JerMa88/BMC_Womens_Health_Peer_Reviews huggingface dataset:
Title: Development and Validation of an Artificial Intelligence Model for Predicting De Novo
Distant Bone Metastasis in Breast Cancer: A Dual-Center Study
Version: 1 Date: 19 Jun 2024
Reviewer's report:
1. Make sure interpretation of Spearman correlation is consistent. Some parts high correlation
noted but no explanation of cut-off values or rationale. Clarify this better.
2. You mention LASSO regression for feature selection. Better to include more details on why
choose certain lambda and how determined. Also, mention any overfitting concerns due to this
choice.
3. ROC curves in Figure 3 can be better with different colors for cohorts. It will help to
differentiate and clear. Add confidence intervals as shaded areas around ROC curves to show
variability.
4. Make sure terminology for biomarkers and statistical terms is consistent. Use either "CEA"
or "Carcinoembryonic Antigen" throughout text. Define abbreviations at first use and use
consistently.
5. Manuscript provides validation using internal and external cohorts. Explain why these cohorts
were chosen and how characteristics ensure robust validation. Discuss limitations of not having
diverse external validation set.
6.  Conclusion states model shows high accuracy, but also address limitations or uncertainties.
Include comparison with existing models and discuss real-world applicability challenges.
7. In discussing machine learning models, consider referencing the study "XGBoost-
aided prediction of lip prominence based on hard-tissue measurements and demographic
characteristics in an Asian population." This paper provides an excellent example of using
XGBoost for predictive modeling with demographic and clinical data, which is closely related
to your work. It could add valuable context and support your methodology.
Title: Development and Validation of an Artificial Intelligence Model for Predicting De Novo
Distant Bone Metastasis in Breast Cancer: A Dual-Center Study
Version: 2 Date: 09 Jul 2024
Reviewer's report:
After reviewing the revised manuscript, I am pleased with the significant improvements made.
The authors have effectively addressed the previous concerns, enhancing the overall quality and
ensuring it meets publication standards. I fully support its publication and look forward to its
contribution to our field.
Title: Evaluation of Female University Students’ Knowledge, Attitudes, and Practices Toward
Human Papillomavirus Infection and Vaccination.  Multicenter Cross#Sectional Study
Version: 2 Date: 06 Jul 2024
Reviewer:  Ahmed Ismail Mohamed
Reviewer's report:
In general, the manuscript is well presented and sheds light on important topic. However, several
concern may be raised. The paper can be considered for publication if the authors address the
following comments
1. The study focuses only on female undergraduate health sciences students from two specific
universities in Ethiopia. This narrow sample selection limits the generalizability of the findings
to a broader population.
2. The authors do not provide information on the demographic characteristics of the study
participants, such as age distribution, ethnic diversity, or socioeconomic background. This
information is crucial for assessing the representativeness of the sample and understanding the
potential biases in the findings.
3. The manuscript mentions using a structured, self-administered questionnaire for data
collection. However, it does not discuss the validity or reliability of the questionnaire. The
absence of information on the questionnaire's development, piloting, and validation raises
concerns about the accuracy and consistency of the collected data.
4. Its bitter to provide specific details on the variables included in the models and the statistical
tests used. Providing more comprehensive information on the analysis methods would enhance
the transparency and reproducibility of the study.
Title: A rare case of combined endometrioid adenocarcinoma arising from uterine adenomyosis
and clear cell carcinoma arising from parametrical deep endometriosis
Version: 1 Date: 21 Apr 2024
Reviewer's report:
Comment #0
I read with great interest the manuscript which falls within the aim of the Journal. The topic
is interesting.
