JerMa88/BMC_Womens_Health_Peer_Reviews huggingface dataset:
Title: Using Implementation Science Frameworks to Translate and Adapt a Pregnancy App for
an Emerging Latino Community
Version: 5 Date: 08 Aug 2022
Reviewer:  Karolina Kuberksa
Reviewer's report:
Thank you for the opportunity to review this revised manuscript. I think the added details and
structural changes have much improved the clarity with which you  describe and explain your
research process.
I am very pleased that you've found my comments useful.
I only have minor notes that do not impact the message of the paper at all - and are  perhaps
things you would be able to see yourselves.
The phrase "Spanish-speaking" is not always hyphenated - I imagine you would like to be
consistent here.
I'm not sure if "culturally sensitive" should be hyphenated, though.
Lines 58-60, you write "The prenatal period is particularly vulnerable for non-English speaking
immigrants due to [...] low English proficiency,..." - it may seem like a bit of contradiction,
and I'm sure it wasn't intended. In this particular sentence,  "low English proficiency " could be
paraphrased as "language difficulties", for example.
Line 85 EHR-embedded - I'm not sure what EHR stands for?
Line 128, "et al." misses a full stop after "al.". Somewhere above, you italicise this - you might
want to make it consistent?
Line 161 "mHealth app" - I'm wondering if "mHealth pregnancy app" would make this sentence
more fitting in the context of the whole sentence?
Line 188-89 Can you tell us about your worries related to your ability to communicate with your
provider - this question misses a question mark at the end.
Line 240, comma missing after the word "need".
Line 317-13 Instead of "have lower timely initiation of prenatal care", may I suggest "have lower
rates of timely initiation of prenatal care"?
Line 342, instead of "arm patients with", may I suggest "equip patinets with"? This is my quest
to discourage military metaphors, please join me!
Lines 359-61, the use of the word "desgraciada" - in line 359 you put it in inverted commas,
in 361, it's italicised. It seems like italics would work well for  both occasions,  I think it's the
change of format that can confuse the reader. To be honest, I'd be delighted with more examples.
I do speak Spanish and have a background in linguistics, so I am biased.
Line 360,  you mention the Edinburgh Postnatal Depression Scale - was that a part of your app?
It seems like it was, put perhaps it would be worth making it unambiguous?
I also would like to add that I think your conclusion is excellent - and I hope you think that too.
I look forward to seeing this paper published.
Title: A novel Silva pattern-based model for precisely predicting recurrence in intermediate-
risk cervical adenocarcinoma patients
Version: 2 Date: 01 Jul 2022
Reviewer:  Elvio G. Silva
Reviewer's report:
ACCEPT
This is an interesting paper, well written and including a significant number of cases. The
conclusions are also excellent.
I have a few comments/suggestions:
1.  It is highly unusual (do not remember seeing a single case) of Silva Pattern A that had
recurrence or that died of disease.  This case the authors are reporting needs more clarification.
Was the recurrence in the cervix after a cone biopsy or it was in the vagina?  Both would be
acceptable after a Silva A Pattern.  However, if it was a distant recurrence then maybe the case
was not a Silva Pattern A.
2.  The 3 cases Silva Pattern B  that recurred and died of disease had lymphovascular invasion?
If not, it would be highly unusual.
3.  Since the authors have a very large number of cases in the types explained in confluent,
diffuse invasion and micropapillary showed recurrences.
Title: A novel Silva pattern-based model for precisely predicting recurrence in intermediate-
risk cervical adenocarcinoma patients
Version: 4 Date: 20 Aug 2022
Reviewer's report:
The article aims to establish a Silva-based model to predict recurrence specific for intermediate-
risk AC patients and guide adjuvant therapy. The research analyzed 345 AC patients that were
classified according to Silva pattern. Their clinicopathological data and survival outcomes were
assessed. Among them, 254 patients with only intermediate-risk factors were identified, and this
population was analyzed to propose the model. The article is about a relevant topic and is well
written.
All the topics of the first review were properly addressed. Missing data, clarification, and
table corrections needed were done.  Also, a new paragraph in the discussion was inserted and
improved some topics that were unclear in the previous version of the paper.
The study limitations were addressed, and the conclusion is suitable for the findings.
I recommend accepting the paper.
