JerMa88/BMC_Womens_Health_Peer_Reviews huggingface dataset:
Title: Significance of the viral load of high-risk HPV in the diagnosis and prediction of cervical
lesions: a retrospective study
Version: 1 Date: 22 May 2021
Reviewer:  Paolo Giorgi Rossi
Reviewer's report:
Abstract
Line 29: high risk is repeated.
Lines 31 32: I think it should be “women were screened for cervical pre-cancer (or cancer
precursors) with HPV…” what should be reported is how women were included, i.e. who is
the target of screening? Why they did the HPV test? how did you assess the presence of CIN
and cancer? Colposcopy? Women classified as normal included only histology negative or also
colposcopy negative without biopsy?
How did you grouped the classes of viral load (low, high, moderate)?
What do represent the ORs? The odds of increasing from one group to the other or the odds
from low to high?
Line 48: the first sentence cannot relate to your data since you included only positive women,
furthermore there is overwhelming evidence that HPV is a necessary cause for high grade CIN.
Introduction
It can be shortened. Some concepts are repeated and  not correctly expresses, for example lines
64-65 and line 78.
Methods
A description of the screening program of the screening population in your context is needed:
how women attend screening? Are they invited? Spontaneously? Who is eligible? Is it free?
What is the interval after a negative test? Are all women screened with HPV or Pap is still used?
HPV positive women are all referred to colposcopy? I do not think so, please describe triaging
method and the management of HPV-positive/triage-negative women: retesting with HPV after
12 months? Other?
I do not understand if biopsy was performed in all colposcopies or not. In the methods it is
described as all colposcopies have random biopsies even if colposcopy evaluation is negative,
in the results you present a 69% biopsy rate.
Discussion
Please consider that the association you found are true only in women with biopsies. I suggest
to repeat the analyses for all the positive women, considering as negative those that have not
been biopsied because colposcopy was negative e and those who became HPV negative during
follow up. In fact if you are going to use viral load as negative, the population in which you will
apply this criterion would be all HPV-positive women.
Particularly for the effect of age, I think there could be some colliding effect due to restriction
of the population to only those with biopsy. If an analysis of viral load on all positives is not
possible because follow up is not available, at least this point should be reported in the limits,
particularly if the result is linked to a possible use as triage method, because triage would apply
to all positive women and not only to those with a biopsy.
In the conclusion it should be noticed that this statement can be done in the light of previous
literature.
References should be integrated, I know many other studies that used HCII RLO to stratify the
risk of HPV-positive women, surely there are also results from the NTCC trial (Ronco et al
2006 and 2008).
Title: Mapping the health systems response to violence against women:  Key learnings from
five LMIC settings (2015-2020)
Version: 1 Date: 26 Mar 2021
Reviewer's report:
This is a comparative analysis of four case studies on health systems responses to VAW from
Nepal, Bangladesh, Brazil and Rwanda. The authors conducted secondary analysis of publicly
available surveys and reports, wrote analytical summaries and mapped findings on the WHO
building blocks of health system responses to VAW. It is not clear what this study adds to the
current knowledge about health systems response to VAW in LMICs that has been summarized
in several systematic reviews referenced by the authors. It was difficult to follow this manuscript
and get key messages. Results do not match Figure 1. Discussion repeats Results, introduces
new findings (p. 14, Tab. 2), does not summarize main findings or compare them with existing
literature.
Title: Mapping the health systems response to violence against women:  Key learnings from
five LMIC settings (2015-2020)
Version: 1 Date: 07 Apr 2021
Reviewer:  Ana Flavia d'Oliveira
Reviewer's report:
The paper has a relevant subject and tries to synthetise responses around the world to VAW.
However, it needs to be more specific with with type of VAW it is referring and which type of
health system response.
