14,838 Matching Annotations
  1. Jul 2018
    1. On 2015 Sep 10, Lydia Maniatis commented:

      The authors claim that their data “characterize the luminance-to-lightness mapping in high-dynamic-range images that lack cues indicating the presence of multiple regions of illumination.” The assumption is that their checkerboards do not produce differential illumination or transparency effects, but a look at their stimuli proves otherwise. That checkerboards can produce impressions of differential illumination is acknowledged by Allred, Radonjic, Gilchrist & Brainard (2012) albeit non-commitally. The stimuli may lack known cues, but self-evidently they do not lack cues.

      The authors conclusions are also complicated by the fact that in higher-range stimuli, the highest luminance was reported as glowing “on most trials.” They dismiss these results as being due to the presentation of stimuli on an “emissive display” but this doesn't explain why glow wasn't reported in the lower-range stimuli for targets of the same luminance.


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    1. On 2014 Mar 17, Gaetano Santulli commented:

      Mega et al. report that in patients across the spectrum of acute coronary syndrome (ACS) low doses of the oral anticoagulant rivaroxaban reduced the risk of death from cardiovascular causes, myocardial infarction or stroke (1). Unfortunately, a large percentage of the enrolled patients was not at high cardiovascular risk. Thus, these results may be not applicable to subjects with an ACS who are commonly treated in routine practice (2). Moreover, patients with atrial fibrillation (AF), which represent up to 22% of subjects with ACS(3), were excluded from the study. Of interest, the Authors report that more than 1% of patients experienced AF, as ‘adverse event’, after rivaroxaban or placebo treatment. Although this is a small number of subjects, it would be of interest to see the data for this group presented separately. Indeed, this population represent the best category that may benefit from combined antiplatelet and anticoagulant therapy and these data could be noteworthy especially after the recent caveats stated by the Food and Drug Administration concerning this issue (4).

      Disclosures: None.

      References 1. Mega JL, Braunwald E, Wiviott SD, et al. Rivaroxaban in Patients with a Recent Acute Coronary Syndrome. N Engl J Med 2011. 2. Roe MT, Messenger JC, Weintraub WS, et al. Treatments, trends, and outcomes of acute myocardial infarction and percutaneous coronary intervention. J Am Coll Cardiol 2010;56:254-63. 3. Jabre P, Roger VL, Murad MH, et al. Mortality associated with atrial fibrillation in patients with myocardial infarction: a systematic review and meta-analysis. Circulation 2011;123:1587-93. 4. Mitka M. FDA advisory decision highlights some problems inherent in pragmatic trials. JAMA 2011;306:1851-2.

      Gaetano Santulli, MD, PhD Columbia University gs2620@columbia.edu


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    1. On 2013 Oct 11, Hilda Bastian commented:

      This review could not take into account lifestyle factors that often accompany healthier diets and lower risk of cancer, such as not smoking. Studies like those analyzed here probably aren't enough to establish that a nutrient can prevent disease: Moorthy D, 2013. In the case of fiber and colorectal cancer, a systematic review of randomized trials (Asano T, 2002) did not find a reduction of colorectal cancer either from fiber supplements or dietary intake as in, for example, the large National Cancer Institute trial: Schatzkin A, 2000. This trial evidence is not discussed in this review by Aune and colleagues. Anyone interested in this subject would be better off starting with the systematic review of trials and trials on fiber and resistant starch published since then: Ishikawa H, 2005, Burn J, 2011. Further discussion here.


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    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 NCT0139171. We believe the correct ID, which we have found by hand searching, is NCT01393171.

      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


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    1. On 2014 Mar 20, Anders von Heijne commented:

      Reviewing the MR images in this case report there is clearly an older lesion in the right medial temporal lobe with atrophy. This is not commented on by the authors. One might speculate that the patient has had an earlier episode of HSE. Additional information would be valuable.


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    1. On 2013 Nov 01, Gerard Ridgway commented:

      There is new version of this work (somewhat confusingly with an unchanged abstract) "Updated April, 18, 2013", Weiner MW, 2013


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    1. On 2013 Oct 23, M Mangan commented:

      Actually I found out about this new NCBI commenting system from BioStar. And I wanted to give it a try.

      Here's the discussion at Biostar: http://www.biostars.org/p/84222/.

      It will be interesting to see if this is much different than forum-style discussions and other sites with comments. I like the idea of a place that's not unique to one publisher. But I expect it could be difficult to build community in the same way forums and blogs do, and manage the comments.


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    1. On 2013 Jul 09, Joshua L Cherry commented:

      This work develops metabolic models for six E. coli strains, performs relevant experiments with these strains, and compares model predictions to observations. The authors state that they have demonstrated that "quantitative models of different strains of E. coli can accurately predict strain-specific phenotypes." The results, however, do not support this conclusion. In fact, they point to the opposite conclusion: the models had little or no value for predicting differences between strains.

      The authors predicted and experimentally determined the abilities of the strains to use various carbon sources under aerobic and anaerobic conditions. Most individual predictions agree with observations, but this fact alone means little; all strains were able to utilize the vast majority of substrates, so that simply "predicting" all positives would yield 95% agreement. For the data in Table 5, results are statistically significant under aerobic conditions for only one strain (Fisher's exact test). Under anaerobic conditions the predictions fare better: 5 of 6 cases are statistically significant. However, none of this tells us whether the predictions capture differences between strains. To address this question requires more information than counts of the sort found in Table 5.

      Additional file 7 of the article provides the necessary kind of data: predicted and observed utilization capabilities for individual substrates. For reasons not clear to me, it contains predictions for only 68 substrates, rather than the 76 reported in Table 5. I have searched this data for correct predictions of differences between strains. These would be cases where one strain utilizes a substrate, another fails to do so under the same conditions, and this is correctly predicted. Across all 68 substrates and all pairings of the 6 strains, there is just one such case. This involves aerobic utilization of phenylethylamine. Even this cannot be considered a success because predictions for the other four strains are all incorrect, and all four possible combinations of predictions and observations occur. All the other differences between strains are missed, and there are several predicted differences that are shown to be false by experiment.

      The authors also predict and measure growth rate and yield for growth on glucose (actually, the flux balance analysis itself predicts only yield; conversion to rate relies on measured rates of glucose uptake). When the aerobic and anaerobic data are combined, correlations between prediction and experiment are strong and significant. However, these high correlations have nothing to do with differences between strains. Rather, they reflect the difference between aerobic growth and anaerobic growth. Simply assuming that the growth rate (or yield) is higher under aerobic conditions than anaerobic conditions, and that there are no strain differences, results in similar high correlations. So does randomly permuting the predictions among strains. As the authors note, correlations disappear when strains are considered under a single condition, so there is no evidence for correct prediction of differences among strains.

      Thus, it appears that the predictions contain little or no information about phenotypic differences between strains. Reconciling the models and experimental results may aid our understanding of metabolism and help improve future predictions.


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    1. On 2014 Jan 08, Tom Kindlon commented:

      The SF-36 subscale scores in this paper are norm-based scores

      The SF-36 subscale scores in this paper are norm-based scores. This was confirmed by the authors following a question by me on the PLoS one site: http://www.plosone.org/annotation/listThread.action?root=21433.


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    1. On 2015 Aug 08, Karl Broman commented:

      The paper describing the JavaScript library D3.js, which has had an enormous impact toward popularizing web-based interactive data visualizations, because it's totally awesome.


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    1. On 2013 Jul 05, Richard Simon commented:

      This is an interesting and important paper but some have misinterpreted it’s findings. The authors addressed the prognostic significance of published gene expression signatures for breast cancer (mostly for non-metastatic disease). They demonstrated that prognostic signatures can be developed over 90% of the time from random sets of >100 genes and that the signatures generated from sets of random genes are often as prognostic as published gene expression signatures. The reason is that there are an enormous number of genes that are correlated with cell proliferation and cell proliferation is strongly correlated with prognosis (estrogen receptor expression is strongly associated with outcome and prognosis and there are thousands of estrogen receptor target genes). Most published gene expression signatures are no longer prognostic after adjustment for the proliferation meta-gene. The take home message is that authors of biological mechanism papers should not claim that the genes they discovered in an experimental model system have relevance for the human breast cancer by showing that a signature based on their genes are prognostic in human breast cancer. That claim is common in cancer biology. The paper should not be misinterpreted to mean that claims of the prognostic accuracy of gene expression signatures are erroneous or that such signatures are not potentially useful for medical decision making. In fact, there are well documented pitfalls in the evaluation of predictive accuracy of prognostic signatures (e.g. using the same dataset to develop the signature and to evaluate it without using complete cross-validation). Predictive signatures which identify patients most likely to benefit from a specific treatment tend to be more useful than prognostic signatures derived based on a heterogeneous collection of cases. Nevertheless, prognostic signatures can be therapeutically relevant. This paper is well done however and it’s conclusions are carefully drawn.


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    1. On 2014 Nov 17, Raphael Levy commented:

      The existence and cell penetrating properties of "striped" nanoparticles have been challenged by Cesbron Y, 2012.

      A detailed analysis of this body of work is published today in PloS One by Stirling et al; from the abstract: “through a combination of an exhaustive re-analysis of the original data with new experimental measurements of a simple control sample comprising entirely unfunctionalised particles, we conclusively show that all of the STM evidence for striped nanoparticles published to date can instead be explained by a combination of well-known instrumental artefacts, strong observer bias, and/or improper data acquisition/analysis protocols.


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    1. On 2014 Nov 28, Juergen Borlak commented:

      There has already been an extensive communication on this matter (see comments on the original manuscript in PLOS One at http://www.plosone.org/annotation/listThread.action?root=69409). Unfortunately, we note serious misconceptions that require clarification.

      First, in our previous communications we already alluded to the methodology employed. Thus, all relevant information can be retrieved from the original paper. Furthermore, in our original study we alerted to the issue of underreporting and the difficulties in defining accurate incidences of ADRs. Apart from statistical issues, e.g. to determine an incidence of just 1 per 10,000 in the control group one would require 180,000 participants in the verum group, prospective studies are inevitably confounded by the study protocol inclusion and exclusion criteria that lead to additional bias. Second, in 2013 the pharmacovigilance risk assessment committee (PRAC) of the European Medical Agency (EMA) evaluated independently the evidence of flupirtine induced liver injury and concluded that the benefit still outweighs the risk for hepatotoxicity particularly when the treatment of acute pain with other analgesics (e.g. non-steroidal anti-inflammatory drugs, weak opioids) is contraindicated and the treatment duration is restricted to 14 days (http://www.ema.europa.eu/docs/en_GB/document_library/Referrals_document/Flupirtine-containing_medicines/Recommendation_provided_by_Pharmacovigilance_Risk_Assessment_Committee/WC500146103.pdf). In our previous communication we referred to the deliberations of the PRAC, however, based on the comment provided we must assume that the commentator has no confidence in the capabilities of the PRAC and this would also imply that the EMA apparently is unaware of the issue of ADR underreporting which is a somewhat baffling assumption. Lastly, we do not believe that an estimate of incidences of ADR without causality assessment adds to the science of drug safety. Indeed, an incidence of less than 1 in 10,000 may be found acceptable; however, for an individual suffering from adverse drug reactions the incidence is intolerable. Therefore, we encourage the commentator to focus on the main thesis of our study, that is to improve pharmacovigilance through causality assessment and to identify individuals at risk for ADR prior to medication, as was recently reported by us for paracetamol (see Borlak et al., Genome Medicine 2013, 5(9):86).


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    2. On 2014 Nov 08, Dirk Wetzel commented:

      Basic epidemiological terms should be used correctly

      I respectfully disagree with the methods and conclusions of this publication. The article suggests that an incidence of flupirtine-related hepatobiliary adverse events of “1:100,000 …or 0.8 in 10,000” has been calculated. In fact, this "incidence" is based on reported cases only. The estimated number of unreported cases might be as high as 90 to 95%, because considerable under-reporting is a well-known phenomenon of spontaneous reporting. Incidence rate is clearly defined as the number of new cases of a certain condition in relation to the population at risk within a specified period of time. As the authors used the number of reported cases as numerator (“new cases”), this method probably leads to a dramatic under-estimation of the potential risks associated with flupirtine. This could be interpreted as downplaying the risks of flupirtine.


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    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


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    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


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    1. On 2016 Apr 05, Leigh Jackson commented:

      The authors state (I have omitted text references):

      "Four commonly held tenets among acupuncturists regarding electrodermal activity (EDA) at acupuncture points are: (1) acupuncture points have lower electrical resistance than surrounding skin; (2) pathology-related acupuncture points are distinguishable from non-pathology-related acupuncture points; (3) changes in electrical skin resistance or conductance at acupuncture points correlate with acupuncture treatments and with the persistence of, or recovery from, disease; and (4) changes in EDA at acupuncture points occur when substances that are either therapeutically beneficial or toxic to an individual are placed in the electrical circuit with that individual.For more than 50 years these widely-held assumptions have formed the basis for the use of electrodermal devices in clinical practice, yet scientific studies to support these beliefs are sparse and methodologically diverse. The first tenet was comprehensively evaluated by Ahn et al in a recent systematic review. This review found preliminary evidence to suggest that acupuncture points and meridians may be electrically distinguishable from non-acupuncture point and non-meridian tissue. The latter three tenets, however, have yet to be rigorously examined."

      If (1) could be scientifically shown to be true, then the other tenets would become a credible prospect. Is (1) scientifically credible? What might explain such a state of affairs? The safest bet as regards the data examined by Colbert et al. is the null hypothesis. Without powerful evidence to support (1) and with no scientific explanation as to why (1) should be true, the other three tenets will require extraordinarily powerful evidence to convince sceptics.

      The first tenet must be scientifically established before the others have a chance to run. Otherwise it is piling weak evidence on top of weak evidence, conjecture on top of conjecture. A house of cards is being built on a pre-scientific foundation.


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    1. On 2014 Mar 21, Pedro Reche commented:

      In this manuscript, we predicted that the MHCI-like protein MR1 will have an empty groove.However, a recent report have shown that MR1 binds vitamin B metabolites (PUBMED: 23051753). Therefore, we have updated our models including that information and repeated the manuscript predictions. With the exception of MR1, all of the predictions remain the same. Prediction of the ligand-type specificity of classical and non-classical MCH I molecules with the updates models is available for free public use at http://imed.med.ucm.es/MHCLIG/


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    1. On 2013 Jun 15, Steven Salzberg commented:

      A very important study looking at long-term use of supplements, which revealed the surprising finding that risk of death increases with regular use of vitamin supplements. Bad news for supplement manufacturers, but important news for anyone who has been taking multivitamins thinking it can't hurt.


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    1. On 2014 Jan 31, Huiqi Qu commented:

      Adiponectin/leptin ratio is suggested as a useful biomarker for metabolic syndrome by this study.


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    1. On 2014 Sep 30, Dale D O Martin commented:

      Several of the proteins identified in this paper, including MACF and CD-IC2 have recently been confirmed endogenously in Thinon et al found here http://www.ncbi.nlm.nih.gov/pubmed/25255805


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    2. On 2014 Feb 07, Dale D O Martin commented:

      We have since shown that caspase-cleavage of HTT releases an autophagy-inducing domain that requires its post-translational myristoylation. http://www.ncbi.nlm.nih.gov/pubmed/24459296

      Videos can be seen here: http://hmg.oxfordjournals.org/content/early/2014/01/22/hmg.ddu027/suppl/DC1


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    1. On 2017 Jun 27, Andy Collings commented:

      A subset of experimental results from this study were the focus of a replication attempt as part of the Reproducibility Project: Cancer Biology (https://osf.io/e81xl/wiki/home/). The experimental designs and protocols were reviewed and approved in a Registered Report (http://dx.doi.org/10.7554/eLife.08997) and the results of the experiments were published in a Replication Study (http://dx.doi.org/10.7554/eLife.25306).


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    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 NCT0016012. We believe the correct ID, which we have found by hand searching, is NCT00160121.

      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


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    1. On 2014 Oct 23, Toby Gibson commented:

      LATS protein kinases function in the Hippo signalling system. They are basophilic kinases known to phosphorylate sites that match Hx[Rk]xx[ST] motifs. The requirement for a His residue marks out LATS from other AGC group basophilic kinases. LATS substrate proteins usually have multiple matches to these motifs, as for example YAP1 (human) and SSD1 (yeast). In these proteins the LATS P-sites are in regions of natively disordered polypeptide.

      The LATS substrate reported here, Snail1 does have two matches to the LATS site as shown in Fig. 3

      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3252572/figure/f3/

      But these lie within DNA-binding zinc finger domains. The His residues are part of the zinc coordinating residues that hold the domain in a folded conformation. So long as the zinc fingers are folded, these His sidechains are unavailable to access a kinase active site cleft. Indeed all the residues in the proposed site(s) are in alpha helices when the zinc fingers are folded. The H, R and T residues are conserved in many other zinc finger proteins. If Snail1 zinc fingers can be phosphorylated by LATS then many other zinc finger proteins should also be targets. Because of the restricted focus of the HIPPO signalling pathway and the limited number of known LATS substrates in fly, yeast and mammal systems, this might be unlikely.

      In the absence of biophysical data showing that the Snail1 sites can become accessible under plausible phosphorylation conditions, they are considered to be false positive sites in our ELM resource entry for LATS kinases

      http://elm.eu.org/elms/elmPages/MOD_LATS_1.html


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    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


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    1. On 2017 Aug 07, Randi Pechacek commented:

      Jonathan Eisen used this paper as inspiration to write a blog post on microBEnet discussing the microbiomes of dishwashers.


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    1. On 2013 Dec 24, Kenneth Witwer commented:

      As of April, 2014, published studies of dietary xenomiR transfer include the following (excluding reviews, in order of publication, and with public availability of high-throughput sequencing data noted if applicable):

      This study: High-throughput sequencing (HTS) mapped up to tens of thousands of reads per million of specific plant microRNAs in human circulation; similar results in bovines; functional consequences for cholesterol metabolism in mice; public data availability not reported.

      Zhang Y, 2012: analysis of >80 public HTS datasets; found uptake of few microRNAs; suggested contamination or other artifact(s) as explanation of miR168a detection; publicly available datasets identified in article.

      Wang K, 2012: HTS, single digit reads per million of MIR168 in human circulation; public data availability not reported.

      Wang K, 2013: HTS, fractional reads per million of MIR168 in murine circulation; public data availability not reported.

      Snow JW, 2013: qPCR, little or no measurable uptake of dietary plant and/or animal microRNAs by humans, mice, and adult bees.

      Witwer KW, 2013: qPCR, no response to dietary intake in a small primate feeding study; reportedly non-specific low-level amplification.

      Dickinson B, 2013: HTS and qPCR; as mentioned by M Mangan, mouse replication study with negative results; data submitted to NCBI SRA as SRP028401.

      Tosar JP, 2014: analysis of data and datasets; interpreted correlation between plant RNAs in original study findings and in a study of Amphioxus by the same group as evidence of contamination and "non-dietary" origin.


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    2. On 2013 Nov 16, M Mangan commented:

      An attempt to replicate the claims in this paper has been published here: Dickinson B, 2013. The researchers were unable to make the same observations.

      There's also an interesting backstory to the publication of the replication paper which you can find here: Anonymous, 2013.


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    1. On 2014 Mar 26, Wei-An (Andy) Lee commented:

      In the safety-net clinic in Los Angeles, I find that premix insulin can be a great way to start patients. It reduces the initial burden of insulin initiation.


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    1. On 2014 Jan 08, Tom Kindlon commented:

      References:

      [1] Ross SD, Estok RP, Frame D, Stone LR, Ludensky V, Levine CB: Disability and chronic fatigue syndrome: a focus on function. Arch Intern Med 2004, 164:1098-1107.

      [2] White P, Goldsmith K, Johnson A, Potts L, Walwyn R, Decesare J, Baber H, Burgess M, Clark L, Cox D, 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, 377:823-836.

      [3] Fukuda K, Straus SE, Hickie I, Sharpe MC, Dobbins JG, Komaroff A: The chronic fatigue syndrome: a comprehensive approach to its definition and study. International Chronic Fatigue Syndrome Study Group. Ann Intern Med 1994, 121:953-959.

      [4] NICE: Chronic fatigue syndrome/Myalgic encephalomyelitis (or encephalopathy); diagnosis and management. National Institute for Health and Clinical Excellence (NICE); 2007.

      [5] 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 September 16, 2011 (French language edition) [6] 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 September 16, 2011 (Dutch language version)

      [7] 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) [The main link seems to (temporarily?) not to work on the Belgium government website; it can be seen combined with another file at: http://bit.ly/t6GxcN ; alternatively it is on its own at: http://sacfs.asn.au/download/ReportCFS-NL.pdf ]

      [8] White PD, Sharpe MC, Chalder T, DeCesare JC, Walwyn R; PACE trial group. Protocol for the PACE trial: a randomised controlled trial of adaptive pacing, cognitive behaviour therapy, and graded exercise, as supplements to standardised specialist medical care versus standardised specialist medical care alone for patients with the chronic fatigue syndrome/myalgic encephalomyelitis or encephalopathy. BMC Neurol. 2007 Mar 8;7:6.

      [9] White PD, Goldsmith KA, Johnson AL, Walwyn R, Baber HL, Chalder T, Sharpe M, on behalf of the coauthors. The PACE trial in chronic fatigue syndrome - Authors' reply. The Lancet - 28 May 2011 ( Vol. 377, Issue 9780, Pages 1834-1835 ) DOI: 10.1016/S0140-6736(11)60651-X

      [10] Tiersky LA, DeLuca J, Hill N, et al. Longitudinal assessment of neuropsychological functioning, psychiatric status, functional disability and employment status in chronic fatigue syndrome. Appl Neuropsychol. 2001;8:41-50.

      [11] Vercoulen JH, Swanink C, Fennis J, Galama JM, van der Meer JW, Bleijenberg G. Dimensional assessment of chronic fatigue syndrome. J Psychosom Res. 1994; 38:383-392.

      [12] Dyck D, Allen S, Barron J, et al. Management of chronic fatigue syndrome: case study. AAOHN J. 1996;44:85-92.

