date: 17 Jan 2024
Reviewer's report:
PEER REVIEWER ASSESSMENTS:
OBJECTIVE - Full research articles: is there a clear objective that addresses one or several
testable research questions? (Brief or other article types: is there a clear objective?)
Yes - there is a clear objective
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for
the objective?
Yes - the approach is appropriate
EXECUTION - Are the experiments and analyses performed with sufficient technical rigor to
allow confidence in the results?
Yes - experiments and analyses were performed appropriately
STATISTICS - Is the use of statistics in the manuscript appropriate?
Yes - appropriate statistical analyses have been used in the study
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not
overstated?
Yes - the author's interpretation is reasonable
OVERALL MANUSCRIPT POTENTIAL - Has the author addressed your concerns sufficiently
for you to now recommend the work as a technically sound contribution? If not, can further
revisions be made to make the work technically sound?
Yes - current version is technically sound
PEER REVIEWER COMMENTS:
GENERAL COMMENTS: 1) yes, the authors responded adequately to the questions provided
in the comments 2)yes, the authors made correct changes in the manuscript without changing
the sense of the manuscript 3) the manuscript is now feasible for publication
ADDITIONAL REQUESTS/SUGGESTIONS:
no
Review for 10.1186/s12876-024-03202-1 (2024)

Title: Poly-#-caprolactone scaffold as staple-line reinforcement of rectal anastomosis: An
experimental piglet study
Version: 6 Date: 25 Feb 2024
Reviewer:  Akira Umemura
Reviewer's report:
The authors have appropriately replied for reviewers' suggestions.
Review for 10.1186/s12876-024-03202-1 (2024)

Title: Poly-#-caprolactone scaffold as staple-line reinforcement of rectal anastomosis: An
experimental piglet study
Version: 6 Date: 26 Feb 2024
Reviewer's report:
First of all, I would like to thank the work team. It can be seen that the expected corrections
for the study have been made. I don't see any harm in publishing it. I think it will contribute
to the literature.
Review for 10.1186/s12876-024-03168-0 (2024)

Title: Association of lymphocyte subsets with the efficacy and prognosis of PD#1 inhibitor
therapy in advanced gastric cancer: results from a monocentric retrospective study
Version: 0 Date: 20 Oct 2023
Reviewer's report:
PEER REVIEWER ASSESSMENTS:
OBJECTIVE - Full research articles: is there a clear objective that addresses a testable research
question(s) (brief or other article types: is there a clear objective)?
Yes - there is a clear objective
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for
the objective?
No - there are minor issues
EXECUTION - Are the experiments and analyses performed with technical rigor to allow
confidence in the results?
Yes - experiments and analyses were performed appropriately
STATISTICS - Is the use of statistics in the manuscript appropriate?
Yes - appropriate statistical analyses have been used in the study
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not
overstated?
No - there are minor issues
OVERALL MANUSCRIPT POTENTIAL - Is the current version of this work technically
sound? If not, can revisions be made to make the work technically sound?
Probably - with minor revisions
PEER REVIEWER COMMENTS:
GENERAL COMMENTS: This is an interesting paper about new possibilities for the treatment
of advanced gastric cancer. The authors did a detailed analysis about multiple markers in the
blood sample which could enter clinical practice in the future.
REQUESTED REVISIONS:
It seems that they have included all advanced patients in the analysis. Is it possible to differentiate
between metastatic from locally advanced and assess any difference? They have seen that
advanced metastatic disease could have an impact on the results. Maybe dividing them from the
locally advanced could give more information.
- Line 79-80: review the sentence
ADDITIONAL REQUESTS/SUGGESTIONS:
As stated above
Review for 10.1186/s12876-024-03168-0 (2024)

