Persius/hicric huggingface dataset:
Sandbox:natural history

# Overview
- If left untreated, % of patients with  may progress to develop , , and .
- Common complications of  include , , and .
- Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with  is approximately %.

# Natural History, Complications, and Prognosis

## Natural History
- The symptoms of (disease name) usually develop in the first/ second/ third decade of life, and start with symptoms such as ___.
- The symptoms of (disease name) typically develop ___ years after exposure to ___.
- If left untreated, % of patients with  may progress to develop , , and .

## Complications
- Common complications of  include:

## Prognosis
- Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with  is approximately %.
- Depending on the extent of the  at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as poor/good/excellent.
- The presence of  is associated with a particularly  prognosis among patients with .
-  is associated with the most favorable prognosis.
- The prognosis varies with the  of tumor;  have the most favorable prognosis.
Sandbox:pathophysiology

# Overview

# Pathophysiology

## Pathogenesis
- The exact pathogenesis of  is not fully understood.
OR
- It is thought that  is the result of / is mediated by / is produced by / is caused by either , , or .
-  is usually transmitted via the  route to the human host.
- Following transmission/ingestion, the  uses the  to invade the  cell.
-  arises from s, which are  cells that are normally involved in .
- The progression to  usually involves the .
- The pathophysiology of  depends on the histological subtype.

# Genetics
-  is transmitted in  pattern.
- Genes involved in the pathogenesis of  include , , and .
- The development of  is the result of multiple genetic mutations.

# Associated Conditions

# Gross Pathology
- On gross pathology, , , and  are characteristic findings of .

# Microscopic Pathology
- On microscopic histopathological analysis, , , and  are characteristic findings of .
Sandbox thyroid adenoma

# Overview
A thyroid adenoma, or solitary thyroid nodule is a benign tumor of the thyroid gland.

# Classification
Almost all thyroid adenomas are follicular adenomas. Follicular adenomas can be described as "cold", "warm" or "hot" depending on their level of function. Histopathologically, follicular adenomas can be classified according to their cellular architecture and relative amounts of cellularity and colloid into the following types:
- Fetal (microfollicular) - these have the potential for microinvasion. These consist of small, closely packed follicles lined with epithelium.
- Colloid (macrofollicular) - these do not have any potential for microinvasion
- Embryonal (atypical) - have the potential for microinvasion.
- Hurthle cell adenoma (oxyphil or oncocytic tumor) - have the potential for microinvasion.
- Hyalinizing trabecular adenoma
Papillary adenomas are very rare.

# Pathophysiology
A thyroid adenoma may be clinically silent, or it may be a "functional" tumor, producing excessive thyroid hormone. In this case, it may result in symptomatic hyperthyroidism, and may be referred to as a toxic thyroid adenoma. Careful pathological examination may be necessary to distinguish a thyroid adenoma from a minimally invasive follicular thyroid carcinoma.

## Morphology
Thyroid follicular adenoma ranges in diameter from  3 cm on an average, but sometimes is larger (up to 10 cm) or smaller. The typical thyroid adenoma is solitary, spherical and encapsulated lesion that is well demarcated from the surrounding parenchyma. The color ranges from gray-white to red-brown, depending upon
- the cellularity of the adenoma
- the colloid content.
Areas of hemorrhage, fibrosis, calcification, and cystic change, similar to what is found in multinodular goiters, are common in thyroid (follicular) adenoma, particularly in larger lesions.

# Causes
- Drug side effect: Pergolide, Potassium iodide

# Differentiating Thyroid adenoma from other Diseases
A thyroid adenoma is distinguished from a multinodular goiter of the thyroid in that an adenoma is typically solitary, and is a neoplasm resulting from a genetic mutation (or other genetic abnormality) in a single precursor cell. In contrast, a multinodular goiter is usually thought to result from a hyperplastic response of the entire thyroid gland to a stimulus, such as iodine deficiency.
Careful pathological examination may be necessary to distinguish a thyroid adenoma from a minimally invasive follicular thyroid carcinoma.

