JerMa88/BMC_Womens_Health_Peer_Reviews huggingface dataset:
Title: Prevalence of chronic pelvic pain and primary dysmenorrhea in women of reproductive
age in Ecuador
Version: 2 Date: 22 Jun 2022
Reviewer's report:
Thank you for the revisions you have made. We feel that you have largely addressed most of
our concerns. The one remaining issue pertains to  the variables that you adjust for in your
prevalence ratios which are inconsistent across all analyses. For example, in Table 3 you adjust
for "age, occupation, smoking, alcohol use disorder, cancer, CVD, dyspareunia, etc". However,
in Table 5 you do not adjust for age, occupation, alcohol use disorder. Similarly, in Table 7 there
is no adjustment for dyspareunia even though in Table 3 it was included in the model. We would
recommend being consistent across all tables with respect to covariate adjustments.
Title: Prevalence of chronic pelvic pain and primary dysmenorrhea in women of reproductive
age in Ecuador
Version: 3 Date: 03 Aug 2022
Reviewer's report:
This paper is a huge work and i want to congratulate with the authors.
All changes has been done.
I think that a brief description of the data at the beginning of the result would help in interpreting
the data
Like amount of women contacted, response rate, total number of questionnaire collected, etc
tables are redundant i would remove Table 1 because is described in the text and  i would gather
together table 3, 5 and 7
Title: Experiences of infertile women pursuing treatment in Kenya: a qualitative study
Version: 2 Date: 14 Jun 2022
Reviewer's report:
1.Please specify the type of qualitative study. For example, content analysis or thematic analysis
2.The phenomenon is about infertility treatment, but some interviews do not say so. Please edit
the interviews
3.Were any questions asked of the participants? So how did you turn the interviews into a
treatment? Data collection seems to be through semi-structured interviews
4.Please bring the demographic table of 33 participants in the results section.
5.Interviews are not rich enough
Title: Experiences of infertile women pursuing treatment in Kenya: a qualitative study
Version: 2 Date: 04 Jul 2022
Reviewer:  Zeinab Hamzehgardeshi
Reviewer's report:
This is an important and interesting study on the “Experiences of infertile women pursuing
treatment in Kenya” that was a qualitative study. The authors explored infertile women's
experiences and coping strategies in the article.
Please respond to the following comments.
Title:
Introduction:
• Explore the study context.
• Explain the literature review to give the reader a balanced view of what has been written on
the subject.
•
• Provide a clear research question or a statement of the problem or purpose.
Methods
• Since authors’ positions and affiliations can influence the readability of quantitative research
papers. Please explore the authors’ positions and affiliations.
• Clarify the Recruitment and sampling methods such as purposeful sampling, Convenience,
and Maximum variation…
• Did not allow audio recordings were exclusion criteria. This condition can limit of study can
decrease access to rich data.
• Explore the Data collection such as:
o  Participants were recruited and consented.
o when and where the data collection took place
o Data collection methods include interviews (structured or unstructured and in-depth one-to-
one or group)
o Group interviews (focus group interviews )
o voice recorded and transcribed verbatim
o face to face, telephone, or any other type of media used
o ethical approval/participants’ consent
• clarify that type of data collection (Semi-structured interview or structured interview)
• Analysis
o Is there more than one person responsible?
o Would you clarify resolved any discrepancies in findings?
o Is there member checking?
o Provide a diagram of how you approached data analysis?
Results:
• Provide the chart of theme or tables
• How the patterns and themes have emerged?
Discussion
• Summarise key results based on study objectives in the first paragraph.
• Explore interpretations and implications for practice
• Provide the recommendations
• Discuss limitations of the study based on biases.
Title: Polymorphisms of TNF-alpha (-308), IL-1beta (+3954) and IL1-Ra (VNTR) are
associated to severe stage of endometriosis in Mexican women: a case control study.
Version: 2 Date: 22 Jun 2022
Reviewer's report:
I congratulate with the authors for the weel conducted and well written study.
I  suggest to reduce the lenght of the introduction section and to add more insights regarding the
association between autoimmune diseases and endometriosis related to cytokine dysregulations
(eg doi 10.1016/j.jmig.2012.03.005)
Title: Polymorphisms of TNF-alpha (-308), IL-1beta (+3954) and IL1-Ra (VNTR) are
associated to severe stage of endometriosis in Mexican women: a case control study.
