update MedS-Bench

update MedS-Bench. Replace some datasets with the official train-test split with the official test set, and balance the number of labels of True of False inClinical_outcome_prediction

MedS-Bench/Clinical_outcome_prediction/task117_mimic4ed_benchmark_hospitalization.json

@@ -1,3 +0,0 @@
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-size 124203

MedS-Bench/Clinical_outcome_prediction/task118_mimic4ed_72h_ed_revisit_disposition.json

@@ -1,3 +0,0 @@
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-size 130316

MedS-Bench/Clinical_outcome_prediction/task119_mimic4ed_benchmark_critical_triage.json

@@ -1,3 +0,0 @@
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-size 124237

MedS-Bench/Diagnosis/task130_DDXPlus_text_classification_test.json

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MedS-Bench/Explanation/task46_do_entity_explanation.json

@@ -1,234 +0,0 @@
-{
-    "Contributors": [
-        "Disease_Oncology~(DO) authors"
-    ],
-    "Source": [
-        "DO"
-    ],
-    "URL": [
-        "https://github.com/DiseaseOntology/HumanDiseaseOntology"
-    ],
-    "Reasoning": [],
-    "Input_language": [
-        "English"
-    ],
-    "Output_language": [
-        "English"
-    ],
-    "Instruction_language": [
-        "English"
-    ],
-    "Domains": [
-        "Medical Knowledge"
-    ],
-    "Positive Examples": [],
-    "Negative Examples": [],
-    "Instances": [
-        {
-            "input": "infiltrating ureter transitional cell carcinoma",
-            "output": "Infiltrating urothelial carcinoma that affects the renal pelvis and ureter."
-        },
-        {
-            "input": "familial melanoma",
-            "output": "A melanoma defined by the presence of multiple cases of cutaneous melanoma among blood-relatives on the same side of the family. it is caused by germline mutations in the cdkn2a or cdk4 genes. it is associated with an increased risk of pancreatic cancer in a subset of cdkn2a families (who, 2006)."
-        },
-        {
-            "input": "adult botryoid rhabdomyosarcoma",
-            "output": "A botryoid rhabdomyosarcoma that is present in an adult."
-        },
-        {
-            "input": "adult vagina botryoid rhabdomyosarcoma",
-            "output": "A vagina botryoid rhabdomyosarcoma that presents in adulthood."
-        },
-        {
-            "input": "ethmoid sinus ectopic meningioma",
-            "output": "An extremely rare meningioma that arises as a primary ectopic tumor in the ethmoid sinus."
-        },
-        {
-            "input": "pineal region teratoma",
-            "output": "A mature or immature teratoma that arises in the pineal region."
-        },
-        {
-            "input": "pineal region mature teratoma",
-            "output": "A mature teratoma that is located_in the pineal region."
-        },
-        {
-            "input": "liver carcinoma",
-            "output": "A liver cancer that has_material_basis_in epithelial cells."
-        },
-        {
-            "input": "oxyphilic endometrial endometrioid adenocarcinoma",
-            "output": "An endometrial adenocarcinoma that is composed predominantly or entirely of large eosinophilic cells."
-        },
-        {
-            "input": "mediastinal gray zone lymphoma",
-            "output": "A mediastinal lymphoma with molecular, morphologic, immunophenotypic, and clinical features of both mediastinal (thymic) large b-cell lymphoma and classic hodgkin lymphoma. the identification of this group of lymphomas, along with recent gene expression profiling results (pdl2 gene expression in both mediastinal (thymic) large b-cell lymphoma tissues and hodgkin lymphoma cell lines), further supports the hypothesis that mediastinal (thymic) large b-cell lymphomas and classic hodgkin lymphomas are related entities."
-        },
-        {
-            "input": "mediastinal malignant lymphoma",
-            "output": "A lymphoma that arises from the mediastinum. representative examples include mediastinal (thymic) large b-cell lymphoma and hodgkin lymphoma."
-        },
-        {
-            "input": "parasagittal meningioma",
-            "output": "A meningioma that affects the falx cerebri."
-        },
-        {
-            "input": "hepatoblastoma",
-            "output": "Hepatoblastoma"
-        },
-        {
-            "input": "spinal cord neuroblastoma",
-            "output": "A neuroblastoma that affects the spinal cord."
-        },
-        {
-            "input": "spinal cord primitive neuroectodermal neoplasm",
-            "output": "A central nervous system embryonal tumor, not otherwise specified arising from the spinal cord."
-        },
-        {
-            "input": "skin tag",
-            "output": "A reactive cutaneous fibrous lesion that is characterized by a small, painless, flesh colored peduncle arising on the surface of the skin, and develops_from areas of friction, or may be associated with hpv virus, or crohn's disease."
-        },
-        {
-            "input": "embryonal cancer",
-            "output": "A germ cell cancer that is associated with an embryo."
-        },
-        {
-            "input": "small bowel fibrosarcoma",
-            "output": "A fibrosarcoma of soft tissue and small intestinal sarcoma that is located_in the small bowel."
-        },
-        {
-            "input": "ureter small cell carcinoma",
-            "output": "A rare carcinoma that arises from the ureter. it is characterized by the presence of small neuroendocrine cells. the prognosis is poor."
-        },
-        {
-            "input": "ureter transitional cell carcinoma",
-            "output": "A carcinoma that arises from the transitional epithelium of the ureter. it is associated with tobacco use and usually presents with gross or microscopic hematuria."
-        },
-        {
-            "input": "ovarian seromucinous carcinoma",
-            "output": "An ovarian carcinoma that is biphasic and has_material_basis_in epithelial and mesenchymal elements."
-        },
-        {
-            "input": "familiar ovarian carcinoma",
-            "output": "Ovarian carcinoma that has developed in relatives of patients that have a history of ovarian carcinoma."
-        },
-        {
-            "input": "eye lymphoma",
-            "output": "A lymphoma by site that is manifested in immune system cells called lymphocytes."
-        },
-        {
-            "input": "glomangiomatosis",
-            "output": "A benign perivascular tumor that is characterized as a vascular variant of a glomus tumor."
-        },
-        {
-            "input": "predominantly cortical thymoma",
-            "output": "A thymic epithelial neoplasm characterized by the presence of expanded areas which resemble the normal thymic cortex. the neoplastic epithelial cells are small and scant and there is a dense t-lymphocytic component present. areas of medullary differentiation with or without hassall's corpuscles are also present. it may be associated with myasthenia gravis, pure red cell aplasia, and hypogammaglobulinemia. it has a low grade malignant potential. the majority of cases occur in the anterior mediastinum as masaoka stage i tumors. a minority of the cases occur as stage ii tumors."
-        },
-        {
-            "input": "peroneal nerve paralysis",
-            "output": "Lesion of lateral popliteal nerve"
-        },
-        {
-            "input": "retinal edema",
-            "output": "Retinal edema"
-        },
-        {
-            "input": "dental enamel hypoplasia",
-            "output": "An acquired or hereditary condition due to deficiency in the formation of tooth enamel (amelogenesis). it is usually characterized by defective, thin, or malformed dental enamel. risk factors for enamel hypoplasia include gene mutations, nutritional deficiencies, diseases, and environmental factors."
-        },
-        {
-            "input": "urinary bladder inverted papilloma",
-            "output": "A neoplasm of the bladder in which the epithelial cells grow downward into the underlying supportive tissue, which often causes hematuria."
-        },
-        {
-            "input": "bladder transitional cell papilloma",
-            "output": "A rare benign condition, characterized by a papillary growth in the urinary tract with a central fibrovascular core. the latter is lined by normal urothelium."
-        },
-        {
-            "input": "urethra inverted papilloma",
-            "output": "A neoplasm of the urethra in which the epithelial cells grow downward into the underlying supportive tissue."
-        },
-        {
-            "input": "ureter inverted papilloma",
-            "output": "A neoplasm of the ureter in which the epithelial cells grow downward into the underlying supportive tissue, which often causes hematuria."
-        },
-        {
-            "input": "ureter urothelial papilloma",
-            "output": "A benign epithelial neoplasm that produces visible warty projections from the epithelial surface of the ureter."
-        },
-        {
-            "input": "childhood intraocular retinoblastoma",
-            "output": "An intraocular retinoblastoma that effects children."
-        },
-        {
-            "input": "childhood brain meningioma",
-            "output": "A brain meningioma of childhood that is characterized by brain tumor which develops from the membranes that surround the brain and spinal cord, has_material_basis_in abnormally proliferating cells derives_from meningeal cells of embryonic ectoderm origin."
-        },
-        {
-            "input": "vulvar inverted follicular keratosis",
-            "output": "An inverted follicular keratosis that is located_in the vulva."
-        },
-        {
-            "input": "vulvar seborrheic keratosis",
-            "output": "A benign squamous neoplasm that arises from the vulva. it is characterized by the proliferation of the basal cells in the squamous epithelium, acanthosis, hyperkeratosis, and cysts formation."
-        },
-        {
-            "input": "inverted follicular keratosis",
-            "output": "Seborrheic keratosis that arises from follicular structures in the skin. it presents as a solitary nodule in the skin and is characterized by the presence of prominent squamous eddies."
-        },
-        {
-            "input": "sphenoidal sinus benign neoplasm",
-            "output": "A benign or malignant neoplasm that affects the sphenoid sinus. representative examples of benign neoplasms include schneiderian papilloma and salivary gland-type adenoma. representative examples of malignant neoplasms include carcinoma and lymphoma."
-        },
-        {
-            "input": "malignant gastric teratoma",
-            "output": "A malignant teratoma that has_material_basis_in gastric tissue."
-        },
-        {
-            "input": "combat disorder",
-            "output": "An acute stress disorder that involves neurotic reactions to unusual, severe, or overwhelming military stress."
-        },
-        {
-            "input": "telangiectatic osteogenic sarcoma",
-            "output": "An osteosarcoma usually arising from the metaphysis of long bones. it is characterized by the presence of a cystic architecture with blood-filled spaces. the prognosis is similar to that of conventional osteosarcoma."
-        },
-        {
-            "input": "aleukemic monocytic leukemia cutis",
-            "output": "An aleukemic leukemia cutis that is characterized by infiltration of the skin by neoplastic monocytes."
-        },
-        {
-            "input": "rectal cloacogenic carcinoma",
-            "output": "A carcinoma that arises from the transitional zone at the junction of the rectum and anus."
-        },
-        {
-            "input": "bartholin's gland squamous cell carcinoma",
-            "output": "A bartholin's gland carcinoma that derives_from squamous epithelial cells."
-        },
-        {
-            "input": "acute canaliculitis",
-            "output": "An acute inflammation of lacrimal passage that is characterized by inflammation of the lacrimal caniculi, has_symptom epiphora, has_symptom conjunctivitis, has_symptom eyelid mattering and has_symptom purulent discharge."
-        },
-        {
-            "input": "acute inflammation of lacrimal passage",
-            "output": "Acute and unspecified inflammation of lacrimal passages"
-        },
-        {
-            "input": "bladder urothelial papillary carcinoma",
-            "output": "An invasive or non-invasive papillary transitional cell carcinoma of the urinary bladder. it is classified as low - or high-grade. -- 2003"
-        },
-        {
-            "input": "micropapillary variant infiltrating bladder urothelial carcinoma",
-            "output": "An infiltrating bladder transitional cell carcinoma exhibiting micropapillary growth pattern."
-        },
-        {
-            "input": "pancreatic cholera",
-            "output": "A rare syndrome characterized by severe watery diarrhea, hypokalemia, and achlorhydria. it is caused by the oversecretion of vasoactive intestinal peptide from the pancreatic islet cells."
-        }
-    ],
-    "Categories": [
-        "Explanation"
-    ],
-    "Definition": [
-        "Assuming you are a doctor, please explan the following given medical professional entity for me."
-    ]
-}

MedS-Bench/Explanation/task50_biolord_explanation.json

@@ -1,234 +0,0 @@
-{
-    "Contributors": [
-        "BioLORD"
-    ],
-    "Source": [
-        "BioLORD"
-    ],
-    "URL": [
-        "https://huggingface.co/datasets/FremyCompany/BioLORD-Dataset"
-    ],
-    "Categories": [
-        "Explanation"
-    ],
-    "Definition": [
-        "Given a concise concept, generate a long detailed definition to explain it."
-    ],
-    "Reasoning": [],
-    "Input_language": [
-        "English"
-    ],
-    "Output_language": [
-        "English"
-    ],
-    "Instruction_language": [
-        "English"
-    ],
-    "Domains": [
-        "Medical Knowledge"
-    ],
-    "Positive Examples": [],
-    "Negative Examples": [],
-    "Instances": [
-        {
-            "input": "Concept: L-amino-acid dehydrogenase activity (oxidoreductase activity, acting on the CH-NH2 group of donors, NAD or NADP as acceptor)",
-            "output": "oxidoreductase activity, acting on the CH-NH2 group of donors, NAD or NADP as acceptor described as catalysis of the reaction: an L-amino acid + H2O + NAD+ = a 2-oxo acid + NH3 + NADH."
-        },
-        {
-            "input": "Concept: anchor (Component of Study Protocol)",
-            "output": "something described as designation for a planned activity, often marking the transition between epochs or elements of a clinical study plan (e.g., \"FPFV-first patient first visit\")."
-        },
-        {
-            "input": "Concept: Tub (Potency Unit)",
-            "output": "Quantitative Concept described as a dosing unit equal to the amount of active ingredient(s) contained in a flat-bottomed container which is typically round and wider than deep."
-        },
-        {
-            "input": "Concept: SPRR1A Gene (Structural gene)",
-            "output": "something described as this gene is involved in keratinization."
-        },
-        {
-            "input": "Concept: protozoal vaccine (Pharmacologic Substance)",
-            "output": "Immunologic Factor described as suspensions of attenuated or killed protozoa administered for the prevention or treatment of infectious protozoan disease."
-        },
-        {
-            "input": "Concept: flutter auricular (Atrial fibrillation and flutter)",
-            "output": "Atrial fibrillation and flutter described as rapid, irregular atrial contractions caused by a block of electrical impulse conduction in the right atrium and a reentrant wave front traveling up the inter-atrial septum and down the right atrial free wall or vice versa. Unlike ATRIAL FIBRILLATION which is caused by abnormal impulse generation, typical atrial flutter is caused by abnormal impulse conduction. As in atrial fibrillation, patients with atrial flutter cannot effectively pump blood into the lower chambers of the heart (HEART VENTRICLES)."
-        },
-        {
-            "input": "Concept: CONSCIOUS (Psychoanalytic Personality Factors)",
-            "output": "Mental Process described as state of being aware, or perceiving physical facts or mental concepts; a state of general wakefulness and responsiveness to environment; a functioning sensorium."
-        },
-        {
-            "input": "Concept: External Examination (Medical Examination)",
-            "output": "Medical Examination described as an assessment of the outer body structures."
-        },
-        {
-            "input": "Concept: up regulation of gene silencing by miRNA, production of miRNAs (regulation of production of miRNAs involved in gene silencing by miRNA)",
-            "output": "positive regulation of gene expression described as any process that activates or increases the frequency, rate or extent of production of miRNAs involved in gene silencing by miRNA."
-        },
-        {
-            "input": "Concept: pyridoxin (Vitamin B6 and vitamin B6 derivative)",
-            "output": "something described as the 4-methanol form of VITAMIN B 6 which is converted to PYRIDOXAL PHOSPHATE which is a coenzyme for synthesis of amino acids, neurotransmitters (serotonin, norepinephrine), sphingolipids, aminolevulinic acid. Although pyridoxine and Vitamin B 6 are still frequently used as synonyms, especially by medical researchers, this practice is erroneous and sometimes misleading (EE Snell; Ann NY Acad Sci, vol 585 pg 1, 1990)."
-        },
-        {
-            "input": "Concept: Population genetics (heredity and evolution)",
-            "output": "something described as the branch of genetics that focuses on gene distribution and transmission through populations."
-        },
-        {
-            "input": "Concept: mycothiol anabolism (Molecular Function)",
-            "output": "something described as the chemical reactions and pathways resulting in the formation of mycothiol, which consists of N-acetyl-L-cysteine linked to a pseudodisaccharide, D-glucosamine and myo-inositol. Mycothiol is produced in actinomycetes like mycobacteria and serves similar functions to glutathione."
-        },
-        {
-            "input": "Concept: alcohol; withdrawal, with delirium (Alcohol Related Disorders)",
-            "output": "Disease or Syndrome described as an acute organic mental disorder induced by cessation or reduction in chronic alcohol consumption. Clinical characteristics include CONFUSION; DELUSIONS; vivid HALLUCINATIONS; TREMOR; agitation; insomnia; and signs of autonomic hyperactivity (e.g., elevated blood pressure and heart rate, dilated pupils, and diaphoresis). This condition may occasionally be fatal. It was formerly called delirium tremens."
-        },
-        {
-            "input": "Concept: SLC16A1 (Amino Acid, Peptide, or Protein)",
-            "output": "something described as monocarboxylate transporter 1 (500 aa, ~54 kDa) is encoded by the human SLC16A1 gene. This protein is involved in monocarboxylate transport across the plasma membrane."
-        },
-        {
-            "input": "Concept: Moraxella catarrhalis, Beta-Lactamase Negative (Moraxella catarrhalis)",
-            "output": "something described as any bacterial species identified as Moraxella catarrhalis that does not produce the enzyme beta-lactamase."
-        },
-        {
-            "input": "Concept: oculo-cerebro-cutaneous (OCC) syndrome (Disease or Syndrome)",
-            "output": "Disease or Syndrome described as orbital cysts and other eye defects, multiple cerebral anomalies, and focal dermal defects are the principal characteristics of this syndrome."
-        },
-        {
-            "input": "Concept: QSTESTCD (Intellectual Product)",
-            "output": "Intellectual Product described as a character or string that represents the short code name of the questionnaire test."
-        },
-        {
-            "input": "Concept: HTR2A: g102T>C (Gene or Genome)",
-            "output": "HTR2A gene described as HTR2A-C Allele is a variant form of 20-kb 3-exon human HTR2A Gene (GPCR1/5HT2 Family), which encodes Serotonin 5-HT-2A Receptor, a conserved integral membrane 5-HT/serotonin receptor protein involved in tracheal smooth muscle contraction, bronchoconstriction, and control of aldosterone production by association with G proteins that activate a PI-calcium second messenger system. 5-HT is a biogenic hormone that affects specific receptors as a neurotransmitter, hormone, or mitogen. HTR2A contains several polymorphic sites. Different alleles differ in the concentration of RNA and protein product of 5HTR2A. HTR2A-C Allele contains a single-nucleotide polymorphism (102 T>C) in an intron and is expressed at a lower level than the 102 C>T allele."
-        },
-        {
-            "input": "Concept: Epilepsy, Complex Partial (Seizures, Focal)",
-            "output": "Seizures, Focal described as a disorder characterized by recurrent partial seizures marked by impairment of cognition. During the seizure the individual may experience a wide variety of psychic phenomenon including formed hallucinations, illusions, deja vu, intense emotional feelings, confusion, and spatial disorientation. Focal motor activity, sensory alterations and AUTOMATISM may also occur. Complex partial seizures often originate from foci in one or both temporal lobes. The etiology may be idiopathic (cryptogenic partial complex epilepsy) or occur as a secondary manifestation of a focal cortical lesion (symptomatic partial complex epilepsy)."
-        },
-        {
-            "input": "Concept: CRADD Signaling Adaptor Protein (Biologically Active Substance)",
-            "output": "CARD Signaling Adaptor Proteins described as a death domain receptor signaling adaptor protein that plays a role in signaling the activation of INITIATOR CASPASES such as CASPASE 2. It contains a death domain that is specific for RIP SERINE-THEONINE KINASES and a caspase-binding domain that binds to and activates CASPASES such as CASPASE 2."
-        },
-        {
-            "input": "Concept: Ethylene Trichloride (Halogenated hydrocarbons, general anesthetics)",
-            "output": "Hydrocarbons, Halogenated described as a synthetic, light sensitive, volatile, colorless, liquid that is miscible with many non-polar organic solvents. Trichloroethylene is used mainly as a degreaser for metal parts. Upon combustion, it produces irritants and toxic gases. Occupational exposure to trichloroethylene is associated with excess incidences of liver cancer, kidney cancer and non-Hodgkin lymphoma. It is reasonably anticipated to be a human carcinogen."
-        },
-        {
-            "input": "Concept: Driver/Extractors (Reusable Devices)",
-            "output": "Reusable Devices described as instruments designed to insert and extract implants and/or prostheses by applying force or torque during surgical or dental procedures. Driver/extractors are typically manual, handheld instruments with a working end that conforms to the device to be driven and a proximal end that can accept impact, pressure, or rotating forces according to the demands of the procedure. They are used mainly for the insertion and extraction of implants and prostheses (e.g., bone nails and pin, bone plates) during orthopedic procedures."
-        },
-        {
-            "input": "Concept: Optics (Occupation or Discipline)",
-            "output": "Occupation or Discipline described as the branch of physics that describes the behavior and properties of light and the interaction of light with matter."
-        },
-        {
-            "input": "Concept: FAC075-Able to Shift Between Activities (Intellectual Product)",
-            "output": "Intellectual Product described as functional Assessment of Cancer Therapy-Cognitive Function Version 3 - Perceived Cognitive Abilities: I am able to shift back and forth between two activities that require thinking."
-        },
-        {
-            "input": "Concept: Coronaviridae (Virus)",
-            "output": "unclassified ssRNA positive-strand viruses described as a family of positive sense ssRNA viruses of zoonotic origin. They are the cause of respiratory, enteric, hepatic, and neurological diseases of varying severity in humans and animals. Bats, birds, and pigs act as major reservoirs of coronaviruses."
-        },
-        {
-            "input": "Concept: PODCI2-Have Pain Relief (PODCI Adolescent Parent-Reported Version Questionnaire Question)",
-            "output": "something described as pediatric Outcomes Data Collection Instrument, Adolescent Parent-Reported Version (PODCI Adolescent Parent-Reported Version) As a result of my child's treatment, I expect my child: To have pain relief."
-        },
-        {
-            "input": "Concept: BPI Questionnaire Question (Clinical or Research Assessment Question)",
-            "output": "Intellectual Product described as a question associated with the BPI questionnaire."
-        },
-        {
-            "input": "Concept: Ritonavir (Nitrogen and nitrogen compound)",
-            "output": "Amides described as a drug used to treat infection with HIV (the virus that causes AIDS). It is also being studied in the treatment of some types of cancer. Ritonavir blocks the ability of HIV to make copies of itself and may block the growth of cancer cells. It is a type of anti-HIV agent and a type of protease inhibitor."
-        },
-        {
-            "input": "Concept: UDP-N-acetylglucosamine:beta-D-mannosyl-glycolipid beta-1,3-N-acetylglucosaminyltransferase activity (Molecular Function)",
-            "output": "something described as catalysis of the transfer of N-acetylglucosamine (GlcNAc) in a beta-1,3 linkage to the mannose(beta-1,4)Glc disaccharide core of glycolipids."
-        },
-        {
-            "input": "Concept: cynomolgus, Plasmodium (Plasmodium <subgenus>)",
-            "output": "Eukaryote described as a protozoan parasite that occurs naturally in the macaque. It is similar to PLASMODIUM VIVAX and produces a type of malaria similar to vivax malaria (MALARIA, VIVAX). This species has been found to give rise to both natural and experimental human infections."
-        },
-        {
-            "input": "Concept: Ketone Bodies (SPECIFIC SUBSTANCE CHEMISTRY TESTS)",
-            "output": "something described as the determination of the amount of ketone bodies (acetone, acetoacetic acid, beta-hydroxybutyric acid, beta-ketopentanoate and beta-hydroxypentanoate) present in a sample."
-        },
-        {
-            "input": "Concept: HEK (Gene or Genome)",
-            "output": "Gene or Genome described as human EPHA3 wild-type allele is located in the vicinity of 3p11.2 and is approximately 375 kb in length. This allele, which encodes ephrin type-A receptor 3 protein, plays a role in mediating developmental events and may be involved in lymphoid function and differentiation."
-        },
-        {
-            "input": "Concept: Carney complex, types I and II (Disease or Syndrome)",
-            "output": "Site-specific disorder of skin described as carney complex (CNC) has characteristics of spotty skin pigmentation, endocrine overactivity and myxomas. The prevalence is unknown but it is a rare disease. Skin pigmentation anomalies include lentigines and blue naevi. The most common endocrine gland manifestations are acromegaly, thyroid and testicular neoplasms and adrenocorticotropic hormone (ACTH)-independent Cushing's syndrome. Myxomas can be observed in the heart, skin and breast. Cardiac myxomas can develop in any cardiac chamber and may be multiple. One of the putative CNC genes located on 17q22-24, (PRKAR1A), has been found to encode the regulatory subunit (R1A) of protein kinase A. Heterozygous inactivating mutations of PRKAR1A were reported initially in 45 to 65% of CNC index cases, and may be present in about 80% of the CNC families presenting mainly with Cushing's syndrome. CNC is a dominantly inherited syndrome."
-        },
-        {
-            "input": "Concept: WEISS Criteria (WEISS System)",
-            "output": "Clinical Attribute described as histopathologic criteria to evaluate adrenocortical tumors. These criteria include nuclear grade III or IV, mitotic rate greater than five per fifty high power fields, presence of atypical mitotic figures, presence of less than or equal to twenty five percent of clear or vacuolated cells that resemble normal zona fasciculata, diffuse architecture, necrosis, venous invasion, sinusoid invasion, and invasion of tumor capsule."
-        },
-        {
-            "input": "Concept: Refractory Ewing Sarcoma/Peripheral Primitive Neuroectodermal Tumor (Refractory cancer)",
-            "output": "something described as a malignant small round cell tumor with or without neural differentiation that is resistant to treatment."
-        },
-        {
-            "input": "Concept: perception of bacterium (Cell Function)",
-            "output": "response to bacterium described as the series of events in which a stimulus from a bacterium is received and converted into a molecular signal."
-        },
-        {
-            "input": "Concept: Transesophageal Electrophysiologic Study (Diagnostic Procedure)",
-            "output": "something described as measurements of the electrical activities of specific areas of the heart, taken from inside the ESOPHAGUS."
-        },
-        {
-            "input": "Concept: 5 HYDROXYTRYPTAMINE UPTAKE INHIB (Psychotropic Drugs)",
-            "output": "Serotonin Antagonists described as any agent or substance which suppresses, prevents or opposes the actions of serotonin."
-        },
-        {
-            "input": "Concept: hemicholinium (Quaternary Ammonium Compounds)",
-            "output": "Quaternary Ammonium Compounds described as a potent inhibitor of the high affinity uptake system for CHOLINE. It has less effect on the low affinity uptake system. Since choline is one of the components of ACETYLCHOLINE, treatment with hemicholinium can deplete acetylcholine from cholinergic terminals. Hemicholinium 3 is commonly used as a research tool in animal and in vitro experiments."
-        },
-        {
-            "input": "Concept: Tie-Downs, Wheelchair (Technical Aids for the Disabled)",
-            "output": "something described as devices (e.g., anchored straps) designed to secure an occupied wheelchair while it is in a motor vehicle. These devices are typically anchored to the vehicle floor."
-        },
-        {
-            "input": "Concept: Stage IA Gastric (Stomach) Cancer (Neoplastic Process)",
-            "output": "Pathologic Stage I Gastric Cancer AJCC v8 described as stage IA includes: (T1, N0, M0). T1: Tumor invades the lamina propria, muscularis mucosae, or submucosa. N0: No regional lymph node metastasis. M0: No distant metastasis."
-        },
-        {
-            "input": "Concept: Capsules, Esophageal, pH Recording (Device Labeled for Single Use)",
-            "output": "something described as capsules designed for clamping onto the esophageal wall tissue to obtain data of pH values in the esophagus. These capsules usually consist of a pH sensor (e.g., antimony electrode) and a telemetry (i.e., wireless) transmitter that send the pH data to a receiver worn by the patient. The data are recorded during a period of hours or a few days; the receiver includes dedicated software that permits recording and further viewing and analyzing the data at the end of the test. These capsules are used by ambulatory patients for esophageal pH measurement and recording; they facilitate correlating pH data to patient symptoms of gastro-esophageal reflux disease. These capsules are especially suited for patients who cannot tolerate nasal intubation; the capsules spontaneously detach and pass through the digestive system after the test is finished. Esophageal recording pH capsules may be supplied with accessories to facilitate calibration of the capsule (pH values)."
-        },
-        {
-            "input": "Concept: Stem Cells, Neural (Stem cells)",
-            "output": "Multipotent Stem Cells described as a stem cell derived from embryonic sources or found in adult neural tissue. It has the capacity to generate all the multiple cell types found in the brain and spinal cord."
-        },
-        {
-            "input": "Concept: autologous CAR T product AUTO2 (Chimeric Antigen Receptor T-cells)",
-            "output": "therapeutic autologous lymphocytes described as a preparation of autologous T lymphocytes that are genetically engineered to contain a dual-targeted chimeric antigen receptor (CAR), which includes the natural protein a proliferation-inducing ligand (APRIL; TNFSF13), that targets the tumor-associated antigens (TAAs) B-cell maturation antigen (BCMA; TNFRSF17) and transmembrane activator and calcium modulator and cyclophilin ligand interactor (TACI; TNFRSF13B), with potential immunomodulating and antineoplastic activities. Upon administration, the autologous BCMA/TACI-targeted CAR T cells AUTO2 bind to BCMA and TACI expressed on tumor cells and induce selective cytotoxicity in those cells. In addition, AUTO2 carries the universal RQR8 safety \"off\" switch, which allows selective removal of the T cells through both complement-dependent cytotoxicity (CDC) and antibody-dependent cellular cytotoxicity (ADCC) following administration of rituximab if unacceptable side-effects occur. Check for \"https://www.cancer.gov/about-cancer/treatment/clinical-trials/intervention/C150509\" active clinical trials using this agent."
-        },
-        {
-            "input": "Concept: 16q22-q23.1 (Cell Component)",
-            "output": "Chromosome band described as a chromosome band present on 16q"
-        },
-        {
-            "input": "Concept: CDHF14 (Cell Adhesion Molecule Gene)",
-            "output": "Cell Adhesion Molecule Gene described as this gene plays a role in planar cell polarity."
-        },
-        {
-            "input": "Concept: L-Methionine (Amino acid - dietary)",
-            "output": "Drugs used in the treatment of paracetamol poisoning described as a kind of amino acid"
-        },
-        {
-            "input": "Concept: lupinus (Fabaceae)",
-            "output": "Plant described as a plant genus of the family FABACEAE that is a source of SPARTEINE, lupanine and other lupin alkaloids."
-        },
-        {
-            "input": "Concept: conical cornea (Non-Neoplastic Corneal Disorder)",
-            "output": "Corneal Diseases described as a noninflammatory, usually bilateral protrusion of the cornea, the apex being displaced downward and nasally. It occurs most commonly in females at about puberty. The cause is unknown but hereditary factors may play a role. The -conus refers to the cone shape of the corneal protrusion."
-        },
-        {
-            "input": "Concept: ATP:D-glucuronate 1-phosphotransferase activity (Molecular Function)",
-            "output": "something described as catalysis of the reaction: D-glucuronate + ATP = 1-phospho-alpha-D-glucuronate + ADP + 2 H(+)."
-        }
-    ]
-}

MedS-Bench/Fact_verication/task100_ebms_answer_vertification.json

@@ -1,434 +0,0 @@
-{
-    "Contributors": [
-        "EBMSummariserCorpus"
-    ],
-    "Source": [
-        "EBMSummariserCorpus"
-    ],
-    "URL": [
-        "https://sourceforge.net/projects/ebmsumcorpus/"
-    ],
-    "Categories": [
-        "Question Answering"
-    ],
-    "Definition": [
-        "Provide a justification or evidence to support a given statement."
-    ],
-    "Reasoning": [],
-    "Input_language": [
-        "English"
-    ],
-    "Output_language": [
-        "English"
-    ],
-    "Instruction_language": [
-        "English"
-    ],
-    "Domains": [
-        "Medical Knowledge"
-    ],
-    "Positive Examples": [],
-    "Negative Examples": [],
-    "Instances": [
-        {
-            "input": "Multiple randomized controlled trials (RCTs) demonstrate the effectiveness of both allergen immunotherapy and antihistamines, with or without nasal steroids, in the treatment of seasonal allergic rhinitis.",
-            "output": "For patients requiring medication, studies comparing antihistamines with nasal corticosteroids have documented the superiority of intranasal steroids for symptom control of allergic rhinitis."
-        },
-        {
-            "input": "Multiple randomized controlled trials (RCTs) demonstrate the effectiveness of both allergen immunotherapy and antihistamines, with or without nasal steroids, in the treatment of seasonal allergic rhinitis.",
-            "output": "Allergy immunotherapy presents risk of systemic reactions, with one study reporting a 0.5% risk of systemic reactions per year of therapy."
-        },
-        {
-            "input": "Multiple randomized controlled trials (RCTs) demonstrate the effectiveness of both allergen immunotherapy and antihistamines, with or without nasal steroids, in the treatment of seasonal allergic rhinitis.",
-            "output": "A review of placebo-controlled trials indicates that the risk of developing asthma among patients with allergic rhinoconjunctivitis is significantly reduced when patients receive specific immunotherapy."
-        },
-        {
-            "input": "Multiple randomized controlled trials (RCTs) demonstrate the effectiveness of both allergen immunotherapy and antihistamines, with or without nasal steroids, in the treatment of seasonal allergic rhinitis.",
-            "output": "Studies indicate that immunotherapy is effective for several years after treatment is discontinued."
-        },
-        {
-            "input": "Multiple randomized controlled trials (RCTs) demonstrate the effectiveness of both allergen immunotherapy and antihistamines, with or without nasal steroids, in the treatment of seasonal allergic rhinitis.",
-            "output": "In standard practice, immunotherapy is not recommended for most patients with seasonal allergic rhinitis unless avoidance measures and symptomatic therapy are ineffective, have adverse effects, or are not feasible."
-        },
-        {
-            "input": "Multiple randomized controlled trials (RCTs) demonstrate the effectiveness of both allergen immunotherapy and antihistamines, with or without nasal steroids, in the treatment of seasonal allergic rhinitis.",
-            "output": "A study allowed patients to choose a treatment arm; it found that immunotherapy was superior to treatment with antihistamines and nasal steroids for patients who chose it."
-        },
-        {
-            "input": "Multiple randomized controlled trials (RCTs) demonstrate the effectiveness of both allergen immunotherapy and antihistamines, with or without nasal steroids, in the treatment of seasonal allergic rhinitis.",
-            "output": "One study reported that inhaled nasal steroid therapy was superior to a nonstandard immunotherapy for ragweed pollen-induced rhinitis."
-        },
-        {
-            "input": "No RCTs directly compare immunotherapy with conservative management. Treatment decisions are driven by the clinical presentation, patient and physician preferences, practice guidelines, and expert opinion.",
-            "output": "A 2002 Agency for Healthcare Research and Quality systematic review on the diagnosis and treatment of allergic rhinitis found no RCTs comparing antihistamines or nasal corticosteroids with immunotherapy."
-        },
-        {
-            "input": "False-positive reports on urine drug screens by immunoassay are rare. Nonsteroidal anti-inflammatory drugs, fluoroquinolones, and Vicks Inhaler are most frequently implicated.",
-            "output": "Positive confirmation tests may occur in urine specimens from patients who legally or unknowingly ingest products that contain drugs of abuse. In these instances, the finding is a true positive but may not reflect drug abuse by the client. Many products available without prescription outside of the US contain opiates (eg, Donnagel PG from Canada)."
-        },
-        {
-            "input": "Ruling out a false-positive result requires confirmation with a more specific test, usually gas chromatography/mass spectrometry (GC-MS). A true-positive drug screen may occur in a urine specimen from a patient who legally or unknowingly ingests a product that is metabolized to a drug of abuse. Passive exposure to a substance is unlikely to cause a positive drug screen.",
-            "output": "Several controlled-exposure studies have shown that as little as 1 poppy seed muffin (about 15 g of seed) can produce detectable amounts of morphine and codeine by immunoassay as well as GC-MS. In 1998, the federal government increased the threshold defining a positive screen for urine morphine and codeine from 300 to 2000 ng/mL to reduce spurious reports of opiate-positive tests from poppy seed consumption."
-        },
-        {
-            "input": "Ruling out a false-positive result requires confirmation with a more specific test, usually gas chromatography/mass spectrometry (GC-MS). A true-positive drug screen may occur in a urine specimen from a patient who legally or unknowingly ingests a product that is metabolized to a drug of abuse. Passive exposure to a substance is unlikely to cause a positive drug screen.",
-            "output": "Substances that do not produce positive urine drug screens include passively inhaled crack cocaine or marijuana (unless \"extreme\"), and ingested products containing hemp or other common herbal preparations."
-        },
-        {
-            "input": "Ruling out a false-positive result requires confirmation with a more specific test, usually gas chromatography/mass spectrometry (GC-MS). A true-positive drug screen may occur in a urine specimen from a patient who legally or unknowingly ingests a product that is metabolized to a drug of abuse. Passive exposure to a substance is unlikely to cause a positive drug screen.",
-            "output": "In one study, 6 volunteers in an 8x8x7-ft enclosed room were exposed to 200 mg freebase cocaine vapor; none of their urine samples exceeded the federal GC-MS threshold. In a similar study of 3 non-smokers exposed to 8 marijuana smokers (smoking 32 joints) in a 10x10x8-ft enclosed room, no samples from the nonsmokers exceeded the federal GC-MS threshold."
-        },
-        {
-            "input": "Ruling out a false-positive result requires confirmation with a more specific test, usually gas chromatography/mass spectrometry (GC-MS). A true-positive drug screen may occur in a urine specimen from a patient who legally or unknowingly ingests a product that is metabolized to a drug of abuse. Passive exposure to a substance is unlikely to cause a positive drug screen.",
-            "output": "In an exposure study of 90 volunteers who ingested 8 different herbal preparations, there were no positive urine drug screens."
-        },
-        {
-            "input": "Low-dose thiazide diuretics (eg, hydrochlorothiazide 12.5 to 25 mg/d) are the best first-line pharmacotherapy for treating uncomplicated hypertension.",
-            "output": "Results from the largest antihypertensive clinical trial, the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT), were included in this meta-analysis. Although these data showed no differences between drug therapies in total and cardiovascular disease mortality, low-dose diuretics reduced certain cardiovascular endpoints (ie, heart failure, stroke, cardiovascular disease events) more than other drug therapies."
-        },
-        {
-            "input": "Low-dose thiazide diuretics (eg, hydrochlorothiazide 12.5 to 25 mg/d) are the best first-line pharmacotherapy for treating uncomplicated hypertension.",
-            "output": "Several other clinical trials have subsequently compared the effect of thiazide diuretics with that of other antihypertensive agents (beta-blockers, calcium channel blockers, and alpha-blockers) on patient-oriented outcomes. These were analyzed in a recent meta-analysis of 42 clinical trials that included 192,478 patients randomized to 7 treatment strategies including placebo."
-        },
-        {
-            "input": "Low-dose thiazide diuretics (eg, hydrochlorothiazide 12.5 to 25 mg/d) are the best first-line pharmacotherapy for treating uncomplicated hypertension.",
-            "output": "Three landmark placebo-controlled studies have established that thiazide diuretic-based treatment reduces morbidity and mortality among patients with hypertension."
-        },
-        {
-            "input": "Alternate first-line agents include angiotensin-converting enzyme (ACE) inhibitors, beta blockers, and calcium channel blockers",
-            "output": "A long-term trial has compared an ARB to other types of drug therapy: losartan vs atenolol in the Losartan Intervention for Endpoint Reduction (LIFE) trial. In the LIFE trial, the primary composite endpoint of cardiovascular death, myocardial infarction, and stroke was less with losartan than atenolol (23.8 vs 27.9 events per 1000 patient-years, losartan and atenolol, respectively; number needed to treat=243 people-years, P=.021)."
-        },
-        {
-            "input": "Alternate first-line agents include angiotensin-converting enzyme (ACE) inhibitors, beta blockers, and calcium channel blockers",
-            "output": "A long-term trial has compared valsartan vs amlodipine in the Valsartan Antihypertensive Long-term Use Evaluation VALUE trial. In the VALUE trial, the primary endpoint of time to cardiac event was not different between valsartan and amlodipine (25.5 vs 24.7 events per 1000 patient-years, valsartan and amlodipine, respectively; P=.49)."
-        },
-        {
-            "input": "Naltrexone (ReVia) and nalmefene (Revex) are the most effective agents for treating alcoholism. Acamprosate is effective but not available in the United States. Serotonergic agents, selective serotonin reuptake inhibitors (SSRIs), and lithium work best in patients with alcoholism and comorbid depression, anxiety, or bipolar disorder. Disulfiram (Antabuse) decreases drink frequency, but is no better than placebo for other outcomes. Greater effectiveness is achieved when pharmacologic agents are combined with either counseling or Alcoholics Anonymous programs.",
-            "output": "Studies combining pharmacologic intervention with Alcoholics Anonymous's 12-step program or psychological interventions showed the most significant effects on decreasing cravings and relapse rates and increasing abstinence rates."
-        },
-        {
-            "input": "Naltrexone (ReVia) and nalmefene (Revex) are the most effective agents for treating alcoholism. Acamprosate is effective but not available in the United States. Serotonergic agents, selective serotonin reuptake inhibitors (SSRIs), and lithium work best in patients with alcoholism and comorbid depression, anxiety, or bipolar disorder. Disulfiram (Antabuse) decreases drink frequency, but is no better than placebo for other outcomes. Greater effectiveness is achieved when pharmacologic agents are combined with either counseling or Alcoholics Anonymous programs.",
-            "output": "Fifteen studies evaluating serotonergic agents, lithium, and SSRIs (including citalopram, viqualine, fluoxetine, and others) taken for 2 to 12 weeks have shown promise for increasing abstinence rates and decreasing cravings in alcoholic patients with coexisting psychiatric conditions such as depression, anxiety, and bipolar disorder."
-        },
-        {
-            "input": "Naltrexone (ReVia) and nalmefene (Revex) are the most effective agents for treating alcoholism. Acamprosate is effective but not available in the United States. Serotonergic agents, selective serotonin reuptake inhibitors (SSRIs), and lithium work best in patients with alcoholism and comorbid depression, anxiety, or bipolar disorder. Disulfiram (Antabuse) decreases drink frequency, but is no better than placebo for other outcomes. Greater effectiveness is achieved when pharmacologic agents are combined with either counseling or Alcoholics Anonymous programs.",
-            "output": "When compared with placebo, disulfiram failed to significantly increase abstinence rates or decrease relapse rates or cravings."
-        },
-        {
-            "input": "Naltrexone (ReVia) and nalmefene (Revex) are the most effective agents for treating alcoholism. Acamprosate is effective but not available in the United States. Serotonergic agents, selective serotonin reuptake inhibitors (SSRIs), and lithium work best in patients with alcoholism and comorbid depression, anxiety, or bipolar disorder. Disulfiram (Antabuse) decreases drink frequency, but is no better than placebo for other outcomes. Greater effectiveness is achieved when pharmacologic agents are combined with either counseling or Alcoholics Anonymous programs.",
-            "output": "When compared with placebo, nalmefene taken for 3 to 24 months significantly reduced relapse without affecting abstinence rates or cravings. Acamprosate taken for 3 to 24 months significantly increased abstinence rates, but did not significantly decrease relapse or cravings as compared with placebo."
-        },
-        {
-            "input": "Naltrexone (ReVia) and nalmefene (Revex) are the most effective agents for treating alcoholism. Acamprosate is effective but not available in the United States. Serotonergic agents, selective serotonin reuptake inhibitors (SSRIs), and lithium work best in patients with alcoholism and comorbid depression, anxiety, or bipolar disorder. Disulfiram (Antabuse) decreases drink frequency, but is no better than placebo for other outcomes. Greater effectiveness is achieved when pharmacologic agents are combined with either counseling or Alcoholics Anonymous programs.",
-            "output": "Naltrexone reduces relapse rates by one half to two thirds."
-        },
-        {
-            "input": "Naltrexone (ReVia) and nalmefene (Revex) are the most effective agents for treating alcoholism. Acamprosate is effective but not available in the United States. Serotonergic agents, selective serotonin reuptake inhibitors (SSRIs), and lithium work best in patients with alcoholism and comorbid depression, anxiety, or bipolar disorder. Disulfiram (Antabuse) decreases drink frequency, but is no better than placebo for other outcomes. Greater effectiveness is achieved when pharmacologic agents are combined with either counseling or Alcoholics Anonymous programs.",
-            "output": "Naltrexone reduces relapse rates by one half to two thirds."
-        },
-        {
-            "input": "Naltrexone (ReVia) and nalmefene (Revex) are the most effective agents for treating alcoholism. Acamprosate is effective but not available in the United States. Serotonergic agents, selective serotonin reuptake inhibitors (SSRIs), and lithium work best in patients with alcoholism and comorbid depression, anxiety, or bipolar disorder. Disulfiram (Antabuse) decreases drink frequency, but is no better than placebo for other outcomes. Greater effectiveness is achieved when pharmacologic agents are combined with either counseling or Alcoholics Anonymous programs.",
-            "output": "Naltrexone (50 mg qd), nalmefene (10-80 mg qd), and acamprosate (dose based on patient weight) are all superior to placebo and other agents such as the SSRIs, disulfiram, and serotonergic agents in reducing relapse rates and the phenomena of craving and in increasing abstinence rates."
-        },
-        {
-            "input": "Patients with steatohepatitis who take HMG Co-A reductase inhibitors statins lower their elevated liver enzymes and show evidence of improvement in fatty liver on follow-up imaging.",
-            "output": "Another study included patients with biopsy-confirmed fatty liver and elevated ALT levels greater than 1.5 times the upper limit of normal. In this 24-week study, 23 predominantly hypertriglyceridemic patients took omega-3 fatty acids, 5 mL 3 times daily, 28 hypercholesterolemic patients took atorvastatin 20 mg daily, and 21 dyslipidemic patients with a body mass index >27.0 took orlistat 120 mg 3 times daily. ALT levels decreased in all 3 groups during the study. Ultrasonography showed normal liver echo pattern at the end of treatment for 35% of omega-3 patients, 61% of atorvastatin patients, and 86% of orlistat patients. No serious adverse events were observed."
-        },
-        {
-            "input": "Patients with steatohepatitis who take HMG Co-A reductase inhibitors statins lower their elevated liver enzymes and show evidence of improvement in fatty liver on follow-up imaging.",
-            "output": "A 6-month unblinded study found similar results among 44 adult patients with biopsy-confirmed NASH. Twenty-seven hyperlipidemic patients (aged 50\u00b11.4 years) with an average alanine aminotransferase (ALT) of 81.8 U/L took 10 mg of atorvastatin daily. Seventeen normolipidemic patients (aged 43.7\u00b11.8 years) with an average ALT of 76.0 U/L took ursodeoxycholic acid (UDCA) 13-15 mg/kg/d for the same duration; 59% of atorvastatin-treated patients normalized liver enzyme levels compared with 23% in the UDCA group. On computed tomography scanning, both groups showed improvement in liver densities, suggesting improvement of fatty liver."
-        },
-        {
-            "input": "Patients with steatohepatitis who take HMG Co-A reductase inhibitors statins lower their elevated liver enzymes and show evidence of improvement in fatty liver on follow-up imaging.",
-            "output": "A prospective study evaluated 5 patients with biopsy-confirmed nonalcoholic steatohepatitis (NASH) who took 20 mg of pravastatin daily for 6 months. Liver enzyme levels at baseline were no more than 3 times the upper limit of normal. All 5 patients had normalized liver enzymes at the end of the study."
-        },
-        {
-            "input": "Statins do not further increase transaminase levels for patients with pre-existing transaminase elevations.",
-            "output": "A retrospective study of patients with baseline elevated transaminases who took statins showed no significant increase in transaminase levels during treatment compared with patients with elevated transaminases who did not take statins. The study reviewed electronic medical records for patients with preexisting elevated liver enzymes who initiated statin therapy (atorvastatin, simvastatin, or fluvastatin) and had follow-up labs drawn 6 months later (cohort 1, n=342). The comparison groups included patients with normal liver enzymes who initiated statins (cohort 2, n=1437) and patients with elevated baseline liver enzymes who did not take statins (cohort 3, n=2245). At follow-up, 4.7% of cohort 1 patients had mild-to-moderate elevations in liver enzymes, which did not differ significantly (P=.2) from those in cohort 3. Within cohort 2, 1.9% experienced mild-to-moderate elevations of transaminases (defined as less than 10 times the upper limit of normal)."
-        },
-        {
-            "input": "Statins do not further increase transaminase levels for patients with pre-existing transaminase elevations.",
-            "output": "A retrospective study of patients with baseline elevated transaminases who took statins showed no significant increase in transaminase levels during treatment compared with patients with elevated transaminases who did not take statins. The cohort study of patients with preexisting elevated liver enzymes found comparable results with lovastatin. Among lovastatin patients (n=135), 6.6% had mild-to-moderate elevations in transaminases during therapy vs 11% of the cohort of patients with preexisting elevated liver enzymes who did not take statins. This difference was not statistically significant (P=.2)."
-        },
-        {
-            "input": "For patients with decompensated liver disease or advanced cirrhosis, balance the benefits of statins against the risks.",
-            "output": "The National Cholesterol Education Project states that \"the incidence of clinically important transaminase elevations in the large statin trials is the same for statins as for placebo. Progression to liver failure is exceedingly rare, if it occurs.\" They further state that the use of statins for persons with decompensated liver disease or advanced cirrhosis depends on clinical judgment, but that their use in NASH is considered safe."
-        },
-        {
-            "input": "Little evidence supports the use of the high-sensitivity C-reactive protein assay (hs-CRP) as a screening test for cardiovascular disease (CVD) in the healthy adult population. There is significant debate about its use in populations at moderate risk for cardiovascular disease, with some evidence suggesting its use if the results of the test will alter treatment recommendations.",
-            "output": "Several retrospective studies have reported risk ratios for developing cardiovascular disease, ranging from 2.3 to 4.4 when comparing subjects with the highest levels of hs-CRP with those who have the lowest levels. Though systematic bias in retrospective study design limits the interpretation of these findings, the findings are of some benefit to answering this question when large, prospective, randomized studies are not available."
-        },
-        {
-            "input": "Little evidence supports the use of the high-sensitivity C-reactive protein assay (hs-CRP) as a screening test for cardiovascular disease (CVD) in the healthy adult population. There is significant debate about its use in populations at moderate risk for cardiovascular disease, with some evidence suggesting its use if the results of the test will alter treatment recommendations.",
-            "output": "Guidelines from the Institute for Clinical Systems Improvement for lipid management in adults state that, \"non-traditional risk factors C-reactive protein [CRP] and total homocysteine have been shown to have some predictive values in screening vascular disease. The value of screening for these risk factors is not yet known.\"."
-        },
-        {
-            "input": "Little evidence supports the use of the high-sensitivity C-reactive protein assay (hs-CRP) as a screening test for cardiovascular disease (CVD) in the healthy adult population. There is significant debate about its use in populations at moderate risk for cardiovascular disease, with some evidence suggesting its use if the results of the test will alter treatment recommendations.",
-            "output": "Two studies evaluating statin therapy for CVD suggest that CRP may be monitored as an independent factor for predicting CVD outcomes for patients undergoing aggressive lipid therapy. These randomized, masked trials suggest that CRP is directly predictive of recurrent events among patients with known CVD. Its usefulness may be greatest when trying to decide whether to pursue aggressive (high-dose) statin therapy for these patients."
-        },
-        {
-            "input": "Little evidence supports the use of the high-sensitivity C-reactive protein assay (hs-CRP) as a screening test for cardiovascular disease (CVD) in the healthy adult population. There is significant debate about its use in populations at moderate risk for cardiovascular disease, with some evidence suggesting its use if the results of the test will alter treatment recommendations.",
-            "output": "A large study reports adjusted odds for development of coronary artery disease of 1.45 (95% confidence interval [CI], 1.25-1.68) for subjects in the top third of hs-CRP levels compared with those in the bottom third. Odds ratios (OR) for other predictors of coronary artery disease are higher than this, in particular total cholesterol (OR=2.35; 95% CI, 2.03-2.74), cigarette smoking (OR=1.87; 95% CI, 1.62-2.22), and elevated systolic blood pressure (OR=1.50; 95% CI, 1.30-1.73). This shows that hs-CRP does not contribute as much as these factors to the established risk profile for coronary heart disease."
-        },
-        {
-            "input": "Little evidence supports the use of the high-sensitivity C-reactive protein assay (hs-CRP) as a screening test for cardiovascular disease (CVD) in the healthy adult population. There is significant debate about its use in populations at moderate risk for cardiovascular disease, with some evidence suggesting its use if the results of the test will alter treatment recommendations.",
-            "output": "C-reactive protein is a nonspecific serum marker of inflammatory response. While it is elevated in a variety of conditions, a link has been suggested between CRP and pathogenesis of clinical cardiovascular disease. A consensus statement from the American Heart Association and the Centers for Disease Control and Prevention discourages use of hs-CRP for screening in the healthy adult population. It offers support for using hs-CRP for assessment of patients at medium risk levels for whom the test will alter treatment decisions."
-        },
-        {
-            "input": "Healthy infants who test positive for anemia on routine screening at 1 year of age are most likely iron-deficient and may be treated empirically with a trial of iron therapy (3-6 mg of elemental iron/kg/d). Documentation of response to iron confirms the diagnosis of iron-deficiency.",
-            "output": "A recent Cochrane review suggests there is a clinically significant benefit for the treatment of iron-deficiency anemia; however, there is a need for further randomized controlled trials with long-term follow-up."
-        },
-        {
-            "input": "Healthy infants who test positive for anemia on routine screening at 1 year of age are most likely iron-deficient and may be treated empirically with a trial of iron therapy (3-6 mg of elemental iron/kg/d). Documentation of response to iron confirms the diagnosis of iron-deficiency.",
-            "output": "A prospective study of 1128 children identified as anemic with a screening hemoglobin level showed that subsequent testing-which included mean corpuscular volume, protoporphyrin, transferrin, and ferritin measurements-did not reliably distinguish potential responders from nonresponders to a 3-month trial of empiric iron therapy. In fact, more than half of the responders would have been missed if treatment had been restricted to infants with abnormal mean corpuscular volume or iron studies. Because of the simplicity, low cost, and relative safety of iron therapy for infants, this trial suggests that a therapeutic trial of iron be given first, reserving further work-up for the small number of infants that still have unexplained hemoglobin concentrations of <11.0 g/dL after a therapeutic trial."
-        },
-        {
-            "input": "Healthy infants who test positive for anemia on routine screening at 1 year of age are most likely iron-deficient and may be treated empirically with a trial of iron therapy (3-6 mg of elemental iron/kg/d). Documentation of response to iron confirms the diagnosis of iron-deficiency.",
-            "output": "A randomized controlled trial of iron supplementation vs placebo in 278 infants testing positive for iron-deficiency anemia demonstrated that once daily, moderate-dose ferrous sulfate (FeSO4) therapy (3 mg/kg/d of elemental iron) given to fasting 1-year-old infants results in no more gastrointestinal side effects than placebo therapy."
-        },
-        {
-            "input": "Healthy infants who test positive for anemia on routine screening at 1 year of age are most likely iron-deficient and may be treated empirically with a trial of iron therapy (3-6 mg of elemental iron/kg/d). Documentation of response to iron confirms the diagnosis of iron-deficiency.",
-            "output": "A prospective study of 970 healthy infants identified 62 infants with a heel-stick capillary hematocrit of <33%. Of these, 31 had repeat hematocrit values of <33% as confirmed by subsequent heel-stick complete blood count measurement. Twenty of these anemic infants (65%) completed the study protocol, which included a 1-month trial of iron, a follow-up complete blood count, and hemoglobin electrophoresis for those infants with persistent microcytosis or positive sickle preparation (performed at initial screening for all African American infants). Six infants (30%) had an increase in hemoglobin concentration of 1.0 g/dL or more and were presumed to be iron-deficient; they went on to receive an additional 2 months of iron therapy. Two of these were found to have co-existing alpha-thalassemia. Of the remainder, 11 (55%) were determined to have a low-normal hematocrit (mean=31.5 \u00b1 0.9), 1 had alpha thalassemia alone, 1 had coexisting alpha-thalassemia and hemoglobin AS, and 1 had hemoglobin SC. Review of data showed that abnormal diagnoses (iron deficiency, thalassemia, and sickle cell trait or disease) were found in 9 of 11 infants with high RDW and in none of the 9 with normal RDW. The authors concluded that RDW alone appears to be predictive of identifiable causes of anemia when used to screen healthy 12-month-old babies."
-        },
-        {
-            "input": "Further testing with a complete blood count, mean corpuscular volume, red cell distribution width (RDW), serum ferritin concentration, as well as hemoglobinopathy screening when appropriate, may be effective in determining the cause of anemia.",
-            "output": "A prospective study of 1128 children identified as anemic with a screening hemoglobin level showed that subsequent testing-which included mean corpuscular volume, protoporphyrin, transferrin, and ferritin measurements-did not reliably distinguish potential responders from nonresponders to a 3-month trial of empiric iron therapy. In fact, more than half of the responders would have been missed if treatment had been restricted to infants with abnormal mean corpuscular volume or iron studies. Because of the simplicity, low cost, and relative safety of iron therapy for infants, this trial suggests that a therapeutic trial of iron be given first, reserving further work-up for the small number of infants that still have unexplained hemoglobin concentrations of <11.0 g/dL after a therapeutic trial."
-        },
-        {
-            "input": "Further testing with a complete blood count, mean corpuscular volume, red cell distribution width (RDW), serum ferritin concentration, as well as hemoglobinopathy screening when appropriate, may be effective in determining the cause of anemia.",
-            "output": "A prospective study of 970 healthy infants identified 62 infants with a heel-stick capillary hematocrit of <33%. Of these, 31 had repeat hematocrit values of <33% as confirmed by subsequent heel-stick complete blood count measurement. Twenty of these anemic infants (65%) completed the study protocol, which included a 1-month trial of iron, a follow-up complete blood count, and hemoglobin electrophoresis for those infants with persistent microcytosis or positive sickle preparation (performed at initial screening for all African American infants). Six infants (30%) had an increase in hemoglobin concentration of 1.0 g/dL or more and were presumed to be iron-deficient; they went on to receive an additional 2 months of iron therapy. Two of these were found to have co-existing alpha-thalassemia. Of the remainder, 11 (55%) were determined to have a low-normal hematocrit (mean=31.5 \u00b1 0.9), 1 had alpha thalassemia alone, 1 had coexisting alpha-thalassemia and hemoglobin AS, and 1 had hemoglobin SC. Review of data showed that abnormal diagnoses (iron deficiency, thalassemia, and sickle cell trait or disease) were found in 9 of 11 infants with high RDW and in none of the 9 with normal RDW. The authors concluded that RDW alone appears to be predictive of identifiable causes of anemia when used to screen healthy 12-month-old babies."
-        },
-        {
-            "input": "other",
-            "output": "Similar results were found in a prospective controlled treatment trial among Alaskan Native children."
-        },
-        {
-            "input": "other",
-            "output": "A study demonstrated that iron sulfate drops (40 mg elemental iron divided 3 times a day) or a single daily dose of microencapsulated ferrous fumarate sprinkles (80 mg elemental iron) plus ascorbic acid resulted in a similar rate of successful treatment of anemia without side effects."
-        },
-        {
-            "input": "other",
-            "output": "Similar results were found in a trial of empiric iron therapy among infants with anemia."
-        },
-        {
-            "input": "other",
-            "output": "In a retrospective cohort study of 1358 innercity children aged 9 to 36 months who underwent screening, 343 (25%) had anemia (Hgb <11 g/dL); of these, 239 (72%) were prescribed iron and 95 (28%) were not. Responders were defined as those with a hemoglobin value of greater than 11 g/dL or an increase of 1 g/dL documented within 6 months of the initial screening visit. Follow-up rates for both groups were low (~50%), but of those prescribed iron, 107 of 150 (71%) responded to treatment compared with 27 of 48 (68%) of those who did not receive iron. Since similar response rates were seen among infants who did and infants who did not receive iron therapy, proving the benefit of routine screening followed by a trial of iron may be problematic in populations with higher rates of anemia, low follow-up rates, and high spontaneous resolution rates."
-        },
-        {
-            "input": "Abrupt discontinuation of the offending analgesic(s), and treating rebound headaches with dihydroergotamine (DHE) as needed, results in significant improvement for most patients.",
-            "output": "A case series studied 50 patients with rebound headaches for 5 or more days a week at baseline. Patients were educated regarding analgesic overuse headaches, after which their analgesics were abruptly discontinued, and they were followed up to a year. Subcutaneous DHE was used as needed for symptomatic relief of excruciating headaches. At study completion, 78% of patients had adequately stopped analgesics. The goal of greater than 6 consecutive headache-free days was achieved in 74% patients in an average of 84 days."
-        },
-        {
-            "input": "Abrupt discontinuation of the offending analgesic(s), and treating rebound headaches with dihydroergotamine (DHE) as needed, results in significant improvement for most patients.",
-            "output": "Also termed analgesic-overuse headaches, they are defined by the International Headache Society guidelines as headaches occurring more than 15 days per month, mild to moderate in intensity, developing or worsening with analgesic overuse, and resolving or reverting to the prior underlying headache pattern within 2 months of discontinuing the analgesic(s)."
-        },
-        {
-            "input": "Abrupt discontinuation of the offending analgesic(s), and treating rebound headaches with dihydroergotamine (DHE) as needed, results in significant improvement for most patients.",
-            "output": "Analgesic rebound headaches are seen in 1% of the population, mostly middle-aged women with underlying migraines."
-        },
-        {
-            "input": "Amitriptyline does not affect the frequency or severity of rebound headaches, but it may improve quality of life.",
-            "output": "A 9-week double-blind, placebo-controlled trial randomized 20 nondepressed patients with analgesic overuse headache to receive amitriptyline or active placebo (trihexyphenidyl). Patients were admitted to the hospital for 1 week and withdrawn from all analgesics. The 2 groups had similar baseline characteristics. During the hospitalization, the amitriptyline treatment group received intravenous amitriptyline escalating from 25 to 75 mg. During the following month, oral study medications were continued, and patients took low doses of aspirin or acetaminophen, as needed. There was no significant difference between the 2 groups with regard to analgesic use. At completion of this low-powered study, no difference was found between the 2 groups in headache frequency or analgesic use, although certain components of a quality-of-life scale were better in the amitriptyline group."
-        },
-        {
-            "input": "Prednisone or naratriptan (Amerge) lessen acute withdrawal symptoms from analgesics and reduce the need for rescue medications during the first 6 days of treatment; however, they do not affect headache frequency or severity.",
-            "output": "An open-label trial of patients with chronic migraine and analgesic overuse in a headache sub-specialty center abruptly withdrew 150 participants from analgesics and quasi-randomized them to 3 groups: prednisone (tapering from 60 to 20 mg over 6 days), naratriptan (Amerge) (2.5 mg twice daily for 6 days), or no prophylactic treatment. Patients given the active substances were told it would reduce withdrawal symptoms; patients given placebo were not given this advice. All patients received education about the pathophysiology of rebound headaches, kept a headache diary, and were phoned weekly to ensure compliance. In addition, they all received capsules containing gradually increasing doses of atenolol, nortriptyline, and flunarazine (a calcium channel blocker not FDA-approved.) Indo-methacin and chlorpromazine were used as needed. Results from the first 6 days showed no difference in headaches between the 3 groups; however, significantly more patients used chlorpromazine in the \"no pharmacologic treatment\" group. By the end of 5 weeks, headache frequency was significantly reduced in all groups from baseline; however, there were no differences between groups in headache frequency or intensity in this small study. Of note, there were statistically fewer withdrawal symptoms and less use of rescue medications among patients who received the initial prophylactic treatments. The indomethacin rescue use was 24%, 18%, and 14% of patients for the no prophylactic treatment, prednisone, and naratriptan groups respectively, while chlorpromazine rescue use was 14%, 0%, and 0%, respectively. The number of patients needed to treat to prevent any withdrawal symptoms (nausea, vomiting, nervousness, dizziness, etc.) was 1 for every 3.5 for naratriptan, and 6.4 for prednisone."
-        },
-        {
-            "input": "Probably not. Ambulation, combined with compression of the affected extremity, appears to be safe for medically stable patients with deep venous thromboses (DVT).",
-            "output": "An RCT revealed a trend toward thrombus progression occurring more often in patients who were treated with bed rest compared with patients treated with ambulation and compression, though the difference didn't reach statistical significance because of small sample size. The clinical importance of these phlebographic studies isn't clear."
-        },
-        {
-            "input": "Probably not. Ambulation, combined with compression of the affected extremity, appears to be safe for medically stable patients with deep venous thromboses (DVT).",
-            "output": "A multicenter RCT showed that thrombus progression occurred more often in patients who were treated with bed rest compared with patients treated with ambulation and compression (P<.01)."
-        },
-        {
-            "input": "Probably not. Ambulation, combined with compression of the affected extremity, appears to be safe for medically stable patients with deep venous thromboses (DVT).",
-            "output": "A study using the RIETE registry, a Spanish registry of consecutively enrolled patients with objectively confirmed acute DVT or PE, found no significant difference in occurrence of new PE between immobilized and mobilized patients. Patients with DVT who were immobilized were generally sicker, more likely to have PaO2 <60, and more likely to have received lower doses of low-molecular-weight heparin (LMWH) compared with the group that walked (P<.005)."
-        },
-        {
-            "input": "Probably not. Ambulation, combined with compression of the affected extremity, appears to be safe for medically stable patients with deep venous thromboses (DVT).",
-            "output": "A prospective cohort study of new PE in patients treated with ambulation and compression plus anticoagulation found that the incidence of PE was significantly lower than historical incidence rates in patients managed with bed rest."
-        },
-        {
-            "input": "Leg compression and ambulation, compared with bed rest without compression, can effectively decrease swelling and pain.",
-            "output": "RCTs have shown that ambulation with leg compression, compared with bed rest without compression, can effectively decrease leg swelling and pain."
-        },
-        {
-            "input": "Leg compression and ambulation, compared with bed rest without compression, can effectively decrease swelling and pain.",
-            "output": "The difference between ambulation with leg compression, compared with bed rest without compression, was detectable 2 years after DVT."
-        },
-        {
-            "input": "Leg compression and ambulation, compared with bed rest without compression, can effectively decrease swelling and pain.",
-            "output": "RCTs in which both ambulating and resting patients received compression therapy showed no significant difference in leg circumference at 1 or 6 months. This finding suggests that the benefit on local symptoms may result from compression rather than ambulation."
-        },
-        {
-            "input": "Only weak data exist to suggest that early ambulation can reduce mortality.",
-            "output": "A cohort study in which 691 patients were kept walking with compression therapy reported a mortality rate of 0.2%."
-        },
-        {
-            "input": "Only weak data exist to suggest that early ambulation can reduce mortality.",
-            "output": "The 0.2% mortality rate (occurred in patients older than 70 years) is lower than rates reported in the historic literature, which typically are 1% among patients treated with unfractionated heparin and bed rest."
-        },
-        {
-            "input": "Only weak data exist to suggest that early ambulation can reduce mortality.",
-            "output": "In a cohort, the mortality rate was also 0.2%, and all deaths occurred in patients older than 70 years."
-        },
-        {
-            "input": "Only weak data exist to suggest that early ambulation can reduce mortality.",
-            "output": "Data from the RIETE registry indicated that overall mortality was significantly higher in immobilized patients with a PE (3.6% vs 0.5% in mobile patients; P=.01).8 Notably, immobilized patients with a PE were more likely to be hypoxic and also tended to receive lower doses of LMWH. No differences were found in outcomes for patients with DVT."
-        },
-        {
-            "input": "Only weak data exist to suggest that early ambulation can reduce mortality.",
-            "output": "A retrospective, multicenter cohort of 1647 patients treated with unfractionated heparin and bed rest in different German hospitals reported a rate of fatal PE of 2.33%."
-        },
-        {
-            "input": "Yes, warfarin is effective in the secondary prevention of venous thromboembolic events (VTEs) for patients positive for lupus anticoagulant or anticardiolipin antibody (also known as antiphospholipid antibodies [aPL]).",
-            "output": "One study prospectively followed patients \u226515 years old recruited from 16 hospitals in Sweden, who had their first or second episode of a VTE. Patients with malignancy or a known congenital deficiency of an inhibitor of coagulation were excluded. These patients were followed for 4 years. Each received at least 6 months of warfarin therapy (INR=2.0-2.85) after initial diagnosis of a VTE. After treatment, the 4-year recurrence rate for VTEs was 29% for patients with aPL (20/68) vs 14% for patients without (47/344) (relative risk [RR]=2.1; 95% confidence interval [CI], 1.3-3.3). The risk of death for those patients with aPL was 15% (10/68) vs 6% for those without (20/324) (RR=1.8; 95% CI, 0.9-3.6). In the same study, those with an aPL and a second clot were randomized to a second 6 months of therapy vs indefinite therapy (INR=2.0-2.85). After 4 years, their risk of another recurrence was 20% (3/15) with 6 months of therapy vs 5% (1/19) with indefinite therapy. This underpowered study did not show a statistical difference under intention-to-treat analysis; however, the single failure in the treatment group had stopped the warfarin prior to the event."
-        },
-        {
-            "input": "Patients should be treated for at least a year with warfarin.",
-            "output": "Guidelines from the American College of Chest Physicians recommend at least 12 months of treatment with warfarin and suggest indefinite treatment for patients with a VTE and antiphospholipid antibodies. The guidelines also suggest a target INR of 3.0 range, 2.5-3.5 for patients with recurrent VTEs or additional risk factors, and a therapeutic INR of 2.5 range, 2.0-3.0 for patients with a VTE and lupus anticoagulant but no additional risk factors."
-        },
-        {
-            "input": "Patients should be treated, possibly indefinitely, with warfarin.",
-            "output": "A meta-analysis of these studies (done in conjunction with the second study) remained insufficiently powered to show any significant differences between high- and moderate-intensity therapy, but there was a trend towards increased thrombosis and bleeding events in the high-intensity groups. Of note, the relative risk for developing a VTE was lower in these studies than in those with time-limited treatment, suggesting that indefinite treatment may be indicated."
-        },
-        {
-            "input": "Moderate-intensity therapy (international normalized ratio [INR] range, 2.0-3.0) appears to be the best balance between risks and benefits.",
-            "output": "A meta-analysis of these studies (done in conjunction with the second study) remained insufficiently powered to show any significant differences between high- and moderate-intensity therapy, but there was a trend towards increased thrombosis and bleeding events in the high-intensity groups. Of note, the relative risk for developing a VTE was lower in these studies than in those with time-limited treatment, suggesting that indefinite treatment may be indicated."
-        },
-        {
-            "input": "Moderate-intensity therapy (international normalized ratio [INR] range, 2.0-3.0) appears to be the best balance between risks and benefits.",
-            "output": "Two recent randomized controlled trials have shown that moderate-intensity warfarin therapy (INR=2.0-3.0) is equally efficacious to high-intensity therapy (INR=3.0-4.0). In these small studies, those with aPL were randomized to moderate-intensity vs high-intensity therapy and followed for approximately 3 years."
-        },
-        {
-            "input": "Little evidence exists regarding primary prevention for patients with an incidental finding of either aPL. For these individuals, the risks of warfarin may outweigh any benefits. Many experts recommend primary prevention with aspirin for those individuals who are aPL positive and who do not have contraindications to aspirin or another compelling reason for warfarin use (malignancy, family history, or accompanying hypercoagulable state).",
-            "output": "Wahl et al constructed a decision analysis of antithrombotic therapy for patients with systemic lupus erythematosus with and without aPL. They compared observation alone with aspirin and with warfarin for the primary prevention of VTE. Using a decision analysis based on the best available efficacy rates, they recommended that the benefits of prophylactic aspirin outweigh the risks. However, due to high complication rates, warfarin's benefits are outweighed by the risks. This analysis has not been validated in an actual patient population and remains theoretical in nature, but is the best available evidence regarding primary prevention of VTE for patients with aPL."
-        },
-        {
-            "input": "One approach is to use antidepressants alone, which reduce symptoms for patients with major depression plus symptoms of anxiety or major depression plus generalized anxiety disorder. Selective serotonin reuptake inhibitors (SSRIs), tricyclics (TCAs), bupropion, mirtazapine, nefazodone, and venlafaxine are equally effective for combined symptom relief.",
-            "output": "Two open-label cohort trials (N=153) found that fluoxetine and fluvoxamine (Luvox, an older SSRI) reduced both depression and anxiety by about half."
-        },
-        {
-            "input": "One approach is to use antidepressants alone, which reduce symptoms for patients with major depression plus symptoms of anxiety or major depression plus generalized anxiety disorder. Selective serotonin reuptake inhibitors (SSRIs), tricyclics (TCAs), bupropion, mirtazapine, nefazodone, and venlafaxine are equally effective for combined symptom relief.",
-            "output": "Three trials evaluated antidepressant medication for patients who met diagnostic criteria for both major depression and generalized anxiety disorder. A manufacturer-sponsored RCT (N=90) found no differences in HAM-A or HAM-D score reduction among fluoxetine, venlafaxine, and placebo (except at 12 weeks, when venlafaxine significantly differed from placebo)."
-        },
-        {
-            "input": "One approach is to use antidepressants alone, which reduce symptoms for patients with major depression plus symptoms of anxiety or major depression plus generalized anxiety disorder. Selective serotonin reuptake inhibitors (SSRIs), tricyclics (TCAs), bupropion, mirtazapine, nefazodone, and venlafaxine are equally effective for combined symptom relief.",
-            "output": "Patients with major depression and high anxiety levels relapsed more often than those with low anxiety levels with discontinuation of fluoxetine compared with placebo in a double-blind placebo-controlled parallel trial with 596 patients."
-        },
-        {
-            "input": "Another approach is to add a benzodiazepine to the antidepressant. This reduces anxiety symptoms (more in the short term) and decreases patient dropout, but it also has possible harms, including development of dependence and accident proneness.",
-            "output": "A Cochrane systematic review (10 RCTs, N=731) compared antidepressants alone vs combinations with benzodiazepines for patients with major depression and a 35% to 85% estimated prevalence of anxiety symptoms. Three studies used standardized scales to measure anxiety symptom severity. Antidepressants in combination with benzodiazepines were more likely than antidepressants alone to reduce depression scores by 50% or more (for 50% depression improvement at 1 week, number needed to treat [NNT]=12; at 4 weeks, NNT=8). The combination group also had fewer dropouts (relative risk [RR]=0.63, 95% confidence interval [CI], 0.49-0. 81). The authors concluded that potential benefits of adding a benzodiazepine to an antidepressant must be balanced against possible harms, such as the development of dependence."
-        },
-        {
-            "input": "Psychotherapy, particularly cognitive behavioral therapy, produces and maintains reductions in symptoms of anxiety and depression that are comparable with the reductions seen with medication.",
-            "output": "A review of 13 controlled clinical trials evaluated standardized depression and anxiety score reductions for patients with generalized anxiety disorder receiving cognitive behavioral therapy compared with various control treatments (waiting list, pill placebo, or alternative therapy-such as supportive listening psychotherapy). Approximately half of the patients were also taking medication (not specified). After an average of 10 sessions, cognitive behavioral therapy reduced anxiety and depression symptom scores more than control treatments (difference in effect size were 0.71 and 0.66, respectively). At 6- to 12-month follow-up, cognitive behavioral therapy gains were maintained (difference in effect size=0.30 for anxiety scores and 0.21 for depression scores). (An effect size of 0.2 is usually considered small, 0.5 moderate, and 0.8 is large.)"
-        },
-        {
-            "input": "Psychotherapy, particularly cognitive behavioral therapy, produces and maintains reductions in symptoms of anxiety and depression that are comparable with the reductions seen with medication.",
-            "output": "Another trial assigned primary care patients (N=464) with depression or mixed depression and anxiety to 1 of 2 psychological therapy groups (cognitive behavioral therapy or non-directive counseling for 12 sessions) vs usual general practitioner care. At 4 months, both psychological therapy groups had lower Beck Depression Index scores (by 4-5 points) than the usual general practitioner care group, but by 12 months there were no significant differences among all groups."
-        },
-        {
-            "input": "other",
-            "output": "A systematic review of 28 randomized trials comparing various antidepressant medications found no significant differences in reduction of symptoms of depression and anxiety for patients who had both. Patients in these trials met DSM (Diagnostic and Statistical Manual of Mental Health) criteria for major depression, with symptom severity as measured by a standardized scale, the Hamilton Rating Scale for Depression (HAM-D). They also had moderate to severe levels of anxiety symptoms as measured by standardized scales (Hamilton Rating Scale for Anxiety [HAM-A], Covi Anxiety Rating Scale, or the anxiety/somatization factors on the HAM-D). Trials ranged from 6 to 24 weeks long, with outcomes including reductions in depression and anxiety symptom scores as measured by standardized scales. Study quality was variable; only 8 trials used a placebo control, and many were sponsored by pharmaceutical manufacturers. Although some individual studies found differences in outcomes between medications, no significant differences in efficacy were seen in combined data from each comparison group. Medication was more efficacious than placebo in most studies that used a placebo control. Side-effect profiles were not described."
-        },
-        {
-            "input": "Testing for gonorrhea is recommended for a patient with genital chlamydia; also test for gonorrhea and chlamydia in their sexual partner because of the high prevalence of coinfection, particularly among younger patients.",
-            "output": "The CDC guidelines recommend evaluation, testing and treatment of partners of persons with chlamydia. As well as testing for other STIs, the guidelines suggest Pap smear screening for women who have not been adequately screened, as they often are at high risk for later cervical cancer. All patients seeking treatment for STDs, including all patients attending STD clinics, should be screened routinely for HIV during each visit for a new complaint, regardless of whether the patient is known or suspected to have specific behavior risks for HIV infection."
-        },
-        {
-            "input": "Testing for gonorrhea is recommended for a patient with genital chlamydia; also test for gonorrhea and chlamydia in their sexual partner because of the high prevalence of coinfection, particularly among younger patients.",
-            "output": "In non-STI clinic settings, gonorrhea has been found in 9% of men and 6% of women with chlamydia."
-        },
-        {
-            "input": "Testing for gonorrhea is recommended for a patient with genital chlamydia; also test for gonorrhea and chlamydia in their sexual partner because of the high prevalence of coinfection, particularly among younger patients.",
-            "output": "A study of the prevalence rate of chlamydia, gonorrhea, and their coinfection in an adolescent population (women n=131,915 and men n=71,074) of juvenile detention centers between 1997 and 2002 found that 18% of women and 13% of males with chlamydia were coinfected with gonorrhea."
-        },
-        {
-            "input": "Testing for gonorrhea is recommended for a patient with genital chlamydia; also test for gonorrhea and chlamydia in their sexual partner because of the high prevalence of coinfection, particularly among younger patients.",
-            "output": "The high prevalence of coinfection of chlamydia and gonorrhea has been shown in several studies. One cross-sectional study of new clients to a hospital-based STI clinic with gonorrhea, chlamydia, or both infections found 39% of 1239 women and 24% of 1141 heterosexual men with gonorrhea also had chlamydia. Thirteen percent of females and 19% of heterosexual males with chlamydia also had gonorrhea. More than half of the women and a third of the men aged 15 to 19 had both gonorrhea and chlamydia. Patients with both STIs tended to be younger than those with one."
-        },
-        {
-            "input": "Testing for gonorrhea is recommended for a patient with genital chlamydia; also test for gonorrhea and chlamydia in their sexual partner because of the high prevalence of coinfection, particularly among younger patients.",
-            "output": "A pilot study evaluated the yield of testing patients for other STIs among patients with genital chlamydia diagnosed during opportunistic screening. The study screened patients of both sexes in primary health care settings, as well as men attending a genitourinary medicine clinic. All patients testing positive in the community were advised to attend the genitourinary medicine clinic for STI screening, partner notification, and testing of patients and their contacts. More than 90% of the patients testing positive for chlamydia attended the genitourinary medicine clinic for management (total numbers seen in the clinic; women n=1245 [957 screened in the community] and men n=490 [280 screened in the community]). At the clinic, further workup included evaluation and testing for chlamydia, gonorrhea, trichomonas, and bacterial vaginosis. Of the patients whose initial screening was in the genitourinary medicine clinic, 28% had an additional STI. Of the patients initially screened in the community setting, 4% had another STI. Partner testing showed that 55% of male partners of female patients had an STI and 76% of female partners of male patients had one or more STI."
-        },
-        {
-            "input": "Testing for syphilis and HIV is also recommended for the patient and their partner.",
-            "output": "The American Academy of Family Physicians AAFP strongly recommends testing for chlamydia in all sexually active women aged 25 years or younger and those at increased risk. The AAFP recommends screening all sexually active women for gonorrhea if they are at increased risk for infection; strongly recommends screening persons at increased risk for syphilis infection; and strongly recommends screening for HIV for persons seeking treatment for STIs."
-        },
-        {
-            "input": "Testing for syphilis and HIV is also recommended for the patient and their partner.",
-            "output": "All patients seeking treatment for STDs, including all patients attending STD clinics, should be screened routinely for HIV during each visit for a new complaint, regardless of whether the patient is known or suspected to have specific behavior risks for HIV infection."
-        },
-        {
-            "input": "Testing for syphilis and HIV is also recommended for the patient and their partner.",
-            "output": "The Institute for Clinical Systems Improvement recommends screening for chlamydia and gonorrhea for all sexually active women aged 25 years and younger and other asymptomatic women at risk for infection. Routine screening for HIV is also recommended to all persons at high risk, including those seeking treatment for any STI."
-        },
-        {
-            "input": "The best way to evaluate a low-normal B12 level is to check serum methylmalonic acid and homocysteine levels.",
-            "output": "Holotranscobalamin may become a first-choice assay for diagnosing early vitamin B12 deficiency. Studies have shown that it compares favorably with current combined measures (B12 levels, methylmalonic acid, homocysteine). Like current assays, holotranscobalamin is also affected by renal function. It requires further investigation to establish relevant cutoff levels before it can be recommended as a diagnostic strategy."
-        },
-        {
-            "input": "The best way to evaluate a low-normal B12 level is to check serum methylmalonic acid and homocysteine levels.",
-            "output": "Vitamin B12 is a necessary coenzyme in the metabolism of methylmalonic acid to succinyl choline, and is also a necessary coenzyme with folate in the metabolism of homocysteine to methionine. Therefore, a vitamin B12 deficiency leads to elevated levels of unmetabolized methylmalonic acid and homocysteine. At a local lab the normal range of methylmalonic acid is 0.00 to 0.40 umol/L, and homocysteine's normal range is 4.0 to 10.0 mmol/L. Normal levels might vary by laboratory. Other conditions, such as renal insufficiency, may also cause elevation of methylmalonic acid and homocysteine."
-        },
-        {
-            "input": "The best way to evaluate a low-normal B12 level is to check serum methylmalonic acid and homocysteine levels.",
-            "output": "A low-normal B12 level is 150 to 350 pg/mL. Levels less than 150 pg/mL indicate deficiency. Levels greater than 350 pg/mL indicate adequate B12 supply."
-        },
-        {
-            "input": "Give 1 or 2 mg of oral vitamin B12 a day if levels are marginally low and either methylmalonic acid or both methylmalonic acid and homocysteine are elevated.",
-            "output": "Oral vitamin B12 at doses of 1000 to 2000 mcg/d is a simple and cost-effective treatment option for any B12-deficient person, and may actually be superior to intramuscular replacement."
-        },
-        {
-            "input": "Give 1 or 2 mg of oral vitamin B12 a day if levels are marginally low and either methylmalonic acid or both methylmalonic acid and homocysteine are elevated.",
-            "output": "A Cochrane Collaboration review of oral vitamin B12 replacement found that these high doses seemed as effective as intramuscular vitamin B12 in all B12-deficient patients-even those with pernicious anemia, Crohn's disease, ileal resection, or malabsorption states. The authors of the review recommend a \"further large, pragmatic trial in a primary care setting\" to determine whether oral vitamin B12 is effective for patients with major common cases of malabsorption and to provide additional evidence for cost effectiveness."
-        },
-        {
-            "input": "Limited evidence delineates the relative probabilities of causes of acute diarrhea, typically defined as a diarrheal disease lasting 14 days or fewer, in the developed world. Viruses (rotavirus, Norwalk, and other enteric viruses) are responsible for most cases. Stool culture helps to identify bacterial causes (Salmonella, Shigella, enterotoxic Escherichia coli), especially in patients with fever and bloody stool. A modified 3-day rule (eg, performing only Clostridium difficile toxin tests on low-risk patients who have been hospitalized for 3 or more days) leads to a more rational use of stool cultures without missing cases of clinically significant disease.",
-            "output": "Using retrospective reviews, Bauer and colleagues developed a prediction rule for cases of infectious diarrhea. The \"modified 3-day rule\" recommends stool cultures for patients with diarrhea beginning more than 3 days after hospitalization only when they fall into 1 of the following groups: patients older than 65 years with permanently altered organ function, those with HIV or neutropenia, those hospitalized during suspected nosocomial outbreaks, and those suspected of nondiarrheal manifestations of enteric infection. When the modified rule was applied prospectively, only 2 cases were missed. Both patients were at risk for immunosuppression, although they did not strictly meet the modified criteria. Neither required treatment."
-        },
-        {
-            "input": "Limited evidence delineates the relative probabilities of causes of acute diarrhea, typically defined as a diarrheal disease lasting 14 days or fewer, in the developed world. Viruses (rotavirus, Norwalk, and other enteric viruses) are responsible for most cases. Stool culture helps to identify bacterial causes (Salmonella, Shigella, enterotoxic Escherichia coli), especially in patients with fever and bloody stool. A modified 3-day rule (eg, performing only Clostridium difficile toxin tests on low-risk patients who have been hospitalized for 3 or more days) leads to a more rational use of stool cultures without missing cases of clinically significant disease.",
-            "output": "A systematic review found no published studies about the likelihood of specific diagnoses in children presenting to the hospital with diarrhea."
-        },
-        {
-            "input": "Limited evidence delineates the relative probabilities of causes of acute diarrhea, typically defined as a diarrheal disease lasting 14 days or fewer, in the developed world. Viruses (rotavirus, Norwalk, and other enteric viruses) are responsible for most cases. Stool culture helps to identify bacterial causes (Salmonella, Shigella, enterotoxic Escherichia coli), especially in patients with fever and bloody stool. A modified 3-day rule (eg, performing only Clostridium difficile toxin tests on low-risk patients who have been hospitalized for 3 or more days) leads to a more rational use of stool cultures without missing cases of clinically significant disease.",
-            "output": "A case-control study of stool cultures for rotavirus in adult patients found that 14% of 683 with diarrhea and 5% of 1115 without diarrhea shed rotavirus."
-        },
-        {
-            "input": "Limited evidence delineates the relative probabilities of causes of acute diarrhea, typically defined as a diarrheal disease lasting 14 days or fewer, in the developed world. Viruses (rotavirus, Norwalk, and other enteric viruses) are responsible for most cases. Stool culture helps to identify bacterial causes (Salmonella, Shigella, enterotoxic Escherichia coli), especially in patients with fever and bloody stool. A modified 3-day rule (eg, performing only Clostridium difficile toxin tests on low-risk patients who have been hospitalized for 3 or more days) leads to a more rational use of stool cultures without missing cases of clinically significant disease.",
-            "output": "A prospective study of 147 US children with acute, mild diarrhea demonstrated that rectal swabs yielded a positive test for an infectious agent in 60.5% of cases."
-        },
-        {
-            "input": "Limited evidence delineates the relative probabilities of causes of acute diarrhea, typically defined as a diarrheal disease lasting 14 days or fewer, in the developed world. Viruses (rotavirus, Norwalk, and other enteric viruses) are responsible for most cases. Stool culture helps to identify bacterial causes (Salmonella, Shigella, enterotoxic Escherichia coli), especially in patients with fever and bloody stool. A modified 3-day rule (eg, performing only Clostridium difficile toxin tests on low-risk patients who have been hospitalized for 3 or more days) leads to a more rational use of stool cultures without missing cases of clinically significant disease.",
-            "output": "Viral causes are most common; in children, viruses are responsible for 70% to 80% of cases of diarrhea."
-        },
-        {
-            "input": "Limited evidence delineates the relative probabilities of causes of acute diarrhea, typically defined as a diarrheal disease lasting 14 days or fewer, in the developed world. Viruses (rotavirus, Norwalk, and other enteric viruses) are responsible for most cases. Stool culture helps to identify bacterial causes (Salmonella, Shigella, enterotoxic Escherichia coli), especially in patients with fever and bloody stool. A modified 3-day rule (eg, performing only Clostridium difficile toxin tests on low-risk patients who have been hospitalized for 3 or more days) leads to a more rational use of stool cultures without missing cases of clinically significant disease.",
-            "output": "While most research on acute diarrhea focuses on infectious causes, noninfectious causes should also be considered eg, drug-induced diarrhea, inflammatory bowel disease. The Infectious Diseases Society of America's practice guidelines for the evaluation and treatment of acute diarrhea recommends that stool culture for bacteria including enterotoxic E coli should be considered in patients with community- or travel-acquired diarrhea, especially when fever or bloody stool is present. In hospitalized patients, only toxin tests for C difficile are recommended. Testing for acute parasitic diseases should be reserved only for patients whose symptoms persist after 7 days."
-        },
-        {
-            "input": "Punch biopsy excision appears to be superior to traditional wide elliptical excision for the treatment of sebaceous cysts when intervention is necessary.",
-            "output": "Minimal excision and punch biopsy techniques are purported to produce minimal bleeding, have faster healing times, and produce less scarring."
-        },
-        {
-            "input": "Punch biopsy excision appears to be superior to traditional wide elliptical excision for the treatment of sebaceous cysts when intervention is necessary.",
-            "output": "Traditional wide excision -involving dissection and removal of the cyst completely from the surrounding tissue through an elliptical incision-is considered the gold standard of treatment. This time-consuming endeavor frequently leads to significant scarring in comparison with minimal excision or punch biopsy, but has almost no recurrence when the cyst wall is entirely removed."
-        },
-        {
-            "input": "other",
-            "output": "Sebaceous cysts-more correctly referred to as epidermal inclusion cysts-are benign lesions of the skin. They rarely require intervention out of medical necessity, but are removed for cosmetic reasons. If the cysts become inflamed, secondary to internal discharge of the cysts' contents, or grow so large that they interfere with the patient's functioning, they may need to be removed."
-        },
-        {
-            "input": "other",
-            "output": "The minimal incision technique involves kneading the lesion following injection of anesthetic and expressing the cyst contents through a 2- to 3-mm incision. Following expulsion of the cyst contents, the loosened capsule is delivered through the small opening. Closure with suture is optional."
-        },
-        {
-            "input": "other",
-            "output": "Punch biopsy excision is similar to the minimal excision technique except that the incision is made using a single-use disposable dermal punch following injection of lidocaine. Expulsion of the cyst contents, with cyst wall, via lateral pressure is performed and occasionally followed by closure with one suture."
-        }
-    ]
-}

MedS-Bench/Fact_verication/task12_pubmedqa_classification.json

@@ -1,769 +0,0 @@
-{
-    "Contributors": [
-        "Jalansh Munshi"
-    ],
-    "Source": [
-        "PubMedQA"
-    ],
-    "URL": [
-        "https://huggingface.co/datasets/pubmed_qa"
-    ],
-    "Categories": [
-        "Fact Verification"
-    ],
-    "Reasoning": [],
-    "Definition": [
-        "Given a passage with a question and an answer to that question, classify if the answer actually answers the question into 'yes' or 'no'. Output 'yes' if the answer answers the question and output 'no' if the answer does not answer the question."
-    ],
-    "Input_language": [
-        "English"
-    ],
-    "Output_language": [
-        "English"
-    ],
-    "Instruction_language": [
-        "English"
-    ],
-    "Domains": [
-        "Academical Papers"
-    ],
-    "Positive Examples": [
-        {
-            "input": "Question: Are group 2 innate lymphoid cells ( ILC2s ) increased in chronic rhinosinusitis with nasal polyps or eosinophilia?\nAnswer: As ILC2s are elevated in patients with CRSwNP, they may drive nasal polyp formation in CRS. ILC2s are also linked with high tissue and blood eosinophilia and have a potential role in the activation and survival of eosinophils during the Th2 immune response. The association of innate lymphoid cells in CRS provides insights into its pathogenesis.",
-            "output": "yes",
-            "explanation": "The answer clearly says that ICLSs are elevated, which is exactly what the question asks. Hence, the output will be yes and it is correct."
-        },
-        {
-            "input": "Question: Does vagus nerve contribute to the development of steatohepatitis and obesity in phosphatidylethanolamine N-methyltransferase deficient mice?\nAnswer: Neuronal signals via the hepatic vagus nerve contribute to the development of steatohepatitis and protection against obesity in HFD fed Pemt(-/-) mice.",
-            "output": "yes",
-            "explanation": "The answer is in accordance with the question and clearly says that neuronal signals contribute to development of steatohepatitis. Hence, the output will be yes and it is correct."
-        },
-        {
-            "input": "Question: Does psammaplin A induce Sirtuin 1-dependent autophagic cell death in doxorubicin-resistant MCF-7/adr human breast cancer cells and xenografts?\nAnswer: PsA significantly inhibited MCF-7/adr cells proliferation in a concentration-dependent manner, with accumulation of cells in G2/M phase of the cell cycle. PsA significantly decreased SIRT1 enzyme activity and reduced expression of SIRT1 protein in the cultured cells with greater potency than sirtinol or salermide. Acetylation of p53, a putative target of SIRT1, increased significantly following PsA treatment. In addition, PsA markedly increased the expression levels of autophagy-related proteins. In support of this, it was found that PsA significantly increased the expression of damage-regulated autophagy modulator (DRAM), a p53-induced protein.",
-            "output": "yes",
-            "explanation": "The answer says that psammaplin (PsA) increased the expression levels of autophagy-related proteins, which is in accordance with the question. Hence, this output is correct."
-        }
-    ],
-    "Negative Examples": [
-        {
-            "input": "Question: Is methylation of the FGFR2 gene associated with high birth weight centile in humans?\n Answer: We identified a novel biologically plausible candidate (FGFR2) for with BWC that merits further study.",
-            "output": "no",
-            "explanation": "It is mentioned in the answer that a novel biologically plausible candidate (FGFR2) for birth weight centile (BWC) as identified that merits further study. This answer satisfies the question. The output should be 'yes' and hence, this is a bad example."
-        },
-        {
-            "input": "Question: Do tumor-infiltrating immune cell profiles and their change after neoadjuvant chemotherapy predict response and prognosis of breast cancer?\nAnswer: Breast cancer immune cell subpopulation profiles, determined by immunohistochemistry-based computerized analysis, identify groups of patients characterized by high response (in the pre-treatment setting) and poor prognosis (in the post-treatment setting). Further understanding of the mechanisms underlying the distribution of immune cells and their changes after chemotherapy may contribute to the development of new immune-targeted therapies for breast cancer.",
-            "output": "no",
-            "explanation": "It has been written in the answer that chemotherapy may contribute to the development of new immune-targeted therapies for breast cancer. This answers the question. The output should be 'yes' and hence, this is a bad example."
-        },
-        {
-            "input": "Question: Is hidradenitis suppurativa a systemic disease with substantial comorbidity burden : a chart-verified case-control analysis?\nAnswer: Control subjects were not validated for absence of HS and comorbidity validation was not performed for either group.",
-            "output": "no",
-            "explanation": "The answer says that the control subjects were not validated for absence of hidradenitis suppurativa (HS) and comorbidity validation was not performed. This is a satisfactory response to the question. The output should be 'yes' and hence, this is a bad example. "
-        }
-    ],
-    "Instances": [
-        {
-            "id": "task846-a3d71eef6d064a63b0fce9d1107451b0",
-            "input": "Question: Is urinary 5-HIAA excretion increased in patients with head and neck paragangliomas?\nAnswer: Urinary 5-HIAA excretion is within the normal reference range in almost all HNPGL patients. Therefore, this parameter has no clinical relevance in the routine clinical assessment of HNPGL patients.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-da39cea1a6b24df2aa737f6586869ff3",
-            "input": "Question: Is inhibition of B-NHEJ in plateau-phase cells a direct consequence of suppressed growth factor signaling?\nAnswer: The results document a rapid and fully reversible adaptation of B-NHEJ to growth activity and point to factors beyond EGFR in its regulation. They show notable differences in the regulation of error-prone DSB repair pathways between proliferating and non proliferating cells that may present new treatment design opportunities in radiation therapy.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-0fe42076c991425fa7e55259a3677abd",
-            "input": "Question: Are posterior pituitary functions altered after growth hormone replacement therapy in hypopituitarism due to Sheehan 's syndrome?\nAnswer: Patients with SS have subtle abnormalities in posterior pituitary functions and the threshold for thirst perception is increased. However GH replacement therapy does not seem to reverse or adversely affect the mildly deteriorated posterior pituitary functions of SS patients.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-b618cd18122a4bf8aa22206d26f6d025",
-            "input": "Question: Does interferon responsiveness change in treatment-experienced hepatitis C subjects : implications for drug development and clinical decisions?\nAnswer: We contend that P/R-experienced subjects are represented within treatment-naive subjects. There are 2 important implications of this finding: (1) from a drug development perspective, a successful direct antiviral plus P/R therapy (IFN-based triple therapy) trial in P/R-experienced subjects may serve as supportive evidence in treatment-naive subjects; and (2) from a clinical decision perspective, previous P/R exposure should not alter new treatment decisions involving IFN-based triple therapy, as the IFN responsiveness to a second course of IFN is comparable.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-a0d8495e89ee4f9a8d8051120eb416c7",
-            "input": "Question: Does [ Hydrocephaly modify neuroblast chain migration in the subventricular zone ( SVZ ) ]?\nAnswer: Sub-chronic hydrocephalus did not modify the proliferation of neural precursors or the migration pattern of neuroblasts in the subventricular zone. This suggests that only the CSF flow and the dissolved signaling proteins are the main regulators of the neuronal migration in vivo.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-830c556f577a4e9b8abbcf0c1254f574",
-            "input": "Question: Is coronary artery disease associated with stroke recurrence?\nAnswer: The results of the presented study indicate that CAD does not influence stroke recurrence.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-69dd3218ef3547a4894fa49b4895b715",
-            "input": "Question: Does coinciding exercise with peak serum caffeine improve cycling performance?\nAnswer: In contrast to coinciding peak serum caffeine concentration with exercise onset, caffeine consumed 60 min prior to exercise resulted in significant improvements in 40 km time trial performance. The ergogenic effect of caffeine was not found to be related to peak caffeine concentration in the blood at the onset of endurance exercise.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-6ee41e8f97e7419691bdfd254f55e1e5",
-            "input": "Question: Does liposomal amphotericin B induce nephrotoxicity or renal function impairment in premature neonates?\nAnswer: LAMB is generally safe and well tolerated in VLBW neonates. The occurrence of LAMB-related nephrotoxicity appears to be uncommon, mild and transient.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-6daadffab67f4ca58c626067624b3b5c",
-            "input": "Question: Does change in oxygen saturation predict acute mountain sickness on Jade Mountain?\nAnswer: Subjects with AMS had a lower Spo(2) than those without AMS; however, the differences between the 2 groups were not clinically significant. The results of this study do not support the use of pulse oximetry in predicting AMS on Jade Mountain.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-235ddbacc6c64bd5b9ce994367a5f609",
-            "input": "Question: Does type of axial analgesia influence time to vaginal delivery in a Proportional Hazards Model?\nAnswer: Parity, labor augmentation, induction of labor and fetal weight determine TTVD; axial analgesia-related factors do not contribute to the model.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-a71e7611720540c09a11970940d8cc9d",
-            "input": "Question: Does chemotherapy within 30 days before surgery augment postoperative mortality and morbidity?\nAnswer: Preoperative use of neoadjuvant chemotherapy in cancer patients undergoing resection surgeries was not associated with a higher rate of early postoperative complications or mortality.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-8ae9864fc4f6453789c5f740953d0b57",
-            "input": "Question: Are adiposity and physical activity related to academic achievement in school-aged children?\nAnswer: These results do not support the hypotheses that increased adiposity is associated with decreased academic achievement or that greater physical activity is related to improved achievement. However, these results are limited by methodological weaknesses, especially the use of cross-sectional data.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-fbe978d820ef4320b57b63700906bac1",
-            "input": "Question: Does improving clinician self-efficacy increase asthma guideline use by primary care clinicians?\nAnswer: Self-efficacy scores correlated with program use at baseline and increased in the intervention arm, but these increases were not associated with greater program-related activities. Self-efficacy may be necessary but not sufficient for behavior change.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-99f722745c624b03aa1b18ab1d01f6c6",
-            "input": "Question: Does ghrelin Receptor Deficiency Affect Diet-Induced Atherosclerosis in Low-Density Lipoprotein Receptor-Null Mice?\nAnswer: These data indicate that, surprisingly, the complex and multifaceted actions of endogenous ghrelin receptor mediated signaling on the cardiovascular system have minimal direct impact on atherosclerotic plaque progression as based on a loss-of-function mouse model of the disease.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-7e3065874894443ba801705f2553795e",
-            "input": "Question: Does preoperative 6-min walking distance predict pulmonary complications in upper abdominal surgery?\nAnswer: The results of the present study suggest that the 6-min walking test is not a useful tool to identify subjects with increased risk of developing PPC following UAS.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-e0b9c35e4672408ea42c73de99206de1",
-            "input": "Question: Does pulmonary exposure to single-walled carbon nanotubes affect the early immune response against Toxoplasma gondii?\nAnswer: Taken together, our data indicate that pre-exposure to SWCNT does not enhance or suppress the early immune response to T. gondii in mice.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-04cf7fc456154119ac8ac0ab12505dcb",
-            "input": "Question: Does medialization of the subscapularis footprint affect functional outcome of arthroscopic repair?\nAnswer: On the basis of this study, functional outcome does not appear to be compromised by medialization of the subscapularis footprint. Medialization by 4 to 7 mm is acceptable when tendon mobility is otherwise insufficient to perform an anatomic tendon-to-bone repair of a complete subscapularis tendon tear.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-cfeb1fa5079b4cb8bcf7e813f1fa93c4",
-            "input": "Question: Is perioperative cardiac evaluation of simulated patients by practicing anesthesiologists consistent with 2007 ACC/AHA guidelines?\nAnswer: When evaluating simulated patients, practicing anesthesiologists who are ASA members did not recommend preoperative evaluations that were consistent with the 2007 ACC/AHA Guidelines.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-aff9d5eaca944ef2af6f585b9d995939",
-            "input": "Question: Are circulating Th17 cells elevated in patients with chronic heart failure?\nAnswer: Circulating Th17 cells are not elevated in patients with CHF.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-2a5d413730bb4709b50abc8074b73a92",
-            "input": "Question: Do impaired fasting glucose and impaired glucose tolerance predict hypertension : a community cohort study?\nAnswer: While metabolic syndrome components related to insulin resistance present at baseline are important risk factors of hypertension, we conclude that coexisting metabolic component, mainly abdominal obesity, rather than IFG and IGT have more predictive value for determining the development of hypertension in a Korean population.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-0c5b4775ad4b4d3ab5c5146f86d68748",
-            "input": "Question: Does repeated applications of cold atmospheric pressure plasma induce resistance in Staphylococcus aureus embedded in biofilms?\nAnswer: The repeated application of cold plasma is a promising option for the treatment of infected wounds without the risk of development of resistance against plasma.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-97404d2c2f35471dbafb592450075798",
-            "input": "Question: Do vitamin D levels affect IVF outcomes following the transfer of euploid blastocysts?\nAnswer: In women undergoing euploid embryo transfer, vitamin D status was unrelated to pregnancy outcomes. Measuring serum 25-OH vitamin D levels does not predict the likelihood that euploid blastocysts will implant. These results may not apply to women who do not undergo extended embryo culture, blastocyst biopsy for comprehensive chromosome screening, and euploid embryo transfer.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-f32c402fe2bf42e0aa6430d8b8f4c97c",
-            "input": "Question: Does remote ischemic preconditioning affect the incidence of acute kidney injury after elective abdominal aortic aneurysm repair?\nAnswer: RIPC did not reduce the risk of postoperative renal failure or myocardial injury in patients undergoing open AAA repair. The authors' results do not support the introduction of this technique to routine clinical practice.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-1b22df3a3e2d4a658a360e77fd49f9ca",
-            "input": "Question: Is fragmented QRS on surface electrocardiogram a reliable predictor of myocardial scar , angiographic coronary disease or long term adverse outcomes?\nAnswer: This study does not support routine assessment of fQRS on surface EKG as a reliable predictor of SPECT myocardial scar, MACE or all-cause mortality over a long period of follow-up.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-2eab0985f3b34529bd994b2ded798f6f",
-            "input": "Question: Does pre-bisection of a single skin biopsy produce technically inadequate specimens for direct immunofluorescence : a review of 3450 specimens?\nAnswer: Pre-bisection of a single skin biopsy does not significantly increase the risk of a technically inadequate specimen for direct immunofluorescence testing.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-d9d1fb08e48f479f93d958f352782aa1",
-            "input": "Question: Does conversion from twice-daily to once-daily tacrolimus reduce intrapatient variability in tacrolimus exposure?\nAnswer: Although conversion from Tac-TD to Tac-OD significantly reduces tacrolimus exposure as measured by C0 and seems safe, it does not reduce IPV in tacrolimus exposure.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-12a270d108b94c079bcd21c1024a42bd",
-            "input": "Question: Does preoperative assessment of gut hormones correlate to weight loss after Roux-en-Y gastric bypass surgery?\nAnswer: Preoperative responses of GLP-1 and PYY to a 400 kcal mixed meal do not correlate to postoperative weight loss after RYGB surgery for morbid obesity.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-7fe8826006254644b1d9b828276b88ab",
-            "input": "Question: Do rats fed diets with different energy contribution from fat differ in adiposity?\nAnswer: We conclude that at similar body mass, adiposity is independent of the macronutrient composition of the feeding regimen used to achieve it.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-b28a7bacaa904c4c82c2220fd53c6b02",
-            "input": "Question: Does the presence of high-grade prostatic intraepithelial neoplasia or atypia on prostate biopsy adversely affect prostatectomy outcomes for patients otherwise eligible for active surveillance?\nAnswer: The presence of HGPIN or ASAP does not increase the risk of upgrading, upstaging, or adverse pathology at the time of prostatectomy for patients who meet the AS criteria. If otherwise suitable, HGPIN and ASAP should not impact the decision to choose AS. However, analysis of prospective AS trials is required to determine if HGPIN or ASAP impacts tumor progression once on AS.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-6f7f72b607aa4d319f97c793cf1f219a",
-            "input": "Question: Do serum osmolarity and haematocrit modify the association between the impedance index ( Ht ( 2 ) /Z ) and total body water in the very old : the Newcastle 85+ study?\nAnswer: The association between the impedance index and TBW was not modified by hydration status, which may support the utilisation of leg-to-leg bioimpedance for the assessment of body composition in the very old.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-9b7939475a5841579eaf07b37bf7c720",
-            "input": "Question: Do inpatient admission for febrile seizure and subsequent outcomes differ in children with vaccine-associated versus non-vaccine associated febrile seizures?\nAnswer: The risk of hospitalization for index FS or select subsequent FS outcomes did not differ between VA or NVA-FS. This suggests that the follow-up care of children with VA-FS does not warrant attention beyond that for NVA-FS.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-dd58b36c828d46dfbab5907a4176d857",
-            "input": "Question: Are somatic mutations observed by exome sequencing of lymphocyte DNA from monozygotic twins discordant for congenital hypothyroidism due to thyroid dysgenesis?\nAnswer: Either somatic mutations are not significant for the etiology of CH or else such mutations lie outside regions of the genome accessible by exome sequencing technology.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-a5325a8622074171ab42bee56a230cc2",
-            "input": "Question: Does the temperature of water ingested ad libitum influence performance during a 40-km self-paced cycling trial in the heat?\nAnswer: The performance, thermoregulatory, cardiovascular and metabolic responses during a 40-km self-paced cycling trial in the heat were unaffected by different water temperatures.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-f44523ee2e1d42b695da58486e3a9603",
-            "input": "Question: Does the apolipoprotein-AI mimetic peptide L4F at a modest dose attenuate weight gain , inflammation , or atherosclerosis in LDLR-null mice?\nAnswer: Our results suggest that neither L4F (100 \u00b5g/day/mouse) nor apoA-I overexpression affects adiposity or insulin resistance in this model. We also were unable to confirm a reduction in atherosclerosis with L4F in our particular model. Further studies on the effect of apoA-I mimetics on atherosclerosis and insulin resistance in a variety of dietary contexts are warranted.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-1bbee29c1453460dac1578bb02af9666",
-            "input": "Question: Do myocardial creatine levels influence response to acute oxidative stress in isolated perfused heart?\nAnswer: Intracellular creatine levels do not influence the response to acute ROS challenge in the intact beating heart, arguing against creatine exerting (patho-)physiologically relevant anti-oxidant activity.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-d9966d5597084c408ea85accb696c041",
-            "input": "Question: Is polymorphism Ala54Thr of fatty acid-binding protein 2 gene associated with stroke risk in Han population of Hunan China?\nAnswer: Our study shows that Ala54Thr of FABP2 may be not associated with stroke risk but associated with plasma TG level of stroke patients for Hunan Han population of China.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-e096aa10abdc4e0a925c7e1800b925b9",
-            "input": "Question: Do small doses of droperidol present relevant torsadogenic actions : a double-blind , ondansetron-controlled study?\nAnswer: In men without cardiovascular disorders small doses (1.25\u2009mg) of droperidol prophylaxis induced transient QTc prolongation without changes in transmural dispersion of repolarization. The apparently low risk of the drug applies only in low risk male patients with a low pro-QTc score.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-a89959aa60b04f7c883915bf39e8979e",
-            "input": "Question: Does variation in 12 porcine genes involved in the carbohydrate moiety assembly of glycosphingolipids account for differential binding of F4 Escherichia coli and their fimbriae?\nAnswer: We conclude that no regulatory or structural variation in any of the investigated genes is responsible for the genetic susceptibility of pigs towards F4 ETEC.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-db693041ee5744939816e4cfd1584864",
-            "input": "Question: Does hypotension always make computed tomography scans unfeasible in the management of blunt abdominal trauma patients?\nAnswer: The traditional priority of diagnostic modalities used to manage BAT patients should be reconsidered because of advancements in facilities and understanding of BAT. With shorter scanning times and transportation distances, hypotension does not always make performing a CT scan unfeasible.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-bcbd302019e544bd9dd0cf095f30a666",
-            "input": "Question: Is \u03b2-blocker therapy associated with adverse outcomes in patients with pulmonary arterial hypertension : a propensity score analysis?\nAnswer: There was no statistically significant difference in long-term mortality between propensity score-matched pairs of PAH patients with and without \u03b2-blocker use. These findings need further validation in prospective clinical trials.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-8a72e358c187477d96a94b3f5cdf84b0",
-            "input": "Question: Are phenylalanine flux and gastric emptying affected by replacement of casein with whey protein in the diet of adult cats consuming frequent small meals?\nAnswer: In adult cats fed frequent small meals, the replacement of casein with whey protein in the diet does not affect supply or utilization of amino acids. These two milk proteins appear to be equally capable of meeting the dietary amino acid needs of cats.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-fab1893499a44ba09f98b74982860ca8",
-            "input": "Question: Are memory difficulties always a sign of incipient dementia : a review of the possible causes of loss of memory efficiency?\nAnswer: This article reviews SCD and whether this can be used to predict Alzheimer's disease. The review also discusses the terminology used for non-progressive memory problems and the long-term outcomes for this patient group.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-89eed9974ebc4801bbd6e22330059a17",
-            "input": "Question: Do changes in patellofemoral alignment cause clinical impact after open-wedge high tibial osteotomy?\nAnswer: After open-wedge high tibial osteotomy, clinical results showed improvement, compared to pre-operative values. The patellar tilt and lateral patellar shift were not changed; however, descent of the patella was observed. Therefore, mild patellofemoral problems should not be a contraindication of the open-wedge high tibial osteotomy.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-81db7f6c311840ccbeccac652fd71587",
-            "input": "Question: Is biofilm formation a prerequisite for production of the antibacterial compound tropodithietic acid in Phaeobacter inhibens DSM17395?\nAnswer: Cell aggregation and biofilm formation are not physiological prerequisites for TDA production.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-06446a6ad5d249e4b0eb5196eb7caef6",
-            "input": "Question: Is monozygotic twinning after in vitro fertilization/intracytoplasmic sperm injection treatment related to advanced maternal age , intracytoplasmic sperm injection , assisted hatching , or blastocyst transfer?\nAnswer: Until definite conclusions are drawn from larger trials, patients receiving IVF should not be overly concerned about the increase in MZT risk when proceeding to various assisted reproductive procedures (i.e., ICSI, AH, and blastocyst transfer). However, there is some evidence that the incidence of monochorionic-monoamniotic twins may be significantly increased after IVF/ICSI cycles. Patients should be informed about the possible obstetric complications regarding this rare type of MZT.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-d00a37a18ce041bcbdf3605f96f27f74",
-            "input": "Question: Does repetitive transcranial magnetic stimulation of the left premotor/dorsolateral prefrontal cortex have analgesic effect on central poststroke pain?\nAnswer: The aim of this double-blind, placebo-controlled study was to evaluate the analgesic effects of rTMS to the PMC/DLPFC in CPSP patients. An interim analysis showed a consistent lack of analgesic effect, and the study was terminated. rTMS of the PMC/DLPFC is not effective in relieving CPSP.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-6e61fba52d224e5086f427e890026187",
-            "input": "Question: Do plain cigarette packs exert Pavlovian to instrumental transfer of control over tobacco-seeking?\nAnswer: Plain packaging may reduce smoking in current smokers by degrading cue-elicited tobacco-seeking.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-e0d42769ba13482e9c705ecfc9e50ce5",
-            "input": "Question: Is echium oil protective against weight loss in head and neck cancer patients undergoing curative radio ( chemo ) therapy : a randomised-controlled trial?\nAnswer: Echium oil effectively increased erythrocyte EPA and GLA FAs in H&N cancer patients. It failed however to protect against weight loss, or improve nutritional parameters.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-2d1f694fec4549719defe5eca32092a0",
-            "input": "Question: Is plasma visfatin/nicotinamide phosphoribosyltransferase ( visfatin/NAMPT ) concentration related to kidney function in elderly subjects?\nAnswer: The results of our study suggest that plasma visfatin/NAMPT levels are not affected by impaired kidney excretory function in elderly subjects.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-c083fbfecfe044c4b7f549ed10a089aa",
-            "input": "Question: Do uniform standards apply to readmission following coronary artery bypass surgery : a multi-institutional study?\nAnswer: Analysis of CABG readmission data from a network of community hospitals that vary in size and patient demographic characteristics suggests that there are many nonclinical factors influencing readmission; readmission rates and associated risk factors may vary considerably between centers; earlier readmissions are more likely to be procedure-related than patient-related; and therefore, considerable caution should be exercised in attempting to apply uniform standards or strategies to address post-CABG readmission.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-c3b0363a97f24377a11ec2a8b7f3a5f0",
-            "input": "Question: Are front-of-pack symbols a reliable indicator of products with healthier nutrient profiles?\nAnswer: FOP symbols are being used to market foods that are no more nutritious than foods without this type of marketing. Because FOP symbols may influence consumer perceptions of products and their purchases, it may be a useful public health strategy to set minimum nutritional standards for products using FOP symbol marketing.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-59debf4fc9634e48aeebcbcbc3945c8d",
-            "input": "Question: Does intravenous insulin therapy during lung resection affect lung function or surfactant proteins?\nAnswer: According to our observations, short insulin treatment applied intravenously during resection does not affect the quality of breathing.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-d471da05d7b74f10a3fc17e8e439789e",
-            "input": "Question: Is head Position Change Associated with Acute Changes in Bilateral Cerebral Oxygenation in Stable Preterm Infants during the First 3 Days of Life?\nAnswer: Stable preterm infants tolerated brief changes in head position from midline without significant alternation in bilateral SctO2; the impact on critically ill infants needs further evaluation.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-a8917d782f864221b2010545b398437c",
-            "input": "Question: Does emergency surgery for colorectal cancer result in nodal understaging compared with elective surgery?\nAnswer: The evidence does not support the common belief that emergency surgery is more commonly understaged in CRC. Our data suggest emergency surgery resulted in a significant increase in the average number of nodes harvested, with no difference in inadequate nodal staging.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-f332edb0b42c44ebbc842f2f316a85d8",
-            "input": "Question: Does shock wave lithotripsy impair renal function in a Swine model of metabolic syndrome?\nAnswer: Our results are consistent with the view that a single SWL session does not result in renal impairment, even in the presence of MetS.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-90c41d5ee92b4730a04f5c5bcabe4252",
-            "input": "Question: Is the clinical antidepressant effect of exogenous agmatine reversed by parachlorophenylalanine : a pilot study?\nAnswer: The antidepressant effect of exogenous agmatine was documented in a small number of MDD subjects, and was not reversed/modified by PCPA confirming findings in animals that therapeutic response is not mediated by serotonergic mechanisms. A NAMDA (N-methyl-D-aspartate) receptor antagonist, agmatine's recognized function in brain as inhibitory modulator of excitatory glutamatergic transmission suggests a pivotal role for brain glutamate, contributing to the ripening glutamatergic basis of depression, and a rational basis for future antidepressant pharmacotherapy.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-221ce459287c42dfaf7f64d387e592d1",
-            "input": "Question: Does vulnerability to sympathetic stress persist in takotsubo stress cardiomyopathy?\nAnswer: We found no difference in standard diastolic parameters between TSC and control subjects, but a significant higher value in LV-MPI in the TSC group at rest. However, no such difference could be demonstrated during DSE between the groups, indicating that vulnerability to sympathetic stimulation does not persist in TSC patients.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-7f1c7e20433449c28f7b66a0dc4f3295",
-            "input": "Question: Is lipopolysaccharide-induced myocardial depression mediated by cyclooxygenase products?\nAnswer: These data suggest that cyclooxygenase products do not mediate lipopolysaccharide-induced cardiac dysfunction in the rat.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-db8a6f91490a4484a898147f006d02d0",
-            "input": "Question: Does prolonged hemorrhagic shock impair regeneration of plasma coagulant masses in the rabbit?\nAnswer: Dilutional coagulopathy corrects spontaneously within hours. Normovolemic shock prolongs dilutional coagulopathy not by impairment of factor regeneration but because of further (internal) dilution due to plasma expansion. Rapid correction of dilutional coagulopathy is likely to necessitate cryoprecipitate administration.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-cc86ebb51f8a4cb08477d7b941bb8e81",
-            "input": "Question: Is the dorsal motor nucleus of the vagus an obligatory trigger site of Parkinson 's disease : a critical analysis of alpha-synuclein staging?\nAnswer: Our results demonstrate a predominant involvement of the SN and NBM in PD but do not support the existence of a medullary induction site of alpha Syn pathology in all PD brains.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-c143c90ffb2e451cb1a7dcbff8ef896d",
-            "input": "Question: Is tracheostomy a risk factor for deep sternal wound infection after cardiac surgery?\nAnswer: The incidence of DSWI remains high in patients with respiratory failure. Tracheostomy is not a risk factor for DSWI and serves as a surrogate for respiratory failure. Therefore, considering that early tracheostomy may be beneficial in patients with respiratory insufficiency, a more liberal approach to early tracheostomy may be warranted.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-85e2f285f7d040af90c9bdf3e9ef2605",
-            "input": "Question: Does coenzyme Q10 protect cochlear hair cells from death in the ischemic organotypic culture?\nAnswer: CoQ(10) seems to protect against only certain modes of cell death.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-8d7ae1a515874edb92d1b6f03546750f",
-            "input": "Question: Does hIV infection disproportionately affect the poorer in sub-Saharan Africa?\nAnswer: In sub-Saharan Africa, HIV prevalence does not exhibit the same pattern of association with poverty as most other diseases. HIV programmes should also focus on the wealthier segments of the population.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-4f1b4a78234f412a9f84d1bd1b253103",
-            "input": "Question: Does recombinant human thyroid stimulating hormone acutely change serum osteoprotegerin and soluble receptor activator of nuclear factor-kappaBeta ligand in patients under evaluation for differentiated thyroid carcinoma?\nAnswer: In a small group of subjects with a history of DTC on L-T4 regimen, our study did not support an acute direct effect of TSH on OPG and RANK-L.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-69704a18df7f4aa88a0c3c3206eaf06a",
-            "input": "Question: Is xanthelasma associated with increased risk of carotid atherosclerosis in normolipidaemia?\nAnswer: Normolipidaemia with xanthelasma is not significantly associated with CA, but did relate with adverse cardiovascular profiles, such as higher BMI, waist circumference and LDL-C levels.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-ffc8bffbefe841a7ac621867ed12b6ff",
-            "input": "Question: Does hyperglycemia after infant cardiac surgery adversely impact neurodevelopmental outcome?\nAnswer: Hyperglycemia is common early after infant cardiac surgery, but is not associated with worse neurodevelopmental outcome at 1 year of age.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-8074abaac32f40eabf19e700973b8b83",
-            "input": "Question: Is angiotensin-converting enzyme insertion/deletion polymorphism associated with susceptibility and outcome in sepsis and acute respiratory distress syndrome?\nAnswer: Our data do not support an association of the ACE gene I/D polymorphism with susceptibility or mortality in severe sepsis or with sepsis-induced ARDS in Spanish patients.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-396f33e2c1ea42d89168ff9343058192",
-            "input": "Question: Does weekend onset of acute myocardial infarction have a negative impact on outcome in Japan?\nAnswer: There were no obvious differences in outcome for Japanese AMI patients in the weekday- or weekend-onset group, suggesting the quality of the Japanese healthcare system is similar for the entire week.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-7399c427a73a4feb866e3f3b2414894f",
-            "input": "Question: Is insulin gene variable number of tandem repeats associated with weight from fetal life until infancy : the Generation R Study?\nAnswer: Class III homozygotes were born at an earlier gestational age. No association was found between INS VNTR and birth weight adjusted for gestational age. Our data suggest that the III/III genotype may be associated with asymmetrical growth in mid-pregnancy, but not in late pregnancy.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-8de01c492e0b43d3a0e2ecea67392662",
-            "input": "Question: Are surgical treatment of active aortic endocarditis : homografts the cornerstone of outcome?\nAnswer: Implantation of conventional prostheses during the active phase of aortic endocarditis yields similar low operative mortality and long-term prognosis as compared with aortic homografts, even in patients with annulus abscess.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-b80dd462772f469cb7ae4734b0da2d89",
-            "input": "Question: Are the cardioprotective effects of the angiotensin-converting enzyme inhibitor perindopril in patients with stable coronary artery disease modified by mild to moderate renal insufficiency : insights from the EUROPA trial?\nAnswer: The treatment benefit of perindopril is consistent and not modified by mild to moderate renal insufficiency.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-c3fe1c41872f457cbb755c853bc9881d",
-            "input": "Question: Does ketamine increase pulmonary vascular resistance in children with pulmonary hypertension undergoing sevoflurane anesthesia and spontaneous ventilation?\nAnswer: In the presence of sevoflurane, ketamine did not increase pulmonary vascular resistance in spontaneously breathing children with severe pulmonary hypertension.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-d4724b6c46b244879331f3e79e830d63",
-            "input": "Question: Is [ Sense of agency : experiencing judging ]?\nAnswer: The conception of the sense of agency has greatly evolved over the years, mainly because of the various experimental methods employed. The consequences of this are the various theoretical interpretations given to the characteristics of the sense of agency. They can be explained in two main points: a non-unified definition of the sense of agency and an absence of experimental data testing alternative interpretations. First, protocols using attribution judgements have proven to be useful to gain better understanding of the attribution mechanism in schizophrenia. However, findings obtained with these judgments have often been used to conclude on deficits of the sense of agency in schizophrenia, whereas the sense of agency is only a sub component of these judgements.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-775c5aee9bbf4410acbb46e0837b75b0",
-            "input": "Question: Does milk affect the bioavailability of cocoa powder flavonoid in healthy human?\nAnswer: Cocoa powder dissolved in milk as one of the most common ways of cocoa powder consumption seems to have a negative effect on the absorption of polyphenols; however, statistical analyses have shown that milk does not impair the bioavailability of polyphenols and thus their potential beneficial effect in chronic and degenerative disease prevention.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-3a35b3f4947848fc85ee797fb0f728ea",
-            "input": "Question: Is magnesium sulfate used for pre-eclampsia and eclampsia in Mexico and Thailand as much as it should be?\nAnswer: Despite compelling evidence, magnesium sulfate use is below desired levels. Clinical practices should be audited and implementation of this effective intervention should be taken up as a priority where universal implementation is not in place.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-adef3a5ae01c438aa7a3d998501ac8bf",
-            "input": "Question: Does the G/G genotype of a single nucleotide polymorphism at -1066 of c-Jun N-terminal kinase 1 gene ( MAPK8 ) affect type 2 diabetes susceptibility despite the specific binding of AP2alpha?\nAnswer: The G/G genotype of MAPK8 SNP-1066 did not affect T2DM susceptibility despite specific binding of AP2alpha.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-fb3dc527773f4781883fd23da2dfc966",
-            "input": "Question: Is promotion of exclusive breastfeeding likely to be cost effective in West Africa . A randomized intervention study from Guinea-Bissau?\nAnswer: Although mothers were sensitive to follow new breastfeeding recommendations, it had no beneficial impact on infant health in this society with traditional, intensive breastfeeding. There seems to be little reason to discourage local practices as long as there are no strong data justifying such a change.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-b6e0cb5adf1745fca4ef6046124df263",
-            "input": "Question: Does acute inflammatory response affect erythrocyte concentrations of copper , zinc and selenium?\nAnswer: Plasma concentrations of copper, zinc and selenium are unreliable markers of status in patients with an acute inflammatory response. Erythrocyte concentrations of these trace elements may provide a more reliable measure in long-term studies of patients with a chronic systemic inflammatory response. Iron can be used instead of haemoglobin as the denominator when expressing erythrocyte concentrations of trace elements.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-0774314adb3e4104b680b31b482438bf",
-            "input": "Question: Are acute myocardial infarction length of stay and hospital mortality associated with language preference?\nAnswer: Language preference is not associated with AMI mortality, and the small increase in length of stay associated with non-English preference is accounted for by hospital level factors. Our results suggest that system level differences are important to consider in studies of the effect of language barriers in the health care setting.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-21088db77d734ec9b685f40f2761b4ac",
-            "input": "Question: Is the presence of Helicobacter pylori in postmenopausal women a factor to the decrease of bone mineral density?\nAnswer: Postmenopausal women with osteoporosis presented a well-preserved parietal cell density in comparison with their counterparts without osteoporosis. Helicobacter pylori infection was not different between the two groups. We concluded that neither atrophic chronic gastritis nor Helicobacter pylori seem to be a reliable risk factor to osteoporosis in postmenopausal women.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-cdb326b9fc2f4c069db3aecd1f67f532",
-            "input": "Question: Does antidepressant medication treatment failure predict lower remission with ECT for major depressive disorder : a report from the consortium for research in electroconvulsive therapy?\nAnswer: Treatment failure with anti-depressant medication does not predict acute remission status with ECT for nonpsychotically depressed patients.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-1631decb842644d697b93274e7f79a82",
-            "input": "Question: Is the pain-induced decrease in low-threshold motor unit discharge rate associated with the amount of increase in spike-triggered average torque?\nAnswer: The pain-induced modifications in the estimated motor unit twitch torque (1) were not caused by changes in muscle fiber action potential, and (2) were not associated with the decrease in discharge rate.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-c761285c13ee4e0a8847b5f176b7317f",
-            "input": "Question: Does metoclopramide influence the frequency of propofol-induced spontaneous movements?\nAnswer: Metoclopramide does not affect the frequency of propofol-induced movements, but propofol and fentanyl doses influence the frequency of movements during propofol induction.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-48a4715994a04a938e29b84a79eee5e8",
-            "input": "Question: Is change in hemostatic markers after recombinant tissue-type plasminogen activator associated with the chance of recanalization?\nAnswer: From a practical point of view, the measurement of these hemostatic markers is probably not useful for predicting recanalization.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-a46ce005709c4287843f2d87fa7a2f66",
-            "input": "Question: Is relaxation and guided imagery program in patients with breast cancer undergoing radiotherapy associated with neuroimmunomodulatory effects?\nAnswer: We conclude that the psychological intervention was capable to attenuate the emotional distress presented during radiotherapy treatment. A longer RVT or worse psychological morbidity at baseline may be necessary to translate psychological into biological changes.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-d46b90fe4d424daa91a818690b7a8d67",
-            "input": "Question: Are cognitive complaints after mild traumatic brain injury : things always what they seem?\nAnswer: Self-reported cognitive complaints were more strongly related to premorbid traits and physical and emotional state factors than to actual cognitive impairments. In line with previous work, this suggests that treatment of emotional distress and fatigue may also reduce cognitive complaints. Cognitive outcome assessment of symptomatic MTBI patients should not be restricted to checklist ratings only, but also include a (neuro)psychological screening. In addition, daily monitoring of complaints is a useful method to gather information about the frequency and pattern of cognitive problems in daily life.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-17b7f1e43f384eee81981b97eca08df1",
-            "input": "Question: Does the genotype specific competitive ability correlate with infection in natural Daphnia magna populations?\nAnswer: Our data do not support the inbreeding-infection hypothesis. They also do not support a cost of resistance, however ignoring other parasite strains or parasite species. We suggest as a possible explanation for our results that resistance genes might segregate largely independently of other fitness associated genes in this system.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-971d68555d484d9e8d2d7ffad9a4c50e",
-            "input": "Question: Is routine prophylactic granulocyte colony stimulating factor ( GCSF ) necessary with accelerated ( dose dense ) paclitaxel for early breast cancer?\nAnswer: Accelerated paclitaxel in breast cancer patients without prophylactic GCSF is safe, avoids side effects, reduces costs and is not associated with an increase risk of neutropenic sepsis or treatment delays.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-6c74b557187e4fe7a91c9f11012552fc",
-            "input": "Question: Is consumption of omega-3 fatty acids associated with a reduction in carotid atherosclerosis : the Genetics of Coronary Artery Disease in Alaska Natives study?\nAnswer: Dietary intake of omega-3 FAs in a moderate-to-high range does not appear to be associated with reduced plaque, but is negatively associated with IMT. The presence and extent of carotid atherosclerosis among Eskimos is higher with increasing consumption of saturated FAs.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-ee1121bea998472a946bf4a9dd4c93e7",
-            "input": "Question: Does systemic methotrexate to treat ectopic pregnancy affect ovarian reserve?\nAnswer: Single-dose MTX is a safe first-treatment choice that does not compromise future reproductive outcomes in women who are diagnosed with EP after ART.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-7452a31b12a8483c931ef5b708071316",
-            "input": "Question: Is the homeostasis model assessment of the insulin resistance score predictive of a sustained virological response in chronic hepatitis C patients?\nAnswer: In this series of treatment-na\u00efve, Caucasian CHC patients at a low risk for the metabolic syndrome, HOMA-IR is not a predictor of SVR, irrespective of the HCV genotype, although it may predict RVR in genotype 3 infection.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-4b260cc339e0418aa3eb7ab6d89bb4e1",
-            "input": "Question: Do rates of labor induction and primary cesarean delivery correlate with rates of adverse neonatal outcome in level I hospitals?\nAnswer: Crude and adjusted rates of labor induction and PCD vary among level I hospitals, but with no consistent effect on neonatal outcome.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-c6f449a09ca845b4ac7e3effcfcacf9b",
-            "input": "Question: Do plasma total homocysteine and the methylenetetrahydrofolate reductase 677C > T polymorphism contribute to the distribution of cervico-cerebral atherosclerosis in ischaemic stroke patients?\nAnswer: Plasma tHcyt level and the MTHFR 677C>T polymorphism do not contribute to the distribution of cervico-cerebral atherosclerosis in ischaemic stroke patients.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-630025059d354ef89f0e6238874cd856",
-            "input": "Question: Does endoscopic ultrasound accurately stage early adenocarcinoma or high-grade dysplasia of the esophagus?\nAnswer: EUS is not sufficiently accurate in determining the T-stage of high-grade dysplasias or superficial adenocarcinomas; other means of staging, such as EMR, should be used.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-d377f49fc845449783ed1fef58d19ee3",
-            "input": "Question: Are all trauma surgeons created equal : asymmetric distribution of malpractice claims risk?\nAnswer: TS are at increased risk of UPCs compared with NTS, but this risk is still largely borne by a minority of TS. UPCs seem to be a reasonable proxy for malpractice risk, so targeted interventions for TS associated with disproportionate shares of UPCs may reduce patient dissatisfaction and, perhaps, malpractice claims.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-a085dd6312dd477facc30764b0cceb79",
-            "input": "Question: Are glucagon-like peptide-1 ( GLP-1 ) receptors overexpressed in pancreatic islets from patients with severe hyperinsulinaemic hypoglycaemia following gastric bypass?\nAnswer: In contrast to insulinoma, hyperinsulinaemic hypoglycaemia after gastric bypass surgery is not accompanied by overexpression of GLP-1 receptor in individual islets. Thus, patients with post-gastric bypass hyperinsulinaemic hypoglycaemia are not candidates for GLP-1 receptor imaging in vivo using radiolabelled exendin. These GLP-1 receptor data support the notion that the islet pathobiology of post-gastric bypass hypoglycaemia is distinctly different from that of benign insulinomas.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-213de433bef748659e7d89b3e633deae",
-            "input": "Question: Does sevoflurane alter norepinephrine-induced intracellular Ca\u00b2 ( + ) changes in the diabetic rat aorta?\nAnswer: Sevoflurane at clinically relevant concentrations inhibited the NE-induced increase in [Ca\u00b2(+)](i) in the aortic smooth muscle from normal rats but not in that from type 2 DM rats. Thus, a Ca\u00b2(+)- signalling pathway resistant to sevoflurane appears to exist in the type 2 DM rat aorta.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-f7846fcf7a5547b3baa2517256eb73a5",
-            "input": "Question: Does the Mycobacterium tuberculosis Beijing genotype affect tuberculosis treatment failure in Vietnam?\nAnswer: The Beijing genotype was not associated with treatment failure in Vietnam; apparent associations were explained by the strong association of this genotype with multidrug resistance. Amplification of resistance in this patient population was rare.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-faf86bd10d5d4618abf11216e16be3d6",
-            "input": "Question: Is microalbuminuria a valuable marker for relapse in Crohn 's disease?\nAnswer: Microalbuminuria was moderately prevalent in quiescent CD patients, but it could not be associated with disease characteristics or the type of medication before randomization, nor as a predictor for relapses.",
-            "output": [
-                "no"
-            ]
-        },
-        {
-            "id": "task846-8afe307cd9734b04863bbb440b786379",
-            "input": "Question: Is exposure to polyfluoroalkyl chemicals during pregnancy associated with offspring age at menarche in a contemporary British cohort?\nAnswer: ALSPAC study participants had nearly ubiquitous exposure to most PFCs examined, but PFC exposure did not appear to be associated with altered age at menarche of their offspring.",
-            "output": [
-                "no"
-            ]
-        }
-    ],
-    "Instance License": [
-        "MIT"
-    ]
-}

