Wikipedia talk:WikiProject Medicine/Archive 29

This is an archive of past discussions on Wikipedia:WikiProject Medicine. Do not edit the contents of this page. If you wish to start a new discussion or revive an old one, please do so on the current talk page.

Archive 25

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Archive 27

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GA nominations looking for a reviewer

The following pages need a reviewer:

Animal models of schizophrenia (talk | history | start review) Quasihuman (talk • contribs) 22:45, 31 July 2012 (UTC)
Impulse control disorder (talk | history | start review) Zoono92 (talk) 07:08, 11 August 2012 (UTC)
Ibogaine (talk | history | start review) (Reviews: 12) ~~Ebe 123~~ → report 22:38, 25 August 2012 (UTC)
Birth control (talk | history | start review) (Reviews: 1) Cupco (talk) 00:14, 29 August 2012 (UTC)

Any registered editor who can read and follow directions (WP:GACR, WP:GACN, WP:RGA) is welcome to do this. It's really not difficult, although it commonly takes a couple of hours all told for medicine-related articles. Anyone at all is welcome to comment on these articles once someone has started the review (or on the article's talk page now). Comments from extra people are very helpful, especially from people who can help look up sources.

If you've never reviewed an article and you'd kind of like to give it a try but you're just not feeling bold enough, then leave a note here, and I'll find a volunteer to help you. WhatamIdoing (talk) 20:31, 1 September 2012 (UTC)

Issue with copyright

A couple of our sections are similar to another site. The question is who has copied from whom. [1] wondering if someone can look into this. Doc James (talk · contribs · email) (if I write on your page reply on mine) 09:19, 2 September 2012 (UTC)

I've responded on the article talk page. From a quick glance at the page history, I'd say it was them rather than us. Shout if that's not sufficient. —MistyMorn (talk) 12:42, 2 September 2012 (UTC)

Help needed on GA review

Can anyone help reviewing the GAC azathioprine? It's been more than two months since I nominated it, and I am getting a bit impatient cause on Chinese Wikipedia it usually only takes a week :(

Your help would be greatly appreciated.--Jsjsjs1111 (talk) 09:58, 31 August 2012 (UTC)

Opened by Jfdwolff (Talk:Azathioprine/GA1). Comments welcome. Biosthmors (talk) 22:34, 4 September 2012 (UTC)

Help tidying up, moving if necessary

I just took and passed my board exam, so now I am getting back into editing Wikipedia. I have a huge 5-inch binder filled with many extensive, high-yield tables I composed myself from many different sources. Tonight I just started a couple of the tables here on Wikipedia, hoping that by adding high-yield derm content more residents will visit Wikipedia, and perhaps get involved. Again, the lists are incomplete at this time, found at:

Before I continue to edit those pages I wanted to know:

Are the articles appropriately named? If you believe there is a better name for one or more of them, please feel free to move the page.
With regard to the list of target antigens in pemphigus, what is the best way to list each of the antigens such that the molecular weight is displayed right next to the corresponding antigen?
What should be the convention for capitalization of the different types of words/acronyms/etc in tables like these?
Could someone help add title cells to these tables?
With regard to each gene and stain name, I have used what (in my field at least) seems to be the most common synonym. Sometimes the name is an acronym/represents initialism. I would like to include a footnote regarding the convention for how the included synonym was selected. What convention should I be using?

On a side note, since these are stubs, I have included a "see also" section. I can remove it later if people feel strongly about it.

Thanks in advance for your help. ---My Core Competency is Competency (talk) 10:04, 3 September 2012 (UTC)

Welcome back and congrats on passing your exams. Doc James (talk · contribs · email) (if I write on your page reply on mine) 10:13, 3 September 2012 (UTC)

Congratulations on passing the exams. I've added a title to the table about genes mutated in cutaneous conditions so you can see how it's done (super easy), but I don't know what title you want, so I'm not going to edit the others. WhatamIdoing (talk) 20:18, 4 September 2012 (UTC)

Human penis size - RfC on image

Since there is no category for "medicine" in the RfC templates, I am posting here to draw attention to Talk:Human penis size#RfC: Is an image illustrating "length" and "circumference" necessary?. Judging from the talk page, this article might benefit from some review by members of this project who are willing to look at things from a more, uh, scientific viewpoint. Thanks. Delicious carbuncle (talk) 15:35, 4 September 2012 (UTC)

He said, she said... how do we handle published criticism of WP:MEDRS studies?

I've seen now at a few articles some issues with how to handle published criticism of studies. Nearly every widely-read study has somebody who didn't like the methodology or conclusions, and so has published criticism about the study. Sometimes even the criticism itself is criticized, etc... How do we handle this in WP:MEDICINE articles? Do we respect the entire "He said, she said" thread back and forth and include all the content in our articles? Do we just go with the study and ignore the criticism? Do we say, "The study said X but this critic said the data says Y, or that the guys who did the study must have been drunk."? Does it matter where or how the criticism is published--Critic's own website? Letter to the editor? Re-analysis of the same data the study used that came up with a different result? Published in the same journal or different journal? What about guy Z who writes a letter saying he agrees with the result of study X and disagrees with Y?

This comes up frequently enough but I don't see any guidelines on it in WP:MEDMOS, advice please. Zad68 18:21, 4 September 2012 (UTC)

I think that this is fundamentally an application of WP:WEIGHT, which is policy (a pillar in fact) so we don't need a specific MEDRS version. The same tension exists for most scientific sources of course, and the response should be the same. If the original source and its criticism are significant viewpoints, then we represent both in proportion to the prominence of each viewpoint. If the criticism is the view of a tiny minority, then we probably should not include it at all. The trick is to ascertain the prominence of the criticism - normally if I wasn't sure, I'd just ask MastCell. --RexxS (talk) 19:05, 4 September 2012 (UTC)

Hah. Now, that should be policy. :P In all seriousness, I agree that it comes down to WP:WEIGHT. Unfortunately, it can be quite difficult to demonstrate the difference between a true, current scientific disagreement and a marginalized objection to mainstream scientific thought. In the best-case scenario, for some topics one can find position statements or consensus documents from major national or international medical bodies (e.g. WHO, U.S. NIH, U.K. RCP, etc). More often, we just have to make a decision about where we want to set the cut-off for inclusion of a viewpoint, and attribute relevant viewpoints. Not very satisfying, I know. MastCell ^Talk 19:17, 4 September 2012 (UTC)

I'd generally skip letters to the editor.

The problem should come up less if you use review articles, textbooks, and other secondary sources rather than primary sources (e.g., original studies and letters). WhatamIdoing (talk) 20:44, 4 September 2012 (UTC)

Good advice, thank you. Would you generally say that if we have a review article from a highly-respected organization like Cochrane, and its findings have been widely accepted by respected organizations like the WHO, AMA, etc., we should (in general) not line up a journal article against it criticizing the findings? Sounds like that would be a WP:WEIGHT problem? Zad68 02:43, 5 September 2012 (UTC)

Yes, as a general matter I think you're absolutely right. In fact, there is some language to this effect in WP:MEDRS#Respect secondary sources. Is there a specific article or source that you're concerned about? MastCell ^Talk 03:25, 5 September 2012 (UTC)

See for example Talk:Circumcision/Archive_73#Criticism_of_Cochrane and Talk:Circumcision/Archive_73#Subsaharan_WHO_studies_called_into_question. I'm looking to rewrite Medical analysis of circumcision and I'm gathering advice on how to weight such things, but I also wanted general advice for other articles. Zad68 03:39, 5 September 2012 (UTC)

(edit conflict)

At the risk of encouraging wp:recentism, it is occasionally seen that a Cochrane review gets out of date, overtaken by significant newer findings. In such rare cases, lesser-quality review sources may be worth discussing, but extra care is definitely warranted. In the longer term, once Cochrane has issued an update, we should be able to dispense with the interim source and trust that they got it right. LeadSongDog come howl! 04:24, 5 September 2012 (UTC)

Appropriately sourcing the definition of evidence-based medicine?

Request for input here - more than just an 'academic' point, imo. —MistyMorn (talk) 21:51, 5 September 2012 (UTC)

I do have serious concerns about certain aspects of this 'High importance' page. —MistyMorn (talk) 11:11, 7 September 2012 (UTC)

Reverse redirect

Could someone reverse this redirect to Smith-Lemli-Opitz syndrome --> Smith–Lemli–Opitz syndrome? ---My Core Competency is Competency (talk) 21:00, 8 September 2012 (UTC)

Hmm, needs an admin.... Axl ¤ [Talk] 21:24, 8 September 2012 (UTC)

And while you're there, perhaps have a look at the only two references in the article. Neither of them match my idea of RS, let alone MEDRS - one is a blog and the other a snake oil sales page aimed at parents of autistic children. --RexxS (talk) 23:55, 8 September 2012 (UTC)

These are referenced by the above sources: PMC2553243, PMID 16761297, PMID 11223857 and may make better cites (still not ideal though). --RexxS (talk) 00:24, 9 September 2012 (UTC)

Referenced and reworked from OMIM and Gene Reviews. There is room for expansion, but the basic material in the article is appropriately sourced as of now. It did require removal of some of the material previously mentioned. Canada Hky (talk) 01:26, 9 September 2012 (UTC)

Looks like the move has been completed now as well. Canada Hky (talk) 18:32, 9 September 2012 (UTC)

Violence

Wikipedia:Reliable sources/Noticeboard#Domestic_violence_in_Pakistan might benefit from some comments from uninvolved people. WhatamIdoing (talk) 03:47, 9 September 2012 (UTC)

Specifically, the proposition that 70-90% of Pakistani women have suffered intimate-partner abuse. I am unfamiliar with proper studies that could result in such a confidence interval.

Somebody familiar with epidemiology and survey studies in less developed countries would be especially helpful. Kiefer.Wolfowitz 11:26, 9 September 2012 (UTC)

It was my impression from the RSN discussion that the source said multiple studies presented different answers, which ranged from 70% to 90%. This therefore is not a confidence interval, but a range without a confidence interval.

But to answer your question, you get a confidence interval of twenty percentage points by underestimating the sample size that you needed to get a narrower confidence interval. The study design can be theoretically perfect, but if you get more variability than you expected, then your planned sample size will prove too small. A result of 80% ± 10% is not unusual, and it's perfectly adequate for many purposes. WhatamIdoing (talk) 04:16, 10 September 2012 (UTC)

Remember, this is not a question about abuse or percentage of abuse. This is question if certain book qualify as RS per WP:RS. My very best wishes (talk) 15:57, 9 September 2012 (UTC)

I've left a note. This seems to be a bit of a storm in a teacup - lots of noise being thrown around as to how implausible certain figures are when the probable source is linked in the same discussion! Andrew Gray (talk) 16:45, 9 September 2012 (UTC)

Fasting#Medical application

Could a knowledgeable person take a look at Fasting#Medical application. I've already removed what looked like puffery for Joel Fuhrman, M.D., but I think it needs further attention. Thanks. AndyTheGrump (talk) 02:51, 10 September 2012 (UTC)

Removed most of that section as most of the material was cited to non-WP:MEDRS compliant sources. Tagged remaining material as citation needed. Yobol (talk) 03:02, 10 September 2012 (UTC)

Thanks. AndyTheGrump (talk) 03:04, 10 September 2012 (UTC)

Actually Intermittent fasting could use some attention as well. Some WP:FRINGEy looking material cited to non-MEDRS sources; a PUBMED search I did found most of the reviews are published in low impact journals, and by a small group of authors (such as Mark Mattson). Suggestions welcome. Yobol (talk) 03:11, 10 September 2012 (UTC)

Newbie editor needing guidance

Hi,

I've been working on the "Medical Uses" section of the Aspirin page for the last couple weeks. i saw a list somewhere that it was a high importance article and went with it. i've done some pretty substantial revision to it already, focusing on making it more concise, removing primary sources in favor of secondary ones, with a preference for Open Access papers. I've been doing this sequentially, maintaining section headings etc, and my issue now is that there is a large "hypothesized uses" section that, quite honestly, does not seem like something appropriate for an encyclopedia. I have mentioned this issue on the article's talk page, and am hoping to solicit some input from more seasoned editors. UseTheCommandLine (talk) 09:01, 5 September 2012 (UTC)

There is also WP:PHARM but yes there are not many active editors working on pharmaceutical articles. Doc James (talk · contribs · email) (if I write on your page reply on mine) 07:16, 12 September 2012 (UTC)

Outside input on Physician

I was hoping for more input on this page; I was trying to remove a section on nurse practitioners from the page (because they are not physicians), but have not been able to come to an agreement on the talk page. Further outside input would be appreciated. Yobol (talk) 17:38, 10 September 2012 (UTC)

An article that I think needs attention, but I'm not knowledgeable enough in editing to do it.

Hello:

I am surprised to see how the article on the Willowbrook State School so casually handles the topic: http://en.wikipedia.org/wiki/Willowbrook_State_School

Although I never worked at Willowbrook, as a former RN, I had clients who were survivors of that institution and know something of it's history and the vital impact it had on the way the developmentally disabled are treated in the United States. The exposure of the abuse (something Geraldo Rivera got right) and the following legal battles were a momentous event in this country. Yet, the major book on this subject isn't even mentioned anywhere on the page, The Willowbrook Wars: Bringing the Mentally Disabled Into the Community by David Rothman and Sheila Rothman.

I'd like to see the Willowbrook article more closely reflect the episode's importance in the history of patient rights, but I am kinda shy on WP and don't know how to do a lot of stuff. I've made some light edits, like spelling, but the one time I was more adventurous, I ended up completely mortified. I have no idea how it happened, but I edited an old version of an article instead of the current version and caused a raft of problems. After some pointed messages were sent to me about it, a kind soul finally figured out what happened and set things right. Now I mostly just make suggestions on Talk pages.

[Here's an example of the difficulties I have - see the second paragraph above. Everything looks fine in the typing window, but in Show Preview, "The Willowbrook Wars:" is italicized, "Bringing the Mentally Disabled Into the Community" is not, then "by David Rothman and Sheila Rothman." is italicized. I've deleted and re-entered the phrase several times with no improvement. Frustration abounds!]

Is there a mentorship program on WP or someone who I could provide with info who would be able to edit in my stead? How does this all work? Please don't tell me to search the Wikipedia: side; it's so extremely frustrating, bloated, and circularly self-referential that I waste an hour or two trying to figure something out, then give up. (That's another area of WP that urgently needs attention.) If this isn't the right place to ask these questions, is there someplace more appropriate?

Thank you, Wordreader (talk) 05:46, 12 September 2012 (UTC)

Thanks for your note. I'd be happy to answer any other specific questions you have at User talk:Biosthmors. The Wikipedia:Teahouse is designed to be welcoming, and there should be open arms there. If you want to find someone to mentor you, Wikipedia:Adopt-a-user is a place to go. User:Bluerasberry might be a great person to talk with. I'll also leave you a note on your talk page. Best. Biosthmors (talk) 06:08, 12 September 2012 (UTC)

Feel free to begin working on it. There are instructions here How_to_edit_a_page Doc James (talk · contribs · email) (if I write on your page reply on mine) 07:15, 12 September 2012 (UTC)

Okay! One of the big problems I have in searching topics is I don't know what they're called and search doesn't find words within articles (at least not that I know how to do). I'll start by ordering the Willowbrook Wars book from the library. I appreciate your helping me. Whew! Wordreader (talk) 07:39, 12 September 2012 (UTC)

By the way, that was a fast reply - more insomniacs? Wordreader (talk) 07:41, 12 September 2012 (UTC)

I'm not sure that our usual sourcing guideline restrictions to review articles and major textbooks etc need strictly apply to the medical history aspects of this article about a school. I'll put a couple of suggestions on the Talk page. —MistyMorn (talk) 12:11, 12 September 2012 (UTC)

History is not "biomedical information" and so the advice for biomedical material dos not apply. The book mentioned sounds like a good idea.

Wordreader, thanks for your persistence. The Wikimedia Foundation is working on a less frustrating edit window. The problem with the italics above is a stray linebreak. The software decided that you meant the formatting to end because you put the second half of the title on a separate line in the edit window. (Then another part of the software decided that since there wasn't a blank line between them, you meant for it all to be one paragraph after you saved it.) If you remove the linebreak, it will all behave like you want it to.

And yes, we know this place is overly complicated. This is a good place to ask for help with questions like that, and there are several specialized places to get help that Biosthmors linked above. WhatamIdoing (talk) 17:05, 12 September 2012 (UTC)

looking for Online Ambassadors to help with medicine-related classes

There are a number of medicine-related classes working with the Wikipedia Education Program that are starting up around now, and several could use the help of experienced editors. If that sounds like something you want to do, you can become an Online Ambassador. If you're interested, let me know, or if you've got questions about the role, please ask. In any case, the work done by students in these classes may be of interest.

Classes without Online Ambassadors

You can see the other courses in the United States and Canada programs (including some that already have at least on Online Ambassador, but would benefit from others as well) here: Canada, US.--Sage Ross (WMF) (talk) 15:43, 12 September 2012 (UTC)

Great thanks. Would be happy to provide some guidance / feedback. Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:52, 12 September 2012 (UTC)

James, you're a wiki-whirlwind! How do you do so much?--Sage Ross (WMF) (talk) 16:03, 12 September 2012 (UTC)

I just said "some guidance". The most I can promise is limited input as yes am a little busy. Doc James (talk · contribs · email) (if I write on your page reply on mine) 18:56, 12 September 2012 (UTC)

Sex identity

Anyone have a good idea what should happen with Sex identity? It seems either incredibly underdeveloped or otherwise needing some attention. Insomesia (talk) 23:50, 9 September 2012 (UTC)

I looked for sources for this a couple of years ago and I could not find any overview of the state of scholarly perception of this even in Western culture. I contacted a hospital which hosts a counseling service for parents of intersex newborns. They could not provide me with any good literature, so I assumed that the meta-review of the medical perspective on this did not exist. Blue Rasberry (talk) 02:50, 10 September 2012 (UTC)

Delete it then? Do you think it's a common misterm that should be redirected? Insomesia (talk) 03:08, 10 September 2012 (UTC)

I fail to see how the term is distinguishable from gender identity. 134.255.247.88 (talk) 17:04, 13 September 2012 (UTC)

Is its use in scholarly application always synonymous? Insomesia (talk) 12:44, 14 September 2012 (UTC)

Done Redirected to gender identity. Zad68 12:58, 14 September 2012 (UTC)

Thank you! Insomesia (talk) 22:41, 14 September 2012 (UTC)

Mercury and high fructose corn syrup

There is currently a discussion of the health effects of mercury in high fructose corn syrup, here. A search on pubmed for those terms turns up precisely two articles, by the same research groups, from 2009. The first, from January 2009 is a primary study. The second is a review article by the same people, attempting to link mercury consumption to oxidative stress and autism (a link which I had thought was well-dead and buried). From what I can tell, nothing else has come of this single 2009 incident, which was, I believe, based on improper cleaning of the equipment. This looks very much like excessive weight on a single secondary article expressing minority opinion that doesn't seem to extend outside of that one research group. WT:MED input would be greatly appreciated.

However, members of the Corn Growers Association of America need not comment, apparently. WLU (t) (c) Wikipedia's rules:^simple/_complex 21:30, 12 September 2012 (UTC)

WLU appears to be making conclusions that are counter to the well known and widely reported^[1]^[2]^[3] peer reviewed study^[4] finding high levels of mercury contamination of HFCS from plants using "Mercury Cell" technology, apparently based on personal prejudice.

WLU declined to disclose any association he or she might have with the Corn Refiners of America when asked (an organization which is currently spending considerable resources defending HFCS, including conducting a non-peer reviewed study of mercury in HFCS to respond to a peer reviewed study that found high levels of mercury in HFCS collected by an FDA employee from plants using legacy "mercury cell" based HFCS refining technology. The peer reviewed study indicates that this is a continuing problem at 4 plants in the US and many older plants world wide and not an isolated incident, could WLU please explain why their conclusion is superior to a peer reviewed study?) Jtankers (talk) 21:44, 12 September 2012 (UTC)

^ Not So Sweet: Missing Mercury and High Fructose Corn Syrup, Institute for Agriculture and Trade Policy
^ WashPost: Study Finds HFCS Contains Mercury Jan. 2009
^ CBS News Investigates HFCS Oct. 2008
^ Dufault Renee; et al. (January 2009). "Mercury from chlor-alkali plants: measured concentrations in food product sugar". Environmental Health. 8 (2). Bibcode:2009EnvHe...8....2D. doi:10.1186/1476-069X-8-2. PMID 19171026. Retrieved 2012-06-27. {{cite journal}}: Explicit use of et al. in: |author= (help)CS1 maint: date and year (link)

Wikipedia editors are not required to provide any information about themselves to anyone. But I think this is a first for WLU; usually people are accusing him of being involved in nefarious psychiatric organizations. Maybe we should start keeping a list.
All kinds of junk gets through the peer-review process. WP:MEDRS wants at least one review article by an WP:Independent source. WhatamIdoing (talk) 20:27, 13 September 2012 (UTC)

What can I say, I'm branching out (though I'm surprised WAID doesn't remember the Great Coconut Oil Wars of 2010).

