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The law regarding [[Gillick competence]] is not a worldwide law. Wikipeida's own article on Gillick Competence only lists several countries in which the law applies, and in explicitly states that the law/standard should be contrasted with the "stricter age-limit approach used in the U.S." This article on Huntington's makes it seem that Gillick Competence is a law/standard that can be applied everywhere. I recommend rewording this section of this article to reflect the differing laws worldwide, or at least mention that Gillick Competence is only valid in certain countries. <span style="font-size: smaller;" class="autosigned">—Preceding [[Wikipedia:Signatures|unsigned]] comment added by [[User:Mhadjiosif22153|Mhadjiosif22153]] ([[User talk:Mhadjiosif22153|talk]] • [[Special:Contributions/Mhadjiosif22153|contribs]]) 06:21, 17 September 2008 (UTC)</span><!-- Template:Unsigned --> <!--Autosigned by SineBot--> |
The law regarding [[Gillick competence]] is not a worldwide law. Wikipeida's own article on Gillick Competence only lists several countries in which the law applies, and in explicitly states that the law/standard should be contrasted with the "stricter age-limit approach used in the U.S." This article on Huntington's makes it seem that Gillick Competence is a law/standard that can be applied everywhere. I recommend rewording this section of this article to reflect the differing laws worldwide, or at least mention that Gillick Competence is only valid in certain countries. <span style="font-size: smaller;" class="autosigned">—Preceding [[Wikipedia:Signatures|unsigned]] comment added by [[User:Mhadjiosif22153|Mhadjiosif22153]] ([[User talk:Mhadjiosif22153|talk]] • [[Special:Contributions/Mhadjiosif22153|contribs]]) 06:21, 17 September 2008 (UTC)</span><!-- Template:Unsigned --> <!--Autosigned by SineBot--> |
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:Noted. As for laws, the recommended guidelines on testing aren't law anywhere (as far as I know), just the common good practice recommendations, will check wording reflects this... [[User:Leevanjackson|LeeVJ]] ([[User talk:Leevanjackson|talk]]) 21:53, 17 September 2008 (UTC) |
:Noted. As for laws, the recommended guidelines on testing aren't law anywhere (as far as I know), just the common good practice recommendations, will check wording reflects this... [[User:Leevanjackson|LeeVJ]] ([[User talk:Leevanjackson|talk]]) 21:53, 17 September 2008 (UTC) |
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== St Vitus Dance == |
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Having failed to find the original reference used for the following fact have moved from the article: |
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*c. 300: Along with other conditions with abnormal movements, it may have been referred to as St Vitus' dance. [[St Vitus]] is the [[patron saint]] of [[epilepsy|epileptics]] who was [[martyr]]ed in 303. |
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The only references I can find state St Vitus Dance as being [[Sydenham's chorea]], but it is feasible that HD was also known in the past so I will leave here for future ref/ comment.[[User:Leevanjackson|LeeVJ]] ([[User talk:Leevanjackson|talk]]) 22:24, 21 September 2008 (UTC) |
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Discussion archive
Previous discussion topics can be found in the archive /Archive 1
Disagreement on Sharp cut off taken from todo ( prev from peer review)
It would be interesting to expand on the age-of-onset phenomenon, which I think is a matter of interest in popular descriptions of the disease. IIRC [If I Remember Correctly ? Leevanjackson] it has been suggested that the "sharp cutoff" in number of repeats needed to create disease is an effect of human lifespan - ie 30 repeats don't cause disease because the aggregation is slow enough that the person dies before it has a neurodegenerative effect. Unfortunately I can't find the paper I'm thinking of, but here is a related paper that expands on the biophysical origins of the effect.
- what is this "sharp cut off" point that is mentioned? This is definitly NOT the case. There are two overlapping populations. The normal group with a peak at 16 CAG repeats and the HD group with a peak at 40 CAG repeats, with some overlap around 36 repeats. There is also a mater of instability. Those in the "normal" range show very little instability in repeat length from generation to generation, while those in the HD range and those in the intermediate range, show instability, particularly in paternal transmission (anticipation). (see Harper and Jones, 2003, in Bates et al, 2003: Huntington's disease, 3rd Ed, Oxford Monographs on Medical Genetics).D666D 22:47, 26 September 2007 (UTC)
- I have found the refernce and summarised in a table which answers this question. LeeVJ (talk) 17:50, 29 April 2008 (UTC)
Epidemiology incongruity
Found this unsigned comment hidden in wring section LeeVJ (talk) 00:47, 8 May 2008 (UTC) There is a incongruity with one of the citations for the article. At the intro, it is stated that HD is a genetic neurological disorder inherited by approximately 3 to 7 per 100,000 people of Western European descent, varying geographically, down to 1 per 1,000,000 of Asian and African descent. It says that this bit of information was retrieved from its source on May 22, 2008. If I am not mistaken, I accessed this article today--that is May 3. Someone ought to check this out.
- Have checked it, links to correct article, there must have been a bug with the citation generator - well spotted though! LeeVJ (talk) 22:08, 13 May 2008 (UTC)
HD Management - Nutrition
In this article, it is said, "Most HD sufferers need two to three times the calories of the average person to maintain body weight", yet I have never seen any source that validates this. The largest supplement I have come across suggested by any particular study is 473 kcal/d in the study by Trejo et al. Conorcosgrave (talk) 17:52, 24 November 2007 (UTC)
- Part of answer: 24hr energy expenditure increased 11% due to movements. ( Gaba AM, Zhang K, Marder K, Moskowitz CB, Werner P, Boozer CN (2005). "Energy balance in early-stage Huntington disease". Am. J. Clin. Nutr. 81 (6): 1335–41. PMID 15941884.
{{cite journal}}
: Unknown parameter|month=
ignored (help)CS1 maint: multiple names: authors list (link) )LeeVJ (talk) 10:30, 2 May 2008 (UTC)
deleted links
Commercial
Since there are many trials and companies performing trials, didn't seem right to pick one out or list them all in main article, so maybe a list of companies conducting HD research is needed - need to trawl through manuals of style to find out if this is the wikipedia way...and have removed following recent link from article; --Leevanjackson (talk) 23:50, 15 March 2008 (UTC)
- 2008 Clinical Trials: Avicena's HD-02 to Proceed to NIH Sponsored Phase III Huntington's Disease Trial
lay organisations
The following links were deleted by another editor, but without discussion so I have put them here in-case any are relevent.LeeVJ (talk) 01:02, 3 July 2008 (UTC)
- Social Networking: Social Support Network for the HD Community!
- The International Huntington Association - Coordinates support organizations in 39 countries, and individual contacts in others.
- Hereditary Disease Foundation - Spearheaded Venezuela Collaborative Huntington's Disease Project.
- Huntington's Disease Lighthouse - Reports on the latest research and studies.
- Huntington's Disease Advocacy Center - Provides community support through shared stories and forums.
- Huntington's Disease Support Club
- European HD Network European research network
- Huntington's Disease Associations of New Zealand
- Australian Huntington's Disease Association (NSW) Inc.
- Huntington's Disease Society of America
- Huntington Society of Canada - Resource materials, latest in Canadian and International HD research and description of comprehensive services portfolio to help families struggling with HD
- Scottish Huntingtons Association - Provides expert care and information for people affected by Huntingtons Disease. Just as importantly, support is offered by families for families via a network of local family support groups.
- Huntington's Disease Association UK United Kingdom support group
- Huntington's Disease Drug Works - Website covering results and progress of clinical trials and alternative treatments for HD.
- WeAreHD.org - Online Community for those living with Huntington's Disease.
global prevalence
trying to make a global map of prevalence but can't find a single source covering everything so have to build it up. some notes on different areas
- ( general Western / venezuala/Australia/tasmania) http://www.ahdansw.asn.au/information/faq_prevalence.html - sites its sources!