Title: Association of lymphocyte subsets with the efficacy and prognosis of PD#1 inhibitor
therapy in advanced gastric cancer: results from a monocentric retrospective study
Version: 1 Date: 11 Nov 2023
Reviewer's report:
PEER REVIEWER ASSESSMENTS:
OBJECTIVE - Full research articles: is there a clear objective that addresses one or several
testable research questions? (Brief or other article types: is there a clear objective?)
Yes - there is a clear objective
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for
the objective?
No - there are minor issues
EXECUTION - Are the experiments and analyses performed with sufficient technical rigor to
allow confidence in the results?
No - there are minor issues
STATISTICS - Is the use of statistics in the manuscript appropriate?
Yes - appropriate statistical analyses have been used in the study
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not
overstated?
No - there are minor issues
OVERALL MANUSCRIPT POTENTIAL - Has the author addressed your concerns sufficiently
for you to now recommend the work as a technically sound contribution? If not, can further
revisions be made to make the work technically sound?
Probably - with minor revisions
PEER REVIEWER COMMENTS:
GENERAL COMMENTS: - The authors responded to my question just mentioning NCCN
guidelines. Not analyzing what could be a potential implication of a different response of
metastatic patients compared to locally advanced. Clinical practice guidelines, like NCCN, are
of course based on the current knowledge of the disease. But in this study it is discussed a
possible future management of advanced gastric cancer; so, in my opinion, we should think "out
of the box" and maybe discuss all the possible scenarios. At least this point should be mentioned
by the authors in the Discussion section.
- I can also see that they have not responded adequately to the several questions of the other
reviewer
REQUESTED REVISIONS:
mentioned above
ADDITIONAL REQUESTS/SUGGESTIONS:
as commented before
Review for 10.1186/s12876-024-03168-0 (2024)

Title: Association of lymphocyte subsets with the efficacy and prognosis of PD#1 inhibitor
therapy in advanced gastric cancer: results from a monocentric retrospective study
Version: 1 Date: 05 Dec 2023
Reviewer's report:
Authors have correctly changed some of the reviewer’s comments, albeit there are some caveats
that need to be addressed. Again, I congratulate the authors for this study, which will be very
useful in the clinical practice if, at my point of view, they differentiate the different patient
cohorts included.
Patients with dMMR (n=9) and pMMR (n=186) tumours should be analyzed separately. Also,
patients receiving chemotherapy plus IO (n=173) from patients receiving IO +/- anti-angiogenic
agents (n=22) should be distinctly addressed. Finally, a distinctive analysis should be added
separating patients receiving IO in the 1st line setting (treatment naïve patients, n=53) from
others (n=142).
Efficacy is reported if CR, PR or SD at the CT scan performed at 3 months. Nevertheless,
in patients receiving chemotherapy, SD at 3 months is normally achieved. This should be
considered: the term “efficacy” is too optimistic.
Differences in PFS lower than 1 months, although statistically significant, aren’t clinically
relevant. Although gastric cancer is an aggressive disease, differences lower than 1 months are
irrelevant in the 1st and 2nd line setting.
Finally, dMMR status should be defined only in those tumours that loose two of the 4 MMR
proteins. If only one protein is loosed, then the diagnosis should be confirmed by PCR.
Review for 10.1186/s12876-024-03168-0 (2024)

Title: Association of lymphocyte subsets with the efficacy and prognosis of PD#1 inhibitor
therapy in advanced gastric cancer: results from a monocentric retrospective study
Version: 4 Date: 02 Jan 2024
Reviewer's report:
In this third version of the manuscript, authors have added different sentences suggesting
possible future investigations for answering the comments provided for the 2 reviewers.
Unfortunately, they haven’t been able to address them.
Review for 10.1186/s12876-024-03168-0 (2024)

Title: Association of lymphocyte subsets with the efficacy and prognosis of PD#1 inhibitor
therapy in advanced gastric cancer: results from a monocentric retrospective study
Version: 4 Date: 02 Jan 2024
Reviewer's report:
PEER REVIEWER ASSESSMENTS:
OBJECTIVE - Full research articles: is there a clear objective that addresses one or several
testable research questions? (Brief or other article types: is there a clear objective?)
Yes - there is a clear objective
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for
the objective?
Yes - the approach is appropriate
EXECUTION - Are the experiments and analyses performed with sufficient technical rigor to
allow confidence in the results?
Yes - experiments and analyses were performed appropriately
STATISTICS - Is the use of statistics in the manuscript appropriate?
Yes - appropriate statistical analyses have been used in the study
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not
overstated?
Yes - the author's interpretation is reasonable
OVERALL MANUSCRIPT POTENTIAL - Has the author addressed your concerns sufficiently
for you to now recommend the work as a technically sound contribution? If not, can further
revisions be made to make the work technically sound?
Yes - current version is technically sound
PEER REVIEWER COMMENTS:
GENERAL COMMENTS: The authors have responded to my concerns and changed the
manuscript.
ADDITIONAL REQUESTS/SUGGESTIONS:
no
Review for 10.1186/s12876-024-03168-0 (2024)

