JerMa88/BMC_Womens_Health_Peer_Reviews huggingface dataset:
Title: The impact of a lifestyle promotion program on anthropometric and clinical
manifestations in adolescents with polycystic ovarian syndrome: a randomized controlled trial
Running title: Lifestyle promotion program in adolescents with polycystic ovarian syndrome
Version: 8 Date: 03 Sep 2024
Reviewer's report:
Dear Authors
I am grateful for your attention to the comments. It's better to pay attention to a few other
remarks.
1. There is no need for the following sentences in the participants' secession. It should be
removed.
'BMI and weight were not considered as inclusion criteria'
'Date of the first patient’s enrollment was January 2, 2021'
2. Line 217, Intervention section: It would be better to clarify which part of Table 1 to focus
on for the control group training.
3. These materials were made available to control groups after the study ended.
In the text, some sentences need to be improved in English.
4. According to the table, the following sentence is considered correct. Please check again. This
is a better option for revising. Please ensure that the similar sentences are correct.
'In this study, the PCOS intervention group was 3.30 times more likely to have the regularity
of the menstrual cycle every six months compared with the PCOS control group (ORAdj=3.30,
95% CI: 2.06,5.25, P<0.001). Additionally, the non-PCOS intervention group was 2.54 times
more likely to have the regularity of the menstrual cycle every six months compared to the non-
PCOS control group (ORAdj=2.45 (95% CI: 1.33, 4.52, P=0.004).'
5. This is a better option for revising. Please ensure that the sentence is correct.
'Table V reveals that the mean score of physical activity of girls increased after 12 months of
follow-up by 38.13 Met/ min/week (95% CI: 12.14, 110.42, P=0.04) in the PCOS intervention
group compared with the PCOS control group and by 161.38 Met/ min/week (95% CI: 84.42,
238.35, P<0.001) in the non-PCOS intervention group compared with the non-PCOS control
group.'
Title: Exploring heterogeneity of perimenopause with application of multivariable analysis
approaches
Version: 2 Date: 07 Nov 2024
Reviewer's report:
Thank you for your efforts in investigating the heterogeneity of perimenopause through the
use of multivariable analysis methods. The work appears to be intriguing and is relevant
to the enhancement of the health outcomes of women. The objective of the study was to
investigate the patterns of perimenopause through the application of latent variable analysis
methods within a multidimensional assessment framework. A two-phase clinical study was
developed and implemented at the research center in Guangzhou, China. The findings suggest
that the conceptual framework exhibits an adequate statistical analysis, with six factors,
including sleep disturbance, mood fluctuations, vasomotor symptoms, positive attitude towards
life, multisystem abnormality, and fatigue. The study concludes that multivariable analysis
methods provide clinicians with improved efficiency and interpretation when measuring
patients with complex heterogeneous appearances, such as perimenopause. However, a concise
recommendation regarding the method to identify potential patterns among the heterogeneity of
perimenopause could be beneficial. Thank you.
Title: Exploring heterogeneity of perimenopause with application of multivariable analysis
approaches
Version: 2 Date: 10 Nov 2024
Reviewer:  Phuc Nhon Nguyen
Reviewer's report:
Thank you for interesting paper.
The discussion should be expanded with the symptoms in perimenopausal stage. Please refer to
this document: Nguyen PN, Nguyen VT. Evaluating Clinical Features in Intracavitary Uterine
Pathologies among Vietnamese Women Presenting with Peri-and Postmenopausal Bleeding: A
Bicentric Observational Descriptive Analysis. J Midlife Health. 2022 Jul-Sep;13(3):225-232.
doi: 10.4103/jmh.jmh_81_22. Epub 2023 Jan 14. PMID: 36950211; PMCID: PMC10025815.
The conclusion should be more detailed.
Title: Measuring Domestic Violence against Egyptian Women and Its Consequent Cost Using
a Latent Variable Model
Version: 1 Date: 30 Sep 2024
Reviewer's report:
Thanks for the opportunity to review this interesting and significant paper.  However, in my
opinion, the methods authors used are relatively simple. I particularly appreciate the fact that
the authors add more details about the construct reliability and validity (see Tabel 1 in Mure#an,
G. M., Fülöp, M. T., & Ciuma#, C. (2021). The road from money to happiness. Journal of Risk
and Financial Management, 14(10), 459.)