Comment #1
Style and English should be improved
Comment #2
There are two distinct entities: carcinomas arising within adenomyosis and carcinomas
associated with adenomyosis. There is no mention of this difference in the article. It is advisable
to delve into this distinction, well-known in the literature, with appropriate bibliography, and
indicate to which nosological entity the presented case belongs
Comment #3
I would recommend adding the rates of cancerization of deep endometriosis and adenomyosis,
and whether these two aspects are correlated with specific clinical characteristics, in order to
compare them with the case presented here
Comment #4
The discussion is scattered and needs to be structured more orderly
Title: A rare case of combined endometrioid adenocarcinoma arising from uterine adenomyosis
and clear cell carcinoma arising from parametrical deep endometriosis
Version: 2 Date: 12 May 2024
Reviewer's report:
Dear Authors,
the enclosed manuscript describe a unique case of a concomitant endometrioid adenocarcinoma
arising from uterine adenomyosis and clear cell carcinoma arising from parametrial deep
endometriosis. Indeed, it is absolutely interesting as a case report.
Despite the novelty, the current version of the manuscript needs reshaping, both from a structure
and formal point of view. Here are my suggestions:
1- A major English revision from a native  is needed
2- Title: I would rather use "concomitant" or "simultaneous"rather than combined.
3- parametrial, not parametrical
4- eutopic, not eutropic
5- Abstract: please better describe the histological findings in the uterus. It is not clear what
was the diagnosis.
6- Abstract: conclusion might briefly summarise the findings and the clinical consequences of it.
7- Dot should be placed after the citations, not before.
8- Introduction section: should be extended. Here are some references to
discuss the coexistence of cancer and endometriosis or adenomyosis: doi:
10.3390/cancers15041142; https://doi.org/10.3390/cancers15215208; https://doi.org/10.1007/
s00404-020-05840-8; https://doi.org/10.3390/jcm13071933; doi: 10.1007/s00404-017-4375-z;
doi: 10.3390/cancers13194918; https://doi.org/10.1016/j.jmig.2015.09.018
You may discuss the molecular and pathological mechanisms behind this association, as well as
the epidemiology of the diseases (prevalence, risk factors, patients characteristics, etc.).
9 - Informed consent statement should be place in the material and methods section
10 - Material and methods section is missing. please provide a checklist for case presentation
(i.e., CARE checklist: https://www.care-statement.org/checklist)
11 - Did the patients have other diseases or previous surgeries other than the gynecologic ones?
12 - please provide details of the methods used for ultrasound (IDEA and MUSA protocol?:
https://doi.org/10.1002/uog.15955;  https://doi.org/10.1002/uog.24786). Use also the right
terminology for it (see previous protocols)
13 - avoid using "+" symbol.
14 - subextensive should be replaced by subtotal
15 - please provide details on the follow up exams and timing (months/years)
16 - please discuss the risk of having also extrauterine adenomyosis, its association with
morcellation, endometriosis, and cancer: 10.1002/ijgo.15049. Also, use this article as an
example of which information and how to provide them in a case report article.
17 - please discuss the therapeutic options, the prognostic data,  and the prevention plans
regarding the coexistence of cancer and endometriosis or adenomyosis, https://doi.org/10.1002/
ijgo.13818; doi: 10.1159/000521105; https://doi.org/10.3390/jcm13020550
18 - avoid discussing your actions alone, while I overall suggest to cite the literature regarding
the topic and the differences with it.
19- provide strength and limitations of the article
Title: Patients’ motives and considerations on treatment decision-making for heavy menstrual
bleeding: a qualitative study
Version: 1 Date: 20 May 2024
Reviewer's report:
Whilst on an important topic and providing useful take aways, the results could be better
supported by more illustrative quotes, and there are a number of incongruences with the results
and discussion that need addressing. In addition, there are numerous typos and grammatical
issues. The preference for hysterectomy is interesting and the finding that some clinicians
withhold desired treatment from women due to preconceived ideas is notable and deserves
greater recognition in clinical practice.
Further specific suggestions are below:
Introduction
- The rationale for the study could be clearer. Suggest explicitly stating the review by Zandstra
and colleagues focuses on heavy menstrual bleeding to make the link between this review and
the current study clearer.
Methods
- Line 105 - Please include more detail of how the final sample size was determined and data
saturation was reached.
- Suggest including topic list as an Appendix
- “The topic list was discussed by two researchers after each interview to ensure dependability.”
– unclear what this means. Two independent researchers or the two conducting the interviews?