I have asked Jtankers for more sources; the news articles are bunk but the IATP might be worthwhile - except that David Wallinga is a co-author of both that paper, the initial primary study and the review article by the same group. With the inclusion of a second potential source (by the IATP) there might be something here - but it's borderline. So if anyone else is interested in the issue on the talk page, you're still welcome. Also worth discussing is whether this information should be put on the "health effects of HFCS" page or, the HFCS page, or the mercury poisoning page. Opinions would be delightfully accepted. WLU (t) (c) Wikipedia's rules:^simple/_complex 21:02, 13 September 2012 (UTC)

Pneumonia query

I'd be grateful for some input here. Don't worry, if you want to characterise it as asking for medical advice, you can, but it's just over 300 years too late. --Dweller (talk) 14:29, 13 September 2012 (UTC)

Poisoning section at the Antifreeze article

There has been back and forth on this article, since 2009, regarding the inclusion of symptoms of antifreeze posioning and one of the few, or two, ways to identify the posioning. See Talk:Antifreeze#Poisoning section. For reasons I cannot make sense of, one editor has consistently objected to the inclusion of this information...while the other editor has consistently argued for its inclusion. Since the section is supposed to summarize this medical issue and this material is all kinds of relevant, I believe that the material should stay. Suffice it to say, input on this matter from editors of this project is needed. This is what I stated in the Current discussion section I recenly made on the talk page of that article:

It seems that Uruiamme doesn't listen to reason or follow WP:Consensus. From the above, it is clear that there should be an appropriate use of WP:Summary style regarding the poisoning information. Yet he recently removed this information after the above input from others, and compromise wording, that this type of information should be in this article. Every editor above agreed that "immediate" and/or primary symptoms should definitely be included. I therefore reverted Uruiamme because the removal simply is not justified. Removing that this poison is diffucult to detect? That's the most relevant thing to mention, aside from the fact that antifreeze, ethylene glycol in particular, is poisonous. And he's been doing this since 2009? Good grief. Don't know what he thinks is going to get resolved by doing this every few months to a year, after he's apparently decided that the opposing editor is no longer paying attention, but it needs to stop. Like I stated already, oddly enough, he'd left in the information about the oxalic acid crystals this time, which is rendered irrelevant in a way without mentioning the fact that this poison is so difficult to identify. I see valid reasons grounded in relevancy, in guidelines and precedent for keeping this material. But none for removal. I also remind all that this article is within the scope of Wikipedia:WikiProject Medicine for a reason; I very much doubt that they'd agree with removal of the symptoms. In fact, I'm going to ask them to weigh in here. This has gone on long enough. 134.255.247.88 (talk) 16:41, 13 September 2012 (UTC)

Help? Can I get some comments from any number of you on this at the Antifreeze article, please? I obviously brought this here for commentary from you guys because you are the ones specializing in medical issues on Wikipedia. 134.255.247.88 (talk) 14:29, 14 September 2012 (UTC)

This is an editorial decision, but I commented and the current version seems fine to me. Biosthmors (talk) 18:05, 14 September 2012 (UTC)

That was my impression too: I couldn't see any real content issue. —MistyMorn (talk) 18:28, 14 September 2012 (UTC)

It's a content issue. But the poisoning aspect is a medical issue as well, which is why the article is currently tagged as being within this project's scope. To somewhat reiterate what I stated above, there is an editor who has been continually insisting that the symptoms and/or that what has been described (on the talk page) as "one of the few ways" that the poisoning can be identified should not be mentioned in the article. This insistence makes me furrow my eyebrows in confusion. I don't understand why the medical issues shouldn't be given an appropriate/proper summary, especially given the examples on the talk page of similar articles doing so. And since this is a back and forth medical-content issue at the article, getting comments from editors here regarding this material's inclusion/exclusion seemed best. So thanks for commenting on it at the article talk page, Biosthmors. 134.255.247.88 (talk) 19:03, 14 September 2012 (UTC)

Protandim

Could a knowledgeable person possibly take a look at our article on Protandim, with regard to its compliance with WP:MEDRS policy? AndyTheGrump (talk) 17:05, 13 September 2012 (UTC)

I ran my quick analysis of sources and posted it to the article's Talk page. Some are WP:PRIMARY, but this one, I'd like to hear what the regulars have to say. It appears to be review article, and therefore a WP:SECONDARY we like, published in a reliable PUBMED-indexed journal with a real review board. It's exactly the kind of source I'd like to find for supporting article content. Except, there's a COI with the author and the product. Interested to hear. Zad68 17:51, 13 September 2012 (UTC)

Zad, you need to sign your talk page comments there.

Andy, I don't know about the other editors, but Rhode Island Red (talk · contribs) has generally been responsive on its talk page. Why don't you explain your concerns there? WhatamIdoing (talk) 20:40, 13 September 2012 (UTC)

Oops fixed. Zad68 20:51, 13 September 2012 (UTC)

(It's all part of my secret plot to get that talk page archived someday. Thanks fir cooperating with Ze Master Plan.

) WhatamIdoing (talk) 21:43, 13 September 2012 (UTC)

Thanks all. As WhatamIdoing says, I should probably have asked Rhode Island Red first, though it is always useful to get outside input, and Zad's source analysis looks useful - some of the sources are rather old. It strikes me as something of a contradiction to have an article which states that Protandim ""is not intended to diagnose, treat, cure, or prevent any disease" and then goes into great detail about clinical studies, side effects etc - but I should probably raise this on the talk page. I'll link this discussion too. AndyTheGrump (talk) 15:09, 14 September 2012 (UTC)

Is Sexual effects of circumcision needed any more?

Could people please chime in at this discussion: Talk:Sexual effects of circumcision#Is this page needed anymore? It should be redirected to Circumcision... title explains it all! Zad68 17:33, 14 September 2012 (UTC)

Done Deed is done, thanks for your input. Zad68 17:58, 14 September 2012 (UTC)

Biopolar disorder

Hey guys, it would be great to get some medical opinion over at bipolar disorder in the context of an effort to see if it could maybe be taken to ga. Cheers - Fayedizard (talk) 20:06, 6 September 2012 (UTC)

Hi - I've just taken a glance at the sourcing, per WP:MEDRS, and enjoyed looking at the article. Some sources would benefit from updating. For instance, this practice guideline surely deserves some mention? 2c for now, —MistyMorn (talk) 00:12, 7 September 2012 (UTC)

Thank you so much for getting involved! :) Fayedizard (talk) 19:54, 7 September 2012 (UTC)

A pleasure. You seem to have a great team there! —MistyMorn (talk) 22:32, 7 September 2012 (UTC)

As an update - the article is now nominated for GA - reviewers welcome :) Fayedizard (talk) 07:11, 17 September 2012 (UTC)

Babywearing

The article on babywearing would benefit from the project's help.

While babywearing has the appearance of a C-class article, it would be improved by using review or survey articles or leading textbooks.

From this project, a pediatrician or epidemiologist or parent would be especially suited to review babywearing.

Thanks, Kiefer.Wolfowitz 11:18, 9 September 2012 (UTC)

"Babywearing" produces exactly one hit on Pubmed. Does anyone have ideas for alternate terms? WhatamIdoing (talk) 04:19, 10 September 2012 (UTC)

Attachment parenting

Ditto. It seems problematic that the criticisms of cosleeping from the American College of Pediatrics is given less weight than Dr. Sears' book. Kiefer.Wolfowitz 12:56, 16 September 2012 (UTC)

I understand that's a cultural issue rather than a strictly scientific one. I believe that cosleeping is normal and considered very safe in Japan, for example. WhatamIdoing (talk) 06:09, 17 September 2012 (UTC)

Albert T. W. Simeons

The Albert T. W. Simeons article contaned a large quantity of unreferenced material, all of which I have removed. Simeons designed a controversial hCG-based diet regime that appears to be the subject of both an FDA ban on the sale of over-the counter drugs for that purpose, and a substantial Internet-based industry selling the stuff -- or "stuff", if you count "homeopathic hCG". Alas, there are vast amounts of unsourced material about him and his diet on the Internet, apparently mostly aimed at publicising the diet or selling the products, some of it easily confusable at first sight with real news sources: this could easily find its way into the article, if we're not vigilant.

I'd greatly appreciate it if a few people here could pop it on their watchlists in case it becomes a marketing vehicle. -- The Anome (talk) 02:03, 13 September 2012 (UTC)

Watchlisted. Thanks. Biosthmors (talk) 18:47, 15 September 2012 (UTC)

Identifying all the review articles that cite an individual primary study

Starting with a primary study, is there a free database one can use to identify all the review articles that cite it? Biosthmors (talk) 17:23, 16 September 2012 (UTC)

Yes, try Google Scholar.-Stillwaterising (talk) 18:07, 16 September 2012 (UTC)

See [2] I don't know how complete GoogleScholar's "cited by" list is, but I suspect not very. In PubMed you can call up PubMedCentral articles and books that cite a particular article, but I'm afraid I don't know of any systematic way to identify citing articles that are not on PMC. I wonder if our man in Bloomsbury (of yore), Andrew Gray, knows some tricks of the trade... —MistyMorn (talk) 20:05, 16 September 2012 (UTC)

Does/should WP:MEDRS apply on the Wikipedia Reference Desk?

Wikipedia talk:Reference desk#How should we treat unsupported health-related content? Your thoughts are welcome. --Anthonyhcole (talk) 04:27, 17 September 2012 (UTC)

Commented. Seem like a strange place. Doc James (talk · contribs · email) (if I write on your page reply on mine) 07:51, 17 September 2012 (UTC)

Indeed. --Anthonyhcole (talk) 10:06, 17 September 2012 (UTC)

Orgastic potency article and its WP:FRINGE health/medical/sexual claims

This article is listed as part of Wikipedia:WikiProject Alternative medicine, but that project, like Wikipedia:WikiProject Sexology and sexuality, is not too active, so I brought the issue here.

Basically, this article is based on a fringe theory, and I am concerned about its promotion on Wikipedia. Concerns were already expressed on the article's talk page by a registered editor. See Fringe written as fact, and now editors of the article are discussing creating spin-offs of this theory and the possibility of giving more weight to it in other articles, such as the Human sexual response cycle article. See The orgasm reflex discussion. One editor stated that he had not even heard of the human sexual response cycle,[3] despite the fact it is mentioned often in sources when detailing sexual stimulation/arousal and orgasm and is the clinically accepted definition of the human sexual response (sexual arousal/orgasm). I responded with this comment:[4] I'm not even sure that "orgastic potency" should have a Wikipedia article. And if it should, certainly, given the concerns about this theory coming across as fact or otherwise legitimate, it would be better to name it Orgastic potency theory. So please have a look at this article and comment on this in one or both of the linked discussions above. 199.229.232.42 (talk) 10:46, 17 September 2012 (UTC)

I've done a little first aid in the lede [5]. —MistyMorn (talk) 11:15, 17 September 2012 (UTC)

That helps. Thanks. I still have concerns about the rest of what I addressed above, though, of course. 199.229.232.42 (talk) 11:19, 17 September 2012 (UTC)

Thank you for this[6] copyedit regarding sexual dysfunction, MistyMorn, and any more copyediting you do of the article to keep these fringe beliefs from sounding as fact. Please, if any others have the time, help out too. Either of the two discussions I mentioned above could still use some input from any of you. 199.229.232.42 (talk) 18:54, 17 September 2012 (UTC)

I've also addressed this issue at the Wikipedia:Fringe theories/Noticeboard for more help. I don't know what else to do, but to ask for this project and that noticeboard to help. 199.229.232.42 (talk) 19:35, 17 September 2012 (UTC)

You are welcome to WP:BOLDly improve the article yourself, too. WhatamIdoing (talk) 20:07, 17 September 2012 (UTC)

I agree the whole Reception section is absurd given that the concept only has any currency within Reichian circles. Will delete. —MistyMorn (talk) 20:14, 17 September 2012 (UTC)

Thanks for reminding me to be bold, WhatamIdoing. I certainly didn't want to try that without getting outside input, though. I made WP:OVERLINKING tweaks and that was it. And I thank you again, MistyMorn. 199.229.232.42 (talk) 21:26, 17 September 2012 (UTC)

I think you'll find the Fringe noticeboard will sort that one out (though I fear the Allen device will also get caught up in the excitement). Thanks for bringing this up, —MistyMorn (talk) 21:41, 17 September 2012 (UTC)

Peer Review?

Hello, I've listed meth mouth for a peer review; I'm trying to bring it to featured status. I'd appreciate it if someone with experience with medical articles could weigh in on whether I'm in compliance with the project's guidelines for medical articles. Thanks, Mark Arsten (talk) 17:47, 17 September 2012 (UTC)

Could use an infobox disease. Doc James (talk · contribs · email) (if I write on your page reply on mine) 18:09, 17 September 2012 (UTC)

I didn't spot any epidemiological frequency estimates on the present page or in the parent article. Some meth use figures at least in Hamamoto and Rhodus 2009, and in Schifano et al 2007. —MistyMorn (talk) 18:56, 17 September 2012 (UTC)

CBT on ANI

Can some of the MEDRS wonks have a look at content matter underlying the edit war on Cognitive behavioral therapy? It's been the subject of some ANI reports and at least DRN one, all of which appear to be an exercise in bureaucracy and vote/revert counting rather than injecting previously uninvolved but knowledgeable editors. Tijfo098 (talk) 15:59, 9 September 2012 (UTC)

I've just acquired a textbook on CBT and will be boning up on it. CBT deserves an FA. --Anthonyhcole (talk) 17:31, 9 September 2012 (UTC)

And again. Tijfo098 (talk) 21:07, 19 September 2012 (UTC)

Talk:Secondary source#RfC: Dubious statement in section

“

The sentence "Unlike in the humanities, scientific and medical peer reviewed sources are not generally considered secondary unless they are a review or a meta-analysis." isn't backed up by any reliable outside source I can find. - Stillwaterising (talk)

”

I'm posting this here because the reliable independent sources referenced in the above section (in my opinion) should be used to help define the term Secondary Source as used in Wp:Medrs. Currently, the Definitions section is using definitions that do not have reliable sourcing and differ from the definitions found elsewhere on the internet. - Stillwaterising (talk) 12:31, 16 September 2012 (UTC)

Absolutely not. The dispute you have with the wording and sourcing of the article Secondary source has nothing to do with the WP:MEDRS page. The former is an article and is subject to our normal sourcing policies (V & NOR). The latter documents the common consensus about how Wikipedia treats the concepts of primary, secondary, and tertiary sources when applied to articles containing biomedical information. See WP:PG as it may help explain the difference. --RexxS (talk) 18:56, 16 September 2012 (UTC)

The mainspace Secondary source page obviously needs to be developed. But as RexxS says, Wikipedia reliable sourcing guidelines are quite different—here, it's not just a question of determining what qualifies as a secondary source, but what sources Wikipedia is going to consider potentially reliable in different contexts. —MistyMorn (talk) 08:31, 17 September 2012 (UTC)

So, if I understand what RexxS is saying, go ahead and edit the article if you can base it the revision on RS etc, but if I think WP:MEDRS should be changed then make a proposal on its talk page? - Stillwaterising (talk) 17:57, 18 September 2012 (UTC)

I think that before you do any of that, you need to read sources like this, this, and this. Peer-review has nothing to do with whether a source is primary or secondary. We could be talking about blog posts for all that matters. What matters is what the source does: A source that reports an original experiment is a primary source. A source that analyzes or comments on previously published work is a secondary source. WhatamIdoing (talk) 21:00, 18 September 2012 (UTC)

Omega-3 fatty acid

User keeps trying to cite a 12 person uncontrolled trial to refute a Cochrane review. Doc James (talk · contribs · email) (if I write on your page reply on mine) 06:52, 18 September 2012 (UTC)

The ref they keep adding (more than 3 times now) is this paper [7] Doc James (talk · contribs · email) (if I write on your page reply on mine) 06:58, 18 September 2012 (UTC)

Watchlisted, and AHC has been attending to the article. That one paper is currently out of the article. There have been a lot of changes. I'd like to finish up the section of another article I'm working on and then I'll try to tease apart what were the effects of the long list of changes that happened to the article. Zad68 19:24, 18 September 2012 (UTC)

Basically stuff has been moved around and primary research has been added. Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:34, 18 September 2012 (UTC)

Doing it now. Zad68 19:42, 18 September 2012 (UTC)

This will take me a some time, I've started by prob won't finish today. Zad68 20:02, 18 September 2012 (UTC)

I ran an analysis of the sources removed and added and largely the overall effect was that the article was made worse. Some good secondary sources were removed and some very questionable primary sources were added. There was a good change or two. I undid all the recent changes and I will have to manually go back and hand-do the few good ones. Zad68 21:00, 18 September 2012 (UTC)

Source changes

Comment	Source
Removed good meta analysis, 2006	<ref name="mozaffarian2006">{{Cite journal \| last = Mozaffarian \| first = Dariush \| coauthors = Rimm, Eric B. \| title = Fish intake, contaminants, and human health: evaluating the risks and the benefits \| journal = JAMA \| volume = 296 \| issue = 15 \| pages = 1885–1899 \| year = 2006 \| month = October \| pmid = 17047219 \| doi = 10.1001/jama.296.15.1885}}</ref>
Removed, 2006	<ref name="trivedi2006">{{Cite news \| last = Trivedi \| first = Bijal \| url = http://www.newscientist.com/channel/health/mg19125701.300-the-good-the-fad-and-the-unhealthy.html \| title = The good, the fad, and the unhealthy \| work = New Scientist \| date = 2006-09-23 \| pages = 42–49}}</ref>
Removed systematic review, 2006	<ref name="wang2006">{{Cite journal \| last = Wang \| first = C \| coauthors = Harris WS, Chung M, Lichtenstein AH, Balk EM, Kupelnick B, Jordan HS, Lau J \| title = ''n''−3 Fatty acids from fish or fish-oil supplements, but not alpha-linolenic acid, benefit cardiovascular disease outcomes in primary- and secondary-prevention studies: a systematic review \| journal = Am J Clin Nutr \| volume = 84 \| issue = 1 \| pages = 5–17 \| year = 2006 \| month = July \| pmid = 16825676}}</ref>
Removed, 2008	<ref>[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2683599/?tool=pmcentrez Pharmacy & Therapeutics (May, 2008) "Omega-3-acid Ethyl Esters (Lovaza) For Severe Hypertriglyceridemia"]</ref>
Removed, 1993	<ref>Duckett, S. K., D. G. Wagner, et al. (1993). "Effects of time on feed on beef nutrient composition." J Anim Sci 71(8): 2079-88.</ref>
Added good, 2012	<ref name=JAMA2012>{{Cite journal \| authors = Evangelos C. Rizos, MD, PhD; Evangelia E. Ntzani, MD, PhD; Eftychia Bika, MD; Michael S. Kostapanos, MD; Moses S. Elisaf, MD, PhD, FASA, FRSH \| title = Association Between Omega-3 Fatty Acid Supplementation and Risk of Major Cardiovascular Disease EventsA Systematic Review and Meta-analysis \| journal = JAMA \| volume = 308 \| issue = 10 \| pages = 1024-1033 \| year = 2012 \| month = September \| pmid = 22968891 \| doi = 10.1001/2012.jama.11374 }}</ref>
Added	<ref>http://ndb.nal.usda.gov/ndb/foods/show/4519</ref>
Added	<ref>http://ndb.nal.usda.gov/ndb/foods/show/4519</ref>
Added, questionable	<ref>http://www.omega3dressings.com/dietaryrecommendations.aspx</ref>
Added, questionable	<ref>http://www.omega3learning.uconn.edu/info/what-are-omega-3-fatty-acids/dietary-recommendations-for-omega-3-fatty-acids/</ref>
Added, good 2009 systematic review	<ref>{{cite journal\|author=Bent S, Bertoglio K, Hendren RL \|title=Omega-3 fatty acids for autistic spectrum disorder: a systematic review \|journal=J Autism Dev Disord \|volume=39 \|issue=8 \|pages=1145–54 \|year=2009 \|month=August \|pmid=19333748 \|pmc=2710498 \|doi=10.1007/s10803-009-0724-5 \|url=}}</ref>
Added primary	<ref>{{cite journal\|author=Couvreur S, Hurtaud C, Lopez C, Delaby L, Peyraud JL \|title=The linear relationship between the proportion of fresh grass in the cow diet, milk fatty acid composition, and butter properties \|journal=J. Dairy Sci. \|volume=89 \|issue=6 \|pages=1956–69 \|year=2006 \|month=June \|pmid=16702259 \|doi=10.3168/jds.S0022-0302(06)72263-9 \|url=http://linkinghub.elsevier.com/retrieve/pii/S0022-0302(06)72263-9}}</ref>
Added old primary	<ref>{{cite journal\|author=Duckett SK, Wagner DG, Yates LD, Dolezal HG, May SG \|title=Effects of time on feed on beef nutrient composition \|journal=J. Anim. Sci. \|volume=71 \|issue=8 \|pages=2079–88 \|year=1993 \|month=August \|pmid=8376232 \|url=http://www.journalofanimalscience.org/cgi/pmidlookup?view=long&pmid=8376232}}</ref>
Added old primary	<ref>{{cite journal\|author=Garton GA \|title=Fatty acid composition of the lipids of pasture grasses \|journal=Nature \|volume=187 \|issue= \|pages=511–2 \|year=1960 \|month=August \|pmid=13826699 \|doi=10.1038/187511b0 \|url=http://www.nature.com/nature/journal/v187/n4736/abs/187511b0.html}}</ref>
Added, "hypothsis" article	<ref>{{cite journal\|author=Golub N, Geba D, Mousa SA, Williams G, Block RC \|title=Greasing the wheels of managing overweight and obesity with omega-3 fatty acids \|journal=Med. Hypotheses \|volume=77 \|issue=6 \|pages=1114–20 \|year=2011 \|month=December \|pmid=21981905 \|doi=10.1016/j.mehy.2011.09.016 \|url=http://linkinghub.elsevier.com/retrieve/pii/S0306-9877(11)00469-5}}</ref>
Added, review article, maybe OK	<ref>{{cite journal\|author=Koski RR \|title=Omega-3-acid Ethyl Esters (Lovaza) For Severe Hypertriglyceridemia \|journal=Pharmacy & Therapeutics \|volume=33 \|issue=5 \|pages=271–303 \|date=May 2008 \|pmc=2683599 }}</ref>
Added old journal article, not conclusive	<ref>{{cite journal\|author=Logan AC \|title=Omega-3 fatty acids and major depression: a primer for the mental health professional \|journal=Lipids Health Dis \|volume=3 \|issue= \|pages=25 \|year=2004 \|month=November \|pmid=15535884 \|pmc=533861 \|doi=10.1186/1476-511X-3-25 \|url=}}</ref>
Added primary	<ref>{{cite journal\|author=Ramel A, Martinéz A, Kiely M, Morais G, Bandarra NM, Thorsdottir I \|title=Beneficial effects of long-chain n-3 fatty acids included in an energy-restricted diet on insulin resistance in overweight and obese European young adults \|journal=Diabetologia \|volume=51 \|issue=7 \|pages=1261–8 \|year=2008 \|month=July \|pmid=18491071 \|doi=10.1007/s00125-008-1035-7 }}</ref>
Added old review	<ref>{{cite journal\|author=Simopoulos AP \|title=The importance of the ratio of omega-6/omega-3 essential fatty acids \|journal=Biomed. Pharmacother. \|volume=56 \|issue=8 \|pages=365–79 \|year=2002 \|month=October \|pmid=12442909 }}</ref>

Science behind Parkinson's disease

Members of this WikiProject may be interested in a new project at Wikiversity.

