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-   -   "Maternal and Neonatal Vaccination Protects Newborn Baboons From Pertussis Infection" (http://www.mothering.com/forum/47-vaccinations/1399751-maternal-neonatal-vaccination-protects-newborn-baboons-pertussis-infection.html)

teacozy 03-31-2014 08:31 AM

http://m.jid.oxfordjournals.org/content/early/2014/02/12/infdis.jiu090.short

 

This was posted in the VOS forum, and thought I would bring it here. 

 

"Results. Naïve infant baboons developed severe disease when challenged with B. pertussis at five weeks of age. Baboons receiving aP vaccine and infants born to mothers vaccinated at the beginning of their third trimester were protected.

Conclusions. Our results demonstrate that neonatal vaccination and maternal vaccination confer protection in the baboon model and support further study of these strategies for protection of newborns from pertussis infection." 

So for debate, what do you make of these results? Compelling? 


Taximom5 03-31-2014 10:00 AM

We can't tell from the link whether the infant baboons were breastfed by their mothers or fed formula in the lab.  If they were not exclusively breastfed, that pretty much invalidates the study.


samaxtics 03-31-2014 10:39 AM

As is said, the devil is in the details.  Teacozy do you have access to the full study?

 

From what is presented, sounds to me they are looking for the CDC to schedule the pertussis vaccine for pregnant women (will ob/gyns then "fire"/ refuse to take on patients who don't vaccinate?) and infants younger than the current 2 months old.

 

Was this study received favourably on VOS?  I ask because I have seen some P'vers eschew baboon studies.


teacozy 03-31-2014 11:15 AM

Quote:
Originally Posted by samaxtics View Post
 

As is said, the devil is in the details.  Teacozy do you have access to the full study?

 

From what is presented, sounds to me they are looking for the CDC to schedule the pertussis vaccine for pregnant women (will ob/gyns then "fire"/ refuse to take on patients who don't vaccinate?) and infants younger than the current 2 months old.

 

Was this study received favourably on VOS?  I ask because I have seen some P'vers eschew baboon studies.

 

I went through a couple of the previous baboon threads and didn't see anyone dismiss the study because it used baboons.  

 

Indeed, I actually posted a link in a thread not too long ago and even quoted a part that actually stated that Primate studies are a great way to study pattern of disease in humans. 

 

What will be interesting is to see how/if NVers who previously posted, quoted, and referenced the other baboon study whose results they liked will try and spin this one to somehow not mean anything.  

 

There's a term for this phenomenon and it's called confirmation bias. 

 

@Taximom5  

 

I have no idea if they were breastfed or not, but I see no reason why they wouldn't have been.  Bottle feeding that many baby primates around the clock would take up a lot of time/money/resources and wouldn't have a purpose in this study. 

 

Additionally, everything I've seen online says that breastfeeding doesn't provide any protection against pertussis (unless the mother has been recently vaccinated).  It does for other diseases, but not this one.  So I'm not sure why it matters, anyway.  If you have a reputable source that says otherwise I'd be interested in seeing it.  I haven't looked into that specific issue very much at all.  


kathymuggle 03-31-2014 12:00 PM

Quote:
Originally Posted by teacozy View Post
 

 

 

What will be interesting is to see how/if NVers who previously posted, quoted, and referenced the other baboon study whose results they liked will try and spin this one to somehow not mean anything.  

 

:eyesroll

 

My concerns with vaccination during pregnancy have more to do with safety than effectiveness.


pers 03-31-2014 12:31 PM

Quote:
Originally Posted by Taximom5 View Post

We can't tell from the link whether the infant baboons were breastfed by their mothers or fed formula in the lab.  If they were not exclusively breastfed, that pretty much invalidates the study.

Why would that invalidate the study?

samaxtics 03-31-2014 12:52 PM

Quote:
Originally Posted by teacozy View Post
 

 

I went through a couple of the previous baboon threads and didn't see anyone dismiss the study because it used baboons.  

 

Indeed, I actually posted a link in a thread not too long ago and even quoted a part that actually stated that Primate studies are a great way to study pattern of disease in humans. 

 

What will be interesting is to see how/if NVers who previously posted, quoted, and referenced the other baboon study whose results they liked will try and spin this one to somehow not mean anything.  

 

There's a term for this phenomenon and it's called confirmation bias. 

