JerMa88/BMC_Womens_Health_Peer_Reviews huggingface dataset:
Title: Rationality of FIGO 2018 IIIC cervical cancer according to local tumor and pelvic lymph
node metastatic extent--A cohort study
Version: 2 Date: 27 May 2024
Reviewer:  Kailash Narayan
Reviewer's report:
Rationality of FIGO 2018 IIIC cervical cancer according to local tumor and pelvic lymph node
metastatic extent--A cohort study
At first glance this looks like an interesting manuscript. Their conclusion… “Patients with stage
IIIC1p showed variable prognoses dependent on local tumor size and the extent of pelvic lymph
node metastases” appears reasonable and correct.
I say this despite problem with patient selection, since patients treated with surgery will have
their pathology report is available, the tumour size and nodal information can be accurately
assessed irrespective of patient selection. However, clinical assessment of tumour size and
nodal information would be variable. It is not clear from the manuscript as to how the size of
primary tumour was assessed in 884 patients treated by primary CCRT (Fig 1). How were the
nodes assessed in these patients? Unless prospectively planned, even the tumour size by clinical
examination is usually not recoded in patients if during pelvic examination a patient is deemed
to be (old stage) 2b or more, since the tumour size was not a part of old FIGO staging system
in patients having stage 2b or more primary.
Throughout the manuscript <4 or > 4cm primary is talked about, it should be mentioned how
was this measurement made in all 884 patients?
In radiotherapy treatment arm, stage 2018 IIIb, estimation of tumour size and  absence of node
positivity based on CT scan alone could be limited.
It is also not clear if PA nodes were evaluated in all surgical and radiotherapy treated patients.
Histological grade and SCC antigen are not related to FIGO IIIC staging question and can be
removed to provide clarity of the central theme of the manuscript.
I think there is some very useful information available in this dataset provided uncertain data and
secondary information is removed. A useful study can be crafted around the result as mentioned
in the conclusion “Patients with stage IIIC1p showed variable prognoses dependent on local
tumor size and the extent of pelvic lymph node metastases”.
For this you should only include surgically staged patients where tumour size and nodal
information is available. Exclude radiotherapy treated patients. Also exclude patients with para-
aortic disease and confine the study to FIGO stage 3C1 group. Even in this group lost to to
follow up (38) patients is not ideal but the remaining patients by providing accurate information
would still be interesting. You can include 39 patients treated with neoadjuvant chemotherapy
since these were node positive on pathology examination.
Title: Rationality of FIGO 2018 IIIC cervical cancer according to local tumor and pelvic lymph
node metastatic extent--A cohort study
Version: 3 Date: 11 Jul 2024
Reviewer:  Kailash Narayan
Reviewer's report:
Please address the following points and suggestions.
1) you mentioned..."Magnetic Resonance Imaging (MRI)imaging examinations were combined
for staging. Tumor size of patients in this group was also recorded according to the clinical
palpation and measurement by MRI."   Does it mean that not all patients had MRI? if all patients
had MRI where was the need to include  or even mention the measurement by clinical method.
2) MRI detected nodes do not co-relate 100% with pathology. Reactive changes and
inflammatory changes can also lead to  slightly enlarged nodes . Also , many MRI machines
may not be able to image abdominal nodes well.
Suggestion: I still feel by using non-surgical patients you may be spoiling the importance of
this otherwise a very good paper, if limited to patients treated by primary surgery. You will also
notice that if you take operable 3C1 (old stage 1 and 2A with positive nodes) they will have
much better survival then FIGO stage (2018) 3B .
Title: Rationality of FIGO 2018 IIIC cervical cancer according to local tumor and pelvic lymph
node metastatic extent--A cohort study
Version: 3 Date: 31 Aug 2024
Reviewer's report:
I believe that you have added experimental data and made the content. My questions have been
answered and my remarks have been appropriately addressed. Thank you for the valuable peer
review opportunity.
