JerMa88/BMC_Womens_Health_Peer_Reviews huggingface dataset:
Title: Knowledge and Compliance towards Alendronate Therapy among Postmenopausal
Women with Osteoporosis in Palestine
Version: 2 Date: 07 Feb 2022
Reviewer's report:
In this interesting cross-sectional research, Authors investigated the compliance to alendronic
acid therapy in a setting of 224 consecutive osteoporotic women receiving alendronate. Their
results suggest that only 42% of the enrolled women were compliant with almost all of the dosing
instructions, whereas, 51.6% had compliance score values (3-5). About 6.4% of the participants
were compliant with only one or two of the dosing advices.
The most common side effect reported was gastrointestinal intolerance. Residency and the
source of instructions emerged as the main factors which influenced the knowledge and the
compliance to alendronate dosing instructions.
“Abstract” section, Line 41: please, replace the semicolon with a colon.
“Introduction” section, line 71-70: When you talk about the poor compliance of women to
alendronate therapy, a large cohort study involving 9851 Italian postmenopausal women with
osteoporosis demonstrated that at least one year after having been prescribed a treatment with
alendronate 10 mg/daily or alendronate 70 mg/weekly, 19.1% of the patients discontinued the
prescribed drug before attending the bone mass reevaluations for drugs related side effects
[Rossini M, Bianchi G, Di Munno O, et al. Determinants of adherence to osteoporosis treatment
in clinical practice. Osteoporos Int. 2006;17(6):914-921. doi:10.1007/s00198-006-0073-6].
“Methodology” section: were all “postmenopausal” women? In the “Inclusion criteria” Authors
talk about age over 45 years, which is not necessarily synonymous with menopause.
In this manuscript, methods are clearly explained. Tables are well done and self-explanatory.
In my opinion, limitations of this study are represented by the small sample size, as already
specified by the Authors, and the relatively short observation period (sixth months) for a drug
such as oral bisphosphonate. The work is intriguing but it needs moderate revisions, as pointed
above.
Title: Determinants of induced abortion among women received maternal health care services
in public hospitals of Arba Minch and Wolayita Sodo town, southern Ethiopia: unmatched case-
control study
Version: 3 Date: 16 Jan 2022
Reviewer:  Dagne Addisu
Reviewer's report:
I read the manuscript in detail and the manuscript is well-structured and written in a good
manner.  However, I raised some minor comments and suggestions below
1. Extensive literatures including systematic review and meta-analysis were available in
Ethiopia. So,
I. Does your finding differ from those previous findings?
II. What new evidence will add for Ethiopia as well as the scientific communities
2. Since the definition of abortion is different for developed and developing countries, it is better
to include the definition of induced abortion in Ethiopian context.
3. During the selection of cases, did you include those mothers who had induced abortion for
medical purpose(medically induced abortion)
4. If you found a woman who had history of more than one induced abortion, for which one
did you collect data?
5. What are the relevance of asking ethnicity, religion, and monthly income for this study?
6. In this study, you included those mothers aged above 30 years. However, remembering some
variables like age at first sex for these study participants were the major challenge (recall basis
and social desirable bias are the major issue). So, how did you manage such issues?
7. Since you had age category between 15-19 years, you might have participants below 16years.
In this scenario, written consent is not recommended for this age. So,  how did you addressed
Ethical clearance and consent to participant?
8. Revise the discussion
I. Better to change the word inline. Since it requires confidence interval, the word is suitable
for magnitude related data
II. In my point of view, no need of discussing non-significant variables under discussion.
9. Too much information under conclusion. So, revise and remove unnecessary information.
Title: Determinants of induced abortion among women received maternal health care services
in public hospitals of Arba Minch and Wolayita Sodo town, southern Ethiopia: unmatched case-
control study
Version: 3 Date: 24 Jan 2022
Reviewer:  Tsegaye Tilahun
Reviewer's report:
Reviewer comments (on determinant of induced abortion)
Dear editor,
Here are my comments on the manuscript
1. Title
a. Title is interesting and familiar. If so, what special thing the authors going to address?
