Persius/hicric huggingface dataset:
Sandbox/Afib

# Cardioversion Strategy

# Anticoagulation Strategy
- For patients with AF and a mechanical heart valve undergoing procedures that require interruption of warfarin bridging therapy with unfractionated heparin (UFH) or low-molecular-weight heparin (LMWH) is needed.

# Do's & Dont's
- IV amiodarone or digoxin may be considered to slow a rapid ventricular response in patients with ACS and AF associated with severe LV dysfunction and HF.
- Avoid beta blockers to control the ventricular rate in patients with AF and chronic obstructive pulmonary disease.
- Avoid amiodarone, adenosine, digoxin, or calcium channel antagonists (oral or intravenous) in patients with WPW syndrome who have pre-excited AF.
- In AF with HF, it is reasonable to perform AV node ablation with ventricular pacing to control heart rate when pharmacological therapy is insufficient or not tolerated.
- For patients with AF and rapid ventricular response causing or suspected of causing tachycardia induced cardiomyopathy, it is reasonable to achieve rate control by either AV nodal blockade or a rhythm-control strategy.
Sandbox/HOCM

# Overview

# Causes

# FIRE: Focused Initial Rapid Evaluation
A Focused Initial Rapid Evaluation (FIRE) should be performed to identify patients in need of immediate intervention.
Boxes in red color signify that an urgent management is needed.

# Complete Diagnostic Approach to Hypertrophic Obstructive Cardiomyopathy
A complete diagnostic approach should be carried out after a focused initial rapid evaluation is conducted and following initiation of any urgent intervention.

# Treatment

# Do's

# Dont's
Sandbox:Diab

# Overview
Diab is a research fellow at BIDMC, Harvard University.

# Test Passage 1
Coagulation necrosis, characterized by Hypereosinophilia and nuclear pyknosis followed by karyorrhexis, karyolysis, total loss of nuclei and loss of cytoplasmic cross-striations is generally first visible in the period from 4,12 hours following infarction. necrotic myocytes may retain their striations for a long time
Neutrophilic infiltration (Acute inflammation) edema and hemorrhage are also first visible at 4-12 hours but generally closer to 12 hours. the interstitium at the margin of the Infarcted area is initially infiltrated with Neutrophils, then with Lymphocytes and Macrophages, who phagocytose or eat the myocyte debris; The necrotic area is surrounded and progressively invaded by granulation tissue: which will replace the infarct with a fibrous or collagenous scar (which are typical steps in wound healing). the interstitial space or the space between cells outside of blood vessels may be infiltrated with red blood cells.
Infiltration by macrophages, lymphocytes, eosinophils, fibroblasts and capillaries begins around the periphery at 3-10 days. contraction band necrosis, characterized by hypereosinophilic transverse bands of precipitated Myofibrils in dead myocytes is usually seen at the edge of an Infarct or with reperfusion for example with Thrombolytic therapy.
Sandbox: HCL

# Laboratory Findings

## Complete Blood Count
- Decreased hemoglobin concentration
- Decreased platelets count
- Decreased WBC count

## Blood Smear
- Presence of smudge cells

## Metabolic Panel
- Elevated low-density lipoprotein level

## Quantitative Immunoglobulin Assay
- Quantitative measurement of IgA, IgG, and IgM immunoglobulins to detect hypogammaglobulinemia
- Elevated 2-microglobulin level

## Electrophoresis
- Monoclonality of kappa and lambda producing B cells is a key diagnostic feature among patients with chronic lymphocytic leukemia.

## Immunohistochemistry
- Chronic lymphocytic leukemia cells typically express CD19, CD20, CD23, and CD5 on the cell surface.
-  Jump up to: 1.0 1.1 1.2 1.3 1.4 1.5 Wadhwa RK, McKenzie R (1972). "Complications of band-aid surgery for sterilization". JAMA. 222 (12): 1558. PMID 4264273..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}
-  Jump up to: 2.0 2.1 2.2 2.3 2.4 Chronic Lymphocytic Leukimea. Wikipedia (2015)  Accessed on October ,12 2015
Sandbox: VJP

# Overview
Brachial plexus injury (BPI) is an injury to brachial plexus which runs from the spine from fifth cervical vertebra(C5) to underneath the first thoracic vertebra(T1). It innervates and runs through the neck, the axilla and into arm.
BPI can significantly impair the function in one or sometimes both the upper limbs, causing inability to perform daily life activities which can lead to economic crisis, depression and also survival hardships in some cases.

