Infant and child mortality in the Netherlands 1935-47 and changes related to the Dutch famine of 1944-45: A population-based analysis.

Precise estimates of the impact of famine on infant and child mortality are rare due to lack of representative data. Using vital statistics reports on the Netherlands for 1935-47, we examine the impact of the Dutch famine (November 1944 to May 1945) on age-specific mortality risk and cause of death in four age groups (stillbirths, <1 year, 1-4, 5-14) in the three largest famine-affected cities and the remainder of the country. Mortality during the famine is compared with the pre-war period January 1935 to April 1940, the war period May 1940 to October 1944, and the post-war period June 1945 to December 1947. The famine's impact was most visible in infants because of the combined effects of a high absolute death rate and a threefold increase in proportional mortality, mostly from gastrointestinal conditions. These factors make infant mortality the most sensitive indicator of famine severity in this setting and a candidate marker for comparative use in future studies.

Neurosurgery at Pearl Harbor: Ralph Cloward's legacy.

Ralph B. Cloward (1908-2000) was the sole neurosurgeon present during the Japanese attack on Pearl Harbor on December 7, 1941. Cloward operated on 42 patients in a span of 4 days during the attacks and was awarded a commendation signed by President Franklin D. Roosevelt in 1945 for his wartime efforts. During the attacks, he primarily treated depressed skull fractures and penetrating shrapnel wounds, but he also treated peripheral nerve and spine injuries in the aftermath. His techniques included innovative advancements such as tantalum cranioplasty plates, electromagnets for intracranial metallic fragment removal, and the application of sulfonamide antibiotic powder within cranial wounds, which had been introduced by military medics for gangrene prevention in 1939 and described for penetrating cranial wounds in 1940. Despite the severity of injuries encountered, only 2 soldiers died in the course of Cloward's interventions. As the sole neurosurgeon in the Pacific Theater until 1944, he remained in Honolulu through World War II's duration and gained immense operative experience through his wartime service. Here, the authors review the history of Cloward's remarkable efforts, techniques, injury patterns treated, and legacy.

Evolution of spinal cord injury treatment in military neurosurgery.

During the mid-1900s, military medicine made historical advancements in the diagnosis, stabilization, and treatment of spinal cord injuries (SCIs). In particular, World War II was an inflection point for clinical practice related to SCIs because of the vast number of devastating injuries to soldiers seen during World War I (WWI). The unprecedented rate of SCI along with growth in the field served as a catalyst for surgical and interdisciplinary advancements through the increased exposure to this challenging pathology. Initially, a tragic fate was assumed for soldiers with SCIs in WWI resulting in a very conservative approach strategy given a multitude of factors. However, soldiers with similar injuries 20 years later saw improved outcomes with more aggressive management interventions by specialists in spine trauma, who applied measures such as spinal traction, arthrodesis, and internal fixation, and with the significant developments in the complex rehabilitation of these patients. This article describes the historical shift in the management of SCIs through the two world wars. These historical lessons of SCI and the fundamental advances in their neurosurgical intervention have molded not only military but also modern civilian treatment of SCI.

Neurosurgical developments of Thierry de Martel (1875-1940), French neurosurgery pioneer, during World Wars I and II.