MedS-Bench/Information_extraction/task1_participant_extraction.json

@@ -1,360 +0,0 @@
-{
-    "Contributors": [
-        "Pegah Alipoormolabashi"
-    ],
-    "Source": [
-        "PICO"
-    ],
-    "URL": [
-        "https://github.com/Markus-Zlabinger/pico-annotation"
-    ],
-    "Categories": [
-        "Information Extraction"
-    ],
-    "Reasoning": [],
-    "Definition": [
-        "In medical studies, treatments are tested within a group of study participants. You will be given a sentence of a study report in which your task is to list the phrases that give information about the participants of the study. You should list the phrases in the same order that they appear in the text, separated by commas. If no information about the participants is mentioned, just output \"not found\". Relevant information about participants include: gender, medical conditions, location, number of people participating. Do not contain participant mentions without relevant information."
-    ],
-    "Input_language": [
-        "English"
-    ],
-    "Output_language": [
-        "English"
-    ],
-    "Instruction_language": [
-        "English"
-    ],
-    "Domains": [
-        "Academical Papers"
-    ],
-    "Positive Examples": [
-        {
-            "input": "A PPARA Polymorphism Influences the Cardiovascular Benefit of Fenofibrate in Type 2 Diabetes: Findings From ACCORD Lipid. ",
-            "output": "Type 2 Diabetes",
-            "explanation": "The only piece of text relevant to participants is \"Type 2 Diabetes\" which is a medical condition."
-        },
-        {
-            "input": "A total of 270 patients with MCI were enrolled in a 24-week, multicenter, randomized, double-blind, placebo-controlled study.",
-            "output": "270 patients with MCI",
-            "explanation": "In this example, both the number of participants and their medical condition is mentioned."
-        }
-    ],
-    "Negative Examples": [
-        {
-            "input": "A total of 270 patients with MCI were enrolled in a 24-week, multicenter, randomized, double-blind, placebo-controlled study.",
-            "output": "270 patients with MCI, 24-week",
-            "explanation": "The duration of the study is not relevant to the participants and shouldn't be included."
-        },
-        {
-            "input": " To investigate the role of nicotinamide adenine dinucleotide phosphate 4 (NADPH4,NOX4) and transforming growth factor-beta (TGF-\u03b2) involve in pathogenesis of airway remodeling in chronic obstructive pulmonary disease (COPD).",
-            "output": "COPD",
-            "explanation": "The complete name of the disease (chronic obstructive pulmonary disease) should be included."
-        }
-    ],
-    "Instances": [
-        {
-            "id": "task179-bf49dbf887b640009915afb129c0f695",
-            "input": "Under Fluoxetine , mPFC activation was up-regulated and normalized in ASD boys relative to controls , but down-regulated in ADHD boys relative to placebo , which was concomitant with worse task performance in ADHD .",
-            "output": [
-                "ASD boys, ADHD boys"
-            ]
-        },
-        {
-            "id": "task179-35a05d694d9946faa08e9c5b191e2f94",
-            "input": "We conclude that granisetron is a better anti-emetic than perphenazine for the long-term prevention of post-operative vomiting in children undergoing general anaesthesia for tonsillectomy .",
-            "output": [
-                "children undergoing general anaesthesia for tonsillectomy"
-            ]
-        },
-        {
-            "id": "task179-3718eea27d6741cd8f6a3bb94d83fb04",
-            "input": "One case of unsubstantiated acute rheumatic fever occurred after 7 days of amoxicillin .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task179-fcf448b8dbba44f8aad1d13e6386b29b",
-            "input": "Costs/QALY gained discounted at 3 % were $ 205,186 using the QWB and $ 32,643 using the CHRD .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task179-696254fa5c074cd584e90ae9ff75cdfd",
-            "input": "Calcium solubility and absorption across Caco-2 cells were studied after the in vitro digestion of the diets .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task179-9baddb311e6b4a02a72715fa025ec144",
-            "input": "Influence of diets rich in Maillard reaction products on calcium bioavailability .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task179-0d40536a321943789c31e41985c3e9bf",
-            "input": "Prior adjuvant chemotherapy was permitted .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task179-d064ad23500949eda605b7754c44b2e6",
-            "input": "Depressive patients are able to follow prescribed lifestyle recommendations in the short-term .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task179-6834f4e07f0d4af294ca29f9c12b1f44",
-            "input": "The influence of injections of Amidotrizoate and Iopromide into the left coronary artery on global myocardial perfusion and function ( pressures in the left ventricle , heart rate ) as well as excitation formation and transmission was studied in 16 patients with ischaemic heart disease .",
-            "output": [
-                "16 patients with ischaemic heart disease"
-            ]
-        },
-        {
-            "id": "task179-7eb920c6b3864eb88ef8b9e74696ab46",
-            "input": "These 22 patients constituted the control group of a controlled trial and received standard outpatient clinic treatment during follow-up .",
-            "output": [
-                "22 patients"
-            ]
-        },
-        {
-            "id": "task179-48f17a1f7a204cb09f35692e2a29a7fd",
-            "input": "Patients could not have had prior chemotherapy for metastatic disease .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task179-589d31b21098423ab45ba7cf0c87773a",
-            "input": "Comparisons with the cyclophosphamide-doxorubicin-5-fluorouracil arm will not be addressed .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task179-25e87d16f93b4d3b85e6f89f82b3df53",
-            "input": "Children with parent-reported ASD had higher levels of health care office visits and prescription drug use compared with children without ASD ( P < .05 ) .",
-            "output": [
-                "children without ASD"
-            ]
-        },
-        {
-            "id": "task179-939c393e042a4a3f8e01f73970c8a3a6",
-            "input": "Short-term phasic activity was only found in 13 out of 40 of the normal infants ( 32.5 % ) .",
-            "output": [
-                "40 of the normal infants"
-            ]
-        },
-        {
-            "id": "task179-52213a2b2e034ab4ab901f6a046c9da7",
-            "input": "Group 1 received a weekly session of posterior tibial nerve stimulation for 12 weeks and group 2 was the placebo group .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task179-48aced4b625940978be2b146c53acecf",
-            "input": "Only deoxypyridinoline values were significantly lower after consumption of the BD ( 13.0 +/- 1.1 compared to 18.3 +/- 2.1 nM/Mm Cr in the WD ) , possibly indicative of less efficient bone turnover during this period .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task179-f6baa8c89ec948209789c4d1586f42d0",
-            "input": "The results suggest that the use of PMRT could enhance quality of life and decrease state anxiety in patients after stoma surgery .",
-            "output": [
-                "patients after stoma surgery"
-            ]
-        },
-        {
-            "id": "task179-883e978e6b7145118dcbe55c95721b0b",
-            "input": "Interventions were conducted 30 min daily for 5-6 weeks .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task179-0f94638fd62441a489349ba3fca4204f",
-            "input": "There were also no differences in manual muscle testing sum scores , activity scale scores and patients ' own assessments after 48 weeks of treatment .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task179-37556951072c41b6b6c456cc03118985",
-            "input": "However , transfusion rate , presence of hepatomegaly , splenomegaly , and jaundice was similar .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task179-cd1e891d328b4375bc30df492cbe1206",
-            "input": "Three hundred sixty-five patients were enrolled .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task179-44ec843ccf9e40d19fe82b4e161c5e3a",
-            "input": "If so , this would be a great support for doctors who might systematically recommend these simple and costless measures , especially in primary care .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task179-9c1461f976dd4a4a9a8e781463537c9b",
-            "input": "Relative to children in the wait-list group , program participants showed greater improvements in social skills over the course of the intervention , as indicated by parent-report measures .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task179-9a3ff97c4c484c5f9386e98f6bbbe48b",
-            "input": "Hence , we hypothesize that specific airway resistance changes ( \u0394sRAW ) should better characterize the acute response to bronchodilators .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task179-c6951bf1a5a24b9eb074b1f2fa78c0bf",
-            "input": "We investigated whether 13 participants with ASD ( age 7 ; 03-22 ; 03 ) and 13 age-matched typically developing ( TD ) controls could comprehend lexicalized conceptual metaphors ( e.g. , Susan is a warm person ) and novel ones ( e.g. , Susan is a toasty person ) .",
-            "output": [
-                "13 participants with ASD, 13 age-matched typically developing ( TD"
-            ]
-        },
-        {
-            "id": "task179-b089accc025245bd83159f07931df61d",
-            "input": "Randomized controlled study of chemoimmunotherapy with bestatin of acute nonlymphocytic leukemia in adults .",
-            "output": [
-                "acute nonlymphocytic leukemia in adults"
-            ]
-        },
-        {
-            "id": "task179-8d4b758964634113b4936f00bb66711e",
-            "input": "Forty-nine children with AS were recruited to participate and randomly assigned to intervention ( n = 26 ) or wait-list control ( n = 23 ) conditions .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task179-6ab5c6f01bcc44169deb95557df33d33",
-            "input": "Observed medication and weekend diary cards were used to monitor adherence .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task179-83b138183afb411da40a9ff452ad56a9",
-            "input": "Use of health care facilities was assessed from diaries/questionnaires and Medicare reimbursement rates used to estimate costs .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task179-b29361fada3843eeaff238b640582ddb",
-            "input": "In 78 children known to be infected with Ascaris at baseline , the rate of weight gain was 21 per cent greater in children treated with levamisole than in those receiving placebo ( p = .03 ) .",
-            "output": [
-                "78 children known to be infected with Ascaris"
-            ]
-        },
-        {
-            "id": "task179-df2105dc2ea34d5781f8a90746052ae6",
-            "input": "Overall , 13 patients ( 46.4 % ) had detrusor overactivity and 14 ( 50 % ) had decreased bladder capacity .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task179-a1a624c2133249fa8aedfc9741283a67",
-            "input": "In patients with neutrophil counts of > 0.1 x 10 ( 9 ) /L lasting for more than 4 weeks , the frequency of infection in the fluconazole group ( 5 of 9 patients ) was significantly higher than in the itraconazole group ( 0 of 7 patients ; P = .03 ) .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task179-47c995de3c8a457e84fc6e8f6ce10f91",
-            "input": "No significant differences , within and between groups , were observed in the exercise-induced increase in the ratios para- and ortho-hydroxyantipyrine to antipyrine .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task179-3e0154d08378446cbd15f25bd49607fa",
-            "input": "Age-matched boys with ADHD ( 15 ) , ASD ( 18 ) , and controls ( 21 ) were compared with functional magnetic resonance imaging ( fMRI ) during a reversal task .",
-            "output": [
-                "15 ) , ASD, 18 ) , and controls, 21"
-            ]
-        },
-        {
-            "id": "task179-c206f3baf1c44b43a2201617b0b1bb0b",
-            "input": "This 7-week program included a computer game , small group sessions , parent training sessions and teacher handouts .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task179-08d53ca8191c43b2b17fe6ca04cd8349",
-            "input": "The patients were randomised into a control group ( n = 10 ) and an experimental group ( n = 8 ) .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task179-ba6209c1215d44dab55a184296623542",
-            "input": "To consider the impact on primary care patient outcomes of using both a screener to determine elevated anxiety levels among patients with previously undetected anxiety and a physician intervention to inform physicians of their patients ' conditions .",
-            "output": [
-                "patients with previously undetected anxiety"
-            ]
-        },
-        {
-            "id": "task179-fd09cf9efe3e4a0d8697a181d09e5a1a",
-            "input": "A persistent phasic activity pattern was found in 19 of the 21 patients , high frequency phasic activity in 11 of the 21 patients .",
-            "output": [
-                "21 patients"
-            ]
-        },
-        {
-            "id": "task179-895cc0bdc24640f38dfd1893b1f21fab",
-            "input": "In a prospective , randomized , double-blind study , 90 paediatric patients , ASA I , aged 4-10 years , received granisetron 40 mg kg-1 or perphenazine 70 mg kg-1 ( n = 45 each ) intravenously immediately after an inhalation induction of anaesthesia .",
-            "output": [
-                "90 paediatric patients, ASA I , aged 4-10 years"
-            ]
-        },
-        {
-            "id": "task179-dbb5eaf8c6344a96993cc7cd7af33ef8",
-            "input": "After three weekly doses of epoetin alfa 40,000 U , a dose of 120,000 U can be administered safely once every 3 weeks without increasing transfusion needs or sacrificing QOL .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task179-788778a502214fa08a4c6c7b50f0b220",
-            "input": "However , to our knowledge , there have been no studies using all these measures together as an adjuvant antidepressant strategy .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task179-3e5d819e6c274c539bb503af68283933",
-            "input": "Accordingly , the current study examined within-person covariation between time-varying abstinence and depressive symptom in a multilevel model ( MLM ) , which allowed for transitions between smoking statuses within a participant .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task179-7715c218357044049a1d3b38cedb5566",
-            "input": "Internal stenting is an integral part of endopyelotomy .",
-            "output": [
-                "not found"
-            ]
-        }
-    ],
-    "Instance License": [
-        "Unknown"
-    ]
-}

MedS-Bench/Information_extraction/task29_drug_dose_extraction.json

@@ -1,220 +0,0 @@
-{
-    "Contributors": [
-        "Ishani Mondal"
-    ],
-    "Source": [
-        "ADE Corpus V2"
-    ],
-    "URL": [
-        "https://github.com/trunghlt/AdverseDrugReaction/tree/master/ADE-Corpus-V2"
-    ],
-    "Categories": [
-        "Information Extraction"
-    ],
-    "Reasoning": [],
-    "Definition": [
-        "In this task, you will be given sentences and a drug name in which your task is to indicate the doses of intake of that particular drug. A dose refers to a specified amount of medication taken at one time. Although there might be several correct answers, you need to write one of them."
-    ],
-    "Input_language": [
-        "English"
-    ],
-    "Output_language": [
-        "English"
-    ],
-    "Instruction_language": [
-        "English"
-    ],
-    "Domains": [
-        "Medical Knowledge"
-    ],
-    "Positive Examples": [
-        {
-            "input": "An episode of subacute encephalopathy after the infusion of methotrexate (1500 mg/m2) (MTX) is reported in a young adult with metastastic gastric cancer.\t methotrexate",
-            "output": "1500 mg/m2",
-            "explanation": "Here, the drug methotrexate mentioned after '\t ' has been mentioned to be taken as 1500 mg/m2 within brackets and hence should be tagged as dosage."
-        },
-        {
-            "input": "A case of normotensive scleroderma renal crisis after high-dose methylprednisolone treatment.\t methylprednisolone",
-            "output": "high",
-            "explanation": "Amount of methylprednisolone is taken in high amount and hence should be tagged with that."
-        }
-    ],
-    "Negative Examples": [
-        {
-            "input": "Ibuprofen overdose is usually characterized by GI upset, dizziness, and mild sedation\t ibuprofen",
-            "output": "mild",
-            "explanation": "Here the drug ibuprofen has been mentioned to be taken in excess but mild is the qualifier of the sedation caused by overdose of the drug, hence mild should not be tagged as drug dosage."
-        },
-        {
-            "input": "She took three doses of methotrexate and two doses of ibuprofen.\t methotrexate",
-            "output": "two",
-            "explanation": "Amount of methotrexate is taken in three doses and hence should be tagged with that, instead of the the dosage mentioned for ibuprofen."
-        }
-    ],
-    "Instances": [
-        {
-            "id": "task1451-4a32996c896e4ba4af9bb6cfb4628ce7",
-            "input": "METHODS: Growth retardation was observed in six severely asthmatic children after introduction of high-dose fluticasone propionate treatment (dry powder).\t fluticasone propionate",
-            "output": [
-                "high"
-            ]
-        },
-        {
-            "id": "task1451-379dc9b35d49462c9722445d9c2f2649",
-            "input": "Two case reports of bilateral granulomatous anterior uveitis are described in patients with open angle glaucoma treated with metripranolol 0.6% eye drops.\t metripranolol",
-            "output": [
-                "0.6"
-            ]
-        },
-        {
-            "id": "task1451-8264c178667641dbac8a59d7d5cf3af4",
-            "input": "This case suggests that acyclovir when given intravenously in doses of 10 mg/kg may result in increased serum lithium concentrations.\t acyclovir",
-            "output": [
-                "10 mg/kg"
-            ]
-        },
-        {
-            "id": "task1451-3fe69c5ac6974445821bc19e3d99b957",
-            "input": "This case suggests that acyclovir when given intravenously in doses of 10 mg/kg may result in increased serum lithium concentrations.\t lithium",
-            "output": [
-                "10 mg/kg"
-            ]
-        },
-        {
-            "id": "task1451-58de8f0c9a7c41a98d914e73b65a7092",
-            "input": "We describe 2 patients with cutaneous lupus erythematosus who developed severe dapsone reaction after low dose therapy, with a fatal outcome in one.\t dapsone",
-            "output": [
-                "low"
-            ]
-        },
-        {
-            "id": "task1451-d84ef3cd7442478f9fb4bd123f83fc0e",
-            "input": "A 17-year-old female patient who had been taking oral minocycline (50 mg twice daily) for 3 weeks for acne developed an eruption that progressed to an exfoliative dermatitis.\t minocycline",
-            "output": [
-                "50 mg twice daily"
-            ]
-        },
-        {
-            "id": "task1451-91e06a4b953148f1927f6aab52b281f1",
-            "input": "Overdose of magnesium sulfate in combination with renal insufficiency, hypocalcemia, or compromise of intestinal integrity may predispose horses to magnesium toxicosis.\t magnesium",
-            "output": [
-                "Overdose"
-            ]
-        },
-        {
-            "id": "task1451-4452acb10e8f45d599299bcbe9fb52f9",
-            "input": "Overdose of magnesium sulfate in combination with renal insufficiency, hypocalcemia, or compromise of intestinal integrity may predispose horses to magnesium toxicosis.\t magnesium sulfate",
-            "output": [
-                "Overdose"
-            ]
-        },
-        {
-            "id": "task1451-24ddea23892a4383825f3a0de39379e8",
-            "input": "We thus concluded that an excessive dose of AZ had probably destroyed the gastric mucosal barrier or thrombocytopenia due to bone marrow disorder and thus eventually led to the development of hemorrhagic gastritis.\t AZ",
-            "output": [
-                "excessive"
-            ]
-        },
-        {
-            "id": "task1451-dbc58ce2ac684f3988b14a8ca41ecd2b",
-            "input": "On the next day, after a total dose of only 600 mg of danazol, gingival bleeding and purpura occurred.\t danazol",
-            "output": [
-                "600 mg"
-            ]
-        },
-        {
-            "id": "task1451-264c8c79515645daa399c5fbe6116ec9",
-            "input": "We reported 3 patients who developed acute generalized dystonia and akinetic rigid syndrome following an initial therapy with d-penicillamine 125-500 mg daily.\t d-penicillamine",
-            "output": [
-                "125-500 mg daily"
-            ]
-        },
-        {
-            "id": "task1451-6bac619b162247e88129e1ae1a6b663d",
-            "input": "Ballistic movements due to ischemic infarcts after intravenous heroin overdose: report of two cases.\t heroin",
-            "output": [
-                "overdose"
-            ]
-        },
-        {
-            "id": "task1451-4129f9617c6141f2b4d32e63dc3bccec",
-            "input": "Two heroin addicts, aged 34 and 19 years, developed ballistic movements after intravenous heroin overdose.\t heroin",
-            "output": [
-                "overdose"
-            ]
-        },
-        {
-            "id": "task1451-7d660f0a50b7419391d8fb207e5277bc",
-            "input": "We report a 76-year-old man who developed an acute blistering eruption following high-dose penicillin treatment for pneumococcal septicaemia.\t penicillin",
-            "output": [
-                "high"
-            ]
-        },
-        {
-            "id": "task1451-d6c36849063c4dc8904a5bfb5f1882dd",
-            "input": "In case 1, a total daily dose of 25 mg sertraline, with nondetectable sertraline and desmethylsertraline blood levels, resulted in a doubling of the lamotrigine blood level with symptoms of toxicity.\t desmethylsertraline",
-            "output": [
-                "25 mg"
-            ]
-        },
-        {
-            "id": "task1451-07560d07eae343728fa11a31574137b2",
-            "input": "In case 1, a total daily dose of 25 mg sertraline, with nondetectable sertraline and desmethylsertraline blood levels, resulted in a doubling of the lamotrigine blood level with symptoms of toxicity.\t lamotrigine",
-            "output": [
-                "25 mg"
-            ]
-        },
-        {
-            "id": "task1451-016380dbada7461193068a44a8786e8e",
-            "input": "We report a case of pancytopenia in a 23-year-old man with Crohn's disease who was treated with 5-aminosalicylic acid (Pentasa; Nisshin, Tokyo, Japan) 3.0 g/day.\t 5-aminosalicylic acid",
-            "output": [
-                "3.0 g/day"
-            ]
-        },
-        {
-            "id": "task1451-c4b2a8dc1f29437291ab2a1c13fd7826",
-            "input": "We report a case of pancytopenia in a 23-year-old man with Crohn's disease who was treated with 5-aminosalicylic acid (Pentasa; Nisshin, Tokyo, Japan) 3.0 g/day.\t Pentasa",
-            "output": [
-                "3.0 g/day"
-            ]
-        },
-        {
-            "id": "task1451-ffc8a60083354d3b8dc3488744ded11c",
-            "input": "1. Changes in the plasma cortisol level were reported in a male patient with panic disorder during the period of low-dose alprazolam treatment (mean 0.62 +/- 0.15 mg/day) compared with during the period of high-dose period (mean 1.08 +/- 0.28 mg/day).\t alprazolam",
-            "output": [
-                "low"
-            ]
-        },
-        {
-            "id": "task1451-e61b0a4e61c44deda1a3cbcbf0eaa8bd",
-            "input": "We report on three patients with acute schizophrenia, who developed severe akathisia during treatment with olanzapine (20-25 mg/d).\t olanzapine",
-            "output": [
-                "20-25 mg/d"
-            ]
-        },
-        {
-            "id": "task1451-5c9e9c67600f4dbe8df63b116cb32d1f",
-            "input": "A 65-year-old woman with angina pectoris presented with syncope after sublingual ingestion of isosorbide dinitrate (5 mg).\t isosorbide dinitrate",
-            "output": [
-                "5 mg"
-            ]
-        },
-        {
-            "id": "task1451-aec3411cd2c048e5a09d907bf90635e5",
-            "input": "In a postural challenge test after administration of isosorbide dinitrate (5 mg), blood pressure decreased from 120/67 to 65/35 mmHg, followed by syncope with a sudden decrease in pulse rate from 85 to 60 beats/min.\t isosorbide dinitrate",
-            "output": [
-                "5 mg"
-            ]
-        },
-        {
-            "id": "task1451-92a7576e81a14e4e9f3bfd78ae7bb175",
-            "input": "High-dose phosphate treatment leads to hypokalemia in hypophosphatemic osteomalacia.\t phosphate",
-            "output": [
-                "High"
-            ]
-        }
-    ],
-    "Instance License": [
-        "Unknown"
-    ]
-}

MedS-Bench/Information_extraction/task2_intervention_extraction.json

@@ -1,370 +0,0 @@
-{
-    "Contributors": [
-        "Pegah Alipoormolabashi"
-    ],
-    "Source": [
-        "PICO"
-    ],
-    "URL": [
-        "https://github.com/Markus-Zlabinger/pico-annotation"
-    ],
-    "Categories": [
-        "Information Extraction"
-    ],
-    "Reasoning": [],
-    "Definition": [
-        "In medical studies, the efficacy of medical treatments (called interventions) is evaluated within a group of study participants. You will be given a sentence of a study report in which your task is to list the phrases that describe the intervention(s) of the study. You should list the phrase in the same order that they appear in the text, separated by commas. If no information about the interventions is mentioned, just answer with \"not found\". Interventions are: a specific drug, surgery, talking therapy, a lifestyle modification, control or placebo treatment. Do not include details, dosages, frequency and duration, intervention mentions that are not in an informative span of text."
-    ],
-    "Input_language": [
-        "English"
-    ],
-    "Output_language": [
-        "English"
-    ],
-    "Instruction_language": [
-        "English"
-    ],
-    "Domains": [
-        "Academical Papers"
-    ],
-    "Positive Examples": [
-        {
-            "input": "The patients received either azithromycin (600 mg/d for 3 days during week 1, then 600 mg/wk during weeks 2-12; n = 3879) or placebo (n = 3868)",
-            "output": "azithromycin, placebo",
-            "explanation": "The word azithromycin refers to a drug, and placebo refers to a control test. Note that no extra information is given in the output."
-        },
-        {
-            "input": "We report findings of a pilot RCT for a parent training intervention with a focus on the development of joint attention skills and joint action routines. ",
-            "output": "parent training intervention",
-            "explanation": "The words parent, training, and intervention refer to some kind of talking therapy."
-        },
-        {
-            "input": "Seventy-two people residing in National Health Service (U.K.) care facilities who had clinically significant agitation in the context of severe dementia were randomly assigned to aromatherapy with Melissa essential oil (N = 36) or placebo (sunflower oil) (N = 36). ",
-            "output": "aromatherapy with melissa essential oil, placebo, sunflower oil",
-            "explanation": "Both the therapy and the control treatment are mentioned as spans of text here."
-        }
-    ],
-    "Negative Examples": [
-        {
-            "input": "Treatment consisted of nitrendipine (10-40 mg/d), with the possible addition of enalapril maleate (5-20 mg/d), hydrochlorothiazide (12.5-25 mg/d), or both add-on drugs.",
-            "output": "nitrendipine (10-40 mg/d, ), enalapril, maleate (5-20, mg/d), hydrochlorothiazide (12.5-25, mg/d), both add-on drugs",
-            "explanation": "The drugs are correctly mentioned as intervention, but their dosage shouldn't be given as answer."
-        },
-        {
-            "input": "Zinc lozenges, 10 mg, orally dissolved, 5 times a day (in grades 1-6) or 6 times a day (in grades 7-12). ",
-            "output": "Zinc lozenges, orally dissolved",
-            "explanation": "Information about the method the intervention is given to patients, in this case \"orally dissolved\" should not be given as answer."
-        },
-        {
-            "input": "Antihypertensive therapy was started immediately after randomization in the active treatment group, but only after termination of the double-blind trial in the control patients.",
-            "output": "Antihypertensive therapy, double-blind trial",
-            "explanation": "The words double-blind and trial are not related to intervention."
-        }
-    ],
-    "Instances": [
-        {
-            "id": "task180-d05f132280184d30b2a7c66a12955f4f",
-            "input": "Under Fluoxetine , mPFC activation was up-regulated and normalized in ASD boys relative to controls , but down-regulated in ADHD boys relative to placebo , which was concomitant with worse task performance in ADHD .",
-            "output": [
-                "Fluoxetine, placebo"
-            ]
-        },
-        {
-            "id": "task180-705583d0b7574261a1d0eb3b9ea21f25",
-            "input": "We conclude that granisetron is a better anti-emetic than perphenazine for the long-term prevention of post-operative vomiting in children undergoing general anaesthesia for tonsillectomy .",
-            "output": [
-                "granisetron, perphenazine"
-            ]
-        },
-        {
-            "id": "task180-e05d4b47a48c455fa73c230a1dc61ede",
-            "input": "One case of unsubstantiated acute rheumatic fever occurred after 7 days of amoxicillin .",
-            "output": [
-                "amoxicillin"
-            ]
-        },
-        {
-            "id": "task180-4b5d472d7ad84ff5bc8c9336e2906d63",
-            "input": "Costs/QALY gained discounted at 3 % were $ 205,186 using the QWB and $ 32,643 using the CHRD .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task180-1e26affc2bf84ba28b3e04ca11d21c4d",
-            "input": "Calcium solubility and absorption across Caco-2 cells were studied after the in vitro digestion of the diets .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task180-2bf7946e98cd4de38087368b5b359e79",
-            "input": "Influence of diets rich in Maillard reaction products on calcium bioavailability .",
-            "output": [
-                "Maillard reaction"
-            ]
-        },
-        {
-            "id": "task180-ed2cbf7a61b9470b9ca0ba3cb93c9bfe",
-            "input": "Prior adjuvant chemotherapy was permitted .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task180-5e208cd3d15d4e74bc2f6a1a15d4e74c",
-            "input": "Depressive patients are able to follow prescribed lifestyle recommendations in the short-term .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task180-b095127d871449a488f0097adab5cb81",
-            "input": "The influence of injections of Amidotrizoate and Iopromide into the left coronary artery on global myocardial perfusion and function ( pressures in the left ventricle , heart rate ) as well as excitation formation and transmission was studied in 16 patients with ischaemic heart disease .",
-            "output": [
-                "Amidotrizoate, Iopromide"
-            ]
-        },
-        {
-            "id": "task180-6a8c5ed874fb4012af3091a5c3d3e043",
-            "input": "These 22 patients constituted the control group of a controlled trial and received standard outpatient clinic treatment during follow-up .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task180-9e5b32d1dd48404496afa9349b44db5c",
-            "input": "Patients could not have had prior chemotherapy for metastatic disease .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task180-6a3f1f6bded24064806c331e1da2dc6f",
-            "input": "Comparisons with the cyclophosphamide-doxorubicin-5-fluorouracil arm will not be addressed .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task180-93498bba94674cbfa26fd8c2fb59fa8b",
-            "input": "Children with parent-reported ASD had higher levels of health care office visits and prescription drug use compared with children without ASD ( P < .05 ) .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task180-fcc6bb6f4136434b96c9162a22134038",
-            "input": "Short-term phasic activity was only found in 13 out of 40 of the normal infants ( 32.5 % ) .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task180-5889efe2ac4f41e488bd6f90202b8ed7",
-            "input": "Group 1 received a weekly session of posterior tibial nerve stimulation for 12 weeks and group 2 was the placebo group .",
-            "output": [
-                "posterior tibial nerve stimulation, placebo"
-            ]
-        },
-        {
-            "id": "task180-dc4ee1c5234f443a9d0a8e698b1c9c52",
-            "input": "Only deoxypyridinoline values were significantly lower after consumption of the BD ( 13.0 +/- 1.1 compared to 18.3 +/- 2.1 nM/Mm Cr in the WD ) , possibly indicative of less efficient bone turnover during this period .",
-            "output": [
-                "BD"
-            ]
-        },
-        {
-            "id": "task180-add4b106e93746b68f4e1f1e8d39e293",
-            "input": "The results suggest that the use of PMRT could enhance quality of life and decrease state anxiety in patients after stoma surgery .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task180-51c88bc4a6f645b9a7070e2ff507bf44",
-            "input": "Interventions were conducted 30 min daily for 5-6 weeks .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task180-734141f8c527467cbaa543c60cf7632d",
-            "input": "There were also no differences in manual muscle testing sum scores , activity scale scores and patients ' own assessments after 48 weeks of treatment .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task180-e61f739b28d04c8fa6d3eff3a350af3a",
-            "input": "However , transfusion rate , presence of hepatomegaly , splenomegaly , and jaundice was similar .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task180-f8139b79b39d48afb5790bf20cfc0eca",
-            "input": "Three hundred sixty-five patients were enrolled .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task180-064aac9cb0b24fa2aae6a0b57b428348",
-            "input": "If so , this would be a great support for doctors who might systematically recommend these simple and costless measures , especially in primary care .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task180-a2a322cc0dbf4e7886a234514fe49b5c",
-            "input": "Relative to children in the wait-list group , program participants showed greater improvements in social skills over the course of the intervention , as indicated by parent-report measures .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task180-5c7e821690ca43798ada163a1c435260",
-            "input": "Hence , we hypothesize that specific airway resistance changes ( \u0394sRAW ) should better characterize the acute response to bronchodilators .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task180-4f9a49878df14dccaace0ce051371d4e",
-            "input": "We investigated whether 13 participants with ASD ( age 7 ; 03-22 ; 03 ) and 13 age-matched typically developing ( TD ) controls could comprehend lexicalized conceptual metaphors ( e.g. , Susan is a warm person ) and novel ones ( e.g. , Susan is a toasty person ) .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task180-bbfca44a968647df974d397c09064de9",
-            "input": "Randomized controlled study of chemoimmunotherapy with bestatin of acute nonlymphocytic leukemia in adults .",
-            "output": [
-                "chemoimmunotherapy, bestatin"
-            ]
-        },
-        {
-            "id": "task180-4307ceaeaffc44dd98a1b1dde9b55c64",
-            "input": "Forty-nine children with AS were recruited to participate and randomly assigned to intervention ( n = 26 ) or wait-list control ( n = 23 ) conditions .",
-            "output": [
-                "wait-list control"
-            ]
-        },
-        {
-            "id": "task180-9adf342a2f844b1794587e21459bf3c2",
-            "input": "Observed medication and weekend diary cards were used to monitor adherence .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task180-df2cc246edd74f9d96d0da5eafcde9a9",
-            "input": "Use of health care facilities was assessed from diaries/questionnaires and Medicare reimbursement rates used to estimate costs .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task180-639b1456c54a41efbe7f35ae81615ee3",
-            "input": "In 78 children known to be infected with Ascaris at baseline , the rate of weight gain was 21 per cent greater in children treated with levamisole than in those receiving placebo ( p = .03 ) .",
-            "output": [
-                "levamisole, placebo"
-            ]
-        },
-        {
-            "id": "task180-4062f1dc9324413e80924a911200b818",
-            "input": "Overall , 13 patients ( 46.4 % ) had detrusor overactivity and 14 ( 50 % ) had decreased bladder capacity .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task180-b287b8fac5a845f882cede4db5e321b1",
-            "input": "In patients with neutrophil counts of > 0.1 x 10 ( 9 ) /L lasting for more than 4 weeks , the frequency of infection in the fluconazole group ( 5 of 9 patients ) was significantly higher than in the itraconazole group ( 0 of 7 patients ; P = .03 ) .",
-            "output": [
-                "fluconazole, itraconazole"
-            ]
-        },
-        {
-            "id": "task180-679cf1cc391f4271be693b9bceb5dc45",
-            "input": "No significant differences , within and between groups , were observed in the exercise-induced increase in the ratios para- and ortho-hydroxyantipyrine to antipyrine .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task180-516f779dd64c4044879904eee1d241bc",
-            "input": "Age-matched boys with ADHD ( 15 ) , ASD ( 18 ) , and controls ( 21 ) were compared with functional magnetic resonance imaging ( fMRI ) during a reversal task .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task180-aa9bc54083594cdb9740e335fa5a48cb",
-            "input": "This 7-week program included a computer game , small group sessions , parent training sessions and teacher handouts .",
-            "output": [
-                "computer game, small group sessions, parent training, teacher handouts"
-            ]
-        },
-        {
-            "id": "task180-e99ffd4d7c9e416a872445b27329251c",
-            "input": "The patients were randomised into a control group ( n = 10 ) and an experimental group ( n = 8 ) .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task180-a841268b7d464f03a461a609cb1a9033",
-            "input": "To consider the impact on primary care patient outcomes of using both a screener to determine elevated anxiety levels among patients with previously undetected anxiety and a physician intervention to inform physicians of their patients ' conditions .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task180-3fcdfafaddbe4eba9de0668b526ac345",
-            "input": "A persistent phasic activity pattern was found in 19 of the 21 patients , high frequency phasic activity in 11 of the 21 patients .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task180-e0f406fe59c04444b11699f4fdc2a11c",
-            "input": "In a prospective , randomized , double-blind study , 90 paediatric patients , ASA I , aged 4-10 years , received granisetron 40 mg kg-1 or perphenazine 70 mg kg-1 ( n = 45 each ) intravenously immediately after an inhalation induction of anaesthesia .",
-            "output": [
-                "granisetron, perphenazine"
-            ]
-        },
-        {
-            "id": "task180-bcdde9881426455eb1bb9a348a2346e5",
-            "input": "After three weekly doses of epoetin alfa 40,000 U , a dose of 120,000 U can be administered safely once every 3 weeks without increasing transfusion needs or sacrificing QOL .",
-            "output": [
-                "epoetin alfa"
-            ]
-        },
-        {
-            "id": "task180-22807ace4fea4089b0058f968864e5c3",
-            "input": "However , to our knowledge , there have been no studies using all these measures together as an adjuvant antidepressant strategy .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task180-fb13ed9c71524d16bfbeef2ccf799542",
-            "input": "Accordingly , the current study examined within-person covariation between time-varying abstinence and depressive symptom in a multilevel model ( MLM ) , which allowed for transitions between smoking statuses within a participant .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task180-11545541370e486d90e11ee7ba8774eb",
-            "input": "Internal stenting is an integral part of endopyelotomy .",
-            "output": [
-                "stenting"
-            ]
-        }
-    ],
-    "Instance License": [
-        "Unknown"
-    ]
-}

MedS-Bench/Information_extraction/task3_outcome_extraction.json

@@ -1,365 +0,0 @@
-{
-    "Contributors": [
-        "Pegah Alipoormolabashi"
-    ],
-    "Source": [
-        "PICO"
-    ],
-    "URL": [
-        "https://github.com/Markus-Zlabinger/pico-annotation"
-    ],
-    "Categories": [
-        "Information Extraction"
-    ],
-    "Reasoning": [],
-    "Definition": [
-        "In medical studies, treatments are tested within a group of study participants. To determine if a new treatment works, various outcomes are measured in the people who take part in the study. You will be given a sentence of a study report in which your task is to list the phrases that give information about the outcomes of the study. You should list the phrases in the same order that they appear in the text, separated by commas. If no information about the outcome is mentioned, just answer with: \"not found\".\n Outcomes contain: outcomes measured in patients: like blood sugar,\n outcomes regarding the intervention: like effectiveness, costs\n the score on a medical test or questionnaire,\n positive or negative events in the patient groups: like quitting smoking, or adverse reactions.\n Do not mention numbers or results, interpretations of outcomes, outcome mentions without relevant information."
-    ],
-    "Input_language": [
-        "English"
-    ],
-    "Output_language": [
-        "English"
-    ],
-    "Instruction_language": [
-        "English"
-    ],
-    "Domains": [
-        "Academical Papers"
-    ],
-    "Positive Examples": [
-        {
-            "input": " Effects of 12 weeks' treatment with a proton pump inhibitor on insulin secretion, glucose metabolism and markers of cardiovascular risk in patients with type 2 diabetes ",
-            "output": "insulin secretion, glucose metabolism and markers of cardiovascular risk",
-            "explanation": "The study is measuring effects of a treatment on several outcomes, which are: insulin secretion, glucose metabolism and markers of cardiovascular risk."
-        },
-        {
-            "input": "There were no serious adverse device effects.",
-            "output": "no serious adverse device effects",
-            "explanation": "Any mention of not-seen effects counts as an outcome."
-        },
-        {
-            "input": " The primary outcome measures were the score on the Irritability subscale of the Aberrant Behavior Checklist and the rating on the Clinical Global Impressions - Improvement (CGI-I) scale at eight weeks. ",
-            "output": "score on the Irritability subscale of the Aberrant Behavior Checklist and the rating on the Clinical Global Impressions - Improvement (CGI-I) scale",
-            "explanation": "All the measured scores are correctly listed in this answer."
-        }
-    ],
-    "Negative Examples": [
-        {
-            "input": "Secondary end points included change in upper-limb measures (including the Fugl-Meyer Assessment-Upper Extremity).",
-            "output": "change in upper-limb measures, Fugl-Meyer Assessment-Upper Extremity",
-            "explanation": "The upper-limb measures are correctly mentioned, but the words \"change in\" should not be included, as they're measured results."
-        },
-        {
-            "input": "More early-stage cancer (stages I and II, 54 vs. 10) were found in the screening group than in the control group.",
-            "output": "early-stage cancer, stages I and II, 54 vs. 10",
-            "explanation": "The information about number of cases in each stage is an example of numbers and measurements that shouldn't be included in the output."
-        }
-    ],
-    "Instances": [
-        {
-            "id": "task181-b6b9cc59fa1144a2ae4adfaf05be19b7",
-            "input": "Under Fluoxetine , mPFC activation was up-regulated and normalized in ASD boys relative to controls , but down-regulated in ADHD boys relative to placebo , which was concomitant with worse task performance in ADHD .",
-            "output": [
-                "mPFC activation, task performance"
-            ]
-        },
-        {
-            "id": "task181-660afac74e1a4144aefc361cacfe5dad",
-            "input": "We conclude that granisetron is a better anti-emetic than perphenazine for the long-term prevention of post-operative vomiting in children undergoing general anaesthesia for tonsillectomy .",
-            "output": [
-                "prevention of post-operative vomiting"
-            ]
-        },
-        {
-            "id": "task181-b92bd0e8930a479092c5f3675e8f1dfb",
-            "input": "One case of unsubstantiated acute rheumatic fever occurred after 7 days of amoxicillin .",
-            "output": [
-                "acute rheumatic"
-            ]
-        },
-        {
-            "id": "task181-f2e2fdd2d65e4eedaf5689d406671512",
-            "input": "Costs/QALY gained discounted at 3 % were $ 205,186 using the QWB and $ 32,643 using the CHRD .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task181-d6d84adef4d748a2a45078bf92625fef",
-            "input": "Calcium solubility and absorption across Caco-2 cells were studied after the in vitro digestion of the diets .",
-            "output": [
-                "absorption"
-            ]
-        },
-        {
-            "id": "task181-c52df3ee2be54a398d7c4bd65b599615",
-            "input": "Influence of diets rich in Maillard reaction products on calcium bioavailability .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task181-f9b50d8667b845a6a1c50339745573fa",
-            "input": "Prior adjuvant chemotherapy was permitted .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task181-ad0425160e8b401eab48421f77e4ad45",
-            "input": "Depressive patients are able to follow prescribed lifestyle recommendations in the short-term .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task181-a1b4e2b22e77474e89085a58da314dd2",
-            "input": "The influence of injections of Amidotrizoate and Iopromide into the left coronary artery on global myocardial perfusion and function ( pressures in the left ventricle , heart rate ) as well as excitation formation and transmission was studied in 16 patients with ischaemic heart disease .",
-            "output": [
-                "global myocardial perfusion and function ( pressures in the left ventricle , heart rate, excitation formation, transmission"
-            ]
-        },
-        {
-            "id": "task181-be54c87829a840cbbd6a3d4ddeaacb6f",
-            "input": "These 22 patients constituted the control group of a controlled trial and received standard outpatient clinic treatment during follow-up .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task181-99ca02a337044cbd88bda6dc0c590196",
-            "input": "Patients could not have had prior chemotherapy for metastatic disease .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task181-5827a79a4ea24d2f8204521bce20799c",
-            "input": "Comparisons with the cyclophosphamide-doxorubicin-5-fluorouracil arm will not be addressed .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task181-fcfedc8932dc4df9abf5e65904fdd5ae",
-            "input": "Children with parent-reported ASD had higher levels of health care office visits and prescription drug use compared with children without ASD ( P < .05 ) .",
-            "output": [
-                "levels of health care office visits, prescription drug use"
-            ]
-        },
-        {
-            "id": "task181-7b1a9e5c12e844b4a55e63ca32eeb7c7",
-            "input": "Short-term phasic activity was only found in 13 out of 40 of the normal infants ( 32.5 % ) .",
-            "output": [
-                "phasic activity"
-            ]
-        },
-        {
-            "id": "task181-7c675b2ed3c449769cf8ab917b2ccf60",
-            "input": "Group 1 received a weekly session of posterior tibial nerve stimulation for 12 weeks and group 2 was the placebo group .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task181-774950e6c3fd439588a89a655407d28b",
-            "input": "Only deoxypyridinoline values were significantly lower after consumption of the BD ( 13.0 +/- 1.1 compared to 18.3 +/- 2.1 nM/Mm Cr in the WD ) , possibly indicative of less efficient bone turnover during this period .",
-            "output": [
-                "deoxypyridinoline, bone turnover"
-            ]
-        },
-        {
-            "id": "task181-68a7c59ab2e04e318983f4184d60e391",
-            "input": "The results suggest that the use of PMRT could enhance quality of life and decrease state anxiety in patients after stoma surgery .",
-            "output": [
-                "quality of life, state anxiety"
-            ]
-        },
-        {
-            "id": "task181-0d279aa13ebc443a9b8b2ee194eaa2fa",
-            "input": "Interventions were conducted 30 min daily for 5-6 weeks .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task181-e0a60203a30c4d81a6befb0e1a2f7e15",
-            "input": "There were also no differences in manual muscle testing sum scores , activity scale scores and patients ' own assessments after 48 weeks of treatment .",
-            "output": [
-                "manual muscle testing sum scores, activity scale scores, patients ' own assessments"
-            ]
-        },
-        {
-            "id": "task181-e2cf137ad96a4c97ac77fd4a6aa5a094",
-            "input": "However , transfusion rate , presence of hepatomegaly , splenomegaly , and jaundice was similar .",
-            "output": [
-                "transfusion rate, hepatomegaly, splenomegaly, jaundice"
-            ]
-        },
-        {
-            "id": "task181-91e4da925405482a86852c2f40e94479",
-            "input": "Three hundred sixty-five patients were enrolled .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task181-5f8df641d10341488507af682b4cd162",
-            "input": "If so , this would be a great support for doctors who might systematically recommend these simple and costless measures , especially in primary care .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task181-174c2bbb0a094cf08d9be77a36021bea",
-            "input": "Relative to children in the wait-list group , program participants showed greater improvements in social skills over the course of the intervention , as indicated by parent-report measures .",
-            "output": [
-                "social skills"
-            ]
-        },
-        {
-            "id": "task181-f397803081c7484596609ab95c11305b",
-            "input": "Hence , we hypothesize that specific airway resistance changes ( \u0394sRAW ) should better characterize the acute response to bronchodilators .",
-            "output": [
-                "airway resistance changes ( \u0394sRAW"
-            ]
-        },
-        {
-            "id": "task181-6be7c34457d44d2aae095c9b8a8545b3",
-            "input": "We investigated whether 13 participants with ASD ( age 7 ; 03-22 ; 03 ) and 13 age-matched typically developing ( TD ) controls could comprehend lexicalized conceptual metaphors ( e.g. , Susan is a warm person ) and novel ones ( e.g. , Susan is a toasty person ) .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task181-a56c014af9e641e0a054df3d539e862b",
-            "input": "Randomized controlled study of chemoimmunotherapy with bestatin of acute nonlymphocytic leukemia in adults .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task181-00f7a9feeca443dba41ea8642d982a43",
-            "input": "Forty-nine children with AS were recruited to participate and randomly assigned to intervention ( n = 26 ) or wait-list control ( n = 23 ) conditions .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task181-a0ad3556ddad4a45816ca1c41f8fb899",
-            "input": "Observed medication and weekend diary cards were used to monitor adherence .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task181-3642ba2f6ecb422bbf9f53b3c83a712d",
-            "input": "Use of health care facilities was assessed from diaries/questionnaires and Medicare reimbursement rates used to estimate costs .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task181-872fcc407c5b4bddab2900ae4e64a409",
-            "input": "In 78 children known to be infected with Ascaris at baseline , the rate of weight gain was 21 per cent greater in children treated with levamisole than in those receiving placebo ( p = .03 ) .",
-            "output": [
-                "weight gain"
-            ]
-        },
-        {
-            "id": "task181-6325c79c66f245a1948b5b3edd34ecac",
-            "input": "Overall , 13 patients ( 46.4 % ) had detrusor overactivity and 14 ( 50 % ) had decreased bladder capacity .",
-            "output": [
-                "detrusor overactivity, bladder capacity"
-            ]
-        },
-        {
-            "id": "task181-88a93544f3ea44549d2830a24e2b92e0",
-            "input": "In patients with neutrophil counts of > 0.1 x 10 ( 9 ) /L lasting for more than 4 weeks , the frequency of infection in the fluconazole group ( 5 of 9 patients ) was significantly higher than in the itraconazole group ( 0 of 7 patients ; P = .03 ) .",
-            "output": [
-                "frequency of infection"
-            ]
-        },
-        {
-            "id": "task181-61f6dd4c233943c1a641eb98a6ac63cc",
-            "input": "No significant differences , within and between groups , were observed in the exercise-induced increase in the ratios para- and ortho-hydroxyantipyrine to antipyrine .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task181-0e571027c3ad402eac59e037eef1f9dc",
-            "input": "Age-matched boys with ADHD ( 15 ) , ASD ( 18 ) , and controls ( 21 ) were compared with functional magnetic resonance imaging ( fMRI ) during a reversal task .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task181-b966d8e535214bcfab19f7807a69aa51",
-            "input": "This 7-week program included a computer game , small group sessions , parent training sessions and teacher handouts .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task181-aa5d3b6da4d4484885016d4d791a5bbb",
-            "input": "The patients were randomised into a control group ( n = 10 ) and an experimental group ( n = 8 ) .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task181-02ed1112902e4c7eaff28cb2c99831d9",
-            "input": "To consider the impact on primary care patient outcomes of using both a screener to determine elevated anxiety levels among patients with previously undetected anxiety and a physician intervention to inform physicians of their patients ' conditions .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task181-be619ba3e04f49ad88a3012d30a053e2",
-            "input": "A persistent phasic activity pattern was found in 19 of the 21 patients , high frequency phasic activity in 11 of the 21 patients .",
-            "output": [
-                "phasic activity, phasic"
-            ]
-        },
-        {
-            "id": "task181-517cc6f8524a4005803c89fe11122459",
-            "input": "In a prospective , randomized , double-blind study , 90 paediatric patients , ASA I , aged 4-10 years , received granisetron 40 mg kg-1 or perphenazine 70 mg kg-1 ( n = 45 each ) intravenously immediately after an inhalation induction of anaesthesia .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task181-3926152d20b8400e8a1b5d374338ff8e",
-            "input": "After three weekly doses of epoetin alfa 40,000 U , a dose of 120,000 U can be administered safely once every 3 weeks without increasing transfusion needs or sacrificing QOL .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task181-1b85989710174167807d1dd176f01fab",
-            "input": "However , to our knowledge , there have been no studies using all these measures together as an adjuvant antidepressant strategy .",
-            "output": [
-                "not found"
-            ]
-        },
-        {
-            "id": "task181-5eb927181cb44fe9964ad7117653f82f",
-            "input": "Accordingly , the current study examined within-person covariation between time-varying abstinence and depressive symptom in a multilevel model ( MLM ) , which allowed for transitions between smoking statuses within a participant .",
-            "output": [
-                "depressive symptom"
-            ]
-        },
-        {
-            "id": "task181-5ffc877487054e8d875578021fb8018b",
-            "input": "Internal stenting is an integral part of endopyelotomy .",
-            "output": [
-                "not found"
-            ]
-        }
-    ],
-    "Instance License": [
-        "Unknown"
-    ]
-}

MedS-Bench/Information_extraction/task74_pmc_patient_case_report_basic_information_extraction.json

@@ -1,3 +0,0 @@
-version https://git-lfs.github.com/spec/v1
-oid sha256:42d9e678a58340e4d1f60cfd4c7d7f5e551d5550777f068de42c4f34d9c2ff34
-size 279246

MedS-Bench/NER/task125_bc4chem_named_enetity_recognition.json

@@ -1,234 +0,0 @@
-{
-    "Contributors": [
-        "BC4-chem"
-    ],
-    "Source": [
-        "BC4-Chem"
-    ],
-    "URL": [
-        "https://github.com/cambridgeltl/MTL-Bioinformatics-2016/tree/master/data"
-    ],
-    "Categories": [
-        "Named Entity Recognition"
-    ],
-    "Definition": [
-        "Given a sentence, you need to recognize the name of the chemical. There might be several correct answers. If it does not exist, you need to output \"There is no related enetity.\"."
-    ],
-    "Reasoning": [],
-    "Input_language": [
-        "English"
-    ],
-    "Output_language": [
-        "English"
-    ],
-    "Instruction_language": [
-        "English"
-    ],
-    "Domains": [
-        "Medical Knowledge"
-    ],
-    "Positive Examples": [],
-    "Negative Examples": [],
-    "Instances": [
-        {
-            "input": "To better understand the concerns, we performed a systematic literature review and experimental competition reactions between DA and TDI.",
-            "output": "TDI."
-        },
-        {
-            "input": "The experimental evidence demonstrates that DA is at least 400 - fold less reactive than TDI.",
-            "output": "TDI."
-        },
-        {
-            "input": "The literature review finds evidence that the EC3 for DA is actually > 11 %.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "We conclude that DA is unlikely to have significant respiratory sensitization potential.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Investigation of aqueous stability of taxol in different release media.",
-            "output": "taxol."
-        },
-        {
-            "input": "Abstract In the present study, the aqueous stability of taxol in different aqueous media and immiscible aqueous / organic systems at 37 degrees C was investigated.",
-            "output": "taxol."
-        },
-        {
-            "input": "The aqueous media included phosphate buffered saline ( PBS ) and PBS containing 10 % methanol, 10 % ethanol, 10 % hydroxypropyl beta - cyclodextrin ( HP - beta CD ), 1 % sodium citrate and 1 % Tween 80.",
-            "output": "phosphate, methanol, ethanol, hydroxypropyl beta - cyclodextrin, HP - beta CD, sodium citrate, Tween 80."
-        },
-        {
-            "input": "The immiscible systems consisted of PBS / octanol, PBS / dichloromethane, PBS / chloroform and PBS / ethyl acetate.",
-            "output": "octanol, dichloromethane, chloroform, ethyl acetate."
-        },
-        {
-            "input": "The concentrations of taxol and related derivatives in each of the media were determined through the high - performance liquid chromatography assay.",
-            "output": "taxol."
-        },
-        {
-            "input": "Results showed that hydrolysis and epimerization were two major types of degradation for taxol in the aqueous media starting from the initial hours of contact ( 6 hours ).",
-            "output": "taxol."
-        },
-        {
-            "input": "Addition of Tween 80 to PBS moderately increased the aqueous stability of taxol.",
-            "output": "Tween 80, taxol."
-        },
-        {
-            "input": "As well, using PBS containing 10 % HP - beta CD inhibited the taxol hydrolysis, while epimerization still in process.",
-            "output": "HP - beta CD, taxol."
-        },
-        {
-            "input": "In the case of immiscible systems, except for PBS / ethyl acetate system, no evidences of taxol hydrolysis were observed.",
-            "output": "ethyl acetate, taxol."
-        },
-        {
-            "input": "Meanwhile, epimerization of taxol in PBS / dichloromethane and PBS / chloroform systems underwent due to the ability of C - Cl bonds to form hydrogen bonding with the hydroxyl group of C7 of taxol.",
-            "output": "taxol, dichloromethane, chloroform, C, Cl, hydrogen, hydroxyl, taxol."
-        },
-        {
-            "input": "Automated actuation of nasal spray products: effect of hand - related variability on the in vitro performance of Flonase nasal spray.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Abstract Objective: To determine if patient - related variability for adults and children recorded during hand spraying of Flonase with an instrumented nasal spray results in significant differences in spray weight, droplet size or spray pattern.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Methods: Settings derived from adult and pediatric participants hand - spraying nasal sprays were implemented into force and velocity - controlled automated actuators.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Spray weight, droplet size distribution and spray pattern tests were performed using iterations of actuation force ( AF ) and force rise, hold and fall times.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Travel, actuation velocity and release velocity settings were also investigated.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Results: The variability measured in adult - derived actuator settings did not result in any differences in spray weight, but pediatric participants spraying with low AF and / or compression velocity ( CV ) were predicted to receive a partial dose or no dose at all under some circumstances.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Droplet size characteristics were sensitive to the hand - based variability, with actuation force, force rise time and CV hand - related settings all resulting in significant differences in the droplet size.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Conclusions: This study demonstrated how variability in hand spraying by adults and pediatric patients could result in differences in nasal spray characteristics, thus demonstrating the importance of monitoring how the prospective patient groups are likely to use a nasal spray.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Signatures of Fano Interferences in the Electron Energy Loss Spectroscopy and Cathodoluminescence of Symmetry - Broken Nanorod Dimers.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Through numerical simulation, we predict the existence of the Fano interference effect in the electron energy loss spectroscopy ( EELS ) and cathodoluminescence ( CL ) of symmetry - broken nanorod dimers that are heterogeneous in material composition and asymmetric in length.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "The differing selection rules of the electron probe in comparison to the photon of a plane wave allow for the simultaneous excitation of both optically bright and dark plasmons of each monomer unit, suggesting that Fano resonances will not arise in EELS and CL.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Yet, interferences are manifested in the dimer ' s scattered near - and far - fields and are evident in EELS and CL due to the rapid pi - phase offset in the polarizations between super - radiant and subradiant hybridized plasmon modes of the dimer as a function of the energy loss suffered by the impinging electron.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Depending upon the location of the electron beam, we demonstrate the conditions under which Fano interferences will be present in both optical and electron spectroscopies ( EELS and CL ) as well as a new class of Fano interferences that are uniquely electron - driven and are absent in the optical response.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Among other things, the knowledge gained from this work bears impact upon the design of some of the world ' s most sensitive sensors, which are currently based upon Fano resonances.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "POST - SURGICAL THYROID ABLATION WITH LOW OR HIGH RADIOIODINE ACTIVITIES RESULTS IN SIMILAR OUTCOMES IN INTERMEDIATE RISK DIFFERENTIATED THYROID CANCER PATIENTS.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "BACKGROUND: In differentiated thyroid cancer ( DTC ) patients at intermediate risk of recurrences, no evidences are provided regarding the optimal radioactive iodine ( RAI ) activity to be administered for post - surgical thyroid ablation.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "METHODS: This study aimed to evaluate the impact of RAI activities on the outcome of 225 DTC patients classified as intermediate risk, treated with low ( 1110 - 1850 MBq ) or high RAI activities ( >= 3700 MBq ).",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "RESULTS: Six - eighteen months after ablation remission was observed in 60. 0 % of patients treated with low and in 60 % of those treated with high RAI activities, biochemical disease was found in 18. 8 % of patients treated with low and in 14. 3 % of patients treated with high RAI activities, metastatic disease was found in 21. 2 % of patients treated with low and in 25. 7 % of patients treated with high RAI activities ( p = 0. 56 ).",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "At the last follow - up ( low activities, median 4. 2 years: high activities median 6. 9 years ) remission was observed in 76. 5 % of patients treated with low and in 72. 1 % of patients treated with high RAI activities, persistent disease was observed in 18. 8 % of patients treated with low and in 23. 5 % of patients treated with high RAI activities, recurrent disease was 2. 4 % in patients treated with low and 2. 1 % in patients treated with high RAI activities, deaths occurred in 2. 4 % of patients treated with low and in 2. 1 % of patients treated with high RAI activities ( p = 0. 87 ).",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "CONCLUSION: our study provides the first evidence that in DTC patients at intermediate risk, high RAI activities at ablation have no major advantage over low activities.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Restoration of cardiac tissue thyroid hormone status in experimental hypothyroidism: a dose - response study in female rats.",
-            "output": "thyroid hormone."
-        },
-        {
-            "input": "Thyroid hormones ( THs ) play a pivotal role in regulating cardiovascular homeostasis.",
-            "output": "Thyroid hormones."
-        },
-        {
-            "input": "To provide a better understanding of the coordinated processes that govern cardiac TH bioavailability, this study investigated the influence of serum and cardiac TH status on the expression of TH transporters and cytosolic binding proteins in the myocardium.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "In addition, we sought to determine if administration of T3 ( instead of T4 ) improves the relationship between THs in serum and cardiac tissue, and cardiac function over a short - term treatment period.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Adult female SD rats were made hypothyroid by seven weeks treatment with the anti - thyroid drug PTU ( 6 - n - propyl - 2 - thiouracil ).",
-            "output": "PTU, 6 - n - propyl - 2 - thiouracil."
-        },
-        {
-            "input": "After establishing hypothyroidism, rats were assigned to one of five graded T3 ( triiodothyronine ) dosages plus PTU for a two week dose - response experiment.",
-            "output": "triiodothyronine, PTU."
-        },
-        {
-            "input": "Untreated, age matched rats served as euthyroid controls.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "PTU was associated with depressed serum and cardiac tissue T3 and T4 levels, arteriolar atrophy, altered TH transporter and cytosolic TH binding protein expression, fetal gene re - expression, and cardiac dysfunction.",
-            "output": "PTU."
-        },
-        {
-            "input": "Short - term administration of T3 led to a mismatch between serum and cardiac tissue TH levels.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Normalization of serum T3 levels was not associated with restoration of cardiac tissue T3 levels or cardiac function.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "In fact, a 3 fold higher T3 dosage was necessary to normalize cardiac tissue T3 levels and cardiac function.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Importantly, this study provides the first comprehensive data on the relationship between altered TH status ( serum and cardiac tissue ), cardiac function, and the coordinated in vivo changes in cardiac TH membrane transporters and cytosolic TH binding proteins in altered TH states.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Brominated Skeletal Components of the Marine Demosponges, Aplysina cavernicola and Ianthella basta: Analytical and Biochemical Investigations.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Demosponges possess a skeleton made of a composite material with various organic constituents and / or siliceous spicules.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Chitin is an integral part of the skeleton of different sponges of the order Verongida.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Moreover, sponges of the order Verongida, such as Aplysina cavernicola or Ianthella basta, are well - known for the biosynthesis of brominated tyrosine derivates, characteristic bioactive natural products.",
-            "output": "brominated tyrosine."
-        }
-    ]
-}

MedS-Bench/NER/task126_bc5chem_named_enetity_recognition.json

@@ -1,234 +0,0 @@
-{
-    "Contributors": [
-        "BC5-chem"
-    ],
-    "Source": [
-        "BC5-Chem"
-    ],
-    "URL": [
-        "https://github.com/cambridgeltl/MTL-Bioinformatics-2016/tree/master/data"
-    ],
-    "Categories": [
-        "Named Entity Recognition"
-    ],
-    "Definition": [
-        "Given a sentence, you need to recognize the name of the chemical. There might be several correct answers. If it does not exist, you need to output \"There is no related enetity.\"."
-    ],
-    "Reasoning": [],
-    "Input_language": [
-        "English"
-    ],
-    "Output_language": [
-        "English"
-    ],
-    "Instruction_language": [
-        "English"
-    ],
-    "Domains": [
-        "Medical Knowledge"
-    ],
-    "Positive Examples": [],
-    "Negative Examples": [],
-    "Instances": [
-        {
-            "input": "At the time of this writing, dose level 4 ( 260, 270, and 280 mg / m2 ) is being evaluated; three patients from this level are evaluable.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "With paclitaxel doses of 200 mg / m2 and higher, granulocyte colony - stimulating factor 5 micrograms / kg / d is given ( days 4 through 12 ).",
-            "output": "paclitaxel."
-        },
-        {
-            "input": "Of 18 patients evaluable for response, seven ( 39 % ) achieved a complete response and six ( 33 % ) achieved a partial response.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Three patients had no change and disease progressed in two.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "The overall response rate is 72 %.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Eleven responding patients had subsequent surgery / radiotherapy or radical radiotherapy.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Two pathologic complete responses were observed in patients who had achieved clinical complete responses.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Alopecia, paresthesias, and arthralgias / myalgias have occurred frequently, but with one exception ( a grade 3 myalgia ) they have been grade 1 or 2.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "No dose - limiting hematologic toxicity has been seen.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Paclitaxel / cisplatin is an effective first - line regimen for locoregionally advanced head and neck cancer and continued study is warranted.",
-            "output": "Paclitaxel, cisplatin."
-        },
-        {
-            "input": "Results thus far suggest no dose - response effect for paclitaxel doses above 200 mg / m2.",
-            "output": "paclitaxel."
-        },
-        {
-            "input": "Improvement of levodopa - induced dyskinesia by propranolol in Parkinson ' s disease.",
-            "output": "levodopa, propranolol."
-        },
-        {
-            "input": "Seven patients suffering from Parkinson ' s disease ( PD ) with severely disabling dyskinesia received low - dose propranolol as an adjunct to the currently used medical treatment.",
-            "output": "propranolol."
-        },
-        {
-            "input": "There was a significant 40 % improvement in the dyskinesia score without increase of parkinsonian motor disability.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Ballistic and choreic dyskinesia were markedly ameliorated, whereas dystonia was not.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "This study suggests that administration of low doses of beta - blockers may improve levodopa - induced ballistic and choreic dyskinesia in PD.",
-            "output": "levodopa."
-        },
-        {
-            "input": "Habitual use of acetaminophen as a risk factor for chronic renal failure: a comparison with phenacetin.",
-            "output": "acetaminophen, phenacetin."
-        },
-        {
-            "input": "Six epidemiologic studies in the United States and Europe indicate that habitual use of phenacetin is associated with the development of chronic renal failure and end - stage renal disease ( ESRD ), with a relative risk in the range of 4 to 19.",
-            "output": "phenacetin."
-        },
-        {
-            "input": "As a result of these and other studies, phenacetin has now been withdrawn from the market in most countries.",
-            "output": "phenacetin."
-        },
-        {
-            "input": "However, three case control studies, one each in North Carolina, northern Maryland, and West Berlin, Germany, showed that habitual use of acetaminophen is also associated with chronic renal failure and ESRD, with a relative risk in the range of 2 to 4.",
-            "output": "acetaminophen."
-        },
-        {
-            "input": "These studies suggest that both phenacetin and acetaminophen may contribute to the burden of ESRD, with the risk of the latter being somewhat less than that of the former.",
-            "output": "phenacetin, acetaminophen."
-        },
-        {
-            "input": "This apparent difference in risk may not be due to differences in nephrotoxic potential of the drugs themselves.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "A lower relative risk would be expected for acetaminophen if the risk of both drugs in combination with other analgesics was higher than the risk of either agent alone.",
-            "output": "acetaminophen."
-        },
-        {
-            "input": "Thus, acetaminophen has been used both as a single agent and in combination with other analgesics, whereas phenacetin was available only in combinations.",
-            "output": "acetaminophen, phenacetin."
-        },
-        {
-            "input": "The possibility that habitual use of acetaminophen alone increases the risk of ESRD has not been clearly demonstrated, but cannot be dismissed.",
-            "output": "acetaminophen."
-        },
-        {
-            "input": "Acetaminophen - induced hypotension.",
-            "output": "Acetaminophen."
-        },
-        {
-            "input": "Through 30 years of widespread use, acetaminophen has been shown to be a remarkably safe medication in therapeutic dosages.",
-            "output": "acetaminophen."
-        },
-        {
-            "input": "The potential for acetaminophen to produce cardiovascular toxicities is very low.",
-            "output": "acetaminophen."
-        },
-        {
-            "input": "However, acetaminophen has been demonstrated to produce symptoms of anaphylaxis, including hypotension, in sensitive individuals.",
-            "output": "acetaminophen."
-        },
-        {
-            "input": "This article describes two critically ill patients in whom transient episodes of hypotension reproducibly developed after administration of acetaminophen.",
-            "output": "acetaminophen."
-        },
-        {
-            "input": "Other symptoms of allergic reactions were not clinically detectable.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "The hypotensive episodes were severe enough to require vasopressor administration.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "The reports illustrate the need for clinicians to consider acetaminophen in patients with hypotension of unknown origin.",
-            "output": "acetaminophen."
-        },
-        {
-            "input": "Reduction of heparan sulphate - associated anionic sites in the glomerular basement membrane of rats with streptozotocin - induced diabetic nephropathy.",
-            "output": "heparan sulphate, streptozotocin."
-        },
-        {
-            "input": "Heparan sulphate - associated anionic sites in the glomerular basement membrane were studied in rats 8 months after induction of diabetes by streptozotocin and in age - adn sex - matched control rats, employing the cationic dye cuprolinic blue.",
-            "output": "Heparan sulphate, streptozotocin, cuprolinic blue."
-        },
-        {
-            "input": "Morphometric analysis at the ultrastructural level was performed using a computerized image processor.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "The heparan sulphate specificity of the cuprolinic blue staining was demonstrated by glycosaminoglycan - degrading enzymes, showing that pretreatment of the sections with heparitinase abolished all staining, whereas chondroitinase ABC had no effect.",
-            "output": "heparan sulphate, cuprolinic blue, glycosaminoglycan."
-        },
-        {
-            "input": "The majority of anionic sites ( 74 % in diabetic and 81 % in control rats ) were found within the lamina rara externa of the glomerular basement membrane.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "A minority of anionic sites were scattered throughout the lamina densa and lamina rara interna, and were significantly smaller than those in the lamina rara externa of the glomerular basement membrane ( p < 0. 001 and p < 0. 01 for diabetic and control rats, respectively ).",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Diabetic rats progressively developed albuminuria reaching 40. 3 ( 32. 2 - 62. 0 ) mg / 24 h after 8 months in contrast to the control animals ( 0. 8 ( 0. 2 - 0. 9 ) mg / 24 h, p < 0. 002 ).",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "At the same time, the number of heparan sulphate anionic sites and the total anionic site surface ( number of anionic sites x mean anionic site surface ) in the lamina rara externa of the glomerular basement membrane was reduced by 19 % ( p < 0. 021 ) and by 26 % ( p < 0. 02 ), respectively.",
-            "output": "heparan sulphate."
-        },
-        {
-            "input": "Number and total anionic site surface in the remaining part of the glomerular basement membrane ( lamina densa and lamina rara interna ) were not significantly changed.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "We conclude that in streptozotocin - diabetic rats with an increased urinary albumin excretion, a reduced heparan sulphate charge barrier / density is found at the lamina rara externa of the glomerular basement membrane.",
-            "output": "streptozotocin, heparan sulphate."
-        },
-        {
-            "input": "Mediation of enhanced reflex vagal bradycardia by L - dopa via central dopamine formation in dogs.",
-            "output": "L - dopa, dopamine."
-        },
-        {
-            "input": "L - Dopa ( 5 mg / kg i. v. ) decreased blood pressure and heart rate after extracerebral decarboxylase inhibition with MK - 486 ( 25 mg / kg i. v. ) in anesthetize MAO - inhibited dogs.",
-            "output": "L - Dopa, MK - 486, MAO."
-        },
-        {
-            "input": "In addition, reflex bradycardia caused by injected norepinephrine was significantly enhanced by L - dopa, DL - Threo - dihydroxyphenylserine had no effect on blood pressure, heart rate or reflex responses to norepinephrine.",
-            "output": "norepinephrine, L - dopa, DL - Threo - dihydroxyphenylserine, norepinephrine."
-        },
-        {
-            "input": "FLA - 63, a dopamine - beta - oxidase inhibitor, did not have any effect on the hypotension, bradycardia or reflex - enhancing effect of L - dopa.",
-            "output": "FLA - 63, dopamine, L - dopa."
-        },
-        {
-            "input": "Pimozide did not affect the actions of L - dopa on blood pressure and heart rate but completely blocked the enhancement of reflexes.",
-            "output": "Pimozide, L - dopa."
-        },
-        {
-            "input": "Removal of the carotid sinuses caused an elevation blood pressure and heart rate and abolished the negative chronotropic effect of norepinephrine.",
-            "output": "norepinephrine."
-        },
-        {
-            "input": "However, L - dopa restored the bradycardia caused by norepinephrine in addition to decreasing blood pressure and heart rate.",
-            "output": "L - dopa, norepinephrine."
-        }
-    ]
-}

MedS-Bench/NER/task127_bc5disease_named_enetity_recognition.json

@@ -1,234 +0,0 @@
-{
-    "Contributors": [
-        "BC5-disease"
-    ],
-    "Source": [
-        "BC5-disease"
-    ],
-    "URL": [
-        "https://github.com/cambridgeltl/MTL-Bioinformatics-2016/tree/master/data"
-    ],
-    "Categories": [
-        "Named Entity Recognition"
-    ],
-    "Definition": [
-        "Given a sentence, you need to recognize the name of the disease. There might be several correct answers. If it does not exist, you need to output \"There is no related enetity.\"."
-    ],
-    "Reasoning": [],
-    "Input_language": [
-        "English"
-    ],
-    "Output_language": [
-        "English"
-    ],
-    "Instruction_language": [
-        "English"
-    ],
-    "Domains": [
-        "Medical Knowledge"
-    ],
-    "Positive Examples": [],
-    "Negative Examples": [],
-    "Instances": [
-        {
-            "input": "At the time of this writing, dose level 4 ( 260, 270, and 280 mg / m2 ) is being evaluated; three patients from this level are evaluable.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "With paclitaxel doses of 200 mg / m2 and higher, granulocyte colony - stimulating factor 5 micrograms / kg / d is given ( days 4 through 12 ).",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Of 18 patients evaluable for response, seven ( 39 % ) achieved a complete response and six ( 33 % ) achieved a partial response.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Three patients had no change and disease progressed in two.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "The overall response rate is 72 %.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Eleven responding patients had subsequent surgery / radiotherapy or radical radiotherapy.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Two pathologic complete responses were observed in patients who had achieved clinical complete responses.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Alopecia, paresthesias, and arthralgias / myalgias have occurred frequently, but with one exception ( a grade 3 myalgia ) they have been grade 1 or 2.",
-            "output": "Alopecia, paresthesias, arthralgias, myalgias, myalgia."
-        },
-        {
-            "input": "No dose - limiting hematologic toxicity has been seen.",
-            "output": "toxicity."
-        },
-        {
-            "input": "Paclitaxel / cisplatin is an effective first - line regimen for locoregionally advanced head and neck cancer and continued study is warranted.",
-            "output": "head and neck cancer."
-        },
-        {
-            "input": "Results thus far suggest no dose - response effect for paclitaxel doses above 200 mg / m2.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Improvement of levodopa - induced dyskinesia by propranolol in Parkinson ' s disease.",
-            "output": "dyskinesia, Parkinson ' s disease."
-        },
-        {
-            "input": "Seven patients suffering from Parkinson ' s disease ( PD ) with severely disabling dyskinesia received low - dose propranolol as an adjunct to the currently used medical treatment.",
-            "output": "Parkinson ' s disease, PD, dyskinesia."
-        },
-        {
-            "input": "There was a significant 40 % improvement in the dyskinesia score without increase of parkinsonian motor disability.",
-            "output": "dyskinesia, parkinsonian, motor disability."
-        },
-        {
-            "input": "Ballistic and choreic dyskinesia were markedly ameliorated, whereas dystonia was not.",
-            "output": "dyskinesia, dystonia."
-        },
-        {
-            "input": "This study suggests that administration of low doses of beta - blockers may improve levodopa - induced ballistic and choreic dyskinesia in PD.",
-            "output": "dyskinesia, PD."
-        },
-        {
-            "input": "Habitual use of acetaminophen as a risk factor for chronic renal failure: a comparison with phenacetin.",
-            "output": "chronic renal failure."
-        },
-        {
-            "input": "Six epidemiologic studies in the United States and Europe indicate that habitual use of phenacetin is associated with the development of chronic renal failure and end - stage renal disease ( ESRD ), with a relative risk in the range of 4 to 19.",
-            "output": "chronic renal failure, end - stage renal disease, ESRD."
-        },
-        {
-            "input": "As a result of these and other studies, phenacetin has now been withdrawn from the market in most countries.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "However, three case control studies, one each in North Carolina, northern Maryland, and West Berlin, Germany, showed that habitual use of acetaminophen is also associated with chronic renal failure and ESRD, with a relative risk in the range of 2 to 4.",
-            "output": "chronic renal failure, ESRD."
-        },
-        {
-            "input": "These studies suggest that both phenacetin and acetaminophen may contribute to the burden of ESRD, with the risk of the latter being somewhat less than that of the former.",
-            "output": "ESRD."
-        },
-        {
-            "input": "This apparent difference in risk may not be due to differences in nephrotoxic potential of the drugs themselves.",
-            "output": "nephrotoxic."
-        },
-        {
-            "input": "A lower relative risk would be expected for acetaminophen if the risk of both drugs in combination with other analgesics was higher than the risk of either agent alone.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Thus, acetaminophen has been used both as a single agent and in combination with other analgesics, whereas phenacetin was available only in combinations.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "The possibility that habitual use of acetaminophen alone increases the risk of ESRD has not been clearly demonstrated, but cannot be dismissed.",
-            "output": "ESRD."
-        },
-        {
-            "input": "Acetaminophen - induced hypotension.",
-            "output": "hypotension."
-        },
-        {
-            "input": "Through 30 years of widespread use, acetaminophen has been shown to be a remarkably safe medication in therapeutic dosages.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "The potential for acetaminophen to produce cardiovascular toxicities is very low.",
-            "output": "cardiovascular toxicities."
-        },
-        {
-            "input": "However, acetaminophen has been demonstrated to produce symptoms of anaphylaxis, including hypotension, in sensitive individuals.",
-            "output": "anaphylaxis, hypotension."
-        },
-        {
-            "input": "This article describes two critically ill patients in whom transient episodes of hypotension reproducibly developed after administration of acetaminophen.",
-            "output": "critically ill, hypotension."
-        },
-        {
-            "input": "Other symptoms of allergic reactions were not clinically detectable.",
-            "output": "allergic reactions."
-        },
-        {
-            "input": "The hypotensive episodes were severe enough to require vasopressor administration.",
-            "output": "hypotensive."
-        },
-        {
-            "input": "The reports illustrate the need for clinicians to consider acetaminophen in patients with hypotension of unknown origin.",
-            "output": "hypotension."
-        },
-        {
-            "input": "Reduction of heparan sulphate - associated anionic sites in the glomerular basement membrane of rats with streptozotocin - induced diabetic nephropathy.",
-            "output": "diabetic nephropathy."
-        },
-        {
-            "input": "Heparan sulphate - associated anionic sites in the glomerular basement membrane were studied in rats 8 months after induction of diabetes by streptozotocin and in age - adn sex - matched control rats, employing the cationic dye cuprolinic blue.",
-            "output": "diabetes."
-        },
-        {
-            "input": "Morphometric analysis at the ultrastructural level was performed using a computerized image processor.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "The heparan sulphate specificity of the cuprolinic blue staining was demonstrated by glycosaminoglycan - degrading enzymes, showing that pretreatment of the sections with heparitinase abolished all staining, whereas chondroitinase ABC had no effect.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "The majority of anionic sites ( 74 % in diabetic and 81 % in control rats ) were found within the lamina rara externa of the glomerular basement membrane.",
-            "output": "diabetic."
-        },
-        {
-            "input": "A minority of anionic sites were scattered throughout the lamina densa and lamina rara interna, and were significantly smaller than those in the lamina rara externa of the glomerular basement membrane ( p < 0. 001 and p < 0. 01 for diabetic and control rats, respectively ).",
-            "output": "diabetic."
-        },
-        {
-            "input": "Diabetic rats progressively developed albuminuria reaching 40. 3 ( 32. 2 - 62. 0 ) mg / 24 h after 8 months in contrast to the control animals ( 0. 8 ( 0. 2 - 0. 9 ) mg / 24 h, p < 0. 002 ).",
-            "output": "Diabetic, albuminuria."
-        },
-        {
-            "input": "At the same time, the number of heparan sulphate anionic sites and the total anionic site surface ( number of anionic sites x mean anionic site surface ) in the lamina rara externa of the glomerular basement membrane was reduced by 19 % ( p < 0. 021 ) and by 26 % ( p < 0. 02 ), respectively.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Number and total anionic site surface in the remaining part of the glomerular basement membrane ( lamina densa and lamina rara interna ) were not significantly changed.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "We conclude that in streptozotocin - diabetic rats with an increased urinary albumin excretion, a reduced heparan sulphate charge barrier / density is found at the lamina rara externa of the glomerular basement membrane.",
-            "output": "diabetic."
-        },
-        {
-            "input": "Mediation of enhanced reflex vagal bradycardia by L - dopa via central dopamine formation in dogs.",
-            "output": "bradycardia."
-        },
-        {
-            "input": "L - Dopa ( 5 mg / kg i. v. ) decreased blood pressure and heart rate after extracerebral decarboxylase inhibition with MK - 486 ( 25 mg / kg i. v. ) in anesthetize MAO - inhibited dogs.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "In addition, reflex bradycardia caused by injected norepinephrine was significantly enhanced by L - dopa, DL - Threo - dihydroxyphenylserine had no effect on blood pressure, heart rate or reflex responses to norepinephrine.",
-            "output": "bradycardia."
-        },
-        {
-            "input": "FLA - 63, a dopamine - beta - oxidase inhibitor, did not have any effect on the hypotension, bradycardia or reflex - enhancing effect of L - dopa.",
-            "output": "hypotension, bradycardia."
-        },
-        {
-            "input": "Pimozide did not affect the actions of L - dopa on blood pressure and heart rate but completely blocked the enhancement of reflexes.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Removal of the carotid sinuses caused an elevation blood pressure and heart rate and abolished the negative chronotropic effect of norepinephrine.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "However, L - dopa restored the bradycardia caused by norepinephrine in addition to decreasing blood pressure and heart rate.",
-            "output": "bradycardia."
-        }
-    ]
-}

MedS-Bench/NER/task128_species800_named_enetity_recognition.json

@@ -1,234 +0,0 @@
-{
-    "Contributors": [
-        "Species-800"
-    ],
-    "Source": [
-        "Species-800"
-    ],
-    "URL": [
-        "https://huggingface.co/datasets/species_800"
-    ],
-    "Categories": [
-        "Named Entity Recognition"
-    ],
-    "Definition": [
-        "Given a sentence, you need to recognize the name of the organism. There might be several correct answers. If it does not exist, you need to output \"There is no related enetity.\"."
-    ],
-    "Reasoning": [],
-    "Input_language": [
-        "English"
-    ],
-    "Output_language": [
-        "English"
-    ],
-    "Instruction_language": [
-        "English"
-    ],
-    "Domains": [
-        "Medical Knowledge"
-    ],
-    "Positive Examples": [],
-    "Negative Examples": [],
-    "Instances": [
-        {
-            "input": "Fifteen anatomical landmarks on three - dimensional Cartesian coordinates were used to describe both the shape and the size of the body of each species on the basis of the centroid located along homologous points in all of the species.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "The first vector of a principal components analysis explained 38. 5 % of the morphological variation among species, and represents a gradient of body shape from elongated, flattened bodies with narrow abdomen to rounded or convex bodies.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "The second component explained 17. 8 % of the remaining variation in body shape, which goes from species with an abdomen that is larger than the elytra to species with constricted abdomens and large elytra.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "The relationship between body size and shape was analyzed separately for diurnal and nocturnal species.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "In both guilds not only were there differences in body size, but also in body shape, suggesting a reduction in their level of competition.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Analysis of genetic variation and phylogeny of the predatory bug, Pilophorus typicus, in Japan using mitochondrial gene sequences.",
-            "output": "predatory bug, Pilophorus typicus."
-        },
-        {
-            "input": "Pilophorus typicus ( Distant ) ( Heteroptera: Miridae ) is a predatory bug occurring in East, Southeast, and South Asia.",
-            "output": "Pilophorus typicus ( Distant ) ( Heteroptera : Miridae ), predatory bug."
-        },
-        {
-            "input": "Because the active stages of P. typicus prey on various agricultural pest insects and mites, this species is a candidate insect as an indigenous natural enemy for use in biological control programs.",
-            "output": "P . typicus."
-        },
-        {
-            "input": "However, the mass releasing of introduced natural enemies into agricultural fields may incur the risk of affecting the genetic integrity of species through hybridization with a local population.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "To clarify the genetic characteristics of the Japanese populations of P. typicus two portions of the mitochondrial DNA, the cytochrome oxidase subunit I ( COI ) ( 534 bp ) and the cytochrome B ( cytB ) ( 217 bp ) genes, were sequenced for 64 individuals collected from 55 localities in a wide range of Japan.",
-            "output": "P . typicus."
-        },
-        {
-            "input": "Totals of 18 and 10 haplotypes were identified for the COI and cytB sequences, respectively ( 25 haplotypes over regions ).",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Phylogenetic analysis using the maximum likelihood method revealed the existence of two genetically distinct groups in P. typicus in Japan.",
-            "output": "P . typicus."
-        },
-        {
-            "input": "These groups were distributed in different geographic ranges: one occurred mainly from the Pacific coastal areas of the Kii Peninsula, the Shikoku Island, and the Ryukyu Islands; whereas the other occurred from the northern Kyushu district to the Kanto and Hokuriku districts of mainland Japan.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "However, both haplotypes were found in a single locality of the southern coast of the Shikoku Island.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "COI phylogeny incorporating other Pilophorus species revealed that these groups were only recently differentiated.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Therefore, use of a certain population of P. typicus across its distribution range should be done with caution because genetic hybridization may occur.",
-            "output": "P . typicus."
-        },
-        {
-            "input": "Fire ant decapitating fly cooperative release programs ( 1994 - 2008 ): two Pseudacteon species, P. tricuspis and P. curvatus, rapidly expand across imported fire ant populations in the southeastern United States.",
-            "output": "P . tricuspis, P . curvatus."
-        },
-        {
-            "input": "Natural enemies of the imported fire ants, Solenopsis invicta Buren S. richteri Forel ( Hymenoptera: Formicidae ), and their hybrid, include a suite of more than 20 fire ant decapitating phorid flies from South America in the genus Pseudacteon.",
-            "output": "Solenopsis invicta Buren, S . richteri Forel."
-        },
-        {
-            "input": "Over the past 12 years, many researchers and associates have cooperated in introducing several species as classical or self - sustaining biological control agents in the United States.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "As a result, two species of flies, Pseudacteon tricuspis Borgmeier and P. curvatus Borgmeier ( Diptera: Phoridae ), are well established across large areas of the southeastern United States.",
-            "output": "Pseudacteon tricuspis Borgmeier, P . curvatus Borgmeier."
-        },
-        {
-            "input": "Whereas many researchers have published local and state information about the establishment and spread of these flies, here distribution data from both published and unpublished sources has been compiled for the entire United States with the goal of presenting confirmed and probable distributions as of the fall of 2008.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Documented rates of expansion were also used to predict the distribution of these flies three years later in the fall of 2011.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "In the fall of 2008, eleven years after the first successful release, we estimate that P. tricuspis covered about 50 % of the fire ant quarantined area and that it will occur in almost 65 % of the quarantine area by 2011.",
-            "output": "P . tricuspis."
-        },
-        {
-            "input": "Complete coverage of the fire ant quarantined area will be delayed or limited by this species ' slow rate of spread and frequent failure to establish in more northerly portions of the fire ant range and also, perhaps, by its preference for red imported fire ants ( S. invicta ).",
-            "output": "red imported fire ants, S . invicta."
-        },
-        {
-            "input": "Eight years after the first successful release of P. curvatus, two biotypes of this species ( one biotype occurring predominantly in the black and hybrid imported fire ants and the other occurring in red imported fire ants ) covered almost 60 % of the fire ant quarantined area.",
-            "output": "P . curvatus, black, red imported fire ants."
-        },
-        {
-            "input": "We estimate these two biotypes will cover almost 90 % of the quarantine area by 2011 and 100 % by 2012 or 2013.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Strategic selection of several distributional gaps for future releases will accelerate complete coverage of quarantine areas.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "However, some gaps may be best used for the release of additional species of decapitating flies because establishment rates may be higher in areas without competing species.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Factors of susceptibility of human myiasis caused by the New World screw - worm, Cochliomyia hominivorax in Sao Gonsigmaalo, Rio de Janeiro, Brazil.",
-            "output": "human, New World screw - worm, Cochliomyia hominivorax."
-        },
-        {
-            "input": "This study was carried out between July 2007 and June 2008 and reports on the occurrence of human myiasis caused by the New World screwworm, Cochliomyia hominivorax ( Coquerel ) ( Diptera: Calliphoridae ) in Sao Gonsigmaalo in the state of Rio de Janeiro, Brazil.",
-            "output": "human, Cochliomyia hominivorax."
-        },
-        {
-            "input": "Liquid or solid vaseline was used to suffocate the larvae, which were then preserved in 70 % ethanol and sent to the Instituto Oswaldo Cruz for identification.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "C. hominivorax were identified in all 22 cases of myiasis.",
-            "output": "C . hominivorax."
-        },
-        {
-            "input": "There were 12 male and 10 female patients with ages ranging from 03 to 71.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Ethnically the highest incidence was among black people, with 17 cases.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Open wounds were the main cause of the parasitosis, whereas poor personal hygiene, the low educational level, alcoholism, bedridden patients, and physical or mental disability were possibly secondary factors; in addition to all these factors the income of the patients was very low.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Assessment of attractiveness of cassava as a roosting plant for the melon fly, Bactrocera cucurbitae, and the Oriental fruit fly, B. dorsalis.",
-            "output": "cassava, melon fly, Bactrocera cucurbitae, Oriental fruit fly, B . dorsalis."
-        },
-        {
-            "input": "Application of bait spray to crop borders is a standard approach for suppression of melon fly, Bactrocera cucurbitae ( Coquillett ) ( Diptera: Tephritidae ) populations and may also be of value for suppression of oriental fruit fly, B. dorsalis ( Hendel ) populations.",
-            "output": "melon fly, Bactrocera cucurbitae, oriental fruit fly, B . dorsalis."
-        },
-        {
-            "input": "Establishment of preferred roosting hosts as crop borders may help to improve suppression of both fruit fly species by providing sites for bait spray applications.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "In an area - wide B. cucurbitae suppression trial, the question was raised as to whether cassava, Manihot esculenta Crantz ( Euphorbiales: Euphorbiaceae ), could be used as a B. cucurbitae roosting host.",
-            "output": "B . cucurbitae, cassava, Manihot esculenta, B . cucurbitae."
-        },
-        {
-            "input": "M. esculenta was of interest as a roosting host because, in contrast to many other identified preferred roosting hosts, it would also be a crop potentially increasing the productivity of the crop production system overall.",
-            "output": "M . esculenta."
-        },
-        {
-            "input": "As a short - lived and shrubby perennial, M. esculenta potentially constitutes a crop with more persistent roosting foliage than an annual crop such as corn, Zea mays L.",
-            "output": "M . esculenta, corn, Zea mays."
-        },
-        {
-            "input": "( Cyperales: Poaceae ), that has often been planted as a roosting host for B. cucurbitae control.",
-            "output": "B . cucurbitae."
-        },
-        {
-            "input": "Using protein - baited traps set amidst potted plants placed adjacent to a papaya Carica papaya L.",
-            "output": "papaya, Carica papaya."
-        },
-        {
-            "input": "( Violales: Caricaceae ) orchard known to have established populations of B. cucurbitae and B. dorsalis, the effectiveness of M. esculenta as a roosting host was assessed by comparing its attractiveness to that of castor bean, Ricinus communis L ( Malpighiales: Euphorbiaceae ), previously identified as one of the most attractive roosting hosts for B. cucurbitae, and to corn, a crop which has been planted as a roosting host for help in B. cucurbitae control.",
-            "output": "B . cucurbitae, B . dorsalis, M . esculenta, castor bean, Ricinus communis, B . cucurbitae, corn, B . cucurbitae."
-        },
-        {
-            "input": "The results showed that use of M. esculenta as a roosting host is comparable to use of R. communis by both B. cucurbitae and B. dorsalis.",
-            "output": "M . esculenta, R . communis, B . cucurbitae, B . dorsalis."
-        },
-        {
-            "input": "These results provide encouragement to incorporate M. esculenta on a farm as a trap crop ( i. e. site for bait spray application ).",
-            "output": "M . esculenta."
-        },
-        {
-            "input": "This has the advantage of having the trap crop be a crop on its own ( as opposed to castor bean ) and, among prospective crops that could be used as a trap crop, has foliage more persistent than an annual trap crop such as corn.",
-            "output": "castor bean, corn."
-        },
-        {
-            "input": "A comparison of the pitfall trap, Winkler extractor and Berlese funnel for sampling ground - dwelling arthropods in tropical montane cloud forests.",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Little is known about the ground - dwelling arthropod diversity in tropical montane cloud forests ( TMCF ).",
-            "output": "There is no related enetity."
-        },
-        {
-            "input": "Due to unique habitat conditions in TMCFs with continuously wet substrates and a waterlogged forest floor along with the innate biases of the pitfall trap, Berlese funnel and Winkler extractor are certain to make it difficult to choose the most appropriate method to sample the ground - dwelling arthropods in TMCFs.",
-            "output": "There is no related enetity."
-        }
-    ]
-}

MedS-Bench/NER/task34_organ_extraction_anem_dataset.json

@@ -1,157 +0,0 @@
-{
-    "Contributors": [
-        "Ishani Mondal"
-    ],
-    "Source": [
-        "ANEM"
-    ],
-    "URL": [
-        "https://github.com/juand-r/entity-recognition-datasets/tree/master/data/AnEM"
-    ],
-    "Categories": [
-        "Named Entity Recognition"
-    ],
-    "Reasoning": [],
-    "Definition": [
-        "In this task, you will be given sentences in which your task is to recognize the name of the organ of the body. An organ is a collection of tissues that structurally form a functional unit specialized to perform a particular function. Although there might be several correct answers, you need to write one of them."
-    ],
-    "Input_language": [
-        "English"
-    ],
-    "Output_language": [
-        "English"
-    ],
-    "Instruction_language": [
-        "English"
-    ],
-    "Domains": [
-        "Medical Knowledge"
-    ],
-    "Positive Examples": [
-        {
-            "input": "I have serious allergy in my left eye.",
-            "output": "eye",
-            "explanation": "Eye is an organ which has been affected, hence should be tagged."
-        },
-        {
-            "input": "My ears are paining since three days.",
-            "output": "ears",
-            "explanation": "Ears denote the organs of our body; hence they should be tagged."
-        }
-    ],
-    "Negative Examples": [
-        {
-            "input": "Human eye is very sensitive.",
-            "output": "Human eye",
-            "explanation": "The organisms related to organs are not relevant and shouldn't be included."
-        },
-        {
-            "input": "Cell lung cancer is very dangerous",
-            "output": "lung cancer",
-            "explanation": "Disorders related to organs are irrelavant and therefore should not be tagged."
-        }
-    ],
-    "Instances": [
-        {
-            "id": "task1485-990d4581ab6b452fae1108d5e631efd9",
-            "input": " One of the major gangliosides in the brain is GM1 .",
-            "output": [
-                "brain"
-            ]
-        },
-        {
-            "id": "task1485-0be9d15c5c964266b94e4b829cd867c6",
-            "input": " We plan to systematically investigate the effects of thawing and refreezing on RNA integrity , by deliberately thawing and freezing small samples of brain tissue over varying time intervals and temperatures .",
-            "output": [
-                "brain"
-            ]
-        },
-        {
-            "id": "task1485-b420d65d525046c98889c47a26fda1d0",
-            "input": " ( B ) Real - time PCR was performed on total RNA samples from the human brain regions known to express MOR1 .",
-            "output": [
-                "brain"
-            ]
-        },
-        {
-            "id": "task1485-57503d760a304fc2b26c333e8526e863",
-            "input": " \" Basal values \" , obtained without the influence of subarachnoid blood , were lower than expected in \" uninjured \" brain , and this fact , although unexplained , should be kept in mind in future investigation in this field .",
-            "output": [
-                "brain"
-            ]
-        },
-        {
-            "id": "task1485-5bd32464d58547b5963ee91fb39ddec7",
-            "input": " Although values that could be predictive of brain ischemia could not be established , an incomplete recovery or continuous decrease in PtiO2 values after definitive clipping should be considered an indicator of high risk for the development of post - operative brain infarction , and , therefore , an indication for verification of the position of the clip .",
-            "output": [
-                "brain"
-            ]
-        },
-        {
-            "id": "task1485-7db02a748c0c401c89e957abe33c7445",
-            "input": " The significance of the early clinical features was not fully appreciated and the diagnosis considered only when stricture of the oesophagus became evident .",
-            "output": [
-                "oesophagus"
-            ]
-        },
-        {
-            "id": "task1485-7fa4133334344baa92094e7f3aa8528a",
-            "input": " Twelve patients were observed for periods of sufficient length for the drug effect to be assessed , and in 11 there was a good response in terms of decrease in spleen size . Cycloguanil pamoate may be of value both for prophylaxis and treatment in areas where tropical splenomegaly syndrome is endemic .",
-            "output": [
-                "spleen"
-            ]
-        },
-        {
-            "id": "task1485-f41f4e0ad3dd4be48a7023fa29017767",
-            "input": " Lung transplant 8 0 1 31",
-            "output": [
-                "Lung"
-            ]
-        },
-        {
-            "id": "task1485-7462170db3af4728b4319e668864902d",
-            "input": " The contribution to radiation risks of different exposure modes ( i . e . inhalation , ingestion and contact with ground surface ) were also analyzed , as well as of specific radionuclides and human body organs .",
-            "output": [
-                "body organs"
-            ]
-        },
-        {
-            "id": "task1485-f650b07d32024ed890e892b48c816bd3",
-            "input": " The hypocholesterolaemic and antioxidant effects of Glycyrrhiza glabra ( GG ) root powder were examined in hypercholesterolaemic male albino rats .",
-            "output": [
-                "root"
-            ]
-        },
-        {
-            "id": "task1485-c912d1643e5f4450b999690d9c3d7d32",
-            "input": " The normo - cholesterolaemic animals when fed with GG root powder at 10 gm % level , registered a significant decline in plasma lipid profiles and an increase in HDL - cholesterol content .",
-            "output": [
-                "root"
-            ]
-        },
-        {
-            "id": "task1485-23f9506dac584457aa682940ea013a93",
-            "input": " Tumor markers such as alpha - fetoprotein , human growth hormone , carcinoembryonic antigen , and placental alkaline phosphatase were negative .",
-            "output": [
-                "placental"
-            ]
-        },
-        {
-            "id": "task1485-902d7ba53f8c4281a337e702de3a177e",
-            "input": " Second trimester placental tissues were collected at the time of termination of pregnancy at 15 and 25 weeks of gestation ( in weeks of amenorrhea ) in trisomy 21 - affected pregnancies .",
-            "output": [
-                "placental"
-            ]
-        },
-        {
-            "id": "task1485-41f05a71c3e943a8a7af6c4c0d53c6e6",
-            "input": " Term placentas were obtained after elective cesarean section from healthy mothers near term with uncomplicated pregnancies .",
-            "output": [
-                "placentas"
-            ]
-        }
-    ],
-    "Instance License": [
-        "Unknown"
-    ]
-}

MedS-Bench/NER/task35_cell_extraction_anem_dataset.json

@@ -1,150 +0,0 @@
-{
-    "Contributors": [
-        "Ishani Mondal"
-    ],
-    "Source": [
-        "ANEM"
-    ],
-    "URL": [
-        "https://github.com/juand-r/entity-recognition-datasets/tree/master/data/AnEM"
-    ],
-    "Categories": [
-        "Named Entity Recognition"
-    ],
-    "Reasoning": [],
-    "Definition": [
-        "In this task, you will be given sentences in which you have to recognize the name of the body cells. A cell is a mass of cytoplasm that is bound externally by a cell membrane. Usually microscopic in size, cells are the smallest structural units of living matter and compose all living things. Although there might be several correct answers, you need to write one of them."
-    ],
-    "Input_language": [
-        "English"
-    ],
-    "Output_language": [
-        "English"
-    ],
-    "Instruction_language": [
-        "English"
-    ],
-    "Domains": [
-        "Medical Knowledge"
-    ],
-    "Positive Examples": [
-        {
-            "input": "HeLa cells were first treated with 250 mug / ml Trail followed by pulse labeling of newly synthesized proteins with [ 35S ] methionine.",
-            "output": "HeLa cells",
-            "explanation": "HeLa cells are the first immortal human cell line. It should be tagged."
-        },
-        {
-            "input": "Antisperm antibodies were assessed in the serum samples of 73 men unable to ejaculate naturally and on the sperm cells of 13 of these men .",
-            "output": "sperm",
-            "explanation": "Sperm is a male reproductive cell, produced by most animals, hence needs to be identified."
-        }
-    ],
-    "Negative Examples": [
-        {
-            "input": "On pathologic examination of the specimen , typical large tumor cells with lymphocytic cell infiltration and prominent granulomatous reaction were observed .",
-            "output": "tumor cells with lymphocytic cell",
-            "explanation": "Detailed description of the tumor cells are irrelvant and should not be included."
-        },
-        {
-            "input": "Antisperm antibodies were assessed in the serum samples of 73 men unable to ejaculate naturally and on the sperm cells of 13 of these men .",
-            "output": "sperm cells of 13 of these men",
-            "explanation": "Organisms containing the cells are not required and should be excluded."
-        }
-    ],
-    "Instances": [
-        {
-            "id": "task1486-71b0b24d368d4069b99978f9286be4aa",
-            "input": " Wild - type neurons were electroporated with vectors expressing GFP ( control ; A , C , E ) or expressing a FLAG - tagged constitutively - active MEK1 ( CA - MEK1 ; B , D , F ) .",
-            "output": [
-                "neurons"
-            ]
-        },
-        {
-            "id": "task1486-b401edcab38841389f28734b3cc0462f",
-            "input": " Ephrin - A5 induces a growth cone collapse , resulting in reduced growth cone area and filopodia number in GFP but not CA - MEK1 expressing neurons .",
-            "output": [
-                "neurons"
-            ]
-        },
-        {
-            "id": "task1486-b63c598d566a4bff904fce4336ee44ea",
-            "input": " In mock - electroporated neurons , BDNF induced an IEG response of c - fos ( A ) , Egr1 ( B ) , Egr2 ( C ) and Arc ( D ) .",
-            "output": [
-                "neurons"
-            ]
-        },
-        {
-            "id": "task1486-3708097ff0fb4afe8a65b3b6583bf851",
-            "input": " Co - application of ephrin - A5 and BDNF reduced mRNA levels of all four IEGs in mock - electroporated neurons ( A - D ) .",
-            "output": [
-                "neurons"
-            ]
-        },
-        {
-            "id": "task1486-dbcf197eef924b798824c9561e886e99",
-            "input": " The average neurite length of neurons overexpressing CA - MEK1 ( Fig . 5B ) was clearly reduced compared to control GFP expressing neurons ( Fig . 5A ; see quantification in ( G ) ) .",
-            "output": [
-                "neurons"
-            ]
-        },
-        {
-            "id": "task1486-04811da9cb284669ac88f3d47a20a1b3",
-            "input": " Growth cones of GFP ( C ) and CA - MEK1 expressing neurons were similar and protruded many filopodia ( arrows in Fig . 5C - F ) .",
-            "output": [
-                "neurons"
-            ]
-        },
-        {
-            "id": "task1486-9678a9e82cea4e24a957effbffbc04fd",
-            "input": " In contrast , in neurons overexpressing CA - MEK1 ( Fig . 5F ) , ephrin - A5 induced only a partial growth cone collapse .",
-            "output": [
-                "neurons"
-            ]
-        },
-        {
-            "id": "task1486-4fa2a026df804cfb99e44a0dbe0b7d85",
-            "input": " In agreement with previous results ( Fig . 4 ) , in mock - electroporated neurons , ephrin - A5 incubation reduced the BDNF - mediated up - regulation of c - fos ( Fig . 6A ) , Egr1 ( Fig . 6B ) , Egr2 ( Fig . 6C ) and Arc ( Fig . 6D ) mRNA .",
-            "output": [
-                "neurons"
-            ]
-        },
-        {
-            "id": "task1486-50f78bca90fa4497b7b14909ef5a3a09",
-            "input": " In contrast , in neurons over - expressing CA - MEK1 , ephrin - A5 could not suppress BDNF - induced IEG responses to the same degree .",
-            "output": [
-                "neurons"
-            ]
-        },
-        {
-            "id": "task1486-c20bf01e8e9a4ddcb589a663228f0cc5",
-            "input": " Particularly Egr1 ( Fig . 6B ) and Egr2 ( Fig . 6C ) mRNA levels were almost identical when comparing neurons treated with BDNF alone and neurons with BDNF and ephrin - A5 together .",
-            "output": [
-                "neurons"
-            ]
-        },
-        {
-            "id": "task1486-225ce363a755474f8ef4c570c7abe4ae",
-            "input": " In vitro cytotoxic potential and mechanism of action of selected coumarins , using human renal cell lines .",
-            "output": [
-                "cell lines"
-            ]
-        },
-        {
-            "id": "task1486-8e9a08a7f8914f8b87771454f89d6c25",
-            "input": " In the same way of thinking , studies have demonstrated that the maintenance of methylated histone H3 Lys4 by Set7 / 9 , a member of the SET methyltransferase family , is crucial to Pdx1 activity in beta - cell lines [ 111 - 113 ] .",
-            "output": [
-                "cell lines"
-            ]
-        },
-        {
-            "id": "task1486-b968153062a94f64874503b9f4786d2b",
-            "input": " ( A , B ) Overexpression of CA - MEK1 ( B ) reduces mean neurite length compared to a control GFP - expressing neuron ( A ) .",
-            "output": [
-                "neuron"
-            ]
-        }
-    ],
-    "Instance License": [
-        "Unknown"
-    ]
-}