Portal:The Science Behind Parkinson's - Wikiversity (shortcut: v:Portal:The Science Behind Parkinson's)

I discovered it by reading Wikipedia:Wikipedia Signpost/Newsroom/Suggestions#A new wikiversity learning project (version of 07:49, 18 September 2012).
—Wavelength (talk) 14:49, 18 September 2012 (UTC)

What's the word I'm looking for

A "complication" is "an unfavorable evolution of a disease, a health condition or a therapy". In general, an ideal application of a therapy or treatment could result in no complications happening. But what is it called when there is an expected but undesired effect of some therapy, and in particular, of a surgery? For example, you cannot perform rhinoplasty without at least some bleeding. You are not intending to cause the bleeding, you don't want the bleeding, but it's a required consequence of doing the operation. Excessive bleeding might be considered a complication, but what do you call the normal, ordinary bleeding you will encounter during the operation? I think I am looking for some word here other than "complication" or "side effect." Zad68 19:17, 18 September 2012 (UTC)

Probably "adverse effect"; these are undesirable events which predictably occur as a consequence of an intervention. MastCell ^Talk 19:21, 18 September 2012 (UTC)

I think that either adverse effect or side effect is what you're after. Adverse effects are undesirable side effects. I don't think that there is a specifically medical term for completely normal, natural consequences (e.g., if you cut yourself, you bleed). WhatamIdoing (talk) 21:59, 18 September 2012 (UTC)

Sequela/Sequelae, although that article might best be nominated for deletion or redirection as a dictionary definition.Novangelis (talk) 22:06, 18 September 2012 (UTC)

I performed a Google search for predictable undesirable effect, and I found

"Adverse effects" at http://quizlet.com/7518008/pharm-chapter-2-flash-cards/

and "side effect" at http://web.squ.edu.om/med-Lib/MED_CD/E_CDs/Essential%20of%20Oral%20Medicine/docs/ch11.pdf

and at http://books.google.ca/books?id=CgWKyeniwskC&pg=PA107&lpg=PA107&dq=%22predictable+undesirable+effect%22&source=bl&ots=gOiAAJdHWR&sig=ZemExV0_ySqQI0tw-FRFMWlPjwo&hl=en&sa=X&ei=qO1YUNWDDsPkiALK4ICoAw&ved=0CC8Q6AEwAw#v=onepage&q=%22predictable%20undesirable%20effect%22&f=false

and "PUDE" ("Predictable UnDesirable Effect") at http://www.myloadingrack.com/blog.php?6-Joe-s-Musings&do=comments

and at http://www.myloadingrack.com/entry.php?23-this-cause-and-effect-led-back-to-me&goto=next.

—Wavelength (talk) 22:10, 18 September 2012 (UTC)

[From my Google search for "bloodless rhinoplasty", I found a 2:59 video at http://www.youtube.com/watch?v=Ci53JRQlJFc.

—Wavelength (talk) 22:46, 19 September 2012 (UTC)]

I really appreciate all the suggestions, thank you very much! This is a great, responsive and supportive project team. :) Zad68 14:31, 20 September 2012 (UTC)

You can also search in List of effects, although I can not guarantee success.

—Wavelength (talk) 16:11, 20 September 2012 (UTC)

Thanks all, I ended up using the word "ordinary," which works pretty well. This is based on my seeing the word "excessive" used to describe events or conditions that were listed as complications ("The most common surgical complication is excessive bleeding (eg, bleeding that did not stop with local pressure, perhaps requiring a suture)", "Complication: Excessive weight loss"). "Excessive bleeding" is a complication, so I figured "ordinary bleeding" is not. Even if it doesn't match medical textbooks, Wikipedia isn't a medical textbook, and I'm not writing for medical students. Zad68 13:29, 21 September 2012 (UTC)

Wheatgrass

This section really needs to be brought up to MEDRS standards. -- Brangifer (talk) 17:15, 20 September 2012 (UTC)

Orthomolecular psychiatry

I see it's now widely accepted after a major rewrite from an IP. Also David R. Hawkins at AfD. Tijfo098 (talk) 10:23, 22 September 2012 (UTC)

The sources are poor, and the American Journal of Clinical Nutrition one doesnt' even support the text. Adding Michael Ellsberg is a coatrack and extra POV and OR was introduced, and it has titles like "A Changing Relationship with Mainstream Psychiatry" (the wording was changed to be more favourable, but the sources weren't). IRWolfie- (talk) 17:22, 22 September 2012 (UTC)

IRWolfie, you mean the sources that the IP added and you reverted? I ask because I don't consider most of the other sources to be poor. 211.154.83.38 (talk) 23:26, 22 September 2012 (UTC)

Well, perhaps you would like to boldly re-add the bit that you believe is supported by the best of the sources, leaving out all of the poor ones and even the middling ones. Then other people can look at that bit alone, and see if they agree that it's an acceptable source. It's always best to start with the low-hanging fruit. WhatamIdoing (talk) 01:26, 23 September 2012 (UTC)

I wasn't advocating that any of the IP's edits be restored; I stated that I don't view most of the sources that were there before the IP's additions to be poor sources; those are the sources that are still there now, of course. 211.154.83.38 (talk) 10:36, 23 September 2012 (UTC)

Help with Soursop

Hi, medical types. I was reading the feedback page for Soursop, one of the articles on my watchlist, and there's a pretty high frequency of people wanting more information about soursop's potential as a cure for cancer. It seems there's actually some scientific seed of truth to this (e.g., Dai et al. 2011), but, of course, also people on the internet selling soursop extract as a magic cancer cure. There's currently one sentence in the article about soursop and cancer, but clearly there is a need for more information. I'm hoping that someone here would be willing to help separate medical hype from fact. Many thanks for any assistance. Tdslk (talk) 17:35, 23 September 2012 (UTC)

Unable to find a single review article on this substance and cancer. The link above is not a review. Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:24, 23 September 2012 (UTC)

Do only review articles count? Tdslk (talk) 22:14, 23 September 2012 (UTC)

Or other secondary sources such as major textbooks. See WP:MEDRS Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:16, 23 September 2012 (UTC)

What constitutes a reliable source depends on what you're trying to support. If you want to support a sentence like "A single report used a soursop extract to kill isolated cells in a glass dish" (which can be done with practically any substance, including distilled water, sugar, and gasoline, to name just three), or "A little bit of lab work on cell lines has been done to begin assessing its potential as a cancer treatment," then this is probably an adequate. If you're trying to support a claim that it works, though, you'd need a review article or other similarly significant source.

What articles like that really need is a source that can support a sentence like "No testing in humans has ever been done. Approximately 99% of substances that seem promising at this stage of testing turn out to be completely worthless or even deadly when taken by humans." WhatamIdoing (talk) 23:43, 23 September 2012 (UTC)

That sounds like what I was envisioning being added. To be clear, I do not think soursop cures cancer. Rather, judging from the feedback from the article, it seems that many people are reading it who may have heard heard something about soursop=cancer cure from a friend, or (rare as it may be) a popular news report that was not %100 accurate. They are then going to Wikipedia to learn more. For them I think it would be helpful to have a statement like, "Eating soursop will not cure your cancer, or the cancer of a loved one. Maybe you've heard that there's scientific proof of this, but there isn't. Here's what scientists have actually found." But, you know, Wikified. Tdslk (talk) 01:03, 24 September 2012 (UTC)

We have a new MD editing

The edits still need improvements as seen here Urinary_incontinence. But hopefully with guidance they will become good. Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:17, 23 September 2012 (UTC)

Misophonia

The Misophonia article looks well-intentioned, but a great part of the article's content was either uncited, or cited to sources that fail to meet the WP:MEDRS, or even WP:RS, criteria. I've now removed about half of the article content, leaving only stuff cited to WP:RS. See this diff for the changes. It could do with further improvement: I'd really appreciate it if someone with relevant expertise could take a look at the new version of the article. -- The Anome (talk) 07:02, 24 September 2012 (UTC)

Do you think the stuff you removed was accurate, despite having been supported by weak sources? WhatamIdoing (talk) 16:20, 24 September 2012 (UTC)

Help request for a Wikiversity project on Parkinson's

A group of us are looking for help in continuing the development of a Wikiversity learning project. I hope this is appropriate place to contact wikipedians who might be interested in giving assistance or spreading the word. The project is The Science Behind Parkinson's. I invite you to visit it to look at its aims and state of development. We have, in fact, got a lot of material on it already. But we want more people to join us in developing it and making it a valuable resource particularly for those affected by Parkinson's who want to understand more about the science underlying the condition.

It would be good if you could also suggest other ways in which we could find other people who would be interested in helping with its development. I am prepared to write individually to all the active wikipedians on the Neuroscience project if that is the best way of contacting relevant people but I don't want to be accused of spamming! Thanks. My user name on Wikiversity is Droflet. Please write on my user talk page there, http://en.wikiversity.org/wiki/User_talk:Droflet or on my user talk page here on wikipedia. Jtelford (talk) 09:05, 24 September 2012 (UTC)

Migraine-related articles giving me a headache...

There's a recently-created article migraine treatment that was just Wikilinked from migraine. Migraine treatment has some problems from a Wikipedia perspective, parts of it appear to be OK, but it definitely has a promotional tone related to Elliot Shevel and a surgical migraine treatment method his article discusses that he developed. A review of the editors involved in these articles shows some probable COI problems. (Sample sentence from the migraine treatment article: "As these vessels have no connection with the arterial supply to the brain, the Shevel Procedure is exceedingly safe with no unpleasant side effects. The cosmetic effect is excellent as most of the incisions are within the hairline.") Migraine was recently made GA so this is an area of current interest. Anybody who has extra time could you please check out these areas.... Zad68 12:26, 24 September 2012 (UTC)

I agree with your concerns. Feel free to tackle it. Doc James (talk · contribs · email) (if I write on your page reply on mine) 13:13, 24 September 2012 (UTC)

I'm already behind on the Wikipedia stuff I use to avoid doing my real work!! :) I'm watchlisting the articles but won't be able to get to them in the next 2-3 days... Hoping someone else here has some time? Zad68 13:18, 24 September 2012 (UTC)

Please keep an eye on the main migraine article as well if you can. The treatment article needs a rewrite and probably a few tags. Doc James (talk · contribs · email) (if I write on your page reply on mine) 13:33, 24 September 2012 (UTC)

It's all watchlisted. This is a busy week for me IRL, I will get to it Thursday if nobody else does before then. Zad68 15:19, 24 September 2012 (UTC)

Significantly affected articles are: Migraine, Prevention of migraines, Migraine treatment, Migraine surgery, Elliot Shevel. Zad68 15:29, 24 September 2012 (UTC)

I started looking at this today, did a little tagging, and then saw that getting the content on these pages to conform to Wikipedia standards will not be quick or easy, in my opinion. Shevel is a legit doctor, a maxillo-facial surgeon with a lot of letters after his name. He is a peer reviewer of journals associated with the AMA and the International Headache Society (current editor-in-chief is at the Mayo clinic). He's gotten about 30 articles published, including some in PUBMED-indexed peer-reviewed journals. But he appears to be a bit of a maverick. I'm just starting to read about this topic for the first time myself, but it looks like migraines can have one of several origination points, and if a migraine has a vascular origination point, it is accepted knowledge that it is intra-cranial and drugs are the therapy of choice, at least for acute treatment. Shevel has been building some notoriety and a business for himself based on the idea that some migraines are caused by a drop in extra-cranial carotid artery pressure from dilation, and a treatment can be to cauterize the artery. Shevel states he independently came to this conclusion before discovering that Wolff came to the same conclusion in the 1930s and 40s (see this for example). I did find Migraine surgery: a plastic surgery solution for refractory migraine headache which does seem to independently echo Shevel's idea (but all I have is the abstract--there are very few free full reports in this subject area). However, this theory has not been picked up by the "mainstream" headache establishment, at least not yet. So the problem is that my normal PUBMED searches--recent review articles and other secondary sources, using keywords like "migraine AND surgery" or "migraine AND carotid"--don't turn up anything. Or, at least not a review written by someone other than Shevel himself, see this for example. This by Shevel gives an idea of the Shevel-vs.-the-establishment feel of what's going on, although, again, I only have access to the abstract. The Shevel bio article itself is clearly autobiographically written and uses almost no independent reliable secondary sources. If we were to apply the hard-core Wikipedia rules of "must use independent reliable secondary sources", we delete most of the Migraine surgery article and we probably end up deleting most or all of the Elliot Shevel article. However then we probably drive away possibly a good technical medical resource. I am not sure what to do now, and won't be back online until probably Thursday. Zad68 18:27, 25 September 2012 (UTC)

Yes saw this issue develop and simply kept it out of the main migraine article. What to do with it is a difficult question. I guess it depends on how much energy you have. Doc James (talk · contribs · email) (if I write on your page reply on mine) 18:44, 25 September 2012 (UTC)

What's your personal sense of urgency about this? I'd like to finish getting circ ready for submission for GA before opening up a whole new can of worms, I still have to resource a few more sections and I'd like to keep the momentum the article currently has going. Zad68 18:50, 25 September 2012 (UTC)

Subarticles are typically much less read than the main articles. Prevention of mirgaines is only viewed about 2500 times a month [8] while migraine surgery is viewed less than 2000 times and migraine treatment less than 100. Would concentrate your efforts on our most read article and simply tag these as needing work. But that is just me. Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:28, 25 September 2012 (UTC)

As circumcision is running at almost 230,000 views per month I'm going to weight my time there first but will not neglect these migraine ones. Zad68 20:13, 25 September 2012 (UTC)

Images from the World Health Organization

Meet for much of the day today with different aspects of WHO. One of the tentative agreements is that they may be willing to release certain images under an open license as a pilot if requested by a Wikipedian. Thus if people see images at WHO that they thing would be useful to illustrate a page email me / drop me a note of my user page and I will see about getting a release from the WHO. This could also apply to graphs and maps. Doc James (talk · contribs · email) (if I write on your page reply on mine) 18:33, 25 September 2012 (UTC)

That would be a great pilot. Thanks so much. Biosthmors (talk) 19:02, 25 September 2012 (UTC)

Infant mortality Page (expansion and revisions)

My name is Allyssa, a senior undergraduate student from Rice University. I would like to extend and revise the Wikipedia article, Infant mortality. I intend on rearranging the sections to make the article flow better. I will expand on existing sections to create a more comprehensive article. Also, I will expand this article by adding sections titled, ‘Top causes for infant mortality,’ ‘Medical disparities,’ ‘Knowledge disparities,’ and ‘Policies addressing infant mortality.’

I hope to contribute salient knowledge on this issue. I also intend on editing this article to meet Wikipedia standards.

If there are any suggestions on ways to go about this, please let me know.

Allyssa.abacan (talk) 00:49, 19 September 2012 (UTC)

Welcome Allyssa! Glad to have you working here, and you've come to the right place when you'd like suggestions. Sorry if this is redundant, but please make sure you're familiar with WP:MEDMOS and other relevant WP guidance (WP:Pillars, etc). Also, please keep in mind that the word "disparities" is somewhat vague. My guess is that you intend it to mean something more specific than "lack of parity" generally - coming from certain contexts it is easy to assume that it always refers to disparities among people of different races or ethnicities, but it could mean other things (i.e. avoid jargon - be clear). -- Scray (talk) 01:54, 19 September 2012 (UTC)

Likewise, welcome and thank you for offering to improve the article. As well as Scray's advice, please have a look at WP:MEDRS, which is our guideline on the referencing of medical articles. In general, secondary sources are preferred. Axl ¤ [Talk] 08:59, 19 September 2012 (UTC)

Further Changes

Thanks for your feedback! I intend on using scholarly and medical articles in this article. I will read WP:MEDRS to ensure that I follow guidelines on referencing medical articles. I'll work on being more clear with my jargon. Thanks again!

I will be focusing on south east asian countries since differences in medical resources and outcomes can be seen on a bigger level (Singapore and the Philippines). I will narrow down my focus to elaborate on causes (dengue fever, polio, etc) and medical infrastructure within each South East Nation I talk about. I will mainly focus on the top 5 causes of infant mortality. Information on medical infrastructure would hopefully allow readers to gain an understanding of how political structure can influence infant mortality. Also, I plan on writing about successful and failed political policies that aim(ed) to ameliorate infant mortality. Hopefully this will allow readers to grasp the root causes for high infant mortality in various countries that have varying SES status. Right now, the article is not holistically explaining infant mortality.

During my research, I will garner more academically viable resources to make this article more reliable.

I will see what I can do when considering adding/reorganizing into Epidemiology, Prevention, History, Society and culture.

Allyssa.abacan (talk) 02:32, 28 September 2012 (UTC)

An interesting article in the guardian

This article highlights the importance of our WP:COI policy and is a very interested read [9]. Doc James (talk · contribs · email) (if I write on your page reply on mine) 12:04, 23 September 2012 (UTC)

Great link, thanks. I might get that book. Are you aware of any ongoing COI problems with our pharmaceuticals articles? --Anthonyhcole (talk) 15:53, 23 September 2012 (UTC)

This isn't news. Ben Goldacre has been going on about this for years. Axl ¤ [Talk] 17:17, 23 September 2012 (UTC)

And Irving Kirsch summarises this problem of undisclosed negative trial results fairly well in The Emperor's New Drugs.. --Anthonyhcole (talk) 07:29, 24 September 2012 (UTC)

Sure. But part of my point is that Ben Goldacre wrote the Guardian article that Doc James refers to. Axl ¤ [Talk] 17:36, 24 September 2012 (UTC)

Also, what does this have to do with Wikipedia's COI policy? Axl ¤ [Talk] 17:19, 23 September 2012 (UTC)

Well we did have this User:Gout2012 not to long ago who was adding content on refractory chronic gout and stated that he worked for a company which had just received FDA approval for a treatment.

I guess the ultimate concern in this case was more the lack of use of secondary sources rather than one of COI. Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:23, 23 September 2012 (UTC)

This is why we proposed an open access guide for pharma about using Wikipedia as well (page 7). NCurse _work 05:35, 24 September 2012 (UTC)

We have a number of sources saying some companies regularly commission studies and then publish only, or mostly, the studies that reflect favourably on their therapeutic product. Does anyone know if there's a Wikipedia article on the topic? --Anthonyhcole (talk) 13:00, 25 September 2012 (UTC)

It's one aspect of the problem of publication bias. TenOfAllTrades(talk) 13:26, 25 September 2012 (UTC)

That's it. Thanks. --Anthonyhcole (talk) 03:02, 28 September 2012 (UTC)

Feedback

If you haven't tried this yet, please take a look at http://en.wikipedia.org/wiki/Special:ArticleFeedbackv5Watchlist?ref=watchlist

This will show all of the Article Feedback Tool version 5 comments from readers for pages on your watchlist. We're getting interesting comments on some pages. For example, Frailty syndrome is accumulating complaints about being too complicated, and readers of Spinal cord injury are begging for more treatment information. Overall, I think that people who leave actionable comments are requesting more pictures and simpler writing (and not just on medicine-related articles).

Many comments are non-actionable, and we're getting some nice compliments, too. But if you see a good suggestion for improving the article, then you can either make the improvement yourself and mark it resolved, or you can click the link to "feature" this comment so that other editors will be more likely to see it. (Non-actionable comments, like compliments, can be marked resolved with an appropriate comment, like "Thanks for the compliment" or "No action requested" or "Not an appropriate request for an encyclopedia article".)

Please let us know what you think of this tool, either here or at WT:AFT5. I've already made simple, quick improvements to several pages as a result of these suggestions. WhatamIdoing (talk) 21:18, 24 September 2012 (UTC)

I have looked at the feedback and I haven't found it very useful.

Current feedback for "Asthma":-

"makes things easier to read and clearer. Make it simple and have everyhting there !"
"Its.rather cool and crispy"
"can Asthma be cured?" *
"this article needs more pictures"
"More information on old age onset of asthma." *
"side effect Of aspirin in asthma" *
"bhgjkvjhvbjygjnb im from aisa"
"needs more signs and symptoms"
"you should also give information about how to cure it. about injections, the medication which you inhale too."
"THIS REALLY HELPED ME WITH MY PROJECT"
"nothing its very well..........."
"here i can find any single information i need,but if possible if they can provide any medical cases or any medical topic with first aid assembly."

