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Shelleh (2012) literature review from last month

"Battlefield reports documented a steady rise of malignancies and newborn malformations after war" -- Shelleh, H.H. (2012) "Depleted Uranium: Is it potentially involved in the recent upsurge of malignancies in populations exposed to war dust?" Saudi Medical Journal 33(5):483-8 PMID 22588807. 71.215.95.182 (talk) 05:15, 15 June 2012 (UTC)

I ask for the mediator's opinion on this reversion without discussion. Both reliance on a more recent secondary PubMed-indexed medical journal literature review and the replacement of the Hindin (2005) literature review were explicitly agreed to above. 75.166.206.120 (talk) 22:36, 20 June 2012 (UTC)

According to MEDRS we should be summarizing the scientific consensus, which you are not doing. Also, Shellah is a new study and has zero citations, so we shouldn't really be using it (see WP:SCHOLARSHIP). You just seem intent on putting in the POV that the gulf war causes birth defects, which according to the scientific evidence is unproven. --sciencewatcher (talk) 23:57, 20 June 2012 (UTC)
So you're saying that Shellah is too new for a literature review? There can be no proof contrary to the fact that breathing uranium fumes causes birth defects. Why would that be a bias or a perspective? It is an absolute fact, first published by Maynard in 1949 and confirmed in every literature review considering the fact thereafter. If there were any such proof, you would have shown evidence for it. Do you believe you have such evidence? 75.166.206.120 (talk) 01:06, 21 June 2012 (UTC)
Yes, Shellah is too new. I was saying there is no overwhelming evidence that gulf war vets' children have birth defects. --sciencewatcher (talk) 02:30, 21 June 2012 (UTC)
This article is about civilians, too, per the first sentence. What do you think the likelihood is that the included statement from Shelleh will be retracted? Can you give an example of any other peer reviewed WP:SECONDARY medical source which was not included in any other article because it was too new? The standard for inclusion is verifiability, which is in abundance, not the existence of overwhelming evidence. Unless you believe the Chief Epidemiologist of the Veterans Administration is incompetent, then there is also overwhelming evidence. 75.166.206.120 (talk) 04:58, 21 June 2012 (UTC)
The main rule we have to follow is NPOV, which you are breaking by cherry-picking sources that fit your POV and removing everything else. --sciencewatcher (talk) 16:07, 21 June 2012 (UTC)
As for sources: verifibility just tells us what we CAN include - it doesn't tell us what we SHOULD include. We use WP:SCHOLARSHIP, WP:WEIGHT and other policies to decide what should be included in the article. It's pretty standard in wikipedia to not include brand new medical studies, unless they are important or there is some other reason to include them. --sciencewatcher (talk) 16:19, 21 June 2012 (UTC)
We have four secondary medical journal articles talking about birth defects: Hindin 2005, Doyle 2006, Abu-Musa 2008, and Shelleh 2012. Three of those reviews say the same thing about birth defects, which I've included. One of those four contrasts very sharply with the other reviews and its primary sources, using non-quantitative terms like "modest". I've been taking that one out. Which one of us is trying to introduce our bias? 71.212.226.91 (talk) 18:39, 21 June 2012 (UTC)

I've rewritten some of the text, as you had misrepresented some of the studies. I've also removed Shelleh from the lede per WP:WEIGHT, as it is a lower quality source than the others. Doyle seems to be the best quality (most citations), so let's just leave that in the lede. Also, Shelleh only discusses leukemia in adults living in Iraq, so it's talking about something completely different to the other reviews. Doyle pretty much agrees with Abu-Musa as far as I can see. It's maybe ok to put a sentence from Shelleh in the main text (which I've done), although I'm pretty sure it fails MEDRS due to having zero citations, so I would be inclined to just delete it. We already include Hindin in the text. Hindin contradicts some of the other parts of the article (like the VA saying that DU has been 'ruled out'). However that is fine - there isn't always agreement in science, so we just present the evidence from the high quality sources. I think we're fairly close to being NPOV now, if not already there. I still think it would be better to include the va.gov link in the links section. --sciencewatcher (talk) 02:44, 22 June 2012 (UTC)

Are you seriously suggesting that the number of citations is more important than recency and consensus in evaluating secondary sources? You have removed the suggestion that there was any increase in birth defects, which is supported by all four of the reviews. As you know, the VA report to which you refer was not peer reviewed and is demonstrably inaccurate. I am reverting the abject whitewash and asking mediator opinion. Shelleh makes weaker statements on this matter than Abu-Musa. Are you suggesting that Doyle and Abu-Musa reach the same conclusions? Or by, "as far as [you] can see," do you mean that you have not yet read Abu-Musa? 71.212.226.91 (talk) 06:45, 22 June 2012 (UTC)
The reviews do agree. Some studies showed an increase in birth defects, but the studies suffered from recall bias and the results need to be treated with caution. All the reviews pretty much state that. If you believe that birth defects are 'proven', you either don't understand the science or your bias is clouding your judgement. As you have openly stated that you have personally written to the VA, it seems that you might perhaps be too close to the subject to edit objectively. Perhaps you should just post on the talk page, and leave the editing to neutral, uninvolved editors who have no personal interest in the subject and can edit objectively based on NPOV and the other wikipedia policies. --sciencewatcher (talk) 14:26, 22 June 2012 (UTC)
All four of the reviews agree with me. I await the mediator's opinion. 71.212.226.91 (talk) 22:24, 22 June 2012 (UTC)
A quick search of that article didn't turn up the term "gulf war syndrome". Is it discussed explicitly? Further, is it the scientific consensus that GWS is caused by depleted uranium? WLU (t) (c) Wikipedia's rules:simple/complex 14:27, 25 June 2012 (UTC)
Of course it is on topic. If you find out where the scientific consensus publishes their definitions of emerging syndrome causes, please let me know. 71.212.226.91 (talk) 18:15, 26 June 2012 (UTC)
Are we talking about the 'unwise deletions' here? If so, it seems to be mostly WP:SYN, and a couple of primary studies. I agree with WLU that the whole thing should be deleted. --sciencewatcher (talk) 18:33, 26 June 2012 (UTC)
Can you point out where the article discusses Gulf War Syndrome? Can you point to a source that states explicitly that Gulf War Syndrome is caused by depleted uranium? There seems to be some moving goalposts here, since GWS was originally about unexplained physical symptoms, but now has a significant amount of text discussing reproductive issues faced by veterans. WLU (t) (c) Wikipedia's rules:simple/complex 20:00, 26 June 2012 (UTC)
What is the definition of Gulf War syndrome? (The "s" is not capitalized.) Does it involve civilians as implied by the first sentence of the article? Are there any authoritative discussions of Gulf War syndrome or Gulf War illness which suggest that it does not involve reproductive problems? Why do you think the text discussing reproductive issues pertains more to veterans than civilians? Is there any reason to believe that the syndrome is not the result of multiple toxins and toxicants? Why do you believe it is important to downplay the discussion of reproductive issues? 70.59.24.38 (talk) 18:32, 27 June 2012 (UTC)
While you are of course free to hypothesize, research and publish on the definition of GWS elsewhere, on wikipedia this is precluded per our policy on original research. If the article "implies" rather than outright states a relation to GWS, we should not cite it in the GWS article. Hypothesizing in the absence of text that explicitly verifies a link is not helpful. I consider this issue closed, Shelleh should not be used on this page. WLU (t) (c) Wikipedia's rules:simple/complex 20:02, 27 June 2012 (UTC)
I would be willing to consider omitting Shelleh if you agree to include the statements from Abu-Masa which you blanket reverted without discussion recently. Do you have any objections to those? 70.59.24.38 (talk) 21:05, 27 June 2012 (UTC)

No. Articles stand or fall on their adherence to policies and guidelines, not on horse trading. Shelleh should not be used, period, as it is unacceptable original research when GWS is not definitively linked to uranium, and the article does not mention the term at all.