Version: 2 Date: 24 Jun 2022
Reviewer's report:
Dear Authors,
Thank you to let me review this interesting manuscript.
The manuscript has many points of originality. In this study, They investigated whether single
nucleotide polymorphisms  mapping to TNF-alphaand IL-1beta  and variable number tandem
repeat polymorphism mapping to IL1-Ra  genetic loci are associated with risk for endometriosis .
The genetic predisposition related to endometriosis is a topic of great interest to the scientific
community. The sample of patients analyzed is quite large and all patients underwent surgery
and this is a strength of the study.
However, in my opinion the authors should  reduce the Discussion section that is too long.
Too long a discussion makes the work less legible, the discussion should be more focused
on results. Also the introduction may be slightly reduced. Furthermore in the introduction
should be introduced references about the role of TNF alpha and IL1 in the development of
other gynecological pathologies like myomas ( PMID: 19614627;  PMID: 31100862;  PMID:
25398968) which in some cases can be confounding factors in research
Correction: Line 367 ( the reference 72 may be  put inside the  brackets)
Title: Polymorphisms of TNF-alpha (-308), IL-1beta (+3954) and IL1-Ra (VNTR) are
associated to severe stage of endometriosis in Mexican women: a case control study.
Version: 2 Date: 25 Jun 2022
Reviewer's report:
I read with great interest the manuscript, which falls within the aim of this Journal. In my honest
opinion, the topic is interesting enough to attract the readers’ attention. Nevertheless, authors
should clarify some points and improve the discussion, as suggested below.
Authors should consider the following recommendations:
- Accumulating evidence suggests that immune cells, adhesion molecules, extracellular matrix
metalloproteinase and pro-inflammatory cytokines activate/alter peritoneal microenvironment,
creating the conditions for differentiation, adhesion, proliferation and survival of ectopic
endometrial cells. I would discuss these points in the light of new theories about the pathogenesis
of endometriosis, referring to: PMID: 34096691; PMID: 33851803; PMID: 31663401; PMID:
34008386
- I would suggest to highlight, at least briefly, that dysmemorrea may be the first symptom of
endometriosis, which should be ruled out promptly (authors may refer to: PMID: 28553145;
PMID: 30074068).
Title: Polymorphisms of TNF-alpha (-308), IL-1beta (+3954) and IL1-Ra (VNTR) are
associated to severe stage of endometriosis in Mexican women: a case control study.
Version: 3 Date: 02 Aug 2022
Reviewer's report:
I read with great interest the manuscript, which falls within the aim of this Journal. In my honest
opinion, the topic is interesting enough to attract the readers’ attention. Nevertheless, authors
should clarify some points and improve the discussion, as suggested below.
Authors should consider the following recommendations:
- Accumulating evidence suggests that immune cells, adhesion molecules, extracellular matrix
metalloproteinase and pro-inflammatory cytokines activate/alter peritoneal microenvironment,
creating the conditions for differentiation, adhesion, proliferation and survival of ectopic
endometrial cells. I would discuss these points in the light of new theories about the pathogenesis
of endometriosis, referring to: PMID: 34096691; PMID: 33851803; PMID: 31663401; PMID:
34008386
- I would suggest to highlight, at least briefly, that dysmemorrea may be the first symptom of
endometriosis, which should be ruled out promptly (authors may refer to: PMID: 28553145;
PMID: 30074068).
Title: Comparison of self-collected versus clinician collected cervicovaginal specimens for
detection of high risk human papillomavirus among HIV infected women in Ethiopia
Version: 3 Date: 24 Jul 2022
Reviewer:  Erika Catania
Reviewer's report:
I read with great interest the Manuscript titled “Comparison of self-collected versus clinician
collected cervicovaginal specimens for detection of high risk human papillomavirus among HIV
infected women in Ethiopia ” (ca77ee6b-e374-4a0d-9338-556df91da2a4), which falls within
the aim of this Journal.
In my honest opinion, the topic is interesting enough to attract the readers’ attention.
Methodology is accurate and conclusions are supported by the data analysis. Nevertheless,
authors should clarify some point and improve the discussion citing relevant and novel key
articles about the topic.
