Persius/hicric huggingface dataset:
Tienilic acid

# Overview
Tienilic acid (INN and BAN) or ticrynafen (USAN) is a loop diuretic drug with uric acid-lowering (uricosuric) action, formerly marketed for the treatment of hypertension. It was approved by FDA on May 2, 1979, and withdrawn in 1982, after case reports in the United States indicated a link between the use of ticrynafen and hepatitis.
Criminal charges were brought against SmithKline executives with regard to hiding data related to toxicity while gaining FDA approval.  The company pleaded guilty to 14 counts of failure to report adverse reactions and 20 counts of selling a misbranded drug.
Tienilic acid was found to act as a suicide substrate at the cytochrome P450 enzymes involved in drug metabolism. Unfortunately, the metabolic reaction carried out by these enzymes converted tienilic acid to a thiophene sulfoxide which proved highly electrophilic. This encouraged a Michael reaction leading to alkylation of a thiol group in the enzyme's active site. Loss of water from the thiophene sulfoxide restored the thiophene ring and resulted in tienilic acid being covalently linked to the enzyme, thus inhibiting the enzyme irreversibly.
The above explanation is a hypothesis. It is still not known (after 15 years) if the reactive intermediate which inactivates the CYP2C9 is the thiophene sulfoxide or the thiophene epoxide. The target on the protein is also not known (could be multiple). However tienilic acid is a good mechanism based inhibitor of CYP2C9 and seems to inactivate it stoichiometrically. Progress in proteomics may one day give the answer.
Recent studies indicate that in fact the primary metabolite of tienilic acid (5-OH tienilic acid) cannot be derived from a thiophene-S-oxide intermediate as was previously hypothesized. It was determined to be derived from a thiophene epoxide intermediate and this reactive intermediate is then likely a cause for the covalent binding to as well as mechanism-based inactivation of CYP2C9.
Timothy-grass
Timothy-grass (Phleum pratense), is an abundant perennial grass native to most of Europe except for the Mediterranean region. It grows to 50150 cm tall, with leaves up to 45 cm long and 1 cm broad. The flowerhead is 715 cm long and 810 mm broad, with densely packed spikelets.
Timothy-grass can be confused with Meadow Foxtail (Alopecurus pratensis) and Purple-stem Cat's-tail (Phleum phleoides).
There are two subspecies:
- Phleum pratense subsp. pratense. Larger, to 150 cm tall. Widespread.
- Phleum pratense subsp. bertolonii. Smaller, to 70 cm tall. Calcareous grassland.

# Cultivation and uses
Timothy-grass was unintentionally introduced to North America by early settlers, and was first described in 1711 by John Herd from plants growing in New Hampshire. Herd named the grass "herd grass" but a farmer named Timothy Hanson began to promote cultivation of it as a hay about 1720, and the grass has been known by its present name since then.
It is commonly grown for cattle feed and, in particular, as hay for horses. It is relatively high in fibre, especially when cut late. It is considered part of the standard mix for grass hay and provides quality nutrition for horses. Timothy hay is a staple food for domestic pet rabbits, guinea pigs, and degus, often making up the bulk of their diet. The caterpillars of some Lepidoptera use it as a foodplant, e.g. the Essex Skipper (Thymelicus lineola).
Its pollen is a common allergen;  It has recently been used in small amounts as part of a new hay fever vaccine Grazax, which is designed to recondition the body's immune system so it no longer responds to pollen.
Token economy
A token economy is a system of behavior modification based on the principles of operant conditioning. Contingency management systems are often employed by those who practice applied behavior analysis. It is one approach to a contingency management program. Specifically, the original proposal for such a system emphasized reinforcing positive behavior by awarding "tokens" for meeting positive behavioral goals. The first therapeutic use of a token system was by Avendano y Carderera in 1859, who described a "ticket" for rewarding good behavior in children. The system as popularized in a year-long study conducted by Teodoro Ayllon in Florida was primarily geared towards changing adolescent behavior. Ayllon's study included only adolescent males.
Ayllon's tokens themselves were not reinforcers; tokens were accumulated and "spent" in order to obtain a reinforcer.  "Patients earn tokens, which they can exchange for privileges, such as time watching television or walks on the hospital grounds, by completing assigned duties (such as making their beds) or even just by engaging in appropriate conversations with others" (Nolen-Hoeksema's Abnormal Psychology, p.409).  Early during the program, a participant would be required to spend all of his or her tokens daily to emphasize the reinforcement activity early, and as time passed and success was made, participants would be allowed (or required) to accumulate their tokens over the course of longer time periods.  This, as a variable-rate scheduling system, helped prevent extinction of the behavior after the program's termination.

