bluuebunny/crossref_metadata_2025_split huggingface dataset:
Embryo Selection in the Context of In Vitro Fertilization
Authors: Pugeda Teofilo Giovan S. 
Published: June 2023

From the Catholic perspective, in vitro fertilization (IVF) is morally problematic because it artificially separates the procreative and unitive aspects of the conjugal act. Embryo selection (ES) in the context of IVF is an injustice against the resulting embryos because it treats them as commodities and works against their right to life by determining their implantation potential in light of their features. The Church opposes the eugenics mentality underlying ES. Meanwhile, the IVF industry increasingly uses artificial intelligence (AI) for ES. However, doing so could worsen the injustice by deepening the disrespect of human lives under the technocratic paradigm. As such, Catholic bioethicists are encouraged to advocate for the Church's teachings with renewed vigor. In this commentary, we will examine (1) ES in the context of IVF, (2) using AI for ES, (3) the moral implications of using AI for ES, and (4) points for further consideration. Summary: Using AI for Embryo selection in the context of IVF deepens the disrespect of human lives under the technocratic paradigm.
The Compounding Impact of Racial Microaggressions: The Experiences of African American Students in Predominantly White Institutions
Authors: DeCuir-Gunby Jessica T. , McCoy Whitney N. , Gibson Stephen M. 
Published: June 2023

Background/Context: African American students often encounter racial microaggressions when attending predominantly white institutions (PWIs). Experiencing racial microaggressions can negatively affect African American students’ feelings of belonging to the campus community. Racial microaggressions can also affect their physical and emotional stability. Purpose of Study: Using a critical race theory (CRT) framework, we focused on the centrality of race and racism and intersectionality. We examined how experiencing racial microaggressions influenced African American students’ ( n = 15) feelings of belonging at PWIs. In addition, we explored how students emotionally coped with their experiences. Research Design: A semi-structured interview was conducted with participants. Using thematic analysis through the process of open coding and axial coding, we developed themes based on students’ experiences with microaggressions, feelings of belonging, and coping strategies. We connected the themes to the larger research literature, focusing on our CRT framework. Conclusions/Recommendations: Experiencing racial microaggressions made students feel devalued in the campus community. In addition, racial microaggressions intersected with other forms of oppression, further impacting students’ sense of belonging. These experiences often led students to use maladaptive coping mechanisms; despite this, students were able to create community by using self-protective coping mechanisms, such as creating supportive networks. Racism-related stress caused by racial microaggressions should be considered a public health issue. By exploring racial microaggressions, researchers and policy makers can understand how racism impacts individuals and provide tools on how to challenge racism on systemic levels.
Determinants of Marxian labor productivity in the Greek economy 1960–2020
Authors: Maniatis Thanasis , Passas Costas 
Published: June 2023

This paper discusses productivity growth in the context of the Greek economy. Productivity of labor in the Marxian sense is estimated using the distinction between productive and unproductive labor, and it is compared and contrasted with its mainstream counterpart. Marxian productivity is generally higher in level and exhibits a higher average rate of growth than mainstream productivity. We also estimate econometrically the determinants of productivity growth. Variables stressed in the classical-Marxian approach expressing capital accumulation appear to account for most of the variation in productivity growth. This is in contrast to certain radical approaches and especially the Social Structures of Accumulation school which stress the importance of ‘social’ variables for the explanation of productivity growth. In particular, the negative correlation found here between productivity growth and unemployment rate for Greece contradicts earlier findings in the Social Structures of Accumulation literature which postulate a positive correlation between those variables for countries like Greece and the United States. JEL classification: E11, E24, J21
Managerial influences on the inclusion of transgender and gender-diverse employees: A critical multi-method study
Authors: Ladwig Robin C 
Published: June 2023

This article examined the work experiences of transgender and gender-diverse (TGD) individuals concerning the organisational environment and managerial influence on their workplace inclusion. The qualitative multi-method study design included semi-structured online interviews with TGD workers ( n = 22); followed by an open-ended, photo-elicit questionnaire with organisational leaders and management personnel, including human resource management and career development practitioners ( n = 42), to evaluate their awareness and approach regarding the inclusion of TGD individuals. A critical grounded theory approach was applied to identify numerous enablers and barriers for TGD employees. Further analysis identified three impact areas of managers: building an inclusive organisational infrastructure, fostering a safe psychological environment and supporting diverse impression-fit management. The three managerial areas provide practical recommendations concerning language use, leadership style, work practices and arrangements that should be considered for increasing TGD workplace inclusion. JEL Classification: M12, M14
Clinical Ethics Committee in an Oncological Research Hospital: two-years Report
Authors: Perin Marta , De Panfilis Ludovica ,   on behalf of the Clinical Ethics Committee of the Azienda USL-IRCCS di Reggio Emilia
Published: June 2023

