In this task, you are given a context, a subject, a relation, and many options. Based on the context, from the options select the object entity that has the given relation with the subject. Answer with text (not indexes).

Input: Consider Input: Context: Chemotherapy (often abbreviated to chemo and sometimes CTX or CTx) is a category of cancer treatment that uses one or more anti-cancer drugs (chemotherapeutic agents) as part of a standardized chemotherapy regimen. Chemotherapy may be given with a curative intent (which almost always involves combinations of drugs), or it may aim to prolong life or to reduce symptoms (palliative chemotherapy). Chemotherapy is one of the major categories of medical oncology (the medical discipline specifically devoted to pharmacotherapy for cancer)., A biopsy is a medical test commonly performed by a surgeon, interventional radiologist, or an interventional cardiologist involving extraction of sample cells or tissues for examination to determine the presence or extent of a disease. The tissue is generally examined under a microscope by a pathologist, and can also be analyzed chemically. When an entire lump or suspicious area is removed, the procedure is called an excisional biopsy. When only a sample of tissue is removed with preservation of the histological architecture of the tissues cells, the procedure is called an incisional biopsy or core biopsy. When a sample of tissue or fluid is removed with a needle in such a way that cells are removed without preserving the histological architecture of the tissue cells, the procedure is called a needle aspiration biopsy. Biopsies are most commonly performed for insight into possible cancerous and inflammatory conditions., Xeroderma pigmentosum (XP) is a rare autosomal recessive genetic disorder of DNA repair in which the ability to repair damage caused by ultraviolet (UV) light is deficient. In extreme cases, "all" exposure to sunlight must be forbidden, no matter how small; as such, individuals with the disease are often colloquially referred to as "Moon child". Multiple basal cell carcinomas (basaliomas) and other skin malignancies frequently occur at a young age in those with XP; metastatic malignant melanoma and squamous cell carcinoma are the two most common causes of death in XP victims. This disease is present in both genders and in all races, with an incidence of 1:250,000 in the United States. XP is roughly six times more common in Japanese people than in other groups., Ivan Yevhenovych Vyshnevskyi ( Ukrainian :    , Russian :    ; born 21 February 1957 in the village of Chortoryia ( today 's Myrolyubivka , Ternopil Raion ) ; died 11 May 1996 in Dnipropetrovsk of melanoma ) was a Ukrainian footballer . He earned 6 caps for the USSR national football team , making his debut on 25 January 1985 in a friendly against Yugoslavia . He was selected for the UEFA Euro 1988 squad , but did not play in any games at the tournament . He is from the region that once belonged to Winiowiecki family that had estates near Zboriv where the village of Vyshnivets is located ., Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. Not all tumors are cancerous; benign tumors do not spread to other parts of the body. Possible signs and symptoms include a lump, abnormal bleeding, prolonged cough, unexplained weight loss and a change in bowel movements. While these symptoms may indicate cancer, they may have other causes. Over 100 types of cancers affect humans.
Tobacco use is the cause of about 22% of cancer deaths. Another 10% is due to obesity, poor diet, lack of physical activity and drinking alcohol. Other factors include certain infections, exposure to ionizing radiation and environmental pollutants. In the developing world nearly 20% of cancers are due to infections such as hepatitis B, hepatitis C and human papillomavirus (HPV). These factors act, at least partly, by changing the genes of a cell. Typically many genetic changes are required before cancer develops. Approximately 510% of cancers are due to inherited genetic defects from a person's parents. Cancer can be detected by certain signs and symptoms or screening tests. It is then typically further investigated by medical imaging and confirmed by biopsy.
Many cancers can be prevented by not smoking, maintaining a healthy weight, not drinking too much alcohol, eating plenty of vegetables, fruits and whole grains, vaccination against certain infectious diseases, not eating too much processed and red meat, and avoiding too much sunlight exposure. Early detection through screening is useful for cervical and colorectal cancer. The benefits of screening in breast cancer are controversial. Cancer is often treated with some combination of radiation therapy, surgery, chemotherapy, and targeted therapy. Pain and symptom management are an important part of care. Palliative care is particularly important in people with advanced disease. The chance of survival depends on the type of cancer and extent of disease at the start of treatment. In children under 15 at diagnosis the five-year survival rate in the developed world is on average 80%. For cancer in the United States the average five-year survival rate is 66%.
