User talk:Doc James/Archive 142

metformin and PCOS
There was no citation in previous versions of this article indicating how often metformin was used for PCOS. If you have a citation showing that metformin is often used for PCOS, please cite it. My impression is that metformin is no longer used much for PCOS, perhaps because the clinical trials have been disappointing. The PCOS indication doesn't belong in the lede, in my opinion. Its use is discussed in the main body of the article, which still seems appropriate.
 * Read the citation https://www.drugs.com/monograph/metformin-hydrochloride.html
 * User:Sbelknap you made a bunch of statements were the reference supported the EXACT opposite. Seriously... Doc James  (talk · contribs · email) 05:24, 19 November 2018 (UTC)
 * Are you sure? The Cochrane review reports "no conclusive evidence of a difference between the groups in live birth rates" for the comparison of metformin plus clomiphene versus clomiphene alone. The Cochrane review reports "When all studies were combined, findings for live birth were inconclusive and inconsistent" for the comparison of Metformin versus clomiphene citrate. The Cochrane review reports a CI for metformin vs placebo that overlaps 1.0. Please slow down, read the cited article carefully, and then make edits. Thanks. Sbelknap (talk) 05:48, 19 November 2018 (UTC)

Really? You need to look at what population the Cochrane review is actually about.

Read this Cochrane review about PCOS https://www.ncbi.nlm.nih.gov/pubmed/29183107 "Our updated review suggests that metformin alone may be beneficial over placebo for live birth" The Cochrane review you are refering to is just about obesity "Metformin for women who are overweight or obese during pregnancy for improving maternal and infant outcomes." https://www.ncbi.nlm.nih.gov/pubmed/30039871
 * You omitted the terminal clause from your quote. The full sentence says, "Our updated review suggests that metformin alone may be beneficial over placebo for live birth, although the evidence quality was low."Sbelknap (talk) 15:16, 19 November 2018 (UTC)

Meformin is not used for infertility in women who are simple obese. They must also have PCOS. Doc James (talk · contribs · email) 05:53, 19 November 2018 (UTC)
 * Metformin has been evaluated for infertility in women who are obese. It has been evaluated, and the reviewers caution us against using, in women who have PCOS but are not obese (see: https://www.ncbi.nlm.nih.gov/pubmed/22956412). It has been evaluated in women who both have PCOS and are obese. It has been evaluated in the setting of assisted fertility methods, such as in vitro fertilization. Are you asserting that your most recent edits accurately reflect these several systematic reviews / meta-analyses? Sbelknap (talk) 06:05, 19 November 2018 (UTC)
 * We go with the newer Cochrane review form 2017. Why use the older ref?
 * The review you link to found that it appeared similar to clominphene in "non obese women with PCOS". Ie both states must be present.
 * Were do they caution "against" it. They just caution as a first line for this group. Doc James  (talk · contribs · email) 06:07, 19 November 2018 (UTC)


 * Pregnancy is not a benefit if it ends in miscarriage. Live birth of a healthy infant is the clinically-relevant benefit. There are several Cochrane reviews that address separate clinical questions about metformin and fertility in women. There are several high-quality systematic reviews from other sources that also address various aspects of metformin and fertility in women. Let us not merge these together inappropriately. There are several meta-analyses that have not yet been added to the article. For example, addresses women with anovulatory cycles. "In women with WHO group II anovulation, letrozole and the combination of clomiphene and metformin are superior to clomiphene alone in terms of ovulation and pregnancy. Compared with clomiphene alone, letrozole is the only treatment showing a significantly higher rate of live birth." As you are in the process of editing the article, it seems best to allow you to complete your edits, rather than argue with you about it. The current version of the article seems to contain errors and is rather far away from the available evidence, but it seems unfair to criticize you in the middle of making your edits. Sbelknap (talk) 06:22, 19 November 2018 (UTC)


