JerMa88/BMC_Womens_Health_Peer_Reviews huggingface dataset:
Title: Beyond Anemia: A Comprehensive Analysis of Iron Deficiency Symptoms in Women
and Their Correlation with Biomarkers
Version: 1 Date: 07 Jun 2025
Reviewer's report:
Dear researcher
This comprehensive study highlights that non-anemic iron deficiency is far from benign,
with symptoms' diversity and prevalence comparable to those in iron deficiency anemia. This
manuscript can be improved by addressing the following issues;
-The study's cross-sectional nature limits the ability to establish causality between iron
deficiency and the observed symptoms.
-With 239 patients, the sample size is relatively small, which may affect the generalizability of
the findings to different populations.
-Limiting the sample to women from a single hospital may introduce selection bias and limit
generalizability to other populations.
-The study does not thoroughly control for other potential causes of similar symptoms, such as
psychological conditions, medication use, or other medical disorders.
-There is a lack of detailed data on symptom severity and duration, which are crucial for
assessing clinical significance.
-Although TSAT shows a strong correlation with symptoms, correlations do not imply causation
and potential confounders may exist due to the study's design and the inability to control for
confounding factors.
-However, further studies with larger, more diverse populations and prospective designs are
needed to confirm causality and inform guidelines.
Discussion:
-Highlight the novel findings, particularly the high frequency of neuropsychiatric symptoms in
NAID and the potential significance of TSAT as a biomarker.
-Address potential confounding factors (e.g., vitamin deficiencies, subjective symptom
reporting) and discuss how these might impact interpretations.
-Compare your findings explicitly with previous studies, especially those that found similarities
or differences, and hypothesize reasons for discrepancies.
The conclusion of the abstract can be strengthened by clearly summarizing the main findings,
emphasizing their clinical implications, and providing specific recommendations tailored to
the context. Focus on the importance of recognizing a wide range of nonspecific symptoms
associated with iron deficiency, regardless of anemia status, and highlight how biochemical
markers, such as TSAT, can aid in early diagnosis. Additionally, mention the need for further
research to validate these findings and explore new symptoms.
Title: Beyond Anemia: A Comprehensive Analysis of Iron Deficiency Symptoms in Women
and Their Correlation with Biomarkers
Version: 1 Date: 09 Jun 2025
Reviewer:  Asaad Ma. Babker
Reviewer's report:
- Incorporate validated tools (e.g., Numeric Rating Scale, Fatigue Severity Scale) to quantify
the severity of weakness, enabling more precise assessments and comparisons
-Explore the underlying biological mechanisms such as mitochondrial dysfunction or
neurotransmitter alterations that could explain weakness associated with iron deficiency. Please
add the following articles to your literature
1- First research provides valuable insights into the hormonal regulation of iron metabolism,
which can be integrated into the symptom and biomarker-focused findings of the original article.
Talawy, T. S., Bylappa, S. K., Ismail, M., Kandakurti, P. K., Gopakumar, A., & Babker, A.
M. (2023). Correlation of Erythroferrone and Hepcidin Hormones with Iron Status Levels in
Patients with Iron Deficiency. Journal of Applied Hematology, 14(1), 28-34.
2- Waggiallah, H. A., Khair, H. E., Almoammar, N. E., Abdelmola, A., & Babker, A. M. (2023).
Iron Deficiency and Iron Storage Markers in Different Pregnancy Stages in Sudanese Women
of Different Age. International Journal of Biomedicine, 13(2), 296-300.
Title: Beyond Anemia: A Comprehensive Analysis of Iron Deficiency Symptoms in Women
and Their Correlation with Biomarkers
Version: 2 Date: 04 Jul 2025
Reviewer's report:
I thank the authors for their thorough response to the plethora of questions/issues raised by the
six reviewers and appreciate their efforts! While there are still some issues which would by nice
if they could be addressed I do understand the nature of the  analysis and think this manuscript
is now ready for publication
Title: Trends in maternal mortality in Latin America and the Caribbean: A joinpoint analysis
Version: 0 Date: 10 Apr 2025
Reviewer's report:
Dear Authors,
Thank you for your submission titled “Trends in maternal mortality in Latin America and the
Caribbean: A joinpoint analysis.” The topic is highly relevant, and your focus on maternal
mortality inequalities in the LAC region addresses an important public health concern.