# Proceeding
The following must be defined:
- Desired behavior(Transparency)
- A large number of rewards
- What is a token
- How are tokens allocated
- How are the token earnings changing while approaching the goals
- How many tokens will be earned achieving the desired behavior
- How many tokens are necessary to get rewards (or maybe to do be allowed to do something). Earning and exchange of tokens have to be      in a well-balanced proportion.
If the desired behavior is achieved, the token program must be faded out.

# Advantages of token economy
- tokens are flexible
- tokens can be used for several needs and therefore saturation is improbable
- there is no delay giving tokens after the desired behavior has been shown
- it does not matter who gives the tokens (an automat is also possible)
- mostly the token economy is well-regulated thus it is easy for therapists to decide whether they have to give a token or not

# Requirements of token economy
- it is very important to observe the rules (nobody must give them awards otherwise the token economy will be corrupted)
- 10% - 20% of clients do not respond to token economies
Tonsil stones

# Overview
Tonsil Stones are a formation combined of food debris, excess phloem, and the remains of white blood cells.  The reason why they form in the tonsils is because the tonsil, especially at a young age, is meant to trap foreign debris entering the mouth.  It's essentially a protector for your body.  White blood cells are your body's normal defense against a multitude of things entering your body but in this case they attack debris in the tonsil, building thicker and thicker and eventually creating a tonsillolith.  Tonsil Stones hide in the holes in your tonsils which are technically known as "tonsil crypts".

# Symptoms
Some typical symptoms of having tonsil stones are chronic bad breath, the feeling of something stuck in your throat that you can't get out, and feeling like you have to brush your teeth more than three times a day, (never feeling like your breath is fresh).  Of course if you look in the mirror and you see white things sticking out of your tonsils, or if you cough up little white chunks, they're both a sure sign of having tonsil stones.  While harmless in nature they're nothing more than annoyance and they don't have any physical negative effects on your body.

# Risk Factors and Promoters
Some foods that aggravate and promote tonsil stone growth are, dairy products (especially milk), high protein meats like fish, sugars and acidic things like coffee

# Treatement
There are a variety of ways that one can remove a tonsil stone.  The most common is using any form of applying pressure to the side of the tonsil to push the tonsil stone out of the crypt.  Some use a waterpik to do this, some use a qtip or even just their finger.  Be careful of your gag reflex in all cases.

# Commercial Products to Prevent Tonsil Stones
While there's many commercial products out there that claim to be effective at combating tonsil stone growth, there's only a handful that actually work well.  Some of the brands out there that sell products for this are profresh, breathrx, therabreath, oramd, smartmouth, to name a few.
Tortilla Wall
The Tortilla Wall is a term given to a 14 mile (22.5 kilometer) section of United States border fence between the Otay Mesa Border Crossing in San Diego, California and the Pacific Ocean. This "San Diego wall" was completed in the early 1990s. While there are other walls at various points along the border, the Tortilla Wall is the longest to date.
The Tortilla Wall is marked with graffiti, crosses, photos and remembrances of individuals who have died trying to illegally cross into the United States.

# Effectiveness
The effectiveness of the wall has been significant according to U.S. Congressional testimony
"...apprehensions along the region with a security fence dropped from 202,000 in 1992 to 9,000 in 1994."
The building of the tortilla wall is generally considered by Mexicans to be an unfriendly gesture.  It is a symbol of the controversial immigration issue. It is argued that the wall simply forces illegal border crossings to be moved to the more dangerous area of the Arizona desert.