Title: Association of lymphocyte subsets with the efficacy and prognosis of PD#1 inhibitor
therapy in advanced gastric cancer: results from a monocentric retrospective study
Version: 6 Date: 08 Feb 2024
Reviewer's report:
In this last version of the manuscript, authors have correctly modified all those queries with
enough potential to be addressed. The effort is much recognized, and I congratulate the authors
for this important effort. I think this manuscript can be accepted for publication.
Review for 10.1186/s12876-024-03194-y (2024)

Title: Prognostic factors of pancreatic tumors in children and adolescents: A population study
based on the Surveillance, Epidemiology, and End Results Database
Version: 3 Date: 18 Dec 2023
Reviewer's report:
This is an interesting population-based study examining prognostic factors for pancreatic tumors
in children using the SEER database. There are a few major issues that need to be addressed:
1) Selection bias - The study includes only patients from the SEER database, which does not
have national coverage. This may limit the generalizability of findings. I would suggest the
authors acknowledge this limitation in the discussion.
2) Information bias - The SEER database lacks detailed information on tumor characteristics,
treatments, and outcomes. Important prognostic information may be missing. Please discuss
how this could impact your results.
3) Confounding - There may be factors that influence both the exposures/treatments and
outcomes in this observational study. For example, patients selected for surgery may have
less advanced tumors. The use of multivariable models helps account for this, but residual
confounding is likely.
4) Small sample size - Given the rarity of these tumors, the study is underpowered to detect
smaller differences in survival between groups. This should be noted as a major limitation,
especially for the subgroup and multivariable analyses.
5) Clarity of objectives - The purpose statement focuses on examining clinicopathological
features and prognosis. However, the results and discussion emphasize prognostic factors. Please
clarify the main objective(s) of your study.
6) Analysis issues - Were assumptions of proportional hazards met for Cox models? This should
be assessed.
Minor issues:
- Standardize terminology for pancreatic tumors throughout the manuscript
- Carefully proofread manuscript to fix typos, grammatical issues
- Improve flow between sections
- Provide descriptive statistics for continuous variables (mean/median, range etc)
Review for 10.1186/s12876-024-03194-y (2024)

Title: Prognostic factors of pancreatic tumors in children and adolescents: A population study
based on the Surveillance, Epidemiology, and End Results Database
Version: 3 Date: 19 Dec 2023
Reviewer's report:
Pancreatic tumors in children and adolescents are exceptionally uncommon, yet they
demonstrate a more favorable overall prognosis compared to their adult counterparts. In this
study, the authors aim to elucidate the epidemiological features and prognostic factors associated
with pancreatic tumors, utilizing data from the SEER database. This endeavor represents
a valuable exploration that enhances our understanding of these tumors. However, several
questions arise from this study.
1. The morphological codes (pseudopapillary neoplasm: 8452; pancreatoblastoma: 8971;
endocrine tumors: 8240, 8246, 8150) utilized in the methods section facilitated the extraction of
case data from the SEER database. It is evident that case data pertaining only to three type of
tumors were extracted, thus excluding other types of pancreatic tumors. However, it is essential
for the authors to provide clarification regarding other types of pancreatic tumors that were
not included in this analysis. This clarification is of paramount importance and needs further
elaboration.
2. It is unnecessary to reiterate the description of the results and table contents within the
article, particularly the "Survival analysis" section. Avoiding such redundancy would enhance
the clarity and conciseness of the manuscript.
3. Regarding Table 4, which includes variables with multiple subgroups such as "SEER
stage," the presence of multiple p-values in the prognostic analysis requires an explanation.
Additionally, it is unclear why certain variables such as "Age" and "Tumor size" were excluded
from the prognostic analysis in Table 4. To provide a comprehensive demonstration, it is
recommended to present Table 1 and Table 4 together.
4. The purpose of displaying the 1-, 3-, and 5-year overall survival (OS) for each variable in
Table 3 need clarification. Specifically, the significance of the numbers in parentheses should
be explained. As the author has obtained factors that impact prognosis from subsequent survival
analysis, it is advisable to solely present the 1-, 3-, and 5-year OS for these prognostic variables.
5. The rationale behind separately displaying Figure 1 and Figure 2 is unclear. In my opinion,
it appears unnecessary to do so, and they could be combined.
6. The prognostic analysis of treatment methods in Figure 3 appears inappropriate since
different pathological subtypes inherently warrant different primary treatment approaches. For
instance, surgery is not the preferred treatment for early neuroendocrine tumors. Therefore, it is
recommended to conduct independent analyses for distinct pathological subgroups.
7. Lastly, it is suggested to include a discussion of the results from Table 2 in the discussion
section to provide a comprehensive interpretation of the findings.
Review for 10.1186/s12876-024-03194-y (2024)

