What Did Deep DNA Sequencing of Traditional Chinese Medicines (TCMs) Really Reveal?

A recent study published in PLOS genetics[1] on a genetic audit of Traditional Chinese Medicines (TCMs) was widely covered in the news. The headlines are a bit confusing as they said different things. Some headlines say “Dangers of Chinese Medicine Brought to Light by DNA Studies“, others that Bear and Antelope DNA are Found in Traditional Chinese Medicine, and still others more neutrally: Breaking down traditional Chinese medicine.

What have Bunce and his group really done and what is the newsworthiness of this article?

Photos from 4 TCM samples used in this study doi/10.1371/journal.pgen.1002657.g001

The researchers from the the Murdoch University, Australia,  have applied Second Generation, high-throughput sequencing to identify the plant and animal composition of 28 TCM samples (see Fig.). These TCM samples had been seized by Australian Customs and Border Protection Service at airports and seaports across Australia, because they contravened Australia’s international wildlife trade laws (Part 13A EPBC Act 1999).

Using primers specific for the plastid trnL gene (plants) and the mitochondrial 16S ribosomal RNA (animals), DNA of sufficient quality was obtained from 15 of the 28 (54%) TCM samples. The resultant 49,000 amplicons (amplified sequences) were analyzed by high-throughput sequencing and compared to reference databases.

Due to better GenBank coverage, the analysis of vertebrate DNA was simpler and less ambiguous than the analysis of the plant origins.

Four TCM samples – Saiga Antelope Horn powder, Bear Bile powder, powder in box with bear outline and Chu Pak Hou Tsao San powder were found to contain DNA from known CITES- (Convention on International Trade in Endangered Species) listed species. This is no real surprise, as the packages were labeled as such.

On the other hand some TCM samples, like the “100% pure” Saiga Antilope powder, were “diluted” with  DNA from bovids (i.e. goats and sheep), deer and/or toads. In 78% of the samples, animal DNA was identified that had not been clearly labeled as such on the packaging.

In total 68 different plant families were detected in the medicines. Some of the TCMs contained plants of potentially toxic genera like Ephedra and Asarum. Ephedra contains the sympathomimetic ephedrine, which has led to many, sometimes fatal, intoxications, also in Western countries. It should be noted however, that pharmacological activity cannot be demonstrated by DNA-analysis. Similarly, certain species of Asarum (wild ginger) contain the nephrotoxic and carcinogenic aristolochic acid, but it would require further testing to establish the presence of aristolochia acid in the samples positive for Asarum. Plant DNA assigned to other potentially toxic, allergic (nuts, soy) and/or subject to CITES regulation were also recovered. Again, other gene regions would need to be targeted, to reveal the exact species involved.

Most newspapers emphasized that the study has brought to light “the dangers of TCM”

For this reason The Telegraph interviewed an expert in the field, Edzard Ernst, Professor of Complementary Medicine at the University of Exeter. Ernst:

“The risks of Chinese herbal medicine are numerous: firstly, the herbs themselves can be toxic; secondly, they might interact with prescription drugs; thirdly, they are often contaminated with heavy metals; fourthly, they are frequently adulterated with prescription drugs; fifthly, the practitioners are often not well trained, make unsubstantiated claims and give irresponsible, dangerous advice to their patients.”

Ernst is right about the risks. However, these adverse effects of TCM have long been known. Fifteen years ago I happened to have written a bibliography about “adverse effects of herbal medicines*” (in Dutch, a good book on this topic is [2]). I did exclude interactions with prescription drugs, contamination with heavy metals and adulteration with prescription drugs, because the events (publications in PubMed and EMBASE) were to numerous(!). Toxic Chinese herbs mostly caused acute toxicity by aconitine, anticholinergic (datura, atropa) and podophyllotoxin intoxications. In Belgium 80 young women got nephropathy (kidney problems) after attending a ”slimming” clinic because of mixup of Stephania (chinese: fangji) with Aristolochia fanghi (which contains the toxic aristolochic acid). Some of the women later developed urinary tract cancer.

