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:::OK, happy to go with your decision....any other opiniios? ] (]) 03:27, 7 September 2008 (UTC) :::OK, happy to go with your decision....any other opiniios? ] (]) 03:27, 7 September 2008 (UTC)
(undent)Nope.] (]) 12:17, 7 September 2008 (UTC) (undent)Nope.] (]) 12:17, 7 September 2008 (UTC)

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Huntington's disease is currently a Biology and medicine good article nominee. Nominated by an unspecified nominator at 22:41, 6 September 2008 (UTC)

An editor has indicated a willingness to review the article in accordance with the good article criteria and will decide whether or not to list it as a good article. Comments are welcome from any editor who has not nominated or contributed significantly to this article. This review will be closed by the first reviewer. To add comments to this review, click discuss review and edit the page.


Former good article nomineeHuntington's disease was a Natural sciences good articles nominee, but did not meet the good article criteria at the time. There may be suggestions below for improving the article. Once these issues have been addressed, the article can be renominated. Editors may also seek a reassessment of the decision if they believe there was a mistake.
Article milestones
DateProcessResult
July 31, 2006WikiProject peer reviewReviewed
August 16, 2006Peer reviewReviewed
May 21, 2008Good article nomineeNot listed
August 27, 2008Good article nomineeNot listed
September 6, 2008Good article nomineeNot listed
Current status: Former good article nominee

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To-do: E · H · W · RUpdated 2017-08-06

Discussion archive

Previous discussion topics can be found in the archive /Archive 1

Disagreement on Sharp cut off taken from todo ( prev from peer review)

It would be interesting to expand on the age-of-onset phenomenon, which I think is a matter of interest in popular descriptions of the disease. IIRC it has been suggested that the "sharp cutoff" in number of repeats needed to create disease is an effect of human lifespan - ie 30 repeats don't cause disease because the aggregation is slow enough that the person dies before it has a neurodegenerative effect. Unfortunately I can't find the paper I'm thinking of, but here is a related paper that expands on the biophysical origins of the effect.

  1. what is this "sharp cut off" point that is mentioned? This is definitly NOT the case. There are two overlapping populations. The normal group with a peak at 16 CAG repeats and the HD group with a peak at 40 CAG repeats, with some overlap around 36 repeats. There is also a mater of instability. Those in the "normal" range show very little instability in repeat length from generation to generation, while those in the HD range and those in the intermediate range, show instability, particularly in paternal transmission (anticipation). (see Harper and Jones, 2003, in Bates et al, 2003: Huntington's disease, 3rd Ed, Oxford Monographs on Medical Genetics).D666D 22:47, 26 September 2007 (UTC)
  2. I have found the refernce and summarised in a table which answers this question. LeeVJ (talk) 17:50, 29 April 2008 (UTC)

Epidemiology incongruity

Found this unsigned comment hidden in wring section LeeVJ (talk) 00:47, 8 May 2008 (UTC) There is a incongruity with one of the citations for the article. At the intro, it is stated that HD is a genetic neurological disorder inherited by approximately 3 to 7 per 100,000 people of Western European descent, varying geographically, down to 1 per 1,000,000 of Asian and African descent. It says that this bit of information was retrieved from its source on May 22, 2008. If I am not mistaken, I accessed this article today--that is May 3. Someone ought to check this out.

Have checked it, links to correct article, there must have been a bug with the citation generator - well spotted though! LeeVJ (talk) 22:08, 13 May 2008 (UTC)

HD Management - Nutrition

In this article, it is said, "Most HD sufferers need two to three times the calories of the average person to maintain body weight", yet I have never seen any source that validates this. The largest supplement I have come across suggested by any particular study is 473 kcal/d in the study by Trejo et al. Conorcosgrave (talk) 17:52, 24 November 2007 (UTC)

Part of answer: 24hr energy expenditure increased 11% due to movements. ( Gaba AM, Zhang K, Marder K, Moskowitz CB, Werner P, Boozer CN (2005). "Energy balance in early-stage Huntington disease". Am. J. Clin. Nutr. 81 (6): 1335–41. PMID 15941884. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link) )LeeVJ (talk) 10:30, 2 May 2008 (UTC)

deleted links

Commercial

Since there are many trials and companies performing trials, didn't seem right to pick one out or list them all in main article, so maybe a list of companies conducting HD research is needed - need to trawl through manuals of style to find out if this is the wikipedia way...and have removed following recent link from article; --Leevanjackson (talk) 23:50, 15 March 2008 (UTC)

2008 Clinical Trials: Avicena's HD-02 to Proceed to NIH Sponsored Phase III Huntington's Disease Trial

lay organisations

The following links were deleted by another editor, but without discussion so I have put them here in-case any are relevent.LeeVJ (talk) 01:02, 3 July 2008 (UTC)

global prevalence

trying to make a global map of prevalence but can't find a single source covering everything so have to build it up. some notes on different areas

GA review

This article generally does a good job covering an important topic on which there is a ton of material, so kudos to the writers. However, I think it does need a thorough copy edit and needs many citations; there are a bunch of sections that are unreferenced. Here are my suggestions. This looks like an awful lot but it's really mostly quick, easy fixes.

