JerMa88/BMC_Womens_Health_Peer_Reviews huggingface dataset:
Title: Increased serum LOXL2 concentration in pelvic inflammatory disease with pelvic
adhesion
Version: 1 Date: 06 Jun 2021
Reviewer's report:
This study aimed to determine associations between serum LOXL2 concentration with PID
and pelvic adhesions via a case-controlled study design. The authors report significantly higher
levels of LOXL2 in patients with PID compared with controls and in PID patients with pelvic
adhesions compared to those without evidence of adhesive disease. The primary concern with
this study is lack of detail with regards to defining PID, pelvic adhesions (including protocols
used), and details regarding how case-matching was performed. Therefore, there is a high risk
of possible confounding effects. It is suggested that the authors further emphasize that this was
an exploratory pilot study that requires confirmation in prospective studies.
Major Concerns:
1. Given the case-control design and variable nature of PID diagnoses, additional details should
be provided describing the population of cases. What proportion of patients had alleviation
of PID symptoms after empiric antibiotics treatment? Physical exam evidence of PID (e.g.
cervical motion tenderness, cervical mucopurulent discharge, adnexal masses)? Were nucleic
acid amplification tests for C. trachomatis and Neisseria gonorrhoeae performed?
2. The authors state: “Pelvic adhesion was confirmed by angiography and salpingography.”
However, I’m unaware of any evidence suggesting how angiography can be used for this
indication. Significant more details need to be provided regarding salpingography. Was this
hysterosalpingography with X-ray? Ultrasound? What was the exact protocol used? What were
the exact criteria used to define adhesion?
3. The authors state that “Blood samples were collected from 143 PID patients and 130 healthy
women with matched age and other sociodemographic and clinical data”. However, there are no
details reported regarding the matching procedure. It appears as though cases were only matched
by age. If not, what other matching criteria were used?
Other concerns:
1. In the abstract, it is reported that “Multivariate logistic regression analysis showed that serum
LOXL2 level was an independent risk factor for pelvic adhesion in PID patients (OR=1.016;
95%CI=1.008-1.024; P<0.001).” However, in the manuscript text, the authors state odds ratio
of 1.058; 95%CI=1.030-1.086, P<0.001.
2. Details regarding the multivariable logistic regression are unclear. The authors state that
results were adjusted for “age, WBC, Neutrophils, CRP, TNF-#, MMP-9, TGF-#1, WBV at
LSR, WBV at HSR, and HcT”. Were these factors selected based on univariate analyses? Also,
the validity of the odds ratios including WBC, ICAM-1, and WBV at HSR are unclear since
the models were adjusted for these factors between groups It would be beneficial to have a
statistician provide guidance on statistical procedures used and reporting.
3. The authors state that all means are reported +/- SD. However, the means look to be reported
with ranges. Please revise accordingly to limit confusion.
Title: Comparison of two invasive non-surgical treatment options for uterine myomas: Uterine
Artery Embolization and Magnetic Resonance guided High Intensity Focused Ultrasound.
Systematic review
Version: 1 Date: 20 Sep 2021
Reviewer:  Michel Canis
Reviewer's report:
Perioperative protocols such as pain management, hospital stay would be interesting to know
to assess and compare the "invasiveness" of both methods. It may be interesting to make a
distinction between immediate and late complications which may be the most interesting. Indeed
both procedure are minimally procedure and so it is acceptable to have post operative side effects
but these may be managed by an adequate perioperative protocol whereas late complications
will impair patients quality of life.
Title: Comparison of two invasive non-surgical treatment options for uterine myomas: Uterine
Artery Embolization and Magnetic Resonance guided High Intensity Focused Ultrasound.
Systematic review
Version: 1 Date: 29 Sep 2021
Reviewer:  Hee-dong Chae
Reviewer's report:
1. “b1” is adopted as an exclusion criterion in table 1, but the abbreviation description omits b1.
Also, please clarify what “fibroid-related disease” means.
2. Thermal injury of the abdominal wall has been reported as a complication of HIFU, but the
data presented do not mention it. As this is a study comparing the efficacy and safety of UAE
and HIFU, it is recommended to supplement related data.
3. More to be covered - Since both treatments have safety issues, please also provide details on
the duration, severity, hospitalization, and management of complication from each treatment.
Title: Comparison of two invasive non-surgical treatment options for uterine myomas: Uterine
Artery Embolization and Magnetic Resonance guided High Intensity Focused Ultrasound.
