[Awards in pathology-a man's world?] / Preise in der Pathologie ­ eine Männerdomäne?

BACKGROUND: Awards provide their recipients with fame and recognition, and subsequently facilitate publications and acquisition of external funding through increased visibility. We hypothesize that despite increasing representation in pathology, women are underrepresented as awardees in the German Society of Pathology and consequently there is an associated imbalance between genders. MATERIAL AND METHODS: Published data from the German Society of Pathology on female awardees during the period from 2000 to 2022 were examined. Only awards specifically dedicated to the field of pathology were considered. In addition, the publicly available data of the German Medical Association on gender and age distribution of pathologists in Germany were considered as reference material. RESULTS: A total of six different awards were included in the analysis. Among the 143 awardees across 150 individual awards in the period from 2000 to 2022, 55 (38.4%) of the awardees were female compared to an average percentage of 31% of women working in the field of pathology in the 23-year period under consideration. Consequently, female awardees in pathology were not underrepresented when compared to the national figures on the proportion of women in the field of pathology. However, the distribution of female awardees across individual awards suggests that women were increasingly represented in less prestigious research and doctoral awards, while men made up a large proportion of awardees of honorary awards (0% women) and prestigious awards (17% women).

[Innovations from the Baltic Sea region: Nils Alwall, Lembit Norviit, Adolfs Martins Steins and the artificial kidney]. / Innovationen im Ostseeraum: Nils Alwall, Lembit Norviit, Adolfs Martins Steins und die künstliche Niere.

In connection with the construction of one of the first practical dialysis machines, medical historians emphasize the work of the Swedish physician Nils Alwall. Together with his colleagues, he developed a device in the 1940s that could implement the combination of dialysis and ultrafiltration with membranes (cellophane tubes). Little known is the involvement of the physicians Lembit Norviit from Estonia and Adolfs Martins Steins from Latvia, both coauthors of the influential research article Clinical extracorporeal dialysis of blood with artificial kidney that was published in The Lancet in 1948 and the transfer of knowledge between Estonian, Latvian and Swedish researchers.

[Franz Büchner's wartime hypoxia research and the Nobel Prize]. / Franz Büchners Hypoxieforschung aus der Kriegszeit und der Nobelpreis.

BACKGROUND: Between 1901 and 1953, a total of 5110 persons were nominated for the Nobel Prize in Physiology or Medicine. This time period spans both world wars and touches on the question of how the Nobel Committees dealt with German prize candidates. PURPOSE: The nominations of the German pathologist Franz Büchner for the Nobel Prize will be used to examine the extent to which it played a role in the awarding of the prize if some of the research results to be honoured were obtained during the National Socialist era. The article also presents an overview of all pathologists from Germany who were nominated for the Nobel Prize during the first half of the 20th century. MATERIALS AND METHODS: Data from the nomination archive in Stockholm as well as nomination letters and expert opinions of the Nobel Committee (Nobel Archive) were analysed. Franz Büchner's nomination is examined in more detail as an example, because the nominators justified their proposal with Büchner's publications traced here, that in part originated from the National Socialist era. RESULTS AND DISCUSSION: Franz Büchner was nominated by three German professors in 1963. Both areas for which he was to be awarded concerned his research on the influence of oxygen deficiency on the function and development of the human organism. In the end, Büchner's achievements were deemed not worthy of the Nobel Prize. His role as a military researcher during National Socialism and the knowledge of hypoxia acquired during this period do not seem to have had a negative impact on the Nobel Prize evaluation.

Excellence in dental research: nominated scholars for the Nobel Prize 1901-1950 with a focus on Lady May Mellanby (1882-1978) and Walter Hess (1885-1980).

Why has no dentist received the Nobel Prize so far? To answer that question, we need to take a closer look at the prize candidates. This article presents an overview of scholars in the field of dental research who were nominated for the Nobel Prize in Physiology or Medicine during the first half of the twentieth century. Drawing on archival sources in the archive of the Nobel Committee, we focus on the physiologist, Lady May Mellanby (1882-1978) and the dentist, Walter Hess (1885-1980). While Hess did not reach the shortlist, Mellanby was judged 'prize-worthy' by the Nobel Committee for Physiology or Medicine but she never received the award in the end. In this paper, we discuss the impact of their work among dentists.

Myocardial efficiency in patients with different aetiologies and stages of heart failure.