Following France's entry into World War I on August 3, 1914, Thierry de Martel (1875-1940), the French neurosurgery pioneer, served on the front line and was wounded on October 3, 1914. He was then assigned as a surgeon in temporary hospitals in Paris, where he published his first observations of cranioencephalic war wounds. In 1915, de Martel met Harvey Cushing at the American Hospital in Neuilly, where de Martel was appointed chief surgeon in 1916. In 1917, he published with the French neurologist Charles Chatelin a book (Blessures du crâne et du cerveau. Clinique et traitement) with the aim to optimize the practice of wartime brain surgery. This book, which included the results of more than 5000 soldiers with head injuries, was considered the most important ever written on war neurology at that time and was translated into English in 1918 (Wounds of the Skull and Brain; Their Clinical Forms and Medical and Surgical Treatment). In this book, de Martel detailed the fundamentals of skull injuries, classified the various craniocerebral lesions, recommended exploratory craniectomy for cranioencephalic injuries, recommended the removal of metal projectiles from the brain using a magnetic nail, and advocated for the prevention of infectious complications. Between the World Wars, de Martel undertook several developments for neurosurgery in France alongside neurologists Joseph Babinski and Clovis Vincent. Following France's entry into World War II on September 3, 1939, de Martel took over as head of the services of the American Hospital of Paris in Neuilly. He updated his work on war surgery with the new cases he personally treated. Together with Vincent, de Martel presented his new approach in "Le traitement des blessures du crâne pendant les opérations militaires" ("The treatment of skull injuries during military operations") on January 30, 1940, and published his own surgical results in April 1940 in "Plan d'un travail sur le traitement des plaies cranio-cérébrales de guerre" ("Work Plan on the Treatment of Cranio-Cerebral Wounds of War"), intended for battlefield surgeons. On June 14, 1940, the day German troops entered Paris, de Martel injected himself with a lethal dose of phenobarbital. Thierry de Martel played a central role in establishing modern neurosurgery in France. His patriotism led him to improve the management of wartime cranioencephalic injuries using his own experience acquired during World Wars I and II.

Arnold Max Meirowsky: champion of the American mobile neurosurgical unit during the Korean War.

Dr. Arnold Max Meirowsky (1910-1984) was enormously influential to military neurosurgery during the Korean War, introducing to the American military the concept of the mobile neurosurgical unit. After implementation of the neurosurgical detachment, meningocerebral infections saw a decrease from 41% to less than 1%, with similar improvements in mortality and complication rates. Additionally, Meirowsky developed many techniques and improvements in neurosurgery, specifically in the field of neurosurgical trauma, which he dedicated himself to even after reentering civilian practice. Furthermore, his mentorship of Korean surgeons and the influence of his mobile neurosurgical unit were major influences cited to be pivotal to the founding of neurosurgery as a specialty in South Korea. As he is underrecognized for these accomplishments in the neurosurgical literature, the authors seek to review his wartime and career contributions. They also specifically present details of his standardization of the mobile neurosurgical unit and showcase several of his other advancements in the treatment of neurosurgical trauma.

WWII trauma impacts physical and mental health in the oldest old: results from a German population-based study.

INTRODUCTION: Epidemiological studies in different traumatised samples indicate an increased risk for numerous physical and mental diseases. It is suspected that this is due to chronic changes in fundamental processes in the immune, nervous, and endocrine systems, which take years to manifest pathologically. Previous studies have considered intervals of a few decades. However, little is known about whether a link between trauma and physical and mental health can be established over very long periods of time and in the oldest old population. MATERIALS AND METHODS: A total of 1,299 German citizens aged 80 and above were interviewed about on-going suffering from the effects of traumatic World War II (WWII) events as well as about physical and mental health. Multiple linear and logistic regression models were used to assess the impact of suffering from the effects of traumatic events on general health, several medical conditions, multimorbidity, pain, and depression. RESULTS: 43.94% of the oldest old were still suffering from the effects of traumatic events in connection with WWII. Participants who were still suffering from the effects of traumatic events were more likely to be treated for heart failure, blood diseases, bladder problems, back pain, respiratory or lung diseases, and sleep disorders. They also had poorer general health, higher multimorbidity, more pain, and higher depression scores. DISCUSSION: Findings suggest that chronic psychological suffering from the effects of traumatic events in early life is associated with impaired physical and mental health even seven decades after the events.

[The pathologist Hans Klein (1912-1984) : Autopsy of his role in the "Third Reich"]. / Der Pathologe Hans Klein (1912­1984) : Obduktion seiner Rolle im "Dritten Reich".

The role of pathologist Hans Klein during the National Socialist era and his career in post-war Germany have hardly received systematic attention. During World War II, Hans Klein worked in two medical institutions, where he collaborated with individuals who were significantly involved in Nazi crimes. Klein's participation initially extended mainly to his work as an employed pathologist at the Rudolf Virchow Hospital in Berlin. There he was introduced to autopsy practices in the context of the children's euthanasia programme and autopsies of victims of medical experiments. Later, a shift in his activities is noticeable at the Hohenlychen Sanatorium. Klein's activities there increasingly involved independent research or voluntary collaboration in the projects of other scientists that were closely connected to the SS and experiments on human beings in concentration camps. He never had to face justice. His role was not further investigated by the Allies - probably due to his non-existent Nazi party and SS membership.

