Bitter authorship issues prompt Expression of Concern in rheumatology journal

A difficult authorship dispute, involving two journals and at least two continents, has led to an Expression of Concern in the Brazilian Journal of Rheumatology.

Here’s the Expression of Concern:

In the December 2011 issue, the Brazilian Journal of Rheumatology published the article: “Anticitrullinated peptide antibodies and rheumatoid factor in Sudanese patients with Leishmania donovani infection” by E. Ahlin, A. Elshafei, M. Nur, S.H. El Safi, R. Johan, and G. Elghazali. [Revista Brasileira de Reumatologia 51, 6 (2011)]. On January 2012, the BJR received a claim from one of the authors, questioning the authorship of the corresponding author, and informed that the article was under submission to another journal, by E. Ahlin, A.I. Elshafie, M.A.M. Nur, and J. Ronnelid. This submission is on hold, the authors were all informed of the claim and the case was submitted to the Committee on Publication Ethics (COPE), which gave some recommendations. The investigation has not yet reached a conclusion. Pending the results of the investigations, BJR is publishing this Editorial Expression of Concern to alert our readers to the fact that serious questions have been raised about the authorship in the Ahlin et al. paper.

Paulo Louzada-Junior and Max Victor Carioca Freitas
Editors-in-chief – Revista Brasileira de Reumatologia

COPE posts some of its cases online anonymously, and they have good reason for that. But there’s a case posted this year that has striking similarities to this one. One detail in particular in the Expression of Concern — the fact that Elshafie’s name is spelled two different ways — seems highly likely to be reason four in the COPE writeup:

A manuscript was published by journal X and submitted by author A (last author). Author B claims that fraud occurred in relation to authorship for the following reasons.

(1) Author A did not take part in producing the data for the paper and has never been a co-author on any version of the manuscript.
(2) A paper with very similar content ,which was part of the PhD thesis of author C (first author), was accepted for publication in journal Y.
(3) The figures in the paper published in journal X were identical to the figures in author C’s PhD thesis.
(4) The name of author B was misspelt in the paper published in journal X to avoid identification of the article search in PubMed.

The editor of journal X contacted all of the authors by email and they responded as follows: author C (first author), author D and author E agreed with author B (claiming author). Author F did not respond, despite receiving five emails.

In addition, author B sent us a letter signed by the Vice-Rector at his University, agreeing and supporting the point raised by author B.

Author A (last author) disagreed with all of the allegations and pointed out the following.
(1) Author A declared that he was the principle investigator of the project in country Z during 2004–2009, and the role of author B was to help in the analysis of the samples in his laboratory, located in country W.
(2) Author A submitted an official complaint to author B’s university, alleging that they (authors B, C and D) had no right to use data without notifying or asking his permission. In addition, they did not have any patient consent.
(3) The paper published in journal X was the original manuscript and it was circulated to all of the authors.
(4) The name of author B was misspelled in journal X by mistake.

Author B requests that the paper must be retracted from journal X, and he also demands that the editors ensure that the paper will disappear from PubMed.

In summary, all of the authors confirm that the data are correct but they disagree regarding the issue of authorship?

You can read the rest of COPE’s advice on the case here, along with the follow up:

The editor published an expression of concern in his journal, stating that one of the authors had questioned the authorship of the corresponding author. The submission is on hold and the authors have been all informed of the claim. The investigation by the journal has not yet reached a conclusion. Pending the results of the investigations, the journal decided to publish an expression of concern to alert readers to the fact that serious questions have been raised about the authorship of the paper.

We’ve tried contacting Elshafie, who according to the paper has affiliations in Sweden and the Sudan, as well as Freitas and corresponding author Gehad Elghazali, of King Fahad Medical City in Riyadh, Saudi Arabia, for more information, and will update with anything we learn.

Update, 3 p.m. Eastern, 10/29/12: Elghazali tells us that his name was removed from the authors’ list without his knowledge, after he “expressed serious ethical concerns about taking skin biopsies from patients and healthy controls” without their written consent. He also said that written consent was unnecessary to obtain skin biopsies from Sudanese patients and healthy subjects.

