JerMa88/BMC_Womens_Health_Peer_Reviews huggingface dataset:
Title: Socioeconomic Factors Influence Surgical Wait Times for Non-emergent Gynecologic
Surgical Procedures: A Retrospective Analysis
Version: 3 Date: 25 Aug 2023
Reviewer:  Christopher C. Destephano
Reviewer's report:
Applaud the authors for taking on a complex topic like the effect of social determinants of health
and facility type on wait times for surgery.   This is especially relevant as countries with National
Health systems are often the only ones who receive coverage of surgical wait times whereas
in the US healthcare system, care is often rationed based on social determinants of health and
facility type without media coverage of these important issues.
Please add the objective to a final paragraph of the introduction instead of the methods.
The primary endpoint was surgical wait time.  How was the "decision made to proceed with
surgical management" documented or defined?  Can more detail be added on this decision and
how it was coded?  Is there an electronic posting that is similar between facilities?
Similarly, how was "require medical clearance" determined?
Can a variable in the adjustment be added for surgical procedure?  If all the hysteroscopies
occurred in the private practice and hysteroscopies are easiest to post and schedule, then this
may be a confounder that was not accounted for in the time to surgery.
Title: Socioeconomic Factors Influence Surgical Wait Times for Non-emergent Gynecologic
Surgical Procedures: A Retrospective Analysis
Version: 3 Date: 30 Aug 2023
Reviewer's report:
1. General comment:  This is a retrospective study of a cohort of patients undergoing benign
gynecologic surgery at a single sponsor institution.  The study sought to determine if surgical
wait time varied by care delivery setting.  The study simply looked at the outcome of surgical
wait time.  There was no linked surgical outcome data.  Technically, the study was well
performed and has no major methodologic flaws. Overall, I think the study has limited impact
given the lack of outcome data.
2. Why did they choose a 5-month timeframe?  Was there some rationale behind the timeframe?
Or was there a pre study determination of sample size?
3. Was there any evidence that increased surgical wait time lead to adverse outcomes?
4. Did the same surgeons practice both in the private setting and at the federally qualified Health
Center or were these groups different?
5. Figure 1 and 2:  These figures do not add much to the text in could be eliminated for space
6. Did OR block time vary between surgeons from the FQHC and the private practice setting?
7. Line 246-248:  Since gynecologic malignancies were excluded from this data analysis, I am
not sure that this reference is relevant to the current work.
8. Line 261:  Avoid claims of primacy in the literature; they are rarely true.
Title: Socioeconomic Factors Influence Surgical Wait Times for Non-emergent Gynecologic
Surgical Procedures: A Retrospective Analysis
Version: 3 Date: 30 Aug 2023
Reviewer:  Ryan J. Spencer
Reviewer's report:
- Abstract: Under methods it says that a univariable analysis was conducted but does not mention
the multivariable analysis. Could you add that here for thoroughness? I was wondering why a
multivariable was not done until I realized later when I was reading.
- Methods: Please add information of whether all 3 hospitals have patients from both private
practice settings and FQHCs at them? Not including analysis by hospital could be a major
unexplored confounder for which the data is available to the authors. The hospital where the
surgery was performed (e.g. Hospital 1, 2, or 3) should be on the demographic table 1 and
table 2. The time from decision to operate to surgery by hospital must be included.  If there are
differences in patients from FQHCs and private practice at those hospitals, then the multivariable
analysis should be performed using hospital site as well.
- Please explicitly state which variables were considered in the multivariable analysis to identify
and/or eliminate independent factors associated with the outcome of interest.
- Please explain for readers why such a short time frame was used for data collection: was it
convenience, time required to collect the data, it was the only data available, a sample size
calculation?
- Discussion: A significant concern of mine is if the 5-month time period before the pandemic
is an accurate reflection of the current issues we are seeing. It would appear that the pandemic
period is specifically eliminated, and more recent time periods would be more reflective of where
effort and energy is needed to reduce inequities in our current medical system. Moreso because
it may be that these inequities worsened since Feb 2020 and that would be more helpful to know
for advocacy and policy.
