bluuebunny/crossref_metadata_2025 huggingface dataset:
Syntaxin 4 Eenrichment in β-cells Prevents Conversion to Autoimmune Diabetes in Non-Obese Diabetic (NOD) Mice
Authors: Oh Eunjin , McCown Erika M. , Ahn Miwon , Garcia Pablo A. , Branciamore Sergio , Tang Shanshan , Zeng De-Fu , Roep Bart O. , Thurmond Debbie C.
Published: September 2021

Syntaxin 4 (STX4), a plasma membrane-localized SNARE
protein, regulates human islet β-cell insulin secretion and preservation of β-cell
mass. We found that human type 1 diabetic (T1D) and non-obese diabetic (NOD)
mouse islets show reduced β-cell STX4 expression, consistent with decreased
STX4 expression as a potential driver of T1D phenotypes. To test this
hypothesis, we generated inducible β-cell-specific STX4-expressing NOD mice
(NOD-iβSTX4). Of NOD-iβSTX4 mice, 73% had sustained normoglycemia versus
<20% of control NOD (NOD-Ctrl) mice, by 25 weeks of age. At 12 weeks of age,
prior to diabetes conversion, NOD-iβSTX4 mice demonstrated superior whole-body
glucose tolerance and β-cell glucose responsiveness than NOD-Ctrl mice. Higher β-cell
mass and reduced β-cell apoptosis were also detected in NOD-iβSTX4 pancreata
compared with those of NOD-Ctrl mice. Single-cell RNA‐sequencing revealed that
islets from NOD-iβSTX4 had markedly reduced IFNƔ signaling and TNFα signaling via NF-ĸB in
islet β-cells, including reduced expression of the chemokine CCL5; CD4+
Treg cells were also enriched in NOD-iβSTX4 islets. These results provide a deeper
mechanistic understanding of STX4 function in β-cell protection and warrant further
investigation of STX4 enrichment as a strategy to reverse or prevent T1D in
humans or protect β-cell grafts.
Peran Guru Ppkn Dalam Mewujudkan Misi Pendidikan Pancasila Dan Kewarganegaraan Sebagai Pendidikan Demokrasi Di SMP Negeri 2 Sawan
Authors: Ludir Leonardus
Published: September 2021

This study aims to describe (1) the role of PPKn teachers in realizing the mission of Pancasila and citizenship education as democratic education at SMPN 2 Sawan (2) the function as a manifestation of the development of democracy at SMPN 2 Sawan, in the research reveals the extracurricular role at SMPN 2 Sawan in realizing and implement the PPKn vision and mission as subjects that are focused on democratic values that will be implemented at SMPN 2 Sawan, what is the role of PPKn teachers in the mission of democratic education at SMPN 2 Sawan and also identify what things are done by teachers in building values the value of democracy at SMPN 2 Sawan. In this study, found several results that can be said to be good with several forms of research in the form of observation, interviews, documentation and questionnaires. In accordance with the reference to Law of the Republic of Indonesia Number 20 of 2003 concerning the national education system which has been internalized and implemented is sufficient as mandated by Law of the Republic of Indonesia Number 20 of 2003 concerning 18 character values.
Penerapan Prinsip Persona Non Grata Terhadap Duta Besar Ditinjau Dari Perspektif Hukum Internasional (Studi Kasus Penganiayaan TKI Oleh Duta Besar Arab Saudi Di Jerman)
Authors: Yusvitasari Devi
Published: September 2021

A country needs to make contact with each other based on the national interests of each country related to each other, including among others economic, social, cultural, legal, political, and so on. With constant and continuous association between the nations of the world, it is one of the conditions for the existence of the international community. One form of cooperation between countries in the world is in the form of international relations by placing diplomatic representation in various countries. These representatives have diplomatic immunity and diplomatic immunity privileges that are in accordance with the jurisdiction of the recipient country and civil and criminal immunity for witnesses. The writing of the article entitled "The Application of the Principle of Non-Grata Persona to the Ambassador Judging from the Perspective of International Law" describes how the law on the abuse of diplomatic immunity, how a country's actions against abuse of diplomatic immunity and how to analyze a case of abuse of diplomatic immunity. To answer the problem used normative juridical methods through the use of secondary data, such as books, laws, and research results related to this research topic. Based on the results of the study explained that cases of violations of diplomatic relations related to the personal immunity of diplomatic officials such as cases such as cases of persecution by the Ambassador of Saudi Arabia to Indonesian Workers in Germany are of serious concern. The existence of diplomatic immunity is considered as protection so that perpetrators are not punished. Actions against the abuse of recipient countries of diplomatic immunity may expel or non- grata persona to diplomatic officials, which is stipulated in the Vienna Convention in 1961, because of the right of immunity attached to each diplomatic representative.
Penegakan Hukum Pajak Melalui Penggunaan Sandera Pajak Dalam Penagihan Utang Pajak Di Indonesia
Authors: Nur Arifin Yeni
Published: September 2021

