Persius/hicric huggingface dataset:
Pediatric Glasgow Coma Scale

# Overview
The Pediatric Glasgow Coma Scale (also known as Pediatric Glasgow Coma Score or simply PGCS) is the equivalent of the Glasgow Coma Scale (GCS) used to assess the mental state of adult patients. As many of the assessments for an adult patient would not be appropriate for infants, the scale was modified slightly. Similar to GCS, the PGCS comprises three tests: eye, verbal and motor responses. The three values separately, as well as their sum, are considered. The lowest possible PGCS (the sum) is 3 (deep coma or death) whilst the highest is 15 (fully awake and aware person).

# Pediatric Glasgow Coma Scale Calculator
The scale is composed of three tests: eye, verbal and motor responses. The three values separately, as well as their sum, are considered. The lowest possible GCS (the sum) is 3 (deep coma or death), while the highest is 15 (fully awake person).

## Calculation of Pediatric Glasgow Coma Scale
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document.forms.value = score;
if(score >= 13){document.forms.value = "Mild head injury";}
if(score >= 9 && score <= 12){document.forms.value = "Moderate head injury";} 
if(score <= 8){document.forms.value = "Severe head injury and significant risk of mortality";}

## Interpretation of Pediatric Glasgow Coma Scale
- pGCS  13: Mild Head Injury
- pGCS 912: Moderate Head Injury
- pGCS  8: Severe Head Injury and represents a significant risk of mortality
Penciclovir clinical studies

# Clinical Studies
Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in clinical practice.
In two double-blind, placebo-controlled trials, 1516 patients were treated with DENAVIR (penciclovir cream) and 1541 with placebo. One or more local adverse reactions were reported by 3% of the patients treated with DENAVIR and 4% of placebo-treated patients. The rates of reported local adverse reactions are shown in Table 1.
Two studies, enrolling 108 healthy subjects, were conducted to evaluate the dermal tolerance of 5% penciclovir cream (a 5-fold higher concentration than the commercial formulation) compared to vehicle using repeated occluded patch testing methodology. The 5% penciclovir cream induced mild erythema in approximately one-half of the subjects exposed, an irritancy profile similar to the vehicle control in terms of severity and proportion of subjects with a response. No evidence of sensitization was observed.
Persistent thyroglossal duct

# Overview
A persistent thyroglossal duct is a usually benign medical condition in which the thyroglossal duct, a structure usually only found during embryonic development, fails to atrophy. The duct persists as a midline structure connecting the back of the tongue to the thyroid gland.

# Background
Early during embryonic development, the thyroglossal duct is a midline structure that connects the back of the tongue to the thyroid gland. The duct usually disappears, or atrophies, during the ninth week of gestation so that in most individuals the thyroid does not connect to the tongue. In individuals with a persistent thyroglossal duct, the duct fails to atrophy, and the connection between the thyroid gland and the tongue is maintained.

# Complications
A persistent thyroglossal duct may become fluid filled, forming a thyroglossal duct cyst, the most common type of congenital neck malformation. Such cysts account for approximately 2-4% of all neck masses.
Policy-based evidence making
The term Policy based evidence making is a pejorative term which refers to the commissioning of research in order to support a policy which has already been decided upon. The name has been suggested as a corollary to evidence based policy making.
As the name suggests, policy based evidence making means working back from a predefined policy to produce underpinning evidence.  Working from a conclusion to provide only supporting evidence is an approach which contradicts most interpretations of the scientific method; however, it should be distinguished from research into the effects of a policy where such research may provide either supporting or opposing evidence.
The term "policy based evidence making" was referred to in a report of the United Kingdom House of Commons Select Committee on Science and Technology into Scientific Advice, Risk and Evidence Based Policy Making issued in October 2006. The committee stated:
 should certainly not seek selectively to pick pieces of evidence which support an already agreed policy, or even commission research in order to produce a justification for policy: so-called "policy-based evidence making" (see paragraphs 956). Where there is an absence of evidence, or even when the Government is knowingly contradicting the evidencemaybe for very good reasonthis should be openly acknowledged.
Paragraph 89, House of Commons Science and Technology Committee: Scientific Advice, Risk and Evidence Based Policy Making
The term has also been applied outside the strictly scientific arena, for example in a position paper for the Arts and Humanities Research Council
Polyglycerol Polyricinoleate
Polyglycerol Polyricinoleate (PGPR), E476, is an emulsifier made from castor beans which reduces the viscosity of chocolate and similar coatings and compounds. It works by decreasing the friction between the particles of cacao, sugar, milk, etc. present so that they can flow more easily when melted. It is used at low levels (fractions of percents.)