Musa must again be used with care - despite being four years old, it has few citations. It's within a new, relatively low-impact journal. And it's not specific to GWS. That being said, it can be used (in fact, my revert retained its use in some sections). But it must be evaluated on its own merits, not as a negotiation relative to another article. WLU (t) (c) Wikipedia's rules:simple/complex 22:12, 27 June 2012 (UTC)

Incidentally, Musa also doesn't seem to use the term "Gulf War syndrome", making it a dubious inclusion and reducing the amount of weight it should get. I have an overall concern that the page is broadening the definition of GWS and including literature that doesn't actually use the term. The page is about Gulf War syndrome, not "any possible health effect that can be related to the Persian Gulf". Is GWS synonymous with adverse fertility? Is that the sole condition linked to the Gulf War? WLU (t) (c) Wikipedia's rules:simple/complex 23:00, 27 June 2012 (UTC)

I am still in support of these external links because of the record of inaccuracy of government authorities. The suggested set balances. 71.212.226.91 (talk) 18:05, 23 June 2012 (UTC)

The RAC link should be replaced, but that's about it as far as I'm concerned. I will also point out that your statement that the government is wrong is a) unsupported assertion b) not a rational per WP:EL and c) illogical (being wrong in the past doesn't mean the site is wrong currently). So no, the DMOZ is adequate but the RAC should be included. WLU (t) (c) Wikipedia's rules:simple/complex 15:15, 9 July 2012 (UTC)
Oh, really? Did you find a source supporting the government's 2008 GWI-RAC report's assertion that soldiers' children's birth defect rates are normal? There are several sources directly contradicting it. 71.212.249.178 (talk) 21:07, 10 July 2012 (UTC)
How does that support removing RAC as an EL? WLU (t) (c) Wikipedia's rules:simple/complex 22:05, 10 July 2012 (UTC)
As per #External Links above: WP:EL states "any site that misleads the reader by use of factually inaccurate material or unverifiable research" should be avoided. WP:ELPOV subsequently suggests that if we include the Research Advisory Committee then we should also include the veterans' support groups with whom they have been at odds. 71.212.249.178 (talk) 22:02, 13 July 2012 (UTC)
You have asserted that RAC was factually inaccurate, but I have yet to see any evidence of this. And keep in mind - there is a difference between incorrect speculation in the face of uncertainty, or not selecting a preferred option out of several, and being deliberately deceptive or ignoring new information; only the final two option are reason to avoid a link. The veterans support groups would not be considered reliable sources, they would be considered discussion forums (ELNO#10) or support groups (Wikipedia:MEDMOS#External links, second point). WLU (t) (c) Wikipedia's rules:simple/complex 12:50, 14 July 2012 (UTC)
You can't find any support for the statement that birth defect rates are normal, but you don't see evidence that saying so isn't accurate when all of the sources which articulate a position on the issue are opposed to the statement? 71.212.249.178 (talk) 05:07, 15 July 2012 (UTC)
Hm...it sounds like what you're saying is your personal research has indicated that RAC is wrong, therefore we can't trust their website. Is that correct? WLU (t) (c) Wikipedia's rules:simple/complex 20:14, 15 July 2012 (UTC)
And therefore we can't trust your incessant attempts to try to include them as a reliable source of ELs without balance from their detractors who have been more accurate. That is not my personal original opinion. It is consistent with the rules and every peer reviewed article which has expressed a finding on the topic, including Doyle's. 71.212.249.178 (talk) 23:07, 15 July 2012 (UTC)
So your own experience indicates RAC is consistently wrong, but you can't substantiate this with any reliable sources? We're done then, you are attempting to use your own research to discount the inclusion of a link to a mainstream and prominent body while attempting to use the same research and opinion to include partisan and unreliable sources. That is not how wikipedia works and that is not how external links are selected. WLU (t) (c) Wikipedia's rules:simple/complex 17:09, 16 July 2012 (UTC)
Replied at #Questions below. 71.212.249.178 (talk) 23:06, 16 July 2012 (UTC)

Unwise deletions

I propose replacing the following portions which were deleted by WLU:

Because uranium is a heavy metal and chemical toxicant with nephrotoxic (kidney-damaging),[1] teratogenic (birth defect-causing),[2][3] immunotoxic,[4] and potentially carcinogenic[5] properties, uranium exposure is associated with a variety of illnesses.[6] The chemical toxicological hazard posed by uranium dwarfs its radiological hazard because it is only weakly radioactive, and depleted uranium even less so. DU has recently been recognized as a neurotoxin.[7] In 2005, depleted uranium was shown to be a neurotoxin in rats.[8]
In 2001, a study was published in Military Medicine that found DU in the urine of Gulf War veterans.[9] Another study, published by Health Physics in 2004, also showed DU in the urine of Gulf War veterans.[10] A study of UK veterans who thought they might have been exposed to DU showed aberrations in their white blood cell chromosomes.[11] Mice immune cells exposed to uranium exhibit abnormalities.[4]
Genotoxic mutagens such as uranium should be treated with chelation therapy[12] or other means shortly after exposure.[13] Incorporated uranium becomes uranyl ions, which accumulate in bone, liver, kidney, and reproductive tissues. Uranium can be decontaminated from steel surfaces[14] and aquifers.[15]

71.212.226.91 (talk) 06:06, 25 June 2012 (UTC)

  1. ^ Health effects of uranium
  2. ^ Hindin R, Brugge D, Panikkar B (2005). "Teratogenicity of depleted uranium aerosols: a review from an epidemiological perspective". Environ Health. 4 (1): 17. doi:10.1186/1476-069X-4-17. PMC 1242351. PMID 16124873.{{cite journal}}: CS1 maint: multiple names: authors list (link) CS1 maint: unflagged free DOI (link)
  3. ^ Arfsten D, Still K, Ritchie G (2001). "A review of the effects of uranium and depleted uranium exposure on reproduction and fetal development". Toxicol Ind Health. 17 (5–10): 180–91. doi:10.1191/0748233701th111oa. PMID 12539863.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  4. ^ a b Wan B, Fleming J, Schultz T, Sayler G (2006). "In vitro immune toxicity of depleted uranium: effects on murine macrophages, CD4+ T cells, and gene expression profiles". Environ Health Perspect. 114 (1): 85–91. PMC 1332661. PMID 16393663.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  5. ^ "Carcinogenic Potential of Depleted Uranium and Tungsten Alloys". Archived from the original on 9 March 2006.
  6. ^ ATSDR — Toxicological Profile: Uranium
  7. ^ Jiang G, Aschner M (2006). "Neurotoxicity of depleted uranium: reasons for increased concern". Biol Trace Elem Res. 110 (1): 1–17. doi:10.1385/BTER:110:1:1. PMID 16679544.
  8. ^ Anandan N, Shetty S, Patil K, Ibrahim A (1992). "Acute urinary retention caused by anterior urethral polyp". Br J Urol. 69 (3): 321–2. doi:10.1111/j.1464-410X.1992.tb15541.x. PMID 1568112.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  9. ^ Hodge S, Ejnik J, Squibb K, McDiarmid M, Morris E, Landauer M, McClain D (2001). "Detection of depleted uranium in biological samples from Gulf War veterans". Mil Med. 166 (12 Suppl): 69–70. PMID 11778443.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  10. ^ Gwiazda R, Squibb K, McDiarmid M, Smith D (2004). "Detection of depleted uranium in urine of veterans from the 1991 Gulf War". Health Phys. 86 (1): 12–8. doi:10.1097/00004032-200401000-00004. PMID 14695004.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  11. ^ Schröder, H.; Heimers, A.; Frentzel-Beyme, R.; Schott, A.; Hoffmann, W. (2003). "Chromosome aberration analysis in peripheral lymphocytes of Gulf War and Balkans War veterans". Radiation protection dosimetry. 103 (3): 211–219. doi:10.1093/oxfordjournals.rpd.a006135. PMID 12678382.
  12. ^ Sawicki, M; Lecerclé, D; Grillon, G; Le Gall, B; Sérandour, AL; Poncy, JL; Bailly, T; Burgada, R; Lecouvey, M (2008). "Bisphosphonate sequestering agents. Synthesis and preliminary evaluation for in vitro and in vivo uranium(VI) chelation". European journal of medicinal chemistry. 43 (12): 2768–77. doi:10.1016/j.ejmech.2008.01.018. PMID 18313802.
  13. ^ Spagnul, A; Bouvier-Capely, C; Phan, G; Rebière, F; Fattal, E (2010). "Calixarene-entrapped nanoemulsion for uranium extraction from contaminated solutions". Journal of pharmaceutical sciences. 99 (3): 1375–83. doi:10.1002/jps.21932. PMID 19780139. {{cite journal}}: Unknown parameter |author-separator= ignored (help); Unknown parameter |month= ignored (help)
  14. ^ Francis, A.J.; Dodge, CJ; McDonald, JA; Halada, GP (2005). "Decontamination of uranium-contaminated steel surfaces by hydroxycarboxylic acid with uranium recovery". Environ Sci Technol. 39 (13): 5015–21. doi:10.1021/es048887c. PMID 16053105.
  15. ^ Wu, W.M.; Carley, J; Gentry, T; Ginder-Vogel, MA; Fienen, M; Mehlhorn, T; Yan, H; Caroll, S; Pace, MN (2006). "Pilot-scale in situ bioremedation of uranium in a highly contaminated aquifer. 2. Reduction of u(VI) and geochemical control of u(VI) bioavailability". Environ Sci Technol. 40 (12): 3986–95. doi:10.1021/es051960u. PMID 16830572.

