Introducing Prof. Dr. Marc H. De Baets, a Karger Ambassador. Watch this video and find out about:
Research on anti-receptor autoimmunity in diseases
Clinical trials and the pharmaceutical industry’s role in developing drugs against autoimmune diseases
The motivation to continue research in autoimmune diseases and the impact on patients
The future role of personalized medicine and epigenetics
Advice to new trainees starting out in the biomedical field
The role of a Karger Ambassador and future projects
Personal hobbies and interests
Dr. Marc H. De Baets is a Professor at the MHeNS School for Mental Health and Neuroscience at Maastricht University, in The Netherlands. He is also a practicing clinical immunologist and specialist in internal medicine and neuroimmunology. His research focuses on new pathological mechanisms in neurological diseases including Myasthenia gravis, epilepsy, and psychiatric disorders. He is a member of the Dutch Society of Immunologists and American Association of Immunologists. Dr. De Baets is currently an Associate Editor of the journal “Immunologic Research” and has published over 170 peer-reviewed articles in scientific journals.
Interview between Christna Chap, Karger’s Head of Editorial Development, and Eirik Wahlstrøm, CEO of Ludenso
What is Augmented Reality?
Augmented Reality (AR) is a powerful tool that enhances our ability to explore our environment through immersive visual elements. It is an increasingly popular digital experience that is sprouting across many industries and gradually becoming a normal part of our lives, whether we are viewing units of measurement through our phones to see if a couch will fit in our living room, playing a mobile game that utilizes our immediate environment, or projecting labels onto a human body to learn anatomy. With such a wide array of applications, it’s no wonder that AR holds so much potential in the field of medical science research and education. Karger’s new partnership withLudensois out to seize this very potential.
Ludenso provides an AR platform that enables readers to view and interact with visual materials – 3D images and video – through AR. Integrating this technology into our peer-reviewed journals, authors of scientific articles can boost reader engagement with the inclusion of 3D models relating to their research, e.g. with 3D representations of biological structures such as cells, tissues and organs. AR is also a means to enhance understanding through immersion and interactivity by allowing the user to explore a concept through new dimensions and ultimately make complex topics more accessible. This partnership marks the debut of Ludenso’s technology in scientific journals, and provides substantial advantages to authors who publish their articles in Karger journals and the broader scientific community. While the application of AR in publishing is in its early stages, its strong utility makes it a significant leap in the world of scientific publishing.
Why Augmented Reality in Research?
As AR technology makes headway, harnessing it for educational and practical purposes will advance communication and transfer of scientific knowledge. Ludenso’s 2023 Impact Report reveals that 50% of surveyed readers reported better information understanding and retention when reading AR enriched publications. Additional research also supports the idea that visual aids such as interactive 3D images can enhance reading comprehension and engagement. When we are able to view and experience concepts in a more immersive and interactive format, it can lead to greater precision in our understanding and practice in the medical field. With AR growing in use among healthcare professionals and researchers, there is a brighter future for scientific communication and medical research, and, thus, for patient care and outcomes.
If you are interested in publishing an article in one of Karger’s journals that features AR enriched models, you can read more about our AR enhancement options and specifications. If the AR option sounds intriguing but you are unsure how to integrate AR into your research article, Karger offers support throughout the entire publication process.
My name is George P. Patrinos and currently serve as Professor of Pharmacogenomics and Pharmaceutical Biotechnology at the University of Patras (Greece), Department of Pharmacy, and Head of Division of Pharmacology and Biosciences of the same Department. I also hold adjunct Full Professorships at Erasmus MC, Faculty of Medicine, Rotterdam (the Netherlands) and the United Arab Emirates University, College of Medicine, Department of Genetics and Genomics, Al-Ain, Abu Dhabi (UAE). Also, since March 2018, I am Chairman of the Global Genomic Medicine Consortium (G2MC), and since May 2023, Chairman of the Scientific Advisory Board of the ASPIRE Abu Dhabi Precision Medicine Research Institute.
What led you to go into your research field?
During my doctoral years, I was intrigued by the fact that some β-thalassemia patients did not require blood transfusions and had a very mild profile even though they had the same genetic profile with β-thalassemia patients that required regular transfusions. Also, some sickle cell disease patients responded better to hydroxyurea treatment to augment fetal hemoglobin levels. This sparked my interest in pharmacogenomics and personalized medicine, as these differences clearly had a strong genetic basis. I have been involved in research since 1992 and became an independent researcher in 2004.
What type of scientific research are you currently doing?
