Persius/hicric huggingface dataset:
Assay sensitivity
Assay sensitivity is a property of a clinical trial defined as the ability to distinguish an effective treatment from a less effective or ineffective treatment. Without assay sensitivity, a trial cannot be said to make a distinction between the efficacy of two treatments.

# Importance
Assay sensitivity has different implications for trials intended to show differences between treatments (superiority trials) and trials intended to show non-inferiority.
If a trial is intended to demonstrate efficacy by showing superiority of a test treatment to control lacks assay sensitivity, it will fail to show that the test treatment is superior and will fail to lead to a conclusion of efficacy.
In contrast, if a trial is intended to demonstrate efficacy by showing a test treatment to be non-inferior to an active control, but lacks assay sensitivity, the trial may find an ineffective treatment to be non-inferior and could lead to an erroneous conclusion of efficacy.
When two treatments within a trial are shown to have different efficacy (i.e., when one treatment is superior), that finding itself demonstrates that the trial had assay sensitivity. In contrast, a successful non-inferiority trial (i.e., one that has shown non-inferiority), or an unsuccessful superiority trial, generally does not contain such direct evidence of assay sensitivity.

# Differences in sensitivity
A trial may have different assay sensitivity depending on the effect of the treatment tested.  For example, the trial may be sensitive to an effect of 10 but not an effect of 5. Clinical trials experts will not accept the validity of a finding of  "difference" or "no difference" between two treatments unless another internal control confirms that the study methods have the ability to show a difference, if one exists, over the range of interest.
Atmosphere (unit)
Standard atmosphere is a pressure defined as 101'325 Pa and used as unit of pressure (symbol: atm). Standard atmosphere is a non-SI unit that is internationally recognized.  The 10th Conference Generale des Poids et Mesures (10th CGPM) adopted standard atmosphere for general use and affirmed its definition of being precisely equal to 1,013,250 dynes per square centimeter (101,325 Pa). This value is intended to represent the mean atmospheric pressure at mean sea level at the latitude of Paris, France, and as a practical matter, truly reflects the mean sea level pressure for many of the industrialized nations (those with latitudes similar to Paris).
In chemistry, the original definition of Standard Temperature and Pressure (STP) was a reference temperature of 0 C (273.15 K) and pressure of 101.325 kPa (1 atm). However, in 1982, the International Union of Pure and Applied Chemistry (IUPAC) recommended that for the purposes of specifying the physical properties of substances, the standard pressure should be defined as precisely 100 kPa (750.062 Torr).

# Pressure units and equivalencies
A pressure of 1 atm can also be stated as:

# Other applications
In the United Kingdom, scuba divers and others often use the word atmosphere loosely (the correct term is "ambient pressure") to mean 1 bar (1000 millibars, or 100 000 Pa).
The unit technical atmosphere (at) is roughly equal to the gauge pressure under 10 m of water; 1 at = 98066.5 Pa.
Atrial infarction

# Overview
Atrial infarction is ischemic necrosis of the upper chamber of the heart (the atrium). It is a disease that has not been well studied.

# Incidence
In autopsy studies, the incidence is highly variable ranging from 0.7% to 42%. The largest series to date involved 182 patients, and the incidence in that study was 17%.

# Pathophysiology
The right atrium is involved five times as often as the left, with the auricle the predominant site in either atria.

# EKG Findings:
The following may be present: supraventricular arrhythmias, atrial rupture, hemodynamic compromise from loss of atrial "kick," and thromboembolic phenomena.
Electrocardiographic diagnostic criteria   

## Major criteria
- PTa-segment elevation >0.5 mm in leads V3 and V6 with reciprocal depression of PTa segments in V1 and V2 leads.
- PTa-segment elevation >0.5 mm in lead I with reciprocal depressions in leads II and III.
- PTa-segment depression >1.5mm in precordial leads and 1.2mm in leads I, II and III, associated with any atrial arrhythmia.

## Minor criteria
- Abormal P-waves, flattening of P-wave in M, flattening of P-wave

# Echocardiography
Transesophageal echocardiography may demonstrate abnormalities.
Atrophic rhinitis
Atrophic Rhinitis also called as Ozaena, it is a chronic inflammation of nose characterised by atrophy of nasal mucosa including the glands, turbinate bones, and the nerve elements supplying the nose.
Atrophic Rhinitis is of two types: primary and secondary.

