Persius/hicric huggingface dataset:
Isotopes of americium
Americium (Am) has no stable isotopes. A standard atomic mass cannot be given.
19 radioisotopes of americium have been characterized, with the most stable being 243Am with a half-life of 7370 years, and 241Am with a half-life of 432.7 years. All of the remaining radioactive isotopes have half-lives that are less than 51 hours, and the majority of these have half-lives that are less than 100 minutes. This element also has 8 meta states, with the most stable being 242mAm (t12 141 years). The isotopes of americium range in atomic weight from 231.046 u (231Am) to 249.078 u (249Am).

# Table

## Notes
- Values marked # are not purely derived from experimental data, but at least partly from systematic trends. Spins with weak assignment arguments are enclosed in parentheses - ( ).
- Uncertainties are given in concise form in parentheses after the corresponding last digits. Uncertainty values denote one standard deviation, except isotopic composition and standard atomic mass from IUPAC which use expanded uncertainties.
Amikacin how supplied

# How Supplied
Amikacin Sulfate Injection, USP is supplied as a colorless solution which requires no refrigeration. At times the solution may become a very pale yellow; this does not indicate a decrease in potency.
Amikacin Sulfate Injection, USP is supplied as follows:
2 mL and 4 mL vials are packaged in shelf packs of 10.
Store at 20 to 25C (68 to 77F) .
KEEP THIS AND ALL MEDICATIONS OUT OF THE REACH OF CHILDREN
Amikacin microbiology

# Microbiology

### Gram-negative
- Pseudomonas species
- Escherichia coli
- Proteus species (indole-positive and indole-negative)
- Providencia species
- Klebsiella species
- Enterobacter species
- Serratia species
- Acinetobacter species
- Citrobacter freundii
When strains of the above organisms are found to be resistant to other aminoglycosides, including gentamicin, tobramycin and kanamycin, many are susceptible to amikacin in vitro.

### Gram-positive
- Penicillinase and non-penicillinase-producing Staphylococcus species, including methicillin-resistant strains.
However, aminoglycosides in general have a low order of activity against other Gram-positive organisms, viz., Streptococcus pyogenes, enterococci and Streptococcus pneumoniae (formerly Diplococcus pneumoniae).
Amikacin resists degradation by most aminoglycoside inactivating enzymes known to affect gentamicin, tobramycin, and kanamycin.
In vitro studies have shown that amikacin sulfate combined with a beta-lactam antibiotic acts synergistically against many clinically significant Gram-negative organisms.

### Disc Susceptibility Test
Quantitative methods that require measurement of zone diameters give the most precise estimates of antibiotic susceptibility. One such procedure has been recommended for use with discs to test susceptibility to amikacin. Interpretation involves correlation of the diameters obtained in the disc test with MIC values for amikacin. When the causative organism is tested by the Kirby-Bauer method of disc susceptibility, a 30 mcg amikacin disc should give a zone of 17 mm or greater to indicate susceptibility. Zone sizes of 14 mm or less indicate resistance. Zone sizes of 15 to 16 mm indicate intermediate susceptibility. With this procedure, a report from the laboratory of "susceptible" indicates that the infecting organism is likely to respond to therapy. A report of "resistant" indicates that the infecting organism is not likely to respond to therapy. A report of "intermediate susceptibility" suggests that the organism would be susceptible if the infection is confined to tissues and fluids (e.g., urine) in which high antibiotic levels are attained.
Anaesthetic equipment
This article discusses various equipment used in anaesthesia, particularly general anaesthesia but also local anaesthesia.

# Anaesthetic machine
General anaesthesia requires the anaesthetic machine, tested daily, as basic equipment. It is imperative that essential medical pipeline gas supply, e.g. oxygen, nitrous oxide and air, are secured firmly to the machine, and readily available without any obstructions, defects or pressure leaks. They should also be checked in between cases, ensuring that the breathing apparatus and breathing circuit are fully patent, for the safe anaesthesia of patients.

