Persius/hicric huggingface dataset:
Very low calorie diet
Very low calorie diet (VLCD) is a diet with very or extremely low calorie consumption per day. It is defined medically as a diet of 800 kilocalories per day or less. VLCDs are formulated, nutritionally complete, liquid meals containing 3350 kJ (800 kcal) or less per day. VLCDs also contain the recommended daily requirements for vitamins, minerals, trace elements, fatty acids and protein. The VLCD products are usually a powder which is mixed with water, juice or other low calorie liquid.
A VLCD diet is aimed primarily for severely or morbidly obese adults who must lose significant amounts of weight quickly, in order to live. It is also for those individuals who wish to lose some of their weight as rapidly as possible in a safe manner. Because of the extremely low calories per day, a VLCD diet cannot be used by children no matter how obese. The average weight loss on the VLCD program is in the range of 3 to 5 pounds per week, but it is to be remembered that at first you only lose excess liquid from your body.
A VLCD should never be undertaken without medical supervision.

# Health benefits
A 1997 study concludes that the short-term use of a VLCD is very effective in rapidly improving glycaemic control and promoting substantial weight loss in obese patients with Type 2 diabetes. Moreover, a VLCD increases insulin sensitivity and reduces the substrate for gluconeogenesis. Thus VLCD treatment may improve glycaemic control more than calorie restriction alone.

# Adverse effects
The risk of gallbladder disease is greatly increased for individuals following a VLCD. 
A slowing of one's metabolism can occur as your body adapts so the brain and central nervous system, as well as other bodily systems, will cease to work efficiently.
The body will break down fat, but it will also break down muscle and other lean body tissue which can be very dangerous.
An imbalance in minerals and electrolytes can occur. Osteoporosis can be another danger, especially for women as can anaemia (a lack of iron in the blood). If taken to extremes, women can find that menstruation (periods) becomes irregular or stops altogether. A lack of serotonin in the brain can lead to clinical depression. The lack of essential nutrients on a very low calorie diet leads to a deterioration in the condition of hair and nails.
Another potential side effect is constipation (depends on the fibre content of the diet).
Vesicovaginal fistula
Vesicovaginal fistula (VVF) is a subtype of female urogenital fistula (UGF).

# Presentation
VVF is an abnormal fistulous tract extending between the bladder and the vagina that allows the continuous involuntary discharge of urine into the vaginal vault.
In addition to the medical sequelae from these fistulas, they often have a profound effect on the patient's emotional well-being.

# Causes
It is often caused by childbirth (in which case it is known as an obstetric fistula), when a prolonged labor presses the unborn child tightly against the pelvis, cutting off blood flow to the vesicovaginal wall.  The affected tissue may necrotize, leaving a hole.
Vaginal fistulas can also result from violent rape. This injury has become common in some war zones, where rape is used as a weapon against civilian populations. As a result, some health centers in countries such as the Democratic Republic of Congo have begun to specialize in the surgical repair of vaginal fistulas.
Vestibulospinal tract

# Overview
The vestibulospinal tract is one of the descending spinal tracts of the ventromedial pathway. It originates from the vestibular nuclei of the medulla, which conducts information from the vestibular labyrinth in the inner ear.
Motion of fluid in the vestibular labyrinth activates hair cells that signal the vestibular nuclei via cranial nerve VIII.

# Parts
The medial part of the vestibulospinal tract project bilaterally down the spinal cord and triggers the cervical spinal circuits, controlling a right position of the head and neck.
The lateral part of the vestibulospinal tract projects ipsilateral down to the lumbar region. There it helps to maintain an upright and balanced posture by stimulating extensor motor neurons in the legs.
Vickers hardness test
The Vickers hardness test was developed in the early 1920s as an alternative method to measure the hardness of materials. The Vickers test is often easier to use than other hardness tests since the required calculations are independent of the size of the indenter, and the indenter can be used for all materials irrespective of hardness. The basic principle, as with all common measures of hardness, is to observe the questioned materials' ability to resist plastic deformation from a standard source. The Vickers test can be used for all metals and has one of the widest scales among hardness tests. The unit of hardness given by the test is known as the Vickers Pyramid Number (HV). The hardness number can be converted into units of Pa, but should not be confused with a pressure, which also has units of Pa. The hardness number is determined by the load over the surface area of the indentation and not the area normal to the force, and is therefore not a pressure.
The hardness number is not really a true property of the material and is an empirical value that should be seen in conjunction with the experimental methods and hardness scale used. When doing the hardness tests the distance between indentations must be more than 2.5 indentation diameters apart to avoid interaction between the work-hardened regions.
The yield strength of the material can be approximated as
where c is a constant determined by geometrical factors usually ranging between 2 and 4.

