Persius/hicric huggingface dataset:
Cervical incompetence

# Overview
In medicine, cervical incompetence is a condition in which a pregnant woman's cervix begins to dilate (widen) and efface (thin) before her pregnancy has reached term. Cervical incompetence is a cause of miscarriage and preterm birth in the second and third trimesters.
In a woman with cervical incompetence, dilation and effacement of the cervix occur without pain or uterine contractions. Instead of happening in response to uterine contractions, as in normal pregnancy, these events occur because of weakness of the cervix, which opens under the growing pressure of the uterus as pregnancy progresses. If the changes are not halted, rupture of the membranes and birth of a premature baby can result. According to statistics provided by the Mayo Clinic, cervical incompetence is relatively rare in the United States, occurring in only 12% of all pregnancies, but it is thought to cause as many as 2025% of miscarriages in the second trimester.

# Risk Factors
Risk factors for premature birth or stillbirth due to cervical incompetence include:
- diagnosis of cervical incompetence in a previous pregnancy,
- previous preterm premature rupture of membranes,
- history of conization (cervical biopsy),
- diethylstilbestrol exposure, which can cause anatomical defects, and
- uterine anomalies.
Repeated procedures (such as mechanical dilation, especially during late pregnancy) appear to create a risk.  Additionally, any significant trauma to the cervix can weaken the tissues involved.

# Treatment
Cervical incompetence is not generally treated except when it appears to threaten a pregnancy.  Cervical incompetence can be treated using cervical cerclage, a surgical technique that reinforces the cervical muscle by placing sutures above the opening of the cervix to narrow the cervical canal.
Cerclage procedures usually entail closing the cervix through the vagina using a speculum. Another approach involves performing the cerclage through an abdominal incision. Transabdominal cerclage of the cervix makes it possible to place the stitch exactly at the level that is needed. It can be carried out when the cervix is very short, effaced or totally distorted. The complications described in the literature have been rare: hemorrhage from damage to the veins at the time of the procedure; and fetal death due to uterine vessels occlusion.
Note: The first revision of this article was adapted from material from the public domain source "Summary Report: ICD-9-CM coordination and maintenance committee", published at .
Challenging behaviour

# Overview
Challenging behaviour is defined as "culturally abnormal behaviour(s) of such intensity, frequency or duration that the physical safety of the person or others is placed in serious jeopardy, or behaviour which is likely to seriously limit or deny access to the use of ordinary community facilities" .
Challenging behaviour is most often exhibited by people with developmental disabilities, dementia, psychosis and by children, although such behaviours can be displayed by any person.

# Types of challenging behaviour
Common types of challenging behaviour include self-injurious behaviour (such as hitting, headbutting, biting), aggressive behaviour (such as hitting others, screaming, spitting, kicking), inappropriate sexualised behaviour (such as public masturbation or groping), behaviour directed at property (such as throwing objects and stealing) and stereotyped behaviours (such as repetitive rocking, echolalia or elective incontinence).

# Causes of challenging behaviour
Challenging behaviour may be caused by a number of factors, including biological (pain, medication, the need for sensory stimulation), social (boredom, seeking social interaction, the need for an element of control, lack of knowledge of community norms, insensitivity of staff and services to the person's wishes and needs), environmental (physical aspects such as noise and lighting, or gaining access to preferred objects or activities), psychological (feeling excluded, lonely, devalued, labelled, disempowered, living up to people's negative expectations) or simply a means of communication. A lot of the time, challenging behaviour is learned and brings rewards and it is very often possible to teach people new behaviours to achieve the same aims.
Experience and research suggests that what professionals call 'challenging behaviour' is often a reaction to the challenging environments that services create around people with developmental disabilities, and a method of communicating dissatisfaction with the failure of services to listen for what kind of life makes most sense to the person, especially where services deliver lifestyles and ways of working that are centred on what suits the service and it's staff rather than what suits the person
A common principle in behaviour management is looking for the message an individual is communicating through their challenging behaviour: "All behaviour has meaning".

