Open main menu

Wikipedia talk:WikiProject Medicine

 
List of archives


Contents

Teaching Wikipedia editing for healthcare audiencesEdit

I am a largely-retired UK geriatrician with an interest in medical education. I am planning to set up some Wikipedia training locally. Following a discussion with Doug Taylor, we thought it would be helpful to draw up a list of transferable skills needed to edit a Wikipedia page successfully, and be a part of the Wikipedia community. Identifying the specific skills in this way will allow teachers to identify how they might teach them and assess them. It could also form a useful template to allow comparison with different healthcare (& other) curricula, for example undergraduate, and UK Foundation Programme. This in turn would improve the ease of incorporating teaching Wikipedia editing into such curricula.

What to teachEdit

Towards this end I thought it might be useful to start a draft template. It's at Matrix of WikiEdu teaching template headings & component skills. If thought useful, it could be amended iteratively by the Wikipedia community, in order to build up a comprehensive document. What do you think? Kitb (talk) 12:21, 20 October 2018 (UTC)

seems like a good idea(though it might need some changes), however youll need more editor opinions--Ozzie10aaaa (talk) 12:06, 21 October 2018 (UTC)
I think that what you need to know depends on whether you want the editors to be engaged in a one-time, in-person workshop or trying to promote ongoing, independent work. One-time workshops are usually project-based. With independent, ongoing work, building up slowly through small assignments is probably a good idea. (Week 1: Fix a typo. Week 2: Tag or remove something that you think is wrong. Week 3: Add a sentence with a source....) WhatamIdoing (talk) 20:12, 21 October 2018 (UTC)
Excellent point - the idea was that we accumulate all the component parts in one place so that people undertaking any training (whether one-off, or long term engagement) can select the appropriate one(s) for their needs. This is just a first step - selecting which to use - and how - might be further peices of work, down stream. Kitb (talk) 13:09, 22 October 2018 (UTC)
Somewhere very high up in that list, should be understanding the mission of Wikipedia, how the community realizes the mission, and why we do it that way. I wrote User:Jytdog/How to help people get oriented to those three basic things. So many things here seem bizarre to people unless they understand those things.
Once somebody understands that our mission is to summarize accepted knowledge, when they go to add content about some topic, the question they should be asking themselves is "What is accepted knowledge about this?" and they should be trying to summarize what MEDRS/RS sources say about it. And making sure that what they write makes sense in the context of the whole page, in terms of the emphasis they give to it. Way too many people grab a source and plop 'some stuff' in an article based on what it says. Which is missing the mark.
I don't know how that fits in your matrix. Jytdog (talk) 20:36, 21 October 2018 (UTC)
Thanks - great point! I'll work on that... ;-) Kitb (talk) 12:44, 22 October 2018 (UTC)
I've tried an amendment to incorporate your suggestion - does that seem OK to you? Kitb (talk) 13:33, 22 October 2018 (UTC)
I doubt that speeches about purpose are effective.
This all seems quite unrelated to how long-term editors begin. Maybe that's why so few students stick around? Most of us start by fixing a typo or reverting vandalism. But with the formal training, we start off with "Create an Account" and "Naming of Parts". They can't actually do anything until we've bored them stiff with lectures about all the buttons in the interface (and after all that, we discover that someone brought a tablet, so we've just described the wrong interface). User:Sage (Wiki Ed), has your team looked into whether newbies could start with something more interesting and obviously useful, like a round of RecentChange patrolling for obvious vandalism? WhatamIdoing (talk) 20:09, 22 October 2018 (UTC)
I've always found that formal training works better if we start with: "This is your user page: make an edit"; "This is your sandbox: make an edit"; followed by working through the steps involved in deciding whether Ombre is actually a card game for two or three players, which leads to adding a reference. Demonstrating and then asking participants to attempt the task themselves is generally accepted as the preferred way of teaching skills. They don't need me to teach them the underpinning knowledge; they can read that for themselves at their leisure. --RexxS (talk) 21:31, 22 October 2018 (UTC)
at the start of the "how" i thing, i note that most people learn by whatever magic socialization impulses we humans have. i wonder if anybody has studied how long-term editors get established and how that socialization process actually works here. It is amazing what we have accomplished as a community where that socialization process is really the only "training" most people get. When people are intentionally trained, in my view putting the mission upfront, along with how we realize it and why we realize it that way, is essential for making sense of what goes on here. People want things to make sense, and helping people understand is a much better way to orient and introduce, than presenting "rules" that come across as arbitrary. One can call intentional orientation "speeches about purpose" but that is just ugly. Jytdog (talk) 15:58, 24 October 2018 (UTC)
WhatamIdoing: We've not tried vandal patrol in particular, but many of our courses do start with minor edits on an article of personal interest — find something to copyedit or otherwise improve. We've also tried using Citation Hunt as the basis for 'getting started' tasks, but we found that a large enough portion of students aren't ready for that early on (because working with citations and sources in nuanced ways can be tough, before you really grok Wikipedia's norms around that). I think the big thing that makes retaining student editors hard is that editing Wikipedia wasn't their idea. Early results from our new program, which uses much of the same training content but is for academics and other researchers to learn to edit themselves (basically, a professional development course), show substantial retention.--Sage (Wiki Ed) (talk) 16:51, 31 October 2018 (UTC)
Thanks for the above valid observations. The key focus of this piece of work I am proposing, though, is not how to teach/help learn, so much as what to. If you like, an epistemology of WP editing, simply to allow any teaching module skills to be easily mapped onto the relevant curriculum. I have tried to put it in an order which fits with Bloom's taxonomy. — Preceding unsigned comment added by Kitb (talkcontribs) 11:02, 23 October 2018 (UTC)
Thanks for sharing this Kit. I am pinging @Blueraspberry: on this discussion as well. @EditingDentist: also has experience organizing Wikiediting clubs at Dental Schools. JenOttawa (talk) 12:53, 23 October 2018 (UTC)
You'll need to ping Bluerasberry to attract Lane's attention, Jen. And @EditingDentist: as well  . Cheers --RexxS (talk) 13:53, 23 October 2018 (UTC)
Thanks, yes I noticed my typo but got called away before it was saved. I appreciate your help!JenOttawa (talk) 14:50, 23 October 2018 (UTC)
Thanks again, Jen and Doug - your input greatly appreciated! (PS sorry I forgot to sign earlier entry!) Kitb (talk) 20:00, 23 October 2018 (UTC)

How to teach it!Edit

Having now done a (small) pilot session, I have learnt some valuable lessoons! I just wondered is there a repository anywhere about how to teach WP editing to a helathcare [esp medical] audience? It would be great to curate some simple dynamic resources re WP medical usage, so that one could rapidly & simply check out latest usage & impact stats to put on a slide (or, even better, get the learners to explore online!). Is there any appetite for this? Kitb (talk) 11:44, 8 November 2018 (UTC)

Hi Kit, my “cheat sheet” is my attempt to summarize important points. If you have any feedback and suggestions, I welcome it at any time! https://en.m.wikipedia.org/wiki/User:JenOttawa/Introduction_to_Medical_Editing:_Cheat_Sheet JenOttawa (talk) 02:24, 9 November 2018 (UTC)

Nicotine addictionEdit

Sorry if this is a stupid question, but should a reader typing in "Nicotine addiction" be redirected to Nicotine#Reinforcement_disorders(now Nicotine#Reinforcement disorders and cognitive effects), or Nicotine dependence? I realize that there exist differing definitions of substance dependence and addiction, but a reader may not (and perhaps the adverse consequences of smoking, and the fact that most smokers want to quit,[1][2] make it a bit moot). Is content quality in Nicotine dependence a factor? HLHJ (talk) 06:05, 21 October 2018 (UTC)

I know ICD treats addiction and dependence as synonyms (see .2 at F10-F19). Other narcotic addictions redirect to either a "use disorder" or "dependency" article, rather than the article on the substance – or a subsection thereof; examples opioid addiction, cocaine addiction and cannabis addiction. Little pob (talk) 12:16, 21 October 2018 (UTC)
Addiction and dependence are not synonymous, but the distinction is probably lost on the average reader. Seppi333 (Insert ) 23:59, 21 October 2018 (UTC)
The Nicotine dependence article discusses both use as synonyms and distinctions, without refs, so I've taken the liberty of adding your ref, Little pob. The article also discusses things that are addiction by any definition. Perhaps a rename of the article would be the best way to deal with this?
Separately, the Nicotine article is in terrible shape. I had a go at it to try and make it vaguely conform to MOS:MED, but it still contains a lot of contradictions and some dubious sources. Doc James, I've seen you fix up such things before, and know that you are much better at it than I. Could you possibly have a look at it? If I've made it worse I apologize. HLHJ (talk) 05:27, 27 October 2018 (UTC)
Nicotine is not strictly a drug. It should be structured like Alcohol, not like Aspirin. WhatamIdoing (talk) 15:21, 27 October 2018 (UTC)
Thank you, WhatamIdoing. Alcohol and Ethanol seem to be structured quite differently; what guidelines would apply here? HLHJ (talk) 16:34, 27 October 2018 (UTC)
How does one reach the conclusion that alcohol and nicotine are not strictly drugs?--Literaturegeek | T@1k? 17:34, 27 October 2018 (UTC)
Nicotine is not just a medication but also a drug of abuse I think is what WAID means. Doc James (talk · contribs · email) 17:55, 27 October 2018 (UTC)
Also that nicotine has uses that have nothing to do with human consumption, most famously as an insecticide, and that it is a naturally occurring substance whose existence is independent of any uses that we might put it to.
There are various definitions of drug. The FDA's definition is that a drug is whatever they've approved. A more generic is anything that you give with the intent to treat a condition. In that model, a glass of water is a drug if you give it to someone with a dehydration headache, and a cup of orange juice is a drug if you give it to someone whose blood sugar is low. I see the utility of this definition, but I don't subscribe to it. My personal definition of drug never includes water, and it is not even broad enough to encompass lime juice, even though that lime juice has been given with the intention of treating a deadly disease. Lime juice IMO is a food, and only tangentially a treatment for nutritional deficiency. Nicotine's claim to being "a drug" is debatable – it falls somewhere on the drug–non-drug spectrum between lime juice and cyclophosphamide – but I personally place it closer to lime juice than to cyclophosphamide. WhatamIdoing (talk) 01:00, 29 October 2018 (UTC)
I think WaID is being just a bit reductive here for argument's sake. The FDA's definition of "drug" is found in 21 USC 321 as seen here. Good luck deciphering what all the "and"s mean. Tobacco products fall under their own definition. LeadSongDog come howl! 19:08, 29 October 2018 (UTC)
(edit conflict) Seppi333, you reverted all of my edits (except one fairly minor edit), stating that "Content on performance enhancement goes under uses; several new statements (e.g., cognitive decline and carcinogenicity) cite sources that state this about smoking and tobacco, but not nicotine (WP:V); lastly, non-clinical neuropsychopharnacology claims requires only SCIRS, not MEDRS" and "I reverted a few constructive edits, but the majority of the changes made were not an improvement". I'd like to put the constructive edits back, so I'd like to clear up what the problems were. I've re-tagged some of my concerns.
I'm not sure why a "Psychoactive effects" section came right at the head of the article. Initially, I just tried to balance it by adding info about the negative mental effects of nicotine (with MEDRS). This was the first edit you reverted; I assume that you objected to the use of a review on the effects of nicotine in cigarettes. However, the review discusses measurements of blood nicotine and statements about nicotine.
I think you are acting on the assumption that e-cigarettes deliver just nicotine, so studies using e-cigarettes can be used to make statements about the effects of nicotine, while studies using cigarettes cannot. I don't think either of these views are supported by MEDRS. E-cigs essentially emit a wet low-temperature smoke, as they char a tobacco extract and simultaneously vapourize the water it was suspended in. Then they cool the vapour into a cloud of wet steam, which visually hides the smoke generated by pyrolysing the tobacco extract (though it still smells like pipe smoke). MEDRS seem to draw conclusions about the effects of nicotine from NRT studies and from findings of similar effects from a variety of nicotine-delivery devices; snus, cigarettes, and e-cigs are all relevant (the carcinogenicity statement was made about snus and drawn from a review on the global disease burden from smokeless tobaccos). Conclusions are also drawn from animal studies. I think that if MEDRS makes statements about nicotine, Wikipedia can.
The section on the use of nicotine as a performance-enhancing drug contains no sources that actually say that it is used in this manner. The section on fetal harms seems structured to bury information on the fetal harms of nicotine. You removed two good MEDRS sources I added there, and a fix of another ref that had failed to include two institutional authors; were those the constructive edits you reverted? The statement "Nicotine also extends the duration of positive effects of dopamine and increases the sensitivity of the brain's reward system to rewarding stimuli" seems to me to be about biochemistry and need MEDRS; can you explain why not?
Overall, I was worried that the article starts off by giving the impression that the mental effects of nicotine are all positive, and it isn't harmful. This does not seem to me to reflect MEDRS. These statements are mixed with bits of neuroscience which have far to little context to actually support the general statements, but lend a certain scienciness to them. HLHJ (talk) 19:03, 27 October 2018 (UTC)

