Serial detection of circulating tumour cells by reverse transcriptase-polymerase chain reaction assays is a marker for poor outcome in patients with malignant melanoma

BACKGROUND: Detection of circulating malignant cells (CMCs) through a reverse transcriptase-polymerase chain reaction (RT-PCR) assay seems to be a demonstration of systemic disease. We here evaluated the prognostic role of RT-PCR assays in serially-taken peripheral blood samples from patients with malignant melanoma (MM). METHODS: One hundred forty-nine melanoma patients with disease stage ranging from I to III were consecutively collected in 1997. A multi-marker RT-PCR assay was used on peripheral blood samples obtained at time of diagnosis and every 6 months during the first two years of follow-up (total: 5 samples). Univariate and multivariate analyses were performed after 83 months of median follow-up. RESULTS: Detection of at least one circulating mRNA marker was considered a signal of the presence of CMC (referred to as PCR-positive assay). A significant correlation was found between the rate of recurrences and the increasing number of PCR-positive assays (P = 0.007). Presence of CMC in a high number (≥2) of analysed blood samples was significantly correlated with a poor clinical outcome (disease-free survival: P = 0.019; overall survival: P = 0.034). Multivariate analysis revealed that presence of a PCR-positive status does play a role as independent prognostic factors for overall survival in melanoma patients, adding precision to the predictive power of the disease stage. CONCLUSION: Our findings indicated that serial RT-PCR assay may identify a high risk subset of melanoma patients with occult cancer cells constantly detected in blood circulation. Prolonged presence of CMCs seems to act as a surrogate marker of disease progression or a sign of more aggressive disease

Conducting Participatory Arts Projects: A Practical Toolkit

This toolkit is intended to help artists and arts researchers to plan, organise, document and evaluate participatory arts projects in different contexts. Its publication evolved in the context of a Europe-wide research project funded by the EU Research and Innovation programme Horizon 2020. This research project – Acting on the Margins: Arts as Social Sculpture (AMASS) – is an arts-based three-year project (2020-2023) that aims to bring people based in different European contexts together with artists to work collaboratively on creative and experimental research. Through participatory approaches conducted in new artistic productions and research projects, AMASS explores and analyses the role of the arts in engaging with societal challenges and evaluating the societal impact of the arts. It also addresses the marginalisation of certain groups in society by analysing power imbalances and exploring artistic, pedagogical and other ways of promoting inclusive strategies and sharing the benefits of innovation and service solutions. The many strategies adopted by different AMASS partners call for the involvement of various stakeholders like NGOs, artists, regional arts advocates, community members and others in decision-making tactics and forum group discussions revolving around social needs and constraints. Strongly embedded in the value of alternative knowledge systems and the belief that the arts can initiate significant transformations in policy and perceptions, AMASS is intended as a catalyst for change in various contexts, and multi-disciplinary results emerging from an evaluation of its testbed will contribute towards policy recommendations at local, regional and international levels. This toolkit shares many of the challenges and enthusiasm for the arts that characterise AMASS and its activities.peer-reviewe

Ethical Considerations of Medical Photography in the Management of Breast Disease.

BACKGROUND: Medical photography has become an important component of the evaluation and management of patients across many specialties. It is increasingly utilized in contemporary practice with modern smartphones and enhanced digital media. Photography can enhance and improve treatment plans and communication between providers and patients. Additionally, photography supplements education, research, and marketing in both print and social media. Ethical and medicolegal standards for medical photography, specifically for patients with breast disease, have not been formally developed to guide medical providers. PURPOSE: To provide guidelines for breast care physicians using medical photography, the Ethics Committee of the American Society of Breast Surgeons presents an updated review of the literature and recommendations for ethical and practical use of photography in patient care. METHODS: An extensive PubMed review of articles in English was performed to identify studies and articles published prior to 2018 investigating the use of medical photography in patient care and the ethics of medical photography. After review of the literature, members of the Ethics Committee convened a panel discussion to identify best practices for the use of medical photography in the breast care setting. Results of the literature and panel discussion were then incorporated to provide the content of this article. CONCLUSION: The Ethics Committee of the American Society of Breast Surgeons acknowledges that photography of the breast has become an invaluable tool in the delivery of state-of-the-art care to our patients with breast disease, and we encourage the use of this important medium. Physicians must be well informed regarding the concerns associated with medical photography of the breast to optimize its safe and ethical use in clinical practice