 

 

I didn't say the P'vers were here at MDC (as I could not recall where it was) and I was careful to use the qualifier "some".

 

There is not enough info in the abstract.  Have you seen the full study TeaCozy?


kathymuggle 03-31-2014 01:12 PM

i thought this article was quite good.  It talked about maternal antibody transfer, including historical data.

 

One theory it put forth was that breastfeeding did offer some protection during the first month.  Historically, deaths from pertussis were higher in the second and third month, and the authors specualte this might be caused my maternal antibody transfer.   I can see other reasons why this might be (were aboslute newborns more likely to be kept at home?  Does it take some time for pertussis to kill infants - which is why we did not see deaths in those under a month?)

 

http://www.hpsc.ie/hpsc/A-Z/VaccinePreventable/PertussisWhoopingCough/NIAC/File,13702,en.pdf

 

"Pertussis notification data from the prevaccine era pro- vide indirect evidence that maternal antibodies provide short lived protection against fatal pertussis by demonstrating that the rate of pertussis deaths in the first month of life was approximately one-third of that in the second and third months of life.24 In contrast, pertussis surveillance data in the vaccine era no longer demonstrate a substantial difference in pertussis-related mortality between the first and second months of life (Table 1).25 This could be the consequence of reduced levels of circulation of Bordetella pertussis in young women of childbearing age after the introduction of mass immunization. Although it is difficult to draw direct compar- isons because of the different laboratory methods, this hy- pothesis is supported indirectly by serologic data. In the prevaccine era, 30–50% of pregnant women had circulating antibodies against pertussis8,11; whereas more recent studies found low anti-PT IgG levels (geometric mean titer, 􏰃10 enzyme-linked immunosorbent assay units/mL) in the major- ity of women.17,26 "


kathymuggle 03-31-2014 01:37 PM

This is what the FDA had to say:

 

"To evaluate the effectiveness of maternal vaccination for the prevention of pertussis, OVRR scientists vaccinated eight female baboons three times before pregnancy with an FDA-approved DTaP vaccine. Seven became pregnant and were subsequently administered a booster shot at the beginning of their third trimester of pregnancy. To evaluate the response in neonatal baboons, the scientists used an FDA-approved DTaP vaccine to immunize two infant baboons at two days of age and two baboons at both two and 28 days of age; three infant baboons remained unvaccinated.  
 

When exposed to B. pertussis, all four vaccinated infant baboons produced high levels of antibodies and remained free of symptoms, even though their respiratory tract was highly colonized with the bacteria. The three unvaccinated animals developed symptoms of severe pertussis disease.  
 
The seven infant baboons born to vaccinated mothers became heavily colonized by the bacteria after exposure to B. pertussis, but did not develop symptoms of pertussis. "

 

http://www.fda.gov/BiologicsBloodVaccines/ScienceResearch/ucm387180.htm

 

so, two issues:

 

1. Is there a control group of unvaccinated during pregnancy and  infancy baboons?  I am not seeing it.  How big is it?  The sample size of the group discussed above is tiny.  

 

2.  It seems those vaccinated in pregnancy alone ( a grand total of 3) did not fare as well as those vaccinated in infancy (total: 4)  Once again, it would have been interesting to see how the vaccinated in pregnancy group fared compared to those unvaccinated during pregnancy.  

 

Ah, well, we need the full study and the sample groups seem really small.  

 

(ETA:  I do not know if the other baboon study was equally small, it probably was if it was the same people doing the research.  If that is a case, then yes, it would have been a flaw in the previous research as well.  That being said, I know the previous baboon study simply confirmed what a bunch of other studies said.  I do not know if this study also confirms what other studies said, if it is a one-off, etc. )


samaxtics 03-31-2014 03:57 PM

What am I missing?  In one breath it says three of the unvaccinated baboons developed symptoms of severe disease but then it says that all seven baboons born to vaccinated mothers, although highly colonized with b.pertussis, did not develop symptoms of pertussis.  Which is it?


kathymuggle 03-31-2014 05:29 PM

I am not sure what is up.  I go back to "we need the full study." I relooked at the FDA article and am still confused/feel like I am missing data.  I did not snip any of the quote, so it isn't a context issue.  