The policies in Brazilian response on health system are not completely described. In Brazil, we
have a sexual violence policy, with a Minister of Health guideline since 1999 ( Norma tecnica
PREVENÇÃO E TRATAMENTO DOS AGRAVOS RESULTANTES DA VIOLÊNCIA
SEXUAL CONTRA MULHERES E ADOLESCENTES). There are about 60 hospitals around
the country with programs to assist sexual violence and give prophylaxis of IST, pregnancy and
AIDS, psico social counseling and perform legal abortion if needed. Women's houses , analysed
in the paper, are more recent policies looking at domestic and intrafamiliar violence, and are
part of women or social welfare departments. There are just 3 at the moment open in Brazil,
because its process of implementation was stoped after the deposition of the president in 2016.
It seems  "sexual violence" services, located at hospitals, are more comparable to the OSC and
need to be at the Table 1 at page 5.
I do not recognise where the sexual assault protocols in Brazil emphasize nurses and no other
health providers, please show the reference ( line 145 page 8). The "Norma Técnica" values
team work and talk about doctors, nurses, social service and psychology. Also wold like more
references for "virginity test"in Brazil, which may occur but never in sexual violence services.
The epidemiological survailance mandatory report, law since 2003 also need to be described
better. In spite of the under report, the reports have been increasing in the country. (line 243
pg 12)
Financing is also not acurate in line 73 pg 9.  There is a national pact, with rules of money
transference  between national government and the states, but the budget was hugely cut recently.
I suggest the papers bellow to look better at the different aspects of Brazilian response.:
https://www.scielosp.org/article/sausoc/2014.v23n3/787-800/en/
https://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-81232018000100093
https://www.scielosp.org/article/csc/2016.v21n2/563-572/en/
https://search.proquest.com/docview/1679187606?pq-origsite=gscholar&fromopenview=true
Title: Mapping the health systems response to violence against women:  Key learnings from
five LMIC settings (2015-2020)
Version: 2 Date: 08 Jun 2021
Reviewer's report:
Dear authors,
Thank you for the detailed replies. You have addressed all the points made in a satisfactory way.
I have just some minor points to further suggest:
• Table 1: Brazil. I would suggest that here the authors add what national level response model
is delivered in Brazil – to be consistent with other countries descriptions, where the main service
delivery model is One Stop Centres. This is not the case for Brazil, as it is a focused response to
SV in hospitals. Although Brazil has also NPV (Violence Prevention Teams) units for violence
in primary health care. I would also add this here and in the text where describing the response.
• Line 133: Just a clarification and possibly rephrase this sentence on screening to clarify that
Cochrane review and WHO do not recommend screening – as there is insufficient evidence
that IPV screening increases effective referral to support services or improves health outcomes
for women (O’Doherty et al.2014; WHO, 2013). WHO though says that if settings want to
implement it, screening should be done when adequate referrals and support systems are in place.
It is also fine to implement it in specific settings like HIV and ANC.
• Table 2: Brazil: I am not sure why the table only focuses on Casas da Mulher’ as they are not
providing health services. Your paper focuses on HS responses and therefore you should focus
instead on the health responses here. Should this describe the hospital response in relation to SV
(as you mentioned this was Brazil main focus)? Although, you could mention what is happening
at primary health care level. In particular, the NPV (Violence Prevention Units) in PHC care
facilities. Look also at references from Ana Flavia De Oliveira and colleagues from HERA study
(in the background as well: De Oliveira et al. paper: https://www.ijhpm.com/article_3980.html).
As for where to place sentence on HERA: I would recommend in the discussion as your 5 settings
are primarily focusing on hospital-based responses.  Although, as it is pointed out in the article,
it is important to also address violence and integrate services for violence against women also
at PHC level.
Title: Mapping the health systems response to violence against women:  Key learnings from
five LMIC settings (2015-2020)
Version: 2 Date: 14 Jun 2021
Reviewer's report:
Even after some very thorough feedback, at this point I do not think you have been able to
adequately define what forms of violence are adequately managed, how systems are gendered
and how training could or should be undertaken. You need to address intimate partner or family
violence better as different from sexual violence outside the family, and in conflict.
I think you need to better explain the methodology as you have removed how you used sources
and clearly these were fewer in Brazil, than Nepal or Sri Lanka. This article would be better as
those two countries, which share cultures being analysed as two cases studies with the WHO FW.