# Primary Atrophic Rhinitis

## Aetiology
- Heredity factors: Disease runs in  families
- Endocrine Imbalance: Disease tends to start at puberty and mostly involves females
- Racial factors: White and yellow races
- Nutritional deficeincy: Vit A, D or iron
- Infection: Klebsiella ozaenae, diphtheroids, P.vulgaris, E.coli etc.
- Autoimmune: Viral infection or some other unidentified insult may trigger antigenicity of nasal mucosa

## Pathology
Ciliated columnar epthelium of the nasal mucosa is replaced by stratified squamous epithelium. Atrophy of mucosa, turbinal bones, seromucinous glands tend to occur. This is due to obliterative endarteritis causing decreased blood supply hence the supplying area atrophies.

## Clinical manifestations
Disease is most commonly seen in females and tends to appear during puberty. The nasal cavities become roomy and are filled with foul smelling crusts which are black and dry. Microorganisims are known to multiply and this produces a foul smell from the nose, though patient is not aware of this because his/her nerve aliments (responsible for the perception of smell) have become atrophied. Patients usually complain of nasal obstruction despite the roomy nasal cavity, which can be caused either by the obstruction produced by the discharge in the nose, or as a result of sensory loss due to atrophy of nerves in the nose so that the patient is unaware of the air flow.  In the case of the second cause, the sensation of obstruction is subjective. Bleeding from the nose, also called epistaxis may occur when the dried discharge (crusts) are removed. Septal perforation and dermatitis of nasal vestibule can occur. Nose may show a saddly nose deformity. Atrophic rhinitis is also associated with similar atrophic changes in the pharynx, larynx producing symptoms pertaining to these structures. Hearing impairment can occur due to Eustachian tube blockage causing middle ear effusion.

## Prognosis
Disease has a tendency to recover spontaneously by middle age.

## Treatment options
Treatment of Atrophic Rhinitis can be either medical or surgical.
Medical measures include:
- Nasal irrigation and removal of crusts using alkaline nasal douches
- 25% glucose in glycerine can be applied to nasal mucosa, this inhibits growth of foul smelling proteolytic organisms
- Local antibiotics like Kemicetine (Chloramphenicol) Ostradiol and Vit D2
- Ostradiol spray
- Systemic streptomycin
- Oral potassium iodide
- placental extract injected in the submucosa
Surgical Interventions include
- Young's operation
- Modified Young's operation
- Narrowing of nasal cavities, submucosal injection of Teflon paste, section and medial displacement of lateral wall of nose
- Transposition of parotid duct to maxillary sinus or nasal mucosa.
Attributable risk

# Overview
The attributable risk of disease given an exposure is simply the rate of disease (incidence) in the exposed people minus the rate in the unexposed people.
So the attributable risk for lung cancer in smokers is, in essence, simply the rate of lung cancer amongst smokers minus the rate of lung cancer amongst non-smokers.
The population attributable risk is an estimate of the proportion of disease or other outcomes in a community due to exposure to a specific factor.
For example, Tobacco smoking is the main cause of lung cancer, but a small proportion of cases of lung cancer in almost all communities are due to other exposures, for example, radon, indoor air pollution, outdoor air pollution, arsenic, unfortunate genetics and so on.
It is possible to imagine what would happen in a community if, say, you removed all the radon, and left everything else unchanged. The number of lung cancer cases would fall. This fall is the population attributable risk for lung cancer from radon. Please note that this isn't actually possible, so this is a thought experiment, but for all that it's a useful one.
Auerbach's plexus

# Overview
Part of the enteric nervous system, Auerbach's plexus (or myenteric plexus) exists between the longitudinal and circular layers of muscularis externa in the gastrointestinal tract and provides motor innervation to both layers and secretomotor innervation to the mucosa.
It arises from cells in the Nucleus ala cinerea, the parasympathetic nucleus of origin for the tenth cranial nerve (Vagus), located in the medulla oblongata. The fibers are carried by both the anterior and posterior vagal nerves.