Authors should consider the following recommendations:
- Manuscript should be further revised by a native English speaker
- Inclusion/exclusion criteria should be better clarified.
- In the Results section, the Authors have simply reported the p values, from which however it
is not possible to deduce the real clinical relevance of the highlighted statistical significance. In
order to better understand the obtained results, I suggest reporting not only the p values, but also
the corresponding confidence intervals
- The authors have not adequately highlighted the strengths of their study. I suggest clarifying
these points
- What are the actual clinical implications of this study? it is important to report the results
obtained by the authors in the context of clinical practice and to adequately highlight what
contribution this study adds to the literature already existing on the topic and to future study
perspectives
- Does this manuscript conform the Enhancing the QUAlity and Transparency Of health
Research (EQUATOR) network guidelines? It would be mandatory to declare about this
element.
- Was this study registered? I could not find any information about this point.
- I could not find any information regarding the approval of the Institutional Review Board. Did
author this approval before the study start?
Title: Factors associated with regularity and length of menstrual cycle: Korea Nurses’ Health
Study
Version: 1 Date: 07 May 2022
Reviewer's report:
This interesting study reports the results of a large and detailed survey of the menstrual cycle
among women in nursing, a profession considered to be physically and mentally hard work. In
particular, irregular menstruation and the length of the menstrual cycle are discussed separately,
but it is considered that this intention has not been fully considered.
Background
“ Long and/or irregular cycles have been associated with increased risk of type 2 diabetes [4, 5],
coronary heart diseases [6, 7] , ovarian cancer [8], and premature mortality [9].”
Some more brief description of the mechanisms of the relationship between irregular
menstruation and diseases such as type 2 diabetes is needed.
Methods [Data collection]
“The menstrual cycle patterns were characterized by cycle regularity and length. In the module
3, participants were asked to report their usual menstrual cycle length as <21, 21–25, 26–31, 32–
39, 40–50 days, or > 50 days or too irregular to estimate. Participants also reported the current
menstrual cycle regularity as very regular (within 3 days), regular (within 5–7 days), usually
irregular, or always irregular.”
Although the subjects were asked to categorise the number of days in their usual menstrual cycle
in detail, you categorised them into three   groups in your analysis: 'short', 'moderate' and 'long'.
What was the intention behind the detailed categorisation of the questionaire?
“Menstrual cycle regularity was categorized as “regular (cycle variability within 7 days)” and
“irregular”. Menstrual cycle length was categorized as “short (<26 days),” “moderate (26–31
days),” and “long (32–50 days)”.”
These criteria require references.
Discussion
“Some studies suggest that cigarette smoking may be associated with short or irregular menstrual
cycles mainly by disrupting endocrine function [3, 46]. We found no significant association
between lifetime cigarette smoking and menstrual cycle characteristics, but a limited number of
smokers may explain the lack of significance.”
Is there a higher rate of smokers compared to the general proportion of female?
This should be taken into account and mentioned in the discussion.
Title: Factors associated with regularity and length of menstrual cycle: Korea Nurses’ Health
Study
Version: 3 Date: 21 Jul 2022
Reviewer's report:
Thank you for your response. Overall, I fully understand your response, but I would like to
provide the following minor comments.
#Discussion#
“The proportion of women reporting lifetime smoking in our study (2.8%) was much lower than
that in the fifth KNHANES (10.9 %) [38].”
Thank you for adding the sentence about the rate of smokers. However, I have checked the
revised manuscript and found that the reference number is listed as 36, not 38. Further, the 10.9%
rate of lifetime smoking was also not confirmed by reviewing the manuscript for number 36
(Bae J, Park S, Kwon JW: Factors associated with menstrual cycle irregularity and menopause.
BMC Womens Health 2018, 18(1):36). It is possible that the reference citation may have been
misplaced when you revised the manuscript, so please check the references again for the entire.
Title: Imaging characteristics of ovarian sclerosing stromal tumor
Version: 2 Date: 08 Jun 2022
Reviewer:  Smrita Swamy
Reviewer's report:
Overall good case review,  keeping in mind, a few points  as below:
-Please improve the language and grammar of the article.
-No mention is made of O-RADS, and how this will fit into that system.
-No latest references are mentioned.