However, I must recommend major revisions before the manuscript can be reconsidered. One
of the central issues is the lack of clarity regarding the methodology used. It remains unclear
whether the mortality estimates were independently calculated by the authors or if they were
derived directly from existing datasets, such as those provided by PAHO or WHO. This
distinction is critical for assessing the scientific contribution of the study.
Furthermore, the methodological description is insufficiently detailed. For a time-series
ecological analysis using joinpoint regression, the manuscript should clearly define the input
data, analytic strategy, and any transformations or adjustments made. Without a more robust
explanation of the data sources, estimation process, and model parameters, the findings cannot
be adequately assessed for validity or reproducibility.
I encourage the authors to substantially strengthen the methods section, clearly differentiate
between primary analysis and secondary use of pre-existing estimates, and include a transparent
discussion of limitations and assumptions.
Sincerely,
Title: Trends in maternal mortality in Latin America and the Caribbean: A joinpoint analysis
Version: 0 Date: 11 Apr 2025
Reviewer:  Bernardo Hernández
Reviewer's report:
Although this paper deals with an important topic, it is a very superficial analysis and actually
does not constitute a significant contribution to the knowledge in this area.  Assessing trends
in maternal mortality in Latin America is something that has been done in the past (even
the authors include some references at the global level).  The article could be significantly
strenghtened by analyzing the impact of some factors that are mentioned in the discussion as
potential contributors to the changes in maternal mortality, like health expenditure , skilled birth
attendance, or poverty.
The article also needs to be revised in its structure (for example it starts with a defiition of
maternal mortality that is actually a definition of maternal mortality ratio.  There is no mention
of any limitations at all, from which it is very important to make a comment about the potential
impact of underegistration of maternal mortality, which can vary across countries and over time.
Title: Trends in maternal mortality in Latin America and the Caribbean: A joinpoint analysis
Version: 0 Date: 18 Apr 2025
Reviewer's report:
The manuscript “Trends in maternal mortality in Latin America and the Caribbean: A joinpoint
analysis” submitted to BMC Women’s Health is a  interesting paper that brings measurements
of change in the maternal mortality for eighteen countries, and a interesting discussion about
these changes. My comments are listed below and are made by major and minor issues.
Major issues:
• In the introduction, the authors wrote a correct introduction. However, there is no a clear
justification for this study. The authors used references of others studies assessing trends. What
new does this study bring? Did happen some specific in Latin America and the Caribbean
between 1997 and 2020?
• In Materials and Methods, it is necessary to write about the sample, the number of countries,
and the criteria selection of these countries.
•  In Materials and Methods, I suggest writing about the ethics issue, specifying the use of
secondary database.
• In Discussion, it would be very important that the authors do a discussion for other countries
in the same line that they made for Guatemala and Venezuela.
Minor issues:
• In the Abstract, about the methods, it is important to write the period time that was analyzed,
the number of countries, and the age of women.
• In the Abstract, about the conclusions, the authors did not measured inequalities among
countries, so, I suggest changing the first line. Maybe it could say that difference trends were
observed in the countries.
• In Discussion, in the third line in the first paragraph, the authors wrote “persistent disparities”,
but in this study, it was not measure inequality. The results showed progress for some countries
and setbacks for other countries.
• In discussion, the fourth paragraph seems that is a complement of the first eight lines of the
third paragraph.
• In discussion, the last three lines of the fourth paragraph seem a little repetitive of the second
paragraph
Title: Trends in maternal mortality in Latin America and the Caribbean: A joinpoint analysis
Version: 1 Date: 09 Jun 2025
Reviewer's report:
The authors have made significant improvements to the manuscript, making it clearer and more
interesting. I have just one comment regarding the conclusion in the abstract:
• In the Abstract, regarding the conclusion, the authors did not measure inequalities among
countries to conclude that regional disparities persist. With this conclusion, they seem to imply
that the changes in maternal mortality rate/ratio-whether increases or decreases-are unfair when
comparing some countries to others in Latin America and the Caribbean. I suggest revising the
first line of the conclusion, perhaps to: “Despite overall progress, regional difference persist”.
