Analysis of HER2-Low Breast Cancer in Aotearoa New Zealand: A Nationwide Retrospective Cohort Study.

Objectives: To perform the first national analysis of demographic and clinicopathological features associated with the HER2 positive, HER2-low, and HER2-zero invasive breast cancers in New Zealand. The study will reveal the proportion of women who may benefit from new HER2-targeted antibody drug conjugate (ADC) therapies.

Methods: Utilising data from Te Rēhita Mate Ūtaetae (Breast Cancer Foundation NZ National Register), the study analysed data from women diagnosed with invasive breast cancer over a 21-year period.

Hope and Exploitation in Commercial Provision of Assisted Reproductive Technologies.

Innovation is a key driver of care provision in assisted reproductive technologies (ART). ART providers offer a range of add-on interventions, aiming to augment standard in vitro fertilization protocols and improve the chances of a live birth. Particularly in the context of commercial provision, an ever-increasing array of add-ons are marketed to ART patients, even when evidence to support them is equivocal.

Encountering offenders in community palliative care settings: challenges for care provision.

Background: There is very little research into the way that offender management strategies impinge on the practices and decision-making of palliative care personnel in community settings.

Aims: To improve understanding of the challenges that community palliative care service providers encounter when caring for people who have been sentenced to custody and are under the supervision of the prison or probation services.

Methods: This paper discusses one part of a larger multidisciplinary study on bereavement, loss and grief in the criminal justice system.

Is Mitochondrial Donation Germ-Line Gene Therapy? Classifications and Ethical Implications.

The classification of techniques used in mitochondrial donation, including their role as purported germ-line gene therapies, is far from clear. These techniques exhibit characteristics typical of a variety of classifications that have been used in both scientific and bioethics scholarship. This raises two connected questions, which we address in this paper: (i) how should we classify mitochondrial donation techniques?; and (ii) what ethical implications surround such a classification? First, we outline how methods of genetic intervention, such as germ-line gene therapy, are typically defined or classified.

Rethinking Moral Expertise.

We argue that the way in which the concept of expertise is understood and invoked has prevented progress in the debate as to whether moral philosophers can be said to be 'moral experts'. We offer an account of expertise that draws on the role of tacit knowledge in order to provide a basis upon which the debate can progress. Our analysis consists of three parts.

Ethical and legal issues in mitochondrial transfer.

The US National Academies of Science, Engineering and Medicine recently provided conditional endorsement for mitochondrial transfer. While its approach is more conservative in some respects than that of the United Kingdom (which passed its own regulations in 2015), it marks a significant policy development for a potentially large implementer of this emerging intervention. In this perspective, we consider some of the ethical and legal aspects of these policy responses.

Recent changes in hypoxia training at the Royal Air Force Centre of Aviation Medicine.

Hypoxia training at the Royal Air Force Centre of Aviation Medicine (RAF CAM) has traditionally involved the use of a hypobaric chamber to induce hypoxia. While giving the student experience of both hypoxia and decompression, hypobaric chamber training is not without risks such as decompression sickness and barotrauma. This article describes the new system for hypoxia training known as Scenario-Based Hypoxia Training (SBHT), which involves the subject sitting in an aircraft simulator and wearing a mask linked by hose to a Reduced Oxygen Breathing Device (ROBD).

Mitochondrial Replacement: Ethics and Identity.

Mitochondrial replacement techniques (MRTs) have the potential to allow prospective parents who are at risk of passing on debilitating or even life-threatening mitochondrial disorders to have healthy children to whom they are genetically related. Ethical concerns have however been raised about these techniques. This article focuses on one aspect of the ethical debate, the question of whether there is any moral difference between the two types of MRT proposed: Pronuclear Transfer (PNT) and Maternal Spindle Transfer (MST).

An ethical defence of the Liverpool Care Pathway.

Palliative care in the UK has been ranked as the best in the world. However, the Liverpool Care Pathway was criticised and phased out. This article looks at the LCP's aims, assesses the problems and how these should be tackled.