Title: Kosovo women’s knowledge and awareness of human papillomavirus (HPV) infection,
HPV vaccination, and its relation to cervical cancer
Version: 3 Date: 07 Jun 2021
Reviewer:  Murat Yassa
Reviewer's report:
I read the article presenting the actual knowledge level of women living in Kosovo about the
HPV and its vaccination program with great interest.
Although this study carries a moderate novelty, its possible effects on public health can be great
and lead for some useful healthcare programs.
The study question, answers and the method are concise and clear.
I only would like to see a brief question to reveal the thoughts and beliefs of the people for the
anti-vaccination movement, if an anti-vaccination belief is currently emerging and if it prevents
people from having the HPV vaccination? I believe authors would like to discuss very briefly.
Otherwise i do not have anything else to add. Regards.
Title: Kosovo women’s knowledge and awareness of human papillomavirus (HPV) infection,
HPV vaccination, and its relation to cervical cancer
Version: 3 Date: 20 Jun 2021
Reviewer:  Bu#ra #ahin
Reviewer's report:
How many patients should be stated in the method section, not in the findings section. In the
method part, the questions should be mentioned a little. The features in the conclusion part
should be specified in the findings part.
In the conclusion part, only the relationship between HPV and cervical cancer should be
considered. The importance of the vaccine should be left behind awareness of the disease.
In the last paragraph of the Background, the purpose of the study should be stated with a clear
sentence and the reference number 14 should be moved earlier (1-2 sentences earlier).
The questions are not fully written in the material method section (we see it for the first time
in the results section).
Which test or tests were used in the material method, that square?? These are not clearly written.
In the discussion section, the young age and the high level of education are simply mentioned in
one sentence (however, in the previous sentences, the cognition levels of other countries were
mentioned in detail). The discussion should be opened further.
Good work.
Title: The role and attributes of Social networks in the provision of support to women after
stillbirth. Experiences from Uganda.
Version: 2 Date: 21 Mar 2021
Reviewer:  David Ellwood
Reviewer's report:
Thanks for allowing me to review your interesting manuscript. It is good to see such a
comprehensive exploration of support networks for women after stillbirth. I do have several
questions and comments;
1. I had assumed when I started to read this that all of the respondents had experienced stillbirth
yet on page 7, line 252-254 it states that 'less than a quarter of respondents had a negative
experience of pregnancy such as stillbirth'  Can you please clarify what you mean by that point?
I would have thought it should be 100% if that was the reason why they were recruited?
2. In the introduction (background) you discuss that support networks might be helpful in
reducing stillbirth by improving an understanding of risk factors. Can you explain that point
further? I don't really see how you can draw that conclusion from your data.
3. Page 5 line 165 presumably were (the second one) should be where, or else this sentence
doesn't really make sense. Can you please clarify this?
3. Page 7 line 237. chi-squire should be chi-square
4. Page 7 line 247 date is should be data are (plural)
5. Page 336 line atleast should be at least
6. A general comment is that there may be some differences in support offered by women's
networks based on the clinical details of the stillbirth (cause, gestational age, gender etc). Did
you find any evidence of such differences?
Title: The role and attributes of Social networks in the provision of support to women after
stillbirth. Experiences from Uganda.
Version: 2 Date: 12 Jun 2021
Reviewer's report:
Study in an area where there is no much literature.
Title: I would add "attributes" in the title - since it was one of the two objectives (lines 132-133).
The same addition would be added to the aim in the abstract (lines 16-17)
Abatract:
Well structured.
Need to mention the number of alters of alters generated by the respondents.
Background:
Participant characteristics ...Enrolled participants in this study included women in their
reproductive age (18 years or older) with eligibility criteria of having experienced a stillbirth
within six months before the study and consented to participate. Was there A minimum time
given to women so as to exclude women who could have had a stillbirth within a few days (eg
less than 1 week) for ethical considerations? please calrify.
Results:
Respondents characteristics- the use of percentages without accompanying numbers on only 17
respondents does not apppear appropriate 9lines (250-263).
