Publications by authors named "Aaeron Metselaar"

Involuntary care in intellectual disability care may be reduced by deployment of multidisciplinary consultation. The Multi-Disciplinary Expertise Team (MDET) method proved effective in a previous trial on increasing involuntary care reduction. The current study aimed to examine how four organizations adapted MDET during implementation, and tested whether these versions were also effective.

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Background: Every healthcare professional (HCP) in the Netherlands is expected to provide palliative care based on their initial education. This requires national consensus and clarity on the quality and goals of palliative care education and accessible education opportunities nationwide. These requirements were not met in the Netherlands, posing a major obstacle to improving the organization and delivery of palliative care.

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Article Synopsis
  • - Sepsis involves an out-of-control immune response, making it challenging to treat effectively; recent research shows that nanomedicines can help in this regard.
  • - In a mouse model, dexamethasone liposomes modified with cRGD peptides effectively target and engage neutrophils, allowing them to accumulate at sites of infection and reduce harmful immune responses.
  • - The targeted liposomes also lower levels of immature neutrophils and inflammatory cytokines, while maintaining beneficial IL-10 levels, showcasing a dual approach of both targeting neutrophils for therapy and using them to deliver drugs.
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Controlled manufacturing and long-term stability are key challenges in the development and translation of nanomedicines. This is exemplified by the mRNA-nanoparticle vaccines against COVID-19, which require (ultra-)cold temperatures for storage and shipment. Various cryogenic protocols have been explored to prolong nanomedicine shelf-life.

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Influential models of fears and phobias suggest that irrational threat beliefs underpin excessive fear. Yet, many fearful individuals recognize their fear is not justified. Drawing on memory competition/multiple representations theory, we developed a novel, fear-relevant procedure, which reveals conflicting representations of threat.

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Pregnancy after orthotopic liver transplantation (OLT) puts the mother, child, and transplanted organ at risk. Little is known about long-term outcomes. We performed a nationwide retrospective cohort study to evaluate short-term and long-term outcomes of post-OLT pregnancies.

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Atypical teratoid/rhabdoid tumors (ATRTs) are highly malignant embryonal tumors of the central nervous system with a dismal prognosis. Using a newly developed and validated patient-derived ATRT culture and xenograft model, alongside a panel of primary ATRT models, we found that ATRTs are selectively sensitive to the nucleoside analog gemcitabine. Gene expression and protein analyses indicate that gemcitabine treatment causes the degradation of sirtuin 1 (SIRT1), resulting in cell death through activation of nuclear factor κB (NF-κB) and p53.

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Because of the low mutational burden and consequently, fewer potential neoantigens, children with acute myeloid leukemia (AML) are thought to have a T cell-depleted or 'cold' tumor microenvironment and may have a low likelihood of response to T cell-directed immunotherapies. Understanding the composition, phenotype, and spatial organization of T cells and other microenvironmental populations in the pediatric AML bone marrow (BM) is essential for informing future immunotherapeutic trials about targetable immune-evasion mechanisms specific to pediatric AML. Here, we conducted a multidimensional analysis of the tumor immune microenvironment in pediatric AML and non-leukemic controls.

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Background & Aims: Tacrolimus has been associated with recurrence of primary biliary cholangitis (PBC) after liver transplantation (LT), which in turn may reduce survival. This study aimed to assess the association between the type of calcineurin inhibitor used and long-term outcomes following LT in patients with PBC.

Methods: Survival analyses were used to assess the association between immunosuppressive drugs and graft or patient survival among adult patients with PBC in the European Liver Transplant Registry.

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Background: The generalist-plus-specialist palliative care model is endorsed worldwide. In the Netherlands, the competencies and profile of the generalist provider of palliative care has been described on all professional levels in nursing and medicine. However, there is no clear description of what specialized expertise in palliative care entails, whereas this is important in order for generalists to know who they can consult in complex palliative care situations and for timely referral of patients to palliative care specialists.