# Behaviour response cycle
Challenging behaviours may be viewed as occurring in a cycle:
- Trigger
- Escalation
- Crisis
- Recovery
Analysis of this cycle provides a foundation for using a variety of strategies to minimize the triggers of challenging behaviour, teach more appropriate behaviours in response to these triggers, or provide consequences to the challenging behaviour that will encourage a more appropriate response. Behavioural strategies such as Applied Behaviour Analysis, operant conditioning and Positive behaviour support use similar approaches to analyzing and responding to challenging behaviours.
Chemical modification

# Overview
In biochemistry, chemical modification is the technique of chemically reacting a protein or nucleic acid with chemical reagents.  Chemical modification can have several goals, such as
- to identify which parts of the molecule are exposed to solvent ("foot printing");
- to determine which residues are important for a particular phenotype, e.g., which residues are important for an enzymatic activity;
- to introduce new groups into a macromolecule; and
- to crosslink macromolecules intra- and intermolecularly.

# Chemical modification of protein side chains

# Chemical modification of nucleic acids
Chenodeoxycholic acid

# Overview
Chenodeoxycholic acid (also known as chenodesoxycholic acid) is a bile acid, a white crystalline substance insoluble in water, with melting point at 165-167 C. Its salts is called chenodeoxycholates. Chenodeoxycholic acid is one of the 4 main organic acids produced by the liver. It is soluble in alcohol and acetic acid.
Chenodeoxycholic acid is synthesized in the liver from cholesterol.
This compound, when altered by bacteria in the colon, will result in conversion to its secondary bile acid known as lithocholic acid. Both of these bile acids, in addition to the others, can be conjugated to taurine or glycine.  Conjugation, a function carried out by the liver will result in a lowered pKa and therefore, the compounds will remain ionized.  These ionized compounds will stay in the gastrointestinal tract until reaching the ileum where they will be reabsorbed.  The purpose of this conjugation is to keep the bile acids in the tract until the end to facilitate lipid digestion all the way to the ileum.
In cases where bacteria overgrow in the small intestine, often due to a blind loop in the intestine retaining chyme in one place, the bacteria will de-conjugate the bile acids and therefore impede fat digestion and absorption.  This can lead to steatorrhea.
Chenodeoxycholic acid and cholic acid are the most important human bile acids. Some other mammals synthesize predominantly deoxycholic acid.

# Potential applications
The Australian biotechnology company Giaconda has developed a treatment for Hepatitis C infection that combines chenodeoxycholic acid with bezafibrate.
In supramolecular chemistry molecular tweezers based on a chenodeoxycholic acid scaffold is an urea receptor  which can contain anions in its binding pocket in order of affinity: H2PO4- (dihydrogen phosphate) > Cl- > Br- > I- reflecting their basicities (tetrabutylammonium counter ion).
Chi square calculator

# Chi Square Calculator
The following file contains a 2x2 contingency table for chi square calculation.
Chi Square Calculator

# How to use it?
- Click on the link above to download the spreadsheet.
- In the white boxes, you should enter the number of individuals for each group.
- You may also enter the name of the groups (rows) and categories (columns).
Child psychopathology

# Overview
Child psychopathology is the manifestation of psychological disorders in children and adolescents. Oppositional defiant disorder, attention-deficit hyperactivity disorder, and pervasive developmental disorder are examples of child psychopathology. Social workers, psychologists and psychiatrists who work with mentally ill children are informed by research in developmental psychology, developmental psychopathology, clinical child psychology, and family systems.
The current trend in the U.S. is to understand child psychopathology from a systems based perspective called developmental psychopathology. Recent emphasis has also been on understanding psychological disorders from a relational perspective with attention also given to neurobiology.
Research and clinical work on child psychopathology tends to fall under several main areas: etiology, epidemiology, diagnosis,  assessment, and treatment.
Chiral pool synthesis

# Overview
Chiral pool synthesis is a strategy that aims to improve the efficiency of chiral synthesis. It  starts the organic synthesis of a complex enantiopure chemical compound from a stock of readily available enantiopure substances. Common chiral starting materials include monosaccharides and amino acids. The built-in chirality is then preserved in the remainder of the reaction sequence.
This strategy is especially helpful if the desired molecule bears a great resemblance to cheap enantiopure natural products. Otherwise, a long, tortuous synthesis involving many steps with attendant losses in yield may be required. At times, it may be difficult to find a suitable enantiopure starting material; other techniques may prove more fruitful.
General methods used in chiral pool synthesis are the use of protecting groups, and functional group interconversion (FGI).

