Persius/hicric huggingface dataset:
Regularized Gamma function
In mathematics, the gamma function is defined by a definite integral. The incomplete gamma function is defined as an integral function of the same integrand. There are two varieties of the incomplete gamma function: the upper incomplete gamma function is for the case that the lower limit of integration is variable (ie where the "upper" limit is fixed), and the lower incomplete gamma function can vary the upper limit of integration.
The upper incomplete gamma function is defined as:
The lower incomplete gamma function is defined as:

# Properties
In both cases a is a complex parameter, such that the real part of a is positive.
By integration by parts we can find that
Since the ordinary gamma function is defined as
we have
Furthermore,
and
Also
where Ei is the exponential integral, erf is the error function, and erfc is the complementary error function, erfc(x) = 1  erf(x).

# Regularized Gamma functions
Two related functions are the regularized Gamma functions:

# Connection with Kummer's confluent hypergeometric function
It is easily shown that, when the real part of z is positive,
\gamma(a,z) = \int_0^z e^{-t}t^{a-1} dt = a^{-1} z^a e^{-z} M(1,a+1,z),
where M(1, a+1, z) is Kummer's confluent hypergeometric function. Since the series
M(1, a+1, z) = 1 + \frac{1}{(a+1)}z + \frac{1}{(a+1)(a+2)}z^2 + \frac{1}{(a+1)(a+2)(a+3)}z^3 + \cdots
has an infinite radius of convergence, we may take
\gamma(a,z) = a^{-1} z^a e^{-z} M(1,a+1,z)\,
as the definition of (a, z) for all complex z. In this light, the lower incomplete gamma function (a, z) is an entire function of the complex variable z. Since the gamma function (z) is a meromorphic function with simple poles at {0, 1, 2, ...}, we may define the meromorphic upper incomplete gamma function as
\Gamma(a, z) = \Gamma(a) - \gamma(a, z). \,
For the actual computation of numerical values, the continued fraction of Gauss provides a useful expansion:
\frac{a e^z}{z^a} \gamma(a, z) = \cfrac{1}{1 - \cfrac{z}{a+1 + \cfrac{z}{a+2 - \cfrac{(a+1)z}
{a+3 + \cfrac{2z}{a+4 - \cfrac{(a+2)z}{a+5 + \cfrac{3z}{a+6 - \ddots}}}}}}}.
This continued fraction converges for all complex z, provided only that a is not a negative integer.
Renal protein reabsorption

# Overview
Renal protein reabsorption is the part of renal physiology that deals with the retrieval of filtered proteins, preventing them from disappearing from the body through the urine.
Almost all reabsorption takes place in the proximal tubule. Only ~1% is left in the final urine.
The proteins cross the apical membrane by endocytosis. They are subsequently degraded in lysosomes. The remaining free amino acids are transported across the basolateral membrane by amino acid transporters.

# Overview table
Reproductive endocrinology
Reproductive endocrinology and infertility (REI) is a surgical subspecialty of obstetrics and gynecology that addresses hormonal functioning as it pertains to reproduction. While a major focus of REI is infertility, reproductive endocrinologists also evaluate and treat hormonal dysfunctions in female and males outside of infertility. Reproductive surgeons operate on anatomical disorders that affect fertility. Reproductive endocrinologists have a specialty training in obstetrics and gynecology before they undergo subspecialty training (fellowship) in reproductive endocrinology and infertility.

# Fields of interest

## Female infertility
A significant part of reproductive endocrinology and infertility is concerned with the diagnosis and management of infertility. Thus reproductive endocrinologists evaluate and treat couples with reproductive disorders, may perform reproductive surgery, and often utilize in-vitro fertilization to achieve pregnancy.  Reproductive endocrinologist also are called upon to utilize preimplantation genetic diagnosis to prevent genetic diseases in couples that carry such diseases or for gender selection.

## Reproductive surgery
Complex surgery in women or men that aims to preserve reproductive potential is often done by RE specialist.

## Non-infertility issues
Reproductive endocrinologists are also especially trained to deal with complex hormonal issues in women or men.