MedS-Bench/NLI/task41_mednli_textual_entailment_discrimitive.json

@@ -1,234 +0,0 @@
-{
-    "Contributors": [
-        "mednli authors"
-    ],
-    "Source": [
-        "MedNLI"
-    ],
-    "URL": [
-        "https://jgc128.github.io/mednli/"
-    ],
-    "Categories": [
-        "Textual Entailment"
-    ],
-    "Definition": [
-        "In medical, a practical task is to perform textual inference. In the following, you will be first presented with a formal clinical premise statement. It may be some condition descriptions or numerical results. Then I will give you a hypothesis statement, you have to determine whether the hypothesis statement can be inferred from the clinical conditions. The two statements will be distinguished our following the format like 'sentence1: ...\n\nsentence2: ...'. You should make your answer clear and short, picking a choice from 3 options: entailment, contradiction, or neutral. "
-    ],
-    "Reasoning": [],
-    "Input_language": [
-        "English"
-    ],
-    "Output_language": [
-        "English"
-    ],
-    "Instruction_language": [
-        "English"
-    ],
-    "Domains": [
-        "Clinical Text"
-    ],
-    "Positive Examples": [],
-    "Negative Examples": [],
-    "Instances": [
-        {
-            "input": "Sentence1: There were frothy secretions from ETT.\n\nSentence2:  the patient is on room air",
-            "output": "Contradiction"
-        },
-        {
-            "input": "Sentence1: There were frothy secretions from ETT.\n\nSentence2:  the patient has pneumonia",
-            "output": "Neutral"
-        },
-        {
-            "input": "Sentence1: Meningioma (lesion identified by CT on [**6-30**] in left perimesencephalic region, being followed) -S/p appendectomy -S/p bilateral oophorectomy and hysterectomy -gout\n\nSentence2:  The patient has a benign brain mass. ",
-            "output": "Entailment"
-        },
-        {
-            "input": "Sentence1: Meningioma (lesion identified by CT on [**6-30**] in left perimesencephalic region, being followed) -S/p appendectomy -S/p bilateral oophorectomy and hysterectomy -gout\n\nSentence2:  The patient has an appendix. ",
-            "output": "Contradiction"
-        },
-        {
-            "input": "Sentence1: Meningioma (lesion identified by CT on [**6-30**] in left perimesencephalic region, being followed) -S/p appendectomy -S/p bilateral oophorectomy and hysterectomy -gout\n\nSentence2:  The patient had ovarian cancer. ",
-            "output": "Neutral"
-        },
-        {
-            "input": "Sentence1: He was transferred to [**Hospital1 1499**] for further management.\n\nSentence2:  The patient was moved to a different location. ",
-            "output": "Entailment"
-        },
-        {
-            "input": "Sentence1: He was transferred to [**Hospital1 1499**] for further management.\n\nSentence2:  The patient was not transferred. ",
-            "output": "Contradiction"
-        },
-        {
-            "input": "Sentence1: He was transferred to [**Hospital1 1499**] for further management.\n\nSentence2:  The patient required higher level of care. ",
-            "output": "Neutral"
-        },
-        {
-            "input": "Sentence1: 62 year old woman with well known history of Aortic stenosis followed by serial echocardiograms.\n\nSentence2:  The patient is being followed for a cardiac condition",
-            "output": "Entailment"
-        },
-        {
-            "input": "Sentence1: 62 year old woman with well known history of Aortic stenosis followed by serial echocardiograms.\n\nSentence2:  Normal cardiac function and anatomy",
-            "output": "Contradiction"
-        },
-        {
-            "input": "Sentence1: 62 year old woman with well known history of Aortic stenosis followed by serial echocardiograms.\n\nSentence2:  She has angina and syncope ",
-            "output": "Neutral"
-        },
-        {
-            "input": "Sentence1: LGIB secondary to rectal ulcer:[**Date range (3) 25131**] with rectal ulcer s/p sigmoidoscopy and cauterization.\n\nSentence2:  The patient has had issues with bleeding. ",
-            "output": "Entailment"
-        },
-        {
-            "input": "Sentence1: LGIB secondary to rectal ulcer:[**Date range (3) 25131**] with rectal ulcer s/p sigmoidoscopy and cauterization.\n\nSentence2:  The patient has had no bleeding issues. ",
-            "output": "Contradiction"
-        },
-        {
-            "input": "Sentence1: LGIB secondary to rectal ulcer:[**Date range (3) 25131**] with rectal ulcer s/p sigmoidoscopy and cauterization.\n\nSentence2:  The patient had a endoscope guided laser ablation of the ulcer. ",
-            "output": "Neutral"
-        },
-        {
-            "input": "Sentence1: Chronic renal failure due to acute tubular nephropathy in [**2700**] s/p renal transplant (second living related renal transplant in 993) Listeria infection in [**2701**].\n\nSentence2:  The patient has a renal transplant. ",
-            "output": "Entailment"
-        },
-        {
-            "input": "Sentence1: Chronic renal failure due to acute tubular nephropathy in [**2700**] s/p renal transplant (second living related renal transplant in 993) Listeria infection in [**2701**].\n\nSentence2:  The patient has functioning native kidneys.",
-            "output": "Contradiction"
-        },
-        {
-            "input": "Sentence1: Chronic renal failure due to acute tubular nephropathy in [**2700**] s/p renal transplant (second living related renal transplant in 993) Listeria infection in [**2701**].\n\nSentence2:  The patient is immunosuppressed.",
-            "output": "Neutral"
-        },
-        {
-            "input": "Sentence1: On arrival she had an approximately 5 mm bleeding ulceration at the midpoint of a large 5 cm by 3 cm aneurysm.\n\nSentence2:  Patient has atherosclerosis",
-            "output": "Entailment"
-        },
-        {
-            "input": "Sentence1: On arrival she had an approximately 5 mm bleeding ulceration at the midpoint of a large 5 cm by 3 cm aneurysm.\n\nSentence2:  Patient has normal vasculature",
-            "output": "Contradiction"
-        },
-        {
-            "input": "Sentence1: On arrival she had an approximately 5 mm bleeding ulceration at the midpoint of a large 5 cm by 3 cm aneurysm.\n\nSentence2:  Patient has low blood pressure",
-            "output": "Neutral"
-        },
-        {
-            "input": "Sentence1: On admission, her hematocrit was 55.4 and was 55.4 secondary to her history of polycythemia, and was due for a blood removal the day after admission.\n\nSentence2:  Patient has elevated HCt",
-            "output": "Entailment"
-        },
-        {
-            "input": "Sentence1: On admission, her hematocrit was 55.4 and was 55.4 secondary to her history of polycythemia, and was due for a blood removal the day after admission.\n\nSentence2:  Patient has normal Hct",
-            "output": "Contradiction"
-        },
-        {
-            "input": "Sentence1: On admission, her hematocrit was 55.4 and was 55.4 secondary to her history of polycythemia, and was due for a blood removal the day after admission.\n\nSentence2:  Patient has elevated Hgb",
-            "output": "Neutral"
-        },
-        {
-            "input": "Sentence1: Patient states that this began with hematemesis on Friday and subsided on Sunday, with melena beginning over teh past several days.\n\nSentence2:  Patient has upper GI bleed",
-            "output": "Entailment"
-        },
-        {
-            "input": "Sentence1: Patient states that this began with hematemesis on Friday and subsided on Sunday, with melena beginning over teh past several days.\n\nSentence2:  Patient has normal stool hemeoccult test",
-            "output": "Contradiction"
-        },
-        {
-            "input": "Sentence1: Patient states that this began with hematemesis on Friday and subsided on Sunday, with melena beginning over teh past several days.\n\nSentence2:  Patient has abnormal EGD",
-            "output": "Neutral"
-        },
-        {
-            "input": "Sentence1: After workup and discussion at tumor conference it was decided with the patient to schedule a gastrectomy.\n\nSentence2:  the patient is scheduled for gastrectomy",
-            "output": "Entailment"
-        },
-        {
-            "input": "Sentence1: After workup and discussion at tumor conference it was decided with the patient to schedule a gastrectomy.\n\nSentence2:  the patient is not an operative canidate",
-            "output": "Contradiction"
-        },
-        {
-            "input": "Sentence1: After workup and discussion at tumor conference it was decided with the patient to schedule a gastrectomy.\n\nSentence2:  the patient has a GIST",
-            "output": "Neutral"
-        },
-        {
-            "input": "Sentence1: She does report fatigue.\n\nSentence2:  Patient has ongoing weakness",
-            "output": "Entailment"
-        },
-        {
-            "input": "Sentence1: She does report fatigue.\n\nSentence2:  Patient has a negative ROS",
-            "output": "Contradiction"
-        },
-        {
-            "input": "Sentence1: She does report fatigue.\n\nSentence2:  Patient has lymphoma",
-            "output": "Neutral"
-        },
-        {
-            "input": "Sentence1: No vision changes or diplopia.\n\nSentence2:  He has no double vision",
-            "output": "Entailment"
-        },
-        {
-            "input": "Sentence1: No vision changes or diplopia.\n\nSentence2:  He has recent loss of vision",
-            "output": "Contradiction"
-        },
-        {
-            "input": "Sentence1: No vision changes or diplopia.\n\nSentence2:  He has normal visual acuity ",
-            "output": "Neutral"
-        },
-        {
-            "input": "Sentence1: Pt reports having HA, N&Vx1, diplopia.\n\nSentence2:  Patient has headache",
-            "output": "Entailment"
-        },
-        {
-            "input": "Sentence1: Pt reports having HA, N&Vx1, diplopia.\n\nSentence2:  Patient has no symptoms",
-            "output": "Contradiction"
-        },
-        {
-            "input": "Sentence1: Pt reports having HA, N&Vx1, diplopia.\n\nSentence2:  Patient has double vision",
-            "output": "Neutral"
-        },
-        {
-            "input": "Sentence1: He had no gag reflex, and was intubated for airway protection with lidocaine, vecuronium, fentanyl, succinylcholine, and etomidate.\n\nSentence2:  the patient is unresponsive",
-            "output": "Entailment"
-        },
-        {
-            "input": "Sentence1: He had no gag reflex, and was intubated for airway protection with lidocaine, vecuronium, fentanyl, succinylcholine, and etomidate.\n\nSentence2:  the patient is alert",
-            "output": "Contradiction"
-        },
-        {
-            "input": "Sentence1: He had no gag reflex, and was intubated for airway protection with lidocaine, vecuronium, fentanyl, succinylcholine, and etomidate.\n\nSentence2:  the patient has diffuse axonal injury",
-            "output": "Neutral"
-        },
-        {
-            "input": "Sentence1: Pt has chronic diarrhea.\n\nSentence2:  The patient has frequent bowel movements",
-            "output": "Entailment"
-        },
-        {
-            "input": "Sentence1: Pt has chronic diarrhea.\n\nSentence2:  The patient denies diarrhea ",
-            "output": "Contradiction"
-        },
-        {
-            "input": "Sentence1: Pt has chronic diarrhea.\n\nSentence2:  The patient complains of abdominal pain",
-            "output": "Neutral"
-        },
-        {
-            "input": "Sentence1: The patient was found to have nonpalpable radial pulses.\n\nSentence2:  Radial pulses were unable to be appreciated on this patient",
-            "output": "Entailment"
-        },
-        {
-            "input": "Sentence1: The patient was found to have nonpalpable radial pulses.\n\nSentence2:  The patient has bounding pulses",
-            "output": "Contradiction"
-        },
-        {
-            "input": "Sentence1: The patient was found to have nonpalpable radial pulses.\n\nSentence2:  The patient has a history of cardiac diseaes",
-            "output": "Neutral"
-        },
-        {
-            "input": "Sentence1: Patient denies any history of CVA, TIA, headache, or syncope.\n\nSentence2:  The patient has never had symptoms of a stroke. ",
-            "output": "Entailment"
-        },
-        {
-            "input": "Sentence1: Patient denies any history of CVA, TIA, headache, or syncope.\n\nSentence2:  The patient has has multiple strokes. ",
-            "output": "Contradiction"
-        },
-        {
-            "input": "Sentence1: Patient denies any history of CVA, TIA, headache, or syncope.\n\nSentence2:  The patient has never had a stroke. ",
-            "output": "Neutral"
-        }
-    ]
-}

MedS-Bench/NLI/task42_mednli_textual_entailment_generative.json

@@ -1,234 +0,0 @@
-{
-    "Contributors": [
-        "mednli authors"
-    ],
-    "Source": [
-        "MedNLI"
-    ],
-    "URL": [
-        "https://jgc128.github.io/mednli/"
-    ],
-    "Categories": [
-        "Textual Entailment"
-    ],
-    "Definition": [
-        "You are a experienced doctor. Next, your task is to perform textual entailment. In the following, you will be presented with a formal clinical premise statement. You should write a clearly right hypothesis statement based on it. "
-    ],
-    "Reasoning": [],
-    "Input_language": [
-        "English"
-    ],
-    "Output_language": [
-        "English"
-    ],
-    "Instruction_language": [
-        "English"
-    ],
-    "Domains": [
-        "Clinical Text"
-    ],
-    "Positive Examples": [],
-    "Negative Examples": [],
-    "Instances": [
-        {
-            "input": "There were frothy secretions from ett.",
-            "output": "The patient is intubated."
-        },
-        {
-            "input": "Meningioma (lesion identified by ct on [**6-30**] in left perimesencephalic region, being followed) -s/p appendectomy -s/p bilateral oophorectomy and hysterectomy -gout",
-            "output": "The patient has a benign brain mass."
-        },
-        {
-            "input": "He was transferred to [**hospital1 1499**] for further management.",
-            "output": "The patient was moved to a different location."
-        },
-        {
-            "input": "62 year old woman with well known history of aortic stenosis followed by serial echocardiograms.",
-            "output": "The patient is being followed for a cardiac condition."
-        },
-        {
-            "input": "Lgib secondary to rectal ulcer:[**date range (3) 25131**] with rectal ulcer s/p sigmoidoscopy and cauterization.",
-            "output": "The patient has had issues with bleeding."
-        },
-        {
-            "input": "Chronic renal failure due to acute tubular nephropathy in [**2700**] s/p renal transplant (second living related renal transplant in 993) listeria infection in [**2701**].",
-            "output": "The patient has a renal transplant."
-        },
-        {
-            "input": "On arrival she had an approximately 5 mm bleeding ulceration at the midpoint of a large 5 cm by 3 cm aneurysm.",
-            "output": "Patient has atherosclerosis."
-        },
-        {
-            "input": "On admission, her hematocrit was 55.4 and was 55.4 secondary to her history of polycythemia, and was due for a blood removal the day after admission.",
-            "output": "Patient has elevated hct."
-        },
-        {
-            "input": "Patient states that this began with hematemesis on friday and subsided on sunday, with melena beginning over teh past several days.",
-            "output": "Patient has upper gi bleed."
-        },
-        {
-            "input": "After workup and discussion at tumor conference it was decided with the patient to schedule a gastrectomy.",
-            "output": "The patient is scheduled for gastrectomy."
-        },
-        {
-            "input": "She does report fatigue.",
-            "output": "Patient has ongoing weakness."
-        },
-        {
-            "input": "No vision changes or diplopia.",
-            "output": "He has no double vision."
-        },
-        {
-            "input": "Pt reports having ha, n&vx1, diplopia.",
-            "output": "Patient has headache."
-        },
-        {
-            "input": "He had no gag reflex, and was intubated for airway protection with lidocaine, vecuronium, fentanyl, succinylcholine, and etomidate.",
-            "output": "The patient is unresponsive."
-        },
-        {
-            "input": "Pt has chronic diarrhea.",
-            "output": "The patient has frequent bowel movements."
-        },
-        {
-            "input": "The patient was found to have nonpalpable radial pulses.",
-            "output": "Radial pulses were unable to be appreciated on this patient."
-        },
-        {
-            "input": "Patient denies any history of cva, tia, headache, or syncope.",
-            "output": "The patient has never had symptoms of a stroke."
-        },
-        {
-            "input": "He also received levoflox 500 mg and flagyl 500 mg for concern for gi pathology.",
-            "output": "The patient has both aerobic and anaerobic bacterial coverage."
-        },
-        {
-            "input": "Electrocardiograms revealed no qrs changes.",
-            "output": "The patient is not having a stemi."
-        },
-        {
-            "input": "Electrocardiogram demonstrated inferior st elevation and st depression in v2 and q waves in the inferior leads.",
-            "output": "The patient is having a stemi."
-        },
-        {
-            "input": "Atrial fibrillation, onset [**8-19**], s/p cv [**1-16**], recurred [**2-18**]  9.",
-            "output": "Arrhythmia."
-        },
-        {
-            "input": "Per ems notes, the pt. called ems complaining of labored breathing.",
-            "output": "The patient had shortness of breath."
-        },
-        {
-            "input": "She received 1 unit ffp, vitamin k 10 mg x1, and 20 meq of kcl at osh.",
-            "output": "The patient has a high inr."
-        },
-        {
-            "input": "Decompressive laparotomy showed massive dilated loops of bowel without specific obstruction.",
-            "output": "The patient has dilated bowel without obstruction."
-        },
-        {
-            "input": "Left total hip replacement 4.",
-            "output": "History of hip surgery."
-        },
-        {
-            "input": "Patient stated that there were positive sick contacts at work.",
-            "output": "The patient has been around sick coworkers."
-        },
-        {
-            "input": "The patient received 10 units of reteplase times two over 30 minutes.",
-            "output": "The patient received a thrombolytic drug."
-        },
-        {
-            "input": "55yom with pmh sig for thrombocytosis s/p splenectomy, p/w black, tarry stool this morning.",
-            "output": "Patient has gi bleed."
-        },
-        {
-            "input": "[**name initial (nameis) 12116**] [**3-6**] bleomycin-induced lung injury.",
-            "output": "History of cancer."
-        },
-        {
-            "input": "Cordis was placed.",
-            "output": "Patient has central line."
-        },
-        {
-            "input": "Daughter reports \"personality changes\". -last year she reportedly had a \"deterioration\" of her ability to care for herself, of unclear etiology.",
-            "output": "The patient has failure to thrive."
-        },
-        {
-            "input": "The patient was the intoxicated unrestrained driver of a high speed motor vehicle involved in a rollover accident.",
-            "output": "The patient suffered a major trauma."
-        },
-        {
-            "input": "Her uop was also poor, with 10 cc/2 hours.",
-            "output": "The patient has poor renal perfusion."
-        },
-        {
-            "input": "She was cardioverted times two with return to normal sinus rhythm.",
-            "output": "Patient has a history of arrhythmia."
-        },
-        {
-            "input": "Mra brain and neck showed no flow above the petrous ica bilaterally with an occluded left vertebral.",
-            "output": "Patient has abnormal imaging."
-        },
-        {
-            "input": "History of present illness:  the patient is a 70-year-old male who was struck by a vehicle traveling about 25 miles per hour.",
-            "output": "Patient has had trauma."
-        },
-        {
-            "input": "Diabetes mellitus type i, has had for over 40 years, on insulin pump.",
-            "output": "Patient has a chronic medical condition."
-        },
-        {
-            "input": "He was started on a lidocaine drip but continued to have nsvt.",
-            "output": "The patient has nsvt."
-        },
-        {
-            "input": "Status post right hip prosthesis.",
-            "output": "The patient is at risk for a deep vein thrombosis."
-        },
-        {
-            "input": "History of present illness:  the patient is a 74 year old female with metastatic ovarian carcinoma status post total abdominal hysterectomy/bilateral salpingo-oophorectomy, omentectomy, ileus cecectomy on [**3121-9-22**], by dr. [**last name (stitle) **], complicated by perforation of anastomosis on [**3121-12-24**], requiring an exploratory laparotomy, lysis of adhesions, resection of anastomosis, ileostomy and mucous fistula.",
-            "output": "Patient has malignancy."
-        },
-        {
-            "input": "Today, o2 sat 85% ra, 96% 2l nc.",
-            "output": "The patient is hypoxic on room air."
-        },
-        {
-            "input": "He continues to complain of tremors.",
-            "output": "The patient has symptoms of shaking."
-        },
-        {
-            "input": "Per patient's wife, she heard a thud in the other room and found the patient \"jerking\" on the ground.",
-            "output": "The patient was found by his wife."
-        },
-        {
-            "input": "The patient reports that she was healthy prior to this event and that she has had no further symptoms since that time.",
-            "output": "Patient healthy at baseline."
-        },
-        {
-            "input": "Congestive heart failure, [**3061-4-9**], ejection fraction 55% with 1+ mitral regurgitation and 2+ tricuspid regurgitation.",
-            "output": "The patient has a normal ejection fraction."
-        },
-        {
-            "input": "Her hematocrit was unchanged at 35.",
-            "output": "Her hematocrit has been 35 previously."
-        },
-        {
-            "input": "2 weeks discharge on [**3080-12-11**], mr.",
-            "output": "The patient was hospitalized."
-        },
-        {
-            "input": "History of hypothyroidism.",
-            "output": "The patient is on thyroid replacement medication."
-        },
-        {
-            "input": "Neurological exam shows patient to be moving all extremities, reactive, with normal newborn reflexes such as grasp and suck.",
-            "output": "Neurological exam reveals no abnormalities."
-        },
-        {
-            "input": "Past medical history:  peripheral vascular disease, history of alcohol abuse, history of type 2 diabetes noninsulin- dependent, history of colonic polyps, history of hypertension, history of bph status post turp, history of gastroesophageal reflux disease, history of coronary artery disease, status post cardiac catheterization, history of gi bleeds, history of hemorrhoids.",
-            "output": "The patient has elevated blood sugars."
-        }
-    ]
-}

MedS-Bench/Reasoning/task51_mmedbench_explanation_chinese_test_only.json

@@ -1,234 +0,0 @@
-{
-    "Contributors": [
-        "MAGIC"
-    ],
-    "Source": [
-        "MMedBench"
-    ],
-    "URL": [
-        "https://huggingface.co/datasets/Henrychur/MMedBench"
-    ],
-    "Categories": [
-        "Explanation"
-    ],
-    "Definition": [
-        "Given a question and its answer, generate an explanation statement."
-    ],
-    "Reasoning": [],
-    "Input_language": [
-        "Chinese"
-    ],
-    "Output_language": [
-        "Chinese"
-    ],
-    "Instruction_language": [
-        "English"
-    ],
-    "Domains": [
-        "Medical Knowledge"
-    ],
-    "Positive Examples": [],
-    "Negative Examples": [],
-    "Instances": [
-        {
-            "input": "\u95ee\u9898: \u7329\u7ea2\u70ed\u591a\u5728\u53d1\u70ed\u540e\u591a\u4e45\u51fa\u73b0\u76ae\u75b9\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: 12\u5c0f\u65f6\u4e4b\u5185\tB: 12\uff5e48\u5c0f\u65f6\tC: 60\uff5e72\u5c0f\u65f6\tD: \u5927\u4e8e96\u5c0f\u65f6\t\n\u6b63\u786e\u7b54\u6848\u662f B: 12\uff5e48\u5c0f\u65f6\u3002",
-            "output": "\u9009\u62e9B\u7684\u7406\u7531\u662f\u7329\u7ea2\u70ed\u7684\u4e34\u5e8a\u8868\u73b0\u901a\u5e38\u9075\u5faa\u7279\u5b9a\u7684\u65f6\u95f4\u987a\u5e8f\u3002\u7329\u7ea2\u70ed\u662f\u7531A\u7ec4\u03b2\u6eb6\u8840\u6027\u94fe\u7403\u83cc\u611f\u67d3\u5f15\u8d77\u7684\uff0c\u53d1\u75c5\u901a\u5e38\u4f34\u6709\u9ad8\u70e7\u548c\u54bd\u75db\u3002\u76ae\u75b9\u4e00\u822c\u5728\u53d1\u70ed\u540e12\u523048\u5c0f\u65f6\u5185\u51fa\u73b0\uff0c\u8fd9\u4e00\u65f6\u671f\u5bf9\u5e94\u4e8e\u7ec6\u83cc\u6bd2\u7d20\u7684\u4ea7\u751f\u548c\u4f53\u5185\u53cd\u5e94\u3002\u76ae\u75b9\u6700\u521d\u51fa\u73b0\u5728\u8033\u540e\u548c\u9888\u90e8\uff0c\u4e4b\u540e\u53ef\u80fd\u8513\u5ef6\u5230\u8eab\u4f53\u5176\u4ed6\u90e8\u5206\u300212\u5c0f\u65f6\u4e4b\u5185\uff08\u9009\u9879A\uff09\u901a\u5e38\u8fd8\u672a\u51fa\u73b0\u76ae\u75b9\uff0c\u800c60\uff5e72\u5c0f\u65f6\uff08\u9009\u9879C\uff09\u548c\u5927\u4e8e96\u5c0f\u65f6\uff08\u9009\u9879D\uff09\u5219\u4e3a\u7329\u7ea2\u70ed\u7684\u76ae\u75b9\u51fa\u73b0\u65f6\u95f4\u5df2\u8fc7\u957f\uff0c\u6545\u9009B 12\uff5e48\u5c0f\u65f6\u4e3a\u6700\u4f73\u7b54\u6848\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: \u6700\u5b9c\u9009\u7528\u963f\u53f8\u5339\u6797\u6cbb\u7597\u7684\u662f\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: \u80c3\u80a0\u75c9\u631b\u6027\u7ede\u75db\tB: \u6708\u7ecf\u75db\tC: \u5fc3\u7ede\u75db\tD: \u80be\u7ede\u75db\t\n\u6b63\u786e\u7b54\u6848\u662f B: \u6708\u7ecf\u75db\u3002",
-            "output": "\u6708\u7ecf\u75db\u591a\u7531\u524d\u5217\u817a\u7d20\u5f15\u8d77\u5b50\u5bab\u8fc7\u5ea6\u6536\u7f29\uff0c\u51fa\u73b0\u75bc\u75db\u3002\u963f\u53f8\u5339\u6797\u5c5e\u4e8e\u975e\u753e\u4f53\u6297\u708e\u836f\uff0c\u5176\u4f5c\u7528\u673a\u5236\u662f\u901a\u8fc7\u6291\u5236\u73af\u6c27\u5316\u9176(COX)\u9176\u7684\u6d3b\u6027, \u51cf\u5c11\u524d\u5217\u817a\u7d20\u7684\u751f\u6210\uff0c\u4ece\u800c\u51cf\u8f7b\u524d\u5217\u817a\u7d20\u5f15\u8d77\u7684\u5b50\u5bab\u6536\u7f29\u548c\u75bc\u75db\u3002\u76f8\u8f83\u4e8e\u5fc3\u7ede\u75db\u3001\u80c3\u80a0\u75c9\u631b\u6027\u7ede\u75db\u548c\u80be\u7ede\u75db\uff0c\u6708\u7ecf\u75db\u4e0e\u524d\u5217\u817a\u7d20\u7684\u76f8\u5173\u6027\u66f4\u5f3a\uff0c\u56e0\u6b64\u963f\u53f8\u5339\u6797\u5728\u6cbb\u7597\u6708\u7ecf\u75db\u65f6\u6548\u679c\u66f4\u663e\u8457\u3002\u6240\u4ee5\u9009\u9879B\u201c\u6708\u7ecf\u75db\u201d\u662f\u963f\u53f8\u5339\u6797\u6cbb\u7597\u6700\u4e3a\u9002\u5b9c\u7684\u75be\u75c5\u3002\u5176\u4ed6\u9009\u9879\u4e2d\u7684\u75be\u75c5\u4e0e\u524d\u5217\u817a\u7d20\u7684\u4f5c\u7528\u5173\u8054\u4e0d\u5927\uff0c\u4e0d\u662f\u963f\u53f8\u5339\u6797\u7684\u4e3b\u8981\u9002\u5e94\u75c7\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: 3\uff0e\u80fd\u6291\u5236DNA\u75c5\u6bd2\u7684\u836f\u7269\u662f\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: \u56db\u73af\u7d20\tB: \u5229\u5df4\u97e6\u6797\tC: \u6c1f\u5eb7\u5511\tD: \u6797\u53ef\u9709\u7d20\t\n\u6b63\u786e\u7b54\u6848\u662f B: \u5229\u5df4\u97e6\u6797\u3002",
-            "output": "\u7531\u4e8e\u5229\u5df4\u97e6\u6797\u662f\u4e00\u79cd\u6297\u75c5\u6bd2\u836f\u7269\uff0c\u5b83\u80fd\u901a\u8fc7\u5f71\u54cd\u75c5\u6bd2\u7684RNA\u4f9d\u8d56\u6027RNA\u805a\u5408\u9176\u6d3b\u6027\u6765\u6291\u5236\u75c5\u6bd2\u7684\u590d\u5236\u3002\u867d\u7136\u5b83\u4e3b\u8981\u7528\u4e8e\u6cbb\u7597RNA\u75c5\u6bd2\uff08\u5982\u809d\u708eC\u75c5\u6bd2\uff09\uff0c\u4f46\u5b83\u4e5f\u663e\u793a\u51fa\u5bf9\u67d0\u4e9bDNA\u75c5\u6bd2\uff08\u5982\u547c\u5438\u9053\u5408\u80de\u4f53\u75c5\u6bd2\u548c\u67d0\u4e9b\u75b1\u75b9\u75c5\u6bd2\uff09\u6709\u4e00\u5b9a\u7684\u6291\u5236\u4f5c\u7528\u3002\u76f8\u6bd4\u4e4b\u4e0b\uff0c\u56db\u73af\u7d20\u662f\u4e00\u79cd\u6297\u751f\u7d20\uff0c\u4e3b\u8981\u7528\u4e8e\u6cbb\u7597\u7ec6\u83cc\u611f\u67d3\uff0c\u5e76\u4e0d\u9488\u5bf9\u75c5\u6bd2\u611f\u67d3\uff1b\u6c1f\u5eb7\u5511\u662f\u4e00\u79cd\u6297\u771f\u83cc\u836f\uff1b\u6797\u53ef\u9709\u7d20\u4e5f\u662f\u6297\u7ec6\u83cc\u7684\u6297\u751f\u7d20\u3002\u56e0\u6b64\uff0cB\u9009\u9879\uff08\u5229\u5df4\u97e6\u6797\uff09\u662f\u552f\u4e00\u80fd\u591f\u6291\u5236DNA\u75c5\u6bd2\u7684\u836f\u7269\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: \u5728\u9aa8\u9abc\u808c\u5174\u594b\u2014\u6536\u7f29\u8026\u8054\u4e2d\u8d77\u5173\u952e\u4f5c\u7528\u7684\u79bb\u5b50\u662f\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: K+\tB: Cl-\tC: Mg2+\tD: Ca2+\t\n\u6b63\u786e\u7b54\u6848\u662f D: Ca2+\u3002",
-            "output": "\u9009\u62e9\u8fd9\u4e2a\u7b54\u6848\u7684\u539f\u56e0\u662f\uff0c\u5728\u9aa8\u9abc\u808c\u7684\u5174\u594b\u2014\u6536\u7f29\u8026\u8054\uff08ECC\uff09\u8fc7\u7a0b\u4e2d\uff0c\u9499\u79bb\u5b50\uff08Ca2+\uff09\u626e\u6f14\u4e86\u81f3\u5173\u91cd\u8981\u7684\u89d2\u8272\u3002\u5f53\u52a8\u4f5c\u7535\u4f4d\u4f20\u5bfc\u81f3\u808c\u8089\u7ec6\u80de\u65f6\uff0c\u4f1a\u89e6\u53d1\u7ec6\u80de\u5185\u9499\u79bb\u5b50\u7684\u91ca\u653e\u3002\u8fd9\u4e9b\u9499\u79bb\u5b50\u4e0e\u808c\u8089\u86cb\u767d\u7ec4\u4ef6\uff08\u808c\u8282\u548c\u808c\u52a8\u86cb\u767d\uff09\u7ed3\u5408\uff0c\u4ece\u800c\u5f15\u8d77\u808c\u8089\u7ea4\u7ef4\u7684\u6ed1\u52a8\u548c\u808c\u8089\u6536\u7f29\u3002\u65e0\u9499\u79bb\u5b50\u7684\u53c2\u4e0e\uff0c\u8fd9\u4e00\u8fc7\u7a0b\u5c06\u65e0\u6cd5\u8fdb\u884c\u3002\u800c\u5176\u4ed6\u9009\u9879A\u7684K+\u3001B\u7684Cl-\u3001\u548cC\u7684Mg2+\u867d\u7136\u5728\u808c\u8089\u5174\u594b\u548c\u7ec6\u80de\u529f\u80fd\u4e2d\u6709\u5404\u81ea\u7684\u4f5c\u7528\uff0c\u4f46\u5728\u5174\u594b\u2014\u6536\u7f29\u8026\u8054\u8fd9\u4e00\u5177\u4f53\u8fc7\u7a0b\u4e2d\uff0c\u4f5c\u7528\u4e0d\u53caCa2+\u5173\u952e\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: 1\uff0e\u62a2\u6551\u4e2d\u3001\u91cd\u5ea6\u6709\u673a\u78f7\u9178\u916f\u7c7b\u4e2d\u6bd2\u7684\u836f\u7269\u662f\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: \u963f\u6258\u54c1+\u6bdb\u679c\u82b8\u9999\u78b1\tB: \u963f\u6258\u54c1+\u7898\u89e3\u78f7\u5b9a\tC: \u53bb\u7532\u80be\u4e0a\u817a\u7d20\tD: \u8272\u7518\u9178\u94a0\t\n\u6b63\u786e\u7b54\u6848\u662f B: \u963f\u6258\u54c1+\u7898\u89e3\u78f7\u5b9a\u3002",
-            "output": "\u9009\u62e9B\uff08\u963f\u6258\u54c1+\u7898\u89e3\u78f7\u5b9a\uff09\u7684\u539f\u56e0\u662f\uff0c\u6709\u673a\u78f7\u9178\u916f\u4e2d\u6bd2\u4f1a\u6291\u5236\u4e59\u9170\u80c6\u78b1\u916f\u9176\u7684\u6d3b\u6027\uff0c\u5bfc\u81f4\u4e59\u9170\u80c6\u78b1\u79ef\u7d2f\uff0c\u4ea7\u751f\u6bd2\u6027\u6548\u5e94\u3002\u963f\u6258\u54c1\u53ef\u4ee5\u4f5c\u4e3a\u80c6\u78b1\u80fd\u53d7\u4f53\u62ee\u6297\u5242\uff0c\u964d\u4f4e\u4e59\u9170\u80c6\u78b1\u7684\u6548\u5e94\uff0c\u7f13\u89e3\u75c7\u72b6\u3002\u7898\u89e3\u78f7\u5b9a\u5219\u80fd\u4e0e\u6709\u673a\u78f7\u9178\u916f\u7ed3\u5408\uff0c\u901a\u8fc7\u975e\u9176\u4fc3\u8fc7\u7a0b\u6062\u590d\u4e59\u9170\u80c6\u78b1\u916f\u9176\u7684\u6d3b\u6027\uff0c\u662f\u7279\u5f02\u6027\u89e3\u6bd2\u5242\u3002\u8fd9\u4e24\u79cd\u836f\u7269\u8054\u5408\u4f7f\u7528\u80fd\u6709\u6548\u5bf9\u6297\u4e2d\u5230\u91cd\u5ea6\u7684\u6709\u673a\u78f7\u9178\u916f\u7c7b\u4e2d\u6bd2\uff0c\u8c03\u8282\u751f\u7406\u529f\u80fd\uff0c\u6240\u4ee5\u662f\u6b63\u786e\u7b54\u6848\u3002\u5176\u4ed6\u9009\u62e9\u7269\u7f3a\u4e4f\u8fd9\u79cd\u8054\u5408\u89e3\u6bd2\u6548\u679c\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: 2\u5c81\u5973\u5b69\uff0c\u56e0\u751f\u957f\u53d1\u80b2\u843d\u540e\uff0c\u667a\u529b\u53d1\u80b2\u843d\u540e\u6765\u8bca\u3002\u6b64\u60a3\u513f\u51fa\u751f\u540e\u5373\u6709\u5403\u5976\u5dee\uff0c\u8179\u80c0\u3001\u4fbf\u79d8\uff0c\u5c11\u54ed\u3001\u5c11\u52a8\uff0c\u54ed\u58f0\u5636\u54d1\uff0c\u8fd12\uff5e3\u4e2a\u6708\u51fa\u73b0\u9762\u90e8\u3001\u773c\u7751\u6c34\u80bf\u3002\u81f3\u4eca\u4e0d\u4f1a\u8bf4\u8bdd\u3001\u4e0d\u4f1a\u8d70\u8def\u3002\u4f53\u68c0\uff1a\u4f53\u6e2935.7\u2103\uff0c\u5fc3\u738766\u6b21/mm\uff0c\u547c\u543822\u6b21/min\uff0c\u76ae\u80a4\u7c97\u7cd9\uff0c\u6bdb\u53d1\u5e72\u71e5\uff0c\u8868\u60c5\u5446\u6ede\uff0c\u58f0\u97f3\u5636\u54d1\uff0c\u773c\u8ddd\u5bbd\uff0c\u9f3b\u6881\u4f4e\u5e73\uff0c\u820c\u4f38\u51fa\u53e3\u5916\uff0c\u9762\u90e8\u773c\u7751\u6c34\u80bf\uff0c\u53cc\u80ba\u542c\u8bca\u65e0\u5570\u97f3\uff0c\u5fc3\u97f3\u4f4e\u949d\uff0c\u8179\u81a8\u9686\uff0c\u6709\u8110\u759d\uff0c\u56db\u80a2\u808c\u5f20\u529b\u5f31\u30023\uff0e\u5e94\u9009\u62e9\u7684\u6700\u4f73\u6cbb\u7597\u836f\u7269\u662f\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: \u03b3-hGH\tB: \u591a\u5df4\u80fa\tC: \u5de6\u65cb\u7532\u72b6\u817a\u7d20\u94a0\tD: \u9499\u5242\t\n\u6b63\u786e\u7b54\u6848\u662f C: \u5de6\u65cb\u7532\u72b6\u817a\u7d20\u94a0\u3002",
-            "output": "\u6b642\u5c81\u5973\u5b69\u7684\u4e34\u5e8a\u75c7\u72b6\u548c\u4f53\u5f81\u8868\u73b0\u4e3a\u751f\u957f\u53d1\u80b2\u8fdf\u7f13\u3001\u667a\u529b\u53d1\u80b2\u8fdf\u7f13\u3001\u5582\u517b\u56f0\u96be\uff08\u5403\u5976\u5dee\uff09\u3001\u8179\u80c0\u3001\u4fbf\u79d8\u3001\u5c11\u54ed\u5c11\u52a8\u3001\u54ed\u58f0\u5636\u54d1\u3001\u9762\u90e8\u548c\u773c\u7751\u6c34\u80bf\u3001\u4e0d\u4f1a\u8bf4\u8bdd\u548c\u8d70\u8def\u7b49\u3002\u7ed3\u5408\u4f53\u68c0\u53d1\u73b0\u4f53\u6e29\u4f4e\u3001\u5fc3\u7387\u6162\u3001\u547c\u5438\u6162\u3001\u76ae\u80a4\u7c97\u7cd9\u3001\u6bdb\u53d1\u5e72\u71e5\u3001\u8868\u60c5\u5446\u6ede\u3001\u58f0\u97f3\u5636\u54d1\u3001\u773c\u8ddd\u5bbd\u3001\u9f3b\u6881\u4f4e\u3001\u820c\u80bf\u4f38\u51fa\u53e3\u5916\u3001\u56db\u80a2\u808c\u5f20\u529b\u5f31\u7b49\u53ef\u80fd\u8868\u793a\u8be5\u60a3\u513f\u60a3\u6709\u5148\u5929\u6027\u7532\u72b6\u817a\u529f\u80fd\u51cf\u9000\u75c7\uff08\u514b\u6c40\u75c5\uff09\u3002\u6cbb\u7597\u8be5\u75c7\u7684\u9996\u9009\u836f\u7269\u662f\u5de6\u65cb\u7532\u72b6\u817a\u7d20\u94a0\uff08\u9009\u9879C\uff09\uff0c\u7528\u4ee5\u66ff\u4ee3\u7f3a\u5931\u7684\u7532\u72b6\u817a\u6fc0\u7d20\uff0c\u6539\u5584\u60a3\u513f\u7684\u4ee3\u8c22\u72b6\u6001\u548c\u4fc3\u8fdb\u5176\u751f\u957f\u53d1\u80b2\u3002\u5176\u4ed6\u9009\u9879\u4e0e\u514b\u6c40\u75c5\u7684\u6cbb\u7597\u65e0\u76f4\u63a5\u5173\u8054\uff0c\u56e0\u6b64\u4e0d\u9009\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: 2\uff0e\u5fc5\u987b\u5728\u536b\u751f\u9632\u75ab\u673a\u6784\u7684\u6307\u5bfc\u76d1\u7763\u4e0b\u4e25\u5bc6\u6d88\u6bd2\u540e\u5904\u7406\u7684\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: \u88ab\u7532\u7c7b\u4f20\u67d3\u75c5\u75c5\u539f\u4f53\u6c61\u67d3\u7684\u6c61\u6c34\tB: \u88ab\u53ef\u7591\u4e59\u7c7b\u4f20\u67d3\u75c5\u4eba\u7528\u8fc7\u7684\u7269\u54c1\tC: \u88ab\u53ef\u7591\u4e19\u7c7b\u4f20\u67d3\u75c5\u4eba\u7528\u8fc7\u7684\u7269\u54c1\tD: \u88ab\u4e19\u7c7b\u4f20\u67d3\u75c5\u75c5\u539f\u4f53\u6c61\u67d3\u7684\u6c61\u6c34\t\n\u6b63\u786e\u7b54\u6848\u662f A: \u88ab\u7532\u7c7b\u4f20\u67d3\u75c5\u75c5\u539f\u4f53\u6c61\u67d3\u7684\u6c61\u6c34\u3002",
-            "output": "\u9009\u62e9A\u7684\u539f\u56e0\u662f\u7532\u7c7b\u4f20\u67d3\u75c5\u4ee3\u8868\u7740\u6700\u4e25\u91cd\u7684\u4f20\u67d3\u75c5\u7c7b\u522b\uff0c\u5305\u62ec\u761f\u75ab\u3001\u970d\u4e71\u7b49\uff0c\u5176\u75c5\u539f\u4f53\u6781\u6613\u4f20\u64ad\uff0c\u5371\u5bb3\u6781\u5927\u3002\u4e00\u65e6\u6c61\u6c34\u88ab\u7532\u7c7b\u4f20\u67d3\u75c5\u75c5\u539f\u4f53\u6c61\u67d3\uff0c\u5982\u679c\u4e0d\u7ecf\u8fc7\u4e13\u4e1a\u7684\u6d88\u6bd2\u5904\u7406\uff0c\u5c31\u53ef\u80fd\u9020\u6210\u5e7f\u6cdb\u7684\u4f20\u64ad\u548c\u5f71\u54cd\u516c\u5171\u536b\u751f\u5b89\u5168\u3002\u56e0\u6b64\uff0c\u5fc5\u987b\u5728\u536b\u751f\u9632\u75ab\u673a\u6784\u7684\u6307\u5bfc\u76d1\u7763\u4e0b\u8fdb\u884c\u4e25\u5bc6\u6d88\u6bd2\uff0c\u4ee5\u786e\u4fdd\u75c5\u539f\u4f53\u5f97\u5230\u6709\u6548\u7684\u6740\u706d\uff0c\u5207\u65ad\u4f20\u64ad\u9014\u5f84\uff0c\u4fdd\u62a4\u4eba\u7fa4\u5065\u5eb7\u3002\u800c\u4e59\u7c7b\u548c\u4e19\u7c7b\u4f20\u67d3\u75c5\u867d\u7136\u4e5f\u9700\u8981\u76f8\u5e94\u7684\u9632\u63a7\u63aa\u65bd\uff0c\u4f46\u5b83\u4eec\u7684\u4f20\u64ad\u529b\u548c\u5371\u5bb3\u6027\u76f8\u5bf9\u8f83\u4f4e\uff0c\u5904\u7406\u4e0a\u7684\u8981\u6c42\u901a\u5e38\u4e0d\u5982\u7532\u7c7b\u4f20\u67d3\u75c5\u90a3\u4e48\u4e25\u683c\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: \u5728\u6025\u6027\u708e\u75c7\u8fc7\u7a0b\u4e2d\uff0c\u4e0b\u5217\u6539\u53d8\u54ea\u4e00\u79cd\u6700\u5148\u51fa\u73b0\uff1f\uff08\u3000\u3000\uff09\n\u9009\u9879: A: \u7ec6\u52a8\u8109\u53ca\u5fae\u8840\u7ba1\u6269\u5f20\tB: \u7ec6\u52a8\u8109\u6536\u7f29\tC: \u8840\u6d41\u901f\u5ea6\u51cf\u6162\tD: \u767d\u7ec6\u80de\u9644\u58c1\t\n\u6b63\u786e\u7b54\u6848\u662f B: \u7ec6\u52a8\u8109\u6536\u7f29\u3002",
-            "output": "\u9009\u62e9B\u201c\u7ec6\u52a8\u8109\u6536\u7f29\u201d\u4f5c\u4e3a\u6700\u5148\u51fa\u73b0\u7684\u6539\u53d8\uff0c\u4e3b\u8981\u57fa\u4e8e\u6025\u6027\u708e\u75c7\u53cd\u5e94\u7684\u521d\u59cb\u9636\u6bb5\u662f\u7ec6\u52a8\u8109\u53d7\u5230\u795e\u7ecf\u8c03\u63a7\u6216\u708e\u75c7\u4ecb\u8d28\u4f5c\u7528\uff0c\u5148\u884c\u53d1\u751f\u77ed\u6682\u6027\u6536\u7f29\uff0c\u8fd9\u662f\u673a\u4f53\u505a\u51fa\u7684\u521d\u6b65\u9632\u5fa1\u53cd\u5e94\u3002\u968f\u540e\uff0c\u7ec6\u52a8\u8109\u5c06\u8fc5\u901f\u6269\u5f20\uff0c\u4f34\u968f\u7740\u6bdb\u7ec6\u8840\u7ba1\u901a\u900f\u6027\u589e\u52a0\uff0c\u5bfc\u81f4\u767d\u7ec6\u80de\u548c\u8840\u6d46\u6210\u5206\u8fdb\u5165\u708e\u75c7\u533a\u57df\u3002\u56e0\u6b64\uff0c\u867d\u7136\u7ec6\u52a8\u8109\u53ca\u5fae\u8840\u7ba1\u6269\u5f20\uff08A\uff09\u662f\u663e\u8457\u7684\u708e\u75c7\u8868\u73b0\uff0c\u4f46\u5b83\u662f\u5728\u77ed\u6682\u7684\u7ec6\u52a8\u8109\u6536\u7f29\uff08B\uff09\u4e4b\u540e\u53d1\u751f\u7684\u3002\u8840\u6d41\u901f\u5ea6\u51cf\u6162\uff08C\uff09\u548c\u767d\u7ec6\u80de\u9644\u58c1\uff08D\uff09\u662f\u7ec6\u52a8\u8109\u6269\u5f20\u540e\u8fdb\u4e00\u6b65\u53d1\u5c55\u7684\u4e8b\u4ef6\u3002\u56e0\u6b64\uff0cB\u9009\u9879\u4ee3\u8868\u4e86\u65f6\u95f4\u987a\u5e8f\u4e0a\u7684\u6700\u5148\u6539\u53d8\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: 2\uff0e\u4e0a\u8ff0\u54ea\u9879\u4e3a\u4eba\u4f53\u5b9e\u9a8c\u7684\u6838\u5fc3\u5b97\u65e8\uff1f\uff08\u3000\u3000\uff09\n\u9009\u9879: A: \u4ee5\u75c5\u4eba\u4f5c\u4e3a\u53d7\u8bd5\u5bf9\u8c61\u7684\u8bd5\u9a8c\tB: \u4ee5\u4eba\u4f5c\u4e3a\u53d7\u8bd5\u5bf9\u8c61\u7684\u8bd5\u9a8c\tC: \u4eba\u4f53\u5b9e\u9a8c\u65f6\u5fc5\u987b\u8981\u505a\u5230\u771f\u6b63\u7684\u77e5\u60c5\u540c\u610f\tD: \u4fdd\u969c\u53d7\u8bd5\u8005\u8eab\u5fc3\u5b89\u5168\t\n\u6b63\u786e\u7b54\u6848\u662f D: \u4fdd\u969c\u53d7\u8bd5\u8005\u8eab\u5fc3\u5b89\u5168\u3002",
-            "output": "\u9009\u62e9D\u9879\u201c\u4fdd\u969c\u53d7\u8bd5\u8005\u8eab\u5fc3\u5b89\u5168\u201d\u4e3a\u4eba\u4f53\u5b9e\u9a8c\u7684\u6838\u5fc3\u5b97\u65e8\u662f\u56e0\u4e3a\uff0c\u53d7\u8bd5\u8005\u7684\u5b89\u5168\u662f\u533b\u5b66\u7814\u7a76\u4e2d\u6700\u4e3a\u91cd\u8981\u7684\u8003\u91cf\u3002\u65e0\u8bba\u5b9e\u9a8c\u7684\u76ee\u7684\u662f\u4ec0\u4e48\uff0c\u5728\u8fdb\u884c\u4eba\u4f53\u5b9e\u9a8c\u65f6\uff0c\u5fc5\u987b\u786e\u4fdd\u53d7\u8bd5\u8005\u4e0d\u4f1a\u53d7\u5230\u4f24\u5bb3\u3002\u771f\u6b63\u7684\u77e5\u60c5\u540c\u610f\uff08\u9009\u9879C\uff09\u662f\u786e\u4fdd\u53d7\u8bd5\u8005\u5b89\u5168\u7684\u524d\u63d0\u4e4b\u4e00\uff0c\u4f46\u5b83\u672c\u8eab\u4e0d\u662f\u5b97\u65e8\uff0c\u800c\u662f\u8fbe\u5230\u5b97\u65e8\u7684\u624b\u6bb5\u4e4b\u4e00\u3002\u5728\u533b\u5b66\u4f26\u7406\u4e2d\uff0c\u201c\u4e0d\u4f24\u5bb3\u201d\u7684\u539f\u5219\u59cb\u7ec8\u5360\u636e\u9996\u8981\u4f4d\u7f6e\uff0c\u56e0\u6b64\u4fdd\u969c\u53d7\u8bd5\u8005\u7684\u8eab\u5fc3\u5b89\u5168\u662f\u8fdb\u884c\u4efb\u4f55\u4eba\u4f53\u5b9e\u9a8c\u65f6\u6700\u57fa\u672c\u4e5f\u662f\u6700\u6838\u5fc3\u7684\u5b97\u65e8\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: \u5973\u6027,22\u5c81\uff0c\u5de6\u4e73\u623f\u5916\u4e0a\u8c61\u9650\u5355\u53d1\u80bf\u5757\uff0c\u65e0\u5176\u4ed6\u4e0d\u9002\u75c7\u72b6\uff0c\u80bf\u5757\u8868\u9762\u5149\u6ed1\uff0c\u6613\u63a8\u52a8\uff0c\u53ef\u80fd\u7684\u8bca\u65ad\u4e3a\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: \u4e73\u817a\u708e\tB: \u4e73\u817a\u56ca\u80bf\tC: \u4e73\u817a\u7ea4\u7ef4\u817a\u7624\tD: \u4e73\u817a\u764c\t\n\u6b63\u786e\u7b54\u6848\u662f C: \u4e73\u817a\u7ea4\u7ef4\u817a\u7624\u3002",
-            "output": "\u9009\u62e9C\uff08\u4e73\u817a\u7ea4\u7ef4\u817a\u7624\uff09\u7684\u7406\u7531\u662f\uff1a\u60a3\u8005\u5e74\u8f7b\uff0c\u4ec522\u5c81\uff0c\u4e14\u80bf\u5757\u5355\u53d1\uff0c\u8868\u9762\u5149\u6ed1\uff0c\u6613\u63a8\u52a8\uff0c\u8fd9\u4e9b\u7279\u70b9\u8f83\u7b26\u5408\u4e73\u817a\u7ea4\u7ef4\u817a\u7624\u7684\u4e34\u5e8a\u8868\u73b0\u3002\u4e73\u817a\u708e\uff08A\u9009\u9879\uff09\u901a\u5e38\u4f34\u6709\u7ea2\u3001\u70ed\u3001\u75db\u7b49\u708e\u75c7\u75c7\u72b6\uff0c\u5e76\u4e14\u53ef\u80fd\u4f1a\u6709\u53d1\u70ed\u3001\u4e73\u6c41\u6de4\u79ef\u7b49\u4f53\u5f81\u3002\u4e73\u817a\u56ca\u80bf\uff08B\u9009\u9879\uff09\u867d\u7136\u4e0e\u7ea4\u7ef4\u817a\u7624\u5728\u67d0\u4e9b\u8868\u73b0\u4e0a\u76f8\u4f3c\uff0c\u4f46\u4e73\u623f\u56ca\u80bf\u5f80\u5f80\u4e0e\u6708\u7ecf\u5468\u671f\u76f8\u5173\uff0c\u4e14\u5728\u8d85\u58f0\u68c0\u67e5\u4e0a\u53ef\u89c1\u6db2\u4f53\u5145\u6ee1\u7684\u7279\u70b9\u3002\u4e73\u817a\u764c\uff08D\u9009\u9879\uff09\u901a\u5e38\u5728\u8f83\u9ad8\u5e74\u9f84\u6bb5\u4e2d\u51fa\u73b0\uff0c\u80bf\u5757\u5e38\u5e38\u8d28\u5730\u786c\u3001\u8fb9\u754c\u4e0d\u6e05\uff0c\u4e14\u4e0e\u76ae\u80a4\u6216\u6df1\u5c42\u7ec4\u7ec7\u7c98\u8fde\u56fa\u5b9a\u3002\u57fa\u4e8e\u6b64\u60a3\u8005\u7684\u5e74\u9f84\u548c\u80bf\u5757\u7684\u6027\u8d28\uff0c\u9009\u62e9C\u4e3a\u6700\u53ef\u80fd\u7684\u8bca\u65ad\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: \u996e\u5927\u91cf\u6e05\u6c34\u540e\u5c3f\u91cf\u589e\u52a0\u7684\u4e3b\u8981\u539f\u56e0\u662f\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: \u80be\u5c0f\u7403\u6bdb\u7ec6\u8840\u7ba1\u8840\u538b\u589e\u9ad8\tB: \u8840\u6d46\u80f6\u4f53\u6e17\u900f\u538b\u964d\u4f4e\tC: \u6297\u5229\u5c3f\u6fc0\u7d20\u5206\u6ccc\u51cf\u5c11\tD: \u919b\u56fa\u916e\u5206\u6ccc\u51cf\u5c11\t\n\u6b63\u786e\u7b54\u6848\u662f C: \u6297\u5229\u5c3f\u6fc0\u7d20\u5206\u6ccc\u51cf\u5c11\u3002",
-            "output": "\u9009\u62e9C\u201c\u6297\u5229\u5c3f\u6fc0\u7d20\u5206\u6ccc\u51cf\u5c11\u201d\u662f\u56e0\u4e3a\u6297\u5229\u5c3f\u6fc0\u7d20\uff08ADH\uff09\u7684\u4e3b\u8981\u4f5c\u7528\u662f\u589e\u52a0\u80be\u810f\u7684\u6c34\u91cd\u5438\u6536\u3002\u5f53\u996e\u7528\u5927\u91cf\u6e05\u6c34\u540e\uff0c\u4f53\u5185\u7684\u6c34\u4efd\u4f1a\u589e\u52a0\uff0c\u4e3a\u4e86\u8c03\u8282\u4f53\u5185\u7684\u6c34\u548c\u7535\u89e3\u8d28\u5e73\u8861\uff0c\u51cf\u5c11\u8840\u6d46\u7684\u6e17\u900f\u6d53\u5ea6\uff0c\u8eab\u4f53\u4f1a\u901a\u8fc7\u51cf\u5c11\u6297\u5229\u5c3f\u6fc0\u7d20\u7684\u5206\u6ccc\uff0c\u6765\u964d\u4f4e\u80be\u810f\u5bf9\u6c34\u7684\u91cd\u5438\u6536\uff0c\u4ece\u800c\u589e\u52a0\u5c3f\u91cf\u6392\u51fa\u591a\u4f59\u7684\u6c34\u5206\uff0c\u9632\u6b62\u51fa\u73b0\u4f4e\u94a0\u8840\u75c7\u7b49\u5f02\u5e38\u72b6\u6001\u3002\u5176\u4ed6\u9009\u9879\uff0c\u5982A\u3001B\u548cD\uff0c\u867d\u7136\u4e5f\u4f1a\u5f71\u54cd\u5c3f\u91cf\uff0c\u4f46\u5728\u6b64\u60c5\u51b5\u4e0b\u5e76\u975e\u996e\u7528\u5927\u91cf\u6e05\u6c34\u540e\u5c3f\u91cf\u589e\u52a0\u7684\u4e3b\u8981\u539f\u56e0\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: Auer\u5c0f\u4f53\u6700\u5e38\u89c1\u4e8e\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: \u7c7b\u767d\u8840\u75c5\u53cd\u5e94\tB: \u6025\u6027\u7c92\u7ec6\u80de\u81ea\u8840\u75c5\tC: \u6025\u6027\u6dcb\u5df4\u7ec6\u80de\u767d\u8840\u75c5\tD: \u6162\u6027\u6dcb\u5df4\u7ec6\u80de\u767d\u8840\u75c5\t\n\u6b63\u786e\u7b54\u6848\u662f B: \u6025\u6027\u7c92\u7ec6\u80de\u81ea\u8840\u75c5\u3002",
-            "output": "Auer\u5c0f\u4f53\u662f\u6025\u6027\u9ad3\u7cfb\u767d\u8840\u75c5\u7279\u6709\u7684\u7ec6\u80de\u5185\u5305\u6db5\u4f53\uff0c\u5c24\u5176\u662f\u6025\u6027\u7c92\u7ec6\u80de\u767d\u8840\u75c5\u4e2d\u8f83\u4e3a\u5e38\u89c1\u3002\u9009\u62e9B\u9879\uff08\u6025\u6027\u7c92\u7ec6\u80de\u767d\u8840\u75c5\uff09\u7684\u7406\u7531\u662f\u7531\u4e8eAuer\u5c0f\u4f53\u591a\u51fa\u73b0\u5728\u5f02\u5e38\u589e\u6b96\u7684\u9ad3\u7cfb\u524d\u4f53\u7ec6\u80de\uff0c\u5982\u7c92\u7ec6\u80de\u7cfb\u5217\u3002\u800c\u5728\u7c7b\u767d\u8840\u75c5\u53cd\u5e94\u3001\u6162\u6027\u6dcb\u5df4\u7ec6\u80de\u767d\u8840\u75c5\u6216\u6025\u6027\u6dcb\u5df4\u7ec6\u80de\u767d\u8840\u75c5\u4e2d\uff0c\u8fd9\u79cd\u5305\u6db5\u4f53\u76f8\u5bf9\u4e0d\u5e38\u89c1\u3002\u7c7b\u767d\u8840\u75c5\u53cd\u5e94\u662f\u53cd\u6620\u673a\u4f53\u5bf9\u67d0\u4e9b\u523a\u6fc0\u7684\u751f\u7406\u6027\u6216\u75c5\u7406\u6027\u53cd\u5e94\uff0c\u5e76\u4e0d\u7279\u6307\u67d0\u79cd\u764c\u75c7\uff1b\u6162\u6027\u6dcb\u5df4\u7ec6\u80de\u767d\u8840\u75c5\u548c\u6025\u6027\u6dcb\u5df4\u7ec6\u80de\u767d\u8840\u75c5\u90fd\u5c5e\u4e8e\u6dcb\u5df4\u7cfb\u7ec6\u80de\u5f02\u5e38\u589e\u6b96\uff0c\u800c\u4e0d\u662f\u9ad3\u7cfb\u7ec6\u80de\u3002\u56e0\u6b64\uff0c\u6700\u4e3a\u5408\u9002\u7684\u9009\u62e9\u662fB\u9879\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: \u7537\u6027\uff0c35\u5c81\uff0c\u56e02\u5929\u6765\u8179\u6cfb\u4e8e8\u670820\u65e5\u6765\u8bca\u3002\u60a3\u8005\u5916\u51fa\u65c5\u6e38\u5f52\u6765\uff0c\u5927\u4fbf\u6bcf\u65e510\u591a\u6b21\uff0c\u4f34\u5455\u5410\u591a\u6b21\uff0c\u4e0d\u53d1\u70ed\uff0c\u53e3\u6e34\uff0cBP100/70mmHg\uff0cP 100\u6b21/\u5206\uff0c\u8179\u8f6f\u65e0\u538b\u75db\uff0c\u80a0\u9e23\u97f3\u6d3b\u8dc3\uff0c\u5927\u4fbf\u955c\u68c0WBC 0\uff5e1/HP\u30021\uff0e\u6b64\u75c5\u4eba\u6700\u53ef\u80fd\u7684\u8bca\u65ad\u662f\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: \u6025\u6027\u83cc\u75e2\tB: \u6025\u6027\u80c3\u80a0\u708e\tC: \u80c3\u80a0\u578b\u98df\u7269\u4e2d\u6bd2\tD: \u970d\u4e71\t\n\u6b63\u786e\u7b54\u6848\u662f D: \u970d\u4e71\u3002",
-            "output": "\u9009\u62e9D\u970d\u4e71\u7684\u7406\u7531\u662f\u60a3\u8005\u6709\u5916\u51fa\u65c5\u6e38\u53f2\uff0c\u51fa\u73b0\u5927\u4fbf\u6b21\u6570\u660e\u663e\u589e\u591a\uff0c\u5e76\u4f34\u6709\u9891\u7e41\u5455\u5410\uff0c\u662f\u970d\u4e71\u7684\u5178\u578b\u75c7\u72b6\u3002\u6b64\u5916\uff0c\u60a3\u8005\u8868\u73b0\u4e3a\u53e3\u6e34\uff0c\u4f4e\u8840\u538b\uff08BP100/70mmHg\uff09\u548c\u5fc3\u7387\u589e\u5feb\uff08P 100\u6b21/\u5206\uff09\uff0c\u8fd9\u90fd\u4e0e\u970d\u4e71\u5f15\u8d77\u7684\u5927\u91cf\u4f53\u6db2\u548c\u7535\u89e3\u8d28\u4e22\u5931\u76f8\u7b26\u5408\u3002\u5c3d\u7ba1\u5927\u4fbf\u955c\u68c0\u767d\u7ec6\u80de\u8ba1\u6570\u4e0d\u9ad8\uff080\uff5e1/HP\uff09\uff0c\u4f46\u8fd9\u5e76\u4e0d\u6392\u9664\u970d\u4e71\u8bca\u65ad\uff0c\u56e0\u4e3a\u970d\u4e71\u7684\u7279\u70b9\u662f\u5206\u6ccc\u6027\u8179\u6cfb\uff0c\u800c\u975e\u708e\u75c7\u6027\u3002\u8003\u8651\u5230\u4ee5\u4e0a\u4e34\u5e8a\u8868\u73b0\uff0c\u970d\u4e71\u662f\u6700\u53ef\u80fd\u7684\u8bca\u65ad\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: \u5973\uff0c15\u5c81\u3002\u53d1\u73b0\u8d2b\u8840\u3001\u9ec4\u75b85\u5e74\u3002\u813e\u808b\u4e0b2.5cm\uff0c\u8d28\u4e2d\u3002\u8840\u7ea2\u86cb\u767d90g/L\uff0c\u7f51\u7ec7\u7ea2\u7ec6\u80de\u6bd4\u4f8b0.05\uff0c\u767d\u7ec6\u80de\u548c\u8840\u5c0f\u677f\u5747\u6b63\u5e38\u3002\u7ea2\u7ec6\u80de\u6e17\u900f\u538b\u6e17\u900f\u8106\u6027\u8bd5\u9a8c\uff1a0.7\uff05\u76d0\u6c34\u6eb6\u6db2\u5f00\u59cb\u6eb6\u8840\u3002\u5176\u7236\u4e5f\u6709\u8f7b\u5ea6\u9ec4\u75b8\u30022\uff0e\u8981\u660e\u786e\u8bca\u65ad\uff0c\u6700\u6709\u4ef7\u503c\u7684\u5b9e\u9a8c\u5ba4\u68c0\u67e5\u662f\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: \u5468\u56f4\u8840\u7247\tB: \u9aa8\u9ad3\u8c61\tC: \u8840\u6e05\u94c1\u603b\u94c1\u7ed3\u5408\u529b\tD: \u8840\u7ea2\u86cb\u767d\u7535\u6cf3\t\n\u6b63\u786e\u7b54\u6848\u662f A: \u5468\u56f4\u8840\u7247\u3002",
-            "output": "\u6839\u636e\u9898\u5e72\u4fe1\u606f\uff0c\u8be5\u5973\u6027\u60a3\u8005\u8d2b\u8840\u548c\u9ec4\u75b8\u8fc1\u5ef6\u591a\u5e74\uff0c\u8d85\u51fa\u4e86\u751f\u7406\u6027\u7684\u8303\u56f4\uff0c\u63d0\u793a\u53ef\u80fd\u4e3a\u9057\u4f20\u6027\u6eb6\u8840\u6027\u75be\u75c5\u3002\u7ea2\u7ec6\u80de\u6e17\u900f\u538b\u8bd5\u9a8c\u63d0\u793a\u4f4e\u4e8e\u6b63\u5e38\u503c\uff0c\u663e\u793a\u6eb6\u8840\u73b0\u8c61\uff0c\u4e14\u4e0e\u7236\u4eb2\u7684\u8f7b\u5ea6\u9ec4\u75b8\u76f8\u7b26\u5408\uff0c\u5f88\u53ef\u80fd\u662f\u9057\u4f20\u6027\u7ea2\u7ec6\u80de\u5f02\u5e38\u6240\u81f4\u3002\u9009\u9879A\u7684\u5468\u56f4\u8840\u7247\uff0c\u53ef\u4ee5\u89c2\u5bdf\u5230\u7ea2\u7ec6\u80de\u7684\u5f62\u6001\uff0c\u53ef\u80fd\u51fa\u73b0\u5f02\u5e38\u5f62\u6001\u7684\u7ea2\u7ec6\u80de\uff08\u5982\u523a\u7403\u7ec6\u80de\u3001\u5706\u5f62\u4e0d\u6210\u719f\u53f0\u7403\u7b49\uff09\uff0c\u6709\u52a9\u4e8e\u8bca\u65ad\u9057\u4f20\u6027\u6eb6\u8840\u6027\u8d2b\u8840\u3002\u5176\u4ed6\u9009\u9879B\u9aa8\u9ad3\u8c61\u3001C\u8840\u6e05\u94c1\u603b\u94c1\u7ed3\u5408\u529b\u3001D\u8840\u7ea2\u86cb\u767d\u7535\u6cf3\u5bf9\u4e8e\u660e\u786e\u6b64\u7c7b\u6eb6\u8840\u6027\u8d2b\u8840\u7684\u8bca\u65ad\u5e2e\u52a9\u6709\u9650\u3002\u56e0\u6b64\uff0c\u6700\u6709\u4ef7\u503c\u7684\u5b9e\u9a8c\u5ba4\u68c0\u67e5\u662f\u5468\u56f4\u8840\u7247\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: \u751f\u957f\u6fc0\u7d20\u7624\u591a\u53d1\u751f\u4e8e\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: \u795e\u7ecf\u5782\u4f53\tB: \u817a\u5782\u4f53\tC: \u8111\u819c\tD: \u8111\u5ba4\t\n\u6b63\u786e\u7b54\u6848\u662f B: \u817a\u5782\u4f53\u3002",
-            "output": "\u751f\u957f\u6fc0\u7d20\u7624\u901a\u5e38\u53d1\u751f\u5728\u817a\u5782\u4f53\uff08\u5373\u8111\u5782\u4f53\u524d\u53f6\uff09\uff0c\u56e0\u4e3a\u8fd9\u4e2a\u533a\u57df\u8d1f\u8d23\u751f\u4ea7\u548c\u5206\u6ccc\u591a\u79cd\u6fc0\u7d20\uff0c\u5305\u62ec\u751f\u957f\u6fc0\u7d20\uff08GH\uff09\u3002\u817a\u5782\u4f53\u662f\u5185\u5206\u6ccc\u817a\u4e2d\u7684\u4e00\u90e8\u5206\uff0c\u5b83\u901a\u8fc7\u8840\u6db2\u5faa\u73af\u7cfb\u7edf\u5411\u8eab\u4f53\u5176\u4ed6\u90e8\u5206\u4f20\u9012\u6fc0\u7d20\u3002\u751f\u957f\u6fc0\u7d20\u7624\u662f\u817a\u5782\u4f53\u5e38\u89c1\u7684\u826f\u6027\u80bf\u7624\uff0c\u4f1a\u5206\u6ccc\u8fc7\u91cf\u7684\u751f\u957f\u6fc0\u7d20\uff0c\u5bfc\u81f4\u5404\u79cd\u75c7\u72b6\uff0c\u4f8b\u5982\u80a2\u7aef\u80a5\u5927\u75c7\u3002\u76f8\u6bd4\u4e4b\u4e0b\uff0c\u795e\u7ecf\u5782\u4f53\uff08\u8111\u5782\u4f53\u540e\u53f6\uff09\u3001\u8111\u819c\u6216\u8111\u5ba4\u5e76\u4e0d\u8d1f\u8d23\u751f\u957f\u6fc0\u7d20\u7684\u751f\u6210\uff0c\u56e0\u6b64\u751f\u957f\u6fc0\u7d20\u7624\u4e0d\u5e38\u5728\u8fd9\u4e9b\u90e8\u4f4d\u53d1\u751f\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: \u4e0d\u5c5e\u4e8e\u6de4\u8840\u540e\u679c\u7684\u662f\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: \u6c34\u80bf\tB: \u51fa\u8840\tC: \u4e0a\u76ae\u7ec4\u7ec7\u5316\u751f\tD: \u7ea4\u7ef4\u7ed3\u7f14\u7ec4\u7ec7\u589e\u751f\t\n\u6b63\u786e\u7b54\u6848\u662f C: \u4e0a\u76ae\u7ec4\u7ec7\u5316\u751f\u3002",
-            "output": "\u9009\u9879C\u201c\u4e0a\u76ae\u7ec4\u7ec7\u5316\u751f\u201d\u4e0d\u5c5e\u4e8e\u6de4\u8840\u7684\u540e\u679c\u3002\u6de4\u8840\u6307\u7684\u662f\u8840\u6db2\u5faa\u73af\u53d7\u963b\uff0c\u8840\u6db2\u5728\u5c40\u90e8\u533a\u57df\u5185\u7684\u79ef\u805a\u72b6\u6001\uff0c\u5176\u540e\u679c\u901a\u5e38\u5305\u62ec\u5c40\u90e8\u7ec4\u7ec7\u6c34\u80bf\u3001\u51fa\u8840\u548c\u7ea4\u7ef4\u7ed3\u7f14\u7ec4\u7ec7\u589e\u751f\u3002\u6c34\u80bf\uff08A\u9879\uff09\u662f\u56e0\u4e3a\u6db2\u4f53\u79ef\u805a\u5728\u7ec4\u7ec7\u95f4\u9699\uff1b\u51fa\u8840\uff08B\u9879\uff09\u53ef\u4ee5\u7531\u8840\u7ba1\u53d7\u538b\u6216\u635f\u4f24\u5bfc\u81f4\uff1b\u7ea4\u7ef4\u7ed3\u7f14\u7ec4\u7ec7\u589e\u751f\uff08D\u9879\uff09\u662f\u957f\u671f\u6de4\u8840\u5bfc\u81f4\u7684\u4fee\u590d\u6027\u53cd\u5e94\u3002\u800c\u4e0a\u76ae\u7ec4\u7ec7\u5316\u751f\uff08C\u9879\uff09\u6307\u7684\u662f\u4e0a\u76ae\u7ec4\u7ec7\u5728\u6162\u6027\u523a\u6fc0\u4e0b\u8f6c\u578b\u6210\u4e3a\u53e6\u4e00\u79cd\u7c7b\u578b\u7684\u4e0a\u76ae\uff0c\u4e0e\u6de4\u8840\u4e4b\u95f4\u6ca1\u6709\u76f4\u63a5\u7684\u56e0\u679c\u8054\u7cfb\uff0c\u6545C\u9879\u4e0d\u5c5e\u4e8e\u6de4\u8840\u7684\u540e\u679c\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: \u8425\u517b\u4e0d\u826f\u65f6\u4f53\u91cd\u6bd4\u6807\u51c6\u4f53\u91cd\u5c11\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: 5%\tB: 10%\tC: 15%\tD: 20%\t\n\u6b63\u786e\u7b54\u6848\u662f C: 15%\u3002",
-            "output": "\u8425\u517b\u4e0d\u826f\u7684\u5b9a\u4e49\u901a\u5e38\u6d89\u53ca\u8bc4\u4f30\u4f53\u91cd\u4e0e\u8eab\u9ad8\u7684\u6bd4\u7387\uff0c\u5373\u4f53\u91cd\u6307\u6570\uff08BMI\uff09\u3002\u6839\u636e\u4e16\u754c\u536b\u751f\u7ec4\u7ec7\u7684\u6807\u51c6\uff0c\u6210\u4eba\u8425\u517b\u4e0d\u826f\u901a\u5e38\u6307\u7684\u662fBMI\u5c0f\u4e8e18.5\u3002\u4f53\u91cd\u6bd4\u6807\u51c6\u4f53\u91cd\u8f7b\u53ef\u4ee5\u6839\u636e\u7a0b\u5ea6\u5206\u4e3a\u8f7b\u5ea6\u3001\u4e2d\u5ea6\u548c\u91cd\u5ea6\u8425\u517b\u4e0d\u826f\u3002\u9009\u62e9C\u7684\u539f\u56e0\u662f\u8425\u517b\u4e0d\u826f\u65f6\uff0c\u6807\u51c6\u4f53\u91cd\u51cf\u8f7b\u4e86\u5927\u7ea615%\u901a\u5e38\u6307\u5411\u4e2d\u5ea6\u8425\u517b\u4e0d\u826f\uff0c\u8fd9\u662f\u533b\u5b66\u4e0a\u5206\u6790\u8425\u517b\u4e0d\u826f\u7a0b\u5ea6\u7684\u4e00\u4e2a\u5e38\u7528\u6307\u6807\u3002\u8f7b\u5ea6\u8425\u517b\u4e0d\u826f\u4f53\u91cd\u51cf\u8f7b\u53ef\u80fd\u57285%-10%\u4e4b\u95f4\uff0c\u800c\u91cd\u5ea6\u8425\u517b\u4e0d\u826f\u5219\u4f53\u91cd\u51cf\u8f7b\u8d85\u8fc715%\uff0c\u751a\u81f3\u53ef\u8fbe20%\u6216\u66f4\u591a\u3002\u56e0\u6b64\uff0c\u6839\u636e\u8fd9\u4e9b\u5206\u7c7b\uff0c\u9009\u9879C\u662f\u4e00\u4e2a\u7b26\u5408\u4e2d\u7b49\u8425\u517b\u4e0d\u826f\u6807\u51c6\u7684\u5408\u9002\u9009\u9879\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: \u5973\u6027\uff0c28\u5c81\uff0cGraves\u75c5\u60a3\u8005\uff0c\u5e94\u7528\u56fd\u4ea7\u4e19\u786b\u6c27\u5627\u5576+\u666e\u8418\u6d1b\u5c14\u6cbb\u75972\u5468\uff0c\u75c5\u4eba\u51fa\u73b0\u4f4e\u70ed\u3001\u4e4f\u529b\u52a0\u91cd\uff0c\u54bd\u75db\uff0cWBC 2.7\u00d7109/L\uff0c\u7c92\u7ec6\u80de\uff1c1.5\u00d7109/L\uff0c\u4e0b\u5217\u54ea\u4e00\u79cd\u5904\u7f6e\u6700\u4e3a\u5408\u9002\uff1f\uff08\u3000\u3000\uff09\n\u9009\u9879: A: \u6539\u7528\u8fdb\u53e3\u4e19\u786b\u6c27\u5627\u5576\tB: \u7ee7\u7eed\u73b0\u6709\u6cbb\u7597\tC: \u7ef4\u6301\u73b0\u6709\u6cbb\u7597+\u5347\u767d\u7ec6\u80de\u836f\tD: \u505c\u6297\u7532\u72b6\u817a\u836f\uff0c\u52a0\u7528\u5347\u767d\u7ec6\u80de\u836f\uff0c\u9884\u9632\u6cbb\u7597\u611f\u67d3\t\n\u6b63\u786e\u7b54\u6848\u662f D: \u505c\u6297\u7532\u72b6\u817a\u836f\uff0c\u52a0\u7528\u5347\u767d\u7ec6\u80de\u836f\uff0c\u9884\u9632\u6cbb\u7597\u611f\u67d3\u3002",
-            "output": "\u60a3\u8005\u5728\u5e94\u7528\u4e19\u786b\u6c27\u5627\u5576\u3001\u666e\u8418\u6d1b\u5c14\u6cbb\u7597Graves\u75c52\u5468\u540e\u51fa\u73b0\u4f4e\u70ed\u3001\u4e4f\u529b\u52a0\u91cd\u3001\u54bd\u75db\u4ee5\u53ca\u767d\u7ec6\u80de\u4e0b\u964d\u3001\u7c92\u7ec6\u80de\u51cf\u5c11\uff0c\u8fd9\u4e9b\u75c7\u72b6\u9ad8\u5ea6\u63d0\u793a\u4e86\u767d\u7ec6\u80de\u51cf\u5c11\u75c7\uff0c\u53ef\u80fd\u4e3a\u836f\u7269\u5f15\u8d77\u7684\u9aa8\u9ad3\u6291\u5236\u3002\u5728\u8fd9\u79cd\u60c5\u51b5\u4e0b\uff0c\u7ee7\u7eed\u4f7f\u7528\u4e19\u786b\u6c27\u5627\u5576\u53ef\u80fd\u4f1a\u52a0\u5267\u767d\u7ec6\u80de\u51cf\u5c11\uff0c\u589e\u52a0\u611f\u67d3\u98ce\u9669\u3002\u56e0\u6b64\uff0c\u6700\u5408\u9002\u7684\u5904\u7406\u662f\u7acb\u5373\u505c\u7528\u53ef\u80fd\u5bfc\u81f4\u767d\u7ec6\u80de\u51cf\u5c11\u7684\u6297\u7532\u72b6\u817a\u836f\u7269\uff0c\u5373\u9009\u9879D\u3002\u6b64\u5916\uff0c\u52a0\u7528\u5347\u767d\u7ec6\u80de\u836f\u7269\u6709\u52a9\u4e8e\u6062\u590d\u6b63\u5e38\u7684\u767d\u7ec6\u80de\u6c34\u5e73\uff0c\u5e76\u9884\u9632\u6cbb\u7597\u611f\u67d3\uff0c\u8fd9\u5bf9\u60a3\u8005\u7684\u5b89\u5168\u81f3\u5173\u91cd\u8981\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: 3\uff0e\u8089\u82bd\u7ec4\u7ec7\u53d6\u4ee3\u574f\u6b7b\u7ec4\u7ec7\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: \u5305\u88f9\tB: \u7a7a\u6d1e\tC: \u673a\u5316\tD: \u6eb6\u89e3\u5438\u6536\t\n\u6b63\u786e\u7b54\u6848\u662f C: \u673a\u5316\u3002",
-            "output": "\u9009\u62e9C\u9879\u201c\u673a\u5316\u201d\u662f\u56e0\u4e3a\u5728\u75c5\u7406\u8fc7\u7a0b\u4e2d\uff0c\u5f53\u7ec4\u7ec7\u53d1\u751f\u574f\u6b7b\u540e\uff0c\u673a\u4f53\u4e3a\u4e86\u4fee\u590d\u53d7\u635f\u7684\u90e8\u4f4d\uff0c\u4f1a\u6709\u65b0\u7684\u8089\u82bd\u7ec4\u7ec7\u751f\u957f\u6765\u66ff\u4ee3\u6b7b\u4ea1\u7684\u7ec6\u80de\u3002\u8089\u82bd\u7ec4\u7ec7\u5bcc\u542b\u6bdb\u7ec6\u8840\u7ba1\u548c\u6210\u7ea4\u7ef4\u7ec6\u80de\uff0c\u80fd\u591f\u4fc3\u8fdb\u53d7\u635f\u7ec4\u7ec7\u7684\u6108\u5408\u548c\u518d\u751f\u3002\u673a\u5316\u662f\u4e00\u79cd\u4fee\u590d\u8fc7\u7a0b\uff0c\u5373\u574f\u6b7b\u7ec4\u7ec7\u88ab\u8fd9\u4e9b\u65b0\u5f62\u6210\u7684\u5bcc\u542b\u8840\u7ba1\u548c\u6210\u7ea4\u7ef4\u7ec6\u80de\u7684\u8089\u82bd\u7ec4\u7ec7\u53d6\u4ee3\u3002\u5176\u4ed6\u9009\u9879\uff0c\u5982A\u201c\u5305\u88f9\u201d\u3001B\u201c\u7a7a\u6d1e\u201d\u548cD\u201c\u6eb6\u89e3\u5438\u6536\u201d\u5e76\u4e0d\u80fd\u51c6\u786e\u63cf\u8ff0\u8089\u82bd\u7ec4\u7ec7\u53d6\u4ee3\u574f\u6b7b\u7ec4\u7ec7\u7684\u8fc7\u7a0b\u3002\u56e0\u6b64\uff0cC\u9879\u201c\u673a\u5316\u201d\u662f\u6b63\u786e\u7b54\u6848\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: \u5973\uff0c58\u5c81\u3002\u4e0a\u8179\u4e0d\u9002\u3001\u7eb3\u5dee3\u5e74\u3002\u4f53\u91cd\u51cf\u8f7b\u3001\u4e4f\u529b\u534a\u5e74\u3002\u67e5\u4f53\uff1a\u8d2b\u8840\u8c8c\uff0c\u4e0a\u8179\u90e8\u8f7b\u538b\u75db\u3002Hb 88g/L\uff0cMCV 115fl\u3002\u80c3\u955c\u68c0\u67e5\u793a\u80c3\u4f53\u76b1\u895e\u7a00\u758f\uff0c\u9ecf\u819c\u8840\u7ba1\u900f\u89c1\u30023\uff0e\u8be5\u60a3\u8005\u53d1\u751f\u8d2b\u8840\u6700\u53ef\u80fd\u7684\u673a\u5236\u662f\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: \u94c1\u5229\u7528\u969c\u788d\tB: \u86cb\u767d\u8d28\u5438\u6536\u969c\u788d\tC: \u7ef4\u751f\u7d20C\u7f3a\u4e4f\tD: \u5185\u56e0\u5b50\u7f3a\u4e4f\t\n\u6b63\u786e\u7b54\u6848\u662f D: \u5185\u56e0\u5b50\u7f3a\u4e4f\u3002",
-            "output": "\u8be5\u60a3\u8005\u7684\u75c7\u72b6\u3001\u4f53\u5f81\u53ca\u5b9e\u9a8c\u5ba4\u68c0\u67e5\u7ed3\u679c\uff0c\u5982\u957f\u65f6\u95f4\u4e0a\u8179\u4e0d\u9002\u3001\u7eb3\u5dee\u3001\u4f53\u91cd\u51cf\u8f7b\u3001\u4e4f\u529b\u4ee5\u53ca\u5b9e\u9a8c\u68c0\u67e5\u7684\u8d2b\u8840\u8c8c\u548c\u9ad8\u5e73\u5747\u7ea2\u7ec6\u80de\u4f53\u79ef\uff08MCV 115 fl\uff09\u7b49\uff0c\u63d0\u793a\u5b58\u5728\u5de8\u5e7c\u7ec6\u80de\u6027\u8d2b\u8840\u7684\u53ef\u80fd\u3002\u80c3\u955c\u53d1\u73b0\u80c3\u4f53\u76b1\u895e\u7a00\u758f\u3001\u9ecf\u819c\u8840\u7ba1\u900f\u89c1\u53ef\u80fd\u8bf4\u660e\u80c3\u9ecf\u819c\u840e\u7f29\uff0c\u8fdb\u800c\u5bfc\u81f4\u4e86\u5185\u56e0\u5b50\u7684\u7f3a\u4e4f\uff0c\u5185\u56e0\u5b50\u662f\u7ef4\u751f\u7d20B12\u5438\u6536\u7684\u5fc5\u8981\u7269\u8d28\u3002\u7ef4\u751f\u7d20B12\u7f3a\u4e4f\u4f1a\u5bfc\u81f4\u5de8\u5e7c\u7ec6\u80de\u6027\u8d2b\u8840\u3002\u800c\u9009\u9879A\u7684\u94c1\u5229\u7528\u969c\u788d\u3001\u9009\u9879B\u7684\u86cb\u767d\u8d28\u5438\u6536\u969c\u788d\u548c\u9009\u9879C\u7684\u7ef4\u751f\u7d20C\u7f3a\u4e4f\u5747\u4e0d\u7b26\u5408\u5de8\u5e7c\u7ec6\u80de\u6027\u8d2b\u8840\u7684\u8868\u73b0\u3002\u56e0\u6b64\uff0c\u7b54\u6848\u9009D\uff0c\u5185\u56e0\u5b50\u7f3a\u4e4f\uff0c\u662f\u8be5\u60a3\u8005\u51fa\u73b0\u8d2b\u8840\u6700\u53ef\u80fd\u7684\u673a\u5236\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: \u5973\u5a74\uff0c10\u4e2a\u6708\uff0c\u5148\u5410\u540e\u6cfb1\u5468\uff0c\u7caa\u4fbf\u5448\u86cb\u82b1\u6c64\u6837\uff0c\u8165\u81ed\uff0c\u6709\u9ecf\u6db2\u4f46\u65e0\u8113\u8840\u3002\u7cbe\u795e\u59d4\u9761\uff0c\u76ae\u80a4\u5f39\u6027\u8f83\u5dee\uff0c\u773c\u7a9d\u51f9\u9677\uff0c\u5507\u6a31\u7ea2\uff0c\u547c\u6c14\u6df1\u5feb\u6709\u4e19\u916e\u5473\uff0c\u5c3f\u91cf\u660e\u663e\u51cf\u5c11\uff0c\u56db\u80a2\u7a0d\u51c9\u3002\u9759\u8109\u8865\u6db2\u5e94\u600e\u6837\u8865\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: \u7b2c\u4e00\u5929\u603b\u91cf120\uff5e150ml/kg\tB: \u8865\u5145\u7d2f\u79ef\u635f\u5931\u630920ml/\uff08kg\u00b7h\uff09\tC: \u5f00\u59cb\u768430\uff5e60\u5206\u949f\u75282:1\u7b49\u5f20\u542b\u94a0\u6db260ml\tD: \u8865\u5145\u6c2f\u5316\u94be0.3%\u6d53\u5ea6\uff0c40ml/\uff08kg\u00b7d\uff09\t\n\u6b63\u786e\u7b54\u6848\u662f A: \u7b2c\u4e00\u5929\u603b\u91cf120\uff5e150ml/kg\u3002",
-            "output": "\u9009\u62e9A\u7684\u7406\u7531\u4e3b\u8981\u8003\u8651\u5230\u8be5\u5973\u5a74\u5b58\u5728\u660e\u663e\u7684\u8131\u6c34\u75c7\u72b6\uff0c\u5982\u76ae\u80a4\u5f39\u6027\u5dee\u3001\u773c\u7a9d\u51f9\u9677\u3001\u5507\u6a31\u7ea2\u548c\u547c\u5438\u6df1\u5feb\u7b49\u3002\u8fd9\u4e9b\u75c7\u72b6\u8868\u660e\u5979\u5904\u4e8e\u8f83\u4e3a\u4e25\u91cd\u7684\u8131\u6c34\u72b6\u6001\uff0c\u53ef\u80fd\u7531\u4e8e\u6301\u7eed\u6027\u7684\u5455\u5410\u548c\u8179\u6cfb\u9020\u6210\u4e86\u8f83\u5927\u7a0b\u5ea6\u7684\u4f53\u6db2\u4e22\u5931\u3002\u56e0\u6b64\uff0c\u9700\u8981\u53ca\u65f6\u8865\u5145\u8db3\u591f\u7684\u6db2\u4f53\u4ee5\u7ea0\u6b63\u8131\u6c34\u548c\u7535\u89e3\u8d28\u7d0a\u4e71\u3002\u9009\u9879A\u63d0\u4f9b\u7684\u603b\u91cf120\uff5e150ml/kg\u662f\u4f30\u7b97\u5c0f\u513f\u8131\u6c34\u65f6\u9996\u65e5\u8865\u6db2\u63a8\u8350\u7684\u91cf\uff0c\u65e8\u5728\u572824\u5c0f\u65f6\u5185\u6062\u590d\u5b69\u5b50\u6b63\u5e38\u7684\u6c34\u5206\u72b6\u6001\uff0c\u51cf\u5c11\u8131\u6c34\u5bf9\u673a\u4f53\u7684\u8d1f\u62c5\u3002\u5176\u4ed6\u9009\u9879\u5219\u672a\u80fd\u8003\u8651\u5230\u75c5\u60c5\u7684\u4e25\u91cd\u7a0b\u5ea6\u548c\u7d27\u6025\u6027\uff0c\u4e0d\u591f\u5168\u9762\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: \u4eba\u683c\u7684\u6838\u5fc3\u662f\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: \u80fd\u529b\tB: \u6027\u683c\tC: \u667a\u529b\tD: \u6c14\u8d28\t\n\u6b63\u786e\u7b54\u6848\u662f B: \u6027\u683c\u3002",
-            "output": "\u4eba\u683c\u7684\u6838\u5fc3\u5728\u4e8e\u4e2a\u4f53\u7684\u6027\u683c\uff0c\u56e0\u4e3a\u6027\u683c\u6d89\u53ca\u5230\u4e2a\u4eba\u7684\u60c5\u611f\u3001\u6001\u5ea6\u3001\u4ef7\u503c\u89c2\u548c\u884c\u4e3a\u6a21\u5f0f\u7b49\u65b9\u9762\uff0c\u662f\u4e00\u4e2a\u4eba\u5728\u793e\u4f1a\u4e92\u52a8\u4e2d\u6240\u8868\u73b0\u51fa\u6765\u7684\u7a33\u5b9a\u7279\u6027\u548c\u503e\u5411\u3002\u6027\u683c\u53ef\u4ee5\u5f71\u54cd\u4e00\u4e2a\u4eba\u5982\u4f55\u8ba4\u77e5\u4e16\u754c\u3001\u5982\u4f55\u4e0e\u4ed6\u4eba\u5efa\u7acb\u5173\u7cfb\u4ee5\u53ca\u5982\u4f55\u505a\u51fa\u51b3\u5b9a\uff0c\u8fd9\u4e9b\u90fd\u662f\u6784\u6210\u4eba\u683c\u7684\u91cd\u8981\u65b9\u9762\u3002\u867d\u7136\u80fd\u529b\u3001\u667a\u529b\u548c\u6c14\u8d28\u4e5f\u662f\u4eba\u683c\u7684\u7ec4\u6210\u90e8\u5206\uff0c\u4f46\u5b83\u4eec\u66f4\u591a\u5730\u5173\u8054\u4e8e\u5177\u4f53\u80fd\u529b\uff0c\u667a\u529b\u6c34\u5e73\u6216\u5916\u5728\u8868\u73b0\u7684\u98ce\u683c\uff0c\u800c\u6027\u683c\u5219\u662f\u51b3\u5b9a\u4e00\u4e2a\u4eba\u5982\u4f55\u8fd0\u7528\u8fd9\u4e9b\u80fd\u529b\u548c\u667a\u529b\u4ee5\u53ca\u5982\u4f55\u8868\u8fbe\u81ea\u5df1\u6c14\u8d28\u7684\u6df1\u5c42\u7279\u8d28\u3002\u56e0\u6b64\uff0c\u6027\u683c\u88ab\u8ba4\u4e3a\u662f\u4eba\u683c\u7684\u6838\u5fc3\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: \u94a9\u7aef\u87ba\u65cb\u4f53\u53ef\u81ea\u50a8\u5b58\u5bbf\u4e3b\u7684\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: \u7caa\u4fbf\u6392\u51fa\tB: \u98de\u6cab\u6392\u51fa\tC: \u5455\u5410\u7269\u4e2d\u6392\u51fa\tD: \u5c3f\u6db2\u6392\u51fa\t\n\u6b63\u786e\u7b54\u6848\u662f D: \u5c3f\u6db2\u6392\u51fa\u3002",
-            "output": "\u4ece\u94a9\u7aef\u87ba\u65cb\u4f53\u7684\u4f20\u64ad\u9014\u5f84\u5206\u6790\uff0c\u9009\u9879D\u201c\u5c3f\u6db2\u6392\u51fa\u201d\u662f\u6b63\u786e\u7684\u3002\u94a9\u7aef\u87ba\u65cb\u4f53\u662f\u4e00\u79cd\u7ec6\u83cc\uff0c\u901a\u5e38\u7531\u611f\u67d3\u7684\u52a8\u7269\u901a\u8fc7\u5c3f\u6db2\u6392\u51fa\uff0c\u8fd9\u79cd\u65b9\u5f0f\u79f0\u4e3a\u201c\u5c3f\u4f20\u64ad\u201d\u3002\u4eba\u901a\u5e38\u901a\u8fc7\u63a5\u89e6\u53d7\u6c61\u67d3\u7684\u6c34\u6e90\u6216\u571f\u58e4\u65f6\uff0c\u5c3f\u6db2\u4e2d\u542b\u6709\u7684\u7ec6\u83cc\u53ef\u4ee5\u901a\u8fc7\u76ae\u80a4\u7684\u7834\u635f\u90e8\u4f4d\u6216\u7c98\u819c\u4fb5\u5165\u4eba\u4f53\uff0c\u4ece\u800c\u5bfc\u81f4\u94a9\u7aef\u87ba\u65cb\u4f53\u75c5\u3002\u7caa\u4fbf\u3001\u98de\u6cab\u53ca\u5455\u5410\u7269\u4e0d\u662f\u94a9\u7aef\u87ba\u65cb\u4f53\u7684\u4e3b\u8981\u6392\u51fa\u9014\u5f84\uff0c\u56e0\u6b64A\u3001B\u3001C\u4e09\u4e2a\u9009\u9879\u5747\u4e0d\u6b63\u786e\u3002\u6240\u4ee5\uff0c\u6839\u636e\u94a9\u7aef\u87ba\u65cb\u4f53\u7684\u751f\u7269\u5b66\u7279\u6027\u548c\u4f20\u64ad\u673a\u5236\uff0c\u9009\u9879D\u662f\u6b63\u786e\u7b54\u6848\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: 2\uff0e\u5fc3\u5883\u9ad8\u6da8\u3001\u4f4e\u843d\u53cd\u590d\u4ea4\u66ff\u51fa\u73b0\uff0c\u4e0d\u7b26\u5408\u8e81\u72c2\u6216\u6291\u90c1\u53d1\u4f5c\u75c7\u72b6\u6807\u51c6\uff0c\u75c5\u7a0b\u81f3\u5c112\u5e74\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: \u73af\u6027\u5fc3\u5883\u969c\u788d\tB: \u6076\u52a3\u5fc3\u5883\u969c\u788d\tC: \u53cc\u76f8\u969c\u788d\u6df7\u5408\u6027\u53d1\u4f5c\tD: \u6291\u90c1\u53d1\u4f5c\t\n\u6b63\u786e\u7b54\u6848\u662f A: \u73af\u6027\u5fc3\u5883\u969c\u788d\u3002",
-            "output": "\u9009\u62e9A\u9009\u9879\u201c\u73af\u6027\u5fc3\u5883\u969c\u788d\u201d\u662f\u56e0\u4e3a\u8be5\u75c5\u75c7\u63cf\u8ff0\u4e86\u60a3\u8005\u5448\u73b0\u53cd\u590d\u9ad8\u6da8\u548c\u4f4e\u843d\u7684\u5fc3\u5883\u53d8\u5316\uff0c\u8fd9\u4e0e\u73af\u6027\u5fc3\u5883\u969c\u788d\uff08Cyclothymic Disorder\uff09\u7684\u8bca\u65ad\u6807\u51c6\u76f8\u543b\u5408\u3002\u73af\u6027\u5fc3\u5883\u969c\u788d\u8981\u6c42\u7684\u75c7\u72b6\u6301\u7eed\u65f6\u95f4\u81f3\u5c11\u4e3a2\u5e74\uff0c\u800c\u4e14\u75c5\u4eba\u7684\u8868\u73b0\u4e0d\u8db3\u4ee5\u6784\u6210\u5b8c\u6574\u7684\u8e81\u72c2\u53d1\u4f5c\u6216\u6291\u90c1\u53d1\u4f5c\uff0c\u8fd9\u4e00\u70b9\u4e0e\u9898\u5e72\u4e2d\u7684\u75c5\u7a0b\u53ca\u75c7\u72b6\u63cf\u8ff0\u76f8\u7b26\u5408\u3002\u53e6\u5916\uff0cB\u9009\u9879\u201c\u6076\u52a3\u5fc3\u5883\u969c\u788d\u201d\uff0cC\u9009\u9879\u201c\u53cc\u76f8\u969c\u788d\u6df7\u5408\u6027\u53d1\u4f5c\u201d\u548cD\u9009\u9879\u201c\u6291\u90c1\u53d1\u4f5c\u201d\u90fd\u6709\u76f8\u5bf9\u4e25\u683c\u7684\u8bca\u65ad\u6807\u51c6\uff0c\u5176\u75c7\u72b6\u7684\u7279\u70b9\u548c\u6301\u7eed\u65f6\u95f4\u4e0e\u9898\u76ee\u4e2d\u63cf\u8ff0\u7684\u60c5\u51b5\u4e0d\u76f8\u4e00\u81f4\u3002\u56e0\u6b64\uff0cA\u9009\u9879\u662f\u6b63\u786e\u7b54\u6848\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: \u5173\u4e8e\u767b\u9769\u70ed\u7684\u53d9\u8ff0\u4e0d\u6b63\u786e\u7684\u662f\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: \u5f62\u6001\u7ed3\u6784\u4e0e\u4e59\u8111\u75c5\u6bd2\u76f8\u4f3c\uff0c\u4f46\u4f53\u79ef\u5c0f\tB: \u5206\u4e3a4\u4e2a\u8840\u6e05\u578b\tC: \u4eba\u548c\u7334\u4e3a\u5176\u50a8\u5b58\u5bbf\u4e3b\tD: \u75c5\u540e\u514d\u75ab\u529b\u7262\u56fa\t\n\u6b63\u786e\u7b54\u6848\u662f D: \u75c5\u540e\u514d\u75ab\u529b\u7262\u56fa\u3002",
-            "output": "\u767b\u9769\u70ed\u662f\u7531\u767b\u9769\u75c5\u6bd2\u5f15\u8d77\u7684\u4e00\u79cd\u6025\u6027\u4f20\u67d3\u75c5\uff0c\u8be5\u75c5\u6bd2\u5c5e\u4e8e\u9ec4\u75c5\u6bd2\u79d1\uff0c\u5176\u5f62\u6001\u7ed3\u6784\u786e\u5b9e\u4e0e\u4e59\u8111\u75c5\u6bd2\u76f8\u4f3c\uff0c\u56e0\u6b64\u9009\u9879A\u7684\u63cf\u8ff0\u662f\u6b63\u786e\u7684\u3002\u767b\u9769\u70ed\u75c5\u6bd2\u5206\u4e3a1\u578b\u30012\u578b\u30013\u578b\u548c4\u578b\u56db\u4e2a\u8840\u6e05\u578b\uff0c\u5b83\u4eec\u4e4b\u95f4\u6709\u4ea4\u53c9\u53cd\u5e94\u6027\uff0c\u4f46\u662f\u611f\u67d3\u5176\u4e2d\u4e00\u578b\u7684\u75c5\u6bd2\u540e\u5e76\u4e0d\u80fd\u4ea7\u751f\u5bf9\u5176\u4ed6\u4e09\u578b\u7684\u957f\u671f\u514d\u75ab\uff0c\u56e0\u800c\u9009\u9879B\u4e5f\u662f\u6b63\u786e\u7684\u3002\u4eba\u548c\u7334\u662f\u767b\u9769\u70ed\u7684\u81ea\u7136\u5bbf\u4e3b\uff0c\u5728\u8fd9\u4e9b\u5bbf\u4e3b\u4e2d\u75c5\u6bd2\u53ef\u4ee5\u5f97\u5230\u4fdd\u5b58\u548c\u4f20\u64ad\uff0c\u6240\u4ee5\u9009\u9879C\u4e5f\u662f\u51c6\u786e\u7684\u3002\u7136\u800c\uff0c\u5bf9\u4e8e\u9009\u9879D\uff0c\u867d\u7136\u611f\u67d3\u767b\u9769\u70ed\u540e\u5bf9\u540c\u4e00\u578b\u522b\u7684\u75c5\u6bd2\u4f1a\u4ea7\u751f\u7ec8\u751f\u514d\u75ab\uff0c\u4f46\u5176\u4ed6\u578b\u522b\u7684\u514d\u75ab\u529b\u4e0d\u7262\u56fa\uff0c\u5bf94\u4e2a\u8840\u6e05\u578b\u7684\u514d\u75ab\u5e76\u4e0d\u662f\u5168\u9762\u7684\u3002\u56e0\u6b64\uff0c\u9009\u9879D\u63cf\u8ff0\u4e0d\u6b63\u786e\uff0c\u662f\u8be5\u95ee\u9898\u7684\u7b54\u6848\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: 1\uff0eHb\u4e0eO2\u7ed3\u5408\u65f6\u5448\u7279\u5f81\u6027\u201cS\u201d\u5f62\u66f2\u7ebf\uff0c\u79f0O2\u4e3a\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: \u53d8\u6784\u86cb\u767d\tB: \u53d8\u6784\u5242\tC: \u534f\u540c\u6548\u5e94\tD: \u4ee5\u4e0a\u90fd\u4e0d\u662f\t\n\u6b63\u786e\u7b54\u6848\u662f B: \u53d8\u6784\u5242\u3002",
-            "output": "\u9009\u62e9\u201cB. \u53d8\u6784\u5242\u201d\u8fd9\u4e2a\u9009\u9879\u662f\u4e0d\u6b63\u786e\u7684\u3002Hb\uff08\u8840\u7ea2\u86cb\u767d\uff09\u4e0e\u6c27\u6c14\u7ed3\u5408\u65f6\u7684\u786e\u5448\u73b0\u51fa\u7279\u5f81\u6027\u7684\u201cS\u201d\u5f62\u66f2\u7ebf\uff0c\u8fd9\u662f\u56e0\u4e3aHb\u5206\u5b50\u5728\u7ed3\u5408\u6c27\u5206\u5b50\u540e\u4f1a\u53d1\u751f\u6784\u8c61\u7684\u53d8\u5316\uff0c\u4f7f\u5f97\u5176\u4f59\u7684\u7ed3\u5408\u4f4d\u70b9\u5bf9\u6c27\u7684\u4eb2\u548c\u529b\u589e\u52a0\uff0c\u8fd9\u79cd\u73b0\u8c61\u79f0\u4e3a\u534f\u540c\u6548\u5e94\uff0c\u662f\u7531\u4e8eHb\u7684\u56db\u4e2a\u4e9a\u57fa\u4e4b\u95f4\u7684\u76f8\u4e92\u4f5c\u7528\u3002\u56e0\u6b64\uff0c\u6b63\u786e\u7b54\u6848\u5e94\u662f\u201cC. \u534f\u540c\u6548\u5e94\u201d\u3002\u53d8\u6784\u86cb\u767d\u662f\u6307\u86cb\u767d\u8d28\u5728\u5916\u754c\u6761\u4ef6\u53d8\u5316\u65f6\u53d1\u751f\u4e8c\u7ea7\u53ca\u4ee5\u4e0a\u7ed3\u6784\u6539\u53d8\u7684\u86cb\u767d\u8d28\uff0c\u53d8\u6784\u5242\u662f\u4f1a\u5bfc\u81f4\u86cb\u767d\u8d28\u53d8\u6784\u7684\u5916\u754c\u56e0\u7d20\u3002\u6240\u4ee5\u201cA. \u53d8\u6784\u86cb\u767d\u201d\u548c\u201cB. \u53d8\u6784\u5242\u201d\u90fd\u4e0e\u9898\u76ee\u63cf\u8ff0\u7684\u73b0\u8c61\u4e0d\u7b26\u3002\u9009\u9879\u201cD. \u4ee5\u4e0a\u90fd\u4e0d\u662f\u201d\u540c\u6837\u4e0d\u6b63\u786e\uff0c\u56e0\u4e3a\u6b63\u786e\u7b54\u6848\u5df2\u7ecf\u7ed9\u51fa\u4e3a\u201cC. \u534f\u540c\u6548\u5e94\u201d\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: 7\u4e2a\u6708\u5a74\u513f\uff0c\u533b\u9662\u51fa\u751f\uff0c\u6839\u636e\u5176\u514d\u75ab\u7279\u70b9\u548c\u4f20\u67d3\u75c5\u53d1\u751f\u7684\u60c5\u51b5\uff0c\u5b8c\u6210\u8ba1\u5212\u514d\u75ab\u548c\u9884\u9632\u63a5\u79cd\u5e94\u4e0d\u5305\u62ec\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: \u5361\u4ecb\u82d7\tB: \u767e\u767d\u7834\u4e09\u8054\u9488\tC: \u4e59\u809d\u75ab\u82d7\tD: \u9ebb\u75b9\u51cf\u6bd2\u6d3b\u75ab\u82d7\t\n\u6b63\u786e\u7b54\u6848\u662f D: \u9ebb\u75b9\u51cf\u6bd2\u6d3b\u75ab\u82d7\u3002",
-            "output": "\u9009\u62e9D. \u9ebb\u75b9\u51cf\u6bd2\u6d3b\u75ab\u82d7\u4f5c\u4e3a\u4e0d\u5305\u62ec\u7684\u9009\u9879\uff0c\u662f\u56e0\u4e3a\u6839\u636e\u6211\u56fd\u7684\u8ba1\u5212\u514d\u75ab\u7a0b\u5e8f\uff0c\u9ebb\u75b9\u75ab\u82d7\u7684\u9996\u5242\u63a5\u79cd\u901a\u5e38\u5b89\u6392\u5728\u5b69\u5b508\u4e2a\u6708\u81f31\u5c81\u65f6\u30027\u4e2a\u6708\u5a74\u513f\u7684\u514d\u75ab\u7cfb\u7edf\u8fd8\u672a\u5b8c\u5168\u6210\u719f\uff0c\u53ef\u80fd\u8fd8\u4e0d\u80fd\u4ea7\u751f\u9488\u5bf9\u9ebb\u75b9\u7684\u6709\u6548\u4fdd\u62a4\u3002\u800c\u4e14\uff0c\u65e9\u4e8e\u5efa\u8bae\u5e74\u9f84\u7684\u63a5\u79cd\u53ef\u80fd\u4f1a\u56e0\u6bcd\u4f53\u6297\u4f53\u7684\u5f71\u54cd\uff0c\u964d\u4f4e\u75ab\u82d7\u7684\u6709\u6548\u6027\u3002\u800c\u5361\u4ecb\u82d7\uff08A\uff09\u3001\u767e\u767d\u7834\u4e09\u8054\u9488\uff08B\uff09\u4ee5\u53ca\u4e59\u809d\u75ab\u82d7\uff08C\uff09\u901a\u5e38\u662f\u51fa\u751f\u540e\u4e0d\u4e45\u5a74\u513f\u5c31\u5e94\u5f00\u59cb\u63a5\u79cd\u7684\uff0c\u8fd9\u4e9b\u75ab\u82d7\u662f\u4fdd\u62a4\u5a74\u513f\u514d\u53d7\u91cd\u8981\u4f20\u67d3\u75c5\u5371\u5bb3\u7684\u91cd\u8981\u624b\u6bb5\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: 1\uff0e\u80c3\u6e83\u75a1\u7a7f\u5b54\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: \u53f3\u4e0a\u8179\u7ede\u75db\uff0c\u4f34\u538b\u75db\u3001\u9ec4\u75b8\uff0cMurphy\u5f81\u9633\u6027\tB: \u4e0a\u8179\u538b\u75db\uff0c\u677f\u6837\u5f3a\u76f4\uff0c\u809d\u6d4a\u97f3\u754c\u6d88\u5931\tC: \u4e0a\u8179\u90e8\u80c0\u75db\uff0c\u4f34\u6709\u80c3\u578b\u53ca\u62cd\u6c34\u58f0\tD: \u80f8\u9aa8\u4e0b\u6301\u7eed\u6027\u949d\u75db\uff0c\u8179\u90e8\u4f53\u5f81\u6b63\u5e38\t\n\u6b63\u786e\u7b54\u6848\u662f B: \u4e0a\u8179\u538b\u75db\uff0c\u677f\u6837\u5f3a\u76f4\uff0c\u809d\u6d4a\u97f3\u754c\u6d88\u5931\u3002",
-            "output": "\u9009\u62e9B\u9009\u9879\u7684\u7406\u7531\u662f\u80c3\u6e83\u75a1\u7a7f\u5b54\u540e\u4f1a\u5bfc\u81f4\u80c3\u5185\u5bb9\u7269\u6cc4\u6f0f\u5230\u8179\u8154\u4e2d\uff0c\u5f15\u8d77\u6025\u6027\u5316\u8113\u6027\u8179\u819c\u708e\u3002\u60a3\u8005\u4f1a\u8868\u73b0\u4e3a\u6025\u6027\u4e0a\u8179\u538b\u75db\uff0c\u8fd9\u662f\u7531\u4e8e\u80c3\u9178\u548c\u6d88\u5316\u9175\u7d20\u523a\u6fc0\u8179\u819c\u6240\u81f4\u3002\u677f\u6837\u5f3a\u76f4\u662f\u7531\u4e8e\u8179\u819c\u7684\u708e\u75c7\u53cd\u5e94\u5bfc\u81f4\u8179\u808c\u7d27\u5f20\u6027\u6536\u7f29\uff0c\u4ee5\u51cf\u5c11\u53d7\u5230\u523a\u6fc0\u7684\u9762\u79ef\u3002\u809d\u6d4a\u97f3\u754c\u6d88\u5931\u53cd\u6620\u4e86\u60a3\u8005\u51fa\u73b0\u4e86\u81ea\u7531\u8179\u8154\u6c14\u4f53\uff0c\u8fd9\u662f\u80c3\u5185\u5bb9\u7269\u8fdb\u5165\u8179\u8154\u7684\u8bc1\u636e\u3002A\u9009\u9879\u7684\u53f3\u4e0a\u8179\u7ede\u75db\u3001\u9ec4\u75b8\u548cMurphy\u5f81\u9633\u6027\uff0c\u591a\u89c1\u4e8e\u80c6\u56ca\u708e\u3002C\u9009\u9879\u7684\u80c3\u578b\u548c\u62cd\u6c34\u58f0\u591a\u89c1\u4e8e\u80c3\u6269\u5f20\u6216\u80c3\u5185\u79ef\u98df\u3002D\u9009\u9879\u7684\u75c7\u72b6\u4e0d\u7b26\u5408\u80c3\u6e83\u75a1\u7a7f\u5b54\u7684\u5178\u578b\u5f81\u8c61\u3002\u56e0\u6b64\uff0cB\u9009\u9879\u7684\u75c7\u72b6\u4e0e\u80c3\u6e83\u75a1\u7a7f\u5b54\u540e\u53ef\u80fd\u51fa\u73b0\u7684\u4e34\u5e8a\u8868\u73b0\u6700\u4e3a\u5339\u914d\uff0c\u6545\u9009\u62e9B\u9009\u9879\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: 3\uff0e\u4e0b\u80a2\u77ed\u7f29\u3001\u5916\u5c55\u3001\u6781\u5ea6\u5916\u65cb\u4f4d\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: \u80a1\u9aa8\u9888\u9aa8\u6298\tB: \u80a1\u9aa8\u7c97\u9686\u95f4\u9aa8\u6298\tC: \u80a1\u9aa8\u4e0a\u4e2d\u6bb5\u9aa8\u6298\tD: \u80a1\u9aa8\u9ac1\u4e0a\u9aa8\u6298\t\n\u6b63\u786e\u7b54\u6848\u662f B: \u80a1\u9aa8\u7c97\u9686\u95f4\u9aa8\u6298\u3002",
-            "output": "\u9009\u9879B\uff1a\u80a1\u9aa8\u7c97\u9686\u95f4\u9aa8\u6298\u7684\u7279\u5f81\u8868\u73b0\u662f\u4e0b\u80a2\u51fa\u73b0\u77ed\u7f29\u3001\u5916\u5c55\u53ca\u6781\u5ea6\u5916\u65cb\u4f4d\u3002\u56e0\u80a1\u9aa8\u7c97\u9686\u95f4\u533a\u57df\u8fdc\u79bb\u80a1\u9aa8\u5934\u8840\u4f9b\uff0c\u9aa8\u6298\u540e\u6613\u5bfc\u81f4\u9aa8\u6298\u4e24\u7aef\u4e4b\u95f4\u7684\u808c\u8089\u6536\u7f29\u4f5c\u7528\u9020\u6210\u77ed\u7f29\uff1b\u80a1\u9aa8\u9888\u90e8\u808c\u8089\u53ca\u97e7\u5e26\u7684\u7275\u62c9\u4f5c\u7528\u5219\u5bfc\u81f4\u5916\u5c55\u548c\u5916\u65cb\u4f4d\u3002\u8fd9\u79cd\u60c5\u51b5\u591a\u89c1\u4e8e\u8001\u5e74\u4eba\uff0c\u5176\u9aa8\u8d28\u758f\u677e\u4f1a\u8ba9\u8fd9\u4e00\u533a\u57df\u5c24\u4e3a\u8106\u5f31\u3002\u76f8\u6bd4\u4e4b\u4e0b\uff0c\u5176\u4ed6\u9009\u9879A\u3001C\u548cD\u7684\u9aa8\u6298\u7c7b\u578b\u901a\u5e38\u4e0d\u4f1a\u8868\u73b0\u4e3a\u8fd9\u6837\u7684\u7279\u5f81\u59ff\u52bf\u3002\u80a1\u9aa8\u9888\u9aa8\u6298\uff08A\uff09\u53ef\u80fd\u5bfc\u81f4\u5916\u65cb\u4f4d\uff0c\u4f46\u901a\u5e38\u4e0d\u4f1a\u5f15\u8d77\u660e\u663e\u7684\u77ed\u7f29\u3002\u800c\u80a1\u9aa8\u4e0a\u4e2d\u6bb5\u9aa8\u6298\uff08C\uff09\u548c\u80a1\u9aa8\u9ac1\u4e0a\u9aa8\u6298\uff08D\uff09\u4e00\u822c\u4f1a\u6709\u4e0d\u540c\u7684\u4e34\u5e8a\u8868\u73b0\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: 6\u4e2a\u6708\u7684\u5a74\u513f\u60a3\u5316\u8113\u6027\u8111\u819c\u708e\uff0c\u7591\u6709\u786c\u819c\u4e0b\u79ef\u6db2\uff0c\u4e3a\u660e\u786e\u8bca\u65ad\uff0c\u9996\u5148\u9700\u505a\u4e0b\u8ff0\u54ea\u4e00\u9879\u68c0\u67e5\uff1f\uff08\u3000\u3000\uff09\n\u9009\u9879: A: \u505a\u8170\u7a7f\uff0c\u89c2\u5bdf\u8111\u810a\u6db2\u7ec6\u80de\u6570\u5347\u9ad8\u5426\tB: \u505a\u8170\u7a7f\uff0c\u89c2\u5bdf\u8111\u810a\u6db2\u86cb\u767d\u662f\u5426\u589e\u9ad8\tC: \u62cd\u6444\u5934\u9aa8X\u7ebf\u5e73\u7247\tD: \u9885\u9aa8\u900f\u7167\u68c0\u67e5\t\n\u6b63\u786e\u7b54\u6848\u662f D: \u9885\u9aa8\u900f\u7167\u68c0\u67e5\u3002",
-            "output": "\u9009\u62e9D\u9009\u9879\uff08\u9885\u9aa8\u900f\u7167\u68c0\u67e5\uff09\u7684\u539f\u56e0\u662f\uff1a\u5728\u521d\u59cb\u9636\u6bb5\uff0c\u5bf9\u4e8e\u7591\u4f3c\u6709\u786c\u819c\u4e0b\u79ef\u6db2\u7684\u5a74\u513f\uff0c\u6211\u4eec\u9700\u8981\u4e00\u4e2a\u975e\u4fb5\u5165\u6027\u3001\u7b80\u4fbf\u3001\u4e14\u5bf9\u5a74\u513f\u5b89\u5168\u7684\u68c0\u67e5\u65b9\u6cd5\u6765\u5feb\u901f\u5bf9\u786c\u819c\u4e0b\u79ef\u6db2\u8fdb\u884c\u7b5b\u67e5\u3002\u9885\u9aa8\u900f\u7167\u68c0\u67e5\u80fd\u591f\u53d1\u73b0\u9885\u5185\u79ef\u6db2\u7684\u8ff9\u8c61\uff0c\u6bd4\u5982\u9885\u9aa8\u6655\u8f6e\uff08halo sign\uff09\uff0c\u800c\u4e0d\u9700\u8981\u7a7f\u523a\u7684\u98ce\u9669\u3002\u5c3d\u7ba1\u8170\u7a7f\u53ef\u4ee5\u89c2\u5bdf\u8111\u810a\u6db2\u7684\u7ec6\u80de\u6570\u548c\u86cb\u767d\u542b\u91cf\u53d8\u5316\uff0c\u4f46\u5728\u5c1a\u672a\u660e\u786e\u6709\u65e0\u79ef\u6db2\u7684\u60c5\u51b5\u4e0b\u76f4\u63a5\u8fdb\u884c\u8170\u7a7f\u5177\u6709\u4e00\u5b9a\u98ce\u9669\u4e14\u4e0d\u592a\u9002\u5b9c\u4f5c\u4e3a\u9996\u9009\u3002\u5934\u9aa8X\u7ebf\u5e73\u7247\u4e0d\u5982\u900f\u7167\u68c0\u67e5\u76f4\u63a5\u6709\u6548\u3002\u56e0\u6b64\uff0c\u5728\u6392\u67e5\u786c\u819c\u4e0b\u79ef\u6db2\u65f6\u5e94\u9996\u9009\u9885\u9aa8\u900f\u7167\u68c0\u67e5\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: \u6211\u56fd\u9881\u5e03\u7684\u201c\u6bcd\u5a74\u4fdd\u5065\u6cd5\u201d\u89c4\u5b9a\u5728\u65b0\u751f\u513f\u671f\u8fdb\u884c\u7b5b\u67e5\u7684\u9057\u4f20\u4ee3\u8c22\u5185\u5206\u6ccc\u75be\u75c5\u662f\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: 21-\u4e09\u4f53\u7efc\u5408\u5f81\uff0c\u82ef\u4e19\u916e\u5c3f\u75c7\tB: \u5148\u5929\u6027\u7532\u72b6\u817a\u529f\u80fd\u51cf\u9000\u75c7\uff0c\u82ef\u4e19\u916e\u5c3f\u75c7\tC: \u5148\u5929\u6027\u7532\u72b6\u817a\u529f\u80fd\u51cf\u9000\u75c7\uff0c\u534a\u4e73\u7cd6\u8840\u75c7\tD: 21-\u4e09\u4f53\u7efc\u5408\u5f81\uff0c\u534a\u4e73\u7cd6\u8840\u75c7\t\n\u6b63\u786e\u7b54\u6848\u662f B: \u5148\u5929\u6027\u7532\u72b6\u817a\u529f\u80fd\u51cf\u9000\u75c7\uff0c\u82ef\u4e19\u916e\u5c3f\u75c7\u3002",
-            "output": "\u9009\u62e9B\uff08\u5148\u5929\u6027\u7532\u72b6\u817a\u529f\u80fd\u51cf\u9000\u75c7\uff0c\u82ef\u4e19\u916e\u5c3f\u75c7\uff09\u7684\u539f\u56e0\u662f\u5b83\u4eec\u90fd\u662f\u91cd\u8981\u7684\u9057\u4f20\u4ee3\u8c22\u75be\u75c5\uff0c\u5e76\u4e14\u5728\u51fa\u751f\u540e\u65e9\u671f\u8fdb\u884c\u7b5b\u67e5\u53ef\u4ee5\u6709\u6548\u9884\u9632\u548c\u51cf\u8f7b\u7531\u6b64\u5e26\u6765\u7684\u667a\u529b\u548c\u751f\u7406\u53d1\u5c55\u969c\u788d\u3002\u5148\u5929\u6027\u7532\u72b6\u817a\u529f\u80fd\u51cf\u9000\u75c7\u662f\u7531\u4e8e\u7532\u72b6\u817a\u6fc0\u7d20\u5408\u6210\u6216\u5206\u6ccc\u4e0d\u8db3\u9020\u6210\u7684\u75be\u75c5\uff0c\u82e5\u4e0d\u53ca\u65f6\u6cbb\u7597\u53ef\u80fd\u5bfc\u81f4\u513f\u7ae5\u667a\u529b\u53d1\u80b2\u8fdf\u6ede\u7b49\u91cd\u5927\u5065\u5eb7\u95ee\u9898\u3002\u82ef\u4e19\u916e\u5c3f\u75c7\u662f\u4e00\u79cd\u56e0\u82ef\u4e19\u6c28\u9178\u4ee3\u8c22\u969c\u788d\u5f15\u8d77\u7684\u9057\u4f20\u4ee3\u8c22\u75c5\uff0c\u65e9\u671f\u53d1\u73b0\u548c\u996e\u98df\u63a7\u5236\u53ef\u6709\u6548\u907f\u514d\u4e25\u91cd\u7684\u667a\u529b\u969c\u788d\u3002\u6545\u672c\u9898\u7b54\u6848\u9009B\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: \u7ecf\u4ea7\u5987\uff0c26\u5c81\u3002\u598a\u5a2037\u5468\uff0c\u6668\u8d77\u53d1\u73b0\u9634\u9053\u6d41\u8840\uff0c\u65e0\u660e\u663e\u8179\u75db\uff0c\u68c0\u67e5\u6709\u5bab\u7f29\u3002\u67e5\u4f53\uff1a\u5b50\u5bab\u5927\u5c0f\u5927\u4e8e\u5b55\u5468\u6570\uff0c\u80ce\u5fc3\u5b58\u5728\u30021\uff0e\u6700\u53ef\u80fd\u7684\u8bca\u65ad\u662f\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: \u524d\u7f6e\u80ce\u76d8\tB: \u5148\u5146\u6d41\u4ea7\tC: \u80ce\u76d8\u65e9\u5265\tD: \u96be\u514d\u6d41\u4ea7\t\n\u6b63\u786e\u7b54\u6848\u662f C: \u80ce\u76d8\u65e9\u5265\u3002",
-            "output": "\u6700\u53ef\u80fd\u7684\u8bca\u65ad\u662fC. \u80ce\u76d8\u65e9\u5265\u3002\u6839\u636e\u75c5\u4f8b\u63cf\u8ff0\uff0c\u60a3\u8005\u662f\u7ecf\u4ea7\u5987\uff0c\u5728\u598a\u5a2037\u5468\u65f6\u53d1\u73b0\u9634\u9053\u51fa\u8840\u4f46\u65e0\u660e\u663e\u8179\u75db\u3002\u7ecf\u4ea7\u5987\u76f8\u8f83\u521d\u4ea7\u5987\u66f4\u5bb9\u6613\u53d1\u751f\u80ce\u76d8\u65e9\u5265\u3002\u6b64\u5916\uff0c\u5b50\u5bab\u5927\u5c0f\u5927\u4e8e\u5b55\u5468\u6570\u53ef\u80fd\u662f\u7531\u4e8e\u79ef\u8840\u9020\u6210\u7684\uff0c\u8fd9\u4e0e\u80ce\u76d8\u65e9\u5265\u7684\u75c7\u72b6\u76f8\u7b26\u3002\u80ce\u76d8\u65e9\u5265\u901a\u5e38\u4f34\u6709\u5bab\u7f29\uff0c\u4e14\u80ce\u5fc3\u5b58\u5728\uff0c\u8fd9\u8bf4\u660e\u80ce\u513f\u5c1a\u672a\u53d1\u751f\u4e25\u91cd\u7f3a\u8840\u6216\u6b7b\u4ea1\u3002\u800cA\u9879\u524d\u7f6e\u80ce\u76d8\u591a\u6709\u65e0\u75db\u6027\u51fa\u8840\uff0cB\u9879\u5148\u5146\u6d41\u4ea7\u591a\u53d1\u751f\u572820\u5468\u524d\uff0cD\u9879\u96be\u514d\u6d41\u4ea7\u5219\u4e0d\u7b26\u5408\u60a3\u8005\u598a\u5a20\u665a\u671f\u548c\u68c0\u67e5\u7ed3\u679c\u3002\u56e0\u6b64\uff0c\u9009\u62e9C\u9879\u4e3a\u6700\u53ef\u80fd\u7684\u8bca\u65ad\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: \u7537\u5a74\uff0c3\u5929\u30022\u5929\u524d\u51fa\u73b0\u76ae\u80a4\u9ec4\u67d3\uff0c\u9010\u6e10\u52a0\u91cd\uff0c1\u5929\u6765\u55dc\u7761\u62d2\u5976\u3002\u67e5\u4f53\uff1a\u53cd\u5e94\u5dee\uff0c\u76ae\u80a4\u91cd\u5ea6\u9ec4\u67d3\uff0c\u5fc3\u80ba\u672a\u89c1\u5f02\u5e38\uff0c\u809d\u808b\u4e0b3cm\uff0c\u808c\u5f20\u529b\u4f4e\u4e0b\u3002\u8840RBC 3.9\u00d71012/L\uff0cHb 120g/L\uff0c\u7f51\u7ec7\u7ea2\u7ec6\u80de0.09\uff0c\u8840\u6e05\u603b\u80c6\u7ea2\u7d20359\u03bcmol/L\u3002\u6700\u53ef\u80fd\u7684\u8bca\u65ad\u662f\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: \u65b0\u751f\u513f\u7f3a\u6c27\u7f3a\u8840\u6027\u8111\u75c5\tB: \u65b0\u751f\u513f\u6eb6\u8840\u75c5\tC: \u65b0\u751f\u513f\u8d25\u8840\u75c7\tD: \u65b0\u751f\u513f\u5316\u8113\u6027\u8111\u819c\u708e\t\n\u6b63\u786e\u7b54\u6848\u662f B: \u65b0\u751f\u513f\u6eb6\u8840\u75c5\u3002",
-            "output": "\u9009\u62e9B\u9879\u65b0\u751f\u513f\u6eb6\u8840\u75c5\u7684\u539f\u56e0\u662f\uff1a\u75c5\u5a74\u51fa\u751f\u540e2\u5929\u5f00\u59cb\u76ae\u80a4\u9ec4\u67d3\uff0c\u5e76\u9010\u6e10\u52a0\u91cd\uff1b\u4f34\u968f\u55dc\u7761\u548c\u62d2\u5976\uff0c\u8fd9\u4e9b\u75c7\u72b6\u548c\u4f53\u5f81\u6307\u5411\u65b0\u751f\u513f\u671f\u95f4\u7ea2\u7ec6\u80de\u7684\u7834\u574f\u3002\u67e5\u4f53\u53ef\u89c1\u660e\u663e\u7684\u76ae\u80a4\u9ec4\u67d3\u548c\u809d\u80bf\u5927\uff08\u809d\u808b\u4e0b3cm\uff09\uff0c\u8fd9\u662f\u7531\u4e8e\u80c6\u7ea2\u7d20\u4ee3\u8c22\u7d0a\u4e71\u5bfc\u81f4\u809d\u810f\u8d1f\u62c5\u52a0\u91cd\u3002\u8840\u68c0\u663e\u793a\u8840\u6e05\u603b\u80c6\u7ea2\u7d20\u660e\u663e\u5347\u9ad8\u81f3359\u03bcmol/L\uff0c\u8840\u7ea2\u86cb\u767d\u6b63\u5e38\uff0c\u7f51\u7ec7\u7ea2\u7ec6\u80de\u7565\u6709\u589e\u52a0\uff0c\u8fd9\u4e9b\u90fd\u662f\u6eb6\u8840\u6027\u75be\u75c5\u7684\u7279\u70b9\uff0c\u6392\u9664\u4e86\u8d25\u8840\u75c7\u548c\u611f\u67d3\u6027\u7684\u53ef\u80fd\u3002\u65b0\u751f\u513f\u7f3a\u6c27\u7f3a\u8840\u6027\u8111\u75c5\u4e3b\u8981\u8868\u73b0\u4e3a\u795e\u7ecf\u7cfb\u7edf\u75c7\u72b6\uff0c\u5e76\u4e0d\u4f34\u6709\u660e\u663e\u7684\u6eb6\u8840\u548c\u9ec4\u75b8\u3002\u56e0\u6b64\uff0c\u65b0\u751f\u513f\u9ec4\u75b8\u3001\u809d\u810f\u80bf\u5927\u4ee5\u53ca\u9ad8\u80c6\u7ea2\u7d20\u8840\u75c7\u7684\u7279\u70b9\u6700\u7b26\u5408\u65b0\u751f\u513f\u6eb6\u8840\u75c5\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: \u5973\uff0c36\u5c81\u3002\u95f4\u65ad\u8179\u75db\u3001\u8179\u6cfb5\u5e74\uff0c\u5927\u4fbf3\uff5e5\u6b21/\u65e5\uff0c\u5e26\u9ecf\u6db2\uff0c\u65e0\u8113\u8840\uff0c\u4fbf\u540e\u80c0\u75db\u7f13\u89e3\uff0c\u53d7\u51c9\u53ca\u7d27\u5f20\u540e\u75c7\u72b6\u52a0\u91cd\uff0c\u65e0\u53d1\u70ed\uff0c\u6297\u751f\u7d20\u6cbb\u7597\u65e0\u6548\u3002\u4f53\u91cd\u65e0\u51cf\u8f7b\u3002\u7caa\u9690\u8840\u8bd5\u9a8c\u9634\u6027\u30022\uff0e\u4e3a\u786e\u5b9a\u8bca\u65ad\uff0c\u9996\u9009\u7684\u68c0\u67e5\u662f\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: \u7ed3\u80a0\u955c\tB: \u7caa\u7ec6\u83cc\u57f9\u517b\tC: \u5c0f\u80a0X\u7ebf\u94a1\u5242\u9020\u5f71\tD: \u8179\u90e8B\u578b\u8d85\u58f0\t\n\u6b63\u786e\u7b54\u6848\u662f A: \u7ed3\u80a0\u955c\u3002",
-            "output": "\u9009\u62e9\u7ed3\u80a0\u955c\uff08A\u9009\u9879\uff09\u7684\u7406\u7531\u662f\uff0c\u6839\u636e\u75c5\u4eba\u7684\u75c7\u72b6\uff0c\u8bf8\u5982\u95f4\u65ad\u6027\u8179\u75db\u3001\u8179\u6cfb\u3001\u4fbf\u540e\u80c0\u75db\u7f13\u89e3\u7b49\uff0c\u4ee5\u53ca\u8179\u6cfb\u5e26\u9ecf\u6db2\u4f46\u65e0\u8113\u8840\uff0c\u7ed3\u5408\u7caa\u9690\u8840\u8bd5\u9a8c\u9634\u6027\uff0c\u4ee5\u53ca\u6297\u751f\u7d20\u6cbb\u7597\u65e0\u6548\uff0c\u8f83\u7b26\u5408\u80a0\u6613\u6fc0\u7efc\u5408\u5f81\u6216\u708e\u75c7\u6027\u80a0\u75c5\u7b49\u75be\u75c5\u7684\u4e34\u5e8a\u8868\u73b0\u3002\u901a\u8fc7\u7ed3\u80a0\u955c\u53ef\u4ee5\u76f4\u63a5\u89c2\u5bdf\u5230\u7ed3\u80a0\u9ecf\u819c\u7684\u72b6\u6001\uff0c\u6392\u9664\u7ed3\u80a0\u80bf\u7624\u3001\u6e83\u75a1\u6027\u7ed3\u80a0\u708e\u7b49\u7ed3\u76f4\u80a0\u75be\u75c5\uff0c\u662f\u786e\u8bca\u8fd9\u4e9b\u53ef\u80fd\u75be\u75c5\u7684\u91d1\u6807\u51c6\u4e4b\u4e00\u3002\u6b64\u5916\uff0c\u7ed3\u80a0\u955c\u8fd8\u53ef\u4ee5\u8fdb\u884c\u6d3b\u68c0\uff0c\u5bf9\u4e8e\u708e\u75c7\u6027\u80a0\u75c5\u7684\u786e\u8bca\u5c24\u4e3a\u91cd\u8981\u3002\u800c\u5176\u4ed6\u9009\u9879\u5982\u7caa\u7ec6\u83cc\u57f9\u517b\u3001\u5c0f\u80a0X\u7ebf\u94a1\u5242\u9020\u5f71\u3001\u8179\u90e8B\u578b\u8d85\u58f0\u7b49\u5219\u66f4\u591a\u5728\u8003\u8651\u5176\u4ed6\u75c5\u7406\u60c5\u51b5\u4e0b\u7684\u68c0\u67e5\uff0c\u6b64\u75c5\u4f8b\u4e2d\u5e76\u975e\u9996\u9009\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: \u5c0f\u513f\u8179\u6cfb\u8f7b\u5ea6\u9178\u4e2d\u6bd2\u65f6\uff0c\u65e9\u671f\u8bca\u65ad\u7684\u53ef\u9760\u4f9d\u636e\u662f\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: \u8131\u6c34\u7a0b\u5ea6\tB: \u9178\u4e2d\u6bd2\u75c7\u72b6\tC: \u547c\u5438\u75c7\u72b6\tD: \u8840\u6c14\u5206\u6790\t\n\u6b63\u786e\u7b54\u6848\u662f D: \u8840\u6c14\u5206\u6790\u3002",
-            "output": "\u9009\u62e9D.\u8840\u6c14\u5206\u6790\u4f5c\u4e3a\u65e9\u671f\u8bca\u65ad\u5c0f\u513f\u8179\u6cfb\u8f7b\u5ea6\u9178\u4e2d\u6bd2\u7684\u53ef\u9760\u4f9d\u636e\u7684\u539f\u56e0\u662f\uff1a\u8840\u6c14\u5206\u6790\u53ef\u4ee5\u76f4\u89c2\u51c6\u786e\u5730\u53cd\u6620\u51fa\u8840\u6db2\u4e2d\u7684\u9178\u78b1\u5e73\u8861\u72b6\u6001\u548c\u6c14\u4f53\u4ea4\u6362\u60c5\u51b5\u3002\u901a\u8fc7\u8840\u6c14\u5206\u6790\uff0c\u533b\u751f\u80fd\u591f\u4e86\u89e3\u60a3\u513f\u4f53\u5185\u7684pH\u503c\u3001\u78b3\u9178\u6c22\u76d0\uff08HCO3^-\uff09\u6c34\u5e73\u3001\u4e8c\u6c27\u5316\u78b3\u5206\u538b\uff08PaCO2\uff09\u7b49\u6307\u6807\uff0c\u8fd9\u4e9b\u90fd\u662f\u8bc4\u4f30\u9178\u4e2d\u6bd2\u72b6\u6001\u7684\u76f4\u63a5\u6307\u6807\u3002\u4e0e\u8131\u6c34\u7a0b\u5ea6\u3001\u9178\u4e2d\u6bd2\u75c7\u72b6\u548c\u547c\u5438\u75c7\u72b6\u76f8\u6bd4\uff0c\u8fd9\u4e9b\u751f\u5316\u53c2\u6570\u66f4\u5177\u6709\u7279\u5f02\u6027\u548c\u654f\u611f\u6027\uff0c\u56e0\u6b64\u66f4\u9002\u5408\u4f5c\u4e3a\u65e9\u671f\u8bca\u65ad\u7684\u4f9d\u636e\u3002\u5c24\u5176\u662f\u5728\u9178\u4e2d\u6bd2\u65e9\u671f\uff0c\u75c7\u72b6\u548c\u4f53\u5f81\u4e0d\u4e00\u5b9a\u663e\u8457\uff0c\u800c\u8840\u6c14\u5206\u6790\u7ed3\u679c\u53ef\u4ee5\u63d0\u4f9b\u66f4\u4e3a\u5ba2\u89c2\u7684\u8bca\u65ad\u8bc1\u636e\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: \u6b63\u5e38\u513f\uff0c\u524d\u56df2.0cm\u00d72.0cm\uff0c\u4f53\u91cd7kg\uff0c\u80fd\u72ec\u5750\u4e00\u4f1a\u3001\u7528\u624b\u6447\u73a9\u5177\uff0c\u80fd\u8ba4\u8bc6\u719f\u4eba\u548c\u964c\u751f\u4eba\uff0c\u5176\u6708\u9f84\u4e3a\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: 8\u4e2a\u6708\tB: 6\u4e2a\u6708\tC: 3\u4e2a\u6708\tD: 12\u4e2a\u6708\t\n\u6b63\u786e\u7b54\u6848\u662f B: 6\u4e2a\u6708\u3002",
-            "output": "\u8003\u8651\u5230\u513f\u7ae5\u53d1\u80b2\u7684\u91cc\u7a0b\u7891\uff0c\u6b63\u5e38\u60c5\u51b5\u4e0b\uff0c6\u4e2a\u6708\u5927\u7684\u5a74\u513f\u524d\u56df\uff08\u524d\u989d\u90e8\u8f6f\u9aa8\uff09\u5f00\u59cb\u95ed\u5408\uff0c\u5927\u5c0f\u53ef\u80fd\u57281-2\u5398\u7c73\u4e4b\u95f4\uff0c\u4f53\u91cd\u5927\u7ea67\u516c\u65a4\u5c5e\u4e8e\u6b63\u5e38\u8303\u56f4\u3002\u6b64\u5916\uff0c6\u4e2a\u6708\u5927\u7684\u5a74\u513f\u5f00\u59cb\u80fd\u72ec\u5750\u4e00\u4f1a\u513f\uff0c\u5e76\u6709\u8db3\u591f\u7684\u7cbe\u7ec6\u52a8\u4f5c\u534f\u8c03\u80fd\u529b\u73a9\u6447\u6446\u7c7b\u73a9\u5177\u3002\u5a74\u513f\u5728\u8fd9\u4e2a\u9636\u6bb5\u4e5f\u5f00\u59cb\u533a\u5206\u719f\u6089\u548c\u4e0d\u719f\u6089\u7684\u4eba\u3002\u56e0\u6b64\uff0c\u6839\u636e\u9898\u76ee\u63cf\u8ff0\u7684\u53d1\u5c55\u7279\u70b9\uff0c\u9009\u62e9B. 6\u4e2a\u6708\u4f5c\u4e3a\u6700\u7b26\u5408\u5a74\u513f\u6708\u9f84\u7684\u7b54\u6848\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: \u4e0b\u5217\u53d7\u4f53\u4e0e\u914d\u4f53\u7684\u7ed3\u5408\u54ea\u9879\u662f\u9519\u8bef\u7684?\uff08\u3000\u3000\uff09\n\u9009\u9879: A: KD39\u4e0eCIMO\tB: CD28\u4e0eCD80\tC: CD4\u4e0eMHC-\u2161\tD: CD8\u4e0eMHC-\u2161\t\n\u6b63\u786e\u7b54\u6848\u662f D: CD8\u4e0eMHC-\u2161\u3002",
-            "output": "\u9009\u62e9\u9009\u9879D\uff08CD8\u4e0eMHC-\u2161\uff09\u662f\u9519\u8bef\u7684\u539f\u56e0\u662f\uff0c\u5728\u514d\u75ab\u7cfb\u7edf\u7684\u76f8\u4e92\u4f5c\u7528\u4e2d\uff0cCD8\u5206\u5b50\u4e3b\u8981\u4e0eMHC-I\u5206\u5b50\u7ed3\u5408\uff0c\u800cCD4\u5206\u5b50\u5219\u4e0eMHC-II\u5206\u5b50\u7ed3\u5408\u3002CD8\u901a\u5e38\u5b58\u5728\u4e8e\u7ec6\u80de\u6bd2\u6027T\u7ec6\u80de\uff08CTLs\uff09\u8868\u9762\uff0c\u5b83\u4eec\u80fd\u8bc6\u522b\u548c\u6740\u6b7b\u643a\u5e26MHC-I\u5206\u5b50\u5448\u9012\u5185\u6e90\u6027\u6297\u539f\u7684\u53d7\u611f\u67d3\u7ec6\u80de\u3002\u76f8\u6bd4\u4e4b\u4e0b\uff0cCD4\u5b58\u5728\u4e8e\u8f85\u52a9T\u7ec6\u80de\u8868\u9762\uff0c\u4e0eMHC-II\u5206\u5b50\u7ed3\u5408\uff0c\u8bc6\u522b\u5916\u6e90\u6027\u6297\u539f\uff0c\u8fd9\u4e9b\u6297\u539f\u901a\u5e38\u7531\u6297\u539f\u63d0\u5448\u7ec6\u80de\uff0c\u5982\u6811\u7a81\u7ec6\u80de\u548c\u5de8\u566c\u7ec6\u80de\uff0c\u901a\u8fc7MHC-II\u5206\u5b50\u5448\u9012\u3002\u56e0\u6b64\uff0cCD8\u4e0eMHC-II\u7684\u7ed3\u5408\u5728\u751f\u7406\u60c5\u51b5\u4e0b\u4e0d\u662f\u5e38\u89c1\u7684\u514d\u75ab\u53cd\u5e94\u8fc7\u7a0b\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: \u514d\u75ab\u53cd\u5e94\u6027\u662f\u6307\u6297\u539f\u80fd\u591f\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: \u523a\u6fc0\u673a\u4f53\u53d1\u751f\u514d\u75ab\u5e94\u7b54\u7684\u6027\u80fd\tB: \u523a\u6fc0\u673a\u4f53\u4ea7\u751f\u6297\u4f53\u7684\u6027\u80fd\tC: \u4e0e\u76f8\u5e94\u514d\u75ab\u5e94\u7b54\u4ea7\u7269\u7279\u5f02\u6027\u7ed3\u5408\uff0c\u53d1\u751f\u514d\u75ab\u53cd\u5e94\u7684\u6027\u80fd\tD: \u4e0e\u81f4\u654f\u6dcb\u5df4\u7ec6\u80de\u7279\u5f02\u6027\u7ed3\u5408\uff0c\u53d1\u751f\u514d\u75ab\u53cd\u5e94\u7684\u6027\u80fd\t\n\u6b63\u786e\u7b54\u6848\u662f C: \u4e0e\u76f8\u5e94\u514d\u75ab\u5e94\u7b54\u4ea7\u7269\u7279\u5f02\u6027\u7ed3\u5408\uff0c\u53d1\u751f\u514d\u75ab\u53cd\u5e94\u7684\u6027\u80fd\u3002",
-            "output": "\u514d\u75ab\u53cd\u5e94\u6027\u7684\u5b9a\u4e49\u662f\u6307\u4e00\u79cd\u6297\u539f\u4e0e\u5176\u76f8\u5e94\u7684\u514d\u75ab\u5e94\u7b54\u4ea7\u7269\uff08\u5982\u6297\u4f53\u3001T\u7ec6\u80de\u53d7\u4f53\uff09\u4e4b\u95f4\u80fd\u7279\u5f02\u6027\u7ed3\u5408\uff0c\u5e76\u56e0\u8fd9\u79cd\u7ed3\u5408\u800c\u89e6\u53d1\u514d\u75ab\u53cd\u5e94\u7684\u80fd\u529b\u3002\u56e0\u6b64\uff0c\u9009\u9879C\u201c\u4e0e\u76f8\u5e94\u514d\u75ab\u5e94\u7b54\u4ea7\u7269\u7279\u5f02\u6027\u7ed3\u5408\uff0c\u53d1\u751f\u514d\u75ab\u53cd\u5e94\u7684\u6027\u80fd\u201d\u6b63\u597d\u7b26\u5408\u8fd9\u4e00\u5b9a\u4e49\u3002\u867d\u7136\u6297\u4f53\u7684\u4ea7\u751f\uff08\u9009\u9879B\uff09\u548c\u6dcb\u5df4\u7ec6\u80de\u7684\u7279\u5f02\u6027\u7ed3\u5408\uff08\u9009\u9879D\uff09\u662f\u514d\u75ab\u5e94\u7b54\u7684\u4e00\u90e8\u5206\uff0c\u5b83\u4eec\u5e76\u4e0d\u5b8c\u5168\u7b49\u540c\u4e8e\u514d\u75ab\u53cd\u5e94\u6027\u7684\u6982\u5ff5\u3002\u9009\u9879A\u201c\u523a\u6fc0\u673a\u4f53\u53d1\u751f\u514d\u75ab\u5e94\u7b54\u7684\u6027\u80fd\u201d\u5e7f\u4e49\u4e0a\u63cf\u8ff0\u4e86\u6297\u539f\u7684\u4f5c\u7528\uff0c\u4f46\u6ca1\u6709\u5f3a\u8c03\u6297\u539f\u4e0e\u514d\u75ab\u5e94\u7b54\u4ea7\u7269\u4e4b\u95f4\u7684\u7279\u5f02\u6027\u7ed3\u5408\uff0c\u56e0\u6b64C\u9009\u9879\u66f4\u4e3a\u7cbe\u51c6\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: \u7834\u4f24\u98ce\u6700\u521d\u51fa\u73b0\u5178\u578b\u7684\u808c\u8089\u5f3a\u70c8\u6536\u7f29\u662f\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: \u54ac\u808c\tB: \u9888\u9879\u808c\tC: \u9762\u808c\tD: \u56db\u80a2\u808c\t\n\u6b63\u786e\u7b54\u6848\u662f A: \u54ac\u808c\u3002",
-            "output": "\u7834\u4f24\u98ce\u662f\u7531\u7834\u4f24\u98ce\u6746\u83cc\u5f15\u8d77\u7684\u6025\u6027\u611f\u67d3\u3002\u5728\u521d\u671f\uff0c\u8fd9\u79cd\u7ec6\u83cc\u4f1a\u9996\u5148\u5f71\u54cd\u9885\u8111\u795e\u7ecf\uff0c\u7279\u522b\u662f\u63a7\u5236\u808c\u8089\u8fd0\u52a8\u7684\u795e\u7ecf\u3002\u54ac\u808c\u662f\u6211\u4eec\u5480\u56bc\u8fd0\u52a8\u7684\u4e3b\u8981\u808c\u8089\uff0c\u7531\u9885\u8111\u795e\u7ecf\u652f\u914d\u3002\u56e0\u6b64\uff0c\u5728\u7834\u4f24\u98ce\u611f\u67d3\u7684\u65e9\u671f\u9636\u6bb5\uff0c\u54ac\u808c\u7531\u4e8e\u795e\u7ecf\u88ab\u6bd2\u7d20\u4f5c\u7528\u4f1a\u51fa\u73b0\u5f3a\u70c8\u7684\uff0c\u4e0d\u53d7\u63a7\u5236\u7684\u808c\u8089\u6536\u7f29\uff0c\u8fd9\u79cd\u73b0\u8c61\u88ab\u79f0\u4e3a\"\u7834\u4f24\u98ce\u9762\u5bb9\"\u6216\"\u9501\u988c\"\u3002\u5176\u4ed6\u9009\u9879\u5982\u9888\u9879\u808c\u3001\u9762\u808c\u548c\u56db\u80a2\u808c\u867d\u7136\u6700\u7ec8\u4e5f\u4f1a\u53d7\u5230\u5f71\u54cd\uff0c\u4f46\u901a\u5e38\u662f\u5728\u75c5\u7a0b\u7684\u7a0d\u540e\u9636\u6bb5\uff0c\u6240\u4ee5\u6700\u521d\u51fa\u73b0\u5178\u578b\u7684\u808c\u8089\u5f3a\u70c8\u6536\u7f29\u662f\u54ac\u808c\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: \u91cd\u75c7\u4e00\u6c27\u5316\u78b3\u4e2d\u6bd2\u60a3\u8005\u7684\u6700\u6709\u6548\u7684\u6cbb\u7597\u63aa\u65bd\u662f\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: \u9f3b\u5bfc\u7ba1\u95f4\u65ad\u4f4e\u6d41\u91cf\u5438\u6c27\tB: \u9ad8\u538b\u6c27\u8231\u6cbb\u7597\tC: \u5438\u5165\u7eaf\u6c27\u9f3b\u5bfc\u7ba1\tD: \u6301\u7eed\u4f4e\u6d41\u91cf\t\n\u6b63\u786e\u7b54\u6848\u662f B: \u9ad8\u538b\u6c27\u8231\u6cbb\u7597\u3002",
-            "output": "\u9009\u62e9B\u9ad8\u538b\u6c27\u8231\u6cbb\u7597\u4f5c\u4e3a\u91cd\u75c7\u4e00\u6c27\u5316\u78b3\u4e2d\u6bd2\u60a3\u8005\u6700\u6709\u6548\u7684\u6cbb\u7597\u63aa\u65bd\u7684\u539f\u56e0\u662f\u9ad8\u538b\u6c27\u53ef\u4ee5\u663e\u8457\u63d0\u9ad8\u8840\u6db2\u4e2d\u7684\u6c27\u5206\u538b\uff0c\u8feb\u4f7f\u4e00\u6c27\u5316\u78b3\u4ece\u8840\u7ea2\u86cb\u767d\u4e0a\u89e3\u79bb\uff0c\u4ee5\u63d0\u9ad8\u8840\u6db2\u8fd0\u642c\u6c27\u6c14\u7684\u80fd\u529b\u3002\u9ad8\u538b\u6c27\u8231\u8fd8\u80fd\u51cf\u5c11\u4e2d\u6bd2\u5f15\u8d77\u7684\u7ec4\u7ec7\u7f3a\u6c27\uff0c\u5e76\u52a0\u901f\u4e00\u6c27\u5316\u78b3\u7684\u6392\u51fa\uff0c\u4ece\u800c\u964d\u4f4e\u4e2d\u6bd2\u540e\u6548\u5e94\u7684\u673a\u4f1a\u3002\u4e0e\u95f4\u65ad\u4f4e\u6d41\u91cf\u5438\u6c27\u6216\u6301\u7eed\u4f4e\u6d41\u91cf\u76f8\u6bd4\uff0c\u9ad8\u538b\u6c27\u8231\u63d0\u4f9b\u7684\u6cbb\u7597\u6548\u679c\u66f4\u52a0\u8fc5\u901f\u4e14\u5f7b\u5e95\uff0c\u662f\u6cbb\u7597\u91cd\u75c7\u4e00\u6c27\u5316\u78b3\u4e2d\u6bd2\u7684\u9996\u9009\u3002\u5438\u5165\u7eaf\u6c27\u9f3b\u5bfc\u7ba1\u867d\u7136\u4e5f\u53ef\u4ee5\u63d0\u9ad8\u6c27\u542b\u91cf\uff0c\u4f46\u6548\u679c\u4e0d\u5982\u9ad8\u538b\u6c27\u660e\u663e\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: \u7537\u6027\uff0c39\u5c81\uff0c\u5546\u4eba\uff0c\u6709\u51b6\u6e38\u53f2\uff0cl\u5468\u6765\u53d1\u70ed\uff0c\u5934\u75db\uff0c\u5168\u8eab\u4e0d\u9002\uff0c\u65e0\u98df\u6b32\uff0c\u5168\u8eab\u6dcb\u5df4\u7ed3\u5747\u80bf\u5927\uff0c\u65e0\u75db\u3002\u767d\u7ec6\u80de3.5\u00d7109/L\uff0cCD4/CD8\u4e3a1.0\uff0c\u5176\u4ed6\u65e0\u7279\u6b8a\uff0c\u6b64\u4f8b\u54ea\u4e00\u79cd\u75be\u75c5\u53ef\u80fd\u6027\u5927\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: \u6025\u6027\u6dcb\u5df4\u7ed3\u708e\tB: \u827e\u6ecb\u75c5\tC: \u970d\u5947\u91d1\u75c5\tD: \u94a9\u4f53\u75c5\t\n\u6b63\u786e\u7b54\u6848\u662f B: \u827e\u6ecb\u75c5\u3002",
-            "output": "\u8be5\u75c5\u4eba\u6709\u51b6\u6e38\u53f2\uff0c\u8868\u73b0\u51fa\u53d1\u70ed\u3001\u5934\u75db\u3001\u5168\u8eab\u4e0d\u9002\u7b49\u5168\u8eab\u6027\u75c7\u72b6\uff0c\u5e76\u4f34\u6709\u5168\u8eab\u6dcb\u5df4\u7ed3\u80bf\u5927\u4f46\u65e0\u75db\uff0c\u767d\u7ec6\u80de\u8ba1\u6570\u504f\u4f4e\uff0c\u4ee5\u53caCD4/CD8\u6bd4\u503c\u4e3a1.0\uff08\u6b63\u5e38\u6bd4\u503c\u4e00\u822c\u4e3a1.5-2\uff09\uff0c\u8fd9\u4e9b\u4e34\u5e8a\u8868\u73b0\u4e0e\u827e\u6ecb\u75c5(HIV\u611f\u67d3)\u76f8\u7b26\u3002\u827e\u6ecb\u75c5\u75c5\u6bd2\u611f\u67d3\u521d\u671f\u53ef\u9020\u6210\u7c7b\u4f3c\u6025\u6027\u75c5\u6bd2\u611f\u67d3\u7684\u5168\u8eab\u6027\u75c7\u72b6\uff0c\u5e76\u4e14\u4f1a\u5f71\u54cd\u514d\u75ab\u7cfb\u7edf\u529f\u80fd\uff0c\u5bfc\u81f4CD4\u7ec6\u80de\u6570\u76ee\u964d\u4f4e\u53ca\u6bd4\u503c\u6539\u53d8\u3002\u5176\u4ed6\u7684\u9009\u9879\u50cf\u662f\u6025\u6027\u6dcb\u5df4\u7ed3\u708e\u901a\u5e38\u4f1a\u4f34\u6709\u75bc\u75db\uff0c\u970d\u5947\u91d1\u75c5\u901a\u5e38\u4e0d\u4f1a\u51fa\u73b0\u5982\u6b64\u4f4e\u7684\u767d\u7ec6\u80de\u8ba1\u6570\uff0c\u94a9\u4f53\u75c5\u5219\u4e0e\u75c5\u4eba\u63cf\u8ff0\u7684\u4e34\u5e8a\u75c7\u72b6\u4e0d\u543b\u5408\u3002\u56e0\u6b64\uff0c\u9009\u62e9B. \u827e\u6ecb\u75c5\u4f5c\u4e3a\u6b64\u75c5\u4f8b\u7684\u6700\u53ef\u80fd\u8bca\u65ad\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: \u4e0b\u5217\u54ea\u9879\u4e0d\u662f\u7ee7\u53d1\u6027\u7ed3\u6838\u75c5\u7684\u7c7b\u578b\uff1f\uff08\u3000\u3000\uff09\n\u9009\u9879: A: \u539f\u53d1\u6027\u7efc\u5408\u75c7\tB: \u6d78\u6da6\u578b\u80ba\u7ed3\u6838\tC: \u7ed3\u6838\u7403\tD: \u5e72\u916a\u6027\u80ba\u708e\t\n\u6b63\u786e\u7b54\u6848\u662f A: \u539f\u53d1\u6027\u7efc\u5408\u75c7\u3002",
-            "output": "\u7ee7\u53d1\u6027\u7ed3\u6838\u75c5\u6307\u7684\u662f\u539f\u6709\u7ed3\u6838\u611f\u67d3\u540e\uff0c\u7531\u4e8e\u673a\u4f53\u514d\u75ab\u529f\u80fd\u4e0b\u964d\u6216\u5176\u4ed6\u56e0\u7d20\u5bfc\u81f4\u7684\u518d\u6d3b\u5316\u6216\u65b0\u7684\u611f\u67d3\u3002B\u9879\u201c\u6d78\u6da6\u578b\u80ba\u7ed3\u6838\u201d\u3001C\u9879\u201c\u7ed3\u6838\u7403\u201d\u548cD\u9879\u201c\u5e72\u916a\u6027\u80ba\u708e\u201d\u5747\u662f\u7ee7\u53d1\u6027\u7ed3\u6838\u75c5\u7684\u4e0d\u540c\u4e34\u5e8a\u8868\u73b0\u5f62\u5f0f\u3002\u800cA\u9879\u201c\u539f\u53d1\u6027\u7efc\u5408\u75c7\u201d\u662f\u6307\u521d\u6b21\u63a5\u89e6\u7ed3\u6838\u83cc\u65f6\u4ea7\u751f\u7684\u4e00\u7ec4\u4e34\u5e8a\u75c7\u72b6\u548c\u4f53\u5f81\uff0c\u901a\u5e38\u5305\u62ec\u539f\u53d1\u7076\u3001\u533a\u57df\u6027\u6dcb\u5df4\u7ed3\u80bf\u5927\u548c\u6709\u65f6\u7684\u8840\u884c\u64ad\u6563\uff0c\u53cd\u6620\u7684\u662f\u521d\u6b21\u611f\u67d3\u7ed3\u6838\u83cc\u7684\u53cd\u5e94\uff0c\u56e0\u6b64\u5b83\u5c5e\u4e8e\u539f\u53d1\u6027\u7ed3\u6838\u75c5\uff0c\u800c\u4e0d\u662f\u7ee7\u53d1\u6027\u7ed3\u6838\u75c5\u7684\u7c7b\u578b\u3002\u6240\u4ee5\uff0c\u9009\u62e9A\u9879\u201c\u539f\u53d1\u6027\u7efc\u5408\u75c7\u201d\u4f5c\u4e3a\u4e0d\u662f\u7ee7\u53d1\u6027\u7ed3\u6838\u75c5\u7684\u7c7b\u578b\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: \u5316\u8113\u6027\u611f\u67d3\u5f62\u6210\u8113\u80bf\u540e,\u5916\u79d1\u6cbb\u7597\u7684\u57fa\u672c\u539f\u5219\u662f\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: \u5168\u8eab\u52a0\u5927\u6297\u751f\u7d20\u5242\u91cf\tB: \u52a0\u7528\u80be\u4e0a\u817a\u76ae\u8d28\u6fc0\u7d20\tC: \u914d\u5408\u5c40\u90e8\u7269\u7406\u6cbb\u7597\tD: \u7acb\u5373\u5207\u5f00\u5f15\u6d41\t\n\u6b63\u786e\u7b54\u6848\u662f D: \u7acb\u5373\u5207\u5f00\u5f15\u6d41\u3002",
-            "output": "\u9009\u62e9\u9009\u9879D\u201c\u7acb\u5373\u5207\u5f00\u5f15\u6d41\u201d\u662f\u56e0\u4e3a\u8113\u80bf\u5f62\u6210\u540e\uff0c\u5c40\u90e8\u901a\u5e38\u5df2\u5f62\u6210\u6709\u9650\u7684\u8113\u8154\uff0c\u6297\u751f\u7d20\u8f83\u96be\u76f4\u63a5\u8fbe\u5230\u8113\u8154\u5185\u90e8\uff0c\u56e0\u6b64\u5355\u9760\u6297\u751f\u7d20\u6cbb\u7597\u6548\u679c\u4e0d\u4f73\u3002\u80be\u4e0a\u817a\u76ae\u8d28\u6fc0\u7d20\u6291\u5236\u708e\u75c7\uff0c\u53ef\u80fd\u4f1a\u5f71\u54cd\u611f\u67d3\u63a7\u5236\u3002\u5c40\u90e8\u7269\u7406\u6cbb\u7597\u53ef\u4ee5\u4f5c\u4e3a\u8f85\u52a9\u624b\u6bb5\uff0c\u4f46\u4e0d\u662f\u57fa\u672c\u539f\u5219\u3002\u5207\u5f00\u5f15\u6d41\u662f\u5904\u7406\u8113\u80bf\u6700\u76f4\u63a5\u3001\u6700\u6709\u6548\u7684\u65b9\u6cd5\uff0c\u53ef\u4ee5\u8fc5\u901f\u6392\u51fa\u8113\u6db2\uff0c\u51cf\u5c11\u7ec4\u7ec7\u6bd2\u7d20\u5438\u6536\uff0c\u7f13\u89e3\u708e\u75c7\uff0c\u4fc3\u8fdb\u75c5\u7076\u63a7\u5236\u548c\u6108\u5408\uff0c\u662f\u5316\u8113\u6027\u611f\u67d3\u5f62\u6210\u8113\u80bf\u540e\u5916\u79d1\u6cbb\u7597\u7684\u57fa\u672c\u539f\u5219\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: \u6709\u5173Q\u70ed\u67ef\u514b\u65af\u4f53\u53d9\u8ff0\u4e0d\u6b63\u786e\u7684\u662f\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: \u5728\u5bbf\u4e3b\u7ec6\u80de\u5916\u80fd\u957f\u671f\u5b58\u6d3b\tB: \u53ef\u901a\u8fc7\u866b\u5a92\u3001\u547c\u5438\u9053\u3001\u6d88\u5316\u9053\u6216\u63a5\u89e6\u800c\u611f\u67d3\tC: \u5916\u6590\u53cd\u5e94\u9633\u6027\tD: \u53ef\u5f15\u8d77\u4eba\u755c\u5171\u60a3\u75be\u75c5\t\n\u6b63\u786e\u7b54\u6848\u662f C: \u5916\u6590\u53cd\u5e94\u9633\u6027\u3002",
-            "output": "\u9009\u62e9C\u9879\u201c\u5916\u6590\u53cd\u5e94\u9633\u6027\u201d\u662f\u56e0\u4e3aQ\u70ed\u67ef\u514b\u65af\u4f53\uff08Coxiella burnetii\uff09\u662f\u4e00\u4e2a\u9769\u5170\u9634\u6027\u7684\u5fae\u751f\u7269\uff0c\u800c\u5916\u6590\u53cd\u5e94\u662f\u7528\u4e8e\u68c0\u6d4b\u9769\u5170\u9633\u6027\u7ec6\u83cc\u7ec6\u80de\u58c1\u4e2d\u7684\u80bd\u805a\u7cd6\u7684\u4e00\u79cd\u5b9e\u9a8c\u3002Q\u70ed\u67ef\u514b\u65af\u4f53\u7684\u7ec6\u80de\u58c1\u7ed3\u6784\u4e0e\u5916\u6590\u53cd\u5e94\u6240\u68c0\u6d4b\u7684\u76ee\u6807\u6210\u5206\u4e0d\u7b26\uff0c\u6240\u4ee5\u5b83\u4e0d\u4f1a\u4ea7\u751f\u9633\u6027\u7684\u5916\u6590\u53cd\u5e94\u3002A\u9879\u9519\u8bef\uff0c\u5b83\u5728\u5bbf\u4e3b\u7ec6\u80de\u5916\u4e0d\u80fd\u957f\u671f\u5b58\u6d3b\uff1bB\u9879\u548cD\u9879\u6b63\u786e\uff0c\u5b83\u7684\u786e\u53ef\u4ee5\u901a\u8fc7\u866b\u5a92\u3001\u547c\u5438\u9053\u3001\u6d88\u5316\u9053\u6216\u63a5\u89e6\u7b49\u591a\u79cd\u65b9\u5f0f\u611f\u67d3\u5bbf\u4e3b\uff0c\u5e76\u53ef\u5f15\u8d77\u4eba\u755c\u5171\u60a3\u75be\u75c5\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: \u8840\u4e2d\u8865\u4f53\u6c34\u5e73\u4e0b\u964d\u4e00\u822c\u4e0d\u89c1\u4e8e\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: \u6025\u8fdb\u6027\u80be\u5c0f\u7403\u80be\u708e\tB: \u819c\u6027\u80be\u75c5\tC: \u7cfb\u819c\u589e\u751f\u6027\u80be\u5c0f\u7403\u80be\u708e\tD: \u6025\u6027\u80be\u5c0f\u7403\u80be\u708e\t\n\u6b63\u786e\u7b54\u6848\u662f C: \u7cfb\u819c\u589e\u751f\u6027\u80be\u5c0f\u7403\u80be\u708e\u3002",
-            "output": "\u8840\u4e2d\u8865\u4f53\u6c34\u5e73\u4e0b\u964d\u5e38\u89c1\u4e8e\u4e0e\u514d\u75ab\u590d\u5408\u7269\u6709\u5173\u7684\u80be\u810f\u75be\u75c5\uff0c\u5982\u6025\u8fdb\u6027\u80be\u5c0f\u7403\u80be\u708e\uff08A\uff09\u3001\u819c\u6027\u80be\u75c5\uff08B\uff09\u4ee5\u53ca\u6025\u6027\u80be\u5c0f\u7403\u80be\u708e\uff08D\uff09\uff0c\u8fd9\u4e9b\u75be\u75c5\u4e2d\uff0c\u5faa\u73af\u514d\u75ab\u590d\u5408\u7269\u6216\u539f\u4f4d\u514d\u75ab\u590d\u5408\u7269\u7684\u6c89\u79ef\u4f1a\u6fc0\u6d3b\u8865\u4f53\u7cfb\u7edf\uff0c\u5bfc\u81f4\u8865\u4f53\u6d88\u8017\u3002\u76f8\u6bd4\u4e4b\u4e0b\uff0c\u7cfb\u819c\u589e\u751f\u6027\u80be\u5c0f\u7403\u80be\u708e\uff08C\uff09\u4e00\u822c\u4e0d\u6d89\u53ca\u5927\u91cf\u514d\u75ab\u590d\u5408\u7269\u6c89\u79ef\u6216\u8865\u4f53\u6fc0\u6d3b\uff0c\u56e0\u6b64\u8865\u4f53\u6c34\u5e73\u4e00\u822c\u4e0d\u4f1a\u4e0b\u964d\u3002\u6240\u4ee5\uff0c\u5728\u8fd9\u4e9b\u9009\u9879\u4e2d\uff0c\u7cfb\u819c\u589e\u751f\u6027\u80be\u5c0f\u7403\u80be\u708e\u4e0d\u5e38\u89c1\u4e8e\u8840\u4e2d\u8865\u4f53\u6c34\u5e73\u4e0b\u964d\uff0c\u6545\u7b54\u6848\u9009C\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: 2\uff0e\u5316\u8113\u83cc\u5165\u8840\u5927\u91cf\u7e41\u6b96\u5e76\u5f15\u8d77\u4e25\u91cd\u75c7\u72b6\u79f0\u4e3a\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: \u8d25\u8840\u75c7\tB: \u6bd2\u8840\u75c7\tC: \u8113\u6bd2\u8840\u75c7\tD: \u83cc\u8840\u75c7\t\n\u6b63\u786e\u7b54\u6848\u662f C: \u8113\u6bd2\u8840\u75c7\u3002",
-            "output": "\u539f\u56e0\u5206\u6790\uff1a\u5316\u8113\u83cc\u8fdb\u5165\u8840\u6db2\u5faa\u73af\u540e\u5927\u91cf\u7e41\u6b96\uff0c\u5e76\u4e14\u4ea7\u751f\u4e86\u6bd2\u7d20\u5bfc\u81f4\u514d\u75ab\u7cfb\u7edf\u8fc7\u5ea6\u53cd\u5e94\uff0c\u8fd9\u79cd\u60c5\u51b5\u901a\u5e38\u88ab\u79f0\u4e3a\u8113\u6bd2\u8840\u75c7\u3002\u8113\u6bd2\u8840\u75c7\u662f\u4e00\u79cd\u4e25\u91cd\u7684\u5168\u8eab\u6027\u708e\u75c7\u53cd\u5e94\u7efc\u5408\u75c7(SIRS)\uff0c\u5b83\u662f\u7531\u4e8e\u7ec6\u83cc\u611f\u67d3\uff0c\u5c24\u5176\u662f\u9769\u5170\u6c0f\u9633\u6027\u6216\u9634\u6027\u7684\u5316\u8113\u83cc\u611f\u67d3\u800c\u5f15\u8d77\u7684\u3002A\u9879\u201c\u8d25\u8840\u75c7\u201d\u901a\u5e38\u662f\u6307\u8840\u6db2\u4e2d\u6709\u75c5\u539f\u4f53\u5b58\u5728\uff0c\u4f46\u4e0d\u4e00\u5b9a\u5f15\u8d77\u4e25\u91cd\u75c7\u72b6\uff1bB\u9879\u201c\u6bd2\u8840\u75c7\u201d\u5e76\u4e0d\u662f\u4e00\u4e2a\u6807\u51c6\u7684\u533b\u5b66\u672f\u8bed\uff1bD\u9879\u201c\u83cc\u8840\u75c7\u201d\u5219\u662f\u6307\u8840\u6db2\u4e2d\u6709\u7ec6\u83cc\u5b58\u5728\u7684\u72b6\u6001\uff0c\u5e76\u4e0d\u6d89\u53ca\u662f\u5426\u5f15\u8d77\u75c7\u72b6\u3002\u56e0\u6b64\uff0c\u6700\u7b26\u5408\u9898\u76ee\u63cf\u8ff0\u7684\u662fC\u9879\u201c\u8113\u6bd2\u8840\u75c7\u201d\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: \u7537\uff0c27\u5c81\uff0c\u559c\u597d\u7f51\u7403\u8fd0\u52a8\uff0c\u53f3\u8098\u5173\u8282\u5916\u4fa7\u75bc\u75db2\u4e2a\u6708\u3002\u52a0\u91cd5\u5929.\u6301\u7269\u65e0\u529b\u3002\u4f53\u68c0\uff1a\u9664\u53f3\u8098\u5173\u8282\u5916\u4fa7\u5c40\u9650\u6027\u538b\u75db\u5916\uff0c\u4e0b\u5217\u54ea\u9879\u68c0\u67e5\u6700\u6709\u52a9\u4e8e\u8bca\u65ad\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: Froment\u8bd5\u9a8c\tB: Finkelstein\u8bd5\u9a8c\tC: Mills\u8bd5\u9a8c\tD: Gaenslen\u8bd5\u9a8c\t\n\u6b63\u786e\u7b54\u6848\u662f C: Mills\u8bd5\u9a8c\u3002",
-            "output": "\u9009\u62e9C\u9879\uff08Mills\u8bd5\u9a8c\uff09\u7684\u539f\u56e0\u662f\u56e0\u4e3a\u75c5\u4eba\u4e3b\u8981\u7684\u75c7\u72b6\u4e3a\u7f51\u7403\u8098\uff0c\u5373\u8098\u5173\u8282\u5916\u4fa7\u75bc\u75db\uff0c\u8fd9\u662f\u7531\u4e8e\u8fc7\u5ea6\u4f7f\u7528\u808c\u8171\uff0c\u7279\u522b\u662f\u5728\u8fdb\u884c\u63e1\u62cd\u3001\u6325\u62cd\u7684\u52a8\u4f5c\u65f6\u3002\u7f51\u7403\u8098\uff08\u80b1\u9aa8\u5916\u4e0a\u9ac1\u708e\uff09\u5e38\u6d89\u53ca\u8098\u90e8\u5916\u4fa7\u7684\u808c\u8171\u9644\u7740\u70b9\u708e\u75c7\uff0c\u800cMills\u8bd5\u9a8c\u662f\u4e00\u4e2a\u7279\u5f02\u6027\u68c0\u67e5\uff0c\u901a\u8fc7\u5f2f\u66f2\u75c5\u4eba\u624b\u8155\u5e76\u8f7b\u8f7b\u538b\u8feb\u6216\u6572\u51fb\u8098\u5916\u4fa7\uff0c\u80fd\u591f\u5f15\u8d77\u6216\u52a0\u5267\u75bc\u75db\u75c7\u72b6\uff0c\u6709\u52a9\u4e8e\u8bca\u65ad\u7f51\u7403\u8098\u3002\u5176\u4ed6\u9009\u9879\u5982Froment\u8bd5\u9a8c\u7528\u4e8e\u5224\u65ad\u5c3a\u795e\u7ecf\u529f\u80fd\uff0cFinkelstein\u8bd5\u9a8c\u7528\u4e8e\u8bca\u65ad\u8155\u7ba1\u7efc\u5408\u75c7\uff0cGaenslen\u8bd5\u9a8c\u7528\u4e8e\u9274\u522b\u9ab6\u9ac2\u5173\u8282\u75bc\u75db\uff0c\u5b83\u4eec\u4e0e\u75c5\u4eba\u7684\u75c7\u72b6\u4e0d\u76f8\u7b26\uff0c\u6240\u4ee5\u4e0d\u9009\u62e9\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: \u4f53\u6e29\u8c03\u8282\u7684\u91cd\u8981\u4e2d\u67a2\u4f4d\u4e8e\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: \u810a\u9ad3\tB: \u5ef6\u9ad3\tC: \u5927\u8111\tD: \u4e0b\u4e18\u8111\t\n\u6b63\u786e\u7b54\u6848\u662f D: \u4e0b\u4e18\u8111\u3002",
-            "output": "\u9009\u62e9D\u9009\u9879\uff08\u4e0b\u4e18\u8111\uff09\u7684\u539f\u56e0\u662f\u56e0\u4e3a\u4e0b\u4e18\u8111\u662f\u8c03\u8282\u4f53\u6e29\u7684\u5173\u952e\u8111\u533a\u3002\u4eba\u4f53\u4f53\u6e29\u7684\u8c03\u8282\u662f\u4e00\u4e2a\u590d\u6742\u7684\u795e\u7ecf-\u5185\u5206\u6ccc\u8fc7\u7a0b\uff0c\u5176\u4e3b\u8981\u8c03\u63a7\u4e2d\u5fc3\u5c31\u4f4d\u4e8e\u4e0b\u4e18\u8111\u3002\u4e0b\u4e18\u8111\u53ef\u4ee5\u63a5\u53d7\u5230\u6765\u81ea\u4f53\u5185\u5916\u7684\u6e29\u5ea6\u53d8\u5316\u4fe1\u53f7\uff0c\u5e76\u901a\u8fc7\u795e\u7ecf\u548c\u5185\u5206\u6ccc\u7684\u9014\u5f84\u8c03\u8282\u4f53\u6e29\uff0c\u4ee5\u4fdd\u6301\u6052\u6e29\u72b6\u6001\u3002\u5f53\u4f53\u6e29\u8fc7\u9ad8\u65f6\uff0c\u4e0b\u4e18\u8111\u4f1a\u542f\u52a8\u6563\u70ed\u673a\u5236\u5982\u51fa\u6c57\u548c\u6269\u5f20\u8840\u7ba1\uff1b\u5f53\u4f53\u6e29\u8fc7\u4f4e\u65f6\uff0c\u5219\u4f1a\u542f\u52a8\u4fdd\u6e29\u673a\u5236\u5982\u98a4\u6296\u548c\u6536\u7f29\u8840\u7ba1\u3002\u800c\u810a\u9ad3\u3001\u5ef6\u9ad3\u548c\u5927\u8111\u5e76\u4e0d\u662f\u4f53\u6e29\u8c03\u8282\u7684\u4e3b\u8981\u4e2d\u67a2\uff0c\u56e0\u6b64\uff0c\u6b63\u786e\u7b54\u6848\u662fD.\u4e0b\u4e18\u8111\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: \u4e00\u5c0f\u513f\u8fd0\u52a8\u3001\u667a\u529b\u53d1\u80b2\u6b63\u5e38\uff0c\u8eab\u6750\u5300\u79f0\uff0c\u4f46\u8eab\u9ad8\u3001\u4f53\u91cd\u5747\u660e\u663e\u4f4e\u4e8e\u6b63\u5e38\u8303\u56f4\uff0c\u4e3a\u4e86\u89e3\u5176\u9aa8\u9abc\u53d1\u80b2\u60c5\u51b5\u30023\uff0e\u53ef\u80fd\u9009\u62e9\u7684\u6709\u6548\u6cbb\u7597\u662f\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: \u751f\u957f\u6fc0\u7d20\u6cbb\u7597\tB: \u7ef4\u751f\u7d20D+\u9499\u5242\u6cbb\u7597\tC: \u9aa8\u9ad3\u5e72\u7ec6\u80de\u79fb\u690d\tD: \u76ee\u524d\u65e0\u6709\u6548\u6cbb\u7597\t\n\u6b63\u786e\u7b54\u6848\u662f A: \u751f\u957f\u6fc0\u7d20\u6cbb\u7597\u3002",
-            "output": "\u9009\u62e9\u751f\u957f\u6fc0\u7d20\u6cbb\u7597\u7684\u539f\u56e0\u662f\u57fa\u4e8e\u8fd9\u4e2a\u5c0f\u513f\u8fd0\u52a8\u3001\u667a\u529b\u53d1\u80b2\u6b63\u5e38\uff0c\u4f53\u578b\u5300\u79f0\uff0c\u4f46\u662f\u8eab\u9ad8\u548c\u4f53\u91cd\u663e\u8457\u4f4e\u4e8e\u6b63\u5e38\u8303\u56f4\u7684\u60c5\u51b5\u3002\u8fd9\u53ef\u80fd\u662f\u7531\u4e8e\u751f\u957f\u6fc0\u7d20\u5206\u6ccc\u4e0d\u8db3\u9020\u6210\u7684\u77ee\u5c0f\u75c7\u3002\u751f\u957f\u6fc0\u7d20\u6cbb\u7597\u53ef\u4ee5\u4fc3\u8fdb\u513f\u7ae5\u7684\u751f\u957f\u53d1\u80b2\uff0c\u5e2e\u52a9\u63d0\u5347\u8eab\u9ad8\u548c\u4f53\u91cd\uff0c\u8fdb\u800c\u4f7f\u5f97\u9aa8\u9abc\u53d1\u80b2\u8fbe\u5230\u9002\u9f84\u513f\u7ae5\u7684\u6b63\u5e38\u6c34\u5e73\u3002\u5176\u4ed6\u9009\u9879\u5982\u7ef4\u751f\u7d20D\u52a0\u9499\u5242\u6cbb\u7597\u4e3b\u8981\u7528\u4e8e\u6cbb\u7597\u56e0\u9499\u3001\u78f7\u4ee3\u8c22\u969c\u788d\u5f15\u8d77\u7684\u9aa8\u8d28\u758f\u677e\u75c7\uff0c\u800c\u9aa8\u9ad3\u5e72\u7ec6\u80de\u79fb\u690d\u591a\u7528\u4e8e\u6cbb\u7597\u8840\u6db2\u7cfb\u7edf\u75be\u75c5\uff0c\u76ee\u524d\u65e0\u6709\u6548\u6cbb\u7597\u5e76\u4e0d\u9002\u7528\u4e8e\u672c\u60c5\u51b5\u3002"
-        },
-        {
-            "input": "\u95ee\u9898: \u5c0f\u513f\u524d\u56df\u8fc7\u65e9\u95ed\u89c1\u4e8e\uff08\u3000\u3000\uff09\u3002\n\u9009\u9879: A: \u4f5d\u507b\u75c5\tB: \u5c0f\u5934\u7578\u5f62\tC: \u6781\u5ea6\u6d88\u7626\u8005\tD: \u8111\u708e\t\n\u6b63\u786e\u7b54\u6848\u662f B: \u5c0f\u5934\u7578\u5f62\u3002",
-            "output": "\u5c0f\u513f\u524d\u56df\u8fc7\u65e9\u95ed\u4e3b\u8981\u89c1\u4e8e\u5c0f\u5934\u7578\u5f62\uff0c\u4e5f\u5c31\u662f\u9009\u9879B\u3002\u5c0f\u5934\u7578\u5f62\uff08microcephaly\uff09\u662f\u4e00\u79cd\u795e\u7ecf\u53d1\u80b2\u5f02\u5e38\uff0c\u513f\u7ae5\u7684\u5934\u56f4\u660e\u663e\u4f4e\u4e8e\u540c\u9f84\u513f\u7ae5\u7684\u5e73\u5747\u6c34\u5e73\uff0c\u8fd9\u5f80\u5f80\u4e0e\u5927\u8111\u53d1\u80b2\u4e0d\u5168\u6709\u5173\u3002\u524d\u56df\u662f\u5a74\u513f\u5934\u9aa8\u7684\u8f6f\u9aa8\u7f1d\u9699\uff0c\u9002\u5e94\u5927\u8111\u7684\u751f\u957f\u3002\u5f53\u5927\u8111\u53d1\u80b2\u53d7\u9650\uff0c\u5982\u5728\u5c0f\u5934\u7578\u5f62\u4e2d\uff0c\u524d\u56df\u53ef\u80fd\u4f1a\u56e0\u4e3a\u6ca1\u6709\u8db3\u591f\u7684\u6269\u5f20\u538b\u800c\u63d0\u524d\u95ed\u5408\u3002\u800c\u4f5d\u507b\u75c5\uff08A\uff09\u4e3b\u8981\u6d89\u53ca\u9aa8\u9abc\u7684\u5f02\u5e38\uff0c\u6781\u5ea6\u6d88\u7626\u8005\uff08C\uff09\u53ef\u80fd\u4f1a\u6709\u53d1\u80b2\u95ee\u9898\uff0c\u4f46\u4e0d\u7279\u5b9a\u5173\u8054\u524d\u56df\u8fc7\u65e9\u95ed\u5408\uff0c\u8111\u708e\uff08D\uff09\u53ef\u80fd\u5bfc\u81f4\u591a\u79cd\u795e\u7ecf\u5b66\u95ee\u9898\uff0c\u4f46\u5e76\u975e\u76f4\u63a5\u5bfc\u81f4\u524d\u56df\u8fc7\u65e9\u95ed\u5408\u3002"
-        }
-    ]
-}

