User:Mapleleafsfan24/sandbox

Welcome to your sandbox!
This is place to practice clicking the "edit" button and practice adding references (via the citation button). Please see Help:My_sandbox or contact User_talk:JenOttawa with any questions.

Link: Project Homepage and Resources


 * Note: Please use your sandbox to submit assignment # 3 by pasting it below. When uploading your improvements to the article talk page please share your exact proposed edit (not the full assignment 3).


 * Talk Page Template: CARL Medical Editing Initiative/Fall 2019/Talk Page Template

Wikipedia Assignment #3: Individual Improvement Plan
Goal: Students will prepare and post their planned edits for the Wikipedia article on their sandbox. Tutors will provide feedback on the planned edits with comments on the sandbox and upload a graded rubric to the Gradebook. This is meant to be an iterative process, with the feedback from your tutors incorporated prior to making the edits in class on November 25th.

Students changes on sandbox must be posted (due) by midnight Monday Nov 18th.

Instructions:

1)    Outline your specific planned changes to your section of the article, labelled “Proposed Changes”. Target 1-2 sentences for your improvements. Use the exact language you plan to post to the Wikipedia community, and ensure that it is written in a way that is easily understood by non-medical people.

The mechanism section of the article, shall be reworded with the additional information obtained from the Yoshifuji 2019 article by adding 1 sentence, dividing 1 sentence into 2 and the changing the wording of both new sentences. It shall now read:

"The pathological mechanism is the result of an inflammatory cascade that is triggered by an as of yet determined cause resulting in dendritic cells in the vessel wall recruiting T cells and macrophages to form granulomatous infiltrates . These infiltrates erode the middle and inner layers of the arterial tunica media leading to conditions such as aneurysm and dissection . Activation of T helper 17 (Th17) cells involved with interleukin (IL) 6, IL-17, IL-21 and IL-23 play a critical part; specifically, Th17 activation leads to further activation of Th17 through IL-6 in a continuous, cyclic fashion . This pathway is suppressed with glucocorticoids, and more recently it has been found that IL-6 inhibitors also play a suppressive role ." This is extremely well-written but lets remember that this has to be for a grade 8 level. Are there any potential ways you could make this simpler? We can discuss that.

2)    After each proposed change, briefly explain the rationale for the change and the reference(s) you have used to support your content. Label this section “Rationale for proposed change.”

The first change was the addition of a sentence describing the effect that granulomatous infiltrates have on arterial structure, where this change in structure can be found and how can they be manifested on a macroscopic level. Nowhere in the article was this previously mentioned and so by adding this, it gives the reader a better way to picture just how giant cell arteritis develops, and if left untreated, what the ramifications can be. A very good point.

The second change was adding more information regarding the molecular mechanism of giant cell arteritis. More information regarding the mechanism had been discovered since the original Wikipedia article was written and so this article is being updated with this new information. The best information is the most up to date information.

Since the second change would have resulted in a very long run-on sentence, the previous sentence was broken in two and expanded to include the IL-6 inhibitors, in addition to glucocorticoid use previously mentioned, are ways to suppress this mechanistic pathway.

The reference I used for all these changes is:

Hajime Yoshifuji. (2019) Pathophysiology of large vessel vasculitis and utility of interleukin-6 inhibition therapy, Modern Rheumatology, 29:2, pages 287-293.

3)    Identify any controversy or varied opinion about planned changes in your section, and explain how you decided to move forward with the position you have taken. Add this piece to the rationale section.

No controversy or varied opinion about my planned changes were mentioned during the research phase of this project. As a result, I will move forward with my proposed changes.

4)    Please identify any issues or concerns with the source (including any possibility of bias) and how (or whether) this has impacted on your plans for the information you are choosing to share. Label this section “Critique of Source.”

With any review article, one must recognize the threats to its validity including: the selective use of articles, strength of those articles used, lack of clarity as to which research was used/not used, and the author's personal experience/conflict of interest. While the first three points are difficult to consider without thorough analysis of the citations used in the source and correspondence with the author, I feel that any serious issues to come out of this would have been caught in the peer-review stage prior to the publication of the source. Although regarding author experience/conflict of interests, the source did state that the author received speaking fees from Chugai Pharmaceutical Co., Ltd. This company is a known producer of IL-6 inhibitors which the author has discussed at length as an appropriate treatment for giant cell arteritis. Having said that, I was comfortable with using this source because this source was used to supplement the article with new peer-reviewed facts about the pathophysiology of giant cell arteritis that have arisen since the Wikipedia article was first written. No opinions were used. The source itself was a neutrally worded peer-reviewed review article that cited a number of RCTs that showed the effectiveness of IL-6 inhibitor use in the treatment of giant cell arteritis. IL-6 inhibitor use is approved for use in treating giant-cell arteritis in the USA and is not an entirely new concept only promoted by this author. In addition, the author’s conclusion is neutrally worded, stressing disease prevention and improving guidelines for IL-6 inhibitor use in consideration of efficacy and safety. As such, I didn’t feel that the speaking fees that this author may have received has compromised this source in such a manner that affected the use of this source in this project. Good for you for picking up on the speaking fees and potential conflict of interest.