  1. The following sections have no citation: "Symptoms", "Cognitive", "Mechanism", "Pathophysiology", "Diagnosis", "Management", "Medication", "Social impact", and "Others".
    Good. delldot talk 04:41, 12 August 2008 (UTC)
  2. The following paragraphs have no citations: The first paragraph under "Genetics", the second and third under "Inheritance".
    Good. delldot talk 04:41, 12 August 2008 (UTC)
  3. I would leave the complicated epidemiology data out of the very first sentence, maybe put it in the second or third. Rather, I'd have the first sentence be about what the disease is like: "Huntington's is characterized by..." That way you could introduce the idea of the varied epidemiology at the beginning of a new sentence: "the number of people varies with ethnicity: 1 in 100,000..."  Done LeeVJ (talk) 23:04, 23 May 2008 (UTC)
    Good. delldot talk 04:41, 12 August 2008 (UTC)
  4. "The disorder has been heavily researched in the last few decades" might be a problem per WP:DATED  Done LeeVJ (talk) 22:14, 23 May 2008 (UTC)
    Good. delldot talk 04:41, 12 August 2008 (UTC)
  5. "late forties/early fifties" - I would write this out rather than using the slash, and make the spelled out number/numeral thing consistent.  Done LeeVJ (talk) 15:51, 22 May 2008 (UTC)
    Good. delldot talk 04:41, 12 August 2008 (UTC)
  6. "usually at around 40-50 years" Use en dashes (–) rather than hyphens (-) for number ranges per WP:DASH. This is a repetition of the 2nd paragraph, too.  Done LeeVJ (talk) 15:54, 22 May 2008 (UTC)
    Good. delldot talk 04:41, 12 August 2008 (UTC)
  7. " psychiatric changes, which pre-empt the physical ones, are overlooked" what does this mean? What does it mean to pre-epmt a symptom? Is that how you spell pre-empt? (I really don't know)  Done LeeVJ (talk) 17:24, 22 May 2008 (UTC)
    Good. delldot talk 04:41, 12 August 2008 (UTC)
  8. "Physical symptoms are almost always evident" Does this mean "almost everyone with Huntington's gets physical symptoms?" Or something about how obvious the symptoms are? Maybe reword for clarity.  Done LeeVJ (talk) 17:24, 22 May 2008 (UTC)
    Good. delldot talk 04:41, 12 August 2008 (UTC)
  9. "cognitive symptoms which can lead to psychopathological problems exhibit differently from person to person." would have a different meaning from "cognitive symptoms, which can lead to psychopathological problems, ..." The former is a more specific type of cognitive problem. Which is it?  Done LeeVJ (talk) 21:16, 22 May 2008 (UTC)
    Good. delldot talk 04:41, 12 August 2008 (UTC)
  10. "some uncontrollable movement of the lips, chewing and swallowing (Dysphagia) which commonly causes weight loss" Some can usually be dropped without changing the meaning (see User:Tony1/How to satisfy Criterion 1a: redundancy exercises). Also, "uncontrollable movement of the lips, chewing and swallowing..." doesn't really make sense. Maybe "uncontrollable movement of the lips, problems with chewing and swallowing"?  Done LeeVJ (talk) 22:49, 23 May 2008 (UTC)
    Good. delldot talk 04:41, 12 August 2008 (UTC)
  11. "Continence, eating and mobility are extremely difficult if not impossible." Impossible is a strong word. This would require a citation.  Done LeeVJ (talk) 17:36, 22 May 2008 (UTC)
    Good. delldot talk 04:41, 12 August 2008 (UTC)
  12. "to date neither of this have been supported". Per WP:DATED, avoid "to date", replacing it with "As of ".  Done LeeVJ (talk) 15:51, 22 May 2008 (UTC)
    Good. delldot talk 04:41, 12 August 2008 (UTC)
  13. I believe citation style calls for a capital letter after a colon in refs.  Done LeeVJ (talk) 15:51, 22 May 2008 (UTC)
    Good. delldot talk 04:41, 12 August 2008 (UTC)
  14. "The latter can cause or worsen addictions such as alcoholism and gambling, or hypersexuality." is hypersexuality an addiction? If not, you could have "The latter can cause or worsen hypersexuality or addictions such as alcoholism and gambling." a cite would be good here too ..5  Done cite is left tagged LeeVJ (talk) 01:34, 27 May 2008 (UTC)
    Good. delldot talk 04:41, 12 August 2008 (UTC)
  15. Making that table float to the right would reduce whitespace (e.g. in rotavirus).  Done LeeVJ (talk) 15:01, 22 May 2008 (UTC)
    Good. delldot talk 04:41, 12 August 2008 (UTC)
  16. Explain or at least wikilink "penetrance". { Done LeeVJ (talk) 18:24, 23 May 2008 (UTC)
    Good. delldot talk 04:41, 12 August 2008 (UTC)
  17. "to have an increased mortality, progressively interfering with their functioning." Yeah, I guess dying would interfere with their functioning. :P Also, is there a simpler way to reword this for laypeople?  Done LeeVJ (talk) 17:54, 23 May 2008 (UTC)
    Good delldot talk 04:41, 12 August 2008 (UTC)
  18. You can do et al. for >3 or 6 names in a ref per WP:MEDMOS  Done LeeVJ (talk) 15:51, 22 May 2008 (UTC)
    Good delldot talk 04:41, 12 August 2008 (UTC)
  19. "Generally, but not always, the greater the number of CAG repeats..." doesn't really fit at the end of that paragraph, maybe you can fit it in the previous one.  Done LeeVJ (talk) 18:24, 23 May 2008 (UTC)
    Good delldot talk 04:41, 12 August 2008 (UTC)
  20. Image:Autosomal Dominant Pedigree Chart.svg could stand to be smaller. I'd recommend cropping the image and increasing the size of the text so it's still legible if you make it smaller (it's an svg so this won't be hard. I can do it if you need me to, I like doing junk like that).
     Done What do you think? Actually, I think I may have made the key box too big, I can shrink it and make the elements closer together if you think it's a good idea. delldot talk 07:05, 24 May 2008 (UTC)
    Much better! Still not sure about it's understanability to anyone who doesn't know what it means ! e.g. (I,II,III?) but at least it can be read now ..LeeVJ (talk) 11:34, 25 May 2008 (UTC)
    I don't think it's a problem, but could add clarifications to the caption if necessary. delldot talk 04:41, 12 August 2008 (UTC)
    I can't put my finger on it, I think it's because each of the generations has differing number of possibilities, i.e. 1st gen has five offspring, 2nd then has 2,3,and 4, I think 1st gen have 4, then second have two sets off four one from an affected and one from a wild type, sounds like hassle though and not sure how pedigree charts are usually depicted .LeeVJ (talk) 21:35, 12 August 2008 (UTC)
    User:Medical geneticist has added a description which improves the situation. LeeVJ (talk) 15:04, 18 August 2008 (UTC)
