JerMa88/BMC_Womens_Health_Peer_Reviews huggingface dataset:
Title: Effects of Benign Ovarian Cyst Volume and Laterality on AMH and CA-125 Levels
Version: 1 Date: 27 Apr 2025
Reviewer's report:
The topic addressed in this article is relevant to the effects of ovarian surgery on ovarian reserve.
Our careful reading of the article allowed us to observe:
The stated objective, "Understanding these relationships may enhance diagnostic accuracy and
optimize patient management strategies in gynecological practice," was not achieved regarding
the optimization of the management strategy for ovarian cysts.
In the methodology section: What surgical technique was used? Laparotomy vs. laparoscopy?
What type of cystectomy: drainage? Enucleation? Alcoholization? Puncture? Laser? Hemostasis
by ligation or electrocautery?
Lines 25-26: Do these values apply to all cysts or only to bilateral cysts? Can you be more
specific?
Lines 28-29: #dem
Did you check whether the AMH and CA-125 values follow a normal distribution before
calculating the means? You have abnormally high standard deviation values, sometimes even
above the mean. herself. That doesn't seem correct.
Lines 34-35: I would rather say, surgery on bilateral cysts has a significant impact on ovarian
reserve.
Lines 96-97: What's the point of this study? And why then include pregnant women whose
condition can increase CA 125 levels without having an ovarian cyst?
We have results that are inconsistent with this study and others that appear in the discussion.
Lines 134-138 and Table 1: The spread of these values is unusual, with even standard deviation
values above the mean, meaning we had negative values?
Table 2: This title does not reflect what is contained in this table.
The table lists the type of surgery, an intraoperative observation, and the notion of pregnancy
before the procedure.
It would have been interesting to have the previous table merged with this one; That is, presenting
all these parameters depending on whether it's a unilateral or bilateral cyst.
Why include pregnant women when pregnancy can elevate CA 125 levels? This can lead to
major bias.
Lines 159-162: Is this important for the objective of this study? If you consider it important, it
might as well be included in the objectives of the work, the nature of which will change.
How did these women conceive? What were the other fertility factors, since AMH is not a marker
of spontaneous fertility.
Table 3: Mann-Whitney U test is used to compare medians, but I don't see any parameter with
median. All of them are expressed as mean +/- SD. Table needs to be redone.
Poor discussion, yet there are several studies on this topic.
221-229: This paragraph seems off-topic to me.
Line 239: “Unlike some studies suggesting partial recovery of AMH levels postoperatively, we
observed no improvement at the second month.” What is the source?
Lines 243-248: Source?
Lines 256-257: This information is not included in your results.
Title: Effects of Benign Ovarian Cyst Volume and Laterality on AMH and CA-125 Levels
Version: 1 Date: 05 May 2025
Reviewer:  Danilo Aravena-Nazif
Reviewer's report:
Please see the attached file for suggestions.
1. The article is very interesting and the topic sound for health care providers. Minor corrections
to the writing are needed.
2. Line 44. Lacks point at the end of the sentence.
3. Line 59. the word "rpe" does not make sense. Maybe a typo?
4. Line 93. I possible, please include the total number of subjects and then specify the subjects
excluded and the cause.
5. Line 116. The word "subtracTheting" does not make sense. Maybe is subtracting?
6. Line 120. If possible include the power calculation result used for the sampling.
7. Line 134. Replace ng/m, L with ng/mL.
8. Line 138. Replace Tables 1 with Table 1.
9. Line 206. Some values (like Total cyst volume) have a very high standard deviation. Perhaps
some comment about it will be useful.
Title: Association between physical activity and gynecological cancers: A meta-analysis of
prospective cohort studies
Version: 0 Date: 30 Apr 2025
Reviewer's report:
Cao and colleagues have conducted a meta-analysis on the association between physical activity
and gynecological cancers. The present meta-analysis included 26 studies, which were analyzed
and written well.
-Abstract, Line 28: It is recommended to use “relationship” or “association” instead of
“correlation”.
- Abstract, results section: Please provide p-values for each reported pooled RR.
- Abstract, methods section: Consider adding a few keywords to enhance clarity and make it
more informative.
- Methods: The search strategy was terminated in July 2024, almost nine months ago. Please,
update the search date to April 2025 for more accuracy. If new studies were added, results should
be re-analyzed.
- Methods: Why did you not include the case-control and cross-sectional studies? It is
recommended that you include the case-control and cross-sectional studies. If you don't want to
include these study designs, please mention them in the exclusion criteria.
- Methods: Please provide the information on the questionnaire used to assess physical activity
for each included study in Supplementary Table 2. If sufficient information is available, perform
a subgroup analysis based on the physical activity questionnaire.
- Methods: Please provide PICO criteria (as a supplementary table) for the present systematic
review and meta-analysis.