Taximom5 03-31-2014 06:24 PM

Quote:
Originally Posted by pers View Post


Why would that invalidate the study?


We don't know whether breastfeeding has an inhibitory effect on acellular vaccines.  We do know that it does with live-virus vaccines.


samaxtics 03-31-2014 07:11 PM

Quote:
Originally Posted by kathymuggle View Post
 

I am not sure what is up.  I go back to "we need the full study." I relooked at the FDA article and am still confused/feel like I am missing data.  I did not snip any of the quote, so it isn't a context issue.  

Sorry kathymuggle,  I should have stated that it was what I also read at the FDA article you linked to; I didn't mean to infer that you had copied it wrong.

 I read it several times to make sure I wasn't missing another group.  Regardless, the take away for me is that the maternity dose of DTaP doesn't protect newborn baboons at 5 weeks of age, so why risk it?

And possibly, if 7/8 recently vaccinated baboons become pregnant then the vaccine causes infertility in 1/8 baboons. ;) 


mama24-7 03-31-2014 07:16 PM

Quote:
Originally Posted by samaxtics View Post

And possibly, if 7/8 recently vaccinated baboons become pregnant then the vaccine causes infertility in 1/8 baboons. ;) 

:laugh

 

Sus


kathymuggle 03-31-2014 07:17 PM

Quote:
Originally Posted by samaxtics View Post
 

Sorry kathymuggle,  I should have stated that it was what I also read at the FDA article you linked to; I didn't mean to infer that you had copied it wrong.  Oh, no, I did not take it that way.    No need for apologies :)

 I read it several times to make sure I wasn't missing another group.  Regardless, the take away for me is that the maternity dose of DTaP doesn't protect newborn baboons at 5 weeks of age, so why risk it?

And possibly, if 7/8 recently vaccinated baboons become pregnant then the vaccine causes infertility in 1/8 baboons. ;) lol


prosciencemum 03-31-2014 11:53 PM

For me it's not about a single study (which can be interesting and worth following up but shouldn't in itself completely change the best advice).

In general I'm fairly convinced of the worth of pertussis vacation for pregnant women in order to protect newborns, so if I were pregnant now I would talk to my midwife about getting it.

Taximom5 04-01-2014 04:11 AM

Quote:
Originally Posted by samaxtics View Post

What am I missing?  In one breath it says three of the unvaccinated baboons developed symptoms of severe disease but then it says that all seven baboons born to vaccinated mothers, although highly colonized with b.pertussis, did not develop symptoms of pertussis.  Which is it?

Both.

Three unvaxxed baboons developed symptoms of severe disease.

All 7 baboons born to VAXXED mothers did not develop symptoms, but were still highly colonized with pertussis (which means they would spread the disease).

samaxtics 04-01-2014 07:01 AM

Quote:
Originally Posted by Taximom5 View Post


Both.

Three unvaxxed baboons developed symptoms of severe disease.

All 7 baboons born to VAXXED mothers did not develop symptoms, but were still highly colonized with pertussis (which means they would spread the disease).

 

It can't be though.  There are only 7 baboon babies total in the study.  All the mothers were vaccinated pre pregnancy and in the third trimester.  Two baboon babies were vaccinated with DTaP at 2 days and two baboon babies were vaccinated at 2 and 28 days.  Three of the baboon babies were not vaccinated.

So the FDA statements:

 

"The three unvaccinated animals developed symptoms of severe pertussis disease."  

 

The seven infant baboons born to vaccinated mothers became heavily colonized by the bacteria after exposure to B. pertussis, but did not develop symptoms of pertussis. "
 
are contradictory.  

 

Contradiction aside, this really isn't an endorsement for the pregnancy vaccine.  But I smell a birth dose coming for babies.


beckybird 04-01-2014 09:09 AM

So now it's ok to use animals in a vaccine study, as long as the results show the benefits of vaccines? I've been asking for years for an animal study that  compares completely unvaccinated animals to fully-vaccinated animals. Compare the health and behaviors between the groups.

 

It's nice that this tiny animal study depicts vaccines in a positive way. However, I am more concerned about the potential neurological and immune system damage from the adjuvants and other chemicals in vaccines. So are many other non/selective/delayed vaccinating parents. Isn't it time to work on a study for that? Since we can accept baboon vaccine studies now, what is the delay for a full-schedule vs. unvacciated study? I'm waiting! 

