User talk:Doc James/Archive 81

AOK on the further reading, after references

Will follow your advice/guidance on med articles, though in cases outside your bailiwick, I may still slip in alternate ordering—in particular when the appearing references are uniformly bad, and the Further reading is serving as a basis for properly formatted, well-chosen and well-formatted future article sources. As a waypoint, an analogy (if you sail). Cheers. LeP. 71.201.62.200 (talk) 04:52, 1 July 2015 (UTC)

ADHD

Hi James, I left a reply for you on my talk page. I don't know if you see those automatically so I am noting it here. Thanks! Ehaugsjaa (talk) 23:07, 2 July 2015 (UTC)

Hypoglycemia

Hello Doc James, I suffer from congenital adrenal hyperplasia and one of the main symptoms I have when my cortisol levels are too low is hypoglycemia. During an adrenal crisis one suffers from seriously low blood sugar and also eleoctrolyte imbalances (low sodium/high potassium). In this article you have mentioned very briefly that cortisol should be checked in patients presenting with hypoglycemia but you never state explicitly anywhere that one of the causes of hypoglycemia could be Addison's disease, or other types of adrenal insufficiency - I think this is a serious oversight that should really be corrected. It is such a problem that often, those of us with Adrenal insufficiency who go to the emergency room because we are having a crisis get brushed off, or accused of being on drugs or alcoholics because even medical professionals don't think that it could be low cortisol - even if we are wearing medical jewelry stating that we have adrenal insufficiency. A friend of mine changed hers to read "Give Solu-cortef or watch me die" because she was left vomiting on an ER floor for 3 hours having an adrenal crisis. Please do what you can to help people be aware of this serious condition by including it where relevant in your wikipedia entries! Thank you for your time, Lahoma J. Howard, M.A. PhD student/Instructor of Sociology - Colorado State University 75.70.67.202 (talk) 12:03, 3 July 2015 (UTC)

It is listed here List of causes of hypoglycemia but agree the body of the article on hypglycemia is in need of improvement. Have updated it some. Doc James (talk · contribs · email) 16:11, 3 July 2015 (UTC)

Moving Text within Wikipedia

user:Doc James how do I know where the content was moved from for this edit [1]? Is there a way to track that? The edit history simply says "moving." How is the original wiki attributed in this case (move versus copy) and does it need to be? — Preceding unsigned comment added by Lucas559 (talk • contribs) 19:40, 3 July 2015 (UTC)

It is all moved within the same article per the history [2] Thus attribution is within the history of that article Doc James (talk · contribs · email) 19:42, 3 July 2015 (UTC)

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July 2015

Hello, I'm Clubjustin4. I noticed that you recently removed some content from Night terror without explaining why. In the future, it would be helpful to others if you described your changes to Wikipedia with an accurate edit summary. If this was a mistake, don't worry; I restored the removed content. If you would like to experiment, please use the sandbox. If you think I made a mistake, or if you have any questions, you can leave me a message on my talk page. Thanks. Clubjustin (talk) 03:10, 4 July 2015 (UTC)

Thanks there was issues with some of the references. Some were spam such as here [3]. Others were simply small low quality studies as removed in this edit [4] Doc James (talk · contribs · email) 03:13, 4 July 2015 (UTC)

What is "MEDMOS"?

Just asking, what is "MEDMOS"? Clubjustin (talk) 03:50, 4 July 2015 (UTC)

It is WP:MEDMOS. It is the manual of style for medical articles. Doc James (talk · contribs · email) 03:53, 4 July 2015 (UTC)

PubMed up for you?

Hey, just wondering, is Pubmed accessible? It seems to be down for me right now. Cheers doc. -- Aronzak (talk) 07:09, 4 July 2015 (UTC)

Works for me. Doc James (talk · contribs · email) 07:11, 4 July 2015 (UTC)

Oh, they seem to have a misconfigured domain server - I was getting NXDOMAIN errors for a while but now it's resolving to a bad IP address. (130.14.29.110 rather than 130.14.29.109). They'll probably have it up in a bit. -- Aronzak (talk) 07:36, 4 July 2015 (UTC)

German pilot study for Roscovitine's effects on Glioblastoma cell lines

Hello Sir,

I was wondering if you've seen the Roscotivine abstact published July 3 by Spadidos Publications. It's a European pilot study which appears to have seen some sucess. I can send you a link to the article if you'd like. I'd love to hear your thoughts on it.

Please let me know if I can email or direct message (Twitter) the link to you.

Thanks for your time,

Gary Hudson [email protected] Twitter @Gary Hudsn4557 — Preceding unsigned comment added by 70.139.35.13 (talk) 18:07, 4 July 2015 (UTC)

A pilot study on a cell line? Sounds like very early stage research.Doc James (talk · contribs · email) 23:30, 4 July 2015 (UTC)

Copyright

I believe you are in error. I did not add copyrighted material. My article that was published in the American Journal of Public Health is copyrighted, but the reference to the journal article is not copyrighted per se. The correction I made was to the entry for Impacted Wisdom Teeth. The reference No. 8 lists my last name and the title of the article but it does not list the name and issue of the journal, which is standard for such references. There was no copyright violation in my entry.

Reference no 8 should read: Friedman JW "The prophylactic extraction of third molars: a public health hazard." Am J Public Health 2007;97(9):1554-1559. Jay W Friedman Jay W Friedman (talk) 02:50, 5 July 2015 (UTC)

User:Jay W Friedman I did not say you did. I just provided you some guidence on editing medical content on Wikipedia. Doc James (talk · contribs · email) 02:54, 5 July 2015 (UTC)

I think I understand what Jay W Friedman was trying to do now. He is the author of reference 8 on impacted wisdom teeth. This reference was present in the article already and incorrectly formatted. I have corrected this issue now. Matthew Ferguson (talk) 08:41, 5 July 2015 (UTC)

Which specialty: RAS?

I recall this concern was raised when this paramater was in discussion.

Might be seen by dentist, General (family) practitioner, oral and maxillofacial surgeon, paediatric physician, dermatologist, ENT, etc.

Most commonly this problem would be dealt with in primary care by non specialists imo. Matthew Ferguson (talk) 08:24, 5 July 2015 (UTC)

Yes. Primary care and ER deal with all conditions. Which specialty studies / publishes most about it though. Doc James (talk · contribs · email) 08:27, 5 July 2015 (UTC)

I would say oral medicine or whatever it may be called in the country in question, but that is my perspective. Historically there was no oral medicine or oral and maxillofacial surgery so ENT did a lot besides. Matthew Ferguson (talk) 08:43, 5 July 2015 (UTC)

Agree that specialties are getting more subdivided. Doc James (talk · contribs · email) 08:48, 5 July 2015 (UTC)

Gabor Racz

You know, Doc - a BLP isn't a journal entry. It's a biography. Why do you want it to read like a science paper? It's one thing to create dry scientific articles about drugs and such, but this is a BLP. FA criteria clearly states: "its prose is engaging, even brilliant, and of a professional standard;" That doesn't mean dry and scientific. Your addition of the template with an edit summary that reads, "this article has serious issues" isn't very helpful. Why don't you point out the issues instead of templating a GA article? Your the medical professional or is there a reason you are refraining from editing and trying to improve this BLP? Atsme^📞📧 17:12, 5 July 2015 (UTC)

I have removed some copyright issues. And explained the problems on the talk page. Doc James (talk · contribs · email) 17:16, 5 July 2015 (UTC)

Interesting Reseach

This research [5] is actually quite promising for extrinsically motivated editors. I was under a bleaker impression of their quality and copyvio issues. --Lucas559 (talk) 18:08, 5 July 2015 (UTC)

Plagiarism is not the only issue. And problems are very dependent on the class / their instructor. Doc James (talk · contribs · email) 18:09, 5 July 2015 (UTC)

PBC

You made some recent edits reverting compromise changes I made to the use of "cholangitis" or "PBC" rather than "cirrhosis". I had previously reverted much more major changes and established a section on the Talk:Primary_biliary_cirrhosis page to discuss this renaming. The patient groups have won almost universal support for this change in name which have been referenced. As I understand it, there will soon be publications in the scientific literature supporting this and will cite these when it has occurred. Thanks for watching these pages and please feel free to contribute to the Talk page! Jrfw51 (talk) 14:15, 6 July 2015 (UTC)

Okay thanks for the heads up. Once the new name becomes established we can look at moving the article.Doc James (talk · contribs · email) 18:16, 6 July 2015 (UTC)

That seems very appropriate. Let's wait until there has been a change published in the wider literature and then consider further edits to the name. Thanks again.Jrfw51 (talk) 19:34, 6 July 2015 (UTC)

I have now created an entry for the UK charity PBC Foundation to help link to patient issues and the name change initiative. This overcomes the External Links issue. Please review it if you have time with all your other activities and let us know how it can be improved. Thanks. Jrfw51 (talk) 11:29, 12 July 2015 (UTC)

Wikipedia Review

Dear Doc James, I've again reviewed the vitamin D and cancer topic in Wikipedia and found that the section still remains somewhat scant. The first reference is to a popular press article about sales of vitamins in general. The remainder seems to trivialize the 35 years or so of active scientific research in this topic area. Rather than citing any original articles, it relies on a single tendentious review. Since students use Wikipedia to learn about the progression of scientific investigations as well as the latest findings on a topic, I wondered if we might consider rewriting this section together to reflect both the historical advancements in the understanding of vitamin D and cancer, as well as results of the latest laboratory, observational, and large cohort studies. I would like to suggest that we set-up an editorial board of subject matter experts who would then together revise this section. We would then submit a final draft to you as the Wikipedia editor. I have several colleagues listed below that I think would likely be very interested and willing to undertake this project. If you are amendable to this suggestion, please respond to my office email. We can then begin circulating revisions to this section. Many thanks. Very respectfully, Ed

Edward Gorham, MPH, PhD Adjunct Professor Department of Family Medicine and Public Health School of Medicine University of California, San Diego (619) 990-3848 Email: [email protected] Dr UVB (talk) 14:51, 6 July 2015 (UTC)

Proposed subject matter experts: University of California Riverside Anthony W. Norman, Ph.D. University of California San Diego Cedric F. Garland, Dr. P.H. Boston University School of Medicine Michael F. Holick, Ph.D., M.D. Creighton University Robert P. Heaney, M.D. Joan M. Lappe, Ph.D., R.N. Harvard School of Public Health Edward Giovannucci, M.D., ScD. Linus Pauling Institute Adrian F. Gombart, Ph.D. Medical University of Graz, Austria Stefan Pilz, M.D. Medical University of South Carolina Bruce W. Hollis, Ph.D. Carol L. Wagner, M.D. Roswell Park Cancer Institute Donald L. Trump, M.D. University of Auckland Robert Scragg, M.D., Ph.D. University of Saskatchewan Susan J. Whiting, Ph.D. University of Toronto, Mt Sinai Hospital Reinhold Vieth, Ph.D. Vienna Medical University Heidi S. Cross, Ph.D.