Still, I think the authors should develop the last paragraph with the limits of their paper and
emphasize how they intend to combat them in the future. Please insist on the international
dimension of the findings of this research: to what extent are these findings valuable within the
worldwide context? These suggestions will improve the quality of this manuscript and it will
make the paper more suitable for being published within the BMC Women's Health.
Title: Measuring Domestic Violence against Egyptian Women and Its Consequent Cost Using
a Latent Variable Model
Version: 1 Date: 07 Oct 2024
Reviewer's report:
I am happy having the opportunity to read and review the manuscript assigned to me, titled
“Measuring Domestic Violence against Egyptian Women and Its Consequent Cost Using a
Latent Variable Model” submitted to the BMC Women's Health.
I have carefully reviewed this manuscript and below is my decision.
- The topic is quite interesting, however, the explanation on the originality of the study is
insufficient. This paper, needs to highlight clearly the originality of the study.
- How does the paper contribute to the extant literature on the subject?
-The literature review section has not been written. In my view, this is one the weakest sections
of the article. The review is quite general and does not offer a synthesis of previous research.
-I would suggest adding to the literature and referencing it within the introduction and discussion
as well.  There are studies that have examined violence.
1) https://doi.org/10.1007/s10389-023-01999-x
2) https://doi.org/10.1371/journal.pone.0248630
3) https://doi.org/10.1371/journal.pone.0275950
4) https://doi.org/10.1186/s12905-021-01333-1
5) https://doi.org/10.3389/fpsyg.2023.1174143
6) https://doi.org/10.1177/21582440241251989
-A more detailed explanation should be written about the data set.
- The manuscript is well-written, though there are minor grammar issues that I leave for the
authors to address in their revision.
- All research has limitations. Prior to the ‘Conclusion’, please ensure to have a limitations
section.
It can be published after corrections are made.
Title: Información es poder (information is power): Menopause knowledge, attitudes, and
experiences in midlife Hispanic women and Latinas
Version: 2 Date: 24 Sep 2024
Reviewer:  Phuc Nhon Nguyen
Reviewer's report:
Thank you for the topic on women’s health. Due to qualitative study, the paper has some limited
points. After reading, I have some concerns:
- Definition of premenopausal period should be reconsidered. The current definition is
incorrected.
-The survey was made through the online system, filled-in paper, or telephone. Did the audio
or film was recorded?
-The investigators and the survey time should be provided.
-The question and reply was made and translated by two different languages (Spanish and
English). This must be a bias.
-External validation has been made for the queries?
-The data remains limited.
-No new literature gap was generated.
-The study should mention and compare with other population.
Title: Información es poder (information is power): Menopause knowledge, attitudes, and
experiences in midlife Hispanic women and Latinas
Version: 2 Date: 04 Oct 2024
Reviewer:  Enas Mahrous Abdelaziz
Reviewer's report:
Dear Authors,
Thank you for your hard work in revising the manuscript and addressing the reviewers' concerns.
Please take the following feedback into account:
General comments:
• The number of keywords exceeds the recommended limit.
• The introduction does not clearly explain the significance of the study or how it addresses
existing gaps. Please include a paragraph discussing the study's importance.
• The eligibility criteria state that participants are aged 35-60, which raises questions about the
relevance of menopausal symptoms at age 35. Could you please provide a reference or rationale
for this age range?
• Participants were asked about their positive or negative views on menopause and hormone
therapy." This could lead to subjective responses; how did the authors take participants'
experiences into account?
• How did the authors assess the participants' perception of their knowledge? Please elaborate
on this.
Title: Transvaginal Natural Orifice Endoscopic Surgery for Hysterectomy: A prospective cohort
study
Version: 3 Date: 17 Sep 2024
Reviewer:  Víctor Manuel Vargas-Hernández
Reviewer's report:
Hysterectomy is considered one of the most common gynecologic surgeries and benign
gynecologic diseases are responsible for 90% of these and vaginal hysterectomy is preferred
considering the efficacy and safety of different surgical techniques. Although vaginal
hysterectomy has been associated with shorter hospital stay, fewer infections, and earlier return
to normal daily activity, it is limited by poor visualization, difficult manipulation, lack of training
and skills.
