When the trainer is trained wrong, they train others in the wrong methods - Passing it forward, like intergenerational trauma. #whistleblower #iodine #PCOS

Systemic problems means everyone practically is using the wrong method, when the system is wrong. Epigenetics and other causal issues of PCOS, some may be reversible or helped by the right supplements

What is Polycystic Ovary Syndrome? 

That depends on who you ask. Currently it is considered by the mainstream medical industry to have an unknown cause and no cure, (Berman, 2022), which is a nocebo - a negative impression of no hope beyond some symptom treatment.

Ask someone else and you may be told that cystic ovaries have long been considered a symptom of iodine deficiency and it is treated with iodine. 

Symptoms: Polycystic ovary syndrome can cause insulin resistance, and possibly weight gain. Hormonal effects cause further metabolic differences. Androgen and estrogen imbalance and elevated testosterone levels with female excess facial hair growth may occur. It also is a frequent cause of infertility in women but is generally not painful like endometriosis. (Berman, 2022)  

This post is a compilation of several posts on PCOS and a continuation or rewrite of the protocol post: New PCOS protocol on my FullScript account - you can be a client & purchase at 20% off, their whole catalog or things I highlight. Dec. 29, 2022, (substack.com)

Supplements can help - but be careful who you ask about what to take. Some dietitians may charge $147 for a 3 month protocol - take these specific supplements at these times of days for a certain number of weeks. Then buy another protocol. Behind the scenes an expectation of non-help is present, and a profit motive. Caution. If iodine is not being recommended - keep reading and learn about our error ridden medical history around iodine.

Health is a life-long endeavor and some supplements may be needed for life due to gene differences, or more temporarily for stress or infection or for a chronic health condition. It is good to learn more about what exactly is being recommended and why something is being recommended and whether any special foods might be a substitute. If it is helpful, why would it only be helpful for three months? Reducing inflammatory triggers in the lifestyle and diet are also important.

• Pomegranate for mitochondrial support (and zinc for a healthy weight too!) Sept 27, 2022, (substack.com)

• Iodine and an old lie, still being spread, Sept. 25, 2022, (substack.com)

• PCOS and Mitochondrial dysfunction; also an Agilent Whitepaper about detecting mitochondrial toxicity for drug safety. Sept. 24, 2022, (substack.com)

• PCOS: iodine deficiency, berberine, and a low/moderate carb diet may help. Sept. 24, 2022, (substack.com)

• Related: Iodine and Hydrogen Ions -Nov 28, 2018, (substack.com) *transcendingsquare.com post.

Iodine was the standard treatment for cystic ovaries.

Providing iodine was the standard treatment for cystic ovaries and it was often successful. (Peres, et al., 2017) As nutrient deficiencies continue the problems throughout the body build up.

Iodine deficiency leads to mitochondrial DNA damage & mtDNA damage is seen in PCOS.

Lack of iodine causes mitochondrial dysfunction which leads to fatigue and mitochondrial DNA (mtDNA) damage may occur within the mitochondrial nuclei. PCOS is associated with mitochondrial dysfunction and mtDNA changes. Iodine deficiency is known to be a cause of DNA damage, (Maier, et al., 2007), and mtDNA damage. (Karbownik-Lewinska, et al., 2015)

Iodine and other mitochondrial support nutrients have been found helpful for PCOS. (Kiana, et al., 2022) (Peres, et al., 2017) (Zeng, et al., 2020) Higher dose iodine supplements have been found safe and effective for many conditions and is equivalent to the amount of iodine in the traditional seaweed seasoned Japanese diet. (Optimox, Iodine) 

Photo by Giammarco on Unsplash

The Wolff-Chaikoff effect, an old error about iodine sufficiency, is still being taught and cited in new research. When iodine sufficiency is reached, the thyroid uptake slows down and more is excreted - but thyroid function continues. The old error was in interpreting that as “iodine is bad for the thyroid” - completely opposite of true. What was true and new at the time was that radioactive iodine did cause thyroid dysfunction. The effects of radioactive iodine were confabulated with the normal function effects of normal iodine. (Peres, et al., 2017) Subclinical hypothyroidism, infertility, PCOS, and other conditions have increased as a result, along with excess weight. This is not supposed to be discussed though…as if by an unspoken policy of people with research grant giving power.