# Certification
In a number of countries the pathway to become a subspecialist in REI is regulated. Thus in the United States the American Board of Obstetrics and Gynecology (ABOG) sets the standards for subspecialtists to become certified. After a four-year training in Obstetrics and Gynecology a three-year approved fellowship needs to be successfully completed. To be board certified in reproductive endocrinolgy and infertility, one must first complete board certification in obstetrics and gynecology (written and oral exams) and then certify in reproductive edncrinology and infertility (written oral and thesis exams).

# Societies
Reproductive endocrinologists often belong to specific medical societies, such as ASRM or ESHRE.
Respiratory exchange ratio
In one breath, you normally breathe in more molecules of oxygen than you breathe out molecules of carbon dioxide.
The ratio between these CO2 / %O2 is the respiratory exchange ratio (RER).
Measuring this ratio can be used for estimating the respiratory quotient (RQ), an indicator of which fuel (carbohydrate or fat) is being metabolised to supply the body with energy.
RER is about 0.8 at rest with a modern diet. This value however, can exceed 1 during intense exercise, as CO2 production by the working muscles becomes greater and more of the inhaled O2 gets used rather than being expelled.  It is important to note that during exercise, using RER for estimating RQ loses accuracy because of factors including bicarbonate buffering of lactic acid, which affects the CO2 levels being expelled by the respiratory system.
Calculation of RER is commonly done in conjunction with exercise tests such as the VO2 Max Test and can be used as an indicator that the participant is nearing exhaustion and the limits of their cardio-respiratory system. An RER of approximately 1.2 is reached at this point.
Retrospective cohort study
A retrospective cohort study, also called a historic cohort study, is a medical research study in which the medical records of groups of individuals who are alike in many ways but differ by a certain characteristic (for example, female nurses who smoke and those who do not smoke) are compared for a particular outcome (such as lung cancer). 
In order to differentiate Retrospective versus Prospective Cohort, following analogy can be considered.
A retrospective (historic) cohort study is different from a prospective cohort study in the manner in which it is conducted. In case of Retrospective Cohort Study, the investigator basically collects data from past records and does not follow patients up as is the case with a prospective study. However, the starting point of this study is the same as for all Cohort studies. The first objective is still to establish two groups - Exposed versus Nonexposed; and these groups are followed up in the ensuing time period.
In a nutshell, in Retrospective Cohort Study, all the events - exposure, latent period, and subsequent development of disease have already occurred in the past. We merely collect the data now, and establish the risk of developing a disease if exposed to a particular risk factor. On the other hand, Prospective Cohort Study is conducted by starting with two groups at the current point, and following up in future for occurrence of disease, if any.
As is obvious, Retrospective Cohort has the benefits of being cheaper and less time consuming. The resources are mainly directed at collection of data only. Additionally, it has essentially all the benefits of a Cohort Study (Statistics)
Rhythmic Movement Disorder

# Overview
Rhythmic Movement Disorder, also referred to as jactatio capitis nocturna, is a condition characterized by repetitive banging or rocking motions just before and during light sleep. This condition occurs primarily in infants and young children, although adults can be affected as well. While rarely harmful, it can be alarming or confusing to parents or others who witness it occurring.

# Symptoms
The symptoms of this condition are characterized by repetitive movements of certain areas of the body, usually the head and neck. There are varying types of movement which may be seen, including:
- The head is forcibly moved in a back and forward direction - head-banging type
- The head is moved laterally while in a supine (lying on the back, face up) position - head-rolling type
- The whole body is rocked while on the hands and knees - body-rocking type
- The whole body is moved laterally while in a supine position - body-rolling type
RMD most commonly affects otherwise healthy children but may also be seen in association with autism and other developmental disabilities.

# Causes
There is very little literature or consensus available as to the cause of this condition, although some theories have been put forth. It is sometimes considered to be affected by hyperactivity and certain autistic tendencies. Some parents may become concerned that the behavior is intended to be self-harming (eg. banging the head on the mattress repeatedly), although observations of people with this condition indicate that this is very rarely the case.
When asked by adults why they "rock" themselves to sleep it has been offered that it is a calming and soothing way to fall asleep, often reminding them of being an infant and being coddled to sleep by a parent or caregiver. It is often a learned response when babies are taught to "self soothe" and also provides the child warmth through body movement.

