Making invisible care visible. Ethics and aesthetics of care in participatory arts practices in times of COVID-19.

The COVID-19 pandemic emphasises the importance of care for our societies, yet underscores the inferiority of relational caring practices. During this time, we studied the participatory work of artists working with older adults using participant observations, in-depth interviews and visual ethnography. In this article, we present a case study of one arts initiative, a theatre company engaging seniors in the Netherlands, using ethics and aesthetics of care as sensitising concepts. The findings reveal that this work can promote relational forms of care. This study makes visible how different forms of care can be identified in a participatory art project.

Flaplessly placed 2.4-mm mini-implants for maxillary overdentures: a prospective multicentre clinical cohort study.

Studies on flaplessly placed, one-piece mini dental implants (MDIs) supporting overdentures in the maxilla are scarce. This prospective multicenter cohort study evaluated the outcomes (over 2 years) of five to six MDIs placed in the maxilla for overdentures. Study patients were ≥50 years old, with an edentulous maxilla and dentate/fixed prosthesis in the mandible. Dentures were provisionalized with the final connection at 6 months. Implant/prosthetic survival was evaluated, and postoperative discomfort and patient satisfaction were assessed (rating scale). Of 185 MDIs placed in 31 patients, 32 failed in 16 patients (17.3%); 22/83 in female patients and 10/102 in male patients. Kaplan-Meier analysis showed survival percentages of 86.3% (6 months), 84.0% (1year), and 82.3% (2 years). Two patients lost five or six MDIs resulting in two prosthetic failures (6.5%). Implant loss was significantly affected by sex, but not by smoking or location. The worst treatment combination was a torque value >25N·cm with an antagonist implant overdenture. The mean pain score was 4.1±2.8 on day 1 and 1.1±1.7 on day 7. The mean final satisfaction score was 8.6±1.7. The majority (96%) of the patients would recommend this treatment. Despite higher MDI failure in the maxilla compared to the mandible, prosthetic survival was acceptable and patient satisfaction was high, suggesting this to be a valuable treatment alternative.

Serum levels of mature microRNAs in DICER1-mutated pleuropulmonary blastoma.

DICER1 is a critical gene in the biogenesis of mature microRNAs, short non-coding RNAs that derive from either -3p or -5p precursor microRNA strands. Germline mutations of DICER1 are associated with a range of human malignancies, including pleuropulmonary blastoma (PPB). Additional somatic 'hotspot' mutations in the microRNA processing ribonuclease IIIb (RNase IIIb) domain of DICER1 are reported in cancer, and which affect microRNA biogenesis, resulting in a -3p mature microRNA strand bias. Here, in a germline (exon11 c.1806_1810insATTGA) DICER1-mutated PPB, we first confirmed the presence of an additional somatic RNase IIIb hotspot mutation (exon25 c.5425G>A [p.G1809R]) by conventional sequencing. Second, we investigated serum levels of mature microRNAs at the time of PPB diagnosis, and compared the findings with serum results from a comprehensive range of pediatric cancer patients and controls (n=52). We identified a panel of 45 microRNAs that were present at elevated levels in the serum at the time of PPB diagnosis, with a significant majority noted be derived from the -3p strand (P=0.013). In addition, we identified a subset of 10 serum microRNAs (namely miR-125a-3p, miR-125b-2-3p, miR-380-5p, miR-125b-1-3p, let-7f-2-3p, let-7a-3p, let-7b-3p, miR-708-3p, miR-138-1-3p and miR-532-3p) that were most abundant in the PPB case. Serum levels of two representative microRNAs, miR-125a-3p and miR-125b-2-3p, were not elevated in DICER1 germline-mutated relatives. In the PPB case, serum levels of miR-125a-3p and miR-125b-2-3p increased before chemotherapy, and then showed an early reduction following treatment. These microRNAs may offer future utility as serum biomarkers for screening patients with known germline DICER1 mutations for early detection of PPB, and for potential disease-monitoring in cases with confirmed PPB.

SELDI-TOF MS serum protein profiles in breast cancer: assessment of robustness and validity.

There is an urgent need for new serum markers that can be applied in e.g. the early detection of breast cancer. Following detection of new, potential biomarkers, such as those reported by Vlahou et al. (Clin Breast Cancer 2003;4:230-239) and Laronga et al. (Dis Markers 2003;19:229-238), assessment of both their robustness and validity is essential to confirm their clinical applicability. We therefore aimed to determine robustness and validity of biomarkers reported by the authors mentioned, by analysis of an independent sample set (breast cancer: n=47, normal women: n=45) in our laboratory, according to the methods described by both authors. Although all markers for the differentiation between breast cancer patients and normal women, discovered in the study of Vlahou et al., were recovered in our validation data set, none had sufficient performance to be applied as a classifier. The markers discovered by Laronga et al. in the differentiation between lymph node positive and -negative breast cancer patients were in part recovered from our validation data set, but were also not applicable as a classifier. In conclusion, although (part of) the proteins discovered and designated as markers by either author could be detected, their validity as biomarkers could not be confirmed by the current study. This finding stresses that, when reporting on a potential biomarker, confirmation of both robustness and validity is essential in obtaining its true clinical applicability.

