14,838 Matching Annotations
  1. Jul 2018
    1. On 2013 Jun 19, Markus Meissner commented:

      In this study Gaji et al. present a new methodology to indentify host cell factors that are involved in Toxoplasma gondii invasion. They performed a high throughput screen and identified several candidates, where the knockdown results in less efficient host cell invasion by this parasite. The authors speculate that six identified candidates affect parasite invasion by modifying actin dynamics. Although at this point no novel mechanistic concept can be presented, the results of this elegant screen will provide the field with novel ideas for future investigations of host cell factors that are involved during invasion by apicomplexan parasites. Currently our view of host cell invasion and the mechanisms involved during this process are challenged by intriguing results from several groups that do not fit the current models. Therefore this study is very timely and provides the field with a new resource for hypothesis driven follow up studies on some of the identified candidates.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2016 Aug 23, Ben Goldacre commented:

      This trial has the wrong trial registry ID associated with it on PubMed: both in the XML on PubMed, and in the originating journal article. The ID given is NCT016648060. We believe the correct ID, which we have found by hand searching, is NCT01664806.

      This comment is being posted as part of the OpenTrials.net project<sup>[1]</sup> , an open database threading together all publicly accessible documents and data on each trial, globally. In the course of creating the database, and matching documents and data sources about trials from different locations, we have identified various anomalies in datasets such as PubMed, and in published papers. Alongside documenting the prevalence of problems, we are also attempting to correct these errors and anomalies wherever possible, by feeding back to the originators. We have corrected this data in the OpenTrials.net database; we hope that this trial’s text and metadata can also be corrected at source, in PubMed and in the accompanying paper.

      Many thanks,

      Jessica Fleminger, Ben Goldacre*

      [1] Goldacre, B., Gray, J., 2016. OpenTrials: towards a collaborative open database of all available information on all clinical trials. Trials 17. doi:10.1186/s13063-016-1290-8 PMID: 27056367

      * Dr Ben Goldacre BA MA MSc MBBS MRCPsych<br> Senior Clinical Research Fellow<br> ben.goldacre@phc.ox.ac.uk<br> www.ebmDataLab.net<br> Centre for Evidence Based Medicine<br> Department of Primary Care Health Sciences<br> University of Oxford<br> Radcliffe Observatory Quarter<br> Woodstock Road<br> Oxford OX2 6GG


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Mar 23, Hilda Bastian commented:

      Readers of this Cochrane review (Gøtzsche PC, 2013) may also be interested in other key reviews that assess much the same body of evidence. One of these is the systematic review undertaken for the US Preventive Services Taskforce (USPSTF) (Nelson HD, 2009). Another is the review by the Independent UK Panel on Breast Cancer Screening (Independent UK Panel on Breast Cancer Screening., 2012; Marmot MG, 2013; full report). In addition, the Canadian Task Force on Preventive Care used the USPSTF review as the basis for its findings and recommendations (Canadian Task Force on Preventive Health Care., 2011).

      Update on 1 May 2014: Another review was published in JAMA in April 2014 (Pace LE, 2014). Its data on breast cancer death use the USPSTF review. The Swiss Medical Board published a review in April 2014 too: its findings and recommendations are based on interpreting the Cochrane, USPSTF and Independent UK Panel data (Takiura K, 1973). And I posted a guide to understanding mammography evidence on my blog at Scientific American.

      Update on 30 October 2014: The WHO published a review of systematic reviews of trials and observational studies, with a search date up to December 2012 (WHO, 2014). Their data interpretation is similar to that of the UK Independent Panel, and they recommend 2-yearly screening from 50 to 69 years of age, where there's a good screening program and informed decisions. Their estimates of harm are lower than those of some others, taking into account more recent practice.

      Differences in the estimates and conclusions about the effect of breast screening with mammography on breast cancer mortality between these reviews are not due to different trials being assessed. The differences principally arise from differing judgments on the strengths and limitations of individual trials, and a focus on local screening practices (which vary in terms of women's ages and whether screening is every one, two or three years).

      There were also some differences in methodologies for analyzing the data. The meta-analyses done by both the review for the USPSTF and the Independent UK Panel used random effects models, there being differences between the trials. The review for the USPSTF used a Bayesian analytic framework. The Cochrane review used a fixed effects model. A fixed effect model assumes that the effect would be consistent across trials.

      The Independent UK Panel by Marmot et al re-analyzed the trial data included in the 2011 version of the Cochrane review (with the same trials and estimates as this version). The Panel derived a comparison of the estimates of various authors, including the reviews included here (Independent UK Panel on Breast Cancer Screening., 2012). In order to prevent one woman's death from breast cancer, the number of women who would need to be invited for screening was estimated as:

      • Cochrane review: 2,000
      • USPSTF, for women aged 50 to 59: 1,339 and for women aged 60 to 69: 377
      • Independent UK Panel, for women aged 55 to 79: 235

        In order to prevent one woman's death from breast cancer, the number of women who would need to be screened was estimated as:

      • Canadian Task Force, for women aged 50 to 69: 720

      • Independent UK Panel, for women aged 55 to 79: 180

      The Independent UK Panel estimated that about 20% of breast cancers detected by mammography screening may be over-diagnosis. They recommended screening only every 3 years to reduce the risk. The Cochrane review suggested this may be 30% or more.

      Longer term follow-up on one of the trials included in these reviews has subsequently been published (Canadian National Breast Screening Study, Miller AB, 2014). That trial is one of the trials judged by reviewers to be of high quality, and has consistently found no significant reduction in deaths attributed to breast cancer. It is the trial with results least favorable to mammography included in these meta-analyses.

      A further systematic review has looked at the question of non-breast cancer mortality in breast cancer screening trials (Erpeldinger S, 2013). Breast cancer trials were not designed to answer this question. These authors conclude that the trials show neither a decrease nor increase in non-breast cancer mortality associated with screening.

      The review for the USPSTF identified two systematic reviews relevant to the question of psychological harm from breast screening with mammography (Brewer NT, 2007, Brett J, 2005). The reviewers concluded false-positives are associated with distress, but no consistent effect on anxiety and depression has been shown for screening with mammography. A more recent systematic review has also looked at the impact of false-positive mammogram results, coming to similar conclusions (Bond M, 2013).

      Marmot pointed out that the members of the UK Independent Panel were chosen both for expertise and not having previously published on the subject, to minimize the risk of a biased approach to analyzing and interpreting evidence (Marmot MG, 2013). The USPSTF commissioned the independent Agency for Health Care Research and Quality (AHRQ) to conduct the review used for its decision-making (Nelson HD, 2009).


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2013 Aug 16, Martin Fenner commented:

      I've written a blog post about this paper, and a plugin for the Jekyll blogging platform that automatically detects database links in blog posts, currently supporting ENA/GenBank/DDBJ, Uniprot, PDB and MGI.

      It is common practice in the life sciences to add tags right into the text. I don't think we necessarily need identifiers for databases, as proposed by William. Writing the tags as links would already be a major step forward, and that is why I wrote the jekyll plugin.

      Even better would be to include database tags in the references of a paper. They would not only be easier to find, but we could also add metadata to the document. But we are probably a few years away from this as we have a strong community practice to have database tags right in the text.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    2. On 2013 Aug 15, William Gunn commented:

      I think what's really needed here is identifiers for databases, so we don't end up with the same problem that we have for authors and institutions, where there is so much ambiguity. Another job for ORCID?


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    3. On 2013 Jul 04, John Overington commented:

      A standard for database tag structures would be really useful in general - 1ABC is a PDB code, but it's also many other things, so PDB1ABC would be more general and useful. However, as a database provider this paper highlighted several features that I didn't know and will now explore - e.g. the NLM JATS DTD.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2016 Jun 08, David C. Norris commented:

      The abstract above must be appreciated in context of the Jun 2014 Erratum, which reports findings of a post-publication review by 3 independent reviewers assigned by Health Affairs. Those findings nullify the abstract’s key statistical claim:

      Reviewers found that the authors’ use of a cluster-robust variance estimator was inappropriate in light of the small number of clusters (two) used in this analysis, because variances estimated by this method are biased downward toward zero as the number of clusters diminishes—a problem that had not been detected in the initial reviews of the paper. As a consequence, the standard errors reported in the article are understated, and the reported finding of a significant difference in mortality between the experimental and control groups is not supported by evidence presented in the article.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Feb 02, Jan Tunér commented:

      This conclusion of this study must be questioned. Not only that a 10 W laser poses a much higher risk of burning and eye injury and is more expensive than a class 3B laser - a Class 3B laser is quicker! The high output forces a sweeping motion or irradiation from a distance, thereby causing a lot of energy loss at the deep target. The time spent was 5 minutes, which is more than required by a conventional Class 3B session for this condition. With a 3B laser in firm contact over tender points and a sweeping motion over the actual condyle, more energy at target can be applied in 2-3 minutes. The authors of the paper above swept over an area of 45 cm2. By spreading the light over a large area, using a wide beam area and irradiating from a distance, the dose became 6.6 J/cm2 and the power density only 22 mW/cm2, which is very low. Irradiating in contact with 10 W is not possible, but with a 3B laser in firm contact, an optimal penetration is achieved and less time is required.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 May 01, G L Francis commented:

      Given the role of IGF-II in embryonic development,including muscle, pancreas etc., as well as postnatally in tissue and wound repair (such as liver regeneration after partial hepatectomy),was the local expression level of this growth factor considered rather than IGF-I?


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2016 Feb 10, Anders von Heijne commented:

      In a recent case with a very large testicular epidermoid cyst we found an ADC-value of 0.544. IT seems that testicular epidermoid cysts have distinctly lower ADC-values than their intracranial counterparts.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2016 Aug 23, Ben Goldacre commented:

      This trial has the wrong trial registry ID associated with it on PubMed: both in the XML on PubMed, and in the originating journal article. The ID given is NCT01576461. We believe the correct ID, which we have found by hand searching, is NCT01576471.

      This comment is being posted as part of the OpenTrials.net project<sup>[1]</sup> , an open database threading together all publicly accessible documents and data on each trial, globally. In the course of creating the database, and matching documents and data sources about trials from different locations, we have identified various anomalies in datasets such as PubMed, and in published papers. Alongside documenting the prevalence of problems, we are also attempting to correct these errors and anomalies wherever possible, by feeding back to the originators. We have corrected this data in the OpenTrials.net database; we hope that this trial’s text and metadata can also be corrected at source, in PubMed and in the accompanying paper.

      Many thanks,

      Jessica Fleminger, Ben Goldacre*

      [1] Goldacre, B., Gray, J., 2016. OpenTrials: towards a collaborative open database of all available information on all clinical trials. Trials 17. doi:10.1186/s13063-016-1290-8 PMID: 27056367

      * Dr Ben Goldacre BA MA MSc MBBS MRCPsych<br> Senior Clinical Research Fellow<br> ben.goldacre@phc.ox.ac.uk<br> www.ebmDataLab.net<br> Centre for Evidence Based Medicine<br> Department of Primary Care Health Sciences<br> University of Oxford<br> Radcliffe Observatory Quarter<br> Woodstock Road<br> Oxford OX2 6GG


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2015 Oct 12, Bill Cayley commented:

      One example of when a less medical approach may actually be better for possible malaria: https://lessismoreebm.wordpress.com/?s=malaria


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Feb 14, David Keller commented:

      Were the benefits due to lower glucose levels, pleiotropic effects of exenatide, or lack of a placebo control?

      The possible beneficial effect of exenatide on the progression of Parkinson disease might have been due to the mild sustained decrease in blood glucose levels which is the usual intended effect of this medication in diabetics, or to the pleiotropic neuroprotective effects hypothesized by the investigators, or to a combination of effects, including the placebo effect. Self-injection is a powerful placebo procedure, especially in a condition like Parkinson's disease, in which the magnitude of the patient's symptoms are affected by their psychological state and mood. Because the comparison group did not self-inject daily, the placebo effect was not controlled for in this study. Some of these questions could be addressed by comparing exenatide to self-injected basal insulin in future studies, dosed to produce an equivalent degree of glucose-lowering but without frank hypoglycemia. A slight lowering of blood glucose (within the normal range) might be neuroprotective by means of decreasing metabolism, and thereby decreasing the oxidative stress and the free radicals generated by metabolic reactions. Any benefit due to reduced metabolism caused by lowered blood glucose should be equivalent for equipotent doses of exenatide and basal insulin. Any additional benefit of exenatide over equipotent basal insulin could be ascribed to pleiotropic neuroprotective effects of the former.

      A recent meta-analysis found that Parkinson patients treated with active drug had significantly less objectively measured motor response to the same intervention if they knew there was a chance that they were receiving placebo, even with effective double blinding (1). This decreased response, dubbed "the lessebo effect", could account for up to 4.1 UPDRS units of motor improvement for patients in studies lacking double-blinded placebo controls.

      Reference

      1) Mestre TA, Shah P, Marras C, Tomlinson G, Lang AE. Another face of placebo: The lessebo effect in Parkinson disease: Meta-analyses. Neurology. 2014 Apr 22;82(16):1402-9. doi: 10.1212/WNL.0000000000000340. Epub 2014 Mar 21. PubMed PMID: 24658930; PubMed Central PMCID: PMC4001195.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Feb 23, David Keller commented:

      A new approach or a step backward?

      The "new approach" to disease-modifying drug trials seems to me to be a step backwards. Due to the inability to obtain placebo Byetta pen-injectors, the study was conducted without a true placebo control. Instead, the intervention group self-injected with actual Byetta pen-injectors daily, while the comparison group did nothing special and was followed passively over time. Thus, there was no control for the powerful placebo effect caused by daily self-injection by the intervention group, which could account for much of the beneficial effect observed. The symptoms of Parkinson disease are known to be somewhat dependent on the psychological state and mood of the patient, which tends to magnify the placebo effect.

      A recent meta-analysis found that Parkinson patients treated with active drug had significantly less objectively measured motor response to the same intervention if they knew there was a chance that they were receiving placebo, even with effective double blinding (1). This decreased response, dubbed "the lessebo effect", could account for up to 4.1 UPDRS units of motor improvement for patients in studies lacking double-blinded placebo controls.

      The manufacturer of Byetta should be encouraged to donate Byetta pen-injectors filled with normal saline to future clinical trials of exenatide, allowing them to be conducted as proper placebo-controlled and double-blinded studies. If such future trials demonstrate benefits, their results can be interpreted without caveats, and Byetta's manufacturer can expect to be repaid for their support of medical science by the subsequent increased sales to non-diabetic Parkinson patients.

      Reference

      1) Mestre TA, Shah P, Marras C, Tomlinson G, Lang AE. Another face of placebo: The lessebo effect in Parkinson disease: Meta-analyses. Neurology. 2014 Apr 22;82(16):1402-9. doi: 10.1212/WNL.0000000000000340. Epub 2014 Mar 21. PubMed PMID: 24658930; PubMed Central PMCID: PMC4001195.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2013 Jun 27, Markus Meissner commented:

      Reply to Gary Ward:

      Hi Gary. Thank you for your comments. We are glad you find the review helpful. For now, I prefer to focus on the first two comments and just mention a few information on the collar. 1) Regarding Non-essential and non-important. I agree with you. In fact all the discussed genes are probably essential in vivo. Although we only have preliminary data for the ama1KO that shows that this parasite is highly attenuated, similar data were obtained for a knockdown of MyoA and MIC2 (Meissner et al., Science 2002; Huynh et al., 2006). I have no doubt that other mutants behave similar. Furthermore, we know that MLC1, GAP45 and act1 are essential and depletion leads to parasite death. However, depletion does NOT lead to a block in host cell invasion. Therefore, none of the discussed genes can be defined as "essential for the process of host cell invasion". I agree that they are important for invasion. Invasion is however a multistep process (attachment, reorientation, junction formation, penetration) and we need to know which step is influenced by removal of the respective gene in order to obtain a clear picture of the (real) invasion mechanism. 2) Regarding interpretation of KO data you propose a third possibility, which relies on the accumulation of compensatory mutations or changes in gene expression. This explanation is certainly appealing and valid for some of the effects seen. For example it could be argued that deletion of an attachment factor can be compensated by upregulation of another, as seen in Plasmodium. Especially in case of non-essential genes (in vitro), long term adaptations are a strong possibility and like you we do observe this effect for some of the KOs. However, in case of conditional KOs for essential genes (i.e. actin) we observe that the whole culture dies within 10 days due to the loss of the apicoplast (Andenmatten et al., 2013). During this whole period the parasites remain able to invade. How would you imagine a scenario, where a gene remains essential for two processes (apicoplast division and egress) but not for invasion? I would strongly argue against a scenario, where an actin-like protein can form a filament (which has been never demonstrated in apicomplexans) that can be used by MyoA only during invasion but not during egress.

      Regarding the Collar, we are not sure at this point what exactly it reflects. In the provided images wild type parasites were analysed and it will be certainly interesting to investigate if KO parasite show an increase in collar formation. Clearly, we need to analyse the collar in detail in the future.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    2. On 2013 Jun 24, Gary Ward commented:

      Thanks to the authors for this timely reanalysis of the current model of apicomplexan invasion. Recent work from the Meissner group has shown that several of the parasite proteins previously thought to be essential for invasion can be knocked out, casting some doubt on the model. I agree with much of what they write, but have three comments:

      1) Non-essential does not mean non-important. In several of these knockouts, invasion and motility are dramatically impaired (e.g., ~80-85% inhibition of invasion) and defects of this magnitude can translate into greatly reduced virulence in vivo (e.g., Meissner et al, Science [2002] 298, 837). While the new data show clearly that MyoA and AMA1 are not essential for invasion, they at the same time show them to be important for invasion. Whether they are important for the reasons predicted by the current model is a separate question.

      2) In the authors' view, the data either show that the "parasites use a single entry mechanism and hence the current invasion model is wrong and needs to be replaced by a new model, [or] the current model is overall valid but an additional, motor independent invasion mechanism is at work that facilitates host cell invasion in KO mutants of the glideosome". Redundant mechanisms are a common feature of parasite biology (e.g., erythrocyte-binding proteins of malaria parasites, Trends in Parasitology [2012] 28, 23), so I agree with these two possibilities. However, I would add a third: by knocking out a parasite protein that plays an important role in a process that is so critical to the parasite lytic cycle, enormous selective pressure is put on the parasites to come up with a way around the problem. Compensatory mutations or changes in the expression of other proteins that can "fill in" for the missing protein may occur. In fact, we have seen an improvement over time in the ability of some of these mutants to invade, which likely represents some advantageous mutation or change in gene expression that is being selected for in culture. Such changes will be hard to track down and even harder to rule out, but the phenotype observed in these knockouts will be due to some combination of the knockout itself and whatever the parasite does to overcome it.

      3) The collar seen around the invading tachyzoite in Fig. 2 is intriguing, and unlike what we typically see by EM during invasion of human foreskin fibroblasts. How rare are these events, and are they specific to this cell type? This profile could reflect an alternative invasion mechanism, as proposed. On the other hand, these cells might have an unusually impenetrable cortical cytoskeleton and the parasites push but can't get in. In this case the moving junction would in fact really be a moving junction and would be pulled along the body of the stationary parasite, much like occurs during Cryptosporidium invasion and consistent with the standard model of invasion.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    3. On 2013 Jun 24, Gary Ward commented:

      None


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Dec 29, David Keller commented:

      Might the addition of sargramostim to combination checkpoint inhibition reduce adverse events?

      Recently, Hodi et al demonstrated that addition of sargramostim (GM-CSF) to high-dose ipilimumab monotherapy (10 mg/kg) resulted in significantly improved median overall survival, and also significant reduction in the rate of adverse effects compared with high-dose ipilimumab alone (1). It seems imperative to test the proposition that sargramostim might provide similar increase in benefit and decrease in risk when administered with combination checkpoint inhibition.

      Reference

      1: Hodi FS, Lee S, McDermott DF, Rao UN, Butterfield LH, Tarhini AA, Leming P, Puzanov I, Shin D, Kirkwood JM. Ipilimumab plus sargramostim vs ipilimumab alone for treatment of metastatic melanoma: a randomized clinical trial. JAMA. 2014 Nov 5;312(17):1744-53. doi: 10.1001/jama.2014.13943. PubMed PMID: 25369488.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    2. On 2013 Jun 20, Martin Fenner commented:

      The systemic therapy for metastatic melanoma changed dramatically in 2010 when ipilimumab, an antibody against cytotoxic T-lymphocyte–associated antigen 4 [CTLA-4], was shown PMCID: PMC3549297 to improve survival in patients previously treated with chemotherapy. In 2011 ipilimumab was shown Robert C, 2011 to also improve survival when given in combination with dacarbazine compared to dacarbazine alone in previously untreated metastatic melanoma patients.

      The present study is a dose-finding phase Ib study looking at the combination of ipilimumab and nivolumab, an antibody against the programmed death 1 [PD-1] receptor. Fifty-five patients received concurrent therapy of the two drugs, whereas 33 patients previously treated with ipilimumab were given nivolumab (sequential therapy). The objective response rate in the 55 patients treated with combination therapy was 40% with 53% of patients experiencing grade 3 or 4 adverse events. In the 33 patients treated with sequential therapy, 20% showed an objective response and 18% had adverse events related to therapy.

      The study results demonstrate clinical activity of the combination therapy with manageable adverse events (although the rate of adverse events was increased in the concurrent therapy group). What the publication unfortunately fails to do is to clearly describe the study design. According to the information at ClinicalTrials.gov the primary endpoint of the trial was safety (as expected for a phase I trial), and this primary endpoint is mentioned neither in the abstract nor the methods section. What the publication also fails to mention is that according to the Clinicaltrials.gov information this is an ongoing trial with an estimated enrollment of 136 patients and an estimated study completion in August 2014. With all the excitement about new treatment options for metastatic melanoma patients we shouldn't forget best practices of reporting clinical trial results.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2013 Jul 05, Brian Caffo commented:

      None


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    2. On 2013 Jul 05, Brian Caffo commented:

      This is a nice manuscript with a fundamentally sound message. However, node selection in brain network analysis using fMRI or DTI remains a fundamental problem. Moreover, as the author has pointed out here and elsewhere, integrating network estimation across modalities and resolutions is the key for success of the BRAIN project.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2013 Oct 23, Stephen Turner commented:

      This paper warrants a closer look for both the strategy and implementation for pulling out microbial next-generation sequencing (NGS) reads from a highly contaminated host background. IMSA (integrated metagenomic sequence analysis) is a computational pipeline that does this and is flexible enough to allow the user to select and update which databases they're using and the stringency for removing host sequence. It also has some decent post-processing and output functionalities.

      The algorithm has a series of steps to remove host sequences, each more computationally intensive than the previous step (e.g. Bowtie... BLAT... BLAST). After that, it BLASTs everything against NCBI/nt. It scores reads in a simple but intuitive manner (a read that maps perfectly and uniquely to a sequence in the reference database gets a score of 1; a read that maps perfectly to two conserved regions scores 0.5; a read that maps to three scores 0.333; etc.). It then outputs a list of taxonomic IDs and annotated FASTQ files of filtered reads aligning to those IDs that can then be used downstream (assembly, etc.).

      They ran this pipeline on a combined set of viral reads from two different human papillomaviruses (HPVs) in two different cell lines and were able to distinguish the two strains and pull out reads from those strains at the expected proportions. Interestingly, they filter against both the genome and the transcriptome. They found that when they filtered against RefSeq RNAs alone, their read coverage for certain regions in HPV dropped to zero. This is because RefSeq still contains annotation errors, where some genes annotated as human actually contain HPV sequence.

      In addition to outputting a breakdown of what's in the sample and an annotated FASTA file of sequences that aligned to taxa, the pipeline also has tools to output data in a format for phylogenetic tree analysis with Treeview, Cluster, etc. With respect to performance, they claim 50bp single-end reads can be processed at 4.5 hours per million reads per node used.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2016 Mar 18, ZHONGMING ZHAO commented:

      My lab recently moved to the University of Texas Health Science Center at Houston. The software is now available at https://bioinfo.uth.edu/VirusFinder/.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Oct 06, Raha Pazoki commented:

      None


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    2. On 2014 Oct 06, Raha Pazoki commented:

      Addendum to previous comment "Tissue-specific online eQTL databases"

      In the previous analysis, I compared heart-specific eQTLs from the GTEx consortium with eQTLs from the study by Koopman and co-workers. In that analysis, I considered SNP-gene pairs that appear with exactly the same names in the 2 databases. However, SNPs in high linkage disequilibrium (LD) and genes with various annotations may exist between these databases. It would be interesting to put a little more effort and search for such SNPs and genes to come-up with additional SNPs that consistently change cardiac expression of specific genes.

      Raha Pazoki (twitter:@rahap)


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    3. On 2014 Sep 20, Raha Pazoki commented:

      Tissue-specific online eQTL databases

      Online eQTL databases provide exciting opportunities for the researchers in the field of genomics. Tissue-specific eQTL databases are especially important to provide information about functional mechanisms related to diseases that have tissue specific characteristics. Examples are heart-specific eQTL databases presented in the GTEx online eQTL database (GTEx Consortium., 2013) or the human heart eQTL database from a study by Koopman and co-workers (Koopmann TT, 2014). For researchers in the field of cardiovascular genetics, such databases provide exciting candidate genes for further follow-up in human disease populations to predict disease or further investigation in experimental studies to identify novel mechanisms. Such databases also provide an opportunity for comparison across eQTL studies to highlight the most promising eQTLs with consistent effects in tissue-specific manner. In the example above, comparison of the eQTLs identified in the human heart, left ventricle tissue from the GTEx eQTL database and the human heart eQTLs identified in the study by Koopman and co-workers reveals that 18 SNP-gene pairs have been reported in both eQTL studies by passing stringent statistical significance thresholds. These pairs include (rs1006771 -DDTL), (rs1030421 -ADHFE1), (rs11603384 -TRPT1), (rs11880207 -ZNF266), (rs12609437 -MARCH2), (rs1319763 -NT5C3L), (rs17518363 -SUSD4), (rs2054365 -QRSL1), (rs241443 -TAP2), (rs371671 -MRI1), (rs3814231 -CASP7), (rs4970777 -GSTM3), (rs4985407 -EXOSC6), (rs6488713 -C12orf60), (rs651601 -RPS16), (rs8066107 -RPH3AL), (rs863214 -DHFR), and (rs8850 -MRPS10). However, only the effect of rs241443 on the expression level of TAP2 gene shows the same direction in both studies. The magnitude of the effect of rs241443 on TAP2 is greater in the GTEx database (Beta= -0.64, P value= 1.1 ×10<sup>-9</sup> ) than in the study of Koopman and co-workers (Beta=-0.34, P value= 4.11 ×10<sup>-9</sup> ). Obviously, more research work is necessary to identify more tissue-specific eQTLs and consequently consistent and promising functional loci.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2013 Jun 24, Dita Gratzinger commented:

      Very helpful review of an entity that is poorly described in the spleen, and may easily be mistaken for a low grade lymphoma such as CLL/SLL or marginal zone lymphoma if the peripheral blood smear and/or clinical history are not readily available.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2016 May 10, Ramune Jacobsen commented:

      On behalf of: Jacobsen R, Abrahamsen B, Bauerek M, Holst C, Jensen CB, Knop J, Raymond K, Rasmussen LB, Stougaard M, Sørensen TI, Vaag AA, Heitmann BL and the D-tect group (The Research Unit for Dietary Studies at the Parker Institute and the Institute of Preventive Medicine, Frederiksberg and Bispebjerg Hospital, The Capital Region, Denmark). In the published paper we describe the design of a Danish societal experiment, the “D-tect study”. Among others, the D-tect study takes advantage of the mandatory vitamin D fortification policy implemented in Denmark, in which we used onset and termination of the vitamin D fortification of margarine to examine the possible effect of food fortification on the risk of adverse health outcomes among individuals from birth through adulthood (Jacobsen R, 2013). Based on official documentation from the Nordic Council of Ministers (1), the commencement of vitamin D fortification was 1961. However, we have recently uncovered new evidence that makes this onset date less secure, and suggests that mandatory fortification may have started even before World War II, for both vitamin A and D (2-4). While this new research weakens our confidence in the onset date of the vitamin D margarine fortification, all data sources we have come across confirms that the date of termination of the mandatory margarine fortification with 50 IU D-vitamin per 100 g margarine was June 1985 (5). Furthermore, the new evidence suggests a change in fortification policies related to mandatory vitamin A fortification around 1961 (an additional 25% vitamin A was added to margarine raising amounts from 20 iu to 25 iu per g margarine) (6). It is feasible that the addition of vitamin A may have programming effects related to both neurodevelopment, immune function and growth (Zhang X, 2009,van de Pavert SA, 2014,Wang YZ, 2009) like those from vitamin D, and that effects seen around initiation, for instance as those we saw in relation to birth weight (Jensen CB, 2015, Jensen CB, 2014), may potentially be explained by the extra vitamin A from fortification (Yassai MB, 1989, Ghebremeskel K, 1994, Tolba AM, 1998). We regret that we had not identified this information prior to study commencement. However, we now have access to analytic epidemiology in order to directly explore links between neonatal vitamin D status and risk of adverse health outcomes, as we have been able to directly measure 25 hydroxyvitamin D concentrations in neonatal dried blood spots over the years of interest. In light of the potential that food supplementation with vitamin D can differentially impact on neonatal and adult health outcomes, we will continue to use the best available evidence to explore this area of research. References: 1.Haraldsdóttir J & Thaarup S: Tilsætning af vitaminer & mineraler til levnedsmidler. Nordisk Ministerråd. 1989; 2.Lov om tilvirkning og forhandling af margarine m.m (Bek. af lov om tilvirkning og forhandling af margarine m.m ). Nr. 229 af 28. juni 1937; 3.Bekendtgørelse angaaende Vitaminvirkning i Margarine. Nr. 247 af 28. juli 1937; 4.Bekendtgørelse om vitaminvirkning i margarine. Nr. 258 af 27. juni 1952; 5.Bekendtgørelse om margarine m.v. Nr. 197 af 20. maj 1985; 6.Bekendtgørelse om vitaminvirkning i margarine. Nr. 344 af 5.december 1961.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2017 Nov 15, David Keller commented:

      Does tunneling through brain parenchyma to implant DBS leads cause subtle verbal impairment?