Taxes make a major contribution to the source of state revenue which is used to finance development in Indonesia. However, there are still many taxpayers / tax insurer who are not compliant in paying taxes. The problems in this study are why the government uses tax hostages in collecting tax debts, how hostages are used as a means of force in collecting tax debts and how hostage-taking is viewed from a juridical aspect. The research method used in this research is normative legal research method. The result of the research is that there are several factors that become the reasons for tax hostage taking. The government (fiskus) in collecting tax debt with tax hostages has been carried out in accordance with the provisions of the law. Based on the aspect of legal certainty, tax hostages in Indonesia already have a legal umbrella, namely Law no. 9 of 2000 and several other regulations. From the aspect of justice, legal protection is provided to taxpayers / tax insurer who are subject to tax hostages. From the benefit aspect, the application of tax hostages is beneficial in increasing taxpayer compliance.
Impact of economic conditions on production efficiency of agricultural enterprises
Authors: Dolmatova L. G.
Published: September 2021

At the present stage of market relations development, it is becoming more and more relevant to take into account the economic conditions of management. It is important to choose the right specialization by enterprises of the agricultural sector, which contributes to the increase in labor productivity, the increase in the efficiency of capital investments use and fixed assets. Relevant is the interdependence of specialization and concentration of production, which, in turn, has a significant impact on the development of socio-economic development program of the enterprise and on the entire process of expanded reproduction.
Methodological foundations of soil fertility reproduction concept
Authors: Tarasov A. S. , Tarasov S. A.
Published: September 2021

The issues of soil fertility reproduction are usually considered as a system of specific measures. This article presents a slightly different approach, the essence of which is to substantiate the methodology for constructing the concept of fertility reproduction, to formulate goals, tasks, to determine the method of forming indicative indicators and to assess effectiveness. The data for the Rostov region on the dynamics of nutrients balance in the soil and the assessment of the effectiveness of changing the structure of sown areas are presented.
Socio-ecological and economic efficiency of agricultural production in China
Authors: Murzin A. D. , Yizhu Li
Published: September 2021

The modern tasks of agriculture are concentrated in the area of reconciling the contradictions between increasing growth rates in conditions of limited natural resources and protecting the interests of citizens and the environment. The study is devoted to the overview of the current state, consideration of development prospects and analysis of the experience of the People's Republic of China in assessing the efficiency of agricultural production based on an index system of indicators, including 12 indicators grouped by social, environmental and economic characteristics, combined into a comprehensive development index. As a result of the study, the problems and mechanisms of support to rural areas at the state level, which can be useful to other agricultural territories and states, have been identified.
The development of domestic agroreclamation sphere through the prism of institutional and organizational transformations
Authors: Cheshev A. S. , Aleksandrovskaya L. A.
Published: September 2021

Based on the study of the processes of organizing the management of land reclamation activities that took place in domestic practice during the XX– beginning of the XXI centuries, the main directions of the transformation of the land reclamation sphere, which had both positive and negative content in the context of ensuring its sustainable development, are shown. Special attention is paid to the analysis of the consequences of the market transformation of this sphere, which took place in the 1990s. In this context, the main tasks of ensuring the sustainable development of domestic land reclamation are identified, the solution of which will allow it to successfully adapt to changing environmental conditions.
PELATIHAN PENYUSUNAN, PEMBUATAN, DAN PENGGUNAAN MEDIA PEMBELAJARAN BAGI GURU DI KECAMATAN LEMONG
Authors: Miswar Dedy , Basri Muhammad , Yarmaidi Yarmaidi , Aristoteles Aristoteles
Published: September 2021

Kemampuan dan keterampilan guru baik menggunakan maupun mengadakan media pembelajaran dalam proses belajar mengajar di dalam kelas bukan lagi merupakan suatu hal yang dapat diabaikan, akan tetapi ini merupakan suatu keharusan, mengingat dalam era pembangunan pendidikan di masa sekarang dan mendatang bertitik tolak pada kualitas keluarannya. Tujuan dalam pelatihan ini untuk meningkatkan pengetahuan, kemampuan dalam membuat dan kemampuan dalam menggunakan media pembelajaran. Metode yang digunakan dalam pelatihan ada 2, yaitu: ceramah (40%) dan praktik (60%) dengan jumlah peserta sebanyak 65 orang guru.  Hasil pengabdian menunjukkan bahwa tingkat pemahaman berupa sikap, penguasaan, dan pembuatan media pembelajaran oleh peserta dilakukan dengan semangat yang ditunjukkan dari hasil post test yang memperoleh nilai yang baik para peserta sebanyak 65 orang atau 76,47%.
Pengaruh Proses Reviu Terhadap Kualitas Laporan Keuangan Pemerintah Daerah
Authors: Juanda Aan , Nauli Pigo
Published: September 2021