- Iranian population - free full text http://www.ijhg.com/article.asp?issn=0971-6866;year=2004;volume=10;issue=2;spage=53;epage=57;aulast=Hormozian
GA review
This article generally does a good job covering an important topic on which there is a ton of material, so kudos to the writers. However, I think it does need a thorough copy edit and needs many citations; there are a bunch of sections that are unreferenced. Here are my suggestions. This looks like an awful lot but it's really mostly quick, easy fixes.
The following sections have no citation: "Symptoms", "Cognitive", "Mechanism", "Pathophysiology", "Diagnosis", "Management", "Medication", "Social impact", and "Others".The following paragraphs have no citations: The first paragraph under "Genetics", the second and third under "Inheritance".- I
would leave the complicated epidemiology data out of the very first sentence, maybe put it in the second or third. Rather, I'd have the first sentence be about what the disease is like: "Huntington's is characterized by..." That way you could introduce the idea of the varied epidemiology at the beginning of a new sentence: "the number of people varies with ethnicity: 1 in 100,000..."Done LeeVJ (talk) 23:04, 23 May 2008 (UTC)
"The disorder has been heavily researched in the last few decades" might be a problem per WP:DATEDDone LeeVJ (talk) 22:14, 23 May 2008 (UTC)
"late forties/early fifties" - I would write this out rather than using the slash, and make the spelled out number/numeral thing consistent.Done LeeVJ (talk) 15:51, 22 May 2008 (UTC)
- "
usually at around 40-50 years" Use en dashes (–) rather than hyphens (-) for number ranges per WP:DASH. This is a repetition of the 2nd paragraph, too.Done LeeVJ (talk) 15:54, 22 May 2008 (UTC)
- "
psychiatric changes, which pre-empt the physical ones, are overlooked" what does this mean? What does it mean to pre-epmt a symptom? Is that how you spell pre-empt? (I really don't know)Done LeeVJ (talk) 17:24, 22 May 2008 (UTC)
- "
Physical symptoms are almost always evident" Does this mean "almost everyone with Huntington's gets physical symptoms?" Or something about how obvious the symptoms are? Maybe reword for clarity.Done LeeVJ (talk) 17:24, 22 May 2008 (UTC)
- "
cognitive symptoms which can lead to psychopathological problems exhibit differently from person to person." would have a different meaning from "cognitive symptoms, which can lead to psychopathological problems, ..." The former is a more specific type of cognitive problem. Which is it?Done LeeVJ (talk) 21:16, 22 May 2008 (UTC)
- "
some uncontrollable movement of the lips, chewing and swallowing (Dysphagia) which commonly causes weight loss" Some can usually be dropped without changing the meaning (see User:Tony1/How to satisfy Criterion 1a: redundancy exercises). Also, "uncontrollable movement of the lips, chewing and swallowing..." doesn't really make sense. Maybe "uncontrollable movement of the lips, problems with chewing and swallowing"?Done LeeVJ (talk) 22:49, 23 May 2008 (UTC)
- "
Continence, eating and mobility are extremely difficult if not impossible." Impossible is a strong word. This would require a citation.Done LeeVJ (talk) 17:36, 22 May 2008 (UTC)
- "
to date neither of this have been supported". Per WP:DATED, avoid "to date", replacing it with "As of [whenever]".Done LeeVJ (talk) 15:51, 22 May 2008 (UTC)
I believe citation style calls for a capital letter after a colon in refs.Done LeeVJ (talk) 15:51, 22 May 2008 (UTC)
"The latter can cause or worsen addictions such as alcoholism and gambling, or hypersexuality."..5is hypersexuality an addiction? If not, you could have "The latter can cause or worsen hypersexuality or addictions such as alcoholism and gambling." a cite would be good here tooDone cite is left tagged LeeVJ (talk) 01:34, 27 May 2008 (UTC)
Making that table float to the right would reduce whitespace (e.g. in rotavirus).Done LeeVJ (talk) 15:01, 22 May 2008 (UTC)
Explain or at least wikilink "penetrance".{Done LeeVJ (talk) 18:24, 23 May 2008 (UTC)
- "
to have an increased mortality, progressively interfering with their functioning." Yeah, I guess dying would interfere with their functioning. :P Also, is there a simpler way to reword this for laypeople?Done LeeVJ (talk) 17:54, 23 May 2008 (UTC)
You can do et al. for >3 or 6 names in a ref per WP:MEDMOSDone LeeVJ (talk) 15:51, 22 May 2008 (UTC)
"Generally, but not always, the greater the number of CAG repeats..." doesn't really fit at the end of that paragraph, maybe you can fit it in the previous one.Done LeeVJ (talk) 18:24, 23 May 2008 (UTC)
Image:Autosomal Dominant Pedigree Chart.svg could stand to be smaller. I'd recommend cropping the image and increasing the size of the text so it's still legible if you make it smaller (it's an svg so this won't be hard. I can do it if you need me to, I like doing junk like that).Done What do you think? Actually, I think I may have made the key box too big, I can shrink it and make the elements closer together if you think it's a good idea. delldot talk 07:05, 24 May 2008 (UTC)
- Much better! Still not sure about it's understanability to anyone who doesn't know what it means ! e.g. (I,II,III?) but at least it can be read now ..LeeVJ (talk) 11:34, 25 May 2008 (UTC)
- I don't think it's a problem, but could add clarifications to the caption if necessary. delldot talk 04:41, 12 August 2008 (UTC)
- I can't put my finger on it, I think it's because each of the generations has differing number of possibilities, i.e. 1st gen has five offspring, 2nd then has 2,3,and 4, I think 1st gen have 4, then second have two sets off four one from an affected and one from a wild type, sounds like hassle though and not sure how pedigree charts are usually depicted .LeeVJ (talk) 21:35, 12 August 2008 (UTC)
- User:Medical geneticist has added a description which improves the situation. LeeVJ (talk) 15:04, 18 August 2008 (UTC)
- I can't put my finger on it, I think it's because each of the generations has differing number of possibilities, i.e. 1st gen has five offspring, 2nd then has 2,3,and 4, I think 1st gen have 4, then second have two sets off four one from an affected and one from a wild type, sounds like hassle though and not sure how pedigree charts are usually depicted .LeeVJ (talk) 21:35, 12 August 2008 (UTC)
- I don't think it's a problem, but could add clarifications to the caption if necessary. delldot talk 04:41, 12 August 2008 (UTC)
- Much better! Still not sure about it's understanability to anyone who doesn't know what it means ! e.g. (I,II,III?) but at least it can be read now ..LeeVJ (talk) 11:34, 25 May 2008 (UTC)
"and are finally cleared up in a process called degradation" cleared up?Done LeeVJ (talk) 17:45, 23 May 2008 (UTC)
"The exact mechanism in which mHtt causes or affects the biological processes of DNA replication and programmed cell death (apoptosis) remains unclear, so research is divided into identifying the functioning of Htt, how mHtt differs or interferes with it, and the proteopathic effects of remnants of the protein (known as aggregates) left after degradation." - long and hard to follow. Is there a simpler way to say proteopathic?Done LeeVJ (talk) 23:59, 23 May 2008 (UTC)
- " This loss of BDNF may contribute to striatal cell death, which does not follow apoptotic pathways as the neurons appear to die of starvation."
Can you reword into simpler terms for the layperson?This section could be fleshed out more anyway. Is this really all there is to say about their function? With mHtt, how are we supposed to deal with starting a sentence with a lower case letter? My instinct would be to reword so it doesn't come first (e.g. "The protein mHtt..." or "The erroneous protein mHtt" if there's an official thing known as an erroneous protein). You may want to look at featured protein articles if there are any to see how they handle the problem.Done LeeVJ (talk) 20:24, 21 May 2008 (UTC)
"polyQ dependent transcription" should probably be "polyQ-dependent transcription". Can you check?Done LeeVJ (talk) 20:24, 21 May 2008 (UTC)
"The aggregates also interact with SP1, thereby preventing it from binding to DNA,the normal functioning of these proteins" Unclear. Maybe "the way proteins normally do" or something.Done LeeVJ (talk) 20:24, 21 May 2008 (UTC)
- "Huntington mice models exposed to better husbandry techniques, especially better access to food and water, lived much longer than mice that were not well cared for."