───────────────────────── I’ll restore the constructive edits by tomorrow evening. I’m very busy off-wiki. The real issue with the edits is that the nicotine article is about pure nicotine and most of the sources you cited made statements about tobacco and smoking. The only form of pure nicotine commercially available is NRT, so reviews of clinical studies involving that are appropriate for the article. Drug monographs could also be used.

The statement requires SCIRS because it’s not clinical. I would, however, remove “positive” - that part is nonsensical.

Seppi333 (Insert ) 20:28, 27 October 2018 (UTC)

Thank you. I'll try and make sure future statements about nicotine are directly supported by source statements about nicotine. I withdraw my suggestion that you view e-cigarette use to be nicotine consumption, as I think it was unfair. Sorry. HLHJ (talk) 22:30, 27 October 2018 (UTC)

Content still not OKEdit

Hi, Seppi333. I'm sorry, but I'm not really happy with the current state of the article. Obviously I don't want an edit war with you and QuackGuru. I would like to discuss the issues below. I'd also welcome more third-party views.
I didn't get pinged from this, so my apologies for my late response. Seppi333 (Insert ) 07:58, 14 November 2018 (UTC)

Brain damageEdit

Nicotine is known to cause permanent cognitive and behavioural deficits; it's a developmental neurotoxin not only in fetuses, but in children, teens, and young adults.[3] The lede currently summarizes this as "The general medical position is that nicotine itself poses few health risks, except among certain vulnerable groups".
Since essentially all people who get hooked on nicotine do so before the age of 25, this is a rather serious omission of highly relevant information. My attempt to insert this information is the lede by adding ", such as young adults" to the end of the sentence was changed, to a statement about adolescents added deeper in the article. Most people getting addicted are also desperately trying to be very grown-up, and identify as young adults. Stating, incorrectly, that nicotine is just bad for adolescents is a well-known way to get more adolescents addicted. So this is not just wrong, but wrong in a way that seriously misleads (and harms) readers. HLHJ (talk) 03:00, 8 November 2018 (UTC)
I'm not sure that "young adult" would be a fair summary of the sentence later in the article that you describe as being about "adolescents". WhatamIdoing (talk) 16:18, 8 November 2018 (UTC)
Hello, WhatamIdoing. The sentence added was "Adolescents seems to be vulnerable to the negative effects of nicotine on the central nervous system". The Surgeon General's report discusses human (correlations, dose-response relationship) and animal (causality) data for adolescents and young adults, and underlying mechanisms, then says "The effects of nicotine exposure on cognitive function after adolescence and young adulthood are unknown" (the US SG also put out a video pointing out that no-one would volunteer their child for a test of how nicotine damaged their cognitive development). I'm not sure how best to summarize this; suggestions? HLHJ (talk) 01:26, 9 November 2018 (UTC)
It appears that the evidence is strongest for an effect in utero, and the picture gets murkier as the user gets older. So why did you choose to emphasize "certain vulnerable groups, such as young adults"? Why did you not choose something uncontroversial, such as "certain vulnerable groups, such as children" or even "certain vulnerable groups, such as children and teenagers"? WhatamIdoing (talk) 16:36, 9 November 2018 (UTC)
Basically, because the lede already covered harms to fetuses (it doesn't cover breastfeeding, but I missed that). I don't think that the non-whole-tobacco nicotine use evidence for post-weaning children is particularly different from that for any older group, with the exception of that single long-term NRT study on adults. The source does not use the well-defined word "teenagers" in relation to cognitive effects; it uses "adolescents" and "young adults". "Adolescents" is extensively used to refer to rats, in the source and its sources, many of which are also MEDRS. The source does not specify these groups by chronological age; it fairly vaguely classifies them by developmental stage, talking about developing brains (fairly necessary if you are going to draw analogies to rats, which don't generally celebrate their fourth birthdays even with the best of care). It mentions that the (human) brain development continues longer than previously thought, into young adulthood.
I've come across this area of research separately in research on learning and memory; as I recall, age and development seem not to be that tightly correlated, especially at older ages, and activities and experiences seem to have a strong effect. Humans generally change cognitive environment with age, and these life-stage-related changes have changed over time (e.g. a couple of generations ago, many English speakers expected to leave school at 16, take a job, and work at the same company until they were 65). So it's difficult to study such age-related changes in a way that makes it clear that we are not just measuring cultural customs. There is obviously a cultural link between "ages where you are doing lots of new stuff" and "ages of 11-25" or some such. The source (and many of its sources) are vague about chronological age, and that probably actually reflects reality.
So I wanted to be non-specific in a way that reflected the sources. I'd read a fair bit of research saying that no-one identifies as an adolescent, and that telling teens that a product was bad for adolescents tended to cause them to think it was safe for them (because they themselves are unusually mature and basically adults). The term "adult" has commonly been used as including teens by people around me, which I realize is a cultural bias I wasn't paying attention to (most age categories are culture-specific; no one says "There's a lot of ephebi on Wikipedia"). "Young adults" seemed sourced and likely to give an accurate impression, communicating information missing from the existing information. It was also short. I thought it likely that I was going to face opposition, and did not want to write a long text before the basic issue of including the information or not was settled.
Rough summary of the info I've seen follows. Evidence is strongest for in-utero and for breastfeeding babies, because their mothers often take NRT. There is a bit of a gap for young children. While some small children do use nicotine, and photos and even old ads show them doing so, I do not know of any research on the effects on them. There is evidence for the harms of second-hand smoke, and children in this age group often die of acute nicotine poisoning, being more susceptible to it, even allowing for body weight, and very prone to stick things (including the tobacco suspensions used to fill e-cigs) in their mouths. At an age around seven or so, children become more independent, and a fair proportion start using nicotine before the age of ten.[1] We have little experimental data on the effects of long-term non-whole-tobacco nicotine use on post-weaning children, teens, and twens. There's hardly much more on long-term use in adults.
Nicotine taken in adulthood (including by eating peppers and tomatoes) may have a protective effect on age-related cognitive decline, especially Parkinson's, and this effect is seen in independent studies too, so I think including it in the article is a good idea. There are prospective observational studies showing that smoking is associated with faster cognitive decline, but of course there are a lot of confounding factors there; for instance, low socieo-economic status seems to make people smoke more and get ill more even when they don't smoke. ("Smoking is a prospective risk factor for impaired cognitive function in later life"[2], based on [3][4]) Some of these prospective studies followed people from birth; some made extensive efforts to eliminate confounding factors. Apart from evidence of developmental neurotoxicity, they found some negative mental effects. Some cognitive abilities oscillate around normal, following blood nicotine levels, averaging out about the same. However, mood goes down with withdrawal and a hit just brings it back to where it would otherwise be, meaning smoking worsens average mood ("Nicotine/smoking thus comprised an additional source of psychobiological distress, irrespective of experiential background... No prospective study has found that the uptake of smoking leads to psychobiological gains. Instead they show the opposite, with smoking leading to increased levels of stress and depression"[4]).
The chance of an ethics committee passing a study that randomizes nonusers to a long-term dose of nicotine is pretty low. Experimentally giving ten-year-olds something that the medical research community thinks likely to lead to emotional distress, addiction, and long-term cognitive impairment seems even less likely to meet with ethical approval. Such an experiment would be likely to cause suicides. I think our choice is between describing the best guesses of reliable sources as such and not mentioning the issue at all. HLHJ (talk) 08:50, 14 November 2018 (UTC)

───────────────────────── I don't see where in this source - [3] - it says that nicotine causes either brain damage or cognitive deficits. The only thing I found in this source that refers to cognitive deficits pertains to smoking: Smoking during adolescence has been associated with lasting cognitive and behavioral impairments, including effects on working memory and attention, although causal relationships are difficult to establish in the presence of potential confounding factors (Goriunova and Mansvelder 2012). That's not sufficient to claim that nicotine causes cognitive deficits or even might cause cognitive deficits, because tobacco contains a very large number of bioactive compounds. If I missed something, please quote the statement from the source so that I know what you're referring to. Seppi333 (Insert ) 08:03, 14 November 2018 (UTC)

