Persius/hicric huggingface dataset:
HAZMAT Class 4 Flammable Solids

# Overview
Flammable solids are any materials in the solid phase of matter that can readily undergo combustion in the presence of a source of ignition under standard circumstances, i.e. without:
- Artificially changing variables such as pressure or density; or
- Adding accelerants.

# Divisions
Division 4.1: Flammable Solid
Flammable solids are any of the following three types of materials:
- Desensitized Explosives: explosives that, when dry, are Explosives of Class 1 other than those of compatibility group A, which are wetted with sufficient water, alcohol, or plasticizer to suppress explosive properties; and are specifically authorized by name either in the 49CFR 172.101 Table or have been assigned a shipping name and hazard class by the Associate Administrator for Hazardous Materials Safety.
- Self-Reactive Materials: materials that are thermally unstable and that can undergo a strongly exothermic decomposition even without participation of oxygen (air). Certain exclusions to this group do apply under 49 CFR.
- Generic Types: Division 4.1 self-reactive materials are assigned to a generic system consisting of seven types. A self-reactive substance identified by technical name in the Self-Reactive Materials Table in 49CFR 173.224 is assigned to a generic type in accordance with that Table. Self-reactive materials not identified in the Self-Reactive Materials Table in 49CFR 173.224 are assigned to generic types under the procedures of paragraph (a)(2)(iii) of this section.
- Readily Combustible Solids: materials that are solids which may cause a fire through friction, such as matches; show a burning rate faster than 2.2 mm (0.087 inches) per second when tested in accordance with UN Manual of Tests and Criteria; or are any metal powders that can be ignited and react over the whole length of a sample in 10 minutes or less, when tested in accordance with UN Manual of Tests and Criteria.
Division 4.2: Spontaneously Combustible
Spontaneously combustible material is:
- Pyrophoric Material: A pyrophoric material is a liquid or solid that, even in small quantities and without an external ignition source, can ignite within five (5) minutes after coming in contact with air when tested according to the UN Manual of Tests and Criteria.
- Self-Heating Material: A self-heating material is a material that, when in contact with air and without an energy supply, is liable to self-heat.
Division 4.3: Dangerous When Wet
Dangerous when wet material is material that, by contact with water, is liable to become spontaneously flammable or to give off flammable or toxic gas at a rate greater than 1 liter per kilogram of the material, per hour, when tested in accordance with the UN Manual of Tests and Criteria.

# Placards

# Compatibility Table
Hereditary neuralgic amyotrophy
Hereditary Neuralgic Amyotropy, alternatively referred to as HNA, is a neuralgic disorder that is characterized by nerve damage and muscle atrophy, preceded by severe pain. It is caused by a mutation to the gene locus 17-q25 of the septin 9 gene. While not much is known about this disorder, it has been characterized to be similar to Parsonage-Turner syndrome in prognosis.
HNA is an episodic disorder; it is characterized by episodes generally lasting 1-6 weeks. During an episode, the nerves of the brachial plexus are targeted by the body as antigens, and the body's immune system begins to degenerate the nerves of the brachial plexus. The exact order or location of the nerve degeneration cannot be deciphered before an episode, as HNA is a highly variable disorder. Other areas of the nervous system that have been targeted in past cases are the phrenic nerves and the recurrent laryngeal. As the nerves lose function, the muscles associated with those nerves begin to atrophy. In brachial plexus degeneration, atrophy may occur in the deltoids. In phrenic nerve degeneration, the diaphragm may be affected. In this case, breathing can be impaired due to a lack of muscle control of the diaphragm. If the recurrent larangyl is targeted, the pharynx will begin to atrophy and voice function may be lost.

# Symptoms
Symptoms of HNA may include pain in the back, neck, arms, or shoulders, nerve pulls in the arms or back, muscular atrophy, and weakness. 

# Treatment
The severe pain of HNA can be controlled with an anti-inflammatory drug such as prednisone, although it is unknown whether these anti-inflammatory drugs actually slow or stop the nerve degeneration process.
Nerve regeneration after an episode is normal, and in less severe cases a full recovery of the nerves and muscles can be expected. However, in a severe case permanent nerve damage may occur.
How to create a calculator page

# Overview
This section provides a step-by-step guide on how to create a calculator page. It starts by choosing a topic of interest from the topics and simply following the instructions below.

# How to create calculators

## Select a Topic
A topic of interest is selected from the list of the most popular risk scores and a name is assigned next to it. Click here to select a topic.

