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Objectives: To correlate the radiological assessment of the mastoid facial canal in postoperative cochlear implant (CI) cone-beam CT (CBCT) and other possible contributing clinical or implant-related factors with postoperative facial nerve stimulation (FNS) occurrence. Methods: Two experienced radiologists evaluated retrospectively 215 postoperative post-CI CBCT examinations. The mastoid facial canal diameter, wall thickness, distance between the electrode cable and mastoid facial canal, and facial-chorda tympani angle were assessed. Additionally, the intracochlear position and the insertion angle and depth of electrodes were evaluated. Clinical data were analyzed for postoperative FNS within 1.5-year follow-up, CI type, onset, and causes for hearing loss such as otosclerosis, meningitis, and history of previous ear surgeries. Postoperative FNS was correlated with the measurements and clinical data using logistic regression. Results: Within the study population (mean age: 56 ± 18 years), ten patients presented with FNS. The correlations between FNS and facial canal diameter (p = 0.09), wall thickness (p = 0.27), distance to CI cable (p = 0.44), and angle with chorda tympani (p = 0.75) were statistically non-significant. There were statistical significances for previous history of meningitis/encephalitis (p = 0.001), extracochlear-electrode-contacts (p = 0.002), scala-vestibuli position (p = 0.02), younger patients’ age (p = 0.03), lateral-wall-electrode type (p = 0.04), and early/childhood onset hearing loss (p = 0.04). Histories of meningitis/encephalitis and extracochlear-electrode-contacts were included in the first two steps of the multivariate logistic regression. Conclusion: The mastoid-facial canal radiological assessment and the positional relationship with the CI electrode provide no predictor of postoperative FNS. Histories of meningitis/encephalitis and extracochlear-electrode-contacts are important risk factors.
Einen wesentlichen Einfluss auf die Ästhetik des cinéma vérité hatte die Entwicklung tontauglicher Handkameras, die den Filmemachern die ästhetische Möglichkeit einer Manipulation und Differenz (im Sinne einer bewussten, eingreifenden Dissoziation und Disjunktion) von Akustischem und Visuellem eröffnete. Anhand ausgewählter Szenen von CHRONIQUE D’UN ÉTÉ möchte ich im Folgenden zeigen, wie sich diese Bewegung auf ästhetischer Ebene darstellt. Im Mittelpunkt soll der Akt des Offenlegens und Reflektierens des filmischen Schaffensprozesses stehen, der als wesentlicher Aspekt filmischer Modernität bezeichnet werden kann. Zu weiten Teilen folge ich dabei den Schriften von Jean-Louis Comolli und Gilles Deleuze, insbesondere was die prominent beschriebene Durchdringung von dokumentarischem und fiktionalem Stil betrifft, die sich in CHRONIQUE D’UN ÉTÉ nicht nur auf bildlicher, sondern auch und gerade – und das ist das Wesentliche an meiner Argumentation – auf akustischer Ebene nachweisen lässt.
Vom klassischen Film zur Zweiten Moderne : Überlegungen zur Differenz von Bild und Ton im Film
(2008)
Michel Chion, einer der wichtigsten Filmtontheoretiker der Gegenwart, geht in seinem Werk L´audio-vision (1990) davon aus, dass Bild und Ton hinsichtlich eines „audiovisuellen Kontrakts“ zwar keine natürliche Beziehung zueinander unterhalten, der Rezipient jedoch eine symbolische Beziehung zwischen beiden sieht, die aus Bild und Ton eine Einheit werden lässt. In der Filmtheorie steht diesem synthetisierenden Modell von Akustischem und Visuellem ein differentieller Denkansatz entgegen, der das audiovisuelle Zusammenspiel im Film nicht als Synthese, sondern als Kräftefeld unterschiedlicher Bestandteile begreift, die zwar einen Bezug zueinander haben, aber dennoch technisch wie ästhetisch getrennt und heterogen sind.
Alan Croslands Film THE JAZZ SINGER wird in zahlreichen wissenschaftlichen Abhandlungen zum Übergang vom Stumm- zum Tonfilm als der Film beschrieben, der dem Tonfilm endgültig zum Durchbruch verhalf (vgl. Dibbets 1998, 197; Nowell-Smith 1998, 193; Henzel 2006, 47). Doch obwohl THE JAZZ SINGER maßgeblich dazu beigetragen hat, das neue Medium Tonfilm am Markt zu etablieren, handelt es sich bei diesem Film nicht um den ersten Tonfilm, wie gelegentlich behauptet wird (vgl. Ferrari 2004, 70), sondern lediglich um einen „Stummfilm mit einigen vertonten Einschüben“ (Dibbets 1998, 197). THE JAZZ SINGER ist ein so genannter part-talkie, ein Film also, der nur zum Teil vertont wurde. An ausgewählten Stellen enthält er „lippensynchrone Lieder und Dialog“ (Dibbets 1998, 197). Das expressive Spiel der Figuren und der Einsatz von Zwischentiteln hingegen erinnern an den Stummfilm. Doch nicht nur die Tatsache, dass THE JAZZ SINGER kein hundertprozentiger Tonfilm ist, steht laut Christoph Henzel einer Definition als erstem Tonfilm entgegen. Darüber hinaus ist er auch nicht der erste Film, der technisch in der Lage war, Bild und Ton zu synchronisieren. Vielmehr positioniert er sich als ein Ereignis unter vielen, als ein Glied innerhalb einer ganzen Reihe technischer Entwicklungen vom Stumm- zum Tonfilm (vgl. Henzel 2006, 48/49).
Background: Although mortality after cardiac surgery has significantly decreased in the last decade, patients still experience clinically relevant postoperative complications. Among others, atrial fibrillation (AF) is a common consequence of cardiac surgery, which is associated with prolonged hospitalization and increased mortality.
Methods: We retrospectively analyzed data from patients who underwent coronary artery bypass grafting, valve surgery or a combination of both at the University Hospital Muenster between April 2014 and July 2015. We evaluated the incidence of new onset and intermittent/permanent AF (patients with pre- and postoperative AF). Furthermore, we investigated the impact of postoperative AF on clinical outcomes and evaluated potential risk factors.
Results: In total, 999 patients were included in the analysis. New onset AF occurred in 24.9% of the patients and the incidence of intermittent/permanent AF was 59.5%. Both types of postoperative AF were associated with prolonged ICU length of stay (median increase approx. 2 days) and duration of mechanical ventilation (median increase 1 h). Additionally, new onset AF patients had a higher rate of dialysis and hospital mortality and more positive fluid balance on the day of surgery and postoperative days 1 and 2. In a multiple logistic regression model, advanced age (odds ratio (OR) = 1.448 per decade increase, p < 0.0001), a combination of CABG and valve surgery (OR = 1.711, p = 0.047), higher C-reactive protein (OR = 1.06 per unit increase, p < 0.0001) and creatinine plasma concentration (OR = 1.287 per unit increase, p = 0.032) significantly predicted new onset AF. Higher Horowitz index values were associated with a reduced risk (OR = 0.996 per unit increase, p = 0.012). In a separate model, higher plasma creatinine concentration (OR = 2.125 per unit increase, p = 0.022) was a significant risk factor for intermittent/permanent AF whereas higher plasma phosphate concentration (OR = 0.522 per unit increase, p = 0.003) indicated reduced occurrence of this arrhythmia.
Conclusions: New onset and intermittent/permanent AF are associated with adverse clinical outcomes of elective cardiac surgery patients. Different risk factors implicated in postoperative AF suggest different mechanisms might be involved in its pathogenesis. Customized clinical management protocols seem to be warranted for a higher success rate of prevention and treatment of postoperative AF.
The Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO) here presents its updated recommendations for the treatment of documented fungal infections. Invasive fungal infections are a main cause of morbidity and mortality in cancer patients undergoing intensive chemotherapy regimens. In recent years, new antifungal agents have been licensed, and agents already approved have been studied in new indications. The choice of the most appropriate antifungal treatment depends on the fungal species suspected or identified, the patient’s risk factors (e.g., length and depth of neutropenia), and the expected side effects. This guideline reviews the clinical studies that served as a basis for the following recommendations. All recommendations including the levels of evidence are summarized in tables to give the reader rapid access to the information.