      [13] Marlin RG, Anchel H, Gibson JC, Goldberg WM, Swinton M. An evaluation of multidisciplinary intervention for chronic fatigue syndrome with long-term follow-up, and a comparison with untreated controls. Am J Med. 1998;105:110S-114S.

      [14] Fulcher KY, White PD. Randomised controlled trial of graded exercise in patients with the chronic fatigue syndrome. BMJ. 1997;314:1647-1652.

      [15] Akagi H, Klimes I, Bass C. Cognitive behavioral therapy for chronic fatigue syndrome in a general hospital: feasible and effective. Gen Hosp Psychiatry. 2001;23:254-260.

      [16] Sharpe MC, Archard LC, Banatvala JE, et al. A report--chronic fatigue syndrome: guidelines for research. J R Soc Med. 1991 Feb;84(2):118-21.

      [17] Darbishire L, Seed P, Ridsdale L. Predictors of outcome following treatment for chronic fatigue. Br J Psychiatry. 2005 Apr;186:350-1.

      [18] ICD-10. The ICD-10 classification of mental, and behavioral disorders. Geneva, World Health Organization, 1992.


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    2. On 2014 Jan 08, Tom Kindlon commented:

      Productivity costs may not drop dramatically when CFS patients avail of current services

      The authors appear to do a reasonable job, given the limits of the data available to them, in calculating the productivity costs before Chronic Fatigue Syndrome (CFS) patients reach the services in the UK. However, the reader is left with the impression that the productivity costs will drop dramatically once the patient reaches the services: "We had no data with which to assess the rate at which people with CFS/ME recover and return to work, either with or without specialized treatment. According to a systematic review of the literature, the proportion of adults in employment increased following interventions for CFS/ME (individualised rehabilitation, cognitive behavioural therapy and exercise therapy) and decreased in observational studies with no intervention [1]. Evidence from a recent evidence trial of cognitive behavioural therapy and graded exercise therapy indicated a recovery rate of 30-40% one year after treatment [2]."

      However it may not be the case that the therapy offered in UK clinics (or in similar clinics elsewhere) will reduce the productivity costs by much if anything.

      It is interesting to consider what happened in Belgium where rehabilitation clinics for patients satisfying the same CFS criteria [3] were treated using cognitive behavioural therapy (CBT) and graded exercise therapy (GET), the same therapies recommended for use in the UK [4]. Extensive external audits were performed there on these (Belgian) clinics. The main reports are in French and Dutch [5,6]; however, for those who can't understand either of those languages, a five-page summary is available in English [7]. It says, "Employment status decreased at the end of the therapy, from an average of 18.3% of a 38h- working week, to 14.9% [...] The percentage of patients living from a sickness allowance increased slightly from 54 to 57%."

      Collin and colleagues claim, "Evidence from a recent evidence trial of cognitive behavioural therapy and graded exercise therapy indicated a recovery rate of 30-40% one year after treatment [9]." However, although a recovery measure was included in the trial's protocol[8], the authors have made clear [10] that no recovery rate was reported in the Lancet paper [9]: "[i]t is important to clarify that our paper did not report on recovery; we will address this in a future publication."

      Collin and colleagues also say, "[a]ccording to a systematic review of the literature, the proportion of adults in employment increased following interventions for CFS/ME (individualised rehabilitation, cognitive behavioural therapy and exercise therapy) and decreased in observational studies with no intervention [1]." This is indeed mentioned in the abstract of the review. However, when one reads the paper, the data on which this is based is very limited: 2 longitudinal studies reported employment at both times with no interventions[10,11], 2 rehabilitation programs [12,13], one trial of GET [14] and one trial of CBT[15].

      The figures for the GET study are for everyone (n=66) who was in the trial so include the people who were in the other arm of the trial (flexibility exercises and relaxation therapy) who then chose to do GET. So not those who had GET alone. This trial used the Oxford criteria [16] to define CFS, criteria which only requires the symptom of fatigue rather than the other symptoms required in the Fukuda criteria [3]. A study of those with fatigue has shown that satisfying the Fukuda CFS criteria [3] was the most powerful predictor of poor response to either GET or CBT [17]. So one cannot be extrapolate from such studies that those satisfying the Fukuda criteria, who are the group that Collin studied (and the group who used the Belgian clinics), will have the same improvements in employment measures.

      Similarly, the trial of CBT [15] didn't use the Fukuda criteria - patients either satisfied the Oxford criteria [16] or else criteria for F48.0 (Neurasthenia) [18] i.e. they didn't all satisfy CFS criteria at all. Employment data was only available for 51 of the 80 individuals who started CBT (64%).

      Finally, in one of the rehabilitation trials quoted [12], only two individuals took part it (at baseline neither was in employment but at follow-up, one of the two was). All in all, the evidence that CBT, GET and similar interventions will increase productivity is not strong. If governments, and those involve in providing health services, want to decrease the costs associated with CFS, throwing more and more money at CBT/GET services may not be the answer; other methods of treating the condition should be investigated. As the authors have shown, costs associated with the condition per individual are substantial, so more expensive therapeutic strategies can be justified on cost grounds alone.


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    1. On 2017 Apr 02, Christine Carson commented:

      There was a follow-up to this article. The full text of the response (in Swedish) is available free from Lakartidningen website http://www.lakartidningen.se/07engine.php?articleId=18503

      The full text of the response (in English) is available free from ResearchGate website at https://www.researchgate.net/publication/315738411_Carson_et_al_2012_Lakartidningen_English_20130626


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    1. On 2015 Aug 12, Tom Kindlon commented:

      This study uses the (so-called) empiric CFS criteria (Reeves et al., 2005)

      This study used the Reeves et al. (2005) criteria(1) for defining Chronic Fatigue Syndrome (CFS) (sometimes described by the CDC as an operationalization of the Fukuda et al. (1994) criteria (2)).

      These (Reeves) criteria greatly increased the prevalence of CFS. The "empirical" definition gives a prevalence rate of 2.54% of the adult population(3) compared to 0.235% (95% confidence interval, 0.142%-0.327%) and 0.422% (95% confidence interval, 0.29%-0.56%) when the Fukuda definition was used in previous population studies in the US(4,5).

      The definition lacks specificity. For example, one research study(6) found that 38% of those with a diagnosis of a Major Depressive Disorder were misclassified as having CFS using the empirical/Reeves definition. A letter of mine discussed my concerns in more detail(7).

      Due to the problems with the criteria, these criteria have not been used by researchers outside those contracted to analyse CDC data (apart from Leonard Jason's research team who studied it and showed problems with it (6)).

      References:

      1 Reeves WC, Wagner D, Nisenbaum R, Jones JF, Gurbaxani B, Solomon L, Papanicolaou DA, Unger ER, Vernon SD, Heim C. Chronic fatigue syndrome – a clinically empirical approach to its definition and study. BMC Med. 2005;3:19.

      2 Fukuda K, Straus SE, Hickie I, Sharpe MC, Dobbins JG, Komaroff A. The chronic fatigue syndrome; a comprehensive approach to its definition and study. Ann Int Med 1994, 121:953-959.

      3 Reeves WC, Jones JF, Maloney E, Heim C, Hoaglin DC, Boneva RS, Morrissey M, Devlin R. Prevalence of chronic fatigue syndrome in metropolitan, urban, and rural Georgia. Popul Health Metr. 2007 Jun 8;5:5.

      4 Reyes M, Nisenbaum R, Hoaglin DC, Unger ER, Emmons C, Randall B, Stewart JA, Abbey S, Jones JF, Gantz N, Minden S, Reeves WC: Prevalence and incidence of chronic fatigue syndrome in Wichita, Kansas. Arch Int Med 2003, 163:1530-1536.

      5 Jason LA, Richman JA, Rademaker AW, Jordan KM, Plioplys AV, Taylor RR, McCready W, Huang CF, Plioplys S. A community-based study of chronic fatigue syndrome. Arch Intern Med. 1999 Oct 11;159(18):2129-37.

      6 Jason, LA, Najar N, Porter N, Reh C. Evaluating the Centers for Disease Control's empirical chronic fatigue syndrome case definition. Journal of Disability Policy Studies 2008, doi:10.1177/1044207308325995.

      7 Kindlon T. Criteria used to define chronic fatigue syndrome questioned. Psychosom Med. 2010 Jun;72(5):506-7


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    1. On 2015 Aug 12, Jim Woodgett commented:

      A direct quote from reference 9 (referring to the source of the GIN inhibitor used here):

      "A similar assay measuring inhibition of GSK3-alpha was also routinely run, but 7-12 showed no significant ability to discriminate between the two isoforms of GSK3 (data not shown). To the best of our knowledge, no isoform specific inhibitors of GSK3 have been reported, probably due to their high sequence homology (vida supra)."

      This inhibitor (GIN) acts equally on both isoforms of GSK-3 (alpha and beta) and should not be referred to as a GSK-3beta selective inhibitor. This makes sense given that inhibition of GSK-3beta alone is insufficient for deregulation of beta-catenin (PMID: 17543867).


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    1. On 2014 Nov 14, Christopher Southan commented:

      A 2014 abstract from Novartis http://www.alzheimersanddementia.com/article/S1552-5260(14)01380-6/fulltext quotes "Bace1/2 inhibition does not regulate TMEM27 cleavage and has no impact on pancreatic β-cell function and mass in diabetic mice". Lets hope new PubMed results can resolve this controversy.


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    1. On 2013 Dec 09, John Cannell commented:

      The authors report that immune system dysregulation is common in autism spectrum disorder (ASD). The question is why does this immune dysregulation occur and what has caused such dysregulation to skyrocket in recent decades?

      Vitamin D deficiency produces very similar immune dysregulation to what the authors reported.

      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, 2014

      Meguid NA, 2010

      Mostafa GA, 2012

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

      DeLuca GC, 2013

      Eyles DW, 2013

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

      Cannell JJ, 2010

      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.

      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, 2012

      As the authors point out, immune dysregulation is common in ASD. The question is why now and what is causing it?

      John J Cannell, MD

      Vitamin D Council

      http://www.vitamindcouncil.org


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    1. On 2013 Oct 28, Konrad U Förstner commented:

      Unfortunately the content of the zip file which can be downloaded from the given URL (http://www.mediafire.com/FengLi/2DGelsoftware) is password protected.


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    1. On 2016 Jan 11, Brian Wasko commented:

      Cholesterol levels are a major risk factor for cardiovascular disease, which is the number one cause of death in the USA. The most commonly prescribed cholesterol lowering drugs are known as statins (e.g., Lipitor), which work by inhibiting cholesterol biosynthesis. Despite their success, statins have many side-effects that are likely due to the fact that statins inhibit not only cholesterol biosynthesis, but also synthesis of other important non-sterol compounds (e.g., Coenzyme Q10, Heme A, and prenylated proteins). By adding an inhibitor of squalene synthase in combination with either a statin or a nitrogenous bisphosphonate, I found that this appears to inhibit cholesterol synthesis more specifically than statins, and prevents the depletion of non-sterol compounds (the undesired effect of statins). This work was a proof of principle, and provides rationale to further develop these inhibitor combinations in order to create drugs superior to statins.


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    1. On 2017 Aug 06, Fernando Castro-Chavez commented:

      Dear Reader, in this work I was able to discover that the methodological linkers are able to self-anneal, escaping in such a way the enzymatic digestion while contaminating thousands of sequences in the Genbank with their undigested fragments while binding together two independent and separate segments of genetic sequence; the most common linkers or adaptors and their annealing, are presented as well as advice on how to recognize and eliminate such false sequences produced by the methodological technologies in use to multiply in vectors the genetic sequences. Sincerely, Fernando Castro-Chavez.


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    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


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    1. On 2017 Jan 20, Andy Collings commented:

      A subset of experimental results from this study were the focus of a replication attempt as part of the Reproducibility Project: Cancer Biology (https://osf.io/e81xl/wiki/home/). The experimental designs and protocols were reviewed and approved in a Registered Report (http://dx.doi.org/10.7554/eLife.07072) and the results of the experiments were published in a Replication Study (http://dx.doi.org/10.7554/eLife.21253).


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    1. On 2017 May 02, Peter Lorenz commented:

      Though the figures and the tables in the supplement contain the (probably correct) label TIF1B for an interaction partner of the HP1 proteins, the text says "TIF1alpha"! TIF1B_HUMAN in Uniprot is TIF1beta/TRIM28. This discrepancy is confusing things since TIF1alpha/TRIM24 can also interact with HP1 proteins.


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

      I found this a very helpful review of breast cancer cell lines and their appropriate use in research.


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    1. On 2014 Mar 09, Gyanshankar Mishra commented:

      We have also done a study on Tuberculosis management In India: Mishra G, Mulani J. Tuberculosis Prescription Practices In Private And Public Sector In India. NJIRM. 2013; 4(2): 71-78. Available online at http://www.scopemed.org/?mno=36915

      Our other study highlights the fact of how drug resistant TB is created under programmatic management of TB in India: Gyanshankar Mishra, S V Ghorpade, Jasmin Mulani (2014) XDR-TB: An outcome of programmatic management of TB in India. Indian Journal of Medical Ethics 11: 1. 47-52 Jan-Mar.Available online at http://216.12.194.36/~ijmein/index.php/ijme/article/download/932/2179

      Full text article Available online at http://www.ijme.in/index.php/ijme/article/view/932


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    1. On 2016 Feb 16, Gary Goldman commented:

      In this second study published 8 months following the first, Moro et al. noted 121 spontaneous abortion (SAB) and 19 stillbirth (SB) reports or a total of 140 fetal-loss reports to VAERS during the first 5 months of the 2009/2010 influenza season. This equates to greater than 57 reports per million (>140/2,437,113) vaccinated pregnant women. The ratio of the 140 fetal-loss reports during the incomplete 2009/2010 season to the 1.21 reports/year representing the mean of the 19 prior seasons, yields a 116-fold (140/1.21) increase in fetal-loss reports (SAB and SB) in the VAERS database. Moro et al. attributed this dramatic increase, in part, to reporting bias, citing a "Weber-like effect." The Weber effect is a temporal reporting pattern whereby the number of reported adverse events (AEs) for a new drug increases during the first 2 years of marketing and then subsequently declines, presumably reflecting decreased enthusiasm for reporting as AEs become well known.

      Despite the statistically significant rate ratio (RR) of 29.4 (95% confidence interval (CI): 19.0–45.8) for 2009/2010 fetal-loss report rate (57 reports/1 million) to the mean rate of 1.9 reports/1 million (over the previous 19 influenza seasons), the second Moro et al. study concluded, "… H1N1 vaccination in pregnant women did not identify any concerning patterns of maternal or fetal outcomes."

      That this large spike in fetal death case reports to VAERS during the 2009/2010 influenza season was unlikely a mere "Weber Effect" and indeed a concerning pattern among pregnant women is addressed in the Goldman GS study titled, Comparison of VAERS fetal-loss reports during three consecutive influenza seasons: Was there a synergistic fetal toxicity associated with the two-vaccine 2009/2010 season? Hum Exp Toxicol. 2013 May;32(5):464-75. doi: 10.1177/0960327112455067. Epub 2012 Sep 27. Goldman GS, 2013

      A study using a different methodology by Brown and Austin was published in Toxicological & Environmental Chemistry 2012 Sept;94(8):1610-27. Maternal transfer of mercury to the developing embryo/fetus: is there a safe level? DOI:10.1080/02772248.2012.724574 http://www.tandfonline.com/doi/abs/10.1080/02772248.2012.724574 It concluded: "It is, therefore, critical that regulatory advisories around maximum safe Hg exposures account for pregnant women and secondary exposure that children in utero experience. This study focused on standardized embryonic and fetal Hg exposures via primary exposure to the pregnant mother of two common Hg sources (dietary fish and parenteral vaccines). Data demonstrated that Hg exposures, particularly during the first trimester of pregnancy, at well-established dose/weight ratios produced severe damage to humans including death. In light of research suggestive of a mercuric risk factor for childhood conditions such as tic disorders, cerebral palsy, and autism, it is essential that Hg advisories account for secondary prenatal human exposures."


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    2. On 2016 Feb 16, Gary Goldman commented:

      None


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    1. On 2014 Mar 02, Joshua Gray commented:

      The article doesn't mention whether the patient's blister was deroofed or whether dermabrasion/debridement was performed. (The article does mention that blisters larger than 2 cm in diameter should be debrided on page 72.) Can you please provide a little more detail about how the blister was treated?

      Joshua Gray, Associate Professor of Chemistry, U.S. Coast Guard Academy


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    1. On 2014 Jul 17, Adam Jacobs commented:

      There are a number of problems with this study, and I fail to see how the authors conclusions of "no major problems of feasibility or acceptability of randomisation were found" can be supported.

      First, there is the question of feasibility. This study attempted to use 6 breast screening units. These units apparently volunteered for the study, so might be considered to be less likely to have feasibility problems than sites in general. Despite that, 1 of the 6 sites was unable to participate.

      There were clearly also resource implications in managing the study, but only an informal description was given of increases in workload. With no attempt made by the authors to quantify the increased workload, it is hard to judge how it might impact on feasibility.

      As for acceptability, it is not surprising that the authors found no problems, as they did not look for them. I could not find any mention of the study participants having been asked questions about acceptability.

      While women who were invited to screening could have spontaneously reported concerns about acceptability if they felt sufficiently strongly (though it is hardly realistic to expect that more than a tiny minority would do so if not specifically asked), women who were not invited, who would still be included in the study in the control group in the main age extension trial, were given no such opportunity.

      This study has therefore told us nothing about how acceptable the study participants found it to be included in a randomised trial without their consent.


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    1. On 2017 Jan 20, Andy Collings commented:

      A subset of experimental results from this study were the focus of a replication attempt as part of the Reproducibility Project: Cancer Biology (https://osf.io/e81xl/wiki/home/). The experimental designs and protocols were reviewed and approved in a Registered Report (http://dx.doi.org/10.7554/eLife.06847) and the results of the experiments were published in a Replication Study (http://dx.doi.org/10.7554/eLife.17044).


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    2. On 2013 Jun 17, Jessie Tenenbaum commented:

      With the disclaimer that this came out of my PhD lab (4 years after I left), I really like this paper. I remember seeing a naysayer comment (on GenomeWeb maybe?) questioning whether this belonged in STM, but this is exactly what big data mining approaches is meant to do- yes, it's about hypothesis generation, but if those hypotheses can then be validated in a model system, trimming years off the drug discovery process, that is truly impactful.


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    1. On 2016 Nov 21, ATUL BUTTE commented:

      Wow, sorry for the delay in replying! Yes, you are correct. The correct data set is GDS1615. Apologies for this error.


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    2. On 2016 May 03, Gregory Stupp commented:

      It seems the authors have referred to the wrong GEO data set (GDS2642: colonoscopic biopsies from CD or UC patients), when the data in fact looks to have come from GDS1615: peripheral blood mononuclear cells from CD or UC patients).

      As an example. The gene with the highest fold change in Table S1 is SERPINB2. This fold change can be seen in the GEO profile graph for GDS1615: http://www.ncbi.nlm.nih.gov/geo/tools/profileGraph.cgi?ID=GDS1615:204614_at but not from GDS2642: http://www.ncbi.nlm.nih.gov/geo/tools/profileGraph.cgi?ID=GDS2642:37185_at

      I verified the rest of the genes using the data from the SOFT files and also using geo2r: https://www.ncbi.nlm.nih.gov/geo/geo2r/?acc=GSE3365 https://www.ncbi.nlm.nih.gov/geo/geo2r/?acc=GSE6731


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    1. On 2015 Sep 17, Tom Kindlon commented:

      This study uses the (so-called) empiric CFS criteria (Reeves et al., 2005)

      Although they don't make it very clear, this study used the Reeves et al. (2005) criteria(1) for defining Chronic Fatigue Syndrome (CFS) (sometimes described by the CDC as an operationalization of the Fukuda et al. (1994) criteria (2)). This can be seen by examining the Reeves et al. (2005) paper which shows that 43 people from the two-day study satisfied the Reeves et al. (2005) operationalization of the criteria which the number satisfying how they operationalized the Fukuda et al. criteria was considering less(1,2).

      These (Reeves) criteria greatly increased the prevalence of CFS. The "empirical" definition gives a prevalence rate of 2.54% of the adult population(3) compared to 0.235% (95% confidence interval, 0.142%-0.327%) and 0.422% (95% confidence interval, 0.29%-0.56%) when the Fukuda definition was used in previous population studies in the US(4,5).

      The definition lacks specificity. For example, one research study(6) found that 38% of those with a diagnosis of a Major Depressive Disorder were misclassified as having CFS using the empirical/Reeves definition. A letter of mine discussed my concerns in more detail(7).

      Due to the problems with the criteria, these criteria have not been used by researchers outside those contracted to analyse CDC data (apart from Leonard Jason's research team who studied it and showed problems with it (6)).

      References:

      1 Reeves WC, Wagner D, Nisenbaum R, Jones JF, Gurbaxani B, Solomon L, Papanicolaou DA, Unger ER, Vernon SD, Heim C. Chronic fatigue syndrome – a clinically empirical approach to its definition and study. BMC Med. 2005;3:19.

      2 Fukuda K, Straus SE, Hickie I, Sharpe MC, Dobbins JG, Komaroff A. The chronic fatigue syndrome; a comprehensive approach to its definition and study. Ann Int Med 1994, 121:953-959.

      3 Reeves WC, Jones JF, Maloney E, Heim C, Hoaglin DC, Boneva RS, Morrissey M, Devlin R. Prevalence of chronic fatigue syndrome in metropolitan, urban, and rural Georgia. Popul Health Metr. 2007 Jun 8;5:5.

      4 Reyes M, Nisenbaum R, Hoaglin DC, Unger ER, Emmons C, Randall B, Stewart JA, Abbey S, Jones JF, Gantz N, Minden S, Reeves WC: Prevalence and incidence of chronic fatigue syndrome in Wichita, Kansas. Arch Int Med 2003, 163:1530-1536.

      5 Jason LA, Richman JA, Rademaker AW, Jordan KM, Plioplys AV, Taylor RR, McCready W, Huang CF, Plioplys S. A community-based study of chronic fatigue syndrome. Arch Intern Med. 1999 Oct 11;159(18):2129-37.

