User talk:TylerDurden8823

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A barnstar for you![edit]

Original Barnstar Hires.png The Original Barnstar
By the way you do good work. Best Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:29, 12 October 2014 (UTC)
Thank you! It's always nice to receive some kind words of encouragement/appreciation. TylerDurden8823 (talk) 01:51, 12 October 2014 (UTC)

Thank you[edit]

Thanks for the nice comment on my talk page. I did like the edits you did to Harm reduction. I can also understand the desire to stay away from toxic articles. I do believe that every editor tries to improve Wikipedia regardless of the information they place in the article. Though I have to ask myself twice with some. Lately I have been playing "Dont Worry, Be Happy" before or after editing the page to put a smile back on my face. :D AlbinoFerret 14:16, 10 November 2014 (UTC)

Kefir[edit]

Mentioning studies in mice that gave preliminary anti-disease evidence without verification in humans is WP:PRIMARY and does not comply with the substantiation of WP:MEDRS. Having it in the article with subtitles misleads non-expert readers into believing the effects exist. The research is far too preliminary to mention it in the context of being anti-inflammatory or anti-carcinogenic.

I felt the evidence of the review on lactose intolerance is weak. It's just one review and not a review of clinical studies on a range of interventions that were effective, so overall is not worth discussing.

I'd like you to take a hard look at the nutrient content listed. How many of these nutrients are present in an amount > 10% of the Daily Value? If not at that level, they are not worth mentioning, according to FDA food labeling guidelines. The present long list gives the inaccurate picture that kefir is loaded with nutrients (same with the probiotics section), when the objective determination of nutrient content is not reported by the USDA or any reliable source I know. Both the nutrients and probiotics sections could be reduced to a sentence each. --Zefr (talk) 06:46, 17 November 2014 (UTC)

Based on the link to WP:Primary that you placed here, the references I used for the claim were, by definition, secondary sources: "A secondary source provides an author's own thinking based on primary sources, generally at least one step removed from an event. It contains an author's interpretation, analysis, or evaluation of the facts, evidence, concepts, and ideas taken from primary sources." Nowhere on the linked page does it say mentioning animal studies without subsequent verification in humans is defined as WP:Primary. This seems like your interpretation but I do not see anything on this page that says that at all. Your statement seems more like a critique of the current evidence base for use of Kefir in humans (certainly understandable, there is absolutely a paucity of data demonstrating health benefits in humans from regular kefir consumption). The issue is that the article does not say there are human benefits (except arguably with the lactose intolerance thing and that statement is really qualified with the "a 2003 study" thing showing that it was one single study from 10 years ago).
Can you show me these FDA guidelines that say they're not worth mentioning if they're not >10% of the DV? These are food labeling guidelines anyway from what you're saying and do not dictate whether it should be mentioned on Wikipedia or not. It's not a health claim, it is simply stating a fact that Kefir contains these things (stating that it contains them in significant amounts and is a rich source of vitamin X is indeed a health claim, but nowhere is that written in the article). I'm not sure how many are or are not above this threshold since I have yet to find a good source that specifies the amounts. The article makes no claim that kefir is a good or excellent source of any of these minerals, vitamins, etc., and only says it contains them. I think you may be reading too much into what's written and looking for hidden implications where there are none being made. Just because there is a bit of a laundry list detailing what nutrients it contains does not imply that it contains any of them in substantial amounts (nowhere is this claim even hinted at and the same is true for the probiotics, all that is said is that Kefir contains these things, it does not say in contains them in tremendous amounts, clinically significant amounts, or that it will translate to health benefits). The bottom line is that Kefir (according to high-quality secondary sources) DOES contain these things.
As for mentioning the studies in mice, I don't agree since WP:MEDRS specifically says otherwise. What subtitles are you referring to exactly? The "health" section heading? If so, take another look at the article, that had already been changed to the research section prior to your reversion. I'm not disagreeing that the evidence is weak, but it was enough to be covered in secondary sources from a high-quality journal and that should count for something. WP:MEDRS is pretty explicit in saying it's permissible to mention mice studies as long as the context is appropriate. If you feel it is misleading, we can work on the wording and make it clearer that these benefits have not been established in human beings. I have no objection to that. The only thing is I haven't found a secondary source discussing the lack of human trials. If you know of one, please let me know. I do not agree that it is necessary to reduce the nutrient and probiotic sections to one sentence each. That seems over the top to me. TylerDurden8823 (talk) 06:57, 17 November 2014 (UTC)
Also, while not an ideal source since it's technically press, this article from the Huffington Post does provide some discussion about the quantities of some of these nutrients (e.g., according to this admittedly suboptimal source, 1 serving of kefir has 20% RDA of calcium, mentions protein in a serving). http://www.huffingtonpost.ca/2013/09/12/kefir-benefits_n_3914818.html If I find better sources verifying this, I will be sure to use them. TylerDurden8823 (talk) 07:56, 17 November 2014 (UTC)
See section N19 and below in FDA document. [1] Also, there is no published unbiased and reliable source for kefir nutrient content, such as in the USDA Nutrient Database,[2] so I'd be wary of the Pakistani article where the authors' abstract statements seem unobjective and over-the-top in recommending kefir. --Zefr (talk) 17:05, 17 November 2014 (UTC)
This is true, despite pouring in some effort, I never could find any USDA data on the nutrient content. I'll take a look at what the FDA document has to say. TylerDurden8823 (talk) 01:12, 18 November 2014 (UTC)
Okay, I've now looked over the pertinent sections of the FDA page you linked. With respect to your point about the 20% RDA figure, I do not think it applies to what is written and I will explain why. To quote what the FDA said on the page you linked directly so there is no ambiguity: "N19. When may a "high" or a "good source" claim be made?