      In 2013, the following letter to the editor of the NEJM questioned the lack of significant loss of verbal fluency reported in EARLYSTIM, in contrast to that seen in prior trials.[1]

      The investigators in the Controlled Trial of Deep Brain Stimulation in Early Patients with Parkinson's Disease (EARLYSTIM) found that “no significant between-group differences were observed for cognitive assessments” when they compared patients who received subthalamic neurostimulation for Parkinson's disease with those who received medical therapy alone. In a recent review, [2] Okun described a meta-analysis finding that “the most common cognitive side effect of deep-brain stimulation was a decrement in verbal fluency.[3] Impaired verbal fluency is characterized by communication difficulties and by problems in generating word lists.” Okun and colleagues also conducted a study that showed that a “decrease in verbal fluency is an effect of surgical electrode implantation, not an effect of stimulation.”[4]

      Did the EARLYSTIM investigators use a technique of lead placement that avoided impairing verbal fluency, or were the tests they used for assessing cognitive outcomes not sensitive instruments for measuring verbal fluency?

      References 1) Keller DL. Neurostimulation for Parkinson's disease with early motor complications. N Engl J Med. 2013 May 23;368(21):2037-8. doi:10.1056/NEJMc1303485#SA2. PubMed PMID: 23697522. 2) Okun MS. Deep-brain stimulation for Parkinson's disease. N Engl J Med 2012;367:1529-1538 3) Parsons TD, Rogers SA, Braaten AJ, Woods SP, Troster AI. Cognitive sequelae of subthalamic nucleus deep brain stimulation in Parkinson's disease: a meta-analysis. Lancet Neurol 2006;5:578-588 4) Okun MS, Gallo BV, et al. Subthalamic deep brain stimulation with a constant-current device in Parkinson's disease: an open-label randomised controlled trial. Lancet Neurol 2012;11:140-149

      The EARLYSTIM investigators replied as follows:

      Keller raises questions regarding the effect of neurostimulation on verbal fluency shown in all controlled studies. We assume that verbal fluency is also significantly worse in patients in the neurostimulation group than in those in the control group in EARLYSTIM. Therefore, we have added a second protocol, EARLYSTIM-speech, to compare standardized speech recordings at baseline and at 24 months. This study will provide more information not only on the frequency and severity of changes of word fluency but also on the effect of these changes on communication in real life.

      The EARLYSTIM-speech add-on study has not reported results yet, but a recent private communication from Günther Deuschl, M.D.-Ph.D., promised that results will be reported soon.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2013 Oct 28, DAVID SANDERS commented:

      From "Covalent modifications of the ebola virus glycoprotein" Jeffers SA, 2002 "The conservation of a mucin-like region and its variability between isolates indicate that it is likely to play a critical role in the ecology and pathogenesis of the virus, factors which cannot be assessed in the pseudotype system. The probable surface exposure of the charged sugar moieties in this region may make it a dominant target for the humoral immune system. Indeed, protective monoclonal antibodies recognizing epitopes that lie between sequences that are likely to be modified by O-linked glycosylation have been identified. The toleration of the mucin-like domain for variations could allow the virus to readily escape immune recognition through mutations. Indeed, the protective monoclonal antibodies recognizing the Ebola virus Zaire GP O-linked glycosylation region have been shown to be specific for particular isolates Wilson JA, 2000.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Nov 17, Pavel Baranov commented:

      Due to a software error in an earlier version of the browser, the data in Figure 4 are not represented correctly. Apologies.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 May 07, T Eugene Day commented:

      This paper addresses a critical aspect of modeling complex systems in healthcare. Dynamic human decision makers exhibit important complexities within systems, and there are demands on their time and attention that should be included in rigorous models. This is especially true in academic environments where attending physicians are required to oversee and instruct residents and fellows. Crucial systemic outcomes depend on these interactions, as well as medical outcomes.

      The validation of this model could be more informative if the authors had compared the simulated data to real-world data from their modeled ED. This would allow us to examine how well the inclusion of physician-delegate interactions allowed them to mimic the performance of a real-world ED. This would provide stronger evidence that this model can be used to inform practice.

      Ever more lifelike models of human behavior will be required to make useful predictions of systems performance, and this is an important step on that road. The use of pseudo-agents, rather than a strict resource/entity model, allows greater flexibility and autonomy on the part of the simulated human resources.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Dec 10, Kath Wright commented:

      Other search filters are available from the InterTASC Information Specialists' Sub-Group Search Filter Resource at https://sites.google.com/a/york.ac.uk/issg-search-filters-resource/home


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2017 May 30, Doug Berger commented:

      Methodologic problems in this meta-analysis:

      (1) This meta-analysis noted whether blinding was incorporated into the trial but did not (and probably cannot) evaluate if blinding was maintained properly.Trials with subjective endpoints (like major depression) that are also unable to maintain double-blinding throughout the trial should be invalidated. These trials cannot say anything about effectiveness of the drug being tested and an unblinded non-inferiority trial of poor quality comparing placebo to unblinded active drug is the result. An exit-analysis of the proportion of subjects and treaters who correctly guessed the arm they were assigned to is needed.

      (2) Indications with objective as well as subjective endpoints in differing indications and therapeutic areas were included in this analysis which make interpretation impossible. Any indication with subjective endpoints and inadequate blinding should be excluded from a meta-analysis, however the quality of blinding would be difficult to confirm by this meta-analysis that did not specifically require proof with exit-analysis data.

      (3) Clinical drug trials are carried out to confirm if drugs work, the drugs are not yet confirmed to be effective. Comparing placebo to a drug that does not work becomes a [placebo vs drug as placebo] comparison and says little about efficacy of placebo vs approved drug. Most drugs on the market with subjective endpoints (psychiatry) have previously been tested vs blind placebo, however, this meta-analysis did not limit itself only to drugs that went on to approval.

      Conclusion: Placebo may function in a clinical setting as a useful tool for certain patients with certain conditions in assuaging some symptoms: pain, worry, hopelessness, etc, however, this meta-analysis had a number of methodologic problems as noted above that limit the conclusions that can be made on the actual effect of placebo vs drugs that have market approval.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2013 Jun 14, Dita Gratzinger commented:

      This single institution retrospective study provides needed information on the landscape of acute myeloid leukemia in children. Of note are significant numbers of children with favorable outcomes associated with recurrent translocations such as t(8;21)(q22;q22);RUNX1-RUNX1T1, or t(15;17)(q22;q12);PML-RARA, as well as myeloid leukemia associated with Down syndrome. Unfortunately similarly large groups of children have poor to very poor outcomes in the categories of acute myeloid leukemia with myelodysplasia-related changes and therapy-related acute myeloid leukemia. This study both confirms the relevance of categories in the WHO 2008 classification to childhood acute myeloid leukemias, and points to areas of need for improved therapy.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2013 Jun 14, Dita Gratzinger commented:

      The authors present a comprehensive and up to date review of an entity that must not be missed due to potentially severe clinical consequences, but is at present diagnosed using a constellation of individually fairly nonspecific criteria. Of note from the perspective of the surgical pathologist or hematopathologist is the fact that while hemophagocytosis itself is one of the 8 criteria that can be used in combination with at least 4 others to diagnose HLH, it is neither required nor very specific for the diagnosis.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2013 Nov 19, Allison Stelling commented:

      One minor quibble with the authors of this quite thorough review: you keep referring to genetic alterations one can test for in brain tumor patients as "molecular diagnostics". Technically this is correct- genes are, indeed, molecules. (Well, macromolecules.) However, perhaps it may be better to simply refer to sequencing of patient DNA as "genetic diagnostics"- just to avoid confusion between this and true molecular phenotype information. (When I read "molecular analysis", I assume someone has done a crystal structure, FTIR, NMR, and mass spec- usually not the case in tissue research!)

      Your call for interdisciplinary cooperation- which is nicely illustrated in Figure 1- necessitates cross border communication as well as orchestration between communities of experts. More nuanced definitions of diagnostic tests may be helpful for facilitating this conversation.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Jan 15, Satoko Hattori commented:

      "ImageLD" and "ImageEP", image analysis application softwares used in this article, are now freely available from http://www.mouse-phenotype.org/software.html.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2016 Aug 23, Ben Goldacre commented:

      This trial has the wrong trial registry ID associated with it on PubMed: both in the XML on PubMed, and in the originating journal article. The ID given is NCT0066305. We believe the correct ID, which we have found by hand searching, is NCT00663052.

      This comment is being posted as part of the OpenTrials.net project<sup>[1]</sup> , an open database threading together all publicly accessible documents and data on each trial, globally. In the course of creating the database, and matching documents and data sources about trials from different locations, we have identified various anomalies in datasets such as PubMed, and in published papers. Alongside documenting the prevalence of problems, we are also attempting to correct these errors and anomalies wherever possible, by feeding back to the originators. We have corrected this data in the OpenTrials.net database; we hope that this trial’s text and metadata can also be corrected at source, in PubMed and in the accompanying paper.

      Many thanks,

      Jessica Fleminger, Ben Goldacre*

      [1] Goldacre, B., Gray, J., 2016. OpenTrials: towards a collaborative open database of all available information on all clinical trials. Trials 17. doi:10.1186/s13063-016-1290-8 PMID: 27056367

      * Dr Ben Goldacre BA MA MSc MBBS MRCPsych<br> Senior Clinical Research Fellow<br> ben.goldacre@phc.ox.ac.uk<br> www.ebmDataLab.net<br> Centre for Evidence Based Medicine<br> Department of Primary Care Health Sciences<br> University of Oxford<br> Radcliffe Observatory Quarter<br> Woodstock Road<br> Oxford OX2 6GG


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Mar 01, Ellen M Goudsmit commented:

      Dr. Melvin Ramsay began writing about the illness now known as ME after the outbreak in north London in 1955. I looked in his book (1988) for a paper written by him in 1959 and found none. The best known article from 1959 was written by the late Dr. Acheson, who gave ME its name in a leader in the Lancet (1956). Dr Ramsay offered a diagnostic protocol but not until the 1980s. I agree with Morris and Maes that the core symptom of ME is an exacerbation of symptoms following minimal exertion (supported by Paul et al who referred to CFS but actually selected patients with ME, pers. comm.). It should also be noted that none of the existing criteria for ME and CFS have been found to have the required specificity and sensitivity. And that includes the 2011 version.

      The abstract indicates a lack of attention to detail. This undermines the understanding of the issues and shows a lack of respect, not only for the researchers but also for the patients, 99% of whom would know how to spell the name of arguably one of the most knowledgeable experts in this field. This failure to check for accuracy is a major cause for confusion in the literature on ME and CFS. And what happened to peer review? Any peer would have noticed the problem with the first sentence.

      People really interested in ME and CFS may like to purchase an excellent publication by Shepherd and Chaudhuri summarising the knowledge to date. It's available from the ME Association in the UK. An authoritative and accurate review (2013).

      Leading article. A new clinical entity? Lancet, 1956, 1, 789-790.

      Paul, L et al. Demonstration of delayed recovery from fatiguing exercise in chronic fatigue syndrome. European Journal of Neurology, 1999, 6, 63-69.

      Ramsay, AM. Myalgic encephalomyelitis and postviral fatigue states. Second Ed. Gower Medical Publ. 1988. now available from the MEA Association, UK.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2013 Jul 16, Matthew Child commented:

      A fascinating story, complemented by elegant proof-of-principal experiments presented by Regev-Rudzki, N (PMID:23683579). Like rats from a sinking ship, the parasite seeks to escape the hostile environment induced by the drug. It neatly addresses phenomenological observations noted during P. falciparum culture and transfection; the process of electroporation and subsequent drug selection for a transgenic population can often result in the production of large numbers of gametocytes.

      One question and point of epidemiological relevance that arises in light of these data is as follows; is the rate of parasite transmission greater in areas where drug-treatment regimes are instigated? Could it be that we have in fact been inadvertently increasing the likelihood of parasite transmission through drug treatment programs that induce gametocytogensis of the parasite population in an infected individual? The data may already be available to answer this, and I’d be fascinated to hear if anyone out there knows of any published studies that have sought to address this point.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    2. On 2013 Jun 25, Dave Richard commented:

      In this paper, Mantel et al provide an in-depth characterization of P. falciparum infected red blood cell derived microvesicles (RMVs) and provide evidence for their role in stimulating the human immune system and interestingly, as a means of cell-to-cell communication leading to increase parasite gametocytogenesis, a phenomenon also described in a recent paper published in Cell by Regev-Rudzki and Wilson et al.

      Intriguingly, the authors demonstrate that RMVs are exempt of knob components such as KAHRP and PfEMP1. The latter's role in modulating host responses is well documented so it will be of great interest to identify what components of the RMVs interact with the host immune system. Moreover, to gain insight into the mechanisms behind RMV secretion, it would be interesting to look whether RMVs produced by knobless parasite strains like D10, where PfEMP1 is distributed more uniformly on the erythrocyte surface, would still be devoid of PfEMP1.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2013 Jun 18, Dan Arking commented:

      This paper presents data that 88% (range 77% to 94%) of eQTLs are shared across tissues, which is marked contrast to the original analysis of this data (69% to 80% were called cell specific!). A nice feature of this approach is the incorporation of a hierarchical model which does not assume that all tissues contribute equally to an eQTL.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2013 Oct 29, Maurice Elphick commented:

      This is a really important contribution to our understanding of the evolution of neuropeptide and peptide hormone signalling systems. It provides the most comprehensive framework to date for comparative analysis of the physiological and behavioural roles of peptide signalling systems in different animal phyla. I strongly recommend it to anyone who has an interest in any aspect of neuropeptide/peptide hormone biology.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2016 Dec 29, Francisco Xavier Castellanos commented:

      Mazza et al. report rates of sudden death or strokes per 100,000 person-years as percents. These must be errors. Please clarify.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Feb 16, Lorene M Nelson commented:

      This article provides a nice overview of the rationale for proposing a high-fat or ketogenic diet in ALS. A correction is needed, however, in one the authors' statements. ". . . a US case-control retrospective study reported a nonsignificant trend toward increased risk of amyotrophic lateral sclerosis in subjects who reported a diet high in fat calories, however this study was not adjusted for tobacco use [22]." As the author of that study, I would like to point out that the study results were adjusted for pack-years of smoking (see Methods section and Table 3 in Nelson LM, Matkin C, Longstreth WT Jr, McGuire V. Population-based case-control study of amyotrophic lateral sclerosis in western Washington State. II. Diet. Am J Epidemiol. 2000;151(2):164-173.)


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2015 Jul 12, Egon Willighagen commented:

      Dear authors, I just searched for your ontology on BioPortal (we do not seem to have a Chemistry equivalent), but could not find your ontology. Have you considered making it available via BioPortal?


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2013 Dec 19, Raphael Stricker commented:

      Our Letter to the Editor of Lancet Infectious Diseases (2014;14:12) expressed concern about the safety of the new Lyme OspA vaccine from Baxter Bioscience. This concern is based on safety issues related to the previous Lyme OspA vaccine, Lymerix®, which was taken off the market after these safety issues surfaced, as outlined in our letter.

      In their response to our letter, the employees of Baxter Bioscience who studied the new vaccine made the following comment: “There are no data in Stricker and Johnson’s cited publications that support the statement that ‘joint-reactive and nerve-reactive antibodies’ are induced in human beings vaccinated with OspA antigen.” This comment is misleading because OspA vaccine-related antibodies against nerve and joint tissue have been detected in animals and humans described in the references below. Furthermore, the fact that antibodies with unknown reactivity were induced by Lymerix® vaccination presents an unresolved safety issue for the new OspA vaccine, and this issue was not addressed by the Baxter Bioscience employees who studied the vaccine.

      Once again, the willingness of Baxter Bioscience to ignore legitimate safety concerns bodes ill for the new Lyme vaccine.

      Raphael B. Stricker, MD, Lorraine Johnson, JD, MBA

      References

      1. Stricker RB. Lymerix® risks revisited. Microbe 2008;3:1-2.

      2. Smith P, Gaito A, Marks DH. Transcript of FDA Lymerix Meeting, Bethesda, MD, January 22, 2002. Available at: http://www.lymediseaseassociation.org/index.php?option=com_content&view=article&id=532:lymerix-meeting&catid=129:hhsfood-a-drug-administration-fda&Itemid=531

      3. Croke CL, Munson EL, Lovrich SD, et al. Occurrence of severe destructive Lyme arthritis in hamsters vaccinated with outer surface protein A and challenged with Borrelia burgdorferi. Infect Immun. 2000;68:658–63.

      4. Rose CD, Fawcett PT, Gibney KM. Arthritis following recombinant outer surface protein A vaccination for Lyme disease. J Rheumatol. 2001;28:2555–7.

      5. Latov N, Wu AT, Chin RL, Sander HW, Alaedini A, Brannagan TH. Neuropathy and cognitive impairment following vaccination with the OspA protein of Borrelia burgdorferi. Periph Nerv Syst. 2004;9:165–7.

      6. Alaedini A, Latov N. Antibodies against OspA epitopes of Borrelia burgdorferi cross-react with neural tissue. J Neuroimmunol. 2005;159:192–5.

      7. Souayah N, Ajroud-Driss S, Sander HW, Brannagan TH, Hays AP, Chin RL. Small fiber neuropathy following vaccination for rabies, varicella or Lyme disease. Vaccine 2009;27:7322-5.

      8. Marks DH. Neurological complications of vaccination with outer surface protein A (OspA). Int J Risk Saf Med. 2011;23:89-96.

      9. Molloy PJ, Berardi VP, Persing DH, Sigal LH. Detection of multiple reactive protein species by immunoblotting after recombinant outer surface protein A Lyme disease vaccination. Clin Infect Dis. 2000;31:42-7.

      10. Fawcett PT, Rose CD, Budd SM, Gibney KM. Effect of immunization with recombinant OspA on serologic tests for Lyme borreliosis. Clin Diagn Lab Immunol. 2001;8:79-84.

      11. Hanson MS, Edelman R. Progress and controversy surrounding vaccines against Lyme disease. Expert Rev Vaccines 2003;2:683–703.

      12. Nigrovic LE, Thompson KM. The Lyme vaccine: a cautionary tale. Epidemiol Infect. 2007;135:1–8.

      13. Nardelli DT, Munson EL, Callister SM, Schell RF. Human Lyme disease vaccines: past and future concerns. Future Microbiol. 2009;4:457-69.

      14. Smith P. Remarks to Vaccines and Related Biological Products Advisory Committee, Bethesda, MD, January 31, 2001. Available at: http://www.lymediseaseassociation.org/index.php?option=com_content&view=article&id=262:vaccine-remarks&catid=80:controversy&Itemid=76

      Disclosure: RBS and LJ are members of the International Lyme and Associated Diseases Society (ILADS) and directors of LymeDisease.org. They have no financial or other conflicts to declare.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Jan 31, George W Hinkal commented:

      The National Cancer Institute has been investing in the development of an online webportal of curated cancer nanotechnology data called caNanoLab. The numerical data and additional nanomaterial characterizations related to this publication have been added to the database and can be found at:

      https://cananolab.nci.nih.gov/caNanoLab/characterization.do?dispatch=summaryView&sampleId=39124992&page=0&tab=ALL

      https://cananolab.nci.nih.gov/caNanoLab/characterization.do?dispatch=summaryView&sampleId=39124993&page=0&tab=ALL

      https://cananolab.nci.nih.gov/caNanoLab/characterization.do?dispatch=summaryView&sampleId=39124994&page=0&tab=ALL

      https://cananolab.nci.nih.gov/caNanoLab/characterization.do?dispatch=summaryView&sampleId=39124995&page=0&tab=ALL

      https://cananolab.nci.nih.gov/caNanoLab/characterization.do?dispatch=summaryView&sampleId=39124996&page=0&tab=ALL

      https://cananolab.nci.nih.gov/caNanoLab/characterization.do?dispatch=summaryView&sampleId=39124997&page=0&tab=ALL

      https://cananolab.nci.nih.gov/caNanoLab/characterization.do?dispatch=summaryView&sampleId=39124998&page=0&tab=ALL

      https://cananolab.nci.nih.gov/caNanoLab/characterization.do?dispatch=summaryView&sampleId=39124999&page=0&tab=ALL

      The left navigation links on these pages provide information about each sample (under Navigation Tree).

      For general information on how to use caNanoLab, please visit https://cananolab.nci.nih.gov/caNanoLab/home.jsp


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Jan 08, Brett Snodgrass commented:

      Dear Authors,

      Thank you for the excellent article. Please provide your kind attention to the distinction between the Thebesian veins and the vessels of Wearn. http://bit.ly/JTWearn

      http://bit.ly/vasaThebesii

      http://www.ncbi.nlm.nih.gov/pubmed/22704295

      The vessels you describe are probably better described as vessels of Wearn as they are (1) not Thebesian veins*, (2) not studied by Thebesius, and (3) they were described by Wearn et al.

      For additional commentary, please see the following link:

      https://twitter.com/BrettSnodgrass1/status/417433946196942848

      Comments and suggestions are welcome.

      Thank you very much.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2016 Aug 30, Ben Goldacre commented:

      This trial has the wrong trial registry ID associated with it on PubMed: both in the XML on PubMed, and in the originating journal article. The ID given is NCT0053089. We believe the correct ID is NCT00530894.

      This comment is being posted as part of the OpenTrials.net project<sup>[1]</sup> , an open database threading together all publicly accessible documents and data on each trial, globally. In the course of creating the database, and matching documents and data sources about trials from different locations, we have identified various anomalies in datasets such as PubMed, and in published papers. Alongside documenting the prevalence of problems, we are also attempting to correct these errors and anomalies wherever possible, by feeding back to the originators. We have corrected this data in the OpenTrials.net database; we hope that this trial’s text and metadata can also be corrected at source, in PubMed and in the accompanying paper.

      Many thanks,

      Jessica Fleminger, Ben Goldacre*

      [1] Goldacre, B., Gray, J., 2016. OpenTrials: towards a collaborative open database of all available information on all clinical trials. Trials 17. doi:10.1186/s13063-016-1290-8 PMID: 27056367

      * Dr Ben Goldacre BA MA MSc MBBS MRCPsych<br> Senior Clinical Research Fellow<br> ben.goldacre@phc.ox.ac.uk<br> www.ebmDataLab.net<br> Centre for Evidence Based Medicine<br> Department of Primary Care Health Sciences<br> University of Oxford<br> Radcliffe Observatory Quarter<br> Woodstock Road<br> Oxford OX2 6GG


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2015 Aug 23, David Keller commented:

      Information theory contradicts Guideline Statement 4: more frequent PSA testing should benefit patients, not harm them

      Information theory describes the reconstruction of continuous signals from discrete samples, and the extraction of signals from noise. Screening for prostate cancer involves scrutiny of a man's serial PSA measurements, with the goal of determining the likelihood that his prostate has developed a malignancy which could affect his longevity or quality of life (ie: his mortality or morbidity). Statement 4 from the 2013 Early Detection of Prostate Cancer: AUA Guideline [1] is as follows:

      "Guideline Statement 4: To reduce the harms of screening, a routine screening interval of two years or more may be preferred over annual screening in those men who have participated in shared decision-making and decided on screening. As compared to annual screening, it is expected that screening intervals of two years preserve the majority of the benefits and reduce over diagnosis and false positives. (Option; Evidence Strength Grade C)"

      Guideline Statement 4 can be proved false using the principles of information theory as follows. Individual PSA blood test results constitute discrete samples of the continuous signal which would result from continuous monitoring of the patient's PSA. The Nyquist-Shannon Sampling theorem states that the minimum sampling rate for perfect reconstruction of a signal is equal to twice the bandwidth of the signal [1]. Expressed another way, the maximum bandwidth of a signal to be perfectly reconstructed from samples taken at a sampling frequency f is f/2.

      The crucial signal we wish to detect is a rising PSA consistent with a dangerous prostate cancer. Empirically, the faster a prostate cancer grows, the more rapid the rise in PSA and therefore the higher the bandwidth of the PSA signal. We would like to detect PSA signals which rise rapidly (have high bandwidth) in order to treat the patient while his cancer is confined to his prostate. The more frequently we sample the PSA, the higher the bandwidth of the PSA signal we can detect, meaning the more rapid rises in PSA will not escape detection. So, increasing the PSA sampling rate from once every 2 years to once every year can only improve the detection of the high-bandwidth signal caused by a rapidly growing prostate cancer. In fact, increasing the PSA sampling rate to twice per year, 4 times per year or even higher will only increase the maximum detectable bandwidth of the PSA signal.

      Harms associated with PSA screening are generally associated with the prostate biopsy procedure and downstream diagnostic and therapeutic intervetions. The purpose of PSA sampling is to inform us when a prostate biopsy is likely to be more beneficial than harmful. The cumulative harm of multiple biopsies is proportional to the number of biopsies done, so we want to minimize the number of biopsies without missing a dangerous cancer. However, if the PSA signal includes useful information about the presence of cancer, the best way to reduce the number of biopsies is to improve the quality (bandwidth) of the detected PSA signal, which requires increasing the PSA sampling rate.

      Reducing the PSA sampling rate in an attempt to reduce the harms caused by prostate biopsy is akin to hiding one's head in the sand. Continuous monitoring of the PSA signal would be ideal, but the maximum practical PSA sampling frequency should be employed to maximize the quality of the reconstructed PSA signal, and thereby increase the likelihood of detecting a fast-growing tumor while it is confined to the prostate. Application of a low-pass filter to the PSA signal should reduce the number of biopsies triggered by noise.

      Lastly, the prostate biopsy rate need not be correlated with the PSA sampling rate, and indeed should be inversely correlated with it if the PSA signal has useful information about the presence of dangerous cancer in the prostate.

      Reference

      1: Shannon CE, Communication in the presence of noise, Proc. Institute of Radio Engineers, vol. 37, no. 1, pp. 10–21, Jan. 1949


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2013 Jun 28, Julia Gilden commented:

      Interesting paper. I would have enjoyed a greater focus on the functional differences between LPS-dependent and Leishmania-dependent exosomes. To me, the most interesting question is whether Leishmania might be have evolved a mechanism for highjacking exosomes for the delivery of GP63. I wish the authors had commented on the quantity of GP63 observed and whether it was enough to potentially effect neighboring cells. I'm also curious as to whether the LPS-dependent exosome preps contain any LPS, since if so, that might contribute to the strongly immunostimulatory effect of those exosomes compared to the other groups.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2016 Nov 22, MICHAEL BALLARD commented:

      This manuscript has been republished as Li, W., et al. (2014). “Elevation of brain magnesium prevents synaptic loss and reverses cognitive deficits in Alzheimer's disease mouse model.” Mol Brain 7(1): 65. See PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172865/ and journal site: https://molecularbrain.biomedcentral.com/articles/10.1186/s13041-014-0065-y

      Figures 4 and 5D from the original article have been removed from the republished version.

      According to the authors' retraction notice: “This article described the effects of elevating brain magnesium on preventing and reversing cognitive deficits in an Alzheimer's disease mouse model. During recent efforts to extend this work, we discovered errors in the quantification of the expression and/or phosphorylation of a subset of signaling pathways, particularly related to Figures 4 and 5D. Despite these errors, the major conclusions of the paper remain substantiated."


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    2. On 2014 Apr 20, Sergio Stagnaro commented:

      None


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    3. On 2014 Apr 18, Ivan Oransky commented:

      This paper has been retracted: http://retractionwatch.com/2014/04/18/authors-retract-study-suggesting-magnesium-prevents-alzheimers-in-mice/


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2013 Oct 28, Egon Willighagen commented:

      The data presented in this paper can be downloaded as CC-BY-SA from the Dutch Dataverse Network with this handle http://hdl.handle.net/10411/10279.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2013 Dec 06, John Cannell commented:

      I congratulate the authors on their intresting paper. I found my self wondering however, how can they explain the dramatic increase in incidence in this centruy? Didn't Tylenol use remain fairly constant from the year 2000 to the present time?

      The question is why do some children exposed to Tylenol may develop autism and some do not? The answer must lie in their immune system. Some mothers and fetuses have enough antioxidant reserve to protect themselves from the oxidative damage induced by paracetamol exposure and some do not.

