JerMa88/BMC_Womens_Health_Peer_Reviews huggingface dataset:
Title: Uptake and correlates of cervical cancer screening among women attending a community-
based multi-disease health campaign in Kenya
Version: 3 Date: 04 Apr 2021
Reviewer's report:
This is an interesting report of survey questions regarding choice to be screened by HPV for
cervical cancer during a community health center NCD campaign.  The results are limited
to responses from a survey.  It is not clear how the survey was developed or whether it was
based on prior formative work in the population.  The short survey design severely limits the
possibility to elucidate reasons for screening/not screening as it only reflects a priori concerns
from the investigators.  In addition, the survey doesn't capture specific reasons associated with
the context of the multiscreen campaign.  Limitations of survey designs for surfacing new,
contextual barriers should be mentioned.
Other specific comments:
1.The study aimed to 'assess feasibility and impact of self-collected HPV testing as part
of a multi-NCD screening campaign conducted over 22 days'.  However, the manuscript
only reports one element of feasibility, using surveys to assess women's knowledge and
intentions for screening during the campaigns.  In depth interviews may have elaborated more
detailed information about feasibility, including structural problems associated with the way the
campaigns were held, which would likely lead to a more fundamental understanding of how to
adapt HPV-based screening in future campaigns.
2. It was unclear where the demographic information was collected for population 1 - was this
at the CHC during the campaign, or during the door-to-door enumeration?  Not clear if the
screened/unscreened are only among those who attended the health campaign.  If there was prior
door-to-door enumeration - is there any data to reflect those who attended vs. did not attend as
well?  Hard to generalize to the target population.
3. Some kind of diagram or more detailed elaboration of the flow or structure of the health
campaign would be really helpful to put the responses into context.  A pathway (swim-lane
diagram?) showing how women progressed through the campaign and when the questionnaires
were administered and cervical screening was performed would help the reader to understand
the woman's experience a bit better.
4. Table 2 would be more informative if row percentages were reported so the reader could
easily see the HPV prevalence by subgroup.
5. Table 3 row headings do not accurately reflect the way the information was assessed when
looking at the supplemental survey form.  The wording of the headings are awkward and should
be revised, and a footnote in the table should indicate that these were choices, not yes or no
answers.
6.  In general, the discussion is overly speculative.  What information was used to develop the
questionnaire?  Was it based on local formative work?  The bias is beyond response or recall
- it is subject to biases from the investigators who may presume they know what to be asking,
when in fact the modifiable reasons may still be unsurfaced.
Title: Distinct gut and vaginal microbiota profile in women with Recurrent Implantation Failure
and Unexplained Infertility
Version: 3 Date: 11 Dec 2021
Reviewer's report:
I read the article entitled ‘Distinct gut and vaginal microbiota profile in women with Recurrent
Implantation Failure and Unexplained Infertility’
The article must be checked for grammatical and spelling errors.
Abstract
1. Please describe recurrent implantation failure as a one sentence in methods.
2. Please describe ‘amplicon sequencing’
3. Which groups are dominant in the vaginal microbiota of L. iners?
4. Please delete the sentence ‘We posit that in the setting of the compromised gut mucosal barrier,
the phyla Firmicutes generates TNF-#-driven systemic inflammation, leading to RIF, while an
overload of Gram-negative bacteria induces IL-6-driven systemic inflammation, leading to UE’,
because this sentence is not the result of the study.
Key Words
1. Please delete ‘Endometrium’ in Key words.
Introduction
1. Please delete the sentence ‘Yet another subgroup of infertile couples, diagnosed as recurrent
pregnancy loss (RPL), exists that conceive several times (#3), but miscarriage occurs each time
before gestational week 28, although controversies exist on its definition 6, 7, because the study
did not related RPL.
Methods
1. The sample size of the study participants is very low. Sample size calculation must be done?
2. The defnition of RIF is controversial. According to Simon and Laufer, RIF can be defned as
the failure to obtain a clinical pregnancy afer three consecutive IVF attempts, in which one to
two embryos of high-grade quality are transferred in each cycle (1) . Coughlan et al. proposed
more stringent diagnostic criteria and defned RIF as the failure afer the transfer of at least four
good-quality embryos within minimum three fresh or frozen cycles under 40 years of age (2).