Title: Prognostic factors of pancreatic tumors in children and adolescents: A population study
based on the Surveillance, Epidemiology, and End Results Database
Version: 6 Date: 05 Jan 2024
Reviewer's report:
Although the present study has some limitations, I recognize the overall value and merit of the
authors' work. After reviewing the revised manuscript, I have no further comments and fully
support the editor's final decision for publication.
Review for 10.1186/s12876-024-03194-y (2024)

Title: Prognostic factors of pancreatic tumors in children and adolescents: A population study
based on the Surveillance, Epidemiology, and End Results Database
Version: 6 Date: 07 Jan 2024
Reviewer's report:
The revised manuscript demonstrates the authors' efforts to enhance the article's quality.
However, I still have a few concerns that remain unaddressed.
1. Table 2 presents overall 1-, 3-, and 5-year survival rates, but it also includes corresponding
rates for each subgroup of variables. This inclusion is perplexing since the prognostic differences
for each variable have already been analyzed in Table 3. Consequently, the information
presented in Table 2 becomes statistically difficult to interpret, meaningless, and inappropriate.
2. The authors' survival analysis in Table 3 is also confusing. They attempt to conduct one-
by-one comparisons within subgroups of variables to demonstrate the corresponding p-values
and potential survival differences. However, there are two issues here. Firstly, performing one-
by-one comparisons for variables with more than two subgroups increases the likelihood of a
Type I error. Secondly, when conducting multiple comparisons of subgroups, the significance
level should no longer be 0.05, but rather adjusted to 0.05/n, where n represents the number of
multiple comparisons. The same issue applies to the multivariate Cox modeling. I recommend
seeking assistance from a statistics professional to address this problem adequately.
3. It is advisable to seek the assistance of a native English speaker to further refine the language.
Additionally, please ensure that the images are appropriately embellished, aligned neatly, have
consistent font sizes, and increased resolution.
I anticipate further revisions from the authors to enhance the manuscript's quality, and I am
willing to review it again.
Review for 10.1186/s12876-024-03194-y (2024)

Title: Prognostic factors of pancreatic tumors in children and adolescents: A population study
based on the Surveillance, Epidemiology, and End Results Database
Version: 7 Date: 25 Jan 2024
Reviewer's report:
This retrospective study examines prognostic factors for pancreatic tumors in 195 pediatric
patients, using the population-based SEER database from 1975-2018. The authors have
previously addressed general limitations regarding the lack of clinical details and treatment
response data in the database. However, despite the authors' analysis, I still have reservations
about the ability to overcome selection and information biases, e.g. the use of surgery is likely
heavily confounded by disease stage/biology, skewing its association with better survival;
details on surgical extent could significantly modify the interpretation of this major result; data
constraints broadly limit accounting for confounding influences on both treatment decisions and
outcomes
Given the grounded limitations of the analysis and the database, I do not believe that deeper
analysis would substantially improve or benefit the manuscript. I will respect the editor's final
decision on publication appropriateness.
Review for 10.1186/s12876-024-03194-y (2024)

Title: Prognostic factors of pancreatic tumors in children and adolescents: A population study
based on the Surveillance, Epidemiology, and End Results Database
Version: 7 Date: 26 Jan 2024
Reviewer's report:
I am satisfied with the revised manuscript, and the author's efforts to improve the quality of the
manuscript alleviate my concerns. I have no further comments.
Review for 10.1186/s12876-024-03194-y (2024)