In my opinion, only three of these statements provide potential points of improvement (*). An article at GA standard should have these included at appropriate weighting. The people who would be inclined to action these points would already know what was required.

I suppose that part of the issue is "What is the purpose of receiving feedback?" Is it to flag up ways to improve the article? Is it to pat ourselves on the back? Axl ¤ [Talk] 23:46, 24 September 2012 (UTC)

I find eight useful comments, including your three: #1 told you that you have a problem with WP:MTAA. #4 told you that visual images would be useful to him. #8 told you that the description of signs and symptoms might be inadequate. #9 is a more detailed version of #3, which you starred. #12 said that the article might lack information about first aid. WhatamIdoing (talk) 00:09, 25 September 2012 (UTC)

The big reasons to allow these comments is to get more people participating. Hopefully after people make a few comments they will realize that they can address the concern themselves and thus will become editors. Yes agree that basically we know that ever article below GA / FA needs improvement. The issue is that we are few and our time is limited. Doc James (talk · contribs · email) (if I write on your page reply on mine) 06:16, 25 September 2012 (UTC)

I've just gone over the last five days of feedback on my watchlist. There is quite a bit of useful comment there. You can find the feedback at the top of the talk page of articles that have the feature enabled. --Anthonyhcole (talk) 06:20, 25 September 2012 (UTC)

Answered the bit about if asthma can be cured. Doc James (talk · contribs · email) (if I write on your page reply on mine) 06:25, 25 September 2012 (UTC)

To WhatamIdoing: taken at face value, your comments are fair. However I disagree with the validity of the feedback. I.e., I don't see a problem with the accessibility, number of pictures, list of signs & symptoms, etc. Axl ¤ [Talk] 18:18, 25 September 2012 (UTC)

I found a very helpful comment here, which prompted me to make substantial changes to the article in regards to anticoagulation. Afterward, someone complimented the article in feedback. Perhaps there was causation behind the correlation. Biosthmors (talk) 19:15, 25 September 2012 (UTC)

I am really happy with the Article Feedback Tool and I see a lot of potential in this. This could be a major step toward getting organizations interested in Wikipedia. This kind of information paired with pageview statistics is supporting evidence that the public cares about Wikipedia articles. The relationship between Wikipedia and organizations now is that most organizations think they are justified in ignoring the contents of Wikipedia articles in their fields, even if Wikipedia articles are what people find doing search engine queries with terms in those fields. If any article has extremely high traffic, like asthma does, then every organization which is founded to educate the world on asthma ought to divert a lot of their attention to this article because it is where people are going for information. Still, organizations often are not convinced. However, paired with comments of any kind whether vandalism or not shows that a certain number of people are coming to this article and taking extra steps to do something. Even nonsense responses mean that someone was here to do something and that they wanted to the feedback tool for some reason that probably was not accidental. No on accidentally is surfing the net and comes to the Wikipedia article on asthma. I like this a lot. Blue Rasberry (talk) 15:49, 27 September 2012 (UTC)

MEDRS in political orientation article

There is an argument [10] that this article: Biology and political orientation is not covered by MEDRS. Is there any comments from someone experienced with MEDRS as to whether this is the case? IRWolfie- (talk) 21:40, 25 September 2012 (UTC)

It is not a medical article, and does not have any sections or content about medical diseases or their treatments, thus MEDRS does not apply to this article.--MrADHD | T@1k? 22:53, 25 September 2012 (UTC)

WP:SCIRS should, though. — Scientizzle 17:43, 26 September 2012 (UTC)

I posted there. I think the article is making some assertions which could be covered under WP:MEDRS but that is because of inappropriate application of concepts from other fields to medicine. The article seems like a sociology article to me. Blue Rasberry (talk) 15:55, 27 September 2012 (UTC)

Gender issues in diagnosing conduct disorder

The article Gender issues in diagnosing conduct disorder seems to be ripe with issues. I notice it has no project tags so invite those more aware of the issues involved to take a look and see if it belongs in this project and if the clean-up issues can be addressed, or if the article should remain. Insomesia (talk) 23:00, 20 September 2012 (UTC)

I am familiar with this disorder although I am certainly no expert though. Gender differences is already discussed in the main conduct disorder page. The sourcing standards are poor on the article that you highlight and I do not think a separate article is warranted for the fact that males are more commonly diagnosed, than girls. I would be of the opinion that the article should be deleted.--MrADHD | T@1k? 00:12, 21 September 2012 (UTC)

Wouldn't redirect be the course then? Insomesia (talk) 00:18, 21 September 2012 (UTC)

No, because it is not a search term that you would expect people to use nor is it a term used in any wikipedia articles so it would serve no value. If that redirect was up for discussion I would vote for its deletion.--MrADHD | T@1k? 08:15, 21 September 2012 (UTC)

Could you or someone else start the AfD? I'm not sure I could cogently word the best deletion and no redirect explanation. Insomesia (talk) 20:53, 21 September 2012 (UTC)

I PRODed it as I thought it wouldn't be a very controversial deletion but if it gets rejected as a PROD then I or someone can place it in AfD. Maybe AfD would have been better? Hmmm.--MrADHD | T@1k? 23:18, 22 September 2012 (UTC)

Thank you for your work on this! Insomesia (talk) 01:58, 2 October 2012 (UTC)

Wikidata

Per here Wikidata will be adding infobox data by the end of this year / early next year.[11] The World Health Organization is interested in collaborating on definitions of diseases. They wish to feed our definitions (along with a bunch of other stuff) to their experts who will than improve on them and hopefully feed them back to us.

A while ago we discussed adding definitions to infoboxes (as well as some other stuff). While some things may not display properly in an infobox as it is simply to much text this sort of content should fit well within Wikidata and than can hopefully be easily feed into Wikipedia's articles on disease.

We want a system where if the WHO updates or changes their definition this will automatically feed from their database into Wikidata and than into the rest of Wikipedia.

What do people think of this proposal? We will hopefully soon have a Wikipedian in Residence at the WHO to help with the development of this idea. Doc James (talk · contribs · email) (if I write on your page reply on mine) 17:35, 26 September 2012 (UTC)

I need to find out more about exactly what kind of information will be "piped in" to the Wikipedia articles from the WHO, and how that will work on a technical level, to make an assessment. What are the pros and cons of giving an outside organization like the WHO basically a direct line to adding their own content to Wikipedia articles? What happens if the WHO changes their information so that it contradicts what the article says? Is anybody else a little bit leery about this? Zad68 15:55, 27 September 2012 (UTC)

I am not at all leery about this and only want this to happen The World Health Organization has the most conservative health policy of any organization in the world, and I would like for Wikipedia to gain more respect for being a thorough, conservative authority in established fields. The pros are that the WHO has a huge amount of resources and expertise and publish superior reviews of medical information which I would consider to be more attractive for Wikipedia purposes than typical secondary sources in medicine. The WHO gives imprimaturs to secondary sources to advocate for other groups to pay attention to them. The con to this is that Wikipedia will begin to more formally replace functions which have traditionally been held by governments; this is not necessarily a con but it is something to consider and will definitely disrupt a lot of people's worldviews and work practices.

The kind of information which will be piped in are international standards and definitions and their official translations in all languages. This kind of project transcends what Wikipedia is now and would give the Wikipedia project diplomatic clout to some extent. This could be highly mutually beneficial - the WHO has information to distribute which the Wikipedia project needs, but has no distribution network as efficient and on-demand as Wikipedia. The Wikipedia project has a distribution network but needs more participants such as those in the WHO. I would be happy to see Wikipedia become more international and authoritative. Blue Rasberry (talk) 16:10, 27 September 2012 (UTC)

I am happy to collaborate with the WHO, but I am not sure that disease definitions can be easily squeezed into an infobox. For example, in "Asthma", the "Classification" section defines asthma: "Asthma is defined by the Global Initiative for Asthma as "a chronic inflammatory disorder of the airways in which many cells and cellular elements play a role. The chronic inflammation is associated with airway hyperresponsiveness that leads to recurrent episodes of wheezing, breathlessness, chest tightness and coughing particularly at night or in the early morning. These episodes are usually associated with widespread, but variable airflow obstruction within the lung that is often reversible either spontaneously or with treatment". " Should this definition be placed in an infobox? I'm not convinced that this would be helpful for readers. Axl ¤ [Talk] 18:37, 27 September 2012 (UTC)

I think the idea is to have an automatic incorporation of WHO's definition into the first sentence of each disease article. is that a main idea here? If we decide to put it in the infobox, I think we should have a world limit that the WHO would agree to. Biosthmors (talk) 19:41, 27 September 2012 (UTC)

The idea is to incorporate this content (definitions) into Wikidata but not into the infoboxes as it would not fit there. Where and how it would be incorporated into the articles is still up in the air. We could start the article with this or we could have it placed in the definition section.

The International Classification of Disease is more or less the world standard for the definition of disease. This does not mean we cannot or should not include other definitions or mention previous definitions. And of course some definitions are disputed and cannot be dealt with in a single sentence or paragraph. Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:56, 27 September 2012 (UTC)

Okay. It sounds like there are a few things to iron out. Is this "Wikidata" visible to readers? Axl ¤ [Talk] 22:35, 27 September 2012 (UTC)

Yes lots of things to iron out. Discussion is in its very early stages. There are demo version of wikidata available but the live version is not yet out. Hopefully by the end of the year. Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:09, 28 September 2012 (UTC)

Wikimedia Medicine

We are nearing incorporation of Wikimedia Medicine, a thematic group (basically a chapter that is international in scope and deals only with medicine). All those here are free to become involved. Its main goals will be to develop collaborations with other organizations and be a liaison between editors here and those organizations. Content decisions will as before still take place within Wikipedia. Comments appreciated. Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:13, 28 September 2012 (UTC)

Some important concerns regarding the form and nature of Wikimedia Medicine have been raised at User talk:Iridescent. The advice of editors with an interest in that project is sought. --Anthonyhcole (talk) 01:40, 30 September 2012 (UTC)

Yes. The main thing is that this organization will have NO greater say over content than a national chapter. Which of course means no say at all over content. This organization will be more about forming collaborations and teaching other organizations about how Wikipedia works. Not very glamorous stuff but others wish to work with us and often do not know how to become involved.

If we take a proactive roll they can work with us better and we can try to prevent any bad outcomes where both us and they end up unhappy.Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:50, 1 October 2012 (UTC)

I've also posted a note to the Village Pump (Miscellaneous). J N 466 20:47, 1 October 2012 (UTC)

Psychoanalysis query

Should this page—or part of it—be within the scope of this project? The page is protected, but I've tried to suggest a series of improvements To help update/revise Evaluation of effectiveness etc per WP:MEDRS. —MistyMorn (talk) 18:04, 29 September 2012 (UTC)

My intuitive reaction would be that it is in the borderland of medicine. Psychoanalysis is perilously close to being scientifically discredited, but it is practiced by psychiatrists worldwide and thus would fall under WPMED by virtue of being a psychiatric treatment modality. The literature on psychoanalysis is a bit difficult to fit in the straitjacket of MEDRS, but the principles apply all the same. JFW | T@lk 21:17, 29 September 2012 (UTC)

"Perilously close to being discredited?!" ....hmmmmm. Yes it would be in this wikiproject but agree with preceding. Given we are not a strict medical text there may be historical or biographical aspects (for instance) not covered in peer-reviewed journals. Each case of using a primary or otherwise non peer-reviewed source can be discussed on its own merits. Casliber (talk · contribs) 21:32, 29 September 2012 (UTC)

With AltMed, we usually include "big" topics (like homeopathy) and omit small ones (like individual products). Following a similar line of logic, I'd include this, even if it seems nearly discredited, at Mid importance. WhatamIdoing (talk) 22:21, 29 September 2012 (UTC)

My reasoning is that, despite everything [12], psychoanalysis continues to be adopted as a real-world treatment [13] for genuine conditions and that its effectiveness is consequently assessed as such in systematic reviews and meta-analyses, by Cochrane among others. So MEDRS should surely apply for assessment of therapeutic effectiveness at least (even though evaluation of long-term interventions may pose serious methodological challenges). —MistyMorn (talk) 23:08, 29 September 2012 (UTC)

I've added a template, marked Mid importance, per WAID's suggestion above. —MistyMorn (talk) 15:38, 30 September 2012 (UTC)

Template talk:Sexual orientation#Pansexuality and polysexuality

Input is needed with regard to the above linked discussion. It has to do with how the medical community defines sexual orientation vs. social terms that have been created to describe sexual preferences/feelings and/or gender. Flyer22 (talk) 18:52, 30 September 2012 (UTC)

The MeSH redirect for "sexual orientation" is to "Sexual Behavior" [14]. Imo, claimed associations between lifestyle factors and health-related outcomes should be subject to MEDRS. As should any currently recognized health condition (eg per DSM). However, I find it hard to see why "sexual orientation", as a general topic, should fall directly within the scope of this project.

Just my 2 cents, —MistyMorn (talk) 19:16, 30 September 2012 (UTC)

Hello, MistyMorn. Despite that redirect, sexual orientation and sexual behavior are usually distinguished by experts in these fields...although sexual behavior is defined as a component of sexual orientation. Sexual orientation and sexuality topics don't fall directly within the scope of this project in the way that diabetes does, for example, but they are within the scope of this project because they are medical aspects in some ways; this is shown with associations such as the American Psychological Association and the American Psychiatric Association. This is why the editor who started this discussion stated, "I see the usual suspects are here claiming we can't include pansexuality and polysexuality, even though we have articles on both, because these sorts of descriptors for orientation do not fit into the binary system used in medical models." And of course aspects of sexuality such as STDs/STIs, sexual dysfunction and sexual-related surgeries are within the scope of this project. All of this is why sexual orientation and sexuality topics keep being brought here for input. It was stated here before that sexual orientation and sexuality topics have some relevance here, although they are not directly listed within this project's scope.

We simply need some opinions from this project on this matter -- in that discussion, not here. Pansexuality and polysexuality are not defined as sexual orientations by any authoritative psychological/psychiatric/medical source. They are considered subsets of bisexuality. They are not listed as sexual orientations in the template, but the editor who initiated the discussion seems to believe that the mainstream categories -- heterosexuality, homosexuality...and bisexuality -- should not be designated as sexual orientations while the other terms are designated as non-binary concepts. If we list the mainstream categories as "Binary concepts," however, it does not relay which of these concepts are legitimately defined as sexual orientations; it implies that the non-binary sexual attraction concepts are legitimate sexual orientations, despite not being listed as one by any authoritative source. I am okay with the way that the template currently is, but am against pansexuality and polysexuality being listed as sexual orientations or listed in a way that they are perceived as such, per my reasoning above. Flyer22 (talk) 20:30, 30 September 2012 (UTC)

I can see where you're coming from, conceptually. A somewhat analogous scope-related issue was recently discussed here. Personally, I think such queries are a rather hard ask for the present Project. However, you might like to try inquiring at the Psychiatry Task force talk page. 2c, —MistyMorn (talk) 22:44, 30 September 2012 (UTC)

Yes, I'd noticed that discussion, MistyMorn. And I thank you for helping in any way that you can. The WikiProject Medicine/Psychiatry task force is very inactive, though, so I'll just settle for the WikiProjects I did contact, in addition to editors specifically, and see how many weigh in. Flyer22 (talk) 22:52, 30 September 2012 (UTC)

External links

We have a user adding external links to many cancer articles to the site cancer.net Special:Contributions/Mmh526 Comments? Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:11, 1 October 2012 (UTC)

It's not a bad site, but most articles don't need that kind basic information. WhatamIdoing (talk) 20:27, 1 October 2012 (UTC)

cancer.net is a good quality site. However from WP:ELNO: "Links normally to be avoided: Any site that does not provide a unique resource beyond what the article would contain if it became a featured article." cancer.net falls under this category, thus it shouldn't be used as an external link for cancer-related articles. Axl ¤ [Talk] 08:19, 2 October 2012 (UTC)

Medical cost-effectiveness analysis and MEDRS?

I think a more appropriate place for the ongoing thread Wikipedia_talk:Identifying_reliable_sources_(medicine)#Does_this_fall_under_MEDRS.3F would be here. User: WhisperToMe queried a particular source which, imo, wouldn't meet WP:RS, let alone MEDRS. However, the query implicitly raises a wider issue about whether medical cost-effectiveness analysis studies should come under MEDRS. —MistyMorn (talk) 01:07, 2 October 2012 (UTC)

From my own research in editing an article about a medical intervention, I did find that the question of the cost-effectiveness of the intervention was very much indeed covered by WP:MEDRS-compliant sources, specifically PUBMED-indexed, peer-reviewed journal articles, meta-analyses and statements from major medical organizations. The fact that MEDRS sources exist makes me think that the world of medicine itself treats cost-effectiveness as a medical claim and so I would tend to think Yes, cost-effectiveness claims would be subject to WP:MEDRS. Zad68 01:19, 2 October 2012 (UTC)

Just because you can find papers on Medline does not mean that you're looking at purely scientific claims. One of the ways you can tell, is that the guidelines disagree with each other. Why is that? Well, because they've used different assumptions, ethical values, and fears, going into the statistics, and in evaluating the studies. And "GIGO" applies just as well in logic as it does in computer science.

I see we need an example. Suppose you've had a thrombotic stroke and you don't have a diseased heart or some easy way to explain it. Your blood pressure and cholesterol are good, and you're not obese and and you don't smoke and so on. Now the question is what kind of anti-platelet agent shall we give you to prevent a second stroke? The official AHA/ASA guidelines [15] say treatment should be "individualized." But they don't tell you how, except obviously people with intolerance to one drug should be given another. They do say: Aspirin is less expensive, which may affect long-term adherence.283,284 However, even small reductions in vascular events compared with aspirin may make combination dipyridamole and aspirin or clopidogrel cost-effective from a broader societal perspective.285 So what do they mean by "may make"? Who decides? Aspirin is pennies a day, whereas the other antiplatelet agents typically are $150 a month or more. The reduction in risk over aspirin is small but statistically real. However, the larger side effects and non-compliance rates for the other drugs are far greater than aspirin, and just as real. So, a couple of Belgians look through all the best studies and find all that, and say: "Despite changes in international guidelines, aspirin monotherapy should retain its position as the main antiplatelet agent for secondary prevention of non-cardioembolic ischaemic stroke." Uh oh.

So now, your HMO or perhaps Medicaid decide that asprin is the thing you need, and all they will pay for, on the basis of this cost-effectiveness analysis that says the the expensive drugs aren't worth it, and haven't been scientifically shown to be worth it, even from the money-alone viewpoint. And you object that these people are not as worried as you are about that slight extra increase in chance of a new stroke, and you don't care if you can't prove that the cost of your slight increase in chance of needing long-term care plus having a bad bleeding side effect, doesn't outweigh the cost of the drugs for the rest of your life. You feel you should have the expensive drugs anyway, and are willing to take the side-effect risk. You put this argument to Medicaid or your HMO doc and add that you can't afford anything but aspirin. Back comes the answer: "Sucks to be you, then." Although they're more polite than that, and have a lot of other legalese and references. Now, you object that the reasoning behind denying you the expensive drug isn't fully scientific and relies on a lot of assumptions about tradeoffs between side effects, costs, and small risk decreases that are statistically real, but clinically not very large. Your HMO doc says Well, you're not being fully scientific, either, sir. I think you're stroke-a-phobic. And besides, who says these Belgian meta analysis guidelines aren't scientific? We found them on Medline: PMID 22997997 as a big meta analysis in Acta Cardiologica, a fully refeereed and highly respected journal. Therefore, they are scientific by definition. They even meet WP:MEDRS, if you allow for a few assumptions. The same goes for the AMA/ASA guidelines, too, of course. But we like the Belgian point of view, and it will save us money...

My point is that this kind of thing goes on EVERYWHERE in medicine. It's very typical. You can't solve it all by application of science, or WP:MEDRS. By the time you get to this level, you're partly operating from differences in taste, and differences in fear. And, of course, differences in outlook that come from whose money it is, that is being spent. S B H arris 03:02, 2 October 2012 (UTC)

I can only assume I'm missing a huge piece of the backstory here. The whole real-world dealing-with-the-HMO aspirin-vs.-antiplatelet agent hypothetical anecdote Sbharris posted is entirely outside the scope of Wikipedia's intent. We don't write Wikipedia articles for the purposes of offering medical advice or guiding HMOs in coming up with their formularies and I don't see how it relates to Misty's question. I agree that Wikipedia articles are only as good as our sources. Relative to other sourcing guidelines for other projects, WP:MEDRS is a pretty high standard, and following it should produce medical articles that reflect the best, most recent and most widely accepted thinking in the medical community. If Sbharris has been personally affected by some medical decision that didn't go his way, that is tragic but I'm not seeing how his story should guide Wikipedia's preference for peer-reviewed journal secondary sources. Zad68 03:52, 2 October 2012 (UTC)

I now see Sbharris is a physician. I was just going to delete my comment but that won't get my question answered: How is what Sbharris wrote supposed to guide our use of sources in writing medical articles? Zad68 03:56, 2 October 2012 (UTC)

I really did want to bring the relevant MEDRS question here. —MistyMorn (talk) 06:40, 2 October 2012 (UTC)

The question I was trying to bring here was simply: Should WP:MEDRS apply to medical cost-effectiveness analysis in the same way as it does to (other) biomedical information?