# Airway equipment
- Variable performance devices
- Fixed performance devices
- Face mask
- Laryngoscope
- Endotracheal tube
- Laryngeal mask airway (LMA)
- Tracheostomy tube
- Endoscopes
- Eshmann Stylet

# IV giving sets, cannulae & needles
- Filters
- Needles
- Cannulae
- Tuohy needle
- Spinal needle

# Further reading
- Dorsch, Susan E.; Dorsch, Jerry A. (1999). Understanding anesthesia equipment. Baltimore: Williams & Wilkins. ISBN 0-683-30487-9.CS1 maint: Multiple names: authors list (link) .mw-parser-output cite.citation{font-style:inherit}.mw-parser-output q{quotes:"\"""\"""'""'"}.mw-parser-output code.cs1-code{color:inherit;background:inherit;border:inherit;padding:inherit}.mw-parser-output .cs1-lock-free a{background:url("")no-repeat;background-position:right .1em center}.mw-parser-output .cs1-lock-limited a,.mw-parser-output .cs1-lock-registration a{background:url("")no-repeat;background-position:right .1em center}.mw-parser-output .cs1-lock-subscription a{background:url("")no-repeat;background-position:right .1em center}.mw-parser-output .cs1-subscription,.mw-parser-output .cs1-registration{color:#555}.mw-parser-output .cs1-subscription span,.mw-parser-output .cs1-registration span{border-bottom:1px dotted;cursor:help}.mw-parser-output .cs1-hidden-error{display:none;font-size:100%}.mw-parser-output .cs1-visible-error{display:none;font-size:100%}.mw-parser-output .cs1-subscription,.mw-parser-output .cs1-registration,.mw-parser-output .cs1-format{font-size:95%}.mw-parser-output .cs1-kern-left,.mw-parser-output .cs1-kern-wl-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right,.mw-parser-output .cs1-kern-wl-right{padding-right:0.2em}
- Eisenkraft, James B.; Ehrenwerth, Jan (1993). Anesthesia equipment: principles and applications. St. Louis: Mosby. ISBN 0-8016-1556-9.CS1 maint: Multiple names: authors list (link)
Anderson-Darling test

# Overview
The Anderson-Darling test, named after Theodore Wilbur Anderson, Jr. (1918?) and Donald A. Darling (1915?), who invented it in 1952, is one of the most powerful statistics for detecting most departures from normality. It may be used with small sample sizes n  25.  Very large sample sizes may reject the assumption of normality with only slight imperfections, but industrial data with sample sizes of 200 and more have passed the Anderson-Darling test.
The Anderson-Darling test assesses whether a sample comes from a specified distribution.  The formula for the test statistic A to assess if data \{Y_1 (note that the data must be put in order) comes from a distribution with cumulative distribution function (CDF) F is
where
The test statistic can then be compared against the critical values of the theoretical distribution (dependent on which F is used) to determine the P-value.
The Anderson-Darling test for normality is a distance or empirical distribution function (EDF) test. It is based upon the concept that when given a hypothesized underlying distribution, the data can be transformed to a uniform distribution. The transformed sample data can be then tested for uniformity with a distance test (Shapiro 1980).
In comparisons of power, Stephens (1974) found A^2 to be one of the best EDF statistics for detecting most departures from normality. The only statistic close was the W^2 (Cramer von-Mises test) statistic.

# Procedure
(If testing for normal distribution of the variable X)
1)  The data of the variable X that should be tested is sorted from low to high.
2)  The mean, \bar{X}, and standard deviation, s, are calculated from the sample of X.
3)  The values of X are standardized as follows:
4)  With the standard normal CDF \Phi, A^2 is calculated using:
5)  A^{2*}, an approximate adjustment for sample size, is calculated using:
6)  If A^{2*} exceeds 0.752 then the hypothesis of normality is rejected for a 5% level test.
Note:
1. If s = 0 or any P_i=(0 or 1) then A^2 cannot be calculated and is undefined.
2. Above, it was assumed that the variable X_i was being tested for normal distribution. Any other theoretical distribution can be assumed by using its CDF. Each theoretical distribution has its own critical values, and some examples are: lognormal, exponential, Weibull, extreme value type I and logistic distribution.
3. Null hypothesis follows the true distribution (in this case, N(0, 1)).
Anembryonic gestation