      6 Jason, LA, Najar N, Porter N, Reh C. Evaluating the Centers for Disease Control's empirical chronic fatigue syndrome case definition. Journal of Disability Policy Studies 2008, doi:10.1177/1044207308325995.

      7 Kindlon T. Criteria used to define chronic fatigue syndrome questioned. Psychosom Med. 2010 Jun;72(5):506-7


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    1. On 2017 Oct 19, Wanliang Shi commented:

      Please see the response: https://www.nature.com/articles/s41598-017-06415-5


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    2. On 2017 Aug 01, ANTHONY BAUGHN commented:

      Anti-tubercular Activity of Pyrazinamide is Independent of trans-Translation and RpsA. Dillon NA, Peterson ND, Feaga HA, Keiler KC, Baughn AD. Sci Rep. 2017 Jul 21;7(1):6135. doi: 10.1038/s41598-017-06415-5. Dillon NA, 2017

      https://www.nature.com/articles/s41598-017-06415-5


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    1. On 2013 Dec 10, Lorene M Nelson commented:

      From the senior author of the original article: Please note that a reply to this letter by Hill-Burns et al. was published in the European Journal of Neurology; however, PubMed failed to index the reply letter. For those who are interested, here is the citation for the reply letter: Popat RA et al., Eur J Neurol 2011;18:e109.


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    1. On 2014 Mar 12, George W Hinkal commented:

      None


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    2. On 2014 Feb 27, 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, nanomaterial characterizations and composition information for the eleven nanoparticles 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=32669696&page=0&tab=ALL

      https://cananolab.nci.nih.gov/caNanoLab/characterization.do?dispatch=summaryView&sampleId=32669697&page=0&tab=ALL

      https://cananolab.nci.nih.gov/caNanoLab/characterization.do?dispatch=summaryView&sampleId=32669698&page=0&tab=ALL

      https://cananolab.nci.nih.gov/caNanoLab/characterization.do?dispatch=summaryView&sampleId=32669699&page=0&tab=ALL

      https://cananolab.nci.nih.gov/caNanoLab/characterization.do?dispatch=summaryView&sampleId=32669700&page=0&tab=ALL

      https://cananolab.nci.nih.gov/caNanoLab/characterization.do?dispatch=summaryView&sampleId=32669701&page=0&tab=ALL

      https://cananolab.nci.nih.gov/caNanoLab/characterization.do?dispatch=summaryView&sampleId=32669702&page=0&tab=ALL

      https://cananolab.nci.nih.gov/caNanoLab/characterization.do?dispatch=summaryView&sampleId=32669703&page=0&tab=ALL

      https://cananolab.nci.nih.gov/caNanoLab/characterization.do?dispatch=summaryView&sampleId=32669704&page=0&tab=ALL

      https://cananolab.nci.nih.gov/caNanoLab/characterization.do?dispatch=summaryView&sampleId=32669705&page=0&tab=ALL

      https://cananolab.nci.nih.gov/caNanoLab/characterization.do?dispatch=summaryView&sampleId=32669707&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


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    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


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    1. On 2014 Sep 25, William Cawthorn commented:

      "impact factors remain the key measure of a journal’s prestige and, by inference, your own."

      I've no doubt that impact factors are important to a journal's editors. But the idea that impact factors in any way reflect the quality or reliability of the science, or indeed the ability and creativity of an individual scientist, is very damaging.

      http://www.sciencedirect.com/science/article/pii/S0960982207015163


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    1. On 2016 Feb 18, Kristina Hanspers commented:

      The pathway in figure 10 is available in the "Open Access Publication" collection at WikiPathways: http://www.wikipathways.org/index.php/Pathway:WP2638. This pathway can be downloaded for use in network analysis tools such as Cytoscape and PathVisio.


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    1. On 2017 Mar 01, Jörg Hakenberg commented:

      GNAT results for Medline citations are now available from our Sourceforge project for download. Please see https://sourceforge.net/projects/gnat/files/results/medline/ .


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    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


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    1. On 2017 Aug 17, Jesper M Kivelä commented:

      This re-analysis He FJ, 2011 of an earlier version Cochrane review Taylor RS, 2011 considering cardiovascular events (CVD) at longest follow-up is based on wrong numbers extracted from trials (namely TOHP 1 trial). There were 17 CVD of total 231 (not 321) patients in intervention group and 32 CVD of total 311 patients in control group in TOHP I (Table 2) Cook NR, 2007. See also my comment in current version of Cochrane review Adler AJ, 2014. Contrary, different numbers were extracted by O´Donnell et al O'Donnell MJ, 2013 in their analysis of the same set of 4 studies than used in He FJ, 2011.

      In current version of Cochrane review, average risk ratio was 0.81 (95% CI 0.66 to 0.98) for CVD at longest follow-up based on 6 studies (Analysis 1.5) Adler AJ, 2014. However, between-study variance was estimated to be zero which is implausible based on empirical evidence from Cochrane Database of Systematic Reviews Turner RM, 2012, Turner RM, 2015. In other words, a small amount of between-study variance should be expected even for end-points like all-cause mortality Turner RM, 2012, Turner RM, 2015.


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    1. On 2014 May 21, Amanda Capes-Davis commented:

      Please be aware that FL is not an amnion cell line. It is known to be cross-contaminated with HeLa, a cervical carcinoma cell line. For a list of known cross-contaminated or misidentified cell lines, see http://iclac.org/databases/cross-contaminations/.


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    1. On 2014 Sep 22, Thomas Perls, MD, MPH commented:

      The corrected version of this work is at: http://www.ncbi.nlm.nih.gov/pubmed/22279548

      PLoS One. 2012;7(1):e29848. doi: 10.1371/journal.pone.0029848. Epub 2012 Jan 18. Genetic signatures of exceptional longevity in humans. Sebastiani P1, Solovieff N, Dewan AT, Walsh KM, Puca A, Hartley SW, Melista E, Andersen S, Dworkis DA, Wilk JB, Myers RH, Steinberg MH, Montano M, Baldwin CT, Hoh J, Perls TT.


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    1. On 2014 Oct 10, Ellen M Goudsmit commented:

      Case definitions should also recognise the progressive form of the disease.

      Howes and Goudsmit (submitted) suggest that :

      A diagnosis of progressive ME is supported by the following:

      1. Sudden increase in sensitivities and gastro-intestinal symptoms.
      2. Sudden worsening of existing neurological symptoms or new symptoms, e.g. blurred vision in one eye, weakness in one leg, incontinence.<br>
      3. Improvements are limited, disability tends to show a downwards trend.
      4. Patient has to spend more time at home or in bed.
      5. New auto-immune diseases e.g. symptoms consistent with Sjogren’s syndrome.

      Supportive evidence of pathology:

      MRI, abnormal white matter lesions not indicative of MS.


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    2. On 2014 Jan 21, Ellen M Goudsmit commented:

      The International Consensus Criteria or ICC initially appeared to be resolve a lot of problems relating to heterogeneity of the population, describing many of the symptoms of classic ME and avoiding the vagueness of the term ‘malaise’ used in case definitions for CFS. The ICC are more specific, referring to a pathological inability to produce sufficient energy on demand, “postexertional symptom exacerbation”, “postexertional exhaustion” , “a marked, rapid physical and/or cognitive fatigability in response to exertion”, a prolonged recovery period and “a low threshold of physical and mental fatigability (lack of stamina) resulting in a substantial reduction in pre-illness activity level”. Postexertional neuro-immune exhaustion (PENE) as they named this characteristic feature, had to cause marked disability and was compulsory for diagnosis. However, it's not easy to assess in practice. In a recent study by Jason et al. [1], more than 10% of the patients selected using the ICC did not report that minimal exercise made them tired. This is possibly because the researchers required only one of the characteristics of PENE to be present, rather than all.

      A second study from Jason and his colleagues also compared the CDC criteria with the ICC and showed that while the latter identified a subset of patients with more functional impairments and physical, mental and cognitive problems, they also had a higher rate of psychiatric illness.[2] Indeed, 61.5% had a current psychiatric diagnosis compared to 27% who fulfilled the CDC criteria. Again, this may be a result of patients reporting evidence of post-exertional worsening but not meeting every characteristic of PENE. This 'short-cut', also likely to occur in clinical practice, might have led to misclassification.

      For example, another interesting finding was that more than a half had a gradual onset. This plus the higher rate of psychiatric illness are at odds with descriptions of individuals with classic ME, more of whom report an acute infectious onset and symptoms such as muscle weakness and an intolerance to alcohol.[3 p.147, 4,5] They also tend to have lower rates of psychiatric illness.[6,7,8] According to Jason et al. [1], the requirement of a larger number of symptoms (at least eight for the ICC versus five for the CDC criteria) might “inadvertently increase the rate of psychiatric morbidity” and they recommended further refinement of case definitions focusing on a small set of core symptoms. Finally, based on a review of all criteria, they noted some of the disadvantages of polythetic case definitions that include patients on the basis that they experience a certain number of listed symptoms, many of which are ubiquitous and do not allow clinicians to differentiate between CFS and other disorders.[1,8,9]

      [1] Jason LA, Sunnquist M, Brown A, Evans M, Vernon, SD, Furst JD, Simonis, V. Examining case definition criteria for chronic fatigue syndrome and myalgic encephalomyelitis. Fatigue: Biomed Health Behav. Epub 2013 Dec 11. Available from: http://dx.doi.org/10.1080/21641846.2013.862993

      [2] Brown AA, Jason LA, Evans MA, Brown M, Flores S. Contrasting case definitions: The ME international consensus criteria vs. the Fukuda et al. CFS criteria. North Am J Psychol. 2013;15(1):103–120.

      [3] Shepherd C. Living with M.E. 2nd ed. London: Cedar; 1992.

      [4] Dowsett EG, Ramsay AM, McCartney RA, Bell EJ. Myalgic encephalomyelitis a persistent enteroviral infection? Postgrad Med J, 1990;66:526 530.

      [5] Smith DG. Understanding M.E. The phenomenon of myalgic encephalomyelitis and acute onset post viral fatigue syndrome. London: Robinson Publishing; 1989. p. 184-185.

      [6] Dowsett EG, Welsby PD. Conversation Piece. Postgrad Med J. 1992; 68:63-65.

      [7] Yeomans JDI, Conway SP. Biopsychosocial aspects of chronic fatigue syndrome (myalgic encephalomyelitis). J Infect. 1991;23:263-269.

      [8] King C, Jason LA. Improving the diagnostic criteria and procedures for chronic fatigue syndrome. Biol Psychol. 2005;68: 87-106.

      [9] Goudsmit E, Shepherd C, Dancey CP, Howes S. ME: Chronic fatigue syndrome or a distinct clinical entity? Health Psychol Update. 2009;18(1):26-33.


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    3. On 2014 Jan 20, Ellen M Goudsmit commented:

      There are other criteria for ME based on the work of experts such as Drs. Ramsay, Dowsett and Parish. Lack of interest in classic ME has made it extremely difficult to place these criteria in the scientific domain.

      Myalgic Encephalomyelitis (ME). Criteria and clinical guidelines 2014.

      Sandra Howes<br> Ellen M Goudsmit PhD FBPsS<br> Charles Shepherd MBBSc

      Abstract

      Myalgic encephalomyelitis (ME) is a disabling condition characterised by profound fatigue following minimal exertion and a delay in recovery after exertion ends. In 1988, when specialists introduced the concept of chronic fatigue syndrome (CFS), it was assumed that the illness in question was identical to ME but the lack of consensus criteria for the latter has prevented the testing of this assumption. In this article, we propose criteria and guidelines which can be used to study ME and determine whether it is a synonym for CFS or one of several subgroups contained within the CFS construct. If clinically meaningful differences are identified, the criteria may help to increase diagnostic precision and facilitate further research into the cause, course and treatment of ME.

      Extract

      The criteria for research into ME [1]

      All patients should fulfil the following five criteria: 1. A new onset of significantly abnormal levels of muscle fatiguability and/or muscle weakness, precipitated by relatively minor levels of activity. Symptoms typically worsen during the next 24-48 hours. 2. The presence of symptoms indicating the involvement of the brain and central nervous system (e.g. impaired short-term memory and concentration, disturbed sleep patterns, balance problems). 3. Periods of impaired circulation compatible with autonomic dysfunction (e.g. facial pallor, disturbances in thermoregulation including inappropriate sweating and sensitivity to both heat and cold; postural hypotension and/or orthostatic intolerance). 4. Fluctuation of symptoms, from hour to hour and day to day. 5. These symptoms must have been present during the past three months (to exclude patients with the debility which often follows illnesses such as influenza).

      Guidelines

      Many symptoms experienced by people with ME are also reported by people with other disorders. The most prevalent of these include pain – which can be muscular, arthritic or neuropathic in character; hyperacusis and tinnitus; photophobia and blurred vision; frequency of micturition and hypersensitivity to chemicals and drugs. Also common are symptoms suggestive of immune system dysfunction and/or persisting infection, such as episodes of low-grade fever (not exceeding an oral temperature of 38.6C) combined with feeling feverish; sore throat which may be persistent or recurrent, and arthralgia.

      While the presence of these symptoms are not discriminative, the marked diurnal fluctuations in severity are typical of ME. Exacerbations are frequently triggered by physical or mental exertion and this association should always be sought whilst taking the history.[2] Characteristic physical signs are sometimes seen in ME and in combination with the symptoms above also contribute to the validity of the diagnosis. Nevertheless their absence does not exclude the condition. They are as follows: 1. Pharyngitis. 2. Tenderness and possible enlargement of lymph nodes. 3. A positive Romberg test or Fukuda test.

      Course

      Although ME often follows an infection, usually a viral illness (which may be sub-clinical), it may also be triggered by other factors such as immunizations, trauma and exposure to chemicals. Furthermore, in a minority of patients, ME has a gradual onset with no apparent triggering factor. For these reasons, and in line with the criteria for CFS, evidence of a preceding viral illness is not a prerequisite for diagnosis or inclusion in a study group.

      Assessment, investigation and diagnosis

      Because it is vital that the samples used in research are as 'pure' as possible, the presence of certain co-morbid disorders would be grounds for disqualification. Some of the more common alternative diagnoses to be borne in mind before selecting a participant for a study on ME are listed in Shepherd and Chaudhuri[2,p.15]

      Other reasons for exclusion from research into ME

      It is of particular importance to identify cases of chronic fatigue which can be largely explained by psychological factors. For example, if there are signs of persistent anhedonia, apathy, low self-esteem, feelings of worthlessness and guilt, the possibility of primary depressive illness should be considered and, if there is any doubt, the participant should be excluded from the study. Similarly, if the patient has had any other illness or undertaken any treatments - orthodox, complementary or nutritional - in the previous three months, their inclusion may introduce additional variables which could confound the results.

      Measures to aid diagnosis and selection of samples

      We recommend that the Profile of Fatigue-Related Symptoms (PFRS) developed by Ray et al. [3] may help support the diagnosis and suggest that a person should score at least 2 out of six on the two items relating to the presence of muscle weakness. This is a core symptom and the score provides additional evidence of its presence and severity. The testing of muscle fatigue on two occasions, at least 24 hours apart, may also be of value.

      A protocol was developed by Dr Parish, a rheumatologist who has studied ME since 1955. Using criteria almost identical to those proposed above (Wood, personal communication), Paul et al. [4] found a significant decline in quadriceps strength which persisted after 24 hours in all the participants. Moreover, there were significant differences between the patients and controls during the recovery phase, 200 minutes following exercise, when the results of the latter had returned to normal, and after 24 hours. This protocol is different to others that have evaluated post-exertional fatigue in that it demands a continually increasing energy cost throughout the duration of the exercise period, and therefore differs from the steady levels achieved in cycle ergometry used in other studies.<br> However, one cycling exercise test that deserves further consideration was recently described by Snell et al.[5] Although the patients were diagnosed with CFS, all reported a worsening of symptoms after physical activity. Various tests using a cycle ergometer were conducted to evaluate work efficiency, i.e., oxygen consumption and work output at the ventilatory/anaerobic threshold. The results revealed lower workloads and oxygen consumption at peak exercise compared to sedentary controls but none of the individual tests helped to discriminate between the groups on day 1. However, data from the second session showed a decrease in performance in patients that was not seen in controls and identified two measures which contributed most to the discrimination between the groups (workload at ventilatory threshold and peak workload). The researchers noted that their findings may have been affected by the heterogeneity of the sample but the results helped to correctly classify over 95% of the participants and demonstrated the importance of a second test.

      [1] Goudsmit E et al. ME: Chronic fatigue syndrome or a distinct clinical entity? Health Psychol Update. 2009;18(1):26-33.

      [2] Shepherd C, Chaudhuri A. ME/CFS/PVFS. An exploration of the key clinical issues. 4th ed. ME Association; 2008.

      [3]Ray C et al. Development of a measure of symptoms in chronic fatigue syndrome: The profile of fatigue-related symptoms (PFRS). Psychol Health. 1992;7:27-43.

      [4] Paul L et al. Demonstration of delayed recovery from fatiguing exercise in chronic fatigue syndrome. Eur J Neurol. 1999;6:63-69.

      [5] Snell CR et al. Discriminative validity of metabolic and workload measurements to identify individuals with chronic fatigue syndrome. Phys Ther. 2013;93(11):1484-1492.


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    1. On 2017 Aug 07, Randi Pechacek commented:

      Jonathan Eisen wrote a blog post on microBEnet using this paper as inspiration for a discussion on the microbes in tobacco products.


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    1. On 2017 May 23, Morten Oksvold commented:

      This article was retracted April 27 2017 together with eight other articles from the same group due to data manipulations.

      Please note that the retraction notice is visible in the PDF document only.

      http://www.jbc.org/content/286/35/31022.full.pdf?sid=a8d5dc2c-dd64-4b19-bf5e-c46f7deb9f49

      "This article has been withdrawn by the authors. The gJNK panel from SK-OV-3 cells was reused in the gJNK panel from OVCAR-3 cells in Fig. 1A. The tubulin panel in Fig. 2 C was reused as the right g-p38  in Fig. 4 B, and as the IP: gMLK3 and IB: gMLK3 panel in Fig. 6F. The left p473 AKT immunoblot and the right p308 AKT immunoblot in Fig. 4D were inappropriately manipulated. Also, the right AKT immunoblot from Fig. 4D was reused as the right AKT immunoblot in supplemental Fig. S2 B. Lanes 2 and 3 of the JNK immunoblot in Fig. 6D were reused in the JNK immunoblot from Fig. 6 E. The MKK4 immunoblots in Fig. 7A were duplicated. Lanes 2 and 3 and lanes 5 and 6 of the upper JNK immunoblot in Fig. 7C were reused in the lower left and right JNK immunoblots, respectively. The AKT immunoblot from SVOG-40 cells in supplemental Fig. S2A was reused in the AKT immunoblot from SVOG-40 cells in supplemental Fig. S2B. The pc-Src panel from supplemental Fig. S3A and the right AKT immunoblot from supplemental Fig. S3C were manipulated inappropriately. The authors state that these errors do not affect the results or conclusions of the work."


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    1. On 2015 Sep 04, David Vaux commented:

      None


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    2. On 2014 Nov 30, Morten Oksvold commented:

      The mice shown in suppl. fig 9 have ulcerating tumors and some of the mice have tumors more than 6cm3 in size. How was the animal experiments in this study reviewed and approved by the MGH Subcommittee on Research Animal Care? Why are the Editors at Nature and its reviewers apparently unaware of the generally accepted guidelines for animal welfare?


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    1. On 2013 Jun 26, Matthew Stephens commented:

      This paper is a beautiful example of a simple idea leading to useful inference (and a type of inference that is generally really difficult). I have to admit I would never have tried this myself, anticipating that variation in mutation rate across the genome would have caused too many problems, but it seems that this is less of a concern than I would have expected.


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    1. On 2016 Aug 21, Morten Oksvold commented:

      Please note that this article represents one of eleven publications which were found to contain false data, after an investigation led by ORI in 2015:

      https://ori.hhs.gov/content/case-summary-dasmahapatra-girija

      This article should therefor not be cited.


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    1. On 2013 Oct 27, Gary Mirams commented:

      The MICEE database is now available for testing https://www.micee.org/. Please try to enter details for any cardiac electrophysiology experimental papers, and give feedback on usability and usefulness, together with any changes you would propose to the schema.


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    2. On 2013 Oct 27, Gary Mirams commented:

      None


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    1. On 2017 Aug 06, Fernando Castro-Chavez commented:

      Dear Reader, Among other things, in this article I present the perfect mathematical symmetry and balance between the opposite quadrants of the classic circular rotating genetic code; and also, the rules of variation are expanded by comparing each compatible organism as an orbit with each dot within such orbit being a variety of it, such as those more than 200 breeds of dogs, being also genetically compatible with them the savage wolves and coyotes and jackals and dingoes, and New Guinea´s singing dogs; the same with the South American Camelids, being genetically compatible the Llama, the Guanaco, the Alpaca and the Vicuña; the same for all the varieties of finches from the Galapagos Islands, just to put some examples of compatible organisms that have been systematically misclassified as if they were many times even members of different genus, not to say "species", this rampant classifying mistake of organisms in biology is as dramatic and drastic as if the different colors of humans had been the basis to misclassify them as different "species", which fortunately did not happen with humans, but it did happen with other every organism, starting with the dog, the "best friend of man", sincerely, Fernando Castro-Chavez.


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    1. On 2013 Dec 22, Lothar Hennighausen commented:

      MiR-193b and miR-365-1 are not required for the development and function of brown fat in the mouse (PMID: 24356587)


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    1. On 2015 Jun 23, Anne Niknejad commented:

      citation:'Prpsap2 negatively regulates phosphoribosyl pyrophosphate (PRPP) synthetase [22].'

      Checking ref.22 (http://www.ncbi.nlm.nih.gov/pubmed/?term=9545573), there is this sentence: 'The contribution of PAP41 to the regulation of PRPP synthesis remains to be studied.'