Citation needed here.The sentence should say "in a 1998 study..." or some such, since these are findings from a particular study, not something general. A review article that discusses the study should be used, not the study itself.- This is OK, I think I was being too strict insisting on no primary sources. As I now understand it, some are ok. I think I was also wrong about using "in a 1998 study"; I've since been told that if the source is reliable you can state just the results. So this is fine. delldot talk 04:41, 12 August 2008 (UTC)
- Not sure about this one either , couldn't find a decent ref for it, aside from the fact it's pretty damned obvious that access to correct levels of food, water and ideal environment will positively affect longevity! LeeVJ (talk) 21:35, 12 August 2008 (UTC)
- Ah, found a relevant study <ref name="pmid14999077">{{cite journal |author=Spires TL, Grote HE, Varshney NK, ''et al'' |title=Environmental enrichment rescues protein deficits in a mouse model of Huntington's disease, indicating a possible disease mechanism |journal=[[J. Neurosci.]] |volume=24 |issue=9 |pages=2270–6 |year=2004 |month=March |pmid=14999077 |doi=10.1523/JNEUROSCI.1658-03.2004 |url=http://www.jneurosci.org/cgi/pmidlookup?view=long&pmid=14999077 |issn=}}</ref> so could reinstate statement,maybe. LeeVJ (talk) 13:14, 9 September 2008 (UTC)
- Not sure about this one either , couldn't find a decent ref for it, aside from the fact it's pretty damned obvious that access to correct levels of food, water and ideal environment will positively affect longevity! LeeVJ (talk) 21:35, 12 August 2008 (UTC)
- This is OK, I think I was being too strict insisting on no primary sources. As I now understand it, some are ok. I think I was also wrong about using "in a 1998 study"; I've since been told that if the source is reliable you can state just the results. So this is fine. delldot talk 04:41, 12 August 2008 (UTC)
"This is a significant find for Huntington's." What is a "significant find"? This sounds like opinion, though it's good that there's a ref. Don't know if this sentence adds anything though, without further explanation.Done LeeVJ (talk) 17:41, 23 May 2008 (UTC)
I don't think the paragraph on Juvenile HD belongs in the prognosis section, it's more about symptoms or classification. Could merge with the mention under epidemiology as a last resort; at least this would cut down on repetition.Done LeeVJ (talk) 23:26, 23 May 2008 (UTC)
- Is there really only one sentence to be written about medication, in the treatment section? If so, this section should maybe be merged into another one. I would think, though, that more needs to be written here to adequately cover the subject.
- Still very short, is medication just not an important part of treatment? delldot talk 04:41, 12 August 2008 (UTC)
- Hard to find huntington's specifically tested classical medicine, mostly broken down by health service as medicine per symptom as it would be treated on it's own, other's used don't seem to be official endorsed yet, but I am delving, should the drugs used just be listed e.g. drug for psychotic episode, apathy etc. or maybe better if I drag in a summary from each of the symptoms articles... LeeVJ (talk) 21:35, 12 August 2008 (UTC)
- Still very short, is medication just not an important part of treatment? delldot talk 04:41, 12 August 2008 (UTC)
- There are a number of very short paragraphs and sections. These are discouraged and should probably be merged or expanded.
- Improved, but still quite a few. delldot talk 04:41, 12 August 2008 (UTC)
- just started on this one...LeeVJ (talk) 21:35, 12 August 2008 (UTC)
- Improved, but still quite a few. delldot talk 04:41, 12 August 2008 (UTC)
" An intracellularly expressed single-chain Fv against the amino-terminal end of mutant huntingtin (mHtt) has been shown to reduce mHtt aggregate formation and increase turnover of the mHtt fragments in tissue culture models of HD." Can the wording be simplified for the lay reader?Done LeeVJ (talk) 01:00, 27 May 2008 (UTC)
"Intensive therapy: A pilot study on July, 2007, of inpatient rehabilitation for the Italian Welfare system, of speech, mind and body showed no motor decline in the two-year study." This needs rewording.Done LeeVJ (talk) 17:41, 23 May 2008 (UTC)
The sentence under "Others" under "Research directions" needs a citation or citations.Any time you have a statistic, it requires a citation. For example, "The prevalence is, on average, between 5 and 8 per 100,000", and "...screening now make it possible (with 99 percent certainty) to have an HD-free child"- It looks like there are an awful lot of primary sources, not the best per WP:MEDRS. Be careful when citing trials to be clear that it's a specific study and not general results, and use review articles or other secondary or tertiary sources whenever possible instead.
find references for all 'citations needed'.
- I have incorporated all the above points regarding missing references here, having tagged sections with 'fact' where required. LeeVJ (talk) 01:34, 27 May 2008 (UTC)
Done LeeVJ (talk) 16:48, 9 August 2008 (UTC)
I'm failing this for now because I think finding all the needed citations will take more than the week usually allotted for a hold. Please feel free to nominate it again once that has been dealt with, though. I'm glad to give it another look when you want me to to let you know if I think it's ready to go up again. Sorry to be so picky, it really is a very nice article, so I decided to use a very fine toothed comb with the prose. Most of my points are very minor, however the citation needed issues need to get dealt with first and foremost. I'd also recommend having a copy editor look over the article, because there were a bunch of minor wording things that made me think the whole article could use a copy edit. It also looks like some of the areas I pointed out need a little expanding. Please don't hesitate to drop me a note if you need any help or explanation. delldot on a public computer talk 07:18, 21 May 2008 (UTC)
- Get down with your bad self Leevanjackson! You're making great progress! delldot talk 07:05, 24 May 2008 (UTC)
- thankyou! :) LeeVJ (talk) 21:35, 12 August 2008 (UTC)
Rechecking for new GA review
- Update: Leevanjackson's done terrific work, addressing all my concerns from the earlier review. I came across a few more things while re-reviewing (very minor):
- This sentence is a fragment and too technical: Profound neuronal degeneration in the striatum with some additional atrophy of the frontal and temporal cortices.
Done
- This sentence is confusing: Testing of a descendant of a person, who is 'at risk', has serious ethical implications because a positive result automatically diagnoses one of the parents. Who is at risk, the parent or the descendant? Everyone's a descendant. Possibly just a comma issue (Testing of a descendant of a person who is 'at risk') but the whole sentence should be reworded.
Done
- Only the first word after periods and colons and proper nouns need to be capitalized in article titles.
- Not sure about this one, do you mean in the article content? LeeVJ (talk) 22:07, 13 August 2008 (UTC)
- Some refs need to be expanded, e.g. "Achievements of Hereditary Disease Foundation"--publisher needed, as well as date and author if available.
- Some of the refs just don't have this info - do I need to find new ones that do ? LeeVJ (talk) 22:07, 13 August 2008 (UTC)
- Confusion with its in the following sentence: The precise way it does this is unknown but a reduction in its level increases neuron cell death and creation, leading to atrophy of areas of the brain. - the first it is mHtt, and the second is BDNF, right?
Done
- Under Social impact, This sentence needs rewriting: Whether or not to have the test for HD Genetic counseling may provide perspective for those at risk of the disease.
Done
- This sentence is a fragment and too technical: Profound neuronal degeneration in the striatum with some additional atrophy of the frontal and temporal cortices.