Sure, Seppi333; from the intro of that 2014 SGUS report: "The evidence is sufficient to infer that nicotine exposure during fetal development, a critical window for brain development, has lasting adverse consequences for brain development... The evidence is suggestive that nicotine exposure during adolescence, a critical window for brain development, may have lasting adverse consequences for brain development". In chapter five, "Nicotine exposure during adolescence also appears to cause long-term structural and functional changes in the brain... Thus, adolescents appear to be particularly vulnerable to the adverse effects of nicotine on the CNS[central nervous system]. Based on existing knowledge of adolescent brain development, results of animal studies, and limited data from studies of adolescent and young adult smokers, it is likely that nicotine exposure during adolescence adversely affects cognitive function and development. Therefore, the potential long-term cognitive effects of exposure to nicotine in this age group are of great concern". By 2016 the doubt seems much reduced; again just from the intros: "Nicotine exposure can also harm brain development in ways that may affect the health and mental health of our kids [obviously a press summary]... Compared with older adults, the brain of youth and young adults is more vulnerable to the negative consequences of nicotine exposure. The effects include addiction, priming for use of other addictive substances, reduced impulse control, deficits in attention and cognition, and mood disorders. Furthermore, fetal exposure to nicotine during pregnancy...Nicotine exposure during adolescence can cause addiction and can harm the developing adolescent brain... Nicotine can cross the placenta and has known effects on fetal and postnatal development. Therefore, nicotine delivered by e-cigarettes during pregnancy can result in multiple adverse consequences, including sudden infant death syndrome, and could result in altered corpus callosum, deficits in auditory processing, and obesity."[5]
I used the term "brain damage" in the heading after I found myself trying to write something like "neurodevelopmental toxicity causing alteration to structural and functional aspects of the central nervous system and associated long-term cognitive and behavioural deficits" and decided to go for succinct. It is not, to my knowledge, found in the reports by the surgeon general's office, nor the article, and if there are reasons not to summarize it that way, please let me know and I'll avoid it too. HLHJ (talk) 06:05, 15 November 2018 (UTC)
I've edited this again in response to QuackGuru. Also added content on the differing addictive potential of different delivery forms. HLHJ (talk) 06:07, 15 November 2018 (UTC)
Brain damage typically refers to lesions in the brain; this sounds more like maladaptive neuroplasticity. Seppi333 (Insert ) 01:55, 16 November 2018 (UTC)
WhatamIdoing, I've added a specific statement with specific chronological ages to the lede, with solid sourcing to a 2016 US surgeon general's report; I've tried to make it unambiguous, any criticism welcome. HLHJ (talk) 07:16, 16 November 2018 (UTC)

PregnancyEdit

I inserted two good MEDRS sources on the effects of nicotine (specifically nicotine), in pregnancy; you reverted this to the current content, which has a long paragraph on how other components of smoke are bad, and ends with what sounds like its lede. Could you please explain why? The removed content:

During pregnancy and breastfeeding, mothers are advised not to use any products containing nicotine,[6] as nicotine harms the fetus.[7] One 2010 review concluded "Overall, the evidence provided in this review overwhelmingly indicates that nicotine should no longer be considered the ‘‘safe’’ component of cigarette smoke. In fact, many of the adverse postnatal health outcomes associated with maternal smoking during pregnancy may be attributable, at least in part, to nicotine alone".[6]

Thanks. HLHJ (talk) 03:00, 8 November 2018 (UTC)
Given the quoted statement - "The use of any products containing nicotine likely will have adverse effects of fetal neurological development." - I'm fine with re-adding the assertion:

During pregnancy and breastfeeding, mothers are advised not to use any products containing nicotine since nicotine could harm the fetus.[6][8]

Seppi333 (Insert ) 08:05, 14 November 2018 (UTC)
I've added this to the section you linked above. Seppi333 (Insert ) 08:08, 14 November 2018 (UTC)
Thanks. I've reordered the section so that it doesn't start with specific statements about smoking. We probably need some more up-to-date refs (here's [https://www.ncbi.nlm.nih.gov/pubmed/27297020 a 2016 one). HLHJ (talk) 09:13, 14 November 2018 (UTC)
Looks good. Seppi333 (Insert ) 09:27, 14 November 2018 (UTC)
Also edited again in response to QG, who had a point that the quotes and the statements did not line up any more. HLHJ (talk) 06:32, 15 November 2018 (UTC)

Used because addictive, not because medicinalEdit

The current article says that nicotine is used for its stimulant effects, replacing content that said that it is used because it is addictive (source says : "Most smokers use tobacco regularly because they are addicted to nicotine"; QuackGuru, why is this FV, given that I specified that it was mostly smoked for its addictive effects?).
Content citing surveys to state that most smokers use unwillingly were removed on grounds that they were not MEDRS. I'm not sure that stats on smokers' own opinions on why they smoke are biomedical claims (removed article text: "Adult smokers mostly want to quit and can't; they commonly feel addicted, and feel misery and disgust at their inability to quit, according to surveys done in the US.") I realize that some nicotine users are not smokers, but a very large proportion of nicotine use is by smokers. Cigarettes are the best-studied nicotine product, so I think studies on cigarettes making statements relevant to nicotine are on-topic. Content about smokers is highly relevant to the point here, namely: according to admittedly imperfect evidence, nicotine is mostly used by addicts because they can't stop. Not just by people who like the mental effects, which are, on average, negative.
Users crave nicotine for its acute effects on mood, which are positive; however, negative mood effects set in shortly after use (20–60 minutes after a cigarette, in smokers)[9]. This rapid mood oscillation is associated with addictiveness. Smokers need the nicotine hits to feel normal.[4][10] Regular use causes chronic depressed moods (including higher reported stress and less energy) which are reversible on quitting[9] (unlike some of the cognitive harms, which are probably permanent effects of the brain).[3]
All this is inadequately covered in the current Nicotine#Reinforcement disorders section, which is confused and self-contradictory.
Finally, the article has a large section under "Uses" on an unsourced use of nicotine as a performance-enhancing drug. I do not think this is a significant use; I think this is unfounded marketing puffery (like a lot of dodgy health claims which circulate on the internet and are naively added to Wikipedia). I therefore think this section should be removed. If you disagree, please let me know why. HLHJ (talk) 03:00, 8 November 2018 (UTC)
I did not tag it as FV. I tagged another sentence as FV content. The content was removed because it was off-topic. QuackGuru (talk) 20:46, 8 November 2018 (UTC)
If content saying that nicotine is used because it is addictive is off-topic, why is content saying that nicotine is used because it is a stimulant on-topic, QuackGuru? HLHJ (talk) 01:17, 9 November 2018 (UTC)
The content added did not state that nicotine is used because it is addictive. You stated in part no source with statement on reasons for nicotine use as a whole found, so using statements about smoking clearly identified as such. Smoking and nicotine are different topics. It is better to use sources that are directly related to recreational drug use. The section name is "Recreational". Content about recreational drug use pertaining to nicotine is on-topic. Current wording is "Nicotine is used as a recreational drug.[42] Recreational drug users commonly use stimulants such nicotine for its mood-altering effects.[43]" Both sources I cited are related to recreational nicotine use. QuackGuru (talk) 03:21, 9 November 2018 (UTC)
Quack, do you think that the statement is actually untrue? Do you believe, or disbelieve, the claim that some nicotine users use nicotine because they're addicted?
(Just so we're all on the same page, "recreational drug use" means "drug use for any purpose other than to treat a disease." Taking nicotine to raise your blood pressure, if you have hypotension, is not recreational. Taking it because you like it is recreational.) WhatamIdoing (talk) 16:42, 9 November 2018 (UTC)
It is irrelevant if it is true or not true. The definition of "recreational drug use" is also irrelevant. The content is relevant when the source indicates it is discussing recreational nicotine use.
The section name is "Recreational". Sources that are not specifically about recreational nicotine use are generally off-topic to the section. QuackGuru (talk) 17:40, 9 November 2018 (UTC)
Nearly all nicotine use by humans recreational, according to that definition. Therefore, nearly all sources about nicotine in general are on topic. Indeed, the recreational use so overwhelms other uses that I would accept all sources that don't say that they're specifically talking about some rare medicinal or functional use as being on topic for that section. WhatamIdoing (talk) 22:38, 11 November 2018 (UTC)

People don't use a drug that's addictive (i.e., rewarding and reinforcing) merely because it's addictive unless they're addicted to it. I can't imagine most people would casually use nicotine due to its rewarding effects because it's not a particularly euphorogenic substance (i.e., nicotine consumption doesn't induce a pleasurable affective state like certain other psychostimulants do). Case in point: I use nicotine lozenges periodically solely to improve my focus at times when I find it difficult to concentrate; nicotine has a very well-established attentional performance-enhancing effect in humans based upon meta-analyses of clinical trials. I don't take it merely because it's reinforcing and I certainly don't use it for modifying my affect (NB: I've never noticed it having any effect on my affect), which is what I assume you mean by "people take it because it's addictive" (to be clear, many addictive drugs induce a positively-valenced or "pleasurable" affective state when consumed, but this is not typical for nicotine). In any event, I doubt we have a source which asserts that people use nicotine recreationally simply because it's "addictive". Seppi333 (Insert ) 08:20, 14 November 2018 (UTC)

I am not sure why you put "addictive" in scare quotes with respect to nicotine. I'd put "recreational", as something that makes you depressed is not my idea of recreation. If we are to go by anecdote, all of the nicotine users I know or have ever known are addicted to it, including the ones who insisted they weren't. The mood swings were pretty obvious; they got antsy and short-tempered before they used it. When given excellent medical reasons to give it up, namely cancer, they could not. I am not arguing that all nicotine use is because it is addictive; that would be absurd, as obviously someone using it for the first time is not using it because they are addicted. I am arguing that most use is because it is addictive. The same source cited for the statement "Recreational drug users commonly use stimulants such as nicotine for its mood-altering effects" actually clarifies it in a way that agrees with your statement about euphorogenicity; it also says "Stimulant drug users suffer a range of negative states when off-drug and feel better in numerous ways when on-drug, hence the strong addictiveness of every CNS stimulant." If you are an addict, you have chronic mild low mood, briefly relieved by a nicotine hit, which brings mood up to normal for a few tens of minutes. I've found a source for the statement that most use is due to nicotine's addictiveness, and I've modified the mood-alteration statement to accord with the source (and what you say):

It is widely used because it is highly addictive.[11] People addicted to nicotine suffer depressed mood, and commonly take nicotine for its mood-normalizing effects.[4][9]

I hope this is OK. HLHJ (talk) 09:49, 14 November 2018 (UTC)
Just to be clear, the term “addictive” describes a drug property. An addiction is a brain disorder which is induced by drugs with that property. People only use addictive drugs compulsively if they have an addiction to one of those drugs.
With that in mind, I think what you mean to say is, “It is widely used because many people are addicted to it.” The clause “because it is highly addictive” comes off sounding like it’s a motivation for using it (i.e., it suggests that people use it because they want to develop an addiction); consequently, that wording is really awkward. I’m sure you’re aware that many people begin using tobacco products for social reasons (e.g., fitting in with a group, a belief that it’s perceived as cool, etc.), not because their goal is to become an addict.  
What you’ve described in the second sentence pertains to psychological dependence and the associated emotional-motivational withdrawal symptoms, not an addiction. So, just change “People addicted to nicotine” to “People dependent upon nicotine” and that sentence will be fine. Seppi333 (Insert ) 02:13, 15 November 2018 (UTC)
On the second, I'd changed it to "dependent" before seeing this. I've changed the first to "Nicotine has become widely used because it is highly addictive, which makes it hard to quit using it" now, as I agree that the idea of aspirational addiction is odd. HLHJ (talk) 06:17, 15 November 2018 (UTC)
Performance-enhancing drugEdit

