Langbahn Team – Weltmeisterschaft

Wikipedia:Peer review/Neurocysticercosis/archive1

Neurocysticercosis

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I've listed this article for peer review because I want to bring it to FA status. I've gotten input from a number of editors and I'm going to be pinging some specific editors who I've reached out to in the past or who I know are great in this area so I'm sorry if I ping anyone who is not interested or does not have the time. Pings: @AirshipJungleman29, Gen. Quon, Jimfbleak, SchroCat, Graham Beards, Gerda Arendt, Ajpolino, and WhatamIdoing: Thanks in advance, IntentionallyDense (Contribs) 21:45, 3 December 2024 (UTC)[reply]

WhatamIdoing

Thanks for your work on this.

  • Links: This is a very technical subject, with lots of unfamiliar anatomical terms. It needs more links than usual. We probably also need links to articles that don't exist yet. I've added some redlinks that you might be able to find suitable redirect targets for. In other cases ("lentil lectin purified glycoprotein (LLGP) enzyme-linked immunoelectrotransfer blot (EITB) assay"?), perhaps we could beg that medical class to create the articles for us. If you dislike any of my suggested links, then I am trusting you to just remove them. I suspect that the link in "human and porcine mass chemotherapy" is pointed at the wrong page. WhatamIdoing (talk) 23:05, 3 December 2024 (UTC)[reply]
  • Wording: Most of this is quite good (i.e., I understand what you're saying, and nothing sounds obviously wrong to me), but I don't love the line "the methods used to diagnose it can be problematic". Does this mean they're dangerous? Unethical? Or is it redundant with "hard to access"? Also, the classification sub-section says there are two types and gives three bullet points. The abbreviation NCC is used only in captions until the ==Prevention== section. WhatamIdoing (talk) 23:05, 3 December 2024 (UTC)[reply]
    • The source does use the word "problematic" but based on what they write elsewhere I think they are trying to imply that the tests used aren't always reliable, unless anyone finds an issue with this I'm going to change the wording to unreliable instead. As for the classification portion this is a result of the source having slightly confusing wording. I've changed it to "two main subtypes" as parenchymal and extraparenchymal are the two most common presentations but the other category is still worth noting. If you have a better idea as to how to approach this please do let me know. The abbreviation thing was me getting lazy while expanding the article. I'll replace NCC with the full term since it is what I used throughout the majority of the article. IntentionallyDense (Contribs) 01:44, 4 December 2024 (UTC)[reply]
  • Diagnostic criteria: There are copyvio problems around (some) diagnostic criteria. I have checked none of the sources, but I would like to see this written, to the greatest extent feasible, in your own words. An exact, word-for-word copy of the official source is not always best. WhatamIdoing (talk) 23:05, 3 December 2024 (UTC)[reply]
  • Sources: The second paragraph of ==Epidemiology== probably needs some refs duplicated. The 1997 (image) source doesn't concern me, but I see several sources from 2014. Ideally, as we approach the start of 2025, almost all of the sources would be from 2020 or more recent. Is there a more recent version of any of these sources available? Any recent source you wished for but couldn't find a copy of? WhatamIdoing (talk) 23:05, 3 December 2024 (UTC)[reply]
    • I added the ref after every figure or number, may have overdone it but I'm sure someone will tell me if I have. As for the map, there's two main reasons why I have an older one used. Mainly it's that I couldn't find any newer sources that had maps that could be used on Wikipedia (copyright reasons) and because I don't remember many other sources having maps for the epidemiology part but I may have missed that. IntentionallyDense (Contribs) 01:44, 4 December 2024 (UTC)[reply]
      I'm not really concerned about the images. I'm mostly concerned about WP:MEDDATE for the text of the article. WhatamIdoing (talk) 21:26, 4 December 2024 (UTC)[reply]
      Oops I misread your original comment. Unfortunately I couldn't find that many more recent comprehensive studies on the topic. I could take a second look but the 2014 source is unfortunately one of the most comprehensive sources on the topic. IntentionallyDense (Contribs) 17:55, 6 December 2024 (UTC)[reply]
  • One thing I'd like to know is, if "intervention programs can take decades", and de-worming is a preventive treatment, how often would de-worming need to happen? I've read about some annual de-worming programs (e.g., the traveling health program de-worms entire villages once a year, rotating through the different villages). Would that be often enough? WhatamIdoing (talk) 23:05, 3 December 2024 (UTC)[reply]
    • While this is an interesting question that I to would love the answer to, I'm not sure if an answer exists yet. It was pretty hard to find non-primary studies on prevention. There unfortunately (at least to my knowledge) there haven't been many large prevention programs for NCC. The main ones I included in the prevention section. I'll see if I can find anything on this tho and see if the studies done thus far have followed a similar timeline. IntentionallyDense (Contribs) 01:44, 4 December 2024 (UTC)[reply]
      If there's no answer in a good source, then I will just have to stay curious about this. WhatamIdoing (talk) 21:27, 4 December 2024 (UTC)[reply]
      I did search for answer and it looks like the time ranged from anywhere from a couple weeks for pig vaccines to years for more in depth education programs. I could add the time it took for the 3 studies I talked about in the last pargraph of the prevention paragraph if you think that would be helpful. IntentionallyDense (Contribs) 17:57, 6 December 2024 (UTC)[reply]
  • Also, how long does treatment take? Does this usually require weeks or months of frequent trips to the doctor? I can imagine that being a barrier to treatment in the rural areas where the risk of transmission is highest. WhatamIdoing (talk) 23:05, 3 December 2024 (UTC)[reply]
    Okay I was able to find the time needed for antiseizure meds and antiparasitic meds but not for steroids. IntentionallyDense (Contribs) 18:10, 6 December 2024 (UTC)[reply]