My group has keen interest in research covering public health genomics projects, all focusing on pharmacogenomics and personalized medicine. In particular, my research interests involve discovery work and clinical implementation of pharmacogenomics, focusing on psychiatry but also cardiovascular diseases and oncology, genomics of rare disorders, and transcriptional regulation of human fetal globin genes. Moreover, my group is internationally recognized for its involvement in developing National/Ethnic Genetic databases to document the genetic heterogeneity in different populations worldwide and of genome informatics tools to translate genomic information into a clinically meaningful format. Also, our group has a keen interest in public health genomics to critically assess the impact of genomics to society and public health, including health economics and ethics in genetics.
What is a typical day at your institution like?
I feel blessed that I am surrounded by very bright and talented colleagues in our lab. We spend a great deal of time to discuss about our research projects. Typical daily routines involve research meetings with colleagues and collaborators, but also some can’t-escape administrative meetings, teaching undergraduate and post-graduate courses, lecturing in national and international conferences and visits to other academic institutions, universities, regulatory bodies, and occasionally corporate entities.
What motivates you the most about your current work?
My motivation of my current work is mostly to inspire and motivate young students by my example, not simply by saying so, and to convince healthcare professionals of the need to adopt personalized medicine and therapeutics in their daily routine. Also, I get particularly enthusiastic when addressing the general public to explain personalized medicine in lay language to raise awareness about personalized medicine. I, of course, get excited when our data get published in high profile scientific journals, when I get a very interesting results from our lab.
What is your vision for the future of your scientific/medical specialty?
Personalized medicine is the medicine of the future and will clearly be integrated into main clinical practice very soon for the benefit of the patients and their relatives. This will improve the quality of life, expand the lifespan and longevity, and reduce the costs of the healthcare expenditure.
What advice would you give to a researcher or healthcare professional starting out?
A young researcher and academic should be objective, hard-working, and persistent, as in our field we often face failures and negative results, which can be disappointing. They should also be a team-player, a problem-solver, and above all academically fair, and believe that anything is impossible!
What motivated you to apply to become a Karger Ambassador?
Given my academic achievements and previous editorial experience as Associate Editor for the Public Health Genomics journal, it was immediately obvious that this was something that would further boost my activities, especially encouraging and motivating young healthcare professionals and raising genomics awareness of the general public. Therefore, in 2023 I became a Karger Ambassador.
How do you see your collaboration with Karger progressing?
I see our collaboration getting stronger and expanding into other disciplines, such as partnering a Karger journal with scientific networks that I am involved with such as the Genomic Medicine Alliance.
What is your vision for your future?
God willing, I expect to have a key role in implementing personalized medicine and therapeutics in the main clinical practice for the benefit of patients.
How do you switch off from a busy day at work?
To unwind from my heavy daily academic routine, my day always includes working out on a continuous daily basis, going to the gym, playing tennis, or running by the seaside. I am engaged in beach sports and SUP during the summer months; this is one of the benefits by living in Greece.
George P. Patrinos is Professor of Pharmacogenomics and Pharmaceutical Biotechnology at the University of Patras (Greece), Department of Pharmacy, and Head of Division of Pharmacology and Biosciences of the same Department. He holds adjunct Full Professorships at Erasmus MC, Faculty of Medicine, Rotterdam (the Netherlands) and the United Arab Emirates University, College of Medicine, Department of Genetics and Genomics, Al-Ain (UAE). Since March 2018, he is Chair of the Global Genomic Medicine Collaborative (G2MC), and since May 2023, Chairman of the Scientific Advisory Board of the ASPIRE Abu Dhabi Precision Medicine Research Institute. He has ample regulatory experience and served for 12.5 years as Full Member and Greece’s National representative in the CHMP Pharmacogenomics Working Party of the European Medicines Agency (EMA) and is still an active member of the European Medicines Agency participating in expert panels providing scientific advice where needed.
George is currently Director of the Laboratory of Pharmacogenomics and Individualized Therapy, the first officially established academic pharmacogenomics laboratory in Greece. His group has a keen interest in research covering public health genomics projects, focusing on pharmacogenomics and personalized medicine.
George has more than 330 publications in peer-reviewed scientific journals, including The Lancet, Lancet EBioMedicine, Nature Genetics, Nature Rev Genet, Nucleic Acids Res, Genes Dev. He has co-authored and co-edited more than 15 textbooks, among which the renowned textbook “Molecular Diagnostics”, published by Academic Press, now in its 3rd edition, and he is the editor of “Translational and Applied Genomics” book series, published by Elsevier. Furthermore, since September 2020, he serves as Editor-In-Chief of the prestigious Pharmacogenomics Journal (TPJ), published by Nature Publishing Group, Associate Editor, and member of the editorial board of several scientific journals, such as Human Mutation, Human Genetics, Human Genomics, Pharmacogenomics, and has been a member of several international boards and advisory and evaluation committees.
George is also the main co-organizer of the Golden Helix Conferences, an international meeting series on Pharmacogenomics and Genomic Medicine with more than 50 conferences organized in more than 25 countries worldwide.