I still think this Nicotine#Enhancing performance section should go; we have no independent source that this use is significant, and the only sourced sentence with the context to make it comprehensible is isolated from important context found in the Nicotine#Reinforcement disorders section (that the effects are acute and counterbalanced by negative effects of dependence, such that dependent nicotine users are not cognitively better off on average). I have tagged the section accordingly. HLHJ (talk) 06:29, 15 November 2018 (UTC)

You’re conflating cognitive deficits that arise from an addiction with a short-term drug effect, so I don’t see a reason to cut that section. A number of articles on other addictive performance-enhancing drugs use that same section to cover the effects on performance. Seppi333 (Insert ) 07:30, 15 November 2018 (UTC)
The "Use/Enhancing performance" section reads:

Nicotine-containing products are sometimes used for the performance-enhancing effects of nicotine on cognition.[citation needed] A meta-analysis of 41 double-blind, placebo-controlled studies concluded that nicotine or smoking had significant positive effects on aspects of fine motor abilities, alerting and orienting attention, and episodic and working memory.[12] A 2015 review noted that stimulation of the α4β2 nicotinic receptor is responsible for certain improvements in attentional performance;[13] among the nicotinic receptor subtypes, nicotine has the highest binding affinity at the α4β2 receptor (ki[equals sign that won't render in talkquote template]1 nM) which is also the biological target that mediates nicotine's addictive properties.[14] Nicotine has potential beneficial effects, but it also has paradoxical effects, which may be due to the inverted U-shape of the dose-response curve or pharmacokinetic features.[15]

We do not have a MEDRS saying that performance enhancement is, in itself and not as a component of dependence, a significant use of nicotine. The second sentence statement was until recently found later in the article, amid more relevant context. The 2015 review in the third sentence mentions nicotine once, to say "Importantly, the non-selective agonist nicotine is less likely to generate such enhancements, in part because nicotine...", so I'm not sure this sentence isn't WP:SYN. The source for the fourth and last sentence says in the abstract "...potentially intervening in age-related changes in diverse molecular pathways leading to pathology. Although nicotine has therapeutic potential, paradoxical effects have been reported, possibly due to its inverted U-shape dose-response effects or pharmacokinetic factors". It is talking about slowing age-related cognitive decline (a use with MEDRS, so we could include that). The point (that high doses of nicotine can have negative effects on cognition, I think) is also made in the first source,[12] in equally obscure language. Anyone else want to weigh in on what this means?
I templated that paragraph as an ad because it looks like a lot of the sciencey industry marketing materials I've read. It make a bold but unsupported claim in plain English, then follows it with a bunch of scientific terminology and claims that sort of look as if they are relevant, but descend into incomprehensibility. This has been shown to be an effective technique for making readers trust claims.[5] The section also leaves out or obfuscates all of the balancing information (for instance, that the benefits in the review are short-term; that a nicotine habit does not give you improved cognitive abilities, and does give you cognitive fluctuations which can cause distress and deeper dependence, and the negative cognitive effects of the maladaptive neuroplasticity described above, which are long-term, with evidence of them in old age).
There are some problems with the cognitive-effects meta-analysis; they included studies of smokers who had not smoked for up to two hours; as the article says, many smokers would be nicotine-deprived by this point. Nearly half the studies did not state funding or were funded by the nicotine industry, and the authors did not examine whether funding source made a difference. They also did not look for publication bias in these mostly very small studies, or separate NRT from smoking (a study on that here, looking at the effect of NRT and cigarettes with almost no nicotine in them). Unfortunately they also do not publish supplementary data, so the reader can't simply run these tests themselves. The Surgeon Genreal's 2014 report also summarizes the review by saying there is no clear evidence for cognitive benefit except for those in withdrawal. There are, however, other sources for the idea that cognitive abilities fluctuate with blood nicotine level in dependent smokers (and more slowly in NRT users), and this fluctuation helps condition dependence. The idea seems likely to be correct and I think it should be included under the mechanisms of dependence. Given more detail and closer sourcing, would you object?
I do not think the short- and long-term, or pre-dependency and withdrawal-based cognitive effects, are the same. I do think they are a factor in addiction (a statement that was sourced in the article). Someone dependent on nicotine feels muzzy and out-of it, so they take nicotine and feel sharper and more focussed. You removed the sentence "Nicotine has clinically significant cognitive-enhancing acute effects at low doses, particularly in fine motor skills, attention, and memory. These beneficial cognitive effects may play a role in the maintenance of tobacco dependence" citing WP:Crystal ball. I think this is more scientific uncertainty than unfounded speculation. I see you also moved the section on dependency and withdrawal from under "adverse effects" to under "Overdose". While the idea that any dose large and swift enough to cause dependence is an overdose is not without merit, and finds some reflection in the proposals to lower the nicotine levels in commercial products to non-addictive levels, I don't think this terminology is widely used in reliable sources, and dependence is certainly a negative effect. We could resolve this by including the section on overdoses as an adverse effect, but I'm not sure if this is acceptable formatting (comments, anyone?).
This is a difficult paragraph; I've tried not to cause offense, and owe you apologies if I fail. I understand from what you posted above that you personally use nicotine lozenges at a level you judge to be non-dependency-inducing; you gave acute cognitive effects as your reason. I'm not attempting to judge whether you are nicotine-dependent; I can't, I shouldn't, and if you wanted to know you'd presumably ask your doctor. But regardless of dependency, you are motivated to believe that the way you use nicotine is harmless. Regardless of the truth of this belief, that motivation will contribute to your POV bias, just as my POV bias is affected by people having first told me they only used nicotine once or twice a month and weren't addicted, and later that they couldn't stop. I am not in any way suggesting that you are being dishonest or otherwise in bad faith in your conceptions around nicotine dependency. I'm just worried; I have learned from experience not to trust any reasoning affecting self-assessments of nicotine dependence.
I also moved the excessively detailed information about plants containing nicotine out of the lede into a separate section. I am a bit worried about the heavy reliance of this section on one source (Siegumund et al. 1999) as I cannot access it and it seems to contradict at least one other source.[6] HLHJ (talk) 06:37, 16 November 2018 (UTC)

Section reflistEdit

References

  1. ^ Pechacek TF, Nayak P, Slovic P, Weaver SR, Huang J, Eriksen MP (November 2017). "Reassessing the importance of 'lost pleasure' associated with smoking cessation: implications for social welfare and policy". Tobacco Control. 27 (e2): tobaccocontrol–2017–053734. doi:10.1136/tobaccocontrol-2017-053734. PMID 29183920.
  2. ^ Chaiton M, Diemert L, Cohen JE, Bondy SJ, Selby P, Philipneri A, Schwartz R (June 2016). "Estimating the number of quit attempts it takes to quit smoking successfully in a longitudinal cohort of smokers". BMJ Open. 6 (6): e011045. doi:10.1136/bmjopen-2016-011045. PMC 4908897. PMID 27288378.
  3. ^ a b c "The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General, Chapter 5 - Nicotine" (PDF). Surgeon General of the United States. 2014. pp. 107–138. PMID 24455788.
  4. ^ a b c Parrott, Andrew C (April 2003). "Cigarette-Derived Nicotine is not a Medicine" (PDF). The World Journal of Biological Psychiatry. 4 (2): 49–55. doi:10.3109/15622970309167951. ISSN 1562-2975.
  5. ^ "E-Cigarette Use Among Youth and Young Adults: A Report of the Surgeon General" (PDF). 2016. Retrieved 15 November 2018. |first1= missing |last1= in Authors list (help)
  6. ^ a b c Bruin, Jennifer E.; Gerstein, Hertzel C.; Holloway, Alison C. (2010-04-02). "Long-Term Consequences of Fetal and Neonatal Nicotine Exposure: A Critical Review". Toxicological Sciences. 116 (2): 364–374. doi:10.1093/toxsci/kfq103. ISSN 1096-6080. PMC 2905398. PMID 20363831. Overall, the evidence provided in this review overwhelmingly indicates that nicotine should no longer be considered the ‘‘safe’’ component of cigarette smoke. In fact, many of the adverse postnatal health outcomes associated with maternal smoking during pregnancy may be attributable, at least in part, to nicotine alone.
  7. ^ England, Lucinda J.; Kim, Shin Y.; Tomar, Scott L.; Ray, Cecily S.; Gupta, Prakash C.; Eissenberg, Thomas; Cnattingius, Sven; Bernert, John T.; Tita, Alan Thevenet N.; Winn, Deborah M.; Djordjevic, Mirjana V.; Lambe, Mats; Stamilio, David; Chipato, Tsungai; Tolosa, Jorge E. (31 December 2010). "Non-cigarette tobacco use among women and adverse pregnancy outcomes". Acta Obstetricia et Gynecologica Scandinavica. 89 (4): 454–464. doi:10.3109/00016341003605719. ISSN 1600-0412. The use of any products containing nicotine likely will have adverse effects of fetal neurological development.
  8. ^ England, Lucinda J.; Kim, Shin Y.; Tomar, Scott L.; Ray, Cecily S.; Gupta, Prakash C.; Eissenberg, Thomas; Cnattingius, Sven; Bernert, John T.; Tita, Alan Thevenet N.; Winn, Deborah M.; Djordjevic, Mirjana V.; Lambe, Mats; Stamilio, David; Chipato, Tsungai; Tolosa, Jorge E. (31 December 2010). "Non-cigarette tobacco use among women and adverse pregnancy outcomes". Acta Obstetricia et Gynecologica Scandinavica. 89 (4): 454–464. doi:10.3109/00016341003605719. ISSN 1600-0412. The use of any products containing nicotine likely will have adverse effects of fetal neurological development.
  9. ^ a b c Parrott, Andrew C. (2015). "Why all stimulant drugs are damaging to recreational users: an empirical overview and psychobiological explanation". Human Psychopharmacology: Clinical and Experimental. 30 (4): 213–224. doi:10.1002/hup.2468. ISSN 0885-6222. PMID 26216554. Stimulant drugs such as nicotine and Ecstasy/3, 4-methylenedioxymethamphetamine (MDMA) are taken for positive reasons, yet their regular use leads to deficits rather than gains... The most widely used CNS stimulant drug is nicotine, because it is the only legal substance in this broad class... However, it is often believed that their novice or light social usage is comparatively safe. Hence, another aim is to explain how and why psycho-biological problems can occur with all types of user — because they are a direct psychobiological consequence of drug-induced changes to the CNS (Table 1)... Acute mood gains, followed by mood decrements on drug withdrawal. The periodicity of these mood fluctuations is most frequent in drugs with a rapid onset and rapid withdrawal (nicotine and crack cocaine)... Regular use of all CNS stimulants can lead to chronic mood deficits. Mood states typically improve following drug cessation... Neuroimaging and neurocognitive studies reveal a range of deficits. They may reflect neurotoxicity or neuroadaptive processes. Some recovery may occur on drug cession, while some problems may endure — an important question for future research. [also see section on "Chronic mood effects of stimulant drugs"] Cite error: Invalid <ref> tag; name "Parrott2015" defined multiple times with different content (see the help page).
  10. ^ Parrott AC (January 1998). "Nesbitt's Paradox resolved? Stress and arousal modulation during cigarette smoking" (PDF). Addiction. 93 (1): 27–39. CiteSeerX 10.1.1.465.2496. doi:10.1046/j.1360-0443.1998.931274.x. PMID 9624709.
  11. ^ Siqueira LM (January 2017). "Nicotine and Tobacco as Substances of Abuse in Children and Adolescents". Pediatrics. 139 (1): e20163436. doi:10.1542/peds.2016-3436. PMID 27994114. The highly addictive nature of nicotine is responsible for its widespread use and difficulty with quitting.
  12. ^ a b Heishman SJ, Kleykamp BA, Singleton EG (July 2010). "Meta-analysis of the acute effects of nicotine and smoking on human performance". Psychopharmacology. 210 (4): 453–69. doi:10.1007/s00213-010-1848-1. PMC 3151730. PMID 20414766.
  13. ^ Sarter M (August 2015). "Behavioral-Cognitive Targets for Cholinergic Enhancement". Current Opinion in Behavioral Sciences. 4: 22–26. doi:10.1016/j.cobeha.2015.01.004. PMC 5466806. PMID 28607947.
  14. ^ "Nicotine: Biological activity". IUPHAR/BPS Guide to Pharmacology. International Union of Basic and Clinical Pharmacology. Retrieved 7 February 2016. Kis as follows; α2β4=9900nM [5], α3β2=14nM [1], α3β4=187nM [1], α4β2=1nM [4,6]. Due to the heterogeneity of nACh channels we have not tagged a primary drug target for nicotine, although the α4β2 is reported to be the predominant high affinity subtype in the brain which mediates nicotine addiction
  15. ^ Majdi A, Kamari F, Vafaee MS, Sadigh-Eteghad S (October 2017). "Revisiting nicotine's role in the ageing brain and cognitive impairment". Reviews in the Neurosciences. 28 (7): 767–781. doi:10.1515/revneuro-2017-0008. PMID 28586306.

