bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fact-checks focus on famous politicians, not partisans
Authors: Greene Kevin T , Pisharody Nilima , Carroll Faelynn , Shapiro Jacob N 
Published: December 2024

Abstract
Does the fact-checking enterprise focus its attention on one party? If Republican or Democratic politicians were systematically more likely to have their statements evaluated, that would call into question both the impartiality of the fact-checking enterprise and the results of the many papers that rely on fact-checks to drive other measurements. Despite frequent claims that fact-checking organizations are biased against Republicans, there is little systematic evidence regarding political bias in this industry. We address these gaps using data on how often each member of Congress was fact-checked from 2018 to 2021. We construct measures to account for multiple factors theorized to influence fact-checking, including a member’s partisanship, prominence, and the quality of the news sites they link to. We find that Republican elected officials are not fact-checked more often than Democratic officials. Politician prominence predicts fact-checking, but partisanship does not. Our findings suggest it is unlikely that the selection approach used by fact-checking groups creates partisan bias in fact-check-derived measures.
The bust card: policing, race, welfare, drugs, and the counterculture in 1960s Britain
Authors: Bradley Kate , Spicer Ellis , Winder Jon 
Published: December 2024

Abstract
Bust cards first emerged in the late 1960s as a way of obtaining help following arrest, giving the user the number of a 24-h telephone line to call on arrival at the police station. In the 2020s, such cards were used by direct action groups involved in civil disobedience campaigns, but tracing bust cards back reveals that their original purpose was different. The bust card was a novel way of enabling an individual to push back against the immediate experience of hostile policing, while enabling organizers to collate information on what was happening. By foregrounding the object and examining its creation and development, this article explores how various influences, initiatives and imperatives intersected, and how activist ideas or tools spread across groups. As this article demonstrates, the bust card became part of wider activism to reform the criminal justice system. It was also about pushing to remake the relationship between the state and marginalized individuals, whether that was through an interaction with the police or through accessing public services.
PA scope of practice reform
Authors: White Ryan D. , Najmabadi Shahpar , Valentin Virginia 
Published: December 2024

ABSTRACT
State-level physician associate/assistant (PA) practice regulations have evolved since the profession's inception. The conditions that influence states' adoption of PA regulatory reforms are not fully understood. As some states begin to adopt components of optimal team practice, PAs in other states continue to face significant legal and regulatory practice restrictions. This article describes state economic, demographic, and workforce characteristics and highlights important differences across states that may affect future reform adoption and shape reform outcomes.
Evaluating the Impact of an Interprofessional Poverty Virtual Simulation Game
Authors: Meyer Brittney A. , Zweifel Alyssa R. 
Published: December 2024

Abstract
The aim of the study was to compare the impact of a virtual simulation game to a poverty live interactive simulation with regard to perceptions of poverty. An interprofessional sample of pharmacy and nursing students completed pre/post surveys with 13 questions (total possible score: 39); the 395 responses were analyzed using a two-way analysis of variance and descriptive statistics. The virtual group had a score improvement of 3.17 points; the live simulation group improved by 3.52 points (both statistically significant). Both experiences positively impacted students and provided similar impact. Consideration of resources can determine the best modality for future use.
Finding Medicine’s Moneyball: How Lessons From Major League Baseball Can Advance Assessment in Precision Education
Authors: Kinnear Benjamin , Caretta-Weyer Holly , Lam Andrew C.L. , Tang Brandon , Ginsburg Shiphra , Wong Brian M. , Kelleher Matthew , Schumacher Daniel J. , Warm Eric J. 
Published: December 2024