Are you referring to Vitamin_D#Cancer? It is supported by 5 review articles. We tend not to cite original articles but tend to use review articles such as meta analysis instead. Doc James (talk · contribs · email) 18:13, 6 July 2015 (UTC)

Agree these reviews are a reasonable standard, but there could be much more added reviewing associations between vitamin D and colorectal, prostate, breast and other cancers. Is there any support for a separate, more detailed entry on "Vitamin D and cancer"? Jrfw51 (talk) 19:43, 6 July 2015 (UTC)

The original message is in some ways wonderful. It would be great to get this kind of academic firepower behind articles. However, there is so much hype around nutrients and risk of getting cancer and the possibility of preventing cancer in the media and the literature, but in my view, in terms of actual medical knowledge there is almost nothing to say. The SELECT trial taught us all that the even the most solid-seeming hypotheses about nutrients and cancer turn out to be not only wrong, but 180 degrees wrong. I think the WEIGHT we give the topic of "Vitamin D and cancer" is perfect. Would be amazing if we could get this kind of effort around well-established topics like Hypertension and especially all our psych articles. Jytdog (talk) 20:08, 6 July 2015 (UTC)

Thank you, Jytdog and Jrfw51, Site specific cancer studies would, in my view, be an important addition to this section. Many dietary and serum studies have been carried out for both colon (1) and breast cancer (2), and for cancers of other sites. Nested case-control serum studies have certain advantages over dietary studies of vitamin D since it doesn't matter whether the vitamin D is dietary or sun-derived. 25(OH)D is relatively stable and an optimal biomarker for vitamin D status. Results from large cohort studies should not be discounted, such as the prospective EPIC study of serum 25 (OH)D and colon cancer in countries across Europe (1). These are important primary sources, and deserve their own citation. In vitro cell studies of antineoplastic effects of 25(OH)D and 1,25(OH)D in several tumor lines should at least be mentioned. These potent vitamin D metabolites act as hormones and influence tight junctions between cells, promote apoptosis, and down-regulate oncogenes. Vitamin D is not simply another nutrient when it comes to cancer. The review of supplement sales is overly broad, not particularly relevant to this section, and should be considered for deletion. The role of most nutrients in disease causation has been contentious since they were first identified (3). This should not discourage us from their study or fair reporting of results of these investigations. Very respectfully, Professor Gorham

1) Jenab M, Bueno-de-Mesquita HB, Ferrari P, van Duijnhoven FJ, Norat T, Pischon T, Jansen EH, et al. Association between pre-diagnostic circulating vitamin D concentration and risk of colorectal cancer in European populations: a nested case–control study. BMJ 340:b5500, 2011. PMID 20093284

2) Abbas S, Linseisen J, Slanger T, Kropp S, Mutschelknauss EJ, Flesch-Janys D, Chang-Claude J. Serum 25-hydroxyvitamin D and risk of post-menopausal breast cancer: results of a large case-control study. Carcinogenesis. 2008;29:93–9 PMID 17974532

3) Heaney RP. Nutrients, endpoints, and the problem of proof. J Nutr. 2008 Sep;138(9):1591-5. PMID 18716155

Dr UVB (talk) 18:27, 8 July 2015 (UTC)

I added PMIDs to the 1st 2 refs and fleshed out the 3rd. Thanks for replying. I agree that the science is important (there are so, so many things that we still need to understand better in terms of human biology in health and disease). But it seems to me that the argument you are trying to make is that the two big studies you cite - that show correlation only - are somehow important for health. We can show studies like that all day, and in vitro studies showing mechanisms too, but nobody has ever been ever able to show that an intervention with supplemention does a darn thing, outside of the very clear nutritional deficiencies like scurvy, rickets, etc., folate in pregnancy (although that is being questioned now, apparently) and a few others. On the flipide, as I mentioned above, with these claims flying around all over the place, that we can somehow prevent cancer or other diseases by trying to micromanage our diets/nutrients/"chemical" exposure, the organic food, dietary supplement, and fad diet industries make piles of money and people walk around full of anxiety. The recent review on Vitamin D, PMID 26071820, nails it from my perspective - there is almost nothing to say, healthwise. But I'll stop soapboxing and let others respond. Jytdog (talk) 18:51, 8 July 2015 (UTC)

Thank you again, Jytdog, for your thoughtful response. Controversy is an inevitable part of scientific progress. EV McCollum himself, who first isolated vitamin D, was widely derided for the idea that it might prevent rickets. The proof of vitamin D in rickets prevention was based on observational and animal studies. Dr. Taylor's commentary represents a certain point of view, but there are many others who would not be so quick to dismiss the importance of vitamin D in public health. I'm attaching a link to another commentary, just for interest. There is incidentally a randomized controlled trial by Lappe et al that meets this highest level of medical evidence which is unfortunately omitted in Dr. Taylor's commentary, but included below. The temporal sequence, consistency across study designs, strength of association, and the dose-response findings each help address the causality issues you question. These factors should be noted in Wikipedia. The important thing in my view is to establish a balanced panel of subject matter experts who could improve this section of Wikipedia, as I've suggested above. Very respectfully, Professor Gorham

Dr UVB (talk) 00:10, 9 July 2015 (UTC)

Dr UVB (talk) 00:10, 9 July 2015 (UTC)

What would show benefit would be a placebo controlled RCT of supplementation. As cancer is common showing benefit should not be that hard if a meaningful benefit exists.

The impact factor of the journal in which the article you link is published is 1.6 [6] This is low.

The impact factor of this journal is 9.1 [7]. Other forms of research are just typically hypothesis generating. Doc James (talk · contribs · email) 03:37, 9 July 2015 (UTC)

I think we are confusing Health effects of supplementation with another topic: Associations of vitamin D with human disease. We all recognize that the reviews of prospective supplementation studies show uncertain benefits. There is much more to this topic than whether supplements are effective or not. I do not find elsewhere on this page any clear review of the multiple and varying associations with different cancers or discussion of the controversies around causation, association and prevention. Jrfw51 (talk) 17:30, 9 July 2015 (UTC)

Yes there are associations between vit D levels and health but the question is is that relationship causal and the only thing that can show that is RCTs. Doc James (talk · contribs · email) 17:43, 9 July 2015 (UTC)

Thank you for this message, Doc James. You may have an interest in the results of a seminal nested case-control study published in Lancet (impact rating?) indicating more than a 75% reduction in colon cancer risk in the third and fourth highest quintiles of serum 25(OH)D. This prospective nested case-control study conducted by myself and colleagues at Johns Hopkins led to numerous others, most with remarkably consistent results. These studies culminated in the EPIC cohort study referenced above.

Incidentally, a randomized controlled trail does exist (abstract also provided below) which found exactly the level of evidence you are seeking. In fact, these investigators observed a 60% reduction in incidence of cancers of all sites in the vitamin D and calcium treatment arm of this trial.

These and many similar results are overlooked in the review by Taylor, et al. This is a drawback of relying solely on reviews. Elevation of this section of Wikipedia to an external panel of experts, such as those suggested above, could, in my opinion, improve this section of Wikipedia substantially. By almost any objective measure, it is currently lacking, both scientifically and factually. If you will not approve, may I request that we elevate to a higher echelon in the Wikipedia review process. Sincerely yours, Prof. Gorham

Lancet. 1989 Nov 18;2(8673):1176-8. Serum 25-hydroxyvitamin D and colon cancer: eight-year prospective study. Garland CF, Comstock GW, Garland FC, Helsing KJ, Shaw EK, Gorham ED.

Abstract Blood samples taken in 1974 in Washington County, Maryland, from 25 620 volunteers were used to investigate the relation of serum 25-hydroxyvitamin D (25-OHD) with subsequent risk of getting colon cancer. 34 cases of colon cancer diagnosed between August, 1975, and January, 1983, were matched to 67 controls by age, race, sex, and month blood was taken. Risk of colon cancer was reduced by 75% in the third quintile (27-32 ng/ml) and by 80% in the fourth quintile (33-41 ng/ml) of serum 25-OHD. Risk of getting colon cancer decreased three-fold in people with a serum 25-OHD concentration of 20 ng/ml or more. The results are consistent with a protective effect of serum 25-OHD on colon cancer.

Am J Clin Nutr. 2007 Jun;85(6):1586-91. Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. Lappe JM, Travers-Gustafson D, Davies KM, Recker RR, Heaney RP.

