Rechtliche und ethische Aspekte grenzüberschreitender Gesundheitsversorgung innerhalb der Europäischen Union

Definition of the problem Patient mobility and cross-border healthcare are phenomena of daily healthcare practice within the EU. With the Directive “on the application of patients’ rights in cross-border healthcare”, the EU in 2011 issued a comprehensive regulatory framework. No inventory or systematic assessment of ethical issues in this context exists. Argumentative strategy The current legal situation of cross-border healthcare within the EU and its historic development are presented. Based on a patient typology focusing on different patient motivations for crossing the border to receive healthcare, ethical issues of cross-border healthcare within the EU are discussed. ConclusionThe possibility of crossing borders for receiving planned healthcare in the EU—which is under certain conditions also reimbursed by health insurance and national health service schemes—potentially increases the autonomy of some patients. However, especially when considered from a justice perspective that asks for real equal opportunities for everyone, many ethical issues are conceivable that are not sufficiently studied or considered in the policy making process.     

EXTRACTION OF MOLYBDENUM(VI) BY PRIMENE JMT

ABSTRACT

Distribution of molybdenum (VI) between aqueous sulfuric acid solution and an organic solution containing Primene JMT has been studied.

The aqueous solutions consist of ammonium molybdate with acid concentration in a pH range 2 - 6.5, the concentration of amine in the organic phase being 0.1 mol/dm³ in benzene. The presence of various species in the aqueous phase is considered and the equilibrium composition of substances in the organic phase is determined. The extraction mechanism is discussed.     

Spray Drying of Mannitol as a Drug Carrier—The Impact of Process Parameters on Product Properties

Powders intended for the use in dry powder inhalers have to fulfill specific product properties, which must be closely controlled in order to ensure reproducible and efficient dosing. Spray drying is an ideal technique for the preparation of such powders for several reasons. The aim of this work was to investigate the influence of spray-drying process parameters on relevant product properties, namely, surface topography, size, breaking strength, and polymorphism of mannitol carrier particles intended for the use in dry powder inhalers. In order to address this question, a full-factorial design with four factors at two levels was used. The four factors were feed concentration (10 and 20% [w/w]), gas heater temperature (170 and 190°C), feed rate (10 and 20 L/h), and atomizer rotation speed (6,300 and 8,100 rpm). The liquid spray was carefully analyzed to better understand the dependence of the particle size of the final product on the former droplet size. High gas heater temperatures and low feed rates, corresponding to high outlet temperatures of the dryer (96–98°C), led to smoother particles with surfaces consisting of smaller crystals compared to those achieved at low outlet temperatures (74–75°C), due to lower gas heater temperatures and higher feed rates. A high solution concentration of the feed also resulted in the formation of comparably rougher surfaces than a low feed concentration. Spray-dried particles showed a volume-weighted mean particle size of 71.4–90.0 µm and narrow particle size distributions. The mean particle size was influenced by the atomizer rotation speed and feed concentration. Higher rotation speeds and lower feed concentrations resulted in smaller particles. Breaking strength of the dried particles was significantly influenced by gas heater temperature and feed rate. High gas heater temperatures increased the breaking strength, whereas high feed rates decreased it. No influence of the process parameters on the polymorphism was observed. All products were crystalline, consisting of at least 96.9% of mannitol crystal modification I.     

Diaminoterephthalate turn-on fluorescence probes for thiols--tagging of recoverin and tracking of its conformational change

Diaminoterephthalates with a maleimide moiety were synthesized and used as fluorescence dyes for sensing thiols. Whereas these "NiWa Blue" dyes showed no emission, the conjugate addition of a thiol to the maleimide group turned on a fluorescence at about 400 nm when irradiating the dye at 338 nm. The neuronal-calcium sensor protein recoverin possesses a single cysteine residue at position 39, which reacts with NiWa Blue, and is therefore labeled by a fluorophore with an emission at about 440 nm. In the absence of Ca(2+), irradiation at 280 nm of a tryptophan residue in close proximity to Cys-bound NiWa Blue lead to strong FRET, which was detected by emission of the dye at 440 nm. In the presence of Ca(2+), the protein holds a conformation with distal Trp and Cys residues, thus FRET of irradiated Trp to Cys-bound NiWa Blue was significantly weakened.     