[Context of the emigration of Jewish neurologists (1933-1939)]. / Rahmenbedingungen der Emigration jüdischer Neurologinnen und Neurologen (1933­1939).

This article focuses on the historical context of the emigration of "Jewish" doctors during the "Third Reich". The approximately 9000 Jewish physicians, who were still able to emigrate, represented 17% of the German medical profession in 1933. Around three quarters of them left the German Reich by 1939, mainly for the USA, Palestine and Great Britain. Initially, Jewish organizations fueled hopes of a temporary exile; however, in the wake of the events of 1938 ("Anschluss" of Austria, failure of the Evian Conference, establishment of the Central Office for Jewish Emigration headed by Adolf Eichmann in Vienna, maximization of economic plundering etc.) emigration via the intermediate step of forced emigration had turned into a life-saving flight. Scientists could appeal to special aid organizations for support. Among the best known are the Emergency Community of German Scientists Abroad initiated in Zurich, the Academic Assistance Council founded in England, from which originated the Society for the Protection of Science and Learning as well as the Emergency Committee in Aid of Displaced German Scholars created in New York. Their help was often subject to criteria, such as publication performance, scientific reputation and age. Promising researchers who were awarded a scholarship before 1933 could rely on a commitment from the Rockefeller Foundation. The historical analysis of options and motivations but also of restrictions and impediments affecting the decision-making process to emigrate, provides the basis for a retrospective approach to individual hardships and fates.

Symonds on fear and Post Traumatic Stress Disorder (PTSD).

Prominent English neurologist Sir Charles Symonds, during World War II service with the Royal Air Force, published a series of articles emphasizing the role of fear initiating psychological breakdown in combat airmen (termed Lack of Moral Fibre). Having served in a medical capacity in the previous war, Symonds re-presented the phylogenetic conceptualizations formed by his colleagues addressing 'shell shock'. In 2013, the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) re-classified Post Traumatic Stress Disorder (PTSD), removing the diagnosis from the category of Anxiety Disorders. This was the view introduced a century ago by the trench doctors of World War I and affirmed by Symonds' clinical experience and studies in World War II.

In the Shadows of Others: Unheard Voices of Older Russian Immigrant Women in the United States.

Older post-Soviet immigrants in the U.S. have been largely overlooked by research despite their unique experience of having lived in a totalitarian regime until middle age, only to find their lives profoundly altered after its fall. Our qualitative study examined the experiences and caregiving expectations of 16 older post-Soviet immigrant women (mean age = 74.5 years, SD =5.8) through in-depth, face-to-face interviews. Data analysis revealed four themes: broken family ties, happiness in the little things that money can buy, intergenerational comparison, and a nursing home is not an option. Overall, our findings emphasize immigration as an important life course event, with profound implications to one's social position, familial ties, employment opportunities contributes to a deeper understanding of how historical context shapes the aging experiences and intergenerational relationships.

Political follower or loyal National Socialist? : On the role of former DGP President Herbert Siegmund (1892-1954) in the Third Reich.

BACKGROUND: Herbert Siegmund (1892-1954) was undoubtedly one of the most influential German pathologists of the 20th century. He received numerous high honors both during the Third Reich and after 1945. He was, among other things, rector of the University of Münster (1943-1945), holder of the Goethe Medal awarded by Hitler (1944), honorary doctor of the University of Cologne (1949), recipient of the Paracelsus Medal (1953), and president of the German Society for Pathology (DGP, 1954). The almost seamless post-war career was possible above all because Siegmund was counted among the politically uninvolved university physicians after 1945. It was not until after the turn of the millennium that this picture cracked. MATERIAL AND METHODS: The article is based on primary sources from the State Archives of Schleswig-Holstein and North Rhine-Westphalia, the University Archives of Münster, the Federal Archives of Berlin, the University Archives of Cologne, and the City Archives of Stuttgart, some of which were evaluated for the first time. Two questions are at the center of this article: (1) To what extent can it be proven that Siegmund benefited from the Nazi state in terms of his career after 1933? (2) Are there indications that he served the Nazi regime and its networks? In addition, we will discuss how Siegmund himself described his role in the Third Reich and whether his statements stand up to critical scrutiny. RESULTS: The paper concludes that Siegmund contributed to valorizing the Nazi system. After 1945, he did not position himself at a critical distance from his activities in the Third Reich; rather, he drew of himself - largely unopposed - the image of a politically blameless scholar.