MedS-Bench/Reasoning/task52_mmedbench_explanation_english_test_only.json

@@ -1,234 +0,0 @@
-{
-    "Contributors": [
-        "MAGIC"
-    ],
-    "Source": [
-        "MMedBench"
-    ],
-    "URL": [
-        "https://huggingface.co/datasets/Henrychur/MMedBench"
-    ],
-    "Categories": [
-        "Explanation"
-    ],
-    "Definition": [
-        "Given a question and its answer, generate an explanation statement."
-    ],
-    "Reasoning": [],
-    "Input_language": [
-        "English"
-    ],
-    "Output_language": [
-        "English"
-    ],
-    "Instruction_language": [
-        "English"
-    ],
-    "Domains": [
-        "Medical Knowledge"
-    ],
-    "Positive Examples": [],
-    "Negative Examples": [],
-    "Instances": [
-        {
-            "input": "Question: Two weeks after undergoing an emergency cardiac catherization with stenting for unstable angina pectoris, a 61-year-old man has decreased urinary output and malaise. He has type 2 diabetes mellitus and osteoarthritis of the hips. Prior to admission, his medications were insulin and naproxen. He was also started on aspirin, clopidogrel, and metoprolol after the coronary intervention. His temperature is 38\u00b0C (100.4\u00b0F), pulse is 93/min, and blood pressure is 125/85 mm Hg. Examination shows mottled, reticulated purplish discoloration of the feet. Laboratory studies show:\nHemoglobin count 14 g/dL\nLeukocyte count 16,400/mm3\nSegmented neutrophils 56%\nEosinophils 11%\nLymphocytes 31%\nMonocytes 2%\nPlatelet count 260,000/mm3\nErythrocyte sedimentation rate 68 mm/h\nSerum\nUrea nitrogen 25 mg/dL\nCreatinine 4.2 mg/dL\nRenal biopsy shows intravascular spindle-shaped vacuoles. Which of the following is the most likely cause of this patient's symptoms?\"\nOptions: A: Renal papillary necrosis\tB: Cholesterol embolization\tC: Eosinophilic granulomatosis with polyangiitis\tD: Polyarteritis nodosa\t\nThe right answer is B: Cholesterol embolization.",
-            "output": "The most likely cause of this patient's symptoms, considering the clinical presentation and laboratory findings, is B. Cholesterol embolization (also known as atheroembolism). The patient's recent history of cardiac catheterization with stenting raises the possibility of cholesterol crystal embolization, which can occur after vascular procedures. The mottled, reticulated purplish discoloration of the feet (livedo reticularis) and the renal biopsy showing intravascular spindle-shaped vacuoles are characteristic findings of cholesterol crystal embolization. The elevated ESR and eosinophilia could also be associated with this condition. While renal papillary necrosis, polyarteritis nodosa, and eosinophilic granulomatosis with polyangiitis may have similar presentations, the recent cardiac intervention and specific biopsy findings make cholesterol embolization the most likely diagnosis."
-        },
-        {
-            "input": "Question: A 72-year-old man comes to the physician because of a 2-month history of fatigue and worsening abdominal pain. During this period, he also has excessive night sweats and shortness of breath on exertion. Over the past 3 months, he has had a 5.6-kg (12-lb) weight loss. He had a myocardial infarction 3 years ago. He has hypertension, diabetes mellitus, and chronic bronchitis. His medications include insulin, aspirin, lisinopril, and an albuterol inhaler. He has smoked half a pack of cigarettes for the past 45 years. Vital signs are within normal limits. The spleen is palpated 6 cm below the left costal margin. Laboratory studies show:\nHemoglobin 6.4 g/dL\nMean corpuscular volume 85 \u03bcm3\nLeukocyte count 5,200/mm3\nPlatelet count 96,000/mm3\nA blood smear is shown. Bone marrow aspiration shows extensive fibrosis and a few scattered plasma cells. A JAK 2 assay is positive. Which of the following is the most appropriate next step in management?\"\nOptions: A: Cladribine\tB: Prednisone\tC: Imatinib\tD: Ruxolitinib\t\nThe right answer is D: Ruxolitinib.",
-            "output": "The clinical picture and laboratory findings are suggestive of myelofibrosis, a myeloproliferative disorder characterized by bone marrow fibrosis, cytopenias, extramedullary hematopoiesis, and commonly, splenomegaly. This is supported by the findings of anemia, thrombocytopenia, splenomegaly, and the presence of a JAK 2 mutation. The appropriate treatment for symptomatic myelofibrosis, particularly in the presence of a JAK 2 mutation, is Ruxolitinib, a JAK 1/2 inhibitor. Ruxolitinib can help reduce spleen size and alleviate constitutional symptoms. Other options, such as Cladribine and Prednisone, are not standard treatments for myelofibrosis. Imatinib is used for chronic myelogenous leukemia, not myelofibrosis. Therefore, D. Ruxolitinib is the most appropriate next step in management."
-        },
-        {
-            "input": "Question: A 59-year-old overweight woman presents to the urgent care clinic with the complaint of severe abdominal pain for the past 2 hours. She also complains of a dull pain in her back with nausea and vomiting several times. Her pain has no relation with food. Her past medical history is significant for recurrent abdominal pain due to cholelithiasis. Her father died at the age of 60 with some form of abdominal cancer. Her temperature is 37\u00b0C (98.6\u00b0F), respirations are 15/min, pulse is 67/min, and blood pressure is 122/98 mm Hg. Physical exam is unremarkable. However, a CT scan of the abdomen shows a calcified mass near her gallbladder. Which of the following diagnoses should be excluded first in this patient?\nOptions: A: Acute cholecystitis\tB: Gallbladder cancer\tC: Choledocholithiasis\tD: Pancreatitis\t\nThe right answer is B: Gallbladder cancer.",
-            "output": "Given the patient\u2019s history of recurrent abdominal pain due to cholelithiasis, a family history of abdominal cancer, and the finding of a calcified mass near the gallbladder on CT, Gallbladder cancer (Option B) should be excluded first. Her age, overweight status, and the calcified mass are risk factors for gallbladder cancer. While her symptoms could also suggest acute cholecystitis, choledocholithiasis, or pancreatitis, the combination of a calcified mass and familial cancer history increases the index of suspicion for a malignant process. Rapid exclusion of cancer is essential due to its potentially aggressive nature and the need for timely intervention."
-        },
-        {
-            "input": "Question: A 3-month-old boy is brought the emergency department by his parents after an episode of cyanosis and muscle hypotonia that resolved after 2 minutes. Diagnostic evaluation fails to discover an exact etiology of the boy's symptoms and the episode is classified as a brief resolved unexplained event (BRUE). The risk profile for BRUE in infants remains largely unknown. The pediatrician who saw the boy in the emergency department is trying to identify risk factors for BRUE. She is aware of several confounders, including age, socioeconomic background, and family history of medical illness. She recruits 75 infants under 1 year of age with BRUE and 75 infants without BRUE of the same age, socioeconomic background, and family history of medical illness. She then compares the two groups with regard to history of feeding problems and history of recent upper respiratory infection. Which of the following methods was conducted to control confounding bias in the study?\nOptions: A: Blinding\tB: Restriction\tC: Randomization\tD: Matching\t\nThe right answer is D: Matching.",
-            "output": "Matching is the method used to control confounding bias in this pediatrician's study. She selected infants with BRUE and a comparison group without BRUE but matched for age, socioeconomic background, and family history of medical illness. Matching ensures that both the study and comparison groups are similar in regards to specific confounding variables. This helps isolate the variables of interest \u2013 history of feeding problems and recent upper respiratory infections \u2013 by reducing the likelihood that confounding factors will distort the association between the exposure and the outcome. Randomization would involve randomly assigning subjects to different groups, which isn't applicable here since the groups are already determined by their BRUE-status. Blinding is a method to prevent bias in the assessment of outcomes, not to control for confounding. Restriction would involve only including subjects with certain characteristics, which was not the specific approach described here."
-        },
-        {
-            "input": "Question: A 3-month-old infant is brought to her pediatrician because she coughs and seems to have difficulty breathing while feeding. In addition, she seems to have less energy compared to other babies and appears listless throughout the day. She was born by cesarean section to a G1P1 woman with no prior medical history and had a normal APGAR score at birth. Her parents say that she has never been observed to turn blue. Physical exam reveals a high-pitched holosystolic murmur that is best heard at the lower left sternal border. The most likely cause of this patient's symptoms is associated with which of the following abnormalities?\nOptions: A: 22q11 deletion\tB: Deletion of genes on chromosome 7\tC: Lithium exposure in utero\tD: Maternal alcohol consumption\t\nThe right answer is A: 22q11 deletion.",
-            "output": "The presenting symptoms of coughing, difficulty breathing while feeding, lethargy, and a high-pitched holosystolic murmur are suggestive of a congenital heart defect. A common condition associated with congenital heart defects is 22q11 deletion, also known as DiGeorge syndrome, which can cause abnormal development of the heart and results in cardiac murmurs and feeding difficulties due to poor coordination of sucking and swallowing. Deletion of genes on chromosome 7 is related to Williams syndrome, which doesn't typically present with congenital heart disease of this nature. Lithium exposure in utero and maternal alcohol consumption have known teratogenic effects but are less likely to cause the cardiac abnormalities indicated by the murmur described in the question. Hence, option A, a 22q11 deletion, is the most likely cause of this infant's symptoms."
-        },
-        {
-            "input": "Question: A 30-year-old African American woman comes to the physician for the evaluation of a dry cough and chest discomfort for the past 3 days. During this period, the patient has had headaches, muscle aches, joint pain, fever, and chills. Ten days ago, she was hiking with her family in Mississippi. The patient has asthma that is treated with an albuterol inhaler. Her mother has a lung disease treated with methotrexate. The patient has smoked one pack of cigarettes daily for the past 10 years. Her temperature is 38\u00b0C (100.4\u00b0F). Physical examination shows slight wheezes throughout both lung fields. Laboratory studies and urinalysis are positive for polysaccharide antigen. Bronchoalveolar lavage using silver/PAS-staining shows macrophages filled with a dimorphic fungus with septate hyphae. Which of the following is the most likely cause of this patient's symptoms?\nOptions: A: Legionella pneumophila infection\tB: Pneumocystis pneumonia\tC: Histoplasma capsulatum infection\tD: Blastomyces dermatitidis infection\t\nThe right answer is C: Histoplasma capsulatum infection.",
-            "output": "The most likely cause of this patient's symptoms is C. Histoplasma capsulatum infection. The clinical presentation suggests an acute respiratory illness with systemic symptoms such as fever, chills, headache, and myalgia. Her recent hiking activity in Mississippi, an area endemic for Histoplasmosis, increases the likelihood of exposure to bird or bat droppings that contain the fungus Histoplasma capsulatum. Her symptoms started about a week after the potential exposure, fitting the incubation period for Histoplasmosis. The laboratory findings of a positive polysaccharide antigen test and the identification of macrophages filled with a dimorphic fungus with septate hyphae on bronchoalveolar lavage further support the diagnosis of Histoplasmosis. The presence of septate hyphae is characteristic of this fungus, differentiating it from other potential fungal causes."
-        },
-        {
-            "input": "Question: A 22-year-old woman is brought to the emergency department because of a 2-day history of fever, intermittent rigors, and night sweats. She also has a 1-month history of progressive fatigue. Five weeks ago, she was hospitalized and received intravenous antibiotics for treatment of bacterial meningitis while visiting relatives in Guatemala. Her temperature is 39.4\u00b0C (102.9\u00b0F), pulse is 130/min, and blood pressure is 105/70 mm Hg. Examination shows pallor and scattered petechiae and ecchymoses. Laboratory studies show a hemoglobin concentration of 9.0 g/dL, a leukocyte count of 1,100/mm3 with 30% segmented neutrophils, and a platelet count of 20,000/mm3 . Blood cultures grow coagulase-negative staphylococci. The patient was most likely treated with which of the following antibiotics?\nOptions: A: Doxycycline\tB: Trimethoprim/sulfamethoxazole\tC: Linezolid\tD: Chloramphenicol\t\nThe right answer is D: Chloramphenicol.",
-            "output": "The patient's presentation of fever, fatigue, and the hematological findings of anemia, leukopenia, and thrombocytopenia, in addition to the growth of coagulase-negative staphylococci in blood cultures, are suggestive of secondary effects from antibiotic treatment. These symptoms and lab findings are consistent with drug-induced bone marrow suppression. Chloramphenicol is known for its potential to cause reversible or irreversible bone marrow suppression, leading to aplastic anemia and other blood dyscrasias. This could manifest as the observed cytopenias. Since the patient was previously treated for bacterial meningitis\u2014a condition sometimes treated with chloramphenicol, especially outside of the United States\u2014this antibiotic is the most likely cause of her current syndrome. Options A, B, and C typically do not cause such severe hematological abnormalities and are less commonly associated with treatment of bacterial meningitis."
-        },
-        {
-            "input": "Question: A 27-year-old man presents to the emergency department. He was brought in by staff from the homeless shelter when they found him unresponsive. The patient is a known IV drug abuser but otherwise has an unknown past medical history. He currently attends a methadone clinic. His temperature is 99.5\u00b0F (37.5\u00b0C), blood pressure is 97/48 mmHg, pulse is 140/min, respirations are 29/min, and oxygen saturation is 98% on room air. Initial laboratory values are shown below.\n\nSerum:\nNa+: 139 mEq/L\nCl-: 100 mEq/L\nK+: 6.3 mEq/L\nHCO3-: 17 mEq/L\nGlucose: 589 mg/dL\n\nThe patient is given treatment. After treatment, his temperature is 99.5\u00b0F (37.5\u00b0C), blood pressure is 117/78 mmHg, pulse is 100/min, respirations are 23/min, and oxygen saturation is 98% on room air. His laboratory values are seen below.\n\nSerum:\nNa+: 139 mEq/L\nCl-: 100 mEq/L\nK+: 4.3 mEq/L\nHCO3-: 19 mEq/L\nGlucose: 90 mg/dL\n\nWhich of the following is the best next step in management?\nOptions: A: Insulin, potassium, IV fluids, and glucose\tB: IV fluids only\tC: Oral rehydration\tD: Supportive therapy and close monitoring\t\nThe right answer is A: Insulin, potassium, IV fluids, and glucose.",
-            "output": "The initial presentation of the patient with a high blood glucose level (589 mg/dL) indicates diabetic ketoacidosis (DKA), a common condition in patients with uncontrolled diabetes. The treatment for DKA includes insulin to lower blood glucose, IV fluids to rehydrate, and potassium to replace losses and prevent hypokalemia as insulin drives potassium into cells. Despite the glucose normalization (90 mg/dL), the patient still requires insulin to close the anion gap and resolve the acidosis indicated by a low bicarbonate (HCO3-) level. The inclusion of glucose in the treatment is crucial to prevent hypoglycemia as insulin continues to be administered. Hence, option A is the best next step in management because it addresses all aspects of DKA's ongoing treatment needs."
-        },
-        {
-            "input": "Question: A 67-year-old man who was diagnosed with arthritis 16 years ago presents with right knee swelling and pain. His left knee was swollen a few weeks ago, but now with both joints affected, he has difficulty walking and feels frustrated. He also has back pain which makes it extremely difficult to move around and be active during the day. He says his pain significantly improves with rest. He also suffers from dandruff for which he uses special shampoos. Physical examination is notable for pitting of his nails. Which of the following is the most likely diagnosis?\nOptions: A: Psoriatic arthritis\tB: Arthritis mutilans\tC: Rheumatoid arthritis\tD: Mixed connective tissue disease\t\nThe right answer is A: Psoriatic arthritis.",
-            "output": "The presentation of arthritis with skin manifestations such as dandruff and pitted nails, alongside a fluctuating pattern of joint involvement, is highly indicative of psoriatic arthritis (PsA). PsA is a chronic inflammatory arthritis associated with the skin condition psoriasis, which often presents with skin scaling (dandruff-like) and nail changes like pitting. The resolution of pain with rest is more typical of PsA versus rheumatoid arthritis, which is generally characterized by persistent stiffness especially after rest. Arthritis mutilans is a severe, but less common form of PsA. Mixed connective tissue disease often presents with more systemic features rather than pitting nails and would not typically cause such improvement of pain with rest. Hence, psoriatic arthritis is the most likely diagnosis."
-        },
-        {
-            "input": "Question: A 45-year-old G5P4105 presents to her gynecologist\u2019s office with six months of increasingly heavy periods. She now soaks one super absorbent tampon every two hours for five days each cycle. Her cycles have also become irregular, with intermenstrual bleeding for the last two months. She now experiences significant dysmenorrhea, requiring 400 mg ibuprofen every four hours for the majority of each menses. In addition, she reports new onset mild dyspareunia with intercourse and a \u201cheavy feeling\u201d in her pelvis. She has also noticed increased urinary frequency but denies bowel changes. The patient has a past medical history of obesity and type II diabetes on metformin. Her last child was born four years ago, and she has had five spontaneous vaginal deliveries. At this office visit, temperature is 98.5\u00b0F (36.9\u00b0C), blood pressure is 137/84 mmHg, pulse is 87/min, and respirations are 14/min. Which of the following physical exam findings is most likely to be present in this patient?\nOptions: A: Globular 10-week sized uterus\tB: Adnexal mass\tC: Irregular 14-week sized uterus\tD: No remarkable physical exam finding\t\nThe right answer is A: Globular 10-week sized uterus.",
-            "output": "The patient's symptoms suggest the possibility of a common gynecological condition such as uterine fibroids, especially given her age and parity. Heavy and prolonged menstrual bleeding (menorrhagia), intermenstrual bleeding, dysmenorrhea, a sensation of pelvic heaviness, and increased urinary frequency are all symptoms consistent with fibroids. Fibroids are benign growths of the uterine muscle and commonly cause the uterus to enlarge. A \"globular\" shaped uterus implies a uniform enlargement typical of fibroids. Given these factors and the absence of other specific signs that would suggest an adnexal mass, malignancy, or irregular growth, a globular 10-week sized uterus (Option A) is the most likely finding on physical examination."
-        },
-        {
-            "input": "Question: A 67-year-old man is hospitalized after several days of fever and increasing shortness of breath. Respiratory viral panel returns positive for influenza A and the patient is started on a standard five day course of oseltamivir. Despite therapy, his shortness of breath continues to worsen and his oxygen saturation decreases to the point where ICU transfer and intubation are required. Chest radiograph shows bilateral infiltrates. Clinical criteria are consistent with development of Acute Respiratory Distress Syndrome (ARDS). After several weeks of supportive therapy, the patient improves with lung function returning to near normal. Which of the following processes is involved in the regeneration of alveolar lining after damage to alveoli occurs?\nOptions: A: Sweeping of debris out of the alveoli by ciliated cells\tB: Excess mucus production by goblet cells\tC: Proliferation of surfactant-secreting cells\tD: Proliferation of club cells\t\nThe right answer is C: Proliferation of surfactant-secreting cells.",
-            "output": "The regeneration of alveolar lining following damage involves the proliferation of surfactant-secreting cells, known as type II pneumocytes or alveolar type II cells. These cells play a crucial role in repairing and regenerating the alveolar epithelium. After damage occurs, such as from ARDS, type II pneumocytes proliferate and differentiate into type I pneumocytes to restore the alveolar surface area necessary for gas exchange. They also secrete pulmonary surfactant to decrease surface tension within the alveoli, preventing alveolar collapse and further aiding in the breathing process. This regenerative ability is essential for recovery from alveolar damage. Options A, B, and D do not directly contribute to the regeneration of the alveolar lining."
-        },
-        {
-            "input": "Question: A 17-year-old football player with no significant past medical history, social history, or family history presents to his pediatrician with itching in his groin. He says this started during summer workouts leading up to this season. He denies having any rash anywhere else on his body. The blood pressure is 123/78 mm Hg, pulse is 67/min, respiratory rate is 15/min, and temperature is 38.1\u00b0C (98.7\u00b0F). Physical examination reveals an erythematous, well-demarcated patch with peripheral scale on the left thigh, pubic region, and perineum. There is no apparent scrotal involvement with the rash. How can you confirm the suspected diagnosis?\nOptions: A: KOH examination of lesion scrapings\tB: Nikolsky's sign on physical exam\tC: Gram stain of skin scrapings\tD: AFB stain of skin scrapings\t\nThe right answer is A: KOH examination of lesion scrapings.",
-            "output": "The presentation of an erythematous, well-demarcated patch with peripheral scaling in the groin of a young athlete suggests a fungal infection such as tinea cruris (\"jock itch\"), which is common in athletes due to sweating and friction. The confirmation of a superficial fungal infection typically involves microscopic examination after a potassium hydroxide (KOH) preparation of lesion scrapings. The KOH dissolves human skin cells, leaving only fungal cells visible, allowing for the identification of dermatophytes (fungi that affect the skin). Nikolsky's sign, Gram stain, and AFB stain are not appropriate for this suspected diagnosis. Nikolsky's sign is used for blistering disorders, Gram stain for bacterial infections, and AFB stain for mycobacterial infections."
-        },
-        {
-            "input": "Question: An otherwise healthy 26-year-old man comes to the physician for medication counseling after recently being diagnosed with schizophrenia. Risperidone therapy is initiated. This patient is at increased risk for which of the following adverse effects?\nOptions: A: Agranulocytosis\tB: Shortened QT interval\tC: Gynecomastia\tD: Weight loss\t\nThe right answer is C: Gynecomastia.",
-            "output": "Risperidone therapy, as an atypical antipsychotic, is associated with a risk of hyperprolactinemia due to its antagonistic effects on dopamine D2 receptors in the tuberoinfundibular pathway. Elevated prolactin levels can lead to gynecomastia in men. This is when the breast tissue enlarges, which is a recognized adverse effect of risperidone. Agranulocytosis is more typically associated with typical antipsychotics, such as clozapine. Antipsychotics can prolong the QT interval, not shorten it. Lastly, these medications are more likely to cause weight gain, not loss, due to their effects on appetite and metabolism."
-        },
-        {
-            "input": "Question: A 4-year-old boy is brought to the emergency department because of severe abdominal pain and bilious vomiting for 6 hours. He has not had bowel movements in the past 24 hours. He appears ill. His temperature is 37.8\u00b0C (100\u00b0F) and pulse is 122/min. Examination shows a distended abdomen. There is tenderness to palpation in the lower abdomen; guarding and rebound tenderness are present. Bowel sounds are decreased. An x-ray of the abdomen shows dilated loops of bowel. He has been accompanied by his 14-year-old brother. The surgeon recommends an emergency laparotomy. The parents are away visiting friends and cannot be reached. Which of the following is the most appropriate next best step in management?\nOptions: A: Get consent from the patient's brother\tB: Get consent from the patient\tC: Perform emergency laparotomy\tD: Delay surgery until parental consent\t\nThe right answer is C: Perform emergency laparotomy.",
-            "output": "The most appropriate next step in management is option C, perform emergency laparotomy. The child is presenting with signs suggestive of intestinal obstruction, which can become life-threatening if not promptly treated. He has severe abdominal pain, bilious vomiting, no bowel movement for 24 hours, fever, tachycardia, abdominal distension, tenderness, guarding, rebound tenderness, and evidence of dilated bowel loops on x-ray. These clinical findings strongly suggest an acute surgical abdomen that requires immediate attention. In such emergent situations, where a delay in treatment can lead to significant morbidity or mortality, medical professionals are ethically and legally allowed to proceed with life-saving treatment without explicit parental consent. The 14-year-old brother is not legally able to provide consent and the patient is obviously too young to give informed consent. Therefore, initiating the emergency surgery is justified to prevent deterioration of the child\u2019s condition."
-        },
-        {
-            "input": "Question: A 3-week-old male newborn is brought to the hospital because of poor weight gain since birth. He was born at 38 weeks' gestation via normal vaginal delivery. He weighed 3005 g (6 lb, 10 oz) at birth and currently weighs 2835 g (6 lb, 4 oz). He has been latching on and breastfeeding well since birth. His mother has a history of Graves' disease and underwent near-total thyroidectomy in the second trimester of her pregnancy after her symptoms could not be controlled with antithyroid drugs. She is currently receiving L-thyroxine therapy. The patient's temperature is 38.9\u00b0C (102\u00b0F), pulse is 176/min, and respirations are 42/min. He appears irritable. Examination shows a diaphoretic infant with a paucity of subcutaneous fat. There is swelling of the neck at the midline. Which of the following is the most likely cause?\nOptions: A: Transplacental passage of thyroid peroxidase antibodies\tB: Transplacental passage of TSH receptor antibodies\tC: Transplacental viral infection\tD: Opiate use in the mother\t\nThe right answer is B: Transplacental passage of TSH receptor antibodies.",
-            "output": "The most likely cause of the newborn's symptoms is B. Transplacental passage of TSH receptor antibodies. Given that the mother has a history of Graves' disease, an autoimmune condition where the body produces antibodies against the thyroid-stimulating hormone (TSH) receptor, it is plausible that these antibodies have been transferred to the fetus transplacentally. These antibodies can stimulate the fetal thyroid gland leading to hyperthyroidism in the newborn, which can account for the poor weight gain, fever, tachycardia, and irritability. The neck swelling may indicate an enlarged thyroid gland or goiter. The other options are less likely given the specific maternal history and clinical presentation of the neonate."
-        },
-        {
-            "input": "Question: A newborn is found to be extremely cyanotic immediately after birth. He then develops progressive respiratory failure and is admitted to the neonatal ICU. A single loud S2 heart sound is appreciated as well as a machine-like murmur at the left upper sternal border. Radiography shows an enlarged \"egg-shaped\" heart. The newborn is then taken for a atrial septostomy to alleviate the condition pending definitive surgical correction. Which of the following is the most likely cause of this newborn's condition?\nOptions: A: Coarctation of the aorta\tB: Persistent truncus arteriosus\tC: Transposition of great vessels\tD: Tricuspid atresia\t\nThe right answer is C: Transposition of great vessels.",
-            "output": "The most likely cause of this newborn's condition, given the presentation, is transposition of the great vessels (Option C). The findings of severe cyanosis immediately after birth and a single loud S2 heart sound are indicative of this diagnosis. In transposition of the great vessels, the aorta and pulmonary artery are reversed, leading to the circulation of deoxygenated blood within the systemic circulation, thereby causing cyanosis. The machine-like murmur can be associated with a patent ductus arteriosus which often coexists with this condition, providing a shunt that can somewhat alleviate cyanosis. The radiography showing an \"egg-shaped\" heart is also consistent with this condition. Atrial septostomy is performed to increase the mixing of oxygenated and deoxygenated blood at the atrial level, temporarily relieving cyanosis until definitive surgery (arterial switch procedure) can be done."
-        },
-        {
-            "input": "Question: A 54-year-old male makes an appointment with his primary care physician due to chronic fatigue that has left him unable to hike or do other physically demanding activities with his friends. He has well-controlled hypertension and diabetes but has otherwise been healthy. He does not smoke but drinks socially with his friends. Physical exam reveals enlarged nodules that are not tender to palpation. A biopsy is obtained showing a characteristic change in chromosome 18. The regulation of which of the following proteins will be most abnormal in this patient?\nOptions: A: Caspase-9\tB: CD15\tC: Cyclin-dependent kinase 4\tD: Ras pathway transcription factors\t\nThe right answer is A: Caspase-9.",
-            "output": "A diagnosis of multiple endocrine neoplasia type 1 (MEN1), caused by mutations in the MEN1 gene which encodes the protein menin (located on chromosome 18), is suggested by the presentation and biopsy showing characteristic chromosomal changes. Menin regulates several proteins and pathways, including those involved in cell cycle control and apoptosis. Caspase-9 is a key protein in the intrinsic apoptotic pathway. Given the regulatory role of menin on apoptosis, a mutation in the MEN1 gene would lead to abnormal regulation of caspase-9. The other options (B: CD15, C: Cyclin-dependent kinase 4, D: Ras pathway transcription factors) are not directly regulated by menin."
-        },
-        {
-            "input": "Question: A 50-year-old man visits his physician after 20 years of not seeking any medical care. He is concerned about his health after a colleague recently had a heart attack. The patient has no active complaints and says he feels healthy; however, he does not exercise regularly and lives a sedentary lifestyle. He is employed as an administrative position at a local college, and is seated at a desk most of the day. His father had a heart attack at age 54 and his mother is still alive with no health concerns. He does not smoke, only drinks socially, and does not use drugs. Today, his blood pressure is 130/90 mm Hg, pulse is 84/min, and respiratory rate is 14/min. Physical examination reveals an obese male with no significant findings. An ECG shows no abnormalities, and laboratory testing shows the following:\nLaboratory test\nSerum glucose (fasting)  105 mg/dL\nSerum electrolytes \nSodium  142 mEq/L\nPotassium 3.9 mEq/L\nChloride 101 mEq/L\nSerum creatinine 0.8 mg/dl\nBlood urea nitrogen 10 mg/dl\nCholesterol, total 250 mg/dL\nHDL-cholesterol 35 mg/dL\nLDL-cholesterol 186 mg/dL\nTriglycerides 170 mg/dL\nUrinalysis \nGlucose  negative\nKetones negative\nLeucocytes negative\nNitrites negative \nRed blood cells (RBC) negative \nCasts negative \nWhich of the following lab abnormalities in this patient is an indication for treatment?\nOptions: A: Blood pressure reading\tB: Patient\u2019s weight\tC: High LDL-cholesterol\tD: Serum glucose level\t\nThe right answer is C: High LDL-cholesterol.",
-            "output": "The patient's LDL-cholesterol level is 186 mg/dL, which is above the recommended threshold of 100 mg/dL for optimal cardiovascular health. Considering his family history of heart disease with his father having had a heart attack at a relatively young age, his sedentary lifestyle, and obesity, he is at an elevated risk for developing cardiovascular diseases himself. The high level of LDL-cholesterol can lead to the buildup of plaque in the arteries, increasing the risk of heart attacks and strokes. His blood pressure is at the higher end of the \"pre-hypertension\" range, but not yet in the range where antihypertensive treatment is imperative. His weight is a risk factor, but not a \"lab abnormality.\" Therefore, the most pressing laboratory indication for treatment is the high LDL-cholesterol level (Option C), which warrants dietary modification, increased physical activity, and potentially lipid-lowering medication to reduce cardiovascular risk."
-        },
-        {
-            "input": "Question: A 32-year-old woman comes to the physician because of a 3-week history of intermittent loose stools and a 1.2-kg (2.6-lb) weight loss. She immigrated to the US from Uganda 6 weeks ago. Abdominal examination shows diffuse tenderness with no guarding or rebound. The liver is firm and palpable 3 cm below the right costal margin, and the spleen is palpable just below the left costal margin. Her leukocyte count is 12,800/mm3 (12% eosinophils). Stool culture shows several oval-shaped eggs with lateral spines. Microscopic examination of a liver biopsy specimen shows granulomatous inflammation with periportal fibrosis. Exposure to which of the following is most likely to have played a role in the development of this patient's symptoms?\nOptions: A: Undercooked pork meat\tB: Undercooked fish meat\tC: Dog feces\tD: Freshwater snails\t\nThe right answer is D: Freshwater snails.",
-            "output": "The patient presents with symptoms suggestive of a parasitic infection, particularly Schistosomiasis, also known as snail fever. The presence of oval-shaped eggs with lateral spines in her stool is characteristic of the Schistosoma species, which use freshwater snails as an intermediate host. The immigration from Uganda, a region where Schistosomiasis is endemic, further supports this diagnosis. The granulomatous inflammation with periportal fibrosis observed in the liver biopsy is indicative of the chronic stage of the disease, which can lead to hepatosplenomegaly, as seen with palpable liver and spleen. Exposure to freshwater snails carrying Schistosoma larvae while in Uganda is the most likely cause of her condition."
-        },
-        {
-            "input": "Question: A 2-day-old male newborn is brought to the physician because of yellowing of the skin and sclerae for 16 hours. He had previously been well. He was born at 38 weeks' gestation via uncomplicated vaginal delivery and weighed 3.1 kg (6 lb 13 oz). The mother has no medical insurance and did not receive prenatal care. The newborn's 4-year-old brother has sickle cell disease. Examination shows jaundice. The abdomen is mildly distended. The liver is palpated 1 cm below the right costal margin and the spleen tip is palpated just below the left costal margin. Laboratory studies show:\nHemoglobin 11 g/dL\nReticulocytes 9%\nLeukocytes 9,100/mm3\nPlatelets 244,000/mm3\nMaternal blood group 0, Rh-negative\nAnti-Rh antibody titer positive\nFetal blood group B, Rh-negative\nSerum\nBilirubin, total 11.3 mg/dL\nDirect 0.3 mg/dL\nWhich of the following is the most likely cause of this patient's condition?\"\nOptions: A: RBC sickling\tB: Anti-D antibodies\tC: Biliary duct malformation\tD: Anti-B antibodies\t\nThe right answer is D: Anti-B antibodies.",
-            "output": "The most likely cause of this newborn's jaundice is D. Anti-B antibodies. This is due to ABO incompatibility, where the mother's blood group is O and the baby's is B. People with blood group O have both anti-A and anti-B antibodies, which can cross the placenta and cause hemolysis of the newborn's B-type red blood cells, leading to jaundice. Additionally, the newborn has an elevated reticulocyte count, which indicates increased red blood cell production as a response to hemolysis. The absence of maternal Rh antibodies and the baby being Rh-negative rules out Rh incompatibility as a cause. Other options like RBC sickling and biliary duct malformation are less likely since the symptoms and laboratory findings do not match those conditions."
-        },
-        {
-            "input": "Question: A 29-year-old man comes in for evaluation of infertility. He has been trying to conceive for over 2 years with his wife and previous evaluation of his wife's fertility revealed no abnormalities. Physical exam reveals a tall man with long extremities, sparse body hair, gynecomastia, and small testes. Laboratory studies reveal increased serum follicle-stimulating hormone concentration and an increased estradiol:testosterone ratio. Genetic studies reveal a cytogenetic abnormality. If this abnormality was inherited from the patient's father, at which stage of spermatogenesis did this error most likely occur?\nOptions: A: Primary spermatocyte\tB: Secondary spermatocyte\tC: Spermatid\tD: Spermatozoon\t\nThe right answer is A: Primary spermatocyte.",
-            "output": "The patient's presentation with tall stature, long extremities, sparse body hair, gynecomastia, and small testes, combined with increased FSH and estradiol:testosterone ratio, is highly suggestive of Klinefelter syndrome (47,XXY karyotype). In this condition, the extra X chromosome is typically the result of nondisjunction\u2014an error in chromosome separation\u2014during meiosis. Since the genetic anomaly in Klinefelter syndrome can be inherited from the father, the nondisjunction error would have occurred in spermatogenesis at the primary spermatocyte stage, which is meiosis I. Meiosis I is where homologous chromosomes are separated, and so it is the phase during which nondisjunction leading to sex chromosome aneuploidies like Klinefelter's would most likely take place."
-        },
-        {
-            "input": "Question: A 40-year-old man presents to the physician with progressive weight loss for the last 3 months. He also says he frequently sweats profusely at night and has a recurring low-grade fever, for which he takes acetaminophen. The patient denies any symptoms like cough, breathlessness, or gastrointestinal symptoms. His temperature is 37.1\u00baC  (98.8\u00baF), pulse is 76/min, blood pressure is 116/78 mm Hg, and respiratory rate is 13/min. On physical examination, he has generalized pallor. Bilateral cervical lymphadenopathy is present. Examination of his abdomen reveals non-tender hepatosplenomegaly in the right upper quadrant. Laboratory evaluation confirms the diagnosis of Hodgkin\u2019s lymphoma. Which of the following viral infections is most likely to have played a role in the pathogenesis of this patient\u2019s malignancy?\nOptions: A: Epstein-Barr virus\tB: Human T-cell leukemia virus type 1\tC: Human herpesvirus-8\tD: Human papillomavirus type 16\t\nThe right answer is A: Epstein-Barr virus.",
-            "output": "The Epstein-Barr virus (EBV) is most likely to have played a role in the pathogenesis of this patient's Hodgkin's lymphoma. EBV is a common herpesvirus that often causes infectious mononucleosis and is associated with various malignancies, including Burkitt's lymphoma, nasopharyngeal carcinoma, and Hodgkin's lymphoma. Research suggests that EBV can be found in the Reed-Sternberg cells, the characteristic cells of Hodgkin's lymphoma, implying a causal relationship. Other viruses listed (HTLV-1, HHV-8, HPV-16) are also associated with different types of cancers but not as strongly with Hodgkin's lymphoma as EBV."
-        },
-        {
-            "input": "Question: A 33-year-old nurse is referred to an infectious disease specialist after she exhibited a PPD skin test with 17 mm of induration. She denies any cough, shortness of breath, hemoptysis, weight loss, fatigue, fevers, or night sweats over the last several months. Her temperature is 97.0\u00b0F (36.1\u00b0C), blood pressure is 120/81 mmHg, pulse is 82/min, respirations are 15/min, and oxygen saturation is 98% on room air. An initial chest radiograph is unremarkable. Which of the following is the most appropriate management of this patient?\nOptions: A: Isoniazid\tB: No management indicated\tC: Repeat PPD in 1 week\tD: Rifampin, isoniazid, pyrazinamide, and ethambutol\t\nThe right answer is A: Isoniazid.",
-            "output": "This patient, a nurse, likely has a latent tuberculosis infection (LTBI) given the significant reaction to the PPD test (17 mm of induration) without any active symptoms or radiographic evidence of tuberculosis (TB). The size of the induration, at 17 mm, is well above the 15 mm threshold for considering treatment for LTBI in individuals with no risk factors, and given her occupation in healthcare, she's at a higher risk for TB exposure and subsequent reactivation. The most appropriate management is to initiate treatment with isoniazid for LTBI to prevent the development of active TB. The choice of isoniazid (option A) is based on the current guidelines for the treatment of LTBI. The need for other medications (option D) would arise only if she had active TB, which is not supported by her lack of symptoms and normal chest X-ray. No management (option B) would be inappropriate due to her increased risk and positive PPD. Repeating the PPD (option C) is unnecessary as the diagnosis of LTBI is already established."
-        },
-        {
-            "input": "Question: An 81-year-old woman is brought to the emergency room by her son after witnessing the patient fall and hit her head. The son reports that the patient was in her usual state of health until she complained of chest palpitations. This startled her while she was climbing down the stairs and lead to a fall. Past medical history is significant for hypertension and atrial fibrillation. Medications are lisinopril, metoprolol, and warfarin. Temperature is 99\u00b0F (37.2\u00b0C), blood pressure is 152/96 mmHg, pulse is 60/min, respirations are 12/min, and pulse oximetry is 98% on room air. On physical examination, she is disoriented and at times difficult to arouse, the left pupil is 6 mm and non-reactive to light, and the right pupil is 2 mm and reactive to light. A right-sided visual field defect is appreciated on visual field testing. There is 1/5 strength on the right upper and lower extremity; as well as 5/5 strength in the left upper and lower extremity. A computerized tomography (CT) scan of the head is shown. Which of the following most likely explains this patient\u2019s symptoms?\nOptions: A: Herniation of the uncus\tB: Herniation of the cingulate gyrus\tC: Occlusion of the basilar artery\tD: Occlusion of the anterior spinal artery\t\nThe right answer is A: Herniation of the uncus.",
-            "output": "The patient's clinical presentation is consistent with an intracranial hemorrhage causing increased intracranial pressure and subsequent herniation of the uncus. The symptoms of unilateral dilated pupil, a right-sided visual field defect, and right-sided hemiparesis all suggest compression of the oculomotor nerve and ipsilateral cerebral peduncle by a herniated uncus (part of the temporal lobe). These signs also are indicative of compression against the midbrain, which would not occur with cingulate gyrus herniation, seen typically in subfalcine herniation, which does not affect the oculomotor nerve in this manner. Additionally, the occlusion of major arteries like the basilar or anterior spinal would present with different neurologic deficits and would not account for the unilateral pupillary response and localized motor findings. Given her history of anticoagulant use for atrial fibrillation, the risk of bleeding is increased, making a hemorrhagic stroke leading to herniation more likely than an acute arterial occlusion."
-        },
-        {
-            "input": "Question: A 65-year-old man presents to his primary care physician for a change in his behavior over the past few months. Initially, the patient was noted to be behaving inappropriately including using foul language and grabbing people unexpectedly. This has progressed to a worsening of his memory and trouble caring for himself. His temperature is 98.1\u00b0F (36.7\u00b0C), blood pressure is 162/103 mmHg, pulse is 83/min, respirations are 13/min, and oxygen saturation is 98% on room air. Physical exam is notable for an elderly man who laughs inappropriately at times and who is a poor historian. When he is engaged in conversation, he exhibits word finding difficulty and is rather inattentive. Which of the following is the most likely diagnosis?\nOptions: A: Alzheimer dementia\tB: Frontotemporal dementia\tC: Kluver-Bucy syndrome\tD: Vascular dementia\t\nThe right answer is B: Frontotemporal dementia.",
-            "output": "Frontotemporal dementia (FTD) is the most likely diagnosis for this patient, considering the onset of socially inappropriate behavior, changes in personality, and language difficulties, which are hallmark features of FTD. This type of dementia is characterized by progressive damage to the frontal and temporal lobes of the brain, areas responsible for behavior, language, and emotion regulation. Unlike Alzheimer's disease, which typically begins with memory loss, FTD often starts with changes in social and executive functions. The patient's lack of personal insight, inattention, and inappropriate laughter also point towards FTD. Moreover, Alzheimer's and Vascular dementia usually do not present primarily with behavioral changes, and Kluver-Bucy syndrome is rare and would involve additional symptoms like hyperorality and hypersexuality, which are not noted here."
-        },
-        {
-            "input": "Question: A 71-year-old man comes to the physician for a routine visit. His psychiatric history is significant for major depression with psychotic features. He was diagnosed after his wife died from pancreatic cancer four years earlier. Three years ago, he deliberately overdosed on sleeping pills. Today, he feels well but still wakes up frequently at night and cannot sleep through the night. He lives alone in his apartment and has no children. He does not possess a firearm at home but has access to weapons at a local hunting club. The patient currently denies suicidal thoughts or thoughts of self-harm. He takes sertraline and olanzapine. He does not smoke or drink alcohol. Which of the following is the strongest risk factor for suicide in this patient?\nOptions: A: Previous suicide attempt\tB: History of psychosis\tC: Sleeping disorder\tD: Age\n\"\t\nThe right answer is A: Previous suicide attempt.",
-            "output": "The strongest risk factor for suicide in this patient is A. Previous suicide attempt. A history of a previous suicide attempt is one of the most significant predictors of future suicide risk. Although other factors such as age, history of psychosis, and sleeping disorders do contribute to the overall risk profile for suicide, none are as strong as a previous attempt. Additionally, the patient's history of major depression with psychotic features and the significant life stressor of his wife's death may further elevate risk, but the actual attempt he made three years ago is the most critical red flag for future suicide risk. Therefore, the prior act of intentionally overdosing on sleeping pills is the single most potent risk factor in this scenario."
-        },
-        {
-            "input": "Question: A 55-year-old man presents to a rheumatologist with bilateral wrist and knee pain that has been present for the last 10 years. The patient was a professional athlete who retired at age 50. He also notes morning stiffness in his joints that lasts approx. 50 minutes. He denies joint swelling, color changes in his digits, dryness of mucous membranes, and constitutional symptoms such as fever and chills. On physical exam, the physician notes several non-tender nodules on the left 1st, 3rd, and 4th distal interphalangeal joints. There is also tenderness with palpation at the base of both thumbs. The patient\u2019s knees are enlarged, bilaterally, and he has pain and crepitus on passive range of motion. Which of the following is the most likely diagnosis?\nOptions: A: Ankylosing spondylitis\tB: Gout\tC: Osteoarthritis\tD: Fibromyalgia\t\nThe right answer is C: Osteoarthritis.",
-            "output": "The most likely diagnosis for this patient, considering his clinical presentation, is osteoarthritis (C). Osteoarthritis is consistent with his history of being a professional athlete, which often leads to joint wear and tear over time. Key features supporting this diagnosis include his age, the chronic nature of his symptoms, morning stiffness that lasts less than an hour, and the presence of non-tender nodules (likely Heberden's nodes) on his distal interphalangeal joints, as well as tenderness at the base of the thumbs. Enlargement of the knees with pain and crepitus on movement further indicates osteoarthritic joint changes rather than other listed conditions like ankylosing spondylitis, gout, or fibromyalgia."
-        },
-        {
-            "input": "Question: A previously healthy 19-year-old man comes to the physician with right-sided, dull, throbbing scrotal pain for 12 hours. He has also had a burning sensation on urination and increased urinary frequency for the past 3 days. He has not had urethral discharge. He is sexually active with one female partner and does not use condoms. Vital signs are within normal limits. Physical examination shows a tender right testicle; lifting it provides relief. The penis appears normal, with no discharge at the meatus. Laboratory studies show a normal complete blood count; urinalysis shows 3 WBC/hpf. A Gram stain of a urethral swab shows polymorphonuclear leukocytes but no organisms. Testicular ultrasound shows increased blood flow to the right testicle compared to the left. Which of the following is the most likely cause of this patient's symptoms?\nOptions: A: Neisseria gonorrhoeae infection\tB: Testicular tumor\tC: Chlamydia trachomatis infection\tD: Varicocele\t\nThe right answer is C: Chlamydia trachomatis infection.",
-            "output": "The patient's presentation of scrotal pain, urinary frequency, and burning sensation during urination, coupled with no visible discharge and relief of pain upon lifting the testicle (Prehn's sign), suggests epididymitis rather than gonococcal urethritis or a testicular tumor, which would likely present with different symptoms. The presence of WBCs in the urine and polymorphonuclear leukocytes on a Gram stain without organisms suggest an infection with an organism not visible on Gram stain, pointing away from Neisseria gonorrhoeae. Chlamydia trachomatis, which is not visible on Gram stain, often presents with these symptoms in a sexually active young male and is the most common cause of epididymitis in this demographic, making option C the most likely cause. Increased blood flow on ultrasound further supports an inflammatory process, consistent with chlamydial infection, rather than a varicocele or tumor."
-        },
-        {
-            "input": "Question: A previously healthy 18-month-old boy is brought to the physician by his parents for evaluation of an abdominal mass noticed a few days ago. He appears markedly pale and lethargic. Examination shows a 6-cm, nonmobile mass in the left upper quadrant that crosses the midline. 24-hour urine collection shows elevated homovanillic acid and vanillylmandelic acid. Further evaluation including biopsy confirms the diagnosis of intermediate-risk neuroblastoma. The physician recommends the established standard treatment, which is initiation of neoadjuvant chemotherapy followed by surgical resection, if possible. After a thorough discussion of the risks and benefits of chemotherapy, the likelihood of unresectability without neoadjuvant treatment, and the prognosis without it, the patient's parents steadily refuse chemotherapy because they do not want their son to suffer the side effects. They prefer to take their son home for supportive care only. Which of the following is the most appropriate action by the physician?\nOptions: A: Help the parents to arrange supportive care at home\tB: Refer the patient to another oncologist\tC: Recommend for parents to take 2 weeks to think about decision\tD: Seek a court order for neoadjuvant chemotherapy\t\nThe right answer is D: Seek a court order for neoadjuvant chemotherapy.",
-            "output": "Choosing option D, seeking a court order for neoadjuvant chemotherapy, is the most appropriate action for the physician in this context. This is based on the principle of beneficence, where the healthcare provider has an obligation to act in the best interest of the patient. An intermediate-risk neuroblastoma in an 18-month-old patient has a potentially favorable prognosis with appropriate treatment, which includes neoadjuvant chemotherapy followed by surgical resection. By refusing chemotherapy, the parents are denying their child the standard care that could significantly improve his chances of recovery and survival. In such a case, where the decision by the parents poses a risk to the child's life and well-being, the physician has a duty to protect the child's interests. Seeking a court order is a measure of last resort when all attempts to reach an understanding with the parents have failed, and it is used to ensure that the child receives the necessary medical treatment to prevent harm."
-        },
-        {
-            "input": "Question: A 65-year-old man with metastatic lung cancer has been experiencing severe, unremitting pain. He has required escalating doses of oral morphine, but is now having dose limiting side-effects. His pain management team recommends using a medication that can reduce his opioid need through interaction with the NMDA-receptor. Which of the following was the most likely recommended agent?\nOptions: A: Propofol\tB: Ketamine\tC: Fentanyl\tD: Midazolam\t\nThe right answer is B: Ketamine.",
-            "output": "Ketamine is an NMDA-receptor antagonist, which means it can help reduce opioid requirements by modulating the pain pathway differently from opioids. This can be effective in cases of severe pain where escalating doses of opioids lead to troubling side effects. Fentanyl is a potent opioid and would not reduce opioid need; it can actually exacerbate side effects. Propofol and midazolam are sedatives used for anesthesia or procedural sedation and do not interact with the NMDA receptor in a way that would reduce the need for opioids in pain management. Therefore, Ketamine (Option B) is the most likely recommended agent."
-        },
-        {
-            "input": "Question: Please refer to the summary above to answer this question\nThe authors of the study have decided to conduct a follow-up analysis on their data. They decide to stratify their results by CD4+T-lymphocyte count at the time of diagnosis. Among patients with CD4+ cell counts below 200/mm3, cART adherence was a significant predictor of DLBCL risk (RR = 0.52, p = 0.01). However, among patients with CD4+ cell counts above 200/mm3, no relationship was found between DLBCL risk and cART adherence (RR = 0.96, p = 0.36). Which of the following explains for the difference observed between the two strata?\"\nOptions: A: Poor generalizability\tB: Stratified sampling\tC: Random error\tD: Effect modification\t\nThe right answer is D: Effect modification.",
-            "output": "Answer D (Effect modification) explains the observed difference between the two strata because it suggests that the effect of cART adherence on DLBCL risk is modified by the level of CD4+ T-lymphocyte count. The significant reduction in DLBCL risk with better cART adherence among patients with lower CD4+ counts (<200/mm3) indicates that when the immune system is more severely compromised, adherence to cART has a more pronounced beneficial effect on reducing lymphoma risk. In contrast, among patients with higher CD4+ counts (>200/mm3), the immune system is less compromised, possibly diminishing the relative impact of cART adherence on DLBCL risk."
-        },
-        {
-            "input": "Question: A group of researchers conducted a study to determine whether there is an association between folic acid supplementation before pregnancy and autism spectrum disorder (ASD) in offspring. The researchers retrospectively surveyed 200 mothers with children diagnosed with ASD during the first 4 years of life and 200 mothers with healthy children. All participants were interviewed about their prenatal consumption of folic acid using standardized questionnaires. A 94% response rate was obtained from the surveys. The study ultimately found that folic acid supplementation was associated with lower rates of ASD in offspring (OR = 0.3, p < 0.01). Which of the following type of bias is most likely to have influenced these results?\nOptions: A: Interviewer bias\tB: Latency period\tC: Recall bias\tD: Survival bias\t\nThe right answer is C: Recall bias.",
-            "output": "The most likely type of bias that could have influenced these results is C, recall bias. Recall bias occurs when participants do not remember past events or exposures accurately. In this retrospective study, mothers were asked to remember their prenatal consumption of folic acid, which could have occurred many years before. Mothers of children with ASD might remember events differently, perhaps more meticulously due to the search for potential causes or contributing factors to their child's condition, compared to mothers of healthy children. This differential in memory accuracy can lead to an under- or overestimation of the association between folic acid supplementation and ASD."
-        },
-        {
-            "input": "Question: A 35-year-old female is brought to the emergency department after being found unconscious. The patient is found to have a blood glucose level of 35 mg/dL. Hgb A1c was found to be 5.1%. C-peptide level was found to be decreased. The patient returned to her baseline after glucose replacement. She states that she has never had an episode like this before. She has no significant past medical history but reports a family history of diabetes in her mother. She states that she has been undergoing a difficult divorce over the past few months. What is the likely cause of this patient's condition?\nOptions: A: Insulinoma\tB: Factitious disorder\tC: Hypothyroidism\tD: Somatization disorder\t\nThe right answer is B: Factitious disorder.",
-            "output": "Factitious disorder seems to be the likely cause of this patient's hypoglycemia based on the given scenario. The normal Hgb A1c indicates this is not a chronic hyperglycemic state as seen with uncontrolled diabetes. The low C-peptide level suggests that the insulin in her system is exogenous, since C-peptide is released in equal amounts to insulin by the pancreas and would be elevated with endogenous hyperinsulinemia, such as with an insulinoma. Furthermore, the stress of a difficult divorce could trigger factitious disorder, where the patient self-administers insulin or other hypoglycemic agents to produce a medical condition. The medical history and stressor suggest a psychological cause rather than an organic one."
-        },
-        {
-            "input": "Question: A 48-year-old man seeks evaluation at a clinic with a complaint of breathlessness for the past couple of weeks. He says that he finds it difficult to walk a few blocks and has to rest. He also complains of a cough for the past 3 months, which is dry and hacking in nature. The medical history is relevant for an idiopathic arrhythmia for which he takes amiodarone daily. He is a non-smoker and does not drink alcohol. He denies any use of illicit drugs. The vital signs are as follows: heart rate 98/min, respiratory rate 16/min, temperature 37.6\u00b0C (99.68\u00b0F), and blood pressure 132/70 mm Hg. The physical examination is significant for inspiratory crackles over the lung bases. An echocardiogram shows a normal ejection fraction. A chest radiograph is performed and shown below. Which of the following findings will most likely be noted on spirometry?\nOptions: A: Decreased FEV1 and normal FVC\tB: Decreased FEV1 and FVC with decreased FEV1/FVC ratio\tC: Decreased FEV1 and FVC with normal FEV1/FVC ratio\tD: Increased FEV1 and FVC\t\nThe right answer is C: Decreased FEV1 and FVC with normal FEV1/FVC ratio.",
-            "output": "The patient has symptoms of breathlessness, a persistent dry cough, and inspiratory crackles, which can be indicative of interstitial lung disease. Since he is taking amiodarone, a known side effect of this medication is amiodarone-induced pulmonary toxicity (AIPT), which can present with these clinical features. AIPT often manifests as interstitial pneumonitis or pulmonary fibrosis. On spirometry, interstitial lung diseases typically show a restrictive pattern characterized by reduced forced vital capacity (FVC) and forced expiratory volume in one second (FEV1), with a preserved or increased FEV1/FVC ratio as the reduction is proportionate. Therefore, choice C (Decreased FEV1 and FVC with normal FEV1/FVC ratio) is the most likely spirometry finding, reflecting a restrictive lung disease pattern potentially caused by amiodarone."
-        },
-        {
-            "input": "Question: A 59-year-old man comes to the emergency department because of excruciating left knee pain for 4 days. He underwent a total knee arthroplasty of his left knee joint 4 months ago. He has hypertension and osteoarthritis. Current medications include glucosamine, amlodipine, and meloxicam. His temperature is 38.1\u00b0C (100.6\u00b0F), pulse is 97/min, and blood pressure is 118/71 mm Hg. Examination shows a tender, swollen left knee joint; range of motion is limited by pain. Analysis of the synovial fluid confirms septic arthritis, and the prosthesis is removed. Which of the following is the most likely causal organism?\nOptions: A: Staphylococcus epidermidis\tB: Escherichia coli\tC: Staphylococcus aureus\tD: Pseudomonas aeruginosa\t\nThe right answer is A: Staphylococcus epidermidis.",
-            "output": "The most likely causal organism for septic arthritis in a patient who has had recent joint replacement surgery is Staphylococcus epidermidis. This bacterium is part of the skin's normal flora and is a common contaminant during surgery. Despite being less virulent than Staphylococcus aureus, it is frequently associated with infections of indwelling devices, such as prosthetic joints, due to its ability to form biofilms on their surfaces. Additionally, the late presentation of infection, four months after surgery, is more characteristic of a low-virulence organism like S. epidermidis, as opposed to the quicker onset that might be seen with more virulent bacteria like S. aureus or Gram-negative rods."
-        },
-        {
-            "input": "Question: A 32-year-old man comes to the physician for a pre-employment examination. He recently traveled to Guatemala. He feels well but has not seen a physician in several years, and his immunization records are unavailable. Physical examination shows no abnormalities. Serum studies show:\nAnti-HAV IgM Positive\nAnti-HAV IgG Negative\nHBsAg Negative\nAnti-HBs Positive\nHBcAg Negative\nAnti-HBc Negative\nHBeAg Negative\nAnti-HBe Negative\nAnti-HCV Negative\nWhich of the following best explains this patient's laboratory findings?\"\nOptions: A: Active hepatitis A infection\tB: Previous hepatitis A infection\tC: Chronic hepatitis B infection\tD: Chronic hepatitis C infection\t\nThe right answer is A: Active hepatitis A infection.",
-            "output": "The laboratory findings for this patient indicate an active hepatitis A infection. The reasons for this conclusion are as follows: The presence of Anti-HAV IgM antibodies suggests a recent infection with hepatitis A virus, as IgM is the first antibody produced in response to an acute infection. The absence of Anti-HAV IgG indicates that the patient has not developed immunity from a past infection or been vaccinated, as IgG antibodies would be present in these cases. Moreover, the negative results for HBsAg, Anti-HBc, HBeAg, Anti-HBe, and Anti-HCV rule out current infections with hepatitis B and C. Anti-HBs positivity suggests previous immunization against hepatitis B. Therefore, the best explanation for this patient's laboratory findings is an active hepatitis A infection (Option A)."
-        },
-        {
-            "input": "Question: A group of researchers decided to explore whether the estimates of incidence and prevalence rates of systemic lupus erythematosus (SLE) were influenced by the number of years it took to examine administrative data. These estimates were not only based on hospital discharges, but also on physician billing codes. For study purposes, the researchers labeled incident cases at the initial occurrence of SLE diagnosis in the hospital database, while prevalent cases were those that were coded as harboring SLE at any time, with patients maintaining their diagnosis until death. Which statement is true regarding the relationship between incidence and prevalence rates during the time period that might be chosen for this specific study?\nOptions: A: Incidence rates will be higher during shorter time periods than longer periods.\tB: The prevalence of SLE during consecutively shorter time windows will be overestimated.\tC: The inclusion of attack rates would increase incidence estimates in longer time periods.\tD: The inclusion of attack rates would decrease incidence estimates in shorter time periods.\t\nThe right answer is A: Incidence rates will be higher during shorter time periods than longer periods..",
-            "output": "The relationship between incidence and prevalence rates is such that incidence reflects the number of new cases that arise in a specific time frame, while prevalence accounts for all existing cases at a given time, including both new and pre-existing ones. In this study, shorter time periods would likely lead to higher apparent incidence rates because there is less time for individuals to exit the \"at risk\" pool due to recovery or death, thus more cases seem new relative to the population at risk. In contrast, longer time periods allow for more turnover in the population, stabilization of case numbers, and potentially reduced incidence rates as once someone has developed SLE, they are no longer part of the population at risk for new cases. Therefore, statement A is true: Incidence rates will be higher during shorter time periods than longer periods."
-        },
-        {
-            "input": "Question: A 41-year-old man presents to his primary care provider with abdominal pain. He says that the pain \u201ccomes and goes\u201d throughout the day and usually lasts 20-30 minutes per episode. He can point to the spot 1-2 inches above the umbilicus where he feels the pain. He denies any feeling of regurgitation or nighttime cough but endorses nausea. He reports that he used to eat three large meals per day but has found that eating more frequently improves his pain. He tried a couple pills of ibuprofen with food over the past couple days and thinks it helped. He has gained four pounds since his past appointment three months ago. The patient denies any diarrhea or change in his stools. He has no past medical history. He drinks 5-6 beers on the weekend and has a 20 pack-year smoking history. He denies any family history of cancer. On physical exam, he is tender to palpation above the umbilicus. Bowel sounds are present. A stool guaiac test is positive. The patient undergoes endoscopy with biopsy to diagnose his condition.\n\nWhich of the following is most likely to be found on histology?\nOptions: A: Mucosal defect in the stomach\tB: Urease-producing organism in the small intestine\tC: PAS-positive material in the small intestine\tD: Crypt abscesses in the large intestine\t\nThe right answer is B: Urease-producing organism in the small intestine.",
-            "output": "The patient's symptoms: intermittent abdominal pain that improves with more frequent meals and use of ibuprofen suggest peptic ulcer disease (PUD). The endoscopic procedure was likely performed in part to investigate for gastric or duodenal ulcers. An important etiological factor for PUD is the infection by the urease-producing organism Helicobacter pylori (H. pylori) in the stomach or proximal small intestine (duodenum). The presence of this bacterium leads to mucosal inflammation and ulceration. Option B, \"Urease-producing organism in the small intestine,\" is consistent with H. pylori infection on biopsy, which is the most likely underlying cause for PUD. The other options (A, C, D) represent different gastrointestinal pathologies not suggested by the given clinical presentation."
-        },
-        {
-            "input": "Question: A 43-year-old man with a history of hepatitis C and current intravenous drug use presents with 5 days of fever, chills, headache, and severe back pain. On physical exam, temperature is 100.6 deg F (38.1 deg C), blood pressure is 109/56 mmHg, pulse is 94/min, and respirations are 18/min. He is thin and diaphoretic with pinpoint pupils, poor dentition, and track marks on his arms and legs. A high-pitched systolic murmur is heard, loudest in the left sternal border and with inspiration. He is admitted to the hospital and started on broad-spectrum antibiotics. One of the blood cultures drawn 12 hours ago returns positive for Staphylococcus aureus. Which of the following is the most appropriate next step to confirm the diagnosis?\nOptions: A: Repeat blood cultures now\tB: Repeat blood cultures 24 hours after initial cultures were drawn\tC: Repeat blood cultures 48 hours after initial cultures were drawn\tD: Do not repeat blood cultures\t\nThe right answer is A: Repeat blood cultures now.",
-            "output": "Choosing to repeat blood cultures immediately (Option A) is the most appropriate next step to confirm the diagnosis of likely infective endocarditis, given the patient's clinical presentation and positive blood culture for Staphylococcus aureus. With his history of intravenous drug use, fever, characteristic murmur, and septic presentation, infective endocarditis is a high concern. Prompt blood cultures are essential for identifying the causative organism, determining its antibiotic susceptibility, and ensuring effective treatment. Continuous bacteremia is expected in infective endocarditis, thus a timely repeat of blood cultures will likely yield positive results, confirming ongoing infection, which is critical for appropriate management."
-        },
-        {
-            "input": "Question: A 35-year-old woman presents with severe fear reactions to seeing dogs after moving into a new suburban neighborhood. She states that she has always had an irrational and excessive fear of dogs but has been able to avoid it for most of her life while living in the city. When she sees her neighbors walking their dogs outside, she is terrified and begins to feel short of breath. Recently, she has stopped picking up her children from the bus stop and no longer plays outside with her children in order to avoid seeing any dogs. Which of the following would be the best definitive treatment for this patient?\nOptions: A: Selective serotonin reuptake inhibitors (SSRIs)\tB: Short-acting benzodiazepines\tC: Systematic desensitization\tD: Cognitive behavioral therapy\t\nThe right answer is C: Systematic desensitization.",
-            "output": "Systematic desensitization is the best definitive treatment for this patient as it is specifically designed to address phobias such as her severe fear of dogs. This therapeutic approach involves gradually exposing the patient to the fear-inducing stimulus (in this case, dogs) under controlled conditions while teaching relaxation techniques to cope with the anxiety. It allows the patient to slowly build tolerance and reduce fear responses. Cognitive behavioral therapy is also effective for phobias, but systematic desensitization is more tailored to address specific fears by combining gradual exposure with relaxation. SSRIs and benzodiazepines may temporarily alleviate symptoms but do not target the root cause of the phobia, nor do they offer a definitive solution."
-        },
-        {
-            "input": "Question: A 13-year-old boy is brought to the emergency department by his mother because of a 6-hour history of severe eye pain and blurry vision. He wears soft contact lenses and has not removed them for 2 days. Ophthalmologic examination shows a deep corneal ulcer, severe conjunctival injection, and purulent discharge on the right. Treatment with topical ciprofloxacin is initiated. A culture of the ocular discharge is most likely to show which of the following?\nOptions: A: Gram-negative, non-maltose fermenting diplococci\tB: Gram-negative, lactose-fermenting bacilli\tC: Gram-negative, oxidase-positive bacilli\tD: Gram-positive, optochin-sensitive diplococci\n\"\t\nThe right answer is C: Gram-negative, oxidase-positive bacilli.",
-            "output": "A deep corneal ulcer in a young contact lens wearer who has not removed his lenses for an extended period is strongly suggestive of a Pseudomonas aeruginosa infection. This pathogen is a common cause of contact lens-related eye infections and can lead to severe keratitis. Pseudomonas aeruginosa is a gram-negative, oxidase-positive bacillus that thrives in moist environments, including those found on the surface of contact lenses and lens cases that are not properly cleaned. The severe eye pain, blurry vision, and purulent discharge are consistent with this type of bacterial infection. Therefore, a culture of the ocular discharge is most likely to show Gram-negative, oxidase-positive bacilli (Option C)."
-        },
-        {
-            "input": "Question: A 9-month-old boy is brought to the physician by his mother because of intermittent watery diarrhea for several months. Pregnancy and delivery were uncomplicated. He was diagnosed with eczematous dermatitis at 3 months old. His height and weight are below the 5th percentile. Immunologic evaluation shows a defect in activated regulatory T cells. A genetic analysis shows a mutation in the FOXP3 gene. This patient is at increased risk for which of the following?\nOptions: A: Hemorrhagic diathesis\tB: Ocular telangiectasias\tC: Autoimmune endocrinopathy\tD: Retained primary teeth\t\nThe right answer is C: Autoimmune endocrinopathy.",
-            "output": "The patient presents with eczematous dermatitis, immunologic abnormalities, and failure to thrive\u2014all consistent with Immune dysregulation, Polyendocrinopathy, Enteropathy, X-linked syndrome (IPEX), caused by mutations in the FOXP3 gene. FOXP3 is essential for the normal function of regulatory T cells (Tregs) which are crucial for maintaining immune tolerance. The defective Tregs lead to a breakdown of self-tolerance and result in various autoimmune disorders. Among the options listed, autoimmune endocrinopathy (C) closely aligns with the manifestation of IPEX syndrome and the role of FOXP3. Options A, B, and D are not typically associated with FOXP3 mutations or IPEX."
-        },
-        {
-            "input": "Question: A 60-year-old man with a history of osteoarthritis has been awaiting hip replacement surgery for 3 years. During his annual physical, he reports that he has been taking over the counter pain medications, but that no amount of analgesics can relieve his constant pain. Laboratory results reveal that his renal function has deteriorated when compared to his last office visit 2 years ago. Serum creatinine is 2.0 mg/dL, and urinalysis shows 1+ proteinuria. There are no abnormalities seen on microscopy of the urine. A renal biopsy shows eosinophilic infiltration and diffuse parenchymal inflammation. What is the most likely explanation for this patient's deterioration in renal function?\nOptions: A: Focal segmental glomerulosclerosis\tB: Ischemic acute tubular necrosis\tC: Nephrotoxic acute tubular necrosis\tD: Toxic tubulointerstitial nephritis\t\nThe right answer is D: Toxic tubulointerstitial nephritis.",
-            "output": "The most likely explanation for the patient's deterioration in renal function is D. Toxic tubulointerstitial nephritis. This condition can often result from the chronic use of nonsteroidal anti-inflammatory drugs (NSAIDs), which are common over-the-counter pain medications. The patient's history of unrelenting pain and the long-term use of analgesics suggest possible excessive consumption of NSAIDs. Laboratory findings such as an elevated serum creatinine, proteinuria, and particularly eosinophilic infiltration on renal biopsy support the diagnosis of an allergic interstitial nephritis, rather than glomerular diseases like focal segmental glomerulosclerosis (A) or vascular conditions like ischemic acute tubular necrosis (B). Nephrotoxic acute tubular necrosis (C) could also arise from toxin exposure but is less likely given the biopsy results showing an inflammatory, rather than necrotic, pattern."
-        },
-        {
-            "input": "Question: A 27-year-old HIV positive female gave birth to a 7lb 2oz (3.2 kg) baby girl. The obstetrician is worried that the child may have been infected due to the mother's haphazard use of her anti-retroviral medications. Which of the following assays would a hospital use detect the genetic material of HIV if the child had been infected?\nOptions: A: Enzyme-linked immunosorbent assay (ELISA)\tB: Rapid HIV antibody test\tC: Polymerase chain reaction\tD: Southern blot\t\nThe right answer is C: Polymerase chain reaction.",
-            "output": "Option C, Polymerase Chain Reaction (PCR), is the best choice for detecting the genetic material of HIV in a newborn. ELISA and rapid HIV antibody tests, options A and B, detect antibodies to HIV, which are produced by the immune system in response to infection. In a newborn, maternal antibodies can persist for several months and can lead to false-positive results, as they reflect maternal rather than infant infection. Option D, Southern blot, is typically used for DNA fragment analysis and is less relevant in direct viral detection. PCR is highly sensitive and specific for identifying the presence of HIV's genetic material (RNA or DNA) directly, which makes it ideal for diagnosing HIV in newborns where serological tests cannot differentiate between maternal antibodies and those produced by an actual infection in the infant."
-        },
-        {
-            "input": "Question: A previously healthy 2-year-old boy is brought to the physician because of a 10-day history of unsteady gait, frequent falls, and twitching of the extremities. Physical examination shows bilateral saccadic eye movement in all directions and brief, involuntary muscle contractions of the trunk and limbs. There is an ill-defined, nontender mass in the upper right abdomen. He undergoes surgical resection of the tumor. Histopathologic examination of this mass is most likely to show which of the following?\nOptions: A: Numerous immature lymphocytes in a starry sky pattern\tB: Abortive glomeruli and tubules in a spindle cell stroma\tC: Small blue cells arranged in rosettes around a central neuropil\tD: Hepatocytes in fetal and embryonic stages of differentiation\t\nThe right answer is C: Small blue cells arranged in rosettes around a central neuropil.",
-            "output": "The described symptoms and findings\u2014unsteady gait, twitching extremities, bilateral saccadic eye movements, along with a nontender abdominal mass\u2014suggest a diagnosis of neuroblastoma, a common extracranial solid cancer in children. Neuroblastomas often present with opsoclonus-myoclonus syndrome, which is characterized by the neurological signs seen in this patient. The histological feature of small blue cells arranged in rosettes around a central neuropil is typical for neuroblastoma, with the cells representing undifferentiated or poorly differentiated neuroblasts, and the \"rosettes\" being indicative of their attempt to form neural structures. This aligns with the clinical presentation and the likely diagnosis."
-        },
-        {
-            "input": "Question: A 52-year-old fisherman presents to the clinic for an evaluation of a pigmented lesion on his neck. He states that he first noticed the lesion last year, but he believes that it has been slowly growing in size. Dermatopathology determines that the lesion contains neoplastic cells of melanocytic origin. Which of the following characteristics of the lesion would likely be found on physical examination?\nOptions: A: Brown-black color in one area of the lesion to red-white in a different area\tB: Macule that is 5mm in diameter\tC: Well-circumscribed papule with smooth borders\tD: Itching and pain to palpation\t\nThe right answer is A: Brown-black color in one area of the lesion to red-white in a different area.",
-            "output": "The given information suggests the presence of a melanocytic neoplasm, which can be indicative of melanoma, especially considering the patient's occupation as a fisherman, which involves significant sun exposure\u2014an established risk factor for skin cancers, including melanoma. Key clinical features of melanoma include variability in color, with uneven distribution of pigmentation, often described as different shades of brown, black, tan, red, white, or blue. Option A (\"Brown-black color in one area of the lesion to red-white in a different area\") best matches this description of asymmetrical color variation, a hallmark of melanoma, making it a characteristic likely to be found on physical examination. Options B, C, and D may describe benign lesions and lack specific features suggestive of melanoma."
-        },
-        {
-            "input": "Question: An 18-month-old girl is brought to the pediatrician by her mother for vaginal bleeding. The mother states that she noticed the bleeding today, which appeared as brown discharge with clots in the patient\u2019s diaper. The mother denies frequent nosebleeds or easy bruising. She also denies any known trauma. She does mention that the patient has been limping and complaining of left leg pain since a fall 2 months ago. On physical exam, there are multiple 2-3 cm hyperpigmented patches on the patient\u2019s trunk. There is bilateral enlargement of the breasts but no pubic hair. The vaginal orifice is normal and clear with an intact hymen. A plain radiograph of the left lower leg shows patchy areas of lytic bone and sclerosis within the femoral metaphysis. Which of the following is associated with the patient\u2019s most likely diagnosis?\nOptions: A: Bitemporal hemianopsia\tB: Hypertension\tC: Pheochromocytoma\tD: Polyostotic fibrous dysplasia\t\nThe right answer is D: Polyostotic fibrous dysplasia.",
-            "output": "The patient's presentation suggests a condition known as McCune-Albright syndrome (MAS), which is associated with the option D, polyostotic fibrous dysplasia. The key symptoms contributing to this diagnosis are the multiple hyperpigmented patches (caf\u00e9-au-lait spots), which are often seen in MAS. Additionally, the limping and pain following a fall with radiographic findings of patchy lytic bone and sclerosis are indicative of fibrous dysplasia, where normal bone is replaced with fibrous tissue, leading to pain, deformity, and fractures. The vaginal bleeding and breast enlargement without pubic hair suggest precocious puberty, another component of MAS. The other options (A-C) are not typically associated with the described symptoms and findings. Bitemporal hemianopsia is associated with lesions affecting the optic chiasm, hypertension could have several other causes, and pheochromocytoma is a neuroendocrine tumor with symptoms not described here."
-        },
-        {
-            "input": "Question: A 72-year-old woman is admitted to the hospital for treatment of unstable angina. Cardiac catheterization shows occlusion that has caused a 50% reduction in the diameter of the left circumflex artery. Resistance to blood flow in this vessel has increased by what factor relative to a vessel with no occlusion?\nOptions: A: 64\tB: 16\tC: 8\tD: 4\t\nThe right answer is B: 16.",
-            "output": "The relationship between vessel diameter and blood flow resistance is given by Poiseuille's Law, which states that resistance is inversely proportional to the fourth power of the radius of a vessel (resistance \u221d 1/radius^4). Therefore, if the diameter (which is twice the radius) is reduced by 50%, the radius is reduced to 50%, or 0.5 of its original size. The new resistance is 1/(0.5)^4 = 1/0.0625 = 16 times the original resistance. Hence, the resistance to blood flow in this artery has increased by a factor of 16, making option B the correct answer."
-        },
-        {
-            "input": "Question: A 5-year-old boy is brought to the physician because of an irregular gait 3 days after receiving age-appropriate vaccinations. Examination of the lower extremities shows no redness or swelling. When the child stands on his right leg, his left leg drops and his pelvis tilts towards the left. Sensation to light touch is normal in both legs. This patient's symptoms are most likely due to the injection of the vaccine into which of the following locations?\nOptions: A: Inferolateral quadrant of the right buttock\tB: Inferomedial quadrant of the right buttock\tC: Inferomedial quadrant of the left buttock\tD: Superomedial quadrant of the right buttock\t\nThe right answer is D: Superomedial quadrant of the right buttock.",
-            "output": "The patient's symptoms suggest a lesion affecting the superior gluteal nerve. The Trendelenburg sign, where the pelvis tilts towards the contralateral side when standing on one leg due to weakness of the gluteus medius and minimus muscles, is indicative of this. These muscles are innervated by the superior gluteal nerve, which could be damaged if an injection were given improperly in the upper buttock region. The correct option, D (Superomedial quadrant of the right buttock), indicates the site where an injection could potentially damage the superior gluteal nerve, leading to the observed gait abnormality. Other options would not typically affect this nerve."
-        },
-        {
-            "input": "Question: A 26-year-old woman comes to the clinic for an annual wellness examination. She is healthy with no prior history of significant illness. She exercises 3-4 times a week and eats a plant-based diet with no carbonated drinks. When asked if anything is bothering her, she reports that she has been having recurring episodes of sneezing, congestion, and itchy eyes for the past year. She denies any fever, sick contacts, cough, headaches, chest pain, urinary symptoms, or constipation/diarrhea during these episodes. She is told to take a medication to alleviate her symptoms as needed. What is the likely mechanism of action of the medication in question?\nOptions: A: Alpha-adrenergic agonist\tB: Competitive blockage of muscarinic receptors\tC: Disruption of disulfide bonds\tD: Short acting beta-2 agonist\t\nThe right answer is A: Alpha-adrenergic agonist.",
-            "output": "The symptoms of sneezing, congestion, and itchy eyes with no associated systemic symptoms such as fever or cough are suggestive of allergic rhinitis. The lack of systemic symptoms helps rule out infection or other systemic diseases. Allergic rhinitis is often treated symptomatically with medications that relieve the congestion and other related symptoms. An alpha-adrenergic agonist, such as pseudoephedrine or phenylephrine, is commonly used in such conditions because it causes vasoconstriction of the nasal mucosa blood vessels, which leads to a decrease in congestion. This mechanism differs from the action of antihistamines (which block histamine receptors), muscarinic receptor blockers (which affect parasympathetic signaling), disulfide bond disruptors (which affect mucous viscosity), and beta-2 agonists (which are more commonly used to relieve bronchospasms in conditions such as asthma). Therefore, the alpha-adrenergic agonist's primary mechanism relevant here is vasoconstriction in nasal passages to alleviate symptoms."
-        }
-    ]
-}