  21. "and are finally cleared up in a process called degradation" cleared up?  Done LeeVJ (talk) 17:45, 23 May 2008 (UTC)
    Good delldot talk 04:41, 12 August 2008 (UTC)
  22. "The exact mechanism in which mHtt causes or affects the biological processes of DNA replication and programmed cell death (apoptosis) remains unclear, so research is divided into identifying the functioning of Htt, how mHtt differs or interferes with it, and the proteopathic effects of remnants of the protein (known as aggregates) left after degradation." - long and hard to follow. Is there a simpler way to say proteopathic?  Done LeeVJ (talk) 23:59, 23 May 2008 (UTC)
    Good delldot talk 04:41, 12 August 2008 (UTC)
  23. " This loss of BDNF may contribute to striatal cell death, which does not follow apoptotic pathways as the neurons appear to die of starvation." Can you reword into simpler terms for the layperson? This section could be fleshed out more anyway. Is this really all there is to say about their function?
    Good delldot talk 04:41, 12 August 2008 (UTC)
  24. With mHtt, how are we supposed to deal with starting a sentence with a lower case letter? My instinct would be to reword so it doesn't come first (e.g. "The protein mHtt..." or "The erroneous protein mHtt" if there's an official thing known as an erroneous protein). You may want to look at featured protein articles if there are any to see how they handle the problem.  Done LeeVJ (talk) 20:24, 21 May 2008 (UTC)
    Good delldot talk 04:41, 12 August 2008 (UTC)
  25. "polyQ dependent transcription" should probably be "polyQ-dependent transcription". Can you check?  Done LeeVJ (talk) 20:24, 21 May 2008 (UTC)
    Good delldot talk 04:41, 12 August 2008 (UTC)
  26. "The aggregates also interact with SP1, thereby preventing it from binding to DNA,the normal functioning of these proteins" Unclear. Maybe "the way proteins normally do" or something.  Done LeeVJ (talk) 20:24, 21 May 2008 (UTC)
    Good delldot talk 04:41, 12 August 2008 (UTC)
  27. "Huntington mice models exposed to better husbandry techniques, especially better access to food and water, lived much longer than mice that were not well cared for." Citation needed here. The sentence should say "in a 1998 study..." or some such, since these are findings from a particular study, not something general. A review article that discusses the study should be used, not the study itself.
    This is OK, I think I was being too strict insisting on no primary sources. As I now understand it, some are ok. I think I was also wrong about using "in a 1998 study"; I've since been told that if the source is reliable you can state just the results. So this is fine. delldot talk 04:41, 12 August 2008 (UTC)
    Not sure about this one either , couldn't find a decent ref for it, aside from the fact it's pretty damned obvious that access to correct levels of food, water and ideal environment will positively affect longevity! LeeVJ (talk) 21:35, 12 August 2008 (UTC)
  28. "This is a significant find for Huntington's." What is a "significant find"? This sounds like opinion, though it's good that there's a ref. Don't know if this sentence adds anything though, without further explanation.  Done LeeVJ (talk) 17:41, 23 May 2008 (UTC)
    Good delldot talk 04:41, 12 August 2008 (UTC)
  29. I don't think the paragraph on Juvenile HD belongs in the prognosis section, it's more about symptoms or classification. Could merge with the mention under epidemiology as a last resort; at least this would cut down on repetition.  Done LeeVJ (talk) 23:26, 23 May 2008 (UTC)
    Good delldot talk 04:41, 12 August 2008 (UTC)
  30. Is there really only one sentence to be written about medication, in the treatment section? If so, this section should maybe be merged into another one. I would think, though, that more needs to be written here to adequately cover the subject.
    Still very short, is medication just not an important part of treatment? delldot talk 04:41, 12 August 2008 (UTC)
    Hard to find huntington's specifically tested classical medicine, mostly broken down by health service as medicine per symptom as it would be treated on it's own, other's used don't seem to be official endorsed yet, but I am delving, should the drugs used just be listed e.g. drug for psychotic episode, apathy etc. or maybe better if I drag in a summary from each of the symptoms articles... LeeVJ (talk) 21:35, 12 August 2008 (UTC)
  31. There are a number of very short paragraphs and sections. These are discouraged and should probably be merged or expanded.
    Improved, but still quite a few. delldot talk 04:41, 12 August 2008 (UTC)
    just started on this one...LeeVJ (talk) 21:35, 12 August 2008 (UTC)
  32. " An intracellularly expressed single-chain Fv against the amino-terminal end of mutant huntingtin (mHtt) has been shown to reduce mHtt aggregate formation and increase turnover of the mHtt fragments in tissue culture models of HD." Can the wording be simplified for the lay reader?  Done LeeVJ (talk) 01:00, 27 May 2008 (UTC)
    Good delldot talk 04:41, 12 August 2008 (UTC)
  33. "Intensive therapy: A pilot study on July, 2007, of inpatient rehabilitation for the Italian Welfare system, of speech, mind and body showed no motor decline in the two-year study." This needs rewording.  Done LeeVJ (talk) 17:41, 23 May 2008 (UTC)
    Good delldot talk 04:41, 12 August 2008 (UTC)
  34. The sentence under "Others" under "Research directions" needs a citation or citations.
    Good delldot talk 04:41, 12 August 2008 (UTC)
  35. Any time you have a statistic, it requires a citation. For example, "The prevalence is, on average, between 5 and 8 per 100,000", and "...screening now make it possible (with 99 percent certainty) to have an HD-free child"
  36. It looks like there are an awful lot of primary sources, not the best per WP:MEDRS. Be careful when citing trials to be clear that it's a specific study and not general results, and use review articles or other secondary or tertiary sources whenever possible instead.
    Good delldot talk 04:41, 12 August 2008 (UTC)
  • find references for all 'citations needed'.
  1. Good delldot talk 04:41, 12 August 2008 (UTC)
I have incorporated all the above points regarding missing references here, having tagged sections with 'fact' where required. LeeVJ (talk) 01:34, 27 May 2008 (UTC)
 Done LeeVJ (talk) 16:48, 9 August 2008 (UTC)