This study aimes to determine the effect of financial statements review on the quality of local financial statement reports with an understanding of the goverment accounting standards as a moderation variable. This research is a quantitative research, with survey method conducted through questionnaire. The population in this study are all inspectorate in all regions of the Province of Lampung. Respondents in this study are all functional officers and other officials who are members of the Review team at each inspectorate at all regions in Lampung Province. The result of data analysis shows that the process of review for local government financial statements has a positive effect on the quality of local government financial reports, and an understanding of the government accounting standards by APIP did not moderate the relationship between the review process with the quality of local government financial reports
Analisis Pengakuan Nilai Aset dan Kualitas Laporan Keuangan Sebelum dan Sesudah Penerapan Sistem Akuntansi Berbasis Akrual
Authors: Novita Ika , Gamayuni Rindu Rika , Farichah Farichah
Published: September 2021

This research aims to examine the affect of awareness of paying tax towards the willingness of paying tax, the affect of tax regulation knowledge towards the willingness of paying tax, perception of tax system effectiveness towards the willingness of paying tax, percieved benefits by taxpayers towards the willingness of paying tax, the quality of taxpayer services towards the willingness of paying tax. The population in this research are individual taxpayer of MSME’s registered in the Pratama Kedaton and Teluk Betung Tax Office, Bandar Lampung. Sample are drawn with convenience sampling method. Data collected using questionnaire. The data uses in this research are primary data, and analysed using data quality test (validity and reliability test), classical assumption test (normality test, multicolinierity test, heteroscedasticity test), and hypothesis testing with multiple linier analysis. The result shows that there are many factors affecting the willingness of paying tax significantly are the awareness of paying tax and the quality of taxpayers services, and the tax regulation knowledge, perception of tax system effectiveness and the benefits percieved by taxpayers does not significantly affect the willingness of paying tax.
EVALUASI PENERAPAN STANDAR AKUNTANSI KEUANGAN No. 45 PADA ORGANISASI NIRLABA DI BANDAR LAMPUNG
Authors: Chaled Saddam , Sarumpaet Susi
Published: September 2021

This study aims to evaluate the implementation of Statement of Financial Accounting Standard (PSAK) No. 45 for non-profit organizations in Bandar Lampung in year 2012. Non- profit entities obtain resources from sponsors who do not expect repayments or economic benefits proportional to the amount of resources provided. This study uses a sample of 22 non-profit entities in Bandar Lampung. However, for this study purpose, 4 nonprofit organizations have been selected as they met the criteria according of financial reporting standards. Data were evaluated using the focus group discussion method. The results of the study found that the PSAK No. 45 on the reporting of financial position, statement of activities, and cash flow statements have not been implemented by non-profit entities in Bandar Lampung. An exception is of one organization which prepared those as a requirement to submit a proposal for international funding.
ANALISIS KELAYAKAN INVESTASI PENAMBAHAN SETORAN MODAL PEMERINTAH KOTA XYZ PADA PT BANK LAMPUNG
Authors: Desriani Neny , Nauli Pigo
Published: September 2021

This study aims to measure the value of investment is ideal amount and feasible to invest by Government City XYZ to PT Bank Lampung. The methods used in this study is ratio analysis and investment faeasibility analysis (Payback Period, Net Present Value, Internal Rate of Return, Profitability Index). The result of this study indicate that investment the results of this study indicate that the investment made by the XYZ city government was feasible in a certain amount.
PENGARUH BUDGET PLANNING MODEL TERHADAP KINERJA PENYUSUNAN ANGGARAN PEMERINTAH DAERAH KABUPATEN LAMPUNG TIMUR
Authors: Prayitno Didik , Evana Einde , Syaipudin Usep
Published: September 2021

The purpose of this study was to determine the effect of budget participation, budget communication and budget details on the performance of local government budgeting. The object of this research is employees who work in the Government of East Lampung Regency and taken 3 people consisting of SKPD Leaders, Treasurers, and Planning (Kasubbag/Kasi). A total sample of 162 came from 54 SKPD and the analysis tool used was multiple linear regression. The results showed that budgetary participation, budget communication and budget detail had positive effect on the performance of the budget preparation of the East Lampung Regency Government.

The more SKPD leaders carry out detailed budget oversight functions, they will be able to reduce the occurrence of budget irregularities, so that the performance of budget preparation is better. Suggestions proposed in this study are: The Government of East Lampung Regency has to improve capabilities and encourage more active participation by providing education programs and training on a regular budget preparation to the employees. SKPD Leaders involve more employees who are involved in budgeting activities during the implementation of the East Lampung Regency Development Plan Deliberation (Musrenbang) from the subdistrict level to the district level deliberation. East Lampung Regency Government has to use the budgeting system with the E-Budgetting System to avoid budget irregularities. Future studies are suggested including other variables outside the budget planning model variables as moderating variables to measure the performance of budgeting.
Faktor-Faktor yang Mempengaruhi Penyusunan Laporan Keuangan Berdasarkan Standar Akuntansi Keuangan Entitas Tanpa Akuntabilitas Publik (SAK ETAP) Pada Usaha Barbershop
Authors: Kusumawardani Niken
Published: September 2021