Title: A CLINICIAN’S DILEMMA: WHAT SHOULD BE COMMUNICATED TO WOMEN
WITH ONCOGENIC GENITAL HPV AND THEIR PARTNERS REGARDING THE RISK
OF ORAL VIRAL TRANSMISSION?
Version: 2 Date: 03 Apr 2022
Reviewer:  Georgios Michail
Reviewer's report:
This submission covers extensively the topic of a common patient’s concern/questioning and
clinician dilemma in gynecological counseling, for which no formal guidance so far exists.
In particular, it deals with the potential beneficial alterations in orogenital sexual practices
following a genital HPV diagnosis which could be possibly communicated by a physician. The
author’s approach represents a very comprehensive and updated review.
Based on CDC US data, by 2010 the annual prevalence of oropharyngeal cancer on males has
trumped that of cervical cancer in women; this trend is also shared with other affluent countries.
Despite the initial impression that HPV driven oropharyngeal carcinogenesis is identical to
cervical, the natural history of these two entities is not identical. As the authors do quote (rows
213-218 & 223-226), gender-neutral vaccination strategies of ages 25-45 based on the principles
of “HPV faster” (FX. Bosch) could possibly change the landscape of HPV driven-cancers.
However, the absence of established precursor precancerous oropharyngeal lesions to assess the
VLP vaccine’s effectiveness represents an obstacle in this perspective, as also does physician’s
poor awareness regarding extra-genital HPV driven neoplasia.
The manuscript is very well structured and especially the main part “Informing women with
persistent high-risk HPV genital infection: practical and bioethical issues” is meticulously
composed covering almost all communication pitfalls. Given the persistent pattern of infections
caused by HPV 16 and that the vast majority of oropharyngeal cancers are HPV16-driven, in
pragmatic terms perhaps clinicians SHOULD indeed tailor their counseling specifically when
dealing with individuals harboring established HPV 16 infections; future sexual partners of these
persons might indeed benefit from abstaining from oral sex practices; in this perspective the
information regarding HPV16 probably should be disclosed.
Some reservations might arise regarding the title “COMMUNICATION BREAKDOWN”
which despite innovative and accurate, could be somewhat misleading and potentially counter-
productive in terms of reads/citations. Very few weaknesses of the article can be identified;
e.g. phrases from referenced articles probably shouldn’t be quoted verbatim (rows 162-164,
164-165,259-260, 279-280, 281-282, 287-288). In row 187 “latency” could be “incubation” .The
conclusion section is somewhat lengthy; suggestions for future directions could be expressed
more concisely. References are current and no language polishing is required.
Overall a meticulously written article with great potential for contribution in an insofar
unaddressed niche.
Title: A CLINICIAN’S DILEMMA: WHAT SHOULD BE COMMUNICATED TO WOMEN
WITH ONCOGENIC GENITAL HPV AND THEIR PARTNERS REGARDING THE RISK
OF ORAL VIRAL TRANSMISSION?
Version: 2 Date: 23 Apr 2022
Reviewer's report:
The authors describe and discuss the role of oral genital HPV transmission and whether it should
be included in counseling messages.
I found this to be a good review of the literature and generally balanced.
I just did feel that at times it felt as  if the authors were ignoring the other issues that come into
play by highlighting the STI nature of this and the decades of research which has shown that
vaccination should be phrased as a cancer -preventive  measure not as a vaccination to prevent
an STI. Even with HPV testing, a lot of stigma and often results in blaming the female sexual
partner or unintended consequences  of lost relationships /divorce.
It also felt as if the authors were focusing on sharing this message with women, ignoring the
decades of blames that occurs with women who have an HPV-related disease and the stigma/
shame that accompanies that message.
Lastly, avoiding sexual behaviour  regardless of the orifice of origin has never been the answer.
Is that what we do with vaginal intercourse or anal intercourse?
If authors could address some of those biases and make this even more balanced than it could
be,  it would be appreciated.
This is an important contribution to the literature to bring these issues to light.
Title: A CLINICIAN’S DILEMMA: WHAT SHOULD BE COMMUNICATED TO WOMEN
WITH ONCOGENIC GENITAL HPV AND THEIR PARTNERS REGARDING THE RISK
OF ORAL VIRAL TRANSMISSION?
