rajpurkar/squad huggingface dataset:
Title: Pain

Pain is the most common reason for physician consultation in most developed countries. It is a major symptom in many medical conditions, and can interfere with a person's quality of life and general functioning. Psychological factors such as social support, hypnotic suggestion, excitement, or distraction can significantly affect pain's intensity or unpleasantness. In some arguments put forth in physician-assisted suicide or euthanasia debates, pain has been used as an argument to permit terminally ill patients to end their lives.

Question: What is the most common reason people go to the doctor in first world countries?
Answer: Pain

Question: How can pain effect a person's quality of life and general functioning?
Answer: interfere

Question: Excitement and distraction are what type of factors which affect pain's intensity?
Answer: Psychological

Question: What has pain sometimes been used as an argument to allow terminally ill patients the right to do?
Answer: end their lives
Title: Pain

In 1994, responding to the need for a more useful system for describing chronic pain, the International Association for the Study of Pain (IASP) classified pain according to specific characteristics: (1) region of the body involved (e.g. abdomen, lower limbs), (2) system whose dysfunction may be causing the pain (e.g., nervous, gastrointestinal), (3) duration and pattern of occurrence, (4) intensity and time since onset, and (5) etiology. However, this system has been criticized by Clifford J. Woolf and others as inadequate for guiding research and treatment. Woolf suggests three classes of pain : (1) nociceptive pain, (2) inflammatory pain which is associated with tissue damage and the infiltration of immune cells, and (3) pathological pain which is a disease state caused by damage to the nervous system or by its abnormal function (e.g. fibromyalgia, irritable bowel syndrome, tension type headache, etc.).

Question: What year did the IASP respond to the need to create a more useful system for describing pain?
Answer: 1994

Question: How many classes of pain does the IASP system note?
Answer: 5

Question: Who has criticized the IASP's system?
Answer: Clifford J. Woolf and others

Question: What do some people feel the IASP's system is inadequate for?
Answer: guiding research and treatment

Question: How many classes of research does Woolf encourage?
Answer: three
Title: Pain

Pain is usually transitory, lasting only until the noxious stimulus is removed or the underlying damage or pathology has healed, but some painful conditions, such as rheumatoid arthritis, peripheral neuropathy, cancer and idiopathic pain, may persist for years. Pain that lasts a long time is called chronic or persistent, and pain that resolves quickly is called acute. Traditionally, the distinction between acute and chronic pain has relied upon an arbitrary interval of time from onset; the two most commonly used markers being 3 months and 6 months since the onset of pain, though some theorists and researchers have placed the transition from acute to chronic pain at 12 months.:93 Others apply acute to pain that lasts less than 30 days, chronic to pain of more than six months' duration, and subacute to pain that lasts from one to six months. A popular alternative definition of chronic pain, involving no arbitrarily fixed durations, is "pain that extends beyond the expected period of healing". Chronic pain may be classified as cancer pain or else as benign.

Question: What is usually temporary?
Answer: Pain

Question: How long does pain tend to last?
Answer: only until the noxious stimulus is removed

Question: What is pain which resolves quickly called?
Answer: acute

Question: What has the distinction between acute and chronic pain been arbitrarily measured by?
Answer: interval of time from onset

Question: What might chronic pain sometimes be referred to as?
Answer: cancer pain
Title: Pain

Nociceptive pain is caused by stimulation of peripheral nerve fibers that respond to stimuli approaching or exceeding harmful intensity (nociceptors), and may be classified according to the mode of noxious stimulation. The most common categories are "thermal" (e.g. heat or cold), "mechanical" (e.g. crushing, tearing, shearing, etc.) and "chemical" (e.g. iodine in a cut or chemicals released during inflammation). Some nociceptors respond to more than one of these modalities and are consequently designated polymodal.

