Talk:Huntington's disease/GA1

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.

1. The following sections have no citation: "Symptoms", "Cognitive", "Mechanism", "Pathophysiology", "Diagnosis", "Management", "Medication", "Social impact", and "Others".

   Good. delldot talk 04:41, 12 August 2008 (UTC)

2. The following paragraphs have no citations: The first paragraph under "Genetics", the second and third under "Inheritance".

   Good. delldot talk 04:41, 12 August 2008 (UTC)

3. 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)

   Good. delldot talk 04:41, 12 August 2008 (UTC)

4. "The disorder has been heavily researched in the last few decades" might be a problem per WP:DATED  Done LeeVJ (talk) 22:14, 23 May 2008 (UTC)

   Good. delldot talk 04:41, 12 August 2008 (UTC)

5. "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)

   Good. delldot talk 04:41, 12 August 2008 (UTC)

6. "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)

   Good. delldot talk 04:41, 12 August 2008 (UTC)

7. " 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)

   Good. delldot talk 04:41, 12 August 2008 (UTC)

8. "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)

   Good. delldot talk 04:41, 12 August 2008 (UTC)

9. "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)

   Good. delldot talk 04:41, 12 August 2008 (UTC)

10. "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)

    Good. delldot talk 04:41, 12 August 2008 (UTC)

11. "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)

    Good. delldot talk 04:41, 12 August 2008 (UTC)

12. "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)

    Good. delldot talk 04:41, 12 August 2008 (UTC)

13. I believe citation style calls for a capital letter after a colon in refs.  Done LeeVJ (talk) 15:51, 22 May 2008 (UTC)

    Good. delldot talk 04:41, 12 August 2008 (UTC)

14. "The latter can cause or worsen addictions such as alcoholism and gambling, or hypersexuality." is 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 too ..5  Done cite is left tagged LeeVJ (talk) 01:34, 27 May 2008 (UTC)

    Good. delldot talk 04:41, 12 August 2008 (UTC)

15. Making that table float to the right would reduce whitespace (e.g. in rotavirus).  Done LeeVJ (talk) 15:01, 22 May 2008 (UTC)

    Good. delldot talk 04:41, 12 August 2008 (UTC)

16. Explain or at least wikilink "penetrance". { Done LeeVJ (talk) 18:24, 23 May 2008 (UTC)

    Good. delldot talk 04:41, 12 August 2008 (UTC)

17. "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)

    Good delldot talk 04:41, 12 August 2008 (UTC)

18. You can do et al. for >3 or 6 names in a ref per WP:MEDMOS  Done LeeVJ (talk) 15:51, 22 May 2008 (UTC)

    Good delldot talk 04:41, 12 August 2008 (UTC)

19. "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)

    Good delldot talk 04:41, 12 August 2008 (UTC)

20. 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)

21. "and are finally cleared up in a process called degradation" cleared up?  Done LeeVJ (talk) 17:45, 23 May 2008 (UTC)

    Good delldot talk 04:41, 12 August 2008 (UTC)

22. "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)

    Good delldot talk 04:41, 12 August 2008 (UTC)

23. " 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?

    Good delldot talk 04:41, 12 August 2008 (UTC)

24. 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)

    Good delldot talk 04:41, 12 August 2008 (UTC)

25. "polyQ dependent transcription" should probably be "polyQ-dependent transcription". Can you check?  Done LeeVJ (talk) 20:24, 21 May 2008 (UTC)

    Good delldot talk 04:41, 12 August 2008 (UTC)

26. "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)

    Good delldot talk 04:41, 12 August 2008 (UTC)

27. "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)

28. "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)

    Good delldot talk 04:41, 12 August 2008 (UTC)

29. 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)

    Good delldot talk 04:41, 12 August 2008 (UTC)

30. 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)

31. 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)

32. " 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)

    Good delldot talk 04:41, 12 August 2008 (UTC)

33. "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)

    Good delldot talk 04:41, 12 August 2008 (UTC)

34. The sentence under "Others" under "Research directions" needs a citation or citations.

    Good delldot talk 04:41, 12 August 2008 (UTC)

35. 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"
36. 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.

    Good delldot talk 04:41, 12 August 2008 (UTC)

• find references for all 'citations needed'.

1. Good delldot talk 04:41, 12 August 2008 (UTC)

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

Overall, looks great! delldot talk 04:41, 12 August 2008 (UTC)

Article as when this was written [[1]]. LeeVJ (talk) 17:12, 12 January 2009 (UTC)