WhatamIdoing (talk) 23:05, 3 December 2024 (UTC)[reply]

Comments

  • Suggest scaling up the life cycle diagram; throughout, scaling should be done with |upright= rather than fixed pixel size
  • You have several sources in the article indicated as being in the public domain, but then you have images from those same sources tagged as being Creative Commons licensed. Which of those is correct?
  • How are you ordering the Sources section?
  • The Causes and Mechanism sections seem to overlap. Nikkimaria (talk) 00:06, 4 December 2024 (UTC)[reply]
    • I changed the scale on all of the images using the upright instead and upscaled that one a bit. I mixed up copyright terms but have changed that now. They are now appropriately tagged. I ordered the sources section based on when the sources are used and then all the image sources at the end as I added those last. The causes and mechanisms do overlap a bit. I based the sections off of the WP:MEDMOS but if you think those sections would be better combined let me know. IntentionallyDense (Contribs) 02:33, 4 December 2024 (UTC)[reply]

Nick-D

I was invited to comment on this PR on my talk page, as a volunteer FAC mentor. With the very large proviso that this isn't a topic I know anything at all about, I'd like to offer the following comments:

  • Overall, the article is in very good shape and covers the topic in a comprehensive but not too detailed way. It would benefit from some polishing to reach FA status though.
  • As a general comment, the article's wording is generally a bit too technical for a general audience (as a single, indicative example, I don't know what "the most common cause of intracranial hypertension in neurocysticercosis is hydrocephalus" means). I'd suggest reviewing the text with an eye to using simpler terminology and explaining concepts more - remember that Wikipedia's most important use is generally as an introduction to topics for a general but interested readership.
  • The sentence starting with 'Neurocysticercosis manifests' is rather over-complex, and should be split into two sentences
  • "The first recorded cases of neurocysticercosis were likely in 1558" - the article later notes though that the disease appears to have been circulating in ancient Egypt and Rome.
  • "is endemic in developing countries, such as Latin America, China, Nepal, Africa, India, and Southeast Asia" - these are regions, not countries, and the regions include many countries that are not "developing" - e.g. much of modern Southeast Asia is at middle income status and countries like Chile and Singapore are classified as being at high levels of development.
  • The "Causes" section implies that people who consume Taenia solium are certain to have tapeworms develop. Is this the case?
  • The Diagnosis section states that the disease is " often hard to access in areas with fewer resources" - do sources allow this statement to be extended to note that this is often the case in the developing economies that are most affected by it? (or are there good ways to diagnose the disease using low tech/cost ways in these countries?)
  • Could the redlink to Eradicable disease point to Eradication of infectious diseases, or are we best off with the redlink as is? (I'm surprised that we don't have an article on Eradicable diseases given the concept seems a bit different, and is very important)
  • For disposal of waste, waste disposal/Waste management seems the appropriate link. You might want to create a redirect.
  • "Urbanization and development cause these factors to go away" - I think that the wording here could be tweaked to be a bit more formal
  • The treatment section notes that this is a fairly complex disease to treat, with the response needing to be tailored to the individual's symptoms and circumstances and often requiring a relatively complex response. While it's not stated, I imagine that this is difficult/impossible in many developing economies and remote areas.
  • "Over half of those with calcified parenchymal neurocysticercosis have relapses in seizures and need antiseizure medications long-term." - needs a reference
  • Are the increase in cases in wealthy countries noted in the 'Epidemiology' section due to local infections or people contracting the disease elsewhere and then travelling to these countries? The later is implied, but is a bit unclear.
  • The map of Indonesia here is a bit odd given that the article says the disease isn't common in Muslim countries. Why is Indonesia being highlighted given it's mainly a Muslim nation?
  • There's a see also link to Neglected tropical diseases, but this diseases' status as such isn't discussed in the body of the article. This would be a good topic to cover if it is a neglected tropical disease (in general, if you need a see also in articles that are being developed for FA status it's probably a topic that should be covered in the article). Nick-D (talk) 10:13, 4 December 2024 (UTC)[reply]
Hi, with regard to the question about Muslim countries, only one of the two provided references actually claimed this, and I think that it is a dated viewpoint in a globalized world (this is not an article about taeniasis, which is more directly linked to undercooked meat consumption). The other reference correctly points out that the pork tapeworm is endemic in "most developing countries" and that neurocysticercosis is more frequently being seen in developed countries as well. Neurocysticercosis absolutely qualifies as a neglected tropical disease.
Singhi, Pratibha; Suthar, Renu (2015). "Neurocysticercosis". Indian Journal of Pediatrics. 82: 166–171. doi:10.1007/s12098-014-1576-3. PMID 25297641.
"Neglected tropical diseases: Taeniasis and cysticercosis". World Health Organization. 6 April 2020. Retrieved 4 December 2024. Tsarivan613 (talk) 03:01, 5 December 2024 (UTC)[reply]
  • This feedback has been super helpful so thank you. I'm going to reply to each of your points individually starting with your second point. I also want to apologize for the delay in response.
  1. The technicality of this subject is something I have really struggled with. I think (and please tell me if you disagree) the lead has been simplified enough to be understandable to the average reader. I did define the terms intracranial hypertension and hydrocephalus as they are used a lot so thank you for pointing that out. However the one kind of struggle I'm having is wether every single section needs to be simplified to the level of an average reader. For example the "diagnostic criteria" section. I don't really think that's something someone who just wanted to know about the disease would be super interested in. That section is more meant for medical proffesionals. With that in mind I have written it a step down (per WP:ONEDOWN) so that hopefully the average medical student could understand it. I'm also struggling to continue to simplify the article without omitting details or losing meaning. Just to give an example, the article ME/CFS is the most recent medical FA. If you look at the "Pathophysiology" section there is some content that will not be understood by the average reader however further simplifying it would lose meaning. All of that being said, if there is certain sections, words, or setences that you find way too technical please point them out but I am struggling a bit with the suggestion of just simplifying the article.
  2. I changed it to Neurocysticercosis manifests with various signs and symptoms, influenced by the location, number of lesions, and immune response. It can range from asymptomatic to fatal; common symptoms include seizures, intracranial hypertension, cognitive impairment, and focal deficits. hopefully that looks better.
  3. I believe this confusion comes from the wording a bit so let me know if I can make this more clear. Based off the sources there was cases of what we can now presume was NCC back in 1500 BC and ancient egypt but it was not identified as such at the time. For a long time autopsies weren't done in part because the catholic church frowned upon them. However sometime around 1558 the catholic church began to allow autopsies and therefore we had someone actually identify NCC in a dead patient. So 1558 was the first time someone actually wrote up a case report or somehow told others that NCC existed despite the fact that it did exist before that.
  4. I changed the wording to regions. I believe what the source was saying was not that all countries in Latin America and Southeast Asia have NCC endemics but that more contries in those areas do than in other areas. I'm not sure if it would be better to just omit those areas and stick to just the countries or find a way to word this better. Let me know what you think.
  5. While I'm almost sure, without a source to confirm this, that everyone who consumes Taenia solium does not immediately get NCC the sources do not make this distinction clearly. There wasn't any information on factors that may impact wether or not ingested Taenia solium becomes NCC or not. I'm not really sure how to clarify this.
  6. The source I used for that statement does say "Accurate diagnosis of NCC is notoriously difficult; available methods are problematic and implementation in resource-poor endemic is patchy." which seems to be the extent of how much detail is provided but I will keep searching. Unfortunately because of the fact that it can take several expensive time consuming tests to diagnose NCC there does not seem to be any proposed cheaper or more accessible diagnostic options.
  7. As for the redlinks, I'm going to go through them myself and see what redirects I can make and possibly bug some med students to create some articles or create some myself.
  8. Changed to Urbanization and development reduce these factors, therefore transmission goes down. hopefully that looks better.
  9. While this is most likely true I'm not finding anything in the sources that could support that well enough to be included.
  10. Fixed
  11. Yes you are correct. I changed the wording to usually a result of people contracting Taenia solium while travelling or immigration. to clarify.
  12. In referance to the map, it is the only map I could find in the PD hence why I used it over more comprehensive maps. Someone else chimed in mentioning that the muslim part is only mentioned in one source, which is correct and I'm considering removing that part since the source that mentions it is a bit older.
  13. While NCC is considered a nglected tropical disease none of the sources outright state that. They kind of imply it in a round about way (it being completely preventable but still not having programs to do so) and I just couldn't figure out a way to coherantly include that. IntentionallyDense (Contribs) 18:52, 6 December 2024 (UTC)[reply]
    Neurocysticercosis is on the WHO neglected tropical diseases list as part of "taeniasis/cysticercosis". It's also on the PLoS NTD list. No opinion on whether that info needs to be included in the article or not. As examples, I included it directly at Buruli ulcer but only tangentially at Dracunculiasis. I didn't intend to have different strategies for the two articles, I was just trying to reflect the coverage (or lack thereof) in sources. Ajpolino (talk) 19:49, 6 December 2024 (UTC) [reply]
On the last point, if you don't have sources saying this is a neglected tropical disease the see also has no justification for being in the article. Details like this matter at FA level. Nick-D (talk) 23:16, 6 December 2024 (UTC)[reply]
Okay I'll remove it thank you. IntentionallyDense (Contribs) 02:39, 7 December 2024 (UTC)[reply]