      PAP41 is short name for Prpsap2 (http://www.uniprot.org/uniprot/O60256)


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    1. On 2017 Mar 23, Misha Koksharov commented:

      By the way, there was an older study on the same topic and with the same problems: Yamazaki S, 1994


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    1. On 2015 May 22, University of Kansas School of Nursing Journal Club commented:

      Team 1: Courtney Borchers, Elizabeth Bruns, Jesi James, Israel Mendoza, Elizabeth Murphy, Faith Nightingale, Kimberly Seals

      Section 3 Journal Club: A review of Smith, C. A., Fisher, C., & Mercer, A. (2011) Rediscovering nursing: A study of overseas nurses working in Western Australia

      Background Introduction:

      The article by Smith, Fisher, and Mercer (2011) studied the work experience of internationally-educated migrant nurses with a non-English speaking background who came to practice in Western Australia (WA), Australia from various countries around the world.  This study was initiated in hopes to gain perspective from competent migrant nurses who must adjust their knowledge, skills, and attitudes about nursing to those of the host country for which they seek employment.  Our team chose this article because we have discussed the concept of migrant nurses in class; in addition, the movement to develop a more diverse nursing work force will impact our nursing careers as the United States becomes even more diversified in the years to come.  This article fills a knowledge gap by providing us with information about the importance of understanding the diversity in practice of internationally-educated migrant nurses and how to better facilitate the transition of the migrant nurse into the work environment.
      

      Methods:

      Our group utilized the CINAHL database to find this particular article. In this study, Smith, Fisher, and Mercer (2011) performed a qualitative study using transcendental phenomenology and Moustakas’ method of analysis for interpretation of results after conducting personal interviews. Open-ended questions about experiences and feelings were asked and responses were audio-taped and transcribed.

      Recruitment in the form of posters and flyers were distributed in two hospitals and participants were ultimately recruited as a result of snowball sampling. Thirteen women from nine different countries who lived in WA between 4 and 20 years were selected for the sample. Countries of origin included China, South Africa, Japan, Taiwan, Zimbabwe, Hong Kong, the Philippines, Sweden, and Nepal. All nurses came from non-English speaking countries, had a non-English speaking background but were still linguistically competent, and were all qualified to work as nurses in Western Australia. Ethical approval was granted by the Human Research Ethics Committee of the University of Western Australia, participants were informed about the purpose of the study, and were promised anonymity and confidentiality.

      Findings:

      Key findings of this particular study by Smith, Fisher, and Mercer (2011) were summarized into four themes: preparedness to work, working with patients, working with doctors, and professionalism.  Regarding preparedness to work, it was concluded that although nurses were deemed competent, had gained registration to practice, and could identify the basic role of the nurse; they found many concepts of nursing in WA to be very different from nursing practice in their home country.  For example, some nurses felt that the scope of clinical skills were more limited and less advanced than the scope of practice in their home country.  However, nurses were puzzled that the broadened scope of practice in terms of emphasis on communication, holistic patient care, and the expectation to know about specialized services in WA was understood as a norm.  Regarding working with patients, nurses expressed that initially they were surprised at the decreased patient load compared to their home country, but eventually understood that the reasoning for this was to promote the holistic and patient-centered approach for which they were so astounded about previously.  In regards to working with doctors, some nurses expressed that the nurse-doctor relationship was more relaxed and less formal in WA, yet they still felt a strong hierarchy that did not exist in their home country.  When it came to professionalism, participants admitted that the working conditions and pay were more favorable in WA than in their home country and felt valued as nurses within the health care system, however, they felt a low level of respect in regards to nursing as a profession from patient’s and society in general.  The study group also felt a sense of lack of unity and motivation from native nurses in WA and contributed these themes to lack of professionalism enforced by the WA health system as a whole.  The results concerning the four themes discussed were consistent with the literature and findings from other studies conducted throughout the world. 
      
      Limitations of the study were not discussed but should include a small sample size. 
      

      Implications:

      Similar to the US, migrant nurses who wish to work in Australia must pass certain eligibility criteria and may be required to take a competency test or pursue further education.  Migrant nurses in Australia must also pass the Occupational English Test or the International English Testing System (Smith, Fisher, & Mercer, 2011).  Regardless of the country in which an internationally-educated nurse wishes to work, all migrant nurses ultimately have to adjust their nursing practice to however the host countries contextual social, political, and economic constructs have made nursing as a profession to become.  According to Newton, Pillay, and Higginbottom (2012), “...Circumstances differ between countries to such an extent that there may be wide variation in the context of health care delivery and the education of health professionals, including nurses” (p. 535).  It is important to understand that the migrant nurse may feel many emotions as he/she may potentially learn about a very different set of nursing standards than his/her home country’s’ standards.
      
      These particular types of studies are important to nursing and nursing practice because the findings demonstrate the need for awareness of nurses to aide in the integration and transition of internationally-educated migrant nurses into practice.  It is also important because educational efforts for cultural competency in the academic setting will continue to grow and become more necessary as the United States is continually becoming more diversified.  
      
      In conclusion, our group feels this topic is important because we, as future nurses, will need to show compassion toward the migrant nurse’s concerns, as well as an eagerness to learn about what they already know.  We will also need to demonstrate a culture of unity and will ultimately need to assist migrant nurses as they go through the journey of becoming accustomed to the American nursing ways.
      

      References

      Newton, S., Pillay, J., & Higginbottom, G. (2012). The migration and transitioning experiences of internationally educated nurses: a global perspective. Journal Of Nursing Management, 20(4), 534-550. doi:10.1111/j.1365-2834.2011.01222.x

      Smith, C. A., Fisher, C., & Mercer, A. (2011). Rediscovering nursing: A study of overseas nurses working in Western Australia. Nursing & Health Sciences, 13(3), 289-295. doi:10.1111/j.1442-2018.2011.00613.x


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    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 NCT00624930. We believe the correct ID, which we have found by hand searching, is NCT00624390.

      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


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    1. On 2014 Feb 28, Valeria Fadda commented:

      Valeria Fadda, Dario Maratea, Sabrina Trippoli, Roberta Gatto and Andrea Messori - HTA Unit, Regional Health System, 50100 Firenze (Italy)

      Since the meta-analysis by Maratea and co-workers was carried out with relative risk (RR) as outcome measure, we recomputed these results according to the outcome measure of risk difference (RD) by using random-effect model. Figure 1 (available at http://www.osservatorioinnovazione.net/papers/thr_res2014.jpg), show the outcome measures (RD) calculated for individual trials (squares = outcome measure; horizontal bars = 95%CIs of the outcome measure) and for the pooled analysis (diamond in blue and vertical dotted line in red). I2 is a measure of heterogeneity. Statistical calculations were performed by the OMA software (Open Meta-Analyst version 4.16.12, Tufts University, U.S., url http://tuftscaes.org/open_meta/). The complete references for the 10 randomized trials can be found in the article Maratea D, Fadda V, Trippoli S, Messori A. Prevention of venous thromboembolism after major orthopedic surgery: indirect comparison of three new oral anticoagulants. J Thromb Haemost. 2011 Sep;9(9):1868-70.

      Abbreviations: Ev, number of events; Trt, number of patients receiving treatment.


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    1. On 2013 Oct 25, Gary Mirams commented:

      I would like to draw attention to the fact that the results indicated in our paper for the Decker 2009 model in Figure 5 are inaccurate, due to a bug in the CellML representation of the model. There are details in a blog entry here.

      This doesn't contradict any of the conclusions of the paper (we did suggest in one case that "This suggests the possibility that the CellML implementation of the model still requires curation"). Rather, this observation strengthens the idea that the community must do more rigorous curation of models. But I want to notify readers that the results shown for the Decker 2009 model are inaccurate.


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    1. On 2014 Aug 10, Matthew Katz commented:

      CALGB 8433 proved the ability to improve cure rates in non-small cell lung cancer by combining chemotherapy with radiation. As of 2014, platinum-based regimens are still standard. The trend has been toward concurrent chemoradiation based on small increases in survival. But some patients still may benefit from a sequential approach to treatment.


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    1. On 2016 Aug 17, Marco Galardini commented:

      This software and server is no longer being actively maintained and supported (even though there might be occasional bugfixes and replies to simple requests). The recommended replacement is Medusa (http://combo.dbe.unifi.it/medusa and http://bioinformatics.oxfordjournals.org/content/31/15/2443)


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    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 NCT006895906. We believe the correct ID, which we have found by hand searching, is NCT00685906.

      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


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    1. On 2013 Jul 01, Joshua L Cherry commented:

      This paper argues that protein evolution proceeds in a particular way: changes to the protein surface occur, and these enable changes to the core. Such a process would be non-time-reversible: fixation of the back-mutation(s) of the core, followed by the thus enabled backward change in the surface, is precluded, or at least less likely. This would be odd long-term behavior in the presence of fixed selective constraints. Furthermore, it is not clear how such irreversibility could be detected by the methods employed. This interpretation of Fig. 4A requires either that our observations start at some special time in the evolutionary process, or that the long-term process is somehow different from the sum of its parts. This is particularly strange-seeming because the longer evolutionary distances correspond to greater distances backward in time from contemporary species to common ancestors.

      The phenomenon in Fig. 4A is in fact expected as an artifact of saturation effects. Rapidly changing positions become subject to such effects at shorter overall distances than slowly changing positions. Because surface positions are on average more rapidly evolving than core positions, the form of the nonlinearities in Fig. 4A is expected even in the complete absence of surface-core interactions.


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    1. On 2014 Jan 12, Brett Snodgrass commented:

      Dear Authors,

      Thank you very much for the excellent publication and acknowledging that the connections between the coronary arteries and left ventricle were not probably not veins.

      These connections may represent the vessels of Wearn, which appear unusually prominent.

      An applicable ICD9 code might be 746.85, coronary artery anomaly, as it may meet the clinical criteria for the definition of fistulae.

      Referring to these arterial connections as Thebesian veins has caused me much confusion when I was trying to understand the simple relationship of pulmonary atresia with intact ventricular septum and the coronary arteriopathy seen in PAIVS. With the growth of social media, and electronic data storage, I think that we may now be able to address the diffuse distribution of ambiguous or misleading nomenclature that fills as least half of related publications.

      Dr. Paul Lurie's plea for collaboration in this regard has motivated me to take several steps in an effort to try to help produce accurate, simple, precise anatomic nomenclature and include:

      1. I collaborated with Elsevier to help get the article by Wearn et al. changed to open-access. http://bit.ly/JTWearn

      2. I obtained the original article (through ArtRieve http://www.artrieve.com/) written by Thebesius and uploaded the first digital copy. http://bit.ly/Thebesius

      3. I published or wrote in the American Journal of Cardiology, Cardiovascular Pathology, Twitter, Facebook, Google Plus, and directly E-mailed several authors that were publishing related content.

      4. I have posted numerous PubMed Commons comments. I regret that they may not always be helpful to every user, but I echo Dr. Lurie’s plea for collaboration in this regard. The PubMed Commons commentary is a welcome means with significant potential to vastly improve the peer review process.

      My aim is that researchers in the future will probably not need to read more than 30 articles before they realize that myocardial sinusoids indeed exist, they were defined by Wearn, and that Thebesian veins are not arteries.

      Please see

      1. http://bit.ly/JTWearn

      2. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1933738/

      3. http://bit.ly/vasaThebesii

      4. http://bit.ly/ThebesianByPratt

      My opinion is that accurate anatomic terminology is a basic principle underlying good medical science, and I ask others to consider whether the aforementioned definitions are appropriate. If this comment is not helpful, please let me know how it might be improved.

      Comments and suggestions are welcome.

      Thank you very much.


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    1. On 2013 Oct 29, Kenneth Witwer commented:

      This paper describes an extremely well controlled study of the respiratory tract microbiome by high throughput sequencing. In addition to the interesting biological findings, the article (along with Charlson ES, 2012) has important technical implications. Nucleic acid contamination is widespread and will confound results if not controlled for carefully, as these authors have so elegantly done. Here, diverse sequences were obtained even from "microbiologically sterile" solutions and medical instruments. Users of sensitive sequencing techniques to investigate foreign sequences should take note.


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    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


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    1. On 2013 Nov 04, Jamie Horder commented:

      In keeping with these results, van Pelt et al van Pelt S, 2012 reported strong heritability of the peak frequency of visually-induced gamma band oscillations, in a MEG study of 80 healthy twins (20 DZ pairs and 20 MZ pairs).


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    1. On 2016 Nov 20, Morten Oksvold commented:

      An investigation committee at Wayne State University (WSU) recommends that 42 articles from Fazlul Sarkar to be retracted (report finished August 31, 2015). This article represents one of them.

      This information was published by Retraction Watch (November 17, 2016) and you can find a link to the full report here:

      http://retractionwatch.com/2016/11/17/details-of-investigative-report-into-sarkar-released-by-aclu/

      This article should therefore no longer be cited.


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    1. On 2014 Feb 14, David Keller commented:

      Clarification: I fully agree with the authors that research is needed to develop better options for treating patients for chronic pain. Physicians should be vigilant regarding persons who lie or feign pain symptoms in order to obtain opioids for illegal purposes. Physicians who violate the law by knowingly prescribing opioids for resale or abuse are criminals and should be prosecuted.


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    2. On 2014 Feb 14, David Keller commented:

      In response to the editorial “Opioids for Chronic Pain”:

      1) The authors distinguish between patients with chronic pain, and patients whose painful condition has a “clear end point of cure or death” (e.g. cancer). They propose restricting or denying opioid prescriptions for chronic pain patients. I disagree. If a patient with severe chronic pain might obtain some relief from opioid therapy, it is wrong to deny the patient that choice.

      2) The authors argue that opioids only reduced pain scores by approximately 30% in clinical trials. Why not let the patient decide whether a 30% reduction in pain is worth the side effects and risks of opioid therapy? The degree of pain reduction is subjective and varies between individuals.

      3) Overdose deaths caused by opioid abuse are tragic, and we need to work harder to prevent them. At the same time, we are obligated to relieve suffering, and if opioids are required, then they should be an option. Doctors need to educate patients on the safe use of opioids, as with other drugs which can cause overdose deaths (e.g. warfarin, insulin). If a patient requires escalating doses of opioids, or if their physician is uncomfortable about their treatment for any reason, they should be referred to a pain specialist.

      4) The authors argue that government regulations make it too burdensome for physicians to prescribe strong opioids, which require monthly visits and non-refillable scripts. We should work to reform those regulations, not use them as an excuse to under-treat pain patients.

      5) The authors advocate trying NSAID's, anti-depressants, and physical therapy before prescribing opioids. However, some patients are in too much pain to tolerate physical therapy. Depression caused by unrelenting physical pain may not remit until the pain is treated. And NSAID's can worsen hypertension, coronary disease, renal insufficiency, peptic ulcer disease and congestive heart failure. Opioids can often be prescribed safely in these conditions when NSAID's cannot. Adjunctive treatments should supplement opioids which are required for severe pain, with the goal of tapering the opioids as tolerated.

      It is true that physicians need to exercise greater care when prescribing strong opioids, but to deny or restrict opioids for chronic pain patients is not humane or sensible.

      To facilitate discussion, I respectfully request the person who found this comment "not helpful" to state their reason


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    1. On 2016 Sep 06, Morten Oksvold commented:

      Please note that part of this study is not reliable due to report of falsified/fabricated data in figure 3C:

      "...Respondent falsified and/or fabricated the results in Figure 3C by using the same gel images to represent expression of PLDN in fibroblasts and melanocytes".

      A full report has been published by ORI:

      http://ori.hhs.gov/content/case-summary-cullinane-andrew-r


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    1. On 2014 Jan 08, Brett Snodgrass commented:

      Dear Author,

      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/Thebesius http://bit.ly/JTWearn

      I am moved by Dr. Lurie's pleas for the scientific community to produce accurate medical nomenclature, and I ask that others consider his please. http://www.ncbi.nlm.nih.gov/pubmed/18505600 http://www.ncbi.nlm.nih.gov/pubmed/22176755 http://www.ncbi.nlm.nih.gov/pubmed/22704295 http://www.ncbi.nlm.nih.gov/pubmed/23332812

      In 2013, it is unfortunate to note that many peer-reviewed articles refer to arterial connections as "veins”. There are several reasons that referring to arteries as veins is potentially harmful.<br> For additional commentary, please see https://twitter.com/BrettSnodgrass1/status/417897291404812288

      Comments or suggestions are welcome.

      Thank you very much.


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    1. On 2014 Sep 13, Vahid Rakhshan commented:

      A detailed version of this review and the author's response can be found from this address (LINK).

      Results

      (1) In the methods, it was stated that ANOVA and Duncan post hoc test had been used to analyze the data. However, in the results, it was Tamhane post hoc test. These two completely differ.

      (2) There was not even any mention of the name ANOVA or its P values.

      (3) There were numerous pairwise comparisons in this study. However, most of them had not been reported and even many of comparisons that had been reported, lacked P values.

      (4) Finally, it is stated that “For further elucidation of the reasons for ion release in the different solutions, the pH values of the 3 mouthwashes and distilled deionized water were measured.”… (A) The pH of mouthwashes should have been reported in the Methods section, not at the end of the Results. (B) A statistical test was needed for this purpose.

      Discussion

      (5) It is stated (p 732) that “all release is completed within 4 weeks”. The level of ion release reduces after sometime, but does not finish in the said period or even longer.<sup>1,2</sup>

      (6) This sentence (p 732) should have been stated very cautiously: “Chlorhexidine … caused not significantly higher release of copper than did Persica” A non-significant result is not of internal validity to be stated like something valuable.

      (7) I could not understand the next sentence: “Since the pH values for mouthwashes had no significant difference in the acidity of the 3 mouthwashes, this could be attributed to the corrosiveness of chlorhexidine compared with the other 2 mouthwashes”… How did the authors find out that the pH values were not significantly different? This sentence was quite incorrect. Also the rest of the sentence was vague.

      (8) I simply did not understand this sentence (after carefully reading the whole paper for some times): “We measured the means of ions released from every bracket in separate vials, but, on the basis of about 20 brackets in a patient’s mouth in clinical use, the results might become clinically significant.” What result might become significant? What are the authors talking about? There was no clue in the previous or later paragraphs.

      Conclusion

      Overall, conclusions were few and unsubstantiated. (9) The comparisons reported do not substantiate the first sentence of conclusions.

      (10) The second sentence is not at all relevant to this study. It was not at all based on the findings or even the scope of this article.

      Abstract

      (11) Many of comparisons were done at a level of significance adjusted to 0.008. However, in the abstract “P < 0.05” or “P > 0.05” are introduced as indicators of statistical significance or lack of it.

      References

      1. Amini F, Rakhshan V, Mesgarzadeh N. Effects of long-term fixed orthodontic treatment on salivary nickel and chromium levels: a 1-year prospective cohort study. Biol Trace Elem Res 2012;150:15-20.

      2. Amini F, Rakhshan V, Sadeghi P. Effect of fixed orthodontic therapy on urinary nickel levels: a long-term retrospective cohort study. Biol Trace Elem Res 2012;150:31-6.


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    1. On 2014 Jan 20, Tom Kindlon commented:

      Things are not clear cut in the CFS field yet

      I'm afraid I found the analysis in this paper to be somewhat superficial. In particular, it did not explore why positive statements might not predominate for GET and CBT.

      Evidence-based medicine should not just be about efficacy measures but also adverse events. The reporting of harms in trials of CBT and GET for CFS has been recognised as being poor (2,3). As one systematic review pointed out: "There is limited evidence about adverse effects associated with behavioural interventions. Withdrawals from treatment in RCTs suggest that there may be an issue but the evidence is often difficult to interpret because of poor reporting."

      A published survey of Norwegian ME/CFS patients found that of 620 who reported their experiences of graded exercise, 488 (78.7%) said that it had caused an overall deterioration (1). Surveys of patients in other countries have also found a high rate of adverse events associated with graded exercise regimes (2).

      I am not that familiar with the Norwegian health system but in other countries central schemes to collate information on adverse events associated with interventions, such as the yellow card scheme, are not available for nonpharmacological interventions (such as CBT and GET), increasing the importance of survey data.

      While some efficacy has been reported for CBT and GET, the measures used have generally been self-reported. Objective results are less impressive. For example, a review of three Dutch CBT studies found that no increase in activity levels, as measured by motion sensors, was recorded (above those in the control groups) despite improvements being reported in fatigue, as well as other subjective measures in the individual studies.

      The recently published PACE Trial got a lot of positive media coverage. However, on the only measure that could be described as being an objective measure, the six-minute walking distance (6MWD), there was no difference between the CBT and control groups. The GET group did improve on the 6MWD. However, 379m is not a particularly impressive result at 12 months considering 644m is the distance reference equations would estimate for this cohort.

      Anyone familiar with such evidence could justifiably be cautious in statements about CBT and GET.

      A common threshold for interventions to be seen as evidence-based is at least two positive (high quality) RCTs. Most posited therapies in the field have not been subjected to two RCTs. Any comments on other therapies, including on the Lightning Process, should certainly be tempered in the meantime.

      References:

      [1]. Bjorkum T, Wang CE, Waterloo K. [Patients' experience with treatment of chronic fatigue syndrome.] Tidsskr Nor Laegeforen. 2009 Jun 11;129(12):1214-6

      [2]. 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(2):59-111. http://www.iacfsme.org/BULLETINFALL2011/Fall2011KindlonHarmsPaperABSTRACT/ tabid/501/Default.aspx

      [3]. Chambers D, Bagnall AM, Hempel S, Forbes C. Interventions for the treatment, management and rehabilitation of patients with chronic fatigue syndrome/myalgic encephalomyelitis: an updated systematic review. J R Soc Med. 2006;99:506-20. Review.

      [4]. 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. Psychol Med. 2010 Aug;40(8):1281-7.

      [5]. White PD, Goldsmith KA, Johnson AL, Potts L, Walwyn R, DeCesare JC, 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.

      Conflict of Interest: I am the Assistant Chairperson and Information Officer of the Irish ME/CFS Association. All my work for the Association is unpaid


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    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 NCT0078634. We believe the correct ID, which we have found by hand searching, is NCT00786344.

      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


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    1. On 2017 Aug 04, Luis Mauricio T. R. Lima commented:

      This is an interesting article showing human amylin and zinc interaction, and the role of His18 in zinc interaction.

      We have recently reported that murine amylin can also interact with zinc, and this peptide has no His18, and interaction is mediated by several other contacts, and can result in modulation of the amyloid aggregation process. https://www.ncbi.nlm.nih.gov/pubmed/27693831 http://dx.doi.org/10.1016/j.bpc.2016.09.008

      Collectively, these data suggest an universal amyloid behavior of amylin analogues and interaction with zinc, regardless of the presence of proline or His18.


