vSEMERA: pilot project assessing health profession students' experiences in an international virtual research program.

BACKGROUND: The "Virtual Semester for Medical Research Aachen" (vSEMERA) is an international, interdisciplinary, virtual education program developed for health profession students. The first edition (2021) was hosted by the Medical Faculty of RWTH Aachen University (Germany) in cooperation with Centro Universitário Christus (Brazil) and Universidad Peruana Cayetano Heredia (Peru). The primary aim of the 12-weeks program was to provide students with skills in health science research and prepare them for scientific career paths. METHODS: vSEMERA was built on a virtual learning platform, the "vSEMERA-Campus", designed to foster students' learning process and social interactions. Maximum flexibility was offered through synchronous and asynchronous teaching, enabling participants to join via any device from any part of the Globe alongside their regular studies. For the program's first edition (September - November 2021), health profession students from Germany, Brazil, Peru, Spain, and Italy filled all 30 available spots. Satisfaction, quality of the program and courses offered, as well as perceived learning outcomes, were examined using questionnaires throughout and at the end of the program. RESULTS: The program received a rating of 4.38 out of 5 stars. While it met most expectations (4.29 out of 5), participants were unable to attend as many courses as intended (2.81 out of 5), mainly due to scheduling conflicts with the home university schedule (46%), internships (23%), and general timing issues (31%). Participants acknowledged considerable improvements in their scientific skills, English language skills, confidence in scientific project management, research career progression, and enthusiasm for a scientific career. CONCLUSIONS: vSEMERA represents a promising example of an online international learning and exchange program using pedagogical and technological elements of virtual collaboration and teaching. In addition to advancing future vSEMERA editions, our results may offer insights for similar projects that address the targeted integration of scientific research education into an international, digital learning environment.

The impact of digital technology use on nurses' professional identity and relations of power: a literature review.

AIM: This study seeks to review how the use of digital technologies in clinical nursing affects nurses' professional identity and the relations of power within clinical environments. DESIGN: Literature review. DATA SOURCES: PubMed and CINAHL databases were searched in April 2023. METHODS: We screened 874 studies in English and German, of which 15 were included in our final synthesis reflecting the scientific discourse from 1992 until 2023. RESULTS: Our review revealed relevant effects of digital technologies on nurses' professional identity and power relations. Few studies cover outcomes relating to identity, such as moral agency or nurses' autonomy. Most studies describe negative impacts of technology on professional identity, for example, creating a barrier between nurses and patients leading to decreased empathetic interaction. Regarding power relations, technologically skilled nurses can yield power over colleagues and patients, while depending on technology. The investigation of these effects is underrepresented. CONCLUSION: Our review presents insights into the relation between technology and nurses' professional identity and prevalent power relations. For future studies, dedicated and critical investigations of digital technologies' impact on the formation of professional identity in nursing are required. IMPLICATIONS FOR THE PROFESSION: Nurses' professional identity may be altered by digital technologies used in clinical care. Nurses, who are aware of the potential effects of digitized work environments, can reflect on the relationship of technology and the nursing profession. IMPACT: The use of digital technology might lead to a decrease in nurses' moral agency and competence to shape patient-centred care. Digital technologies seem to become an essential measure for nurses to wield power over patients and colleagues, whilst being a control mechanism. Our work encourages nurses to actively shape digital care. REPORTING METHOD: We adhere to the JBI Manual for Evidence Synthesis where applicable. EQUATOR reporting guidelines were not applicable for this type of review. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Organization of the human cerebral cortex estimated within individuals: networks, global topography, and function.