In 2012 about 14.1 million new cases of cancer occurred globally (not including skin cancer other than melanoma). It caused about 8.2 million deaths or 14.6% of human deaths. The most common types of cancer in males are lung cancer, prostate cancer, colorectal cancer and stomach cancer. In females, the most common types are breast cancer, colorectal cancer, lung cancer and cervical cancer. If skin cancer other than melanoma were included in total new cancers each year it would account for around 40% of cases. In children, acute lymphoblastic leukaemia and brain tumors are most common except in Africa where non-Hodgkin lymphoma occurs more often. In 2012, about 165,000 children under 15 years of age were diagnosed with cancer. The risk of cancer increases significantly with age and many cancers occur more commonly in developed countries. Rates are increasing as more people live to an old age and as lifestyle changes occur in the developing world. The financial costs of cancer were estimated at $1.16 trillion US dollars per year as of 2010.
Definitions.
Cancers are a large family of diseases that involve abnormal cell growth with the potential to invade or spread to other parts of the body. They form a subset of neoplasms. A neoplasm or tumor is a group of cells that have undergone unregulated growth and will often form a mass or lump, but may be distributed diffusely., A lymph node or lymph gland, is an ovoid or kidney-shaped organ of the lymphatic system, and of the adaptive immune system, that is widely present throughout the body. They are linked by the lymphatic vessels as a part of the circulatory system. Lymph nodes are major sites of B and T lymphocytes, and other white blood cells. Lymph nodes are important for the proper functioning of the immune system, acting as filters for foreign particles and cancer cells. Lymph nodes do not have a detoxification function, which is primarily dealt with by the liver and kidneys., Radiation therapy or radiotherapy, often abbreviated RT, RTx, or XRT, is therapy using ionizing radiation, generally as part of cancer treatment to control or kill malignant cells and normally delivered by a linear accelerator. Radiation therapy may be curative in a number of types of cancer if they are localized to one area of the body. It may also be used as part of adjuvant therapy, to prevent tumor recurrence after surgery to remove a primary malignant tumor (for example, early stages of breast cancer). Radiation therapy is synergistic with chemotherapy, and has been used before, during, and after chemotherapy in susceptible cancers. The subspecialty of oncology concerned with radiotherapy is called radiation oncology., Melanoma, also known as malignant melanoma, is a type of cancer that develops from the pigment-containing cells known as melanocytes. Melanomas typically occur in the skin but may rarely occur in the mouth, intestines, or eye. In women they most commonly occur on the legs, while in men they are most common on the back. Sometimes they develop from a mole with concerning changes including an increase in size, irregular edges, change in color, itchiness, or skin breakdown.
The primary cause of melanoma is ultraviolet light (UV) exposure in those with low levels of skin pigment. The UV light may be from either the sun or from other sources, such as tanning devices. About 25% develop from moles. Those with many moles, a history of affected family members, and who have poor immune function are at greater risk. A number of rare genetic defects such as xeroderma pigmentosum also increase risk. Diagnosis is by biopsy of any concerning skin lesion.
Using sunscreen and avoiding UV light may prevent melanoma. Treatment is typically removal by surgery. In those with slightly larger cancers, nearby lymph nodes may be tested for spread. Most people are cured if spread has not occurred. For those in whom melanoma has spread, immunotherapy, biologic therapy, radiation therapy, or chemotherapy may improve survival. With treatment the five-year survival rates in the United States is 98% among those with localized disease and 17% among those in whom spread has occurred. The likelihood that it will come back or spread depends how thick the melanoma is, how fast the cells are dividing, and whether or not the overlying skin has broken down.