Abstract Numerous observational studies have found supplemental calcium and vitamin D to be associated with reduced risk of common cancers. However, interventional studies to test this effect are lacking. The purpose of this analysis was to determine the efficacy of calcium alone and calcium plus vitamin D in reducing incident cancer risk of all types. This was a 4-y, population-based, double-blind, randomized placebo-controlled trial. The primary outcome was fracture incidence, and the principal secondary outcome was cancer incidence. The subjects were 1179 community-dwelling women randomly selected from the population of healthy postmenopausal women aged >55 y in a 9-county rural area of Nebraska centered at latitude 41.4 degrees N. Subjects were randomly assigned to receive 1400-1500 mg supplemental calcium/d alone (Ca-only), supplemental calcium plus 1100 IU vitamin D3/d (Ca + D), or placebo. When analyzed by intention to treat, cancer incidence was lower in the Ca + D women than in the placebo control subjects (P < 0.03). With the use of logistic regression, the unadjusted relative risks (RR) of incident cancer in the Ca + D and Ca-only groups were 0.402 (P = 0.01) and 0.532 (P = 0.06), respectively. When analysis was confined to cancers diagnosed after the first 12 mo, RR for the Ca + D group fell to 0.232 (CI: 0.09, 0.60; P < 0.005) but did not change significantly for the Ca-only group. In multiple logistic regression models, both treatment and serum 25-hydroxyvitamin D concentrations were significant, independent predictors of cancer risk. Improving calcium and vitamin D nutritional status substantially reduces all-cancer risk in postmenopausal women. This trial was registered at clinicaltrials.gov as NCT00352170. Dr UVB (talk) 20:58, 9 July 2015 (UTC)

I have given the Cochrane review greater weight in the section in question. It found a small benefit. Doc James (talk · contribs · email) 21:25, 9 July 2015 (UTC)

Cochrane excludes all observational epidemiologic studies including prospective cohort studies, nested case-control studies, and of course, case-control studies, and ecological studies. I don't want to turn this into a discussion of Cochrane, but public health advances linking cigarettes to lung cancer, lack of sunlight and vitamin D to rickets, passive smoking to heart disease, and numerous other medical advances would never have occurred if held to Cochrane criteria. John Snow, to his undying credit, did not randomly allocate people to drink or not drink cholera-tainted water from London's Broad Street pump. We have an opportunity to improve this section of Wikipedia substantially by admitting much published, peer-reviewed evidence approved medical journal editors and excluded by Cochrane. Koch's postulates of causality don't depend on Cochrane. If Cochrane is the current Wiki standard, the result will be to arbitrarily exclude all the lines of epidemiologic evidence described above. I would respectfully request an appeal of that decision, and a repeal of that standard. To whom should I address this request? V/r, Prof. Gorham

Dr UVB (talk) 22:20, 9 July 2015 (UTC)

Toxicity is very different from treatment. One can study treatment in a blinded fashion. One cannot do the same with toxicity. RCTs are thus not appropriate for toxicity but are for treatment due to the issues of multiple confounders. We do not have the same precautionary principles when doing something like taking a pill that we have when not doing something like smoking or improving air quality.

Additionally we do not just use Cochrane but they are a major position in medicine. We also use the IOM and other systematic reviews. By the way what content are you interested in adding? And are you willing to base the content on recent high quality secondary sources? Doc James (talk · contribs · email) 22:28, 9 July 2015 (UTC)

By the way here are the IOP's conclusions "For extraskeletal outcomes, including cancer, cardiovascular disease, diabetes, and autoimmune disorders, the evidence was inconsistent, inconclusive as to causality, and insufficient to inform nutritional requirements." [8] Doc James (talk · contribs · email) 22:37, 9 July 2015 (UTC)

By the way this conversation should be taking place here Talk:Vitamin_D#Vitamin_D_and_Cancer and has already had a number of other editors comment. Doc James (talk · contribs · email)

Excellent! So observational epidemiologic studies including prospective cohort studies, nested case-control studies, and of course, case-control studies, and ecological studies are admissible. Our panel will review and submit these for inclusion. Thank you, Dr. James. We'll get started on this right away. I'm not sure I completely follow your statements regarding toxicity. It is rarely an issue in vitamin D until serum levels of 25(OH)D exceed at least 100 ng/ml. This would be the approximate equivalent of a daily oral intake of 10,000 IU per day for several weeks. 50,000 IU per week is the prescribed replenishment dose for treating deficiency, or approximately 7,000 IU per day. I hope this is helpful. V/r, Prof. Gorham

Dr UVB (talk) 22:52, 9 July 2015 (UTC)

• To make it clear reviews of RCTs are required to determine if treatment with vitamin D is useful
• RCTs are not required to determine if smoking is harmful.
• I did not say "So observational epidemiologic studies including prospective cohort studies, nested case-control studies, and of course, case-control studies, and ecological studies are admissible" nor has the others who have commented on the talk page. Doc James (talk · contribs · email) 22:56, 9 July 2015 (UTC)

Okay, so I am not talking about vitamin D for treatment, although there is evidence that vitamin D is an effective adjuvant in cancer treatment. Vitamin D is a nutrient with important hormonal metabolites that have critical endocrine and autocrine functions. There is much epidemiological evidence suggesting that vitamin D (as a nutrient, not a treatment) is important in chronic disease prevention. Are you restricting this page to prevention trials? If so, this page in Wikipedia will not represent the current level of understanding of the role of vitamin D in cancer prevention. It will remain lacking both scientifically and factually. Is that your decision? If so, how may I appeal it? V/r, Prof Gorham

Dr UVB (talk) 23:17, 9 July 2015 (UTC)

Please move this to the talk:Vitamin_D page where it surely belongs.

This debate still has not addressed whether the scientific background and epidemiological associations of vitamin D and cancer need separate section. The current section is on supplementation (which I have clarified.) Jrfw51 (talk) 08:04, 10 July 2015 (UTC)

an aggressive chroinc infection of the sweat glands

YDear doctor james I would like to thank you for this amazing description of the disease(Hidradenitis suppurativa)my name yasmina ahmed and i My father suffers from the disease for about 15 years but now the case has spread widely and the lesions became aggressive under arm and in the region of the thigh. Now he can't tolerate the pain and this makes him suffering from depression. He has undergone several treatment modalities such as intra lesional steroids injection but this treatment has masked the manifestation of the disease for a while and then the case got worsen to end by abscess and has suppressed the immune system .. My dad is also suffering from diabetes mellitus , hypertension and also he has undergone the surgery of cardiac catherization from 3 months ago and now he is taking anticoagulant therapyaand the doctors refused to do any surgery unless after 6 months to allow him to stop the anticoagulant therapy.. Also my dad has taken some medications such as several types of antibiotics and Netlook but now it is kinda don't give benefits.. I need for your help to rtell me the suitable treatment for my dad and can you also tell me the most suitable country in the treatment of this disease.. — Preceding unsigned comment added by Doc yasmina madkour (talk • contribs) 21:35, 7 July 2015 (UTC)

I have only made a few edits to that article and am not its main author. Would be best to get further advice from a specialist. Doc James (talk · contribs · email) 03:26, 9 July 2015 (UTC)

Fistula in ano. Missing " perfact technique"

Hi doc James Last week I just read about fistula in ano and I found the latest technique " perfact" by dr. Pankarg garg from India , however I read wiki again and now this technique did not show up on page , why ? — Preceding unsigned comment added by 27.55.34.24 (talk) 04:20, 8 July 2015 (UTC)

Replied. Doc James (talk · contribs · email) 03:20, 9 July 2015 (UTC)

Removal of ADA

Why? Anmccaff (talk) 16:08, 9 July 2015 (UTC)

Per WP:ELNO we are not a list of other resources. We are an encyclopedia right here. Nothing unique on that page. Doc James (talk · contribs · email) 16:54, 9 July 2015 (UTC)

This WP:ELNO policy seems perverse. There are links to their official websites on three high profile pages I just went to: White House, Medicare and American Medical Association. You will have much more work to do if you wish to delete everything external to WP on the basis there is "nothing unique" there. They will have more detail than we will provide and give a different emphasis! Jrfw51 (talk) 17:07, 9 July 2015 (UTC)

Just because every page is not perfect does not mean we do not improve things. Doc James (talk · contribs · email) 17:33, 9 July 2015 (UTC)

Gabor B. Racz

Doc, are you acting in your capacity as an admin at the Racz article? Atsme^📞📧 17:59, 9 July 2015 (UTC)

No I am warning you for edit warring. That page has serious issues. Doc James (talk · contribs · email) 18:01, 9 July 2015 (UTC)

With all due respect, I think the most serious issue is potential bias of one doctor editing the BLP of another doctor. What you're calling spammy does not fit the description per WP:SPAM, what you're calling "peacock" does not fit the description of WP:PEACOCK. You are picking on facts that are sourced. To summarize a doctor's notability as "known internationally" is not a peacock term, it is a fact. I don't get what your problem is with regards to stating facts about the man. Atsme^📞📧 18:33, 9 July 2015 (UTC)

Sorry this article has serious issues.

1) puffery language

2) was full of copyright infringement

3) has content not supported by the references.

It is far from being a GA. Doc James (talk · contribs · email) 19:19, 9 July 2015 (UTC)

It's easy to list general statements that point to nothing. An accomplished reviewer and writer of numerous GAs and FAs disagreed with you twice and you refuse to drop the stick.

• The language is not puffery - it is factual and it is sourced.
• It was never copyright infringement - that claim is unwarranted. You are not acting in GF and this is a terrible reflection on you considering your status on WP.
• It does not have content that is unsupported by references. I have asked for the specifics and all I get are generalizations and POV from you.