Personally, I agree with Zad that it should. As I wrote in the initial discussion over at Talk:Identifying reliable sources (medicine):

It's true that cost-effectiveness is a form of economic analysis. But when talking about the cost-effectiveness of a medical intervention, the effectiveness part (ie the denominator of a cost-effectiveness ratio) implicitly incorporates health-status outcomes such as quality of life and survival; for example, a commonly used outcome measure is quality-adjusted life years (QALY) [16], where the cost-effectiveness ratio is expressed as $/QALY etc, allowing economic comparisons of different treatments/interventions to be made using incremental cost-effectiveness ratios. So I think there's a strong case for applying MEDRS for cost-effectiveness studies of medical or health interventions (especially when multiple primary studies are available).

—MistyMorn (talk) 15:30, 2 October 2012 (UTC)

In general, I'm not fond of discussing whether or not unspecific information that relates to medicine should or should not be covered by MEDRS. But for this topic, I think we're talking about health economics and not biomedical (medical research) information. As long as we use good editorial judgement then we should incorporate high-quality (peer reviewed, published, etc.) economic information and expert opinion. My impression is that the field of health economics is not as developed as the field of clincial research, so I don't see any benefit in trying to limit things to reviews (which is a major pragmatic implication of MEDRS). Take the economics section of deep vein thrombosis, for example. I cited something indexed as a review only to find that a rebuttal to the review had been published. Now I cite all the correspondence. I don't think this sort of thing happens in medical research as much. Biosthmors (talk) 17:23, 2 October 2012 (UTC)

MEDRS is about identifying "ideal sources for biomedical material". The price of an item is not "biomedical material", no matter how much you stretch the concept of "biomedical". You cannot evaluate cost-effectiveness without dealing with the "cost" aspect. Therefore, MEDRS does not directly apply. It might give you some good principles to follow, but it does not directly apply.

MEDRS does apply when you are talking specifically about efficacy (not efficacy-relative-to-price): this extremely expensive medication works this well. But "we find the old antihypertensive drug to be cheaper than the newest antihypertensive, even though they both are equally (in)effective for mild hypertension" or "we find early-term abortions performed by nurses to be cheaper than the same procedure performed by a gynecological surgeon, even though they have the same biological result" is not really a MEDRS issue, because it's not really a biological question. WhatamIdoing (talk) 18:21, 2 October 2012 (UTC)

And for those that missed the backstory, the question originally posed was whether a dental service organization provides more "cost-effective" dental care than private dentists. This is really about how much an office visit costs, and whether a low-income person can afford it, than about comparing the biological outcomes of a person taking aspirin vs a person taking a statin. There's nothing "biomedical" about being "more cost-efficient...than the average Texas dentist". WhatamIdoing (talk) 18:25, 2 October 2012 (UTC)

I certainly agree with WAID about the commercial backstory citation [17], which (if I'm not mistaken) regarded cost minimization rather than cost effectiveness, as claimed by the highly conflicted author. But I think we may have to differ on the broader question regarding cost-effectiveness analysis and the scope of MEDRS. While fully agreeing with Bios about the key role of good editorial judgement and also respecting your personal impressions and views, I would hate to see health economics information POV-pushed. Just as I hate seeing other types of unsubstantiated health claims publicized [18]—whether medical, bio, epi, or whatever... In brief I don't see any hard cut-off between health-related and medical knowledge. —MistyMorn (talk) 20:13, 2 October 2012 (UTC)

I think the quality of the source/data is much more important here. If a particular treatment is more expensive than another, and there is good secondary sourcing available to support this, we should be prepared to discuss it. JFW | T@lk 21:35, 2 October 2012 (UTC)

But why under these guidelines, which are set up to evaluate biomedical scientific questions? (Not even physics-related or chemistry-related scientific questions). An issue does not really a biomedical science issue just because it involves a biomedical thingie. For example, one sports car might be more expensive than another, but that's not a MEDRS issue. But now does it automatically become a MEDRS issue if one ambulance is more expensive than another? That would be bizzare. But how about when one defibrillator costs more than another type? See below, but we're basically not used to using Consumer Reports when it comes to health issues, since these things involve questions involving a mix of science and many other values of a type that Consumer Reports is not used to handling. Basically, the costs of biomedical things (lab equipment, drugs, surgical procedures, you name it) are straighforward economic fact (not natural science fact) questions when we're talking about the price of the exact same thing in one location vs. another (as with the price of anything), but when we begin to make cost-tradeoffs vs. effectiveness or performance tradeoffs for significantly different things that related to biomedicine, now we're in lab-management or health-policy or clinical judgement sphere, where natural science only partly applies, and the guidelines in MEDRS really only apply to a part of the premises of such things.

As I said someplace else, natural science knowledge (including biomedical knowledge) tells you only what you can (probably) do, but not what you should do. Thus, it's best to keep fairly pure biomedical science questions off in their own corner, and deal with biomedical ethics and policy questions under other WP guidelines (which are the same ones where we discuss global warming initiatives and politics and religion). Manmade global warming is a scientific question, but what to do about it (if anything) is not really a scientific question (or at least, mostly not). These same intangibles are what differentiate materials science (say) from structural engineering, and stuctural engineering from (say) architecture. The nature of WP:IRS changes completely as you go from materials science to architecture. One RS policy really can't cover it, and a MEDRS policy specifically crafted to look at natural science questions fails badly when harnessed into doing ethics and values-laden things also. How could it not? These are different modes of discourse. S B H arris 02:00, 3 October 2012 (UTC)

Well, I think we're pretty much all agreed that MEDRS should not apply to questions confined to cost issues. And that the backstory reference [19] does not satisfy WP:IRS as a reliable, independent secondary source (whereas a Consumer Reports article on the subject likely would?).

But if we turn to a source genuinely regarding cost effectiveness, such as Clinical effectiveness and cost-effectiveness of implantable cardioverter defibrillators for arrhythmias: a systematic review and economic evaluation, we're obviously not just dealing with relative costs of different devices, but rather with maximizing long-term clinical effectiveness within a given (national) economic scenario. JFW has suggested that that sort of question is better discussed at WT:MEDRS.—MistyMorn (talk) 11:47, 3 October 2012 (UTC)

A related question

I am having a closely related problem. I am working with Consumer Reports, a United States-based non-profit organization, on a project to add consumer-facing health content to Wikipedia. This is part of an educational campaign to disseminate information produced by medical specialty professional organizations based in the United States and to get more professional educators involved in developing Wikipedia health articles. Information is at WP:Consumer Reports and the talk page particularly discusses health issues.

Zad68 and MistyMorn just asked what the relevant question is and it is the same as the one Consumer Reports is exploring now and which I think many organizations will explore soon - what is the place of tertiary sources in Wikipedia? Suppose that there are review articles which give scientific information about the way things are fundamentally. A tertiary source may present this information to a specific audience, such as to the public instead of to researchers or to people with a special constraining condition, such as people who do not have unlimited access to health resources as in Sbharris's case of the person taking aspirin as the best option for the community because of limited funds to provide the drug which is medically best from any individual's perspective.

The relevant MEDRS question is if there is a respected health organization that cites review articles when stating an interpretation, what place does that have in health articles? In the case of Consumer Reports, an argument for inclusion of their content is that since Wikipedia is primarily trafficked by the public, then health articles should include interpretations targeted to the public rather than to researchers. In Sbharris's claim it seems that review articles recommend one course of treatment, but the disciplines of economics, government, and public health encroach into what medicine can practically deliver and some medical researchers make an acknowledgement of this.

I am very interested in exploring this further with anyone. Blue Rasberry (talk) 13:49, 2 October 2012 (UTC)

I'm not sure whether I really understand Blue's question here. As an economic tool, medical cost-effectiveness analyses (CEA) [20] are often employed to help planning of health services (the British NHS, for example, uses them through NICE) or help make more rational decisions for, say, disease prevention/treatment programs in developing countries where resources are scarce (eg [21]). The approach has not been without its ethical controversies (eg [22]) and methodological limitations (eg [23]). CEA provide stuff which health economists understand, but may leave the general public baffled, when not openly hostile [24]. (Additionally, clinicians may be highly skeptical or deeply opposed.) —MistyMorn (talk) 16:08, 2 October 2012 (UTC)

I've already been in discussion with Bluerasberry (on-Wiki and off-Wiki) about the use of the Consumer Reports publications. I think cost-effectiveness analyses should be suitable for inclusion as long as the sources meet the requirements set out in MEDRS. Now personally I would want such analyses to be performed by completely independent organisations (NICE in the UK is a good example) in a validated manner with hard outcome measures as guiding principles. We should be discussing this on WT:MEDRS. JFW | T@lk 21:35, 2 October 2012 (UTC)

I've kicked off on WT:MEDRS with a couple of examples for implantable cardioverter-defibrillators. —MistyMorn (talk) 23:29, 2 October 2012 (UTC)

Should the science reference desk be publishing unsourced medical assertions?

They're still doing it. I've asked for opinions at Village pump (policy). Why are these Randys allowed to tell individual readers made-up, unsourced health-related stuff that wouldn't last five minutes on a watched medical article? --Anthonyhcole (talk) 06:43, 2 October 2012 (UTC)

It is unfortunate but this is a user experience problem. The volunteers at the help desk mean well and are not supported with sufficient question-answering infrastructure. I think the reference desk could use a fundamental redesign to incorporate a decision tree and better directory assistance, but I do not know anyone who could take this on. Through the grants program the Wikimedia Foundation has funded proposals for reform of such things as Help:Contents (see the project here) and dispute resolution (see this request for comment happening right now). I think that any proposal to reform the reference desk would be welcome also as a project to be in queue for someone to fix. Blue Rasberry (talk) 13:22, 2 October 2012 (UTC)

International emergency medicine page (expansion and revisions)

Hello, my name is Matthew, and I'm an undergraduate student from Rice University. I'm intending on expanding and rewriting the current article on International emergency medicine. It's currently a start class article so there is a lot of room for improvement. I'd like to focus on the establishment/improvement of emergency medicine in developing countries. My plan is reorganize what is already there and to create sections like "Overview of international emergency medicine", "Institutions involved", "Role in the overall health system", "Initiatives to expand emergency medicine", and "Challenges." There is a pretty good body of literature on these topics in some of the emergency medicine journals but I would be glad to hear if anyone had ideas on other sources I could use. Any suggestions for the best way to go about this? Mjs15 (talk) 14:29, 3 October 2012 (UTC)

Hello Mjs and welcome to WP:MED (WikiProject Medicine). Good to have you around!

I had a quick scout around for you on PubMed, and, yes, it does indeed seem that most of the pertinent articles are in the specialist literature.* You might like to try the TRIP database [25]. I did come across an article in the Bulletin of the WHO [26]. I didn't stumble upon any obviously useful book sources, but you may well know of some.

*FYI, the most sensitive PubMed string I tried to search for potentially relevant reliable medical sources (WP:MEDRS) was:
"international emergency medicine" OR ("Emergency Medicine"[Mesh] OR "Disaster Medicine"[Mesh]) AND ("International Agencies"[Mesh] OR "International Cooperation"[Mesh] OR "Internationality"[Mesh] OR "World Health Organization"[Mesh] OR internat* OR world* OR global*) AND (Meta-Analysis[ptyp] OR Review[ptyp] OR systematic[sb] OR Guideline[ptyp])
= 104 results, 34 from the last 5 years

—MistyMorn (talk) 16:36, 3 October 2012 (UTC)

That article could use some love, and I'm glad you've decided to take it on. My recommendation is that you WP:BOLDly get started, and do your best. This is a good page for asking questions if you get stuck. Good luck, WhatamIdoing (talk) 17:47, 3 October 2012 (UTC)

Wikimedia Medicine

If people are interested please sign up here meta:Wikimedia_Medicine#People_interested. The chap comm wants 25 people in support before they will approve this. Doc James (talk · contribs · email) (if I write on your page reply on mine) 18:51, 2 October 2012 (UTC)

A few eyes please

...at Antigen leukocyte cellular antibody test? Seems I'm thought to be guilty of an outrageous COATRACK. LeadSongDog come howl! 17:13, 3 October 2012 (UTC)

Well, now, I suppose there is a case to be made for your addition being a bit strong. For example, you wrote that it is "not recommended to be used for diagnosing allergies of any form", which is untrue, because the manufacturer's sales staff probably recommends it all the time.

WhatamIdoing (talk) 19:08, 3 October 2012 (UTC)

But manufacturers aren't reliable medical sources for recommendations, so they have no say on this. =) Biosthmors (talk) 21:09, 3 October 2012 (UTC)

Is death from hypertension "preventable"?

Please lend your expertise at Talk:List_of_preventable_causes_of_death#Hypertension.3F. Thanks. --Dweller (talk) 20:06, 3 October 2012 (UTC)

Yes as their is effective treatment. Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:05, 3 October 2012 (UTC)

Proposed “HIV and MSM” Article

As part of a class at Rice University, I propose to start a new Wikipedia page entitled “HIV and Men Who Have Sex with Men (MSM)” to expand the current small subsection on the Men who have sex with men page. The current HIV subsection of the MSM page is far more detailed than anything else on the MSM page (everything else is merely a survey) and would benefit from having freedom to expand by itself. The CDC, UNAIDS, and AVERT websites all have pages specifically dedicated to HIV and MSM so Wikipedia should have a page that goes into an equal level of detail. The page should also include information beyond public health risks alone, like the stigma associated with an HIV diagnosis in the MSM community and prevention methods. This would make the page a thorough sociological analysis of how HIV affects the MSM population. Although I will draw on the Center for Disease Control for statistics about the prevalence of HIV in the MSM community and demographic data, I will rely mainly on journal articles for my references. There are a variety of scholarly articles available on HIV/AIDS and its specific relationship to men who have sex with men. Journals like The Lancet, AIDS Journal, The American Foundation for AIDS Research, The Journal of Homosexuality, The Journal of Urban Health, AIDS and Behavior, and the British Medical Journal all have published multiple articles on topics relevant to my Wikipedia article. I will make sure my sources are varied, unbiased, and represent a variety of scholarly work. I would be interested to hear the WikiProject members’ feedback on how I can better improve my contribution. Cshaase (talk) 01:09, 4 October 2012 (UTC)

We already have this article here HIV/AIDS. Please read WP:MEDRS. We typically use secondary sources such as review articles and not primary research such as most research papers. Doc James (talk · contribs · email) (if I write on your page reply on mine) 03:12, 4 October 2012 (UTC)

Why don't you start the page in your sandbox, and see how it develops? After seeing things fleshed out and referenced, you might get better opinions on whether it should be added to an existing page or worth starting a new article for. Canada Hky (talk) 02:59, 5 October 2012 (UTC)

We have a variety of individual articles that are linked at AIDS#Society_and_culture. Hmmm... Biosthmors (talk) 03:41, 5 October 2012 (UTC)

Diseases of poverty

I will be editing and adding contributions to the Wikipedia page Diseases of poverty. I believe that this fits into the Wikiproject medicine. This contribution will expand on diseases of poverty to include those found in United States, as well as disparities in access to health care between the rich and the poor, and the impact of lack of resources such as clean water. For this article I will use information from the Centers of Disease Control and prevention, the National Institute of Health and other scholarly articles. I will be contributing these additions as part of an extensive class assignment.

I welcome any recommendations for further edits as well as credible sources of information. I also welcome and tips for raising the quality of the overall page.Bellechic (talk) 04:21, 4 October 2012 (UTC) (talk)

Hello and welcome Bellechic. Yes, this fits into WP:MED, so you'll need to follow our reliable medical sources (MEDRS) and style (MEDMOS) guidelines. When considering how you plan to develop the page, please bear in mind the need to present a world-wide perspective. It's true that the US, like other developed countries, has poverty issues and related health inequalities (disease). But it's also true that, overall, by far the greatest burden of poverty-related disease is to be found elsewhere, in poorer or less developed countries, such as in sub-Saharan Africa. —MistyMorn (talk) 08:36, 4 October 2012 (UTC)

A new article has been proposed for deletion

Post-Finasteride Syndrome. Biosthmors (talk) 16:07, 4 October 2012 (UTC)

Deletion discussions for medical articles are all concentrated on Wikipedia:WikiProject Deletion sorting/Medicine. You can put that on your watchlist. JFW | T@lk 05:58, 5 October 2012 (UTC)

DELSORT is human-generated. See Wikipedia:WikiProject Medicine/Article alerts for an automatic list of every page tagged by the project. The overlap is imperfect. WhatamIdoing (talk) 17:32, 5 October 2012 (UTC)

Patient handouts

There is some interest in creating "patient handouts" under a CC BY SA license. I am thinking on Wikibooks. Are others interested or do they have any thoughts on this? I have a few collaborators interested. They would of course be referenced. Doc James (talk · contribs · email) (if I write on your page reply on mine) 03:56, 5 October 2012 (UTC)

Mailing list for Wikimedia Medicine

We have a new mailing list here [27] All who are interested are welcome to sign up. Doc James (talk · contribs · email) (if I write on your page reply on mine) 10:21, 5 October 2012 (UTC)

Trip database projects

At the end of August, several of us attended the Medical Wiki Workshop in Coventry, UK ( http://coventrywiki.eventbrite.co.uk/ ). One of the key speakers was Jon Brassey, Co-Founder of TRIP Database, which is a search engine that concentrates on finding the best clinical evidence ( http://www.tripdatabase.com/ ). After Jon's presentation, I chatted with him about specific ways in which we might be able to make use of his resources to improve medical articles on Wikipedia. A couple of possibilities have emerged and I wanted to share them with WikiProject members to see how we could proceed. --RexxS (talk) 14:12, 4 October 2012 (UTC)

Quality mark

Those of you who use Trip database will know that it already classifies articles as "Secondary evidence" / "Evidence based synopses" / "Systematic reviews", etc. I have often found that one of the biggest problems for new editors of medical articles is that they want to substitute their own judgement of article quality for that of expert reviewers. It's exactly that problem that fuels a lot of disputes about whether a given source is suitable for inclusion in an article. I have suggested to Jon that he might be able to put a 'quality mark' on the very best articles in his database - 'wikipedia approved', if you will. This would at least give editors an external assessment of source quality that could point them to the best evidence to use in an article. I can see that it is only likely to work well if it is accurately implemented, but I would be grateful for comments on the potential usefulness of the idea before we move further with it. --RexxS (talk) 14:12, 4 October 2012 (UTC)

We need to be clear that the secondary requirement in MEDRS is not because "secondary" is a marker of better content, but just that WP has no internal mechanism for assessing and comparing the quality of primary sources. By using recently published peer-reviewed, review articles as sources we have credible experts making that assessment of the primary sources for us. These papers are not 'wikipedia approved', but rather 'suitable for WPMED, as confirmed by outside experts'. Similar utility can be had from Pubmed queries using appropriate filter settings. LeadSongDog come howl! 18:05, 4 October 2012 (UTC)

Agree with both of you and TRIP is a great way to find these sources. Doc James (talk · contribs · email) (if I write on your page reply on mine) 03:53, 5 October 2012 (UTC)

New source feed

Talking with Jon, he explained that they add about 500 new articles to the Trip database per month. Jon asked if we would like to receive a copy of those on-wiki in some usable format, and categorised in some way - and if so where would they be delivered to? We discussed the possibility of delivering notices of new sources to relevant Wikipedia articles, probably on the talk page in the same way that newsletters are delivered to user talk pages. I suggested the possibility of delivering them to subpages of this project, broken down into broad categories, so that interested editors could find all of those on a particular topic en bloc. Other possibilities must exist, so I would again be grateful for thoughts on how useful this may be, and what implementation would be best. Thanks in advance, --RexxS (talk) 14:12, 4 October 2012 (UTC)

I think one great way to start would be to add a line about TRIP database to our WP:MED template we have on all the talk pages associated with our articles that would automatically link to a search on TRIP using the key word of the article name. Doc James (talk · contribs · email) (if I write on your page reply on mine) 03:55, 5 October 2012 (UTC)

That should be straightforward as the URL for our search results are standard e.g. http://www.tripdatabase.com/search?criteria=prostate+cancer for prostate cancer. It simply requires someone to insert the title of the page into that URL, with any spaces replaced with a + e.g. http://www.tripdatabase.com/search?criteria=term1+term2 Jrbtrip (talk) 09:51, 5 October 2012 (UTC)

Wondering how best to do this? Should not be too hard. Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:44, 7 October 2012 (UTC)

Can we create a template like {{find sources}} that we could add to our {{WPMED}} banner? I'm thinking of something that automatically takes the page name ("Talk:Prostate cancer") and turns it into a search query on the TRIP database. So instead of {{find sources}}, which produces this:

Find sources: "prostate cancer" – news · books · scholar · JSTOR · free images

we would get something that said "Search the TRIP database for high-quality sources about Prostate cancer". WhatamIdoing (talk) 20:44, 7 October 2012 (UTC)

Yes that would be excellent. Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:13, 7 October 2012 (UTC)

Further input is requested here

[28] Thanks Doc James (talk · contribs · email) (if I write on your page reply on mine) 10:50, 5 October 2012 (UTC)

Unfortunate, that. LeadSongDog come howl! 20:36, 5 October 2012 (UTC)

I have warned the user to cease personal attacks [29]. —MistyMorn (talk) 13:51, 6 October 2012 (UTC)

User does not seem to understand the distinction however. They appear to have had a number of blocks already. Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:14, 6 October 2012 (UTC)

Yup. —MistyMorn (talk) 23:30, 6 October 2012 (UTC)

Outbreak of fungal menigitis

We are getting content about this localized US outbreak added to the main meningitis page. I have move the content to the talk page. I guess the main question is how do we address news like this within an established article? Doc James (talk · contribs · email) (if I write on your page reply on mine) 09:46, 6 October 2012 (UTC)

Such information should not be added to an existing generic article. Perhaps it would be better to transfer it to Wikinews. If the matter becomes notable in its own right, it would justify its own article. Axl ¤ [Talk] 11:15, 6 October 2012 (UTC)

Yes that was sort of my position. Doc James (talk · contribs · email) (if I write on your page reply on mine) 12:06, 6 October 2012 (UTC)

WP:RECENT is an essay rather than a guideline, but it's very relevant, imo. —MistyMorn (talk) 12:13, 6 October 2012 (UTC)

Input concerning Chiropractic

Your input concerning Chiropractic would be appreciated. Discussion is underway at Talk:Chiropractic.

