Telling stories about European Union Health Law: The emergence of a new field of law

The ideational narrative power of law has now solidified, and continues to solidify, ‘European Union health law’, into an entity with a distinctive legal identity. EU health law was previously seen as either non-existent, or so broad as to be meaningless, or as existing only in relations between EU law and health (the ‘and’ approach), or as consisting of a body of barely or loosely connected policy domains (the ‘patchwork’ approach). The process of bringing EU health law into being is a process of narration. The ways in which EU health law is narrated (and continues to be narrated) involve three main groups of actors: the legislature, courts and the academy

Correlating pore size and shape to local disorder in microporous carbon A combined small angle neutron and X ray scattering study

We present a model free analysis of the structure of a microporous carbon Kynol fiber cloth with neutrons SANS and X rays SAXS . SANS with contrast matching is used to analyze the accessible pores. It is shown that the SAXS and the SANS intensities agree after correction of the SANS specific background. Moreover, we analyze the scattering contribution due to the finite size and the bending of the carbon sheets. This contribution that scales with q 2 at high q values q magnitude of scattering vector is subtracted and the remaining intensity that exhibits a q 4 final slope gives the specific inner surface 1090 m2 g and the porosity 29 with excellent precision. The spatial distribution of the pores is analyzed in terms of the chord length distribution g r . This distribution has its maximum below 1 nm and a finite intercept g 0 that indicates pores with sharp edges. The analysis gives furthermore the number and weight average chord length. Finally, a parameter characterizing the degree of disorder of the carbonaceous structure introduced by Ruland was determined. Its value 25 indicates a rather disordered structure that is visualized in terms of a detailed model. The entire analysis shows the power of small angle scattering for a detailed analysis of microporous structure

Poly ionic liquid derived nanoporous carbon analyzed by combination of gas physisorption and small angle neutron scattering

The preparation of nanoporous carbon materials and their characterization combining small angle neutron scattering SANS with gas physisorption is presented. Carbon with a porous structure and tunable form is obtained here by a salt templating approach using poly ionic liquid as precursor. SANS in combination with contrast matching by deuterated p xylene was used for a separation of the scattering component deriving from the density fluctuations of the carbon matrix and the inaccessible porosity. The resulting scattering curves could be used for an unambiguous characterization of the pore structure of the materials. SANS curves measured at different partial pressure of the matching agent p xylene were used for a differential filling of the micro and mesopores. The analysis using the chord length distribution CLD was employed to determine the specific surface area and the pore size at different adsorption steps. The SANS results were in good agreement with the quenched solid density functional theory QSDFT analysis of the nitrogen physisorption. By the comparison of both characterization methods the pore shape could be determined. The combination of both SANS and gas physisorption is thus shown to provide a comprehensive characterization of the pore structure of the carbon monoliths throughout the entire pertinent length scal

Qualification Test System for Radiation Detection Devices QuTeSt

Measurement equipment for the detection and identification of radioactive and nuclear (RN) material has a wide application area. The main application aspects are monitoring, search, and identification. A common goal is to gain reliable measurement results. In the past, the only way to assess the performance of a measuring device was to rely on the data given by the manufacturer of the device itself. Reliable test results from an independent third party are more than welcome. These tests can be performed against consensus standards in order to have reproducible test results, independent of the testing location and the performing laboratory. Fraunhofer INT has conceived and built a test environment to perform dynamic and static test measurements using neutron and gamma sources. Tests can be performed in accordance with the IEC and ANSI standards as well as the ITRAP+10 test procedures. This includes qualification tests of truck portal monitors with the dynamic test system. Generally, the effects of one test parameter on other test parameters are not considered in the test procedures. For example, the accuracy of the dose rate may depend on the energy range of the radioactive source used. Besides the overview of the test systems the paper will address restrictions, problems and limitations of the possible qualification measurements as well as potential limitations arising from the given test procedures themselves

Separating the wheat from the chaff—COVID-19 in a German emergency department: a case-control study

