Persius/hicric huggingface dataset:
ME/CFS outbreaks
Myalgic Encephalomyelitis is often associated with outbreaks. This leads to the firm belief among many researchers and patient groups that the illness is, at least in its initial forms, a contagious virus or triggered by one or more such viruses.
Especially in early documented cases, the name of the condition varies significantly, even in cases where it is believed by the people attending to it at the time to be a form of polio.
Clusters of symptoms also vary between outbreaks.

# Outbreaks in chronological order
- Los Angeles County Hospital
- St Anges Convent, Fond-du-Lac, Wisconsin
- Erstfeld, Switzerland and Frohburg, Switzerland
- Harefield Sanatorium in Middlesex, England
- Switzerland
- University Hospital of Pennsylvania
- Iceland in 1946 and 1947
- Three north coast towns in Iceland in 1948-1949
- Adelaide, South Australia in 1949-1951
- Louisville, Kentuky in 1950
- Upper New York State
- Middlesex Hospital Nurse's Home in London, England, 1952
- Copenhagen, Denmark
- Lakeland, Florida
- Coventry District, England
- Rockville, Maryland at Chestnut Lodge Hospital
- Jutland, Denmark
- Tallahassee, Florida
- Seward, Alaska
- British Army stationed in Berlin, Germany
- Liverpool, England at Liverpool Hospital
- Johannesburg, South Africa, through 1955
- Dalston, Cumbria, England
- London, England at the Royal Free Hospital
- Perth, Western Australia
- Gilfach Goch, Wales
- Durban City, South Africa  at Addington Hospital
- Segbwema, Sierra Leone through 1956
- Patreksfordur and Thorshofn, Iceland
- North West London, England at a residential home for nurses
- Ridgefield, Connecticut, United States
- Punta Gorda, Florida, United States
- Newton-le-Willows, Lancashire, England
- Pittsfield and Williamstown, Massachusetts, United States
- Coventry, England through 1957
- Brighton, South Australia
- Athens, Greece, in a nursing school
- Newcastle upon Tyne, England
- A New York State convent (United States)
- Northwestern London, England  through 1966
- A Franklin, Kentucky factory in the United States
- Galveston County, Texas, United States through 1966
- Fraidek, Lebanon
- State University of New York Medical Centre, United States
- Lackland Air Force Base, Texas, United States
- London, England at the Hospital for Sick Children on Great Oromond Street
- Sacramento, California, United States  at the Mercy San Juan Hospital
- Dallas and Fort Worth, Texas, United States
- Southampton, England at a girls' school
- West Kilbridge, Ayrshire, Scotland through 1981
- Helensburgh, Scotland through 1983
- West Otago, New Zealand through 1984
- Gunnedah, New South Wales, Australia
- Incline Village in Lake Tahoe, Nevada, United States
- Chapel Hill, North Carolina, United States affecting the North Carolina Symphony Orchestra
- Montreal, Quebec and Ontario, Canada
- Truckee, California through 1985
- Lyndonville, New York, United States
- Yerington, Nevada, United States at a reservation
- Placerville, California, United States
- Columbia Community College and Sonora, California
- Rosedale Hopital, Roseville, California
- Elk Grove, California
Magnesium iodide
Magnesium iodide is the name for the chemical compounds with the formulas MgI2 and its various hydrates MgI2(H2O)x.  These salts are typical ionic halides, being highly soluble in water.  Magnesium iodide has few commercial uses but can be used to prepare compounds for organic synthesis.