Title: Rationality of FIGO 2018 IIIC cervical cancer according to local tumor and pelvic lymph
node metastatic extent--A cohort study
Version: 4 Date: 28 Mar 2025
Reviewer's report:
PEER REVIEWER ASSESSMENTS:
OBJECTIVE - Full research articles: is there a clear objective that addresses a testable research
question(s) (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 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 - Is the current version of this work technically
sound? If not, can revisions be made to make the work technically sound?
Yes - current version is technically sound
PEER REVIEWER COMMENTS:
GENERAL COMMENTS: The authors did a good job responding to the comments raised by
the reviewers.  While the authors did not agree with a comment of a reviewer, their response
is adequate and scientifically correct. The study met best practices of clinical and scientific
research.
The FIGO staging for cervical cancer is valid and reliable for predicting survival and prognosis.
Findings from this study could be applicable to clinical research in other countries that may relay
on FIGO staging for predicting cervical cancer prognosis and survival.
Title: Diaphragmatic Endometriosis Associated with Pelvic Endometriosis: A Case Report
Version: 0 Date: 23 Mar 2024
Reviewer's report:
the paper is well conducted and written but is more a generic description of the problem with a
general overview of the diseases than a paper focused on diaphramatic endometriosis.
In my opinion it does add much to the literature.
It can be published in case report journal with  more complete description of the technique used
for the resection.
Images quality id too low
Title: Diaphragmatic Endometriosis Associated with Pelvic Endometriosis: A Case Report
Version: 1 Date: 03 Aug 2024
Reviewer's report:
Dear authors,
I read your manuscript with great interest.
Thoracic endometriosis is very rare, and is often a spread of pelvic endometriosis. The
manuscript is well written and may be interesting to readers.
To improve the manuscript, I suggest:
-underline the  role of symtoms to suspect and detect endometriosis. In your case the presence
or absence of pelvic symptoms, in particular dysmenorrhea, due to the ongoing therapy,  (this
recent article might be useful to add, doi: 10.3390/jcm12175624.)
- add a recent reference on prevalence of endometriosis in adolescents/young  women
- add a flow-chart to manage a suspect case of thoracic endometriosis
Best Regards
Title: Diaphragmatic Endometriosis Associated with Pelvic Endometriosis: A Case Report
Version: 1 Date: 18 Aug 2024
Reviewer:  Antoine Naem
Reviewer's report:
The authors reported the case of a 22-year-old patient who was diagnosed with diaphragmatic
endometriosis incidentally. The case is typical for diaphragmatic endometriosis since it is almost
always diagnosed intraoperatively in asymptomatic patients. This report has several limitations:
1) Endometriosis should be defined as endometrial-like glands and stroma throughout the text.
The term "endometrial glands" is incorrect.
2) The authors confused thoracic endometriosis (endometriosis of the diaphragmatic, parietal,
and visceral pleura) with diaphragmatic endometriosis (endometriosis of the visceral part of the
diaphragm). Those are two different entities that could be related, but the introduction focuses
on thoracic endometriosis while the report is about diaphragmatic endometriosis.
3) The authors failed to report whether the patient had preoperative symptoms of diaphragmatic
endometriosis. If the patient did not report symptoms of endometriosis of the diaphragm, then the
surgery was not necessary, especially since the patient developed postoperative pain. However,
it is unclear whether this pain is related to diaphragmatic endometriosis or cholecystectomy.
4) The steps of the surgical procedure are not described. It is unclear whether the authors
mobilized the liver, performed peritonectomy of the diaphragm, or full-thickness resection of
the diaphragm. It is also unclear whether the thoracic cavity was inspected intraoperatively and
whether the magnetic resonance imaging revealed intrathoracic endometriosis.
For these reasons, I believe this paper should not be published.