# Management
Most patients with thyroid adenoma can be managed by watchful waiting (without surgical excision) with regular monitoring. However, some patients still choose surgery after being fully informed of the risks. Regular monitoring mainly consists of watching for changes in nodule size and symptoms, and repeat ultrasonography or needle aspiration biopsy if the nodule grows.
Sanguisorba officinalis
Sanguisorba officinalis (Great Burnet) is a plant in the family Rosaceae, subfamily Rosoideae. It is native throughout the cooler regions of the Northern Hemisphere in Europe, northern Asia, and northern North America.
It is a herbaceous perennial plant growing to 1 m tall, which occurs in grasslands, growing well on grassy banks.

# Commercial Uses
Use is made of its extensive root system for erosion control, as well as a bioremediator, used to reclaim derelict sites such as landfills.
The leaves are used in salads because they are mildly reminiscent of cucumber. Selective pruning of apical meristems, such as at flower heads, is used to encourage an increase in leaf production.

# Ethnomedical Uses
It has been in use by Traditional Chinese Medicine (TCM) for thousands of years, probably through the employment of the doctrine of signatures as a treatment for bleeding.
Specifically, the root is used to stop bloody dysentery, nosebleeds, and is applied topically to treat burns and insect bites.
Saquinavir how supplied

# How Supplied/Storage And Handling
INVIRASE 200-mg capsules are light brown and green opaque capsules with ROCHE and 0245 imprinted on the capsule shellbottles of 270 (NDC 0004-0245-15).
INVIRASE 500-mg film-coated tablets are light orange to greyish- or brownish-orange, oval cylindrical, biconvex tablets with ROCHE and SQV 500 imprinted on the tablet facebottles of 120 (NDC 0004-0244-51).
The capsules and tablets should be stored at 25C (77F); excursions permitted to 15 to 30C (59 to 86F)  in tightly closed bottles.
Serum response elements
"The serum response element (SRE), a region of the c-fos gene which controls growth factor-induced transcription, is  shown to mediate c-fos transcription in response to activation of L-type voltage-sensitive calcium channels. Calcium-dependent transcriptional activation through the SRE is mediated by the serum response factor (SRF). Membrane depolarization induces phosphorylation of SRF at Ser-103, an event shown to enhance the ability of SRF to bind the SRE."
The SRE wild type (SREwt) contains the nucleotide sequence ACAGGATGTCCATATTAGGACATCTGC, of which CCATATTAGG is the CArG box, TTAGGACAT is the C/EBP box, and CATCTG is the E box.

# Human genes
Gene ID: 2353 is FOS Fos proto-oncogene, AP-1 transcription factor subunit. "The Fos gene family consists of 4 members: FOS, FOSB, FOSL1, and FOSL2. These genes encode leucine zipper proteins that can dimerize with proteins of the JUN family, thereby forming the transcription factor complex AP-1. As such, the FOS proteins have been implicated as regulators of cell proliferation, differentiation, and transformation. In some cases, expression of the FOS gene has also been associated with apoptotic cell death." "Serum response factor and the (CC(A/T)6GG) (CArG) box interact to promote the transcription of c-fos and muscle genes".
- NP_005243.1 proto-oncogene c-Fos, cd14721 Location:147  200, bZIP_Fos; Basic leucine zipper (bZIP) domain of the oncogene Fos (Fos): a DNA-binding and dimerization domain.

# Acknowledgements
The content on this page was first contributed by: Henry A. Hoff.
Initial content for this page in some instances came from Wikiversity.
Werdnig-Hoffman disease

# Overview
Werdnig-Hoffman disease (also known as "Severe infantile spinal muscular atrophy", or "spinal muscular atrophy type I") is an autosomal recessive neuromuscular disease. It is the most severe form of spinal muscular atrophy, which is one of a number of neuromuscular diseases classified as a type of muscular dystrophy.
Werdnig-Hoffman affects the lower motor neurons only.