Cysts in the kidney or liver tissue may also occur along with ovary cysts but are called different “conditions” than “cysts”. 

Mitochondria need iodine to reduce oxidative damage and for autophagy.

Iodine for mitochondrial function and protection: Iodine is known as the mineral used in the thyroid hormone which is essential for energy metabolism but it is also essential for mitochondria which produce energy within every cell.

To make a complex topic simple - iodine is a metallic element that can be electrically active and it helps stabilize water and hydrogen ions in an electrically active form. Magnesium can stabilize a cloud of 18 water molecules around each atom of magnesium. 

The combination of iodine and water in ionic form can create changes in protein structure more rapidly than regular enzymatic chemical reactions - quantum speed. The combination protects DNA and mitochondria which helps explain why iodine is so important to infant development and energy levels throughout life. For more details: Tensegrity #6: Hydrogen Bonding Networks in Water, by Dr. Jack Kruse, a neurosurgeon, jackkruse.com. *See Excerpt at the end of the PCOS discussion.

Mitochondria need many beneficial nutrients - most all of them to keep it simple and Nrf2 promoting phytonutrients.

Urolithin A, zinc and resistant starch for butyrate colon microbiota, pomegranate or spemidine to promote mitophagy: As mitochondrial dysfunction worsens there can also be an increase in defective mitochondria that are not removed by mitophagy and other defective cells may not be removed by autophagy. 

Low carb diet (avoid saturated fat ratio above 10% or total fat above 50-65% as it promotes mitochondrial switch to fermentation of fats), ketogenic diet, or intermittent fasting: Promote autophagy and mitophagy with low carb (Zhang, Zheng, Guo, Lai, 2019) or ketogenic diet, (Paoli, et al., 2020), intermittent fasting, and pomegranate or spermidine promote mitophagy. Pomegranate also promotes autophagy. (Tan, et al, 2019) Urolithin A, a postbiotic produced by butyrate/SCFA producing species in the colon, is a component of pomegranate that promotes autophagy. Mitochondrial dysfunction, continued. (substack.com) *post with my mitochondria focused graphics.

Magnesium is needed for mitophagy, autophagy and good blood pressure.

Magnesium deficiency and high blood pressure.

Magnesium: High blood pressure is somewhat common among middle aged women with PCOS but is at a similar risk as any other post-menopausal women after menopause. (Reckelhoff, Shawky, Romero, Yanes Cardozo, 2022) *Anytime I see ‘hypertension’ associated with a condition for which magnesium has been found helpful, my first thought is that the person is low in magnesium or has elevated needs due to inflammation, chronic stress, or poor GI absorption or increased renal loss. Magnesium supplementation has been found helpful for PCOS. (Peres, et al., 2017)

Elevated Androgens in ratio to estrogens.

Saw palmetto, spironolactone, DIM, pomegranate, TCM herbals: An imbalance in female to male hormones is generally present and providing anti-androgen support is typical. (Alois, Estores, 2019) Saw palmetto, spironolactone, or DIM may be helpful or other herbals that are protective against prostate cancer, (Logie, PCOStreatments), which includes pomegranate peel extract. Pomegranate fruit extract was found helpful for anti-androgenic effects in an animal model of PCOS. (Hossein, et al., 2015) Traditional Chinese Medicinal herbs (Lin, et al., 2019) and acupuncture have long been used for PCOS type symptoms. (Alois, Estores, 2019)

Glucose and insulin imbalance.

Berberine: Glucose intolerance treatment of Type 2 diabetes medications are often used for PCOS. Metformin has been used but has side effects. Berberine may be an herbal equivalent with fewer side effects and it may help weight control. (Rondanelli, et al., 2020) (Mishra, Verma, Jadaun, 2022)

Vitamin D adequacy needs magnesium and protein. Gene variants may be involved.

Vitamin D adequacy is important and gene variants may be involved that make deficiency of vitamin D more likely; compared to the VDR Fok-I GG, the VDR Fok-I AG allele was associated with higher total testosterone (β = 5.537, P = 0.005) in a case control study of women with PCOS. (Song, Lee, Hong, Sung, 2019) Less than 4000 IU Vit D / day was recommended for longer term use. (Kiana, et al., 2022) Higher dosing may risk hypercalcemia and a few conditions should avoid vitamin D supplements (including sarcoidosis, cancer of the parathyroid gland). Vitamin D3 is more bioactive if glyphosate is inhibiting CYP enzymes necessary in vitamin D metabolism.

