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While philosophy has been defined as a critical endeavour since Plato, the critical potential of rhetoric has been mostly overlooked. In recent years, critique itself – as a means of enlightenment and emancipation – has come under attack. While there have been various attempts to renew and strengthen critical theory and practice, rhetoric has not yet played a part in these attempts. Addressing this lacuna, the article argues that rhetoric can function as a critical force within philosophy. The rhetorical perspective confronts the claim to rational discourse and universal knowledge with the contingency of philosophical languages, means of representation, and social practices. Moreover, it allows us to think of critique as an activity of a subject that is at the same time constituted and transformed by it. This opens up the possibility of a rhetorical philosophizing that meets its critical standards by taking into account both the conditions of its own speaking and what it must exclude as its ‘other’ in order to function.

Contrary demands like a reduction of carbon dioxide emissions and an increase in functionality are facing the manufacturing industry with growing challenges. When processing functional components, like synchronizer rings, conventional process chains, like shearing and subsequent joining, are reaching their limits due to an increased complexity of the components and a lack in efficiency, referring to the long process time. To meet these challenges, the strategy of lightweight construction combines the application of lightweight materials with efficient manufacturing processes and an innovative product design. One possibility within lightweight construction is the utilization of load-adapted hybrid components, featuring different material strength classes. In previous research, the process of orbital forming is used to manufacture semi-finished products with a varying thickness profile due to the specific radial material flow. This material flow should now be used to realize a permanent joint between materials of two different strength levels. Therefore, the process of orbital forming is modified to manufacture hybrid semi-finished products from a dual-phase steel DP600 and a naturally rigid aluminum alloy EN AW 5754, both with an initial thickness of 2.0 mm. Different joint geometries are cut by laser into a steel ring and the part is coaxially positioned around a basic aluminum disc inside a die and subsequently formed. The joint is investigated regarding the geometrical and mechanical properties, comparing a radial cross-section and the micro hardness distribution. In order to reveal the potential of orbital forming for a combined forming and joining operation, the axial as well as the peeling strength of the multi-material components are investigated and evaluated.

Conventional processes like shearing dispose a lack in efficiency and formability to manufacture functional components with a high geometric variety. A possibility to allow the efficient and sustainable manufacturing is the application of innovative forming operations like orbital forming. Thus, a strain-hardened component with a load-adapted thickness profile can be manufactured in a single-stage process. Thereby, the control of the material flow could be identified as major challenge due to the three-dimensional stress and strain state. In order to reduce the parts weight and simultaneously guarantee the same level of performance, conventional steel is substituted by lightweight materials such as precipitation hardenable aluminum alloys. However, new challenges arise due to the reduced formability of aluminum compared to conventional steel. In recent research, the potential of a short-term heat treatment to enlarge the formability could be shown. The presented process locally reduces the materials strength, thus allowing a control of the material flow by the interaction between softened areas and areas, which offer the initial conditions. In this contribution, the influence on the formability of orbital formed components manufactured out of the precipitation hardenable aluminum alloy EN AW 6016 by a local short-term heat treatment is investigated. Different geometry-based heat treatment layouts are applied in order to maximize the thickening on different radial positions. The potential to enhance the formability is evaluated by comparing geometrical and mechanical properties of the components manufactured in the conventional process route and with a previous heat treatment. The analysis of radial cross-sections and the hardness distribution reveals the positive influence of the heat treatment but also points out the geometrical dependency of the effect due to the characteristic material flow in orbital forming.