 * Also, harms/benefits may diverge for woman and fetus. For example, metformin may reduce risk of pre-eclampsia: https://onlinelibrary.wiley.com/doi/abs/10.1111/dme.13523 Sbelknap (talk) 06:26, 19 November 2018 (UTC)


 * From the conclusion of a recent review article about metformin use in fertility treatment of PCOS patients:
 * "Recent studies show no clear advantage to the use of metformin in fertility treatment for PCOS patients. Prescribing metformin in the immediate pre conception period to a patient with PCOS with no proven insulin resistance is therefore not indicated. It may also be associated with disturbing side effects as well as with long term adverse effects on the health of the offspring. Thus, one should carefully consider the potential metabolic impairment at a crucial and sensitive stage in embryo development with possible long term consequence on reprogramming of energy metabolism and adult morbidity. Further researches regarding the impact of metformin on oocytes, embryos and long lasting effects on offspring should be performed before future use of metformin during fertility treatments." Sbelknap (talk) 06:48, 19 November 2018 (UTC)

The NICE guidelines are not current. Other guidelines are available. See Fertil Steril! 2017;108:426–41. These ASRM guidelines conclude that there is insufficient evidence that metformin in combination with other agents used to induce ovulation increases live-birth rates. Sbelknap (talk) 15:12, 19 November 2018 (UTC)
 * Medical Hypothesis is NOT an appropriate source.
 * Sure it is. I did not add this cite to the wikipedia article. I mentioned this article because it is very well written and explains the relevant issues very clearly.Sbelknap (talk) 19:12, 19 November 2018 (UTC)
 * Does NICE have a more recent version? Doc James  (talk · contribs · email) 17:04, 19 November 2018 (UTC)
 * NICE hasn't been active on this since the 2004 guidelines. There are some minor updates, I think the most recent was 2015, but it was clearly not comprehensive. I expect that NICE is waiting until the results of the MITY trial and the MITY Kids trial are done. The Varney article remains best primary source, as that was a high-quality study, but that is 8 years old. I haven't put that in the wikipedia article, because it is old and it is a primary source. I wouldn't object to including it, though.Sbelknap (talk) 19:12, 19 November 2018 (UTC)


 * Sbelknap we generally consider Medical Hypotheses to be the National Enquirer of medical journals, here, because our mission is to transmit accepted knowledge, and that journal is full of all sorts of ... stuff that people have tried too many times to represent as "accepted knowledge". It is too bad the authors of that piece didn't publish it in a more appropriate journal if it really is a high quality review of the evidence.
 * More importantly, the two of you are both advocates for evidence-based medicine and this is, to be frank, a dumb argument. We should describe what medical practice is, as best we can glean it from refs, we should describe what guidelines say, and we should summarize the best quality reviews of the evidence. We should just describe that stuff, and let any contradictions between practice and guidelines and evidence show, including contradictions among guidelines or among reviews of the evidence.  Importantly, SBelknap, it is not our place as Wikipedia editors to judge guidelines against the evidence. Please stop doing that.  It is however fine to note the date a guideline was issued. Jytdog (talk) 20:25, 19 November 2018 (UTC)

New Classification of Periodontal Diseases
Dear Doc. James,

For your information, there has been new classification of periodontal diseases which was introduced formally and officially in 2018. Thus, it's necessary for us to add 2017 classification as new subheading and differentiate it from 1999 classification.

Thanks — Preceding unsigned comment added by Rosebud Babybreath (talk • contribs) 23:19, 22 November 2018 (UTC)
 * Okay... Doc James  (talk · contribs · email) 00:41, 23 November 2018 (UTC)

Possible reasons for perhaps missing articles
Hi A hearty winter welcome from Scotland. I wonder if you could answer a question for me, even tell me if it is question, as I am not a doctor. I was wondering why there is not an article for Paediatric Neurology, or indeed Paediatric Nephrology, and other types of paediatric articles that seem to be missing. Is it possible that they are embedded within other articles. Surely as a Paediatrics is a sub-specialism they should have their own articles. Looking at Paediatric nephrology, on the Pediatrics page, it links to the main article. Is there no case for creating these individual articles, or that we have not got round to doing it yet. I seems there is something wrong, there should be depth here. scope_creep (talk) 16:00, 23 November 2018 (UTC)
 * User:Scope creep in my opinion it would be sufficient to mention at pediatrics and at neurology. As it is a combination of the two. Not sure they need independent pages. Doc James  (talk · contribs · email) 16:24, 23 November 2018 (UTC)

