JerMa88/BMC_Womens_Health_Peer_Reviews huggingface dataset:
Title: The impact of social determinants of health on feminicide in the second-largest state of
the Brazilian Amazon: a spatial epidemiological analysis.
Version: 1 Date: 06 Mar 2025
Reviewer's report:
The study presents a solid and well-structured methodology, demonstrating scientific rigor and
methodological coherence in investigating femicides in the state of Pará. The choice of an
ecological study design is appropriate for spatial and temporal violence analysis, allowing the
identification of geographical patterns and trends over time. The use of secondary data from the
Integrated Public Security System (SISP-WEB) ensures a reliable and comprehensive database,
strengthening the validity of the findings. The spatial and temporal analysis methodology is a key
strength of the study. The application of Getis-Ord G and Gi* spatial autocorrelation statistics to
identify femicide clusters is well-founded, providing an accurate interpretation of the territorial
distribution of violence and adding robustness to the study by enabling associations between
femicide variations and contextual factors, public policies, and socioeconomic changes. Another
positive aspect is the inclusion of Geographically Weighted Regression (GWR) to examine
the influence of Social Determinants of Health (SDH). The careful selection of independent
variables and validation of statistical models (OLS and GWR), considering criteria such as
AIC, VIF, and adjusted R², demonstrate exemplary analytical rigor. Additionally, the concern
with sample normality (Shapiro-Wilk test) and the exclusion of spatial dependence in residuals
indicate the high quality of the analysis. The study also stands out for its transparency in
obtaining secondary data, with well-referenced sources, including the Ministry of Health and
the Brazilian Public Security Forum. The methodological approach demonstrates a high level
of scientific rigor, employing advanced statistical methods and appropriate spatial techniques
to address the research question. The clear description of procedures ensures the study’s
replicability, enhancing its impact and relevance for public policies addressing violence against
women. The results are original and discussed with up-to-date literature. Thus, the article is
consistent, well-founded, and should be approved for publication in its current form.
Title: The impact of social determinants of health on feminicide in the second-largest state of
the Brazilian Amazon: a spatial epidemiological analysis.
Version: 2 Date: 08 Apr 2025
Reviewer:  Hisrael Passarelli-Araujo
Reviewer's report:
Thank you for your detailed reply and for acknowledging my concerns during the first round.
I fully understand and respect your decision not to exclude any cases due to missing age
information—especially given the small number of feminicides in several municipalities.
However, I would like to respectfully point out several methodological issues in your rationale,
as this decision impacts the accuracy of your spatial comparison.
First, the existence of 41 notifications without age (slightly over 10%) is indeed a limitation,
but this could be effectively addressed through basic imputation techniques, either probabilistic
imputation or a simple pro-rata approach based on the age distribution of known cases. This
can be implemented with just a few lines of code and would allow the use of age-adjusted rates
without discarding these cases.
Second, the claim that “the age-adjusted rate would not show the reality of femicide in Pará” is
unfortunately misleading. On the contrary, age-adjusted rates are a standard and well-established
tool in both epidemiology and demography specifically designed to show a more accurate and
comparable measure of population-level risk. This is because crude rates are influenced by the
age distribution of the population in each municipality. Some municipalities in Pará may have
more young women, while others may have more older women—and this matters because the
risk of feminicide is not the same at all ages. For example, younger women might be more
exposed to intimate partner violence, making them more vulnerable. So, when you compare
crude rates across municipalities without accounting for differences in age structure, you may
not be comparing the actual risk of feminicide—you may just be seeing differences in the
population’s age makeup. Age-standardized rates correct for this, making the comparisons fairer
and more accurate.
That’s why I disagree with the sentence in the limitations that says adjusted rates “would not
reflect reality”. In fact, age-standardized rates reflect reality more accurately, because they
remove the distortion caused by different age structures.
