Misplaced Pages

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• WT:MED

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Regional variation in standards of care

Hi. I am currently in a fellowship and am interested in working on a project that contributes and surfaces information related to regional variations in standards of care by disease state. I have created a mock-up page, titled Hypertension in Scotland, that contains the type of information I am interested in working on in Misplaced Pages. I have realized that similar efforts are currently going on for HIV/AIDS by country (e.g. Category:HIV/AIDS by country). What's the best way for me to go about doing this? Thanks. GT67 (talk) 14:49, 3 January 2013 (UTC)

Thanks for posting here and welcome. First of all an in depth explanation of what you propose to do is probably the first thing needed. I am not sure what surfacing information means? Look at the link above are you proposing to create an article called Hypertension in Scotland than another called Hypertension in Wales, Hypertension in Canada, Hypertension in India etc? We typically have a main article and than subarticle based on our usual sections. Epidemiology in different places would be discussed in Epidemiology of hypertension, etc. Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:17, 3 January 2013 (UTC)

I have talked with this user previously. By "surfacing information" he means that it would be good for users to be able to see standards of care in one place and compare it to the standard in another place. There need not be commentary or sources to back this; the sources for Scotland only talk about Scotland and for Canada would only talk about Canada, and users get to be surprised by seeing variations in the two places. In this model there is no system for discussing the differences overtly or pointing them out on Misplaced Pages because sources which do that would be much more difficult to find and format than the practice guidelines. A key aspect of this is that hopefully, sharing regional guidelines would be something which could be replicated in rote for multiple diseases in many regions. I believe that this user is able to replicate this kind of content if the Misplaced Pages community finds that it is useful. I also think that this could be the basis for starting discussions off-wiki about why there are regional variations in standards of care.

Another way to state the project proposal is that it is to collect a government's description of the standard care in a region, then describe in a Misplaced Pages article the care for that place only. This process is repeated for many diseases and regions. This is interesting only if there is regional variation in standards of care, which there are, and I think that users would be fascinated to see that differences exist.

I see these problems with this model:

1. Misplaced Pages often does not have high quality general articles on health issues, so developing articles on particular regional variations may not be a priority.
2. It is not certain that sources describing care in a particular region will be easily found. Knowing that sources exist would make engaging this project a lot easier.
3. It may not be easy to give all articles parallel structure. I would like to think that the information in one article, say hypertension in Scotland, could be compared with hypertension information for another region. However, this depends how easy it is to identify comparable information in the various sets of source data.

If this project were to proceed, I can imagine there being a section in the base article for a topic which was called "regional variation". This would link to a list of all existing articles on standards of care by region. This could be a lot of work requiring skilled workers, or it could be something which could be done by rote if the source data was understandable and if a model template existed.

About epidemiology - many regions track their own epidemiology. The one to which James linked is sufficient for the base article on hypertension, but there is data for many individual countries. No one has ever thought to add each countries' own statistics to Misplaced Pages because we had enough trouble just giving one global measurement. Undoubtedly this project would be forking each existing health article into a dozen or even a hundred more articles.

If it really were feasible to incorporate this sort of information into Misplaced Pages then I think that would radically improve the quality of health articles on Misplaced Pages in a way that only Misplaced Pages and not other communication platforms could deliver. The potential for interlinking in this way would be very difficult to do outside of Misplaced Pages and this is a novel and very creative idea. I think that this idea deserves consideration. Blue Rasberry (talk) 15:56, 3 January 2013 (UTC)

Sure a better example is here Epidemiology_of_obesity. Doc James (talk · contribs · email) (if I write on your page reply on mine) 16:31, 3 January 2013 (UTC)

That is a much better example... wow, this is very close to the original proposal. I will have to think about that. Blue Rasberry (talk) 16:53, 3 January 2013 (UTC)

Thanks for your feedback. I'd be happy to clarify further. Blue Rasberry has expanded on the key points well. I've learned that many countries view and/or tackle disease states differently, whether it be due to cultural, societal, economic or other reasons, and this type of information is not readily available for all to view in one standardized place. The mock-up article I created, is an example only, of the facets of information that can vary. To add to Blue Rasberry 's comments on 'surfacing information', perhaps patients and patients advocates at the local level of these regions would have notable resources that are available/visible to them that perhaps may not be to the rest of us. Doc James's example of Epidemiology of Obesity speaks to the notion of surfacing a facet of the regional standards of care and I've also seen the Management of Obesity article, which could potentially have the same notion of regionalization applied. I could also envision articles to fork into other facets such as Diagnosis by region as well. I've also seen the format used in the Category:HIV/AIDS_by_country, which stems from the Portal link of each country's articles page (see 'Health in China' in Portal:China page) and seems to mash together information into one article location. Both of these are great examples for structuring regional variations. I'd be interested to know which type of article structure would be deemed most editor- and user-friendly. GT67 (talk) 18:11, 3 January 2013 (UTC)

IMO each subarticle could deal with national variations as it pertains to that subtopic. This would allow people to more easily compare different stats or practices in different countries. Typically this is too much detail for the main articles. These articles often already exist and could simply be added to. I am not a big fan of "disease in X" format as it is not clear how they would be linked in. Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:51, 3 January 2013 (UTC)

@GT67. Is it possible you could improve unwarranted variation? Biosthmors (talk) 20:54, 4 January 2013 (UTC)

@Biosthmors. You bring up a good point. Surfacing information around regional variations in care may help discern where unwarranted variation exists. One could envision this sort of information to populate and look something similar to John Wennberg's work at the Dartmouth Atlas of Health Care, but on a global-regional, scale. And one could argue that with this sort of information organizations, similar to the NCQA in the U.S., could potentially be a vehicle for improving some of these variations. However, determining the route cause of the unwarranted variation is debatable. GT67 (talk) 18:45, 5 January 2013 (UTC)

@Doc James. I believe I understand what you have in mind. I'm going to mock-up some articles and see if the structure is on par with what you are thinking. Thanks. GT67 (talk) 18:45, 5 January 2013 (UTC)

I've reformatted my original mock-up article (Hypertension in Scotland) and have broken it down into subtopic articles. I want to be sure the format aligns with what you have in mind; the Epidemiology_of_obesity article also contains a "regional box" at the bottom of the article. It sounds as though you prefer to have regionalization within the subtopic article as follows: Management of Hypertension, Diagnosis of Hypertension, and Epidemiology of Hypertension (please note the sections I filled in for "Scotland") rather than a regional box stemming off of the main article (See "External links" section of Hypertension). Does this look on par with what you have in mind? Thanks. GT67 (talk) 23:19, 8 January 2013 (UTC)

After chatting with Biosthmors, I learned that the mock-ups were a bit too detailed in faceted information and did not align well with the summary style format; I could see how this could introduce clutter. Additionally, as Doc James mentioned, it would be better served to follow a format similar to the Epidemiology_of_obesity article, where each subtopic that presents variation would fork out to separate articles, and offers side-by-side comparison of the regions. My next question is, in WikiProject Medicine, when is it deemed the appropriate time to fork out a separate subtopic (e.g. Epidemiology of obesity or Management of obesity) from the main article if let's say those articles did not currently exist? Thanks. GT67 (talk) 15:25, 18 January 2013 (UTC)

Leverage a possible recommendation letter from WP:MED M.D.s in return for great contributions?