Huh?
Why no thanks? --Gryllida (talk) 10:09, 25 November 2018 (UTC)
 * User:Gryllida We generally just put the first / main brandname in the lead. Many drugs are sold under thousands of brands. Doc James (talk · contribs · email) 12:48, 25 November 2018 (UTC)
 * Oh. That was not at all clear from the edit summary, Doc James. I appreciate your prompt and concise explanation. :-)
 * Perhaps to remedy this maybe a redirect from Klacid to Clarithromycin can be created? I was looking up the brand online and Wikipedia article did not immediately come up. --Gryllida (talk) 02:16, 26 November 2018 (UTC)
 * Redirect is present. Strange it did not come up. Perhapes something to bring to the search team. Doc James  (talk · contribs · email) 19:09, 27 November 2018 (UTC)

The schizophrenia article and infections
Thanks for your change about what I added to the schizophrenia article, it's indeed more rigorous.

I'd like to remove a part of a sentence, but I prefer ask you what you think about that.

In "Developmental factor" Chapter in the schizophrenia article, it's also written: Other infections during pregnancy or around the time of birth that may increase the risk include Toxoplasma gondi and Chlamydia. .

I believe the term "during pregnancy or around the time of birth" doesn't correspond to what is said in the abstract of the publication and should be removed, moreover an odd ratio about the correlation between one of this infections and schizophrenia may be added.

Best regards --Nicobzz (talk) 21:12, 22 November 2018 (UTC)
 * User:Nicobzz the ref says "This hypothesis is based on epidemiological evidence showing that prenatal or perinatal exposure to different infectious agents, including Toxoplasma gondii, Cytomegalovirus, Chlamydia spp., and all types of Human Herpes Virus or Influenza, is associated to an increased risk for adult schizophrenia (Brown et al., 2004, Fellerhoff et al., 2005, Brown, 2006, Fellerhoff et al., 2007, Hammond and Hobbs, 2007, Dalman et al., 2008, Niebuhr et al., 2008)."
 * Seems to support it fairly well. Doc James  (talk · contribs · email) 00:45, 23 November 2018 (UTC)
 * I agree with you about this sentence, but this sentence correspond to the result of previous publications, not the publication "Infectious agents associated with schizophrenia: a meta-analysis". This publication supports there is an association between schizophrenia and some infections, that's true it doesn't conclude that infections may be responsible for schizophrenia. One may interpret that infections may be responsible for schizophrenia, I agree there is lot of other possible interpretations because of confounding factors, so I believe the best to do is to write what it assesses : "Significant association between schizophrenia and different kind of pathogens has been detected". But I insist, the sentence " In "Developmental factor" Chapter in the schizophrenia article, it's also written: Other infections during pregnancy or around the time of birth that may increase the risk include Toxoplasma gondi and Chlamydia " correspond to a conclusion of different publications than the one cited. The last sentence I cited from the article may be kept but this one could be added.--Nicobzz (talk) 09:53, 23 November 2018 (UTC)
 * How about we change it to "linked"? Doc James  (talk · contribs · email) 16:21, 23 November 2018 (UTC)