If you choose not to revise the analysis, I strongly recommend clarifying this limitation more
precisely. You may consider the following paragraph for inclusion in the limitations section:
“One limitation of this study is the absence of age information for 41 cases (approximately 10%
of the dataset), which prevented the calculation of age-adjusted feminicide rates. Given the small
number of events in several municipalities, we opted to use crude rates to retain all observations.
However, it is important to note that variations in age composition across municipalities could
bias comparisons, as some areas may have a higher proportion of women in age groups at
greater risk for feminicide. This is a well-known limitation in demographic and epidemiological
analyses and should be considered when interpreting the results.”
Title: The role of women’s empowerment in fertility preferences and outcomes: analysis of the
2017 Demographic and Health Survey in Indonesia
Version: 2 Date: 22 Mar 2025
Reviewer:  Sarni Maniar Berliana
Reviewer's report:
Thank you for your efforts on this manuscript. Below is a summary of feedback intended to
help refine your study:
1. Methodology:
o Linear regression is unsuitable for discrete variable. Consider alternative statistical model like
Poisson or negative binomial regression to handle count data effectively.
o Clarify the methodology for deriving Prevalence Ratios (PR), as logistic regression naturally
yields odds ratios. Specify the statistical approach and software tools used.
2. Data:
o The TFR figure used is outdated (from 2017). Utilize the most recent TFR data (2.18) from
the 2020 Population Census to ensure findings reflect current demographic trends.
o It is important to refer to official sources, such as BPS (Statistics Indonesia), for accurate and
credible data (TFR data).
3. Data Presentation:
o Consider including overall averages for variables in the last row of Table 2 for a clearer
summary.
4. Clarifications and Consistency:
o The number of children: Clarify whether this refers to total children ever born or children alive
during the survey.
o Empowerment indicators: Revise or clarify inconsistencies between Table 3 and textual claims
regarding significant associations.
5. Policy Recommendations:
o Align recommendations with findings. Addressing national fertility levels may not be relevant,
as Indonesia's TFR is close to replacement level. While regional disparities exist, they fall
outside the scope of this study.
These refinements will strengthen the transparency, alignment, and relevance of your research
conclusions. Detailed suggestions are provided in the comments within the attached file for your
reference.
Title: Association Between Cardiometabolic Index and Infertility among American women aged
20-45 years: A cross-sectional analysis from 2013-2020 NHANES data
Version: 0 Date: 09 Mar 2025
Reviewer:  Rajani Dube
Reviewer's report:
• The article explores the association between cardiometabolic index and infertility involving
a large sample size, using the database. Identifying the factors that contribute to the infertility
will help in patient selection and appropriate counseling as well as use of corrective measures
for the modifiable factors. It will be of value to those practicing in the field.
• Abstract is structured and is representative of the study. Keywords are appropriate but few
more can be added, like BMI, dyslipidaemia.
• The title is appropriate and the introduction adequately provides an overview of existing
literature, identifies the gap, and states the goals of the study.
• Methodology is elaborate, well-described, and clear. A detailed explanation of the procedure,
outcome measures, and statistical analyses are given so that it can be replicated if required.
• The figures and tables are appropriately used and are representative of the data. They are clearly
understandable without much repetition of data with the text.
• The discussion compares the findings to other research in the literature and appropriately
highlights the similarities and contrasts. It further mentions the limitations. It is suggested to
highlight strengths of the study or what it adds to existing literature.
• The conclusion section is consistent with the results and interpretation.
• Minor modifications- Needs language and grammar correction
o Statistical analysis- Paragraph 2- CMIs in place of Cmis; Notes for table 2- Education
o Expand terms at the first mention in the text. Then, use abbreviation throughout the text.
o Table 2 needs adjustment
o Include calculation/definition of PIR in the variables/outcomes.
• The references are appropriate and well-cited. However, there are inconsistencies in the style.
It can be modified to a uniform style according to the journal guidelines.