The cerebral cortex is populated by specialized regions that are organized into networks. Here we estimated networks from functional MRI (fMRI) data in intensively sampled participants. The procedure was developed in two participants (scanned 31 times) and then prospectively applied to 15 participants (scanned 8-11 times). Analysis of the networks revealed a global organization. Locally organized first-order sensory and motor networks were surrounded by spatially adjacent second-order networks that linked to distant regions. Third-order networks possessed regions distributed widely throughout association cortex. Regions of distinct third-order networks displayed side-by-side juxtapositions with a pattern that repeated across multiple cortical zones. We refer to these as supra-areal association megaclusters (SAAMs). Within each SAAM, two candidate control regions were adjacent to three separate domain-specialized regions. Response properties were explored with task data. The somatomotor and visual networks responded to body movements and visual stimulation, respectively. Second-order networks responded to transients in an oddball detection task, consistent with a role in orienting to salient events. The third-order networks, including distinct regions within each SAAM, showed two levels of functional specialization. Regions linked to candidate control networks responded to working memory load across multiple stimulus domains. The remaining regions dissociated across language, social, and spatial/episodic processing domains. These results suggest that progressively higher-order networks nest outward from primary sensory and motor cortices. Within the apex zones of association cortex, there is specialization that repeatedly divides domain-flexible from domain-specialized regions. We discuss implications of these findings, including how repeating organizational motifs may emerge during development.NEW & NOTEWORTHY The organization of cerebral networks was estimated within individuals with intensive, repeat sampling of fMRI data. A hierarchical organization emerged in each individual that delineated first-, second-, and third-order cortical networks. Regions of distinct third-order association networks consistently exhibited side-by-side juxtapositions that repeated across multiple cortical zones, with clear and robust functional specialization among the embedded regions.

Sedentary behavior does not predict low BMD nor fracture-population-based Canadian Multicentre Osteoporosis Study.

Sedentary behavior (SB) or sitting is associated with multiple unfavorable health outcomes. Bone tissue responds to imposed gravitational and muscular strain with there being some evidence suggesting a causal link between SB and poor bone health. However, there are no population-based data on the longitudinal relationship between SB, bone change, and incidence of fragility fractures. This study aimed to examine the associations of sitting/SB (defined as daily sitting time), areal BMD (by DXA), and incident low trauma (fragility) osteoporotic fractures (excluding hands, feet, face, and head). We measured baseline (1995-7) and 10-yr self-reported SB, femoral neck (FN), total hip (TH), and lumbar spine (L1-L4) BMD in 5708 women and 2564 men aged 25 to 80+ yr from the population-based, nationwide, 9-center Canadian Multicentre Osteoporosis Study. Incident 10-yr fragility fracture data were obtained from 4624 participants; >80% of fractures were objectively confirmed by medical records or radiology reports. Vertebral fractures were confirmed by qualitative morphological methods. All analyses were stratified by sex. Multivariable regression models assessed SB-BMD relationships; Cox proportional models were fit for fracture risk. Models were adjusted for age, height, BMI, physical activity, and sex-specific covariates. Women in third/fourth quartiles had lower adjusted FN BMD versus women with the least SB (first quartile); women in the SB third quartile had lower adjusted TH BMD. Men in the SB third quartile had lower adjusted FN BMD than those in SB first quartile. Neither baseline nor stable 10-yr SB was related to BMD change nor to incident fragility fractures. Increased sitting (SB) in this large, population-based cohort was associated with lower baseline FN BMD. Stable SB was not associated with 10-yr BMD loss nor increased fragility fracture. In conclusion, habitual adult SB was not associated with subsequent loss of BMD nor increased risk of fracture.

The number of hours of sitting in a day (often called "sedentary behavior") is currently understood to be "bad for bone health" both because of increased bone loss and a higher risk for fractures. Very few studies in randomly sampled men and women from a whole population have consistently asked about hours of sitting and examined baseline bone density. Fewer still have compared hours of sitting and its changes over 10 yr with changes in bone density and the number of new fractures that occurred. The Canadian Multicentre Osteoporosis Study obtained sitting hours from 5708 women and 2564 men aged 25 to 80+ yr and compared it with the spine, total hip (TH), and femoral neck (FN) bone density values. The average sitting at 7.4 h in men was associated with slightly lower adjusted femoral neck bone density; in women, sitting 6.7 h/d was associated with slightly lower adjusted FN and TH bone density. Ten-year follow-up data (now in about 5000 people) showed no relationship between the slightly longer sitting (an increase of 18% in men and 22% in women) and bone loss or new bone fractures. In this large country-wide population-based study, hours of sitting each day were not associated with 10-yr BMD loss in women or men nor did sitting more associate with new bone fractures. These data are reassuring; women and men who walk regularly and have some moderate-vigorous physical activity each day, despite more sitting, do not seem to be at greater risk for osteoporosis.