Melanoma is the most dangerous type of skin cancer. Globally, in 2012, it occurred in 232,000 people and resulted in 55,000 deaths. Australia and New Zealand have the highest rates of melanoma in the world. There are also high rates in Northern Europe and North America, while it is less common in Asia, Africa, and Latin America. Melanoma is more common in men than women. Melanoma has become more common since the 1960s in areas that are mostly Caucasian., Subject: ivan vyshnevskyi, Relation: cause_of_death, Options: (A) bleeding (B) breast cancer (C) cancer (D) carcinoma (E) disease (F) hepatitis (G) lung cancer (H) melanoma (I) old age (J) skin cancer (K) tumor

Output: skin cancer


Input: Consider Input: Context: South Cotabato, officially the Province of South Cotabato (Maguindanaon: "Kuta Wato Saut"), is a province in the Philippines located in the SOCCSKSARGEN region in Mindanao. Its capital is Koronadal City, and it borders Sultan Kudarat to the north and west, Sarangani to the south and northeast, and Davao del Sur to the far northeast. To the southeast lies Sarangani Bay., Taiwan, officially the Republic of China (ROC), is a state in East Asia. Neighbors include China (officially the People's Republic of China, abbreviated as PRC) to the west, Japan to the northeast, and the Philippines to the south.
Taiwan is the most populous state that is not a member of the United Nations, and the one with the largest economy., Davao del Sur is a province in the Philippines located in the Davao Region in Mindanao. Its capital and largest city is Digos. The province is bordered by Davao City to the north, Davao Occidental to the south and Cotabato, Sultan Kudarat, South Cotabato and Sarangani to the west. To the east lies the Davao Gulf., Sarangani Bay is a bay located on the southern tip of Mindanao in the Philippines. It opens up to the Celebes Sea on the Pacific Ocean. General Santos City, one of the Philippines most important cities and ports, is located at the head of the bay, making the bay one of the busiest and often the sight of shipping accidents. The province of Sarangani, created in 1992, is named after the bay., Palau (historically Belau or Pelew), officially the Republic of Palau, is an island country located in the western Pacific Ocean. The country contains approximately 250 islands, forming the western chain of the Caroline Islands in Micronesia, and has an area of . The most populous island is Koror. The capital Ngerulmud is located on the nearby island of Babeldaob, in Melekeok State. Palau shares maritime boundaries with Indonesia, the Philippines, and the Federated States of Micronesia., Metropolitan Manila, commonly known as Metro Manila or simply Manila, is the capital region of the Philippines, is the seat of government, the 2nd most populous and the most densely populated region of the country. The National Capital Region (NCR) is composed of Manila, the capital city of the country, Quezon City, the country's most populous city, and the cities of Caloocan, Las Piñas, Makati, Malabon, Mandaluyong, Marikina, Muntinlupa, Navotas, Parañaque, Pasay, Pasig, San Juan, Taguig, and Valenzuela, including the only remaining municipality of Pateros., Luzon is the largest and most populous island in the Philippines and the 15th largest in the world. Located in the northern region of the archipelago, it is the economic and political center of the nation, being home to the country's capital city, Manila, as well as Quezon City, the country's most populous. With a population of 52.99 million , it is the fourth most populous island in the world (after Java, Honshu, and Great Britain), containing about 53% of the country's total population., The Celebes Sea of the western Pacific Ocean is bordered on the north by the Sulu Archipelago and Sulu Sea and Mindanao Island of the Philippines, on the east by the Sangihe Islands chain, on the south by Sulawesi's Minahassa Peninsula, and on the west by Kalimantan in Indonesia. It extends 420 miles (675 km) north-south by 520 miles (837 km) east-west and has a total surface area of , to a maximum depth of . The sea opens southwest through the Makassar Strait into the Java Sea., Malapatan is a first class municipality in the province of Sarangani , Philippines . According to the 2010 census , it has a population of 72,386 people . As of 2010 , it has a total voting population of 35,569 voters . Malapatan is bounded on the west by Sarangani Bay , on the east by Davao del Sur , on the north by Alabel , and on the south by Glan ., Asia is Earth's largest and most populous continent, located primarily in the eastern and northern hemispheres and sharing the continental landmass of Eurasia with the continent of Europe. Asia covers an area of , about 30% of Earth's total land area and 8.7% of the Earth's total surface area. The continent, which has long