Research question and aim Clinical Ethics Committees (CECs) aim to support healthcare professionals (HPs) and healthcare organizations to deal with the ethical issues of clinical practice. In 2020, a CEC was established in an Oncology Research Hospital in the North of Italy. This paper describes the development process and the activities performed 20 months from the CEC’s implementation, to increase knowledge about CEC’s implementation strategy. Research design We collected quantitative data related to number and characteristics of CEC activities carried out from October 2020 to June 2022 using the CEC internal database. Data were reported descriptively and compared with data from the literature to provide a complete overview of the CEC’s development and implementation process. Participants and research context The study has been conducted at the local health authority (LHA) of Reggio Emilia. It is a report of the activities provided by the CEC, where no HPs or patients were involved. Ethical Considerations The report is part of a larger study named EVAluating a Clinical Ethics Committee implementation process (EvaCEC), which has been approved by the Local Ethics Committee (AUSLRE Protocollo n° 2022/0026554 of 24/02/2022). EvaCEC is also the first author's PhD project. Findings In total, the CEC performed 7 ethics consultations (EC), published three policies related to particular ethical questions of clinical and organizational practice, provided one educational online course on ethics consultation targeting employed HPs, and promoted a specific dissemination process among the different departments of the LHA. According to our results, the CEC widely fulfilled the standard threefold set of clinical ethics support services tasks (namely, ethics consultation, ethics education, and policy development), but further investigations are needed to evaluate the CEC’s impact on clinical practice. Conclusion Our findings may increase knowledge regarding the composition, role, and tasks of a CEC in an Italian setting, informing future strategies and efforts to regulate these institutions officially.
Infective complications in cancer patients treated with subcutaneous versus intravenous trastuzumab and rituximab: An individual patient data meta-analysis
Authors: Alexander Marliese , Jachno Kim , Phillips Kelly-Anne , Seymour John F , Slavin Monica A , Cheung Ada , Shen Vivian , Maarouf Dana , Wolfe Rory , Lingaratnam Senthil 
Published: June 2023

Background Investigation of infection risk with subcutaneous versus intravenous trastuzumab and rituximab administration in an individual patient data (IPD) and published data meta-analysis of randomised controlled trials (RCTs). Methods Databases were searched to September 2021. Primary outcomes were serious and high-grade infection. Relative-risk (RR) and 95% confidence intervals (95%CI) were calculated using random-effects models. Results IPD meta-analysis (6 RCTs, 2971 participants, 2320 infections) demonstrated higher infection incidence with subcutaneous versus intravenous administration, without reaching statistical significance (serious: 12.2% versus 9.3%, RR 1.28, 95%CI 0.93to1.77, P = 0.13; high-grade: 12.2% versus 9.9%, RR 1.32, 95%CI 0.98to1.77, P = 0.07). With exclusion of an outlying study in post-hoc analysis, increased risks were statistically significant (serious: 13.1% versus 8.4%, RR 1.53, 95%CI 1.14to2.06, P = 0.01; high-grade: 13.2% versus 9.3%, RR 1.56, 95%CI 1.16to2.11, P < 0.01). Published data meta-analysis (8 RCTs, 3745 participants, 648 infections) demonstrated higher incidence of serious (HR 1.31, 95%CI 1.02to1.68, P = 0.04) and high-grade (HR 1.52, 95%CI 1.17to1.98, P < 0.01) infection with subcutaneous versus intravenous administration. Conclusions Results suggest increased infection risk with subcutaneous versus intravenous administration, although IPD findings are sensitive to exclusion of one trial with inconsistent results and identified risk-of-bias. Ongoing trials may confirm findings. Clinical surveillance should be considered when switching to subcutaneous administration. PROSPERO registration CRD42020221866/CRD42020125376.
LHPP Inhibits the Viability, Migration, and Proliferation of PDAC Cells and Significantly Affects the Expression of SDC1 and S100p
Authors: Xia Zhaozhi , Zhao Shuchao , Gao Xin , Sun Hongrui , Yang Faji , Zhu Huaqiang , Gao Hengjun , Lu Jun , Zhou Xu 
Published: June 2023