Please give more detailed information about the patients with RIF.
1. Simon, A. & Laufer, N. Repeated implantation failure: Clinical approach. Fertil. Steril. 97,
1039–1043 (2012).
2.  Coughlan, C. et al. Recurrent implantation failure: Defnition and management. Reprod.
Biomed. Online. 28, 14–38 (2014).
3. What is normal male partner?
4. Tests for the diagnosis of unexplained infertility are not sufficient(especially low ovarian
reserve)
5. Please delete ongoing pregnancy i# exclusion criteria?Age was not specified as the exclusion
criterion of the patients.
6. At which period of the menstrual cycle were vaginal samples taken?
7. Why was the V2-V3 hypervariable regions of the 16S rRNA gene chosen?
8. Why did the authors compare the three groups? Those women with RIF had unexplained
infertility.
Result
1. Please reduce the Result section.
2. More information should be given about the clinical characteristics of the patients
participating in the study.
3. Please do not repeat what is written in the table in the text.
Discussion
1. The Discussion section is very complex and disorganized.
2. Please reduce the Discussion section.
Title: Distinct gut and vaginal microbiota profile in women with Recurrent Implantation Failure
and Unexplained Infertility
Version: 4 Date: 14 Jan 2022
Reviewer's report:
I read the article entitled ‘Distinct gut and vaginal microbiota profile in women with Recurrent
Implantation Failure and Unexplained Infertility’.
- Please don’t compare the three groups, because the patients with unexplained infertility may
have RIF after treatment. Please compare first infertility and fertility and  RIF vs fertility)
- Please demonstrate the data sort as below: (in Abstract and main text- Introduction,
Methods,Result, and Discussion). The whole article must be reconstructed as below.
1. Gut microbiota (#NFERT#L#TY vs CONTROL FERT#L)
2. Vaginal microbiota(#NFERT#L#TY vs CONTROL FERT#L)
3. Gut microbiota (RIF vs  CONTROL FERT#L)
4. Vaginal microbiota (RIF vs  CONTROL FERT#L)
Introduction
1. Please delete ‘Yet another subgroup of infertile couples, diagnosed as recurrent pregnancy
loss (RPL), exists that conceive several times (#3), but miscarriage occurs each time before
gestational week 28, although controversies exist on its definition5, 6.It has been argued that
RIF and RPL represent the same condition spectrum7.’, It has been argued that RIF and RPL
represent the same condition spectrum7.’ because RIF and RPL are distinct entity.
2. Please add one paragraph only RIF.
Methods
1. Please add reference/references for ‘The RIF group’s inclusion criteria were women who
could not conceive after #2 fresh IVF-embryo transfer cycles/ ICSI, or had #3 consecutive
miscarriages  and  UE was diagnosed if a cause remains undefined after our routine fertility tests
with the following criteria
2. Please add references for sample collections.
3. Please add reference or references for The V2-V3 hypervariable regions of the 16S rRNA.
4. Why the authors analyzed 31 faecal samples?
Please add recent works in reference/references:
1. Vitale, Salvatore Giovanni, et al. "The Role of Genital Tract Microbiome in Fertility: A
Systematic Review." International Journal of Molecular Sciences 23.1 (2022): 180.
2. Punzón-Jiménez, Paula, and Elena Labarta. "The impact of the female genital tract
microbiome in women health and reproduction: a review." Journal of Assisted Reproduction
and Genetics (2021): 1-23.
3. Karaer, Abdullah, et al. "The vaginal microbiota composition of women undergoing assisted
reproduction: a prospective cohort study." BJOG: An International Journal of Obstetrics &
Gynaecology (2021).
4. Tsonis, O., Gkrozou, F., & Paschopoulos, M. (2021). Microbiome affecting reproductive
outcome in ARTs. Journal of Gynecology Obstetrics and Human Reproduction, 50(3), 102036.
5. Gruteke, P., van den Boogaard, N., & van de Laar, T. (2021). More details on microbiome
profile and IVF, would allow readers to judge for themselves. Human Reproduction.
Title: Multimorbidity among midlife women in India: well-being beyond reproductive age
Version: 1 Date: 13 Dec 2021
Reviewer's report:
The topic is very pertinent given the aging population and the rising burden of non-
communicable diseases in India and the usual focus on reproductive health in women. The
analyses serves to answer the research question formulated by the authors. The rational and
discussion helps place the research in context. Some modifications can be made to make the
analysis tighter.