In other words, toxic side effects of herbs including chinese herbs are long known. And the same is true for the presence of (traces of) endangered species in TCM.

In a media release the complementary health council (CHC) of Australia emphasized that the 15 TCM products featured in this study were rogue products seized by Customs as they were found to contain prohibited and undeclared ingredients. The CHC emphasizes the proficiency of rigorous regulatory regime around complementary medicines, i.e. all ingredients used in listed products must be on the permitted list of ingredients. However, Australian regulations do not apply to products purchased online from overseas.

Thus if the findings are not new and (perhaps) not applicable to most legal TCM, then what is the value of this paper?

The new aspect is the high throughput DNA sequencing approach, which allows determination of a larger number of animal and plant taxa than would have been possible through morphological and/or biochemical means. Various TCM-samples are suitable: powders, tablets, capsules, flakes and herbal teas.

There are also some limitations:

1. DNA of sufficient quality could only be obtained from appr. half of the samples.
2. Plants sequences could often not be resolved beyond the family level. Therefore it could often not be established whether an endangered of toxic species was really present (or an innocent family member).
3. Only DNA sequences can be determined, not pharmacological activity.
4. The method is at best semi-quantitative.
5. Only plant and animal ingredients are determined, not contaminating heavy metals or prescription drugs.

In the future, species assignment (2) can be improved with the development of better reference databases involving multiple genes and (3) can be solved by combining genetic (sequencing) and metabolomic (for compound detection) approaches. According to the authors this may be a cost-effective way to audit TCM products.

Non-technical approaches may be equally important: like convincing consumers not to use medicines containing animal traces (not to speak of  endangered species), not to order  TCM online and to avoid the use of complex, uncontrolled TCM-mixes.

Furthermore, there should be more info on what works and what doesn’t.

*including but not limited to TCM

References

1. Coghlan ML, Haile J, Houston J, Murray DC, White NE, Moolhuijzen P, Bellgard MI, & Bunce M (2012). Deep Sequencing of Plant and Animal DNA Contained within Traditional Chinese Medicines Reveals Legality Issues and Health Safety Concerns. PLoS genetics, 8 (4) PMID: 22511890 (Free Full Text)
2. Adverse Effects of Herbal Drugs 2 P. A. G. M. De Smet K. Keller R. Hansel R. F. Chandler, Paperback. Springer 1993-01-15. ISBN 0387558004 / 0-387-55800-4 EAN 9780387558004
3. DNA may weed out toxic Chinese medicine (abc.net.au)
4. Bedreigde beren in potje Lucas Brouwers, NRC Wetenschap 14 april 2012, bl 3 [Dutch]
5. Dangers in herbal medicine (continued) – DNA sequencing to hunt illegal ingredients (somethingaboutscience.wordpress.com)
6. Breaking down traditional Chinese medicine. (green.blogs.nytimes.com)
7. Dangers of Chinese Medicine Brought to Light by DNA Studies (news.sciencemag.org)
8. Chinese herbal medicines contained toxic mix (cbc.ca)
9. Screen uncovers hidden ingredients of Chinese medicine (Nature News)
10. Media release: CHC emphasises proficiency of rigorous regulatory regime around complementary medicines (http://www.chc.org.au/)

Health and Science Twitter & Blog Top 50 and 100 Lists. How to Separate the Wheat from the Chaff.

Recently a Top 100 scientists-Twitter list got viral on Twitter. It was published at accreditedonlinecolleges.com/blog.*

Most people just tweeted “Top 100 Scientists on Twitter”, others were excited to be on the list, a few mentioned the lack of scientist X or discipline Y  in the top 100.

Two scientist noticed something peculiar about the list: @seanmcarroll noticed two fake (!) accounts under “physics” (as later explained these were: @NIMAARKANIHAMED and @Prof_S_Hawking). And @nutsci (having read two posts of mine about spam top 50 or 100 lists [1, 2]) recognized this Twitter list as spam:

Beware of "top 100 scientists" and similar lists passing around twitter. See @laikas posts on why bit.ly/yPMSzG

—
Colby Vorland (@nutsci) March 18, 2012

It is surprising how easy it (still) is for such spammy Top 50 or 100 Lists to get viral, whereas they only have been published to generate more traffic to the website and/or to earn revenue through click-throughs.