Minimally invasive procedures such as laparoscopy, natural orifice transluminal endoscopic
surgery (NOTES), robotic-assisted laparoscopy, and single-port laparoscopic surgery aim to
decrease tissue injury and postoperative morbidity and mortality and improve patient quality of
life, surgeons use natural orifices in the human body to reach the abdominal cavity and perform
surgeries.
Title: Transvaginal Natural Orifice Endoscopic Surgery for Hysterectomy: A prospective cohort
study
Version: 3 Date: 17 Sep 2024
Reviewer:  Phuc Nhon Nguyen
Reviewer's report:
Dear authors,
Thank you for you work on women’s health.
-This study aims to compare the surgical outcomes of vaginal natural orifice transluminal
endoscopic surgery (vNOTES) vs transumbilical laparoendoscopic single-site surgery (LESS)
for hysterectomy. However, why the LESS was chosen for a comparison? Meanwhile, it was
not a standardized management for hysterectomy. The classic laparoscopic hysterectomy with
3 or 4 trocars is more popular.
-The sample size calculation was not used. Why the number cases of LESS were 122 and that
of vNOTES were 70?
-The indication for hysterectomy between 2 groups is not the same.
-The surgeon’s skill is different. So the bias was present.
-Long-term outcomes relating to parasite fibroid, uterine tissue dissemination, and pelvic organ
prolapse are still required.
-Propensity score matching study or RCT will be more suitable.
-Univariate and multivariate logistic regression should be applied.
-Kaplan-Meier curve should be used to reveal the timepoint and risk factors for adverse outcome.
-The intraoperative photos would be more significant.
-These documents could be read:
-A recent systematic review has concluded that “ While the feasibility and safety of the vNOTES
hysterectomy were already established, this review also underlines the noninferiority of this
technique when compared to laparoscopic hysterectomy in terms of surgical outcomes. In
addition, vNOTES hysterectomy was associated with faster operating time, shorter hospital
stay, and better post-operative pain scores compared with laparoscopic hysterectomy.”
Chaccour C, Giannini A, Golia D'Augè T, et al. Hysterectomy Using Vaginal Natural Orifice
Transluminal Endoscopic Surgery Compared with Classic Laparoscopic Hysterectomy: A New
Advantageous Approach? A Systematic Review on Surgical Outcomes. Gynecol Obstet Invest.
2023;88(4):187-196. doi:10.1159/000530797.
-Similar to the result of Baekelandt et al., vNOTES is non-inferior to total laparoscopic
hysterectomy (TLH) for successfully performing hysterectomy without conversion. Compared
with TLH, vNOTES may allow more women to be treated in a day-care setting. Baekelandt
JF, De Mulder PA, Le Roy I, et al. Hysterectomy by transvaginal natural orifice transluminal
endoscopic surgery versus laparoscopy as a day-care procedure: a randomised controlled trial.
BJOG. 2019;126(1):105-113. doi:10.1111/1471-0528.15504
Title: Transvaginal Natural Orifice Endoscopic Surgery for Hysterectomy: A prospective cohort
study
Version: 3 Date: 19 Sep 2024
Reviewer's report:
Manuscript Title: Transvaginal Natural Orifice Endoscopic Surgery for Hysterectomy: A
Prospective Cohort Study.
Thank you for the opportunity to review this manuscript. While the study presents an interesting
approach, there are several issues that need to be addressed.
Major Issues:
-Study Design: The design is a prospective observational cohort study. However, the
study aims to compare two procedures or assess the efficacy of one procedure. Without
randomization, confounding factors are inevitable, particularly related to the selection of
procedures (confounding by indication). Although the authors state that the procedure selection
was based on patient preference, physicians often influence patients’ choices. The authors need
to demonstrate how they adjusted for this imbalance. It’s noteworthy that several variables
were collected that could impact the outcomes (e.g., surgeon experience, BMI, age, uterine
size, adhesions). These variables should be included in a confounder-adjustment analysis (e.g.,
multivariable analysis, propensity score analysis). While the manuscript mentions the use of
multivariable analysis, it appears to be used for exploratory purposes rather than confounder
adjustment, which is inappropriate for answering the primary study question—evaluating the
safety and efficacy of vNOTES.