This research aims to; 1) Determine the effect of education level on the preparation of SAK ETAP financial statements; 2) Determine the influence of educational background on the preparation of SAK ETAP financial statements; 3) Determine the effect of business scale on the preparation of SAK ETAP financial statements; 4) Determine the effect of business experience on the preparation of SAK ETAP financial statements. The sample of this research is the Barbershop Micro, Small and Medium Enterprises (UMKM) in Tanjung Senang District. This sampling method uses random sampling. Data were analyzed using multiple linear regression analysis. The results showed that the level of education, educational background, and business scale did not significantly influence the preparation of SAK ETAP financial statements. Only business experience has a significant effect on the preparation of SAK ETAP financial statements.
Analisis Kinerja Non Financial Terhadap Kepuasan Kerja dan Prestasi Kerja
Authors: Tubarad Chara Pratami Tidespania
Published: September 2021

Nowadays the performance of Civil Servants (PNS) related to service to the community has always been the spotlight. The low work discipline, awareness, and service shown by some of the Civil Servants has an impact on negative stereotypes provided by the community. Therefore there is a need for significant improvements so the performance of government employees can be as expected. Because undisciplined work behavior can result in a reduction in the performance of Civil Servants in general, especially in the Lampung Regional, coupled with negative opinions from the public because in the presentation of financial statements they cannot be accountable and timely. Non-financial performance affects work performance and job satisfaction affects work performance
PENGARUH ELEMEN GOOD GOVERNANCE TERHADAP TINGKAT KORUPSI DI ASIA TENGGARA
Authors: Dizrisa Dinda Ayu , Sudrajat Sudrajat , Kusumawardani Niken
Published: September 2021

Corruption is a complex social, political and economic problem and occurs in every country with different levels. Corruption will complicate democracy and governance of a country. To overcome the problem of corruption, the government must implement good governance. This study aims to provide empirical evidence regarding the effect of elements of good governance on the level of corruption in Southeast Asia. Good governance variables are presented by six variables: voice and accountability, political stability and absence of violence / terrorism, government effectiveness, regulatory quality, rule of law and control of corruption.

Meanwhile, the level of corruption is measured using the Corruption Perceptions Index (CPI). The research sample was selected using the purposive sampling method and produced a sample of 8 countries and the observation period was carried out in 2009-2018 or as many as 10 years, so the number of samples in this study were 80 samples. Corruption level data used in this study uses the Corruption Perceptions Index (Transparency International), while the good governance data used in this study uses the Worldwide Governance Indicators (World Bank). The research methodology used in this study is multiple linear regression analysis with the IBM SPSS Statistics 24 program. The results showed that the variable voice and accountability, political stability and absence of violence / terrorism, and rule of law had no effect on the level of corruption, whereas the government variable effectiveness, regulatory quality, and control of corruption affect the level of corruption.
PENGARUH KARAKTERISTIK SISTEM INFORMASI AKUNTANSI MANAJEMEN TERHADAP KINERJA MANAJERIAL PADA BPR DI KOTA BANDAR LAMPUNG
Authors: Sari Anggun Novita , Oktavia Reni , Nauli Pigo
Published: September 2021

BPR face difficulties with the high ratio of non-performing loans and competition for peer-to-peer landing online or financial technology (fintech) which was published in CNBC Indonesia. To survive in the sphere of intense business competition, where in the future there will be many digital economic developments, the emergence of products that are increasingly integrated in various financial companies, business must be able to create flexible and innovative business conditions, and must also consider external factors of their business. It must also be followed by technological developments in order to survive and be able to compete in global competition. The high competitiveness created by a business actor can be achieved in one way, which is by increasing managerial performance. This study aims to analyze the influence of the characteristics of management accounting information systems on the managerial performance of rural banks. This study uses primary data using a survey method by giving questionnaires to operational managers of BPR in the city of Bandar Lampung. Based on the research results, it is known that broadscape, timeliness, aggregation, integration significantly and positively affect managerial performance
The Studentsâ€™ Reading Competence in Recount Text: A Study on the Ninth Grade Students of SMP Bustanul Ulum Bantarkawung
Authors: Mujiburrohman M
Published: September 2021

The research aim to measure the studentsâ€™ reading competence in using Recount Text tense. The reading skill became very important in the education field, students need to be exercised and trained in order to have a good reading skill. The research was descriptive quantitative method. The writer had been conducted on September 2013 and The subject of this research was the Eighth Grade students of SMP Bustanul ulum Bantarkawung, Brebes in the Academic year 2012/2013. The sample was 41 students of 82 Students, consisting of 41 from class VIII A and 41 students from class VIII B. In collecting data, the writer used a subjective test which consisted of 20 items, all the items were multiple choice test. After conducting the research, it revealed that the mean of the studentsâ€™ reading competence in using Recount Text tense was 78. It means that the average of the students could answer 61-80%% of the test items correctly. It indicated that the studentsâ€™ reading competence in using Recount Text belonged to â€œgoodâ€ category. The finding of the research had been contribution to reading competence education in SMP Bustanul Ulum Bantarkawung. The English teacher could get some different ways to improve the studentsâ€™ reading competence.
Implementasi Manajemen Kelas Pada Pembelajaran Jarak Jauh Di MI Muhamadiyah Pandansari
Authors: Juriyati Juriyati
Published: September 2021