Table 2 (line 276) - has a column on range but has a value of 16.1 at the bottom.
Table 8 word ?squire
Discussion:
The introductory text is very long (lines 397-415). The reader would be more interested in
discussion of main findings first.
Availability of social support (428-431) ..Targeting mothers immediately to engage them in
postnatal counseling is key to guide them in subsequent pregnancies since studies have long
established that the desire for more children increases with a loss of a child and women tend to
conceive immediately. - studies need to be referenced.
Conclusion:
The conclusion lacks some key messages from the study findings. The conclusion in the abstract
is better.
Abbreviations:
HIV - Human Immunodeficiency Virus
Title: The role and attributes of Social networks in the provision of support to women after
stillbirth. Experiences from Uganda.
Version: 6 Date: 22 Aug 2021
Reviewer:  David Ellwood
Reviewer's report:
Thanks for allowing me to read your interesting manuscript. I have only three minor comments/
questions for you:
1. What definition is used for stillbirth in Uganda? There are several used globally and it would
be of interest to readers to know if you were using the WHO definition of >28 weeks gestation.
2. Were any of the stillbirths associated with congenital anomalies?
2. It is noteworthy that many of the women were in their 5 pregnancy when stillbirth occurred.
This is quite unusual, as although high parity is a risk factor for stillbirth, nulliparity is a much
more common association. Can you comment on that?
3. In the supplementary file for the interview/survey questions there is an unfortunate
typographical error where it appears that the word 'vaginal' has been replaced with the word
'virginal' on two separate occasions. Can this be corrected?
Title: Patterns of changing pregnancy intentions among women living with HIV in Canada
Version: 1 Date: 15 Aug 2021
Reviewer's report:
This is a well-written article on an important topic. Authors should download the STROBE
checklist and ensure they follow the reporting guideline. There are several punctuation errors
and a few typos. I will suggest authors take their time to proofread their manuscript one more
time. Authors should split Table 2 into two tables, and the adjusted odds ratios for all the
confounders should be shown. It is important to see how each of the confounders influence
pregnancy intention.
Authors should be cautious of how they interpreted their findings on the association between
pregnancy intention and subsequent pregnancy.  The difference is huge, especially at 18 months,
20.8% vs. 11.0% vs. 5.9%. The strength of the association did not reach a significant level
because of the study's small sample size. Overall the direction of the association consistently
shows that pregnancy intention is positively associated with a subsequent pregnancy.  This is
a major limitation of this study and should be highlighted in the discussion section. Authors
rightly said that we should move away from reliance on statistical significance in interpreting
research results.  So it is important to highlight the direction of the effect and cautiously indicate
the sample size is powered to detect large effect sizes.
Title: A comparative analysis of the influence of contraceptive use and fertility desire on the
duration of second birth interval in four sub- Saharan African countries
Version: 0 Date: 08 May 2021
Reviewer's report:
Overall, the manuscript is well written and the topic is interesting.  The authors conducted a
comprehensive statistical analyses.
Line 44: change predictors to determinants..
The background is too long.. 2 pages maximum is enough.
Line 127 : Please add your rational of why you select only these four countries out of many
other SSA countries with available data in the DHS.
Line 230 Results: Please reduce the amounts of texts reporting results. You already have tables
and there is no need to go into details results.
Title: A comparative analysis of the influence of contraceptive use and fertility desire on the
duration of second birth interval in four sub- Saharan African countries
Version: 0 Date: 12 May 2021
Reviewer:  Chandra Mani Pandey
Reviewer's report:
(1) Very important study based on huge dataset from DHS which is considered as a reliable
source of demographic data in most of the countries.
(2) The authors have examined the gap between two consecutive births (1st and 2nd) assuming
that it depends on covariates/characteristics of mothers and households etc. available in the
database and have presented descriptive statistics of relevant variables used in analysis.
(3) Using Cox proportional Hazard regression risk of event (second birth) and median length of
2nd birth interval has been presented for four countries.