# Overview
An anembryonic gestation (aka blighted ovum) is a pregnancy in which a visible embryo never develops within a normal-appearing gestational sac, which likely occurs as a result of early embryonic death with continued development of the trophoblast.
When small, the sac cannot be distinguished from the early normal pregnancy, as there may be a yolk sac, though a fetal pole is not seen.
This is one of the causes of miscarriage of a pregnancy.
For diagnosis, the sac must be of sufficient size that the absence of normal embryonic elements is established.
A pregnancy is anembryonic if a transvaginal ultrasound reveals a sac with a mean gestational sac diameter (MGD) greater than 13 mm and no yolk sac, or a MGD >18 mm with no embryo.
Many centers offer mothers a follow-up ultrasound 10 days later to verify diagnosis.
Several management options exist for anembryonic pregnancies which have not miscarried on their own.
Anemone ranunculoides
Anemone ranunculoides, the yellow anemone, yellow wood anemone or buttercup anemone, is a species of herbaceous perennial plant that grows in forests across most of Continental Europe, and less frequently in the Mediterranean region. It is not native to the British Isles, though it may occasionally be found as a garden escape.
It flowers between March and May.
Growing to 5-15 cm tall, the plant is herbaceous, dying back down to its root-like rhizomes by mid summer. The rhizomes spread just below the earth surface and grow quickly, contributing to its rapid spread in woodland conditions. The flower is about 1.5 cm diameter, with from five to eight petal-like segments (actually tepals) of rich yellow colouring.

# Cultivation
The plant is widely grown as a garden plant, especially by rock garden and alpine garden enthusiasts. It has been awarded an Award of Garden Merit or AGM, H4 (hardy throughout the British Isles) by the Royal Horticultural Society.
Anemone ranunculoides 'Frank Waley', a larger-growing, more robust cultivar, is sometimes available, as are the miniature subspecies A. ranunculoides subsp. wockeana and a selection known as A. ranunculoides 'Laciniata', with finely divided leaves. There is also a double-flowered cultivar, A. ranunculoides 'Pleniflora' (also sometimes listed as 'Semiplena' or 'Flore Pleno').

# Related species and hybrids
Wood anemone, Anemone nemorosa, is similar to A. ranunculoides with slightly larger flowers (usually white, but they may be pinkish or lilac, often with a darker tint to the back of the 'petals'). Anemone  lipsiensis is a hybrid between these two species and has pale yellow flowers; it is often found where the two parent species grow near each other.  A.  lipsiensis 'Pallida' is the best-known result of this cross. A most attractive plant, it has been awarded the AGM, H4, like both of its parents.
Angiopoietin receptor
The angiopoietin receptors are receptors that bind angiopoietin.
TIE-1 and TIE-2 comprise the cell-surface receptors that bind and are activated by the angiopoietins, (Ang1, Ang2, Ang3, Ang4).  The angiopoietins are protein growth factors required for the formation of blood vessels (angiogenesis).

# Angiopoietins
The angiopoietins  are protein growth factors that regulate angiogenesis, the formation of blood vessels.  In humans, three angiopoietins have been identified: Ang1, Ang2, and Ang4 (Ang 3 is the mouse ortholog of human Ang4). Ang1 and Ang4 function as agonistic or activating ligands for Tie2, whereas Ang2 and Ang3 behave as competitive antagonists. They function by binding their physiologic receptors, Tie-1 and Tie-2.  These are receptor tyrosine kinases, so named because they mediate cell signals by inducing the phosphorylation of key tyrosines, thus initiating cell signalling.
It is somewhat controversial which of the Tie receptors mediate functional signals downstream of Ang stimulation. But it is clear that at least Tie-2 is capable of physiologic activation as a result of binding the angiopoietins.
Annual wellness visit
In primary care and preventive medicine, Annual wellness visit is a " yearly 'Wellness' visit to develop or update your personalized plan to help prevent disease and disability, based on your current health and risk factors. The yearly Wellness visit isnt a physical exam."
As of Jan 2011, the Affordable Care Act expanded coverage to include an Annual Wellness Visit (AWV) for Medicare Advantage enrollees. The AWV's focus is on health promotion as well as disease prevention through coordination of evidence-based preventive services that include, but are not limited to, lipid and metabolic panels, pneumonia vaccine, flu vaccine, depression screening, etc. Based on the policy statement in the AARP Public Policy Institute May 2019 edition and supported by Camacho, Yao, and Anderson, a steady rise in AWVs was observed from 2011-2015 which led to an increase in use of preventive services. A more recent review associates some preventive care services with receiving an annual wellness visit.

# Implementing annual wellness visits
In 2014, 14% and 15.6^ of Medicare beneficiaries had an annual wellness visit in two cohorts.
In 2020, a large scale quality improvement project yielded let to 60% of patients receiving an annual wellness visit.
Cusps of heart valves

# Overview
The cusps of the heart valves serve to seal the heart valves when closed. There are normally three cusps for each valve except the mitral valve (hence its alternate name, "bicuspid valve".)
"Nodules" are located at the tip of the valve, to form a tighter seal.