Curcumin is a Vitamin D receptor agonist, bypassing vitamin D metabolism.

Old railroad bypass, in a wooded area. Photo by Christopher Beddies on Unsplash

Epigenetic hypomethylation may be causal and reversible. It would be transmissible to the next generations unless reversed.

More encouragingly, epigenetic changes in key genes linked to PCOS have been reversed in animal models of PCOS with supplements of S-adenosylmethionine (SAM), a methyl donor. The PCOS mice, after SAM supplementation, were found to have defects corrected in metabolism, neuroendocrine function and the transcriptome - the mRNA present in the animals. Intergenerational inheritance is possible with epigenetic hypomethylation of DNA. (Mimouni, et al., 2021) Methylation causes a gene to be “off,” unavailable for transcription of the protein it encodes; and hypo - too little methylation - could cause it to be permanently “on” and may be over-producing the protein it encodes. 

Methylation cycles must be working in the cytoplasm and mitochondria for it to be able to also work within the cell nucleus and provide methyl groups

For DNA methylation to occur, the methylation/methionine/transsulfuration cycles all have to be working within the cytoplasm and within mitochondria, and then it can  work in the nucleus too. A chemical made in the cytoplasm is needed within the mitochondria and the nucleus needs a chemical formed by the cycles functioning in the mitochondria. (Hayden, Tyagi, 2022)

Figure 2. Compartmentalization of FOCM. Note the presence of the folate-methionine one carbon cycle metabolism in the cytoplasm (cytosol), mitochondria and nucleus. Additionally, note the importance of formate being transferred from the mitochondria to the nucleus, as well as S-adenosylmethionine (SAM) via nuclear pores. Importantly, deoxythymidine monophosphate (dTMP) synthesis occurs in the cytosol, nucleus and mitochondria, whereas purine synthesis and methionine synthesis take place within the cytosol. Mitochondrial FOCM generates formate for cytosolic and nuclear FOCM and biosynthetic precursors for mtDNA synthesis and mitochondrial protein translation. Thymidylate synthase (TYMS) converts deoxyuridine monophosphate (dUMP) to dTMP in a 5,10-methylene-THF-dependent reaction (not shown). It is important to note that mitochondrial SAM (Mt SAM) is derived from cytosolic SAM (cSAM). Additionally, the Krebs cycle also resides within the mitochondria and provides NADH and FADH2 to the electron transport chain for ATP production. ATP = adenosine triphosphate; c = cytosol; ETC = electron transport chain; FAD = flavin adenine dinucleotide; FADH = reduced flavin adenine dinucleotide; FFA = free fatty acids; HHcy = hyperhomocysteinemia; MS = methionine synthase; Mt = mitochondria; NADH = reduced nicotinamide adenine dinucleotide; T = thymidylate-thymine; U = uracil. (Hayden, Tyagi, 2022)

Excerpt from the post that talks about that graphic and formate: Nature loves a good design; Cancer, POTS, Epigenetics & the One-Carbon Methylation Cycles. (substack.com)

I had a reply recently saying nobody understands this (roughly) and my response would be:

We learn by studying things that we don’t understand and looking up whatever words we need to look up in order to better understand it.

Quantum bonus feature:

Iodine and water make ionic plasma 

The hydrogen protons become free flowing ions, mingling, in an energy field and iodine may be added. Iodine is taken up preferentially by the thyroid gland and intestinal lining and by the choroid plexus of our brain where it is added to the Cerebral Spinal Fluid (CSF). Quantum tunneling is a term used to describe the free flow of light Hydrogen protons. When moving in a quantum flow, the protons can move faster and enzymatic reactions can be faster than expected for normal chemical energy expenditures.

Excerpt from: Tensegrity #6: Hydrogen Bonding Networks in Water, by Dr. Jack Kruse, a neurosurgeon, jackkruse.com.