Established in 2021, the Young Investigators Award (YIA) is supported by the journal Cells Tissues Organs. Once again, the Karger publication is seeking self-nominations for its Young Investigator Award competition which started March 31, 2024. We asked a few previous awardees from Japan, Turkey and China to share their thoughts about why they applied.
2022 winner Harvard-trained Dr. Rio Sugimura is a Principal Investigator at the University of Hong Kong and the Centre for Translational Stem Cell Biology. Originally from Japan, he found out about the award on X. After some consideration, he applied.
What motivated you to apply for the award?
Dr. Rio Sugimura: On X, formerly Twitter, the award was described as for those researchers focused on cell development, with some emphasis potentially on stem cells. I knew people from the editorial board, whose background is very much the fundamental science of stem cells and signaling. So, I thought that my background and my direction of research fit with those editors, and potential reviewers, and decided to apply for this award.
What do you like the most about the journal Cells Tissues Organs?
Dr. Rio Sugimura: The big thing is the broad range of topics. It covers cell biology, stem cells to disease modeling. So, I would feel safe to submit many types of studies. I see that the reviewers and the editorial board are decent. I was quite impressed by the awardee round table and the highly talented awardees, doing important science. Cells Tissues Organs has value from the editorial board and I think that’s quite an important thing to highlight because nowadays the impact factor does not mean so much and there are some fraudulent predatory journals, so that is probably how Cells Tissues Organs stands out among all other new journals.
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Karger Publishers 2022 YIA winner Prof. Tugba Ozdemir, Assistant Professor at the Department of Nanoscience and Biomedical Engineering, South Dakota, USA, hails from Turkey. She describes the award as a confidence and visibility booster.
Has the award affected your career, or your work, in any way?
Prof. Tugba Ozdemir: First of all, publishing this review article was important for showcasing our research and ideas, and I think it’s a good assurance that my ideas are received well in the community. In that aspect, it was a confidence boost for me. The other aspect is that it increased my visibility. After the article was published, I submitted it to X and ResearchGate and I have seen that it’s getting a lot of visibility. It’s a nice way to showcase our research. We had a roundtable discussion after the awards were released with the editors and the other awardees, and it was really useful for me, because, after that roundtable discussion, I had another call with some of the editors in the journal Cells Tissues Organs who are international experts on my research area and I had a chance to discuss with them some of my grant ideas and they gave me some suggestions. So I’m very happy about this experience personally.
Do you have any expectations on how this might influence your career in the future?
Prof. Tugba Ozdemir: First of all, getting a young investigator award from a journal like Cells Tissues Organs is a big achievement, in my opinion, so it will certainly be useful for my CV when I apply for grants.
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Karger Publishers 2022 YIA winner Dr. Xiaoping Bao is Assistant Professor at Davidson School of Chemical Engineering, Purdue University, Indiana, USA. He applied for the award to gain exposure for his work.
Why did you apply to the award?
Dr. Xiaoping Bao: As a young faculty member, I want to get more exposure and I think this journal fits well with my overall area so that I can promote my profile with many people on the faculty level, new graduate students, or postdocs. It gives me exposure to these potential students or postdocs to be recruited into my lab. This is also a good platform to showcase my research and my articles in the field.
You mentioned a couple of aspects that you like about the journal and the award. What do you like the most, what would be the main benefit, why you would recommend it?
Dr. Xiaoping Bao: Sometimes, in another journal, the review may take a long time. The review time from submission to acceptance is relatively shorter than for many other journals.
The World Health Organization (WHO) conceptualizes mental health as a “state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.” This is quite a good definition. One could also say that a person is mentally healthy when he/she does not suffer from any mental illness.
Why is mental health important in society?
Well, I think mental health is the most important prerequisite for happiness in a society. And is not what we all long for, happiness? Also, societies depend on the contributions of individuals and mentally healthy people can contribute to the well-being of all.
What led you to go into the field of mental health?
When I was 16 years old, I read Sigmund Freud and was very impressed by his thoughts about the unconscious and all the psychological processes driving human beings. Then, during my training in psychoanalysis and psychiatry, I got more interested in scientific evidence and therefore started to do research in addition to clinical work.
What type of scientific/clinical research have you conducted?
I always was especially interested in sex and gender differences of mental disorders on the one hand, and in the development of psychosis on the other hand. I did clinical and epidemiological studies mainly in these fields.
What do you think are some of the most important facets of mental health that need to be addressed?
There are so many! And many facets have been quite neglected until recently. In the last decades, we have achieved a lot regarding early detection and prevention of psychosis, and this should now be achieved for other mental disorders as well. Also, sex- and gender influences of mental disorders are so far still widely neglected, although I notice a growing interest recently. We need much more research on sex- and gender related factors, which can influence mental health – biological factors such as sex hormones as well as psychosocial factors.