      Certainly, a controlling factor in such reserve is the amount of the key antioxidants superoxide dismutase and thioredoxin reductase expressed by the mother or fetus. It has been known for some time that both of these antioxidants have been shown to be upregulated rather dramatically by the neurosteroid calcitriol or activated vitamin D. Although it is not clear from the papers below, it is probable that a vitamin D response element is involved in directly or indirectly controlling the genetic expression of both antioxidants.

      Peehl DM, Shinghal R, Nonn L, Seto E, Krishnan AV, Brooks JD, Feldman D. Molecular activity of 1,25-dihydroxyvitamin D3 in primary cultures of human prostatic epithelial cells revealed by cDNA microarray analysis. J. Steroid Biochem Mol. Biol. 2004;92:131–141.

      Swami S, Raghavachari N, Muller UR, Bao YP, Feldman D. Vitamin D growth inhibition of breast cancer cells: gene expression patterns assessed by cDNA microarray. Breast Cancer Res Treat. 2003;80:49–62.

      Palmer HG, Sanchez-Carbayo M, Ordonez-Moran P, Larriba MJ, Cordon-Cardo C, Munoz A. Genetic signatures of differentiation induced by 1α,25-dihydroxyvitamin D3 in human colon cancer cells. Cancer Res. 2003;63:7799–7806.

      I propose that much of the autism epidemic is caused by the meeting of a dysfunctional antioxidant reserve with paracetamol. That is, gestational or early childhood vitamin D deficiency causes down-regulation of key antioxidants, which leave the fetus vulnerable to the oxidative damage induced by paracetamol. Thus a combination of vitamin D deficiency and paracetamol exposure is both a necessary and sufficient condition to trigger an unkown percentage of autism and explains the rapid rise in the prevalence of the disorder, at least in the 1980s and 90s.

      As far as vitamin D deficiency is concerned, three recent studies, using community controls, have found 25(OH)D levels are significantly lower in children with autism. Two of the studies below (Mostafa et al and Gong et al) also found autism severity, as rated on standard autism rating scales, is inversely correlated with 25(OH)D levels. Mostafa et al found an R value of -.86 for the association of serum 25(OH)D with autism severity.

      Gong ZL, Luo CM, Wang L, Shen L, Wei F, Tong RJ, Liu Y. Serum 25-hydroxyvitamin D levels in Chinese children with autism spectrum disorders. Neuroreport. 2013 Oct 1.

      Meguid NA, Hashish AF, Anwar M, Sidhom G. Reduced serum levels of 25-hydroxy and 1,25-dihydroxy vitamin D in Egyptian children with autism. J Altern Complement Med. 2010 Jun;16(6):641-5.

      Mostafa GA, Al-Ayadhi LY.Reduced serum concentrations of 25-hydroxy vitamin D in children with autism: relation to autoimmunity. J Neuroinflammation. 2012 Aug 17;9:201.

      There is a plethora of basic science explaining why low gestational or early childhood 25(OH)D levels would adversely affect brain development.

      Eyles DW, Feron F, Cui X, Kesby JP, Harms LH, Ko P, McGrath JJ, Burne TH. Developmental vitamin D deficiency causes abnormal brain development. Psychoneuroendocrinology. 2009 Dec;34 Suppl 1:S247-57.

      DeLuca GC, Kimball SM, Kolasinski J, Ramagopalan SV, Ebers GC. Review: the role of vitamin D in nervous system health and disease. Neuropathol Appl Neurobiol. 2013 Aug;39(5):458-84.

      Eyles DW, Burne TH, McGrath JJ. Vitamin D, effects on brain development, adult brain function and the links between low levels of vitamin D and neuropsychiatric disease. Front Neuroendocrinol. 2013 Jan;34(1):47-64.

      Furthermore, the vitamin D theory of autism explains many of the epidemiological facts of autism.

      Cannell JJ. On the aetiology of autism. Acta Paediatr. 2010 Aug; 99(8):1128-30.

      Cannell JJ. Autism and vitamin D. Med Hypotheses. 2008;70(4):750-9.

      It is likely that much of the autism epidemic is caused by the perfect storm of paracetamol meeting a vitamin D deficient immune system.

      John Cannell, MD

      Vitamin D Council

      http://www.vitamindcouncil.org/


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Apr 04, GREGORY CROWTHER commented:

      I understand and agree with the central point of this article, i.e., that biology textbooks should emphasize scientific thinking and scientific investigation, but often don't. What is the solution to this problem? Duncan et al. imply that the textbook authors should simply prepare their books differently: "Textbook authors might better serve students by focusing more on how the information in their chapters was discovered, rather than devoting most illustrations to describing biology by representing what is known." This reasonable-sounding advice sidesteps the fact that authors do not have sole control of their books; the publishers exert much influence based on market considerations, and professional illustrators (who are actually responsible for preparing the figures) have input as well. Thus, making textbooks more research-based is not as simple as telling the textbook authors to "Make it so." An author of one of the texts reviewed by this article told me that he made his book "as data-intensive as reviewers would stand." In other words, he himself was not the bottleneck in getting more research data into the book. One hopes that publishers and editorial teams are now starting to expect more of a research flavor in their texts.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Feb 23, Vinay Gopalani commented:

      @ conclusion: Human mesenchymal stem cells have a potential to adhere to plastic surface. I think its incorrectly mentioned as Human dermal fibroblasts.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2017 Jan 24, Tom Weishaar commented:

      This article was apparently published twice by mistake. For the non-retracted version, see https://www.ncbi.nlm.nih.gov/pubmed/23507683


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2013 Oct 24, Tom Kindlon commented:

      In 2011, I was accused by Professors Lloyd & van der Meer of an unscientific and personal attack in a published letter of mine.<sup>1,2</sup> The accusation was made without any explanation, and they never replied when I e-mailed them about this issue. I believe the accusation was clearly false on both counts. Now I find that Prof. Lloyd (while apologising to Stouten et al. for having wrongly claimed that their letter was an unscientific and personal attack, no less) has re-iterated the claim that this was an apt characterization for my letter, as well as letters written by others.<sup>3</sup> I would like to take this opportunity to correct the record.

      In the letter in question, I challenged the PACE Trial authors’ claims about the safety of cognitive behaviour therapy (CBT) and graded exercise therapy (GET) for chronic fatigue syndrome (CFS), distilling my points into 250 words, the maximum allowed by the journal.<sup>2</sup> At no point do I attack individuals. As is common in letters to the editor, I challenge points made in the original paper—it has been recognised that such correspondence can be an important part of the scientific process. I subsequently expanded on the points about that particular trial, and the reporting of harms for these interventions in general, in a peer-reviewed paper.<sup>4</sup> I have had several letters published, before and since, on the subject of CBT and GET interventions in reply to different research groups in a variety of journals.<sup>5</sup>

      Incidentally, I do not believe the description is suitable or appropriate for the other letters that the Lancet published either.

      References:

      1 van der Meer JW, Lloyd AR. A controversial consensus--comment on article by Broderick et al. J Intern Med. 2012;271:29-31. Epub 2011 Nov 11.

      2 Kindlon T. The PACE trial in chronic fatigue syndrome. Lancet 2011;377:1833; author reply 4–5.

      3 Lloyd AR. Apology. J Intern Med. 2013;273:628.

      4 Kindlon T. Reporting of Harms Associated with Graded Exercise Therapy and Cognitive Behavioural Therapy in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Bulletin of the IACFS/ME. 2011;19:59-111.

      5 https://www.researchgate.net/profile/Tom_Kindlon2/publications/


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2013 Oct 31, John Cannell commented:

      The authors reported that immune system dysregulation is common in autism spectrum disorder (ASD”. Vitamin D deficiency produces very similar immune dysregulation.

      Prietl B, 2013

      Kamen DL, 2010

      Yang CY, 2013

      Baeke F, 2010

      Thus the vitamin D theory of ASD (vitamin D deficiency being the environmental risk factor for this highly heritable disorder) is consistent with the authors work. Three recent studies, using community controls, have found 25(OH)D levels are significantly lower in children with ASD. Two of the studies below (Mostafa et al and Gong et al) also found ASD severity, as rated on standard ASD rating scales, is inversely correlated with 25(OH)D levels. Mostafa et al found an R value of -.86 for the association of serum 25(OH)D with ASD severity.

      Gong ZL, Luo CM, Wang L, Shen L, Wei F, Tong RJ, Liu Y. Serum 25-hydroxyvitamin D levels in Chinese children with autism spectrum disorders. Neuroreport. 2013 Oct 1. Gong ZL, 2014

      Meguid NA, Hashish AF, Anwar M, Sidhom G. Reduced serum levels of 25-hydroxy and 1,25-dihydroxy vitamin D in Egyptian children with autism. J Altern Complement Med. 2010 Jun;16(6):641-5. Meguid NA, 2010

      Mostafa GA, Al-Ayadhi LY.Reduced serum concentrations of 25-hydroxy vitamin D in children with autism: relation to autoimmunity. J Neuroinflammation. 2012 Aug 17;9:201. Mostafa GA, 2012

      There is a plethora of basic science explaining why low gestational or early childhood 25(OH)D levels would adversely effect brain development.

      Eyles DW, Feron F, Cui X, Kesby JP, Harms LH, Ko P, McGrath JJ, Burne TH. Developmental vitamin D deficiency causes abnormal brain development. Psychoneuroendocrinology. 2009 Dec;34 Suppl 1:S247-57. doi: 10.1016/j.psyneuen.2009.04.015. Epub . Review. Eyles DW, 2009

      DeLuca GC, Kimball SM, Kolasinski J, Ramagopalan SV, Ebers GC. Review: the role of vitamin D in nervous system health and disease. Neuropathol Appl Neurobiol. 2013 Aug;39(5):458-84. doi: 10.1111/nan.12020. DeLuca GC, 2013

      Eyles DW, Burne TH, McGrath JJ. Vitamin D, effects on brain development, adult brain function and the links between low levels of vitamin D and neuropsychiatric disease. Front Neuroendocrinol. 2013 Jan;34(1):47-64. doi: 10.1016/j.yfrne.2012.07.001. Epub 2012 Jul 11. Review. Eyles DW, 2013

      Furthermore, the vitamin D theory of autism explains most of the epidemiological facts of ASD.

      Cannell JJ. On the aetiology of autism. Acta Paediatr. 2010 Aug;99(8):1128-30. Cannell JJ, 2010

      Cannell JJ. Autism and vitamin D. Med Hypotheses. 2008;70(4):750-9. Cannell JJ, 2008

      70% of American toddlers do not take the American Pediatric Association's recommended vitamin D supplement of 400 IU/day and few toddlers or pregnant women get any sunshine due to the sun scare. As vitamin D fortified milk consumption and sun exposure has declined, so have toddlers and pregnant women’s vitamin D levels. The dramatic increase in the incidence of ASD occurred during the same time vitamin D levels were falling in toddlers and pregnant women.

      Cannell JJ. Autism, will vitamin D treat core symptoms? Medical Hypotheses. 2013 Aug;81(2):195-8. Cannell JJ, 2013

      Some autism researchers seem cognizant of the entire body of autism research. For example, a group of well-known European ASD researchers, including Professor Christopher Gillberg of the Gillberg Neuropsychiatric Institute, have recently called for the need for “urgent research” into the vitamin D deficiency theory of ASD.

      Kočovská E, Fernell E, Billstedt E, Minnis H, Gillberg C. Vitamin D and autism: clinical review. Res Dev Disabil. 2012 Sep-Oct;33(5):1541-50. doi: 10.1016/j.ridd.2012.02.015. Epub 2012 Apr 21.Kočovská E, 2012

      Until all autism researchers become cognizant of the wider body of scientific research, we will continue to wonder how to prevent - and perhaps even treat - this modern day plague.

      John J Cannell, MD

      Vitamin D Council

      http://www.vitamindcouncil.org


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Jun 20, Alexander (Lex) Nederbragt commented:

      I was a reviewer of this paper. My review reports can be found on publons: https://publons.com/review/3891/


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2016 Sep 26, Lydia Maniatis commented:

      Pelli and Bex (2013) make the following assertion:

      "Neurally, Campbell and Robson (1968) revealed the presence of multiple channels in vision, each selective to a different band of spatial frequencies. This greatly increased interest in measuring the CSF. Today, the set of thresholds as a function of spatial frequency is usually fit with a contrast sensitivity function (Watson, 2000)."

      The claim regarding Campbell and Robson (1968) is false.

      It has been made previously by Pelli and coauthors, (and others), e.g. by Solomon and Pelli (1994). In a comment on that article (https://pubpeer.com/publications/6EA25EFC758D6B5C990CFDFD5899BD) I quote Robson and Campbell (1968), as follows:

      "Thus, it seems that we cannot satisfactorily model the over-all visual system by a simple peak detector following a spatial filter...As a modification of this theory, we may assume...Thus, we may suppose that the visual system behaves not as a single detector mechanism preceded by a single broadband spatial filter but as a number of independent detector mechanisms each preceded by a relatively narrowband filter 'tuned' to a different frequency...Such a model could account for our findings...

      In other words, Robson and Cambell's (1968) results did not bear out their original predictions, and they discuss purely speculative alternatives to account for their data. Between 1968 and 2013, no firmer references apparently became available.

      Nevertheless, as is evident from the second part of Pelli and Bex (2013) statement, measurements based on Robson and Campbell's (1968) uncorroborated assumptions have become very popular. These measurements involve "fitting" a "constrast sensitivity function." As Pelli and Bex (2013) note, this fitting involves a minimum of four free parameters. What does this mean?

      According to Wikipedia, a free parameter "is a variable in a mathematical model which cannot be predicted precisely or constrained by the model..." The mathematician and physicist Jon von Neumann is quoted as saying that "With four parameters I can fit an elephant, and with five I can make him wiggle his trunk." Investigators at the Max Planck institute have, in fact, fit an elephant with four free parameters (https://publications.mpi-cbg.de/Mayer_2010_4314.pdf).

      What four free parameters means, in short, is that the model doesn't have to predict anything. The model assumptions (e.g., "the presence of multiple channels in vision, each selective to a different band of spatial frequencies") can be false, but still be fit to the (qualitatively generic) shape of the data.

      The authors are advocating a method to be used to generate a certain score for individuals. But given the situation described above, we really can't say what that score means, in any theoretical sense.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2016 Aug 24, Ben Goldacre commented:

      This trial has the wrong trial registry ID associated with it on PubMed: both in the XML on PubMed, and in the originating journal article. The ID given is NCT017354435. We believe the correct ID, which we have found by hand searching, is NCT01735435.

      This comment is being posted as part of the OpenTrials.net project<sup>[1]</sup> , an open database threading together all publicly accessible documents and data on each trial, globally. In the course of creating the database, and matching documents and data sources about trials from different locations, we have identified various anomalies in datasets such as PubMed, and in published papers. Alongside documenting the prevalence of problems, we are also attempting to correct these errors and anomalies wherever possible, by feeding back to the originators. We have corrected this data in the OpenTrials.net database; we hope that this trial’s text and metadata can also be corrected at source, in PubMed and in the accompanying paper.

      Many thanks,

      Jessica Fleminger, Ben Goldacre*

      [1] Goldacre, B., Gray, J., 2016. OpenTrials: towards a collaborative open database of all available information on all clinical trials. Trials 17. doi:10.1186/s13063-016-1290-8 PMID: 27056367

      * Dr Ben Goldacre BA MA MSc MBBS MRCPsych<br> Senior Clinical Research Fellow<br> ben.goldacre@phc.ox.ac.uk<br> www.ebmDataLab.net<br> Centre for Evidence Based Medicine<br> Department of Primary Care Health Sciences<br> University of Oxford<br> Radcliffe Observatory Quarter<br> Woodstock Road<br> Oxford OX2 6GG


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2015 Jul 12, Egon Willighagen commented:

      The paper uses the CDK, which you can read about in these two papers:

      Steinbeck, C., Han, Y., Kuhn, S., Horlacher, O., Luttmann, E., Willighagen, E., Mar. 2003. The chemistry development kit (CDK):  an Open-Source java library for chemo- and bioinformatics. J. Chem. Inf. Comput. Sci. 43 (2), 493-500. URL http://dx.doi.org/10.1021/ci025584y

      Steinbeck, C., Hoppe, C., Kuhn, S., Floris, M., Guha, R., Willighagen, E. L., 2006. Recent developments of the chemistry development kit (CDK) - an open-source java library for chemo- and bioinformatics. Current pharmaceutical design 12 (17), 2111-2120. URL http://dx.doi.org/10.2174/138161206777585274


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2016 Aug 23, Ben Goldacre commented:

      This trial has the wrong trial registry ID associated with it on PubMed: both in the XML on PubMed, and in the originating journal article. The ID given is NCT0029779. We believe the correct ID, which we have found by hand searching, is NCT00297791.

      This comment is being posted as part of the OpenTrials.net project<sup>[1]</sup> , an open database threading together all publicly accessible documents and data on each trial, globally. In the course of creating the database, and matching documents and data sources about trials from different locations, we have identified various anomalies in datasets such as PubMed, and in published papers. Alongside documenting the prevalence of problems, we are also attempting to correct these errors and anomalies wherever possible, by feeding back to the originators. We have corrected this data in the OpenTrials.net database; we hope that this trial’s text and metadata can also be corrected at source, in PubMed and in the accompanying paper.

      Many thanks,

      Jessica Fleminger, Ben Goldacre*

      [1] Goldacre, B., Gray, J., 2016. OpenTrials: towards a collaborative open database of all available information on all clinical trials. Trials 17. doi:10.1186/s13063-016-1290-8 PMID: 27056367

      * Dr Ben Goldacre BA MA MSc MBBS MRCPsych<br> Senior Clinical Research Fellow<br> ben.goldacre@phc.ox.ac.uk<br> www.ebmDataLab.net<br> Centre for Evidence Based Medicine<br> Department of Primary Care Health Sciences<br> University of Oxford<br> Radcliffe Observatory Quarter<br> Woodstock Road<br> Oxford OX2 6GG


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2013 Nov 13, Daniel Mietchen commented:

      Fig. 3 and Animation S1 use materials from Google Earth, which are properly attributed but licensed under terms not compatible with the Creative Commons Attribution License that the entire article has been released under.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Apr 10, Adam VanWert commented:

      This article should be recognized as one of the best in its category. It is written very well with a very logical sequence. The information is presented in a highly understandable manner. Invaluable resource! I'm a pharmacology professor with GI pharmacotherapy/pharmacology as one of my course responsibilities. Thank you for this!


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2013 Oct 29, Maurice Elphick commented:

      This is a really important contribution to our understanding of the evolution of neuropeptide and peptide hormone signalling systems. By analysing genomic/transcriptomic sequence data throughout the animal kingdom, it provides new insights on the origins and evolution of peptide signalling systems. I strongly recommend it to anyone who has an interest in any aspect of neuropeptide/peptide hormone biology.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 May 05, Neil Saunders commented:

      Be aware that there is no available software implementation associated with this publication.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2016 Dec 02, Aurélie Névéol commented:

      Follow-up work relying on the Scielo database led to the release of a large corpus of parallel scientific publications for biomedicine in three language pairs (EN/ES, EN/FR and EN/PT). The corpus is freely available and it was used in the 2016 conference on Machine Translation (WMT16).


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2016 Aug 23, Ben Goldacre commented:

      This trial has the wrong trial registry ID associated with it on PubMed: both in the XML on PubMed, and in the originating journal article. The ID given is NCT0071879. We believe the correct ID, which we have found by hand searching, is NCT00718796.

      This comment is being posted as part of the OpenTrials.net project<sup>[1]</sup> , an open database threading together all publicly accessible documents and data on each trial, globally. In the course of creating the database, and matching documents and data sources about trials from different locations, we have identified various anomalies in datasets such as PubMed, and in published papers. Alongside documenting the prevalence of problems, we are also attempting to correct these errors and anomalies wherever possible, by feeding back to the originators. We have corrected this data in the OpenTrials.net database; we hope that this trial’s text and metadata can also be corrected at source, in PubMed and in the accompanying paper.

      Many thanks,

      Jessica Fleminger, Ben Goldacre*

      [1] Goldacre, B., Gray, J., 2016. OpenTrials: towards a collaborative open database of all available information on all clinical trials. Trials 17. doi:10.1186/s13063-016-1290-8 PMID: 27056367

      * Dr Ben Goldacre BA MA MSc MBBS MRCPsych<br> Senior Clinical Research Fellow<br> ben.goldacre@phc.ox.ac.uk<br> www.ebmDataLab.net<br> Centre for Evidence Based Medicine<br> Department of Primary Care Health Sciences<br> University of Oxford<br> Radcliffe Observatory Quarter<br> Woodstock Road<br> Oxford OX2 6GG


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2015 Oct 30, Christopher Southan commented:

      The evolution of the beta secretase is described in http://www.ncbi.nlm.nih.gov/pubmed/24381583 which complements this useful analysis. Howerver, given the major differences in evolutionary trajectories co-evolution seems unlikely


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2013 Jun 29, Rahul Bakshi commented:

      Fascinating. However, I am still puzzled by the emphatic use of the term 'artemisinin-resistant' to describe these parasites. The drug clearly still works. True resistance would have been reproduced using isolates and isolate-derived strains in vitro. More importantly,true resistance would lead to treatment failures all over the place. Is there a demonstrable increase in drug failure directly associated with these parasites?


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2016 Nov 01, Michael Axtell commented:

      I should also add that the miscellaneous scripts mentioned in this 2013 paper have also been relocated, to https://psu.app.box.com/v/axtelldata in directory 'old_scripts'


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    2. On 2016 Nov 01, Michael Axtell commented:

      The URLs in this paper for software availability and data availability are out of date; here are the updated URLs:

      The ShortStack program is now at github .. the latest release is at https://github.com/MikeAxtell/ShortStack/releases

      The datasets used in this 2013 paper are now at https://psu.app.box.com/v/axtelldata in directory 'ShortStackPaperData'

      A tutorial and test data for ShortStack are at https://psu.app.box.com/v/axtelldata in directory 'ShortStack_TestData'

      Finally, I would like to point out that the current version of ShortStack is much enhanced relative to what was described in this 2013 paper. Many of the advancements are described by my group in Johnson et al. (2016) : https://www.ncbi.nlm.nih.gov/pubmed/27175019

      Thanks, Mike Axtell


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2015 Apr 27, Chloe Wong commented:

      Thank you for your interest and comments on our manuscript. As we hope is clear from the Discussion section of our paper, we are very conservative in our conclusions and are the first to recognize the many limitations of doing this type of work. Please also see our articles highlighting the many important issues to consider when undertaking and interpreting epigenetic epidemiological analyses (Mill & Heijmans, 2013; Heijmans & Mill, 2012).

      There are many reasons why the standard research approaches developed for genetic epidemiology are not necessarily appropriate for epigenetic studies of common disease. To date, no real precedents have been set about the optimal sample-sizes needed to detect epigenetic changes associated with disease. The number of ASD-discordant twin-pairs available for this study was small - these are extremely rare samples, and we were only able to recruit and characterize six discordant monozygotic (MZ) pairs. Furthermore, it is recognized that standard multiple testing parameters (as used in GWAS analyses) are not necessarily appropriate for genome-wide DNA methylation data ­ first, most of the sites on the commonly-used Illumina EWAS array are actually non-variable, and second there is considerable non-independence between DNA methylation at proximal CpG sites. With the aim of identifying real, biologically relevant within-twin and between-group DNA methylation differences, we therefore decided to use an analytic approach that incorporated both the significance (that is, t-test statistic) and magnitude (that is, absolute DNA methylation difference) of any observed differences to produce a ranked list of DMRs. Of note, we confirmed the variation at selected loci using an independent technology (bisulfite-pyrosequencing) to rule out technical artifacts in the data.

      Because individual studies such as this are, by necessity, small, it is absolutely clear that findings should be treated with caution until they are replicated and/or validated using complimentary approaches. In this regard, it is noteworthy that one of the top-ranked differentially methylated regions identified in our twin study ­ located in the vicinity of the OR2L13 gene - is also a top-ranked differentially methylated locus in a more recent epigenetic study of ASD by Berko and colleagues (2014). Furthermore, OR2L13 was found to be significantly differentially expressed in post-mortem brain tissue from ASD cases compared to unaffected controls in the most systematic transcriptomic analysis of autism brain yet undertaken (Voineagu et al, 2011). Finally, this gene has also been implicated in autism by genetic studies that have identified recurrent CNVs spanning the locus in cases.

      The main concern raised by Professor Bishop is that methylomic differences are also identified within concordant affected and concordant unaffected twins. We would argue this is not necessarily surprising; given that it is not feasible to directly study brain tissue from our twins, and ASD is a subtle developmental brain problem, it's plausible (perhaps likely) that these individuals are discordant for other traits/exposures that are also associated with epigenetic variation detected in blood. That doesn¹t mean that differences specific to ASD discordant twin-pairs are not interesting. What is clear from our analyses is that i) the sites identified as differentially methylated in the six ASD-discordant twin-pairs are not differentially methylated in concordant-unaffected twin-pairs, and ii) the overall distribution of average within-pair DNA methylation differences is significantly skewed in ASD-discordant twins, with a higher number of CpG sites demonstrating a larger average difference in DNA methylation.

      We acknowledge that our data represent only the first step in identifying molecular variation associated with autism. For example, we cannot begin to tackle issues regarding causality in this study, and it is possible (perhaps likely) that many of the changes we identified represent consequences of the disease. As discussed, we were also limited to using DNA derived from blood, and moving forward it will be important to understand the utility of peripheral tissues as a proxy for inaccessible organs such as the brain. We are currently undertaking more systematic analyses in larger samples of twins and post-mortem brain to address many of the limitations of this study.

      Berko ER, Suzuki M, Beren F, Lemetre C, Alaimo CM, Calder RB, Ballaban-Gil K, Gounder B, Kampf K, Kirschen J, Maqbool SB, Momin Z, Reynolds DM, Russo N, Shulman L, Stasiek E, Tozour J, Valicenti-McDermott M, Wang S, Abrahams BS, Hargitai J, Inbar D, Zhang Z, Buxbaum JD, Molholm S, Foxe JJ, Marion RW, Auton A, Greally JM. Mosaic epigenetic dysregulation of ectodermal cells in autism spectrum disorder. PLoS Genet. 2014 May 29;10(5):e1004402.

      Heijmans BT, Mill J. Commentary: The seven plagues of epigenetic epidemiology. Int J Epidemiol. 2012 Feb;41(1):74-8.

      Mill J, Heijmans BT. From promises to practical strategies in epigenetic epidemiology. Nat Rev Genet. 2013 Aug;14(8):585-94.

      Voineagu I, Wang X, Johnston P, Lowe JK, Tian Y, et al. (2011) Transcriptomic analysis of autistic brain reveals convergent molecular pathology. Nature 474: 380­384.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    2. On 2015 Apr 25, Dorothy V M Bishop commented:

      This is a pioneering study using a clever design with a unique dataset. I am grateful to the authors for making their raw data available. A colleague had suggested that I might be able to use the methods described in this paper with some of my own data, and it was good to have the opportunity to work through the analyses and gain more understanding of what was done.

      Unfortunately, having done so, I became dubious as to whether the results show differentially methylated regions associated with ASD, as claimed. Over 23,000 sites were examined for methylation differences, and the numbers where discordant twins differed was not high. Most tellingly, when I used the authors' data to analyse concordant groups in similar fashion, the number of methylation differences was similar. This was true both for twins concordant for ASD (where there were 341 between-twin differences with p < .01, compared with 203 such differences in the discordant twins), and for twins who were concordant for low symptom scores on CAST (where there were 188 between-twin differences with p < .01 – here I selected the first 6 twins from this group to give an equivalent sample size to the discordant twins).

      In addition, the findings of correlations between CAST scales and levels of methylation at given site is not impressive, given that the number of correlations computed was over 90,000 (4 per site), so some would be expected to achieve low p-values by chance.

      I appreciate this is a new area, and exploratory work needs to be done, but given that the field of molecular genetics has learned the importance for controlling for chance findings when looking for associations with SNPs, I am wondering perhaps the same lesson will prove necessary when examining methylation data. With a twin data set such as this one, I would argue it is very useful to have concordant twins as a comparison group, as they can be used to give an indication of the amount of discordance between twins in methylation that is to be expected regardless of phenotype.

      I have uploaded the analysis file I used to compare methylation patterns in different groups here: osf.io/z6w92 so that others can check my working.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2013 Oct 31, John Cannell commented:

      The authors stated that markers of oxidative stress are present in autism spectrum disorder (ASD). I wonder if the authors are aware that the genes for the antioxidants superoxide dismutase and thioredoxin reductase are directly up-regulated by the secosteroid 1,25 di-hydroxy vitamin D3 (calcitriol). I believe both genes also harbor a vitamin D response element.

      Peehl DM, Shinghal R, Nonn L, Seto E, Krishnan AV, Brooks JD, Feldman D. Molecular activity of 1,25‐dihydroxyvitamin D3 in primary cultures of human prostatic epithelial cells revealed by cDNA microarray analysis. J. Steroid Biochem Mol. Biol 2004;92:131–141. PMID:15555907>

      Calcitriol also directly up-regulates glutathione reductase and increases glutathione levels.