- Overall, looks great! delldot talk 04:41, 12 August 2008 (UTC)
- Update: Leevanjackson's done terrific work, addressing all my concerns from the earlier review. I came across a few more things while re-reviewing (very minor):
GA review
This article generally does a good job covering an important topic on which there is a ton of material, so kudos to the writers. However, I think it does need a thorough copy edit and needs many citations; there are a bunch of sections that are unreferenced. Here are my suggestions. This looks like an awful lot but it's really mostly quick, easy fixes.
The following sections have no citation: "Symptoms", "Cognitive", "Mechanism", "Pathophysiology", "Diagnosis", "Management", "Medication", "Social impact", and "Others".The following paragraphs have no citations: The first paragraph under "Genetics", the second and third under "Inheritance".- I
would leave the complicated epidemiology data out of the very first sentence, maybe put it in the second or third. Rather, I'd have the first sentence be about what the disease is like: "Huntington's is characterized by..." That way you could introduce the idea of the varied epidemiology at the beginning of a new sentence: "the number of people varies with ethnicity: 1 in 100,000..."Done LeeVJ (talk) 23:04, 23 May 2008 (UTC)
"The disorder has been heavily researched in the last few decades" might be a problem per WP:DATEDDone LeeVJ (talk) 22:14, 23 May 2008 (UTC)
"late forties/early fifties" - I would write this out rather than using the slash, and make the spelled out number/numeral thing consistent.Done LeeVJ (talk) 15:51, 22 May 2008 (UTC)
- "
usually at around 40-50 years" Use en dashes (–) rather than hyphens (-) for number ranges per WP:DASH. This is a repetition of the 2nd paragraph, too.Done LeeVJ (talk) 15:54, 22 May 2008 (UTC)
- "
psychiatric changes, which pre-empt the physical ones, are overlooked" what does this mean? What does it mean to pre-epmt a symptom? Is that how you spell pre-empt? (I really don't know)Done LeeVJ (talk) 17:24, 22 May 2008 (UTC)
- "
Physical symptoms are almost always evident" Does this mean "almost everyone with Huntington's gets physical symptoms?" Or something about how obvious the symptoms are? Maybe reword for clarity.Done LeeVJ (talk) 17:24, 22 May 2008 (UTC)
- "
cognitive symptoms which can lead to psychopathological problems exhibit differently from person to person." would have a different meaning from "cognitive symptoms, which can lead to psychopathological problems, ..." The former is a more specific type of cognitive problem. Which is it?Done LeeVJ (talk) 21:16, 22 May 2008 (UTC)
- "
some uncontrollable movement of the lips, chewing and swallowing (Dysphagia) which commonly causes weight loss" Some can usually be dropped without changing the meaning (see User:Tony1/How to satisfy Criterion 1a: redundancy exercises). Also, "uncontrollable movement of the lips, chewing and swallowing..." doesn't really make sense. Maybe "uncontrollable movement of the lips, problems with chewing and swallowing"?Done LeeVJ (talk) 22:49, 23 May 2008 (UTC)
- "
Continence, eating and mobility are extremely difficult if not impossible." Impossible is a strong word. This would require a citation.Done LeeVJ (talk) 17:36, 22 May 2008 (UTC)
- "
to date neither of this have been supported". Per WP:DATED, avoid "to date", replacing it with "As of [whenever]".Done LeeVJ (talk) 15:51, 22 May 2008 (UTC)
I believe citation style calls for a capital letter after a colon in refs.Done LeeVJ (talk) 15:51, 22 May 2008 (UTC)
"The latter can cause or worsen addictions such as alcoholism and gambling, or hypersexuality."..5is hypersexuality an addiction? If not, you could have "The latter can cause or worsen hypersexuality or addictions such as alcoholism and gambling." a cite would be good here tooDone cite is left tagged LeeVJ (talk) 01:34, 27 May 2008 (UTC)
Making that table float to the right would reduce whitespace (e.g. in rotavirus).Done LeeVJ (talk) 15:01, 22 May 2008 (UTC)
Explain or at least wikilink "penetrance".{Done LeeVJ (talk) 18:24, 23 May 2008 (UTC)
- "
to have an increased mortality, progressively interfering with their functioning." Yeah, I guess dying would interfere with their functioning. :P Also, is there a simpler way to reword this for laypeople?Done LeeVJ (talk) 17:54, 23 May 2008 (UTC)
You can do et al. for >3 or 6 names in a ref per WP:MEDMOSDone LeeVJ (talk) 15:51, 22 May 2008 (UTC)
"Generally, but not always, the greater the number of CAG repeats..." doesn't really fit at the end of that paragraph, maybe you can fit it in the previous one.Done LeeVJ (talk) 18:24, 23 May 2008 (UTC)
Image:Autosomal Dominant Pedigree Chart.svg could stand to be smaller. I'd recommend cropping the image and increasing the size of the text so it's still legible if you make it smaller (it's an svg so this won't be hard. I can do it if you need me to, I like doing junk like that).Done What do you think? Actually, I think I may have made the key box too big, I can shrink it and make the elements closer together if you think it's a good idea. delldot talk 07:05, 24 May 2008 (UTC)
- Much better! Still not sure about it's understanability to anyone who doesn't know what it means ! e.g. (I,II,III?) but at least it can be read now ..LeeVJ (talk) 11:34, 25 May 2008 (UTC)
- I don't think it's a problem, but could add clarifications to the caption if necessary. delldot talk 04:41, 12 August 2008 (UTC)
- I can't put my finger on it, I think it's because each of the generations has differing number of possibilities, i.e. 1st gen has five offspring, 2nd then has 2,3,and 4, I think 1st gen have 4, then second have two sets off four one from an affected and one from a wild type, sounds like hassle though and not sure how pedigree charts are usually depicted .LeeVJ (talk) 21:35, 12 August 2008 (UTC)
- User:Medical geneticist has added a description which improves the situation. LeeVJ (talk) 15:04, 18 August 2008 (UTC)
- I can't put my finger on it, I think it's because each of the generations has differing number of possibilities, i.e. 1st gen has five offspring, 2nd then has 2,3,and 4, I think 1st gen have 4, then second have two sets off four one from an affected and one from a wild type, sounds like hassle though and not sure how pedigree charts are usually depicted .LeeVJ (talk) 21:35, 12 August 2008 (UTC)
- I don't think it's a problem, but could add clarifications to the caption if necessary. delldot talk 04:41, 12 August 2008 (UTC)
- Much better! Still not sure about it's understanability to anyone who doesn't know what it means ! e.g. (I,II,III?) but at least it can be read now ..LeeVJ (talk) 11:34, 25 May 2008 (UTC)
"and are finally cleared up in a process called degradation" cleared up?Done LeeVJ (talk) 17:45, 23 May 2008 (UTC)
"The exact mechanism in which mHtt causes or affects the biological processes of DNA replication and programmed cell death (apoptosis) remains unclear, so research is divided into identifying the functioning of Htt, how mHtt differs or interferes with it, and the proteopathic effects of remnants of the protein (known as aggregates) left after degradation." - long and hard to follow. Is there a simpler way to say proteopathic?Done LeeVJ (talk) 23:59, 23 May 2008 (UTC)
- " This loss of BDNF may contribute to striatal cell death, which does not follow apoptotic pathways as the neurons appear to die of starvation."
Can you reword into simpler terms for the layperson?This section could be fleshed out more anyway. Is this really all there is to say about their function? With mHtt, how are we supposed to deal with starting a sentence with a lower case letter? My instinct would be to reword so it doesn't come first (e.g. "The protein mHtt..." or "The erroneous protein mHtt" if there's an official thing known as an erroneous protein). You may want to look at featured protein articles if there are any to see how they handle the problem.Done LeeVJ (talk) 20:24, 21 May 2008 (UTC)
"polyQ dependent transcription" should probably be "polyQ-dependent transcription". Can you check?Done LeeVJ (talk) 20:24, 21 May 2008 (UTC)
"The aggregates also interact with SP1, thereby preventing it from binding to DNA,the normal functioning of these proteins" Unclear. Maybe "the way proteins normally do" or something.Done LeeVJ (talk) 20:24, 21 May 2008 (UTC)
- "Huntington mice models exposed to better husbandry techniques, especially better access to food and water, lived much longer than mice that were not well cared for."