# Reactions
Magnesium iodide can be prepared from magnesium oxide, magnesium hydroxide, and magnesium carbonate by treatment with hydroiodic acid:
Magnesium iodide is stable at high heat under a hydrogen atmosphere, but decomposes in air at normal temperatures, turning brown from the release of elemental iodine. When heated in air, it decomposes completely to magnesium oxide
Usage of magnesium iodide in the Baylis-Hillman reaction tends to give (Z)-vinyl compounds
Maintenance dose
A maintenance dose is the maintenance rate  of drug administration equal to the rate of elimination at steady state.  This is not to be confused with a dose regimen, which is a type of drug therapy in which the dose  of a drug is given at a regular dosing interval on a repetitive basis. Continuing the maintenance dose for about 4 to 5 half lives (t12) of the drug will approximate the steady state level. One or more doses higher than the maintenance dose can be given together at the beginning of therapy with a loading dose.
A loading dose is most useful for drugs that are eliminated from the body relatively slowly.  Such drugs need only a low maintenance dose in order to keep the amount of the drug in the body at the appropriate level, but this also means that, without an initial higher dose, it would take a long time for the amount of the drug in the body to reach that level.

# Calculating the maintenance dose
The required maintenance dose may be calculated as:
Where:
For an intravenously administered drug, the bioavailability F will equal 1, since the drug is directly introduced to the bloodstream. If the patient requires an oral dose, bioavailability will be less than 1 (depending upon absorption, first pass metabolism etc.), requiring a larger loading dose.
Majocchi disease
Synonyms and keywords: Purpura annularis telangiectodes; purpura annularis telangiectodes of Majocchi.

# Overview
Majocchi's disease (also known as "Purpura annularis telangiectodes," and "Purpura annularis telangiectodes of Majocchi") is a skin condition characterized by bluish-red 1- to 3-cm annular patches composed of dark red telangiectases with petechiae.:829

# Physical Examination

## Extremities
- Majocchis disease.  With permission of Dermatology Atlas"Dermatology Atlas"..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}
- Majocchis disease.  With permission of Dermatology Atlas"Dermatology Atlas".
- Majocchis disease.  With permission of Dermatology Atlas"Dermatology Atlas".
- Majocchis disease.  With permission of Dermatology Atlas"Dermatology Atlas".
- Majocchis disease.  With permission of Dermatology Atlas"Dermatology Atlas".
Malaise overview

# Overview
Malaise is a feeling of general discomfort or uneasiness, an "out of sorts" feeling, often the first indication of an infection or other disease. Often defined in medicinal research as a "general feeling of being unwell".
Colloquially, malaise has been referred to as "the  creeping crud" (especially in reference to the malaise caused by communicable diseases such as influenza and the common cold). This usage may have originated in folk medicine, but it is adopted from the French word meaning "discomfort," "feeling faint," "feeling sick."
The term is also often used figuratively in such contexts as "economic malaise."

# Historical Perspective
U.S. President Jimmy Carter, who on July 15, 1979, gave his famous "national malaise" speech where he described a "crisis in the growing doubt about the meaning of our own lives and in the loss of a unity of purpose for our nation." The word "malaise" did not appear in the text of the speech.

# Cause
There can be various causes to a malaise, from the slightest like an emotion (causing vagal response) or hunger (lighthypoglycemia) to the most serious (cancer, cerebrovascular accident, internal bleeding etc.).
Generally speaking, the malaise expresses that "something is wrong," like a general warning light, but only a medical examination can determine the cause.

# Treatment

## Medical Therapy
The following step depends on the organization of the emergency medical assistance. Some countries provide free medical advice by phone (e.g., SAMU in France): it is then useful to call this service to know what to do. Otherwise, it is useful to contact the usual general practitioner of the person, to get his or her advice, or any medical or paramedical professional at least. The bystander who calls must mention all the elements collected so far.  When it is not possible to contact the individual's primary-care physician, it is then necessary to assess the situation in order to decide whether it is necessary to call anambulance.
Maleic anhydride

# Overview
Maleic anhydride (cis-butenedioic anhydride, toxilic anhydride, dihydro-2,5-dioxofuran) is an organic compound with the formula C4H2O3.  In its pure state it is a colourless or white solid with an acrid odour.
Maleic anhydride was traditionally manufactured by the oxidation of benzene or other aromatic compounds.  Due to rising benzene prices, most maleic anhydride plants now use n-butane as a feedstock.  As of 2006, only few smaller plants continue to use benzene:

# Characteristic reactions
The chemistry of maleic anhydride is very rich, reflecting its ready availability and bifunctional reactivity.
- It hydrolyzes, producing maleic acid, cis-HO2CCH=CHCO2H.  With alcohols, the half-ester is generated, e.g., cis-HO2CCH=CHCO2CH3.
- Maleic anhydride is a potent dienophile in Diels-Alder reactions.
- Maleic anhydride (MA) is an excellent ligand for low-valent metal complexes, examples being Pt(PPh3)2(MA) and Fe(CO)4(MA).
Mallampati score

# Overview
In anesthesiology, the Mallampati score, also Mallampati classification, is used to predict the ease of intubation.  It is determined by looking at the anatomy of the oral cavity; specifically, it is based on the visibility of the base of uvula, faucial pillars (the arches in front of and behind the tonsils) and soft palate. Scoring may be done with or without phonation. Higher Mallampati Score (Class 4) is associated with more difficult intubation as well as a higher incidence of Sleep Apnea.
Scoring is as follows:
Class 1: Full visibility of tonsils, uvula and soft palate
Class 2: Visibility of hard and soft palate, upper portion of tonsils and uvula
Class 3: Soft and hard palate and base of the uvula are visible
Class 4: Only Hard Palate visible
Manchester score

# Overview
Manchester score is an indicator of prognosis in small cell lung cancer. It is calculated from a number of physical and biochemical markers.
A patient with small cell lung cancer scores one point for each of the following: -
- Serum lactate dehydrogenase exceeds the upper limit of the reference range.
- Serum sodium concentration less than 132 mmol/l.
- Serum alkaline phosphatase over one-and-a-half times the upper limit of the reference range.
- Serum bicarbonate less than 24.
- Karnofsky performance status less than 60.
- Extensive stage disease.

# Prognosis
Mandibular nerve
The mandibular nerve (V3) is the largest of the three branches  of the trigeminal nerve.

# Structure

## Roots
It is made up of two roots:
- a large sensory root proceeding from the inferior angle of the trigeminal ganglion.
- a small motor root (the motor part of the trigeminal), which passes beneath the ganglion, and unites with the sensory root, just after its exit through the foramen ovale.

## Path
The two roots (sensory and motor) exit the middle cranial fossa through the foramen ovale.  The two roots then combine.  The nerve descends, soon splitting into an anterior division and a posterior division.
Immediately in the infratemporal fossa beneath the base of the skull, the nerve gives off two branches from its medial side: a recurrent branch (nervus spinosus) and the nerve to the medial pterygoid muscle. The mandibular nerve then divides into two trunks, an anterior and a posterior.

## Branches
The mandibular nerve gives off the following branches:
- From the main trunk of the nerve (before the division)
nervus spinosus (meningeal branch)
medial pterygoid nerve
nerve to tensor tympani
nerve to tensor veli palatini
- nervus spinosus (meningeal branch)
- medial pterygoid nerve
- nerve to tensor tympani
- nerve to tensor veli palatini
- From the anterior division
masseteric nerve
deep temporal nerves (anterior and posterior)
buccal nerve (a sensory nerve)
lateral pterygoid nerve
- masseteric nerve
- deep temporal nerves (anterior and posterior)
- buccal nerve (a sensory nerve)
- lateral pterygoid nerve
- From the posterior division
auriculotemporal nerve
lingual nerve
inferior alveolar nerve
motor branch to mylohyoid and anterior belly of digastric muscles (mylohyoid nerve)
- auriculotemporal nerve
- lingual nerve
- inferior alveolar nerve
- motor branch to mylohyoid and anterior belly of digastric muscles (mylohyoid nerve)
The mandibular nerve also gives off branches to the otic ganglion

# Supplies
The mandibular nerve innervates:
- mucous membrane of the anterior two-thirds of the tongue
- the inside of the cheek (the buccal mucosa)
- teeth and gums of the mandible
- skin of the temporal region
- auricula
- lower lip, and chin
- muscles of mastication
- the muscles tensor tympani and tensor veli palatini
Marjolin's ulcer
Marjolin's ulcer refers to an aggressive ulcerating squamous cell carcinoma presenting in an area of previously traumatised , chronically inflamed , or scarred skin .  They are commonly present in the context of chronic wounds including burn injuries, venous ulcers, ulcers from osteomyelitis , and post radiotherapy scars.
The term was named after French surgeon, Jean Nicolas Marjolin, who first described the condition in 1828.  The term was later coined by J C De Costa.