Development and Optimization of the Veterans Affairs' National Heart Failure Dashboard for Population Health Management.

BACKGROUND: In 2020, the Veterans Affairs (VA) health care system deployed a heart failure (HF) dashboard for use nationally. The initial version was notably imprecise and unreliable for the identification of HF subtypes. We describe the development and subsequent optimization of the VA national HF dashboard. MATERIALS AND METHODS: This study describes the stepwise process for improving the accuracy of the VA national HF dashboard, including defining the initial dashboard, improving case definitions, using natural language processing for patient identification, and incorporating an imaging-quality hierarchy model. Optimization further included evaluating whether to require concurrent ICD-codes for inclusion in the dashboard and assessing various imaging modalities for patient characterization. RESULTS: Through multiple rounds of optimization, the dashboard accuracy (defined as the proportion of true results to the total population) was improved from 54.1% to 89.2% for the identification of HF with reduced ejection fraction (HFrEF) and from 53.9% to 88.0% for the identification of HF with preserved ejection fraction (HFpEF). To align with current guidelines, HF with mildly reduced ejection fraction (HFmrEF) was added to the dashboard output with 88.0% accuracy. CONCLUSIONS: The inclusion of an imaging-quality hierarchy model and natural-language processing algorithm improved the accuracy of the VA national HF dashboard. The revised dashboard informatics algorithm has higher use rates and improved reliability for the health management of the population.

An Inconspicuous Offender: Apixaban-Induced Anticoagulant-Related Nephropathy.

Direct oral anticoagulants (DOACs) have shifted the landscape of anticoagulation over the past decade, becoming a frequently used pharmaceutical agent. The increased use of DOACs for long-term anticoagulation has led to a rise in reported anticoagulant-related adverse reactions, such as anticoagulant-related nephropathy (ARN). The occurrence of ARN is well reported with warfarin; however, there are few cases of ARN reported with DOAC use. We report the case of an elderly man with coronary artery disease and hypertension who was initiated on apixaban for atrial fibrillation three years prior to presentation but developed rapid renal decline over the six months prior to presentation. The estimated glomerular filtration rate (eGFR) had decreased precipitously from 48 mL/min/1.73 m2 to 19 mL/min/1.73 m2 with a concurrent drop in hemoglobin in the setting of persistent microscopic hematuria. A renal biopsy showed red blood cell casts consistent with glomerular hematuria, despite no crescents or signs of other forms of glomerulonephritis. The patient's renal function ceased to deteriorate and had a 35% recovery (serum creatinine 2.6 mg/dL, eGFR 25 mL/min/1.73 m2) after the discontinuation of apixaban and conversion to rivaroxaban without the use of corticosteroids. The patient reported at follow-up that he discontinued rivaroxaban four days after initiation on his own accord due to extrarenal bleeding. Our case highlights the importance of prompt recognition and treatment of the underreported but potentially significant incidence of ARN with apixaban in a patient with an otherwise unexplained kidney injury.

Within-Individual Organization of the Human Cerebral Cortex: Networks, Global Topography, and Function.