Citation needed here.The sentence should say "in a 1998 study..." or some such, since these are findings from a particular study, not something general. A review article that discusses the study should be used, not the study itself.- This is OK, I think I was being too strict insisting on no primary sources. As I now understand it, some are ok. I think I was also wrong about using "in a 1998 study"; I've since been told that if the source is reliable you can state just the results. So this is fine. delldot talk 04:41, 12 August 2008 (UTC)
- Not sure about this one either , couldn't find a decent ref for it, aside from the fact it's pretty damned obvious that access to correct levels of food, water and ideal environment will positively affect longevity! LeeVJ (talk) 21:35, 12 August 2008 (UTC)
- Ah, found a relevant study <ref name="pmid14999077">{{cite journal |author=Spires TL, Grote HE, Varshney NK, ''et al'' |title=Environmental enrichment rescues protein deficits in a mouse model of Huntington's disease, indicating a possible disease mechanism |journal=[[J. Neurosci.]] |volume=24 |issue=9 |pages=2270–6 |year=2004 |month=March |pmid=14999077 |doi=10.1523/JNEUROSCI.1658-03.2004 |url=http://www.jneurosci.org/cgi/pmidlookup?view=long&pmid=14999077 |issn=}}</ref> so could reinstate statement,maybe. LeeVJ (talk) 13:14, 9 September 2008 (UTC)
- Not sure about this one either , couldn't find a decent ref for it, aside from the fact it's pretty damned obvious that access to correct levels of food, water and ideal environment will positively affect longevity! LeeVJ (talk) 21:35, 12 August 2008 (UTC)
- This is OK, I think I was being too strict insisting on no primary sources. As I now understand it, some are ok. I think I was also wrong about using "in a 1998 study"; I've since been told that if the source is reliable you can state just the results. So this is fine. delldot talk 04:41, 12 August 2008 (UTC)
"This is a significant find for Huntington's." What is a "significant find"? This sounds like opinion, though it's good that there's a ref. Don't know if this sentence adds anything though, without further explanation.Done LeeVJ (talk) 17:41, 23 May 2008 (UTC)
I don't think the paragraph on Juvenile HD belongs in the prognosis section, it's more about symptoms or classification. Could merge with the mention under epidemiology as a last resort; at least this would cut down on repetition.Done LeeVJ (talk) 23:26, 23 May 2008 (UTC)
- Is there really only one sentence to be written about medication, in the treatment section? If so, this section should maybe be merged into another one. I would think, though, that more needs to be written here to adequately cover the subject.
- Still very short, is medication just not an important part of treatment? delldot talk 04:41, 12 August 2008 (UTC)
- Hard to find huntington's specifically tested classical medicine, mostly broken down by health service as medicine per symptom as it would be treated on it's own, other's used don't seem to be official endorsed yet, but I am delving, should the drugs used just be listed e.g. drug for psychotic episode, apathy etc. or maybe better if I drag in a summary from each of the symptoms articles... LeeVJ (talk) 21:35, 12 August 2008 (UTC)
- Still very short, is medication just not an important part of treatment? delldot talk 04:41, 12 August 2008 (UTC)
- There are a number of very short paragraphs and sections. These are discouraged and should probably be merged or expanded.
- Improved, but still quite a few. delldot talk 04:41, 12 August 2008 (UTC)
- just started on this one...LeeVJ (talk) 21:35, 12 August 2008 (UTC)
- Improved, but still quite a few. delldot talk 04:41, 12 August 2008 (UTC)
" An intracellularly expressed single-chain Fv against the amino-terminal end of mutant huntingtin (mHtt) has been shown to reduce mHtt aggregate formation and increase turnover of the mHtt fragments in tissue culture models of HD." Can the wording be simplified for the lay reader?Done LeeVJ (talk) 01:00, 27 May 2008 (UTC)
"Intensive therapy: A pilot study on July, 2007, of inpatient rehabilitation for the Italian Welfare system, of speech, mind and body showed no motor decline in the two-year study." This needs rewording.Done LeeVJ (talk) 17:41, 23 May 2008 (UTC)
The sentence under "Others" under "Research directions" needs a citation or citations.Any time you have a statistic, it requires a citation. For example, "The prevalence is, on average, between 5 and 8 per 100,000", and "...screening now make it possible (with 99 percent certainty) to have an HD-free child"- It looks like there are an awful lot of primary sources, not the best per WP:MEDRS. Be careful when citing trials to be clear that it's a specific study and not general results, and use review articles or other secondary or tertiary sources whenever possible instead.
find references for all 'citations needed'.
- I have incorporated all the above points regarding missing references here, having tagged sections with 'fact' where required. LeeVJ (talk) 01:34, 27 May 2008 (UTC)
Done LeeVJ (talk) 16:48, 9 August 2008 (UTC)
I'm failing this for now because I think finding all the needed citations will take more than the week usually allotted for a hold. Please feel free to nominate it again once that has been dealt with, though. I'm glad to give it another look when you want me to to let you know if I think it's ready to go up again. Sorry to be so picky, it really is a very nice article, so I decided to use a very fine toothed comb with the prose. Most of my points are very minor, however the citation needed issues need to get dealt with first and foremost. I'd also recommend having a copy editor look over the article, because there were a bunch of minor wording things that made me think the whole article could use a copy edit. It also looks like some of the areas I pointed out need a little expanding. Please don't hesitate to drop me a note if you need any help or explanation. delldot on a public computer talk 07:18, 21 May 2008 (UTC)
- Get down with your bad self Leevanjackson! You're making great progress! delldot talk 07:05, 24 May 2008 (UTC)
- thankyou! :) LeeVJ (talk) 21:35, 12 August 2008 (UTC)
Rechecking for new GA review
- Update: Leevanjackson's done terrific work, addressing all my concerns from the earlier review. I came across a few more things while re-reviewing (very minor):
- This sentence is a fragment and too technical: Profound neuronal degeneration in the striatum with some additional atrophy of the frontal and temporal cortices.
Done
- This sentence is confusing: Testing of a descendant of a person, who is 'at risk', has serious ethical implications because a positive result automatically diagnoses one of the parents. Who is at risk, the parent or the descendant? Everyone's a descendant. Possibly just a comma issue (Testing of a descendant of a person who is 'at risk') but the whole sentence should be reworded.
Done
- Only the first word after periods and colons and proper nouns need to be capitalized in article titles.
- Not sure about this one, do you mean in the article content? LeeVJ (talk) 22:07, 13 August 2008 (UTC)
- Some refs need to be expanded, e.g. "Achievements of Hereditary Disease Foundation"--publisher needed, as well as date and author if available.
- Some of the refs just don't have this info - do I need to find new ones that do ? LeeVJ (talk) 22:07, 13 August 2008 (UTC)
- Confusion with its in the following sentence: The precise way it does this is unknown but a reduction in its level increases neuron cell death and creation, leading to atrophy of areas of the brain. - the first it is mHtt, and the second is BDNF, right?
Done
- Under Social impact, This sentence needs rewriting: Whether or not to have the test for HD Genetic counseling may provide perspective for those at risk of the disease.
Done
- This sentence is a fragment and too technical: Profound neuronal degeneration in the striatum with some additional atrophy of the frontal and temporal cortices.