# Eponym
The myenteric plexus is referred to as Auerbach's plexus for its first describer Leopold Auerbach.
Darwin's tubercle
Darwin's tubercle is a congenital ear condition which often presents as a thickening on the helix at the junction of the upper and middle thirds. The feature is present in approximately 10.4% of the population. This acuminate nodule represents the point of the mammalian ear.
This atavistic feature is so called because its description was first published by Charles Darwin in the opening pages of The Descent of Man, as evidence of a vestigial feature indicating common ancestry among primates. However Darwin himself named it the "Woolnerian tip", after Thomas Woolner, a British sculptor who had depicted it in one of his sculptures and had first theorised that it was an atavistic feature.
The gene for Darwin's tubercle is inherited in an autosomal dominant pattern, and has variable penetration, meaning that those who possess the gene will not necessarily possess the ear tubercle.
Axenfeld syndrome
Synonyms and keywords: Axenfeld-Rieger syndrome; Hagedoom syndrome

# Overview
Axenfeld syndrome is the name commonly given to a spectrum of autosomal dominant developmental disorders. It is so named after the German ophthalmologist Theodor Axenfeld. Although most recognized for its correlation with the onset of glaucoma in the eye, the AR malformation is itself not limited to the eye but describes a fetal anomaly of bone/tooth development as well as mental retardation.
The molecular genetics of the disease are poorly understood, and centers on two genes identified by cloning of chromosomal beakpoints from patients.
The most characteristic feature is a distinct posterior arcuate ring, known as an "embryotoxon". The iris is commonly adherent to the Schwalbe's line (posterior surface of the cornea).
The condition is heritable as an autosomal dominant trait.
BCL-6 corepressor
BCL-6 corepressor is a protein that in humans is encoded by the BCOR gene.

# Function
The protein encoded by this gene was identified as an interacting corepressor of BCL6, a POZ/zinc finger transcription repressor that is required for germinal center formation and may influence apoptosis. This protein selectively interacts with the POZ domain of BCL6, but not with eight other POZ proteins. Specific class I and II histone deacetylases (HDACs) have been shown to interact with this protein, which suggests a possible link between the two classes of HDACs. At least four alternatively spliced transcript variants, which encode different isoforms, have been reported for this gene.

# Clinical significance
Mutations in the BCOR gene cause a form of syndromic microphthalmia (small eye) called MCOPS2. This syndrome incorporates microphthalmia, congenital cataracts, cardiac defects, dental defects and skeletal anomalies. Mutations in this gene have also been found associated to acute myeloid leukemia.

# Interactions
BCOR has been shown to interact with MLLT3 and BCL6.
Borjeson syndrome
Synonyms and keywords: Borjeson-Forssman-Lehmann syndrome , BFL syndrome, Mental deficiency - epilepsy - endocrine disorders.

# Overview
Borjeson-Forssman-Lehmann syndrome is characterised by the association of intellectual deficit with endocrine anomalies, epilepsy, hypogonadism and facial dysmorphism.

# Pathophysiology

## Genetics
The disorder is inherited as an X-linked recessive trait and is caused by mutations in the PHF6 gene, which maps to the human Xq26q27 region. Some heterozygous females show milder clinical features such as tapering fingers and shortened toes. Twenty percent have significant learning problems, and 95% have skewed X inactivation.

# Epidemiology and Demographics
The incidence of the sporadic forms is unknown.

# Differentiating Borjeson syndrome from other Diseases
The differential diagnosis of obesity related syndromes includes the Prader-Willi, Bardet-Biedl, or Wilson-Turner syndromes.

# Diagnosis

## Symptoms
- Walking is acquired late.
- Adult forms usually combine intellectual deficit with seizures, poor muscular development and hyperextensible joints.
- Frequent visual problems (hyperopia, cataract with onset before age 30) have also been reported.

## Physical Examination
- Mixed hypogonadism with small soft testes (testicular volume: 8mL), micropenis, sparse pubic hair, and low testosterone levels are also present and gynecomastia appears after puberty.
- Progressive dysmorphism occurs with coarse facies due to thickened connective tissue, deep-set eyes accentuated by prominent eyebrows, narrow palpebral openings and/or ptosis, and long, thick ears with large but normally shaped lobes.
- Newborns are obese, hypotonic, and have large ears and micropenis.
The clinical history and physical findings in the affected males reveal that the phenotype becomes milder, varies and evolves with age.
- Generally, in the first year, the babies are floppy, with failure to thrive, big ears, and small external genitalia.
- As schoolboys, the picture is one of learning problems and moderate short stature, with emerging truncal obesity and gynecomastia.
- Head circumferences are usually normal but macrocephaly may be seen.
- Big ears and small genitalia remain.
- The toes are short and fingers tapered and malleable.
- In late adolescence and adult life, the classically described heavy facial appearance emerges.