been home to the majority of the human population, was the site of many of the first civilizations. Asia is notable for not only its overall large size and population, but also dense and large settlements as well as vast barely populated regions within the continent of 4.4 billion people., The Philippine Sea is a marginal sea east and northeast of the Philippines occupying an estimated surface area of 5 million km² (2 million mi²). of the western part of the North Pacific Ocean. It is bordered by the Philippine archipelago (Luzon, Catanduanes, Samar, Leyte and Mindanao) on the southwest; Halmahera, Morotai, Palau, Yap, and Ulithi (of the Carolines) on the southeast; the Marianas, including Guam, Saipan, and Tinian, on the east; the Bonin and Iwo Jima on the northeast; the Japanese islands of Honshu, Shikoku, and Kysh on the north; the Ryukyu Islands on the northwest; and Taiwan in the west., An island country is a country whose primary territory consists of one or more islands or parts of islands. As of 2011, 46 (approximately 24%) of the 193 UN member states are island countries., Southeast Asia or Southeastern Asia is a subregion of Asia, consisting of the countries that are geographically south of China, east of India, west of New Guinea and north of Australia. The region lies near the intersection of geological plates, with heavy seismic and volcanic activity. Southeast Asia consists of two geographic regions:, Vietnam, officially the Socialist Republic of Vietnam (SRV), is the easternmost country on the Indochina Peninsula in Southeast Asia. With an estimated 90.5 million inhabitants , it is the world's 14th-most-populous country, and the eighth-most-populous Asian country. Vietnam is bordered by China to the north, Laos to the northwest, Cambodia to the southwest, Thailand across the Gulf of Thailand to the southwest, and the Philippines, Malaysia and Indonesia across the South China Sea to the east and southeast. Its capital city has been Hanoi since the reunification of North and South Vietnam in 1976., The Philippines, officially the Republic of the Philippines, is a sovereign island country in Southeast Asia situated in the western Pacific Ocean. It consists of about 7,641 islands that are categorized broadly under three main geographical divisions from north to south: Luzon, Visayas, and Mindanao. The capital city of the Philippines is Manila and the most populous city is Quezon City, both part of Metro Manila. Bounded by the South China Sea on the west, the Philippine Sea on the east and the Celebes Sea on the southwest, the Philippines shares maritime borders with Taiwan to the north, Vietnam to the west, Palau to the east and Malaysia and Indonesia to the south., Indonesia (or ; Indonesian: ), officially the Republic of Indonesia, is a unitary sovereign state and transcontinental country located mainly in Southeast Asia with some territories in Oceania. Situated between the Indian and Pacific oceans, it is the world's largest island country, with more than seventeen thousand islands. At , Indonesia is the world's 14th-largest country in terms of land area and world's 7th-largest country in terms of combined sea and land area. It has an estimated population of over 260 million people and is the world's fourth most populous country, the most populous Austronesian nation, as well as the most populous Muslim-majority country. The world's most populous island of Java contains more than half of the country's population., Soccsksargen (officially styled as SOCCSKSARGEN) (pronounced ) is an administrative region of the Philippines, located in south-central Mindanao. It is numerically designated as Region XII. The name is an acronym that stands for the region's four provinces (South Cotabato, Cotabato, Sultan Kudarat and Sarangani) and one of its cities (General Santos). The region used to be called "Central Mindanao". The regional center is Koronadal located in the province of South Cotabato, and the center of commerce, industry and the most populous city is General Santos., China, officially the People's Republic of China (PRC), is a unitary sovereign state in East Asia. With a population of over 1.381 billion, it is the world's most populous country. The state is governed by the Communist Party of China, and its capital is Beijing. It exercises jurisdiction over 22 provinces, five autonomous regions, four direct-controlled municipalities (Beijing, Tianjin, Shanghai, and Chongqing), and two mostly self-governing special administrative regions (Hong Kong and Macau), and claims sovereignty over Taiwan. The country's major urban areas include Shanghai, Guangzhou, Beijing, Chongqing, Shenzhen, Tianjin and Hong Kong. China is a great power and a major regional power within Asia, and has been characterized as a potential superpower., Malaysia is a federal constitutional monarchy located