--Mknjbhvgcf (talk) 17:01, 8 October 2012 (UTC)

Help requested for Fibromyalgia article

We could use some help with the fibromyalgia article from someone who has access to the International Journal of Rheumatic Diseases. The issue has to do with the following article: "The use of opioids in fibromyalgia", February 2011, PMID 21303476. This journal article is being used as a source for the following text: "[Opioids] are not recommended as they can worsen mood, such as depression in fibromyalgia, have abuse and dependence potential as well as have a significant adverse effect profile. Long-term use of opioids may worsen pain in some people...".

As stated in the journal article's abstract, there are no randomized controlled studies dealing with the use of opioids for fibromyalgia. So, question is, what type of evidence is used to support the claims in the quotation above? Is this evidence high enough in quality to be used in a Wikipedia article, given what WP:MEDRS says about assessing evidence quality?

Thanks in advance for any help you can provide. -- JTSchreiber (talk) 05:40, 9 October 2012 (UTC)

I have access and will comment there. -- Scray (talk) 06:00, 9 October 2012 (UTC)

ischaemic heart disease

the article on this has very little in the prevention section. Missing is excercise.

http://www.ncbi.nlm.nih.gov/pubmed/7934752 looks like a start. — Preceding unsigned comment added by 70.44.113.171 (talk) 12:50, 9 October 2012 (UTC)

Commented at Talk:Ischaemic heart disease. Better sources are available, but the section does need work. LeadSongDog come howl! 17:33, 9 October 2012 (UTC)

ALCAT test

Eyes needed again on ALCAT test please to prevent pushing of a commercial concern not based on reliable evidence. —MistyMorn (talk) 21:48, 9 October 2012 (UTC)

Disconjugate gaze

Hi, I need an expert opinion: am I incorrect in assuming that "disconjugate gaze" is synonymous with strabismus? Sasata (talk) 22:02, 9 October 2012 (UTC)

I think this is a little fuzzy in the literature, but my understanding is that "disconjugate" means that the two eyes do not move in synchrony, whereas "strabismus" means that the two eyes are not pointing in the same direction. In other words, one is dynamic, the other is static. Looie496 (talk) 22:27, 9 October 2012 (UTC)

Yes, that's right. Axl ¤ [Talk] 22:38, 9 October 2012 (UTC)

Thanks guys; I've corrected the text. Perhaps disconjugate gaze should have an article? I couldn't find anything to link it to. Sasata (talk) 23:01, 9 October 2012 (UTC)

We have "conjugate gaze palsy". I have created a redirect. Axl ¤ [Talk] 11:03, 10 October 2012 (UTC)

Link addition to American Board of Internal Medicine

Would appreciate some additional eyes on this article - is the link being added appropriately? -- Scray (talk) 00:52, 10 October 2012 (UTC)

The link is to this site - Change Board Recert. The site seems to be by a single entity pushing an agenda to reform certification to practice medicine. It may or may not have a relationship to ABIM - I find the website to be not well-written. I sympathize with the intent to add counterpoint to the article, and probably the issues this site raises would be appropriate for the article. But this website does not obviously connect itself to the subject of the article, nor is its purpose to inform the reader of anything but its own intentionally biased perspective. It seems not to meet WP:EL to me. Blue Rasberry (talk) 01:27, 10 October 2012 (UTC)

These are my thoughts as well, and I would appreciate more eyes. I have started a Talk page discussion there. Please consider editing the page and/or Talk rather than here. -- Scray (talk) 13:23, 10 October 2012 (UTC)

Images

I ran across this image in my ongoing quest to sort through commons:Category:Diseases and disorders. I thought it was a nice way to present multiple signs and symptoms, so I decided to post it here in case anyone's ever looking for some inspiration. WhatamIdoing (talk) 19:17, 10 October 2012 (UTC)

Mikael Haggstrom makes these. The trouble is that you can't edit the captions without an image editor. If anyone needs me to translate the Dutch terms in this image, let me know. JFW | T@lk 19:36, 10 October 2012 (UTC)

Centers for Disease Control and Prevention

This high-importance article has long needed some love. Anyone care to dig in? LeadSongDog come howl! 22:48, 10 October 2012 (UTC)

Eyes needed: Ciprofloxacin, Insulin

Would welcome additional opinions. -- Scray (talk) 04:04, 12 October 2012 (UTC)

watchlisted insulin but can't actually edit right now, will look closer tomorrow. Recent edits are poorly written and are unsourced or sourcing fails MEDRS, easy reverts. Zad68 04:16, 12 October 2012 (UTC)

Regarding Insulin: I removed the most unclear, unsourced additions, tagged the decently-sourced but unclear additions, brought one paragraph of content that sounded reasonable but was poorly sourced and poorly written over to the Talk page for further discussion, left a note at the responsible editor's User Talk page pointing him to WP:MEDRS. Zad68 13:57, 12 October 2012 (UTC)

Any WT:MED admins out there care to take a look at a couple of related 3RR reports that seem to be getting no attention while the editing of these articles continues? I know this is not an emergency, but with activity on most of the other 3RR reports there, I'm getting the impression I did not do my report properly. -- Scray (talk) 00:48, 13 October 2012 (UTC)

Resolved with a couple of blocks. -- Scray (talk) 15:09, 13 October 2012 (UTC)

Proposed deletion: List of viruses

I've proposed deletion of List of viruses. Please discuss there. I am guessing that editors here might have valuable perspective. -- Scray (talk) 15:08, 13 October 2012 (UTC)

Generally we inform the main contributors when we AfD articles. Rich Farmbrough, 22:42, 14 October 2012 (UTC).

I'll keep that in mind; this particular "article" is an outlier. -- Scray (talk) 23:51, 14 October 2012 (UTC)

Brain herniation

Two questions arise on the talk page, one somewhat technical (from 2010, and unaddressed), and one I raise about synonyms. Assistance from an expert, which in this case probably means generally competent about medicine, would be appreciated. Rich Farmbrough, 22:42, 14 October 2012 (UTC).

I've answered one of them, presuming I understood it, but the other is beyond my pay grade. Looie496 (talk) 23:03, 14 October 2012 (UTC)

How many articles are in Category:Medicine?

Does anybody know where to find that number? --Anthonyhcole (talk) 06:34, 16 October 2012 (UTC)

Found it: 25000. (On James's excellent cc-by-sa outreach Power Point presentation.) --Anthonyhcole (talk) 17:24, 16 October 2012 (UTC)

Thanks Anthony. Data comes from here [30]. Just need to subtract the redirects. Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:27, 17 October 2012 (UTC)

Onset and ending of puberty differences between girls and boys

Hello, everyone. Do any of you mind weighing in on the Talk:Puberty#Lede and puberty discussion?[31] This topic is part of WikiProject Medicine for obvious reasons shown in the Puberty article, and we clearly need other views on this particular matter. I and another editor worked out the initial issue in the discussion, but another issue has cropped up because defining puberty, especially the onset and ending of it, is complex. We're currently on the "boys at ages 11-12"/"How are [we] defining the beginning of puberty?" part of the discussion. So I'm only asking for comments on that -- our most recent point of views -- but you can of course weigh in on everything we addressed in that discussion if you want. Flyer22 (talk) 15:28, 15 October 2012 (UTC)

You are also likely to get a better idea of the issue by reading a discussion about this topic that took place at the Hebephilia article last year: Talk:Hebephilia#"Boys begin puberty generally at ages 12-13", which is also noted in the current discussion at the Puberty article. Flyer22 (talk) 15:39, 15 October 2012 (UTC)

I read earlier this year that in girls, the gold-standard definition of the onset of puberty was the hormonal spike that normally precedes ovulation (so if everything's working perfectly, which it doesn't always, puberty begins 10–14 days before menarche). This reduces "onset of puberty" to a single day, and probably to a few hours, rather than the common, subjective methods (is that just fat or true breast development?) or the gradual-changes-that-take-years POV, which is kind of silly when you're trying to define the onset of puberty rather than the whole thing. (I haven't looked for a good source for this, but I think we'd benefit from taking this approach to defining the onset.)

Does anyone know if there is a similar moment for boys? This would presumably be in the serious research literature, not in the list of signs or clinical markers for parents (or even clinicians) on the web. WhatamIdoing (talk) 18:25, 15 October 2012 (UTC)

WhatamIdoing, considering that some aspects of puberty for girls, such as breast development, that start before menarche go on for much longer than 10–14 days before menarche, I'm confused as to how it can be stated that puberty begins 10–14 days before the latter. Typically-speaking anyway. What I mean is that girls have usually developed breasts, not just breast buds, and some have well-developed breasts, before they have their first menstrual cycle; most modern sources cite girls as entering puberty at age 10, but having their first menstrual cycle at some point at age 12. James Cantor stated that the Tanner scale is a good model to go by, but, as seen in the discussion on the Hebephilia talk page linked above, as well as this one, I challenged that in a few respects with regard to each discussion; for example, most modern sources don't state that boys begin puberty at age 9. And even Cantor stated, "I think what I am saying is that it is true that puberty can start as early as 9, in the sense that is is not a medical problem when it occurs, but that puberty at age 9 is atypical enough so that I would not use age 9 as an exemplar when trying to describe when puberty typically hits."

Basically, all of this makes my head hurt...which is one reason I brought the topic to this project. I'm not sure about going with new research literature for how to define the onset of puberty when most modern biomedical sources don't define the onset of puberty in that way. WP:MEDRS does state "it is vital that the biomedical information in articles be based on reliable, third-party, published sources and accurately reflect current medical knowledge," but scientific consensus is also important; I'd state that it has to pretty much be a consensus matter among the medical community before we can state it as a definitive or typical definition. Flyer22 (talk) 21:33, 15 October 2012 (UTC)

You seem to be confusing the whole of "puberty" (a multi-year process) with "the beginning of (central, i.e., real) puberty". The latter appears to be defined in the serious literature as nocturnal LH elevation, not by the conveniently non-invasive peripheral markers (e.g., breast development, pubic hair). You can get those imprecise markers from drug exposure or tumors, and there is significant inter-provider variation. That's why pubarche or thelarche (even if correctly identified, rather than being confused with fat tissue) isn't the definition of puberty. No LH activity means no puberty. Apparent breast buds can mean "I like Mommy's estrogen-containing skin lotion" or "I have an ovarian cyst" or "I have a significant amount of estrogen-producing adipose tissue), neither of which are related to puberty. But the nocturnal gonadotropin release is the onset of true puberty, and it causes the steroid hormones that cause breast development.

This suggests, BTW, that contrary to what I was reading earlier this year, menarche could be years after the true onset of puberty, not just two weeks. But I still believe that it's the endogenous hormones, not the visible results of them, that is the real definition. WhatamIdoing (talk) 22:55, 15 October 2012 (UTC)

WhatamIdoing, your responses on this are interesting, and I'm aware of the LH elevation aspect; it's also noted in the article. But I don't see how I'm confusing "the whole of puberty (a multi-year process)" with "the beginning of (central, i.e., real) puberty." You mentioned puberty as beginning 10–14 days before menarche; that is stating that 10-14 days after puberty starts, a girl enters menarche. I mentioned how that, if we go by most biomedical sources on what is the beginning of puberty, is unusual. A girl has usually been going through puberty for 2 years, or 1 year and a half, before menarche. Menarche usually does not start 10-14 days following the onset of puberty. Again, this is all according to most biomedical sources concerning puberty. If I am confusing this topic, then so are these sources, since, like I noted, they usually cite girls as entering puberty at age 10 and having their first menstrual cycle at some point at age 12. Menarche is usually cited as the central event of female puberty, not as the beginning/near beginning of female puberty. You are defining puberty differently than these sources, and I'm not convinced that we should definitively define it that way. Once gathering the sources for what you cite, it should definitely be in the Puberty article, though, of course. Flyer22 (talk) 19:02, 16 October 2012 (UTC)

See, for example, this The Merck Manual source currently in the Puberty onset section; it states: "In girls, the first pubertal milestone is typically breast development (thelarche), followed soon after by appearance of pubic hair (pubarche) and axillary hair and later by the first menstrual period (menarche). In boys, the first pubertal milestone is typically testicular growth, followed by penile growth and appearance of pubic and axillary hair. In both sexes, appearance of pubic and axillary hair is called adrenarche." Flyer22 (talk) 19:32, 16 October 2012 (UTC)

Have a look at this page. Notice that "first, the breasts start growing" isn't one of the currently accepted theories for the start of puberty. All the serious sources agree that true puberty starts in the brain. Breasts aren't even mentioned by this source, but thelarche is a result of puberty starting, not the cause of true puberty starting (except, of course, when thelarche has nothing to do with puberty. There's a long list of reasons why thelarche is an unreliable sign of puberty starting, as evidenced by thelarche in newborns, men, people exposed to exogenous estrogen, etc.)

"A milestone" is not the same thing as "the beginning". Milestones normally appear when you've already gone down the road a long ways. Thelarche is commonly the first sign of puberty that can be measured non-invasively, but it is a sign that puberty (probably, assuming none of the long list of confounding factors apply) started a while ago, not the actual onset. WhatamIdoing (talk) 20:19, 16 October 2012 (UTC)

Yes, FWIW I suspect the quibble may partly arise from a possible distinction between puberty in a physiological sense (ie as a biological event/process), and in a more anthropological sense (as a human psychological/social experience). —MistyMorn (talk) 22:13, 16 October 2012 (UTC)

Sorry for the late reply. I was without Internet access for a few days. As for the current discussion... WhatamIdoing, about the onset of puberty starting in the brain, your comment is similar to what Nancydarling (an editor who researches adolescence a great deal in her professional life) stated. She recently stated, "I'm just going back to sources defining puberty as 'The period during which an individual becomes capable of reproduction." (Steinberg, 2012). Generally, this includes growth acceleration and the development of primary and sexual characteristics. It's a fuzzy term in terms of definitions. You can SEE pubertal changes around 10, but you can MEASURE changes in hormones much earlier. Researchers like Elizabeth Sussman often mark the rise in hormones as the best and most accurate indicator of puberty starting (Sisk & Foster, 2004). Most people become interested in sex around 10, and that's probably the result of adrenarche."

We know that signals in the brain usually trigger puberty. I did not state that thelarche is the cause of puberty. I was simply stating that it is usually cited as a part of puberty (I mean "true puberty") and as the first pubertal physical development among human females (something that usually occurs well before menarche). I have not come across any source stating that menarche begins two weeks after puberty starts. And considering the changes in the brain that happen before physical development is apparent, as well as breast development usually happening well before menarche, it's easy to see why I have not come across a source stating that menarche begins two weeks after the onset of puberty. You stated that you have. I'm stating that I would like to see that source, but definitely don't feel that we should use that to definitively state that this is how puberty generally happens for human females. We agree that "[a] milestone" is not the same thing as "the beginning"; I never stated that they are the same thing. I stated that "Menarche is usually cited as the central event of female puberty, not as the beginning/near beginning of female puberty." and cited The Merck Manual source stating "In girls, the first pubertal milestone is typically breast development (thelarche)." Thelarche, while usually not where female puberty begins (since puberty does usually happen in the brain first), is typically cited as a physical development that happens at the beginning of puberty (as in "during early puberty"). You mentioned thelarche as not being a sign of true puberty, but most biomedical sources do cite it as a sign of true puberty. I never see sources distinguishing it as anything else, this division of "false puberty" and "true puberty" that you speak of, except for in the cases of boys who have already went through puberty/men. But I don't think that such development in males is usually termed thelarche. The newborn thing is interesting and would no doubt also be distinguished from "true puberty" in some sources. But as the Timing of the onset of puberty section in the Puberty article currently states, "The definition of the onset of puberty may depend on perspective (e.g., hormonal versus physical) and purpose (establishing population normal standards, clinical care of early or late pubescent individuals, etc.). A common definition for the onset of puberty is physical changes to a person's body." The development of secondary sex characteristics brought on by tumors or xenoestrogens is still considered puberty, often precocious puberty. Sources in the Precocious puberty article, as well as The Merck Manual source, make this clear. For example, The Merck Manual states that precocious puberty can be divided into 2 types: Gonadotropin-releasing hormone (GnRH)–dependent...and GnRH-independent. "In GnRH-dependent precocious puberty, the hypothalamic-pituitary axis is activated, resulting in enlargement and maturation of the gonads, development of secondary sexual characteristics, and oogenesis or spermatogenesis. In GnRH-independent precocious puberty, secondary sexual characteristics result from high circulating levels of estrogens or androgens, without activation of the hypothalamic-pituitary axis."

This discussion has moved away from how to define the onset and ending of puberty by age, which is what I was originally concerned about. Even though puberty no doubt usually starts in the brain, I see no indication that the age ranges defining the onset of puberty being 10 for girls and 11 or 12 for boys are basing this on changes in the brain. And like I told Nancy, since puberty starts in the brain before those ages, it's safe to state that most sources are not defining it by when it begins in the brain. Age-range wise, we can only go by what the sources state. And I do feel that mentioning age ranges for the onset of puberty is important. On the Puberty talk page, I suggested that "the best way to go about all of this is to address the different ways that sources define the onset and ending of puberty, and what timing is considered more typical for whatever ethnicity. Note, however, that the Timing of the onset of puberty section is somewhat doing that; it just needs to be expanded. This article definitely notes that puberty varies, but, like most texts in this regard, it also gives the typical age ranges." Flyer22 (talk) 23:15, 19 October 2012 (UTC)

Birth rape

This article is a complete shipwreck in my opinion. The neologism refers to women who claim to have been "raped" by medical professionals during the childbirth process, because the medical professional did things to ensure the safe delivery of the baby. Is this topic notable? None of the references provided seem remotely reliable and non-tabloid. Then there's the whole controversy and neutrality thing. I've removed a whole load of emotional tabloid fluff, though I would also like additional opinions on what should be done with this article. -- 李博杰 | —Talk contribs email 16:37, 16 October 2012 (UTC)

One or (maybe) two sentences from the article should be merged into Unassisted childbirth with redirect. Not enough independent reliable secondary sources exist to support a full encyclopedia article on this. All the sourcing ties back to back to one individual, Amity Reed, and her personal advocacy of her views on the subject. The only half-decent source is the Salon article, and even the title of the article--"The push to recognize 'birth rape'"--indicates that the notability of the subject is not established. Go ahead and be WP:BOLD and do the merge and redirect, I will watchlist. Zad68 17:09, 16 October 2012 (UTC)

Agree with Zad68. Better sources are available (e.g. PMID 20636467, ISBN 9781405176989 p.219) but still, this is just going to be a very ugly wp:DICDEF at best. Certainly the title is so POV that it violates wp:AT. Find sources: Google (books · news · scholar · free images · WP refs) · FENS · JSTOR · TWL LeadSongDog come howl! 17:27, 16 October 2012 (UTC)

Btw, the page was midwifed by a blocked sock puppet. —MistyMorn (talk) 17:31, 16 October 2012 (UTC)

I AfD'd this. See Wikipedia:Articles_for_deletion/Birth_rape. Blue Rasberry (talk) 13:40, 17 October 2012 (UTC)

Health issues in athletics

This errmm POV page was created earlier this year by a gf newbie who last showed up in April [32]. Sports medicine carries a merger proposal. What to do? —MistyMorn (talk) 13:22, 17 October 2012 (UTC)

In the current absence of feedback from more experienced hands, I've gone and done a WP:BRD... In brief, I've stubbified this article which, as explained at Talk:Health_issues_in_athletics, moved from the premise that athletes are physically and mentally underdeveloped [33]. Hope the monstrosity of my action doesn't come back to bite me! —MistyMorn (talk) 13:47, 18 October 2012 (UTC)

Class editing global health

A group of people are suddenly editing global health. I presume it is a class - it is about 15 new editors who have created accounts and done nothing but dropped content into the article, most of which is not an improvement. I posted welcome templates on all their talk pages and directed them to the Teahouse. If any of them responds to identify their actions I will try to contact their professor and coach this person. I hate to see wasted effort, but it is not good for professors to tell students to go to Wikipedia and do as they see fit without considering community guidelines.