b. Other health facilities (government, private) were not including. Please include it in the
limitation part
2. Abstract
a. “In Ethiopia, abortion and its complications are responsible for 30% of maternal deaths”. I
don’t think abortion is contributing to this much in maternal death ,currently, in Ethiopia
b. Methods: include the ratio of case to control with number of cases and controls. Who are
controls and cases?
c. Conclusion: make conclusion based on the finding. It needs modification
3. Introduction
a. Definition of abortion: please make it based on Ethiopian context
b. The authors used EDHS 2016. Let them use the recent editions
c. Include about the legal abortion in Ethiopia
4. Study setting
# Include about maternal health services(total number of deliveries, postnatal care, etc) and
abortion services in the area
5. Case selection
# Why was matching not done? Include it
6. Sample size determination
# Why power was 80% selected?
7. Sampling technique
# Let the authors put it pictorially/flow chart
8. Table 1
# Better if monthly income is mentioned in USD
9. Table 3
# What is the difference between emergency pills and oral contraceptives? Both are taken orally.
Please specify it
# What is regular contraception? Please specify it. Is it oral contraception?
# ‘Implants’ is out-dating word. Please replace it with better term
# What is the difference between ‘Know any contraceptive methods’ and ‘Knowledge about
contraceptive’. Better if merged together
10. Discussion
# Try to compare the current findings with study done in other parts of Ethiopia
11. Limitation
# Mention it as subheading
12. Conclusion
# It is too long. Try to shorten it and make it based on the finding
13. Language
# Needs edition by native speaker
Title: Determinants of induced abortion among women received maternal health care services
in public hospitals of Arba Minch and Wolayita Sodo town, southern Ethiopia: unmatched case-
control study
Version: 4 Date: 14 Feb 2022
Reviewer:  Tsegaye Tilahun
Reviewer's report:
Reviewer comment February
Dear editor,
The authors made significant changes but there are still some points to be addressed
1. Abstract a. “In Ethiopia, abortion and its complications are responsible for 30% of maternal
deaths”. I don’t think abortion is contributing to this much in maternal death, currently, in
Ethiopia Author response: Thank very much for your concern but this figure take from recently
published article “Siraneh, Y. and A. Workneh, Determinants and Outcome of Safe Second
Trimester Medical Abortion at Jimma University Medical Center, Southwest Ethiopia. Journal
of pregnancy, 2019.
Dear authors, it is clear that the above paper is published recently. However, they refered the
2006 report (too old) ‘’  Ethiopian Federal Ministry of health, report, 2006, http://www.who.int/
pmnch/knowledge/publications/ethiopia_country_report.pdf’’.   Since this time the government
of Ethiopia was implementing different approaches to decrease maternal death from abortion.
Please look at it again and make amendments.
2. Figure 2: there is a missing value
3. Language: needs edition
Title: Determinants of induced abortion among women received maternal health care services
in public hospitals of Arba Minch and Wolayita Sodo town, southern Ethiopia: unmatched case-
control study
Version: 4 Date: 24 Feb 2022
Reviewer:  Dagne Addisu
Reviewer's report:
Thank you for addressing my previous comments and suggestions. To improve the quality of
this manuscript, I raised additional comments and suggestions below
1. The manuscript has some editorial issues such unnecessary spacing between words and
grammatical errors
2. In abstract and introduction part, you stated that abortion and its complications are responsible
for 30% of maternal deaths in Ethiopia. However, this figure does not represent the recent burden
of abortion for maternal mortality. So, you should revise this percentage.
3. Result—
I. Under reproductive characteristics,  (The minimum and maximum age at first sex among cases
and controls was 15 and 28 years old respectively). This sentences is not clear, please revise it.
4. In figure 1(reason for termination of current pregnancy)
I. Did you  collect this reasons from medical charts or gathered by interview
II. The percentage of continuation of pregnancy threaten women’s health is not mentioned. So,
please include the percentage.