- What does a thick description mean? Line 148-149
Results
- Some of the interviews seem quite retrospective, given the age range of participants was up
to 59 years. Please comment.
- The tense switches from past to present tense. Suggest writing results consistently in past tense.
- The names of the main themes don’t seem to adequately capture all the subthemes described.
For example, how does impact on daily life and coping strategies, or stopping treatment due to
dislike of hormones, fit under considerations in taking the first step to seek help? I would have
thought commencing and then stopping treatment occurs after help is sought?
- Whilst some quotes are included, the results could be better supported by more illustrative
quotes. E.g. do you have a quote that participants were not prepared for the abdominal pain
after EA? The current quote does not convey this. Similarly, the meaning of other quotes is not
always clear.
Discussion
- The discussion around preferences for treatment does not always match the results. For
example, the discussion states “many participants favored the least invasive and least risky
treatment”, however the results conclude that hysterectomy was favoured by many. If there was
a diverse range, then the discussion and results need to reflect this.
- Please comment on the potential influence of medical doctor being present for interviews. Also,
the fact that two researchers were present for each interview and how this may have influenced
the power dynamic.
- The option grid is repeatedly discussed in the discussion however is not mentioned at all in
the results.
Title: Clients’ satisfaction with cervical cancer screening services and influencing factors at
public health facilities in Debre Markos town, Northwest Ethiopia, 2022/23: A Convergent
parallel mixed method
Version: 2 Date: 26 May 2024
Reviewer:  Temesgen Geta
Reviewer's report:
Dear Editor, thank you for giving me the opportunity to review this paper or “Clients’ satisfaction
with cervical cancer screening services and influencing factors at public health facilities in Debre
Markos town, Northwest Ethiopia, 2022/23: A Convergent parallel mixed method”.
Comments to authors
General comments
1. This is an interesting study. Cervical screening is one of the main approaches to prevent the
spread of cancer in developing countries such as Ethiopia. The use and quality of health care
are strongly related to patient or client satisfaction with the health services given. However, it
is unexpected in Ethiopia to have sufficient women using screening. This is why this service
(screening) is generally recommended for the young age group. And also they are healthy and
not interested in using such a sensitive health service because they are a fearful group to expose
their body to the screener. Please justify this.
2. Please add line and page numbers to easily comment for reviewers.
Specific comments
Abstract
1. . Your background needs a change. You stated that there was no previous study in Amhara,
but there is a study in Gondar (see https://bmccancer.biomedcentral.com/articles/10.1186/
s12885-023-11533-7). Please correct the gap in the study
2.   Why have you used convergent parallel mixed methods design?
3. Add a research area in your keyword
4.  Describe the exact time of data collection in the methodology and abstract (exit or after
service)
5. Please limit the age of the study participants. Women include all age groups from 15 to
menopause
6. In your sample size calculation, you used the proportion of the study done in Jimma why? It
is better to study done in the Amhara region(Gondar)
7. Please indicate the validity and reliability of the study
8.  Who translated your study
9.  Your introduction lost size, severity, and factors with CS. Please revise
10. Your recommendation should be in line with the result and discussion (consider mixed study)
11. Please revise the gap in study
12.  You used an average of one quarter of the data for the study. But your study period was
conducted from October 10, 2022 to January 10, 2023. This contradicts each other. To estimate
an appropriate proportion, you should use at least two quarters of the data.
13.   Please provide a table that shows the level of CS with cervical cancersc in each institution.
Title: Clients’ satisfaction with cervical cancer screening services and influencing factors at
public health facilities in Debre Markos town, Northwest Ethiopia, 2022/23: A Convergent
parallel mixed method
Version: 2 Date: 11 Jun 2024
Reviewer's report:
I read with great interest the Manuscript titled " Clients’ satisfaction with cervical cancer
screening services and influencing factors at public health facilities in Debre Markos town,
Northwest Ethiopia, 2022/23: A Convergent parallel mixed method" which falls within the aim
of the Journal.