I suppose this needs no particular action from anyone else on this board but I wanted to share. Blue Rasberry (talk) 13:36, 17 October 2012 (UTC)

Better revert to how it was before the onset of class action? —MistyMorn (talk) 20:39, 17 October 2012 (UTC)

Have reverted, watchlisted and left a note on the talk page. While protect the page if further issues happen. Has anyone posted at the EDU notice board? We are coming to the end of another school year... I think we need to make it clear that all education projects MUST be lead by an experiences Wikipedia (one with at least 5000 edits). Otherwise they simply piss everyone off. Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:14, 17 October 2012 (UTC)

the IPs, names, and a little sleuthing lead me to think that this is an undergraduate global health class at Michigan State University. global health is part of their epidemiology department -- that page may have some contact info. I'd be happy to inquire a bit, if that would be helpful. UseTheCommandLine (talk) 07:39, 18 October 2012 (UTC)

Actually, more WP-centric, there is a campus ambassador for MSU (Chlopeck), but she doesnt have any edits since March of this year. Jaobar has more recent edits, and appears to be a professor at MSU, though in an entirely different department. Should I place messages on their talk pages directing them to this conversation, in the hopes that they might be able to contact the course director? UseTheCommandLine (talk) 07:53, 18 October 2012 (UTC)

It's worth a try. Thanks for your help. Axl ¤ [Talk] 11:21, 18 October 2012 (UTC)

Any idea who the prof is? I'll have a look on the epi dept's course page. If we can figure out who it is, I'll be happy to give them a call if need be. Thanks. Jaobar (talk) 18:40, 18 October 2012 (UTC)

There isn't a class from MSU participating in the Wikipedia Education Program this semester, now that Jonathan is in Toronto. It does look like students editing, but I can't seem to see who their prof is or if they're a part of a class not at MSU. If anyone figures out they are a class and where they are located, please note that here. Thanks! JMathewson (WMF) (talk) 18:55, 18 October 2012 (UTC)

I had guessed MSU because even though several of the IPs geolocate to the Flint area rather than Lansing, MSU has a Flint campus, and geolocation isnt always that great. one of the usernames, though, came up in a google search for some kind of charity race MSU did about a week and a half ago. I looked at a couple of other universities in the area, and didnt see any obvious signs of global health classes or departments. So MSU should still be just a guess, but I think there are enough suggestions in that direction to use it as a working hypothesis. I actually called the department at the main contact number listed on that website just asking if there was an undergraduate global health class going on right now, but i havent received a response. Whether I will or not, not having identified myself as a WPian or what have you remains to be seen.

I don't think that simply asking around, starting with the larger unis is bad. it seems like there are enough students in this class that it is probably at a larger uni, so there arent too many of those to check. I know that some schools, usually secondary or elementary schools, have permanent bans (not that im in any way suggesting that here), but i don't know how this stuff works for universities and colleges, i.e. what the process/protocol is, etc. I'll take a gander at some of the education pages to try and get a sense, but i didnt see anything that jumped out at me, so if there's obvious and established guidance for this stuff that i'm missing i would appreciate a pointer to it. UseTheCommandLine (talk) 01:46, 19 October 2012 (UTC)

Poking around on MSU's website, if i had to hazard a guess, it would be EPI 200, "A Multi-disciplinary Approach to Problems in Global Public Health and Epidemiology" -- It says it's offered every fall to undergrads, and they just passed the middle of the semester, which might explain the increasing frequency of edits coming up to the 17th or so. again, just a hunch, purely circumstantial. UseTheCommandLine (talk) 02:05, 19 October 2012 (UTC)

Just noticed that there is also an online course at UMich-Flint on global health. I have sent an email asking the current instructor if some of their students might be editing the page for this reason, and directing them to this page. UseTheCommandLine (talk) 02:30, 19 October 2012 (UTC)

Done Doc James, UseTheCommandLine, and I all are in contact with the professor. It would be nice if the professor agreed to participate in the campus ambassador program and this person has been invited. Anyone who wants to get involved may, but otherwise at this point no further action or thought is needed. Blue Rasberry (talk) 16:17, 19 October 2012 (UTC)

Cochrane

A very nice poster regarding us was presented at the Cochrane Colloquium this year [34]. It relates to this project here Wikipedia:WikiProject_Medicine/Evidence_based_content_for_medical_articles_on_Wikipedia Doc James (talk · contribs · email) (if I write on your page reply on mine) 05:45, 18 October 2012 (UTC)

It's a nice poster. (There are a couple of spelling mistakes and a grammatical issue that I would like to fix, LOL.) Do you know if any of the authors have a presence on Wikipedia? Axl ¤ [Talk] 10:33, 18 October 2012 (UTC)

Yes the lead author is User:Manum56 Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:02, 18 October 2012 (UTC)

Thanks. Axl ¤ [Talk] 19:20, 18 October 2012 (UTC)

This is very cool. I wish it were licensed compatibly for upload to and distribution through Wikipedia, and its utility is diminished because it is not, but still it is very useful and I am grateful for it and the resources which the authors put into creating it. Blue Rasberry (talk) 17:29, 19 October 2012 (UTC)

Thanks all. Sorry about the mistakes :D. I have a corrected version ready. I'll upload it as soon as I get the required permissions. It would be great to hear your ideas on this(see the barriers section in the poster).Manum56 (talk · contribs) 00:49, 20 October 2012 (UTC)

WMUK blog on WikiProject Medicine

Following on from the Coventry conference, Martin Poulter has written a blog about some of the work done by WPMED:

http://blog.wikimedia.org.uk/2012/10/bringing-evidence-based-medicine-to-the-world/

Feel free to comment there if anyone is interested. --RexxS (talk) 19:34, 19 October 2012 (UTC)

R-peak

I've nominated this page for deletion. It seems to me this is a hoax with respect to the article's content. Created by a WP:SPA, it sat in mainspace for two years. Someone added it to Category:Pseudoscience and Category:Types of scientific fallacy, which is how I found it; it's not liked from any articles. (It looks like a couple of readers found it before me, because they rated it with one star.) However, the title seems to be some genuine ECG jargon. I don't know if it's something notable enough for its own article though; probably just delete+redirect. Tijfo098 (talk) 20:02, 19 October 2012 (UTC)

Based on the IPs which edited alongside the SPA, our hoaxer friend works at the SLAC National Accelerator Laboratory. Tijfo098 (talk) 20:14, 19 October 2012 (UTC)

not related to medicine. IRWolfie- (talk) 20:52, 19 October 2012 (UTC)

Translation of Klinefelter's syndrome

Hello everyone! I am Adert, a italian Wikipedian who is also a translator from en.wiki to it.wiki. To change, together with participants of project medicine in Italian and a translator, we expanded your voice Klinefelter's syndrome. The draft you can find it here. What do you think? I'd like to start a partnership with you to improve with the articles of medicine. Thanks for your attention--Adert-it (talk) 20:54, 19 October 2012 (UTC)

We of course would love to be involved. Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:26, 19 October 2012 (UTC)

Have a look at the translation task force. Doc James co-ordinates it. Axl ¤ [Talk] 01:31, 20 October 2012 (UTC)

Thank you. You think, I can begin to integrate the draft into article? On it.wiki currently the article is proposed as FA. Bye. --80.180.186.30 (talk) 14:46, 20 October 2012 (UTC)

2 centesimi: en.WP has sourcing and style guidelines which differ somewhat from received editorial practice on it:WP. For example, we have stricter rules here, I think, about use of primary sources, and the section order differs from textbook conventions. I think it'd be a good thing for whoever does the integrating to have some familiarity with our WP:MEDRS and WP:MEDMOS. Regards, —MistyMorn (talk) 15:11, 20 October 2012 (UTC)

Thank you for your answer. In fact, before you begin, I wanted to advertise. Do you want the help? (Adert) --80.180.186.30 (talk) 15:42, 20 October 2012 (UTC)

Yes will need to look at it. But we do emphasise the WP:MEDRS policy here in English. Specifically the bit about using secondary sources. Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:44, 20 October 2012 (UTC)

IMO, we need to be careful not to get bogged down in trivial misunderstandings due to differences in editorial practices. For what it's worth, my own sensation is that it would be worth taking it relatively slowly at first to try to set up a good working understanding. Again, just my 2 cents, —MistyMorn (talk) 15:56, 20 October 2012 (UTC)

I think that we want the help. We can re-arrange sections and update sources later, if there are some differences. WhatamIdoing (talk) 03:21, 21 October 2012 (UTC)

Value of student edits

I'm trying to assess whether some of the edits made by students working on Wikipedia in the spring 2012 semester were worthwhile, and was hoping for some help with the medical articles. Would someone be able to look at a couple of articles and tell me if they have useful content, or if they use primary sources and are low value, or just nonsense -- or whatever.

This assessment is being recorded as part of the education program's attempt to evaluate the work of the classes in the program.

If anyone is interested, here are the edits I'd like to assess.

~~There may be one or two more; I'm still working through the list of spring 2012 courses.~~ Thanks for any help with this. Mike Christie (talk - contribs - library) 19:41, 20 October 2012 (UTC)

Hi. Of the four pages posted so far, only Narcissistic personality disorder falls within the scope of the Medicine project. To my skirt-chasing eyes (scarcely the best judge of personality!), the two edits don't look especially helpful, but they're probably a step up from some of the more pop content in close proximity. What I think I can safely say is that neither of the sources used really satisfies WP:MEDRS, since both [44] [45] are validation studies of novel instruments. So, overall I feel the experience might have been a good one for the contributor, without really providing an incremental contribution to the encyclopedia. Oh well, back to the real world... [46] —MistyMorn (talk) 21:44, 20 October 2012 (UTC)

Adding: I see the student's (inappropriate) use of primary sources [47] was pretty much determined by the instructions of the supervisor: "Your bibliography should contain at least four scholarly sources. Of those four sources, one may be a textbook, but the other three should be primary research." [48] —MistyMorn (talk) 00:04, 21 October 2012 (UTC)

Thanks -- the assessment and that link are very useful -- much appreciated. Mike Christie (talk - contribs - library) 19:07, 21 October 2012 (UTC)

"skirt-chasing eyes"? Axl ¤ [Talk] 23:11, 20 October 2012 (UTC)

[49] (resisting the temptation to discuss tool validation). —MistyMorn (talk) 23:33, 20 October 2012 (UTC)

Awesome Youtube link. --Anthonyhcole (talk) 23:57, 20 October 2012 (UTC)

Grande! —MistyMorn (talk) 00:10, 21 October 2012 (UTC)

Hmmm, I've never even heard of the HEXACO model of personality structure let alone a subsection - Honesty-humility factor of the HEXACO model of personality...I'll have to ask some psychologists at work tomorrow....Casliber (talk · contribs) 10:52, 21 October 2012 (UTC)

Thanks -- anything that would help figure out the value of those edits would be great. Mike Christie (talk - contribs - library) 19:07, 21 October 2012 (UTC)

Not such an active project perhaps, but maybe you could try posting at WT:PSYCH. —MistyMorn (talk) 22:15, 21 October 2012 (UTC)

Yes that is part of the issue. There are very few experienced people maintaining the psychology articles. Doc James (talk · contribs · email) (if I write on your page reply on mine) 03:17, 22 October 2012 (UTC)

Agreed - I'll post there later today, but I don't think I'll hear much back.

The primary source comment was very useful, MistyMorn - would you be able to identify any primary sources in the diffs for the other articles? I would guess that there's some overlap in the requirement to avoid primary sources, and I was wondering if the identifying stigmata of a primary source carry over from MED to PSYCH. Mike Christie (talk - contribs - library) 15:39, 22 October 2012 (UTC)

You raise a very important point. I hope that it would. Certainly WP:MEDRS covers cognitive behavioral therapy, as it is making deep inroads into medicine. Some areas of neuroscience, especially where it overlaps with pathology and surgery, are covered by WP:MEDRS. Someone needs to write Wikipedia:Identifying reliable sources:Social sciences to cover those parts of psychology and other social sciences that aren't covered by WP:MEDRS; and Wikipedia:Identifying reliable sources (natural sciences) should be elevated to guideline status, to cover those areas of biology and other natural sciences not covered by WP:MEDRS. The biological and social sciences should be held to at least as high a sourcing standard as medicine. --Anthonyhcole (talk) 18:20, 22 October 2012 (UTC)

I notified the prof at User talk:ScottPKingPhD of this discussion.

This is an area in which we have room for systemic improvement. We should have an agreed-upon expectation for clear identification of primary sources, whether that agreement be for in-text mention, for in-citation mention, or for hidden wikitext comments. My thinking is that the best place is in the citation. I've previously argued that we should have a {{cite journal}} parameter equivalent to the Pubmed "PublicationType" parameter. That way we could standardize the presented values to such as (Journal Article) (Systematic Review) (Meta-analysis) etc. Further, these could (at least in principle) be bot-populated. The amount of effort that goes into catching improper use of primary sources is simply ridiculous. We can do better things with our time. LeadSongDog come howl! 17:12, 22 October 2012 (UTC)

I support LeadSongDog strongly in this suggestion. We already require secondary sources to be used nearly exclusively for an article to reach GA/FA. Not to long ago Schizophrenia was nearly delisted as a FA based on this issue. Doc James (talk · contribs · email) (if I write on your page reply on mine) 17:24, 22 October 2012 (UTC)

Just checked. CS1 templates support the |type= parameter for this purpose. We ought to make better use of it.LeadSongDog come howl! 17:44, 22 October 2012 (UTC)

FWIW:

The student who created and developed Honesty-humility factor of the HEXACO model of personality appears to have followed quite a different course. This is clearly a serious piece of work, based on at least one secondary source (ref 1 actually seems to satisfy MEDRS) in conjunction with a series of what appear to be carefully handled primary sources (if we were to apply MEDRS) drawn from peer-review journals. My layman's impression is that the student/supervisor may have identified a useful topic for (sub-)article creation. Some of the broader editorial issues one might raise (eg regarding conceptual integration with the parent page) would, I guess, be pretty much in line with what one would expect from any promising new Wikipedia editor. Had I not known this was a student, I really wouldn't have guessed. —MistyMorn (talk) 17:51, 22 October 2012 (UTC)
Personality judgment: The student, who created the page, has adopted a mix of secondary and primary sources from academic journals. Certainly seems to be a serious piece of work. Note: Looking at the work through layman's eyes and from a "MEDRS perspective", one can't help noticing that while some of the primary studies sourced are recent (eg [50] from 2011), others most certainly aren't ([51] from 1987, [52] from 1977). Presumably, up-to-date secondary sources should be available for the concepts addressed in the latter two, at least. I agree with Anthony (above) that in a developing field of research like the social sciences some guidance broadly equivalent to MEDRS could have helped this student.

Attitude (psychology): This comprehensible but somewhat unwieldy single sentence contribution [53] is sourced from a "pilot study" (very much primary) from 1984. Per Personality judgment above. —MistyMorn (talk) 17:06, 24 October 2012 (UTC)
The Catechol-O-methyl transferase edit [54] is intriguing, imo. The editorial approach here appears to have been a reasoned one, as credited by ~~the supervisor~~ a colleague [55]. In the usual academic way (more or less), the editor has strung together three clauses, each containing a single concept, into a lengthy but reasonably coherent sentence. Each clause is sourced with a primary study. By contrast, an editor following MEDRS might have turned to one of the many recent review articles available on PubMed (eg in the last 5 years, 13 reviews have Catechol-O-methyl transferase in the title, and there are plenty more reviews in which the enzyme has been indexed as a major or significant topic). However, this page ~~is subject to~~ WP:SCIRS rather than MEDRS. And SCIRS seems to have a rather different approach to primary sources. (Maybe others here would like to comment?) —MistyMorn (talk) 22:03, 22 October 2012 (UTC)

@Mike: You might like to take this one to Wikipedia talk:WikiProject Molecular and Cellular Biology for a second opinion. —MistyMorn (talk) 12:03, 23 October 2012 (UTC)

Thanks, MistyMorn; this is very useful. Based on your comments I think it's fair to say these are contributions that are not as good as they could be, but which have not made the article worse, and which can be improved by subsequent editors. What we've seen in some student articles, often in medical articles, is edits that are actively harmful, requiring substantial clean up time. If students cost editors more in cleanup effort than they bring in added content, then the education program is not worth doing. As it turns out, it looks as though there is a net benefit, but there are definitely some black spots. You can see the summarized results as well as the detailed assessments here, if you're curious. Once again, thanks -- I really appreciate you assessing these edits. Mike Christie (talk - contribs - library) 11:43, 25 October 2012 (UTC)

I just added one more -- not sure if it's in scope for y'all or not. I'm through with the course list so that'll be the last one. Thanks for the HEXACO comments, MistyMorn; it's reassuring to know that it looks reasonable. Mike Christie (talk - contribs - library) 19:28, 22 October 2012 (UTC)

Arbitrary break, per WP:SCIRS?

WP:SECONDARY says Wikipedia is based off of secondary sources, so I think it is inapropriate for someone to string together a sentence with three primary sources for separate clauses if secondary sources can be found. Biosthmors (talk) 22:46, 22 October 2012 (UTC)

But, per WP:SCIRS#Respect_secondary_sources, Primary sources should be used [my emphasis] when discussing a particular result or recent research directions. Is this really crystal clear? —MistyMorn (talk) 10:14, 23 October 2012 (UTC)

Interesting, but I don't think it would/should be common for an encyclopedia article to be discussing a particular result since we are based off of secondary sources. Biosthmors (talk) 21:08, 23 October 2012 (UTC)

You don't think that, I don't think that, but unfortunately there are plenty of those who do, and who are only too happy to push the point just as hard as they can... Not to mention gf contributions from students, new editors, and the generally well intentioned. Imo, MEDRS provides much stronger and clearer guidance. (Though, personally, I'm happy to see references to key primary studies included alongside, or in tandem with, high quality secondary sources.) —MistyMorn (talk) 21:32, 23 October 2012 (UTC)

WP:MEDRS was one of the main things that got me interested in doing WP:MED project work in the first place. I like having clear guidelines. Actually I wish WP:MEDRS was more strongly emphatic about insisting on secondary sources near the top of WP:MEDASSESS. I do not feel how WP:MEDRS is written actually reflects how I see experienced WP:MED folks edit. For example, WP:MEDRS says, "Avoid over-emphasizing single studies, particularly in vitro or animal studies." Frankly this is rather weak advice against using a small in vitro study in, for example, Thiomersal controversy or Insulin. In reality I see editors point to WP:MEDRS in removing such sourced content. WP:MEDRS could use a rewrite in this area. Zad68 03:03, 24 October 2012 (UTC)

Wilson

It is 100 years since Wilson's disease was first fully described. The article is currently GA, and I was wondering if someone was up for a collaboration to push it up to FA. I have listed some useful sources on the talk page. JFW | T@lk 09:48, 21 October 2012 (UTC)

Great idea. Happy to help. -- Scray (talk) 14:04, 21 October 2012 (UTC)

Imo, the quality of the prose seems generally excellent. —MistyMorn (talk) 23:47, 21 October 2012 (UTC)

sounds neat. count me in, to the extent that i have time. UseTheCommandLine (talk) 07:17, 25 October 2012 (UTC)

Pituitary gland

Could someone who actually knows something about medicine please take a look at Pituitary gland, and specifically at this diff by a new contributor? I'm willing to AGF that the user is an expert in the field as xe claims, and that the previous version of the article was inaccurate, but, of course, that doesn't absolve him of the need to include reliable sources. I'm also concerned about any claim that "isn't included in many college textbooks". However, the user did go to the effort to leave me a long and detailed message on my talk page (see User Talk:Qwyrxian#Pituitary gland), so I felt it would help if someone with more subject matter competence than me took a look. Qwyrxian (talk) 22:07, 21 October 2012 (UTC)

It needs some copyediting, obviously, but yeah, that's accurate. I can't absolutely speak for the developmental sequence, but it's perfectly reasonable to speak of the posterior pituitary as being an extension of the hypothalamus. As the posterior pituitary article already notes, that gland is mainly composed of the axons and axon end bulbs of (magnocellular) neurons whose dendrites and cell bodies are in the hypothalamus. Furthermore, the parallelism between parvocellular and magnocellular neurons in the current lead of pituitary gland is badly misleading, because it implies their mechanisms of control are similarly parallel. In fact, it would be more accurate to say that the anterior pituitary receives its signals from the parvocellular neurons while the posterior pituitary is composed of the ends of the magnocellular neurons. I don't know about "most college textbooks", but I use the current edition of Tortora for my A&P course and it certainly describes this. Don't have it on me now but I can supply a citation in a day or so. Choess (talk) 23:12, 21 October 2012 (UTC)

The text looks accurate. (I don't know about the pituitary breaking off when the brain is lifted out, but it sounds plausible.) Axl ¤ [Talk] 23:45, 21 October 2012 (UTC)

There are a number of "bits of the brain" that break off when it is removed, like parts of the retina of the eye, the olfactory bulb, and posterior pituitary. All indeed are sort of direct axonic emanations of the brain that are "hanging out in the wind" (or into the blood supply a long way from the brain), so to speak. In the pituitary those axons secrete neuropeptides directly into the blood or into the portal circulation that goes into the anterior part (which is derived from ectoderm in the mouth, ultimately, quite a way away from the posterior part). So this somewhat parallels the structure of the adrenals, which are also composed of a neural part (the medula, where the chromaffin cells are just modified neurons that come from the neural crest) which directly secretes neurotransmitters into the blood in response to neural stimulation, vs. and the cortex, which is of a different derivation (mesoderm this time, also from a long away away) and does a completely different job of making steroid hormones. Not that long ago, we thought the two parts of the adrenals just lived together physically but didn't talk to each other (as the two parts of the pituitary do). We should have guessed this wasn't so, and it's beginning to look like it's not. They do communicate and their proximity isn't just accidental. see here. So this theme in the adrenals (a neural part and a non-neural part) is repeated from the pituitary, although not with such complete control. S B H arris 01:15, 26 October 2012 (UTC)

Herpes nosodes

This new article, Herpes nosodes, could probably use some attention from someone with medical knowledge. Thank you. Deli nk (talk) 16:07, 22 October 2012 (UTC)

Erm... [56] AFD? —MistyMorn (talk) 19:18, 22 October 2012 (UTC)

Seems that WPMED minds think alike -- Scray (talk) 20:28, 22 October 2012 (UTC)

I've renewed the PROD, which on reflection probably wasn't the correct next step. I suppose it really does have to go via AFD? —MistyMorn (talk) 10:30, 23 October 2012 (UTC)

AfD, not repeat PROD. Axl ¤ [Talk] 10:32, 23 October 2012 (UTC)

Done. —MistyMorn (talk) 11:24, 23 October 2012 (UTC)

Infant mortality

Infant mortality recently had a large expansion thanks to a good student editor. It probably could benefit from some attention. Prenatal care in the United States was an article they created last semester. Biosthmors (talk) 16:46, 22 October 2012 (UTC)

Proposed deletion: James Norman

I've proposed James Norman for deletion. The article is marked as part of Wikiproject Medicine; the creator and major contributors have been informed. Additional input from uninvested Wikiproject Medicine editors is welcome. --Rhombus (talk) 10:37, 26 October 2012 (UTC)

I am finishing up a major rip-out of an enormous bunch of BLP violations. No secondary sourcing at all. This article needs help but probably not deletion. Zad68 14:35, 26 October 2012 (UTC)

A thread at WT:MCB

FYI, Wikipedia_talk:WikiProject_Molecular_and_Cellular_Biology#scope_of_the_medicine_project

—MistyMorn (talk) 14:45, 26 October 2012 (UTC)

Pallidotomy - copyviol?