Additionally, I recommend reviewing this article to better understand the definitions of terms
such as disparities and inequalities: Arcaya MC, Arcaya AL, Subramanian SV. Inequalities
in health: definitions, concepts, and theories. Glob Health Action. 2015 Jun 24;8:27106. doi:
10.3402/gha.v8.27106.
Title: Trends in maternal mortality in Latin America and the Caribbean: A joinpoint analysis
Version: 2 Date: 07 Jul 2025
Reviewer:  Kevin Martinez-Folgar
Reviewer's report:
After careful review, the authors did a great work and addressed all the previous concerns.
While there are multiple limitations with the use of cross-country mortality datasets, the authors
did acknowledge them. I don't have anything else to add and recommend this manuscript for
publication.
Title: Trends in maternal mortality in Latin America and the Caribbean: A joinpoint analysis
Version: 2 Date: 14 Jul 2025
Reviewer's report:
Comment for authors
I would like to highlight the excellent work made by the authors. The manuscript is clear and
using an interesting method to measure the trends, brings important results about advances and
setbacks across the study countries. The discussion section brings arguments that help explain
the changes observed, particularly in countries with the worst scenarios, making the manuscript
more compelling. I have only three comments about the method and conclusion section, and
the figure.
Minor issues:
• In the Conclusion section, as it was corrected in the Abstract, the first line could change to
“Despite overall progress, regional difference persist”.
• In the Methods section, in the subtitle “Age Adjusted mortality rates”, I suggest complementing
“Age Adjusted mortality rates and Mortality Ratio”.
• In the Tables 2 and 3, I suggest adding a footnote with the meaning of the abbreviations: APC
(Annual Percentage Change) and AAPC (Average Annual Percentage Change). This for the
Figure 2 too.
Title: The Role of Micro-, Meso-, and Macro-Level Stigma on the Uptake of Medications for
Opioid Use Disorder (MOUD) Among Women in the Criminal Legal System
Version: 4 Date: 17 Mar 2025
Reviewer's report:
Thank you for the opportunity to read and review this manuscript. This paper investigates
how different forms of stigma create barriers to medications for opioid use disorder (MOUD)
among women with opioid use disorder who have been involved in the criminal legal system.
The study uniquely combines perspectives from the women themselves with insights from
criminal legal system and substance use disorder treatment professionals. Through qualitative
interviews, the research identifies three distinct types of stigma affecting treatment: enacted
stigma (actual discrimination experienced in healthcare, legal, and recovery settings), perceived
stigma (awareness of negative stereotypes), and internalized stigma (when women accept these
negative stereotypes about themselves). This paper contributes to the literature examining how
perceived, enacted, and internalized stigma influence MOUD treatment  among criminal-legal
involved women, offering descriptive accounts from multiple stakeholder perspectives that
highlight barriers to treatment access and retention, though currently the analysis falls short of
effectively integrating these perspectives to generate novel theoretical insights.
While the study offers important insights, several major methodological, analytical, and
conceptual issues need addressing before publication. With some major revisions, I think this
paper would make a relevant contribution to BMC Women’s Health. I provide my comments
for the authors attached.
Title: Cervical and vaginal metastases from ascending colon cancer: a case report and literature
review
Version: 0 Date: 12 Apr 2025
Reviewer's report:
The histopathology report shown by the authors is "Postoperative pathological diagnosis:
adenocarcinoma (from the rectal muscle wall to the serosa, cervical stroma, and vaginal wall),
combined with immunohistochemistry and medical history, consistent with intestinal origin. "
Isn't this a second primary in rectum with cervical and vaginal infiltration which is a very
common clinical scenerio, how can the authors label this a mets fron ca colon treated 3 years back
Your clinical picture shows a anterior lower vaginal tumour which is not shown in the pathology
report, please enlighten
Title: Navigating the Future Landscape of Uterine Fibroid Research: A Comprehensive
Summary of Patient-Centered Outcome Measures and Implications
Version: 3 Date: 30 Apr 2025
Reviewer's report:
The manuscript presents a valuable overview of Patient-Reported Outcome Measures used in
uterine fibroid research. It highlights an important and often underappreciated aspect of clinical
research and offers an extensive cataloging of existing instruments, their scope, and limitations.
