Wikipedia:Featured list candidates/List of signs and symptoms of diving disorders/archive1

The following is an archived discussion of a featured list nomination. Please do not modify it. Subsequent comments should be made on the article's talk page or in Wikipedia talk:Featured list candidates. No further edits should be made to this page.

The list was promoted by Dabomb87 22:38, 19 January 2011 [1].

---

List of signs and symptoms of diving disorders

List of signs and symptoms of diving disorders (edit | talk | history | protect | delete | links | watch | logs | views)

• Featured list candidates/List of signs and symptoms of diving disorders/archive1

Nominator(s): RexxS (talk) 21:56, 8 December 2010 (UTC)

I am nominating this for featured list because, as a scuba diver, I feel it meets a need for information, and is also useful for navigation (per WP:LISTPURP). It is somewhat unusual in being a compendium of five lists, but Wikipedia has no other single page that presents the commonest signs and symptoms of diving disorders, which I have categorised by the causal disorder. This is my first FLC nomination, so I am a little unsure of how well it will meet the criteria, but I am available to respond to criticisms on a daily basis. I have participated in discussions on FLC recently, so I have attempted to ensure that the lists meet standards of accessibility and usability, where appropriate. RexxS (talk) 21:56, 8 December 2010 (UTC)

Resolved comments from Arsenikk (talk) 01:53, 31 December 2010 (UTC)