EG

Having been invited here by IntentionallyDense, I'll leave a few comments later. I will also specify that I don't know anything about the topic, so I'll try to point out anything that seems unclear or confusing. – Epicgenius (talk) 16:30, 6 December 2024 (UTC)[reply]

Sorry for the delay. I'll leave some quick feedback for now:
  • Seizures: "In areas where neurocysticercosis is common, adult-onset seizures are heavily correlated with the condition" - You mean geographical areas? In addition, since "adult-onset seizures" is currently a red link, I think it may be a good idea to gloss, or provide a brief definition of, this.
  • Focal deficits: "Pyramidal tract symptoms, such as weakness, Babinski's sign, spasticity, and overactive reflexes are the most common; however sensory impairments, parkinsonian rigidity, involuntary movements, language disturbances, and signs of brain-stem dysfunction can also occur." - First, this sentence is pretty long, so I'd split it. Second, I think pyramidal tract may need to be glossed, too.
  • Intracranial hypertension:
    • I'd link cerebrospinal fluid at first mention ("it is most frequently caused by buildup of cerebrospinal fluid in the brain") and put the CSF acronym after that link, rather than in the next sentence.
    • "Cysticercotic encephalitis, which is a severe type of neurocysticercosis usually affecting younger women and children can also cause intracranial hypertension." - There is a missing comma after "children".
  • Other symptoms: I'd also gloss "sellar region".
Causes:
  • "Neurocysticercosis often results from undercooked infected pork or other food" - Does it result from the act of undercooking, or does it result from eating undercooked food? Probably the latter, but at FAC someone's liable to point this out.
More in a bit. As a casual reader, this seems like a well-written article so far. Looking at the rest of the article, though, I do think we can gloss/reword some of the more specialized medical terms so that they are more accessible to readers. I see you have also received some advice from medical editors including SandyGeorgia and Ajpolino; I'd take that advice as well. – Epicgenius (talk) 17:38, 23 December 2024 (UTC)[reply]