Many new editors that get introduced to Misplaced Pages through the Education Program in the sciences are pre-med (here's one). They would like to obtain recommendation letters to get into medical school. I think we could retain some of them to raise the quality of our important articles to GA if there were some WP:MED M.D.s willing to mentor/interview them online a bit (maybe three 30 min skype interviews)/and oversee some of their edits in return for a letter of recommendation. Maybe we could even recruit some M.D.s to help out with this even if they weren't super active Wikipedians. Comments? Biosthmors (talk) 00:34, 17 January 2013 (UTC)

User:JMathewson (WMF) (Jami Mathewson) of the Misplaced Pages Education Program was planning some kind of certification program for anyone who participated in Misplaced Pages projects and wanted some kind of reference. It might be a good idea for meta:WikiProject Med to develop standards for certification for medical courses, then allow students or anyone else to go through the screening process for that organization and get a recommendation from that organization. The idea that Jami was exploring was for the upcoming thematic chapter which will handle the US and Canadian education program to issue certificates or recommendations for that program, but I am sure they would love for other organizations to share some of the reviewing responsibility and if WikiProject Med wanted to take on that role then that would be an excellent way to partner with the education program.

If anyone were to explore this further, I would recommend checking in with Jami to see if anyone has already drafted a certification process. If not, then it needs to be drafted. Once it is drafted, then the education program and the medical review project could share it and encourage other organizations to also emulate the model if they liked in other fields.

There are other potential advantages to partnering with the education program, and the disadvantages which come to my mind are not so great. Thoughts? Blue Rasberry (talk) 01:04, 17 January 2013 (UTC)

Yes I think it would be appropriate to send out letters of recommendation. If a student comes and significantly improve an article here I would personally feel comfortable writing said letter. Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:10, 17 January 2013 (UTC)

I like the spirit of this, but would such a letter carry much weight? An important preamble to a medical school recommendation letter is the basis of the recommendation - is it based on personal knowledge and substantive interaction? I hope students will consider this carefully. How would the letter-writer know who did the editing they are judging? Compare this with a university faculty member who leads a WP-editing course during which login-sharing would represent academic fraud. I think the stakes are too low while editing WP casually for it to be a meaningful academic activity, and identity would be very hard to confirm. In the end, such a letter might be a liability or an asset, and students should seek guidance from an academic adviser. I just don't want to manipulate very vulnerable editors if the only clear benefit is WP content. -- Scray (talk) 03:47, 17 January 2013 (UTC)

Or the student uses (or declares) their real name and ends up making a right mess of their contributions. Either because they didn't understand the subject well enough, didn't understand plagiarism issues, say, or picked a hot topic where they had to mix with some unsavory types. That could bugger-up their chances of med school for good. Colin° 11:39, 17 January 2013 (UTC)

Is there some reason those risks identified by Scray and Colin cannot be avoided by the proper design of the "standards of certification for medical courses" that Blue Rasberry discussed? LeadSongDog come howl! 14:32, 17 January 2013 (UTC)

Scray - I think that gaining an understanding of how Misplaced Pages works is increasingly becoming a fundamental job skill in many fields, including medicine. If the patients of any health care provider are getting health information from any online media source at all, then the most likely source of that information is Misplaced Pages. Because of this, I think that health care providers who work with people who use the Internet as an information source should understand how Misplaced Pages works and what information it contains. Certification for minimal Misplaced Pages literacy has value. This program could expand from student certification to health worker certification or into certain countries' "continuing education" requirements for jobs, because the Internet-using demographic is becoming increasingly important as a health education outreach audience.

Colin and LeadSongDog - I also think there are a lot of problems with this proposal and I do not want to sort through all of them. If possible, I would like to tie the success of this program to the success of the Misplaced Pages Education Program. That project is already to come up with a certification program of some kind and the people with that must develop something. If we work with them then at least they will be forced to manage reputation control for worst case scenarios, which I think is the most difficult and boring part of this to manage. I think that no one wants for this program to harm anyone who cannot complete it. Blue Rasberry (talk) 14:45, 17 January 2013 (UTC)

I don't have a problem with this per se. With that said, I think that there are a couple related issues that might argue against a student asking for such a letter in the first place

1. There remains an academic bias against wikipedia as a reliable, scholarly endeavor. With very rare exceptions, I think it's probably safe to say that a letter from a WPian based on activity here will still, and for the forseeable future, get you the proverbial side-eye, because it seems unlikely to me that as a whole, admissions committees (AdComs) are going to be composed of people who do not share this bias.
2. My understanding (and I have not sat on any admissions committees but i do have some experience with this, please feel free to contact me on my talk page or directly) is that the reasons AdComs like seeing LoRs from professors is that professors have direct, substantial contact with students, and see a lot of students each year and so are prepared to assess the promise of their students in a way that e.g. an employer is not (for reasons of turnover, standards of progress, etc). I don't get the sense that a LoR from someone on WP would go very far towards addressing the largely-unstated requirements there.

With that said, if someone has the room to pursue this (other good strong letters, etc) I would have no issue with it. It puts the issue out into the minds of AdComs, which can be useful in changing the debate. In the near term though, it has the potential to reflect negatively rather than positively on an applicant. If an applicant is otherwise strong it may be worth that risk.

-- UseTheCommandLine (talk) 20:34, 17 January 2013 (UTC)

The opinion of medical school regarding Misplaced Pages has changed dramatically over the last few years. The dean of UCSF attended one of my talks about Misplaced Pages and Medicine last week and the assistant dean with whom we meet was interested in the project. As the most read medical resource on line and thus in the world we are in an interesting position. If a students came and did prominent work to an article I would have no problem with WikiProject Med. Foundation giving a LoR that states this. Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:07, 18 January 2013 (UTC)

I agree that the prevailing opinion of WP is improving. That's not the same as saying that working on WP, or a letter from a WP editor whom the student has never met, would carry much weight. There's a real risk here of manipulating the hopes of vulnerable students. I'd be much more swayed by a letter from a research mentor with whom an applicant worked personally and co-authored a peer-reviewed publication (where the mentor can attest to identity, integrity, reliability, and attention to detail). I am not saying it (editing WP in hope of a recommendation-at-a-distance) is without merit, but we have a conflict of interest that should be acknowledged (we need editors, and we might value WP's goals more than we value the those of the student-editor). -- Scray (talk) 03:54, 18 January 2013 (UTC)

Heads up on HIV topics

An upcoming paper is getting a lot of fanfare:

• Ann Apolloni, Haran Sivakumaran, Min-Husan Lin, Dongsheng Li, Michael H Kershaw, David Harrich (January 8, 2013). "A mutant Tat protein provides strong protection from HIV-1 infection in human CD4+ T cells". Human Gene Therapy. doi:10.1089/hum.2012.176. {{cite journal}}: Unknown parameter |laysummary= ignored (help)CS1 maint: multiple names: authors list (link)

HIV-related articles are going to need a close watch. LeadSongDog come howl! 16:04, 18 January 2013 (UTC)

This would be FANTASTIC if it bears out to be true after much further scrutiny, study and independent verification and testing! But not for Misplaced Pages articles right now... Thanks for the heads up. Zad68 17:06, 18 January 2013 (UTC)

Rashomon effect

At WT:JAPAN we are discussing if adding macron (diacritic accents) to this title to conform to the Japanese romanization of "Rashōmon" is original research or correcting bad spelling and whether MOS:JAPAN applies to this psychological concept. You are invited to respond. -- 76.65.128.43 (talk) 11:03, 19 January 2013 (UTC)