Title: Diaphragmatic Endometriosis Associated with Pelvic Endometriosis: A Case Report
Version: 1 Date: 25 Mar 2025
Reviewer's report:
This manuscript reported the case of diaphragmatic endometriosis associated with pelvic
endometriosis. The authors revised the manuscript precisely in response to the initial reviewer’s
comments. Please correct the following.
#Line 207-216: this statement is not essential because it merely explains the general hormonal
therapies for endometriosis. Please remove this part.
Title: The Effect of Menstrual Cycle on Inter-Joint Coordination Variability during Roundhouse
Kicks in Taekwondo
Version: 2 Date: 03 Feb 2025
Reviewer's report:
Thank you to the authors for the careful revision. Since the author's data presentation is not very
comprehensive, I have two final suggestions:
1. I hope the authors can provide the original lower limb joint angle curves, rather than just
the CRP and CRPV graphs. Sometimes, comparing the original data can make the results more
intuitive.
2. I suggest that the authors include standard deviation in the figures, as this would make the
visual representation more rigorous.
Title: The Effect of Menstrual Cycle on Inter-Joint Coordination Variability during Roundhouse
Kicks in Taekwondo
Version: 2 Date: 09 Feb 2025
Reviewer's report:
BMC Women's Health
The Effect of Menstrual Cycle on Inter-Joint Coordination Variability during Roundhouse Kicks
in Taekwondo
Reviewer's Comments on the resubmitted manuscript
In the resubmitted version of manuscript, the author(s) addressed adequately most of the topics
raised in the initial round of review. However, there are still some topics to be resolved.
Comments
• L94-96: provide reference(s) for this statement.
• LL151-156: despite a self-selected kicking speed was instructed to the participants, they had
also to equally divide the timing of the separate kicking phase. This is an ambiguous instruction.
Are there scientific reports providing evidence that at self-selected kicking speed the duration
of the separate phases is equally distributed in the total duration of the kick?
• LL158-159: to secure clarity, it is recommended to use “kicking leg” and “stance leg” rather
than dominant/non dominant leg. Check throughout the text.
• L196, LL201-203, Table 1: provide the results for F and the effect size = this comment referred
to the repeated measures ANOVA, not the SPM analysis.
• LL196-197: specify the assumption criteria that were met to run the SPM1d analysis.
• L199: provide the Matlab version and manufacturer details.
• L215: “non-significant” instead of “noteworthy”.
• L298: insert your reply to the reviewer’s comments about the absence of data for balance, joint
ROM tests and clinical knee stability tests in each menstrual cycle phase.
• LL294-296: this statement is rather speculative unless scientific evidence will be provided
regarding the relationship between age and stable menstrual cycle.
• Check the abbreviated journal titles (i.e., #7, #13, #27, #31, etc.) and correct to Human Kinetics
in L436.
Title: The Effect of Menstrual Cycle on Inter-Joint Coordination Variability during Roundhouse
Kicks in Taekwondo
Version: 3 Date: 26 Mar 2025
Reviewer's report:
BMC Women's Health
The Effect of Menstrual Cycle on Inter-Joint Coordination Variability during Roundhouse Kicks
in Taekwondo
Reviewer's Comments on the 2nd resubmitted manuscript
In the resubmitted version of manuscript, the author(s) improved further the quality of the text.
Some final comments are provided below.
Comments
• LL151-156: the rationale of providing the definition of the phases is adequately stated in the
response to the Reviewer and it is recommended that it should be embedded in the manuscript.
• L196: state the metric of the effect size for the repeated measures ANOVA that is provided
in Table 1.
• L200: check homogeneity of variance or equality of variance (https://spm1d.org/
NewFeatures.html)?
• LL221-223: it is recommended to rephrase; non-significant is mentioned twice.
• L351: please check the abbreviated journal title
• L353: delete “and” in the abbreviated journal title
• L371: please check the abbreviated journal title
• L378: please correct the typing error
• L391: delete “January”
• LL428-429: ref #37; please check as not all citation data are provided.