- Conclusions: Could the authors provide specifics into what next steps should be undertaken?
In gynecology, there is unlikely another group of people more in tune with the nuances of this
issue than these authors.
Title: Socioeconomic Factors Influence Surgical Wait Times for Non-emergent Gynecologic
Surgical Procedures: A Retrospective Analysis
Version: 4 Date: 18 Nov 2023
Reviewer's report:
This revision is much improved. It has addressed all of my concerns except for one minor
comment regarding the figures:
"would be clearer if the bar graphs were listed in an ascending or descending frequency, and
to include the counts."
Title: Factors associated with utilization of cervical cancer screening services among HIV-
positive women aged 18 to 49 years at Lira Regional Referral Hospital, Northern Uganda
Version: 1 Date: 06 Nov 2023
Reviewer's report:
- Thank you for sharing your work on cervical cancer screening in Lira, Uganda. I have 2 main
concerns regarding this study. First of all, it is mandatory in Uganda for all research to be
registered at the Uganda National Council for Science and Technology (in addition to Research
and Ethical Committee approval). This seems not to have been done. Secondly, the use of odds
ratios may not have been suitable since the outcome various was highly prevalent. Reanalysis of
the data using an appropriate test may be required. Below is further feedback for consideration.
- Add ‘Uganda’ after Lira City in the abstract.
- Abstract: were there many types of questionnaires or rather a questionnaire?
- Ethical approval details may not be needed in the abstract.
- Response rate may be omitted from the abstract.
- Abstract: use ‘5 years prior to data collection’.
- CCS should be first used together with the acronym in full.
- Use past tense in the results of the abstract.
- Odds ratios and confidence intervals may be provided in the abstract.
- One of the abstract recommendations is to integrate CCS into routine HIV services (but there
is no finding that this was not existent).
- Why was Lira RRH specifically selected for this study?
- Why was the age group of 18 to 49 years used in the study?
- The limitations of using consecutive sampling should be highlighted.
- Operational definitions may not be needed as a stand-alone sub-section in the methods.
- More details of the individual and health systems independent variables are needed in the
methods.
- Was the questionnaire developed by only one researcher?
- Who administered the tool and what were their qualifications? Were they trained before data
collection?
- Figure 2 is not necessary.
- Figure 3 may not be necessary if all the findings therein can be presented descriptively.
- Statistically significant results should be indicated in Table 4 (for example using *).
- The introductory paragraph of the discussion should provide an overview of the findings and
their general significance to public health. The detailed discussion of the respective findings can
then follow in the subsequent paragraphs.
- What could be the possible reason for the difference in prevalence of CCS with other countries
as noted in the discussion?
- Avoid short discussion paragraphs (for example paragraph 3).
- There is no need to repeat results in the conclusion.
- The conclusion / recommendation should be written to suit the global audience and not only
Lira RRH.
Title: Factors associated with utilization of cervical cancer screening services among HIV-
positive women aged 18 to 49 years at Lira Regional Referral Hospital, Northern Uganda
Version: 1 Date: 08 Nov 2023
Reviewer:  David Lagoro Kitara
Reviewer's report:
REVIEW OF MANUSCRIPT
Factors associated with utilization of cervical cancer screening services among HIV-positive
women aged 18 to 49 years at Lira Regional Referral Hospital, Northern Uganda.
Thank you, authors, for this fascinating paper. This manuscript is fascinating and should be
considered to advance further.
However, several issues need to be addressed.
Many typos and errors need to be corrected. I recommend English editing services for this
manuscript.
The abstract
1. This needs to be rewritten, including significant findings, and the results should provide
findings guiding the conclusion.
2. the authors should give recommendations based on the findings after the conclusion.
In the methods.
1. Could the authors explain how they conducted sensitivity analysis?
2. The authors should get convincing exclusion criteria for this study population.
3. What is the explanation for the sample size of 294 when the total population of HIV patients
in the clinic was 800?