It makes me wonder why well-educated people like scientists and doctors swallow the bait. Don’t they recognize the spam? Do they feel flattered to be on the list, or do they take offence when they (or another person who “deserves” it) aren’t chosen? Or perhaps they just find the list useful and want to share it, without taking a close look?

To help you to recognize and avoid such spammy lists, here are some tips to separate the wheat from the chaff:

1. Check WHO made the list. Is it from an expert in the field, someone you trust? (and/or someone you like to follow?)
2. If you don’t know the author in person, check the site which publishes the list (often a “blog”):
   1. Beware if there is no (or little info in the) ABOUT-section.
   2. Beware if the site mainly (only) has these kind of lists or short -very general-blogposts (like 10 ways to….) except when the author is somebody like Darren Rowse aka @ProBlogger [3].
   3. Beware if it is a very general site producing a diversity of very specialised lists (who can be expert in all fields?)
   4. Beware if the website has any of the following (not mutually exclusive) characteristics:
      1. Web addresses like accreditedonlinecolleges.com, onlinecolleges.com, onlinecollegesusa.org,  onlinedegrees.com (watch out com sites anyway)
      2. Websites with a Quick-degree, nursing degree, technician school etc finder
      3. Prominent links at the homepage to Kaplan University, University of Phoenix, Grand Canyon University etc
   5. Reputable sites less likely produce nonsense lists. See for instance this “Women in science blogging”-list published in the Guardian [4].
3. When the site itself seems ok, check whether the names on the list seem trustworthy and worth a follow. Clearly, lists with fake accounts (other then lists with “top 50 fake accounts” ) aren’t worth the bother: apparently the creator didn’t make the effort to verify the accounts and/or hasn’t the capacity to understand the tweets/topic.
4. Ideally the list should have added value. Meaning that it should be more than a summary of names and copy pasting of the bio or “about” section.
   For instance I have recently been put on a list of onlinecollegesusa.org [b], but the author had just copied the subtitle of my blog: …. a medical librarian and her blog explores the web 2.0 world as it relates to library science and beyond.
   However, sometimes, the added value may just be that the author is a highly recognized expert or opinion leader. For instance this Top Health & Medical Bloggers (& Their Twitter Names) List [5] by the well known health blogger Dean Giustini.
5. In what way do these lists represent *top* Blogs or Twitter accounts? Are their blogs worth reading and/or their Twitter accounts worth following? A nobel price winner may be a top scientist, but may not necessarily be a good blogger and/or may not have interesting tweets. (personally I know various examples of uninteresting accounts of *celebrities* in health, science and politics)
6. Beware if you are actively approached and kindly requested to spread the list to your audience. (for this is what they want).It goes like this (watch the impersonal tone):
   

   Your Blog is being featured!

   Hi There,

   I recently compiled a list of the best librarian blogs, and I wanted to let you know that you made the list! You can find your site linked here: [...]

   If you have any feedback please let me know, or if you think your audience would find any of this information useful, please feel free to share the link. We always appreciate a Facebook Like, a Google +1, a Stumble Upon or even a regular old link back, as we’re trying to increase our readership.

   Thanks again, and have a great day!

While some of the list may be worthwhile in itself, it is best NOT TO LINK TO DOUBTFUL LISTS, thus not  mention them on Twitter, not retweet the lists and not blog about it. For this is what they only want to achieve.

But what if you really find this list interesting?

