Persius/hicric huggingface dataset:
Robinson annulation
The Robinson annulation is an organic reaction used to create a six-membered ring ,-unsaturated ketone using a ketone (or aldehyde) and methyl vinyl ketone    It is named after the British chemist who discovered it, Sir Robert Robinson while at the University of Oxford.
In addition to methyl vinyl ketone, 1-chloro-3-propanone   and isoxazoles  will give the same product.
The Wieland-Miescher ketone is the Robinson annulation product of 2-methyl-1,3-cyclohexanedione and methyl vinyl ketone while the Hajos-Parrish ketone is the product of 2-methyl-1,3-cyclopentanedione and methyl vinyl ketone.

# Reaction mechanism
Methyl vinyl ketone (or variants thereof) are essential for the annulation as they are simultaneously a Michael acceptor and able to take part in an aldol condensation.  The first step in the Robinson annulation is a Michael addition followed by an aldol reaction as the annulation step in the process. The reaction then proceeds as an aldol condensation to make the desired cyclohexenone ring.

# Variations

## Asymmetric Robinson annulation
The organocatalyst Proline has been used to resolve the enantiomeric isomers of Robinson annulations in asymmetric synthesis. . A proline derivative was employed in an asymmetric annulation of a geranial :

## Wichterle reaction
The Wichterle reaction is a variant of the Robinson annulation that replaces methyl vinyl ketone with 1,3-dichloro-cis-2-butene.   

## Hauser annulation
The reaction sequence in the related Hauser annulation is michael addition - Dieckman condensation - elimination . The Hauser donor is an aromatic methylene sulfoxide or sulfone with a carboxylic ester group in the ortho position. The Hauser acceptor is also a Michael acceptor.  In the original Hauser publication  ethyl 2-carboxybenzyl phenyl sulfoxide reacts with 3-pentene-2-one with LDA as a base in THF at -78C :
The original reaction product still contains the sulfoxide group but it is lost on heating in an elimination reaction. The ultimate reaction product is a napthalene derivative.  The dual purpose of the sulfoxide group is as stabilizing group for the carbanion in the first reaction step and as leaving group in the second.
Rothia dentocariosa

# Overview
Rothia dentocariosa is a bacteria that is a part of the normal community of microbes residing in the mouth and respiratory tract.  Variable or pleomorphic in shape and similar to Actinomyces and Nocardia, Rothia was only defined as a genus in 1967.

# Microbiology
Rothia dentocariosa is a species of gram-positive, round to rod shaped bacteria that is a part of the normal community of microbes residing in the mouth and respiratory tract.  Rothia dentocariosa, like several other species of oral bacteria, is able to reduce nitrate to nitrite, and one study found it in 3% of isolates of nitrate reducing bacteria from the mouth.

# Role in Disease
First isolated from dental caries, Rothia dentocariosa is largely benign, but does very rarely cause disease.  The most common Rothia infection is endocarditis, typically in people with underlying heart valve disorders.  Literature case reports show other tissues that are rarely infected include the peritoneum, tonsils, lung, cornea, endophthalmitis.  It has been implicated in periodontal disease, and one hypothesis is that Rothia periodontal disease, or dental procedures in turn, may be first steps in the infection of other tissues.  They are also known to cause fatal in utero infections and septic arthritis.

# Treatment
Like other Rothia infections reported in the literature, once the cause of infection was identified, this responded fully to treatment with antibiotics.  Rothia infections may be treated with penicillin, erythromycin,  cefazolin, rifampin, aminoglycoside, tetracycline, chloramphenicol, and trimethoprim-sulfamethoxazole.
Ryan White Care Act
The Ryan White Comprehensive AIDS Resources Emergency (CARE) Act (Ryan White Care Act, Ryan White, Template:USStatute) was an Act of the U.S. Congress passed in honor of Ryan White, an Indiana teenager who contracted AIDS through a tainted hemophilia treatment in 1984, and was expelled from school because of the disease.  White became a well-known advocate for AIDS research and awareness, until his death on April 8, 1990.
The act is the United States's largest federally funded program for people living with HIV/AIDS.  The act sought funding to improve availability of care for low-income, uninsured and under-insured victims of AIDS and their families.
Unlike Medicare or Medicaid, Ryan White programs are "payer of last resort," which fund treatment when no other resources are available.  As AIDS has spread, the funding of the program has increased.  In 1991, the first year funds were appropriated, around $220 million were spent; by the early 2000s, this number had almost increased 10-fold. The Ryan White Care Act was reauthorized in 1996, 2000 and 2006.  The program provides some level of care for around 500,000 people a year and, in 2004, provided funds to 2,567 organizations.  The Ryan White programs also fund local and State primary medical care providers, support services, healthcare provider training programs, and provide technical assistance to such organizations.
In fiscal year 2005, federal funding for the Ryan White Care Act was $2.1 billion.  As of 2005, roughly one third of this money went to the AIDS Drug Assistance Program (ADAP).  The primary activity of ADAP is providing FDA-approved prescription medication.