Major comments
1. Details of how the variable levels were defined (and rational for the choice) is not provided,
for example ‘low risk’ and ‘high risk’ categories for waist-hip ratio, or ‘deprived class’ and
‘affluent class’ for wealth. Also, rather than dichotomizing the continuous variables, it may be
better to model the relationship as a non-linear function. Assuming a linear relationship is an
approximation, but it is better than dichotomizing continuous variables.
2. The outcome in the regression examining correlates of single and multimorbidity is ordinal.
An ordinal model (proportional odds logistic regression model) may be a better choice.
3. Given that there is huge variation in prevalence of multimorbidity across states, it will be
good to adjust for state fixed effects in the regression.
4. Some description of the proportion of missing values and their handling in the derivation of
variables and in the analysis is warranted
5. The HRQoL indicators such as ADL and IADL are count variables – Poisson or Negative
binomial regression may be more appropriate. Also, the indicators such as self-rated health and
life satisfaction have ordered categories and therefore would be better to use ordinal logistic
regression.
6. Lastly, the focus is on mildlife women. This is partly based on the fact that women transit
towards menopause around midlife accompanied by a series of natural physiological changes.
Since this transformation is absent in men, is the pattern different in midlife men – for example,
the nature and strength of associations between morbidity status and HRQoL indicators? Some
discussion around this may help emphasize why we need to look at this group separately.
Minor comments
1. Please spell out PR
2. The table numbers are confusing. It says ‘Table 3 illustrates the results from the bivariate
analysis.’ and then ‘Findings from multivariable analysis considering ‘no morbidity’ as the base
outcome are presented in Table 2.’. Not sure if the numbers (odds ratios and 95% confidence
intervals) in Table 3 are from bivariate or multivariable analysis.
3. Age at marriage for the women ‘not in union’ were probably categorized as ’18 years and
above’. It will be good to clearly specify this, and more generally, how the variables and their
levels were defined.
4. A table in the appendix providing sample size for each regression and estimates and
confidence intervals of regression coefficients (including for covariates that were adjusted for)
from the regressions of HRQoL indicators on morbidity status, will be good to include.
Title: Multimorbidity among midlife women in India: well-being beyond reproductive age
Version: 1 Date: 01 Feb 2022
Reviewer's report:
Dear Editor,
Thank you for allowing me to read this interesting paper regarding multimorbidity in midlife
women in India.
I have only some questions that I would like the authors to reflect upon:
- Since there is a known relationship regarding the number of conditions used to define
multimorbidity and the prevalence of multimorbidity, why do the authors consider that using a
small number of 17 conditions is a strength of the study? In my opinion it can be a limitation of
the study since there are several other lists with up to 140 conditions.
- All the multivariable associations between single and multimorbidity with indicators of
HRQoL are not correct. The authors must compare the groups with single morbidity with the
ones with multimorbidity.
For example, the authors wrote (page 22) that "the likelihood of reporting low level of live
satisfaction was higher for women with multimorbidity as compared to women who reported
high life satisfaction", I think that what the authors should analyse would be If the likelihood of
reporting low level of live satisfaction was higher for women with multimorbidity as compared
to women with single morbidity? This is valid to all analyses done in pages 21 and 22 of the
manuscript.
- The sentence "Also, it marks the start to often navigating healthcare system" is not
understandable. Can the authors please rephrase it?
Best regards.
Title: Multimorbidity among midlife women in India: well-being beyond reproductive age
Version: 3 Date: 10 Mar 2022
Reviewer's report:
Thank you for considering the suggestions and incorporating them.  Please include these changes
in the abstract as well, for example multinomial will be proportional odds. Also, In table 4, it
may be helpful to present both sets of odds ratios -  multimorbidity versus the combined single
and no morbidity and also any morbidity (single or multiple) vs no morbidity. Lastly, instead
of incidence rate ratios for measuring association between chronic disease score and ADL and
iADL, consider prevalence ratios, as this is a cross-sectional  study.
