Persius/hicric huggingface dataset:
Directed ortho metalation
Directed ortho metalation (DoM) is an adaptation of electrophilic aromatic substitution in which electrophiles attach themselves exclusively to the ortho- position of a direct metalation group or DMG through the intermediary of an aryllithium compound . The DMG interacts with lithium through a hetero atom. Examples of DMG's are the methoxy group, a tertiary amine group and an amide group.
The general principle is outlined in scheme 1. An aromatic ring system with a DMG group 1 interacts with an alkyllithium such as n-butyllithium in its specific aggregation state (hence (R-Li)n) to intermediate 2 since the hetero atom on the DMG is a Lewis base and lithium the Lewis acid. The very basic alkyllithium then deprotonates the ring in the nearest ortho- position forming the aryllithium 3 all the while maintaining the acid-base interaction. An electrophile reacts in the next phase in an electrophilic aromatic substitution with a strong preference for the lithium ipso position replacing the lithium atom.
Ordinary electrophilic substitutions with an activating group show preference for both the ortho and para position, this reaction demonstrates increased regioselectivity because the ortho position alone is targeted.
This reaction type was discovered independently by Henry Gilman  and Georg Wittig  around 1940.

# Scope
DOM has been applied to the synthesis of enantiopure benzyl amines   in scheme 3  . On approach to the lithium intermediate, the bulky tosyl group on the imine electrophile is responsible for the asymmetric induction taking place.
In another application  DOM is applied in placing a bulky tert-butyl group in an ortho position (scheme 4). The lithiation is an nucleophilic aromatic substitution and the subsequent reaction to the sulfoxide an electrophilic aromatic substitution. In the final step tert-butyllithium acts as a nucleophile in another nucleophilic aromatic substitution through an anionic intermediate.
Directed metallation is not limited to lithium intermediates or even to an ortho preference. In one study  it is found that the reaction product of N,N-dimethylaniline with a complex of TMEDA, sodium salt of TMP and di-tert-butylzinc is a meta zincated complex as a stable crystalline compound. This complex reacts with electrophilic iodine to N,N-dimethyl-3-iodoaniline :
DoM has also been applied combined with a Suzuki reaction in a one-pot synthesis  :
Donor lymphocyte infusion

# Overview
Donor lymphocyte infusion (DLI) is a form of adoptive immunotherapy used after hematopoietic stem cell transplantation. Lymphocytes from the original stem cell donor are infused, after the transplant, to augment an anti-tumor immune response or ensure that the donor stem cells remain engrafted. Complications of DLI include acute and chronic graft-versus-host disease and bone marrow aplasia, resulting in immunosuppression and susceptibility to opportunistic infections.

# Notes
-  Porter D, Levine JE (2006). "Graft-versus-host disease and graft-versus-leukemia after donor leukocyte infusion". Semin. Hematol. 43 (1): 5361. doi:10.1053/j.seminhematol.2005.09.005. PMID 16412789..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}
-  Loren AW, Porter DL (2006). "Donor leukocyte infusions after unrelated donor hematopoietic stem cell transplantation". Current opinion in oncology. 18 (2): 10714. doi:10.1097/01.cco.0000208781.61452.d3. PMID 16462177.
-  Luznik L, Fuchs EJ (2002). "Donor lymphocyte infusions to treat hematologic malignancies in relapse after allogeneic blood or marrow transplantation". Cancer control : journal of the Moffitt Cancer Center. 9 (2): 12337. PMID 11965233.Full text
Double circulatory system
The double circulatory system of blood flow refers to the separate systems of pulmonary circulation and the systemic circulation in amphibians, birds and mammals (including humans.)  In contrast, fish have a single circulation system.
For instance the adult human heart consists of two separated pumps, the right side with the right atrium and ventricle (which pumps deoxygenated blood into the pulmonary circulation), and the left side with the left atrium and ventricle (which pumps oxygenated blood into the systemic circulation).  Blood in one circuit has to go through the heart to enter the other circuit.
Blood circulates through the body at speeds which vary by a factor of ten, from 1.2 m/s in the aorta to approximately 1.1 cm/s in the capillaries. The circulatory system features numerous return paths (out to the kidneys and back, to the liver and back, to the legs and back, etc.), so it is incorrect to think of blood cells traveling the entire circulatory distance. The average heart pumps about 5,040 ml of blood per minute and an average adult has about 5 liters of total blood volume, so the heart is exchanging blood volume at a rate of about ten times per second.
Double inferior vena cava