Oh, and this study needs to be completely transparent. 


samaxtics 04-01-2014 10:51 AM

Quote:
Originally Posted by prosciencemum View Post

For me it's not about a single study (which can be interesting and worth following up but shouldn't in itself completely change the best advice).

In general I'm fairly convinced of the worth of pertussis vacation for pregnant women in order to protect newborns, so if I were pregnant now I would talk to my midwife about getting it.

 

My question is what is their "best advice" based on?  Is it based on similar or even any studies on humans?  

 

And it's not just the pertussis vaccine you would be getting in pregnancy.  It also has diphtheria and tetanus and the recommendation is to get the dTaP for each pregnancy.

Where is the "science" on getting vaccinated over and over and over with diphtheria and tetanus?  


beckybird 04-01-2014 11:08 AM

Where is the science for the entire schedule for US children? The CDC should not use observation to prove the schedule is safe, because it will not accept parental observation of adverse events after vaccination.

 

The CDC cannot have it both ways. It cannot say the entire schedule is safe because "we've been vaccinating for years and kids are just fine" (aka, observation of the children), while at the same time, when parents report adverse events after vaccination--autism or Guillain Barre for example, the adverse effects are usually considered to be coincidences. The CDC schedule is not based on science, but on observation. The same type of observation that is not good enough if you are reporting a reaction. There are no scientific studies to support the CDC schedule. 

 

So, if I understand it correctly, it is only a coincidence if there is an adverse effect? Where is the actual science behind the US schedule? There is nothing. The health of kids in the US is far below many other countries, and our schedule is nearly double that of other countries. Coincidene, right? 

 

Ha. Coincidence Theorists strike again.


pers 04-01-2014 11:28 AM

Quote:
Originally Posted by Taximom5 View Post
 


We don't know whether breastfeeding has an inhibitory effect on acellular vaccines.  We do know that it does with live-virus vaccines.

 

This still wouldn't invalidate the study which is testing so far as asking if the maternal vaccination or early vaccination confers protection.  Factors that can hinder this would be another question that should be looked into, but there isn't any point in going there if the answer to the first question is no.

 

Do we know that breastfeeding has an inhibitory effect on live-virus vaccines?  We know it does for rotavirus when breastmilk from a mother with high antibodies for rotavirus mixes directly with the rotavirus vaccine in the baby's stomach so neutralizes it before the baby's immune system has a chance to respond.  That's all I have heard of - though I do wonder about oral polio too.  Have you seen it mentioned in regards to other vaccines?

 

Maternal antibodies the baby is born with can interfere with the MMR and chickenpox, but my assumption would be that that is due to the high level of antibodies in the mother since the infections give lifelong immunity and the measles vaccine likely gives lifelong immunity too and the others at least long lasting immunity.  It would make sense to me that this would not be so much of a problem with vaccines/disease for which there is not lifelong immunity such as tetanus and whooping cough.  But this is just me thinking, so grain of salt, and I have no idea how polio fits in with that idea.

 

There are studies looking at how long maternal measles antibodies from vaccinated mothers lasted compared to mothers who have had natural measles infection (the latter lasts a lot longer, of course), which also looked at other factors such as breastfeeding and concluded that breastfeeding did not have a significant impact on length of immunity.  This makes sense to me - my understanding is that breastmilk pays an important role in preventing infection by leaving a coating of antibodies on the lining of the mouth/nose/throat and through the digestive system which fights off harmful bacteria and viruses before they can actually infect the baby, and also by in general strengthening the immune system, but the amount of antibodies the baby actually absorbs from breastmilk into their system is very low compared to the amount of maternal antibodies baby is born with, so beastmilk shouldn't negatively affect vaccines (though they may have a positive influence -  some studies show that vaccines are more effective in breastfed infants - probably due to strengthening of immune system) unless the vaccine is mixed directly with the breastmilk in the babies stomach.   Health Canada does reassuringly post that breastfeeding will not interfere with how effective the vaccines are for the baby. 