Comments by Dudley

  • "improperly cooked food". This is an odd expression. There is not a proper way of cooking. Maybe "undercooked".
  • You often use technical terms without links or explanation, for example, focal deficit, antiedema, Ependymitis, Arachnoiditis etc.
  • I think that the causes and mechanism sections should come before signs and symptoms.
  • "Neurocysticercosis often results from improperly cooked infected pork or other food, or contaminated water." Do you mean always by eating or drinking? I have read that some parasites can enter through wounds when bathing in contaminated water. You seem to imply that it can always be prevented by thorough cooking and boiling. If this is so, then you should say so. If not, then you should clarify other mechanisms.
  • "in which the cysticercus is no further viable". This is ungrammatical.
  • "a huge body composed of several hundred proglottids". "huge" is vague and unhelpful.
  • There is an excessive number of red links. This is unhelpful to the reader.
  • The word "improper" is over-used. I doubt whether it should ever be used in this article as it always seems to mean inadequate, which is a more accurate term.
  • Thanks for all your work, but I am not sure what the audience is for this article. There are far too many unexplained technical terms for the general reader, and anyone capable of understanding it would read a textbook rather than a Wikipedia article. I think you need to make the article much clearer to non-expert readers. Dudley Miles (talk) 19:14, 6 December 2024 (UTC)[reply]
    • I'm going to address each one of your points individually to stay organized. Thank you for your feedback it means a lot to me.
    1. fixed the improperly to undercooked
    2. The reason these are not linked is because articles for them don't exist but I'm working on that. Focal deficit is somewhat defined in the section "Focal deficit" as "specific neurologic symptoms determined by the size, number, and location of the parasites." as a focal deficit is simply a problem with nerve, spinal cord, or brain function affecting a specefic location. antiedema seems a bit more straight forward as the word anti means to get rid of (or something along those lines) and so one could assume it would mean a medication that gets rid of edema. As for Ependymitis and Arachnoiditis I will add definitions for those.
    3. I'm going to have to disagree with the ordering of the sections as it is what is stated it WP:MEDMOS and is used in other (recent) medical FA such as ME/CFS
    4. While some parasites can enter in other ways it seems that NCC is specefically caused by ingesting the parasite as it needs to attach to the intestines to grow. While I can't say for sure that there has never been a case of NCC through other means it is not mentioned in secondary sources. I do state in the prevention section that NCC is completely preventable and how it is preventable but I'm not sure how I could make this more clear.
    5. Fixed to in which the cysticercus is no longer viable
    6. Changed to large. Let me know if I should just ommit any description of size here.
    7. As for the red links, I'm not quite sure what you want me to do about this. Wikipedia encourages adding red links as per WP:RED "Add red links to articles to indicate that a page will be created soon or that an article should be created for the topic because the subject is notable and verifiable. Red links help Wikipedia grow... In general, a red link should remain in an article if there is a reasonable expectation that the article in question will eventually be created (either as its own article or as a redirect); remove red links if and only if Wikipedia should not have any coverage on the subject.".
    8. Improper is now used 3 times in the article. In all the contexts it's is used it's is meant to mean that the proccess isn't being done correctly, not just that it is not being done well enough. Maybe inccorect would be a better term instead?
    9. As for the intended audience of the article, it differs. The lead is meant to be targetted towards the everyday reader. I think I've got it to that point but let me know if I haven't. Other sections (such as symptoms, causes, prevention, history etc) are meant for someone who wants a bit more info on the topic. As per Wikipedia:Make technical articles understandable "some subjects naturally attract a more limited audience" which I think would apply to these sections. The average reader probably won't read much past the lead by default. Some of the sections, such as the diagnosis and treatment aren't of much interest to the general public. I mean how many people outside of the medical feild do you see taking interest in the diagnostic criteria of a brain parasite? In those cases I write WP:ONEDOWN. So while specefic diagnostic criteria of a disease is something you would probably be learning as a medical resident I tried to write it at the level of a medical student instead. As for why people would choose Wikipedia over a textbook, it's not uncommon for people to need a quick refresher on a topic instead of an indepth textbook chapter. IntentionallyDense (Contribs) 20:12, 6 December 2024 (UTC)[reply]
On the parasite entering other ways I think it would be clearer if you specified drinking contaminated water to make clear that it is not other ways such as through wounds. Dudley Miles (talk) 21:39, 6 December 2024 (UTC)[reply]
done. IntentionallyDense (Contribs) 21:52, 6 December 2024 (UTC)[reply]

ZKang123

I decided to take a look at this.

  • Minor thing, but I might first describe the symptoms before the causes for the first paragraph, given that's how you organised the rest of the article.
  • The second and third leading paragraphs could be combined in some way. The second seems a bit short and hanging there.
  • Seizures are more common in parenchymal neurocysticercosis than in other forms of neurocysticercosis.[2] Seizures may occur at any stage of the disease – might combine these two sentences. Just watch out for short sentences so it doesn't seem too choppy.
  • If neurocysticercosis is left untreated seizures will often reoccur, and persist despite treatment – The placement of commas here is a bit awkward. I would write If neurocysticercosis is left untreated, seizures will often reoccur, and persist despite treatment The second comma seems optional, but I guess it means despite treatment, it would continue to persist.
  • Seizures are more commonly associated with degenerating cysts.[4] These cysts are often accompanied by – ...associated with degenerating cysts, which are often accompanied by...
  • I felt the seizures subsection gets rather choppy especially with plenty of sentences starting with "seizures". It's kind of giving me a seizure, haha. Similarly for Intracranial hypertension, which tends to have many sentences beginning with it.
  • In truth, and I might be dumb, but I'm not so sure what's focal deficits?
  • For the sentence beginning with Those with neurocysticercosis and inflammation of the arachnoid..., it's a bit too long and there are two "caused by...", which makes reading this sentence hard to read.
  • a build of pressure around the brain – Do you mean a "build-up of pressure"?
  • Only one source for the "other symptoms" subsection?