I am really disappointed to see such behavior. What you're doing is trying to create instability and cause the article to be delisted. That is downright shameful. This is retaliatory, nothing more. A lot of editors are aware of it, too. Atsme^📞📧 19:38, 9 July 2015 (UTC)

Sure I am also a accomplished reviewer and writer of numerous GAs and FAs. Retaliatory for what I do not know. Good to have lots of people aware of this article though. The evidence wrt copyright issues are clearly explained on the talk page. Doc James (talk · contribs · email) 19:44, 9 July 2015 (UTC)

Yes, you are and you are a brilliant physician and deserve respect in every sense. Read the edit summaries if you don't know why I believe it's retaliatory. Also, you're well versed in writing GAs and FAs so you already know that general comments like you keep making are not helpful [9]. I've jumped through all the hoops and if you've been watching that article you know that it doesn't matter how many hoops I jump through, there's another waiting. That is retaliatory and not GF. The only reason a group of editors would propose delisting is if there was conflict and the stewards of the GA were not being cooperative. I'm not talking about bending over to fix unwarranted criticisms, or POVs - I went through and fixed the issues you pointed out. Even after I fixed them, they continued to be criticized and reverted. That will be easy to establish with diffs. I just demonstrated one example of DGG butchering the article by reverting the correction I made after you pointed it out to me, and then removing descriptive material. The evidence that there are no copyvios are also explained. The Duplication Detecter is a good tool to have and it says no copyvios exist. Atsme^📞📧 01:51, 11 July 2015 (UTC)

It is getting better but still issues. I have fixed some more.

There was a large number of copyright issues Doc James (talk · contribs · email) 01:57, 11 July 2015 (UTC)

The duplication detector tool isn't working? Or are you talking about the credentials list? Doc, I don't want to get all mushy and everything, but you actually brought me to tears because I would have considered it an honor to collaborate on an article with you. It appeared to me that you believed all the nonsense about me being a pusher of quackery and all that other BS that laid on me when it wasn't true at all. And neither were the allegations or what happened to me at COIN. I'm here just trying to go some good, help other editors with copy editing, especially those editors who have trouble with English because it's not their 1st language. And the things you called puffery and what I call puffery are simply differences of opinion. When I used "pioneered" it was (1) because the source said so, and (2) it was innovative. He invented it. Perhaps in medicine it's called "developed". It's not that I'm a bad editor and that I'm trying to promote anything - it's simply a choice of terminology. Atsme^📞📧 02:05, 11 July 2015 (UTC)

One needs to substancially paraphrase sources. Basically one must put content in their own words. The concerns raised here Talk:Gabor_B._Racz#Copy_and_paste and Talk:Gabor_B._Racz#COPYVIO have been fixed.

In English their or boring words like "developed" and "designed" and promotional words like "pioneered" and "innovated". We should always be using the boring ones even if the sources use promotional language. It is mostly fixed aswell. Doc James (talk · contribs · email) 02:12, 11 July 2015 (UTC)

quackguru/question

hi,,,i was going to answer a question posted by an editor just yesterday on the main talk page but its not there any more?--Ozzie10aaaa (talk) 18:44, 10 July 2015 (UTC)

Main talkpage of were User:Ozzie10aaaa? Doc James (talk · contribs · email) 18:50, 10 July 2015 (UTC)

wikiproject medicine main talk, I noticed few "one click archive"--Ozzie10aaaa (talk) 18:52, 10 July 2015 (UTC)

Okay so put back the question and answer it :-) Doc James (talk · contribs · email) 18:55, 10 July 2015 (UTC)

ok--Ozzie10aaaa (talk) 18:57, 10 July 2015 (UTC)

User:Ozzie10aaaa, the image I requested was uploaded and I added it to the article. QuackGuru (talk) 18:57, 10 July 2015 (UTC)

perfect, thanks--Ozzie10aaaa (talk) 18:59, 10 July 2015 (UTC)

Introducing the new WikiProject Cannabis!

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Hope to see you join! Harej (talk) 20:57, 10 July 2015 (UTC)

Thanks. Doc James (talk · contribs · email) 21:05, 10 July 2015 (UTC)

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"Floater", as described in the media

Hi Doc James. I feel very tempted to remove this, as it hardly ads any value, it is anecdotal and not collected from scientific environment. What is your feeling? Thanks, Rui ''Gabriel'' Correia (talk) 15:18, 11 July 2015 (UTC)

I agree User:Rui Gabriel Correia Doc James (talk · contribs · email) 16:13, 11 July 2015 (UTC)

Thanks, DJ. Rui ''Gabriel'' Correia (talk) 16:31, 11 July 2015 (UTC)

Abuse of COIN

You are involved in a recently filed request for arbitration. Please review the request at Wikipedia:Arbitration/Requests/Case# and, if you wish to do so, enter your statement and any other material you wish to submit to the Arbitration Committee. As threaded discussion is not permitted on most arbitration pages, please ensure that you make all comments in your own section only. Additionally, the guide to arbitration and the Arbitration Committee's procedures may be of use.

Thanks, Atsme^📞📧 02:06, 12 July 2015 (UTC)

Thanks for the heads up User:Atsme Doc James (talk · contribs · email) 07:08, 12 July 2015 (UTC)

Copyvio

Doc, even though I disagreed with you about the copyvio issue, (I just requested confirmation from the author), I went ahead and changed the entire paragraph where there is not even a question of a copyvio. [10] I guess you overlooked it? Atsme^📞📧 09:19, 12 July 2015 (UTC)

The issue is that there was copyright violations. And you appear to disagree that their were. That causes me concern Doc James (talk · contribs · email) 16:50, 12 July 2015 (UTC)

I disagreed because the material is public domain. I am growing weary of the accusations which are based on your misunderstanding of public domain, fair use, and copyright laws. FYI, I just received pre-confirmation of the public domain status of the material that raised your concerns and will have the formal notice hopefully by tomorrow. Permissions will receive the original notice and I asked to be copied on it. It's time to drop the stick. We have certain procedures we're expected to follow, and quite frankly you haven't been following them, so please stop trying to make me look like the bad guy. Atsme^📞📧 21:12, 12 July 2015 (UTC)

Ah. This is the first time you have mentioned this new arguement that the sources you are using were public domain. It is interesting that you have not mentioned said arguement here before

No were on the site does it state the content in question is public domain or CC BY or CC BY SA.[11] In fact it says Copyright © 2005-2015 World Institute of Pain

Now of course you can try to now get it release under an open license or into the public domain. But that does not deal with the prior state of things.

With respect to your second arguement regarding "fair use" we only allow fair use on Wikipedia in very rare situations which you can read about here Wikipedia:Non-free content. The fair use arguement is different than the public domain arguement and trying to make both at the same time is disconcerting. Doc James (talk · contribs · email) 21:32, 12 July 2015 (UTC)

I did mention it before on the TP - you must not have read it. [12] Perhaps now would be a good time instead of trying to formulate a conspiracy theory. I also changed it entirely to accommodate your concerns but the cries of copyvio kept coming. [13]. We both know you didn't come to edit Racz by chance, Doc. You arrived at Racz with preconceived notions based on the sloppy COIN case that turned into a colonoscopy for me. It has painted us into a corner and now we're waiting for the paint to dry so we can move on. Doc, I understand copvio firsthand based on my experiences in and out of courtroom, most cases settled out of court, and I was never the defendant. I have been extremely careful about my writing and releasing anything that could be construed as a copyvio. I'm not a copyright attorney but I have paid enough of them to raise me to a level or two above ignorance of the law. I also maintained an E&O policy for 30+ years and not once was I ever a defendant in a copyvio case. I don't intend to get stupid now. I'll say it again and maybe this time you'll believe me, but the only reason I created the Racz article was because a friend of mine was his patient. She raved on about him, and I saw her transformation with each treatment. She flew to Lubbock to the pain clinic to get these treatments. Of course I didn't believe her at first - I thought it was the placebo effect - and then I did the research all the while watching her progress. I was inspired - that's what writers do, Doc. They get inspired and they write. Look at the variation of the things I write about. I do thorough research - that's just me. In 2014, I didn't have a clue about MEDRS, but I'm learning. I am weary of the accusations - they are unwarranted. And I don't have a problem with WP:HEAR. Atsme^📞📧 23:21, 12 July 2015 (UTC)

The tool you mention is not perfect. There were copy and paste issues based on the fact of similarities with sources that were not marked as PD. You have corrected those issues and the concern is that you are denying that their was ever any issues.