I'm failing this for now because I think finding all the needed citations will take more than the week usually allotted for a hold. Please feel free to nominate it again once that has been dealt with, though. I'm glad to give it another look when you want me to to let you know if I think it's ready to go up again. Sorry to be so picky, it really is a very nice article, so I decided to use a very fine toothed comb with the prose. Most of my points are very minor, however the citation needed issues need to get dealt with first and foremost. I'd also recommend having a copy editor look over the article, because there were a bunch of minor wording things that made me think the whole article could use a copy edit. It also looks like some of the areas I pointed out need a little expanding. Please don't hesitate to drop me a note if you need any help or explanation. delldot on a public computer talk 07:18, 21 May 2008 (UTC)

Get down with your bad self Leevanjackson! You're making great progress! delldot talk 07:05, 24 May 2008 (UTC)
thankyou! :) LeeVJ (talk) 21:35, 12 August 2008 (UTC)

Rechecking for new GA review

Update: Leevanjackson's done terrific work, addressing all my concerns from the earlier review. I came across a few more things while re-reviewing (very minor):
  • This sentence is a fragment and too technical: Profound neuronal degeneration in the striatum with some additional atrophy of the frontal and temporal cortices. Done
  • This sentence is confusing: Testing of a descendant of a person, who is 'at risk', has serious ethical implications because a positive result automatically diagnoses one of the parents. Who is at risk, the parent or the descendant? Everyone's a descendant. Possibly just a comma issue (Testing of a descendant of a person who is 'at risk') but the whole sentence should be reworded. Done
  • Only the first word after periods and colons and proper nouns need to be capitalized in article titles.
Not sure about this one, do you mean in the article content? LeeVJ (talk) 22:07, 13 August 2008 (UTC)
  • Some refs need to be expanded, e.g. "Achievements of Hereditary Disease Foundation"--publisher needed, as well as date and author if available.
Some of the refs just don't have this info - do I need to find new ones that do ? LeeVJ (talk) 22:07, 13 August 2008 (UTC)
  • Confusion with its in the following sentence: The precise way it does this is unknown but a reduction in its level increases neuron cell death and creation, leading to atrophy of areas of the brain. - the first it is mHtt, and the second is BDNF, right?  Done
  • Under Social impact, This sentence needs rewriting: Whether or not to have the test for HD Genetic counseling may provide perspective for those at risk of the disease.  Done
Overall, looks great! delldot talk 04:41, 12 August 2008 (UTC)

GA review

This article generally does a good job covering an important topic on which there is a ton of material, so kudos to the writers. However, I think it does need a thorough copy edit and needs many citations; there are a bunch of sections that are unreferenced. Here are my suggestions. This looks like an awful lot but it's really mostly quick, easy fixes.