Medical uses of silver

Concerns at the above article. User is trying to emphasis the benefits of silver. And is removing secondary sources that question its benefits in this edit Also attempting to deemphasize the Cochrane conclusions. Doc James (talk · contribs · email) (if I write on your page reply on mine) 08:30, 20 January 2013 (UTC)

Clarity...differential diagnosis and diagnostic approach sections

As per WP:MEDMOS#Symptoms or signs; the suggested template contains both the above headings. Exactly what should be in these sections? To me, differential diagnosis section might be a list of possible causes of a given sign or symptom. If so might this be also covered in the mechanism/pathophysiology section? Then again, this section could be a list of similar things which can be mistaken for the sign/symptom in question and how to differentiate them. Is the diagnostic approach section intended to be essentially a description of a diagnostic algorithm? Or a list of special investigations that might be involved in the diagnosis? lesion (talk) 00:46, 21 January 2013 (UTC)

If an article is primarily about a symptom or sign, the sections about differential and diagnostic approach should cover the possible causes (differential) and how physicians will normally distinguish between them (diagnostic approach). An article such as diplopia should contain a referenced list of differential causes, and a section on how diplopia is investigated in routine practice. JFW | T@lk 06:57, 21 January 2013 (UTC)

Ty for clearing this up...so the differential diagnosis section is more a list of possible causes, rather than a differential diagnosis in the strict sense of the word. Maybe the diagnostic approach section would be better termed differential diagnosis, and the differential diagnosis section just called "causes" or something...lesion (talk) 14:46, 21 January 2013 (UTC)

Template:Did you know nominations/Hair-brushing syndrome

Hi, would anyone be willing to weigh in on sourcing at this this DYK nomination? The article seems to be of the kind which should follow MEDRS, but I'm not quite sure how it would apply and if there is any wiggle room. Thanks. — Crisco 1492 (talk) 01:02, 21 January 2013 (UTC)

Only two reported cases...is this notable enough for an article? "hair brushing syndrome" gave no pubmed hits. Agree none of these refs meet the above guidelines. lesion (talk) 01:19, 21 January 2013 (UTC)

Ghastly. Didn't know the Daily Mail was a medical journal. JFW | T@lk 06:58, 21 January 2013 (UTC)

Graves' disease

Have brought this issue to ANI Not sure if people here wish to weight in. Doc James (talk · contribs · email) (if I write on your page reply on mine) 06:24, 21 January 2013 (UTC)

Noticed a new WP:COI/potential spam target

So I've been watching the articles Contract research organization and List of contract research organizations and making occasional edits for a couple months now. The list page is a fairly attractive target for drive-by spammers, but I've now run into two separate instances of editors adding a seemingly non-notable company's name to the list page, and when I look at the editors' talk or user pages, it looks like a prospective wp article for the company in question. I nominated one, User:Richmond pharmacology for deletion at WP:MFD, but after coming across the second one, User:Thessence, I am beginning to think that this is going to occur more frequently, and I'm not sure how to handle it. I have not yet dug through the history of the list page to try and identify similar pages.

I am wondering which other wikiprojects or pages i should mention this on? I know this is not, strictly speaking, a medical page, but it doesn't look like the wikiprojects on businesses are particularly active.

advice and direction would be appreciated. -- UseTheCommandLine (talk) 00:35, 22 January 2013 (UTC)

WP:PHARMA or WP:MCB might be interested. WhatamIdoing (talk) 01:01, 22 January 2013 (UTC)

These two examples are from 2008 and 2009 respectively. My concern is more when companies come and try to alter our disease related articles when they raise evidence that is negative towards something they sell. And when they do this as a way to effect regulators and maintain their profits. Doc James (talk · contribs · email) (if I write on your page reply on mine) 02:41, 22 January 2013 (UTC)

History of both High and Normal ANA Levels

I have a History of both High and Normal ANA Levels, and I found the Compounds that raise my ANA Level, in Medications and Foods and some Bacteria and Fungi, and made my ANA Level Normal to stop the pain. I need a peer review of my findings on my talk page, we may be able to lower other People/s ANA Level to stop the pain. Stopping taking Medications is the only way to stop the pain and Lower the ANA Level, because all of their pains Medications and Antibiotics and most of the other classes of Medications, contain Inert Ingredients that raise my ANA Level, causing the Immune System to destroy many different parts of my Body that show up on CAT Scans and X-rays and Urine Tests afterwards. JosephLoegering (talk) 05:22, 22 January 2013 (UTC)

We are here to write an encyclopedia by summarizing the best available literature. The above is sort of out of scope. Doc James (talk · contribs · email) (if I write on your page reply on mine) 06:22, 22 January 2013 (UTC)

JMIR Wiki Medical Reviews

Per Gunther as posted JMIR Publications is currently (Jan 2013) pilot-testing an innovative peer-reviewed journal JMIR Wiki Medical Reviews which sets out to publish Misplaced Pages (Review) and Wikiversity (Original Works) papers. Authors who have made significant contributions to Misplaced Pages articles are invited to submit the article to http://wikimedical.jmir.org/author

JMIR Wiki Medical Reviews (JMIR Wiki Med Rev) is an innovative journal which takes the best wikipedia articles in medicine, peer-reviews them, and publishes them as citable scholarly review article, with the goals to 1) Improve Misplaced Pages articles, 2) enhance public trust in the accuracy of medical Misplaced Pages articles, 4) improve visibility and indexing of outstanding Misplaced Pages articles (e.g. by indexing in bibliographic databases and featuring them on JMIR), 5) to acknowledge authors who volunteer their time on wikipedia to improve articles by listing them as authors in a "citable" publication, 6) to add an additional layer of formal peer-review to wikipedia articles (JMIR Wiki Med Rev - About us/Focus and Scope)

JMIR Publications will publish the first 20 articles free of charge, deposit them in PubMed Central, and will apply for PubMed indexing. JMIR Wiki Medical Reviews is hoped to become the first peer-reviewed journal publishing Misplaced Pages articles.

Dr James Heilman has agreed to serve as Editor-in-chief, other editorial board members are to be recruited (ideally active in Misplaced Pages Medicine). Editorial board members encourage Misplaced Pages authors to submit their articles to the journal for peer-review, select external peer-reviewers, and guide articles through the peer-review process. The publisher (JMIR Publications, represented by Dr Gunther Eysenbach) will coordinate production, which includes converting the Misplaced Pages article into XML, and depositing the articles in various bibliographic databases and full text databases. It is hoped that the journal will be Medline-indexed and will receive an impact factor. For the latter it is important to primarily publish articles which will be highly cited.

Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:07, 22 January 2013 (UTC)

Fantastic. I will be helping with this effort. Biosthmors (talk) 22:29, 22 January 2013 (UTC)

Seriously, Doc James is always making me feel bad with all the wonderful work he does. Yobol (talk) 04:50, 24 January 2013 (UTC)

What can we do to help?Remember (talk) 23:32, 22 January 2013 (UTC)

Awesome! Bagsy a place on the editorial board. Axl ¤ 00:19, 23 January 2013 (UTC)

Does bagsy mean you want to be on the editorial board? I hope so, because I think that would be great news! Biosthmors (talk) 19:19, 23 January 2013 (UTC)

_{Yes. Although it may be British schoolboy slang. Axl ¤ 12:30, 24 January 2013 (UTC)}

I agree with others. This is obviously great news. Flyer22 (talk) 00:23, 23 January 2013 (UTC)

As far as I am aware, to help this succeed, we need to produce great content for publication and/or serve on the editorial board. Biosthmors (talk) 00:45, 23 January 2013 (UTC)

Yes exactly. I need all of you people to join me :-) Doc James (talk · contribs · email) (if I write on your page reply on mine) 06:54, 23 January 2013 (UTC)

Very interesting, indeed. What a pity that I don't know English --SU ltd. (talk) 16:54, 23 January 2013 (UTC)

You read, write and translate/understand English sufficiently enough, SU ltd. So I don't see why you wouldn't be able to participate, unless you are busy or would rather not. Flyer22 (talk) 19:14, 23 January 2013 (UTC)

Thank you very much, Flyer22. If you, a native speaker of English, consider my English sufficiently enough, then I’ll be glad to take part. I’ll be away about a month or two. As soon as I’m back, I’ll share my opinion on that if you consider it possible. Personally, I can’t agree with 7mike5000. To my mind, Jmh649 undertakes a great thing. --SU ltd. (talk) 17:02, 24 January 2013 (UTC)

LOL, you created Russian versions of those soap opera couple articles I created, SU ltd.? *Blushes* I'm not sure how interested Russian audiences are or would be in those couples, but thank you for spreading the knowledge. Flyer22 (talk) 20:45, 24 January 2013 (UTC)

BTW, Russian audiences use Cyrillic script (unlike the Poles). If you see texts in a Latin alphabet, they can’t be written in Russian. Sometimes I write something in a foreign language just for a change because I neither watch TV nor listen to music. As for the rest of audiences, they don’t matter to me. They have undoubted right to watch TV and go to the cinema if they like. --SU ltd. (talk) 02:38, 25 January 2013 (UTC)

And about the encouragement, you're welcome. Flyer22 (talk) 20:52, 24 January 2013 (UTC)

I was not an author on the article, but Influenza seems like a good article to go through the publication process since it is already a FA and has lots of global public health implications. Remember (talk) 14:08, 23 January 2013 (UTC)

Certainly. Will need a lead person take it on. IMO there is still some work to do. Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:27, 23 January 2013 (UTC)

Hmm. Would ketogenic diet be suitable? It needs an update with some recent reviews, though I don't think anything drastic will change as a result. Perhaps I may even get round to writing a decent epilepsy article. -- Colin° 16:09, 23 January 2013 (UTC)

I sure hope ketogenic diet would fly. I want the journal to also have enough scope to publish fundamental topics to the field of medicine itself, such as blood coagulation and human circulatory system. I think we should use the journal to get topics that are valuable to medical students upgraded in quality. Medical students are a very valuable target audience or "constituency" for WikiProject Medicine. Biosthmors (talk) 19:15, 23 January 2013 (UTC)

Must you keep raising the bar? You're making the rest of us look lazy... Now I'm wondering how Misplaced Pages:WikiProject Academic Journals is going to address this from secondary sources ;-) LeadSongDog come howl! 20:02, 23 January 2013 (UTC)

I think he's a group account. That's the only possible explanation. --Anthonyhcole (talk) 05:15, 24 January 2013 (UTC)

I've met one of him. My theory is some sort of space-time manipulation where he gets 48hr days and the rest of us struggle on 24. Certainly I don't know anyone who isn't also called James who gives more to Misplaced Pages. Colin° 11:40, 24 January 2013 (UTC)

Thanks for the words of encouragement. It has sort of gotten into my head that what we are doing here truly matters. I have been unable to shake this feeling and thus wondering around promoting Misplaced Pages to whomever I run across. I'm uncertain if I am starting to annoy people yet :-) Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:45, 25 January 2013 (UTC)

My interest is piqued, but I'd appreciate clarification. Having recently signed up with the Misplaced Pages Education Program where I am getting a crash course in the ways of WP editing, primarily by our terrific Ambassador, Biosthmors. I have just explained to my students how a Misplaced Pages article should be written in the style of an encyclopedia and not in the style of a review article for a scientific or medical journal. Differences include the emphasis on secondary sources rather than primary sources in WP articles. This is in contrast to professional review articles which (speaking as a scientist, but not an MD) I would expect to include more information about the underlying research. Biolprof (talk) 05:12, 25 January 2013 (UTC)

Yes so these are going to be Misplaced Pages style literature reviews which will be slightly different than standard literature reviews. Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:42, 25 January 2013 (UTC)

I just stopped by to post about another article (see below) and I just happened upon this thread. This is a great idea, and it is exciting! Good luck to all contributors and participants. --- Steve Quinn (talk) 06:03, 25 January 2013 (UTC)

Authorship question

If someone were to support an article for publication as the author, what are the requirements? Do they have to have added a large portion of the text to the article? Do they just have to support it during review and make all the necessary corrections? I may be interested in helping to get an article published, but I don't want to bite off more than I can chew. Remember (talk) 18:20, 24 January 2013 (UTC)

I doubt having to contribute a large portion of text would be a requirement. A current featured article might not need much updating on the prose and sources, but I do think an author should know the level of text–source integrity of the article and the recent literature. Biosthmors (talk) 20:08, 24 January 2013 (UTC)

As an author you need to feel comfortable standing behind the text as your name will be attached to it. Typically I would say this would require having made a fairly substantial contribution to it.

Typically this should apply for any article you have helped bring to GA/FA. I am hoping that this will encourage more people to get involved. Currently less than 1% of our medical articles has passed GA or FA thus there is a lot to chose from.

How we would handle authorship in cases where the submitting author is not one of the top authors I do not know yet. Instinctively I would prefer if this were not the case. If one has never made an edit to the article your name will not be applied. If one has only made minor changes you will be listed as a contributor rather than an author. Where this cut off will be than is the next question. Major journals allow ghost writing but this is not something I am happy with.

There is no perfect way to determine who has made the most contributions. We have this tool that breaks down edits by time and number by editor but of course different people edit in different style. Some people may make a bunch of grammar changes while other may write large amounts in one go. I think part of this will be discussion with the 10 most frequent authors. Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:07, 24 January 2013 (UTC)

Editorial board size and responsibilities?

I was thinking of doing some outreach to M.D.s or Ph.D.s without current involvement in Misplaced Pages to invite them to participate as an editorial board member of JMIR Wiki Medical Reviews. Do we have a theoretical maximum of people for positions on the editorial board? 10? 15? 20? What are the expectations? A certain amount of peer-reviews? Biosthmors (talk) 20:08, 24 January 2013 (UTC)

Probably best to direct this to Gunther. I am not sure how many people he wishes. I am going to ask a few docs at UCLA if they would be interested. A number have expressed interest in Misplaced Pages before. I have already sent a note to UCSF. Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:12, 24 January 2013 (UTC)

Feedback

We've discussed the WP:Article feedback tool/Version 5 here before, so I some of you may be interested in Misplaced Pages:Requests for comment/Article feedback. The RFC is trying to collect information from a variety of people who follow feedback to see what they think about it. WhatamIdoing (talk) 21:25, 22 January 2013 (UTC)

New article and DYK nomination

Template:Did you know nominations/podoconiosis. Biosthmors (talk) 01:49, 23 January 2013 (UTC)

Copyediting needed on sciatica

An OTRS ticket pointed me to a problem with the Sciatica. I've flagged it up on the page and talk page. If you know about the subject and have a few minutes, it'd be great if it could be fixed. —Tom Morris (talk) 18:40, 23 January 2013 (UTC)

