Berufsrecht der Tierärzte in Europa

Im Jahre 2013 führte das im Jahr zuvor gegründete Europäische Zentrum für Freie Berufe der Universität zu Köln (EuZFB) eine EU-weite Umfrage unter Ministerien, Berufskammern und –verbänden zum Zwecke einer Bestandsaufnahme der Regulierung der Freien Berufe und ihrer ökonomischen Auswirkungen durch. Die Auswertung der Ergebnisse der Umfrage sowie die Forschungstätigkeit erlauben zum jetzigen Zeitpunkt bereits einen guten Überblick über die Regulierung der Freien Berufe in den EU-Mitgliedstaaten. Die gewonnenen Erkenntnisse sind ein wichtiger Ausgangspunkt für die weitere Forschung und zukünftige Projekte des EuZFB. In diesem Zusammenhang wurde neben anderen Freien Berufen auch die Regulierung der Tierärzte in der EU untersucht, die nun im Folgenden dargestellt wird. Die Ergebnisse beruhen weitgehend auf der vom EuZFB durchgeführten Umfrage. Da in diesem Rahmen häufig keine oder nur widersprüchliche bzw. unklare Angaben gemacht wurden, liegen derzeit noch nicht alle Informationen zu allen Fragen und EU-Staaten vor. Damit ist der Bericht nicht abschließend, sondern fasst vor allem die bisher gewonnenen Erkenntnisse zusammen

Berufsrecht der Apotheker in Europa

Im Jahre 2013 führte das bereits im Jahr zuvor gegründete Europäische Zentrum für Freie Berufe der Universität zu Köln (EuZFB) eine EU-weite Umfrage unter Ministerien, Berufskammern und –verbänden zum Zwecke einer Bestandsaufnahme der Regulierung der Freien Berufe und ihrer ökonomischen Auswirkungen durch. Die Auswertung der Ergebnisse der Umfrage sowie die Forschungstätigkeit erlaubt zum jetzigen Zeitpunkt bereits einen guten Überblick über die Regulierung der Freien Berufe in den EU-Mitgliedstaaten. Diese Feststellungen sind ein erster Schritt im Rahmen der Forschungstätigkeit des EuZFB, an den sich weitere Forschungen und Projekte anschließen werden

Direct oral anticoagulant drug level testing in clinical practice: A single institution experience

We performed a review of all direct oral anticoagulant (DOAC) levels – ecarin times for dabigatran and anti-Xa levels for rivaroxaban and apixaban – ordered at our institution with the purpose of evaluating DOAC levels from “real-world” (non-clinical trial) patients taking DOACs long-term, in order to assess levels obtained, reasons for checking levels, and actions taken based on the testing result. A total of 28 patients had 48 levels sent over a 36-month period. The majority of outpatient levels were within or close to the range of published values. The setting in which levels were sent influenced how results affected management decisions: in the outpatient setting, the majority of levels served to reassure clinicians that DOAC levels were within expected ranges resulting in continuation of chosen management, whereas in the inpatient setting, DOAC levels were used most frequently to detect DOAC presence in urgent clinical situations and influenced clinical decision-making in the peri-procedural and pre-operative periods. Our results demonstrate that while testing may be useful if immediately available in urgent clinical situations where assessment of drug presence is needed, DOAC level monitoring is infrequently used overall, and the lack of use combined with the paucity of available evidence to guide clinical decision-making based on the results suggests there is little urgency to make the tests widely available for routine use outside of acute settings in the emergency department and urgent surgical setting

Utilizing Dual Information for Moving Target Search Trajectory Optimization

Various recent events have shown the enormous importance of maritime search-and-rescue missions. By reducing the time to find floating victims at sea, the number of casualties can be reduced. A major improvement can be achieved by employing autonomous aerial systems for autonomous search missions, allowed by the recent rise in technological development. In this context, the need for efficient search trajectory planning methods arises. The objective is to maximize the probability of detecting the target at a certain time k, which depends on the estimation of the position of the target. For stationary target search, this is a function of the observation at time k. When considering the target movement, this is a function of all previous observations up until time k. This is the main difficulty arising in solving moving target search problems when the duration of the search mission increases. We present an intermediate result for the single searcher single target case towards an efficient algorithm for longer missions with multiple aerial vehicles. Our primary aim in the development of this algorithm is to disconnect the networks of the target and platform, which we have achieved by applying Benders decomposition. Consequently, we solve two much smaller problems sequentially in iterations. Between the problems, primal and dual information is exchanged. To the best of our knowledge, this is the first approach utilizing dual information within the category of moving target search problems. We show the applicability in computational experiments and provide an analysis of the results. Furthermore, we propose well-founded improvements for further research towards solving real-life instances with multiple searchers

Tumor necrosis factor-α\alpha in combination with interferon-γ\gamma, but not with interleukin 4 activates murine macrophages for elimination of Leishmania major amastigotes

We have previously shown that during an infection with Leishmania major, susceptible BALB/c mice, as opposed to mice of a resistant strain (C57BLl6), are primed by lipopolysaccharide for the production of high levels of tumor necrosis factor-$\alpha$ (TNF-$\alpha$) which is known to be a potent maerophage M$\Phi$ stimulator in other parasitic diseases. In the present study we investigated whether TNF-$\alpha$ activates M$\Phi$ for killing of L. major parasites. In the absence of interferon-y (IFN-$\gamma$) or lipopolysaccharide, TNF-$\alpha$ (0.025-25000 U/ml) failed to activate peritoneal exudate M$\Phi$ from BALB/c mice for killling of L. major amastigotes. In the presence of suboptimal doses of IFN-$\gamma$ (5 or 10 Vlml), however, TNF-$\alpha$ mediated a rapid elimination of intracellular parasites, which was highly significant compared to IFN-$\gamma$ alone. Tbe combination of TNF with interleukin 4, in contrast, was inactive in this respect and allowed survival of intracellular parasites. From these data we conelude that the presence of IFN-$\gamma$ is crucial for TNF-$\alpha$-mediated killing of L. major parasites by M$\Phi$. Disease progression in susceptible mice therefore seems to be a consequence of a deficiency of IFN-$\gamma$ and a predominance of interleukin 4 rather than the result of an excess amount of TNF-$\alpha$

Oral Anticoagulant Use After Bariatric Surgery: A Literature Review and Clinical Guidance

Abstract Bariatric surgery may alter the absorption, distribution, metabolism, or elimination (disposition) of orally administered drugs via changes to the gastrointestinal tract anatomy, body weight, and adipose tissue composition. As some patients who have undergone bariatric surgery will need therapeutic anticoagulation for various indications, appropriate knowledge is needed regarding anticoagulant drug disposition and resulting efficacy and safety in this population. We review general considerations about oral drug disposition in patients after bariatric surgery, as well as existing literature on oral anticoagulation after bariatric surgery. Overall, available evidence on therapeutic anticoagulation is very limited, and individual drug studies are necessary to learn how to safely and effectively use the direct oral anticoagulants. Given the sparsity of currently available data, it appears most prudent to use warfarin with international normalized ratio monitoring, and not direct oral anticoagulants, when full-dose anticoagulation is needed after bariatric surgery