bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Doctrine of Double Effect: An Aid in Decision-Making
Authors: Dancák Pavol 
Published: November 2020

Human society of the modern world, which is greatly affected by technological and economic advancements, has to address moral problems with a new urgency. In many instances, the decision does not bring only positive effects. Such cases can be found in applied ethics: bio-medical ethics, business ethics, and legal ethics, but also in other areas of human activity, too, most recently, in debates, concerning the use of autonomous vehicles or autonomous machines in general. This paper aims to describe and explain the principle of ‘double effect’, when solving complicated and, from the perspective of morality, profoundly dilemmatic situations. The principle of double effect was gradually developed as a means of seeking the right moral decisions. It has a firm and respected position within Catholic medical ethics, but also in secular legislation. The paper presents current thought experiments, which clarify moral decision-making in dilemmatic situations. What seems to be a shortcoming here, is that ethical thought experiments are far too abstract. On the one hand, they refine our knowledge, but on the other hand, they are very partial. The evolution of medical imaging methods, has enabled us to take a closer look at the relationship between the deontological and utilitarian approaches to making moral judgments, but it does not relieve us of our responsibility for the decisions that we have made. The positive side of the principle of double effect, is that it protects us from the slippery slope of utilitarian consequentialism, where the admission of a lesser evil, is only a step away from committing evil in the name of the greater good.
The Problem of the Conscience Clause of Healthcare Professionals in Italy in the Years 2017-2020
Authors: Kobyliński Andrzej 
Published: November 2020

The main goal of the article is to analyse the key elements of the living will in Italy and present the dispute regarding the understanding of the conscience clause of healthcare professionals. In the country on the Tiber, a law on the living will was passed in 2017. A living will consists in the anticipatory expression of ‘will’, by an adult or legal guardian acting in full possession of their mental faculties, concerning the possible administration or discontinuation of certain medical therapies in the future. The conscience clause, on the other hand, means the right to refuse to take such actions, which a particular person considers to be contrary to their personal convictions. The Italian law on the living will does not contain a provision on the conscience clause. For this reason, an ethical and legal problem arose for healthcare professionals, who refused to comply with the wishes of their patients for moral or religious reasons, for example by discontinuing artificial hydration or nutrition, thus, leading to the patient’s death. The ethical and legal dispute in Italy is part of a contemporary global debate on conscience clauses, euthanasia, assisted suicide, human rights, and the dignity of human life. Analyses have shown that healthcare professionals should be guaranteed the right, not to perform such medical procedures, which are contrary to their moral and religious convictions.
Developing Novel Anticancer Drugs for Targeted Populations: An Update
Authors: Tafesse Tadesse B. , Bule Mohammed H. , Khan Fazlullah , Abdollahi Mohammad , Amini Mohsen 
Published: November 2020

Background:
Due to higher failure rates, lengthy time and high cost of the traditional de novo drug
discovery and development process, the rate of opportunity to get new, safe and efficacious drugs for the targeted
population, including pediatric patients with cancer, becomes sluggish.

Objectives:
This paper discusses the development of novel anticancer drugs focusing on the identification and
selection of targeted anticancer drug development for the targeted population.

Methods:
Information presented in this review was obtained from different databases, including PUBMED,
SCOPUS, Web of Science, and EMBASE. Various keywords were used as search terms.

Results:
The pharmaceutical companies currently are executing drug repurposing as an alternative means to accelerate
the drug development process that reduces the risk of failure, time and cost, which take 3-12 years with
almost 25% overall probability of success as compared to de novo drug discovery and development process (10-
17 years) which has less than 10% probability of success. An alternative strategy to the traditional de novo drug
discovery and development process, called drug repurposing, is also presented.