 * I agree with this word, we could also write there is an association. As you like, english is not my native language, I let you choose.--Nicobzz (talk) 17:25, 23 November 2018 (UTC)
 * Linked and association mean the same. Doc James  (talk · contribs · email) 17:33, 23 November 2018 (UTC)
 * Hi James, I'm sorry to disturb you again, I fear that the sentence you change give the idea to the reader that only infections during pregnancy or around the time of birth are linked to schizophrenia, whereas in fact it's not know in the reference when infection has been contracted because seropositivity to infections is assessed during adulthood of patient. I know that lot of other publications talked only about infections during pregnancy or around the time of birth, but this reference talk about seropositivity in adulthood.--Nicobzz (talk) 12:47, 26 November 2018 (UTC)
 * Ref says that prenatal or perinatal exposure to different infectious agents which means around the time of birth. Doc James  (talk · contribs · email) 19:11, 27 November 2018 (UTC)

Myelodysplastic syndrome
Why remove references to p53 mutation? This is well-established (I am hematopathologist), included in the WHO and multiple papers (including the one cited). FYI, the MDS classification outlined is out of date; the WHO has revised criteria and categories. — Preceding unsigned comment added by Hobosuit (talk • contribs) 22:41, 27 November 2018 (UTC)


 * User:Hobosuit please read WP:MEDRS.
 * This is a primary source. Doc James  (talk · contribs · email) 22:52, 27 November 2018 (UTC)

The Signpost: 1 December 2018
 * Read this Signpost in full * Single-page * Unsubscribe * MediaWiki message delivery (talk) 04:46, 1 December 2018 (UTC)

Iron-Deficiency Anemia
Hi Doc James,

I am a medical student working on the IDA page this month. I just started working on the article, but it is already quite good. Any suggestions on how I can take this article from a "C" rating to a "B?"

Thank you, Shelli — Preceding unsigned comment added by Sciande (talk • contribs) 19:59, 28 November 2018 (UTC)
 * Im certain Doc James will answer ASAP(please see WikiProject_Wikipedia/Assessment)--Ozzie10aaaa (talk) 20:14, 28 November 2018 (UTC)
 * User:Sciande the lead of the article is good. The body of the article could use further improvement and further references. Best Doc James  (talk · contribs · email) 18:09, 1 December 2018 (UTC)

OTRS request
If you have a couple minutes, this ticket: ticket:2018120110003617 Could use your input.

As an aside, I don't want to overwhelm you. Is there a general place where MEDRS experts gather, assuming there are others who are OTRS agents?-- S Philbrick (Talk)  19:43, 1 December 2018 (UTC)
 * WT:MED is probably what you want (although OTRS people will only be a small percentage). --Tryptofish (talk) 20:50, 1 December 2018 (UTC)
 * I will take a look in a bit if the satellite Internet and electricity holds up. Doc James  (talk · contribs · email) 20:58, 1 December 2018 (UTC)
 * User:Sphilbrick evidence appears to be poor.
 * They would need to present excellent sources. Case already closed. Happy to tell them that if you wish. If they present an excellent source happy to look at it.  Doc James  (talk · contribs · email) 23:57, 1 December 2018 (UTC)

Mucinous cystic neoplasm
Hello, Doc James. I see that you recently created Mucinous cystic neoplasm, but it is barely a stub. Is there a plan to improve the article? What about Ovarian and Pancreatic MCNs? While on the topic and given your influence on medical articles, neoplasm-related articles on Wikipedia are fairly disorganized, is there a plan to improve that? Best, Classicwiki (talk) If you reply here, please ping me. 23:09, 28 November 2018 (UTC)
 * Doc James is away Im certain he'll answer ASAP--Ozzie10aaaa (talk) 11:29, 29 November 2018 (UTC)
 * Yes it is a stub for a very rare cancer. Feel free to improve further. I guess the question is should we have all the mucinous cystic neoplasm on one page or over 3 pages? Created it as it was a recently deleted article due to copyright reasons and this created a bunch of red links. Doc James  (talk · contribs · email) 18:08, 1 December 2018 (UTC)
 * For now and given its brevity, I would recommend Mucinous cystic neoplasm to not be liver-specific only as it could be misleading. Classicwiki (talk) If you reply here, please ping me. 19:09, 2 December 2018 (UTC)
 * User:Classicwiki Sure go for it, if you have not already. Doc James (talk · contribs · email) 20:28, 2 December 2018 (UTC)