Unmyelinated nerve fibers in senile nerves and in late thalidomide neuropathy: a quantitative electron microscopic study (author's transl)

Sural nerve biopsies of four patients, aged 54--76 years, with a predominantly sensory type of neuropathy following high dosages of thalidomide were examined by light and electron microscopy. The present study includes a qualitative and quantitative evaluation of unmyelinated nerve fibers. Despite severe neuropathy, increased numbers of small unmyelinated axons per endoneurial area were noted in all patients. This numerical increase appeared to be independent of aging, since it was not seen in two senile controls, studied at the age of 83 and 88 years. The increase in the endoneurial density of unmyelinated axons, especially of small sized fibers, is likely to be related to regeneration following degeneration of unmyelinated axons although endoneurial shrinkage secondary to loss of large myelinated fibers could have caused an additional increase in the number of axons per endoneurial area. Axonal sprouting, despite degeneration of large numbers of myelinated and unmyelinated fibers, appears to be consistent with some of the characteristic clinical features of thalidomide neuropathy such as paresthesias, hyperesthesia for pain and temperature, and disturbances of autonomic functions. On the other hand, a variable number of empty Schwann cells (bands of Büngner) and pockets at the surface of many Schwann cells noted in the four patients with neuropathy were also seen in both senile controls with no signs of neuropathy. Thus, it is obvious that pockets and empty Schwann cells may be related to aging or other causes of slow axonal wasting with Schwann cell proliferation and are not necessarily associated with clinically manifest neuropathy.     

Microbial fuel cells: methodology and technology

Microbial fuel cell (MFC) research is a rapidly evolving field that lacks established terminology and methods for the analysis of system performance. This makes it difficult for researchers to compare devices on an equivalent basis. The construction and analysis of MFCs requires knowledge of different scientific and engineering fields, ranging from microbiology and electrochemistry to materials and environmental engineering. Describing MFC systems therefore involves an understanding of these different scientific and engineering principles. In this paper, we provide a review of the different materials and methods used to construct MFCs, techniques used to analyze system performance, and recommendations on what information to include in MFC studies and the most useful ways to present results.     

Chemical investigation of eight different types of carbonaceous particles using thermoanalytical techniques

The chemical composition of ambient aerosol particles affects numerous important aerosol parameters such as their hygroscopicity, optics, and mass as well as their potentially adverse health effects. The objective of this study was to derive both detailed chemical speciation and useful proxies for the quantitative classification of the organic matter (OM) content of carbonaceous aerosol samples. Using three different thermal desorption techniques in an inert atmosphere we investigated eight different carbonaceous particulate matter (PM) samples used for health effect studies: thermal desorption gas chromatography with mass spectrometry, evolved gas analysis with mass spectrometry, and thermogravimetry with Fourier transform infrared spectroscopy. The samples include different types of laboratory-generated particles (pigment black, diffusion flame soot, spark-generated carbon) and two ambient aerosol samples (diesel soot and particulates collected in a road tunnel). All samples showed increasing mass desorption with rising temperature, but no reliable OM classification was possible based on thermal mass desorption alone. In fact, the "organic-free" spark-generated carbon particles showed the second highest mass desorption at 800 degrees C due to the formation of oxygenated structures on unsaturated surface sites and the subsequent evolution of CO and CO2 at elevated temperatures. A quantitative OM classification was accomplished by combining measurements of thermogravimetry and mass spectrometry (up to 800 degrees C) into a novel parameter, the "apparent organic mass fraction". The validity of this classification was confirmed with a second proxy parameter, based only on the evolution of organic components during thermal desorption and information on the generation process of the particles. Both types of pigment blacks (Printex) samples and the spark-generated carbon particles showed the lowest apparent organic mass fraction (< 5%), whereas for road tunnel and diesel emission particles < 16 and < 19% was estimated, respectively.