# Treatment
Testosterone supplementation may enhance intellectual performance and induce weight loss when testosterone levels are low.
Bainbridge reflex
The Bainbridge reflex is an increase in heart rate due to an increase in the blood volume.  Increased blood volume is detected by stretch receptors located in both atria at the venoatrial junctions.

# History
A scientist by the name of Francis Arthur Bainbridge reported this reflex in 1915 when he was experimenting on dogs.  Bainbridge found that infusing blood or saline into the animal increased heart rate.  This phenomenon occurred even if arterial blood pressure did not increase.  He further observed that heart rate increased when venous pressure rose high enough to distend the right atrium, but denervation of the vagi to the heart eliminated these effects.

# Control of Heart Rate
The Bainbridge reflex and the baroreceptor reflex act antagonistically to control heart rate.  The baroreceptor reflex acts to decrease heart rate when blood pressure rises.  When blood volume is increased, the Bainbridge reflex is dominant; when blood volume is decreased, the baroreceptor reflex is dominant.

# Venous Return
As venous return increases, the pressure in the superior and inferior vena cavae increase. This results in an increase in the pressure of the right atrium, which stimulates the atrial stretch receptors. These receptors in turn signal the medullary control centers to increase sympathetic stimulation of the heart, leading to increased heart rate, a.k.a. tachycardia.
Increasing the heart rate serves to decrease the pressure in the superior and inferior vena cavae by drawing more blood out of the right atrium. This results in a decrease in atrial pressure, which serves to bring in more blood from the vena cavae, resulting in a decrease in the venous pressure of the great veins. This continues until right atrial blood pressure returns to normal levels, upon which the heart rate decreases to its original level.

# Atrial Stretch Receptors
In the right atrium, the stretch receptors occur at the junction of the vena cavae.  In the left atrium, the junction is at the pulmonary veins.  Increasing stretch of the receptors stimulates both an increase in heart rate and a decrease in vasopressin (a.k.a. anti-diuretic hormone) secretion from posterior pituitary.  This decrease in vasopressin secretion results in an increase in the volume of urine excreted, serving to lower blood pressure.  In addition, stretching of atrial receptors increases secretion of atrial natriuretic peptide (ANP), which promotes increased water and sodium excretion through the urine.
Balloon swallower
A balloon swallower is an individual who crosses a border with the intent to smuggle drugs contained in his or her gastrointestinal tract.
In particular the term is used in American law enforcement for this regarding crossing the United States-Mexico border.
A balloon swallower typically fills tiny balloons with small quantities of a drug, usually heroin or cocaine, and then swallows these balloons.  The swallower then attempts to cross into the United States from Mexico, excrete the balloons, and then sell the drugs for profit. It is far more common for the swallower to be making the trip for a drug lord or drug dealer. Swallowers are often impoverished and agree to transport the drugs in exchange for money and view it as a way into the United States.
The U.S. Supreme Court dealt with this issue in United States v. Montoya De Hernandez.  In Hernandez, a woman attempted to smuggle 88 balloons of cocaine in her gastrointestinal tract.  She had been detained for over 16 hours by customs inspectors before she finally passed some of the balloons.  She was being held because her abdomen was noticeably swollen (she claimed to be pregnant) and a search of her body had revealed she was wearing two pairs of elastic underpants and had lined her crotch area with paper towels.  This is done because balloon swallowing makes bowel movements difficult to control.

# Fiction
- The 2004 film Maria Full of Grace (advertised as "Based on 1,000 true stories") depicts the voyage of a young Colombian woman to New York as a balloon swallowing mule in great detail.
- In Bolletjes Blues, a 2006 Dutch musical film, a character is smuggling cocaine from Suriname to the Netherlands as a balloon swallower.
nl:Bolletjesslikker
Balloonist theory
Balloonist theory was a theory in early neuroscience that attempted to explain muscle movement by asserting that muscles contract by inflating with air or fluid.
The Greek physician Galen believed that muscles contracted due to a fluid flowing into them, and for 1500 years afterward, it was believed that nerves were hollow and that they carried fluid.
Rene Descartes, who was interested in hydraulics and used fluid pressure to explain various aspects of physiology such as the reflex arc, proposed that "animal spirits" flowed into muscle and were responsible for their contraction.
1n 1667, Thomas Willis proposed that muscles may expand by the reaction of animal spirits with vital spirits.  He hypothesized that this reaction would produce air in a manner similar to the reaction that causes an explosion, causing muscles to swell and produce movement.