Good-by to Jytdog
Sorry to read that Jytdog has left Wikipedia. Often contentious, not hindered by an excess of tact, but I personally felt always had the interests of Wikipedia at heart (including an early-on challenge on whether I was COI and/or PAID, and reverting my efforts that were using primary research in med/health articles). David notMD (talk) 16:38, 7 December 2018 (UTC)
 * Jytdog was a very good editor--Ozzie10aaaa (talk) 19:33, 7 December 2018 (UTC)
 * Well he and I also did not always agree, still a significant loss for WP. Doc James  (talk · contribs · email) 16:57, 9 December 2018 (UTC)

SCN
Hello there, Doc James. I see that you recently added a very short article on Solid cell nests. As their discovery is a result of work carried out by Sophia Getzowa, you might like to look at the section I have just written on her contributions to research. As you will see, it is based on her recognition in the sources I have drawn on. You might like to look through the section, making any necessary changes.--Ipigott (talk) 12:24, 7 December 2018 (UTC)
 * Im certain Doc James will answer ASAP--Ozzie10aaaa (talk) 18:52, 8 December 2018 (UTC)
 * Yes would be reasonable to add a history section at SCN and add details on Getzowa... Doc James  (talk · contribs · email) 16:59, 9 December 2018 (UTC)

Hearing loss
Doc James I revised the hearing loss additions I made, and added references. You have an appropriate point in noting my entries were not references. In reading the rest of the information on that page I note that many other bits of information were not referenced, at this late data how do you get to the original author to have the references added? I'm still new to this and just curious. Thanks — Preceding unsigned comment added by UIowagrad (talk • contribs) 18:25, 6 December 2018 (UTC)
 * Doc James is away, Im certain he'll ASAP(please see MEDRS Identifying_reliable_sources_(medicine) as artilces should not be older than 5 years yours are2009 and 1996, they should also be reviews thank you)--Ozzie10aaaa (talk) 19:48, 7 December 2018 (UTC)
 * User:UIowagrad when WP started we did not require high quality references. Thus much text got grandfathered in. We now require high quality references going forwards. Let me know if that makes sense? Best Doc James  (talk · contribs · email) 17:08, 9 December 2018 (UTC)

Use of Cochlear Implants in children with Auditory Neuropathy
Doc James, I'm curious why you would delete a referenced comment that some children with auditory neuropathy benefit from cochlear implants. It seems appropriate to me to add a documented fact about this disorder, and also to inform people interested in this disorder about the possibility of improved communication through CI. Thank you for your reply. UIowagrad — Preceding unsigned comment added by UIowagrad (talk • contribs) 21:59, 9 December 2018 (UTC)
 * Please read WP:MEDRS User:UIowagrad Doc James  (talk · contribs · email) 00:34, 10 December 2018 (UTC)

Talk:Heroin
Please discuss on talk page. Anastrophe (talk) 00:29, 10 December 2018 (UTC)
 * Am trying but edit conflicts keep occuring. Doc James  (talk · contribs · email) 00:38, 10 December 2018 (UTC)
 * Apologies. Yes, I do have a fast internet connection, and as well I am a ridiculously fast typist. Add the two together... :) Anastrophe (talk) 00:40, 10 December 2018 (UTC)
 * Am trying to download this again http://www.unodc.org/doc/wdr2016/WORLD_DRUG_REPORT_2016_web.pdf
 * User:Anastrophe to see if they have numbers that are more specific for heroin. Doc James  (talk · contribs · email) 00:44, 10 December 2018 (UTC)
 * Thanks. Specific use percentages are hard to come by, naturally, since use is illicit. My 1% value was from something I read today, which is pretty useless as a reference, since I can't remember which source it was. Anastrophe (talk) 00:46, 10 December 2018 (UTC)

sent an email
but can be completely forgotten if you are too busy JarrahTree 00:47, 11 December 2018 (UTC)
 * Thanks User:JarrahTree will reply... Doc James  (talk · contribs · email) 00:58, 11 December 2018 (UTC)