Here are some tips to find alternatives to these spammy lists (often opposite to above-mentioned words of caution) 

1. Find posts/lists produced by experts in the field and/or people you trust or like to follow. Their choice of blogs or twitter-accounts (albeit subjective and incomplete) will probably suit you the best. For isn’t this what it is all about?
2. Especially useful are posts that give you more information about the people on the list. Like this top-10 librarian list by Phil Bradley [6] and the excellent “100+ women healthcare academics” compiled by @amcunningham and @trishgreenhalgh [7].
   Strikingly the reason to create the latter list was that a spammy list not recognized as such (“50 Medical School Professors You Should Be Following On Twitter”  [c])  seemed short on women….
3. In case of Twitter-accounts:
   1. Check existing Twitter lists of people you find interesting to follow. You can follow the entire lists or just those people you find most interesting.
      Examples: I created a list with people from the EBM-cochrane people & sceptics [8]. Nutritional science grad student @Nutsci has a nutrition-health-science list [9]. The more followers, the more popular the list.
   2. Check interesting conversation partners of people you follow.
   3. Check accounts of people who are often retweeted in the field.
   4. Keep an eye on #FF (#FollowFriday) mentions, where people worth following are highlighted
   5. Check a topic on Listorious. For instance @hrana made a list of Twitter-doctors[10]. There are also scientists-lists (then again, check who made the list and who is on the list. Some health/nutrition lists are really bad if you’re interested in science and not junk)
   6. Worth mentioning are shared lists that are open for edit (so there are many contributors besides the curator). Lists [4] and [7] are examples of crowd sourced lists. Other examples are truly open-to-edit lists using public spreadsheets, like the Top Twitter Doctors[11], created by Dr Ves and  lists for science and bio(medical) journals [12], created by me.
4. Finally, if you find the spam top 100 list truly helpful, and don’t know too many people in the field, just check out some of the names without linking to the list or spreading the word.

*For obvious reasons I will not hyperlink to these sites, but if you would like to check them, these are the links

[a] accreditedonlinecolleges.com/blog/2012/top-100-scientists-on-twitter

[b] onlinecollegesusa.org/librarian-resources-online

[c] thedegree360.onlinedegrees.com/50-must-follow-medical-school-professors-on-twitter

Related articles

1. Beware of Top 50 “Great Tools to Double Check your Doctor” or whatever Lists. (laikaspoetnik.wordpress.com)
2. Vanity is the Quicksand of Reasoning: Beware of Top 100 and 50 lists! ((laikaspoetnik.wordpress.com)
3. Google+ Tactics of the Blogging Pros (problogger.net)
4. “Women in science blogging” by Martin Robbins ( http://www.guardian.co.uk/science)
5. Top Health & Medical Bloggers (& Their Twitter Names) List (blog.openmedicine.ca)
6. Top-10 librarian list by Phil Bradley (www.blogs.com/topten)
7. 100+ women healthcare academics by Annemarie Cunningham/ Trisha Greenhalgh (wishfulthinkinginmedicaleducation.blogspot.com)
8. Twitter-doctors by @hrana (listorious.com)
9. EBM-cochrane people & sceptics (Twitter list by @laikas)
10. Nutrition-health-science (Twitter list by @nutsci)
11. Open for edit: Top Twitter Doctors arranged by specialty in alphabetical order (Google Spreadsheet by @drves)
12. TWITTER BIOMEDICAL AND OTHER SCIENTIFIC JOURNALS & MAGAZINES (Google Spreadsheet by @laikas)

Silly Sunday #50: Molecular Designs & Synthetic DNA

As a teenager I found it hard to picture the 3D structure of DNA, proteins and other molecules. Remember we didn’t have a computer then, no videos, nor 3D-pictures or 3D models.

I tried to fill the gap, by making DNA-molecules of (used) matches and colored clay, based on descriptions in dry (and dull 2D) textbooks, but you can imagine that these creative 3D clay figures beard little resemblance to the real molecular structures.

But luckily things have changed over the last 40 years. Not only do we have computers and videos, there are also ready-made molecular models, specially designed for education.

O, how I wished, my chemistry teachers would have had those DNA-(starters)-kits.

Hattip: Joanne Manaster‏ @sciencegoddess on Twitter: 

Curious? Here is the Products Catalog of http://3dmoleculardesigns.com/news2.php

Of course, such “synthesis” (copying) of existing molecules -though very useful for educational purposes- is overshadowed by the recent “CREATION of molecules other than DNA and RNA [xeno-nucleic acids (XNAs)], that can be used to store and propagate information and have the capacity for Darwinian evolution.

