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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.

Participants in those protests that gave rise to the Arab Spring and to the Gezi-movement repeatedly mentioned a decisive moment for their public assembly: the breaking of the cycles of fear. In this chapter, Hetzel explores the role of fear in the affective economy of subjectivation and indicates why and under which conditions the breaking of a cycle of fear may be regarded as a political event. For this purpose, Hetzel draws on concepts of an exodus-politics, as it has been outlined in Walzer’s and in Virno’s respective accounts of the biblical exodus-myth. For both authors the exodus designates a ‘presentic’, inner-worldly eschatology, which focuses on acts of in-subordination that generate a political subject, which is associated by confidence and not by fear anymore.

Summary Cerebral autoregulation is particularly challenged in acute ischemic stroke. In this review we summarize the data of our previous studies on autoregulation regarding the effect of rtPA on autoregulation after stroke. A pooled analysis of two studies (45 patients) has shown a worsening of the autoregulatory index Mx between an early (first 48 h) and late (days 5–7) measurement. This increase was more pronounced on affected sides than on unaffected sides. Poor ipsilateral Mx was associated with a greater volume of MCA infarction at a late measurement and related to poor clinical outcome. Overall, autoregulatory impairment tends to increase mainly in large infarction and generalize to the contralateral side during the first days after ischemic stroke. As a limitation, transcranial Doppler sonography does not allow to detect focal areas of dysautoregulation in smaller strokes. To better understand the temporal and spatial dynamics of dysautoregulation in acute stroke in relation to the type and size of infarction, new bedside hemodynamic monitoring techniques (like multi-channel near-infrared spectroscopy) are needed.

The controversy as to whether Doppler ultrasonic methods should play a role in clinical decision-making in the prevention of stroke is attributable to reported disagreement between angiographic and ultrasonic results and the lack of internationally accepted ultrasound criteria for describing the degree of stenosis. Foremost among the explanations for both is the broad scatter of peak systolic velocities in the stenosis, the criterion that has so far received most attention. Grading based on a set of main and additional criteria can overcome diagnostic errors. Morphological measurements (B-mode images and color flow imaging) are the main criteria for low and moderate degrees of stenosis. Increased velocities in the stenosis indicate narrowing, but the appearance of collateral flow and decreased poststenotic flow velocity prove a high degree stenosis (≥70%), additionally allowing the estimation of the hemodynamic effect in the category of high-degree stenosis. Additional criteria refer to the effect of a stenosis on prestenotic flow (common carotid artery), the extent of poststenotic flow disturbances, and derived velocity criteria (diastolic peak velocity and the carotid ratio). This multiparametric approach is intended to increase the reliability and the standard of reporting of ultrasonic results for arteriosclerotic disease of the carotid artery.

This article shows how Jürgen Habermas and Claude Lefort try to explain the relationship between universality and particularity in modern democratic societies, politics and civil society. It will demonstrate that Habermas defends a substantive kind of universality that is opposed to particular positions and thus to real politics. This article further argues that Lefort’s lesser known theory of negative universality is better at combining a universal and a particular perspective. It claims that where Habermas requires citizens to transform their particular interests, Lefort emphasizes that individual actors should acknowledge their particular position and interests when invoking universal principles. The article further argues that their disagreement leads to a different interpretation of ideology, politics, power, civil society, human rights, popular sovereignty, elections and the state.

Reinhard M, Rutsch S, Lambeck J, Wihler C, Czosnyka M, Weiller C, Hetzel A. Dynamic cerebral autoregulation associates with infarct size and outcome after ischemic stroke. Acta Neurol Scand: 2012: 125: 156–162. © 2011 John Wiley & Sons A/S. Objectives – Cerebral autoregulation is particularly challenged in acute ischemic stroke. We investigated (1) clinical and radiological factors related to dynamic cerebral autoregulation (DCA) in acute stroke and (2) the relationship between DCA and clinical outcome of stroke. Methods – A total of 45 patients with middle cerebral artery (MCA) stroke were analyzed pooling two previous studies. DCA was measured by transcranial Doppler in both MCAs early (within 48 h from onset) and late (day 5–7) using low-frequency phase and correlation analysis (index Mx). Outcome was assessed by modified Rankin scale after a mean period of 4 months. Results – Mx increased (i.e. autoregulation worsened) between the early and late measurement, more so on affected (P = 0.005) than on unaffected sides (P = 0.014). Poorer autoregulation as indicated by lower ipsilateral phase (early and late) and higher Mx (late measurement) were significantly related to larger infarction. More severe stroke was significantly related to poorer ipsilateral Mx and phase. Ipsilateral phase in the early (P = 0.019) and Mx in the late measurement (P = 0.016) were related to poor clinical outcome according to univariate analysis. Conclusions – Impairment of DCA ipsilateral to acute ischemic stroke is associated with larger infarction. Dysautoregulation tends to worsen and spread to the contralateral side over the first days post-stroke and is associated with poor clinical outcome.