# Treatment
Although sometimes disconcerting for parents to witness, RMD is usually a benign behavior which typically resolves itself by age five. For most affected children, RMD is a self-limited condition that does not require treatment. For youngsters exhibiting particularly violent movements, use of protective padding in the crib or bed is often helpful.
Rifampin contraindications

# Contraindications
RIFADIN is contraindicated in patients with a history of hypersensitivity to rifampin or any of the components, or to any of the rifamycins. (See Warnings.)
Rifampin is contraindicated in patients who are also receiving ritonavir-boosted saquinavir due to an increased risk of severe hepatocellular toxicity. (See Precautions, Drug Interactions.)
Rifampin is contraindicated in patients who are also receiving atazanavir, darunavir, fosamprenavir, saquinavir, or tipranavir due to the potential of rifampin to substantially decrease plasma concentrations of these antiviral drugs, which may result in loss of antiviral efficacy and/or development of viral resistance.
Robertsonian translocation
Robertsonian translocation is a common form of chromosomal rearrangement that occurs in the five acrocentric human chromosome pairs, namely 13, 14, 15, 21, and 22. They are named after the American insect geneticist W. R. B. Robertson, who first described a Robertsonian translocation in grasshoppers in 1916. They are also called whole-arm translocations or centric-fusion translocations. They are a type of chromosomal translocations.

# Consequence
A Robertsonian translocation is a type of nonreciprocal translocation in which two nonhomologous acrocentric chromosomes (chromosomes with centromeres near their ends) break at their centromeres, following which the long arms become attached to a single centromere. The short arms also join to form the reciprocal product, which typically contains nonessential genes and usually is lost within a few cell divisions.
In humans, when a Robertsonian translocation joins the long arm of chromosome 21 with the long arm of chromosome 14 (or 15), the heterozygous carrier is phenotypically normal because there are two copies of all major chromosome arms and hence two copies of all essential genes. However, the progeny of this carrier may inherit an unbalanced trisomy 21, causing Down Syndrome.
About one in a thousand newborns has a Robertsonian translocation. The most frequent forms of Robertsonian translocations are between chromosomes 13 and 14, 13 and 21, and 21 and 22, and occur when the long arms of two acrocentric chromosomes fuse at the centromere and the two short arms are lost.
A Robertsonian translocation in balanced form results in no excess or deficit of genetic material and causes no health difficulties. In unbalanced forms, Robertsonian translocations cause chromosomal deletions or addition and result in syndromes of multiple malformations, including trisomy 13 (Patau syndrome) and trisomy 21 (Down syndrome).
A Robertsonian translocation results when the long arms of two acrocentric chromosomes fuse at the centromere and the two short arms are lost. In this case, the long arms of chromosomes 13 and 14 have fused, but no genetic material was lost - this person is completely normal despite the translocation. Common Robertsonian translocations are confined to the acrocentric chromosomes 13, 14, 15, 21 and 22, because the short arms of these chromosomes encode for rRNA which is present in multiple copies.
People with Robertsonian translocations have only 45 chromosomes in each of their cells, yet all essential genetic material is present, and they appear normal. Their children, however, may either be normal and carry the fusion chromosome (depending which chromosome is represented in the gamete), or they may inherit a missing or extra long arm of an acrocentric chromosome.  Genetic counseling and genetic testing is offered to families that may be carriers of chromosomal translocations.
Rokitansky-Aschoff sinuses

# Overview
Rokitansky-Aschoff sinuses, also entrapped epithelial crypts, are diverticula or pockets in the wall of the gallbladder.  They may be microscopic or macroscopic.
Histologically, they are outpouchings of gallbladder mucosa into the gallbladder muscle layer.
They are not of themselves considered abnormal, but they can be associated with cholecystitis.

# Causes
They form as a result of increased pressure in the gallbladder and recurrent damage to the wall of the gallbladder.  They are associated with gallstones (cholelithiasis).