But that is quite a different story.

Related articles

• Friday Foolery #49: The Shortest Abstract Ever! [2] (laikaspoetnik.wordpress.com)
• Synthetic DNA substitute gets its own enzymes, undergoes evolution (arstechnica.com)
• DNA Alternative Created By Scientists (freeinternetpress.com)
• Evolution seen in ‘synthetic DNA’ (talesfromthelou.wordpress.com)

Friday Foolery #49: The Shortest Abstract Ever! [2]

In a previous Friday Foolery post I mentioned what I thought was the shortest abstract ever.

 ”Probably not”.

But a reader (“Trollface”) pointed out in a comment that there was an even shorter (and much older) abstract of a paper in the Bulletin of the Seismological Society of America. It was published in 1974.

The abstract simply says: Yes.

It could only be beaten by an abstract saying: “No”, “!”, “?” or a blank one.

Related articles

• Friday Foolery #46 Bad Science: The Psychology Behind Exaggerated & False Results (laikaspoetnik.wordpress.com)
• Friday Foolery # 47 WTF, the True Spirit of Christmas (laikaspoetnik.wordpress.com)
• Friday Foolery #48 Brilliant Library Notices (laikaspoetnik.wordpress.com)

Friday Foolery #48 Brilliant Library Notices

Today’s Friday Foolery post is handed on a silver platter by my Australian friend Mike Cadogan @sandnsurf from Life in the Fast Lane

brilliant library notice | The Poke: bit.ly/zULx5p cc @laikas

—
Mike Cadogan (@sandnsurf) January 12, 2012

Yes, aren’t these brilliant librarian notices from the Milwaukee Public Library?!

Note:

@Bitethedust, also from Australian rightly noticed: there’s no better place to stick @sandnsurf than in Friday foolery

Indeed at Life at the Fast Lane they have fun posts amidst the serious (mostly ER) topics. Want more Friday Fun than have a look at the Funtabulously Frivolous Friday Five Posts.

Related articles

• Friday Foolery # 47 WTF, the True Spirit of Christmas (laikaspoetnik.wordpress.com)
• Friday Foolery #46 Bad Science: The Psychology Behind Exaggerated & False Results (laikaspoetnik.wordpress.com)
• Friday Foolery #44. The Shortest Abstract Ever. (laikaspoetnik.wordpress.com)
• Friday Foolery #45. What have you got in your head? (laikaspoetnik.wordpress.com)

“Pharmacological Action” in PubMed has no True Equivalent in OVID MEDLINE

Searching for EMBASE Subject Headings (the EMBASE index terms) for drugs is relatively straight forward in EMBASE.

When you want to search for aromatase inhibitors you first search for the Subject Heading mapping to aromatase inhibitors (aromatase inhibitor). Next you explode aromatase inhibitor/ if you are interested in all its narrower terms. If not, you search both for the general term aromatase inhibitor and those specific narrower terms you want to include.
Exploding aromatase inhibitor (exp aromatase inhibitor/) yields 15938 results. That is approximately twice what you get by searching aromatase inhibitor/ alone (not exploded). This yields 7434 hits.

It is different in MEDLINE. If you search for aromatase inhibitors in the MeSH database you get two suggestions.

The first index term “Aromatase Inhibitors” is a Mesh. It has no narrower terms.
Drug-Mesh are generally not arranged by working mechanism, but by chemical structure/type of compound. That is often confusing. Spironolactone for instance belongs to the MeSH Lactones (and Pregnenes) not to the MeSH Aldosterone Antagonists or Androgen Antagonist. Most Clinicians want to search for a group of compounds with the same mechanism of action, not the same biochemical family

The second term “Aromatase Inhibitors” [Pharmacological Action]  however does stand for the working mechanism. It does have narrower terms, including 2 MeSH terms (highlighted) and various substance names, also called Supplementary Concepts. 