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    1. On 2016 May 02, Riccardo Polosa commented:

      We read with great interest the recent article by Grainge and coll. (1) showing that experimental airway narrowing induced by serial bronchoprovocation testing in patients with asthma may in itself be a stimulus for the development of airway remodelling. These tissue changes were independent of the broncoprovocant used in the study, development of remodelling being equivalent either after allergen or methacholine challenge. Surprisingly, however, the occurrence the characteristic late asthmatic response associated with a progressive fall in FEV1 after allergen (but not methacholine) challenge, failed to produce additional effects in term of enhanced airway remodeling changes in this study.

      As for the action of hemodynamic sheer stress in endothelial pathophysiology and atherosclerotic plaque formation (2), it is likely that adaptative wall remodelling in asthma occurs only in response to a brisk mechanical stimulus (as in the severe acute bronchoconstriction of the early asthmatic response), whereas a slow, more progressive fall in FEV1 (as in the late asthmatic response of the allergen challenge) is not able to induce a sufficient stress response for tissue remodeling. Given the wide variability in individual fall in FEV1 and remodelling responses reported in the study by Grainge and coll., it cold have been relevant to investigate a possible correlation between severity of bronchoconstriction and amplitude of remodelling changes. This is important to substantiate these authors speculations.

      Remodelling changes in response to bronchoconstriction are not necessarily detrimental, and may have a protective role by stabilizing airway calibre and limiting further narrowing (3). However, in presence of an inflammatory infiltrate and of an intrinsically dysfunctional epithelium – as in asthma (4,5) - mechanotransduction may promote a more harmful form of airway remodelling. To test specificity of the observed effects in asthma, a further study group to control for a non specific effect of bronchoconstriction (by high dose inhaled methacholine) in non-asthmatic individuals would have been highly informative.

      Given the relative insensitivity of inhaled corticosteroids in modulating airway remodelling and its progression (6), the search for novel therapies that can specifically reverse or prevent airway remodeling has become an active area for drug development. For the time being, as appropriately pointed out by Grainge and coll., sustained (and safe) bronchodilatation should be recommended more insistently in addition to classical means of disease exacerbation prevention. Unsurprisingly, these considerations may be also valid for patients with chronic obstructive pulmonary disease (COPD).

      REFERENCES

      1. Grainge CL, Lau LCK, Ward JA, Dulay V, Lahiff G, Wilson S, Holgate ST, Davies DE, Howarth PH. Effect of bronchoconstriction on airway remodeling in asthma. N Engl J Med 2011; 364: 2006-15.
      2. Davies PF. Hemodynamic shear stress and the endothelium in cardiovascular pathophysiology. Nat Clin Pract Cardiovasc Med 2009; 6(1): 16-26.
      3. McParland BE, Macklem PT, Pare PD. Airway wall remodelling: friend or foe? J Appl Physiol 2003; 95: 426-434.
      4. Puddicombe SM, Polosa R, Richter A, Krishna MT, Howarth PH, Holgate ST, Davies DE. Involvement of the epidermal growth factor receptor in epithelial repair in asthma. FASEB J 2000;14: 1362-74.
      5. Holgate ST, Polosa R. The mechanisms, diagnosis, and management of severe asthma in adults. Lancet. 2006 Aug 26;368(9537):780-93.
      6. Royce RG, Tang ML. The effects of current therapies on airway remodelling in asthma and new possibilities for treatment and prevention. Curr Mol Pharmacol 2009; 2(2):169-81.


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    1. On 2014 Mar 12, George W Hinkal commented:

      None


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    2. On 2014 Feb 27, 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, nanomaterial characterizations and composition information for the nanoparticle 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=37191685&page=0&tab=ALL

      The left navigation links on this page 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


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    1. On 2014 Nov 17, Peter H. Asdahl commented:

      The study by Villani et al. addresses the issue of cancer surveillance among TP53 mutation carriers with Li-Fraumeni syndrome. The authors interpreted data from an institutionally-devised cancer surveillance program. Villani et al. concluded that their surveillance approach is feasible, and may lead to a reduction in mortality. In addition, the authors emphasized the importance of genetic testing for early detection. Nonetheless, certain results of the study warrant further discussion.

      Villani et al. used an observational design to address their aim, where mutation carriers were given the option of participating in the surveillance or non-surveillance (i.e. standard clinical practice) groups, and were subsequently followed for incident cancers. Given the goal of systematic cancer surveillance, we would expect a higher yield of incident cancers in the surveillance group. Nevertheless, the result from the Villani et al. study contradicts expectation. Specifically, one or more tumors were detected among seven of the 18 (39%) participants who opted for surveillance in contrast to 10 of the 16 participants (63%) who opted for non-surveillance. Given insufficient data in the published report by Villani et al. to estimate person-time contribution for individuals in each group, we assume equivalent follow-up between groups for the purpose of our illustration. Consequently, a patient-level comparison of the two groups yields a 24% reduction in the absolute risk of incident cancers in the surveillance group (risk difference= -24%, 95% confidence interval: -56% to 9%). We would not expect a negative risk difference in this scenario, which raises concerns about potential biases such as healthy user bias or confounding by functional status [1].

      Healthy user bias and confounding by functional status are often overlooked but legitimate problems in observational studies of screening effects. For example, if participants in the non-surveillance group had more functional impairments (e.g. related to underlying but undetected cancer) which resulted in opting for standard clinical care rather than systematic surveillance, then eventual detection of underlying cancer in this group may result in a higher yield compared with the surveillance group. Some evidence for this phenomenon may be apparent by the lower than expected survival among participants with incident cancers in the non-surveillance group. In particular, three-year survival among the non-surveillance group was 21%, which is low even for aggressive tumors.

      An ideal screening program aims for early detection of cancer with subsequent reduction in cancer-related mortality. Although we do not reject the notion that the screening program in this study detected asymptomatic tumors, the interpretation that the authors’ surveillance program is superior to non-surveillance is not supported by the results. To investigate a possible effect of screening in this population, a more robust study design with random allocation to intervention may be less sensitive to bias.

      REFERENCE 1. Shrank WH, Patrick AR, Brookhart MA. Healthy user and related biases in observational studies of preventive interventions: a primer for physicians. J Gen Intern Med. 2011 May;26(5):546-50.


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    1. On 2017 May 23, Egon Willighagen commented:

      The link to the source code repository no longer exists and now points to this (currently active) repository: https://bitbucket.org/wwmm/chemicaltagger


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    1. On 2015 Feb 08, Arnaud Chiolero MD PhD commented:

      An elegant demonstration of how age could be the only element to consider for the individual primary prevention of CVD


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    1. On 2014 Mar 06, Christopher Southan commented:

      There is a follow-on paper http://www.ncbi.nlm.nih.gov/pubmed/24204758 that analyses an update of the same data but sliced on a per-year basis


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    1. On 2015 Mar 30, University of Kansas School of Nursing Journal Club commented:

      University of Kansas School of Nursing Undergraduate Program Team 12: Stacy Hanson, Chelsi Puskas, Shannan Orpin, Sami Johnson, Chandler Schoen, Jen Huynh, and Valerie Melin

      Introduction:<br> The purpose of this Journal Club Literature Review was to take a closer look at shared governance by evaluating the functionality Unit Practice Councils through a study by Beverly Fray (2011). Not only did the article create a credible tool for rating this specific hospital’s system, it also obtained important qualitative data that the hospital can use to identify weaknesses in their Unit Practice Councils. This information is crucial for the hospital that this survey serves because this hospital system is on their Magnet journey. This survey is working to fill the gap in knowledge of a credible survey to access functionality of Unit Practice Councils. Our team chose this article after listening to two presentations about Shared Governance from the University of Kansas Hospital and Children’s Mercy Hospital, we were interested on how effectiveness of Shared Governance, specifically Unity Practice Councils, can be measured. We were also interested in this article because it was looking at a hospital system that had not yet achieved Magnet status, unlike the University of Kansas Hospital and Children’s Mercy Hospital. We were interested in a non-magnet status hospital because according to Clavelle, O’Grady, and Drenkard (2013), magnet hospitals have shown to have higher rates of shared governance, resulting in higher levels of nurse-physician relationships and greater positive work environments. Therefore, we were wondering how non-magnet status hospitals approached shared governance.

      For this Journal Club Literature Review, we used ProQuest Nursing & Allied Health Source for search for the article. To retrieve this specific article, we typed “shared governance and nurse satisfaction” in the search bar, and then we restricted the search to only include articles that were peer reviewed and published in the last 5 years. This was a descriptive study, describing the Functionality of the Unity Practice Councils and testing the validity of the newly created survey. The target population is Jackson Health System, a health system attempting to achieve magnet status. While Jackson Health System wanted to identify strengths and weaknesses in Unit Practice Councils, they believe that this survey could be used in other hospitals to identify ways to strengthen Unit Practice Councils. This is important because Unit Practice Councils are one of the primary ways that voices are given to nurses, and if the Unit Practice Council is not functioning properly, some of the ideas brought by nurses may not be properly implemented. It is also important because this tool would be able to be used in other hospitals, and weak Unit Practice Council would be able to use strong Unit Practice Councils as resources. Data for the study was collected by surveys based on traits that were observed from highly functional and successful Unit Practice Councils. These surveys results were compared between the Unit Practice Council Coordinator and then the Center for Nursing Excellence.

      Findings:<br> The Center for Nursing Excellence and the Unit Practice Council Coordinators reached a 78% concurrence level for functionality of Unit Practice Councils. The study found that 38% of the Unit Practice Councils were low functioning, 22% were middle functioning, and 40% were high functioning. It is also notable to look at what the Unit Practice Councils focus on: 96% focus on improving clinical practice or patient, staff, and physician satisfaction; 92% had invited management to their meetings; 64% use their communication network; and 68% reported being innovative in making tangible improvements at the bedside. While this study was not compared to other settings, the survey would be able to be implemented in other locations to compare the functionality of Unit Practice Councils. The limitations of this study included a low survey response rate and more research needs to be completed to establish reliability of the instrument. Implications: This study is important to nursing because it identifies the functionality of Unit Practice Councils. Because the importance of Shared Governance has been identified, it is important to look at the Unit Practice Council as a source for nursing ideas and empowerment. This survey can be used to identify strength and weaknesses of Unit Practice Councils. The tool is simple enough that it could also be used to measure improvement in Unit Practice Councils, and evaluate nursing practice outcomes. and can be used as objective tool to access quality of Unit Practice Councils. A functional Practice Council can leads to nurse-lead changes on the unit. These changes promote nurse satisfaction and patient-centered care, leading to a positive work environment. Any tool that can promote the higher functioning of Practice Councils is worth studying.

      Reference: Clavelle, J., O’Grady, P., Drenkard, K. (2013). Structural empowerment and the nursing practice environment in Magnet organizations. The Journal of Nursing Administration. 43(11), 566-573.


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    1. On 2016 Sep 21, Morten Oksvold commented:

      There is an interesting Brief Communication letter which is questioning the role of BID in NOD signaling (Nachbur U et al., 2012). Please see link:

      http://www.nature.com/nature/journal/v488/n7412/full/nature11366.html

      In the communications arising, Yeretssian et al., have a reply:

      http://www.nature.com/nature/journal/v488/n7412/full/nature11367.html

      Yeretssian et al. have even a correction to their reply, due to the fact that they removed several data points from a figure generated by the authors of the original Brief Communication (Nachbur U et al., 2012). Please see link:

      http://www.nature.com/nature/journal/v491/n7426/full/nature11668.html


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    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 NCT0110743. We believe the correct ID, which we have found by hand searching, is NCT01107431.

      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


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    1. On 2014 Jul 25, Prof.Dr.Jogenananda Pramanik commented:

      The effects of noise on sleep and their potential harmful repercussions on cardiac patients in hospitals"

      Invited Co-Authors: Dr.Saurabh Kole, MBBS.Dip Card.MD.Cardiologist,Belle Vue Clinic, Kolkata,India;and Tanu Pramanik, Lecturer (Clin.Psychology), Allianze University College of Medical Sciences, 13200-Penang, Malaysia.

      The author of the current paper (1) deserve applause for timely evaluation of the effects of sound pollution on hospitalized cardiac patients. The World Health Organization guidelines say that for a good sleep, sound level should not exceed 30 dB(A) for continuous background noise, and 45 dB(A) for individual noise events.(2,3) The effect of noise on sleep, however, not only depends on the acoustical parameters of noise but also on the individual as there is large variance in the experience of a person with a particular noise. Personal characteristics such as personality traits, diurnal type, age and self-estimated sensitivity to noise are important individual factors.(4) These autonomic responses to noise during sleep can be obtained for much lower peak noise intensities as during wake states. These effects, mainly involving increased heart rate and vasoconstriction, have been found to habituate over successive noise-exposed nights as opposed to long exposure times. This could indicate an effect on cardiovascular response over the long term exposure. (5) During sleep, heart rate is related to changes in the parasympathetic-sympathetic balance with an increase in sympathetic tone associated with activation and with electroencephalogram (EEG) arousal. Catecholamine levels and sympathetic activity decrease during sleep. So, as one might assume that decreased sleep is associated with increased sympathetic activity and as a result increased blood pressure and heart rate. This association has been observed not only with sleep deprivation but also with regard to sleep disruption. Brief awakenings from sleep for only a few seconds are associated with temporary elevation in blood pressure and heart rate that results from an autonomic reflex.(6) Noise that prevents or interrupts sleep is a nearly universal complaint of patients who are hospitalized (1,2) However, no previous record of systematic research or published report from developing countries like ours is available till date.

      The causal relationships between noise exposure, effects on sleep, and contribution to health disturbances, both behavioral and physical, are not firmly established yet. Therefore, we designed current research proposal with a well-defined objective to study noise induced repercussions on cardiac patients in a hospital setting. During our study, we will use EEG, EKG, polysomnogram and other monitoring systems for the patients selected under stringent criteria set by the clinical research committee and University ethical committee. Our research may reveal adequate experimental data to substantiate noise induced repercussions on cardiac patients which may enlighten hospital authorities to be more cautious to protect vulnerable patients from sound pollution.

      References: 1. Babisch W.: Cardiovascular effect of noise :Noise Health. 2011 May-Jun;13(52):201-4. doi: 10.4103/1463-1741.80148.

      2.Sleep Disruption due to Hospital Noises: Ann Intern Med. 7 August 2012;157(3):1-32 3. Berglund B, Lindvall T, Schwela DH. Guidelines for Community Noise. World Health Organization 1999. Available from: http://www.who.int/docstore/peh/noise/guidelines2.html . [Accessed on 2010 March 28].<br> 4.Muzet A, Weber LD, Di Nisi J, Ehrhart J. Comparison of cardiovascular reactivity to noise during waking and sleep. National Center for Scientific Research Center for Bioclimatic studies. Convention No 82243, 1985.

      5.Muzet A, Ehrhart J, Eschenlauer R, Lienhard JP. Habituation and age differences of cardiovascular responses to noise during sleep. In Sleep 1980;212-5.<br> 6.Sforza E, Chapotot F, Lavoie S, Roche F, Pigeau R, Buguet A. Heart rate activation during spontaneous arousals from sleep: Effect of sleep deprivation. Clin Neurophysiol 2004;115:2442-51.


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    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 NCT00314575. We believe the correct ID, which we have found by hand searching, is NCT00314574.

      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


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    1. On 2017 Jul 07, Wei Wang commented:

      Several issues have been raised about this paper on PubPeer. Below are some of the comments:

      Comment #1: "Jonathan Warner and colleagues failed to reproduce results reported in this paper. In their paper (PMID: 24860015), Warner et al. state:

      "These results are at significant odds with the report that there can be 100-fold differences in the levels of the various RP mRNAs in several tissues of the developing mouse embryo (Kondrashov et al. 2011)."

      Comment #3: "The authors wrote:

      "Strikingly, we observed tremendous heterogeneity in RP expression among different RPs and within different tissues over a 250-fold range, expressed in log2 space (Figure 7D and Table S3)."

      As Jon Warner and colleagues noted, this strikingly tremendous heterogeneity is at odds with any other dataset that we have seen. We downloaded the data from Table S3 and could not reproduce the 250-fold range either. Can the authors explain how they analyzed the data to find the 250-fold range ?

      Hopefully, the authors can provide the raw data used for Figure 7D and Table S3.

      Maybe some tissues express the mRNAs for all ribosomal proteins at higher levels because they need more ribosomes. Were the transcript data normalized for different global levels of ribosomal protein in different tissues ? "

      Comment #4: "In addition to the mentioned issues with this paper, I would like to note some further points. I don't want to discredit the authors, they are certainly working on a very exciting topic, however, this paper makes conclusions and over interpretations, which are by no means proven by the data that they present. The authors claim to "uncover an important role for RPL38 in transcript-specific translational control". However, there are several important concerns with that claim:

      (1) The authors don't provide any evidence that the ribosomes in the tissues/cells they are using are lacking RPL38, hence any assumptions about RPL38 specifically regulating the translation of these certain Hox mRNAs are purely speculative.

      (2) As "evidence" that the translational defect of these mRNAs is specific to RPL38 deficiency, the authors present figure 4Q, where they are using additional mouse mutants. However, no data are provided to present how much the levels of the respectively affected ribosomal protein in the mutants are actually affected in the used tissues. Furthermore, out of the 8 Hox mRNAs, whose translation is impaired with RPL38 deficiency, the authors test the protein levels only for one (HoxA5) of these 8 transcripts in the additional mouse mutants, this seems like this was picked on purpose. And even for that 1 Hox protein, the data seem questionable. The RPS19 mutant seems to have also reduced HoxA5 protein levels when I look at the western, suggesting that the translational defect is not specific to RPL38 deficiency. The westerns for the other mutants seem to be slightly overloaded in the mutant samples compared to controls, hard to make a conclusion there.

      (3) The polysome profiles in figure 3b are more than questionable. The polysomes are basically just a flat line, any quantitative data from RT-qPCR from isolated RNA of these polysomes don’t seem really reliable in terms of translation. Also, it appears hard to believe that the authors were able to dissect selectively the somites without including non-affected tissue material. "


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    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


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    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 NCT0083283. We believe the correct ID, which we have found by hand searching, is NCT00832832.

      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


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    1. On 2014 Mar 12, George W Hinkal commented:

      None


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    2. On 2014 Feb 27, 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, nanomaterial characterizations and composition information for the two nanoparticles 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=37191682&page=0&tab=ALL

      https://cananolab.nci.nih.gov/caNanoLab/characterization.do?dispatch=summaryView&sampleId=37191683&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


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    1. On 2016 May 02, Riccardo Polosa commented:

      Evidence that activation of the haemo-coagulative system occurs in COPD is accumulating with potential implications for cardiovascular disease (CVD)(1,2). Maclay and colleagues(3) have recently reported a significant but small increase in platelet activity by flow cytometric analysis of circulating platelet-monocyte aggregates in COPD patients. This does not seem to be strongly supportive of this view as the observed changes are well within test repeatability and mainly due to a handful of outliers. Moreover, no changes were reported for the well characterised platelet activation marker, P-selectin.

      Although small sample size, co-morbidities and medications may have contributed to these largely negative findings, an important factor to be considered is smoking. Of note, the authors excluded active smokers from COPD patients and included a control group of smoking habit- (i.e. ≥10 pack/yrs; at least 6 months tobacco abstinence) and age-matched ex-smokers with no respiratory symptoms. However, as for several biomarkers of systemic inflammation (e.g. C-reactive protein)(4), airway inflammation (e.g. sputum neutrophilia)(5), and clotting activation (e.g. D-Dimer and prothrombin fragment 1+2)(6), elevation in markers of platelet activation may persist for many years after smoking cessation, reflecting that the underlying damage caused by smoking takes a protracted time to recover. Thus, the baseline level of platelet activation in the control group may not be truly representative. Future studies should recruit either lifetime non-smokers or ex-smokers who have been abstinent for 3-5 years as controls.

      Assuming that platelet activation is significant in COPD, it is highly speculative to suggest that such mechanisms are associated with increased risk of CVD in COPD. Firstly, measurements of platelet activation in smoking-related conditions may not be that efficient in predicting cardiovascular mortality and morbidity. Secondly, platelet activation is not disease specific (can occur in degenerative, inflammatory and smoking-related diseases) and may be due to immobilization during hospitalization. A control group for this confounder was not included in the exacerbation study. Thirdly, although systemic inflammation may be responsible for platelet activation, we cannot discount a role for the underlying tissue/cellular injury that persists for many years after smoking cessation(4-6). Specifically, the source of systemic inflammation (± platelet activation) in COPD may not necessarily be associated with activation/injury of the airway epithelium. Alternatively, direct spill-over of pro-inflammatory mediators and potent platelet activators in the bloodstream can be traced to the vascular endothelium, which are metabolically activated on smoke exposure(7,8). Lastly, it is unclear whether the low-grade systemic inflammation reported in COPD has an independent causal role in cardiovascular co-morbidities(9). CVD is known to occur long before the onset of COPD and is known to be strongly associated with cigarette smoking. Conclusive evidence of systemic inflammation contributing to greater risk of CVD requires large well-controlled long-term prospective studies normalized for intensity and duration of smoking.