Answer: A "good source" claim may be made when a food contains 10-19% of the RDI or DRV (both declared on the label as the % Daily Value (%DV)). A "high" claim may be made when a food contains at least 20% of the DV. 21 CFR 101.54(b)-(c)

N20. May a "high" or a "good source" claim be made for a nutrient that does not have an established daily value? Answer: No. "High" and "good source" claims are defined as a percentage of the DV. Therefore, nutrients that do not have an established DV are not covered by the definition and may not make "high" or "good source" claims. 21 CFR 101.54(a)

If you look closely at what is written (in the Kefir article as well as in this excerpt from the FDA page), nowhere are there any claims about Kefir representing a good/excellent source or being "high" in any of these nutrients and that is what the FDA addresses on this page. If I were to say that Kefir is a "good" or "excellent" source of any of these vitamins or minerals without knowing if their amount exceeds this 20% threshold, then I would agree with your objection. However, no such claim is made. The paragraph in question on the Kefir page never makes any claim about being a good/excellent source for any of the listed nutrients and therefore this 20% FDA rule does not apply. The only claim that is made is that Kefir is a source of these nutrients at all. I will address the research part separately since they're really separate issues. TylerDurden8823 (talk) 01:18, 18 November 2014 (UTC)

The purpose of the FDA guidelines is to assure manufacturers state the reality of nutrient content to make it easy for consumers to understand food quality. If a nutrient content is < 10%, then it cannot be mentioned on a product label because it is negligible in value. From a physiologist's point of view, this makes sense, since such a low Daily Value means the nutrient intake from that food is not meaningful for cellular activity and disease prevention (all defined nutrients are based on disease prevention).

Likewise for Wikipedia, mentioning a long list of nutrients and probiotics without showing their individual contents and Daily Values, as exists now, is misleading because the typical user/consumer is going to think kefir is loaded with those long lists of nutrients and probiotics, when it may have negligible content of anything (except milk protein and calcium).