The human cerebral cortex is populated by specialized regions that are organized into networks. Here we estimated networks using a Multi-Session Hierarchical Bayesian Model (MS-HBM) applied to intensively sampled within-individual functional MRI (fMRI) data. The network estimation procedure was initially developed and tested in two participants (each scanned 31 times) and then prospectively applied to 15 new participants (each scanned 8 to 11 times). Detailed analysis of the networks revealed a global organization. Locally organized first-order sensory and motor networks were surrounded by spatially adjacent second-order networks that also linked to distant regions. Third-order networks each possessed regions distributed widely throughout association cortex. Moreover, regions of distinct third-order networks displayed side-by-side juxtapositions with a pattern that repeated similarly across multiple cortical zones. We refer to these as Supra-Areal Association Megaclusters (SAAMs). Within each SAAM, two candidate control regions were typically adjacent to three separate domain-specialized regions. Independent task data were analyzed to explore functional response properties. The somatomotor and visual first-order networks responded to body movements and visual stimulation, respectively. A subset of the second-order networks responded to transients in an oddball detection task, consistent with a role in orienting to salient or novel events. The third-order networks, including distinct regions within each SAAM, showed two levels of functional specialization. Regions linked to candidate control networks responded to working memory load across multiple stimulus domains. The remaining regions within each SAAM did not track working memory load but rather dissociated across language, social, and spatial / episodic processing domains. These results support a model of the cerebral cortex in which progressively higher-order networks nest outwards from primary sensory and motor cortices. Within the apex zones of association cortex there is specialization of large-scale networks that divides domain-flexible from domain-specialized regions repeatedly across parietal, temporal, and prefrontal cortices. We discuss implications of these findings including how repeating organizational motifs may emerge during development.

[From Nazi to Hitler Analyst: The Autobiographical Reinterpretations of the Psychiatrist Johann Recktenwald (1882-1964)]. / Vom Nationalsozialisten zum Hitler-Erklärer: Die autobiografischen Umdeutungen des Psychiaters Johann Recktenwald (1882­1964).

AIM OF THE STUDY: The focus of this article is the psychiatrist Johann Recktenwald (1882-1964) who has so far received little attention: acquitted of the charge of "crimes against humanity", he went public in post-war Germany with a neuropsychiatric treatise on Hitler. But is this appearance as a Hitler-critical psychiatrist consistent with the available historical sources? What was Recktenwald's relationship with the Nazi regime, and how did he behave in the "Third Reich" towards the patients entrusted to his care? METHODS: The paper is largely based on documents from various archives, some of which have been evaluated for the first time, and on court records. The latter are supplemented and compared with the writings of Recktenwald and the available secondary literature. RESULTS: During the "Third Reich", Recktenwald served the Nazi regime in many ways, was jointly responsible for numerous patient murders and thus moved into the role of a Nazi perpetrator. After his acquittal in post-war Germany, he endeavored to construct a personal distance to National Socialism by critically examining Hitler's psychopathology, which at the same time served his own exculpation. CONCLUSION: Recktenwald is a particularly impressive example of the efforts of Nazi perpetrators to retrospectively rewrite their own role in the "Third Reich" - and at the same time a reflection of a post-war society that was willing to accept such biographical reinterpretations in order to avoid coming to terms with the Nazi past.

Machine Learning-Based Automated Detection of Hydroxychloroquine Toxicity and Prediction of Future Toxicity Using Higher-Order OCT Biomarkers.

OBJECTIVE: Despite guidelines for hydroxychloroquine (HCQ) toxicity screening, there are clear challenges to accurate detection and interpretation. In the current report, the feasibility of automated machine learning (ML)-based detection of HCQ retinopathy and prediction of progression to toxicity in eyes without preexisting toxicity has been described. DESIGN: Retrospective, longitudinal cohort study. SUBJECTS: Subjects on HCQ therapy. METHODS: This was an institutional review board-approved, retrospective, longitudinal image analysis of 388 subjects on HCQ. Multilayer, compartmental, retinal segmentation with ellipsoid zone (EZ) mapping was used to harvest quantitative spectral-domain (SD)-OCT biomarkers. Using a combination of clinical features (i.e., cumulative HCQ dose and the duration of therapy) and quantitative imaging biomarkers (e.g., volumetric EZ integrity and compartmental measurements), ML models were created to detect toxicity and predict progression based on ground-truth OCT-based toxicity readings by 2 masked retina specialists. Furthermore, 10-fold cross-validation was performed. MAIN OUTCOME MEASURES: The model performance was visualized using receiver operator curves and calculating the area under the curve (AUC). The corresponding sensitivity and specificity values were evaluated for the feasibility of HCQ toxicity screening and prediction. RESULTS: The prevalence of HCQ toxicity in this cohort of 388 patients was 9.8% (n = 38). Twenty-one eyes progressed to toxicity during follow-up. OCT-based features (i.e., partial EZ attenuation, EZ volume, outer nuclear layer volume, and compartmental thicknesses) and clinical features (i.e., HCQ daily dose, HCQ cumulative dose, and duration of therapy) showed significant differences between the toxic and nontoxic groups. Percentage area with partial EZ attenuation (i.e., percentage of the macula with an EZ-retinal pigment epithelium thickness of ≤ 20 µm) was the most discriminating single feature (toxic, 35.7 ± 46.5%; nontoxic, 1.8 ± 4.4%; P < 0.0001). Using a random forest model, high-performance, automated toxicity detection was achieved, with a mean AUC of 0.97, sensitivity of 95%, and specificity of 91%. Furthermore, the toxicity progression prediction model had a mean AUC of 0.89, with a sensitivity and specificity of 90% and 80%, respectively. CONCLUSIONS: This report described the feasibility of high-performance automated classification models that used a combination of clinical and quantitative SD-OCT biomarkers to detect HCQ retinal toxicity and predict progression to toxicity in cases without toxicity. Future work is needed to validate these findings in an independent dataset.