- Overall, looks great! delldot talk 04:41, 12 August 2008 (UTC)
- Update: Leevanjackson's done terrific work, addressing all my concerns from the earlier review. I came across a few more things while re-reviewing (very minor):
- Article as when this was written [[1]]. LeeVJ (talk) 17:12, 12 January 2009 (UTC)
Usage of HTT for gene, HTT for protein and mHTT for mutant form of protein
Hi Lee- really nice work on the HD article by the way. I stopped by today to make some scattered revisions particularly on the genetics parts. One thing I noticed is the gene symbol/protein symbol issue (discussed here[2]). I switched the gene name to all-caps italics wherever I saw it and the protein name to all-caps non-italics. To my best knowledge, this is the "proper" way to distinguish gene names and protein names. What I don't know is how the mutant protein is designated (mHtt or mHTT). My guess is you can find examples of both usages, but probably mHTT is more consistent with the typical protein designations in humans (as opposed to mouse, where the gene is Htt and the protein is Htt).
- Thankyou :) When I looked into it a year ago, there didn't seem to be a concensus in journals etc, but what I did get the gist of was that genes where capitalised, and proteins they produced weren't i.e. HTT the gene, Htt the protein, seemed right so I stopped looking into it. As for mhtt makes sense to me that since it is actually a form of Htt it is just a lower case 'm' denoting 'essentiall htt but altered' also seems right - but I have been known to be wrong! LeeVJ (talk) 00:02, 14 August 2008 (UTC)
Are there other sections that you think could benefit from additional work? I'd be happy to help you get this one GA status. Medical geneticist (talk) 22:38, 13 August 2008 (UTC)
- Great! Your copyedits and additions have already been magnificient! As for GA there are a couple of trickies - full details for the citations and some of the short sections. I've reduced the technical jargon over time to something readable and understandable (hopefully) but some of them now need expanding on! An essential piece mentioned yonks ago in peer review that would add help start rounding off the article is about DNA replication! Someone asked about how dna had problems replicating long sequences, ie.e cleavage points and such, but I got lost in translation ;( (sorry) I think they meant for the protein generation - initially I was looking at how the repeat expansion can change as it is passed on, but I think both would be an excellent addition...if there are two functions, like I said I got a bit lost which is why the other wiki articles still need some work! LeeVJ (talk) 00:02, 14 August 2008 (UTC)
Just a litte note
![](https://upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/20px-Yes_check.svg.png)
I have removed the <BR> tags that were present in some places and not others as it makes the article untidily laid out. Hope no one minds.
—CyclonenimT@lk? 17:27, 15 August 2008 (UTC)
I disagree with moving the Social Impact section to "Society and Culture"
I saw the recent move of some of the ethical considerations (Social Impact) to the Society and Culture subheading. While I understand that this is a standard category for MEDMOS, the thrust of that section has nothing to do with the pop-culture aspects and is completely out of context in that section. It's actually quite a non-sequiter to have it in the same section as Arlo Guthrie and "Alice's Restaurant". I'm sure that the change was well-meaning, but IMHO misguided. I would suggest instead that this section go under a different subheading titled "Ethical Considerations". Medical geneticist (talk) 02:00, 22 August 2008 (UTC)
- It was me who moved it per MEDMOS. Precisely the intention of the last revision of MEDMOS was to reduce the Pop culture sections and really create a section which had important society things to tell, and if you think about it and just look into the titles a title like social impact should clearly be inside a section called society and culture. It does not have sense to have a separate section. As an example take a look at the Alzheimer's disease society and culture section. I talks about the caregiver burden, economic aspects and also a minor "pop culture" subsection. The alzheimer disease will quite surely become a FA and in its revision everybody has agreed in such section. Similarly AIDS which formerly was a FA and it is still a very good article has in its section of society stigma, economic impact and denialism of AIDS, and no pop culture section in the whole article. Finally I only one to say that if you revert it I won't fight (at least until I get heavily involved with this article) even if I believe it is the correct place for the section. Best regards. --Garrondo (talk) 07:02, 22 August 2008 (UTC)
Like I said, I understand the MEDMOS recommendations, I just think that the implementation in this case is not well executed. It takes something unique about Huntington's disease (i.e. the absolutely fundamental impact this disorder has had on ethics in genetic testing) and buries it in what is now a very strangely organized section. You cite good examples of diseases (Alzheimer's and AIDS) that have a huge impact on society as a whole, where discussion of these issues in that context makes sense. There are certainly analogous issues in HD (stigma, cost of care, impact on insurability etc.) that could be discussed in this section but perhaps the ethical aspects of genetic testing could be moved to a different subsection (not sure where) on the "impact on medical genetics" or something like that. I'm not going to revert your edits, I'll just see if Lee has any strong feelings on the subject. Medical geneticist (talk) 01:31, 23 August 2008 (UTC)
The society and impact section has always been a bit 'messy' and deserves a rewrite - I split off media depictions to stem the flow. A while ago I tried to put the point across about HD being a pivotal stage in genetic testing and ethics, but was unable, at the time, to find decent references and write it in a NPOV way. If you are saying that this is the case from a medgen point of view, then this is a very important part of the article, with better coverage in the lead - probably it's own paragraph! So in conclusion I agree with both of you, I think this is the right section, but the section as it reads now is too 'tucked away', the whole article should be interesting reading and with the important section research directions following it, history preceding, this tail end of the article can be made much stronger. Do you have any ideas MedicalGeneticist, where the best overview of genetics that might put the HD issue in perspective of the field is- it seems to be taken as read rather than stated where I have seen LeeVJ (talk) 11:19, 23 August 2008 (UTC)
Poor presentation of data and discussion
I do think this is generally a very good article, but the presentation of the research in HD is not great. The 'Degradation' section is downright wrong -- it suggests 'a little knowledge' or just reading a couple of articles and misinterpreting them, rather than reading about the area. Uncleaved fragments of mHTT aren't called aggregates. The coalescence of mHTT fragments is thought to form 'protofilmanets' which further coalesce (aggregate) to form inclusions. Inclusions can be nuclear OR cytoplasmic (where they are sometimes called aggregates) and toxicity has been demonstrated with BOTH! This section contains outright contradictions -- "...unprocessed pieces are called aggregates..."; "aggregates consist mainly of the amino terminal end of mHtt" (the second statement is correct). There is plenty of data suggesting a direct correlation between the presence of inclusions and toxicity, however, whether the inclusions themselves are toxic is a different matter and there is also plenty of evidence suggesting that inclusions are cytoprotective.
The 'Mechanism' section in general seems rather weak. Which 'mechanism' is being referred to?
"Like all proteins, Htt and mHtt are translated, perform or affect biological functioning, and are finally dissolved in a process called biodegradation." No. The intracellular removal of functionally redundant proteins is not biodegradation. Proteins are removed via the ubiquitin-proteasome system, a vital system whose dysregulation as a consequence of aggregated mHTT is thought to be a possible source of cellular toxicity in HD. Also I've never seen anywhere the suggestion that HTT is involved in DNA replication.
I realise that a line has to be drawn as to how much detail is gone in to. HD pathology is vastly complex and poorly understood, but the different theories on its mechanisms and the arguments for and against them could be better presented. For good recent reviews, see Imarisio et al, Biochem. J., 2008;412:191-209 (This group is primarily interested in 'autophagy' and HD, so in the interests of a balanced opinion...) and Orr & Zoghbi, Annu Rev Neurosci. 2007;30:575-621.
(Should I be putting this in a bulleted list instead?!) Matstuff (talk) 10:47, 27 August 2008 (UTC)
- Thankyou for the analysisand pointers to refs...your previous post wasn't overlooked - just got waylayed in improving the current refs and other GA stuff - in which I included a note pointing it out... The current sections are an artifact of past good faith edits citing primary sources alone and transclusions of huntingtin protein and gen articles, so does need a good work out - please feel free to edit anything! I have recently got hold of the Lancet seminar, and am trying for the Imariso et al ref and will add the neuroscience one to my list ... LeeVJ (talk) 12:54, 27 August 2008 (UTC)
free full text articles
- relevant to previous section on polyglutamine aggregation: http://hmg.oxfordjournals.org/cgi/content/full/12/suppl_2/R173.