;Comments by Arsenikk As a fellow diver I much appreciate the list. Listing of signs and symptoms of diving disorders is definitively an encyclopedic topic, and easily something people might look up here, even if they have never and don't plan on diving. However, there are issues before it can receive the star: Lists don't need to start with a bold title, instead just link to 'diving disorders'. 'Breathing gas' needs to be explained. The third sentence (starting with "The disorders are...") is very long and contains a lot of information. Break up the sentences. The lead should give a brief explanation of each disoder. I doubt non-divers know what oxygen toxicity or high-pressure nervous syndrome is. The lead should be much longer and contain a summary of the list, including information of the various signs and symptoms. Any suitable images? Even if they are just of scuba divers, they will brighten up the article. There is a severe underlinking in this article. Terms like 'toxic', 'antioxidants', 'US Navy', 'helium' etc. For each disorder there should be a full explanation of what it is. For instance under 'decompression sickness' there is nothing explaining what causes the disease or what it really is; it just starts off with talking about bubbles. It is not common to bold information within the tables, and I don't really understand why the first column is center-aligned. The first sentence under 'arterial gas embolism and pulmonary barotrauma' is long, and presents a lot of vary different information without at all explaining what the disorder is. Please start with a simple explanation of what it is, and then go on to talk about death rates etc. The first time I read the last sentence, I thought only ten percent of diagnosis gave symptoms. Center-aligning text in a table makes it much harder to read. Again, avoid boldface, and linked bold-face is a no-no. Euphoria is linked to 'Euphoria (emotion)' which redirect to 'Euphoria'. For the table for nitrogen narcosis it should be specified that the depth refers to breathing air, and that different breathing gas mixes (nitrox, trimix etc) will give a different narcotic equivalent depth. Although I would not recommend it, there are people who still use deep air and otherwise avoid helium. Be less blatant, and state that helium is a possibility for deeper dives. Also unsure if 'large proportions' is an accurate term for 40 meter dives with helium. Could you repeat the link to the disorder in question once for each section (now they are only linked in the lead). Ditto regarding boldface and center-alignment. In all five tables, there is no real need for the table header (e.g. "Signs and symptoms of HPNS"). The list under oxygen toxicity is a data dump from a single survey, and is hardly appropriate in an encyclopedia. Instead, it would be better to summarize the various symptoms. As it is now, it is difficult to read and understand, and often duplicates signs and symptoms. 'Blackout' is a disambiguation link. 'Category:Diving medicine' is a subcategory of 'Category:Underwater diving', so the latter should be removed. Arsenikk (talk) 00:36, 9 December 2010 (UTC) Thanks for such a comprehensive commentary. I've made a number of changes to address some of the points you raise and I'll summarise them here: I hadn't realised lists were an exception to WP:BOLDTITLE, but I've now unbolded 'Diving disorders' and wikilinked it. I've expanded the lead to give more context and explain 'breathing gas', which I agree is central to an understanding of the disorders. I've also broken up the longer sentences throughout. I've gone as far as I think I can in providing more internal links. The ones you suggested were blatant omissions, and I've added rather more, but I'm wary of violating WP:OVERLINK. Perhaps you can look again and see if you feel the balance is right yet. I've expanded the introduction to some of the sections. I originally intended not to make any of the prose too long, and to rely on the internal links to give context to those who need it. However, I'm persuaded that there is room for a brief description in each case, so I've made an attempt to balance that against my perception that list articles shouldn't be overburdened with prose. I'm happy to be guided on that. I've sorted 'euphoria' and 'blackout', hopefully satisfactorily. As a former 'deep air' diver from the days before we could get helium (you don't want to know what narcosis is like at 80+ m), I've become a zealous convert to using helium, ever since we were able to brew 50% He 'heliar' in the garage for diving in the 100 m range. So I probably overstated the case, and I've amended the relevant sentence to be more neutral (although without a 'large proportion' of He, the mixes are not very useful). I've now tried to treat each section as self-contained as far as wikilinks are concerned. It's a degree of overlinking, but I can see the sense in your argument and hopefully I've have now complied. The parent category has now been removed. That leaves a number of issues that I feel I need to explain: In Nitrogen narcosis, I was hoping that the final sentence of the introduction ("Since the choice of breathing gas also affects the depth at which narcosis occurs, the table below represents typical manifestations when breathing air") would be sufficient to set the table in context, but would you suggest I expanded that further to discuss Equivalent narcotic depth? I agree that some images would be an improvement and I'll search for some that meet WP:IMAGES#Pertinence and encyclopedic nature: "Images must be relevant to the article that they appear in and be significantly related to the article's topic". Complying with WP:ACCESSIBILTY does require certain changes that do not seem relevant to a sighted person. However, giving a table a caption allows anyone using a screen reader to jump directly to a table selected by its caption. More importantly, tables which have row headers allow a screen reader to navigate up and down a data column, while having the column header and row header read out to them. For example, going down the 'Clinical manifestations' column in Decompression sickness, they could hear "Clinical manifestations", "Musculoskeletal", "Localized deep pain, ranging from ...". Whereas without the row header, they would not hear that symptoms were musculoskeletal, and would have to navigate left and right to pick up that information. The way that Wikipedia treats table headers in a wikitable is to mark them up as bold and centred with a darker background. So it's not me that's producing the bolding and centring that you find problematical, it's the Wikipedia site-wide style sheet. There is a class provided to override part of that ("plainrowheaders"), but it's not mandated by our Manual of Style. I have noticed that numbers are almost always centred in featured lists, so although I could make the first column in each table normal weight and left-aligned, those with numbers in the first column would no longer be centred. I'm not sure if it would be acceptable to have a mixture of styles between the different tables. The signs and symptoms of oxygen toxicity is indeed taken directly from Professor Kenneth Donald's seminal study undertaken during World War II. During my research to take Oxygen toxicity to featured article, I was unable to find any significant controlled study on humans since then (probably because ethics would now forbid it). Almost all studies on oxtox are not related to CNS toxicity, but to pulmonary toxicity, so are quite irrelevant to diving. Smertz (2004) reviews a number of reports gathered from hyperbaric treatment, but says nothing of symptoms other than convulsions. Christian Lambertsen's wide-ranging research since around 1965 still adds nothing to Donald's observations of symptoms. In truth, every decent source on the subject relies on Donald's findings or on anecdote. I suppose I could just name the symptoms, but that seems so lacking in context, compared to Donald's results which I feel demonstrate the array of symptoms and the extreme variability in their onset, which is so characteristic of oxygen toxicity. I'm very grateful for your input here and I'd appreciate any further thoughts on the above – particularly on how best to fit in the consequences of WP:ACCESSIBILITY on producing a good-looking article. Finding a good consensus would undoubtedly be a benefit to the FL process, as complying with ACCESS will have effects on the visual presentation of many lists. --RexxS (talk) 17:07, 9 December 2010 (UTC) Further, I've now added a few images that I think are relevant. Feedback appreciated. --RexxS (talk) 21:43, 11 December 2010 (UTC) I've provided demonstrations of a consolidated format for the oxygen toxicity table at Talk:List of signs and symptoms of diving disorders, both with and without plain row headers. Would either of those come closer to meeting your comments? --RexxS (talk) 19:58, 12 December 2010 (UTC) In response to both your comments and Axl's, I've set several of the tables to use "plainrowheaders", which would seem to be preferred. --RexxS (talk) 15:08, 17 December 2010 (UTC)