To be included, the studies must be secondary (per WP:MEDRS), explicitly involve discussions of Gulf War Syndrome (per WP:SYNTH) and should reflect the degree to which uranium is thought to be involved in GWS (per WP:UNDUE). The sources I removed a couple months back failed one or more of these criteria, and I see no reason to replace them. WLU (t) (c) Wikipedia's rules:simple/complex 19:58, 26 June 2012 (UTC)

The facts established by the WP:SECONDARY sources imply that the above portions are useful and likely to be helpful to readers seeking further information on these topics. Many of the deleted sources are themselves reviews which easily pass WP:MEDRS. Of those which don't, which of them in particular do you believe fail UNDUE or SYNTH? Something is clearly wrong with reference [8], because a 1992 paper can't support a 2005 finding. I wonder how that got in there and why, and what the original 2005-6 reference there must have been. 70.59.24.38 (talk) 18:56, 27 June 2012 (UTC)
We only discuss facts verified by secondary sources; if those sources do not make relevant points explicitly, per WP:OR we are not free to make the points usinng primary sources. At minimum, for a source to be used here it should discuss (i.e. use the term) Gulf War syndrome. A second minimum threshold is that it be a review article. Listing the adverse effects of uranium exposure is a task for uranium, and should only be done here using sources that explicitly links uranium to GWS. Unless treatment for uranium exposure has been shown to improve GWS, those treatments shouldn't be used here. I realize I am repeating myself, but really - I shouldn't have to. Explicit, secondary sources are required, not sources you think can be collected together to prove GWS is caused by uranium. WLU (t) (c) Wikipedia's rules:simple/complex 20:06, 27 June 2012 (UTC)
Do you consider the decontamination of surfaces and drinking water to be a successful treatment for some of the reproductive symptoms discussed, e.g., in the Hindin and Abu-Musa reviews? 70.59.24.38 (talk) 21:07, 27 June 2012 (UTC)
It doesn't matter what I think, what matters is the explicit discussions in the articles. Hindin actually uses the term "Gulf War Syndrome" only once, in the title of an article found in the references. I will review both and give you my opinion, a cursory look at Hindin indicates much of it is a summary of other literature, but there is still value in using it (particularly compared to the primary and inappropriate sources cited above). Abu-Musa, as I say above, should be used with care. WLU (t) (c) Wikipedia's rules:simple/complex 22:18, 27 June 2012 (UTC)
Are you opposed on principle to the idea that Gulf War syndrome includes civilians with increased incidence of birth defects? It's been well documented for decades. 75.166.192.187 (talk) 18:34, 28 June 2012 (UTC)
My issue is with the broadening, and ossification, of the definition of GWS. Uranium poisoning isn't GWS, it's uranium poisoning. If GW combatants and civilians have uranium poisoning, that has a distinct set of symptoms. If GWS is actually uranium poisoning, this should be easy to demonstrate. Making GWS uranium poisoning and/or poisoning from well fires and/or vaccine reaction and/or... then it's whatever you want. I don't know if I'd even call birth defects "GWS" - they are birth defects (presumably caused by something in the Gulf war). As your removed comment alluded, this page isn't about "any health effect found in Gulf War vets", and I'm not sure such a page should exist. The flat point is - we need sources that explicitly link to the title of the page, not whatever we think GWS actually is. And definitely not a long summary of dubious sources that you think are relevant. Explicit sources, not original research. WLU (t) (c) Wikipedia's rules:simple/complex 15:50, 29 June 2012 (UTC)
Why would any article on GWI not include the significant effects observed in civilians or soldiers? As you point out below, there is no medical syndrome in the strict sense, so using the lack of a formal definition for the popular name is a very weak position to be arguing from. 75.166.192.187 (talk) 18:54, 29 June 2012 (UTC)
If GWI is uranium poisoning, we should say this. If it's pesticide residue, we should say this. If all of these are proposed, but none are accepted as the cause, we should note this. We shouldn't include a section on how to treat uranium poisoning (or anything else) if it's not considered the cause of GWI. Much like chronic fatigue syndrome or anything else with an uncertain etiology, pathophysiology and the like, we shouldn't attempt to describe it as what we think is most likely. We should describe the undertainty. WLU (t) (c) Wikipedia's rules:simple/complex 20:23, 29 June 2012 (UTC)

How about "Gulf War illnesses include uranium poisoning."? 75.166.192.187 (talk) 21:42, 29 June 2012 (UTC)

If there are reliable sources that explicitly make that link, then yes. But from what I've seen, uranium poisoning is at best considered a potential cause of GWS, it is not definite. For that matter, I believe they're still debating whether GWS even exists. So yes, we can not that some people have proposed uranium is the cause of GWS. But no, we can not say "GWS is caused by uranium poisoning" unless there is general agreement on this point, supported by multiple reliable sources that say, without controversy, that this is the case. And we would have to include the caveats, which means listing all the reason people don't think GWS is caused by uranium. That is neutral. WLU (t) (c) Wikipedia's rules:simple/complex 23:51, 29 June 2012 (UTC)
Even if uranium wasn't involved, the illnesses associated with the Gulf War involve multiple toxins and toxicants. Speaking of a single cause is imprecise. What reasons are there that people don't think uranium is one of the causes? 75.166.192.187 (talk) 22:36, 1 July 2012 (UTC)
Again I refer to WP:V and WP:OR. It doesn't matter what you think causes GWS or what is imprecise. What matters is what reliable sources say about it. Links between toxins and toxicants are, as far as I am aware, still speculative. The cause(s) of GWS, if it even exists, is/are still proposed, not definite. For the purposes of this page, it doesn't matter what the effects of uranium exposure are, and even less so what the treatments for uranium exposure are. What matters is the number and quality of sources that explicitly link uranium poisoning to GWS. WLU (t) (c) Wikipedia's rules:simple/complex 19:41, 3 July 2012 (UTC)
All of the secondary sources but Doyle make that link explicitly. Abu-Musa is the review in your preferred 3-5 year age range, and implicates four teratogens. "Exposure to heavy metals, solvents, paints and pesticides was associated with poor sperm quality, spontaneous abortion, birth defects, and cancer in offspring. Depleted uranium may cause reproductive toxicity, and exposure to it should be followed for increased risk of fertility problems and reproductive cancers." Could it be any more explicit? 70.59.11.4 (talk) 03:24, 4 July 2012 (UTC)
Then we use those secondary sources. Abu-Musa may be secondary, but it doesn't refer to GWS specifically and shoudln't be used. WLU (t) (c) Wikipedia's rules:simple/complex 16:51, 4 July 2012 (UTC)
That quote is from the section in Abu-Musa on the 1990-1 Gulf War. Until the syndrome committees do their thing, we include illnesses associated with the war. What is the reason for the incessant idea that birth defects should not be included? Because they prove that uranium pyrophorics harm off the battlefield? If not, what is the motivation for this endless opposition? 75.166.192.187 (talk) 18:05, 4 July 2012 (UTC)
Abu-Musa doesn't reference GWS, GWS isn't considered "uranium poisoning", and we don't write anything here until the syndrome committees publish their decisions. The reason for not including birth defects is that we need explicit discussion linking birth defects to GWS, and this page is about GWS. The fact that uranium is poisonous is relevant to uranium, unless someone says "GWS is uranium poisoning", it's irrelevant here. The reason for the "endless opposition" is because you keep trying to write what you think GWS is, and wikipedia is not based on what you think. It's about what is verifiable in reliable sources. I keep repeating it because you keep repeating what you believe, not what is explicit in reliable sources. WLU (t) (c) Wikipedia's rules:simple/complex 11:03, 5 July 2012 (UTC)
Do either of us have any beliefs about the situation beyond the causes and effects reported in Abu-Musa? "Exposure to heavy metals, solvents, paints and pesticides was associated with poor sperm quality, spontaneous abortion, birth defects, and cancer in offspring. Depleted uranium may cause reproductive toxicity, and exposure to it should be followed for increased risk of fertility problems and reproductive cancers." If there were any evidence contrary to those statements, then why haven't you cited it? I am not trying to push my unsupported beliefs on Wikipedia. I am trying to make the article consistent with the WP:MEDRSs. Why are you so opposed to this? 75.166.192.187 (talk) 00:11, 6 July 2012 (UTC)
I have no problem with the article being used to source the effects of war and depleted uranium on human health. I take issue with this article being used on this specific page, because the page is about GWS and Abu-Musa doesn't use the term ever. There's a difference between "people got uranium poisoning during the Gulf Wars" and "GWS is uranium poisoning". At best, uranium is a potential cause of a proposed diagnosis that is itself under debate over whether it even exists. Abu-Musa is a MEDRS, I have no issue with that. It's just irrelevant to this page. WLU (t) (c) Wikipedia's rules:simple/complex 16:43, 6 July 2012 (UTC)
And all without a single source supporting the ever more remote possibility that uranium fume inhalation was not a major cause of the illnesses associated with the Gulf War, and against all of the secondary sources which consider the question, because they all say it is. What is the purpose of such determination to contradict the MEDRSs which you were demanding just a few months ago? 71.212.249.178 (talk) 05:40, 8 July 2012 (UTC)

The point is that the source MUST actually say 'gulf war syndrome' or 'gulf war illness'. If it does not, then we can't use it in this article. To include it would be WP:SYN. --sciencewatcher (talk) 16:03, 8 July 2012 (UTC)