COPD Cough Sound File for Bronchitis Page

Hey guys, if there are any physicians out there, I have a question for you. While searching through sound files on wikipedia, I came across some sound files that a peer-reviewed paper made available and two of the sounds were COPD coughs. Both were productive coughs and had wheezes. My question to you is whether a COPD cough file will be sufficient for the bronchitis page. I understand that chronic bronchitis is a type of COPD, but does the cough in emphysema sound any different from a chronic bronchitis cough? Or will a sound file of a COPD cough sound the same? I also believe I read something that said that chronic bronchitis patients may also have emphysema, so that is also why I am wondering if the cough is the same. This is the paper from which the cough sound files were taken: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1413549/?tool=pmcentrez and it is cough sound files 2 and 9 (2 is COPD with bronchiectasis and 9 is just COPD with bronchiectasis both with productive coughs with wheezing but the paper is more detailed). Thank you in advance for your input and help. TylerDurden8823 (talk) 06:46, 24 January 2013 (UTC)

"Bronchitis" is a rather vague term, and includes different disease processes. I'm not convinced that the "Bronchitis" article should be expanded in this way. It would be better to use only very brief descriptions, leading to the main articles "Acute bronchitis" and "Chronic bronchitis". In turn, "Chronic bronchitis" should also be a brief article leading to "Chronic obstructive pulmonary disease".

I'm not sure of the licensing situation of those sound files. If they have free licenses, the files should be uploaded to Wikimedia Commons. Otherwise, it would be better not to use them in Misplaced Pages at all.

Regarding license, I think the sound files have already been uploaded to wikipedia or to wikimedia commons and are available to use. If you search cough under multimedia you can find the sound files. This addition to the bronchitis article was suggested during peer review. Axl, there are still links on the bronchitis page leading to main articles about acute and chronic bronchitis.TylerDurden8823 (talk) 15:15, 24 January 2013 (UTC)

Most cases of COPD have a mixture of bronchitis and emphysema (in the pathological sense), in various proportions. Pure emphysema causes very little cough, and it would generally be "dry". Axl ¤ 10:41, 24 January 2013 (UTC)

Most acute bronchitis has no wheeze. I could take a recording of it next time I hear one.

With respect to license, yes sound files must be CC BY SA or the like. Doc James (talk · contribs · email) (if I write on your page reply on mine) 13:39, 24 January 2013 (UTC)

To clarify for everyone, I am specifically asking about the difference in the cough sound of chronic bronchitis and emphysema (if there is a difference). TylerDurden8823 (talk) 15:12, 24 January 2013 (UTC)

Not that I have ever seen described. All cough excepted maybe that of croup (barky) and whoop cough (cough until you vomit for 100 days) are more or less the same. Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:22, 24 January 2013 (UTC)

I would expect the cough of chronic bronchitis to sound "wet" (i.e. implying the presence of significant sputum/mucus) and that of emphysema to sound "dry". (This is my own "original research".) The study participants identified this feature correctly in 76.1% of cases; random guessing would be correct in 50% of cases, so this isn't an impressive figure. As I noted above, cough is not a significant feature of pure emphysema. Axl ¤ 20:38, 24 January 2013 (UTC)

So, is the bottom line here that the cough sound file of COPD/bronchiectasis that sounds wet with mucus/sputum and wheeze an accurate representation of the cough expected in a chronic bronchitis patient? Would you agree that this is a fair representation? TylerDurden8823 (talk) 00:14, 25 January 2013 (UTC)

Bronchiectasis typically sounds rather more wet than chronic bronchitis. People with bronchiectasis produce a lot more sputum than those with chronic bronchitis. I would not say that the sound file of COPD/bronchiectasis is a fair representation of chronic bronchitis, but there is a degree of overlap. In particular, during acute exacerbation of COPD, the "wetness" is more marked. Note that this is just my opinion, not a "fact" and not suitable for stating in an article. Axl ¤ 17:09, 26 January 2013 (UTC)

Remember, that's only one of the COPD cough files that is classified as COPD/bronchiectasis. What about the one listed solely as a COPD cough?TylerDurden8823 (talk) 17:57, 26 January 2013 (UTC)

Infectivity period for measles

I am trying to understand what the definitive answer to the infectivity period of measles is.

There are many views on this on the net but I am sure one knows by now the truth. The wikipedia article on measles lists two different views:

The period of infectivity has not been definitively established, some saying it lasts from two to four days prior, until two to five days following the onset of the rash (i.e. four to nine days infectivity in total), whereas others say it lasts from from two to four days prior until the complete disappearance of the rash.

Any thoughts?

Jaeljojo (talk) 19:41, 24 January 2013 (UTC)

1. "Measles".
2. "Measles".

Misplaced Pages use by medical students

Summary:

• Letter to the editor
• 6-year study on 361 participants, Australia
• 94% used Misplaced Pages while studying
• 85% of non-users said Wikipeda was unreliable
• Use was not significantly correlated with year of study (R=0.67, p=0.12)
• Decline in use as a first resource was significantly correlated with year of study (R=0.81, p < 0.02)
• Significant declines also seen with perceived reliability, use as the only resource, and being the most common resource over time
• Ease of access and understanding as important strengths
• Last sentence: "Medical school administrators would benefit from embracing and developing web2.0 resources and include their use in ongoing dynamic medical education."
  Allahwala UK, Nadkarni A, Sebaratnam DF (2012). "Misplaced Pages use amongst medical students - New insights into the digital revolution". Med Teach. doi:10.3109/0142159X.2012.737064. PMID 23137251.{{cite journal}}: CS1 maint: multiple names: authors list (link)

Corresponding Author: Usaid K. Allahwala, Royal North Shore Hospital, Sydney, Australia. I can contact Allahwala about doing an WP:AFSE, or if someone else wants to, feel free. Let's not all email though. =) Biosthmors (talk) 21:34, 24 January 2013 (UTC)

Some of these results (decline in use) should be no surprise when we consider that some editors resist scientific depth added by others, arguing that WP is for a general readership. I think this is one reason scientific experts editors lose interest. I'm sure this isn't uniform, just an individual observation (it's been awhile since I've seen this, in part because I self-censor scientific depth). -- Scray (talk) 03:53, 25 January 2013 (UTC)

I think the most likely reason for decline is less than 1% of our articles are of high quality. There is a huge amount of work to do. People have higher demands of sources as they get closer to actual practice. This of course is a good thing. And I do not want to convince this group to read Misplaced Pages I want to convince them to write it. On Scary's point if anyone sees someone removing scientific depth that is well sources paste here and I am sure some of us will be happy to look into it. We have article nesting with sub articles where we can go into as much depth as anyone would care for. We have an article on obesity a in depth one on management called Management of obesity and an even more in depth one on a single aspect of management Bariatric surgery and an even more indepth one on a type of bariatric sugery Vertical banded gastroplasty surgery. Yes some of the subarticles need work. Hopefully this next generation of physicians will take it on. Doc James (talk · contribs · email) (if I write on your page reply on mine) 12:27, 25 January 2013 (UTC)

I was throwing away my 1st year notes (would have been 2005) a few weeks ago... I had printed of the 2005 fever wikipedia article. I compared it to the current article and it is significantly better now. I suspect many sections in mainstream textbooks on the topic would be less thorough. It is no wonder students are using WP more and more. lesion (talk) 14:48, 25 January 2013 (UTC)

I was going to state that Scray has a good point on this. But then I read what James and Lesion think and feel that those are good points as well. Each post brings up things that play a role, or likely plays a role, in the Misplaced Pages readership among medical students. Flyer22 (talk) 03:01, 26 January 2013 (UTC)

Category:WikiProject Medicine descendant projects

Category:WikiProject Medicine descendant projects has been nominated for deletion, by merging it into Category:WikiProject Medicine -- 76.65.128.43 (talk) 01:53, 25 January 2013 (UTC)

Need a new title?