• Support 01:53, 31 December 2010 (UTC)

This discussion has been closed. Please do not modify it.
The following discussion has been closed. Please do not modify it.
Comments hello RexxS, good to see you here. Some comments. I think (and please, correct me if I'm wrong) that the alt text in the lead image is weak. After all, you don't mention the two chaps being trained... Stick to one version of English, seems that you have "recognise" and "localize" (and metre and disorganization) in the same article. "for each 10 metres (33 ft) of depth" could be me, but I'd say "for every 10 metres"... ", up to about 40 metres (130 ft)" I'm the biggest parenthesis-phobe, but in this case I'd say put that clause in parentheses so we can be sure that recreational depths are "up to about 40m", not that this is a subset of recreational depths. "Unfortunately, at extreme ..." Not sure you need "Unfortunately" - it's true that it's unfortunate, but it doesn't really seem encyclopedic. You have one reference in the lead, end of second para. Usually we'd go for referencing everything or nothing (in the understanding that it's a summary of the list and therefore all will be referenced later), so I think you should choose one approach. Caption - Lab -> Laboratory. Not convinced we need a link to itch. Some of the manifestations are complete sentences (e.g. "The pain may be reduced by bending the joint to find a more comfortable position") so should have full stops. However, re-reading that, it's less a manifestation, more a cure? Don't link to "pain" from "ache", especially on the second instance. I think our regular readers know what ache means. "Sensation of tiny insects crawling" - seems very specific... Also not sure you need to link cough. You have no alt text for the Pulmonary Circuit diagram (I'm shocked!) "particularly in a rapid ascent" no need to repeat, perhaps "particularly a rapid one" Caption says "Signs and symptoms" while table has only "Symptom" and should the caption say something about the fact that this shows the % of divers who suffered from it? Narcosis image caption needs a full stop. What is "idea fixation"? It's a red link and somewhat odd because of it! "Reasoning and immediate memory affected more than motor coordination." has a full stop, none of the other notes seem to. Be consistent. Not sure you need to link "death". EEG net image has no alt text (shocked? yep!) If you want to link hertz, then put (Hz) afterwards because that's what you use thereinafter. Same comment on alt text for the oxygen toxicity image. Not sure of the utility of a sortable table where you just have time and a free text (e.g. Lip-twitching and Severe lip-twitching sort far apart, should they?) Refs 4 & 5 come from the same place so could be generalised with just their page numbers used. And be consistent with page numbering, ref 4 has pp. 557–8 and ref 5 has p. 568–71, would use the same number of digits for these, and have pp. for ref 5. The Rambling Man (talk) 19:09, 9 December 2010 (UTC) Hi TRM, and thanks for your comments. I thought it would do me good to subject myself to this process, as I'm hoping to contribute more as a reviewer in future. Here's what I've done so far: Yes, the images were added after Arsenikk requested, and I was remiss in not providing better/any alt text. Arguably, an image with a descriptive caption doesn't need much help from alt text (as the two together are alternate text), but I think I've improved that aspect now. Both 'recognise' and 'recognize' are standard British English (en-gb), so it's not a question of version, more of style (and there's no conflict with 'metre' en-gb). I must admit, I'm not wholly consistent in my usage of -ise vs -ize; some words just look right to me with a particular ending. Nevertheless, being a foolish hobgoblin, I've now attempted to standardise on 's' rather than 'z'. Agreed & changed - 'for every 10 metres' is no more correct than 'each', but is more idiomatic. I originally set 'up to 40 metres (130 ft)' in parentheses, but disliked the doubled '))' that you get ({{convert}} places the inner parentheses by default). Thinking about it, 'up to 40 metres' is a subset of recreational diving depths in the UK (limit is 50 m), although not in the USA (limit 130 ft). Nevertheless, the point is that the phrase is meant to be illustrative, not definitive, so I've adopted your suggestion and the extra parentheses (ugh). I've copyedited out 'Unfortunately' and think it now reads better. Refs in the lead: that's what I get for following Arsenikk's advice to expand the lead, which was originally one paragraph (all sourced to Bennett & Elliott chapter 9). I'm loathe to lose that reference, as it refers to the crucial chapter in the definitive work on diving medicine, and for anyone wanting an overview of the topic, it's simply the best reading. I've added that for each paragraph and a specific ref for use of hydreliox, which B&E skims over. I've rewritten the manifestations to be noun phrases for consistency. If you can find a more comfortable position when bending a joint, it's an indicator for the diagnosis of DCS (as are all of those symptoms), and that's the point of it, rather than treatment (which is hyperbaric oxygen therapy). I've added a period to the narcosis caption, and removed the errant one from "Reasoning and immediate memory affected more than motor coordination" The source for the table in oxygen toxicity uses "Symptom" as the column heading; whereas they are mainly signs by a strict definition. I've amended it to 'Signs and