If you think the section headings in Abu-Musa (2008) don't establish abundant context to include here, you are going to have to come up with a better reason than that he didn't use the word "syndrome" especially since it's not an official syndrome anywhere but MeSH. Such absurdity! 71.212.249.178 (talk) 18:04, 8 July 2012 (UTC)
Anony, the page is not about what you think what GWS is. The page is not about what you attribute the symtpoms of GWS to. The page is about what experts have published on GWS. If an article doesn't use the words "Gulf War Syndrome" or "Gulf War Illness" then it shouldn't be used. As SW says, otherwise you (and I mean "you" refering to people in general, but specifically to you as an editor who has been inappropriately attempting to make the article into what you think it should be about) are using wikipedia to promote your own original research. Abu-Musa does not use the term "Gulf War syndrome", "Gulf War illness", "Persial Gulf syndrome" or "Persial Gulf illness". The MESH heading specifies fatigue, joint pain and a whole bunch of other symptoms completely unrelated to fertility, the topic discussed by Abu-Musa. The Abu-Musa article is irrelevant here. It may be about illnesses, disease and fertility in the Persial Gulf, but it is not about Gulf War syndrome. WLU (t) (c) Wikipedia's rules:simple/complex 14:36, 9 July 2012 (UTC)
I was just looking at the Depleted Uranium section of the article. There is a whole long spiel of WP:SYN followed by a single sentence saying there is no association between DU and GWS. I think the section should be trimmed down for WP:WEIGHT. --sciencewatcher (talk) 14:47, 9 July 2012 (UTC)
We should definitely discuss the fact that uranium us a proposed agent in the etiology of GWS, with pro- and con- arguments included. I haven't had a chance to read through the section but I would not be surprised in the least if it was full of inappropriate material. WLU (t) (c) Wikipedia's rules:simple/complex 15:04, 9 July 2012 (UTC)
Then what of Hindin (2005)? Can you cite a single WP:MEDRS in support of your assertion that uranium poisoning is not an illness associated with the Gulf War? Of course you can't. It has been months and you have both been utterly unable to support even a tiny aspect of that absurd position to which you seem so wedded. Is this your idea of trying to improve the encyclopedia? Do you think you will get brownie points from someone if you keep trying to sweep the uncomfortable under the rug? Get real. 71.212.249.178 (talk) 08:43, 10 July 2012 (UTC)
Hindin doesn't discuss GWS at all - it uses the term once, in the title of a citation. Uranium poisoning isn't GWS, though it's certainly associated with the gulf war. While uranium poisoning may have happened during the Gulf War (and Hindin certainly seems to support this fact), the article fundamentally doesn't discuss Gulf War syndrome. In order to use it, we must make the statement and connection that Gulf War syndrome is uranium poisoning. And per WP:SYNTH, this is inappropriate. Anon, if you want to link GWS and uranium poisoning, start a blog. If you want to talk about uranium poisoning, go elsewhere. There are lots of potential pages such as Gulf War, depleted uranium or you could start uranium poisoning. But the general consensus does not seem to indicate GWS is a synonym for uranium poisoning. Presumably because if GWS were uranium poisoning, they'd simply call it uranium poisoning. WLU (t) (c) Wikipedia's rules:simple/complex 17:31, 16 July 2012 (UTC)
Replied at #Questions below. 71.212.249.178 (talk) 23:06, 16 July 2012 (UTC)

Sources

  • [1]
  • [2]
  • [3] - note page 3 stating that no unique syndrome exists; why is this not cited more heavily?

— Preceding unsigned comment added by WLU (talkcontribs)

"Syndrome" has more than one meaning. The proper title for the article in a medical reference would be "Gulf war illness" but per WP:NC we use the term "syndrome" less precisely than the strict medical definition because it gets more mentions. 75.166.192.187 (talk) 18:36, 28 June 2012 (UTC)
We need sources that make the link for us, and it should be relatively trivial to find them if GWS has indeed been re-named GWI. Editor opinion is unimportant, reliable sources are what is required. The report above makes explicit statement that GWS has not been identified as a unique clinical entity, and that should be noted, prominently. WLU (t) (c) Wikipedia's rules:simple/complex 19:44, 3 July 2012 (UTC)
I am not relying on my opinion of how syndromes are named in the medical profession, but it is suprisingly arcane, and I defer to the mediator on such questions of nomenclature. I would strongly support moving the article to Gulf War illness but I won't propose such a move because of WP:NC. 70.59.11.4 (talk) 03:27, 4 July 2012 (UTC)
  1. What mediator?
  2. If anything is difficult to verify, or can't be verified, we shouldn't really be discussing it. WLU (t) (c) Wikipedia's rules:simple/complex 16:50, 4 July 2012 (UTC)
1. Doc James. 2. The process for naming a syndrome isn't difficult to verify, but it's not in that article yet, and the authorities involved are apparently determined by an obscure combination of tradition, merit, subject matter expertise, and a corporate publisher. 75.166.192.187 (talk) 18:12, 4 July 2012 (UTC)
Don't care about the process to name a syndrome, I care about this syndrome. We document what the mainstream opinion is, not what an anonymous editor speculates. In case I haven't said it before - on wikipedia we do not engage in original research or promotion of what individual editors think. We document what scholars, doctors, politicians and bureaucrats think. Please stop making statements that are your opinion about GWS, and substantiate them with references. WLU (t) (c) Wikipedia's rules:simple/complex 10:58, 5 July 2012 (UTC)
As it is still an informal syndrome at present, caring about it implies caring about the naming process. You might want to look at the histories of syndromes which started out as informally defined, and in particular those which involved multiple causes and effects. 75.166.192.187 (talk) 00:15, 6 July 2012 (UTC)
I would characterize it as still having its existence debated. I don't care about the naming of other syndromes, I care about what is said about GWS specifically. WLU (t) (c) Wikipedia's rules:simple/complex 16:40, 6 July 2012 (UTC)
Then take it up with the MeSH librarians and move the article to Gulf War illness if you think that isn't controversial given WP:NC. 71.212.249.178 (talk) 05:42, 8 July 2012 (UTC)
Fortunately we are not limited to solely MESH as a source; there are numerous sources that indicate GWS is a proposed syndrome, not a definite thing. As I've said before, it is still being debated, they're not chelating the uranium/pesticides/oil fire residues out of GW veterans because they're not sure that any of these things have actually caused illnesses. WLU (t) (c) Wikipedia's rules:simple/complex 15:02, 9 July 2012 (UTC)
And as I've pointed out before, you don't have a single WP:MEDRS in support of your absurd contention that uranium poisoning wasn't a major if not the most major lasting illness associated with the Gulf War. If you had such a source, you would have cited it by now. 71.212.249.178 (talk) 08:46, 10 July 2012 (UTC)

That's backwards, a positive claim rests on the claimant. If you want the article to say GWS is really uranium poisoning, you need a source saying this, explicitly using the term GWS/GWI. What is your best source that says "GWS is really uranium poisoning"? Your own opinion doesn't count, what source do you have that is explicit in linking GWS to uranium? WLU (t) (c) Wikipedia's rules:simple/complex 22:04, 10 July 2012 (UTC)

Which of the WP:MEDRSs which address the topic do you think do not support the idea that uranium poisoning is a major illness associated with the Gulf War? 71.212.249.178 (talk) 22:05, 13 July 2012 (UTC)
That is not the question. The question is which sources explicitly link uranium poisoning with GWS? You can't say "here are the symptoms of GWS[1] and here are the symptoms of uranium poisoning[2] and they line up." That is original research. What sources make an explicit link between GWS and uranium poisoning without you having to make the link for them?
Put another way, I don't care what you think, or what I think GWS is. I care what MEDRS have said GWS is or might be. I don't care what veteran's groups think, unless published in a reliable (medical) source. I don't care what symptoms you, your brother, your daughter, your uncle, your grocer or your dog have experienced, I care what reliable sources have said about GWS. So please, you have been told many, many times now that original research is prohibited, you are very well aware of this. Make the point with a source, your opinion is worth nothing on wikipedia. WLU (t) (c) Wikipedia's rules:simple/complex 12:58, 14 July 2012 (UTC)
Abu-Musa and Hindin, the peer reviewed secondary medical journal articles, both explicitly support the fact that uranium poisoning is an major illness associated with the Gulf War. The more recent literature review does, too. Explicitly. 71.212.249.178 (talk) 05:10, 15 July 2012 (UTC)
So what link is there between uranium poisoning and Gulf War syndrome? Many things happen in the Gulf, including rape, malnutrition, watching movies, dehydration, sneezing, childbirth and the manufacture of hummus. Are they all therefore Gulf War Syndrome? Is anything that happens in the Gulf region Gulf War Syndrome, or just the things you are personally convinced of?
Look, sources must discuss GWS explicitly, you can't proclaim something to be GWS just because you believe it so. Since you aren't changing your tune, if you keep this up I'll have to raise it somewhere else since you've already edit warred to insert your own opinions and original research into the article. WLU (t) (c) Wikipedia's rules:simple/complex 20:19, 15 July 2012 (UTC)
Uranium poisoning in war is unique to conflicts where uranium weapons were used. Why don't you ask the mediator if he is able to find any MEDRSs which agree with your absurd contention that uranium poisoning is not a major if not the most substantial illness associated with the Gulf War? All of the pertinent WP:MEDRS WP:SECONDARY literature reviews explicitly contradict it. Under those conditions, why would you think that further forum shopping will go any better for you? 71.212.249.178 (talk) 23:17, 15 July 2012 (UTC)
Please be civil. It's not up to WLU to disprove a negative. The only reference we have is the VA, which concluded that DU is not associated with GWI. To be honest I think further discussion is just a waste of time, WLU. --sciencewatcher (talk) 02:56, 16 July 2012 (UTC)
What happened to the MEDRS literature reviews? The RAC-GWI is not the VA. A majority of the RAC-GWI aren't even from the VA. Their 2008 report wasn't peer reviewed, and it is explicitly contradicted by the peer reviewed sources, including the MEDRSs. Why do you say that it is "the only reference we have"? I have shown patience beyond any hopes of Sisyphus here. Trying to limit discussion to only the tiny minority of unreliable sources with which you agree shows a lack of civility among those of us interested in building a neutral encyclopedia. "If you keep this up I'll have to raise it somewhere else" shows a lack of civility. I deserve a medal for putting up with this for so long. 71.212.249.178 (talk) 06:13, 16 July 2012 (UTC)