# Eponym
They are named after Carl Freiherr von Rokitansky and Ludwig Aschoff.
Royal North Shore Hospital
The Royal North Shore Hospital (RNSH) is a major public teaching hospital in Sydney, Australia, located in St Leonards. It serves as a teaching hospital for the University of Sydney and has approximately 740 beds. It is a major hospital in the Northern Sydney Health area, providing health care for the Lower and Upper North Shore area.

# History
The Royal North Shore Hospital began as a cottage hospital in located in Willoughby Rd, Crows Nest. The foundation stone was laid  by Sir Henry Parkes, 18th June, 1887. The hospital was opened with accommodation for 14 patients, with the requisite office and rooms for the medical and nursing staff. Medical staff numbered 4 honorary doctors and nursing staff numbered 5. The site of the original hospital was bounded by Willoughby Rd., Albany and Holterman Streets and Zig Zag Lane. The old site is now a busy part of the commercial center of Willoughby.
In 1903 it moved to its current site at St Leonards,  with 48 beds available for patients. It became a teaching hospital of the University of Sydney in 1947.
Currently, the Royal North Shore Hospital  (RNSH) is a 740 bed hospital situated in St Leonards, Sydney, Australia. Situated at the hospital is the Kolling Institute of Medical Research. Royal North Shore Hospital provides postgraduate training in a number of specialties, including medicine, surgery, nursing and allied health.
RNSH provides care to the local community, the Northern Sydney Health area (population: 777,000), New South Wales and also to the Pacific Island nations.
RNSH is located on Sydney's lower north shore about 6km from the CBD, surrounded by suburbs with some of the most stunning harbour views of Sydney. The hospital is 118 years old and a leading research and trauma centre with a particular interest and expertise in cancer diagnosis and treatment, cardiovascular disease, spinal cord injury, severe burn injury, neonatal, intensive care, neurosurgery, pain management and anaesthesia.
The Hospital is currently undergoing total redevelopment. Approval for construction was given in July 2000. The new clinical services building (The Douglas Building) marks the first stage of the redevelopment of the entire hospital campus. The NSW government has allocated approximately A$450 million for this project, the largest in NSW Health history. This new development will no doubt ensure the hospital maintains its role as a health care leader in Australia.
Like with many other Sydney hospitals, RNSH has, in recent times, suffered budget cuts due to an alleged state government policy of redistributing health resources. 
The problem is especially apparent after the Jana Horska case in September 2007, when a pregnant woman suffered a miscarriage in the hospital's toilet due to a lack of available beds and staff, and a neurosurgeon's claim that a patient had to wait 5 days for an urgent spinal surgery due to a lack of staff.
Runaway pacemaker syndrome

# Overview
Runaway pacemaker syndrome is a potentially life-threatening malfunction of older pacemaker technologies whereby the pacemaker intermittently fires at a rate of nearly 2000 bpm.

# Causes
The malfunction is often related to a low battery voltage.

# Diagnosis

## Physical Examination

### Vital Signs
- Generally the low amplitude pacemaker spikes fail to capture and there is bradycardia.

# Complications, Natural History and Prognosis
- Generally the low amplitude pacemaker spikes fail to capture and there is bradycardia.
- Ventricular fibrillation can occur

# Treatment
- A magnet should be placed on the chest to stop the potentially life-threatening stimulation.
- The pacemaker should be replaced.
Saccharopine dehydrogenase
In molecular biology, the protein domain Saccharopine dehydrogenase (SDH), also named Saccharopine reductase, is an enzyme involved in the metabolism of the amino acid lysine, via an intermediate substance called saccharopine. The Saccharopine dehydrogenase enzyme can be classified under EC 1.5.1.7, EC 1.5.1.8, EC 1.5.1.9, and EC 1.5.1.10. It has an important function in lysine metabolism and catalyses a reaction in the alpha-Aminoadipic acid pathway. This pathway is unique to fungal organisms therefore, this molecule could be useful in the search for new antibiotics. This protein family also includes saccharopine dehydrogenase and homospermidine synthase. It is found in prokaryotes, eukaryotes and archaea.