You should simply state, 1) yes I copied and pasted from the source 2) I understand that this is not allowed per WPs policies (we do not typically allow text under fair use) 3) Than state that you will not do it again. Instead we have this. But as you will. Doc James (talk · contribs · email) 23:28, 12 July 2015 (UTC)

Please...even if it wasn't public domain, and it is, facts are not copyrightable and there's also fair use. Please, please try to understand what I'm saying. In some instances, a special arrangement of facts may be - for example, a specially designed chart, or a graph, etc. - but this was a list of his credentials and recognitions that were used for his biography. Works Not Covered By Copyright There is also "fair use" which states (my bold): "purposes such as criticism, comment, news reporting, teaching (including multiple copies for classroom use), scholarship, or research, is not an infringement of copyright." [14]. I would venture to guess an encyclopedia would fall under "teaching" and "scholarship". There was one sentence - a statement of fact - that I used verbatim citing the WIP site, but that statement of fact was also in his CV which lists other statements of fact about his credentials and recognitions that I used as well. I can extract facts from that CV - that's what a CV is for - it's a list of facts. His CV is 66 pages - I used a couple of paragraphs. It is public domain. [15] If you really need me to admit to something, I will admit that I may have gotten a little lazy trying to reword all of the facts, some of which were impossible to reword. I managed to get most of it done, but I couldn't get all of it. That doesn't make it a copyvio and I would appreciate it very much if you would stop accusing me of copyvio. I have jumped through enough hoops to satisfy your concerns and should not have to keep jumping. Now then - you can teach me how to perform an appendectomy. Atsme^📞📧 02:40, 13 July 2015 (UTC)

It does not look to me like you used a couple of paragraphs from the CV. For example, on page 25, the CV says Awarded the MORICCA AWARD presented by the Italian Pain Society, July 2006 whereas the WIP text said In July 2006 he received the MORICCA AWARD, the highest award presented by the Italian Pain Society. Similarly, there's nothing in the CV about 1,800 physicians from 72 countries attending the 2007 WIP world congress, which also appeared on the WIP page. In both cases, the additional details would have had to have been researched and referenced if you'd pulled the basic facts from the CV. As well, there's nothing in the CV about him being an advocate for high standards of certification and training among pain physicians and works toward the advancement of those goals but that information does appear on the WIP page. Finally, the CV isn't structured in paragraphs like the WIP page is. Since the article text was almost identical to the WIP text in wording, layout, and order, but differed from the CV text in details and layout, to me it appears much more likely that you used a couple of paragraphs from the WIP page instead of the CV. Ca2james (talk) 06:03, 13 July 2015 (UTC)

The CV is shared on the Yumpu/i-mag site (and should probably not be used as a source in any case). Note that material here is not public domain but appears to be subject to this company's Terms of Service, specifically:

5.1 All information on this website is provided by i-mag without guarantee of accuracy, completeness, or topicality.
 5.2 Unless explicitly prohibited in regards to an excerpt, a file, or document, the User may view, copy, print, or share documents in accordance to following provisions:
  5.2.1 Use for commercial purposes is prohibited.
  5.2.2 Any copy of a document or parts of a document shall embody these copyright provisions.
  5.2.3 Amendments to documents as well as copies or parts thereof, are subject to i-mag’s prior written approval.

This (effective) content license is fundamentally incompatible with Wikipedia's which does not (e.g.) prohibit commercial use. Alexbrn (talk) 06:22, 13 July 2015 (UTC)

WP:DROPTHESTICK, you're WP:WIKILAWYERING and you are not making any sense, WP:CIR. As I explained to Doc James, I contacted the author. Doc James also advised me to have them add the notice on their website which I did. It was embarrassing for me to do because common sense and copyright laws tell us it is not a copyvio so it took them totally by surprise because they thought I was accusing them of a copyright infringement. I advised them of what Doc James advised me to do. It is public domain and all you're doing now is beating a decaying carcass and raising a stink. You cannot copyright facts. There is fair use. If you wish to pursue this further despite the information I've provided, contact the attorneys for Wikipedia and have them confirm. Doc James is a functionary - it shouldn't be an issue for him to contact them. Atsme^📞📧 12:43, 13 July 2015 (UTC)

The point is the content on the Yumpu/i-mag site is not public domain. A cavalier attitude about content permissions is a worry, as it jeopardizes the position of Wikipedia & the WMF. However it's clear at this point you're not listening but still on the attack, so I'll write no more here. Alexbrn (talk) 13:29, 13 July 2015 (UTC)

Atsme, which page did the CV author tell you was public domain? Was it the CV itself on Yumpu or was it the bio published on WIP (that has been removed and no public domain notice has been added)? Also, while facts aren't copyrighted, the language used to present them is copyrighted; even if use of the WIP text was allowable under fair use (which it wasn't - please see WP:NFCCP and WP:COPYOTHERS), it would have had to be properly quoted and attributed. Ca2james (talk) 14:32, 13 July 2015 (UTC)

Please refer to my response immediately above your question. Atsme^📞📧 15:10, 13 July 2015 (UTC)

Yes, I read that, but it isn't clear to me which site the "it" in It is public domain is referring to: the CV, or the WIP site. Thanks. Ca2james (talk) 16:43, 13 July 2015 (UTC)

User:Atsme your arguments do not make sense. You have had a number of very experience Wikipedians explain to you that what you did is not okay and that your explanation does not make sense. Attacking those giving you advice is not useful.

Please note that if you do what you did again and you will likely get blocked. Further conversation does not appear useful at this point in time. Doc James (talk · contribs · email) 18:09, 13 July 2015 (UTC)

If I do what I did....and that means? Just to confirm so there is no further question, your warning implies that what I did was a copyvio, correct? I just want to be clear about the warning. Atsme^📞📧 18:21, 13 July 2015 (UTC)

My warning is that what you did is not allowed by Wikipedia policy. And if you do it again you will likely get blocked. Doc James (talk · contribs · email) 18:23, 13 July 2015 (UTC)

Please tell me what I did. Atsme^📞📧 18:30, 13 July 2015 (UTC)

Well, Doc - I hope the following will ease your mind regarding what you thought was a copyvio:

From: "Brashear, Paula"

Subject: FW: I need a statement from you, please?
Date: July 13, 2015 at 2:53:59 PM AST
To: "[email protected]" <[email protected]>

Dear Atsme:

I am Paula Brashear, (Secretary to Gabor Racz) and editor of Curriculum Vitae of Gabor B. Racz, MD, ChB, DABPM, FIPP

Be advised the article is free of copyright and in the public domain.

(Proper signatories)

And also

From: Gabor Racz

Subject: Re: I need a statement from you, please?
Date: July 12, 2015 at 3:34:01 PM AST
To: Atsme Thatsme

Thank you for the clarification and I am asking Paula to send you such a statement. In addition I am also stating that I am the responsible author and my name and title: Gabor B Racz MD, FIPP, DABPP. Grover Murray Professor Professor and Chairman Emeritus Department of Anesthesiology. Co-Director Pain Center, TTUHSC be advised the article is free of copyright and in the public domain. Sincerely Gabor B Racz MD FIPP, DABPP, Grover Murray Professor, Professor and Chairman Emeritus TTUHSC, Co-Director PainCenter.

Past President WIP

Correct me if I'm wrong, but to issue warnings of blocks without specifying what I did wrong is inappropriate, and carries the strong scent of retaliation. I'm not a bad editor and I actually am competent not to mention thorough. I'm not perfect but I strive to be. Let's say for example 3 editors here on WP told you that the surgery article you created, co-authored and had promoted to GA was incorrect, full of inaccuracies, that it was garbage, should be deleted, and was a violation of your Hippocratic Oath when all that actually needed improvement were a few upgrades to RS, a correction in wording of a treatment, and the rest being POV regarding style of writing - how would you respond? (just trying to provide a scenario to which you can best relate because a copyvio to me is like a Hippocratic Oath to you, of course on a much lesser scale). You know what you know - you're not just experienced at it, you're skilled at it - so please, let's try to exercise a little professional courtesy here. I addressed all of your concerns at Racz. I went the extra mile but you're still making groundless accusations and now a warning that just isn't fair. Atsme^📞📧 19:37, 13 July 2015 (UTC)

Salman

Thank you! The pleasure is all mine. I too hope to be an active member of the Wikipedia community. Thanks again — Preceding unsigned comment added by Salman.ali87 (talk • contribs) 10:41, 12 July 2015 (UTC)

Perfect. Doc James (talk · contribs · email) 16:50, 12 July 2015 (UTC)

Thanks

... for the GAN on Guillain-Barré syndrome. TylerDurden8823 and now myself have gone through the recommendations and I hope it is now ready for GA status. JFW | T@lk 10:46, 12 July 2015 (UTC)

Yes looks good. Doc James (talk · contribs · email) 21:22, 12 July 2015 (UTC)

Edits

Thanks for the feedback. Making the first few edits can be a little daunting. I will make sure that I go through the relevant guidelines before making any further edits. Thank you again for all the help. Salman.ali87 (talk) 12:13, 13 July 2015 (UTC)

User:Salman.ali87 It can take a little time to figure out editing Wikipedia. This was true for all of us. Pubmed allows one to search for reviews from the last 5 years using the tabs on the left. If you start with recent review articles from well recognized journals like PLOS, Cochrane, NEJM, BMJ all will go well :-) Doc James (talk · contribs · email) 18:11, 13 July 2015 (UTC)

coi?

i don't mean to bother you with this (usually it goes to JYTDog, however there is some ARBcom/ self imposed topic ban on COI)...in any event Wikipedia talk:WikiProject Medicine#Steatohepatitis is indicating COI...? thanks--Ozzie10aaaa (talk) 19:14, 13 July 2015 (UTC)

Trimmed some low quality refs. Doc James (talk · contribs · email) 19:47, 13 July 2015 (UTC)

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Sleep problems

Hey Doctor, I am Satwinder Singh From India . I read your report on Night terror on wiki. I think it is similar to my condition . since my childhood days i see these odd dreams . when i tried to tell my parents they took it as some sort of wodo magic . wasted like 3000$ till now. Sir i think i m in stage 2 . sir please i need ur help please . i can't sleep . my parents cant help . i tried suicide many times but it didn't help i am stuck between life n death ....life which i m not able to live n death which i cant have. Satwinder3178 (talk) 13:22, 17 July 2015 (UTC)

I'm contacting the WMF. --NeilN ^{talk to me} 13:31, 17 July 2015 (UTC)

concur--Ozzie10aaaa (talk) 13:40, 18 July 2015 (UTC)

There are doctors that specialise in sleep medicine. I have worked very little on this article but plan to work on it more. Thanks User:NeilN for taking care of this. Am super busy. Doc James (talk · contribs · email) 04:40, 19 July 2015 (UTC)

CBT Page

Doc, I understand the majority of your edits on my section today, but I don't understand why you took out the quote and the absolutely vital information about the Beck treatment manual. I worked really hard on that article and getting the section added last night. I worked hard to narrow it down to just the most pertinent information. I really feel that quote is necessary so as that readers know that the interpretations of the study are the authors' and not those of the wikipedia user putting the information up. I understand you're a moderator, and that I have to show good faith. But, I can't understand what the point of contributing is when you are going to habitually follow up after me and "tidy up" everything single thing I do. I work very hard to make my posts count. I am not a casual "adder" to wikipedia. If you have a problem with what I am posting, then please let me know and I will stop contributing because I don't want to be putting in the kind of time that I do just to have it consistently edited and/or undone by you. Please, restore the quote and the comment about the manual. I completely agreed with your other edits, though. Urstadt (talk) 18:48, 21 July 2015 (UTC)

We use very few quotes per WP:Non free text User:Urstadt. We should just provide a summary of the ref and provide the ref to indicate that that is were the position comes from.