# Appearance
Marjolin's ulcer presents as a raised, firm, pink-to-flesh-colored papule or plaque arising in a chronic site of inflammation or scar.  It is characterized by slow growth, painlessness (as the ulcer is usually not associated with nerve tissue), and absence of lymphatic spread due to local destruction of lymphatic channels .

# Characteristics
Histologically, the tumour is a well-differentiated squamous cell carcinoma.  This carcinoma is aggressive in nature, spreads locally and is associated with a poor prognosis.

# Diagnosis
Biopsy is favored method of diagnosis.  Tissue specimens obtained should be taken from both the centre and margin of lesion, as the central ulcerated deposits may be necrotic.

# Treatment
Treatment is usually surgical, with a wide excision of the lesion; typically a 1 cm margin all around is required.
Martin R. Dinnes
Martin R. Dinnes is a renowned veterinarian from Agua Dulce, California recognized for his accomplishments in the profession of veterinary medicine.
Martin R. Dinnes graduated from UC Davis School of Veterinary Medicine in 1966. He is well-known for creating novel innovative medical protocols benefiting the health and well-being of zoological animals. He invented and developed the Telinject system for remotely injecting reptiles, mammals, and birds. He also has formulated and tested commercially produced, balanced diets for non-domestic species.

# Career
In 1972 Dinnes founded Dinnes Memorial Veterinary Hospital of Santa Clarita, California and is the first veterinarian to completely devote veterinary practice to non-domestic animals limiting his practice to zoo and aquatic animal medicine and surgery.
Dinnes participated as veterinarian on the 1983 adventure film, The Golden Seal.
In 1984 Dinnes was chosen as one of eight veterinarians by the American Veterinary Medical Association to form the American College of Zoological Medicine.
Dr. Dinnes founded the International Zoo Veterinary Group providing consulting in disease prevention, quarantine procedures and tranquilizing procedures for the international shipment of animals. The IZVG promotes the international exchange of pharmaceuticals and biologicals guidelines that may or may not be allowed for use in a particular country.
Dinnes is a veterinarian for Shambala Preserve in Acton, California. Dinnes also serves as Director of Product Research & Development of Zoological Formulas for Natural Balance Pet Foods.

# Accolades
In 2000 Dinnes was presented with Previous Alumni Achievement Award at UC-Davis.
Matrix-isolation
Matrix isolation is an experimental technique used in chemistry and physics which generally involves a material being trapped within an unreactive matrix. A host matrix is a continuous solid phase in which guest particles (atoms, molecules, ions, etc.) are embedded. The guest is said to be isolated within the host matrix. Initially the term matrix-isolation was used to describe the placing of a chemical species in any unreactive material, often polymers or resins, but more recently has referred specifically to gases in low-temperature solids. A typical matrix isolation experiment involves a guest sample being diluted in the gas phase with the host material, usually a noble gas or nitrogen. This mixture is then deposited on a cold window, often cooled to 10 kelvins or below. The sample may then be studied using various spectroscopic procedures.

# Experiments
The transparent window, on to which the sample is deposited, is usually cooled using a compressed helium or similar refrigerator. Experiments must be performed under a high vacuum to prevent contaminates from unwanted gases freezing to the cold window. Lower temperatures are preferred, due to the improved rigidity and glassiness of the matrix material. Noble gases such as argon are used not just because of their unreactivity but also because of their broad optical transparency in the solid state. Mono-atomic gases have relatively simple face-centered cubic (fcc) crystal structure, which can make interpretations of the site occupancy and crystal-field splitting of the guest easier. In some cases a reactive material, for example, methane, hydrogen or ammonia, may be used as the host material so that the reaction of the host with the guest species may be studied.
Using the matrix isolation technique, short-lived, highly-reactive species such as radical ions and reaction intermediates may be observed and identified by spectroscopic means. For example, the solid noble gas krypton can be used to form an inert matrix within which a reactive F3- ion can sit in chemical isolation. A species may be created chemically before deposition, or after by photochemical means. The technique may be used to simulate a species in the gas phase without rotational and translational interference. The low temperatures also help to produce simpler spectra, since only the lower electronic and vibrational quantum states are populated.

