bluuebunny/crossref_metadata_2025_split huggingface dataset:
Value of P‐wave Parameters in Predicting Outcomes of Repeat Catheter Ablation for Paroxysmal Atrial Fibrillation
Authors: Antoun Ibrahim , Li Xin , Vali Zakkariya , Koev Ivelin , Somani Riyaz , Ng G. André 
Published: December 2024

ABSTRACTBackgroundPulmonary vein isolation (PVI) has been established as an effective management option for symptomatic paroxysmal atrial fibrillation (PAF). We aimed to explore the role of P‐wave parameters in a 12‐lead electrocardiogram (ECG) in predicting the success of repeat PAF ablation.MethodsWe enrolled consecutive patients who underwent a second AF ablation procedure for PAF in a UK tertiary center after an index ablation conducted between 2018 and 2019 and a repeat ablation up to 2021. A digital 12‐lead ECG was recorded with a 1–50‐Hz bandpass filter applied. P‐wave duration (PWD), P‐wave voltage (PWV), P‐wave dispersion (PWDisp), and P‐wave terminal force in V1 (PTFV1) were measured before and after the procedure. Changes were correlated with the 12‐month clinical outcome. Procedural success was freedom from ECG‐documented AF up to 12 months following ablation.ResultsStudy criteria were satisfied by 72 patients, of which 43 (60%) had successful repeat PVI at 12 months. The mean age is 65, and 47 (65%) were males. The demographics were comparable between both study arms. PWD decreased after successful repeat ablations (136.7 to 124.6 ms, p = 0.01) and failed repeat ablations (135.4 to 125.3 ms, p = 0.009) without a significant change between both arms. PMV and PWDisp did not change significantly after both study arms. PTFV1 significantly decreased after successful repeat ablations (‐3.1 to ‐4.4 mm.s, p = 0.005) without a significant change after failed ablations (‐2.9 to ‐2.7 mm.s, p = 0.42). Changes were statistically significant between both arms (p = 0.004).ConclusionPTFV1 reduction following the second AF ablation was correlated with successful repeat AF ablation at 12 months.
Vitamin D Dependent Rickets 2A With Alopecia: Three Cases With Novel Genetic Variants
Authors: Chiramel Minu Jose , George Anju , Sathishkumar Dharshini , Simon Anna , Mathai Sarah 
Published: December 2024

ABSTRACTVitamin D‐dependent rickets type 2A (VDDR2A) is a rare cause of infantile‐onset alopecia, characterized by severe hypotrichosis, small cutaneous cysts, early‐onset treatment‐resistant rickets, and hypocalcemia. Alopecia, often starting a few weeks to months after birth, may be the presenting feature. We present three cases of VDDR2A with genetic variants in the vitamin D receptor (VDR) gene, their clinical features and biochemical parameters. This case series emphasizes that early identification of this rare cause of alopecia and treating the metabolic abnormalities can improve bone health.
Prognostic Analysis of Nonmetastatic Nasopharyngeal Carcinoma in Older Patients Undergoing Intensity‐Modulated Radiotherapy
Authors: Wang Shuangyue , Huang Heqing , Huang Fengqiao , Wu Haiyan , Li Zhiru , Zhou Ziyan , Kang Min 
Published: December 2024

Background: We investigated a visual model for estimating prognosis in older patients with nonmetastatic nasopharyngeal carcinoma (NPC) and analyzed the survival rates in different patient groups during intensity‐modulated radiotherapy (IMRT).Methods: Between January 2012 and March 2021, patients with NPC aged > 65 years who received IMRT and were initially diagnosed with no distant metastases were enrolled. Propensity score analysis with 1:1 matching was used to balance baseline characteristics, including age, sex, tumor stage, and comorbidities. Kaplan–Meier analysis was used to calculate survival. Cox regression analysis was used to identify independent prognostic factors for overall survival (OS). A nomogram was constructed based on the determined prognostic factors, and prediction accuracy was evaluated using receiver operating characteristic (ROC) and calibration curves.Results: In total, 140 patients were included in the analysis (median age: 69 years; range: 66–81 years). The median follow‐up was 84.9 (26.2–131.5) months. Compared with radiotherapy (RT) alone, chemotherapy during RT failed to improve OS (54.2% vs. 50.0%, respectively; p = 0.969), cancer‐specific survival (CSS) (59.1% vs. 60.5%, respectively; p = 0.712), distant metastasis–free survival (DMFS) (66.7% vs. 70.5%, respectively; p = 0.824), or locoregional relapse–free survival (LRFS) (85.0% vs. 86.9%, respectively; p = 0.811). After the final regression analysis, age, age‐adjusted Charlson comorbidity index (ACCI) score, N stage, and total stage were identified as independent factors affecting OS prognosis. The OS nomogram was applied to the data and, based on the value of the area under the ROC and calibration curves, demonstrated satisfactory predictive performance.Conclusions: Survival outcomes in older patients with NPC treated with RT alone were similar to those in patients treated with both chemotherapy and RT. Our nomogram had good performance in predicting OS in older patients with NPC and may benefit the clinical decision‐making process.
The Papal Bulls Dividing the Americas between Spain and Portugal: A Reappraisal
Authors: McNeil Kent 
Published: December 2024

