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  1. Jul 2018
    1. On 2014 Jan 07, Tom Kindlon commented:

      Does reduced similarity across timescales really mean reduced complexity?

      Despite a good familiarity with the CFS literature and despite taking many mathematics courses in university, including a methods course which included some coverage of non-linear dynamics, I will admit to not fully understanding this paper. However, I think I will not be alone in that and so will put my head above the parapet and ask the following: This study found CFS cases (compared to controls) showed reduced dissimilarity within timescales as well as reduced similarity across timescales. This is summarised by the authors as CFS patients showing a reduction in complexity. But does the second finding not show the CFS cases demonstrated increased complexity compared to controls for that measure? For measurements within a timeframe, the controls are closer to the scores one would see with random patterns (4.75). For measurements across timescales, the scores of the CFS patients are closer to the scores one would see with random patterns (1.5).


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    1. On 2016 Aug 24, Ben Goldacre commented:

      This trial has the wrong trial registry ID associated with it on PubMed: both in the XML on PubMed, and in the originating journal article. The ID given is NCT100457106. We believe the correct ID, which we have found by hand searching, is NCT00457106.

      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 Apr 21, Vera Sharav commented:

      A warning to doctors who have relied on the claimed safety and efficacy of rivaroxaban (trade name Xarelto) based on reports about the RECORD trials such as this one, published in The Lancet.

      Please read “C. Seife. Research Misconduct Identified by the US Food and Drug Administration: Out of Sight, Out of Mind, Out of the Peer-Reviewed LiteratureJAMA Internal Medicine, April 2015.” The JAMA report identified the Lancet report as failing to disclose that the FDA inspections had found serious violations at 8 of the 16 sites at which the RECORD 4 trial was conducted. The violations, including “systemic discarding of medical records, falsification, improprieties in randomization,” were so serious that “the entire study, RECORD 4 […] was deemed unreliable by the FDA.”

      Among the findings by the FDA Compliance Review: Xarelto (rivaroxaban), May 24, 2011, include: "violation of good clinical practice including prospective randomization, falsification, missing records…Although issues with clinical trial monitoring inadequacies were present in all four RECORD trials, the deficiencies were most frequent in RECORD 4.”

      FDA cites unreported serious adverse events (SAEs) “defined by the necessity of expeditious medical evaluation or involving bleeding or hepatic events."

      “There were 8 unreported SAEs noted in the audits, all in RECORD 4. When the unreported AEs were individually examined for significance as defined by the necessity for expeditious medical evaluation, or were AEs involving bleeding or hepatic events, there were 16 in RECORD 1, 24 in RECORD 2, and 265 in RECORD 4; RECORD 3 could not be tabulated due to failure to list individual laboratory abnormalities.

      During the data verification process of RECORD 4, 504 unreported AEs were noted, as were 28 previously unreported SAEs. The audits identified more than twice as many AEs in RECORD 4 than in the other RECORD studies, and all of the unreported AEs were from RECORD 4”.

      Seife reported that of the 78 publications that resulted from trials in which the FDA found significant violation – only 3 (4%) – mentioned the violations or serious objectionable practices found during the inspection. “No corrections, retractions, expressions of concern, or other comments acknowledging the key issues identified by the inspection were subsequently published.”

      A retraction of this grossly misleading report by AG Turpie & 171 collaborators is long overdue.

      Vera Sharav President, Alliance for Human Research Protection www.ahrp.org veracare@ahrp.org


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    1. On 2014 Jan 08, Jean-Jacques Orban de Xivry commented:

      In this paper, Hunter and colleagues claim that anodal tDCS on M1 improves motor adaptation to force-field perturbation (Shadmehr R, 1994).

      In force-field adaptation, one critical aspect of the task is to control movement speed as the magnitude of the perturbation depends on the velocity of the hand. Indeed, the magnitude of the force pushing the hand away of its trajectory is equal to the velocity of the hand times the magnitude of the field. Unfortunately, I don't think that hand velocity was properly controlled in the paper by Hunter and colleagues. Here are two results that suggest that changes in hand velocity might be a confounding factor:

      1) In the present study, anodal tDCS, but not sham tDCS, appears to modulate the velocity of the hand although this effect did not reach significance (p.2995, movement time differences: p=0.07; last panel of Fig.4). (Note that the values in Table 1 do not seem to correspond to the paragraph on movement times on p.2995 or to the last panel of Fig.4). Therefore, one wonders if the larger adaptation with anodal tDCS reported by the authors is not due to a larger perturbation being experienced during anodal tDCS.

      2) In force-field tasks, it is well documented that the after-effect observed when the perturbation is suddenly removed at the end of the perturbation period is equal to or slightly lower than the deviation observed after the initial introduction of the observation. Here, for the anodal group, the after-effect appears to be larger than the initial deviation due to the perturbation (Fig.3B and first panel of Fig.5). This is only possible if the magnitude of the perturbation is larger during N5 than during F1. That is, it is only possible if hand velocity is larger during N5 than during F1. Again, this effect appears to be specific to the anodal tDCS groups.

      Taken together, these two facts suggest that anodal tDCS but not sham tDCS might influence movement speed in the study by Hunter and colleagues. The larger hand velocity of the anodal tDCS group results in a larger perturbation. A larger perturbation required the subjects to adapt more to it.

      To solve the problem of changes in velocity apparently due to anodal tDCS, the authors should 1) provide graphs on peak hand velocity over the course of trials 2) perform an analysis that directly takes into account changes in movement speed. I suggest that the authors use an ANCOVA analysis with Delta Summed Error or Delta Signed Error as dependent variables, group as discrete predictor and movement speed as continuous predictor.

      In conclusion, I think that it is safe to conclude that until the authors provide the appropriate analyses, this paper does not provide strong evidence that anodal tDCS enhances adaptation to force-field perturbation. Rather, it suggest than anodal tDCS might modulate movement speed specifically. At least two papers did not demonstrate an improvement in motor adaptation with anodal tDCS (Orban de Xivry JJ, 2011;Galea JM, 2011) (Disclosure: I co-authored both of these papers).


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    1. On 2014 Mar 11, Daniel Haft commented:

      The CXX repeat proteins described in this paper are almost certainly modified post-translationally, with the side chains of multiple Cys residues bridged to their preceding residues to form thiazole-type heterocycles. In retrospect, the paper should have avoided overconfident use of the term "bacteriocin," given the lack of evidence then that these heterocycle-containing natural products were toxins rather than, say, peptide pheromones. The term "ribosomally synthesized and post-translationally modified peptide," or RiPP, was introduced in 2013 (see PMID:23165928), and addresses the linguistic hole for natural products that resemble bacteriocins in structure but may have another function. In the absence of convincing evidence for toxin activity, the broader term RiPP should be used.

      However, Chopra, et al. have just published a description of sonorensin, a member of the heterocycloanthracin family from a marine isolate, Bacillus sonorensis MT93. They purified the product to homogeneity, and found broad spectrum antibiotic activity, affecting both Gram positive and Gram negative bacteria. (see http://aem.asm.org/content/early/2014/03/03/AEM.04259-13.abstract). Consequently, it now seems likely that additional members of the protein family defined by TIGRFAMs entry TIGR03601, including heterocycloanthracin itself (from Bacillus anthracis), indeed are active as bacteriocins.


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    1. On 2015 Oct 27, Peter Gøtzsche commented:

      The authors report that escitalopram was significantly more effective than citalopram but caution against the “potential for overestimation of treatment effect due to sponsorship bias.” Indeed. Both substances were patented by Lundbeck, and the rejuvenated “me-again” drug, escitalopram, is merely the active half of the “old me” stereoisomer drug, citalopram.

      One would not expect a molecule to be better than itself. I therefore suggest that the Cochrane review mention the results of a 2012 meta-analysis (1), also in the abstract and plain language summary. Independent researchers confirmed the Cochrane review’s findings that escitalopram was better than citalopram in head-to-head trials. All seven trials found this, apart from the single one that was not sponsored by Lundbeck or its affiliates. These researchers also did an indirect comparison of the two drugs based on 10 citalopram and 12 escitalopram placebo controlled trials (1), and now the effect of “me-again” and “old me” was very similar (odds ratio 1.03; 0.82 to 1.30).

      Usually, direct comparisons are more reliable than indirect comparisons, but the drug industry routinely distorts its research to such an extent (2) that the indirect comparisons are sometimes the most reliable ones, which I believe is the case here. Lundbeck did not have any particular incentive to manipulate its placebo controlled studies more with escitalopram than with citalopram.

      The Cochrane authors note that cost-effectiveness information is also needed in the field of antidepressant trials. Indeed. Even if we take Lundbeck’s results in its head-to-head trials at face value, there is no meaningful difference between the two versions of the drug. In one of Lundbeck’s own meta-analyses, the difference after eight weeks was 1 on a scale that goes up to 60 (2,3), which is totally irrelevant (4).

      When I checked the Danish prices in 2009, Cipralex (escitalopram) cost 19 times as much for a daily dose as Cipramil (citalopram). This enormous price difference should have deterred the doctors from using Cipralex, but it didn’t. The sales of Cipralex were six times higher in monetary terms than the sales of citalopram both at hospitals and in primary care. I have calculated that if all patients had received the cheapest citalopram instead of Cipralex or other SSRIs, Danish taxpayers could have saved around €30 million a year, or 87% of the total amount spent on SSRIs.

      1 Alkhafaji AA, Trinquart L, Baron G, et al. Impact of evergreening on patients and health insurance: a meta analysis and reimbursement cost analysis of ci¬talopram/escitalopram antidepressants. BMC Med 2012;10:142.

      2 Gøtzsche PC. Deadly medicines and organised crime: How big pharma has corrupted health care. London: Radcliffe Publishing; 2013.

      3 Gorman JM, Korotzer A, Su G. Efficacy comparison of escitalopram and citalopram in the treatment of major depressive disorder: pooled analysis of placebo-controlled trials. CNS Spectr. 2002; 7(4 Suppl. 1): 40–4.

      4 Leucht S, Fennema H, Engel R, et al. What does the HAMD mean? J Affect Disord 2013;148:243-8


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    1. On 2014 Dec 22, James G Thornton commented:

      I appreciate that this review is about the effect of male circumcision on heterosexual acquisition of HIV in men, but the effect on the risk of female acquisition of HIV is surely relevant, and since there is no Cochrane review of that, I am commenting here.

      The only randomised trial (Wawer et al 2009) showed 17/93 (18%) HIV acquisition in male circumcision female partners v 8/70 (11%) in control female partners. The difference might have occurred by chance (hazard ratio 1.58, 95% CI: 0.68–3.66, p=0.287), but the point estimate is almost exactly the same size harmful effect as the beneficial effect in men. Unfortunately the trial was stopped early for futility because the conditional power to detect 60% efficacy, was only 4.9%.

      The trial authors have never adequately explained why stopping for futility was appropriate, given that the evidence in men was regarded as sufficient to encourage male circumcision.

      Can I suggest that until there is a separate Cochrane review for the effect on women, that the outcome "heterosexual acquisition of HIV in female partners" be included in this review?

      Wawer MJ, Makumbi F, Kigozi G, et al. Circumcision in HIV-infected men and its effect on HIV transmission to female partners in Rakai, Uganda: a randomised controlled trial. Lancet 2009;374:229-37.


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    1. On 2014 Apr 16, Tom Kindlon commented:

      Some comments:

      In this study, CFS/ME (or CFS in the abstract) is defined in this extremely strange way:

      "Identification of fatigue syndrome cases A list of fatigue syndrome diagnoses was collated from the library of diagnostic codes within the GPRD (Gallagher et al. 2004). Patients aged >16 years with a new fatigue syndrome diagnosis in their records for the calendar years 1988-2001 were identified: only patients with a complete record for the 3 years before the date of diagnosis (the index date) were studied. Two subgroups of fatigue syndrome cases were studied: those with a diagnostic label that included the word ' post-viral ' or ' post-infectious ', which we call PVFS here, and the remainder, composed of CFS or ME, which we call CFS/ME."

      Peter White (the corresponding author) knows that this is not how CFS/ME is defined of course (i.e. CFS/ME includes many post-viral or post-infectious cases).

      Most of the paper actually isn't about comparing the PVFS group vs the CFS/ME and there is no table given for making the comparison. We just really have the text:

      "Differences in risk markers between the two subgroups of fatigue syndrome, CFS/ME and PVFS, were assessed by testing for interaction terms in the models presented in Table 3. The presence of prior fatigue symptoms or prior depressive disorders was more common in patients labelled with CFS/ME. Prior infections, particularly viral ones (but not influenza), were more common in patients labelled with PVFS. The interaction terms all had p values of <0.001 in likelihood ratio tests, except for depressive disorder in the fatigue syndrome versus OA analysis, where p=0.04. The multivariable models for CFS are presented in Table 4. Fatigue and depressive disorders predicted CFS in both models, but different recent infections differentiated CFS from IBS in particular."

      Discussion: "The data also suggested that there are subgroup differences in the risks for particular fatigue syndromes. The symptom of fatigue, mood and symptom- based diagnoses were all specific risks for a diagnosis of CFS/ME compared to PVFS, whereas almost all infectious groups were specific to PVFS in contrast to CFS/ME. CFS/ME was more similar to IBS than PVFS with regard to its risk markers. Even so, depressive diagnoses were a greater long-term risk marker for CFS/ME than IBS, and, as expected, systemic and gut infections also differentiated the two syndromes."

      Just before the very end of the paper, they come out with this: "These data also suggest that fatigue syndromes are heterogeneous (Vollmer-Conna et al. 2006), and that CFS/ME and PVFS should be considered as separate conditions, with CFS/ME having more in common with IBS than PVFS does (Aggarwal et al. 2006). This requires revision of the ICD-10 taxonomy, which classifies PVFS with ME (WHO, 1992). The duration of PVFS of the same patients in this study was considerably less than CFS/ME, supporting this distinction (Hamilton et al. 2005)." [Remember PVFS is the group where a GP said it was a post-viral or post-infectious case and CFS/ME are the other cases. The paper doesn't even mention that CFS is linked to G93:3 or even that he's talking about G93;3]

      One basic flaw is that all this shows is that a GP may be more inclined to give a "post-viral" or "post-infectious" diagnosis if they have viewed/"experienced" a patient in a certain way before attending, and give an alternative diagnosis if a patient has already had depressive symptoms (or the GP decided they were depressive symptoms) or fatigue in the past otherwise. It doesn't prove that the actual conditions the patients have are different i.e. it doesn't prove that the symptoms in the second group aren't post-viral/post-infectious.

