JerMa88/BMC_Womens_Health_Peer_Reviews huggingface dataset:
Title: Establishment and validation of a simple nomogram for predicting early postpartum stress
urinary incontinence among women with vaginal delivery: A retrospective study
Version: 2 Date: 29 Dec 2022
Reviewer:  Tullio Golia D'auge
Reviewer's report:
Dear authors, thank you for sending me the correct manuscript.
I read your work with great interest and pleasure. The work with the changes made after my
advice and those of the other authors is complete and, in my opinion, ready for publication.
Title: Does women's empowerment and their socioeconomic condition affect the uptake of
breast cancer screening? Findings from NFHS-5, India
Version: 1 Date: 07 Jul 2022
Reviewer's report:
I appreciate the author’s effort to examine women's empowerment and socio-economic
conditions' effect on the uptake of breast cancer screening. I believe the study holds great
importance once the manuscript is significantly revised. My comments are-
Insufficient literature review: The literature review offers an extensive summary of existing
research on the concerned topic.  This research does not have a solid theoretical framework.
Data source and methodology: Detailed information about dependent and independent variables
should include in the manuscript. Methodologies should be elaborated in the method section.
Result: Result parts need more elaboration. High p-values denote that result is not strong enough
to draw inferences. In table 3 it was found that maximum p-values were insignificant which
refers that result is statistically insignificant in this context.
Comment: Reject
Title: Does women's empowerment and their socioeconomic condition affect the uptake of
breast cancer screening? Findings from NFHS-5, India
Version: 5 Date: 20 Nov 2022
Reviewer's report:
I am satisfied with the revisions. Yet, I strongly recommend that the following writing should
be fixed before publication:
BACKGROUND:
Paragraph 2, p.4: remove: ", India" (it is already said at the beginning of the paragraph that it
is India's Ministry)
"Since India has wide intra-country variations in socioeconomic status, and women
empowerment (18). Mapping coverage of screening across states, within the setting of
government-run screening programs would allow us to assess service utilization."
-> should be one sentence with a "," and not a "." after "(18), and not "," after "states"
-> I recommend deleting "within the setting of government-run screening programs", because
the scope of the study is larger than these programs (screening participation in general)
METHODS:
"and then scale up" -> should be "scaled up" (past tense)
"central government-run screening programs" -> I understood from the response letter of the
authors and from the background section that there was no screening programme implemented
(or "run") by the central government of India, please kindly consider revising this in order to
be consistent
DISCUSSION:
Paragraph 2: “this present study” should be revised as “this study” if this refers to the
“multinational study from sub-Saharan Africa” ("this present study"  it sounds that authors are
referring to their own study)
Paragraph 3 should be “impacts their ABILITY” (not "inability")
Paragraph 4: “educated women” should be revised as “women with higher education”  (to avoid
that some may understand that other women are "uneducated")
"It is likely because of the poor access to healthcare services that women have due to the rugged
hilly terrains which have very few centers offering screening and specialized cancer care"
-> should be revised, for example as " It likely to be due to the poor access to healthcare services
women have in a state with rugged hilly terrains and very few centers offering screening and
specialized cancer care"
"Screening programs were implemented in by the Ministry"
-->"Screening programs were implemented by the Ministry"
"Also, the religion of the woman and her marital status are other known determinants that but
this study did not consider those due to lack of individual level data at the time of this study..."
->"In addition, women's religion and marital status are other known determinants this study did
not consider those due to lack of individual level data at the time of this study..."
CONCLUSION:
First sentence: change "improve" for "enhance" (to avoid repetition with "improvents"
Title: Molecular diagnosis of Trichomonas vaginalis in liquid-based Papanicolaou samples in
Shiraz, southern Iran
Version: 1 Date: 15 Aug 2022
Reviewer's report:
Dear editor,
Dear authors of manuscript as "Molecular diagnosis of Trichomonas vaginalis in liquid-based
Papanicolaou samples in Shiraz, southern Iran",
This study is valuable and important for laboratory diagnosis and treatment of diseases.
The claims are supported by the experimental data and statistical population, number of samples
and experimental methods are accurate and adequate for this study.
The results are appropriate and acceptable.