 

One thing I would worry about is if boosting the mother's immunity late in pregnancy could cause the baby to be born with more maternal antibodies which would make the vaccines they get less effective, but I would assume/hope that they would be looking into that. 


pers 04-01-2014 11:42 AM

Quote:
Originally Posted by samaxtics View Post
 

 

It can't be though.  There are only 7 baboon babies total in the study.  All the mothers were vaccinated pre pregnancy and in the third trimester.  Two baboon babies were vaccinated with DTaP at 2 days and two baboon babies were vaccinated at 2 and 28 days.  Three of the baboon babies were not vaccinated.

So the FDA statements:

 

"The three unvaccinated animals developed symptoms of severe pertussis disease."  

 

The seven infant baboons born to vaccinated mothers became heavily colonized by the bacteria after exposure to B. pertussis, but did not develop symptoms of pertussis. "
 
are contradictory.  

 

Contradiction aside, this really isn't an endorsement for the pregnancy vaccine.  But I smell a birth dose coming for babies.

 

FDA writeup SUCKS.  It is confusing.  Big fail to whoever wrote it. 

 

This part from the top of the FDA writeup link says that there were both vaccinated and unvaccinated mothers - 

 

Quote:
 he results demonstrated that infant baboons born of mothers that had been vaccinated during pregnancy were protected against pertussis when exposed to it five weeks after birth. The FDA study also showed that newborn baboons of mothers who had not been vaccinated were protected after vaccination at either two days of age or two and 28 days of age.   

 

Also this bit from the abstract linked from the OP shows more babboons - 

Quote:
 Neonatally-vaccinated infants, infants born to vaccinated mothers and naïve infants from unvaccinated mothers were infected with B. pertussis at five weeks of age.

 

So it looks like there were actually three separate groups, infants born to vaxed mothers but not vaxed themselves, infants born to unvaxed mothers then vaccinated, and infants born to unvaxed mothers then left unvaxed.  (Or could be considered four groups if the vaxed infants are divided into one vaccine and two vaccine groups)

 

So it could make sense if this

 

Quote:
 To evaluate the effectiveness of maternal vaccination for the prevention of pertussis, OVRR scientists vaccinated eight female baboons three times before pregnancy with an FDA-approved DTaP vaccine. Seven became pregnant and were subsequently administered a booster shot at the beginning of their third trimester of pregnancy.

 

And this

Quote:
 To evaluate the response in neonatal baboons, the scientists used an FDA-approved DTaP vaccine to immunize two infant baboons at two days of age and two baboons at both two and 28 days of age; three infant baboons remained unvaccinated.  

 

Are not talking about the same baboons and there were actually fourteen infants in the study, seven born to vaxed mothers and seven born to unvaxed.  

 

So, seven born to vaccinated mothers but not vaccinated themselves. 

 

Two born to unvaxed mothers and given two doses of vaccine. 

 

Two born to unvaxed mothers and given one dose of vaccine. 

 

Three acting as controls/born from unvaxed mothers and not vaxed. 

 

It appears that they did not vaccinate any of the infants born to vaccinated mothers, which as I mentioned above is something I would like to see, but I hope/assume that they are looking into that in human studies and at least checking that post-vaccine titres/titres in older infants are not any lower in babies born to vaccinated-in-pregnancy mothers than they are for other babies. 


teacozy 04-01-2014 11:57 AM

@Pers 

 

I've seen some studies before, don't have time to dig for them right now but I did at least find this one with a quick google search. 

 

http://www.ncbi.nlm.nih.gov/pubmed/23799518

 

I don't have a link to the full study, unfortunately. 

 

Edit:  I also found this link (haven't read the whole thing yet) but they provide several links at the bottom that might be of interest. 

 

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3653651/#b7-0590497


pers 04-01-2014 01:10 PM

Thanks, Teacozy.  I haven't read the longer one yet, but the conclusion of the abstract was basically my concern:

 

Quote:
 Maternal Tdap immunization resulted in higher pertussis antibody concentrations during the period between birth and the first vaccine dose. Although slightly decreased immune responses following the primary series were seen compared with controls, differences did not persist following the booster.

 

So it appears that increased maternal antibodies does interfere with how effective the vaccine is :(  But if it is, as they say, slight and temporary, then it seems the benefit of providing protection for the first couple months when pertussis is most dangerous may indeed outweigh a small decrease in protection between the initial series and the booster. 


sassyfirechick 04-01-2014 03:19 PM

Quote:
Originally Posted by kathymuggle View Post
 

To evaluate the response in neonatal baboons, the scientists used an FDA-approved DTaP vaccine to immunize two infant baboons at two days of age and two baboons at both two and 28 days of age; three infant baboons remained unvaccinated.  
 

When exposed to B. pertussis, all four vaccinated infant baboons produced high levels of antibodies and remained free of symptoms, even though their respiratory tract was highly colonized with the bacteria. The three unvaccinated animals developed symptoms of severe pertussis disease.  
 
The seven infant baboons born to vaccinated mothers became heavily colonized by the bacteria after exposure to B. pertussis, but did not develop symptoms of pertussis. "

 

Ok, so my takeaway from this is that 7 mothers were vaxxed - the 4 babies that were vaxxed were symptom free but the 3 unvaxxed babies were not - and if that is the case then what does vaccination in-utero have to do with anything if they have be vaxxed practically at birth to "avoid symptoms"??  Then of course the contradictory "The seven infant baboons born to vaccinated mothers became heavily colonized by the bacteria after exposure to B. pertussis, but did not develop symptoms of pertussis" so all were suddenly symptom free?  And I agree with taxi's earlier comment that sure they may be symptom free but that doesn't prevent them from continuing the chain of transmission.

 

Searching for feed protocols on animals regarding breastfeeding doesn't bring up much, BUT, having majored in animal science and having taken a few Lab Animal Science class, I can say the likelihood of bottle feeding is actually extremely high.  Most lab animals serve multiple purposes - so to have a mother give birth and then allow her to do nothing but nurse an infant would be considered a huge money drain in the industry.  More likely the mothers are AI'd, given C-sections, to ensure a same date of birth for all infants and then given off to some concurrent study regarding surgery, birth or what have you.  The infants would be given a bottle via a heated blanket to simulate mom.  Lab animals receive very little human interaction - it's many times frowned upon unless it is a specific requirement of the study.  It's far cheaper to serve formula than wait for an animal to continue studies - also they can track feed intake via formula to ensure all animals receive the same amount.


pers 04-01-2014 03:32 PM

Quote:
Originally Posted by sassyfirechick View Post
 

Ok, so my takeaway from this is that 7 mothers were vaxxed - the 4 babies that were vaxxed were symptom free but the 3 unvaxxed babies were not - and if that is the case then what does vaccination in-utero have to do with anything if they have be vaxxed practically at birth to "avoid symptoms"??  Then of course the contradictory "The seven infant baboons born to vaccinated mothers became heavily colonized by the bacteria after exposure to B. pertussis, but did not develop symptoms of pertussis" so all were suddenly symptom free?  And I agree with taxi's earlier comment that sure they may be symptom free but that doesn't prevent them from continuing the chain of transmission.

 

Searching for feed protocols on animals regarding breastfeeding doesn't bring up much, BUT, having majored in animal science and having taken a few Lab Animal Science class, I can say the likelihood of bottle feeding is actually extremely high.  Most lab animals serve multiple purposes - so to have a mother give birth and then allow her to do nothing but nurse an infant would be considered a huge money drain in the industry.  More likely the mothers are AI'd, given C-sections, to ensure a same date of birth for all infants and then given off to some concurrent study regarding surgery, birth or what have you.  The infants would be given a bottle via a heated blanket to simulate mom.  Lab animals receive very little human interaction - it's many times frowned upon unless it is a specific requirement of the study.  It's far cheaper to serve formula than wait for an animal to continue studies - also they can track feed intake via formula to ensure all animals receive the same amount.

 

My interpretation is that there were 14 infants - 7 unvaxed but born to vaxed mothers, and 7 some vaxed/some not vaxed born to unvaxed mothers.  See my post just a few posts above for my T;LDR interpretation: http://www.mothering.com/community/t/1399751/maternal-and-neonatal-vaccination-protects-newborn-baboons-from-pertussis-infection/20#post_17601076

 

Yes, if they are colonized, they can still spread it (though how many people can a newborn spread it to?), but the main point of a vaccine is to protect the person it is given too (or, in the case of pregnancy, the soon to be born child of the mother it is given to), and keeping it from spreading is a secondary benefit. 

 

Reading about lab animals always makes me so sad :(


samaxtics 04-01-2014 03:41 PM

Thanks pers.

 

It was so convoluted that I thought they were speaking about two studies.

 

It is a big fail. 



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