My first impression thus far is that while it's clean to read, as a few others point out, it can get rather technical at bits especially when you just list the symptoms. For example, I'm unsure what are "ophthalmologic" and "endocrinologic" symptoms. The specific forms of each disease can be a bit alien to ordinary readers, and perhaps the medical term for like some body parts such as "ventricles", "parenchyma", "subretinal space".--ZKang123 (talk) 06:34, 7 December 2024 (UTC)[reply]

  • Thank you for your feedback, I really appreciate it. I'm going to respond to each bit of feedback individually so I can stay organized.
  1. I've kinda always formatted my first setence of med articles as "xyz disease is <definition> caused by xyz" and never thought about following the format used elsewhere. I do quite like the way this sounds as cutting the intro setence to just "Neurocysticercosis (NCC) is a parasitic infection of the nervous system" seems a little short. Would it look uncohesive if i changes it to "Neurocysticercosis (NCC) is a parasitic infection of the nervous system caused by the tapeworm Taenia solium, also known as the "pork tapeworm". This tapeworm can travel to the brain, muscles, eyes, and skin. Neurocysticercosis manifests with various signs and symptoms, influenced by the location, number of lesions, and immune response. It can range from asymptomatic to fatal; common symptoms include seizures, intracranial hypertension, cognitive impairment, and focal deficits. The disease is often caused by eating undercooked food or drinking water contaminated with tapeworm larvae (cysticerci). When cysticerci enter the small intestine, they attach to the intestinal wall and grow into a tapeworm."?
  2. Agreed. I combined them for now but let me know if you have any ideas on how to make it flow better.
  3. Good point! I changed it to Seizures are more common in parenchymal neurocysticercosis than in other forms of neurocysticercosis; they can occur at any stage of the disease., hopefully that looks better.
  4. Thank you, done. Commas are not my stroung suit
  5. done, thank you.
  6. Good point. I've noticed I tend to do this a lot. I'll see what I can do to vary the setences a bit.
  7. Not dumb at all. I would expect most people to know what focal deficits are, I didn't know what they were until I started working on this article. Focal deficits are problems with the CNS (nerves, brain, spinal cord) affecting a specefic area of the body. Which itself is kind of a confusing definition. But basically muscle weakness due to working out wouldn't be a focal deficit because it's not just affecting a specefic area of the body, it's a diffuse weakness due to working out. But if say there was a tumour pressing on a specefic nerve causing weakness that would be a focal deficit since it is effecting a specefic location and not just a generalized loss of strength. I tried to clarify this by saying "Those with neurocysticercosis can exhibit a variety of specific neurologic symptoms determined by the size, number, and location of the parasites." but I'm not sure if that came off clear enough. let me know if you have suggestions to make this clearer.
  8. I've reworded that setence a lot cause it's a tricky one. I split it into two so it reads as "Those with neurocysticercosis and inflammation of the arachnoid may present with focal signs and ischaemic strokes caused by intracranial artery blockage, cranial nerve compression, hearing loss, and facial nerve palsy or trigeminal neuralgia. There may also be focal neurological symptoms caused by brainstem damage." which is hopefully better.
  9. That is exactly what I meant oops.
  10. Other sources did mention "other symptoms" but in a much more scattered way (as in randomly adding them in) while that specefic source was a) the most in depth source and b) the only one that organized it into a seperate section. The symptoms in this section are a lot rarer so if I wanted to get more sources for them I would most likely have to look farther back or rely on primary sources hence why I didn't pay much attention to it.
  11. The ophthalmologic and endocrinologic part bugs me as well. The issue is that secondary sources don't seem to go into much detail regarding the specefics of these which is annoying. I'm going to take another look at the technical aspects today and hopefully I can continue to improve that aspect. IntentionallyDense (Contribs) 22:03, 7 December 2024 (UTC)[reply]

Feedback from SandyGeorgia

I'm sorry I haven't yet found time to participate; real life has been unkind. You have a very fine start, and I particularly noted you've given page numbers from sources. Hooray!

When I first looked in, I saw lots of serious problems, and although I haven't had time to follow closely, I suspect some of those are being worked or will be worked out before I find time to look in more detail. I hope you will be able to wait for my more detailed feedback, and be sure to get Colin and Ajpolino and Graham Beards to go through before approaching FAC. And after they (along with WhatamIdoing) have been through, then again have a non-medical editor run through one more time. And I do not suggest approaching FAC during December; FAC slows down over the holiday season, when folks are busy. For now, quickly adding:

  1. Have you had a chance to read User:SandyGeorgia/Achieving excellence through featured content ? General advice.
  2. Sources should be alphabetical, and put the "This source incorporates ... " templates at the end of the citation rather than the beginning, so as not to interfere with the reader's ability to easily locate a source alphabetically.
  3. The first time I looked, I saw too much WP:CLOP; be sure to have someone run through and check on that, and be aware that just because you can use text from a CC-by-x source doesn't mean all reviewers at FAC will accept text that isn't written in our words -- I've seen reviewers state that FAs should be original.
  4. Colin would be better than me to check this, but on the first sentence in the Seizures section, I am unconvinced a) that source is adequate for an FA, and b) the source is correctly represented. I saw other places where I was concerned about source-to-text integrity.
    • For example, in History, society, and culture, the cited source does not back the statement that "The New York Times stated that RFK ... " ... a) say where you got it, and b) the actual NYT article does not say that at all, best I can tell. Source-to-text integrity is a deal-killer at FAC, and needs close checking from medical and lay people.
  5. WP:MEDDATE needs review.
  6. I see the "country" versus "region" error in the lead has now been corrected, but when I first looked in and saw that, it revealed that an independent copyedit would help.
    • For example:
      • The lentil lectin purified glycoprotein (LLGP) enzyme-linked immunoelectrotransfer blot (EITB) assay, uses specific proteins to detect T. solium antibodies in blood, has given the most reliable results.
  7. "Once the scolex is attatched, the proglottids begin to multiply and mature into a 2–4 m ribbon-like tapeworm about 4 months after infection." ... WP:MOSNUM, four months, get a MOS person to check throughout.

I will try to look in more detail as I find time ... SandyGeorgia (Talk) 22:27, 8 December 2024 (UTC)[reply]

  • @SandyGeorgia Thank you for your advice! I really appreciate you taking time to respond as I know you are very busy off-wiki. I'm going to respond to each of your points individually to keep myself organized.
  1. I had not checked out your essay before this. My main takeaway is that I have some reading to do over the next few days to learn from other medical FAs.
  2. I didn't know the alphebetical aspect. I fixed this along with the template order.
  3. Close paraphrasing with medical articles can be a rough one. All of the CC by sources are solely used for the captions of the images which I didn't bother to reword much and thought I would play it safe by including the templates.
  4. Hmm I didn't notice that this was a clinical commentary when I first found the source as I was looking for more recent sources. You're right that that is less than ideal. I'm not really sure how I ended up using that wording but you're right that it doesn't quite reflect what the source is saying. I'm going to take another look at all my sources and make sure that they match up well with what I'm trying to say and that there is no CLOP going on once I finish further simplifying the article. Good catch with the NYT article.
  5. Unfortunately a lot of the more comprehensive studies on NCC are not so recent. I tried really hard to find more up to date lituratue but unfortunately couldn't find many newer publications that had the level of detail some of the older studies had.
  6. Copyediting is definetly not my strong suit. I appreciate the fresh pair of eyes on this article and I may even add this article to the backlog for WP:GOCE if things line up well.
  7. MOS is again not my strong suit. I will fix the error you pointed out and see if anyone else is willing to help me out with that. IntentionallyDense (Contribs) 03:13, 9 December 2024 (UTC)[reply]
    ID, only a quick response ... I would not rely on GOCE if you plan on approaching FAC. Read my essay, collaborate with other writers of medical content at the FA level, and build your network. THAT is what takes time for a successful FAC. Also, engage FAC as a reviewer to learn the standards. A typical GOCE person might further damage your source-to-text integrity, while not necessarily improving the prose. Let the good medical editors go through one at a time, so as not to overlap, and don't be in a hurry on your first FAC ... all of us can tell you that a successful medical FA takes gobs of time. I can easily fix the MOS stuff once you've got more significant issues worked out. SandyGeorgia (Talk) 04:49, 9 December 2024 (UTC)[reply]
    Sounds good, thank you! IntentionallyDense (Contribs) 19:52, 9 December 2024 (UTC)[reply]
    I'll have a look and have a go at copyediting Cas Liber (talk · contribs) 02:59, 15 December 2024 (UTC)[reply]

IntentionallyDense the faulty content about Robert F. Kennedy Jr. is still in the article. The article now says,

The New York Times stated that RFK Jr. had contracted neurocysticercosis after travelling to Africa, South America, and Asia. (Cited to NBC News)

but neither NBC News nor the NYT actually state that. What NBC News says is

On Wednesday, The New York Times reported that Kennedy, who is running for president as an independent, once experienced a parasitic brain infection

(with others speculating about what that specific condition might be and where he might have gotten it -- I don't think the speculation of non-treating physicians rises to the level of sourcing expected for an FA.)

The actual New York Times article similarly never states that RFK Jr had neurocysticercosis, rather has non-treating physicians speculating.

Searching for a better source, I found MANY supposedly reliable sources misreporting this story as the "The New York Times said", which is false. We should be careful not to source that similarly on Wikipedia, since we can see what the NYT itself did say. I was unable to find any high quality source reporting it correctly, so I'm unsure the content belongs in the article. And if we decide that reporting on a misreporting is DUE, we have to attribute and say where we got it.

BUT ... In searching for whether RFK Jr actually ever said this, I found this article which forced me to watch a two-hour Youtube (yuk), where beginning at minute 42, you can find that RFK Jr himself did call it neurocysticercosis. (Do we know his physicians actually called it that, or did he just make that up after seeing the NYT report?)