      Also the suggestion that CFS/ME and PVFS be separated by the WHO involves a few assumptions:

      • It would have to be said that CFS/ME does not include PVFS/Post-infectious fatigue. What they did in the study was define CFS/ME as CFS/ME minus PVFS and minus PIFS.

      • This was a prospective study. If a patient comes in with symptoms after being ill for 1/2/3+ years of being ill, how would a doctor/other know which WHO category to put the patient in? They would need to show that there was a good objective way of separating patients into either the PVFS/PIFS and CFS/ME (which is CFS/ME minus PVFS/PIFS). They haven't shown this.


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    1. On 2015 Mar 27, Daniel Haft commented:

      This landmark paper stopped short of determining the biologically relevant substrates of VanH and VanA. For the next step, see Handwerger, et al. (PMID:1522072), which clarified that D-ala-D-ala is replaced by D-Ala-D-lactate at the terminus of the peptidoglycan precursor molecule in vancomycin-resistant Enterococcus faecalis. VanH is now described as a D-lactate dehydrogenase (EC 1.1.1.28) and VanA as a D-alanine--(R)-lactate ligase (EC 6.1.2.1).


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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 2013 Dec 30, Tom Kindlon commented:

      I had a response published: "Many questions remain about treatments for CFS"

      I submitted a response to this article entitled, ""Many questions remain about treatments for CFS". It can be read at: http://www.bmj.com/rapid-response/2011/11/02/many-questions-remain-about-treatments-cfs

      A version of it was subsequently published in the BMJ (1).

      References:

      [1]. Kindlon TP. Chronic fatigue syndrome. Many questions remain about treatments for CFS. BMJ. 2009 Apr 7;338:b1371. doi: 10.1136/bmj.b1371.


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    1. On 2016 Oct 03, Morten Oksvold commented:

      Please note that after an investigation at the University of Cologne, six articles where T. Wenz figures as first or senior author were found to contain questionable data due to scientific misconduct. This article is one of these six articles.

      The conclusion from the report was ready June 28, 2016, please see the link (in German):

      http://www.portal.uni-koeln.de/9015.html?&tx_news_pi1[news]=4335&tx_news_pi1[controller]=News&tx_news_pi1[action]=detail&cHash=1deb8399d7f796d65ca9f6ae4764a1ce


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    1. On 2017 Sep 02, thomas samaras commented:

      A recent paper indicates that shorter, smaller people have lower cardiovascular risk factors than taller people: Samaras T: Biological parameters explain why shorter, smaller people have lower cardiovascular disease and greater longevity. JSRR 15(1): 1-16, 2017; article no. JSRR.34729. The article identifies 36 parameters and factors that support the biological advantages of shorter, smaller bodies.

      Some additional factors to consider in determining conflicting evidence on the cardiovascular risks of short and tall people follow:

      1. The top developed countries with the lowest risk of heart disease are both short and tall. They include S. Korea, France, Japan, Luxembourg, Ihe Netherlands and Portugal.

      2. No developed country is free of coronary heart disease (CHD) and stroke but many short populations were during the 20th century;e.g.,Solomon Islands, Papua New Guinea, Kalahari Bushmen, Congo Pygmies, and Kitavans.

      3. Before 1970, taller upper class males had higher rates of heart problems compared to shorter working class. After 1970, it reversed.

      4. In 1900, CHD was low compared to today. Yet, the average height was about 3 inches shorter in 1900.

      5. In 1960s, Greece had one of the lowest CHD rates in Europe and was shorter than central and northern Europe. Today, Greek men are several inches taller and are seeing an alarming increase in CHD.

      6. Osika found that within the low income segments of society, tall people had ~40% higher risk of heart attacks compared to shorter ones.

      7. Tall dogs have 60 times the risk of heart failure as short dogs.

      8. Chronic diseases (including CHD) were rare, even in elderly people, until recently according to the WCRF Report of 2007. People were also shorter then. (The report also stated that chronic disease were rare before the industrial revolution.)

      9. Two recent large studies found short people had lower heart disease than taller ones. (Shapiro, et al. 2015; Elsayed et al.2015)

      10. Women are shorter than men and have lower heart disease mortality.

      The biological aspects of shorter, lighter stature favor lower heart disease and greater longevity. (Biologists and other scientists have found that within a species, smaller individuals tend to live longer.) The reasons for findings showing shorter people have more heart problems need to be explored more deeply.


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    1. On 2015 Jun 06, Preben Berthelsen commented:

      On page 136, Ristagno et al state that the Danish anaesthesiologist Bjørn Ibsen’s involvement in the Copenhagen poliomyelitis epidemic 1952-3 was not the beginning of critical care medicine. I beg to differ. It was the respect of his peers - gained from his pivotal engagement in the polio epidemic - that made it possible for Ibsen to inaugurate the first multidisciplinary intensive care unit in the world at Kommunehospitalet in Copenhagen December 21, 1953. (Berthelsen PG, Cronquist M. The first intensive care unit in the world: Copenhagen 1953. Acta Anaesthesiol Scand 2003;47:1190-5).

      On page 138, the Norwegian Kristian Igelsrud is credited for the first successful open-chest cardiac massage in 1901. The account of the resuscitation, however, only appeared in the lay press so few clinical details are known. (There is a second-hand account in Keen ref. 43). In 1900, the Danish surgeon Hjalmar Maag used open-chest cardiac massage in a 27-yr-old man whose heart had stopped during chloroform anaesthesia (24 October, 1900). The beat of the heart was restored by Maag’s massage but cerebral damage was so severe that the patient died 10 hours later. (Maag H. Ein Versuch der Wiederbelebung (a.m. Prus) eines in Chloroformnarkose gestorbenen Mannes. Centralblatt fur Chirugie 1901;1:20-2).

      P.G. Berthelsen, MD. Charlottenlund, Denmark.


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    1. On 2013 Nov 24, John Sotos commented:

      Desai et al (1) describe a tragic case of panhypopituitarism diagnosed only when the patient developed cardiogenic shock and required two weeks of mechanical and pharmacological inotropic support, plus an implanted defibrillator.

      Because they focus chiefly on the final outcome, the authors consider the patient’s management as a success. Instead, they should have used techniques of aviation mishap investigation to question how this patient’s close, 21st-century medical care over the preceding year could have allowed an eminently treatable disease to reach Dickensian severity.

      Why did the review of systems upon admission not disclose the patient’s symptoms of hypothyroidism? Why did the admission physical miss the obvious hair and skin signs? Why was the neurological examination deemed “unremarkable” when this patient very likely had markedly delayed relaxation of tendon reflexes (2,3,4)? Evaluating such suspicious findings could have advanced hormone replacement and averted complications.

      Aviators live and die by their checklists — literally. Thorough patient histories and physical exams are medicine’s ultimate checklist. We shortcut them at our peril, and at the peril of our patients.

      (1) Desai NR, Ceng S, Nohria A, Halperin F, Giugliano RP. When past is prologue. N Engl J Med. 2009; 360: 1016-1022. Pubmed 19264691 doi: 10.1056/NEJMcps0805508

      (2) Jonckheer M, Blockx P, Molter F. Use of the Achilles-tendon reflex in thyroid clinical investigation. Acta Endocrinol (Copenh). 1970; 63: 175-184. Pubmed 5467016

      (3) [No authors listed] The Achilles heel of the ankle jerk. Journal of the American Medical Association. 1967; 199: 39. Pubmed 6071124

      (4) Chaney WE. Tendon reflexes in myxoedema: valuable aid in diagnosis. Journal of the American Medical Association. 1924; 82: 2013-20166.


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    1. On 2014 Jan 11, Brett Snodgrass commented:

      Dear Authors,

      Thank you for the refreshing article that prudently identifies the Thebesian veins as veins, structures distinct from both the arteriosinusoidal (vessels-arteries) and the arterioluminal (vessels-arteries).

      Please consider the excerpt:

      "Arteriosinusoidal vessels connect arterioles to the chambers and Thebesian veins connect capillaries to the chambers. Beside these two vessel types, few small arterioluminal arteries drain directly into the chambers*

      The definition of Thebesian veins connecting to the chambers may be correct, but might be more descriptively stated as by Pratt as they also include connections larger than capillaries. It is possible that the Thebesian veins do not always directly connect the venular end of a capillary bed to the heart chamber, but may occasionally connect a small vein to the heart chamber.

      http://bit.ly/ThebesianByPratt

      Please consider that both the arterioluminal and arteriosinusoidal vessels (vessels of Wearn) drain to the heart chambers from the coronary arteries.

      The arteriosinusoidal vessels connect {small arteries &/or arterioles} to [myocardial sinusoids] which connect to the (heart chambers).

      The arterioluminal vessels connect {small arteries &/or arterioles} to (heart chambers). http://bit.ly/JTWearn Wearn examined the celloidin casts of the arterioluminal vessels and noted that they exhibit vessel diameters that range from 0.2 mm to 1.0 mm. The diameter of the lumina as measured in the collapsed state ranged from 0.04 to 0.2 mm. (http://bit.ly/JTWearn page 158).

      Wearn was probably too humble to name the vessels after himself. However, he referred to both the arteriosinusoidal & arterioluminal vessels collectively as "arterioluminal." An analogy for this difficult nosology is appreciated by consideration the drum and drumset termed "Tabla." A wise professor once told of a drumset where both drums were collectively called “Tabla,” and the drum on the right was also called “Tabla.”

      In this analogy, the term “Tabla” is comparable to the term “arteriosinusoidal vessel.”

      In summary, using the same word to represent two different concepts or two different things can probably be confusing. When uncertain of the specific type of arterial-vessel as defined by Wearn, the term “vessels of Wearn” may be appropriate. The eponym vessels of Wearn is the only specific noun that has been appropriately applied to these connections.

      The vessels of Wearn connect coronary arteries to each of the four heart chambers. The term "ventriculocoronary connection,"(VCC) is certainly appropriate when referring to isolated ventricular connections. However, using the term VCC could also be applied to traumatically induced fistulae and therefore it does not reflect the normal nature of these connections. Thus the noun "vessels of Wearn," is appropriate in a manner similar to the term "distal convuluted tubule" is appropriate for those specific tubules. Thus, an eponym vessels of Wearn may be appropriate for these normal connections between the coronary arteries and heart chambers.

      Thank you again for the excellent article.

      Comments and suggestions are kindly requested. My aim is to follow the plea of Dr. Lurie and work with others to help produce accurate cardiac nomenclature.

      Thank you very much.


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    1. On 2014 Apr 28, Francisco Xavier Castellanos commented:

      This line of work represents an important advance in seeking to identify the nature of the timing-related processing abnormalities that are regularly reported in ADHD and related conditions. As recently summarized by Kofler et al. (2013; PMID 23872284), reaction time variability is robustly associated with ADHD, but this is not specific to ADHD, as other psychiatric conditions also exhibit markedly elevated response time variability. Similarly, timing abnormalities have been noted at multiple time scales in ADHD (e.g., Noreika, Falter, Rubia, 2013; PMID 23022430) which likely reflects involvement of multiple brain systems. Gilden and colleagues are focusing on a specific frequency band/temporal window, which may allow tighter specification of the neurobiological correlate. In this regard, see their most recent paper, which is not yet allowing comments (Marusich and Gilden, 2014, Neuropsychology) PMID 24708046.


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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 2016 Mar 31, Margaret Sampson commented:

      Please see the updated version of PRESS: McGowan J, Sampson M, Salzwedel DM, Cogo E, Foerster V, Lefebvre C. PRESS Peer Review of Electronic Search Strategies: 2015 Guideline Statement. J Clin Epidemiol. 2016 Mar 18. pii: S0895-4356(16)00058-5. doi: 10.1016/j.jclinepi.2016.01.021. [Epub ahead of print] PubMed PMID: 27005575.

      And the revised Explanation & Elaboration document: McGowan J, Sampson M, Salzwedel D, Cogo E, Foerster V, Lefebvre C. PRESS – Peer Review Electronic Search Strategies: 2015 Guideline Explanation and Elaboration (PRESS E&E). Ottawa: CADTH; 2015 Jan. https://www.cadth.ca/sites/default/files/pdf/CP0015_PRESS_Update_Report_2016.pdf


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    1. On 2014 May 05, Martine Crasnier-Mednansky commented:

      Data by Wanner BL, 1978 did not indicate β-galactosidase activity is inversely proportional to the specific growth rate. In fact, data from Wanner Figure 1A indicated a large variation in β-galactosidase activity occurred in media supporting similar growth rate (thus synthesis rate is not constant). In addition, data from Wanner Figure 2B did not indicate addition of exogenous cAMP increased β-galactosidase activities less than two-fold. Wanner et al. stated "Media in which there was marked growth rate inhibition by cAMP also showed large stimulation of β-galactosidase synthesis; a growth rate inhibition, however, was not a necessary condition for an increase in the enzyme activity". In the presence of cAMP however, even though much of the variation was eliminated, repression remained which was carbon source dependent and growth related. Whether it [the remaining repression] is mediated by cAMP is uncertain - concluded Wanner et al.


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    1. On 2017 Jul 07, Morten Oksvold commented:

      This article should have been retracted after an investigation by The University of Maryland found this article to contain "compromised" data (a total of 26 articles in 11 journals were affected). The journal Clinical Cancer Research was informed in February 2017, according to Retraction Watch.

      http://retractionwatch.com/2017/04/26/university-asked-numerous-retractions-eight-months-later-three-journals-done-nothing/


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    1. On 2014 Mar 30, Tero Kivelä commented:

      Figure 4 in this paper raises a few questions:

      1: The graph has 2 steps indicating 2 patients who died, and 5 ticks indicating 5 censored observations; this adds to 7, but 11 patients entered the study.

      2.1: According to the text "Three patients have died from extrahepatic metastases at 2.5, 3, and 18 months posttreatment". The one who died at 3 months is not plotted.

      2.2: According to the text "One patient was lost to follow-up after 2.5 months". This patient is not plotted.

      2.3: If we add these two apparently non-plotted patients, the plot seems to account only for 9 of the 11 patients.

      2.4: Adding these 2 patients to the plot would drop 1-year survival to 25%, and 50% mortality would be reached around 18 months.