# Implementation
The Vickers hardness test uses a diamond, with the shape of square-based pyramid with an angle of 136 between opposite faces as an indenter (22 between the indenter face and surface). It is based on the principle that impressions made by this indenter are geometrically similar regardless of load. Accordingly, loads of various magnitudes are applied to a flat surface, depending on the hardness of the material to be measured. The Vickers Pyramid Number (HV) is then determined by the ratio F/A where F is the force applied to the diamond and A is the surface area of the resulting indentation. A can be determined by the formula
which can be approximated by evaluating the sine term to give
where d is the average length of the diagonal left by the indenter. Hence,
The corresponding units of HV are then kilogram-force per square millimetre (kgf/mm2). To convert a Vickers hardness number in SI units (MPa or GPa) one needs to convert the force applied from kgf to newtons and the area from mm2 to m2  to give results in pascals (1 kgf/mm2 = 9.80665106 Pa).
A practical method to convert HV to SI units:
Vickers hardness numbers are reported as xxxHVyy, e.g. 440HV30, where:
- 440 is the hardness number,
- HV gives the hardness scale (Vickers),
- 30 indicates the load used in kg.

# Examples
Some HV values
- Stainless Steels 140-180HV30 (316L & 347L stainless respectively)
- Carbon Steel 55-120HV5 (Note: load is different to that of stainless)
- Iron 30-80HV5
- Case Hardened Steel - Rapid Quench - Vickers Hardness Test
Case Hardened Steel - Rapid Quench - Vickers Hardness Test
Von Meyenburg complex
Synonyms and keywords: Biliary hamartomas; biliary microhamartomas

# Overview
The Von Meyenburg complex is a form of hepatic hamartoma. They are found in the periportal zone.

# Historical Perspective
It is named for Hans von Meyenburg.

# Diagnosis
The Imaging findings are
- Biliary hamartomas are typically multiple round or irregular focal lesions of nearly uniform size (up to 15 mm) scattered throughout the liver.
- CT:Biliary hamartomas are hypoattenuating at CT
- MRI:Biliary hamartomas are hypointense at T1-weighted MR imaging and hyperintense at T2-weighted imaging. If the echo time is increased at T2-weighted imaging, the signal intensity of these lesions increases further and approaches that of cerebrospinal fluid. Biliary hamartomas do not usually show contrast enhancement, although a peripheral enhancing rim has been described. This has been hypothesized as related to compressed surrounding normal liver parenchyma
- T2
- T2Image:
- T1 with GD
- Out of phase
- In phase
Wastebasket diagnosis
A trashcan diagnosis or wastebasket diagnosis is a vague or fake medical or psychiatric diagnosis that is given to the patient or to the medical records department for essentially non-medical reasons.  It may be given when there's obviously something wrong but the doctor doesn't know what it is, when the doctor wants to reassure an anxious patient about the doctor's belief in their symptoms, when the patient is pressuring the doctor for a label, or when the doctor wants to facilitate bureaucratic approval of treatment.
The term may also be used pejoratively to describe disputed medical conditions.  In this sense, the term is somewhat pejorative, in that it implies that the condition has not been properly classified.  It can carry a connotation that the prognosis of individuals with the condition are more heterogeneous than would be associated with a more precisely defined clinical entry.  As diagnostic tools improve, it is possible for these kinds of wastebasket diagnoses to be properly defined and reclassified as a clinical diagnosis.
In the best circumstances, a trashcan diagnosis gives the patient and physician a convenient label for talking about the patient's problems while they are attempting to address the specific issues.  In the worst circumstances, the existence of the label results in the patient and physician "treating the label" instead of treating the patient's actual problems.