-Sample Size Calculation: There is no mention of how the sample size was calculated, which is
critical for interpreting the study’s power and validity.
-Tables 3, 4, and 5: The results presented in these tables do not align with the main objective
of the study, which is to evaluate the safety and efficacy of vNOTES. This study is focused on
efficacy, not on exploring risk factors.
Minor Issues: Several minor inaccuracies have been noted, and there are likely more throughout
the manuscript. I strongly recommend that the authors thoroughly revise the manuscript for
accuracy and clarity. For example:
-Method Section: The term “bladder lithotomy position” is unclear. I could not find any reference
to this position. The authors may have meant “lithotomy position,” which is the standard term.
-Result Section: The statement, “Among the 219 patients, 122 (63.5%) underwent LESS and
70 (36.5%) underwent vNOTES (Table 1),” seems incorrect. Please verify the total number of
patients.
-Terminology: The term “exhaust time” is unclear. I recommend using a more precise term.
-Table 2: The variable “bleeding volume” was analyzed as a categorical variable (using
percentages and chi-square analysis), though it should be treated as a continuous variable.
In conclusion, while this study addresses an interesting topic and involves a considerable
number of patients undergoing these advanced procedures, the current analytic methods are
inappropriate for answering the main research question. As such, the overall quality of the
manuscript remains suboptimal.
Title: Transvaginal Natural Orifice Endoscopic Surgery for Hysterectomy: A prospective cohort
study
Version: 3 Date: 22 Sep 2024
Reviewer's report:
Thanks to the respected author. The items are provided for correction or completion.
The discussion section of the study results did not compare them with previous studies.
Is the surgeon's skill a limitation or an advantage in the study?
What are the practical results of the present study?
The study is well designed and effectively presented in the article.
After completing and correcting the articles, the article can be printed.
Best Regards
Title: Transvaginal Natural Orifice Endoscopic Surgery for Hysterectomy: A prospective cohort
study
Version: 3 Date: 23 Sep 2024
Reviewer's report:
Thank you for the opportunity to review the manuscript
In the introduction section, the importance of the subject should be shown with statistics and a
review of studies should be added
A detailed comparison of the methods should be added in the introduction
Which CIN (1,2,3???????) was included in the study?
Did you do correlation regression of variables before? Please add the table
What is meant by safety? What was the safety review tool?
What was the validity and reliability of your tool?
How were the inspection times?
Title: Transvaginal Natural Orifice Endoscopic Surgery for Hysterectomy: A prospective cohort
study
Version: 3 Date: 24 Sep 2024
Reviewer's report:
I read with great interest the Manuscript titled " Transvaginal Natural Orifice Endoscopic
Surgery for Hysterectomy: A prospective cohort " 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 analyzed in this study, I suggest that the authors add a reference to
current evidence of hysterectomy’s approaches, considering various outcomes, evolution, and
improvement in last years. I would be glad if the authors discuss this important point, referring
to PMID: 36498515
- The authors, considering the topic of this study, could extend and improve the discussion by
evaluating and citing current evidence about comparison hysterectomy by vNOTES) with other
surgical approaches in terms of efficacy, surgical outcomes, complications, and cost. I would be
glad if the authors discuss this important point, referring to PMID: 37231836
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: Transvaginal Natural Orifice Endoscopic Surgery for Hysterectomy: A prospective cohort
study
Version: 3 Date: 01 Oct 2024
Reviewer:  Michael Odida
Reviewer's report:
A well written paper on a  new surgical technique. There are a few issues to address.
1. On page 6.
"The average age of the patients, duration of amenorrhea, and BMI at recruitment were 50.12
±6.78 years#24.3±3.03kg/m2#6.92±2.26 cm, respectively." The duration of amenorrhea is in
cm. This should be corrected.
"Surgeons with more than 20 years of qualifications saved approximately 20.9
minutes of surgical duration compared to physicians with more than 10 years of
qualifications(95%CI:-34.30,-7.54, P=0.002)". Qualification better replaced by experience and
physicians better replaced by surgeons.
2. On page 7 "Among the 193 patients included" In Table 1 and other parts of manuscript, there
is 192. Please reconcile.