Are there gender disparities between biological males and females with regards to mental health and what are they?
Oh sure, sex and gender differences in mental disorders are amongthe most intriguing and stable findings in psychiatry. Differences exist regarding prevalence, symptomatology, risk factors and course of disorders. Thus, it is for example well known that women suffer from mood or anxiety disorders 2-3 times more often than men. On the other hand, men have a much higher risk of suicide as compared to women.
Another example for well-established sex-differences we see in schizophrenic psychoses: these disorders start on average 4-5 years later in women than in men. And women have an increased risk after menopause.
This is interesting. What are the reasons for these sex and gender differences?
Unfortunately, we still do not really understand the causes of these differences and comparatively little research has been done to explain them. This lack of research is more than surprising since explanations of these findings could give us important insights into the aetiological and pathogenetic mechanisms of mental disorders in general. At the same time, they would most likely improve our therapeutic approaches for both women and men.
What are some examples to explain these gender-based differences?
The gender gap in depression is probably mainly due to psychosocial reasons. In fact, many psychosocial risk factors for depression are more common in women, for example sexual abuse, domestic violence, discrimination – and certain personality factors such as girls’ and women’s lower self-esteem and higher tendency for rumination. Around menopause also fluctuating sex hormones probably play a role for increasing the depression risk.
Gender differences in psychosis are probably mainly due to the protective effect of the female sex hormone estradiol. It seems to protect women from the outbreak of this disease during midlife when the level of this oestrogen is high.
Can sex hormones influence mental well-being?
Surely! Especially the female sex hormone estradiol can obviously modulate neurotransmitters in our brain and thereby influence emotion and cognition. We would need much more research in psycho-endocrinology to better understand these mechanisms.
How has mental health in the general population changed in the pandemic?
Stress, anxiety, and depressive symptoms have increased during the pandemic, especially in the vulnerable groups including people with pre-existing mental problems, those young, lonely, living alone, all those working in affected businesses – above all health care workers especially those in intensive care or in contact with COVID patients. In some groups, such as in the young people, this seems not to have completely normalised yet.
You have published a number of books, book chapters, and research articles with Karger focusing on women’s mental health in particular. Tell us about the importance of these topics.
Well, in my clinical practise as a psychiatrist and psychotherapist I realised very early on that you cannot offer the same sort of diagnostics and therapy to each individual, but you have to tailor it to their personal needs. I suppose nowadays it is called personalised medicine. Sex, gender, and cultural background are amongst the most important characteristics of an individual. Thus, with gender-sensitive and culture-sensitive psychiatry, I have always tried to consider the basic and most important personal needs of men and women or of patients from different cultural backgrounds. The needs of women are different in many areas, for example, if you look at psychopharmacology or psychotherapy, especially if you consider sex specific disorders such as peripartum disorders, or disorders around menopause. If you look at the high suicide risk in men, it is also clear that they need a specific psychotherapeutic approach.
What is the best way to address mental illness?
I realised quite quickly that prevention is the best therapy. This interest mainly started with a big research project in which we interviewed almost 400 patients with first episodes of psychosis and their relatives. These interviews showed me that the illness, in fact, had started many years before the outbreak of the first episode, and that one possibly could have prevented this serious disorder by intervening much earlier in the so-called prodromal phase. This and further projects laid the ground for an, in the meantime, worldwide movement for early detection and prevention of psychosis. This should also stimulate similar research and movements for other mental disorders.
In conclusion, I would say that I published not only to publish our own research but also to stimulate other research and above all to improve and individualise the diagnostic process and therapeutic approaches for our patients.
Anita Riecher-Rössler is Professora emerita of Psychiatry at the University of Basel, Switzerland. She has specialized in psychiatry, psychotherapy/psychoanalysis, consultation/liaison psychiatry, and geronto-psychiatry. In 1998, she was the first woman to be appointed to a full chair for psychiatry in a German-speaking country.
Her research interests include schizophrenic psychoses, gender differences in mental disorders, and mental disorders in women. In the field of schizophrenic psychoses, she has mainly worked on the onset and early detection of these disorders, but also on late-onset schizophrenia. In the field of women’s mental health, she is particularly interested in the peripartum and the menopausal transition and in psycho-neuroendocrine and psychosocial risk factors.
She was a founding member/president of several interdisciplinary societies for women’s mental health. In 2018, she was awarded the Constance Pascal – Helen Boyle Prize by the European Psychiatric Association for outstanding achievements by a woman in working to improve mental health care in Europe. According to the Web of Science, she belongs to the most highly cited researchers.