Abstract
The papacy recently repudiated the doctrine of discovery that was relied upon by European nations when they colonized lands inhabited by Indigenous peoples. However, the Vatican did not repeal the papal bulls that authorized and provided canon law support for colonization of West Africa and the Americas by Portugal and Spain. This article examines these bulls and questions the Pope’s legal authority to issue them. It contends that the bulls bound only the Christian monarchs who accepted the Pope’s authority in this regard. They had no legal force insofar as the Indigenous peoples were concerned. Moreover, the historical record reveals that other colonizing European powers, such as France and England, rejected the validity of the bulls. In fact, Spain and Portugal acquired their overseas empires in the fifteen and sixteenth centuries, not by means of discovery or papal bulls, but by subduing Indigenous peoples and forcibly occupying their territories.
The Jus ad Bellum and the War in Gaza
Authors: Gill T.D. 
Published: December 2024

Abstract
This article examines some of the main arguments relating to the applicability and relevance of the right of self-defence to the ongoing war in Gaza. It starts by discussing the question whether Israel has the right to invoke self-defence in response to the attack by Hamas of 7 October 2023. Questions examined include the relevance of the Wall advisory opinion of 2004 to the invocation of self-defence, the status of Gaza as occupied territory in October 2007 and the applicability of self-defence to attacks by non-State actors. It then goes on to discuss how the principles of necessity and proportionality in the context of the exercise of self-defence regulate the application of force and whether Israel’s conduct of the war meets those criteria and focuses particular attention on the impact of obstruction of relief supplies on the right of self-defence. This piece was submitted in May 2024 and does not examine or discuss events that have occurred since then.
Gaza and the Rise of the “Humanitarian Council”
Authors: Gowan Richard 
Published: December 2024

Abstract
The United Nations Security Council often compensates for failing to agree on political solutions to conflicts by engaging on their humanitarian consequences, as this essay shows with reference to Gaza, Syria, Myanmar and Ethiopia. The elected members of the Council in particular frequently focus on humanitarian topics in attempts to forge compromises with and among the permanent members. This humanitarian turn in Council diplomacy allows diplomats to paper over their differences, and insist the institution is still relevant but involves moral hazards. The Council risks becoming overly involved in the technicalities of aid operations, and members can use thematic and country-specific debates to relitigate aspects of International Humanitarian Law (ihl). The short-term benefits of agreement on humanitarian resolutions and Council statements must be weighed against these long-term risks, and Council members should pursue a policy of “do no harm” in their humanitarian diplomacy.
Withdrawal from UN Peacekeeping? Germany’s Role in UN Peacekeeping and Its Lessons from minusma
Authors: Rosenow Patrick 
Published: December 2024

Abstract
The closure of the United Nations Multidimensional Integrated Stabilization Mission in Mali (minusma) in December 2023 marked the end of Germany’s largest personnel contribution to a UN peace mission in a decade. Given Germany’s post-war history, its role as a middle power, and its status as the world’s third-largest economy, multilateral action plays a crucial role in its foreign policy. The UN, as a global organization, is an indispensable pillar of Germany’s multilateral orientation. Germany’s generally cautious participation in UN peacekeeping occurs against the backdrop of a mixed record of UN missions and recurring reform discussions within the UN system. The German experiences from minusma—including its abrupt end at the behest of the Malian government without improving civilian security—will influence future national mandate debates on German involvement in UN operations. This article analyzes the reasons for Germany’s withdrawal from UN peacekeeping using the minusma mission as a case study, within the context of the concept of multilateralism.
African-Led Stabilisation: a Normative Framework or Organised Practical Response to Insecurity?
Authors: Tchie Andrew E. Yaw 
Published: December 2024

Abstract
Over two decades, the African Union (au), complemented by Regional Economic Communities and Regional Mechanisms (rec s/rm s) have carried out and managed activities which can conceptually be viewed as distinctive African-led stabilisation effort(s) designed to stabilise states, environments, and regions. These African-led stabilisation efforts have led to the deployment of the au peace enforcement efforts in Somalia, the au Regional Stabilisation Strategy for the Lake Chad Basin Region with support from the Multinational Joint Task Force; the au’s mission to the Gambia; the G5 Sahel Force; the Southern African Development Community mission to Mozambique and others. Despite this increase African institutions do not have a coherent conceptualisation and framework to understand and clarify these emerging African-led stabilisation efforts. The analysis examines the rise of African-led stabilisation efforts and explains how African-led stabilisation efforts can adopt an adaptive stabilisation approach to improve these interventions.
The Dilemma of Troop Contribution to International Peace Missions: a Case of the Kenya Police Deployment to Haiti
Authors: Onyango James Tindi , Agwanda Billy , Nyadera Israel Nyaburi 
Published: December 2024