By the way what does " An additional finding of this study was that the declining treatment effects were more pronounced when the Beck treatment manual for CBT was used." refer to? Can you clarify? Do you mean that the decline was greater among those treated using the procedures outlines in the Beck treatment manual? Doc James (talk · contribs · email) 18:55, 21 July 2015 (UTC)

My sincere apologies. I was fully aware of the few quotes as possible policy but had forgotten about it in my work last night. So, I completely own that and further agree with your decision to remove it. I will do better to remember that policy in future contributions.

Regarding the Beck manual, the authors are saying that the downward trend in CBT efficacy between 1977 and 2014 was steeper when they just analyzed studies where the researchers had therapists in the test group use said manual. Meaning, studies where therapists in the test group were not instructed to use the manual are showing a decline in positive outcomes, but studies of therapists adhering to the manual are showing a steeper decline in positive outcomes the past 37 years. So in answer to your last question of the post, yes. Urstadt (talk) 19:14, 21 July 2015 (UTC)

I am happy with this improved wording. Feel free to re add that bit. The reason I removed it was I was not sure what it meant. Doc James (talk · contribs · email) 19:17, 21 July 2015 (UTC)

Cirrhosis

You have removed "potentially life threatening" from the varices part of the lede. Why? Is it not true? 92.128.1.84 (talk) 21:11, 21 July 2015 (UTC)

Sure it is true. But that detail IMO belongs on the varices page. Hepatic encephalopathy is also potentially life threatening as is spontaneous bacterial peritonitis. These complications are not good. Doc James (talk · contribs · email) 21:54, 21 July 2015 (UTC)

Does it not seem strange that nowhere in the lede of the article it is explained that cirrhosis as a condition is potentially life threatening due to complications stemming for its effects on the body? That seems like such a fundamental aspect about cirrhosis, no? 92.128.1.84 (talk) 22:19, 21 July 2015 (UTC)

It states "Cirrhosis resulted in 1.2 million deaths in 2013" which sounds very bad. So yes it states cirrhosis is not only life threatening but results in a large loss of life. Doc James (talk · contribs · email) 22:46, 21 July 2015 (UTC)

Yes, down towards the bottom. It wouldn't be out of place to put a bit of emphasis on such a fundamental part of what cirrhosis and its complications are about (being life-threatening) more towards the initial part of the lede. Having the statistics to back it up lower in the lede will explain in more concrete terms what that looks like. 92.128.1.84 (talk) 23:36, 21 July 2015 (UTC)

It is a fine balance. Some argue for not containing prognosis for diseases with a poor prognosis in the lead as not to too negatively effect those who are reading the article initially. The compromise has been to put it in the lower part of the lead. Doc James (talk · contribs · email) 00:18, 22 July 2015 (UTC)

The issue with that though is that folks will almost certainly be more inclined to have less regard for the seriousness of a given malady. I read in your response the thought to provide a sort of psychological buffer for those affected by such diseases when they come to read the articles on them but it is likely more to the benefit of those readers that the stark reality of those conditions be made plain so that if they so desire they can try to take steps (i.e. self advocation) to get themselves more comprehensive treatments. Having worked with people affected by cirrhosis in particular I know from personal experience that it has been the case that there was a distinct lack of respect for what having cirrhosis would mean for those individuals short of having liver transplants. 92.128.1.84 (talk) 00:36, 22 July 2015 (UTC)

This was guidance recommended by Cancer Research UK. Also our article leads typically follow our article bodies. Thus epidemiology and prognosis go lower in the lead / body. Doc James (talk · contribs · email) 00:43, 22 July 2015 (UTC)

List of human diseases associated with infectious pathogens

If you want this article deleted, why have you been working on it to improve it? I'm trying to decide whether or not I need to keep trying to edit it so that it meets MEDRs and addresses the concerns of those involved in the discussion, but if there is consensus for its deletion why try? Best Regards,

  Bfpage |leave a message  22:51, 21 July 2015 (UTC)

I initially voted to userfy it. But now think there are too many issues. It mixes up to many titles of associations from direct causal to indirect to unclear. You can of course put it in your user space and create something new from it though. Doc James (talk · contribs · email) 22:56, 21 July 2015 (UTC)

Is it appropriate for you to suggest that on the AfD page? I've put substantial effort in deleting unreliable, non-MEDR references, inserting appropriate references, and deleting primary sources. I think it could be a good article some day. I've put in over 80 edits but don't want to waste my time just to see the article get deleted.

  Bfpage |leave a message  02:45, 22 July 2015 (UTC)

Heya!

Can I look at the source of the deleted page "Pīchī no Shiro de Rokkuman to Patī"? Just asking. 67.82.89.253 (talk) 01:12, 22 July 2015 (UTC)

I am not seeing a deleted page at that red link. Doc James (talk · contribs · email) 01:17, 22 July 2015 (UTC)

My bad. Pīchi no Shiro de no Rokkuman to Pātī. 67.82.89.253 (talk) 02:33, 22 July 2015 (UTC)

I got an account so deleted source can be e-mailed to me. Can you e-mail the source to me? Now I've gotta play them all. (talk) 03:34, 22 July 2015 (UTC)

Okay and why do you need it? Doc James (talk · contribs · email) 03:59, 22 July 2015 (UTC)

Someone else e-mailed it to me! Now I've gotta play them all. (talk) 14:00, 22 July 2015 (UTC)

Argus retinal prosthesis

In the UK we regard the BBC and the Daily Telegraph as high-quality reliable sources.Rathfelder (talk) 08:55, 22 July 2015 (UTC)

see discussion here: Talk:Argus_retinal_prosthesis#comment Jytdog (talk) 12:02, 22 July 2015 (UTC)

Yes not for medical content they are not. Doc James (talk · contribs · email) 20:32, 22 July 2015 (UTC)

Health videos - Konkani Wikipedia

Hello Doc James, I noticed the note regarding videos you posted at Vaishali Parab's talkpage on the Konkani Wikipedia. The video you posted is not in Konkani; I think it's probably the Kukna language. Regards, The Discoverer (talk) 15:44, 22 July 2015 (UTC)

Here they call the language Kokana [16]. Do we have a Wikipedia in that language User:The Discoverer? Doc James (talk · contribs · email) 20:34, 22 July 2015 (UTC)

No, kexwiki doesn't exist. But the language is similar to the Marathi language, so perhaps you could check at the Marathi Wikipedia if it's useful for them. The Discoverer (talk) 04:51, 23 July 2015 (UTC)

Thanks. Also have the release of videos in Marathi. Doc James (talk · contribs · email) 05:00, 23 July 2015 (UTC)

one-click??

[17] this which another editor had answered and this which had been posted for 1 hour [18] were deleted by [19] ...? (he has reverted twice)--Ozzie10aaaa (talk) 18:33, 22 July 2015 (UTC)

It was archived 3 days after it had been posted. IMO posts to WT:MED should contain specific ideas about how to improve our medical articles on Wikipedia. We should not generally be posting interesting studies. Those posts should occur on the talk pages of the articles in question or else WT:MED may get over run. Best Doc James (talk · contribs · email) 20:37, 22 July 2015 (UTC)

Cranial Electrotherapy Stimulation

Hello, I'm ColumbiaLion212. I noticed that you recently removed some content from Cranial electrotherapy stimulation  with this edit on July 22nd, 2015, without explaining why. In the future, it would be helpful to others if you described your changes to Wikipedia with an edit summary. If this was a mistake, don't worry, the removed content has been restored. If you think I made a mistake, or if you have any questions, you can leave me a message on my talk page. Thanks.

And your edit has been reverted again (not by me). Cochrane reviews are generally considered the strongest sources, especially when they are more recent than other reviews. More directly, if you are unable to gain consensus for your changes in a talk page discussion, they won't survive in the article. Looie496 (talk) 19:24, 23 July 2015 (UTC)

Discussion was on the talk page all along Talk:Cranial_electrotherapy_stimulation#Cochrane_review. I even pinged you to it. Doc James (talk · contribs · email) 19:41, 23 July 2015 (UTC)

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Community desysoping RfC

Hi. You are invited to comment at RfC for BARC - a community desysoping process. Kudpung กุดผึ้ง (talk) 07:17, 24 July 2015 (UTC)

Thanks will look Doc James (talk · contribs · email) 21:20, 24 July 2015 (UTC)

Request for adequate CoI disclosure.

I've recently been very firm with some users with a FCoI - namely PR employees - regarding the (in)adequacy of their CoI disclosures - they've disclosed a FCoI but there's no info about where the conflicts lie. And I think it's only fair to ask you meet the FCoI disclosure standards as I've asked them to. I'm not a critic - I admire your work here, and am a big fan of EBM and quack busting. But we should follow the rules we demand other follow if we don't want to be hypocrites.

DocJames, I see on your user page the following disclosure: "I do accept travel costs for speaking events by organizations that can afford them."