Nowadays, the manufacturing industry faces opposing challenges like a reduction of carbon dioxide on the one hand and on the other hand an increasing weight due to higher safety standards and additional functions. Concepts like lightweight design and functional integration are essential to ensure a sustainable and individual mobility. Gear systems consist of multi-functional parts with a varying sheet thickness and different geometric elements. Since conventional manufacturing processes like shearing are reaching their limits due to complexity and a lack in efficiency, the application of Tailored Blanks is a promising approach to meet these requirements. Manufactured by orbital forming, these process-adapted blanks dispose a high material efficiency. A tumbling motion of the upper punch enables the material distribution, realizing functional components with different material thickenings. The substitution of steel by aluminum is a common approach to meet the demands of lightweight construction. However, the use of aluminum results in a decreased formability at a constant level of strength. In order to enhance the local forming limits, a short-term heat treatment can be applied, reducing the materials’ strength, whereas the untreated areas still offer the initial properties. To transfer the results of fundamental research in Sheet-Bulk Metal Forming with conventional steel to the use of lightweight material, the precipitation hardenable aluminum alloy EN AW 6016 is investigated in an orbital forming process. Since the formability of aluminum is limited and the material flow during the process is three-dimensional, different heat treatment strategies are applied to a rotational-symmetric Tailored Blank and the resulting components are investigated regarding their geometry and mechanical properties. To increase the geometric complexity with regard to an industrial application, the transferability to a cyclic-symmetric layout is analyzed. To evaluate the potential of the heat treatment, the treated components are compared to Tailored Blanks manufactured without heat treatment.

Background and Purpose— Many patients with acute ischemic stroke are not eligible for thrombolysis or mechanical reperfusion therapies due to contraindications, inaccessible vascular occlusions, late presentation, or large infarct core. Sphenopalatine ganglion (SPG) stimulation to enhance collateral flow and stabilize the blood-brain barrier offers an alternative, potentially more widely deliverable, therapy. Methods— In a randomized, sham-controlled, double-masked trial at 41 centers in 7 countries, patients with anterior circulation ischemic stroke not treated with reperfusion therapies within 24 hours of onset were randomly allocated to active SPG stimulation or sham control. The primary efficacy outcome was improvement beyond expectations on the modified Rankin Scale of global disability at 90 days (sliding dichotomy), assessed in the modified intention-to-treat population. The initial planned sample size was 660 patients, but the trial was stopped early when technical improvements in device placement occurred, so that analysis of accumulated experience could be conducted to inform a successor trial. Results— Among 303 enrolled patients, 253 received at least one active SPG or sham stimulation, constituting the modified intention-to-treat population (153 SPG stimulation and 100 sham control). Age was median 73 years (interquartile range, 64–79), 52.6% were female, deficit severity on the National Institutes of Health Stroke Scale was median 11 (interquartile range, 9–15), and time from last known well median 18.6 hours (interquartile range, 14.5–22.5). For the primary outcome, improved 3-month disability beyond expectations, rates in the SPG versus sham treatment groups were 49.7% versus 40.0%; odds ratio, 1.48 (95% CI, 0.89–2.47); P =0.13. A significant treatment interaction with stroke location (cortical versus noncortical) was noted, P =0.04. In the 87 patients with confirmed cortical involvement, rates of improvement beyond expectations were 50.0% versus 27.0%; odds ratio, 2.70 (95% CI, 1.08–6.73); P =0.03. Similar response patterns were observed for all prespecified secondary efficacy outcomes. No differences in mortality or serious adverse event safety end points were observed. Conclusions— SPG stimulation within 24 hours of onset is safe in acute ischemic stroke. SPG stimulation was not shown to statistically significantly improve 3-month disability above expectations, though favorable outcomes were nominally higher with SPG stimulation. Beneficial effects may distinctively be conferred in patients with confirmed cortical involvement. The results of this study need to be confirmed in a larger pivotal study. Clinical Trial Registration— URL: https://www.clinicaltrials.gov . Unique identifier: NCT03767192.

The efficient process of orbital forming can be used to manufacture functional components with a varying sheet thickness profile. It is characterized by a tumbling movement of the die and counterpunch, thus reducing the contact area between work piece and tool as well as the maximum forming force significantly. Within the project A1 of the Transregional Collaborative Research Centre (TCRC 73), the process of orbital forming has been investigated fundamentally. The control of the material flow to increase the maximum form filling could be identified as major challenge. The objective of this transfer project is the enlargement of the forming limits in comparison to conventional orbital forming by developing and applying tailor-made process and heat treatment strategies for industrial relevant steel and aluminum alloys. For the purpose of a transfer to industrial application, a demonstrator geometry with a varying sheet thickness profile is defined. Main aspects of the investigation are the resulting geometrical and mechanical properties and the possibility to enlarge the forming limits. The final geometric shape is realized by applying different cutting operations. An industrial application is evaluated by assembling the demonstrator to a near-series clutch disc and analyzing the functional behavior.