# Examples
Chiral pool synthesis is used to build a part of the epothilone molecule (an alternative to Paclitaxel), from readily available enantiopure (-)-pantolactone.
Chlorodifluoromethane

# Overview
Chlorodifluoromethane or difluoromonochloromethane is a hydrochlorofluorocarbon (HCFC).  It is better known under its code names of HCFC-22, R-22, Genetron 22 or Freon 22, and is commonly used in air conditioning applications, such as residential split systems in the US, rooftop units and window air conditioners.
Chlorodifluoromethane was first used as an alternative to the ozone depleting CFC-11 and CFC-12, but was later decided to be not environmentally friendly enough, although its ozone depletion potential is 0.055, among the lowest for chlorine-containing haloalkanes.  It will be phased out soon under the Montreal Protocol, to be replaced by more environmentally friendly refrigerants such as Propane (R-290), and other refrigerants ( even though not having very similar properties ): R-410A (an azeotropic mixture of difluoromethane and pentafluoroethane), R-502, R-134a (1,1,1,2-tetrafluroethane) and R-409A.
It is an intermediate in the synthesis of tetrafluoroethylene, into which it is converted by pyrolysis. Difluorocarbene is an intermediate in this reaction. The compound also yields difluorocarbene upon treatment with strong base and is used in the laboratory as a source of this reactive intermediate.
The US EPA has enacted regulation which will phase out the use of HCFC-22 in the near future. Air conditioning manufacturers will no longer be allowed to sell R22 equipment as of January 1, 2010. In the aftermarket service business, the allocation rights for producers who manufacture R22 will be cut each year making the remaining R22 supply potentially smaller than the service demand for the product. This could make R22 scarce in the future, and drive prices to consumers higher.

# Physical Properties
It has two allotropes: crystaline II below 59 K and crystaline I above 59 K to 115.73 K.
Cholesterol granuloma

# Overview
Cholesterol granulomas can occur in any obstructed air cells. They often arise from the apex of the petrous bone and may enlarge enough to expand in the posterior cranial fossa and produce nerve disturbances.

# Differentiating Cholesterol granuloma from Other Diseases
- Mucocele
- Dermoid/Epidermoid

# Diagnosis
The imaging findings are
- At CT, cholesterol granulomas appear as sharply and smoothly marginated expansile lesions in the temporal bone, isoattenuating with brain tissue and nonenhancing.
- At MR imaging, they characteristically have a large central region of increased signal intensity and a thin peripheral rim of decreased signal intensity on both T1- and T2-weighted images. The latter finding corresponds to expanded cortical bone and hemosiderin deposits.
- Spontaneous and homogeneous central high signal intensity on T1-weighted images is very suggestive of a cholesterol granuloma.
Chromosomal inversion
An inversion is a chromosome rearrangement in which a segment of a chromosome is reversed end to end. An inversion occurs when a single chromosome undergoes breakage and rearrangement within itself. Inversions are of two types: paracentric and pericentric.
Paracentric inversions do not include the centromere and both breaks occur in one arm of the chromosome.  Pericentric inversions include the centromere and there is a break point in each arm.
Cytogenetic techniques may be able to detect inversions, or inversions may be inferred from genetic analysis. Nevertheless, in most species small inversions go undetected. In insects with polytene chromosomes, for example Drosophila, preparations of larval salivary gland chromosomes allow inversions to be seen when they are heterozygous. This useful characteristic of polytene chromosomes was first advertised by Theophilus Shickel Painter in 1933.
Inversions usually do not cause any abnormalities in carriers as long as the rearrangement is balanced with no extra or missing genetic information. However, in individuals which are heterozygous for an inversion, there is an increased production of abnormal chromatids (this occurs when crossing-over occurs within the span of the inversion). This leads to lowered fertility.
Families that may be carriers of inversions may be offered genetic counseling and genetic testing. 
The most common inversion seen in humans is on chromosome 9, at inv(9)(p11q12).  This inversion is generally considered to have no deleterious or harmful effects, but there is some evidence it leads to an increased risk for miscarriage for about 30% of affected couples.
Chronic pain overview