Title: Imaging characteristics of ovarian sclerosing stromal tumor
Version: 2 Date: 09 Jun 2022
Reviewer:  Jeevan Divakaran
Reviewer's report:
• Typos and grammatical mistakes need to be corrected
• Were any guidelines followed by the radiologists in reviewing the cases? In how many cases
was the diagnosis inconsistent and how was consensus reached?
• Since this was a retrospective review of confirmed cases, was any comparison attempted with
the pre-op imaging reports?
• Clinical presentation data is missing for CT02 in Table 1
• Considering that some of the imaging features (lake-island sign, progressive continual
enhancement, early-fast sustained enhancement) were not present in all cases, was there any
correlation with factors other the pathological findings, such as age of the patient, tumor size?
• The legend for the pathology slide states “microscopic image of the cellular portion reveals
an admixture of cellular areas, collagenous, edematous hypocellular areas, and pseudolobular
appearance are noticeable”. Labelling might help to clarify, it can be somewhat confusing to
understand the cellular portion showing both cellular and hypocellular areas?
Title: Imaging characteristics of ovarian sclerosing stromal tumor
Version: 5 Date: 10 Aug 2022
Reviewer:  Smrita Swamy
Reviewer's report:
Overall it  is good to see a considered response to all the points raised in the earlier review.
However  the attempts at improving grammar has not had the desired effect. Sentence
construction is ambiguous and so  the points made are not very clear. Proper unambiguous use
of the language would be appreciated.
Title: Factors that influence breast cancer screening among women of reproductive age in the
Nandom Municipality, Ghana
Version: 1 Date: 20 Jul 2022
Reviewer's report:
1. Correct all typos  e.g. Page 6  - ....I can schedule an appointment for breast acncer screening ....
and ...Table 4: Constucts of the Health Belief Model.
2. Given that the  HBM  defines key factors that influence health behaviors in the context of an
individual's perceived threat to breast cancer, it is unclear how cultural factors where considered
in the study. Therefore, explain why the HBM was selected as a model of choice for the study
considering the significance of  Ghana's pluralistic healthcare system as an attempt to address
cultural factors in health behavior .
Title: Co-designed, culturally tailored cervical screening education with migrant and refugee
women in Australia: A feasibility study
Version: 1 Date: 16 Jun 2022
Reviewer:  Erika Catania
Reviewer's report:
I read with great interest the Manuscript titled “Co-designed, culturally tailored cervical
screening education with migrant and refugee women in Australia: A feasibility
study” (63662645-805a-49c6-96f7-eeb2afc57222), which falls within the aim of this Journal.
In my honest opinion, the topic is interesting enough to attract the readers’ attention.
Methodology is accurate and conclusions are supported by the data analysis. Nevertheless,
authors should clarify some point and improve the discussion citing relevant and novel key
articles about the topic.
Authors should consider the following recommendations:
- Inclusion/exclusion criteria should be better clarified.
- The authors have not adequately highlighted the strengths and limitations of their study. I
suggest clarifying these points
- Does this manuscript conform the Enhancing the QUAlity and Transparency Of health
Research (EQUATOR) network guidelines? It would be mandatory to declare about this
element.
- Was this study registered?
- I could not find any information regarding the approval of the Institutional Review Board. Did
author this approval before the study start?
-  To date, several lines of evidence support the possibility to use specific biomarkers to identify
early-stage cervical cancer and, in this way, offer a better prognosis to the patients. This point
deserves to be discussed, referring to: PMID: 33152105; PMID: 28918603.
- I would recommend to stress novel pieces of evidence about high-risk HPV-negative high-
grade cervical dysplasia, which seems to have more favorable outcomes than patients with
documented high-risk-HPV infection (PMID: 32552158; PMID: 33514481).
- Authors should discuss the potential role of pre-operative conization before radical
hysterectomy for early-stage cervical cancer (PMID: 33620615; PMID: 32320800).
- The management of women affected by cervical cancer needs particular attention even to the
preservation of an appropriate quality of life and sexual function, which risk being severely
impaired by surgical/chemo/radio treatments. I would discuss this point, at least briefly, referring
to: PMID: 33063258; PMID: 31818165.