Hydrogen rarely exhibits behavior comparable to that of the alkali metals. For example, all the alkali metals react with water, with the heavier alkali metals reacting more vigorously than the lighter ones. The word “alkali” received its name from the Arabic word “al qali,” meaning “from ashes”. These particular elements were given the name “alkali” because they react with water to form hydroxide ions, creating very basic solutions (with pH > 7), which are also called alkaline solutions.  Hydrogen forms water with oxygen directly and does not form a basic solution. Adding more hydrogen to it does not cause a special reaction at all, as it does with the other metals in group 1.  Why is hydrogen fundamentally different?

Water is most famous for forming hydrogen bonds with other water molecules and with other ions dissolved in it. A hydrogen bond consists of a hydrogen shared between two electronegative atoms like oxygen or sulfur. The compound that donates the hydrogen to the chemical reaction is the hydrogen donor, and the acceptor atoms is the hydrogen acceptor. Water is unique because it can be both an acceptor and a donor of hydrogen. It means water can be a switch hitter in many biochemical reactions.  This is why water is the universal solvent on Earth.  In fact, water can even donate two of its hydrogen's if need be. This makes the water molecule take on the tetrahedral structure in its frozen form linked in a crystalline hexagonal array in crystal ice.

I told you hydrogen can also act as a group 7 halogen.  It means it can gain electrons to become a non metal.  When hydrogen does this in water when it is associated with iodine it forms an ionic liquid. Ionic liquids are now receiving special attention in science, owing to their unique properties such as high ionic conductivity, non-volatility and non-flammability.  This ability makes these fluids versatile alternatives to conventional solvent-based systems used to make batteries, fuel cells, and super capacitors that hold large charges.  They are also quite helpful as heat-transfer fluids to move infrared energies within a system.   Iodine addition to iodide-based ionic liquids leads to extraordinarily efficient charge transport, vastly exceeding that expected for a standard viscous system.  Hydrogen and iodine form an ionic plasma within CSF of the human brain. The choroid plexus of the human brain is designed to add iodine to CSF.  CSF, you will recall is an ultra-filtrate of blood plasma and is made up of 99.9% water.

When iodine meets water that has been charged separated by IR light or by the hydrophilic proteins within the dura matter a massive amount of H+ is made in the CSF of the brain.  H+ is equivalent to a proton.  Using the Grotthuss mechanism, iodine is able to move protons closer together than we would normally expect,  to alter their hydrogen bonding network to allow them to form superconducting proton cables that act like a positive charge electric current.  The mechanism allows for charges to be transported not by the movement of particles, by the breaking and reformation of chemical bonds. As water is charge separated by IR light or by hydrophilic substances, many excess H+ ions are made adjacent to the exclusion zone of water. Gerald Pollack’s experiments have shown this exquisitely.  The excess protons can then diffuse through the hydrogen bond network of water molecules or other hydrogen-bonded liquids (iodized CSF)  through the formation or cleavage of covalent bonds.

Grotthuss was the first correct concept for the charge transport in electrolytes, and it still remains valid for the charge transport in water.  It allows for protons cable construction within an ionic fluid by using a current of protons (H+) that use a hopping mechanism.  That hopping mechanism is referred to as quantum tunneling of protons.  Quantum tunneling becomes more probable the smaller the mass of the cation is, and the proton is the lightest possible stable cation on Earth. 

[Keypoint—>] Iodine and iodides turbocharge this ability by turning the sea of protons into an ionic plasma.  This is why the thyroid gland, choroid plexus, and intestinal gut lining all concentrate iodine and iodides and H+.

Tensegrity #6: Hydrogen Bonding Networks in Water, by Dr. Jack Kruse, a neurosurgeon, jackkruse.com.

Happy New Year - May you feel quantumly fit this year!

Crystal therapy: “C’mon, fix my life.”

Disclaimer: Opinions are my own and the information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes.

Reference List

Endocrine support with acupuncture and herbal supplements for PCOS. (Alois, Estores, 2019) Alois M, Estores IM. Hormonal Regulation In Pcos Using Acupuncture And Herbal Supplements: A Case Report And Review Of The Literature. Integr Med (Encinitas). 2019 Oct;18(5):36-39. PMID: 32549844; PMCID: PMC7219449. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7219449/ 

(Berman, 2022) Berman, M.R., (2022), “PCOS Pain Caused Kelly Ripa to Pass Out During Sex — The talk-show host shares about her condition in an upcoming memoir” Sept. 21, 2022, medpagetoday.com, https://www.medpagetoday.com/popmedicine/celebritydiagnosis/100847 

One-Carbon Methylation Metabolism (Hayden, Tyagi, 2022) Hayden, M.R., Tyagi, S.C., (2022). Impaired Folate-Mediated One-Carbon Metabolism in Type 2 Diabetes, Late-Onset Alzheimer’s Disease and Long COVID. Medicina. 58(1):16. https://doi.org/10.3390/medicina58010016 Available at https://www.mdpi.com/1648-9144/58/1/16 (Accessed: 4 Dec 2022) Figure 1: Folate-Mediated One-Carbon Metabolism (FOCM), Figure 2. Compartmentalization of FOCM.

Pomegranate juice, anti-androgenic effect in animal model of PCOS. (Hossein, et al., 2015) Hossein K. J, Leila K. J, Ebrahim T. K, Nazanin S. J, Farzad P, Elham R, Mohammad P, Zahra H. J. The Effect of Pomegranate Juice Extract on Hormonal Changes of Female Wistar Rats Caused by Polycystic Ovarian Syndrome. Biomed Pharmacol J 2015;8(2). Available from: http://biomedpharmajournal.org/?p=3789

(Iodine, PCOSgirl) PCOS Girl, Iodine: The Cause and The Cure for PCOS? April 18, 2016,
http://www.pcosgirl.com/iodine-the-cause-and-the-cure-for-pcos/

Potassium iodide protects mitochondrial DNA in porcine thyroid. (Karbownik-Lewinska, et al., 2015) Karbownik-Lewinska M, Stepniak J, Milczarek M, Lewinski A. Protective effect of KI in mtDNA in porcine thyroid: comparison with KIO₃ and nDNA. Eur J Nutr. 2015 Mar;54(2):319-23. doi: 10.1007/s00394-014-0797-6. Epub 2014 Nov 9. PMID: 25381633; PMCID: PMC4323512. https://pubmed.ncbi.nlm.nih.gov/25381633/

Curcumin, Vit D, Inositol, CoQ10. (Kiana, et al., 2022) Kiani AK, Donato K, Dhuli K, Stuppia L, Bertelli M. Dietary supplements for polycystic ovary syndrome. J Prev Med Hyg. 2022 Oct 17;63(2 Suppl 3):E206-E213. doi: 10.15167/2421-4248/jpmh2022.63.2S3.2762. PMID: 36479481; PMCID: PMC9710389. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9710389/ *Includes: Curcumin, Vitamin D, (*less than 4000 IU dosing/day is mentioned unless short term), Inositol, (alone or in combination with melatonin or alpha lipoic acid helped PCOS), and CoQ10 (200 mg day/ 8 weeks in a study found benefits for PCOS) *this is one I take long-term along with all the B's. 

TCM use for PCOS. (Lin, et al., 2019) Lin MJ, Chen HW, Liu PH, Cheng WJ, Kuo SL, Kao MC. The prescription patterns of traditional Chinese medicine for women with polycystic ovary syndrome in Taiwan: A nationwide population-based study. Medicine (Baltimore). 2019 Jun;98(24):e15890. doi: 10.1097/MD.0000000000015890. PMID: 31192922; PMCID: PMC6587642. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6587642/ 

DIM, Saw palmetto, spirolactone, (Logie, PCOStreatments) Logie, R., ‘Why I Stopped Taking DIM for PCOS’, PCOStreatments.com, https://pcostreatments.com/supplements/why-i-stopped-taking-dim-for-pcos/ 

Iodine deficiency leads to DNA damage (animal-based study). (Maier, et al., 2007) Maier J, van Steeg H, van Oostrom C, Paschke R, Weiss RE, Krohn K. Iodine deficiency activates antioxidant genes and causes DNA damage in the thyroid gland of rats and mice. Biochim Biophys Acta. 2007 Jun;1773(6):990-9. doi: 10.1016/j.bbamcr.2007.03.011. Epub 2007 Mar 24. PMID: 17467074. https://pubmed.ncbi.nlm.nih.gov/17467074/