Although the manuscript can be considered already of good quality, I would suggest following
recommendations:
- I suggest round of language revision, in order to correct few typos and improve readability;
- Considering the topic and results of this study, I suggest reading and adding current evidence
about the state of the art on HPV infections and persistence, and its crucial role on precancerous
lesions progression, also after treatment of cervical lesions. I would be glad if the authors
discuss this important point PMID: 37747763 and “State of the art on HPV-related cervical
lesions, Tullio Golia D’Augè, Ilaria Cuccu, Andrea Etrusco, Antonio D’Amato, Antonio
Simone Laganà, Ottavia D’Oria, Giorgio Bogani, Violante Di Donato, Ludovico Muzii, Andrea
Giannini, doi: 10.36129/jog.2024.16.
Because of these reasons, the article should be revised and completed. Considering all these
points, I think it could be of interest to the readers and, in my opinion, it deserves the priority
to be published after minor revisions.
Title: Clients’ satisfaction with cervical cancer screening services and influencing factors at
public health facilities in Debre Markos town, Northwest Ethiopia, 2022/23: A Convergent
parallel mixed method
Version: 4 Date: 06 Jul 2024
Reviewer's report:
The quality of the manuscript has improved thanks to the changes made. I think it could be of
interest to the readers and, in my opinion, it deserves the priority to be published.
Title: Time trend analysis and impacts of the COVID-19 pandemic on mammography and
Papanicolaou test coverage in Brazilian state capitals
Version: 1 Date: 14 Jun 2024
Reviewer's report:
The article presents an appropriate methodological strategy with the objective. The results are of
interest because breast and cervical cancer represent priority public health problems worldwide
and in some Latin American countries such as Brazil.
Therefore, I suggest accepting the article but following the recommendations listed below:
In the discussion section, answer what is attributed to the decrease in trends in both coverage,
discuss the gender and geographic differences indicated by the results.
The discussion is more focused on indicators such as incidence or mortality, but the real impact
of the pandemic on both coverage of mammography and Papanicolaou should be discussed, for
example, answer those places or areas where there was a decrease in coverage of both indicators
were associated with higher incidence and/or mortality COVID 19?
Figure 1: Considering that the audience of the journal is international, it´s suggested to add
names according to the territorial delimitations in figure 1, as well as a context map, since not
all of us are familiar with the study area.
Other comments have been added to the body of the text.
Title: Time trend analysis and impacts of the COVID-19 pandemic on mammography and
Papanicolaou test coverage in Brazilian state capitals
Version: 1 Date: 22 Jun 2024
Reviewer's report:
This is a study investigating impacts of COVID9 pandemic on breast and cervical screening
in Brazil. However I concern that a time series study using survey data has limited internal
and external validity, particularly for self-reported survey data. Also there was no information
provided regarding why the authors did not use high-quality data, such as population-based data
from screening practice, for this study.
Detailed comments:
Introduction:
- 2nd paragraph: I don’t see how this paragraph was connected to the other paragraphs in the
introduction.
- 3rd paragraph: it is worth adding statistics s of breast and cervical cancers in Brazil, such as
age-standardized incidence rate, and how it was compared with the incidences in other regions
worldwide.
- 6th paragraph: this paragraph is not very relevant to this study.
Methods:
- The description of study setting is not clear or detailed, such as why the data collection for
2023 started from December 2022 and ended in April 2023, and why a further reduction was
necessary.
- Lack of sufficient details regarding the interview, such as how it was conducted, by who, using
which format, .etc.
- Lack of full description of variables in the interview/survey, such as education/school levels,
which abruptly appeared in the results.
Results:
- More details are needed when describing tables 1-2.
- 3rd paragraph: suggest to shorten this section because there is no need to list every city/district.
Discussion:
- The information of breast and cervical cancer incidence and mortality as well as health services
in Brazil (e.g. 3rd -4th, 7th  paragraphs) can be removed to introduction.
- Generally, this section reads like a background which introducing the cancer profile and health
services in Brazil rather than discussing and exploring the significance of the results of the work
Language: A language editing for this manuscript is suggested before further submission.