Question: Stimulating nociceptors will induce which type of pain?
Answer: Nociceptive

Question: How is nociceptive pain classified?
Answer: according to the mode of noxious stimulation

Question: The thermal category of pain deals with which two temperature ranges?
Answer: heat or cold

Question: Crushing, tearing and shearing are examples of which type of pain?
Answer: mechanical

Question: What is the term for nociceptors which respond to more than one type of stimuli?
Answer: polymodal
Title: Pain

Nociceptive pain may also be divided into "visceral", "deep somatic" and "superficial somatic" pain. Visceral structures are highly sensitive to stretch, ischemia and inflammation, but relatively insensitive to other stimuli that normally evoke pain in other structures, such as burning and cutting. Visceral pain is diffuse, difficult to locate and often referred to a distant, usually superficial, structure. It may be accompanied by nausea and vomiting and may be described as sickening, deep, squeezing, and dull. Deep somatic pain is initiated by stimulation of nociceptors in ligaments, tendons, bones, blood vessels, fasciae and muscles, and is dull, aching, poorly-localized pain. Examples include sprains and broken bones. Superficial pain is initiated by activation of nociceptors in the skin or other superficial tissue, and is sharp, well-defined and clearly located. Examples of injuries that produce superficial somatic pain include minor wounds and minor (first degree) burns.

Question: What type of of pain is visceral a division of?
Answer: Nociceptive

Question: What type of structures are sensitive to being stretched but not very sensitive to burning?
Answer: Visceral

Question: Which type of pain is dull, aching and hard to pin-point?
Answer: Deep somatic

Question: What can visceral pain be accompanied by?
Answer: nausea and vomiting

Question: What type of pain are first degree burns classified as causing?
Answer: Superficial
Title: Pain

The prevalence of phantom pain in upper limb amputees is nearly 82%, and in lower limb amputees is 54%. One study found that eight days after amputation, 72 percent of patients had phantom limb pain, and six months later, 65 percent reported it. Some amputees experience continuous pain that varies in intensity or quality; others experience several bouts a day, or it may occur only once every week or two. It is often described as shooting, crushing, burning or cramping. If the pain is continuous for a long period, parts of the intact body may become sensitized, so that touching them evokes pain in the phantom limb, or phantom limb pain may accompany urination or defecation.

Question: What percentage of people who've had upper limbs amputated feel phantom pain?
Answer: nearly 82%

Question: What is the percentage of of phantom pain felt by lower limb amputees?
Answer: 54%

Question: What may accompany urination for amputees? 
Answer: phantom limb pain

Question: What may happen with intact body parts if there is continuous pain for a long period?
Answer: become sensitized

Question: After six months, what percentage of people who had limbs amputated still felt pain in those limbs?
Answer: 65 percent
Title: Pain

Local anesthetic injections into the nerves or sensitive areas of the stump may relieve pain for days, weeks, or sometimes permanently, despite the drug wearing off in a matter of hours; and small injections of hypertonic saline into the soft tissue between vertebrae produces local pain that radiates into the phantom limb for ten minutes or so and may be followed by hours, weeks or even longer of partial or total relief from phantom pain. Vigorous vibration or electrical stimulation of the stump, or current from electrodes surgically implanted onto the spinal cord, all produce relief in some patients.

Question: What happens when an anesthetic injection is directed into the nerves a limb stump?
Answer: may relieve pain

Question: How long can an anesthetic, at max, relieve pain for, despite wearing off in only hours?
Answer: permanently

Question: What is injected in small amounts into the soft tissue between vertebrae to produce local pain?
Answer: hypertonic saline

Question: Vibrating the stump of an amputee's limb can produce what in some patients?
Answer: relief
Title: Pain

Paraplegia, the loss of sensation and voluntary motor control after serious spinal cord damage, may be accompanied by girdle pain at the level of the spinal cord damage, visceral pain evoked by a filling bladder or bowel, or, in five to ten per cent of paraplegics, phantom body pain in areas of complete sensory loss. This phantom body pain is initially described as burning or tingling but may evolve into severe crushing or pinching pain, or the sensation of fire running down the legs or of a knife twisting in the flesh. Onset may be immediate or may not occur until years after the disabling injury. Surgical treatment rarely provides lasting relief.