      3: According to the text "Of the remaining 8 patients in follow-up, 1 patient developed new hepatic lesions at 14 months posttreatment". If we deduct from the 11 patients who entered the study the 3 who died and the 1 who was lost to follow-up, only 7 patients remain.


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    1. On 2015 Jun 02, thomas samaras commented:

      Additional information on height, body size and longevity is available from:

      Samaras TT. Evidence from eight different types of studies showing that smaller body size is related to greater longevity. Journal of Scientific Research & Reports. 2014: 3 (16): 2150-2160, 2014; article no. JSRR.2014.16.003.

      Samaras TT. Human Scaling and Body Mass Index. In: Samaras TT (ed): Human Body Size and the Laws of Scaling: Physiological Performance, Growth, Longevity and Ecological Ramifications. New York: Nova Science Pub; 2007: pp 17-32.

      He Q, Morris BJ, Grove JS, Petrovitch H, Ross W, Masaki KH, et al. Shorter men live longer: Association of height with longevity and FOXO3 genotype in American men of Japanese ancestry. Plos ONE 9(5): e94385. doi:10.1371/journal.pone.0094385.

      Salaris L, Poulain M, Samaras TT. Height and survival at older ages among men born in an inland village in Sardinia (Italy), 1866-2006. Biodemography and Social Biology, 58:1, 1-13.

      Bartke A. Healthy Aging: Is Smaller better? A mini-review. Gerontology 2012; 58:337-43.


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    1. On 2014 Oct 23, Khalid Hassan commented:

      One of my students did a similar study for her dissertation (currently in press). She found that the consumption of alchohol is the single biggest cause for car crashes in Turkey (35% of all crashes were associated with alcohol use). This finding is no suprise by itself and complements numerous previous studies. However, she did find a very interesting new correlation. Since her group uses anonymized data from insurance companies, they were able to test several hypothesis which were in coordance with car crashes caused by the consumption of alcohol. For example, she found that certain car brands are associated with a 75% increase in alcohol related car crashes. While this is most likely just correlational and not caused because these cars are harder to drive when under influence, she did find another correlation which might be very intruiging to study further.

      Because most of her data was provided by insurance companies, they were very detailed and trustable. For example, they included police reports were applicable. Because of this data they were able to establish wether the alcoholic user was the perpetrator of these crashes or wether (while driving under influence is technically illegal) were the culprit of these crashes. In the vast majority of cases the drivers under the influence of alcohol were indeed the perpetrator (85%). However she did a very intruiging finding when digging deeper in the data that was provided by insurance companies. The use of dashcams Wikipedia has gained a lot of popularity in Turkey in recent years. This is caused by multiple factors, one of which has to do with reduced insurance costs by car insurance companies. When my student corrected for the use of a dashcam, she found dat the pepetrator/culprit(85%/15%) ratio decreased significantly to 55/45%. Of course this is a very intruiging finding which can be caused be several factors. This is the first research to examine the use of a dashcam in relation to the amount of alcohol related car crashes. We're currently looking to see wether these results hold up in a bigger sample size. While this is the first study to find this correlation, there is a previous Dutch one (Website) which found that the use of a dashcam is associated with a reduction of the involvement in general car crashes of 34%. Incidentally, our study showed the same result in alcohol related crashes, but further study is now urgently needed.


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    1. On 2014 Apr 16, Tom Kindlon commented:

      Prevalence estimates have been inflated due to the female predominance in the samples

      (I previously posted this as a comment on the Br J Psych http://bjp.rcpsych.org/content/194/2/117.abstract/reply#content-block but not everyone may see it there)

      We are not given information on the gender breakdown of Chronic Fatigue Syndrome (CFS) in this study but if it is in-line with other studies in the field, females would be much more likely to have CFS. Given a much larger percentage of the cohorts are female compared to the general population, this would mean that the (adjusted) prevalence rates for each country would be lower.

      The total number of CFS cases found in a particular country cohort = Number of women with CFS + Number of men with CFS = P(CFS|F)N(F)+P(CFS|M)N(M) where F=Female, M=Male, N(F)=Number of Females, P(CFS|F)=Probability of a female having CFS, etc.

      If one takes P(CFS|M)=0.25*P(CFS|F), which would be comparable to an approximate average of previous studies (for example, [1-4]), and assumes the number of men and women are equal in the 18-45 age bracket, the prevalence rates for CFS in the UK and Brazil are 1.65% and 1.21% respectively.

      These figures in themselves are an upper bound on the true prevalence rates, given individuals in neither group went through rigorous and thorough individual assessments to exclude other conditions.

      References:

      [1] Bazelmans E, Vercoulen JH, Swanink CM, Fennis JF, Galama JM, van Weel C, van der Meer JW, Bleijenberg G. Chronic Fatigue Syndrome and Primary Fibromyalgia Syndrome as recognized by GPs. Fam Pract. 1999 Dec;16(6):602-4.

      [2] 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.

      [3] Kim CH, Shin HC, Won CW. Prevalence of chronic fatigue and chronic fatigue syndrome in Korea: community-based primary care study. J Korean Med Sci. 2005 Aug;20(4):529-34.

      [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 Intern Med. 2003 Jul 14;163(13):1530-6.


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    1. On 2014 Jan 08, Tom Kindlon commented:

      The inclusion of more quotes and qualitative information in the paper would have been useful

      I think this is an interesting issue. However I think the paper would have benefited from quotes from what the participants said and generally more qualitative information. If healthcare providers are to improve on the situation, they need as much information as they can get about what exactly are the barriers.

      In particular, I feel more qualitative information on "Knowledge, Attitudes, and Beliefs (KABs)" and "Healthcare System" would have been useful. Perhaps the data could be used to write another paper.

      By the way, I find the use of the phrase (and acronym) "while those with insufficient fatigue (ISF)" in the abstract to be far from satisfactory. It seems to put fatigue onto a pedestal as the primary part of the definition of CFS. People for example may be in the ISF category because they don't have four of the case defining symptoms (while at the same time having "sufficient fatigue" i.e. the fatigue satisfies the entry criteria for CFS).


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    1. On 2017 Dec 06, Alexander Kraev commented:

      The authors of this paper claim to have generated mouse strains that carry a PLN(R9C) transgene and 2, 1, or 0 endogenous PLN alleles. However, the mutant PLN resides on a transgenic array, with multiple copies the number of which the authors chose not to determine. It was independently found (https://doi.org/10.1101/075671), that the mutant PLN gene, assuming the transgene does not re-arrange during breeding, is present in 13 copies. This work also did not determine the actual mutant to wildtype PLN ratio at the mouse age, when the expression of the transgenic promoter is maximal (1 month), which would have estimated the scope of the overexpressed protein "bolus injection" that each strain received. Therefore, the conclusions of this paper should be interpreted with extreme caution, especially as such gene combinations never occur in human patients carrying PLN mutations.


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    1. On 2015 May 07, Jeff Kiefer commented:

      DAVID is continuously being used as evidenced by its numerous citations in current biomedical literature http://bit.ly/1FS1JgT. However, the data resources used by DAVID appear to not have been updated since 2009 http://david.abcc.ncifcrf.gov/helps/update.html. The fact that DAVID has not been updated going on 5 years calls into question the current utility of using this tool.


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    1. On 2013 Jun 15, Steven Salzberg commented:

      This is a terrific article that rebuts the bad science promulgated by a popular children's doctor, who has been pushing an anti-vaccination message for years. Offit and Moser go through Sears' claims point-by-point and show how each one is misleading or simply wrong. Every pediatrician should read this.


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    1. On 2016 Apr 12, Wolfgang Huber commented:

      Dear Kenneth

      Thank you for pointing this out. Apologies for the two months delay in response, I only saw your post today. The main online reference to the package remains the Bioconductor project: https://bioconductor.org/packages/arrayQualityMetrics . Running the code in the package vignette produces all the example reports mentioned in the above abstract. Moreover, we are also hosting a copy of these reports here: http://www-huber.embl.de/arrayQualityMetrics

      The now defunct URL http://www.microarray-quality.org was associated with a grant-funded project (European Commission FP6) that achieved a lot of excellent outcomes but eventually reached the end of its life cycle (http://publications.jrc.ec.europa.eu/repository/handle/JRC60783).


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    1. On 2017 May 12, Kevin Hall commented:

      In the copy editing process, it appears that several typographical errors were introduced in equations 5, 10, 14, and 15. The corrected equation 5 is:

      DeltaBW = [(1-beta) x DeltaEI -Deltadelta x BWinit -(gammaFFM -gammaFM) x FM_init]/(gammaFFM +deltainit +Deltadelta) +[C x (gammaFFM -gammaFM)/(gammaFM +deltainit +Deltadelta)] x LambertW{[(gammaFM +deltainit+Deltadelta) x FMinit]/[C x (gammaFFM +deltainit +Deltadelta)] x Exp[[(gammaFM +deltainit +Deltadelta) x FMinit]/[C x (gammaFFM +deltainit +Deltadelta)]] x Exp[[(1-beta) x DeltaEI - Deltadelta x BWinit]//[C x (gammaFFM +deltainit +Deltadelta)]]}

      The corrected Equation 10 is:

      DeltaEI = Deltadelta x BWinit/(1-beta) + C<sup>2</sup> x (gammaFFM-gammaFM) x FMinit/(1-beta) + DeltaBW x (gammaFFM-gammaFM) x C<sup>2</sup> /(1-beta) x [1+(gammaFM +deltainit +Deltadelta)/(gammaFFM-gammaFM)]-C x (gammaFFM-gammaFM)/(1-beta) x LambertW{C x FMinit x Exp[C x (1 +FMinit) +DeltaBW]}

      The corrected Equation 14 is:

      DeltaBW=[(1-beta) x DeltaEI -Deltadelta x BWinit]/[gammaFFM +deltainit +Deltadelta-(gammaFFM -gammaFM) x Phi]

      The corrected Equation 15 is:

      d/dPhi{DeltaBW/DeltaEI} = (gammaFFM -gammaFM) x (1-beta)/[gammaFFM +deltainit-(gammaFFM -gammaFM) x Phi]<sup>2</sup> > 0


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    1. On 2014 Mar 05, Jacob Puliyel commented:

      IT IS EXPEDIENT BUT IS IT PRUDENT TO LABEL ADVERSE EVENTS FOLLOWING IMMUNIZATION AS 'NOT AN EVENT OF [AEFI]'?

      The old scheme of monitoring signals for vaccine safety (adverse events following immunization – AEFI monitoring), of the Advisory Committee on Causality Assessment Collet JP, 2000 has been overtaken by the Revised WHO Classification of AEFI. The changes have been described in 4 PubMed articles Tozzi AE, 2013, Bonhoeffer J, 2009, Halsey NA, 2012, Williams SE, 2013.

      I wrote two very detailed comments to the article by Tozzi et al Tozzi AE, 2013 on the PubMed Commons which is envisaged as a forum for open constructive criticism and discussion of scientific issues. To facilitate meaningful discussion it has a link to 'Invite an author to comment'. Tozzi and colleagues have not responded so far. PubMed suggests that the main reason for not getting a response is a changed email contact address.

      As this is a matter of patient safety I think it is important that the experts who understand the new scheme must explain why the revision was needed and that it is an improvement over the old scheme - that it will not miss opportunities of picking up new signals by classifying AEFI as 'Not a case of [AEFI]'. I will not repeat the posting but it may be viewed here

      The purpose of this posting is to invite the learned authors of this article on causality assessment Bonhoeffer J, 2009 to respond. The article by Bonhoeffer and colleagues mostly describes a guideline for collection of data which is unexceptional, but the subsequent 'analysis and presentation of vaccine safety data in the surveillance system' may cause signals to be ignored because they are classified as ‘Not a case of [AEFI]’. Would the new scheme have picked up and flagged signals of adverse-effects like the RotaShield-reactions, had the scheme been in use in 1998?


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    1. On 2015 Nov 29, Mauro De Rosa commented:

      Replacing branded medicines with generic ones

      In most countries, regulatory agencies have the responsibility of indicating the situations in which branded medicines can be substituted by equivalent ones (i.e. generics). In Italy, these regulatory recommendations have been issued by our national medicine agency (AIFA) by indicating the exceptions, i.e. those cases where a branded medicine cannot be replaced by the equivalent counterpart. A total of six such cases have been identified in Italy, which included the following agents: levetiracetam and topiramate (1), levotyroxine (2), cyclosporine (3), metformine + glibenclamide (4), tacrolimus (5).

      References

      1. AIFA website - Specialità medicinali contenenti Levetiracetam e Topiramato (17/09/2012), http://www.agenziafarmaco.gov.it/it/content/specialità-medicinali-contenenti-levetiracetam-e-topiramato-17092012); accessed 3.9.2015

      2. AIFA website - http://www.agenziafarmaco.gov.it/it/content/precisazione-aifa-sulla-prescrizione-base-di-levotiroxina-15122014 accessed 30.10.2015

      3. AIFA website - http://www.agenziafarmaco.gov.it/it/content/precisazioni-aifa-su-specialità-medicinali-contenenti-ciclosporina-15042015 Precisazioni AIFA del 15 aprile 2015 su specialità medicinali contenenti ciclosporina accessed 3.9.2015

      4. AIFA website http://www.agenziafarmaco.gov.it/it/content/liste-di-trasparenza-metformina-e-glibenclamide-500-mg-5-mg accessed 3.9.2015

      5. AIFA website http://www.agenziafarmaco.gov.it/it/content/precisazioni-aifa-su-specialità-medicinali-contenenti-tacrolimus accessed 3.9.2015


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    1. On 2014 Aug 16, Christopher Southan commented:

      A 2013 study of BACE evolution http://www.ncbi.nlm.nih.gov/pubmed/24381583 (the " A tale of two drug targets" citation link on the right) indicates the fly beta-secretase-like enzyme refered to above (UniProt Q9VLK3) is not in fact BACE-like but rather a lysosomal cathepsin. By the criteria detailed in that paper, true BACE-like homologs are absent from Drosophila and possibly all Ecdysozoa


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    1. On 2015 Jul 30, Keith Bradnam commented:

      As of 2015, development of CEGMA v2 has ceased completely and we can no longer respond to support requests. While the latest version still runs, it should be pointed out that the underlying set of orthologs that CEGMA uses is based on the KOGs database that was published back in 2003. We would advise potential users of CEGMA to consider newer tools like BUSCO which perform a similar role, are easier to install, take less time to run, and which are based on more modern sets of orthologous genes. We don't rule out making a completely new version of CEGMA some day, but for now we consider CEGMA v2 an end-of-life product.