symptoms' Making columns sortable is often helpful, but sometimes worthless. Taking your point, I've suppressed the sorting on 'Signs and symptoms', but retained it for exposure time, as it's possible someone may wish to see what symptoms arose as time increased. I've changed to "... during an ascent, particularly a rapid one," - much nicer. I've changed "|page" to "|pages" in ref 6 (was ref 5). I hope you'll excuse my unfamiliarity with the process, but these are the points I'd like to discuss further: "Sensation of tiny insects" is indeed terribly specific, but it's often found in the sources as a lay description of formication - which is derived from the Latin for 'ant'. I think I'd prefer to keep it (peculiar as it is), as I always try to explain the most obvious jargon. Okay, no major issue really. The Rambling Man (talk) 18:09, 11 December 2010 (UTC) Hz and hertz: This is what WP:MOSNUM#Conventions says: "In prose it is usually better to spell out unit names, but symbols may also be used when a unit (especially one with a very long name) is used many times in an article. However, spell out the first instance of each unit in an article (for example, the typical batch is 250 kilograms ... and then 15 kg of emulsifier is added)'" I spelled out the unit 'hertz' at its first occurrence (and linked it as it may be unfamiliar to all readers) and used 'Hz' thereafter. Unlike acronyms, MOS doesn't ask us to parenthesise the unit symbol immediately after the first spelled-out occurrence (as in the example of 'kilograms' above). I can see the sense in adding the symbol for an uncommon unit in parentheses following its first spelled-out use, but I suspect that doing so violates MOS. Again, no major issue. The Rambling Man (talk) 18:09, 11 December 2010 (UTC) I've thought hard about this, and searched MOS & MOSNUM thoroughly. My conclusion is that it doesn't violate MOS after all. I've now added '(Hz)' as I feel it is useful here; if it sticks, I'll have a go at changing MOSNUM to specifically mention the idea as an example of good practice. Thanks, --RexxS (talk) 21:43, 11 December 2010 (UTC) Contrary to popular belief, table captions don't need to be descriptive or explanatory (that's the job of the summary element) and visually-impaired don't need to have the column headers pre-announced for simple tables with just two or three columns, as most folk can remember the order in simple cases. However, captions are very useful for blind readers because they are the identifiers for the table - hearing the caption tells a blind reader that they're in the right place for the info they want. I'd suggest that the captions I used are as concise but useful as I can make them. Understood. We have a way to go in completely understanding the real emphasis of WP:ACCESS. The Rambling Man (talk) 18:09, 11 December 2010 (UTC) Page ranges: I've always used the convention that you supply only enough digits in the second item of a numeric range to distinguish it. For example, 2885–2887 becomes 2885–7; 2885–2891 becomes 2885–91; 2885–2902 becomes 2885–902; and 2885–3002 is written in full. WP:MOSNUM is silent on the issue (apart from a single example of a date range), but I've seen both my style and the convention of using the last two digits argued over and accepted at WP:FAC. If the expectation here is that my style is not acceptable, I'll change it to conform with your norms, but it ought to be referenced to a guideline somewhere. Okay, no problem. I would prefer consistency in the range but you make a good point and I'll let it go. MOS should do better here. The Rambling Man (talk) 18:09, 11 December 2010 (UTC) Let's see if any other reviewers want to comment on this. I'm content to go with whatever consensus can be found, and I'm also happy to raise the issue at MOSNUM if we can get more input. --RexxS (talk) 21:43, 11 December 2010 (UTC) Refs 5 & 6 (were 4 & 5) refer to different pages in the same chapter. The same is true for refs 10 & 11. I've often used {{harvnb}} in articles to condense such references – in fact I wrote a guide on how to do that at User:RexxS/Cite multiple pages – but I'm not sure the extra complication and difference in style is worth it when only two refs in each case are to be condensed. If there were several refs to the same chapter, I'd agree 100%, but how much would it help in this case? You're right, for two instances, it's probably not much of a gain, other than to remove all the repeated text in the refs. The Rambling Man (talk) 18:09, 11 December 2010 (UTC) Linking: Now, you'll have to explain this a bit more to me. I understand WP:OVERLINK very well, but my reading of WP:LIST seems to suggest a higher degree of linking is appropriate for lists than for articles, since the list also performs the task of navigation. I tried to ensure that any signs or symptoms were well-linked throughout, as I expected someone reading this article might want to actually read more about them (however mundane). Hence I made the links to 'cough', 'itch', 'pain', 'death', etc. - which I would not normally link in an article (common words). Ache isn't actually synonymous with pain, and I'm disappointed that the redirect is not better. One day we'll have an article or a better (section) link for ache, so I'd argue that it's a proper link to make. I won't argue with this. If I'm the only complaining about it, then it ought to stay...! The Rambling Man (talk) 18:09, 11 December 2010 (UTC) Thanks again for all of your help here – did I miss anything? Regards, --RexxS (talk) 23:59, 10 December 2010 (UTC)