The pathologist and "short-term rector" Albert Dietrich (1873-1961) and his ambivalent relationship with the Nazi regime : Not Nazi enough?

Throughout his professional life, the pathologist Albert Dietrich devoted himself to researching and combating cancer. Due to his considerable reputation and success, he was one of the first doctors to be awarded the Paracelsus Medal for his scientific services in 1952.However, Dietrich's role in the Third Reich was - and still is - far less defined. In May 1933, he became rector of the Eberhard Karls University in Tübingen, which at that time was one of the most Nazi-oriented universities. However, his term of office was short - by the end of 1933 he had already been replaced by the protestant theologian Karl Fezer.This article sheds light on Dietrich's ambivalent relationship to National Socialism and analyzes and discusses the background to his dismissal, his later (also politically influenced) emeritus status (1938/39), and his entry into the NSDAP, which took place at retirement age (1941). The study is based on archival sources partly evaluated for the first time and on a reanalysis of the relevant research literature.The study shows that Dietrich was targeted by individual Nazi decision-makers primarily because he advocated a supposedly "liberalist" university policy. Dietrich thus ultimately stands for a type of university lecturer who renounced a decidedly Nazi stance in public without, however, placing himself in a critical relationship to Nazi ideology. Against this background, statements from the postwar period that saw him retrospectively near Nazi opposition are to be classified as the formation of legends.

Hans Wolfgang Sachs (1912-2000) : From Nazi Volkstumskämpfer and chief pathologist of the Reich Physician SS to chairholder in the Federal Republic of Germany. English version.

During the Second World War, the German Wehrmacht and the SS tested various chemical warfare agents on prisoners of concentration camps. The SS needed a pathologist to do this. Therefore, Reichsarzt SS Ernst-Robert Grawitz recruited the 32-year-old Hans Wolfgang Sachs. Despite his position as senior pathologist at the office of the Reichsarzt SS, Sachs was spared interrogation and prosecution after 1945, although the prosecution presented a document about chemical warfare and human experiments during the Nuremberg medical trial. In this, Sachs was named as a participant in so-called "N-Stoff" (chlorine trifluoride) experiments. Little is known about Sachs to this day. This article is intended to close this gap. Of particular interest are the motives and reasons why Sachs joined the party and the SS, as well as his career after 1945.

Virchow medallists and honorary members of the German Society of Pathology and their relationship with National Socialism : A cross-sectional study.

The present study focuses on the group of pathologists who (1) were appointed honorary members or bearers of the Rudolf Virchow Medal by the German Society for Pathology (DGP) and (2) experienced the Third Reich as a citizen of the Third Reich. In particular, it examines the relationship between those distinguished persons and National Socialism, and, at the same time, the criteria of the professional society when awarding such honors. Specifically, it is important to clarify what role the DGP officials ascribed to the political stance or experience of the candidates in the Nazi dictatorship during the selection process: were there victims of the Nazis among the honorees whose repressive experiences and personal fates were intended to be acknowledged in this way? Of equal interest is the counter-question: were pathologists honored who had made (party) political commitments to National Socialism during the Third Reich?A total of nine Virchow medallists and three honorary members met the inclusion criteria. None of those affected belonged to the group of pathologists who suffered injustice during the Third Reich or who could be described as victims of the Nazis. On the other hand, four of the nine German Virchow medal winners and one of the three honorary members had joined the National Socialist Party and to some extent other Nazi organisations. Obviously, previous closeness to National Socialism was not a decisive factor in the selection of honorary members and Virchow medallists and, in particular, was not an exclusion criterion.The aforementioned results correspond to the findings of a parallel study, in which the political past of the German DGP chairmen appointed up to 1986 was examined. This showed that two thirds of them had joined the National Socialist Party during the Third Reich.