# Overview
- Duplication of the IVC results from persistence of both supracardinal veins.
- The prevalence is 0.2%3%.
- Double IVC should be suspected in cases of recurrent pulmonary embolism following placement of an IVC filter.
- As with left IVC, misdiagnosis of the aberrant vessel as lymphadenopathy should be avoided.

# Diagnosis
- The left IVC typically ends at the left renal vein, which crosses anterior to the aorta in the normal fashion to join the right IVC. However, there may be variations in this arrangement.
- There may be significant asymmetry in the sizes of the left and right veins.
Duane-radial ray syndrome
Duane-radial ray syndrome is a rare disorder that affects the eyes and causes abnormalities of bones in the arms and hands. This condition is characterized by a particular problem with eye movement called Duane anomaly (also known as Duane syndrome). Duane anomaly results from the improper development of certain nerves that control eye movement. This condition limits outward eye movement (toward the ear), and in some cases may limit inward eye movement (toward the nose). As the eye moves inward, the eye opening becomes narrower and the eyeball may pull back (retract) into its socket.
Bone abnormalities in the hands include malformed or absent thumbs, an extra thumb, or a thumb that looks like a finger. Partial or complete absence of bones in the forearm is also common. Together, these hand and arm abnormalities are called radial ray malformations.
People with the combination of Duane anomaly and radial ray malformations may have a variety of other signs and symptoms. These features include unusually shaped ears, hearing loss, heart and kidney defects, a distinctive facial appearance, an inward- and downward-turning foot (a clubfoot), and fused vertebrae.
The varied signs and symptoms of Duane-radial ray syndrome often overlap with features of other disorders. For example, acro-renal-ocular syndrome is characterized by Duane anomaly and other eye abnormalities, radial ray malformations, and kidney defects. Both conditions can be caused by mutations in the same gene. Based on these similarities, researchers are investigating whether Duane-radial ray syndrome and acro-renal-ocular syndrome are separate disorders or part of a single syndrome with many possible signs and symptoms. The features of Duane-radial ray syndrome also overlap with those of a condition called Holt-Oram syndrome; however, these two disorders are caused by mutations in different genes.
Mutations in the SALL4 gene cause Duane-radial ray syndrome. The SALL4 gene is part of a group of genes called the SALL family. These genes provide instructions for making proteins that are involved in the formation of tissues and organs before birth. SALL proteins act as transcription factors, which means they bind to specific regions of DNA and help control the activity of particular genes. Mutations in the SALL4 gene prevent one copy of the gene in each cell from making any protein. It remains unclear how a reduction in the amount of SALL4 protein leads to Duane anomaly, radial ray malformations, and the other features of Duane-radial ray syndrome and similar conditions. Duane-radial ray syndrome often is inherited in an autosomal dominant pattern, which means one copy of the altered gene in each cell is sufficient to cause the disorder.

# Reference
- Duane-radial ray syndrome at NLM Genetics Home Reference
de:Okihiro-Syndrom
Ductus arteriosus closure
Assistant Editor-In-Chief: Kristin Feeney, B.S. ]

# Normal ductus arteriosus closure
In the developing fetus, the ductus arteriosus (DA) is a shunt connecting the pulmonary artery to the aortic arch that allows much of the blood from the right ventricle to bypass the fetus' fluid-filled lungs. During fetal development, this shunt protects the right ventricle from pumping against the high resistance in the lungs, which can lead to right ventricular failure if the DA closes in-utero.
When the newborn takes its first breath, the lungs open and pulmonary pressure decreases below that of the left heart. At the same time, the lungs release bradykinin to constrict the smooth muscle wall of the DA and reduce bloodflow. Additionally, because of reduced pulmonary resistance, more blood flows from the pulmonary arteries to the lungs and thus the lungs deliver more oxygenated blood to the left heart. This further increases aortic pressure so that blood no longer flows from the pulmonary artery to the aorta via the DA.
In normal newborns, the DA is closed within 15 hours after birth, and is completely sealed after three weeks. The fall in circulating maternal prostaglandins contributes to this. A nonfunctional vestige of the DA, called the ligamentum arteriosum, remains in the normal adult heart.
Dysplastic nevus overview