Title: Prognostic factors of pancreatic tumors in children and adolescents: A population study
based on the Surveillance, Epidemiology, and End Results Database
Version: 7 Date: 27 Jan 2024
Reviewer's report:
Significance and Originality: The manuscript provides valuable insights into the epidemiology
and prognosis of pediatric pancreatic tumors, a notably understudied area in oncology. By
leveraging a large, population-based database, the study addresses a critical gap in the literature.
However, it would be beneficial to further highlight the unique contributions of this research
in the context of existing literature. The discussion section could be enhanced by comparing
and contrasting these findings with previous studies, particularly those that may have reported
contrasting results or insights. This comparison would not only reinforce the significance of the
current study but also provide a more comprehensive understanding of the state of research in
this field.
Methodological Rigor: The methodology, including patient selection and statistical analysis,
appears well-structured and appropriate for the study objectives. Nonetheless, there are a
few areas that could be improved for greater clarity and robustness. Firstly, a more detailed
explanation of the criteria for patient inclusion and exclusion would strengthen the study's
validity. Secondly, while the use of the SEER database is a strength, acknowledging its
limitations more thoroughly in the discussion would enhance the manuscript's credibility. This
includes potential biases and the generalizability of the findings. Lastly, the authors might
consider discussing the rationale behind the choice of statistical tests and the implications of
these choices for their findings.
Clinical Implications and Future Directions: The study's findings have significant implications
for the clinical management of pediatric pancreatic tumors, particularly emphasizing the role
of surgical intervention. It would be beneficial for the authors to more explicitly discuss these
implications, perhaps offering specific recommendations for clinical practice or guidelines based
on their findings. Additionally, the study opens avenues for future research, such as investigating
the biological mechanisms underlying the observed differences in survival rates between genders
and tumor types. Addressing these aspects would not only enhance the applicability of the study
but also guide future research efforts in this field.
In summary, while the study provides important contributions to our understanding of pediatric
pancreatic tumors, enhancing the discussion around its context in the broader literature,
clarifying methodological details, and expanding on its clinical implications would further
strengthen the manuscript.
Review for 10.1186/s12876-024-03194-y (2024)

Title: Prognostic factors of pancreatic tumors in children and adolescents: A population study
based on the Surveillance, Epidemiology, and End Results Database
Version: 8 Date: 27 Feb 2024
Reviewer's report:
The authors sincerely responded to the reviewer's comments, and the manuscript has been
revised appropriately.  I have no further comments.
Review for 10.1186/s12876-024-03190-2 (2024)

Title: Using new indices to predict Metabolism dysfunction-associated fatty liver disease
(MAFLD): Analysis of the National Health and Nutrition Examination Survey database.
Version: 0 Date: 08 Jan 2024
Reviewer's report:
This study presents a detailed and comprehensive analysis of new indices for predicting
Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD) using the NHANES database.
Here are some specific and professional suggestions for improvement:
Lifestyle and Environmental Factors: The study should consider the impact of lifestyle and
environmental factors on MAFLD and its predictors. Factors such as diet, exercise, alcohol
consumption, and exposure to environmental toxins could have significant effects on the disease
and its markers.
Biological Mechanisms: While the statistical associations are robust, a deeper exploration of the
biological mechanisms behind the observed relationships would be valuable. Specifically, how
AGTR, AIP, and UHR relate to the pathophysiology of MAFLD could be further elucidated.
Comparative Analysis with Established Models: To underscore the study's novelty, compare the
predictive performance of AGTR, AIP, and UHR with existing predictive models for MAFLD.
This comparison can provide context on how these new indices might improve or complement
current diagnostic practices.
External Validation and Diverse Populations: The study primarily utilizes NHANES data.
Conducting external validation in different cohorts, particularly those with diverse ethnic and
geographical backgrounds, can enhance the generalizability of the findings.
Longitudinal Study Design: Given the cross-sectional nature of NHANES data, a longitudinal
study design could provide insights into the progression of MAFLD and the long-term
applicability of these indices.
Cost-Effectiveness Analysis: Analyze the cost-effectiveness and practicality of implementing
these new indices in various healthcare settings, which would be valuable for healthcare
policymakers and practitioners.
Public Health Implications: Elaborate on the public health implications of these findings,
particularly in terms of MAFLD screening and prevention strategies.
The following references are recommended to be cited: PMID: 34234521; PMID: 33204721;
PMID: 34095297; PMID: 35958467; PMID: 35251371.
Expanded Subgroup Analysis: Widen the subgroup analyses to include additional relevant
demographic factors like ethnicity, socio-economic status, and lifestyle factors, which could
influence MAFLD risk and progression.
Clarification of Data Sources and Limitations: Address any potential biases or limitations
arising from using self-reported data and non-invasive diagnostic methods. This could involve
discussing the implications of these data sources on the study's findings.
Review for 10.1186/s12876-024-03190-2 (2024)