9 thoughts on “Bitter authorship issues prompt Expression of Concern in rheumatology journal”

  1. When I was a postdoc, my boss misspelled my name (both my first name and my surname, sic!) on a patent application. He has never bothered to correct this as, after all, he got the spelling of his name right. So having gone through this myself, I am sure that what really ticked Elshafie off was somebody’s depriving him due credit by misspelling his name. I do not think it was intentional as Elghazali could not possibly have expected this to be enough to cover his misconduct (alleged, of course) in the long run. My guess is that Elghazali used his seniority relative to Elshafie to hijack his research and expected the latter to put up with it. Having misspelled Elshafie’s name, he inadvertently left him no other option but to contact the BJP’s editor.

    1. Elshafei is a graduate student who was recruited by Prof ElGhazali. In addition, Elghazali, as documented by University of Khartoum officials, established this leishmania project to train Elshafie in Immunology. BJR editor was contacted by our collaborator from Sweden (Associate Prof Ronnelid). The graduate student (Elshafei) has supervisors at the two sites of the project (Sweden & Sudan).

  2. I wonder if this is one of those multi-university “teams” that are required in order to get grants these days. One professor takes the role of the principal investigator, but lacks the expertise or the equipment to do the research, so an entry-level professor elsewhere with actual know-how is recruited to do the research. The graduate student spends a large amount of time under the tutelage of the junior professor. Once the real work is done, the principal investigator reasserts him/herself and claims credit on the basis of having provided the money for the project.

    If putting up the money were a legitimate qualification for authorship, any rich person could develop an impressive resume without scientific training or ability (or even participation) by simply paying scientists to do research.

    Just speculating. I wonder if the claim that Author A has never been a co-author on previous versions of the manuscript is related to posters, oral presentations, and other non-refereed output. Maybe Author A didn’t know about minor output or didn’t care whether s/he got credit on such things as long as s/he was included in the part that counts — the journal publication. The fact that Author A has access to the figures in the Ph.D. dissertation suggests that s/he is the advisor of record whether or not s/he participated in the education of the graduate student. S/he has a copy of the dissertation. Interesting that the graduate student sides with Author B, the junior-level unofficial advisor.

    Both Author A and Author B seem to have written up the research. There is no claim that the writing is identical, only that the figures are identical, so perhaps the principal investigator had a different opinion about the findings and wrote a substantially different report. The principal investigator seems to be faster with the word processor — or perhaps has better connections and was able to get his/her manuscript through the review process at journal X faster– so s/he got into print faster despite having later access to the figures.

    Both sets of rationales seem to be missing part of the complete story. I notice that Author A says his/her manuscript was “circulated to all authors” but does not say that all authors participated in writing it or approved the final version. Maybe that’s why there is a competing version of the paper written by the group of people who actually did the research.

    And poor Author F either is unaware of the controversy or is keeping his/her head down in hopes of avoiding damage from the fallout.

    1. Author F and A are the Sudanese component (=Supervisors) of the Sudanese/Swedish collaborative project. They established the project in Sudan, recruited and supervised the PhD student (Author D) and oversaw Author D research activities in Sudan.

      Author B represents the Swedish component of the collaboration. His role was limited to laboratory analysis. No contribution at all to the field work and research activities in Sudan.

      Author D is the graduate SUDANESE student running the project.

      Author C= helped author D in his lab work in Sweden and contributed significantly to data analysis and writing.

      Author E= allowed Author D to obtain blood from 20 patients with RA (positive controls).

      Author D (graduate Sudanese student) is the victim. Based on conflicts between Authors A and B, tendency of author B to exclude the Sudanese Supervisors/seniors (Authors A and F) was expected.

  3. In the attached document below (see the 5th page in the document) there is a list of papers and manuscripts. Manuscript 4 is the manuscript in question. In that manuscript Professor Sayda H. Elsafi (S. H. El safi) was a co-author. She was also included in the published paper published at BrJR.