The use of homologous veins in arterial reconstructions. An experimental study.

In order to evaluate under what conditions the use of venous homografts could yield the best results. 230 arterial reconstructions were performed in mongrel dogs bypassing their ligated femoral arteries. Cumulative 6-month patency-rates were: Group 1: Prosthetic materials: a) Dacron grafts: 48%, b) PTFE grafts: 53%. Group 2: Fresh veins: a) autografts: 100%, b) allografts: 37%, c) allografts treated with cyclosporin 4 mg/kg.day for one month: 74% (100% after one month). Group 3: Veins preserved in saline at 4 degrees C. for one month: a) autografts: 44%, b) allografts: 34%. Group 4: Frozen veins preserved in saline at -70 degrees C. for one month: a) autografts: 58%, b) allografts: 47%. Group 5: Veins preserved in glutaraldehyde 0.25% for one month: a) autografts: 26%, b) allografts: 22%. Group 6: Veins preserved in 15% DMSO in Hanks solution at -160 degrees C for one month: a) autografts: 77%, b) allografts: 35%, c) allografts treated with cyclosporin 4 mg/kg.day for one month: 72%, d) allografts treated with methylprednisolone 1 mg/kg.day for one month: 38%, e) allografts treated with cyclosporin 4 mg/kg and methylprednisolone 1 mg/kg daily for one month: 83%. Fresh veins and veins preserved in 15% DMSO at -160 degrees C. are viable but immunologically active grafts. In allografts rejection phenomena cause a relatively high occlusion rate which, however, can be prevented with low dose cyclosporin. The optimal duration of immunosuppressive therapy remains to be determined. Veins stored at 4 degrees C or at -70 degrees C are not viable and only weakly antigenic. Their results are not better than those obtained with prosthetic material.(ABSTRACT TRUNCATED AT 250 WORDS)

Venous allografts for vascular reconstructions.

In order to evaluate various protocols for the preservation of venous allografts 162 arterial reconstructions were performed in mongrel dogs bypassing their ligated femoral arteries. The cumulative 6-month patency-rates as determined by weekly palpation and regular angiography were. Group I = Synthetic grafts: (a) Dacron 48%, (b) PTFE 53%. Group II = Fresh venous grafts: (a) autografts 100%, (b) allografts 37%. Group III = Veins preserved in saline at 4 degrees C for 1 month: (a) autografts 44%, (b) allografts 34%. Group IV = Veins preserved in saline at -70 degrees C: (a) autografts 58%, (b) allografts 47%. Group V = Veins preserved in glutaraldehyde solution: (a) autografts 26%, (b) allografts 22%. Group VI = Veins preserved in Hanks-solution with 15% DMSO at -160 degrees C: (a) autografts 77%, (b) allografts 35%. Histological as well as immunological studies suggest that these results are determined by the preservation protocol in Groups III, IV and V and by the presence of rejection in Groups I and VI. As the results with the allografts are not superior to those obtained with synthetic grafts, their use should be confined to those cases where the use of synthetic materials should be avoided at any price. Further experiments with immunosuppression and antigenic matching are indicated to see whether this would improve the results obtained with viable venous allografts.

Immunosuppressive treatment of venous allografts.

In order to evaluate whether temporary immunosuppressive therapy is able to improve the results obtained with viable venous allografts and achieve better results than with synthetic grafts, 142 arterial reconstructions were performed in mongrel dogs bypassing their ligated femoral arteries. Histological as well as immunological studies were performed and patency determined by weekly palpation and regular angiography. The 6-month cumulative patency rates were: Group I: synthetic grafts (a) Dacron: 48%, (b) plasma-TFE: 53%. Group II: fresh grafts (a) autografts: 100%, (b) allografts: 37%, (c) allografts treated with cyclosporin 4 mg kg-1 daily for 1 month: 74% (100% after 1 month). Group III: grafts preserved in Hanks' solution with 15% DMSO at -160 degrees C for 1 month (a) autografts: 77%, (b) allografts: 35%, (c) allografts treated with methylprednisolone 1 mg kg-1 daily: 38%, (e) allografts treated with cyclosporin and methylprednisolone: 83%. Group IV: human saphenous veins implanted as xenografts and treated with cyclosporin and methylprednisolone: 18%. Immunosuppressive therapy with cyclosporin seems to be able to prevent early thromboses due to rejection seen after implantation of viable fresh or cryopreserved venous allografts, and the results are significantly better than those obtained with synthetic grafts. Tissue matching might further improve these results. This study suggests that cryopreserved venous allografts could be used for the creation of a vein-bank and their use, in combination with tissue typing and temporary immunosuppressive therapy may be warranted for arterial reconstructions when autologous saphenous vein is not available.