So if you decide to use this, it will need some careful citing and attribution that would look more like "after the NYT reported that RFK Jr had stated in a 2012 deposition that he had had a brain parasite (cited to NYT), RFK stated in a 2024 interview that it was probably neurocysticercosis (cited to the Youtube, including the 42-minute-mark timestamp so other readers don't have to suffer through the full interview as RFK Jr's appearance is repeatedly delayed)." Or similar. I don't know if that YouTube will get past FAC; I suspect it will. Similar careful attribution will be needed on the "where he might have gotten it" content. If you decide to leave this in the article, I also suggest spelling out Robert F. Kennedy Jr. Best regards, SandyGeorgia (Talk) 15:27, 21 December 2024 (UTC)[reply]

PS, I took the time because, with the prospect of RFK Jr being placed in the incoming US administration, my concern is that very careful writing with attribution is going to be needed in lots of medical content going forward -- not only might we need more careful attention WP:MEDASSESS, we may have to deal with more misreporting in the laypress in addition to quackery and pseudoscience, compounding matters. SandyGeorgia (Talk) 15:49, 21 December 2024 (UTC)[reply]
Thank you for suffering through the youtube video to find this information, I truly appreciate it. I apologize for my delay in response. Real life has gotten busy for me and I found myself overwhelmed by the prospect of retuurning to Wikipedia with my usual activity. I should hopefully be more active over the next few weeks. For now I have changed it to RFK Jr. stated he had contracted neurocysticercosis after travelling to Africa, South America, and Asia. which I'll be the first to admit isn't the full story however I wanted to remove the NYT part. Based on what others have said I suspect it may be best to remove this bit altogether. Thank you again for your help, I hope my delay in response did not give off the impression that I haven't been appreciating your feedback. IntentionallyDense (Contribs) 22:13, 24 December 2024 (UTC)[reply]

Casliber

Ok, I've done this so far. There us alot of repetition of words, but please revert if you feel I inadvertently change/lose meaning - as accuracy trumps simplicity. Will look more as time permits. Cas Liber (talk · contribs) 03:42, 15 December 2024 (UTC)[reply]

Awesome, Casliber; I didn't know you were active again! SandyGeorgia (Talk) 03:55, 15 December 2024 (UTC)[reply]
I'm trying - I just have alot of competing interests...Cas Liber (talk · contribs) 04:00, 15 December 2024 (UTC)[reply]
@Casliber All of these changes look great, no meaning has been lost and I really appreicate the help. IntentionallyDense (Contribs) 22:14, 24 December 2024 (UTC)[reply]

Okay - I don't get a sense from this how prevalent/rare/ultra-rare it is in various places. When was it eradicated? How big a deal is undercooked pork now in the US, in Hawaii, in wherever? For instance, there was this which was pretty big news when it happened - as it was newsworthy I think is worth including though I don't know if is in a Review Article as such yet). Also, I happen to love pork so have thought about this over the years. When I was a kid my family made a really big deal about the hazards of undercooked pork and it really freaked me out. Reading this I think it need more detail on a public health perspective. Also, why have those articles in Further reading and not use them? Cas Liber (talk · contribs) 19:55, 15 December 2024 (UTC)[reply]

Okay part of this may come from the dact that there is no solid prevelance or incidence rates. Usually with a disease there is studies showing prevelance but for NCC there isn't any recent secondary sources giving us a nice pretty number to include. I don't believe NCC has ever been officially eradicated. From what I understand from my research, NCC is rare enough in North America that it is mostly covered in case studies. It seems that the vast majority of cases in North America are from people imigrating from endemic region and getting diagnosed in NA or from people travveling to endemic areas getting NCC and returning home to be diagnosed. That being said I would imagine it is possible that NCC contaminated meat could end up in NA either due to poor sanitary conditions within meat processing plants in NA and an employee carrying NCC or imported meat (is that even a thing?). However those cases would be considered an oddity, hence the case report. I will see if/how i could incorperate this. As for further reading, those are studies which I found in my intial search for sources that I wasn't able to incorperate into the article. Ususally this is because the information in them is repeated in other sources so insetad of citing both I just cited whichever one I got the information from and added the rest to further reading.
I appreciate your feedback and questions. I'm sorry for the delay in response. Real life got busy for me. I wish I had more satisfactory answers to all of your questions. IntentionallyDense (Contribs) 22:24, 24 December 2024 (UTC)[reply]
Yeah all this is what I thought would be the case. And we are limited by source material, but there might be scope for greater discussion of limitations/fragmentary data Cas Liber (talk · contribs) 00:41, 25 December 2024 (UTC)[reply]

Ajpolino

Just a drive-by comment for now, I'm happy to go through with a fine-toothed comb when you're ready. I saw Benzisoxazole dropped off some {{cn}} tags earlier today. Just expanding on her problem with the opening sentences. My impression was you can get the adult tapeworm (in your intestine) from eating tissue cysts. You can only become the host of tissue cysts (in your brain in this case) by eating eggs, which would have to be from human feces. Is that wrong? I don't have access to the relevant sources in the Cause section. Ajpolino (talk) 19:30, 22 December 2024 (UTC)[reply]