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    1. On 2013 Nov 15, Darren L Dahly commented:

      In figures 1 and 2, the arrows should be pointing from latent AFA and latent HT to (not from) AFA and HT, respectively, i.e. the observed indicators are determined by the underlying latent variable, not the other way around. This graphical typo also explains why there are no disturbance terms displayed for latent AFA and latent HT. They are in fact exogenous, and all reported results in the paper reflect the correctly specified model.


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    1. On 2016 Jan 24, Daniel Schwartz commented:

      This is a useful index that may offer a non-invasive approach in patients with liver disease. In practice, clinicians often have difficulty calculating this at the bedside. Here is a simple to use web-based and smartphone-based tool to calculate the APRI

      http://www.qxmd.com/calculate/apri-ast-to-platelet-ratio-index

      Conflict of interest: Medical Director, QxMD


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    1. On 2016 Nov 12, Daniel Corcos commented:

      It is surprising that the prevalent screen of the control group detects 14% more cancers than that of the screened group. Also, the incidence of cancer at the second screen is much too high as compared to cancer incidence in the control group. Both results strongly suggest that cancers ascribed to the second round of screening were actually detected at the prevalent screen of the screened group. After correction, it appears that all the differential increase between screened and control groups occurs between the second and third round of screening. Therefore we are not dealing with cancers that spontaneously regress, but with cancers that are induced by x-rays.


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    1. On 2013 Jun 17, Mike Fay commented:

      This article gives a nice Bayesian argument for using three-sided tests for comparing two treatments. So after running a three-sided test for testing between treatments A and B, we conclude either (1) A is better than B, (2) B is better than A, or (3) the data are not sufficient to say which is better. This makes sense to me, since we usually want to know which is better when we reject the null that they are the same.

      For standard use, this essentially translates into using two one-sided tests at the 0.025 level.

      Another advantage of shifting to three-sided tests (or two one-sided 0.025 level tests), is that it avoids absurd things such as rejecting a two-sided hypothesis test, but then failing to reject after adding more data in either direction. See Vos and Hudson (2008) http://onlinelibrary.wiley.com/doi/10.1111/j.1467-842X.2007.00501.x/abstract for examples.


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    1. On 2016 Nov 01, Michael Axtell commented:

      CleaveLand is no longer available at the URL given in this paper. Instead, the most current release of CleaveLand can be found at github at https://github.com/MikeAxtell/CleaveLand4/releases

      Full documentation and a tutorial for CleaveLand4 can be found at https://psu.box.com/v/axtelldata , in directory 'CleaveLand4_Tutorial'.

      Best Wishes, Mike Axtell


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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 NCT0061850. We believe the correct ID, which we have found by hand searching, is NCT00618150.

      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 Sep 21, Eric Yarnell commented:

      This paper is absurd. What possible reason could there be to show that a dose 10,000+ times the normal dose is toxic? Isn't that a given with all known substances? I fear many people would read the abstract or even just the title and conclude that Hibiscus sabdariffa, which is incredibly safe, is dangerous, while in fact this paper supports just how safe it is (when given in reasonable amounts).


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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 NCT00211459. We believe the correct ID, which we have found by hand searching, is NCT00121459.

      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 Dec 30, Keizo Takao commented:

      The raw data of behavioral tests, which are not described in this paper, are shown in the Mouse Phenotype Database (http://www.mouse-phenotype.org/). "ImageLD", "ImageEP", "ImageTM", and "ImageFZ", image analysis application softwares used in this article, are now freely available from http://www.mouse-phenotype.org/software.html.


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    1. On 2013 Dec 29, Keizo Takao commented:

      The URL of the gene-brain-phenotyping database has now changed to http://www.mouse-phenotype.org/ (the Mouse Phenotype Database). "ImageLD", "ImageEP", and "ImageTM", image analysis application softwares used in this article, are now freely available from http://www.mouse-phenotype.org/software.html.


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    1. On 2014 Jan 08, Tom Kindlon commented:

      The references don't show that CFS "affects at least 4 million adults in the United States"

      This is not necessarily a major point to do with the methodology. However given the paper involves CFS medical education, and gives few facts about CFS, one would think that the statements that are made are at least reasonably accurate.

      However, this statement clearly isn't: "CFS affects at least 4 million adults in the United States [2-4]." The references given are the first three references below. The second study found a prevalence of 422 per 100,000 adults and the third study found a prevalence of 235 per 100,000 adults. These aren't even close to 4 million adults - the second one suggests a figure of at least 400,000 adults. This study involved one of the authors (William C Reeves). The other study[1], also involved Reeves, did find a prevalence of 2540 per 100,000 adults, which would equate to over 4 million adults. As can be seen, this is much higher than previous estimates of the prevalence of CFS in the US. The reason for the huge discrepancy is largely because it used a different method of defining CFS[4].

      There has been some criticism of this new definition[5]. Unlike previous times when the CDC produced definitions for CFS[6,7], the definition used in this study is generally only being used by the CDC-funded CFS research team [the cohorts from the Wichita 2-day study in 2003 (not to be confused with the Reyes study) and the Georgia prevalence study[3]]. So it's far from clear that most people would accept that CFS "affects at least 4 million adults in the United States". But certainly two of the three studies given to back up this reference did not find anything close to such a prevalence.

      References:

      [1] Reeves WC, et al. Prevalence of chronic fatigue syndrome in metropolitan, urban, and rural Georgia. Population Health Metrics 2007, 5:5.

      [2] Jason LA, Richman JA, Rademaker AW, Jordan KM, Plioplys AV, Taylor RR, McCready W, Huan CF, Plioplys S: A community-based study of chronic fatigue syndrome. Arch Int Med 1999, 159:2129-2137.

      [3] Reyes M, Nisenbaum R, Hoaglin DC, Emmons C, Stewart G, 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 Intern Med 2003, 163:1530-1536.

      [4] 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 Medicine 2005, 3:19 (15 December 2005)

      [5] Jason LA, Richman JA: How Science Can Stigmatize: The Case of Chronic Fatigue Syndrome. Journal of Chronic Fatigue Syndrome, Vol. 14(4), 2007

      [6] Fukuda, K., Straus, S.E., Hickie, I., Sharpe, M.C., Dobbins, J.G., & Komaroff, A. (1994). The chronic fatigue syndrome: A comprehensive approach to its definition and study. Annals of Internal Medicine, 121 (12):953-959. http://www.annals.org/cgi/content/full/121/12/953

      [7] Holmes GP, Kaplan JE, Gantz NM, Komaroff AL, Schonberger LB, Straus SE, et al. Chronic fatigue syndrome: a working case definition. Ann Intern Med. 1988; 108:387-9.


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    1. On 2013 Nov 07, Rafael Najmanovich commented:

      Is there any measurement of how complete the network is? The proverbial 'known unknowns'? for example independent metabonomics studies coming up with several small molecules that don't appear in the network? not that every molecule must necessarily be a substrate or product in a reaction but most are.


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    1. On 2014 Mar 07, Devi Prasad Mohapatra commented:

      This is a very interesting and practical article. Highly recommended for all cleft surgeons. What remains to be seen is how important is the experience of the operating surgeon and technique of palatoplasty in contributing to the formation of palatal fistula. Would the authors possibly throw some light on that?


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    1. On 2017 Jul 07, Morten Oksvold commented:

      This article should have been retracted after an investigation by The University of Maryland found this article to contain "compromised" data (a total of 26 articles in 11 journals were affected). The journal Cancer Research was informed in August 2016, according to Retraction Watch.

      http://retractionwatch.com/2017/04/26/university-asked-numerous-retractions-eight-months-later-three-journals-done-nothing/


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    1. On 2013 Oct 24, Tom Kindlon commented:

      Treating severely affected CFS patients with CBT

      This study found that the "more severely disabled patients benefit less from the self-instructions" (to be more specific, "the treatment effect is more than halved for patients with an SIP8 score of 1 standard deviation above the mean").

      At least one other Cognitive Behavioural Therapy (CBT) for Chronic Fatigue Syndrome (CFS) study found that the outcome may be related to the level of impairment at baseline[1]. In this study, 10 (37%) reported being "better or much better" following treatment and 17 (63%) were the same or worse (we are not given a breakdown between the two categories).

      Comparing the two groups at baseline, the patients who reported improvement reported significantly less (p<0.05) functional impairment as measured by the SIP-8 [a mean (SD) of 1330 (417) vs 1985 (730)], less daily observed fatigue [7.4 (2.6) vs 9.7 (2.3)], and less daily observed pain [4.5 (2.6) vs 7.8 (3.5)]. For the pre-treatment variable "mean hours working a week" a trend (p=0.062) was found with improved patients working more hours at baseline compared to non-improved patients [10.9 (12.8) vs 2.6 (6.6)]. As with the current study, there was not a statistical difference on initial fatigue (CIS-fatigue). The paper<sup>1</sup> devotes quite a bit of space to this analysis including a table (Table 3).

      Reference:

      1 Bazelmans E, Prins JB, Lulofs R, van der Meer JW, Bleijenberg G. Cognitive behaviour group therapy for chronic fatigue syndrome: a non-randomised waiting list controlled study. Psychother Psychosom. 2005;74(4):218-24


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    2. On 2013 Oct 25, Tom Kindlon commented:

      Andrew Kewley explored this issue in a recent commentary.<sup>1</sup>

      References:

      Kewley AJ. Does Cognitive Behavioral Therapy or Graded Exercise Therapy Reduce Disability in Chronic Fatigue Syndrome Patients? Objective Measures Are Necessary. Clinical Psychology: Science and Practice. 2013 20;3:321-322 DOI: 10.1111/cpsp.12042


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    3. On 2013 Oct 24, Tom Kindlon commented:

      Are there CBT studies with CFS controls that found objective (e.g. actometer) increases in activity?

      In an e-letter,<sup>1</sup> I pointed out the problem of the lack of use and/or reporting of objective outcome measures in the area.

      I have read more papers on the topic since then and it is interesting that the Nijmegen group themselves have been aware of this issue for over a decade. For example, two of the three co-authors of this study co-wrote a paper in 1997<sup>2</sup> which said: "It is not clear whether subjective accounts of physical activity level adequately reflect the actual level of physical activity. Therefore the primary aims of the present study were to assess actual activity level in patients with CFS to validate claims of lower levels of physical activity and to validate the reported relationship between fatigue and activity level that was found on self-report questionnaires. In addition, we evaluated whether physical activity level adequately can be assessed by self-report measures. An Accelerometer was used as a reference for actual level of physical activity.". The authors reported on the correlations on 7 outcome measures in relation to the actometer readings: "none of the self-report questionnaires had strong correlations with the Actometer. Thus, self-report questionnaires are no perfect parallel tests for the Actometer." The authors pointed out that "the subjective instruments do not measure actual behaviour. Responses on these instruments appear to be an expression of the patients' views about activity and may be biased by cognitions concerning illness and disability."

      This finding was re-iterated in another paper three years later again involving Bleijenberg and Van der Meer:<sup>3</sup> "In earlier studies of our research group, actual motor activity has been recorded with an ankle-worn motion-sensing device (actometer) in conjunction with self-report measures of physical activity. The data of these studies suggest that self-report measures of activity reflect the patients' view about their physical activity and may have been biased by cognitions concerning illness and disability."

      So could it be the case that Cognitive Behaviour Therapy for CFS is simply changing how patients respond to self-report questionnaires and that no actual changes of activity are occurring? Some research suggests this is possible.<sup>4</sup>

      References

      1 Kindlon T. How effective is the treatment for CFS? http://bjp.rcpsych.org/content/193/4/340.abstract/reply#bjprcpsych_el_22380

      2 Vercoulen JH, Bazelmans E, Swanink CM, Fennis JF, Galama JM, Jongen PJ, Hommes O, Van der Meer JW, Bleijenberg G. Physical activity in chronic fatigue syndrome: assessment and its role in fatigue. J Psychiatr Res. 1997 Nov-Dec;31(6):661-73.

      3 van der Werf SP, Prins JB, Vercoulen JH, van der Meer JW, Bleijenberg G. Identifying physical activity patterns in chronic fatigue syndrome using actigraphic assessment. J Psychosom Res. 2000 Nov;49(5):373-9.

      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.


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    4. On 2013 Oct 24, Tom Kindlon commented:

      Data subsequently releasted from on this study reveals that there was no change in activity levels

      Some people may be interested to know that a review of three Dutch Chronic Fatigue Syndrome (CFS) studies that was subsequently released<sup>1</sup> showed that this intervention did not result in an increase in physical activity levels in this study<sup>2</sup> along with two other Dutch CBT studies <sup>3,4.</sup> The authors say these three studies were based on the same general therapeutic approach to the illness.<sup>5</sup>

      The mean (standard deviations) for the guided self-instructions/CBT and Control groups were respectively 63.1 (23.5) and 63.5 (21.8) before treatment and 67.3 (22.5) and 67.8 (21.4) at the second assessment. In terms of change scores, this equates to: 4.3 (20.4) and 4.3 (21.0). Different devices can be used to measure activity levels; for the actometers used in this study, healthy controls were previously found to have a mean Actometer score of 91 (S.D.=25).<sup>6</sup> That study found that the mean Actometer score of tested CFS patients was 66 (S.D.=22).<sup>6</sup>

      Another research team in the US also found similar results with regard to physical activity.<sup>7</sup> In a study investigating an intervention involving Cognitive Behavior Therapy (CBT) which included encouraging CFS patients for going for longer walks, they found that on the SF-36 Physical Functioning (PF) scale, patients improved from a pre-treatment mean (SD) of 49.44 (25.19) to 58.18 (26.48) post-treatment, equivalent to a Cohen's d value of 0.35. On the Fatigue Severity Scale (FSS), the improvement as measured by the cohen's d value was even great (0.78) from an initial pre-treatment mean (SD) of 5.93 (0.93) to a 5.20 (0.95) post-treatment. However on actigraphy there was actually a numerical decrease from a pre-treatment mean (SD) of 224696.90 (158389.64) to 203916.67 (122585.92) post-treatment (cohen's d: -0.13).

      These studies raise questions about what are the best outcome measures to use in trials of CBT for CFS.