I'd still like you to pare down both paragraphs unless a reliable source describes the nutrient and probiotic contents as significant. --Zefr (talk) 01:49, 18 November 2014 (UTC)

Sorry, but I don't agree and would like to open it up to a wider forum for additional opinions. I'm willing to add more quantitative statements about it if we can find them, but I do not agree that readers will automatically assume because Kefir CONTAINS many nutrients that they will make the jump that it is chock full of all of them. I think you're reading a bit too much into this. Is there a Wikipedia guideline or policy you can cite for support specific to such nutritional information? I'm happy to discuss this on WP: Medicine's talk page and get additional opinions. I wouldn't hold this up as a "great" source for nutritional information, but at least it provides some degree of quantitative data to give us a frame of reference (note-not suggesting using for the article, more for our general knowledge about how much Kefir really does have in the way of various vitamins, minerals, etc.): http://www.pjbs.org/pjnonline/fin94.pdf TylerDurden8823 (talk) 01:54, 18 November 2014 (UTC)
If you go the Wikipedia page for common plant foods, you'll see the standard for nutrient content descriptions is the USDA database (already provided to you; hundreds of foods can be searched for nutrient content), usually presented in comprehensive tables on the right page of each Article. This online source uses the USDA database, although it's not current with the present Standard Reference.[3] If you want additional points of view, WP:MEDICINE is fine; I think it will help you see my points. --Zefr (talk) 02:08, 18 November 2014 (UTC)
I already know how to access the USDA database, your response did not answer my question. The question is whether there is a policy or guideline stating that Wikipedia does not mention nutrients in this manner if they do not exceed the FDA's threshold of 20% qualifying it as a good source (again, that claim is never made on the Kefir page) or that listing these nutrients is considered to be an implication that the food or beverage in question possesses these nutrients in high amounts (I maintain that this implication does not necessarily follow at all). As I said earlier, I'm fine with having others weigh in and give their respective viewpoints. If someone else presents a better reason to remove it, I would be amenable to that, but I think the reasons you have presented aren't sufficient cause and I disagree with the logic behind them.
Also, while stopping short of actually quantifying it, this paper (http://www.ncbi.nlm.nih.gov/pubmed/20492126) states that fermented milk products (including kefir-yes, it actually specifically named Kefir as an example) are rich sources of folate due to their folate-producing microorganisms and probably contain even more folate than milk and could represent a significant source of folate in the diet. Here is the paragraph to which I am referring in the article: "Many dairy products, however, are processed using microbial fermentations in which folate can be synthesized, significantly (Lin and Young 2000) increasing folate concentrations in the final prod- uct. Therefore, fermented milk products like yogurt (100 μg/L), are reported to contain even higher concentrations of folate than nonfermented milk (20μg/L). The elevation of folate level can be attributed to the production of additional folates by bacteria. Therefore, production and consumption of folates by the microor- ganisms will be probably the most detrimental factors in determin- ing the final folate level in various fermented foods, such as yogurt, kefir, bread, and fermented milk products. Yogurt and buttermilk contain approximately 13.7 and 7.5 μg 100/g folate, respectively, with approximately 80% to 90% of the total folate appearing in the 5-formyl-THF form (Muller 1993; Vahteristo and others 1997)." TylerDurden8823 (talk) 02:13, 18 November 2014 (UTC)

Benzalkonium Chloride page edits[edit]

Many of the references you removed conformed to WP:MEDRS, yet were removed, eg. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2958436/

Also, your application of WP:MEDRS seems quite selective, ie. not removing this: http://www.aornjournal.org/article/S0001-2092%2806%2962517-9/abstract

Kindly review your changes in good faith. — Preceding unsigned comment added by WitheredLimb (talkcontribs) 01:33, 28 November 2014 (UTC)