MedS-Bench/Reasoning/task53_mmedbench_explanation_french_test_only.json

@@ -1,234 +0,0 @@
-{
-    "Contributors": [
-        "MAGIC"
-    ],
-    "Source": [
-        "MMedBench"
-    ],
-    "URL": [
-        "https://huggingface.co/datasets/Henrychur/MMedBench"
-    ],
-    "Categories": [
-        "Explanation"
-    ],
-    "Definition": [
-        "Given a question and its answer, generate an explanation statement."
-    ],
-    "Reasoning": [],
-    "Input_language": [
-        "French"
-    ],
-    "Output_language": [
-        "French"
-    ],
-    "Instruction_language": [
-        "English"
-    ],
-    "Domains": [
-        "Medical Knowledge"
-    ],
-    "Positive Examples": [],
-    "Negative Examples": [],
-    "Instances": [
-        {
-            "input": "Question: Parmi les propositions suivantes, indiquer celle qui est exacte. Dans les conditions physiologiques, le pH le plus \u00e9lev\u00e9 est mesur\u00e9 dans:\nOptions: A: Le suc gastrique\tB: La bile v\u00e9siculaire\tC: Le suc pancr\u00e9atique\tD: La salive\tE: Les s\u00e9cr\u00e9tions intestinales\t\nLa bonne r\u00e9ponse est C: Le suc pancr\u00e9atique.",
-            "output": "La r\u00e9ponse correcte est C, le suc pancr\u00e9atique. Ceci s'explique par le fait que le suc pancr\u00e9atique est riche en bicarbonate de sodium, une substance alcaline qui permet de neutraliser l'acidit\u00e9 du chyme en provenance de l'estomac lorsque celui-ci entre dans le duod\u00e9num. Son pH se situe aux alentours de 8, ce qui est nettement plus \u00e9lev\u00e9 que les autres s\u00e9cr\u00e9tions telles que le suc gastrique (pH environ 2), la bile (pH environ 7.0-8.0), la salive (pH environ 6.5-7.5) et les s\u00e9cr\u00e9tions intestinales (pH varie, mais est g\u00e9n\u00e9ralement inf\u00e9rieur \u00e0 celui du suc pancr\u00e9atique)."
-        },
-        {
-            "input": "Question: Parmi les propositions suivantes, quelle est celle qui est exacte? Lorsqu'on ajoute un acide fort \u00e0 une solution tampon:\nOptions: A: Le pH reste constant\tB: Le pH diminue l\u00e9g\u00e8rement\tC: Le constituant basique du tampon reste constant\tD: Le constituant acide du tampon r\u00e9agit\tE: Le rapport acide/base reste inchang\u00e9\t\nLa bonne r\u00e9ponse est B: Le pH diminue l\u00e9g\u00e8rement.",
-            "output": "Choisir l'option B se justifie par le principe de fonctionnement d'une solution tampon. Une solution tampon est capable de r\u00e9sister aux changements de pH lors de l\u2019ajout d'un acide ou d'une base gr\u00e2ce \u00e0 la r\u00e9action de ses composants : l\u2019acide faible et sa base conjugu\u00e9e. En ajoutant un acide fort, le constituant basique du tampon neutralise une partie des ions H+ ajout\u00e9s, ce qui entra\u00eene une l\u00e9g\u00e8re diminution du pH plut\u00f4t qu'un changement brusque. Le tampon agit ainsi pour att\u00e9nuer l'effet de l'acide ajout\u00e9, mais ce syst\u00e8me a des limites et ne peut maintenir un pH strictement constant."
-        },
-        {
-            "input": "Question: Parmi les 5 mesures suivantes, quelle est celle qui rel\u00e8ve de la pr\u00e9vention primaire?\nOptions: A: Vaccination antit\u00e9tanique\tB: D\u00e9pistage du cancer colorectal par l'H\u00e9moccult (recherche d'H\u00e9moglobine dans les selles)\tC: Pr\u00e9vention des r\u00e9cidives d'accident vasculaire c\u00e9r\u00e9bral par les anti-agr\u00e9gants\tD: R\u00e9\u00e9ducation des coronariens\tE: R\u00e9insertion sociale des handicap\u00e9s\t\nLa bonne r\u00e9ponse est A: Vaccination antit\u00e9tanique.",
-            "output": "La vaccination antit\u00e9tanique constitue une mesure de pr\u00e9vention primaire car son objectif est de pr\u00e9venir l'apparition de la maladie (le t\u00e9tanos) avant que celle-ci ne survienne. Cette action intervient en amont en immunisant l'individu contre l'agent pathog\u00e8ne responsable du t\u00e9tanos, contribuant ainsi \u00e0 \u00e9viter l'infection. A contrario, les autres options mentionn\u00e9es se r\u00e9f\u00e8rent \u00e0 des formes de pr\u00e9ventions secondaire ou tertiaire: le d\u00e9pistage vise \u00e0 d\u00e9tecter pr\u00e9cocement une maladie d\u00e9j\u00e0 pr\u00e9sente (pr\u00e9vention secondaire), la pr\u00e9vention des r\u00e9cidives, la r\u00e9\u00e9ducation et la r\u00e9insertion visent \u00e0 minimiser l'impact ou les complications de maladies d\u00e9j\u00e0 existantes (pr\u00e9vention tertiaire)."
-        },
-        {
-            "input": "Question: Parmi les propositions suivantes, quelle est la cible d'action de la flucytosine (ANCOTIL\u00ae) sur la cellule fongique:\nOptions: A: La paroi\tB: La membrane plasmique\tC: Le noyau\tD: La capsule\tE: Le r\u00e9ticulum endoplasmique\t\nLa bonne r\u00e9ponse est C: Le noyau.",
-            "output": "La flucytosine, ou ANCOTIL\u00ae, exerce son action antifongique en ciblant le noyau de la cellule fongique. Elle est m\u00e9tabolis\u00e9e en fluorouracile \u00e0 l'int\u00e9rieur des cellules fongiques, agissant alors comme un analogue de la cytosine, ce qui interf\u00e8re avec la synth\u00e8se de l'ADN et l\u2019ARN du champignon. Ce m\u00e9canisme entrave la r\u00e9plication de l'ADN et la transcription de l'ARN, perturbant ainsi les fonctions vitales du noyau et conduisant \u00e0 la mort cellulaire. C\u2019est pourquoi l'option C est la r\u00e9ponse correcte. Les autres options \u00e9num\u00e9r\u00e9es correspondent \u00e0 diff\u00e9rentes structures cellulaires qui ne sont pas sp\u00e9cifiquement cibl\u00e9es par la flucytosine."
-        },
-        {
-            "input": "Question: Parmi les propositions suivantes concernant la chromatographie d'exclusion-diffusion, indiquer celle qui est exacte\u00a0?\nOptions: A: La phase stationnaire peut \u00eatre constitu\u00e9e d'un gel de silice\tB: Les ions de petite taille sont \u00e9lu\u00e9s avec le volume mort\tC: La capacit\u00e9 de gonflement d'un gel d\u00e9pend de son degr\u00e9 de r\u00e9ticulation\tD: L'utilisation d'un gel mou (S\u00e9phadex) permet de travailler \u00e0 un d\u00e9bit de phase mobile \u00e9lev\u00e9\tE: Les a\u00e9rogels gonflent au contact de la phase mobile\t\nLa bonne r\u00e9ponse est C: La capacit\u00e9 de gonflement d'un gel d\u00e9pend de son degr\u00e9 de r\u00e9ticulation.",
-            "output": "La chromatographie d'exclusion-diffusion, \u00e9galement connue sous le nom de chromatographie par filtration sur gel, repose sur la capacit\u00e9 des gels \u00e0 trier les mol\u00e9cules en fonction de leur taille gr\u00e2ce \u00e0 un r\u00e9seau de pores. La capacit\u00e9 de gonflement d'un gel est directement d\u00e9pendante de son degr\u00e9 de r\u00e9ticulation : plus un gel est r\u00e9ticul\u00e9, moins il pourra gonfler, car la densit\u00e9 de liens entre les cha\u00eenes polym\u00e8res limite l'entr\u00e9e d'eau et donc le volume du gel. Cette propri\u00e9t\u00e9 affecte la distribution des tailles de pores et, par cons\u00e9quent, la s\u00e9paration des mol\u00e9cules lors de la chromatographie."
-        },
-        {
-            "input": "Question: Quelle est approximativement la masse d'\u00e9thanol pur contenue dans 1 litre de vin titrant 12 degr\u00e9s alcooliques?\nOptions: A: 60 g\tB: 72g\tC: 96 g\tD: 120 g\tE: 150 g\t\nLa bonne r\u00e9ponse est C: 96 g.",
-            "output": "Pour analyser cette question, comprenons d'abord que les degr\u00e9s alcooliques repr\u00e9sentent le pourcentage en volume d'\u00e9thanol contenu dans une solution. Ainsi, un vin \u00e0 12 degr\u00e9s contient 12% de son volume en \u00e9thanol. Sachant que 1 litre \u00e9quivaut \u00e0 1000 millilitres et que la masse volumique de l'\u00e9thanol est d'environ 0,789 g/ml, on peut calculer la masse d'\u00e9thanol pur comme suit : 1000 ml * 12% = 120 ml d'\u00e9thanol pur. Ensuite, on multiplie le volume trouv\u00e9 par la masse volumique : 120 ml * 0,789 g/ml \u2248 94,68 g. L'option la plus proche est donc C. 96 g."
-        },
-        {
-            "input": "Question: Parmi les propositions suivantes concernant l'albumine, une seule est fausse, laquelle?\nOptions: A: C'est la prot\u00e9ine plasmatique qualitativement plus importante\tB: Elle est synth\u00e9tis\u00e9e dans le foie\tC: C'est un marqueur de la cytolyse h\u00e9patique\tD: Elle joue un r\u00f4le dans la pression oncotique\tE: Elle transporte de nombreuses substances endog\u00e8nes et exog\u00e8nes\t\nLa bonne r\u00e9ponse est C: C'est un marqueur de la cytolyse h\u00e9patique.",
-            "output": "La proposition fausse est C: \"C'est un marqueur de la cytolyse h\u00e9patique\". L'albumine est en effet une prot\u00e9ine s\u00e9rique principale synth\u00e9tis\u00e9e par le foie, comme indiqu\u00e9 dans la proposition B, et elle a un r\u00f4le cl\u00e9 dans le maintien de la pression oncotique (option D) ainsi que dans le transport de diverses substances (option E). Cependant, l'albumine n'est pas un marqueur direct de cytolyse h\u00e9patique. Les marqueurs de cytolyse sont des enzymes h\u00e9patocellulaires comme les transaminases (ALT et AST); une diminution de l\u2019albumine peut indiquer une synth\u00e8se h\u00e9patique insuffisante dans le contexte d'une maladie h\u00e9patique chronique, mais elle n'est pas un indicateur direct de destruction des cellules h\u00e9patiques (cytolyse)."
-        },
-        {
-            "input": "Question: Parmi les affirmations suivantes concernant la pristinamycine, une seule est fausse. Laquelle?\nOptions: A: Elle n'est pas habituellement utilis\u00e9e dans le traitement des infections \u00e0 bacille pyocyanique\tB: Elle agit par perturbation de la synth\u00e8se des prot\u00e9ines bact\u00e9riennes\tC: Une souche bact\u00e9rienne r\u00e9sistante \u00e0 l'\u00e9rythromycine peut rester sensible \u00e0 la pristinamycine\tD: Elle est habituellement active \u00e0 l'\u00e9gard de Streptococcus pyogenes\tE: Elle n'est administr\u00e9e que par voie parent\u00e9rale\t\nLa bonne r\u00e9ponse est E: Elle n'est administr\u00e9e que par voie parent\u00e9rale.",
-            "output": "La raison pour laquelle l'option E est fausse est que la pristinamycine est souvent administr\u00e9e par voie orale, pas uniquement par voie parent\u00e9rale. Cette caract\u00e9ristique distingue la pristinamycine de certains autres antibiotiques, souvent disponibles uniquement sous forme injectable. Les autres affirmations sont correctes. La pristinamycine n'est effectivement pas la premi\u00e8re ligne de traitement pour les infections \u00e0 Pseudomonas aeruginosa (bacille pyocyanique), elle agit en perturbant la synth\u00e8se des prot\u00e9ines bact\u00e9riennes, une souche r\u00e9sistante \u00e0 l'\u00e9rythromycine peut rester sensible \u00e0 la pristinamycine, et cet antibiotique est actif contre Streptococcus pyogenes."
-        },
-        {
-            "input": "Question: Parmi les propositions suivantes relatives au TNFalpha, laquelle est inexacte?\nOptions: A: Il est produit physiologiquement en abondance par les cellules \u00e9pith\u00e9liales de la muqueuse intestinale\tB: C'est une cytokine pro-inflammatoire\tC: Il stimule la production d'IL-6\tD: C'est une cytokine impliqu\u00e9e dans la physiopathologie de la polyarthrite rhumatoide\tE: Il est la cible d'un anticorps monoclonal utilis\u00e9 en th\u00e9rapeutique\t\nLa bonne r\u00e9ponse est A: Il est produit physiologiquement en abondance par les cellules \u00e9pith\u00e9liales de la muqueuse intestinale.",
-            "output": "Le TNFalpha (facteur de n\u00e9crose tumorale alpha) est une cytokine principalement produite par les macrophages et les cellules mononucl\u00e9\u00e9es en r\u00e9ponse \u00e0 une inflammation ou une infection. L'option A est inexacte car, si des cellules \u00e9pith\u00e9liales peuvent produire du TNFalpha en r\u00e9ponse \u00e0 certains stimuli, cette production n'est pas faite en abondance physiologiquement par les cellules \u00e9pith\u00e9liales de la muqueuse intestinale. C'est plut\u00f4t une r\u00e9action \u00e0 un \u00e9tat pathologique. Les autres options sont correctes: B) Il est pro-inflammatoire, C) Il stimule la production d'autres cytokines comme l'IL-6, D) Il joue un r\u00f4le dans la polyarthrite rhumato\u00efde et E) Des anticorps monoclonaux ciblent le TNFalpha en th\u00e9rapeutique, notamment dans le traitement de certaines maladies inflammatoires comme la polyarthrite rhumato\u00efde ou les maladies inflammatoires de l'intestin."
-        },
-        {
-            "input": "Question: Parmi les propositions suivantes concernant les ph\u00e9nom\u00e8nes pouvant entra\u00eener une inhibition de la fluorescence. Laquelle est fausse?\nOptions: A: La variation du pH peut modifier l'intensit\u00e9 de la fluorescence\tB: L'oxyg\u00e8ne dissous inhibe la fluorescence\tC: Si la temp\u00e9rature augmente, l'intensit\u00e9 de la fluorescence augmente\tD: Le solvant peut inhiber la fluorescence\tE: La pr\u00e9sence d'impuret\u00e9s dans la solution peut provoquer une inhibition de la fluorescence\t\nLa bonne r\u00e9ponse est C: Si la temp\u00e9rature augmente, l'intensit\u00e9 de la fluorescence augmente.",
-            "output": "L'option C est incorrecte car g\u00e9n\u00e9ralement, une augmentation de la temp\u00e9rature entra\u00eene une diminution de l'intensit\u00e9 de la fluorescence et non une augmentation. Cela s'explique par plusieurs ph\u00e9nom\u00e8nes physico-chimiques : avec l'\u00e9l\u00e9vation de temp\u00e9rature, il y a une augmentation des collisions entre mol\u00e9cules, ce qui favorise la non-radiative relaxation \u2013 les mol\u00e9cules perdent de l'\u00e9nergie sous forme de chaleur plut\u00f4t que de lumi\u00e8re (fluorescence). En outre, l'augmentation de la temp\u00e9rature peut parfois conduire \u00e0 l'alt\u00e9ration des structures mol\u00e9culaires fluorescentes, affectant ainsi leurs propri\u00e9t\u00e9s de fluorescence. C'est pourquoi l'affirmation C est fausse dans le contexte des options propos\u00e9es."
-        },
-        {
-            "input": "Question: Parmi les bact\u00e9ries suivantes, quelle est celle fr\u00e9quemment responsable de chol\u00e9cystite aigu\u00eb?\nOptions: A: Pseudomonas aeruginosa\tB: Escherichia Coli\tC: Shigella\tD: Neisseria meningitidis\tE: Vibrio cholerae\t\nLa bonne r\u00e9ponse est B: Escherichia Coli.",
-            "output": "L'Escherichia coli (option B) est souvent responsable de la chol\u00e9cystite aigu\u00eb, c'est une infection bact\u00e9rienne de la v\u00e9sicule biliaire. E. coli est typiquement trouv\u00e9e dans la flore intestinale et peut atteindre la v\u00e9sicule biliaire par l'interm\u00e9diaire du canal cystique. Cette bact\u00e9rie est l'agent pathog\u00e8ne le plus commun\u00e9ment isol\u00e9 dans les infections biliaires, en raison de sa proximit\u00e9 avec les voies biliaires et sa capacit\u00e9 \u00e0 provoquer des infections. Les autres bact\u00e9ries list\u00e9es ne sont pas fr\u00e9quemment associ\u00e9es \u00e0 la pathologie de la chol\u00e9cystite aigu\u00eb."
-        },
-        {
-            "input": "Question: Parmi les propositions suivantes concernant la doxycycline, une seule est exacte; laquelle?\nOptions: A: Est un antibiotique bact\u00e9ricide\tB: Poss\u00e8de un spectre antibact\u00e9rien limit\u00e9 aux bact\u00e9ries \u00e0 Gram positif\tC: Poss\u00e8de une bonne diffusion intracellulaire\tD: Est utilis\u00e9 dans le traitement des m\u00e9ningites \u00e0 Haemophilus influenzae\tE: Est utilis\u00e9e chez l'enfant de moins de 8 ans\t\nLa bonne r\u00e9ponse est C: Poss\u00e8de une bonne diffusion intracellulaire.",
-            "output": "La doxycycline est un antibiotique de la classe des t\u00e9tracyclines qui est connue pour sa capacit\u00e9 \u00e0 bien se diffuser dans les cellules, ce qui explique pourquoi la r\u00e9ponse C est correcte. Elle est donc efficace contre les bact\u00e9ries intracellulaires comme les chlamydiae ou les rickettsies. La doxycycline n'est pas exclusivement bact\u00e9ricide, elle peut aussi agir comme bact\u00e9riostatique en inhibant la synth\u00e8se prot\u00e9ique des bact\u00e9ries (\u00e9liminant ainsi l'option A). Son spectre d'action est large et inclut des bact\u00e9ries \u00e0 Gram positif et \u00e0 Gram n\u00e9gatif, rendant l'option B incorrecte. La doxycycline n'est g\u00e9n\u00e9ralement pas le traitement de choix pour les m\u00e9ningites \u00e0 Haemophilus influenzae (\u00e9cartant l'option D). Finalement, l'utilisation de la doxycycline n'est pas recommand\u00e9e chez les enfants de moins de 8 ans en raison du risque de coloration dentaire et d'atteinte de l'\u00e9mail (ce qui rend l'option E incorrecte)."
-        },
-        {
-            "input": "Question: Parmi les propositions suivantes concernant Vibrio cholerae, quelle est celle qui est fausse?\nOptions: A: C'est une bact\u00e9rie \u00e0 Gram n\u00e9gatif en virgule\tB: Sa transmission est f\u00e9co-orale\tC: Elle produit une ent\u00e9rotoxine\tD: C'est une bact\u00e9rie a\u00e9robie stricte\tE: Il existe une prophylaxie vaccinale des infections qu'elle provoque\t\nLa bonne r\u00e9ponse est D: C'est une bact\u00e9rie a\u00e9robie stricte.",
-            "output": "La proposition fausse est la D. Vibrio cholerae n'est pas une bact\u00e9rie a\u00e9robie stricte; elle est en r\u00e9alit\u00e9 facultative ana\u00e9robie. Cela signifie qu'elle peut cro\u00eetre en pr\u00e9sence ou en absence d'oxyg\u00e8ne, ce qui est diff\u00e9rent d'une bact\u00e9rie a\u00e9robie stricte qui n\u00e9cessite obligatoirement de l'oxyg\u00e8ne pour vivre. Les autres propositions sont correctes : A) Vibrio cholerae est bien une bact\u00e9rie Gram n\u00e9gatif en forme de virgule, B) sa transmission se fait principalement par la voie f\u00e9co-orale, C) elle produit en effet une ent\u00e9rotoxine qui cause la diarrh\u00e9e aqueuse caract\u00e9ristique du chol\u00e9ra, et E) il existe des vaccins pour la pr\u00e9vention de la chol\u00e9ra."
-        },
-        {
-            "input": "Question: Parmi les solvants chlor\u00e9s suivants, lequel pr\u00e9sente un pouvoir canc\u00e9rog\u00e8ne nettement d\u00e9montr\u00e9 chez l'homme?\nOptions: A: Le dichlorom\u00e9thane\tB: Le chlorure de vinyle\tC: Le t\u00e9trachlorure de carbone\tD: Le trichlor\u00e9thyl\u00e8ne\tE: Le chloroforme\t\nLa bonne r\u00e9ponse est B: Le chlorure de vinyle.",
-            "output": "Le chlorure de vinyle, option B, est clairement identifi\u00e9 comme un canc\u00e9rog\u00e8ne pour l'homme. Son usage est principalement dans la production de PVC, et des \u00e9tudes \u00e9pid\u00e9miologiques ont montr\u00e9 un lien entre l'exposition au chlorure de vinyle et l'apparition de certains cancers, notamment l'angiosarcome du foie. Les agences internationales de recherche sur le cancer, comme le CIRC, l\u2019ont class\u00e9 dans la cat\u00e9gorie des canc\u00e9rog\u00e8nes certains. Les autres solvants list\u00e9s ont aussi des risques associ\u00e9s, mais le lien direct avec le cancer chez l'homme est moins clairement \u00e9tabli que pour le chlorure de vinyle."
-        },
-        {
-            "input": "Question: Parmi les propositions suivantes, indiquer celle qui est vraie. La s\u00e9cr\u00e9tion d'aldost\u00e9rone r\u00e9sulte d'une:\nOptions: A: Diminution du d\u00e9bit de NaCl dans le tubule proximal\tB: Augmentation de pression dans l'art\u00e9riole aff\u00e9rente glom\u00e9rulaire\tC: \u00c9l\u00e9vation de pression dans l'art\u00e9riole eff\u00e9rente glom\u00e9rulaire\tD: Diminution de pression dans l'art\u00e9riole aff\u00e9rente glom\u00e9rulaire\tE: Stimulation nerveuse parasympathique\t\nLa bonne r\u00e9ponse est D: Diminution de pression dans l'art\u00e9riole aff\u00e9rente glom\u00e9rulaire.",
-            "output": "La r\u00e9ponse D est correcte. La s\u00e9cr\u00e9tion d'aldost\u00e9rone est r\u00e9gul\u00e9e principalement par le syst\u00e8me r\u00e9nine-angiotensine-aldost\u00e9rone (SRAA). Une diminution de la pression sanguine dans l'art\u00e9riole aff\u00e9rente glom\u00e9rulaire est interpr\u00e9t\u00e9e comme une baisse de la vol\u00e9mie. Cela d\u00e9clenche la s\u00e9cr\u00e9tion de r\u00e9nine par les cellules juxtaglom\u00e9rulaires, qui \u00e0 son tour engendre la production d'angiotensine II, un puissant vasoconstricteur qui stimule la lib\u00e9ration d'aldost\u00e9rone par les glandes surr\u00e9nales. L'aldost\u00e9rone favorise la r\u00e9absorption du sodium et de l'eau, compensant ainsi la baisse initiale de vol\u00e9mie et de pression art\u00e9rielle. Les autres options ne d\u00e9crivent pas des m\u00e9canismes directement li\u00e9s \u00e0 la s\u00e9cr\u00e9tion d'aldost\u00e9rone."
-        },
-        {
-            "input": "Question: Une seule d\u00e9finition de l'amn\u00e9sie ant\u00e9rograde caus\u00e9e par les benzodiaz\u00e9pines est exacte. Laquelle?\nOptions: A: Elle concerne les \u00e9v\u00e8nements ant\u00e9rieurs \u00e0 la prise du m\u00e9dicament\tB: Elle concerne les \u00e9v\u00e8nements post\u00e9rieurs \u00e0 la prise du m\u00e9dicament\tC: Elle concerne \u00e0 la fois les \u00e9v\u00e8nements ant\u00e9rieurs et post\u00e9rieurs \u00e0 la prise du m\u00e9dicament\tD: Elle concerne les \u00e9v\u00e8nements post\u00e9rieurs \u00e0 l'arr\u00eat brutal du traitement\tE: Les benzodiaz\u00e9pines ne sont pas amn\u00e9siantes\t\nLa bonne r\u00e9ponse est B: Elle concerne les \u00e9v\u00e8nements post\u00e9rieurs \u00e0 la prise du m\u00e9dicament.",
-            "output": "L'amn\u00e9sie ant\u00e9rograde caus\u00e9e par les benzodiaz\u00e9pines se caract\u00e9rise par une difficult\u00e9, voire une incapacit\u00e9, \u00e0 former de nouveaux souvenirs apr\u00e8s la prise du m\u00e9dicament. C'est pourquoi l'option B est correcte: elle concerne les \u00e9v\u00e9nements post\u00e9rieurs \u00e0 la prise du m\u00e9dicament. Les benzodiaz\u00e9pines agissent sur les r\u00e9cepteurs GABA du cerveau, ce qui peut alt\u00e9rer la m\u00e9morisation de nouvelles informations. L'option A est incorrecte car elle d\u00e9crit l'amn\u00e9sie r\u00e9trograde. L'option C est fausse puisque l'amn\u00e9sie ne touche pas les souvenirs anciens. L'option D est irr\u00e9levante car l'amn\u00e9sie concerne la p\u00e9riode post-ingestion et non post-arr\u00eat. Enfin, l'option E est fausse car les benzodiaz\u00e9pines ont un effet amn\u00e9siant reconnu."
-        },
-        {
-            "input": "Question: Parmi les bact\u00e9ries suivantes, une seule n'est pas responsable de diarrh\u00e9es. Laquelle?\nOptions: A: Escherichia Coli\tB: Streptococcus agalactiae\tC: Clostridium perfringens\tD: Salmonella typhimurium\tE: Shigella sonnei\t\nLa bonne r\u00e9ponse est B: Streptococcus agalactiae.",
-            "output": "Streptococcus agalactiae, \u00e9galement appel\u00e9 streptocoque du groupe B, est connu pour causer des infections n\u00e9onatales, des infections urinaires chez les femmes enceintes, et des infections chez l'adulte, telles que les endocardites ou les septic\u00e9mies. \u00c0 l'oppos\u00e9, Escherichia coli, Clostridium perfringens, Salmonella typhimurium, et Shigella sonnei sont fr\u00e9quemment associ\u00e9s \u00e0 des gastro-ent\u00e9rites et peuvent donc \u00eatre responsables de diarrh\u00e9es. Streptococcus agalactiae n'est pas typiquement associ\u00e9 aux maladies ent\u00e9riques et n'est donc pas une cause habituelle de diarrh\u00e9e comparativement aux autres bact\u00e9ries list\u00e9es. C'est pourquoi l'option B est la bonne r\u00e9ponse."
-        },
-        {
-            "input": "Question: En 1998, sur 85.000 hommes de 60 \u00e0 64 ans, 300 cas d'infarctus du myocarde ont \u00e9t\u00e9 d\u00e9nombr\u00e9s dont 270 nouveaux. Parmi les nouveaux cas, 135 sont d\u00e9c\u00e9d\u00e9s dans l'ann\u00e9e. Le nombre total de d\u00e9c\u00e8s dus \u00e0 cette maladie pour l'ann\u00e9e est de 150; Parmi les r\u00e9sultats ci-dessous, indiquer celui qui repr\u00e9sente le taux d'incidence:\nOptions: A: 135/85.000\tB: 300/85.000\tC: 150/85.000\tD: 270 /85.000\tE: 135/270\t\nLa bonne r\u00e9ponse est D: 270 /85.000.",
-            "output": "La r\u00e9ponse D, soit 270/85.000, repr\u00e9sente le taux d'incidence de nouveaux cas d'infarctus du myocarde dans cette population d'hommes de 60 \u00e0 64 ans en 1998. Le taux d'incidence mesure le nombre de nouveaux cas d'une maladie qui surviennent dans une population donn\u00e9e pendant une p\u00e9riode sp\u00e9cifique. Ici, on recense 270 nouveaux cas sur 85.000 hommes donc le taux d'incidence est obtenu en divisant le nombre de nouveaux cas (270) par la population \u00e0 risque (85.000). Les autres options incluent soit des cas pr\u00e9existants, soit des d\u00e9c\u00e8s, qui ne sont pas pertinents pour calculer le taux d'incidence des nouveaux cas."
-        },
-        {
-            "input": "Question: Parmi les produits suivants, lequel est un antagoniste pur vis-\u00e0-vis des r\u00e9cepteurs morphiniques\u00a0?\nOptions: A: Morphine\tB: Pentazocine\tC: Bupr\u00e9norphine\tD: Nalorphine\tE: Naloxone\t\nLa bonne r\u00e9ponse est E: Naloxone.",
-            "output": "La raison pour laquelle le naloxone (option E) est consid\u00e9r\u00e9 comme un antagoniste pur des r\u00e9cepteurs morphiniques est qu'il se lie aux r\u00e9cepteurs opio\u00efdes sans activer l'effet analg\u00e9sique typique des agonistes comme la morphine. Sa fonction principale est de d\u00e9placer les agonistes opio\u00efdes d\u00e9j\u00e0 li\u00e9s, comme la morphine, et de bloquer l'effet de nouvelles doses, ce qui le rend utile dans le traitement des surdoses d'opio\u00efdes. Les autres substances list\u00e9es ont des effets partiellement agonistes (la bupr\u00e9norphine et la pentazocine) ou agonistes-antagonistes (la nalorphine), tandis que la morphine est un exemple classique d'un agoniste pur."
-        },
-        {
-            "input": "Question: Parmi les antibiotiques suivants, lequel n'est utilis\u00e9 que dans le traitement de la gonococcie?\nOptions: A: Streptomycine\tB: Gentamicine\tC: Spectinomycine\tD: Spiramycine\tE: Sulfadiazine\t\nLa bonne r\u00e9ponse est C: Spectinomycine.",
-            "output": "La spectinomycine (option C) est une option th\u00e9rapeutique sp\u00e9cifiquement utilis\u00e9e dans le traitement de la gonorrh\u00e9e (gonococcie), en particulier lorsque les souches de Neisseria gonorrhoeae sont r\u00e9sistantes aux p\u00e9nicillines ou aux c\u00e9phalosporines. Les autres antibiotiques list\u00e9s ont des spectres d'activit\u00e9 plus larges et ne sont pas r\u00e9serv\u00e9s uniquement au traitement de la gonococcie. Par cons\u00e9quent, la spectinomycine est choisie comme \u00e9tant l'antibiotique sp\u00e9cifique \u00e0 cette infection, en raison de son indication restreinte et de son efficacit\u00e9 face aux souches r\u00e9sistantes."
-        },
-        {
-            "input": "Question: Parmi les propositions suivantes, une seule est exacte. Laquelle? Les lymphocytes T exprimant un r\u00e9cepteur gamma delta:\nOptions: A: Expriment n\u00e9cessairement la mol\u00e9cule CD3\tB: Repr\u00e9sentent une sous population de lymphocytes auxiliaires\tC: Coexpriment toujours CD4 et CD8\tD: Sont localis\u00e9s principalement dans les ganglions lymphatiques\tE: Sont incapables de s\u00e9cr\u00e9ter des cytokines\t\nLa bonne r\u00e9ponse est A: Expriment n\u00e9cessairement la mol\u00e9cule CD3.",
-            "output": "La raison derri\u00e8re le choix de l'option A est que tous les lymphocytes T, y compris ceux exprimant un r\u00e9cepteur gamma delta (\u03b3\u03b4), expriment la mol\u00e9cule CD3 sur leur surface. CD3 joue un r\u00f4le crucial dans la transduction du signal du r\u00e9cepteur des cellules T (TCR) apr\u00e8s la reconnaissance de l'antig\u00e8ne. Les autres options sont incorrectes : B est fausse car les lymphocytes T \u03b3\u03b4 ne sont pas une sous-population de lymphocytes auxiliaires (helper) mais constituent plut\u00f4t une population distincte. L'option C est incorrecte car ils n'expriment pas syst\u00e9matiquement les deux co-r\u00e9cepteurs CD4 et CD8. D est incorrecte car bien qu'ils puissent \u00eatre trouv\u00e9s dans les ganglions lymphatiques, ils sont aussi pr\u00e9sents dans d'autres sites comme les tissus muqueux. Enfin, E est incorrecte puisque les lymphocytes T \u03b3\u03b4 peuvent s\u00e9cr\u00e9ter des cytokines."
-        },
-        {
-            "input": "Question: Parmi les propositions suivantes, une seule est exacte. Laquelle? L'immunit\u00e9 \u00e0 m\u00e9diation cellulaire peut-\u00eatre transmise par:\nOptions: A: Le s\u00e9rum\tB: Les lymphocytes B\tC: Les polynucl\u00e9aires basophiles\tD: Les lymphocytes T\tE: Les monocytes\t\nLa bonne r\u00e9ponse est D: Les lymphocytes T.",
-            "output": "L'immunit\u00e9 \u00e0 m\u00e9diation cellulaire fait r\u00e9f\u00e9rence aux m\u00e9canismes de d\u00e9fense o\u00f9 les lymphocytes T jouent un r\u00f4le majeur. Contrairement aux anticorps, qui sont des prot\u00e9ines solubles fabriqu\u00e9es par les lymphocytes B et pouvant \u00eatre transmises par le s\u00e9rum, l'immunit\u00e9 cellulaire d\u00e9pend de l'activit\u00e9 directe des lymphocytes T. Ces cellules sont capables de d\u00e9truire les cellules infect\u00e9es ou anormales, d'activer d'autres cellules immunitaires et de r\u00e9guler la r\u00e9ponse immunitaire. Les options A, B, C, et E sont incorrectes, car elles ne concernent pas la transmission de l'immunit\u00e9 \u00e0 m\u00e9diation cellulaire sp\u00e9cifique, contrairement au choix D, qui est correct."
-        },
-        {
-            "input": "Question: Parmi les propositions suivantes, indiquer celle qui est exacte. Lors d'une intoxication par le m\u00e9thanol, le traitement peut faire intervenir\nOptions: A: La N-ac\u00e9tyl cyst\u00e9ine\tB: La pralidoxime\tC: L'acide ascorbique\tD: Le 4-m\u00e9thyl pyrazole\tE: L'\u00e9thyl\u00e8ne glycol\t\nLa bonne r\u00e9ponse est D: Le 4-m\u00e9thyl pyrazole.",
-            "output": "Le choix D, le 4-m\u00e9thyl pyrazole (aussi connu sous le nom de fomepizole), est correct car il s'agit d'un inhibiteur de l'alcool d\u00e9shydrog\u00e9nase, l'enzyme responsable de la conversion du m\u00e9thanol en formald\u00e9hyde et acide formique, substances toxiques pour l'organisme. En inhibant cette enzyme, le fomepizole pr\u00e9vient la formation de ces m\u00e9tabolites toxiques. La N-ac\u00e9tyl cyst\u00e9ine est utilis\u00e9e pour les intoxications par le parac\u00e9tamol, la pralidoxime pour certains agents neurotoxiques organophosphor\u00e9s, l'acide ascorbique n'a pas d'indication sp\u00e9cifique dans ce cas, et l'\u00e9thyl\u00e8ne glycol est lui-m\u00eame une substance toxique pouvant causer une intoxication similaire."
-        },
-        {
-            "input": "Question: Parmi les antidotes suivants, un seul n'est pas utilis\u00e9 dans l'intoxication par le plomb, indiquer lequel?\nOptions: A: Acide dithiosuccinique\tB: Dimercaprol\tC: EDTA dicolbatique\tD: Sel disodique monocalcique de l'EDTA\tE: P\u00e9nicillamine\t\nLa bonne r\u00e9ponse est C: EDTA dicolbatique.",
-            "output": "L'antidote C, l'EDTA dicobaltique, n'est pas utilis\u00e9 pour traiter l'intoxication par le plomb. Le cobalt n'a aucun r\u00f4le dans l\u2019\u00e9limination du plomb dans l'organisme. Les autres options offrent des ch\u00e9lateurs efficaces pour \u00e9liminer le plomb : l'acide dithiosuccinique (A), le dimercaprol (B), le sel disodique monocalcique de l'EDTA (D), et la p\u00e9nicillamine (E) ont la capacit\u00e9 de se lier aux m\u00e9taux lourds tels que le plomb, permettant leur excretion ult\u00e9rieure. L'intoxication par le plomb requiert un antidote qui puisse se lier sp\u00e9cifiquement aux ions de plomb et les neutraliser pour r\u00e9duire la toxicit\u00e9 et permettre leur \u00e9limination."
-        },
-        {
-            "input": "Question: Les examens suivants sont normaux dans le my\u00e9lome non s\u00e9cr\u00e9tant, sauf un, lequel?\nOptions: A: Vitesse de s\u00e9dimentation\tB: Concentration des prot\u00e9ines s\u00e9riques\tC: \u00c9lectrophor\u00e8se des prot\u00e9ines s\u00e9riques\tD: My\u00e9logramme\tE: \u00c9lectrophor\u00e8se des prot\u00e9ines urinaires\t\nLa bonne r\u00e9ponse est D: My\u00e9logramme.",
-            "output": "Le my\u00e9lome non s\u00e9cr\u00e9tant est caract\u00e9ris\u00e9 par l'absence de production excessives de cha\u00eenes l\u00e9g\u00e8res d'immunoglobulines d\u00e9tectables dans le s\u00e9rum ou l'urine, ce qui explique la normalit\u00e9 de l'\u00e9lectrophor\u00e8se des prot\u00e9ines s\u00e9riques (C) et urinaires (E). La vitesse de s\u00e9dimentation (A) peut \u00eatre normale ou \u00e9lev\u00e9e, ind\u00e9pendamment de la s\u00e9cr\u00e9tion des prot\u00e9ines. La concentration des prot\u00e9ines s\u00e9riques (B) est souvent normale, car il n'y a pas de surproduction d\u00e9tect\u00e9e. Le my\u00e9logramme (D), par contre, r\u00e9v\u00e8lera g\u00e9n\u00e9ralement l'anomalie clonale des cellules plasmatiques, m\u00eame en absence de s\u00e9cr\u00e9tion, d\u2019o\u00f9 c'est l'examen qui sera anormal dans cette situation."
-        },
-        {
-            "input": "Question: Parmi les propositions suivantes concernant l'infection par le virus de l'immunod\u00e9ficience humaine, laquelle est fausse?\nOptions: A: Le stade SIDA est d\u00e9fini en fonction d'une liste de pathologies\tB: Le diagnostic d'infection chez le nouveau-n\u00e9 d'une m\u00e8re infect\u00e9e repose sur la recherche des anticorps\tC: Les inhibiteurs de la fusion de l'enveloppe virale avec la membrane cellulaire peuvent \u00eatre utilis\u00e9s en th\u00e9rapeutique antir\u00e9trovirale\tD: Les lymphocytes CD4+ ne sont pas les seules cellules cibles de ce virus\tE: La transmission de la m\u00e8re \u00e0 l'enfant a surtout lieu en fin de grossesse et \u00e0 l'accouchement\t\nLa bonne r\u00e9ponse est B: Le diagnostic d'infection chez le nouveau-n\u00e9 d'une m\u00e8re infect\u00e9e repose sur la recherche des anticorps.",
-            "output": "L'option B est fausse car le diagnostic d'infection par le VIH chez le nouveau-n\u00e9 d'une m\u00e8re infect\u00e9e ne repose pas sur la recherche des anticorps. En effet, les anticorps maternels anti-VIH peuvent traverser le placenta et \u00eatre pr\u00e9sents chez le nouveau-n\u00e9 sans que celui-ci ne soit infect\u00e9. Le diagnostic chez les enfants de moins de 18 mois repose sur la d\u00e9tection du g\u00e9nome viral (PCR pour la d\u00e9tection de l'ARN ou de l'ADN du VIH) ou sur les antig\u00e8nes du virus, permettant d'identifier une infection active ind\u00e9pendamment des anticorps maternels transmis."
-        },
-        {
-            "input": "Question: Parmi les propositions suivantes concernant le m\u00e9tronidazole (FLAGYL\u00ae), une seule est exacte. Laquelle?\nOptions: A: C'est un anti-amibien uniquement intestinal\tB: Il est toujours inactif sur les germes ana\u00e9robies\tC: Il est tr\u00e8s peu r\u00e9sorb\u00e9 apr\u00e8s administration par voie orale\tD: Il poss\u00e8de un effet antabuse\tE: Il est tr\u00e8s n\u00e9phrotoxique\t\nLa bonne r\u00e9ponse est D: Il poss\u00e8de un effet antabuse.",
-            "output": "La bonne r\u00e9ponse est D - Il poss\u00e8de un effet antabuse. Le m\u00e9tronidazole a la propri\u00e9t\u00e9 de provoquer des r\u00e9actions similaires \u00e0 celles de la disulfiram (effet antabuse) en pr\u00e9sence d'alcool. Cette r\u00e9action induit des sympt\u00f4mes d\u00e9sagr\u00e9ables tels que des bouff\u00e9es vasomotrices, des vomissements et des palpitations, ce qui dissuade la consommation d'alcool pendant le traitement. Les autres options sont incorrectes: A est fausse car le m\u00e9tronidazole a une activit\u00e9 contre les protozoaires et les bact\u00e9ries ana\u00e9robies en dehors de l'intestin; B est incorrecte car il est actif contre les ana\u00e9robies; C est fausse car il est bien r\u00e9sorb\u00e9 par voie orale; E est fausse car il est g\u00e9n\u00e9ralement peu n\u00e9phrotoxique."
-        },
-        {
-            "input": "Question: Parmi les sympt\u00f4mes suivants l'un d'entre eux n'est pas observ\u00e9 au cours d'un syndrome de manque \u00e0 l'h\u00e9ro\u00efne. Lequel?\nOptions: A: Anxi\u00e9t\u00e9\tB: Myosis\tC: Douleurs abdominales\tD: Contractures musculaires\tE: Naus\u00e9es\t\nLa bonne r\u00e9ponse est B: Myosis.",
-            "output": "Le myosis, ou r\u00e9tr\u00e9cissement pupillaire, est typique de la consommation d'opio\u00efdes, y compris l'h\u00e9ro\u00efne. Cependant, lors du sevrage et donc lors d'un syndrome de manque, on observe plut\u00f4t une mydriase, soit une dilatation des pupilles. Les autres sympt\u00f4mes pr\u00e9sent\u00e9s \u2013 anxi\u00e9t\u00e9, douleurs abdominales, contractures musculaires, naus\u00e9es \u2013 sont coh\u00e9rents avec le tableau clinique du syndrome de sevrage aux opio\u00efdes. Ces signes traduisent la r\u00e9ponse du syst\u00e8me nerveux autonome ainsi que les effets physiques suite \u00e0 l'interruption de la consommation d'h\u00e9ro\u00efne \u00e0 laquelle le corps s'\u00e9tait habitu\u00e9."
-        },
-        {
-            "input": "Question: Quelle est la proposition exacte?\nOptions: A: Les barbituriques sont utilisables dans toutes les formes d'\u00e9pilepsie\tB: Le vigabatrin (SABRIL\u00ae) provoque des anomalies du champ visuel\tC: Le vigabatrin (SABRIL\u00ae) est principalement un inhibiteur de la recapture du GABA\tD: La carbamaz\u00e9pine (TEGRETOL\u00ae) poss\u00e8de un groupement carbamate\tE: La lamotrigine (LAMICTAL\u00ae) est une mol\u00e9cule d\u00e9rivant des benzodiaz\u00e9pines\t\nLa bonne r\u00e9ponse est B: Le vigabatrin (SABRIL\u00ae) provoque des anomalies du champ visuel.",
-            "output": "La proposition B est correcte car le vigabatrin (SABRIL\u00ae) est connu pour induire des anomalies du champ visuel, notamment une constriction du champ visuel p\u00e9riph\u00e9rique, pouvant survenir chez une proportion significative de patients trait\u00e9s avec ce m\u00e9dicament. L'effet est d\u00fb \u00e0 la toxicit\u00e9 r\u00e9tinienne associ\u00e9e \u00e0 l'utilisation \u00e0 long terme du vigabatrin. Ce m\u00e9dicament est un inhibiteur irr\u00e9versible de la GABA-transaminase (GABA-T), une enzyme d\u00e9gradant le GABA, un neurotransmetteur inhibiteur, ce qui augmente la concentration de GABA dans le cerveau mais n'agit pas par inhibition de la recapture du GABA, \u00e9cartant ainsi la proposition C. Les autres options sont incorrectes car les barbituriques ne sont pas indiqu\u00e9s dans toutes les formes d'\u00e9pilepsie (A), la carbamaz\u00e9pine contient effectivement un groupement tricyclique et non un carbamate (D), et la lamotrigine n'est pas d\u00e9riv\u00e9e des benzodiaz\u00e9pines mais est plut\u00f4t un inhibiteur de la lib\u00e9ration des glutamates (E)."
-        },
-        {
-            "input": "Question: Parmi les propositions suivantes, laquelle est exacte? Les facteurs rhumato\u00efdes sont:\nOptions: A: Des anticorps dirig\u00e9s contre des antig\u00e8nes de la membrane synoviale\tB: Des anticorps dirig\u00e9s contre des IgM\tC: Des anticorps appartenant toujours \u00e0 la classe des IgG\tD: Pr\u00e9sents dans la circulation de la majorit\u00e9 des malades atteints de polyarthrite rhumato\u00efde (PR)\tE: Pr\u00e9sents uniquement chez les malades atteints de PR\t\nLa bonne r\u00e9ponse est D: Pr\u00e9sents dans la circulation de la majorit\u00e9 des malades atteints de polyarthrite rhumato\u00efde (PR).",
-            "output": "La r\u00e9ponse exacte est D. Les facteurs rhumato\u00efdes (FR) sont en r\u00e9alit\u00e9 des auto-anticorps principalement de la classe des IgM qui se dirigent contre la r\u00e9gion Fc des IgG. Bien qu'ils ne soient pas sp\u00e9cifiques \u00e0 la polyarthrite rhumato\u00efde (PR), leur pr\u00e9sence est d\u00e9tect\u00e9e chez la majorit\u00e9 des patients atteints de cette maladie, soit environ 70 \u00e0 80%. Cela fait des FR un marqueur utile dans le diagnostic de la PR, mais il est important de noter qu'ils peuvent \u00e9galement \u00eatre pr\u00e9sents dans d'autres maladies auto-immunes ou infectieuses."
-        },
-        {
-            "input": "Question: Parmi ces propositions concernant Echinococcus granulosus, une seule est fausse, laquelle?\nOptions: A: C'est un cestode\tB: Le ver adulte mesure quelques miIlim\u00e8tres\tC: L'h\u00f4te d\u00e9finitif est le chien\tD: Ses oeufs contiennent un embryon hexacanthe\tE: L'homme se contamine par ingestion de viande\t\nLa bonne r\u00e9ponse est E: L'homme se contamine par ingestion de viande.",
-            "output": "Echinococcus granulosus est un cestode (A vrai), dont le stade adulte est effectivement de petite taille, quelques millim\u00e8tres (B vrai). L'h\u00f4te d\u00e9finitif o\u00f9 le ver atteint sa maturit\u00e9 et se reproduit sexuellement est le chien (C vrai). Ses oeufs lib\u00e8rent un embryon hexacanthe lorsqu'ils \u00e9closent dans l'intestin de l'h\u00f4te interm\u00e9diaire (D vrai). L'option E est fausse, car l'homme se contamine g\u00e9n\u00e9ralement en ing\u00e9rant des aliments ou de l'eau contamin\u00e9s par les \u0153ufs du parasite, et non pas par la consommation de viande. La viande est concern\u00e9e par d'autres parasites comme Taenia, mais pas par Echinococcus granulosus."
-        },
-        {
-            "input": "Question: Parmi les propositions suivantes, laquelle est exacte\u00a0? On veut estimer un pourcentage proche de 0,5 avec une pr\u00e9cision (\u00e9cart-type) \u00e9gale \u00e0 5%. La taille de l'\u00e9chantillon \u00e0 retenir est:\nOptions: A: 100\tB: 200\tC: 1000\tD: 500\tE: Sup\u00e9rieur \u00e0 1000\t\nLa bonne r\u00e9ponse est A: 100.",
-            "output": "La taille d\u2019un \u00e9chantillon (n) n\u00e9cessaire pour estimer un pourcentage avec une pr\u00e9cision donn\u00e9e peut \u00eatre calcul\u00e9e avec la formule n = (1,96\u00b2*p*(1-p)) / e\u00b2, o\u00f9 p est le pourcentage que l\u2019on souhaite estimer et e est la marge d\u2019erreur tol\u00e9r\u00e9e. Ici, p = 0,5 (maximisant le produit p*(1-p)) et e = 0,05. La formule donne n = (1,96\u00b2*0,5*0,5) / 0,05\u00b2, soit n \u2248 384. Une taille d\u2019\u00e9chantillon de 100 (Option A) est insuffisante pour atteindre la pr\u00e9cision souhait\u00e9e. La bonne r\u00e9ponse serait plut\u00f4t D (500), proche de la valeur calcul\u00e9e. L'analyse sugg\u00e8re donc une erreur dans la proposition initiale."
-        },
-        {
-            "input": "Question: En cas d'intoxication par une benzodiaz\u00e9pine, quel est l'antidote \u00e0 utiliser parmi les produits suivants?\nOptions: A: naloxone (NARCAN\u00ae)\tB: lactate de sodium\tC: flumaz\u00e9nil (ANEXATE\u00ae)\tD: furos\u00e9mide (LASILlX\u00ae)\tE: chlorpromazine (LARGACTIL\u00ae)\t\nLa bonne r\u00e9ponse est C: flumaz\u00e9nil (ANEXATE\u00ae).",
-            "output": "L'antidote \u00e0 privil\u00e9gier en cas d'intoxication par une benzodiaz\u00e9pine est le flumaz\u00e9nil (option C - ANEXATE\u00ae). Ceci s'explique par le fait que le flumaz\u00e9nil est un antagoniste sp\u00e9cifique des r\u00e9cepteurs aux benzodiaz\u00e9pines au niveau du syst\u00e8me nerveux central, capable de renverser les effets s\u00e9datifs des benzodiaz\u00e9pines. Les autres produits list\u00e9s n'ont pas cette propri\u00e9t\u00e9 sp\u00e9cifique ; par exemple, la naloxone est un antagoniste des opio\u00efdes, et le furos\u00e9mide est un diur\u00e9tique qui n'aiderait pas dans le cas d'une intoxication benzodiaz\u00e9pinique. Le flumaz\u00e9nil est donc la mol\u00e9cule de choix pour contrer une surdose de benzodiaz\u00e9pines."
-        },
-        {
-            "input": "Question: Lors de l'examen direct du LCR, la d\u00e9couverte de diplocoques \u00e0 Gram n\u00e9gatif doit faire \u00e9voquer le germe suivant. Donner la r\u00e9ponse exacte.\nOptions: A: Streptococcus pneumoniae\tB: Escherichia coli\tC: Neisseria meningitidis\tD: Cryptococcus neoformans\tE: Haemophilus influenzae\t\nLa bonne r\u00e9ponse est C: Neisseria meningitidis.",
-            "output": "La d\u00e9couverte de diplocoques \u00e0 Gram n\u00e9gatif lors de l'examen direct du liquide c\u00e9phalorachidien (LCR) oriente vers Neisseria meningitidis, la r\u00e9ponse C. Cette caract\u00e9risation morphologique et coloration sp\u00e9cifique exclut les autres germes list\u00e9s. Streptococcus pneumoniae (A) et Haemophilus influenzae (E) sont des bact\u00e9ries \u00e0 Gram positif, ce qui ne correspond pas. Escherichia coli (B) est un bacille \u00e0 Gram n\u00e9gatif et non un diplocoque. Enfin, Cryptococcus neoformans (D) est un champignon, identifiable notamment par une encre de Chine. Donc, seul Neisseria meningitidis correspond au profil du diplocoque \u00e0 Gram n\u00e9gatif retrouv\u00e9 dans le LCR."
-        },
-        {
-            "input": "Question: Parmi les observations suivantes, indiquer celle qui ne correspond pas \u00e0 une intoxication par l'\u00e9thyl\u00e8ne glycol.\nOptions: A: Troubles digestifs\tB: Alcalose m\u00e9tabolique\tC: Signes neurologiques\tD: Hypocalc\u00e9mie\tE: Hyperosmolalit\u00e9 plasmatique\t\nLa bonne r\u00e9ponse est B: Alcalose m\u00e9tabolique.",
-            "output": "L'intoxication par l'\u00e9thyl\u00e8ne glycol entra\u00eene g\u00e9n\u00e9ralement une acidose m\u00e9tabolique s\u00e9v\u00e8re, due \u00e0 la m\u00e9tabolisation de l'\u00e9thyl\u00e8ne glycol en acides toxiques comme l'acide glycolique et l'acide oxalique. Donc, la pr\u00e9sence d'une alcalose m\u00e9tabolique ne correspond pas au tableau clinique typique de l'intoxication par l'\u00e9thyl\u00e8ne glycol et serait plut\u00f4t \u00e0 l'oppos\u00e9 de l'acidose attendue. Les autres options, A, C, D et E, sont des manifestations qui peuvent \u00eatre associ\u00e9es \u00e0 l'intoxication par \u00e9thyl\u00e8ne glycol: troubles digestifs, signes neurologiques, hypocalc\u00e9mie due \u00e0 la pr\u00e9cipitation de cristaux d'oxalate de calcium, et hyperosmolalit\u00e9 plasmatique r\u00e9sultant de l'accumulation de m\u00e9tabolites."
-        },
-        {
-            "input": "Question: Parmi les propositions concernant la bile, une seule est fausse. Laquelle?\nOptions: A: Elle est produite par le foie\tB: Elle est lib\u00e9r\u00e9e en fonction des besoins dans l'intestin\tC: Elle se pr\u00e9sente sous la forme d'un liquide incolore\tD: Le volume de sa s\u00e9cr\u00e9tion varie de 300 \u00e0 700 mL/24h\tE: Elle est stock\u00e9e dans la v\u00e9sicule biliaire\t\nLa bonne r\u00e9ponse est C: Elle se pr\u00e9sente sous la forme d'un liquide incolore.",
-            "output": "La proposition fausse est C. La bile se caract\u00e9rise par une couleur qui peut varier du jaune verd\u00e2tre au brun fonc\u00e9, mais elle n'est certainement pas incolore. Elle est, en effet, produite par le foie (A), et sa lib\u00e9ration dans l'intestin est r\u00e9gul\u00e9e en fonction des besoins digestifs, notamment apr\u00e8s un repas riche en graisses (B). Le volume quotidien de bile s\u00e9cr\u00e9t\u00e9e varie effectivement de 300 \u00e0 700 mL (D), et elle est effectivement stock\u00e9e et concentr\u00e9e dans la v\u00e9sicule biliaire (E) avant d'\u00eatre lib\u00e9r\u00e9e dans l'intestin gr\u00eale."
-        },
-        {
-            "input": "Question: Toutes les propositions suivantes sont des manifestations d'une intoxication salicyl\u00e9e. Sauf une, laquelle?\nOptions: A: C\u00e9phal\u00e9es\tB: Troubles visuels\tC: Vertiges\tD: Gastralgies\tE: Hypothermie\t\nLa bonne r\u00e9ponse est E: Hypothermie.",
-            "output": "L'intoxication salicyl\u00e9e, g\u00e9n\u00e9ralement caus\u00e9e par une ingestion excessive d'aspirine ou d'autres salicyl\u00e9s, induit une stimulation du syst\u00e8me nerveux central et une action irritante sur la muqueuse gastro-intestinale. Les sympt\u00f4mes incluent des c\u00e9phal\u00e9es (A), des troubles visuels (B), des vertiges (C) et des gastralgies (D), car les salicyl\u00e9s peuvent entra\u00eener une augmentation de la pression intracr\u00e2nienne, des effets toxiques sur la r\u00e9tine, une perturbation de l'\u00e9quilibre, et une irritation de l'estomac. Cependant, l'hypothermie (E) n'est pas typique d'une intoxication salicyl\u00e9e ; au contraire, on observe souvent une hyperthermie due \u00e0 l'augmentation du m\u00e9tabolisme et \u00e0 l'alt\u00e9ration de la thermor\u00e9gulation."
-        },
-        {
-            "input": "Question: Concernant l'\u00e9rythromycine, quelle est la proposition exacte?\nOptions: A: Elle est sensible \u00e0 l'acidit\u00e9 gastrique\tB: Elle se caract\u00e9rise par une excellente diffusion dans le LCR\tC: Elle est \u00e9limin\u00e9e essentiellement par le rein sous forme active\tD: Elle n'est jamais administr\u00e9e par voie parent\u00e9rale\tE: Elle a des propri\u00e9t\u00e9s inductrices des cytochromes P450\t\nLa bonne r\u00e9ponse est A: Elle est sensible \u00e0 l'acidit\u00e9 gastrique.",
-            "output": "L'\u00e9rythromycine est un antibiotique de la classe des macrolides. L'option A est correcte car l'\u00e9rythromycine est sensible \u00e0 l'acidit\u00e9 gastrique, ce qui signifie qu'elle peut se d\u00e9grader dans l'estomac si elle n'est pas administr\u00e9e sous une forme prot\u00e9g\u00e9e. Les formes gal\u00e9niques destin\u00e9es \u00e0 la voie orale sont donc formul\u00e9es pour r\u00e9sister \u00e0 l'acidit\u00e9. Les autres options ne sont pas correctes : B est fausse car l'\u00e9rythromycine traverse mal la barri\u00e8re h\u00e9mato-enc\u00e9phalique, donc elle a une mauvaise diffusion dans le LCR. C est incorrecte car l'\u00e9rythromycine est principalement m\u00e9tabolis\u00e9e par le foie. D est fausse car elle peut \u00eatre administr\u00e9e par voie parent\u00e9rale. E est \u00e9galement incorrecte, l'\u00e9rythromycine est un inhibiteur des cytochromes P450, elle n'est pas inductrice."
-        },
-        {
-            "input": "Question: Parmi les m\u00e9dicaments suivants, lequel est le plus efficace dans le traitement de l'hypercholest\u00e9rol\u00e9mie lIa?\nOptions: A: Le clofibrate\tB: La simvastatine\tC: Le f\u00e9nofibrate\tD: La colestyramine\tE: Les acides om\u00e9ga-3 polyinsatur\u00e9s\t\nLa bonne r\u00e9ponse est B: La simvastatine.",
-            "output": "La simvastatine (option B) est souvent privil\u00e9gi\u00e9e dans le traitement de l'hypercholest\u00e9rol\u00e9mie de type IIa en raison de son m\u00e9canisme d\u2019action puissant et efficace. Appartenant \u00e0 la classe des statines, elle inhibe l'enzyme HMG-CoA r\u00e9ductase, responsable de la production de cholest\u00e9rol dans le foie. Cette inhibition entra\u00eene une diminution significative des taux de cholest\u00e9rol LDL (mauvais cholest\u00e9rol) et une l\u00e9g\u00e8re augmentation du cholest\u00e9rol HDL (bon cholest\u00e9rol), ce qui r\u00e9duit le risque de complications cardiovasculaires. Les autres options sont moins efficaces ou ciblent des m\u00e9canismes diff\u00e9rents de gestion du cholest\u00e9rol."
-        },
-        {
-            "input": "Question: Parmi les propositions suivantes concernant le d\u00e9bit de filtration glom\u00e9rulaire, une seule est fausse. Laquelle?\nOptions: A: Il est mesur\u00e9 par la clairance \u00e0 la cr\u00e9atinine\tB: Il est augment\u00e9 par lib\u00e9ration du facteur natriur\u00e9tique auriculaire\tC: Il repr\u00e9sente en moyenne de 16 \u00e0 20 % du d\u00e9bit plasmatique r\u00e9nal\tD: Il augmente \u00e0 l'effort\tE: Il diminue avec l'\u00e2ge\t\nLa bonne r\u00e9ponse est D: Il augmente \u00e0 l'effort.",
-            "output": "La r\u00e9ponse D, \"Il augmente \u00e0 l'effort\", est la seule option fausse. Le d\u00e9bit de filtration glom\u00e9rulaire (DFG) correspond \u00e0 la quantit\u00e9 de plasma filtr\u00e9 par les glom\u00e9rules r\u00e9naux par unit\u00e9 de temps. Il est principalement stable et ne conna\u00eet pas une augmentation significative lors de l'exercice. Au contraire, pendant un effort intense, le flux sanguin r\u00e9nal peut diminuer \u00e0 cause de la redistribution du sang vers les muscles en exercice et les autres organes vitaux. Les autres options sont vraies : la clairance de la cr\u00e9atinine est une mesure du DFG (A), le facteur natriur\u00e9tique auriculaire, s\u00e9cr\u00e9t\u00e9 par le c\u0153ur, peut augmenter le DFG en vasodilatant les art\u00e9rioles aff\u00e9rentes du rein (B), le DFG repr\u00e9sente une portion du d\u00e9bit plasmatique r\u00e9nal (C), et il diminue effectivement avec l\u2019\u00e2ge (E)."
-        },
-        {
-            "input": "Question: Parmi les propositions suivantes, donner la r\u00e9ponse exacte. Le terme de morbidit\u00e9 est synonyme de\nOptions: A: L\u00e9talit\u00e9\tB: Infections nosocomiales\tC: Consommation de services ambulatoires\tD: Ph\u00e9nom\u00e8nes pathologiques\tE: Facteurs de risque\t\nLa bonne r\u00e9ponse est D: Ph\u00e9nom\u00e8nes pathologiques.",
-            "output": "Le terme de morbidit\u00e9 fait r\u00e9f\u00e9rence \u00e0 la fr\u00e9quence des maladies ou des ph\u00e9nom\u00e8nes pathologiques au sein d'une population donn\u00e9e. Ce n'est pas synonyme de l\u00e9talit\u00e9 (A), qui d\u00e9signe le taux de d\u00e9c\u00e8s dus \u00e0 une maladie. Ce n'est pas non plus li\u00e9 sp\u00e9cifiquement aux infections nosocomiales (B), consommation de services ambulatoires (C), ou aux facteurs de risque (E). La morbidit\u00e9 englobe l'ensemble des conditions et maladies pr\u00e9sentes dans une population, donc l'option (D) \"Ph\u00e9nom\u00e8nes pathologiques\" est la plus appropri\u00e9e, car elle correspond \u00e0 l'ensemble des \u00e9tats pathologiques qui affectent un groupe."
-        },
-        {
-            "input": "Question: Parmi les propositions suivantes, une seule est fausse. Laquelle? Lors de l'extraction par un solvant non miscible \u00e0 l'eau, d'ions m\u00e9talliques en pr\u00e9sence d'un ch\u00e9latant acide HL\nOptions: A: Le rendement de l'extraction augmente avec la concentration en protons de la solution aqueuse\tB: Le rendement de l'extraction augmente avec la concentration en r\u00e9actif ch\u00e9latant dans la solution organique\tC: Le taux de distribution du m\u00e9tal est proportionnel \u00e0 la constante d'extraction Kex\tD: Le taux de distribution du m\u00e9tal est proportionnel \u00e0 la concentration de l'exc\u00e8s de r\u00e9actif ch\u00e9latant\tE: Les ch\u00e9lates m\u00e9talliques de Kex tr\u00e8s diff\u00e9rents sont extraits s\u00e9lectivement \u00e0 des pH diff\u00e9rents\t\nLa bonne r\u00e9ponse est A: Le rendement de l'extraction augmente avec la concentration en protons de la solution aqueuse.",
-            "output": "L'option A est incorrecte car le rendement d'extraction d'ions m\u00e9talliques en pr\u00e9sence d'un ch\u00e9latant acide HL diminue g\u00e9n\u00e9ralement avec l'augmentation de la concentration en protons (H+) dans la solution aqueuse. En effet, une forte concentration en protons favorise la comp\u00e9tition avec les ions m\u00e9talliques pour la liaison avec le ch\u00e9latant, ce qui diminue la formation du complexe metal-ch\u00e9latant qui serait extrait par le solvant organique. Les protons peuvent \u00e9galement protoner le ch\u00e9latant (HL), r\u00e9duisant ainsi sa capacit\u00e9 \u00e0 se lier efficacement aux ions m\u00e9talliques, r\u00e9sultant en une baisse du rendement d'extraction."
-        },
-        {
-            "input": "Question: Parmi les propositions suivantes, une seule est fausse. Laquelle? Le m\u00e9thanol:\nOptions: A: Est narcotique \u00e0 forte dose\tB: Est irritant pour les muqueuses oculaires\tC: Provoque une atteinte oculaire lors d'une intoxication aigu\u00eb\tD: Peut-\u00eatre dos\u00e9 par chromatographie en phase gazeuse\tE: Est m\u00e9tabolis\u00e9 en acide oxalique\t\nLa bonne r\u00e9ponse est E: Est m\u00e9tabolis\u00e9 en acide oxalique.",
-            "output": "L'option E est incorrecte car le m\u00e9thanol n'est pas m\u00e9tabolis\u00e9 en acide oxalique, mais en formald\u00e9hyde et en acide formique, suite \u00e0 l'action des enzymes alcool d\u00e9shydrog\u00e9nase et ald\u00e9hyde d\u00e9shydrog\u00e9nase. C'est l'accumulation d'acide formique qui est responsable de la toxicit\u00e9 oculaire, et non l'acide oxalique. Par ailleurs, les autres propositions sont correctes : le m\u00e9thanol est effectivement narcotique \u00e0 forte dose (A), irritant pour les muqueuses, notamment oculaires (B), provoque une atteinte oculaire lors d'une intoxication aigu\u00eb (C), et peut \u00eatre dos\u00e9 par chromatographie en phase gazeuse (D)."
-        },
-        {
-            "input": "Question: A propos des mycoses ungu\u00e9ales, une seule de ces propositions est fausse, laquelle?\nOptions: A: Trichophyton rubrum est un agent classique des onyxis dermatophytiques\tB: Un onyxis \u00e0 Candida albicans a classiquement pour point de d\u00e9part un p\u00e9rionyxis\tC: La gris\u00e9ofulvine est inefficace dans les onyxis levuriques\tD: La source de contamination des onyxis dermatophytiques est endog\u00e8ne\tE: Leur diagnostic repose sur l'examen direct et la mise en culture du pr\u00e9l\u00e8vement\t\nLa bonne r\u00e9ponse est D: La source de contamination des onyxis dermatophytiques est endog\u00e8ne.",
-            "output": "La r\u00e9ponse fausse est la proposition D. Les onyxis dermatophytiques, qui sont des infections fongiques des ongles caus\u00e9es par des dermatophytes comme Trichophyton rubrum, ont g\u00e9n\u00e9ralement une source de contamination exog\u00e8ne, pas endog\u00e8ne. Cela signifie que l'infection est acquise du milieu ext\u00e9rieur, souvent par contact avec des surfaces contamin\u00e9es, et non de l'int\u00e9rieur du corps de l'individu. Les autres propositions sont exactes : A confirme que Trichophyton rubrum est un agent classique, B indique le p\u00e9rionyxis comme point de d\u00e9part pour les onyxis \u00e0 Candida, C souligne l'inefficacit\u00e9 de la gris\u00e9ofulvine dans le traitement des onyxis levuriques, et E mentionne la n\u00e9cessit\u00e9 de l'examen direct et de la culture pour le diagnostic."
-        },
-        {
-            "input": "Question: Quelle est l'affirmation qui ne s'applique pas aux excipients d'un comprim\u00e9?\nOptions: A: Comme diluant, on peut utiliser le lactose\tB: Le st\u00e9arate de magn\u00e9sium est un lubrifiant\tC: Les amidons peuvent avoir des actions de liant ou \u00eatre des agents de d\u00e9sagr\u00e9gation\tD: Le poly\u00e9thyl\u00e8ne glycol (PEG) 400 est le plus utilis\u00e9 en compression\tE: Les d\u00e9riv\u00e9s m\u00e9thacryliques sont mis en oeuvre pour l'enrobage\t\nLa bonne r\u00e9ponse est D: Le poly\u00e9thyl\u00e8ne glycol (PEG) 400 est le plus utilis\u00e9 en compression.",
-            "output": "L'affirmation D est celle qui ne s'applique pas aux excipients d'un comprim\u00e9. En effet, le poly\u00e9thyl\u00e8ne glycol (PEG) est une s\u00e9rie de polym\u00e8res qui sont effectivement utilis\u00e9s dans la formulation des m\u00e9dicaments, mais le PEG 400 sp\u00e9cifiquement n'est g\u00e9n\u00e9ralement pas le plus utilis\u00e9 en compression. Il sert plut\u00f4t comme solvant ou plastifiant dans les pr\u00e9parations pharmaceutiques. Par contraste, les autres options mentionn\u00e9es sont des usages communs des excipients dans la fabrication des comprim\u00e9s : le lactose comme diluant (A), le st\u00e9arate de magn\u00e9sium comme lubrifiant (B), et les amidons pouvant jouer le r\u00f4le de liant ou d'agents de d\u00e9sagr\u00e9gation (C), tandis que les d\u00e9riv\u00e9s m\u00e9thacryliques sont souvent utilis\u00e9s pour l'enrobage (E)."
-        },
-        {
-            "input": "Question: Monsieur Y, 77 ans, doit \u00eatre trait\u00e9 par l'amiodarone (CORDARONE\u00ae). Parmi les examens suivants, quel est celui qui doit \u00eatre fait avant la mise en route de ce traitement?\nOptions: A: Cortisol\u00e9mie\tB: FSH\tC: TSH\tD: Testost\u00e9ron\u00e9mie\tE: Prolactin\u00e9mie\t\nLa bonne r\u00e9ponse est C: TSH.",
-            "output": "L'amiodarone est une substance ayant un effet significatif sur la thyro\u00efde en raison de sa richesse en iode et de son m\u00e9canisme d\u2019action. Ainsi, il est crucial d\u2019\u00e9valuer la fonction thyro\u00efdienne avant de l\u2019initier pour pr\u00e9venir des d\u00e9sordres tels que l'hypothyro\u00efdie ou l'hyperthyro\u00efdie, qui peuvent \u00eatre induits par le traitement. La TSH (Thyroid-Stimulating Hormone) est l\u2019hormone de r\u00e9f\u00e9rence pour le d\u00e9pistage des dysfonctionnements thyro\u00efdiens. C\u2019est pourquoi l\u2019option C est la plus appropri\u00e9e parmi les choix propos\u00e9s, les autres examens \u00e9tant moins pertinents pour \u00e9valuer la fonction thyro\u00efdienne avant prescription d'amiodarone."
-        },
-        {
-            "input": "Question: Parmi les propositions suivantes concernant la conduite \u00e0 tenir en cas de contamination interne par un radionucl\u00e9ide, indiquer celle qui est fausse.\nOptions: A: La conduite \u00e0 tenir d\u00e9pend du radionucl\u00e9ide\tB: Administration d'iode stable si contamination par l'iode radioactif\tC: Administration d'a\u00e9rosol de complexant\tD: Lavage des t\u00e9guments \u00e0 l'eau savonneuse\tE: Examen \u00e0 l'anthropogammam\u00e8tre pour suivre l'\u00e9limination\t\nLa bonne r\u00e9ponse est D: Lavage des t\u00e9guments \u00e0 l'eau savonneuse.",
-            "output": "La r\u00e9ponse D est incorrecte car le lavage des t\u00e9guments \u00e0 l'eau savonneuse est effectivement une mesure appropri\u00e9e en cas de contamination externe par un radionucl\u00e9ide. Cependant, la question porte sur une contamination interne. Dans ce cas, les mesures de d\u00e9contamination externe sont moins pertinentes puisqu'elles n'agissent pas sur les radionucl\u00e9ides d\u00e9j\u00e0 absorb\u00e9s dans l'organisme. Les autres options (A, B, C, E) correspondent bien \u00e0 des interventions pouvant \u00eatre n\u00e9cessaires et sp\u00e9cifiques selon le type de radionucl\u00e9ide ing\u00e9r\u00e9, inhal\u00e9 ou incorpor\u00e9 dans l'organisme, ce qui justifie que la r\u00e9ponse D soit choisie comme \u00e9tant la fausse."
-        },
-        {
-            "input": "Question: Parmi les propositions suivantes concernant la vaccination contre le t\u00e9tanos, quelle est la r\u00e9ponse exacte?\nOptions: A: C'est un vaccin vivant att\u00e9nu\u00e9\tB: Il provoque chez le sujet vaccin\u00e9 la formation d'anticorps anti-toxine t\u00e9tanique\tC: Il se compose d'une suspension de Clostridium tetani\tD: Il ne doit pas \u00eatre associ\u00e9 \u00e0 d'autres vaccins\tE: La vaccination n'est recommand\u00e9e qu'\u00e0 partir de l'\u00e2ge de 10 ans\t\nLa bonne r\u00e9ponse est B: Il provoque chez le sujet vaccin\u00e9 la formation d'anticorps anti-toxine t\u00e9tanique.",
-            "output": "La r\u00e9ponse exacte est la B : \"Il provoque chez le sujet vaccin\u00e9 la formation d'anticorps anti-toxine t\u00e9tanique.\" La raison pour laquelle cette option est correcte est que le vaccin contre le t\u00e9tanos contient une toxo\u00efde, une toxine inactiv\u00e9e. Le syst\u00e8me immunitaire r\u00e9agit en produisant des anticorps sp\u00e9cifiques qui seront efficaces contre la toxine t\u00e9tanique en cas d'exposition future. Les autres options sont incorrectes : A) Le vaccin n'est pas un vaccin vivant att\u00e9nu\u00e9, C) il ne contient pas de bact\u00e9ries vivantes, D) il peut \u00eatre associ\u00e9 \u00e0 d'autres vaccins (comme le DTP), et E) la vaccination est recommand\u00e9e bien avant l'\u00e2ge de 10 ans, typiquement d\u00e8s les premiers mois de la vie selon le calendrier vaccinal."
-        },
-        {
-            "input": "Question: Parmi ces actions de pr\u00e9vention, quelle est celle qui ne rel\u00e8ve pas de la pr\u00e9vention primaire?\nOptions: A: Lutte anti-tabac pour l'infarctus du myocarde et le cancer du poumon\tB: Vaccination par le BCG\tC: Hyst\u00e9rectomie apr\u00e8s mise en \u00e9vidence de cellules tumorales par frottis du col de l'ut\u00e9rus\tD: Cong\u00e9 pr\u00e9natal en cas de grossesse multiple\tE: Diminution de la consommation de graisses satur\u00e9es dans la pr\u00e9vention des cardiopathies isch\u00e9miques\t\nLa bonne r\u00e9ponse est C: Hyst\u00e9rectomie apr\u00e8s mise en \u00e9vidence de cellules tumorales par frottis du col de l'ut\u00e9rus.",
-            "output": "Une hyst\u00e9rectomie apr\u00e8s la mise en \u00e9vidence de cellules tumorales par frottis du col de l'ut\u00e9rus rel\u00e8ve de la pr\u00e9vention secondaire, car elle vise \u00e0 pr\u00e9venir l'\u00e9volution d'une maladie d\u00e9tect\u00e9e pr\u00e9cocement, en l\u2019occurrence le cancer du col de l'ut\u00e9rus. La pr\u00e9vention primaire consiste, elle, \u00e0 pr\u00e9venir l'apparition de la maladie en s'attaquant aux facteurs de risque avant que la maladie ne se d\u00e9veloppe. Les autres options (A, B, D, E) mentionnent des mesures qui s'inscrivent dans cette logique de pr\u00e9venir l'\u00e9mergence de maladies, en \u00e9liminant ou en r\u00e9duisant les risques associ\u00e9s."
-        },
-        {
-            "input": "Question: Parmi les propositions suivantes, une seule est fausse. Laquelle? Les amines primaires aromatiques peuvent \u00eatre dos\u00e9es par:\nOptions: A: Spectrophotom\u00e9trie dans l'UV\tB: Photom\u00e9trie apr\u00e8s diazocopulation\tC: Chromatographie liquide, apr\u00e8s formation de paires d'ions\tD: Le m\u00e9thylate de sodium en milieu aqueux\tE: Diazotation titrim\u00e9trique\t\nLa bonne r\u00e9ponse est D: Le m\u00e9thylate de sodium en milieu aqueux.",
-            "output": "La proposition D est fausse car les amines primaires aromatiques ne peuvent pas \u00eatre dos\u00e9es par le m\u00e9thylate de sodium en milieu aqueux. En effet, le m\u00e9thylate de sodium est une base forte, qui pourrait deprotoner les amines primaires, mais cela ne permet pas un dosage sp\u00e9cifique. Les autres m\u00e9thodes (A, B, C, E) sont adapt\u00e9es car elles permettent une r\u00e9action sp\u00e9cifique suivie d'une mesure quantitative. La spectrophotom\u00e9trie dans l'UV (A) et la diazotation titrim\u00e9trique (E) permettent une quantification directe tandis que la photom\u00e9trie apr\u00e8s diazocopulation (B) et la chromatographie (C) permettent de suivre des produits de r\u00e9action sp\u00e9cifiques apr\u00e8s formation de d\u00e9riv\u00e9s."
-        }
-    ]
-}