I'm not trying to limit the discussion to that ref. But if you read through the DU section in the article at present, that is the only ref that actually talks about the gulf war. All the others are just synthesis. If we don't have that, then we should probably delete the entire section! What other ref discusses DU and GWI and what exactly does it say (Hindin doesn't seem to have any conclusion, and Abu Musa isn't really about Gulf War illness and doesn't really discuss DU anyway). The problem seems to be that you have a conflict of interest here, and you are trying to skew the data to fit your preconceptions rather than vice-versa. Also you are being argumentative and slightly deceptive as well - in the past you told me you didn't have any personal interest in GWI, but later you admitted you had written a personal letter to the VA asking about their research. Really, I think you should rethink your editing of this article. Neither WLU nor I have any personal/emotional interest in GWI at all as far as I know. --sciencewatcher (talk) 15:44, 16 July 2012 (UTC)

Sciencewatcher, I agree. However, anon has shown a willingness to argue and edit war over these points, which is frustrating. Dispute resolution may be the best next step.
Anon, there is a difference between "an illness acquired in the Gulf War" such as uranium poisoning - which can be explained and diagnosed, and has a known set of associated symptoms - and GWS which is still debated and not well-understood. This is the page about GWS, if you want to talk about uranium poisoning, go to uranium. Even if "uranium poisoning [is] a major if not the most substantial illness associated with the Gulf War", that doesn't make it Gulf War syndrome. That makes it uranium poisoning and means it goes on a different page. Please provide sources that say "Gulf War syndrome has been identified as uranium poisoning" or stop raising the issue and edit warring. WLU (t) (c) Wikipedia's rules:simple/complex 17:17, 16 July 2012 (UTC)
If you want to make the exceptional claim that uranium poisoning is not a Gulf War illness, which is contradicted by all of the WP:MEDRSs which touch on the topic, then it is your burden to provide exceptional evidence in support of it. 71.212.249.178 (talk) 23:09, 16 July 2012 (UTC)
Claiming Gulf War syndrome is uranium poisoning is an exceptional claim. Claiming uranium poisoning is a Gulf War illness is a tangent completely unrelated to this page. WLU (t) (c) Wikipedia's rules:simple/complex 14:51, 17 July 2012 (UTC)
Replied at #Questions below. 75.166.200.250 (talk) 18:45, 20 July 2012 (UTC)

Questions

  1. Does the WP:SECONDARY WP:MEDRS Hindin (2005) pertain to Gulf War illnesses?
  2. Does any WP:MEDRS source support the GWI-RAC's un-peer reviewed 2008 statement (cited in detail above) that birth defect rates in the Gulf War participants' children are normal and the increases are "modest"? Do all the WP:SECONDARY sources pertaining to the topic except Doyle (2006) contradict that statement? Do at least three of the WP:MEDRS reviews contradict it?
  3. Should the GWI-RAC be balanced by detractors with a history of greater accuracy if it is replaced as an external link?
  4. Should the deleted information concerning uranium poisoning and mitigation be replaced?
  5. Given that there is no official definition of the syndrome, and authorities other than MeSH use the term "Gulf War illness," is it appropriate to discuss uranium poisoning and associated symptoms in the article?

As the discussion above regarding these questions has become difficult, I ask that the mediator Doc James respond. My opinion is: (1) Yes; (2) No; Yes; Yes; (3) Yes; (4) Yes; (5) Yes. 75.166.200.250 (talk) 18:45, 20 July 2012 (UTC)

I saw a post at Doc James' talk page, and I came over here. On the first question, it depends? A word count showed "Gulf War" was mentioned numerous times. The potential for toxicity of depeleted uranium has relevance to Gulf War syndrome as it is a possible cause. Maybe we could have a "Background" section with subsections that say "Potential for X toxicity" if they pass WP:MEDRS and relate to the Gulf War. We could simply summarize the science without any original research saying it causes Gulf War syndrome. Biosthmors (talk) 20:20, 14 August 2012 (UTC)
Thank you. I would be more than happy to agree to structural changes which don't result in the expunging of birth defect and uranium teratology. Are you willing to mediate in place of Doc James? The second paragraph of the introduction makes it clear that uranium exposure isn't a primary cause of most of the GWI symptoms, but I strongly object to separating birth defects out as unrelated because we now have at least three MEDRS reviews and dozens of sources indicating that Gulf War soldiers and civilians ended up with 2x+ birth defects. 75.166.207.214 (talk) 20:58, 14 August 2012 (UTC)
I'm willing to discuss this some but I don't know it my input will satisfy all of your concerns. OK, but that doesn't mean the babies have GWS, does it? They seem to have birth defects from what could be a partial cause of GWS. Possible birth defects as a result of uranium exposure from the Gulf War should be documented at the Gulf War page, in my opinion, and not here. We can't document all the possible toxic effects of the Gulf War here, unless sources say they are GWS. Biosthmors (talk) 22:18, 14 August 2012 (UTC)
On the fourth question, the first sentence "Because uranium is a heavy metal and chemical toxicant with nephrotoxic (kidney-damaging),[1] teratogenic (birth defect-causing),[2][3] immunotoxic,[4] and potentially carcinogenic[5] properties, uranium exposure is associated with a variety of illnesses." is problematic, in my opinion. The reason is the use of the word "because" and an unclear presentation of data. The sentence appears to mix evidence from toxicology studies in animals with epidemiological evidence from humans. @75.166.200.250, is your position that the complete text in the linked section perfectly acceptable? Biosthmors (talk) 20:37, 14 August 2012 (UTC)
I would be happy to rephrase that in a way that more effectively conveys the gist. There is a table in Uranium#Effects_and_precautions from a 2004 toxicology review describing all the same properties in humans. 75.166.207.214 (talk) 20:55, 14 August 2012 (UTC)
I'm glad you are open to rephrasing it. Biosthmors (talk) 22:18, 14 August 2012 (UTC)
Hindin mentions Gulf War, 86 times. It never uses the term "Gulf War syndrome" or "Gulf War illness", in the main text (GWS appears once in the title of a journal article in the references section). Gulf War syndrome is not synonymous with uranium poisoning, it is at best a proposed association, not a certain one - and if there are sources that make that link explicit, we should use them. If uranium is firmly linked to GWS, it should be easy to provide those sources, meaning we don't need to use sources that don't use the term(s) at all. If we include a discussion of the health effects of uranium on the Gulf War syndrome page, without explicit sources that's an unverified synthesis that uranium causes GWS. I have no problem with GWS being linked to uranium, provided sources are explicit. Hindin is not. It's about uranium poisoning, which has definite, recognized symptoms - from what I know, GWS is a vague cluster of symptoms that vary person to person rather than an exact list.
Birth defects are birth defects, they are not Gulf War syndrome. This page is not about all possible health effects of uranium poisoning. That should be reserved for uranium. This page is also not about any health effect that can be linked to combat in the Gulf War. It is about Gulf War syndrome, again a vague cluster of varying symptoms with no accepted diagnostic test, no universally-accepted clause or even a concrete list of symptoms.
The sources mentioned above are problematic, as I indicated in that section, most are primary sources, some are primary sources on mice, and Hindin again, doesn't mention GWS. I dislike having to repeat myself this often, it seems a very minimum threshold that in order to use a document on a page, it should mention the page's name at least once, shouldn't it? Seems obvious to me since our core content policies include verifiability and no original research. The anon, for all of their faith and good intentions, has not addressed these points and merely keeps insisting these sources be used to write his/her preferred version. WLU (t) (c) Wikipedia's rules:simple/complex 23:57, 14 August 2012 (UTC)
I disagree strongly because the Abu-Musa MEDRS discusses the civilian birth defects in his section devoted to the 1990-1 Gulf War. You are right that "Gulf War syndrome" lacks a formal definition, but that means "Gulf War illness" refers to all of the illness associated with the Gulf War by the multiple MEDRS reviews, not just those illnesses which you personally do not want to exclude for whatever reason. But, how do you feel about a WP:SUMMARY split into something like Gulf War uranium exposure? 75.166.207.214 (talk) 03:06, 15 August 2012 (UTC)
GWS is not "any illness associated with the Gulf War" - unless you can provide those multiple reliable sources that say so explicitly. We know what uranium poisoning is, does it mimic the proposed symptoms of GWS? Is there even a coherent list of such symptoms? Please link to MEDRS to answer each question, this is not an unreasonable request. If you can provide said sources, I will cease to object.
As I have said repeatedly, Abu-Musa also does not mention Gulf War syndrome at all, making it totally irrelevant here.
Gulf War uranium exposure would almost certainly be a POV-fork of GWS. I think those materials are best dealt with via uranium and possibly Gulf War.
Please provide sources for your assertions rather than merely assertions. WLU (t) (c) Wikipedia's rules:simple/complex 13:18, 15 August 2012 (UTC)
@IP, I don't understand how your sentence "I disagree strongly because Abu-Musa MEDRS discusses the civilian birth defects in his section devoted to the 1990-1 Gulf War" relates to the discussion. And I don't what part of what WLU said you're disagreeing with either. Your claim that " 'Gulf War illness' refers to all of the illness associated with the Gulf War by the multiple MEDRS reviews" is interesting and has potential implications. Could you link me to links so I can verify that? Toxic effects (or presumable effects) of the Gulf War belong at the Gulf War page first (or uranium page), before we split it out, I think (unless a majority of sources treat Gulf War illness with a different definition than we have for GWS, then it should be created into an article instead of redirected here). @WLU, I agree with what you're saying except I disagree with your statement that "If we include a discussion of the health effects of uranium on the Gulf War syndrome page, without explicit sources that's an unverified synthesis that uranium causes GWS." That is not what OR means, in my opinion. We could clearly state in the beginning of a Background section that while none of these agents are definitely linked to the spectrum of the syndrome, here are their individual toxicities in summary style. Background sections are background. They don't have to use the word of the subject of the article. Biosthmors (talk) 14:09, 15 August 2012 (UTC)
If the anon IP provides references that make explicit links between uranium and GWS, those references should provide sufficient background on uranium toxicity and related topics such that we probably won't have to go outside of those references. Like all things on wikipedia, it depends on the sources. I think the most important step at this point is to find sources that explicitly say "GWS might be caused by uranium". I have no issue with such a section if the sources (even sources phrasing it as a "might") are there. WLU (t) (c) Wikipedia's rules:simple/complex 14:40, 15 August 2012 (UTC)
PMID 19485101 is a secondary WP:MEDRS review from 2009 which specifically states that depleted uranium is associated with Gulf War illnesses. 75.166.207.214 (talk) 23:27, 15 August 2012 (UTC)
The first sentence of the article states that the article is about the illnesses associated with the Gulf War experienced by both civilians and soldiers, and as far as I know that has not been disputed. It's discussed above without objection. There have been several attempts to limit the subject to specific symptoms of the entire cadre of 1991 coalition troops, while ignoring other symptoms of civilians, Iraqi combat veterans, and even US combat veterans as opposed to their wider deployed but non-combat cohort. US troops in Saudi Arabia who did not participate in combat are entirely asymptomatic, and I personally believe that the Doyle review's use of that wider cohort to downplay birth defect statistics is unethical. I would like to know whether others agree or disagree, please. 75.166.207.214 (talk) 23:58, 15 August 2012 (UTC)