# Overview
A dysplastic nevus, is an atypical mole; a mole whose appearance is different from that of common moles.  Dysplastic nevi are generally larger than ordinary moles and have irregular and indistinct borders. Their color frequently is not uniform and ranges from pink to dark brown; they usually are flat, but parts may be raised above the skin surface.  Dysplastic nevus can be found anywhere, but are most common on the trunk in men, and on the calves in women.

# Classification
Dysplastic nevus is a type of melanocytic lesion.

# Pathophysiology
Depending on cytologic atypia, melanocytic lesions range from dysplastic nevus to melanoma.

# Differential diagnosis
Dysplastic nevus should be differentiated from common moles and melanoma.

# Epidemiology
Males are more commonly affected by dysplastic nevus compared to females.

# Risk factors
Sunlight exposure is the most important risk factor for the development of dysplastic nevus.

# Screening
Patients with dysplastic nevus should undergo regular screening to prevent progression to melanoma.

# Natural history and complications
Dysplastic nevus can progress to melanoma if it is not treated adequately. Complications of dysplastic nevi include melanoma and metastasis.

# Physical Examination
The only way to diagnose dysplastic nevus is to remove tissue and check it for dysplasia.

# Biopsy
When an atypical mole has been identified, a biopsy takes place in order to best diagnose it.  Local anesthetic is used to numb the area, then the mole is biopsied.  The biopsy material is then sent to a laboratory to be evaluated by a Pathologist.

# Treatment
Surgery is the mainstay of treatment for dysplastic nevus.

# Primary Prevention
Everyone should protect their skin from the sun and stay away from sunlamps and tanning booths, but for people who have dysplastic nevi, it is even more important to protect the skin and avoid getting a suntan or sunburn.
E1cB elimination reaction
The E1cB elimination reaction is a special type of elimination reaction in organic chemistry. This reaction mechanism explains the formation of alkenes from (mostly) alkyl halides through a carbanion intermediate given specified reaction conditions and specified substrates. The abbreviation stands for  E limination conjugate Base. The reaction takes place around a sp3 - sp3 carbon to carbon covalent bond with an -acidic hydrogen atom substituent and a -leaving group. This leaving group can be a halide or a sulfonic acid ester such as a tosyl group. A strong base abstracts the  proton generating a carbanion. The electron pair then expels the leaving group and the double bond is formed. When the first step to the carbanion is slow and the second step fast the reaction is irreversible and named (E1cB)i. When the first step is fast and the deprotonation reversible then the reaction mechanism is (E1cB)r. In the (E1cB)anion variation the carbanion is especially stable with a rapid first step and a slow second step.
A named reaction displaying E1cB elimination mechanism is the Boord olefin synthesis.
Being able to distinguish between different elimination reaction mechanisms (E2, E1, E1cB) is often difficult and involves the study of chemical kinetics, kinetic isotope effects, substituent effects and computational chemistry. The dehydration of 1-methyl-2-(2-fluoroethyl)pyridinium iodide by the hydroxide ion in water is an example of a 2-step E1cB reaction because the carbanion is stabilized by the resonance effect with the enamine . Computational chemistry predicts that the carbanion in this example is stabilized by only 2.8 kcal/mol (11.7 kJ/mol) and only when solvatation of all the chemical species with water is taken into account. The same fluoride substrate but as a free pyridine does not have this stabilization and the reaction proceeds by a concerted one-step E2 reaction mechanism. When the leaving group in the methylated pyridine compound is chlorine instead of fluoride the reaction mechanism is also E2 because now the carbon to chloride bond is too weak.
EKG lead placement errors