MedS-Bench/Reasoning/task56_mmedbench_explanation_spanish_test_only.json

@@ -1,234 +0,0 @@
-{
-    "Contributors": [
-        "MAGIC"
-    ],
-    "Source": [
-        "MMedBench"
-    ],
-    "URL": [
-        "https://huggingface.co/datasets/Henrychur/MMedBench"
-    ],
-    "Categories": [
-        "Explanation"
-    ],
-    "Definition": [
-        "Given a question and its answer, generate an explanation statement."
-    ],
-    "Reasoning": [],
-    "Input_language": [
-        "Spanish"
-    ],
-    "Output_language": [
-        "Spanish"
-    ],
-    "Instruction_language": [
-        "English"
-    ],
-    "Domains": [
-        "Medical Knowledge"
-    ],
-    "Positive Examples": [],
-    "Negative Examples": [],
-    "Instances": [
-        {
-            "input": "Pregunta: La formaci\u00f3n de hueso a partir de un molde de cart\u00edlago hialino se denomina:\nOpciones: A: Intramembranosa.\tB: Trabecular.\tC: Endocondral.\tD: Aposicional.\t\nLa respuesta correcta es C: Endocondral..",
-            "output": "La opci\u00f3n C, \"Endocondral\", es la correcta porque describe el proceso por el cual el cart\u00edlago hialino es progresivamente reemplazado por tejido \u00f3seo. Este m\u00e9todo de osificaci\u00f3n es caracter\u00edstico en la formaci\u00f3n de huesos largos, donde primero se forma un molde de cart\u00edlago y luego, en un proceso regulado por factores de crecimiento, se va calcificando y sustituyendo por hueso. Las otras opciones no corresponden con este proceso: la osificaci\u00f3n \"Intramembranosa\" se da en huesos planos y no parte de cart\u00edlago, \"Trabecular\" se refiere a la microstructura \u00f3sea y \"Aposicional\" al crecimiento en superficie de hueso ya existente."
-        },
-        {
-            "input": "Pregunta: Los discos intercalares son una caracter\u00edstica del tejido muscular:\nOpciones: A: Esquel\u00e9tico.\tB: Cardiaco.\tC: Liso vascular.\tD: Liso visceral.\t\nLa respuesta correcta es B: Cardiaco..",
-            "output": "Los discos intercalares son estructuras distintivas del tejido muscular card\u00edaco. Ofrecen una conexi\u00f3n mec\u00e1nica y el\u00e9ctrica entre las c\u00e9lulas cardiacas (miocitos), permitiendo una sincron\u00eda en la contracci\u00f3n del coraz\u00f3n y una transmisi\u00f3n r\u00e1pida de los impulsos el\u00e9ctricos. Estas estructuras no est\u00e1n presentes en el m\u00fasculo esquel\u00e9tico, el cual se controla voluntariamente y sus c\u00e9lulas no requieren conexi\u00f3n sincr\u00f3nica. Tampoco se encuentran en los m\u00fasculos lisos vasculares o viscerales, donde las c\u00e9lulas act\u00faan de manera m\u00e1s aut\u00f3noma y las contracciones son coordinadas de manera diferente, a menudo por se\u00f1ales qu\u00edmicas y no por conexiones el\u00e9ctricas directas."
-        },
-        {
-            "input": "Pregunta: El \u00f3rgano miotendinoso de Golgi:\nOpciones: A: Monitoriza cambios en la tensi\u00f3n muscular.\tB: Informa de la longitud del m\u00fasculo.\tC: Est\u00e1 inervado por fibras sensoriales tipo Ia.\tD: Evoca el reflejo miot\u00e1tico.\t\nLa respuesta correcta es A: Monitoriza cambios en la tensi\u00f3n muscular..",
-            "output": "El \u00f3rgano de Golgi, o mejor conocido como \u00f3rgano tendinoso de Golgi, est\u00e1 implicado en monitorear los cambios en la tensi\u00f3n que se generan dentro de los m\u00fasculos. Esta funci\u00f3n es cr\u00edtica para prevenir da\u00f1os por sobreestiramiento o tensi\u00f3n excesiva en los m\u00fasculos y tendones. El \u00f3rgano de Golgi est\u00e1 inervado por fibras sensoriales tipo Ib, y no tipo Ia. Estas fibras tipo Ib se activan cuando hay un incremento en la tensi\u00f3n muscular y contribuyen en la inhibici\u00f3n del reflejo miot\u00e1tico, propiciando la relajaci\u00f3n del m\u00fasculo para evitar lesiones, no evocan el reflejo por s\u00ed mismas. Por ende, la opci\u00f3n A es la correcta."
-        },
-        {
-            "input": "Pregunta: Aumenta la presi\u00f3n arterial la estimulaci\u00f3n:\nOpciones: A: Parasimp\u00e1tica.\tB: De los barorreceptores.\tC: Vagal.\tD: Simp\u00e1tica.\t\nLa respuesta correcta es D: Simp\u00e1tica..",
-            "output": "La estimulaci\u00f3n simp\u00e1tica es la responsable del aumento de la presi\u00f3n arterial debido a su acci\u00f3n en la regulaci\u00f3n cardiovascular. El sistema nervioso simp\u00e1tico, cuando se activa, libera neurotransmisores como la noradrenalina, los cuales act\u00faan sobre los receptores adren\u00e9rgicos de los vasos sangu\u00edneos, provocando vasoconstricci\u00f3n. Asimismo, aumenta la frecuencia y la contractilidad card\u00edaca, lo cual eleva la presi\u00f3n arterial. Las otras opciones, como la estimulaci\u00f3n parasimp\u00e1tica y vagal, tienden a disminuir la presi\u00f3n arterial a trav\u00e9s de la vasodilataci\u00f3n y reducci\u00f3n de la frecuencia card\u00edaca. Los barorreceptores no estimulan directamente, sino que regulan la presi\u00f3n mediante retroalimentaci\u00f3n negativa."
-        },
-        {
-            "input": "Pregunta: \u00bfA qu\u00e9 g\u00e9nero pertenecen las bacterias que en medios s\u00f3lidos presentan colonias en forma de \u201chuevo frito\u201d? :\nOpciones: A: Bartonella.\tB: Mycoplasma.\tC: Francisella.\tD: Mycobacterium.\t\nLa respuesta correcta es B: Mycoplasma..",
-            "output": "Las bacterias del g\u00e9nero Mycoplasma se caracterizan por la ausencia de pared celular, lo que les confiere una morfolog\u00eda distintiva de colonias en cultivos s\u00f3lidos, a menudo comparada con el aspecto de un \"huevo frito\". Esta apariencia se debe a la zona central granulada que semeja la yema y un halo perif\u00e9rico m\u00e1s claro, pareciendo la clara. Los otros g\u00e9neros listados, como Bartonella, Francisella y Mycobacterium, no muestran esta caracter\u00edstica morfol\u00f3gica en sus colonias. Por lo tanto, la opci\u00f3n correcta es B. Mycoplasma, que es conocido por formar tales colonias distintivas en medios de cultivo s\u00f3lidos."
-        },
-        {
-            "input": "Pregunta: \u00bfCu\u00e1l de las siguientes asociaciones es correcta?:\nOpciones: A: Rickettsia prowazekii / erliquiosis.\tB: Coxiella burnetti / fiebre Q.\tC: Rickettsia rickettsii / enfermedad de Lyme.\tD: Borrelia burgdorferi / tifus.\t\nLa respuesta correcta es B: Coxiella burnetti / fiebre Q..",
-            "output": "La opci\u00f3n B, Coxiella burnetti / fiebre Q, es la asociaci\u00f3n correcta. Coxiella burnetti es la bacteria responsable de causar la fiebre Q, una zoonosis que puede transmitirse a los humanos principalmente por inhalaci\u00f3n de aerosoles contaminados provenientes de animales infectados. Las otras asociaciones son incorrectas: A. Rickettsia prowazekii causa tifus epid\u00e9mico, no erliquiosis. C. Rickettsia rickettsii es el agente de la fiebre maculosa de las monta\u00f1as rocosas, no de la enfermedad de Lyme, la cual es causada por Borrelia burgdorferi, desmintiendo as\u00ed tambi\u00e9n la opci\u00f3n D. Adem\u00e1s, el tifus est\u00e1 causado por diferentes especies de Rickettsia, no por Borrelia burgdorferi."
-        },
-        {
-            "input": "Pregunta: \u00bfA qu\u00e9 g\u00e9nero pertenecen las bacterias que causan enfermedades como escarlatina, fiebre reum\u00e1tica o caries dental?:\nOpciones: A: Streptococcus.\tB: Fusobacterium.\tC: Actinomyces.\tD: Nocardia.\t\nLa respuesta correcta es A: Streptococcus..",
-            "output": "Las bacterias del g\u00e9nero Streptococcus son las responsables de enfermedades como la escarlatina, la fiebre reum\u00e1tica y la caries dental. Estos microorganismos son cocos grampositivos que tienden a agruparse en cadenas. La escarlatina es causada por Streptococcus pyogenes, productor de la toxina eritrog\u00e9nica. La fiebre reum\u00e1tica puede seguir a una infecci\u00f3n por este mismo pat\u00f3geno. Por su parte, Streptococcus mutans es bien conocido por su papel en la caries dental, debido a su capacidad para fermentar carbohidratos y producir \u00e1cidos que desmineralizan el esmalte dental. Por ende, la opci\u00f3n A es la correcta."
-        },
-        {
-            "input": "Pregunta: La diferencia entre bacterias Gram-positivas y Gram-negativas que explica por qu\u00e9 las primeras retienen el complejo cristal violeta-yodo es:\nOpciones: A: El mayor contenido en peptidoglicano.\tB: La presencia de \u00e1cidos teicoicos.\tC: La ausencia de porinas.\tD: La ausencia de membrana externa.\t\nLa respuesta correcta es A: El mayor contenido en peptidoglicano..",
-            "output": "La principal raz\u00f3n por la que las bacterias Gram-positivas retienen el complejo cristal violeta-yodo durante la coloraci\u00f3n de Gram es A. El mayor contenido en peptidoglicano en su pared celular. Esta capa gruesa de peptidoglicano es capaz de retener el colorante de manera m\u00e1s efectiva que la pared de las bacterias Gram-negativas, que contiene menos peptidoglicano y est\u00e1 rodeada por una membrana externa que impide la retenci\u00f3n del complejo. Las opciones B, C y D est\u00e1n relacionadas con las caracter\u00edsticas de las gram-positivas pero no explican directamente la retenci\u00f3n del colorante."
-        },
-        {
-            "input": "Pregunta: La hipersensibilidad tubercul\u00ednica se genera por una reacci\u00f3n inflamatoria mediada por linfocitos:\nOpciones: A: Th1.\tB: Th2.\tC: B.\tD: Th17.\t\nLa respuesta correcta es A: Th1..",
-            "output": "La hipersensibilidad de tipo IV o tubercul\u00ednica es una reacci\u00f3n de hipersensibilidad retardada mediada por c\u00e9lulas T. La respuesta Th1 est\u00e1 caracterizada por la producci\u00f3n de citocinas como IFN-\u03b3, que activan los macr\u00f3fagos y favorecen la eliminaci\u00f3n de pat\u00f3genos intracelulares como Mycobacterium tuberculosis. Los linfocitos Th1 son esenciales en la formaci\u00f3n del granuloma, una estructura t\u00edpica en la tuberculosis. Esta reacci\u00f3n inflamatoria localizada contribuye al desarrollo de la hipersensibilidad tubercul\u00ednica. Por el contrario, Th2, B y Th17 med\u00edan otros tipos de respuestas inmunitarias que no son predominantes en este contexto de hipersensibilidad celular."
-        },
-        {
-            "input": "Pregunta: La tolerancia central en los linfocitos T se adquiere:\nOpciones: A: Gracias a la expresi\u00f3n de la enzima AID.\tB: Durante su maduraci\u00f3n y desarrollo en el timo.\tC: Durante las fases de desarrollo inicial en la m\u00e9dula \u00f3sea.\tD: Durante el encuentro con el ant\u00edgeno en los ganglios linf\u00e1ticos.\t\nLa respuesta correcta es B: Durante su maduraci\u00f3n y desarrollo en el timo..",
-            "output": "La opci\u00f3n B es correcta debido a que la tolerancia central de los linfocitos T se establece durante su maduraci\u00f3n y desarrollo en el timo. Este proceso es esencial para prevenir la autoinmunidad. Los linfocitos T progenitores migran desde la m\u00e9dula \u00f3sea al timo, donde son sometidos a procesos de selecci\u00f3n positiva y negativa. Aquellos que reconocen con alta afinidad los autoant\u00edgenos presentados por c\u00e9lulas del timo son eliminados por selecci\u00f3n negativa, mientras que los que reconocen con afinidad moderada son seleccionados positivamente para continuar su desarrollo, estableciendo as\u00ed la tolerancia central y evitando reacciones contra tejidos propios."
-        },
-        {
-            "input": "Pregunta: Es una enfermedad causada por expansi\u00f3n por repetici\u00f3n de trinucle\u00f3tidos:\nOpciones: A: S\u00edndrome de Noonan.\tB: Ataxia de Friedrich.\tC: S\u00edndrome de Pearson.\tD: Distrofia muscular de Duchenne.\t\nLa respuesta correcta es B: Ataxia de Friedrich..",
-            "output": "La ataxia de Friedrich es una enfermedad gen\u00e9tica que se caracteriza por una expansi\u00f3n de la repetici\u00f3n de trinucle\u00f3tidos GAA en el gen FXN. Esta expansi\u00f3n causa una producci\u00f3n deficiente de la prote\u00edna frataxina, llevando a los s\u00edntomas neurol\u00f3gicos y card\u00edacos t\u00edpicos de la enfermedad. Las otras opciones no se asocian con una expansi\u00f3n de trinucle\u00f3tidos. El S\u00edndrome de Noonan tiene una base gen\u00e9tica diferente, no est\u00e1 ligado a repeticiones de trinucle\u00f3tidos. El S\u00edndrome de Pearson es un trastorno mitocondrial, y la Distrofia Muscular de Duchenne es causada por mutaciones en el gen DMD, que codifica la distrofina."
-        },
-        {
-            "input": "Pregunta: Un intervalo de confianza para estimar la media poblacional ser\u00e1 tanto m\u00e1s preciso cuanto:\nOpciones: A: Menor sea el nivel de confianza.\tB: Mayor sea la dispersi\u00f3n de la muestra.\tC: Menor sea el tama\u00f1o de la muestra.\tD: Mayor sea el nivel de confianza.\t\nLa respuesta correcta es A: Menor sea el nivel de confianza..",
-            "output": "La opci\u00f3n correcta es A, \"Menor sea el nivel de confianza\". Un intervalo de confianza m\u00e1s preciso significa que es m\u00e1s estrecho, lo cual implica una menor amplitud. Esto se consigue reduciendo el nivel de confianza, ya que al disminuirlo (por ejemplo, de un 95% a un 90%), aceptamos un mayor riesgo de que el intervalo no contenga la verdadera media poblacional, pero a cambio obtenemos un intervalo m\u00e1s preciso. Las otras opciones, como aumentar la dispersi\u00f3n de la muestra o disminuir el tama\u00f1o de la muestra, generalmente conducen a intervalos de confianza m\u00e1s amplios y, por tanto, menos precisos."
-        },
-        {
-            "input": "Pregunta: Una hibridaci\u00f3n por el m\u00e9todo de Northern es apropiada para:\nOpciones: A: Detectar la transcripci\u00f3n de un gen en un organismo con una sonda de cDNA.\tB: Detectar la presencia de un gen en el genoma de un microorganismo.\tC: Detectar la presencia de un pl\u00e1smido en una bacteria.\tD: Comprobar la expresi\u00f3n de una prote\u00edna en una bacteria.\t\nLa respuesta correcta es A: Detectar la transcripci\u00f3n de un gen en un organismo con una sonda de cDNA..",
-            "output": "La hibridaci\u00f3n por el m\u00e9todo de Northern es adecuada para detectar y medir la transcripci\u00f3n de un gen espec\u00edfico a trav\u00e9s de sus ARNm. Usando una sonda de cDNA complementaria al ARNm de inter\u00e9s, se puede identificar y cuantificar la expresi\u00f3n g\u00e9nica ante diversas condiciones experimentales o en distintos tejidos. Las opciones B y C involucrar\u00edan usualmente una hibridaci\u00f3n Southern o un PCR para detectar secuencias de ADN. Para la opci\u00f3n D se preferir\u00eda utilizar t\u00e9cnicas como Western blot que detectan prote\u00ednas. Por lo tanto, la opci\u00f3n A es la m\u00e1s apropiada para el objetivo mencionado."
-        },
-        {
-            "input": "Pregunta: La consecuencia metab\u00f3lica m\u00e1s probable de la deficiencia de glucosa-6-fosfato deshidrogenasa es:\nOpciones: A: Aumento del n\u00famero de ramificaciones del gluc\u00f3geno.\tB: Disminuci\u00f3n de los niveles de gluc\u00f3geno.\tC: Reducci\u00f3n de los niveles de NADPH.\tD: Hipoglucemia persistente.\t\nLa respuesta correcta es C: Reducci\u00f3n de los niveles de NADPH..",
-            "output": "La glucosa-6-fosfato deshidrogenasa (G6PD) es una enzima clave en la v\u00eda del monofosfato de pentosa, cuya funci\u00f3n es producir NADPH, necesario para mantener el equilibrio reducido de glutati\u00f3n, crucial para proteger a las c\u00e9lulas contra el estr\u00e9s oxidativo. Una deficiencia de G6PD no afecta directamente el metabolismo del gluc\u00f3geno ni provoca hipoglucemia como mecanismo primario. Por tanto, la consecuencia metab\u00f3lica m\u00e1s directa y probable de esta deficiencia es la reducci\u00f3n de los niveles de NADPH (opci\u00f3n C), lo que lleva a un aumento de la susceptibilidad de los gl\u00f3bulos rojos al da\u00f1o oxidativo y a la hem\u00f3lisis."
-        },
-        {
-            "input": "Pregunta: La acci\u00f3n enzim\u00e1tica:\nOpciones: A: No altera la velocidad de las reacciones.\tB: Facilita la formaci\u00f3n del estado de transici\u00f3n.\tC: Disminuye la energ\u00eda de los sustratos.\tD: Altera el equilibrio de la reacci\u00f3n.\t\nLa respuesta correcta es B: Facilita la formaci\u00f3n del estado de transici\u00f3n..",
-            "output": "La opci\u00f3n B es correcta porque la acci\u00f3n de las enzimas facilita la formaci\u00f3n del estado de transici\u00f3n. Las enzimas son catalizadores biol\u00f3gicos que aceleran las reacciones qu\u00edmicas disminuyendo la energ\u00eda de activaci\u00f3n necesaria para alcanzar el estado de transici\u00f3n, que es el punto cr\u00edtico donde los reactivos se convierten en productos. Sin alterar el equilibrio de la reacci\u00f3n ni la energ\u00eda total de los sustratos y productos, las enzimas hacen que las reacciones sean m\u00e1s r\u00e1pidas al proporcionar un camino alternativo con menor energ\u00eda de activaci\u00f3n, lo cual explica su efectividad en procesos biol\u00f3gicos."
-        },
-        {
-            "input": "Pregunta: El escorbuto es un s\u00edntoma de carencia grave de vitamina C que impide la:\nOpciones: A: Hidroxilaci\u00f3n de prolinas y lisinas en el col\u00e1geno.\tB: Incorporaci\u00f3n de glicinas al col\u00e1geno.\tC: Acetilaci\u00f3n de prolinas en el tropocol\u00e1geno.\tD: Metilaci\u00f3n de lisinas en el col\u00e1geno.\t\nLa respuesta correcta es A: Hidroxilaci\u00f3n de prolinas y lisinas en el col\u00e1geno..",
-            "output": "El escorbuto se caracteriza por una deficiencia severa de vitamina C, esencial para la s\u00edntesis correcta del col\u00e1geno. La vitamina C act\u00faa como cofactor para las enzimas prolil y lisil hidroxilasa, las cuales son necesarias para la hidroxilaci\u00f3n de los residuos de prolina y lisina en las cadenas de procollageno. Este paso es vital para la estabilizaci\u00f3n de la estructura triple h\u00e9lice del col\u00e1geno. Sin suficiente vitamina C, este proceso falla, conduciendo a col\u00e1geno inestable y a los s\u00edntomas del escorbuto. Por tanto, la opci\u00f3n A refleja la consecuencia directa de la falta de vitamina C en la s\u00edntesis de col\u00e1geno."
-        },
-        {
-            "input": "Pregunta: El hombre se infecta ocasionalmente por Dicrocelium dentriticum por ingesti\u00f3n de:\nOpciones: A: Hormigas (Formica fusca) que contienen metacercarias.\tB: Hormigas (Formica fusca) que contienen redias.\tC: Huevos.\tD: Penetraci\u00f3n cut\u00e1nea de cercar\u00edas.\t\nLa respuesta correcta es A: Hormigas (Formica fusca) que contienen metacercarias..",
-            "output": "La infecci\u00f3n por Dicrocoelium dendriticum, conocido como el \"peque\u00f1o gusano hep\u00e1tico\", se produce cuando un humano ingiere accidentalmente hormigas que contienen metacercarias, la etapa infectiva de este par\u00e1sito. Normalmente, su ciclo de vida incluye a los caracoles como hospedadores intermedios y las hormigas como segundos hospedadores intermediarios, donde las larvas se encistan y forman las metacercarias. La ingesti\u00f3n de otras etapas del par\u00e1sito, como redias o huevos, o a trav\u00e9s de la piel por contacto con cercar\u00edas no resulta en infecci\u00f3n, ya que es necesario que el par\u00e1sito se encuentre en su forma de metacercaria para que pueda establecerse en el hospedador definitivo, que incluye a los humanos en casos accidentales."
-        },
-        {
-            "input": "Pregunta: \u00bfQu\u00e9 es el muestreo aleatorio simple?:\nOpciones: A: Es la t\u00e9cnica que decide el n\u00ba de individuos que tienen que participar en el estudio.\tB: Es la t\u00e9cnica de selecci\u00f3n de sujetos donde no interviene el azar.\tC: Es la t\u00e9cnica aleatoria de selecci\u00f3n de variables de estudio.\tD: Es aquella t\u00e9cnica en la que cada unidad del marco muestral tiene la misma probabilidad de ser escogida.\t\nLa respuesta correcta es D: Es aquella t\u00e9cnica en la que cada unidad del marco muestral tiene la misma probabilidad de ser escogida..",
-            "output": "El muestreo aleatorio simple es una t\u00e9cnica fundamental en la investigaci\u00f3n cient\u00edfica y en la estad\u00edstica, que garantiza que las conclusiones obtenidas puedan generalizarse a toda la poblaci\u00f3n desde la cual se ha extra\u00eddo la muestra. La opci\u00f3n D define correctamente esta t\u00e9cnica, ya que en el muestreo aleatorio simple cada elemento de la poblaci\u00f3n tiene la misma posibilidad de ser seleccionado, lo cual elimina sesgos en la elecci\u00f3n y permite que la muestra sea representativa de la poblaci\u00f3n. Las dem\u00e1s opciones o no describen m\u00e9todos aleatorios o se refieren a aspectos que no corresponden a la definici\u00f3n precisa del muestreo aleatorio simple."
-        },
-        {
-            "input": "Pregunta: \u00bfCu\u00e1l es la respuesta correcta respecto a la incidencia de SIDA en Espa\u00f1a en los \u00faltimos cinco a\u00f1os?:\nOpciones: A: La v\u00eda sexual es la categor\u00eda de transmisi\u00f3n que presenta la incidencia de SIDA m\u00e1s elevada.\tB: El grupo de edad que presenta la incidencia de SIDA m\u00e1s elevada son los menores de 25 a\u00f1os.\tC: Las personas procedentes de \u00c1frica Subsahariana presentan la incidencia de SIDA m\u00e1s elevada.\tD: La enfermedad definitoria de SIDA m\u00e1s frecuente es el sarcoma de Kaposi.\t\nLa respuesta correcta es A: La v\u00eda sexual es la categor\u00eda de transmisi\u00f3n que presenta la incidencia de SIDA m\u00e1s elevada..",
-            "output": "La opci\u00f3n A es la correcta, ya que en Espa\u00f1a, al igual que en otros muchos pa\u00edses desarrollados, la principal v\u00eda de transmisi\u00f3n del VIH que lleva al desarrollo del SIDA es la sexual. Ha habido una tendencia creciente en la incidencia de casos de transmisi\u00f3n por v\u00eda sexual tanto en hombres que tienen sexo con hombres (HSH) como en transmisiones heterosexuales, mientras que otros modos de transmisi\u00f3n, como el uso compartido de agujas, han disminuido debido a programas de intercambio de agujas y tratamientos de sustituci\u00f3n. La informaci\u00f3n epidemiol\u00f3gica actual respalda este patr\u00f3n en la incidencia del SIDA. Las dem\u00e1s opciones no reflejan con precisi\u00f3n este patr\u00f3n. Los menores de 25 a\u00f1os (B), las personas de \u00c1frica Subsahariana (C) y las enfermedades definitorias (D), como el sarcoma de Kaposi, no son las categor\u00edas con incidencia m\u00e1s elevada en los \u00faltimos cinco a\u00f1os."
-        },
-        {
-            "input": "Pregunta: \u00bfCu\u00e1l es el proceso en el cual se valoran, planifican, aplican, coordinan, monitorizan y eval\u00faan las opciones y servicios necesarios para satisfacer las necesidades de salud de una persona, articulando la comunicaci\u00f3n y los recursos disponibles que promuevan resultados de calidad y resulten costoefectivos?:\nOpciones: A: Planificaci\u00f3n centrada en la persona.\tB: Enfermer\u00eda de Enlace.\tC: Gesti\u00f3n de casos.\tD: Continuidad asistencial.\t\nLa respuesta correcta es C: Gesti\u00f3n de casos..",
-            "output": "La opci\u00f3n C, la Gesti\u00f3n de casos, es la m\u00e1s acertada porque describe precisamente el proceso integral de gesti\u00f3n individualizada de un paciente. Este proceso implica identificar sus necesidades particulares de salud y coordinar los recursos y servicios adecuados para atenderlas eficazmente. La Planificaci\u00f3n centrada en la persona (A) tambi\u00e9n considera las preferencias del individuo, pero no abarca la gesti\u00f3n amplia y continuada que implica la Gesti\u00f3n de casos. La Enfermer\u00eda de Enlace (B) se enfoca en la transici\u00f3n entre niveles asistenciales y la Continuidad asistencial (D) se refiere m\u00e1s a la coherencia en la atenci\u00f3n a lo largo del tiempo. La Gesti\u00f3n de casos, por lo tanto, es la respuesta que encapsula mejor la descripci\u00f3n dada, al ser una disciplina que se ocupa de la valoraci\u00f3n, planificaci\u00f3n, implementaci\u00f3n, coordinaci\u00f3n, monitoreo y evaluaci\u00f3n de las opciones y servicios para alcanzar los objetivos de salud de manera \u00f3ptima y econ\u00f3mica."
-        },
-        {
-            "input": "Pregunta: \u00bfA qu\u00e9 fase de la adaptaci\u00f3n a la situaci\u00f3n del cuidado corresponde aquella en que la cuidadora puede tener dificultad para verbalizar los sentimientos provocados por los acontecimientos dolorosos del cuidado?:\nOpciones: A: Fase de negaci\u00f3n o falta de Conciencia del Problema.\tB: Fase de B\u00fasqueda de informaci\u00f3n y aparici\u00f3n de sentimientos negativos.\tC: Fase de Reorganizaci\u00f3n.\tD: Fase de Resoluci\u00f3n.\t\nLa respuesta correcta es A: Fase de negaci\u00f3n o falta de Conciencia del Problema..",
-            "output": "La opci\u00f3n A, Fase de negaci\u00f3n o falta de Conciencia del Problema, es la que mejor se ajusta a la situaci\u00f3n descrita. Durante esta fase inicial, la cuidadora puede no reconocer completamente la magnitud de la situaci\u00f3n o rehusar a aceptar la realidad del cuidado. Esto puede incluir dificultades para expresar los sentimientos asociados con eventos traum\u00e1ticos o estresantes, ya que la capacidad de identificar y verbalizar las emociones se ve obstaculizada por la negaci\u00f3n y la falta de conciencia. Es una respuesta emocional defensiva que protege a la persona de la plena comprensi\u00f3n del impacto emocional del cuidado."
-        },
-        {
-            "input": "Pregunta: En un diagn\u00f3stico de salud de la comunidad es cierto que:\nOpciones: A: Es un examen que se realiza de forma previa al acceso a la comunidad.\tB: La herramienta clave es el uso de los sistemas de informaci\u00f3n.\tC: Es un diagn\u00f3stico que incluye principalmente los problemas de salud de una zona.\tD: Es necesario contactar directamente con la poblaci\u00f3n del barrio y actores locales.\t\nLa respuesta correcta es D: Es necesario contactar directamente con la poblaci\u00f3n del barrio y actores locales..",
-            "output": "La opci\u00f3n D es la m\u00e1s acertada pues en un diagn\u00f3stico de salud comunitario es esencial el contacto directo con la poblaci\u00f3n y los actores locales para obtener una visi\u00f3n real y profunda de la salud de la comunidad. Este acercamiento permite recoger informaci\u00f3n vital sobre las condiciones de vida, los problemas de salud prevalentes, y las din\u00e1micas sociales que pueden influir en el bienestar de los habitantes. Adem\u00e1s, asegura la participaci\u00f3n comunitaria y la relevancia del diagn\u00f3stico, fomentando el empoderamiento de los ciudadanos en la gesti\u00f3n de su salud y la de su entorno."
-        },
-        {
-            "input": "Pregunta: Se entiende por promoci\u00f3n de salud:\nOpciones: A: Una estrategia que tiene varios elementos comprendiendo en forma integrada varios programas dirigidos a poblaciones para la salud general.\tB: Conjunto de instrumentos y decisiones de una determinada sociedad que asigna funciones sociales y a su vez recursos para alcanzar una meta de salud de una poblaci\u00f3n.\tC: Proceso pol\u00edtico y social global dirigido a que las personas incrementen su control sobre los determinantes de salud.\tD: Medidas destinadas no solamente a prevenir la aparici\u00f3n de la enfermedad, tales como la reducci\u00f3n de los factores de riesgo, sino tambi\u00e9n a detener su avance y atenuar sus consecuencias una vez establecida.\t\nLa respuesta correcta es C: Proceso pol\u00edtico y social global dirigido a que las personas incrementen su control sobre los determinantes de salud..",
-            "output": "La opci\u00f3n C se centra en un enfoque hol\u00edstico y empoderador de la promoci\u00f3n de la salud, que es precisamente lo que define a esta disciplina. La promoci\u00f3n de la salud busca, en su esencia, fomentar una mayor autonom\u00eda y control de las personas sobre su propia salud, poniendo especial \u00e9nfasis en los determinantes sociales y ambientales que pueden impactarla. Este proceso pol\u00edtico y social busca la participaci\u00f3n activa de la comunidad y el desarrollo de pol\u00edticas saludables. No se limita solo a la prevenci\u00f3n de enfermedades, sino que tambi\u00e9n contempla la mejora continua del bienestar general."
-        },
-        {
-            "input": "Pregunta: En un Centro de salud se ha llevado a cabo una intervenci\u00f3n en Educaci\u00f3n para la Salud con 15 pacientes, dirigida a reducir la prevalencia de trastornos de ansiedad. Los evaluadores analizaron el tiempo que dur\u00f3 cada sesi\u00f3n, as\u00ed como el grado de participaci\u00f3n. Podemos decir que se ha realizado una evaluaci\u00f3n:\nOpciones: A: Evaluaci\u00f3n de impacto.\tB: Evaluaci\u00f3n de resultado.\tC: Evaluaci\u00f3n de proceso.\tD: Evaluaci\u00f3n implementadora.\t\nLa respuesta correcta es C: Evaluaci\u00f3n de proceso..",
-            "output": "La opci\u00f3n C, \"Evaluaci\u00f3n de proceso\", es la adecuada porque este tipo de evaluaci\u00f3n se centra en los m\u00e9todos y actividades realizadas durante un programa educativo, as\u00ed como en c\u00f3mo se han llevado a cabo dichas intervenciones y el grado de participaci\u00f3n de los involucrados. Al analizar tanto la duraci\u00f3n de las sesiones de educaci\u00f3n para la salud como el nivel de participaci\u00f3n de los pacientes, los evaluadores est\u00e1n observando los componentes y la din\u00e1mica del proceso educativo, no solo los resultados finales o los impactos a largo plazo, lo cual ser\u00eda el caso de una evaluaci\u00f3n de resultado o impacto, respectivamente. Por lo tanto, esta aproximaci\u00f3n se alinea con los principios de la evaluaci\u00f3n de proceso."
-        },
-        {
-            "input": "Pregunta: Seg\u00fan la definici\u00f3n que aporta el modelo radical de la Educaci\u00f3n para la Salud, \u00bfqu\u00e9 personas ser\u00edan las apropiadas para llevar a cabo el dise\u00f1o de este programa de Educaci\u00f3n para la Salud?:\nOpciones: A: S\u00f3lo los gestores, ya que s\u00f3lo ellos pueden imponer medidas organizativas.\tB: Toda la poblaci\u00f3n en su conjunto.\tC: S\u00f3lo los gestores, ya que poseen control sobre todo el proceso y pueden llevar una adecuada evaluaci\u00f3n.\tD: S\u00f3lo los profesionales sanitarios, ya que se trata de una cuesti\u00f3n que afecta a la salud.\t\nLa respuesta correcta es B: Toda la poblaci\u00f3n en su conjunto..",
-            "output": "El modelo radical de la Educaci\u00f3n para la Salud enfatiza en la importancia de la participaci\u00f3n comunitaria y en considerar los aspectos sociales y pol\u00edticos que influyen en la salud. Seg\u00fan este modelo, es fundamental incluir a toda la poblaci\u00f3n en el dise\u00f1o de programas de educaci\u00f3n para la salud, ya que permite que sean culturalmente relevantes, socialmente justos y efectivos en la promoci\u00f3n del cambio. La opci\u00f3n B es la correcta porque fomenta la autonom\u00eda y el empoderamiento de las personas para gestionar su propia salud, al mismo tiempo que reconoce la diversidad de experiencias y necesidades dentro de una comunidad."
-        },
-        {
-            "input": "Pregunta: Con respecto al pensamiento cr\u00edtico, cu\u00e1l de los siguientes t\u00e9rminos utilizados por Richard Paul como caracter\u00edsticas de los pensadores cr\u00edticos es INCORRECTA. Los pensadores cr\u00edticos son:\nOpciones: A: Humildes.\tB: Realistas.\tC: Reactivos.\tD: Buenos comunicadores.\t\nLa respuesta correcta es C: Reactivos..",
-            "output": "La opci\u00f3n incorrecta es la C, \"Reactivos\". El pensamiento cr\u00edtico de acuerdo con Richard Paul enfatiza la capacidad de analizar y evaluar de manera activa y reflexiva, en lugar de reaccionar de forma inmediata y sin reflexi\u00f3n a los est\u00edmulos o argumentos. Los pensadores cr\u00edticos son humildes (A), ya que reconocen la posibilidad de cometer errores y la necesidad de aprender de otros; realistas (B), al apreciar la realidad y ajustar sus pensamientos a esta; y buenos comunicadores (D), porque articulan eficazmente sus ideas y est\u00e1n dispuestos a dialogar. Por ende, ser reactivo contradice la naturaleza deliberativa del pensamiento cr\u00edtico."
-        },
-        {
-            "input": "Pregunta: \u00bfCu\u00e1l de los siguientes efectos NO es propio de las benzodiacepinas?:\nOpciones: A: Efecto ansiol\u00edtico.\tB: Efecto anticonvulsivante.\tC: Efecto antipsic\u00f3tico.\tD: Efecto sedante.\t\nLa respuesta correcta es C: Efecto antipsic\u00f3tico..",
-            "output": "Las benzodiacepinas son un grupo de f\u00e1rmacos conocidos por su capacidad de reducir la ansiedad (efecto ansiol\u00edtico), causar sedaci\u00f3n, y disminuir las convulsiones (efecto anticonvulsivante). Estas propiedades son ampliamente reconocidas y aprovechadas en la pr\u00e1ctica cl\u00ednica para tratar diversas condiciones, como trastornos de ansiedad, insomnio y epilepsia. Sin embargo, no poseen efecto antipsic\u00f3tico; esta es una acci\u00f3n m\u00e1s caracter\u00edstica de los antipsic\u00f3ticos o neurol\u00e9pticos, que se emplean para tratar des\u00f3rdenes como la esquizofrenia. Por lo tanto, la opci\u00f3n C es el efecto que NO es propio de las benzodiacepinas."
-        },
-        {
-            "input": "Pregunta: Un paciente que lleva una semana de reposo absoluto tras una cirug\u00eda p\u00e9lvica, empieza a hacer ejercicios isom\u00e9tricos de miembros inferiores. En esta situaci\u00f3n, \u00bfqu\u00e9 diagn\u00f3stico de enfermer\u00eda considera que aborda adecuadamente la situaci\u00f3n de este paciente?:\nOpciones: A: Trastorno de la identidad personal.\tB: Deterioro de la integridad cut\u00e1nea.\tC: Trastorno de la imagen corporal.\tD: Riesgo de intolerancia a la actividad.\t\nLa respuesta correcta es D: Riesgo de intolerancia a la actividad..",
-            "output": "La opci\u00f3n D, \"Riesgo de intolerancia a la actividad\", es la m\u00e1s apropiada para el diagn\u00f3stico de enfermer\u00eda en el caso de un paciente que empieza a hacer ejercicios isom\u00e9tricos de miembros inferiores tras una semana de reposo absoluto por una cirug\u00eda p\u00e9lvica. La raz\u00f3n principal es que despu\u00e9s de un periodo de inmovilizaci\u00f3n, el paciente puede experimentar una disminuci\u00f3n en su condici\u00f3n f\u00edsica y en la resistencia de los m\u00fasculos afectados. Los ejercicios isom\u00e9tricos son una forma de actividad f\u00edsica que ayuda a prevenir complicaciones como la trombosis venosa profunda y mantenimiento de la fuerza muscular. Sin embargo, tras un reposo prolongado, el paciente est\u00e1 en riesgo de no tolerar bien el incremento de la actividad, lo cual justifica el enfoque en este diagn\u00f3stico de enfermer\u00eda. Las otras opciones no se relacionan directamente con los riesgos asociados al proceso de reintroducci\u00f3n de actividad f\u00edsica tras un periodo de reposo."
-        },
-        {
-            "input": "Pregunta: Concepci\u00f3n, cuidadora principal de su padre con demencia vascular, acude a la consulta de enfermer\u00eda, donde nos refiere que cada vez se siente menos capaz de cuidar de su padre, y que su vida social se ha visto altamente mermada desde que cuida a \u00e9ste. \u00bfCu\u00e1l de los siguientes instrumentos emplear\u00edamos a fin de valorar la sobrecarga del cuidador?:\nOpciones: A: Escala de salud familiar (APGAR).\tB: Escala de evaluaci\u00f3n de las Relaciones Intrafamiliares (ERI).\tC: Escala de evaluaci\u00f3n del funcionamiento familiar.\tD: Escala de Zarit.\t\nLa respuesta correcta es D: Escala de Zarit..",
-            "output": "La Escala de Zarit es el instrumento espec\u00edficamente dise\u00f1ado para evaluar el nivel de sobrecarga que experimentan los cuidadores de personas con demencia o discapacidad. Mide el impacto emocional, psicol\u00f3gico y social que el cuidado tiene sobre la persona. Esta escala es adecuada para Concepci\u00f3n, ya que detecta el estr\u00e9s del cuidador y la afectaci\u00f3n que el cuidado tiene en su vida, incluyendo la social. Otras escalas como APGAR, ERI o la de evaluaci\u00f3n del funcionamiento familiar, eval\u00faan m\u00e1s ampliamente la din\u00e1mica y relaciones familiares, pero no concentran su foco en la sobrecarga del cuidador individual como tal. Por ello, la Escala de Zarit es la herramienta m\u00e1s adecuada para evaluar la situaci\u00f3n de Concepci\u00f3n."
-        },
-        {
-            "input": "Pregunta: \u00bfCu\u00e1l de las siguientes actividades NO se deber\u00e1 realizar en un paciente cr\u00edtico en dec\u00fabito prono?:\nOpciones: A: Rotar la colocaci\u00f3n de cabeza y los brazos peri\u00f3dicamente, colocando un brazo a un lado de la cabeza, hacia donde mire la cara, y el otro a lo largo del tronco.\tB: Colocar la cama en posici\u00f3n de trendelemburg para evitar el edema facial y ocular y facilitar la tolerancia a la dieta.\tC: Elevar los pies con almohadas de manera que la articulaci\u00f3n del tobillo quede en un \u00e1ngulo de 45\u00ba y los dedos de los pies libres de presi\u00f3n.\tD: Comprobar la correcta alineaci\u00f3n de la columna y los miembros inferiores.\t\nLa respuesta correcta es B: Colocar la cama en posici\u00f3n de trendelemburg para evitar el edema facial y ocular y facilitar la tolerancia a la dieta..",
-            "output": "La opci\u00f3n B, \"Colocar la cama en posici\u00f3n de trendelemburg para evitar el edema facial y ocular y facilitar la tolerancia a la dieta,\" no se debe realizar en un paciente cr\u00edtico en dec\u00fabito prono, ya que esta posici\u00f3n consiste en elevar los pies por encima del nivel de la cabeza, lo cual podr\u00eda aumentar la presi\u00f3n intracraneal y reducir el retorno venoso cerebral, potencialmente empeorando el edema facial y ocular. Adem\u00e1s, no se ha demostrado que facilite la tolerancia a la dieta en esta posici\u00f3n y puede aumentar el riesgo de aspiraci\u00f3n. Las dem\u00e1s opciones son procedimientos recomendados para prevenir complicaciones asociadas al dec\u00fabito prono."
-        },
-        {
-            "input": "Pregunta: Margarita R. ha sido operada hace ocho horas de una fractura de tibia y tiene colocada una escayola. Llama porque tiene mucho dolor a pesar de haberle administrado el analg\u00e9sico pautado hace una hora. La enfermera sospecha de un s\u00edndrome compartimental agudo. \u00bfQu\u00e9 es lo que NO est\u00e1 indicado?:\nOpciones: A: Valorar los bordes de la escayola por si le est\u00e1n da\u00f1ando la piel y si est\u00e1 demasiado apretada.\tB: Darle la analgesia pautada y volver a evaluar su eficacia al cabo de una hora.\tC: Hacer una valoraci\u00f3n neurovascular a intervalos peri\u00f3dicos comprobando la temperatura, el movimiento y la sensibilidad y avisar de inmediato al m\u00e9dico responsable en el caso de que haya alteraciones.\tD: Aplicar hielo y elevar la pierna afectada.\t\nLa respuesta correcta es D: Aplicar hielo y elevar la pierna afectada..",
-            "output": "La opci\u00f3n D, aplicar hielo y elevar la pierna afectada, no est\u00e1 indicada en el escenario de sospecha de un s\u00edndrome compartimental agudo. El s\u00edndrome compartimental se caracteriza por el aumento de la presi\u00f3n en un compartimento muscular, comprometiendo la circulaci\u00f3n y el tejido nervioso. La aplicaci\u00f3n de hielo podr\u00eda potencialmente empeorar la perfusi\u00f3n al \u00e1rea afectada debido a la vasoconstricci\u00f3n que provoca. Elevar la extremidad tambi\u00e9n podr\u00eda disminuir el flujo sangu\u00edneo arterial hacia el \u00e1rea, exacerbando a\u00fan m\u00e1s el problema de perfusi\u00f3n. En el contexto de s\u00edndrome compartimental, es esencial un diagn\u00f3stico y tratamiento precoces para evitar da\u00f1os a largo plazo, y ambos, la aplicaci\u00f3n de hielo y la elevaci\u00f3n, podr\u00edan retrasar el reconocimiento de la necesidad de una fasciotom\u00eda urgente."
-        },
-        {
-            "input": "Pregunta: Diego, hombre de 31 a\u00f1os y enfermero, acude a consulta con un informe que expone: Sarampi\u00f3n negativo; Rubeola negativa; Parotiditis positivo. Se desconoce su historia vacunal y no presenta ning\u00fan proceso de salud cr\u00f3nico ni agudo. Se\u00f1ale la respuesta correcta entre las siguientes afirmaciones:\nOpciones: A: Ante esta situaci\u00f3n, la recomendaci\u00f3n ser\u00eda la administraci\u00f3n de dos vacunas triple v\u00edrica con separaci\u00f3n de al menos cuatro semanas entre ambas.\tB: Ante esta situaci\u00f3n, no estar\u00eda recomendado la administraci\u00f3n de vacuna triple v\u00edrica al presentar Parotiditis positivo.\tC: Ante esta situaci\u00f3n y por la edad de Diego, estar\u00eda recomendada una \u00fanica dosis de vacuna triple v\u00edrica.\tD: Ante esta situaci\u00f3n, estar\u00eda recomendada la vacuna triple v\u00edrica si no conviviese con una embarazada.\t\nLa respuesta correcta es A: Ante esta situaci\u00f3n, la recomendaci\u00f3n ser\u00eda la administraci\u00f3n de dos vacunas triple v\u00edrica con separaci\u00f3n de al menos cuatro semanas entre ambas..",
-            "output": "La opci\u00f3n correcta es la A. Diego ha dado positivo para parotiditis (paperas), pero negativo para sarampi\u00f3n y rubeola. Desconociendo su historia vacunal, la recomendaci\u00f3n general ser\u00eda asumir que no est\u00e1 inmunizado y actuar en consecuencia. La vacuna triple v\u00edrica (sarampi\u00f3n, rubeola, parotiditis) proporcionar\u00eda inmunizaci\u00f3n para las enfermedades que ha dado negativo. La dosis doble - con un intervalo de al menos cuatro semanas - es para garantizar una mayor probabilidad de inmunidad, especialmente dado que no hay registro previo de vacunaci\u00f3n. Este esquema sigue las recomendaciones para garantizar la cobertura inmunol\u00f3gica adecuada en adultos."
-        },
-        {
-            "input": "Pregunta: ABVD es un esquema de tratamiento utilizado en la terapia de personas que tienen enfermedad de HODGKIN \u00bfCu\u00e1les son los f\u00e1rmacos que lo componen?:\nOpciones: A: Adriamicina,   Bleomicina,   Vinorelbina, Dacarbacina.\tB: Adriamicina, Bleomicina, Vincristina, Doxorrubicina.\tC: Adriamicina,   Bleomicina,   Vinblastina, Dacarbacina.\tD: Adriamicina, Bleomicina, Vinflunina, Doxorrubicina.\t\nLa respuesta correcta es C: Adriamicina,   Bleomicina,   Vinblastina, Dacarbacina..",
-            "output": "La opci\u00f3n C es la correcta porque corresponde a los f\u00e1rmacos que componen el esquema ABVD para la terapia de la enfermedad de Hodgkin. ABVD es un acr\u00f3nimo de los agentes quimioterap\u00e9uticos utilizados en el tratamiento: Adriamicina (tambi\u00e9n conocida como Doxorrubicina), Bleomicina, Vinblastina y Dacarbacina. Estos f\u00e1rmacos se combinan por su efectividad sin\u00e9rgica y perfiles de toxicidad manejables, ofreciendo una alta tasa de remisi\u00f3n. Las dem\u00e1s opciones incluyen f\u00e1rmacos que no forman parte de este esquema, ya sea porque no son utilizados para Hodgkin o porque no corresponden con la combinaci\u00f3n establecida y probada en la pr\u00e1ctica cl\u00ednica y en los ensayos cl\u00ednicos."
-        },
-        {
-            "input": "Pregunta: Soledad se encuentra en casa reci\u00e9n operada de un c\u00e1ncer de p\u00e1ncreas. La hija y el marido de Soledad acuden a la consulta para solicitar cita con su enfermero. La hija pregunta si su madre va a morir y si a ella tambi\u00e9n le pasar\u00e1 lo mismo. Seleccione el diagn\u00f3stico que presenta:\nOpciones: A: Afrontamiento familiar comprometido.\tB: Procesos familiares disfuncionales.\tC: Ansiedad ante la muerte.\tD: Temor.\t\nLa respuesta correcta es C: Ansiedad ante la muerte..",
-            "output": "La opci\u00f3n C, \"Ansiedad ante la muerte\", parece ser la m\u00e1s adecuada en este contexto. Tras una operaci\u00f3n de c\u00e1ncer de p\u00e1ncreas, una enfermedad con un pron\u00f3stico grave, es comprensible que la familia experimente ansiedad significativa respecto a la posibilidad de la muerte de Soledad. Adem\u00e1s, la preocupaci\u00f3n espec\u00edfica de la hija sobre su propia salud indica un miedo a la mortalidad y a la posibilidad de heredar predisposiciones al c\u00e1ncer. Aunque todos los diagn\u00f3sticos pueden ser pertinentes, la ansiedad ante la muerte es la que m\u00e1s directamente refleja las preocupaciones inmediatas planteadas por la hija y el marido de Soledad."
-        },
-        {
-            "input": "Pregunta: \u00bfCu\u00e1l de los siguientes bloqueantes neuromusculares se utiliza para la intubaci\u00f3n endotraqueal por su rapidez de inicio de acci\u00f3n y por ser el m\u00e1s r\u00e1pido en revertir su acci\u00f3n?:\nOpciones: A: Suxametonio.\tB: Cisatracurio.\tC: Rocuronio.\tD: Atracurio.\t\nLa respuesta correcta es A: Suxametonio..",
-            "output": "El suxametonio (opci\u00f3n A) es la opci\u00f3n preferida para la intubaci\u00f3n endotraqueal de acci\u00f3n r\u00e1pida debido a su inicio de acci\u00f3n casi inmediato, que generalmente ocurre dentro de 30 a 60 segundos tras la administraci\u00f3n. Adem\u00e1s, su corta duraci\u00f3n de acci\u00f3n, debido a su r\u00e1pida hidr\u00f3lisis por colinesterasas plasm\u00e1ticas, permite una recuperaci\u00f3n m\u00e1s veloz en comparaci\u00f3n con otros bloqueantes neuromusculares, lo que es deseable en procedimientos de corta duraci\u00f3n o en situaciones de urgencia donde se requiere una r\u00e1pida reversi\u00f3n de la par\u00e1lisis para permitir la respiraci\u00f3n espont\u00e1nea en caso de complicaciones con la ventilaci\u00f3n mec\u00e1nica."
-        },
-        {
-            "input": "Pregunta: Con respecto a Strongyloides, \u00bfcu\u00e1l de las siguientes afirmaciones es cierta?:\nOpciones: A: Es un trematodo de distribuci\u00f3n mundial.\tB: La infecci\u00f3n humana se adquiere cuando la larva filariforme de tercer estadio atraviesa la piel.\tC: Se diagnostica identificando sus huevos caracter\u00edsticos en las heces de la persona infectada.\tD: Las larvas rabditiformes se distinguen de las de uncinarias en su canal bucal, m\u00e1s largo en las de Strongyloides.\t\nLa respuesta correcta es B: La infecci\u00f3n humana se adquiere cuando la larva filariforme de tercer estadio atraviesa la piel..",
-            "output": "La opci\u00f3n B es correcta porque refleja el ciclo de vida caracter\u00edstico del par\u00e1sito Strongyloides stercoralis. Este nematodo tiene un ciclo de vida que incluye una fase de larva filariforme infecciosa que puede penetrar activamente la piel de los humanos, generalmente al entrar en contacto con suelo contaminado. La opci\u00f3n A es incorrecta porque Strongyloides no es un trematodo sino un nematodo. La opci\u00f3n C tambi\u00e9n es incorrecta debido a que Strongyloides stercoralis se diagnostica m\u00e1s com\u00fanmente por la detecci\u00f3n de larvas en las heces y no por huevos, como es el caso de otros par\u00e1sitos intestinales. La opci\u00f3n D es incorrecta, pues aunque las diferencias morfol\u00f3gicas son relevantes para la distinci\u00f3n de larvas entre diferentes par\u00e1sitos, no se ajusta a la afirmaci\u00f3n m\u00e1s precisa y directa asociada con la infecci\u00f3n humana."
-        },
-        {
-            "input": "Pregunta: \u00bfPara cu\u00e1l de las siguientes infecciones el trimetoprim/sulfametoxazol constituye el tratamiento de primera elecci\u00f3n?:\nOpciones: A: En la neumon\u00eda asociada a ventilaci\u00f3n mec\u00e1nica por Pseudomonas aeruginosa.\tB: En la neumon\u00eda intersticial por Pneumocystis jiroveci.\tC: En la neumon\u00eda cavitada por Legionella pneumophila.\tD: En la neumon\u00eda necrosante polimicrobiana.\t\nLa respuesta correcta es B: En la neumon\u00eda intersticial por Pneumocystis jiroveci..",
-            "output": "La opci\u00f3n B es la correcta porque el trimetoprim/sulfametoxazol (TMP/SMX), tambi\u00e9n conocido como cotrimoxazol, es el tratamiento de elecci\u00f3n para la neumon\u00eda por Pneumocystis jiroveci, especialmente en pacientes con VIH/SIDA, donde esta infecci\u00f3n es una oportunista frecuente. La combinaci\u00f3n de estos dos antibi\u00f3ticos interfiere con la s\u00edntesis del \u00e1cido f\u00f3lico en organismos como Pneumocystis, inhibiendo su crecimiento. Otras opciones, aunque involucran pat\u00f3genos respiratorios, tienen tratamientos de primera elecci\u00f3n distintos y son menos susceptibles al TMP/SMX, por ejemplo, las infecciones por Pseudomonas requieren antibi\u00f3ticos espec\u00edficos como ceftazidima o ciprofloxacino, y Legionella se trata con macr\u00f3lidos o fluoroquinolonas."
-        },
-        {
-            "input": "Pregunta: Mujer de 43 a\u00f1os que tras regresar de Mali presenta un cuadro de fiebre, malestar general y artromialgias. En la tinci\u00f3n de Giemsa se observan: gl\u00f3bulos rojos parasitados aumentados de tama\u00f1o con finos gr\u00e1nulos de Sch\u00fcffner, trofozo\u00edtos maduros irregulares, ameboides y esquizontes con 12 \u2013 24      merozo\u00edtos. No se observan gametocitos. \u00bfA qu\u00e9 especie de Plasmodium corresponde esta descripci\u00f3n?:\nOpciones: A: Plasmodium falciparum.\tB: Plasmodium vivax.\tC: Plasmodium ovale.\tD: Plasmodium malarie.\t\nLa respuesta correcta es B: Plasmodium vivax..",
-            "output": "La descripci\u00f3n ofrecida coincide con las caracter\u00edsticas morfol\u00f3gicas de Plasmodium vivax observables mediante la tinci\u00f3n de Giemsa. Los gl\u00f3bulos rojos parasitados aumentados de tama\u00f1o y la presencia de finos gr\u00e1nulos de Sch\u00fcffner son hallazgos t\u00edpicos de P. vivax. Adem\u00e1s, los trofozo\u00edtos ameboides y los esquizontes con 12\u201324 merozo\u00edtos tambi\u00e9n son caracter\u00edsticos de esta especie. En contraste, Plasmodium falciparum presentar\u00eda m\u00faltiples trofozo\u00edtos por gl\u00f3bulo rojo sin agrandamiento del mismo ni gr\u00e1nulos de Sch\u00fcffner, Plasmodium malariae mostrar\u00eda un ciclo esquizonte de 6\u201312 merozo\u00edtos, y Plasmodium ovale exhibir\u00eda gl\u00f3bulos rojos agrandados con fimbriaci\u00f3n."
-        },
-        {
-            "input": "Pregunta: \u00bfC\u00f3mo se inicia la contracci\u00f3n muscular?:\nOpciones: A: Mediante se\u00f1ales del calcio (Ca 2+).\tB: Por la formaci\u00f3n de ATP a partir de ADP + Pi.\tC: Mediante la hidr\u00f3lisis de puentes cruzados.\tD: Por la elongaci\u00f3n del sarc\u00f3mero.\t\nLa respuesta correcta es A: Mediante se\u00f1ales del calcio (Ca 2+)..",
-            "output": "La contracci\u00f3n muscular se inicia mediante se\u00f1ales del calcio (Ca2+). Cuando una neurona motora env\u00eda una se\u00f1al al m\u00fasculo, se libera acetilcolina en la uni\u00f3n neuromuscular, lo que desencadena la apertura de canales de calcio en el ret\u00edculo sarcopl\u00e1smico. El flujo de iones de calcio hacia el citosol induce un cambio en la conformaci\u00f3n de la troponina, lo cual aparta la tropomiosina de los sitios activos de la actina, permitiendo la formaci\u00f3n de puentes cruzados entre la miosina y la actina. Este proceso es esencial para que puedan deslizarse los filamentos de actina y miosina uno sobre el otro, produciendo as\u00ed la contracci\u00f3n muscular."
-        },
-        {
-            "input": "Pregunta: \u00bfA cu\u00e1l de los siguientes grupos sangu\u00edneos puede donar sangre sin peligro de incompatibilidad un donante con un grupo sangu\u00edneo AB y Rh negativo?:\nOpciones: A: Grupo AB y Rh positivo.\tB: Grupo 0 y Rh positivo.\tC: Grupo A y Rh positivo.\tD: Grupo B y Rh positivo.\t\nLa respuesta correcta es A: Grupo AB y Rh positivo..",
-            "output": "El grupo sangu\u00edneo AB Rh negativo es conocido como receptor universal para el plasma, debido a que no posee anticuerpos anti-A ni anti-B en su plasma. Sin embargo, para la donaci\u00f3n de sangre, es crucial considerar los ant\u00edgenos presentes en los gl\u00f3bulos rojos. Como un donante AB Rh negativo tiene ambos ant\u00edgenos A y B, pero no el ant\u00edgeno Rh, puede donar sin peligro de incompatibilidad al grupo AB Rh positivo, ya que la presencia del factor Rh positivo en el receptor significa que no hay riesgo de reacci\u00f3n por el Rh negativo del donante."
-        },
-        {
-            "input": "Pregunta: \u00bfCu\u00e1l de estas anomal\u00edas morfol\u00f3gicas NO pertenece a la serie roja?:\nOpciones: A: Esquistocitos.\tB: Drepanocitos.\tC: Corp\u00fasculos de Howell - Jolly.\tD: Bastones de Auer.\t\nLa respuesta correcta es D: Bastones de Auer..",
-            "output": "La opci\u00f3n D, \"Bastones de Auer\", no pertenece a la serie roja ya que son inclusiones citoplasm\u00e1ticas anormales encontradas en los blastos de leucemia mieloide aguda y otras mielodisplasias, y por ende, est\u00e1n asociados a los gl\u00f3bulos blancos o serie blanca. En contraste, los \"Esquistocitos\" (A), \"Drepanocitos\" (B) y \"Corp\u00fasculos de Howell - Jolly\" (C) son todas anomal\u00edas que se observan en los eritrocitos o c\u00e9lulas de la serie roja y se relacionan con diferentes tipos de anemia y trastornos eritrocitarios, como la anemia hemol\u00edtica, la anemia de c\u00e9lulas falciformes y la asplenia, respectivamente."
-        },
-        {
-            "input": "Pregunta: Paciente con anemia, prote\u00ednas plasm\u00e1ticas altas, alteraciones \u00f3seas y renales, pico monoclonal en el proteinograma. En la extensi\u00f3n de sangre perif\u00e9rica se observan eritrocitos formando \u201cpilas de moneda\u201d. \u00bfCu\u00e1l es el diagn\u00f3stico m\u00e1s probable?:\nOpciones: A: Infecci\u00f3n v\u00edrica.\tB: Mieloma m\u00faltiple.\tC: Leucemia linf\u00e1tica cr\u00f3nica.\tD: Mononucleosis infecciosa.\t\nLa respuesta correcta es B: Mieloma m\u00faltiple..",
-            "output": "La respuesta m\u00e1s adecuada es B. Mieloma m\u00faltiple. Los s\u00edntomas descritos \u2013anemia, prote\u00ednas plasm\u00e1ticas altas (posiblemente cadenas ligeras de inmunoglobulinas o paraprote\u00ednas), alteraciones \u00f3seas y renales\u2013 son t\u00edpicos de esta patolog\u00eda. El pico monoclonal en el proteinograma apoya tambi\u00e9n este diagn\u00f3stico, ya que indica la presencia de una inmunoglobulina producida en exceso por un clon \u00fanico de c\u00e9lulas plasm\u00e1ticas malignas. Adem\u00e1s, la observaci\u00f3n de eritrocitos en \"pilas de moneda\" puede ser una manifestaci\u00f3n secundaria al aumento de prote\u00ednas s\u00e9ricas que alteran la carga electrost\u00e1tica de los eritrocitos. Estos hallazgos no son t\u00edpicos de infecciones virales, leucemia linf\u00e1tica cr\u00f3nica, ni de mononucleosis infecciosa."
-        },
-        {
-            "input": "Pregunta: \u00bfCu\u00e1l de los d\u00e9ficits de actividad en las siguientes enzimas del ciclo de la urea puede provocar una or\u00f3tico aciduria, adem\u00e1s de hiperamonemia?:\nOpciones: A: Ornitina transcarbamilasa.\tB: Arginasa.\tC: Arginino succinato sintasa.\tD: Carbamoil fosfato sintetasa.\t\nLa respuesta correcta es A: Ornitina transcarbamilasa..",
-            "output": "La or\u00f3tico aciduria junto con hiperamonemia son s\u00edntomas caracter\u00edsticos del d\u00e9ficit de la enzima ornitina transcarbamilasa (OTC). La deficiencia de OTC interrumpe el ciclo de la urea, impidiendo la s\u00edntesis de citrulina a partir de ornitina y carbamoil fosfato. Esto lleva a una acumulaci\u00f3n de carbamoil fosfato que se desv\u00eda hacia la s\u00edntesis de pirimidinas, aumentando los niveles de \u00e1cido or\u00f3tico. Adem\u00e1s, la hiperamonemia resulta de la incapacidad para convertir el amoniaco en urea para su excreci\u00f3n. Las otras enzimas mencionadas no est\u00e1n directamente relacionadas con la producci\u00f3n de \u00e1cido or\u00f3tico cuando est\u00e1n deficientes."
-        },
-        {
-            "input": "Pregunta: \u00bfCu\u00e1l de los siguientes acontecimientos se produce cuando la insulina se une a su receptor?:\nOpciones: A: Aumenta la cantidad de restos de treonina fosforilada en las subunidades \u0251 del receptor.\tB: Aumenta la cantidad de restos de serina y treonina fosforiladas en la parte extracelular del receptor.\tC: El receptor cataliza su propia fosforilaci\u00f3n en restos de tirosina de su parte citos\u00f3lica.\tD: El receptor se autofosforila en la regi\u00f3n extracelular donde se ponen en contacto sus cadenas \u0251 y \u03b2.\t\nLa respuesta correcta es C: El receptor cataliza su propia fosforilaci\u00f3n en restos de tirosina de su parte citos\u00f3lica..",
-            "output": "La opci\u00f3n C es la correcta porque al unirse la insulina a su receptor, que es un receptor tirosina quinasa, se inducen cambios conformacionales que permiten la autofosforilaci\u00f3n en residuos espec\u00edficos de tirosina en la regi\u00f3n citos\u00f3lica del receptor. Esta fosforilaci\u00f3n es esencial para la activaci\u00f3n del receptor y para la iniciaci\u00f3n de la cascada de se\u00f1alizaci\u00f3n intracelular que conduce a los m\u00faltiples efectos de la insulina, como la captaci\u00f3n de glucosa y la s\u00edntesis de gluc\u00f3geno. Las otras opciones (A, B y D) no describen correctamente el mecanismo de acci\u00f3n inicial cuando la insulina se une a su receptor."
-        },
-        {
-            "input": "Pregunta: Respecto a la fijaci\u00f3n proteica de los f\u00e1rmacos a nivel plasm\u00e1tico o tisular, es cierto que:\nOpciones: A: El aclaramiento hep\u00e1tico depende exclusivamente de la actividad enzim\u00e1tica de los hepatocitos.\tB: La uni\u00f3n a las prote\u00ednas plasm\u00e1ticas es un fen\u00f3meno regulador de la excreci\u00f3n renal de los f\u00e1rmacos.\tC: Solo la forma ionizada e hidrosoluble de un f\u00e1rmaco puede reabsorberse en los t\u00fabulos renales.\tD: La no linealidad de la cin\u00e9tica solo se manifiesta en el caso de saturaci\u00f3n de los sistemas enzim\u00e1ticos.\t\nLa respuesta correcta es B: La uni\u00f3n a las prote\u00ednas plasm\u00e1ticas es un fen\u00f3meno regulador de la excreci\u00f3n renal de los f\u00e1rmacos..",
-            "output": "La opci\u00f3n B es correcta porque la uni\u00f3n de los f\u00e1rmacos a las prote\u00ednas plasm\u00e1ticas regula su biodisponibilidad y su excreci\u00f3n. Los f\u00e1rmacos unidos a prote\u00ednas no se filtran f\u00e1cilmente en los glom\u00e9rulos renales debido a su gran tama\u00f1o. Solo la fracci\u00f3n libre (no unida) del f\u00e1rmaco se filtra y puede ser excretada. Por lo tanto, la uni\u00f3n a prote\u00ednas plasm\u00e1ticas act\u00faa como un reservorio que libera lentamente el f\u00e1rmaco, influyendo as\u00ed en la duraci\u00f3n de su efecto y en la excreci\u00f3n renal. Adem\u00e1s, cambios en la uni\u00f3n proteica pueden alterar la fracci\u00f3n de f\u00e1rmaco que se somete a filtraci\u00f3n glomerular."
-        },
-        {
-            "input": "Pregunta: El \u00e1cido fosfat\u00eddico es precursor de:\nOpciones: A: Triacilgliceroles.\tB: Eicosanoides.\tC: Cerebr\u00f3sidos.\tD: Esfingofosfol\u00edpidos.\t\nLa respuesta correcta es A: Triacilgliceroles..",
-            "output": "El \u00e1cido fosfat\u00eddico es un intermediario clave en la bios\u00edntesis de l\u00edpidos. Espec\u00edficamente, es el precursor de los triacilgliceroles, que son la principal forma de almacenamiento de energ\u00eda en las c\u00e9lulas. Estos compuestos se forman a partir del \u00e1cido fosfat\u00eddico mediante la acci\u00f3n de la enzima fosfatidato fosfohidrolasa, que remueve un grupo fosfato. Esto lleva a la formaci\u00f3n de diglic\u00e9rido, que posteriormente recibe una tercera mol\u00e9cula de \u00e1cido graso para formar el triacilglicerol. Por tanto, la opci\u00f3n correcta es la A, ya que las otras opciones son productos de otros rutas metab\u00f3licas espec\u00edficas."
-        },
-        {
-            "input": "Pregunta: De acuerdo con las normas establecidas en nuestro ordenamiento constitucional, las materias de sanidad exterior corresponden a:\nOpciones: A: El Estado.\tB: La Uni\u00f3n Europea.\tC: Las Comunidades Aut\u00f3nomas.\tD: La Organizaci\u00f3n Mundial de la Salud.\t\nLa respuesta correcta es A: El Estado..",
-            "output": "Las materias de sanidad exterior corresponden al Estado, seg\u00fan el ordenamiento constitucional espa\u00f1ol, dado que se trata de pol\u00edticas y medidas que inciden en la gesti\u00f3n de la salud p\u00fablica en relaci\u00f3n con las fronteras exteriores del pa\u00eds. Esto incluye el control de enfermedades transmisibles, la regulaci\u00f3n de la entrada y salida de productos sanitarios y la prevenci\u00f3n de riesgos a la salud p\u00fablica que puedan surgir del tr\u00e1fico internacional de personas y bienes. Al ser competencias que involucran relaciones internacionales y la protecci\u00f3n del conjunto del territorio nacional, es el Estado el que tiene la capacidad normativa y ejecutiva en esta materia, en contraposici\u00f3n a las comunidades aut\u00f3nomas que gestionan la sanidad de forma interna, pero sin alcance fuera de sus l\u00edmites geogr\u00e1ficos. Las opciones B, C y D no son correctas en el contexto del ordenamiento constitucional espa\u00f1ol, aunque la UE y la OMS puedan influir en las pol\u00edticas de sanidad exterior."
-        },
-        {
-            "input": "Pregunta: La zona glomerulosa (capa externa) de la corteza suprarrenal secreta:\nOpciones: A: Glucocorticoides.\tB: Andr\u00f3genos.\tC: Aldosterona.\tD: Adrenalina.\t\nLa respuesta correcta es C: Aldosterona..",
-            "output": "La capa externa de la corteza suprarrenal, la zona glomerulosa, es principalmente responsable de la secreci\u00f3n de mineralocorticoides, y la aldosterona es el mineralocorticoide m\u00e1s importante producido en esta zona. La aldosterona regula el equilibrio de sodio y potasio as\u00ed como la presi\u00f3n arterial. A diferencia de las otras opciones, los glucocorticoides como el cortisol se producen en la zona fasciculada, los andr\u00f3genos en la zona reticularis, y la adrenalina es un producto de la m\u00e9dula suprarrenal, no de la corteza. Por lo tanto, la opci\u00f3n correcta es la C, aldosterona, correlacionando la funci\u00f3n de la zona glomerulosa con su secreci\u00f3n principal."
-        },
-        {
-            "input": "Pregunta: Pregunta vinculada a la imagen n\u00ba6 Ante el siguiente ECG y sabiendo que corresponde a un paciente de 78 a\u00f1os con antecedentes de infarto anterior extenso y disfunci\u00f3n ventricular moderada residual, \u00bfcu\u00e1l ser\u00eda su primera sospecha diagn\u00f3stica?\nOpciones: A: Taquicardia auricular.\tB: Taquicardia supraventricular por reentrada intranodal.\tC: Taquicardia ventricular.\tD: Flutter auricular at\u00edpico.\t\nLa respuesta correcta es C: Taquicardia ventricular..",
-            "output": "La opci\u00f3n C, Taquicardia ventricular, ser\u00eda la primera sospecha diagn\u00f3stica dado que el paciente tiene un historial de infarto anterior extenso y disfunci\u00f3n ventricular moderada residual. En este contexto, es m\u00e1s probable que se desarrolle una arritmia a nivel ventricular en lugar de auricular, debido al da\u00f1o mioc\u00e1rdico previo que predispone a trastornos del ritmo ventricular. Un ECG con taquicardia y antecedentes card\u00edacos como los que presenta el paciente, apunta m\u00e1s hacia un origen ventricular de la taquicardia. Las otras opciones son menos probables ante un paciente con estas caracter\u00edsticas cl\u00ednicas y antecedentes."
-        },
-        {
-            "input": "Pregunta: Pregunta vinculada a la imagen n\u00ba10 Mujer de 80 a\u00f1os con antecedentes de hipertensi\u00f3n arterial, dislipemia y artrosis cervical       en         tratamiento       con enalapril/hidroclorotiazida    y    simvastatina desde hace a\u00f1os y espor\u00e1dico con paracetamol. Consulta por lesiones cut\u00e1neas pruriginosas en tronco y extremidades de 2 semanas de evoluci\u00f3n para las que no ha realizado tratamiento m\u00e9dico (Imagen). La paciente se encuentra hemodin\u00e1micamente estable y afebril cuando acude al servicio de urgencias. Se\u00f1ale la opci\u00f3n correcta:\nOpciones: A: En la biopsia cut\u00e1nea realizada de una lesi\u00f3n de reciente aparici\u00f3n esperar\u00eda encontrar espongiosis       epid\u00e9rmica,         ves\u00edculas espongi\u00f3ticas y un infiltrado eosinof\u00edlico.\tB: Las lesiones son compatibles con una pustulosis exantem\u00e1tica aguda generalizada por lo que iniciar\u00eda tratamiento con amoxicilina/clavul\u00e1nico por v\u00eda oral.\tC: Con la sospecha de una enfermedad ampollosa autoinmune se realiza una biopsia de las lesiones para inmunofluorescencia directa. Se cursa ingreso hospitalario y se inicia tratamiento con prednisona a dosis de 1mg/kg/d\u00eda.\tD: Con la sospecha de eccema diseminado se realiza biopsia de lesiones para hematoxilinaeosina y se inicia tratamiento con prednisona a dosis de 1mg/kg/d\u00eda.\t\nLa respuesta correcta es C: Con la sospecha de una enfermedad ampollosa autoinmune se realiza una biopsia de las lesiones para inmunofluorescencia directa. Se cursa ingreso hospitalario y se inicia tratamiento con prednisona a dosis de 1mg/kg/d\u00eda..",
-            "output": "La opci\u00f3n correcta es C, sospechando de una enfermedad ampollosa autoinmune. Esto se debe a que las lesiones descritas en la paciente son pruriginosas y se diseminan en tronco y extremidades, lo cual es compatible con enfermedades como el penfigoide o la dermatitis herpetiforme. La estabilidad hemodin\u00e1mica y ausencia de fiebre descartan una infecci\u00f3n grave o una reacci\u00f3n adversa a medicamentos que requieran manejo de urgencia, como podr\u00eda ser el caso en la opci\u00f3n B. Adem\u00e1s, la historia cr\u00f3nica de la paciente con un cuadro agudo sugiere que es menos probable un eccema diseminado (opci\u00f3n D), que suele tener una presentaci\u00f3n m\u00e1s cr\u00f3nica o recurrente. Por tanto, la realizaci\u00f3n de una biopsia para inmunofluorescencia directa es esencial para confirmar el diagn\u00f3stico y un tratamiento con prednisona es el pilar del tratamiento inicial para este grupo de enfermedades."
-        }
-    ]
-}

MedS-Bench/Text_classification/task106_hoc_text_classification.json

@@ -1,234 +0,0 @@
-{
-    "Contributors": [
-        "HoC"
-    ],
-    "Source": [
-        "HoC"
-    ],
-    "URL": [
-        "https://github.com/sb895/Hallmarks-of-Cancer"
-    ],
-    "Categories": [
-        "Text Classification"
-    ],
-    "Definition": [
-        "Given the biomedical publication abstracts, you are required to classify the hallmarks of cancer. Each article may have one or more of the ten hallmarks. The ten hallmarks are as follows: 1. Sustaining proliferative signaling, 2. Evading growth suppressors, 3. Resisting cell death, 4. Enabling replicative immortality, 5. Inducing angiogenesis, 6. Activating invasion and metastasis, 7. Genomic instability and mutation, 8. Tumor promoting inflammation, 9. Cellular energetics, 10. Avoiding immune destruction."
-    ],
-    "Reasoning": [],
-    "Input_language": [
-        "English"
-    ],
-    "Output_language": [
-        "English"
-    ],
-    "Instruction_language": [
-        "English"
-    ],
-    "Domains": [
-        "Medical Knowledge"
-    ],
-    "Positive Examples": [],
-    "Negative Examples": [],
-    "Instances": [
-        {
-            "input": "MicroRNAs ( miRNAs ) are involved in cancer development and progression , acting as tumor suppressors or oncogenes .\n\nIn this study , miRNA profiling was performed on 10 paired bladder cancer ( BC ) tissues using 20 GeneChipTM miRNA Array , and 10 differentially expressed miRNAs were identified in BC and adjacent noncancerous tissues of any disease stage/grade .\n\nAfter validated on expanded cohort of 67 paired BC tissues and 10 human BC cell lines by qRT-PCR , it was found that miR-100 was down-regulated most significantly in cancer tissues .\n\nEctopic restoration of miR-100 expression in BC cells suppressed cell proliferation and motility , induced cell-cycle arrest in vitro , and inhibited tumorigenesis in vivo both in subcutaneous and intravesical passage .\n\nBioinformatic analysis showed that mTOR gene was a direct target of miR-100. siRNA-mediated mTOR knockdown phenocopied the effect of miR-100 in BC cell lines .\n\nIn addition , the cancerous metastatic nude mouse model established on the basis of primary BC cell lines suggested that miR-100/mTOR regulated cell motility and was associated with tumor metastasis .\n\nBoth mTOR and p70S6K ( downstream messenger ) presented higher expression levels in distant metastatic foci such as in liver and kidney metastases than in primary tumor .\n\nTaken together , miR-100 may act as a tumor suppressor in BC , and reintroduction of this mature miRNA into tumor tissue may prove to be a therapeutic strategy by reducing the expression of target genes .",
-            "output": "Sustaining proliferative signaling, Evading growth suppressors, Activating invasion and metastasis"
-        },
-        {
-            "input": "Diffuse intrinsic pontine glioma ( DIPG ) is a fatal pediatric disease .\n\nThus far no therapeutic agent has proven beneficial in the treatment of this malignancy .\n\nHence , conventional DNA-damaging radiotherapy ( RT ) remains the standard treatment , providing transient neurological improvement without improving probability of overall survival .\n\nDuring RT , WEE1 kinase controls the G2 cell cycle checkpoint allowing for repair of irradiation ( IR)-induced DNA damage .\n\nHere we show that WEE1 kinase is one of the highest overexpressed kinases in primary DIPG tissues as compared to matching non-neoplastic brain tissues .\n\nInhibition of WEE1 by MK-1775 treatment of DIPG cells inhibited the IR-induced WEE1-mediated phosphorylation of CDC2 , resulting in reduced G2/M arrest and decreased cell viability .\n\nFinally , we demonstrate that MK-1775 enhances the radiation response of E98-Fluc-mCherry DIPG mouse xenografts .\n\nAltogether , these results show that inhibition of WEE1 kinase in conjunction with RT holds potential as a therapeutic approach for the treatment of DIPG .",
-            "output": "Sustaining proliferative signaling, Evading growth suppressors"
-        },
-        {
-            "input": "OBJECTIVES : Cigarette smoking is a major risk factor for pancreatic cancer ( PaCa ) .\n\nHowever , the mechanisms of smoking-induced PaCa remain unknown .\n\nHere we investigated the effect of smoking compounds on cell death pathways in pancreatic ductal cells , precursors of PaCa .\n\nMETHODS : Human pancreatic ductal cells ( HPDE6-c7 ) were cultured with cigarette smoke extract ( CSE ) or smoking compound 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone ( NNK ) .\n\nApoptosis and autophagy were assessed by DNA fragmentation and immunofluorescence , respectively .\n\nRESULTS : Exposure to CSE or NNK decreased DNA fragmentation and up-regulated BclXL .\n\nAkt kinase was activated by smoking compounds through reactive oxygen species-dependent mechanism .\n\nSpecifically , Akt activation was prevented by inhibition of nicotinamide adenine dinucleotide oxidase .\n\nMolecular or pharmacologic inhibitions of Akt prevented the antiapoptotic effect of smoking compounds .\n\nSmoking compounds stimulated rapid ( 1 hour ) and transient activation of 5'-adenosine monophosphate-activated protein kinase and formation of autophagic vacuoles , indicating stimulation of autophagy .\n\nRepeated exposure to CSE/NNK ( 48 hours or longer ) abolished the early activation of autophagic markers .\n\nInhibition of Akt prevented the antiautophagic effect of long exposure to smoking compounds , indicating that smoking-induced late activation of Akt prevents autophagy .\n\nCONCLUSIONS : Long exposure of pancreatic ductal cells to smoking compounds inhibited apoptosis and autophagy .\n\nThe results revealed a central role for Akt kinase in mediating key procarcinogenic effects of smoking compounds .",
-            "output": "Tumor promoting inflammation, Resisting cell death"
-        },
-        {
-            "input": "Most hepatocellular carcinomas ( HCC ) develop in the context of severe liver fibrosis and cirrhosis caused by chronic liver inflammation , which also results in accumulation of reactive oxygen species ( ROS ) .\n\nIn this study , we examined whether the stress-activated protein kinase p38\u03b1 ( Mapk14 ) controls ROS metabolism and development of fibrosis and cancer in mice given thioacetamide to induce chronic liver injury .\n\nLiver-specific p38\u03b1 ablation was found to enhance ROS accumulation , which appears to be exerted through the reduced expression of antioxidant protein HSP25 ( Hspb1 ) , a mouse homolog of HSP27 .\n\nIts reexpression in p38\u03b1-deficient liver prevents ROS accumulation and thioacetamide-induced fibrosis. p38\u03b1 deficiency increased expression of SOX2 , a marker for cancer stem cells and the liver oncoproteins c-Jun ( Jun ) and Gankyrin ( Psmd10 ) and led to enhanced thioacetamide-induced hepatocarcinogenesis .\n\nThe upregulation of SOX2 and c-Jun was prevented by administration of the antioxidant butylated hydroxyanisole .\n\nIntriguingly , the risk of human HCC recurrence is positively correlated with ROS accumulation in liver .\n\nThus , p38\u03b1 and its target HSP25/HSP27 appear to play a conserved and critical hepatoprotective function by curtailing ROS accumulation in liver parenchymal cells engaged in oxidative metabolism of exogenous chemicals .\n\nAugmented oxidative stress of liver parenchymal cells may explain the close relationship between liver fibrosis and hepatocarcinogenesis .",
-            "output": "Tumor promoting inflammation"
-        },
-        {
-            "input": "The role of inflammatory cytokine interleukin-20 ( IL-20 ) has not yet been studied in cancer biology .\n\nHere , we demonstrated up-regulation of both IL-20 and IL-20R1 in muscle invasive bladder cancer ( MIBC ) patients .\n\nThe expressions of IL-20 and IL-20R1 were observed in bladder cancer 5637 and T-24 cells .\n\nWe found that IL-20 significantly increased the expression of matrix metalloproteinase ( MMP)-9 via binding activity of NF-\u03baB and AP-1 in bladder cancer cells and stimulated the activation of ERK1/2 , JNK , p38MAPK , and Jak-Stat signaling .\n\nAmong the pathways examined , only ERK1/2 inhibitor U0126 significantly inhibited IL-20-induced migration and invasion .\n\nMoreover , siRNA knockdown of IL-20R1 suppressed migration , invasion , ERK1/2 activation , and NF-\u03baB-mediated MMP-9 expression induced by IL-20 .\n\nUnexpectedly , cell cycle inhibitor p21WAF1 was induced by IL-20 treatment without altering cell cycle progression .\n\nBlockade of p21WAF1 function by siRNA reversed migration , invasion , activation of ERK signaling , MMP-9 expression , and activation of NF-\u03baB in IL-20-treated cells .\n\nIn addition , IL-20 induced the activation of IKK , the degradation and phosphorylation of I\u03baBa , and NF-\u03baB p65 nuclear translocation , which was regulated by ERK1/2 .\n\nIL-20 stimulated the recruitment of p65 to the MMP-9 promoter region .\n\nFinally , the IL-20-induced migration and invasion of cells was confirmed by IL-20 gene transfection and by addition of anti-IL-20 antibody .\n\nThis is the first report that p21WAF1 is involved in ERK1/2-mediated MMP-9 expression via increased binding activity of NF-\u03baB , which resulted in the induction of migration in IL-20/IL-20R1 dyad-induced bladder cancer cells .\n\nThese unexpected results might provide a critical new target for the treatment of bladder cancer .",
-            "output": "Sustaining proliferative signaling, Evading growth suppressors, Activating invasion and metastasis"
-        },
-        {
-            "input": "Each year , more than 700,000 people undergo cancer surgery in the United States .\n\nHowever , more than 40% of those patients develop recurrences and have a poor outcome .\n\nTraditionally , the medical community has assumed that recurrent tumors arise from selected tumor clones that are refractory to therapy .\n\nHowever , we found that tumor cells have few phenotypical differences after surgery .\n\nThus , we propose an alternative explanation for the resistance of recurrent tumors .\n\nSurgery promotes inhibitory factors that allow lingering immunosuppressive cells to repopulate small pockets of residual disease quickly .\n\nRecurrent tumors and draining lymph nodes are infiltrated with M2 ( CD11b(+)F4/80(hi)CD206(hi) and CD11b(+)F4/80(hi)CD124(hi) ) macrophages and CD4(+)Foxp3(+) regulatory T cells .\n\nThis complex network of immunosuppression in the surrounding tumor microenvironment explains the resistance of tumor recurrences to conventional cancer vaccines despite small tumor size , an intact antitumor immune response , and unaltered cancer cells .\n\nTherapeutic strategies coupling antitumor agents with inhibition of immunosuppressive cells potentially could impact the outcomes of more than 250,000 people each year .",
-            "output": "Avoiding immune destruction"
-        },
-        {
-            "input": "Chromosomal DNA must be in single-strand form for important transactions such as replication , transcription , and recombination to occur .\n\nThe single-strand DNA ( ssDNA ) is more prone to damage than double-strand DNA ( dsDNA ) , due to greater exposure of chemically reactive moieties in the nitrogenous bases .\n\nThus , there can be agents that damage regions of ssDNA in vivo while being inert toward dsDNA .\n\nTo assess the potential hazard posed by such agents , we devised an ssDNA-specific mutagenesis reporter system in budding yeast .\n\nThe reporter strains bear the cdc13-1 temperature-sensitive mutation , such that shifting to 37\u00b0C results in telomere uncapping and ensuing 5 ' to 3 ' enzymatic resection .\n\nThis exposes the reporter region , containing three closely-spaced reporter genes , as a long 3 ' ssDNA overhang .\n\nWe validated the ability of the system to detect mutagenic damage within ssDNA by expressing a modified human single-strand specific cytosine deaminase , APOBEC3G .\n\nAPOBEC3G induced a high density of substitutions at cytosines in the ssDNA overhang strand , resulting in frequent , simultaneous inactivation of two reporter genes .\n\nWe then examined the mutagenicity of sulfites , a class of reactive sulfur oxides to which humans are exposed frequently via respiration and food intake .\n\nSulfites , at a concentration similar to that found in some foods , induced a high density of mutations , almost always as substitutions at cytosines in the ssDNA overhang strand , resulting in simultaneous inactivation of at least two reporter genes .\n\nFurthermore , sulfites formed a long-lived adducted 2'-deoxyuracil intermediate in DNA that was resistant to excision by uracil-DNA N-glycosylase .\n\nThis intermediate was bypassed by error-prone translesion DNA synthesis , frequently involving Pol \\u03b6 , during repair synthesis .\n\nOur results suggest that sulfite-induced lesions in DNA can be particularly deleterious , since cells might not possess the means to repair or bypass such lesions accurately .",
-            "output": "Genomic instability and mutation"
-        },
-        {
-            "input": "Hypoxia is known to play critical roles in cell survival , angiogenesis , tumor invasion , and metastasis .\n\nHypoxia mediated over-expression of hypoxia-inducible factor ( HIF ) has been shown to be associated with therapeutic resistance , and contributes to poor prognosis of cancer patients .\n\nEmerging evidence suggest that hypoxia and HIF pathways contributes to the acquisition of epithelial-to-mesenchymal transition ( EMT ) , maintenance of cancer stem cell ( CSC ) functions , and also maintains the vicious cycle of inflammation-all which lead to therapeutic resistance .\n\nHowever , the precise molecular mechanism(s) by which hypoxia/HIF drives these events are not fully understood .\n\nHere , we show , for the first time , that hypoxia leads to increased expression of VEGF , IL-6 , and CSC signature genes Nanog , Oct4 and EZH2 consistent with increased cell migration/invasion and angiogenesis , and the formation of pancreatospheres , concomitant with increased expression of miR-21 and miR-210 in human pancreatic cancer ( PC ) cells .\n\nThe treatment of PC cells with CDF , a novel synthetic compound inhibited the production of VEGF and IL-6 , and down-regulated the expression of Nanog , Oct4 , EZH2 mRNAs , as well as miR-21 and miR-210 under hypoxia .\n\nCDF also led to decreased cell migration/invasion , angiogenesis , and formation of pancreatospheres under hypoxia .\n\nMoreover , CDF decreased gene expression of miR-21 , miR-210 , IL-6 , HIF-1\u03b1 , VEGF , and CSC signatures in vivo in a mouse orthotopic model of human PC .\n\nCollectively , these results suggest that the anti-tumor activity of CDF is in part mediated through deregulation of tumor hypoxic pathways , and thus CDF could become a novel , and effective anti-tumor agent for PC therapy .",
-            "output": "Inducing angiogenesis, Activating invasion and metastasis"
-        },
-        {
-            "input": "The ATM/ATR DNA damage checkpoint functions in the maintenance of genetic stability and some missense variants of the ATM gene have been shown to confer a moderate increased risk of prostate cancer .\n\nHowever , whether inactivation of this checkpoint contributes directly to prostate specific cancer predisposition is still unknown .\n\nHere , we show that exposure of non-malignant prostate epithelial cells ( HPr-1AR ) to androgen led to activation of the ATM/ATR DNA damage response and induction of cellular senescence .\n\nNotably , knockdown of the ATM gene expression in HPr-1AR cells can promote androgen-induced TMPRSS2 : ERG rearrangement , a prostate-specific chromosome translocation frequently found in prostate cancer cells .\n\nIntriguingly , unlike the non-malignant prostate epithelial cells , the ATM/ATR DNA damage checkpoint appears to be defective in prostate cancer cells , since androgen treatment only induced a partial activation of the DNA damage response .\n\nThis mechanism appears to preserve androgen induced autophosphorylation of ATM and phosphorylation of H2AX , lesion processing and repair pathway yet restrain ATM/CHK1/CHK2 and p53 signaling pathway .\n\nOur findings demonstrate that ATM/ATR inactivation is a crucial step in promoting androgen-induced genomic instability and prostate carcinogenesis .",
-            "output": "Genomic instability and mutation, Enabling replicative immortality"
-        },
-        {
-            "input": "Human CD93 , an epidermal growth factor ( EGF)-like domain containing transmembrane protein , is predominantly expressed in the vascular endothelium .\n\nStudies have shown that AA4 , the homolog of CD93 in mice , may mediate cell migration and angiogenesis in endothelial cells .\n\nSoluble CD93 has been detected in the plasma of healthy individuals .\n\nHowever , the role of soluble CD93 in the endothelium remains unclear .\n\nRecombinant soluble CD93 proteins with EGF-like domains ( rCD93D123 , with domains 1 , 2 , and 3 ; and rCD93D23 , with domains 2 and 3 ) were generated to determine their functions in angiogenesis .\n\nWe found that rCD93D23 was more potent than rCD93D123 in stimulating the proliferation and migration of human umbilical vein endothelial cells ( HUVECs ) .\n\nProduction of matrix-metalloproteinase 2 increased after the HUVECs were treated with rCD93D23 .\n\nFurther , in a tube formation assay , rCD93D23 induced cell differentiation of HUVECs through phosphoinositide 3-kinase/Akt/endothelial nitric oxide synthase and extracellular signal-regulated kinases-1/2 signaling .\n\nMoreover , rCD93D23 promoted blood vessel formation in a Matrigel-plug assay and an oxygen-induced retinopathy model in vivo .\n\nOur findings suggest that the soluble EGF-like domain containing CD93 protein is a novel angiogenic factor acting on the endothelium .",
-            "output": "Inducing angiogenesis"
-        },
-        {
-            "input": "Prostate cancer is the most frequent and second most lethal cancer in men in the United States .\n\nInnate immunity and inflammation may increase the risk of prostate cancer .\n\nTo determine the role of innate immunity and inflammation in advanced prostate cancer , we investigated the association of 320 single nucleotide polymorphisms , located in 46 genes involved in this pathway , with disease risk using 494 cases with advanced disease and 536 controls from Cleveland , Ohio .\n\nTaken together , the whole pathway was associated with advanced prostate cancer risk ( P\u200a=\u200a0.02 ) .\n\nTwo sub-pathways ( intracellular antiviral molecules and extracellular pattern recognition ) and four genes in these sub-pathways ( TLR1 , TLR6 , OAS1 , and OAS2 ) were nominally associated with advanced prostate cancer risk and harbor several SNPs nominally associated with advanced prostate cancer risk .\n\nOur results suggest that the innate immunity and inflammation pathway may play a modest role in the etiology of advanced prostate cancer through multiple small effects .",
-            "output": "Tumor promoting inflammation"
-        },
-        {
-            "input": "Ulcerative colitis ( UC ) is a major form of chronic inflammation that can frequently progress to colon cancer .\n\nSeveral studies have demonstrated massive infiltration of neutrophils and macrophages into the lamina propria and submucosa in the progression of UC-associated colon carcinogenesis .\n\nMacrophages contribute to the development of colitis-associated colon cancer ( CAC ) .\n\nHowever , the role of neutrophils is not well understood .\n\nTo better understand the involvement of tumor-associated neutrophils ( TANs ) in the regulation of CAC , we used a mouse CAC model produced by administering azoxymethane ( AOM ) , followed by repeated dextran sulfate sodium ( DSS ) ingestion .\n\nThis causes severe colonic inflammation and subsequent development of multiple tumors in mice colon .\n\nWe observed that colorectal mucosal inflammation became increasingly severe with AOM and DSS treatment .\n\nMacrophages infiltrated the lamina propria and submucosa , together with a marked increase in neutrophil infiltration .\n\nThe chemokine CXCL2 increased in the lamina propria and submucosal regions of the colons of the treated mice , together with the infiltration of neutrophils expressing CXCR2 , a specific receptor for CXCL2 .\n\nThis process was followed by neoplastic transformation .\n\nAfter AOM and DSS treatment , the mice showed enhanced production of metalloproteinase ( MMP)-9 and neutrophil elastase ( NE ) , accompanied by excessive vessel generation and cell proliferation .\n\nMoreover , CXCL2 promoted neutrophil recruitment and induced neutrophils to express MMP-9 and NE in vitro .\n\nFurthermore , administration of neutrophil-neutralizing antibodies after the last DSS cycle markedly reduced the number and size of tumors and decreased the expression of CXCR2 , CXCL2 , MMP-9 , and NE .\n\nThese observations indicate a crucial role for TANs in the initiation and progression of CAC and suggest that the CXCL2-CXCR2 axis might be useful in reducing the risk of UC-associated colon cancer .",
-            "output": "Inducing angiogenesis, Tumor promoting inflammation"
-        },
-        {
-            "input": "Cellular senescence is considered as a tumor suppressive mechanism .\n\nRecent evidence indicates however that senescent cells secrete various growth factors and cytokines , some of which may paradoxically promote cancer progression .\n\nThis phenomenon termed senescence-associated secretory phenotype ( SASP ) must be inhibited in order for anti-proliferative agents to be effective .\n\nThe present study was designed to determine whether the \u03b2-catenin destruction complex ( BCDC ) , known to integrate the action of various growth factors and cytokines , would represent a suitable target to inhibit the activity of SASP components .\n\nFor this , we carried out experiments to determine the effect of drug-induced senescence on secretion of SASP , \u03b2-catenin transactivation , and the relationship between these processes .\n\nMoreover , genetic and pharmacological approaches were used to define the implication of BCDC in mediating the effects of SASP components on cell migration and resistance to drugs .\n\nThe findings indicate that drug-induced senescence was associated with expression of various Wnt ligands in addition to previously known SASP components .\n\nBeta catenin transactivation and expression of genes implicated in epithelial-mesenchymal transition ( EMT ) also increased in response to drug-induced SASP .\n\nThese effects were prevented by Pyrvinium , a recently described activator of BCDC .\n\nPyrvinium also suppressed the effects of SASP on cell migration and resistance to doxorubicin .\n\nTogether , these findings provide insights on the potential role of BCDC in mediating the effects of drug-induced SASP on cancer cell invasion and resistance to therapy , and suggest that targeting this pathway may represent an effective approach to enhance the activity of current and prospective anti-cancer therapeutics .",
-            "output": "Enabling replicative immortality, Activating invasion and metastasis"
-        },
-        {
-            "input": "Loss of p53 is considered to allow progression of colorectal tumors from the adenoma to the carcinoma stage .\n\nUsing mice with an intestinal epithelial cell ( IEC)-specific p53 deletion , we demonstrate that loss ofp53 alone is insufficient to initiate intestinal tumorigenesis but markedly enhances carcinogen-induced tumor incidence and leads to invasive cancer and lymph node metastasis .\n\nWhereas p53 controls DNA damage and IEC survival during the initiation stage , loss of p53 during tumor progression is associated with increased intestinal permeability , causing formation of an NF-\u03baB-dependent inflammatory microenvironment and the induction of epithelial-mesenchymal transition .\n\nThus , we propose a p53-controlled tumor-suppressive function that is independent of its well-established role in cell-cycle regulation , apoptosis , and senescence .",
-            "output": "Enabling replicative immortality, Activating invasion and metastasis, Evading growth suppressors, Tumor promoting inflammation, Resisting cell death"
-        },
-        {
-            "input": "Binding within or nearby target genes involved in cell proliferation and survival enables the p53 tumor suppressor gene to regulate their transcription and cell-cycle progression .\n\nUsing genome-wide chromatin-binding profiles , we describe binding of p53 also to regions located distantly from any known p53 target gene .\n\nInterestingly , many of these regions possess conserved p53-binding sites and all known hallmarks of enhancer regions .\n\nWe demonstrate that these p53-bound enhancer regions ( p53BERs ) indeed contain enhancer activity and interact intrachromosomally with multiple neighboring genes to convey long-distance p53-dependent transcription regulation .\n\nFurthermore , p53BERs produce , ina p53-dependent manner , enhancer RNAs ( eRNAs ) that are required for efficient transcriptional enhancement of interacting target genes and induction of a p53-dependent cell-cycle arrest .\n\nThus , our results ascribe transcription enhancement activity to p53 with the capacity to regulate multiple genes from a single genomic binding site .\n\nMoreover , eRNA production from p53BERs is required for efficient p53 transcription enhancement .",
-            "output": "Evading growth suppressors"
-        },
-        {
-            "input": "Jaceosidin , a flavonoid derived from Artemisia princeps ( Japanese mugwort ) , has been shown to inhibit the growth of several human cancer cells , However , the exact mechanism for the cytotoxic effect of jaceosidin is not completely understood .\n\nIn this study , we investigated the molecular mechanism involved in the antiproliferative effect of jaceosidin in human endometrial cancer cells .\n\nWe demonstrated that jaceosidin is a more potent inhibitor of cell growth than cisplatin in human endometrial cancer cells .\n\nIn contrast , jaceosidin-induced cytotoxicity in normal endometrial cells was lower than that observed for cisplatin .\n\nJaceosidin induced G2/M phase cell cycle arrest and modulated the levels of cyclin B and p-Cdc2 in Hec1A cells .\n\nKnockdown of p21 using specific siRNAs partially abrogated jaceosidin-induced cell growth inhibition .\n\nAdditional mechanistic studies revealed that jaceosidin treatment resulted in an increase in phosphorylation of Cdc25C and ATM-Chk1/2 .\n\nKu55933 , an ATM inhibitor , reversed jaceosidin-induced cell growth inhibition , in part .\n\nMoreover , jaceosidin treatment resulted in phosphorylation of ERK , and pretreatment with the ERK inhibitor , PD98059 , attenuated cell growth inhibition by jaceosidin .\n\nThese data suggest that jaceosidin , isolated from Japanese mugwort , modulates the ERK/ATM/Chk1/2 pathway , leading to inactivation of the Cdc2-cyclin B1 complex , followed by G2/M cell cycle arrest in endometrial cancer cells .",
-            "output": "Sustaining proliferative signaling"
-        },
-        {
-            "input": "AMPK is a metabolic sensor that helps maintain cellular energy homeostasis .\n\nDespite evidence linking AMPK with tumor suppressor functions , the role of AMPK in tumorigenesis and tumor metabolism isunknown .\n\nHere we show that AMPK negatively regulates aerobic glycolysis ( the Warburg effect ) in cancer cells and suppresses tumor growth invivo .\n\nGenetic ablation of the \\u03b11 catalytic subunit of AMPK accelerates Myc-induced lymphomagenesis .\n\nInactivation of AMPK\\u03b1 in both transformed and nontransformed cells promotes a metabolic shift to aerobic glycolysis , increased allocation of glucose carbon into lipids , and biomass accumulation .\n\nThese metabolic effects require normoxic stabilization of the hypoxia-inducible factor-1\\u03b1 ( HIF-1\\u03b1 ) , as silencing HIF-1\\u03b1 reverses the shift to aerobic glycolysis and the biosynthetic and proliferative advantages conferred by reduced AMPK\\u03b1 signaling .\n\nTogether our findings suggest that AMPK activity opposes tumor development and that its loss fosters tumor progression in part by regulating cellular metabolic pathways that support cell growth and proliferation .",
-            "output": "Cellular energetics"
-        },
-        {
-            "input": "Indolylmaleimides display a broad spectrum of biological activity and offer great opportunity to influence several aspects of cell fate , as proliferation and differentiation .\n\nIn this study we describe the effect of PDA-66 , a newly synthesised indolylmaleimide , showing a strong dose dependent anti-proliferative effect on immortalised human progenitor and cancer cells .\n\nWe demonstrated a highly depolymerizing effect on in vitro tubulin assembly and conclude that PDA-66 acts as microtubule destabilising agent .\n\nIn addition we found that PDA-66 induces mitotic arrest of cells in the G(2)/M phase of the cell cycle .\n\nSubsequently cells undergo apoptosis , indicating the major mechanism of the anti-proliferative effect .\n\nTo prove a potential anti-cancer activity of PDA-66 we examined the effect of PDA-66 on human SH-SY5Y neuroblastoma and A-459 lung cancer cells , showing a significant reduction in cancer cell proliferation in a dose dependent manner .\n\nThus PDA-66 is a new anti-mitotic compound with an indole-core with the potential to be used for cancer therapy .",
-            "output": "Sustaining proliferative signaling, Evading growth suppressors, Resisting cell death"
-        },
-        {
-            "input": "In human epithelial cancers , the microRNA ( miRNA ) mir-30d is amplified with high frequency and serves as a critical oncomir by regulating metastasis , apoptosis , proliferation , and differentiation .\n\nAutophagy , a degradation pathway for long-lived protein and organelles , regulates the survival and death of many cell types .\n\nIncreasing evidence suggests that autophagy plays an important function in epithelial tumor initiation and progression .\n\nUsing a combined bioinformatics approach , gene set enrichment analysis and miRNA target prediction , we found that mir-30d might regulate multiple genes in the autophagy pathway including BECN1 , BNIP3L , ATG12 , ATG5 , ATG2 .\n\nOur further functional experiments demonstrated that the expression of these core proteins in the autophagy pathway was directly suppressed by mir-30d in cancer cells .\n\nFinally , we showed that mir-30d regulated the autophagy process by inhibiting autophagosome formation and LC3B-I conversion to LC3B-II .\n\nTaken together , our results provide evidence that the oncomir mir-30d impairs the autophagy process by targeting multiple genes in the autophagy pathway .\n\nThis result will contribute to understanding the molecular mechanism of mir-30d in tumorigenesis and developing novel cancer therapy strategy .",
-            "output": "Resisting cell death"
-        },
-        {
-            "input": "Compound C , a well-known inhibitor of the intracellular energy sensor AMP-activated protein kinase ( AMPK ) , has been reported to cause apoptotic cell death in myeloma , breast cancer cells and glioma cells .\n\nIn this study , we have demonstrated that compound C not only induced autophagy in all tested skin cancer cell lines but also caused more apoptosis in p53 wildtype skin cancer cells than in p53-mutant skin cancer cells .\n\nCompound C can induce upregulation , phosphorylation and nuclear translocalization of the p53 protein and upregulate expression of p53 target genes in wildtype p53-expressing skin basal cell carcinoma ( BCC ) cells .\n\nThe changes of p53 status were dependent on DNA damage which was caused by compound C induced reactive oxygen species ( ROS ) generation and associated with activated ataxia-telangiectasia mutated ( ATM ) protein .\n\nUsing the wildtype p53-expressing BCC cells versus stable p53-knockdown BCC sublines , we present evidence that p53-knockdown cancer cells were much less sensitive to compound C treatment with significant G2/M cell cycle arrest and attenuated the compound C-induced apoptosis but not autophagy .\n\nThe compound C induced G2/M arrest in p53-knockdown BCC cells was associated with the sustained inactive Tyr15 phosphor-Cdc2 expression .\n\nOverall , our results established that compound C-induced apoptosis in skin cancer cells was dependent on the cell's p53 status .",
-            "output": "Genomic instability and mutation, Sustaining proliferative signaling, Evading growth suppressors, Tumor promoting inflammation, Resisting cell death"
-        },
-        {
-            "input": "Bisphenol A ( BPA ) is one of the most prevalent chemicals in daily-use materials , therefore , human exposure to BPA is ubiquitous .\n\nWe found that low concentrations of BPA stimulate the spermatogonial GC-1 cells proliferation by G protein-coupled receptor 30 ( GPR30)-mediated epidermal growth factor receptor ( EGFR)-extracellular regulated kinase ( ERK)-c-Fos pathway .\n\nHowever , through the same pathway GPR30 expression has been shown to be induced by EGF , an EGFR ligand .\n\nThus , we want to know if low concentrations of BPA are able to induce the GPR30 expression and the possible mechanism(s) in GC-1 cells .\n\nBy transient transfection with expression plasmids , 10(-9)M BPA significantly transactivates the Gpr30-5'-flanking region through activating the GPR30 , cGMP-dependent protein kinase ( PKG ) , estrogen receptor-\u03b1 ( ER-\u03b1 ) , and EFGR-ERK pathways .\n\nFurthermore , an activator protein-1 ( AP-1 ) site located within this region is found to be responsible for the transactivation of BPA .\n\nExpectedly , through the same pathways , BPA significantly induces the gene and protein expression of GPR30. c-Fos is further observed to be strongly recruited to the AP-1 site in a chromatin immunoprecipitation assay and its dysfunction on the AP-1 site markedly suppresses the expression of GPR30 , p-ERK1/2 , p-Ser118-ER-\u03b1 and cell proliferation by BPA .\n\nOur results demonstrate that a low-concentration BPA induces GPR30 expression through the GPR30-EFGR-ERK-c-Fos , ER-\u03b1 , and PKG pathways , presumably boosting the cells proliferation via a regulatory loop .\n\nThe present study provides a novel insight into the potential role of GPR30 in the initiation and progression of male germ cell cancer induced by environmentally relevant BPA .",
-            "output": "Sustaining proliferative signaling"
-        },
-        {
-            "input": "Nitric oxide ( NO)-releasing non-steroidal anti-inflammatory drugs ( NO-NSAIDs ) which have been synthesized to reduce gastro-intestinal and cardiovascular toxicities of NSAIDs , possess anti-proliferative , pro-apoptotic and anti-cancer activities .\n\nHere , we show that NO-sulindac inhibited UVB-induced skin tumorigenesis in SKH-1 hairless mice .\n\nTopical application of NO-sulindac reduced tumor incidence , number ( p<0.05 ) and volume ( p<0.005 ) as compared to UVB ( alone)-irradiated vehicle-treated mice .\n\nAn increase in TUNEL-positive cells in skin lesions was accompanied by the enhanced Bax:Bcl-2 ratio .\n\nThe expression of pro-apoptotic Bax was increased whereas anti-apoptotic Bcl-2 reduced .\n\nHowever , proliferation was identified as the major target of NO-sulindac in this study .\n\nA reduced expression of PCNA and cyclin D1 associated with the dampening of cell cycle progression was observed .\n\nThe mechanism of this inhibition was related to the reduction in UVB-induced Notch signaling pathway .\n\nUVB-induced inflammatory responses were diminished by NO-sulindac as observed by a remarkable reduction in the levels of phosphorylated MAP Kinases Erk1/2 , p38 and JNK1/2 .\n\nIn this regard , NO-sulindac also inhibited NF\u03baB by enhancing I\u03baB\u03b1 as evidenced by the reduced expression of iNOS and COX-2 , the direct NF\u03baB transcription target proteins .\n\nNO-sulindac significantly diminished the progression of benign lesions to invasive carcinomas by suppressing the tumor aggressiveness and retarding epithelial-mesenchymal transition .\n\nA marked decrease in the expression of mesenchymal markers such as Fibronectin , N-cadherin , SNAI , Slug and Twist and an increase in epithelial cell polarity marker E-cadherin were noted in NO-sulindac-treated tumors .\n\nOur data suggest that NO-sulindac is a potent inhibitor of UVB-induced skin carcinogenesis and acts by targeting proliferation-regulatory pathways .",
-            "output": "Activating invasion and metastasis, Tumor promoting inflammation, Sustaining proliferative signaling, Resisting cell death"
-        },
-        {
-            "input": "Breast cancer is the second most common cancer with a high incidence rate worldwide .\n\nOne of the promising therapeutic approaches on breast cancer is to use the drugs that target the estrogen receptor ( ER ) .\n\nIn the present investigation , marmorin , a type I ribosome inactivating protein from the mushroom Hypsizigus marmoreus , inhibited the survival of breast cancer in vitro and in vivo .\n\nIt evinced more potent cytotoxicity toward estrogen receptor ( ER)-positive MCF7 breast cancer cells than ER-negative MDA-MB-231 cells .\n\nFurther study disclosed that marmorin undermined the expression level of estrogen receptor \u03b1 ( ER\u03b1 ) and significantly inhibited the proliferation of MCF7 cells induced by 17\u03b2-estradiol .\n\nKnockdown of ER\u03b1 in MCF7 cells significantly attenuated the inhibitory effect of marmorin on proliferation , suggesting that the ER\u03b1-mediated pathway was implicated in the suppressive action of marmorin on ER-positive breast cancer cells .\n\nMoreover , marmorin induced time-dependent apoptosis in both MCF7 and MDA-MB-231 cells .\n\nIt brought about G2/M-phase arrest , mitochondrial membrane potential depolarization and caspase-9 activation in MCF7 cells , and to a lesser extent in MDA-MB-231 cells .\n\nMarmorin triggered the death receptor apoptotic pathway ( e.g. caspase-8 activation ) and endoplasmic reticulum stress ( ERS , as evidenced by phosphorylation of PERK and IRE1\u03b1 , cleavage of caspase-12 , and up-regulation of CHOP expression ) in both MCF7 and MDA-MB-231 cells .\n\nIn summary , marmorin exhibited inhibitory effect on breast cancer partially via diminution of ER\u03b1 and apoptotic pathways mediated by mitochondrial , death receptor and ERS .\n\nThe results advocate that marmorin is a potential candidate for breast cancer therapy .",
-            "output": "Sustaining proliferative signaling, Resisting cell death"
-        },
-        {
-            "input": "A new line of human ovarian serous adenocarcinoma cells , TU-OS-4 , was established and characterized .\n\nThe cells showed a short , spindle-shaped morphology and grew in monolayers without contact inhibition while forming an arrangement resembling a jigsaw puzzle .\n\nChromosome numbers ranged from 55 to 73 .\n\nThe proliferation rate was lower than other serous adenocarcinoma cell lines tested ( KF , SHIN-3 , and SK-OV-3 ) , and the doubling time was 53.3 h .\n\nWestern blot analysis showed that TU-OS-4 cells overexpressed epidermal growth factor receptor , human epidermal growth factor receptor ( HER ) 2 , and phosphorylated HER2 protein .\n\nThe IC(50) values to cisplatin , paclitaxel , and lapatinib were 25.8 \\u03bcM , 686 nM , and 183 nM , respectively .\n\nHeterotransplantation in nude mice reflected the original tumor of the cells .\n\nThese results suggested that this cell line would be useful to study chemoresistant mechanisms and contribute to establishing novel treatment strategies for patients with ovarian cancer .",
-            "output": "Sustaining proliferative signaling, Evading growth suppressors"
-        },
-        {
-            "input": "N-Ras is one member of a family of oncoproteins that are commonly mutated in cancer .\n\nActivating mutations in N-Ras occur in a subset of colorectal cancers , but little in known about how the mutant protein contributes to onset and progression of the disease .\n\nUsing genetically engineered mice , we find that mutant N-Ras strongly promotes tumorigenesis in the context of inflammation .\n\nThe pro-tumorigenic nature of mutant N-Ras is related to its anti-apoptotic function , which is mediated by activation of a non-canonical MAPK pathway that signals through Stat3 .\n\nAs a result , inhibition of MEK selectively induces apoptosis in autochthonous colonic tumors expressing mutant N-Ras .\n\nThe translational significance of this finding is highlighted by our observation that NRAS mutation correlates with a less favorable clinical outcome for colorectal cancer patients .\n\nThese data demonstrate for the first time the important role that N-Ras plays in colorectal cancer .",
-            "output": "Genomic instability and mutation, Resisting cell death"
-        },
-        {
-            "input": "Cells undergoing malignant transformation often exhibit a shift in cellular metabolism from oxidative phosphorylation to glycolysis .\n\nThis glycolytic shift , called the Warburg effect , provides a mechanistic basis for targeting glycolysis to suppress carcinogenesis through the use of dietary caloric restriction and energy restriction-mimetic agents ( ERMA ) .\n\nWe recently reported the development of a novel class of ERMAs that exhibits high potency in eliciting starvation-associated cellular responses and epigenetic changes in cancer cells though glucose uptake inhibition .\n\nThe lead ERMA in this class , OSU-CG5 , decreases the production of ATP and NADH in LNCaP prostate cancer cells .\n\nIn this study , we examined the effect of OSU-CG5 on the severity of preneoplastic lesions in male transgenic adenocarcinoma of the mouse prostate ( TRAMP ) mice .\n\nDaily oral treatment with OSU-CG5 at 100 mg/kg from 6 to 10 weeks of age resulted in a statistically significant decrease in the weight of urogenital tract and microdissected dorsal , lateral , and anterior prostatic lobes relative to vehicle controls .\n\nThe suppressive effect of OSU-CG5 was evidenced by marked decreases in Ki67 immunostaining and proliferating cell nuclear antigen ( PCNA ) expression in the prostate .\n\nOSU-CG5 treatment was not associated with evidence of systemic toxicity .\n\nMicroarray analysis indicated a central role for Akt , and Western blot analysis showed reduced phosphorylation and/or expression levels of Akt , Src , androgen receptor , and insulin-like growth factor-1 receptor in prostate lobes .\n\nThese findings support further investigation of OSU-CG5 as a potential chemopreventive agent .",
-            "output": "Sustaining proliferative signaling"
-        },
-        {
-            "input": "It is well established that hyperplasia and decreased apoptosis of airway smooth muscle cells ( ASMCs ) play an important role in the asthmatic airway remodeling .\n\nTumor suppressor PTEN gene with phosphatase activity plays an important regulatory role in embryonic development , cell proliferation , and apoptosis , cell cycle regulation , migration ( invasion ) of the cytoskeleton .\n\nWe hypotheses that PTEN gene could affect the growth and viability of ASMCs through the regulation of PI3K/Akt , MAPK , and cell cycle-related gene expression .\n\nWe constructed a recombinant adenovirus to transfect ASMCs .\n\nCells were divided into the overexpression of PTEN gene group ( Ad-PTEN-GFP ) , negative control group ( Ad-GFP ) , and blank control group ( DMEM ) .\n\nThe cell apoptosis of ASMCs were evaluated by Hoechst-33342 staining and PE-7AAD double-labeled flow cytometry .\n\nThe cell cycle distribution was observed by flow cytometry with PI staining .\n\nThe expression of PTEN , p-Akt , total-Akt , p-ERK1/2 , total-ERK1/2 , cleaved-Caspases-3 , Caspases-9 , p21 , and Cyclin D1 were tested by the Western blotting .\n\nOur study revealed that overexpression of PTEN gene did not induce apoptosis of human ASMCs cultured in vitro .\n\nHowever , overexpression of PTEN inhibited proliferation of human ASMCs cultured in vitro and was associated with downregulation of Akt phosphorylation levels , while did not affect ERK1/2 phosphorylation levels .\n\nMoreover , overexpression of PTEN could induce ASMCs arrested in the G0/G1 phase through the downregulation of Cyclin D1 and upregulation of p21 expressions .",
-            "output": "Sustaining proliferative signaling, Evading growth suppressors, Resisting cell death"
-        },
-        {
-            "input": "Platinum compounds are the foundation of chemotherapy regimens for non-small cell lung cancer ( NSCLC ) despite poor response rates and limited response duration .\n\nIt has been reported that tumor expression of ERCC1 , a key component in nucleotide excision repair , may correlate with clinical response to platinum agents .\n\nWe found that most primary lung tumor specimens demonstrated a stronger protein expression of poly ( ADP ribose ) polymerases 1 ( PARP1 ) than their normal counterparts .\n\nWe therefore hypothesized that combining PARP inhibition with platinum compounds may be an approach to improve platinum-based therapy for NSCLC .\n\nDrug combination experiments revealed that two distinct PARP inhibitors , olaparib and veliparib not only potentiated the cell killing by cisplatin but also conferred cytotoxicity as a single agent specifically in ERCC1-low HCC827 and PC9 but not in ERCC1-high A549 and H157 lung cancer cells .\n\nMoreover , siRNA knockdown of ERCC1 in A549 and H157 cells increased their sensitivities to both cisplatin and olaparib in a synergistic manner in our model .\n\nFurthermore , mechanistic studies indicated that combined PARP inhibitor and cisplatin could lead to sustained DNA double strand breaks , prolonged G2/M cell cycle arrest with distinct activation of checkpoint kinase 1 signaling , and more pronounced apoptosis preferentially in lung cancer cells with low ERCC1 expression .\n\nCollectively , these data suggest that there is a synergistic relationship between PARP inhibition and low ERCC1 expression in NSCLC that could be exploited for novel therapeutic approaches in lung cancer therapy based on tumor ERCC1 expression .",
-            "output": "Genomic instability and mutation, Evading growth suppressors, Resisting cell death"
-        },
-        {
-            "input": "In the present study , the question was addressed whether anthocyanins interfere with the topoisomerase I poison irinotecan in vivo .\n\nIn vivo complexes of enzyme to DNA bioassay was used to detect irinotecan-induced stabilization of topoisomerase I/DNA complexes and single cell gel electrophoresis to determine DNA-strand-break induction in the colon of male Wistar rats .\n\nFurthermore , analysis of anthocyanin concentrations in rat plasma and rat colon was included in the testing , demonstrating that anthocyanins reach the colon and the concentrations do not differ between rats that only received anthocyanins and the anthocyanin/irinotecan group .\n\nBlackberry extract was found to significantly reduce irinotecan-mediated topoisomerase I/DNA cleavable complex formation .\n\nOverall , anthocyanins did not notably increase cleavable complex formation .\n\nHowever , a significant increase of DNA damage was shown after a single dose of irinotecan as well as the single compounds cyanidin ( cy ) and cyanidin-3-glucoside ( cy-3-g ) .\n\nFurthermore , a significant reduction of irinotecan-induced DNA-strand breaks after a pretreatment with cy , cy-3-g and blackberry extract was observed .\n\nThus , the question arises whether anthocyanin-rich preparations might interfere with chemotherapy or whether , due to low systemic bioavailability , the preparations might provide protective potential in the gastrointestinal tract .",
-            "output": "Genomic instability and mutation"
-        },
-        {
-            "input": "Peroxisome proliferator activated receptor \u03b3 ( PPAR\u03b3 ) , a subgroup of ligand-activated nuclear receptors , plays critical roles in cell cycle regulation , differentiation , apoptosis and invasion .\n\nPPAR\u03b3 is involved in tumorigenesis and is a potent target for cancer therapy .\n\nPPAR\u03b3 transactivation of KLF4 has been demonstrated in various studies ; however , how PPAR\u03b3 regulates KLF4 expression is not clear .\n\nIn this study , we revealed that PPAR\u03b3 regulates the expression of KLF4 by binding directly to the PPAR response element ( PPRE ) within the KLF4 promoter .\n\nThe PPRE resided at -1657bp to -1669bp upstream of the KLF4 ATG codon , which is essential for the transactivation of TGZ-induced KLF4 expression .\n\nFurthermore , we found that stable silencing of KLF4 obviously suppressed the G1/S arrest and anti-proliferation effects induced by PPAR\u03b3 ligands .\n\nTaken together , our data indicated that upregulating KLF4 upon PPAR\u03b3 activation is mediated through PPRE in KLF4 promoter , thus providing further insights into PPAR\u03b3 signal transduction pathway as well as a novel cancer therapeutic strategy .",
-            "output": "Sustaining proliferative signaling, Evading growth suppressors"
-        },
-        {
-            "input": "Splenic haemangiosarcomas ( HSAs ) from 122 dogs were characterized and classified according to their patterns of growth , survival time post splenectomy , metastases and chemotherapy .\n\nThe most common pattern of growth was a mixture of cavernous , capillary and solid tumour tissue .\n\nSurvival time post splenectomy was independent of the growth pattern ; however , it was influenced by chemotherapy and metastases .\n\nImmunohistochemical assessment of the expression of angiogenic factors ( fetal liver kinase-1 , angiopoietin-2 , angiopoietin receptor-2 and vascular endothelial growth factor A ) and conventional endothelial markers ( CD31 , factor VIII-related antigen ) revealed variable expression , particularly in undifferentiated HSAs .\n\nTherefore , a combination of endothelial markers should be used to confirm the endothelial origin of splenic tumours .",
-            "output": "Inducing angiogenesis, Activating invasion and metastasis"
-        },
-        {
-            "input": "Bladder cancer ( BCa ) remained a major health problem .\n\nMed19 was related to tumor growth of BCa .\n\nBone morphogenetic proteins ( BMPs ) were reported to be critical in bone metastasis of cancer .\n\nWe therefore investigated the relations between Med19 and BMPs in BCa and their effect on bone metastasis of BCa .\n\nBladder cancer cell lines were cultured and interfered with Med19 shRNA and control .\n\nExpressions of BMP-1 , BMP-2 , BMP-4 , BMP-5 , BMP-6 , BMP-7 , BMP-9 , and BMP-15 were studied between 2 groups .\n\nFifty-two BCa samples were included for immunohistochemical staining of Med19 and BMP-2 .\n\nExpressions were scored and studied statistically .\n\nInvasiveness was studied with Transwell assay .\n\nSilencing or Med19 in BCa cells induced altered expressions of BMPs .\n\nIncreased expressions of BMP-1 , BMP-4 , BMP-6 , BMP-7 , and BMP-15 and decreased expressions of BMP-2 , BMP-5 , and BMP-9 were noticed , but only BMP-2 reached statistical significance .\n\nExpressions of Med19 and BMP-2 were significantly higher in cases with bone metastasis and were positively correlated in cases with bone metastasis and muscle invasion .\n\nMed19 is a critical factor involved in the invasiveness and promotion of bone metastasis of BCa , possibly via BMP-2 .",
-            "output": "Activating invasion and metastasis"
-        },
-        {
-            "input": "Nectin-like molucule-5 ( Necl-5 ) is an immunoglobulin-like molecule that was originally identified as a poliovirus receptor and is often upregulated in cancer cells .\n\nIt has been said that Necl-5 plays a role in not only cell-cell adhesion , but also cell migration , proliferation , and metastasis .\n\nIn this study , we used a bronchioloalveolar carcinoma ( BAC ) cell line and fibroblasts to assess the expression of Necl-5 in the development of cancer-stroma communication by using an easy-to-prepare double-layered collagen gel hemisphere ( DL- CGH ) system that enables visualization of cell migration during invasion .\n\nThe expression of Necl-5 was higher in BAC cells than in fibroblasts .\n\nThis tendency didn't change even when the BAC cells were mixed with fibroblasts .\n\nTo assess the role of Necl-5 in the invasive activity of the BAC cells , we knocked down its expression using RNA interference ( RNAi ) .\n\nThe invasion assay with DL-CGH revealed that inhibitation of Necl-5 expression in the BAC cells was associated with suppressed invasiveness .\n\nIn addition , Necl-5 knockdown inhibited the movement and proliferation of the BAC cells .\n\nNecl-5 expression in lung cancer cells is crucial for their invasiveness in the cancer-stromal interaction , suggesting that Necl-5 could be a favorable molecular target for the suppression of invasiveness in lung adenocarcinoma .",
-            "output": "Sustaining proliferative signaling, Activating invasion and metastasis"
-        },
-        {
-            "input": "AMP-activated protein kinase ( AMPK ) has been implicated in anti-proliferative actions in a range of cell systems .\n\nRecently , it was observed that Compound C , an inhibitor of AMPK , also reduced the cell viability in human diploid fibroblasts ( HDFs ) .\n\nCompound C-induced growth arrest was associated with a decrease in the cell cycle regulatory proteins , such as proliferating cell nuclear antigen , phosphorylated pRB , cyclin-dependent protein kinases ( Cdk 2 and 4 ) , cyclins ( D and E ) , and the Cdk inhibitors ( p21 , p16 , and p27 ) .\n\nTherefore , the present study examined the molecular mechanism of the antiproliferative effects of Compound C. Although Compound C inhibited serum-induced phosphorylation of Akt and its substrate , glycogen synthase kinase-3\u03b2 , it did not affect the Akt activity in vitro .\n\nCompound C significantly inhibited the receptor tyrosine phosphorylation and the activity of downstream signaling molecules , such as p85 phosphoinositide 3-kinase , phospholipase C-\u03b31 , and extracellular signal-regulated kinase 1/2 , induced by platelet-derived growth factor ( PDGF ) but not by epidermal growth factor- and insulin-like growth factor .\n\nIn vitro growth factor receptor tyrosine kinase activity profiling revealed the IC(50) for PDGF receptor-\u03b2 ( PDGFR\u03b2 ) to be 5.07 \u03bcM , whereas the IC(50) for the epidermal growth factor receptor and insulin-like growth factor receptor was \u2265100 \u03bcM .\n\nThe inhibitory effect of Compound C on PDGFR\u03b2 and Akt was also observed in AMPK\u03b1(1)/\u03b1(2)-knockout mouse embryonic fibroblasts , indicating that its inhibitory effect is independent of the AMPK activity .\n\nThe inhibitory effect of Compound C on cell proliferation and PDGFR\u03b2 tyrosine phosphorylation was also demonstrated in various PDGFR-expressing cells , including MRC-5 , BEAS-2B , rat aortic vascular smooth muscle cells , and A172 glioblastoma cells .\n\nThese results indicate that Compound C can be used as a potential antiproliferative agent for PDGF- or PDGFR-associated diseases , such as cancer , atherosclerosis , and fibrosis .",
-            "output": "Sustaining proliferative signaling"
-        },
-        {
-            "input": "SMG1 is a member of the phosphoinositide kinase-like kinase family of proteins that includes ATM , ATR , and DNA-PK , proteins with known roles in DNA damage and cellular stress responses .\n\nSMG1 has a well-characterized role in nonsense-mediated decay as well as suggested roles in the DNA damage response , resistance to oxidative stress , regulation of hypoxic responses , and apoptosis .\n\nTo understand the roles of SMG1 further , we generated a Genetrap Smg1 mouse model .\n\nSmg1 homozygous KO mice were early embryonic lethal , but Smg1 heterozygous mice showed a predisposition to a range of cancers , particularly lung and hematopoietic malignancies , as well as development of chronic inflammation .\n\nThese mice did not display deficiencies in known roles of SMG1 , including nonsense-mediated decay .\n\nHowever , they showed elevated basal tissue and serum cytokine levels , indicating low-level inflammation before the development of tumors .\n\nSmg1 heterozygous mice also showed evidence of oxidative damage in tissues .\n\nThese data suggest that the inflammation observed in Smg1 haploinsufficiency contributes to susceptibility to cancer and that Smg1-deficient animals represent a model of inflammation-enhanced cancer development .",
-            "output": "Tumor promoting inflammation, Genomic instability and mutation"
-        },
-        {
-            "input": "BACKGROUND O(6) -methylguanine-DNA methyltransferase ( MGMT ) is a DNA repair enzyme that can protect cells from carcinogenic effects of alkylating agents by removing adducts from the O(6) position of guanine .\n\nEvidences indicated that areca quid chewing may increase the risk of oral squamous cell carcinoma ( OSCC ) .\n\nThis study was to investigate the role of MGMT expression in OSCCs and the normal oral tissues .\n\nMETHODS Thirty-two OSCCs from areca quid chewers and ten normal oral tissue biopsy samples without areca quid chewing were analyzed by the immunohistochemistry for MGMT .\n\nPrimary human oral keratinocytes ( HOKs ) were challenged with arecoline , the major alkaloid of areca nut , by Western blot .\n\nNicotine , an important component of cigarette smoke , was added to find the possible regulatory mechanisms .\n\nRESULTS Significant association was observed between low MGMT expression and advanced clinical stage of OSCCs and lymph node metastasis ( P=0.03 ) .\n\nMGMT expression was significantly higher in patients only chewing areca quid than patients both chewing areca quid and smoking ( P=0.028 ) .\n\nArecoline was found to elevate MGMT expression in a dose- and time-dependent manner .\n\nThe addition of nicotine was found to enhance arecoline-induced MGMT expression .\n\nCONCLUSION Our results indicate that MGMT could be used clinically as a predictive marker for tumor processing , the potential for lymph node metastasis as well as advanced clinical stage .\n\nMGMT expression was significantly upregulated by arecoline in HOKs .\n\nNicotine has a synergistic effect of arecoline-induced MGMT expression .\n\nThe cigarette smoking may act synergistically in the pathogenesis of OSCC in areca quid chewers via the upregulation of MGMT .",
-            "output": "Genomic instability and mutation, Activating invasion and metastasis"
-        },
-        {
-            "input": "The ALKBH family of proteins are highly expressed in various types of human cancer where they are involved in tumor growth and progression .\n\nHowever , multiple isoforms of ALKBH exist and the effect of individual isoforms on the development of urinary bladder cancer is unknown , particularly the molecular mechanisms involved in the progression from a noninvasive to invasive phenotype .\n\nWe examined the role and function of ALKBH2 in human bladder cancer development in vitro and provide the first report that suppression of ALKBH2 in a human urothelial carcinoma cell line , KU7 , reduced the expression of the transmembrane mucin protein , MUC1 , and induced G1 cell cycle arrest .\n\nMoreover , reduction of ALKBH2 suppressed epithelial to mesenchymal transition ( EMT ) via increasing E-cadherin and decreasing vimentin expression .\n\nTransfection of MUC1 siRNA inhibited cell proliferation and EMT to the same extent as ALKBH2 gene silencing in vitro .\n\nALKBH2 knockdown significantly suppressed MUC1 expression and tumor volume of bladder cancers in vivo as assessed in an orthotopic mouse model using ALKBH2 shRNA transfected KU7 cells .\n\nImmunohistochemical examination showed high expression levels of ALKBH2 in human urothelial carcinoma samples , especially in high-grade , superficially and deeply invasive carcinomas ( pT(1) and >pT(2) ) , and in carcinoma in situ but not in normal urothelium .\n\nThis study demonstrates that ALKBH2 is an upstream molecule of the oncoprotein , MUC1 , and regulates cell cycle and EMT , resulting in progression of urothelial carcinomas .",
-            "output": "Sustaining proliferative signaling, Evading growth suppressors, Activating invasion and metastasis"
-        },
-        {
-            "input": "Sonodynamic therapy ( SDT ) has shown great potential in target cancer therapy , but it induced cell death modes hasn't been fully investigated .\n\nThis study was to examine autophagic and apoptotic responses to protoporphyrin IX ( PpIX ) mediated SDT in murine leukemia L1210 cells .\n\nAfter SDT , the occurrence of autophagy was identified by morphological observation and biochemical analysis .\n\nMeanwhile , the mitochondria dependent apoptosis pathway was examined to participate in SDT induced cell death .\n\nThe relationship between autophagy and apoptosis was further investigated by applying pharmacological inhibition studies , which indicated that impairment of autophagy enhanced the anti-tumor effect of SDT through induction of apoptosis and necrosis , while caspase inhibition didn't affect autophagic vacuoles formation or protect SDT induced cytotoxicity .\n\nThe findings supported that autophagic vacuoles formed upstream and independently from caspase-dependent cell death .\n\nAdditionally , the possible mechanism of SDT-induced autophagy was evaluated by measurement of ROS ( reactive oxygen species ) formation .\n\nResult suggested ROS play important role in initiating autophagy , possibly through the sono-damaged mitochondria being enclosed by autophagic vacuoles .\n\nAll together , these data indicate that autophagy may be cytoprotective in our experimental system , and point to an important insight into how autophagy inhibitors , in combination with SDT may contribute a regimen for cancer therapy .",
-            "output": "Tumor promoting inflammation, Resisting cell death"
-        },
-        {
-            "input": "The Wnt/\u03b2-catenin pathway regulates the viability and radiosensitivity of head and neck squamous cancer cells ( HNSCC ) .\n\nIncreased \u03b2-catenin predisposes HNSCC patients to poor prognosis and survival .\n\nThis study was conducted to determine the mechanism by which \u03b2-catenin regulates the viability of HNSCC .\n\nAMC-HN-3 , -HN-8 , UM-SCC-38 , and -SCC-47 cells , which were established from human head and neck cancer specimens , underwent cell death following \u03b2-catenin silencing. \u03b2-Catenin silencing significantly induced G1 arrest and increased the expression of Bax and active caspase-3 , which demonstrates the sequential activation of apoptotic cascades following treatment of HNSCC with targeted siRNA .\n\nIntriguingly , \u03b2-catenin silencing also induced autophagy .\n\nHere , we confirm that the number of autophagic vacuoles and the expression of type II light chain 3 were increased in cells that were treated with \u03b2-catenin siRNA .\n\nThese cell death modes are most likely due to the activation of LKB1-dependent AMPK following \u03b2-catenin silencing .\n\nThe activated LKB1/AMPK pathway in AMC-HN-3 cells caused G1 arrest by phosphorylating p53 and suppressing mTOR signaling .\n\nIn addition , treating AMC-HN-3 cells with LKB1 siRNA preserved cell viability against \u03b2-catenin silencing-induced cytotoxicity .\n\nTaken together , these results imply that following \u03b2-catenin silencing , HNSCC undergo both apoptotic and autophagic cell death that are under the control of LKB1/AMPK .\n\nTo the best of our knowledge , these results suggest for the first time that novel crosstalk between \u03b2-catenin and the LKB1/AMPK pathway regulates the viability of HNSCC .\n\nThis study thus presents new insights into our understanding of the cellular and molecular mechanisms involved in \u03b2-catenin silencing-induced cell death .",
-            "output": "Resisting cell death"
-        },
-        {
-            "input": "Colorectal cancer ( CRC ) is one of the leading causes of cancer deaths in Western countries .\n\nA significant number of CRC patients undergoing curatively intended surgery subsequently develop recurrence and die from the disease .\n\nMicroRNAs ( miRNAs ) are aberrantly expressed in cancers and appear to have both diagnostic and prognostic significance .\n\nIn this study , we identified novel miRNAs associated with recurrence of CRC , and their possible mechanism of action .\n\nTaqMan\ufffd Human MicroRNA Array Set v2.0 was used to profile the expression of 667 miRNAs in 14 normal colon mucosas and 46 microsatellite stable CRC tumors .\n\nFour miRNAs ( miR-362-3p , miR-570 , miR-148a* and miR-944 ) were expressed at a higher level in tumors from patients with no recurrence ( p < 0.015 ) , compared to tumors from patients with recurrence .\n\nA significant association with increased disease free survival was confirmed for miR-362-3p in a second independent cohort of 43 CRC patients , using single TaqMan\ufffd microRNA assays .\n\nIn vitro functional analysis showed that over-expression of miR-362-3p in colon cancer cell lines reduced cell viability , and proliferation mainly due to cell cycle arrest .\n\nE2F1 , USF2 and PTPN1 were identified as potential miR-362-3p targets by mRNA profiling of HCT116 cells over-expressing miR-362-3p .\n\nSubsequently , these genes were confirmed as direct targets by Luciferase reporter assays .\n\nTheir knockdown in vitro phenocopied the effects of miR-362-3p over-expression .\n\nWe conclude that miR-362-3p may be a novel prognostic marker in CRC , and hypothesize that the positive effects of augmented miR-362-3p expression may in part be mediated through the targets E2F1 , USF2 and PTPN1. \ufffd 2012 Wiley Periodicals , Inc .",
-            "output": "Sustaining proliferative signaling, Evading growth suppressors"
-        },
-        {
-            "input": "Dichlorvos , an organophosphate ( OP ) , is known to cause oxidative stress in the central nervous system ( CNS ) .\n\nPreviously we have shown that dichlorvos treatment promoted the levels of proinflammatory molecules and ultimately induced apoptotic cell death in primary microglial cells .\n\nHere we studied the effect of dichlorvos on crucial cell cycle regulatory proteins and the DNA damage sensor ataxia-telangiectasia mutated ( ATM ) .\n\nWe found a significant increase in p53 and its downstream target , p21 , levels in dichlorvos-treated microglial cells compared with control cells .\n\nMoreover , dichlorvos exposure promoted the levels of different cell cycle regulatory proteins .\n\nThese results along with flow cytometry results suggested that primary microglial cells were arrested at G1 and G2/M phase after dichlorvos exposure .\n\nWe have shown in a previous study that dichlorvos can induce DNA damage in microglia ; here we found that microglial cells also tried to repair this damage by inducing a DNA repair enzyme , i.e. , ATM .\n\nWe observed a significant increase in the levels of ATM after dichlorvos treatment compared with control .",
-            "output": "Evading growth suppressors"
-        },
-        {
-            "input": "Growth differentiation factor-15 ( GDF-15 ) and the CCN family member , connective tissue growth factor ( CCN2 ) , are associated with cardiac disease , inflammation and cancer .\n\nThe precise role and signaling mechanism for these factors in normal and diseased tissues remains elusive .\n\nHere we demonstrate an interaction between GDF-15 and CCN2 using yeast two-hybrid assays and have mapped the domain of interaction to the von Willebrand factor type C domain of CCN2 .\n\nBiochemical pull down assays using secreted GDF-15 and His-tagged CCN2 produced in PC-3 prostate cancer cells confirmed a direct interaction between these proteins .\n\nTo investigate the functional consequences of this interaction , in vitro angiogenesis assays were performed .\n\nWe demonstrate that GDF-15 blocks CCN2-mediated tube formation in human umbilical vein endothelial ( HUVEC ) cells .\n\nTo examine the molecular mechanism whereby GDF-15 inhibits CCN2-mediated angiogenesis , activation of \u03b1(V) \u03b2(3) integrins and focal adhesion kinase ( FAK ) was examined .\n\nCCN2-mediated FAK activation was inhibited by GDF-15 and was accompanied by a decrease in \u03b1(V) \u03b2(3) integrin clustering in HUVEC cells .\n\nThese results demonstrate , for the first time , a novel signaling pathway for GDF-15 through interaction with the matricellular signaling molecule CCN2 .\n\nFurthermore , antagonism of CCN2 mediated angiogenesis by GDF-15 may provide insight into the functional role of GDF-15 in disease states .\n\nJ. Cell .\n\nBiochem. \ufffd 2012 Wiley Periodicals , Inc .",
-            "output": "Inducing angiogenesis"
-        },
-        {
-            "input": "MD-Fraction is a highly purified soluble \u03b2-glucan derived from Grifola frondosa ( an oriental edible mushroom ) .\n\nIntraperitoneal ( i.p. ) injection of MD-Fraction has been reported to inhibit tumor growth via enhancement of the host immune system .\n\nIn this study , we demonstrated that oral administration of MD-Fraction as well as i.p. injection significantly inhibited tumor growth in murine tumor models .\n\nAfter oral administration , MD-Fraction was not transferred to the blood in its free form but was captured by antigen-presenting cells such as macrophages and dendritic cells ( DCs ) present in the Peyer's patch .\n\nThe captured MD-Fraction was then transported to the spleen , thereby inducing the systemic immune response .\n\nOur study showed that MD-Fraction directly induced DC maturation via a C-type lectin receptor dectin-1 pathway .\n\nThe therapeutic response of orally administered MD-Fraction was associated with ( i ) induced systemic tumor-antigen specific T cell response via dectin-1-dependent activation of DCs , ( ii ) increased infiltration of the activated T cells into the tumor , and ( iii ) decreased number of tumor-caused immunosuppressive cells such as regulatory T cells and myeloid-derived suppressor cells .\n\nOur preclinical study suggests that MD-Fraction is a useful oral therapeutic agent in the management of patients with cancer. \ufffd 2012 Wiley Periodicals , Inc .",
-            "output": "Avoiding immune destruction"
-        },
-        {
-            "input": "Aurora kinases play an essential role in mitotic progression and are potentially druggable targets in cancer therapy .\n\nWe identified benzo[e]pyridoindoles ( BePI ) as powerful aurora kinase inhibitors .\n\nTheir efficiency was demonstrated both in enzymatic inhibition studies and in cell culture assays .\n\nNew BePI molecules were synthesized , and a structure-activity relationship study was conducted with the aim of improving the activity and solubility of the lead compound .\n\nTetracyclic BePI derivatives are characterized by a particular curved shape , and the presence of an oxo group on the pyridine ring was found to be required for aurora kinase\u2005B inhibition .\n\nNew hydrosoluble benzo[e]pyridoindolones were subsequently designed , and their efficacy was tested by a combination of cell-cycle analysis and time-lapse experiments in live cells .\n\nThe most active BePI derivative , 13\u2009b , inhibited the cell cycle , drove cells to polyploidy , and eventually induced apoptosis .\n\nIt exhibited high antiproliferative activity in HeLa cells with an IC(50) value of 63\u2005nM .\n\nRelative to compounds tested in clinical trials , this antiproliferative potency places 13\u2009b among the top 10 aurora kinase inhibitors .\n\nOur results justify further in\u2005vivo evaluation in preclinical animal models of cancer .",
-            "output": "Sustaining proliferative signaling, Evading growth suppressors, Resisting cell death"
-        },
-        {
-            "input": "Elevated androgen receptor ( AR ) activity in castration-resistant prostate cancer ( CRPC ) may occur through increased levels of AR coactivator proteins .\n\nVav3 , a guanine nucleotide exchange factor ( GEF ) , is upregulated following progression to castration-resistance in preclinical models and is overexpressed in a significant number of human prostate cancers .\n\nVav3 is a novel coactivator of the AR .\n\nWe sought to identify Vav3 binding partners in an effort to understand the molecular mechanisms underlying Vav3 enhancement of AR activity and to identify new therapeutic targets .\n\nThe cell division cycle 37 homolog ( Cdc37 ) , a protein kinase-specific co-chaperone for Hsp90 , was identified as a Vav3 interacting protein by yeast two hybrid screening .\n\nVav3-Cdc37 interaction was confirmed by GST pulldown and , for native proteins , by coimmunoprecipitation experiments in prostate cancer cells .\n\nCdc37 potentiated Vav3 coactivation of AR transcriptional activity and Vav3 enhancement of AR amino-carboxyl terminal ( N-C ) interaction , which is essential for optimal receptor transcriptional activity .\n\nCdc37 increased prostate cancer cell proliferation selectively in Vav3 expressing cells .\n\nCdc37 did not affect Vav3 nucleotide exchange activity , Vav3 protein levels or subcellular localization .\n\nDisruption of Vav3-Cdc37 interaction inhibited Vav3 enhancement of AR transcriptional activity and AR N-C interaction .\n\nDiminished Vav3-Cdc37 interaction also caused decreased prostate cancer cell proliferation selectively in Vav3 expressing cells .\n\nTaken together , we identified a novel Vav3 interacting protein that enhances Vav3 coactivation of AR and prostate cancer cell proliferation .\n\nVav3-Cdc37 interaction may provide a new therapeutic target in prostate cancer .",
-            "output": "Sustaining proliferative signaling"
-        },
-        {
-            "input": "The anti-tumor antibiotic salinomycin ( Sal ) was recently identified as a selective inhibitor of breast cancer stem cells ; however , the effect of Sal on hepatocellular carcinoma ( HCC ) is not clear .\n\nThis study aimed to determine the anti-tumor efficacy and mechanism of Sal on HCC .\n\nHCC cell lines ( HepG2 , SMMC-7721 , and BEL-7402 ) were treated with Sal .\n\nCell doubling time was determinated by drawing growth curve , cell viability was evaluated using the Cell Counting Kit 8 .\n\nThe fraction of CD133(+) cell subpopulations was assessed by flow cytometry .\n\nWe found that Sal inhibits proliferation and decreases PCNA levels as well as the proportion of HCC CD133(+)cell subpopulations in HCC cells .\n\nCell cycle was analyzed using flow cytometry and showed that Sal caused cell cycle arrest of the various HCC cell lines in different phases .\n\nCell apoptosis was evaluated using flow cytometry and Hoechst 33342 staining .\n\nSal induced apoptosis as characterized by an increase in the Bax/Bcl-2 ratio .\n\nSeveral signaling pathways were selected for further mechanistic analyses using real time-PCR and Western blot assays .\n\nCompared to control , \u03b2-catenin expression is significantly down-regulated upon Sal addition .\n\nThe Ca(2+) concentration in HCC cells was examined by flow cytometry and higher Ca(2+) concentrations were observed in Sal treatment groups .\n\nThe anti-tumor effect of Sal was further verified in vivo using the hepatoma orthotopic tumor model and the data obtained showed that the size of liver tumors in Sal-treated groups decreased compared to controls .\n\nImmunohistochemistry and TUNEL staining also demonstrated that Sal inhibits proliferation and induces apoptosis in vivo .\n\nFinally , the role of Sal on in vivo Wnt/\u03b2-catenin signaling was evaluated by Western blot and immunohistochemistry .\n\nThis study demonstrates Sal inhibits proliferation and induces apoptosis of HCC cells in vitro and in vivo and one potential mechanism is inhibition of Wnt/\u03b2-catenin signaling via increased intracellular Ca(2+) levels .",
-            "output": "Sustaining proliferative signaling, Evading growth suppressors, Resisting cell death"
-        },
-        {
-            "input": "The pancreatic stellate cells ( PSCs ) have complex roles in pancreas , including tissue repair and fibrosis .\n\nPSCs surround ATP releasing exocrine cells , but little is known about purinergic receptors and their function in PSCs .\n\nOur aim was to resolve whether PSCs express the multifunctional P2X7 receptor and elucidate how it regulates PSC viability .\n\nThe number of PSCs isolated from wild type ( WT ) mice was 50% higher than those from the Pfizer P2X7 receptor knock out ( KO ) mice .\n\nThe P2X7 receptor protein and mRNA of all known isoforms were expressed in WT PSCs , while KO PSCs only expressed truncated versions of the receptor .\n\nIn culture , the proliferation rate of the KO PSCs was significantly lower .\n\nInclusion of apyrase reduced the proliferation rate in both WT and KO PSCs , indicating importance of endogenous ATP .\n\nExogenous ATP had a two-sided effect .\n\nProliferation of both WT and KO cells was stimulated with ATP in a concentration-dependent manner with a maximum effect at 100 \u00b5M .\n\nAt high ATP concentration ( 5 mM ) , WT PSCs , but not the KO PSCs died .\n\nThe intracellular Ca(2+) signals and proliferation rate induced by micromolar ATP concentrations were inhibited by the allosteric P2X7 receptor inhibitor az10606120 .\n\nThe P2X7 receptor-pore inhibitor A438079 partially prevented cell death induced by millimolar ATP concentrations .\n\nThis study shows that ATP and P2X7 receptors are important regulators of PSC proliferation and death , and therefore might be potential targets for treatments of pancreatic fibrosis and cancer .",
-            "output": "Sustaining proliferative signaling"
-        },
-        {
-            "input": "CDA-2 ( cell differentiation agent 2 ) , a urinary preparation , has potent anti- proliferative and pro-apoptotic properties in cancer cells .\n\nHowever , the mechanisms of tumor inhibitory action of CDA-2 are far from clear , and especially there was no report on lung cancer .\n\nHere we demonstrate that CDA-2 and its main component phenylacetylglutamine ( PG ) reduce the metastatic lung tumor growth , and increases survival time after inoculation with Lewis lung carcinoma ( LLC ) cells in a dose-dependent manner in C57BL6 mice .\n\nProliferative program analysis in cancer cells revealed a fundamental impact of CDA-2 and PG on proliferation and apoptosis , including Bcl-2 , Bcl-XL , cIAP1 , Survivin , PCNA , Ki-67 proteins and TUNEL assays .\n\nCDA-2 and PG significantly reduced NF-\u03baB DNA-binding activity in lung cancer cells and in alveolar macrophages of tumor bearing mice and especially decreased the release of inflammatory factors including TNF\u03b1 , IL-6 , and KC .\n\nFurthermore , CDA-2 and PG decrease the expressions of TLR2 , TLR6 , and CD14 , but not TLR1 , TLR3 , TLR4 , and TLR9 in bone-marrow-derived macrophages ( BMDM ) of mice stimulated by LLC-conditioned medium ( LLC-CM ) .\n\nOver-expressing TLR2 in BMDM prevented CDA-2 and PG from inhibiting NF-\u03baB activation , as well as induction of TNF\u03b1 and IL-6 .\n\nTLR2:TLR6 complexes mediate the effect of NF-\u03baB inactivation by CDA-2 .\n\nIn conclusion , CDA-2 potently inhibits lung tumor development by reduction of the inflammation in lung through suppression of NF-\u03baB activation in myeloid cells , associating with modulation of TLR2 signaling .",
-            "output": "Tumor promoting inflammation, Resisting cell death, Activating invasion and metastasis"
-        },
-        {
-            "input": "Hepatocellular carcinoma ( HCC ) is the most prevalent liver tumor and a deadly disease with limited therapeutic options .\n\nDysregulation of cell signaling pathways is a common denominator in tumorigenesis , including hepatocarcinogenesis .\n\nThe epidermal growth factor receptor ( EGFR ) signaling system is commonly activated in HCC , and is currently being evaluated as a therapeutic target in combination therapies .\n\nWe and others have identified a central role for the EGFR ligand amphiregulin ( AR ) in the proliferation , survival and drug resistance of HCC cells .\n\nAR expression is frequently up-regulated in HCC tissues and cells through mechanisms not completely known .\n\nHere we identify the \u03b2-catenin signaling pathway as a novel mechanism leading to transcriptional activation of the AR gene in human HCC cells .\n\nActivation of \u03b2-catenin signaling , or expression of the T41A \u03b2-catenin active mutant , led to the induction of AR expression involving three specific \u03b2-catenin-Tcf responsive elements in its proximal promoter .\n\nWe demonstrate that HCC cells expressing the T41A \u03b2-catenin active mutant show enhanced proliferation that is dependent in part on AR expression and EGFR signaling .\n\nWe also demonstrate here a novel cross-talk of the EGFR system with fibroblast growth factor 19 ( FGF19 ) .\n\nFGF19 is a recently identified driver gene in hepatocarcinogenesis and an activator of \u03b2-catenin signaling in HCC and colon cancer cells .\n\nWe show that FGF19 induced AR gene expression through the \u03b2-catenin pathway in human HCC cells .\n\nImportantly , AR up-regulation and EGFR signaling participated in the induction of cyclin D1 and cell proliferation elicited by FGF19 .\n\nFinally , we demonstrate a positive correlation between FGF19 and AR expression in human HCC tissues , therefore supporting in clinical samples our experimental observations .\n\nThese findings identify the AR/EGFR system as a key mediator of FGF19 responses in HCC cells involving \u03b2-catenin signaling , and suggest that combined targeting of FGF19 and AR/EGFR may enhance therapeutic efficacy .",
-            "output": "Sustaining proliferative signaling"
-        },
-        {
-            "input": "Lung cancers express the cholinergic autocrine loop , which facilitates the progression of cancer cells .\n\nThe antagonists of mAChRs have been demonstrated to depress the growth of small cell lung cancers ( SCLCs ) .\n\nIn this study we intended to investigate the growth inhibitory effect of R2HBJJ , a novel muscarinic antagonist , on non-small cell lung cancer ( NSCLC ) cells and the possible mechanisms .\n\nThe competitive binding assay revealed that R2HBJJ had a high affinity to M3 and M1 AChRs .\n\nR2HBJJ presented a strong anticholinergic activity on carbachol-induced contraction of guinea-pig trachea .\n\nR2HBJJ markedly suppressed the growth of NSCLC cells , such as H1299 , H460 and H157 .\n\nIn H1299 cells , both R2HBJJ and its leading compound R2-PHC displayed significant anti-proliferative activity as M3 receptor antagonist darifenacin .\n\nExogenous replenish of ACh could attenuate R2HBJJ-induced growth inhibition .\n\nSilencing M3 receptor or ChAT by specific-siRNAs resulted in a growth inhibition of 55.5% and 37.9% on H1299 cells 96 h post transfection , respectively .\n\nFurther studies revealed that treatment with R2HBJJ arrested the cell cycle in G0/G1 by down-regulation of cyclin D1-CDK4/6-Rb .\n\nTherefore , the current study reveals that NSCLC cells express an autocrine and paracrine cholinergic system which stimulates the growth of NSCLC cells .\n\nR2HBJJ , as a novel mAChRs antagonist , can block the local cholinergic loop by antagonizing predominantly M3 receptors and inhibit NSCLC cell growth , which suggest that M3 receptor antagonist might be a potential chemotherapeutic regimen for NSCLC .",
-            "output": "Sustaining proliferative signaling, Evading growth suppressors"
-        }
-    ]
-}