      References:

      [1] 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 Jan 5:1-7. [Epub ahead of print]

      [2] Knoop H, van der Meer JW, Bleijenberg G (2008). Guided self-instructions for people with chronic fatigue syndrome: randomised controlled trial. British Journal of Psychiatry 193, 340-341.

      [3] Stulemeijer M, de Jong LW, Fiselier TJ, Hoogveld SW, Bleijenberg G (2005). Cognitive behaviour therapy for adolescents with chronic fatigue syndrome: randomised controlled trial. British Medical Journal 330. Published online : 7 December 2004. doi:10.1136/bmj.38301.587106.63.

      [4] Prins JB, Bleijenberg G, Bazelmans E, Elving LD, de Boo TM, Severens JL, van der Wilt GJ, Spinhoven P, van der Meer JW (2001). Cognitive behaviour therapy for chronic fatigue syndrome: a multicentre randomised controlled trial. Lancet 357, 841-847.

      [5] Bleijenberg G, Prins JB, Bazelmans E (2003). Cognitive behavioral therapies. In Handbook of Chronic Fatigue Syndrome (ed. L. A. Jason, P. A. Fennell and R. R. Taylor), pp. 493-526. Wiley: New York.

      [6] Van der Werf SP, Prins JB, Vercoulen JH, van der Meer JW, Bleijenberg G (2000). Identifying physical activity patterns in chronic fatigue syndrome using actigraphic assessment. Journal of Psychosomatic Research 49, 373-379.

      [7] Friedberg F, Sohl S. Cognitive-behavior therapy in chronic fatigue syndrome: is improvement related to increased physical activity? J Clin Psychol. 2009 Feb 11.


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    1. On 2013 Oct 03, Brett D Thombs commented:

      The authors recommend routine depression screening for all heart patients. Even in primary care, where physicians are trained to manage depression, this is not recommended. This recommendation by the AHA was not based on a systematic review of evidence of benefit. See two systematic reviews:

      Thombs BD, de Jonge P, Coyne JC, Whooley MA, Frasure-Smith N, Mitchell AJ, Zuidersma M, Eze-Nliam C, Bezerra B, Smith CG, Soderlund K, Ziegelstein RC. Depression screening and patient outcomes in cardiovascular care: A systematic review. JAMA. 2008;300(18):2161-2171.

      Thombs BD, Roseman M, Coyne JC, de Jonge P, Delisle VC, Arthurs E, Levis B, Ziegelstein R. Does Evidence Support the American Heart Association's Recommendation to Screen Patients for Depression in Cardiovascular Care? An Updated Systematic Review. PLoS ONE. 2013;8(1):e52654.


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    1. On 2014 Aug 29, Massimo Ciccozzi commented:

      I read with interest the paper by Santosh et al. HIV 2 infections were geographically restricted, affecting West African countries1, 2, whereas in Europe the prevalence of HIV-2 is high in those countries that have socioeconomic relationships with this African region 3-5 . However, increased migration from/to other countries and international travels might increase the risk of spreading of this virus worldwide. We recently published a phylogenetic analysis of HIV2 case series in Italy using sequences isolated from Indian patients try to connect this infection with other from different countries 6. This article is very interesting and give important information on HIV-2 using a complete genome analysis. In Indian country few papers have been written in Phylogenetic analysis and Santosh and coauthors have given a sort of thrust in this way. In my opinion I only suggest the use of Bayesian Methods to have more robust information about the origin of Indian epidemics, moreover I encourage all Indian researchers, that are able to make sequences, to do this. It is also important that the scientific community don't lower the watch and monitor this infection also because to study HIV 2 can be an opportunity to better understand the HIV disease pathogenesis, protein immunity and this have to be taken before it disappears.<br> References

      1. Dougan S, Patel B, Tosswill JH, and Sinka K: Diagnoses of HIV-1 and HIV-2 in England, Wales, and Northern Ireland associated with west Africa. Sex Transm Infect 2005;81:338– 341.
      2. Matheron S, Mendoza-Sassi G, Simon F, Olivares R, Coulaud JP, and Brun-Vezinet F: HIV-1 and HIV-2 AIDS in African patients living in Paris. AIDS 1997;11:934–936.3

      3. Valadas E, Franc¸a L, Sousa S, and Antunes F: 20 years of HIV-2 infection in Portugal: Trends and changes in epidemiology. Clin Infect Dis 2009;48:1166–1167.

      4. Barin F, Cazein F, Lot F, et al.: Prevalence of HIV-2 and HIV-1 group O infections among new HIV diagnoses in France: 2003– 2006. AIDS 2007;21:2351–2353.

      5. Soriano V, Gomes P, Heneine W, et al.: Human immunodeficiency virus type 2 (HIV-2) in Portugal: Clinical spectrum, circulating subtypes, virus isolation, and plasma viral load. J Med Virol 2000;61:111–116.

      6. D’Ettorre,G, Lo Presti A,Gori C, Cella E,Bertoli A,Vullo V,Perno CF, Ciotti M,. Foley Brian T, and Massimo Ciccozzi. An HIV Type 2 Case Series in Italy: A Phylogenetic Analysis.(2013) AIDS Res HUM Retroviruses


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    1. On 2013 Oct 20, Ivan Oransky commented:

      This study has been retracted. Here's background from Retraction Watch (which I co-founded): http://retractionwatch.wordpress.com/2013/10/09/retraction-appears-for-stem-cell-researcher-found-to-have-used-funds-for-his-companys-gain/

      And here is corresponding author Gerold Feuer's response to the retraction, in which he says he can "unequivocally state that the data in all published manuscripts is valid and sound and is not falsified or fabricated": http://retractionwatch.wordpress.com/2013/10/11/stem-cell-scientist-says-data-in-retracted-paper-is-not-falsified-or-fabricated/


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    1. On 2013 Dec 29, Keizo Takao commented:

      The raw data of behavioral tests, which are not described in this paper, are shown in the Mouse Phenotype Database (http://www.mouse-phenotype.org/). "ImageEP", "ImageLD" and "ImageFZ", image analysis application softwares used in this article, are now freely available from http://www.mouse-phenotype.org/software.html.


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    1. On 2013 Dec 29, Keizo Takao commented:

      The raw data of behavioral tests, which are not described in this paper, are shown in the Mouse Phenotype Database (http://www.mouse-phenotype.org/). "ImageLD", "ImageEP", and "ImageFZ", image analysis application softwares used in this article, are now freely available from http://www.mouse-phenotype.org/software.html.


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    1. On 2014 Jan 27, Anders von Heijne commented:

      Development of visual diagnostic skills in pathology, as in radiology, is a sine qua non to become proficient in ones field. It requires training, feedback and guidance by more experienced collegues. It would be interesting if the author would like to update readers how the changes in the educational system actually impacted training and professional development, now several years after the original paper.


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    1. On 2017 May 18, Misha Koksharov commented:

      FYI:

      In contrast to Luciola mingrelica luciferase, in Photinus pyralis luc the homologous mutation Y33H doesn't affect pH-sensitivity of its color (at least there are no any differences in E. coli colonies compared with WT Ppy). Apparently, something is different in the surrounding interactions (it's not particularly surprising given the 67% sequence identity between the P. pyralis and L. mingrelica luciferases).

      Regarding this region of the 3D structure, the mutation D234G in Ppy luc comes to mind: it makes Ppy luc quite pH-resistant (hence, greenish colony color with low pH-dependent shift); however, in the fully pH-sensitive L. mingrelica luc the corresponding residue is already G236.


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    1. On 2014 Jan 08, Brett Snodgrass commented:

      Dear Authors,

      Thank you for the excellent article. Please provide your kind consideration to the vascular nomenclature and the distinction between the Thebesian veins and the vessels of Wearn.

      Might the article be titled as the "Wearn Coronary System?" The fine (minute) nature of the vessels is consistent with the arteriosinusoidal type of vessels of Wearn. However, arterio-capillary-cameral & arterio-capillary-venular-cameral connections might be considered.

      The text highlights found at the following website may illustrate the difference.

      https://twitter.com/BrettSnodgrass1/status/417972133642240000/

      Comments and suggestions are welcome.

      Thank you kindly.


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    1. On 2016 Oct 03, Morten Oksvold commented:

      Please note that after an investigation at the University of Cologne, six articles where T. Wenz figures as first or senior author were found to contain questionable data due to scientific misconduct. This article is one of these six articles.

      The conclusion from the report was ready June 28, 2016, please see the link (in German):

      http://www.portal.uni-koeln.de/9015.html?&tx_news_pi1[news]=4335&tx_news_pi1[controller]=News&tx_news_pi1[action]=detail&cHash=1deb8399d7f796d65ca9f6ae4764a1ce


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    1. On 2015 Aug 05, Tracy Shields commented:

      According to a retraction statement published online 2 July 2014, the article was retracted "due to errors in the data analysis which affect the article's findings" by agreement between the journal Editor-in-Chief, the authors, and publisher. See: http://onlinelibrary.wiley.com/doi/10.1111/jocn.12652/abstract


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    1. On 2014 Nov 30, Harri Hemila commented:

      Morens DM, 2008 examined pieces of lung tissues from 1918-19 flu pandemic victims and perused contemporary autopsy reports, concluding that the high mortality associated with influenza was caused by secondary bacterial pneumonia. They suggested that antibiotics and bacterial vaccines should be stockpiled for the next flu pandemic.

      I would like to propose that as part of pandemic-related research activities, the effect of vitamin C on bacterial pneumonia should be investigated.

      In mice, influenza A infection decreases the level of vitamin C in the lungs Hennet T, 1992, and vitamin C deficiency leads to more severe pathological changes in these organs Li W, 2006. In dozens of animal studies, vitamin C protected against infections by various viruses and bacteria Hemilä 2006, pp. 5-9,105-21. In the early 20th century, Alfred Hess carried out extensive studies of scurvy and summarized a large series of autopsy findings as follows: “pneumonia, lobular or lobar, is one of the most frequent complications [of scurvy] and causes of death” and “secondary pneumonias, usually broncho-pneumonic in type, are of common occurrence, and in many [scurvy] epidemics constitute the prevailing cause of death”, see Hemilä H, 2007. Furthermore, in about two dozen placebo-controlled trials, vitamin C reduced the duration and severity of the common cold suggesting that the vitamin may have effects on the respiratory system of humans even in the absence of frank deficiency Hemilä H, 2013.

      Because of the evidence suggesting that vitamin C may have an effect on pneumonia, Hemilä H, 2013 carried out a Cochrane review and found three controlled trials that looked at whether vitamin C prevents pneumonia and two that looked at whether it might help in curing pneumonia. Each of the five trials found that vitamin C supplementation was beneficial. Two of the studies were double-blind placebo-controlled RCTs, one was prophylactic and the other therapeutic.

      Pitt HA, 1979 administered vitamin C to US marine recruits and reported 7 cases of pneumonia in the placebo-group compared with 1 case in the vitamin C group. Hunt C, 1994 administered vitamin C to elderly people who were admitted to hospital in the UK because of bronchopneumonia or acute exacerbation of chronic bronchitis. They reported a significant decrease in the “total respiratory score” by vitamin C administration, and 5 deaths in the placebo group compared with 1 death in the vitamin C group. Hunt et al. tested the effect of vitamin C “over and above those of normal medication (mainly antibiotics and cough medicines) to which all participants were exposed” so that all their patients received antibiotics and vitamin C was not an alternative to them.

      As to bacterial pneumonia caused by influenza A infection, Kimbarowski JA, 1967 is particularly interesting as they administered vitamin C to soldiers of the former USSR who were hospitalized because of influenza A. Their main purpose was to examine an investigational laboratory test; however, as a secondary issue, they reported the number of bronchopneumonia cases in the study groups after hospitalization. The reason for diagnosing pneumonia was that the authors excluded those cases from their further study of the laboratory test. Thus, the pneumonia cases occurred after vitamin C supplementation was initiated for the influenza A patients. The two arms were balanced for the severity of influenza. The allocation method was not described but the study arms were of very similar size (112 versus 114 in the control and vitamin C arms) so it is possible that allocation occurred sequentially in the two trial arms. A placebo was not mentioned in the paper and apparently not used. Blinding of outcome assessment was not described; however, since pneumonia was a nuisance issue in their study, it seems improbable that the trial authors had substantial bias in their diagnosis of pneumonia. There were 10 cases of bronchopneumonia in the control group compared with 2 cases in the vitamin C group (P = .02, Fisher’s exact test).

      Even though Kimbarowski and Mokrow’s trial is methodologically unsatisfactory in comparison with current standards, the difference in the occurrence of pneumonia in the study groups cannot be dismissed because of obvious biases Hemilä H, 2013. Furthermore, the finding is consistent with other evidence suggesting that under some conditions vitamin C may affect respiratory infections. Methodologically satisfactory trials are needed to corroborate or refute the possibility that vitamin C has an effect on bacterial pneumonia caused by influenza.


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    1. On 2014 Jan 08, Tom Kindlon commented:

      Thresholds for recovery were set very very "low" (perhaps the bottom percentile and 5th lowest percentile of the healthy adult population on the two scales used)

      (I originally posted this as a comment here: http://www.biomedcentral.com/1472-6963/8/175/comments. However all the paragraph breaks have been deleted so I doubt many would read it there)

      The thresholds for recovery seem very very low: "Patients were defined as being CSI at post treatment if they had a reliable change index > 1.96 on the CIS fatigue severity subscale [22], a fatigue severity score <= 35 and a Rand-36 physical functioning score > = 65".

      Many of the patients already likely had a "physical functioning score >=65" given the mean (SD) values before treatment were: "Physical impairment (Rand 36) 54.0(23.4)" And the threshold for recovery was only 0.47 SDs above the initial mean score. I am aware of the questions on the SF-36 PF subscale (scores can range from 0 to 100 with the higher the score, the better their "physical functionaling") and I don't believe most healthy adults would believe scoring 65 on the SF-36 PF scale would mean they were recovered. As a study[1], that was co-written by one of the authors of this study (Gijs Bleijenberg), pointed out, a community study found that "healthy adults without a chronic condition" had "a mean score of 93.1 (SD 11.7)." The authors of that study[1] pointed out they did not know the exact distribution of the SF-36 subscales - they just made the assumption that the mean - 1SD would represent a threshold for the 85th percentile and rounded this figure to 80.The threshold in the current study is 65. That is 2.4 SDs below the healthy population's mean score. If the same assumptions were made (i.e. that the curve was normally distributed), this would represent the bottom percentile!