      References

      1. Wedzicha JA, Syndercombe-Court D, Tan KC. Increased platelet aggregate formation in patients with chronic airflow obstruction and hypoxaemia. Thorax. 1991;46(7):504-7.
      2. Polosa R, Malerba M, Cacciola RR, Morjaria JB, Maugeri C, Prosperini G, et al. Effect of acute exacerbations on circulating endothelial, clotting and fibrinolytic markers in COPD patients. Intern Emerg Med. 2011. Epub 2011/06/11.
      3. Maclay JD, McAllister DA, Johnston S, Raftis J, McGuinnes C, Deans A, et al. Increased platelet activation in patients with stable and acute exacerbation of COPD. Thorax. 2011;66(9):769-74.
      4. Yanbaeva DG, Dentener MA, Creutzberg EC, Wesseling G, Wouters EF. Systemic effects of smoking. Chest. 2007;131(5):1557-66.
      5. Willemse BW, ten Hacken NH, Rutgers B, Lesman-Leegte IG, Postma DS, Timens W. Effect of 1-year smoking cessation on airway inflammation in COPD and asymptomatic smokers. Eur Respir J. 2005;26(5):835-45.
      6. Caponnetto P, Russo C, Di Maria A, Morjaria JB, Barton S, Guarino F, et al. Circulating endothelial-coagulative activation markers after smoking cessation: a 12-month observational study. Eur J Clin Invest. 2011;41(6):616-26.
      7. Cacciola RR, Guarino F, Polosa R. Relevance of endothelial-haemostatic dysfunction in cigarette smoking. Curr Med Chem. 2007;14(17):1887-92.
      8. Guarino F, Cantarella G, Caruso M, Russo C, Mancuso S, Arcidiacono G, et al. Endothelial activation and injury by cigarette smoke exposure. J Biol Regul Homeost Agents. 2011;25(2):259-68.
      9. Morjaria JB, Polosa, R. The holistic perspective of chronic obstructive pulmonary disease: doubt some more. Ther Adv Chronic Dis. 2010;1(2):37-41.


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    1. On 2013 Oct 21, John Boothroyd commented:

      I find this an extremely exciting paper and one of the most important in Toxoplasma epidemiology in the past decade. For years, there has been debate about what fraction of toxoplasmosis infections in humans stems from ingestion of oocysts (in drinking water or on soil-contaminated food) vs. tissue cysts (in under-cooked meat, etc.). But until this paper, there was no way to do more than guess. Here, the authors report very exciting data showing that antibodies to an oocyst (sporozoite) protein are elicited and detectable in oocyst-initiated infections in animals and humans. Further work will be needed to determine how reliable it is but all the indications are that it is, in fact, a good predictor of oocyst-initiated vs. tissue-cyst-initiated infections. The results to follow could alter the public health message in very important ways and allow advice to be targeted to the most risky activities.


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    1. On 2015 Feb 04, Alberto Halabe Bucay commented:

      In this article is cited in the references my work regarding treatment of cancer with citric acid (citrate) published in PubMed since March, 2007: PMID: 17368752.


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    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 NCT0094398. We believe the correct ID, which we have found by hand searching, is NCT00944398.

      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


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    1. On 2014 May 15, G L Francis commented:

      In setting out to produce a simplified chemically defined culture medium for human embryonic stem cells (hESCs) and induced pluripotent stem cells (iPSCs) the authors demonstrated removal of bovine serum albumin (BSA) and other constituents was possible. By judicious screening the resultant optimized medium (E8) was greatly simplified compared to the starting medium (TeSR) and provided comparable outcomes for long term undifferentiated proliferation of both human ESCs and iPSCs.

      The authors appear to show quite convincingly that in the original TeSR medium BSA serves the purpose of neutralizing the potential toxicity of β-mercaptoethanol (BME) (see Fig 1 : Title. ‘’Albumin is not required for hESC culture’’). The only question I raise is about the veracity of the overall conclusion is that albumin presence in the absence of BME does not enhance the proliferation (I assume equals combined survival of plated ESCs and subsequent proliferation) measured at 120h after plating in TeSR-based medium, as depicted in Fig.1 panel (f).The first bar in Fig.1 panel (f) representing the activity for ‘’complete TeSR medium (with BSA & BME)’’, is stimulated a further two- fold in the ‘’without BME’’ medium (presumably with BSA!) represented in the last bar of that panel (f). If that is the case, does that not indicate that addition of albumin significantly improves the performance of the medium in the long term proliferation of hESCs – apparently at odds with the conclusions argued in the Discussion of the paper?

      Moreover, in Figure 2 titled “Essential medium components for human ESC survival and proliferation” in panel (c) the improvement in proliferation at 129 h for plated hESCs over the starting TeSR medium by a number of additions to a base E8 medium was only 40% (compare this to the improvement of TeSR by TeSR –BME+BSA above in Fig.1). Admittedly the further addition of other components, and finally Nodal, led to incremental improvement over the base components of E8.

      I understand the importance of eliminating an animal or human sera sourced component (also what about the transferrin?) This still prompts the question as what would have been the result if albumin was added to the final E8 medium in terms of long term proliferation of hESCs in this study. For the experimental evaluation of this question the best performing batch of BSA would have been most appropriate, however, to address the issues raised about the use of this xenobiotic material, a human recombinant source of albumin could have been evaluated. Human recombinant albumin is now produced at scale under GMP conditions and I believe the price has become more acceptable - I agree the final acceptance of that would rely on a cost benefit analysis at the process level.


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    1. On 2017 Oct 11, Joe Herbert commented:

      A recent paper (Hosp JA, Strüber M, Yanagawa Y, Obata K, Vida I, Jonas P, Bartos M.

      Hippocampus. 2014 24:189-203.) says 24% . But I can't see this is very relevant to the major thrust of the paper.


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    2. On 2017 Oct 05, Jason Snyder commented:

      Doesn't the majority of dentate granule cells express calbindin? And yet there are only ~20 calbindin+ cells per dentate gyrus slice (fig 4).


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    1. On 2014 May 05, Madhusudana Girija Sanal commented:

      1) Provides evidence for the endosymbiotic theory on the origin of mitochondria 2) It says it is possible to make transgenic higher animals with photosynthetic ability (limited by the available body surface area) 3) It shows the adaptability of an organism to foreign genes and gene products through co-evolution 4) It shows the capability of embryonic cells to accept foreign genes and gene products and opens the possibility for wonderful 'compound organisms' Is there any evidence of genetic exchanges between the genomes of the salamander and the alga? It would be nice to do a whole genome sequencing of the salamander and alga and compare with the closest neighbors and relatives (species) to understand the depth of co-evolution.


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    1. On 2014 Oct 10, Martin Turner commented:

      Would the authors care to report the limits of agreement between the Tonosafe and standard Goldmann prisms? Thank you.


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    1. On 2015 Feb 19, Devon Ryan commented:

      In the off-chance that someone else comes across this paper and wonders why exactly they chose a bonferroni-adjusted p-value threshold of 1.81e-6, it's presumably because that turns out to be a benjamini-hochberg adjusted p-value threshold of 0.05 for maternal age in their microarray dataset. I have no clue why they didn't just say that in their methods.


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    1. On 2014 Jul 25, Jens Staal commented:

      The VRPR experiment was unfortunately not the best verification that we could have done. In a later experiment, we silenced the uncleavable CYLD in our stable Jurkat cells with siRNA and could restore JNK activation to levels equal to that of normal Jurkats silenced for CYLD, providing further proof that the uncleavable CYLD is indeed causing the JNK inhibition and that it is not a clonal effect.

      On the other hand, later results indicate that MALT1 protease activity is not required for JNK activation so the most likely explanation for our observations is that they are visible thanks to the overexpression of CYLD (both WT and R/A are overexpressed to the same extent so the difference is cleavage-dependent) whereas the effect is not visible when expressed at endogenous levels.


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    1. On 2016 Apr 07, Dr. Kam Cheong Wong commented:

      There are various methods that can be applied to generate inputs for an Ishikawa diagram such as focus group discussion, review of process-flow, survey, interview, literature review, brain storming, and failure mode and effects analysis (FMEA).

      FMEA is an engineering methodology in origin. It can be modified and applied to provide inputs into an Ishikawa diagram via team work or self-directed learning. The human biliary system was used to illustrate a modified FMEA (in short, mFMEA) in an editorial paper which can be accessed via: http://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-016-0850-6


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    1. On 2015 Aug 11, Lydia Maniatis commented:

      The claim that this study controlled for shape is incorrect. The contour elements making up the "patterned rectangles" referred to in the abstract did have a shape, and this shape was perfectly confounded with the factor of "entropy." The elements in the "low entropy" figures had squared-off, rectangular, edges, while the elements in the "high-entropy" figures had non-rectangular, slanted edges. Inferring an occlusion allows their shape to be regularised.


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    1. On 2013 Oct 22, Jonathan Eisen commented:

      I am the senior author of this paper and I wrote a detailed blog post about the "Story behind the paper" that may be of interest. See http://phylogenomics.blogspot.com/2011/03/story-behind-story-of-my-new-plosone.html.


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    1. On 2013 Dec 24, Kenneth Witwer commented:

      Following the link to the VMir download results in a "Seite nicht gefunden" (page not found) error. Is there a new site, or is there an error in the published URL?


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    1. On 2016 Oct 05, Santosh Kondekar commented:

      Though distal RTA is often related to urological disease or associated immune disease; we had a case of familial distal RTA. These cases often go unnoticed if the acidosis doesnot manifest with clinical symptoms. The cases may get missed as Rickets if proper workup is not done. I suggest to complete the RTA workup in all cases of rickets with deformities that appear slow responsive to vitamin D and calcium.


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    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 NCT0102293. We believe the correct ID, which we have found by hand searching, is NCT01022931.

      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


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    1. On 2014 Jan 08, Tom Kindlon commented:

      The criteria for CFS require 5 symptoms (fatigue plus 4 more) not 4 symptoms as were assessed

      Bhui and colleagues [1] state: "We counted as CFS those individuals with all four of the above symptoms, each lasting for at least 6 months. Our definition of at least four symptoms meets the threshold criteria, as CFS is usually diagnosed on the basis of four of eight symptoms, including fatigue [2]." It is incorrect to say: "CFS is usually diagnosed on the basis of four of eight symptoms, including fatigue" One can either say: "CFS is usually diagnosed on the basis of five of nine symptoms, one of which must be fatigue" Or "CFS is usually diagnosed on the basis of four out of eight symptoms, plus fatigue".

      This doesn't appear to be a typo: the questions used only involve 4 symptoms including fatigue: "The questions asked about the following symptoms: (1) getting tired and lacking energy and whether there were any reasons for this (such as physical illness), (2) having any problems with concentrating or noticing any problems with forgetting things, (3) having problems with falling asleep or with getting back to sleep, (4) any sort of ache or pain or being troubled by any sort of discomfort such as headache or indigestion." The symptoms that make up the referenced definition are: Fatigue Plus 4 out of 8 of the following: "post-exertional malaise lasting more than 24 hours; unrefreshing sleep; impaired short-term memory or concentration severe enough to cause substantial reduction in previous levels of occupational, educational, social, or personal activities; headaches of a new type, pattern, or severity; muscle pain; multi-joint pain without swelling or redness; sore throat; and tender cervical/axillary lymph nodes."

      The authors explain that what they is discussed is CFS-like illness as the individuals were not assessed individually by a physician to check for exclusions. The authors state they “were able to identify diseases that might exclude a diagnosis of CFS (31 of 108 (28.7%) participants met the criteria for CFS): cancer, diabetes, epilepsy, arthritis or fibrositis and infectious or parasitic disease.” We probably do not have enough data from previous work to estimate the percentage who would have been excluded from a diagnosis of CFS following an individual assessment; however one large expensive US study conducted by the CDC [3] which used a comparable definition [4] to the 2003 definition[2] found that while 1.607% had a CFS-like illness, only 0.235% had CFS (or 14.62% of those with a CFS-like illness). If the figure was similar for the current study, only 16 out of the 108 would have CFS.

      While not evidence per se about the validity of the CFS definition used, the fact that female gender was not a risk factor for the "diagnosis" in this study adds another level of doubt about the cohort of "CFS" patients used, given the consistent findings that CFS is more prevalent in female adults e.g. [4,5]. The NICE guidelines for "CFS/ME" say it affects "women at four times the rate of men"[6].

      Finally, I think there is a risk that the "risk factors" mentioned in the abstract will be misread by some: an ongoing discussion in the CFS field is whether a certain level of activity predisposes one to CFS e.g. whether people with CFS were more or less active than the general population before becoming ill [7-13]. However, this study does not attempt to look at the period before individuals become ill; instead, it makes use of data collected close to when the symptoms were assessed, using a cross-sectional type of design; it is not thus not that surprising that such individuals [with CFS] were found to relatively inactive given the definition of CFS.

      References:

      [1] Bhui KS, Dinos S, Ashby D, Nazroo J, Wessely S, White PD. Chronic fatigue syndrome in an ethnically diverse population: the influence of psychosocial adversity and physical inactivity. BMC Med. 2011 Mar 21;9(1):26.

      [2] Reeves WC, Lloyd A, Vernon SD, Klimas N, Jason LA, Bleijenberg G, Evengard B, White PD, Nisenbaum R, Unger ER, International Chronic Fatigue Syndrome Study Group: Identification of ambiguities in the 1994 chronic fatigue syndrome research case definition and recommendations for resolution. BMC Health Serv Res 2003, 3:25.

      [3] Reyes M, Nisenbaum R, Hoaglin DC, Unger ER, Emmons C, Randall B, Stewart JA, Abbey S, Jones JF, Gantz N, Minden S, Reeves WC (2003). Prevalence and incidence of chronic fatigue syndrome in Wichita, Kansas. Archives of Internal Medicine 163, 1530–1536.

      [4] Fukuda K, Straus SE, Hickie I, Sharpe MC, Dobbins JG, Komaroff AL, and the International CFS Study Group (1994). The chronic fatigue syndrome: a comprehensive approach to its definition and study. Annals of Internal Medicine 121, 953–959.

      [5] Jason LA, Richman JA, Rademaker AW, Jordan KM, Plioplys AV, Taylor RR, McCready W, Huang C-F, Plioplys S (1999). A community-based study of chronic fatigue syndrome. Archives of Internal Medicine 159, 2129–2137.

      [6] Turnbull N, Shaw EJ, Baker R, Dunsdon S, Costin N, Britton G, Kuntze S and Norman R (2007). Chronic fatigue syndrome/myalgic encephalomyelitis (or encephalopathy): diagnosis and management of chronic fatigue syndrome/myalgic encephalomyelitis (or encephalopathy) in adults and children. London: Royal College of General Practitioners.

      [7] Smith WR, White PD, Buchwald D: A case control study of premorbid and currently reported physical activity levels in chronic fatigue syndrome. BMC Psychiatry 2006, 6:53.

      [8] Harvey SB, Wadsworth M, Wessely S, Hotopf M: Etiology of Chronic Fatigue Syndrome: Testing Popular Hypotheses Using a National Birth Cohort Study. Psychosom Med. 2008 Mar 31

      [9] Viner R, Hotopf M: Childhood predictors of self reported chronic fatigue syndrome/myalgic encephalomyelitis in adults: national birth cohort study. BMJ 2004, 329:941.

      [10] Riley MS, O'Brien CJ, McCluskey DR, Bell NP, Nicholls DP: Aerobic work capacity in patients with chronic fatigue syndrome. BMJ 1990, 301:953-6.

      [11] Van Houdenhove B, Onghena P, Neerinckx E, Hellin J: Does high "action-proneness" make people more vulnerable to chronic fatigue syndrome? A controlled psychometric study. J Psychosom Res 1995, 39:633-40.

      [12] MacDonald KL, Osterholm MT, LeDell KH, White KE, Schenck CH, Chao CC, Persing DH, Johnson RC, Barker JM, Peterson PK: A case-control study to assess possible triggers and cofactors in chronic fatigue syndrome. Am J Med 1996, 100:548-54.

      [13] Van Houdenhove B, Neerinckx E, Onghena P, Lysens R, Vertommnen H: Premorbid "overactive" lifestyle in chronic fatigue syndrome and fibromyalgia: an etiological relationship or proof of good citizenship? J Psychosom Res 2001, 51:571-6.


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    1. On 2014 May 21, Arnaud Chiolero MD PhD commented:

      A fantastic paper, about a major issue in public health


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    1. On 2015 Oct 08, Elie Akl commented:

      Dear Hilda Thank you for the excellent and critical review. I agree that this review is due for updating, and its conclusions are not current. We are not aware of more recent studies besides the ones you pointed to, but there are likely few of them. We will consider in the update the points you make below about how to include studies of medical students. thank you again Elie


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    2. On 2015 Mar 09, Hilda Bastian commented:

      This is an excellent and important review, and its conclusions are likely to generally still be valid. The authors' reply to a 2011 comment about missing trials by Steven Woloshin and Lisa Schwartz indicates a particularly key trial subsequent to the 2007 search is missing (Waters EA, 2006; Cuite CL, 2008; Woloshin S, 2011). There are likely to be many more. (Several are included in a post of mine on using NNTs, at PLOS Blogs.)

      The relatively small amount of data in this review on some comparisons is, I believe, becoming a problem as the conclusions of the authors are being too readily dismissed. If the update of this review is not likely to be soon, it may be useful to add a comment about the currency of the review, and highlight studies awaiting assessment to counteract the current impression.

      It would also be useful if the authors could clarify in their update the status of the "additional results" in Appendix 4. As these trials are also listed as excluded from the review, it is a little confusing. Indeed, at least some of those studies do seem to be eligible: the time-to-event measure, for example.

      Although I can understand the reasoning for including medical students as lay people rather than health professionals, I think that is potentially problematic, and they require separate analysis as the quantity grows.

      I look forward to the update of this important review. Thanks!


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    1. On 2015 May 06, M Mangan commented:

      In preparation for a blog post on TargetMine, I contacted the authors. They asked me to note that the URL to access TargetMine is now: http://targetmine.mizuguchilab.org

      Blog post, in case you wish to see that: http://blog.openhelix.com/?p=21533


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    1. On 2014 Dec 27, DAVID ALLISON commented:

      Our paper contains one or more typographical errors which are corrected in this paper:

      Cresswell L, Mander AP. How to use published complete case results from weight loss studies in a missing data sensitivity analysis. Obesity (Silver Spring). 2014 Apr;22(4):996-1001. doi: 10.1002/oby.20635. Epub 2013 Dec 5. PMID: 24124049.


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    1. On 2016 Dec 20, Alessandro Rasman commented:

      Anatomical stenosis of the internal jugular veins : supportive evidence of chronic cerebrospinal venous insufficiency ?

      Andrea Baiocchini, MD Raffaele Toscano, Wilfredo von Lorch and Franca Del Nonno National Institute for Infectious Diseases "L. Spallanzani", Via Portuense 292, 00149 Rome, Italy, +390655170277, Fax +390655170430

      We write in relation to the editorial commentary from Khan et Tselis (1) who rightly suggest caution to consider chronic cerebrospinal venous insufficiency (CCSVI) as a pathological entity and cast serious doubt on its relevance to multiple sclerosis (MS); they forecast properly designed studies to investigate the relevance of CCSVI to MS, in order to carry out interventional procedures.

      The absence of extracranial venous stenosis at the earliest stage of MS makes it an unlikely cause of the disease (2). The idea of venous congestion as a possible contributor to the pathogenesis of MS has been discussed for the past 40 years, but remained widely unappreciated by the scientific community.

      In contrast with other authors, Zamboni et al (3) defined CCSVI as a vascular condition associated with MS; it is characterized by multiple intraluminal stenosing malformations of the principal pathways of extracranial venous drainage, particularly in the internal jugular veins (IJVs) and the azygous vein (AZY), that restrict the normal outflow of blood from the brain. In the study of Zamboni et al there was significant extracranial venous stenosis localised at the principal level of the cerebrospinal venous segments as detected by selective venography and anomalies of venous outflow at color Doppler high resolution examination. The pathological consequences of CCSVI have been hypothesised to emanate from chronic venous reflux and hypertension leading to increased iron deposition in the brain and subsequent MS pathology, including inflammation and neurodegeneration.

      Other recent reports found no differences in cerebrospinal venous drainage using transcranial and extracranial Doppler imaging (4-5). The discrepancies in the results may be explained with the absence of standardized internationally accepted criteria for normal Doppler venous flow parameters (2).

      We performed complete post-mortem examination of two patients with MS, died for different causes. One patient, a 74 year-old-woman, was hospitalized for acute respiratory illness and died because of bacterial pneumonia; the other one, a 35 year-old-woman, died for otogenic bacterial meningitis complicated with internal jugular thrombosis as demonstrated on MR venography.

      Postmortem examination demonstrated in both patients a marked stenosis of left internal jugular vein at the apex of the angle formed by the two heads of the sternocleidomastoid muscle where the IJV overlie the carotid artery with ectasia and congestion of the intracranial veins. Venous flow slowing, caused by the stenosis, had predisposed to IJV thrombosis, histologically demonstrated in the second case.

      Severe inflammatory disease may be a risk factor for deep venous thrombosis but also chronic cerebrospinal venous insufficiency. We demonstrate, for the first time as far as we are aware, the presence of anatomical alteration in the veins of the neck with impaired venous drainage from the central nervous system in two patients with multiple sclerosis who died from other causes.

      We do not know the exact implications in MS pathology and certainly there is no doubt that this area warrants a great deal more study. Clinical trials for evaluating new therapeutic agents and other clinical experimental protocols may be required.

      References: 1. Khan O, Tselis A. Chronic cerebrospinal venous insufficiency and multiple sclerosis: science or science fiction? J Neurol Neurosurg Psychiatry 2011;82:355. 2. Yamout B, Herlopian A, Issa Z Extracranial venous stenosis is an unlikely cause of multiple sclerosis Mult Scler 2010 16: 1341-9 3. Zamboni P, Galeotti R, Menegatti E, et al Chronic cerebrospinal venous insuffiency in patients with multiple sclerosis. J Neurol Neurosurg Psychiatry 2009;80:392-9. 4. Doepp F, Paul F, Valdueza JM, et al No cerebrocervical venous congestion in patients with multiple sclerosis. Ann Neurol 2010, 68:173-183. 5. Sundstrom P, Wahlin A, Ambarki K, et al Venous and cerebrospinal fluid flow in multiple sclerosis: a case-control study. Ann Neurol 2010, 68:255-259.

      Conflict of Interest: None declared

      Published 28 April 2011


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    1. On 2014 May 09, Madhusudana Girija Sanal commented:

      A SIMPLER DEFINITION OF CANCER

      The following two conditions needs to be satisfied to define a cancer:

      1) Non physiological rate and duration of cell proliferation. Non physiological rate is defined as a growth rate which is a statistical outlier spatially and temporally for a given type of cell and organism. 2) A change, genetic or epigenetic with reference to the "healthy genome" The genetic or epigenetic 'change' is a statistical outlier, spatially and temporally, for a given cell type and organism. Healthy reference genome and epigenome may be defined as the 'consensus' genome of individuals which satisfy two conditions a) falling within the statistically defined normal range of anatomical and physiological parameters for a population b) demonstrated longevity above 99.9 percentile of the population of a given organism under optimal growth conditions and environment and excluding accidental deaths. Consensus may be reached through statistical or non-statistical approaches (functional,computational or even based on social and economic goals).