Abstract
This paper explores the dilemma states face when choosing between domestic concerns and international obligations in international Peacekeeping operations (pko s) and peace support operations (pso s). Most of the existing literature focuses on the nature, number, distribution, success, and failures of pko s and pso s. However, little attention has been directed to the delicate balance contributing countries face due to competing domestic and international interests. Using a qualitative method approach, this study examines efforts by Kenya to deploy a contingent of National Police Service (nps) officers to Haiti as part of an international peace support intervention. The authors argue that weaponization of information is increasingly posing a serious dilemma for countries involved in peacekeeping. By looking at the controversies that have engulfed Kenya’s deployment of its national police to Haiti, the study analyses how the framing of peacekeeping operations is likely to affect the legitimacy, trust and increase polarization.
Reinventing Leadership for Sustainable Development in Africa: Student Perceptions of Leadership in Selected African Countries
Authors: Chiome Chrispen 
Published: December 2024

Abstract
In Africa,1 new forms of leadership have emerged at various social levels to drive a development agenda based on peer learning and knowledge sharing. Despite this, Africa remains confronted with many challenges on its path to sustained growth and development. This research sought to characterise leadership for sustainable development using students’ lenses. It is a multiple-case study informed by a purposive sample of 30 mba students from five business schools. The findings reveal, among other things, that rather than leadership that is embodied in a sole heroic individual, Africa needs diffuse, pluralistic, collective and facilitative leadership that promotes sustainable development. Leaders should demonstrate attributes of cooperation, understanding, pluralistic knowing and seeking union, as this aligns more closely with the work required to develop more sophisticated, encompassing and collaborative efforts. Leaders should have intimate knowledge of sustainable development, creating and sustaining relations, and accommodating the heterogeneity and diversity of localities and regions. The paper argues that the foundational building block for leaders is the ability to make decisions from a long-term perspective that leads Africa towards economic prosperity, social cohesion and environmental sustainability.
When Democratic Transition Leads to Anarchy: Lessons from Ethiopia
Authors: Gebreyesus Terefe 
Published: December 2024

Abstract
Ethiopia has tried to transit to democracy, in 1991 and 2018. In both attempts, it was not that successful. This paper tries to explain why democratic transition in Ethiopia has not been successful and what lessons can be drawn from these experiences. Democratic transition and consolidation require certain social, economic, cultural and external preconditions. An attempt at democratic transition may not succeed if these preconditions do not exist in the society that attempts it. Ethiopia does not have any of these preconditions. Contrarily, its ethnic diversity, poverty, absence of strong political institutions, polarisation, and culture of solving political differences with conflict and violence make democratic transition and consolidation almost impossible. The Ethiopian experience provides that for states like Ethiopia, democratic transition is hard and sustaining it is even harder. For states like Ethiopia, the best way to transit to democracy is to first develop the democratic preconditions, such as political compromise and fidelity to peaceful resolution of political conflict, before an attempt at democratic transition can be made.
A Systematic Review of Research on Cooperative/Collaborative Learning in Science and Engineering Education in the Republic of Korea
Authors: Lee Gyeonggeon , Kang Da Yeon 
Published: December 2024

Abstract
Constructivist learning theories have emphasized learners’ interactions with the environment, which includes their peers. Therefore, student cooperation/collaboration has been considered crucial in science education. However, although there have been many science cooperative/collaborative learning (CCL) studies reported in Korea, there has been a lack of review studies done to delineate trends and elicit implications for future science education research. This study systematically reviewed empirical science and engineering CCL studies reported in Korea. The researchers collected literature via the Korea Citation Index repository and selected 121 papers to be reviewed. The analytical framework was adapted from the cultural-historical activity theory (CHAT). The results of a review by two science education experts showed patterns revealed in each component of CHAT, which led to a discussion aimed at comprehensively understanding Korean science and engineering CCL research. Implications for future research and teaching were elicited.
Enhancing Scientific Research Competencies of Vietnamese High School Students through STEM Education
Authors: Vu Ngoc-Oanh , Luu Hoai-Thu , Nhu Van-Cuong , Vu Trung-Quoc , Do Quynh Mai Thi 
Published: December 2024