III. What are those conditions that threaten women’s health?
IV. You tried to show Ethiopian abortion law under introduction. Based on this evidence,
unplanned pregnancy is not an indication for termination of pregnancy. However, your finding
reported that unplanned pregnancy was the major reason for termination of current pregnancy.
So, how it could be?
5. The way you measured level of knowledge for contraceptive is not clear. I did not found those
six knowledge assessment questions on the manuscript.
Title: Perceptions of pelvic floor dysfunction and rehabilitation care amongst women in
southeast China after radical hysterectomy: a qualitative study
Version: 2 Date: 06 Oct 2021
Reviewer:  Heidi Wendell Brown
Reviewer's report:
I commend you on this well-written manuscript, a qualitative analysis of interviews with 30
women who have recently undergone radical hysterectomy for cancer treatment regarding their
knowledge, experiences, and attitudes and beliefs about pelvic floor disorders. Your sample is
large for a qualitative study and the themes identified are similar to those identified in other
qualitative papers focusing on pelvic floor disorders in other populations. Your manuscript
makes a valuable contribution to the literature but should be revised to include more details about
methods and same description, and to remove duplicate quotes in tables and results section.
1) It would be helpful if you could better characterize the women who participated, so that
the conclusions could be qualified a bit more. There is no doubt that limited knowledge about
pelvic floor disorders is widespread, but i would suggest that conclusions be gently reworded,
so that the authors themselves suggest that campaigns should aim to increase public awareness
about the prevalence and treatability of pelvic floor disorders both in the context of radical
hysterectomy and more generally, rather than the current wording, which implies that the
participants make these suggestions. As I have described in later comments, it would be helpful
to qualify whether participants were in the acute post-operative period, because that is very
different than having had a radical hysterectomy several months ago, and many pelvic floor
symptoms in the immediate postoperative period do resolve (such as constipation and urinary
urgency).
2) The description of how patients were approached and invited to participate should be clarified.
There is a big difference between someone who underwent a radical hysterectomy 6 days ago and
6 months ago, and it appears that people along that entire spectrum were included. Pelvic floor
disorder symptoms in the acute post-operative period are different from long-term symptoms,
and so it makes sense to describe when patients were approached. If you do have a nice spread
of participants, it may make sense to present data from these groups differently (perhaps within
4 weeks of surgery versus >4 weeks from surgery, for example).
3) Overall the manuscript is extremely well-written, but would benefit from proof-reading by a
native English speaker prior to publication. It is also unconventional to include quotes in both the
results section and the tables - I would just highlight themes in the results section and direct the
reader to specific quotes in the tables rather than duplicating them. Quotes that are not included
in the tables should be written in the text, and enriches the reader's experience.
Title: Perceptions of pelvic floor dysfunction and rehabilitation care amongst women in
southeast China after radical hysterectomy: a qualitative study
Version: 4 Date: 19 Jan 2022
Reviewer:  Heidi Wendell Brown
Reviewer's report:
I really appreciate the effort you've undertaken with this manuscript and revisions and find the
information you present very interesting. My concern remains about the framing of your results
within their context, as well as continued difficulty understanding some of the English phrasing.
I have these specific comments:
1) The vast majority of patients interviewed were women within 3 months of major surgery
for cancer, where pelvic floor symptoms may be evolving as surgical recovery progresses, and
where women are also experiencing many other symptoms and stressors. My suggestion would
be that your conclusions focus specifically on the need to better prepare patients (and their
families, based on what patients told you) for these experiences in the post-operative period.
As a pelvic floor surgeon, I routinely counsel patients that they may experience worsening
incontinence after surgery, and that this symptom may improve as they heal, or may persist, and
that we will work together to address these symptoms if they are bothersome  / worsen / persist.
Might you suggest that the gyn oncologists performing radical hysterectomies provide some
similar counseling? Should their be some attempt to engage family members to support patients
in post-op recovery more broadly, based on the expressed need for family support? Should these
patients have a consult with a urogynecologist before or after surgery?  Increasing awareness of
pelvic floor disorders is obviously an important goal for all women, but i think your population
is so specific that your recommendations should also be specific.