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Deepfakes are hyper-realistic but fabricated videos created with the use of artificial intelligence. In the context of psychotherapy, the first studies on using deepfake technology are emerging, with potential applications including grief counselling and treatment for sexual violence-related trauma. This paper explores these applications from the perspective of medical ethics and health law.

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When making critical treatment decisions, shared decision-making (SDM) between healthcare providers and patients is essential. SDM involves discussing care options, considering patient preferences, and ensuring decisions align with patient values and medical conditions. This process becomes challenging in life-threatening emergencies, where time constraints hinder thorough discussions and coordination among healthcare providers, potentially leading to inappropriate care.

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Many doctors regularly write a prescription for themselves or for family members or friends. In this article, we discuss the legal and ethical considerations surrounding these prescriptions. We also discuss the role of the pharmacist who receives the prescription.

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Cancer vaccines can be utilized in combination with checkpoint inhibitors to optimally stimulate the anti-tumor immune response. Uptake of vaccine antigen by antigen presenting cells (APCs) is a prerequisite for T cell priming, but often relies on non-specific mechanisms. Here, we have developed a novel vaccination strategy consisting of cancer antigen-containing liposomes conjugated with CD169- or DC-SIGN-specific nanobodies (single domain antibodies) to achieve specific uptake by APCs.

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Background: In the Netherlands, palliative care is provided by generalist healthcare professionals (HCPs) if possible and by palliative care specialists if necessary. However, it still needs to be clarified what specialist expertise entails, what specialized care consists of, and which training or work experience is needed to become a palliative care specialist. In addition to generalists and specialists, 'experts' in palliative care are recognized within the nursing and medical professions, but it is unclear how these three roles relate.

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Mental health chatbots (MHCBs) designed to support individuals in coping with mental health issues are rapidly advancing. Currently, these MHCBs are predominantly used in commercial rather than clinical contexts, but this might change soon. The question is whether this use is ethically desirable.

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Despite decades of research, the prognosis of high-grade pediatric brain tumors (PBTs) remains dismal; however, recent cases of favorable clinical responses were documented in clinical trials using oncolytic viruses (OVs). In the current study, we employed four different species of OVs: adenovirus Delta24-RGD, herpes simplex virus rQNestin34.5v1, reovirus R124, and the non-virulent Newcastle disease virus rNDV-F0-GFP against three entities of PBTs (high-grade gliomas, atypical teratoid/rhabdoid tumors, and ependymomas) to determine their efficacy.

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The coatings industry is aiming to replace petrochemical-based binders in products such as paints and lacquers with bio-based alternatives. Native polysaccharide additives are already used, especially as adhesives, and here we show the use of oxidised dextran as a bio-based binder additive. Linear dextran with a molecular weight of 6 kDa was aerobically oxidised in water at the C3-position of its glucose units, catalysed by [(neocuproine)PdOAc](OTf).

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Article Synopsis
  • A multicenter, randomized controlled study aimed to assess the impact of LCP-tacrolimus versus ER-tacrolimus on the development of posttransplant diabetes, hypertension, and chronic kidney disease (CKD) in liver transplant recipients over 12 months.
  • The study involved 105 patients, and results showed that a lower percentage of those on LCP-tacrolimus experienced the combined health issues compared to those on ER-tacrolimus, with statistically significant results.
  • Overall, LCP-tacrolimus demonstrated a notable reduction in the prevalence of these conditions without affecting rejection rates or overall survival compared to ER-tacrolimus.
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Purpose: The popularity of direct oral anticoagulants (DOACs) is increasing among patients with cirrhosis. Cirrhosis has a major impact on the pharmacokinetics of drugs, potentially increasing adverse events. Safe use of drugs in cirrhosis requires a diligent risk-benefit analysis.

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Background: Increasing social pluralism adds to the already existing variety of heterogeneous moral perspectives on good care, health, and quality of life. Pluralism in social identities is also connected to health and care disparities for minoritized patient (i.e.

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