# Use in chocolate candy bars
It is primarily used to reduce the fat content of chocolate. Since 2006, commercial-grade candy bars, such as those made by Hersheys and Nestle, made an industry-wide switch to include PGPR as an ingredient - a possible indicator of a cost saving measure by the commercial chocolate industry. Makers of PGPR (see source link below) such as Danisco and Palsgaard indicate that PGPR can be used to replace the more expensive cocoa butter as an ingredient in chocolate. Palsgaard's website asserts, "Cocoa butter is an expensive raw material for chocolate manufacturers. By using PALSGAARD 4150 the chocolate recipe has lower costs in terms of less cocoa butter but also gives the benefit of having less fat."
PGPR is a yellowish, viscous liquid composed of polyglycerol esters of polycondensed fatty acids from castor oil. It may also be polyglycerol esters of dimerized fatty acids of soya bean oil.
PGPR is strongly lipophilic, soluble in fats and oils and insoluble in water and ethyl alcohol. In chocolates it is used as a viscosity reducing agent. It is virtually always paired with lecithin or another plastic viscosity-reducing agent.
It can also be used as an emulsifier in spreads and in salad dressings or as a crystal inhibitor and anti-clouding agent in fractionated vegetable oils.
The Vegan Society claims that PGPR may be animal-derived, but no evidence has been presented that any commercially available PGPR products are made using animal-derived substances.
Polynucleotide phosphorylase
Polynucleotide Phosphorylase (PNPase) is a bifunctional enzyme with a phosphorolytic 3' to 5' exoribonuclease activity and a 3'-terminal oligonucleotide polymerase activity. That is, it dismantles the RNA chain starting at the 3' end and working toward the 5' end. It also synthesizes long, highly heteropolymeric tails in vivo. It accounts for all of the observed residual polyadenylation in strains of Escherichia coli missing the normal polyadenylation enzyme. Discovered by Marianne Grunberg-Manago working in Severo Ochoa's lab in 1955, the RNA-polymerization activity of PNPase was initially believed to be responsible for DNA-dependent synthesis of messenger RNA, a notion that got disproved by the late 1950s.
It is involved on mRNA processing and degradation in bacteria, plants, and in humans.
In humans, the enzyme is encoded by the PNPT1 gene. In its active form, the protein forms a ring structure consisting of three PNPase molecules. Each PNPase molecule consists of two RNase PH domains, an S1 RNA binding domain and a K-homology domain. The protein is present in bacteria and in the chloroplasts and mitochondria of some eukaryotic cells. In eukaryotes and archaea, a structurally and evolutionary related complex exists, called the exosome complex.
The same abbreviation (PNPase) is also used for another, otherwise unrelated enzyme, Purine nucleoside phosphorylase.

# Model organisms
Model organisms have been used in the study of PNPT1 function. A conditional knockout mouse line, called Pnpt1tm1a(KOMP)Wtsi was generated as part of the International Knockout Mouse Consortium program  a high-throughput mutagenesis project to generate and distribute animal models of disease to interested scientists.
Male and female animals underwent a standardized phenotypic screen to determine the effects of deletion. Twenty six tests were carried out on mutant mice and two significant abnormalities were observed. No homozygous mutant embryos were identified during gestation, and therefore none survived until weaning. The remaining tests were carried out on heterozygous mutant adult mice; no additional significant abnormalities were observed in these animals.
Post-polio syndrome overview

# Overview
Post-polio syndrome (PPS) is a condition that affects survivors of poliomyelitis, a viral infection of the nervous system, after recovery from an initial paralytic attack of the virus.