  1. The following sections have no citation: "Symptoms", "Cognitive", "Mechanism", "Pathophysiology", "Diagnosis", "Management", "Medication", "Social impact", and "Others".
    Good. delldot talk 04:41, 12 August 2008 (UTC)
  2. The following paragraphs have no citations: The first paragraph under "Genetics", the second and third under "Inheritance".
    Good. delldot talk 04:41, 12 August 2008 (UTC)
  3. I would leave the complicated epidemiology data out of the very first sentence, maybe put it in the second or third. Rather, I'd have the first sentence be about what the disease is like: "Huntington's is characterized by..." That way you could introduce the idea of the varied epidemiology at the beginning of a new sentence: "the number of people varies with ethnicity: 1 in 100,000..."  Done LeeVJ (talk) 23:04, 23 May 2008 (UTC)
    Good. delldot talk 04:41, 12 August 2008 (UTC)
  4. "The disorder has been heavily researched in the last few decades" might be a problem per WP:DATED  Done LeeVJ (talk) 22:14, 23 May 2008 (UTC)
    Good. delldot talk 04:41, 12 August 2008 (UTC)
  5. "late forties/early fifties" - I would write this out rather than using the slash, and make the spelled out number/numeral thing consistent.  Done LeeVJ (talk) 15:51, 22 May 2008 (UTC)
    Good. delldot talk 04:41, 12 August 2008 (UTC)
  6. "usually at around 40-50 years" Use en dashes (–) rather than hyphens (-) for number ranges per WP:DASH. This is a repetition of the 2nd paragraph, too.  Done LeeVJ (talk) 15:54, 22 May 2008 (UTC)
    Good. delldot talk 04:41, 12 August 2008 (UTC)
  7. " psychiatric changes, which pre-empt the physical ones, are overlooked" what does this mean? What does it mean to pre-epmt a symptom? Is that how you spell pre-empt? (I really don't know)  Done LeeVJ (talk) 17:24, 22 May 2008 (UTC)
    Good. delldot talk 04:41, 12 August 2008 (UTC)
  8. "Physical symptoms are almost always evident" Does this mean "almost everyone with Huntington's gets physical symptoms?" Or something about how obvious the symptoms are? Maybe reword for clarity.  Done LeeVJ (talk) 17:24, 22 May 2008 (UTC)
    Good. delldot talk 04:41, 12 August 2008 (UTC)
  9. "cognitive symptoms which can lead to psychopathological problems exhibit differently from person to person." would have a different meaning from "cognitive symptoms, which can lead to psychopathological problems, ..." The former is a more specific type of cognitive problem. Which is it?  Done LeeVJ (talk) 21:16, 22 May 2008 (UTC)
    Good. delldot talk 04:41, 12 August 2008 (UTC)
  10. "some uncontrollable movement of the lips, chewing and swallowing (Dysphagia) which commonly causes weight loss" Some can usually be dropped without changing the meaning (see User:Tony1/How to satisfy Criterion 1a: redundancy exercises). Also, "uncontrollable movement of the lips, chewing and swallowing..." doesn't really make sense. Maybe "uncontrollable movement of the lips, problems with chewing and swallowing"?  Done LeeVJ (talk) 22:49, 23 May 2008 (UTC)
    Good. delldot talk 04:41, 12 August 2008 (UTC)
  11. "Continence, eating and mobility are extremely difficult if not impossible." Impossible is a strong word. This would require a citation.  Done LeeVJ (talk) 17:36, 22 May 2008 (UTC)
    Good. delldot talk 04:41, 12 August 2008 (UTC)
  12. "to date neither of this have been supported". Per WP:DATED, avoid "to date", replacing it with "As of ".  Done LeeVJ (talk) 15:51, 22 May 2008 (UTC)
    Good. delldot talk 04:41, 12 August 2008 (UTC)
  13. I believe citation style calls for a capital letter after a colon in refs.  Done LeeVJ (talk) 15:51, 22 May 2008 (UTC)
    Good. delldot talk 04:41, 12 August 2008 (UTC)
  14. "The latter can cause or worsen addictions such as alcoholism and gambling, or hypersexuality." is hypersexuality an addiction? If not, you could have "The latter can cause or worsen hypersexuality or addictions such as alcoholism and gambling." a cite would be good here too ..5  Done cite is left tagged LeeVJ (talk) 01:34, 27 May 2008 (UTC)
    Good. delldot talk 04:41, 12 August 2008 (UTC)
  15. Making that table float to the right would reduce whitespace (e.g. in rotavirus).  Done LeeVJ (talk) 15:01, 22 May 2008 (UTC)
    Good. delldot talk 04:41, 12 August 2008 (UTC)
  16. Explain or at least wikilink "penetrance". { Done LeeVJ (talk) 18:24, 23 May 2008 (UTC)
    Good. delldot talk 04:41, 12 August 2008 (UTC)
  17. "to have an increased mortality, progressively interfering with their functioning." Yeah, I guess dying would interfere with their functioning. :P Also, is there a simpler way to reword this for laypeople?  Done LeeVJ (talk) 17:54, 23 May 2008 (UTC)
    Good delldot talk 04:41, 12 August 2008 (UTC)
  18. You can do et al. for >3 or 6 names in a ref per WP:MEDMOS  Done LeeVJ (talk) 15:51, 22 May 2008 (UTC)
    Good delldot talk 04:41, 12 August 2008 (UTC)
  19. "Generally, but not always, the greater the number of CAG repeats..." doesn't really fit at the end of that paragraph, maybe you can fit it in the previous one.  Done LeeVJ (talk) 18:24, 23 May 2008 (UTC)
    Good delldot talk 04:41, 12 August 2008 (UTC)
  20. Image:Autosomal Dominant Pedigree Chart.svg could stand to be smaller. I'd recommend cropping the image and increasing the size of the text so it's still legible if you make it smaller (it's an svg so this won't be hard. I can do it if you need me to, I like doing junk like that).
     Done What do you think? Actually, I think I may have made the key box too big, I can shrink it and make the elements closer together if you think it's a good idea. delldot talk 07:05, 24 May 2008 (UTC)
    Much better! Still not sure about it's understanability to anyone who doesn't know what it means ! e.g. (I,II,III?) but at least it can be read now ..LeeVJ (talk) 11:34, 25 May 2008 (UTC)
    I don't think it's a problem, but could add clarifications to the caption if necessary. delldot talk 04:41, 12 August 2008 (UTC)
    I can't put my finger on it, I think it's because each of the generations has differing number of possibilities, i.e. 1st gen has five offspring, 2nd then has 2,3,and 4, I think 1st gen have 4, then second have two sets off four one from an affected and one from a wild type, sounds like hassle though and not sure how pedigree charts are usually depicted .LeeVJ (talk) 21:35, 12 August 2008 (UTC)
    User:Medical geneticist has added a description which improves the situation. LeeVJ (talk) 15:04, 18 August 2008 (UTC)
  21. "and are finally cleared up in a process called degradation" cleared up?  Done LeeVJ (talk) 17:45, 23 May 2008 (UTC)
    Good delldot talk 04:41, 12 August 2008 (UTC)