I just created DNA computing (2013). This is the only name I could think of because the sources did not appear to specifically have a title. I based this wiki-title on the central theme. Anyway, if anyone can think of a better name for this article I am open to suggestions here. -- Steve Quinn (talk) 06:08, 25 January 2013 (UTC)

It doesn't look like it's a WPMED article... wouldn't this be a question for WP:COMPUTING or WP:MCB? -- 76.65.128.43 (talk) 09:39, 25 January 2013 (UTC)

Charity promoting itself?

This user who is now editing as an IP keeps changing the words to link to his website . And keeps adding these links to a number of pages. Thoughts? Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:47, 25 January 2013 (UTC)

Although apparently well intentioned, we don't link to external websites like this. Yobol (talk) 19:53, 25 January 2013 (UTC)

Life support article

There's a problematic issue at the Life support article. Fairly new registered editor AlanPage007 added some WP:Original research combined with WP:SOAPBOXING (along with speaking to readers in first person, which violates Misplaced Pages:Manual of Style#First-person pronouns). See here and here. As that second link shows, he's likely to revert anyone who removes his addition. His addition also comes before the medical definition. I removed his user name from the article.

I'm surprised that this article is in such a bad state, with or without AlanPage007's addition. Flyer22 (talk) 21:50, 25 January 2013 (UTC)

I've removed the offending paragraph and restored the uncited template, and left him a note on his talk page with some advice. If he reverts again then he should probably be blocked until he reads WP:EW and WP:V at the very least. The real problem, of course, is that the article is just as unsourced as his addition, so really could do with some attention if anybody has some decent sources - perhaps some medical textbooks or handbooks for emergency responders might contain something that is relevant? --RexxS (talk) 23:14, 25 January 2013 (UTC)

Thank you, RexxS. I may look into fixing that article up with WP:MEDRS-compliant sources at some point. Hopefully, one or more other WP:MED participants, or non-WP:MED participants, help out with that at some point as well. Flyer22 (talk) 00:21, 26 January 2013 (UTC)

WP:MED pages needing attention, which needs are the most important?

User:Jtmorgan has agreed to help us by developing some code when he has spare time (which is limited) to make a pilot page that will track the backlogs or open processes of 10 project-related needs. I imagine it will be a mini and WP:MED version of Category:Misplaced Pages backlogs. This pilot will hopefully grow to create a one-stop-shop making the separate (and mostly outdated) pages like Template:MCOTWannounce, Misplaced Pages:WikiProject Medicine/Article alerts, Misplaced Pages:WikiProject Medicine/Cleanup listing, and Misplaced Pages:Pages needing attention/Medicine obsolete and unnecessary. (The long-term goal is to submit an IEG that can result in a system can automatically create default (and customizable) project need pages for every WikiProject, active or not.) I plan on suggesting that we keep track of Category:Unassessed medicine articles, Category:Medicine articles needing expert attention, Good article nominations, Requests for Comment, Peer reviews, Category:Articles to be merged, Category:Articles lacking sources, Category:NPOV disputes, articles tagged with {{medref}}, and articles tagged with {{mcn}} for the 10. If anyone has recommendations for other categories in case one/some of these won't work or aren't that important to you, let me know. Biosthmors (talk) 01:30, 26 January 2013 (UTC)

Not sure if this would be possible, or even useful... an auto generated list of article rating by date. E.g. an article is initially rated as stub or start... a lot of time may pass and the article outgrows this rating, making the stub rating invalid. I feel article ratings need to be regularly updated, say every 6 months or year, and this could aid editors wishing to make "most needed" edits by giving them more accurate page ratings without having to visit each page...lesion (talk) 18:47, 26 January 2013 (UTC)

I think this kind of tool would be nice. I think it is something each WikiProject could use. It might already exist. Try asking at WP:VPT? Usually people that know about the toolserver, etc., pay attention there. Biosthmors (talk) 17:57, 28 January 2013 (UTC)

Hi there, Medicine. I'm excited to work on this little experimental feature. For this round, I will only be able to gather page counts on category pages or template pages that are specific to medical articles, e.g. (from above):

• Category:Unassessed medicine articles
• Category:Medicine articles needing expert attention

or

• Template:Medical_citation_needed
• Template:Medref

Cross-referencing is a little trickier and slower, so finding current peer review requests on articles listed under Medicine is probably beyond the scope of version 1.0. Although methinks that would ultimately be a pretty useful feature. Unless WP:MED uses a custom peer review request category or template? I haven't checked our everything you've got going on. Also, probably won't be able to get started on this 'til mid/late february... but hey, WP:TIND right? - J-Mo _{Email Me} 03:12, 27 January 2013 (UTC)

Template:Unreliable medical source is the only other medicine specific backlog I know of! Is anyone else aware of others? Biosthmors (talk) 03:14, 29 January 2013 (UTC)

Recent C&P move of Idiopathic thrombocytopenic purpura

Johndheathcote (talk · contribs) recently performed a cut-and-paste move of Idiopathic thrombocytopenic purpura to Immune thrombocytopenia, citing PMID 21632906 in support. I have reverted the move instead of fixing it outright as I do not believe this to be an "uncontroversial" decision, especially in light of our naming guidelines. Further input (preferably at the ITP talk page) would be appreciated. Fvasconcellos (t·c) 10:38, 26 January 2013 (UTC)

ICD10 still calls it Idiopathic thrombocytopenic purpura. Thus a little early for a move IMO. Doc James (talk · contribs · email) (if I write on your page reply on mine) 12:22, 26 January 2013 (UTC)

Zinc and the common cold

Wondering if I could get peoples opinion on how we should present the effect of Zinc on the common cold Doc James (talk · contribs · email) (if I write on your page reply on mine) 13:16, 26 January 2013 (UTC)

MEDRS

Could someone familiar with the guideline double check the nomination Template:Did you know nominations/Catastrophic injury to see if Catastrophic injury (or at least, the parts which would require references in-line with WP:MEDRS) is up to snuff? Thanks. — Crisco 1492 (talk) 00:16, 27 January 2013 (UTC)

Labiaplasty

Could someone please have a look: I have just deleted a large amount of mumbo-jumbo claiming that any woman who has externally visible labia minora suffers from labial "hypertrophy" which is an "indication" for plastic surgery. We have had problems in this area before . The article could do much more to highlight the way the marketing of this fad trades on women's insecurities; cf. the German article. Thanks. Andreas JN466 09:25, 27 January 2013 (UTC)

The article is in a horrible state, I refrain from any editing attempts there because I am not willing to waste my time with the WP:OWN and WP:CIVIL issues there. Richiez (talk) 14:05, 27 January 2013 (UTC)

Yes same here. I typically stay away from these sorts of articles. Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:10, 27 January 2013 (UTC)