Version: 3 Date: 21 May 2022
Reviewer:  Georgios Michail
Reviewer's report:
The authors have addressed most concerns. The article can be published as is; however the
authors might consider some minor remarks:
Row 1 (Title) Instead of “WHAT SHOULD BE COMMUNICATED etc”, consider changing
to ‘CLINICIAN DILEMMAS: WHAT SHOULD BE COMMUNICATED etc”.
Row 161: Instead of “more efficient transmission of infection”, consider changing to “higher
transmission rates”.
Row 197-98: Instead of “persistence infection”, consider changing to “persistent infection”.
Row 363: Instead of “unintended consequences of lost relationships / love”, consider changing
to “detrimental effect in emotional aspects of sexual relationships”
Row 381: Instead of “Moreover, avoiding sexual behavior has never been the answer”, consider
changing to “Obviously, avoiding sexual intercourse altogether is unacceptable”.
For such a comprehensive review, a short phrase mentioning gaps in knowledge regarding
HPV latency is totally justified. This could be accommodated in the section “Informing women
with persistent high-risk HPV genital infection: practical and bioethical issues”. For example:
“Uncertainties regarding viral latency and the ability of individuals harboring HPV active
infections below the DNA positivity threshold to contaminate their sexual partners could pose
additional challenges in patient counseling”. The article of Gravitt, P.E.; Winer, R.L. Natural
History of HPV Infection across the Lifespan: Role of Viral Latency. Viruses 2017, 9, 267.
https://doi.org/10.3390/v9100267 provides lots of insight in this direction.
Title: A CLINICIAN’S DILEMMA: WHAT SHOULD BE COMMUNICATED TO WOMEN
WITH ONCOGENIC GENITAL HPV AND THEIR PARTNERS REGARDING THE RISK
OF ORAL VIRAL TRANSMISSION?
Version: 3 Date: 16 Jun 2022
Reviewer's report:
The authors addressed all comments.
I would just be clear that HPV vaccination after age 26-45 is not considered routine by ACIP
and many other international vaccine recommendation groups and will have reduced efficacy
compared to vaccination at routine younger ages. THe SOGC was highlighted. Again make it
more balanced--
Title: A CLINICIAN’S DILEMMA: WHAT SHOULD BE COMMUNICATED TO WOMEN
WITH ONCOGENIC GENITAL HPV AND THEIR PARTNERS REGARDING THE RISK
OF ORAL VIRAL TRANSMISSION?
Version: 4 Date: 23 Jul 2022
Reviewer:  Georgios Michail
Reviewer's report:
An excellent review, all minor points previously identified have been addressed, no pending
issues.
Title: A CLINICIAN’S DILEMMA: WHAT SHOULD BE COMMUNICATED TO WOMEN
WITH ONCOGENIC GENITAL HPV AND THEIR PARTNERS REGARDING THE RISK
OF ORAL VIRAL TRANSMISSION?
Version: 5 Date: 27 Aug 2022
Reviewer:  Georgios Michail
Reviewer's report:
As I mentioned in my previous Review this is an excellent manuscript, which potentially can
provide guidance and help to health professionals (predominantly gynecologists, among others)
in their consultation.
I do not consider the manuscript as elitist in nature. Besides, I am deeply disappointed because
of this prolonged delay (5 months so far and on the 3rd revision) in the final Decision and
publication of a well composed, comprehensive and ethically flawless manuscript.
Title: Lived experience of medical management in recurrent vulvovaginal candidiasis: A
qualitative study of an uncertain journey.
Version: 1 Date: 04 Jun 2022
Reviewer's report:
Thank you for the opportunity to review the article "Lived experience of recurrent vulvovaginal
candidiasis: an exploratory study of an uncertain journey".
It is a well-written article and tackles an important topic. By coincidence maybe, I was sent this
article and I am happy to read it as I have worked in sexual health for many years, and I see these
patients after a journey with PCPs who did not consider these patients for long-term therapy.
First of all, I find the title of the article should be changed.  I would put a qualitative study
instead of "an exploratory study of an uncertain journey" to make it more simple for the reader
and I would incorporate GPs somewhere in it cause we are talking about the triad of RVVC with
PCPcs and women patients. I only understood the objective while reading the article. The title
made me feel I am reading something already known. It is not about women only, it is about
GPs lacking knowledge and communications skills in tackling this problem from the first or the
second visit.
I found the article also too long. The body is 6631 words. I would suggest shortening it and
avoiding repetitions to 4000 words cause readers might not continue till the end.