Systematic review
Version: 3 Date: 13 Dec 2021
Reviewer's report:
I have carefully read he manuscript entitled: “ Comparison of two invasive non-surgical
treatment options for uterine myomas: Uterine Artery Embolization and Magnetic Resonance
guided High Intensity Focused Ultrasound" and I really appreciated the effort the authors have
done to investigate on this interesting topic.However, I suggest some necessary changes to
improve the quality of this study. A major revision is required before accepting for publication.
- Firstly,  recommend an extensive English revision, conducted by a native English speaker: in
fact, some concepts seem to be confusing and grammatically incorrect.
-  In Tables 1 and 2 a lot of alphabetical abbreviations are reported in the exclusion and inclusion
criteria. I think that reporting data in this way don’t allow the reader to focus on the most
important features of each study. Please change.
- Results should be improved, the authors should better explain the contrasting data and make
a comparison between the different techniques.
- On line 189, page 6, the authors consider only one study that reported differences between these
techniques in the fibroid volume shrinkage. I don’t think that these data should be considered
statistically significant in a systematic review of the literature.
- This study lacks an overview of international guidelines, regarding the invasive and non-
invasive treatment of uterine fibroid.
Title: Comparison of two invasive non-surgical treatment options for uterine myomas: Uterine
Artery Embolization and Magnetic Resonance guided High Intensity Focused Ultrasound.
Systematic review
Version: 4 Date: 28 Jan 2022
Reviewer's report:
Dear Editor,
I carefully reviewed the revised version of the paper entitled ‘Comparison of two invasive
non-surgical treatment options for uterine myomas: Uterine Artery Embolization and Magnetic
Resonance guided High Intensity Focused Ultrasound. Systematic review’ by Madina
Yerezhepbayeva et al.
Authors meticulously answered the raised comments and modified the manuscript including
guidelines and other sources from the Literature and checking both linguistic inaccuracies and
typing errors. Tables were re-edited.
Moreover, the several changes within the manuscript make the paper more critical and accurate,
strengthening its scientific value.
Therefore, the Systematic review can be accepted for  publication in ‘BMC Women’s health’.
Title: Influence of Toileting Behavior on the Natural Course of Anterior Vaginal Wall Prolapse
Version: 1 Date: 28 Sep 2021
Reviewer's report:
Thank you for this innovative study about voiding positions and their effect on anterior Vaginal
wall prolapse after surgery. It is a good study but i have some comments, suggestions and a few
questions to make the study better.
Background:
1. you need to have a better definition of POP. Please look in available literature to get a better
definition than the one you have please provide a reference to the definition.
2. The language used in the statement beginning in line 59 "accused" is not correct. Please find
a better word than 'accused"
3.  Please provide reference for the POP-Q system you used
4. Statement in line 59-64 doesn't sound correct. i suggest you change it to "activities that lead
to increased intra-abdominal pressure......."
Methods:
Please clearly clarify how you knew which participants was using squatting or sitting position
since this was a retrospective study.
Results:
How sure are you that the recurrence of AVWP was due to the position of voiding/defecation
and not due to other confounders like Obesity, other strenuous work practices etc since you
didn't do any logistic regression (multivariable and bi-variable)?
Discussion:
1. Your discussion can be improved. Most of the opening statements in your discussion should
go to the background.
2. Please begin the discussion by giving a summary of your findings.
3. State your findings and compare them with what is known in literature and give an explanation
why your findings are similar or differ from what is known in literature.
Conclusion:
This can be made better and the language needs to improve
Title: Influence of Toileting Behavior on the Natural Course of Anterior Vaginal Wall Prolapse
Version: 1 Date: 26 Oct 2021
Reviewer's report:
This is a retrospective study looking at the impact of voiding position on a woman's decision to
have anterior prolapse surgery.  Authors have found women adopting a squatting position choose
surgery about a year earlier than those using a sitting position with statistical  significance.  They
highlight  toileting position as an important characteristic to ascertain from the Urogynae history.
They suggest this could allow an opportunity to counsel on adopting a sitting position, reducing
the time to surgery and preventing worsening symptoms.
Interesting topic which would be of interest although revisions needed.
The main issue is that there is no definition of what a sitting position and what a squatting
position is.
Were participants hovering over the toilet area when squatting akin to an  'exercise squat' or
were they sitting on a toilet with their feet up on supports in a squat position, which actually
relaxes the pelvic floor and is encouraged by physiotherapists to aid defaecation?
Were they squatting during both voiding and defaecation?
Methods
Authors state that those with overactive bladder and urge urinary incontinence were excluded,
however this data was part of demographic details and part of the discussion.
-More details on the  questionnaires used would be nice - items on the questionnaires, scoring /
what is a significant score? / are they validated or not?
-Also a note on when POP-Q was assessed and questionnaires undertaken? At initial consult/
on day of surgery?