## Before Creating a Page
Use the official name for the risk score or criteria from the index article.
If there is more than one score with the same name, create a landing page that has links to the corresponding pages.
For example, Wells score may refer to Wells score for DVT (original), Wells score for DVT (modified), Wells score for PE (original), or Wells score for PE (modified).

## Create a Page
Use the template for the calculator page.

## Create a Widget
Use the template for the calculator widget page. Replace the names, variables, and values accordingly.
Insert widget code into the page. {{#widget:Calculator_widget_template}}

## Add Appropriate Category
Add all the following categories as well as related systems:
] ==> If the calculator is externally validated by other groups
] ==> Whenever is applicable
] ==> Whenever is applicable
] ==> Whenever is applicable

# Notes
To view the page correctly on the cell phone, please use the following symbols:
- Instead of < use "<"
- Instead of > use ">"

# Resources
- Create a New Page: Click here
- How to create a page on WikiDoc: Click here
- How to add a reference: Click here
How to create a guidelines page

# How to Create A Guidelines Page
The following steps should be followed when adding or updating the guidelines:

## Select a Topic
- To claim a topic, email WikiDoc  with the name of the topic you are choosing.
- Active assignments can be viewed here.

## Next Steps
1. Open the disease page you have chosen to add or update the guidelines.
2. Start with the second-level heading (==) and add "(DO NOT EDIT)" at the end of the title as shown in the example below.
3. Use the third-level heading (===) for the subsection and add "(DO NOT EDIT)" at the end of subsection-title as shown in the example below.
4. Use following codes to make tables for adding the guidelines according to their classification in the following order:

### Class I
What you type,
What it looks like,

### Class III
What you type,
What it looks like,

### Class II
What you type,
What it looks like,
5. Include the reference article in the sources section as shown in the example below.
What you type,
What it looks like,
6. Click on the following link to learn about adding appropriate references.
Help:Adding References to Articles
Hudson River Psychiatric Center
The  Hudson River State Hospital, later known as the Hudson River Psychiatric Center is a former psychiatric hospital that has been designated a National Historic Landmark for its extraordinary architecture. It is located on US 9 just north of Poughkeepsie, where it dominates the view to the east of the road.
The facility is linked to Frederick Clark Withers, a partner with Calvert Vaux and Frederick Law Olmsted (famous for their design of Central Park), who created a Gothic Revival plan for a mental health institution.
The main building was designated a National Historic Landmark in 1989.,,
The building was closed down in 2003 and since then has fallen into a state of disrepair. It was seriously damaged in a 2007 fire. It is not open to the public and the Town of Poughkeepsie police regularly patrol the site to discourage trespassing.
Stewart-Morel-Morgagni Syndrome
Synonyms and keywords: Morel's syndrome, Morel-Moore syndrome, Morgagnis syndrome, Morgagni's trias, Morgagni-Morel-Stewart syndrome, Stewart-Morel syndrome, Stewart-Morel-Morgagni syndrome, metabolic craniopathy

# Overview
Morgagni Stewart Morel syndrome is a condition characterized by thickening of the frontal bone of the skull (hyperostosis frontalis interna), as well as obesity and excessive hair growth (hypertrichosis) in some individuals. Other signs and symptoms may include seizures, headaches, diabetes insipidus, and sex gland disturbances.

# Historical Perspective
It was first described in 1765.

# Pathophysiology

## Associated Conditions
- Diabetes mellitus
- Diabetes insipidus
- Hyperparathyroidism.

# Diagnosis

## Symptoms
- Headache
- Vertigo
- Hirsutism
- Menstrual problems
- Galactorrhoea
- Obesity
- Depression
- Seizures

## Physical Examination

### Head
- Thickening of the inner table of the frontal part of the skull a usually benign condition known as  hyperostosis frontalis interna.
Innovative Medicines Initiative
The Innovative Medicines Initiative (IMI) is a European initiative to improve the competitive situation of the European Union in the field of pharmaceutical research. The IMI is a joint initiative (Public-Private Partnership) of the DG Research of the European Commission, representing the European Communities, and the European Federation of Pharmaceutical Industries and Associations (EFPIA). IMI is laid out as a Joint Technology Initiative within the Seventh Framework Programme.
The Innovative Medicines Initiative is aimed towards removing research bottlenecks in the current drug development process. The IMI Joint Technology Initiative (IMI JTI), to be implemented by the IMI Joint Undertaking is meant to address these research bottlenecks.
The Sixth Framework Programme's research projects  InnoMed AddNeuroMed and InnoMed PredTox act as pilot projects establishing the feasibility of this particular public-private partnership.
IMITREX spray adverse reactions

