Sigmund Freud University Vienna

There are two main points of reference to Frankfurt School's authoritarianism research. On the one hand, scholars who, following Fromm (1932), seek to identify a contemporary social character under conditions of post-Fordist capitalism emphasize that the authoritarian character has been replaced by a flexible, entrepreneurial self. On the other hand, research on authoritarianism still relies on adaptations of the F-scale developed by Adorno et al. (1950) (e.g., Altemeyer, 1981; Beierlein et al., 2014; Oesterreich, 1998; Decker et al., 2022). At the same time, certain new forms of authoritarianism are being identified (Amlinger & Nachtwey, 2025). In this paper, we aim to bridge this tension by introducing a measurement tool for a contemporary “affirmative social character” adapted to flexible capitalism, and to explore the relationship between this social character and authoritarian tendencies. Based on a German sample ( N = 1,196), we develop the 28-item Aff-Scale to measure the adaptive authoritarian tendencies aligned with the demands of 21st-century meritocracy. The scale captures five dimensions: affirmation, self-optimization, flexibility & mobility, solutionism, and libertarianism. Validation measures included traditional authoritarianism (KSA-3; Beierlein et al., 2014), right-wing extremism (FR-LF; Heller et al., 2020), and sociodemographic variables. Confirmatory factor analysis confirmed the multidimensionality ( CFI = 0.927; RMSEA = 0.048) but showed a need for further validation. Internal consistency was good (Cronbach's α = .83; ω = .64) and the expected correlations with RWA and educational-, social status and age were significant. Despite its limitations, the Aff-scale is a useful tool for examining a 21st century social character and contributes to a better understanding of modernized forms of authoritarianism.

Male idiopathic osteoporosis (MIO), defined as primary osteoporosis with unclear etiology in men, is characterized by low bone mass and increased fracture risk. The underlying pathophysiology remains poorly understood, particularly regarding bone microstructure, turnover, and mineralization. To characterize bone material properties in men with idiopathic osteoporosis using histomorphometry, bone mineralization analysis, and osteocyte lacunae morphology. Transiliac bone biopsies from 20 men with idiopathic osteoporosis (mean age 46.5 ± 12.1years) were analyzed after exclusion of secondary causes. Undecalcified PMMA-embedded samples were assessed for static and dynamic histomorphometric parameters. Dynamic bone formation was evaluated using tetracycline double labeling. Quantitative backscattered electron imaging determined bone mineralization density distribution in cortical and trabecular compartments and osteocyte lacunae section characteristics. Compared with age-matched reference data, patients exhibited significantly reduced trabecular bone volume fraction (p = 0.007), thickness (p = 0.003), and number (p = 0.03), alongside decreased osteoid thickness (p < 0.001) and osteoblast surface (p = 0.002). Dynamic analysis revealed lower adjusted apposition rate (p = 0.003) and prolonged mineralization lag time (p = 0.007), indicating low bone turnover. Trabecular bone mineralization was reduced, with lower CaMean (p = 0.001), CaPeak (p < 0.001), and CaHigh (p = 0.007), and higher CaLow (p = 0.02). Cortical mineralization remained normal, although cortical width was decreased (p = 0.044). Osteocyte lacunar aspect ratio was significantly reduced in cortical and trabecular bone (both p < 0.001), while lacunar density and area were unchanged. Men with idiopathic osteoporosis present a distinct skeletal phenotype characterized by compromised trabecular microarchitecture, suppressed bone formation, and selective trabecular hypomineralization, despite preserved cortical mineralization. These findings suggest that MIO represents a low-turnover bone disorder with impaired mineralization kinetics.