Introduction Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive malignancy with a poor response to chemotherapy and an extremely poor prognosis. Recent studies have revealed that phospholysine phosphohistidine inorganic pyrophosphate phosphatase (LHPP) can inhibit the growth of various cancers. Therefore, the current study was conducted to investigate the antitumor effects of LHPP in PDAC and to explore its mechanism using proteomics analysis. Methods and Results Immunohistochemical analysis of clinical samples demonstrated that LHPP expression levels were lower in tumor tissues compared to adjacent nontumor tissues. Moreover, multivariate COX regression analysis showed that LHPP expression level was an independent prognostic factor for the patients with PDAC. Patients with high LHPP expression had a better prognosis. The lentiviral vectors for normal control (NC), LHPP knockdown (KD), and LHPP overexpression (OE) were infected with BxPC-3 and PANC-1 cell lines. Cell counting kit-8 assay, Transwell assay, and flow cytometry analyses showed that LHPP overexpression significantly inhibited the cell viability, migration, and proliferation of BxPC-3 and PANC-1 cells. Moreover, xenograft tumor model demonstrated that LHPP overexpression inhibited xenograft tumor growth in vivo. Subsequently, proteins with significantly altered expression in BxPC-3 cells after lentivirus infection were detected using proteomics analyses. Interestingly, compared to the NC group, the expression of Syndecan 1 (SDC1) was significantly upregulated in the KD group, while that of S100P was significantly downregulated in the OE group. Conclusion LHPP might emerge as an important target for delaying the advancement of PDAC, thereby providing a novel therapeutic approach for the treatment of PDAC.
Urinary incontinence in women 55 years and older: A scoping review to understand prevalence, incidence, and mortality of urinary incontinence during secondary care admission
Authors: McMillan Isobel , Hill Lyndsay , McCarthy Robyn , Haas-Eckersley Ruth , Russell Margaret , Wood Julie , Doxford-Hook Liz , Fu Yu , McGowan Linda , Iles-Smith Heather 
Published: June 2023

Background: Up to 40% of older women living in the community experience urinary incontinence. In community settings, urinary incontinence impacts the quality of life, morbidity, and mortality rates. However, little is known about urinary incontinence and its impact on older women admitted to hospitals. Objectives: This scoping review aims to establish the current knowledge of urinary incontinence during hospital admission for women (⩾ 55 years of age) with three key objectives: (a) What is the prevalence/incidence of urinary incontinence? (b) What health conditions are associated with urinary incontinence? (c) Is there an association between urinary incontinence and mortality? Eligibility criteria: Empirical studies were included in assessing the incidence/prevalence of urinary incontinence during hospital admissions and its related morbidities and mortality rates. Studies which only included men or younger women (< 55 years of age) were excluded. Only articles written in English and conducted between 2015 and 2021 were included. Sources of evidence: A search strategy was developed, and CINAHL, MEDLINE, and Cochrane databases were searched. Charting methods: Data from each article meeting the criteria were pulled into a table, including study design, study population, and setting, aims, methods, outcome measures, and significant findings. A second researcher then reviewed the populated data extraction table. Results: Overall, 383 papers were found: 7 met inclusion/exclusion criteria. Prevalence rates ranged from 22% to 80% depending on the study cohort. Several conditions were associated with urinary incontinence, including frailty, orthopaedics, stroke, palliative care, neurology, and cardiology. There was a potential positive association between mortality and urinary incontinence, although only two papers reviewed reported mortality. Conclusion: A dearth of literature determined the prevalence, incidence, and mortality rates for older women admitted to hospitals. Limited consensus on associated conditions was found. Further research is needed to fully explore urinary incontinence in older women during hospital admissions, particularly concerning prevalence/incidence and its association with mortality.
A comparative study on the value of lower airway exhaled nitric oxide combined with small airway parameters for diagnosing cough-variant asthma
Authors: Bai Haodong , Shi Cuiqin , Yu Sue , Wen Siwan , Sha Bingxian , Xu Xianghuai , Yu Li 
Published: June 2023

Background: The diagnosis of cough-variant asthma (CVA) is based on bronchial provocation test, which is challenging to be conducted. Most CVA patients have type 2 airway inflammation and small airway dysfunction. FeNO200, reflecting small airway inflammation, may be used to diagnose CVA. Objective: This study aimed to explore and compare the value of lower airway exhaled nitric oxide (FeNO50, FeNO200, and CaNO) combined with small airway parameters for diagnosing CVA. Methods: Chronic cough patients who attended the clinic from September 2021 to August 2022 were enrolled and divided into CVA group ( n = 71) and non-CVA (NCVA) group ( n = 212). The diagnostic values of FeNO50, FeNO200, concentration of alveolar nitric oxide (CaNO), maximal mid-expiratory flow (MMEF), forced expiratory flow at 75% of forced vital capacity (FEF75%) and forced expiratory flow at 50% of forced vital capacity (FEF50%) for CVA were evaluated. Results: FeNO50 [39(39) ppb versus 17(12) parts per billion (ppb), p < 0.01], FeNO200 [17(14) ppb versus 8(5) ppb, p < 0.01] and CaNO [5.0(6.1) ppb versus 3.5(3.6) ppb, p < 0.01] in CVA group were significantly higher than those in NCVA group. The optimal cut-off values of FeNO50, FeNO200, and CaNO for diagnosis of CVA were 27.00 ppb [area under the curve (AUC) 0.88, sensitivity 78.87%, specificity 79.25%], 11.00 ppb (AUC 0.92, sensitivity 88.73%, specificity 81.60%) and 3.60 ppb (AUC 0.66, sensitivity 73.24%, specificity 52.36%), respectively. For diagnosing CVA, the value of FeNO200 was better than FeNO50 ( p = 0.04). The optimal cut-off values of MMEF, FEF75%, and FEF50% for the diagnosis of CVA were 63.80% (AUC 0.75, sensitivity 53.52%, specificity 86.32%), 77.9% (AUC 0.74, sensitivity 57.75%, specificity 83.49%) and 73.50% (AUC 0.75, sensitivity 60.56%, specificity 80.19%), respectively. The AUCs of FeNO50 combined with MMEF, FEF75%, and FEF50% for the diagnosis of CVA were all 0.89. The AUCs of FeNO200 combined with MMEF, FEF75%, and FEF50% for the diagnosis of CVA were all 0.93. Conclusion: FeNO200 > 11 ppb contributed strongly for differentiating CVA from chronic cough, especially in patients with small airway dysfunction.
How Mental Health Affects Injury Risk and Outcomes in Athletes
Authors: Rogers Davis L. , Tanaka Miho J. , Cosgarea Andrew J. , Ginsburg Richard D. , Dreher Geoffrey M. 
Published: June 2023