# Adverse Reactions
The following adverse reactions are discussed in more detail in other sections of the prescribing information:
- Myocardial ischemia, myocardial infarction, and Prinzmetals angina 
- Arrhythmias 
- Chest, throat, neck, and/or jaw pain/tightness/pressure 
- Cerebrovascular events 
- Other vasospasm reactions 
- Medication overuse headache 
- Serotonin syndrome 
- Increase in blood pressure 
- Local irritation 
- Hypersensitivity reactions 
- Seizures 

### Clinical Trials Experience
Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared with rates in the clinical trials of another drug and may not reflect the rates observed in practice.
Table 1 lists adverse reactions that occurred in worldwide placebo-controlled clinical trials in 3,419 patients with migraine. Only treatment-emergent adverse reactions that occurred at a frequency of 1% or more in the group treated with IMITREX Nasal Spray 20 mg and that occurred at a frequency greater than the placebo group are included in Table 1.
The incidence of adverse reactions in controlled clinical trials was not affected by gender, weight, or age of the patients; use of prophylactic medications; or presence of aura. There were insufficient data to assess the impact of race on the incidence of adverse reactions.

### Postmarketing Experience
The following adverse reactions have been identified during postapproval use of IMITREX Tablets, IMITREX Nasal Spray, and IMITREX Injection. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. These reactions have been chosen for inclusion due to either their seriousness, frequency of reporting, or causal connection to IMITREX or a combination of these factors.
- Cardiovascular: Hypotension, palpitations.
- Neurological: Dystonia, tremor.
IMITREX spray contraindications

# Contraindications
IMITREX Nasal Spray is contraindicated in patients with:
- Ischemic coronary artery disease (CAD) (angina pectoris, history of myocardial infarction, or documented silent ischemia) or coronary artery vasospasm, including Prinzmetals angina 
- Wolff-Parkinson-White syndrome or arrhythmias associated with other cardiac accessory conduction pathway disorders 
- History of stroke, transient ischemic attack (TIA), or history of hemiplegic or basilar migraine because these patients are at a higher risk of stroke 
- Peripheral vascular disease 
- Ischemic bowel disease 
- Uncontrolled hypertension 
- Recent use (i.e., within 24 hours) of ergotamine-containing medication, ergot-type medication (such as dihydroergotamine or methysergide), or another 5-hydroxytryptamine1 (5-HT1) agonist 
- Concurrent administration of a monoamine oxidase (MAO)-A inhibitor or recent (within 2 weeks) use of an MAO-A inhibitor 
- Hypersensitivity to IMITREX (angioedema and anaphylaxis seen) 
- Severe hepatic impairment
IMITREX spray drug interactions

# Drug Interactions

### Ergot-Containing Drugs
Ergot-containing drugs have been reported to cause prolonged vasospastic reactions. Because these effects may be additive, use of ergotamine-containing or ergot-type medications (like dihydroergotamine or methysergide) and IMITREX Nasal Spray within 24 hours of each other is contraindicated.

### Monoamine Oxidase-A Inhibitors
MAO-A inhibitors increase systemic exposure by up to 7-fold. Therefore, the use of IMITREX Nasal Spray in patients receiving MAO-A inhibitors is contraindicated .

### Other 5-HT1 Agonists
Because their vasospastic effects may be additive, co-administration of IMITREX Nasal Spray and other 5-HT1 agonists (e.g., triptans) within 24 hours of each other is contraindicated.

### Selective Serotonin Reuptake Inhibitors/Serotonin Norepinephrine Reuptake Inhibitors and Serotonin Syndrome
Cases of serotonin syndrome have been reported during co-administration of triptans and SSRIs, SNRIs, TCAs, and MAO inhibitors .
Icthyosis (patient information)

# Overview
Ichthyosis vulgaris, also known as fish scale disease or scaling skin,  is a common skin disorder passed down through families that leads to dry, scaly skin.  People or animals with ichthyosis have scaly skin which can vaguely resemble the scales of a fish.

# What are the symptoms of Icthyosis?
The symptoms of Icthyosis include:
- Dry skin, severe
- Scaly skin ( scales)
- Possible skin thickening
- Mild itching of the skin
The dry, scaly skin is usually most severe over the legs but may also involve the arms, hands, and middle of the body. Persons with this condition may also have many fine lines over the palm of the hand.