This study aims to assess the prevalence and longitudinal transitions of spirometric patterns defined by the lower limit of normal (LLN) criteria: normal airflow (FEV1 /FVC≥LLN, FEV1 ≥ LLN); preserved ratio impaired spirometry (PRISm; FEV1 /FVC≥LLN, FEV1 < LLN); or obstruction (FEV1 /FVC<LLN). Post-bronchodilator values of pulmonary function tests in the transitional states of these spirometric patterns were examined in the population-based Austrian LEAD study at visits 1 (V1) and 2 (V2). 7232 (aged ≥ 18 years) were re-examined after 4.3 ± 0.6 years and categorized into different spirometric patterns. Changes in static lung volumes and flow rates were additionally examined to better characterize changes in spirometric patterns and associated spirometric measurements. Whilst abnormal spirometry was found in 6.7% individuals at baseline, the prevalence of PRISm (2.2% and 1.6%), but not obstruction (4.5% and 6.1%), remained consistent over time (V1 and V2 respectively). Individuals with PRISm-V1 exhibited substantial rates of transition (48.9%) whilst individuals with obstruction-V1 remained relatively stable (77.8%). Most individuals who reverted from obstruction to improved spirometry had baseline FEV1/FVC values closer to the LLN threshold (optimal cut-off: 64.5%) while those who progressed to obstruction had an optimal predicted threshold of approximately 75%. Changes in pulmonary function tests over time were substantially different between transitional states, and notably more so in those with incident PRISm compared to incident obstructive individuals. We demonstrate the changes in lung function in different transitional states of spirometric patterns over time which thereby illustrate the need for repeated spirometric assessments combined with lung volume measurements for accurate monitoring and diagnosis.

BackgroundEffective chest drainage is essential in thoracic surgery to prevent postoperative complications such as pneumothorax, subcutaneous emphysema, and retained pleural fluid. Although conventional single-lumen chest tubes have been standard practice, their limitations—particularly in the presence of high air leak or bloody effusions—have prompted investigation into more efficient alternatives such as coaxial drains. This study compares the clinical performance of conventional and coaxial drainage systems following video-assisted thoracoscopic surgery (VATS) lobectomy.MethodsIn a prospective, randomized trial, 300 patients undergoing VATS lobectomy for non-small cell lung cancer were assigned to receive either a 24 F conventional tube (CT) group (n=150) or a 24 F coaxial drain (CD) group (n=150). All drains were connected to a digital suction device. Recorded parameters included air flow, pleural fluid volume, drain occlusion, subcutaneous emphysema, drainage duration, hospital stay, and C-reactive protein (CRP) levels from postoperative day (POD) 1 to 5.ResultsDrainage duration was significantly shorter in the coaxial group (4±2 days) compared with the conventional group (6±3 days, P=0.04). Tube occlusion occurred in 30% of CTs versus 4% of coaxial drains (P=0.02). Subcutaneous emphysema was more frequent in the conventional group (56% vs. 38%, P=0.03). CRP levels were significantly lower in the coaxial group on PODs 3 to 5 (P<0.01). Fluid output thresholds on the operative day (>1,000 mL) and POD 1 (>500 mL) were predictive of prolonged drainage.ConclusionsCoaxial chest drains offer superior performance in cases of significant air leakage, reducing complications and postoperative inflammation. Combined with digital drainage systems, they support faster recovery and better compliance with Enhanced Recovery After Surgery (ERAS) protocols. These findings advocate for broader adoption of coaxial drains in thoracic surgical practice.Trial RegistrationClinical Trial Registry, NCT04778826.

BackgroundFrailty is common in old age and associated with decreased cognition, depression, and anxiety. Since transitioning between frailty states can offer targets for interventions, the aims of the current study were to assess the prevalence of frailty and changes over time as well as the impact of mental health, living environment (rural vs. urban) and sex on frailty transition.Methods683 participants ≥ 65 years were categorized into three frailty stages (robust, pre-frail, frail) according to the Fried frailty phenotype during two consecutive visits (mean assessment interval: 4 years). Aspects of mental health including anxiety and depression (Hospital Anxiety and Depression Scale, HADS) and cognition (mini-mental state examination, MMSE, and number connection test, NCT) were assessed for the purposes of this study.ResultsAt visit 1, 35% of participants were classified as robust and 64.1% as pre-frail. More than 40% of participants transitioned between frailty states between visits. For the analysis, frailty status was dichotomized into two categories: robust and pre-frail/frail. A mixed-effect logistic model indicated that the HADS depression subscale was significantly associated with the risk of being pre-frail/frail [odds ratio (OR): 1.28 (95% confidence interval (CI): 1.21–1.36), p < 0.001] and that participants from rural areas were less likely to be pre-frail/frail [OR: 0.57 (95% CI: 0.44–0.75), p = 0.001]. Similar findings were obtained with independent sex-specific models, whereas multivariate logistic regression revealed a positive association between a higher baseline HADS anxiety score and the risk of worsening frailty in females [OR: 1.12 (95% CI: 1.00-1.25), p = 0.05], but not in males.ConclusionsDepression and anxiety are two potentially treatable conditions contributing to frailty over time, with anxiety specifically affecting women. As frailty status can change from pre-frail to robust over time, recognizing pre-frailty is paramount to start interventions at this stage with the aim of improving frailty status.