Question: What is paraplegia?
Answer: loss of sensation and voluntary motor control

Question: What is the initial phantom body pain sensation experienced by people with spinal cord damage?
Answer: burning or tingling

Question: What can cause paraplegia?
Answer: serious spinal cord damage,

Question: What is an inefficient treatment for chronic pain which rarely provides any sort of true relief?
Answer: Surgical

Question: The sensation of a knife twisting in the flesh is an example of what type of pain?
Answer: phantom body
Title: Pain

People with long-term pain frequently display psychological disturbance, with elevated scores on the Minnesota Multiphasic Personality Inventory scales of hysteria, depression and hypochondriasis (the "neurotic triad"). Some investigators have argued that it is this neuroticism that causes acute pain to turn chronic, but clinical evidence points the other way, to chronic pain causing neuroticism. When long-term pain is relieved by therapeutic intervention, scores on the neurotic triad and anxiety fall, often to normal levels. Self-esteem, often low in chronic pain patients, also shows improvement once pain has resolved.

Question: What triad are the inventory scales of hysteria, depression and hypochondriasis classified as?
Answer: neurotic

Question: When people have long-term pain, what do they frequently display?
Answer: psychological disturbance

Question: Clinical evidence indicates that neuroticism is caused by what?
Answer: chronic pain

Question: If long-term pain can be relieved by therapy, what does a person's neurotic triad score do?
Answer: fall

Question: What shows improvement in many patients once their pain has been resolved?
Answer: Self-esteem
Title: Pain

Breakthrough pain is transitory acute pain that comes on suddenly and is not alleviated by the patient's normal pain management. It is common in cancer patients who often have background pain that is generally well-controlled by medications, but who also sometimes experience bouts of severe pain that from time to time "breaks through" the medication. The characteristics of breakthrough cancer pain vary from person to person and according to the cause. Management of breakthrough pain can entail intensive use of opioids, including fentanyl.

Question: What is the term for pain which is acute and note alleviated by normal pain management?
Answer: Breakthrough

Question: How do cancer patients usually control their background pain?
Answer: medications

Question: Who is breakthrough pain common among?
Answer: cancer patients

Question: What class of medication is fentanyl an example of?
Answer: opioids

Question: What activity in relation to breakthrough pain requires heavy use of opiods?
Answer: Management
Title: Pain

Although unpleasantness is an essential part of the IASP definition of pain, it is possible to induce a state described as intense pain devoid of unpleasantness in some patients, with morphine injection or psychosurgery. Such patients report that they have pain but are not bothered by it; they recognize the sensation of pain but suffer little, or not at all. Indifference to pain can also rarely be present from birth; these people have normal nerves on medical investigations, and find pain unpleasant, but do not avoid repetition of the pain stimulus.

Question: Which type of injection has caused patients to report they have pain but aren't bothered by it?
Answer: morphine

Question: How much do some patients going through psychosurgery suffer from the sensation of pain?
Answer: little, or not at all

Question: IASP's definition of pain includes what aspect as an essential part?
Answer: unpleasantness

Question: What is it possible to induce which is, contrary to expectations, devoid of unpleasantness?
Answer: a state described as intense pain

Question: What perspective towards pain are some people with perfectly normal nerves born with?
Answer: Indifference
Title: Pain

A much smaller number of people are insensitive to pain due to an inborn abnormality of the nervous system, known as "congenital insensitivity to pain". Children with this condition incur carelessly-repeated damage to their tongues, eyes, joints, skin, and muscles. Some die before adulthood, and others have a reduced life expectancy.[citation needed] Most people with congenital insensitivity to pain have one of five hereditary sensory and autonomic neuropathies (which includes familial dysautonomia and congenital insensitivity to pain with anhidrosis). These conditions feature decreased sensitivity to pain together with other neurological abnormalities, particularly of the autonomic nervous system. A very rare syndrome with isolated congenital insensitivity to pain has been linked with mutations in the SCN9A gene, which codes for a sodium channel (Nav1.7) necessary in conducting pain nerve stimuli.