Background!#!COVID-19 pandemia is a major challenge to worldwide health care systems. Whereas the majority of disease presents with mild symptoms that can be treated as outpatients, severely ill COVID-19 patients and patients presenting with similar symptoms cross their ways in the emergency department. Especially, the variety of symptoms is challenging with primary triage. Are there parameters to distinguish between proven COVID-19 and without before? How can a safe and efficient management of these inpatients be achieved?!##!Methods!#!We conducted a retrospective analysis of 314 consecutive inpatient patients who presented with possible symptoms of COVID-19 in a German emergency department between March and April 2020 and were tested with a SARS-Cov-2 nasopharyngeal swab. Clinical parameters, Manchester Triage System categories, and lab results were compared between patients with positive and negative test results for SARS-Cov-2. Furthermore, we present the existing COVID-19 workflow model of the university hospital in Essen which proved to be efficient during pandemia.!##!Results!#!Forty-three of the 314 patients (13.7%) were tested positive for COVID-19 by SARS-Cov-2 nasopharyngeal swab. We did not find any laboratory parameter to distinguish safely between patients with COVID-19 and those with similar symptoms. Dysgeusia was the only clinical symptom that was significantly more frequent among COVID-19 patients.!##!Conclusion!#!Dysgeusia seems to be a typical symptom for COVID-19, which occurred in 14% of our COVID-19 patients. However, no valid parameters could be found to distinguish clinically between COVID-19 and other diseases with similar symptoms. Therefore, early testing, a strict isolation policy, and proper personal protection are crucial to maintain workflow and safety of patients and ED staff for the months to come.!##!Trial registration!#!German Clinical Trials registry, DRKS00021675

The role of neuromuscular ultrasound in diagnostics of peripheral neuropathies induced by cytostatic agents or immunotherapies

Abstract A relevant number of cancer patients who receive potentially neurotoxic cytostatic agents develop a chemotherapy-induced peripheral neuropathy over time. Moreover, the increasing use of immunotherapies and targeted agents leads to a raising awareness of treatment-associated peripheral neurotoxicity, e.g., axonal and demyelinating neuropathies such as Guillain–Barré-like syndromes. To date, the differentiation of these phenomena from concurrent neurological co-morbidities or (para-)neoplastic nerve affection as well as their longitudinal monitoring remain challenging. Neuromuscular ultrasound (NMUS) is an established diagnostic tool for peripheral neuropathies. Performed by specialized neurologists, it completes clinical and neurophysiological diagnostics especially in differentiation of axonal and demyelinating neuropathies. No generally approved biomarkers of treatment-induced peripheral neurotoxicity have been established so far. NMUS might significantly extend the repertoire of diagnostic and neuromonitoring methods in this growing patient group in short term. In this article, we present enlargements of the dorsal roots both in cytostatic and in immunotherapy-induced neurotoxicity for the first time. We discuss related literature regarding new integrative applications of NMUS for cancer patients by reference to two representative case studies. Moreover, we demonstrate the integration of NMUS in a diagnostic algorithm for suspected peripheral neurotoxicity independently of a certain cancer treatment regimen emphasizing the emerging potential of NMUS for clinical routine in this interdisciplinary field and prospective clinical trials

What about the others: differential diagnosis of COVID-19 in a German emergency department

Background!#!The ongoing COVID-19 pandemic remains a major challenge for worldwide health care systems and in particular emergency medicine. An early and safe triage in the emergency department (ED) is especially crucial for proper therapy. Clinical symptoms of COVID-19 comprise those of many common diseases; thus, differential diagnosis remains challenging.!##!Method!#!We performed a retrospective study of 314 ED patients presenting with conceivable COVID-19 symptoms during the first wave in Germany. All were tested for COVID-19 with SARS-Cov-2-nasopharyngeal swabs. Forty-seven patients were positive. We analyzed the 267 COVID-19 negative patients for their main diagnosis and compared COVID-19 patients with COVID-19 negative respiratory infections for differences in laboratory parameters, symptoms, and vital signs.!##!Results!#!Among the 267 COVID-19 negative patients, 42.7% had respiratory, 14.2% had other infectious, and 11.2% had cardiovascular diseases. Further, 9.0% and 6.7% had oncological and gastroenterological diagnoses, respectively. Compared to COVID-19 negative airway infections, COVID-19 patients showed less dyspnea (OR 0.440; p = 0.024) but more dysgeusia (OR 7.631; p = 0.005). Their hospital stay was significantly longer (9.0 vs. 5.6 days; p = 0.014), and their mortality significantly higher (OR 3.979; p = 0.014).!##!Conclusion!#!For many common ED diagnoses, COVID-19 should be considered a differential diagnosis. COVID-19 cannot be distinguished from COVID-19 negative respiratory infections by clinical signs, symptoms, or laboratory results. When hospitalization is necessary, the clinical course of COVID-19 airway infections seems to be more severe compared to other respiratory infections.!##!Trial registration!#!German Clinical Trial Registry DRKS, DRKS-ID of the study: DRKS00021675 date of registration: May 8th, 2020, retrospectively registered

Additional file 1 of The role of neuromuscular ultrasound in diagnostics of peripheral neuropathies induced by cytostatic agents or immunotherapies

Additional file 1. Table S1: Detailed NMUS measurements of the presented patients