Summarizing Drugs.com information on the Xylitol articleEdit

 
Xylitol

Myself and User:Zefr appear to both have reached a disagreement on Talk:Xylitol#Veterinary_studies, over the inclusion of this sentence. In small, laboratory scale animal studies, controlled feeds very high in Xylitol, increased the bone density of rat's with osteoporosis.[1][2]

User:Zefr's position appears to be repeating that this is either a primary source issue, when drugs.com is clearly a reputable secondary source or that it is FRINGE medical advice. However the stance I've taken is that respect for reliable sources per WP:MEDREV, is central to the project, alongside repeating that this is not an article on animal osteoporosis, so it doesn't require the level of scientific rigor that would understandably be deemed necessary on that article. Which I would agree with, if it were. Instead this is an encyclopedic article on a relatively obscure sugar, what it has been used for and where areas of study have gone. So I hope you can understand why I am perpexpled by what I see as an entirely misplaced apprehension to suggest A review...is not compliant with WP:MEDRS to imply any effect on osteoporosis. When again, this is not an article on animal osteoporosis? so how is their concern applicable?

A google search will find a hundred plus citations for this allegedly fringe area of study. Which anyone can do, by typing - xylitol bone mineralization - into your favorite search engine. It is clearly squarely in the domain of WP:MEDANIMAL and it is further made absolutely clear that it is not to be tried by humans, with the inclusion of the Monica Reinagel citation, which explicitly spells out exactly why this is not to be taken as medical advice, in graphic detail. So in sum, I'm perplexed by how WP:MEDRS or any other policy applies, as grounds for exluding this.

Boundarylayer (talk) 00:19, 26 October 2018 (UTC)

The subject of the article isn't the most important factor. For better or worse, this kind of claim is often understood by average (i.e., non-scientists) as meaning "Grandma should take xylitol for her osteoporosis".
Ultimately, this is not a question of "RS". It is a question of WP:DUE. And the question to be asked is: Why is this so important that it needs to be included in the article at all? WhatamIdoing (talk) 00:33, 26 October 2018 (UTC)
Aye, we do not generally include generic "small scale laboratory animal studies" in articles as either a) they would quickly overtake the page or b) require massive cherry-picking prohibited by WP:NPOV. Jo-Jo Eumerus (talk, contributions) 06:36, 26 October 2018 (UTC)
There are tens of thousands of small-scale laboratory experiments on animals that may be of interest to rats, but which contribute nothing to the sum of human knowledge. They could indeed be misleading to the lay reader who might extrapolate a greater significance to their conclusions than is warranted for primary studies on animals. --RexxS (talk) 13:00, 26 October 2018 (UTC)
I do not know of anyone who wants to know about preventing osteoporosis in rats. We should wait until human studies are carried out. Doc James (talk · contribs · email) 17:03, 26 October 2018 (UTC)
I'll take a stance of WP:USEBYOTHERS to respond. Doc James Looking at Proligestone, which is apparently used in veterinary medicine to control hypersexuality in cats and dogs...now while it too could be argued that some lay readers may decide to read into that article and equally extrapolate that Grandma so-and-so should take this for that problem. We don't exclude information on the basis of what lay readers may do with it. Do we? We have articles with more than the proposed single line, given to the likes of anti-malaria drugs used on salmon, that's right fish and a similar wealth of material that one could equally rather dismissably argue, that it does not [directly] contribute to the sum of human knowledge RexxS, though I would consider an encyclopedia without that information, especially when that very information is in reliable secondary sources like drugs.com, more than just a little deficient as an encyclopedia.
Indeed for those two other examples above, there isn't even a secondary medical source referenced and they're just two substances off the top of my head. While in the case of xylitol and WP:DUE, the mention to its use in these studies, is in the very first paragraph of the drugs.com entry. So I have to say, my interest has been slightly piqued by this, when there is the complete lack of clearly defined policy on the matter of if wikipedia should summarize the uses of a substance, as they are found in the opening paragraph of secondary sources like drugs.com, would that really create POV issues as you suggest Jo-Jo Eumerus? How? When as I've mentioned, there are scores of articles that convey the kind of information that substance xyz was investigated as an anti-malaria drug for salmon and so on found on the project and for good reason. Yet Xylitol getting a line, that's just a summary of drugs.com is verboten?
Boundarylayer (talk) 10:00, 27 October 2018 (UTC)
@Boundarylayer: Please read WP:INDENTGAP to help you in formatting your posts. As for your question, you only have to read WP:DUE to get the answer. Excluding sourceable information from the encyclopedia in this case is not done on account of what the reader may do with it, but because it is not accepted knowledge. Are you sure drugs.com is acting as a secondary source here? When I look at https://www.drugs.com/inactive/xylitol-64.html drugs.com calls it a "pharmacologically inactive substance". So which page are we to believe? On the page you picked, it is introduced with the phrase "Medical literature documents the use of xylitol in medical conditions and applications." Sure, but medical literature documents the use of statins to treat pneumonia - although, of course, the treatment had no effect. It's one thing that some sort of lab experiments have been made, but that's a huge leap to extrapolate that to state that drug X has an effect on condition Y. You're going to need a lot more secondary sourcing before you get to assert that xylitol has any mainstream-accepted effect on osteoporosis in any situation. --RexxS (talk) 11:25, 27 October 2018 (UTC)
I think you may have been unfortunately misled RexxS, as the likely reason for your preceived contradictory presentation on viewing drugs.com, is that specific page you linked to, is the common use of Xyltol in typical sub-gram quantities in the mentioned Excipient role, with the usual amounts ingested in this application resulting in the inactive label. However this is not an actual contradiction that casts a bad light on the website, or confusion about which the other page is to not be believed, as you understandably bring up. Instead, as you will similarly find that same inactive-label attached to substances like the related PEG/polyethylene glycol on drugs.com, which almost identically is a widely used inactive excipient at most oral doses usually encountered, as an excipient. However the question of something happening at massive doses of PEG...is truly brilliantly called miralax, a well known and very active regimen. See https://www.drugs.com/inactive/polyethylene-glycol-177.html. That latter page even incidentally provides an explanation for why the site calls some substances inactive and also then active within the same breath, which should clear up any lingering clouds of distrust of the sites reputation.
Quite similarly, as you may know, the xylitol lab studies, if put in easily relateable terms are the equivalent of an anverage human ingesting over a cup full of pure xylitol per day, for weeks. Some thousand times the inactive excipient dose usually encountered and almost identically, ingesting a cup of xylitol a day will result in the widely accepted and fairly active laxative effects -which is likely why we'll never see any human trials, as they'd be close to inhumane- The Monica Reinagel reference, was added explicitly to prevent anyone even thinking of gaining some bright ideas from self-usage. However despite that, I think it is incontrovertible that Xylitol has met the criteria for inclusion into wikipedia, given the hundreds of pubmed citations, for exploring the condition of osteoporosis in rats, though it again, is outside the reasonable expected therapeutic window of a reasonable drug to treat osteoporosis, even of the rat kind, I would not cast it off as completely useless on that either, as I have heard they make good pets and their was a craze in the eighties with a particular movie featuring Michael Jackson, titled Ben. So I really consider it completely bizarre that there is resistance to inclusion. It really isn't going to be selling more Xylitol, in fact we might see about doing the very opposite. By if you wish giving more than a single line to it and explaining in the article that it's not a good idea to take a cup full of it, if you do have osteoporosis, for obvious reasons relating to quality of life, to put it mildly. It's just simply a WP:NOTABLE applicably to veterinary scenarios fact, worthy of exploration of how it works, if you want to be completely utilitarian about it.
Those poor rats may hate us but their osteoporosis did improve. Drugs.com notes it, a reliable Secondary source and perhaps there is actually a WP:DUE reason to mention it in the Xylitol article. In order to prevent any bright spark from continually trying it?
I mean self experimenters are, as I've just found, already buying bulk bags of it and taking still relatively low doses. https://treato.com/Xylitol,Osteoporosis/?a=s So is it not WP:DUE to write something about why it's a bad idea, as these effects were only observed in rats and at mega-doses, which could you know, cause serious and totally unexplored digestion impacts in humans?
19:50, 27 October 2018 (UTC)
It seems you didn't manage to read or understand WP:INDENTGAP in much the same way that you've failed to understand why we want secondary sources, or my objection to inclusion of information about a couple of lab trials. In a nutshell, those experiments show nothing about the general effects of xylitol on any organism. The actual trials show that those particular rats (some calcium-deficient, some diabetic, etc.) saw some improvements in their bones while being fed particular doses of xylitol. That's well below the threshold for an encyclopedia to make any use of whatsoever. Drugs.com is no more a secondary source for those claims than PubMed would be. It performs no review, no selection, no analysis, no aggregation, no overview, or any of the jobs that we use secondary sourcing for. --RexxS (talk) 21:36, 27 October 2018 (UTC)
secondary sources are essential, (agree w/ RexxS)see MEDRS--Ozzie10aaaa (talk) 11:15, 8 November 2018 (UTC)