In internal carotid artery occlusion (ICAO), a spontaneous increase of cerebral vasoreactivity (CVR) may occur over time. Statins are known to increase CVR. We analyzed the influence of statin treatment and other cofactors on CVR improvement in patients with ICAO. Sixty-six patients with ICAO were reexamined after 15 ± 6 months. CVR in both middle cerebral arteries was assessed by transcranial Doppler and inhalation of 7% CO(2). Pre-defined cut-off values were used to define exhausted CVR. Cofactors analyzed were: age, sex, hypertension, diabetes, statin treatment, degree of contralateral stenosis, quality of intracranial collateral flow, duration of ICAO. Mean CVR did not differ between the two studies. Twenty patients had exhausted CVR at baseline, 11 of them improved above the cut-off at follow-up (55%). Factors significantly associated with this improvement were good collateral pattern at baseline (p = 0.0065) and statin treatment (p = 0.0179). Odds ratios for improving CVR were 36.0 [95% CI 2.7-476.3] for good collateral flow and 20.0 [95% CI 1.7-238.6] for statin treatment. In conclusion, exhausted CVR frequently improves during the course of ICAO. Good collateral function and statin treatment are significantly associated with improving CVR.

Blood pressure management in acute intracerebral hemorrhage (ICH) relies on functioning cerebral autoregulation. The time course of autoregulation in acute ICH and its relation with clinical outcome are not known.Twenty-six patients with spontaneous ICH were studied on days 1, 3 and 5 after ictus. Autoregulation was noninvasively measured from spontaneous fluctuations of blood pressure and middle cerebral artery flow velocity (assessed by transcranial Doppler) using the correlation coefficient index Mx. From the same signals, non-invasive cerebral perfusion pressure was calculated. Results were compared with 55 healthy controls and related with clinical and radiological factors and 90-day outcome (modified Rankin scale).Average Mx values of all patients did not differ across days or from controls. Higher Mx (i.e., poorer autoregulation) on day 5 was significantly related with lower Glasgow coma score, ventricular hemorrhage (both sides) and lower noninvasive cerebral perfusion pressure (ipsilateral). Increasing ipsilateral Mx between days 3 and 5 was related with lower Glasgow coma score and ventricular hemorrhage. In a multivariate analysis controlling for other hemodynamic factors, higher ipsilateral Mx on day 5 (p = 0.013) was a significant predictor for poor 90-day outcome.Cerebral autoregulation is primarily preserved in acute ICH, but a secondary decline mainly ipsilateral to the ICH can occur. This is associated with poor clinical status, ventricular hemorrhage, lower cerebral perfusion pressure and worse clinical outcome.

In a prospective study the results of 238 consecutive ultrasound examinations of the carotid artery were correlated with angiography to test the reliability of colour coded duplex sonography in preocclusive carotid artery disease. This series was compared with a series of 611 vessels with angiographically controlled conventional duplex sonography. In 61 resp. 84 cases stenoses > or = 90% or occlusions of the internal carotid artery were found. The reliability of colour coded duplex sonography for the diagnosis of > or = 90% stenoses was extremely high (sensitivity and specificity 98%), as well as in preocclusive, > 95% stenoses (100% and 98%), and for the diagnosis of occlusion, after exclusion of angiographic false positive diagnosis of occlusion (95% and 99%). Statistically colour coded flow imaging failed to increase significantly the high diagnostic sensitivity or specificity of conventional duplex sonography, especially in preocclusive carotid artery disease. However, the remarkable increase in frequency of the diagnosis preocclusive stenosis with the introduction of colour coded Duplex Sonography probably reflects a higher sensitivity of this method. In addition the direct comparison of both ultrasound techniques showed a better image of the vessel wall abnormalities and the residual lumen with colour coded duplex sonography.