in Southeast Asia. It consists of thirteen states and three federal territories and has a total landmass of separated by the South China Sea into two similarly sized regions, Peninsular Malaysia and East Malaysia (Malaysian Borneo). Peninsular Malaysia shares a land and maritime border with Thailand and maritime borders with Singapore, Vietnam, and Indonesia. East Malaysia shares land and maritime borders with Brunei and Indonesia and a maritime border with the Philippines and Vietnam. The capital city is Kuala Lumpur, while Putrajaya is the seat of the federal government. With a population of over 30 million, Malaysia is the 44th most populous country. The southernmost point of continental Eurasia, Tanjung Piai, is in Malaysia. Located in the tropics, Malaysia is one of 17 megadiverse countries on earth, with large numbers of endemic species., Sarangani, or "Saragani", is a province in the Philippines located in the Soccsksargen region. Its capital is Alabel. With a coastline along the Sarangani Bay and Celebes Sea, the province is at the southernmost tip of Mindanao island, and borders South Cotabato and Davao del Sur to the north, Davao Occidental to the east, and the Celebes Sea to the south., Manila (or ), officially City of Manila, is the capital of the Philippines., Mindanao is the second largest and southernmost major island in the Philippines. It is also the name of one of the three island groups in the country (the other two being Luzon and the Visayas), consisting of the island of Mindanao and smaller outlying islands. Davao City is the largest city in Mindanao. As of the 2010 census, the island's population itself is 20,281,545 people, while the Mindanao island group has 21,968,174 inhabitants. Davao City is the most populous in Mindanao as 1,632,991 population, and the 2nd is Zamboanga City as 861,799 population, the 3rd is Cagayan de Oro City as 675,950 population, and followed by General Santos City as 594,446 population as of 2015 census., Quezon City (  also known as QC) is the most populous city in the Philippines. It is one of the cities that make up Metro Manila, the National Capital Region of the Philippines. Quezon City was named after Manuel L. Quezon, second President of the Philippines, who founded the city and developed it to replace Manila as the national capital for 28 years from 1948 to 1976. Quezon City is not located in and should not be confused with Quezon Province, which was also named after the president. It is the largest city in Metro Manila in terms of land area and most populated local government unit in the country., The South China Sea is a marginal sea that is part of the Pacific Ocean, encompassing an area from the Karimata and Malacca Straits to the Strait of Taiwan of around . The area's importance largely results from one-third of the world's shipping sailing through its waters and that it is believed to hold huge oil and gas reserves beneath its seabed., The Visayas or the Visayan Islands (Visayan: "Kabisay-an",  ), is one of the three principal geographical divisions of the Philippines, along with Luzon and Mindanao. It consists of several islands, primarily surrounding the Visayan Sea, although the Visayas are considered the northeast extremity of the entire Sulu Sea. Its inhabitants are predominantly the Visayan people., Subject: malapatan, Relation: shares_border_with, Options: (A) as (B) asia (C) cagayan de oro (D) celebes sea (E) chongqing (F) davao city (G) davao del sur (H) digos (I) east (J) general santos (K) guangzhou (L) hong kong (M) indonesia (N) island (O) java sea (P) leyte (Q) major (R) malaysia (S) manila (T) most (U) muntinlupa (V) national capital region (W) navotas (X) north (Y) northern region (Z) northwest ([) pacific ocean (\) palau (]) parañaque (^) pasig (_) putrajaya (`) quezon (a) quezon city (b) sarangani (c) shanghai (d) south (e) southwest (f) sulu sea (g) sur (h) taiwan (i) tianjin (j) valenzuela (k) vietnam

Output: general santos


Input: Consider Input: Context: Myocardial infarction (MI) or acute myocardial infarction (AMI), commonly known as a heart attack, occurs when blood flow stops to a part of the heart causing damage to the heart muscle. The most common symptom is chest pain or discomfort which may travel into the shoulder, arm, back, neck, or jaw. Often it is in the center or left side of the chest and lasts for more than a few minutes. The discomfort may occasionally feel like heartburn. Other symptoms may include shortness of breath, nausea, feeling faint, a cold sweat, or feeling tired. About 30% of people have atypical symptoms, with women more likely than men to present atypically. Among those over 75 years old, about 5% have had an MI with little or no history of symptoms. An MI may cause heart failure, an irregular heartbeat (including serious types), cardiogenic shock, or cardiac arrest.