4. What were the strengths and limitations of your study?
5. Can you discuss the generalizability of this result?
6. References of this manuscript need to be reviewed to match the journal’s specifications.
Title: Factors associated with utilization of cervical cancer screening services among HIV-
positive women aged 18 to 49 years at Lira Regional Referral Hospital, Northern Uganda
Version: 1 Date: 09 Nov 2023
Reviewer's report:
I read with great interest the Manuscript titled “Factors associated with utilization of cervical
cancer screening services among HIV positive women aged 18 to 49 years at Lira Regional
Referral Hospital, Northern Uganda” which falls within the aim of the Journal.
Although the manuscript can be considered already of good quality, I would suggest to take into
account the following recommendations:
- I suggest round of language revision, in order to correct few typos and improve readability;
-  Considerin the higher risk of getting cervical cancer in women with HIV- infection, It would
be interesting to discuss how various factors could be crucial in the development of HPV-related
carcinogenesis, and how they could influence the persistence and / or recurrence of HPV-related
lesions. I would be glad if the authors discuss this important point, referring to PMID: 37401466
and 37747763.
Because of these reasons, the article should be revised and completed. Considering all these
points, I think it could be of interest to the readers and, in my opinion, it deserves the priority
to be published after minor revisions.
Title: Factors associated with utilization of cervical cancer screening services among HIV-
positive women aged 18 to 49 years at Lira Regional Referral Hospital, Northern Uganda
Version: 1 Date: 10 Nov 2023
Reviewer's report:
I read with great interest the manuscript, which falls within the aim of this Journal and offers
a high-quality overview of the topic.
Indeed, the topic is of the utmost importance given the efforts made by the WHO for the
prevention and early diagnosis of cervical cancer and precancerous cervical lesions.
The abstract perfectly summarizes the contents of the manuscript. The introduction is
satisfactory. The tables and figures are clear and interesting.
Although the manuscript can be considered already of high quality, I would suggest taking into
account the following minor recommendations:
- I suggest another round of language revision, in order to correct a few typos and improve
readability.
- Inclusion/exclusion criteria should be better clarified by extending their description.
- I also suggest authors better organize the discussion section following this ideal structure: main
findings of the study, strengths and limitations of the study, implications and comparison with
literature and future directions.
- I think that the discussion could be studied in depth. In fact, some aspects should be highlighted.
In particular, the importance of cervical cancer screening and vaccination should be improved by
analyzing the obstetrical outcomes and the positive margins persistence in patients. This could
emphasize the importance of screening. I suggest these articles to get deeper in the topic : PMID:
33140628 and PMID: 36992282.
Considering all these points, I think it could be of interest to the readers and, in my opinion, it
deserves the priority to be published after minor revisions.
Title: Factors associated with utilization of cervical cancer screening services among HIV-
positive women aged 18 to 49 years at Lira Regional Referral Hospital, Northern Uganda
Version: 3 Date: 20 Dec 2023
Reviewer's report:
The authors have addressed the major concerns raised earlier. However, a few issues are still
outstanding:
- UNCST research registration  in the Ugandan context is independent of Research and Ethics
Committee approval. This therefore remains  an outstanding major ethical limitation of the
manuscript.
- Interviews are different from questionnaire surveys. Therefore, the use of 'face to face
interviews' may not be appropriate. The authors could use 'The questionnaire was administered
by 2 research assistants ......'.
- The first paragraph of the discussion should include the general public health significance of
the major findings from the study.
Title: Factors associated with utilization of cervical cancer screening services among HIV-
positive women aged 18 to 49 years at Lira Regional Referral Hospital, Northern Uganda
Version: 4 Date: 04 Jan 2024
Reviewer's report:
I am satisfied with the revisions. However, the authors should include in the manuscript that this
was research carried out by a student which exempts them from obtaining specific registration
from the Uganda National Council for Science and Technology.
Title: Factors associated with utilization of cervical cancer screening services among HIV-
positive women aged 18 to 49 years at Lira Regional Referral Hospital, Northern Uganda
Version: 4 Date: 06 Jan 2024
Reviewer:  David Lagoro Kitara
Reviewer's report:
Factors associated with utilization of cervical cancer screening services among HIV-positive
women aged 18 to 49 years at Lira Regional Referral Hospital, Northern Uganda
I wish to congratulate the authors for the improved revised manuscript. This is commendable.