It isn't even used on the page, is it? I've requested a copy and will review it, thank you for providing it. The first sentence actually says "Gulf War syndrome (GWS) or Gulf War illness (GWI) is a chronic multisymptom disorder affecting veterans and civilians after the 1991 Gulf War", this being a wiki, that's not necessarily the most appropriate summary - it depends on the sources. I've requested a half-dozen other recent review articles about GWS, several of which are not used at all and some are used only once. Looks like the whole page needs a pretty thorough rewrite based on more recent documents. For instance, that very review aritcle you provide suggests that no specific toxin or substance has been linked to GWI, and no new syndrome identified - just a lot of hypotheses including uranium exposure. WLU (t) (c) Wikipedia's rules:simple/complex 15:04, 16 August 2012 (UTC)

Again, @IP: Your claim that " 'Gulf War illness' refers to all of the illness associated with the Gulf War by the multiple MEDRS reviews" is interesting and has potential implications. Could you link me to links so I can verify that? Biosthmors (talk) 18:41, 16 August 2012 (UTC)
Here are some of the definitions I am able to find with a cursory search. If you don't think these are consistent with that statement, please let me know why. 71.212.250.193 (talk) 20:49, 21 August 2012 (UTC)
  1. As was pointed out above, "Gulf War" occurs 88 times in Hindin (2005) which is an article about reproductive illness, although the string "Gulf War illness" does not appear.
  2. "Service in the Persian Gulf in 1991 is associated with increased reporting of symptoms and distress in a proportion of those who served there. Yet despite clear evidence of an increase in symptom burden and a decrease in well being, exhaustive clinical and laboratory based scientific research has failed to document many reproducible biomedical abnormalities in this group" -- PMID 17707114
  3. "a higher incidence of clinical and laboratory abnormalities in veterans of Operations Desert Storm and Desert Shield" -- PMID 11262710
  4. "chronic health problems" -- PMID 22519425
  5. "Unexplained symptoms reported by veterans of the Persian Gulf War with Iraq in 1991." -- MeSH
PMID 22691951 and PMID 22327017, very recent papers, have the first uses of the term "Gulf War Syndromes" in the medical literature I can find, and they refers to three of them. But they are apparently confined to very specific neurological abnormalities in fMRI images. 71.212.250.193 (talk) 20:49, 21 August 2012 (UTC)
I don't see anything you've typed that matches your claim that " 'Gulf War illness' refers to all of the illness associated with the Gulf War by the multiple MEDRS reviews". Please either back up your claim or retract it. Also, maybe you do not understand what original research is? Are you familiar with the concept? Biosthmors (talk) 20:58, 21 August 2012 (UTC)
Why exactly do you believe those excerpts do not support that definition? Can you give an example of an alternative definition which would be consistent with those excerpts? Of course I am familiar with the concept of original research. Those excerpts are from peer reviewed secondary medical literature reviews and the operative NLM definition, not something I just made up. 71.212.250.193 (talk) 21:01, 21 August 2012 (UTC)
Can you provide a quote from a source that proves that the term Gulf War illness " "refers to all of the illness associated with the Gulf War"? Biosthmors (talk) 21:07, 21 August 2012 (UTC)
Why do you think universal quantification is not implicit? None of those excerpts or any other source says that GWI excludes reproductive illnesses. What makes you think that is the case? 71.212.250.193 (talk) 21:13, 21 August 2012 (UTC)

Recent edits and removal of dispute tag

WLU recently removed the dispute tag while I was waiting for the mediator to respond to the #Questions above. WLU also removed MEDRSs Hindin (2005) and Abu-Musa (2008) which they specifically consented to above, while leaving Shelleh (2012) which they called too new to include. Because of the contrary nature of these inconsistencies, I don't think the edits were made in bad faith, and I'm sorry if my refusal to revert them in an article which had just been fully protected twice because of edit warring was seen as implying that the article was no longer in dispute. I hope the mediator responds soon. 75.166.207.214 (talk) 08:50, 14 August 2012 (UTC)

I would also like to point out, that for an article which has been in dispute essentially since its creation, it has the best AFTv4 feedback scores I've seen for any article with more than a dozen ratings. 75.166.207.214 (talk) 08:57, 14 August 2012 (UTC)