Zusammenfassung Das Schilddrüsenkarzinom weist eine steigende Inzidenz auf, was vor allem auf eine verbesserte Diagnostik – insbesondere durch die hochauflösende Sonographie– zurückzuführen ist. Die häufigste Form ist das papilläre Karzinom, gefolgt vom follikulären, medullären und raren anaplastischen Karzinom. Eine genaue Anamnese, klinische Untersuchung sowie die Bestimmung von Thyreoidea-stimulierendem Hormon (TSH), Trijodthyronin (fT3)/Thyroxin (fT4) und Calcitonin bilden die Basis der Diagnostik. Die Sonographie mit ACR-TIRADS-Kriterien (Thyroid Imaging Reporting &amp; Data System des American College of Radiologiy) liefert entscheidende Hinweise zur Risikoeinschätzung, im Jodmangelgebiet Mitteleuropa ist die Sensitivität der TIRADS-Kriterien allerdings etwas niedriger als in Gebieten mit ausreichender Jodversorgung. Die Szintigraphie dient zum Ausschluss autonomer, fast ausschließlich gutartiger Knoten, die in der Sonographie ebenfalls hohe TIRADS-Scores aufweisen können. Bei sonographisch suspekten, nicht-autonomen Knoten erfolgt eine Feinnadelpunktion, jedoch nur bei unauffälligem Calcitonin. Therapeutisch steht meist die totale Thyreoidektomie im Vordergrund, wobei bei kleinen Tumoren ohne Hinweis auf Metastasierung ggf. eine Lobektomie ausreicht. Die Radiojodtherapie folgt streng postoperativ bei differenzierten Karzinomen zur Ablation jodspeichernden Gewebes und ermöglicht eine gezielte Tumornachsorge über den Marker Thyreoglobulin. Medulläre Karzinome erfordern eine Thyreoidektomie mit Lymphknotendissektion; Radiojod hat hier keinen Einfluss. Das hochaggressive anaplastische Karzinom erfordert ein rasches Behandlungsvorgehen. Die Nachsorge des differenzierten und medullären Schilddrüsenkarzinoms erfolgt mittels Tumormarker-Überwachung, sonographischer Verlaufskontrollen und ggf. weiterer Bildgebung (z. B. konventionelle Bildgebung, PET-CT oder Ganzkörperszintigraphie).

Background and aims: Questionnaire-based tools such as the Exercise Dependence Scale (EDS) are widely used to identify individuals at risk for exercise addiction (EA), but it remains unclear how accurately these classifications reflect clinically diagnosable cases. This study combined quantitative screening with structured clinical interviews to (1) determine the proportion of false-positive classifications, (2) characterize psychological and motivational differences between clinically addicted and non-addicted athletes, and (3) identify the most discriminative predictors of EA. Methods: A total of 342 endurance athletes (126 female, 153 male) completed an online survey including the EDS, life satisfaction, and motivational factors. Athletes exceeding the EDS cut-off (&gt;77; n = 63) were invited to structured interviews based on ICD-11 criteria for disorders due to addictive behaviors and additionally completed the SCL-90-R. Group comparisons used t-tests or Mann Whitney U tests, and significant variables entered a LASSO logistic regression. Results: Of the 34 interviewed athletes, 24 (70.6%) met ICD-11 criteria for EA, while 10 (29.4%) did not, indicating a notable false-positive rate of EDS-based screening. Interrater reliability for diagnostic classification was 97%. Compared to non-addicted athletes, those with EA were older, reported lower life satisfaction, higher weight-related exercise motivation, more withdrawal symptoms, greater interpersonal sensitivity, and more comorbidities. In the LASSO model, withdrawal symptoms, past comorbidities, and interview-based anamnesis emerged as strongest predictors of EA (AUC = 0.97). Conclusions: Combining self-report and clinical assessment revealed that questionnaire-based screening overestimates EA prevalence. Findings underscore the importance of withdrawal-related and comorbidity features for differential diagnosis and support a multi-method approach to distinguish high involvement from true addictive exercise.