  22. "The exact mechanism in which mHtt causes or affects the biological processes of DNA replication and programmed cell death (apoptosis) remains unclear, so research is divided into identifying the functioning of Htt, how mHtt differs or interferes with it, and the proteopathic effects of remnants of the protein (known as aggregates) left after degradation." - long and hard to follow. Is there a simpler way to say proteopathic?  Done LeeVJ (talk) 23:59, 23 May 2008 (UTC)
    Good delldot talk 04:41, 12 August 2008 (UTC)
  23. " This loss of BDNF may contribute to striatal cell death, which does not follow apoptotic pathways as the neurons appear to die of starvation." Can you reword into simpler terms for the layperson? This section could be fleshed out more anyway. Is this really all there is to say about their function?
    Good delldot talk 04:41, 12 August 2008 (UTC)
  24. With mHtt, how are we supposed to deal with starting a sentence with a lower case letter? My instinct would be to reword so it doesn't come first (e.g. "The protein mHtt..." or "The erroneous protein mHtt" if there's an official thing known as an erroneous protein). You may want to look at featured protein articles if there are any to see how they handle the problem.  Done LeeVJ (talk) 20:24, 21 May 2008 (UTC)
    Good delldot talk 04:41, 12 August 2008 (UTC)
  25. "polyQ dependent transcription" should probably be "polyQ-dependent transcription". Can you check?  Done LeeVJ (talk) 20:24, 21 May 2008 (UTC)
    Good delldot talk 04:41, 12 August 2008 (UTC)
  26. "The aggregates also interact with SP1, thereby preventing it from binding to DNA,the normal functioning of these proteins" Unclear. Maybe "the way proteins normally do" or something.  Done LeeVJ (talk) 20:24, 21 May 2008 (UTC)
    Good delldot talk 04:41, 12 August 2008 (UTC)
  27. "Huntington mice models exposed to better husbandry techniques, especially better access to food and water, lived much longer than mice that were not well cared for." Citation needed here. The sentence should say "in a 1998 study..." or some such, since these are findings from a particular study, not something general. A review article that discusses the study should be used, not the study itself.
    This is OK, I think I was being too strict insisting on no primary sources. As I now understand it, some are ok. I think I was also wrong about using "in a 1998 study"; I've since been told that if the source is reliable you can state just the results. So this is fine. delldot talk 04:41, 12 August 2008 (UTC)
    Not sure about this one either , couldn't find a decent ref for it, aside from the fact it's pretty damned obvious that access to correct levels of food, water and ideal environment will positively affect longevity! LeeVJ (talk) 21:35, 12 August 2008 (UTC)
    Ah, found a relevant study <ref name="pmid14999077">{{cite journal |author=Spires TL, Grote HE, Varshney NK, ''et al'' |title=Environmental enrichment rescues protein deficits in a mouse model of Huntington's disease, indicating a possible disease mechanism |journal=] |volume=24 |issue=9 |pages=2270–6 |year=2004 |month=March |pmid=14999077 |doi=10.1523/JNEUROSCI.1658-03.2004 |url=http://www.jneurosci.org/cgi/pmidlookup?view=long&pmid=14999077 |issn=}}</ref> so could reinstate statement,maybe. LeeVJ (talk) 13:14, 9 September 2008 (UTC)
  28. "This is a significant find for Huntington's." What is a "significant find"? This sounds like opinion, though it's good that there's a ref. Don't know if this sentence adds anything though, without further explanation.  Done LeeVJ (talk) 17:41, 23 May 2008 (UTC)
    Good delldot talk 04:41, 12 August 2008 (UTC)
  29. I don't think the paragraph on Juvenile HD belongs in the prognosis section, it's more about symptoms or classification. Could merge with the mention under epidemiology as a last resort; at least this would cut down on repetition.  Done LeeVJ (talk) 23:26, 23 May 2008 (UTC)
    Good delldot talk 04:41, 12 August 2008 (UTC)
  30. Is there really only one sentence to be written about medication, in the treatment section? If so, this section should maybe be merged into another one. I would think, though, that more needs to be written here to adequately cover the subject.
    Still very short, is medication just not an important part of treatment? delldot talk 04:41, 12 August 2008 (UTC)
    Hard to find huntington's specifically tested classical medicine, mostly broken down by health service as medicine per symptom as it would be treated on it's own, other's used don't seem to be official endorsed yet, but I am delving, should the drugs used just be listed e.g. drug for psychotic episode, apathy etc. or maybe better if I drag in a summary from each of the symptoms articles... LeeVJ (talk) 21:35, 12 August 2008 (UTC)
  31. There are a number of very short paragraphs and sections. These are discouraged and should probably be merged or expanded.
    Improved, but still quite a few. delldot talk 04:41, 12 August 2008 (UTC)
    just started on this one...LeeVJ (talk) 21:35, 12 August 2008 (UTC)
  32. " An intracellularly expressed single-chain Fv against the amino-terminal end of mutant huntingtin (mHtt) has been shown to reduce mHtt aggregate formation and increase turnover of the mHtt fragments in tissue culture models of HD." Can the wording be simplified for the lay reader?  Done LeeVJ (talk) 01:00, 27 May 2008 (UTC)
    Good delldot talk 04:41, 12 August 2008 (UTC)
  33. "Intensive therapy: A pilot study on July, 2007, of inpatient rehabilitation for the Italian Welfare system, of speech, mind and body showed no motor decline in the two-year study." This needs rewording.  Done LeeVJ (talk) 17:41, 23 May 2008 (UTC)
    Good delldot talk 04:41, 12 August 2008 (UTC)
  34. The sentence under "Others" under "Research directions" needs a citation or citations.
    Good delldot talk 04:41, 12 August 2008 (UTC)
  35. Any time you have a statistic, it requires a citation. For example, "The prevalence is, on average, between 5 and 8 per 100,000", and "...screening now make it possible (with 99 percent certainty) to have an HD-free child"
  36. It looks like there are an awful lot of primary sources, not the best per WP:MEDRS. Be careful when citing trials to be clear that it's a specific study and not general results, and use review articles or other secondary or tertiary sources whenever possible instead.
    Good delldot talk 04:41, 12 August 2008 (UTC)
  • find references for all 'citations needed'.
  1. Good delldot talk 04:41, 12 August 2008 (UTC)
I have incorporated all the above points regarding missing references here, having tagged sections with 'fact' where required. LeeVJ (talk) 01:34, 27 May 2008 (UTC)
 Done LeeVJ (talk) 16:48, 9 August 2008 (UTC)