Ya, there is no mediator coming, you didnt' do anything official. I've addressed those sources previously - they are being mis-used, not discussing GWS specifically and conflating GWS with uranium poisoning, which is not considered the definitive cause of what isn't even an accepted diagnosis. WLU (t) (c) Wikipedia's rules:simple/complex 15:27, 14 August 2012 (UTC)
I've asked Doc James if he is willing to try to help find another mediator. Why did you remove the dispute tag again, after Sciencewatcher and Kaltenmeyer made incremental edits? 75.166.207.214 (talk) 19:56, 14 August 2012 (UTC)
I'm happy with WLU's revert. I didn't really have time to look at the edits this morning...the DU section is a mess and I didn't have time to look at it. Also I wish the admins would stop just continually protecting this page, which doesn't help - the same shit keeps happening again and again. The problem is one user, not a content dispute. Please admins, have a look at the edits. --sciencewatcher (talk) 23:08, 14 August 2012 (UTC)
I have a feeling that the "one editor" to whom you are referring is not the editor who reverted without discussion prior to all three of the recent full protections. In any case, I'd like to ask you about this edit where your edit summary says "the review doesn't say that at all," but those are direct quotes from page 51 of the Abu-Musa MEDRS, aren't they? 75.166.207.214 (talk) 03:19, 15 August 2012 (UTC)
Yes, it's a direct quote, but it is an animal study (nothing to do with GWS). . --sciencewatcher (talk) 03:37, 15 August 2012 (UTC)
Agreed, Abu-Musa shouldn't be discussed further here since it's fundamentally not about the page's topic. WLU (t) (c) Wikipedia's rules:simple/complex 13:19, 15 August 2012 (UTC)
Do you have a source which supports your assertion that reproductive illnesses are not Gulf War illnesses? All of the MEDRSs show that they are associated. 75.166.207.214 (talk) 23:18, 15 August 2012 (UTC)
On the contrary, the full excerpted sentence reads: "There was evidence from occupational epidemiology and animal studies that male exposure to heavy metals, solvents, paints and pesticides were associated with poor sperm quality, spontaneous abortion, birth defects and cancer in offspring (Welch et al., 1988; Olshan et al., 1991; Daniels et al., 1997; Savitz et al., 1997)" (emphasis added.) Occupational epidemiology is strictly human medicine. The animal studies are merely to confirm and quantify without breaching human subject ethics. 75.166.207.214 (talk) 23:18, 15 August 2012 (UTC)
"occupational epidemiology" is still nothing to do with gulf war illness. What I meant by my edit comment is that you were misrepresenting the source by implying that it had something to do with gulf war illness when it did not. Also your personal views on Dolye are irrelevant. --sciencewatcher (talk) 02:24, 16 August 2012 (UTC)
Do you believe that the first paragraph of the introduction of Abu-Musa implies that the article pertains to Gulf War illnesses? If not, why not? What do you think statements such as "the review doesn't say that at all" and "it is an animal study (nothing to do with GWS)" imply about whether you are editing in good faith? 75.166.207.214 (talk) 03:53, 16 August 2012 (UTC)
Do you have a source that says "Gulf War syndrome causes birth defects"? The page is not "all illness associated with the Gulf War or the Persian Gulf". It is about a specific, proposed clinical entity that, as far as I know, is ill-defined, has no coherent list of symptoms and no agreed-upon etiological agent. WLU (t) (c) Wikipedia's rules:simple/complex 14:45, 16 August 2012 (UTC)

That is exactly right: it is ill-defined, has no coherent list of symptoms and no agreed-upon etiological agent. So why do you want to exclude what MEDRS reviews say are the illnesses associated with the war? 71.212.250.193 (talk) 20:54, 21 August 2012 (UTC)

Because this article is not about all the illnesses associated with the war. Please edit the Gulf War page for that. Biosthmors (talk) 21:05, 21 August 2012 (UTC)
That seems absurd. What source do you believe supports excluding some of the illnesses associated with the war? 71.212.250.193 (talk) 21:07, 21 August 2012 (UTC)
Before I look up a source, let's say soldiers were huffing gasoline to get high and got sick. Should that be covered here? Isn't it an illness associated with the war? Biosthmors (talk) 21:13, 21 August 2012 (UTC)
Of course not. Hindin (2005) and Abu-Musa (2008) both discuss the possibility of causes not unique to war in detail, and dismiss them because of the reproductive health outcome differences between the cohorts exposed to combat and those in their wider cohort (soldiers and civilians, coalition and Iraqi) who were not in combat. Have you read any of the reviews we have been discussing? 71.212.250.193 (talk) 21:16, 21 August 2012 (UTC)

Bigger problems?

I've tried to help out with a content dispute above, which led me to look up a reliable source. I think we may have bigger problems than are discussed above. This article begins by stating:

Gulf War syndrome (GWS) or Gulf War illness (GWI) is a chronic multisymptom disorder affecting veterans and civilians after the 1991 Gulf War.

However, when I looked up a reliable secondary source (doi:10.1016/j.cpr.2007.07.006), it says:

"the term Gulf War Syndrome (GWS) has entered the lexicon to describe these symptoms, although it is almost certain that no actual new syndrome is involved"

Isn't the beginning of the article in direct contradiction to the medical literature? What is the basis for this article? What should it cover? Biosthmors (talk) 21:37, 21 August 2012 (UTC)

Yes, this is discussed above. There is no formal Syndrome beyond very recently described fMRI patterns and the MeSH definition, but per WP:NC we use popular names. 71.212.250.193 (talk) 22:11, 21 August 2012 (UTC)
Like CFS or fibromyalgia nobody is quite sure of the etiology. I think we may just need to tweak the intro so that it agrees with the reliable reviews if it doesn't already. --sciencewatcher (talk) 22:50, 21 August 2012 (UTC)

I added a discussion of the fact that there are no formal definitions to the "Classification" section. 71.212.250.193 (talk) 23:35, 21 August 2012 (UTC)

Edit warring and page protection

The page has been the subject of an edit war and under page protection for long stretches of time now. The edit warring has been based solely on the actions of the single anonymous editor, whose points have been addressed repeatedly, and in my opinion more than adequately, without acquiring any consensus that their claims have merit. Rather than the page being held hostage by a single editor who is unable to convince any others of his or her points, I suggest we seek semi-protection to disable anonymous editing and require the points raised be addressed on the talk page instead of through pointless tagging and reverts to the main page. The latest round of edits were simply to tag sections, which is inappropriate since section and article tags are not meant as badges of shame to indicate one person disagrees with the information. WLU (t) (c) Wikipedia's rules:simple/complex 15:02, 21 August 2012 (UTC)

Agreed...I've been saying this for a while. It's just getting ridiculous now. I wish admins would actually take a look at a page before just slapping on yet another edit protection. --sciencewatcher (talk) 15:12, 21 August 2012 (UTC)
The Wikipedia:Protection policy explicitly states that semi-protection is not to be used to give some users the uppper hand in content disputes, and administrators that have to take responsibility for their admin actions, are within their rights to act only within this policy. It is not the role of administrators in general to rule on content disputes, and I'm not going to shut the IP down just because a few editors on one side think they've won the argument, particularly as no avenues beyond discussing on the talk page have really been tried. The IP wants a mediator, apparently there isn't one coming - how about getting one? - WP:MEDCOM is available. WP:DRN can also be used as a first step. CT Cooper · talk 17:29, 21 August 2012 (UTC)
I came here to discuss some things with the IP and WLU as a "third party"/unofficial mediator. The most interesting thing I've seen so far is that the IP has made a significant claim, but has not yet directed me to the reliable sources, as one can see above. Biosthmors (talk) 17:48, 21 August 2012 (UTC)
The sources are all the ones cited above on this page. I have replied with excerpts at #Questions above. 71.212.250.193 (talk) 20:58, 21 August 2012 (UTC)
(ec) Replied above. Biosthmors (talk) 20:59, 21 August 2012 (UTC)
If Hindin (2005), Abu-Musa (2008), Shelleh (2012), and PMID 19485101 do not satisfy your criteria for peer-reviewed WP:SECONDARY WP:MEDRS reviews linking uranium to the causes of some of the observed symptoms of Gulf War illness, please let me know why. 71.212.250.193 (talk) 21:02, 21 August 2012 (UTC)
In general, we don't cite sources that do not directly relate information to the subject unless we're writing a background section. That way we avoid original research. Does that help? Biosthmors (talk) 21:04, 21 August 2012 (UTC)
No, you seem to think there is some reason to exclude reproductive illnesses from the symptoms to be discussed here, but you have not provided any source in support of that opinion. Would you please answer the question: Do those four literature reviews link uranium to Gulf War illnesses or not? 71.212.250.193 (talk) 21:10, 21 August 2012 (UTC)
Sorry, but I'm not about to read four papers to respond. Can you please provide a direct quote from a reliable source that shows reproductive illnesses are part of Gulf war syndrome? Biosthmors (talk) 21:16, 21 August 2012 (UTC)
There is no formal definition of the syndrome, and the excerpts I quoted above in #Questions are the usual definitions of GWI. None of them exclude any particular set of symptoms or imply that there is any exclusive set of symptoms. If you aren't willing to read the reviews, I don't think you can be qualified to mediate the disputes. 71.212.250.193 (talk) 21:25, 21 August 2012 (UTC)

ip: the point is that we can't just include any old research having to do with illness in the persian gulf. We can ONLY include it if the reference specifically mentions 'gulf war syndrome' or 'gulf war illness'. That is just how wikipedia works, and it's a waste of time trying to argue otherwise.