AIMS: Myocardial external efficiency (MEE) is the ratio of cardiac work in relation with energy expenditure. We studied MEE in patients with different aetiologies and stages of heart failure (HF) to discover the role and causes of deranged MEE. In addition, we explored the impact of patient characteristics such as sex, body mass index (BMI), and age on myocardial energetics. METHODS AND RESULTS: Cardiac energetic profiles were assessed with 11C-acetate positron emission tomography (PET) and left ventricular ejection fraction (LVEF) was acquired with echocardiography. MEE was studied in 121 participants: healthy controls (n = 20); HF patients with reduced (HFrEF; n = 25) and mildly reduced (HFmrEF; n = 23) LVEF; and patients with asymptomatic (AS-asymp; n = 38) and symptomatic (AS-symp; n = 15) aortic stenosis (AS). Reduced MEE coincided with symptoms of HF irrespective of aetiology and declined in tandem with deteriorating LVEF. Patients with AS-symp and HFmrEF had reduced MEE as compared with controls (22.2 ± 4.9%, P = 0.041 and 20.0 ± 4.2%, P < 0.001 vs. 26.1 ± 5.8% in controls) and a further decline was observed in patients with HFrEF (14.7 ± 6.3%, P < 0.001). Disproportionate left ventricular hypertrophy was a major cause of reduced MEE. Female sex (P < 0.001), a lower BMI (P = 0.001), and advanced age (P = 0.03) were associated with a lower MEE. CONCLUSION: MEE was reduced in patients with HFrEF, HFmrEF, and HF due to pressure overload and MEE may therefore constitute a treatment target in HF. Patients with LVH, advanced age, female sex, and low BMI had more pronounced reduction in MEE and personalized treatment within these patient subgroups could be relevant.

[A researcher and physician who gained international fame: Otfrid Foerster (1873-1941) as Nobel Prize candidate]. / "Ein zu internationaler Berühmtheit gelangter Forscher und Arzt": Otfrid Foerster (1873­1941) als Nobelpreiskandidat.

This paper discusses the 17 Nobel Prize nominations for the neurologist and neurosurgeon Otfrid Foerster (1873-1941). Drawing on files from the Stockholm Nobel Prize Archive, primary and secondary literature, it addresses the following questions: what were the reasons given by nominators for Foerster's nominations? What was the relationship between him and his nominators? Why was he ultimately not awarded the Nobel Prize? Most nominators of Foerster's highlighted as the main motive his Handbuch der Neurologie, which he had edited with Oswald Bumke. According to the nominators, this book together with Foerster's neurosurgical work had an enormous impact on contemporary neurology. Furthermore, his "honorable character" was underlined in the nomination letters; however, these reasons were not sufficient for the Nobel Committee: the members classified the handbook as not being original research. Despite this, Foerster's fame is reflected in the present, for example in the Otfrid Foerster Medal, which has been awarded to researchers by the German Society of Neurosurgery since 1953.

Placing women in Cytogenetics: Lore Zech and the chromosome banding technique.

BACKGROUND: Scholars agree that Torbjörn Caspersson's lab at the Institute of Medical Cell Research and Genetics at the Karolinska Institute, Sweden, played a key role in the first description of the so-called Q-banding technique. It laid the foundation for a new era of cytogenetic diagnostics and had a lasting impact in several areas of biology and medicine. METHODS: Based on a mixed-method approach, essential aspects of the history of human cytogenetics are considered via primary and secondary analysis of biographical interviews as well as the qualitative evaluation of bibliometrics. Drawing on interviews with colleagues of lab member Lore Zech (1923-2013) and contemporary publications, this paper illuminates the role of and contribution by Zech: To what extent is the discovery attached to her and what does her legacy look like today? RESULTS: The analysis of the contemporary witness interviews with colleagues, students and junior researchers shows that Lore Zech was a committed member of Caspersson's research group. In addition, memoirs by contemporary colleagues describe her outstanding skills in microscopy. The different sources paint a multifaceted picture. In addition to the historians' patterns of interpretation, different legacies can also be found within the peer group. CONCLUSIONS: We argue that Zech represent the type of scientist who, although her research was acknowledged with several prizes, so far has not been part of the canon of pioneers of international cytogenetics.

Ernst von Leyden (1832-1910): a pioneer in making oncology a respected medical discipline.

PURPOSE: This article presents new research on the role of the renowned German physician Ernst von Leyden (1832-1910) in the emergence of oncology as a scientific discipline. METHODS: The article draws on archival sources from the archive of the German Society of Haematology and primary and secondary literature. RESULTS: Leyden initiated two important events in the early history of oncology: the first international cancer conference, which took place in Heidelberg, Germany, in 1906, and the founding of the first international association for cancer research (forerunner of today's UICC) in Berlin in 1908. Unfortunately, these facts are not mentioned in the most recent accounts. Both had a strong impact on the professionalization of oncology as a discipline in its own right. CONCLUSION: Although not of Jewish origin, von Leyden was considered by the National Socialists to be "Jewish tainted", which had a lasting effect on his perception at home and abroad.