# Overview
Sometimes an ECG is not made properly. Mistakes do happen and leads can be switched. Always remain careful to check this or you might come to the wrong conclusions. One of the most common mistakes is to switch the right and left arm. This will result in negative complexes in I, indicating a right axis deviation!
Common mistakes are reversal of:
- Right leg and right arm:
Hardly seen any signal in lead II.
- Hardly seen any signal in lead II.
- Right and left arm electrodes;
Reversal of leads II and III
Reversal of leads aVR and aVL
- Reversal of leads II and III
- Reversal of leads aVR and aVL
- Left arm and left leg:
Reversal of leads I and II
Reversal of leads aVR and aVF
Inversion of lead III
- Reversal of leads I and II
- Reversal of leads aVR and aVF
- Inversion of lead III
- Right arm and left leg:
Inversion of leads I, II and III
Reversal of leads aVR and aVF
- Inversion of leads I, II and III
- Reversal of leads aVR and aVF
It is possible to distinguish lead reversal and dextrocardia by watching the precordial leads. Dextrocardia will show an R wave inversion, whereas lead reversal will not.

# EKG examples
- An example of reverse lead placement
- Right and left arm lead reversal can be distinguished from the (much rarer) dextrocardia by looking at the precordial R wave progression.
- Right arm and left leg lead reversal. Lead II now measures the signal between the left and right leg, which is remote from the heart.

# Reference
-  Hammill S. C. Electrocardiographic diagnoses: Criteria and definitions of abnormalities, Chapter 18, MAYO Clinic, Concise Textbook of Cardiology, 3rd edition, 2007 ISBN 0-8493-9057-5

# Additional resources
- ECGpedia: Course for interpretation of ECG
- The whole ECG - A basic ECG primer
- 12-lead ECG library
- Simulation tool to demonstrate and study the relation between the electric activity of the heart and the ECG
- ECG information from Children's Hospital Heart Center, Seattle
- ECG Challenge from the ACC D2B Initiative
- National Heart, Lung, and Blood Institute, Diseases and Conditions Index
- A history of electrocardiography
- EKG Interpretations in infants and children
Epithelial sodium channel
The epithelial sodium channel (short: ENaC, also: sodium channel non-neuronal 1 (SCNN1) or amiloride sensitive sodium channel (ASSC)) is a membrane-bound ion-channel that is permeable for Li+-ions, protons and especially Na+-ions. It is a constitutively active ion-channel. It is arguably the most selective ion channel.

# Structure
ENaC consists of three different subunits: , , . The stoichometry of these subunits is still to be verified, but ENaC is very likely to be a heterotrimeric protein like the recently analyzed acid-sensing ion channel 1 (ASIC1), which belongs to the same family. Each of the subunits consists of two transmembrane helices and an extracellular loop. The amino- and carboxy-termini of all polypeptides are located in the cytosol.

# Location and function
ENaC is located in the apical membrane of polarized epithelial cells particularly in the kidney, the lung and the colon. It is involved in the transepithelial Na+-ion transport which it accomplishes together with the Na+/K+-ATPase.
It plays a major role in the Na+- and K+-ion homeostasis of blood, epithelia and extraepithelial fluids by resorption of Na+-ions. The activity of ENaC in colon and kidney is modulated by the mineralcorticoid aldosterone. It is blocked by amiloride, which is used in medical science, where amiloride serves as a diuretic.
ENaC can furthermore be found in taste receptor cells, where it plays an important role in salt taste perception. In rodents virtually the entire salt taste is mediated by ENaC, whereas it seems to play a less significant role in humans: about 20 percent can be accredited to the epithelial sodium channel.

# -subunit
In addition there is a fourth, so-called -subunit, that shares considerable sequence similarity with the -subunit and can form a functional ion-channel together with the - and -subunits. Such , , -ENaC appears in pancreas, testes and ovaries. Their function is yet unknown.

# Clinical significance
Units  and  are associated with Liddle's syndrome.
Amiloride and triamterene are potassium-sparing diuretics which act upon the Epithelial sodium channel.