Abstract
Precision education (PE) leverages longitudinal data and analytics to tailor educational interventions to improve patient, learner, and system-level outcomes. At present, few programs in medical education can accomplish this goal as they must develop new data streams transformed by analytics to drive trainee learning and program improvement. Other professions, such as Major League Baseball (MLB), have already developed extremely sophisticated approaches to gathering large volumes of precise data points to inform assessment of individual performance.
In this perspective, the authors argue that medical education—whose entry into precision assessment is fairly nascent—can look to MLB to learn the possibilities and pitfalls of precision assessment strategies. They describe 3 epochs of player assessment in MLB: observation, analytics (sabermetrics), and technology (Statcast). The longest tenured approach, observation, relies on scouting and expert opinion. Sabermetrics brought new approaches to analyzing existing data in a way that better predicted which players would help the team win. Statcast created precise, granular data about highly attributable elements of player performance while helping to account for nonplayer factors that confound assessment such as weather, ballpark dimensions, and the performance of other players. Medical education is progressing through similar epochs marked by workplace-based assessment, learning analytics, and novel measurement technologies. The authors explore how medical education can leverage intersectional concepts of MLB player and medical trainee assessment to inform present and future directions of PE.
Hepcidin inhibits hepatocyte apoptosis through the PERK pathway in acute liver injury and fibrosis
Authors: Li Changying , Pang Guojin , Zhao Weihua , Liu Yingying , Huang Xiaoli , Chen Wei , Zhao Xinyan , Liu Tianhui , Wang Ping , Fan Xu , Gao Ming , Cong Min 
Published: December 2024

Background:
Hepcidin, a peptide hormone primarily produced by the liver, regulates iron metabolism by interacting with its receptor, ferroportin. Studies have demonstrated that hepcidin participates in the progression of liver fibrosis by regulating HSC activation, but its regulatory effect on hepatocytes remains largely unknown.

Methods:
A carbon tetrachloride (CCl4)-induced liver fibrosis model was established in C57BL/6 wild-type (WT) and hepcidin knockout (Hamp
−/−) mice. Liver injury and inflammation were assessed in WT and Hamp
−/− mice at 24 and 48 hours following acute CCl4 exposure. In addition, transcriptomic sequencing of primary hepatocytes was performed to compare gene expression profiles between WT and Hamp
−/− mice 24 hours after liver injury. The function of the identified molecule Eif2ak3/PERK (protein kinase R(PKR)-like endoplasmic reticulum kinase), was evaluated both in vitro and in vivo.

Results:
We found that serum hepcidin significantly increased during the progression of liver fibrosis induced by CCl4 and bile duct ligation. In addition, CCl4-treated Hamp
−/− mice developed more severe liver injury, liver fibrosis, and hepatocyte apoptosis, with elevated Bax and decreased Bcl-2 expression, compared to the WT mice. Transcriptomic analysis of primary hepatocytes revealed that PERK was upregulated in Hamp
−/− mice after CCl4 treatment, promoting apoptosis by regulating Bax and Bcl-2 expression. Subsequently, we demonstrated that hepcidin prevents hepatocyte apoptosis by inhibiting PERK both in vitro and in vivo.

Conclusions:
Hepcidin inhibits hepatocyte apoptosis through suppression of the PERK pathway, highlighting its protective role in liver fibrosis and identifying a potential therapeutic target for the treatment of liver fibrosis.
Preparing for stormy weather: building VA health system resilience for dialysis emergency preparedness in the era of climate change
Authors: Martin DeAndra , Brewster Peter , Crowley Susan T. 
Published: December 2024

Purpose of review
Climate change has been implicated as the driver for the increasing number, intensity, duration, and consequences of catastrophic weather events. As a result of extreme weather events, climate change has also been implicated as an important mediator of adverse kidney health outcomes, not only increasing the risk for the development of acute and chronic kidney diseases, but also disrupting the delivery of critical kidney health services. In particular, the delivery of dialysis services during major emergencies remains an ongoing and increasing problem, with a recognized need for improved emergency preparedness and disaster management (EP-DM) strategies to mitigate the increased risk of morbidity and mortality associated with missed dialysis treatment.

Recent findings
There are increasing reports detailing the challenges of kidney dialysis care in times of crisis, to include those resulting from both man-made and natural disasters. Optimized management of the high-risk vulnerable dialysis patient population must include both facility-facing comprehensive continuity of operations and emergency response plans, and ongoing patient-facing emergency preparedness education.