Question: An abnormality of the nervous system can render a small number of people insensitive to what?
Answer: pain

Question: What is it known as when someone is born without being able to feel pain because of their nervous system?
Answer: congenital insensitivity to pain

Question: What happens to children with congenital insensitivity to pain?
Answer: repeated damage to their tongues, eyes, joints, skin, and muscles

Question: What is the life expectancy for people who can't feel pain?
Answer: reduced

Question: What gene is responsible for coding for a sodium channel necessary for conducting pain nerve stimuli?
Answer: SCN9A
Title: Pain

In 1644, René Descartes theorized that pain was a disturbance that passed down along nerve fibers until the disturbance reached the brain, a development that transformed the perception of pain from a spiritual, mystical experience to a physical, mechanical sensation[citation needed]. Descartes's work, along with Avicenna's, prefigured the 19th-century development of specificity theory. Specificity theory saw pain as "a specific sensation, with its own sensory apparatus independent of touch and other senses". Another theory that came to prominence in the 18th and 19th centuries was intensive theory, which conceived of pain not as a unique sensory modality, but an emotional state produced by stronger than normal stimuli such as intense light, pressure or temperature. By the mid-1890s, specificity was backed mostly by physiologists and physicians, and the intensive theory was mostly backed by psychologists. However, after a series of clinical observations by Henry Head and experiments by Max von Frey, the psychologists migrated to specificity almost en masse, and by century's end, most textbooks on physiology and psychology were presenting pain specificity as fact.

Question: When was Descartes pontificating about his theories regarding pain?
Answer: 1644

Question: What did Descartes think pain was?
Answer: a disturbance

Question: What state does the intensive theory conceive pain as being?
Answer: emotional

Question: What theory perceives pain as being a specific sensation?
Answer: Specificity

Question: Who migrated to the theory of specificity en mass?
Answer: psychologists
Title: Pain

 In 1955, DC Sinclair and G Weddell developed peripheral pattern theory, based on a 1934 suggestion by John Paul Nafe. They proposed that all skin fiber endings (with the exception of those innervating hair cells) are identical, and that pain is produced by intense stimulation of these fibers. Another 20th-century theory was gate control theory, introduced by Ronald Melzack and Patrick Wall in the 1965 Science article "Pain Mechanisms: A New Theory". The authors proposed that both thin (pain) and large diameter (touch, pressure, vibration) nerve fibers carry information from the site of injury to two destinations in the dorsal horn of the spinal cord, and that the more large fiber activity relative to thin fiber activity at the inhibitory cell, the less pain is felt. Both peripheral pattern theory and gate control theory have been superseded by more modern theories of pain[citation needed].

Question: What year was peripheral pattern theory developed? 
Answer: 1955

Question: Whose suggestion prompted the development of peripheral pattern theory?
Answer: John Paul Nafe

Question: What does the gate control theory specify the diameter of which is responsible for the amount of pain sensation?
Answer: nerve fibers

Question: What did DC Sinclair and G Weddell propose a property of all skin fiber endings is?
Answer: identical

Question: Why were peripheral pattern theory and gate control theory left behind?
Answer: superseded by more modern theories of pain
Title: Pain

In 1968 Ronald Melzack and Kenneth Casey described pain in terms of its three dimensions: "sensory-discriminative" (sense of the intensity, location, quality and duration of the pain), "affective-motivational" (unpleasantness and urge to escape the unpleasantness), and "cognitive-evaluative" (cognitions such as appraisal, cultural values, distraction and hypnotic suggestion). They theorized that pain intensity (the sensory discriminative dimension) and unpleasantness (the affective-motivational dimension) are not simply determined by the magnitude of the painful stimulus, but "higher" cognitive activities can influence perceived intensity and unpleasantness. Cognitive activities "may affect both sensory and affective experience or they may modify primarily the affective-motivational dimension. Thus, excitement in games or war appears to block both dimensions of pain, while suggestion and placebos may modulate the affective-motivational dimension and leave the sensory-discriminative dimension relatively undisturbed." (p. 432) The paper ends with a call to action: "Pain can be treated not only by trying to cut down the sensory input by anesthetic block, surgical intervention and the like, but also by influencing the motivational-affective and cognitive factors as well." (p. 435)