The claims had been appropriately discussed in the context of with previous literature and
conclusion is good.
I suggest this manuscript for publication in BMC Women's Health.
Title: Molecular diagnosis of Trichomonas vaginalis in liquid-based Papanicolaou samples in
Shiraz, southern Iran
Version: 1 Date: 27 Aug 2022
Reviewer's report:
In the manuscript “Molecular diagnosis of Trichomonas vaginalis in liquid-based Papanicolaou
samples in Shiraz, southern Iran”, Saleh Bahreini et al. espouse nucleic acid amplification testing
as a means of detecting T. vaginalis from liquid-based cervical cytology collections.  From a
study set of 534 specimens, a detection rate of 4.9% was reported.  The authors additionally
associate increased age (including a 41- to 50-year-old demographic) and foamy discharge with
molecular T. vaginalis detection.
The manuscript was fairly well written yet could benefit from extended literature review.  Some
of the peer-reviewed data cited in the manuscript are a bit outdated and potentially not truly
representative (particularly the cited United States data).  Specific comments follow:
1) Lines 41-42, what was the rationale for the authors calling their population a “high-risk
population”?
2) Lines 56-57 (studies relative to Iran) may call the novelty of findings from the current study
into question;
3) Line 60, may consider antigen testing as another common (and suboptimal in low-prevalence
areas) means of trichomoniasis diagnosis (PMID 26659216);
4) Line 78 (and elsewhere), “liquid-based”;
5) Line 98, findings may be limited by utilization of agarose gel electrophoresis as a detection
method, rather than real-time detection chemistries;
6) Lines 107-112, written description of results is a bit verbose (these data are found in the
Table);
7) Lines 132-134, the authors report “no significant relationship…”, then finish the statement
with a P value of < 0.05.  Please clarify;
8) Lines 139 and following, are these literature citations also liquid-based cytology specimens
or are they vaginal specimens?
9) Lines 142-143, the 3% prevalence of T. vaginalis in the United States may be an underestimate
(see PMID 21998416 and others);
10) Line 157, “wet culture”? and,
11) Lines 169-171, PCR has been shown to be less sensitive than RNA amplification (PMID
19185101).
Title: Molecular diagnosis of Trichomonas vaginalis in liquid-based Papanicolaou samples in
Shiraz, southern Iran
Version: 2 Date: 04 Oct 2022
Reviewer's report:
Thank you for the opportunity to re-review this manuscript. The authors did a great job revising
the manuscript in response to my comments. I have a few minor comments and corrections.
Line 63-66: “Wet-mount test, the Diamond’s medium culture and antigen test are the common
methods of trichomoniasis diagnosis based on vaginal secretions. However, both of these
techniques have low sensitivity in detecting low parasite loads [10-12].” The authors list 3 testing
methods and then say “both of these techniques” in the following statement. Which 2 tests are
they referring to? Please rephrase.
Line 89: “…history of itching and dysuria of the genital area, and frequent urination…”. Please
rephrase this to read: …history of itching of the genital area, dysuria and frequent urination…
Results
Line 114-133: On my previous report, I asked the authors to correct decimal points. However,
this has not been corrected. Please correct this. I have highlighted the differences (different
colors) in decimal points for the author’s reference.
Line 121-123: “The history of abortion, history of premature birth and history of itching and
dysuria of the genital area, and frequent urination...” Please rephrase to read: The history of
abortion, history of premature birth and history of itching of the genital area, dysuria and frequent
urination…
Title: Molecular diagnosis of Trichomonas vaginalis in liquid-based Papanicolaou samples in
Shiraz, southern Iran
Version: 2 Date: 14 Oct 2022
Reviewer's report:
In the revised manuscript "Molecular diagnosis of Trichomonas vaginalis in liquid-based
Papanicolaou samples in Shiraz, southern Iran", Bahreini and colleagues utilized a laboratory-
developed PCR method to determine T. vaginalis detection rates from liquid-based cytology
specimens in an Iranian regional population.  The authors report a near-5% detection rate, along
with potential associations with specific age groups and foamy vaginal discharge.