Title: Risk factors predicting residual lesion in subsequent hysterectomy following cold knife
conization(CKC) for high-grade squamous intraepithelial lesion(HSIL)
Version: 1 Date: 05 Jun 2022
Reviewer's report:
This manuscript adds little new information to the literature on risk factors for residual disease
in hysterectomy specimen post CKC. AS authors you acknowledge the limitations of a single-
centre retrospective study. There is much missing information:
How was HPV status determined? What test/s was/were performed and on what samples?
What was the HIV STATUS?
When referring to diseases of the immune system to what are you referring?
What is TCT?
What were the indications for CKC in the first instance - please put these in the methods
There are a number of minor gramatical errors
Title: Risk factors predicting residual lesion in subsequent hysterectomy following cold knife
conization(CKC) for high-grade squamous intraepithelial lesion(HSIL)
Version: 1 Date: 11 Jun 2022
Reviewer:  Juan C. Felix
Reviewer's report:
This manuscript reports on the results of a retrospective investigation of women who had
undergone cervical conization for high-grade squamous intraepithelial lesions (HSIL) and
had a subsequent hysterectomy within the following their conization. The authors evaluated
factors that would predicts the likelihood of finding residual HSIL or cervical cancer in the
examination of the hysterectomy specimen. The authors found that positive resection margins,
particularly positive endocervical or combined endocervical and ectocervical margins were a
strong predictor of finding residual HSIL  of cancer on the subsequent hysterectomy specimen.
They also found that endocervical glandular involvement, HPV 16/18, and multiple HPV
infections were all independent risk factors for finding residual disease.
This is a well designed, well analyzed, and well reported study on a topic of continued interest,
particularly in Low and Middle Income Countries (LMIC). The study is well powered and the
statistical analysis well paired.
I have only one strong suggestion for the authors, one that would make this manuscript of even
greater value and significance. The authors used the the standardised nomenclature protocol
for cervical lesion jointly published in 2012 by the American Society for Pathology (CAP) and
the American Society for Colposcopy and Cervical Pathology (ASCCP). They mentioned in
their Methods section that they converted data from the cervical intraepithelial neoplasia (CIN)
system to the standardized one. This is entirely acceptable, yet analyzing whether  CIN 3 is an
independent risk factor for recurrence and presenting this data to the reader would go a long way
to either add credibility that the three tier system is still of value (if CIN 3 predicts recurrence)
or that there is no evidence, from the data presented here that a three tier classification in of
value (if CIN 3 does not predict recurrence). From the description in the Methods section this
data should be readily available to the authors to consider this a minor revision.
The only other comment is that the authors use an abbreviation on page 5, line 104 (TCT) that is
not spelled out or included in the list of abbreviations at the end of the manuscript. The authors
need to provide what the term TCT means.
Title: Risk factors predicting residual lesion in subsequent hysterectomy following cold knife
conization(CKC) for high-grade squamous intraepithelial lesion(HSIL)
Version: 1 Date: 13 Jun 2022
Reviewer:  Diama Bhadra Vale
Reviewer's report:
Dear authors.
Thanks for the opportunity to review your manuscript.
I have some comments that I hope you help you to improve your manuscript.
Sincerely.
It is a retrospective study of 740 women who underwent HT 3 months after CKC for HSIL. The
authors aimed to determine risks predicting residual disease. Although the residual disease is
not as relevant as HPV status (or lesser relevant margin status), the large sample is the highlight
of the paper.
It is not a current practice to recommend HT or even re-conization after an excisional procedure.
Even when both margins are positive, the risk of relapse is low (around 20%). It is overtreatment,
especially in women in their reproductive ages. This ethical issue must be carefully addressed.
I noticed that you have written something about it in the discussion. In my opinion, 14% of
residual disease is low and supports the recommendation to not perform HT. However:
1) The statements regarding this topic (ethical issue) are confusing in the first paragraph of the
discussion. Please read and re-state it.
2) This should be addressed on methods. Which guideline does the service use? Who are the
women referred for the HT? What are their characteristics? We need to know who is the sample
to analyze if your results can be extrapolated to other populations... How many (or %) were not
submitted to HT in the same period?
Other comments:
3) Table 1 is unnecessary. I would recommend removing it. The same data is presented in table
2 with descriptive analysis.
4) tables should have a proper title and legends. Formatting should be improved.