Wabah corona yang disebabkan oleh Novel Corona Virus (SARS-Cov- 2) sejak akhir bulan Desember 2019 dan sampai sekarang belum dapat diatasi menyebabkan dunia pendidikan harus beradaptasi dengan menyelenggarakan kegiatan belajar mengajar secara daring atau dikenal dengan istilah Pembelajaran Jarak Jauh (PJJ). Tujuan penelitian ini adalah untuk mengetahui implementasi manajemen kelas pada pembelajaran jarak jauh di MI Muhammadiyah Pandansari Kecamatan Ajibarang. Penelitian yang dilakukan pada tanggal 4-15 Januari 2021 di kelas I  (satu) pada semester genap tahun pelajaran 2020/2021 ini menggunakan metode penelitian kualitatif dengan jenis penelitian studi kasus. Tehnik untuk mengumpulkan data adalah dengan pengamatan (observasi), interview (wawancara), analisis dokumen dan atau analisis isi wawancara. Dari hasil penelitian dapat disimpulkan bahwa untuk mengimplementasikan manajemen kelas pada pembelajaran jarak jauh, guru melakukan kegiatan: 1) mengabsen siswa untuk   mengetahui kesiapan siswa  dalam mengikuti pembelajaran, 2) melibatkan orang tua dalam proses pembelajaran, 3) memberikan batas waktu dalam mengirimkan tugas pembelajaran.
Psychological determination of personality types of young suicides
Authors: Bonkalo Tatyana I. , Shafazhinskaya Natalia E. , Karpinskaya Nadezhda I. , Tsygankova Maria N. , Logachev Nikita V. , Udodov Alexey G.
Published: September 2021

The purpose of the study is to identify the factors that determine the formation of a certain type of personality who has committed suicidal attempts at a young age. In order to identify the types of suicides, there was conducted a survey of 25 doctors in psychiatric clinical hospitals in Moscow. The survey results were processed using cluster analysis. To identify the factorial conditioning of suicidal behavior of each personality type, a complex of psychodiagnostic techniques was used, focused on the study of the characteristics of the emotional, value-semantic and behavioral spheres of the personality. The obtained empirical data were processed with the help of factor analysis. Between the ages of 24 and 35, common types of persons with suicidal tendencies are "protester" (negative attitudes toward life and its foundations, repeated attempts to prove oneself right with a high level of pretensions, and low level of development of abilities necessary for self-realization), "self-isolating" (a conviction of their failure and lack of right to life), "self-destructive" (excessive self-criticism and self-blaming).
Public danger of bankruptcy offenses in modern Russia
Authors: Popov Denis
Published: September 2021

The article aims at studying the Russian criminal legislation on the insolvency (bankruptcy) procedure over the past 15 years. An important indicator of the deterioration of bankruptcy cases is the judicial practice discussed in the article. The main method for studying the issue in question was the statistical method which allows to consider some court cases indicative for Russia and draw certain conclusions about prospects for the development of the Russian legislation on criminal liability for bankruptcy (insolvency) offenses in modern Russia. This scientific article also uses the method of system analysis, the historical method, deduction, induction, etc. The article concludes that bankruptcy abuse is a dynamic and rapidly changing environment due to the constant emergence of new forms of such abuse by the subjects of these legal relations. Therefore, the current legislation is not always able to resolve emerging issues in this area.
Russian empire’s civil law codification in the second half XIX – the beginning of xx century
Authors: Kramarenko Vladimir Olegovich
Published: September 2021

The article describes the history of the Civil code project of the Russian Empire. It also describes the progress of the Drafting Commission, its composition, objectives of activities and sources that formed the basis of the project. The Civil code project is an excellent example of the legal culture of Russia the thrifty and attentive attitude of its developers to the social and spiritual values of the people. The Civil code project as well as the history of its drafting can be used and should be taken into account today during the conduct of legislative activity the creation of legal structures of civil law. The Civil code became an important source of civil relationship in the Russian Empire.
The Role of Research Ethics Committees: Making a Fair Offer
Authors:   Ethics Fellow, University of Oxford, United Kingdom, Sheehan Mark ,   E-mail: mark.sheehan@ethox.ox.ac.uk
Published: September 2021

"In this paper, I engage with the on-going debate about the nature of the task that research ethics committees (RECs) have in coming to assess the ethics of research proposals. Some have argued that the role of RECs is to protect participants from harm in the context of researchers who want to benefit future people. Others have argued that the role of RECs is primarily to ensure that potential participants are provided with full information – enough to make an informed choice. On this later view, RECs protect choice rather than restrict it. I argue that both of these orientations are mistaken and that the role of RECs more akin to a societal overseer who ensures that the research is worthwhile and, most importantly, that it presents a fair offer to potential participants. On this view, the REC’s role is to balance potential harms to participants with the potential benefits of the research in the context of presenting the choice about whether to participate to potential participants. "
How Smart are Smart Materials? A Conceptual and Ethical Analysis
Authors:   MSc MA, University Medical Center Utrecht, The Netherlands, de Kanter Anne-Floor J. ,   E-mail: a.j.dekanter@umcutrecht.nl, Jongsma Karin R. ,   University Medical Center Utrecht, The Netherlands, Bredenoord Annelien L. ,   University Medical Center Utrecht, The Netherlands
Published: September 2021