Why so few Nobel Prizes for cancer researchers? An analysis of Nobel Prize nominations for German physicians with a focus on Ernst von Leyden and Karl Heinrich Bauer.

PURPOSE: To date, 11 scientists have received the Nobel Prize for discoveries directly related to cancer research. This article provides an overview of cancer researchers nominated for the Nobel Prize from 1901 to 1960 with a focus on Ernst von Leyden (1832-1910), the founder of this journal, and Karl Heinrich Bauer (1890-1978). METHODS: We collected nominations and evaluations in the archive of the Nobel committee of physiology or medicine in Sweden to identify research trends and to analyse oncology in a Nobel Prize context. RESULTS: We found a total of 54 nominations citing work on cancer as motivation for 11 candidates based in Germany from 1901 to 1953. In the 1930s, the US became the leading nation of cancer research in a Nobel context with nominees like Harvey Cushing (1869-1939) and George N. Papanicolaou (1883-1962). DISCUSSION: The will of Alfred Nobel stipulates that Nobel laureates should have "conferred the greatest benefit to mankind". Why were then so few cancer researchers recognized with the Nobel medal from 1901 to 1960? Our analysis of the Nobel dossiers points at multiple reasons: (1) Many of the proposed cancer researchers were surgeons, and surgery has a weak track record in a Nobel context; (2) several scholars were put forward for clinical work and not for basic research (historically, the Nobel committee has favoured basic researchers); (3) the scientists were usually not nominated for a single discovery, but rather for a wide range of different achievements.

Who is who in cardiovascular research? What a review of Nobel Prize nominations reveals about scientific trends.

BACKGROUND: Since 1901, at least 15 scholars who contributed to cardiovascular research have received a Nobel prize in physiology or medicine. METHODS: Using the Nobel nomination database (nobelprize.org), which contains 5950 nominations in the accessible period from 1901 to 1953 in physiology or medicine, we listed all international nominees who contributed to cardiovascular research. We subsequently collected nomination letters and jury reports of the prime candidates from the archive of the Nobel Committee in Sweden to identify shortlisted candidates. RESULTS: The five most frequently nominated researchers with cardiovascular connections from 1901 to 1953 were, in descending order, the surgeon René Leriche (1879-1955) (FR) with a total of 79 nominations, the physiologist and 1924 Nobel laureate Willem Einthoven (1860-1927) (NL) (31 nominations), the surgeon Alfred Blalock (1899-1964) (US) (29 nominations), the pharmacologist and 1936 Nobel laureate Otto Loewi (1873-1961) (DE, AT, US) (27 nominations) and the paediatric cardiologist Helen Taussig (1898-1986) (US) (24 nominations). The research of these scholars merely hints at the width of topics brought up by nominators ranging from the physiological and pathological basics to the diagnosis and (surgical) interventions of diseases such as heart malformation or hypertension. CONCLUSION: We argue that an analysis of Nobel Prize nominations can reconstruct important scientific trends within cardiovascular research during the first half of the twentieth century.

Between two stools? Pharmacologists nominated for Nobel prizes in "physiology or medicine" and "chemistry" 1901-1950 with a focus on John Jacob Abel (1857-1938).

Since the early stages of its academic professionalization, pharmacology has been an interdisciplinary field strongly influenced by the natural sciences. Using the Nobel Prize as a lens to study the history of pharmacology, this article analyzes nominations of pharmacologists for two Nobel Prize categories, namely "chemistry" and "physiology or medicine" from 1901 to 1950. Who were they? Why were they proposed, and what do the Nobel dossiers say about excellence in pharmacology and research trends? This paper highlights the evaluation of "shortlisted" candidates, i.e., those candidates who were of particular interest for the members of the Nobel Committee in physiology or medicine. We focus on the US scholar John Jacob Abel (1857-1938), repeatedly referred to as the "Founder of American Pharmacology." Nominated 17 times in both categories, Abel was praised by his nominators for both basic research as well as for his influential positions as editor and his work as chair at Johns Hopkins University. The Abel nominations were evaluated for the Nobel Committee in chemistry by the Swedish professor of chemistry and pharmaceutics Einar Hammarsten (1889-1968), particularly interested in Abel's work on hormones in the adrenal glands and in the pituitary gland. Eventually, Hammarsten did not view Abel's work prizeworthy, partly because other scholars had done-according to Hammarsten-more important discoveries in the same fields. In conclusion, analyses of Nobel Prize nominations help us to better understand various meanings of excellence in pharmacology during the twentieth century and beyond.

Association between meniscal volume and development of knee osteoarthritis.