# Semilunar valves
- pulmonary valve
"right cusp"
"left cusp"
"anterior cusp"
- "right cusp"
- "left cusp"
- "anterior cusp"
- aortic valve. (Note that one is absent in the condition bicuspid aortic valve.)
"right cusp"
"left cusp"
"posterior cusp" (or "noncoronary cusp")
- "right cusp"
- "left cusp"
- "posterior cusp" (or "noncoronary cusp")

# Atrioventricular valves
- tricuspid valve
"anterior cusp" (or "infundibular cusp")
"posterior cusp" (or "marginal cusp")
"septal cusp" (or "medial cusp")
- "anterior cusp" (or "infundibular cusp")
- "posterior cusp" (or "marginal cusp")
- "septal cusp" (or "medial cusp")
- mitral valve
"anterior cusp"
"posterior cusp"
- "anterior cusp"
- "posterior cusp"
Anterior jugular vein
The anterior jugular vein begins near the hyoid bone by the confluence of several superficial veins from the submaxillary region.
It descends between the median line and the anterior border of the Sternocleidomastoideus, and, at the lower part of the neck, passes beneath that muscle to open into the termination of the external jugular, or, in some instances, into the subclavian vein.
It varies considerably in size, bearing usually an inverse proportion to the external jugular; most frequently there are two anterior jugulars, a right and left; but sometimes only one.
Its tributaries are some laryngeal veins, and occasionally a small thyroid vein.
Just above the sternum the two anterior jugular veins communicate by a transverse trunk, the venous jugular arch, which receive tributaries from the inferior thyroid veins; each also communicates with the internal jugular.
There are no valves in this vein.

# Additional images
- Section of the neck at about the level of the sixth cervical vertebra.
Anthoxanthum odoratum
Vanilla grass, anthoxanthum odorata, is also known as sweet vernal grass, holy grass, or buffalo grass. It can be grown in the yard, but is popular for growth in pots inside the house, because it smells like vanilla, especially after being cut and dried.
- one small plug should grow to cover 2 square feet per growing season
- Hardy, to zone 3a
- up to 2 feet tall
- Perennial
- Full sun to partial shade
This grass contains coumarin glycoside and benzoic acid, producing its desirable scent, a cross between fresh hay and vanilla. Smells much like Sweet Woodruff.
Growing:
Sow by scattering on the ground in the spring through fall. Germinates in 4 to 5 days.
Prefers sandy loam and a high pH (can be obtained by fertilizing with used coffee grounds, pine needles, or sawdust).
Anti-nuclear antibody
Anti-nuclear antibodies (ANAs, also known as anti-nuclear factor or ANF) are antibodies present in higher than normal numbers in autoimmune disease.  The ANA test measures the pattern and amount of autoantibody which can attack the body's tissues as if they were foreign material.  Autoantibodies are present in low titres in the general population, but in about 5% of the population, their concentration is increased, and about half of this 5% have an autoimmune disease.

# Autoimmunity
Normal titer of ANA is 1:40. Higher titers are indicative of an autoimmune disease. The presence of ANA is indicative of lupus erythematosus (present in 80-90% of cases), though they also appear in some other auto-immune diseases such as Sjogren's syndrome (60%), rheumatoid arthritis, autoimmune hepatitis, scleroderma and polymyositis & dermatomyositis (30%), and various non-rheumatological conditions associated with tissue damage. ANA are also directed to the nuclear pore complex in primary biliary cirrhosis. Other conditions with high ANA titre include Addison disease, Idiopathic thrombocytopenic purpura (ITP), Hashimoto's, Autoimmune hemolytic anemia, Type I diabetes mellitus, Mixed connective tissue disorder.

# Antinuclear antibodies
Antinuclear antibodies (ANAs) are unusual antibodies, detectable in the blood, that have the capability of binding to certain structures within the nucleus of the cells. The nucleus contains DNA, the genetic material. ANAs are found in patients whose immune system may be predisposed to cause inflammation against their own body tissues. Antibodies that are directed against one's own tissues are referred to as auto-antibodies. The propensity for the immune system to work against its own body is  why ANAs indicate the possible presence of autoimmunity and provide, therefore, an indication for doctors to consider the possibility of autoimmune illness.
Following detection of a high titer of ANAs (e.g. 1:160), various subtypes are determined. This is typically done on cells of the HEp-2 cell line. Examples include:
- Anti-ENA (Extractable_nuclear_antigen)
- Anti-gp-210 (nuclear pore gp-210)
- Anti-p62 (Nucleoporin 62)
- Anti-dsDNA (double-stranded DNA)
- Anti-Ro (SS-A)
- Anti-La (SS-B)
- Anti-Sm (Smith antigen)
- Anti-nRNP (nuclear ribonucleoproteins)
- Anti Scl-70 (topoisomerase I)
- Anti-centromere
- Anti-Jo