# Function
Simplistically, SDH uses NAD+ as an oxidant to catalyse the reversible pyridine nucleotide dependent oxidative deamination of the substrate, Saccharopine, in order to form the products, lysine and alpha-ketoglutarate.
This can be described by the following equation:
Saccharopine       lysine + alpha-ketoglutarate
Saccharopine dehydrogenase EC catalyses the condensation to of l-alpha-aminoadipate-delta-semialdehyde (AASA) with l-glutamate to give an imine, which is reduced by NADPH to give saccharopine. In some organisms this enzyme is found as a bifunctional polypeptide with lysine ketoglutarate reductase (PF).
Homospermidine synthase proteins (EC). Homospermidine synthase (HSS) catalyses the synthesis of the polyamine homospermidine from 2 mol putrescine in an NAD+-dependent reaction.

# Structure
There appears to be two  protein domains of similar size. One domain is a Rossmann fold that binds NAD+/NADH, and the other is relatively similar. Both domains contain a six-stranded parallel beta-sheet surrounded by alpha-helices and loops (alpha/beta fold).

# Clinical significance
Deficiencies are associated with hyperlysinemia.
Sandbox: Cardiogenic Shock

# AHA SCIENTIFIC STATEMENT - 2017

# Contemporary Management of Cariogenic Shock

## Pragmatic and Clinical Trial Definitions of Cardiogenic Shock

## Potential Hemodynamic Presentations of Cardiogenic Shock

## Considerations for Initial Critical Care Monitoring in Patients With Cardiogenic Shock

## Mechanism of Action and Hemodynamic Effects of Common Vasoactive Medications in Cardiogenic Shock

## Initial Vasoactive Management Considerations in Types of Cardiogenic Shock (CS)
Sandbox: hyperthyroidism 2

# Differentiating hyperthyroidism from other diseases

## According to iodine uptake
Hyperthyroidism can be classified according to the results of iodine uptake test into

### High iodine uptake
- Graves' disease
- Toxic multinodular goiter
- Toxic thyroid adenoma

### High or normal uptake:
- Iodine caused hyperthyroidism
- Hashitoxicosis
- Germ cell tumors (choriocarcinoma in males and testicular germ cell tumors)
- Pituitary TSH producing adenoma
- Vasomotor instability in the form of Hot flashes, hot flushes, including night sweats and Sleep disturbances
- Urogenital atrophy causing Itching, Dryness, Bleeding, Watery discharge, Urinary frequency, Urinary urgency andUrinary incontinence
- Skeletal symptoms in the form of Osteoporosis (gradually developing over time), Joint pain, muscle pain and Back pain
- Psychological manifestations such as Mood disturbance, Irritability, Fatigue, Memory loss anDepression
- Sexual disorders: Decreased libido, Vaginal dryness, Problems reaching orgasm and Dyspareunia

### Low uptake:
- Subacute thyroiditis
- Hyperthyroidism due to ectopic thyroid tissue
- Factitious thyrotoxicosis
- Struma ovarii
- Painless thyroiditis
- Amiodarone induced thyroiditis-Type 1
- Amiodarone induced thyroiditis-Type 2
According to DSM V, the following criteria should be present to fit the diagnosis of opioid withdrawal:
- Cessation of (or reduction in) opioid use that has been heavy and prolonged (i.e.,several weeks or longer) or administration of an opioid antagonist after a period of opioid use.
- Development of three or more of the following criteria minutes to days after cessation of drug use: Dysphoric mood, Nausea or vomiting, Muscle aches, Lacrimation or rhinorrhea, Pupillary dilation, piloerection, or sweating, Diarrhea, Yawning, Fever, Insomnia.
-   Check |url= value (help)..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}
Sandbox:primary prevention

# Overview
- There are no established measures for the primary prevention of .
- There are no available vaccines against .
OR
- Effective measures for the primary prevention of  include , , and .
-  vaccine is recommended for  to prevent . Other primary prevention strategies include , , and .

# Primary Prevention
- There are no established measures for the primary prevention of .
- There are no available vaccines against .
OR
- Effective measures for the primary prevention of  include:
OR
-  vaccine is recommended for  to prevent . Other primary prevention strategies include: