Open Access

Nowadays, several options are available to treat patients with conductive or mixed hearing loss. Whenever surgical intervention is not possible or contra-indicated, and amplification by a conventional hearing device (e.g., behind-the-ear device) is not feasible, then implantable hearing devices are an indispensable next option. Implantable bone-conduction devices and middle-ear implants have advantages but also limitations concerning complexity/invasiveness of the surgery, medical complications, and effectiveness. To counsel the patient, the clinician should have a good overview of the options with regard to safety and reliability as well as unequivocal technical performance data. The present consensus document is the outcome of an extensive iterative process including ENT specialists, audiologists, health-policy scientists, and representatives/technicians of the main companies in this field. This document should provide a first framework for procedures and technical characterization to enhance effective communication between these stakeholders, improving health care.

Thermodynamical variables and their time evolution are studied for central relativistic heavy ion collisions from 10.7 to 160 AGeV in the microscopic Ultrarelativistic Quantum Molecular Dynamics model (UrQMD). The UrQMD model exhibits drastic deviations from equilibrium during the early high density phase of the collision. Local thermal and chemical equilibration of the hadronic matter seems to be established only at later stages of the quasi-isentropic expansion in the central reaction cell with volume 125 fm 3. Baryon energy spectra in this cell are reproduced by Boltzmann distributions at all collision energies for t > 10 fm/c with a unique rapidly dropping temperature. At these times the equation of state has a simple form: P = (0.12 - 0.15) Epsilon. At SPS energies the strong deviation from chemical equilibrium is found for mesons, especially for pions, even at the late stage of the reaction. The final enhancement of pions is supported by experimental data.

Neuronal ceroid lipofuscinosis (NCL) is a group of neurodegenerative lysosomal storage disorders characterized by vision loss, mental and motor deficits, and spontaneous seizures. Neuropathological analyses of autopsy material from NCL patients and animal models revealed brain atrophy closely associated with glial activity. Earlier reports also noticed loss of retinal cells and reactive gliosis in some forms of NCL. To study this phenomenon in detail, we analyzed the ocular phenotype of CLN6nclf mice, an established mouse model for variant-late infantile NCL. Retinal morphometry, immunohistochemistry, optokinetic tracking, electroretinography, and mRNA expression were used to characterize retinal morphology and function as well as the responses of Müller cells and microglia. Our histological data showed a severe and progressive degeneration in the CLN6nclf retina co-inciding with reactive Müller glia. Furthermore, a prominent phenotypic transformation of ramified microglia to phagocytic, bloated, and mislocalized microglial cells was identified in CLN6nclf retinas. These events overlapped with a rapid loss of visual perception and retinal function. Based on the strong microglia reactivity we hypothesized that dietary supplementation with immuno-regulatory compounds, curcumin and docosahexaenoic acid (DHA), could ameliorate microgliosis and reduce retinal degeneration. Our analyses showed that treatment of three-week-old CLN6nclf mice with either 5% DHA or 0.6% curcumin for 30 weeks resulted in a reduced number of amoeboid reactive microglia and partially improved retinal function. DHA-treatment also improved the morphology of CLN6nclf retinas with a preserved thickness of the photoreceptor layer in most regions of the retina. Our results suggest that microglial reactivity closely accompanies disease progression in the CLN6nclf retina and both processes can be attenuated with dietary supplemented immuno-modulating compounds.

The assumption of local equilibrium in relativistic heavy ion collisions at energies from 10.7 AGeV (AGS) up to 160 AGeV (SPS) is checked in the microscopic transport model. Dynamical calculations performed for a central cell in the reaction are compared to the predictions of the thermal statistical model. We find that kinetic, thermal and chemical equilibration of the expanding hadronic matter are nearly approached late in central collisions at AGS energy for t >= 10 fm/c in a central cell. At these times the equation of state may be approximated by a simple dependence P ~= (0.12-0.15) epsilon. Increasing deviations of the yields and the energy spectra of hadrons from statistical model values are observed for increasing energy, 40 AGeV and 160 AGeV. These violations of local equilibrium indicate that a fully equilibrated state is not reached, not even in the central cell of heavy ion collisions at energies above 10 AGeV. The origin of these findings is traced to the multiparticle decays of strings and many-body decays of resonances.