"Today, a person can receive a hip implant to replace a deformed, swollen hip joint or a pacemaker to sustain the beating rhythm of their heart. Thanks to Regenerative Medicine, soon, it may become possible not just to replace, but to re-grow healthy tissues after injury or disease. To this end, tissue engineers are designing ‘smart’, ‘life-like’ biomaterial implants to activate the inherent regenerative capacity of the human body. Such a smart life-like biomaterial may for example stimulate re-growth of a fresh, living heart valve after implantation in a patient’s heart. However, the meaning of the smartness and lifelikeness of these synthetic biomaterials is conceptually unclear. Therefore, in this paper, we first aim to unravel the meaning of the terms ‘smart’ and ‘life-like’, and next, analyse what ethical and societal implications are associated with this new generation of biomaterial implants as a result. Our conceptual analysis reveals that the biomaterials are considered ‘smart’ because they can communicate with human tissues and ‘life-like’ because they are structurally similar to these tissues. Moreover, the biomaterial artifacts are designed to integrate to a high degree with the living tissue of the human body. While these characteristics provide the biomaterials with their therapeutic potential, we argue that it complicates a) the irreversibility of the implantation process, b) questions of ownership regarding the biomaterial implant, and c) the sense of embodiment of the receiver of the implant. Overall, timely anticipation and consideration of these ethical challenges will promote responsible development of biomaterials in Regenerative Medicine. "
Results of HIV and STD Tests: What Contribution of Internet? What Ethical Issues?
Authors:   MD, Centre d'éthique clinique, Paris, France, Foureur Nicolas ,   E-mail: nicolas.foureur@aphp.fr
Published: September 2021

"A specialized service for anonymous and free HIV and STD (sexual transmitted diseases) screening asked us, as a Clinical Ethics Centre, to reflect on the opportunity of making the results available to patients on the internet. Several options are possible: the provision might apply only to negative results or also to positive results, only for STD or also for HIV, to all patients or according to their own choice. In addition, if we consider that patients can manage alone the reception of their results, and to learn that they need to be treated, they might even choose to do the screening alone. Based on the caregivers’ appreciation of these issues (secretary, laboratory manager, nurses and physicians) and the work of the multidisciplinary clinical ethics group, this presentation will discuss: - The ethical issues raised by these differtents possibilities. Do they contribute to a higher level of empowerment for patients? Do they constitute a benefit or a risk for either single patients or public health? What ethical considerations should ground the doctor-patient relationship in this context? - The impact of the use of the internet or other technological means of communication in medicine. In the specific case of sexual health, technology can question the particular status with which information related to HIV testing is processed. Perhaps these new procedures might help to fight the stigma related to HIV by treating the result of the screening process like that of other STD. "
A “School Of Clinical Ethics”: Clinical Ethics Education for Clinicians and Philosophy Students
Authors:   PhD, MA – Researcher, Bruno Kessler Foundation, Trento, Italy, Galvagni Lucia ,   E-mail: lgalva@fbk.eu
Published: September 2021

"The presentation intends to present and illustrate an experience of teaching clinical ethics realized with a group of clinicians and philosophy students and held at the Philosophy Department of the University of Trento, Italy (Spring 2013 and Spring 2015). The class was intended to train clinicians and students to the main concepts of clinical ethics and to a specific methodology to approach clinical matters with ethical and philosophical tools. The class offered a space and time of listening, confronting, debating and learning. The opportunity to dialogue and to reflect, starting form clinical cases presented by clinicians and to realize an ethical analysis of them, combining languages and competences, resulted extremely relevant for clinicians, for students involved and for the teachers themselves. It represented – as well – a first and previous step to start some action-research in specific clinical units, as the local Intensive Care Unit, the Transplantation Coordination Unit and the Mountain Medicine and Ethics Lab. "
Management of Medical Data in Emerging Threats
Authors:   PhD, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania, Hostiuc Sorin ,   E-mail: soraer@gmail.com
Published: September 2021