Statements addressing Reviewers' previous concerns were added to this version of the
manuscript.  The authors appeared to address most concerns to satisfaction--yet the text used to
convey these thoughts could use revision (with the assistance of a medical writer whose native
tongue is English).  No new data have been added to the manuscript.
Title: Barriers to Health in Women of Reproductive Age Living With or at Risk of Non-
Communicable Diseases in Nigeria: A Photovoice Study
Version: 1 Date: 13 Feb 2022
Reviewer:  Bola Lukman Solanke
Reviewer's report:
The manuscript focused on the challenges to healthcare among women living with or exposed
to risk of non-communicable diseases in Nigeria. This is an important public health issue in
the country due to rising incidence of non-communicable diseases among men and women in
the country. The study was well-conceptualised and executed. However, authors need to fix the
following:
1. Where possible, authors should update most of the cited works particularly citations 3-9
2. In Lines 83-84, authors should state the inadequacies in existing studies that using photovoice
improve upon
3. The opening sentence of the Study design section should include the adoption of descriptive
cross-sectional design
4. Clarify what ‘risk factors for chronic disease’ in Table 1 actually measure – presence of risk
factor or number of risk factors present
Title: Barriers to Health in Women of Reproductive Age Living With or at Risk of Non-
Communicable Diseases in Nigeria: A Photovoice Study
Version: 3 Date: 19 Nov 2022
Reviewer:  Bola Lukman Solanke
Reviewer's report:
The authors have responded adequately to the queries raised in the earlier version. The
revised version has the potential to contribute to the discourse on barriers to healthcare among
childbearing women.
Title: Association between history of childbirth and chronic, functionally significant back pain
in later life
Version: 2 Date: 17 May 2022
Reviewer:  Kimberly Templeton
Reviewer's report:
This is an interesting study that attempts to elucidate why women are more likely than men to
have chronic back pain.  The investigators posit that this is related to pregnancy and childbirth
and evaluated this by assessing prevalence of back pain among parous vs nulliparous women.
This is an interesting concept, and the results of the study can serve as baseline for larger studies.
However, while the results helped to support the investigators' hypotheses, they need to place
them in better context.
1. While parous women had a higher prevalence of back pain, the prevalence in nulliparous
women was not zero, so pregnancy and childbirth are not the only sex-based risk factors for
chronic back pain (not necessarily an "obvious explanation".  The authors should mention some
of the other sex-based factors that have been proposed to explain differences between women
and men in prevalence of back pain (e.g., increased lumbar lordosis, differences in facet angles).
2. While the NRS for pain severity was statistically significant, was it clinically significant?
There is overlap between the score ranges and seemingly  not much difference between mean
scores 6 vs 7.
3. did the investigators ask participants about other areas of pain?  was their chronic back pain
related to conditions of more diffuse pain or chronic pain syndromes?  this would seem to be
important if the goal is to associate pregnancy and childbirth with longer term pain.  There could
be other factors that intervene before or after pregnancy.
4. the authors note the percentage of pts delivering via c/s.  was there a difference in prevalence
of back pain between women who underwent vaginal deliveries vs c/s?
5. I would recommend commenting more on the outcomes of PT postpartum in addressing back
and pelvic pain.  Is there a role for routine post-partum PT, especially for women at risk of
chronic pain?
6. I would also recommend a stronger comment about the use of opioids for this condition,
as they should be not initiated for the treatment of chronic pain, unless other options are not
effective and only as part of a multimodal approach.
Title: Association between history of childbirth and chronic, functionally significant back pain
in later life
Version: 2 Date: 08 Aug 2022
Reviewer's report:
Many thanks for inviting me to review this paper. This is an important study that would add
important insight to the existing literature. I have a few very minor comments that authors should
consider-
1. How many participants stopped the survey after opening the email? Authors should add this
information in the methods section of the manuscript, and if this percentage is higher, then
authors should address this as a source of bias in the study limitation section.
2. I am not sure whether the question asked to determine back pain status was limited for any
time frame, like two years or one year etc. Also, the number of times women faced back pain
in a certain time period is an important area to consider. However, I am not sure whether this
data is available.
3. Is there any chance to get physical functioning data and adjust them in the model? I am
assuming it might be possible since the authors collected data from participants attached to the
Stanford pain management centre.