Conclusion:
Therefore, to continue with the progress of developing novel anticancer drugs for the targeted population,
identification and selection of target to specific disease type is important. Considering the aspects of the
age of the patient and the disease stages such as each cancer types are different when we study the disease at a
molecular level. Drug repurposing technique becomes an influential alternative strategy to discover and develop
novel anticancer drug candidates.
The Potential Migrated Mechanism of Water-Soluble Components in Pellets Prepared by Wet Extrusion/Spheronization: Effect of Drying Rate
Authors: Wang Bingwei , Liu Jianping , Li Zhenghua , Xia Yulong , Zhang Shuangshuang , Li Ziyi 
Published: November 2020

Introduction:
At present, there are numerous researches on the migration of components
in tablets and granules, however, the investigation in the pharmaceutical literatures concerning
the effect of drying rate on the migration of water-soluble components of pellets is limited.
Temperature and Relative Humidity (RH) are crucial parameters during the drying process, which
is an essential step in the preparation of pellets via wet extrusion/spheronization. To quantify these
variables, the water loss percentage of pellets per minute is defined as the drying rate.

Aim:
The study aimed to investigate the influence of drying rate on the migration of water-soluble
components in wet pellets and the potential migrated mechanism.

Methods:
The pellets containing tartrazine as a water-soluble model drug and microcrystalline cellulose
as a matrix former were prepared by extrusion/spheronization and dried at four different drying
temperatures and relative humidity. Afterwards, the extent of migrated tartrazine was assessed
regarding appearance, in-vitro dissolution test, Differential Scanning Calorimetry, X-Ray Powder
Diffraction, Attenuated total reflectance Fourier transform infrared spectroscopy and Confocal Raman
Mapping.

Results:
Results demonstrated that red spots of tartrazine appeared on the surface of pellets and
more than 40% tartrazine were burst released within 5 minutes when pellets were dried at 60°C/RH
10%. When pellets were dried at 40°C/RH 80%, none of these aforementioned phenomena were observed.

Conclusion:
In conclusion, the faster the drying rate was, the more tartrazine migrated to the exterior
of pellets. Adjusting drying temperature and relative humidity appropriately could inhibit the migration
of water-soluble components within wet extrusion/spheronization pellets.
Self-Assembled Nanoparticles of Natural Phytochemicals (Berberine and 3,4,5-Methoxycinnamic Acid) Originated from Traditional Chinese Medicine for Inhibiting Multidrug-Resistant Staphylococcus aureus
Authors: Han Nana , Huang Xuemei , Tian Xuehao , Li Tong , Liu Xiaojing , Li Wen , Huo Su , Wu Qianwen , Gu Yuhao , Dai Ziqi , Xu Bing , Wang Penglong , Lei Haimin 
Published: November 2020

Background:
In the field of antibacterial, nanomaterials are favored by researchers because
of their unique advantages. Medicinal plants, especially traditional Chinese medicine, are
considered to be an important source of new chemicals with potential therapeutic effects, as well as
an important source for the discovery of new antibiotics. MRSA is endangering people's lives as a
kind of multidrug-resistant Staphylococcus aureus, which is resistant to tetracycline, amoxicillin,
norfloxacin and other first-line antibiotics. It is a hotspot to find good anti-drug-resistant bacteriae,
nature-originated nanomaterials with good biocompatibility.

Objective:
We reported the formation of phytochemical nanoparticles (NPs) by the self-assembly
of berberine (BBR) and 3,4,5-methoxycinnamic acid (3,4,5-TCA) from Chinese herb medicine,
which had good antibacterial activity against MRSA.

Method and Results:
We found that NPs had good antibacterial activity against MRSA; especially,
its antibacterial activity was better than first-line amoxicillin, norfloxacin and its self-assembling
precursors on MRSA. When the concentration reached 0.1 μmol/mL, the inhibition rate of
NPs reached 94.62%, which was higher than that of BBR and the other two antibiotics (p < 0.001).
It was observed by Field-Emission Scanning Electron Microscopy (FESEM) that NPs could directly
adhere to the bacterial surface, which might be an important aspect of the antibacterial activity
of NPs. Meanwhile, we further analyzed that the self-assembly was formed by hydrogen bonds and
π-π stacking through Ultraviolet-Visible (UV-vis), Fourier Transform Infrared Spectroscopy (FTIR),
hydrogen Nuclear Magnetic Spectrum (1H NMR), and powder X-ray Diffraction (pXRD).
NPs’ morphology was observed by FESEM and TEM. The particle size and surface charge were
characterized by Dynamic Light Scattering (DLS); and the surface charge was -31.6 mv, which
proved that the synthesized NPs were stable.