Following votes in the Coniacian Working Group, the Cretaceous Subcommission and the International Commission on Stratigraphy, on May 1st, 2021, the International Union of Geological Sciences voted unanimously to ratify the Global Stratotype Section and Point (GSSP) proposal for the base of the Coniacian Stage of the Upper Cretaceous Series and Cretaceous System. The lower boundary of the Coniacian Stage is placed at the base of Bed 46 of the Salzgitter-Salder section in northern Germany. The boundary is defined by the first appearance of the inoceramid bivalve species Cremnoceramus deformis erectus (Meek) and complemented by the Navigation carbon isotope event. Additional data include the bivalve genus Didymotis, foraminifera, ammonite, nannofossil and organic-walled dinoflagellate cyst events. Three auxiliary sections (Słupia Nadbrzeżna, central Poland; Střeleč, Czech Republic; El Rosario, NE Mexico) supplement the details of the boundary record in various facies, and in differing geographic and biogeographic contexts.
Objective: Vertigo is a common side effect of cochlear implant (CI) treatment. This prospective study examines the incidence of postoperative vertigo over time and aims to analyze influencing factors such as electrode design and insertion angle (IA).
Study Design and Setting: This is a prospective study which has been conducted at a tertiary referral center (academic hospital).
Patients: A total of 29 adults were enrolled and received a unilateral CI using one of six different electrode carriers, which were categorized into “structure-preserving” (I), “potentially structure-preserving” (II), and “not structure-preserving” (III).
Intervention: Subjective vertigo was assessed by questionnaires at five different time-points before up to 6 months after surgery. The participants were divided into four groups depending on the time of the presence of vertigo before and after surgery. Preoperatively and at 6 months postoperatively, a comprehensive vertigo diagnosis consisting of Romberg test, Unterberger test, subjective visual vertical, optokinetic test, video head impulse test, and caloric irrigation test was performed. In addition, the IA was determined, and the patients were divided in two groups (<430°; ≥430°).
Main Outcome Measures: The incidence of vertigo after CI surgery (group 1) was reported, as well as the correlation of subjective vertigo with electrode array categories (I–III) and IA.
Results: Among the participants, 45.8% experienced new vertigo after implantation. Based on the questionnaire data, a vestibular origin was suspected in 72.7%. The results did not show a significant correlation with subjective vertigo for any of the performed tests. In group 1 with postoperative vertigo, 18% of patients showed conspicuous results in a quantitative analysis of caloric irrigation test despite the fact that the category I or II electrodes were implanted, which are suitable for structure preservation. Average IA was 404° for the overall group and 409° for group 1. There was no statistically significant correlation between IA and perceived vertigo.
Conclusions: Though vertigo after CI surgery seems to be a common complication, the test battery used here could not objectify the symptoms. Further studies should clarify whether this is due to the multifactorial cause of vertigo or to the lack of sensitivity of the tests currently in use. The proof of reduced probability for vertigo when using atraumatic electrode carrier was not successful, nor was the proof of a negative influence of the insertion depth.
An ever-increasing demand for novel antimicrobials to treat life-threatening infections caused by the global spread of multidrug-resistant bacterial pathogens stands in stark contrast to the current level of investment in their development, particularly in the fields of natural-product-derived and synthetic small molecules. New agents displaying innovative chemistry and modes of action are desperately needed worldwide to tackle the public health menace posed by antimicrobial resistance. Here, our consortium presents a strategic blueprint to substantially improve our ability to discover and develop new antibiotics. We propose both short-term and long-term solutions to overcome the most urgent limitations in the various sectors of research and funding, aiming to bridge the gap between academic, industrial and political stakeholders, and to unite interdisciplinary expertise in order to efficiently fuel the translational pipeline for the benefit of future generations.