# Causes
It has been linked to an abnormal survival motor neuron (SMN) gene.

# Eponym
It is named for Johann Hoffmann and Guido Werdnig.

# Symptoms
It is evident before birth or within the first few months of life. There may be a reduction in fetal movement in the final months of pregnancy. Symptoms include floppiness of the limbs and trunk, feeble movements of the arms and legs, swallowing and feeding difficulties, and impaired breathing. Affected children never sit or stand unassisted and will require respiratory support to survive before the age of 2. Other symptoms include:
- Fasciculations of the tongue
- Marked Hypotonia in Proximal, Distal muscles, Intercostals & bulbar muscles (Patient lies in a Frog-Leg position,i.e. hips adducted & knee flexed)
- Flaccid Quadriplegia
- Difficulty breathing
- Poor feeding - need gastrostomy
- Weak cry
- Areflexia in the extremities
- Normal Intelligence

# Diagnosis
- Electro-Myelo Gram (EMG) will show Fibrillation & Muscle Denervation
- Serum Createnine-Kinase may be normal or Increased
- Most accurate test is Molecular marker for SMN gene( Survivor motor neuron gene)

# Treatment
Treatment is symptomatic and supportive and includes treating pneumonia, curvature of the spine and respiratory infections, if present. Also, physical therapy, orthotic supports, and rehabilitation are useful. For individuals who survive early childhood, assistive technology can be vital to providing access to work and entertainment. Genetic counseling is imperative.

# Prognosis
The patient's condition tends to deteriorate over time, depending on the severity of the symptoms. Children with Werdnig-Hoffman disease / SMA Type 1 face a difficult battle. They are constantly at risk of respiratory infection and pneumonia. Feeding difficulties make it a real challenge for parents to give their children adequate nutrition and supplemental feedings may be required. Tubes placed through the nose or directly onto the stomach may be necessary. Recurrent respiratory problems mean that mechanical support for breathing - usually initially in the form of BiPAP and later often tracheostomy and ventilation - are necessary for the baby to have any chance of long-term survival. Affected children never sit or stand and usually die before the age of 2 if the decision is made not to provide breathing support. However, some individuals have survived to become adults, in which case sexual function is unimpaired.
Sexual arousal disorder
Sexual arousal disorder is a disorder found in the DSM-IV that is generally defined as the inability to attain or maintain typical responses to sexual arousal.

# Signs and symptoms
The term is often used to diagnose women (as the term erectile dysfunction (ED) is often used for men), particularly those with sexual symptoms such as:
- Lack of vaginal lubrication
- Lack of vaginal dilation or lengthening
- Decreased genital tumescence
- Decreased genital or nipple sensation
Contrary to popular belief, the disorder is not always caused from a lack of sexual arousal. Possible causes of sexual arousal disorder include psychological and emotional factors, such as depression, anger, and stress; relationship factors, such as conflict or lack of trust; and medical factors, such as depleted hormones, reduced regional blood flow, and nerve damage.

# Diagnosis
It is, therefore, important for a licensed psychologist to first remove doubt of psychological or emotional problems, a trained sex therapist to then remove doubt of relationship concerns, and a medical doctor to further investigate medical causes.

# Treatment
Depending on the cause of the disorder, hormone therapy or a blood-flow enhancing medication, like Viagra, may be appropriate.
A new medication, bremelanotide (formerly PT-141), is directly increasing sexual desire in both males and females, and is currently in clinical tests. A scientific study on bremelanotide is available at PNAS 101: 10201 (2004).
Short-chain fatty acids
Short chain fatty acids are a sub-group of fatty acids with aliphatic tails of less than eight carbons. They include:
- Acetic acid
- Propionic acid
- Isobutyric acid
- Butyric acid
- Isovaleric acid
- Valeric acid
- Caproic acid
- Lactic acid
- Succinic acid
Short chain fatty acids, just as medium chain fatty acids, are taken up directly to the portal vein during lipid digestion, in contrast to long chain fatty acids, which are packed into chylomicrons and enter lymphatic capillaries and enter the blood first at the subclavian vein.
Short chain fatty acids are produced when dietary fiber is fermented in the colon.
Single-subject research
Single-subject research is a group of research methods that are used extensively in the experimental analysis of behavior and applied behavior analysis with both human and non-human participants. Four principal methods in this type of research are: changing criterion, reversal ("ABA"), alternating treatments, and multiple baseline. In verbal behavior research the multipleprobe research design is popular.
These methods form the heart of the data collection and analytic code of behavior analysis. Behavior analysis is data driven, inductive, and disinclined to hypothetico-deductive methods. Statistical methods, from The Behavior of Organisms (Skinner 1938) until now, have been largely ignored.

# AB research designs
The AB design is the simplest version of this design in which a baseline ("A") is tracked, and then some treatment ("B") is implemented. If there is a change then the treatment is said to have had an effect. However, it is subject to many possible competing hypotheses, making it a very weak research design. The other variants essentially introduce ways to control for the competing hypotheses.