(4) To draw a valid conclusion from such analysis certain assumptions about the estimates are
essential and accordingly sample size estimation is required to ensure the validity and reliability
of inferences drawn
SPECIFIC TO MANUSCRIPT
Line 134-137: Talks about population of participating countries. It will be relevant to mention
the sample size drawn for DHS from these countries
Line152: Women "aged 5-59 " is perhaps  "aged 15-59 "
Line162: Contraceptive use and fertility desire are considered as independent variables in
the model but they seem to be highly correlated. eg couples opting for terminal method of
contraception have no desire of further births.
Table 1:   Terms used to classify ethnicity need further explanation to improve understanding
for global audience. Table is very lengthy and clumsy, consider reorganizing into smaller tables/
sub tables.
Table 2a, 2b:  Both tables are labelled  as  Table 2b . A column containing combined estimates
for all   countries could add value to this table.
FIG1: The X axis usually presents the accrual time and Y axis  is the probability of survival
at a given level of covariates. In PH model covariates also change with time, it is not clear at
what level of covariates these survival functions are estimated.  The end point of X-axis is 480
months i.e. 40 years. This means that mothers were observed for 40 years after the first birth to
see the occurrence of 2nd birth, whereas, the DHS data is cross sectional observation.
The survival curve for Ethiopia becomes parallel  to X-axis around survival rate of 0.25. This
means that about one-fourth of Ethiopian mothers will never have the event (2nd birth) whereas
DHS reports a very high TFR for this country as 4.3 (line 139)
Similarly, the problem of interpretation of Fig 2 (Hazard rate) also exists and needs critical
attention.
Title: A comparative analysis of the influence of contraceptive use and fertility desire on the
duration of second birth interval in four sub- Saharan African countries
Version: 1 Date: 16 Jul 2021
Reviewer:  Chandra Mani Pandey
Reviewer's report:
The authors have attended all the points raised in the previous review and improved the
manuscript significantly. However the justification for not estimating the sample size is
unconvincing. The sample size of a study does not depend on source of data but several other
statistical consideration. The WHO manual for sample size estimation my be referred  for further
details.
Title: Long term impact of the WHI studies on information-seeking and decision-making in
menopause symptoms management: a longitudinal analysis of questions to a medicines call
centre
Version: 2 Date: 21 May 2021
Reviewer:  Narjes Bahri
Reviewer's report:
Dear authors
Thank you for your work. I read the article carefully. The subject of the article is very important
and interesting. The authors in this article have examined the effect of the published results of
the WHI study the care seeking behaviors and women's questions and concerns about HT. Here
are some tips to improve the quality of the article.
1- Regarding the contents of method and background the focus of the paper has been on the
WHI study, but there is no mention of this issue in the title, please amend the title accordingly.
2- In the introduction, it is better to mention more about the unexpected results of the WHI study
and negative impact on the people.
3- Regarding the various method of managing menopausal symptoms some evidence shows that
still HT is the most common option. For Example, following paper that you can cite it:
Bahri N, Pourali L, Esmaily H. Application of various menopausal symptoms treatment options
and its related factors, Gonabad- 2016. Iranian Journal of Obstetrics, Gynecology and Infertility
2016, 19(26):1-8.     DOI: 10.22038/ijogi.2016.7796
4- In page 5, lines 8 to 11: Also, one of influencing factors that affect the process of decision
making regarding the treatment of menopausal symptoms is decision making styles.  please
notice the following paper:
Bahri N, Sajjadi M, Sadeghmoghadam L. The Relationship between Management Strategies for
Menopausal Symptoms and Women’s Decision-Making Styles during Menopausal Transition.
Menopause Review 2019 Dec, 18(3): 174-179.  DOI: 10.5114/pm.2018.74896
5- Please mention the type of study as well as the time of study in the first line of Method section.
6- The purpose of thematic analysis and qualitative study is not clear. In this case, it is necessary
to explain more about the purpose of this analysis and what results did the authors seek?
7- I suggest that the results of the qualitative part be presented in a separate paper, and in this
paper only main themes mentioned.
8- Most of references are outdated. It is recommended to use more references from the recent
five years.
Best regard