# Historical Perspective
Discovery
- The first ever documentation of Obstetric type of BPI was done by Smellie in 1764.
- In 1872, Duchenne found out that traction was the cause of BPI.
- Another Scientist named Erb proposed a theory that the traction or pinching of C5 or C6 roots can also produce BPI.
- Moreover, the first scientist who published an article regarding the direct repair of the components of BPI was Thourborn in 1900.
- In 1903, Harris and Low reported the first neurotizations.
- In 1920, some of the fascicles of the pectoral nerves onto the musculocutaneous and the axillary nerves were re-routed by Vulpius and Stoffel.
- In 1947, Seddon got his method of the surgical correction of traction injuries with application of long interpositional nerve grafts published.
- In 1966, at the Paris meeting of the International Society of Orthopedic Surgery and Traumatology (SICOT), conclusion was made that surgical repair of BPI is almost impossible.
- Later Stevens precisely proposed the bio mechanics of traction in the upper limb and neck and the resultant injuries of the brachial plexus.
- Narakas, Millesi, Allieu, Brunelli, Gu, Terzis, Doi, and others introduced the microsurgical, nerve repair and nerve regeneration techniques successfully.
Sandbox: epi

# Overview
Hairy cell leukemia is found to approximately comprise 2% of all leukemias in the United States. The incidence of hairy cell leukemia is approximately 3.2 per 1,000,000 individuals in the United States. The incidence of hairy cell leukemia increases with age; the median age at diagnosis is 58 years. Males are more commonly affected with hairy cell leukemia than females. The male to female ratio is approximately 4 to 1.

# Epidemiology and Demographics

## Prevalence
- Hairy cell leukemia is considered one of the least common types of leukemias in the United States.
- Hairy cell leukemia is found to approximately  comprise 2% of all leukemias in the United States.

## Incidence
- The incidence of hairy cell leukemia is approximately 3.2 per 1,000,000 individuals in the United States.
- For the past 30 years, the incidence of hairy cell leukemia has been relatively constant.

## Age
- The incidence of hairy cell leukemia increases with age; the median age at diagnosis is 58 years.

## Gender
- Males are more commonly affected with hairy cell leukemia than females. The male to female ratio is approximately 4 to 1.

## Race
- Hairy cell leukemia usually affects individuals of the Caucasian race. Asian and African American individuals are less likely to develop hairy cell leukemia.
-  Jump up to: 1.0 1.1 Hairy Cell Leukemia. Wikipedia (2015) #Pathophysiology Accesed on October, 20 2015
-  Jump up to: 2.0 2.1 2.2 2.3 2.4 2.5  Epidemiology. HAIRY CELL LEUKEMIA FOUNDATION. (2015) / Accessed on October, 21 2015
Sandbox:opht

# Overview
It is important to have accurate insight when you are interpreting an imaging series such as CT scans, MRIs, or angiography. From a student's point of view, it may be needlessly complicated to look for a lesion in many frames. For this reason, creating an animated image with highlighted lesions is preferable to uploading many images, since it makes the image more accessible for all users.  Here we describe how to make an animated GIF file with highlighted lesions.