# The Future of the Tortilla Wall
In 2006, the U.S. Congress voted The Secure Fence Act of 2006 which authorized spending $1.2 billion to build 700 miles (1,100 km) of additional fencing on the southern border facing Mexico.  Additional fencing would lend some plausibility that the Tortilla Wall will continue to have support on the U.S. side.

# Anecdotal Wall Stories
Tunnels under the wall are still a popular way to cross the border.  Some tunnels are quite sophisticated.  One such tunnel created by smugglers ran from Tijuana to San Diego, was a half mile long, and included a concrete floor as well as electricity.  Other tunnels have included steel rails, while other tunnels are simply dirt passageways or connect to sewer or drain systems.
As a stunt, a circus cannon was placed on the south side of the wall and an acrobat was blasted over the wall into the Border Field State Park in the U.S.  He had his passport with him.
Transcriptome

# Overview
The transcriptome is the set of all messenger RNA (mRNA) molecules, or "transcripts", produced in one or a population of cells. The term can be applied to the total set of transcripts in a given organism, or to the specific subset of transcripts present in a particular cell type. Unlike the genome, which is roughly fixed for a given cell line (excluding mutations), the transcriptome can vary with external environmental conditions. Because it includes all mRNA transcripts in the cell, the transcriptome reflects the genes that are being actively expressed at any given time, with the exception of mRNA degradation phenomena such as transcriptional attenuation. The study of transcriptomics examines the expression level of mRNAs in a given cell population, often using high-throughput techniques based on DNA microarray technology.

# Applications and analysis
The transcriptomes of stem cells and cancer cells are of particular interest to researchers who seek to understand the processes of cellular differentiation and carcinogenesis. A number of organism-specific transcriptome databases have been constructed and annotated to aid in the identification of genes that are differentially expressed in distinct cell populations or subtypes; however, the analysis of relative mRNA expression levels can be complicated by the fact that relatively small changes in mRNA expression can produce large changes in the total amount of the corresponding protein present in the cell. One analysis method, known as Gene Set Enrichment Analysis, identifies coregulated gene networks rather than individual genes that are up- or down-regulated in different cell populations.

# mRNA regulation
Although microarray studies can reveal the relative amounts of different mRNAs in the cell, levels of mRNA are not directly proportional to the expression level of the proteins they code for. The number of protein molecules synthesized using a given mRNA molecule as a template is highly dependent on translation-initiation features of the mRNA sequence; in particular, the ability of the translation initiation sequence is a key determinant in the recruiting of ribosomes for protein translation. The complete protein complement of a cell or organism is known as the proteome.
A study of 158,807 mouse transcripts revealed that 4520 of these transcripts form antisense partners that are base pair complementary to the exons of genes. These results raise the possibility that significant numbers of "antisense RNA-coding genes" might participate in the regulation of the levels of expression of protein-coding mRNAs.
Transportin-3
Transportin-3 is a protein that in humans is encoded by the TNPO3 gene.

# Function
TNPO3 is a nuclear import receptor for serine/arginine-rich (SR) proteins, including Serine/arginine-rich splicing factor 1, which are essential precursor-mRNA splicing factors.

# Clinical significance
The TNPO3-IRF5 locus is implicated in primary biliary cirrhosis and systemic sclerosis.
Transportin 1
Transportin-1 (or Importin- 2) is a protein that in humans is encoded by the TNPO1 gene.

# Function
This protein is a karyopherin which interacts with nuclear localization sequence to target nuclear proteins to the nucleus. The classical karyopherin receptor complex, such as the complex that uses Importin-1 (encoded by gene KPNB1), is a heterodimer of an alpha subunit which recognizes the nuclear localization signal and a beta subunit which docks the complex at nucleoporins. However, Transportin-1 can directly bind to the cargo proteins and may not need importin alpha subunit to do it.
Transportin-1 is thought to use the same principal mechanism to carry out nuclear transport as other Importins. It mediates docking to the nuclear pore complex through binding to nucleoporin and is subsequently translocated through the pore by an energy requiring mechanism. Then, in the nucleus Ran binds to Transportin-1, it dissociates from cargo, and Transportin-1 is re-exported from the nucleus to the cytoplasm where GTP hydrolysis releases Ran. Then Transportin-1 is free to bind new cargo.
In addition, Transportin-1 is implicated in helping protein transport into primary cilium. The function of Transportin-1 in this case is thought to be similar to carrying proteins into the nucleus through a nuclear pore. Transportin-1 binds cargo and then is helping this cargo to pass through a pore at the base of the cilium. Ran and nucleoporins are also implicated in this mechanism.
Alternate splicing of this gene results in two transcript variants encoding different proteins.