      Jain SK, et alo. Vitamin D upregulates glutamate cysteine ligase and glutathione reductase, and GSH formation, and decreases ROS and MCP-1 and IL-8 secretion in high-glucose exposed U937 monocytes. Biochem Biophys Res Commun. 2013 Jul 19;437(1):7-11. doi: 10.1016/j.bbrc.2013.06.004. Jain SK, 2013

      Also, supplemental vitamin D significantly reduces oxidative stress in humans.

      Nikooyeh B, et al. Daily intake of vitamin D- or calcium-vitamin D-fortified Persian yogurt drink (doogh) attenuates diabetes-induced oxidative stress: evidence for antioxidative properties of vitamin D.J Hum Nutr Diet. 2013 Jul 5. doi: 10.1111/jhn.12142. Nikooyeh B, 2014

      Asemi Z, et al. Vitamin D supplementation affects serum high-sensitivity C-reactive protein, insulin resistance, and biomarkers of oxidative stress in pregnant women. J Nutr. 2013 Sep;143(9):1432-8. doi: 10.3945/jn.113.177550. Asemi Z, 2013

      Thus the vitamin D theory of ASD (vitamin D deficiency being the environmental risk factor for this highly heritable disorder) is consistent with the authors work. Three recent studies, using community controls, have found 25(OH)D levels are significantly lower in children with ASD. Two of the studies below (Mostafa et al and Gong et al) also found ASD severity, as rated on standard ASD rating scales, is inversely correlated with 25(OH)D levels. Mostafa et al found an R value of -.86 for the association of serum 25(OH)D with ASD severity.

      Gong ZL, Luo CM, Wang L, Shen L, Wei F, Tong RJ, Liu Y. Serum 25-hydroxyvitamin D levels in Chinese children with autism spectrum disorders. Neuroreport. 2013 Oct 1. Gong ZL, 2014

      Meguid NA, Hashish AF, Anwar M, Sidhom G. Reduced serum levels of 25-hydroxy and 1,25-dihydroxy vitamin D in Egyptian children with autism. J Altern Complement Med. 2010 Jun;16(6):641-5. Meguid NA, 2010

      Mostafa GA, Al-Ayadhi LY.Reduced serum concentrations of 25-hydroxy vitamin D in children with autism: relation to autoimmunity. J Neuroinflammation. 2012 Aug 17;9:201. Mostafa GA, 2012

      There is a plethora of basic science explaining why low gestational or early childhood 25(OH)D levels would adversely effect brain development.

      Eyles DW, Feron F, Cui X, Kesby JP, Harms LH, Ko P, McGrath JJ, Burne TH. Developmental vitamin D deficiency causes abnormal brain development. Psychoneuroendocrinology. 2009 Dec;34 Suppl 1:S247-57. doi: 10.1016/j.psyneuen.2009.04.015. Epub . Review. Eyles DW, 2009

      DeLuca GC, Kimball SM, Kolasinski J, Ramagopalan SV, Ebers GC. Review: the role of vitamin D in nervous system health and disease. Neuropathol Appl Neurobiol. 2013 Aug;39(5):458-84. doi: 10.1111/nan.12020. DeLuca GC, 2013

      Eyles DW, Burne TH, McGrath JJ. Vitamin D, effects on brain development, adult brain function and the links between low levels of vitamin D and neuropsychiatric disease. Front Neuroendocrinol. 2013 Jan;34(1):47-64. doi: 10.1016/j.yfrne.2012.07.001. Epub 2012 Jul 11. Review. Eyles DW, 2013

      Furthermore, the vitamin D theory of autism explains most of the epidemiological facts of ASD.

      Cannell JJ. On the aetiology of autism. Acta Paediatr. 2010 Aug;99(8):1128-30. Cannell JJ, 2010

      Cannell JJ. Autism and vitamin D. Med Hypotheses. 2008;70(4):750-9. Cannell JJ, 2008

      70% of American toddlers do not take


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2015 Jul 18, Jan Tunér commented:

      A problem with most studies trying to treat tinnitus with laser light is the lack of proper diagnosis of the patients. Quite a few of these have a somatosensory background (the problem is basicly muscluar). Irradiation into the ear will then have no effect.

      References: Bjorne A, Agerberg G. Reduction in sick leave and costs to society of patients with Ménière´s disease after treatment of temporomandibular and cervical spine disorders: A controlled 6-year cost-benefit study. Cranio. 2003; 21 (2): 136-143. Bernhardt O, Gesch D, Schwahn C, Bitter K et al. Signs of temporomandibular disorders in tinnitus patients and in a population-based group of volunteers: results of the Study of Health in Pomerania. J Oral Rehabil. 2004; 31 (4): 311-319. Levine RA, Abel M, Cheng H. CNS somatosensory-auditory interactions elicit or modulate tinnitus. Exp Brain Res. 2003; 153 (4): 643-648. Tullberg M, Ernberg M. Long-term effect on tinnitus by treatment of temporomandibular disorders: a two-year follow-up by questionnaire. Acta Odontol Scand. 2006; 64 (2): 89- 96.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2013 Oct 31, John Cannell commented:

      The authors reported that immune system dysregulation is common in autism spectrum disorder (ASD”. Vitamin D deficiency produces very similar immune dysregulation.

      Prietl B, 2013

      Kamen DL, 2010

      Yang CY, 2013

      Baeke F, 2010

      Thus the vitamin D theory of ASD (vitamin D deficiency being the environmental risk factor for this highly heritable disorder) is consistent with the authors work. Three recent studies, using community controls, have found 25(OH)D levels are significantly lower in children with ASD. Two of the studies below (Mostafa et al and Gong et al) also found ASD severity, as rated on standard ASD rating scales, is inversely correlated with 25(OH)D levels. Mostafa et al found an R value of -.86 for the association of serum 25(OH)D with ASD severity.

      Gong ZL, Luo CM, Wang L, Shen L, Wei F, Tong RJ, Liu Y. Serum 25-hydroxyvitamin D levels in Chinese children with autism spectrum disorders. Neuroreport. 2013 Oct 1. Gong ZL, 2014

      Meguid NA, Hashish AF, Anwar M, Sidhom G. Reduced serum levels of 25-hydroxy and 1,25-dihydroxy vitamin D in Egyptian children with autism. J Altern Complement Med. 2010 Jun;16(6):641-5. Meguid NA, 2010

      Mostafa GA, Al-Ayadhi LY.Reduced serum concentrations of 25-hydroxy vitamin D in children with autism: relation to autoimmunity. J Neuroinflammation. 2012 Aug 17;9:201. Mostafa GA, 2012

      There is a plethora of basic science explaining why low gestational or early childhood 25(OH)D levels would adversely effect brain development.

      Eyles DW, Feron F, Cui X, Kesby JP, Harms LH, Ko P, McGrath JJ, Burne TH. Developmental vitamin D deficiency causes abnormal brain development. Psychoneuroendocrinology. 2009 Dec;34 Suppl 1:S247-57. doi: 10.1016/j.psyneuen.2009.04.015. Epub . Review. Eyles DW, 2009

      DeLuca GC, Kimball SM, Kolasinski J, Ramagopalan SV, Ebers GC. Review: the role of vitamin D in nervous system health and disease. Neuropathol Appl Neurobiol. 2013 Aug;39(5):458-84. doi: 10.1111/nan.12020. DeLuca GC, 2013

      Eyles DW, Burne TH, McGrath JJ. Vitamin D, effects on brain development, adult brain function and the links between low levels of vitamin D and neuropsychiatric disease. Front Neuroendocrinol. 2013 Jan;34(1):47-64. doi: 10.1016/j.yfrne.2012.07.001. Epub 2012 Jul 11. Review. Eyles DW, 2013

      Furthermore, the vitamin D theory of autism explains most of the epidemiological facts of ASD.

      Cannell JJ. On the aetiology of autism. Acta Paediatr. 2010 Aug;99(8):1128-30. Cannell JJ, 2010

      Cannell JJ. Autism and vitamin D. Med Hypotheses. 2008;70(4):750-9. Cannell JJ, 2008

      70% of American toddlers do not take the American Pediatric Association's recommended vitamin D supplement of 400 IU/day and few toddlers or pregnant women get any sunshine due to the sun scare. As vitamin D fortified milk consumption and sun exposure has declined, so have toddlers and pregnant women’s vitamin D levels. The dramatic increase in the incidence of ASD occurred during the same time vitamin D levels were falling in toddlers and pregnant women.

      Cannell JJ. Autism, will vitamin D treat core symptoms? Medical Hypotheses. 2013 Aug;81(2):195-8. Cannell JJ, 2013

      Some autism researchers seem cognizant of the entire body of autism research. For example, a group of well-known European ASD researchers, including Professor Christopher Gillberg of the Gillberg Neuropsychiatric Institute, have recently called for the need for “urgent research” into the vitamin D deficiency theory of ASD.

      Kočovská E, Fernell E, Billstedt E, Minnis H, Gillberg C. Vitamin D and autism: clinical review. Res Dev Disabil. 2012 Sep-Oct;33(5):1541-50. doi: 10.1016/j.ridd.2012.02.015. Epub 2012 Apr 21.Kočovská E, 2012

      Until all autism researchers become cognizant of the wider body of scientific research, we will continue to wonder how to prevent - and perhaps even treat - this modern day plague.

      John J Cannell, MD

      Vitamin D Council

      http://www.vitamindcouncil.org


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2015 Oct 08, thomas samaras commented:

      There's a large body of research that indicates smaller humans live longer. Examples include studies of Okinawans, Spaniards,Sardinian,Japanese in Hawaii, US veterans, basketball players, Harvard male graduates, and US government reports on the age-adjusted mortality of five different ethnic groups.In addition, US males average 9% taller than females and have a 9% shorter life expectancy. Various areas of study supporting the thesis that smaller humans live longer is given in: Evidence from eight different types of studies showing that smaller body size is related to greater longevity: JSRR 2(16): 2150-2160, 2014; article no. JSRR.2014.16.003


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2017 Dec 18, Shaun Khoo commented:

      Open Data: The underlying dataset for this paper is available on Figshare.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Feb 19, Valeria Fadda commented:

      Co-authors of this Note: Roberta Gatto, Dario Maratea, Sabrina Trippoli, and Andrea Messori (all from the HTA Unit of Estav in Firenze, Italy).

      The studies by Surder et al.[1] and by Traverse et al. [2] are a further improvement to the overall knowledge about the effectiveness of stem cell treatment in ischemic heart disease. Very few experiences are in fact available in the scientific literature about this relatively new therapeutic strategy. Since the systematic review of Clifford et al. [3] represents the most accurate previous attempt to shed light on this intervention for the acute treatment of myocardial infarction, adding the two trials (Surder et al.; Traverse et al.) to Clifford’s meta-analysis can be worthwhile. With reference to the end-point of left ventricular ejection fraction, we incorporated the results of the two trials (Surder et al.; Traverse et al.)into the meta-analysis of Clifford et al. The results of our analysis (Figure 1) show the superiority of treatment with intracoronary bone marrow-derived cells over placebo, thus confirming the results reported by Clifford et al. The main difference is that confidence intervals have become slightly wider after the addition of the two above mentioned trials.

      References

      1. Surder D, Manka R, Lo Cicero V et al. Intracoronary injection of bone marrow-derived mononuclear cells early or late after acute myocardial infarction: effects on global left ventricular function. Circulation. 2013 May 14;127(19):1968-79. doi: 10.1161/CIRCULATIONAHA.112.001035

      2. Traverse JH, Henry TD, Pepine CJ et al. Cardiovascular Cell Therapy Research Network (CCTRN). Effect of the use and timing of bone marrow mononuclear cell delivery on left ventricular function after acute myocardial infarction: the TIME randomized trial. JAMA. 2012 Dec 12;308(22):2380-9. Erratum in: JAMA. 2013 Jan 23;309(4):343. PubMed PMID: 23129008; PubMed Central PMCID: PMC3652242.

      3. Clifford DM, Fisher SA, Brunskill SJ et al. Stem cell treatment for acute myocardial infarction. Cochrane Database Syst Rev. 2012 Feb 15;2:CD006536. doi: 10.1002/14651858.CD006536.pub3

      Figure 1. Comparison of intracoronary stem cell treatment with no stem cells in patients with acute myocardial infarction: pooled difference in mean change in LVEF from baseline to end of study. This figure is available at: http://www.osservatorioinnovazione.net/papers/Figure_1.jpg

      Valeria Fadda HTA Unit Estav Regional Health System 50100 Firenze Italy


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Apr 29, Amanda Capes-Davis commented:

      Please be aware that HEp-2 is not a human laryngeal carcinoma cell line. It was shown to be cross-contaminated by Walter Nelson-Rees and is actually HeLa. For a list of known cross-contaminated or otherwise misidentified cell lines, see http://iclac.org/databases/cross-contaminations/.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Mar 13, Jonathan Eisen commented:

      Richard Grant wrote an article for the Guardian discussing (in part) this article. See Say 'Ome': scientists get silly


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    2. On 2014 Mar 13, Jonathan Eisen commented:

      Robert Lee Hotz wrote an article in the Wall Street Journal discussing (in part) this article. See Here's an Omical Tale: Scientists Discover Spreading Suffix


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Jun 20, Alexander (Lex) Nederbragt commented:

      Together with three colleagues from my group, I was a reviewer of this paper. All review reports can be found on the journals website (including all versions of the manuscript) or on publons: https://publons.com/publon/4891/


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2017 Dec 14, Denise N Slenter commented:

      The pathway model outlined in Figure 1 is available as free machine readable data in WP4190 in WikiPathways: https://www.wikipathways.org/index.php/Pathway:WP4190


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    2. On 2017 Nov 27, Steven Watterson commented:

      In our recent paper (https://www.ncbi.nlm.nih.gov/pubmed/28910500) we merge this pathway model with pharmacological data and explore how to create multi-drug therapies that optimally suppress cholesterol synthesis and eliminate off-target effects.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Feb 27, James Carroll commented:

      Kadhim-Saleh et al make significant errors and subsequently draw the wrong conclusion. A comprehensive rebuttal by Bjordal et al is published here Bjordal JM, 2014 but as as most readers are unlikely to pay $39.95 to read the letter I have listed some highlights here to help restore some balance.

      The authors claim they used “A very strict study selection criterion” but they excluded Chow 2004 because it “most likely” included the same cohort as Chow 2006. It it is clearly stated in the Lancet review they cited Kimler WC IV, 1996 that one cohort was recruited in 1998 – 1999, and the other cohort recruited in 2002–2003.

      Rather than contacting the trial authors to resolve uncertainty about the cohorts, which is normal practice for systematic reviewers Kadhim-Saleh et al. decided to base their decision on guess work, not stringent reviewing practice.

      Kadhim-Saleh et al. had criticised the lancet review because “… investigators included trials that used different and more subjective tools for assessing the primary pain outcome measure”. Bjordal et al point out they only included studies that used well-recognized and validated scales for pain assessment including “weighted mean difference for continuous data from visual analogues scale (VAS) scores for pain intensity, relative risk for dichotomized data for global improvement, and standardized mean difference to combine different validated scales of disability including the Neck Disability Index, Neck Disability Scale and the Northwick Park Questionnaire”.

      Bjordal et al said they enabled a comprehensive analysis of the available evidence and the finding was that the results were consistent across the different measurement tools actually strengthened the robustness of the Lancet conclusion. Kadhim-Saleh et al. only used a single outcome measure at a single time-point as their outcome measure of success.

      Kadhim-Saleh et al. also added a study by Konstantinovic 2010 that they say “failed to detect a statistically significance difference between LLLT and placebo” based on only on VAS, but Konstantinovic had measured seven other outcomes and all were in favour of LLLT [but not reported by Kadhim-Saleh]. The study was on acute radiculopathy, which is a specific diagnosis for neck pain, and this would have increased heterogeneity not reduced it which which was their criticism of the Lancet review.

      Kadhim-Saleh et al. criticized the Lancet review for having heterogeneity but Bjordal et al noted that Kadhim-Saleh et al was actually worse in their analysis (I2 = 94 % compared with the Lancet analysis I2 = 91 %). This revealed that the so called “stringent” criteria used by Kadhim-Saleh et al. had failed

      Bjordal et al explained that in the Lancet they had included a 650-word paragraph that described a sensitivity analyses that found that most heterogeneity was attributed to interventions and that Kadhim-Saleh et al. gave no serious consideration to the appropriateness of LLLT technique including dosage, a priori in selection criteria or analysis protocol.

      He pointed out that an example of how LLLT dose explains heterogeneity was provided by examining the two acute group trials included in the Lancet review. The negative trial using LLLT on acupuncture points by Aigner et al. was under-dosed (632 nm wavelength, 0.075 J) with an ineffective dose of only 0.02 % when compared with the positive trial by Soriano et al. (904 nm wavelength, 4 J). The additional acute radiculopathy trial by Konstantinovic et al. included in the review by Kadhim-Saleh et al. had similar doses and wavelength (904 nm wavelength, 2 J) to the positive trial by Soriano et al., and both were complying with the dosage recommendations from World Association for Laser Therapy (WALT). By conducting a meta-analysis that excludes the trial by Aigner et al. and substituting it with the new acute radiculopathy trial by Konstantinovic et al. Bjordal et al have found that heterogeneity disappears completely(from I2 =91% to I2 =0%). This results in a significant and clinically relevant RR for global improvement at 2.63 (95 % CI 1.73, 4.01).

      Kadhim-Saleh et al also made an unsubstantiated claim about a re-analysis of the Lancet meta-analysis by Shiri and Viikari- Juntura 2010 “After applying a random-effects model Shiri and Viikari-Juntura found no significant difference between laser-treated and placebo-treated groups in pain reduction”. Bjordal et al emphatically state “This is simply untrue, as Shiri and Viika-Junturi 2010 confirmed that pain reduction on VAS with a weighted mean difference of 19.41 (95 % CI 9.67, 29.15) in a random-effects model. The inaccuracies in our original analysis brought to our attention by Shiri and Viikari-Juntura weakened slightly the size of effect on recalculation, yet the overall result remained that LLLT gave significant and clinically relevant relief for 6 out of 8 outcomes and lasting up to 22 weeks”.

      Bjordal et al also criticised the Kadhim-Saleh paper because it “cited meta-analyses published over 20 years ago to demonstrate the consistency of their claim with previous reviews that found no effect from LLLT despite 80–90 % of RCTs on LLLT being published after these citations. The rate of publication of RCTs in recent years means that the survival period for systematic reviews is typically less than 5 years. In addition, they used literature published between 14 and 30 years ago to support descriptions of LLLT mechanisms. We stand by our original findings that LLLT gives clinically relevant neck pain relief and disability improvement after treatment and possibly follow-ups up to 5 months.”

      DISCLOSURE

      James Carroll

      CEO

      THOR Photomedicine Ltd

      My publications


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2015 Nov 12, Leonid Teytelman commented:

      I think there are harder questions underneath this discussion. Is funding ENCODE-like projects a good idea? If so, which ones?

      I agree with Sean Eddy that the misleading hype in the presentation of the ENCODE results was deplorable. I also agree that it is critical to develop common resources, datasets, and infrastructure. I would be crazy to argue that the enormous effort to sequence the human genome wasn't worth the money.

      However, just because the human genome sequencing was a great idea, that doesn't necessarily mean all Big Science efforts are good ideas. The difficult question here is whether ENCODE itself was in fact a good idea. Was it a good use of the already over-stretched NIH budget? What else could we have done with that $200m? Were the resulting datasets enabling in a transformative way? If not, could funding for dedicated method and technology development on a fraction of the cost, have served the community better?

      Michael Eisen asked these questions in Blinded by Big Science: The lesson I learned from ENCODE is that projects like ENCODE are not a good idea. Very hard to answer this, but if we don't, we may end up wasting a lot of money in the years to come.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    2. On 2015 Nov 11, Nikolai Slavov commented:

      This is a very insightful essay that presents the different sides in a balanced and reasonable framework. I agree that much of the controversy and tension arise from misrepresentation and not recognizing large-scale projects for what they really are. Such dissonance, I believe, is rooted in the politics of credit attribution and budget justification. The incentives for exaggeration are strong. Until these incentives are counterbalanced, we will continue to have problems with exaggeration, misrepresentation, and failure to recognize and credit large-scale projects for what they really are.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Apr 08, David Reardon commented:

      The authors of this study<sup>1</sup> concluded that smoking explains about one-third of the variation in preterm birth rates among low income and high income groups (SES) while reproductive history accounts for only one-fourth of preterm births.

      Unfortunately this analysis and conclusion is marred by the incorrect assumption that smoking behavior is independent of prior reproductive history. It is not.

      Smoking behavior is driven by many emotional factors, including loss and bereavement.<sup>2</sup> Women are especially more likely to explain a desire to smoke to cope with emotional upsets.<sup>3</sup>

      Most importantly to the study at hand, research has consistently shown that women with a history of abortion smoke substantially more.<sup>4,5</sup> In addition, a dose effect has also been observed, with the number of abortions correlating with even higher rates of smoking.<sup>6</sup>

      Research has also shown that women with a history of abortion are more likely to persist in or increase smoking (and alcohol or illegal drug use) during subsequent wanted pregnancies.<sup>7,8</sup> The most common explanation for this—provided by women themselves and by therapists experienced in treating post-abortion maladjustment<sup>9</sup> is that subsequent wanted pregnancies may stir up unresolved feelings of loss, grief, or guilt relative to past abortions. From this perspective, smoking, drinking, and the use of other mood altering substances are just forms self-medication employed to assist in the repression of unresolved negative emotions.

      A causal connection between abortion and smoking behavior is reported in a survey of 527 women interviewed one month after their abortions in which 23% reported using smoking specifically “to help deal with [their] abortion." Drinking and drug use were also reported as being used “to help deal with” their abortions by 18% and 9% respectively.10 Yet another follow up survey of women after their abortions found that higher post-abortion anxiety scores correlated to heavier smoking patterns.<sup>11</sup>

      It is also known that smoking rates increase with exposue to trauma and PTSD<sup>12.</sup> This is important because studies of abortion patients, using multiple scales and assessments before and subsequent to abortion, show a significantly higher rates of PTSD following abortion.<sup>13,14,15</sup>

      In light of this evidence, it is clear that history of abortion should not be treated as simply an aspect of a woman’s physical history. It has psychological components more profound than, for example, a history of placenta previa. These psychological reactions can contribute to behaviors such as elevated smoking, drinking, and drug use which may not only persist through subsequent wanted pregnancies<sup>16,</sup> but may even be accentuated by the emotions surrounding the pregnancy.<sup>9</sup>

      In light of the above observations, I would encourage the authors to undertake additional analyses to tease out any possible distinctions between the direct biological effect associated with abortion and the possible indirect effects which may be associated with the psychological effects of abortion on behaviors like smoking.

      Notably, the current study observe adjusted odds ratios for extremely preterm, very preterm, and moderately preterm for abortion (1.28, 1.16, 1.07, respectively) which were in a range similar to the adjusted odds ratios for smoking (1.21, 1.23, 1.15). Additional analyses could be performed to separate the potential effects of smoking and abortion.

      In my proposed analysis, the first uninterrupted pregnancy outcomes (full term live singleton birth, stillbirth, moderate preterm, very preterm, extremely preterm, miscarriage, ectopic pregnancy) would be compared for three groups of women (no smoking, quit smoking during first trimester, smoked beyond first trimester) with results segregated for a prior exposure to induced abortion.

      The proposed analysis would also allow us to determine if a history of abortion does reduce the likelihood that woman will stop smoking in the first trimester. In addition, comparing the two groups of women without any history of smoking would give us a clearer picture of the effects of abortion when smoking is not a confounding factor. This comparison would not eliminate other possible indirect, emotional factors (such as eating disorders, which can also be associated with abortion<sup>9,</sup> might still play a role, but it would at least demonstrate whether smoking behavior in combination with abortion is confounding these currently published results.

      References

      1) Raisanen S, Gissler M, Saari J, Kramer M, Heinonen S (2013) Contribution of Risk Factors to Extremely, Very and Moderately Preterm Births – Register- Based Analysis of 1,390,742 Singleton Births. PLoS ONE 8(4): e60660.

      2) Parkes CM, Brown RJ. Health after bereavement. A controlled study of young Boston widows and widowers. Psychosom Med. 1972 Sep-Oct;34(5):449-61.

      3) United States Public Health Service, Adult Use of Tobacco. U.S. Dept of Health, Education and Welfare, CDC, Bureau of Health Education (1975)

      4) Pedersen W. Childbirth, abortion and subsequent substance use in young women: a population-based longitudinal study. Addiction. 2007 Dec;102(12):1971-8.

      5) Henriet L, Kaminski M. Impact of induced abortions on subsequent pregnancy outcome: the 1995 French national perinatal pregnancy survey, Br J Obstet Gynaecol 108:1036-1042, 2001.

      6) Levin AA, Schoenbaum SC, Monson RR, Stubblefield PG, Ryan KJ. Association of induced abortion with subsequent pregnancy loss. JAMA. 1980 Jun 27;243(24):2495-9.

      7) Coleman P, Reardon D, Rue V, Cougle J. A history of induced abortion in relation to substance use during subsequent pregnancies carried to term. Am J Obst Gynecol 2002; 187: 1673–8.

      8) Coleman P, Reardon D, Cougle J. Substance use among pregnant women in the context of previous reproductive loss and desire for current pregnancy. Br J Health Psychol 2005; 10: 255–68.

      9) Burke T, Reardon DC. Forbidden Grief: The Unspoken Pain of Abortion. Acorn Books. (2002) Springfield, IL.

      10) Major B, Richards C, Cooper ML, Cozzarelli C, Zubek J. Personal resilience, cognitive appraisals, and coping: an integrative model of adjustment to abortion. J Pers Soc Psychol. 1998 Mar;74(3):735-52.

      11) Henshaw R, et al, "Psychological responses following medical abortion (using mifepristone and gemepost) and surgical aspiration. Acta Obstet Gynecol Scand 73:812, 1994.

      12) Feldner MT, Babson KA, Zvolensky MJ. Smoking, traumatic event exposure, and post-traumatic stress: a critical review of the empirical literature.. Clin Psychol Rev. 2007 Jan;27(1):14-45. Epub 2006 Oct 10.

      13) Sharain Suliman et. al., Comparison of pain, cortisol levels, and psychological distress in women undergoing surgical termination of pregnancy under local anaesthesia versus intravenous sedation. BMC Psychiatry 2007, 7:24.

      14) Rue VM, Coleman PK, Rue JJ, Reardon DC. Induced abortion and traumatic stress: A preliminary comparison of American and Russian women. Med Sci Monit, 2004 10(10): SR5-16.

      15) Rousset, C. Brulfert, N. Séjourné, N. Goutaudier & H. Chabrol. Posttraumatic Stress Disorder and psychological distress following medical and surgical abortion. C. Journal of Reproductive and Infant Psychology, (2011) Volume 29(5), 506-517.

      16) Coleman PK, Reardon DC, Cougle JR. Substance use among pregnant women in the context of previous reproductive loss and desire for current pregnancy.Br J Health Psychol. 2005 May;10(Pt 2):255-68.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2013 Jun 16, Liam Paninski commented:

      Seems very promising, along similar lines to recent work by Ahrens et al.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Aug 29, Felicitas Merz commented:

      !!Please note!! There was a mistake in the first version of the pdf. The formulation of the culture medium does NOT content N-hydroxysuccimide, but normal horse serum (25%). This will be corrected as soon as possible. For any further questions or comments, please contact us.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Feb 20, Koji Ohira commented:

      We made the electrophoresis chambers and performed the CLARITY according to the protocol. The chambers were made with the same materials/dimensions as the ones shown in the methods by a manufacturer. However, brains did not become transparent. I think that hydrogel tissue embedding is going well, but electrophoretic tissue clearing (ETC) is not. In our ECT, brain samples were applied with 30V at 37 °C for more than 10 days. Many air bubbles were generated around both electrodes during ETC and seemed to disturb the electricity. In fact, more than 50V cannot apply to the chamber in our system. I heard that some of our colleagues failed to make brain transparent with exactly same problems (i.e. a lot of air bubbles were generated). When you established the method, would you have a similar problem? Any tips? I wonder if I could get your comments and advice about that.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2013 Oct 23, Stephen Turner commented:

      This paper is a groundbreaking exploration of the use of metagenomics to investigate and determine the causal organism of an infectious disease outbreak. The authors retrospectively collected fecal samples from symptomatic patients from the 2011 Escherichia coli O104:H4 outbreak in Germany and performed high-throughput shotgun sequencing, followed by a sophisticated analysis to determine the outbreak's causal organism. The analysis included comparing genetic markers from many symptomatic patients' metagenomes with those of healthy controls, followed by de novo assembly of the outbreak strain from the shotgun metagenomic data. This illustrates both the power, but the real limitations, of using metagenomic approaches for clinical diagnostics. Also see David Relman's synopsis of the study in the same JAMA issue.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Nov 25, Harri Hemila commented:

      Khan AA, 2013 reviewed potential interventions against neonatal tetanus. Vitamin C might also be included as a potential intervention worth further study.