["And she turns around and sees it fully " Psychological consequences in children of survivors of the "Hamburg Firestorm" (1943) in a systematic evaluation]. / "Und sie dreht sich um und sieht das voll " Psychische Folgen bei Kindern von Überlebenden des "Hamburger Feuersturms" (1943) in einer systematischen Evaluation.

"And she turns around and sees it fully …" Psychological consequences in children of survivors of the "Hamburg Firestorm" (1943) in a systematic evaluation Objectives: Is there a transmission of traumatic war experiences through the generations? In an interdisciplinary research project at Hamburg University psychoanalysts and historians investigated the long-term psychological effects of World War II bombing attacks in the "Hamburg Firestorm" (Operation Gomorrha) in 1943. In the frame of this work the paper asks for the psychological consequences in the following generation Methods: Evaluation of 45 completely transcribed life-historical interviews (28 female and 17 male of an average age of 50.2 years) with descendants of contemporary witnesses (at the time of the firestorm between 3 and 27 years old) by systematic diagnostic assessment. Results: There are no certain consequences for everyone. Most of the consequences occurred, when the mother was the contemporary witness and the child the daughter. Conclusion: Different assessments on the intergenerational consequences of experiences of violence in World War II can be explained by the heterogeneity of the findings.

Military-related experiences and late-life depressive symptomatology among Japanese-American world war II veterans.

Objectives: To examine military service-related variables and late-life depressive symptomatology among older Japanese-American males.Method: This study is a secondary data analysis of a longitudinal, community-based study. A sample of 2669 participants (771 World War II veterans, 1898 civilians) was drawn from the Honolulu-Asia Aging Study. Depressive symptoms were assessed twice across a 9-year period with the Center for Epidemiologic Studies-Depression scale. Covariates included sociodemographic, physical health, health behavior, and psychosocial variables. Combat exposure and symptomatology were examined among a subset of 426 veterans. Cross-sectional and longitudinal designs were analyzed with linear regression.Results: Veterans and civilians did not differ in depression scores. Baseline depression scores significantly predicted follow-up depression scores. For the full sample, lower ratings of quality of life satisfaction, daily activity control and general health were associated with higher depression scores both cross-sectionally and longitudinally. Among veterans, light combat exposure was marginally associated with lower depression scores and longitudinally, previous depression scores and poorer health ratings were significant predictors of depression scores.Conclusion: Results suggest that military service does not affect late-life depressive symptomatology. However, combat exposure may play a marginal role in increased symptoms. Reasons for results include the possibility that other factors are more relevant to late-life depression, symptomatology naturally decreasing over time, or type of combat exposure measurement. Results expand literature by examination of an ethnoracial group not studied often and longitudinal examination of late-life depressive symptoms within a military-related context. Stakeholders should be knowledgeable of the distinct issues presented when serving aging veterans.

[The pathologist and "short-term rector" Albert Dietrich (1873-1961) and his ambivalent relationship with the Nazi regime : Not Nazi enough? German version]. / Der Pathologe und "Kurzzeitrektor" Albert Dietrich (1873­1961) und sein ambivalentes Verhältnis zum NS­Regime : Nicht nationalsozialistisch genug?