Nazi, collaborator or opponent? The role of the pathologist Robert Rössle in the Third Reich.

For many, Robert Rössle is one of the most important pathologists of the first half of the 20th century. His research in the fields of inflammation, constitution, growth and age, and immunity gave him the status of a pioneer. Because he was not a nominal member of the Nazi Party (NSDAP), Rössle did not have to undergo denazification proceedings and was able to continue his academic career seamlessly after 1945. Only recently, the question of Rössle's actual role in the Third Reich has been raised - in connection with a possible renaming of the Robert-Rössle-Straße in Berlin. Our paper takes this issue as an opportunity to critically examine Rössle's involvement in National Socialism. For this study, all available literature and extensive primary material on Rössle from various archives was reviewed and evaluated with regard to the question posed. The investigations show that Rössle held a number of offices in the administrative apparatus of the Nazi state even though not being a party member. They gave him access to high-ranking representatives and most likely also knowledge about medical crimes. Rössle researched and published on hereditary biology and racial hygiene issues, thus supporting the ideology of the Nazi State. Robert Rössle must be regarded as an early proponent of racial hygiene, political collaborator and profiteer of the Third Reich. However, it remains unclear whether he was directly involved in human experiments. There is no evidence that he critically distanced himself from his role in the Third Reich after 1945.

Political pragmatist or man of conviction? Heinrich Bredt (1906-1989) and his involvement in the Third Reich.

Heinrich Bredt (1906-1989) has to be considered one of the most prominent German pathologists of the past century. While his scientific oeuvre - especially his research on pathology of the cardiovascular system - received widespread attention, his actual connection to National Socialism remains largely concealed. This paper takes this need for clarification as an occasion for a detailed investigation of Bredt's political role in the Third Reich, based on source material from Federal, State and University Archives. The analysis shows that Heinrich Bredt had already joined the anti-Semitic and anti-democratic Association of German Students in the 1920s, and from 1933 onward he entered various Nazi organizations - including the Nazi Party. Unlike in later statements, Bredt was not just a nominal member of the Party, he held various offices in National Socialist organizations and was accordingly classified as loyal to the regime by the Nazi authorities. In contrast, during his time in the socialist dictatorship of East Germany, Bredt remained aloof from the ruling Socialist Unity Party of Germany and its political organizations - unlike many former Nazi Party members who behaved in a political opportune manner in East Germany as well. Bredt demonstrated a distance from the socialist system which suggests that his political actions were guided not by pragmatic but by ideological considerations.

Current and Future Anti-VEGF Agents for Neovascular Age-Related Macular Degeneration.

Age-related macular degeneration (AMD) is the most common cause of legal blindness in developed countries. Neovascular (ie, wet) AMD is currently managed with intravitreal therapy. Traditional treatments (ie, bevacizumab, ranibizumab, aflibercept) provide high-efficacy therapy but can also require frequent dosing. Newer and future anti-VEGF therapies aim to decrease injection frequency through eitherlonger half life or port-delivery systems (brolucizumab, conbercept, KSI-301, ranibizumab). This review outlines current anti-VEGF treatments and ways by which their duration might be extended.