Discussion section-
165  - Among patient  groups with  similar demographic data - in  your  results you state
characteristics all were similar between groups
171 -  what  is the importance of  this  result in relation to the literature?
180 - repetitive
Clarity and grammar
-Spelling Pads NOT Peds
-Can simply write 'Parity' not 'number of parity'
-146-149 is contradictory.  There is no study... As a result of the studies... Please reword to
make sense
-169 - Grammatically not making sense
-In the conclusion (abstract), Questioning' is not a  treatment ... suggest reword e.g. questioning
toileting position may enhance decisions on management with a lifestyle change to sitting
position encouraged.
-Suggest VAS score and time to surgery are not part of baseline characteristics/ demographic
data and remove from Table 1
-* beside p values in Table 2 are confusing and suggest stat. significance - please just state Mann-
Whitney U test used for statistically analysis and remove *
-Given squat position whilst seated on a toilet with feet supports is encouraged by
physiotherapists, are you recommending going against this? Are you advising sitting for both
voiding and defaecation?
Clarifying your definition of 'squat' and whether this was undertaken during voiding, defaecation
or both by particpants it critical to interpreting the results and the subsequent discussion and
recommendations
Title: Influence of Toileting Behavior on the Natural Course of Anterior Vaginal Wall Prolapse
Version: 3 Date: 13 Dec 2021
Reviewer's report:
Many thanks for your revisions.  Just a few points
• 72 - There are many studies on the effect of toilet position on voiding and defecation physiology
– Please add some References to these studies
• 85 - After obtaining ethics committee approval, - No need to say again, can remove
• 119 – Participants were housewives who did not perform strenuous work – I would think
there is large variability between individuals in the intensity at which housework activities
are performed.  Unless there has been a population study showing it is not strenuous?/Or you
recorded the activities performed
• Limitations of the study should be documented in the discussion
Title: Determinants of contraceptive decision making among married women in Sub-Saharan
Africa from the recent Demographic and Health Survey data
Version: 2 Date: 21 Nov 2021
Reviewer's report:
The study investigated the determinants of contraceptive decision making among couples in
sub-Saharan Africa
(1) Why do the authors use the IR (individual women recode) and not the PR file, since the study
intends to look at couple decision
(2) The authors should reduce the details of the multinomial regression model
(3) The model adequacy test should be related to the paper – this statement “As MNLR model
is not a linear model, we can't calculate R2 directly as for the linear regression model” is not
necessary, and a lot more of the methodology section.
(4) The methodology section does not discuss how the data were pooled, and importantly how
the weights were denormalized to allow for valid estimation for pooled analysis.
(5) The variable country income was not discussed in the methodology section –More so, the
variables and their categorization were not also discussed
(6) The reproductive decision making should be Jointly, husband/Partner only, woman only,
and not mother only
(7) The authors did not also discuss the approach used for the adjusted multinomial regression
model
(8) The multinomial logistic regression does not estimate relative risk ratio but odds ratio.
However, relative risk was used in this paper, some interpretations were also discussed as log-
odds in the manuscript
(9) This study does not relate clearly to contraceptive decision-making and women’s
empowerment as richly discussed in the introduction and discussion section. Studies on women’s
empowerment used several indicators to measure this construct.
Title: Determinants of contraceptive decision making among married women in Sub-Saharan
Africa from the recent Demographic and Health Survey data
Version: 2 Date: 24 Nov 2021
Reviewer:  Kenneth Setorwu Adde
Reviewer's report:
General
1. the authors keep interchanging words especially maternal, mother, women and married
women. The data set was on married women hence I will suggest the authors stick to the use of
married women and stop misleading the readers.
2. the are a lot of grammatical errors in the manuscript. The authors need to send the paper for
proofreading to improve the language. As it is, it is difficult to read
Title
1. I think the topic is misleading. The study used data on only married women hence the use of
couple is misleading. One would think the sample size comprised both men and women in the
union. I suggest the authors change the “couples” to “married women”
Abstract
Background
1. the authors have lumped up various ideas into one paragraph to be the background. The authors
should reorganise the various ideas into different paragraphs.
2. line 81, “…contraceptives in African, particularly…” ‘African’ should be written ‘Africa’
3. lines 89 to 92, since the study made use of data from only women’s file, the authors should
find a way to use ‘married women’ instead of ‘couples’. The use of couples is misleading
Methods
1. line 98 to 99, ‘The survey target groups were women aged 15-49 and men aged 15-59 in
randomly selected households in each country…’ the abstract and the analysis shows the data
used was on only women so why are men aged 15-49 included in the target group?