For complete results you have to search for both MeSH and Pharmacological action: “Aromatase Inhibitors”[Mesh] yields 3930 records, whereas (“Aromatase Inhibitors”[Mesh]) OR “Aromatase Inhibitors” [Pharmacological Action] yields 6045. That is a lot more.

I usually don’t search PubMed, but OVID MEDLINE.

I know that Pharmacological Action-subheadings are important, so I tried to find the equivalent in OVID .

I found the MeSH Aromatase Inhibitors, but -unlike PubMed- OVID showed only two narrower Drug Terms (called Non-MeSH here versus MeSH in PubMed).

I found that odd.

I reasoned “Pharmacological action” might perhaps be combined with the MESH in OVID MEDLINE. This was later confirmed by Melissa Rethlefsen (see Twitter discussion below)

In Ovid MEDLINE I got 3937 hits with Aromatase Inhibitors/ and 5219 with exp Aromatase Inhibitors/ (thus including aminogluthemide or Fadrozole)

At this point I checked PubMed (shown above). Here I found  that “Aromatase Inhibitors”[Mesh] OR “Aromatase Inhibitors” [Pharmacological Action] yielded 6045 hits in PubMed, against 5219 in OVID MEDLINE for exp Aromatase Inhibitors/

The specific aromatase inhibitors Aminogluthemide/and Fadrozole/ [set 60] accounted fully for the difference  between exploded [set 59] and non-exploded Aromatase Inhibitors[set 58].

But what explained the gap of approximately 800 records between “Aromatase Inhibitors”[Mesh] OR “Aromatase Inhibitors”[Pharmacological Action]* in PubMed and exp aromatase inhibitors/ in OVID MEDLINE?

Could it be the substance names, mentioned under “Aromatase Inhibitors”[Pharmacological Action], I wondered?

Thus I added all the individual substance names in OVID MEDLINE (code= .rn.). See search set 61 below.

Indeed these accounted fully for the difference (set 62= 59 or 61 : the total number of hits in PubMed is similar)

It obviously is a mistake of OVID MEDLINE and I will inform them.

For the meanwhile, take care to add the individual substance names when you search for drug terms that have a pharmacological action-equivalent in PubMed. The substance names are not automatically searched when exploding the MeSH-term in OVID MEDLINE.

——–

For more info on Pharmacological action, see: http://www.nlm.nih.gov/bsd/disted/mesh/paterms.html

Twitter Discussion between me and Melissa Rethlefsen about the discrepancy between PubMed and OVID MEDLINE (again showing how helpful Twitter can be for immediate discussions and exchange of thoughts)

[read from bottom to top]

Related articles

• Things to Keep in Mind when Searching OVID MEDLINE instead of PubMed (laikaspoetnik.wordpress.com)

Grand Rounds: Evolving from Link-♥♥ to ♬♫-Links?

Grand Rounds is “the weekly summary of the best healthcare writing online”. I’ve hosted this medical blog carnival twice and considered it a great honor to do so.

I have submitted a lot of posts to the Grand Rounds. Often I even wrote a special blog post to fit the theme if there was one. Almost all my submissions have been accepted. I really enjoyed the compilations. There was a lot of outstanding creativity and originality in how the links to the blogs were “aggregated” and highlighted.

Usually I only read those posts that seemed the most interesting to me (the summary thus works as a filter). But through the Grand Rounds I read posts that I would never have read and I learned about bloggers I never heard of.

Why am I talking in the past tense? The Grand Round is still there, isn’t it?!

Yes, it is still there (luckily), but the organizers are thinking of a “rejuvenation of  this old dinosaur”. As the previous host, Margaret Polaneczky explained

“… Grand Rounds has dropped a bit off all of our radars. Many, if not most of us have abandoned the old RSS feed to hang out on Twitter, where our online community has grown from a few dozen bloggers to feeds and followers in the hundreds and even thousands.”

One of the measures is that the Grand Rounds editions should be more concise and only include the “best posts”.