    Why Prof “S. H. El safi” was excluded from the version of the manuscript under consideration by the other journal submitted by Johan Ronnelid? Prof Sayda wrote a letter to the National Ethical Committee in Sudan giving details. See the different versions of the manuscript:

    E. Ahlin, A. Elshafei, M. Nur, S.H. El Safi, R. Johan, and G. Elghazali
    E. Ahlin, A. Elshafei, M. Nur, S.H. El Safi, R. Johan
    E. Ahlin, A. Elshafei, M. Nur, R. Johan

    My self (Geyhad ElGhazali) and Professor Sayda H. El Safi are the seniors from our home country (Sudan) where leishmania is endemic. Both of us are Professors of parasite immunology as demonstrated by our publications in the area and we are considered pioneers in this area in Sudan.
    There is no leishmania in sweden and Johan Ronnelid did not supervise any student in Sudan (Amir Elshafei), he did not even see Sudan or worked there. As proved in records, the graduate student Amir Elshafie was recruited by my self as graduate student in Sudan (early 2004) to work on role of Immunocomplexes in Leishmaia infection (my idea). Prof Per and Dr Johan were neither involved in the design of the project at the field in Sudan nor planning where the laboratory work will be done. I sent the graduate student Amir Elshafei to sweden to do his laboratory experiment in collaboration with my colleagues in Uppsala Dr Johan Ronnelid and Prof Per venge. I designed two separate laboratory activities for the graduate student Amir Elshafie, one at Prof Per’s lab. (chemistry) and the other at immunology lab. With Johan Ronnelid. My role (Concept, design, initiate) was acknowledged by Professor Per venge by an E-mail, he supported this fact that I established the project and invited him to provide help to my graduate student Amir Elshafie in his lab.

    The leishmania project is a bilateral collaboration between Sudan and Sweden, involving FROM SUDAN a graduate student (Amir Elshafei) and two Professors: Sayda H. Elsafi and Geyhad ElGhazali).

    Both Dr Johan Ronnelid and Prof Per Venge were not aware of what we did in the field in Sudan in 2004-2005, how samples were collected and how patients were enrolled. They just received the samples in their laboratory with my plans set before hand. I presented to them in April/May 2005 my graduate student Amir Elshafie that they have never see/met before, who came to sweden carrying a white box containing the Leishmania samples. There is official communications to prove this.

    The study had two phases.

    Phase I (2004-early 2006): was exclusively under my supervision
    Phase II (2006-2009): was under the supervision of My self and Prof Sayda H. Elsafi. The role of Prof Sayda El safi was limited to carrying the responsibility of applying for ethical approval (end 2005) while I was out of Sudan. I supervised the graduate student Amir Elshafie.

    Dr Musa Nour’s role was to allow the graduate student to take blood from his RA patients (started 2009).
    Dr Erik Ahlin (graduate student with Dr Johan Ronnelid, Immunology Lab) was the graduate student who helped my graduate student Amir Elshafie with his lab. work.
    On the other hand, Dr Lena Hakansson (working in Per Venge Lab) helped my graduate student Amir Elshafie at the chemistry laboratory). See publications below.

    Six papers were planned for publication in 2006-2011:

    1. Immunocomplex-induce cytokine profile (already published). RF was also analyzed and left for manuscript 4.

    2. Renal function in patients with active Visceral leishmaniasis (already published).

    3. Role of Eosinophils and Neutrophils (+ granular proteins/ Cytokines/ chemokines) in Leishmania infection (already Published).

    4. Rheumatoid factor and RA associated autoantibodies in Leishmania infected patients (paper in question). Same patients’ samples from our patients are use. RF and CIC were analyzed in 2005 and was planned to be published after completing the analysis (anti-CCP)

    5. ECP, MPO and FcGRII polymorphisms and Leishmaniasis (preparation). Same patients’ samples from our patients are use.

    6. Kinetics of Immune complexes, Cytokine and chemokine following treatment with Stibogluconate (preparation). Same patients’ samples from our patients are use.

    Three papers published so far from the two collaborators (Prof Per and Dr Johan’s Collaboration):

    ElShafie AI, Elghazali G, Rönnelid J, Venge P. Cystatin C as a marker of immune complex-associated renal impairment in a Sudanese population with visceral leishmaniasis. Am J Trop Med Hyg ;75:864-8.

    Elshafie AI, Hlin E, Håkansson LD, Elghazali G, Safi SH, Rönnelid J, Venge P.
    Activity and turnover of eosinophil and neutrophil granulocytes are altered in visceral leishmaniasis. Int J Parasitol. 2011 Mar;41(3-4):463-9. Epub 2010 Dec 21.