Conclusion:
We successfully constructed a naturally self-assembled nanoparticle, originating from
traditional Chinese medicine, which had a good antibacterial activity for MRSA. It is a promising
way to obtain natural nanoparticles from medicinal plants and apply them to antibacterial therapy.
Antioxidant Activity Profiling of Acetonic Extract of Jamun (Syzygium cumini L.) Seeds in Different In-Vitro Models
Authors: Yadav Neha , Pal Ajay , Sihag Sonam , C.R Nagesh 
Published: November 2020

Background:

Syzygium cumini L., commonly known as Jamun, black-plum, and Indian blackberry, is one of the most widely distributed trees in India with booming medical benefits and possesses antioxidant, anticancer and anti-diabetic properties. It belongs to the family Myrtaceae. Despite countless phytochemicals, seeds are not consumed and are the waste part of Jamun fruit.

Objective:
The objective of this study was to evaluate the antioxidant capacity of phenolics from Jamun seeds against a bundle of oxidant moieties.

Methods:
The 50% acetone extract of Jamun seeds was investigated for in-vitro antioxidant profiling. Assays include free radical scavenging activity, metal chelation activity, hydroxyl radical scavenging activity, hydrogen peroxide scavenging activity, total antioxidant activity, total reducing power, nitric oxide scavenging activity, and lipid peroxidation inhibition activity.

Results:
The extract depicted maximum DPPH radical scavenging activity followed by ABTS radical scavenging activity. Hefty metal chelation and nitric oxide scavenging activity were recorded while lipid peroxidation, H2O2, and OH- scavenging activity was intermediate.

Conclusion:
Jamun seed showed ample antioxidant activity and certifies that it is the right candidate for exploitation as a source of natural antioxidants to counteract autoxidation-induced pathologies or diseases.
Antibacterial Activity of Honey against Methicillin-Resistant and Sensitive Staphylococcus Aureus Isolated from Patients with Diabetic Foot Ulcer
Authors: Mirzaei Arezou , Karamolah Kolsoom Shirzadi , Mahnaie Mina Pourmbarak , Mousavi Fatemeh , Moghadam Parisa Mehrabi , Mahmoudi Hassan 
Published: November 2020

Introduction:Staphylococcus aureusis the most important causative agent of wound infections, including diabetic foot ulcers. Honey is a very useful nutrient with antimicrobial properties and other biological properties such as antitumor, anti-inflammatory, antioxidant and antiviral properties. The aim was to examine the antibacterial activity of honey against methicillin-resistant and sensitiveS. aureus(MRSA and MSSA) isolated from patients with diabetic foot ulcers.Methods:This cross-sectional study was performed from January 2019 to December 2019. TwentyS. aureusisolates were collected from patients with diabetic foot ulcers. Different concentrations (100%, 70%, 50%, 25% vol/vol) of honey were studied. Dilutions of honey solutions were examined to determine the minimum inhibitory concentration (MIC) againstS. aureus. MICs were determined by spectrophotometric assay at 620 nm.Results:All strains showed sensitivity to honey with MIC equal to 25% (vol/vol). The MIC (%) values of honey for all studiedS. aureus (MRSA and MSSA) isolates ranged between 18-100% (v/v).Conclusion:Honey with confirmed, antibacterial activity has the potential to be an efficient treatment complementary for diabetic foot ulcers infected or at risk of infection withS. aureus.
AN ANALYSIS OF THE NEEDS OF ELDERLY-FRIENDLY NEIGHBOURHOOD IN MALAYSIA: PERSPECTIVES OF OLDER AND YOUNGER GROUPS
Authors: Ahmad Khalid Husna , Ling Oliver Hoon Leh , Rifhan Jalil Nur Iklil , Marzukhi Marlyana Azyyati , Nasrudin Na’asah 
Published: November 2020