      According to this definition an apparently "healthy" person having hundreds of cells with known cancer causing mutations do not have cancer because condition #1 is not met. So he will have cancer only when mutated cells start to proliferate at a non-physiological speed.


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    1. On 2014 Mar 10, Madhusudana Girija Sanal commented:

      You observed that significantly more CNVs are present in early-passage human iPS cells than intermediate passage human iPS cells or human ES cells. Can the reason for the observed improvements in genetic quality be a conscious selection by a trained eye for ideal hES cell morphology resulting in improvement of the quality of iPSC over passages-(although the investigators were not knowing that they are selecting for genetically/epigenetically normal cells)!

      It has been observed by several groups that the genetic/epigenetic quality of iPSC improves over passages (1,2). The reasons could be DNA repair mechanisms acting over time, natural selection or human (artificial) selection over passages. Primary cells become adapted over time in culture conditions, short term adaptations due to changes in regulation and expression of various genes at transcription and translational levels and later by acquiring genetic changes including mutations, copy number variations, deletions and probably epigenetic changes (3-5). It is observed that cells will accumulate mutations under the ‘natural’ selection pressure which favor in-vitro growth and proliferation and most of the robust cell lines have mutations which make them successful for in-vitro growth. This is a contrast to iPSC which improves the genetic quality over passage. Morphology identified by human eye is very powerful in identifying subtle differences in phenotype which in turn reflects the changes in the genotype. This is why a trained person can identify types of cancer from a simple H&E stained section without going for genetic markers or one can distinguish between the identical twins. In case of iPSC, every time the investigator observes the culture dishes under microscope, he discards ‘bad looking’ colonies and selects ‘good-healthy’ colonies. In this process he unknowingly selects for genetically/epigenetically normal cells. It may be noted that all of the established human embryonic stem (hES) cell lines have undergone several passages and hence careful human selection and hence less genetic defects compared to relatively ‘fresh’ (low passage number) iPSC. Conscious selection by a trained eye for ideal hES cell morphology could be the prime reason for the observed improvement of the quality of iPSC over passages.

      "majority of the cells, whether during the early or late passages, had the ideal hES morphology" The first author notes. But majority is a relative term. Anyway, the majority of the IPSC has normal genetics also.

      Please see an extract from first and second page of your article : "A control probe was selected from a chromosome 1 location that showed normal copy number across all human iPS cell lines that were tested. During early passages, the test probe demonstrated a significantly higher fraction of cells with aberrant copy number state than the control probe. The fraction of aberrant cells was also significantly higher in early-passage human iPS cells (18%) than in fibroblasts (3%) or in later-passage human iPS cells (9%)".

      "The median number of CNVs in human iPS cell lines was about twofold higher than in human ES cell lines and fibroblasts" This is expected because most of the established human ES lines have undergone several passages compared to relatively "freshly brewed iPSC" and hence more rounds of selection by an expert's eye!

      It may be noted that morphology is one or the most important markers of ES cells, all others- alkaline PO4ase staining, expression of Nanog, TRAs are non-specific. They are present in several cancer cell lines also. In contrast, typical ES cell morphology is quite rare among non-ES cells.

      A note on the methods: "consistently passaged the cells enzymatically (Collagenase or dispase), and as such this alleviates bias that may occur by manual passaging of ideal hESCs"

      Suppose you have a dish of IPSC cells, say 40-60 colonies and you find one or two colonies looking "bad" or atypical or 'differentiated', then you will most likely discard the entire dish. You will not attempt an enzymatic splitting and passaging. This is what we do in our lab. Suppose the ES/IPSC line is precious, then we would do? We would manually pick good colonies by cutting them out using a pipette tip. In both cases we are doing the same.

      You believe that "most of the selection pressure may actually occur through the fact that several of the mutations observed in early passage hiPSCs (as highlighted in your paper, supplementary table 8) carry the possibility of hindering hESC maintenance and self-renewal."

      I will say several of the mutations which hinders with maintenance/self-renewal will not be selected because as soon as they show these phenotypic changes the experimenter will discard them!

      "hiPSCs are genetically mosaic, more so in early passage than in later passages". Moreover, SNP arrays (as highlighted in your paper) would detect CNVs that are found in the majority of the cells.

      I would explain this fact, this way: This can be because of inefficiency of the method -the positive predictive value versus negative predictive value of the test! Again, our key question why more defects in early passages? My answer is that with every passage genetically/epigenetically bad colonies were discarded by the experimenter. It is possible that mosaics are generated during enzyme treatment (collagenase/trypsin/dispase) when two or more monoclonal colonies gets mixed up. So these facts cannot be followed up without studying and following up iPSC clonal selection and proliferation.

      It is possible that genetically defective cells, parasite on (or may be complementing!) the growth and maintenance of IPSC colonies which is facilitated by mosaic-ism.

      References:

      1. Mayshar Y et al. Identification and classification of chromosomal aberrations in human induced pluripotent stem cells. Cell Stem Cell. 7:521-31(2010).

      2. Hussein, S. M. et al. Nature 471, 58–62 (2011).

      3. http://www.sanger.ac.uk/genetics/CGP/CellLines/

      4. Freshney, R.I. (2005) Culture of Animal Cells, a Manual of Basic Technique, 5th Ed. Hoboken NJ, John Wiley & Sons.

      5. Chen J et al. Evaluation of x-inactivation status and cytogenetic stability of human dermal fibroblasts after long-term culture. Int J Cell Biol.2010:289653 (2010).


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    1. On 2016 Nov 18, David Keller commented:

      This study supports a controlled clinical trial of ibuprofen for treatment of Parkinson's disease

      This study found that users of ibuprofen had a significant 38% reduction in their adjusted risk of Parkinson disease (PD) compared with nonusers of ibuprofen. Furthermore, a significant dose-response relationship was observed between the number of ibuprofen tablets taken per week and the reduction in PD risk. Further still, an accompanying meta-analysis found a significant 27% reduction in the risk of PD with ibuprofen use, but not with other NSAIDs.

      The above three results [1] strongly support the authors' suggestion that "ibuprofen should be further investigated as a potential neuroprotective agent against PD". In particular, a randomized, placebo-controlled trial of ibuprofen in the setting of early PD seems justified, yet has not been reported in the years since the publication of this paper in 2011. Can anyone explain why?

      Reference

      1: Gao X, Chen H, Schwarzschild MA, Ascherio A. Use of ibuprofen and risk of Parkinson disease. Neurology. 2011 Mar 8;76(10):863-9. doi:10.1212/WNL.0b013e31820f2d79. PubMed PMID: 21368281; PubMed Central PMCID:PMC3059148.


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    1. On 2017 Feb 20, David Keller commented:

      These editorialists actually favor a clinical trial of ibuprofen in patients with Parkinson disease

      In 2011, Gao and colleagues published data from 2 large cohorts which demonstrated ibuprofen use was associated with a significant 38% reduction in risk of developing Parkinson disease (PD), with a significant dose response. In addition, they conducted a new meta-analysis including these plus 5 other similar studies, demonstrating a significant 27% reduction in the incidence of PD for persons taking ibuprofen [1]. The accompanying editorial was titled "Is the answer for Parkinson disease already in the medicine cabinet? Unfortunately not". This title seems to contradict the beneficial findings described in Gao's new study and meta-analysis, and the favorable assessment of the design and execution of the studies. The caveat is a familiar one: reduction of risk for PD has been associated with ibuprofen in observational studies only. Treatment cannot be based on observational evidence alone, which cannot eliminate bias and confounding. In the end, the editorialists do conclude that "a clinical trial of ibuprofen, or perhaps a safer PPAR-gamma agonist, may be warranted." A randomized, placebo-controlled clinical trial is necessary to prove that ibuprofen is beneficial before it can be recommended for prevention or treatment of PD.

      However, why wait for a PPAR-gamma agonist other than ibuprofen, which is safe enough that millions of patients take it as a non-prescription medicine for pain? Its adverse effects are well-known and can be monitored for during a clinical trial, or prophylaxed. The call by Gao and colleagues for further research on ibuprofen, so well-supported by their findings, has gone unanswered since 2011. Millions of PD patients await proof that any medication can slow the progression of their disease, while a promising possibility may be, indeed, already in the medicine cabinet.

      Reference

      1: Gao X, Chen H, Schwarzschild MA, Ascherio A. Use of ibuprofen and risk of Parkinson disease. Neurology. 2011 Mar 8;76(10):863-9. doi: 10.1212/WNL.0b013e31820f2d79. PubMed PMID: 21368281; PubMed Central PMCID: PMC3059148.


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    1. On 2016 Apr 06, Daniel Tsin commented:

      Correction in Reference 3. Tsin DA, Sequeria RJ, Giannikas G.Culdolaparoscopic cholecystectomy during vaginal hysterectomy.JSLS. 2003 Apr-Jun;7(2):171-2. PMID 12856851


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    1. On 2014 Jan 10, Helmi BEN SAAD commented:

      The second author name is "BEN SAAD H" not "SAAD HB".


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    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 NCT001195663. We believe the correct ID, which we have found by hand searching, is NCT00195663.

      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

      * 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


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    1. On 2014 Oct 23, Casey M Bergman commented:

      Genomic DNA sequences for the Canton-S and w1 strains studied in this paper have not been deposited in the Short Read Archive. The GEO accession given in the paper (GSE25180 corresponding to SRA accession SRP004442) only contains RNA-seq data, but not DNA-seq data. DNA-seq data for these strains can be obtained from the authors' website at: http://www.eisenlab.org/dosage/data/Reads/Genomic/

      Edit 28 Aug 2015 Genomic data for Canton-S from this study have now been deposited in SRA: http://www.ncbi.nlm.nih.gov/sra/?term=SRP061802


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    1. On 2014 Feb 06, Anastasia L Bodnar commented:

      This comment focuses on the claim by Aris and Leblanc that CryAb1 toxin was detected. In short, they used an incorrect method and an incorrect standard.

      The ELISA kit used by Aris and Leblanc to detect Bt was made by a company called Agdia (as described in section 2.4. of the paper). The kit was created and tested to detect Bt in plant tissues (Agdia doesn’t make any kits for animal tissues). This is potentially a problem because a kit that is not tested on mammalian tissues might cross-react with proteins found in mammals that aren’t found in plants, giving a false positive result. ELISA methods have been developed for Cry proteins in mammalian blood, but these methods have had varying success.

      German researchers developed an ELISA method for cows’ blood, which was able to detect Cry proteins in blood that was spiked with the protein. They did not find any significant difference between cows that had been fed Bt and conventional maize for a two month period, and all values detected in all cows’ blood were less than 1.5 ng/mL. Paul V, 2008

      Aris and Leblanc did cite a paper that showed fragments and intact Bt protein could be detected with ELISA in the gastrointestinal tract (not in blood). Aris and Leblanc did not mention that the researchers found that Bt was probably digested in cattle, and suggested that a different method besides ELISA should be used to confirm presence of Cry protein. Lutz B, 2005

      Aris and Leblanc also cited a paper that used ELISA to detect Cry protein in pigs. ELISA, immunochromatography, and immunoblot were sucessful in detecting Cry protein fragments in the gastrointestinal tract. Aris and Leblanc did not mention that the researchers did not detect any Cry protein in blood with any of these methods. Chowdhury EH, 2003

      In addition to using an incorrect method to detect Cry proteins in blood, Aris and Leblanc also used an incorrect standard. Aris and LeBlanc created Cry protein solutions of 0.1 to 10 ng/mL. In Table 2, they report that a a range of 0 to 1.50 ng/mL was detected in maternal blood and 0 to 0.14 was detected in fetal cord blood. The mean and SD for maternal was 0.19 ng/mL ± 0.30 and for fetal was 0.04 ± 0.04 ng/mL. Ideally, test values will be in the middle of a standard curve. Any values outside or at the edges of of the standard curve may be false positives. Aris and Leblanc could have confirmed their results with a Western blot or any number of other methods, but they did not.


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    1. On 2014 Mar 26, Gwinyai Masukume commented:

      The authors write, “With respect to the concern that men might engage in riskier sexual behavior after circumcision, data from the three RCTs1–3 and a prospective cohort study8 found no overall increases in risk behavior following circumcision.”

      In the abstract of the first RCT it is written, “When controlling for behavioural factors, including sexual behaviour that increased slightly in the intervention group, condom use, and health-seeking behaviour, the protection was of 61% (95% CI: 34%-77%).” Auvert B, 2005

      In the abstract of a meta-analysis of the three RCTs it is written, “For the South African trial [the first RCT] the mean number of sexual contacts at the 12-month visit was 5.9 in the circumcision group versus 5 in the control group, which was a statistically significant difference (p < 0.001). This difference remained statistically significant at the 21-month visit (7.5 versus 6.4; p = 0.0015).” Siegfried N, 2009

      One can then conclude that in the first RCT men engaged in riskier sexual behavior after circumcision. The authors appear to downplay risk compensation i.e. men engaging in riskier sexual behavior after circumcision.

      In the abstract of the next paper that the authors cite (9), it is written, “In the context of a RCT [not the first RCT but one of the three], circumcision did not result in increased HIV risk behavior. Continued monitoring and evaluation of risk compensation associated with circumcision is needed as evidence supporting its' efficacy is disseminated and MC is widely promoted for HIV prevention.” Mattson CL, 2008

      Apparently downplaying risk compensation seems curious since continued monitoring and evaluation is needed.

      RCT - Randomized Controlled Trial


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    1. On 2017 Nov 23, Tom Kindlon commented:

      More data demonstrating why the SF-36 physical functioning threshold of 60+ is problematic

      The PACE trial's principal investigators (PIs) argue that scores of 60 or higher on the SF-36 physical function subscale (SF-36 PF) fall within the "normal range" and use this threshold as one component of their revised definition of recovery from Chronic Fatigue Syndrome (CFS), as well as a post hoc measure in this paper[1,2].

      Referring to the normal ranges for physical function and fatigue used in the PACE trial, one of the trial's PIs, Trudie Chalder, stated that “twice as many people on graded exercise therapy and cognitive behaviour therapy got back to normal”[3]. This same terminology, "back to normal", was also used by the PIs in a patient information leaflet[4].

      The use of this phrase, which implies full restoration of health, merits closer scrutiny following publication of a new paper containing data from CFS patients assessed at one of the PACE trial's treatment centres, the Chronic Fatigue Research and Treatment Unit in London, UK, between November 2007 and January 2014[5].

      The paper, whose corresponding author is Trudie Chalder, reports that 39.6% of the patients diagnosed with CFS (228/576) had SF-36 PF scores of more than 60; i.e, despite having a score within the normal range, they were judged as sufficiently disabled to be diagnosed with CFS. Note that the data given were for more than 60 on the SF-36 PF so the figure for 60 or more would likely be higher again.

      Moreover, Dutch researchers recently reported that 39% of patients with CFS had SF-36 PF scores of 65 or higher[6], and in the PACE trial itself patients could start with a SF-36 PF score of 65 at baseline[7]. Also, as we reported in a reanalysis of the PACE Trial data, in a large British community sample 90% of people aged 18–59 without a long-term illness or disability actually score 90 or higher[8].

      Taken together, these data suggest that the derived normal range threshold for physical function is too low to serve as a meaningful indicator of recovery and does not, in fact, represent getting "back to normal".

      References:

      1 White PD1, Goldsmith KA, Johnson AL, Potts L, Walwyn R, DeCesare JC, Baber HL, Burgess M, Clark LV, Cox DL, Bavinton J, Angus BJ, Murphy G, Murphy M, O'Dowd H, Wilks D, McCrone P, Chalder T, Sharpe M; PACE trial management group. 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: 611–690

      2 White PD, Goldsmith K, Johnson AL, Chalder T, Sharpe M. Recovery from chronic fatigue syndrome after treatments given in the PACE trial. Psychol Med. 2013;43(10):2227–2235.

      3 Boseley, S. Study finds therapy and exercise best for ME. The Guardian. Feb 18, 2011 https://www.theguardian.com/society/2011/feb/18/study-exercise-therapy-me-treatment

      4 PACE participants newsletter 4. February 2011. http://www.wolfson.qmul.ac.uk/images/pdfs/participantsnewsletter4.pdf

      5 Ryan EG, Vitoratou S, Goldsmith KA, Chalder T. Psychometric properties and factor structure of a shortened version of the Cognitive Behavioural Responses Questionnaire (CBRQ). Psychosom Med. 2017 Oct 10. doi: 10.1097/PSY.0000000000000536. [Epub ahead of print]

      6 Janse A, Nikolaus S, Wiborg JF, Heins M, van der Meer JWM, Bleijenberg G, Tummers M, Twisk J, Knoop H. Long-term follow-up after cognitive behaviour therapy for chronic fatigue syndrome. J Psychosom Res, 2017. doi: 10.1016/j.jpsychores.2017.03.016.

      7 White, PD, Sharpe, MC, Chalder, T et al. Protocol for the PACE trial: a randomised controlled trial of adaptive pacing, cognitive behaviour therapy, and graded exercise, as supplements to standardised specialist medical care versus standardised specialist medical care alone for patients with the chronic fatigue syndrome/myalgic encephalomyelitis or encephalopathy. BMC Neurol. 2007; 7: 6

      8 Wilshire CE, Kindlon T, Matthees A, et al. Can patients with chronic fatigue syndrome really recover after graded exercise or cognitive behavioural therapy? A critical commentary and preliminary re-analysis of the PACE trial. Fatigue. 2017;5:1–4.


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    2. On 2016 Sep 27, Alem Matthees commented:

      Post-hoc outcome switching inflated clinical response rates by several times

      The primary outcomes as pre-specified in the published PACE trial protocol [1] were abandoned after the trial was over but before the unmasking of data [2] (although the trial was already open-label). While the new primary outcomes are useful, they were group-level and therefore not a direct replacement of the original primary outcomes, which were individual-level i.e. the proportion of participants meeting thresholds for fatigue and physical function.

      The thresholds for individual-level improvement on the measures of fatigue and physical function were eventually replaced with post-hoc analyses after the unmasking of data [3], and it is unclear whether these changes were independently approved. The new thresholds have been criticised for being too lax, much less stringent than the pre-specified version, poorly calculated, and a possible example of "outcome reporting bias" [4,5].

      On 8 September 2016, Queen Mary University of London (QMUL) released the PACE trial primary outcome results as defined in the published trial protocol [6]. This happened one day before the deadline to appeal the Information Tribunal’s ruling that QMUL must disclose a selection of de-identified participant-level data under the Freedom of Information Act (see EA/2015/0269).

      Here is a comparison of the different rates: the clinically useful difference in both fatigue and physical function (Lancet 2011) [3] was 45% for SMC, 59% for CBT, and 61% for GET; the overall improvers or positive outcomes for both fatigue and physical function (QMUL 2016) [6] were 10% for SMC, 20% for CBT, and 21% for GET.

      Without going into the issues with the nature and generalisability of the reported benefits, these new results provide a more realistic estimation of the clinical response rates of CBT and GET. However it also indicates that post-hoc outcome switching had inflated the estimated response rates in the PACE trial by several times. This exaggeration allowed proponents of CBT and GET to claim that 60% improved after these therapies (often without mentioning the SMC control rate of 45%). Outcome switching is recognised as a major problem in the research community [7].

      There is also evidence that the PACE trial investigators changed the primary outcome measures in the trial registration entry (ISRCTN54285094 [8]). Using web.archive.org shows that an earlier version dated May 2005 [9] describes the primary outcomes with details about the pre-specified thresholds for improvement, but the current version only describes the primary hypotheses being tested or general objectives, without those additional details, allowing the investigators to change their primary outcomes without appearing to be deviating from the trial registration details.

      References

      1) White PD, Sharpe MC, Chalder T, DeCesare JC, Walwyn R; PACE trial group. Protocol for the PACE trial: a randomised controlled trial of adaptive pacing, cognitive behaviour therapy, and graded exercise, as supplements to standardised specialist medical care versus standardised specialist medical care alone for patients with the chronic fatigue syndrome/myalgic encephalomyelitis or encephalopathy. BMC Neurol. 2007 Mar 8;7:6. PMID: 17397525. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2147058/

      2) Walwyn R, Potts L, McCrone P, Johnson AL, DeCesare JC, Baber H, Goldsmith K, Sharpe M, Chalder T, White PD. A randomised trial of adaptive pacing therapy, cognitive behaviour therapy, graded exercise, and specialist medical care for chronic fatigue syndrome (PACE): statistical analysis plan. Trials. 2013 Nov 13;14:386. doi: 10.1186/1745-6215-14-386. PMID: 24225069. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4226009/

      3) White PD, Goldsmith KA, Johnson AL, Potts L, Walwyn R, DeCesare JC, Baber HL, Burgess M, Clark LV, Cox DL, Bavinton J, Angus BJ, Murphy G, Murphy M, O'Dowd H, Wilks D, McCrone P, Chalder T, Sharpe M; PACE trial management group. 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 Mar 5;377(9768):823-36. doi: 10.1016/S0140-6736(11)60096-2. Epub 2011 Feb 18. PMID: 21334061. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3065633/

      4) Giakoumakis J. The PACE trial in chronic fatigue syndrome. Lancet. 2011 May 28;377(9780):1831; author reply 1834-5. doi: 10.1016/S0140-6736(11)60689-2. Epub 2011 May 16. PMID: 21592554. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)60689-2/fulltext

      5) Stouten B, Goudsmit EM, Riley N. The PACE trial in chronic fatigue syndrome. Lancet. 2011 May 28;377(9780):1832-3; author reply 1834-5. doi: 10.1016/S0140-6736(11)60685-5. Epub 2011 May 16. PMID: 21592558. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)60685-5/fulltext

      6) Goldsmith KA, White PD, Chalder T, Johnson AL, Sharpe M. The PACE trial: analysis of primary outcomes using composite measures of improvement. 8 September 2016. http://www.wolfson.qmul.ac.uk/images/pdfs/pace/PACE_published_protocol_based_analysis_final_8th_Sept_2016.pdf

      7) http://compare-trials.org/

      8) http://www.controlled-trials.com/ISRCTN54285094

      9) <http://web.archive.org/web/20050524130106/http://www.controlled-trials.com/mrct/trial/CHRONIC FATIGUE SYNDROME/1042/40645.html>


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    3. On 2016 Aug 29, Ellen M Goudsmit commented:

      See Goudsmit et al. Editorial bias in the Lancet. ME research Online. http://www.axfordsabode.org.uk/me/melist.htm

      Things have not changed yet.