    Elshafie AI, Ahlin E, Mathsson L, ElGhazali G, Rönnelid J. Circulating immune complexes (IC) and IC-induced levels of GM-CSF are increased in sudanese patients with acute visceral Leishmania donovani infection undergoing sodium stibogluconate treatment: implications for disease pathogenesis. J Immunol ;178:5383-9.

    In 2007, my self and Johan Ronnelid had a serious conflict due to a PATENT issue that resulted in break in our relation but the graduate student was left in sweden to continue his PhD studies at Uppsala University. He is now a victim of our conflict Johan and me.

    In addition, Johan Ronnelid planned renal biopsies from leishmania infected patients and we conflicted again on this issue as Johan was insisting to have this part of the project done. Both my self and Professor Sayda (supervsiors and seniors from Sudan) questioned the possibility to take renal biopsies from these patients without medical indication. Prof Sayda was kept on dark after she issued the ethical approved for phase II study (after 2005). We have communications on this issue.


    1. Following the two conflicts that we had (me and Johan). I had communications (E-mails) sent from my former graduate student Amir Elshafei, requesting from Dr Johan Ronnelid not to marginalize his Boss (Prof Geyhad ElGhazali) who established the project and sent him to sweden. We keep the E-mails as official communications. These E-mails were received as BCC.

      1. I wanted to add a 4th version of the manuscript that was published in the proceedings of the 2nd European Federation for Immunology Societies (EFIS) in Berlin, Germany September 2009. I was discovered by Sudanese Supervisors of the Leishmania Project (The Sudanese component of the Swedish/Sudanese collaboration). This created the 3rd conflict between me and Johan. The Sudanese colleagues were informed about this. To ease the stress and pressure, Johan Ronnelid called (for the first time in his life) Drs Musa Nur (Rheumatologist, 20 of his patients were bled without his knowledge) and Dr Elnour Elagib (Rheumatolist). Prof Sayda Elsafie was also called by Johan. Johan reassure all that they will be included in the next versions. see the Abstracted presented in the EFIS, Berlin, Sept 2009 (3 authors only):


        Erik Ahlin, Amir Elshafie and Johan Ronnelid

        Background: Visceral Leishmaniasis (VL) or Kala-azar, is the most severe form of leishmaniasis and is caused by parasites of the Leishmania genus. Post-Kala-azar dermal leishmaniasis (PKDL) is a complication of VL characterised by severe rashes and skin lesions in mostly young patients who have recovered from VL. Circulating immune complexes (CIC) are increased in chronic leishmaniasis. Rheumatoid factor (RF) is a common finding in IC -associated chronic infectious diseass. In one small study the occurrence of anti-Cyclic Citrullinated Peptide (anti-CCP) antibodies has been described in Brazilian patients infected withLeishmania major. We have investigated the occurrence of different RA-associated autoantibodies in a larger cohort of Sudanese patients infected with Leishmania donovani.
        Methods: Serum samples were collected from 83 VL patients, 47 PKDL patients, 55 healthy Sudanese controls and 34 Sudanese patients seeing a rheumatologist due to joint complaints. Levels of CIC, anti-CCP and anti-human collagen type II antibodies (anti-CII) were investigated with ELISA and RF by nephelometry.
        Results: The results are summarised in table 1 and presented as number of autoantibody positive samples out of total and with the mean value among the positive samples (positive/total, mean)

        VL PKDL Joint complaints Control
        RF, >20 IU/mL
        73/83, 225 30/42, 47 18/31, 123 26/55, 28
        Anti-CCP, >25 E/mL 9/80, 46 2/47, 64) 7/34, 620 1/52
        Anti-CII, >29 AU/mL 74/82, 85 37/45, 58) 12/34, 91 29/52, 78

        Conclusions: The anti-CCP positivity among VL patients might imply shared pathogenic characteristics with anti-CCP positive arthritis. However, the anti-CCP positive samples in the VL group are at a moderate level as compared to the levels found in anti-CCP positive Sudanese rheumatology patients. This together with the observed general increase in other RA-associated autoantibodies in Leishmania-infected patients might instead argue that this is an effect of extensive inflammation and immune activation. Our findings of increased RF and anti-CII levels among young Sudanese controls stress the importance of defining local cut-off levels when studying immune activation in non-Caucasian populations.

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