Der Beitrag geht exemplarisch der Frage nach, welchen substantiellen Beitrag die Philosophie zum Verstandnis des Geldes leisten kann, der sich einerseits nicht in kulturkritischen Invektiven erschopft, und der andererseits uber die Ergebnisse von Einzelwissenschaften hinausgeht. Einstellungen der antiken Philosophie zum Geld, die durch mehrfache Frontstellung gegen das Geld charakterisiert sind, so argumentiert Hetzel, finden ihr Echo in einer ganzen Reihe von Versuchen, den Wahrheitsbezug der Philosophie von okonomischen Nutzlichkeitserwagungen nicht nur zu trennen, sondern Geldwert und Wahrheitsgeltung als ein Verhaltnis wechselseitigen Ausschlusses zu denken. Bei Aristoteles ist Geld nur ein Mittel fur andere Zwecke und deswegen konnen nur Lust, Ehre und Wahrheit als Endziele des Menschen aufgefasst werden, nicht aber das Streben nach einem blosen Mittel. Geld verfuge bei Aristoteles jedoch uber die Kraft, alle anderen Guter in Mittel zur Vermehrung des Geldes zu verwandeln und damit zu entsubstantialisieren. Die Philosophie der Neuzeit schliese sich der antiken Skepsis in Bezug auf das Geld an, so Hetzel. Von Jean-Jacques Rousseau bis Karl Marx und Friedrich Nietzsche wird dabei immer wieder die Tendenz des Geldes kritisiert, sich in alle Selbst- und Weltverhaltnisse einzuschreiben, alle Wahrheiten und Werte zu entwerten. Georg Simmels Philosophie des Geldes als Medientheorie nutzt methodisch die von Marx propagierte Verwechslung und Vertauschung aller Dinge, fur die Geld verantwortlich gemacht wird. In einem zweiten Abschnitt setzt sich Hetzel dann mit jenen Theorien auseinander, die nicht bereit sind, der Diagnose von Marx und Simmel zu folgen und stellt dabei die Theorie von Marcel Mauss zur Gabe, die gerade nicht mit der Forderung einer Bezahlung oder Gegengabe einhergeht, in den Mittelpunkt. In Jacques Derridas Mauss-Rezeption bleibt die Gabe im Rahmen der Okonomie auf die Moglichkeit einer Gegengabe bezogen. Wir sind, so Derridas Beobachtung, immer schon eingelassen in eine wirtschaftliche, libidinose und semiotische Gabenokonomie, in einen geldformigen Zyklus des Gebens und Empfangens. Der Beitrag endet mit der Forderung nach einer kritischen Sozialphilosophie, die nicht vorschnell ein Bild universeller und irreversibler Monetarisierung unserer Weltverhaltnisse zeichnet.

To assess the usefulness of transcranial Doppler CO2 reactivity (CO2R) for prediction of ipsilateral ischemic stroke in carotid artery stenosis and occlusion with a meta-analysis of prospective studies based on individual patient data.We searched Medline, Biosis Previews, Science Citation Index, The Cochrane Library, and EMBASE for studies in which patients with severe carotid artery stenosis or occlusion underwent Doppler CO2R testing (inhalation of CO2 or breath-holding) and were prospectively followed for ipsilateral ischemic stroke. Individual data from 754 patients from 9 studies were included. We used percentage cerebral blood flow velocity increase (pCi) during hypercapnia as the primary CO2R measure, and defined impaired reactivity as pCi20% increase.In a multiple regression model, impaired CO2R was independently associated with an increased risk of ipsilateral ischemic stroke (hazard ratio [HR] 3.69; confidence interval [CI] 2.01, 6.77; p0.0001). Risk prediction was similar for recently symptomatic vs asymptomatic patients. Using continuous values of pCi, a significant association between decreasing pCi and increasing risk of ipsilateral stroke was found: HR of 1.64 (95% CI 1.33, 2.02; p0.0001) per 10% decrease in pCi. For patients with asymptomatic internal carotid artery stenosis only (n = 330), a comparable stroke risk prediction was found: increasing HR 1.95 (95% CI 1.26, 3.04; p = 0.003) per 10% decrease in pCi.This analysis supports the usefulness of CO2R in risk prediction for patients with severe carotid artery stenosis or occlusion, both in recently symptomatic and asymptomatic patients. Further studies should evaluate whether treatment strategies in asymptomatic patients based on CO2R could improve patient outcomes.