The increase of the elderly population in Malaysia can be one of the main challenges to planners, architects and policy makers. This indicates that provision of a suitable neighbourhood design for a population of different ages is necessary. The elderly group requires specific design standards in neighbourhood planning to ensure a comfortable, conducive and safe living environment. It is a known fact that health issues are part and parcel in elderly care. Having a proper neighbourhood design will likely contribute to an increase in health care services and safety of the elderly. This study analysed the people’s perspective on the needs of elderly-friendly neighbourhood in Malaysia and the elements that should be taken into consideration to fulfil the needs. This study aimed to observe the opinion of the elderly, as well as young people for future planning. Data were collected from the residents in the study areas which were Kajang and Sungai Chua. These study areas are located in Hulu Langat district, in which a high percentage of the elderly population was available. The respondents were chosen to participate in a survey in a form of questionnaire that was administered in the study areas. The questionnaire survey did not specifically focus only on older people, but also towards the young people. These young people will either become a caretaker of their elderly or an elderly in the future. Results of this study concluded that elderly-friendly neighbourhood was indeed important and the most suitable type of house for the elderly was single-storey. The elderly-friendly neighbourhood should also be equipped with elements that prioritised the physical activity of the residents. This study provides insights in order to promote the elderly-friendly neighbourhood concept.
Tracking Demographic Movements and Immunization Status to Improve Children's Access to Immunization (TDM-IAI): Protocol for a Field-Based Randomized Controlled Trial
Authors: Ateudjieu Jérôme , Yakum Ndinakie Martin , Goura André Pascal , Guenou Etienne , Beyala Landry Bita’a , Amada Lapia , Ngoche Isabelle , Kiadjieu Frank Forex , Nangue Charlette , Djosseu Elvis Briand Soukep , Kenfack Bruno 
Published: November 2020

Background
In Cameroon, the coverage, completeness, and timeliness of the Expanded Programme on Immunization (EPI) vaccines administration in children have remained heterogeneous and below the national and districts targets in several districts. In an effort to solve this problem, many interventions have been tested but none has shown significant improvement of the situation.

Objective
This trial aims to test whether involving Community Volunteers to assess children vaccination status and demographic movements and using recorded data to plan catch-up immunization sessions can improve children vaccination timeliness, completeness and coverage.

Methods
Communities of the Foumban Health district, West region of Cameroon will be selected and assigned to either intervention or control groups using a restricted randomization of 2. In the intervention group, one Community Volunteer per community will be trained to visit households and record EPI-targeted children in a register, record their demographic movements, and assess their immunization status monthly for a year. The information recorded will be snapped and sent to the competent health center immunization team through WhatsApp. These will be used to plan and implement monthly community catch up immunization sessions in collaboration with the community volunteer. In the control group, the routine immunization sessions will be conducted with health centers organizing either weekly vaccination sessions for communities situated not farther than 5 kilometers away from the health facility or monthly vaccination sessions in communities situated more than 5 kilometers away from the health center. Baseline, mid-term and end-line surveys will be conducted to assess and compare immunization coverage, timeliness, and completeness.

Results
Funded in 2018, data collection started in 2018 and has been completed. Data analysis and reporting are ongoing.

Conclusions
This trial is expecting to test an innovative approach to improving children’s immunization timeliness, completeness and coverage of immunization by tracking EPI targeted population vaccination status and denominator at household level and building collaboration between the community and health facilities vaccination teams to organize monthly community-based response vaccination sessions. This intervention is expected to improve children sustainable access to EPI vaccination as it offers assessing and responding to their immunization needs at monthly basis using low cost local human resources.

