A quick response to Beall's latest blog

Date: 2015-04-28

A quick response to the latest blog of Mr. Beall
http://scholarlyoa.com/2015/04/23/more-published-pseudo-science-from-chinese-publisher-scirp/): the article “Changes in congenital anomaly incidence in West Coast and Pacific States (USA) after arrival of Fukushima fallout” has been peer-reviewed and the results are to accept the paper. More details have been provided here:


Review 1:

This study should be published, although not in its current form. The tables would be easier to understand in a different format and with some additional clarification and description in both the text and in a table legend.

It is somewhat confusing as to how the actual dates of data accruement were chosen: all 5 congenital anomalies chosen to report would have occurred before 3 months ega so, unless births in April, May, June, July, Aug and Sept (and possibly Oct) are used as a control population (representing 10-4 months of ega at time of exposure respectively), one would not predict the in utero exposure to have an effect on the defects chosen.  It might be better (except in the case of premature births) to use data from infants born in Oct,Nov, Dec and Jan (representing in utero exposure at 4, 3, 2 and 1 month, respectively) as that might increase the statistical significance of the findings.

It is also interesting that Hawaii, which is about 1000 miles closer to Japan, than California, has lower rates. Thus, some mechanism needs to be used to be able to compare aggregate data from each state.  That is usually the number per 100,000 births, but that seems to be skewed here as well.

Finally, in describing the different anomalies, the authors should include more information about embryology--for example, timing of closure of the anterior neuropore in anencephaly (week 4 postconception), the posterior neuropore in spina bifida (week 4 postconception), the palate and lip (4-6 weeks postconception) and the return of the intestines and closure of the abdominal wall in omphalocele (by week 11 postconception). Regarding the use of trisomy 21 as a measured anomaly syndrome, since this condition is related to preconception or time of conception (as meiosis is completed in the egg only after conception) nondisjunction, one might predict an increase in the future overall rates of trisomy 21 occurrence since nondisjunction can affect any gamete after exposure.

Again, this paper should be published, it is just rather difficult to read and understand in its current form.

Review 2:

The article requires major revision for acceptance in the journal.

A. The introduction should be short mentioning only relevant points.

B. What is new in the incidence of congenital malformation in this article. Please highlight those points.

C. The methodology requires explanation---The statistical significance of differences in 2010-2011 changes between the two groups of states will be tested using a formula (below) that creates a 95% confidence interval of the differences. If the upper and lower bounds of the confidence interval both exceed zero, the difference is statistically significant

D. what was the inclusion and exclusion criteria?

E. Were these pregnant females exposed to any other teratogens? Pl mention

F. The discussion should be short related to your results.

Review 3:

This is a very interesting analysis which makes the most of the available data to ask questions about the effects of the very low levels of radionuclide contamination from Fukushima which reached the west coast of the USA. The authors have avoided a time series and compared increases in two reasonably chosen groups, exposed and not exposed to fallout from Fukushima. The statistical method they chose to use seems rather unusual but is not to be faulted for that reason. I would prefer to see tables showing the base populations in each group and time period, but the populations can be generated from the data they give, and using a different approach shows that their statistical conclusions are valid.  It would have been interesting to see what the normal variation in the rates of these combined malformations are over a longer period, say from 2005, so that we can be secure that the rate change per year is less than the rate changes which they  ascribe to Fukushima. I do not demand that, but I believe their paper would be stronger for it, and it is certain that there will be criticisms from others on this matter. However, the comparisons of the high dose and low dose groups seem to show that these low dose exposures are having an effect. Other studies have also suggested that the foetus is exquisitely sensitive to internal radiation exposures and I believe this paper should be published to encourage further research on this very serious and important issue.

Review 4:

(1) Major comments

- Word count- the whole write up needs to be concise and succinct, including introduction.

- Methodology needs to be precise,

- You cannot just cite US CDC tables, you have to summarize in order to make it simple.

- Results needs major revamp- make a single comparative pre post table including P values and important details

- Limitations & Future directions of your study needs to be discussed

(2) Minor comments

- Affiliations not mentioned

- Conflict of interest not clarified