A b s t r ac t BACKGROUND Studies to date have shown an association between the presence of patent foramen ovale and cryptogenic stroke in patients younger than 55 years of age. This association has not been established in patients 55 years of age or older. METHODS We prospectively examined 503 consecutive patients who had had a stroke, and we compared the 227 patients with cryptogenic stroke and the 276 control patients with stroke of known cause. We examined the prevalences of patent foramen ovale and of patent foramen ovale with concomitant atrial septal aneurysm in all patients, using transesophageal echocardiography. We also compared data for the 131 younger patients (

Starting from a pragmatist point of view the paper dismisses the argument that ethical conduct is always based on knowledge of justifying and applying rules. In a first section I show that Plato and Kant already claimed that the originality of the ethical can’t be represented as either propositional knowledge or a norm, but is instead given to us in a way that is never fully available for our rational grasp. In a second section, I will address the ethical conclusions James and Dewey draw from the fact that ethical demands can’t be translated into forms of knowledge. In a third section, I conclude with an argument for the originality of the ethical based on the thoughts of Stanley Cavell, stating that it is always something more than a mere competence in the sense of a knowledge of rules.

ZusammenfassungDer/die Autor/in von Text 1.3 [Manuel Dries] und der/die Autor/ in von Text 1.9 [Maudemarie Clark] bemühen sich um eine Klärung der normativen Implikationen von Nietzsches Umwertung der Werte. Der Beitrag kritisiert zunächst den Versuch, Nietzsche als metaethischen Antirealisten zu lesen (1.3.). Demgegenüber zeige ich, dass sich Nietzsches Moralkritik nicht im Tableau metaethischer Positionen unserer Tage verorten lasst. Gegen den Text 1.9 mache ich geltend, dass Nietzsche erst recht nicht als Vorläufer des Inferentialismus gelten kann. Die Frage, was unter welchen Bedingungen und für wen als guter Grund zahlt, lasst sich für Nietzsche nicht unabhängig von politischer Macht und kultureller Hegemonie beantworten.

ZusammenfassungDas Schaffen neuer Werte ist für Nietzsche gleichbedeutend mit der Umwertung älterer Werte. Als Instanz dieser Umwertung begreift er eine als Praxis verstandene Kultur. Werte gehen für ihn aus einer individuellen wie individuierenden kulturellen Praxis hervor. Nur durch die Verdrängung dieser Praxis nehmen sie den Anschein des Ewigen, Unwandelbaren und Objektiven an. Der Beitrag stellt Nietzsches Theorie einer Umwertung der Werte in ihrer kulturphilosophischen Relevanz vor, diskutiert ihre metaphysik kritischen Implikationen und weist auf ihr Erbe in zeitgenössischen Kulturtheorien (Arthur Danto, Boris Groys, René Girard) hin. Abschließend wird das Verhältnis der Umwertung der Werte zum Christentum diskutiert.

Als inchoativ (von lateinisch inchoāre, „anfangen“) werden in der Sprachwissenschaft Verben bezeichnet, die den in der Regel plotzlichen Beginn eines Geschehens ausdrucken. Sie unterscheiden sich damit von durativen (den Verlauf einer Handlung) und resultativen (das Ergebnis einer Handlung bezeichnenden) Verben. So bildet etwa „brennen“ den durativen Gegenpol zum resultativen „verbrennen“ und zum inchoativen „entbrennen“. In meinem Beitrag mochte ich versuchen, ausgehend vom pragmatistischen Begriff menschlicher Praxis den moral point of view bzw. den spezifischen Eigensinn des Ethischen im Sinne eines Ermoglichens von Anfangen auszubuchstabieren.

The phase shift between oscillations of blood pressure (BP) and Doppler middle cerebral artery flow velocity (MCAFV) reflects continuous cerebral autoregulatory action. It is not known whether a similar phase shift exists for cortical hemodynamics ('microvascular level') assessed by near infrared spectroscopy (NIRS) and what the effects are of pathological conditions. This study investigates the phase relations between oscillations of BP, MCAFV and NIRS parameters in 38 healthy older adults and 28 patients with unilateral severe obstructive carotid disease. BP was recorded noninvasively by finger plethysmography. Stable 0.1 Hz oscillations of all hemodynamic parameters were induced by regular breathing at a rate of 6/min. Basic results were that: (1) BP-induced cortical microvascular oscillations (NIRS) follow those of macrovascular oscillations (MCAFV) with a phase of 80-90 degrees (corresponding to 2-2.5 s at 0.1 Hz), most likely reflecting a transit time phenomenon; (2) oxy- and deoxyhemoglobin thereby oscillate in counterphase; (3) hemodynamic compromise in carotid obstruction leads to (a) delayed NIRS oscillations in comparison to BP which are highly correlated to a shorter phase lead of MCAFV against BP and (b) a decoupling of the oxy-/deoxyhemoglobin counterphase to 240 degrees . Cortical hemodynamic responses to BP oscillations follow specific phase relationships due to cerebral autoregulatory action and circulatory transit times. With hemodynamic impairment, as in unilateral carotid obstruction, these phases are significantly changed reflecting disturbed autoregulation.