# Debunking
Also in 1667, Jan Swammerdam, a Dutch anatomist famous for working with insects, made the first important blow to the balloonist theory.  Swammerdam, who was the first to experiment on nerve-muscle preparations, showed that muscles do not increase in size when they contract.  He separated a frog's leg from the frog, but left the sciatic nerve connecting them, and put the leg under water.  Irritating the nerve caused the muscle to contract and the leg to twitch.  Swammerdam noticed that the level of the water did not rise: no fluid or gas could be entering the leg.  Further, he showed that irritation of the nerve alone was enough to provoke movement, an important step toward the current understanding of how nerves actually cause muscle contraction.
Balloonist theory took a second hit from Francis Glisson who performed an experiment in which a man flexed a muscle under water. The water level did not go up (in fact it went down slightly), further supporting the conclusion that no air or fluid could be entering the muscle.
The idea that muscle is inflated by air was further debunked when Giovanni Alfonso Borelli slit the muscle of an animal under water and watched to see if bubbles of air would rise to the surface; of course, none did.
The invention of the microscope allowed preparations of nerves to be viewed at high magnification, showing that they are not hollow.
In 1791 Luigi Galvani learned that frogs' muscles could be made to move by the application of electricity.  This finding provided a basis for the current understanding that electrical energy (carried by ions), and not air or fluid, is the impetus behind muscle movement.
Bariatric surgery
In surgery, Bariatric surgery is defined as "surgical procedures aimed at affecting metabolism and producing major weight reduction in patients with morbid obesity."

# Complications
Neurologic complications have been reviewed.

## Polyneuropathy
Thiamine deficiency after bariatric surgery has been reported to display demyelination by nerve conduction study although per Shible, citing the two Koike reports, this may be late stage finding and due to severe protein calorie malnutrition.
After bariatric surgery, 6% of patients developed polyneuropathy (none showed demyelination although inflammation was present) . One form of neuropathy is beriberi from thiamine deficiency. However, both axonal and demyelination have been reported. See Beriberi other diagnostic studies.
However, demyelination after bariatric surgery may be associated with:
- Copper deficiency. This patient also received treatment for immune globulin for possible Guillain-Barre Syndrome.
- Guillain-Barre Syndrome including a case with axonal loss and positive anti-GM1, anti-MAG, anti-GD1a antibodies and a case and with demeyllination with anti-GM1 IgG and anti-GD1a antibodies.
Barnett Rosenberg

# Overview
Barnett Rosenberg (1926 - ) is an American chemist best known for the discovery of the anti-cancer drug cisplatin.
Rosenberg obtained his PhD in Physics at New York University (NYU) in 1956. He joined Michigan State University in 1961 and worked there until 1997.
In 1965, Rosenberg and his colleagues proved that certain platinum-containing compounds inhibited cell division and thereby cured solid tumors. The chemotherapy drug that eventually resulted from this work, cisplatin, obtained Food and Drug Administration (FDA) approval in 1978. The initial discovery was quite serendipitous. Rosenberg was looking into the  effects of an electric field on the growth of bacteria. He noticed that bacteria ceased to divide when placed in an electric field and eventually pinned down the cause of this phenomenon to the platinum electrode he was using.
Rosenberg was named Michiganian of the Year in 1979.
Bartholin's gland

# Overview
The Bartholin's glands (also called Bartholin glands or greater vestibular glands) are two glands located slightly below and to the left and right of the opening of the vagina in women. They secrete mucus to provide lubrication.
Bartholin's glands are homologous to Cowper's glands in males. However, while Bartholin's glands are located in the superficial perineal pouch, Cowper's glands are located in the deep perineal pouch.

# Eponym
They were first described in the 17th century, by the Danish anatomist Caspar Bartholin the Younger (1655-1738). Some sources mistakenly ascribe their discovery to his grandfather, theologian and anatomist Caspar Bartholin the Elder (1585 - 1629).