# Targets
Transportin 1 (TRN1) is part of the non-classical nuclear import pathway. In conjunction with the RanGTP hydroysis cascade TRN1 acts to import a selection of proteins into the nucleus of cells. These targets typically contain a PY-motif otherwise known as a M9 nuclear localisation signal. Well described examples include hnRNP A1.
The type of cargo proteins that Transportin 1 can carry into the nucleus include RNA-binding proteins (such as hnRNP A1 and hnRNP F) and also ribosomal proteins.

# Clinical Significance
TRN1 has been implicated in the pathogenesis of two neurodegenerative diseases namely Amyotrophic lateral sclerosis and frontotemporal dementia.

# Interactions
Transportin 1 has been shown to interact with:
- RGPD5 and
- Ran (biology).
Trauma center

# Overview
A trauma center is a hospital equipped to perform as a casualty receiving station for the emergency medical services by providing the best possible medical care for traumatic injuries 24 hours a day, 365 days per year. Trauma centers were established as the medical establishment realized that such injuries often require immediate and complex surgery to save the patient.
In order to qualify as a trauma center, a hospital must have a number of facilities, including a high-quality intensive-care ward and an operating room staffed around the clock. A trauma service is led by a team of trauma surgeons, including such specialists as neurosurgeons and orthopedic surgeons.  A trauma center will often have a helipad for receiving patients by MEDEVAC.
The operation of a trauma center is extremely expensive.  Some areas are under-served by trauma centers because of this expense (for example, Harborview Medical Center in Seattle, Washington serves the states of Washington, Idaho, Montana, and Alaska). In Florida, Orlando Regional Medical Center, built to serve five counties, serves more than twenty. Still, in many cases, persons injured in remote areas and brought to a trauma center by helicopter can receive faster and better care than a person injured in a city and taken to a normal hospital by ground ambulance.
In the United States, trauma centers are ranked, from limited-care facilities up to comprehensive service in Level I centers.  Some centers specialize in adult or pediatric care.

# History
The concept of a trauma center was developed at the University of Maryland, Baltimore in the 1960s and 1970s by heart surgeon and shock researcher R Adams Cowley, who founded what became the Shock Trauma Center in Baltimore, Maryland in 1961 . Cook County Hospital in Chicago, Illinois claims to be the first trauma center (opened in 1966) in the United States.  Dr. David R Boyd interned at Cook County Hospital from 1963-1964 before being drafted into the United States Army. Upon his release from the Army, Dr. Boyd became the first shock-trauma fellow at the Shock Trauma Center from 1967-1968. Dr. Boyd returned to Cook County Hospital, where he went on to serve as resident director of the Cook County Trauma Unit.

# Definitions
The four levels refer to the kinds of resources available in a trauma center and the number of patients admitted yearly.  These are categories that define national standards for trauma care in hospitals.  Developed and recommended by the American College of Surgeons.
Tree marigold
The tree marigold, Mexican tournesol, Mexican sunflower or Nitobe chrysanthemum (Tithonia diversifolia) is a species of plant in the Asteraceae family now distributed in tropical and subtropical areas such as Central America, Southeast Asia and Africa. Depending on the area they may be either annual or perennial, two to three metres in height with upright and sometimes ligneous stalks in the form of woody shrubs. The flowers are orange. It is widely accepted that they were at one stage native to Central America or Mexico, hence the name.