# 2006 Reauthorization
The Ryan White Care Act was due to be reauthorized at the end of 2005, but congress could not reach agreement on changes, and the act was extended for one year under the old terms.  In 2006, the act was reauthorized for three more years, ending on September 30, 2009 with a funding level of $2.1 billion.
Prior to the reauthorization, the act allocated money based on the proportion of patients with full-blown AIDS in each region.  The 2006 reauthorization changed this allocation mechanism to also consider the number of people with HIV infection.  A significant portion of funding from the act is emergency relief for Eligible Metropolitan Areas.  The 2006 reauthorization redefined EMAs as cities with a population greater than 50,000, instead of previous versions which required 500,000.
STEMI case examples

# Case # 1

## EKG

## Coronary angiography

### Left Coronary Artery
(Angiographic image courtesy of C. Michael Gibson MS MD, and copylefted)

### Right Coronary Artery
(Angiographic image courtesy of C. Michael Gibson MS MD, and copylefted)

# Case # 2

## EKG

## Coronary angiography

### Left Coronary Artery
(Angiographic image courtesy of C. Michael Gibson MS MD, and copylefted)

### Right Coronary Artery
(Angiographic image courtesy of C. Michael Gibson MS MD, and copylefted)

# Case # 3

## EKG

## Coronary angiography

### Left Coronary Artery
(Angiographic image courtesy of C. Michael Gibson MS MD, and copylefted)

### Right Coronary Artery
(Angiographic image courtesy of C. Michael Gibson MS MD, and copylefted)

# Case # 4

## EKG

## Coronary angiography

### Left Coronary Artery
(Angiographic image courtesy of C. Michael Gibson MS MD, and copylefted)

### Right Coronary Artery
(Angiographic image courtesy of C. Michael Gibson MS MD, and copylefted)

### Left Ventriculography
(Image courtesy of C. Michael Gibson MS MD, and copylefted)
Short tandem repeat

# Overview
A short tandem repeat (STR) in DNA is a class of polymorphisms that occurs when a pattern of two or more nucleotides are repeated and the repeated sequences are directly adjacent to each other.  The pattern can range in length from 2 to 10 base pairs (bp) (for example (CATG)n in a genomic region) and is typically in the non-coding intron region, making it junk DNA.  By examining enough STR loci and counting how many repeats of a specific STR sequence there are at a given locus, it is possible to create a unique genetic profile of an individual.  There are currently over 10,000 published STR sequences in the human genome.  STR analysis has become the prevalent analysis method for determining genetic profiles in forensic cases.

# Forensic STR Analysis
STR analysis is a relatively new technology in the field of forensics, having come into popularity in the mid-to-late 1990s.  It is used for the genetic fingerprinting of individuals. The STRs in use today for forensic analysis are all tetra- or penta-nucleotide repeats (4 or 5 repeat units), as these give a high degree of error-free data while being robust enough to survive degradation in non-ideal conditions.  Shorter repeat sequences tend to suffer from artifacts such as stutter and preferential amplification, as well as the fact that several genetic diseases are associated with tri-nucleotide repeats such as Huntington's disease.  Longer repeat sequences will suffer more highly from environmental degradation and do not amplify by PCR as well as shorter sequences.
The analysis is performed by extracting nuclear DNA from the cells of a forensic sample of interest, then amplifying specific polymorphic regions of the extracted DNA by means of the polymerase chain reaction.  Once these sequences have been amplified, they are resolved either through gel electrophoresis or capillary electrophoresis, which will allow the analyst to determine how many repeats of the STR sequence in question there are.  If the DNA was resolved by gel electrophoresis, the DNA can be visualized either by silver staining (not very high resolution, safe, inexpensive), or an intercalating dye such as ethidium bromide (fairly sensitive, moderate health risks, inexpensive), or as most modern forensics labs use, fluorescent dyes (highly sensitive, safe, expensive).  Instruments built to resolve STR fragments by capillary electrophoresis also use fluorescent dyes to great effect. It also used to follow up BMT patients.
In the United States, 13 core STR loci have been decided upon to be the basis by which an individual genetic profile can be generated.  These profiles are stored on a local, state and national level in DNA databanks such as CODIS.  The British data base for STR loci identification is the UK National DNA Database (NDNAD). The British system uses 10 loci, rather than the American 13 loci.
Y-STRs (STRs on the Y chromosome) are often used in genealogical DNA testing.
Safe injection site
Safe injection sites (also known as Supervised injection sites) are places for intravenous injectors of illegal drugs to use their drugs in a controlled and monitored environment.
However, they are the subject of much controversy. Proponents argue that these spaces save lives and improve hygiene for injecting drug users and act as a harm reduction strategy for the community overall by reducing the overdose factor, and prevalence of blood-borne diseases. Opponents state that sites send the message that the government promotes illegal drug use, and that the sites themselves are unnecessary, costly, and contribute to crime in the area which they are situated.
In North America, the first safe injection site, Insite, was established in the Downtown Eastside area of Vancouver, British Columbia in late 2003. As of early 2006, it has more than 7,000 participants registered, and staff have assisted in preventing over 200 overdoses.
At the other end of the spectrum from the safe injection site is the "shooting gallery", an unregulated typically unclean indoor space frequented by drug users and often prostitutes.