Stating that research has happened is of value to readers. Wholly in contrast to your suggestion that this is, somehow below the threshold for an encyclopedia to make any use of. You only have to view the Methylene blue article, were what it likewise has been studied for. Is succinctly listed. To quote the article. It has been studied in AIDS-related Kaposi's sarcoma, West Nile virus, and to inactivate staphylococcus aureus, and HIV-1. Phenothiazine dyes and light have been known to have virucidal properties for over 70 years - that sentence is well balanced and of due weight. While none of these applications are clinical practice for a galaxy of reasons, the fact that study has occurred with substance A to treat a condition B, is both definitely of value and truly encyclopedic. I note that entire sentence there on the Methylene blue article, went unchallenged and did not cause a fuss. Yet for some reason using a secondary source here with the case of Xylitol, to communicate that something has been investigated. Is for some reason not good enough because we need aggregation of studies? ...Why exactly? We're simply stating a fact. Just like the methylene blue article does and just like countless other aricles that do the same. Yet am I to take away that you and others here, similarly object to all of the inclusion occurring in these other articles? ...Really? Boundarylayer (talk) 12:13, 28 October 2018 (UTC)

The equivalent sentence for xylitol would be something like "It has been studied in people with sore throats, dry mouths, and infections".
The drugs.com page contains a lot of facts. Why did you pick this one out of it? For example, why do you want to say that it prevents osteoporosis in rats, but not that it causes explosive diarrhea in humans (at the equivalent dose)? WhatamIdoing (talk) 23:33, 28 October 2018 (UTC)
Would you believe WhatamIdoing, I incidentally just added the first mention to diarrhea on the article page, moments before just coming back to check up on this trend. So I clearly do not have a problem with the article mentioning that. As what I do have a problem with is opposition to the stating of fact, that this has been studied. It is a novel area of study, a sugar was found to increase bone volume in lab rats, treating osteoporosis? Wow, how did that work? That's notable. I had initially just added a short section focused as a synopsis of the various studies, per WP:DUE. Having gone back and forth with Zefr on the talk page, I even added the Reinagel reference that states with no ambiguity that - if you are human, do not try this. Now having more recently found that there are apparently forums with people going back to 2009, in practice buying xylitol in bulk to try it for their very human osteoporosis. For that reason alone I think it certainly meets WP:DUE to mention not to try it, or at very least, tightly bound what is written, by communicating that no humans trials have occurred or are expected at the dose equivalent. If it really needs to be further driven home any futher, we could also say, that it is not clear if the effect would even be seen in humans. linking to Animal testing on rodents#Limitations could be done there too.
Would that be acceptable? As this is really above and beyond what Methylene blue and many other articles, have no problem with the stating of fact. I do not understand the opposition? Has it been studied for osteopororsis in rats? Yes. So why is it seemingly forbidden to even have a mention to the fact?
Boundarylayer (talk) 04:56, 29 October 2018 (UTC)

PubMed LabsEdit

A beta site with some new tools that might get incorporated into Pubmed depending on the feedback they receive can be found here CV9933 (talk) 16:48, 29 October 2018 (UTC)

thanks for info--Ozzie10aaaa (talk) 10:01, 31 October 2018 (UTC)
Thanks - the 'PubMed Health' website is different from 'PubMed', and the changes mentioned in your link do not affect the latter (NB please sign your posts with 4 tilde [′~'] marks)! Kitb (talk) 23:43, 8 November 2018 (UTC)
'PubMed Health' was closely connected to the work of Hilda Bastian ( aka User:Hildabast, and also a thoughtful and good-humoured EBM blogger [7][8] :). I believe 'PubMed Health' kept the needs of Wikipedia's medical editing here in mind. I'm sorry to see it go. Among other characteristics, I appreciated its use of DARE appraisals. Thank you @Hilda! 109.145.79.163 (talk) 11:28, 10 November 2018 (UTC)
PubMed Health is now gone, which means one of the links in {{Reliable sources for medical articles}} is obsolete (the link named ..."or to systematic reviews"). I mentioned this on the templates talk page but I don't think anyone noticed (link to discussion: Template talk:Reliable sources for medical articles#PubMed Health will be discontinued 31 October 2018). This link needs to be updated/replaced in the template, which is featured on many articles' talk pages. --Treetear (talk) 23:18, 13 November 2018 (UTC)
I've removed the link for now. --RexxS (talk) 23:36, 13 November 2018 (UTC)

Med article retractionsEdit

I noticed this site: Retractiondatabase.org. Do we have a project page that lists retractions that need to be cleaned up on medical pages in Wikipedia? I am visualising something similar to the Cochrane bot (that flags retracted and updated reviews for humans to adjust the knowledge being shared and the citations accordingly).
Does anyone have any suggestions?
Thanks, JenOttawa (talk) 14:12, 30 October 2018 (UTC)

I see some folks going around and removing retracted / predatory papers. Not sure if we have technology assisting in this. Would be a good idea especially for predatory journals. Doc James (talk · contribs · email) 15:49, 30 October 2018 (UTC)
User:Headbomb do you do some work on this? Doc James (talk · contribs · email) 17:23, 30 October 2018 (UTC)
Not on retractions specifically, but I am working on predatory publishing through WP:CRAPWATCH with JLaTondre (talk · contribs). Adding unreliable/predatory to the Crapwatch is pretty easy to do, although retractions would be out of scope as many (most?) legit journals will have retractions at some point in their lives. A dedicated retraction bot would be a great thing though, as would a |retracted=yes in CS1 templates. There is {{retracted}} though. Headbomb {t · c · p · b} 19:00, 30 October 2018 (UTC)
I'd make a request for such a bot at WP:BOTREQ if I were you. Headbomb {t · c · p · b} 19:05, 30 October 2018 (UTC)
Thanks for the feedback. Do you think that the retractiondatabase.org site I noted above would be a good place to start with a bot? The bot could generate a list that we can work from and insert the retracted flag into the articles as @Headbomb: suggested?JenOttawa (talk) 16:13, 31 October 2018 (UTC)
Honestly I don't know where else you could start, short of compiling retractions yourself. Headbomb {t · c · p · b} 15:00, 1 November 2018 (UTC)
Totally support this suggestion, Jen (& there is a good rationale as to why the staus quo generally is inadequate[1]). Nowhere else systematically incorporates retraction notices into their searches, so this could be a major coup for WP - making it the 'go to' place to check! Just had a look, and the Retraction Watch database contains over 19,000 items, so it would be an invaluable place to start for a bot - and a long process for humans, even if crowd-sourced! Kitb (talk) 21:50, 8 November 2018 (UTC)

References

  1. ^ "Watching out for retractions". I, Science. 6 July 2018. Retrieved 8 November 2018.

Links to DAB pages in medicine-related articlesEdit

 
Head of femur

Since my last visit here, I've collected some more pages with bad links which need expert attention. Search for 'disam' in main view and for '{{d' in edit mode. As always, if you solve one of these puzzles, remove the {{dn}} tag from the article and add {{done}} here.

As always, thanks in advance. Narky Blert (talk) 10:50, 5 November 2018 (UTC)

Great work! I'll be back in a month or so with some more :-( Narky Blert (talk) 09:36, 8 November 2018 (UTC)
Thanks for hunting them out for us less experienced folk to work on!! Kitb (talk) 11:31, 8 November 2018 (UTC)
A handy tip someone placed here before, was to go to your user preferences and on the gadgets tab, select the box "Display links to disambiguation pages in orange" CV9933 (talk) 12:25, 8 November 2018 (UTC)
Quick link on above tip: Special:Preferences#mw-prefsection-gadgets -> scroll down to "Appearance" -> select box (5th from bottom) "Display links to disambiguation pages in orange" -> click Save. --Treetear (talk) 21:58, 9 November 2018 (UTC)
thanks Treetear--Ozzie10aaaa (talk) 15:33, 10 November 2018 (UTC)
When I joined WP:DPL, there were c. 40,000 known bad links to WP:DAB pages which had never been looked at or which had been flagged {{dn}} as too difficult. (I was late to the party - I've seen old reports suggesting 200,000 and much worse.)
Once we got that number down below 10,000 or so, I began to ask specialist WikiProjects to help solve some of the remaining problems. Some of those WikiProjects have been utterly indifferent, and therefore utterly useless. However, I can cheerfully say that Wikipedia:WikiProject Medicine is one of the three WikiProjects whose members I have found always to be well-informed and eager to solve puzzles relating to their speciality. Props!
A tip. I or other disambiguators will, sooner or later, pick up bad links to WP:DAB pages, because User:DPL bot flags them as needing attention. However, none of us will ever pick up bad links to WP:SIA pages. Narky Blert (talk) 03:19, 11 November 2018 (UTC)
I've always believed that this group was awesome. :-) WhatamIdoing (talk) 22:41, 11 November 2018 (UTC)
@Narky Blert: Why is a link to a WP:SIA a "bad link"? The reason I ask is that I "disambiguated" the glutamate synthase link in GltS RNA motif by changing that page from a DAB to a SIA, as all of those articles refer to enzymes which catalyze glutamate synthesis. Seppi333 (Insert ) 07:52, 14 November 2018 (UTC)
@Seppi333: SIAs aren't always bad ideas, but they very often are. They are only good ideas if it can be guaranteed that every incoming link is designed to point readers to every article on the page. If even one incoming link is meant for only one of those articles, that confuses readers and degrades the encyclopaedia.
The three enzymes on the glutamate synthase page have different coenzymes. I very much doubt whether every future incoming link will intend to refer to all three.
There is a way to link to a DAB page showing that all articles on it are meant. Link through the (disambiguation) qualifier, and mark it as <!--intentional link to DAB page-->. Narky Blert (talk) 10:28, 14 November 2018 (UTC)

Medical marketing (eg Medtronic)Edit

I am not sure if this has been previously addressed by this Wikiproject, but it sort of stuns me how commercial companies have brazenly inserted wikilinks to themselves into "see also" sections for articles about medical devices like artificial cardiac pacemaker and implantable cardioverter-defibrillator (two such diffs where I removed these UNDUE influences: here and here.

This paragraph that I removed, which cites "google.com" (lol) was particularly bad. Out of the almost dozen commercial influences and self-important redlinked doctors/companies mentioned, only Anthony Adducci was actually mentioned in the patent (the coinventor, Schwalm, was not even mentioned in the article as a "pioneer").