Most MIs occur due to coronary artery disease. Risk factors include high blood pressure, smoking, diabetes, lack of exercise, obesity, high blood cholesterol, poor diet, and excessive alcohol intake, among others. The mechanism of an MI often involves the complete blockage of a coronary artery caused by a rupture of an atherosclerotic plaque. MIs are less commonly caused by coronary artery spasms, which may be due to cocaine, significant emotional stress, and extreme cold, among others. A number of tests are useful to help with diagnosis, including electrocardiograms (ECGs), blood tests, and coronary angiography. An ECG may confirm an ST elevation MI if ST elevation is present. Commonly used blood tests include troponin and less often creatine kinase MB.
Aspirin is an appropriate immediate treatment for a suspected MI. Nitroglycerin or opioids may be used to help with chest pain; however, they do not improve overall outcomes. Supplemental oxygen should be used in those with low oxygen levels or shortness of breath. In ST elevation MIs treatments which attempt to restore blood flow to the heart are typically recommended and include angioplasty, where the arteries are pushed open, or thrombolysis, where the blockage is removed using medications. People who have a non-ST elevation myocardial infarction (NSTEMI) are often managed with the blood thinner heparin, with the additional use of angioplasty in those at high risk. In people with blockages of multiple coronary arteries and diabetes, bypass surgery (CABG) may be recommended rather than angioplasty. After an MI, lifestyle modifications, along with long term treatment with aspirin, beta blockers, and statins, are typically recommended.
Worldwide, about 8.6 million myocardial infarctions occurred in 2013. More than 3 million people had an ST elevation MI and more than 4 million had an NSTEMI. STEMIs occur about twice as often in men as women. About one million people have an MI each year in the United States. In the developed world the risk of death in those who have had an STEMI is about 10%. Rates of MI for a given age have decreased globally between 1990 and 2010., A disease is a particular abnormal condition, a disorder of a structure or function, that affects part or all of an organism. The study of disease is called pathology which includes the causal study of etiology. Disease is often construed as a medical condition associated with specific symptoms and signs. It may be caused by external factors such as pathogens, or it may be caused by internal dysfunctions particularly of the immune system such as an immunodeficiency, or a hypersensitivity including allergies and autoimmunity., Stroke is when poor blood flow to the brain results in cell death. There are two main types of stroke: ischemic, due to lack of blood flow, and hemorrhagic, due to bleeding. They result in part of the brain not functioning properly. Signs and symptoms of a stroke may include an inability to move or feel on one side of the body, problems understanding or speaking, feeling like the world is spinning, or loss of vision to one side. Signs and symptoms often appear soon after the stroke has occurred. If symptoms last less than one or two hours it is known as a transient ischemic attack (TIA) or mini-stroke. A hemorrhagic stroke may also be associated with a severe headache. The symptoms of a stroke can be permanent. Long-term complications may include pneumonia or loss of bladder control.
The main risk factor for stroke is high blood pressure. Other risk factors include tobacco smoking, obesity, high blood cholesterol, diabetes mellitus, previous TIA, and atrial fibrillation. An ischemic stroke is typically caused by blockage of a blood vessel, though there are also less common causes. A hemorrhagic stroke is caused by either bleeding directly into the brain or into the space between the brain's membranes. Bleeding may occur due to a ruptured brain aneurysm. Diagnosis is typically with medical imaging such as a CT scan or magnetic resonance imaging (MRI) scan along with a physical exam. Other tests such as an electrocardiogram (ECG) and blood tests are done to determine risk factors and rule out other possible causes. Low blood sugar may cause similar symptoms.