Currently, she is Editor-in-Chief of the “Archives of Women’s Mental Health” and is active in publishing, teaching, counselling, and mentoring, and in many national and international societies and advisory boards.
It was an Oscar award-winning moment for the aorta recently as it was finally officially recognized by the medical community in the European Union and the United States as an independent human organ. As with any kind of public recognition, it has taken a bit of time for the aorta to recover from the excitement. A few weeks after the dust had settled, we sat down with the newly minted organ for a fireside chat.
How does it feel to finally be placed at the level of other major organs?
Aorta: Let’s face it. It was about time. I am thrilled to no longer have to jockey for position among my peers. Being called an organ places me on par with the brain, heart and lungs for the first time in history. If I weren’t the superhighway for the body’s oxygen-enriched blood to get, supporting the steadiness of the blood flow along its journey throughout the body, I’d get really excited just thinking about it. But I’ve got a job to do so I have to maintain a calm demeanor to ensure the blood flows smoothly.
How did this recognition come about?
Aorta: The recognition as a full-blown organ came after I was defined in the guidelines for aortic surgery treatments of the European Association for Cardiothoracic Surgery (EACTS) and the US Society of Thoracic Surgeons (STS), published in February 2024. That’s good news for patients who are combatting aortic diseases. I do my best to keep people healthy, but sometimes that’s hard.
How does being named an organ help patients?
Aorta: Look. You’ve got to know I am a massive blood vessel that runs from the heart’s left ventricle downwards to the pelvic area. Up until now, aortic disease treatment was either done in cardiac surgery or in vascular surgery, depending the disease type or where the disease is located. By getting promoted to the status of vital organ, I hope that this treatment becomes a separate specialty altogether, or at least in coordination with other specialties. A holistic view would help with, for instance, aortic rupture. And believe me when I say, I wouldn’t recommend a rupture to anyone. It’s a real drag.
Another final comments?
I finally feel seen as a whole. It’s about time I got the recognition I deserve as a vital organ that also makes sure the whole show keeps running in concert with the others. Although I am flattered to get so much attention, but to be honest, it’s not really about me at all. The main thing is that patients get the best possible treatment available.
Thank you for this conversation.
Aorta: It’s been a real blood pressure. I mean pleasure!
Maybe you have something to reveal about the aorta or other cardiology-related research. If yes, we would love to hear from you. Check out our journals Cardiology, Journal of Vascular Research and Pulse.
The aorta’s credentials are vast. Did you know…?
Length: The aorta, extending about 30-40 centimeters from the heart to the abdomen, is the body’s longest artery.
Diameter: Its diameter ranges from 2 to 3 centimeters in the ascending part and 1.5 to 2.5 centimeters in the descending part.
Blood Volume: Holding around 50 to 75 milliliters of blood per cardiac cycle, it plays a crucial role in systemic circulation.
Blood Flow: Carrying approximately 5 liters of blood per minute, it accounts for a significant portion of total cardiac output.
Elasticity: Its elastic properties allow it to stretch and recoil, maintaining continuous blood flow despite changes in pressure.
Pressure: Blood pressure within the aorta can reach up to 120-130 mmHg during systole.
Oxygen Transport: It delivers oxygen-rich blood from the heart to various organs and tissues throughout the body.
Cross-Sectional Area: Gradually decreasing from the ascending to the descending part, it facilitates smooth blood flow transition.
Aging Effects: With age, the aorta may undergo changes like stiffening of arterial walls, increasing the risk of cardiovascular issues.
Vital Function: Understanding the aorta’s structure and function is crucial for maintaining overall cardiovascular health.
Find out what Susanne Meister does in the position as a “Manager Healthcare Publications” and how she structures her workday in the latest interview of our “Day in the Life” blog series!
Take us through a day in your work life? What are some of the work habits you’ve developed over the years that help you maintain productivity?
As Manager Healthcare Publications, I am responsible for Karger’s patient resources in the unit Healthcare Markets. The first thing I do every morning is to check my inbox. I answer/forward the mails that can be dealt with immediately; I add all others to my to-do-list and answer them later that day. Mails checked, tasks prioritized, the calls and meetings start coming in, which usually leads to more mails, more tasks, more calls, more meetings … However, the variety of tasks I have to do is exactly what I enjoy about my work.
In order to keep track of all the different assignments and deadlines, I use an old-fashioned agenda (paper) into which I pen my to-dos. Crossing out tasks from my to-do-list at the end of the day is really relaxing and satisfying. However, said list always seems to be growing rather than shrinking!
What motivated you to apply for a position at Karger?
I received my vocational training in a business publishing house, after which I worked for a publisher of local business directories. After a stint at the reception in a language school, I wanted to get back into publishing and stumbled across an intriguing job offer by Karger. The rest is history.
What has been your experience during the remote working over the last two years?