      For the CIS fatigue severity subscale (where the possible scores are 8-56 with the higher the score, the greater the fatigue), that same study that Gijs Bleijenberg co-wrote[2] used (to calculate thresholds i.e. from another study) a "normal group of 53 healthy adults with a mean age of 37.1 (SD 11.5)" who had "a mean score on the CIS-fatigue of 17.3 (SD 10.1)."[3] The ages of those healthy adults are similar to the ages of the CFS patients in this study: Mean (SD) 38.1 (10.2). In that study[1], they estimated that the 85th percentile (mean+1SD) would be 27 (due to rounding). This study uses 35 or the mean + 1.7525SD or the 95th percentile. Put another way, patients in this study could be considered recovered if they scored in the bottom percentile on the physical functioning subscale (of the SF-36) and in the 5th lowest percentile on the CIS-fatigue scale!

      References:

      [1] Knoop H, Bleijenberg G, Gielissen MF, van der Meer JW, White PD. Is a full recovery possible after cognitive behavioural therapy for chronic fatigue syndrome? Psychother Psychosom. 2007;76(3):171-6.

      [2] Aaronson NK, Muller M, Cohen PD, Essink-Bot ML, Fekkes M, Sanderman R, Sprangers MA, te Velde A, Verrips E: Translation, validation, and norming of the Dutch language version of the SF-36 Health Survey in community and chronic disease population. J Clin Epidemiol 1998; 51: 1055-1068.

      [3] Vercoulen JHMM, Alberts M, Bleijenberg G: De Checklist Individual Strength (CIS) (The Checklist Individual Strength). Gedragstherapie (Behavioural Therapy) 1999; 32: 642-649.


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    2. On 2013 Oct 24, Tom Kindlon commented:

      Another paper by the authors provides information on the effects of self-efficacy and fatigue severity on health use

      I find it strange that in this paper, there is no mention of: "Determinants of health care use in chronic fatigue syndrome patients: a cross-sectional study." That study was written the four authors of the current study plus one other person.<sup>1</sup>

      I'm far from an expert on health economics but it seems to have information and data relevant to the current study or at least worthy of mention in the discussion section.

      They found for example, that: "self-efficacy showed a positive instead of a negative relation with health care use. We checked the direct correlation between self-efficacy and health care use, which also appeared to be positive (Pearson's R=0.12, p=.04). It thus seems that using more health care services might form an aspect of, or is stimulated by, a high self-efficacy instead of being the result of a low self-efficacy."

      One of the aims of CBT for CFS is to increase self-efficacy. As they say in the paper: "Subsequently, dysfunctional fatigue related cognitions are being challenged to diminish somatic attributions of fatigue, to improve a sense of control over symptoms and to facilitate behavior change. Finally a plan for work rehabilitation is outlined and worked out. Patients without a paid job focus on rehabilitation in other personal activities. The last session deals with relapse prevention and further improvement of self-control."

      Self-efficacy is a commonly used term in the literature on CBT for CFS.

      That study<sup>1</sup> also found that: "Fatigue severity itself showed no relation with health care use." So improving fatigue scores will not necessarily change health care use.

      References:

      [1] Scheeres K, Wensing M, Severens H, Adang E, Bleijenberg G. Determinants of health care use in chronic fatigue syndrome patients: a cross-sectional study. J Psychosom Res. 2008 Jul;65(1):39-46.


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    3. On 2013 Oct 24, Tom Kindlon commented:

      (This follows on from an earlier comment that I thought was already long enough)

      Some of the calculations in this study use in the study use the recovery rate of 37%.

      For example: "Given the recovery rate of 37% the COR of implementing CBT for CFS was 5.320 per recovered CFS patient. The COR acceptability curve (figure 3) shows that the probability that implementing CBT for CFS has a favorable COR is 100% when the decision maker values a recovered CFS patient at least 6.500."

      They become very different if the threshold for recovery was much different.

      Alternatively, with the lax definition for recovery they used, the amount of people who would have "recovered" without treatment may be a lot higher than the 5% assumed in this study.

      "Finally, to get an impression of this study's results when compensating for spontaneous recovery, an additional analysis was performed. This was done from the health care perspective, presuming a spontaneous recovering rate of 5% [2], implying a recovery rate due to treatment of 32%. It revealed that the COR would rise from 5.320 to about 5.969 per recovered patient."

      I also don't understand why a "recovered group" should have a much worse average score in a domain e.g. around the lower end of any scale. Surely the null hypothesis would be that there is no difference between the means and if this is not satisfied, it's not a "recovered group". What could be done would be that some people would have to be taken out of the "recovered group" until one got to a situation where the mean of the recovered group was within a confidence interval for the mean of the normal population (the variance of a mean is of course much smaller than the variance of an individual entry i.e. the average value would have to be "pretty close" to the mean of the healthy population). Of course, it could be the case that there would only be a recovered group of 1 (say) as none of the values were above the mean.


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    4. On 2013 Oct 24, Tom Kindlon commented:

      (contd.)

      In a review of CFS treatments, Whiting et al<sup>6</sup> recommended objective outcome measures be used: "Outcomes such as "improvement," in which participants were asked to rate themselves as better or worse than they were before the intervention began, were frequently reported. However, the person may feel better able to cope with daily activities because they have reduced their expectations of what they should achieve, rather than because they have made any recovery as a result of the intervention. A more objective measure of the effect of any intervention would be whether participants have increased their working hours, returned to work or school, or increased their physical activities."

      Actometers or pedometers were not used in the study. So by the measures the review<sup>6</sup> suggested, this paper doesn't prove that CBT is an "effective treatment" let alone that it leads to a recovery rate of 37%.

      This review<sup>6</sup> also recommended long-term follow-up:

      "The relapsing nature of CFS suggests that follow-up should continue for at least an additional 6 to 12 months after the intervention period has ended, to confirm that any improvement observed was due to the intervention itself and not just to a naturally occurring fluctuation in the course of the illness."

      This also brings up the question of recovery being assessed by questionnaires at one point at time. This seems a strange way to define recovery especially in a condition with a condition like CFS where the symptoms can intensify and reduce over a period.

      So based on the information in my two comments, I think it's difficult to sustain that 37% of the patients recovered.

      References:

      1 Kindlon T. Thresholds for recovery were set very very "low" (perhaps the bottom percentile and 5th lowest percentile of the healthy adult population on the two scales used). Comment at: http://www.biomedcentral.com/1472-6963/8/175/comments

      2 Wessely, S: Chronic Fatigue Syndrome-Trials and Tribulations. JAMA.2001; 286: 1378-1379.

      3 Malouff, J. M., et al., Efficacy of cognitive behavioral therapy for chronic fatigue syndrome: A meta-analysis. Clinical Psychology Review (2007), doi:10.1016/j.cpr.2007.10.004

      4 Cohen J: Statistical power analysis for the behavioural sciences. Edited by: 2. New Jersey: Lawrence Erlbaum; 1988.

      5 Deale A, Husain K, Chalder T, Wessely S. Long-term outcome of cognitive behavior therapy versus relaxation therapy for chronic fatigue syndrome: a 5-year follow-up study. Am J Psychiatry. 2001 Dec;158(12):2038-42.

      6 Whiting P, Bagnall AM, Sowden AJ, Cornell JE, Mulrow CD, Rammrez G.Interventions for the treatment and management of chronic fatigue syndrome: a systematic review. JAMA. 2001;286:1360-1368 http://jama.ama-assn.org/cgi/content/full/286/11/1360


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    5. On 2013 Oct 24, Tom Kindlon commented:

      Information on occupational performance does not suggest 37% of the patients were recovered

      In a comment,<sup>1</sup> I pointed out that the thresholds for recovery using were set very low. However it is useful to investigate the other data to see what it might say about recovery rates. Also other data from other studies.

      This paper claims that CBT led to a recovery rate of 37% in CFS patients. That is one of the highest if not the highest recovery rate I can recall from a CBT study.

      It is my impression that, outside the Netherlands, claims of CBT leading to recovery in CFS are not that common. For example, Prof. Simon Wessely, who could be said to be one of the chief proponents of CBT for CFS worldwide over the last couple of decades has said that CBT is not "remotely curative".<sup>2</sup>

      Recently, a meta-analysis of the efficacy of CBT for CFS was published.<sup>3</sup> The studies involved a total of 1371 patients. This involved calculating the size of an effect measure, the Cohen's d value.

      They calculated d using the following method: "Separate mean effect sizes were calculated for each category of outcome variable (e.g., fatigue self- rating) and for each type of outcome variable (mental, physical, and mixed mental and physical). Studies generally included multiple outcome measures. For all analyses except those that compared different categories or types of outcome variables, we used the mean effect size of all the relevant outcome variables of the study."

      d was calculated to be 0.48.

      For anyone unfamiliar with Cohen's d values, they are not bounded by 1; also, the higher the score, the bigger the "effect size" i.e. the more "effective" a treatment was found to be. Cohen's d values are considered to be a small effect size at 0.2, a moderate effect size at 0.5, and a large effect size at 0.8.<sup>4</sup>

      So this suggests CBT leading to a 37% recovering would be unusual.

      I noticed in the discussion section, we are told: "Concerning work productivity, fewer patients had a paid job after treatment than before, but the mean hours of paid work per week had increased after treatment." We are not given the percentage of patients who work.

      What we are told is that the median number of hours actually worked before the treatment was 0 hours. That means that at least 50% of the patients were working 0 hours per week. For the whole group, they worked a mean number of 9.4 hours. Some of these people who were not actually working were actually in paid employment at the start as the median number of hours they were contracted to work was 7 hours. Like most studies of adults with CFS, these patients were of working age. The mean age was 38.1 with a standard deviation of 10.2. 34% were male (larger than most studies) and 66% were female.

      Given the sample group, one would think that an "effective" treatment for CFS which is supposed to improve functioning and which the authors claim led to a recovery rate of 37% would dramatically effect the professional functioning of the patients.

      Indeed at least one study of CBT has used hours worked in its definition of recovery: "Predetermined criteria for "complete recovery" required that patients no longer met chronic fatigue syndrome criteria, were employed full-time, and scored less than 4 on the Fatigue Questionnaire and more than 83 on the Medical Outcomes Study Short-Form General Health Survey physical functioning scale."

      However in the current study we find that the mean number of hours work they are contracted to work actually decreased from a mean (SD) of 16.2 (16.3) to 14.9 (16.2) and given that median number of hours actually worked after the intervention is 0 hours, more than 50% of the patients are still not working at the end.

      [The number of hours actually worked did increase from a mean (SD) of 9.4 (13.5) to 11.4 (14.7) but a quick t-test suggests this isn't statistically significant].

      (contd.)


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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 NCT003229758. We believe the correct ID, which we have found by hand searching, is NCT00329758.

      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 2016 Aug 24, Ben Goldacre commented:

      This trial has the wrong trial registry ID associated with it on PubMed: both in the XML on PubMed, and in the originating journal article. The ID given is NCT03318019. We believe the correct ID, which we have found by hand searching, is NCT00318019.

      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 Nov 30, Harri Hemila commented:

      Brundage JF, 2008 suggest that the high mortality associated with 1918-19 flu pandemic was caused by secondary bacterial pneumonia. They propose that antibiotics and bacterial vaccines should be stockpiled for the next flu pandemic.

      I would like to suggest that as part of pandemic-related research activities, the effect of vitamin C on bacterial pneumonia should be investigated. In dozens of animal studies, vitamin C protected against infections by various viruses and bacteria, see Hemilä 2006, pp. 5-9, 105-21.

      In the early 20th century, Alfred Hess carried out extensive studies of scurvy and summarized a large series of autopsy findings as follows: “pneumonia, lobular or lobar, is one of the most frequent complications [of scurvy] and causes of death” and “secondary pneumonias, usually broncho-pneumonic in type, are of common occurrence, and in many [scurvy] epidemics constitute the prevailing cause of death”, see Hemilä H, 2007. Thus, there seemed to be a close association between vitamin C and pneumonia.

      Hemilä H, 2013 carried out a Cochrane review, and found 3 controlled trials that looked at whether vitamin C prevents pneumonia and 2 that looked at whether it might help in curing pneumonia; 2 of them were RCTs. Each of the 5 trials found that vitamin C supplementation was beneficial.

      As to bacterial pneumonia caused by influenza A infection, Kimbarowski JA, 1967 is particularly relevant as they administered vitamin C to soldiers of the former USSR who were hospitalized because of influenza A. Their main purpose was to examine an investigational laboratory test; but, as a secondary issue, they reported the number of bronchopneumonia cases in the vitamin C and control groups after hospitalization. There were 10 cases of bronchopneumonia in the control group compared with 2 cases in the vitamin C group (P = 0.02, Fisher’s exact test). Although the trial is methodologically unsatisfactory in comparison with current standards, the difference in the occurrence of pneumonia in the study groups cannot be dismissed because of obvious biases Hemilä H, 2013. Methodologically satisfactory trials are needed to corroborate or refute the possibility that vitamin C has an effect on bacterial pneumonia caused by influenza.


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    1. On 2013 Dec 29, Keizo Takao commented:

      The raw data of behavioral tests, which are not described in this paper, are shown in the Mouse Phenotype Database (http://www.mouse-phenotype.org/). "ImageLD", "ImageEP", "ImageFZ", and "ImageTM", image analysis application softwares used in this article, are now freely available from http://www.mouse-phenotype.org/software.html.


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    1. On 2014 May 15, Bill Sardi commented:

      This abstract does not do justice to this landmark study. 12 weeks on an CR diet significantly differentiated 198 genes, resveratrol 225 genes,resveratrol+polyphenol (Longevinex) diet 1711 genes. Life-long CR diet in mice differentiates 831 genes. This suggests what takes a lifetime to accomplish epigenetically can be accomplished over a shorter time! Furthermore, the nutraceutical switched 677 of 831 (82%) longevity genes in the same direction (expressed or silenced) as CR, which makes this nutraceutical the closest molecular mimic of CR to date. (Note: I have a commercial interest in this nutraceutical)


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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 NCT005725079. We believe the correct ID, which we have found by hand searching, is NCT00572507.

      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 Dec 18, Claudia Paiva commented:

      Is it possible that the recurrency is overestimated because patients without recurrent events leave the hospital and are excluded from the study? 1334 cases were found and 127 chosen because they could be followed for long term... The rate of recurrency among high-tone controls is 11% (without vertigo) and 17% (without SN), while in the literature the total recurrency among SSNHL sufferers is approximately 2%.