# What causes Icthyosis?
Ichthyosis vulgaris is one of the most common of the inherited skin disorders. It may begin in early childhood. The condition is inherited in an autosomal dominant pattern. That means you only need to get the abnormal gene from one parent in order for you to inherit the disease.
The condition is often more noticeable in the winter. It may occur along with atopic dermatitis, keratosis pilaris (small bumps on the back of the arms), or other skin disorders.

# Diagnosis
Your doctor can usually diagnose this condition by looking at your skin. Tests may be needed to rule out other possible causes of dry, scaly skin.
Your doctor will ask you if you have a family history of similar skin dryness.

# When to seek urgent medical care?
Call for an appointment with your health care provider if:
- Symptoms continue despite treatment
- Symptoms get worse
- Skin lesions spread
- New symptoms develop

# Treatment options
Your doctor will recommend heavy duty moisturizers. Creams and ointments work better than lotions. Apply these to moist skin immediately after bathing. You should use mild, non-drying soaps.
Your doctor may tell you to use moisturizing creams that contain chemicals that help skin to shed normally, including lactic acid, salicylic acid, and urea.

# Prevention
If you have this condition, be aware that your children are at risk for developing it.

# What to expect (Outlook/Prognosis)?
Ichthyosis vulgaris can be a nuisance, but it rarely affects your overall health. The condition usually disappears during adulthood, but may return years later.

# Possible complications
A bacterial skin infection may develop if scratching causes openings in the skin.
Imipenem cilastatin description

# Description
PRIMAXIN I.V. (Imipenem and Cilastatin for Injection) is a sterile formulation of imipenem (a thienamycin antibiotic) and cilastatin sodium (the inhibitor of the renal dipeptidase, dehydropeptidase l), with sodium bicarbonate added as a buffer. PRIMAXIN I.V. is a potent broad spectrum antibacterial agent for intravenous administration.
Imipenem (N-formimidoylthienamycin monohydrate) is a crystalline derivative of thienamycin, which is produced by Streptomyces cattleya. Its chemical name is (5R,6S)-3-thio]-6--7-oxo-1-azabicyclohept-2-ene-2-carboxylic acid monohydrate. It is an off-white, nonhygroscopic crystalline compound with a molecular weight of 317.37. It is sparingly soluble in water and slightly soluble in methanol. Its empirical formula is C12H17N3O4SH2O, and its structural formula is:
Cilastatin sodium is the sodium salt of a derivatized heptenoic acid. Its chemical name is sodium (Z )-7thio]-2--2-heptenoate. It is an off-white to yellowish-white, hygroscopic, amorphous compound with a molecular weight of 380.43. It is very soluble in water and in methanol. Its empirical formula is C16H25N2O5SNa, and its structural formula is:
PRIMAXIN I.V. is buffered to provide solutions in the pH range of 6.5 to 8.5. There is no significant change in pH when solutions are prepared and used as directed. (SeeCOMPATIBILITY AND STABILITY.) PRIMAXIN I.V. 250 contains 18.8 mg of sodium (0.8 mEq) and PRIMAXIN I.V. 500 contains 37.5 mg of sodium (1.6 mEq). Solutions of PRIMAXIN I.V. range from colorless to yellow. Variations of color within this range do not affect the potency of the product.
Immunologically privileged site

# Overview
An immunologically privileged site is any of those locations in the body--the brain, anterior chamber of the eye, testis, renal tubule, uterus, and possibly joints and adrenal glands--where immune response to antigens are not destructive to tissue or is suppressed. It is necessary due to unique self-proteins that reside only in particular tissues and do not travel through the lymphatic system. Examples of tissue-specific proteins include myelin of the central nervous system. Such proteins are sequestered in organs and extracellular fluid does not travel the lymphatic system, meaning they do not come into contact with T cells during negative selection in the thymus. Allografts to these sites are not rejected.
Immune response is modified by the privileged sites through anti-inflammatory cytokine release of TGF-beta, which suppresses immune responses likely to cause tissue damage (favors B-cell antibody release vs. macrophage activation). Cells express FasL on their surface, which binds to cytotoxic T cells and causes the cytotoxic T cells to apoptose rather than destroy the tissue of privileged sites.
Medically, a cornea transplant is currently the only procedure that takes advantage of this.
references:
Increased bowel sounds overview

# Overview
Increased (hyperactive) bowel sounds can sometimes be heard even without a stethoscope. Hyperactive bowel sounds means that there is an increase in intestinal activity. This can sometimes occur with diarrhea and after eating. Very high-pitched bowel sounds may be a sign of early bowel obstruction.

