JerMa88/BMC_Womens_Health_Peer_Reviews huggingface dataset:
Title: The Use of Standardised Tools to Measure Post-Mastectomy Quality of Life Among
Women in Africa: A Scoping Review
Version: 1 Date: 20 May 2025
Reviewer's report:
Overall the scoping review was thorough and systemized as possible.  Each aim/question
identified was met in the results section of the paper. However I understand that the original
intent was to aimed at young girls and women. The results only show participants ranging from
18-85 years old. In the background section of the paper, I did not see a definition for young girls
nor any prevalence of breast cancer in this age group.
Girl is included in the overall search terms for review  and seems to be correct but not noted in
the limitations of the study.  This may make the title misleading.
Title: The Use of Standardised Tools to Measure Post-Mastectomy Quality of Life Among
Women in Africa: A Scoping Review
Version: 2 Date: 28 May 2025
Reviewer:  Anne Katrine Hartmann Søby
Reviewer's report:
Thank you for the revised well-written manuscript.
A few comments still, which are shown in the attached doc., concerning:
Background:
- Much interesting information. However, seems like going in circles somewhere. Also, to me,
the link to QoL post-mastectomy from some of the points is missing.
Method:
- when was the search conducted (and updated?)?
- How was the Mixed Methods Appraisal Tool (MMAT) used to guide the selection of relevant
studies?
Discussion:
- It is stated that "Variation in sample size, ranging from 30 to 1,476 participants, affects
study reliability and generalisability". Is this so? How about the fact that both qualitative and
quantitative studies are included? Are small sample sizes necessarily a threat to the quality of
the study in qualitative research?
Title: Home birth and its associated factors among mothers aged 15–49 years in Somalia: A
nationwide population-based cross-sectional study
Version: 1 Date: 09 Sep 2024
Reviewer:  Monica Ewomazino Akokuwebe
Reviewer's report:
Dear Authors, Thank you for your concerted efforts in your research. To the best of my
knowledge, the authors addressed all reviewer comments adequately. The references were up-
to-date about the study topics, and I am satisfied with the clean copy of the manuscript.
I recommend the paper for acceptance.
Sincerely,
Reviewer
Title: Home birth and its associated factors among mothers aged 15–49 years in Somalia: A
nationwide population-based cross-sectional study
Version: 2 Date: 27 Jan 2025
Reviewer's report:
PEER REVIEWER ASSESSMENTS:
OBJECTIVE - Full research articles: is there a clear objective that addresses one or several
testable research questions? (Brief or other article types: is there a clear objective?)
Yes - there is a clear objective
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for
the objective?
Yes - the approach is appropriate
EXECUTION - Are the experiments and analyses performed with sufficient technical rigor to
allow confidence in the results?
Yes - experiments and analyses were performed appropriately
STATISTICS - Is the use of statistics in the manuscript appropriate?
Yes - appropriate statistical analyses have been used in the study
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not
overstated?
Yes - the author's interpretation is reasonable
OVERALL MANUSCRIPT POTENTIAL - Has the author addressed your concerns sufficiently
for you to now recommend the work as a technically sound contribution? If not, can further
revisions be made to make the work technically sound?
Yes - current version is technically sound
PEER REVIEWER COMMENTS:
GENERAL COMMENTS: I am satisfied with the revisions. I recommend the manuscript for
acceptance .
Thank you
Title: Is Hypertension Negatively Associated with Memory Performance in Women During
Climacteric? A Systematic Review
Version: 1 Date: 08 Aug 2024
Reviewer's report:
The authors sought to know if association between hypertension and memory performance
exists in  middle-aged women. They included three longitudinal studies with one cross-sectional
study. I believe that cross-sectional study is very poor to address the association between two
variables. Furthermore, sever heterogenity existed between the studies. I don't think that this
review provides any thing new to the literature.
Title: Is Hypertension Negatively Associated with Memory Performance in Women During
Climacteric? A Systematic Review
Version: 2 Date: 09 Sep 2024
Reviewer:  Ananthan Ambikairajah
Reviewer's report:
The authors have made some progress in addressing the comments made in the initial review.
However, further justification regarding the methods and explanation of results is required.
- Updating the word association to effect is not appropriate, as the analyses are not causal. The
initial comment was not in relation to the word used, but rather the fact that the direction of
the association (i.e. positive vs negative) requires clarification. Please re-vise to use the word
association and use the above to clarify the response. The current wording of "detrimental effect"
infers causality, which is beyond the scope of what this study investigated.
- If the authors agree that the exclusion of studies with male participants was not optimal, it
is not appropriate to just list this in the limitations. Instead, the search needs to be re-run and
updated to ensure the women that should be included in the study are included, and analyses
accurately reflects this.