# Changing-criterion research designs
In a changing-criterion research design a criterion for reinforcement is changed across the experiment to demonstrate the functional relationship between the reinforcement and the behavior. See Mark Dixon's work with a participant using a short video clip to generate a preference for a progressively delayed variable reinforcement over a fixed shorter delay reinforcement in physical therapy

# Reversal or ABA designs
The reversal design is the most powerful of the single-subject research designs showing a strong reversal from baseline ("A") to treatment ("B") and back again. However, many interventions cannot be reversed, some for ethical reasons (e.g., involving self-injurious behavior, smoking) and some for practical reasons (they cannot be unlearned, like a skill)

# Alternating-treatment designs
The alternating-treatment design is used in order to ascertain the comparative effect of two treatments. Two treatments are alternated in rapid succession and correlated changes are plotted on a graph to facilitate comparison.

# Multiple-baseline designs
The multiple baseline design was first reported in 1960 as used in basic operant research. It was applied in the late 1960s to human experiments in response to practical and ethical issues that arose in withdrawing apparently successful treatments from human subjects. In it two or more (often three) behaviors, people or settings are plotted in a staggered graph where a change is made to one, but not the other two, and then to the second, but not the third behavior, person or setting. Differential changes that occur to each behavior, person or in each setting help to strengthen what is essentially an AB design with its problematic competing hypotheses.

# Multipleprobe designs
Popular in Verbal Behavior research, the multiproble research design has elements of the other research designs.
Sinusoid (blood vessel)
A sinusoid is a small blood vessel similar to a capillary but with a discontinuous endothelium.
Sinusoids are found in the liver, lymphoid tissue, endocrine organs, and  hematopoietic organs such as the bone marrow and the spleen. Sinusoids found within terminal villi of the placenta are not comparable to these; they possess a continuous endothelium and complete basal lamina.
Their highly permeable nature is due to larger inter-cellular clefts, fewer tight junctions, and discontinous endothelial cells, allows small and medium-sized proteins such as albumin to enter and leave the blood stream. Some spaces are large enough for blood cells to pass.
The sinusoids of the liver are of particular importance to the function of that organ, and are discussed in more detail at liver sinusoid.
de:Sinusoid (Blutgefa)
Small nucleolar RNA R16
Small nucleolar RNA R16 is a non-coding RNA (ncRNA) molecule identified in plants which functions in the modification of other small nuclear RNAs (snRNAs). This type of modifiying RNA is usually located in the nucleolus of the eukaryotic cell which is a major site of snRNA biogenesis. It is known as a small nucleolar RNA (snoRNA) and also often referred to as a guide RNA.
snoRNA R16 belongs to the C/D box class of snoRNAs which contain the conserved sequence motifs known as the C box (UGAUGA) and the D box (CUGA). Most of the members of the box C/D family function in directing site-specific 2'-O-methylation of substrate RNAs.
snoR16 was identified in Arabidopsis thaliana . snoRNA R16 is related to another Arabidopsis snoRNA called R40.
Small nucleolar RNA R24
Small nucleolar RNA R24 (also known as snoRNA R24)  is a non-coding RNA (ncRNA) molecule identified in plants which functions in the modification of other small nuclear RNAs (snRNAs). This type of modifiying RNA is usually located in the nucleolus of the eukaryotic cell which is a major site of snRNA biogenesis. It is known as a small nucleolar RNA (snoRNA) and also often referred to as a guide RNA.
R24 belongs to the C/D box class of snoRNAs which contain the conserved sequence motifs known as the C box (UGAUGA) and the D box (CUGA). Most of the members of the box C/D family function in directing site-specific 2'-O-methylation of substrate RNAs.
snoR24 was originally identified in Arabidopsis thaliana and is proposed to acts as a methylation guide for 18S ribosomal RNA (rRNA) in plants .
Social hygiene movement
The social or mental hygiene movement of the late 19th and early 20th centuries was an attempt by Progressive-era reformers to control venereal disease, regulate prostitution and vice, and disseminate sexual education through the use of scientific research methods and modern media techniques.
The social hygiene movement represented a rationalized, professionalized version of the earlier social purity movement. Many reformers, such as Dr Marie Stopes, were also exponents of eugenics. Inspired by Charles Darwin's theory of natural selection, they argued for the sterilisation of certain groups, even racial groups, in society. This link between racial hygiene and social hygiene can be seen in Australia, where the Racial Hygiene Association of New South Wales is now named The Family Planning Association.
Social hygiene as a profession grew alongside social work and other public health movements of the era.  Social hygienists emphasized sexual continence and strict self-discipline as a solution to societal ills, tracing prostitution, drug use and illegitimacy to rapid urbanization.
The American Social Hygiene Association was formed in 1913 and later renamed to the American Social Health Association.
The movement remained alive throughout the 20th century and found its way into American schools, where it was transmitted in the form of classroom films about menstruation, sexually transmitted disease, drug abuse and acceptable sexual behavior in addition to an array of pamphlets, posters, textbooks and films.
Sorbitol-MacConkey agar
MacConkey Sorbitol Agar is a variant of traditional MacConkey agar used in the detection of E. coli O157:H7.  Traditionally, MacConkey agar has been used to distinguish those bacteria that ferment lactose from those that do not.  This is important because gut bacteria, such as Escherichia coli can typically ferment lactose, while important gut pathogens such as Salmonella enterica and most shigellas are unable to ferment lactose.  Shigella sonnei can ferment lactose, but only after prolonged incubation and so it is referred to as a late-lactose fermenter.
During fermentation of the sugar, acid is formed and the pH of the medium drops, changing the color of the pH indicator.  Different formulations use different indicators: neutral red is often used.  For example, lactose fermenters turn a deep red when this pH indicator is used.  Those bacteria that are unable to ferment lactose, often referred to as non-lactose fermenters, or NLFs for short, use the peptone in the medium.  This releases ammonia, which raises the pH of the medium.  Although some authors refer to NLFs as being colourless, in reality they turn neutral red a buff-ish color.
E. coli O157:H7 differs from most other strains of E. coli in being unable to ferment sorbitol.  In sorbitol MacConkey agar, lactose is replaced by sorbitol.  Most strains of E. coli ferment sorbitol to produce acid:  E. coli O157:H7 can not ferment sorbitol, so this strain uses peptone to grow. This raises the pH of the medium allowing the O157:H7 strain to be differentiated from other E.coli strains through the action of the pH indicator in the medium.
Splenic artery aneurysm