Summary
This review discusses the adverse impact of climate change-related natural disasters on the delivery of dialysis services, and the evolving EP-DM strategies developed and implemented by the Veterans Health Administration (VA) to optimize the care and well being of the vulnerable end stage kidney disease (ESKD) patient population.
Emerging challenges: clozapine-associated hepatotoxicity in bipolar disorder: a case report
Authors: Hersi Hassan Omar , Jeele Mohamed Osman Omar , Adam Bakar Ali , Hassan Mohamed Omar 
Published: December 2024

Introduction:
Clozapine can cause major adverse effects, including rare but serious drug-induced liver injury. Understanding how clozapine causes liver injury is crucial for prompt diagnosis and effective management.

Case presentation:
We presented a case of a 42-year-old man with bipolar disorder who presented to our emergency department with a complaint of fatigue, nausea, vomiting, and pain in the upper right abdomen for 1 week. The patient was commenced with clozapine 1 month prior. He appeared jaundiced with a slightly swollen abdomen. Blood tests revealed highly elevated liver enzymes (AST 1679 U/L, ALT 1752 U/L) and bilirubin levels (total bilirubin 8.5 mg/dL, direct bilirubin 3.02 mg/dL). Tests for viral hepatitis and autoimmune diseases were negative. Suspecting clozapine-induced liver injury, we stopped the medication and provided supportive care.

Discussion:
Clozapine-induced liver injury likely occurs through a variety of pathophysiological pathways that include its metabolism by cytochrome P450 enzymes. Recognizing symptoms like jaundice and abdominal pain early is crucial for diagnosis. Our case reflects similar cases in literature, highlighting the variability in how this condition presents and the importance of prompt intervention to prevent severe consequences. Treatment involves stopping clozapine, supportive care, and closely monitoring the patient’s recovery.

Conclusion:
Physicians who prescribe clozapine should make sure that liver function is closely monitored, especially in the initial few months of the medication, and stop it if liver function become more than 3 times of upper limit of normal and patient developed signs and symptoms of liver injury.
Malignant melanoma with bone metastases in a child: a case report and review of literature
Authors: Ashayeri Neda , Khani Parya , Miri-Aliabad Ghasem , Jafari Masoumeh , Pajouhi Ali 
Published: December 2024

Introduction and importance:
Melanoma is the fifth most common cancer diagnosed in the US in 2022. While its incidence increased from 1980 to 2017, it rarely happens in children. Its diagnosis and treatment are challenging in pediatric patients due to its rarity and different presentations compared to adults.

Case presentation:
An 11.5-year-old boy with a complaint of back pain was admitted to the hospital. Initial examinations were normal; however, due to continued pain and symptoms (e.g., inability to walk, knee pain and ankle ecchymosis, weight loss, vomiting, nausea, and dyspnea), further examinations were performed. Biopsy, nuclear scan, computed tomography (CT) scan, and immunohistochemistry (IHC) confirmed the malignant melanoma diagnosis with bone and lung metastasis. Single-agent treatment with nivolumab was initiated after the diagnosis confirmation with no specific complication. The patient’s parents decided to continue the treatment in their city of residence to reduce costs. However, the treatment was not continued, and unfortunately, the patient has passed away.

Clinical discussion:
Melanoma is rare in children, making its diagnosis challenging. There are no specific guidelines for treating melanoma in pediatric patients, especially in children under 12, with ongoing debate on the most suitable treatment and follow-up options for these patients. It is important to fully examine resected legions for malignancy.