Request regarding pantoprazole external link
Dear Doc James, Hope you are doing well. I have included an externallink to pantoprazole, but it was removed, although it contains A lot of information. Could you please include it as an external link. If not what information do you need for this link to be accepted again. Thanks & Regards Omair Hasan Osmani. Omairosmani (talk) 17:27, 10 December 2018 (UTC)
 * We have fairly strong rules on external links. Please see WP:ELNO. Best Doc James  (talk · contribs · email) 00:40, 11 December 2018 (UTC)
 * Here you removed a bunch of categories
 * This is not a suitable source themedpharma
 * By the way User:Omairosmani what is your relation to the website in question?
 * Doc James (talk · contribs · email) 01:02, 11 December 2018 (UTC)

Can fascia contract?
Hi! Been a long time... was flattered you thanked me for getting rid of a ''Med. Hypotheses'' reference... been working my way down the list, looking for obvious weirdness. Here's one: there's a paragraph in Deep fascia that says that fascia can contract during fight-flight response, possibly explaining amazing feats during such situations. A quick google search doesn't seem to turn up what I'd expect if this was commonly accepted, but then again, the Med Hypotheses article has a lot more cites than the average random theory. But, as they say, I'm not a doctor... Here's the paragraph in question...
 * Deep fascia can contract. What happens during the fight-or-flight response is an example of rapid fascial contraction. In response to a real or imagined threat to the organism, the body responds with a temporary increase in the stiffness of the fascia.  Bolstered with tensioned fascia, people are able to perform extraordinary feats of strength and speed under emergency conditions. How fascia contracts is still not well understood, but appears to involve the activity of myofibroblasts. Myofibroblasts are fascial cells that are created as a response to mechanical stress. In a two step process, fibroblasts differentiate into proto-myofibroblasts that with continued mechanical stress, become  differentiated myofibroblasts. Fibroblasts cannot contract, but myofibroblasts are able to contract in a smooth muscle-like manner.

Cheers, hope you're well Chris vLS (talk) 02:14, 11 December 2018 (UTC)
 * Agree User:Chrisvls and trimmed MH. Doc James  (talk · contribs · email) 02:21, 11 December 2018 (UTC)

A kitten for you!
Thanks for the ref. info.

Imersion (talk) 12:41, 11 December 2018 (UTC) 

Deletion in Chikungunya
Your reason for deleting the sentence is "just because RNA is present does not mean it is spread that way." The deleted sentence does not state that RNA being present means that the virus is spread that way, it states that the presence of RNA suggests that transmission could occur. Is it not true that viral RNA in semen suggests that sexual transmission could occur? Cohee (talk) 21:16, 11 December 2018 (UTC)
 * User:Cohee please use high quality secondary sources per WP:MEDRS. Best Doc James  (talk · contribs · email) 22:35, 11 December 2018 (UTC)
 * Your original reason for deletion: You didn't answer my question. New reason for deletion: It may be weeks, months, or years before the media picks this up and produces a secondary source. Meanwhile, Wikipedia is once again diminished by a deletion. Thanks for replying. Best Cohee (talk) 23:14, 11 December 2018 (UTC)
 * When the CDC takes that "suggestion" seriously than we will also include it. Basis this on a single case report that it might be true is undue weight. Doc James  (talk · contribs · email) 23:18, 11 December 2018 (UTC)

Diclofenac
Why did you remove the reference of diclofenac. Vultures bread not before 6 years and only 50% of them survive. It is given in the med pharma. I need an explanation. Thanks Omairosmani (talk) 12:50, 11 December 2018 (UTC)
 * User:Omairosmani medpharma is not a suitable source. Please read WP:MEDRS. Best Doc James  (talk · contribs · email) 13:21, 11 December 2018 (UTC)