• L452: Human Kinetics was not corrected.
Title: Diagnostic gaps in vulvar diseases from referral to final diagnosis in a specialized center:
Analysis of pathways and recommendations for enhancing future diagnostic accuracy
Version: 1 Date: 30 Jan 2025
Reviewer's report:
1. The study compares suspected and final diagnoses, but it is unclear what specific criteria were
used to determine the final diagnosis for each condition. Providing a more detailed explanation
of the diagnostic process for key conditions (e.g., vulvodynia, eczema, lichen sclerosus) would
enhance the study's transparency and reproducibility.
2. Since dermatologists had a much higher diagnostic accuracy than gynecologists (83.3% vs.
36.1%), could this be due to a referral bias? Dermatologists might only refer cases they are
uncertain about, whereas gynecologists refer a broader range of cases. Discussing this potential
limitation would strengthen the interpretation of findings.
3. The study highlights long delays in diagnosis for some conditions (e.g., lichen sclerosus:
71.1 ± 92.9 months). However, the discussion does not fully explore the clinical consequences
of these delays, such as disease progression, impact on quality of life, or treatment outcomes.
Expanding on this would emphasize the urgency of improving diagnostic strategies.
4. The conclusion calls for standardized diagnostic methods, but the study does not specify what
an improved diagnostic protocol might look like. It would be beneficial to suggest concrete steps
for standardization, such as specific diagnostic algorithms, training for referring physicians, or
guidelines for when to perform a biopsy or cotton-swab test.
5. The manuscript presents a range of statistical comparisons (e.g., matching rates, time
intervals), but the statistical methods used to analyze these data are not explicitly described.
Were any statistical tests performed to compare diagnostic accuracy between specialties or to
analyze factors influencing diagnostic latency? Including this information would improve the
rigor of the study.
Title: Diagnostic gaps in vulvar diseases from referral to final diagnosis in a specialized center:
Analysis of pathways and recommendations for enhancing future diagnostic accuracy
Version: 2 Date: 06 Mar 2025
Reviewer's report:
Dear authors,
Thank you for this study. It is important that clinicians be aware of  possible shortcomings
of their knowledge when seeing patients with vulvar complaints.  This manuscript can help in
raising awareness and be an incentive to improve ones knowledge on the topic of vulvar disease.
I see that the manuscript has already been reviewed and revised. It has been sent to me without
a specific question so I will state my major concerns regarding your manuscript:
- I agree with the concerns already stated by the previous reviewer #2  including, potential
referral bias differences between gynecologists and dermatologists. This is still a concern in the
revised manuscript.
- also, the small number of cases that were referrals from dermatologists makes a statistical
comparison limited. The vast majority of cases came from gynecologists.
- the discussion section is rather lengthy,  and could be better structured in accordance with the
aim of the study as described in the introduction (lines 63-68)
- the final conclusion is well-stated and to the point!
Title: Bladder Erosion and Stone Formation: A Rare Complication of Laparoscopic Cervical
Cerclage
Version: 1 Date: 22 May 2024
Reviewer:  Adel Elatreisy
Reviewer's report:
I have identified several areas that would benefit from significant improvement:
1. Redundancy is present in the definition of cervical cerclage in the background.
2. The manuscript contains numerous grammar, spelling, and punctuation errors that require
attention. Accordingly, it should undergo a comprehensive English editing process.
3. The conclusion in the abstract requires improvement.
4. Following an exhaustive literature review, it is recommended that the number of published
cases with the same complication be stated and a table of published cases provided.
5. Please consider using more professional urological terminology, such as "painful micturition"
instead of "stinging urination."
6. There is no benefit in mentioning routine, irrelevant lab work.
7. The discussion would benefit from being rephrased more professionally.
8. The conclusion should be rephrased to be more specific and concise.
Title: Bladder Erosion and Stone Formation: A Rare Complication of Laparoscopic Cervical
Cerclage
Version: 1 Date: 14 Aug 2024
Reviewer's report:
Congratulation for this submitting this case report .