Conclusion:
The study highlights the difficulties in diagnosing and treating malignant melanoma in children, considering its rarity and unusual signs and symptoms compared to adults. Specific guidelines are needed for diagnosing and treating malignant melanoma in pediatric patients.
A protocol for lumbar spine surgery under spinal anesthesia in resource limited countries: illustrative case series
Authors: Muzien Sulaiman Jemal 
Published: December 2024

Introduction:
Lumbar spine surgery can be performed under either general or spinal anesthesia. Numerous studies highlight the benefits of spinal anesthesia (SA), including cost-effectiveness, reduced anesthesia-related complications, and suitability for patients who do not favor general anesthesia (GA). Those informal case series emphasizes the advantages of SA and introduces a working protocol tailored for resource-limited countries (RLCs).

Presentation of case:
Two patients, aged 35 and 58, underwent spinal surgery using SA combined with local infiltration for the skin and facet joints. We implemented a new protocol believed to be beneficial in RLCs. In both cases, intraoperative vital signs remained stable, and there was effective pain control postoperatively.

Clinical discussion:
Spine surgery under SA has gained acceptance due to evidence indicating reduced perioperative risks and lower opioid consumption, alongside decreased healthcare costs. Although there are suggested protocols for SA in spine surgery, many are not applicable in RLCs. Our case series demonstrate similar advantages, suggesting that the protocol used in this study may be helpful. Despite its benefits, SA for spine surgery still faces resistance and has not been widely adopted in many neurosurgery centers.

Conclusion:
The study aim to outline essential steps for initiating SA for spine surgery in RLCs. The guidelines utilized in this study have proven effective. SA can lead to reduced healthcare costs, lower opioid usage, and increased patient turnover. The two cases series demonstrate improved anesthesia outcomes. Future randomized clinical trials with sufficiently large sample sizes are necessary to establish high-quality evidence regarding the safety, efficacy, and cost-effectiveness of SA.
Ovarian cancer with breast metastasis: a rare case report
Authors: Dang Tien Giang , Nguyen Hong Quang , Khuc Chi Hieu , Tran Trung Toan , Nguyen Thanh Long 
Published: December 2024

Introduction:
Ovarian cancer with breast metastasis is an exceedingly rare entity. We hereby reported a case of ovarian cancer presenting with synchronous breast metastasis.

Case presentation:
We report a case of a 39-year-old patient who was diagnosed with FIGO stage IV ovarian cancer, with pleural effusion and a suspected lesion in the breast. Biopsies of the breast lesion showed invasive carcinoma, immunohistochemistry stains of the breast biopsy specimen were positive for PAX-8, CA-125 markers, and negative for P53, SMA, Her2/neu, Mammaglobin. Immunohistochemistry results combined with the diagnosis of ovarian cancer helped confirm the ovarian origin of breast tumor.

Discussion:
Ovarian cancer presenting with breast cancer metastasis concurrently is rare. The differential diagnosis between primary breast cancer and breast metastasis from ovarian cancer is challenging and immunohistochemistry results play a crucial role in establishing a definitive diagnosis in such cases.

Conclusion:
Oncologist and pathologist should be able to identify this rare clinical scenario promptly for early diagnosis and treatment which relies on thorough examination, imaging and immunohistochemical studies. Nevertheless, owing to the extensive spread of the disease, the prognosis for this rare clinical scenario is generally poor.
The portrayal of injuries to the extremities and their reconstruction in times of conflict (Khartoum, Sudan): a cross-sectional
Authors: Yassin Amin M. , Mohamed Momen , Dirar Mohamed , Karar Ismail , Ali Maany , Ahmed Muhnnad , Salah Musab 
Published: December 2024

Introduction:
Military weapons primarily damage the upper and lower limbs of the body, causing significant structural disruption in these injuries. The goal of limb reconstruction is to keep the extremity’s sensorimotor functions, skeletal stability, and adorable aesthetic result.

Materials and methods:
This is a descriptive prospective cross-sectional hospital-based study performed to assess presentation of extremities injuries due to war weapon in Khartoum, Sudan, during conflict period July–December 2023. All patients with lower and upper extremities wounds due to combat injury and who underwent reconstructive surgery were included. Patients with concomitant injuries to trunk and head and neck regions were excluded.