      According to WHO 2005, p. 27, Somalia has had particularly high rate of neonatal tetanus; 16.5 neonatal tetanus deaths per 1000 live births in 1999. The prevalence of vitamin C deficiency has also been particularly high in Somalia, WHO 1999, Table 2. The two conditions might have associations.

      In dozens of animal studies, vitamin C increased resistance against diverse infections and purified bacterial toxins Hemilä, 2006. In particular, Dey PK, 1966 reported that five rats administered twice the minimal lethal dose of tetanus toxin all died, whereas 25 rats administered vitamin C either before or after the toxin all lived. CHAKRABARTI B, 1955 reported that tetanus patients had lower plasma vitamin C levels than healthy people, and tetanus patients who died had lower levels than those who survived. Furthermore, tetanus patients had elevated levels of dehydroascorbate, which is the oxidized form of vitamin C. Such changes in vitamin C metabolism suggest that it might be involved in the pathogenesis of tetanus.

      One single controlled trial has examined the effect of vitamin C in the treatment of tetanus; the trial was undertaken in Bangladesh by Jahan K, 1984. Vitamin C at a dosage of 1 g/day was administered intravenously alongside conventional treatment. In tetanus patients aged 1 to 12 years, vitamin C treatment was associated with a 100% reduction in case fatality rate (95% CI from -100% to -94%): 74% (23/31) of the control children died but none in the vitamin C group (0/31). Although the Jahan trial has methodological shortcomings, the findings should not be ignored Hemilä H, 2013. Evidently the possible effects of vitamin C on neonatal tetanus patients should be studied.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Dec 07, Eric Vallabh Minikel commented:

      Please see our recent work in which we have provided evidence that the apparent anticipation in E200K families is driven by ascertainment bias: Minikel EV, 2014


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2013 Oct 28, Mick Watson commented:

      We have now published the software behind many of the analyses in this paper:

      Watson M, Schnettler E, Kohl A. (2013) viRome: an R package for the visualization and analysis of viral small RNA sequence datasets. Bioinformatics. 29(15):1902-3

      http://www.ncbi.nlm.nih.gov/pubmed/23709497

      The website for the software is here: http://www.ark-genomics.org/bioinformatics/virome


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Feb 12, David Keller commented:

      None


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    2. On 2014 Feb 12, David Keller commented:

      The “Special Article” on Influenza Vaccines by Peter Doshi, PhD. (1) casts doubts on the benefits of influenza vaccination in a way which could dangerously mislead clinicians. He states that “influenza vaccines target a disease that is, for most people, self-limiting. While unpleasant, today, tragedies are rare”. This statement ignores the role the vaccine has played in preventing tragedies such as the 1918 flu pandemic, in which influenza was seen to be a highly contagious infection capable of quickly killing untold millions of humans, including the young and healthy. Doshi further states that between 33 and 100 adults would need to be vaccinated to prevent one case of influenza. This statistic is misleading because it pertains to the U.S. population, in which tens of millions get annual flu vaccinations, providing individuals with a broad-spectrum of antibodies to influenza, and partial herd immunity at a population level. The number needed to treat to prevent one case of influenza would undoubtedly be much lower if this huge segment of the population were not immunized. To achieve the full benefits of herd immunity, at least 80% of healthy Americans must be immunized (2), which is a worthy goal. Doshi cites retrospective cohort studies showing a 48% reduction in mortality among the elderly who are vaccinated, but decries the lack of evidence from placebo-controlled trials. However, given the evidence we do have, it would seem unethical to administer placebo instead of influenza vaccine to persons over age 75, for lack of equipoise (the same reason a randomized controlled trial of smoking has never been conducted). Doshi objects that the increase in influenza vaccination rates has not been accompanied by a decrease in total winter mortality. However, the relevant statistic to examine would be age-adjusted annual mortality. Everyone dies sooner or later, but I would rather die at age 85 than at age 75, regardless of the season, even if it means I have to get a flu shot annually. The problem among the elderly of inadequate antibody titer increase after influenza vaccine has been pointed out before, and is being addressed by such measures as increasing the dose of vaccine or changing the route of administration (3); it is not a reason to abandon the benefits of immunization in this population.

      1) Doshi P. Influenza Vaccines: Time for a Rethink. JAMA Intern Med.2013;173(11):1014-1016. doi:10.1001/jamainternmed.2013.490.

      2) Plans-Rubió P. The vaccination coverage required to establish herd immunity against influenza viruses. Prev Med. 2012 Jul;55(1):72-7. doi: 10.1016/j.ypmed.2012.02.015. Epub 2012 Mar 4.3.

      3) DiazGranados CA, Dunning AJ, Jordanov E, Landolfi V, Denis M, Talbot HK. High-dose trivalent influenza vaccine compared to standard dose vaccine in elderly adults: safety, immunogenicity and relative efficacy during the 2009-2010 season. Vaccine. 2013 Jan 30;31(6):861-6. doi: 10.1016/j.vaccine.2012.12.013.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2016 Mar 22, Joshua L Cherry commented:

      This excellent study provides much useful information, but some important points are not apparent from the article. An important claim of the article is that the unmutated common ancestor (UCA) antibody binds the founder ENV protein with high affinity. However, several amino acids in the important CDR3 of the heavy chain “UCA” cannot have been encoded by germline sequences. These include most of the RGQLVN sequence that comprises six of the twelve paratope residues in the heavy chain. Either the nucleotide positions in question represent mutated germline residues, or they represent random additions by TdT. In the first case, the “UCA” that bound antigen with high affinity actually included mutations, presumably the product of affinity maturation. In the second case, we cannot know the identities of the original, unmutated nucleotides, and it is reasonable to suspect that the true UCA had a different sequence and a lower affinity for ENV. In any case, the fact that so many important residues are not encoded by the germline might mean that antibodies of this type are rare in the naive repertoire and therefore difficult to elicit.

      The reconstructed UCA sequence contains 27 bases between the V and J regions. The longest perfect match to any germline D segment is just five bases. Five bases would be an unusually small size for a D region; less than 1% of the naive B cell repertoire contains a D region of five or fewer bases. Furthermore, a total of 22 N nucleotides, though not extraordinary, would be larger than typical. This suggests that some of the “UCA” bases in this region, including some of those encoding the critical RGQLVN sequence, are actually mutated D nucleotides, presumably selected for higher affinity to ENV.

      Suppose, though, that the 22 bases that do not match the germline indeed represent N nucleotides, randomly added by TdT (with perhaps a small contribution from P nucleotides). In that case, we cannot know with any certainty what these bases were in the unmutated ancestor. If these bases changed early in the affinity maturation, perhaps greatly increasing the more modest affinity of the actual unmutated ancestor, there would be no way to know this.

      The authors did construct three other candidate UCAs that differed at one or two amino acids. These, however, encompass only a small component of the uncertainty in the UCA sequence. Furthermore, results with these variants illustrate the concern raised here. Two of the variants bore an E at the third position of the critical hexapeptide, which is consistent with a longer D region. These more plausible UCA antibodies exhibited a 3.8- to 7-fold reduction in ENV affinity compared to the candidate containing RGQLVN.

      If the UCA sequence is correct, the fact that several of the most important residues are encoded by randomly added nucleotides may have implications for the ease of eliciting similar antibodies through vaccination. Sequences encoded by commonly used germline segments will be present at reasonable frequencies in the naive B cell repertoire. Sequences encoded by N nucleotides will be rarer. If they must be associated with unusually short D regions, the combination will be rarer still. To the extent that a vaccination strategy is aimed at eliciting antibodies of this type, this may be a problem.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2013 Nov 07, Allison Stelling commented:

      This paper found that an increase in volume in the brain's "irrigation system" (the ventricular area) could be observed in patients with age-related disorders like Alzheimer disease. This could suggest that imbalances in brain's delicate nutrient and chemical content may be one of the things that promotes the onset of these diseases.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2017 Jul 23, David Keller commented:

      Final Comments on "The Ethics of Commercial Testing"

      Organizations such as the USPSTF issue guidelines which are based on the results of large clinical trials and therefore apply on average to entire populations, but may not apply to atypical individuals. We have all seen "outliers" who suffered a heart attack despite having few or no Framingham risk factors. Tests which are not justified on a population-wide basis can yield valuable information for atypical individuals. Since risk scores are not perfect at predicting who will have an adverse outcome, individuals should be allowed to decide for themselves how much risk they are willing to take, and how much of their own money they are willing to spend to assess their risk.

      Consider the Affordable Care Act's mandate of free aneurysm screening for men aged 65 to 75 who have ever smoked: a man aged 65 who quit smoking 30 years ago gets a free ultrasound, but a 64 year old man who has been smoking 2 packs per day for the past 40 years does not. This makes no clinical sense, but is a perfect example of what Charles Dickens [1] meant when he said "the law is an ass [donkey]". Clinical decisions should be left to patients and their physicians, not written into law. Furthermore, these "free" ultrasounds will cost taxpayers a lot more if ordered by physicians and performed in hospital radiology departments than if patients can self-refer to commercial test companies which offer abdominal ultrasounds for $129, with carotid and peripheral artery screens included for no additional fee. The cost of hospital-based imaging is inflated in part due to excessive regulation. Commercial imaging companies can provide ultrasound at such a low cost partly because they are not yet burdened with providing mandatory counseling sessions which their customers may not even want.

      Here is the crux of our disagreement. I believe that individuals in a free society should be allowed to purchase tests such as ultrasound and genetic testing, which pose no risk of direct harm. Stigmatizing commercial vendors of such tests as unethical for not providing counseling is the first step toward laws mandating counseling, which will increase the cost of the tests. To me, that outcome would be unethical.

      The above comments were posted on an Annals of Internal Medicine website on March 26, 2013, and are being posted on PubMed Commons to complete the chain of comments for readers with no access to the Annals website.

      [1] Mark Twain said it too, but was quoting Charles Dickens, through the character Mr. Bumble in the novel "Oliver Twist".


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2013 Dec 20, Eric Johnson commented:

      I get comments referring to this paper quite a bit, so I wanted to add a clarification that many casual readers seemed to have missed. The title uses "RADseq" generically, and then analyzes two different protocols: "RADseq" with the shearing step (Baird et al., 2008), and ddRAD which replaces the shearing step with a frequently-cutting enzyme (Peterson et al., 2012). The results are not the same for the two protocols. For example, Table 1 shows that "standard" RADseq deviates from the expected value of π by .995, while ddRAD deviates by .836.

      All existing genotyping by sequencing methods that reduce the complexity of the genome will have biases and missing data when polymorphisms disrupt the sequence used to anchor the amplification and subsequent sequencing, and this paper shows how these biases can affect the calculation of population statistics. I just wanted to make clear the distinction between the two protocols, so when researchers use one or the other they can understand how to plan their projects and analyses accordingly.

      [Conflict of interest note: I am an author on Baird et al.]


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Apr 05, Andrea Messori commented:

      Incidence of new vertebral fractures in women treated with an antireabsorptive agent or placebo: re-analysis of 9 randomized trials

      In the study of anti-reabsorptive agents for preventing vertebral fractures in women with post-menopausal osteoporosis, the systematic review published by Migliore et al[1] is the most recent contribution in this area and has also the merit that mixed treatment comparisons were carried out.

      One limitation of the study by Migliore et al[1] is that, in studying the end-point of new vertebral fractures according to 9 randomized placebo-controlled trials [2-10], the crude event rates were not presented for individual trials. In fact, only the denominators of these rates were reported (see Table I of the publication by Migliore et al[1]). In addition, these denominators were affected by some typographical errors (eg. see the number of patients enrolled in the placebo arm of the trial by Lieberman et al. [3], N=42, which is erroneous and seems to be an inadvertent duplicate presentation of the age of the same patients).

      We have previously stressed that the crude event rates extracted from individual trials should be reported in any meta-analysis study [11] because this presentation allows us to verify the quality of the extraction process and the reliability of the final results.

      We have therefore re-extracted the event rates from the 9 trials [2-10] and we have reanalyzed these rates by redoing the same meta-analysis carried out by Migliore et al.[1] (see their Table II, first five comparisons vs placebo). Our analysis was based on the random-effect model as implemented in the OMA software [12]. We expressed our results as both odds-ratio and relative risk.

      Figure 1 shows the results of this re-analysis. Our results are nearly identical to those published by Migliore et al. [1] and can therefore be seen as a useful confirmation of the findings of the referenced study.

      Andrea Messori HTA Unit ESTAV Centro 50100 Firenze Italy

      FIGURE 1 - Incidence of new vertebral fractures in women treated with an anti-reabsorptive agent or placebo.

      The Forest plot shows the subgroup analysis for 5 treatments (alendronate, risedronate, zolendronate, ibandronate, and denosumab) compared with placebo. The original material was derived from 9 randomized trials [2-10]. The meta-analysis results are expressed as odds-ratio (Panel A) and relative risk (Panel B).<br> Abbreviations and symbols: horizontal black lines represent the 95CI% around the event rate (■); yellow diamonds represent the pooled (meta-analytical) rate with its 95%CI for the various subgroups, while the blue diamond represents the pooled overall rate across the two subgroups. The vertical dotted line (in red) represents the pooled rate from the overall series of 9 trials. I<sup>2</sup> is the index of heterogeneity and is accompanied by the p-value of its statistical significance. Abbreviations: RR, relative risk; Ev, number of events; Trt, number of patients in the treatment group; Ctrl, number of patient in the control group; ALE, alendronate; RIS, risedronate,; ZOL, zolendronate; IBA, ibandronate; DEN, denosumab.

      This figure can be downloaded at the address: http://www.osservatorioinnovazione.net/papers/migliore2013fig1.jpg

      References

      1. Migliore A, Broccoli S, Massafra U, Cassol M, Frediani B. Ranking antireabsorptive agents to prevent vertebral fractures in postmenopausal osteoporosis by mixed treatment comparison meta-analysis. Eur Rev Med Pharmacol Sci. 2013 Mar;17(5):658-67.

      2. Black DM, Cummings SR, Karpf DB, Cauley JA, Thompson DE, Nevitt MC, Bauer DC, Genant HK, Haskell WL, Marcus R, Ott SM, Torner JC, Quandt SA, Reiss TF, Ensrud KE. Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fractures. Fracture Intervention Trial Research Group. Lancet. 1996 Dec 7;348(9041):1535-41. PubMed PMID: 8950879.

      3. Liberman UA, Weiss SR, Bröll J, Minne HW, Quan H, Bell NH, Rodriguez-Portales J, Downs RW Jr, Dequeker J, Favus M. Effect of oral alendronate on bone mineral density and the incidence of fractures in postmenopausal osteoporosis. The Alendronate Phase III Osteoporosis Treatment Study Group. N Engl J Med. 1995 Nov 30;333(22):1437-43. PubMed PMID: 7477143.

      4. Cummings SR, Black DM, Thompson DE, Applegate WB, Barrett-Connor E, Musliner TA, Palermo L, Prineas R, Rubin SM, Scott JC, Vogt T, Wallace R, Yates AJ, LaCroix AZ. Effect of alendronate on risk of fracture in women with low bone density but without vertebral fractures: results from the Fracture Intervention Trial. JAMA. 1998 Dec 23-30;280(24):2077-82. PubMed PMID: 9875874.

      5. Harris ST, Watts NB, Genant HK, McKeever CD, Hangartner T, Keller M, Chesnut CH 3rd, Brown J, Eriksen EF, Hoseyni MS, Axelrod DW, Miller PD. Effects of risedronate treatment on vertebral and nonvertebral fractures in women with postmenopausal osteoporosis: a randomized controlled trial. Vertebral Efficacy With Risedronate Therapy (VERT) Study Group. JAMA. 1999 Oct 13;282(14):1344-52. PubMed PMID: 10527181.

      6. Reginster J, Minne HW, Sorensen OH, Hooper M, Roux C, Brandi ML, Lund B, Ethgen D, Pack S, Roumagnac I, Eastell R. Randomized trial of the effects of risedronate on vertebral fractures in women with established postmenopausal osteoporosis. Vertebral Efficacy with Risedronate Therapy (VERT) Study Group. Osteoporos Int. 2000;11(1):83-91. PubMed PMID: 10663363.

      7. Black DM, Delmas PD, Eastell R, Reid IR, Boonen S, Cauley JA, Cosman F, Lakatos P, Leung PC, Man Z, Mautalen C, Mesenbrink P, Hu H, Caminis J, Tong K, Rosario-Jansen T, Krasnow J, Hue TF, Sellmeyer D, Eriksen EF, Cummings SR; HORIZON Pivotal Fracture Trial. Once-yearly zoledronic acid for treatment of postmenopausal osteoporosis. N Engl J Med. 2007 May 3;356(18):1809-22. PubMed PMID: 17476007.

      8. Lyles KW, Colón-Emeric CS, Magaziner JS, Adachi JD, Pieper CF, Mautalen C, Hyldstrup L, Recknor C, Nordsletten L, Moore KA, Lavecchia C, Zhang J, Mesenbrink P, Hodgson PK, Abrams K, Orloff JJ, Horowitz Z, Eriksen EF, Boonen S; HORIZON Recurrent Fracture Trial. Zoledronic acid and clinical fractures and mortality after hip fracture. N Engl J Med. 2007 Nov 1;357(18):1799-809. Epub 2007 Sep 17. PubMed PMID: 17878149.

      9. Chesnut III CH, Skag A, Christiansen C, Recker R, Stakkestad JA, Hoiseth A, Felsenberg D, Huss H, Gilbride J, Schimmer RC, Delmas PD; Oral Ibandronate Osteoporosis Vertebral Fracture Trial in North America and Europe (BONE). Effects of oral ibandronate administered daily or intermittently on fracture risk in postmenopausal osteoporosis. J Bone Miner Res. 2004 Aug;19(8):1241-9. Epub 2004 Mar 29. PubMed PMID: 15231010.

      10. Cummings SR, San Martin J, McClung MR, Siris ES, Eastell R, Reid IR, Delmas P, Zoog HB, Austin M, Wang A, Kutilek S, Adami S, Zanchetta J, Libanati C, Siddhanti S, Christiansen C; FREEDOM Trial. Denosumab for prevention of fractures in postmenopausal women with osteoporosis. N Engl J Med. 2009 Aug 20;361(8):756-65. doi: 10.1056/NEJMoa0809493. Epub 2009 Aug 11. Erratum in: N Engl J Med. 2009 Nov 5;361(19):1914. PubMed PMID: 19671655.

      11. Messori A, Fadda V, Maratea D, Trippoli S. The need to know crude event rates in meta-analysis. Am Heart J. 2013 Sep;166(3):e17. doi: 10.1016/j.ahj.2013.06.016. Epub 2013 Jul 25. PubMed PMID: 24016516.

      12. OMA software (OMA, Open Meta-Analyst version 4.16.12, Tufts University, U.S., url http://tuftscaes.org/open_meta/)


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2015 Oct 22, George McNamara commented:

      This paper (ACP branded, the original publication) may now be open access at

      http://downloads.hindawi.com/journals/acp/2012/904828.pdf


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    2. On 2013 Nov 15, George McNamara commented:

      Instead of citing this reference (IOS Press repackages many of its manuscripts to expand its bundles to make more money), please cite our original publication:

      Spectral imaging in preclinical research and clinical pathology. Levenson R, Beechem J, McNamara G. Anal Cell Pathol (Amst). 2012;35(5-6):339-61. doi: 10.3233/ACP-2012-0062. Review. PMID: 22475632


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 May 11, Chetan Mandelia commented:

      Author Comment- This study was done back in 2009 when smart-phones and internet access through mobile phones were very limited, at least in India. Would be very interesting to see the prevalence of "Ringxiety" in present times.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Jul 25, Serge Ahmed commented:

      Thanks for your comments on my previous comments which, contrary to what you claim, were not based on “incorrect assumptions”. I leave the readers to judge for themselves. Here I just want to persist and sign for the sake of clarification. There is no solid evidence for compulsive cocaine use in your study. Mice gave up easily on cocaine and this apparently, I now learn from your comments, regardless of strain differences. I agree that your study was not designed to directly compare the motivation for food with that for cocaine. But still it shows that mice are able to produce hundreds of responses to obtain certain rewards of importance to them. The fact that mice are able to but do not expand a comparable level of effort to obtain cocaine shows that they are not that motivated for cocaine. More specifically, it shows that even after several weeks of cocaine intake, the motivation for cocaine fails to acquire a degree of intensity that approaches that for food in hungry mice. This is perhaps one of the reasons why mice were trained on a FR1 for cocaine in your study and not on a FR10 like for food. Finally, your operational measure of “perseverative responding” is difficult to interpret because the introduction of the drug-off periods also considerably influences cocaine self-administration during the drug-on periods. Judging from Figure 1, cocaine self-administration rapidly becomes very irregular, with short and long inter-injection intervals. As a result, some of the inter-injection intervals during the drug-on periods are much longer than the drug-off periods themselves, making behavior during the latter periods quite difficult to interpret!


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    2. On 2014 Jul 22, Veronica Alvarez commented:

      Thanks for your interest in our study. These are interesting comments but based on incorrect assumptions. First, the behavioral score is a combination of breakpoint and responding during the time out period and thus it asses/compounds the individual variability in the incentive motivation for cocaine and the inability to restrain responding when the drug is not available (even when it is an anticipatory response and subjects “are unable to wait until the end of the drug period”). Second, the comparison of breakpoint for cocaine and food is an unfair comparison under these conditions. Mice responding for food were under caloric restriction and must work during the session to earn their remaining daily caloric requirement. This is a very different situation than for cocaine and the incentive motivation for food and cocaine are just incomparable. In addition, mice trained on FR1 for cocaine and FR10 for food which will influence the breakpoint values. The study was not designed to compare breakpoints for cocaine and food. Third, there is no effect of CNO per se. The effect seen corresponds to activation of Gi-coupled DREADDS in indirect-pathway D2-receptor expressing neurons in the NAc which is shown to inhibit the output (GABA transmission) of these neurons and increase the breakpoint for cocaine compared to days the same mice received saline (Fig. 4). The difference in responding between mice in Fig. 1-3 and mice in Fig. 4 and 5 is due to the fact that these are two different strains of genetically engineered mice. Experiments in Fig. 1-3 utilized Drd1a-GFP mice (Swiss Webster background) to identity direct- and indirect-pathway neurons while experiments in Fig. 4 and 5 used Adora2a-Cre-/+ mice (C57Bl6 background) to selectively manipulate the activity of indirect pathway neurons using DREADDs or ChR2. Contrary to the comment’s statement, responding was higher for mice of C57Bl6 background (35±9.5 mg/kg/day) than mice of SW background (18.7±6.1 mg/k/day) but the rate of responding might not be so different are the sessions were longer for C57Bl6 mice and there was no drug-off period.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    3. On 2014 Jan 28, Serge Ahmed commented:

      This study is very interesting but it also has several potential problems that may limit its relevance to understand the neural basis of compulsive cocaine use. First, there is no solid evidence for compulsive cocaine use in this study. For instance, mice were clearly able to inhibit cocaine seeking at the onset of the signaled drug-off periods. What they seemed unable to do was to wait until the end of the drug-off periods before resuming responding. This behavior may merely reflect an anticipation of cocaine availability at the end of the drug-off periods and not a compulsion (see: http://www.ncbi.nlm.nih.gov/pubmed/22985696). In addition, PR responding for cocaine was very low in this study and, in fact, 10-30 times lower that PR responding for food (i.e., about 50 versus 1000 responses per PR sessions for cocaine and food, respectively). In other words, mice gave up quickly on cocaine, without spending much effort. Calling this behavior “compulsive” or even “compulsive-like” is excessive. Finally, the facilitatory effects of CNO-induced inhibition of D2-MSNs on PR responding for cocaine should be interpreted with caution. These effects were seen in a small group of mice (n = 6) that had an atypical low baseline (i.e., saline) level of PR responding compared to the other groups from this study (i.e., 18.7±6.1 versus 35±9.5, 41.5±18.2 or 59.2±24.1). In fact, PR responding following CNO-induced inhibition of D2-MSNs did not differ from baseline responding in these other groups.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2013 Jun 29, Andries Zijlstra commented:

      In addition to the specific experimental findings, this article demonstrates that: 1) Regulating a molecular mechanism of migration can be an independent predictor of patient survival. 2) For molecular mechanism that drive cancer, the protein availability and function and not gene-expression correlate to disease progression and patient outcome.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2013 Oct 24, Tom Kindlon commented:

      None


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    2. On 2013 Oct 24, Tom Kindlon commented:

      (rest of references)

      7 Moss-Morris R, Sharon C, Tobin R, Baldi JC. A randomized controlled graded exercise trial for chronic fatigue syndrome: outcomes and mechanisms of change. Journal of Health Psychology 2005; 10:245-59.

      8 White P, Goldsmith K, Johnson A, Potts L, Walwyn R, Decesare J, et al. Comparison of adaptive pacing therapy, cognitive behaviour therapy, graded exercise therapy, and specialist medical care for chronic fatigue syndrome (PACE): a randomised trial. Lancet 2011; 377:823–36.

      9 McCrone P, Sharpe M, Chalder T, Knapp M, Johnson AL, Goldsmith KA, et al. Adaptive Pacing, Cognitive Behaviour Therapy, Graded Exercise, and Specialist Medical Care for Chronic Fatigue Syndrome: A Cost-Effectiveness Analysis. PLoS ONE 2012; 7(8):e40808.

      10 Haywood KL, Staniszewska S, Chapman S. Quality and acceptability of patient-reported outcome measures used in chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): a systematic review. Quality of Life Research 2012; 21:35-52.

      11 Collin SM, Crawley E, May M, Sterne JA, Hollingworth W, UK CFS/ME National Outcomes Database ME. The impact of CFS/ME on employment and productivity in the UK: a cross-sectional study based on the CFS/ME National Outcomes Database. BMC Health Services Research 2011; 11:217.

      (By the way, the reason I deleted another comment on this paper was simply because PubMed Commons had posted the same comment by me twice)


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    3. On 2013 Oct 24, Tom Kindlon commented:

      Objective outcome data from the chronic fatigue syndrome specialist services would have been interesting

      It is disappointing that Crawley et al.<sup>1</sup> presented no objective outcome data from the six chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) specialist services; an audit of Belgian CFS rehabilitation centres that used cognitive behavioural therapy (CBT) and graded exercise therapy (GET) found that, while improvements were reported with various subjective measures, no change was noted with exercise testing.<sup>2-4</sup> Moreover, there was actually a decrease in average hours in paid employment, from 18.3% of a 38 hour-working week to 14.9%.

      Discrepancies between subjective and objective measures have also been found in trials of both CBT<sup>5,6</sup> and GET for CFS.<sup>7</sup> Indeed, in the PACE Trial (which compared to the specialist services reported similar improvements on the Chalder Fatigue questionnaire (CFQ) but better SF-36 physical functioning (PF) scores), although moderate sized improvements were found with self-report instruments like the CFQ and SF-36 PF, differences with more objective measures were smaller, if they existed at all.<sup>8,9</sup> For example, there was no difference between the CBT and specialist medical care only (SMC) groups on the six minute walking test.<sup>8</sup> And no difference between SMC and both CBT and GET in terms of employment losses, overall service costs, welfare benefits or other financial payments.<sup>9</sup>

      Research on patient-reported outcome measures, and measures of improvement that CFS patients consider important, is underdeveloped.<sup>10</sup> Given the known considerable impact of CFS/ME on productivity and employment in those attending such services, it is reasonable to speculate that many patients, and indeed other taxpayers, would find employment data of more interest.<sup>11</sup>

      References:

      1 Crawley E, Collin SM, White PD, Rimes K, Sterne JAC, May MT, et al. Treatment outcome in adults with chronic fatigue syndrome: a prospective study in England based on the CFS/ME National Outcomes Database. QJM first published online March 28, 2013 doi:10.1093/qjmed/hct061

      2 Rapport d’évaluation (2002-2004) portant sur l’exécution des conventions de rééducation entre le Comité de l’assurance soins de santé (INAMI) et les Centres de référence pour le Syndrome de fatigue chronique (SFC). 2006. http://www.inami.fgov.be/care/fr/revalidatie/general-information/studies/study-sfc-cvs/pdf/rapport.pdf. Accessed March 30, 2013 (French language edition)

      3 Evaluatierapport (2002-2004) met betrekking tot de uitvoering van de revalidatieovereenkomsten tussen het Comité van de verzekering voor geneeskundige verzorging (ingesteld bij het Rijksinstituut voor Ziekte- en invaliditeitsverzekering) en de Referentiecentra voor het Chronisch vermoeidheidssyndroom (CVS). 2006. Available online: http://www.inami.fgov.be/care/nl/revalidatie/general-information/studies/study-sfc-cvs/pdf/rapport.pdf. Accessed March 30, 2013 (Dutch language version)

      4 Stordeur S, Thiry N, Eyssen M. Chronisch Vermoeidheidssyndroom: diagnose, behandeling en zorgorganisatie. Health Services Research (HSR). Brussel: Federaal Kenniscentrum voor de Gezondheidszorg (KCE); 2008. KCE reports 88A (D/2008/10.273/58) https://kce.fgov.be/sites/default/files/page_documents/d20081027358.pdf Accessed March 30, 2013

      5 Wiborg JF, Knoop H, Stulemeijer M, Prins JB, Bleijenberg G. How does cognitive behaviour therapy reduce fatigue in patients with chronic fatigue syndrome? The role of physical activity. Psychological Medicine 2010; 40:1281–1287.