- Results: Please provide p-values for each reported pooled RR in the “results” section.
-Discussion, Line 202: It is recommended to use “relationship” or “association” instead of
“correlation”.
- Discussion: Given the crucial role of physical activity in weight management and the potential
effect of obesity on increased risk of hormone-sensitive cancers in women, it is suggested
that discussing the role of physical activity in weight management and its association with
gynecological cancer risk.
- Please provide more explanation on the possible mechanisms and cellular aspects of physical
activity's influence on gynecological cancer risk.
Title: Transactional Sex and associated factors among young women in a tertiary institution in
Northern Ghana: evidence from a cross-sectional survey
Version: 1 Date: 16 May 2025
Reviewer's report:
Permit me to commend the authors. I was really thrilled reading the work because of its flow
and narratives. I have few areas to point out few lines.
1. I think the abstract is fine but exceeded 500 words. Really do not know what number of words
are required by BMC but abstract of 300 to 500 words should do just fine.
2. The Literature section, was not well outline. So i have few questions here, is there no need
for a theoretical framework? what are the dimension of empirical discussions around this areas,
i think readers may wish to see that.
3. what statistical tool was used in the analysis?
Title: Effectiveness of physical therapy on pain, disability and quality of life in women with
lumbopelvic pain in postpartum period: A systematic review with evidence gap map and meta-
analysis
Version: 1 Date: 16 May 2025
Reviewer:  Döndü Kurnaz
Reviewer's report:
Your manuscript addresses a highly current and valuable topic that contributes to the field. My
suggestions to enhance the quality of the meta-analysis are provided in the attached document.
Kind regards.
Title: Effectiveness of physical therapy on pain, disability and quality of life in women with
lumbopelvic pain in postpartum period: A systematic review with evidence gap map and meta-
analysis
Version: 1 Date: 28 May 2025
Reviewer's report:
1. The paper demonstrates a certain degree of innovation. However, previous
studies, such as: DOIs 10.1136/bjsports-2024-108488, 10.56499/jppres24.2072_13.1.299, and
10.1177/10998004221081083, have primarily focused on exercise therapy and acupuncture. It
is recommended to clarify the innovativeness and necessity of this study in the Introduction
section.
2. While the Limitations section states the high heterogeneity observed in the study, it remains
unclear whether further analytical approaches (e.g., stratified analysis or sensitivity analysis)
were conducted to identify potential causes of heterogeneity.
3. Regarding missing data, it is necessary to confirm whether additional statistical analyses were
performed to handle incomplete data appropriately.
Title: Effectiveness of physical therapy on pain, disability and quality of life in women with
lumbopelvic pain in postpartum period: A systematic review with evidence gap map and meta-
analysis
Version: 2 Date: 06 Jun 2025
Reviewer:  Döndü Kurnaz
Reviewer's report:
The authors have meticulously addressed the suggestions I provided during the review process.
The revisions have significantly enhanced the scientific quality and clarity of the manuscript.
Therefore, I find the current version suitable for publication.
I would like to thank the authors for their diligent efforts and constructive approach, and the
editorial team for managing the process with care.
Title: Navigating Treatment Options: A Qualitative Study Exploring Australian Women’s
Decision-making Experiences and Satisfaction with Treatment of Heavy Menstrual Bleeding
Version: 2 Date: 05 Apr 2025
Reviewer's report:
Thank you for the opportunity to review this important qualitative paper exploring the
experiences of those navigating treatment for HMB in Australia. This is a well written and
interesting study that makes a meaningful contribution to the literature in this area. Further
information regarding the study design as well as the background section are suggested prior
to publication.
Title: Navigating Treatment Options: A Qualitative Study Exploring Australian Women’s
Decision-making Experiences and Satisfaction with Treatment of Heavy Menstrual Bleeding
Version: 2 Date: 11 Apr 2025
Reviewer's report:
This is a well  written and relevant study.  The qualitative aspect is presented.
The results are comprehensive. And lenghty.
The methodology sound, some of the major tenants of qualitative reporting were not addressed,
saturation of data,  trustworthiness, credibility are some categories that need to be addressed.
The guided questions, would be helpful to discuss how these were developed.
To results are interesting and give rich insight. To strengthen the paper, the length is an issue.
A table or bullet may help with this. Keeping in mind the data is rich and needs reporting, but
keep it short.
Title: Stillbirth increase long-term health risks of diabetes, CVD, CVD mortality, and all-cause
mortality
Version: 1 Date: 06 Mar 2025
Reviewer:  Felix P Chilunga
Reviewer's report:
diabetes, cardiovascular disease (CVD), and mortality, using data from the UK Biobank. The
findings suggest that stillbirth is associated with an increased risk of these outcomes. Overall,
the authors have done a good job utilizing this valuable biobank resource.
However, there are areas that require improvement.