# Overview
Chronic pain was originally defined as pain that has lasted 6 months or longer. More recently it has been defined as pain that persists longer than the temporal course of natural healing, associated with a particular type of injury or disease process.
The International Association for the Study of Pain defines pain as "an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage." It is important to note that pain is subjective in nature and is defined by the person experiencing it, and the medical community's understanding of chronic pain now includes the impact that the mind has in processing and interpreting pain signals.
As a summary;
- Chronic pain is defined as pain that continues beyond the recognized time for the body to heal (usually 4-6 weeks)
- Historically, chronic pain is underdiagnosed, and therefore undertreated
- Chronic pain becomes a disease state itself without a physiologic role
- Depending upon the distribution of symptoms, the pain can be categorized as regional or diffuse
- High rates of psychiatric co-morbidities exist with these conditions
Mixed angina pectoris

# Overview
Mixed or variable threshold angina pectoris is a syndrome in which there is substantial variation in the magnitude of physical activity that induces anginal chest pain.

# Pathophysiology
Dynamic vasoconstriction which is superimposed on fixed atherosclerotic coronary artery obstruction has been postulated as the underlying pathophysiologic mechanism for the changes in exercise threshold in mixed angina pectoris.

# Diagnosis

### Symptoms
- The essential clinical feature of mixed angina is a substantial variation in the degree of physical activity that induces angina.
- This group of patients may also experience nocturnal angina on certain occasions.
- Anginal episodes may also occur upon exposure to cold, during periods of emotional stress, or after meals.

# Treatment
- The treatment is the same as in chronic stable angina.
Cidofovir description

# Description
VISTIDE is the brand name for cidofovir injection. The chemical name of cidofovir is 1-cytosine dihydrate (HPMPC), with the molecular formula of C8H14N3O6P2H2O and a molecular weight of 315.22 (279.19 for anhydrous). The chemical structure is:
Cidofovir is a white crystalline powder with an aqueous solubility of  170 mg/mL at pH 68 and a log P (octanol/aqueous buffer, pH 7.1) value of -3.3.
VISTIDE is a sterile, hypertonic aqueous solution for intravenous infusion only. The solution is clear and colorless. It is supplied in clear glass vials, each containing 375 mg of anhydrous cidofovir in 5 mL aqueous solution at a concentration of 75 mg/mL. The formulation is pH-adjusted to 7.4 with sodium hydroxide and/or hydrochloric acid and contains no preservatives. The appropriate volume of VISTIDE must be removed from the single-use vial and diluted prior to administration (see DOSAGE AND ADMINISTRATION).
Classical swine fever
Classical swine fever (CSF) or hog cholera (also sometimes called pig plague based on the German word Schweinepest) is a highly contagious disease of pigs and wild boar.

# Symptoms
Swine fever causes fever, skin lesions, convulsions and usually (particularly in young animals) death within 15 days.
The symptoms are indistinguishable from those of African swine fever.

# Epidemology
The disease is endemic in much of Asia, Central and South America, and parts of Europe and Africa. It was believed to have been eradicated in the United Kingdom by 1966 (according to the Department for Environment, Food & Rural Affairs), but an outbreak occurred in East Anglia in 2000.  It was eradicated in the USA by 1978, according to the United States Department of Agriculture.
Other regions believed to be free of CSF include Australia, Canada, Ireland, New Zealand and Scandinavia.