# Specific diagnoses
Many alternative medicine diagnoses, such as candida overgrowth and multiple chemical sensitivities, are considered trashcan diagnoses by medical personnel.
Diagnoses which include a wide variety of complaints and symptoms are particularly prone to being used as trashcan diagnoses, as well as diseases with variable presentations.  For example, fibromyalgia has been used as a trashcan diagnosis to describe chronic pain.  Costochondritis, gastroesophageal reflux, and chronic fatigue syndrome are all commonly used as trashcan diagnoses.  Bronchitis may be used as a trashcan diagnosis to label sick children.  Reactive hypoglycemia has been used as a trashcan diagnosis for people who complain about normal physiological reactions to being hungry.  In these cases, the labels are offered when nothing more serious can be identified.
Some diagnoses are being used as trashcan diagnoses in response to unintentional incentives.  For example, government-run schools in the United States get additional funding for providing services to students with autism spectrum disorders, so some children with nontypical behavior patterns are labeled as having ASD so that the school can obtain more funding.
Some trashcan diagnoses such as schizophrenia have become more narrowly defined and are now used to refer to specific problems. Others, such as borderline personality disorder, have had a variety of definitions over the years.

# History
Fake diagnoses are not a modern invention.  Medicine around the world has a long history of using and abusing the concept of trashcan diagnoses, from "rectifying the humours" to neurasthenia to garbled Latin-sounding names which were made up to impress the patient's family.
Water pipe percolator
A water pipe percolator is a small additional sub chamber within the main chamber of a water pipe that  
provides in-line smoke-water interaction via heat exchange and dissolution.

# Function and Purpose
A percolator works by utilizing a pressure differential between its bottom and top in/outlets. Reduced pressure at  
the outlet end is usually provided by the users lungs. The fluid at the inlet (ie: a smoke, vapor, and air mixture)  
is directed to the bottom of a column of water, where the pressure differential causes the inlet fluid to pass  
though the water in small pockets (liquid bubbles), and then rise to the outlet.
File:Percolator col 2.gif
Figure: Schematic of the flow through a percolator (inlet at bottom, outlet at top).
1. Initial state
2. Water displacement 
3. Flow
- The percolator serves the primary function of cooling the smoke and combustion vapors that pass through it. The surface of the bubbles come into direct contact with the water, where the temperature difference causes an exchange of heat between the hot smoke/vapor, and the cool water. Many percolator designs incorporate a number of small openings within the water instead of large singular ones in order to diffuse the smoke into a larger number of smaller bubbles. This serves the purpose of increasing the surface area of the smoke that is in contact with the water and increasing the efficiency of heat transfer.
- A secondary function of the percolator is to trap certain components contained within the smoke. Water soluble substances enter into solution as the smoke/vapor contacts the water, while less soluble substances pass through with relative ease. However, studies conducted by MAPS and CA-NORML have demonstrated that filtration by solvation is inneffective when consuming smoked cannabis. The studies infer that the solubility of Cannabinoids, the active components in the smoke, are similar to or greater than that of tar, and so no (or negative) "filtration" takes place. There is no data available for tobacco or other substances.
- A tertiary function of the percolator is to hydrate the air-smoke-vapor mixture. Humidity of the air passing through the percolator water is increased. The increased humidity reduces the irritation to the upper respiratory tract experienced by some users according to anecdotal claims.

# Types
There are a number of percolator designs on the market today. The two most prevalent are the branched and  
cylindrical designs.

## Branched
Branched percolators utilize between 1 and 4 individual flow paths for the smoke to enter the water. This design is more recent than the cylindrical design. Branched percolators are sometimes referred to as "tree" percolators due to their geometry. See image.

## Cylindrical
Cylindrical percolators instead use a single encirculating cylindrical piece to direct smoke to the bottom of the water column. Cylindrical percolators may be essentially interpreted as the branch design with an infinite number of branches compounded together to form one singular flow path. Cylindrical percolators are sometimes referred to as "dome" percolators due to their geometry. See image.
Wolff-Chaikoff effect
Wolff-Chaikoff effect is used to describe hypothyroidism caused by ingestion of a large amount of iodine.
It is an autoregulatory phenomenon which inhibits formation of thyroid hormones inside of the thyroid follicle. This becomes evident secondary to elevated levels of circulating iodide. Wolff-Chaikoff effect lasts several days, after which it is followed by an "escape phenomenon", which is described by resumption of normal organification of iodine and normal thyroid peroxidased function. "Escape phenomenon" is believed to occur because of decreased inorganic iodine concentration secondary to down-regulation of sodium-iodide symporter on the basolateral membrane of the Thyroid Follicular cell.
Wolff-Chaikoff effect can be used as a treatment principle against thyroid storm by infusion a large amount of iodine to shut down the hyperfunctioning thyroid gland, or an unpleasant iatrogenic effect of several iodine containing drugs, of which the most famous is amiodarone.
Zanamivir description