Abstract
Science, technology, engineering, and mathematics (STEM) education offers a valuable approach for developing scientific research competencies (SRC) in students, yet it remains underutilized for this purpose in Vietnamese high schools. Additionally, no suitable tools currently exist to assess SRCs effectively. This study explores a model for applying STEM education to enhance SRCs among high school students in Vietnam and introduces tools to measure performance gains. The research was conducted in four stages: administering surveys to 71 chemistry teachers and 860 students across Vietnam to assess current practices and select participants; developing SRC assessment tools; conducting an experiment on making smart epoxy lamps; and conducting an experiment on the synthesis of glucosamine hydrochloride. Data from tests and rubrics showed measurable increases in students’ SRCs. This study is the first in Vietnam to present a model integrating STEM education and competency assessment tools to both enhance and measure SRCs in high school students.
From Medical Feminism to Conservatism? Changing French Attitudes Towards Women Doctors and their Views on the Female Body: The Reception of Woman as Family Doctor between 1905 and the 1920s
Authors: Fauvel Aude , Puche Amélie 
Published: December 2024

Abstract
In this article, we examine the contrasting reception of the book Woman as Family Doctor in France between 1905 and the 1920s. Written by Dr Anna Fischer-Dückelmann, one of the first female doctors of the modern era, the book was an international bestseller. When first translated from German into French in 1905, it was well received; in 1911 it even won a prize at a state-sponsored exhibition. But a sudden outcry greeted its republication in 1922. Drawing on a wide range of sources, this paper shows that this reversal reflected changing attitudes towards women doctors. During the Belle Époque, the French authorities had been proud of their “medical feminism” and this was reflected in their support for books such as Woman as Family Doctor, which argued that women should have more control over their bodies, especially sexually. But after the war, this discourse disappeared. The authorities now had a single objective: to repopulate the nation, even if it meant restricting women’s autonomy. The analysis of the reception of Woman as Family Doctor thus provides a prism through which to shed light on a little-known page of French history: the history of “medical feminism” and the first women physicians of the Belle Époque, their impact on women’s emancipation, and the reasons for their oblivion.
Concordance and discordance of anticoagulation assays in children supported by ECMO: The truth is out there
Authors: Carmona Carlos A , Bain Jesse , Karam Oliver 
Published: December 2024

Introduction Extracorporeal membrane oxygenation (ECMO) provides critical support to patients in severe cardiac and respiratory failure, but it requires anticoagulation to prevent complications like bleeding and thrombosis. Heparin, the primary anticoagulant utilized, is monitored by activated partial thromboplastin time (aPTT) and anti-Factor Xa (AntiXa) levels. Discordance between the two assays complicates its titration and the impact on patient outcomes is not well-established. This study examines the prevalence of discordance, its impact on heparin dosing, and the association of bleeding, thrombosis, ICU-free days, and mortality in pediatric ECMO patients. Methods This secondary analysis of the Bleeding and Thrombosis on Extracorporeal Membrane Oxygenation study consisted of 511 patients under 19 years. Demographics, laboratory results, ECMO indications, daily heparin doses, and clinical outcomes were collected. Discordance was categorized as major or minor, and adjustments to heparin dosing were analyzed for appropriateness based on normal ranges of aPTT and AntiXa. Logistic regression models assessed the impact of heparin titration strategies on bleeding, clotting, ICU-free days, and mortality. Results Major discordance occurred on 17.5% of days with high aPTT and low AntiXa being most common. Titrating heparin based on AntiXa in scenarios of discordance was associated with an 11% lower incidence of bleeding compared to aPTT ( p = .02). Higher proportion of concordance was independently associated with increased bleeding and/or clotting, but not significantly affect ICU-free days or mortality. Conclusion Discordance is common in pediatric ECMO patients. AntiXa-guided heparin titration, notably during discordant periods, is associated with fewer bleeding and clotting events. This emphasizes the need for improved anticoagulation protocols since discordance does not demonstrate worse ICU-free days or mortality.
Compressive Properties of Rigid Polyurethane Foams
Authors: Tate Philip C. Miller , Talal Sina 
Published: December 2024

We have investigated the compressive stress-strain properties, and long-term compression set properties of highly crosslinked, rigid, polyurethane foams ranging in density from 100 kg m-3 to 810 kg nr-3. Samples were maintained under a range of compressive strains for periods ranging from three days to one year, and their dimensional recovery followed after release. The compressive strength and moduli of the samples were found to vary as the square of the foam density. The compression set study revealed that recovery of all samples following release occurs in two stages, with very different rates, which we believe to he associated with the independent recovery of the polymer molecules and the cellular structure of the foam. The results also show that the long-term recovery from compression demonstrated by a particular sample is largely independent of sample density, and only slightly dependent on the time period of constraint, but mainly influenced by the degree of deformation during the confinement period.