The first article you linked here does not conform to WP:MEDRS as it is a primary in-vitro study. Upon further review, the second paper is indeed a literature review, but is from 1998 and the section already contains newer literature reviews, so its necessity is questionable at best. If you have concerns about other material removed, feel free to let me know with specific diffs and specific concerns about what was removed. If you think something I removed conformed to MEDRS and I removed it incorrectly, please explain how it conformed to MEDRS. TylerDurden8823 (talk) 03:45, 28 November 2014 (UTC)
I seem to have misread your earlier comment on my talk page here about the 1998 literature review. Perhaps consider that I wasn't done and had to leave for dinner? I haven't scanned the entire article and the 1998 literature review you have pointed to was in a different section that I did not work on yet, correct? That's in the biological activity section and if you look through my edits you'll see I never touched that section once. It's best not to jump to conclusions or make implications like that about "selectivity" as you say. TylerDurden8823 (talk) 03:54, 28 November 2014 (UTC)

Wholesale removal of my additions, which were made in good faith, is not in line with WP good conduct. The onus is on the subsequent editor to justify each edit, not on the editee to justify (using diffs!) why the edit should not have been made. In the 25 minutes it took you to evaluate approximately 50 citations you removed a citation to a clinical trial, which you did in error. I have since reinstated this.

Further, re: your removal of pre-clinical studies; you would be aware that the lack of progression from pre-clinical trials is due to the findings of deleterious effects in animal and experimental studies, it is not ethical for these studies to be extended to humans. To include these studies provides a context for the lack of human clinical trials, to exclude them is to withhold information from readers, which is not in line with WP principles. I will re-present the other citations in a way which confirms with WP reliable data guidelines and request that they are only removed following consensus on the BZK Talk page.

I remind you that the benzalkonium chloride page is a page on a chemical compound, not a medical page. BZK has many applications and this page is unlikely to only be searched for those looking for medical information relating to humans only.

Please disclose any conflicts of interest and please conform to WP good conduct.

I will copy this over to the BZK Talk page and request that consensus is obtained prior to removal. ```` — Preceding unsigned comment added by WitheredLimb (talkcontribs) 07:40, 28 November 2014 (UTC)

First, I had no idea these were your additions (it doesn't 'matter to me who added the content). Second, I do not appreciate your tone or implication and you sound like you are not assuming good faith despite your earlier implication that you would (notice I have not removed the material you added back in and have been conducting myself properly by discussing here and opening the discussion to other editors to determine if there is consensus for your edits, mine, or neither). Third, I did justify my edits as I remain convinced that the material you added (primary studies including case reports and preclinical animal and in-vitro studies) do not conform to the guidelines at WP:MEDRS and clearly stated so in my edit summaries. Fourth, your implication that I have a COI relating to benzalkonium chloride is groundless and ridiculous and I'll leave it at that. We will see if the community at large agrees with your reasoning for keeping this information in the article or not. That's really all there is to it. It does not matter if the benzalkonium chloride page as a whole is not a medical page, if we are making claims about human health, then the material is subject to the MEDRS guidelines and that's the only information I've edited on this page. TylerDurden8823 (talk) 07:53, 28 November 2014 (UTC)
Oh, and please be sure to remember to sign your comments (a minor matter, but you should do it all the same). TylerDurden8823 (talk) 07:53, 28 November 2014 (UTC)

A Barnstar for you[edit]

Bio barnstar2.png The Bio-star
For your contributions to Sepsis in particular recognition of your de-jargonification. MrBill3 (talk) 03:14, 1 December 2014 (UTC)
Thanks Bill! I also like the term de-jargonification :) TylerDurden8823 (talk) 04:12, 1 December 2014 (UTC)

Ebola Virus Disease[edit]

Tyler,

As DocJames and I already discussed, Section:Misconceptions is for the good of the common man who reads this article for information, and not as an encyclopedic reference.