The med pharma has the reference to their claims. You should read the article in the med pharma. I feel like you are targeting my claims. Omairosmani (talk) 13:40, 11 December 2018 (UTC)
 * Looks like you are spamming that site... Doc James  (talk · contribs · email) 13:46, 11 December 2018 (UTC)

Thanks for your advice. Please tell me what it takes for the med pharma to contribute to Wikipedia. Do you want to say that the med pharma has no chance to be a reference source to a Wikipedia articles Omairosmani (talk) 13:54, 11 December 2018 (UTC)
 * What is your relation to the site in question. Doc James  (talk · contribs · email) 13:57, 11 December 2018 (UTC)

I have started the med pharma and I am doing my best to write the articles from reliable sources and references. Dr Vibhu Prakash is a Principal Scientist, Bombay Natural History Society (BNHS) and Programme Head, National Level Vulture Conservation team. I don't think I have to hide anything. If I am wrong guide me, unless experienced people like you don't guide us we cannot develop. Omairosmani (talk) 14:06, 11 December 2018 (UTC)
 * Okay so you are not to use that website as a reference on Wikipedia. Please read and follow WP:MEDRS. Best Doc James  (talk · contribs · email) 14:23, 11 December 2018 (UTC)

If I am a spammer. I would not be having this discussion. Omairosmani (talk) 14:25, 11 December 2018 (UTC)
 * By the way I assume User:Maqbul33 and User:DavidSmith007 are also related to you? Doc James  (talk · contribs · email) 14:27, 11 December 2018 (UTC)

I din't get. Omairosmani (talk) 14:57, 11 December 2018 (UTC)

The way you are talking to me. I feel like you just want to one dominant player in the Wikipedia. You have to remove any information from Wikipedia only if you find the information is wrong. But you are just targeting without any explanation Omairosmani (talk) 15:06, 11 December 2018 (UTC)

You have kept the information I have included in the article but removed the reference. I didn't understand the logic Omairosmani (talk) 16:18, 11 December 2018 (UTC)
 * I have brought this up at WP:ANI Bri.public (talk) 18:21, 12 December 2018 (UTC)

followup regarding epidemiology course
Hey Doc James, just wanted to let you know that the epidemiology instructor got back to me. They said "I will look into the matter further, the students’ grade will reflect their “efforts,” and I will think about how to prevent this from happening again in the future. The assignment was clear – they were to add new material – but the execution isn’t always as expected." This is a 3x returning instructor, so hopefully, if they continue to teach with us, they will be able to proactively warn students against doing this. Best, Elysia (Wiki Ed) (talk) 16:49, 12 December 2018 (UTC)
 * User:Elysia (Wiki Ed) thanks. Students likely just need a bit more of an intro to WP:MEDMOS and WP:MEDRS. Doc James  (talk · contribs · email) 11:03, 13 December 2018 (UTC)

Merry Xmas
  "And the angel said unto them, Fear not: for, behold,  I bring you good tidings of great joy, which shall be to all people.  For unto you is born this day in the city of David a Saviour, which is Christ the Lord." Luke 2:10-11 (King James Version) Ozzie10aaaa (talk) is wishing you a  Merry Christmas. This greeting (and season) promotes WikiLove. Spread the cheer by adding to their talk page with a friendly message.

--Ozzie10aaaa (talk) 13:35, 13 December 2018 (UTC)
 * Thanks User:Ozzie10aaaa to you aswell :-) Doc James  (talk · contribs · email) 21:28, 13 December 2018 (UTC)

Help with Substance use disorder
Hi Doc James, I recently completed a wiki medical editing project with MUSC, and worked on the article "Substance Use Disorder." I made substantial changes to the article including creating a few sections, but predominately removing many sections that were irrelevant/out of date/not cited/poorly representative/ or just far too jargo-heavy to be comprehensible to the general public. I didn't get to work on every section, and many of them I was only able to begin. (the article still has a good deal to go)