I know that it's common practice for conferences to be held in very swanky places where doctors' expenses that are covered often (but not always!) include luxury accommodation, say, at a beautiful resort in Hawaii or where banquets or use of the golf courses and/or other amenities are included in the cost of accommodation, and the conferences are sponsored by a long list of pharmaceutical and medical device companies. So such travel costs count as 'compensation'.

From the FAQ:

Q:What does the phrase "employer, client, and affiliation" mean?

A:This means the person or organization that is paying you compensation – money, goods, or services...

So I have a few questions. Can you list any conferences, events, and the like that you've attended in the past year? Things like the Michigan Emergency Medicine Assembly, Urban Emergency Medicine, Annual Summer Conference on EM...? I tried to find out without bugging you - I searched https://www.emedevents.com for you and came up empty.

The COI template {{uw-coi}} notea that Wikipedia's terms of use require disclosure of your employer, client, and affiliation with respect to any contribution for which you receive, or expect to receive, compensation.

P.S. I see "I do not and have never accepted pharmaceutical funding." on your page as well; that's not great English, and I see you welcome corrections. I think you mean to say "I do not and have never accepted pharmaceutical company funding."

--Elvey^(t•c) 03:01, 25 July 2015 (UTC)

I recommend that fishing expeditions like the above be ignored. The only acceptable reason to ask an editor about what they do off-wiki would be due to a concern relating to a particular article. If there were concerns about editing an article for an organization, it might be reasonable to ask whether payment has ever been received from that organization, however the basic premise is nonsensical because it should be assumed that many editors receive payments for off-wiki work, and we do not ask editors to list who has paid them. Reminding Doc James about the ToU is totally redundant. The English correction is similarly redundant as anyone familiar with colloquialisms would know. Johnuniq (talk) 04:25, 25 July 2015 (UTC)

No that is cool.

• I received a flight to Washington DC and accommodations in Bethesda Maryland from the US government for 5 days or so of talks I gave at the NIH
• I received entry to the Cochrane colloquium in Quebec city and Hyderabad India. I paid for my own travel and accommodation.
• I received the cost of a flight to San Fran for a bunch of lectures I gave at UCSF once. I paid my own food and accommodation. Recent talks I paid all travel and accommodations.

I pay my own entry fees, travel, and accommodations for Wikimania / board meetings and plan to continue to do so. Doc James (talk · contribs · email) 08:48, 25 July 2015 (UTC)

I resent Johnuniq's WP:AGF-violating mischaracterization of my query as an unacceptable "fishing expedition", backed by misrepresentations of policy. Complying with the ToU is not optional. Johnuniq is essentially saying it is. As for the English issue, I wouldn't want people to think it was a Non-denial denial. I see James has made/accepted the correction.

I thank you, Doc James, for replying. Kudos and thanks for an exemplary response. (I guess these are the UCSF lectures you were referring to, which were pre ToS change and related to this laudable work?)

Oh, and please copy the disclosure to your user page, where the ToS say disclosures should be. And maybe strike your "That is about it.", which could be seen as a Non-denial denial too. (edited reply)--Elvey^(t•c) 00:43, 26 July 2015 (UTC)

One needs two things for a FCOI to exist. One need to receive money and one needs to write about the organization / topic in question. I do not write about UCSF or the US gov so not sure how this applies? Doc James (talk · contribs · email) 01:15, 26 July 2015 (UTC)

Doh! You're right. Two thinGs. I was just asking another user who DOES have a FCoI to do the same. Thanks! These are the UCSF lectures you were referring to? --Elvey^(t•c) 03:35, 26 July 2015 (UTC)

Yes those are the ones. Doc James (talk · contribs · email) 07:36, 26 July 2015 (UTC)

Unfortunately, Johnuniq is so pissed off by my comments above that he's trying to get me banned for them over at ANI. You think a ban is fair, DocJames?--Elvey^(t•c) 04:42, 26 July 2015 (UTC)

I think it is important to have evidence of both payment for work in a specific topic area and evidence of work in that topic area before raising COI issues.

I personally; however, do not have issues with your questions above. As an admin I am okay with being held to a greater level of transparency WRT COI. Additionally I think we as a community need to have further discussions around COI.

Regarding your specific question regarding the ban, I do not think the above should be used to justify it. I have not had time to look at the rest of the issues involved. Doc James (talk · contribs · email) 07:59, 26 July 2015 (UTC)

Sex addiction

Hi,

I noticed you edited the sex addiction page a while back? It has been completely taken over by anti-porn nuts. They are now citing a bunch of books by practitioners who treat, but disagree with all the science (which was removed). They also removed all the controversy about the "addiction" label. They did this so many times a while back that I just stopped trying to fix it, now I see they are at it again.

Is there any way to limit editing on controversial pages like this? — Preceding unsigned comment added by 118.200.229.10 (talk • contribs)

Which edits are you specifically concerned about? Doc James (talk · contribs · email) 10:05, 25 July 2015 (UTC)

Kallmann syndrome

Hello Dr James,

Thank you for the edits to the Kallmann Syndrome page. I was worried at first to see so much editing on a page I watch very closely and contributed a high percentage of content to but I see it was useful & helpful formatting changes rather than changes to the text.

I am a patient with KS and work closely with clinicians to try to raise awareness of this rare condition. I edit this page as much as possible to keep the information up to date and try to maintain a balance between information useful to both clinicians and patients alike.

Would this article be anywhere near GA status ? Would you be able to suggest any changes I could make to improve it even further ?

Thank you.

Neilsmith38 (talk) 12:21, 25 July 2015 (UTC)

Would need work to follow the WP:MEDMOS User:Neilsmith38. Will take a look at it some more. Doc James (talk · contribs · email) 12:23, 25 July 2015 (UTC)

Editing on Hypertension

Hi DocJames,

As a long time wikipedia watcher, I feel like I'm talking to a celebrity here after seeing your name on so many medical pages. I'm a medical student who uses wikipedia very frequently, and now that I'm getting to the end of my training I'd love to be able to contribute back to the encyclopedia that got me through my training.

As you can see, I'm fairly new to the editing scene, so any guidance you can give me would be much appreciated. Regarding my recent edits on the Hypertension article, as I mentioned in the "talk" page I'm basically trying to find a way to get rid of the "daunting wall of text" problem that I feel the article has at the moment. I'd like to preserve all the hard work that others have done on providing detailed research, but to try to keep the page as something that even people who got diagnosed with hypertension and are wondering "what's that?" can browse with relative ease. As such, I feel that the best way to go forward is to preserve the highly detailed content (most of which is only relevant to medical professionals) on specific pages, and keeping the sections of this page down to a few short paragraphs summarising the most relevant points. Let me know what you think about this approach, and please modify my submissions or revert them as you see fit.

Nren4237 (talk) 13:03, 25 July 2015 (UTC)

Agree User:Nren4237 the article could use some simplification. I think your recent edits are a good step in that direction. Doc James (talk · contribs · email) 13:10, 25 July 2015 (UTC)

Thanks for your support! I've made another major edit to the hypertension page, this time summarising the management section as I alluded to earlier. I'd appreciate if you could review the edit and let me know what you think. Feel free to revert/rework as necessary. Nren4237 (talk) 14:12, 30 July 2015 (UTC)

Your aggressive attacks on peer reviewed NIH Pub med sources is troubling

Your aggressive attack on a single cited sentence contribution to VAD where there was no mention of whiplash, using a cited source is extremely troubling, and I find your chronic assertions to your own education as to get into a public neurological qualification (pun intended) based specialization to be nothing more than hubris.

NIH is Encyclopedic - the U.S. National Institutes of Health is Encyclopedic

Please read WP:MEDRS. Doc James (talk · contribs · email) 23:54, 25 July 2015 (UTC)

A single sentence of seven words is not a viable "Copy Paste" as medically it cannot be expressed in any mother way. You're being outlandish here, and are throwing out negative wiki buzz words, go review your source claim, as NIH is encyclopedic, and review the copy paste claim, as you cannot apply this to a medical 7 word assertion. i.e. "Cancer Patients frequently experience nausea" cannot be written any other way, and leveraging common terms doesn't suffice.

You copy and paste from sources again and you will be blocked. Doc James (talk · contribs · email) 00:07, 26 July 2015 (UTC)

Congrats!

Somehow I managed to miss that you were elected to the board of trustees. I wish you the best of luck in that, you are a great choice for the position! Zell Faze (talk) 02:40, 26 July 2015 (UTC)

Thanks. Has been interesting so far. Doc James (talk · contribs · email) 07:28, 26 July 2015 (UTC)

Great meeting you

Hi James, it was great meeting you at Wikimania this year. Let me know if you have any other questions about South African topics and I will help out how ever I can. I see there already is an article on the Virgin cleansing myth in South Africa. Here are some more links about this terrible phenomenon though.