Title: Association Between Cardiometabolic Index and Infertility among American women aged
20-45 years: A cross-sectional analysis from 2013-2020 NHANES data
Version: 0 Date: 24 Mar 2025
Reviewer's report:
I appreciate the opportunity to review the manuscript entitled “Association Between
Cardiometabolic Index and Infertility among American women aged 20-45 years: A cross-
sectional analysis from 2013-2020 NHANES data” submitted to the journal BMC Womens
Health.
Reviewer Comments:
1. What is scientific importance and interest for the readership of your results? Please clarify in
the end of the discussion or conclusion.
2. What is the clinical usage of the conclusions of your manuscript? What is the clinical
importance of your study?
3. Are there the meta-analysis which accessed the relationship between cardiometabolic risk and
infertility. Please include if available.
Taking into account the above-mentioned comments, my opinion is that this submission meets
the criteria to be published in the journal BMC Womens Health after revisions and inclusion
of the data I suggested.
Title: Global burden of metabolic disorders among women of child-bearing age, 1990- 2021:
a population-based study
Version: 0 Date: 24 Feb 2025
Reviewer:  Zaher Khazaei
Reviewer's report:
Strengths:
1. Relevance: The introduction effectively highlights the significance of maternal and neonatal
mortality as global public health issues, linking them to metabolic disorders in WCBA.
2. Current Gaps: You clearly identify the lack of research specifically targeting WCBA, which
establishes the need for your study.
3. Scope of Study: The inclusion of five major metabolic disorders (T2DM, HTN, NAFLD,
HLD, and obesity) provides a focused framework for your analysis.
4. Objectives: The aim of providing epidemiological descriptions and insights is clearly stated,
indicating the practical applications of your research.
Areas for Improvement:
1. Clarity and Conciseness: Some sentences are lengthy and could be simplified for better
readability. For example, consider breaking down complex sentences into shorter ones.
2. Flow and Transition: The transition between discussing the lack of studies and the specific
findings from Chew et al. and Zhang et al. could be smoother. Consider using transitional phrases
to connect these ideas more fluidly.
3. Citations: Ensure that all citations are formatted consistently and are up-to-date. You may
want to provide a brief context for each cited study to enhance understanding.
4. Specificity: When mentioning the increased prevalence of obesity in South Africa, it could
be beneficial to specify the percentage increase or any relevant statistics to strengthen your
argument.
5. Research Implications: You might want to elaborate on how your findings could influence
clinical practices or public health policies. This would enhance the significance of your study.
Please hyperlink this link.
See the text of the article.
Title: Can the CANKADO Online Application Improve Quality of Life Monitoring via the
Endometriosis Health Profile-30 in Endometriosis Patients? A Randomized Cohort Study on
Acceptance, Usability, and Correlations with Demographics and Media Usage
Version: 1 Date: 28 Feb 2025
Reviewer's report:
This study assessed the acceptance and usability of ePRO for HRQoL measurement in
patients with endometriosis to allow further research regarding the implementation of eHealth
applications in the clinical setting.
However,  some revisions are needed.
-Line 89: Please point out the standards of clinical diagnosis of endometriosis
-Line 89: What are acute symptoms? Please clarify.
-Please add the trial registration number and registry name. Prospective trial registration is
mandatory for RCTs under ICMJE guidelines.
-Please provide the flow diagram for the study.
-The sample size is small with a high dropout rate.
-The severity and type of endometriosis and type of treatment should be included in patients'
characteristics.
Title: Can the CANKADO Online Application Improve Quality of Life Monitoring via the
Endometriosis Health Profile-30 in Endometriosis Patients? A Randomized Cohort Study on
Acceptance, Usability, and Correlations with Demographics and Media Usage
Version: 1 Date: 03 Mar 2025
Reviewer's report:
The title of the manuscript suggested that the work addresses QoL questionnaires in
endometriosis, however it only addressed one of them (EHP-30).