Prevention includes decreasing risk factors, as well as possibly aspirin, statins, surgery to open up the arteries to the brain in those with problematic narrowing, and warfarin in those with atrial fibrillation. A stroke or TIA often requires emergency care. An ischemic stroke, if detected within three to four and half hours, may be treatable with a medication that can break down the clot. Aspirin should be used. Some hemorrhagic strokes benefit from surgery. Treatment to try recover lost function is called stroke rehabilitation and ideally takes place in a stroke unit; however, these are not available in much of the world.
In 2013 approximately 6.9 million people had an ischemic stroke and 3.4 million people had a hemorrhagic stroke. In 2010 there were about 33 million people who had previously had a stroke and were still alive. Between 1990 and 2010 the number of strokes which occurred each year decreased by approximately 10% in the developed world and increased by 10% in the developing world. In 2013, stroke was the second most frequent cause of death after coronary artery disease, accounting for 6.4 million deaths (12% of the total). About 3.3 million deaths resulted from ischemic stroke while 3.2 million deaths resulted from hemorrhagic stroke. About half of people who have had a stroke live less than one year. Overall, two thirds of strokes occurred in those over 65 years old., Substituted amphetamines are a class of compounds based upon the amphetamine structure; it includes all derivative compounds which are formed by replacing, or substituting, one or more hydrogen atoms in the amphetamine core structure with substituents. The compounds in this class span a variety of pharmacological subclasses, including stimulants, empathogens, and hallucinogens, among others. Examples of substituted amphetamines are amphetamine (itself), methamphetamine, ephedrine, cathinone, phentermine, mephentermine, bupropion, methoxyphenamine, selegiline, amfepramone, pyrovalerone, MDMA (ecstasy), and DOM (STP)., A muscle relaxant is a drug that affects skeletal muscle function and decreases the muscle tone. It may be used to alleviate symptoms such as muscle spasms, pain, and hyperreflexia. The term "muscle relaxant" is used to refer to two major therapeutic groups: neuromuscular blockers and spasmolytics. Neuromuscular blockers act by interfering with transmission at the neuromuscular end plate and have no central nervous system (CNS) activity. They are often used during surgical procedures and in intensive care and emergency medicine to cause temporary paralysis. Spasmolytics, also known as "centrally acting" muscle relaxants, are used to alleviate musculoskeletal pain and spasms and to reduce spasticity in a variety of neurological conditions. While both neuromuscular blockers and spasmolytics are often grouped together as muscle relaxants, the term is commonly used to refer to spasmolytics only., Mephentermine is a cardiac stimulant. It was formerly used in Wyamine nasal decongestant inhalers and before that as a stimulant in psychiatry., A pandemic (from Greek  "pan" "all" and  "demos" "people") is an epidemic of infectious disease that has spread through human populations across a large region; for instance multiple continents, or even worldwide. A widespread endemic disease that is stable in terms of how many people are getting sick from it is not a pandemic. Further, flu pandemics generally exclude recurrences of seasonal flu. Throughout history, there have been a number of pandemics, such as smallpox and tuberculosis. One of the most devastating pandemics was the Black Death, killing over 75 million people in 1350. The most recent pandemics include the HIV pandemic as well as the 1918 and 2009 H1N1 pandemics., Substance abuse , also known as drug abuse , is a patterned use of a drug in which the user consumes the substance in amounts or with methods which are harmful to themselves or others , and is a form of substance - related disorder . Widely differing definitions of drug abuse are used in public health , medical and criminal justice contexts . The exact cause of substance abuse is not clear , with theories including : a genetic disposition ; learned from others - or a habit which if addiction develops , manifests as a chronic debilitating disease . Drugs most often associated with this term include : alcohol , substituted amphetamines , barbiturates , benzodiazepines ( particularly alprazolam , lorazepam , diazepam and clonazepam ) , cocaine , methaqualone , cannabis and opioids . In some cases criminal or anti-social behavior occurs when the person is under the influence of a drug , and long term personality changes in individuals may occur as well . In addition to possible physical , social , and psychological harm , use of some drugs may also lead to criminal penalties , although these vary widely depending on the local jurisdiction . Substance abuse is widespread with an estimated 120 million users of hard drugs such as cocaine , heroin , and other synthetic drugs . In 2013 drug use disorders resulted in 127,000 deaths up from 53,000 in 1990 . The highest number of deaths are from opioid use disorders at 51,000 . Cocaine use disorder resulted in 4,300 deaths and amphetamine use disorder resulted in 3,800 deaths . Alcohol use disorders resulted in an additional 139,000 deaths ., Methaqualone, sold under the brand name Quaalude (\kw-lüd\) in the US and Mandrax in the UK and South Africa, is a sedative and hypnotic medication. It is a member of the quinazolinone class.