Results:
Among 200 patients, 82% were male, while 18% were female. The majority of patients, accounting for 28.5%, were between 20 and 30 years old. The lower limb was the most commonly involved extremity (56%), while in 54.9% of cases, the upper limb is dominant. In most cases, all components were injured except for neural and vascular elements. The ratio of fasciocutaneous to muscle flap was 73–27%. Complications were not experienced by more than half of the patients, with infection being the most common complication encountered in 60% of complicated cases.

Conclusion:
War-related trauma to the extremities leads to complex wounds with various structural complications, often contaminated, posing a significant challenge during the reconstruction phase. In resource-limited settings, a customized reconstructive ladder may be implemented if free flaps are not an option, utilizing pedicled flaps to achieve satisfactory outcomes.
Successful healing of chronic venous ulcer using zinc oxide nanoparticles and compression therapy in a 75-year-old Syrian female: a case report
Authors: Shreiki Hiba , Bashour George , Kinjo Houssam 
Published: December 2024

Introduction:
Chronic venous disease is a commonly underdiagnosed condition that gradually diminishes a patient’s quality of life and imposes a growing burden on healthcare resources. Venous leg ulcers (VLUs) arise as a complication of chronic venous insufficiency and represent the most prevalent type of slow-healing wound in the lower extremities.

Case presentation:
In this case report, we present the successful treatment of a 75-year-old woman with a chronic venous ulcer caused by chronic deep venous insufficiency. The patient had been struggling with an unresponsive venous leg ulcer for 7 years with no improvement from previous treatments. A three-layer Unna boot treatment, including (ZnO NPs) and a two-component compression system was applied, and significant ulcer reduction was observed.

Discussion:
ZnO NPs impregnated bandages, like those found in an Unna boot, offer compression by wrapping gauze dressing impregnated with ZnO NPs around the patient’s leg forming a semi-solid mold around the extremity. A more efficient treatment approach could lead to fewer clinic visits, thereby reducing healthcare expenses by enhancing the method of managing venous ulcers through a combination of compression and simple, cost-effective surface dressing materials. It’s worth noting that ZnO NPs have demonstrated significant benefits for wound healing.

Conclusion:
Utilizing ZnO NPs alongside compression therapy has proven highly effective, accelerating healing and offering a cost-effective solution. Further research is needed to study the safety of ZnO NPs.
Perinatal Management of Hepatic Adenomas
Authors: Nocita Megan A. , Brady Carla W. , Kuller Jeffrey A. , Gatta Luke A. 
Published: December 2024

Importance
With a strong association between hepatic adenomas and estrogen established, understanding the risks, evaluation, and perinatal management of hepatic adenomas is necessary for obstetric clinicians.

Objective
The aim of this study is to review the preconception counseling, perinatal management, and postpartum care of hepatic adenomas.

Evidence Acquisition
A literature review identified relevant research, review articles, textbook chapters, databases, and societal guidelines.

Results
Hepatic adenomas require individualized recommendations based on their prepregnancy size and evolution over pregnancy. Hepatic adenomas measuring greater than 5 cm are associated with a significantly increased risk during pregnancy including rupture. Ideally, optimal management of hepatic adenoma includes accurate diagnosis, discontinuation of estrogen-containing contraception, and surgical resection of large masses prior to conception. Patients should undergo serial surveillance of the adenoma during the antenatal and postpartum periods, with surgical intervention as indicated with multidisciplinary planning.

Conclusions and Relevance
An individualized approach is necessary when managing hepatic adenomas in the patient who is pregnant or intends pregnancy. More contemporary data are required to guide management and patient counseling.

Target Audience
Obstetricians and gynecologists, family physicians

Learning Objectives
After completing this activity, the learner will be better able to discuss the epidemiology, diagnosis, and natural history of hepatic adenomas; describe potential complications of hepatic adenomas in pregnancy; and explain management recommendations for hepatic adenomas in the preconception and antepartum periods.