Companies like Medtronic are large and prestigious and deserve appropriate coverage. However, looking at the "what links here" for this company (as an example), it seems someone at this company wants to insert mention of this company into as many medical device pages as possible, possibly to boost their search results when people search for medical devices on the internet. I feel the project should be aware of and actively fight this unethical form of search engine optimization. Yanping Nora Soong (talk) 01:02, 7 November 2018 (UTC)

What you are describing is of course possible, but it is also possible (and perhaps more likely) that it's just the result of entirely natural editing by regular editors here. Is there actually any evidence for what you claim? Are there certain accounts adding these links, or certain IPs, or any specific edits that are concerning? Deli nk (talk) 01:15, 7 November 2018 (UTC)
I just removed more content that definitely must have been inserted by paid editors. This seems pretty prima facie (though behavior not confined to Medtronic), and especially this one. Why would regular editors be compelled to bold product pitches, proclaiming how novel and improved something is? Unpaid editors are more likely to document history they feel has been neglected, as far as medical devices go. I will dig into the page histories over the next few days. Yanping Nora Soong (talk) 01:18, 7 November 2018 (UTC)
I don't know about that.
Consider this line:
  • bolus calculators: Pump software helps by calculating the dose for the next insulin bolus.
MOS:NOBOLD says that those terms should have been in italics rather than bold, but that's not an unusual mistake. (It might even be easier to read.) Properly, it should be in definition list format, but I'm practically the only editor who ever uses that. But even if it's not ideal formatting, that kind of basic definition it doesn't exactly scream promotionalism, does it?
The content you're complaining about was added in 2006 (just days after the first draft of MEDRS was started), includes multiple manufacturers (why would Medtronic pay someone to mention their competitors?), and was made by an editor whose userpage says that his kid has Type 1 diabetes. I think that "save my kid's life" is a far more plausible explanation than "paid editing" in this case. WhatamIdoing (talk) 05:22, 7 November 2018 (UTC)
I might have been overzealous there, because I was trying to chase down where Medtronic might have inserted themselves into other articles via there Whatlinkshere, but I feel that they definitely inserted themselves into pacemaker-related articles in a rather egregious manner. Yanping Nora Soong (talk) 20:23, 8 November 2018 (UTC)

User:Yanping Nora Soong We have had multiple global heads of marketing at Medtronic try to white wash a Wikipedia article. They, like most undisclosed paid editors, told falsehoods and their stories changed once caught. Was written up in the Atalantic.othe Agressive trimmed of these "see also" sections is fine by me. Doc James (talk · contribs · email) 06:41, 8 November 2018 (UTC)

  • yep we are always driving this stuff out of the encyclopedia -- we are aware of the problem generally, and calling attention to specific instances is very helpful. Thanks for posting. Jytdog (talk) 20:11, 8 November 2018 (UTC)

Complex orphan diseases; lumping or splittingEdit

I while back I came across Multisystem proteinopathy which looked like this at the time. I trimmed out the primary sources which made it like this.

I then merged it into Hereditary inclusion body myopathy.

An IP editor objected to this and would like to see the multisystem proteinopathy page split back out. Which you can see at the HIBM talk page at Talk:Hereditary_inclusion_body_myopathy#Undoing_merge_with_multisystem_proteinopathy.

They've been following up with me (with remarkable patience) and I have not made up my own mind yet.

More input would be helpful. Jytdog (talk) 16:01, 7 November 2018 (UTC)

The article you merged into the bigger article is a stub. It can be forked back out, per MOS guidelines, if that disease gets enough material or expanded on. Yanping Nora Soong (talk) 20:07, 8 November 2018 (UTC)
There are lots of things we can do. The question is what is best. But the place to discuss is there, not here. Jytdog (talk) 20:09, 8 November 2018 (UTC)

Random #cite editorsEdit

Where are editors like this one at the Cracked nipple article and this one at the Oophorectomy article coming from? Notice it's the first editor's first edit. Flyer22 Reborn (talk) 01:16, 8 November 2018 (UTC)

Looks like an editathon: Wikipedia:WikiProject_Medicine/National_Network_of_Libraries_of_Medicine. ♠PMC(talk) 01:41, 8 November 2018 (UTC)
Have provided them feedback about ADAM again (that it is not public domain). Any specific issues User:Flyer22 Reborn? Doc James (talk · contribs · email) 06:32, 8 November 2018 (UTC)

another student articleEdit

From the previous, or another, class:

Outriggr (talk) 02:22, 8 November 2018 (UTC)

User:Outriggr Trimmed the poor sources. Added some good ones. Merged into the main topic. Doc James (talk · contribs · email) 06:31, 8 November 2018 (UTC)

Cleanup needed: Spinal Muscular AtrophyEdit

I noticed that this article contains a lot of primary references. I removed one sentence that was added (no reference and seemed to be self promo). I will flag it here if anyone has time to take a look: https://en.m.wikipedia.org/wiki/Spinal_muscular_atrophy# Thanks, JenOttawa (talk) 02:53, 9 November 2018 (UTC)

It's a rare disease. Primary sources are sometimes the best possible sources for standard information about rare diseases. Secondary is not the definition of a good source. It's important to balance multiple considerations around the reliability of sources. A recent primary source from an expert in a respected journal in a relevant area is often better than a review article written by a grad student in a third-tier journal. When we're writing about a common or well-researched condition, we can pick the best of the best of the best (and that's what we wrote MEDRS around), but when we're working on articles about rare diseases, we need to think about sources holistically, and not just through a simplistic primary-bad/secondary-good lens. WhatamIdoing (talk) 16:50, 9 November 2018 (UTC)
Thanks for this clarification, WhatamIdoing - really helpful to us less experienced folk! Kitb (talk) 18:04, 9 November 2018 (UTC)
We have decent reviews on the topic
https://rarediseases.org/rare-diseases/spinal-muscular-atrophy/
https://rarediseases.info.nih.gov/diseases/7674/spinal-muscular-atrophy
Doc James (talk · contribs · email) 06:37, 11 November 2018 (UTC)
I agree that those are decent secondary sources, and I would encourage anyone interested in the subject to use them. However, they are not technically review articles, because they are not published in peer-reviewed academic journals. WhatamIdoing (talk) 06:20, 12 November 2018 (UTC)
Thanks for all the feedback @WhatamIdoing and Doc James:. There are many sections of Spinal Muscular Atrophy that are summaries of RCTs/case studies and in vitro/in vivo work. For example,
"Butyrates (sodium butyrate and sodium phenylbutyrate) held some promise in in vitro studies[1][2][3] but a clinical trial in symptomatic people did not confirm their efficacy.[4] Another clinical trial in pre-symptomatic types 1–2 infants was completed in 2015 but no results have been published.[5]"
When you mention above that primary sources are often the best that we have, I do not disagree with you for background info in a Wikipedia article. How do you feel about the above paragraph? It is my understanding that this would not be acceptable as per MEDRS. Similar to @Kitb:, I really appreciate this discussion from a learning point of view.JenOttawa (talk) 14:27, 12 November 2018 (UTC)
User:JenOttawa better to replace with secondary sources IMO Doc James (talk · contribs · email) 02:17, 13 November 2018 (UTC)
I think it depends upon what sources exist. In the case of the sentence about the file drawer problem, the source could be updated to PMID 27490705, which is a 2016 review.
If the three animal studies are the ones cited by the primary source that says it didn't work in humans, then it's a bit like "citing" a historically important paper (which we accept as a valid use): you're putting it there for the convenience of the interested reader, not really as proof that the statement is accurate. The 2016 review mentions both of these substances. WhatamIdoing (talk) 19:27, 13 November 2018 (UTC)

References

  1. ^ Chang, J. -G.; Hsieh-Li, H. -M.; Jong, Y. -J.; Wang, N. M.; Tsai, C. -H.; Li, H. (2001). "Treatment of spinal muscular atrophy by sodium butyrate". Proceedings of the National Academy of Sciences. 98 (17): 9808–13. Bibcode:2001PNAS...98.9808C. doi:10.1073/pnas.171105098. PMC 55534. PMID 11504946.
  2. ^ Andreassi, C.; Angelozzi, C.; Tiziano, F. D.; Vitali, T.; De Vincenzi, E.; Boninsegna, A.; Villanova, M.; Bertini, E.; Pini, A.; Neri, G.; Brahe, C. (2003). "Phenylbutyrate increases SMN expression in vitro: Relevance for treatment of spinal muscular atrophy". European Journal of Human Genetics. 12 (1): 59–65. doi:10.1038/sj.ejhg.5201102. PMID 14560316.
  3. ^ Brahe, C.; Vitali, T.; Tiziano, F. D.; Angelozzi, C.; Pinto, A. M.; Borgo, F.; Moscato, U.; Bertini, E.; Mercuri, E.; Neri, G. (2004). "Phenylbutyrate increases SMN gene expression in spinal muscular atrophy patients". European Journal of Human Genetics. 13 (2): 256–9. doi:10.1038/sj.ejhg.5201320. PMID 15523494.
  4. ^ Mercuri, E.; Bertini, E.; Messina, S.; Solari, A.; d'Amico, A.; Angelozzi, C.; Battini, R.; Berardinelli, A.; Boffi, P.; Bruno, C.; Cini, C.; Colitto, F.; Kinali, M.; Minetti, C.; Mongini, T.; Morandi, L.; Neri, G.; Orcesi, S.; Pane, M.; Pelliccioni, M.; Pini, A.; Tiziano, F. D.; Villanova, M.; Vita, G.; Brahe, C. (2007). "Randomized, double-blind, placebo-controlled trial of phenylbutyrate in spinal muscular atrophy". Neurology. 68 (1): 51–55. doi:10.1212/01.wnl.0000249142.82285.d6. PMID 17082463.
  5. ^ "Study to Evaluate Sodium Phenylbutyrate in Pre-symptomatic Infants With Spinal Muscular Atrophy (STOPSMA)". Retrieved 28 December 2011.

MucosectomyEdit

Hello, it's me again! Is a mucosectomy the same as an endoscopic mucosal resection? de:Mukosektomie through Google Translate says yes, but I have no idea. ♠PMC(talk) 13:03, 10 November 2018 (UTC)

I don't think they're exactly synonyms. I think that mucosectomy is the goal you're trying to achieve, and cutting it out by passing a knife down (or up) the digestive tract is just one of several ways to achieve the goal. Other methods seem to include laparoscopic mucosal resection (stick the knife through a 'keyhole' in your skin) and ablative mucosectomy (destroy the tissue, e.g., by burning or freezing).
It might be reasonable to merge the articles, and describe the different techniques all in the same place, but I don't think that they're exactly the same things. WhatamIdoing (talk) 06:29, 12 November 2018 (UTC)
Hmm ok. I think I'll link mucosectomy from endoscopic mucosal resection and leave a merge for someone else to determine. As always, I appreciate you weighing in. ♠PMC(talk) 07:49, 12 November 2018 (UTC)

Talk:Breathing_circuit#Requested_move_4_November_2018Edit

There is a move discussion at Talk:Breathing_circuit#Requested_move_4_November_2018. Flooded with them hundreds 08:09, 11 November 2018 (UTC)

commented--Ozzie10aaaa (talk) 11:55, 11 November 2018 (UTC)

Featured quality source review RFCEdit

Editors in this WikiProject may be interested in the featured quality source review RFC that has been ongoing. It would change the featured article candidate process (FAC) so that source reviews would need to occur prior to any other reviews for FAC. Your comments are appreciated. --Izno (talk) 21:31, 11 November 2018 (UTC)


Help needed improving gene infobox (alternate title: Tom (LT)'s annual gene infobox whinge)Edit

I need some help from this project to improve an infobox, specifically infobox gene

The article agrees that it's a protein. First line: "Ceruloplasmin (or caeruloplasmin) is a ferroxidase enzyme that in humans is encoded by the CP gene" Yet the infobox... incomprehensible!! Just look at that monster!