Title: Post Laparoscopy Pain Reduction Project I (POLYPREP I): Intraperitoneal Normal Saline
Instillation—A Randomised Controlled Trial
Version: 3 Date: 10 Dec 2021
Reviewer:  Ahmed M. Maged
Reviewer's report:
Well conducted study. Some issues need to be clarified
1. In the abstract please  correct 42 hours to 24 hours
2. Add the reference used for ASA classification
3. Add the reference for volume of saline installation
4. Clarify sample size or power calculation
5. Describe the exclusion criteria in details what about women with neurological and
psychological conditions that may affect pain perception
6. Add Data about bowel recovery (intestinal sounds , passing flatus and gases, time of
feeding, ...........)
7. Time of ambulation and time of hospital stay should be added
Title: Post Laparoscopy Pain Reduction Project I (POLYPREP I): Intraperitoneal Normal Saline
Instillation—A Randomised Controlled Trial
Version: 3 Date: 10 Feb 2022
Reviewer's report:
The aim of this randomized controlled study was to evaluate the effect of intraperitoneal normal
saline instillation at the end of a gynaecological laparoscopic procedure on postoperative pain.
Strength:
1. A randomized controlled study.
2. The amount of normal saline instillation was in proportion to the body weight.
3. The patients received a standard regimen of postoperative pain relief
The manuscript cannot be accepted for publication in the present format because of the following
reasons.
Major concerns:
1. Introduction: The intraperitoneal normal saline instillation has potential positive and possible
harmful effects (Line 82-84). This study aimed to assess the effect of postoperative pain but did
not attempt to address the harmful effects such as peritoneal adhesion.
2. Intervention (Line 125): The authors did not give any details about general anaethesia and
any pain relief during and at the end of general anaethesia.
3. Measurement of pain score: “ The primary outcome of this study was the severity of post-
laparoscopic pain in the shoulder and upper abdominal areas at 24 h, 48 h, and 72 h after the
surgery.” (L154-156) There should be just one primary outcome for most of randomized studies.
However, the authors considered pain levels at various sites and point times. The authors should
clearly state the primary outcome i.e. pain level at which site and at what time point at rest or
on movement.
4. Line 164-166: There is problem in the sample size calculation as the pain level in the control
group was lower than those in the intervention group. Moreover, pain levels may be different in
different patients because of different pain thresholds of subjects studied and different surgical
techniques. The authors should try to use the data from their own centre to calculate the sample
size.
5. Table 1 comparing the background parameters between the intervention and control groups
should not give P value in randomized trials (Page 27-28).
Title: Post Laparoscopy Pain Reduction Project I (POLYPREP I): Intraperitoneal Normal Saline
Instillation—A Randomised Controlled Trial
Version: 5 Date: 14 Mar 2022
Reviewer's report:
I reviewed the manuscript again.
The authors should revise the sentences as f
1. Line 165-168:  Based on a previous study (11), the mean shoulder pain (standard deviation
[SD]) of VAS at 48 h post laparoscopic procedure was pain 1.26 [1.95] and 3.21 [2.78] for INSI
and control groups (control and INSI groups in the revised manuscript, respectively.
Title: Women’s decision-making power and knowledge of prevention of mother to child
transmission of HIV in sub-Saharan Africa
Version: 0 Date: 23 Sep 2021
Reviewer's report:
*1. Background: You mentioned "sothern" in paragraph 3. Do you mean Southern? Please
address if necessary.
2. PMTCT knowledge: You stated "Moreover, approximately 70.4% of married women knew all
three abovementioned HIV transmission means and about 81.8% of married women knew that
drugs could prevent HIV transmission to their baby during pregnancy". Kindly adjust (rephrase)
the last part of the statement to enable readers to understand the information better.
3. Figure 1 and 2: Consider changing the text color in the bar chart to a bright color. Readers
may find it difficult to follow through.
4. Table 2 title: Consider changing the title to read “Knowledge of PMTCT...”. You want to be
consistent on how you use this term in a sentence.
*5. Table 2 and 3: Since variables such as "reading newspaper", "listening radio", and "watching
television" are measuring the same thing, and it seems that the majority of survey participants
said no to the question asked. Could you consider making them a composite variable “Media
access”? That way, Knowledge of PMTCT can either increase or decrease based on media
access.