# Description
The active component of RELENZA is zanamivir. The chemical name of zanamivir is 5-(acetylamino)-4--2,6-anhydro-3,4,5-trideoxy-D-glycero-D-galacto-non-2-enonic acid. It has a molecular formula of C12H20N4O7 and a molecular weight of 332.3. It has the following structural formula:
Zanamivir is a white to off-white powder for oral inhalation with a solubility of approximately 18 mg/mL in water at 20C.
RELENZA is for administration to the respiratory tract by oral inhalation only. Each RELENZA ROTADISK contains 4 regularly spaced double-foil blisters with each blister containing a powder mixture of 5 mg of zanamivir and 20 mg of lactose (which contains milk proteins). The contents of each blister are inhaled using a specially designed breath-activated plastic device for inhaling powder called the DISKHALER. After a RELENZA ROTADISK is loaded into the DISKHALER, a blister that contains medication is pierced and the zanamivir is dispersed into the air stream created when the patient inhales through the mouthpiece. The amount of drug delivered to the respiratory tract will depend on patient factors such as inspiratory flow. Under standardized in vitro testing, RELENZA ROTADISK delivers 4 mg of zanamivir from the DISKHALER device when tested at a pressure drop of 3 kPa (corresponding to a flow rate of about 62 to 65 L/min) for 3 seconds.
11-nor-9-Carboxy-THC

# Overview
11-nor-9-Carboxy-9-tetrahydrocannabinol (11-COOH-THC, THC-COOH, THC-11-oic acid) is the main secondary metabolite of THC which is formed in the body after cannabis is smoked.
11-COOH-THC is formed in the body by oxidation of the active metabolite 11-Hydroxy-THC by liver enzymes. It is then metabolised further by conjugation with glucuronide, forming a water-soluble congener which can be more easily excreted by the body.
11-COOH-THC is not psychoactive itself, but has a long half-life in the body of up to several days (or even weeks in very heavy users), making it the main metabolite tested for when blood or urine testing for cannabis use. More sensitive tests are able to distinguish between 11-OH-THC and 11-COOH-THC, which can help determine how recently cannabis was consumed; if only 11-COOH-THC is present then the cannabis was used some time ago and any impairment in cognitive ability or motor function will have dissipated, whereas if both 11-OH-THC and 11-COOH-THC are present then the cannabis was consumed more recently and motor impairment may still be present.
Some jurisdictions where cannabis use is decriminalised or permitted under some circumstances use such tests when determining whether drivers were legally intoxicated and therefore unfit to drive, with the comparative levels of THC, 11-OH-THC and 11-COOH-THC being used to derive a "blood cannabis level" analogous to the blood alcohol level used in prosecuting impaired drivers. On the other hand in jurisdictions where cannabis is completely illegal, any detectable levels of 11-COOH-THC may be deemed to constitute driving while intoxicated, even though this approach has been criticised as tantamount to prohibition of "driving whilst being a regular user of cannabis" regardless of the presence or absence of any actual impairment that might impact on driving performance.
While 11-COOH-THC does not have any psychoactive effects in its own right, it may still have a role in the analgesic and antiinflammatory effects of cannabis, and has also been shown to moderate the effects of THC itself which may help explain the difference in subjective effects seen between occasional and regular users of cannabis.
Toluene diisocyanate

# Overview
Toluene diisocyanate (TDI) is an aromatic diisocyanate. It is produced for reaction with polyols to form polyurethanes. It exists in two isomers, 2,4-TDI (CAS: 584-84-9) and 2,6-TDI (CAS: 91-08-7). 2,4-TDI is produced in the pure state, but TDI is often marketed as 80/20 and 65/35 mixtures of the 2,4 and 2,6 isomers respectively. It is a highly produced diisocyanate, accounting for 34.1% of the global isocyanate market in 2000, second only to MDI.