      Alternatively, it could be due to a higher rate of recurrency in Japan, since no western studies were made concerning the recurrency rates among low tone hearing loss in western countries. Do you know any broad study in Japan that show the total recurrency rate of SSNHL in Japan and percentages of high x low tone hearing loss among total SSNHL?

      It is very important to define the rate of recurrency, so that the patient is aware of the possibility and plot a plan to face it with drs (in case it is high) or can live without the constant burden of "is it going to happen again?" in their heads (in case it is low).

      Anyway, these are just considerations made by a worried low tone SSNHL patient and a scientist from another field.


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    1. On 2015 Dec 06, Mark Bolland commented:

      This comment provides background information to an earlier comment.

      We were interested in why different meta-analyses of vitamin D supplements came to different conclusions, and noticed that different meta-analyses used different data from this trial. We identified several errors/inconsistencies in the text and emailed the lead author requesting clarification about the data in March 2014. He responded that the data in the Tables were correct. We replied that there were inconsistencies within the Tables as well and asked for clarification, but he did not respond.

      Therefore in April 2014, we contacted the editor of Osteoporosis International advising the editor of the inconsistencies and requested that they be corrected. We felt this is particularly important as it is a highly cited, influential trial reporting benefits of vitamin D supplements on falls, and the inconsistencies occur in the treatment group numbers and the primary and secondary outcomes, so have a major bearing of the interpretation of the trial results. Our primary concern was/is to use the correct data for the trial in meta-analyses. In May 2014, the editor passed on an extract of the lead author’s response and indicated that an erratum would be published. However, we felt the lead author’s response was inadequate because it left a number of uncorrected inconsistencies/errors in the text. We pointed this out to the editor. We are not sure what action the editor took, but no erratum was published. We followed up with 2 further emails to the editor over the next year, and in April 2015, the editor advised that it seemed unlikely that an erratum would be forthcoming.

      Therefore, we requested the permission to summarize the issues in a very brief letter. The editor agreed and a short letter summarizing the six errors/inconsistencies in the article was published (Osteoporos Int 2015;26:2713 Bolland MJ, 2015) with a response from the author (Osteoporos Int. 2015;26:2715-6 Pfeifer M, 2015). Unfortunately, in his response the author chose to correct only 2 of the errors identified and introduced a further inconsistency.

      In a further letter to the editor, we therefore highlighted the remaining errors/inconsistencies and the consequence of using different possible data combinations from this trial for meta-analyses. The editor indicated that the issues we raised were important but probably irresolvable and offered to publish the letter in Archives of Osteoporosis. We indicated that our preference was that the data were corrected in the original publication rather than our letter being published. We think it quite straightforward to make the simple necessary corrections to two tables and a couple of sentences of text. We feel it is essential that the corrections occur as the errors are in the most important data from the trial: the treatment group numbers and the primary outcome data for falls. The editor considered the issue further and then published our letter (Arch Osteoporos. 2015;10:43 Bolland MJ, 2015) along with a response from the author (Arch Osteoporos. 2015;10:42 Pfeifer M, 2015).

      In this second response, the author has still not corrected the identified errors, so, because of the inconsistencies/errors in the data, it is not possible to be sure how many women were in each randomized treatment group, how many women had a fall during the trial, how many total falls occurred in each treatment group, or what is the breakdown of participants by numbers of falls (no falls, 1 fall, 2 falls, etc).

      Therefore, we think that the study should be excluded from meta-analyses and systematic reviews and its results viewed with caution until consistent data are provided by the authors with some explanation as to how the errors/inconsistencies occurred.

      Mark Bolland, Andrew Grey. University of Auckland


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    2. On 2015 Dec 06, Mark Bolland commented:

      There are several errors/inconsistencies in the data related to treatment group numbers and numbers of falls and fractures in this paper. These include:

      • 1. The text and Table 1 reports 121 participants in each treatment group, but Table 3 reports 120 for Ca and 122 for CaD.
      • 2. Table 3 reports that 75 participants fell with Ca and 49 with CaD, but the breakdown of fallers in Table 3 sums to 71 for Ca and 53 for CaD.
      • 3. The text reports the total number of falls as 171 with Ca and 76 with CaD, but Table 3 reports 169 with Ca and 106 with CaD.
      • 4. The breakdown of total falls in Table 3 sums to at least 111 with CaD, which is greater than the total falls for CaD reported in the text (76) and Table 3 (106).
      • 5. The text reports the mean number of falls per group as 1.41 with Ca and 0.63 with CaD which are incompatible with the reported total number of falls in the text and Table 3.
      • 6. The text reports 13 participants with fracture with Ca whereas Table 3 reports 12.

      These are discussed in two letters to the editor (Osteoporos Int 2015;26:2713 Bolland MJ, 2015 and Arch Osteoporos. 2015;10:43 Bolland MJ, 2015) with responses by the lead author to each letter (Osteoporos Int. 2015;26:2715-6 Pfeifer M, 2015 and Arch Osteoporos. 2015;10:42 Pfeifer M, 2015).

      Given the unwillingness/inability of the author to provide consistent data from the trial, we think it should be excluded from systematic reviews or meta-analyses until consistent data are provided by the authors, with some explanation as to how the errors/inconsistencies occurred.

      We have described the full sequence of events in a separate comment.

      Mark Bolland, Andrew Grey. University of Auckland


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    1. On 2015 Jul 20, Salzman Lab Journal Club commented:

      This paper provides strong evidence for the dramatic functional change in protein coding enabled by precise RNA editing. An interesting followup would be to see if there are changes in expression levels of the editing guide RNA during the course of trypanosome development. Also, it would be interesting to know the level of expression of the dominant negative AEP1-GFP protein relative to endogenous levels of AEP1.


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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 NCT00605058. We believe the correct ID, which we have found by hand searching, is NCT00605085.

      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 Dec 30, Tom Kindlon commented:

      My published response: "Change in grey matter volume cannot be assumed to be due to cognitive behavioural therapy"

      I had a letter published in reply to the authors' response to the Inge Bramsen letter. Among other things, I highlighted that there was no CFS control group in this study, so one shouldn't assume any change was due to CBT e.g. it could be due to the passage of time (plausible given people with CFS, once diagnosed, are more likely to improve than deteriorate, at least in the short term). The letter can be read here: http://brain.oxfordjournals.org/content/132/7/e119.long


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    1. On 2013 Oct 26, Michael Eisen commented:

      Would like to point to a followup paper from our lab: Lusk RW, 2010 used simulations of enhancer evolution to examine one of the conclusions of this paper - that the enrichment and conservation of paired binding sites we observe is the result of selection for paired sites - and found that a selection on binding site composition alone in the presence of a bias for deletions over insertions can result in an enrichment of clustered binding sites that appear (but are not) to be under purifying selection.


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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 2015 Oct 16, David Keller commented:

      How did same-sex preference genes persist despite their effects on reproduction?

      Evidence suggests the existence of genes which promote homosexual preference. A gene which tends to decrease its own reproduction in this way must have some countervailing effect in order to persist in the gene pool.

      If the same mutation which promotes homosexuality in men also increases fecundity in women, it could persist in equilibrium with wild-type alleles. The reduced number of offspring of male carriers would have to be offset by an increased number of offspring in female carriers large enough to avoid the disappearance of the gene which would otherwise occur over time.

      Another possibility is that social repression of homosexuality had the paradoxical effect of promoting the survival of same-sex preference genes. Modern society's tolerance, by reducing the social pressure to reproduce, could ironically lead to the gradual disappearance of genes which promote homosexual preference.


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    1. On 2017 Aug 20, Daniel Weiss commented:

      This paper employs flawed circular reasoning.

      The methods section clearly states that “in all patients with neurologic, cardiac or joint involvement, a serologic test positive for B. burgdorferi by ELISA and Western blot was required for case inclusion.”

      Then in the results section, the authors state that “among the 44 patients with neurologic, heart or joint abnormalities, all had positive IgM or IgG responses to B. burgdorferi with 2 tier testing”… 2 tier testing had a sensitivity of 100%” .

      This often cited manuscript claims that two tier testing has a sensitivity of 100% among those who have positive two tier tests. I urge all to read this paper before citing it.


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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 NCT00364963. We believe the correct ID, which we have found by hand searching, is NCT00364936.

      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 Nov 17, Raphael Levy commented:

      The article has been corrected after re-use of a figure from a previous article had been raised.

      There is barely any evidence for the existence of this particular type of stripy nanoparticles blog post, and, more broadly, the evidence behind the structure and special properties of “striped” nanoparticles has been challenged by Cesbron Y, 2012. The publication in 2012 of Cesbron Y, 2012 took three years and has been followed by post-publication peer review of the various existing and new stripy articles on my blog, PubPeer, etc.

      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 13, Robert Eibl commented:

      After contacting the editor in 2008 about some issues with this paper, she suggested considering a “Corrigendum”, but did not publish it. Please find below my updated and slightly modified letter to the editor:

      Robert Eibl: Single-receptor adhesion measurements on living cells

      Helenius et al. (1) reviewed the use of atomic force microscopy (AFM) for single-cell force spectroscopy (SCFS). They listed in table 1 the references for "receptor-ligand interactions by SCFS using living cells as probes" and pointed to two reports on cell adhesion bonds between integrin alpha4beta1 (very late antigen 4, VLA-4) and its ligand vascular cell adhesion molecule 1 (VCAM-1). Surprisingly, however, Helenius and co-workers have not included the work of Eibl and Benoit (2) in their list, although this original finding on the same integrin to ligand interaction was published well before the two cited references appeared, i.e. 5 and 18 months, respectively, earlier.

      In addition to this major exclusion to the very first AFM report on VLA-4/VCAM-1 measurements at the single-molecule level on a living cell, table 1 contains two more mistakes. First, the information stated to be found in a referenced paper is actually not there: Thie et al. (3) serves as reference for the specific measurement of integrin alpha(L)beta2 (leukocyte function antigen 1, LFA-1) on its ligand interstitial cell adhesion molecule 1 (ICAM-1); these authors -- although including one of the co-authors of this review -- never claimed being able to specifically measure any cell adhesion receptor; on the contrary, they state that they could only speculate regarding the cell adhesion receptors involved in their generally unspecific measurements, which might include several integrins and other cell adhesion receptors. This error may also mislead readers with regard to several other aspects of the AFM technique for measuring leukocyte homing receptors with AFM at the single-molecule or single-receptor level, including the original developers of the approach and the time-frame in which it was developed. Second, table 1 also includes a minor, but repeated typing error: “concavalin A” instead of “concanavalin A”.

      In my view, a detailed step-by-step protocol in this area could have been included at that time in the review, too (4). For readers interested in an extensive overview of this topic, a book chapter reviews this subject and includes a similar table as well as further protocols for experiments (5). Despite the discussed errors, the review includes a very useful overview on many aspects between physics and biology, and may bring the AFM technology into the scope of cell biologists, i.e. the readers of that journal. The authors are free to use their own nomenclature, like SCFS, very consistently through the review, which may appear to be useful for the beginner, but may not always be specific enough: “single-cell” measurements appear to contradict measurements between two cells, and often SCFS is also used for so-called single-molecule measurements on a cell, but a more precise nomenclature was not in the scope of the review.

      REFERENCES

      (1) Helenius, J., Heisenberg, C.P., Gaub, H.E., Muller, D.J. (2008). Single-cell force spectroscopy. J. Cell. Sci. 121, 1785-91

      (2) Eibl, R.H. and Benoit, M. (2004). Molecular resolution of cell adhesion forces. IEE - Nanobiotechnology 151, 128-132

      (3) Thie M, Röspel R, Dettmann W, Benoit M, Ludwig M, Gaub HE, Denker HW (1998). Interactions between trophoblast and uterine epithelium: monitoring of adhesive forces. Hum Reprod. (11):3211-9

      (4) Eibl, R.H. and Moy V.T. (2005). Atomic force microscopy measurements of protein-ligand interactions on living cells. In: Protein-Ligand Interactions. (Editor: G.Ulrich Nienhaus), Humana Press, Totowa, NJ, U.S.A., pp. 437-448 ISBN 1588293726

      (5) Eibl, R.H. (2013). Single-Molecule Studies of Integrins by AFM-Based Force Spectroscopy on Living Cells. Scanning Probe Microscopy in Nanoscience and Nanotechnology 3: 137-169, ISBN 978-3-642-25414-7_6


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    1. On 2014 Jan 08, Tom Kindlon commented:

      Various comments

      This paper refers to the use of a re-attribution programme. I thought I would highlight the results of a trial[1] published last year on the topic. It involved testing practice-based training of GPs in reattribution. The method to test the hypothesis was a "cluster randomised controlled trial in 16 practices, 74 GPs and 141 patients with medically unexplained symptoms of 6 hours of reattribution training v. treatment as usual." It found that "Practice-based training in reattribution changed doctor-patient communication without improving outcome of patients with medically unexplained symptoms". Hardly a ringing endorsement of the method.

      There has been a lot of hype about the effectiveness of Cognitive Behavioural Therapy (CBT) for Chronic Fatigue Syndrome (CFS). However, a meta-analysis[2] of its efficacy of CBT for CFS published in 2008 might temper some of the enthusiasm. The studies involved a total of 1371 patients. This involved calculating the size of an effect measure, the Cohen's d value. They calculated d using the following method: "Separate mean effect sizes were calculated for each category of outcome variable (e.g., fatigue self-rating) and for each type of outcome variable (mental, physical, and mixed mental and physical). Studies generally included multiple outcome measures. For all analyses except those that compared different categories or types of outcome variables, we used the mean effect size of all the relevant outcome variables of the study."d was calculated to be 0.48. For anyone unfamiliar with Cohen's d values, they are not bounded by 1; also, the higher the score, the bigger the "effect size" i.e. the more "effective" a treatment was found to be. Cohen's d values are considered to be a small effect size at 0.2, a moderate effect size at 0.5, and a large effect size at 0.8[2].