# Pathophysiology
The precise mechanism that causes post-polio syndrome is unknown.

# Differentiating Post-polio Syndrome from other Diseases
PPS has been confused with amyotrophic lateral sclerosis (ALS), which progressively weakens muscles. PPS patients do not have an elevated risk of ALS.
PPS shares many features in common with myalgic encephalomyelitis, a form of chronic fatigue syndrome that is apparently caused by viral infections, but unlike those disorders it tends to be progressive, and can cause tangible loss of muscle strength.

# Natural History, Complications and Prognosis
In general, PPS is not life-threatening. The major exception are patients left with severe residual respiratory difficulties, who may experience new severe respiratory impairment.There have been no sufficient longitudinal studies on the prognosis of post-polio syndrome; however, speculations have been made by several physicians based on experience. Fatigue and mobility usually return to normal over a long period of time. The prognosis also differs depending upon different causes and factors affecting the individual. An overall mortality rate of 25% exists due to possible respiratory paralysis of persons with post-polio syndrome; otherwise, post-polio syndrome is usually non-lethal.

# Diagnosis
Typically the symptoms appear 20-40 years after the original infection, at an age of 35 to 60.  Symptoms include new or increased muscular weakness, pain in the muscles, and fatigue.
Diagnosis of post-polio syndrome can be difficult, since the symptoms are hard to separate from the original symptoms of polio and from the normal infirmities of aging.  There is no laboratory test for post-polio syndrome, nor is there any other specific diagnostic, and diagnosis is usually a "diagnosis of exclusion" whereby other possible causes of the symptoms are eliminated.

## Physical Examination
PPS may be difficult to diagnose in some because it is hard to determine what component of a neuromuscular deficit is old and what is new: Neurological examination aided by other laboratory studies can help to exclude all other possible diagnoses. Objective assessment of muscle strength in PPS patients may not be easy. Changes in muscle strength are determined in specific muscle groups sing various muscle scales which quantify strength, such as the Medical Research Council (MRC) scale.

## Laboratory Findings
Muscle biopsies and spinal fluid analysis may also be used in establishing a PPS diagnosis.

## MRI
Magnetic resonance imaging (MRI) and neuroimaging may also be used in establishing a PPS diagnosis.

## Other Diagnostic Studies
Electrophysiological studies may also be used in establishing a PPS diagnosis.

# Treatment
Treatment generally is limited to supportive measures, primarily leg braces and energy-saving devices such as powered wheelchairs, plus pain relievers, sleep aids, etc.
Posterior lobe of cerebellum
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# Overview
The posterior lobe of cerebellum is the portion of the cerebellum caudal to the primary fissure.
It is sometimes equated to the "neocerebellum".
Progressive massive fibrosis
Synonyms and keywords: Complex pneumoconiosis