I was never interested in working remotely as I always enjoyed being in the office together with my colleagues. So, it was a new experience when we started working from home during lockdown. I surprised myself by how fast I got used to working remotely and by how much I enjoy and value the experience. The downside of working from home is that the fridge is too close …
What do you enjoy the most about your time at Karger?
It makes me happy to get to know and work with so many wonderful people – be it colleagues, authors, sales reps, patients or patient advocates. And I appreciate the possibility to learn about different topics. Sometimes after an interview, I feel like I could do an appendectomy, diagnose an allergy, or treat hair loss – just by listening to these amazing experts in their respective field.
I enjoy getting in touch with many different people and all kinds of topics. I love to look at the editorial calendar wondering whom best to approach and ask for an interview about asthma, dementia, or kidney diseases I relish in visiting conferences and events, talking to people and listening to their stories, always in search of new ideas for our blog “The Waiting Room.” I look forward to brainstorming with colleagues, discussing novel concepts, and trying out new formats. (Yes, I am looking at you, podcast!)
What would you like someone who’s interested in applying to Karger to know?
Be prepared to work with the nicest, funniest, most helpful, clever and inspiring colleagues, keep an open mind, and don’t be afraid of change.
What publications do you read most, podcasts you listen to, any books you are currently reading?
I read a local newspaper, SPIEGEL and the New York Times. While cleaning, I like to listen to the radio or to real crime podcasts. Books range from novels (contemporary and classic) to thrillers to cookbooks.
After twenty years, the famous Maestro João Carlos Martins is finally able to play piano again, thanks to modern technology. In his case, it was a pair of bionic gloves that helped his fingers tickle the ivories after such a long break. What hindered his playing was focal dystonia, the loss of control over long-practiced fine motor movements. It is a common illness of professional musicians. In celebration of Maestro Martins’ comeback concert, we talked with Prof. Dr. Eckart Altenmüller about how his research resulted in today’s treatment of focal dystonia, his thoughts on bionic gloves, and what composer Robert Schumann and Maestro Martins have in common.
What is focal dystonia, also often called musician dystonia?
Focal dystonia is the loss of control over long-practiced fine motor movements. The term ‘focal’ means that it usually affects only one limb, for example, the left or the right hand; and dystonia means abnormal muscle movement. For musicians it often occurs at the peak of their career, when arbitrary movements such as fine coordinated movements on the instrument are disturbed.
How do you get the disease?
There is a strong connection with the length of practicing time: how much time and how many years you spent practicing, repeating the same movements over and over. Other risk factors are, for example, a history of chronic pain, starting late in life with practicing, or genetic factors such as family members who suffer from Parkinson’s or something similar.
Is there a cure?
This is a learned disease that can be unlearned. It is a matter of disturbed neuronal networks. They are malleable, they are adaptable. Although the movements are different after recovering from dystonia, the symptoms can be alleviated and you can modify your repertoire in such a way that you can still make music at the highest level. This is part of the rehabilitation process.
For Maestro Martins help came in form of bionic gloves. They helped him play again. How do they work?
There are two effects. The first is the so-called sensory trick. All movements are tied to feelings in the hand. If I change the feelings in the hand, I usually change the movement for the better. The second effect is that the gloves can counteract the cramping tendency and the involuntary retraction of fingers, in addition to relieving the muscles of the forearm.
Bionic gloves have two effects – the sensory trick and counteracting the cramping tendency. (photo credit: Jean-Claude Kuner)
So bionic gloves are doing the magic trick?
No, they are still being developed. They are not yet able to handle highly complex, very fast finger movements like trilling accurately down to the millisecond. It has brought Maestro Martins a certain relief, but you can see clearly that he does not have his former virtuosity.
So why are the bionic gloves from Maestro Martins are getting so much attention?
Maestro Martins has a very honorable motivation in promoting his story. He wants to improve the lives of professional musicians. Focal dystonia is the most frequent occupational hazard for musicians. And even today there is a need to make this disease known.
What do you mean by that?
The diagnosis for focal dystonia has only been known since 1992. Back then, it was very unexplored and most of the affected musicians experienced a years-long journey similar to João Carlos Martins. And although we are able to diagnose focal dystonia a lot earlier and better today, we have more to learn about prevention methods such as healthy practicing and good self-management. Today, the focus needs to lie more acutely on the psychological consequences of a musician’s dystonia.
Can you explain that in more detail?
All of our motor activity is a constant expression of our emotions and an expression of our psyche. If I have a very rigid mind, then my musculature automatically becomes rigid. The pressure musicians are under nowadays is much greater than in the past. Paganini just went on stage and played what he enjoyed. Today we have 20 reference recordings for comparison. So, our therapeutic measures are also geared toward relieving the Four Horsemen of the Apocalypse coming with musician’s dystonia: the anger that you are practicing and it is not getting better, the shame that colleagues do not understand your problem, the guilt that you have overworked yourself, and the fear about whether you can continue your profession at all.