I'm failing this for now because I think finding all the needed citations will take more than the week usually allotted for a hold. Please feel free to nominate it again once that has been dealt with, though. I'm glad to give it another look when you want me to to let you know if I think it's ready to go up again. Sorry to be so picky, it really is a very nice article, so I decided to use a very fine toothed comb with the prose. Most of my points are very minor, however the citation needed issues need to get dealt with first and foremost. I'd also recommend having a copy editor look over the article, because there were a bunch of minor wording things that made me think the whole article could use a copy edit. It also looks like some of the areas I pointed out need a little expanding. Please don't hesitate to drop me a note if you need any help or explanation. delldot on a public computer talk 07:18, 21 May 2008 (UTC)

Get down with your bad self Leevanjackson! You're making great progress! delldot talk 07:05, 24 May 2008 (UTC)
thankyou! :) LeeVJ (talk) 21:35, 12 August 2008 (UTC)

Rechecking for new GA review

Update: Leevanjackson's done terrific work, addressing all my concerns from the earlier review. I came across a few more things while re-reviewing (very minor):
  • This sentence is a fragment and too technical: Profound neuronal degeneration in the striatum with some additional atrophy of the frontal and temporal cortices. Done
  • This sentence is confusing: Testing of a descendant of a person, who is 'at risk', has serious ethical implications because a positive result automatically diagnoses one of the parents. Who is at risk, the parent or the descendant? Everyone's a descendant. Possibly just a comma issue (Testing of a descendant of a person who is 'at risk') but the whole sentence should be reworded. Done
  • Only the first word after periods and colons and proper nouns need to be capitalized in article titles.
Not sure about this one, do you mean in the article content? LeeVJ (talk) 22:07, 13 August 2008 (UTC)
  • Some refs need to be expanded, e.g. "Achievements of Hereditary Disease Foundation"--publisher needed, as well as date and author if available.
Some of the refs just don't have this info - do I need to find new ones that do ? LeeVJ (talk) 22:07, 13 August 2008 (UTC)
  • Confusion with its in the following sentence: The precise way it does this is unknown but a reduction in its level increases neuron cell death and creation, leading to atrophy of areas of the brain. - the first it is mHtt, and the second is BDNF, right?  Done
  • Under Social impact, This sentence needs rewriting: Whether or not to have the test for HD Genetic counseling may provide perspective for those at risk of the disease.  Done
Overall, looks great! delldot talk 04:41, 12 August 2008 (UTC)
Article as when this was written ]. LeeVJ (talk) 17:12, 12 January 2009 (UTC)

Usage of HTT for gene, HTT for protein and mHTT for mutant form of protein

Hi Lee- really nice work on the HD article by the way. I stopped by today to make some scattered revisions particularly on the genetics parts. One thing I noticed is the gene symbol/protein symbol issue (discussed here). I switched the gene name to all-caps italics wherever I saw it and the protein name to all-caps non-italics. To my best knowledge, this is the "proper" way to distinguish gene names and protein names. What I don't know is how the mutant protein is designated (mHtt or mHTT). My guess is you can find examples of both usages, but probably mHTT is more consistent with the typical protein designations in humans (as opposed to mouse, where the gene is Htt and the protein is Htt).

Thankyou :) When I looked into it a year ago, there didn't seem to be a concensus in journals etc, but what I did get the gist of was that genes where capitalised, and proteins they produced weren't i.e. HTT the gene, Htt the protein, seemed right so I stopped looking into it. As for mhtt makes sense to me that since it is actually a form of Htt it is just a lower case 'm' denoting 'essentiall htt but altered' also seems right - but I have been known to be wrong! LeeVJ (talk) 00:02, 14 August 2008 (UTC)

Are there other sections that you think could benefit from additional work? I'd be happy to help you get this one GA status. Medical geneticist (talk) 22:38, 13 August 2008 (UTC)

Great! Your copyedits and additions have already been magnificient! As for GA there are a couple of trickies - full details for the citations and some of the short sections. I've reduced the technical jargon over time to something readable and understandable (hopefully) but some of them now need expanding on! An essential piece mentioned yonks ago in peer review that would add help start rounding off the article is about DNA replication! Someone asked about how dna had problems replicating long sequences, ie.e cleavage points and such, but I got lost in translation ;( (sorry) I think they meant for the protein generation - initially I was looking at how the repeat expansion can change as it is passed on, but I think both would be an excellent addition...if there are two functions, like I said I got a bit lost which is why the other wiki articles still need some work! LeeVJ (talk) 00:02, 14 August 2008 (UTC)

Just a litte note

Resolved

I have removed the <BR> tags that were present in some places and not others as it makes the article untidily laid out. Hope no one minds.

—Cyclonenim 17:27, 15 August 2008 (UTC)

I disagree with moving the Social Impact section to "Society and Culture"

I saw the recent move of some of the ethical considerations (Social Impact) to the Society and Culture subheading. While I understand that this is a standard category for MEDMOS, the thrust of that section has nothing to do with the pop-culture aspects and is completely out of context in that section. It's actually quite a non-sequiter to have it in the same section as Arlo Guthrie and "Alice's Restaurant". I'm sure that the change was well-meaning, but IMHO misguided. I would suggest instead that this section go under a different subheading titled "Ethical Considerations". Medical geneticist (talk) 02:00, 22 August 2008 (UTC)

It was me who moved it per MEDMOS. Precisely the intention of the last revision of MEDMOS was to reduce the Pop culture sections and really create a section which had important society things to tell, and if you think about it and just look into the titles a title like social impact should clearly be inside a section called society and culture. It does not have sense to have a separate section. As an example take a look at the Alzheimer's disease society and culture section. I talks about the caregiver burden, economic aspects and also a minor "pop culture" subsection. The alzheimer disease will quite surely become a FA and in its revision everybody has agreed in such section. Similarly AIDS which formerly was a FA and it is still a very good article has in its section of society stigma, economic impact and denialism of AIDS, and no pop culture section in the whole article. Finally I only one to say that if you revert it I won't fight (at least until I get heavily involved with this article) even if I believe it is the correct place for the section. Best regards. --Garrondo (talk) 07:02, 22 August 2008 (UTC)