There are conclusions of the work without the explanation of the methodology applied (if
implemented), for determining, for instance, difference between groups (e.g., time in doing the
questionnaires paper-based vs. on-line).
There is lack of clarity in the description of the trial design
The manuscript missed definition of important variables: "complex" vs "laborious".
I also identified typos in the manuscript and in some cases the language is not properly handled.
Finally, the CANKADO platform is not well-defined nor characterized and this is the main
objective of the work
Title: Pre-operative expectations in patients with endometriosis - A qualitative interview study
Version: 3 Date: 23 May 2024
Reviewer's report:
Dear Authors,
you present the results of a sophisticated study , which is carried out methodologically very
correctly. To my knowledge, the topic has not yet been published, so I recommend publishing
the manuscript as it is.
I just have one comment: in a qualitative study it is not usual to give standard deviations or
mean values. In this case, however, the information seems to me to be quite informative for the
understanding of the study participants involved.
Best wishes.
Title: Pre-operative expectations in patients with endometriosis - A qualitative interview study
Version: 3 Date: 28 Feb 2025
Reviewer's report:
Dear Authors,
I read your manuscript with great interest. Endometriosis is a chronic disease that has a
significant impact on women's quality of life. Painful symptoms or reduced fertility are primarily
treated with medical therapy. When medical therapy is not sufficient, surgery may help to
improve symptoms and improve fertility. However, it is important to inform patients that even
surgical treatment often does not eliminate the disease but improves the symptoms, which
however can persist.
To improve the article I suggest:
- underline the role of painful symptoms and reduced response to medical therapy as an
indication for surgery.
-underline the possible concomitant presence of adenomyosis, even in younger patients, which
often causes persistence of symptoms after surgery (could be useful this recent article: doi:
10.3390/diagnostics14212344.)
-underline the persistence of symptoms even after surgery  in presence of deep endometriosis
Best Regards
Title: A Communicative Model of Premenstrual Syndrome with Social Determinants of Health:
A Path Analysis
Version: 1 Date: 22 Mar 2025
Reviewer's report:
- Considering the significance of premenstrual syndrome (PMS) in women's lives, research in
this area is undoubtedly valuable. Your article presents new findings; however, confounding
variables such as diet, stress levels, individual anxiety, and others have not been measured or
considered in the study. How were the effects of these variables minimized in the study, and
how do you justify the impact of the omitted variables on potential bias in the results?
- Given the extensive research conducted on this syndrome in recent years, it is essential to
update the references, as nearly half of them are quite outdated. Ensuring the use of current and
relevant sources will enhance the credibility and value of the study.
Title: A Communicative Model of Premenstrual Syndrome with Social Determinants of Health:
A Path Analysis
Version: 2 Date: 08 Apr 2025
Reviewer's report:
Dear Authors,
Thank you for addressing the comments provided during the review process. The changes you
have implemented and your responses are satisfactory and reflect a thorough consideration of
the feedback.
I am optimistic that the results of this study will contribute significantly to improving the health
and well-being of women suffering from premenstrual syndrome.
Wishing you success in the dissemination of this important research.
Title: Improving cervical cancer screening participation by introducing HPV vaginal self-
sampling to women living with HIV in Denmark – a pilot study
Version: 2 Date: 21 Oct 2024
Reviewer's report:
Thank you for the opportunity to review this paper on uptake of vaginal self-sampling in women
living with HIV in Denmark. This represents an important area of study examining the uptake
of evidence into practice. Overall the study is well described.
I have some minor comments or suggestions to the author.
1. Please clearly state in the inclusion criteria that the women must be living HIV
2. Is it reported in the paper that 42%  Individuals (WLWH)  were not screened according to
WHO recommendation. Please clarify or explore if this accounts for the  57 individual excluded
from the study as being screened within 12 months (and therefore meeting guidelines but not
study criteria). Please link the results (42%) in this comment under discussion back to a table
in paper.