- The retrospective definition of middle age for eligibility criteria does not align with the pre-
registered prospero protocol
- As noted in Ambikairajah, A., Walsh, E., & Cherbuin, N. (2022). A review of menopause
nomenclature. Reproductive health, 19(1), 29. The STRAW 2001 criteria states "...that the terms
perimenopause and climacteric should be synonymous in meaning and used with patients or
the public, but not in scientific papers, in accordance with the WHO recommendations." Could
the authors clarify why they did not adhere to these international recommendations by placing
"Climacteric" as a Subject Heading, rather than perimenopause, in addition to their discussion
of the topic throughout the manuscript?
- It is still not clear to me why premenopausal women are excluded. Given the age
range specified, this would include premenopausal women, perimenopausal women and
postmenoapusal women. If the focus is on perimenopause then age should not be the criteria
used to include/exclude participants, given the stages of reproductive ageing vary between
participants
Title: Is Hypertension Negatively Associated with Memory Performance in Women During
Climacteric? A Systematic Review
Version: 3 Date: 29 Oct 2024
Reviewer:  Ananthan Ambikairajah
Reviewer's report:
- The authors note that there are discrepancies between what is listed in the PROSPERO pre-
registration and the manuscript. However, the manuscript does not transparently describe the
deviations that occurred from the PROSPERO registration. It is important to note what changes
were made after the pre-registration was lodged, rather than stating the review was "registered
in the PROSPERO database".
- Regarding menopause nomenclature, whilst it is understandable for the search string to include
the term climacteric, given its historical use, the current paper should adhere to the most recent
guidelines regarding the use of the term in scientific papers.
Title: Demographic, Socioeconomic and Functional Health-Related Factors in the selection of
vaginal pessaries used for the conservative treatment of pelvic organ prolapse: a retrospective
study
Version: 1 Date: 05 Oct 2023
Reviewer's report:
The authors  did a retrospective study. they compared patients with genital prolaps under
conservative treatment. They compared 73 patients who used a daily control pessary with 42
patients who used a long term pessary.  Both groups are significantly different in multiple
parameters
For me the issue of  this study is not clear.
the first choice in conservative treatment is a daily control pessary.  ONly patients who are not
able to  put the pessary in and out  are treated with a long term pessary.  It is obvious that these
two groups must be different.
1. If it is not the choice of the patient, can we talk about patients preference ?
2. the differences in age, poor general condition, fertility status, marital status, emploiment
status, physical skills etc are  the confirmation, that these patients had no other choice than a
long term pessary.
Also in the discussion the topic of this study remains unclear.
Title: Demographic, Socioeconomic and Functional Health-Related Factors in the selection of
vaginal pessaries used for the conservative treatment of pelvic organ prolapse: a retrospective
study
Version: 3 Date: 22 Sep 2024
Reviewer's report:
Title: Demographic, Socioeconomic and Functional Health-Related Factors in the selection of
vaginal pessaries used for the conservative treatment of pelvic organ prolapse: a retrospective
study
Introduction Summary: Pessary therapy is very individual, long term and daily control pessaries
are being chosen as a result of many different factors
Novelty: not given
Methodology: well written
Presentation: well written
Hypothesis: not defined
Null hypothesis: not defined
Population: not described
Study Design: retrospective
Inclusion Criteria: not defined
Exclusion Criteria: not defined
Primary outcome: not defined
Secondary outcomes: not defined
Data Collected: patients’ age, education level, employment, fertility and marital status,
independence, hand function, vision, mobility, physical activity (VAS 0–10), and sexual activity
were all different
Statistics: student t-test and Pearson's chi-square
Results: age, fertility, employment, marital, educational, weakened hand function, vision,
reduced mobility, sexual activity ration
Conclusions: choice of pessary type is influenced by multiple aspects.
Questions/comments for the Authors:
The article “Demographic, Socioeconomic and Functional Health-Related Factors in the
selection of vaginal pessaries used for the conservative treatment of pelvic organ prolapse: a
retrospective study” is an interesting manuscript. I have the following comments:
1. You need to be able to use a cube. Therefore, it is reasonable, that these women are younger.
Usually they get a recommendation to use a cube. So how is this unexpected?
2. Are there really 100 different surgical options to treat pelvic organ prolapse?
3. You are analyzing conservative treatment, so why are you mentioning so many surgical
options?
4. A lot of your results are expected. So what is new in your study?
5. Inclusion and exclusion criteria have not been described.
Title: Demographic, Socioeconomic and Functional Health-Related Factors in the selection of
vaginal pessaries used for the conservative treatment of pelvic organ prolapse: a retrospective
study
Version: 4 Date: 21 May 2025
Reviewer's report:
PEER REVIEWER ASSESSMENTS:
OBJECTIVE - Full research articles: is there a clear objective that addresses one or several
testable research questions? (Brief or other article types: is there a clear objective?)