In my paper I reconstruct J. Shklar’s arguments against legalistic positions which try to reduce the moral point of view to a model of legitimizing and applying rules. I emphasize in particular the relevance of her arguments for current metaethical debates. The paper shows that Shklar’s thought comes close to some arguments of S. Cavell, who locates the problem of how to define the relation between a rule and a case at the very center of ethical reflection. Finally I discuss how Shklar’s scepticism about any objective moral point of view corresponds with two other negativistic motives of her philosophy: a) her accusation that traditional theories of justice make invisible the perspective of the victims of injustice, and b) her thesis that injustice cannot be reduced to “a prelude, a rejection, and a collapse of justice.”

Post-traumatic growth (PTG) is the experience of positive changes that can follow a traumatic event. The current study examined the factorial as well as the discriminant validity of the German version of the Post-traumatic Growth Inventory (PTGI-G) in stroke patients. A total of 188 adult stroke patients (63.3% male; median age 69 years) completed the PTGI-G and the German version of the Hospital Anxiety and Depression Scale (HADS-D) at the end of their inpatient rehabilitation. Confirmatory factor analyses indicate an acceptable model fit of both the original five-factor solution as well as a second-order factor model of the PTGI-G (CFI > .95; RMSEA < .01). Small and non-significant correlations between the PTGI-G subscales and the depression scale of the HADS-D support the discriminant validity of the PTGI-G. The PTGI-G appears to be a valid tool in the context of stroke research.

In our paper we discuss the political aesthetics of Jacques Rancière, specially his writings on the documentaries of the French director Chris Marker. In a first section we give an introduction to Rancière’s political philosophy, which explains political acts in terms of seizing the word by those who have no share in our societies. Such a seizing of words reconfigures the discursive regimes that decide who can say what and under what conditions publicly. In a second section we will show how Rancière’s aesthetical writings discuss works of art in a similar way as agents of a transfiguration of orders of visibility or sight. This becomes clear, as our third section will argue, in Rancière’s film aesthetics, especially in his essays on Chris Marker. Markers movies (for instance Le Tombeau d'Alexandre) focus on and at the same time complicate the boundaries between documentary and fiction; they allow us to understand a reality which is supposedly without alternatives as a result of human practice which always can be changed.

Introduction: Identifying factors associated with short term outcome following carotid endarterectomy (CEA) is important to improve patient selection. There are limited data assessing 30-day major adverse cardiac and cerebrovascular events (MACCE: stroke, myocardial infarction (MI) and death) in clinical practice. Hypothesis: We hypothesized that patients fulfilling SAPPHIRE high risk (SHR) or exclusion (SEC) criteria contribute to worse outcomes in a real-life cohort. Methods: Patients undergoing CEA at 2 centers between 1998 and 2010 were prospectively entered into a database. Baseline characteristics, comorbidities, SHR and SEC were assessed using Cox regression to determine predictors for the MACCE 30-day endpoint. Results: The analysis included 748 operations, 262 (35%) asymptomatic , 211 (28%) with previous strokes, and 278 (37%) with transient ischemic attacks (TIA). The overall MACCE rate was 6.7%, 5.0% of asymptomatic and 7.6% in symptomatic patients. SEC patients (n=137) had a MACCE rate of 14.7%; after exclusion, the MACCE rate of the remainder dropped to 4.9% (3.5% in asymptomatic and 5.4% in symptomatic patients). Hazard ratio (HR) for SEC was 3.605 (p=0.0001) after adjustment for symptomatic status. SHR patients did not show a significantly increased event rate (HR 1.714, p=0.16). In multivariate analysis diabetes (HR 2.019, p=0.02), symptomatic status (HR 2.015, p=0.049) and prior MI (HR 1.957, p=0.03) showed an independent influence on MACCE. Conclusion: High risk clinical characteristics, as defined by the SAPPHIRE study were not independently associated with 30-day increased risk of MACCE, although exclusion criteria from that study, diabetes, symptomatic status and prior MI were associated with outcomes.