# Notes
-  Chris Barrish (10 June 2006). "To stop AIDS 'breeding ground' needle exchange a must, many say". The News Journal. pp. A1, A5. Retrieved 10 June 2006..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} Note: this article contains a picture of the interior of a "shooting gallery"
Saint Paul Hospital
Saint Paul Hospital is a large multi-field medical complex situated in the central part of Hanoi - the capital of Vietnam. The hospital was founded during the French colonial rule in Indochina (19-th - early 20-th centuries).
In 2001, it has been helped by the United States non-governmental organisations of Counterpart International, Project Hope, and World Medical Relief, in medicines and medical equipment worth USD 302,457 for its emergency services . Norway, the United States, Japan and Netherlands in January, 2007 pledged to donate 7 million US dollars to establish a modern research centre at the hospital. 
By declared plans of the Hanoi Health Department, Saint Paul Hospital will be upgraded to have a 6-storey building with 100 beds for the Therapeutics Ward and similar building with 150 beds for the Pediatrics Ward. The Hospital's second branch will have 500 beds after renovation.
Salmeterol overdose

# Overdosage topics
Signs/symptoms
Treatment

## Signs/symptoms
The expected signs and symptoms with overdosage are those of excessive beta-adrenergic stimulation and/or occurrence or exaggeration of any of the following symptoms: seizures, angina, hypertension or hypotension, tachycardia with rates up to 200 beats/min, arrhythmias, nervousness, headache, tremor, muscle cramps, dry mouth, palpitation, nausea, dizziness, fatigue, malaise, and insomnia. Overdosage with salmeterol may be expected to result in exaggeration of the pharmacologic adverse effects associated with beta-adrenoceptor agonists, including tachycardia and/or arrhythmia, tremor, headache, and muscle cramps. Overdosage with salmeterol can lead to clinically significant prolongation of the QTc interval, which can produce ventricular arrhythmias. Other signs of overdosage may include hypokalemia and hyperglycemia.
As with all sympathomimetic aerosol medications, cardiac arrest and even death may be associated with abuse of Serevent Inhalation Aerosol. Return to top