      6 Knoop H, Prins JB, Stulemeijer M, van der Meer JW, Bleijenberg G. The effect of cognitive behaviour therapy for chronic fatigue syndrome on self-reported cognitive impairments and neuropsychological test performance. Journal of Neurology, Neurosurgery & Psychiatry 2007; 78:434-446.

      (references continue in next message)


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2013 Jul 10, Julia Gilden commented:

      This is a nice little paper that might explain the frustrations of researchers having trouble with consistent ectopic expression. The authors speculate in the discussion that reduced RNA Polymerase I transcription at high densities may reflect a developmental transition toward the short stumpy form of the parasite. It is not clear, however, what the authors think this reduced RNA Pol I activity might accomplish, particularly because (as they point out) procyclin transcription is RNA Pol I-dependent, and a switch to the procyclin coat must be induced upon uptake by the fly.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Jul 12, Jorge H Ramírez commented:

      The overall quality of this randomized clinical trial is poor:

      • Limited time of follow-up (12 weeks) to determine the safety and effectiveness of an active pharmacological principle or a fixed-dose combination (i.e., solifenacin plus tamsulosin).

      • No appropriate description of the interventions in each study arm

      • The study evaluates surrogate instead of definitive outcomes.

      • No description of allocation concealment mechanisms.

      • No description of sample size calculation.

      • The full text article does not specify dates for patient recruitment and follow-up

      • No description of methods used to generate the random sequence used in the randomization of patients to each study arms

      • The article does not describe methods for the implementation of the random sequence.

      • No appropriate description of blindings in the study.

      • No intention-to-treat analysis

      • Cardiovascular adverse events were not appropriately described in this article.

      • Haemodynamic variables were not included as primary or secondary outcomes in this study.

      Tamsulosin is a nonuroselective alpha blocker associated with severe hypotension in men.(1,2) Moreover, over three quarters of the studies with tamsulosin in humans are unpublished.(3)

      References

      1. Bird Steven T, Delaney Joseph A C, Brophy James M, Etminan Mahyar, Skeldon Sean C, Hartzema Abraham G et al. Tamsulosin treatment for benign prostatic hyperplasia and risk of severe hypotension in men aged 40-85 years in the United States: risk window analyses using between and within patient methodology BMJ 2013; 347:f6320 http://www.bmj.com/content/347/bmj.f6320

      2. Ramirez Jorge. Severe hypotension associated with α blocker tamsulosin BMJ 2013; 347:f6492 http://www.bmj.com/content/347/bmj.f6492

      3. Ramirez, Jorge H (2014): Expression of concern about tamsulosin: over three quarters of human studies are unpublished. figshare. http://dx.doi.org/10.6084/m9.figshare.1094338 URL:http://figshare.com/articles/Expression_of_concern_about_tamsulosin_over_three_quarters_of_human_studies_are_unpublished/1094338


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2013 Jul 17, James Troendle commented:

      The section on the importance of interim monitoring leaves out one important drawback to sequential studies when the sequential design is motivated by reducing the sample size. Yes, sequential studies can on average reduce the sample size. However, they do that by delivering reduced precision of the effect estimate. This reduction in precision of the final estimate is often ignored when a decision is made about whether to adopt a sequential or fixed design.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Jan 01, José Morales Roselló commented:

      Like many other psicological disorders in the past, science goes behind reality. In this syndrome, children have an absolutely normal father (or mother) but have been programmed to hate him. The hate and the attitude of the children have no correlation with the father behaviour, and have more to do with a subtle denigration campaign with a mother (or father) origin. The original syndrome descriptions made by Gardner are easily found in most of the cases.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Jun 20, Christos Chinopoulos commented:

      Could it be that LPS-induced succinate over-production is due to itaconate formation? LPS induces Irg1, a gene

      coding for cis-aconitate decarboxylase, specifically expressed in cells of macrophage lineage Proc Natl Acad Sci

      U S A. 2013 May 7;110(19):7820-5. doi: 10.1073/pnas.1218599110, yielding itaconate. Itaconate is preferentially

      used by succinyl CoA ligase forming itaconyl CoA, thus generating an accumulation of succinate when the ligase

      operates towards succinyl CoA formation ADLER J, WANG SF, & Lardy HA (1957) The metabolism of itaconic acid by

      liver mitochondria. J. Biol. Chem, 229, 865-879, and WANG SF, ADLER J, & Lardy HA (1961) The pathway of

      itaconate metabolism by liver mitochondria. J. Biol. Chem, 236, 26-30.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2016 Sep 27, Andrea Messori commented:

      Modeling the economic consequences of inhibitor development in previously untreated patients with severe hemophilia A

      By Andrea Messori, HTA Unit, Regional Health System, 50100 Firenze (Italy)

      Background

      If one performs a PubMed search using the keywords “Markov AND (haemophilia OR hemophilia) AND inhibitors”, only 4 articles are retrieved (published in 2013, 2003, 2003, and 2000). This demonstrates that, despite its potential advantages, the use of Markov models in haemophilia patients is still very limited. In the past 10 years, the study by Farrugia and co-workers (Haemophilia. 2013 Jul;19:e228-38.) is the only example of a Markov model designed to handle the data of patients with severe disease and inhibitors. Quite recently, we have developed a similar model that has not yet been formally published. Hence, this Comment has the purpose to describe the main characteristics of our model.

      Model description

      Our model is represented in Figure 1 (link to display this figure: http://www.osservatorioinnovazione.net/papers/markov-hemophilia-figure1.gif ). A commercial software (TreeagePro, Treeage Software Inc., 2011 version, Williamstown, MA, USA) has been employed for its development. Briefly, the core of the model is a decision node (not shown in Figure 1) from which two branches originate, the first describing the patients assigned to recombinant factor VIII (Panel A in Figure 1) and the second those assigned to plasma-derived factor VIII (Panel B in Figure 1). A total of 10 health states are included in the Markov model (see the Appendix reported below for further details). The purpose of the model is to carry out a budget impact analysis in which the replacement therapy and the treatment of inhibitors are the main cost items. The transition probabilities that manage how patients move across the health states are also presented in Figure 1 (Panels A and B). Probabilities with values of 0 or 1 are self-explanatory; accordin to the syntax of TreeagePro, the symbol “#” identifies a probability equal to the value needed to reach 100% after taking into account the other probability/probabilities directly expressed in numerical form and assigned to the other branch(es) of the same node. In each of the two main sections of the model (i.e. recombinant factor VIII [Panel A] and plasma-derived factor VIII [Panel B]), the Markov analysis incorporates the adjustment for annual discount rates and traces the number of cycles evaluated in the iterative process. According to the Markov approach, costs incurred in the model are iteratively summed upon each cycle. Three items participate in the cost analysis, namely the annual cost per patient treated with recombinant factor VIII (denoted as “annualcostric”), the annual cost per patient treated with plasma-derived factor VIII (denoted as “annualcostpd”), and the cost per patient of immunotolerance therapy (denoted as “costofIT”). As regards the syntax of the Treeage software, cost data are handled as “incremental rewards” (denoted as “Incr Rwd”). In other words, the variable “Rewards” was used to cumulate the various cost data at each cycle. The TreeagePro code needed for running the model is available from th author upon request.

      Appendix. Detailed description of the 10 health states included in the Markov model

      The main health states included in the recombinant branch of the model (ordered bottom-up according to Panel A of Figure 1) are the following: a) state denoted as “Without” in which patients assigned to heath-state ( c) are assumed not to develop high-titer inhibitors and then move to the health state “all-people-final-ric”; b) state denoted as “With” in which patients assigned to heath-state ( c) are assumed to develop high-titer inhibitors and then move to the health state “IT-ric”; c) state denoted as “all people ric” in which patients treated with recombinant factor VIII proceed in their Markov iterative process and are exposed to the risk of developing high-titer inhibitors; d) state denoted as “all-people-final-ric” in which patients treated with recombinant factor VIII (irrespective of whether they have developed or not high-titer inhibitors) proceed in their Markov iterative process until the end of the time horizon without being any longer exposed to the risk of developing high-titer inhibitors; e) state denoted as “IT-ric” in which patients treated with recombinant factor VIII who have developed high-titer inhibitors receive immune-tolerance therapy and move to the health state “post-IT-ric” and then to the health state “all-people-final-ric”. The main health states included in the plasma-derived branch of the model (ordered bottom-up according to Panel B of Figure 1) are the following: f) state denoted as “Without” in which patients assigned to heath-state (h) are assumed not to develop high-titer inhibitors and then move to the health state “all-people-final-pd”; g) state denoted as “With” in which patients assigned to heath-state (h) are assumed to develop high-titer inhibitors and then move to the health state “IT-pd”; h) state denoted as “all people ric” in which patients treated with recombinant factor VIII proceed in their Markov iterative process and are exposed to the risk of developing high-titer inhibitors; i) state denoted as “all-people-final-pd” in which patients treated with recombinant factor VIII (irrespective of whether they have developed or not high-titer inhibitors) proceed in their Markov iterative process until the end of the time horizon without being any longer exposed to the risk of developing high-titer inhibitors. j) state denoted as “IT-pd” in which patients treated with recombinant factor VIII who have developed high-titer inhibitors receive immune-tolerance therapy and move to the health state “post-IT-pd” and then to the health state “all-people-final-pd”. The model was designed to predict in these cohorts the expected expenditures, that were quantified on the basis of the (different) cumulative incidence of high-titer inhibitors and the (different) cost of the replacement products between the cohorts. It should be noted that some health states assigned, in Figure 1, to the first-level branches of both Panels A and B (governed by the Markov node) are not reachable at the first cycle of the Markov process (i.e. probability = 0 at this cycle), but are designed to be reached from the second-level branches, associated with the development or not of high-titer inhibitors. Finally, although the Treaage software allows to manage other variables participating in the calculation of rewards (namely: initial reward denoted as “Init Rwd”, which is summed upon entry in the health state; and: final reward denoted as “Fin Rwd”, which is summed upon exit from the health state), these were not necessary for the purposes of our model and were therefore kept at 0 (as illustrated in the two panels of Figure 1).


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2013 Jun 14, Sebastian Schneeweiss commented:

      Nice summary of assumptions and the issues arising when doing 1:1:1 matching with testing of several algorithms. If you plan PS matching of several treatment groups this is worth reading.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Jan 31, Huiqi Qu commented:

      Evolutionary selection evidence on synonymous codon usage was observed in this study. Email: huiqi.qu@gmail.com


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2015 Mar 29, Harri Hemila commented:

      Impure placebo as an unsound concept and other problems in the paper by Howick et al. (2013).

      A number of problems in the Howick et al. paper are described at the PLoS ONE comment page and the comments are also available as a separate document with A4 layout.

      The above mentioned criticism was formulated to a regular paper by Louhiala P, 2015.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2016 Sep 27, UFRJ Neurobiology and Reproducibility Journal Club commented:

      We’d like to point out that in the legends of all figures in these article (except for Figure 7), the authors mention that data is presented as mean +- s.e.m.; nevertheless, in some of these figures (e.g. 2F, 3B, 3C and 3F), the error bars are clearly asymmetric. As standard errors of the mean are symmetric by definition, this seems to indicate that the data does not match the description in the legend. Therefore, the authors should clarify what the error bars presented stand for, as different kinds of error bars represent very different things and can lead to different inferences about the data (Cumming G, 2007; Krzywinski M, 2013).


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2015 Jan 31, George McNamara commented:

      I hope the US patent office rejects their patent application based on prior art - MVI has been selling DarkLite adapter since 2000 or earlier (possibly a decade earlier), see http://www.mvi-inc.com/products/microscopy-accessories/darklite-for-autoradiography/


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Mar 07, Arnaud Chiolero MD PhD commented:

      A strong argumentation against the idea that having free access to all kind of (big-)data will lead eventually to better research


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2016 Apr 03, Ariel Fernandez commented:

      Protein folding in vitro is a spontaneous process [1]. This means it is irreversible in the thermodynamic sense [2]. The endpoints of the folding process, the native state and the denatured ensemble, may be recovered by restoring renaturing or denaturing conditions, respectively. Thus, at a variance with thermodynamics, this is what protein scientists usually mean when they claim that protein folding is reversible [1]. On the other hand, according to the tenets of thermodynamics, the folding and unfolding pathways themselves are untraceable and irreproducible [2]. In fact the very notion of “pathway” for a spontaneous process is thermodynamically meaningless or at least questionable. Dissipative forces intervene in the folding process producing a net increase in the entropy of the universe, and this is the hallmark of irreversibility. Therefore, the intermediate states associated with the folding process are irretrievable, as it would be the case for any spontaneous process in nature or in the lab.

      Notwithstanding these thermodynamic considerations, a very active quest for folding intermediates continues to this day [3]. This search may be futile, probably meaningless from a thermodynamic perspective, unless some sort of paradox holds that, at the very least, needs to be properly dispelled. To the best of my knowledge this has not been done. Real folding intermediates are not only very difficult to trap: they do not exist per se, plain and simple. Any claim to the contrary inevitably violates the second law of thermodynamics.

      Even more puzzling are the efforts to characterize folding intermediates by denaturing the native state (however carefully [4]). As the second law of thermodynamics tells us, the denaturation process is not the reverse of the folding process: only the endpoints are reversed. To discourage efforts in this direction, it would be more eloquent to resort to an analogy. Imagine you need to describe the way a standing house has been put together. No one in his/her right mind would address the problem by having the house demolished (however carefully), taking snapshots at different stages of demolition and then playing the movie backwards. Yet, intriguingly, a similar reasoning has been assumed to hold mutatis mutandis in the context of protein folding [5]. This accumulation of seeming contradictions may well lead to a paradox - and thermodynamics is full of those - and at the very least the paradox demands proper clarification in thermodynamic terms before the saga for the quest of folding intermediates continues. Ariel Fernandez

      References

      1. Anfinsen, C.B. Science 181, 223-230 (1973).

      2. Planck, M. Treatise on Thermodynamics, 3rd edition, Dover, New York (2010).

      3. Vendruscolo M. & Dobson, C.M. Nature Chem. Biol. 9, 216-217 (2013).

      4. Jaremko, M., Jaremko, Ł., Kim, H.Y., Cho, M.K., Schwieters, C.D., Giller, K., Becker, S. & Zweckstetter, M. Nature Chem. Biol. 9, 264-270 (2013).

      5. Fernandez, A. Biomolecular Interfaces (ISBN 978-3-319-16849-4), Springer, Berlin (2015).


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Nov 14, Christopher Southan commented:

      While they followed Roche into BACE2-inhibition patents for diabetes, Novartis have since published a abstract contradicting the target status http://cdsouthan.blogspot.se/2014/12/bace2-as-diabetes-target-or-maybe-not.html


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    2. On 2014 Feb 22, Christopher Southan commented:

      The 46 PubChem structures refered to in this article can be retrieved via http://www.ncbi.nlm.nih.gov/sites/myncbi/collections/public/1zuPd27ihNyflkXH7XHUWAU5L/ The CIDs are specified in the text, with activity values aligned to the example numbers. Note SureChEMBL SIDs may connect to the patents where addtional SAR data can be found. An open version of the PMID:23506624 text can be found at http://figshare.com/articles/BACE2_as_a_new_diabetes_target_a_patent_review_2010_2012_/977844


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2017 Jul 31, Boris Barbour commented:

      The restrictive journal correspondence format might allow the impression that there remains some uncertainty about these issues, but in my opinion there is none. I have added my viewpoint under the original commentary.

      https://www.ncbi.nlm.nih.gov/pubmed/22572946#cm22572946_73372


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2017 Aug 05, Fernando Castro-Chavez commented:

      Dear Reader, in this work I had the opportunity to use the novel technology of 3-D magnetic levitation to produce human Vascular Smooth Muscle Cells (VSMC) calcifying after the addition of Lyso Phosphatidyl Choline (LPC), it took me a couple of years to optimize every detail to obtain the most amazing images of those spherical clusters secreting the calcium Hydroxyl Apatite (HA) in an ordered and organized manner; so, we saw that the LPC (a traveler on the surface of the LDL) is the main culprit of Atherosclerosis, because it acts as detergent of the VSMC, so, actually their efforts at calcification, trans-differentiating into osteogenic cells is their strategy of survival to continue alive. The SHN3 slightly delayed the process. Att., Fernando Castro-Chavez.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Jan 15, Hirotaka Shoji commented:

      "ImageLD/EP/TM", image analysis application softwares used for behavioral analysis in this article, are now freely available from http://www.mouse-phenotype.org/software.html.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2013 Oct 31, John Cannell commented:

      The authors reported that immune system dysregulation is common in autism spectrum disorder (ASD”. Vitamin D deficiency produces very similar immune dysregulation.

      Prietl B, 2013

      Kamen DL, 2010

      Yang CY, 2013

      Baeke F, 2010

      Thus the vitamin D theory of ASD (vitamin D deficiency being the environmental risk factor for this highly heritable disorder) is consistent with the authors work. Three recent studies, using community controls, have found 25(OH)D levels are significantly lower in children with ASD. Two of the studies below (Mostafa et al and Gong et al) also found ASD severity, as rated on standard ASD rating scales, is inversely correlated with 25(OH)D levels. Mostafa et al found an R value of -.86 for the association of serum 25(OH)D with ASD severity.

      Gong ZL, Luo CM, Wang L, Shen L, Wei F, Tong RJ, Liu Y. Serum 25-hydroxyvitamin D levels in Chinese children with autism spectrum disorders. Neuroreport. 2013 Oct 1. Gong ZL, 2014

      Meguid NA, Hashish AF, Anwar M, Sidhom G. Reduced serum levels of 25-hydroxy and 1,25-dihydroxy vitamin D in Egyptian children with autism. J Altern Complement Med. 2010 Jun;16(6):641-5. Meguid NA, 2010

      Mostafa GA, Al-Ayadhi LY.Reduced serum concentrations of 25-hydroxy vitamin D in children with autism: relation to autoimmunity. J Neuroinflammation. 2012 Aug 17;9:201. Mostafa GA, 2012

      There is a plethora of basic science explaining why low gestational or early childhood 25(OH)D levels would adversely effect brain development.

      Eyles DW, Feron F, Cui X, Kesby JP, Harms LH, Ko P, McGrath JJ, Burne TH. Developmental vitamin D deficiency causes abnormal brain development. Psychoneuroendocrinology. 2009 Dec;34 Suppl 1:S247-57. doi: 10.1016/j.psyneuen.2009.04.015. Epub . Review. Eyles DW, 2009

      DeLuca GC, Kimball SM, Kolasinski J, Ramagopalan SV, Ebers GC. Review: the role of vitamin D in nervous system health and disease. Neuropathol Appl Neurobiol. 2013 Aug;39(5):458-84. doi: 10.1111/nan.12020. DeLuca GC, 2013

      Eyles DW, Burne TH, McGrath JJ. Vitamin D, effects on brain development, adult brain function and the links between low levels of vitamin D and neuropsychiatric disease. Front Neuroendocrinol. 2013 Jan;34(1):47-64. doi: 10.1016/j.yfrne.2012.07.001. Epub 2012 Jul 11. Review. Eyles DW, 2013

      Furthermore, the vitamin D theory of autism explains most of the epidemiological facts of ASD.

      Cannell JJ. On the aetiology of autism. Acta Paediatr. 2010 Aug;99(8):1128-30. Cannell JJ, 2010

      Cannell JJ. Autism and vitamin D. Med Hypotheses. 2008;70(4):750-9. Cannell JJ, 2008

      70% of American toddlers do not take the American Pediatric Association's recommended vitamin D supplement of 400 IU/day and few toddlers or pregnant women get any sunshine due to the sun scare. As vitamin D fortified milk consumption and sun exposure has declined, so have toddlers and pregnant women’s vitamin D levels. The dramatic increase in the incidence of ASD occurred during the same time vitamin D levels were falling in toddlers and pregnant women.

      Cannell JJ. Autism, will vitamin D treat core symptoms? Medical Hypotheses. 2013 Aug;81(2):195-8. Cannell JJ, 2013

      Some autism researchers seem cognizant of the entire body of autism research. For example, a group of well-known European ASD researchers, including Professor Christopher Gillberg of the Gillberg Neuropsychiatric Institute, have recently called for the need for “urgent research” into the vitamin D deficiency theory of ASD.

      Kočovská E, Fernell E, Billstedt E, Minnis H, Gillberg C. Vitamin D and autism: clinical review. Res Dev Disabil. 2012 Sep-Oct;33(5):1541-50. doi: 10.1016/j.ridd.2012.02.015. Epub 2012 Apr 21.Kočovská E, 2012

      Until all autism researchers become cognizant of the wider body of scientific research, we will continue to wonder how to prevent - and perhaps even treat - this modern day plague.

      John J Cannell, MD

      Vitamin D Council

      http://www.vitamindcouncil.org


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2013 Jul 01, lu tian commented:

      It is a very interesting idea of using observable short-term event information such as PFS status up to a landmark time point to predict the long term survival status. Predicting the residual life based on most updated current information (including short-term event status) is THE real-life problem. The "baseline" used in traditional survival analysis is somewhat artificial and pertains to the study from which the data is collected.

      On the other hand, it will be interesting to study the proposed prediction performance measure such as AUC as a function of time t0, i.e., the landmark time. This can provide useful information on the choice of landmark time to evaluate the short-term event status such as tumor growth to maximize the performance boost in the predicting the long-term event outcome.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2015 Oct 09, Simon Young commented:

      The authors of this study conclude “there was a statistically significant decrease on depression, stress, and mood disturbances scores among the intervention group”. They attribute this to the nutritional content of the Talbinah. However another explanation is more plausible. During the intervention period the participants received a single serving of Talbinah once a day, and during the control phase they received no nutritional supplement. Even if the participants were not aware of the belief that Talbinah improves mood before the study they would have been informed of this in description of the study in the consent form. Thus participants were fully aware of the fact that they were receiving a nutritional supplement thought to improve mood during one period and nothing in the other period. Given the lack of an active control group the expectations of the participants could have explained the changes seen when ingesting Talbinah. In this type of study a plausible placebo treatment is essential if the effect of an intervention is to be established. The authors discuss three potential mechanisms for the effect of Talbinah. The first is the effect of the carbohydrate in the Talbinah. The supplement contained 21.6g of carbohydrate per dose, which would obviously be a small percentage of the participants’ total daily carbohydrate intake and highly unlikely to alter mood significantly over the period of a day. While the paper includes information, on page 283, on nutrient intakes during intervention and control periods, results are given only for total calories (increased by 9.2% during the intervention period, although the Talbinah alone would have increased it by only 6.5%), zinc and magnesium. Although the authors must have had information on the increase in carbohydrate intake during the intervention, that information, surprisingly, is not included in the paper. The second potential mechanism is an increase in brain tryptophan and serotonin due to the tryptophan content of the Talbinah. The paper documents the fact that the ratio of trp:BCAA in Talbinah is much higher than in either milk or barley. However, the authors are not correct in stating on p.284 that “The amino acid composition of food is associated with brain serotonin levels, especially trp:BCAA and trp:LNCAA” and that “The ratio of trp:BCAA may have increased the tryptophan available to the brain”. As stated in the reference they cite in support of these statements (number 9 in the reference list) Wurtman RJ, 2003 “Brain tryptophan concentrations and the flux of tryptophan from blood to brain, depend, in turn, partly on plasma tryptophan and partly on plasma concentrations of ≥ 6 other large neutral amino acids (LNAAs): tyrosine, phenylalanine, leucine, isoleucine, valine, and methionine, which compete with tryptophan for blood-brain barrier transport”. The ratio of trp:BCAA is irrelevant as the brached chain amino acids are only some of the amino acids that compete with tryptophan for transport from blood to brain. The authors docment on page 284 of the manuscript that Talbinah has a low trp:LNAA ratio of 1:21. Given the low protein content of the Talbinah (1.2 g per dose, Table 1) and the low trp:LNAA ratio the Tablinah could not have increased brain tryptophan and serotonin to any appreciable extent. The third potential mechanism is an increase in zinc levels. Several studies have shown that zinc levels are often low in depressed patients. A recent review includes four studies on the effect of zinc on depressed mood Lai J, 2012. Two studies with a daily dose of 25 mg zinc showed an antidepressant effect in patients with major depression, while two other studies, one with a dose of 7 mg per day and the other with doses of 10.1 mg per day and 20.2 mg per day in different groups, did not reliably show an effect on mood in healthy people. In this paper the Tablinah increased mean zinc intake from 3.7 mg per day to 8.7 mg per day. There is no evidence that a supplemental dose of 5 mg per day of zinc can influence mood. In conclusion there is no plausible bioligcal mechanism for an effect of Talbinah, at the dose given, on mood. Given the way the study was designed the most plausible explanation for the effects on mood was a psychological mechanism, the expections of the participants.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2013 Dec 23, guoan zhang commented:

      this study is very helpful to clarify the role of aspirin in cancer prevention because of its big sample and long follow-up time.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2013 Oct 31, John Cannell commented:

      The authors reported that immune system dysregulation is common in autism spectrum disorder (ASD”. Vitamin D deficiency produces very similar immune dysregulation.

      Prietl B, 2013

      Kamen DL, 2010

      Yang CY, 2013

      Baeke F, 2010

      Thus the vitamin D theory of ASD (vitamin D deficiency being the environmental risk factor for this highly heritable disorder) is consistent with the authors work. Three recent studies, using community controls, have found 25(OH)D levels are significantly lower in children with ASD. Two of the studies below (Mostafa et al and Gong et al) also found ASD severity, as rated on standard ASD rating scales, is inversely correlated with 25(OH)D levels. Mostafa et al found an R value of -.86 for the association of serum 25(OH)D with ASD severity.

      Gong ZL, Luo CM, Wang L, Shen L, Wei F, Tong RJ, Liu Y. Serum 25-hydroxyvitamin D levels in Chinese children with autism spectrum disorders. Neuroreport. 2013 Oct 1. Gong ZL, 2014

      Meguid NA, Hashish AF, Anwar M, Sidhom G. Reduced serum levels of 25-hydroxy and 1,25-dihydroxy vitamin D in Egyptian children with autism. J Altern Complement Med. 2010 Jun;16(6):641-5. Meguid NA, 2010

      Mostafa GA, Al-Ayadhi LY.Reduced serum concentrations of 25-hydroxy vitamin D in children with autism: relation to autoimmunity. J Neuroinflammation. 2012 Aug 17;9:201. Mostafa GA, 2012

      There is a plethora of basic science explaining why low gestational or early childhood 25(OH)D levels would adversely effect brain development.

      Eyles DW, Feron F, Cui X, Kesby JP, Harms LH, Ko P, McGrath JJ, Burne TH. Developmental vitamin D deficiency causes abnormal brain development. Psychoneuroendocrinology. 2009 Dec;34 Suppl 1:S247-57. doi: 10.1016/j.psyneuen.2009.04.015. Epub . Review. Eyles DW, 2009

      DeLuca GC, Kimball SM, Kolasinski J, Ramagopalan SV, Ebers GC. Review: the role of vitamin D in nervous system health and disease. Neuropathol Appl Neurobiol. 2013 Aug;39(5):458-84. doi: 10.1111/nan.12020. DeLuca GC, 2013

      Eyles DW, Burne TH, McGrath JJ. Vitamin D, effects on brain development, adult brain function and the links between low levels of vitamin D and neuropsychiatric disease. Front Neuroendocrinol. 2013 Jan;34(1):47-64. doi: 10.1016/j.yfrne.2012.07.001. Epub 2012 Jul 11. Review. Eyles DW, 2013

      Furthermore, the vitamin D theory of autism explains most of the epidemiological facts of ASD.

      Cannell JJ. On the aetiology of autism. Acta Paediatr. 2010 Aug;99(8):1128-30. Cannell JJ, 2010

      Cannell JJ. Autism and vitamin D. Med Hypotheses. 2008;70(4):750-9. Cannell JJ, 2008

      70% of American toddlers do not take the American Pediatric Association's recommended vitamin D supplement of 400 IU/day and few toddlers or pregnant women get any sunshine due to the sun scare. As vitamin D fortified milk consumption and sun exposure has declined, so have toddlers and pregnant women’s vitamin D levels. The dramatic increase in the incidence of ASD occurred during the same time vitamin D levels were falling in toddlers and pregnant women.

      Cannell JJ. Autism, will vitamin D treat core symptoms? Medical Hypotheses. 2013 Aug;81(2):195-8. Cannell JJ, 2013

      Some autism researchers seem cognizant of the entire body of autism research. For example, a group of well-known European ASD researchers, including Professor Christopher Gillberg of the Gillberg Neuropsychiatric Institute, have recently called for the need for “urgent research” into the vitamin D deficiency theory of ASD.