2) It is not particularly clear to me how you defined pelvic floor symptoms for patients.
incontinence is mentioned but little other information is provided. was incontinence really the
focus? If so, it would be much clearer for most readers to just say that the study was about
incontinence rather than using the broader term pelvic floor disorders  /symptoms.
Title: Perceptions of pelvic floor dysfunction and rehabilitation care amongst women in
southeast China after radical hysterectomy: a qualitative study
Version: 5 Date: 02 Mar 2022
Reviewer's report:
1) Line 50: I would refrain from defining PFD as a a single disease -- rather this is a spectrum
of conditions that include the symptoms you list in the following sentence. Consider, instead,
using PFD as "pelvic floor disorders" which is a common abbreviation that accompanies all of
the disease states listed by the authors.
2) Line 55: PFDs with an 's' could remain if you change PFD to pelvic floor disorders as above;
otherwise, would remove
3) Line 58: No "s" after prolapse
4) Line 67: No "s" after function
Thank you to the authors for their important work in this field.  They have done a great job
summarizing the interviews and thematically sorting them. While there are some limitations
given the translation needed, I do think that this is important work that can especially help the
women receiving GYN cancer care in China.
Title: Perceptions of pelvic floor dysfunction and rehabilitation care amongst women in
southeast China after radical hysterectomy: a qualitative study
Version: 6 Date: 07 Mar 2022
Reviewer's report:
Dear Authors, I am unsure why the journal has yet again sent this back to me to review.  I already
gave my endorsment for publication in my last review and stated I would not provide further
comment, and therefore have nothing further to add.
Title: HPV knowledge, screening barriers and facilitators, and sources of health information
among women living with HIV: perspectives from the DC community during the COVID-19
pandemic
Version: 3 Date: 01 Feb 2022
Reviewer's report:
The manuscript improved a lot compared to the previous version. However, I still stink some
additional changes need to me made before it can be accepted.
Background
- You mention estimates and projections for ICC diagnoses in 2021 and deaths in 2020 (lines
64-65 and 69). It is useful to have numbers to get an idea of how large the population affected
is, but since it is 2022 by now I think you better mention projections for 2022 or confirmed/
observed numbers from earlier years.
- Please change the numbering of the references to chronological order or appearance.
- Thank you for adding information about the Wards, this makes it more clear. However I don't
think this is relevant in the background section, since it is a little out of the blue for me. I would
prefer to read this information in the methods section, where you could also elaborate why it is
useful to look at these separate wards (representativeness?).
- The background section has a better flow and is in general more to the point, but it is still nearly
as long as the previous version. Can you see if there is information that can be pointed out more
compact  or maybe left out completely?
Results
- In your methods section you mention that participants are eligible from age 21 on. However
women under age 31 are missing in table 1. For clarity, please add a row mentioning this category
and a number (even if it’s 0).
- In my opinion, figure 1 does not add a lot of information to the manuscript, because only single
words are portrayed. By just showing single words it is not clear what the women said in which
context.
I would still like a figure or table in which the answers given by the women are somehow
quantified. I would suggest either adding numbers to table 2 representing the number of women
who said/confirmed this. Or to create a bar chart in which single risk factors/ preventive
measures/ recommendations etc. are shown with a bar of how often this was mentioned/
confirmed.
Conclusions
- The first sentence in the conclusion section is very long which makes it difficult to understand
what is meant. Can you split this sentence up into two or three sentences?
- "Improved cervical cancer screening knowledge can, in turn, lead to increases in screening
intention and behavior [29]." (lines 378-379). Please don't bring new information (and
references) in the conclusion section. This is an interesting sentence, but it comes out of the blue
and is only mention in the conclusion. Please mention this information before (in the background
or discussion section) so it has a better flow.