That is correct, and the distinction between the two is very important. I suggest checking out CDC for both cysticercosis: https://www.cdc.gov/dpdx/cysticercosis/index.html, and taeniasis: https://www.cdc.gov/dpdx/taeniasis/index.html Benzisoxazole (talk) 20:09, 22 December 2024 (UTC)[reply]
I will have to do some further research (hopefully tomorrow when I am on my laptop) on the exact causes/mechanisms as there may have been something lost between me reading the studies, writing the page and then going back and trying to simplify it. sorry i have been very busy lately. IntentionallyDense (Contribs) 08:34, 23 December 2024 (UTC)[reply]
That is correct, it appears somewhere between reading that and all the copyediting I've done I made this unclear. I'm going to work on fixing this now. Thank you to both you and Benzisoxazole for pointing this out. IntentionallyDense (Contribs) 22:54, 24 December 2024 (UTC)[reply]
@Ajpolino@Benzisoxazole Sorry for pinging you guys again, but it looks to me that the causes and mechanism section are correct about this (although perhaps could use some rewording to make that clearer) but it's the lead that is inccorect about this. For now I'll change The disease is often caused by eating undercooked food or drinking water contaminated with tapeworm larvae (cysticerci). When cysticerci enter the small intestine, they attach to the intestinal wall and grow into a tapeworm. This tapeworm can travel to the brain, muscles, eyes, and skin. to The disease is often caused by eating undercooked food or drinking water contaminated with tapeworm eggs. These eggs hatch into larvae which enter the small intestine and attach to the intestinal wall. The larvae can travel to the brain, muscles, eyes, and skin. IntentionallyDense (Contribs) 23:04, 24 December 2024 (UTC)[reply]
The Mechanism section is correct but the Causes section is not. The causes section confuses acquiring the adult tapeworm (by eating undercooked food with tissue cysts) with acquiring cysts (by eating eggs). Ajpolino (talk) 23:08, 24 December 2024 (UTC)[reply]
Okay thank you, I will focus on rewriting that section. IntentionallyDense (Contribs) 01:57, 25 December 2024 (UTC)[reply]

Colin

I started looking into the cultural figures mentioned, which led me to Fake news in neglected tropical diseases: The case of neurocysticercosis and I spotted Ajpolino's comment. From that and several other links it does seem to me that this article has a quite serious flaw, ranging from being unclear to misleading. The very opening sentence, that it is caused by the pork tapeworm, is misleading. There are no worms wriggling about in the person with neurocysticercosis. I think it needs an overhaul to emphasise the human faecal-oral direct cause of neurocysticercosis, and that pigs have a separate role in the cause of the tapeworm lifecycle stage. The article does not link to taeniasis until the history section of the lead, whereas that needs to be early (see introduction of this review. It would appear that our lead needs to emphasise that eating pork contaminated with cysts may cause taeniasis, an intestinal tapeworm, but it is eating food and drink contaminated with human faeces containing the eggs of that tapeworm which is the cause of neurocysticercosis. The article is flat out wrong in saying "Neurocysticercosis often results from undercooked infected pork". The lead saying "contaminated with tapeworm larvae (cysticerci)." is also wrong. The human eats eggs, not larvae, which hatch in the intestine as larvae. The article Taenia solium seems to explain better the lifecycle and two separate diseases.

I think the example, from 1792, of an individual who had both infections is very unhelpful to the lead. This is an atypical case but hardly surprising that it could occur if both infections are common to an area.

WP:MEDCASE covers cases in disease articles. There's no definitive rule but I think all three examples here are weak.

  1. Sebastián Ferrat As a Spanish-speaking actor in Mexican TV dramas, who died in 2019, he is unlikely to be known to many readers of an English version of Wikipedia. His cause of death may well be useful information in his own article, but this disease in endemic in many poor countries, and readers might rightly question why we mention them particularly.
  2. RFK Jr. As discussed above, information on this is conflicting. Neurocysticercosis is not a "a worm that got into my brain and ate a portion of it and then died". Per WP:NOTNEWS this was something that briefly excited some newspapers back in May 2024. Not an enduring or even reliable example.
  3. Julius Caesar. The source for this does not support a statement "Gaius Julius Caesar is believed to have had epilepsy related to cysticercosis" It merely notes "it has been suggested", so hardly a widely held belief among academics or historians. As List of people with epilepsy, and our article on Julius Caesar note, whether he even had epilepsy is highly contentious. There are almost no end to medical conditions one might speculate Julius Caesar had.

My vote would be to remove all three. None of them add to our readers knowledge of the disease.

I would also vote to remove the House pilot. This is an example of misinformation in a medical drama and yet we repeat that misinformation: "The episode followed a young woman who contracted neurocysticercosis after eating contaminated ham." She did not. The only reason one might mention House is as an example of misinformation (per https://pmc.ncbi.nlm.nih.gov/articles/PMC7302432/). But it is a bit complicated to explain the plot only to then explain why it is wrong. -- Colin°Talk 19:23, 23 December 2024 (UTC)[reply]

Thanks Colin for the in depth feedback. I apologize for my innactivity lately. I'll try to hopefully get to all of your points.
You're very right about the causes being unclear in this article. I've (hopefully) fixed the lead up a bit. I'll most likely change the causes part of the lead a bit more later on but for now I've specified that NCC is caused by larvea and changed the wording to refelct that it is the eggs and larvea not the actual tapeworm.
I do plan on completely rewriting the causes section to make things more clear. I think the mechanisms section is okay for now but if you disagree, please let me know. I found this tidbit from this source that I'm going to reword and try to encorperate into the causes section as I think it explains a lot: "Human cysticercosis should now be considered as a disease mostly transmitted from person to person, and the role of infected pigs is to perpetuate the infection"
The historical case is most likely not important enough for the lead, you're right. It was only noted in reviews since it was the irst recorded case of both diseases in one person.
I struggled a lot in writting this article as to if I should include notable or probable cases. The RFK case would requre such specefic wording and sources that I have just decided it would probably be easier to remove as you mentioned. As for the House case, the reason I included it was because it is probably the only representation of NCC that people would have, if any. It may be worth mentioning it and adding a bit more on how it was incorect but I'm also fine with it being removed.
Thanks again for the feedback, I really appreciate it. IntentionallyDense (Contribs) 02:20, 25 December 2024 (UTC)[reply]
I have made the changes to the causes section and lead. Hopefully this clarifies things. IntentionallyDense (Contribs) 02:51, 25 December 2024 (UTC)[reply]
Quelle: https://en.wikipedia.org/wiki/Wikipedia:Peer_review/Neurocysticercosis/archive1