However, several aspects of the manuscript require refinement.
These are detailed below.
- The manuscript reads more like a catalog than a critical analysis. Strengthen the discussion
by addressing:
# Which PROMs demonstrate the strongest psychometric properties (validity, reliability) in UF
populations?
# What are the practical limitations of multi-instrument use (response burden, data integration)?
# How do the PROMs align with key outcomes valued by patients (reproductive health, social
functioning)?
- The tables are comprehensive but would benefit from:
# A column summarizing psychometric validation (yes/no, or rating scale).
# More detail about geographic/cultural validation (which instruments have been validated in
non-Western populations).
# Discuss why most existing PROMs are not fibroid-specific, what barriers exist for developing
or adopting tailored tools?
- A thorough language review by a native or professional editor is recommended to improve
clarity and flow.
- It is important to specify in the Materials and Methods section that this work is a scoping
review. The current version does not clearly define the study type, which may lead to confusion
regarding its scope and purpose
- As a scoping review, adherence to the SANRA (Scale for the Assessment of Narrative Review
Articles) guidelines should be explicitly stated and justified (PMID: 30962953). The authors
should include a brief methodological checklist or narrative description of how each criterion
was addressed.
- The introduction, while adequate in setting the general context, lacks sufficient depth regarding
the clinical burden of uterine fibroids. Please elaborate on:
# The spectrum of symptoms beyond heavy bleeding and discomfort, such as infertility, chronic
pain, anemia, and mental health deterioration.
# The daily-life consequences for affected women, including impacts on work productivity,
intimate relationships, and emotional well-being.
#  A more current overview of emerging treatment options, including both pharmacological
(GnRH antagonists, relugolix)  and minimally invasive surgical interventions (myolysis,
laparoscopic myomectomy) (PMID: 34741454, PMID: 37831177). These advances are essential
to contextualize the importance of accurate and responsive PROMs in evaluating treatment
efficacy.
Title: Navigating the Future Landscape of Uterine Fibroid Research: A Comprehensive
Summary of Patient-Centered Outcome Measures and Implications
Version: 3 Date: 12 Jun 2025
Reviewer's report:
In this article "Navigating the Future Landscape of Uterine Fibroid Research: A Comprehensive
Summary of Patient-Centered Outcome Measures and Implications"  Yang et al review the
Patient-Reported Outcome Measures (PROMs) used in the study of uterine fibroids.
I would like to congratulate the authors for the effort and time dedicated to the elaboration of
this article.
Plesea see my comments below
General
- A complete revision of the English used is needed. Frequent grammatical errors, misuse of
connectors (“Actually”, “Nowadays”), and unnecessary repetition.
-The meaning is understandable, but requires professional linguistic editing.
Abstract
- The phrase “Patient-Reported Outcome Measures (PROMs)” is repeated excessively.
- Generic phrases such as “valuable references” or “advances uterine fibroid research” are used,
which could be more specific.
- Results are not quantified (number of studies, proportion of specific PROMs, etc.).
Introduction
- The title “introduction” is missing.
- Repetition of ideas. Psychological impact and social burden is discussed several times.
Methods
- No pre-registered protocol or quality analysis of the included studies is included. Are they all
equally valid?
- The methodology is weak in terms of reproducibility of the qualitative analysis or
categorization of PROMs.
- I think that the figure “S-Figure 1: Flow of the Literature Search” should be included in the
manuscript.
Results
- Table 1 is too long and tedious to read. We would have to find a way to synthesize the
information more. A table of 4 pages is not reasonable.
- Some of the claims are not quantified (“minority of studies” without a specific proportion).
-Inconsistent wording, mix of active and passive voice, and grammatical errors (“Nowadays,
Currently”).
Disussion
- Repetition of content already addressed in results.
-Some conclusions lack a direct empirical basis (“more precise and convenient assessment
methods” without examples).
- Lack of methodological critique of the studies reviewed.