Some questions :
- why do laparoscopy ? Instead of  cystoscopy + laser fragmentation ?
- during cystoscopy, can author identify both ureter  orificium ?
What is the noveltiea from this case report?
Title: Bladder Erosion and Stone Formation: A Rare Complication of Laparoscopic Cervical
Cerclage
Version: 4 Date: 08 Sep 2024
Reviewer:  Adel Elatreisy
Reviewer's report:
please correct your definition to cervical cerclage in the first line in abstract:Background:
Cervical cerclage is cervical insufficiency and effective way.
for example you can change as follows:
Cervical cerclage represents a practical approach to addressing cervical insufficiency.
Title: Motherhood role concerns in young women with breast cancer: A mixed-methods study
Version: 1 Date: 14 Apr 2025
Reviewer's report:
Introduction
1. The rationale for employing a mixed-methods approach is not sufficiently justified. Please
provide stronger evidence or theoretical reasoning for why both qualitative and quantitative
methods were necessary for this study.
Methods
1. Participants and Recruitment – The study appears to have primarily followed a qualitative
research procedure, with quantitative results serving only as supplementary support. This seems
to stem from the lack of a clear rationale for the mixed-methods design. Please clarify the
justification for adopting this approach.
2. Please describe any efforts the authors made to enhance reflexivity in the study.
Results
1. There is an imbalance between the quantitative and qualitative findings. To better leverage
the quantitative data, consider adding results that show differences in PCQ scores across
demographic characteristics (e.g., TNM stage, number of children).
Discussion
1. While the discussion includes comparisons with prior studies, it lacks integration of the
qualitative and quantitative findings. Please add content that interprets the results in an integrated
manner, highlighting how the two data sources complement each other.
Title: Women’s experiences of life and healthcare after levator ani avulsion: a qualitative
interview study
Version: 2 Date: 07 Apr 2025
Reviewer's report:
Thank you for undertaking this important research. It is a clear area requiring action and service
development and your work will help to shine a light on it using the service user lived experience.
I have minor comments to consider:
1. BMI is abbreviated from first mention, please write body mass index out in full on first
mention and abbreviate in brackets.
2. Remove the Aim section, you already mention the study aim at the end of the intro, the
duplication is not necessary
3. Text formatting is variable in places, e.g. in table 1 text size changes in different cells. I know
this will be picked up at copy editing stage but I think authors should endeavour to have the
manuscript in good format on submission
4. Under theme 2, under Physical and mental well-being, reference to the first period after birth
is confusing as it may lead the reader to think you are meaning the return of the first menstrual
period after birth. Please rephrase to something like "...it emerged that the initial time period
after childbirth...."
Again later down consider "For some, it was emotionally difficult to talk about this time
period...." and ...."it emerged that the initial time period after childbirth....."
Page 14, Consider referring to bowel emptying issues rather than bowel movement issues.
P22 - "As previously mentioned....about muscles among midwives" - what muscles? Please
specify pelvic floor muscles if this is what you mean.
P26 - discussion - ...>"how to be physically active, concern about pelvic floor symptoms...."
remove the ed from concerned and make it concern to correct tense
P28 - middle section...".....the women were open to talking about their problems"
add ing to talk to make the tense appropriate
P29 - ".....The regions are recommended to develop guidelines on...."
add "on" to the sentence
P29 last line - ..."promote and adapt physical exercise, and provide advice"
add and to sentence as above
Title: Women’s experiences of life and healthcare after levator ani avulsion: a qualitative
interview study
Version: 2 Date: 07 Apr 2025
Reviewer:  Emilia Rotstein
Reviewer's report:
Thank you for this manuscript on a clinically very relevant topic. The approach and focus om
patients' experiences is very valuable and neglected to a great extent in this field of research.
Please see the attached file for specific comments.