## Treatment
Treatment consists of discontinuation of salmeterol together with appropriate symptomatic therapy. The judicious use of a cardioselective beta-receptor blocker may be considered, bearing in mind that such medication can produce bronchospasm. There is insufficient evidence to determine if dialysis is beneficial for overdosage of salmeterol. Cardiac monitoring is recommended in cases of overdosage. Return to top
Adapted from the FDA Package Insert.
Samarium(II) iodide
Samarium(II) iodide (SmI2) is a green solid composed of samarium and iodine, with a melting point of 520 C. It can be formed by high temperature decomposition of SmI3 (the more stable iodide), but a convenient lab preparation is to react Sm powder with 1,2-diiodoethane in anhydrous THF, or CH2I2 may also be used. Samarium(II) iodide is a powerful reducing agent - for example it rapidly reduces water to hydrogen. It is available commercially as a dark blue 0.1 M solution in THF.
Samarium(II)iodide has become a popular reagent for carbon-carbon bond formation, for example in a Barbier reaction (similar to the Grignard reaction) between a ketone and an alkyl iodide to form a tertiary alcohol:
RI + R'COR  R(R')C(OH)R
Typical reaction conditions use SmI2 in THF in the presence of catalytic NiI2.
Esters react similarly (adding two R groups), but aldehydes give by-products. The reaction is convenient in that it is often very rapid (5 minutes or less in the cold). Although samarium (II) iodide is considered a powerful single-electron reducing agent, it does display remarkable chemoselectivity among functional groups. For example, sulfones and sulfoxides can be reduced to the corresponding sulfide in the presence of a variety of carbonyl-containing functionalities (such as esters, ketones, amides, aldehydes, etc). This is presumably due to the considerably slower reaction with carbonyls as compared to sulfones and sulfoxides. Furthermore, hydrodehalogenation of halogenated hydrocarbons to the corresponding hydrocarbon compound can be achieved using samarium (II) iodide. Also, it can be monitored by the color change that occurs as the dark blue color of SmI2 in THF discharges to a light yellow once the reaction has occurred. The picture shows the dark colour disappearing immediately upon contact with the Barbier reaction mixture.
Work-up is with dilute hydrochloric acid, and the samarium is removed as aqueous Sm3+.
Carbonyl compounds can also be coupled with simple alkenes to form five, six or eight membered rings.
The applications of SmI2 have been reviewed.
Sambucus canadensis
Sambucus canadensis (American Elderberry) is a species of elderberry native to a large area of North America east of the Rocky Mountains, and south through eastern Mexico and Central America to Panama. It grows in a variety of conditions including both wet and dry soils, primarily in sunny locations.
It is a deciduous suckering shrub growing to 3 m or more tall.
The leaves are arranged in opposite pairs, pinnate with five to nine leaflets, the leaflets around 10 cm long and 5 cm broad.
In summer, it bears large (20-30 cm diameter) corymbs of white flowers above the foliage, the individual flowers 5-6 mm diameter, with five petals.
The fruit is a dark purple to black berry 3-5 mm diameter, produced in drooping clusters in the fall. The berries are edible, but other parts of the plant are poisonous, containing toxic calcium oxalate crystals.
It is closely related to the European Sambucus nigra, and some authors treat it as conspecific, under the name Sambucus nigra subsp. canadensis.
Uses for the fruit include: medicinal products, wine, jelly and dye.
Research on elderberries is being conducted at The University of Missouri's South West Center in Mounty Vernon and at the Missouri State Fruit Experiment Station in Mountain Grove.
Sample (statistics)
In statistics, a sample is a subset of a population. Typically, the population is very large, making a census or a complete enumeration of all the values in the population impractical or impossible. The sample represents a subset of manageable size. Samples are collected and statistics are calculated from the samples so that one can make inferences or extrapolations from the sample to the population. This process of collecting information from a sample is referred to as sampling.
The best way to avoid a biased or unrepresentative sample is to select a random sample, also known as a probability sample. A random sample is defined as a sample where the probability that any individual member from the population being selected as part of the sample is exactly the same as any other individual member of the population. Several types of random samples are simple random samples, systematic samples, stratified random samples, and cluster random samples.
A sample that is not random is called a nonrandom sample or a nonprobability sample. Some examples of nonrandom samples are convenience samples, judgment samples, purposive samples, quota samples, snowball samples, and quadrature nodes in quasi-Monte Carlo methods.
The concept of a sample thus includes the process of how the data are obtained (that is, the random variables). This is necessary so that mathematical statements can be made about the sample and statistics computed from it, such as the sample mean and covariance.
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Synonyms and keywords:
First statement
Overview
A paradoxical embolism refers to a phenomenon of dislodging a clot from venous vasculature which traverses through intracardiac or intrapulmonary shunt into systemic circulation. If dislodged into brain, it could cause ischemic stroke with neurological manifestations depending on the site of blockade of intracranial arteries.
Pathophysiology
Paradoxical embolism involves passage of a venous clot (thrombus) from a vein to an artery. When clots in veins break off (embolize), they travel first to the right side of the heart and, normally, then to the lungs where they lodge, causing pulmonary embolism. On the other hand, when there is a hole in the wall between the two upper chambers of the heart (an atrial septal defect), a clot can cross from the right to the left side of the heart, then pass into the arteries as a paradoxical embolism. Once in the arterial circulation, a clot can travel to the brain, block a vessel there, and cause a stroke (cerebrovascular accident). The clot can lodge in the cerebral circulation, the coronary circulation, the mesenteric circulation, or in the circulation to a limb.
Diagnosis
Three conditions are required to meet clinical diagnosis:
1) Venous source of embolism
2) Presence of intracardiac shunt or pulmonary fistula
3) Arterial Embolism
Echocardiography
A bubble study can be useful in establishing the presence of right-to-left shunting in the evaluation of the patient with suspected paradoxical embolism. It should be noted that bidirectional shunting can also be associated with paradoxical embolism.
Treatment
Treatment of paradoxical embolization involves either:
Closure of the defect in the heart( closure of an atrial septal defect (ASD), ventricular septal defect (VSD), or patent foramen ovale (PFO))
Anticoagulation
Placement of a inferior vena cava (IVC) filter
Discontinuation of birth control pills
Smoking cessation