# Virus
The infectious agent responsible is a virus CSFV (previously called hog cholera virus) of the genus Pestivirus in the family Flaviviridae (or Togaviridae ). CSFV is closely related to the ruminant pestiviruses which cause Bovine Viral Diarrhoea (BVDV) and Border Disease (BDV).
The effect of different CSFV strains varies widely, leading to a wide range of symptoms. Highly virulent strains correlate with acute, obvious disease and high mortality, including neurological symptoms and hemorrhages within the skin.
Less virulent strains can give rise to subacute or chronic infections that may escape detection, while still inducing mortality in fetuses and new-borns.
Infected piglets birthed from infected but subclinical sows help maintain the disease within a population. Other symptoms can include lethargy, fever, immunosuppression and secondary respiratory infections. The incubation period of CSFV ranges from 2 to 14 days but symptoms may not be apparent until after 2 to 4 weeks. Animals with an acute infection can survive 2  to 3 months before their eventual death.
Eradicating CSF is problematic. Current programmes revolve around rapid detection and diagnosis, and preventive culling, possibly followed by emergency vaccination. Possible sources for maintaining and introducing infection include the wide transport of pigs and pork products, as well as endemic CSF within wild boar and feral pig populations.

# Diagnosis
epidemiology+symptoms+pathology+laboratory examination
- Direct immunofluorescence - detection of virus in histological edges
- Indirect immunofluorescence - detection of specific antibodies from sera
- ELISA

# The Philippine hog cholera outbreak of 2007
On August 20, 2007, Department of Agriculture officers investigated the outbreak of swine flu in Nueva Ecija and Central Luzon, Philippines. The mortality rate is less than 10 % for swine flu, if there are no complications like hog cholera. Earlier, or on July 27, 2007, the Philippine National Meat Inspection Service (NMIS) raised a hog cholera "red alert" warning over Metro Manila and 5 regions of Luzon after the disease spread to backyard pig farms in Bulacan and Pampanga, even if these tested negative for the swine flu  virus.
Climacteric (biology)

# Overview
In current practice, climacteric is most often a synonym for female menopause. However, in Princeton University's online dictionary, Climacteric is defined as: 
1. (n) climacteric (a period in a man's life corresponding to menopause)
2. (n) menopause, climacteric, change of life (the time in a woman's life in which the menstrual cycle ends)
The term is used for both genders by The International Menopause Society, which defines itself as "The society for the study of all aspects of the climacteric in men and women."

# In botany
The climacteric is a stage of fruit ripening associated with ethylene production and cell respiration rise. Apples, melons, apricots, tomatoes (among others) are climacteric fruit. Citrus, grapes, strawberries are non-climacteric (they ripen without ethylene and respiration bursts). However, there are non-climacteric melons and apricots, and grapes and strawberries harbour several ethylene receptors which are active. Climacteric is the final physiological process that marks the end of fruit maturation and the beginning of fruit senescence.  Its defining point is the sudden rise in respiration of the fruit and normally takes place without any external influences. After the climacteric period respiration rates (noted by carbon dioxide production) return to or below the point before the event.  The climacteric event also leads to other changes in the fruit including pigment changes and sugar release. For those fruits raised as food the climacteric event marks the peak of edible ripeness, with fruits having the best taste and texture for consumption.  After the event fruits are more susceptible to fungal invasion and begin to degrade with cell death.
Clinical pharmacology

# Overview
Clinical pharmacology is the science of drugs and their clinical use. It is underpinned by the basic science of pharmacology, with added focus on the application of pharmacological principles and methods in the real world. It has a broad scope, from the discovery of new target molecules, to the effects of drug usage in whole populations.
Clinical pharmacologists usually have a rigorous medical and scientific training which enables them to evaluate evidence and produce new data through well designed studies. At least, that is the theory.

# Branches
- Pharmacodynamics - finding out what drugs do to the body and how. This includes not just the cellular and molecular aspects, but also more relevant clinical measurements. For example, not just the biology of salbutamol, a beta2-adrenergic receptor agonist, but the peak flow rate of both healthy volunteers and real patients.
- Pharmacokinetics - what happens to the drug while in the body. This involves the body systems for handling the drug, usually divided into the following classifcation:
- Absorption
Distribution
Metabolism
Elimination
- Absorption
- Distribution
- Metabolism
- Elimination
- Rational Prescribing - using the right medication, at the right dose, using the right route and frequency of administration for the patient, and stopping the drug appropropriately.
- Adverse Drug Effects
- Toxicology
- Drug interactions
- Drug development - usually culminating in some form of clinical trial.
de:Klinische Pharmakologie
id:Farmakologi klinis