Comment: In the section "Oxygen toxicity", the table of the case series symptoms does not help readers understand how likely or significant those symptoms are. The table should be removed. Axl ¤ [Talk] 11:49, 13 December 2010 (UTC)

Thanks Axl. I'm willing to be corrected, but I don't believe anyone knows how likely any particular symptom is - and surely all observed symptoms are significant? Donald's work is still the best experimental evidence we have. Anyway, I've made an alternative formulation of the data at Talk:List of signs and symptoms of diving disorders. Would that table (with a more detailed introduction) be more acceptable? --RexxS (talk) 18:34, 13 December 2010 (UTC)

The list of symptoms for "Arterial gas embolism" shows the frequency of symptoms nicely. If you tell me that the frequency of symptoms for "Oxygen toxicity" is not available, I'll take your word for it. [You are Wikipedia's expert on oxygen toxicity ;-) ] In my opinion, "lip-twitching" (observed at 13 minutes, 14 minutes, etc.) is less significant than "convulsed", but that may be original research. The tables that you added to the talk page are a little better because they give the reader a vague idea of frequency. It would be better to have the symptoms ordered by the frequency rather than the earliest appearance of the symptom (thus lip-twitching, convulsion, nausea, vertigo, etc.). A third column indicating the total number of observed events would also be helpful (thus lip-twitching 18, convulsion 5, etc.). I'm unsure of the difference between "blubbering of the lips" and "lip-twitching", but I don't suppose that Donald clarified that. Axl ¤ [Talk] 09:47, 14 December 2010 (UTC)