CT Cooper: this isn't a content dispute, it is one individual with a COI edit-warring and ignoring wikipedia rules. Even so we have had two mediators and it hasn't helped. --sciencewatcher (talk) 22:46, 21 August 2012 (UTC)

The vast majority of the undisputed sources in the article do not use the term "gulf war illness" or "gulf war syndrome" because there are no formal definitions for those terms. The vast majority of the sources on PubMed which include the terms "Gulf War" and refer to soldier or civilian illnesses (about 1500) do not use the term "Gulf War illness" (about 90) for the same reason. Your only edits here have been to try to remove mention of reproductive illnesses associated with the war. Why? And how can you possibly claim that isn't a content dispute? I have no COI: I'm not a veteran and I've never been near the Middle East; nor do I have any friends or family who have. I simply object to the endless attempts to whitewash the plain language of the secondary peer reviewed sources pertaining to reproductive illnesses from the article. 71.212.250.193 (talk) 23:10, 21 August 2012 (UTC)
The problem isn't that we are refusing to include reproductive issues, the problem is the most recent secondary sources indicate that no such issues have been soundly linked to GWS.
CT Cooper's suggestion is a good one - the last time I took something to DRN it was resolved relatively quickly, and featured similar issues. When it became obvious the issue was one party didn't understand or wasn't willing to adhere to wikipedia's policies, the issue was closed. WLU (t) (c) Wikipedia's rules:simple/complex 23:51, 21 August 2012 (UTC)
To which "most recent secondary sources" do you refer? All of the MEDRSs except Doyle (2006) which touch on the subject confirm such a link, including Hindin, which you have deleted entirely from the article at least three times now even though you agreed to include it above, Abu-Musa, and Shelleh. This fact has been the case since the Arfsten (2001) review. 71.212.250.193 (talk) 00:01, 22 August 2012 (UTC)
You admitted here that you had written a letter to the VA asking about research. There is nothing wrong with that of course or any type of COI, but it can be a red flag along with other factors. It's frankly insane to say that WLU or I are trying to remove mention of reproductive illness from the article. I'm happy to go along with DRN if it gets this sorted out. --sciencewatcher (talk) 01:47, 22 August 2012 (UTC)
Yes, I've emailed and phoned the VA to learn more about the subject, but everything I've added to the article is sourced to the peer reviewed literature, and I have no COI on the subject. 71.212.250.193 (talk) 04:45, 22 August 2012 (UTC)
I did indeed initially say Hindin was an acceptable source. However, I subsequently stated, twice [4] [5] that it was not acceptable because it did not discuss GWS explicitly - a point echoed by several other editors now. Hindin confirms no link between GWS and any other condition, because it does not discuss GWS. It does discuss uranium poisoning, which other sources link to GWS, but it would be an inappropriate synthesis to link them. You know this. I dislike repeating such basic objections. I dislike even more when other editors cherry-pick my statements to completely misrepresent my opinions. It is for reasons like these that I think dispute resolution will end up with the mediator saying you are wrong and should stop POV-pushing. CT Cooper may have objected to the use of page protection on procedural grounds, but that's not the same thing as endorsing your view on GWS. Nobody to date has done so, several have voiced valid, policy-based objections, and you have failed to acknowledge these objections and continued to repeat your points without adequate references to back them up. The same issues arise with Abu-Musa and Shelleh, none actually discuss GWS, they discuss topics, events and pathogens that happen to be in the Persian Gulf region. Several editors have pointed out that GWS is not the same thing as "any adverse effect that happens in the Persian Gulf", but I have yet to see you acknowledge this point. How do you reconcile the use of these sources with the policy on original research? Such questions will be asked at DRN, so you might as well think about what you're going to say now. WLU (t) (c) Wikipedia's rules:simple/complex 02:08, 22 August 2012 (UTC)
Hindin refers to the Gulf War more than 80 times. It's absurd to say it doesn't refer to GWI when less than 100 out of 1500 PubMed articles describing Gulf War illnesses include the string "Gulf War illness" or syndrome. Illnesses associated with those exposed to combat and battlefields of the 1991 Gulf War by the peer reviewed medical literature are very different than "any adverse effect that happens in the Persian Gulf" and clearly differentiated as such in the MEDRSs we've been discussing. 71.212.250.193 (talk) 04:54, 22 August 2012 (UTC)

It's not absurd, it's simply wrong to say GWS is uranium poisoning and OR to use Hindin in this article. You're the only POV-pushing editor who thinks it should be used, everyone else agrees that it is inappropriate. Consensus is against you. WLU (t) (c) Wikipedia's rules:simple/complex 12:07, 22 August 2012 (UTC)

Seems highly likely, looking at the edit logs (and this banned user has also petitioned the VA). --sciencewatcher (talk) 15:31, 22 August 2012 (UTC)
Also, both the ip user and the banned user are from Denver. --sciencewatcher (talk) 16:07, 22 August 2012 (UTC)
See Wikipedia:Sockpuppet investigations/Dualus‎. (I'm not the 74.82 user; I was watching this page for info for the SPI report). --Amble (talk) 16:17, 22 August 2012 (UTC)
Whoever is making the edits, the two sources added last night look like WP:MEDRS reviews which clearly link DU to GWI. 199.16.130.122 (talk) 19:52, 22 August 2012 (UTC)
It was the other edits I was reverting. I was going to fix it, but I don't have time now so I've just reverted back. Interesting that a new ip address shows up once we under the other banned user's sockpuppet. Also interesting that 199.16.130.122 is a server in Montreal, so obviously someone trying to hide their real ip. --sciencewatcher (talk) 21:21, 22 August 2012 (UTC)
And another new user (Pinre) pops up, probably another sock. This is getting ridiculous. Admins - have your opinions on page protection changed perhaps? --sciencewatcher (talk) 23:17, 22 August 2012 (UTC)
I've reviewed the evidence, and on the balance of probabilities, I think we are dealing with a banner user - which makes this a lot easier. Therefore I have semi-protected the page for a month, which should calm things down on the article front. Further admin action can be taken as necessary. CT Cooper · talk 01:36, 23 August 2012 (UTC)

Bear with me for a bit

I've got a couple new sources (already identified, Friedl and Iverson) that I plan on integrating along with some of the changes made in the past couple days. The new sources are fairly negative about GWS being something new or a coherent clinical entity with a single etiology, but still make interesting comments. I'll try to be quick but it may take me a couple hours, I've added {{underconstruction}} but it may look like I'm not actually working on the page. If I can beg for some time... WLU (t) (c) Wikipedia's rules:simple/complex 14:22, 23 August 2012 (UTC)

Fuck a duck.
Wow, the page is a gong show. It asserts that some causes have been linked to GWS that the RAC 2008 report says have been ruled out, and other causes are ruled out that the RAC 2008 report says are still valid. I don't know if this is due to aging of sources, but it looks like thos whole page was written a couple years back and simply not updated wholesale. The whole page needs a lot of work, and it's simply beyond me timewise right now. I've taken down the under construction tag and have given up for a while, but the page still needs a lot of work - and editors need to do a lot of reading before assuming they know what's going on. The RAC report says there are two pretty much solid links between GWS/GWI and anti-nerve gas agents and pesticides, that needs to be developed. Anyway, done for now, giving up (temporarily) in frustration. This'll take some time but is worth it methinks. WLU (t) (c) Wikipedia's rules:simple/complex 15:55, 23 August 2012 (UTC)
Yes, definitely. I had a go with this article a year or so ago and tidied it up a bit, but I didn't have the time to give it a proper overhaul. Part of the problem is that (like CFS) there is no real agreement over what causes it. The VA in particular have changed their opinion. Originally they looked at stress, but then (under pressure from veterans) they they said stress had been ruled out (although their logic is a little dubious, as you'll see if you dig into why they said that). As far as I can see, other researchers still believe that stress could be a cause. If you look at the major reviews - if my memory serves - you'll see they say there is disagreement about whether it is psychiatric or not, but we're not reflecting that viewpoint at all in the article. --sciencewatcher (talk) 17:35, 23 August 2012 (UTC)
Though I think we can, and should, rely heavily on the RAC reports, their vulnerability to lobbying by veterans' groups is unsurprising. We should absolutely go outside of just that document when we have the sources available - though my searches didn't turn up a whole lot of useful stuff. At least we can consider the DU issue pretty much dead and eliminate it from the page as a cause needing treatment. WLU (t) (c) Wikipedia's rules:simple/complex 17:50, 23 August 2012 (UTC)
I'd suggest reading the full-text of Iverson (http://ia201120.eu.archive.org/ea/20070108123845/http://kcl.ac.uk/kcmhr/information/publications/articles/gulf_war/lessons_iversen.pdf). We reference this in the article, but don't really include anything from it. This is about the only decent review I can find apart from the VA stuff, and it presents a very different picture from the VA. It's from 2007, but to be honest there hasn't really been much more research done since then. --sciencewatcher (talk) 18:43, 23 August 2012 (UTC)
Agreed, there's a LOT of stuff that needs to be read and integrated. I'm surprised (or perhaps not) that anon would push to integrate 2012 articles on uranium in veteran's urine, but not spend more time on actual review articles on real causes. Uranium has been ruled out for eff's sake, by RAC - which goes on to say there are definite links to organophosphate pesticides and anti-nerve agent pills! By chopping out some of the unrelated drek and nonsense, hopefully it's closer to a more reasonable page and less intimidating to try and update all of it. WLU (t) (c) Wikipedia's rules:simple/complex 19:47, 23 August 2012 (UTC)