- Huntington Disease genetics http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=15717026.
- Diagnosis of HD http://www.clinchem.org/cgi/content/full/49/10/1726. LeeVJ (talk) 11:55, 1 September 2008 (UTC)
editing tip
top tip: for comlicated articles use wikied , it highlights syntax grays out comments and refs, leaving article text clear to see... brief installation - works in firefox at least... goto to your wikipedia preferences / gadgets - wikied is listed, just activate it and that's it, hope it helps LeeVJ (talk) 12:09, 28 August 2008 (UTC)
- I think you mean WikEd. Personally I recommend 'Display an assessment of an article's quality as part of the page header for each article' which can be found under 'User interface gadgets' in your preferences. Really saves some time! —Cyclonenim (talk · contribs · email) 17:12, 28 August 2008 (UTC)
- Yep, I did - your tip will also help - it's great, despite it's catchy name ! :) LeeVJ (talk) 22:32, 28 August 2008 (UTC)
Last sentence before " Cognitive" moved
I moved the last sentence before " Cognitive" to "Genetics".Bettering the Wiki (talk) 22:20, 6 September 2008 (UTC)
- Not sure if it really fits in this section, which is about the basic genetics. Maybe the mechanism/function section would be more appropriate?LeeVJ (talk) 00:21, 7 September 2008 (UTC)
- I disagree;while not perfectly, it fits better where it is. We can delete it, but only as a last resort, when all other places we try fail.Bettering the Wiki (talk) 02:52, 7 September 2008 (UTC)
- OK, happy to go with your decision....any other opiniios? LeeVJ (talk) 03:27, 7 September 2008 (UTC)
- I disagree;while not perfectly, it fits better where it is. We can delete it, but only as a last resort, when all other places we try fail.Bettering the Wiki (talk) 02:52, 7 September 2008 (UTC)
(undent)Nope.Bettering the Wiki (talk) 12:17, 7 September 2008 (UTC)
GA Review
- This review is transcluded from Talk:Huntington's disease/GA1. The edit link for this section can be used to add comments to the review.
I will be reviewing this article, so please expect a long list of constructive advice below. While I make my recommendations, could I quickly point out the following issues:
Done The article currently does not follow the header names suggested by WP:MEDMOS.
Done Several references (e.g. 79-84) are not templated. Others lack PMID, DOI or ISBN codes that would help the reader locate the source quickly.
- These details have been filled up by numerous editors since review LeeVJ (talk) 15:03, 14 March 2009 (UTC)
Done Some sections are very short, suggesting that they should either be expanded or merged with others.
- Apart from BDNF which is new. LeeVJ (talk) 15:03, 14 March 2009 (UTC)
Here is the continued review:
Here we go then. I will provide individual comments that are each signed, so it is easy to keep track of what I have had to say and what the response may have been. JFW | T@lk 23:21, 14 August 2008 (UTC)
Done General: any hope of more pictures? JFW | T@lk 23:21, 14 August 2008 (UTC)
- would the ones in the todo list satisfy this? LeeVJ (talk) 23:12, 17 August 2008 (UTC)
- Yes. JFW | T@lk 23:20, 17 August 2008 (UTC)
- Global map and molecule will have to wait until they are available, CAG graph when a free image becomes available - or are created from scratch. L∴V 00:04, 2 April 2009 (UTC)
- Yes. JFW | T@lk 23:20, 17 August 2008 (UTC)
- would the ones in the todo list satisfy this? LeeVJ (talk) 23:12, 17 August 2008 (UTC)
Done General: some of the secondary sources used are excellent, yet some sections seem to use primary sources where one would imagine the secondary sources to be able to supply the necessary background. I will flag this up whenever possible. Perhaps bring some of the sources from "Bibliography" into the footnotes apparatus? JFW | T@lk 23:21, 14 August 2008 (UTC) bibliography now incorporated into refs
- Garrondo has done an epic job of secondary rerefercing and weeding out unneccesary primaries. L∴V 00:04, 2 April 2009 (UTC)
Done General: I was quite surprised to see no mention of Ian McEwan's excellent novel Saturday, in which HD plays a significant role and the literary description he makes is quite accurate. This is definitely not WP:TRIVIA. JFW | T@lk 23:21, 14 August 2008 (UTC)
- This is listed in the media depictions subarticle, see later point...LeeVJ (talk) 21:13, 19 August 2008 (UTC)
Done Intro: perhaps a bit more clinical information (which mental abilities are affected?) and slightly less hard scientific terminology. The intro needs to be as plain as possible, however fascinating CAG repeats are. JFW | T@lk 23:21, 14 August 2008 (UTC)
- started LeeVJ (talk) 00:17, 20 October 2008 (UTC)
Done Intro: I feel that every statement should be supported by a single source, unless that is genuinely impossible. WP:CITE applies to the entire article, which includes the intro. JFW | T@lk 23:21, 14 August 2008 (UTC)
- bar first genetic test which is covered by another pointLeeVJ (talk) 13:23, 26 August 2008 (UTC)
Done Signs and symptoms - Intro: comment on the difference between JHD and HD should probably be moved to the physical symptoms section. I have rewritten the section a bit, and the statement can readily be moved. JFW | T@lk 23:21, 14 August 2008 (UTC)
Done Signs and symptoms - Physical: when do bradykinesia & dystonia occur? Instead of, or in addition to, the choreatiform movements? Can anything be said about their signifcance, or should they just be mentioned alongside the chorea? JFW | T@lk 23:21, 14 August 2008 (UTC)
- Expanded description, think it is clearer now L∴V 00:28, 6 April 2009 (UTC)
- Signs and symptoms - Physical: "slurring of speech" - can anything be said about the nature of the dysarthria? "Slurring" is nonspecific and could be bulbar, ataxic etc. JFW | T@lk 23:21, 14 August 2008 (UTC)
- The wording slurring of speech does not appear any more in the article. What is left is "any function that requires muscle control is affected, resulting in physical instability, abnormal facial expression, and difficulties chewing, swallowing and speaking" Is it enough?--Garrondo (talk) 08:18, 2 April 2009 (UTC)
- Done √ Sorry missed the question amongst the others - good point in that context I think it's ok L∴V 00:12, 6 April 2009 (UTC)
- The wording slurring of speech does not appear any more in the article. What is left is "any function that requires muscle control is affected, resulting in physical instability, abnormal facial expression, and difficulties chewing, swallowing and speaking" Is it enough?--Garrondo (talk) 08:18, 2 April 2009 (UTC)
Done Signs and symptoms - Physical: entire section about TP53 is completely off-topic and needs to be moved. The sources are also more than doubtful, and probably fail WP:MEDRS. JFW | T@lk 23:21, 14 August 2008 (UTC)
DoneSigns and symptoms - Cognitive: source definitely fails MEDRS. Can't readily comment on the content of the section. JFW | T@lk 23:21, 14 August 2008 (UTC)
- now referenced to Lancet. L∴V 01:47, 2 April 2009 (UTC)
Done Signs and symptoms - Psychopathological: rename section "psychiatric"? Less confusing, perhaps a bit more confrontational. Are there any good secondary sources here? JFW | T@lk 23:21, 14 August 2008 (UTC)
- Name changed, refs to come...LeeVJ (talk) 21:13, 19 August 2008 (UTC)
- Now referenced by Garrondo.L∴V 00:04, 2 April 2009 (UTC)
- Name changed, refs to come...LeeVJ (talk) 21:13, 19 August 2008 (UTC)
Done Genetics: strong section, not much comments. Do we know why only paternal CAG repeats exhibit expansion and cause anticipation? If not, perhaps we should say that this is unknown. JFW | T@lk 23:21, 14 August 2008 (UTC)
- Done: I have added: This occurs because instability is greater in spermatogenesis than oogenesis (obtained from lancet seminar)--Garrondo (talk) 08:18, 2 April 2009 (UTC)
- Mechanism: the Imarisio et al source seems underused. Being a secondary source in a core journal, it looks ideal, although it is unfree. JFW | T@lk 23:21, 14 August 2008 (UTC)
- Has been rereferenced, but I don't think anyone has had access to the ref suggested. L∴V 00:30, 2 April 2009 (UTC)
Done Mechanism: there are several very short sections that could probably be merged. In general, I would discourage level 4 headers if it can at all be helped. JFW | T@lk 23:21, 14 August 2008 (UTC)