# How to insert an imaging series for CT scan or MRI
If you want to present a series of images (e.g., CT scans, MRIs) instead of uploading many discrete images, you can highlight the pathologic part of the image by encircling it in yellow and then mixing the images to create a GIF file by following the steps listed below:
- The row image
- 1st highlighted image
- 2nd highlighted image
- 3rd highlighted image
- 4th highlighted image
- 5th highlighted image
- 6th highlighted image
- 7th highlighted image
- 8th highlighted image
- 9th highlighted image
- 10th highlighted image
- 11th highlighted image
Here are 2 examples for imaging series:
Sandbox:risk
- High risk neuroblastoma patients include:
- Patients with stage 2A/2B, 3, 4, or 4S tumor, irrespective of the age, irrespective of the grade, MYCN amplified
- Patients with stage 3 tumor,  547 days of age, unfavorable histology, MYCN not amplified
- Patients with stage 4 tumor, 365-547 days of age, unfavorable histology, DNA index=1, MYCN not amplified
- Patients with stage 4 tumor, >547 days of age, irrespective the grade, MYCN amplification state
Sandbox Tree
The Sandbox tree (Hura crepitans; syn. Hura brasiliensis Wild.), also known as Possumwood and Jabillo, is an evergreen tree of the spurge family (Euphorbiaceae), native to tropical regions of North and South America in Amazon Rainforest. It is recognized by the many dark, pointed spines and smooth brown bark. These spines have caused it to be called Monkey no-climb.
Sandbox trees can grow to 100 ft, and the large ovate leaves grow to two feet wide. They are monoecious. The red flowers have no petals. Male flowers grow on long spikes; female flowers are solitary in axils. The fruit is a large capsule with explosive dehiscence. When ripe, pods catapult the seeds as far as 100 meters (328 ft). It has also been known as the Dynamite tree, so named for the explosive sound of the ripe fruit as it splits into segments.
This tree prefers wet soil, and partial shade or partial sun to full sun. It is often cultivated for shade.
Fishermen have been said to use the milky, caustic sap from this tree to poison fish. The wood is used for furniture under the name "hura".
Hura crepitans is an additive to some forms of the hallucinogenic drink Ayahuasca.
Sarsaparilla
Sarsaparilla (pronounced SAS-per-il-luh, IPA /sspl/) (Smilax regelii and other closely related species of Smilax) is a perennial trailing vine with prickly stems native to tropical America and the West Indies. Its name (which is zarzaparrilla in Spanish) comes from the Spanish words zarza for "shrub" and parrilla for "little grape vine."
The name sarsaparilla can also refer to a drink made from the roots of the vine. The name "Sasparilla" is also often used but is a common mis-spelling of Sarsaparilla.

# History
Throughout history, Sarsaparilla has been used to cure syphilis. Native Americans used Saraparilla for its medical benefits also. The root of the plant is what is used in medicine. In the nineteenth century, it was believed it could improve one's vigor.

# Uses
Sarsaparilla contains active principle, Parillin (Smilacin), glucoside, sarsapic acid, sarsapogenin (related to progesterone  and used in its synthesis), sarsaponin and starch 
Fatty acids:
- palmitic acid
- stearic acid
- behenic acid
- oleic acid
- linolic acid
Oral remedy for psoriasis

# Appearance
The vine has a long prickly stem and shiny leaves, and numerous reddish-brown roots up to 3 meters long. Several species of Smilax are used in agriculture, but the Jamaican S. regelii (syn. S. officinalis) is the species preferred for commercial use. Sarsaparilla is also grown in Mexico, Central America and parts of South America. It is also grown in parts of South India, known in Telugu as Sugandhi-pala, in Kannada as sogade beru and in Tamil as Nannaari. The primary uses of sarsaparilla include the flavoring of beverages, and folk medicine.
Before processing, the roots are bitter, sticky, and have a strong odor. They are dried and boiled in order to produce the extract. In beverages, oil of wintergreen or other flavors may be added in order to mask the natural bitterness of the root. Root beer made from sarsaparilla roots is generally more "birchy" than the sarasparilla extract used in the more popular, commercial brands.
A carbonated beverage, made from and called sarsaparilla, is available in many countries.
Schizophasia
In the mental health field, schizophasia, commonly referred to as word salad (see "word salad" for other meanings), is used to describe the symptom of confused, and often repetitious, language that is symptomatic of various mental illnesses. It is usually associated with a manic presentation and other symptoms of serious mental illnesses, such as psychoses, including schizophrenia.
It describes the apparently confused usage of words with no apparent meaning or relationship attached to them.  In this context, it is considered to be a symptom of a formal thought disorder. In some cases schizophasia can be a sign of asymptomatic schizophrenia; e.g. the question "Why do people believe in God?" could elicit a response consisting of a series of words commonly associated with religion or prayer but strung together with no regard to language rules.
Schizophasia is in contrast to another symptom of cognitive disruption and cognitive slippage. It may, or may not, be grammatically correct depending on the severity of the disease and the particular mechanisms which have been impacted by it. Thus, "Satan, oscillate my metallic sonatas" as well as "Blue does runs shaky lovely very" can be authentic schizophasias (one grammatically correct, one not) if they were produced as a result of mental disease or defect. In contrast, intentionally producing nonsense, as in the contrived palindrome "Satan, oscillate my metallic sonatas" is not really considered schizophasia, due to the intentional production of that language. Schizophasia refers to a defect in processing and organizing language, as opposed to the ability to create a nonsense word which happens to conform to a very specific set of rules.
The American diagnostic codes, from the DSM-IV, do not specifically code for this disorder although they include it as a symptom under the diagnosis of Schizophrenia.
Scrotal cyst
Synonyms and keywords:: Idiopathic scrotal calcinosis, idiopathic calcified nodules of the scrotum,