Trial Registration
Pan African Clinical Trials Registry ID PACTR201808527428720; tinyurl.com/u058qnse

International Registered Report Identifier (IRRID)
DERR1-10.2196/21734
Mining Electronic Health Records to Promote the Reach of Digital Interventions for Cancer Prevention Through Proactive Electronic Outreach: Protocol for the Mixed Methods OptiMine Study
Authors: Amato Michael S , El-Toukhy Sherine , Abroms Lorien C , Goodfellow Henry , Ramsey Alex T , Brown Tracey , Jopling Helena , Khadjesari Zarnie 
Published: November 2020

Background
Digital behavior change interventions have demonstrated effectiveness for smoking cessation and reducing alcohol intake, which ultimately reduce cancer risk. Leveraging electronic health records (EHR) to identify at-risk patients and increasing the reach of digital interventions through proactive electronic outreach provide a novel approach that may increase the number of individuals who engage with evidence-based treatment.

Objective
This study aims to increase the reach of digital behavior change interventions by implementing a proactive electronic message system for smoking cessation and alcohol reduction among a large, at-risk population identified through an acute hospital EHR.

Methods
This protocol describes a 3-phase, mixed-methods implementation study to assess the acceptability, feasibility, and reach of a proactive electronic message system to digital interventions using a hospital’s EHR system to identify eligible patients. In Phase 1, we will conduct focus group discussions with patients and hospital staff to assess the overall acceptability of the electronic message system. In Phase 2, we will conduct a descriptive analysis of the patient population in the hospital EHR regarding target risk behaviors and other person-level characteristics to determine the project’s feasibility and potential reach. In Phase 3, we will send proactive messages to patients identified as smokers or risky drinkers. Messages will encourage and provide access to behavior change mobile apps via an embedded link; the primary outcome will be the proportion of participants who click on the link to access information about the apps.

Results
At the time of initial protocol submission, data collection was complete, but analysis had not begun. This study was funded by Cancer Research UK from April 2019 to March 2020. Health Research Authority approval was granted in June 2019.

Conclusions
Increasing the reach of digital behavior change interventions can improve population health by reducing the burden of preventable death and disease.

International Registered Report Identifier (IRRID)
DERR1-10.2196/23669
The Current State and Diagnostic Accuracy of Digital Mental Health Assessment Tools for Psychiatric Disorders: Protocol for a Systematic Review and Meta-analysis
Authors: Martin-Key Nayra A , Schei Thea S , Barker Eleanor J , Spadaro Benedetta , Funnell Erin , Benacek Jiri , Tomasik Jakub , Bahn Sabine 
Published: November 2020

Background
Despite the rapidly growing number of digital assessment tools for screening and diagnosing mental health disorders, little is known about their diagnostic accuracy.

Objective
The purpose of this systematic review and meta-analysis is to establish the diagnostic accuracy of question- and answer-based digital assessment tools for diagnosing a range of highly prevalent psychiatric conditions in the adult population.

Methods
The Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) will be used. The focus of the systematic review is guided by the population, intervention, comparator, and outcome framework (PICO). We will conduct a comprehensive systematic literature search of MEDLINE, PsychINFO, Embase, Web of Science Core Collection, Cochrane Library, Applied Social Sciences Index and Abstracts (ASSIA), and Cumulative Index to Nursing and Allied Health Literature (CINAHL) for appropriate articles published from January 1, 2005. Two authors will independently screen the titles and abstracts of identified references and select studies according to the eligibility criteria. Any inconsistencies will be discussed and resolved. The two authors will then extract data into a standardized form. Risk of bias will be assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool, and a descriptive analysis and meta-analysis will summarize the diagnostic accuracy of the identified digital assessment tools.

Results
The systematic review and meta-analysis commenced in November 2020, with findings expected by May 2021.

Conclusions
This systematic review and meta-analysis will summarize the diagnostic accuracy of question- and answer-based digital assessment tools. It will identify implications for clinical practice, areas for improvement, and directions for future research.

Trial Registration
PROSPERO International Prospective Register of Systematic Reviews CRD42020214724; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020214724.

International Registered Report Identifier (IRRID)
DERR1-10.2196/25382