I have no comments about how robust the qualitative study is conducted and I prefer another
reviewer to comment on that.
I would recommend acceptance with revision with an addition of another reviewer if I am one
of two reviewing it.
Many Regards,
Title: Lived experience of medical management in recurrent vulvovaginal candidiasis: A
qualitative study of an uncertain journey.
Version: 1 Date: 15 Jun 2022
Reviewer:  Theophilus Ogochukwu Nwankwo
Reviewer's report:
Reviewer's Comment.
Topic: An interesting  one
Abstract:
Method. Find a place for including type of study (qualitative)
Results. Stating more specific findings in relation to the reported themes may be more
elucidating. E.g. theme one, the study elucidated difficulty and delay in obtaining correct
diagnosis due to poor knowledge of HCPS.
The volume of the conclusion  in the abstract may be reduced if complying with the above
suggestions made the abstract bulky.
Methods.
Participant:
You stated in the result section that 28 women had RVVC diagnosed from the screening
programme.
a. it may be relevant to mention one or two statements about the screening  programme e.g.
method used for the diagnosis and population studied.
b. You didn't mention this population(28 positive women for RVVC) in your methods. How did
you select those you studied from this population? If you sent the invitation to all, do you think
that response of less than 50% was adequate for the study.
c. Did you validate the tool used for this study or was it a standardised tool?
d. Were all you respondents English language speaking, any possible language challenges? It
may be pertinent to mention in the methods or demography.
e. Was the interview conducted individually or as a group?
Discussion:
Generally  good
Page 28, the last but one statement is not clear to me. Is it possible to modify  for clarity. Does
the ‘delivered’ there mean ‘provided’?
Title: Evaluation of the food effect on a drospirenone only contraceptive containing 4 mg
administered with and without high-fat breakfast in a randomised trial
Version: 3 Date: 12 Jan 2022
Reviewer:  Özlem Erten
Reviewer's report:
Thank you to those who contributed to the article. Although the data of the article belong to
the old years, the subject has been tried to be discussed and processed by giving current dated
references.
I have the opinion that a major revision is needed in the article.
My suggestions are as follows;
-Annotated forms of abbreviations used in the abstract and in the main text should be used before
their abbreviations (eg DRSP, SHBG, CYP, h etc).
-Applications made with volunteers should be detailed in the material method section.
-The 25th and 26th references in the references list are not included in the text.
-In the Consort diagram in Figure 1, there is a date of 2010, however, the dates of the work
in the article are as follows; ''Date of first enrolment: 15-JAN-2013 date of first subject dosed:
20-JAN-2013
Date of last completion: 06-FEB-2013 (last regular final visit), on 22-FEB-2013, additional
control visit in 1 subject.
Trial registration number: EudraCT-No: 2012-004309-28. https://
www.clinicaltrialsregister.eu''. It would be appropriate to make an explanation about the
mentioned dates.
-Word spelling mistakes and meaning errors should be checked and the article should be
reviewed by the native speaker.
Title: Evaluation of the food effect on a drospirenone only contraceptive containing 4 mg
administered with and without high-fat breakfast in a randomised trial
Version: 3 Date: 21 Feb 2022
Reviewer's report:
It is an interesting article about pharmacokinetics of 4 mg drospirenone under fasting conditions
compared to after food intake. Below my considerations.
Title: According with CONSORT, authors should identify as a randomised trial in the title.
Abstract: I suggest excluding from the conclusion the comparison with COC containing 0.02
mg EE and 3 mg drospirenone. Since this information is swindling results
Methodology: describe plasma interval collection during the study
Discussion: describe study limitations
Title: Evaluation of the food effect on a drospirenone only contraceptive containing 4 mg
administered with and without high-fat breakfast in a randomised trial
Version: 7 Date: 16 Jul 2022
Reviewer:  Marie Mawet
Reviewer's report:
Dear Authors,
Thanks for this interesting PK data on DRSP.
I have only minor comments to your manuscript:
1) Introduction, P5, line 83: "a single oral dose with a mean bioavailability of 76%" => add the
confidence interval around the 76%.
2) Introduction, P5, line 88:  " DRSP binds to aldosterone receptors in the kidney, blocking the
effects of aldosterone and resulting in moderately increased sodium and water excretion " => I
would add that this is beneficial in terms of blood pressure balance.