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    4. On 2016 Aug 29, VINCENT RACANIELLO commented:

      Below is the text of a letter sent to The Lancet earlier this year, asking for an independent review of the PACE trial. The Lancet invited us to submit this letter, then rejected it for no reason. To keep the text within the limits of PubMedCommons, only the first six names of those who signed the letter are shown.

      Sir: The PACE trial reported that exercise and psychotherapy were effective treatments for chronic fatigue syndrome. Yet PACE was an unblinded study with subjective primary outcomes—a design already vulnerable to bias. As patients have long noted, PACE also suffered from additional methodological lapses likely to produce unreliable results. A recent investigation by David Tuller of the University of California, Berkeley, heightened public awareness of PACE’s flaws and sparked an open letter from us to The Lancet requesting an independent review.

      Among PACE’s serious missteps:

      *In a paradox, participants could—before treatment—already qualify as improved or “within the normal range” for fatigue and physical function, the primary outcomes. How? Because PACE’s “normal range” outcome scores actually allowed for worse health status than the eligibility scores required at entry to demonstrate serious disability. At entry, 13 percent of participants scored “within normal range” on one or both measures—details unreported in the paper. One PACE investigator described participants meeting these lax “normal ranges” as “back to normal”—a misleading statement highlighted in news coverage. An accompanying commentary, reviewed pre-publication by the PACE investigators, called this “a strict criterion for recovery.”

      *PACE claimed success based solely on subjective outcomes. Participants in one arm improved slightly on a walking test but remained severely disabled. The investigators subsequently dismissed this test and other objective measures--which all failed to demonstrate success--as irrelevant or non-objective. They describe their findings as robust, but unblinded trials with subjective endpoints, even without PACE’s many other problems, can only yield low-quality evidence.

      *PACE used one symptom to identify participants—six months of disabling, unexplained fatigue. A 2015 National Institutes of Health report recommended abandoning this broad definition because it generates heterogeneous samples that could “impair progress and cause harm.” PACE’s sub-group analyses of two alternate criteria are also difficult to interpret—an unknown number of patients might have met these criteria but been excluded by the initial definition and thus unobserved.

      *PACE significantly revised its protocol strategy for assessing primary measures and “recovery” criteria but did not include sensitivity analyses, the accepted method of evaluating the impact and dispelling concerns about bias. Whether or not investigators made revisions before reviewing outcome data is irrelevant: Outcome trends in unblinded trials are often apparent to trial leadership early on, even if assessors do not know treatment assignment. The investigators have declined to provide the protocol results and rebuffed data requests as “vexatious.”

      *A newsletter for participants--published while a third were still undergoing assessment-- included glowing testimonials from earlier participants about excellent outcomes but none reporting poor outcomes, potentially biasing subjective ratings toward the positive. The same newsletter reported that new U.K. treatment guidelines, “based on the best available evidence,” recommended the two PACE interventions favored by the investigators. Adaptive Pacing Therapy, an untested intervention developed specifically for PACE, was not mentioned.

      *Despite investigators’ explicit protocol promise to inform participants of “any possible conflicts of interest,” consent forms did not mention their ME/CFS-related work for disability insurers. It is irrelevant that they disclosed these conflicts in The Lancet and that insurers played no role in PACE. Given the omission, the signed consents are of questionable legitimacy.

      The investigators’ previous responses to such concerns have been unsatisfactory. We firmly believe the trial data should undergo a fully independent review.

      Vincent R. Racaniello, PhD Professor of Microbiology and Immunology Columbia University

      Ronald W. Davis, PhD Professor of Biochemistry and Genetics Stanford University

      Jonathan C.W. Edwards, MD Emeritus Professor of Medicine University College London

      Leonard A. Jason, PhD Professor of Psychology DePaul University

      Bruce Levin, PhD Professor of Biostatistics Columbia University

      Arthur L. Reingold, MD Professor of Epidemiology University of California, Berkeley


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    5. On 2016 Jan 08, Tom Kindlon commented:

      "Trial By Error, Continued: Did the PACE Trial Really Prove that Graded Exercise Is Safe?"

      By two journalists: Julie Rehmeyer is a journalist and Ted Scripps Environmental Journalism Fellow at the University of Colorado, Boulder, who has written extensively about ME/CFS.

      David Tuller DrPH is academic coordinator of the concurrent masters degree program in public health and journalism at the University of California, Berkeley.

      I am quoted in it.

      http://www.virology.ws/2016/01/07/trial-by-error-continued-did-the-pace-trial-really-prove-that-graded-exercise-is-safe/


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    6. On 2015 Oct 23, Lily Chu commented:

      No study is perfect but this trial suffered from some major flaws. These are covered by Dr. David Tuller in the following link:

      http://www.virology.ws/2015/10/21/trial-by-error-i/


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    7. On 2014 Sep 28, Tom Kindlon commented:

      Letter published criticising the threshold for normal functioning and recovery in the PACE Trial:

      Quotes some population data to show how ridiculous a threshold of 60+ on the SF-36 physical functioning is to define "normal functioning" and recovery.

      Kindlon T, Baldwin A. Response to: reports of recovery in chronic fatigue syndrome may present less than meets the eye. Evid Based Mental Health doi:10.1136/eb-2014-101961 http://ebmh.bmj.com/content/early/2014/09/19/eb-2014-101961.extract


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    8. On 2013 Nov 15, Ellen M Goudsmit commented:

      As a co-author of the London criteria for myalgic encephalomyelitis, I wish it to be known that this stdy did not use the criteria and that their citation refers to an incomplete and flawed version written by someone without permission from the original authors. It is therefore unclear if there were any patients with ME who participated in this trial.

      Dr E Goudsmit PhD FBPsS


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    1. On 2016 Sep 27, Alem Matthees commented:

      The 'normal range' was not a strict criterion for recovery nor was it based on healthy scores

      The editorial by Bleijenberg & Knoop (2011) contains a misleading statement: “PACE used a strict criterion for recovery: a score on both fatigue and physical function within the range of the mean plus (or minus) one standard deviation of a healthy person’s score. In accordance with this criterion, the recovery rate of cognitive behavioural and graded exercise therapy was about 30%—although not very high, the rate is significantly higher than that with both other interventions.” [1]

      However, the PACE publication did not report on "recovery" [2] and the PACE authors issued a statement to that effect [3] despite previously approving the editorial before it was published [4,5]. The normal range overlapped with trial eligibility criteria for severe disabling fatigue [2]. The largest overlap was with SF-36 physical function, where 13% of participants simultaneously met the normal range on this measure and the entry criteria for "significant disability" [6]. The individual participant data recently released from the PACE trial reveals that 45% (60/134) of those within the normal range at 52-week follow-up still met Oxford CFS criteria [7].

      It is disappointing that the Lancet and Bleijenberg & Knoop stand by the comment on recovery despite being alerted of the problems [5]. The Press Complaints Commission ruled that the editorial was misleading [4,5]. Oddly enough, both Bleijenberg & Knoop have previously co-authored papers where a score of 60 (the threshold for normal physical function) was regarded as severe impairment [8-11].

      The normal range was not based on healthy people of working age only. For example, the normal range for physical function was based on a general population that included the elderly and chronically disabled [3]. If the normal range was based on a healthy population as asserted, the threshold for normal physical function would be 85 points or more, not 60 or more [6]. A preliminary re-analysis of recovery in the PACE trial, based on the protocol-specified recovery criteria, shows that the recovery rates in the CBT and GET groups were 6.8% and 4.4% respectively, and not significantly higher than with specialist medical care alone [7].

      References

      1) Bleijenberg G, Knoop H. Chronic fatigue syndrome: where to PACE from here? Lancet. 2011 Mar 5;377(9768):786-8. doi: 10.1016/S0140-6736(11)60172-4. Epub 2011 Feb 18. PMID: 21334060. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)60172-4/fulltext

      2) White PD, Goldsmith KA, Johnson AL, Potts L, Walwyn R, DeCesare JC, Baber HL, Burgess M, Clark LV, Cox DL, Bavinton J, Angus BJ, Murphy G, Murphy M, O'Dowd H, Wilks D, McCrone P, Chalder T, Sharpe M; PACE trial management group. 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 Mar 5;377(9768):823-36. doi: 10.1016/S0140-6736(11)60096-2. Epub 2011 Feb 18. PMID: 21334061. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3065633/

      3) White PD, Goldsmith KA, Johnson AL, Walwyn R, Baber HL, Chalder T, Sharpe M, [on behalf of the coauthors]. The PACE trial in chronic fatigue syndrome — Authors' reply. The Lancet, Volume 377, Issue 9780, Pages 1834 - 1835, 28 May 2011 (Published Online: 17 May 2011). doi:10.1016/S0140-6736(11)60651-X http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)60651-X/fulltext

      4) http://www.pcc.org.uk/cases/adjudicated.html?article=ODQwOQ

      5) Continuing Correspondence Between Countess of Mar and Professor Peter White and Professor Sir Simon Wessely. 26 January 2013. http://forums.phoenixrising.me/index.php?threads/continuing-correspondence-countess-of-mar-and-prof-white-and-prof-sir-s-wessely.21545/

      6) Matthees A. Re: Tackling fears about exercise is important for ME treatment, analysis indicates. BMJ Rapid Response. 21 January 2015. http://www.bmj.com/content/350/bmj.h227/rr-16

      7) Matthees A, Kindlon T, Maryhew C, Stark P, Levin B. A preliminary analysis of ‘recovery’ from chronic fatigue syndrome in the PACE trial using individual participant data. Virology Blog. 21 September 2016. http://www.virology.ws/wp-content/uploads/2016/09/preliminary-analysis.pdf

      8) van't Leven M, Zielhuis GA, van der Meer JW, Verbeek AL, Bleijenberg G. Fatigue and chronic fatigue syndrome-like complaints in the general population. Eur J Public Health. 2010 Jun;20(3):251-7. Epub 2009 Aug 18. PMID: 19689970. http://eurpub.oxfordjournals.org/content/20/3/251.long

      9) Tummers M, Knoop H, van Dam A, Bleijenberg G. Implementing a minimal intervention for chronic fatigue syndrome in a mental health centre: a randomized controlled trial. Psychol Med. 2012 Oct;42(10):2205-15. doi: 10.1017/S0033291712000232. Epub 2012 Feb 21. PMID: 22354999. http://www.ncbi.nlm.nih.gov/pubmed/22354999

      10) Stulemeijer M, de Jong LW, Fiselier TJ, Hoogveld SW, Bleijenberg G. Cognitive behaviour therapy for adolescents with chronic fatigue syndrome: randomised controlled trial. BMJ. 2005 Jan 1;330(7481):14. Epub 2004 Dec 7. doi: 10.1136/bmj.38301.587106.63. PMID: 15585538. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC539840

      11) Heins M, Knoop H, Nijs J, Feskens R, Meeus M, Moorkens G, Bleijenberg G. Influence of symptom expectancies on stair-climbing performance in chronic fatigue syndrome: effect of study context. Int J Behav Med. 2013 Jun;20(2):213-8. doi: 10.1007/s12529-012-9253-2. PMID: 22865100. http://www.ncbi.nlm.nih.gov/pubmed/22865100


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    2. On 2014 Nov 24, Tom Kindlon commented:

      Letter published criticising threshold for normal functioning used in PACE Trial:

      Bleijenberg and Knoop claimed a strict criterion for recovery was used in the PACE Trial. A letter has been published challenging this: it quotes some population data to show how ridiculous a threshold of 60+ on the SF-36 physical functioning is to define "normal functioning" and recovery (particularly in the PACE Trial given its own entry criteria).

      Kindlon T, Baldwin A. Response to: reports of recovery in chronic fatigue syndrome may present less than meets the eye. Evid Based Mental Health doi:10.1136/eb-2014-101961 http://ebmh.bmj.com/content/early/2014/09/19/eb-2014-101961.extract


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    1. On 2014 Dec 06, Harri Hemila commented:

      Errors in the Cochrane review (2011) on zinc for the common cold

      The Cochrane review (2011) on zinc for the common cold by Singh M, 2011; DOI; had a number of problems, which were commented on in detail in a separate document. Here the problems in the Cochrane review (2011) are listed and briefly described:

      1) Search of the studies was not thorough. Singh M, 2011 did not include Eby GA, 2006 although that study was listed in Pubmed with keywords zinc and the common cold.

      2) There were errors in the extraction of data. In Fig. 3 (p.15) Singh M, 2011 claimed that in the Petrus 1998 study (http://dx.doi.org/10.1016/S0011-393X(98)85058-3), the duration of colds in the zinc group was 4.4 days, whereas Petrus reported 3.8 days for the zinc group, see the link.

      3) The characteristics of included studies table had errors and was not consistent in describing the included trials.

      4) The characteristics of excluded studies table had errors. For example, Singh M, 2011 (p.39) claimed that the study by Turner RB, 2000 was “Not a randomised trial” though the study report clearly describes that the trial was randomised, see pp.1202-3 in DOI.

      5) Different methods of administering zinc should be analyzed separately, whereas Singh M, 2011 pooled all together. Some studies administered zinc as syrup or tablets, some as lozenges. It is probable that the benefit of zinc in syrup and tablet trials is caused by biological mechanisms that are different from the mechanisms of the zinc lozenges, which are intended to be dissolved slowly in the mouth, see eg Hemilä H, 2011 and Eby GA, 2004. Combining different methods of zinc administration is the classical apples and oranges problem of meta-analysis.

      6) The duration of the common cold should not be arbitrarily dichotomized as was done in Analyses 2.1 to 2.3 (pp.43-5) by Singh M, 2011. Duration is a continuous variable and should be analyzed as a continuous variable. The results of the zinc lozenge studies can be and should be analyzed using cold duration as a continuous variable, see Hemilä H, 2011.

      7) Duration of the common cold should have been normalized so that placebo groups have length 100%. There is substantial variation in the duration of colds in the placebo groups of the zinc lozenge trials, from 5.1 days to 9.0 days and 10.8 days, see Hemilä H, 2011. For example, if a 5-day cold is shortened by 4 days, it is not equivalent to a 11-day cold being shortened by 4 days although both differences are equal in absolute units. The former is an 80% decrease in duration, whereas the latter is only a 36% decrease. Although part of the placebo group variation is caused by random variation, it is also caused by differences in viruses and in the severity of disease in different patient groups, and in differences in outcome definitions. Therefore, the relative effect of zinc on the common cold duration should be calculated in percentages, because the relative effect partly adjusts for the variations between patient groups and outcome definitions. In another study, the results of the zinc lozenge studies were analyzed as percentage effects, see Hemilä H, 2011.

      8) Subgroup analysis should have been carried out. In the Background section (p.6), Singh M, 2011 wrote that a “significant correlation between total daily dosages of positively charged zinc species and a reduction in the mean duration of common colds” has been reported, however, they did not analyze that question. In the zinc lozenge studies, there is a 6-fold variation in the total zinc dose from 30 to 207 mg per day, see Hemilä H, 2011. Dose-response relation is a basic concept in pharmacology and thus the relation between dose and the effect of zinc lozenges should have been analyzed in the Cochrane review (2011). Hemilä H, 2011 found that none of the low zinc dose studies found effects of zinc lozenges, whereas high zinc dose studies found very strong evidence that colds were shortened by zinc. Such findings are consistent with the dose-response concept.

      9) Pooling the adverse effects of all zinc trials is unsound, yet Singh M, 2011 did so in Fig. 6 (p.18). Eby GA, 2004 pointed out that the adverse effects of zinc lozenges, such as bad taste, can be explained largely by the differences in the composition of the lozenges. Furthermore, it is obvious that dissolving a zinc lozenge slowly in the mouth causes different adverse effects compared with ingesting a zinc syrup or tablet straight to the stomach. There is no justification to pool adverse effects of all zinc trials together, ignoring the considerable variations in the zinc products. As to the zinc lozenges, Eby GA, 2004 commented that “although pure zinc gluconate is bland and chalky in taste, it reacts with dextrose and related carbohydrates (excluding fructose) upon aging of lozenge compositions to produce noisome bitterness... On the other hand, zinc acetate allows the production of pleasant tasting, flavor stable lozenges”. In the most recent zinc acetate lozenge trial, Prasad AS, 2008 found no significant differences between the zinc and placebo groups in the occurrence of adverse effects although the daily dose of zinc was 92 mg.

      10) Credit should be given to earlier work on the same topic. In the Introduction, Singh M, 2011 (p.7) wrote “The last review of all available RCTs of zinc for the common cold was published in 1999”, which is false. Reviews on zinc and the common cold by Jackson JL, 2000 and Caruso TJ, 2007 were published after 1999 and should have been mentioned as previous reviews on the same topic.

      There is much evidence to indicate that high doses of zinc as zinc lozenges have effects on the duration of colds, see Hemilä H, 2011 and Eby GA, 2004. Therefore the topic of Singh M, 2011 is important; however, there were numerous methodological problems which limited the relevance of the conclusions.

      Singh M, 2011 concluded that “In view of this and the differences in study populations, dosages, formulations and duration of treatment, it is difficult to make firm recommendations about the dose, formulation and duration that should be used.”

      Had Singh M, 2011 separately analyzed the syrup and tablet studies and the lozenge studies, and had they analyzed the relation between the dose and effect, they could have reached much more clear conclusions.

      Hemilä H, 2011 limited analysis to the zinc lozenge studies and found that five trials that used the lowest doses of zinc uniformly found no effect. Three trials used zinc acetate in daily doses of over 75 mg, and the pooled result indicated a 42% reduction in the duration of colds (95% CI: 35% to 48%). Five trials used zinc salts other than acetate in daily doses of over 75 mg, the pooled result indicating a 20% reduction in the duration of colds (95% CI: 12% to 28%). Thus, clear conclusions for patients and for further research could have been drawn from the studies that were available to Singh M, 2011.


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    1. On 2015 Nov 25, Uday Yanamandra commented:

      The second author name Uday Y should read as Yanamandra U.


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    1. On 2015 Apr 22, Bernard J Crespi commented:

      With regard to interpretation of the results of this article, do note that of the four schizophrenia patients described here with maternal duplications, one had a duplication that spanned BP1-BP3, two showed duplications of BP2-BP3, and one had a duplication from BP1 to a region between BP4 and BP5. By contrast, of the comparison subjects with maternal duplications, two had BP1-BP3 duplications and one had a duplication of BP2-BP3. These duplications are thus rather heterogeneous, which complicates inferences regarding causation.

      Restricting the analysis to the BP2-BP3 region (and noting also that BP1-BP2 region deletions have been associated statistically with schizophrenia in previous work), yields two patients and one control with the maternal duplication (Fisher’s exact test, p = 0.061). If the BP2-BP3 duplication is considered regardless of parental origin, then two patients and two controls show the duplications (Fisher's exact test, P = 0.10). It would thus be useful if, at some point, further analysis could be done with larger samples of individuals with relevant duplications.

      With regard to the causal genes, a newly-published study (Noor et al. 2015) shows that duplications encompassing just the maternally-expressed, imprinted gene UBE3A, which is in the BP2-BP3 region, segregate with psychiatric diagnoses including schizophrenia, anxiety and depression, in an extended pedigree.

      Reference

      Noor A, Dupuis L, Mittal K, Lionel AC, Marshall CR, Scherer SW, Stockley T, Vincent JB, Mendoza-Londono R, Stavropoulos DJ. 15q11.2 Duplication Encompassing only the UBE3A Gene is Associated with Developmental Delay and Neuropsychiatric Phenotypes. Hum Mutat. 2015 Apr 17. doi: 10.1002/humu.22800.


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    1. On 2014 Nov 21, Gerhard Nebe-von-Caron commented:

      This work is unfortunatelly missing appropriate revision. There is no evidence that the authors observed single bacteria due to the fact that no pictures of scatter versus nucleic acid fluorescence are shown. It would be recommended that the authors submit the raw data listmode files to http://flowrepository.org/ for validation. The fact that the picture in their 2010 poster "Flow cytometry as a means of observing the effects of ultrasound on bacteria" shows scatter data and antibody fluorescence of white blood cells instead of bacteria and regions of interest that indicate a lack understanding of the data analysis made me search for a follow up paper from the authors and my suspicion was confirmed in this paper. For example there is no distinction made between bacteria and noise signals. Figure 5 and 7 show the settings of quadrants cutting across clusters which is scientifically incorrect, and some of the clusters are in part likely to be caused by trigger artefacts. Figure 5e include permeabilised cells and DNA negative events in the lower left quadrant which could be pumping cells, cell debris as well as bubbles and micelles, distinguishable by appropriate data analysis.

      The conclusion "Although flow cytometry data were comparable to viable plate count techniques, the percentage of live cells appeared higher. This observation is considered to be almost certainly because of the ability of flow cytometry to identify and count bacteria as single cells, whereas viable plate counts only enumerate colony forming units (CFUs) which can be either single bacterial cells or agglomerates of cells" indicates a lack of understanding of the measurement principles. Apart from the problems of colony formation, discussed in several of my publications, when measuring bacteria, cell aggregation can only be detected if genome equivalents are measures or one realises that double positive cells in case of energy transfer staining combinations represent two cells with one red and permeabilised and another green and intact, either coincident or still attached to each other. Most instruments unless aligned and maintained to the standards required for microbial analysis will not detect bacteria adequately when triggering on forward scatter. Thus the separation of bacteria from instrument noise needs to be demonstrated and a comprison of the data should be based on absolute counts. Also the use of aggregated bacteria would have been preferential to compare the effect of disaggregation compared to cellular injury as an indicator for the delivered energy on the membrane.


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    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 NCT003311032. We believe the correct ID, which we have found by hand searching, is NCT00331032.

      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


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