*6.  Table 3: Why do you have an empty cell for religion in model II? Kindly explain
7. Table 3 footnote: Kindly adjust your footnotes to read appropriately. For example, “Ref=
reference”
8. Discussion: In the last part of paragraph 2,  you stated  "Women who utilize healthcare
services such as ANC and health facility delivery are high likely to have PMTCT knowledge".
Please clarify what you mean by “high likely”. Otherwise, consider changing this term to a more
suitable word.
*9 Discussion: In paragraph 7, you stated that you used data from "DHSs". Do you mean DHS?
I believe this is an error. Kindly clarify
*10. Limitation: you stated, "First, we used data from DHSs that were conducted within a ten-
year period; comparison of findings might not be always possible due to the time effect".
Did you consider controlling for the year DHS was conducted in your model?
This is important because it would partially control for the effects of unknown factors that may
have been introduced due to the time effects of the survey.
Title: Women’s decision-making power and knowledge of prevention of mother to child
transmission of HIV in sub-Saharan Africa
Version: 0 Date: 16 Nov 2021
Reviewer:  Catherine E. Ford
Reviewer's report:
Overall, the information in the manuscript is very interesting and important. The analysis seems
to be done correctly and shows a connection that makes sense, but is important to show and
evaluate.  I would recommend editing the manuscript so that it is clearer and more readible.
There are several sentences missing prepositions and somewhat hang without completely stating
the thought. This is noted throughout the manuscript, so before agreeing to accept this, I would
encourage revision with correct editing.
Title: Women’s decision-making power and knowledge of prevention of mother to child
transmission of HIV in sub-Saharan Africa
Version: 0 Date: 17 Nov 2021
Reviewer's report:
The authors have conducted a relevant study considering the low uptake of PMTCT and the slow
progress in reducing mother to child transmission of HIV in SSA. The study was well conducted
and the manuscript well written. There are a few grammatical errors that can be corrected with
proof reading.
Title: Women’s decision-making power and knowledge of prevention of mother to child
transmission of HIV in sub-Saharan Africa
Version: 2 Date: 22 Feb 2022
Reviewer's report:
Overall, the authors have added to the body of knowledge pertaining to PMTCT in SSA.  The
authors have improved on the manuscript and have addressed most of my comments.  Kindly
provide feedback on the comments below.
Comments:
Figure 1 and figure 2 legends read "Knowledge of PMTCT among married women: Evidence
from 25 SSA countries DHS" and "Knowledge of PMTCT among married women across
countries: Evidence from 25 SSA countries DHS". This is not true, considering the fact that the
current study used data from only 24 countries in sub-Saharan Africa. Kindly adjust or provide
evidence why it should read as stated.  It is the author's responsibility to ensure that any changes
made are reflected in the texts and footnotes of the manuscript.
Title: Multi-level predictors of sexual autonomy among married women in Nigeria
Version: 0 Date: 17 Mar 2022
Reviewer's report:
The manuscript tried to examined the Multi-level predictors of sexual autonomy among married
women in Nigeria. I must appreciate that authors have done the proper justice to the manuscript.
However, minor edits are required like
1. Background section is lengthy and can be cut short especially last two paragraphs
2. Full form of ICF should be mentioned in the method section
3. Sampling and participants section can be started with Comprehensive detail of the survey
methodology has been published and widely available (https://dhsprogram.com/pubs/pdf/
FR359/FR359.pdf). However, briefly described here.
4. References are required for .... line number 355-356. (Four, community features have a major
impact on sexual autonomy. This is an essential factor that has been overlooked in many previous
studies).
5. Its better , if authors may add one or two recommendation in the conclusion section.
Title: Knowledge and Compliance towards Alendronate Therapy among Postmenopausal
Women with Osteoporosis in Palestine
Version: 2 Date: 12 Jan 2022
Reviewer:  Riku Erkkola
Reviewer's report:
This is a nice manuscript which reminds the readers about a through instruction about how to use
bisphosphonates correctly.  I also praise the Palestinian researcher for their activities to conduct
good high level research. I have only minor comments
Line 67:  Dosing instructions. Put the abbreviation DI here, and use it thereafter all the time
i38  Kruskal
139  were used
158  ,while
165  ,while
166  of whom (which)
173-4 no parentheses
210 no parentheses
215  use DI only
224 reference nb, no year
228  one decimal only
232  risedronate
Tables 1,3 Socio-demographic with low-case s