Question: How many dimensions did Melzack and Casey describe pain in terms of?
Answer: three

Question: The affective-motivational dimension of pain is characterized by what urge?
Answer: urge to escape the unpleasantness

Question: What did Melzack and Casey theorize could influence the perception of the magnitude of pain?
Answer: cognitive activities

Question: War game excitement appears to block what aspect of pain?
Answer: dimensions

Question: What did Melack's and Casey's paper end with a call towards?
Answer: action
Title: Pain

Wilhelm Erb's (1874) "intensive" theory, that a pain signal can be generated by intense enough stimulation of any sensory receptor, has been soundly disproved. Some sensory fibers do not differentiate between noxious and non-noxious stimuli, while others, nociceptors, respond only to noxious, high intensity stimuli. At the peripheral end of the nociceptor, noxious stimuli generate currents that, above a given threshold, begin to send signals along the nerve fiber to the spinal cord. The "specificity" (whether it responds to thermal, chemical or mechanical features of its environment) of a nociceptor is determined by which ion channels it expresses at its peripheral end. Dozens of different types of nociceptor ion channels have so far been identified, and their exact functions are still being determined.

Question: What type of signal can be generated by intense enough stimulation of any sensory receptor?
Answer: pain

Question: What types of stimuli can't some sensory fibers differentiate between?
Answer: noxious and non-noxious

Question: What type of stimuli do nociceptors response to?
Answer: noxious, high intensity

Question: How many different types of ion channels have so far been identified?
Answer: Dozens

Question: What does stimuli generate to send signals along a nerve fiber?
Answer: currents
Title: Pain

The pain signal travels from the periphery to the spinal cord along an A-delta or C fiber. Because the A-delta fiber is thicker than the C fiber, and is thinly sheathed in an electrically insulating material (myelin), it carries its signal faster (5–30 m/s) than the unmyelinated C fiber (0.5–2 m/s). Pain evoked by the (faster) A-delta fibers is described as sharp and is felt first. This is followed by a duller pain, often described as burning, carried by the C fibers. These first order neurons enter the spinal cord via Lissauer's tract.

Question: How does the pain signal travel from the periphery to the spinal cord?
Answer: along an A-delta or C fiber

Question: Which fiber is thicker?
Answer: A-delta

Question: What is the electrically insulting material that sheaths a-delta fiber?
Answer: myelin

Question: How do first order neurons enter the spinal cord?
Answer: via Lissauer's tract

Question: What is pain evoked by a-delta fibers described as?
Answer: sharp and is felt first
Title: Pain

Spinal cord fibers dedicated to carrying A-delta fiber pain signals, and others that carry both A-delta and C fiber pain signals up the spinal cord to the thalamus in the brain have been identified. Other spinal cord fibers, known as wide dynamic range neurons, respond to A-delta and C fibers, but also to the large A-beta fibers that carry touch, pressure and vibration signals. Pain-related activity in the thalamus spreads to the insular cortex (thought to embody, among other things, the feeling that distinguishes pain from other homeostatic emotions such as itch and nausea) and anterior cingulate cortex (thought to embody, among other things, the motivational element of pain); and pain that is distinctly located also activates the primary and secondary somatosensory cortices. Melzack and Casey's 1968 picture of the dimensions of pain is as influential today as ever, firmly framing theory and guiding research in the functional neuroanatomy and psychology of pain.

Question: What are some spinal cord fibers exclusive to?
Answer: A-delta

Question: Pain signals travel first to what region of the brain?
Answer: thalamus

Question: What are dynamic range neurons?
Answer: spinal cord fibers

Question: Where does pain-related activity in the thalamus spread to? 
Answer: the insular cortex

Question: Pain which is distinctly located also activates what cortices? 
Answer: somatosensory