I think there is a problem of copyviol of this page;
Article says that this tecnique is not more used. Is it true?

Thanks--Pierpao (talk) 13:21, 27 October 2012 (UTC)

Thank you for pointing this out, Pierpao. The implicated text was added by an ip contributor in September 2009 [57] (based on the citation, the earliest possible date for the WebMD content would be 2007). Some reliable medical sources that could be useful include: a review from 2008 [58]; recent practice guidelines [59][60]; evidence summary from 2007 [61]. More at the TRIP database [62]. —MistyMorn (talk) 14:30, 27 October 2012 (UTC)

Thanks to you. A lot--Pierpao (talk) 18:16, 27 October 2012 (UTC)

Prego. I'll wait and see whether anyone else wants to intervene. Otherwise, I guess I'll see what I can do sometime next week. Saluti —MistyMorn (talk) 18:29, 27 October 2012 (UTC)

Pathologic description needed for image caption.

This picture for use on the work in progress page rectal prolapse requires a caption. I contacted the original uploader (nephron) a few weeks ago, they don't seem to be around. Are there any pathologists that could make some general comments about the cells? 23_2{(SBST:SU:m.}} (talk) 19:02, 27 October 2012 (UTC)

You mean other than "Low magnification micrograph showing microscopic changes consistent with rectal prolapse. H&E stain. The image shows a marked increase of fibrous tissue in the submucosa and fibrous tissue +/- smooth muscle hyperplasia in the lamina propria." Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:35, 27 October 2012 (UTC)

yeah, other than that. TY for info I will put it into the new caption. 23_2{(SBST:SU:m.}} (talk) 21:01, 27 October 2012 (UTC)

Can we still use books as refs?

This follows from statements above by user:UseTheCommandLine, Doc James, User:Axl, user:LeadSongDog,

It appears so many of them are simply plagiarism of Wikipedia. We are coming to a point in time where someone comes to Wikipedia and makes something up. It than gets into a textbook. And along I come to try to reference our text by looking for sources and low and behold the worlds books support us just a little to well. Another example:

Our article on pneumonia (prevention section) from Dec 2006 http://en.wikipedia.org/w/index.php?title=Pneumonia&oldid=97517043#Prevention

There are several ways to prevent infectious pneumonia. Appropriately treating underlying illnesses (such as AIDS) can decrease a person's risk of pneumonia. Smoking cessation is important not only because it helps to limit lung damage, but also because cigarette smoke interferes with many of the body's natural defenses against pneumonia. Research shows that there are several ways to prevent pneumonia in newborn infants. Testing pregnant women for Group B Streptococcus and Chlamydia trachomatis, and then giving antibiotic treatment if needed, reduces pneumonia in infants. Suctioning the mouth and throat of infants with meconium-stainedamniotic fluid decreases the rate of aspiration pneumonia.

Check out this textbook from 2007/2008 page 678 Diseases and disorders. Tarrytown, NY: Marshall Cavendish. 2008. p. 678. ISBN 9780761477709. They have copied word for word large sections without giving credit and they are selling the book for $340 on amazon.com [63] Doc James (talk · contribs · email) (if I write on your page reply on mine) 04:14, 18 October 2012 (UTC)

Ouch. Not good. Just out of curiosity (having no medical qualifications beyond a vague ability to identify - unreliably - bones of some guy who's been dead for 100,000 years...), are medical textbooks usually that badly written? Wouldn't the 'throw random sentences together to make a paragraph' prose rather give the game away? AndyTheGrump (talk) 04:41, 18 October 2012 (UTC)

This simply re enforces what an amazing resource Wikipedia is. With a minor copy edit and some work on layout one can sell it for big money. My hats off to all the great editors here. I think it is time that we inform libraries that some of the time they are simply buying old copy edited versions of Wikipedia and that the current version is better and free.

By the way the suctioning for meconium to decrease aspiration is not recommended. I have fixed our article and emailed the publisher to inform them of my concerns. Doc James (talk · contribs · email) (if I write on your page reply on mine) 05:01, 18 October 2012 (UTC)

The parent company of the publisher is worth $14 billion. It appears this title however may have been bought by Amazon. Doc James (talk · contribs · email) (if I write on your page reply on mine) 05:15, 18 October 2012 (UTC)

Somehow I doubt the attributed author on that book knew about the plagiarism. She's the chair of medicine at Washington University, St. Louis, with over 200 publications listed on Pubmed. She probably would not have called herself "M.d." on the cover and many times in the book. Definitely something odd going on. LeadSongDog come howl! 06:30, 18 October 2012 (UTC)

Andy, sure it isn't our best writing that's been plagiarized, but that's why the book only sells for $340. The book that plagiarizes from our GA articles is over $700 and from our FAs is over $1000. Zad68 13:58, 18 October 2012 (UTC)

Looking at this Worldcat search it seems the books are geared at "young adult readers", as for high school health classes. Certainly the 186 listed librarys were mostly public libraries, public schools, etc. Not the sort of mix one would see for a "medical textbook", which is usually mostly held by university libraries. Oddly, the e-book results lean more to universities and colleges than the paper. LeadSongDog come howl! 17:00, 19 October 2012 (UTC)

Medical textbooks of this size are typically written by a collaboration of many authors. Subsections are often "outsourced" to junior/middle-grade doctors. There is usually a small fee for the junior doctor, but the main benefit is addition to the CV. A single lead editor (or small group of senior editors) oversees the whole project.

Of course it is impossible for one person to scrutinize every part of a book of this size. The main editor relies on the integrity of the junior authors. Authors are typically required to affirm that the material is their own work. While the vast majority of authors are conscientious, it is inevitable that there are a few who will "cheat".

In the case of this textbook, the author of each chapter is given at the end of the chapter. Here, the offending author is Julie A. McDougal. Axl ¤ [Talk] 10:16, 18 October 2012 (UTC)

I found this pdf document online. One of the authors is "Julie A McDougal", e-mail address julie.mcdougal@ccc.uab.edu . If you intend to contact her, it would be best to ask if she is the author of the chapter first before making any accusation or declaration about the chapter's content. Axl ¤ [Talk] 10:39, 18 October 2012 (UTC)

Sigh. Yes so she responded and it is the same person. Currently it looks like she is studying smoking cessation in Birmingham Alabama. I guess the question is did she write this content originally on Wikipedia (better check more thoroughly)?

While I think it is bad that people take from Wikipedia and claim it as their own while large multinationals make large sums of money of us without giving us any recognition. I do not want to harm anyone career. Ah I have lost my nerve. What do you recommend next Axl? Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:57, 18 October 2012 (UTC)

I've asked Moonriddengirl to visit this discussion. She's got a knack for tracking these things down. LeadSongDog come howl! 20:57, 18 October 2012 (UTC)

"This simply re enforces what an amazing resource Wikipedia is." To me what it reinforces is how influential Wikipedia is, and therefore how important it is that we get it right. Adrian J. Hunter^{(talk•contribs)} 11:10, 18 October 2012 (UTC)

Yes agree Adrian which is why I think many of us are here. Doc James (talk · contribs · email) (if I write on your page reply on mine) 18:53, 18 October 2012 (UTC)

With good software to check what one is publishing for plagiarism their is simply no excuse for it. We need to get some up and running ourselves. Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:04, 18 October 2012 (UTC)

Well we have a bot that checks new articles here against google, but perhaps we need the reverse too. LeadSongDog come howl! 20:57, 18 October 2012 (UTC)

Agree. This could make an amazing study. Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:13, 18 October 2012 (UTC)

The "smoking cessation" bit was added in this edit on 19 Oct 2005. Back then it was just the GFDL in play. There are indications on the related userpage of edits to Washington University School of Medicine, Pneumonia, and others that suggest that wp editor might be proximate to Dr McDougal. LeadSongDog come howl! 21:58, 18 October 2012 (UTC)

I don't think that we (Wikipedia and Wikimedia Foundation) can afford to ignore this issue. The whole point of Wikipedia is that the content is free and subject to cc-by-sa Creative Commons license. If we ignore the matter, everyone else certainly will. Publishers and authors should realise that it is not acceptable to plagiarize from Wikipedia.

I suggest that you contact the book's publisher and main editor (with a copy to Julie A McDougal) and explain the situation, including a statement that cc-by-sa 3.0 applies to the chapter. The quantity of plagiarism is less than in "Understanding and Management of Special Child in Pediatric Dentistry". The most likely response is that the publisher will ask a different author to write a new chapter for the next edition.

Ms (Dr?) McDougal will not lose her job. However she will not be asked to write for textbooks in the near future.

If you would like me to support you when you contact the publisher, I would happy to do so. Indeed I would be happy to be the "main author" (LOL) if you want. Axl ¤ [Talk] 21:36, 18 October 2012 (UTC)

" I guess the question is did she write this content originally on Wikipedia (better check more thoroughly)? "

If she did originally write the text on Wikipedia, then it would not be plagiarism. However the cc-by-sa license would still apply to the textbook's chapter. Axl ¤ [Talk] 21:45, 18 October 2012 (UTC)

One can release the same content under different licenses to different people as far as I am aware. I will ask here if she is this editor. A number of other sections are very similar as well. I am not sure if this user wrote those as well. Might be good to check other chapters too. Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:00, 18 October 2012 (UTC)

Okay the author in question states that this editor is not her. Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:12, 18 October 2012 (UTC)

I agree with this. Has anyone from WP or WMF done outreach to publishers, specifically to their legal departments, about things like the requirements of our citations, and the use of history pages? I'm not as familiar with the software backend as I'd like to be, but are there tools that allow, say, publishers' legal departments to search the historical revisions of wikipedia to look for plagiarism? (Is that how this example was found, by using such a tool?)

Sorry for the noob-ish questions. UseTheCommandLine (talk) 02:14, 19 October 2012 (UTC)

Software dose exist. I do not know how good it is but universities often use it. We at Wikipedia do not as I think it may be expensive.

This case was found by me looking up a sentence in our article on pneumonia (which was wrong by the way) and finding it word for word in Google books. Than noticing that the sentences that came before and after that one where also exactly the same.

That one should not copy and paste from others and claim it as their own is hopefully something that we do not need to explain to the publishing industry. Especially since most of them that have been around for any length of time have sued other people over this exact issue. Doc James (talk · contribs · email) (if I write on your page reply on mine) 03:26, 19 October 2012 (UTC)

Turns out we have an article Plagiarism detection that talks about some of the available software, some of which runs as services on the net. LeadSongDog come howl! 04:12, 19 October 2012 (UTC)

Yes, I'm sure publishers are already aware of these things. However, they might benefit from a helpful explanation of citation style and requirements of the particular CC license we use, as a way of letting them know that we're trying to police this more aggressively, if indeed we want to do that. And I'm also not suggesting that WP buy commercial software for this purpose. when I look up a phrase on google or some other search engine, and a wikipedia link is returned, it is typically the most recent edit. By the time an author submits a paper to a publisher and the publisher gets around to editing it or vetting it, legal, whatever, it is quite possible that the phrasing or something on WP has changed, and it no longer is a match. So, having tools that can allow search within old edits of wikipedia seems like something that would (in addition to being of scholarly interest or otherwise useful for its own sake) be of use to WP insofar as it could force publishers to do more self-policing. Again, I don't know whether this exists on the toolserver already -- I imagine that that would be a pretty substantial drain on infrastructure. But it would lower at least a little bit the barrier to discovery of this in the pre-publication phase. Which means that publishers would have even less wiggle room to claim that they had done their due diligence, it was an honest mistake, etc. if it winds up going to court or something. Again, just spitballing, feel free to ignore me. UseTheCommandLine (talk) 05:25, 19 October 2012 (UTC)

I think this is a great suggestion. Doc James (talk · contribs · email) (if I write on your page reply on mine) 06:44, 19 October 2012 (UTC)

Comment 1: If the author wrote the original Wikipedia text, as Doc James says, they can also publish that text elsewhere under a different licence as it is theirs to do with as they like. However, one it starts being built on by other editors, one can't take this improved text and publish it elsewhere other than by following one of Wikipedia's licences.
Comment 2: Please read WP:OUTING and remove the speculation on editor identity. This is a very serious issue: "attempted outing is grounds for an immediate block". Colin°^Talk 13:47, 19 October 2012 (UTC)

Okay well it turns out the author in question is not the editor in question and thus this would not be outing. But agree we have an issue. If I am going to expose this author to real life difficulty because she has copied and pasted from Wikipedia I better made sure that my accusations are true. If Wikipedia outing policy prevents me from doing due diligence we at Wikipedia have a problem with this policy. It would be unethical for me NOT to break the outing policy in this situation IMO. You thought? Doc James (talk · contribs · email) (if I write on your page reply on mine) 16:13, 19 October 2012 (UTC)

Please read WP:OUTING again. It doesn't matter if the attempted outing was correct or not, indeed we must absolutely not confirm whether it was as then we're just as bad. This sort of investigation simply can't be done on Wikipedia -- it must be done behind closed doors in private. I don't know if this means a special group of admins, the arbs or WMF but it has no place on the talk page of this Encyclopaedia. I suggest you find someone familiar with the policy as there may be some text/revisions that need deleted. Colin°^Talk 20:56, 19 October 2012 (UTC)

I do sort of see your position Colin. There however is not other group within Wikipedia's whose opinion I respect as much as that of those here. If you would all be so kind as to join Wikimedia Medicine than we could discuss these issues on a private list. Doc James (talk ·contribs · email) (if I write on your page reply on mine) 23:28, 19 October 2012 (UTC)

If I walked too close to the line above, and I may have, feel free to delete as necessary. It does, however, appear that the plagiarism was from the WP article in toto, not from one editor's contribs. No one contributor could own the copyright, accordingly no one could license the text under any terms other than the GFDL. LeadSongDog come howl! 07:31, 20 October 2012 (UTC)

There's possibly a misunderstanding that plagiarising text from Wikipedia will somehow make a book chapter or even the whole book GFDL or CC BY-SA. Have a read of The GPL is a License, Not a Contract, Which is Why the Sky Isn't Falling which refers to GPL but similar issues apply to our licenses. If the terms of the licence (such as attribution) aren't met then it falls back on copyright. The owner(s) of the work can sue for damages/legal-costs and request an injunction to prevent further publication. Who are the owners of the Wikipedia article text? Not the WMF. All the folk who wrote it. Don't know about you, but I don't have the funds for a lawyer, nor do I suspect my contributions would earn me much in damages. Instead we should pursue the ethical rather than legal issues here. Any professional publisher should be upset about this. Colin°^Talk 11:15, 20 October 2012 (UTC)

For what it's worth, I posted a review on Amazon. Axl ¤ [Talk] 11:25, 20 October 2012 (UTC)

You guys be careful. There's plenty text on Wikipedia that was plagiarised. And should you be wrong, the balance of power (being able to afford lawyers and claim substantial damages) is not in your favour. Colin°^Talk 13:09, 20 October 2012 (UTC)

Thanks for sharing the link and comment above, Colin. The majority of legal disputes in the world do not involve lawyers, but rather they are settled when the parties talk to each other and discuss the issue without legal advice. It hurts nothing for a Wikipedian to begin a conversation without consulting a lawyer and if the publisher wants to make statements through a lawyer then that is their business. I see no harm in merely having a Wikipedian ask a publisher if they copied content from Wikipedia. No matter what the publisher says or does not say or even whether the publisher replies or not is extremely interesting, especially when the question-asking is done publicly. I think no one need accuse anyone of anything. I propose sending a note to someone saying, "Hey, that looks like Wikipedia, where did you get it?" and seeing what they say. No lawyers are need for that. Blue Rasberry (talk) 14:17, 21 October 2012 (UTC)

Off-Wikipedia outreach activism process

I am interested in two related situations.

Some entity misuses Wikimedia content and they ought to know better. The above case is one example, here is the Springer issue reported in the signpost, here is the case Doc James reported, and there are others.
Some entity ought to know more about Wikipedia and Wikimedia content anyway for their own good.

In both of these cases there needs to be some kind of institutional outreach. Ideally, someone (or multiple people?) would write letters and emails to the organization and encourage them to properly engage Wikipedia. In response, hopefully the organization would make a commitment to recognize best practices for interacting with Wikipedia and how Wikipedia can help them.

Historically there has been worry that all organizational interaction would be a Wikipedia:Conflict of interest which was most likely to mean that the organization would exploit a relatively defenseless Wikipedia community of volunteers. More and more lately I am seeing the Wikipedia community as an international superpower directing the world's most popular media source and wondering what would happen if the community started making very public demands to be recognized as a legitimate peer to any other media outlet and requesting in open letters that organizations which misuse Wikimedia content make good by having their staff serve a fair part in the Wikipedia mission to advance access to the same resources that are already using, critically need, but inappropriately and in ignorance republish with much less respect than they would had this content been published elsewhere. If such a complaint process were developed to ask organizations to have their staff learn Wikipedia so as not to misuse it, the same process could be used to ask other organizations to learn Wikipedia to use it properly.

I really wish that all organizations which seek to advance education, perhaps particularly non-profit educational organizations, would start to consider their public positions and relationship to Wikipedia. I think it would be in their interest to declare publicly that they will have a staff person become minimally competent in understanding how Wikipedia works and how to properly use content from the site. Thoughts from anyone? How would anyone feel about drafting both one-page letters of complaint and letters of outreach with me? If such letters existed, would anyone be interested in sending them publicly and publicly posting the responses they got for them? Is that a sensible, respectful thing to do? If not this, then what should we do? Blue Rasberry (talk) 17:54, 19 October 2012 (UTC)

I think that WP:MED occupies a particularly sticky space when it comes to these issues. I am interested in pursuing the idea and helping out, but also feel caution is warranted, and ideally a protocol for this sort of contact would be written up, publicized here and wherever else appropriate. Also, this may be germane -- though it is kind of sprawling in scope and discussion, it seems like it might be at odds with the sort of actions you're proposing. (I just saw a post to this effect on the wikiEN list.)

UseTheCommandLine (talk) 18:23, 19 October 2012 (UTC)

Lane I would be willing to support this effort. With respect to Sue's statement about narrowing the scope of the WMF, I think her position is that she wants the community to take on much of these other roles. Which is what we are doing here. Doc James (talk · contribs · email) (if I write on your page reply on mine) 18:26, 19 October 2012 (UTC)

Sure so I guess this is one of the activities that WMMED could take on. Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:30, 19 October 2012 (UTC)

I drafted an initial proposal of how this could work at meta:Wikimedia Medicine/letters. Blue Rasberry (talk) 14:06, 21 October 2012 (UTC)

While I understand and sympathise with the frustration over seeing other publishers copyvios, I am far more concerned with the potential for circular referencing. We should be able to handle these instances in such a way as to preclude using violating "sources" that we know to (or even strongly suspect) constitute {{reverse copyvio}}s. The last thing we need is to start using these as the cited basis for dubious content. Imagine the rats' nest this could create: spammer inserts that "Pickled unicorn horn, while scarce, is an effective cure for recurring-remitting projectile leprosy" into our article Alternative medicine, and a book copies that version before the spam is caught. We then would have that book to cite as a "reliable" notability basis for articles on both Pickled unicorn horn and Recurring-remitting projectile leprosy. To my thinking this is something we do not need a legal basis to prevent.LeadSongDog come howl! 19:07, 22 October 2012 (UTC)

For that goal, all you really need is the {{backwardscopy}} template. WhatamIdoing (talk) 23:48, 23 October 2012 (UTC)

That template is appropriate when we are certain that WP was the source, but not when we just think so without firm evidence. Worse, it does not do much to help find multiple instances by the same author or publisher. LeadSongDog come howl! 19:27, 30 October 2012 (UTC)

Wikipedia Ambassador Program course assignment

This article is the subject of an educational assignment at Rice University supported by the Wikipedia Ambassador Program during the 2012 Q4 term. Further details are available on the course page.

The above message was substituted from {{WAP assignment}} by PrimeBOT (talk) on 16:56, 2 January 2023 (UTC)

[1] Not So Sweet: Missing Mercury and High Fructose Corn Syrup, Institute for Agriculture and Trade Policy

[2] WashPost: Study Finds HFCS Contains Mercury Jan. 2009

[3] CBS News Investigates HFCS Oct. 2008

[Dufault2009-4] Dufault Renee; et al. (January 2009). "Mercury from chlor-alkali plants: measured concentrations in food product sugar". Environmental Health. 8 (2). Bibcode:2009EnvHe...8....2D. doi:10.1186/1476-069X-8-2. PMID 19171026. Retrieved 2012-06-27. {{cite journal}}: Explicit use of et al. in: |author= (help)CS1 maint: date and year (link)

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