MedS-Bench/Text_summarization/task112_mimic_cxr_text_summurization.json

@@ -1,434 +0,0 @@
-{
-    "Contributors": [
-        "MIMIC-CXR"
-    ],
-    "Source": [
-        "MIMIC-CXR"
-    ],
-    "URL": [
-        "https://physionet.org/content/mimic-cxr-jpg/2.0.0/"
-    ],
-    "Categories": [
-        "Text Summarization"
-    ],
-    "Definition": [
-        "You will be given a description of the important aspects in the Chest X-ray image. Your task is to give a short summary of the most immediately relevant findings"
-    ],
-    "Reasoning": [],
-    "Input_language": [
-        "English"
-    ],
-    "Output_language": [
-        "English"
-    ],
-    "Instruction_language": [
-        "English"
-    ],
-    "Domains": [
-        "Clinical Text"
-    ],
-    "Positive Examples": [],
-    "Negative Examples": [],
-    "Instances": [
-        {
-            "input": "The lungs are clear without focal consolidation.  No pleural effusion or  pneumothorax is seen. The cardiac and mediastinal silhouettes are  unremarkable.",
-            "output": "No acute cardiopulmonary process."
-        },
-        {
-            "input": "There is a right lower lung opacity.  There is no pulmonary edema, pleural  effusion or pneumothorax.  The cardiac and mediastinal contours are normal.",
-            "output": "Right lower lung opacity concerning for aspiration or pneumonia."
-        },
-        {
-            "input": "Left-sided dual-chamber pacemaker/AICD device is re- demonstrated with leads  in unchanged positions. Mild enlargement of cardiac silhouette is again noted.  The aortic knob is calcified. The mediastinal and hilar contours are  unremarkable. Pulmonary vasculature is normal. Scarring is seen in the right  lung base with tenting of the right hemidiaphragm. No focal consolidation,  pleural effusion or pneumothorax is present. Lungs remain hyperinflated.  No  acute osseous abnormality is detected.",
-            "output": "No acute cardiopulmonary abnormality."
-        },
-        {
-            "input": "There is no new consolidation or pleural effusion.  The heart and mediastinum  are within normal limits.  Multilevel spinal degenerative changes are stable.  An old right lower rib fracture is re-demonstrated. There is no pneumothorax.",
-            "output": "No radiographic evidence of pneumonia."
-        },
-        {
-            "input": "PA and lateral views of the chest provided.    There is no focal consolidation, effusion, or pneumothorax. The  cardiomediastinal silhouette is normal. Imaged osseous structures are intact.   No free air below the right hemidiaphragm is seen.",
-            "output": "No acute intrathoracic process."
-        },
-        {
-            "input": "AP semi upright view of the chest provided.    There is no focal consolidation, effusion, or pneumothorax.  Bibasilar  atelectasis is similar to prior.  Mild cardiomegaly and large hiatal hernia  are similar to prior. Imaged osseous structures are intact.  No free air below  the right hemidiaphragm is seen.",
-            "output": "No acute intrathoracic process."
-        },
-        {
-            "input": "AP and lateral views of the chest.  In the mid right lung, there is  a new round opacity that is concerning for a mass however may represent focal  infection.  There is no pleural effusion or pneumothorax.  No focal  consolidation.  Cardiomediastinal and hilar contours are normal.",
-            "output": "Right mid lung rounded opacity may represent a new mass or  infection.  Recommend CT for further evaluation.     These findings were emailed to the ___ nurses by Dr. ___ at 747am on  ___."
-        },
-        {
-            "input": "In comparison to the chest radiographs obtained ___, no significant  changes are appreciated.  Lungs are fully expanded and clear without focal  consolidation or suspicious pulmonary nodules.  No pleural effusions.  Mild  cardiomegaly is unchanged without pulmonary vascular congestion or pulmonary  edema.  Descending thoracic aorta is tortuous, but unchanged.  Median  sternotomy wires are well aligned and intact.",
-            "output": "No radiographic evidence of pneumonia, intrathoracic malignancy, or other  acute cardiopulmonary abnormalities."
-        },
-        {
-            "input": "Patient is status post median sternotomy and CABG.  Mild cardiomegaly is  similar.  The aorta remains tortuous, and the mediastinal and hilar contours  are unchanged.  Pulmonary vasculature is not engorged.  There is minimal  atelectasis at the lung bases without focal consolidation.  No pleural  effusion or pneumothorax is detected.  Degenerative changes are seen  throughout the thoracic spine.",
-            "output": "No acute cardiopulmonary abnormality."
-        },
-        {
-            "input": "The lungs are clear without consolidation, effusion, or vascular congestion.  Cardiomediastinal silhouette is within normal limits. Tortuous descending  thoracic aorta is noted. Median sternotomy wires and mediastinal clips are  again seen. Chronic changes identified at the shoulders as on prior. No acute  osseous abnormalities.",
-            "output": "No acute cardiopulmonary process."
-        },
-        {
-            "input": "Persistent subtle right lower lobe and retrocardiac opacity.  Left basilar  atelectasis is noted.  No pulmonary edema.  No pleural effusion or  pneumothorax.  Heart is top-normal in size.  Mediastinal contour and hila are  unremarkable.    Intact median sternotomy wires.  Mediastinal clips are noted.",
-            "output": "Bilateral lower lobe bronchopneumonia, unchanged in appearance since prior  examination.    RECOMMENDATION(S):  Recommend short interval followup chest radiograph ___  weeks after completion of treatment to assess for resolution."
-        },
-        {
-            "input": "Postoperative cardiomediastinal silhouette and hilar contours are stable.   Lungs are clear.  There is no pleural effusion or pneumothorax.",
-            "output": "No acute cardiopulmonary process; specifically, no evidence of pneumonia."
-        },
-        {
-            "input": "AP view of the chest was provided.  Midline sternotomy wires and  mediastinal clips are noted.  The lungs appear clear without focal  consolidation, effusion, or pneumothorax.  Subtle nodular opacities are noted  in the left mid lung.  No large effusion or pneumothorax.  Cardiomediastinal  silhouette appears stable.  Bony structures are intact.",
-            "output": "No acute findings.  Subtle nodular opacities in the left mid  lung.  Please refer to subsequent CT of the chest for further details."
-        },
-        {
-            "input": "Support Devices:  None.    The lungs are clear. The sternotomy wires and mediastinal surgical clips are  unchanged. Heart size normal. There is no pneumothorax or pleural effusion.   Pulmonary vascularity is normal.  There is a high riding right humeral head  consistent with rotator cuff rupture.",
-            "output": "No evidence of pneumonia."
-        },
-        {
-            "input": "Lung volumes are slightly low.  Subtle opacity in the right infrahilar region  as well as retrocardiac region is concerning for bronchopneumonia given the  provided history.  Atelectasis at the left lung base is mild.  No edema,  pleural effusion, or pneumothorax.  The cardiomediastinal silhouette is  unchanged.  Median sternotomy wires and mediastinal clips are also unchanged.   The descending thoracic aorta is tortuous.",
-            "output": "Bilateral lower lobe bronchopneumonia.  Repeat chest radiograph in ___ weeks  to ensure resolution after treatment is recommended.    RECOMMENDATION(S):  Repeat chest radiograph in ___ weeks to ensure resolution  after treatment is recommended."
-        },
-        {
-            "input": "PA and lateral views of the chest.  Sternotomy wires and  mediastinal clips are stable.  There is no focal consolidation, pleural  effusion, or pneumothorax.  The cardiomediastinal and hilar contours are  normal.",
-            "output": "No acute cardiopulmonary process.      These findings were discussed with Dr. ___ by Dr. ___ at 1:12 p.m. on  ___ by telephone at the time of discovery."
-        },
-        {
-            "input": "The patient is status post median sternotomy with intact sternotomy  wires.  The lungs are clear without focal consolidation, effusion, or  pneumothorax.  A 4-mm nodular opacity in the right lower lobe is apparent on  today's exam, as are the subtle nodular opacities in the left lower lobe  previously noted on the ___ radiograph and better seen on the  CT from ___.  Bony structures are intact.  Cardiomediastinal  silhouette appears stable.",
-            "output": "No acute cardiopulmonary process."
-        },
-        {
-            "input": "Lung volumes are slightly low, particularly on the frontal view.  There is no  focal consolidation, effusion or overt edema.  Cardiac silhouette is within  normal limits.  Median sternotomy wires, mediastinal clips and coronary artery  stents are noted.  No acute osseous abnormalities.",
-            "output": "No acute cardiopulmonary process."
-        },
-        {
-            "input": "PA and lateral chest radiograph demonstrate clear lungs bilaterally.  Linear  lucencies paralleling the upper mediastinum extending into the neck is  compatible with pneumomediastinum.  Pulmonary vasculature is normal.  There is  no pneumothorax or pleural effusion.  No air under the right hemidiaphragm.",
-            "output": "Pneumomediastinum."
-        },
-        {
-            "input": "Heart size is normal.  The mediastinal and hilar contours are normal. The  pulmonary vasculature is normal. Lungs are clear.  No pleural effusion or  pneumothorax is seen.  Mild anterior wedge compression deformity of an upper  lumbar vertebral body is age indeterminate.",
-            "output": "No acute cardiopulmonary abnormality.  Age indeterminate mild anterior wedge  compression deformity of an upper lumbar vertebral body."
-        },
-        {
-            "input": "PA and lateral views of chest demonstrate clear lungs.  Heart size is normal.   No pleural effusion pneumothorax or pulmonary edema.",
-            "output": "No acute cardiopulmonary process."
-        },
-        {
-            "input": "PA and lateral views of the chest were provided.  The heart is normal in size.  There is no focal consolidation or evidence of pulmonary edema.  No pleural  effusion or pneumothorax is seen.  The mediastinal contour is normal.  No free  air is seen below the right hemidiaphragm.  The bony structures are intact.",
-            "output": "No acute intrathoracic process."
-        },
-        {
-            "input": "A single portable semi-erect chest radiograph was obtained.  Low lung volumes  exaggerate the heart size and interstitial markings.  The lungs are clear.   There is no focal consolidation, effusion, or pneumothorax.  The heart size is  top normal. Mediastinal contours are normal.  Cholecystectomy clips are  visible in the right upper quadrant.  There is no displaced rib fracture.",
-            "output": "Top normal heart size."
-        },
-        {
-            "input": "Chest:  The heart is not enlarged.  No CHF, focal infiltrate, effusion, or  pneumothorax detected.    Ribs:  No localizing history is available.  No marker is placed to indicate  the site of focal symptoms.  No dedicated rib radiographs were included.  Of  note, the lower most right ribs are not fully included on the available views.  Allowing for this, the possibility of slight cortical offset involving the  right eighth rib anteriorly cannot be excluded.",
-            "output": "No acute pulmonary process identified.    No focal pneumonic infiltrate, pneumothorax or pleural effusion detected.    Possible minimally displaced fracture of the right anterior eighth rib.   Clinical correlation for any focal site of symptoms is requested.  If there is  ongoing concern for a a rib fracture, then dedicated rib radiographs could  help for further assessment."
-        },
-        {
-            "input": "Single frontal chest radiograph demonstrates a right-sided  subclavian venous catheter terminating at the cavoatrial junction.   Endotracheal tube terminates at the level of the clavicles.  Enteric catheter  courses below the left hemidiaphragm terminating in the body of stomach.   Cardiomediastinal and hilar contours are unremarkable.  Left lung base  opacification is poorly assessed given patient positioning, but may reflect  combination of atelectasis and effusion.  Underlying infectious process cannot  be excluded.",
-            "output": "Medical support devices are well positioned.  Left lower lung  opacification evident."
-        },
-        {
-            "input": "Frontal and lateral views of the chest demonstrate fully expanded and clear  lungs.  The cardiomediastinal and hilar contours are normal.  There is no  pneumothorax or pleural effusion.  Pleural surfaces are unremarkable.  There  is no mediastinal air.",
-            "output": "Normal chest radiograph.  No evidence of mediastinal air."
-        },
-        {
-            "input": "Heart size is normal.  Mediastinal and hilar contours are unremarkable.  The  pulmonary vasculature is normal and the lungs are clear.  No pleural effusion,  focal consolidation or pneumothorax is demonstrated.  There are no acute  osseous abnormalities.",
-            "output": "No acute cardiopulmonary process."
-        },
-        {
-            "input": "The lungs are clear without focal consolidation.  No pleural effusion or  pneumothorax is seen.  The cardiac and mediastinal silhouettes are  unremarkable.",
-            "output": "No acute cardiopulmonary process."
-        },
-        {
-            "input": "Heart size is normal.  The mediastinal and hilar contours are normal. The  pulmonary vasculature is normal. Lungs are clear.  No pleural effusion or  pneumothorax is seen. There are no acute osseous abnormalities.",
-            "output": "No acute cardiopulmonary abnormality."
-        },
-        {
-            "input": "Lung volumes are low.  The heart size is normal.  Aorta remains unfolded, and  the mediastinal and hilar contours are unchanged.  The pulmonary vascularity  is not engorged.  Minimal streaky opacity within the left lower lobe likely  reflects atelectasis.  There is no focal consolidation, large pleural effusion  or pneumothorax identified.  No acute osseous abnormalities detected.",
-            "output": "Minimal left lower lobe atelectasis."
-        },
-        {
-            "input": "AP and lateral chest radiographs were provided.  There is no focal  consolidation, pleural effusion or pneumothorax.  Lung volumes are slightly  low.  The cardiomediastinal silhouette is notable for a tortuous aorta.  The  bones are intact without evidence of displaced rib fractures.  There are mild  degenerative changes in the thoracic spine.",
-            "output": "No acute cardiopulmonary process or displaced rib fracture."
-        },
-        {
-            "input": "There has been interval placement of an endotracheal tube, terminating at the  carina.  Recommend withdrawal by approximately 3 cm for more optimal  positioning.  A nasogastric tube has also been placed in the interval with  distal tip at the GE junction, side port within the distal esophagus.   Recommend advancement by approximately 15 cm so that it is well within the  stomach.  Subtle patchy left mid lung opacity is seen which may represent  overlap of vascular structures however small focus of infection may be  present.  Minimal right costophrenic angle atelectasis is seen.  There is no  large pleural effusion or evidence of pneumothorax.  The cardiac and  mediastinal silhouettes are unremarkable.",
-            "output": "Endotracheal tube terminates at the level of the carina.  Recommend withdrawal  by approximately 3 cm for more optimal positioning.    Nasogastric tube terminates at the GE junction, side port in the distal  esophagus, Recommend advancement by approximately 15 cm so that it is well  within the stomach.    The above findings were discussed with Dr. ___ at 11:36AM  on ___, via telephone 2 minutes after discovery.    Small patchy opacity projecting over the left mid lung, may represent small  focus of infection."
-        },
-        {
-            "input": "Cardiomediastinal and hilar contours are stable.  There has been  interval removal of a right internal jugular catheter.  No new focal lung  opacities are identified.  There is no pleural effusion or pneumothorax.   Blunting of the left costophrenic angle is again seen. Pulmonary vasculature  is within normal limits.",
-            "output": "No acute cardiopulmonary process."
-        },
-        {
-            "input": "The heart size is normal.  The aorta is mildly unfolded.  Mediastinal and  hilar contours otherwise are unchanged.  Pulmonary vascularity is normal.   Lungs are clear.  No pleural effusion or pneumothorax is visualized.  There  are no acute osseous abnormalities.",
-            "output": "No acute cardiopulmonary process."
-        },
-        {
-            "input": "The endotracheal tube has been withdrawn in the interval, now  terminating approximately 3.5 cm above the level of the carina.  Nasogastric  tube tip remains at the GE junction with side port in the distal esophagus.   Again, recommend advancement so that it is well within the stomach.  A  right-sided internal jugular central venous catheter again terminates in the  mid-to-lower SVC.  There is no pneumothorax.  There is persistent slight  blunting of the left costophrenic angle.  No focal consolidation.  Cardiac and  mediastinal silhouettes are stable.",
-            "output": "1.  Endotracheal tube now in appropriate position.  2.  Nasoenteric tube still remains high in position, as above.    The above findings were discussed with Dr. ___ on ___ at 9:50 p.m.  via telephone immediately after discovery by Dr. ___."
-        },
-        {
-            "input": "Previously seen endotracheal tube, right PICC, right central venous catheter,  and orogastric tube have been removed.  The heart size is normal.  The  mediastinal and hilar contours are unchanged.  There is minimal blunting of  left costophrenic angle suggestive of a trace effusion.  No pneumothorax is  seen, and there is no right-sided pleural effusion.  Ill-defined nodular  opacities are noted within the right mid lung field, which could reflect areas  of infection or inflammation.  No focal consolidation is demonstrated.  There  is no pulmonary vascular congestion.",
-            "output": "Ill-defined nodular opacities within the right mid lung field could reflect an  area of infection or inflammation.  Trace left pleural effusion."
-        },
-        {
-            "input": "Frontal and lateral views of the chest were obtained.  Lungs are  clear without focal consolidation.  No pleural effusion or pneumothorax is  seen.  Cardiac and mediastinal silhouettes are unremarkable.  No overt  pulmonary edema is seen.",
-            "output": "No acute cardiopulmonary process."
-        },
-        {
-            "input": "PA and lateral views of the chest provided.   Midline sternotomy wires and  left chest wall pacer device appear unchanged.  The pacer leads extending to  the region of the right atrium and right ventricle.  The lungs are clear.   There is no focal consolidation, effusion, or pneumothorax. The  cardiomediastinal silhouette is unchanged. Imaged osseous structures are  intact.  No free air below the right hemidiaphragm is seen.",
-            "output": "No acute intrathoracic process."
-        },
-        {
-            "input": "The patient is status post median sternotomy and CABG.  Left-sided  dual-chamber pacemaker device is seen with leads terminating in the right  atrium and right ventricle.  The heart is normal in size.  Mediastinal and  hilar contours are unremarkable.  The pulmonary vascularity is normal.  Lungs  are clear without focal consolidation.  No pleural effusion or pneumothorax is  seen.  There are no acute osseous abnormalities.  Multiple spiral radiopaque  densities within the upper anterior abdominal wall are compatible with prior  ventral hernia repair.  No free air is seen under the diaphragms.",
-            "output": "No acute cardiopulmonary abnormality.  No free air under the diaphragms."
-        },
-        {
-            "input": "Rotated positioning.  A left-sided pacemaker present, with lead tips over  right atrium right ventricle.  An NG tube is present, tip extending beneath  diaphragm, off film.  Surgical ___ are noted over the upper abdomen in the  midline.  Linear density overlying the left lung could represent an epidural  catheter, best correlated clinically.    The patient is status post sternotomy.  Note is made that the lower most  sternotomy wire is fractured.  There is probable mild cardiomegaly.  There is  increased retrocardiac density with a probable small left effusion and partial  obscuration the left hemidiaphragm.  There is minimal atelectasis in the right  cardiophrenic region.  No pneumothorax is detected.  There is pleural  parenchymal thickening/scarring at the left lung apex.  The right first rib  may be truncated, but is unchanged.  Aside from right base atelectasis, the  right lung is grossly clear.  No gross right effusion, though minimal pleural  fluid could be present on the right.  Suspect background hyperinflation/COPD.   Note made of old rib fractures seen in lower right chest, similar to ___.    Compared to ___ the heart size is larger.  Left effusion and left  lower lobe collapse and/or consolidation is new and right cardiophrenic  atelectasis is more pronounced.",
-            "output": "1. Small to moderate left effusion with underlying collapse and/or  consolidation of the left base.  2. Atelectasis in the right cardiophrenic region.  3. Cardiac silhouette larger compared with ___.  4. Clinical correlation is required for full assessment.  5. Fractured inferior sternotomy wire, unchanged compared with ___."
-        },
-        {
-            "input": "Compared with the prior study, the cardiomediastinal silhouette is probably  unchanged.  There is upper zone redistribution, without overt CHF.  Fractured  inferior sternotomy wire again noted.    The left hemidiaphragm and left costophrenic sulcus are now better defined,  suggesting interval improvement in the the left effusion and left lower lobe  collapse/consolidation.  Some residual left lower lobe atelectasis persists.    On the right, there has been slight improvement in the right cardiophrenic  opacity.  The small right effusion is again seen, similar to prior.    Left-greater-than-right apical pleural thickening again noted.  Fractures of  the  mid/lower posterior right ribs again noted, presumably old.  No  pneumothorax detected.    NG tube, pacemaker, and presumed epidural catheter again noted.",
-            "output": "Partial interval improvement in collapse/consolidation at the left base and in  the right cardiophrenic opacity.  Marked improvement in left pleural effusion.    NG tube extends beneath the diaphragm off the film.  The sideport is not well  delineated, but appears to lie immediately beyond the GE junction."
-        },
-        {
-            "input": "There is no pleural effusion, pneumothorax or focal air airspace  consolidation.  The heart size is normal.  The mediastinal contours and hilar  structures are unremarkable.  There is no pneumomediastinum.",
-            "output": "No acute cardiopulmonary process."
-        },
-        {
-            "input": "Heart size is normal. The mediastinal and hilar contours are normal. The  pulmonary vasculature is normal.  Very small region of consolidation probably  in the right middle lobe. No pneumothorax or pleural abnormality.",
-            "output": "Right middle lobe consolidation could be atelectasis if there are no symptoms  of acute pneumonia."
-        },
-        {
-            "input": "The lungs are clear without focal consolidation.  No pleural effusion or  pneumothorax is seen. The cardiac and mediastinal silhouettes are  unremarkable.  No pulmonary edema is seen.",
-            "output": "No acute cardiopulmonary process."
-        },
-        {
-            "input": "PA and lateral views of the chest provided.    There is no focal consolidation, effusion, or pneumothorax. The  cardiomediastinal silhouette is normal. Imaged osseous structures are intact.   No free air below the right hemidiaphragm is seen.",
-            "output": "No acute intrathoracic process."
-        },
-        {
-            "input": "Study is slightly limited due to mild patient rotation.  There is moderate to  severe cardiomegaly.  Endotracheal tube tip terminates 4.4 cm from the carina.  Low lung volumes are noted with crowding of the pulmonary vascular structures,  and probable mild pulmonary vascular congestion.  Air bronchograms with  opacification in both lung bases may reflect areas of infection.  Patchy  opacities are also noted within the right upper lung field as well as the left  upper and mid lung fields, concerning for additional sites of infection or  aspiration.  No large pleural effusion or pneumothorax is seen.  Prominent  gaseous distention of the stomach is noted.",
-            "output": "1. Endotracheal tube in standard position.    2. Consolidative opacities in the lung bases may reflect areas of infection.   Additional patchy opacities within the left lung and right upper lung field  are concerning for additional sites of infection or aspiration.    3. Cardiomegaly with possible mild pulmonary vascular congestion."
-        },
-        {
-            "input": "Since the prior exam, there is increasing opacification of the bilateral bases  which is likely atelectasis.  There is no pulmonary edema, pleural effusion,  or pneumothorax. The cardiomediastinal silhouette is normal.",
-            "output": "No definite evidence of pneumonia. New bibasilar opacities are likely  atelectasis.  Recommend a repeat chest radiograph later today or tomorrow to  ensure the opacities are not increasing."
-        },
-        {
-            "input": "The lungs are hyper-expanded and clear.  The cardiomediastinal and hilar  contours are unremarkable.  There is no pneumothorax, pleural effusion, or  consolidation.",
-            "output": "No acute cardiopulmonary process."
-        },
-        {
-            "input": "Heart size is normal.  The mediastinal and hilar contours are normal. The  pulmonary vasculature is normal. Lungs are clear.  No pleural effusion or  pneumothorax is seen. There are no acute osseous abnormalities.  Clips are  noted in the right upper quadrant of the abdomen compatible prior  cholecystectomy.",
-            "output": "No acute cardiopulmonary abnormality."
-        },
-        {
-            "input": "Frontal and lateral views of the chest were obtained.  Low lung  volumes result in bronchovascular crowding.  There is bibasilar atelectasis  without focal consolidation, pleural effusion or pneumothorax.  A nodular  opacity in the right upper lobe is superimposed over the right sixth posterior  rib.  The heart cannot be well evaluated due to lung volumes.  The aorta is  tortuous.  Hilar contours are normal.  Degenerative change is seen in the  shoulder girdles bilaterally. There is no free air under the diaphragm.  Compression deformities in the thoracic spine are noted.",
-            "output": "1.  No acute intrathoracic process.    2.  Nodule in the right upper lobe is superimposed over the right posterior  rib, new from ___.  Shallow obliques off the frontal view could be performed  for further evaluation.    Findings and recommendations discussed with Dr. ___ by phone at  3:41pm ___."
-        },
-        {
-            "input": "A right PICC line terminates in the upper SVC. The heart is top  normal in size.  There is no definite pneumonia or pneumothorax.  There is no  pulmonary edema.",
-            "output": "Stable chest examination with no definite pneumonia."
-        },
-        {
-            "input": "As compared to prior chest radiograph from ___, lung volumes have  increased and there has been interval removal of a right-sided PICC line.  The  cardiomediastinal and hilar contours are within normal limits.  Slight  prominence of interstitial lung markings could relate to patient's known  underlying emphysema.  There is no focal consolidation, pleural effusion or  pneumothorax.",
-            "output": "No acute cardiopulmonary findings."
-        },
-        {
-            "input": "Since ___, left lower lobe pneumonia is significantly improved.i The  right lung is clear.  The cardiomediastinal silhouette, hilar contours, and  pleural surfaces are normal.  No pleural effusion or pneumothorax.  No new  focal consolidations are seen.",
-            "output": "Significant improvement in left lower lobe pneumonia since ___.   No new focal consolidations are noted."
-        },
-        {
-            "input": "PA and lateral views of the chest provided.   Airspace consolidation is noted  within the left lower lobe compatible with pneumonia.  Right lung is clear.   Cardiomediastinal silhouette is stable.  Imaged osseous structures are intact.  No free air below the right hemidiaphragm is seen.",
-            "output": "Left lower lobe pneumonia."
-        },
-        {
-            "input": "Cardiomediastinal silhouette is normal.  The lungs are clear.  There is no  pneumothorax or pleural effusion.  Coronary artery calcifications are noted.   There is no acute osseous abnormality.",
-            "output": "No radiographic explanation chronic cough.    RECOMMENDATION(S):   The findings were discussed by Dr. ___  with Dr. ___ on the ___ ___ at 1:15 PM, 1 minutes after  discovery of the findings."
-        },
-        {
-            "input": "There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary  edema. The cardiomediastinal silhouette is within normal limits.  Sternotomy  wires are unchanged.",
-            "output": "No acute cardiopulmonary process."
-        },
-        {
-            "input": "Frontal and lateral views of the chest.  No prior.  The lungs are  clear.  The cardiomediastinal silhouette is within normal limits.  Osseous and  soft tissue structures are grossly unremarkable.",
-            "output": "No acute cardiopulmonary process."
-        },
-        {
-            "input": "No focal consolidation, pleural effusion, or evidence of  pneumothorax is seen.  The cardiac and mediastinal silhouettes are stable and  unremarkable.",
-            "output": "No acute cardiopulmonary process."
-        },
-        {
-            "input": "PA and lateral views of the chest.  The lungs are clear.  Cardiomediastinal  silhouette is normal.  Mid thoracic dextroscoliosis is noted.  No acute  osseous abnormality detected.",
-            "output": "No acute cardiopulmonary process."
-        },
-        {
-            "input": "The heart is normal in size. The cardiomediastinal and hilar contours are  within normal limits. The lungs appear clear. There is no evidence of  pneumothorax or effusion.  Bony structures appear intact.",
-            "output": "No acute findings."
-        },
-        {
-            "input": "There is no focal consolidation, pleural effusion or pneumothorax.   Cardiomediastinal silhouette is within normal limits.  No evidence of  pneumomediastinum.  No acute osseous abnormalities are identified.  Lumbar  spinal fusion hardware is partially imaged.",
-            "output": "No pneumomediastinum or radiographic evidence of an intrathoracic mass."
-        },
-        {
-            "input": "Mild bronchial wall thickening is noted without focal consolidation.  There is  no pleural effusion, pulmonary vascular congestion, or pneumothorax.  The  cardiomediastinal silhouette is normal.",
-            "output": "Mild bronchial wall thickening suggesting bronchitis without evidence of  pneumonia.    NOTIFICATION:   The findings were discussed with ___ with with with  the, M.D. by ___, M.D. on the telephone on ___ at 11:06 AM, 1  minutes after discovery of the findings."
-        },
-        {
-            "input": "No consolidation, pleural effusion or pulmonary edema is seen, and the cardiac  and mediastinal contours are normal.  Hyperinflated lungs are seen.",
-            "output": "No acute cardiopulmonary disease."
-        },
-        {
-            "input": "Moderate to severe cardiomegaly is stable.  Patient has a hiatal hernia.   Aside from minimal atelectasis in the right base, the lungs are clear.  There  is no pneumothorax or pleural effusion.",
-            "output": "No acute cardiopulmonary abnormality  Stable cardiomegaly and hiatal hernia"
-        },
-        {
-            "input": "Lung volumes are low causing crowding and an apparent increase in  the size of the only mildly enlarged cardiac silhouette.  Lungs are otherwise  clear.  No pleural effusion or pneumothorax.  Osseous structure appear  unchanged since ___.",
-            "output": "No evidence of pneumonia."
-        },
-        {
-            "input": "Frontal and lateral chest radiographs demonstrate clear,  well-expanded lungs, with note made of eventration of the right hemidiaphragm.  There is no pleural effusion or pneumothorax.  The pulmonary vasculature is  normal.  The cardiac silhouette is mildly enlarged, unchanged.  The aortic  valve annulus and coronary arteries are heavily calcified. The mediastinal  contours are normal. There is a small hiatal hernia, newly appreciated.",
-            "output": "1.  No acute chest abnormality.  2.  Small hiatal hernia"
-        },
-        {
-            "input": "The patient is status post sternotomy.  There is similar volume  loss in the right hemithorax with opacification at the medial right apex and  thickening of what appears to represent the minor fissure.  Blunting of the  right costophrenic sulcus has increased and suggests minor scarring or  atelectasis with a potential small effusion.  There is also patchy new  opacification in the right lower lobe compared to the prior chest radiographs  while the left lung remains clear.",
-            "output": "Patchy new right lower lobe opacity with possible small pleural  effusion.  Depending on the clinical setting, mild pneumonia or sequelae of  aspiration could be considered, although evolving scarring or atelectasis with  associated with an interval effusion could also be considered."
-        },
-        {
-            "input": "AP and lateral views of the chest are compared to previous chest  x-ray from ___ and images from prior PET-CT from ___.      Again seen is evidence of right upper lobe scarring medially with associated  volume loss.  This appearance is similar compared to prior chest x-ray.   Elsewhere, the lungs are clear without evidence of new consolidation or  effusion.  Cardiomediastinal silhouette is stable.  Median sternotomy wires  again seen.  Osseous and soft tissue structures are unremarkable.",
-            "output": "Post-treatment changes seen in the right upper lung.  No evidence  of acute cardiopulmonary process."
-        },
-        {
-            "input": "The cardiac, mediastinal and hilar contours appear unchanged.   There is no pleural effusion or pneumothorax.  The lungs appear clear.  Mild  degenerative changes are noted along the mid thoracic spine with small  osteophytes and mildly narrowed interspaces.",
-            "output": "No evidence of acute cardiopulmonary disease."
-        },
-        {
-            "input": "The lungs are normally expanded and clear.  The cardiomediastinal  silhouette, hilar contours and pleural surfaces are normal.  There is no  pleural effusion or pneumothorax. There is slight indentation of the left side  of the trachea.",
-            "output": "1. No evidence of acute cardiopulmonary abnormality.  2. Indentation of the left side of the trachea possibly from thyroid  enlargement. Please correlate with physical exam.     Updated results were telephoned to Dr. ___ by ___ at 8:10 am,  ___, 10 minutes after discovery."
-        },
-        {
-            "input": "PA and lateral views of the chest provided.   Low lung volumes.  There is no  focal consolidation, effusion, or pneumothorax. The cardiomediastinal  silhouette is normal. Imaged osseous structures are intact.  No free air below  the right hemidiaphragm is seen.",
-            "output": "No acute intrathoracic process."
-        },
-        {
-            "input": "Streaky right basilar opacities are identified particularly in the right  middle lobe. Elsewhere, the lungs are clear. The cardiomediastinal silhouette  is within normal limits.  No acute osseous abnormality is identified.",
-            "output": "Streaky right middle lobe opacities most suggestive of atelectasis."
-        },
-        {
-            "input": "Lung volumes are low. There is mild elevation of the right hemidiaphragm with  new right lower lobe subsegmental atelectasis. The left lung is clear.",
-            "output": "New right lower lobe subsegmental atelectasis."
-        },
-        {
-            "input": "Cardiac size is top normal. Bibasilar atelectasis larger on the right have  minimally increased. There are low lung volumes. There is no pneumothorax or  pleural effusion.",
-            "output": "Bibasilar atelectases no pneumothorax."
-        },
-        {
-            "input": "Single portable view of the chest.  The lungs are clear where not  obscured by overlying cardiac leads and wires.  The cardiomediastinal  silhouette is normal.  No acute osseous abnormality is identified.",
-            "output": "No acute cardiopulmonary process."
-        },
-        {
-            "input": "The heart size is normal.  The hilar and mediastinal contours are within  normal limits.  There is no pneumothorax, focal consolidation, or pleural  effusion.",
-            "output": "No acute intrathoracic process."
-        },
-        {
-            "input": "No focal consolidation, pleural effusion or evidence of  pneumothorax is seen.  Cardiac, mediastinal, and hilar contours are stable.   There is flattening of the diaphragm, suggesting chronic obstructive pulmonary  disease.",
-            "output": "No acute cardiopulmonary process.  Flattening of the diaphragms  suggests chronic obstructive pulmonary disease.  No significant interval  change since the prior study."
-        },
-        {
-            "input": "Moderate to severe bilateral pleural effusions and bibasilar consolidations,  left side has increased in size from prior.    Bilateral chest tubes are in place.    Right sided PICC line, tip in the SVC.    Mild pulmonary edema.    Stable left sided rib fractures.    Healed right sided rib fractures.    Multiple compression fractures in the thoracic and lumbar spine.  Innumerable  osseous lucencies consistent with known multiple myeloma.    Cardiomediastinal silhouette is obscured.     This preliminary report was reviewed with Dr. ___, ___  radiologist.",
-            "output": "Moderate to severe bilateral pleural effusions and bibasilar consolidations,  left side has slightly worsened from ___."
-        },
-        {
-            "input": "Right-sided PICC terminates in the low SVC.  Bilateral chest tubes are  unchanged in position.  There has been interval decrease in cardiomegaly.   Mediastinal congestion has improved.  Focal consolidation at the right lung  base obscuring the right heart border reflects atelectasis versus pneumonia,  better evaluated on most recent chest CT.  A small right pleural effusion  persists.  Partial collapse of the left lower lobe and moderate left pleural  effusion better evaluated on most recent chest CT.  There is no pneumothorax.",
-            "output": "1. No evidence of pneumothorax.  2. Cardiomegaly and mediastinal congestion have improved.  3. Consolidation in the right lower lobe better evaluated on most recent chest  CT likely reflects pneumonia versus atelectasis.  4.  Partial collapse of the left lower lobe and moderate left pleural effusion  better evaluated on most recent chest CT."
-        },
-        {
-            "input": "Opacification of the right mid and lower hemithorax is new since ___,  consistent with large pleural effusion and atelectasis.  Concurrent pneumonia  is possible.  Remaining aerated right apex is clear.  Opacification of the  left lower hemithorax is also new, consistent with an increasing, now moderate  pleural effusion.  Concurrent pneumonia is possible.  Aerated portions of the  left lung are clear.  Heart size cannot be assessed, borders obscured by the  bilateral opacities.  Dextroconvex curvature of the upper thoracic spine could  be positional.",
-            "output": "Bilateral large right and moderate left pleural effusion, markedly increased  since ___.  Underlying pneumonia cannot be excluded."
-        },
-        {
-            "input": "Bilateral moderate pleural effusions, left greater than right, and adjacent  atelectasis are stable to mildly increased since ___.  The heart size is  somewhat obscured but appears enlarged.  No pneumothorax.",
-            "output": "Stable to mild interval increase in bilateral moderate pleural effusions, left  greater than right, since ___."
-        },
-        {
-            "input": "Bilateral chest drainage tubes in situ.  Right-sided PICC line in situ with  the tip at the cavoatrial junction.  No pneumothorax.  Interval decrease in  size of the bibasal pleural effusions.  Adjacent subsegmental atelectasis seen  in the lower lung zones.  Coarsened appearance of the bones.",
-            "output": "Interval improved as evidenced by decrease in the size of the bilateral  pleural effusions."
-        },
-        {
-            "input": "Right-sided PICC terminates in the low SVC. Bilateral chest tubes are  unchanged in position.  Cardiomediastinal silhouette is unchanged within the limitations of patient  rotation. Previously seen opacity at the right mid to lower lung has improved.  There is increased retrocardiac and left lung base opacity.  There is no pneumothorax .",
-            "output": "Right basilar atelectasis has improved.  Increased moderate left pleural effusion and left basilar atelectasis."
-        },
-        {
-            "input": "A right chest drain has been placed in the interim, projecting over the right  mid hemithorax just under the superior aspect of the opacity that likely  pleural effusion.  The tip of the catheters straight and does not have the  \"pigtail appearance.  No significant subcutaneous emphysema.  Mottled  appearance of the bones is consistent with history of multiple myeloma with  bilateral chronic rib deformities likely old pathologic fractures.  No  significant change in bilateral large right and moderate left pleural  effusions.  Underlying pneumonia cannot be excluded.  No pneumothorax.  Heart  size cannot be assessed.",
-            "output": "1.  Interval placement of right chest drain with tip projecting over the  mid-upper hemithorax, just below the uppermost aspect of the effusion without  typical pig-tail configuration.  The position of this drain may be inadequate  to clear the pleural effusion.    2.  No change otherwise."
-        },
-        {
-            "input": "Right pleural catheter appears to have been withdrawn by 3 cm but terminates  within the chest cage.  Small right pleural effusion is less than before.   Large left pleural effusion is increased with increased rightward mediastinal  shift.  The right lung base opacity is probably atelectasis.  There is  persistent complete collapse of left lower lobe.",
-            "output": "1. Large left pleural effusion and rightward mediastinal shift is increased  than 1 day ago.  Small right pleural effusion is less  2. right pleural catheter appears to have been withdrawn by 3 cm but  terminates within the chest change.    NOTIFICATION:  Ipression 1 was discussed with ___, N.P. by ___, M.D. on  the telephone on ___ at 9:52 AM, 5 minutes after discovery of the  findings."
-        },
-        {
-            "input": "Compared to 4 days prior, no appreciable change in the size of the moderate  bilateral pleural effusions.  Lungs are otherwise clear.  Heart size and  cardiomediastinal hilar silhouettes are unchanged.  Multiple compression  deformities throughout the visualized spine are unchanged.  Markedly abnormal  sternum contour is similarly unchanged.",
-            "output": "Unchanged moderate bilateral pleural effusions."
-        },
-        {
-            "input": "AP and lateral views of the chest.  No prior.  There is elevation  of the left hemidiaphragm.  The lungs are grossly clear of consolidation or  large effusion.  The cardiac silhouette is enlarged and the aorta is tortuous.  Osseous and soft tissue structures are unremarkable.",
-            "output": "Cardiomegaly.  No definite acute cardiopulmonary process."
-        },
-        {
-            "input": "Dual lumen right-sided central venous catheter seen with the tip in the upper  right atrium. There is mild prominence of interstitial markings without and  bibasilar opacities potentially due to atelectasis. There is no large  effusion. The cardiomediastinal silhouette is within normal limits. No acute  osseous abnormalities identified.",
-            "output": "Bibasilar opacities could be due to atelectasis however infection is not  entirely excluded. Consider two views to further characterize."
-        },
-        {
-            "input": "Lungs are well-expanded and clear, with minimal atelectasis in the right lung  base. There is mild cardiomegaly. The mediastinal hilar contours are  unremarkable. There is no pleural effusion, pulmonary edema, pneumothorax, or  focal consolidation.",
-            "output": "Mild cardiomegaly. No evidence of pneumonia."
-        },
-        {
-            "input": "The lungs are clear.  Cardiac silhouette is normal.  No pleural effusion or  pneumothorax. There is no free air.    Previously, the left hilar region was thought to be slightly rounded in its  contour however, recent chest CT demonstrated this was vascular in origin and  not due to lymphadenopathy.  There was a borderline lymphnode seen on that CT  for which recommendation was for repeat limited CT with contrast.",
-            "output": "No acute cardiopulmonary process."
-        },
-        {
-            "input": "The lungs are clear.  There is no pleural effusion, pneumothorax or  focal airspace consolidation.  The heart size is normal. The left hilus  demonstrates a rounded opacity which is indeterminate but likely overlapping  vessels.  The hilar structures and pleural surfaces are unremarkable.  There  are no acute osseous abnormalities.  The imaged upper abdomen is normal.",
-            "output": "Rounded prominence of the left hilus is likely vascular, however,  given the provided history a CT is recommended for further characterization.    These findings were entered into the Critical Results dashboard on ___."
-        },
-        {
-            "input": "Lungs are mildly hypoinflated.  No infiltrate or edema.    The cardio-mediastinal silhouette is unremarkable.    No significant pleural effusion or pneumothorax.",
-            "output": "No acute pulmonary disease"
-        },
-        {
-            "input": "Lung volumes are slightly low, resulting in bronchovascular crowding.  There  is mild bibasilar atelectasis.  Cardiomediastinal and hilar contours are  unremarkable.  No pneumothorax or pleural effusion.",
-            "output": "No acute cardiopulmonary process."
-        },
-        {
-            "input": "Frontal and lateral chest radiographs demonstrate elevation of the left  hemidiaphragm.  This obscures the left heart border, but allowing for this the  heart is likely normal in size.  There is no focal consolidation.  At the left  lung base is atelectasis, likely a small amount of pleural fluid.  No  pneumothorax is seen.",
-            "output": "Elevation of the left hemidiaphragm with atelectasis and possible small  pleural effusion.  No definite focal consolidation."
-        },
-        {
-            "input": "Heart size is normal.  The aorta is tortuous.  Pulmonary vascularity is normal  and the hilar contours are within normal limits.  No focal consolidation,  pleural effusion or pneumothorax is present.  Minimal linear opacities within  the left lung base likely reflect subsegmental atelectasis.  There is are no  acute osseous abnormalities.",
-            "output": "No acute cardiopulmonary abnormality."
-        },
-        {
-            "input": "The lungs are mildly hyperinflated.   There is a rounded opacity measuring 3.3  x 2.3 cm projecting over the descending aorta, best seen on the lateral view.  There is no pleural abnormality.  The heart size is normal.  The mediastinal  and hilar contours are normal.",
-            "output": "Rounded opacity projecting over the descending aorta.  Oblique views are  recommended for further evaluation.    RECOMMENDATION(S):  Oblique views are recommended for clarification of the  location of the opacity.    NOTIFICATION:   The findings were discussed with ___ at ___, ___, M.D.'s  office by ___, M.D. on the telephone on ___ at 12:53 PM, 5  minutes after discovery of the findings."
-        },
-        {
-            "input": "The lungs are well expanded and clear.  Cardiomediastinal  silhouette is unremarkable.  There is no pneumothorax or pleural effusion.   Visualized osseous structures are unremarkable.",
-            "output": "No acute cardiopulmonary process."
-        },
-        {
-            "input": "The lungs are hyperinflated with flattened diaphragms, consistent with known  COPD. There is a sublte predominantly linear opacity in the right lung base.  There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette  is unremarkable.",
-            "output": "1.  Subtle opacity in the right lung base, which may represent atelectasis but  an early focus of pneumonia is also possible.  If the diagnosis is in doubt  clinically, short-term followup radiograph could be obtained.    2. Pulmonary hyperinflation, consistent with known COPD."
-        },
-        {
-            "input": "Frontal and lateral chest radiographs demonstrate mildly hyperinflated lungs  which are clear.  No new consolidation or other findings concerning for  infection.  Symmetric biapical pleural thickening is noted. No pleural  effusion or pneumothorax. Cardiomediastinal and hilar contours are  unremarkable.  There are degenerative changes of the thoracic spine.",
-            "output": "No findings to suggest infection."
-        },
-        {
-            "input": "The heart size is normal.  The hilar mediastinal contours are normal.  Subtle  retrocardiac opacity is seen.  There is no large pleural effusion or  pneumothorax.  The visualized osseous structures are unremarkable.",
-            "output": "Subtle opacity in the retrocardiac region, may be secondary to pneumonia."
-        }
-    ]
-}

MedS-Bench/Text_summarization/task114_medqsum_text_summurization.json

@@ -1,434 +0,0 @@
-{
-    "Contributors": [
-        "MeQSum"
-    ],
-    "Source": [
-        "MeQSum"
-    ],
-    "URL": [
-        "https://github.com/abachaa/MeQSum"
-    ],
-    "Categories": [
-        "Text Summarization"
-    ],
-    "Definition": [
-        "You will be given a long medical question. Your task is to summarize the consumer health question."
-    ],
-    "Reasoning": [],
-    "Input_language": [
-        "English"
-    ],
-    "Output_language": [
-        "English"
-    ],
-    "Instruction_language": [
-        "English"
-    ],
-    "Domains": [
-        "Medical Knowledge"
-    ],
-    "Positive Examples": [],
-    "Negative Examples": [],
-    "Instances": [
-        {
-            "input": "SUBJECT: just a question\nMESSAGE: hi..just wanna ask... 1.how the aspirin can affect the ear? 2. what is the cause of suddenly ringging in the ear? isn't dangerous? tq.. :)",
-            "output": "What causes ringing in the ear, and can aspirin affect the ear?"
-        },
-        {
-            "input": "Dear Doc,\nI am now turning 40years in November and all my life I have desired\nmiserably for a divine intervention to restore my smell sense so that I can\nfully appreciate and participate in this one life on earth. I truly wish to\nbe a part of your research if need be because the disorder had greatly\naffected my life. If you already have medical drugs to cure and restore my\nsmell sense kindly give information on how I can acquire to benefit from\nthis. I pray that God the Creator gracefully grants me favour with this so\nthat I can enjoy the beauty of His creation in this world, with respect to\nsmell, before I depart to continue with Him in heaven. Cheers for now as I\nwait to hear from you.\n[NAME], Ms.\nSmell disorder (anosmia) patient /sufferer,\nwriting from [LOCATION]. Cell: [CONTACT], [CONTACT].",
-            "output": "What are the treatments for anosmia?"
-        },
-        {
-            "input": "SUBJECT: cosmetic leg shortening surgery\nMESSAGE: Hi,  I am a tall girl(5'8\"), who wants to undergo leg shortening sugery of 2 inches for cosmetic purpose. It would be good if I can get more information about it. I would like to know the cost of this surgery, the recovery time and the risks associated with it. How long should I stay in the hospital?  Thanks and regards",
-            "output": "Where can I find information on leg shortening surgery, including risks, cost, and recovery time?"
-        },
-        {
-            "input": "SUBJECT: ClinicalTrials.gov - Question - specific study\nMESSAGE: I am working with a Hep C   patient who needs treatment but cannot afford Tx. How can I help her get in touch with a recruiting study? There are no numbers or ways to contact a recruiting study. Sincerely, [NAME]",
-            "output": "Where can I find clinical trials on hepatitis C?"
-        },
-        {
-            "input": "SUBJECT: Laparoscopic Splenectomy\nMESSAGE: Dear Sir/Madam My brother [NAME] is diagnosed ITP. His doctor advises Laparoscopic Splenectomy for him. Can you please mail me detail and cost of this surgery. His Platletts count is decreased to 12 and his doctors giving him Injection Mebthera today to increase plattlets count. We are form [LOCATION], [LOCATION]. Please mail us as soon possible. Thanks & Best Regards [NAME]",
-            "output": "Where can I find information on laparoscopic splenectomy, including cost?"
-        },
-        {
-            "input": "SUBJECT: abetalipoproteimemia\nMESSAGE: hi, I would like to know if there is any support for those suffering with abetalipoproteinemia? I am not diagnosed but have had many test that indicate I am suffering with this, keen to learn how to get it diagnosed and how to manage, many thanks",
-            "output": "Where can I find information on abetalipoproteinemia, including diagnosis and treatment?"
-        },
-        {
-            "input": "hi. i'm a student that suffers from Pectus excavatum (funnel chest), and i need help to pass it. please give me some way to get the solution of this problem. waiting for your answer. please need help!",
-            "output": "What are treatments for pectus excavatum?"
-        },
-        {
-            "input": "SUBJECT: Looking for comparison FloraQ/RisaQuad\nMESSAGE: My MD instructed FloraQ.  Amazon advertises RisaQuad as comparable.\nYour site has never heard of RisaQuad.  Amazon ad doesn't tell you much.\nI checked several drugstores and can't find flora q in stock\nCan you help",
-            "output": "What are the differences between Flora Q and RisaQuad?"
-        },
-        {
-            "input": "SUBJECT: Research Report Assistance for Sudden Cardiac Arrest in Adolescence\nMESSAGE: Hello,               My name is [NAME] and I am a high school freshman at the [LOCATION] in [LOCATION]. I am doing a research report on Sudden Cardiac Arrest in Adolescence and I am contacting you to see if you could send me any articles, newsletters, brochures, research, pamphelts, or any other item(s) that you think might help me with my paper (especially any research that has been done or absolutely any information that you have on my topic). I am very interested in finding out more about this and the progress that has been made. I am mainly interested in researching about causes, symptoms, warning signs, treatment (if any), detection of it, and if it is purely genetic. I was also hoping you could help me better understand Sudden Cardiac Arrest in Adolescence. Let me thank you in advance for anything you send me via e-mail or mail. (In addition, if you have absolutely anything you can send me in the mail, please just tell me and I will gladly provide you with my address.) I hope that one day we can find eliminate Sudden Cardiac Arrest in Adolescence.  Thank you for your time and help, [NAME]",
-            "output": "Where can I find information on sudden cardiac arrest in adolescents?"
-        },
-        {
-            "input": "SUBJECT: gilberts diseases\nMESSAGE: my name is [NAME].  5days later i admitted in a hospital in treatment of viral fever.In hospital lot of tests blood,urine,ultrasound scan.In all tests my organs (lever,kidney,etc) are normal but my bilirubin Total is higher than normal. In my admission in hospital bilirubin is 3.2. Day by day my bilirubin decreased in the way of 2.8, 2.6, 2.4, 2.6, 2.5, respectevely. The other contents of blood and urine are normal at all. Hepatitis A,B,C are also negative.Today  Bilirubin direct  is 0.8. Doctor says it is Gilberts disease. Sir what can i do?. what is the reason for this?. what is your opinion sir? please reply soon .",
-            "output": "What causes gilberts syndrome and what are the treatments for it?"
-        },
-        {
-            "input": "SUBJECT: lupus an info on the diseise\nMESSAGE: Need all up date on lupus an send by mail informations on this subject..please i need more information to see if what i am exprienceing is in fact related to lupus ...thank you.",
-            "output": "Where can I find the latest information on lupus?"
-        },
-        {
-            "input": "Phobia: fear of taxidermy.\n Hello, I was wondering if there was a name for the fear of taxidermy? I often find myself having the symptoms this website describes when in the presence of something I fear deeply.",
-            "output": "Where can I find information on fear of taxidermy?"
-        },
-        {
-            "input": "spina bifida; vertbral fusion;syrinx tethered cord. can u help for treatment of these problem",
-            "output": "What are the treatments for spina bifida, vertebral fusion, and syrinx tethered cord?"
-        },
-        {
-            "input": "Regarding Gene. Hello!Can you advise me as to where I might be able to find information on the Gene and Variation:  BCMO1 rs 4889294, BCMO1 R267S rs 12934922 by chance please?  I believe it has to do with Vitamin A conversation but I cannot locate any info about it and treatment of course!  Thank you for your time and help! Gratefully,[NAME]",
-            "output": "Where can I find information on conditions caused by SNPs BCMO1 rs 4889294 and BCMO1 R267S rs 12934922, and what are the treatments for them?"
-        },
-        {
-            "input": "SUBJECT: Rubella\nMESSAGE: My grandson (4 yrs old) has contracted Rubella.  I know for sure he has had at least one of the vaccines.  They are living in Mexico right now.  Should we be worried?",
-            "output": "What is the prognosis of rubella in a child?"
-        },
-        {
-            "input": "SUBJECT: You know Diabetes Insipidus?\nMESSAGE: I was born with Diabetes Insipidus and have many problems since the cell was removed when I was 22 and ALL",
-            "output": "Where can I find information on diabetes insipidus?"
-        },
-        {
-            "input": "SUBJECT: Apraxia and Dyspraxia\nMESSAGE: What are the basic differences between apraxia and dyspraxia?  I get different answers from different sources. One suggests that apraxia is a motor coordination disability acquired due to damage, head injury, stroke or leasions in the brain whereas dyspraxia is inherited.  Another says that the difference is absence of coordination (apraxia) versus a more mild impairment (dyspraxia).  It is very confusing to try to sort it all out.  Thank you!",
-            "output": "What are the differences between apraxia and dyspraxia?"
-        },
-        {
-            "input": "SUBJECT: Ochoa syndrome\nMESSAGE: Where could I find more information about the rare disease, Ochoa syndrome. I think a sibling of mine might have it.",
-            "output": "Where can I find information on ochoa syndrome?"
-        },
-        {
-            "input": "SUBJECT: Progressive Supernuclear Palsy\nMESSAGE: What  is the best thing to do for my Dad who we r sure has psp!  Who r the best dr to treat this cease.  We believe my uncle had pep also   He recently passed away ,  I want to give my dad the best treatment available",
-            "output": "What are the treatments for progressive supranuclear palsy and how can I find physician(s) who specialize in it?"
-        },
-        {
-            "input": "Pupil Dilation.\n How often can a pupil dilation or eye fundus can be performed? For example is there a problem if I had one last week and then to have another this week? I appreciate your quick answer.  Thank you",
-            "output": "How often can pupil dilation be performed?"
-        },
-        {
-            "input": "MESSAGE: should Advair and Spiriva be used together?  It is my understanding that they are both control meds",
-            "output": "Can Advair and Spiriva be taken together?"
-        },
-        {
-            "input": "SUBJECT: Periventricular Heterotopia\nMESSAGE: I have a 10 year old boy with that syndrome and I will like to know if there someone doing reasech about it.  At the same time I will like to learn more about it. When my son was diagnose I was told he wasn't going to be able to do nothing at all. He was very weak , he learn to walk when he was 7 years. it been hard but I will do anything for my baby.",
-            "output": "Where can I find information on periventricular heterotopia, including the latest research?"
-        },
-        {
-            "input": "SUBJECT: Regarding falaria diseases\nMESSAGE: Sir, my wife has been suffering from falaria disease in her right leg for 2 years , please show/ tell me the treatment. my contact no. is [CONTACT].",
-            "output": "What are the treatments for filarial disease?"
-        },
-        {
-            "input": "SUBJECT: chemical reactions to meds.\nMESSAGE: What is the clinical name for people who have chemical reactions to medications? Is there a cure?  Thanks",
-            "output": "What are the treatments for drug reactions?"
-        },
-        {
-            "input": "SUBJECT: Sle\nMESSAGE: How much level of feritin is responsible for SLE? Adult still's disease is related with Sle? How we differ them?",
-            "output": "How is a differential diagnosis made between SLE and adult still's disease?"
-        },
-        {
-            "input": "SUBJECT: varicella  shingles\nMESSAGE: How can I determine whether or not I've had chicken pox.  If there is a test for it, what are the results of the tests I need to know that will tell me whether or not I have had chicken pox?  I want to know this to determine if I should have shingles vaccine  (Zostavax) Thank you.",
-            "output": "How do i find out if i had chickenpox?"
-        },
-        {
-            "input": "Achondroplasia research.\n Hello, We are students from [LOCATION] and we are doing a biology project of genetic diseases. We chose Achondroplasia as our disease to research. We have a few question and we are hoping you could answer them. Our questions are, can you tell if your child will have Achondroplasia when you are pregnant? When do people usually come in when they think something isn't right with their child? what are the worse cases of Achondroplasia you've ever seen? Thank you in advance.\nsincerely,\n[NAME]",
-            "output": "Where can I find information on achondroplasia, including prenatal diagnosis and prognosis?"
-        },
-        {
-            "input": "SUBJECT: about manturation cycle\nMESSAGE: My mensuration cycle is not uniform.. there are many days gap in a month. Some time the gap is more then 1month. What I have to do.",
-            "output": "What are the treatments for irregular periods?"
-        },
-        {
-            "input": "MESSAGE: I want more information on Hypertension and fibromyalgia, I seem to be getting only topics on diabetes and I do not have this.   I enjoy reading the current info.  thanks [NAME]",
-            "output": "Where can I find information on hypertension and fibromyalgia?"
-        },
-        {
-            "input": "SUBJECT: inversion of long arm chromasome7\nMESSAGE: My son has been diagnosed with inversion of long arm chromasome 7 and down syndrome . please could you give me information on the chromasome 7 please because our doctors have not yet mentioned it",
-            "output": "Where can I find information on chromosome 7?"
-        },
-        {
-            "input": "SUBJECT: lupus\nMESSAGE: Hi,  I  want to know about Lupus and its treatment. Best,  [NAME]",
-            "output": "Where can I find information on lupus and what are the treatments for it?"
-        },
-        {
-            "input": "SUBJECT: Asking about Hairy cell leukemia\nMESSAGE: I get report for my father from hospital it is saying that he have Hairy cell leukemia i am here to ask if this dissease dangerous and there is treatment for it  Also if The one who have it will live for long or not ?  My father age is 55  We discover the dissease by blood test",
-            "output": "Where can I find information on hairy cell leukemia, including treatment and prognosis?"
-        },
-        {
-            "input": "diagnosis of OI/ resources. I was writing to inquire about more information regarding the diagnosis of OI.  We have family members who are in the process of waiting for genetic testing to come back but are under allegations of child abuse.  Is there any information and / or resources that may be helpful to us? Any help is appreciated. Thank you,[NAME]",
-            "output": "How is osteogenesis imperfecta diagnosed and what are its symptoms?"
-        },
-        {
-            "input": "SUBJECT: shingles\nMESSAGE: Hi\nI had shingles a while ago on my left forehead and above my eye, not long after it started again, this time under my left breast, extremely painful and am wondering can this start again ?\nty\n[NAME]",
-            "output": "Where can I find information on recurrent shingles?"
-        },
-        {
-            "input": "SUBJECT: ODD facilities\nMESSAGE: Two friends of ours have an 8-year-old child with Oppositional Defiant Disorder and autism, and they are being told by a facility that they need to institutionalize him there. Our friends are heartbroken. Are there any excellent places in the country that specialize in ODD in combination with autism that might offer other options for them? Thanks for any counsel you might have.",
-            "output": "How can I find physician(s) or hospital(s) who specialize in oppositional defiant disorder and autism?"
-        },
-        {
-            "input": "SUBJECT: \"ClinicalTrials.gov - Question - general information\n\"\nMESSAGE: Please i really need your reply and your help :( My wife has Allergy from all milk products and whenever she drinks or eats any thing contains small amount of any milk products she goes to the hospital. I have faith that there is a cure for that but i really donno what to say to her. She thinks that she will never be cured. So please can you tell me is there is any cure for milk products allergy, any cure? or any cure in the very near future? I will be very very very grateful if you replied, Thanks alot. :)",
-            "output": "What are the treatments for lactose intolerance and can it be cured?"
-        },
-        {
-            "input": "SUBJECT: Plantar Fasiciitis\nMESSAGE: Is it true that more likely than not that Plantar fasiciitis could be aggravated by a consistancy of weight bearing activities?    Are there other forms of aggravation? if so will you please inform me.",
-            "output": "What are the prevention and  treatments for plantar fasciitis?"
-        },
-        {
-            "input": "SUBJECT: Very high blood sugar!\nMESSAGE: I had two injections in my feet yesterday (5-22-14).  The physician said to watch my blood sugar carefully, as the injections could cause a rise in my blood count. I began having memory problems last evening after an MRI, and then this morning and at noon today (5-23-14), my count has been 427.  I have read my magazines about diabetes, pulled up several things on Medline Plus, and tried to get in touch with two of my doctors who might help.  Everyone is busy, and I totally understand.  I just need to know what, if anything, I can do to get my blood sugar down as fast as possible.  Thank you,  [NAME] [CONTACT]",
-            "output": "What are the treatments for high blood sugar?"
-        },
-        {
-            "input": "Vitamins.\n Can I take zinc and zinc citrate at the same time?",
-            "output": "Can zinc and zinc citrate be taken together?"
-        },
-        {
-            "input": "Does either of these help with skin keloids?\nWhat would help keloids?",
-            "output": "What are the treatments for skin keloids?"
-        },
-        {
-            "input": "Project. Hi my name is [NAME] and I'm doing a school project about leukemia and I was wondering if you can anwser some of my questions please.1. What cause leukemia cancer?2. Can you survive leukemia?3. How does leukemia affect your body?4. Is leukemia inherited?5. What is advanced leukemia?6. How long can someone with leukemia expect to live?7. Can you tell if you have leukemia?8. What treatments do you need to take?9. What are the signs of leukemia?10. What is the difference between AML and CML ?",
-            "output": "Where can I find information on the different types of leukemia, including causes, treatment, prognosis, diagnosis, symptoms, and inheritance?"
-        },
-        {
-            "input": "SUBJECT: New Hep C Virus Treatments\nMESSAGE: In 2006-2007, at the VAMC in [LOCATION], i went through the HEP C Treatment using Ribavirin and Interferon. My viral load was undetectable immediately at the BOT. I stayed on the treatment faithfully and painfully for a4 months; when at the EOT my viral load was still indictable. I was considered a success. When i came back after 6 months for a checkup, it was found my HCV had relapsed. Now I want to know what treatments are now available to me. I hear of these new wonder cures that have been approved in the past year and i want to be retreated. Please send me all the info you have on these new treatments while i wait here and die at age 45. I was exposed with the HCV virus from a tattoo while in the armed forces overseas.",
-            "output": "What new treatments are available for recurrent hepatitis C?"
-        },
-        {
-            "input": "SUBJECT: shingles\nMESSAGE: I work at the Airport and I am in contact with hundreds of people a day. I want to be sure that I am not going to expose people to Shingles. When is it safe for me to go back to work?",
-            "output": "When is shingles contagious?"
-        },
-        {
-            "input": "SUBJECT: Treatment required\nMESSAGE: I m 37 years old and i m suffer from poor hunger,loss of appetite and and no desire to eat. I have only some anxietic condition and some heart burn problem. Kindly suggest something for me to solve my problem.",
-            "output": "What are the treatments for anxiety, heartburn, and loss of appetite?"
-        },
-        {
-            "input": "SUBJECT: Negative Interaction\nMESSAGE: My question is the following : is there any negative interaction between Ginkgo and Pycnogenol. Thank very much for your attention.",
-            "output": "Are there drug interactions between ginkgo and pycnogenol?"
-        },
-        {
-            "input": "SUBJECT: RUSSEL SILVER SYNDROME\nMESSAGE: I want to know about RUSSEL SILVER SYNDROME If I ask you my little son nine month old but he look like very little I don't know anything about this symptoms please send me all information. my address [CONTACT].",
-            "output": "Where can I find information on russell-silver syndrome?"
-        },
-        {
-            "input": "Cross Eye.\n Need to fix my cross eyed",
-            "output": "How to treat crossed eyes?"
-        },
-        {
-            "input": "MESSAGE: hi my name is [NAME] I'm currently working with [LOCATION] and I was wondering  I came across some of you healthy tip fliers for HIV/Aids treatment .at the moment we have a study  going on that helps HIV positive transgender women into HIV quality care .so it would be great to have some more information on HIV/Aids treatment",
-            "output": "What are the treatments for HIV/AIDS?"
-        },
-        {
-            "input": "MESSAGE: I have had renal organ transplant surgery a year ago. What risk factos must I avoid to prevent the recurrance of ESRD and to maintain a healthy &functioning grafted kidney ?",
-            "output": "How do I care for my kidney after renal transplant?"
-        },
-        {
-            "input": "SUBJECT: oleander poisoning\nMESSAGE: If oleandor was ingested by touching the plant stems inner part and then directly eating without washing hands, how long would u exspect symptoms would start? And how severe would you say symptoms may get.",
-            "output": "When do symptoms of oleander poisoning appear after ingesting the plant, and how severe can they get?"
-        },
-        {
-            "input": "ClinicalTrials.gov - Question - general information.\n My granddaughter was born with Klippel-Tranaunay Syndrome...There is very little information about this.  We are looking for the current research and treatments available.  She is 5 months old now and her leg seems to be most affected.  We want to get her help as soon as possible to address the symptoms and treat her condition.",
-            "output": "What is the latest research on klippel-trenaunay syndrome, and what are the treatments for it?"
-        },
-        {
-            "input": "SUBJECT: spinal cord stenosos\nMESSAGE: I have acute arthritic spinal stenosis. What treatment is recommended?",
-            "output": "What are the treatments for spinal cord stenosis due to arthritis?"
-        },
-        {
-            "input": "SUBJECT: questins\nMESSAGE: i am looking for the latest evidence based practice on guidelines for assessing and treating Alcohol and Opiate withdrawal. Thanks.",
-            "output": "What are the latest evidence based treatments for alcohol and opiate withdrawal?"
-        },
-        {
-            "input": "hello\ni am looking for information related to the above (myostatin-related muscular hypertrophy) genetic condition.\ncan you direct me to a hospital or other genetic research institution that might be doing research on this genetic condition?",
-            "output": "Where can I find information on myostatin-related muscular hypertrophy, and how can I find an organization doing research on it?"
-        },
-        {
-            "input": "SUBJECT: Painful menstrual periods\nMESSAGE: My wife has suffered this . How can treat this.",
-            "output": "What are the treatments for painful menstrual periods?"
-        },
-        {
-            "input": "I have an hernia I would love to take care off it ASAP I was wondering if you guys could help me . Thanks",
-            "output": "What are the treatments for hernia?"
-        },
-        {
-            "input": "SUBJECT: ClinicalTrials.gov - Question - general information\nMESSAGE: I HAVE A BOY 16 WHO JUST GOT OUT OF A PLACE THAT GAVE HIM MEDACATION,THES ARE THE MEDS.MONTELUKAST,LORATADINE,OXCARBAPINE. WHAT DISORDER ARE THEY FOR?",
-            "output": "What are the indications for montelukast, loratadine, and oxcarbazepine?"
-        },
-        {
-            "input": "SUBJECT: LGMD\nMESSAGE: Dear Sir, i would like to bring your kind attention to a serious matter that my Mother has been suffering from LGMD so i would like to request you for any possible assistance regarding the treatment of this disease.  my email id is [CONTACT]",
-            "output": "What are the treatments for LGMD?"
-        },
-        {
-            "input": "SUBJECT: Cervical Cancer\nMESSAGE: Can a long term untreated bladder infection aid in the cause of cervical cancer? And can the fact that my mom has cervical cancer aid in my chance of getting cervical cancer?",
-            "output": "What causes cervical cancer, and is it hereditary?"
-        },
-        {
-            "input": "cant use site.\n I want to find a doctor who specializes in burning mouth syndrome and that could be in many specialities, I cannot understand how to do this on your website.",
-            "output": "How can I find physician(s) who specialize in burning mouth syndrome?"
-        },
-        {
-            "input": "Good evening, I will contact you as my [NAME] a year and a half have been diagnosed with the genetic mutation STXBP1. I would like to know if there is something in the world that can help my son. I hope you contact us as soon as possible. \nGreetings [NAME]",
-            "output": "What are the treatments for genetic mutation STXBP1?"
-        },
-        {
-            "input": "SUBJECT: please send me medical information about heart failer for care.\nMESSAGE: send me information about heart failer.",
-            "output": "What are the treatments for heart failure?"
-        },
-        {
-            "input": "Kartagener's syndrome. I am suffering from Kartagener's syndrome and wanted information from you or from Dr. [NAME]. for this syndrome. (About fertility) and if possible other symptoms. Thank you.",
-            "output": "Where can I find information on kartagener's syndrome and its symptoms, including  fertility?"
-        },
-        {
-            "input": "pierre robins syndrome. Good Morning, Just a query for you regarding the above. Is it true to saythis is caused by an abnormal chromezone and is carried by the mother and transferred to boys only. This is supposed to happen 1 in 4. The male does not carry the jene. I would appreciate your expert information please.",
-            "output": "What are the inheritance patterns for pierre robins syndrome?"
-        },
-        {
-            "input": "migraine. I want to know the treatment for FHM type of migrain . I had observed the all symptoms which are same as provided in information and additionally my father and my younger sister face the acidity problem too. they feel relief after vomiting so both of them do the same by drinking warm water containing salt.",
-            "output": "What are the treatments for familial hemiplegic migraine?"
-        },
-        {
-            "input": "SUBJECT: Obesity Questions\nMESSAGE: Hello. My name is [NAME] and I am a junior in high school. I am currently doing a research topic on obesity and was wondering if you would be able to answer a few questions. It would be greatly appreciated if you could! Thank you! 1)What/Who is to blame for obesity? 2)Do you think putting  a tax on junk food will reduce the amount of obese people? Why or why not? 3)How can we prevent obesity? 4)What are the benefits of getting 30 minutes of exercise daily and eating healthy? 5)Should the government be more involved in the help to stop obesity? Why or why not? 6)What is the number one thing we should eat less of/ cut out of our diets? (such as, fats, carbs, sugars,etc)  Thank you for your time!",
-            "output": "Where can I find information on obesity, including causes, prevention, and treatments?"
-        },
-        {
-            "input": "SUBJECT: once you open the bottle of Releev, how long is it good for?\nMESSAGE: once you open the bottle of Releev, how long is it good for?",
-            "output": "How long does releev retain its potency after opening?"
-        },
-        {
-            "input": "SUBJECT: dry maculare tetinal degeneration\nMESSAGE: my grandfather had lens implants, now he has dry macular retinal degeneration.  he can hardly see!  searching for help!",
-            "output": "What are the treatments for dry macular retinal degeneration? "
-        },
-        {
-            "input": "SUBJECT: is there any medicines for peristaltic movements?\nMESSAGE: I V[NAME] From [LOCATION] which is located at INDIA. I am a patient of less peristaltic movements which was digests the eaten food in 3 to 4 hours... In normal humans which was digests the eaten food in 2 to 3 hours...  I visited several hospitals in [LOCATION] which is located in INDIA...  When i was visited [LOCATION]\" Hospital at HYDERBAD in the year of 2010..  There Doctors has told there is no medicins for this problem..  Is  there any medicines to improve my  peristaltic movements?  Please Replay to My E-mail[CONTACT] and My Mobile Number is: [CONTACT]  Thanking You taking my request....",
-            "output": "What are the treatments for slow peristaltic movements? "
-        },
-        {
-            "input": "SUBJECT: question about ingredients\nMESSAGE: I am currently taking 20mg generic Adderall immediate release from your company. Does this medication have gluten containing ingredients? I have Celiac disease and I am very sensitive to small amounts, so I am trying to make sure this medication is safe to take.\nThank you for any and all help.\n-[NAME]",
-            "output": "What are the ingredients of  20mg generic Adderall and it is gluten free?"
-        },
-        {
-            "input": "what does it means if someone blood is light.\n I took injection this night and the nurse said my blood is light, what's does that mean. Sinfe , have been worry.",
-            "output": "Why is my blood a light red?"
-        },
-        {
-            "input": "SUBJECT: Omege 3 Acid capsule\nMESSAGE: I am currently taking Lovaza. My pharmacy, CVS, has advised me that the above, Omega 3 Acid capsule is now available as a generic alternate. My doctor has said that she is not aware of a generic for Lovaza. Who is correct?",
-            "output": "Is there a generic version of Lovaza? "
-        },
-        {
-            "input": "Factor 12 defeincy. I have factor 12 defiency, my GP has told me it is linked to aboriginal/ TSI heritage, is this correct ?    Thanks [NAME]",
-            "output": "Is factor 12 deficiency linked to aboriginal heritage?"
-        },
-        {
-            "input": "SUBJECT: fibroadenomas\nMESSAGE: i have a fibroadenomas? my question is it can remove without surgery? taking medicine is help to reduce or remove this? or if i didnt undergo operation it is safe? because surgery is expensive here at the philippines",
-            "output": "Can fibroadenoma be treated without surgery?"
-        },
-        {
-            "input": "SUBJECT: foreskin\nMESSAGE: I want to regrow my foreskin back. When will stem cell be able to regrow foreskin.",
-            "output": "Is stem cell therapy used to regrow foreskin?"
-        },
-        {
-            "input": "SUBJECT: methotrexate - gluten free?\nMESSAGE: is the injection form of methotrexate gluten free?\nthanks -",
-            "output": "Is the injection form of methotrexate gluten free?"
-        },
-        {
-            "input": "SUBJECT: Peruvian girl\nMESSAGE: Dear Sir/Madam, I am writing you on behalf of [NAME], who is very stress and with a lot of tension,looking for HELP for her daughter [NAME].  [NAME] has a complex hearth defect called Tetralogy of Fallot, she is about 7 months old and her family dont have resources to cover her treatment in order to get her welfare.  [NAME] has a very low income, lives in a rented room with her husband and her two children, in [LOCATION] - Peru. She works at [LOCATION] and she has been taking her daughter to children hospital in [LOCATION] but she cant afford the medicines and treatment that they ask for, she is looking desperately for help for her daughter.  I was wondering if you guys have any contact here in [LOCATION] of any organization, who can help [NAME]. I have been looking but cant find or never not came back to me when I asked them.  If you please know about any organization who can help us here in [LOCATION] Peru, I will really appreciate and we can make help to give [NAME] a better life :-)  I am a Health and Social care worker and work at the hospital too with the employees. Thank you very much for your time  [NAME]  [CONTACT]",
-            "output": "Which organizations provide support for Tetralogy of Fallot in Peru?"
-        },
-        {
-            "input": "SUBJECT: Heat rash\nMESSAGE: I am looking for information on heat rash.  Specifically, can it look like a red line and how it appears at it resolves.\nIf information is available, I can come to the library to read hard copy text or copy photographs.\nI can be reached through email or by calling [CONTACT].\nI appreciate all the help that may be available on this important matter.",
-            "output": "Where can I find information on heat rash, including symptoms and treatment? "
-        },
-        {
-            "input": "SUBJECT: high inner eye pressure above 21 possible glacoma\nMESSAGE: have seen inner eye pressure increase as I have begin taking Rizatriptan. I understand the med narrows blood vessels.  Can this med.  cause or effect the closed or wide angle issues with the eye lense/glacoma.",
-            "output": "Can Rizatriptan cause glaucoma?"
-        },
-        {
-            "input": "hypothyroidism.\n My doctor started me on levothyroxene 5oMCG. for 5mths.How do I know if this is  the rite dosage? Do not want to cause myself any harm by overdosing",
-            "output": "What is the normal dosage of levothyroxine for hypothyroidism?"
-        },
-        {
-            "input": "SUBJECT: theoretical question\nMESSAGE: How much time you can spend at most before a cerebral aneurysm will cause death? Sorry I'm using translator because I speak and write in Spanish if they were so kind to send me the answer to [CONTACT] Thanks.",
-            "output": "What is the prognosis of cerebral aneurysm?"
-        },
-        {
-            "input": "SUBJECT: adrenoleukodystrophy\nMESSAGE: A child I have been asked to work with has been diagnosed with this condition.I am so far unable to find info pertaining to this illness. Can you help??",
-            "output": "Where can I find information on adrenoleukodystrophy? "
-        },
-        {
-            "input": "laser hair removal treatment.\n I HAVE EXCESS HAIR GROWTH ON MY NECK AND CHIN. REASON IS MY HORMONAL IMBALANCE AND THYROID. THEY ARE BLACK HARD HAIRS. I WANT TO KNOW THAT LASER HAIR REMOVAL IS SAFE AND SATISFATORY FOR ME OR NOT? WHAT IS ITS CONSEQUENCES IN LONG TERM? WILL THE HAIR GROWTH WILL BE CONTROLLED LIFE TIME! PLEASE GUIDE ME.. ! THANKING YOU!",
-            "output": "Where can I find information on laser hair removal including long term consequences?"
-        },
-        {
-            "input": "Hey I was just wanting to know how I can try to receive stem cell treatment for spinal cord injury using the stem cells I have banked from my newborn baby's umbilical cord tissue? If u have any information please tell me, you'll be helping to save my life!",
-            "output": "How to receive stem cell treatment for spinal cord injury?"
-        },
-        {
-            "input": "SUBJECT: spg11\nMESSAGE: My 24 year old son was recently diagnosed with  spg11 after over 15 years of trying to figure out what was wrong.  We are already doing some of the common treatments.  My question is, where do we go from here to give him the best chance at life,",
-            "output": "What are the treatments and prognosis for spg11?"
-        },
-        {
-            "input": "SUBJECT: diabetes\nMESSAGE: It was really helpful after reading about type 1 diabetes but would like some more suggestions from you .my friend is 35 year old and its been 1 year of his diabetes n his sugar level is around 100 or 120 OR SO.. each time he tests his sugar level. is there ANY COMPLICATIONS? HE ALSO GO FOR EXERCISES AND BLOOD TEST EVERY 2 OR 3 MONTHS N TAKES A PROPER DIET LIKE GREEN JUICE,OLIVE OIL AND ALL. WAITING FOR YOUR FEED BACK. THANK YOU.",
-            "output": "What are the complications of type 1 diabetes?"
-        },
-        {
-            "input": "MESSAGE: I have to start applying ciclopirox to infected toes. I know u cannot use nail polish bit can I put a band aid on once the medication has dried?",
-            "output": "Can i cover ciclopirox with bandaids?"
-        },
-        {
-            "input": "About Aarskog Syndrome. hi my name is [NAME] i am 21 this year and was wondering if it is connected with server  Astigmatism as i got it in my left eye. I have a mild form of As, i have the wide peek eyes and rugby shaped and missing DNA which they have discovered in MRI scans. I was diagnosed when i was born but it still seems to be in research as we speak and ever since i turned 18 i have been doing my own research and finding others around by connecting with them on Facebook. I live in the [LOCATION] and found out there are four people that have Aarskog syndrome. thank you for your time",
-            "output": "Is Astigmatism related to Aarskog Syndrome?"
-        },
-        {
-            "input": "GERD.\n I'm a 72 year old female, and have diverticulosis,gastritis, and esophagitis.  I tried to see three different doctors today, but all were booked.  I honestly don't know what to do.  It hurts in my chest, and I can hardly talk.",
-            "output": "How to treat chest pain potentially associated with  diverticulosis, gastritis, and esophagitis?"
-        },
-        {
-            "input": "SUBJECT: Ankle Injury\nMESSAGE: I got hurt in my left leg ankle almost 5 months ago. I went to doctor, got x-ray, where no damage was found. He suggested me some pain killers and advised me to wear anklet. I have been following the instruction since then; I went to another doctor who advised me to go for physiotherapy (Short Wave Diathermy) and advised me some exercises. I have been following them too. But yet now, I have not been fully recovered from the pain. Especially when I try to walk quickly or try to put pressure with my left leg, I feel pain. I am very tensed about this. Can you please suggest me how to overcome the pain. Thanks.",
-            "output": "What are the treatments for ankle injury and pain? "
-        },
-        {
-            "input": "SUBJECT: Ankylosing Spondylitis\nMESSAGE: Hello, My name is [NAME] and i live in india. I have suffered Ankylosing Spondylitis problem since last 2 years in lower back. so plz guid me properly how to cure this problem?  Thanks [NAME]",
-            "output": "What are the treatments for Ankylosing Spondylitis?"
-        },
-        {
-            "input": "SUBJECT: Ingredients\nMESSAGE: Pleease email  me a llist of 100%, all, of the ingredients iPerioMed, .63% floride concetrate Oral rinse,, alcohol rinse.\nThank you!  [NAME]",
-            "output": "What are the ingredients of PerioMed 63% fluoride concentrated oral rinse?"
-        },
-        {
-            "input": "ARE THERE ANY SKIN CREAMS THAT HAVE POSITIVE EFFECTS ON SKIN CANCER?? \u00a0WHICH ARE THE BEST??\u00a0[CONTACT]\u00a0",
-            "output": "What are the best creams for skin cancer? "
-        },
-        {
-            "input": "asthsma.\n I have been having problems w/ shortness of breath and dizziness and stress heat. what do you think? do i have asthsma or not?",
-            "output": "What are the symptoms of asthma? "
-        },
-        {
-            "input": "ClinicalTrials.gov - Question - specific study. Do you have any more indepth information regarding pseudocholinesterace deficiency? My son 28 and myself 56 have this problem and we both have systemic muscle spasms. cramps contractions. Most seem to be caused by knots or trigger points. I assume this has something to do with this deficiency because it deals with neuro transmissions correct. Anyway we are looking for relief. The muscle relaxants help a bit but the knots do not go away and so the pain is still there at a deeper level. The doctors and neurologist have no idea. Thank you. [NAME]",
-            "output": "Where can I find information on pseudocholinesterase deficiency icluding treatment?"
-        },
-        {
-            "input": "SUBJECT: after surgery of ear drum still same problem\nMESSAGE: i got surgery for hole in my ear drum(hole was in my ear from 5 0r 6 ears but i did not know it but when i came to know i got surgery) but after  two year surgery still i have same problem. problem in listening and continuous noise like buzzing or ringing in my right ear.so sir what should i do right now? plz sir help me. buzzing in my both has been started from last 3 year.plz help me....",
-            "output": "What are the treatments for perforated eardrum?"
-        },
-        {
-            "input": "SUBJECT: ClinicalTrials.gov - Question - specific study\nMESSAGE: LOOKING FOR HELP FOR MY NEPHEW WITH GLYCOGEN STORAGE DISEASE.  HE LIVES IN VIRGINIA AND IS SUFFERING BADLY.  HE HAS BEEN HOSPITALIZED FOR SEVERE CRAMPING ABOUT 5 TIMES THIS YEAR SO FAR.  ANY GUIDANCE YOU COULD GIVE WOULD BE GREATLY APPRECIATED.",
-            "output": "What are the treatments for Glycogen storage disease?"
-        },
-        {
-            "input": "MESSAGE: I have numbness/tingling in my lower right arm from elbow to my fingers. A EMG has shown nothing abnormal. I have had this for a long time, I need help.",
-            "output": "Where can I find information and treatment for numbness and tingling in lower right arm?"
-        },
-        {
-            "input": "SUBJECT: sleep apnea\nMESSAGE: I was diagnosed with sleep apnea (prolly had it for 5 years) and I have swelling issues caused from that (it has been ruled out from everything else so the doctor thinks).  I just got my cPap machine.  I was wondering how long will it take for the swelling to go away.  Thank you!",
-            "output": "How long does swelling from sleep apnea take to heal? "
-        },
-        {
-            "input": "SUBJECT: Home resources for AMD people\nMESSAGE: What specific resources are available for an elderly male living by himself at home?  My father in law is 85 years old, lives alone and has macular degeneration.  Looking for visual aids to assist him around the house.",
-            "output": "What resources are available for elderly with age-related macular degeneration?"
-        }
-    ]
-}

MedS-Bench/Text_summarization/task85_mimic_ct_brain_summarization.json

@@ -1,62 +0,0 @@
-{
-    "Contributors": [
-        "MIMIC"
-    ],
-    "Source": [
-        "MIMIC-IV"
-    ],
-    "URL": [
-        "https://www.physionet.org/content/mimic-iv-note/2.2/"
-    ],
-    "Categories": [
-        "Text Summarization"
-    ],
-    "Definition": [
-        "Summarize the CT imaging diagnostics' detailed findings for the Brain into a concise conclusion."
-    ],
-    "Reasoning": [],
-    "Input_language": [
-        "English"
-    ],
-    "Output_language": [
-        "English"
-    ],
-    "Instruction_language": [
-        "English"
-    ],
-    "Domains": [
-        "Clinical Text"
-    ],
-    "Positive Examples": [],
-    "Negative Examples": [],
-    "Instances": [
-        {
-            "input": "There is no evidence of infarct, hemorrhage, or mass.  The\nventricles, cisterns, and sulci show symmetric, age-related prominence.  There\nis no fracture.",
-            "output": "Normal for age."
-        },
-        {
-            "input": "There is no evidence of acute intracranial hemorrhage, mass, mass effect or\nlarge territorial infarction.  Prominence of the ventricles and sulci is\nlikely related to age related involutional changes.  Periventricular deep\nsubcortical white matter hypodensities are likely sequelae of chronic\nmicroangiopathy.  The basilar cisterns are patent, and there is otherwise good\npreservation of the gray-white matter differentiation.\n\nMild mucosal sinus thickening is seen involving the ethmoid air cells.  The\nremainder the visualized paranasal sinuses, mastoid air cells, and middle ear\ncavities are clear.  The globes are unremarkable.\n\nCT BRAIN PERFUSION:\nCBF <30% volume: 12 cc\nTmax >6.0s volume: 12 cc\nMismatch volume: 0 cc\nMismatch ratio: 1.0",
-            "output": "No acute intracranial abnormalities identified.  Chronic microangiopathy."
-        },
-        {
-            "input": "CT HEAD WITHOUT CONTRAST:\nThere is loss of the gray-white differentiation involving the left MCA\nvascular territory distribution, consistent with acute ischemic infarction. \nThere is mild sulcal effacement in the left frontal and parietal lobes in a\nsimilar distribution, compatible with cytotoxic edema.  There is no evidence\nof intracerebral hemorrhage or suspicious mass.  The ventricles and sulci are\nnormal in size and configuration.\n\nThere is no acute calvarial fracture. The visualized portion of the paranasal\nsinuses, mastoid air cells,and middle ear cavities are clear. The visualized\nportion of the orbits are normal.\n\nCT PERFUSION: RAPID perfusion maps demonstrate an area of increased mean\ntransit time with corresponding decreased region through blood volume,\nindicative portion of the left MCA territory.  Surrounding the score is a\nsmall number of the demonstrates preserved volume with a reduction in cerebral\nblood flow, indicating ischemic penumbra.  Per the RAPID perfusion maps, there\nis an approximate the mismatch volume of 351 mL with a mismatch ratio of 8.2. \nThere is significant motion artifact, which may artificially increased the\nmean transit time.\n\nCBF <30% Volume: 49 mL\nTmax>6.0s: 400 mL\nMismatch Volume: 351 mL\nMismatch ratio: 8.2",
-            "output": "1. There is loss of gray-white matter differentiation in the left the MCA\nvascular territory concerning for acute infarction.  There is a corresponding\ninfarct core with surrounding ischemic penumbra in the left frontal and\nparietal lobe on the perfusion imaging."
-        },
-        {
-            "input": "There has been progressive decrease in size of the bifrontal\nextra-axial collections measuring 5-mm thick on the left and 4-mm thick on the\nright today compared to 8 mm on the left and 5 mm on the right on ___. \nAs before, these collections are predominantly low in density with a higher\ndensity portion peripherally.  There is no evidence of new hemorrhage or mass.\nProminent cisterna magna is again incidentally noted.  There is no evidence of\ninterval infarct.  Osseous structures are significant only for a defect from\nthe prior burr hole decompression bilaterally.",
-            "output": "1. Continued interval decrease in size of bifrontal extra-axial collections.\n2. Status post bilateral burr hole evacuation."
-        },
-        {
-            "input": "Study is mildly degraded by motion.\n\nCT HEAD WITHOUT CONTRAST:\nThere is no evidence of there is hypoattenuation in the right temporal and\nparietal lobes with loss of gray-white matter differentiation, sulcal\neffacement, and there is also hypoattenuation along the insula and involving\nthe right caudate nucleus.  There is no hemorrhage.  In addition, there is a\nlarge intermediate attenuation structure which appears to extend from the\nright ICA terminus towards the middle cerebral artery bifurcation consistent\nwith a partially calcified aneurysm, with a pipeline flow diverting or noted\nextending from the cavernous internal carotid artery through the M1 segment on\nthe right.  This measures 3.9 x 2.6 cm.  There are prominent calcifications of\nthe bilateral carotid siphons.\n\n No hydrocephalus.  Mild prominence of the ventricle and sulci reflecting\nvolume loss is noted.\n\nThe visualized portion of the there is mild mucosal thickening in the\nmaxillary sinuses and ethmoid air cells, with sclerosis and thickening of the\nwalls of the right maxillary sinus likely reflecting the sequelae of chronic\nsinus disease.  There is deformity of the right mandibular condyle likely\nreflecting old trauma.  Poor dentition, with the remaining teeth showing\ndental caries.  The mastoid air cells,and middle ear cavities are clear. The\nvisualized portion of the orbits are unremarkable.\n\n\nCT PERFUSION: RAPID perfusion maps demonstrate perfusion defect in the right\nmiddle cerebral artery territory with quantitative values as below:\n\nCBF<30% volume: 89 mL\nTmax>6.0s volume: 264 mL\nMismatch volume: 175 mL\nMismatch ratio: 3.0",
-            "output": "1. Findings consistent with ischemia in the right middle cerebral artery\nterritory with perfusion defect as detailed above, mismatch volume of 175 mL. \nNo hemorrhage.\n2. There is a large approximately 3.9 cm calcified aneurysm likely arising\nfrom the right internal carotid artery terminus and projecting laterally\ntowards the middle cerebral artery, with a flow diverting stent in place. \nThis examination does not include a formal angiogram for assessment of stent\npatency or aneurysm patency.\n\nNOTIFICATION:\n The findings were discussed with ___, M.D. by ___, M.D.\non the telephone on ___ at 12:25 pm, 3 minutes after discovery of the\nfindings."
-        },
-        {
-            "input": "CT Head: There is no evidence of hemorrhage, mass effect, edema, or\ninfarction. The ventricles and sulci are normal in size and configuration. \nThere is age-appropriate diffuse parenchymal volume loss with commensurate\nprominence of the ventricles and sulci.  There is nonspecific periventricular\nand subcortical white matter hypodensities, likely sequela of chronic small\nvessel microangiopathy.\n\nAerosolized secretions are seen in the left posterior ethmoid air cells.  Mild\nmucosal thickening is noted in the right posterior ethmoid air cells. \nOtherwise, the remaining paranasal sinuses and mastoid air cells are clear. \nThe orbits are unremarkable.\n\nCTA head:  The major intracranial arterial vasculature is patent without\nevidence of stenosis, occlusion, or aneurysm.  There is an azygos anterior\ncerebral artery, which is a normal variant.  A fenestration is noted along the\nright A1 branch of the anterior cerebral artery, adjacent to confluence of the\nright and left A1 branches (series 4: Image 242).  A small infundibulum is\nnoted at the origin of the left internal choroidal artery.\n\nCT Perfusion:  The perfusion maps appear unremarkable.  There is no evidence\nof delayed transit time, or reduced blood volume, or reduced blood flow.\n\nCTA Neck:   The common carotid and vertebral arteries and their major branches\nare patent with no evidence of stenoses.  There is calcified atherosclerotic\nplaque in the distal common carotid artery extending to the origins of the\nright internal and external carotid arteries.  There is no evidence of right\ninternal carotid  by NASCET criteria.  There is calcified and noncalcified\nplaque at the origin of the left internal carotid artery with an approximately\n50% stenosis by NASCET criteria.\n\nAtherosclerotic calcifications are seen in the aortic arch, bilateral\nvertebral artery origins, bilateral carotid siphons, and carotid bifurcations.\nThere is a 3 vessel aortic arch.  Tiny subcentimeter hypodensities are seen in\nthe right thyroid lobe, likely thyroid nodules.  ___ College of Radiology\nguidelines do not suggest further evaluation for incidental thyroid nodules of\nthis size.  Emphysematous changes are seen in the bilateral lung apices. \nRespiratory motion artifact limits evaluation for small pulmonary nodules.",
-            "output": "1.  No evidence of infarction or hemorrhage.\n2.  50% stenosis at the origin of the left internal carotid artery.\n3. The major intracranial arterial vasculature is patent without evidence of\nstenosis, occlusion, or aneurysm.\n4.  The carotid and vertebral arteries and their major branches are patent\nwithout evidence of stenoses.\n5.  Chronic small vessel ischemic disease and age appropriate involutional\nchanges.\n6.  Emphysematous changes are incidentally seen in the bilateral lung apices."
-        },
-        {
-            "input": "CT head perfusion:\n\nRAPID analysis of perfusion images not available, as scan was performed on a\nscanner which does not contain software.\n\nOLEA analysis-these numbers are not validated and study:\nThere is decrease cerebral blood flow left MCA distribution, volume 0.6 mL.\nProlonged T-max left MCA distribution, volume 26 mm.\n\nColor maps:\nOn color maps there is no abnormality on the CBV.\nSmall area of decreased CBF left MCA distribution cortex and corona radiata M\n5 zone.\nModerate zone of prolonged T-max in the left MCA distribution, M4, M 5, M 6\nzone.\nModerate zone of prolonged T-max right MCA distribution.",
-            "output": "1. No RAPID analysis available.\n2. Visual color maps demonstrate prolonged mean transit time bilateral MCA,\nleft greater than right.  Small area of decreased cerebral blood flow left MCA\ndistribution.\n3. OLEA analysis as above, not validated in a study."
-        }
-    ]
-}