How does it feel to see how your research results are translated into practice?
For me it is a great success, a very satisfying activity. I have been at the Institute in Hannover for 28 years doing this musician clinic/consultation with a focus on dystonia. Since then, I have treated over 2,000 patients. And today we are in a position to offer so many therapeutic options, which we have developed over the last 30 years. It’s a great feeling for me.
Thanks to bionic gloves Maestro Martins is able to play piano again. (photo credit: Jean-Claude Kuner)
How would you have helped Maestro Martins?
The standard treatment is to start with retraining. Retraining means that you learn to perform the movements correctly again. This includes putting obsessive behavior into perspective. Freeing the patients from the pressure to succeed. In addition, there are currently two medications that work very well on dystonia.
The wrong movements in his hands I could have treated with a carefully dosed local injection of botulinum toxin, so that he no longer cramps his fingers, but still has enough strength to strike the piano keys. And finally, and maybe most importantly, I would have encouraged him to move to composing and conducting much earlier and make himself less dependent on his hands.
Why is finding new ways as a musician so important?
He has the best example before his eyes: Robert Schumann, who also suffered from focal dystonia. Imagine if I had treated Robert Schumann. That would have been a disaster. He would have become one of the nameless, Romantic piano virtuosos that no one knows today. Now, fortunately, he is one of the greatest Romantic composers of his day.
Would Schumann have jumped at the chance to wear bionic gloves?
No, not at all. In a letter to his mother, he wrote “Don’t worry about my fingers. I can compose without them, and I wouldn’t have been suitable for a traveling virtuoso in the first place.” He had very good self-awareness. And I think that’s the task for all of us – that we find solutions with the resources we have available and adapt if necessary. And if I am a very musical person, then I can develop and refine musical skills without my hands and pass them on to others.
Prof. Dr. Eckart Altenmüller is Full Professor and Head of the Department of Music-Physiology and Musician’s Medicine at the University for Music Drama, and Media, Hannover since 1994 and a leading expert on the topic of focal dystonia. His research focus is on brain processing of music and motor learning in musicians. If you are interested in more details regarding Schumann and focal dystonia, have a look at his book chapter “Robert Schumann’s Focal Dystonia” written by Prof. Altenmüller. You may also be interested in our article collection about dystonia.
What is it like to work in two roles at the same time? Samuel Lei, Executive Assistant of CPM and Rights & Permission Manager, shares his insights and what he appreciates most about Karger at the moment.
Take us through a day in your work life. What are some of the work habits you’ve developed over the years that help you maintain productivity?
There are two things that come to my mind. First, as I have to switch roles between being Executive Assistant of CPM and Rights & Permission Manager (where I share responsibilities), I try to separate my tasks like working on Rights & Permission emails only after lunch.
And secondly for bigger tasks where I need to brainstorm or focus on one subject at a time, you can call this deep work, I block 1-2 hours in my calendar. During this time I focus only on this one task/project, without the distraction of emails or Teams chat; which I shut down during this block.
What motivated you to apply for a position at Karger?
I’d rather answer the question “What motivated me to say yes to a position at Karger?”. I decided to sign my contract because I sensed back in mid-2017 that there is not only change happening at Karger, but also a lot of opportunities waiting for me. I felt Karger was an employer I’d like to work at right from the beginning. From my point of view this has not changed, which apparently also has a lot to do with the team I am working in – CPM.
What has been your experience during the remote work over the last two years?
Lots of flexibility, which brings freedom but responsibilities at the same time. I was able to quickly adapt to this and learned that there is always a chance to grow when facing a crisis.
What do you enjoy the most about your time at Karger?
Being involved in different kinds of activities, tasks and departments like answering requests for reuse of a table from an article in Rights & Permission, researching a healthcare topic, making the publication plan of CPM available internally, working with international clients or making short introductions to CPM to new employees at Karger. Also, I find the wide variety of departments that I am working with interesting. And so on … Actually, there is a lot more that I like about working at Karger.
What would you like someone who’s interested in applying to Karger to know?
The currently implemented remote guidelines and the flexibility that comes with it. I appreciate this a lot, since I have kids myself. This working mode comes with, as I said earlier, more responsibilities but also more freedom in terms of work-life balance. Sometimes this is dismissed as lip-service instead of acknowledged as something that actually is being done. Karger has acted with integrity when it comes to this matter, which cannot be appreciated highly enough from my point of view.
What publications do you read most, podcasts you listen to, any books you are currently reading?