4. The way that the authors used to present their outcomes in the method section is difficult to
understand.
5. References should be added to support the covariates considered in this study for adjustment.
6. The way that authors used to present R codes on page 10 is uncommon.
7. I am not sure why the authors reported RR instead of reporting OR that the binary logistic
regression model was produced.
8. The first four lines in the results section should be presented in the method section. This would
help the readers to properly understand this paper.
9. Instead of the textual representation of large numeric numbers authors should consider
numeric representation if journal style permits.
Title: Clinicopathologic characteristics of early-onset breast cancer: A comparative analysis of
cases from across Ghana
Version: 3 Date: 09 Oct 2022
Reviewer's report:
This is a study of breast cancer cases in Ghana
the scientific writing does not meet minimum standards
need English editing and a co-author who is familiar with clinical breast cancer diagnosis and
presentation. e.g. what is meant by prevalence
just call them under forty and over forty dont need abbreviations
remove all abbreviations and acronyms
much of the data on specifics re: pathology is missing please elaborate in limitations
Title: Clinicopathologic characteristics of early-onset breast cancer: A comparative analysis of
cases from across Ghana
Version: 3 Date: 19 Nov 2022
Reviewer's report:
Important and excellent study about breast cancer in Ghanaian women.  This paper sheds some
light on the global similarities and differences of early-onset breast cancer.
Would love to see a sentence or 2 explaining the screening program availability in Ghana and
what percentage of newly diagnosed breast cancer is screen detected.
Recognizing this is a pathology dataset, is there any data regarding treatment: lumpectomy
versus mastectomy, sentinel node biopsy versus axillary dissection, radiation usage?
Appreciating what resources are available in Ghana is very useful world wide.
Please clean up places in paper that say “Add cite”.  Also the table is missing the p-value for
hormone receptor positivity
Excellent paper
Title: The effect of prophylactic chemotherapy on treatment outcome of postmolar gestational
trophoblastic neoplasia
Version: 1 Date: 04 Dec 2021
Reviewer:  Antonio Braga
Reviewer's report:
Dear Editors.
I would like to thank you for the opportunity to review the paper: “The effect of
prophylactic chemotherapy on treatment outcome of postmolar gestational trophoblastic
neoplasia” submitted to the BMC Women’s Health. The objective of the paper was to evaluate
whether prophylactic chemotherapy (P-chem) increased the drug resistance rate of postmolar
GTN and whether the first-line chemotherapy should be different from P-chem.
Similarly, I would like to congratulate the authors for their interest in the topic.
I would like to highlight some aspects that deserve more reflection.
1. In the sentence: “High risk factors for malignant transformation of HM include: age > 40 years,
human chorionic gonadotropin (hCG) levels > 100,000 IU/L, excessive uterine enlargement,”
I suggest change to: “High risk factors for malignant transformation of HM include: age > 40
years, preevacuation human chorionic gonadotropin (hCG) levels > 100,000 IU/L, enlarged
uterus for gestational age”.
2. It was not clear in the methods section which criteria were used to indicate P-chem. It needs
to be well defined. Likewise, it was not clear which criteria were used to indicate treatment
using MTX, Act-D or 5-FU. For example, in Table 1 there were no differences between clinical
parameters between patients who received P-chemo and those who did not, showing that the
criteria for indicating P-chemo are not well defined. And in Table 2, it can be seen that Act-
D was used 7x more among patients who received P-chemo. As this scheme tends to be more
effective than MTX, it would be correct to assume a lower occurrence of resistance. However,
what is observed is the occurrence of chemoresistance with no difference between these groups.
Perhaps there would be a difference if the analysis were used considering each of the adopted
single-agent regimens.