Guys, I sympathise. I really do. But that article gets 2,000 views a day. A lot of those will be teenagers, male and female; the male ones will get completely unrealistic expectations as to what labia should look like, and make their girlfriends feel there is something wrong with them when they are entirely normally endowed, and girls with completely normal anatomies looking at the article the way it was over the past few months would have gotten away with the impression that there is something wrong with how their vulvas look, and that they should go under the knife to look pretty. We have a responsibility not to let articles like that rest in the hands of plastic surgeons who edit with an ulterior commercial motive. If you yourself can't stand the interaction – and I've been there – please try to get someone else to help, or at least put it on your watchlists and leave the occasional drive-by comment to support those who are trying to ensure that these articles aren't simply advertisements for plastic surgery. Thanks. Andreas JN466 17:43, 27 January 2013 (UTC)

I've done a superficial run-through, stripping out value-laden terms and cleaning up the English. It needs a proper working-over for MOS and repetition, and adverse events/complications are a little underplayed. --Anthonyhcole (talk) 17:42, 27 January 2013 (UTC)

Thanks, Anthony. Andreas JN466 17:44, 27 January 2013 (UTC)

The images need addressing. And I'm uncomfortable about our treatment of the psychological/sociocultural issues, too. --Anthonyhcole (talk) 17:53, 27 January 2013 (UTC)

I've been concerned about these articles for some time. There was a surgeon editing some of them, who appeared to be promoting the view (with text and images) that women with normal labia would benefit from surgery. I tried to edit some of them, but it was just too depressing to have to spend time on. I did make contact with a woman doctor and academic in London who has written about this, and my thinking was to try to obtain some images from her to replace the ones from private surgeons. I didn't pursue it, because I hated having to edit those articles. (I've just removed an image again from Labiaplasty that implies that women who look like that need surgery.) SlimVirgin 18:23, 27 January 2013 (UTC)

Yes have also dealt with some cases regarding plastic surgery where a surgeon was trying to promote their own work via Misplaced Pages. Our abilities to define COI here let alone deal with it without being blocked for OUTing is miserable. If the community is not willing to back up editors who take on these issues I am simply not inclined to try to take it on myself. I see so many other areas where I can make huge differences with little drama and few headaches all in relative peace. I however appreciate those who are willing to jump into these issues. They are definitely deserving of admiration. Doc James (talk · contribs · email) (if I write on your page reply on mine) 18:31, 27 January 2013 (UTC)

I completely understand what you're saying. The COI situation has become so bad (so many paid advocates, yet Wikipedians are expected to treat them with kid gloves), that I also mostly think nowadays: "If the community want this, then they can have it." SlimVirgin 19:32, 27 January 2013 (UTC)

The article's edit history is usually not too active. So reverting those who should be reverted is easier than it would be on a usually active article. As for this image that SlimVirgin removed, I wouldn't state that it implies that surgery is needed. To me, it simply shows what labiaplasty can look like. And there really should be an image in the article showing what labiaplasty can look like and/or the procedure being performed. Flyer22 (talk) 18:44, 27 January 2013 (UTC)

We ought not to post images of women with ordinary labia who have chosen to have surgery for aesthetic reasons alone; doing so implies that anyone else who looks like this would benefit from surgery too. It is like posting a "before" image of an adult woman who weighs 120 lbs to advertise a diet. As Jayen says, the article gets a lot of hits, a lot of them doubtless from young women wondering whether they're "normal". If we have to use an image, we should request one from one of the academics who've written about this. But personally I don't think we do have to use an image. SlimVirgin 19:28, 27 January 2013 (UTC)

In what case is labiaplasty done when the woman has not chosen it? And whether the woman has chosen it or it's the result a medical situation where it was needed but she was unable to consent, it should not matter. It's an article about a medical procedure. We include images showing what a body part looks like before and after surgery all the time in Misplaced Pages medical articles, such as the Circumcision and Rhinoplasty (Nose job) articles. And in the case of rhinoplasty, the person has almost always chosen to have the surgery (as opposed to it being something decided for them at birth, like circumcision). Just like I don't agree that images in those articles are telling people they should have those surgeries, I don't agree that the image you removed from the Labiaplasty article is telling girls/women that they should have labiaplasty/that that's what their vulvas should look like. I only view the image as informative, and I'm certain that many other people would only view it that way as well. Jayen spoke of nothing about excluding images about the medical procedure. Flyer22 (talk) 19:51, 27 January 2013 (UTC)

Sorry, I meant to write "chosen for aesthetic reasons"; I've fixed my post. There's a significant difference between labia and noses, namely that we all have easy access to what other people's noses look like, and we therefore have a firm sense of when a nose is unappealing according to community standards. We have no such sense with labia, because for the most part the only ones people see (apart from their own or a partner's) are in pornography, where they are shaved, bleached and probably operated on to look as though they belong to children. So a generation of teenage girls is growing up thinking there is something wrong with them (or something ugly about them). When they come to Misplaced Pages for information, it would be inappropriate to show them a "before" image that shows perfectly ordinary labia, because that would confirm the pornography aesthetic. SlimVirgin 20:09, 27 January 2013 (UTC)

Thanks for clarifying. I was just about to state that if you meant that we should only use images of women who did not have ordinary labia before getting the surgery, how would "ordinary labia" be defined? And why should we think this should matter with regard to our readers? After all, they will not know why a woman decided to have the surgery unless the description page of the image accurately states so; but then again, I'm certain that most of our readers don't click on images to read the description page of whatever image. My point on this particular aspect is that there is no Misplaced Pages policy or guideline that states that we should only use images of people who have chosen a medical procedure for a medical, rather than an aesthetic, reason.

I still see the circumcision and nose job examples as pretty much the same as the labiaplasty example. You speak of protecting young girls/women. Some would argue similar about circumcision, that a generation of teenage boys are growing up thinking that there is something wrong with them if they are not circumcised. However, I argue that this does not mean that we should not show a "before and after" image of what takes place with circumcision. By showing such an image, we are not adding on to the view that a boy/man should be circumcised in order to be appealing "down there." Having a circumcised penis is also a pornographic view. You could argue that circumcision is different because it is so widely accepted, but my point is still valid. And regarding nose jobs, many teenage boys and girls, but especially girls, are growing up thinking that they should have a nose job even when their noses are perfectly fine to everyone else (or perfectly fine to most people, at least). But this does not mean that we should not have a "before and after" image of a nose job. With the Labiaplasty article, I of course argue similar -- the fact that a lot of young people are growing up thinking that girls/women who have prominently visible labia minora are visually unappealing "down there" does not mean that we should not have a "before and after" image of what takes place with labiaplasty. You believe that Misplaced Pages is taking the position of "You should look like this" by including such an image; I don't feel that way, and I don't understand how any regular member of WP:MED would either. All Misplaced Pages is doing is providing information; we aren't taking a position by including these images. But we are taking a position by excluding them for the reasons you cited, and that's not how we are supposed to work. But I'm not interested in trying to get you to put the image back in the article; so if others aren't going to fight you on it, I'm letting this issue drop. If it comes up on the talk page of the Labiaplasty article and I see it/am available to weigh in on it/feel like weighing in on it, my argument will be the same on this matter. Once this discussion here at WP:MED is over, I'll likely mention/link to this discussion there in the Images section that's currently on its talk page, however. Flyer22 (talk) 20:55, 27 January 2013 (UTC)

Is "hypertrophy" even an appropriate term? Inline with other terms to describe "larger than average" bit of anatomy that does not represent an acquired pathologic enlargement, I think "macro", "mega" or "hyper" as prefix then the anatomic term. lesion (talk) 19:01, 27 January 2013 (UTC)

I don't know much about this, but it seems to be a commonly used term (by proponents, at least).