# History
The LE cell was discovered in bone marrow in 1948 by Hargraves et al. This was the first indication that processes affecting the cell nucleus were responsible for lupus erythematosus (LE). In the 1950s, progressively more sensitive and specific ANA serology tests became available.
Antimony pentasulfide

# Overview
Antimony pentasulfide is an inorganic compound of antimony and sulfur, also known as antimony red. It is a nonstoichiometric compound with a variable composition. Its exact structure is unknown. Commercial samples are usually are contaminated with sulfur, which may be removed by washing with carbon disulfide in a Soxhlet extractor.

# Production
Antimony pentasulfide can be produced by the reaction of antimony with sulfur at a temperature between 250-400 C in an inert atmosphere.

# Uses
It may be used as a red pigment and is one possible precursor to Schlippe's Salt, Na3SbS4, which can be prepared according to the equation:

# Physical chemistry
Like many sulfides, this compound liberates hydrogen sulfide upon treatment with strong acids like hydrochloric acid.
Analysis by Mossbauer spectroscopy indicates that this compound is a derivative antimony(III), explaining the production of antimony(III) chloride, rather than antimony(V) chloride, upon acidification.  It is therefore not analogous to the phosphorus(V) compound phosphorus pentasulfide.
Aortopulmonary window

# Overview
Aortopulmonary window or Aorticopulmonary window (APW) is a rare congenital opening between the aorta and the pulmonary trunk just above the aortic valve.
It is associated with other abnormalities in approximately 1/2 the cases, such as anomalous origin of the coronary arteries from the pulmonary trunk and coarctation of the aorta.
The murmur is lower and more medial in location. In adults is presented without a murmur and clinical features of the Eisenmenger's syndrome.
Apocrine sweat glands
Apocrine sweat glands develop during the  early- to mid-puberty ages within the age range of 13 to 15, and release more than normal amounts of sweat for approximately a month, regulating and releasing normal amounts of sweat after a certain period of time. They are located wherever there is body hair. 
These glands produce sweat that contains fatty materials. Mainly present on the face, in the armpits, and around the genital area, their activity is the main cause of sweat odor, due to the bacteria that break down the organic compounds in the sweat.
Emotional stress causes sweat present in the tubule to be squeezed out. Thus, apocrine sweat glands serve as scent glands.
The name apocrine sweat gland is archaic; these glands are no longer believed to secrete their products by an apocrine mechanism in which the apical portion of the cell is sloughed off with secretory products inside. Rather, the apocrine sweat glands secrete in an merocrine fashion: membrane-bound vesicles bind to the plasma membrane of secretory cells and release products by exocytosis with no net loss of the plasma membrane. These glands are still called apocrine sweat glands to distinguish them from the eccrine sweat glands.
Arakawa's syndrome II
Arakawa's syndrome II is an inborn error of metabolism, a genetic disorder that causes a deficiency of the enzyme tetrahydrofolate-methyltransferase; affected individuals cannot properly metabolize methylcobalamin, a type of Vitamin B12.
It is also called Methionine synthase deficiency, Tetrahydrofolate-methyltransferase deficiency syndrome, and N5-methylhomocysteine transferase deficiency.

# Presentation
This disorder causes neurological problems, including mental retardation, brain atrophy and ventricular dilation, myoclonus, hypotonia, and epilepsy.
It is also associated with growth retardation, megaloblastic anemia, pectus excavatum, scoliosis, vomiting, diarrhea, and hepatosplenomegaly.  Inheritance is autosomal dominant.

# Eponym
It is often called "Arakawa syndrome 2" after Tsuneo Arakawa; in this context, "Arakawa syndrome 1" refers to Glutamate formiminotransferase deficiency.
Argininosuccinic acid

# Overview
Arginosuccinic acid is a chemical compound that belongs to the class of the amino acids.

# Reactions
Some cells synthesize it from citrulline, aspartic acid and use it as a precursor for arginine in the urea cycle or Citrulline-NO cycle. The enzyme that catalyzes the reaction is argininosuccinate synthetase.
Argininosuccinic acid also forms Fumarate in the Citric Acid Cycle, via argininosuccinate lyase.