Title: Using new indices to predict Metabolism dysfunction-associated fatty liver disease
(MAFLD): Analysis of the National Health and Nutrition Examination Survey database.
Version: 2 Date: 26 Jan 2024
Reviewer's report:
I appreciate the thoroughness with which you responded to each of my comments. Your
explanations and modifications have significantly improved the clarity and quality of your
research paper. It is evident that you have taken great care in revising your work, and I am
pleased with the level of detail you have provided.
Review for 10.1186/s12876-024-03198-8 (2024)

Title: Comparison of vonoprazan and proton pump inhibitors for the treatment of gastric
endoscopic submucosal dissection-induced ulcer: An updated systematic review and meta-
analysis
Version: 1 Date: 04 Jan 2024
Reviewer's report:
Chen et al. conducted a sophisticated systematic review on post-ESD bleeding, highlighting the
superiority of vonoprazan over PPIs. The manuscript is well-written and informative.
1. It would be beneficial to address the potential influence of the gastric lesion's location
on delayed bleeding. If this information is available in the RCTs analyzed, please provide
clarification.
2. Considering the impact of the endoscopic knife type on delayed bleeding rates is crucial. If
feasible, please include details regarding the types of endoscopic knives used in the studies.
Review for 10.1186/s12876-024-03198-8 (2024)

Title: Comparison of vonoprazan and proton pump inhibitors for the treatment of gastric
endoscopic submucosal dissection-induced ulcer: An updated systematic review and meta-
analysis
Version: 1 Date: 16 Jan 2024
Reviewer's report:
This article adopts a randomized controlled method, involving a total of 926 patients, to compare
the incidence of complications after gastric mucosal dissection using  vonoprazan and PPI.
Compared with PPI,  vonoprazan has advantages in delayed bleeding, reasonable experimental
design, reliable data, and can be published.
Review for 10.1186/s12876-024-03198-8 (2024)

Title: Comparison of vonoprazan and proton pump inhibitors for the treatment of gastric
endoscopic submucosal dissection-induced ulcer: An updated systematic review and meta-
analysis
Version: 2 Date: 30 Jan 2024
Reviewer's report:
This article compared the therapeutic effects of vonoprazan and PPI in the treatment of
ulcer healing rate, reduction rate, delayed bleeding rate and perforation rate after endoscopic
dissection, and concluded that vonoprazan had more advantages in delayed bleeding rate.A total
of 926 patients were included in the article, which is sufficient for publication with reliable data.
Review for 10.1186/s12876-024-03198-8 (2024)

Title: Comparison of vonoprazan and proton pump inhibitors for the treatment of gastric
endoscopic submucosal dissection-induced ulcer: An updated systematic review and meta-
analysis
Version: 2 Date: 31 Jan 2024
Reviewer's report:
1. The authors should provide the registration number of this meta-analysis.
2. In the methods section, the authors should have specified the follow-up time for adverse
reactions in the vonoprazan and PPI groups.
3. Is there a risk of bias due to the different dosages administered in the vonoprazan and PPI
groups?
4. Why did the authors choose lansoprazole versus vonoprazan for the comparison of adverse
effects rather than other PPIs?
5. Language and grammar should be extensively improved.
#Some of the authors’ expressions are confusing, for example, the sentence “Is vonoprazan
superior to the PPIs remains controversial”.
#The sentence “there was no significant difference between the two groups in the healing rate
after ESD (RR 1.09, 95% CI 0.72-1.65, P = 0.70) with nonheterogeneity (I2 = 0%) (Fig. 3A)”
should be revised as “there was no significant difference between the two groups in the healing
rate after ESD (RR 1.09, 95% CI 0.72-1.65, P = 0.70) with no significant heterogeneity (I2 =
0%) (Fig. 3A)”.
6. The authors mentioned that “The assessment of various items showed a low risk of bias among
the included studies”, it seems unlikely that all studies were rated as low risk of bias in the meta-
analysis, and the authors should reassess all studies.
Review for 10.1186/s12876-024-03198-8 (2024)

Title: Comparison of vonoprazan and proton pump inhibitors for the treatment of gastric
endoscopic submucosal dissection-induced ulcer: An updated systematic review and meta-
analysis
Version: 6 Date: 27 Feb 2024
Reviewer's report:
1. The authors should revised delayed bleeding as delayed postoperative bleeding#DPPB).
2. In the point-by-point response, the authors should change the positions of comments 4 and 5.
Review for 10.1186/s12876-024-03192-0 (2024)