# History
Matrix isolation has its origins in the first half of the 20th century with the experiments by photo-chemists and physicists freezing samples in liquefied gases. The earliest isolation experiments involved the freezing of species in transparent, low temperature organic glasses. The modern matrix isolation technique was developed extensively during the 1950s, in particular by George C. Pimentel. He initially used higher-boiling inert gases like xenon and nitrogen as the host material, and is often said to be the "father of matrix isolation".
McBurney's point

# Overview
McBurney's point is the name given to the point over the right side of the human abdomen that is one-third of the distance from the ASIS (anterior superior iliac spine) to the umbilicus. This point roughly corresponds to the most common location of the base of the appendix where it is attached to the cecum.
The anterior cutaneous branch of iliohypogastric nerve is found near McBurney's point.

# Historical Perspective
The sign is named for Charles McBurney, U.S. surgeon, 18451913. 

# Clinical Relevance
Deep tenderness at McBurney's point, known as McBurney's sign, is a sign of acute appendicitis. 
The clinical sign of rebound pain when pressure is applied is also known as Aaron's sign.
Specific localization of tenderness to McBurney's point indicates that inflammation is no longer limited to the lumen of the bowel (which localizes pain poorly), and is irritating the lining of the peritoneum at the place where the peritoneum comes into contact with the appendix. Tenderness at McBurney's point suggests the evolution of acute appendicitis to a later stage, and thus, the increased likelihood of rupture. Because the location of the appendix is often different in different people, and can migrate within the abdomen, many cases of appendicitis do not cause point tenderness at McBurney's point. Other abdominal processes can also sometimes cause tenderness at McBurney's point. Thus, this sign is highly useful but neither necessary nor sufficient to make a diagnosis of acute appendicitis. Also, the anatomical position of the appendix is highly variable (for example in retrocaecal appendix, an appendix behind the caecum), which also limits the use of this sign.

# Related Chapters
- Rovsing's sign
- Appendicitis
- - Psoas sign
- Obturator sign
McMurry reaction
The McMurry reaction is an organic reaction in which two ketone or aldehyde groups are coupled to an alkene in the presence of a titanium chloride compound such as titanium(III) chloride and a reducing agent .
The McMurry reaction is named after its discoverer, John E. McMurry, who is currently professor emeritus at Cornell University.

# Reaction mechanism
This reductive coupling is related to the Pinacol coupling reaction because in both reactions the first step of the reaction mechanism is one-electron reduction to a ketyl radical ion with a reducing agent such as zinc or zinc / copper and the second step the free radical coupling. The titanium salt is reduced to divalent titanium which forms a titanium(0) adduct with the diol. From this cyclic intermediate the alkene is formed in a concerted rearrangement reaction with generation of titanium oxide.

# Scope
The original publication concerned the coupling of retinal to carotene with a titanium(III) trichloride / Lithium aluminium hydride system. In a similar fashion tetraphenylethylene is synthesized from benzophenone. Other dimers formed in the original publication are those of adamantanone and civetone. A McMurry reaction with titanium tetrachloride and zinc is employed in the synthesis of a molecular motor .
Medical protocol
Medical protocol can refer to:
- medical guidelines for a medical treatment. It usually includes a treatment plan, summarized consensus statements and addresses practical issues.
- Clinical protocol, which has a more specific meaning. It describes a method to be used in a clinical trial (e.g. of a drug or medical treatment) or a medical research study.
- A set of rules followed by providers such as EMTs or nurses. More strict than guidelines, medical protocols often carry the weight of law.