3. On page 8
"in patients in known studies[14-16]".  Better replace "known" by previous or other
Title: Transvaginal Natural Orifice Endoscopic Surgery for Hysterectomy: A prospective cohort
study
Version: 4 Date: 17 Oct 2024
Reviewer:  Phuc Nhon Nguyen
Reviewer's report:
Thank you for your  responses to reviewer's comments.
The paper is more improved now. However, the English editing is still required. Please check
with language editing service. For example, I found some  inappropriate words such as Max
diameter of uterian,  uterian fibroids, and flatus time. Please add the full-word for abbreviation
as foot-note under table. For example: VIF.
Title: Transvaginal Natural Orifice Endoscopic Surgery for Hysterectomy: A prospective cohort
study
Version: 4 Date: 21 Oct 2024
Reviewer's report:
Review of the revised manuscript titled “Transvaginal Natural Orifice Endoscopic Surgery for
Hysterectomy: A Prospective Cohort Study”
Thank you for inviting me to re-review this manuscript. I appreciate the authors’ efforts to
address the concerns raised in the initial review. The revised version has resolved most of the
issues I noted previously. However, one issue remains.
In your limitations section, you state, “Further propensity score-matched studies or randomized
controlled trials would provide a more robust validation of our findings.” While I understand
the intent, there are some issues with this statement. Propensity score matching is a statistical
method for adjusting confounders in observational studies, not a study design. Furthermore,
your current dataset already contains the necessary variables to perform propensity score
matching. Thus, suggesting the need for “further propensity score-matched studies” sounds
somewhat awkward. It would be clearer to emphasize the need for robust statistical adjustments
using propensity scores to enhance the current analysis. Additionally, as mentioned previously,
describing propensity score matching as a study design creates confusion.
Lastly, please note that this comment does not require any revisions. However, I still find
it problematic to interpret the main comparative results using only a univariable analysis in
observational study. Your study already has the necessary variables to perform a multivariable
analysis, which would be more appropriate for adjusting confounders—even if propensity
score matching isn't feasible. Given that the main objective is to compare the interventions, I
am unclear why multivariable analysis wasn't used for confounder adjustment, as opposed to
exploring factors like operative time and blood loss, which seem secondary.
Title: Awareness, attendance, and attitudes toward cervical cancer screening among HIV-
positive Chinese women in Yunnan province: a cross-sectional study
Version: 0 Date: 17 May 2024
Reviewer's report:
This study surveyed the awareness, attendance, and attitudes toward CCS and their associated
factors among Chinese WLHIV in an HIV-endemic province. It is useful to provide the evidence
for policy makers to develop relative measures and strategies for cervical cancer prevention for
WLHIV in China and other HIV-endemic regions. There are some modification suggestions for
this manuscript.
1.Needs further explanation
#1#How were the subjects recruited? Including: where, when and by whom? What is the
sampling principle? Random, clustered or convenient?
#2#In the inclusion criteria, why do subjects need to be with ongoing ART? Why the age of
subjects was #18 years old? According to the WHO and China's cervical cancer prevention and
control guidelines, the age of cervical cancer screening is recommended to be #25 years old,
while under 25 years old, screening is not recommended.
#3#Is it too simple to identify as being aware of CCS just based on "Participants who had heard
of CCS " ?
#4#Why is it necessary to conduct "A brief health education on CC before the interview on
attitudes#
#5#What's the meaning of "Secondary and Tertiary education"? How to define them?
#6#Lines 271-273 “However, the up-to-date attendance might be even lower among the whole
WLHIV population, particularly those who do not regularly attend the HIV/AIDS clinics or the
department of infectious diseases.” Is this sentence based on the results of this study, or other
findings, or just the author's guess?
2. Suggestions
#1#In order to achieve elimination of CC, WHO proposed to receive at least one efficient
cervical cancer screening at the age of 35 and 45, and according to the China's free cervical
cancer screening policy, the target population is 35-64 years old. Therefore, 35 years old is a
very important age group, but this study does not reflect this age group.
It is suggested that the age of the population should be divided into groups each 5 years old, so
as to compare with the results of other studies, and provide a more targeted evidences for the
formulation of relevant policies and strategies.
#2#Line 407 “our study found that most Chinese WLHIV in Yunnan were aware of CCS”#This
study is only conducted in one hospital in Yunnan and does not represent the whole of Yunnan.
Therefore, it cannot come to such a conclusion.