Throughout his professional life, the pathologist Albert Dietrich devoted himself to researching and combating cancer. Due to his considerable reputation and success, he was one of the first doctors to be awarded the Paracelsus Medal for his scientific services in 1952.However, Dietrich's role in the Third Reich was - and still is - far less defined. In May 1933, he became rector of the Eberhard Karls University in Tübingen, which at that time was one of the most Nazi-oriented universities. However, his term of office was short - by the end of 1933 he had already been replaced by the protestant theologian Karl Fezer.This article sheds light on Dietrich's ambivalent relationship to National Socialism and analyzes and discusses the background to his dismissal, his later (also politically influenced) emeritus status (1938/39), and his entry into the NSDAP, which took place at retirement age (1941). The study is based on archival sources partly evaluated for the first time and on a reanalysis of the relevant research literature.The study shows that Dietrich was targeted by individual Nazi decision-makers primarily because he advocated a supposedly "liberalist" university policy. Dietrich thus ultimately stands for a type of university lecturer who renounced a decidedly Nazi stance in public without, however, placing himself in a critical relationship to Nazi ideology. Against this background, statements from the postwar period that saw him retrospectively near Nazi opposition are to be classified as the formation of legends.

A career start in the Third Reich : The pathologist and Rudolf Virchow Award recipient Walter Müller (1907-1983).

The pathologist Walter Müller is undoubtedly one of the most prominent post-war representatives of his profession. He became full professor and founding dean in Essen, and in 1983 the German Society for Pathology (DGP) awarded him the Rudolf Virchow Medal - the highest distinction of the society - for his merits to the field of pathology.But this glorious career was by no means predetermined. Rather, after the end of the Second World War there were signs of a career break that were still largely unknown. After fleeing Königsberg from the approaching Red Army, Müller had to fear for his professional existence and his scientific advancement, as he was threatened with a ban on his profession in connection with denazification. As a young assistant doctor, Müller had joined the Berlin SA soon after the National Socialists took power and had also applied for membership of the NSDAP in 1937.Using Müller as an example, this article deals with the political influences and effects of National Socialism on young scientists and their career development. It poses the question of typical political barriers and overarching patterns of adaptation.On the basis of the personal written estate, personal archive sources, and a reanalysis of the available secondary literature, existing self-portrayals and narratives of Walter Müller are critically reviewed and supplemented. Several examples show that Müller's career development was characterized by a willingness to adapt politically. After a brief career slump in the years 1946/47, he succeeded in consolidating his career thanks to a mild denazification process and subsequently became one of the leading experts in German-language pathology.

[Hans Wolfgang Sachs (1912-2000) : From Nazi "Volkstumskämpfer" and chief pathologist of the Reich Physician SS to chairholder in the Federal Republic. German version]. / Hans Wolfgang Sachs (1912­2000) : Vom nationalsozialistischen "Volkstumskämpfer" und "Leitenden Pathologen beim Reichsarzt-SS" zum Lehrstuhlinhaber in der Bundesrepublik.

During the Second World War, the German Wehrmacht and the SS tested various chemical warfare agents on prisoners of concentration camps. The SS needed a pathologist to do this. Therefore Reichsarzt SS Ernst-Robert Grawitz recruited the 32-year-old Hans Wolfgang Sachs. Despite his position as senior pathologist at the office of the Reichsarzt SS, Sachs was spared interrogation and prosecution after 1945, although the prosecution presented a document about chemical warfare and human experiments during the Nuremberg medical trial. In this, Sachs was named as a participant in so-called "N-Stoff" (chlorine trifluoride) experiments. Little is known about Sachs to this day. This article is intended to close this gap. Of particular interest are the motives and reasons why Sachs joined the party and the SS, as well as his career after 1945.

[Walter Büngeler (1900-1987) : Nazi victim or political influencer in Brazil?] / Walter Büngeler (1900­1987) : Opfer der NS-Zeit oder nationalsozialistischer Kontaktmann in Brasilien?

Walter Büngeler is one of the best known German pathologists of the 20th century. He became internationally known for his basic research on leukaemia and the pathology of tumours. In 1936 he left Europe for Brazil but returned in 1942. After 1945, he staged himself as a political victim who had been expelled first by the National Socialists and later from Brazil. In fact, with this portrayal he succeeded in passing the denazification procedure without any damage and in continuing and considerably expanding his university career. Until the recent past, Büngeler was described in the relevant literature as a Nazi critic or victim. But does the presentation handed down by Büngeler stand up to a critical examination of the facts?On the basis of contemporary sources, the article reveals serious differences between Büngeler's statements and historical facts. It can be shown that Büngeler's allegations in denazification were incorrect in all relevant aspects.