      Kočovská E, Fernell E, Billstedt E, Minnis H, Gillberg C. Vitamin D and autism: clinical review. Res Dev Disabil. 2012 Sep-Oct;33(5):1541-50. doi: 10.1016/j.ridd.2012.02.015. Epub 2012 Apr 21.Kočovská E, 2012

      Until all autism researchers become cognizant of the wider body of scientific research, we will continue to wonder how to prevent - and perhaps even treat - this modern day plague.

      John J Cannell, MD

      Vitamin D Council

      http://www.vitamindcouncil.org


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Jul 25, Claudiu Bandea commented:

      Everlasting confusion on ‘functional DNA’ and ‘junk DNA’

      As discussed by Doolittle (1), addressing and defining the functionality of genomic DNA can be challenging. However, our common sense combined with our philosophical instinct - we know a function when we see one - should allow us to sensibly address the biology of our genome. After all, the ENCODE ‘function fiasco’ was not the result of misunderstanding the concept of biological function, nor was it due to scientific incompetence as suggested by others (2). On the contrary, because it conflicted with some of the project’s objectives and with its significance, there was a concerted effort not to bring this concept forward (3); indeed, as clearly shown in a recent ENCODE publication (4), at least some ENCODE members seem well aware of the scientific rationale and criteria for addressing putative biological functions for genomic DNA.

      Nevertheless, as concluded by Doolittle (1), poor use of words in communicating scientific observations, and lack of attention to detail have led to significant misrepresentations and confusion. Here are a few examples spanning more than four decades.

      In a recent study entitled “Multiple knockout mouse models reveal lncRNAs are required for life and brain,” which addressed putative biological functions of long noncoding RNAs (lncRNAs), it was concluded that “This study demonstrates that lncRNAs play critical roles in vivo…” (5). Unfortunately, both the title and the conclusion misrepresent the results; an accurate interpretation of the results is that “Multiple knockout mouse models reveal that some (or a few) lncRNAs are required for life and brain,” and that “This study demonstrates that some (or a few) lncRNAs play critical roles in vivo….” As a matter of fact, based on the results of the study, which showed that only 5 of the 18 lncRNAs, which have been selected from hundreds sequences as the best candidates for being functional, a more appropriate scientific interpretation would be: “This study demonstrates that most lncRNAs (i.e. 13 out of 18) do not appear to play critical roles in vivo….” Moreover, if the goal is to evaluate this study at the highest scientific standards (as presumably required by the journal eLife, where it was published), then, I would suggest that, due to lack of appropriate control experiments such as duplicated knockout experiments, we don’t know if the observed dysfunctions were associated with specific lncRNAs, or they were caused by untargeted genome modifications introduced accidentally during the procedure of generating knockout mice, which in fact questions the validly of the entire study. As previously noted (3), all these problems reflect the deficiencies of the current limited and closed peer review system; indeed, a document reviewed by a few peers (usually, 2 or 3) can hardly be considered peer-reviewed.

      The next three examples illustrate some of the confusion surrounding the concepts of biological function and junk DNA (jDNA), albeit in a more subtle way.

      In one of the first papers addressing the notion of jDNA (6), David Comings writes: “These considerations suggest that up to 20% of the genome is actively used and the remaining 80+% is junk. But being junk doesn’t mean it is entirely useless. Common sense suggests that anything that is completely useless would be discarded.”

      In their iconic paper “Selfish DNA: the ultimate parasite” (7), Leslie Orgel and Francis Crick, summarize their thoughts as follows: “The DNA of higher organisms usually falls into two classes, one specific and the other comparatively nonspecific. It seems plausible that most of the latter originated by the spreading of sequences which had little or no effect on the phenotype.”

      More recently, in a publication addressing the ENCODE project (8), Sean Eddy, remarked: “These data support a view that eukaryotic genomes contain a substantial fraction of DNA that serves little useful purpose for the organism, much of which has originated from the replication of transposable (selfish) elements.”

      Although seemingly innocent, these citations are relevant examples of poor use of words. Some of this confusion might dissipate by recognizing that: (i) if genomic sequences are not entirely useless, (ii) if they have little effect on the phenotype, or (iii) if they serve little useful purpose for the organism, then, these DNA sequences are functional, period.

      In the next example, the protagonists are Michael Eisen, the host of a popular blog suggestively named “it is NOT junk”, and Ryan Gregory, the host of another popular blog “Genomicron”. Interestingly, Eisen was the PNAS editor in charge of Doolittle’s article on jDNA (1), and, according to Doolittle, Gregory is “now the principal C-value theorist” (1). Undoubtedly, Eisen and Gregory are among the most knowledgeable and versed communicators on genome biology and jDNA and, therefore, their ‘words’ are representative of the thinking in the field.

      Immediately after the publication of ENCODE’s flurry of articles and the associated publicity stunt orchestrated by a few ENCODE scientists, both Eisen and Gregory reacted forcefully, but apparently from opposite perspectives. In a post in which he blasts ENCODE as “a carefully orchestrated spectacle” (9), Eisen writes: “nobody actually thinks that non-coding DNA is ‘junk’ any more. It’s an idea that pretty much only appears in the popular press… It is dishonest – nobody can credibly claim this to be a finding of ENCODE….”

      In a prompt response (10), entitled “Michael Eisen’s take on ENCODE — there’s no junk?”, Gregory goes into a detailed and cynical questioning of Eisen’s perspective. Fortunately, due to the open communication platform offered by these blogs, this scientific ‘drama’ ended within hours, when Eisen apparently clarified: “I was not saying that everybody knows that 100% of the genome is functional! I was saying that nobody thinks that 100% of non-coding DNA is non-functional” (10).

      Is there an end to this distressing confusion in the field of genome biology? Unlikely, if the funding system continues to focus primarily on generating data and observations, while neglecting their interpretation and integration into productive conceptual frameworks; in other words, you only get what you pay for.

      References

      (1) Doolittle WF. 2013. Is junk DNA bunk? A critique of ENCODE. Proc Natl Acad Sci USA., 110:5294-300. Doolittle WF, 2013

      (2) Graur D et al., 2013. On the immortality of television sets: "function" in the human genome according to the evolution-free gospel of ENCODE. Genome Biol Evol., 5:578-90. Graur D, 2013

      (3) Bandea CI. 2014. Closing the gap between ‘words’ and ‘facts’ in evaluating genome biology and the ENCODE project. PubMed Commons (National Library of Medicine; Bethesda, MD). Comment on: Doolittle WF, 2013

      (4) Kellis M. et al., 2014. Defining functional DNA elements in the human genome. Proc Natl Acad Sci USA., 111:6131-8. Kellis M, 2014

      (5) Sauvageau M. et al., 2014. Multiple knockout mouse models reveal lincRNAs are required for life and brain development. eLife (DOI: 10.7554/eLife.01749) Sauvageau M, 2013

      (6) Comings DE.1972. The structure and function of chromatin. Adv Hum Genet. 3:237-431. Comings DE, 1972

      (7) Orgel LE, Crick FH. 1980. Selfish DNA: the ultimate parasite. Nature. 284:604-7. Orgel LE, 1980

      (8) Eddy SR. 2012. The C-value paradox, junk DNA and ENCODE. Curr Biol. 22:898-9. Eddy SR, 2012

      (9) Eisen M. 2012. This 100,000 word post on the ENCODE media bonanza will cure cancer. Blog: it is NOT junk. http://www.michaeleisen.org/blog/?p=1167

      (10) Gregory TR. 2012. Michael Eisen’s take on ENCODE — there’s no junk? Blog: Genomicron. http://www.genomicron.evolverzone.com/2012/09/michael-eisens-take-on-encode-theres-no-junk/


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    2. On 2014 Jul 16, Claudiu Bandea commented:

      Closing the gap between ‘words’ and ‘facts’ in evaluating genome biology and the ENCODE project

      When I referred to Ford Doolittle’s article (1) as “7 pages of small print text” (2), I meant it both, literary and figuratively. Indeed, Doolittle’s paper is a remarkable example of fine print, which is likely to induce heated arguments for a long time, just as the author concluded: “many of the most heated arguments in biology are not about facts at all but rather about the words that we use to describe what we think the facts might be.”

      Remarkably, more than 40 years ago, Susumu Ohno started his famous paper on junk DNA (3) with a related statement: “Over the years, I have learned that there is no such thing as a fact. What passes for a fact is in truth a set of observations and its interpretation. Therefore, the interpretation is just as important to a fact as the observation itself.”

      In my previous mini-essay (2) on Doolittle’s article (1), I made 3 main points:

      (i) Ever since the notion of ‘junk DNA’ (jDNA) was introduced as a metaphor for presumably non-functional genomic DNA in species with relatively high C-value, it has been clearly used by the scientists in the field of genome biology and evolution to denote genomic DNA that has no biological function at all, whether informational (iDNA) or non-informational (niDNA), and implying otherwise is nonsensical.

      (ii) The two main theories on putative non-informational functions for the so called jDNA, the nucleo-skeletal and the nucleotypic functions, which “describe genome size variation as the outcome of selection via the intermediate of cell size” (4), and which Doolittle uses as pillars for his theoretical framework on genome evolution and biology, do not explain the C-value paradox.

      (iii) Apparently, Doolittle is not aware of the theory that most genomic niDNA, redefined as symbiotic DNA (sDNA), functions as a protective mechanism (adaptive genomic immunity) against deleterious insertional mutagenesis by endogenous and exogenous inserting elements, such as retroviruses, and that this theory is fully supported by the current data and observations and it explains the C-value paradox (5, 6).

      Here, I attempt to further close the gap between 'words' and 'facts' in addressing the genome biology and in evaluating the ENCODE project.

      In the introductory section, Doolittle outlines the premise for his paper: “a flurry of articles and letters”, published in Nature in other journals under the umbrella of the ENCODE project, “collectively claim function for the majority of the 3.2 Gb human genome”, which, if true, would debunk the notion of jDNA (1). The problem with Doolittle’s premise, however, is that it is not based on facts; indeed, the “flurry of ENCODE publications” did not claim that the majority of the human genome is functional (7). On the contrary, in what seems to have been a concerted, but tacit ‘silence policy,’ the ENCODE authors went out of their way not to address the ‘functionally’ of the human genome in their publications. In light of this fact, Doolittle had no choice but to build the premise for his paper on secondary sources offered by various science writers (8-10), who were apparently caught into a publicity stunt orchestrated on the side by a few of ENCODE scientists. Whether Doolittle’s approach of using secondary sources, which is a strong departure from conventional academic standards, sets up a hasty precedent for the scientific literature remains to be seen.

      So, why wasn’t the ENCODE project designed in context of the fundamental issues and knowledge about genome biology and evolution, such as the C-value paradox, limited sequence conservation among closely related species, mutational load, and the evolutionary origin of most genomic sequences from transposable elements? And, why did the ENCODE researchers choose not to address these fundamental issues in their official publications? Obviously, this makes no sense considering that their massive and expensive project was funded specifically to annotate the ‘functional sequences’ of the human genome.

      Fully addressing these questions might take us deep into the science of human behavior, and might highlight deep deficiencies in our current system of funding science, which relies on a weak and closed peer review system (parenthetically, a sensible solution would be to replace this system, which is vulnerable to abuse, with a stronger and true peer review system that is open to all peers).

      Nevertheless, it is inconceivable that the ENCODE leaders, who represent some of the finest science institutions in the world, were scientifically incompetent, as suggested by some critics of ENCODE (10), and were not aware of these fundamental issues on genome biology and evolution. On the contrary, it was the appreciation for this fundamental knowledge that prompted them to be silent, as this knowledge is in conflict with some of their study objectives and raises inconvenient questions about the relevance of their study and results.

      However, as illustrated by Doolittle’s article, the full significance of this fundamental knowledge on genome biology and evolution is not clearly recognized in the field, which has led to tremendous confusion and has allowed projects such as ENCODE to flourish. Indeed, unfortunately, the knowledge on genome biology and evolution has yet to crystalize in clear facts. However, here is one (in large print): based on the C-value paradox, limited sequence conservation, mutational load, and the evolutionary origin of most genomic sequences from transposable elements, it is clear that MOST OF THE HUMAN GENOME CANNOT HAVE INFORMATIONAL FUNCTIONS, period.

      Now that we have cracked ENCODE’s ‘code of silence’, reset some of Doolittle’s small print, and crystalized the fact that only a small fraction of the human genome has informational functions, it is time to focus on the major question remaining in the field of genome evolution and biology:

      Does most of the genome in organisms with relatively high C-value have non-informational functions, or most of it is non-functional, metaphorically speaking junk?

      References

      (1) Doolittle WF. 2013. Is junk DNA bunk? A critique of ENCODE. Proc Natl Acad Sci USA., 110:5294-300. Doolittle WF, 2013

      (2) Bandea CI. 2013. Junk DNA is bunk, but not as suggested by ENCODE or Doolittle. PubMed Commons (National Library of Medicine; Bethesda, MD). Comment on: Doolittle WF, 2013

      (3) Ohno S. 1973. Evolutional reason for having so much junk DNA. In Modern Aspects of Cytogenetics: Constitutive Heterochromatin in Man (ed. R.A. Pfeiffer), pp. 169-173. F.K. Schattauer Verlag, Stuttgart, Germany.

      (4) Gregory TR. 2004. Insertion-deletion biases and the evolution of genome size. Gene, 324:15-34. Gregory TR, 2004

      (5) Bandea CI. 1990. A protective function for noncoding, or secondary DNA. Med. Hypoth., 31:33-4. Bandea CI, 1990

      (6) Bandea CI. 2013. On the concept of biological function, junk DNA and the gospels of ENCODE and Graur et al. bioRxiv doi: 10.1101/000588; http://biorxiv.org/content/early/2013/11/18/000588

      (7) ENCODE Project Consortium. 2012. An integrated encyclopedia of DNA elements in the human genome. Nature, 489:57–74. ENCODE Project Consortium., 2012

      (8) Kolata G. 2012 (September 5). Bits of mystery DNA, far from ‘junk’, play crucial role. The New York Times, Section A, p. 1.

      (9) Anonymous, 2012. Cracking ENCODE. Lancet, 380:950. Anonymous, 2012

      (10) Pennisi E. 2012. Genomics. ENCODE project writes eulogy for junk DNA. Science, 337:1159–1161. Pennisi E, 2012

      (11) Graur D et al., 2013. On the immortality of television sets: "function" in the human genome according to the evolution-free gospel of ENCODE. Genome Biol Evol., 5(3):578-90.Graur D, 2013


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    3. On 2013 Dec 08, Claudiu Bandea commented:

      Junk DNA is bunk, but not as suggested by ENCODE or Doolittle

      “Do data from the Encyclopedia Of DNA Elements (ENCODE) project render the notion of junk DNA obsolete?” (1). Echoing much of the response by evolutionary biologists to ENCODE’s suggestion that more than 80% of the human genome is functional (2), Ford Doolittle’s answer is clearly ‘No’ (1).

      However, Doolittle did not write 7 pages of small print text in PNAS (1) to discredit ENCODE’s questionable suggestion; many people only needed a paragraph or two (3; but see Ref 4). Instead, the author uses the ENCODE momentum to cover half of century of research and thinking on the evolution of genome size, junk DNA (jDNA) and the C-value enigma in search of solutions to these top remaining puzzles in genome biology. Doolittle navigates through deep conceptual gaps left open by decades of neglect in defining even the most basic notions, such as the meaning of biological function, and concludes his epic journey with a sensible prescription: “A larger theoretical framework, embracing informational and structural roles for DNA, neutral as well as adaptive causes of complexity, and selection as a multilevel phenomenon, is needed” and that, by building this theoretical framework, “Much that we now call junk could then become functional” (1).

      Like other scholars in the field of genome evolution (see, for example, Refs 3 and 4), Doolittle starts building his theoretical framework by outlining convincing data and arguments that exclude informational roles for most jDNA. Addressing non-informational roles for jDNA, however, is a much more complex and confusing issue, to the extent that the author’s narrative gets entangled as it navigates very close to a school of red herrings: “I submit that, up until now, junk has been used to denote DNA whose presence cannot reasonably be explained by natural selection at the level of the organism for encoded informational roles (bold added) (1).

      However, ever since the term ‘junk DNA’ was introduced a few decades ago (apparently, in the 1960’s, not in the 70’s as previously assumed; see Ref. 5) as jargon for presumably non-functional genomic DNA in species with high C-value, it denoted DNA whose presence could not be reasonably explained by natural selection at the level of the organism for both informational and non-informational roles, and implying otherwise is, well, fishy. Moreover, saying that “junk advocates have to date generally considered that even DNA fulfilling bulk structural roles remains, in terms of encoded information, just junk” (1) is also deceiving considering that the nucleo-skeletal and nucleotypic theories, which “describe genome size variation as the outcome of selection via intermediate of cell size” (6) have dominated the thinking in field of genome size evolution for decades; obviously, it would be equally nonsensical to state that from the perspective of non-informational functions of jDNA, the informational DNA is just junk.

      Nevertheless, it is admirable that Doolittle embraces the nucleo-skeletal and nucleotypic theories as pillars of his theoretical framework on genome size evolution and jDNA, because, as stated in the following excerpt, the nucleotypic theory was presented as a substitute for his previous ideas (7) about jDNA as ‘selfish DNA’: “Although some researchers continue to characterize much variation in genome size as a mere by-product of an intragenomic selfish DNA "free-for-all" there is increasing evidence for the primacy of selection in molding genome sizes via impacts on cell size and division rates” (8).

      So, is Doolittle’s suggestion valid? I don’t think so, not until the nucleo-skeletal and nucleotypic hypotheses or other hierarchical selection theories clearly explain the C-value enigma, and not before they pass the formidable ‘onion test’ (see Ref 4). As previously suggested (9,10), the data and observations interpreted as evidence for these theories can be explained simply as accommodating or adaptive responses by the hosts to the presence of large quantities of genomic jDNA sequences, which are there for other reasons.

      Is jDNA bunk? As proposed almost a quarter century ago (9) and re-emphasized more recently (10), there is strong evidence that jDNA serves as an adaptive defensive mechanism against insertional mutagenesis (in both germline and somatic cells) by endogenous and exogenous inserting elements, such as retroviruses, which in humans and other multicellular species can lead to a high incidence of uncontrolled cellular proliferation, or cancer. Expectedly, as an adaptive, genomic defense mechanism, the amount of protective jDNA varies from one species to another based on insertional mutagenesis activity and evolutionary constraints on genome size, which might explain the evolution of genome size and C-value enigma.

      References

      (1) Doolittle WF. 2013. Is junk DNA bunk? A critique of ENCODE. Proc Natl Acad Sci USA., 110:5294-300. Doolittle WF, 2013

      (2) ENCODE Project Consortium. 2012. An integrated encyclopedia of DNA elements in the human genome. Nature, 489:57–74. ENCODE Project Consortium., 2012

      (3) Eddy SR. 2012. The C-value paradox, junk DNA and ENCODE. Curr Biol. 6;22(21):R898-9; Eddy SR, 2012

      (4) Graur D, Zheng Y, Price N, Azevedo RB, Zufall RA, Elhaik E. 2013. On the immortality of television sets: "function" in the human genome according to the evolution-free gospel of ENCODE. Genome Biol Evol., 5(3):578-90.Graur D, 2013

      (5) Graur D. 2013. The Origin of Junk DNA: A Historical Whodunnit. Judge Starling; http://judgestarling.tumblr.com/post/64504735261/the-origin-of-junk-dna-a-historical-whodunnit

      (6) Gregory TR. 2004. Insertion-deletion biases and the evolution of genome size. Gene, 324:15-34). Gregory TR, 2004

      (7) Doolittle WF, Sapienza C. 1980. Selfish genes, the phenotype paradigm and genome evolution. Nature. 284(5757):601-3. Doolittle WF, 1980

      (8) Gregory TR, Hebert PD. 1999. The modulation of DNA content: proximate causes and ultimate consequences. Genome Res. 9(4):317-24. Gregory TR, 1999

      (9) Bandea CI. 1990. A protective function for noncoding, or secondary DNA. Med. Hypoth., 31:33-4. Bandea CI, 1990

      (10) Bandea CI. 2013. On the concept of biological function, junk DNA and the gospels of ENCODE and Graur et al. bioRxiv doi: 10.1101/000588; http://biorxiv.org/content/early/2013/11/18/000588


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2017 Sep 27, Seán Turner commented:

      According to the BCRC online catalog of strains, the type strain of Chiayiivirga flava is 80274, not 80273. Strain BCRC 80273 is assigned as the type strain of Azospirillum formosense Lin et al. 2012 (PubMed Id 21742820).


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2017 Oct 31, Morten Oksvold commented:

      Please note that this article contains unreliable data, and should not be cited. The central ethical review board in Sweden found research misconduct in six articles by Macchiarini, including this one.

      Please see the report from the Central ethical review board in Sweden: http://www.epn.se/media/2516/pressmeddelande-o-12-2016eng.pdf https://drive.google.com/file/d/0By2HqPi4t2RbYzZweVRieVVMajhJQUM0cmFMekwyRVJTUFVr/view

      This information was provided by Leonid Schneider (forbetterscience.com).


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2013 Oct 18, James C Coyne commented:

      The authors had a responsibility to inform readers that patients assigned to the control group had to pay for any care related to diagnosis and treatment of depression. In contrast, patients assigned to the intervention group received free care. More care resulting from care being free might readily explain extraordinary differences between the two groups in receipt of care and in the primary outcome.

      For an extended discussion, see my PLOS blog post at Mind the Brain. Coordinating depression treatment from afar: Are results credible?

      http://blogs.plos.org/mindthebrain/2013/03/12/coordinating-depression-treatment-from-afar-are-results-credible/

      The letter posted below was rejected from JAMA Internal Medicine, eliminating the possibility for post publication correction of the limitations of peer review of this paper.

      Effect size in depression trial could be due to inadequacies of control treatment: Comment on Davidson and colleagues (2013) Davidson and colleagues [1] claimed benefits for a collaborative care (CC) intervention for depression that exceed not only previous CC trials, but also effect sizes for a variety of interventions for depression. Strong claims often later prove to be exaggerated or simply false [2] and deserve special scrutiny. We should keep in mind that effect sizes observed in trials are not attributes of interventions, but of comparisons between interventions and control groups. Large effect sizes can simply represent the exceptionally poor outcomes of control groups. Davison et al.’s underspecified “routine” care could simply have been inadequate care. The authors failed to acknowledge that patients in the control group had to pay for any depression treatment, whereas it was provided free to the patients in the intervention group. This might explain that the number of patients in the “routine” care group who received a new prescription of antidepressants increased by only two, versus ten in the intervention group. Similarly, the number of patients in the routine care group that received psychotherapy increased only by seven, versus an increase of 42 in the intervention group. The low rate of increased treatment occurred in the control group despite providers having been informed of patients’ depression scores. Patients were designated as “depressed” based on a self-report questionnaire. Thus, we cannot determine the extent to which patients with heightened depressive symptoms but failing to meet formal criteria for major depression were appropriately not having treatment initiated or inappropriately treated. Overall, we cannot determine whether active treatment or the mere attention and support and awareness of treatment being available free were associated with the greater improvement in the intervention group. Moreover, most patients identified as “depressed” in the intervention group were not in remission at follow up. Difficulty interpreting results could have been anticipated at the time of the study’s design. In short, results of this trial are insufficient to encourage a more ambitious trial with the same basic design, because of a lack of demonstration that any particular elements of centralized care management account for the group differences in improvement in depression that were observed, rather than inadequacies in the care provided to the control group.

      1. Davidson, KW, Bigger, JT, Burg, MM, Carney, RM, Chaplin, WF, Czajkowski, S, Dornelas, E, Duer-Hefele, J, Frasure-Smith, N, Freedland, KE; Haas, DC; Allan S. Jaffe, AS,, Ladapo, JA,; Lespe´rance, F, Medina, V, Newman, JD, Osorio, GA Parsons, F, Schwartz, JE, Shaffer, JA Shapiro, PA,. Sheps, DS, Vaccarino, V, Whang, W, Ye, S. Centralized, Stepped, Patient Preference–Based Treatment for Patients With Post–Acute Coronary Syndrome Depression CODIACS Vanguard Randomized Controlled TrialCODIACS Vanguard RCT. JAMA Internal Medicine, 2013, 1-8.

      2. Ioannidis, J. P. (2005). Why most published research findings are false. PLoS Medicine,


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2013 Oct 23, Paul Gardner commented:

      This is, in my totally unbiased opinion, a very exciting comparison of transposon mutagenesis libraries from two related species. This has fascinating consequences for pathogen evolution.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2015 Apr 04, Arnaud Chiolero MD PhD commented:

      A fantastic and useful book to understand what is health risk. Highly recommended for all health scientists and especially epidemiologists lost in their odds ratios


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2015 May 12, Gareth Pryce commented:

      There would appear to be a methodological flaw in this study which makes it's extrapolation to the human situation tenuous. Taken from this article http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1397713 (Food & Drink intake of mouse)the food/fluid intake of a mouse (C57Bl/6 strain used in this study)is 4.4g/day and fluid = 6ml of fluid a day, this study used 1% salt in water = 1g in 100ml and 4% in food = 4g in 100g of food. I have calculated that on average the mice would ingest (before of course they got sick, when they wouldn't ingest any food or water) 236 mg/day for a 25g mouse = 236mg/25g = 9.44g/kg so 660g for a human ie over half a Kg of salt a day. The likelihood of any human ingesting this amount of salt is very unlikely.

      Even doing a factor of ten 60g of salt which is 8 times a recommended limit of 8g/day. and twice the 35g/day found in some papers.

      There was no dose response done in this paper, or repetition of the result reported. I am surprised that this was not picked up during the refereeing process.

      These results need to be taken with a pinch of salt!


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2017 Jul 13, Robin P Clarke commented:

      This is an interesting finding but there is much danger of over-interpreting from it. Urine mercury has long been known to have little relationship to toxicity problems caused by mercury. The mercury causes harm not from being in the urine but from not being in the urine, due to instead getting bound up in the brain and other organs. There is abundant evidence elsewhere of the major harms being caused by mercury, and this study in no way counters that evidence.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2015 May 04, Peter Good commented:

      I asked Dr. Cynober whether oral arginine, citrulline, or glutamine would be the best source of arginine for brain nitric oxide and creatine in ASD children. He replied it was controversial whether oral arginine or glutamine produces more citrulline in the intestines. Citrulline enters the brain, he said, but whether it generates creatine there, and the balance between production of nitric oxide (NO) and creatine from citrulline-derived arginine, is unclear.[personal communication 2015]

      Their 2010 paper [Cynober L, 2010] presented much evidence critical to autistic disorders (ASD). Citrulline (CIT) is not normally present in protein; its usual sources are arginine (ARG) and glutamine in dietary proteins, which produce CIT in the intestines: “CIT is almost absent from natural foods, watermelon being a notable exception.” CIT bypasses the liver and forms ARG in the kidneys, which limits wasting of nitrogen as urea, and provides ARG to many other tissues, including the brain.

      “[D]irect supplementation of CIT should be more useful than ARG supplementation, leaving the kidney to convert CIT into ARG, so avoiding heavy first-pass splanchnic extraction of the ARG and the possible harmful effects of an excessive ARG [therefore NO] supply. . . . CIT is able to sustain NO production through eNOS but not iNOS. . . . CIT could also be a safe way to deliver ARG to endothelial and immune cells, and can certainly prevent excessive uncontrolled nitric oxide production. . . . [A]ntioxidant properties, together with the ability to generate NO, make CIT an excellent candidate for the treatment of pathological situations characterized by oxidative stress and decreased arginine availability . . . .”

      Because CIT stimulates protein synthesis when dietary proteins (i.e. ARG and glutamine) are low, it should be given in the postabsorptive state (3–5 hrs after meals) or fasted state (before breakfast). 10–15g/day of oral citrulline in healthy adults showed high bioavailability and no adverse effects. Because CIT is synthesized almost exclusively in the intestines, it may also be a useful biomarker of functional gut tissue.[Cynober L, 2010]

      In their 2005 paper [Curis E, 2005] Cynober and colleagues discussed other aspects of citrulline metabolism: “Citrulline presents the common reactivity of the α-amino acid family. In particular, it can form peptide bonds; hence it can therefore be present in proteins. However, since there is no known codon in the genetic table for this amino acid, its presence in a protein must always result from a post-translational modification of the protein. . . .

      “The main reason for this citrulline metabolism split between two organs [gut and kidney] is related to the efficacy of the capture of arginine by the liver. In fact, without metabolic adaptation, almost all the arginine coming from food supply would be withdrawn from the portal blood by the liver, leaving only very low amounts of available arginine for other organs. . . .