# Overview
The splenic artery is the third most common site of intraabdominal aneurysms after abdominal aortic aneurysms and the  iliac artery aneurysms. Splenic artery aneurysm is four times more common in women but approximately three times more likely to rupture in men. It is associated with hypertension, portal hypertension, cirrhosis, liver transplantation, and pregnancy. In contrast to aneurysms of larger vessels such as the aorta, atherosclerosis is not considered to be the underlying cause. It is usually smaller than 3 cm. It is most commonly located in the distal portion of the artery and peripheral calcification is common

# Natural History, Complications and Prognosis
- Rupture occurs in approximately 2-3%.
- Frequency of rupture is increased with liver transplantation, portal hypertension, and pregnancy.

# Diagnosis
- Splenic artery aneurysms can appear well defined and homogeneous on contrast-enhanced CT.
- Mural thrombus may be present
- Peripheral calcification is apparent in many cases

# Treatment
- Treatment of symptomatic splenic artery aneurysms should be performed.
- In addition, several high-risk groups of asymptomatic patients should also be considered for repair
Pregnant women or women of childbearing age
Liver transplant or patients with cirrhosis and portal hypertension.
- Pregnant women or women of childbearing age
- Liver transplant or patients with cirrhosis and portal hypertension.
Splenius capitis muscle

# Overview
The splenius capitis arises from the lower half of the ligamentum nuch, from the spinousial process of the seventh cervical vertebra, and from the spinous processes of the upper three or four thoracic vertebr.
The name derives from the Greek word "splenion," which means plaster or patch.
The fibers of the muscle are directed upward and lateralward and are inserted, under cover of the Sternocleidomastoideus, into the mastoid process of the temporal bone, and into the rough surface on the occipital bone just below the lateral third of the superior nuchal line.

# Additional images
- Occipital bone. Outer surface.
- Left temporal bone. Outer surface.
- Muscles of the neck. Lateral view.