Kieran P. Clark (talk) 01:13, 2 December 2014 (UTC)

Hi Kiernan, where and when was this discussed? I don't see it on the article's talk page. If it occurred on Doc James' talk page, I don't keep track of every conversation that takes place there. There was no edit summary that I saw explaining why this information should be included. Can you clarify why this is a beneficial and necessary addition to the article? As for not being useful as an encyclopedic reference, this is an encyclopedia, so please do not lose sight of that fact. I do not disagree with you that misconceptions about EVD are rampant, but the article aims to dispel such misconceptions by providing accurate information sourced to high-quality references. TylerDurden8823 (talk) 04:17, 2 December 2014 (UTC)

Comment[edit]

Hey Tyler,

I am an Osteopathic Medical Student and was thinking of making it a project to clean up the wikipedia pages about Osteopathic Medicine since they are kind of a mess. My goal was to give unbiased information from globally respected Osteopathic associations/organizations as well as published articles and books about Osteopathy that are current. Especially since Osteopathic Medicine is a respected profession, I was hoping to provide more reliable and accurate information about the philosophy and profession. I am a busy medical student, however, so I'll probably have to give up on this project if you undo all of the updates I am trying to make, which would be unfortunate. I understand that wikipedia is so great because people can collaborate and question each other, and I also realize that you are way more experienced in wiki editing than I am (and I appreciate all of the proofreading!!!). I just wanted to express what I am trying to do in this little corner of wikipedia and hope you understand that I am just trying to update the information so that it is as accurate and professional as it can be.

Thanks, brimwanthony Brimwanthony (talk) 16:47, 18 December 2014 (UTC)

I do understand what you are saying about primary sources. I was under the impression that using those sources in order to define and provide a simple explanation would be ok since that shouldn't be contested information. It makes sense to me that the content that either supports the philosophy or slanders it would be re-organized in the effectiveness and criticism sections of the article. Doesn't that make sense? I don't think it's fair to start discrediting a profession in the introduction of the page without even properly defining what it is being discussed. I am in no way wanting to remove negative things about osteopathy; it is important to include all perspectives and as much wide breadth as possible, but as of now, the site is very much swayed to the pseudoscience end, which is pretty offensive and incorrect. Am I wrong in thinking that it is ok to use AOA, AACOM, etc. as sources for defining the profession? Brimwanthony (talk) 01:30, 19 December 2014 (UTC)
Hi Brim, the answer to your question is...yes and no. OMT is considered one aspect of the osteopathic medical profession and that of osteopathy as practiced by non-physician osteopaths outside of the United States. When considering this question, the better question to ask is if you can find such a definition in a secondary source (my money is on yes since I've seen definitions of OMM in such sources). The efficacy of OMT is considered controversial (and therefore most claims on the Wikipedia page (even of the most benign sort)) are best supported by the highest-quality references available. Sources like the American Osteopathic Association, the American Association of Colleges of Osteopathic Medicine, etc. are primary in nature and are better used on a page like Osteopathic medicine in the United States for defining aspects of the profession there (though probably best to do this in conjunction with non-osteopathic sources as well).
These primary sources tend to have wording in them that may not be viewed as neutral by all editors on Wikipedia and such edits may view the use of sources that are so close to the topic as promotional in nature or as pushing a certain pro-osteopathic medicine point of view. This is why, when in doubt, it's best to stick to secondary sources that won't have their neutrality questioned. This is of even greater importance on pages of controversy such as OMT. In terms of the offense, I cannot comment one way or the other, but the bottom line is that as an encyclopedia Wikipedia has to reflect what the mainstream sources say and be balanced. From your comments, I understand you don't feel the lead section of the article is balanced and your point is definitely heard. This is still best discussed on the article's talk page where you can make compelling, well-reasoned arguments supported by high-quality evidence. Wikipedia is also a collaborative effort and editors often disagree with one another. One editor can be right and yet be outweighed by community consensus, so it's an imperfect system that is hopefully getting better over time. Wikipedia is not meant to be on the "cutting edge" of things either. So, in short, there's no rush when it comes to adding new content.