If possible, also add that the theoretical increase in potassium level has finally never had
consequence in clinical practice.
3) Materials & Methods, P6, line 128 => Maybe good to add how the washout period length
was calculated.
4) Materials & Methods, P6, line 131 => Please, also add the European or FDA guidelines on
food effect that were followed.
5) Materials & Methods, P11, line 244 "For studies to determine bioequivalence of immediate-
release formulations at steady-state, AUC(0-#) and Cmax,ss should be analyzed using the same
acceptance interval as stated above." => Is this part of the guideline necessary?
6) General comment: please harmonize to either UK or US English throughout the document.
7) Discussion, line 298 "the 2 steroids" should be replaced by "EE and DRSP" for the sake of
clarity.
8) Discussion, line 313: For the sake of clarity, maybe good to add that indeed, for ovulation
inhibition, this is the AUC 0-72 that is the main parameter to be taken into consideration.
9) Discussion, line 315, 316, 317: Please, consider rephrasing the entire sentence since this part
is not clear to me.
I hope this will help.
Good luck!
Title: Women empowerment and Health insurance utilisation in Rwanda: a nationwide cross-
sectional survey
Version: 3 Date: 25 Aug 2022
Reviewer:  Emmanuel Biracyaza
Reviewer's report:
The authors have significantly improved the manuscript and I recommended this paper to be
accepted for publication, however, minor errors and typos need to be addressed. So, the work
still have some unnecessary words  and the abstract still needs some improvement.
Abstract
The word “moreover” that starts the second sentence of the background should be removed
In methods, you can say “…who were selected using multistage sampling” instead of saying
“…who were selected by multistage sampling”
Apart from this part of methods you mostly say “with women empowerment as well as other
socio-demographic factors”, did you previously identify some socio-demographic data. So, I
can recommend you to use “socio-demographic factors” to avoid confusion.
In your results section, you can say remove of the following words to avoid unnecessary words
“…were using or had subscribed to health insurance”
Again, you can improve the way the results are presented and interpreted in the part of the results.
Please, refer to the interpretation you provide in the body of the work
Body of the study
The first section should be “Background” instead of “Introduction”. It is better to have the same
titles in the subheading of abstract and main text.
The details or description of the socio-demographic should also be minimized such as indicating
the categories for each variable may not be needed since the categories are provided in the results
section.
On page 5 in the statistical analysis, you can edit because there are some unnecessary words. For
example; you can remove one of the words …variables/factors…., remove the words confidence
intervals and then keep its abbreviation because you previously use it.
Title: Women empowerment and Health insurance utilisation in Rwanda: a nationwide cross-
sectional survey
Version: 3 Date: 26 Aug 2022
Reviewer:  Jean Damascene Makuza
Reviewer's report:
Thank you to the authors for the improvement of this article.  Most of my comments were
addressed, but I still have a few comments to be addressed too.
Introduction
1) The second paragraph is very long; the author can divide it into two paragraphs. This is
the same with the sentence in this paragraph “Although Rwanda achieved the Millennium
Development Goals (MDG) 4 and 5 [11,12] ….. ” which is long and needs to be shortened.
Methods
1) For the inclusion and exclusion criteria, as you are considering women empowerment as
exposure and health insurance as an outcome, people with missing value or undefined responses
in both exposure and outcome could be excluded. I think authors could think about these
exclusion criteria. This explains why only 14,634 out of 14,675 were considered in the study.
2) The definition of the outcome variable is needed, and I do not think the first reviewer
recommended shortening the part of outcome variables but the exposure or explanatory variables
which is more detailed. If possible, a summarized definition of the outcome variable could be
given.
3) This study is looking for an association between women empowerment as exposure and health
insurance as an outcome. That is why a mediator for the relationship between the two variables
needs to be excluded. Therefore, a mediator for your study is not out of your study scope. Maybe
you should state that you did not find variables that could be mediators for this relationship.
Title: Women empowerment and Health insurance utilisation in Rwanda: a nationwide cross-
sectional survey
Version: 4 Date: 05 Sep 2022
Reviewer:  Emmanuel Biracyaza
Reviewer's report:
Authors have importantly improved this study and it is scientifically sounding great. So, this
work is extremely useful and merits to contribute to informing policymakers about which
strategies to be designed for empowering women. I confirm that it is of an acceptable scientific
standard and can be published.