3. It would be important to calculate the power of the study.
Title: The effect of prophylactic chemotherapy on treatment outcome of postmolar gestational
trophoblastic neoplasia
Version: 1 Date: 10 Jan 2022
Reviewer:  Barry W. Hancock
Reviewer's report:
The authors have chosen an important topic in GTD - the study provides information on the role
of prophylactic chemotherapy after evacuation of a molar pregnancy. Unfortunately there are
several variables which make the data difficult to evaluate. The authors comment on possible
flaws - that the study is retrospective, that the patients are from a single centre, that the sample
size is small (particularly when subsets are evaluated) and chemotherapy varied. All of these
make the statistical analysis relatively weak. There is already enough published evidence (albeit
from small and disparate studies) for clinicians to say that prophylactic chemotherapy  only has
a role for patients with high-risk molar disease where follow-up and serial hCG surveillance
is impossible, either due to a lack of hospital resources or factors surrounding patient non-
compliance or access to a treatment centre. Having said this the authors have made the effort
to put their study into context, but unfortunately this information does not alter the current
advice given in established international GTD guidelines.  Also, because of the lack of academic
facilities in those places where prophylactic chemotherapy may have role, randomised controlled
studies will be difficult, if not impossible, to conduct
Title: The effect of prophylactic chemotherapy on treatment outcome of postmolar gestational
trophoblastic neoplasia
Version: 2 Date: 29 Mar 2022
Reviewer:  Ray Osborne
Reviewer's report:
Despite your best intentions this report cannot be accepted for publication in its present form.
There are substantive issues with the structure of the paper (STYLE: METHODS SECTION not
precisely defined, the matching process that selected 81/460 in the control group is not defined,
the use of very old criteria to define risk of persistence, incorrect FIGO 2020 criteria (CCA not
a criterion) etc).   The statistical conclusions are inappropriate given the disparity between the
study groups which are themselves poorly defined.  The treatment regimens and the dosings are
noted defined or standardized.
There are also  a significant number of other issues as well..
I sorry but I must conclude that this study needs to be re-written and/or re-conceptualized.
Title: The effect of prophylactic chemotherapy on treatment outcome of postmolar gestational
trophoblastic neoplasia
Version: 3 Date: 03 Oct 2022
Reviewer's report:
Dear Authors
I have reviewed the manuscript of "The effect of prophylactic chemotherapy on treatment
outcome of postmolar gestational trophoblastic neoplasia” thoroughly. There are major issues
with the paper's organizational structure for examples:
The dose and detailed P-chemo drugs  has not been determined  in the study.
The number of P- chemo group was 27 cases in the text  (line 33, 130, 182), but it  was 24 cases
in tables 2 and 3!!
The information is such that it is not possible to understand the research design. These limitations
in the writing as well as the presentation of the data would preclude a meaningful conclusion
from being reached, and I do not see a way for these limitations to be readily addressed in
revision.
Kind regards
Title: The effect of prophylactic chemotherapy on treatment outcome of postmolar gestational
trophoblastic neoplasia
Version: 3 Date: 03 Oct 2022
Reviewer's report:
Topic.
I think it is important subject as publications that investigated prophylactic chemotherapy in
post-molar GTN are few.
Introduction. Well edited.
Methods.
1. Line 105.You mentioned: “During treatment, serum hCG levels were monitored weekly”. It
is strange as the chemotherapy cycle usually takes 14 days, then hCG is checked.
2. Line 106….“Failure of chemotherapy was defined as an inadequate response to the agent,
including elevated or roughly same hCG level or newly developed metastasis”…….Please
clarify definition of drug failure; did you consider after one or two cycles.
3. What was the chemotherapy protocol for low and high risk?  Fixed or weight-based dosing?
4. Did any GTN case underwent a second uterine curettage?
Results.
Line 147. “Methotrexate (MTX) was prescribed as first-line chemotherapy to 96% patients in
control group and to 54% patients in P-chem group”.. How you compare outcome of 2 different
treatment agents. E.g MTX can not compared with ACT-D results.
Tables.
Clear, but I do not find any case of ultra-high risk group (Score of 12 or more)
Title: The effect of prophylactic chemotherapy on treatment outcome of postmolar gestational
trophoblastic neoplasia
Version: 4 Date: 06 Nov 2022
Reviewer's report:
The authors have addressed some of the reviewer comments. Unfortunately, no corrections
have been made to comment #1 in the manuscript or Table 3. I know P-chem regimen is not
standardized yet for GTN, but researchers have done this retrospective study for "The Effect
of  Drug..... on Treatment Outcome". Therefore, the dosage and details of the P-chem regimen
should be specified for their patients, otherwise the method and conclusion of the study are not
valid and effective.