      “[M]any cell types which are able to metabolize arginine into NO are able to uptake circulating citrulline, which explains why citrulline induces certain of the NO effects . . . . The figure seems to be even more complex in the brain, since the recycling of citrulline into arginine is split between various cell types, defining a unique inter-cell-type cycle. Indeed, the brain neurones producing NO are not able to reconvert citrulline into arginine since they do not express the [necessary] enzymes. Hence, citrulline is released from the neurons and taken up by surrounding neural cells where return-conversion to arginine is performed.”[Curis E, 2005]

      Romero and colleagues presented other valuable information about citrulline [Romero MJ, 2006]: “With development, intestinal synthesis of L-arginine from glutamine decreases and the small intestine gradually becomes the major site of net L-citrulline production. . . . L-citrulline is largely taken up and metabolized by the kidney, which in turn releases arginine equivalent to ~75% of the L-citrulline taken up. Thus, much of the L-citrulline produced by enterocytes reaches the systemic circulation as L-arginine. This L-arginine/L-citrulline homeostasis allows a proper supply of L-arginine for the whole body. About 60% of dietary L-arginine makes it into the hepatic portal circulation, while the rest is metabolized in the intestine. . . . L-citrulline synthesis in many tissues also occurs as a byproduct of NOS activity. . . . Although NOS is widely distributed throughout the body, its activity does not contribute substantially to whole body L-citrulline flux under normal conditions. . . .

      “[A]cute oral administration of L-citrulline appears to be considerably more efficient raising plasma levels of L-arginine than L-arginine itself. Additionally, a recent study in children and young adults showed that five oral doses of L-citrulline every 12 hours (1.9 g/m2/dose) for a total dose of 9.5 g/m2 resulted in 57 and 85% increases in mean plasma levels of L-arginine and L-citrulline, respectively. . . . L-citrulline is generally recognized as safe for oral consumption. In fact, L-citrulline can prevent some of the untoward effects of L-arginine supplementation. . . . L-citrulline is a natural and apparently safe means of providing L-arginine for constitutive NOS production of NO.”[my emphasis] [Romero MJ, 2006]

      Deutz also presented important observations about plasma concentrations and interorgan transport of glutamine, citrulline, and arginine [Deutz NE, 2008]: “In daily practice, the plasma concentration is usually viewed as a parameter of production. This is not always correct as the plasma concentration can be high due to an increased production of the substrate and/or a reduced capacity of the body to dispose [of] this substrate. This means that the level of plasma concentration can be misleading and does not always give reliable information whether there is actually an intracellular deficiency of a certain substrate. . . .

      “The quantitative main production site [of glutamine] in the body is muscle and the main consumption sites are the gut, liver and the kidney. Liver plays a dual role as it can both produce and consume glutamine, depending on the metabolic state (fasting/fed). . . . [A]bout 80–90% of the citrulline is derived from the gut glutamine to citrulline conversion. Therefore, whole body citrulline production is related to the quantity of gut glutamine conversion to citrulline, and is most likely influenced by the amount of active gut tissue.”

      Most important conclusions for ASD: (1) oral citrulline bypasses the liver and becomes arginine in the kidneys, making arginine more available to other tissues, including the brain; (2) oral citrulline supports production of constitutive nitric oxide but not inducible nitric oxide; (3) in light of the benefit of casein-free/gluten-free diets in ASD children, citrulline’s stimulation of protein synthesis when dietary protein is low may be invaluable; (4) citrulline synthesis may be a useful marker of functional gut tissue in these children; (5) oral citrulline is safer than oral arginine. The evidence speaks for itself.

      Peter Good Autism Studies www.autismstudies.net autismstudies1@gmail.com

      Curis E, Nicolis I, Moinard C, et al. Almost all about citrulline in mammals. Amino Acids 2005;29:177–205.

      Cynober L, Moinard C, De Bandt J-P. The 2009 ESPEN Sir David Cuthbertson. Citrulline: A new major signaling molecule or just another player in the pharmaconutrition game? Clin Nutrit 2010;29:545–551.

      Deutz NEP. The 2007 ESPEN Sir David Cuthbertson Lecture: Amino acids between and within organs. The glutamate-glutamine-citrulline-arginine pathway. Clin Nutrit 2008;27:321–327.

      Romero MJ, Platt DH, Caldwell RB, Caldwell RW. Therapeutic use of citrulline in cardiovascular disease. Cardiovasc Drug Rev 2006;24:275–290.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    2. On 2015 Apr 30, Peter Good commented:

      None


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    3. On 2015 Apr 06, Peter Good commented:

      To PubMed Commons: comment to Frye RE, 2013.<br> Frye et al. [2010] previously reported that sapropterin, a synthetic form of tetrahydrobiopterin (BH4), improved behavior in children with autism spectrum disorders (ASD) [Frye RE, 2010]. Their 2013 study [Frye RE, 2013] was intended to test whether sapropterin’s benefit was due to BH4’s role as cofactor for synthesis of the monoamine neurotransmitters dopamine and serotonin (as previous investigators suspected), or BH4’s role as cofactor for nitric oxide synthase (NOS), which produces the critical gaseous molecule nitric oxide (NO). Frye et al. concluded that improvements in communicative language in these children from sapropterin were due to restoration of NOS “coupling” disrupted by lack of BH4, which dysregulated nitric oxide metabolism. In support of their conclusion they cited evidence by Sweeten et al. [Sweeten TL, 2004] and others of high levels of nitric oxide metabolites nitrite and nitrate in blood of ASD children. In their previous study Frye et al. concluded: “[I]t is possible that BH4 in ASD could be depleted by the overactivation of the immune system and inflammatory processes during an excessive production of nitric oxide.” [Frye RE, 2010]

      There may, however, be more to this story. A few months after publication of Frye et al. 2013, Stanhewicz et al. reported sapropterin increased reflex vasodilation in aging human skin by increasing release of nitric oxide by endothelial and neuronal nitric oxide synthases [Stanhewicz AE, 2013]. Nitric oxide, the primary dilator of blood vessels in the body, is produced by three different forms of nitric oxide synthase – two constitutive forms present in blood vessel endothelial cells (eNOS) and neurons (nNOS), and a third form (iNOS) induced in brain microglia and other cells of the immune system in response to infections and other agencies. Endothelial nitric oxide maintains the vasodilator tone of blood vessels. Neuronal nitric oxide may be largely responsible for neurovascular coupling – dilation of nearby blood vessels when brain neurons fire. Faraci & Brian: “. . . NO appears to mediate cerebral vasodilatation in response to local neuronal activation.” [Faraci FM, 1994]. Koehler et al.: “. . . NO is required as a mediator of neurovascular coupling in the cerebellum, whereas NO acts as a modulator in the cerebral cortex.” [Koehler RC, 2009]. Inducible nitric oxide is released in large quantities to flush infective agents and toxins, and kill damaged cells.

      If nitric oxide is too high in autistic disorders, inducible nitric oxide is the form likely responsible, Frye et al. concluded. Sweeten et al. concluded likewise: “[I]t is reasonable to hypothesize that iNOS is involved in the elevated NO production in autism.” [Sweeten TL, 2004]. Yet inducible nitric oxide is often released to compensate deficiencies of constitutive nitric oxide [Hecker M, 1999;Kubes P, 2000]. One indication neuronal nitric oxide is deficient in children with autistic disorders is their failure of neurovascular coupling – their brains are often hyperexcitable, yet brain blood flow is consistently low [e.g. Ohnishi T, 2000]. Nitrite and nitrate also serve as reservoir forms to deliver nitric oxide elsewhere [Dejam A, 2005]. Lundberg & Weitzberg: “[N]itrate and nitrite should probably be viewed as storage pools for NO rather than inert waste products.” [Lundberg JO, 2005].

      Did sapropterin increase endothelial and neuronal nitric oxide in the brains of ASD children in Frye et al. 2013? Why would endothelial and neuronal nitric oxide be deficient in these children? One explanation is deficiency of BH4. Another is deficiency of the amino acid arginine – only substrate for nitric oxide [Wiesinger H, 2001]. Frye et al. found higher baseline levels of blood arginine in these children, and higher ratios of arginine to citrulline, were associated with greater improvements in language from sapropterin. They noted blood arginine and the arginine/citrulline ratio did not change significantly during sapropterin treatment – but also stated improvements in language were greater in children with “an attenuated increase in arginine.” [Frye RE, 2013]

      Considerable evidence argues that arginine is deficient in ASD children: (a) high levels of inducible nitric oxide; (b) consistently low brain creatine (arginine + glycine) [Friedman SD, 2003]; (c) frequent high blood ammonia [Filipek PA, 2004] which requires arginine to detoxify to urea; and (d) high levels of arginine vasopressin in autistic boys [Carter CS, 2007; Momeni N, 2005]. Furthermore, NOS produces harmful oxidants superoxide and peroxynitrite when NOS “uncouples” from lack of BH4 – or when arginine is deficient [Xia Y, 1996]. Because most supplemental arginine is taken up by the liver (thus unavailable to other tissues), citrulline (arginine’s precursor) or glutamine (citrulline’s precursor) may be better sources of arginine for NOS [Cynober L, 2010]. The evidence speaks for itself.

      Peter Good Autism Studies La Pine, OR www.autismstudies.net autismstudies1@gmail.com

      Carter CS. Sex differences in oxytocin and vasopressin: implications for autism spectrum disorders? Behav Brain Res 2007;176:170–186.

      Cynober L, Moinard C, De Bandt J. The 2009 ESPEN Sir David Cuthbertson. Citrulline: A new major signaling molecule or just another player in the pharmaconutrition game? Clinical Nutrition 2010;29:545–551.

      Dejam A, Hunter CJ, Pelletier MM, et al. Erythrocytes are the major intravascular storage sites of nitrite in human blood. Blood 2005;106:734–739.

      Faraci FM, Brian Jr. JE. Nitric oxide and the cerebral circulation. Stroke 1994;25:692–703.

      Filipek PA, Juranek J, Nguyen MT, et al. Relative carnitine deficiency in autism. J Autism Dev Disord 2004;34:615–623.

      Friedman SD, Shaw DW, Artru AA, et al. Regional brain chemical alterations in young children with autism spectrum disorder. Neurology 2003;60:100–107.

      Frye RE, Huffman LC, Elliott GR. Tetrahydrobiopterin as a novel therapeutic intervention for autism. Neurotherapeutics. 2010;7(3):241–249.

      Hecker M, Cattaruzza M, Wagner AH. Regulation of inducible nitric oxide synthase gene expression in vascular smooth muscle cells. Gen Pharmacol 1999;32:9–16.

      Koehler RC, Roman RJ, Harder DR. Astrocytes and the regulation of cerebral blood flow. TINS 2009;32(3):160–169.

      Kubes P. Inducible nitric oxide synthase – a little bit of good in all of us. Glia 2000;47:6–9.

      Lundberg JO, Weitzberg E. NO generation from nitrite and its role in vascular control. Arterioscler Thromb Vasc Biol 2005;25:915–922.

      Momeni N, Nordström BM, Horstmann V, et al. Alterations of prolyl endopeptidase activity in the plasma of children with autistic spectrum disorders. BMC Psychiatry 2005;5:27–32.

      Ohnishi T, Matsuda H, Hashimoto T, et al. Abnormal regional cerebral blood flow in childhood autism. Brain 2000;123(Pt. 9):1838–1844.

      Stanhewicz AE, Alexander LM, Kenney WL. Oral sapropterin acutely augments reflex vasodilation in aged human skin through nitric oxide-dependent mechanisms. J Appl Physiol 2013:115:972–978.

      Sweeten TL, Posey DJ, Shankar S, McDougle CJ. High nitric oxide production in autistic disorder: a possible role for interferon-gamma. Biol Psychiatry 2004;55(4):434–437.

      Wiesinger H. Arginine metabolism and the synthesis of nitric oxide in the nervous system. Prog Neurobiol 2001;64(4):365–391.

      Xia Y, Dawson VL, Dawson TM, et al. Nitric oxide synthase generates superoxide and nitric oxide in arginine-depleted cells leading to peroxynitrite-mediated cellular injury. Proc Natl Acad Sci USA 1996;93:6770–6774.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2015 Oct 06, Jan Egger commented:

      A videos demonstrating the semi-automatic GBM segmentation can be found here: https://www.youtube.com/watch?v=z0f9RFRnC3g

      Best wishes, Jan


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Mar 08, Iffat Sumia commented:

      Love the paper ! I wonder, though, why the β-catenin-Venus fusion protein used has two point mutations in its Armadillo domain. I checked the von Kries et al., 2000 paper that's cited and it didn't help much. Is the reason for these mutations something trivial or purely technical that I missed?


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Jul 29, David Keller commented:

      B vitamins for levodopa-associated peripheral neuropathy

      The problem: "Cases of symptomatic peripheral neuropathy [PN], sometimes severe, have been reported in patients receiving LCIG [levodopa/carbidopa intestinal gel]. Cases are generally a sensorimotor polyneuropathy with both subacute and chronic onsets, often associated with vitamin B12 and/or B6 deficiency."

      Observation: "Cases of LCIG-associated PN often have responded to vitamin supplementation"

      Advice: "It may be advisable to monitor vitamin B12/B6 status before and after patients start LCIG and be vigilant for signs of PN. Prospective, large-scale, long-term studies are needed."

      Administration of levodopa is associated with elevation of blood levels of homocysteine, a neurotoxic waste product which consumes vitamins B6, B12 and folic acid during its metabolism (1). Administration of these B-complex vitamins has been demonstrated to lower homocysteine levels, with postulated favorable effects on neurological degeneration (2). However, while I agree with the recommendation to monitor levels of B12 and B6 during levodopa therapy, I would add the suggestion that homocysteine levels be monitored directly as well, since homocysteine is the actual neurotoxin. Preventative addition of a vitamin B-complex supplement if taking levodopa is also reasonable, despite the lack of evidence from a clinical trial yet. By the time homocysteine-mediated peripheral neuropathy is symptomatic, it may be difficult or impossible to reverse.

      References

      1: Obeid R, Herrmann W. Mechanisms of homocysteine neurotoxicity in neurodegenerative diseases with special reference to dementia. FEBS Lett. 2006 May 29;580(13):2994-3005. Epub 2006 May 6. Review. PubMed PMID: 16697371.

      2: Cacciapuoti F. Lowering homocysteine levels with folic acid and B-vitamins do not reduce early atherosclerosis, but could interfere with cognitive decline and Alzheimer's disease. J Thromb Thrombolysis. 2013 Oct;36(3):258-62. doi: 10.1007/s11239-012-0856-x. Review. PubMed PMID: 23224755.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Mar 21, Jacob Puliyel commented:

      Williams and colleagues have described assessment of AEFI employing the algorithm described by Halsey < PMID: 22507656>.

      I have posted two very detailed comments to an article by Tozzi Tozzi AE, 2013 which discusses the same subject of the revised WHO Classification of AEFI. I will not repeat the points I have made there but it may be viewed here.

      As this is a matter of patient safety I think it is important that the experts who understand the new scheme must explain why the revision was needed and that it will not miss opportunities of picking up new signals. The question is whether the new scheme would have picked up and flagged the signal of adverse-effects like the RotaShield-reactions, had the scheme been in use in 1999. The purpose of this posting is to invite the learned authors of this article on causality assessment to respond to the issues raised in the postings to the Tozzi article and I propose to flesh out those concerns a little further in the context of the article in Pediatrics by Williams and colleagues.

      1) Williams and colleagues Williams SE, 2013 suggest that the first step in the general approach to evaluating serious AEFI is to establish a clear diagnosis using Brighton Collaboration case definitions.

      The second step is to consider known biological mechanisms.

      Neither of these would have been evident when the intussusceptions signal was picked up by the old scheme (and the vaccine was withdrawn expeditiously preventing unnecessary distress to thousands of babies). Even today although a case definition has been developed for ‘intussusceptions’, the biological mechanism is not clearly defined and so the second step described by Williams et al cannot be completed.

      It was reported recently that Pentavalent vaccine (DPT co-administered with measles vaccine (MV) and yellow fever (YF) vaccine) is associated with increased mortality compared to MV + YF alone Fisker AB, 2014. It is pertinent to mention that the biological mechanisms involved are not understood.

      Neither is the biological mechanism for increased female mortality in recipients of the high-titer Edmonston-Zagreb vaccine known, although this was first noticed 2 decades ago. < PMID: 8237989>, Aaby P, 1993.

      2) It will be instructive to look at how the new algorithm has failed to flag up the deaths following Pentavalent vaccine used in Asia (DPT + Hib + Hepatitis B) and as a result, numerous children continue to be exposed to the risks of this vaccine.

      The glossary of the User Manual for the [Revised WHO classification]( who.int/vaccinesafety/publications/aevimanual.pdf) suggests ways and means to rule out a causal association. It defines causal association as a cause-and-effect relationship between the causative factor and a disease with no other factor intervening in the process.

      There have been many deaths following use of this Pentavalent vaccine in Sri Lanka. The committee WHO vaccine safety examined 19 deaths in Sri Lanka, 14 of them between 2010 and 2012. In six of the 19, a congenital heart disease was reported.

      Does preexisting congenital heart disease rule out a causal association between the vaccine and the deaths? Under this definition the 6 deaths in children with heart disease were not causally related to the vaccination.

      The older Advisory Committee on Causality Assessment Collet JP, 2000 looked at the problem more logically and holistically. For example it noted that elderly persons with concomitant or preceding chronic cardiac failure can develop cardiac decompensation after influenza vaccination due to a vaccine-caused elevation in temperature or from stress from a local reaction at the site of vaccinating. The vaccine is considered to have contributed to cardiac failure in this specific situation. It is obvious that with the older method of assessment of AEFI, caution would have been exercised when administering influenza vaccine to persons with preceding chronic cardiac failure, to avoid decompensation.

      The deaths in children with heart disease following administration of Pentavalent vaccine could well be due to decompensation. The Pentavalent vaccine must be used with caution in the presence of an underlying heart condition albeit asymptomatic. However detection of asymptomatic heart disease prior to vaccination in developing countries is impractical where the vaccine is administered by health workers who are barely literate. Is it prudent to use the vaccine under these circumstances given the findings of the Sri Lanka investigation? The new system disregards this real danger.

      3) Step 2 Checklist 4 of the revised [WHO classification for causality assessment]( who.int/vaccinesafety/publications/aevimanual.pdf) asks to check if the event can occur independently of vaccination (background rate). Thus it seems that until the deaths from vaccine AEFI are frequent enough as to increase the age specific mortality-rate in a statistically significant manner, they are to be ignored.

      The question of what background rate to use is not addressed specifically and this can further confound objective assessment of the AEFI. The Pentavalent vaccine in Asia is administered after 6 weeks of age. Would the local post-neonatal infant mortality rate (PN IMR) in the community before introduction of the vaccine be the comparator?

      Most of this post-neonatal IMR is made of babies who are very sick with pneumonia, diarrhea, sepsis, meningitis etc. The fact that the AEFI babies were brought by the mother for routine immunization suggests that the child was not sick and the mother did not consider the child was likely to die in the next day or two. The comparator must really be the SIDS rate in the locality for babies of a comparable age.

      Deaths in Bhutan were investigated and local newspapers reported on the various official explanations. It was argued that the deaths could have been due to encephalitis although there was little evidence for it. Officials explained that the encephalitis death rate in the years after the vaccine was introduced (even after adding AEFI deaths) had not increase significantly. This was sufficient grounds to accept the ‘coincidental encephalitis’ theory. One cheeky health official however pointed out that there were no cases of meningo-encephalitis reported among children below one year, in the eight months when Pentavalent vaccine was suspended in Bhutan.

      4) Another factor related to the deaths following Pentavalent vaccine is that the vast majority have occurred after the first dose and fewer after the second dose. A random event or coincidental SIDS cannot explain these deaths. However the new algorithm does not take this important factor into consideration.

      For all these reasons it would appear that the new algorithm is not a comprehensive means to assess serious adverse events. Its use will delay withdrawal of vaccines that result in serious AEFI and in the end it will erode confidence in the entire immunization programme and those who administer it.

      Can I suggest that we need to go back use older scheme namely Brighton Classification of AEFI till we find a better method to assess AEFI.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2017 Dec 01, Su-Fang Lin commented:

      Dear Authors:

      There are some discrepancies between Figure S7 legend (p9) and Table S8, could you please clarify those confusion for us? BTW, your work has paved the way for HNC stratification, thank you ALL very much! :-)

      1. SCC15 (predicted basal in Fig S7, noted as MS in Table S8)
      2. KYSE140 (predicted MS in Fig S7, noted as CL in Table S8)
      3. FADU (predicated MS in Fig S7, noted as AT in Table S8)


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2013 Oct 23, Stephen Turner commented:

      This review lays out some of the challenges and recent advances in viral metagenomic sequencing. There is a good discussion of library preparation and how that affects downstream sequencing. Alarmingly, they reference another paper that showed that different amplification methods resulted in detection of a completely different set of viruses (dsDNA viruses with LASL, ssDNA with MDA). The review also discusses many of the data management, analysis, and bioinformatics challenges associated with viral metagenomics.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Jan 14, Hilmar Lapp commented:

      While I agree with the advantages the author advocates for Git, any distributed version control system (DVCS) can in principle have the same. There are several other mature and widely used DVCSs, in particular Mercurial (Hg) and Bazaar (Bzr), with similarly sophisticated repository hosting platforms and web interfaces available (Bitbucket and Launchpad, respectively). Thus, while Git does have great potential for facilitating reproducibility and transparency in science as the author argues, it is DVCSs in general that do, in contrast to client-server oriented VCSs, and Git is just one example of those, even if a particularly good one.

      This is indeed mentioned in the text, albeit only briefly, and is thus easily missed. In particular, I wish the title had a reference to distributed version control, rather than only to a single product that implements DVCS.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Mar 18, Willem Schaik commented:

      There is a typo in the abstract of our paper. The name of the gene which was deleted is ptsD (not pstD) to indicate that it encodes the IID subunit of the PTS. I apologize for this error.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2017 Mar 23, University of Kansas School of Nursing Journal Club commented:

      Team Members: Cassie Caedo, Jessica Garcia, Jamie Radakovich, Olivia Kolar, Aaron Rutledge, Courtney Will, Sarah Stokes, Macy McKee. [Class of 2017)

      Background

      Shared governance is an increasingly prevalent leadership strategy in which nurses are an integral component of decision-making, both on the unit and institutional level. Shared governance gives nurses the power to influence their practice, which can positively affect both nurses’ job satisfaction and patient satisfaction. As we have learned in class, shared governance systems should integrate nursing professionals’ experiences and attitudes to shape nursing practice and improve nurses’ job satisfaction. Shared governance can also be viewed as a source of empowerment for nursing professionals. This literature helps fill the gap in perspectives that were not presented in class. In the presentations from staff nurses who participate in shared governance, they expressed the perspective of staff nurses’ participation in unit based councils and institutional councils. However, this article integrates viewpoints from both the staff nurses and nurse managers who participate in shared governance models. It was explained that shared governance models deviate from classic hierarchal structures of governance because nurses at the bedside can influence clinical practice across the entire institution. The success of shared governance can depend on the personal accountability of the nursing staff involved, and requires the institution to be receptive to the suggestions and ideas brought forth by nursing staff. By utilizing the perspectives of nurses who are directly impacted by institutional and unit policies, shared governance gives nursing staff more control over their practice.

      Methods

      This particular article was found on PubMed using the search terms “shared governance,” “nursing,” and “satisfaction.” We decided to select this particular article based on the insight that this qualitative study provided. In class, we explore the ways that shared governance can affect nursing staff and inadvertently affect patient outcomes. Nurse burnout, satisfaction, and retention can all be influenced by nursing leadership. The design of this study was a qualitative analysis via interview questions answered by 11 RNs. The study was designed for the purposes of assessing and documenting the attitudes and experiences of both staff RNs and nurse managers in shared governance structures. Specifically, nurses and nurse managers were asked for their opinion of the effect shared governance has on patient outcomes, their experiences with implementing a shared governance model, and describing their perceived roles in a shared governance system. The population of interest focused on staff nurses and nurse managers who implement shared governance models; in this study, this was implemented by utilizing unit practice councils. Evaluating attitudes about shared governance is important in assessing the efficacy of shared governance models and whether or not they have a positive impact on staff nurses’ experiences. Each verbal interview ranged from one minute to a minute and a half, and was recorded for data analysis later. Most nurses were interviewed in pairs by the unit practice councils.

      Findings

      The nurse managers cited shared decision-making and staff empowerment as integral components of succeeding in shared governance models. Nurses collaborated with clinical staff on the floor, including physicians and nursing administration, and nurse managers acted as facilitators between staff nurses and other professionals within the institution. Nurses who utilized shared governance models also integrated more evidence-based practice and quality improvement to improve processes on the unit. Empowerment by nurse managers fostered better job satisfaction and accountability for the staff nurses. Shared governance was viewed as a way to foster better communication between members of the care team, and encouraged a team-oriented mentality. Overall, shared governance was seen as an acceptable and effective avenue for improving patient outcomes, increasing nurses’ job satisfaction, and building stronger interprofessional relationships. Limitations of the study included small sample size (n=11), including five nurse managers and six staff RNs. Unit councils, as well as the individual participants, varied in shared governance experience but were all involved on their units’ practice councils. The generalizability of the study is limited because of the small sample size, the universal participation in practice councils, and the limited experiences with shared governance.

      Nursing Implications

      Implementing shared governance is important to nursing professionals because nurse burnout and job satisfaction can be affected based on the amount of influence nurses are able to have on their own practice. This is important on a personal level because nurses should be able to influence the policies and procedures that impact our daily practice. Not only would shared governance improve nursing professionals’ visibility, but it would also promote workplace satisfaction. The health care system stands to benefit from shared governance models because nurses are such a profound aspect of patient care, and their direct participation in how their unit provides care could lead to better patient outcomes and increased patient satisfaction. Nurses have a unique perspective that can identify more efficient procedures, more cost-effective utilization of resources, and promotion of a healing environment. This literature relates to future nursing practice because shared governance offers the promise of improved patient outcomes, higher rates of job satisfaction among nurses, and a method for collaborative improvement of entire institutions.

      References

      Ott, J., & Ross, C. (2014). The journey toward shared governance: the lived experience of nurse managers and staff nurses. Journal of nursing management, 22(6), 761-768.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2014 Aug 19, Qin-hong Zhang commented:

      Comment on "Interventions for treating persistent and intractable hiccups in adults"

      Zhang QH, Yue JH

      Department of Acupuncture and Moxibustion, College of Acupuncture and Moxibustion, Heilongjiang University of Chinese Medicine, Harbin 150040, China.

      I read with great interest the published article by Moretto et al., entitled “Interventions for treating persistent and intractable hiccups in adults”[1]. They evaluated the effectiveness of pharmacological and non-pharmacological interventions for treating persistent and intractable hiccups of any aetiology in adults. However, I had a few comments to make regarding the same. The authors only included four Chinese trials in acupuncture. However, they failed to search the Chinese databases, such as Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (which includes the database China Academic Journals) (CNKI), VIP Information (VIP), and Wanfang Data (WAN FANG). Thus, to our best knowledge, the authors far failed to include at least 18 eligible studies (including four randomized controlled trials (RCTs), and 14 quasi-randomized controlled trials (Q-RCTs)). In addition, three of 4 included studies used wrong comparator that means both groups used acupuncture, which could not evaluate the effect of acupuncture [2-4].

      References

      1.Moretto EN, Wee B, Wiffen PJ, Murchison AG. Interventions for treating persistent and Intractable hiccups in adults. Cochrane Database Syst Rev 2013; 1:CD008768.

      2.Bao F, Liang Z, Wang F. Clinical observation on treatment of stubborn hiccup by acupuncture with different needle retaining time. World Journal of Acupuncture-Moxibustion 2003;13(2):50–4.

      3.Jiang Feizhou.Stubborn hiccup treated with thumb-tack needles and needle-embedding on otopoint. Journal of Clinical Acupuncture and Moxibustion 2002;18(2):36.

      4.Wang B. 80 cases of intractable hiccup treated by acupuncture. Chinese Acupuncture and Moxibustion 2011; 31(2):181–2.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2017 Nov 29, Liz Dooley commented:

      This Cochrane Review has been superseded. A new author team has taken over and will expand the scope of the review to cover acute upper respiratory tract infections. Information provided by the Cochrane Acute Respiratory Infections Group.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    1. On 2015 Jun 02, thomas samaras commented:

      Additional information on height, CHD, and longevity is available from these recent publications.

      Samaras TT. Evidence from eight different types of studies showing that smaller body size is related to greater longevity. Journal of Scientific Research & Reports. 2014: 3 (16): 2150-2160, 2014; article no. JSRR.2014.16.003.

      Samaras TT. Human Scaling and Body Mass Index. In: Samaras TT (ed): Human Body Size and the Laws of Scaling: Physiological Performance, Growth, Longevity and Ecological Ramifications. New York: Nova Science Pub; 2007: pp 17-32.

      He Q, Morris BJ, Grove JS, Petrovitch H, Ross W, Masaki KH, et al. Shorter men live longer: Association of height with longevity and FOXO3 genotype in American men of Japanese ancestry. Plos ONE 9(5): e94385. doi:10.1371/journal.pone.0094385.

      Salaris L, Poulain M, Samaras TT. Height and survival at older ages among men born in an inland village in Sardinia (Italy), 1866-2006. Biodemography and Social Biology, 58:1, 1-13.

      Bartke A. Healthy Aging: Is Smaller better? A mini-review. Gerontology 2012; 58:337-43.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.

    2. On 2015 Jun 02, thomas samaras commented:

      None


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.