Title: Clinical significance of endometrial abnormalities: an observational study on 1020
women undergoing hysteroscopic surgery
Version: 1 Date: 29 Oct 2021
Reviewer's report:
In the present study, the rate of false-negative findings of endometrial pathologies at TVS
(468/986) was 47.86%, the additional use of diagnostic hysteroscopy considerably improves the
detection of polyps (758/820) 92.43%. The authors have to correlate the presence of abnormal
endometrial histological features with abnormal ultrasonic features and hysteroscopic findings
All 1020 women underwent operative hysteroscopy, 34/1020 (3.33%) premalignant/malignant
lesions were
detected (complex hyperplasia with atypia in 22 (2.15%) women but 4 of 12 endometrial cancers
were underdiagnosed (33.33%) and detected only in post hysterectomy specimens.
diagnostic hysteroscopy was not performed in 34 women or hysteroscopic resection is
considered a diagnostic tool and an additional support to endometrial cancer diagnosis by the
authors?
Title: Clinical significance of endometrial abnormalities: an observational study on 1020
women undergoing hysteroscopic surgery
Version: 1 Date: 02 Nov 2021
Reviewer's report:
I have reviewed the manuscript entitled “Clinical significance of endometrial abnormalities: an
observational study on 1020 women undergoing hysteroscopic surgery” I found the manuscript
interesting and informative. I have the following considerations:
The entire manuscript needs revision for better use of English grammar and medical writing
style.
The first reference cited is number 8? Please revise.
The indication for ultrasound in “asymptomatic women undergoing routine periodic
gynecologic visits” is not clear, please explain why such a patient needs an ultrasound exam.
The definition of AUB “intermenstrual bleeding lasting LESS than 6 months?" Please revise.
The following sentence is unclear and needs further explanation. Indeed, premenopausal women
were more frequently symptomatic than postmenopausal ones; conversely, postmenopausal
subjects underwent a more in-depth investigation mainly following pelvic ultrasound carried out
during a routinary gynecologic check. What do you mean by “a more in-depth investigation”
The authors place most of their attention on the menopausal status, adding another study
confirming the risk factors for endometrial cancer will not add anything to the current literature,
The authors then describe “atypical aspect of endometrial polyp at hysteroscopy” What does
that mean? What do the authors refer by “atypical aspect at hysteroscopy?”
The statistical analysis presented in the results is only descriptive statistics.
As an example, in the discussion, the authors describe that the rate of endometrial atypia was
“significantly” higher than that found in premenopausal women but present only the percentage
and not the statistical analysis.
In short, the authors are presenting a study that does not add anything new to the current
literature, I would recommend focusing on the hysteroscopic findings which could be an
interesting point of view of this paper.
Title: Support for lowering cervical cancer screening age to 25 for women living with HIV:
Retrospective cross-sectional programmatic data from Botswana
Version: 1 Date: 28 Sep 2021
Reviewer's report:
Very interesting study exploring an important question about the age for screening in women
living with HIV (WLWH); HIV positive women have high rates of HPV infection and cervical
cancer, and all the guidelines on cervical cancer prevention agree that WLWH are at higher risk
and more research is needed to determine the age for starting screening, and the method for
screening them.
Some comments:
1) Please review the grammar, for example in line 85 it is written "till" instead of the word "until".
2) The authors center significant part of the study on the VIA+ rates in women 25-29 compared
to 30-49; but VIA positivity is very subjective, it varies significantly from evaluator to evaluator,
and also over time; but most importantly, VIA positivity rate increases in populations with high
prevalence of cervicitis, and actually the authors mentioned in the discussion that the rates of
cervicitis were higher in women 25-29; therefore, the higher VIA+ rates in that age group is not
related to high prevalence of pre-cancer, it is related to higher rates of cervicitis.
3) The most important part of this study is related to women referred to colposcopy, there we
can observe that the referral rates, and the histologically-confirmed CIN2+ rates, are similar in
WLWH 25-29 and 30-49 y/o. This information is critical because it shows that WLWH 25-29
y/o are at the same risk of pre-cancer, and cancer, than women 30 and older and therefore they
should have the same recommendation for cervical cancer screening.
4) Please provide more information about the histological diagnosis:
- experience of pathologists?
- instead of presenting just the rates of CIN2+, please provide more detailed information about
rates of CIN2, CIN3 and cancer.
I'll very glad to review the revised version of this important research.