      There are now hundreds of studies that have found "physical" abnormalities of one sort or another in Chronic Fatigue Syndrome. Thus I question the placement of "Chronic Fatigue" (which many/most people would read as referring to Chronic Fatigue Syndrome as it is listed beside Fibromyalgia and Irritable Bowel Syndrome) in figure 1, "Hypothetical scatter plot of dysfunction versus pathology in primary care consultations" where "evidence of pathological change" is said to be "absent". The numerous abnormalities found raise questions about the placement on the scatter plot or else the limitations of the concept. Also how "reversible" the "abnormal functioning, either physiological or psychological" is, remains far from clear given the low recovery rates.

      References:

      [1] Morriss R, Dowrick C, Salmon P, Peters S, Dunn G, Rogers A, Lewis B, Charles-Jones H, Hogg J, Clifford R, Rigby C, Gask L. Cluster randomised controlled trial of training practices in reattribution for medically unexplained symptoms. Br J Psychiatry. 2007 Dec;191:536-42

      [2] Malouff, J. M., et al., Efficacy of cognitive behavioral therapy for chronic fatigue syndrome: A meta-analysis. Clinical Psychology Review (2007), doi:10.1016/j.cpr.2007.10.004

      [3] Cohen J: Statistical power analysis for the behavioural sciences. Edited by: 2. New Jersey: Lawrence Erlbaum; 1988.


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    1. On 2014 Apr 07, Muhammad Aslam commented:

      This is an interesting study but there is a technical mistake. Hopefully the authors can respond to that. On page 1351 (page 2 of article) the authors state ''Here, we have used 2 such Ras effector mutants to identify selective contributions of Ras effectors of the extracellular signal-regulated kinase (ERK)/mitogen-activated protein kinase (MAPK) or PI3K pathway to vascular phenotypes in vivo. RasV12C40 (G12→V12, T40→C40) binds to and selectively activates PI3K, whereas RasV12S35 (G12→V12, Y35→S35) binds to Raf1 and selectively activates the ERK/MAPK pathway.''

      In original H-Ras sequence (NP_001123914.1) there exist no T40 or Y35 rather it is the other way round. In sequence it is T35 and Y40 which is changed to S35 and C40, respectively, as stated by article from Joneson T et al (Science 1996; 271: 810–812).

      Regards,


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    1. On 2013 Oct 24, Tom Kindlon commented:

      Extremes In Activity Levels Of Those With Persistent Fatigue Were Not Investigated

      I question the claim in Viner et al<sup>1</sup> that "being highly sedentary or highly active independently increased the risk of persistent fatigue, suggesting that divergence in either direction from healthy levels of activity increases the risk for persistent fatigue."

      The authors themselves point out that their "definition of being physically active (1 hour of exercise on >=2 days per week) is roughly similar to the current recommendations for adolescents of the President’s Council on Physical Fitness and Sports and the National Association for Sport and Physical Education: “teens should do at least 20 minutes of vigorous activity 3 days a week and 30 minutes of moderate activity 5 days a week”.<sup>2</sup> So why is this level of activity, which was reported by 48.7% of the young people, being presented as being excessive? If they wanted to investigate being "highly active" (as opposed to simply being “active”), activity levels should not have been dichotomized at level they were in this study.

      The question about sedentary activities was: “Outside school hours, on average, how many hours a day do you usually watch TV or videos, play video games, or play on the computer?” If a young person was sedentary for >4 hours a day, it does not mean they was necessarily inactive; indeed in phase 1, 23% of active young people were sedentary for more than 4 hours per day (compared with 30% of inactive young people). Such a lifestyle could be associated with fatigue for other reasons; for example, it could result in a shortage of sleep, rather than it necessarily causing unhealthily low levels of activity.

      1 Viner RM, Clark C, Taylor SJ, Bhui K, Klineberg E, Head J, Booy R, Stansfeld SA. Longitudinal risk factors for persistent fatigue in adolescents. Arch Pediatr Adolesc Med. 2008 May;162(5):469-75.

      2 Corbin CB, Pangrazi RP, Le Masurier GC. Physical activity for children: current patterns and guidelines. Res Dig. 2004;5(2):1-8.


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    1. On 2016 Mar 10, Kristina Hanspers commented:

      The pathways in figures 6-9 are available in the "Open Access Publication" collection at WikiPathways: http://wikipathways.org/index.php/Pathway:WP152, http://wikipathways.org/index.php/Pathway:WP566, http://wikipathways.org/index.php/Pathway:WP341 and http://wikipathways.org/index.php/Pathway:WP211. These pathways can be downloaded for use in network analysis tools such as Cytoscape and PathVisio.


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    1. On 2014 Jan 07, Brett Snodgrass commented:

      Dear Reader,

      Thank you for providing the excellent report and images. Please provide your kind attention to the distinction between the Thebesian veins and the vessels of Wearn.

      http://bit.ly/JTWearn

      https://twitter.com/BrettSnodgrass1/status/415908673412530177

      A possible name for the title may be: Persistent vessels of Wearn Presenting as Ischemic Heart Disease.

      Comments and suggestions are welcome.

      Thank you kindly.


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    1. On 2017 Jul 11, Daniel Haft commented:

      Readers may wish to note that the passenger domain of this autotransporter has multiple copies of repeat that averages about 88 residues in length, with consensus sequence GDNTYAGGTEVEAGTLRVSRDANLGAAAGAVTLDGGALAATASFASARALTLKAAGALDVAAGTTLDWRGAVSGAGKLVKEGAGTLVL. The BatB orthologs discussed in this paper have 17 repeats in Bordetella pertussis and B. bronchiseptica, and 11 repeats in B. parapertussis. The deletion of 531 amino acids in B. parapertussis maps to this repeat region. Additional batB gene translations from Bordetella isolates obtained since this paper show additional examples of changes in the numbers of repeats. Since individual repeats are quite different from each other, these changing repeat copy numbers very likely represent natural variation, not sequencing and assembly errors. Therefore, the shorter form seen in B. parapertussis should not be viewed as non-functional simply because it shows a large deletion relative to B. pertussis.


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    1. On 2014 Jan 08, Tom Kindlon commented:

      More information on what exactly was measured in Reynolds (2004) would have been useful

      An important part of this paper is the indirect cost estimates taken from Reynolds et al [1]. It would have been useful to have been given clear information on what was measured in that study.

      The current paper says at one point: "Indirect costs include transportation, work productivity losses, disability reimbursements, loss of leisure or duties at home, or services provided by family members, friends, or other informal care providers". However what Reynolds measured was the loss of productivity. It didn't not measure the cost of disability re-imbursements, for example.

      This would partly explain differences with some other figures. For example, a report published by Sheffield Halham University in the UK in 2003 estimated the cost to the UK at 3.467 billion pounds Sterling. It calculated the "cost to the nation" by adding together the figure for the lost taxes from people not working plus the cost of paying them disability payments. There could be said to be pluses and minuses with either method of course.

      Also, one other minor point: it might have been useful to point out that part of the reason there would be discrepancies between quoted studies is the effect of inflation. For example, we are told "Lloyd and Pender estimated an average cost of $9,436 per patient with ME/CFS, including about AU $2,000 per patient in direct medical costs". But we are not told in the text that the Lloyd and Pender study was published in 1992 (perhaps the figure was increased due to inflation but this has not been made clear).

      References:

      [1] Reynolds KJ, Vernon SD, Bouchery E, Reeves WC. The economic impact of chronic fatigue syndrome. Cost Eff Resour Alloc. 2004 Jun 21;2(1):4.

      [2] Lloyd AR, Pender H. The economic impact of chronic fatigue syndrome. Med J Aust. 1992 Nov 2;157(9):599-601.


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    1. On 2013 Nov 05, Fiona Walsh commented:

      The beta-lactams in our study were not 'catabolised' but were digested by the antibiotic resistance enzymes, the beta-lactamases. We used the same strains as the Dantas study i.e. two beta-lactam catabolising bacteria and also identified that the degradation of the beta-lactams was due to the beta-lactamases. These bacteria were either Pseudomonas or Burkholderia species, both of which contain chromosomal beta-lactamases. We identified bacteria which presented with a streptomycin or trimethoprim 'catabolising' phenotype, which we isolated from soil (the original strains from Dantas et al., study with such phenotypes were lost). However, the HPLC experiments clearly showed that these antibiotics were not degraded over 28 days, we concluded based on these and other results that the bacteria did not catabolise the antibiotics. The Dantas study described the HPLC/ chemical degradation studies only for the beta-lactams (carbenicillin and penicillin) and extrapolated these results to all other classes of antibiotics described in the study.


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    2. On 2013 Nov 04, Laura Williams commented:

      Walsh F, 2013 recently investigated the central claim of this article, which is that many soil bacteria are able to grow using different classes of antibiotics as a single carbon source. Contrary to the findings of Dantas et al., Walsh et al. were only able to confirm catabolism of beta-lactam antibiotics, rather than catabolism of multiple classes of antibiotics. Their paper points to the presence of EDTA in the minimal medium used in the original study as a possible source of carbon sufficient for bacterial growth, which would suggest that growth in the media+antibiotic condition is not a indication of catabolism of the antibiotic, but simply antibiotic resistance.


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    1. On 2015 Jun 02, thomas samaras commented:

      Additional information is available on height, body size and longevity from the following publications.

      Samaras TT. Evidence from eight different types of studies showing that smaller body size is related to greater longevity. Journal of Scientific Research & Reports. 2014: 3 (16): 2150-2160, 2014; article no. JSRR.2014.16.003.

      Samaras TT. Human Scaling and Body Mass Index. In: Samaras TT (ed): Human Body Size and the Laws of Scaling: Physiological Performance, Growth, Longevity and Ecological Ramifications. New York: Nova Science Pub; 2007: pp 17-32.

      He Q, Morris BJ, Grove JS, Petrovitch H, Ross W, Masaki KH, et al. Shorter men live longer: Association of height with longevity and FOXO3 genotype in American men of Japanese ancestry. Plos ONE 9(5): e94385. doi:10.1371/journal.pone.0094385.

      Salaris L, Poulain M, Samaras TT. Height and survival at older ages among men born in an inland village in Sardinia (Italy), 1866-2006. Biodemography and Social Biology, 58:1, 1-13.

      Bartke A. Healthy Aging: Is Smaller better? A mini-review. Gerontology 2012; 58:337-43.


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    1. On 2014 Mar 09, Mark Milton commented:

      This a good review article. However, the values cited for the vitreal volume of the cynomolgus monkey are incorrect. The source articles were misread. The quoted vitreal volumes (1.5 and 3.2 mL) shouldn't be used when calculating a safety margin based upon the differences in vitreal volume between cynomolgus monkey and man.


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    1. On 2017 Jul 31, valentina di pietro commented:

      Notes: The substitution I226T has never been found in patients affected by Canavan disease. Bioinformatics tools recently deployed to predict mutations did not confirm substitution of I226T as a mutation. According to PredictSNP (https://loschmidt.chemi.muni.cz/predictsnp1/) which combines six different methods (MAPP, Phd-SNP, Poly-phen1, Poly-phen2, SIFT, SNAP) into a consensus classifier, this is a neutral substitution with an 83% level of confidence. Meta-SNP (http://snps.biofold.org/meta-snp/), a meta-predictor which combines the outputs of PANTHER, PhD-SNP, SIFT and SNAP gives a final score of 0.242 . Only a score >0.5 indicates prediction of disease mutations.


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    1. On 2014 Feb 11, Franz Adlkofer commented:

      Two papers from a research team at the Medical University of Vienna (MUV), the one above and a previous one [1], point to a genotoxic potential of radiofrequency electromagnetic fields. Both papers result from the REFLEX project, a multi-national study on biological effects of electromagnetic fields funded by the European Union, which I coordinated [2]. About three years after REFLEX had been completed all of a sudden the claim was circulated that the Vienna results might have been faked. With this allegation the editors of the two peer-reviewed scientific journals should be forced to retract the respective papers. However, they carried out their own investigations, and in both editorial boards the outcome of a thorough scrutiny led to the conclusion that there is no evidence of fraud.

      At the same time, the MUV mandated its Council for Scientific Ethics to investigate in detail how the Vienna REFLEX data were generated. This Council confirmed already at its first meeting and without any investigation the suspected fraud, and recommended the retraction of the two papers. By chance, it turned out that its chairman was a lawyer from the Austrian telecommunication industry. After his replacement the new Council came to the decision that the allegation is unfounded and that there is no reason to further pursue the case. Unhappy with this acquittal, the matter was finally transferred to the newly established Austrian Agency for Research Integrity that after a further scrutiny followed the Council’s decision [3].

      Criticism of scientific data is absolutely necessary, but to claim fraud in order to get rid of them is unacceptable, whatever the reasons behind.

      1. Diem E, Schwarz C, Adlkofer F, Jahn O, Rüdiger HW (2005) Non-thermal DNA breakage by mobile phone radiation (1800 MHz) in human fibroblasts and transformed GFSH-R17 rat granulosa cells in vitro. Mutat Res 583:178-83.
      2. See „REFLEX Final Report“ in http://www.itis.ethz.ch/assets/Downloads/Papers-Reports/Reports/REFLEXFinal-Report171104.pdf
      3. See “Part I. A campaign to destroy scientific findings” in http://www.kompetenzinitiative.net/assets/broschuerenreihe_heft-5_eng_screen.pdf


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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/283/17/11176.full.pdf?sid=a8d5dc2c-dd64-4b19-bf5e-c46f7deb9f49

      "This article has been withdrawn by the authors. The authors were recently made aware of issues in Figs. 1A and 2A. In Fig. 1A, the actERK2 panel was manipulated inappropriately, and the GST panel was duplicated in Fig. 1C as the GST panel. In Fig. 2A, the P-Elk panels for ERK2 were duplicated, and the right actERK2 panel for RSK was duplicated in the right actERK2 panel for cFOS. Because the original data are no longer available, in the interest of maintaining accuracy in the published scientific literature, the authors wish to withdraw this article. However, the authors have full confidence in the findings and conclusions of this paper and have replicated the findings in subsequent work."


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    1. On 2013 Jun 17, Mike Fay commented:

      This paper shows an improved way to calculate the variance when using multiple imputation with interval censored data. Huang, Lee and Yu show this is better than calculating the variance by using a correction for multiple imputation developed by Rubin for a different situation, that was used in earlier papers.

      Another advantage of this test (not studied in the original paper) is that it retains the type I error fairly well even when the assessment times depend on treatment (see my paper with Joanna Shih Fay MP, 2012).

      Software to calculate this test is available in the interval R package, http://cran.r-project.org/web/packages/interval/index.html.


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