Title: Time trend analysis and impacts of the COVID-19 pandemic on mammography and
Papanicolaou test coverage in Brazilian state capitals
Version: 2 Date: 10 Jul 2024
Reviewer's report:
My previous comments were well addressed and the revision is improved. Please see the
following for minor comments:
Introduction:
- “In 2022, female breast cancer was the second most common cancer globally, with an estimated
2.3 million new cases, accounting for 11.6% of all cancer cases. It ranked as the fourth leading
cause of cancer mortality worldwide, with 666,000 deaths (6.9% of all cancer deaths).” “Cervical
cancer is ranked in both incidence and mortality among women, with an estimated 660,000
new cases and 350,000 deaths worldwide in 2022.” “73,610 new cases of breast cancer were
estimated annually for the period 2023-2025, representing an adjusted incidence rate of 41.89
cases per 100,000 women." Please add references.
Results:
- Please correct the typos: “IC95%”
- There is no need to duplicate all data for each statistically significant finding, because these
numbers were  already listed in tables. For some of them, suggesting to remove the prevalence
rates of 2007 and 2023 and only keep APC and 95%CI.
Title: Based on 3D-PDU and clinical characteristics nomogram for prediction of lymph node
metastasis and lymph-vascular space invasion of early cervical cancer preoperatively
Version: 1 Date: 20 Jun 2024
Reviewer:  Yifan Li
Reviewer's report:
1#Develop and validate a nomogram based on 3D-PDU parameters and clinical characteristics
to predict LNM and LVSI in early-stage cervical cancer is  a innovative idea for me,   but
something important need to be adressed
2#Validation  only used ROC and DCA,  why not use calibration curves?
3#The figures is too blure for me and sepefic information is not real
4#Language polishing to seek professional
Title: Based on 3D-PDU and clinical characteristics nomogram for prediction of lymph node
metastasis and lymph-vascular space invasion of early cervical cancer preoperatively
Version: 1 Date: 25 Jun 2024
Reviewer's report:
I read with great interest the Manuscript titled " Based on 3D-PDU and clinical characteristics
nomogram for prediction of lymph node metastasis and lymph-vascular space invasion of early
cervical cancer preoperatively”, topic interesting enough to attract readers' attention.
Authors should clarify some point and improve the discussion citing relevant and novel key
articles about the topic:
- I suggest a round of language revision, in order to correct few typos and improve readability.
- To date, the management of early stage cervical cancer is still a challenge.  The authors could
extend the discussion by evaluating and citing current evidence about comparison of different
surgical approaches for surgical treatment of cervical cancer, considering various outcomes,
possible complications, different patterns of recurrence of the disease and how each patient's
tailored-treatment could be improved. I would be glad if the authors discuss this important point,
referring to PMID: 36293758 and 37862783.
Because of these reasons, the article should be revised and completed. Figures are clear and
interesting. Considered all this points, I think it could be of interest for the readers and, in my
opinion, it deserves the priority to be published after minor revisions.
Title: Based on 3D-PDU and clinical characteristics nomogram for prediction of lymph node
metastasis and lymph-vascular space invasion of early cervical cancer preoperatively
Version: 2 Date: 12 Jul 2024
Reviewer's report:
The quality of the manuscript has improved thanks to the changes made. I think it could be of
interest to the readers and, in my opinion, it deserves the priority to be published
Title: Based on 3D-PDU and clinical characteristics nomogram for prediction of lymph node
metastasis and lymph-vascular space invasion of early cervical cancer preoperatively
Version: 2 Date: 17 Jul 2024
Reviewer's report:
In my honest opinion, the topic is interesting enough to attract the readers’ attention. The
abstract perfectly summarizes the contents of the manuscript. The introduction is satisfactory.
The methodology is accurate and the data analysis supports conclusions. References are relevant
to the research. The discussions sufficiently answer the following questions: main findings of
the study, strengths and Limitations of the study, implications and comparison with literature
and future directions.
Considering all these points, I think it could be of interest for the readers and, in my opinion,
it deserves the priority to be published.