Done Mechanism - Degradation: this needs rewriting. In particular, the model needs to be sourced to a secondary source (with optional retention of the most crucial primary sources only), and most of the concepts discussed need to be clarified in lay terms (e.g. "knockin mouse"). It's not easy, but it is crucial for readability. JFW | T@lk 23:21, 14 August 2008 (UTC)
- Section has have several copyeditors and reduction in complexity. L∴V 00:30, 2 April 2009 (UTC)
Done Mechanism - Other systems: I think this section is irrelevant, unless you can demonstrate that other organs are clinically affected in HD (not to my knowledge). JFW | T@lk 23:21, 14 August 2008 (UTC)
- Expanded slightly, does seem to be emerging evidence, but the section might be better placed in research directions. LeeVJ (talk) 16:14, 14 March 2009 (UTC)
- Section has been disbanded. L∴V 00:30, 2 April 2009 (UTC)
Done Diagnosis: The actual content about counselling before testing, as well as restricting testing in children, has no reference. JFW | T@lk 23:21, 14 August 2008 (UTC)
Done Management: Much more can be quoted from the Bonelli & Wenning review with regards to pharmacological treatment options. Just dropping the name of one drug is unhelpful. For instance, are there antipsychotics that also have antichoreatic properties? JFW | T@lk 23:21, 14 August 2008 (UTC)
- Prognosis: some of the clinical content (e.g. heart failure and suicide risk) could possibly be moved to "signs and symptoms". JFW | T@lk 23:21, 14 August 2008 (UTC)
- Heart failure has moved and suicide risk seems to flow in its current place, so unsure. L∴V 00:30, 2 April 2009 (UTC)
Done Social impact: needs tightening, removal of weasel words, referencing. JFW | T@lk 23:21, 14 August 2008 (UTC)
- References added. Can you specify which "weasel words" you find? Medical geneticist (talk) 18:50, 17 August 2008 (UTC)
- "Some individuals have chosen" is unsourced; in general, there is much in this section that applies to other genetic diseases also. JFW | T@lk 22:28, 17 August 2008 (UTC)
- Right, I'll add the reference for the individual preferences. You are correct that much of this applies to other genetic diseases as well -- it's just that HD has been THE paradigm for application of genetic testing, particularly in the presymptomatic, "at-risk" individual. Maybe I'll make that more clear, thanks. Medical geneticist (talk) 22:43, 17 August 2008 (UTC)
- This section is always tricky to write sympathetically whilst dodging weasel words - I'll give it an ed LeeVJ (talk) 23:12, 17 August 2008 (UTC)
- Right, I'll add the reference for the individual preferences. You are correct that much of this applies to other genetic diseases as well -- it's just that HD has been THE paradigm for application of genetic testing, particularly in the presymptomatic, "at-risk" individual. Maybe I'll make that more clear, thanks. Medical geneticist (talk) 22:43, 17 August 2008 (UTC)
- "Some individuals have chosen" is unsourced; in general, there is much in this section that applies to other genetic diseases also. JFW | T@lk 22:28, 17 August 2008 (UTC)
- References added. Can you specify which "weasel words" you find? Medical geneticist (talk) 18:50, 17 August 2008 (UTC)
Done Epidemiology: some content belongs in the genetics section (e.g. the de novo mutation rate). Is there anything more we can do with the fact that JHD seems to have specific clinical characteristics (as well as having its own eponym)? Move it to the relevant section? JFW | T@lk 23:21, 14 August 2008 (UTC)
Done History: needs to be turned into prose, with sources for all presently unsourced landmarks. JFW | T@lk 23:21, 14 August 2008 (UTC)
- Society and culture: why on earth was List of Huntington's disease media depictions split off from here? Turned into prose with the Lancet source this could easily be merged back. I don't think the list of organisations and when they met is encyclopedic. JFW | T@lk 23:21, 14 August 2008 (UTC)
- Sections turned into prose and put into context, the list of media depictions does seem to have has stemmed the flow of trivial references being added, so further deliberation required. L∴V 00:11, 2 April 2009 (UTC)
Done Research directions: will comment at a later date, but I'm certain that this needs secondary sources as a matter of urgency. JFW | T@lk 23:21, 14 August 2008 (UTC)
- Has been copyedited several times and referenced. L∴V 00:11, 2 April 2009 (UTC)
In conclusion, I think a large amount of work is still needed. I am particularly concerned about the fact that much information is inadequately sourced, and this is going to be an obstactle to GA unless this is addressed. I will try to help out if I can, but I have no access to the most promising secondary sources (the Bates/Harper/Jones book, the Imarisio and the Bonelli papers). Could I also point out a 2007 Lancet Seminar (doi:10.1016/S0140-6736(07)60111-1) that we really must cite prominently. JFW | T@lk 23:21, 14 August 2008 (UTC)
Comments on failing GAC. I feel uneasy about having to fail this once again, because so much excellent work has been done on it. It continues to receive much attention from some very dedicated editors, and I am in little doubt that it will reach GA status in the near future, and probably FA not much later. At present, however, there are some pretty significant impediments to GA. Most of them are outstanding issues that I listed above, such as the diversion into p53 in the "signs and symptoms" section. I'm also a bit surprised that the Lancet review I recommended was not used more often. Please keep me informed of signifant progress, and I will happily provide further input. JFW | T@lk 22:19, 27 August 2008 (UTC)
GA Review
- This review is transcluded from Talk:Huntington's disease/GA2. The edit link for this section can be used to add comments to the review.
All of the concerns I brought up in my original GA review have been addressed. However, JFW brought up another set of concerns in the second GA review (archived at Talk:Huntington's disease/GA1 because the original review took place before we were doing that) and there has not been time to address these. Rather than restating them here, I'll refer you to Talk:Huntington's disease/GA1. I urge editors not to renominate this article for GA until the concerns from the second review are dealt with and a consensus has been reached among those who have been working on the article that it should be nominated. However, the article has come a long way and I'm sure it will pass with flying colors once this is the case! Let me know if you have any questions or anything to discuss, I'm always happy to help however I can. delldot ∇. 16:29, 7 September 2008 (UTC)
Gillick Competence
The law regarding Gillick competence is not a worldwide law. Wikipeida's own article on Gillick Competence only lists several countries in which the law applies, and in explicitly states that the law/standard should be contrasted with the "stricter age-limit approach used in the U.S." This article on Huntington's makes it seem that Gillick Competence is a law/standard that can be applied everywhere. I recommend rewording this section of this article to reflect the differing laws worldwide, or at least mention that Gillick Competence is only valid in certain countries. —Preceding unsigned comment added by Mhadjiosif22153 (talk • contribs) 06:21, 17 September 2008 (UTC)
- Noted. As for laws, the recommended guidelines on testing aren't law anywhere (as far as I know), just the common good practice recommendations, will check wording reflects this... LeeVJ (talk) 21:53, 17 September 2008 (UTC)
St Vitus Dance
Having failed to find the original reference used for the following fact have moved from the article:
- c. 300: Along with other conditions with abnormal movements, it may have been referred to as St Vitus' dance. St Vitus is the patron saint of epileptics who was martyred in 303.
The only references I can find state St Vitus Dance as being Sydenham's chorea, but it is feasible that HD was also known in the past so I will leave here for future ref/ comment.LeeVJ (talk) 22:24, 21 September 2008 (UTC)