# Overview
Progressive Massive Fibrosis is also known as Complex Pneumoconiosis. It is a disease that almost entirely affects coal miners. The disease arises firstly through the deposition of coal dust within the lung, and then through the body's immunological reactions to the dust.  If disease is to be classified as PMF, the lung must contain lesions which are at least 1 cm in size, although some authorities place the boundary at 2 cm.  In PMF, lesions most commonly occupy the upper lobes of the lung. Another characteristic of PMF lesions is that they are black.. The pathogenesis of PMF is complicated, but involves two main routes - an immunological route, and a mechanical route.
Immunologically, disease is caused primarily through the activity of lung macrophages, which phagocytose dust particles after their deposition. These macrophages seek to eliminate the dust particle through either the mucociliary mechanism, or through lymphatic vessels which drain the lungs. Macrophages also produce an inflammatory mediator known as interleukin-1 (IL-1), which is part of the immune systems first line defenses against infecting particles. IL-1 is responsible for 'activation' of local vasculature, causing endothelial cells to express certain cell adhesion molecules, which help the cells of the bodies immune system to migrate into tissues. Macrophages exposed to dust have been shown to have markedly decreased chemotaxis. Production of inflammatory mediators - and the tissue damage that ensues as an effect of this, as well as reduced motility of cells, is fundamental to the pathogenesis of pneumoconiosis and the accompanying inflammation, fibrosis, and emphysema.
There are also some mechanical factors involved in the pathogenesis of Complex Pneumoconiosis that should be considered. The most notable indications are the fact that the disease tends to develop in the upper lobe of the lung - especially on the right, and its common occurrence in taller individuals.
Prohibited degree of kinship
The prohibited degree of kinship refers to a degree of consanguinity (relatedness) below which sexual interrelationships are regarded as incestuous.  Inbreeding is a taboo across nearly all cultures worldwide, but the line at which a relationship is considered incestuous varies.  The prohibited degree of kinship may exist between siblings, half-siblings, first cousins, third cousins, etc.

# In Catholicism
In the Roman Catholic Church, unwittingly marrying a closely-consanguinious blood relative is grounds for an annulment, but dispensations were granted, actually almost routinely (the Roman Catholic Church's ban on marriage within the fourth degree of relationship (third cousins) lasted from 1550 to 1917; before that, the prohibition was to marriages between as much as seventh degree of kinship).
The relevant Latin Rite Canon Law in force since 1983 is as follows:
Can. 108
Can. 109
Can. 110
Can. 1091
Can. 1092
Can. 1093
Can. 1094
Canons 1091.2, 1092, 1093, 1094 represent dispensable ecclesiastical law, and as such do not apply to the marriage of two non-Catholics per canon 11.

# In the Eastern Church
Until the 20th century  the Russian Orthodox Church explicitly prohibited marriage within seven degrees of kinship. Many Old Believer groups maintain the prohibition to this day. Nevertheless, sexual relations between in-laws (in particular, snokhachestvo) were fairly common in Imperial Russia.

# In Asian Cultures
Up until recently, in certain Asian Cultures, it was forbidden to marry those with the same surname regardless of relations. These clan marriages were considered incestuous. However, first cousins with different surnames were allowed to marry. For example, one can marry their mother's sibling's child, but could not marry a non-blood related stranger because having the same surname was considered as having the same ancestor. However, these rules were not clearly defined. In Korean culture for example, surnames were designated by region as well as the name itself. So, a "Kim" family originating from a northern region was not considered the same as one that originated from a southern region, making marriage between the two allowable.
In Hindu belief, the scripture Manusmriti states one cannot marry one who is less than seven generations away from his/her father's side and five from his/her mother's side.

# The Church of England
The Church of England traditionally follows the rules set out in the Book of Common Prayer which includes a "Table of Kindred and Affinity". This states that:
It further states that the term 'brother' includes a brother of the half-blood, and the term 'sister' includes a sister of the half-blood.
Pseudostellaria heterophylla
Known as Tai Zi Shen, Pseudostellaria, False starwort or Prince Seng, this plant is an adaptogen in the Caryophyllaceae family that is used in Chinese medicine and herbalism to tonify the qi and generate yin fluids.  It is known as the "ginseng of the lungs". The plant is a low growing caryophyllaceae that is grown in Southern China in the provinces of  Jiangsu, Anhui, Shandong, Heilongjiang, Jilin, Liaoning, Hebei, Henan,  Shaanxi,  Zhejiang, Jiangxi, Hubei, Shaanxi. and Shaanxi provinces.   Botanically it is known as Pseudostellaria heterophylla (Miq.) Pax ex Pax et Hoffm.