Epigenetics (Mimouni, et al., 2021) Mimouni, N.E.H., Paiva, I., Barbotin, A.L., Timzoura, F.E., Plassard, D., Stephanie Le Gras, S., et al., (2021). Polycystic ovary syndrome is transmitted via a transgenerational epigenetic process, Cell Metabolism, 33(3);513-530.e8, ISSN 1550-4131, https://doi.org/10.1016/j.cmet.2021.01.004. https://www.sciencedirect.com/science/article/pii/S1550413121000048 

Berberine, Myoinositol and metformin, combined treatment 2 (Mishra, Verma, Jadaun, 2022) Mishra N, Verma R, Jadaun P. Study on the Effect of Berberine, Myoinositol, and Metformin in Women with Polycystic Ovary Syndrome: A Prospective Randomised Study. Cureus. 2022 Jan 31;14(1):e21781. doi: 10.7759/cureus.21781. PMID: 35251851; PMCID: PMC8890747. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8890747/

Iodoral in general (Optimox, Iodine) https://www.optimox.com/iodine-study-8

Ketogenic diet (Paoli, et al., 2020) Paoli A, Mancin L, Giacona MC, Bianco A, Caprio M. Effects of a ketogenic diet in overweight women with polycystic ovary syndrome. J Transl Med. 2020 Feb 27;18(1):104. doi: 10.1186/s12967-020-02277-0. PMID: 32103756; PMCID: PMC7045520. https://pubmed.ncbi.nlm.nih.gov/32103756/

Iodine, Selenium, magnesium & Omega 3 fatty acids (Peres, et al., 2017) Peres, et al., 2017, An Update- The Role of Nutrients Crucial in the Infertility of Couples- New Insights for the Effects of Iodine, Selenium, Omega 3 Fatty Acids and Magnesium, https://symbiosisonlinepublishing.com/nutritionalhealth-foodscience/nutritionalhealth-foodscience116.php

(Reckelhoff, Shawky, Romero, Yanes Cardozo, 2022) Reckelhoff, J.F., Shawky, N.M., Romero, D.G., Yanes Cardozo, L.L., (2022), Polycystic Ovary Syndrome: Insights from Preclinical Research, Kidney360, August 2022, 3 (8) 1449-1457; DOI: https://doi.org/10.34067/KID.0002052022 https://kidney360.asnjournals.org/content/3/8/1449 

Berberine (Rondanelli, et al., 2020) Rondanelli M, Infantino V, Riva A, Petrangolini G, Faliva MA, Peroni G, Naso M, Nichetti M, Spadaccini D, Gasparri C, Perna S. Polycystic ovary syndrome management: a review of the possible amazing role of berberine. Arch Gynecol Obstet. 2020 Jan;301(1):53-60. doi: 10.1007/s00404-020-05450-4. Epub 2020 Feb 14. PMID: 32060683; PMCID: PMC7028834. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8890747/

Pom activates autophagy (Tan, et al, 2019) Tan S, Yu CY, Sim ZW, Low ZS, Lee B, See F, Min N, Gautam A, Chu JJH, Ng KW, Wong E. Pomegranate activates TFEB to promote autophagy-lysosomal fitness and mitophagy. Sci Rep. 2019 Jan 24;9(1):727. doi: 10.1038/s41598-018-37400-1. PMID: 30679718; PMCID: PMC6346015. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6346015/

Low Carb diet 5 (Zhang, Zheng, Guo, Lai, 2019) Zhang, X., Zheng, Y., Guo, Y., Lai, Z., "The Effect of Low Carbohydrate Diet on Polycystic Ovary Syndrome: A Meta-Analysis of Randomized Controlled Trials", Int J of Endocrinology, vol. 2019, Article ID 4386401, 14 pages, 2019. https://doi.org/10.1155/2019/4386401 https://www.hindawi.com/journals/ije/2019/4386401/

Mitochondrial (Zeng, et al., 2020) Zeng X, Huang Q, Long SL, Zhong Q, Mo Z. Mitochondrial Dysfunction in Polycystic Ovary Syndrome. DNA Cell Biol. 2020 Aug;39(8):1401-1409. doi: 10.1089/dna.2019.5172. Epub 2020 Feb 20. PMID: 32077751. https://pubmed.ncbi.nlm.nih.gov/32077751/