General comments.
1. There are many typos and grammatical errors. The authors must correct these by using an
English editing services before the manuscript can be considered by the Editors.
2. In Table 1: Not all variables are sociodemographic characteristics. Revise the headings and
include a legend on every table.
3. Much of the corrections in the previous review have not been effected. You are requested to
do so or provide a rebuttal.
Title: Factors associated with utilization of cervical cancer screening services among HIV-
positive women aged 18 to 49 years at Lira Regional Referral Hospital, Northern Uganda
Version: 5 Date: 14 Jan 2024
Reviewer:  David Lagoro Kitara
Reviewer's report:
There is a great improvement in the revised manuscript.
Include the caption of the Tables (footnotes of each of the tables).
Title: Factors associated with utilization of cervical cancer screening services among HIV-
positive women aged 18 to 49 years at Lira Regional Referral Hospital, Northern Uganda
Version: 6 Date: 22 Jan 2024
Reviewer:  David Lagoro Kitara
Reviewer's report:
Authors,
The manuscript has greatly improved, but you have not included each table's legend (footnotes).
Ensure that it is done for all tables.
Title: Factors associated with utilization of cervical cancer screening services among HIV-
positive women aged 18 to 49 years at Lira Regional Referral Hospital, Northern Uganda
Version: 7 Date: 06 Feb 2024
Reviewer's report:
The quality of the manuscript has improved thanks to the changes made.  I think it could be of
interest to the readers and, in my opinion, it deserves the priority to be published.
Title: Resting energy expenditure, body composition, and metabolic alterations in breast cancer
survivors vs. healthy controls: A cross-sectional study
Version: 0 Date: 21 Oct 2023
Reviewer's report:
There are a no of concerns.
First, comparing group data based on the calculation of  the REE/FFM-ratio is faulty, because
the REE on FFM association has a non-zero intercept. Alternatively a regression analysis is
needed taking into account both, the association as well as the slope of the association.
Second, the data base  is too small and the study design (cross-sectional study) is  inappropriate
to reach any far reaching conclusions.
Third, the presentation of body composition data is inappropriate, i.e., for inter-individual
comparisons data on FM and FFM should be  adjusted for height squared. In addition, %FM
is inappropriate  because  dividing fat mass by weight is statistically problematic, because the
fat is present in both numerator and denominator. As absolute fat mass increases, %fat rises
increasingly slowly, eventually trending toward an asymptote at ~60% fat. In obese individuals,
even large gains or losses in adipose tissue mass may induce only small changes in %fat. A
second conceptual problem with %fat is that it is not an index of adiposity
that is fully independent of body size. High %fat values might reflect high adiposity or low lean
mass as, for example, in some patient groups.
Title: Resting energy expenditure, body composition, and metabolic alterations in breast cancer
survivors vs. healthy controls: A cross-sectional study
Version: 3 Date: 05 Jan 2024
Reviewer's report:
The authors have addressed most of the reviewer comments. The results are much clearer. Thank
you!
One minor point: While I agree that body composition should be measured for many different
populations and for many reasons, I am still not convinced that the study highlights the
“importance of accurate measurement of FFM and FM (in relation to survival year) in BCs”.
I think the R2 values are simply due to how the authors approached the analysis. In addition,
inclusion of body composition into predictive REE equations does not improve accuracy
compared to measured REE in people with accuracy (PMID: 31347209). I am not aware of
any research to suggest that measuring body composition would improve estimation of energy
expenditure/ metabolic status as implied by the sentence in the conclusion. I do agree that: 1.
Body composition can be helpful for other outcomes, and 2. There is a need for research on
whether or not body composition can improve the provision of more accurate energy requirement
targets. If the authors insist on keeping this conclusion, I strongly encourage them to change the
wording (e.g., something like ‘Future research should continue to explore accurate measurement
of FFM and FM (in relation to survival year) in relation to energy expenditure and metabolic
health among BCs).