Yes - there is a clear objective
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for
the objective?
Yes - the approach is appropriate
EXECUTION - Are the experiments and analyses performed with sufficient technical rigor to
allow confidence in the results?
Yes - experiments and analyses were performed appropriately
STATISTICS - Is the use of statistics in the manuscript appropriate?
Yes - appropriate statistical analyses have been used in the study
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not
overstated?
Yes - the author's interpretation is reasonable
OVERALL MANUSCRIPT POTENTIAL - Has the author addressed your concerns sufficiently
for you to now recommend the work as a technically sound contribution? If not, can further
revisions be made to make the work technically sound?
Yes - current version is technically sound
PEER REVIEWER COMMENTS:
GENERAL COMMENTS: I carefully evaluated the revised version of this manuscript.
The authors have performed the required changes, improving significantly the quality of the
paper.
ADDITIONAL REQUESTS/SUGGESTIONS:
I do not have further concerns.
Title: Prevalence, Safety Evidence, and Determinants of Medicine Use during Breastfeeding
among Women in Kampala, Uganda
Version: 2 Date: 21 May 2025
Reviewer:  Collins Ouma
Reviewer's report:
This is an important, timely, and well-designed study that addresses a notable gap in knowledge
regarding medicine use during breastfeeding in a low-resource setting. The manuscript
is comprehensive and provides useful insights into prevalence, safety classifications, and
associated factors influencing medication use. It also evaluates the risks using pharmacological
safety references, which adds scientific robustness.
However, a few critical and minor revisions would significantly strengthen the paper. Below is
a structured review based on key manuscript sections.
Major Comments
1. Clarify in the Introduction how this study adds to existing evidence (e.g., comparison to other
LMICs or recent WHO guidance).
2. The method of determining RID and classifying safety could be clearer.
3. In addition, include formulae and define thresholds from Hale’s and LactMed. Clarify how
herbs were categorized. Discuss how recall bias was minimized and whether prescriptions were
verified.
4. In the results, emphasize and interpret the finding that 67% obtained medicines without
prescription.
5. In addition, improve figure legends and integrate visual summaries like heatmaps or stacked
bars.
6. In the Discussion section, caution is needed in interpreting associations (e.g., education level
and medicine use). In addition, avoid repeating points. Consider a short sub-section summarizing
public health implications.
7. Expand on the limitation regarding theoretical RID and lack of pharmacokinetic confirmation.
8. Add commentary on use of self-reported data and implications.
9. There are grammatical and formatting issues. Apply professional language editing and use
consistent past tense.
Minor Comments
- Abstract: Add sample size early and define 'self-prescribed'.
- Figures: Reorder and label Figure 2 for better context.
- Supplementary Table 3: Ensure proper citation and clarify classification of herbal medicines.
- References: Ensure formatting consistency, especially in-text citations.
Title: Prevalence, Safety Evidence, and Determinants of Medicine Use during Breastfeeding
among Women in Kampala, Uganda
Version: 2 Date: 26 May 2025
Reviewer's report:
Well written article!
I notice inconsistencies in text (Medical history, social history and HIV/AIDS) in Table 1.
In Table 1, the co-morbidities do not seem to add up to 100%; did the authors miss a "No" in
the table?
I notice the social history has "Alcohol intake" and "Smoking"? Is this current status or from the
past? I assume this is current status, which makes the "Social history" label probably confusing.
Relatedly, I don't know if the authors considered history of smoking or drinking as a factor...
perhaps, not.
Do we know the proportion of those with chronic comorbidities, including HIV are on any
medicines for their comorbidities?
In Table 2, should the denominator for non-HIV comorbid be 23 (from Table 1) and not 27?
Also, why is the denominator for the "No" under non-HIV comorbid 267?  My thinking (and it
may not necessarily be right) is that if you are considering non-HIV comorbidities, then do not
have them in the denominator for the "No" group too; in which case your denominator shouldn't
include them altogether.
You do not report a non-response (did I miss it?) but suddenly report a lower N without any
reason to back it up.
Just wondering if the EBF numbers is related with the HIV positivity among the participants.
Title: Prevalence, Safety Evidence, and Determinants of Medicine Use during Breastfeeding
among Women in Kampala, Uganda
Version: 2 Date: 28 May 2025
Reviewer's report:
This is a well written and informative study. There are a few issues that the authors should
address.