1. The study defines stillbirth as fetal death at or after 20 weeks of gestation, which differs from
the WHO definition of 28 weeks and the UK legal definition of 24 weeks. The authors should
justify this choice, as it affects comparability with other research and may influence prevalence
estimates.
2. The biological mechanisms linking stillbirth to CVD and diabetes are not well explained in
the introduction, and no hypothesis is provided. The study would benefit from a discussion of
potential pathways, such as inflammation, endothelial dysfunction, and metabolic disturbances,
as well as a clear hypothesis to frame the research question.
3. Pre-existing cardiometabolic vulnerabilities, such as lipid profile before pregnancy,
undiagnosed diabetes, and undiagnosed hypertension, are not accounted for. Pregnancy acts as
a stress test that can reveal underlying metabolic dysfunction. The authors should consider pre-
stillbirth health conditions, as these may be the true drivers of increased risk rather than stillbirth
itself.
4. The reported baseline characteristics were measured after stillbirth occurred, meaning they do
not represent true baseline measures. These characteristics may already reflect health changes
triggered by stillbirth rather than pre-existing differences. A clearer comparison of health status
at the time of stillbirth would provide a more accurate assessment.
5. A time-to-event analysis is necessary. Since the study includes both the age at stillbirth
and the timing of disease onset, survival models could clarify whether CVD risk accelerates
after stillbirth or remains constant over time. This would provide a better understanding of the
temporal relationship between stillbirth and cardiometabolic disease.
Title: Stillbirth increase long-term health risks of diabetes, CVD, CVD mortality, and all-cause
mortality
Version: 1 Date: 09 Mar 2025
Reviewer:  Víctor Juan Vera-Ponce
Reviewer's report:
Dear Authors:
I have reviewed with great interest your manuscript titled "Stillbirth increase long-term health
risks of diabetes, CVD, CVD mortality, and all-cause mortality." Your research addresses a topic
of considerable public health importance, exploring the long-term consequences of stillbirths
on women's health. The utilization of the UK Biobank, with its large cohort of participants and
extended follow-up, provides a unique opportunity to examine these associations. I particularly
appreciate the meticulous approach to controlling for potential confounding factors and the
comprehensive sensitivity analyses that strengthen the validity of your findings. In the text
below, I will provide the major and minor observations that I believe could improve your work.
Title: Stillbirth increase long-term health risks of diabetes, CVD, CVD mortality, and all-cause
mortality
Version: 1 Date: 14 Mar 2025
Reviewer's report:
Review: Stillbirth increase long-term health risks of diabetes, CVD, CVD mortality, and all-
cause mortality
Summary
Using a subsample of the UK Biobank, this manuscript examines the association between
stillbirth and diabetes, cardiovascular disease, all-cause and cardiovascular mortality. This is
indeed a topic that requires more research, and the particular strengths of the contribution are:
i) the large sample size including 6,796 stillbirth cases and ii) analyzing stillbirth both as a
categorical and a continuous variable. The authors find that indeed, stillbirth is associated with
increased diabetes, cardiovascular disease, and both all-cause as well as cardiovascular mortality
risk.
General comments
1. The manuscript is well written, demonstrates technical competency and a good command of
the literature. The figures and tables are appropriate, and the results are well explained.
2. The main concern I have is about imputing missing covariate data. While this procedure is
important to maintain sample size, it could also bias the results. For this reason, I would first
urge the authors to include information about how many data points were missing per variable.
Ideally, this information should appear in Table 1, which should show the population data before
the data imputation. Second, the authors conducted extensive, well-though sensitivity analysis,
but it would be good to also present sensitivity analysis before and after data imputation, at least
for the main results (Table 2).
3. Another issue is about the explanation of the study population. While it may seem obvious, the
authors never state that they exclude male participants. The issue is then that it seems that half of
the population was excluded due to missing data, refusal or unclear responses on stillbirth and
miscarriage, when in reality, half of the population was excluded because the analysis focuses
on women only. Thus, I ask the authors to revise accordingly Lines 125 to 131 and Figure 1.
4. In some places the writing could be improved, please consider my specific comments below
and in the attached PDF.
Specific comments
1. L213, the last sentence appears to be incomplete, in which group were these more frequent?
Please add “in women that experienced stillbirth”.
2. The legend of Figure 1 “Technology roadmap” seems quite unusual, and is not clear why the
word technology is used here. Please consider rephrasing to something more fitting, for example
“Roadmap showing the derivation of the study population, analyses and conclusions”.
3. eTable 8 says “any of the three outcomes”, but I believe it should be “four” instead.
Title: Stillbirth increase long-term health risks of diabetes, CVD, CVD mortality, and all-cause
mortality
Version: 3 Date: 04 May 2025
Reviewer:  Felix P Chilunga
Reviewer's report:
I commend the authors for addressing all my previous comments. I have just a few minor points
for further consideration. (1) Please explicitly state that the 24-week definition of stillbirth
applies to the UK, as the World Health Organization (WHO) defines stillbirth as occurring
at 28 weeks or later. Clarifying this will aid comparison with studies from other countries.