• The Myth of Child Rape as a Cure for HIV/AIDS in Transkei (2003)
• Infant rape in South Africa (2002)

Interestingly enough most of the more recent stuff on this topic seem to be coming from the main stream media. Reports on this happening still appear but less frequently than in the past. These days there seems to be fewer academic publications on the issue than between 2001-2006.--Discott (talk) 05:59, 26 July 2015 (UTC)

Thanks User:Discott appreciate the sources. Doc James (talk · contribs · email) 07:29, 26 July 2015 (UTC)

Unclear on what you are referring to

I really don't know what you mean on my talk page. I added citations to two articles in medical journals. It would be more helpful if you gave direct info as to what is wrong rather than a generic cut and paste regarding recommended practice. --Jeffmcneill (talk) 13:06, 26 July 2015 (UTC)

Provided further details on your talk. Doc James (talk · contribs · email) 00:10, 27 July 2015 (UTC)

Yeah, so I add two interesting and important new, relevant references to an article which indicates potential harm to pregnant women on the Paracetamol page. These are removed because you guys don't like primary sources? This is ridiculous and frankly an extreme case of what is wrong with Wikipedia. My wife is pregnant. I for sure want to know about potential harm of this drug. I would think as a medical professional that you would be more inspired by the "first do no harm" idea. The fact that you Wikipedia jerks are so focused on having only sources from a narrow range of whatever it takes for a given article is so frustrating. I've continued to run into this kind of thing. You would think that academic journals have taken over Wikipedia. The idea that I have actually improved the article with my additions, and that others can improve it further, has completely escaped much of the Wikipedia culture these days. Wikipedia has simply forgotten the idea that this is collaboratively edited, rather than having a coterie of people who simply reject all edits if they do not thread the eye of the needle through the dozens of acronym style guides. You guys are disgusting, really. You are standing on the shoulders of millions of edits and now you reject the very thing that got you to where you are, namely lots of collaboratively edited small improvements. Now any change has to go through hurdles that would never have created Wikipedia in the first place. The fact that you have excluded something that is evidence of significant danger to pregnant women based on this culture of exclusiveness should trouble you deeply. --Jeffmcneill (talk) 02:58, 27 July 2015 (UTC)

First of all this is a retrospective survey analysis. This is a very low quality study design and does not prove anything.

There are secondary source available that you could have used that provide a more nuanced position. The issue is that it is not a "significant danger to pregnant women". Best Doc James (talk · contribs · email) 06:33, 27 July 2015 (UTC)

PBC and PBC Foundation

I would like your advice as an experienced editor who has been involved with the Primary biliary cirrhosis entry. I created an entry for the PBC Foundation following your advice that external linking should be avoided. This foundation is notable as it has an established presence with patient and research support with a national and international notability including citations and references in the BBC, the Scotsman, NHS Choices and At Home, and in research publications including Nature Genetics, Gut and Lancet, which are evident on the Scholar search. It has helped lead a renaming initiative which, because of its nature, is only just starting to appear in web searches. It has a large membership and presence in the Association of Medical Research Charities. Within a few minutes of creation of the article, it was listed for deletion by another editor with his own POV (Wikipedia:Articles for deletion/PBC Foundation). You can review his comments which ask to ignore multiple other health related charity entries. Another view was to Merge with Primary biliary cirrhosis and this was the agreed "consensus" with one or two editors putting this forward. The degree of discussion was minimal however. I do not think merging will be correct for the disease or the foundation entry. Is a WP:Deletion review appropriate? Jrfw51 (talk) 07:53, 28 July 2015 (UTC)

Merging does not seem too unreasonable at this point in time. Doc James (talk · contribs · email) 11:12, 28 July 2015 (UTC)

Doc, it is commonplace for foundations and other organizations to have their own pages. (Often, even the founders and principles of them have their own pages.) If this organization is noteworthy in the UK part of the English speaking world—as judged by the citations, scientific and lay—why should it not have its own page? I will also state this at the deletion page, but wanted to hear your reasoning/personal perspective. Cheers. Le Prof Leprof 7272 (talk) 16:42, 28 July 2015 (UTC)

Please note, a request has been made of the relevant administrator, to reopen this discussion. Please, in good faith, and out of respect, do not proceed with merging until this further discussion is closed. Le Prof Leprof 7272 (talk) 18:02, 28 July 2015 (UTC)

The wp:GNG still pertains. People or foundations writing about themselves are not wp:RS. They may be wonderful people doing valuable work, but we have no usable sources to say so. If no independent sources are more than oneliners, then wp:FAILN comes into play.LeadSongDog come howl! 17:13, 28 July 2015 (UTC)

See the discussion at that page site. I believe the foregoing editor is not knowledgable about this area, or has not done sufficient "homework" to stand behind such strong opinions. In 5 mins work from a mobile device (and an additional 10 when returning to office to type them in, in reasonable format), I found a bakers half dozen solid citations from reputable sources, about reputable events, all regarding this UK health organization. (Granted, this is made harder by the plethora of charitable mirror sites that dilute real content, and by the confounding of the abbreviation with Palm Beach County, but to a scholar, such hurdles are minor.) It is not clear to my why there is an issue here, except that the original defending editor, @Jrfw51: was inexperienced, and did not know how to build a consensus. See the citations here, Talk:PBC_Foundation. Bottom line, the article needs work, but its notability is distinct from the disease (whose article needs, at best passing reference to the various charitable foundations that are in all English speaking countries). And it is a far cry better, in content, format, and sourcing, than many stub articles here. Please help maintain it, as is, in the main editing space, so it can be improved. I will at a Further reading section now, with these citations. Cheers. Le Prof Leprof 7272 (talk) 18:01, 28 July 2015 (UTC)

I do not have strong feelings one way or the other on this.Doc James (talk · contribs · email) 23:54, 28 July 2015 (UTC)

Profile

Hi Doc James,

Just wondering your name and credentials? Thanks! — Preceding unsigned comment added by 173.238.227.132 (talk) 21:09, 5 August 2015 (UTC)

Profile

Nevermind, I managed to find the page. Thank you. — Preceding unsigned comment added by 173.238.227.132 (talk) 21:14, 5 August 2015 (UTC)

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Racz

GA review says apparently written by someone close to the subject? Really? I can see the early edits are all by Atmse. I may be forced to reassess my belief that she can be OK in article space. Guy (Help!) 14:00, 6 August 2015 (UTC)

User:JzG where are you seeing that? Doc James (talk · contribs · email) 15:11, 6 August 2015 (UTC)

In Wikipedia:Good article reassessment/Gabor B. Racz/1:

I was the original reviewer of this article. At the time I had some reservations about the way the article was written, seemingly by someone too close to the subject, but after reassurance from the nominator on this, I decided it met the GA criteria. Looking at the article now, I think this still is the case. I do not like, nor do I want to take part in, any behind the scene allegations and recriminations. The article was stable enough before this reassessment was proposed and instability should not therefore be used as a reason to delist it.

— Cwmhiraeth (talk) 12:34, 7 July 2015 (UTC)

Took me by surprise: I don't see Atsme as COI, but could be wrong. Guy (Help!) 15:48, 6 August 2015 (UTC)

I had thought there ~might~ be a COI b/c the article was very promotional, and because Atsme posted about completing the Racz article on the facebook page of her foundation (Earthwave). (I always said there "might" be a COI) and asked for a reasonable explanation as to why she posted there about the Racz article - where she had also posted about her edits to WP articles where she had added ELs and refs to Earthwave's website. She never answered directly. She said later, in different places and different times, that a) she was treating that facebook page as a personal facebook page (not purely about foundation stuff), b) that she learned about Racz because of a friend who was treated by him and got great results and thought he should get a WP article. From that I take away that she is a "fan" but that there wasn't a COI. Jytdog (talk) 16:06, 6 August 2015 (UTC) (added key reason Jytdog (talk) 13:49, 7 August 2015 (UTC))

Yes I have no evidence of one. She managed to get release of his CV under an open license, but that means little. Doc James (talk · contribs · email) 11:55, 7 August 2015 (UTC)

This uploaded image which is meant to include Racz is described as "sent to me personally". Not sure what the significance of that is, if any. Alexbrn (talk) 11:59, 7 August 2015 (UTC)

My personal belief is that Atsme is a badge-collector who looks to get articles to GA standard, and who does not realise that a shiny puff-piece that looks good at GA review can still be a fundamental violation of WP:5P. The idea that a warts-and-all portrait that is a bit ugly round the edges is, for Wikipedia purposes, a better article than a carefully polished and airbrushed PR job, simply does not seem to get through to her. The Griffin dispute brought this home. Griffin was and, as far as I can tell, remains, a prominent advocate of arguably the worst cancer scam ever perpetrated in the US. He advocated this because of his John Birch Society connections, a clear case of motivated reasoning. And Atsme tried for months first to downplay it and then, when that failed, to pretend that laetrile is not quackery. She did this because she wanted to get the article to GA standard. But an article on Griffin that does not show him as the crank he clearly is, is not a good article by Wikipedia's standards> It might be a nice article, but as an entry in something that aspires to be reliable, it is actually terribly bad. And the penny never dropped, and I don't suppose it ever will, at this rate, which is sad, because Atsme is energetic and diligent and capable of being entirely delightful. Guy (Help!) 16:33, 7 August 2015 (UTC)

Agree an unfortunate case. More skepticism on their part is required. Doc James (talk · contribs · email) 05:45, 8 August 2015 (UTC)

August 2015

Your recent editing history at Attention deficit disorder shows that you are currently engaged in an edit war. To resolve the content dispute, please do not revert or change the edits of others when you get reverted. Instead of reverting, please use the article's talk page to work toward making a version that represents consensus among editors. The best practice at this stage is to discuss, not edit-war. See BRD for how this is done. If discussions reach an impasse, you can then post a request for help at a relevant noticeboard or seek dispute resolution. In some cases, you may wish to request temporary page protection.

Being involved in an edit war can result in your being blocked from editing—especially if you violate the three-revert rule, which states that an editor must not perform more than three reverts on a single page within a 24-hour period. Undoing another editor's work—whether in whole or in part, whether involving the same or different material each time—counts as a revert. Also keep in mind that while violating the three-revert rule often leads to a block, you can still be blocked for edit warring—even if you don't violate the three-revert rule—should your behavior indicate that you intend to continue reverting repeatedly. Seppi333 (Insert 2¢) 06:16, 9 August 2015 (UTC)

Yes User:Seppi333 same to you here so I did not think I needed to warn you again. We just finished a page move request here which was closed "not moved". Doc James (talk · contribs · email) 06:21, 9 August 2015 (UTC)