Analysis
1. authors should avoid the use of mothers to represent the respondents. The study made use
of data on married women and not mothers. Not every married woman is a mother hence the
authors should edit the writeup and replace ‘mothers’ with ‘married women’ where appropriate
2. Joint (mother and husband) should be replaced with Joint (woman and partner)
3. I think it will be prudent if the authors can give us a figure to illustrate the contraception
utilisation rate in the various countries and also the average utilisation rate for SSA
Discussion
1. the authors use categorical language in explaining possible reasons for their findings.
However, I think the authors should be using propositions. For instance, in line 259, the authors
used “This is because…”. I suggest the authors refrain from such categorical statements and use
phrases such as “a possible explanation…, this could be attributed to…, etc”
2. the authors need to break down the discussion section into different paragraphs.
Title: Women's experiences in the transition to menopause: A qualitative research
Version: 2 Date: 23 Nov 2021
Reviewer's report:
Dear Editor,
Thank you so much for choosing me as a reviewer.  This article needs some minor revision.
My suggestions are as follow;
-Women's experiences in the transition to menopause: Should be revised as a qualitative study.
Because this study focuses on experiences, not fear and hope.
-The method should be reviewed according to the COREQ checklist, and the method using this
checklist should be stated in the abstract.
-Content analysis is said to be done in the analysis, but the names of the themes indicate thematic
analysis. This should be rethought.
Title: Women's experiences in the transition to menopause: A qualitative research
Version: 2 Date: 21 Dec 2021
Reviewer's report:
Thank you for the opportunity to review this well-designed study of an underexamined research
area. This qualitative study examines the experience of 16 women in Iran who are approx. 47
years old and premenopausal. It details their hopes, fears, the impact on social and familial
relationships, and their emotional and physical health.
The methods are explained in sufficient detail to establish trustworthiness in the data. Including
the example of data analysis is helpful to see how themes were derived from interview
transcripts. Understanding the study team’s expertise on this topic also lends credibility. It would
be interesting to know how the researcher examined her own positionality vis a vis the research
participants as demonstration of reflexivity, if there is room.
My main suggestion is as follows: Theme 5 suggests that social support would be beneficial to
women undergoing menopause, and indeed is an important need for many people dealing with
an illness or change in physical status that can be isolating. It is important to see direct quotations
in this section that speak to the importance of peer social support (i.e., other women undergoing
perimenopause), especially since this is addressed in the discussion as an opportunity to improve
care. These could go under the subsection “The need for empathic peers.”
A quick note for the discussion: please check this sentence for clarity, not sure of the meaning:
“This study showed that premenopausal women are experiencing changes recently faced by
them.”
I recommend for publication with these minor revisions.
Title: Trends in total fertility rate in Ghana by different inequality dimensions from 1993 to 2014
Version: 2 Date: 07 Sep 2021
Reviewer's report:
Review report for the article titled “Trends in total fertility rate in Ghana by different inequality
dimensions from 1993 to 2014”
Abstract
1. Perhaps 1993-2014 instead of 1993-1994???
2. For the phrase “for the all surveys” the word “the” should be dropped
3. ‘the’ is missing  in the phrase “consistently highest among poorest”
Introduction
1. “work force” is one word or should be hyphenated
2. “Policy document illustrated the variations in the trends”, not variations on
3. “the” missing from the phrase “slight increase in the fertility rate”
Methods
1. The wealth index quintiles don’t seem well ordered to this reviewer, following what the
authors have done,  the order should be Poorest- poorer-poor- rich-richer-richest, which may
imply six groups. This reviewer sees the “poor-rich” being grouped as middle
2. “the most-disadvantaged sub-group, which is represented by the secondary school and above
subgroups” seems ambiguous to this reviewer. If secondary school and above are referred to as
the disadvantaged group, what above those with none or primary school education??? Similarly
for the richest, etc
Results
1. In the heading of Table 2 “births per women” should probably be “births per woman”??
Discussion
1. “dimension” in the phrase “trends in TFR by different inequality dimension” should be plural
2. I think “the” should precede“richest women” and “poorest women” in most instances in the
methods, results and discussion
3. Besides the high cost of living forcing urban residents to reduce their number of children, it
is also the case that most urban dwellers are more educated and in the richest quintile of wealth
4. “a” should precede premium in the phrase “still place premium” and “a” can be dropped from
the phrase “ a large family size”
Conclusion
1. “dimension” should be plural in the phrase “ different inequality dimension”
2. Instead of a full stop, perhaps a semi-colon can precede the sentence “Thus, those women are
likely to desire for more children”; the word “for”  in the sentence can also be dropped