3. Please address the exclusion of english language only in the limitations (ie n=21 (10% overall)
were excluded from participating)
4. Please consider examining if there are differences amongst time since first screen for those
that took up HPV self-sampling in comparison to those that did not
5. Please speak to findings in relation to age in the discussion/findings/limitations. There are
very few individuals aged 25-40 included in this study which when considering the prevalence
of HPV (by age) would be important to address.
Again, thank you for the opportunity to review this paper
Title: Improving cervical cancer screening participation by introducing HPV vaginal self-
sampling to women living with HIV in Denmark – a pilot study
Version: 2 Date: 12 Jan 2025
Reviewer's report:
This is an interesting paper adressing the complaince of WLWH to Cervical cancer screening.
Nevertheless some clarification is necessary:
Text:
a) please define ethnicity.
b) please use the LAST terminoly (LSIL, HSIL, Darragh TM. The LAST Project and the
diagnostic bottom line. Cytopathology. 2015 Dec;26(6):343-5) and not  the CIN terminology).
c) The results on complaince to  self-sampling  cervical cancer screening on WLWH must be
compared to literature data on self-sampling  cervical cancer screening on the general population
(Daponte N, Valasoulis G, Michail G, Magaliou I, Daponte A-I, Garas A, Grivea I, Bogdanos
DP, Daponte A. HPV-Based Self-Sampling in Cervical Cancer Screening: An Updated Review
of the Current Evidence in the Literature. Cancers. 2023; 15(6):1669. https://doi.org/10.3390/
cancers15061669)
d) please refer to countries as "low income countries" and not as "third-world countries".
Table 1:
a)What is Danish Ethnicity and how do you evaluate that? Do you mean Nationality?
b) How many patients were on cART  (all?), if not all , please correlate that  with the HPV and
cytology findings.
Title: Improving cervical cancer screening participation by introducing HPV vaginal self-
sampling to women living with HIV in Denmark – a pilot study
Version: 2 Date: 15 Jan 2025
Reviewer's report:
In this manuscript authors aimed to estimate the proportion of Women Living with HIV
(WLWH) attending the Department of Infectious Diseases at Aarhus University Hospital,
Central Denmark Region who are not be screened for cervical cancer.
Moreover, other objectives were to evaluate the proportion of WLWH who accept to participate
to cervical cancer screening by offering a self-collection kit; to estimate the hrHPV positivity
rate and the compliance to the follow-up visit in case of positivity from vaginal self-collected
sample.
The contribution of this paper is relevant, particularly regarding the potential of self-sampling to
improve access to cervical cancer screening. The manuscript is well-organized, but some major
revisions are necessary. One of the limits of this study is the sample size. Collected data are
limited and not always can support the conclusions.
Title
I suggest describing this study as pilot study and to change the title as: Improving cervical cancer
screening participation by introducing HPV vaginal self-sampling to women living with HIV
in Denmark – a pilot study
Abstract
In the Results section of the Abstract, authors should report the absolute number in brackets
next to the relative percentage.
Methods
Did authors perform a calculation of the population size to obtain statistically significant results?
Why did the authors not use instructions for use in English? This would have allowed the
participation of 21 other patients.
Authors should implement the section regarding the pre-analytical methodology used for
the analysis of vaginal self-collected samples. In which volume was it resuspended? Which
resuspension volume was used? What was the starting volume of the sample used for the
analysis?
Results
Among the 3 women results HPV16 or HPV18 positive, how many were HPV16 and how many
HPV18? This result should be better explained in the manuscript.
Discussion
The discussion should not be divided in separate paragraphs. The first section “main findings”
seems a repetition of the results. This section could be merged with “Interpretation and
comparison with previous research”. In the discussion authors should better underline that this
is a pilot study and that the data regarding the percentage regarding the participation using self-
sampling and the compliance to the follow-up visit are related to a very few numbers of patients.
Authors should report that larger data maybe considering a multi-centre study could better
explained the preliminary data obtained in this pilot study.