Cognitive decline is associated with an accelerated rate of bone loss and increased fracture risk in women: a prospective study from the Canadian Multicentre Osteoporosis Study.

Cognitive decline and osteoporosis often coexist and some evidence suggests a causal link. However, there are no data on the longitudinal relationship between cognitive decline, bone loss and fracture risk, independent of aging. This study aimed to determine the association between: (i) cognitive decline and bone loss; and (ii) clinically significant cognitive decline (≥3 points) on Mini Mental State Examination (MMSE) over the first 5 years and subsequent fracture risk over the following 10 years. A total of 1741 women and 620 men aged ≥65 years from the population-based Canadian Multicentre Osteoporosis Study were followed from 1997 to 2013. Association between cognitive decline and (i) bone loss was estimated using mixed-effects models; and (ii) fracture risk was estimated using adjusted Cox models. Over 95% of participants had normal cognition at baseline (MMSE ≥ 24). The annual % change in MMSE was similar for both genders (women -0.33, interquartile range [IQR] -0.70 to +0.00; and men -0.34, IQR: -0.99 to 0.01). After multivariable adjustment, cognitive decline was associated with bone loss in women (6.5%; 95% confidence interval [CI], 3.2% to 9.9% for each percent decline in MMSE from baseline) but not men. Approximately 13% of participants experienced significant cognitive decline by year 5. In women, fracture risk was increased significantly (multivariable hazard ratio [HR], 1.61; 95% CI, 1.11 to 2.34). There were too few men to analyze. There was a significant association between cognitive decline and both bone loss and fracture risk, independent of aging, in women. Further studies are needed to determine mechanisms that link these common conditions. © 2021 American Society for Bone and Mineral Research (ASBMR).

Just "one of so many"? The pathologist Theodor Fahr (1877-1945) and his ambivalent relationship to National Socialism.

Theodor Fahr is well known as a pioneer in renal pathology and the eponym of "Fahr's disease". While his professional merits are undisputed, his relationship to National Socialism remains unclear. On the one hand, he signed the public "oath of allegiance" of German professors to Adolf Hitler, on the other hand, he appeared as a mentor to his Jewish colleague Paul Kimmelstiel. In 1945, Fahr committed suicide after being dismissed by the Allied military government for political reasons. However, he left behind memoirs in which he outlined himself as a determined opponent of National Socialism. It is precisely these ambiguities that form the starting point of this study. The aim is to reconstruct Fahr's personal and professional career and to outline his political stance in the Third Reich. In addition, it will be clarified how Fahr's life and work were received after 1945 and whether (or how) his relationship to National Socialism was addressed. This study is based on different types of sources: Various archival documents on Fahr and Kimmelstiel are compared and contrasted with Fahr's unpublished autobiography and the available secondary literature on Fahr and his work. The analysis shows that Fahr's relationship to National Socialism became more distanced over time. However, he did not emerge as a critic of Nazi ideology during the Third Reich - even though he claimed in his memoirs that he had consistently despised Hitler. While Fahr is not to be considered an ardent National Socialist, he held to the stereotype of the "unscrupulous" Jew. The study concludes that Fahr was a politically ambivalent character with a distinctly anti-Semitic disposition, which he tried to soften by emphasizing his relationships with individual Jewish colleagues such as Kimmelstiel.

Political continuity or a new beginning? The re-foundation of the "German Society for Pathology" and its politics in postwar Germany.