# Overview
Idiopathic scrotal calcinosis (also known as idiopathic calcified nodules of the scrotum) is a cutaneous condition characterized by calcification of the skin resulting from the deposition of calcium and phosphorus occurring on the scrotum.:528 However, the levels of calcium and phosphate in the blood are normal. Idiopathic scrotal calcinosis typically affects young males, with an onset between adolescence and early adulthood. The scrotal calcinosis appears, without any symptoms, as yellowish nodules that range in size from 1 mm to several centimeters.

# Pathogenesis
The cause is not well defined.

# Physical examination

## Gallery

### Skin
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# Treatment
Treatment may involve surgery, which is currently the only recommended intervention. Surgery should include the removal of even small nodules, to prevent the recurrence of the scrotal calcinosis.

# History
Scrotal calcinosis was first described in 1883 by Lewinski.
Segmentation
Segmentation in biology refers to the division of some metazoan bodies and plant body plans into a series of semi-repetitive segments, and the question of the benefits and costs of doing so. As such, segmentation is related to the more general concept of modularity.
Examples of segmented animals are the annelids and arthropods. However it does not exist in cnidarians. Vertebrae are also inherited in a segmented way, making it easy for those animals to adapt to have the correct number of these spinal cord segments in the vertebral column. This has been extensively studied in mice. Among plants, the horsetails are a clear example of segmentation.
Segmentation allows for a high degree of specialization of bodily regions. This regional specialization is seen to some degree in annelids, but is an evolutionary development of the body plan of arthropods.
The process of establishing such a segmented body pattern is discussed in morphogenesis.
de:Segmentierung (Biologie)
sv:Segmentering
Selenic acid
Selenic acid is the chemical compound with the formula H2SeO4.  This  oxoacid is more descriptively written (HO)2SeO2, which emphasises that Se is attached to four oxygen atoms.  As predicted by VSEPR theory, the selenium center is tetrahedral.