An Eliminativist Approach to Vulnerability.

The concept of vulnerability has been subject to numerous different interpretations but accounts are still beset with significant problems as to their adequacy, such as their contentious application or the lack of genuine explanatory role for the concept. The constant failure to provide a compelling conceptual analysis and satisfactory definition leaves the concept open to an eliminativist move whereby we can question whether we need the concept at all. I highlight problems with various kinds of approach and explain why a satisfactory account of vulnerability is unlikely ever to be offered if we wish the concept to play a genuinely explanatory role in bioethical contexts.

Ethics and end of life care: the Liverpool Care Pathway and the Neuberger Review.

The Liverpool Care Pathway for the Dying has recently been the topic of substantial media interest and also been subject to the independent Neuberger Review. This review has identified clear failings in some areas of care and recommended the Liverpool Care Pathway be phased out. I argue that while the evidence gathered of poor incidences of practice by the Review is of genuine concern for end of life care, the inferences drawn from this evidence are inconsistent with the causes for the concern.

Limitations on personhood arguments for abortion and 'after-birth abortion'.

Two notable limitations exist on the use of personhood arguments in establishing moral status. Firstly, although the attribution of personhood may give us sufficient reason to grant something moral status, it is not a necessary condition. Secondly, even if a person is that which has the 'highest' moral status, this does not mean that any interests of a person are justifiable grounds to kill something that has a 'lower' moral status.

Optimizing performance by improving core stability and core strength.

Core stability and core strength have been subject to research since the early 1980s. Research has highlighted benefits of training these processes for people with back pain and for carrying out everyday activities. However, less research has been performed on the benefits of core training for elite athletes and how this training should be carried out to optimize sporting performance.

The identification of age-related differences in kinetic gait parameters using principal component analysis.

Background. The age of onset of adult-like kinetic gait patterns is controversial. A potential cause of discrepant results between studies is the statistical analyses used to test for differences in kinetic parameters between age groups.

Proxy consent: moral authority misconceived.

The Mental Capacity Act 2005 has provided unified scope in the British medical system for proxy consent with regard to medical decisions, in the form of a lasting power of attorney. While the intentions are to increase the autonomous decision making powers of those unable to consent, the author of this paper argues that the whole notion of proxy consent collapses into a paternalistic judgement regarding the other person's best interests and that the new legislation introduces only an advisor, not a proxy with the moral authority to make treatment decisions on behalf of another. The criticism is threefold.

A validation of a posture matching approach for the determination of 3D cumulative back loads.

The purpose of this project was to investigate the amount of error in calculating cumulative lumbar spine kinetics using a posture matching approach (3DMatch) compared to a 3D coordinate electromagnetic tracking approach (FASTRAK). Six subjects were required to perform five repeats each of two symmetrical and two asymmetrical lifts while being simultaneously recorded from 4 camera views at viewing angles of 0 degrees , 45 degrees , 60 degrees and 90 degrees to the sagittal plane while wearing eight FASTRAK sensors to define an 8 segment rigid link model (RLM) of the head, arms, and trunk. Four hundred and eighty lifts (6 subjects x20 lifts x4 camera views) were analyzed using the 3DMatch posture-matching program to calculate the following cumulative loads at the L4/L5 joint: compression, anterior shear, posterior shear, reaction shear and extension moment.

The effect of camera viewing angle on posture assessment repeatability and cumulative spinal loading.

Video-based task analysis in the workplace is often limited by equipment location and production line arrangement, therefore making it difficult to capture the motion in a single plane. The purpose of this study was to investigate the effects of camera placement on an observer's ability to accurately assess working postures in three dimensions and the resultant influence on the reliability and repeatability of calculated cumulative loading variables. Four video cameras were placed at viewing angles of 0 degrees, 45 degrees, 60 degrees and 90 degrees to the frontal plane, enabling the simultaneous collection of views of four lifting tasks (two symmetric and two asymmetric).