"Emerging viral or bacterial threats pose significant medical and ethical issues, caused not only by the management of the disease, but also by the uncontrolled dissemination of information, both true and fake. Even the most correct and impartially presented piece of information can be understood by the patients or by the public at large in ways that are opposite to those intended by the communicators. This, associated with the increased prevalence of fake news, may cause havoc and decrease the efficacy of the needed preventive measures that have to be taken to tackle the actual medical problem. Within the context of the coronavirus outbreak, this has been coined as “infodemic”, increasing the difficulty of finding an optimal solution to the actual problem. Medical data about an emerging medical threat is disseminated through mass – and social media, especially by public authorities and physicians. The latter have specific duties, appertaining to their professional codes of morals, toward minimizing the harms generated by diseases, both at a personal and at a populational level. In infodemics, the management of the information they present to the public is extremely important, as each wording can be improperly interpreted and cause opposite effects. In this paper, we will discuss whether and which healthcare professionals should be involved in disseminating information about emerging healthcare threats, and which moral duties should prevail in these instances. "
Ethical Aspects of Using Virtual Reality in Psychiatry
Authors:   ", Isailă Oana Maria ,   Assistant Professor, “Carol Davila “ University of Medicine and Pharmacy Bucharest, Romania,   E-mail: oana_maria.isaila@yahoo.com ", Hostiuc Sorin ,   “Carol Davila” University of Medicine and Pharmacy Bucharest, Romania, Curcă Filip ,   “Carol Davila” University of Medicine and Pharmacy Bucharest, Romania, Curcă George Cristian ,   “Carol Davila” University of Medicine and Pharmacy Bucharest, Romania
Published: September 2021

"Virtual reality (VR), initially a form of entertainment has begun to find its way in healthcare practice. One of its main areas of interest is the treatment of psychiatric disorders. When using VR, the basic ethical principles underlying the physician-patient relationship should be respected, but they should be customized by the presence of an additional layer of complexity generated by the interposition of the virtual world. The physician-patient relationship is often multidirectional, often including a larger team of healthcare professionals, family members or acquaintances, working conjointly to optimize the medical care. Each time other participants are involved within this relationship, the complexity of the ethical issues tends to increase. For example, if the patient has decreased insight, it is possible that other persons must make some medical decisions – resulting a prioritization of beneficence compared to autonomy. Also, we must take into account the fact that many psychiatric symptoms can be seen as a form of “virtual reality” by the patient. The healthcare provider must take additional safety measures to minimize the harms made by VR techniques in psychiatric patients, by using methods that are individually tailored. The main aim of this paper is to debate the ethical aspects surrounding the applicability of virtual reality in treating psychiatric patients, with an emphasis on the elements that were mentioned earlier. "
Does Institutionalising Reasonable Accommodation Increase Conscientious Objections of Medical Professionals?
Authors:   ", Ishikawa Ryoko ,   Associate Professor, Ritsumeikan University, Kyoto, Japan,   E-mail: rishikaw@fc.ritsumei.ac.jp "
Published: September 2021

"In January 2020, the Council of Europe has rejected a resolution that recommends reasonable accommodation of employee’s religious practices in the workplace. The concept of reasonable accommodation emerged in the United States and in Canada to allow some flexibility in the application of laws to achieve substantial equality for all, as uniform application of seemingly neutral laws can cause disadvantages to ethnic or religious minorities, and people with disability. However, reasonable accommodation of religious practices in the workplace such as hospitals is often criticised in two ways; first, it makes it easier for the doctors to register a conscientious objection against providing abortion or reproductive treatment and thus harms women’s reproductive rights. Second, in the same manner, medical professionals may use reasonable accommodation as an excuse to refrain from providing certain medical care to sexual minorities. The purpose of this paper is to indicate that such secularist criticisms of reasonable accommodation are implausible. To show this, this paper first reviews the idea of reasonable accommodation in North America and Europe. Then, the reasonable accommodation debate occurred in Québec, Canada and the report by Bouchard-Taylor Commission (2007-2008) are examined in light of theories of deliberative democracy to illustrate the asymmetry of power between the majority and the minority groups in the negotiation process. Lastly, this paper argues that reasonable accommodation as a means to negotiate the demands for accommodation of religious practices is limited. Thus it is unlikely to undermine the fundamental liberal values of the majority. "
From Gene-Edited Baby to Cyborg Soldier: On the Limits to New Biotechnology by the Eugenics Movement
Authors:   Ph.D., Academia Sinica, Taipei City, Taiwan, Ku Chang-Yun ,   E-mail: evelynku@gate.sinica.edu.tw
Published: September 2021

"Biotechnology for Health and Human Performance (BHPC) of the U.S. DOD recently released a research report titled “Cyborg Soldier 2050: Human/Machine Fusion and the Impact for the Future of the DOD”. In this report, Emanuel et al. predicted that ocular and auditory enhancements, muscular control through bodysuit, and neural enhancement of human brain will be feasible before 2050. And not so long ago, the world’s first Gene-edited twins LuLu and NaNa were made by a Chinese Scientist, who was sentenced and fined by the Chinese Government in December 2019, claims that these babies are now immune to the HIV virus. While the biotechnological breakthroughs show the potentials that humans can have different lives than we have now, it’s also worrisome for those unforeseen disadvantages of bio-inventions will cost human too much and too soon, before we have the abilities to stop it. Along with the developments of biotechnology, it’s not surprised that new bio-inventions will emerge and go beyond our imagination. But, the “artificial selection” character of these bio-inventions also reminds us of the Eugenics Movement which happened only a century ago. In this article, I’ll discuss these two bio-inventions by reviewing the Eugenics Movement. First, I’ll brief the cases of Gene-edited Baby and the CRISPR technology as well. Second, I’ll introduce the Cyborg Soldier and BHPC’s report. Third, I’ll talk about the Eugenic Movement and its consequences. Fourth, I’ll analyze these two bio-inventions from the historical perspectives of the Eugenic Movement. Finally, I will summarize and conclude this article. "
Co-Creation: A Novel Approach to Developing Guidelines for Research Integrity Policy – Lessons Learned from the SOPS4RI Project
Authors:   PhD student, Amsterdam UMC, location VUmc, Amsterdam, the Netherlands, Labib Krishma ,   E-mail: k.labib@amsterdamumc.nl, Tijdink Joeri ,   Amsterdam UMC, location VUmc, Amsterdam, the Netherlands
Published: September 2021

