What actually helps, ranked by evidence
Dietary measures are widely recommended, plausible on mechanism, and supported mainly by observational data and clinical experience.
Volume II
Every issue published in 2025 — 12 numbers, 2,040 pieces.
Features in Volume 2
Tandem mass spectrometry, and the difference between weighing and reading
An intact mass measurement establishes elemental composition, at best. The number of distinct sequences consistent with a given composition is astronomically large.
Oxidation, and the peroxide that came in with the surfactant
Deamidation, oxidation, aggregation and hydrolysis account for nearly all of what happens to a peptide over time. Each has a characteristic residue, a characteristic…
The supply gap as a clinical event
A supply interruption is a discontinuation with no notice, no taper and no plan. That is a distinct clinical situation.
What the liraglutide schedule assumes about a person it has never met
The four-week step exists because four to five weeks is approximately how long a once-weekly drug takes to stop rising at a fixed dose. That is a good reason, and it is not…
Sterility is not a percentage, which is the whole difficulty
Purity, content, identity, sterility and endotoxin are five separate determinations. A single sheet of paper carrying one of them is not evidence about the other four.
Fructosamine, glycated albumin, and the shorter window nobody orders
The alternatives with shorter windows, what they measure, and why they are rarely ordered.
LAL, kinetic chromogenic, recombinant factor C: three ways to the same figure
We submitted vials for endotoxin determination and report the results, the method and the laboratory, because a pyrogen figure without a method is as empty as a purity…
The mechanism behind the mechanism
The clinical effect profile is almost fully predictable from where the receptor is expressed, which is unusual and useful.
The interventions with trial support, and the much longer list without
Almost nothing in the standard management repertoire has been tested in a randomised trial in this specific population. We say what is extrapolated and from where.
A calculation you should do twice and write down once
Every time a vial changes, the conversion must be recalculated. Carrying forward a unit count from the last vial is the single most reliable way to give the wrong dose.
The lowest effective dose is a real concept with almost no data behind it
The commonest real-world strategy in this drug class is the least studied one.
Same material, different gradients, different answers
The Journal submitted split samples from single lots to three assay services, under names unconnected to this publication, and published each method alongside each result.
Why people actually stop, in the order they actually stop
Why the reason for stopping changes what happens afterwards.
Why a 0.036-dalton difference is the hardest number in peptide identity
Calibration drift is real, unremarkable, and the reason serious laboratories run internal standards.
HbA1c and its lag: what a result three months old is telling you
The assay is not the problem. The interpretation of a lagging integral as a current measurement is the problem.
Endotoxin is not a microorganism, and killing the bacteria does not remove it
The masking phenomenon known as low endotoxin recovery means a formulation can return a clean result while containing endotoxin the assay cannot see.
The area postrema, and the anatomy of an unwanted effect
Delayed gastric emptying is a mechanism that becomes an adverse effect above a threshold. It is not a complication in the ordinary sense.
How a single percentage came to stand for quality
This piece takes the measurement apart into the decisions it is made of, because each decision moves the answer.
HbA1c and its lag: what a result three months old is telling you
HbA1c integrates roughly three months of glycaemia with the most recent weeks weighted most heavily. Almost every misreading of it is a misreading of that weighting.
The dose that got you here and the dose that keeps you here
What the labels permit, what clinicians do, and the size of the gap between them.
Delayed emptying explains some of this, and not all of it
The receptor populations that produce satiety and the ones that produce nausea overlap substantially. That is why the ceiling of this drug class is where it is, and it is…
Sterility is not a percentage, which is the whole difficulty
Every certificate circulating in this market answers a question about molecules. Almost none answers a question about organisms, pyrogens, or the integrity of the seal.
The one-quarter rule, and the paper that took it apart
Grading six widely repeated claims against the studies actually behind them.