If feasible, a sensitivity analysis using the 28-week threshold may be informative. (2) The
proportion of missing values for the main variables should be reported to provide transparency
on data completeness. It would also be helpful to indicate whether imputation was performed
even for variables with more than 30% missingness. (3) Smoking is included both in the lifestyle
index and as a separate covariate in the adjustment model, which results in double adjustment
and should be reconsidered. (4) Referring to these variables as "baseline characteristics" may be
misleading, since the baseline in this context is defined by the stillbirth event; a more accurate
term may be "characteristics at recruitment."
Title: Stillbirth increase long-term health risks of diabetes, CVD, CVD mortality, and all-cause
mortality
Version: 3 Date: 13 May 2025
Reviewer's report:
Reviewer 3 – Comments to the Authors
1 Major residual concern – exclusion of nine women
“participants whose diabetes or CVD was diagnosed and who died earlier than the stillbirth
experience (n = 9)”
Please clarify how it is possible for a participant to die before experiencing her own stillbirth.
Do these records represent maternal–fetal double deaths at delivery, date-coding errors, or
some other scenario? Separate the counts if both pre-existing disease and death are reasons for
exclusion. Revise the wording in the text and Figure 1 to make the criterion unambiguous (e.g.
“participants with implausible date sequences indicating death before the recorded stillbirth (n
= 9) were excluded”).
2 Stillbirth ascertainment and recall bias
Discuss any validation studies of the reproductive-history questionnaire and whether
misclassification is likely to be non-differential. Add one or two sentences in Limitations to that
effect.
3 Psychological sequelae and downstream health risks
Emerging evidence suggests that the excess cardiometabolic and mortality risk observed
after stillbirth may be partly mediated by mental-health consequences: Addressing the points
above will eliminate remaining ambiguities and greatly improve the manuscript’s clarity,
reproducibility, and clinical interpretability. Thank you again for your careful work.
4 Fetal cardiac channelopathies as a cause of stillbirth
Recent work highlights inherited or de-novo pathogenic variants in cardiac ion-channel genes
(eg KCNQ1, KCNH2, SCN5A) that can precipitate lethal fetal arrhythmia without structural
anomalies or growth restriction. Large case-series, fetal-magnetocardiography studies and
registry data collectively show that long- or short-QT syndromes and related channelopathies
account for a clinically meaningful subset of otherwise “unexplained” stillbirths. Maternal
LQTS itself may also impair placental or myometrial function, further raising fetal-loss risk.
Title: #diastasisrecti: a mixed-methods analysis of Instagram posts and their influence on
women’s exercise and sports participation
Version: 3 Date: 24 May 2025
Reviewer's report:
Thank you to the authorship team for the revisions that have been made. I particularly like the
tables that have been enhanced. This has strengthened the readability of the results. The methods
as well have been clarified further.
I think this paper has the ability to be of value to the research base of Instagram content in health.
Title: Rationality of FIGO 2018 IIIC cervical cancer according to local tumor and pelvic lymph
node metastatic extent--A cohort study
Version: 2 Date: 24 May 2024
Reviewer's report:
I believe this is a significant article about the prognosis of stage IIIC, but there are a few issues
that should be considered. I agree with the issue stated that the 2018 FIGO stage IIIC does not
include tumor size and the extent of local tumor involvement.
1) I would like to know about the imaging modalities (CT, MRI, and PET-CT).
2) Did all patients undergo para-aortic node dissemination in group of radical hysterectomy?
3) The prognosis is strongly associated with postoperative adjuvant therapy. Please note the data
on adjuvant therapy.
4) The discussion sections should be summarized. The sentences, such as those starting with A
et al and B et al, are not understandable.
5) Some sentences are incomplete. Verbs are missing.
Title: Rationality of FIGO 2018 IIIC cervical cancer according to local tumor and pelvic lymph
node metastatic extent--A cohort study
Version: 2 Date: 26 May 2024
Reviewer's report:
Dear authors;
Thank you for the opportunity to review your interesting manuscript.
There are some points to be revised in this manuscript.
# Some information on factors that affect patient prognosis is missing. Please provide details of
the surgical procedures for patients who underwent surgery (e.g., Piver classification), details
of postoperative adjuvant therapy and details of the radiation therapy dose and regimen.
# In the multivariate analysis in Figure 3, the difference in treatment modality (whether surgery
or radiation therapy) is not included as a factor. Since it is an important factor that affects
prognosis, it would be better to include it as a prognostic factor.
# Please indicate the imaging modality used to assess lymph node enlargement and the criteria
for assessing enlargement.
I hope I have been helpful
Regards