Title: HIV status and knowledge of cervical cancer among women in Ghana
Version: 0 Date: 24 Sep 2023
Reviewer's report:
Thank You for the opportunity to review this article. I will briefly give my comments below;
Title: The title 'Predictors of comprehensive knowledge of cervical cancer among women with
and without HIV in Ghana' suggest that it's all women in the category, hence I strongly suggest
that authors will revise that into
''Predictors of comprehensive knowledge of cervical cancer among women in Ghana''
Abstract: It will be expedient to indicate the statistical tool employed in the work, that allowed
frequencies, chi squares and regression. Were these done manually or with a software?
background: The statement by the authors that seeks to portray Ghana as not having an organized
screening programmes, may NOT be entirely true. Authors are widely across the Cape Coast and
that is NOT the national cancer center. The Korle-Bu Teaching Hospital and the Komfo-Anokye
where I work have an organized cervical cancer screening programme and a whole department
is dedicated to this. This assertion may NOT give a true reflection of Ghana.
Methods: The study was done in CCTH, could the authors give justification on the age selected.
Why not 25 years, not 20, 18, or 30? Why did authors exclude those who had had treatment for
cervical cancer? how many women attended the HIV clinic. the focus is on women so do not
mix the data with men and women.
Findings were clearly suggestive of the objective of the study which sought to determine the
predictors of comprehensive knowledge of HPV and cervical cancer among h WLHIV and
those with negative or unknown HIV status to inform the development of effective public health
interventions on cervical cancer prevention among diverse women.
What does the study bring to board as a new knowledge? Women without HIV had more
knowledge of cervical cancer compared to WLHIV. This could have been further discussed with
a standout focus as this perhaps was the only new findings and all others confirmed existing
knowledge.
Overall impression is that the work brings out something new and could be considered for
publications when all areas have been clearly outlined
Title: HIV status and knowledge of cervical cancer among women in Ghana
Version: 0 Date: 21 Oct 2023
Reviewer's report:
This manuscript is well-written, thorough, and concise. It dealt very well with the subject at
hand. However, there are a few typographical errors that need to be corrected.
Title and abstract:  The abstract is concise and brilliantly written.  It reflects the message of
the study.
Background: This portion of the manuscript was also well-written, and appropriate.
It is appropriate and adequate for readers even unfamiliar with the subject. It clearly depicts the
purpose of the study.
Methods: Appropriate for the study and hand. The study was thoroughly carried out as per the
study procedure described.
Results: Well-expressed  and covers all the essentially parts of the study
Discussion: This comprehensively written. It took into account all major perspectives of the
study.
References: All important references in relation to the topic were stated. They are up-to-date.
Title: HIV status and knowledge of cervical cancer among women in Ghana
Version: 0 Date: 27 Oct 2023
Reviewer:  Moses Banyeh
Reviewer's report:
The study is interesting and provides useful information for policy markers in Ghana. However,
there are few concerns that needs to be addressed
General
1. It is recommended to include line numbers in manuscripts for easy reference
2. There are minor grammatical errors throughout the manuscript that the authors have to correct
Abstract
1. The study period should be indicated
2. Was the questionnaire validated?
3. Adjusted odds ratios are preferred to crude odds ratios. The authors should rather present the
former and not the latter
Materials and methods
3. Study design and study population:
There is an overlap between ‘study design and population’ and ‘study population and selection’.
The former should be ‘study design and settings’ where only the study design, the settings and
the study period are included. The latter should describe the study population in addition to the
inclusion and exclusion criteria.
4. Data collection instrument:
It is not clear how the responses of the participants were scored to determine adequate or
inadequate knowledge. What constituted good or poor knowledge?
Results
1. Table 1: P-values should be reported as P<0.001 and not 0.000 as no P-value is absolute zero.
2. I have noticed “Table 2 continued” in Table 1. Is that correct?
3. The symbol of Pearson Chi-Square should be used for clarity followed by the difference (#2,
df2, 3….)
4. Table 2: “After adjusting for other background factors in multivariate analysis (Model 2),”
can you clarify what these background factors were?
5. The presentation of results in the Table is quite confusing. I will suggest the results are
presented as in Table 1 and then the odds ratio (95%CI) can be added