# Preparation and reactions
Selenic acid is prepared by oxidation of selenium dioxide with hydrogen peroxide:
To obtain the anhydrous acid as a crystalline solid, the resulting solution is evaporated at temperatures<140 C in vacuum.
Like sulfuric acid, selenic acid is a strong acid that is hygroscopic and extremely soluble in water.  Concentrated solutions are viscous.  Crystalline mono- and di-hydrates are known.  Unlike sulfuric acid, H2SeO4 is a sufficiently strong oxidizer to liberate chlorine from chloride ions, being reduced to selenious acid (selenic  acid).
Selenic acid reacts with barium salts to precipitate BaSeO4, analogous to the sulfate.  Calcium selenate is however more soluble than the sulfate.
Treatment of selenic acid with fluorosulfuric acid gives the dioxydifluoride (b.p. -8.4C):
Hot selenic acid is capable of dissolving gold.
Serotonergic
Serotonergic or serotoninergic means "related to the neurotransmitter serotonin".  A synapse is serotonergic if it uses serotonin as its neurotransmitter.  A substance is serotonergic if it produces its effects via interactions with the serotonin system.
A serotonergic, or serotonergic agent, is any chemical which functions to enhance the effects mediated by serotonin in the central nervous system, and they include the following classes of chemicals:
- Serotonin precursors (such as tryptophan and 5-HTP)
- Cofactors required in the body's production of serotonin
- Serotonergic enzymes
- Selective serotonin reuptake inhibitor - A common class of serotonergic antidepressants
- Noradrenergic and specific serotonergic antidepressant - Another class of serotonergic antidepressants
- serotonergic psychedelics - The serotonergic psychedelic drugs
Serous fluid
In physiology, the term serous fluid is used for various bodily fluids that are typically pale yellow and transparent, and of a benign nature.
Saliva consists of mucus and serous fluid; the serous fluid contains the enzyme amylase important for the digestion of carbohydrates. Minor salivary glands of von Ebner present on the tongue secrete the amylase. The parotid gland produces purely serous saliva. The other major salivary glands produce mixed (serous and mucus) saliva.
Another type of serous fluid is secreted by the serous membranes (or serosa), two layered membranes which line the body cavities. The serous fluid between the two layers acts as a lubricant and reduces friction from muscle movement.
A common trait of serous fluids is their role in assisting digestion, excretion, and respiration.
Blood serum is the liquid part of blood remaining after clotting, and is therefore lacking in clotting factors. It is therefore distinct from blood plasma.
Sialoadhesin
Sialoadhesin is a cell adhesion molecule found on the surface of macrophages. It is found in especially high amounts on macrophages of the spleen, liver, lymph node, bone marrow, colon, and lungs. Also, in patients suffering from rheumatoid arthritis, the protein has been found in great amounts on macrophages of the affected tissues. It is defined as an I-type lectin, since it contains 17 immunoglobulin (Ig) domains (one variable domain and 16 constant domains), and thus also belongs to the immunoglobulin superfamily (IgSF).  Sialoadhesin binds to certain molecules called sialic acids. During this binding process a salt bridge (protein) is formed between a highly conserved arginine residue (from the v-set domain to the 3'-sialyllactose) and the carboxylate group of the sialic acid. Since sialoadhesin binds sialic acids with its N-terminal IgV-domain, it is also a member of the SIGLEC family. Alternate names for sialoadhesin include siglec-1 and CD169 (cluster of differentiation 169).
Sialoadhesin predominantly binds neutrophils, but can also bind monocytes, natural killer cells, B cells and a subset of cytotoxic T cells by interacting with sialic acid molecules in the ligands on their surfaces.
Sialaodhesin (CD169) positive macrophages, along with mesenchymal stem cells and beta-adrenergic neurons, form the hematopoietic stem cell niche in the bone marrow.  CD169+ macrophages mediate signaling between the various cells and seem to promote hematopoietic stem cell retention to the niche.
Silicic acid
Silicic acid is a general name for a family of chemical compounds of the element silicon, hydrogen, and oxygen, with the general formula n.  Some simple silicic acids have been identified in very dilute aqueous solution, such as metasilicic acid (H2SiO3), orthosilicic acid (H4SiO4, pKa1=9.84, pKa2=13.2 at 25 C), disilicic acid (H2Si2O5), and pyrosilicic acid (H6Si2O7); however in the solid state these probably condense to form polymeric silicic acids of complex structure.
Silicic acids may be formed by acidification of silicate salts (such as sodium silicate) in aqueous solution.  When heated they lose water to form silica gel, an active form of silicon dioxide.
In the oceans, silicon exists primarily as orthosilicic acid (H4SiO4), and its biogeochemical cycle is regulated by the group of algae known as the diatoms.  These algae polymerise the silicic acid to so-called biogenic silica, used to construct their cell walls (called frustules).
Continuing research of the correlation of aluminium and Alzheimer's disease has in the last few years included the use of silicic acid in beverages, due to its abilities to both reduce aluminium uptake in the digestive system as well as cause renal excretion of aluminium.
Orthosilicic acid is the form predominantly absorbed by humans and is found in numerous tissues including bone, tendons, aorta, liver and kidney. Compelling data suggest that silica is essential for health although no RDI has been established. However, deficiency induces deformities in skull and peripheral bones, poorly formed joints, reduced contents of cartilage, collagen, and disruption of mineral balance in the femur and vertebrae.
Choline-stabilized orthosilicic acid is bioavailable nutritional supplement. It has been shown to stimulate collagen type 1 synthesis and osteoblastic differentiation in human osteoblast-like cells in vitro, improve hair tensile strength, have positive effect on skin surface and skin mechanical properties, and on brittleness of hair and nails, abate brittle nail syndrome, partially prevent femoral bone loss in the aged ovariectomized rat model, and increase collagen concentration in calves