Title: Status of Osteoporosis in Postmenopausal Women in Rural Communities of Southeast
Nigeria: A Cross-Sectional Study
Version: 0 Date: 03 Jul 2025
Reviewer:  Sunday Charles Adeyemo
Reviewer's report:
The choice of the research by Authors is commendable as Osteoporosis is an issue of
public health importance considering its impact.  The expressions in manuscript are clear and
comprehensible however I make the following suggestions to improve on the manuscript.
1)Comma punctuation after women in line 2 of the Background is needless.
2)The manuscript is characterized by overstated claims and exaggerations, much as the Author’s
intention to justify the relevance of the study is acknowledged it’s however necessary to do that
ethically. E.g use of “limited body”in paragraph 4 of the introduction,  “only 28.1” in line 3
of results “critical” in the discussion section,”valuable” in line 1 the of strength of study, and
“alarmingly” in the conclusion section.
3)State the  exact formula used for sample size determination e.g  Cohen’s, Taro Yamane e.t.c
to make the study reproducible.
4) Was any measure taken to minimize cognitive bias among the respondents? If yes please
include in the manuscript if no report that as one of the weaknesses of the study.
5) Location and Time are variables of interest in prevalence studies, The Authors are advised to
include the geography of southeast Nigeria where data are collected and the time of collection.
Title: Status of Osteoporosis in Postmenopausal Women in Rural Communities of Southeast
Nigeria: A Cross-Sectional Study
Version: 0 Date: 12 Jul 2025
Reviewer's report:
The authors should explain how they identified postmenopausal women with osteoporosis at
the homes to be able to determine the prevalence of osteoporosis. Did they conduct any test/
screening to identify the participants? Did they use secondary data from the hospitals in the
selected communities? How did they diagnose or differentiate osteoporosis from other arthritic/
musculoskeletal conditions?
If there are no answers to the above questions, then I would suggest they limit their
study to Knowledge, Attitude and Practice of Preventive measures for Osteoporosis among
postmenopausal women
Title: Association Between Prior Antibiotic Use and Reduced Chlamydia trachomatis Infection
Prevalence: A Cross-Sectional Study in China
Version: 1 Date: 06 May 2025
Reviewer's report:
"PEER REVIEWER ASSESSMENTS:
OBJECTIVE - Full research articles: is there a clear objective that addresses a testable research
question(s) (brief or other article types: is there a clear objective)?
Yes - there is a clear objective
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for
the objective?
Yes - the approach is appropriate
EXECUTION - Are the experiments and analyses performed with technical rigor to allow
confidence in the results?
Yes - experiments and analyses were performed appropriately
STATISTICS - Is the use of statistics in the manuscript appropriate?
Not sure - I am not able to assess the statistics in this study
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not
overstated?
No - there are minor issues
OVERALL MANUSCRIPT POTENTIAL - Is the current version of this work technically
sound? If not, can revisions be made to make the work technically sound?
Probably - with minor revisions
PEER REVIEWER COMMENTS:
GENERAL COMMENTS: This is a good paper on the association between prior antibiotic use
and chlamydia infection in Guangdong province, China.  Overall the paper is well written and
clearly describes a secondary data analysis amongst women of reproductive age attending three
hospitals representing districts with high, medium and low incidence of chlamydia.
I have a couple of comments that would improve the interpretability of this paper within the
current literature.  Firstly, I would suggest the authors be more explicit about their categorisation
of high, medium and low facilities in the methods section. This is currently not clear.  Secondly
the study population is women attending a gynecological department although again it is not
clear what the rationale for attendance is within the baseline characteristics.  Again this might
help in terms of wider interpretability of their findings.  Thirdly, the participant selection
(randomisation?) process is not explained.  More detail as to whether they recruited every nth
woman or otherwise following inclusion criteria assessment would be useful.  Whilst I certainly
acknowledge that hospital based studies are easier in terms of recruitment, the authors perhaps
might consider the limitations of the sampling in terms of wider applicability beyond women
who are gynaecologically (at risk) i.e. attending a clinic.  This introduces a (necessary) inherent
bias in the results since it does not represent the wider population.  And finally the paper might
benefit from a final port read, particularly in the discussion with the use of tenses when referring
to the history of STI treatment.
REQUESTED REVISIONS:
Please see above"