# Causes
Most of the sounds heard in the stomach and intestines are due to normal digestion and are no need for concern. Many conditions can cause hyperactive or hypoactive bowel sounds. Most are harmless and do not need to be treated.

# Diagnosis

## History and Symptoms
Complete history is critical in evaluation of the patient with increased bowel sounds.

## X Ray
X-rays (flat and upright) are useful in evaluating the cause of increased bowel sounds.

## CT
Etiology is demonstrated best by abdominal CT scan.

## Other Diagnostic Studies
Enteroclysis helps to determine the degree of obstruction.

# Treatment

## Surgery
Complete bowel obstruction usually requires surgical intervention.
Inositol trisphosphate receptor
Inositol trisphosphate receptor (InsP3R) is a membrane glycoprotein complex acting as a Ca2+ channel activated by inositol trisphosphate (InsP3). InsP3R is very diverse among organisms, and is necessary for the control of cellular and physiological processes including cell division, cell proliferation, apoptosis, fertilization, development, behavior, learning and memory. Inositol triphosphate receptor represents a dominant second messenger leading to the release of Ca2+ from intracellular store sites. There is strong evidence suggesting that the InsP3R plays an important role in the conversion of external stimuli to intracellular Ca2+ signals characterized by complex patterns relative to both space and time, such as Ca2+ waves and oscillations.

# Discovery
The InsP3 receptor was first purified from rat cerebellum by neuroscientists Surachai Supattapone and Solomon Snyder at Johns Hopkins University School of Medicine.
The cDNA of the InsP3 receptor was first cloned in the laboratory of Katsuhiko Mikoshiba.  The initial sequencing was reported as an unknown protein enriched in the cerebellum called P400.  The large size of this open reading frame indicated a molecular weight similar to the protein purified biochemically, and soon thereafter it was confirmed that the protein p400 was in fact the inositol trisphosphate receptor.

# Distribution
The receptor has a broad tissue distribution but is especially abundant in the cerebellum. Most of the InsP3Rs are found integrated into the endoplasmic reticulum.

# Structure
The asymmetric structure consists of an N-terminal beta-trefoil domain and a C-terminal alpha helical domain with a folding pattern similar to an armadillo repeat fold. The split formed by the two terminals contains multiple arginine and lysine residues that coordinate the three phosphoryl groups of InsP3R. The InsP3R complex is formed of four 313 kDa subunits. In amphibians, fish and mammals, there are 3 paralogs and these can form homo- or hetero-oligomers. InsP3R-1 is the most widely expressed of these three and is found in all tissue types and all developmental stages of life. It is additionally the means for further InsP3 receptor diversity in that it has as many as four splice sites with as many as 9 different optional exons or exon variants. Combinations of these can be introduced into a given transcript in order to modulate its pharmacological activity.
Interferon alfa-2a how supplied

# How Supplied

## Single Use Prefilled Syringes
(for subcutaneous administration)
3 million IU Roferon-A per syringe  Each 0.5 mL contains 3 MIU of Interferon alfa-2a, recombinant, 3.605 mg sodium chloride, 0.1 mg polysorbate 80, 5 mg benzyl alcohol as a preservative and 0.385 mg ammonium acetate. Boxes of 1 (NDC 0004-2015-09); Boxes of 6 (NDC 0004-2015-07).
6 million IU Roferon-A per syringe  Each 0.5 mL contains 6 MIU of Interferon alfa-2a, recombinant, 3.605 mg sodium chloride, 0.1 mg polysorbate 80, 5 mg benzyl alcohol as a preservative and 0.385 mg ammonium acetate. Boxes of 1 (NDC 0004-2016-09); Boxes of 6 (NDC 0004-2016-07).
9 million IU Roferon-A per syringe  Each 0.5 mL contains 9 MIU of Interferon alfa-2a, recombinant, 3.605 mg sodium chloride, 0.1 mg polysorbate 80, 5 mg benzyl alcohol as a preservative and 0.385 mg ammonium acetate. Boxes of 1 (NDC 0004-2017-09); Boxes of 6 (NDC 0004-2017-07).

## Storage
The prefilled syringe should be stored in the refrigerator at 36 to 46F (2 to 8C). Do not freeze or shake. Protect Roferon-A from light during storage.