Context: The importance of mental health among athletes is becoming more recognized and valued. Athletes experience symptoms of depression, anxiety, and related mental health disorders at rates similar to those of the general population, but because athletes face unique cultural and environmental pressures, such disorders are exacerbated in the context of an injury. Furthermore, we review the less well-known evidence that mental health disorders in athletes are associated with an increased risk of injury. We discuss the increasing awareness of the deficiencies in mental health support for athletes, which has been especially highlighted during the COVID-19 pandemic as well as in prominent professional and Olympic athletes, and describe both internal and external barriers to appropriate care. Evidence Acquisition: We searched PubMed for pertinent peer-reviewed studies. Study Design: Clinical review. Level of Evidence: Level 5. Results: There is a known psychological response to injury that can prolong recovery from musculoskeletal injury; conversely, mental health disorders in athletes are not only associated with an increased injury risk but also portend poorer outcomes subsequently, including prolonged recovery times, increased rates of injury recurrence, decreased rates of return to sport, and reduced performance upon return. Because of inherent barriers to appropriate care of athletes, including identification, stigma, and resource availability, there are currently various ongoing efforts nationally to create and implement initiatives regarding athlete mental health screening, support systems, and directed interventions to address the inextricably linked physical and mental health of athletes. Conclusion: Athletic injury negatively impacts the mental health of athletes. Likewise, mental health can and does influence athletic performance and is also intimately tied to the risk of athletic injury, thus creating a complex cycle with inability to separate physical and mental health.
In-Game Workload Demands of Position Players in Major League Baseball
Authors: Freeston Jonathan , Soloff Lonnie , Schickendantz Mark , Genin Jason , Frangiamore Salvatore , Whiteley Rod 
Published: June 2023

Background: Athletes who are well prepared for the physical demands of competition are less susceptible to injury. Defining and then preparing athletes for these in-game demands is critical to athlete health and performance. The injury burden within Major League Baseball (MLB) is significant and differs by position. Despite its importance, the workload demands have not been described for position players in MLB. Hypothesis: That running demands would be significantly higher for outfielders, followed by infielders, and catchers, respectively, while batting and baserunning metrics would be similar across positions. Study Design: Cohort study. Level of Evidence: Level 3. Methods: Total and high-speed running distance (>75% Vmax), high-speed running count, hard accelerations (>2.78 m/s/s), defensive and baserunning minutes, total and hard throws (>75% max), and bat swing counts were calculated from Statcast data. Players with 100 games or more in the 2018 season ( n = 126) were included for analysis. Results: All offensive and baserunning metrics were similar across positions; however, significant positional differences were observed for defensive and overall workload metrics. High-speed running was highest among outfielders ( F1,7 = 27.1, P < 0.01), followed by infielders, then catchers. Hard accelerations ( F1,7 = 12.9, P < 0.01) were highest among first basemen, then outfielders, remaining infielders, and catchers. Total throws ( F1,7 = 17.7, P < 0.01) were highest among middle infielders. Hard throws ( P < 0.01) were highest among shortstops and third basemen. Conclusion: In-game workloads differ significantly by defensive position in MLB. These differences in running, throwing, and hitting volumes have significant implications for physical preparation and injury return-to-play progressions to optimize performance and minimize injury and reinjury risk for these athletes. Clinical Relevance: These data provide insight into how best to prepare athletes of different positions for the demands of the game both in terms of preseason preparation as well as return-to-play benchmarks following injury. These data should also serve as a platform for future research into the relationship between workload and injury among professional baseball players.