The disorders apart from oxygen toxicity, are either common (like narcosis), or have longer-term sequelae (like DCS/AGE), so in many ways are more amenable to study, either as experiments or by collection of reported incidents. With oxygen toxicity, the really significant effect is the convulsion (as you say), which can end in drowning - anything short of that is unlikely to get much mention in an incident report. The other setting for CNS oxygen toxicity is, of course, in a recompression chamber, and many of the symptoms Donald's observed are reported there. Unfortunately, Donald showed early on that the onset of oxygen toxicity is quite different "in the dry" from underwater, so it becomes difficult to try to extrapolate from reports of symptoms during HBOT to the diving scenario. The best we can probably say is that "these are the sort of symptoms that are associated with oxygen toxicity; their onset is unpredictable; and we don't really know how high partial pressures of oxygen will affect any individual." Not terribly helpful, I'm afraid. On the other hand, we can say "Donald observed symptom X on Y occasions, during a particular series of experiments." In fact, you always make me think of better ways of looking at information (for which I'm grateful). I'll put together another table showing the relative frequency observed by Donald, and see if other columns like "earliest onset"/"latest onset" would fit in. The onset of toxicity is actually very interesting as it shows that some individuals succumbed in a few minutes, while others withstood the same conditions for well over an hour. That's the reason why we use such very conservative limits on ppO2 breathed - we don't know who the outliers are, nor what a "safe limit for 99.99% of the population" would be. Anyway, I'll also see if I can dig up some of the data from when the US Navy tried screening their divers - they eventually gave up because the screening provided to be of practically no predictive value. FWIW, Lip-twitching is far less significant than convulsion in its likely outcomes - and that needs no OR; but perversely, lip-twitching is probably the most 'characteristic' symptom short of convulsion, and it is significant because any other disorder is so unlikely to cause it that it confirms the diagnosis for all practical purposes. --RexxS (talk) 23:46, 14 December 2010 (UTC)

"Perversely, lip-twitching is significant because any other disorder is so unlikely to cause it that it confirms the diagnosis for all practical purposes." Okay, I take your point. (I approach symptoms from a different point of view.) I'll have a look at your revised table. Axl ¤ [Talk] 09:26, 15 December 2010 (UTC)

The points you make are sufficiently compelling for me to replace the previous table with a summary one, showing relative frequency as well as earliest and latest times of onset – thank you. I've included the latter two columns because the really key problem of oxygen toxicity is the massive variability in time to onset, which makes it so unpredictable. Divers are taught to scrupulously limit their ppO2 to 1.4 bar, even though some individuals may tolerate more than twice that for hours. I've provided a version of the new table with centred numbers and plain row headers at Talk:List of signs and symptoms of diving disorders. All of the tables are equally accessible, but any views on the best visual presentation would be most welcome. --RexxS (talk) 21:42, 15 December 2010 (UTC)

• Support. The new table is much better. Axl ¤ [Talk] 10:54, 23 December 2010 (UTC)

• Comment Has Arsenikk been asked to revisit? Dabomb87 (talk) 23:28, 30 December 2010 (UTC)

• I'm always uneasy asking folks to invest more of their time, but I've "pinged" him now. Merry Bishmas and Happy New Year! --RexxS (talk) 01:43, 31 December 2010 (UTC)

• Support good work, different from our regular stuff, a welcome change. The Rambling Man (talk) 19:45, 11 January 2011 (UTC)

• Support – Meets FL standards. I did make one small fix a few days ago, but that was all I could find at the time, and there haven't been any more edits since then. Giants2008 (27 and counting) 22:08, 11 January 2011 (UTC)

The above discussion is preserved as an archive. Please do not modify it. No further edits should be made to this page.