OBJECTIVE: To assess the association between meniscal volume, its change over time and the development of knee OA after 30 months in overweight/obese women. METHODS: Data from the PRevention of knee Osteoarthritis in Overweight Females study were used. This cohort included 407 women with a BMI ≥ 27 kg/m2, free of OA-related symptoms. The primary outcome measure was incident OA after 30 months, defined by one out of the following criteria: medial or lateral joint space narrowing (JSN) ≥ 1.0 mm, incident radiographic OA [Kellgren and Lawrence (K&L) ≥ 2], or incident clinical OA. The secondary outcomes were either of these items separately. Menisci at both baseline and follow-up were automatically segmented to obtain meniscal volume and delta-volumes. Generalized estimating equations were used to evaluate associations between the volume measures and the outcomes. RESULTS: Medial and lateral baseline and delta-volumes were not significantly associated to the primary outcome. Lateral meniscal baseline volume was significantly associated to lateral JSN [odds ratio (OR) = 0.87; 95% CI: 0.75, 0.99], while other measures were not. Medial and lateral baseline volume were positively associated to K&L incidence (OR = 1.32 and 1.22; 95% CI: 1.15, 1.50 and 1.03, 1.45, respectively), while medial and lateral delta-volume were negatively associated to K&L incidence (OR = 0.998 and 0.997; 95% CI: 0.997, 1.000 and 0.996, 0.999, respectively). None of the meniscal measures were significantly associated to incident clinical OA. CONCLUSION: Larger baseline meniscal volume and the decrease of meniscal volume over time were associated to the development of structural OA after 30 months in overweight and obese women.

Metformin Lowers Body Weight But Fails to Increase Insulin Sensitivity in Chronic Heart Failure Patients without Diabetes: a Randomized, Double-Blind, Placebo-Controlled Study.

PURPOSE: The glucose-lowering drug metformin has recently been shown to reduce myocardial oxygen consumption and increase myocardial efficiency in chronic heart failure (HF) patients without diabetes. However, it remains to be established whether these beneficial myocardial effects are associated with metformin-induced alterations in whole-body insulin sensitivity and substrate metabolism. METHODS: Eighteen HF patients with reduced ejection fraction and without diabetes (median age, 65 (interquartile range 55-68); ejection fraction 39 ± 6%; HbA1c 5.5 to 6.4%) were randomized to receive metformin (n = 10) or placebo (n = 8) for 3 months. We studied the effects of metformin on whole-body insulin sensitivity using a two-step hyperinsulinemic euglycemic clamp incorporating isotope-labeled tracers of glucose, palmitate, and urea. Substrate metabolism and skeletal muscle mitochondrial respiratory capacity were determined by indirect calorimetry and high-resolution respirometry, and body composition was assessed by bioelectrical impedance analysis. The primary outcome measure was change in insulin sensitivity. RESULTS: Compared with placebo, metformin treatment lowered mean glycated hemoglobin levels (absolute mean difference, - 0.2%; 95% CI - 0.3 to 0.0; p = 0.03), reduced body weight (- 2.8 kg; 95% CI - 5.0 to - 0.6; p = 0.02), and increased fasting glucagon levels (3.2 pmol L-1; 95% CI 0.4 to 6.0; p = 0.03). No changes were observed in whole-body insulin sensitivity, endogenous glucose production, and peripheral glucose disposal or oxidation with metformin. Equally, resting energy expenditure, lipid and urea turnover, and skeletal muscle mitochondrial respiratory capacity remained unaltered. CONCLUSION: Increased myocardial efficiency during metformin treatment is not mediated through improvements in insulin action in HF patients without diabetes. CLINICAL TRIAL REGISTRATION: URL: https://clinicaltrials.gov . Unique identifier: NCT02810132. Date of registration: June 22, 2016.

The enactment of physician-authors in Nobel Prize nominations.

Several physicians have been nominated for the Nobel Prize in literature, but so far none of them have received it. Because physicians as women and men of letters have been a major topic of feuilletons, seminars and books for many years, questions arise to what extent medicine was a topic in the proposals for the Nobel Prize and in the Nobel jury evaluations: how were the nominees enacted (or not) as physicians, and why were none of them awarded? Drawing on nomination letters and evaluations by the Nobel committee for literature collected in the archive of the Swedish Academy in Stockholm, this article offers a first overview of nominated physician-author candidates. The focus is on the Austrian historian of medicine Max Neuburger (1868-1955), the German novelist Hans Carossa (1878-1956), and the German poet Gottfried Benn (1886-1956), but it also briefly takes further physician-author nominees into account such as Sigmund Freud (1856-1939) and William Somerset Maugham (1874-1965). The article is part of an interdisciplinary medical humanities project that analyses nominations and committee reports for physicians and natural scientists nominated for the Nobel Prize from 1901 to 1970.