Like I said, I understand the MEDMOS recommendations, I just think that the implementation in this case is not well executed. It takes something unique about Huntington's disease (i.e. the absolutely fundamental impact this disorder has had on ethics in genetic testing) and buries it in what is now a very strangely organized section. You cite good examples of diseases (Alzheimer's and AIDS) that have a huge impact on society as a whole, where discussion of these issues in that context makes sense. There are certainly analogous issues in HD (stigma, cost of care, impact on insurability etc.) that could be discussed in this section but perhaps the ethical aspects of genetic testing could be moved to a different subsection (not sure where) on the "impact on medical genetics" or something like that. I'm not going to revert your edits, I'll just see if Lee has any strong feelings on the subject. Medical geneticist (talk) 01:31, 23 August 2008 (UTC)

The society and impact section has always been a bit 'messy' and deserves a rewrite - I split off media depictions to stem the flow. A while ago I tried to put the point across about HD being a pivotal stage in genetic testing and ethics, but was unable, at the time, to find decent references and write it in a NPOV way. If you are saying that this is the case from a medgen point of view, then this is a very important part of the article, with better coverage in the lead - probably it's own paragraph! So in conclusion I agree with both of you, I think this is the right section, but the section as it reads now is too 'tucked away', the whole article should be interesting reading and with the important section research directions following it, history preceding, this tail end of the article can be made much stronger. Do you have any ideas MedicalGeneticist, where the best overview of genetics that might put the HD issue in perspective of the field is- it seems to be taken as read rather than stated where I have seen LeeVJ (talk) 11:19, 23 August 2008 (UTC)

Poor presentation of data and discussion

I do think this is generally a very good article, but the presentation of the research in HD is not great. The 'Degradation' section is downright wrong -- it suggests 'a little knowledge' or just reading a couple of articles and misinterpreting them, rather than reading about the area. Uncleaved fragments of mHTT aren't called aggregates. The coalescence of mHTT fragments is thought to form 'protofilmanets' which further coalesce (aggregate) to form inclusions. Inclusions can be nuclear OR cytoplasmic (where they are sometimes called aggregates) and toxicity has been demonstrated with BOTH! This section contains outright contradictions -- "...unprocessed pieces are called aggregates..."; "aggregates consist mainly of the amino terminal end of mHtt" (the second statement is correct). There is plenty of data suggesting a direct correlation between the presence of inclusions and toxicity, however, whether the inclusions themselves are toxic is a different matter and there is also plenty of evidence suggesting that inclusions are cytoprotective.

The 'Mechanism' section in general seems rather weak. Which 'mechanism' is being referred to?

"Like all proteins, Htt and mHtt are translated, perform or affect biological functioning, and are finally dissolved in a process called biodegradation." No. The intracellular removal of functionally redundant proteins is not biodegradation. Proteins are removed via the ubiquitin-proteasome system, a vital system whose dysregulation as a consequence of aggregated mHTT is thought to be a possible source of cellular toxicity in HD. Also I've never seen anywhere the suggestion that HTT is involved in DNA replication.

I realise that a line has to be drawn as to how much detail is gone in to. HD pathology is vastly complex and poorly understood, but the different theories on its mechanisms and the arguments for and against them could be better presented. For good recent reviews, see Imarisio et al, Biochem. J., 2008;412:191-209 (This group is primarily interested in 'autophagy' and HD, so in the interests of a balanced opinion...) and Orr & Zoghbi, Annu Rev Neurosci. 2007;30:575-621.

(Should I be putting this in a bulleted list instead?!) Matstuff (talk) 10:47, 27 August 2008 (UTC)

Thankyou for the analysisand pointers to refs...your previous post wasn't overlooked - just got waylayed in improving the current refs and other GA stuff - in which I included a note pointing it out... The current sections are an artifact of past good faith edits citing primary sources alone and transclusions of huntingtin protein and gen articles, so does need a good work out - please feel free to edit anything! I have recently got hold of the Lancet seminar, and am trying for the Imariso et al ref and will add the neuroscience one to my list ... LeeVJ (talk) 12:54, 27 August 2008 (UTC)

free full text articles

editing tip

top tip: for comlicated articles use wikied , it highlights syntax grays out comments and refs, leaving article text clear to see... brief installation - works in firefox at least... goto to your wikipedia preferences / gadgets - wikied is listed, just activate it and that's it, hope it helps LeeVJ (talk) 12:09, 28 August 2008 (UTC)

I think you mean WikEd. Personally I recommend 'Display an assessment of an article's quality as part of the page header for each article' which can be found under 'User interface gadgets' in your preferences. Really saves some time! —Cyclonenim (talk · contribs · email) 17:12, 28 August 2008 (UTC)
Yep, I did - your tip will also help - it's great, despite it's catchy name ! :) LeeVJ (talk) 22:32, 28 August 2008 (UTC)

Last sentence before " Cognitive" moved

I moved the last sentence before " Cognitive" to "Genetics".Bettering the Wiki (talk) 22:20, 6 September 2008 (UTC)

Not sure if it really fits in this section, which is about the basic genetics. Maybe the mechanism/function section would be more appropriate?LeeVJ (talk) 00:21, 7 September 2008 (UTC)
I disagree;while not perfectly, it fits better where it is. We can delete it, but only as a last resort, when all other places we try fail.Bettering the Wiki (talk) 02:52, 7 September 2008 (UTC)
OK, happy to go with your decision....any other opiniios? LeeVJ (talk) 03:27, 7 September 2008 (UTC)

(undent)Nope.Bettering the Wiki (talk) 12:17, 7 September 2008 (UTC)

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