I read fiction as well as non-fiction. To try to be a better human being and work on being happier in life I’d recommend to aim for a book a week. If that’s too much, cut some of your daily news, which in larger amounts can be toxic anyway, in my opinion. There is no other shortcut to getting there (being happy and fulfilled). If that makes sense … at least it does for me.
Are you interested in a career at Karger? Explore our current job opportunities at our job portal. Also, find out what Stephanie does in the role as a “Strategy, Innovation & Venture Specialist”.
This November the University of Basel awarded Gabriella Karger, Chairwoman of the Board of Directors at Karger Publishers, an honorary doctoral degree. Gabriella Karger thereby joined a family tradition: both her grandfather and her father were also given this honor. In an interview Gabriella spoke about what this honorary degree means to her and why she would like to share the credit.
Congratulations, Gabriella, on receiving your honorary degree from the Faculty of Medicine of the University of Basel. What was your first thought when you heard the news?
“Wow, that’s great! What an honor! That’s wonderful.” But since I’m a modest Basler as well it was also a little embarrassing. I was just doing my job. But of course I was overjoyed about it, especially for the publishing house. The distinction shows how much we all accomplish together, the Karger team.
What does an honorary degree mean to you?
This distinction is something very special to me. The Faculty of Medicine at the University of Basel has a very good reputation. Being honored by Basel means that I was able to carry this good reputation of my hometown, and of the seat of this publishing house, out into the wider world, and that I can continue to do so.
Moreover I see myself as the representative of my generation, which is why I would like to dedicate this honor to the memory of my brother Steven, who led this business until he passed far too young.
Why were you given this honorary degree?
From the activities that were listed by Professor Schär, the dean of the medical faculty, in his Laudatio address, I would emphasize two of them: the support of young researchers, and scientific communication.
We support the development of young researchers at the University of Basel by taking part in the annual science month of the Faculty of Medicine for over ten years now . Moreover it will soon be twenty years now that we’ve been involved with the Faculty of Psychology in funding the Steven Karger Prize for the best dissertations.
Internationally, we began in 2020 by establishing the Vesalius Innovation Award focusing on startups in the health sciences and scientific publishing.
And what were the reasons for the honorary degree involving scientific communication?
We published the masterpiece of the anatomist Andreas Vesalius in an English translation; that was something special and unique for me. Vesalius wrote medical history more than 500 years ago with his atlas “De Humani Corporis Fabrica” and is rightly called the father of anatomy. The English translation of his oeuvre is important for an understanding of all of medicine — both historically as well as for the future.
For this reason I have also pushed for the digitalization of all Karger publications, so that now practically every text we publish is available online — medicine can also learn a lot from history.
With our efforts in the domain of open science we are taking our traditional role of making medical content as broadly available as possible into the future. We would like to make new scientific findings openly accessible in order to advance the health sciences. Here a sustainable transformation is important to us to ensure that the interests of all our stakeholders are still upheld.
All of these projects are planned and implemented together with many other Karger employees. Is the honorary degree a distinction for the entire Karger company?
Yes, absolutely. We all live the idea of “Connecting and Advancing Health Sciences”. This is not the achievement of any individual. For this reason I accept this distinction as the bearer of the Karger name for all who help to carry Karger. For me as an entrepreneur it is very clear that this distinction was earned by many people together. Besides the staff of Karger Publishers I also share this distionction with my family, who have supported me and us as a family business in everything.
What does the company mean for your family?
Very much! We all agree that we absolutely wish to continue this business. Of course none of us know how the industry will change and what challenges we will face. It is important that the family shares an engagement, interest and understanding for the company.
Your grandfather, Heinz Karger, and also your father Thomas were both given the honorary doctorate. How was that at the time?
I can remember very well when my father received the honorary degree in 1993. It meant a lot to him, because he had to take over the company as a 29-year-old after the sudden death of his father. It was a validation of his work, for him, also because Basel and the close contact with the university were particularly important to him. Unfortunately he can no longer see the ceremony this year. He certainly would have been more than proud to see me also received the same distinction.
What does this distinction mean for Karger as a publisher?
It is a confirmation that Karger Publishers is pursuing the right strategy. Like those before me, we offer an important platform for the exchange between scientists by publishing their research following its assessment by their peers. But research is never finished, especially if it fails to look at the bigger picture. The clarification of the research for the clinical and practical context has to be ensured as well as conversely informing researchers of the feedback from patients and doctors. The Karger publishing house has a rich history and I’m happy to continue writing this history together with my family, with all the Karger staff, and with our important partners in the sciences, in industry and in publishing.
Sophie manages the Karger brand and has accompanied its launch from the beginning. As a studied biologist with an additional education in communication, and an interest for design, branding at a scientific publisher is the perfect topic for her. She hates excel and loves coffee.
Take us through a day in your work life. What are some of the work habits you’ve developed over the years that help you maintain productivity?