# Ethnobotany
Tai zi shen is a relatively recent addition to the Chung Yao Chi New Chinese Materia Medica, having been officially added in 1959, based upon local and ethnic use.   It is weaker than Panax ginseng. The herb is a mild adaptogen, demulcent, an immune tonic,  nutritive, and a pectoral herb.  In Chinese terms it tonifies the yin.  Accordingly the herb is restorative for lung damage due to excess
heat or dryness including hot or dry asthma, pleurisy, bronchitis, bacterial pneumonia, wheezing, dry cough, and emphysema.  Scientific research shows that Pseudostellaria aids in protecting the mucin layer that lines the respiratory tract and functions as an immune defense system. In the form Li Gan Zi Shen Tang (Regulate the Liver & Enrich the Kidneys Decoction) it is used to treat yin deficiency in diabetes mellitusThe polysaccharide fractions have anti-tumor properties.  A lectin in the roots is being studied  for anti HIV purposes.

# Constituents
Major constituents include:
- Arginine
- Aspartic Acid
- Fructose
- Inulin
- Phosphatides
- Polysaccharides:
- PH-1A (antitumor activity)
- PH-1B (antitumor activity)
- PH-1C (antitumor activity)
- Pseudostellarin H (octapeptide)
- Pseudostellarin D (heptopeptide)
- Saponins
- Trace elements of iron, copper, manganese, zinc, selenium, cobalt, molybdenum etc.

# Botanical Description
- Herbs, perennial.
- Taproots absent,  Root tubers white, slightly grayish yellow, long fusiform.
- Stems Stem solitary, erect, (8--)15--20 cm tall, with 2 lines of hairs.
- Leaves Proximal leaves usually 1 or 2 pairs, spatulate or oblanceolate; middle leaves lanceolate; distal leaves 2 or 3 pairs, decussate, approximate, broadly ovate, not succulent.
- Inflorescences terminal.
- Pedicels recurved to reflexed.
- Flowers: perianth and androecium hypogynous; sepals 5, distinct; petals 5 , white.
- Capsules ovoid.
- Seeds  Seeds brown, compressed orbicular, marginal wing absent, appendage absent.    

# Notes
-  David Winston & Steven Maimes. ADAPTOGENS: Herbs for Strength, Stamina, and Stress Relief, Healing Arts Press, 2007.
-  David Winston & Steven Maimes. ADAPTOGENS: Herbs for Strength, Stamina, and Stress Relief, Healing Arts Press, 2007.

# See Also
- Adaptogen
- Herbalism
- Chinese Medicine
Pulmonary contusion overview

# Overview
A pulmonary contusion (or lung contusion) is a contusion (bruise) of the lung, caused by chest trauma. As a result of damage to capillaries, blood and other fluids accumulate in the lung tissue.  The excess fluid interferes with gas exchange, potentially leading to inadequate oxygen levels (hypoxia).  Unlike pulmonary laceration, another type of lung injury, pulmonary contusion does not involve a cut or tear of the lung tissue.

# Pathophysiology
A pulmonary contusion usually is caused by blunt trauma but also is caused by explosions or a shock wave associated with penetrating trauma. With the use of explosives during World Wars I and II, pulmonary contusion resulting from blasts gained recognition. In the 1960s its occurrence began to receive wider recognition in civilians, for whom it is usually caused by traffic accidents. The use of seat belts and airbags reduces the risk to vehicle occupants.

# Treatment

## Medical Therapy
No treatment is known to speed the healing of a pulmonary contusion; the main care is supportive. Attempts are made to discover injuries accompanying the contusion, to prevent additional injury, and to provide supportive care while waiting for the contusion to heal. Monitoring, including keeping track of fluid balance, respiratory function, and oxygen saturation using pulse oximetry is also required as the patient's condition may progressively worsen. Monitoring for complications such as pneumonia and acute respiratory distress syndrome is of critical importance. Treatment aims to prevent respiratory failure and to ensure adequate blood oxygenation. Supplemental oxygen can be given and it may be warmed and humidified. When the contusion does not respond to other treatments, extracorporeal membranous oxygenation may be used, pumping blood from the body into a machine that oxygenates it and removes carbon dioxide prior to pumping it back in.