User talk:Doc James/Archive 167

!!!! You just removed all breathing from transmission
If I have to do a RFC about that, I give up on Wikipedia, the amount of consensus here and elsewhere is ridiculous. Back to the wording before and then discuss individual sentences, Mark my words this has already been an edit war —Almaty (talk)
 * Blocked. Boing! said Zebedee (talk) 14:48, 27 March 2020 (UTC)
 * And I have unblocked after Almaty appears to have stated that they will not edit war. Boing! said Zebedee (talk) 15:24, 27 March 2020 (UTC)
 * I am troubled by Almaty's constant threats to "go to the media". Allrighty then, but it feels almost like a legal threat.  Sandy Georgia  (Talk)  15:46, 27 March 2020 (UTC)
 * I wasn't aware of any previous threats, but yes, there's clearly a chilling aspect to that kind of behaviour that we really don't want here. Boing! said Zebedee (talk) 15:52, 27 March 2020 (UTC)
 * Boing, he has mentioned it repeatedly on this page, making me wonder if we need to add "threats to go the press" to "legal threats". It's not a collaborative way to edit.  I understand that James talks to the press all the time, but not used as a threat.  Sandy Georgia  (Talk)  15:56, 27 March 2020 (UTC)
 * Some kind of policy prohibition on using threats (of any outside action) to win disputes would seem to be a sensible thing to have, yes. Boing! said Zebedee (talk) 16:01, 27 March 2020 (UTC)

User:Almaty this appears to be the edit you are referring to. Please note 1) that is not me 2) yes sometimes I sleep 3) I do not agree with that persons edits.

Editing a topic such as this requires a great deal of persistence and discussion as new editors are constantly joining who many not have read the prior discussions. Yes threats to go to the press to try to tarnish Wikipedia's reputation is definitely not appropriate. Doc James (talk · contribs · email) 16:10, 27 March 2020 (UTC)
 * Having been through months of Venezuela being on the mainpage InTheNews for the Venezuelan presidential crisis, I hope some medical editors are now seeing why I objected to the Coronavirus banner on InTheNews. We now have a growing mess, where everyone and their brother has an opinion, medical editors are a minority, and reason cannot prevail anywhere.  I have given up and unwatched most of these articles, as I find them to be hopelessly unhelpful, POV, and all too often breaching MEDRS and NOTNEWS.  That is what you get when you are ITN, and that will continue as long as it is ITN.  Even when Venezuela was finally removed from ITN, the articles were stuck with a proliferation of editors who had no idea of the history, the politics, the reliable sources, what was DUE or UNDUE, but they sure all had an opinion.  There are not enough medical editors to prevail content-wise when ITN has brought in the entire Wikipedia.  I had many problems days ago with that editor's edits.  With the added complication of being under sanctions, I see no hope of keeping the coronavirus articles in any kind of readable shape. Sandy Georgia  (Talk)  16:19, 27 March 2020 (UTC)
 * This disease has captured the worlds attention. Not sure I would attribute everything to ITN. Doc James  (talk · contribs · email) 16:55, 27 March 2020 (UTC)
 * there is no way to keep Wikipedia in any kind of good shape on this disease at this stage and for the forseeable future, I tried my best but it isn’t for me, I am not yet built for repetitive disputes about what the words exhale and airborne mean in public during a pandemic. Thanks for the support. —Almaty (talk) 04:29, 28 March 2020 (UTC)


 * Guys, calm down, there is no legal matter here whatsoever. Everyone is frightened about this virus, everyone just needs to be take things down a notch. I support Almaty's position as it is abundantly clear that Doc James has a long track record of repeatedly making a controversial changes without (or against) consensus. He clearly knows how to game the system and come out on top of edit wars. He is not held to the same standards of behaviour as other editors, particularly when it comes to edit warring, because other moderators blindly 'bootlick' him whenever such a matter occurs. The enormity of Doc James' overall positive contribution to Wikipedia is difficult to describe. He will leave an enduring legacy. However, given the extent of his poor behaviour - and how it has been left unchecked - any biography written about his leadership at Wikipedia will need to include a footnote outlining how he undermined his own leadership by being a disruptive editor. Vitreology   talk  05:20, 29 March 2020 (UTC)
 * User:Almaty and I reached a degree of consensus after a fair bit of discussion. The edit that removed breathe from the body of the text was made by someone else. I have restored it to the body of the text in fact. Doc James  (talk · contribs · email) 05:25, 29 March 2020 (UTC)
 * just to confirm that we did Over email. I might come back once the confusion off wiki is clarified. Please also refer to the WHOs tweet about this today, wiki is are reflecting the worlds confusion. they say cough sneeze and talk, with the word mainly, and confirm that according to them it is not airborne. They then state breathing but they de-emphasise it in their tweet. the word exhale and airborne are extremely difficult to convey to the public, the public remain confused. doc James and me are fine with the current wording and current consensus --49.195.72.73 (talk) 08:39, 29 March 2020 (UTC)

Can we do an eradication vs flatten the curve vs unknown strategy map?
Australia’s is unknown. New Zealand’s is eradication. We’re virtually identical countries, the prime ministers decide. Isn’t that just mental ? We have sustained transmission in Sydney now, 238 not in a cluster but I think we’re going the wrong way. —Almaty (talk)

Oxford have done a good study on the severity of governmental responses but I think people deserve to encyclopaedically know what decision their country has taken. —Almaty ps am I allowed to use talk page when retired —Almaty (talk) 15:05, 29 March 2020 (UTC)
 * Of course you are allowed to use talk pages :-) Do we have enough sources for such as map? Agree would be useful if it can be made. Would be great if OurWorldinData made one and than we just used it. Doc James  (talk · contribs · email) 17:05, 29 March 2020 (UTC)

The Signpost: 29 March 2020
 * Read this Signpost in full * Single-page * Unsubscribe * MediaWiki message delivery (talk) 17:42, 29 March 2020 (UTC)

Low magnesium associated with chlortalidone
1. What is the issue with chlortalidone-associated hypomagnesemia? I have provided citations to authoritative, high quality sources. You repeatedly remove these from the lead. A peer-reviewed summary of 4 clinical trials finding that 1 in 5 patients get this is more than enough to establish this adverse effect of chlortalidone. Rejecting this because the article is "old" doesn't seem to make sense to me. This is an adverse effect, not a therapeutic effect. Chlortalidone-associated hypomagnesemia is in the full prescribing information, it is abundantly documented in the literature, and it causes or contributes to many of the other adverse effects of the drug (low K+, low glucose, etc).

2. I've made hundreds of edits and have endeavored to use formatting that is consistent with that in each article I edit. Please explain what you believe I have done wrong with formatting of the link to the FPI for chlortalidone. I've seen this formatting used in wikipedia drug articles. How do you recommend this be formatted. You've been around long enough to know how to provide useful feedback, please do so.Sbelknap (talk) 21:03, 28 March 2020 (UTC)
 * Lets look at your edit than
 * You switched it from using a cite template to a bar url. Cite templates are used throughout the article. Please see WP:MEDHOW. I have already told you this four times on your talk page.
 * OK, I see what you are saying.
 * The ref being used does not says 20% it just says that it can occur. Doc James  (talk · contribs · email) 21:12, 28 March 2020 (UTC)
 * My comment on this edit mentioned that the cite is in the body of the article. This one:  Sbelknap (talk) 00:51, 29 March 2020 (UTC)
 * One issue with that paper is 1) it is 20 years old 2) it is about a dose that is no longer used. Basically no one uses 50mg/day (almost always 12.5mg per day).  I am happy with listing it as a side effect. Not sure we have sufficient evidence to list it as a common side effect. And that was not a review. They did not look for all data on the subject, just pulled data from 4 papers..  Doc James  (talk · contribs · email) 01:16, 29 March 2020 (UTC)
 * 1)Hypomagnesemia is a pharmacologic effect of exposure to chlortalidone, not an efficacy outcome. The age of the review article is irrelevant. These are high-quality observations of the magnesium-depleting effect of chlortalidone. Humans have not evolved much in the past 20 years. 2)Let us not confuse initial dosing of chlortalidone with maintenance dosing after dose titration. It is simply not the case that the 50 mg dose of chlortalidone is no longer used. Doses of 50 mg and 100 mg of chlortalidone are used in resistant hypertension and as part of triple nephron blocking therapy in heart failure. In these cases, the chlortalidone is combined with other diuretics, such as amiloride or eplerenone, or with ACE inhibitors or ARBs so as to mitigate against potassium depletion. Notably, magnesium depletion *does* occur at doses of 50 or 100 mg of chlortalidone, particularly in diabetics. For this reason, magnesium is routinely repleted in these patients. Sbelknap (talk) 04:41, 29 March 2020 (UTC)
 * It is not a review. The dosing for hypertension is less than it used to be. Doc James  (talk · contribs · email) 04:48, 29 March 2020 (UTC)
 * Some patients are on lower doses of chlortalidone. Others are on higher doses. That is what happens when one titrates dosing. There are many patients on 50 mg and some on 100 mg and the stat pearls article describes this. Sbelknap (talk) 04:56, 29 March 2020 (UTC)
 * "Some experts recommend dosage of 12.5–25 mg once daily based on efficacy and tolerance demonstrated in clinical studies" That is a less common dose from 20 years ago. And it is still not a review article. Doc James  (talk · contribs · email) 04:58, 29 March 2020 (UTC)
 * "Dosing regimens vary depending on clinical indication. For the treatment of heart-failure, guidelines recommend dosing started at 12.5 mg or 25 mg daily and can be titrated up to 100 mg daily as necessary. For generalized edema, dosing begins with 50 to 100 mg daily and can be titrated up to a maximum of 200 mg daily." Sbelknap (talk) 05:03, 29 March 2020 (UTC)
 * Not a review. Good enough as it is. Doc James  (talk · contribs · email) 05:04, 29 March 2020 (UTC)
 * Are you looking at the article I am citing or the other article? I am citing the stat pearls article, which mentions the doses of chlorthalidone used for heart failure and edema. This is a review article. Sbelknap (talk) 17:03, 29 March 2020 (UTC)
 * As I understand it, your opinion is that high doses of chlorthalidone are no longer used and that for this reason, chlorthalidone-associated hypomagnesemia is not a common problem. There are authoritative sources that contradict your opinion that high doses of chlortalidone are not used. For example, In fact, doses of 50 mg and 100 mg are commonly used. Also, as I understand it, you are dismissing the Pak article because you claim that it is not a review article. Yet, Dr. Pak uses the word review in the title of his article and it clearly is a review of high-quality evidence from four published trials. Hypomagnesemia is not an efficacy outcome. This evidence about chlorthalidone-associated hypomagnesemia is certainly (in my view) adequate to establish that chlorthalidone causes hypomagnesemia. It seems to me that you formed an opinion and are now reluctant to change it. Should we defer to your opinion or go with authoritative sources? Sbelknap (talk) 17:18, 29 March 2020 (UTC)
 * No I did not say that at all. We already say that hypomag is cause by chlorthalidone in the lead. P.S. A review is a method of doing a study, it is not the words one uses in a title. Doc James  (talk · contribs · email) 18:05, 29 March 2020 (UTC)
 * Fair enough…Thanks.Sbelknap (talk) 18:40, 29 March 2020 (UTC)

Azithromycin
It looks like you accidentally added Cephalexin information to the Azithromycin page. https://en.wikipedia.org/w/index.php?title=Azithromycin&diff=948102444&oldid=948100029 Whywhenwhohow (talk) 04:48, 30 March 2020 (UTC)
 * User:Whywhenwhohow thank mis edit. Doc James  (talk · contribs · email) 04:52, 30 March 2020 (UTC)

You've got mail
Hello James, recently you've removed info about Chingleput Trial regarding BCG vaccine with justification "we should use review articles" - what does it mean? The source of that info is publicly accessible and posted on reliable site - https://www.ncbi.nlm.nih.gov/pubmed/10573656.
 * User:Matolch we have high quality secondary sources on the topic. This is an old primary source.
 * Here is a 2018 review of the topic by WHO. Doc James  (talk · contribs · email) 14:42, 30 March 2020 (UTC)

WP:RS check
Hello James,

do you think https://patient.info/doctor/acute-severe-asthma-and-status-asthmaticus is a reliable source? Thank you. --Reciprocater (Talk) 07:05, 30 March 2020 (UTC)
 * User:Reciprocater Okay for what sort of content? I would say it is somewhat reliable but not ideal. Doc James  (talk · contribs · email) 14:41, 30 March 2020 (UTC)
 * Silent chest. Thank you for the time! --Reciprocater (Talk) 16:10, 30 March 2020 (UTC)
 * Sure Doc James  (talk · contribs · email) 16:13, 30 March 2020 (UTC)
 * 👌 Thanks! --Reciprocater (Talk) 16:22, 30 March 2020 (UTC)

Small droplets that fall to the ground
That’s the WHO tweet and it’s perfect for our purposes, no? —Almaty (talk) 16:29, 1 April 2020 (UTC)
 * User:Almaty which tweet? Doc James  (talk · contribs · email) 16:32, 1 April 2020 (UTC)

Same one you emailed me. I think it’s the best explanation I cited it —Almaty (talk) 16:38, 1 April 2020 (UTC)
 * User:Almaty can you give the discussion some time. Doc James  (talk · contribs · email) 17:24, 1 April 2020 (UTC)
 * we don’t have time. —Almaty (talk)
 * Yes we do. A bunch of people agreed on that prior consensus including you. Doc James  (talk · contribs · email) 17:34, 1 April 2020 (UTC)

Māori Wikipedia
Thanks for the notification. I've put one of the cartoons on the front page.- gadfium 22:35, 1 April 2020 (UTC)
 * Thanks User:gadfium I will see if I can get other people who speak that language to work there aswell :-) Doc James  (talk · contribs · email) 23:22, 1 April 2020 (UTC)

Letter to Doc James on editing Wikipedia
Dear Doc James, I am fan of Wikipedia which is the site I always visit first when I need information on a topic. For the first time 2 days ago I proposed a small modification to a Wikipedia text ("Epileptic seizure"). I expected someone to ask me to motivate the change, instead I see that it was immediately accepted. Yet I am sure that you or someone for you performs an excellent check on what is written, because the texts on Wikipedia have a high degree of reliability in my opinion. So who checked the correctness of my modification? How is the procedure? I also ask this because I hope to contribute to Wikipedia again. Congratulations on your great and important and well-conducted work, for which as a user of Wikipedia I thank you very much and I apologize for stealing your time. Warmest regards Carlo Cianchetti Former professor of Child and Adolescent Neuro-Psychiatry, University of Cagliari, Italy

Carlo.Cianchetti.MD P.S. I see that most of the collaborators, including you, have a fancy name. I gave this as a username, not imagining that it would become my official ID. Is this a problem? — Preceding unsigned comment added by Carlo.Cianchetti.MD (talk • contribs) 20:46, 1 April 2020 (UTC)
 * User:Carlo.Cianchetti.MD for a lot of pages anyone can directly contribute and those contributions go live immediately. They than often get reviewed over time. I noticed your edits and agree that they are an improvement so thankful :-) Let me know if you have any questions. A good overview of editing is at student Doc James  (talk · contribs · email) 23:26, 1 April 2020 (UTC)

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

Thanks, Barkeep49 (talk) 03:33, 31 March 2020 (UTC)
 * Yah thanks. Doc James  (talk · contribs · email) 04:28, 31 March 2020 (UTC)
 * Just know that's what the template said. I would not have included it if I were writing it. Barkeep49 (talk) 17:40, 1 April 2020 (UTC)
 * The message is reasonable. No worries. Doc James  (talk · contribs · email) 23:28, 1 April 2020 (UTC)

GMO stuff
Hi Doc, a bit of an odd duck for you since you were on the WMF (and admin). If you take a look at Talk:S%C3%A9ralini_affair, we have a new editor that has jumped into the glyphosate topic,.

They've been running pretty hot with comments like This page has thus been reported to the Wikimedia Foundation, in line with previous cases such as Alexander Waibel v Wikimedia Foundation. The Wikimedia Foundation has confirmed it is is running a full investigation into this page. or This is part of the text on this page that Wikimedia Foundation has been made aware of with much more supportive evidence from the history of this page. Editors will be subject to financial and other conflicts of interest investigations. Kind of seems like legal threat territory, but it's an odd one.

I've alerted them to the GMO DS (especially for aspersions in GMO topics), but this one has left my head scratching. I was thinking of bringing it to an admin board at one point, but decided to just let it be up to today. I'm curious what you think. Kingofaces43 (talk) 00:42, 2 April 2020 (UTC)
 * User:Kingofaces43 no idea what they mean. Doc James  (talk · contribs · email) 00:47, 2 April 2020 (UTC)
 * Yeah, I didn't either and kind of expected that. I wouldn't worry about it too much right now since I think the topic is settled enough for now we can afford to watch and see what they do or say for a little bit. Just an interesting heads up. Kingofaces43 (talk) 00:52, 2 April 2020 (UTC)
 * Doc James I have been alerted to guidelines by User:Kingofaces43 and will follow closely as a new editor. I am a conflicts of interest expert and am working to identify specific pages across the Wikipedia platform that may have been based on corporate PR campaigns with or without (as is true in most cases) the knowledge of the editors. The Wikimedia Foundation is aware of this and I am helping to make progress specifically on pages that could be defamatory and are based more or less exclusively on corporate PR campaigns. This is of course an important assignment for the future of Wikipedia and its neutral status. I hope this is not such an 'odd duck' for you now.BillyHatch2020 (talk) 01:00, 2 April 2020 (UTC)
 * I will send you an email best. Doc James  (talk · contribs · email) 01:20, 2 April 2020 (UTC)
 * Happy to discuss any questions you may have here.BillyHatch2020 (talk) 02:08, 2 April 2020 (UTC)
 * So who at the foundation are you working with? Doc James  (talk · contribs · email) 02:10, 2 April 2020 (UTC)
 * Looks like they were a sock. Kingofaces43 (talk) 19:22, 2 April 2020 (UTC)
 * Yah so were BSing about reporting to the WMF. Doc James  (talk · contribs · email) 20:10, 2 April 2020 (UTC)
 * I'm making a mistake with respect to my own mental health by posting at WP, but I guess this is sort of related, and it's a question that's been in my mind. ArbCom may be starting a case at Arbitration/Requests/Case, which is not what I'm asking about, but they have, as a named party, the editor who made this edit: . There's something familiar about the edit summary, that I can't put my finger on, that makes me think that this, too, is a sock. That's nowhere near enough for an SPI, but could you (or anyone else here) maybe think about whether you've seen another account make GMO reverts that look just like that? Thanks. --Tryptofish (talk) 20:53, 2 April 2020 (UTC)
 * Yeah, I was curious about that one at the time, but didn't think anything of it either. I'll take a look later tonight. Kingofaces43 (talk) 21:32, 2 April 2020 (UTC)

Atomoxetine
The drug was found useful to treat SCT (Sluggish cognitive tempo) but further research needs to be conducted.

Is this better ? If not, please be clearer as to why my edit is not good. Generic messages are of no use.


 * Please see WP:MEDRS. "a post hoc analysis of a 16-week placebo-controlled" does not support that it was useful. Doc James  (talk · contribs · email) 22:46, 2 April 2020 (UTC)
 * Seeing Atomoxetine pop on my watchlist, and having some experience with the literature and the history of how Lilly aggressively marketed Strattera for treatment of ADHD in the presence of Tourette syndrome (TS), I was not surprised to see that this study was funded by Lilly, with the second author apparently a Lilly employee.  the edit is no good because this is precisely the kind of study that should be discussed in independent reviews by non-conflicted authors, who don't have a financial interest. One of things WP:MEDRS protects our content from is drug company marketing efforts. Sluggish cognitive tempo and "post hoc analysis" indeed. It looks like Lilly is still trying to find a use for this medication, which didn't pan out for TS as promised, but did get prescribed a lot because of the aggressive marketing. (James, if you would tell posters like this that they really should post their questions to article talk, more people could get involved there, and not have to barge in to your talk page. Sugus38, content questions really belong on article talk. I am watchlisting that article now, lest we get more of this particular nothing-burger nonsense from Lilly.)  Sandy Georgia  (Talk)  23:12, 2 April 2020 (UTC)