In 1948, about 70 pathologists decided to reconstitute the "Deutsche Pathologische Gesellschaft" (German Pathological Society). With Arnold Lauche, a new president was elected; at the same time, the organization was renamed the "Deutsche Gesellschaft für Pathologie" (German Society of Pathology). But did these two obvious changes really mark a new beginning, a conscious turning away from the Nazi ideology that had significantly shaped the policies of the professional associations until 1945? The present paper pursues this very question. It examines the personnel and political course set by the German Society of Pathology, and takes a close look its first representatives - Arnold Lauche, Georg B. Gruber und Edmund Randerath - and their professional activities. Special attention is paid to their positions during the Third Reich, their denazification processes and their dealings with the past in the early postwar period. This also includes the Society's policy towards Jewish colleagues marginalized in the Third Reich. The article is based on archival material from the Federal Archives in Berlin, various university archives, and Gruber's estate. In addition, a critical analysis of the relevant secondary literature was conducted. During the Third Reich, Lauche, Gruber, and Randerath were involved in National Socialism to varying degrees. Their board activities in the postwar period stood for personal and political continuity which also included the Society's policy towards former members of the Nazi Party and Jewish colleagues. The article concludes that there was no clean break with the Nazi past; Gruber in particular, who had already played a leading role in the Society in the Third Reich, continued to exert considerable influence. The German Society for Pathology also failed to bring persecuted Jewish colleagues into its midst - former members of the Nazi Party were given preference both in board positions and in the awarding of honors.

Facts and fiction: The pathologist Gerhard Seifert (1921-2014) and his dealings with National Socialism.

Gerhard Seifert is considered one of the leading German pathologists of his time. He was not only an outstanding scientist but also shaped the politics of university pathology like hardly anyone else. In the context of a national research project on the role of German pathologists in the Third Reich, it was recently discovered that Seifert had joined the Nazi Party. The present study takes this hitherto unknown fact as an occasion for a closer analysis of Seifert's life and work - with a special focus on the Third Reich; the aim is to clarify (1) when and how Seifert's membership came about and (2) how he dealt with the Nazi era and his own political role in the period after 1945. The present study is based on various archival documents. Furthermore, Seifert's autobiography "A Saxon in Hamburg - A Doctor's Life from East to West" was evaluated and cross-referenced with the archival sources. Last not least a systematic re-analysis of the literature on Seifert was conducted, including eulogies and obituaries on his life and work. It can be shown that Gerhard Seifert was an outstanding scientist - with special merits in the fields of oral pathology (including salivary glands), the pathology of the pancreas, endocrine pathology and osteopathology -, an extensive networker and an enigmatic personality. However, it is also demonstrable that Seifert joined the Nazi Party at the age of 17, remained a member until its abolition at the end of the Second World War, and concealed his party membership after 1945. In this respect, he built his career in postwar Germany on a false statement.

Vertebral Fractures: Which Radiological Criteria Are Better Associated With the Clinical Course of Osteoporosis?

STUDY PURPOSE: Morphometric methods categorize potential osteoporotic vertebral fractures (OVF) on the basis of loss of vertebral height. A particular example is the widely used semiquantitative morphometric tool proposed by Genant (GSQ). A newer morphologic algorithm-based qualitative (mABQ) tool focuses on vertebral end-plate damage in recognizing OVF. We used data from both sexes in the Canadian Multicentre Osteoporosis Study (CaMos) to compare the 2 methods in identifying OVF at baseline and during 10 years of follow-up. MATERIALS AND METHODS: We obtained lateral thoracic and lumbar spinal radiographs (T4-L4) 3 times, at 5-year intervals, in 828 participants of the population-based CaMos. Logistic regressions were used to study the association of 10-year changes in bone mineral density (BMD) with incident fractures. RESULTS: At baseline, 161 participants had grade 1 and 32 had grade 2 GSQ OVF; over the next 10 years, only 9 of these participants had sustained incident GSQ OVF. Contrastingly, 21 participants at baseline had grade 1 and 48 grade 2 mABQ events; over the next 10 years, 79 subjects experienced incident grade 1 or grade 2 mABQ events. Thus, incident grades 1 and 2 morphologic fractures were 8 times more common than morphometric deformities alone. Each 10-year decrease of 0.01 g/cm2 in total hip BMD was associated with a 4.1% (95% CI: 0.7-7.3) higher odds of having an incident vertebral fracture. CONCLUSIONS: This analysis further suggests that morphometric deformities and morphologic fractures constitute distinct entities; morphologic fractures conform more closely to the expected epidemiology of OVF.