I think that for educational reasons, it would be appropriate to show an image with truly obvious hypertrophy. We don't have to make a judgment about what's "disordered" to identify and present something that's statistically uncommon.

As for the general issue of people not knowing what the normal range of anatomical diversity is, I once ran across a webpage (some years ago; I have no idea where it is) that showed twenty or thirty areolas, with different ages, childbirth statuses, etc. noted. We might see whether a source like that was available as an external link for the related articles. Something like File:Vulva Diversity 1.jpg would maybe work, but they're all white, and I understand that there is some significant race-related diversity for labia, so it may significantly underrepresent "normal". WhatamIdoing (talk) 03:30, 28 January 2013 (UTC)

If there are any situations of article ownership or COI POV-pushing requiring administrator intervention, please let me know. Kaldari (talk) 08:03, 28 January 2013 (UTC)

Appart from other issues, the description of the labia minora is questionable so I am wondering if it is needed at all when we have separate articles for everything. Especially this statements: "The labia minora consist of two (2) connective folds of flesh that contain some adipose tissue" - wording and wrong histology. "The skin and the mucosa..." - misleading. "folds of vulvo-vaginal skin have a core of connective, erectile tissue (analogous to the corpus spongiosum penis)," - don't believe it without seeing a source. Richiez (talk) 11:36, 28 January 2013 (UTC)

A section called "The patient"? The content of it is mostly garbage. Richiez (talk) 12:05, 28 January 2013 (UTC)

Regarding the histology of the vulva, although modern-day sources are mostly consistent in their descriptions of what type of tissue makes up what, they also sometimes differ on certain parts. That's one frustrating thing I've found when extensively researching the anatomy of the human female sex organs over the years, and especially last year, and is why you sometimes have to present two or more arguments. This source by Yang et al.; 2006 (pages 766–772), and this source featuring research by O'Connell and Sanjeevan; 2006 (pages 105–112) and others (such as Richard F Hoyt, Jr.), are great sources for the descriptions of the vulva, but they also provide different conclusions about a few things. For example, Yang et al. state: "The anatomy of the vulva is typically presented with no unifying theme, i.e. there are numerous but disparate descriptions of the vagina, introitus and its structures, urethra, and clitoris. There is a lack of unity probably because of the perceived differences in function of each of these structures. However, our previous work using MRI of the female sexual response showed the interconnectedness of these structures in the context of sexual function. Previously described vascular changes with sexual arousal occurring in the vagina, clitoris, labia minora and urethra were corroborated, but we also found vascular changes occurring in the clitoral bulbs."

As for the labia minora and adipose tissue, Yang et al. state: "The labia minora are well demarcated from the labia majora by an interface between the adipose of the labia majora and the absence of adipose in the labia minora." Flyer22 (talk) 14:02, 28 January 2013 (UTC)

I've restored parts of an earlier version to replace some of the problematic additions. SlimVirgin 16:56, 28 January 2013 (UTC)

Myofascial release

Hello,
I think that the sources used on myofascial release fall short of WP:MEDRS, so the article presents somewhat fringe views at face value. What does everybody else think? Is the article fixable? bobrayner (talk) 12:38, 27 January 2013 (UTC)

I removed the unsourced physiology and efficacy claims. I guess the remainder is harmless enough. I'll leave it on my watchlist. --Anthonyhcole (talk) 13:45, 27 January 2013 (UTC)

Nice work! bobrayner (talk) 19:34, 27 January 2013 (UTC)

>5000 ECGs5000_ECGs-2013-01-28T01:01:00.000Z">

More than a year ago now got an agreement with ECGepedia to release all of their images under a CC BY SA license. More than 5000 of them are now being moved over by smallman12q per here If anyone wishes to help with integration of this content into Misplaced Pages that would be wonderful. Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:01, 28 January 2013 (UTC)5000_ECGs"> 5000_ECGs">

I'll admit not knowing Commons very well - I went to the page you linked, but the discussion there does not seem to point to any content. When there's content to incorporate into WP, I hope someone might provide a link. Will these ECGs be unified under a Commons category, perhaps? -- Scray (talk) 01:38, 28 January 2013 (UTC)

Yes will post again when the content starts streaming in. Doc James (talk · contribs · email) (if I write on your page reply on mine) 02:13, 28 January 2013 (UTC)

Wow, that's a huge donation.

Ideally they'll be listed in a cat for ECGs plus a cat named something like commons:Category:Media from ECGpedia. The who-donated-all-this cat could be listed under commons:Media from medical journals, books, and other sources‎. WhatamIdoing (talk) 03:22, 28 January 2013 (UTC)

Feedback trends

In the WP:Article feedback tool/Version 5 comments, I've recently seen a lot of requests for information about prognosis. If you've got a list of articles that you usually take care of, you might want to see whether it would benefit from a ==Prognosis== section. Some of our readers need even the basics spelled out, so don't be afraid to include a sentence or two that tells people what's obvious to you or that repeats information briefly touched on in passing earlier in the article. WhatamIdoing (talk) 04:49, 28 January 2013 (UTC)

"Side-effects" of lobotomy

I recently stumbled across the lobotomy article, and was rather dumbstruck that the "Side effects" section consisted of a single sentence about reduced empathy in lobotomy patients. I added a couple more sentences about the negative effects of lobotomy, but it still seems woefully inadequate. I'm not even sure that "Side effects" is a proper section here, as most people consider the intended effects of lobotomy to be negative for the patient. This seems to be one of those cases where the information is such common knowledge that no one has bothered to add it to the article. Kaldari (talk) 08:14, 28 January 2013 (UTC)

Been meaning to do this since IP editor raised the issue a few days ago. FiachraByrne (talk) 14:37, 28 January 2013 (UTC)

The new section heading ==Results of lobotomy== seems more appropriate to me. "Side effects" generally refers exclusively unintentional effects. (Vomiting might be a side effect of an antibiotic, but a reduced fever isn't a side effect, even though it's a result.) WhatamIdoing (talk) 21:45, 28 January 2013 (UTC)

Hermann Stieve

Hermann Stieve is in the news today: specifically, reports of his anatomical investigations into recently-executed women under the Nazi regime. Misplaced Pages's article on him reads very oddly indeed: it reads like a machine translation and seems to be at pains to portray him and his research in a favourable light. Can editors here please review the article? -- Gigacephalus (talk) 08:17, 28 January 2013 (UTC)

I've rewritten for clarity, and everything's sourced now. I think it's neutral, as best as I can judge. The only crime there is good evidence for is dissection of the bodies of executed prisoners, and the article reports that - in fact, that's pretty much all the article addresses. --Anthonyhcole (talk) 18:10, 28 January 2013 (UTC)

And I've made this edit to ask for an inline citation. Biosthmors (talk) 19:27, 28 January 2013 (UTC)

Jokestress and Cantor

It may be of interest to some that there has been a discussion of Jokestress's participation on the Talk:Hebephilia page at WP:AN/I; there are proposals under consideration presently to topic ban either Jokestress or James Cantor or both from sexology articles. FiachraByrne (talk) 10:49, 29 January 2013 (UTC)