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Notably, eight taxa at the genus level were significantly abundant in the TMAO-producer group (FDR 10 M) that grouped to low producers after carnitine supplementation

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A few commenters further stated that at the very least, CMS' failure to consider the operability of this requirement would be arbitrary and capricious, with one commenter again citing case law to support their position

Sharma P, Retz M, and Siefker-Radtke A, et al (2017) Nivolumab in metastatic urothelial carcinoma after platinum therapy (CheckMate 275): a multicentre, single-arm, phase 2 trial Lancet Oncol 18 (3) 312322 PMID: 28131785 9

Key similarities: Negative charge Involved in protein interactions Difference: Glutamic acid has one extra carbon in its side chain