The sedativehypnotic activity of methaqualone was first noted by researchers in the 1950s. In 1962, methaqualone was patented in the US by Wallace and Tiernan. Its use peaked in the early 1970s as a hypnotic, for the treatment of insomnia, and as a sedative and muscle relaxant., Public health refers to "the science and art of preventing disease, prolonging life and promoting human health through organized efforts and informed choices of society, organizations, public and private, communities and individuals." It is concerned with threats to health based on population health analysis. The population in question can be as small as a handful of people, or as large as all the inhabitants of several continents (for instance, in the case of a pandemic). The dimensions of health can encompass "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity," as defined by the United Nations' World Health Organization. Public health incorporates the interdisciplinary approaches of epidemiology, biostatistics and health services. Environmental health, community health, behavioral health, health economics, public policy, insurance medicine, mental health and occupational safety and health are other important subfields., Cocaine, also known as coke, is a strong stimulant mostly used as a recreational drug. It is commonly snorted, inhaled, or injected into the veins. Mental effects may include loss of contact with reality, an intense feeling of happiness, or agitation. Physical symptoms may include a fast heart rate, sweating, and large pupils. High doses can result in very high blood pressure or body temperature. Effects begin within seconds to minutes of use and last between five and ninety minutes. Cocaine has a small number of accepted medical uses such as numbing and decreasing bleeding during nasal surgery.
Cocaine is addictive due to its effect on the reward pathway in the brain. After a short period of use, there is a high risk that dependence will occur. Its use also increases the risk of stroke, myocardial infarction, lung problems in those who smoke it, blood infections, and sudden cardiac death. Cocaine sold on the street is commonly mixed with local anesthetics, cornstarch, quinine, or sugar which can result in additional toxicity. Following repeated doses a person may have decreased ability to feel pleasure and be very physically tired.
Cocaine acts by inhibiting the reuptake of serotonin, norepinephrine, and dopamine. This results in greater concentrations of these three neurotransmitters in the brain. It can easily cross the bloodbrain barrier and may lead to the breakdown of the barrier. Cocaine is made from the leaves of the "coca" plant which are mostly grown in South America. In 2013, 419 kilograms were produced legally. It is estimated that the illegal market for cocaine is 100 to 500 billion USD each year. With further processing crack cocaine can be produced from cocaine.
After cannabis, cocaine is the most frequently used illegal drug globally. Between 14 and 21 million people use the drug each year. Use is highest in North America followed by Europe and South America. Between one and three percent of people in the developed world have used cocaine at some point in their life. In 2013 cocaine use directly resulted in 4,300 deaths, up from 2,400 in 1990. The leaves of the "coca" plant have been used by Peruvians since ancient times. Cocaine was first isolated from the leaves in 1860. Since 1961 the international Single Convention on Narcotic Drugs has required countries to make recreational use of cocaine a crime., Subject: substance abuse, Relation: medical_specialty, Options: (A) emergency medicine (B) infectious disease (C) pathology (D) psychiatry (E) surgery
Output: psychiatry