I too go for quality, and think one should carefully select contributors (and hosts), but is the 7-year-old dinosaur to be saved by chopping him in pieces? Should we only refer to 10 posts at the max and put the message in a tweet-format like Margaret did in an experiment?
I was glad that Margaret gave a good old fashioned long introduction in the Dinosaur’s style, for that was what I read, NOT the tweets. Sorry tweets are NOT a nice compilation. They are difficult to read.
It also isn’t a solution to tweet the individual links, because a lot of those individual tweets will be missed by most of the potential readers. It is not coherent either. The strength of the Grand Rounds is in the compilation, in the way the host makes the posts digestible. I would say: let the host present the posts in an attractive way and let the reader do the selection and digestion.

Also important: how many of us will write blog posts specially for the Grand Rounds if there is a chance of 2 in 3 that it will be rejected?

It is true that the Grand Rounds is less popular than a few years ago and it is harder to get hosts. But that may partly have to do with advertising. My first Grand Rounds got far more hits than the second one, mainly because we sent a notice to great blogs that linked to us, like Instapundit (853 hits alone) and there was an interview with the host announcing the Grand Rounds at MEDSCAPE. In this way the main intended audience (non-blogging lay people) were also reached. The second time my post was just found by a handful of people checking the edition plus this blog own readers.
(I have to admit that this last Grand Rounds Edition might have been better if it had been more concise, but at least one person (Pranab of Scepticemia) spend  2 hours in reading almost all the posts of the round-up. So it wasn’t for nothing)

If some busy clinicians can be persuaded to host The Grand Rounds using a shorter format, that is fine. And it is good to be more concise and leave out what isn’t of high quality. But why make it a rule to include just 10 or 12? Even more important, don’t change blog posts for tweets. For I don’t think, as Margaret passed on, that the concept of the individual blog has been sometimes “overshadowed by Twitter and Facebook, whose continual unending stream demands our constant attention, lest we miss something important that someone said or re-said…” Even I have given up to constantly follow all streams, and I suppose the same is true for most clinicians, nurses etc. Lets not replace posts by tweets but lets use Twitter and Facebook to promote the Grand Rounds and augment its radius.

The main reason for writing this post is that I disliked the description by Bryan Vartebedian (host of the next round) rather off-putting, perhaps even arrogant:

Grand Rounds is evolving as a more focused, curated publication.  Rather than a 4,000 word chain-o-links, Nick Genes, Val Jones and others felt that a focused collection of recommendations would be more manageable for both readers and hosts.  This is Grand Rounds for quality rather than link love.

Bryan loves the word link-love. Two posts back he wrote:

It isn’t contacts, followers, friends, subscriptions, readers, link love, mentions, or people’s attention.  It’s time.  With time I can have all of these things.  

“Link love” and “chain-o-links” undervalue what blog carnivals are about. Perhaps some bloggers just want to be linked to, but most want to be read, and that is the entire idea behind the blog carnival. I can’t imagine that the blog hosts aim to include as many links as possible. At the most it is love for particular posts not “link love” perse.

Changing the format to tweets (♬♫) will only increase the link/text ratio. Links will become more prominent.

I would rather go for the ♥♥-links*, because I ♥ to blog and I ♥ to read good stuff.

——–

* Note that ♥♥-links is not the same as link-♥

——–

Here is a short Twitter Discussion about the new approach. I fully agree with Ves Dimov viewpoint, especially the last tweet.

@laikas Grand Rounds keep changing – now it's "Submit your buddy's blog and the host will decided whether to include it, 10 links max in GR"—
Ves Dimov, M.D. (@DrVes) January 07, 2012

@laikas Me too—
  (@rlbates) January 07, 2012

RT @DrVes: @laikas Even if you submit to Grand Rounds, the post may not be included. Selection criteria are unclear, and change from hos …—
Bongi (@Bongi1) January 07, 2012

RT @DrVes: @laikas That said, I still think Grand Rounds is a great initiative but sometimes it's difficult to embrace each of its evolv …—
Bongi (@Bongi1) January 07, 2012

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