# Symbolism and Uses
- In Japan, towards the end of the Meiji Period, they were imported as ornamental plants although seldom cultivated there. Having a characteristic bitter taste, they were  used to induce a fever to help fight poisoning, although not used for direct medicinal purposes. There is also the story of the species being introduced to Japan by Nitobe Inazo, hence its Japanese name, the Nitobe chrysanthemum (; Nitobegiku).
- In Mexico, they are used to treat sprains, bone fractures, bruises and contusions.
- In Southern China they are used to treat skin diseases (such as athlete's foot), night sweats, as a diuretic, hepatitis, jaundice and cystitis.
- They are sold in herbal medicine markets in Taiwan to be infused to improve liver function.
- It is the provincial flower of Mae Hong Son Province, Thailand.
de:Mexikanische Sonnenblume
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Tricep reflex
The tricep reflex is tested as part of the neurological examination to asses the sensory and motor pathways within the C7 and C8 spinal nerves. The triceps reflex originates from the triceps brachii muscle, and is initiated by the C7 nerve root.

# Testing
The test is performed by tapping the tendon while the forearm is hanging loose at a right angle to the arm. A sudden contraction of the triceps muscle causes extension of the forearm, and indicates a normal reflex.

# Test indicators
- Normal: There are no problems detected.
- Absence of a reflex (areflexia): If no reflex is elicited then it is essential to try again with reinforcement, with the patient clenching his or her teeth just as the reflex hammer strikes.
- Hyper-reflexia (a response far larger than considered normal): Indicates a potential upper motor neurone lesion.

# Absence of reflex
An absence of reflex can be an indicator of several medical conditions: Myopathy, neuropathy, spondylosis, sensory nerve disease, euritis, potential lower motor neurone lesion, or poliomyelitis.
Other medical problems that may cause irregular reflexes include Hyperthyroidism and Hypothyroidism.
Trimeperidine
Trimeperidine (Promedol) is an opioid analgesic that is an analogue of prodine. It was developed in the 1950s during research into the related drug pethidine.
Trimeperidine has four structural isomers, of which two are active, the  isomer trimeperidine, and the  isomer isopromedol. It is around half the potency of morphine as an analgesic, and has been widely used for the treatment of pain.
Trimeperidine produces similar effects to other opioids, such as analgesia and sedation, along with side effects such as nausea, itching, vomiting and respiratory depression which may be harmful or fatal.
Trimetazidine

# Overview
Trimetazidine is a drug for angina pectoris sometimes referred to by the brand name Vastarel MR. Each tablet contains 35 mg of trimetazidine.
Trimetazidine is an anti-ischemic (anti-anginal) metabolic agent, that improves myocardial glucose utilization through inhibition of Fatty acid metabolism.
By preserving the energy metabolism in cells exposed to hypoxia or ischemia, trimetazidine prevents a decrease in intracellular adenosine triphosphate levels, thereby ensuring the proper functioning of ionic pumps and transmembranous sodium-potassium flow whilst maintaining cellular homeostasis.
The drug also inhibit b oxidation of fatty acid in blood vessles
Controlled studies in angina patients have shown that trimetazidine increases coronary flow reserve, thereby delaying the onset of ischemia associated with exercise, limits rapid swings in blood pressure without any significant variations in heart rate, significantly decreases the frequency of angina attacks, and leads to a significant decrease in the use of nitrates.
It improves left ventricular function in diabetic patients with coronary artery disease. Recently, it has been shown to be effective in patients with heart failure of different etiologies.
It is described as the first cytoprotective anti-ischemic agent, acts by directly counteracting all the major metabolic disorders occurring within the ischemic cell. The actions of trimetazidine include limitation of intracellular acidosis, correction of disturbances of transmembrane ion exchanges, and prevention of excessive production of free radicals.
It is usually prescribed as a long-term treatment of angina pectoris, and in some countries (including France) for tinnitus and dizziness.

# Interactions
Vastarel MR has high safety and tolerability profile.
Q. Can i use sildenafil(viagra) while taking Vastarel MR?
A. Go on, unlike nitrates, Vastarel MR with sildenafil is fully safe (allowed).
Vastarel MR is very safe (no drug-drug interactions)

# Dosage and Administration
Vastarel MR tablets is taken twice daily, providing 24-hr cardioprotection.

# World Wide
Vastarel MR is also distributed as: Vastarel 35 mg, Vastarel 20 mg, Vastarel LM, Vastarel LP, Preductal MR, Flavedon MR and Trizedon MR.