MedS-Bench/Text_summarization/task88_mimic_ct_spine_summarization.json

@@ -1,434 +0,0 @@
-{
-    "Contributors": [
-        "MIMIC"
-    ],
-    "Source": [
-        "MIMIC-IV"
-    ],
-    "URL": [
-        "https://www.physionet.org/content/mimic-iv-note/2.2/"
-    ],
-    "Categories": [
-        "Text Summarization"
-    ],
-    "Definition": [
-        "Summarize the CT imaging diagnostics' detailed findings for the Spine into a concise conclusion."
-    ],
-    "Reasoning": [],
-    "Input_language": [
-        "English"
-    ],
-    "Output_language": [
-        "English"
-    ],
-    "Instruction_language": [
-        "English"
-    ],
-    "Domains": [
-        "Clinical Text"
-    ],
-    "Positive Examples": [],
-    "Negative Examples": [],
-    "Instances": [
-        {
-            "input": "There is no evidence of acute fracture in the cervical spine. There is 3 mm\nretrolisthesis of C4 on C5, which is chronic appearing and unchanged from the\nprior exam. Severe, multilevel degenerative change is noted mostpronounced at\nC4-5  with moderate to severe spinal canal narrowing.  There is moderate\nmultilevel uncovertebral and facet joint hypertrophy.\n\nNo prevertebral soft tissue swelling is present. The patient is status post\nthyroidectomy with surgical clips seen in the thyroid bed.",
-            "output": "No evidence of acute fracture or change in alignment.\n\nMultilevel degenerative change noted throughout the cervical spine most severe\nat C4-5 with moderate central canal narrowing."
-        },
-        {
-            "input": "Alignment is preserved.No fractures are identified.Mild degenerative changes\nincluding intervertebral disc height loss at C4-5.  Left worse than right\nfacet joint hypertrophy spans C2-3 through C4-5 without significant canal or\nforaminal narrowing.  There is no prevertebral soft tissue swelling.\n\nThyroid is unremarkable.  Dense atherosclerotic calcifications noted in the\ncarotid arteries.",
-            "output": "No evidence of acute fracture or traumatic malalignment."
-        },
-        {
-            "input": "Exaggerated thoracic kyphosis causes oblique quit T of the cervical spine on\naxial images, limiting evaluation.  The bones are demineralized.  There is a\nfracture of the anterior superior corner of C5 of unknown chronicity, image\n602:32, with associated disc bulge.  No definite prevertebral edema is seen. \nThere is associated 2 mm retrolisthesis of C4 on C5 without disc space\nwidening.  There is also 1-2 mm anterolisthesis of C6 on C7 with anterior disc\nspace widening.  There is 1 mm anterolisthesis of C7 on T1 without disc space\nwidening.\n\nDisc protrusions and endplate osteophytes mildly indent the ventral thecal sac\nat multiple levels.  There is multilevel neural foraminal narrowing by\nuncovertebral and facet osteophytes.\n\nThere is calcified pleural/parenchymal scarring and mild emphysema the\nvisualized lung apices. Partially visualized thyroid gland is unremarkable. \nMultifocal arterial calcifications are noted.  This exam is not technically\noptimized for evaluation of the included brain parenchyma, which is better\nassessed on the head CT from 1 day earlier on ___.",
-            "output": "1. C4 anterior superior corner fracture of unknown chronicity.  Associated 2\nmm retrolisthesis of C4 on C5 without disc space widening, and a disc bulge\nwithout definite prevertebral edema.\n2. 1-2 mm anterolisthesis of C6 and C7.  Associated anterior disc space\nwidening, which may be secondary to traumatic injury versus sequela of the\nexaggerated cervical lordosis in the setting of exaggerated thoracic kyphosis.\n3. 1 mm anterolisthesis and C7 of T1, likely degenerative.\n4. Multilevel degenerative disease.\n5. Mild emphysema at the included lung apices.\n\nRECOMMENDATION(S):  Cervical spine MRI to assess for ligamentous and other\nsoft tissue injury.\n\nNOTIFICATION:  Impression items 1 and 2 and the recommendation for MRI were\ndiscussed over the telephone by Dr. ___ with Dr. ___ in the emergency\ndepartment on ___ at approximately 10:00."
-        },
-        {
-            "input": "Multilevel degenerate changes are seen about C5 and C6 without evidence of\nacute fracture or malalignment.\nThere is no prevertebral edema.\n\nThe lung apices are unremarkable.  The thyroid is heterogeneous with a 2.6 cm\nright lower lobe nodule that can be evaluated with follow-up imaging for\nfurther characterization.",
-            "output": "1. No evidence of acute fracture or dislocation..\n2. Multilevel degenerate changes are seen about C5 and C6 with disc space\nnarrowing.\n3. 2.6 cm right lower thyroid nodule that can be further assessed with\nfollow-up ultrasound.\n\nRECOMMENDATION(S):  Recommend follow-up ultrasound for right lower thyroid\nnodule if clinically appropriate once patient is stabilized."
-        },
-        {
-            "input": "Alignment is normal.  No fractures are identified.  There are moderate to\nsevere degenerative changes from C3 through C6 characterized by endplate\nosteophyte formation, loss of intervertebral disc height, and anterior wedging\nof the C4 vertebral body, findings which have progressed since ___. No\nprevertebral soft tissue swelling is demonstrated.",
-            "output": "Multilevel degenerative changes, progressed since ___, predominantly from C3\nthrough C6, however no evidence of acute fracture or malalignment."
-        },
-        {
-            "input": "There is no fracture or prevertebral soft tissue fluid.  The imaged cervical\nand upper thoracic vertebral bodies are normally aligned.  There is mild\nmultilevel cervical spine degenerative change, with mild disc height loss,\nendplate sclerosis, and intervertebral osteophytes.  There is mild spinal\ncanal narrowing worst at C4-5 due to a posterior central disc bulge (series 3,\nimage 45).  There is mild neural foraminal narrowing worst on the right at\nC3-4 (series 3 image 39) and C5-6 (series 3, image 55) due to uncovertebral\nosteophytes.\n\nThe thyroid is unremarkable.  There is no cervical lymphadenopathy.  The\npartially imaged lung apices are clear.",
-            "output": "1. No cervical or upper thoracic spine fracture or prevertebral fluid.  No\nmalalignment.\n2. Mild multilevel cervical spine degenerative change, as above."
-        },
-        {
-            "input": "No fracture is seen involving the cervical spine.  Multilevel degenerative\ndisc disease is noted extending from C4 through C7 with disc space narrowing\nnoted.  Subtle anterolisthesis of C2 on 3 and C3 on 4 is likely chronic.  No\nprevertebral edema is seen.  There is a cystic structure in the right\nsupraclavicular fossa best seen on series 3, image 55 measuring 2.9 x 3.9 x\n2.4 cm.  This cystic lesion is partially calcified along the periphery and\ncentral attenuation suggests simple fluid content.  The thyroid gland is\npartially visualized and appears normal.",
-            "output": "1. No fracture.  Subtle anterolisthesis of C2 and C3 likely chronic, though\nclinical correlation advised.\n2. Degenerative changes as stated.\n3. Cystic lesion within the right supraclavicular fossa measuring 2.9 x 3.9 x\n2.4 cm, is indeterminate.  Please correlate clinically, consider ultrasound or\nMRI to further assess."
-        },
-        {
-            "input": "Alignment is normal. No fractures are identified. There is no evidence of\nspinal canal or neural foraminal stenosis.  There is intervertebral disc space\nnarrowing and subchondral sclerosis of the lower cervical vertebral bodies\ncompatible with degenerative changes, most significant in C5-C7.  There is\ndiffuse left-sided facet arthropathy of the cervical spine.  There is no\nprevertebral soft tissue swelling. There is no evidence of infection or\nneoplasm.  Severe emphysematous changes are noted in the partially visualized\nlung apices.  The cervical esophagus appears patulous.",
-            "output": "1.  No evidence of fracture or malalignment.\n2.  Moderate degenerative changes in the cervical spine.\n3.  Severe emphysematous changes in the lung apices."
-        },
-        {
-            "input": "There is mild straightening of the cervical spine.  No fractures are\nidentified.There are moderate multilevel degenerative changes of the cervical\nspine with multilevel central disc protrusion and effacement of the ventral\nthecal sac.  There is mild to moderate central canal stenosis from C2 through\nC7.  There is no prevertebral soft tissue swelling.There is no evidence of\ninfection or neoplasm.  There is diffuse osteopenia. The thyroid and partially\nvisualized bilateral lung apex are grossly unremarkable.",
-            "output": "1. No evidence of acute cervical spine fracture.\n2. Moderate multilevel degenerative changes of the cervical spine with mild to\nmoderate central canal stenosis."
-        },
-        {
-            "input": "There is loss of normal cervical spinal lordosis; alignment is otherwise\nnormal.  No fractures are identified.There is mild spinal canal narrowing at\nC6-C7 secondary to degeneration.  There is no significant foraminal\nnarrowing.There is no prevertebral edema.  There is calcification at the left\ncarotid siphon.\n\nThe thyroid and included lung apices are unremarkable.",
-            "output": "No acute cervical fractures."
-        },
-        {
-            "input": "Straightening of the typical cervical lordosis.  Otherwise, the alignment is\nnormal.  No acute cervical spine fractures are identified.There is no\nsignificant canal or foraminal narrowing.There is no prevertebral edema.\n\nThe thyroid and included lung apices are unremarkable.",
-            "output": "No acute cervical spine fracture or traumatic malalignment."
-        },
-        {
-            "input": "Cervical vertebral bodies are maintained in height and alignment.  There is no\nfracture. There is preservation of the normal cervical lordosis.  Prevertebral\nsoft tissues are unremarkable. Mild degenerative changes with anterior\nosteophyte formation at the C3 and C4 level as well as C5 level are noted.\n\nThe thyroid and included lung apices are unremarkable.",
-            "output": "No fracture or malalignment."
-        },
-        {
-            "input": "Alignment is normal. No acute cervical spine fractures are identified. There\nis no critical spinal canal stenosis. There is no prevertebral soft tissue\nswelling.  Mild degenerative changes with anterior osteophyte formation at C3,\nC4, and C5 are similar to prior.  The lung apices are clear, the thyroid gland\nappears unremarkable.",
-            "output": "There is no evidence of acute cervical spine fracture or traumatic\nmalalignment."
-        },
-        {
-            "input": "Alignment is normal. No acute fractures are identified.Degenerative changes\nwith anterior osteophytes at C3-C4 and C5 the remained stable since the prior\nexamination.  There is mild, stable, multilevel central canal narrowing. \nAnterior soft tissue superior similar to comparison examination.\n\nThe visualized thyroid and lung apices are unremarkable.",
-            "output": "1. No acute abnormality."
-        },
-        {
-            "input": "Alignment is normal.  No fractures are identified.There is no significant\ncanal or foraminal narrowing.There is no prevertebral edema.\n\nThe thyroid and included lung apices are unremarkable.",
-            "output": "No fractures or dislocations."
-        },
-        {
-            "input": "Dental amalgam streak artifact limits study.  There is straightening of\ncervical lordosis.  No fractures are identified.Multilevel degenerative\nchanges of the cervical spine are again noted, including loss of\nintervertebral disc height, disc osteophyte complexes and facet joint\nhypertrophy, with at least mild vertebral canal narrowing at C4-5. There is no\nprevertebral edema.\n\nThe thyroid and included lung apices are unremarkable.",
-            "output": "1. Dental amalgam streak artifact limits study.\n2. No cervical spine fracture or traumatic malalignment.\n3. Multilevel degenerative changes cervical spine as described, with at least\nmild vertebral canal narrowing at C4-5."
-        },
-        {
-            "input": "Alignment is normal. No acute fractures are identified.  Chronic deformity of\nthe right first rib is noted.  There is no significant canal or foraminal\nnarrowing.  There is no prevertebral soft tissue swelling.\n\nThyroid and lung apices are unremarkable.",
-            "output": "No acute fracture or traumatic subluxation of the cervical spine."
-        },
-        {
-            "input": "Alignment is normal.  No fractures are identified.There is no significant\ncanal or foraminal narrowing.There is no prevertebral edema.\n\nThe thyroid and included lung apices are unremarkable.",
-            "output": "No cervical spine fracture or malalignment."
-        },
-        {
-            "input": "The cervical spine alignment is normal. No acute cervical spine fractures are\nidentified.  Mild degenerative changes of the cervical spine consistent with\nanterior and posterior spondylosis, more significant from C3-C4 through C6-C7\nlevels.  There is no evidence of severe spinal canal or neural foraminal\nstenosis. There is no prevertebral soft tissue swelling.  The lung apices are\nclear, the thyroid gland appears unremarkable.",
-            "output": "1.  No acute fracture or traumatic subluxation.\n\n2.  Multilevel degenerative changes throughout cervical spine, more\nsignificant from C3-C4 through C6-C7 levels."
-        },
-        {
-            "input": "Alignment is normal.  No fractures are identified.There is no significant\ncanal or foraminal narrowing.There is no prevertebral edema.\n\nThe thyroid and included lung apices are unremarkable.",
-            "output": "No acute fracture or traumatic malalignment."
-        },
-        {
-            "input": "Alignment is normal. No fractures are identified.Mild multiple degenerative\nchanges of the cervical spine with anterior and posterior osteophytes,\nendplate sclerosis and disc space narrowing.  There is mild asymmetry of the\nleft atlantooccipital joint due to patient head rotation.  There is a small\ndisc bulge at C4-C5 causing mild canal narrowing, better characterized on MR\ncervical spine from ___.  Mild left neural foraminal narrowing at C5-C6 and\nC6-C7 from facet and uncovertebral hypertrophy is unchanged. There is no\nevidence of new spinal canal or neural foraminal stenosis. There is no\nprevertebral soft tissue swelling.\n\n There is no evidence of infection or neoplasm.  There is subtle fat stranding\nalong the left lower lateral neck (03:42) without associated fluid collection.",
-            "output": "1. No acute fracture or acute malalignment.\n2. Mild multilevel degenerative changes of cervical spine with small posterior\ndisc bulge at C4-C5 causing mild canal narrowing as well as C5-C6 and C6-C7\nmild left neural foraminal narrowing, unchanged from ___ MR.\n3. Mild fat stranding of left lower lateral neck likely represents seat belt\ninjury with soft tissue contusion."
-        },
-        {
-            "input": "There is no evidence for a fracture.  There is near complete fusion of C3 and\nC4 vertebral bodies and right C3-C4 facet joint, and complete fusion of the\nleft C3-C4 facet joint.  There is mild anterolisthesis of C4 on C5 and mild\nretrolisthesis of C5 on C6.  There is a levoconvex curvature centered in the\nthoracic spine, incompletely evaluated.  There is advanced disc space\nnarrowing with endplate cystic changes and endplate osteophytes from C4-C5\nthrough C6-C7.  There is also ossification of the anterior longitudinal\nligament at C5-C6 through C6-C7.\n\nC2-C3: No significant spinal canal narrowing.  Mild right neural foraminal\nnarrowing by facet osteophytes.\n\nC3-C4: Broad-based posterior endplate osteophytes minimally indent the ventral\nthecal sac.  Mild to moderate right and moderate left neural foraminal\nnarrowing by uncovertebral and facet osteophytes.\n\nC4-C5: Central disc protrusion and overlying endplate osteophytes indent the\nventral thecal sac with mild-to-moderate spinal canal narrowing.  Also\nmoderate right and severe left neural foraminal narrowing by uncovertebral and\nfacet osteophytes.\n\nC5-C6: Broad-based central disc protrusion and overlying endplate osteophytes,\nlarger on the right than left, cause moderate spinal canal narrowing.  There\nis severe, right greater than left neural foraminal narrowing by uncovertebral\nand facet osteophytes.\n\nC6-C7: Small central disc protrusion may minimally indent the ventral thecal\nsac.  There is moderate right and moderate to severe left neural foraminal\nnarrowing by uncovertebral and facet osteophytes.\n\nC7-T1: No significant spinal canal narrowing.  Moderate narrowing of the\ndistal right neural foramen by facet osteophytes.  Moderate to severe\nnarrowing of the left neural foramen by facet osteophytes.\n\nThis exam is not technically optimized for evaluation of the included brain\nparenchyma.  Visualized posterior fossa appears grossly unremarkable.  The\nthyroid is grossly unremarkable.  Visualized upper lungs are clear.",
-            "output": "1. Multilevel cervical degenerative disease with up to moderate spinal canal\nstenosis at C5-C6, as well as up to severe multilevel neural foraminal\nnarrowing.\n2. Ossification of the anterior longitudinal ligament from C5 C6 through C6.\n3. No evidence for a fracture.\n4. Near complete fusion of C3 and C4.\n5. Mild anterolisthesis of C4 on C5 and mild retrolisthesis of C5 on C6 is\nlikely degenerative, though there are no comparison exams to confirm\nchronicity."
-        },
-        {
-            "input": "Alignment is normal. No fractures are identified.There is minimal multilevel\nosteophytosis and intervertebral disc height loss with incidental note made of\nC4-C5 facet arthrosis on the left.  No significant osseous spinal canal or\nneural foraminal narrowing.There is no prevertebral soft tissue swelling.\nThere is no evidence of infection or neoplasm.",
-            "output": "1. No evidence of fracture or malalignment.\n2. Minimal cervical spine osteoarthritis."
-        },
-        {
-            "input": "There is no acute fracture or traumatic malalignment.  There is no\nprevertebral soft tissue swelling.  There is no significant spinal canal\nstenosis or neural foraminal narrowing.\nThe thyroid gland is unremarkable.  Minimal paraseptal emphysema is noted in\nthe lung apices.  There is no cervical lymphadenopathy.",
-            "output": "No acute fracture or traumatic malalignment."
-        },
-        {
-            "input": "Postoperative changes of spinal fusion identified from L3 to L5 level.  There\nis no compression fracture seen.  At L2-3 level there is spinal canal\nnarrowing identified.  At L3-4 L4-5 and L5-S1 levels laminectomies are seen. \nAt L4-5 grade 1 spondylolisthesis of L4 over L5 seen.  There is no evidence of\nspondylolysis at L2 level.  Vascular calcifications are identified.  No\ncompression fracture is seen.  The metallic implants appear unchanged in\nposition compared to the previous CT of ___ with left L5 screw\nprojecting anteriorly.  No lucencies are seen surrounding the implants.",
-            "output": "1. Postoperative changes are identified.  Spinal stenosis is seen at L2-3\nlevel above the level of surgery.  This is better demonstrated on the MRI of\nthe same day.  No evidence of an acute fracture identified.  Osteopenia seen."
-        },
-        {
-            "input": "The lumbar spine alignment appears maintained.No acute lumbar spine fractures\nare identified.Mild degenerative changes are visualized in the lower lumbar\nspine consistent with diffuse disc bulging at L3-L4, causing mild anterior\nthecal sac deformity and mild bilateral neural foraminal narrowing,\nadditionally there is mild articular joint facet hypertrophy with sclerotic\nchanges.\n\nAt L4-5 level, there is diffuse disc bulge causing mild bilateral neural\nforaminal narrowing, mild bilateral articular joint facet hypertrophy is seen.\n\nAt L5-S1 level, there is a prominent osteophytic formation causing anterior\nthecal sac deformity, mild diffuse disc bulge is seen causing mild bilateral\nneural foraminal narrowing, there is also mild articular joint facet\nhypertrophy.\n\nThe sacroiliac joints and the visualized paravertebral structures are\nunremarkable, vascular atherosclerotic calcifications are seen in the\nabdominal aorta and iliac arteries.",
-            "output": "1. There is no evidence of lumbar spine fracture or lumbar spine malalignment.\n2. Mild-to-moderate multilevel degenerative changes throughout the lower\nlumbar spine, more significant at L3-L4, L4-5 and L5-S1 levels.\nPREVALENCE:  Prevalence of lumbar degenerative disk disease in subjects\nwithout low back pain:\nOverall evidence of disk degeneration 91% (decreased T2 signal, height loss,\nbulge)\nT2 signal loss 83%\nDisk height loss 58%\nDisk protrusion 32%\nAnnular fissure 38%\nJarvik, et all.  Spine ___ 26(10):1158-1166\nLumbar spinal stenosis prevalence- present in approximately 20% of\nasymptomatic adults over ___ years old\n___, et al, Spine Journal ___ 9 (7):545-550\n\nThese findings are so common in asymptomatic persons that they must be\ninterpreted with caution and in context of the clinical situation."
-        },
-        {
-            "input": "Alignment is normal.  No fractures are identified.There is no significant\ncanal or foraminal narrowing.There is no prevertebral edema.\n\nThe thyroid and included lung apices are unremarkable.",
-            "output": "No cervical spine fracture or malalignment."
-        },
-        {
-            "input": "The cervical spine alignment is normal.  No acute cervical spine fractures are\nidentified.There is no significant canal or foraminal narrowing.There is no\nprevertebral edema.\n\nThe thyroid and included lung apices are unremarkable.  Endotracheal tube and\nenteric tube are noted.  Several foci of gas are present behind the left\nclavicle, please see separate CT chest from the same day.",
-            "output": "No acute fracture or traumatic malalignment in the cervical spine.\nSeveral foci of gas are present posterior to the left clavicle.  Please see\nsame-day CT chest for further description of these findings."
-        },
-        {
-            "input": "Alignment is normal. No fractures are identified. There is no evidence of\nspinal canal or neural foraminal stenosis. There is no prevertebral soft\ntissue swelling. Within the limits of this noncontrast study, there is no\nevidence of infection or neoplasm.  The lung apices appear clear.  The thyroid\ngland is preserved.  Scattered subcentimeter nonspecific lymph nodes are noted\nthroughout the neck bilaterally, without definite enlargement by CT size\ncriteria.",
-            "output": "1. No evidence of acute fracture or traumatic malalignment.\n2. Nonspecific subcentimeter cervical lymph nodes as described, which may be\nreactive."
-        },
-        {
-            "input": "Exam is mildly motion degraded at the C2 level.  Alignment is normal.  No\nfractures are identified.There is no significant canal or foraminal\nnarrowing.There is no prevertebral edema.\n\nThe thyroid and included lung apices are unremarkable.",
-            "output": "No fracture or malalignment."
-        },
-        {
-            "input": "Minimal anterolisthesis of C4 on C5 is likely degenerative.No fractures are\nidentified.There is no prevertebral soft tissue swelling.  There is no severe\nneuroforaminal or spinal canal narrowing.  Multilevel degenerative changes\npresent with disc height loss, facet arthropathy, osteophytosis, worse from C5\nthrough C7.  A hemangioma is present in the T3 vertebral body, partially\nvisualized\n\nSurgical clips are consistent with prior right partial thyroidectomy.  Right\napical lung scarring is re-demonstrated, minimally more prominent than in\n___.  Calcified left cervical and axillary some lymphadenopathy is\nre-demonstrated consistent with prior granulomatous infection.",
-            "output": "1. No fracture or traumatic malalignment in the cervical spine.\n2. Multilevel degenerative changes mild anterolisthesis of C4 on C5, likely\ndegenerative."
-        },
-        {
-            "input": "Alignment is normal.  No fractures are identified.  There is no evidence of\nspinal canal or neural foraminal narrowing.  There is no evidence of infection\nor neoplasm.",
-            "output": "No acute fracture traumatic malalignment."
-        },
-        {
-            "input": "Alignment is normal. No fractures are identified.Multilevel degenerative\nchanges are noted with loss of disc height and mild anterior and posterior\nosteophytes worse at C4-5 and C5-6.  Small disc osteophyte complexes at C4-5\nand C5-6 indent the thecal sac anteriorly. There is no prevertebral soft\ntissue swelling.",
-            "output": "No evidence of fracture or traumatic malalignment."
-        },
-        {
-            "input": "Motion artifact limits assessment, study was repeated twice.\n\nPatient is in a collar.  Alignment is maintained.\n\nNo acute cervical spine fractures are identified.\n\nMild multilevel posterior disc osseous complex, early uncovertebral arthrosis\nand facet hypertrophy, most pronounced at C2-C3 and C4-C5 and C6/C7 with up to\nmild central canal narrowing, but no significant neural foraminal narrowing.\n\nThere is no prevertebral soft tissue swelling.  The thyroid is mildly\nheterogeneous, but no discrete thyroid nodules are identified.\n\nThe imaged lung apices are unremarkable.",
-            "output": "1. No evidence of acute cervical spine fracture or traumatic malalignment.\n2. Mild, multilevel degenerative changes."
-        },
-        {
-            "input": "No acute fracture.  There is retrolisthesis of L2 on L3 as well as L3 on L4,\nlikely degenerative nature.  There is no prevertebral soft tissue swelling. \nMultilevel, multifactorial degenerative changes are identified with extensive\nvacuum disc phenomenon, disc space narrowing, endplate osteophyte formation\nand irregularity.  There is also extensive facet hypertrophy throughout the\nentire lumbar spine.  There is a large disc bulge at L4 to L5 causing at least\nmoderate spinal canal stenosis and a disc bulge at L5-S1 causing moderate to\nsevere spinal canal narrowing.  There is also likely narrowing of the left\nneural foramen at L4-L5 as well as bilateral neural foraminal narrowing at\nL5-S1.\n\nEvaluation of the paraspinal soft tissues demonstrate moderate atherosclerotic\ndisease of the abdominal aorta.  There is sigmoid diverticulosis.  Coarse\ncalcifications are noted within the uterus.  A 2 mm nonobstructing stone is\nnoted in the interpolar region of the left kidney.",
-            "output": "1. No acute fracture of the lumbar spine.\n2. Extensive multilevel degenerative changes as described above, most severe\nat L4-L5 and L5-S1 with moderate to severe neural foraminal narrowing and\nspinal canal stenosis.\n3. Sigmoid diverticulosis.\n4. 2 mm punctate non obstructing left renal stone."
-        },
-        {
-            "input": "Alignment is normal.  No spine fractures are identified.There is no\nsignificant canal or foraminal narrowing.There is no prevertebral edema.\n\nRight clavicular and left posterior second rib fracture are seen on concurrent\nCT torso.\n\nThe thyroid and included lung apices are unremarkable.  Endotracheal and\nenteric tubes are partially visualized.",
-            "output": "No acute cervical fracture or subluxation."
-        },
-        {
-            "input": "There is mild-to-moderate dextroscoliosis of the mid lumbosacral spine\ncentered at approximately L3.  Mild right lateral spinal listhesis of L4 on L5\nis unchanged.  Otherwise, the imaged lumbar vertebral bodies are normally\naligned.  Vertebral body heights are preserved.  Mild anterior wedging of T12\nis unchanged since the prior MR ___.  Minimal anterior height\nloss of T11 is likely physiologic.  Elsewhere, there is no evidence of lumbar\nspine fracture or traumatic malalignment.  A right L5 pars defect is\nunchanged.\n\nThere is severe multilevel, multifactorial lumbar spine degenerative change. \nAlthough the degree of spinal canal and neural foraminal narrowing is not well\nassessed by CT, there is probably at least moderate spinal canal narrowing at\nL4-5 due to a posterior disc bulge/protrusion (series 2, image 85). \nMultilevel neural foraminal narrowing appears severe on the right at L5-S1 and\non the left at L4-5 (see series 602b, images 42 and 31).  There are no\nconcerning focal lytic or sclerotic osseous lesions identified.  There is\ndiffuse subjective osseous demineralization.\n\nThere is severe infrarenal abdominal aortic calcification without aneurysm or\ndilation.  There is no evidence of retroperitoneal mesenteric lymphadenopathy.\nNo evidence of acute focal abnormality within the imaged retroperitoneum,\nabdomen, or pelvis.",
-            "output": "1. No evidence of fracture or new malalignment within the lumbar spine.\n2. Within limitation of CT scan, no appreciable interval change in severe\nmultilevel, multifactorial lumbar spine degenerative change causing multilevel\nspinal canal and neural foraminal narrowing which is suboptimally assessed by\nCT.  Grossly, there is unchanged spinal canal narrowing which is at least\nmoderate and most pronounced at L4-5 due to disc disease, as well as left L4-5\nand right L5-S1 severe neural foraminal narrowing, also not appreciably\nchanged."
-        },
-        {
-            "input": "The imaged cervical vertebral bodies are normally aligned.  Re- demonstrated\nis C5-7 anterior spinal fusion hardware which appears intact without evidence\nof fracture, perihardware lucency to suggest loosening, or other hardware\nrelated complication.  Osseous ankylosis of the C5 through C7 vertebral bodies\nis unchanged.  There is no evidence of fracture through the fused vertebral\nbodies.  The facet joints are normally aligned.  There is trace prevertebral\nfluid primarily seen at the level of C4-5 (2, 40), new from the prior exam of\n___.  There is no discrete fracture or new malalignment seen.  There\nis mild multilevel cervical spine degenerative change.  Mild spinal canal\nnarrowing is most pronounced at C3-4 due to a posterior disc bulge (3, 30). \nMild neural foraminal narrowing is most pronounced on the right at C5-6 (3,\n44) due to uncovertebral osteophytosis.\n\nCarotid bulb calcifications are noted bilaterally.  The thyroid gland is\nmildly heterogeneous and demonstrates internal calcifications but without\ndiscrete, measurable nodule.  A calcified right level III calcified focus is\nunchanged, possibly phleobliths with a venolymphatic malformation or a\ncalcified lymph node. Otherwise, there is no cervical lymphadenopathy. \nPartially visualized is right mastoid air cell opacification.",
-            "output": "1. New trace prevertebral edema is noted, nonspecific. It is difficult to\nexclude ligamentous injury given this appearance. If clinically indicated, MRI\nwould better assess for ligamentous injury.\n2. Otheriwse, no CT evidence of cervical spine fracture or malalignment.\n3. Intact C5-7 anterior spinal fusion hardware without evidence of\ncomplication.\n4. Mild multilevel cervical spine degenerative change causing mild right-sided\nneural foraminal narrowing at C4-5.  No spinal canal stenosis.\n5. Right mastoid air cell opacification.\n6. Unchanged right level III calcified focus, venolymphatic malformation\nversus calcified lymph node."
-        },
-        {
-            "input": "There is no traumatic malalignment.  No acute fracture is identified.  Patient\nis status post anterior spinal fusion from C5 through C7 with osseous fusion\nat those levels.  Postsurgical changes are noted along the posterior vertebral\nbodies at C5 through C7.  Mild spinal canal narrowing at C3-4 due to\nuncovertebral hypertrophy and disc protrusion is stable.  There is no\nprevertebral soft tissue swelling.  Calcified nodules in the thyroid are\nunchanged.  Sclerotic focus at T2 is likely a bone island, unchanged.  A 13 mm\nsoft tissue nodule with internal calcification in the neck on the right is\nstable and may represent a vascular/lymphatic malformation or calcified lymph\nnode.  Mucosal thickening of the subglottic airway is overall stable, mildly\nnarrowing the level of the false and true cords.  This is likely due to post\nradiation changes.",
-            "output": "1. No traumatic malalignment or acute fracture.\n2. Postsurgical changes from anterior spinal fusion from C5 through C7."
-        },
-        {
-            "input": "Again noted is a displaced type 2 dens fracture, with approximally 9 mm of\nposterior displacement of the superior fracture fragment, and 2 mm of inferior\ndisplacement, overall not significantly changed in alignment allowing for\ndifferences in patient positioning.  A posterior portion of sheared cortex\nwhich is bowed is similar to prior.  There has been interval minimal increase\nin sclerosis of the fracture lines, with no significant interosseous bridging.\nPosterior subluxation of the lateral masses of C1 with respect to C2 is\nsimilar to prior.  There is associated narrowing of the spinal canal at C1,\nwith no definite associated cord impingement.  Tiny ossific fragments anterior\nto the dens are similar to prior, and may represent calcification of the\nlongus ___.  There has been interval slight decrease in prevertebral soft\ntissue swelling.\n\nAlignment is otherwise maintained, with no additional fractures seen.  Mild\nmultilevel degenerative changes throughout the remainder of the cervical spine\nare similar to prior.\n\nA 1.6 x 1.2 cm calcified right thyroid nodule is not significantly changed.",
-            "output": "Re- demonstration of a posteriorly and inferiorly displaced type 2 dens\nfracture, with associated posterior subluxation of the lateral masses of C1,\nand narrowing of the spinal canal without definite cord impingement, not\nsignificantly changed in alignment allowing for differences in patient\npositioning.  There has been interval minimal sclerosis of the fracture line,\nwith no significant interosseous bridging."
-        },
-        {
-            "input": "CERVICAL SPINE:\nMild to moderate degenerative changes are seen in the cervical spine with\nexaggeration of the normal cervical lordosis.\n\nWithin the limits of this noncontrast study there is no evidence of infection\nor neoplasm.  There is a hypodensity with calcifications within the right\nthyroid lobe, measuring up to 2.8 cm (series 3: Image 90), as well as a\nhypodensity within the left thyroid lobe, measuring up to approximately 1.0\ncm, likely thyroid nodules.  Extensive atherosclerotic vascular calcifications\nare noted.\n\nThere is no prevertebral soft tissue swelling.. The visualized portion of the\nposterior fossa, cervicomedullary junction, paranasal sinuses and lung\napicesare preserved.\n\nAt the C1-2, there is a chronic appearing type II odontoid process fracture\nwith approximately 8 mm of posterior displacement of the odontoid fracture\nfragment, which is stable compared to the prior CT exam in ___. \nAgain seen is posterior subluxation of the lateral masses of C1 with respect\nto C2, also not significantly changed since the prior study.\n\nThere is mild sclerosis surrounding the fracture site which is reflective of\nhealing, without evidence of significant interval intraosseous bridging or\ncallus formation, potentially concerning for nonunion.\n\n At C2-3 there is no vertebral canal narrowing.  Mild bilateral neural\nforaminal narrowing is noted due to facet joint hypertrophy and uncovertebral\nhypertrophy.\n\nAt C3-4 there is mild posterior disc bulge which is seen narrowing the ventral\nCSF space.  No evidence of neural foraminal stenosis.\n\nAt C4-5 there is mild posterior disc bulge, uncovertebral hypertrophy, and\nbilateral facet joint hypertrophy causing narrowing of the vertebral canal\nwith contact upon the ventral thecal sac and mild bilateral neural foraminal\nstenosis.\n\nAt C5-6 there is mild posterior disc bulge and uncovertebral hypertrophy which\ncauses narrowing of the central CSF space without evidence of neural foraminal\nstenosis.\n\nAt C6-7 there is no vertebral canal or neural foraminal stenosis.\n\nAt C7-T1 there is no vertebral canal or neural foraminal stenosis.",
-            "output": "1. At the C1-C2, there is unchanged appearance of a known type 2 odontoid\nprocess fracture with continued 8 mm of posterior displacement of the fracture\nfragment as well as persistent posterior subluxation of the lateral masses of\nC1 moved respect to C2 since the prior exam in ___.  No evidence\nof significant interval intraosseous bridging or callus formation, which is\nconcerning for potential nonunion.\n2. Multilevel mild degenerative changes are seen throughout the cervical\nspine.\n3. A calcified right thyroid nodule is similar to prior exam in ___, but should be further evaluated with a dedicated thyroid ultrasound.\n\nRECOMMENDATION(S):  Point 3.  A calcified right thyroid nodule is similar to\nprior exam in ___, measuring up to 2.8 cm (series 3: Image 90),\nevaluation with a dedicated thyroid ultrasound is recommended for further\ncharacterization."
-        },
-        {
-            "input": "Again seen is a transverse fracture through the anterior right arch of C1 and\ncomminuted fracture of the posterior right arch of C1.There is anterolateral\ndistraction of the right lateral mass of C1 with respect to the remainder of\nthe C1 vertebral body.  This appears increased compared to ___,\neven allowing for differences in planes of scanning (for example,\nanterolateral distraction measuring 8 mm on axial view at 2:20, previously 5\nmm, or 10 mm on coronal view on 601b:20, previously 7 mm).An ossific fragment\nadjacent to the dens compatible with transverse ligament avulsion.  However,\nthe interval between the anterior and posterior arches of C1 and the dens\nremains preserved.There is persistent mild edema anterior to the C1 and C2\nvertebral bodies.\n\nThere is widening of the articulations of the the C1-2 lateral masses\nbilaterally.  This appears unchanged since the prior study.\n\nAgain seen is expansion and sclerosis of the body in ankle of the left\nmandible most suggestive of fibrous dysplasia.  Within the limits of this\nnoncontrast exam, there is no evidence of infection or neoplasm.",
-            "output": "1. Increased anterolateral distraction of the right lateral mass of C1 with\nrespect the remainder of the C1 vertebral body.\n2. Findings compatible with transverse ligament avulsion.  However, the\ninterval between the anterior and posterior arches of C1 and the dens remain\npreserved, unchanged.\n\nNOTIFICATION:  The findings were discussed by Dr. ___ with Dr.\n___ on the telephone on ___ at 7:35 ___, 10 minutes after\ndiscovery of the findings."
-        },
-        {
-            "input": "Again seen is a transverse fracture through the anterior right arch of C1 and\na comminuted fracture of the posterior right arch of C1.  Anterolateral\ndistraction of the right lateral mass of C1 with respect to the remainder of\nthe C1 vertebral body has remained stable since the prior examination,\napproximately 8 mm (2:  13).  An ossific fragment is again seen adjacent to\nthe dense.  The interval between the anterior and posterior arches of C1 and\nthe dens appears preserved.  Widening of the articulations of the C1/2 lateral\nmasses is stable.",
-            "output": "1. Overall stable examination since ___ of known C1 fracture ."
-        },
-        {
-            "input": "Alignment is normal. No fractures are identified.At L4/L5 and L5/S1 levels,\nthere is mild disc bulge, causing anterior thecal sac deformity, partially\nevaluated in this exam, correlation with MRI is advised for further\ncharacterization if clinically warranted. There is no prevertebral soft tissue\nswelling.No concerning lytic or sclerotic lesions identified in the lumbar\nspine.  There is no abnormal enhancement on post contrast imaging.  Partially\nimaged intra-abdominal structures are grossly unremarkable.  Please note that\nthis study is not tailored for evaluation of abdominal lymphadenopathy, which\nwould be better assessed with a contrast enhanced abdominal CT.",
-            "output": "Mild disc bulging is identified at L4/L5 and L5/S1 levels, partially evaluated\nin this exam, if clinically warranted, correlation with MRI of the lumbar\nspine is recommended for further characterization.  There is no evidence of\nabnormal enhancement.\n\nRECOMMENDATION(S):  Mild disc bulging is noted at L4/L5 and L5/S1 levels,\npartially evaluated in this exam, correlation with MRI of the lumbar spine is\nrecommended for further characterization and if clinically warranted."
-        },
-        {
-            "input": "Alignment is normal. No fractures are identified. There is no evidence of\nspinal canal or neural foraminal stenosis. There is no prevertebral soft\ntissue swelling.  There is no abnormal enhancement on post contrast imaging. \nNo concerning lytic or sclerotic lesion is identified.\n\nEvaluation of the partially imaged lung parenchyma is limited by respiratory\nmotion.  There is suggestion of an opacity at the right lung base (3:75),\nwhich may be due to atelectasis, although superimposed infection cannot be\nexcluded.  Additionally, this study is not tailored for evaluation of\nintrathoracic lymphadenopathy.",
-            "output": "1. No fracture or malalignment.\n2. Limited evaluation of the lung parenchyma reveals a right lung base opacity\nthat most likely represents atelectasis.  If there is concern for pneumonia, a\nchest radiograph should be obtained.\n3. Please note that this study is not tailored for evaluation of mediastinal\nlymphadenopathy, which would be better assessed with a contrast enhanced chest\nCT."
-        },
-        {
-            "input": "Alignment of the cervical spine is normal.   No fractures are identified. \nThere is no prevertebral soft tissue swelling.\n\nThere are enlarged cervical lymph nodes bilaterally, measuring up to 1.4 cm at\nlevel II on the right (6b:21), and up to 1.2 cm at level II on the left\n(6b:19).  At level 3 on the right, the largest lymph node measures up to 1.3\ncm in short axis (6b:21).\n\nThere are changes of degenerative disc disease with a broad bulge of the disc\nat C2-3 mildly encroaching on the spinal canal.  The neural foramina appear\nnormal.\n\nAt C3-4, there is a midline disc protrusion that indents the anterior surface\nof the spinal cord.  The neural foramina appear normal.\n\nAt C4-5, there is a midline protrusion of the intervertebral disc.  The neural\nforamina appear normal.\n\nAt C5-6, there is a broad bulge of the intervertebral disc that contacts the\nanterior surface of the spinal cord.  The neural foramina appear normal.\n\nThere are no significant abnormalities at C6-7 or C7-T1.",
-            "output": "Bilateral cervical lymphadenopathy, for which the differential includes\nunderlying infection, inflammatory process or malignancy.\nDegenerative disc disease at multiple levels with disc bulges and protrusions\nnarrowing the spinal canal."
-        },
-        {
-            "input": "Alignment is normal. No fractures are identified.There is no prevertebral soft\ntissue swelling.Multilevel moderate degenerative changes along with\ncongenitally shortened pedicles cause up to moderate spinal canal narrowing at\nC4-C5, C5-C6, and C6-C7.  There is moderate to severe right neural foraminal\nnarrowing at C6-C7.  Soft tissue edema and locules of gas overlying the left\nmandible are compatible with laceration, better assessed on dedicated\nmaxillofacial CT exam.  The lung apices are clear.  Prominent posterior\nnasopharyngeal soft tissue is seen.",
-            "output": "1. No acute fracture or traumatic malalignment in the cervical spine.\n2. Moderate cervical spondylosis.\n3. Prominence of the posterior nasopharyngeal soft tissues for which direct\nvisualization is recommended.\n\nNOTIFICATION:  The findings were discussed with ___, M.D. by ___\n___, M.D. on the telephone on ___ at 7:25 pm, 4 minutes after\ndiscovery of the findings."
-        },
-        {
-            "input": "Alignment is normal.  No acute fractures are identified.Multilevel\ndegenerative changes are seen, most extensive at C6-C7 and notable for\nmoderate bilateral neural foraminal stenosis.There is no prevertebral edema. \nMinimal fat in the fat planes are seen on this study.\n\nThe thyroid and included lung apices are unremarkable.",
-            "output": "No acute fracture or traumatic malalignment of the cervical spine."
-        },
-        {
-            "input": "Alignment is normal.  No fractures are identified.There is no significant\ncanal or foraminal narrowing.There is no prevertebral edema.\n\nThe thyroid and included lung apices are unremarkable.",
-            "output": "No cervical spine fracture or malalignment."
-        },
-        {
-            "input": "There is no evidence of acute fracture or prevertebral soft tissue swelling. \nMild anterolisthesis of C7 on T1 is likely degenerative in nature.  Otherwise,\nthe cervical vertebral bodies demonstrate normal alignment.  There is mild\nspinal canal narrowing due to prominent posterior osteophytes at C5-6 and\nC6-7.  There is moderate to severe multilevel cervical spine degenerative\nchange.  There is moderate to severe neural foraminal narrowing due to\nmultilevel uncovertebral osteophytosis and facet hypertrophy, worst on the\nleft at C3-4 (series 2, image 38).  No concerning focal lytic or sclerotic\nosseous lesions are seen.  An approximately 2.0 x 1.4 cm midline hypoenhancing\nthyroid nodule is identified within the isthmus (series 3, image 60).  There\nis no cervical lymphadenopathy by CT size criteria.  The partially imaged lung\napices are clear.",
-            "output": "1. No fracture or prevertebral soft tissue fluid.\n2. Mild C7 on T1 anterolisthesis is likely degenerative in nature.\n3. Moderate to severe multilevel cervical spine degenerative change, as above.\n4. 2.0 x 1.4 cm midline/isthmic hypoenhancing thyroid nodule.\n\nRECOMMENDATION(S):  Nonurgent/routine thyroid ultrasound could be performed\nfor 2.0 x 1.4 cm hypoenhancing midline/isthmic thyroid nodule, if not\npreviously performed elsewhere."
-        },
-        {
-            "input": "There is no evidence of fracture or malalignment within the thoracic spine. \nThere is severe multilevel, multifactorial degenerative change throughout the\nimaged thoracic spine, with multilevel disc height loss and confluent, flowing\nanterior and bridging osteophytes, compatible with diffuse idiopathic skeletal\nhyperostosis (DISH).  There is mild spinal canal narrowing at T5-6 and at\nT12-L1 due to prominent disc osteophyte complexes at those levels. \nIncidentally noted is a 12 x 9 mm sclerotic density in the left aspect of the\nT3 vertebral body.\n\nAn 18 mm simple renal cyst arises from the superior right renal pole. \nModerate atherosclerotic calcification of the abdominal aorta is noted. \nOtherwise, the partially imaged abdominal and retroperitoneal solid and hollow\nviscous organs are unremarkable.\n\nAlso noted at right lung base is an area of irregular linear opacity in\napparent bronchovascular distribution, likely reflective of some component of\natelectasis and possibly superimposed small airways disease.  There is no\npleural effusion.  The large isthmic thyroid nodule is better characterized on\nsame-day CT cervical spine.",
-            "output": "1. No evidence of fracture or malalignment.\n2. Severe multilevel, multifactorial degenerative change of the imaged\nthoracic spine, as above, including multilevel disc height loss and confluent,\nflowing anterior bridging osteophytes, compatible with diffuse idiopathic\nskeletal hyperostosis (DISH).\n3. Incidentally noted 12 x 9 mm sclerotic density in the left aspect of the T3\nvertebral body.  Correlate with any history of malignancy.\n\nRECOMMENDATION(S):  Nonurgent/routine bone scan could be performed for further\nevaluation of T3 sclerotic density if there is a history of malignancy."
-        },
-        {
-            "input": "There are 5 non-rib-bearing lumbar type vertebral bodies.  Focal,\nwell-corticated scalloping involving the superior end-plate of the L2 and L3\nvertebral bodies likely represent chronic Schmorl's nodes.  A Schmorl's node\nis additionally seen in the superior endplate of L1, with internal vacuum disc\nphenomenon.  Levoscoliosis of the lumbar ___ at L4 is noted. \nAdditionally, there is approximately 10 mm of left lateral subluxation of L4\non L5, likely degenerative in nature.  Additionally, there is grade 1 L4 on L5\nanterolisthesis, also likely degenerative.  There is severe multilevel,\nmultifactorial degenerative change in the imaged lumbar spine, with marked\nmultilevel disc height loss, large anterior and posterior intervertebral\nosteophytes, and posterior element hypertrophy.  Posterior element hypertrophy\nin addition to a prominent posterior osteophyte results in at least moderate\nspinal canal narrowing at L2-3 (series 3, image 31).\n\nColonic diverticula partially imaged.  Mild to moderate atherosclerotic\ncalcifications are seen within the aorta and major branches.  The partially\nimaged retroperitoneal and intra-abdominal solid and hollow viscous organs are\ngrossly unremarkable.",
-            "output": "1. No evidence of acute fracture.\n2. Grade 1 L4-5 anterolisthesis, in addition to 10 mm of left lateral\nsubluxation of L4 on L5, are likely degenerative in nature.\n3. Marked levoscoliosis centered at L4.\n4. Severe multilevel, multifactorial lumbosacral spine degenerative change, as\nabove.  In particular, there is moderate spinal canal narrowing at L2-3 due to\na prominent posterior osteophyte and facet hypertrophy."
-        },
-        {
-            "input": "No acute fracture identified.  Moderate-to-severe multilevel degenerative\nchanges of the cervical spine, with disc height loss, disc bulge, facet joint\nhypertrophy, uncovertebral osteophytes, subchondral cyst formation and\nendplate sclerosis, most notable at C5-C6.  Grade 1 listhesis of C7 on T1 is\nsimilar to prior.  Posterior osteophytes and disc bulge C4-C5, C5-C6 and C6-C7\nresults in mild spinal canal narrowing.  Moderate-to-severe the level\nneuroforaminal narrowing secondary to vertebral osteophytes and facet joint\nhypertrophy, most\nThe partially imaged 2.0 x 1.5 cm midline thyroid nodule is seen within the\nisthmus (3:55), also seen on the prior study.  Lung apices are clear. There is\nno cervical lymphadenopathy by CT size criteria.",
-            "output": "1. No acute fracture seen.\n2. Moderate-to-severe multilevel degenerative changes of the cervical spine.\nGrade 1 C7 on T1 anterolisthesis is similar to prior, likely degenerative in\nnature.\n3. Partially imaged 2.0 x 1.5 cm midline/isthmic thyroid nodule ;\nrecommendations remain per the prior study.  Nonurgent thyroid ultrasound\ncould be performed, if not previously performed elsewhere."
-        },
-        {
-            "input": "Thoracic spine: Alignment is normal.  No fractures are identified.Multilevel\ndegenerative changes are noted with bridging anterior osteophytes consistent\nwith DISH, loss of intervertebral disc height and facet arthropathy.There is\nno evidence of a paraspinal hematoma.  There is a stable 1.2 cm sclerotic\nfocus in the left T3 vertebral body.\n\nLumbar spine: There is stable grade 1 anterolisthesis of L4 on L5.  There is\nlevoconvex scoliosis centered at L3-L4.  Focal linear lucency through the\nanterior bridging ossification at L2-3 is new since ___ and may be chronic,\nbut is of indeterminate age.  There is no evidence of a paraspinal\nhematoma.Multilevel degenerative changes are noted with bridging anterior\nosteophytes and loss of intervertebral disc height.\n\nThere is mild left lung base atelectasis.  A 1.9 cm stable hypodense thyroid\nnodule is seen in the isthmus.  Atherosclerotic calcifications are seen along\nthe thoracic and abdominal aorta.  There is diverticulosis of the colon\nwithout evidence of diverticulitis.",
-            "output": "1. Focal linear lucency through the anterior ossification at L2-3, new since\n___ and of indeterminate age, but may be chronic, there is no evidence of\nparaspinal hematoma. No acute fracture seen elsewhere.\n2. Severe degenerative changes in the thoracic spine."
-        },
-        {
-            "input": "There is minimal anterolisthesis of C4 on C5 and C7 on T1, similar to prior. \nNo fractures are identified.Multilevel degenerative changes are seen, most\nextensive at C5-6 and C6-7 and notable for loss of intervertebral disc height,\nosteophytosis, and uncovertebral and facet hypertrophy causing mild spinal\ncanal narrowing.  There is multilevel moderate neural foraminal narrowing. \nThere is fusion of the left C2-3 facet joints.  There is no prevertebral\nedema.\n\nA 1.9 cm thyroid nodule is again seen in the isthmus stable.  The included\nlung apices are unremarkable.",
-            "output": "Multilevel degenerative changes of the cervical spine without acute fracture\nor traumatic malalignment."
-        },
-        {
-            "input": "Thoracic spine: Alignment is normal.  No fractures are identified.Multilevel\ndegenerative changes are noted with bridging anterior osteophytes consistent\nwith DISH, loss of intervertebral disc height and facet arthropathy.There is\nno evidence of a paraspinal hematoma.  There is a stable 1.2 cm sclerotic\nfocus in the left T3 vertebral body.\n\nLumbar spine: There is stable grade 1 anterolisthesis of L4 on L5.  There is\nlevoconvex scoliosis centered at L3-L4.  Focal linear lucency through the\nanterior bridging ossification at L2-3 is new since ___ and may be chronic,\nbut is of indeterminate age.  There is no evidence of a paraspinal\nhematoma.Multilevel degenerative changes are noted with bridging anterior\nosteophytes and loss of intervertebral disc height.\n\nThere is mild left lung base atelectasis.  A 1.9 cm stable hypodense thyroid\nnodule is seen in the isthmus.  Atherosclerotic calcifications are seen along\nthe thoracic and abdominal aorta.  There is diverticulosis of the colon\nwithout evidence of diverticulitis.",
-            "output": "1. Focal linear lucency through the anterior ossification at L2-3, new since\n___ and of indeterminate age, but may be chronic, there is no evidence of\nparaspinal hematoma. No acute fracture seen elsewhere.\n2. Severe degenerative changes in the thoracic spine."
-        },
-        {
-            "input": "There is minimal anterolisthesis of C4 on C5 and C7 on T1, unchanged compared\nto most recent prior and likely due to degenerative changes.  Alignment is\notherwise anatomic.No acute fractures are identified.Severe multilevel\ndegenerative changes are again seen, most extensive at C5 through C7 and\nnotable for loss of intervertebral disc height, osteophytosis, and\nuncovertebral and facet hypertrophy, causing mild spinal canal narrowing. \nMultilevel moderate neural foraminal narrowing.  There is fusion of the left\nC2-3 facet joints.  No prevertebral soft tissue swelling is identified. \nVisualized on the apices are unremarkable.  Incidentally noted in the thyroid\ngland is an unchanged 1.8 cm hypodense nodule, unchanged compared to multiple\nprior.",
-            "output": "1. No acute fracture or traumatic subluxation of the cervical spine.\n2. Severe, multilevel degenerative changes, most severe at C5 through C7, as\nabove.\n3. Unchanged 1.8 cm hypodense nodule in the thyroid gland."
-        },
-        {
-            "input": "Alignment is normal. No acute fractures are identified.Again seen are\nmultilevel degenerative changes with bridging anterior osteophytes, consistent\nwith DISH, as well as loss of intervertebral disc height and facet\narthropathy.  There is no evidence of paraspinal hematoma.There is no\nprevertebral soft tissue swelling.There is an unchanged sclerotic focus in the\nleft portion of the T3 vertebral body.  Partially visualized adrenal glands\nare unremarkable.  There is no hydronephrosis.  There is mild cortical\nthinning of the partially visualized bilateral kidneys.  Bilateral lung fields\nare without focal consolidation.",
-            "output": "1. No acute fracture or traumatic subluxation identified in the thoracic\nspine.\n2. Severe degenerative changes in the thoracic spine, as above."
-        },
-        {
-            "input": "There is levo-scoliotic curvature of the visualized lumbar spine with apex at\nthe L3-4 intervertebral disc.  There is unchanged grade 1 anterolisthesis of\nL4 on L5.  Previously seen linear lucency through the anterior bridging\nossification of L2-3 is less apparent on today's examination.  No acute\nfractures are identified.There is no paraspinal hematoma.  Multilevel\ndegenerative changes are severe and unchanged from prior, with bridging\nanterior osteophytes and loss of intervertebral disc height.",
-            "output": "1. No acute fracture identified.\n2. Severe degenerative changes in the lumbar spine, similar compared to prior."
-        },
-        {
-            "input": "There is minimal anterolisthesis of C4 on C5 and C7 on T1, similar to prior. \nNo acute fractures are identified. There is no prevertebral edema.  Mild retro\ndental degenerative pannus.  Severe multilevel degenerative changes are again\nnoted, most extensive at C5-C7, with near complete loss of intervertebral disc\nspace height, osteophytosis, uncovertebral hypertrophy, and facet hypertrophy.\nThere is mild spinal canal narrowing at C5-C7 secondary to degenerative\nchange, similar to prior.  Multi level facet arthropathy results in severe\nleft C3-C4 moderate to severe bilateral C4-C5, moderate bilateral C5-C6 and\nC6-C7 neural foraminal narrowing, similar to prior exam.\n\nThere is a 1.9 cm thyroid isthmus hypodense nodule.  There are no pulmonary\nnodules in the visualized lung apices.  There is no cervical lymphadenopathy\nby size criteria.",
-            "output": "1. No acute cervical fractures identified.  No traumatic malalignment.\n2. Severe degenerative changes as described above, similar to ___.\n3. Thyroid isthmus 1.9 cm hypodense nodule, unchanged from prior exam.  Of\nnote, this had been previously biopsied on ___."
-        },
-        {
-            "input": "Minimal anterolisthesis of C4 on C5 and mild anterolisthesis of C7 on T1 is\nunchanged.  No fractures are seen.  Severe multilevel degenerative changes are\nagain noted, most extensive at C5-C7, with near complete loss of\nintervertebral disc height, there are vertebral osteophytes, uncovertebral and\nfacet osteophytes.  There is mild spinal canal narrowing at C5-C7 due to\ndegenerative disease, similar to prior.  Multilevel facet osteophytes results\nin severe left C3-4, moderate to severe bilateral C4-5, moderate bilateral\nC5-6 and C6-7 neural foraminal narrowing, similar to prior.  There is no\nprevertebral edema.\n\n1.9 cm thyroid isthmus hypoattenuating nodule is unchanged.  The included lung\napices are unremarkable.",
-            "output": "No evidence of fracture.\nMild degenerative subluxation, unchanged.\nDegenerative disease with spinal canal and neural foraminal narrowing at\nmultiple levels."
-        },
-        {
-            "input": "Alignment is normal. No acute cervical spine fractures are\nidentified.Multilevel degenerative changes of the cervical spine are most\nsevere at C5-6 level, with posterior osteophytes result in mild canal\nnarrowing with indentation on the anterior thecal sac.  Multilevel neural\nforaminal narrowing is present, most severe on the left at C4-5 where it is\nmoderate.There is no prevertebral soft tissue swelling. There is no evidence\nof infection or neoplasm.\n\nThe imaged lung apices are clear.  Thyroid gland is unremarkable.  Cervical\nlymph nodes are not enlarged by CT size criteria.",
-            "output": "1. No acute cervical spine fracture or traumatic subluxation.\n2. Multilevel degenerative changes throughout the cervical spine, as described\nabove, more pronounced C5-C6 level."
-        },
-        {
-            "input": "Alignment is preserved.No fractures are identified.  Mild multilevel\ndegenerative changes with intervertebral disc space narrowing, endplate\nsclerosis and anterior osteophyte formation is most pronounced at C6-7.  Mild\ncentral canal narrowing due to a moderate disc bulges seen at C5-6.  There is\nno high-grade neural foraminal stenosis. There is no prevertebral soft tissue\nswelling. There is no evidence of infection or neoplasm.\n\nA nondisplaced fracture of the posterior right second rib is partially\nvisualized.  Additionally, a right apical pneumothorax is partially seen as\nwell.",
-            "output": "1. No acute fracture or traumatic malalignment.\n2. Partially visualized nondisplaced fracture of the posterior second right\nrib and right-sided pneumothorax are better assessed on same day CT torso."
-        },
-        {
-            "input": "No traumatic malalignment is identified. No fractures are identified.  There\nis no prevertebral soft tissue swelling. There is no evidence of infection or\nneoplasm.\nMultilevel degenerative changes are most notable at C5/C6 level, consistent\nwith posterior osteophyte, causing moderate spinal canal and severe bilateral\nneural foraminal narrowing (image 41, series 2).",
-            "output": "1. No fracture is identified.\n2. Multilevel degenerative changes are most notable for C4-5 posterior\nosteophyte causing moderate spinal canal and severe bilateral neural foraminal\nnarrowing."
-        },
-        {
-            "input": "There is no acute fracture or alignment abnormality within the lumbar spine. \nSignificant facet arthropathy is noted in the lower lumbar spine extending\ninferiorly from L3-4 through L5-S1.  No significant disc disease.  No large\nhematoma.  The imaged intra-abdominal structures are unremarkable aside from\nthe presence of diverticulosis and aortic calcification.  Gallstones partially\nvisualized in the gallbladder.",
-            "output": "No lumbar spine fracture or malalignment."
-        },
-        {
-            "input": "Minimal anterolisthesis of the C3 on C4 and C4 on C5 vertebral bodies is\nunchanged compared ___.  No acute fracture is identified.  Multilevel\nneural foraminal narrowing due to facet hypertrophy is noted. There is no\nprevertebral soft tissue swelling.Thyroid is unremarkable.  Carotid bulb\ncalcifications are noted.",
-            "output": "No acute fracture.  Mild C3 and C4 listhesis is stable."
-        },
-        {
-            "input": "The bones are severely osteopenic.\n\nThere is marked kyphosis of the thoracic spine.  No subluxation.\n\nAn acute two-column compression fracture is noted at the T11 vertebral body,\nwith surrounding hematoma and roughly 25% vertebral body height loss.  No\nretropulsion is noted.  The central canal is patent.\n\nModerate multilevel degenerative changes are noted within the thoracic spine\nwith bridging anterior osteophytes.  No high-grade central canal stenosis is\npresent.\n\nDextroscoliosis of the lumbar spine is demonstrated without spondylolisthesis.\nThere is no acute lumbar spine fracture.  Moderate multilevel degenerative\nchanges are seen in the lumbar spine with intervertebral disc space height\nloss and mild disc bulging.  Additionally, mild central canal narrowing is\ndemonstrated at L2-3, L3-4, and L4-5 due to small disc bulges and ligamentum\nflavum hypertrophy.  Additionally, mild left neural foraminal narrowing at\nL2-3 is present..\n\nA sclerotic lesion is seen in the right third rib (2:63), concerning for an\nosseous metastases.  Healed fractures are seen of the right twelfth posterior\nrib as well as the right transverse processes of the L1 and L2 vertebrae.\n\nLimited evaluation of the lungs demonstrates bibasilar atelectasis and\nbiapical scarring.  Heart demonstrates mild left atrial enlargement and\ndiffuse coronary artery calcifications.  A small hiatal hernia is present. \nScattered calcifications in the spleen may reflect prior granulomatous\ndisease.  Hepatic hypodensity measuring 10 mm is noted in the right lobe,\nlikely a cyst.  The thoracic aorta is tortuous.  Extensive fecal loading is\nnoted within the colon.  The rectum is markedly distended with fecal matter,\nwith mild presacral edema.  The prostate is enlarged and the bladder\ndemonstrates multiple diverticula with bladder wall thickening suggestive of\nchronic outlet obstruction.  Moderate atherosclerotic calcifications are seen\nin aorta and mesenteric vessels.  12 mm left subcutaneous cyst within the left\nupper back is noted (03:48).",
-            "output": "1. Acute compression fracture of the T11 vertebral body with approximately 25%\nloss of height without retropulsion of bony fragments.\n2. Large fecal load with large stool ball in the rectum.\n3. Sclerotic metastasis involving the right third rib.\n4. Remote right twelfth rib and right L1 and L2 transverse process fractures.\n5. Prostatomegaly with evidence chronic bladder outlet obstruction."
-        },
-        {
-            "input": "There is very minimal retrolisthesis of C2 over C3, which may be degenerative.\nNo acute fractures are identified.Multilevel degenerative changes are seen,\nmost extensive at C4-5 and notable for loss of intervertebral disc height,\nosteophytosis, and uncovertebral and facet hypertrophy causing mild neural\nforaminal narrowing..There is no prevertebral edema.\n\nA 6 mm hypodense nodule is seen in the right thyroid lobe. The included lung\napices show biapical scarring.",
-            "output": "Multilevel degenerative changes of the cervical spine without acute fracture\nor dislocation.  Very minimal retrolisthesis of C2 over C3 may be\ndegenerative."
-        },
-        {
-            "input": "Alignment is normal. No acute fractures are identified.There is subtle focal\nprevertebral soft tissue edema anterior to the vertebral body of C4.\n\nDegenerative changes are present most notable at C2-C3 and C3-C4 including\nosteophytosis and uncovertebral joint hypertrophy. Multilevel disc bulges\nresult in mild spinal canal narrowing.  Incidentally noted is a calcified\nright stylohyoid ligament.",
-            "output": "1. No acute fracture or malalignment.\n2. Focal prevertebral soft tissue edema anterior to C4 which raises the\npossibility of ligamentous injury.  If focally tender in this area, MRI could\nbe obtained if clinically indicated.\n\nNOTIFICATION:  The updated findings were discussed with ___, M.D.\nby ___, M.D. on the telephone on ___ at 11:17 AM, 2 minutes\nafter discovery of the findings."
-        },
-        {
-            "input": "Alignment is normal.  No acute fractures are identified.  Multilevel\ndegenerative changes with intervertebral disc space narrowing and osteophyte\nformation.  There is no prevertebral edema.\n\nThe thyroid and included lung apices are unremarkable.",
-            "output": "No acute fracture or dislocation of the cervical spine."
-        },
-        {
-            "input": "Evaluation is limited by streak artifact from dental hardware.  Multilevel\ndegenerative changes include facet arthropathy, loss of intervertebral disc\nheight, vacuum disc phenomenon, subchondral cyst formation, and osteophytosis.\nThere is mild anterolisthesis at C3-C4 and C6-C7, which is likely\ndegenerative.  Alignment is otherwise normal. No fractures are\nidentified.There is mild bony vertebral canal stenosis at C4-C5. There is no\nprevertebral soft tissue swelling.",
-            "output": "1. No acute cervical spine fracture.\n2. Multilevel degenerative changes."
-        },
-        {
-            "input": "There is mild anterolisthesis of C3 on C4, C6 on C7 and C7 on T1 unchanged. \nNo traumatic malalignment detected. No fractures are identified.Multilevel\ndegenerative changes of the cervical spine are again seen including loss of\nheight of the intervertebral discs, endplate sclerosis and osteophyte\nformation.\n\nThere is a disc bulge at C 2 3 that mildly encroaches on the spinal canal but\ndoes not contact the spinal cord.  The neural foramina appear normal.\n\nAt C3-4, intervertebral osteophytes and bulging of the disc narrow the spinal\ncanal and in concert with ligamentum flavum thickening flatten the spinal\ncord.  Uncovertebral and facet osteophytes produce severe bilateral neural\nforaminal narrowing.\n\nAt C4-5, intervertebral osteophytes and disc bulging flatten the spinal cord. \nUncovertebral and facet joints osteophytes produce severe bilateral neural\nforaminal narrowing.\n\nAt C5-6, intervertebral osteophytes and a bulge of the disc flatten the spinal\ncord.  Uncovertebral and facet osteophytes produce severe neural foraminal\nnarrowing.\n\nAt C 6 7, small intervertebral osteophytes and subluxation of 6 on 7 mildly\nnarrow the spinal canal.  The neural foramina appear normal.\n\nAt C7-T1 and the included portions of the upper thoracic spine there is no\nspinal canal or neural foraminal narrowing.  There is again seen compression\nof the superior endplate of the T1 vertebral body.\n\nSuperior endplate deformity at T1 is unchanged, presumably degenerative. There\nis no prevertebral soft tissue swelling.\n\nThere are bilateral hypodense thyroid nodules, better seen on the current\nexamination but which do not appear enlarged since the prior study.  The\nlargest of these, on the right, measures approximately 15 mm in greatest\ndimension.  This meets ___ College of Radiology criteria for further\nevaluation with ultrasound of an incidental thyroid nodule.  There is mild\npleuroparenchymal scarring in the lung apices.",
-            "output": "-No evidence offracture or traumatic malalignment.\n-15 mm right thyroid nodule that meets ___ College of Radiology\nguidelines for further evaluation\n\nRECOMMENDATION(S):  Thyroid nodule.  ___ College of Radiology guidelines\nrecommend further evaluation with ultrasound for incidental thyroid nodules\ngreater than 1.0 cm in patients under age ___ or 1.5 cm in patients age ___ or\nolder.\n\nNOTIFICATION:  The finding of a 1.5 mm right thyroid nodule and recommendation\nof ultrasound for further evaluation were entered in the Radiology department\nnon urgent critical imaging findings system at 13:57 ___ by Dr.\n___"
-        },
-        {
-            "input": "There is mild anterolisthesis, 3 mm, of C6 on C7, unchanged over multiple\nprior examinations.No acute fractures are identified.There is moderate to\nsevere multilevel uncovertebral, facet, anterior, and posterior osteophytosis.\nA combination of osteophytes and posterior disc bulges/protrusions results in\nmoderate spinal canal narrowing at C4-C5, C5-C6, and C6-C7.  There is severe\nleft neural foraminal narrowing at C3-C4, moderate bilateral neural foraminal\nnarrowing at C4-C5, moderate bilateral neural foraminal narrowing at C5-C6,\nand mild left neural foraminal narrowing at C6-C7.No prevertebral soft tissue\nswelling.  Carotid bifurcation calcifications are moderate.  The thyroid gland\nis nodular and heterogeneous, no nodules larger than 1.5 cm.  Mild biapical\nscarring.",
-            "output": "1. No evidence of fracture or traumatic malalignment.\n2. Heterogeneous and multinodular thyroid gland.  No nodules larger than 1.5\ncm.  Per ACR guidelines on incidentally discovered thyroid nodules, no imaging\nfollow-up is recommended."
-        },
-        {
-            "input": "Alignment is unchanged with re-demonstration of mild anterolisthesis of C3 on\nC4, C6 on C7, and C7 on T1.No fractures are identified.Moderate multilevel\ndegenerative changes with disc height loss, endplate sclerosis and\nirregularity, and anterior and posterior osteophytes are seen throughout the\ncervical spine, worse at C4-5, C5-6, and C6-7.  The cervical spinal vertebral\nbody heights are preserved.  Uncovertebral and facet osteophytes moderate left\nneural foraminal narrowing at C3-4, moderate bilateral neural foraminal\nnarrowing at C4-5 and C5-6.  Disc bulge and bridging osteophytes cause mild to\nmoderate canal stenosis at C3-4, C4-5 and C5-6.No prevertebral soft tissue\nswelling. There is no evidence of infection or neoplasm.  There is a 0.9 cm\nleft thyroid lobe hypodense nodule (series 3, image 51) which does not need\nfurther imaging follow-up per ACR criteria.  Bilateral lung apices demonstrate\nscarring.",
-            "output": "1. No acute fracture or traumatic malalignment.\n2. Multilevel moderate degenerative changes of the cervical spine most severe\nat C3-4, C4-5 and C5-6."
-        },
-        {
-            "input": "There is no acute fracture.  Mild anterolisthesis is unchanged at C3 on 4, C6\non 7, and to a lesser extent C7 on T1.  Multilevel degenerative disc disease\nis unchanged, from prior performed 1 month ago.  No prevertebral edema.  Mild\nscarring in the apices.  Thyroid appears unremarkable.",
-            "output": "No acute fracture or change in alignment."
-        },
-        {
-            "input": "There is mild motion degradation at the C2 level.  There is no visualized\nfracture.  There is no new malalignment.  Minimal anterolisthesis of C3 on C4,\nC6 on C7 and C7 on T1 are unchanged.  Multilevel degenerative changes are\nnotable for intervertebral disc height loss, posterior osteophytes and\nuncovertebral joint hypertrophy most notably at C4-5, C5-6 and C6-7.  No\ncritical canal narrowing.  There is moderate foraminal narrowing on the left\nat C3-4 on the right at C4-5.  Mild to moderate bilateral foraminal narrowing\nat C5-6.  There is no prevertebral soft tissue swelling.\n\nThere is mild scarring at the apex of the lungs bilaterally.  The thyroid is\nheterogeneous without visualized nodule larger than 1.5 cm.  A 1 cm left level\nfive lymph node is unchanged.  Atherosclerotic calcifications noted at the\ncarotid bulbs.",
-            "output": "No acute fracture or traumatic malalignment."
-        },
-        {
-            "input": "Alignment is anatomic.  No acute fractures are identified.Multilevel\ndegenerative changes are seen, most extensive at C5-6 and notable for\nintervertebral disc disease, anterior osteophytes and mild-to-moderate left\nneural foraminal narrowing.There is no prevertebral edema.\n\nThe thyroid is unremarkable.  Scarring is seen in the bilateral lung apices. \nDebris is noted in the upper esophagus.",
-            "output": "No evidence of acute fracture or traumatic malalignment.  Debris noted in the\nupper esophagus."
-        },
-        {
-            "input": "Alignment is normal.  No fractures are identified. There is no prevertebral\nedema.\n\nDegenerative changes noted at C5-C6 with intervertebral disc height loss and\nuncovertebral joint hypertrophy.  Posterior osteophytes and disc bulge\ncontribute to effacement of the ventral CSF, mild to moderate canal narrowing\nand may contact the ventral aspect of the cord.  There is also moderate left\nforaminal narrowing at this level.\n\nThe thyroid and included lung apices are unremarkable.",
-            "output": "No cervical spine fracture or malalignment."
-        },
-        {
-            "input": "Alignment is normal. No fractures are identified. There is no evidence of\nspinal canal or neural foraminal stenosis. There is no prevertebral soft\ntissue swelling. There is no evidence of infection or neoplasm.",
-            "output": "No acute fracture or malalignment of the cervical spine."
-        },
-        {
-            "input": "There are 12 rib-bearing vertebrae with short ribs at T12. There is\ndextroconvex scoliosis centered at T8-T9 and incompletely assessed levoconvex\nscoliosis centered at L1-L2.  The bones are demineralized.  Vertebral body\nheights are within normal limits, and no fractures are seen.  Subcentimeter\nsclerotic foci within T4 and T8 vertebral bodies are nonspecific but\ncompatible with bone islands.\n\nEvaluation of the thoracic spinal canal detail by CT is limited, particularly\ngiven the streak artifact from the pacemaker, and even more extensive streak\nartifact through C7 and T1 at the level of the shoulder girdles.\n\nSmall central disc protrusions are noted at T1-T2 and T4-T5, and mild disc\nbulges are noted at T10-T11 through T12-L1, without evidence for significant\nspinal canal narrowing.\n\nLigamentum flavum calcification is seen at T2-T3 on the right, T4-T5\nbilaterally, and at T9-T10 and T10-T11 bilaterally, without mass effect on the\nthecal sac.\n\nFacet arthropathy is present at:\nT2-T3 on the left without significant neural foraminal narrowing,\nT4-T5 bilaterally with mild left neural foraminal narrowing,\nT5-T6 bilaterally without significant neural foraminal narrowing,\nT6-T7 bilaterally with mild left neural foraminal narrowing,\nT7-T8 bilaterally with mild, right greater than left neural foraminal\nnarrowing,\nT8-T9 bilaterally with mild bilateral neural foraminal narrowing,\nT9-T10 bilaterally without significant neural foraminal narrowing,\nT10-T11 bilaterally without significant neural foraminal narrowing.\n\nLinear opacities in the visualized portion of the basal left lower lobe are\nsimilar to CT chest from ___, compatible with scarring with possible\nsuperimposed atelectasis.\nCalcified plaque is seen in the visualized portion of the aorta and at\nbilateral subclavian artery origins.\nA prosthetic mitral valve is again noted, with evidence of median sternotomy.\nThere is a small hiatal hernia, as seen previously.",
-            "output": "1. S-shaped thoracolumbar scoliosis.\n2. Evaluation of the spinal canal detail by CTs limited, especially given the\nstreak artifact from the pacemaker.  Small central disc protrusions and mild\ndisc bulges are noted at several levels without evidence for significant\nspinal canal narrowing.\n3. Multilevel facet arthropathy with mild neural foraminal narrowing at\nseveral levels, as detailed above."
-        },
-        {
-            "input": "There is no acute fracture or malalignment of the cervical spine.  Mild loss\nof height anteriorly of the C5 vertebral body appears to be chronic. The\nvisualized outline of the thecal sac is unremarkable. No significant\ndegenerative disease.  No prevertebral edema.\n\nThe aerodigestive tract appears patent. Lung apices are clear. Thyroid gland\nappears normal.",
-            "output": "No acute fracture or malalignment of cervical spine."
-        },
-        {
-            "input": "No evidence of acute fracture is seen.  Chronic appearing osseous\nfragmentation seen just superior to the anterior arch of C1.  There is no\ndislocation.  Multilevel degenerative changes are seen.  These include mild\ndisc space narrowing and C5 through C7 with there are also prominent anterior\nand small posterior osteophytes..  No prevertebral soft tissue swelling is\nseen.\nPartially imaged lung apices show no focal consolidation.  Apical paraseptal\nemphysema is noted bilaterally.",
-            "output": "No acute fracture or dislocation of the cervical spine.  Multi-level\ndegenerative changes."
-        },
-        {
-            "input": "Alignment is normal.  No fractures are identified.  There is mild multilevel\ndegenerative changes of the cervical spine, most notable at C5-C6 and C6-C7\nwith loss of disc space, osteophyte formation, and vacuum phenomenon.  There\nis moderate spinal canal stenosis at C5-C6 and mild neural foraminal narrowing\nat C5-C6 and C6-C7.  There is no prevertebral edema.\n\nThe thyroid and included lung apices are unremarkable.",
-            "output": "No evidence of cervical spine fracture.  No traumatic malalignment."
-        },
-        {
-            "input": "Alignment is normal.  No acute fractures are identified.  There is no\nprevertebral edema.\n\nThe lung apices show centrilobular emphysema.  There also appears to be some\nseptal thickening which can be seen with pulmonary edema.\n\nPosterior to the right lobe of the thyroid on series 3A, image 46, is a 1.0 x\n0.9 cm soft tissue structure which could represent a thyroid nodule or\nenlarged parathyroid gland.",
-            "output": "No acute fracture or traumatic malalignment.\n\n1.0 x 0.9 cm soft tissue structure just posterior to the right lobe of the\nthyroid could represent a thyroid nodule or prominent parathyroid gland. \nRecommend further assessment with outpatient ultrasound.\n\nPartially imaged lung apices demonstrate septal thickening which can be seen\nwith pulmonary edema."
-        },
-        {
-            "input": "Alignment is normal.  No fractures are identified.There is no significant\ncanal or foraminal narrowing.There is no prevertebral edema.\n\nThe thyroid and included lung apices are unremarkable.",
-            "output": "No acute findings."
-        },
-        {
-            "input": "Alignment is normal. No fractures are identified.  There is no prevertebral\nsoft tissue swelling.\n\nModerate degenerative changes are present from C4-C6 including spurring and\ndisc space height loss.  There is probably mild central canal narrowing at\nC4-C5, C5-C6 levels.  Posterior element degenerative changes.  Probably\nmoderate bilateral C5-C6 foraminal narrowing.\n\nThe thyroid gland is unremarkable.  There is mild biapical scarring in the\nlung.",
-            "output": "1. No fracture.\n2. Degenerative changes spine, as described."
-        },
-        {
-            "input": "Study is somewhat limited by streak artifact from dental hardware.  Multilevel\ndegenerative changes include facet arthropathy, osteophytosis, and loss of\nintervertebral disc height.  Alignment is normal.No acute fracture is seen. \nThere is no prevertebral soft tissue swelling.\n\nImaged portion of the lung apices is unremarkable.  The thyroid gland is\nunremarkable.",
-            "output": "No acute cervical spine fracture or traumatic malalignment."
-        },
-        {
-            "input": "There is a triangular bone fragment of the anterior inferior corner of the C5\nvertebral body, without clearly corticated margins (602b:42), of unclear\nchronicity.  No evidence for prevertebral edema, disc space widening, or\ndistraction of the posterior elements is seen. Alignment is normal.  There is\nno evidence of spinal canal narrowing.  Right C3-4 neural foramen is mildly\nnarrowed by uncovertebral osteophytes.\n\nVisualized lung apices are clear. There are numerous tiny lymph nodes at the\nthoracic inlet caudal to the right thyroid lobe. There are also small\nbilateral supraclavicular lymph nodes, right greater than left.",
-            "output": "1. Anterior inferior corner fragment of the C5 vertebral body, of unclear\nchronicity, without evidence for prevertebral edema.  Normal alignment.\n2. Numerous tiny lymph nodes are the thoracic inlet caudal to the right\nthyroid lobe, and small bilateral supraclavicular lymph nodes, right greater\nthan left. Please correlate clinically.\n\nRECOMMENDATION(S):  MRI could assess for marrow edema and ligamentous edema,\nif clinically warranted.\n\nNOTIFICATION:   These findings were communicated via telephone by Dr.\n___ to Dr. ___  at 01:11 on ___ ."
-        },
-        {
-            "input": "Numbering of the cervical spine is provided on series 602b, image 34.\n\nAlignment of the cervical spine is unremarkable.  There is no acute fracture. \nNo prevertebral soft tissue swelling.  Moderately severe multilevel\ndegenerative changes and noted in the form of anterior/posterior osteophytes,\nloss of intervertebral disc space height and uncovertebral hypertrophy, most\npronounced at C5-C6 and C6-C7 where there is mild indentation of the ventral\nthecal sac at these levels.  Facet joint arthropathy is also noted at multiple\nlevels, more pronounced on the right.  C2-C3 facets are fused on the right. \nC5-C6 facets are fused on the left.  Low attenuation at T1 vertebral body in\nthe sagittal reformations (image 34, series 602b) apparently is artifactual\ndue to streak artifact.\n\nImaged thyroid gland is grossly unremarkable in appearance, within the\nlimitations of this study.  Bilateral pleural parenchymal scarring is noted at\nthe lung apices.",
-            "output": "No acute cervical spine fracture or traumatic malalignment."
-        },
-        {
-            "input": "Alignment is normal. No fractures are identified. There is no evidence of\nspinal canal or neural foraminal stenosis.Moderate to severe multilevel\ndegenerative changes have progressed in the interval with partial fusion of\nthe C4 through C6 vertebral bodies and bilateral facet joints of C4 and C5. \nMultilevel mild central canal and bilateral neural foraminal narrowing is\npresent without high-grade stenosis.  There is no evidence of infection or\nneoplasm.\n\nThe thyroid gland is diffusely enlarged with a partly rim calcified isodense\nleft nodule measuring approximately 15 mm, similar to the prior exam.  The\nlung apices are clear.",
-            "output": "1. No acute fracture or malalignment.\n2. Moderate to severe cervical spondylosis, progressed in the interval, most\npronounced from C4 through C6 vertebral body levels.\n3. Diffusely enlarged thyroid gland with partly rim calcified isodense left\nthyroid nodule measuring up to 15 mm, similar to the prior exam.  Thyroid\nultrasound can be obtained for further assessment, if not previously performed\nand if clinically warranted.\n\nRECOMMENDATION(S):  Thyroid nodule.  Ultrasound follow up recommended.\n___ College of Radiology guidelines recommend further evaluation for\nincidental thyroid nodules of 1.0 cm or larger in patients under age ___ or 1.5\ncm in patients age ___ or ___, or with suspicious findings.\n\nSuspicious findings include: Abnormal lymph nodes (those displaying\nenlargement, calcification, cystic components and/or increased enhancement) or\ninvasion of local tissues by the thyroid nodule.\n\n___, et al, \"Managing Incidental Thyroid Nodules Detected on Imaging: White\nPaper of the ACR Incidental Findings Committee\". J ___ ___\n12:143-150."
-        },
-        {
-            "input": "No fracture is identified. There is again mild retrolisthesis of the C5 on C6\nvertebral bodies with decreased disk space height at this level, unchanged\ncompared to ___. No new malalignment is seen. There is no prevertebral\nsoft tissue abnormality. At the C2-3 and C3-4 levels is mild disc bulge, with\nindentation of the anterior thecal sac. There is mild neural foraminal\nnarrowing on the left at the C2-3 level, moderate on the right at the C3-4\nlevel, and moderate to severe bilaterally at the C5-6 level. There is no\nevidence of infection or neoplasm.",
-            "output": "1. No fracture or prevertebral soft tissue abnormality identified.\n2. Unchanged mild retrolisthesis of the C5 on C6 vertebral bodies with\ndecreased disk space height at this level.\n3. Mild spinal canal an neural foraminal narrowing at multiple levels, likely\nrelated to multilevel degenerative changes."
-        },
-        {
-            "input": "Alignment is normal. No fractures.  No prevertebral soft tissue swelling.\nMultilevel degenerative changes, disc osteophyte complexes, hypertrophic\nchanges.  Multilevel mild-to-moderate central canal narrowing, most prominent\nat C5-C6, C6-C7 levels.  Multilevel moderate to severe foraminal narrowing.\n There is no evidence of infection or neoplasm.  Small thyroid nodules do not\nmeet ACR criteria for further evaluation.  Nonspecific soft tissue density in\nthe right external auditory canal likely represents cerumen.",
-            "output": "No acute fracture or malalignment of the cervical spine.\nAdvanced degenerative changes cervical spine."
-        },
-        {
-            "input": "The bones are demineralized without evidence for a displaced fracture.\nPrevertebral soft tissues are unremarkable.  There is minimal anterolisthesis\nof C2 on C3, unchanged compared to ___ brain MRI, and minimal\nretrolisthesis of C4 on C5, unchanged compared to ___ pituitary\nMRI, without disc space widening, which are likely secondary to facet\narthropathy. There is no acute subluxation. There is a kyphotic curvature\ncentered at C3-4. There are multilevel degenerative changes.  At C3-4, a disc\nosteophyte complex mildly to moderately indents the ventral thecal sac. There\nis multilevel neural foraminal narrowing by uncovertebral osteophytes.\n\nThere is minimal dependent atelectasis in the visualized right upper lung. The\nthyroid gland is not visualized. There are no surgical clips in the thyroid\nbed. There are calcifications at the internal carotid artery origins, right\ngreater than left, and at the left subclavian artery origin.",
-            "output": "1. Demineralized bones without evidence for a fracture. No acute subluxation.\n2. Multilevel degenerative disease.\n3. The thyroid gland is not visualized. Please correlate clinically."
-        },
-        {
-            "input": "No acute cervical spine fractures are identified.  There is no prevertebral\nsoft tissue swelling.\n\nAlignment of the cervical spine is anatomic.  There are no suspicious\nosteoblastic or lytic lesions.\n\nThere are severe multilevel degenerative changes of the cervical spine,\nincluding facet joint and uncovertebral hypertrophy, osteophytosis, loss of\nintervertebral disc space, and endplate changes, which is most prominent at\nC5-C6 and C6-C7. Specifically, there is severe bilateral C2-C3 and right C5-6\nneural foraminal narrowing.  No severe canal narrowing.  There is fusion of\nthe bilateral C3, C4, and C5 facets, with large bridging anterior osteophytes\nat C5, C6, and C7.\n\nThe visualized portion of the lungs are unremarkable.  The visualized portion\nof the thyroid is unremarkable. There is no lymphadenopathy by CT size\ncriteria.",
-            "output": "1. No acute cervical spine fracture or malalignment.  No prevertebral edema.\n2. Severe multilevel degenerative changes of the cervical spine, as described."
-        },
-        {
-            "input": "Alignment is normal.  No acute fractures are identified.Multilevel\ndegenerative changes are seen, most extensive at C5-C6 and notable for disc\nspace narrowing and severe anterior osteophyte formation.  No foraminal\nnarrowing is seen, including on the right at C5-C6.  There is also mild\nnarrowing of the central canal at C5-C6, related to posterior disc osteophyte.\nOsseous fusion of the bilateral C3, C4, and C5 facets is redemonstrated. \nThere is no prevertebral edema.\n\nThere is respiratory motion through the imaged lung apices, but no focal\nconsolidation is identified.  The imaged thyroid gland is grossly homogeneous.\nPartially imaged fluid is seen superior to the sternum.  Please refer to\nconcurrent CT torso for further details.",
-            "output": "1. No acute fracture or traumatic subluxation.\n2. Multilevel degenerative changes, stable since most recent prior.\n3. Partially imaged fluid seen in the midline superior to the sternum.  Please\nrefer to concurrent CT torso for further details."
-        },
-        {
-            "input": "Alignment is normal. No fractures are identified. There is no evidence of\nspinal canal or neural foraminal stenosis. There is no prevertebral soft\ntissue swelling.The thyroid and lung apices are unremarkable.",
-            "output": "Normal study."
-        },
-        {
-            "input": "No traumatic malalignment or acute fractures of the cervical spine are\nidentified.No prevertebral soft tissue edema.\n\nThere are multilevel degenerative changes of the cervical spine most\npronounced at C5-C6 where there is moderate loss of the disc space and\nbilateral mild-to-moderate neural foraminal narrowing.  There is no high-grade\ncentral spinal canal narrowing.\n\nThe thyroid is unremarkable.  There are moderate calcifications of the carotid\nbulbs bilaterally.  There is mild biapical emphysema and re-demonstration of a\n11 x 9 mm spiculated right apical pulmonary nodule, similar to the prior exam\nfrom ___ when it was first seen, however remains concerning and warrants\nfurther evaluation with PET-CT or biopsy.",
-            "output": "1. No traumatic malalignment or acute fractures of the cervical spine.\n2. Right apical 11 x 9 mm spiculated pulmonary nodule is stable since ___ when it was first seen, however morphology remains concerning and\nwarrants further evaluation with PET-CT and/or biopsy.\n3. Multilevel degenerative changes worst at C5-C6."
-        },
-        {
-            "input": "No acute fracture or traumatic alignment abnormality.  When compared with\nprior CT performed 4 days earlier, there has been no significant change. \nMultilevel degenerative changes with disc disease most pronounced at C5-6 and\nC6-7 levels.  No critical central canal or neural foraminal stenosis. Again\nseen at the right lung apex, is a suspicious nodular structure measuring\napproximately 13 mm.  No prevertebral edema.  The imaged thyroid is\nunremarkable.",
-            "output": "1. No fracture or malalignment.\n2. Suspicious pulmonary nodule at the right lung apex up to 13 mm.  Agree with\nprior recommendations for further workup with PET-CT or biopsy."
-        },
-        {
-            "input": "Alignment is normal.  No fractures are identified.Multilevel degenerative\nchanges are seen, most extensive at C5-C6 and notable for disc space narrowing\nand anterior and posterior osteophyte formation..There is no prevertebral\nedema.\n\nThe thyroid is unremarkable.  There is scarring of the right lung apex\nincompletely evaluated.  This is decreased in size compared with ___ but\nstable since ___.  This was further evaluated by chest CT of ___.",
-            "output": "1. No acute fracture or traumatic subluxation.\n2. Multilevel degenerative changes most extensive at C5-C6.\n3. Right upper lung nodule which was further evaluated by chest CT of ___.  Correlate with findings and recommendations of that study."
-        },
-        {
-            "input": "There is no acute fracture or malalignment of the cervical spine.  There is\nmild loss of disc height at C5-C6 with mild inferior endplate changes at C5\nand superior endplate changes at C6, consistent with degenerative change. \nPosterior osteophytes and uncovertebral joint hypertrophy contribute to mild\ncanal and mild bilateral foraminal narrowing, worse on the left.  \\No\nprevertebral edema.\n\nThe aerodigestive tract appears patent.  Paraseptal apical emphysema, right\ngreater than left.  Thyroid appears normal.  Left mastoidectomy changes are\nvisualized.  Atherosclerotic calcifications noted at the carotid bulbs\nbilaterally.",
-            "output": "1. No acute fracture or malalignment of the cervical spine.\n2. Minimal degenerative changes at C5-C6.\n3. Paraseptal apical emphysema."
-        }
-    ]
-}

MedS-Bench/Text_summarization/task89_mimic_mri_chest_summarization.json

@@ -1,126 +0,0 @@
-{
-    "Contributors": [
-        "MIMIC"
-    ],
-    "Source": [
-        "MIMIC-IV"
-    ],
-    "URL": [
-        "https://www.physionet.org/content/mimic-iv-note/2.2/"
-    ],
-    "Categories": [
-        "Text Summarization"
-    ],
-    "Definition": [
-        "Summarize the MRI imaging diagnostics' detailed findings for the Chest into a concise conclusion."
-    ],
-    "Reasoning": [],
-    "Input_language": [
-        "English"
-    ],
-    "Output_language": [
-        "English"
-    ],
-    "Instruction_language": [
-        "English"
-    ],
-    "Domains": [
-        "Clinical Text"
-    ],
-    "Positive Examples": [],
-    "Negative Examples": [],
-    "Instances": [
-        {
-            "input": "LUNGS: The visualized portions of the lungs do not demonstrate any obvious\nmasses, given the limitations of MRI.  There is abnormal right pleural\nthickening which enhances post gadolinium administration, concerning for\nmetastatic disease.  Associated trace right pleural effusion.\n\nVASCULATURE: Visualized portions of the thoracic aorta and pulmonary arteries\nare unremarkable.\n\nHEART AND MEDIASTINUM: There is no lower mediastinal lymphadenopathy.  No\npericardial effusion.\n\nUPPER ABDOMEN: Visualized cuts through the upper abdomen demonstrate few T2\nhyperintense foci in the liver, measuring up to 1 cm in segment 2, likely\ncysts.\n\nOSSEOUS STRUCTURES AND SOFT TISSUES: Multiple thoracic vertebral body\nmetastatic lesions are again demonstrated, involving the T2, T3, T6, T10 and\nT12 vertebral bodies.  There is abnormal enhancement extending into the\nposterior right transverse processes and ribs in the mid thoracic spine. \nThere are also foci of abnormal enhancement along the anterior chest wall,\npossibly within the ribs, which are also concerning for metastatic disease.",
-            "output": "1.  Re-demonstration of diffuse metastatic bone disease involving multiple\nthoracic vertebral bodies and posterior right ribs.  For comparison of extent\nis difficult, versus prior thoracic spine MRI given differences in planes of\nimaging.\n\n2.  Small of abnormal enhancement within the soft tissues of the right\nanterior and lateral chest wall, possibly within the ribs, which are\nconcerning for metastatic disease.\n\n3.  Right pleural thickening and enhancement with associated trace right\npleural effusion, also concerning for metastatic disease.\n\nRECOMMENDATION(S):  A bone scan is may be considered as clinically indicated\nfor further evaluation of the possible rib metastases if clinically suspicious\nfor progression since bone scan of ___."
-        },
-        {
-            "input": "LUNGS: Within limits of MRI, the lungs are clear.  Please refer to the\ndedicated CT chest from ___ for details.\n\nVASCULATURE: Patient is status post right chest wall infusion port placement\nwith tip at the cavoatrial junction, unchanged from prior exam.  Please note\nthat the evaluation for pulmonary embolism is limited on the current\ntechnique.  The ascending and descending aorta are not dilated.  The pulmonary\nartery appears well opacified centrally.\n\nHEART AND MEDIASTINUM: The heart is normal in size.  There is no pericardial\neffusion.  As previously, again seen is a soft tissue density in the anterior\nmediastinum measuring 1.9 x 4.0 cm.  There is evidence of dropout in signal on\nin and imaging, suggestive of intravoxel fat.  The ratio between in and out of\nphase images when compared to the paraspinal muscles measure 0.86 ___ et\nal.  AJNR ___ Jul;197(1):W15-20).  The enhancement is mostly homogeneous. \nThere is no lymphadenopathy in the mediastinum.\n\nUPPER ABDOMEN: The imaged portion of the upper abdomen is unremarkable.\n\nOSSEOUS STRUCTURES AND SOFT TISSUES: The imaged osseous structures and soft\ntissues are within normal limits.",
-            "output": "Soft tissue in the anterior mediastinum, most likely representing thymic\nhyperplasia given clinical history and signal characteristics.  No suspicious\nenhancement within the thymus.  No new lymphadenopathy."
-        },
-        {
-            "input": "LUNGS: Within limits of an MRI examination, no significant pulmonary\nabnormality seen.\n\nVASCULATURE: Again seen is a right sided Port-A-Cath with tip in the proximal\nright atrium.  The aorta is normal in caliber.  The main and central pulmonary\narteries are normally opacified.  Please note limitation of MRI for assessment\nof distal pulmonary arterial vessels.\n\nHEART AND MEDIASTINUM: Heart is normal in size.  There is no pericardial\neffusion.  Again seen is the mildly enhancing soft tissue density in the\nanterior superior mediastinum showing evidence of signal dropout on the out of\nphase images measuring approximately 3.5 x 2.0 cm (previously 4.0 x 1.9 cm). \nThe ratio between in and out of phase images compared to the paraspinal\nmuscles measures 0.5, which is in keeping with normal thymus/thymic\nhyperplasia ___ et al ___ AJNR).  No significantly enlarged mediastinal\nlymph nodes seen.\n\nUPPER ABDOMEN: No significant abnormality seen in the visualized upper\nabdomen.\n\nOSSEOUS STRUCTURES AND SOFT TISSUES: No abnormal marrow signal or soft tissue\nabnormality.",
-            "output": "Mild interval decrease in size of the thymic hyperplasia in the anterior\nmediastinum.  No suspicious mass or lymphadenopathy seen."
-        },
-        {
-            "input": "LUNGS: Postsurgical changes are again seen at the left lung base with a small\nleft pleural effusion.  Multiple nodules are seen along the left major fissure\nmeasuring up to 5 mm, unchanged and likely benign lymph nodes (8:26). \nMultiple enhancing T1 isointense and T2 hyperintense nodules are seen along\nthe posterior left pleura at the apex measuring 1.3 x 1.2 cm (10:11) and at\nthe left lung base measuring up to 1.5 x 0.7 cm, more conspicuous compared to\nprior exam (8:51, 52, 55).  A 3.4 x 2.6 cm T2 hyperintense enhancing mass is\nseen in the left costophrenic angle, previously measuring 3.9 x 2 cm, grossly\nsimilar to prior given difference in modality (11:11).\n\nVASCULATURE: No aortic aneurysm or significant atherosclerotic disease.\n\nHEART AND MEDIASTINUM: Heart size is normal.  No mediastinal lymphadenopathy\nor mass.\n\nUPPER ABDOMEN: The visualized portion of the upper abdomen is unremarkable.\n\nOSSEOUS STRUCTURES AND SOFT TISSUES: Postsurgical changes are seen along the\nleft chest wall.  Mild degenerative changes are seen in the thoracic spine. \nNo aggressive osseous lesion.  The thyroid gland is without concerning focal\nlesion.  A right chest Port-A-Cath is visualized terminating in the mid SVC.",
-            "output": "1. Multiple enhancing nodules along the left pleura, concerning for metastatic\ndisease.\n2. Left costophrenic angle mass is stable in size but avidly enhancing.  While\nthis may represent postsurgical sequela, metastatic disease can have a similar\nappearance.\n\nNOTIFICATION:   The impression and recommendation above was entered by Dr.\n___  ___ on ___ at 18:26 into the Department of Radiology\ncritical communications system for direct communication to the referring\nprovider."
-        },
-        {
-            "input": "There is marked, necrotic-appearing lymphadenopathy identified within the\nanterior mediastinum, prevascular area, left paratracheal, left suprahilar and\nright paratracheal stations.  The largest lymph nodes is seen in the left\nanterior lateral mediastinum and measures 2.4 cm.  The largest left\nparatracheal lymph node measures 1.6 cm.  The left largest suprahilar lymph\nnode measures 2.1 cm.  There is bilateral moderate-sized pleural effusions\nwhich are new compared to the prior study.  There is also significant increase\nin the consolidation in left upper lung lobe with bronchial wall thickening of\nthe upper lobe bronchi consistent with post obstructive bronchitis.\n\nPostcontrast administration there appears to be central hypervascularity of\nthe lymph nodes suggesting a more atypical source such as an a typical\ninfection, and based on the age of the patient less likely a neoplastic\nprocess.  Further characterization by means of biopsy is recommended.",
-            "output": "There is marked, necrotic-appearing lymphadenopathy identified within the\nanterior mediastinum, prevascular area, left paratracheal, left suprahilar and\nright paratracheal stations. Postcontrast administration there appears to be\ncentral hypervascularity of the lymph nodes suggesting a more atypical source\nsuch as an a typical infection, and based on the age of the patient less\nlikely a neoplastic process.\n\nRECOMMENDATION(S):  Further characterization by means of biopsy is\nrecommended."
-        },
-        {
-            "input": "AORTA: The patient is status post resection and grafting of the ascending and\nhemi-arch of the aorta for previous type A aortic dissection.\n\nAgain demonstrated is an anterior outpouching of the anterior aortic root,\nsuperior to the right coronary cusp (15b:61), and is unchanged since the most\nrecent prior study of ___.\n\nAgain identified is an aortic dissection extending from the distal thoracic\naorta at the level of the diaphragmatic hiatus (16b:53) into the proximal left\ncommon iliac artery (18b:72). The configuration and appearance of the\ndissection is unchanged since the most recent prior study. The celiac artery,\nSMA and right renal artery originate from the true lumen and are patent. \nThere is severe narrowing of the origin of the celiac axis with marked\npoststenotic aneurysmal dilation of the proximal celiac artery measuring up to\n16 mm in diameter (17b:5), which is unchanged from the prior study. The left\nrenal artery arises from both the true and false lumen, with the dissection\nflap extending into the left renal artery (17b:25). There is aneurysmal\ndilatation of the distal left renal artery which measures 15 x 13 mm and is\nunchanged since previous (17b:24). The inferior mesenteric artery arises from\nthe false lumen and fills retrograde.\n\nThe left common iliac artery is again dilated measuring 2.7 x 2.4 cm and is\nunchanged since previous (previously 2.6 x 2.5 cm).\n\nAortic measurements (all are unchanged since the most recent prior study):\n\nAortic root: 4.2 cm (10:6).\nAscending aorta: 2.7 cm (15b:40).\nAortic arch: 3.6 cm (15b:23).\nDescending aorta:  3.6 x 3.1 cm (15b:50).\nDescending aorta at the esophageal hiatus:  4.0 x 3.6 cm (16b:45).\nAbdominal aorta at the level of SMA:  4.0 x 3.4 cm (17b:14).\nInfrarenal abdominal aorta:  4.3 x 3.7 cm (17b:64).\n\nCHEST: There is evidence of prior sternotomy. No mediastinal, axillary or\nhilar lymphadenopathy is appreciated. There is minimal dependent atelectasis\nin the bilateral lung bases. No pericardial or pleural effusions are present.\n\nABDOMEN:  A few subcentimeter T2 hyperintense cystic lesions within the liver\n(6:34, 35, 37) are consistent with biliary hamartomas. The liver is otherwise\nunremarkable. The portal and hepatic veins are patent.  Incidental note is\nmade of a replaced right hepatic artery arising from the SMA. No intra or\nextrahepatic biliary duct dilatation is seen. There are multiple small\ngallstones within the gallbladder, which is nondistended and nonedematous.\n\nThere are multiple T2 hyperintense cystic lesions within both kidneys, the\nlargest of which measures 5.1 x 4.5 cm within the upper pole of the right\nkidney, consistent with a simple cyst.  A 6 mm T1 hyperintense lesion in the\nright upper pole renal cortex ___: 104) is compatible with a\nhemorrhagic/proteinaceous renal cyst. Both kidneys enhance symmetrically and\nexcrete contrast normally without hydronephrosis or suspicious renal mass. The\nbilateral adrenal glands and spleen are within normal limits. The pancreas\nshows normal signal intensity and homogeneous enhancement without pancreatic\nduct dilation.\n\nThere is a small axial hiatal hernia.  The stomach, duodenum and\nintra-abdominal loops of bowel are unremarkable except to note a few colonic\ndiverticula. There is a small fat-containing umbilical hernia. No\nlymphadenopathy or ascites is seen.\n\nPELVIS:  The urinary bladder and seminal vesicles are unremarkable.  The\nprostate is not well-visualized and is likely surgically absent. The rectum is\nwithin normal limits. No free pelvic fluid or pelvic lymphadenopathy is seen. \nUncomplicated bilateral small fat containing inguinal hernias are noted.\n\nThere is no bone marrow signal abnormality concerning for infection or\nmalignancy.",
-            "output": "1. Stable extent and appearance of distal thoracic and abdominal aortic\ndissection involving the left common iliac and left renal arteries. Aneurysmal\ndilatation of the abdominal aorta, left common iliac artery and distal left\nrenal artery are unchanged from the prior examination. Unchanged postsurgical\noutpouching of the anterior aortic root.\n\n2. Unchanged severe stenosis of the origin of the celiac artery with market\npost stenotic aneurysmal dilatation.\n\n3. Cholelithiasis without evidence of cholecystitis.\n\n4. Small axial hiatal hernia."
-        },
-        {
-            "input": "AORTA: The patient is status post resection and grafting of the ascending and\nhemi-arch of the aorta for previous type A aortic dissection.\n\nAgain demonstrated is an anterior outpouching of the anterior aortic root,\nsuperior to the right coronary cusp (15b:61), and is unchanged since the most\nrecent prior study of ___.\n\nAgain identified is an aortic dissection extending from the distal thoracic\naorta at the level of the diaphragmatic hiatus (16b:53) into the proximal left\ncommon iliac artery (18b:72). The configuration and appearance of the\ndissection is unchanged since the most recent prior study. The celiac artery,\nSMA and right renal artery originate from the true lumen and are patent. \nThere is severe narrowing of the origin of the celiac axis with marked\npoststenotic aneurysmal dilation of the proximal celiac artery measuring up to\n16 mm in diameter (17b:5), which is unchanged from the prior study. The left\nrenal artery arises from both the true and false lumen, with the dissection\nflap extending into the left renal artery (17b:25). There is aneurysmal\ndilatation of the distal left renal artery which measures 15 x 13 mm and is\nunchanged since previous (17b:24). The inferior mesenteric artery arises from\nthe false lumen and fills retrograde.\n\nThe left common iliac artery is again dilated measuring 2.7 x 2.4 cm and is\nunchanged since previous (previously 2.6 x 2.5 cm).\n\nAortic measurements (all are unchanged since the most recent prior study):\n\nAortic root: 4.2 cm (10:6).\nAscending aorta: 2.7 cm (15b:40).\nAortic arch: 3.6 cm (15b:23).\nDescending aorta:  3.6 x 3.1 cm (15b:50).\nDescending aorta at the esophageal hiatus:  4.0 x 3.6 cm (16b:45).\nAbdominal aorta at the level of SMA:  4.0 x 3.4 cm (17b:14).\nInfrarenal abdominal aorta:  4.3 x 3.7 cm (17b:64).\n\nCHEST: There is evidence of prior sternotomy. No mediastinal, axillary or\nhilar lymphadenopathy is appreciated. There is minimal dependent atelectasis\nin the bilateral lung bases. No pericardial or pleural effusions are present.\n\nABDOMEN:  A few subcentimeter T2 hyperintense cystic lesions within the liver\n(6:34, 35, 37) are consistent with biliary hamartomas. The liver is otherwise\nunremarkable. The portal and hepatic veins are patent.  Incidental note is\nmade of a replaced right hepatic artery arising from the SMA. No intra or\nextrahepatic biliary duct dilatation is seen. There are multiple small\ngallstones within the gallbladder, which is nondistended and nonedematous.\n\nThere are multiple T2 hyperintense cystic lesions within both kidneys, the\nlargest of which measures 5.1 x 4.5 cm within the upper pole of the right\nkidney, consistent with a simple cyst.  A 6 mm T1 hyperintense lesion in the\nright upper pole renal cortex ___: 104) is compatible with a\nhemorrhagic/proteinaceous renal cyst. Both kidneys enhance symmetrically and\nexcrete contrast normally without hydronephrosis or suspicious renal mass. The\nbilateral adrenal glands and spleen are within normal limits. The pancreas\nshows normal signal intensity and homogeneous enhancement without pancreatic\nduct dilation.\n\nThere is a small axial hiatal hernia.  The stomach, duodenum and\nintra-abdominal loops of bowel are unremarkable except to note a few colonic\ndiverticula. There is a small fat-containing umbilical hernia. No\nlymphadenopathy or ascites is seen.\n\nPELVIS:  The urinary bladder and seminal vesicles are unremarkable.  The\nprostate is not well-visualized and is likely surgically absent. The rectum is\nwithin normal limits. No free pelvic fluid or pelvic lymphadenopathy is seen. \nUncomplicated bilateral small fat containing inguinal hernias are noted.\n\nThere is no bone marrow signal abnormality concerning for infection or\nmalignancy.",
-            "output": "1. Stable extent and appearance of distal thoracic and abdominal aortic\ndissection involving the left common iliac and left renal arteries. Aneurysmal\ndilatation of the abdominal aorta, left common iliac artery and distal left\nrenal artery are unchanged from the prior examination. Unchanged postsurgical\noutpouching of the anterior aortic root.\n\n2. Unchanged severe stenosis of the origin of the celiac artery with market\npost stenotic aneurysmal dilatation.\n\n3. Cholelithiasis without evidence of cholecystitis.\n\n4. Small axial hiatal hernia."
-        },
-        {
-            "input": "MR ANGIOGRAM: Postsurgical changes related to prior repair ___ type A\ndissection are again noted, with persistent anterior outpouching of the aortic\nroot, unchanged in appearance (25:50).  The origins of the great vessels\narising from the aortic arch are patent.\n\nA ___ type B aortic dissection arises at the level of the diaphragmatic\nhiatus common extends into the left common iliac artery.  The overall\nconfiguration extent of the dissection appears similar compared to the prior\nexamination.  There is stable degree of concentric variability of the\nthrombosis in the false lumen.  There is persistent severe stenosis of the\nceliac artery, poststenotic dilatation measuring up to 14 mm (26:30),\nunchanged.  The celiac artery, superior mesenteric artery, and right renal\nartery arise from the true lumen.  The inferior mesenteric artery arises from\nthe false lumen and fills via retrograde flow.  Slight irregular thrombosis\nwithin the superior mesenteric artery near the origin is unchanged.  There is\nre- demonstration of a replaced right hepatic artery, arising from the\nsuperior mesenteric artery.\n\nThe aortic dissection flap extends into the left renal artery (2700, 22:74),\nwith predominant filling by the true lumen.  There is likely fenestration in\nthe proximal left renal artery. The false lumen of the left renal artery is\nopacified for only approximately 1.5 cm.  The distal left renal artery is\naneurysmal, spanning approximately 13 mm (27:79), unchanged.   Left common\niliac artery aneurysm is also noted (measured below).\n\nMeasurements include:\nAortic root:  3.9 x 4.4 cm\nAscending thoracic aorta at the level of the main pulmonary artery:  4.2 x 3.4\ncm\nProximal arch:  3.4 x 3.6 cm\nDistal arch:  3.6 x 3.6 cm\nMid descending:  3.8 x 3.8 cm\nDistal descending:  3.9 x 3.6 cm\nSuprarenal abdominal aorta:  4.1 x 3.7 cm\nInfrarenal abdominal aorta:  4.1 x 3.6\nLeft common iliac artery:  2.8 x 2.2 cm\n\n\nLUNGS:  A 6mm pulmonary nodule in the right middle lobe is stable since the\nchest CT from ___ (25:13).  There is no pleural effusion.\n\nHEART AND MEDIASTINUM: The heart and mediastinum are unremarkable.  There is\nno mediastinal or hilar lymphadenopathy.  No pericardial effusion is\nidentified.\n\nABDOMEN:  There is a small hiatal hernia.  The liver is unremarkable with\nexception of small cysts or biliary hamartomas, unchanged (5:5).  The\npancreas, spleen, and bilateral adrenal glands are normal in appearance. \nThere are several simple cysts in the bilateral kidneys, unchanged.  The\ngastrointestinal tract is within normal limits.  There is no free fluid in the\nabdomen.  No retroperitoneal or mesenteric lymphadenopathy is present.\n\nOSSEOUS STRUCTURES AND SOFT TISSUES: No osseous lesion worrisome for\nmalignancy or infection is identified.",
-            "output": "1. Overall stable appearance of Type B aortic dissection.\n2. Graft repair of prior Type A dissection is unchanged.\n3. Aneurysmal dilation of the left common iliac artery, distal left renal\nartery, and celiac artery just beyond celiac origin stenosis are overall\nunchanged.\n4. Hepatic and renal cysts."
-        },
-        {
-            "input": "There are bilateral pleural effusions, left greater than right\nside.  There is a large anterior and middle mediastinal mass which extends\nanterior to the branch vessels of the aorta.  It extends inferiorly anterior\nto the arch and posterior to the sternum and involves the sternum.  It extends\nfurther inferiorly to surround the main pulmonary artery and the proximal\npericardium.  It encases the left brachiocephalic vein.  It encases the\ninternal mammary arteries.  The mass extends down to the aortopulmonary window\nand the subcarinal space.  The mass encases the branch vessels of the aorta\nextending posteriorly between the SVC and trachea and abutting the azygos\nvein.  Anteriorly, it elevates the left pectoralis muscle.\n\nNo evidence of any occlusion of any of the vasculature.  No evidence of any\nemboli.\n\n2D and 3D reformations provided multiple perspectives for the dynamic series.",
-            "output": "1.  Large anterior and middle mediastinal mass which surrounds and abuts the\naorta and pulmonary artery as well as the branch vessels of the aorta,\ninvolves the sternum and elevates and slightly invadses the left pectoralis\nanteriorly and inferiorly involves the pericardium.  The appearance is most\nlikely that of an aggressive thymoma.\n\n2.  Bilateral pleural effusions with associated atelectasis, left more than\nright side."
-        },
-        {
-            "input": "Motion artifact degrades the quality of the study.\n\nIn the anterior mediastinum prevascular space extending inferiorly anterior to\nthe heart, there is lobulated soft tissue lesion in a triangular configuration\nwhich is mildly hyperintense on the T2 weighted images.   There is signal loss\non the out of phase sequence as opposed to the in phase sequence consistent\nwith intravoxel fat.  This area measures approximately 2.0 x 4.6 cm and is\nunchanged compared to the prior exam. This area is most consistent with thymic\nhyperplasia.  There are no discrete masses.\n\nThere are bilateral simple appearing 4 and 2 mm cysts in the right and left\nlobes of the thyroid respectively.\n\nNo supraclavicular or axillary lymphadenopathy by size criteria.\n\nThe great vessels are of normal caliber throughout.  Heart size is normal.  No\npericardial effusion.\n\nAlthough the study is not optimized for assessment of the lung parenchyma.  No\ngross masses.  No areas of consolidation.  No mediastinal or hilar\nlymphadenopathy by size criteria.\n\nThe visualized portion of the abdomen is not well assessed due to motion\nartifact.\n\nThe bone marrow demonstrates normal signal characteristics.  No concerning\nosseous lesions.",
-            "output": "Soft tissue in the anterior mediastinum appears unchanged from CT chest ___ and is compatible with thymic hyperplasia."
-        },
-        {
-            "input": "The study is mildly limited by motion.\n\nLUNGS: The study is not targeted for evaluation of lung parenchyma.  Within\nthis limitation, there is no focal consolidation or mass.  No pleural\neffusion.\n\nVASCULATURE: The thoracic aorta appears normal in caliber.\n\nHEART AND MEDIASTINUM: Visualized thyroid appears unremarkable.  Visualized\nportion of the base of the neck appears unremarkable.  There is no axillary\nlymphadenopathy or supraclavicular lymphadenopathy.  In the anterior\nmediastinum, there is significant decrease in soft tissue with again loss of\nsignal on out of phase imaging suggesting intravoxel fat now measuring\napproximately 3.7 x 1.8 cm, previously measuring at least 7.3 x 2.0 cm (4; 21)\nconsistent with thymic hyperplasia.  There is no mediastinal lymphadenopathy. \nThe heart is not enlarged.  There is no pericardial effusion.\n\nUPPER ABDOMEN: Visualized portion of the upper abdomen appears unremarkable.\n\nOSSEOUS STRUCTURES AND SOFT TISSUES: No suspicious osseous lesion is\nidentified.",
-            "output": "Interval decrease in anterior mediastinal soft tissue which again drops in\nsignal on out of phase imaging consistent with thymic hyperplasia, decreased\ncompared to prior."
-        },
-        {
-            "input": "Within the skin and subcutaneous tissues of the anterior right chest wall\nthere is a STIR hyperintense and T1 hypo intense lesion, which measures\napproximately 1.7 x 4.4 x 5.3 cm (AP, transverse, cc dimension).  There are\nmultiple hypo intense curvilinear flow voids within the lesion and within the\nsurrounding subcutaneous fat.  There is a large tortuous artery that leads\nfrom the right internal mammary artery to the lesion, better delineated on\nprior CT.  No definite nidus identified, however, this study was not tailored\nto evaluate the vasculature.  The associated T1 hypointense and STIR\nhypointense signal is non mass like, suggesting this may represent a vascular\nmalformation.  Difficult to definitively exclude a highly vascularized soft\ntissue tumor.  There is thickening of the overlying skin.  In addition, there\nis a smaller ill defined nodular T1 hypointense and STIR hyperintense area\ndeep the dominant lesion measuring up 1.3 x 0.8 x 1.5 cm (series 6, image 15).\nThere are flow voids leading to and within this area as well.  This second\nportion of the lesion abuts the fascia overlying the pectoralis muscle.  No\nevidence of definite involvement of the pectoralis muscle.  Postcontrast\nimaging demonstrates enhancement within both lesions.\n\nNo axillary lymphadenopathy.\n\nNo suspicious bone marrow signal.",
-            "output": "T1 and STIR hypointense lesion in the right anterior chest wall subcutaneous\ntissues involving the overlying skin with multiple large flow voids.  The\nabnormal signal intensity is non mass like in configuration and likely\nrepresents a vascular malformation, however, a highly vascular tumor cannot be\nexcluded.\n\nNOTIFICATION:  The findings were discussed with Dr.  ___, M.D. by\n___, M.D. on the telephone on ___ at 8:22AM, 5 minutes\nafter discovery of the findings."
-        },
-        {
-            "input": "In the anterior mediastinum, there is soft tissue measuring 19 x 11 mm which\nis triangular in configuration and demonstrates signal loss on the out of\nphase sequence as opposed to the in phase sequence consistent with intravoxel\nfat.  This constellation of finding is most in keeping with thymic\nhyperplasia.  There are no masses.\n\nNo mediastinal or hilar lymphadenopathy by size criteria.\n\nThere is conventional 3 arch anatomy.  The great vessels are normal in\ncaliber.  Heart size is normal.  No pericardial effusion.\n\nThe lungs are clear.  No pleural effusion.\n\nThe thyroid gland is within normal limits.\n\n The bone marrow demonstrates normal signal characteristics.  No concerning\nosseous lesions.",
-            "output": "1.  Thymic hyperplasia\n2.  No thymic masses."
-        },
-        {
-            "input": "MRA:  The superior vena cava, bilateral subclavian veins and axillary veins\nare patent and contrast opacified.  Superficial venous branches of the\ndraining from the anterior aspect of the right upper arm are also contrast\nopacified, although course immediately adjacent to the soft tissue mass\ndescribed below.\n\nMRI: There is extensive soft tissue abnormality centered anterior to the right\nshoulder joint.  This material spans 6.7 cm caudocranially, 8.4 cm\ntransversely and 3.1 cm anterior to posterior. This is soft tissue is slightly\nhyperintense has to skeletal muscle on T2 weighted imaging, isointense to\nskeletal muscle on T1 weighted imaging and is avidly and progressively\nenhancing. The margins are irregular and infiltrative, involving multiple\nmyofascial planes.  There is infiltration of the medial aspect of the right \ndeltoid, lateral aspect of the pectoralis, and anterior biceps muscles.  The\nnoninvolved muscle maintains normal signal without identified edema or\ninflammation. Along the medial aspect there is deeper infiltration to the\nthoracic chest wall, with abnormal enhancement involving the intercostal\nmuscles surrounding the first rib (17:55). There is no extension into the\nthoracic cavity. No pleural effusion or airspace opacity is seen.\n\nInnumerable osseous metastases are seen throughout the visualized spine,\ncorrelating with appearance on the prior CT.\n\nLimited evaluation of the upper abdomen is notable for a T2 hyperintense,\nnonenhancing cysts scattered throughout the liver and bilateral kidneys.\n\nNote is made of bilateral mastectomies and reconstructions.\n\nThe arms beyond the shoulders are not included in the field of view and are\nnot assessed for edema.",
-            "output": "Extensive abnormal enhancing soft tissue process infiltrating anterior right\nchest wall and proximal arm musculature and extending towards but not into the\nright thoracic cavity.  While this could represent recurrence of known\nmetastatic breast cancer, the infiltrative appearance and progressive\nenhancement is atypical, and can also be seen with other tumors such as\nlymphoma or desmoid tumor.  Lack of surrounding edema argues against an\ninflammatory myositis and contours are not typical for radiation myositis. The\ndeep venous structures of the thorax remain patent at this time.\n\nNOTIFICATION:  Findings were discussed with person between Dr ___ Dr\n___ at approximately 16:30 on ___."
-        },
-        {
-            "input": "Study is severely degraded by motion despite repeating sequences.\n\nThere is no definite lesion visualized at the right eleventh costochondral\njunction corresponding to the increased SUV uptake in the previous PET-CT. \nNoting that there is motion artifact.\n\nThe evaluation of the intra-abdominal structures are significantly limited due\nto severe motion artifact.  There are multiple high T2 lesions in the liver\nwith no internal enhancement poorly characterized at the current study likely\nrepresenting previously described cysts and better assessed on the dedicated\nprior liver MRI studies..\n\nThere are also bilateral renal high T2 lesions obscured by the significant\nmotion artifact with grossly no internal enhancement likely representing the\npreviously described cysts.  There are severe degenerative changes and\nscoliosis throughout the thoracolumbar spine.\n\nThere bilateral trace pleural effusion.  There is small ascites visualized.",
-            "output": "No definite lesion visualized at the right eleventh costochondral junction\ncorresponding to the increased SUV uptake in the previous PET-CT.  Noting that\nsignificantly limited evaluation due to severe motion artifact."
-        },
-        {
-            "input": "LUNGS: There is a 3.7 x 2.4 x 3.0 cm oval, predominantly T2 hyperintense, T1\nhypointense, well-circumscribed lesion with peripheral enhancement including\nfocal enhancing nodularity located along the posterior-lateral left upper lung\npleura (series 3, image 24; series 4, image 30; series 11, image 27).  The\ndominant nodular component measures 1.0 x 0.6 cm, located along the\nposterolateral aspect of the lesion (series 11, image 28).  There is no\nmicroscopic or macroscopic fat within this lesion.  There appears to be a\ncurvilinear line of subpleural fat between the margins of the lesion and the\nadjacent lung. The lesion does not appear to extend beyond the lateral margins\nof the intercostal structures.  The remainder of the imaged lungs is\nunremarkable.  No pleural effusion.\n\nVASCULATURE: The thoracic aorta is normal in caliber.  No evidence of\ndissection.  Incidental common origin of the left common carotid and\ninnominate arteries.  The main pulmonary artery is normal in caliber.  No\ncentral pulmonary embolism.\n\nHEART AND MEDIASTINUM: No cardiomegaly.  No upper mediastinal lymphadenopathy.\n\nOSSEOUS STRUCTURES AND SOFT TISSUES: No suspicious osseous lesions.  The\nabdominal wall is unremarkable.",
-            "output": "A cystic lesion with peripheral enhancing nodularity located along the\nposterolateral left upper lung pleura is probably a cystic neurogenic tumor\nrelated to the intercostal nerve or a branch of the intercostal nerve.  Less\nlikely considerations include a solitary fibrous tumor of the pleura given the\nrelatively small amount of solid tissue and probable extra pleural location,\nor cystic/necrotic malignancy such as mesothelioma or primary lung cancer\ngiven probable extra pleural location."
-        },
-        {
-            "input": "MRI OF THE CHEST WITH AND WITHOUT IV CONTRAST:\n\nA 3.1 x 2.5 cm retrosternal goiter arising from the lower pole of the right\nthyroid lobe is again seen (series 4, image 7), unchanged in size since the CT\nexamination from ___, demonstrating intermediate signal intensity on\nT2 weighted sequences with moderate contrast enhancement (series 15, image\n40). At least three left supraclavicular lesions demonstrate high signal\nintensity on T2 weighted sequences, with avid contrast enhancement, the\nlargest measuring 3.2 x 2.3 cm (series 9, image 9). T1 and T2 signal\ncharacters are slightly different from the thryoid, making it less likely to\nbe ectopic thyroid tissue, and are most likely enlarged lymph nodes. Only the\ntwo lower nodes are visualized on the CT examination from ___,\nappearing similar in size.\n\nA paraesophageal nodule measuring 16 x 9 mm appears stable (series 9, image\n12). There is no hilar lymphadenopathy. No pulmonary mass or nodule is\ndetected.\n\nProminent triangular-shaped anterior mediastinal tissue demonstrates moderate\nsignal drop-off on T1 weighted out of phase images in comparison to in phase\nsequences (series 11 image 43), compatible with hyperplastic thymic tissue.\n\nThe left common carotid and innominate arteries arise from a common trunk\n(series 15, image 49). The thoracic aorta and pulmonary arteries are patent\nand normal in caliber. The subclavian and carotid arteries are patent and\nnormal in caliber. No pulmonary embolus is detected at the proximal\nsubsegmental levels.\n\nThe heart size is normal. There is no pericardial effusion.\n\nThere is mild bibasilar dependent atelectasis (series 1403, image 106). There\nis no pleural effusion.\n\nIncluded views of the liver, spleen, kidneys, spleen, adrenal glands, stomach,\nand splenic flexure are within normal limits.\n\nThere are no bony lesions concerning for malignancy or infection.",
-            "output": "1. Multiple abnormally-enlarged left supraclavicular lymph nodes, measuring up\nto 3.2 cm. Ultrasound-guided biopsy/FNA recommended, assuming the cause is not\nalready known.\n2. Very large right-sided low cervical/retrosternal goiter.  Based on it size,\nadvise biopsy/FNA which can also be performed at the time of lymph node FNA.\n3. Enlarged paraesophageal lymph node remains stable since ___\nexamination.\n4. Hyperplastic thymic tissue."
-        },
-        {
-            "input": "Motion artifact from breathing, inhomogeneous fat saturation and the lack of\nintravenous contrast limits interpretation of the study.\n\nLUNGS: There are moderate-sized bilateral pleural effusions, increased in size\nfrom the prior study.  No large lung mass is identified.\n\nVASCULATURE: Limited evaluation but no obvious abnormality.\n\nHEART AND MEDIASTINUM: Limited evaluation but no obvious abnormality.\n\nOSSEOUS STRUCTURES AND SOFT TISSUES: No definite abnormal signal or edema is\nseen in the region of the left sternoclavicular joint or manubrium.  No fluid\nseen in the sternoclavicular joints.  However, as noted above, there is marked\nmotion artifact.",
-            "output": "Technically limited study as outlined above.  Allowing for the limitations of\nthis study, there is no evidence of edema in the left sternoclavicular joint. \nPlease note that prior chest CT demonstrates normal appearing sternoclavicular\njoint and  manubrium without evidence of effusion."
-        },
-        {
-            "input": "Patient is intubated.  Orogastric tube passes into the stomach.\n\nThe great arch vessels and the thoracic aorta appears normal in contour and\ncaliber.  Arteries of the chest are widely patent without stenoses.  There is\nno wall thickening, hyperenhancement or edema in the wall of the aorta or the\nproximal great arch vessels of the chest.\n\nThe heart is normal in size.  There are trace bilateral pleural effusions. \nThere is no significant pericardial effusion.",
-            "output": "No evidence for vasculitis in the chest."
-        },
-        {
-            "input": "Within the anterior costophrenic angle of the right hemithorax is a triangular\ncystic structure. This is T2 hyperintense, T1 hypointense and nonenhancing. It\nhas smooth, rounded contour with subtle, thin septations anteriorly. This has\n___ of 6 cm anterior to posterior, 3 cm caudocranially and 11 cm\ntransversely. This conforms to its space, respecting the anterior margin of\nthe major fissure. It abuts the free wall of the right atrium and right\nventricle, without mass effect on the heart. This structure is unchanged in\nshape, size and signal/enhancement characteristics, and is consistent with a\nbenign pericardial cyst.\n\nNo additional mediastinal mass is identified. Cardiac function is not assessed\non this examination. The morphology of the heart is normal. There is\nconventional vascular anatomy of the chest.\n\nThere is mild consolidative change within the dependent portions of each lung,\npresumably from hypo ventilation.\n\nLimited evaluation the upper abdomen reveals no additional incidental\nabnormality.  There is no evidence of hepatic steatosis.",
-            "output": "Unchanged benign pericardial cyst within the anterior costophrenic angle of\nthe right hemithorax."
-        },
-        {
-            "input": "At the level of the pulmonary artery, the ascending aorta measures\n3.5 cm in maximum dimension and the descending aorta measures 3 cm in maximum\ndimension.  In the anterior mediastinum in the prevascular area, note is made\nof a lesion of high signal intensity on both FIESTA and T2-weighted imaging,\nwhich measures 13 mm and may represent a thymic cyst.  This was also seen on\nthe previous CT from ___ and ___ and is unchanged.  At the level of\nthe diaphragmatic hiatus, the suprarenal aorta measures 2.5 cm.\n\nNo evidence of any dissection.  No evidence of any pulmonary embolus.\n\nThe lungs where visualized are normal.  The origins of the brachiocephalic,\nleft carotid, and left subclavian arteries are normal.\n\nThe lungs where visualized are normal.\n\nNote is made of a gastric pull-up in the right side of the chest in this\npatient status post esophagectomy.\n\nUpper cuts of the abdomen reveal a cyst in the upper pole of the right kidney\nmeasuring 17 mm.  Visualized images of the liver and spleen appear\nunremarkable.\n\nThe osseous structures where visualized are normal.\n\n2D and 3D reformations provided multiple perspectives for the dynamic series.",
-            "output": "1.  No evidence of any aortic dissection.\n2.  Gastric pull-up in patient status post esophagectomy.\n3.  Incidental right renal cyst noted."
-        },
-        {
-            "input": "Four markers denote the area of clinical concern.\n\nImmediately deep to the right upper trapezius muscle, there is a\nwell-circumscribed 5.1 cm CC by 1.3 cm AP by 5.4 cm transverse T1 hyperintense\nlesion which demonstrates loss of signal on fat saturated sequences.  There is\na single enhancing septation--although this appears thin, it measures up to 2\nmm in thickness.  No evidence of nodular soft tissue component.  No other\nseptations identified.  Otherwise, no convincing internal enhancement.\n\nThe mass lies deep to the right trapezius muscle, overlying the rhomboid\nmuscles.  Surrounding muscles and overlying subcutaneous fat are within normal\nlimits.\n\nNo other focal mass fluid collection is detected in this area.  No overlying\nsoft tissue edema.\n\nVisualized muscles and bones about the upper chest are otherwise grossly\nunremarkable.\n\nThis examination is not diagnostic for evaluation of the lung parenchyma. \nHowever, bibasilar dependent atelectasis is noted.",
-            "output": "Palpable abnormality corresponds to a 5.1 x 1.3 x 5.4 cm fat containing lesion\ndeep to the right upper trapezius muscle, likely representing a lipoma. Note\nis made of a single internal septation that is at the upper limits of normal\nin thickness.  No evidence of nodular soft tissue thickening or focus of\nnodular enhancement to suggest malignancy.\n\nRecommend follow-up MRI in ___ year to confirm expected stability.  Also\nrecommend re-imaging if there is a change in symptoms or interval growth\nrelated to this lesion.\n\nRECOMMENDATION(S):  Recommend follow-up MRI in ___ year to confirm expected\nstability.\n\nAlso recommend re-imaging if there is a change in symptoms or interval growth\nrelated to this lesion."
-        },
-        {
-            "input": "A external marker overlies the right upper posterior chest wall, in the area\nof patient's palpable abnormality.  Compared with ___, a\nwell-circumscribed 5.4 x 1.4 (TRV x AP) fat density lesion immediately deep to\nthe right trapezius muscle is not significantly changed in size, previously\nmeasuring 5.4 x 1.3 cm.  Although the mass appears slightly longer in the CC\ndirection, spanning approximately 5.7 cm compared with 5.1 cm previously, the\npatient is slightly oblique, likely accounting for this difference.  This mass\nagain contains a single septation measuring up to 2 mm in thickness.  No new\nthick septal or nodular enhancement.\n\nThe bone marrow intensity appears isointense to muscle on T1 weighted imaging,\nslightly lower in signal than normally seen, however unchanged and may be\nrelated to red marrow conversion.  There is a 5 mm T1 hyperintense enhancing\nlesion in a midthoracic vertebral body, only included on the axial images,\nsaturates out on fat sat precontrast images and is not well seen on STIR\nweighted imaging (09:33; 03:33).",
-            "output": "1. A fat density lesion in the right posterior chest wall with a single thin\ninternal enhancing septation is not significantly changed compared with\n___, with slight increase in the length of the mass in the CC\ndirection accounted for by differences in obliquity of the patient, favored a\nlipoma.  No new thick septal or nodular enhancement.\n2. The signal intensity of the bone marrow on T1 weighted imaging is\nrelatively hypointense, however is unchanged and may be related to red marrow\nconversion. Correlate clinically.\n3. A 5 mm enhancing lesion in a midthoracic vertebral body is favored a\nhemangioma, however given the history of pheochromocytoma, metastasis\ndifficult to exclude.  MIBG nuclear medicine imaging could be performed if\nthere is clinical concern for metastases."
-        }
-    ]
-}