# Genes
- SCNN1A, SCNN1B, SCNN1C, SCNN1D
Eagle Brand Medicated Oil
Eagle Brand Medicated Oil is a popular Asian remedy for aches and pains of muscle or joints.  It is normally seen in small clear bottles filled with a green liquid.
Eagle Brand Medicated Oil is manufactured by the Borden Company (PTE) Limited of Singapore for distribution in the United States of America by Anhing Corporation in Los Angeles.

# Ingredients
According to a 1987 FDA alert, Eagle Brand Medicated Oil has two formulas: one sold in the United States of America and one sold elsewhere.  The formula sold in the United States of America consisted of:
menthol (13.5%), ethyl alcohol (13%), methyl salicylate (4.5%), chlorophyll, mineral oil, and otto of roses.
The other older formula consisted of: 12% chloroform and 20% methyl salicylate, among other ingredients.  Chloroform is carcinogenic and such high levels of methyl salicylate can be toxic.
Since then the formula has been updated to exclude the chloroform and methyl salicylate.
Eastern tiger swallowtail
The Eastern tiger swallowtail, Papilio glaucus, is a large (12 cm wingspan) swallowtail butterfly.  It is found in the Eastern United States, as far north as southern Vermont, and as far West as extreme Eastern Colorado.  It flies from spring through fall, and most of the year in the southern portions of its range, where it may produce two or three broods a year. In the Appalachian region, it is replaced by the closely-related and only recently described Papilio appalachiensis, and in the north, it is replaced by the closely-related Papilio canadensis. These three species can be very difficult to distinguish, and were formerly all considered to be a single species.
Adult males are yellow, with four black "tiger stripes" on each fore wing. The trailing edges of the fore and hind wings are black which is broken with yellow spots. On the medial margin of the hind wing next to the abdomen there are small red and blue spots.
There are two morphs of adult females, a yellow and a dark one.  The yellow morph is similar to the male, except that the hind wings have an area of blue between the black margin and the main yellow area. In the dark morph, most of the yellow areas are replaced with a dark gray to a black. A shadow of the "tiger stripes" can still be seen on the dark females.  The dark form is more common in the Southern portions of the range, especially in areas also inhabited by the Pipevine Swallowtail, which it seems to mimic.
Eastern Tiger Swallowtails often rest with their wings fully spread, particularly if the sun is out.
Female lays spherical green eggs on the top of leaves of host plants. After hatching, the caterpillars often eat the shell of their egg. The first instars are dark and mimic bird droppings. The larvae eat the leaves of a wide variety of trees and shrubs, including cottonwood, tulip tree, sweet bay, and cherry. Adults are strictly diurnal; they start to fly towards noon and by and by return to rest throughout the afternoon (Fullard & Napoleone 2001).
It is the state butterfly of Georgia, Virginia, Alabama, South Carolina and Delaware.

# Image gallery
- Two eggs on a tulip tree leaf
Two eggs on a tulip tree leaf
- First instar caterpillar
First instar caterpillar
- Second or third instar caterpillar showing osmeterium
- Old caterpillar
Old caterpillar
- Chrysalis
Chrysalis
- Female in southern Maine
Female in southern Maine
- Underside of wings
Underside of wings
- Old yellow-morph female lies dying in a pool of water
Old yellow-morph female lies dying in a pool of water
- Eastern tiger swallowtail in Virginia
Eastern tiger swallowtail in Virginia
- File:Eastern Tiger Swallowtail Papilio glaucus Flower 2345px.jpg
- dark form female
dark form female
- Pristine male specimen
Pristine male specimen
Elbs persulfate oxidation
The Elbs persulfate oxidation is the organic reaction of phenols with alkaline potassium persulfate to form para-diphenols.
Several review have been published.

# Reaction mechanism
A reaction mechanism has been postulated accounting for the observed para substitution featuring the tautomeric para carbanion of the starting phenolate ion:
which gives a nucleophilic displacement on the peroxide oxygen of the peroxydisulfate ion. The intermediate sulfate group is then hydrolyzed to the alcohol.
The reaction is disadvantaged by low chemical yields with recovery of starting material and complete consumption of the persulfate. It is suggested that the phenol in many cases is a catalyst converting the persulfate into a sulfate.