"Co-creation is a qualitative research methodology that engages stakeholders in playful activities to produce user-centered outputs. Through an interactive and open approach, co-creation explores stakeholders’ latent values, generates innovative ideas, and captures minority views, allowing for in-depth understanding of how stakeholders are affected by various factors. Therefore, co-creation is a promising methodology for developing guidelines on research integrity (RI), although there is no literature available about co-creation in this context. In our presentation, we share experiences of using co-creation to design institutional guidelines on RI together with research managers, funders and researchers across Europe. We conducted 24 co-creation workshops on topics ranging from RI education, to creating a responsible research environment, resulting in concrete guidelines that research institutions and funders can implement to foster RI. Our experience has provided us with valuable insights on using co-creation for RI guideline development. While motivating research stakeholders – often serious and analytically oriented people – to engage in creative exercises can be a challenge, particularly in the online setting, it is possible to achieve when ‘play’ and ‘work’ are carefully balanced. Additionally, to ensure the concreteness of guidelines while accounting for differences among institutions and countries, best practice examples can be used to show different approaches to implementing more general guidance. We have also learned that it is valuable to explore stakeholders’ preferences regarding the guideline format, since implementability is not only influenced by the content. These insights provide practical considerations that other researchers can use when co-creating RI guidelines. "
Moral Challenges of Ethics Support Staff. Developing a Moral Compass for Facilitators of Moral Case Deliberation
Authors:   Junior Researcher, Amsterdam UMC, The Netherlands, Ligtenberg Wieke ,   E-mail: w.m.r.ligtenberg@amsterdamumc.nl, Stolper Margreet ,   Amsterdam UMC, The Netherlands, Molewijk Bert ,   Amsterdam UMC, The Netherlands
Published: September 2021

"Ethics support staff often help others to deal with moral challenges. However, they themselves can also experience moral challenges when practicing ethics support. Facilitators of Moral Case Deliberation (MCD) sometimes for example experience ethical questions when it comes to (breaking) confidentiality. Facilitators might find themselves compelled to intervene or act upon things they hear or see whilst facilitating a MCD. For example, a MCD facilitator finds out that a participant does something illegal. Or, what to do if a MCD facilitator is asked to inform the Inspectorate about details of a MCD? When is a facilitator allowed or obligated to break confidentiality and share information with others? How to make such a decision? And, if allowed to break confidentiality, how to do this in a morally sound way? Currently there are no moral guidelines on how to act upon these questions. We conducted empirical research that explores moral challenges of MCD facilitators related to confidentiality and develops a moral compass which provides directions to approach these challenges. Data collection consists of three complementary methods: * analyses of 3 a 4 audiotaped and transcribed MCD sessions about how and when to break confidentiality; * in-depth interviews about the topic; * focus group to validate the findings and co-create a moral compass. In our presentation, we will reflect upon both the theoretical and normative considerations concerning confidentiality in ethics support and the empirical results of this study. Furthermore, we will present a preliminary version of a moral compass in order to strengthen the moral competency of MCD facilitators. "
Using Goals of Care Conversations to Build Ethics Competency
Authors:   ", Nortje Nico ,   PhD, University of Texas MD Anderson Cancer Center, Houston, United States of America,   E-mail: nortjenico@gmail.com "
Published: September 2021

"Literature indicates that 99% of clinicians believe that timely Goals of Care (GOC) conversations are important. However, only 11% of patients report having had GOC conversations with their providers throughout the trajectory of their disease. Congruent to this, it is reported that only 41% of patients feel that they have received care consistent with their preferences. One can therefore deduct that there is a great ethical gap in how patients are approached by healthcare providers, especially respecting their autonomous decision-making. As a concept, GOC refers to discussing patients’ therapy intend, which is informed by the patients’ hope, fears, information preferences, presumed minimally acceptable quality of life, and expectations for their future. Therefore it needs to be an explicit conversation which is personalized to each patient’s context and circumstances. Within these conceptual ideas there are a myriad of ethical values which needs to be addressed. The author will explain how a Goals of Care initiative was started at the hospital where the author is a clinical ethicist and how these interactions with various members of the care team have been used to build ethics competencies of all the members of the care team. This innovative approach has been applauded by the participants for making ethics practical and applicable. The structure of the talk will focus on basic literature review, discussion on initiative (how it was set up), challenges, lessons learnt, value in ethics competency development. "