# Synthesis
There are six steps to the synthesis of pure 2,4-TDI:
- Nitration: Reaction of toluene with nitric acid and a catalyst to form dinitrotoluene
- Hydrogenation: Reaction of the dinitrotoluene with hydrogen and a catalyst to form a mixture of isomers of toluene diamine (TDA)
- Purification: Distillation of the TDA mixture to produce meta-TDA
- Phosgenation: Reaction of the meta-TDA with phosgene to form a crude TDI mixture
- Purification: Distillation of the crude TDI mixture to produce an 80:20 mixture of 2,4-TDI and 2,6-TDI, known as TDI (80/20)
- Differentiation: Separation of the TDI (80/20) to produce pure 2,4-TDI and a 65:35 mixture of 2,4-TDI and 2,6-TDI, known as TDI (65/35)

# Chemistry
Each of the isocyanate functional groups in TDI can react with a hydroxyl group to form a urethane linkage.
2,4-TDI is an asymmetrical molecule and thus has two isocyanate groups of different reactivity. The 4-position is approximately four times more reactive than the 2-position. 2,6-TDI is a symmetrical molecule and thus has two isocyanate groups of similar reactivity, similar to the 2-position on 2,4-TDI. However, since both isocyanate groups are attached to the same aromatic ring, reaction of one isocyanate group will cause a change in the reactivity of the second isocyanate group.

# Hazards
Exposure to TDI and its vapors should be avoided. It is a well-documented causative agent of asthma.
3-Methylthiofentanyl
3-Methyl-thiofentanyl is an opioid analgesic that is an analogue of fentanyl.
3-Methyl-thiofentanyl was sold briefly on the black market in the early 1980s, before the introduction of the Federal Analog Act which for the first time attempted to control entire families of drugs based on their structural similarity rather than scheduling each drug individually as they appeared. 
3-Methyl-thiofentanyl has similar effects to fentanyl. Side effects of fentanyl analogues are similar to those of fentanyl itself, which include itching, nausea and potentially serious respiratory depression which can be life-threatening.
7-Dehydrocholesterol

# Overview
7-Dehydrocholesterol is a zoosterol that functions in the serum as a cholesterol precursor, and is converted to pre-vitamin D3 in the skin, therefore functioning as provitamin-D3. The presence of this compound in human skin enables humans to manufacture vitamin D3 from ultra-violet rays in the sun light, via an intermediate isomer pre-vitamin D3. It is also found in the milk of several mammalian species. It was discovered by Nobel-laureate organic chemist Adolf Windaus.

# Location
The skin consists of two primary layers: the inner layer called the dermis, composed largely of connective tissue, and the outer thinner epidermis. The thickness of the epidermis ranges from 0.08mm to more than 0.6mm (0.003 to 0.024 inches). The epidermis consists of five strata; from outer to inner they are: the stratum corneum, stratum lucidum, stratum granulosum, stratum spinosum, and stratum basale. The highest concentrations of 7-dehydrocholesterol are found in the epidermal layer of skin, specifically in the stratum basale and stratum spinosum. The production of pre-vitamin D3 is therefore greatest in these two layers, whereas production in the other layers is reduced.

# Radiation
Synthesis of pre-vitamin D3 in the skin involves UVB radiation which effectively penetrates only the epidermal layers of skin. 7-Dehydrocholesterol absorbs UV light most effectively at wavelengths between 270290 nm and thus the production of vitamin D3 will only occur at those wavelengths. The two most important factors that govern the generation of pre-vitamin D3 are the quantity (intensity) and quality (appropriate wavelength) of the UVB irradiation reaching the 7-dehydrocholesterol deep in the stratum basale and stratum spinosum. Another important consideration is the quantity of 7-dehydrocholesterol present in the skin. Under normal circumstances, ample quantities of 7-dehydrocholesterol (about 2550 mg/cm2 of skin) are available in the stratum spinosum and stratum basale of human skin to meet the body's vitamin D requirements.
ACTH-secreting tumor

# Overview
An ACTH secreting tumor is a type of pituitary adenoma which produces ACTH.

# Pathophysiology
The tumor stains basophilic on pathologic examination.  The excess production of ACTH by the tumor results in Cushing's syndrome.

# Diagnosis
Pituitary adenomas may grow and compress adjacent structures, most commonly causing a bitemporal hemianopsia due to compression of the optic chiasm. Lateral extension into the cavernous sinuses can result in cranial nerve palsies.