Title: The relationship between Sarcopenia and Metabolic dysfunction-associated fatty liver
disease among the young and middle-aged populations
Version: 0 Date: 03 Oct 2023
Reviewer's report:
Thank you for the opportunity to review this paper. I have several concerns about this
manuscript.
1. Terminology - the paper is predicated on the terminology MAFLD - which is not incorrect but
as authors will know, in June 2023, a global consensus suggested a change to the term MASLD.
This may well influence the approach to the entire manuscript. I the authors wish to use the
term MAFLD, can they please explain why this is so and what their justification is. It appears
the article was constructed before June 2023, but having only been submitted now, materially
influences the position of the term MAFLD. Using the term may well be reasonable but needs
justification.
2. The results section in the abstract needs to be re-written to contain actual results not
interpretation e.g."The relationship between the MAFLD and sarcopenia were mediated by C-
reactive protein and high-density lipoprotein cholesterol" - no indication of the actual data?
3. Conclusion (in abstract) -"Sarcopenia patients are more prone to MAFLD and MAFLD with
liver fibrosis." This does not make sense. Are you trying to say MAFLD is a risk factor for
sarcopenia and this risk increases with increasing liver fibrosis??
4. Line 212:"The association between MAFLD and sarcopenia was significant for both alcohol
drinkers [OR = 2.86 (95% CI: 1.46-5.61)] and people who sit for higher than three hours per
day [OR = 3.26 (95% CI: 1.91-5.57)], ..." How much alcohol?  Is this accounted for?
5. Is there a proposed pathogenic mechanism for HDL effect in mediating sarcopenia?
6. Line 56 and elsewhere : "Research" not researches
Overall the paper makes for interesting analyses. However I am of the view the manuscript
seemingly confuses aspects such as the proposed nomenclature change from NAFLD to MAFLD
(which is seemingly obsolete) .  The paper can well do with significant review in trimming down
many superfluous aspects and producing a clear message that sarcopenia associates with fatty
liver disease and this risk increases with increasing fibrosis.
Review for 10.1186/s12876-024-03192-0 (2024)

Title: The relationship between Sarcopenia and Metabolic dysfunction-associated fatty liver
disease among the young and middle-aged populations
Version: 2 Date: 28 Feb 2024
Reviewer:  Laurens A. van Kleef
Reviewer's report:
We thank the authors for their extensive review and further improvement of the manuscript.
The only issue remaining is that I still do not understand why there is such a large decrease in
OR when the analysis is stratified for BMI < 30 and BMI > 30, compared to the un-stratified
analysis. This may indicate that BMI is an effect modifier or a very important co-factor in these
associations. I am looking forward to further studies revealing this association.
Review for 10.1186/s12876-024-03199-7 (2024)

Title: Circulatory Resistin Levels in Inflammatory Bowel Disease: A Systematic Review and
Meta-Analysis
Version: 0 Date: 01 Jan 2024
Reviewer:  Spyros I. Siakavellas
Reviewer's report:
Many thanks to the authors for submitting their valuable work. This is a well designed review
with rigorous statistical methodology and well presented results.
My comments are as follows:
Main comments:
Your discussion does not go into detail about some of your findings and the potential role of
resistin in the assessment of IBD.
1) For example has there been any comparison with fecal calprotectin?
2) What do you think the role of resistin could be? How confident can you be in its potential
given the high heterogeneity?
3) Are the methods for measuring resistin standardised?
4) Have there been any studies with any of the newer biologic agents?
5) Would you be able to exand a bit on the other conditions affecting resistin levels apart from
BMI?
Furthermore,
6) I noticed that despite the sample size differences the weights in your Forrest plot analysis are
roughly equal. How can this be given that the study from Konrad et al. has the biggest sample
size by far?
7) How do you account for the more modest differences seen in more recent studies?
Minor queries
In the last sentence of the abstract please rephrase as "clues" does not fit with the context. I
would suggest "this indicates that further studies may provide valuable insights for the role of
resistin in the pathogenesis of IBD".
In the first paragraph of the introduction the last sentence can be omitted.
Please replace "circus" with "circle".
In page 15 of the manuscript in the discussion please change "have" after ""meta-analysis" to
"has".
In your discussion paragraphs 2-4 reiterate the points made in the introduction and can be
omitted.