My question to you is do you have any ideas how to get more activity to the article (bringing others to the page to contribute and update)? The treatment section especially needs attention. So much of the article had to be either deleted/or written from scratch, I'd love to make minor edits comments on other people's contributions to the article for a change. Thanks in advance for your thoughts. MedicalEdits (talk) 21:35, 14 December 2018 (UTC)
 * User:MedicalEdits the community of medical editors is very small. Hard to find people. Doc James  (talk · contribs · email) 22:49, 14 December 2018 (UTC)
 * Thanks for the edits, I suppose it's a good sign that many of the edits were on sections I didn't update. I guess that makes sense regarding the lack of medical editors. Maybe I'll be able to recruit a counselor or two to help with pages.  Regarding editing to add page numbers, the books I had were digital books.  I'm not sure what to do when I can't autogenerate the citation (due to university proxy issues), and so I just typed in the basic book name, rather than using the digital auto source.MedicalEdits (talk) 00:00, 15 December 2018 (UTC)
 * User:MedicalEdits you can use chapter names / numbers instead of pages. If you take the name of the book it is easy to find the ISBN. WP:MEDHOW will than explain how to auto populate most of the ref. Doc James  (talk · contribs · email) 00:03, 15 December 2018 (UTC)

Editing Suicide
Are you telling me that referencing the Suicide Prevention Resource Center and the American Journal of Suicidology will not be accepted?

Or are you telling me that I'm putting the references in the wrong category?

Am I better off using this Journal? https://www.ncbi.nlm.nih.gov/pubmed/22320194 Petebertine (talk) 15:32, 18 December 2018 (UTC)
 * User:Petebertine I am informing you of the importance of using high quality secondary sources per WP:MEDRS. Please read about secondary sources. The source you have provided is a primary source. 15:51, 18 December 2018 (UTC)
 * Looks like things are worked out... Doc James  (talk · contribs · email) 02:54, 20 December 2018 (UTC)

Low back pain
Thank you for contacting me regarding my edits to "Low Back Pain", and for not simply reverting my edits without comment. Considering the length of my editing record, I was surprised that you chose to offer me advice about editing the encyclopedia!

With regard to the details of these particular edits, you reverted on the grounds that my edits referenced primary sources. As you will be aware, it is not always easy to determine whether a source is primary or secondary - it depends on context. I agree that the title "Continuous Low-Level Heat Wrap Therapy for the Prevention and Early Phase Treatment of Delayed-Onset Muscle Soreness of the Low Back: A Randomized Controlled Trial" implies, at first glance, a purely primary source. However, if you read the section "Possible Mechanisms for the Heat Wrap's Effects" on page 1316, you will see that this section references no less than nine primary sources. Therefore, in the context of heat mechanisms at least, this paper qualifies, in my view, as a secondary source - because this section offers conclusions based on a review of earlier research on the topic.

I found it rather ironic that an editor from Canda - Canada! - would revert my edits revealing the role of heat in the prevention of acute Low Back Pain. Setting aside the scientific literature for a moment, the anecdotal evidence for an association between "keeping the lower back warm" and the prevention of acute muscular Low Back Pain (earlier known as Lumbago) is very strong.

Lastly: if you don't agree to revert your reversions of my edits, would you at least agree to allow me to move this correspondence to the Low Back Pain talk page? I think that this topic is of sufficient importance that all Wikipedia editors should be enabled to contribute to it.Piedmont (talk) 10:37, 21 December 2018 (UTC)
 * User:Piedmont Pubmed states what kind of sources different journal articles are. For example this is labeled as a RCT. As is this.
 * We can of course discuss further on the talk page. Doc James  (talk · contribs · email) 11:09, 21 December 2018 (UTC)

Jingle bells, ho-ho, Merry Christmas Doc!

 * Thanks :-) Doc James  (talk · contribs · email) 23:18, 23 December 2018 (UTC)

Merry Christmas !!!

 * Thanks User:CAPTAIN RAJU. Likewise... Doc James  (talk · contribs · email) 23:45, 23 December 2018 (UTC)