I encounter this issue every protein article I visit. They are darned difficult to read!! I can confidently say they are completely incomprehensible to any reader that's not trained to biology at a university level. Is that what we want??

I proposed some changes here, some with consensus, but unfortunately the discussion was archived without any being made.

I would in the wiki way make these changes (including small ones myself), but the infobox is programmed in lua. Whilst I admire the lovingly handcrafted box this means that only a handful of editors can change this 2,000+ line programmed monolith.

I am seeking some help improving the infobox. I'm not too fussed how but some simple suggestions are:

  • primary purpose of the box be summarising key points of information to readers (WP:INFOBOX) - readers who are not biomedically trained
  • Use plain english where possible (WP:TECHNICAL)
  • Decrease the use of images which are unnecessary, such as the mouse karyotype
  • If the gene infobox is used in an article about a protein, include some information about the main functions of that protein (such as what it primarily does, where it is, where it's mostly made in the body) in simple terms. (WP:INFOBOX)

--Tom (LT) (talk) 10:37, 12 November 2018 (UTC)

    • I'd love to see some changes in the gene / protein pages in general. I'm a clinical laboratory geneticist, and my eyes glaze over reading them. There is also significant work on protein / enzyme vs gene, but I don't even know where to begin with that one. The inclusion of all the info for the gene on the page for the protein / enzyme makes things difficult to parse, even if you know what you are looking for. Canada Hky (talk) 20:40, 12 November 2018 (UTC)
      • Infoboxes aren't necessarily for reading are they? I think they are more for referencing information quickly. There could be some information added (although standardizing it would be difficult), but I think the purpose of it is fulfilled. We can use prose in the article itself. Natureium (talk) 21:27, 12 November 2018 (UTC)
        • On a page for the protein, much of the information in the infoboxes is irrelevant and confuses the distinction between gene and protein. That isn't helpful. Canada Hky (talk) 21:37, 12 November 2018 (UTC)
          • I completely agree Canada Hky, the distinction between the gene and protein is lost which adds an additional level of confusion. As a clinical geneticist you don't even find it useful! I wonder if it may be better just to completely recreate a new infobox in wikicode for proteins and then replace the existing set. At least the new ones could be edited and/or sandboxed in a normal manner. --Tom (LT) (talk) 06:47, 14 November 2018 (UTC)

───────────────────────── @Boghog: You might be interested in this thread. Seppi333 (Insert ) 08:31, 14 November 2018 (UTC)

I was hoping for a bit more buy-in from the maintainers of the infobox since Module:Infobox gene is scripted in Lua which I am not very familiar with. Based on the ideas generated in the previous discussion, I will try to hack a prototype when I find time. Boghog (talk) 08:57, 14 November 2018 (UTC)
Template:Infobox protein already exists and has 944 transclusions. I would have thought it would be simplest to make use of that. Further parameters can be added on request.
However, as Template:Infobox gene draws its information from Wikidata, I wondered if you would like me to convert Template:Infobox protein to do the same? I would not code the whole thing in Lua, but simply use Module:WikidataIB to fetch values from Wikidata where no local parameter was supplied. That would allow us to override the Wikidata value whenever we chose, and it would not have any visible effect on existing uses. What do folks think? --RexxS (talk) 15:25, 14 November 2018 (UTC)
We spent several years replacing thousands of {{infobox protein}} transclusions with {{infobox gene}}, so I am not so keen on that solution ;-) Also it really doesn't solve the problem, except perhaps make it easier for non-Lua programmers to implement. The best solution is to get the maintainers of the infobox to implement these changes, but that doesn't seem to be high on their priority list. If we can put together a prototype for community comment, that might catalyze the process.
Please note (this was a source of confusion in previous discussions) that despite the names, both infoboxes are about the gene and the protein. The protein box is still used for special cases (for example families of proteins). Boghog (talk) 17:24, 14 November 2018 (UTC)

Problems today with the PMID tool in visual editorEdit

Is anyone else having problems? Using Chrome I cannot seem to get the PMID tool to work today (visual editor). I can use the DOI. I got an error message with the PMID: "We couldn't make a citation for you. You can create one manually using the "Manual" tab above." JenOttawa (talk) 16:12, 12 November 2018 (UTC)

sometimes it does happen--Ozzie10aaaa (talk) 20:29, 12 November 2018 (UTC)
Working again now. Just a few hours down! Thanks. JenOttawa (talk) 21:08, 12 November 2018 (UTC)
I asked a dev about this yesterday (we were waiting for a meeting to start), and he said that this kind of behavior is usually due to a server problem somewhere, rather than a software bug. If it happens more frequently, then please let me know. WhatamIdoing (talk) 19:29, 13 November 2018 (UTC)

N,N-DimethyltryptamineEdit

Could use some additional eyes. --Tryptofish (talk) 21:54, 12 November 2018 (UTC)

Specifically [9] Enigmamsg 00:21, 13 November 2018 (UTC)

PhospholipidosisEdit

 
Phospholipid

Can editors with medical experience please have a look at Phospholipidosis? There's lots of poorly formatted recent editing and an over-reliance on primary sources. Plus there is what appeas to me to be promotion for a company named Nextcea, Inc. Considering one of the major editors of the article is an account named Nextcea (talk · contribs · deleted contribs · logs · edit filter log · block user · block log), I'm sure there is COI/paid editing involved too. Sorry to just drop this here, but this topic is out of my league. Deli nk (talk) 23:38, 12 November 2018 (UTC)

though it has medical aspects, talk page[10] only indicates Wikipedia:WikiProject_Pharmacology--Ozzie10aaaa (talk) 13:36, 13 November 2018 (UTC)
Trimmed the mass of primary sources and tried to better summarize the review. Doc James (talk · contribs · email) 04:11, 14 November 2018 (UTC)
Further comments here Talk:Phospholipidosis would be useful. Doc James (talk · contribs · email) 15:35, 15 November 2018 (UTC)
I left a message and I am happy to help. JenOttawa (talk) 15:52, 15 November 2018 (UTC)
talk[11] indicated COI--Ozzie10aaaa (talk) 17:17, 15 November 2018 (UTC)

Student editorsEdit

We have several articles being edited by students who seem to have not been informed about MEDRS. The following articles would benefit from increased monitoring:

Thanks. Natureium (talk) 00:25, 15 November 2018 (UTC)

thank you for posting--Ozzie10aaaa (talk) 03:00, 16 November 2018 (UTC)
Class seems to be very active right now. JenOttawa (talk) 01:33, 17 November 2018 (UTC)

The MerckManual and MerckHome templates - don't workEdit

Hi, (well at least one doesn't work, I'm extrapolating...EDIT on the template page of the two examples Folliculitis doesn't work, Lymphadenitis does)

Does anyone know who should be looking after these templates? (https://en.wikipedia.org/wiki/Template:MerckHome & MerckManual)

I tried a link, e.g. at the bottom of Miliaria it links to: http://www.merck.com/mmhe/sec18/ch206/ch206b.html which is sort of broken, it goes to Lice Infestation. The layout of the site seems to have changed from the section chapter topic format. I assume it (merck.com) was trying to translate to the new format, but got the wrong redirection.

e.g. the new place for Miliaria is https://www.merckmanuals.com/home/skin-disorders/sweating-disorders/prickly-heat

I was about to edit the page but found the template, which implies many such links may be broken. ˥ Ǝ Ʉ H Ɔ I Ɯ (talk) 02:41, 15 November 2018 (UTC) Edited ˥ Ǝ Ʉ H Ɔ I Ɯ (talk) 02:55, 15 November 2018 (UTC)

Well, sort of nobody. User:Davidruben created the template, but hasn't edited for over a year, and User:Scottalter, whom I've often asked for help with templates before, has only made a few edits this year.
It doesn't look like there is a clear path from the old path to the new one. We're starting with {{MerckHome|18|206|b||Prickly Heat}} and I don't think that information can be bashed into the new URL. They might require manual updates. The good news is that this will probably require only a few dozen edits, as the templates are not very widely used. WhatamIdoing (talk) 03:40, 15 November 2018 (UTC)

Feedback would be helpful regarding adding two reviews to the PTSD article pertaining to AcupunctureEdit

https://en.wikipedia.org/wiki/Talk:Posttraumatic_stress_disorder#Acupuncture If you have a chance, gathering a consensus/suggestions would be helpful here. Thanks! JenOttawa (talk) 12:57, 15 November 2018 (UTC)


give opinion(gave mine)--Ozzie10aaaa (talk) 22:22, 16 November 2018 (UTC)

Clinic for Special ChildrenEdit

Just dropping this here in case anyone is interested to take a look at it. Came across this because of a request at WP:FFU. I basically gutted the article. I did a bit of BEFOREish poking around and I suspect there may be enough to piece together an article with some substance, but it's not my forte. So here is it in case anyone has a particular interest in apparently rare genetic disorders and Amish people. GMGtalk 18:37, 15 November 2018 (UTC)

I will take a look, and can likely source and expand. It is quite an astonishing story and very well regarded genetics clinic and community health initiative. Canada Hky (talk) 18:45, 15 November 2018 (UTC)

School projectEdit

The new article Common Practices in Pain Management with an Emphasis on the Role of Opioids, which appears to be the product of a school assignment, could use medical review. Peacock (talk) 21:01, 15 November 2018 (UTC)

I'm tempted to draftify it, it's clearly an essay rather than an attempt at an encyclopedia article. ♠PMC(talk) 21:03, 15 November 2018 (UTC)
That seems reasonable to me. Peacock (talk) 21:04, 15 November 2018 (UTC)
It was draftified by Praxidicae. Natureium (talk) 21:10, 15 November 2018 (UTC)

IP refspamEdit

I'm canvassing here for more input on this issue that no one has any proposed solutions for at ANI. Someone has been using a variety of IP addresses (12 that I found) to insert his own primary research papers as references in many biomedical articles. He's done this in batches since 2012. He has been blocked twice but doesn't care. Does anyone have any ideas of how to stop this? Natureium (talk) 21:12, 16 November 2018 (UTC)

If it's the same papers, maybe an edit filter? I don't know how to do them, so I can't help there, but it's a thought. ♠PMC(talk) 21:19, 16 November 2018 (UTC)
Yah not sure of any good solutions. Doc James (talk · contribs · email) 00:45, 17 November 2018 (UTC)
Return to the project page "WikiProject Medicine".