1. Lines 95-97: The first part of this statement is not clear: Influence of medication use on what?
Additionally, it does not match the statement of the aim of study presented in lines 100-101.
2. Lines 112-115: Are the researchers concerned that this level of support to study participants
can be construed by others as incentivization?
3. Lines 137-139: Are the researchers concerned that translation of the questionnaire by research
assistants as they administered the questionnaire could be problematic? Why did the researchers
translate the questionnaire into Luganda?
4. Line 156: It would be great to see the syntax or code for the modified Poisson model. This
is especially important because we are talking about a matter/variable, medicine use by breast-
feeding mothers, that is less likely to follow a Poisson distribution.
5. Lines 159-162: How did the authors arrive at this set of factors out of the potential pool of
factors associated with medication use?
6. Lines 176-177: This statement is not clear.
7. Line 191: The reported prevalence of 78.9% is inconsistent with how prevalence was defined
in this study: mothers actively using medication at recruitment into the study.
8. Figure 1: Some text In Figure 1 are obscured.
9. What is the interpretation of the results on medication use as a function of acute vs chronic
medical conditions.
10. Line 273: Could what manifests as the effect of education be that of socioeconomic status,
driven with the role of education in improving economic status of individuals?
11: 275-284: The place of exclusive breastfeeding in this study is not clear. The authors must
find a clear motivation for it.
Title: Prevalence, Safety Evidence, and Determinants of Medicine Use during Breastfeeding
among Women in Kampala, Uganda
Version: 2 Date: 02 Jun 2025
Reviewer's report:
GENERAL COMMENTS:
This study tackles a very important area and contributes new knowledge in understanding safety
of medicines in breastfeeding women.
ABSTRACT
The abstract is well written
The study aims in abstract in Line 23-25, in line 95-97 in the introduction and line 100-101 in
the materials and methods should be consistent throughout.
DISCUSSION
Line 285-290: Where do the participants obtained the medications without prescriptions? Is
self-medication practice and unregulated medication use among breastfeeding women used
interchangeably or are different? If they are different please provide a context in the case of
Uganda.
What was the source of information from this study that guided their the self medication practice?
Do you have any suggestions in terms of policy recommendations in the light of these results?
Include the relevant strengths and limitation this section
CONCLUSION
Include your policy recommendations to specific ministries or departments in Uganda
Line 387: Consent to participate to read Informed consent to participate
Line 388-389: How was informed consent obtained from participants? please show that is is a
process in the explanation.
Title: Prevalence, Safety Evidence, and Determinants of Medicine Use during Breastfeeding
among Women in Kampala, Uganda
Version: 4 Date: 24 Jun 2025
Reviewer's report:
Manuscript Number: Submission ID: e4bb3e86-5524-423d-9e1e-5c09568879c3
Title: Prevalence, Safety Evidence, and Determinants of Medicine Use during Breastfeeding
among Women in Kampala, Uganda
General comments
The authors have largely addressed the comments in the initial review, which has improved
the quality of the manuscript. There are just a few outstanding observations for the authors to
address.
Comments:
Study design and setting
Lines 122-123: The revised statement that “the study population included breastfeeding women
aged 18 years and older, regardless of HIV status”, is inconsistent with how the study population
is defined under the subsection of "eligibility and recruitment" (lines 154-155). The authors need
to revise and harmonize the study population to uphold consistency.
Eligibility and recruitment
The authors have provided additional details regarding the determination of the sample size.
However, it remains unclear how the number of participants recruited from each facility was
determined out of the total of 294. Was any proportionality used?
Statistical analysis
In their response, the authors assert in the manuscript that descriptive statistics – including
means and medians – were used to summarize participants’ characteristics. However, there
are no corresponding mean or median values presented in the results, rendering this statement
somewhat out of context. At the very least, the authors could have provided the mean or median
ages of the infants and their mothers.
Results
Lines 250-253: The revised statement about the HIV prevalence is that “Of the 294 participants,
116 (39.5%) were living with HIV/AIDS. This high proportion likely reflects the characteristics
of the study sites, as data were collected from urban health facilities that provide integrated
maternal and HIV services, as presented in Table 1 under demographic characteristics.”
However, this result presentation with regard to HIV status still beckons some concerns.
• Would it be correct to assume that all the participants from IDI (a purely HIV services clinic)
were living with HIV? If so, then this would be an outlier in estimating the prevalence of HIV
among the participants in this study.
• The authors should provide a detailed breakdown of the number of participants recruited from
each site, with particular emphasis on the number recruited from the IDI, which is solely an
HIV services clinic.
• What is the proportion of the participants from the other sites other than IDI who were also
living with HIV/AIDS? Providing disaggregated results by site would enhance the appreciation
of the findings with regard to HIV status.